Diabetes Melitus Tipe-1 pada Anak: Situasi di Indonesia dan Tata Laksana
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Insidens Diabetes Mellitus (DM) Tipe-1 pada anak di dunia dan Indonesia terus meningkat. Berdasarkan data Ikatan Dokter Anak Indonesia (IDAI), tercatat 1220 dengan DM tipe-1 pada tahun 2018. Kesadaran masyarakat dan tenaga kesehatan mengenai DM pada anak masih rendah, yang direfleksikan melalui tingginya angka anak yang terdiagnosis dengan DM tipe-1 saat mengalami ketoasidosis diabetikum mencapai 71% pada tahun 2017. Berdasarkan pedoman IDAI, terdapat lima pilar penanganan DM tipe-1 pada anak: injeksi insulin, pemantauan gula darah, nutrisi, aktivitas fisik, dan edukasi. IDAI merekomendasikan insulin minimal dua kali per hari menggunakan insulin basal dan kerja cepat. Pemantauan gula darah mandiri dilakukan minimal 4-6 kali per hari. Keterlibatan pemegang kebijakan, termasuk pemerintah, dan dukungan masyarakat dibutuhkan agar anak dengan DM tipe 1 tertangani dengan baik.
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Skyler JS, Bakris GL, Bonifacio E, Darsow T, Eckel RH, Groop L. Differentiation of Diabetes by Pathophysiology, Natural History, and Prognosis. Diabetes 2017;66:241-55.
Ikatan Dokter Anak Indonesia. Registri DM tipe-1 pada anak [belum dipublikasi]. Jakarta: IDAI; 2018.
Pulungan A. Increasing incidence of DM type 1 in Indonesia. Int J Pediatr Endocrinol 2013; Suppl 1: O12.
Pulungan AB. Type 1 Diabetes Mellitus in Children and Adolescents: Experience in Indonesia. Dalam: Urakami T, editor. Proceeding book of The 52nd Annual Scientific Meeting of the Japanese Society for Pediatric Endocrinology. 2018 Okt 4-6; Japan, Tokyo.
Badan Pusat Statistik. Sensus Penduduk Indonesia 2010 [internet]. 2012 Juli 09 [Diunduh 2018 Desember]. Diunduh dari: https://www.bps.go.id/statictable/2009/02/20/1267/penduduk-indonesia-menurut-provinsi-1971-1980-1990-1995-2000-dan-2010.html
Mayer-Davis EJ, Kahkoska AR, Jefferies C, Dabelea D, Balde N, Gong CX. ISPAD Clinical Practice Consensus Guidelines 2018: Definition, epidemiology, and classification of diabetes in children and adolescents. Pediatric Diabetes 2018;19:7-19.
Marcdante KJ, Kliegman RM, editor. Nelson Essentials of Pediatrics. Edisi Ke-8. Philadelphia: Elsevier; 2019.
Paschou SA, Papadopoulou-Marketou N, Chrousos GP, Kanaka-Gantenbein C. On type 1 diabetes mellitus pathogenesis. Endocrine Connections 2018;7:R38-46.
Devendra D, Liu E, Eisenbarth GS. Type 1 diabetes: recent developments. BMJ 2004;32:750-4.
UKK Endokrinologi Ikatan Dokter Anak Indonesia. Diagnosis dan Tata Laksana Diabetes Mellitus Tipe-1 pada Anak dan Remaja. Jakarta: Ikatan Dokter Anak Indonesia; 2017.
Chiang JL, Maahs DM, Garvey KC, Hood KK, Laffel LM, Weinzimer SA. Type 1 Diabetes in Children and Adolescents: A Position Statement by the American Diabetes Association. Diabetes Care 2018;41:2026-44.
Cho MJ, Kim MS, Kim CJ, Kim EY, Kim JD, Kim EY, dkk. Fasting serum C-peptide is useful for initial classification of diabetes mellitus in children and adolescents. Ann Pediatr Endocrinol Metab 2014;19:80-5.
Batubara JRL, Tridjaja B, Pulungan AP. Buku Ajar Endokrinologi. Edisi Kedua. Jakarta: Badan Penerbit Ikatan Dokter Indonesia; 2017.
Danne T, Phillip M, Buckingham BA, Jarosz-Chobot P, Saboo B, Urakami T. ISPAD Clinical Practice Concensus Guidelines 2018: Insulin treatment in children and adolescents with diabetes. Pediatric Diabetes 2018;19:115-35.
Alemzadeh R, Palma-Sisto P, Holzum M, Parton E, Kicher J. Continuous subcutaneous insulin infusion attenuated glycemic instability in preschool children with type 1 diabetes mellitus. Diabetes Technol Ther 2007;9:339-47.
Sulli N, Shashaj B. Continuous subcutaneous insulin infusion in children and adolescents with diabetes mellitus: decreased HbA1c with low risk of hypoglycemia. J Pediatr Endocrinol Metab 2003;16:393-9.
