Jumlah Neutrofil sebagai Penanda Inflamasi pada Diabetes Melitus Tipe 2 dengan dan tanpa Ulkus
DOI:
https://doi.org/10.55606/jikki.v6i2.10194Keywords:
Clinical Pathology Laboratory, Diabetic Foot Ulcer, Inflammation, Neutrophil Count, T2DMAbstract
Type 2 diabetes mellitus causes chronic hyperglycemia, systemic inflammation, and immune dysfunction, which increase the risk of diabetic foot ulcers, amputation, and mortality. This study is urgent because the dominance of elevated neutrophil counts in T2DM patients with ulcers reflects an active inflammatory response that may worsen wound healing, while neutrophil testing is widely available in clinical pathology laboratories. The literature highlights the role of inflammation, cytokines, NLR, and complex biomarkers in diabetic complications; however, these indicators are often costly, less applicable in regional healthcare settings, and rarely compare ulcerated and non-ulcerated T2DM patients directly. This study addresses this gap by proposing absolute neutrophil count as a simple, quantitative, and categorical inflammatory indicator. The objective was to analyze differences in neutrophil counts between T2DM patients with and without ulcers at RSU Daha Husada Kediri using a comparative descriptive quantitative design involving 20 patients. The results showed that 80% of ulcerated T2DM patients had elevated neutrophil levels compared with 10% in the non-ulcer group, with a significantly higher mean neutrophil count (9.19 ± 2.56 vs 4.80 ± 1.32 ×10³/µL; p = 0.00012). In conclusion, increased neutrophil counts significantly distinguish the inflammatory status of T2DM patients with ulcers and represent a practical clinical marker for early screening of diabetic foot ulcer complications in regional hospitals.
References
Bulu, A. (2025). The relationship between pan-immune inflammation value and different stages of diabetic retinopathy in patients with type 2 diabetes mellitus: A prospective cross-sectional study. BMC Endocrine Disorders. https://doi.org/10.1186/s12902-025-02007-x
Chen, S., Li, Y., Song, W., Cheng, Y., Gao, Y., Xie, L., Huang, M., & Yan, X. (2024). Insulin eye drops improve corneal wound healing in STZ-induced diabetic mice by regulating corneal inflammation and neuropeptide release. BMC Ophthalmology, 1-10. https://doi.org/10.1186/s12886-024-03436-3
Chen, Y., Yang, J., Wang, Y., You, J., Zhu, W., Liu, C., Luan, Y., Li, L., & Li, H. (2023). Staphylococcus aureus infection of diabetic foot ulcers in an eastern diabetic foot center in a tertiary hospital in China: A retrospective study. BMC Infectious Diseases, 1-9. https://doi.org/10.1186/s12879-023-08631-z
Djulbegovic, B., Boylan, A., Kolo, S., Scheurer, D. B., Anuskiewicz, S., Khaledi, F., Youkhana, K., Madgwick, S., Maharjan, N., & Hozo, I. (2024). Converting IMPROVE bleeding and VTE risk assessment models into a fast-and-frugal decision tree for optimal hospital VTE prophylaxis. Blood Advances, 8(12), 3214-3224. https://doi.org/10.1182/bloodadvances.2024013166
Erlidawati, E., Safrida, S., & Mukhlis, M. (2018). Potensi antioksidan sebagai antidiabetes. Potensi Antioksidan Sebagai Antidiabetes, 1-11. https://doi.org/10.52574/syiahkualauniversitypress.350
Gao, J., Liu, H., Zhang, T., & Wang, Y. (2025). A simple and accessible diabetic retinopathy risk prediction model: Establishment and validation in a hospital-based cohort of type 2 diabetes patients. Diabetes Research and Clinical Practice Journal, 224(May), 0-6. https://doi.org/10.1016/j.diabres.2025.112211
Hatibie, M., Christian, M., Tjandra, D. E., Sedu, S. W., Sumarauw, E. R. N., Michelle, D., Aling, R., Angela, J., Asadul, A., Hatta, M., & Faruk, M. (2020). Hyperbaric oxygen therapy in the healing process of foot ulcers in diabetic type 2 patients marked by interleukin 6, vascular endothelial growth factor, and PEDIS score: A randomized controlled trial study. International Journal of Surgery Open, 27(56), 154-161. https://doi.org/10.1016/j.ijso.2020.11.012
Husain, A. A., Rombot, D. V., & Porajow, Z. C. J. G. (2022). Prevalensi diabetes melitus tipe 2 pada masa pandemi COVID-19 di praktik dokter keluarga Kota Manado. Jurnal Kedokteran Kom Tropik, 10(2), 417-420.
