Hubungan Kadar HBA1C dan Insulin Puasa Terhadap Infeksi Saluran Kemih Pada Kelompok Lanjut Usia di Panti Santa Anna
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ABSTRACT
Urinary tract infection (UTI) poses a serious concern in the elderly population, with approximately 25% of total infection cases in the geriatric group being UTIs. Diabetes mellitus stands as a leading cause of global morbidity and is associated with severe complications, including an increased risk of infections impacting the quality of life. Patients with diabetes face a twofold higher risk of mortality due to infections. Advanced age is also a risk factor for UTIs, influenced by factors such as uncontrolled diabetes. Measuring parameters such as fasting insulin and HbA1c levels is crucial for understanding correlation between diabetes and UTIs. HbA1c can reflect long-term glycemic control in diabetic patients. This cross-sectional study aims to investigate relationship between HbA1c and fasting insulin levels concerning the occurrence of UTIs in the elderly population, conducted at the Santa Anna Nursing Home in 2023. The study included 33 respondents with an average age of 72.88 years, predominantly comprising 24 female respondents (72.7%). The mean fasting insulin level was 12.46 mIU/mL, and HbA1c level was 5.97%. UTIs were diagnosed in 11 respondents (33.3%). The correlation analysis between these variables indicated no significant difference in the mean HbA1c levels between groups with or without UTIs (p = 0.955). However, a significant difference was observed in the mean fasting insulin levels between the two groups (p < 0.001). This finding is noteworthy as fasting insulin levels have a direct correlation with circulating blood glucose levels and formation of red blood cells, potentially influencing HbA1c levels. Further clarification is needed on how these three variables interact.
Keywords: Elderly, Fasting Insulin, HbA1c, Urinary Tract Infection
ABSTRAK
Infeksi saluran kemih (ISK) adalah masalah serius pada populasi lanjut usia, sekitar 25% dari total kasus infeksi pada kelompok geriatri adalah ISK. Diabetes melitus adalah penyebab utama morbiditas global dan berhubungan dengan komplikasi serius, termasuk risiko infeksi yang berdampak pada kualitas hidup. Pasien diabetes memiliki risiko dua kali lipat lebih tinggi untuk kematian akibat infeksi. Peningkatan usia juga merupakan faktor risiko untuk ISK, yang dipengaruhi oleh faktor-faktor seperti diabetes yang tidak terkontrol. Pengukuran parameter seperti insulin puasa dan HbA1c adalah kunci dalam memahami korelasi antara diabetes dan ISK. HbA1c dapat mencerminkan kontrol glikemik jangka panjang pada pasien diabetes. Penelitian potong lintang ini bertujuan untuk mengetahui hubungan antara kadar HbA1c dan insulin puasa terhadap kejadian ISK pada kelompok lanjut usia yang dilakukan di Panti Lansia Santa Anna pada tahun 2023. Penelitian mengikutsertakan 33 responden dengan rata-rata usia 72,88 tahun dan didominasi oleh jenis kelamin perempuan sebanyak 24 responden (72,7%). Rerata kadar insulin puasa sebesar 12,46 mIU/mL dan kadar HbA1c sebanyak 5,97%. Sebanyak 11 responden (33,3%) terdiagnosis ISK. Hasil korelasi antara kedua variabel tersebut menunjukkan bahwa tidak ada perbedaan signifikan dalam rerata kadar HbA1c antara kelompok dengan atau tanpa ISK (p = 0,955). Meskipun demikian, terdapat perbedaan signifikan dalam rerata kadar insulin puasa antara kedua kelompok (p < 0,001). Hal ini menjadi sebuah pertimbangan karena kadar insulin puasa memiliki korelasi langsung dengan jumlah gula yang beredar bebas dalam darah dan pembentukan sel darah merah yang dapat meningkatkan tingkat HbA1c. Diperlukan penjelasan lebih lanjut tentang bagaimana ketiga variabel ini berinteraksi.
