Perbandingan Efektivitas Penggunaan Obat Oral Antiabetik Tunggal dan Kombinasi pada Pasien Diabetes Mellitus Tipe 2 di Rumah Sakit Umum Royal Prima Medan
DOI:
https://doi.org/10.55606/jikki.v5i2.6857Keywords:
Diabetes Mellitus, Antidiabetic, Monotherapy, Combination Therapy, EffectivenessAbstract
Diabetes mellitus is a chronic metabolic disorder characterized by elevated blood glucose levels, with a high prevalence in Indonesia. Pharmacological therapy using oral antidiabetic medications (OAD), either singly or in combination, is a primary approach to managing type 2 DM. Evaluating the effectiveness of therapy is essential to ensure the achievement of glycemic targets and to prevent complications. This study aims to compare the effectiveness of using single and combination oral antidiabetic medications in reducing blood glucose levels in patients with type 2 Diabetes Mellitus at Royal Prima General Hospital Medan. This study is a non-experimental observational study, utilizing a retrospective descriptive design with a cross-sectional approach. A sample of 60 patients with type 2 DM who were hospitalized between January - June 2024, consisted of 30 patients on single therapy and 30 patients on combination therapy. Data was taken from medical records, and the effectiveness was assessed based on the decrease in blood sugar levels over six days of treatment. The results of this study show that the average percentage decrease in blood sugar levels over 6 days for single oral antidiabetics was 28.87%, and the average reduction in blood sugar levels for combination antidiabetics was 31.34%. Combination therapy shows higher effectiveness in reducing blood sugar levels compared to single therapy. There is a difference in effectiveness between single OAD therapy and combination therapy in patients with T2DM. Combination therapy tends to be more effective and can be a rational alternative for patients who do not reach glycemic targets with monotherapy.
References
ADA. (2020). Understanding type 2 diabetes. American Diabetes Association. https://diabetes.org/about-diabetes/type-2
Al-Aziz, A., Magadmi, R., Bakedo, L., Yaqoub, R., Darwish, E., & Khawjah, A. (2018). The association between neutrophil to lymphocyte ratio and demographic and clinical data in diabetic peripheral neuropathy patients in Jeddah. Journal of Pharmaceutical Research International, 34(60), 54–62.
Alfi, A., Idi, S., & Weni, K. (2019). Konseling gizi menggunakan media aplikasi Nutri Diabetic Care untuk meningkatkan pengetahuan pasien diabetes melitus tipe 2 di Puskesmas Gamping I [Tugas akhir, Poltekkes Kemenkes Yogyakarta]. http://eprints.poltekkesjogja.ac.id/1352/
Alhadramy, O. M. (2019). Nutritional therapy for alleviating AGEs- and polyol pathway-induced diabetic and cardiac complications: Toward better therapeutic outcomes. International Journal of Medicine in Developing Countries, 4(9), 1507.
Al-Saleh, Y., Sabico, S., Al-Furqani, A., Jayyousi, A., Alromaihi, D., Ba-Essa, E., Alawadi, F., Alkaabi, J., Hassanein, M., & Al-Sifri, S. (2021). Sulfonylureas in the current practice of type 2 diabetes management: Are they all the same? Consensus from the Gulf Cooperation Council (GCC) countries advisory board on sulfonylureas. Diabetes Therapy, 12(8), 2115–2132.
American Diabetes Association. (2023). Standards of care in diabetes—2023 abridged for primary care providers. https://diabetesjournals.org/clinical/article/41/1/4/148029/Standards-of-Care-in-Diabetes-2023-Abridged-for
Aprilia, S. M., Lestari, D. R., & Rachmawati, K. (2020). Hubungan fungsi kognitif dengan risiko jatuh pada lanjut usia di Panti Sosial Tresna Werdha Budi Sejahtera Banjarbaru. Dinamika Kesehatan: Jurnal Kebidanan dan Keperawatan, 10(1), 402–413.
Ardiani, H. E., Permatasari, T. A. E., & Sugiatmi, S. (2021). Obesitas, pola diet, dan aktivitas fisik dalam penanganan diabetes melitus pada masa pandemi COVID-19. Muhammadiyah Journal of Nutrition and Food Science, 2(1), 1–12. https://jurnal.umj.ac.id/index.php/MJNF/article/view/8491/0
Arief, I. (2022). Education related to the pharmacotherapy of type 2 diabetes mellitus. JAM: Jurnal Abdi Masyarakat, 3(1), 139–143.
Aschner, P., Gagliardino, J. J., Ilkova, H., Lavalle, F., Ramachandran, A., Mbanya, J. C., Shestakova, M., Chantelot, J.-M., & Chan, J. C. N. (2020). Persistent poor glycaemic control in individuals with type 2 diabetes in developing countries: 12 years of real-world evidence from the International Diabetes Management Practices Study (IDMPS). Diabetologia, 63, 711–721.
Bell, M., Gruss, S. M., Nhim, K., Gregg, E., Luman, E., & Albright, A. (2019). Public health approaches to type 2 diabetes prevention: The US National Diabetes Prevention Program and beyond. Current Diabetes Reports, 19, 1–11.
