Gambaran Uji Fungsi Paru pada Diabetes Melitus Tipe 1 Usia 8-18 Tahun

Irlisnia Irlisnia, Bambang Supriyatno, Bambang Tridjadja, Endang Windiastuti

Sari


Latar belakang. Uji fungsi paru dapat membedakan kelainan paru obstruktif, restriktif atau campuran antara obstruktif dn restriktif.
Namun demikian, sampai saat ini belum ada penelitian tentang dampak DMT1 terhadap paru di Indonesia.
Tujuan. Mengetahui gambaran uji fungsi paru pada pasien DMT1 usia 8-18 tahun.
Metode. Penelitian potong lintang dilakukan di Poliklinik Endokrinologi dan Respirologi Rumah Sakit Cipto Mangunkusumo
(RSCM), serta Laboratorium Prodia pada bulan Januari 2015.Wawancara orangtua dilakukan dan data kadar HbA1c dalam rentang
satu tahun terakhir diambil dari rekam medis atau berdasarkan hasil pemeriksaan sebelumnya. Uji fungsi paru dilakukan tiga
kali dan diambil salah satu hasil yang terbaik. Kemudian darah subjek diambil untuk pemeriksaan kadar HbA1c dengan metode
cation-exchange high pressure liquod chromatography (HPLC).
Hasil. Terdapat 35 subjek, terdiri atas 68,6% perempuan. Rerata usia 14±2,7 dan median durasi DM 4 tahun (1,3-10,2). Rerata
parameter FEV1  86,8%±14%, FVC 82,7%±12% dan V 25 83,1% ± 26,2%. Median FEV1 /FVC 92,4% (77,6-100) dan V 50 91,5%
(41,1-204). Fungsi paru normal dan terganggu didapatkan 19 (54,3%) dan 16 (45,7%) subjek, terdiri atas 10 (28,6%) gangguan
restriktif, 2 (5,7%) obstruktif dan 4 (11,4%) subjek campuran. Rerata HbA1c dalam 1 tahun terakhir pada subjek dengan
gangguan restriktif 10,3%.
Kesimpulan.Nilai parameter uji fungsi paru pasien DMT1 usia 8-18 tahun masih dalam batas normal. Gangguan fungsi paru
didapatkan 16 (45,7%) subjek dengan gangguan restriksi terbanyak 10 (28,6%) subjek


Kata Kunci


diabetes melitus tipe 1; uji fungsi paru; HbA1c

Teks Lengkap:

PDF

Referensi


ISPAD Clinical Practice Consensus Guidelines

Compendium. Definition, epidemiology and

classification of diabetes in children and adolescents.

Pediatr Diabetes 2009;10:3-12.

Norris AW, Wolfsdorf JI. Diabetes mellitus. Dalam:

Brook C, Clayton P, Brown R, penyunting. Clinical

Pediatric Endocrinology. Edisi 5. Philadelphia: Blackwell

publishing. 2005.h.436-73 .

Pulungan A. Increasing incidence of DM type 1 in

Indonesia. Int J Pediatr Endocrinol 2013;1:12.

Kuziemski K, Specjalski K, Jassem E. Diabetic pulmonary

microangiopathy — fact or fiction? Pol J Endocrinol

;62:171-5.

Villa M, Montesano M, Barreto M, Pagani J, Stegnano

M, Multari G, dkk. Diffusing capacity for carbon

monoxide in children with type 1 diabetes. Diabetologia

;47:1931-5.

Silverstein j, Klingensmith G, Copeland K, Plotnick

L, Kaufman F, Laffel L, dkk. Care of children and

adolescents with type 1 diabetes. Diabetes Care

;28:186-212.

Donaghue KC, Wadwa RP, Dimeglio LA, Wong TY,

Chiarelli F, Marcovecchio ML, dkk. Microvascular and

macrovaskular complications in children and adolescents.

Pediatr Diabetes 2014;15:257-69.

Harjutsalo V, Forsblom C, Groop PH. Time trends

in mortality in patients with type 1 diabetes: nationwide population based cohort study. Br Med J

;343:534-6.

The Diabetes Control and Complication Trial Research

Group. The effect of intensive treatment of diabetes

on the development and progression of long-term

complication in insulin-dependent diabetes mellitus. N

Engl J Med 1993;329:977-86.