Ibrahim, I., Nuermaimaiti, Y., Maimaituxun, G., & Luo, X. (2024). Neutrophil extracellular traps (NETs) are associated with type 2 diabetes and diabetic foot ulcer-related amputation: A prospective cohort study. Diabetes Therapy, 15(6), 1333-1348. https://doi.org/10.1007/s13300-024-01579-6
Jaaban, M., Billah, A., Hesenow, S., & Hessenow, R. (2021). Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as novel risk markers for diabetic nephropathy in patients with type 2 diabetes. Heliyon, 7(7), e07564. https://doi.org/10.1016/j.heliyon.2021.e07564
Kekilli, M. (2023). Can neutrophil to lymphocyte ratio be a non-invasive indicator of the presence of duodenal ulcer related Helicobacter pylori in dyspeptic patients? Practical Laboratory Medicine, 36(June). https://doi.org/10.1016/j.plabm.2023.e00319
Mokolomban, C., Wiyono, W. I., & Mpila, D. A. (2018). Kepatuhan minum obat pada pasien diabetes melitus tipe 2 disertai hipertensi dengan menggunakan metode MMAS-8. Pharmacon, 7(4), 69-78.
Norma Lalla, N. S., & Rumatiga, J. (2022). Ketidakstabilan kadar glukosa darah pada pasien diabetes melitus tipe II. Jurnal Ilmiah Kesehatan Sandi Husada, 11, 473-479. https://doi.org/10.35816/jiskh.v11i2.816
Omobolanle, A., Oluwapelumi, R., Folorunsho, S., Shittu, M., Jimoh, G., Aremu, A., & Basiru, A. (2025). Co-administration of Hibiscus sabdariffa linn and Daflon-500® mitigates weight loss, hyperglycemia, hematological, and oxidative changes in male rats with type-2 diabetes. Phytomedicine Plus, 5(1), 100699. https://doi.org/10.1016/j.phyplu.2024.100699
Rhee, J. J., Zheng, Y., Liu, S., Montez-rath, M. E., Hamill, R. J., Ishida, J. H., & Winkelmayer, W. C. (2020). Glycemic control and infections among US hemodialysis patients with diabetes mellitus. Kidney International Reports, 5(7), 1014-1025. https://doi.org/10.1016/j.ekir.2020.04.020
Sánchez-Santos, R., Sabench Pereferrer, F., Estévez Fernandez, S., del Castillo Dejardin, D., Vilarrasa, N., Frutos Bernal, D., Ruiz de Adana, J. C., Masdevall Noguera, C., & Torres García, A. (2013). Is the morbid obesity surgery profitable in times of crisis? A cost-benefit analysis of bariatric surgery. Cirugía Española (English Edition), 91(8), 476-484. https://doi.org/10.1016/j.cireng.2013.02.001
Shen, X., Yang, L., Gu, X., Liu, Y. Y., & Jiang, L. (2023). Geriatric nutrition risk index as a predictor of cardiovascular and all-cause mortality in older Americans with diabetes. Diabetology & Metabolic Syndrome, 7, 1-12. https://doi.org/10.1186/s13098-023-01060-7
Vangaveti, V. N., Jhamb, S., Hayes, O., Goodall, J., Bulbrook, J., Robertson, K., Biros, E., Sangla, K. S., & Malabu, U. H. (2022). Effects of vildagliptin on wound healing and markers of inflammation in patients with type 2 diabetic foot ulcer: A prospective, randomized, double-blind, placebo-controlled, single-center study. Diabetology & Metabolic Syndrome, 1-8. https://doi.org/10.1186/s13098-022-00938-2
Wang, M., Cao, X., Shang, Y., Jiang, Y., Chen, P., Duan, C., Zhang, D., Wang, P., Ji, J., & Gong, Z. (2024). Correlational analysis of PLIN1 with inflammation in diabetic foot ulcer wounds. Diabetes Research and Clinical Practice, 209(February), 111605. https://doi.org/10.1016/j.diabres.2024.111605
Yang, P., Bao, H., Sun, G., & Zhang, Y. (2026). Single-cell dissection of CD8+ T cell-driven immune dysregulation in type 1 diabetes mellitus: Mechanistic links to diabetic foot pathogenesis. Clinical Immunology, 283(July 2025), 110646. https://doi.org/10.1016/j.clim.2025.110646
Zhao, B., Zhang, M., Zhang, Z., Liang, Y., & Yang, Z. (2025). Association of increased serum I-309 with renal function impairment and diabetic kidney disease in type 2 diabetes mellitus. Endocrine Connections. https://doi.org/10.1530/EC-25-0252
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Jurnal Ilmu Kedokteran dan Kesehatan Indonesia
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
_001.jpg)