Korkmaz O, Demir G, Cetin H, Mecidov I, Altinok YA, Ozen S, dkk. Effectiveness of Continuous Subcutaneous Insulin Infusion Pump Therapy During Five Years of Treatment on Metabolic Control in Children and Adolescents with Type 1 Diabetes Melltius. J Clin Res Pediatr Endocrinol 2018;10:147-52.
DiMeglio LA, Acerini CL, Codner E, Craig ME, Hofer SE, Pillay K, dkk. ISPAD Clinical Practice Consensus Guidelines 2018: Glycemic control targets and glucose monitoring for children, adolescents, and young adults with diabetes. Pediatric Diabetes 2018;19:105-14.
Cemeroglu AP, Stone R, Kleis L, Racine MS, Postellon DC, Wood MA. Use of a real-time contiuous glucose monitoring system in children and young adults on insulin pump therapy: patients’ and caregivers’ perception of benefit. Pediatric Diabetes 2010;11:182-7.
Pulungan AB, Juwita E, Pudjiadi AH, Rahmayanti S, Tsaniya I. Diabetic Ketoacidosis in Adolescents and Children: A Prospective Study of Blood versus Urine Ketones in Monitoring Therapeutic Response. Indones J Intern Med 2018;50:.46-52.
Smart CE, Annan F, Higgins LA, Jelleryd E, Lopez M, Acerini CL. ISPAD Clinical Practice Concensus Guidelines 2018: Nutritional management in children and adolescents with diabetes. Pediatric Diabetes 2018;19:136-54.
Hatun S, Demirbilek H, Dacran S, Yuksel A, Binay C, Simsek DG. Evaluation of therapeutics management patterns and glycemic control of pediatric type 1 diabetes mellitus patients in Turkey: A nationwide cross-sectional study. Diabetes Research and Clinical Practice 2016;119:32-40.
Adolfsson P, Riddel MC, Taplin CE, Davis EA, Fournier PA, Annan F, dkk. ISPAD Clinical Practice Consensus Guidelines 2018: Exercise in children and adolescents with diabetes. Pediatric Diabetes 2018;19:205-26.
Sundberg F, Forsander G, Fasth A, Ekelund U. Children younger than 7 years with type 1 diabetes are less physically active than healthy controls. Acta Paediatr 2012;101:1164-9.
Mozzillo E, Zito E, Maffeis C, De Nitto E, Maltoni G, Marigliano M, dkk. Unhealthy lifestyle habits and diabetes-specific health-related quality of life in youths with tye 1 diabetes. Acta Diabetol 2017;54:1073-80.
Phelan H, Lange K, Cengiz E, Gallego P, Majaliwa E, Pelicand J, dkk. ISPAD Clinical Practice Consensus Guidelines 2018: Diabetes education in children and adolescents. Pediatric Diabetes 2018;19:75-83.
Pulgaron ER, Sanders LM, Patino-Fernandez AM, Wile D, Sanchez J, Rothman RL, dkk. Glycemic Control in Young Children with Diabetes: The Role of Parental Health Literacy. Patient Educ Couns 2014;94:1-8.
Vanelli M, Chiari G, Gizzoni L, Costi G, Giacalone T, Chiarelli F. Effectiveness of a Prevention Program for Diabetic Ketoacidosis in Children. Diabetes Care 1999;22:7-9.
Vanelli M, Chiari G, Lacava S, Iovane B. Campaign for Diabetic Ketoacidosis Prevention Still Effective 8 Years Later. Diabetes Care 2007;30:e12.
Rewers A, Klingensmith G, Davis C, Petitti DB, Pihoker C, Rodriguez BR, dkk. Presence of Diabetic Ketoacidosis of Diabetes Mellitus in Youth: The Search for Diabetes in Youth Study. Pediatrics 2008;121:1258-66.
Wolfsdorf JI, Glaser N, Agus M, Fritsch M, Hanas R, Rewers A, dkk. ISPAD Clinical Practice Consensus Guidelines 2018: Diabetic ketoacidosis and the hyperglycemic hyperosmolar state. Pediatric Diabetes 2018;19:155-77.
Nakhla M, Rahme E, Simard M, Larocque I, Legault L, Li P. Risk of ketoacidosis in children at the time of diabetes mellitus diagnosis by primary caregriver status: a population-based retrospective cohort study. CMAJ 2018;190:E416-21.
Abraham MB, Jones TW, Naranjo D, Karges B, Oduwole A, Tauschmann M, dkk. ISPAD Clinical Practice Consensus Guidelines 2018: Assessment and management of hypoglycemia in children and adolescents with diabetes. Pediatric Diabetes 2018;19:178-92.
White NH. Long-term Outcomes in Youth with Diabetes Mellitus. Pediatr Clin North Am 2015;62:889-909.
Donaghue KC, Marcovecchio ML, Wadwa RP, Chew EY, Wong TY, Calliari LE, dkk. ISPAD Clinical Practice Consensus Guidelines 2018: Microvascular and macrovascular complications in children and adolescents. Pediatric Diabetes 2018;19:262-74.
DOI: http://dx.doi.org/10.14238/sp20.6.2019.392-400
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