ISPAD Clinical Practice Consensus Guidelines

Compendium. Microvascular and macrovascular

complications in children and adolescents. Pediatr Diabetes 2014; 15: 257–69.

Couriel JM, Child F. Applied physiology: lung function

testing in children. Curr Paediatr 2004;14:444-51.

Cazzato S, Bernardi F, Salardi S, Tassinari D, Corsini I,

Ragni L, dkk. Lung function in children with diabetes

mellitus.Pediatr Pulmonol2004;37:17-23.

Pienawska A, Józwa HA, Petriczko E, Walczak M.

Evaluation of respiratory function test in children and

adolescents with type 1 diabetes. Pediatr Endocrinol

Diabetes Metab 2012;18:15-20.

Said M, Daulay R, Naning R, Dadiyanto DW. Prosedur

tindakan pada penyakit respiratori. Dalam: Rahajoe

NN, Supriyatno B, Setyanto DB, penyunting. Buku

ajar respirologi anak. Edisi ke-1. Jakarta: Badan Penerbit

IDAI;2008.h.583-94.

Wirjodiarjo M, Boediman I. Uji fungsi paru pada anak.

Penanganan asma pada anak. Panduan kursus uji fungsi

paru dan terapi inhalasi. Jakarta, 1 Desember 1994.

Fitzgerald P. Hemoglobin A1c testing. Diakses tanggal 3

November 2014. Diunduh dari : http://fitzgeraldmd.com/

diabetes/hemoglobin-a1c-testing.

Batubara JRL, Pulungan AB, Tridjaja B. Diabetes mellitus. Buku ajar endokrinologi anak. Edisi 1. Jakarta:

Badan Penerbit IDAI;2010. h.125-93.

Dorothy J, Becker. Complication of insulin-dependent

diabetes mellitus in childhood and adolescence. Dalam:

Lifshitz F, penyunting. Pediatric endocrinology. Edisi

ke-3. New York: Marcel Dekker;1996. h.583-605.

Miller M, Hankinson J, Brusasco V. Standardisation of

spirometry. Eur Respir J 2005;26:319-38.

Pitocco, Fuso L, Cone EG, Zaccardi F, Condoluci C,

Scavone G, dkk. The diabetic lung-a new target organ?.

Rev Diabet Stud 2012;9:23-35.

Somasekhar AR, Nagarajan SA, Saketh, Mallikarjuna

HB, Kumar HS. Lung functions in children with yype 1

diabetes mellitus: a cross sectional study. Indian J Child

Health 2014;1:49-53.

Rahajoe N, Supriyatno B, Setyanto DB, penyunting.

Pedoman nasional asma anak. Jakarta: UKK Respirologi

PP IDAI; 2004.

Makmuri MS. Patofisiologi asma. Dalam: Rahajoe N,

Supriyatno B, Setyanto DB, penyunting. Buku ajar

respirologi anak. Edisi ke-1. Jakarta: Balai penerbit

FKUI; 2008.h.98-104.

Jeffery P. Remodelling in asthma and chronic obstructive

lung disease. Am J Respir Crit Care Med 2001;164:28-38.

Ulrik CS. Outcome of asthma: longitudinal changes in

lung function. Eur Respir J 1999;13:904-18.

Black MH, Anderson A, Bell RA, Dabelea D, Pihoker C,

Saydah S, dkk. Prevalence of asthma and its association

with glycemic control among youth with diabetes.

Pediatrics2011;128:839-47.

Fsadni P, Fsadni C, Fava S, Montefort S. Correlation of

worldwide incidence of type 1 diabetes (DiaMond) with

prevalence of asthma and atopic eczema (ISAAC). Clin

Respir J2012;6:18-25.

Strulovici-Barel Y, Omberg L, O’Mahony M, Gordon

C, Hollman C, Tilley AE, dkk. Threshold of biologic

response of the small airway epithelium to low

levels of tobacco smoke. Am J Respir Crit Care Med

;182:1524-32.

Barcala FJ, Takkouche B, Valdés L, Temes E, Leis R,

Cabanas R, dkk. Parental smoking and lung function in

healthy children and adolescents. Arch Broncopneumol

;43:81-5.