Chan, J. C. N., Lim, L.-L., Wareham, N. J., Shaw, J. E., Orchard, T. J., Zhang, P., Lau, E. S. H., Eliasson, B., Kong, A. P. S., & Ezzati, M. (2020). The Lancet Commission on Diabetes: Using data to transform diabetes care and patient lives. The Lancet, 396(10267), 2019–2082.
Decroli, E. (2019). Diabetes melitus tipe 2. Pusat Penerbitan Bagian Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Andalas.
Depkes RI. (2019). Acarbose.
DiPiro, J. T. (2009). Concepts in clinical pharmacokinetics. ASHP.
Dropkin, B. M., Chisholm, L. P., Dallmer, J. D., Johnsen, N. V., Dmochowski, R. R., Milam, D. F., & Kaufman, M. R. (2011). Penile prosthesis insertion in the era of antibiotic stewardship: Are postoperative antibiotics necessary? The Journal of Urology, 203(3), 611–614.
Gupta, S., Eavey, R. D., Wang, M., Curhan, S. G., & Curhan, G. C. (2018). Type 2 diabetes and the risk of incident hearing loss. Diabetologia, 62, 281–285.
Hanefeld, M., Fischer, S., Schulze, J., Spengler, M., Wargenau, M., Schollberg, K., & Fücker, K. (2018). Therapeutic potentials of acarbose as a first-line drug in NIDDM insufficiently treated with diet alone. Diabetes Care, 14(8), 732–737.
IDF. (2022). Diabetes around the world in 2021. International Diabetes Federation. https://idf.org/about-diabetes/diabetes-facts-figures/
Jasmani, J. (2019). Edukasi dan kadar glukosa darah pada pasien diabetes. Jurnal Ilmiah Keperawatan Sai Betik, 12(1), 140–148.
Jean-Marie, K. (2018). Etiologies of infections in diabetic patients hospitalized at Bouaké University Teaching Hospital, Côte d’Ivoire. African Journal of Infectious Diseases, 17(2 Suppl), 1.
Kanzanabilla, R. (2021). Exercise can reduce blood glucose levels in patients with type 2 diabetes mellitus. Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan, 1(3), 4.
Kemenkes RI. (2020). Penyakit diabetes melitus. https://p2ptm.kemkes.go.id/informasi-p2ptm/penyakit-diabetes-melitus
Making, M. R., Torres-Peña, J. D., Uitbeijerse, B. S., Arenas de Larriva, A. P., Huisman, S. D., Namli, T., Salzsieder, E., Vogt, L., Ploessnig, M., & van der Putte, B. (2023). Clinical impact of an integrated e-health system for diabetes self-management support and shared decision-making (POWER2DM): A randomised controlled trial. Diabetologia, 66(12), 2213–2225.
Omnia, M. (2018). Effect of Psidium guajava leaf extract, glibenclamide, and their combination on a rat model of diabetes induced by streptozotocin. (Tidak dipublikasikan, n.d.)
PERKENI. (2021). Pedoman pengelolaan dan pencegahan diabetes melitus tipe 2 di Indonesia. https://pbperkeni.or.id/wp-content/uploads/2021/11/22-10-21-Website-Pedoman-Pengelolaan-dan-Pencegahan-DMT2-Ebook.pdf
Riddle, M. C., Bolli, G. B., Home, P. D., Bergenstal, R. M., Ziemen, M., Muehlen-Bartmer, I., Wardecki, M., Vinet, L., Jeandidier, N., & Yki-Järvinen, H. (2016). Efficacy and safety of flexible versus fixed dosing intervals of insulin glargine 300 U/mL in people with type 2 diabetes. Diabetes Technology & Therapeutics, 18(4), 252–257.
Rondonuwu, Y. A. Z., Mambo, C. D., & Posangi, J. (2020). Perhitungan biaya satuan diabetes melitus tipe 2 dengan komplikasi ulkus kaki diabetik di RSUP Prof. Dr. R. D. Kandou Manado periode September–November 2019. JKK (Jurnal Kedokteran Klinik), 4(1), 15–25.
Sari, S., & Handayani, R. (2018). Determinan kejadian diabetes melitus tipe 2 di Posbindu Mawar Kuning Gambir. ARKESMAS (Arsip Kesehatan Masyarakat), 5(1), 42–48.
Simatupang, R. (2017). Pedoman diet penderita diabetes melitus. EGC.
Smeltzer, S. C., & Bare, B. G. (2019). Buku ajar keperawatan medikal bedah. EGC.
Sugiyono. (2019). Metode penelitian kombinasi (3rd ed.). Alfabeta.
Tandra, H. (2020). Dari diabetes menuju kaki. Gramedia Pustaka Utama.
World Health Organization. (2020). Diabetes. https://www.who.int/news-room/fact-sheets/detail/diabetes
Zhang, C., Chen, X., Li, J., Liu, Z., Liu, W., Zhang, J., & Zhou, Z. (2021). Anaemia and related nutritional deficiencies in Chinese patients with obesity, 12 months following laparoscopic sleeve gastrectomy. Diabetes, Metabolic Syndrome and Obesity, 1575–1587.
Zul Adhayani, A., Hanapi, S., Paramata, Y., & Ngobuto, A. R. (2019). Kualitas hidup penderita diabetes melitus dan determinannya di Kabupaten Gorontalo. Jurnal Promotif Preventif, 3(1), 14–21.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Jurnal Ilmu Kedokteran dan Kesehatan Indonesia
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