Kata Kunci: HbA1c, Infeksi Saluran Kemih, Insulin Puasa, Lanjut Usia
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Berbudi, A., Rahmadika, N., Tjahjadi, A. I., & Ruslami, R. (2020). Type 2 Diabetes and its Impact on the Immune System. Current Diabetes Reviews, 16(5), 442–449. https://doi.org/10.2174/1573399815666191024085838
Bono, M. J., Leslie, S. W., & Reygaert, W. C. (2023). Urinary Tract Infection. In StatPearls.http://www.ncbi.nlm.nih.gov/pubmed/30297448
Borj, M. R., Taghizadehborojeni, S., Shokati, A., Sanikhani, N., Pourghadamyari,H.,Mohammadi,A.,Abbariki,E.,Golmohammadi,T.,& Hoseiniharouni, S. M. (2017). Urinary Tract Infection Among Diabetic Patients with Regard to the Risk Factors, Causative Organisms and Their Antibicrobial Susceptibility Profiles. International Journal of Life Science & Pharma Research, 7(3), 38–47.
Brusch, J. L. (2021). Urinary Tract Infections (UTI) in Diabetes Mellitus.Medscape.https://emedicine.medscape.com/article/2040207-overview?form=fpf
Chu, C. M., & Lowder, J. L. (2018). Diagnosis and treatment of urinary tract infections across age groups. American Journal of Obstetrics and Gynecology, 219(1),4051.https://doi.org/10.1016/j.ajog.2017.12.231
Cole, J. B., & Florez, J. C. (2020). Genetics of diabetes mellitus and diabetes complications. Nature Reviews Nephrology, 16(7),377390.https://doi.org/10.1038/s41581-020-0278-5
Cortes-Penfield, N. W., Trautner, B. W., & Jump, R. L. P. (2017). Urinary Tract Infection and Asymptomatic Bacteriuria in OlderAdults. Infectious Disease ClinicsofNorth America, 31(4), 673688.https://doi.org/10.1016/j.idc.2017.07.002
Flores-Mireles, A. L., Walker, J. N., Caparon, M., & Hultgren, S. J. (2015).Urinarytract infections: epidemiology, mechanisms of infectionandtreatmentoptions. Nature Reviews Microbiology, 13(5),269284.https://doi.org/10.1038/nrmicro3432
Forbes, A., Murrells, T., Mulnier, H., & Sinclair, A. J. (2018). Mean HbA1c, HbA1c variability, and mortality in people with diabetes aged 70 years and older: a retrospective cohort study. The Lancet Diabetes & Endocrinology, 6(6), 476–486. https://doi.org/10.1016/S2213-8587(18)30048-2
Geerlings, S. E. (2016). Clinical PresentationsandEpidemiology of Urinary Tract Infections. Microbiology Spectrum, 4(5). https://doi.org/10.1128/microbiolspec.UTI-0002-2012
Goyal, R., Singhal, M., & Jialal, I. (2023). Type 2 Diabetes. In StatPearls.https://doi.org/30020625
Green, A., Hede, S. M., Patterson, C. C., Wild, S. H., Imperatore, G., Roglic, G., & Beran, D. (2021). Type 1 diabetes in 2017: global estimates of incident and prevalent cases in children and adults. Diabetologia, 64(12), 27412750.https://doi.org/10.1007/s00125-021-05571-8
Gregg, E. W., Sattar, N., & Ali, M. K. (2016). The changing face of diabetes complications. The Lancet Diabetes & Endocrinology, 4(6), 537–547. https://doi.org/10.1016/S2213-8587(16)30010-9
Gupta, K., Grigoryan, L., & Trautner, B. (2017). Urinary Tract Infection. Annals of Internal Medicine, 167(7), ITC49.https://doi.org/10.7326/AITC201710030
Gupta, S., Utkarsh, J., & Nidhi, C. (2017). Laboratory Diagnosis of HbA1c: A Review. Journal of NAnomedicine Research, 5(4).