Cook DG, Whincup PH, Papacosta O, Strachan DP, Jarvis

MJ, Bryant A. Relation of passive smoking as assessed

by salivary cotinine concentration and questionnaire to

spirometric indices in children. Thorax1993;48:14-20.

Jarvis MJ. Application of biochemical intake markers to

passive smoking measurement and risk estimation. Mutat

Res 1989;222:101-10.

Heimer D, Brami J, Lieberman D, Bark H. Respiratory

muscle performance in patient with type 1 diabetes.

Diabetes Med 1990;7:434-7.

Primhak RA, Whincup G, Tsanakas JN, Milner RD.

Reduced vital capacity in insulin-dependent diabetes.

Diabetes 1987;36:324-6.

Goldman MD. Lung dysfunction in diabetes. Diabetes

Care 2003;26:1915-8.

Schuyler M, Niewoehner D, Inkley S, Kohn R. Abnormal

lung elasticity in juvenile diabetes mellitus. Am Rev Resp

Dis 1976;113:37-41.

Sandler M, Bunn A, Stewart R. Cross-section study of

pulmonary function in patients with insulin-dependent

diabetes mellitus. Am Rev Respir Dis 1987;135:223-8.

Asanuma Y, Fujiya S, Ide H, Agishi Y. Characteristics of

pulmonary function in patients with diabetes mellitus.

Diabetes Res Clin Pract1985;1:95-101.

Mori H, Okubo M, Okamura M, Yamane K, Kado S, Egusa

G, dkk. Abnormalities of pulmonary function in patients

with non-insulin- dependent diabetes mellitus. Intern

Med 1992;31:189-193.

Ljubic S, Metelko Z, Car N, Roglic G, Drazic Z.

Reduction of diffusion capacity for carbon monoxide

in diabetic patients. Chest 1998;114:1033-5.

Marvisi M, Bartolini L, del Borrello P, Brianti M, Marani

G, Guariglia A, dkk. Pulmonary function in non-insulindependent diabetes mellitus. Respiration 2001;68:268-72.

Hankinson JL, Odencrantz JR, Fedan KB. Spirometric

reference values from a sample of the general U.S.

population. Am J Respir Crit Care Med 1999;159:179-87.

Viegi G, Sherrill DL, Carrozzi L, Di Pede F, Baldacci S,

Pistelli F, dkk. An 8-year follow-up of carbonmonoxide

diffusing capacity in a general population sample of

northern Italy. Chest 2001;120:74–80.

Wannamethee SG, Shaper AG, Whincup PH: Body fat

distribution, body composition, and respiratory function

in elderly men. Am J Clin Nutr 2005;82:996-1003.

Alfonso HS, Fritschi L, de Klerk NH, Olsen N, Sleith

J, Musk AB. Effects of asbestos and smoking on gas

diffusion in people exposed to crocidolite. Med J Aust

;183:184-7.

Niranjan V, McBrayer DG, Ramirez LC, Raskin P, Hsia

CCW. Glycemic control and cardiopulmonary function

in patients with insulin-dependent diabetes mellitus. Am

J Med 1997;103:504-13.

Dieterle CD, Schmauss S, Arbogast H, Domsch C,

Huber RM, Landgraf R. Pulmonary function in patients

with type 1 diabetes before and after simultaneous

pancreas and kidney transplantation. Transplantation

;83:566-9.

Lange P, Groth S, Mortensen J, Appleyard M, Nyboe

J, Schnohr P, dkk. Diabetes mellitus and ventilator

capacity: a five year follow-up study. Eur Respir J

;288-92.




DOI: http://dx.doi.org/10.14238/sp17.4.2015.241-8

Refbacks

  • Saat ini tidak ada refbacks.


##submission.copyrightStatement##

##submission.license.cc.by-nc-sa4.footer##

Informasi Editorial:
Badan Penerbit Ikatan Dokter Anak Indonesia
Jl. Salemba I No 5, Jakarta 10430, Indonesia
Phone/Fax: +62-21-3912577
Email: editorial [at] saripediatri.org

Lisensi Creative Commons
Sari Pediatri diterbitkan oleh Badan Penerbit Ikatan Dokter Anak Indonesia
Ciptaan disebarluaskan di bawah Lisensi Creative Commons Atribusi-NonKomersial-BerbagiSerupa 4.0 Internasional.