He, K., Hu, Y., Shi, J.-C., Zhu, Y.-Q., & Mao, X.-M. (2018). Prevalence, risk factors and microorganisms of urinary tract infections in patients with type 2 diabetes mellitus: a retrospective study in China. Therapeutics and Clinical Risk Management, Volume 14, 403–408.https://doi.org/10.2147/TCRM.S147078
Olayemi Abdul, I., Osazuwa, F., & Osilume, D. (2015). Association Between Elevated HbA1c Levels and Urinary Tract Infection Among Diabetic Women. Zahedan Journal of Research in Medical Sciences, 17(6).https://doi.org/10.17795/zjrms994
Ong, K. L., Stafford, L. K., McLaughlin, S. A., Boyko, E. J., Vollset, S. E., Smith, A. E., Dalton, B. E., Duprey, J., Cruz, J. A., Hagins, H., Lindstedt, P. A., Aali, A., Abate, Y. H., Abate, M. D., Abbasian, M., Abbasi-Kangevari, Z., Abbasi-Kangevari, M., Abd ElHafeez, S., Abd-Rabu, R., … Vos, T. (2023). Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. The Lancet, 402(10397), 203–234. https://doi.org/10.1016/S0140-6736(23)01301-6
Pearson-Stuttard, J., Blundell, S., Harris, T., Cook, D. G., & Critchley, J. (2016). Diabetes and infection: assessing the association with glycaemic control in population-based studies. The Lancet Diabetes & Endocrinology, 4(2), 148–158. https://doi.org/10.1016/S2213-8587(15)00379-4
Perkumpulan Endokrinologi Indonesia. (2021). Pedoman Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 Dewasa di Indonesia (S. A. Soelistijo (ed.)). PB Perkeni.
Petersmann, A., Müller-Wieland, D., Müller, U. A., Landgraf, R., Nauck, M., Freckmann, G., Heinemann, L., & Schleicher, E.(2019).Definition,Classification and Diagnosis of Diabetes Mellitus.ExperimentalandClinical Endocrinolog & Diabetes, 127(S01),S1S7.https://doi.org/10.1055/a-1018-9078
Petersmann, A., Nauck, M., Müller-Wieland, D., Kerner, W., Müller, U., Landgraf, R., Freckmann, G., & Heinemann, L.(2018).Definition,Classification and Diagnosis of Diabetes Mellitus. Experimental and Clinical Endocrinology & Diabetes, 126(07), 406–410. https://doi.org/10.1055/a-0584-6223
Rowe, T. A., & Juthani-Mehta, M. (2014). Diagnosis and Management of Urinary Tract Infection in Older Adults. Infectious Disease Clinics of North America, 28(1), 75–89. https://doi.org/10.1016/j.idc.2013.10.004
Schnell, O., Crocker, J. B., & Weng, J. (2017). Impact of HbA1c Testing at Point of Care on Diabetes Management. Journal of Diabetes Science and Technology, 11(3), 611–617. https://doi.org/10.1177/1932296816678263
Sharma, S. (2017). Clinical and Laboratory Profile of Urinary Tract Infections in Type 2 Diabetics Aged over 60 Years. JournalofClinicalandDiagnosticResearch.https://doi.org/10.7860/JCDR/2017/25019.9662
Spoto, B., Pisano, A., & Zoccali, C. (2016). Insulin resistance in chronic kidney disease: a systematic review. American Journal of Physiology-Renal Physiology, 311(6), F1087–F1108.https://doi.org/10.1152/ajprenal.00340.2016
Srinivas, A. (2014). Clinical profile of urinary tract infections in diabetics and non-diabetics. Australasian Medical Journal, 7(1),2934.https://doi.org/10.4066/AMJ.2014.1906
Wang, M., & Hng, T.-M. (2021). HbA1c: More than just a number. Australian Journal of General Practice, 50(9), 628–632.https://doi.org/10.31128/AJGP-03-21-5866
Weykamp, C. (2013). HbA1c: A Review of Analytical and Clinical Aspects. Annals of Laboratory Medicine, 33(6), 393400.https://doi.org/10.3343/alm.2013.33.6.393
Zheng, Y., Ley, S. H., & Hu, F. B. (2018). Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nature Reviews Endocrinology, 14(2), 88–98. https://doi.org/10.1038/nrendo.2017.151
DOI: https://doi.org/10.33024/mnj.v6i7.13510
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