Karakteristik Pasien Ketoasidosis Diabetik Sebelum dan Saat Pandemi COVID-19 di RSUD Abdul Wahab Sjahranie Samarinda
DOI:
https://doi.org/10.29303/jku.v10i3.554Kata Kunci:
diabetes mellitus, ketoasidosis diabetik, COVID-19Abstrak
Latar Belakang: Situasi pandemi Corona Virus Disease-19 (COVID-19) telah menjadi tantangan dalam manajemen penyakit bagi pasien diabetes mellitus (DM) sehingga meningkatkan risiko komplikasi, termasuk ketoasidosis diabetik (KAD). Kasus KAD telah dilaporkan meningkat selama pandemi dan dapat tercetuskan oleh COVID-19. Penelitian ini bertujuan untuk mengetahui karakteristik pasien KAD sebelum dan saat pandemi di RSUD Abdul Wahab Sjahranie Samarinda
Metode: Penelitian ini menggunakan desain deskriptif observasional dan pengambilan sampel dengan metode sampel total. Variabel yang diteliti mencakup demografi, klinis, hasil laboratorium, serta jenis infeksi.
Hasil: 59 pasien masuk dalam kriteria (17 selama pandemi dan 42 sebelum pandemi). Usia dewasa (58,82% & 71,43%), perempuan (64,7% & 66,67), dan DM tipe 2 (58,82% & 71,43%) mendominasi di kedua kelompok. Selama pandemi, kasus KAD berat relatif tinggi (82,35% vs 76,19%). Mortalitas relatif menurun (23,52% vs 45,23%), tetapi masih lebih tinggi dibanding studi lainnya. Kadar glukosa darah, HbA1c, HCO3-, pCO2, dan leukosit relatif tinggi sebelum pandemi. Meski begitu, kami menemukan kadar pH, ketonuria, ureum, dan kreatinin yang lebih tinggi selama pandemi. Di antara kedua kelompok, hampir seluruh pasien memiliki riwayat infeksi yang mencetuskan KAD (94,11% & 92,85%) dengan sepsis sebagai jenis infeksi terbanyak. Tetapi, kami tidak menemukan infeksi Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2) mencetuskan KAD pada studi ini.
Kesimpulan: Pandemi COVID-19 memberikan dampak pada klinis serta luaran pasien KAD.
Referensi
1. World Health Organization. WHO Coronavirus (COVID-19) Dashboard [Internet]. 2021 [cited 2021 Jun 18]. Available from: https://covid19.who.int/
2. Komite Penanganan Covid-19 dan Pemulihan Ekonomi Nasional (KPCPEN). Peta Sebaran COVID-19 [Internet]. 2021 [cited 2021 Jun 18]. Available from: https://covid19.go.id/peta-sebaran-covid19
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5. Yang J, Zheng Y, Gou X, Pu K, Chen Z. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis [Internet]. 2020;94(March):91–5. Available from: https://pubmed.ncbi.nlm.nih.gov/32173574/
6. Guo W, Li M, Dong Y, Zhou H, Zhang Z, Tian C, et al. Diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes Metab Res Rev. 2020;36(7):1–9.
7. Kshanti IA, Epriliawati M, Mokoagow MI, Nasarudin J, Magfira N. The Impact of Coronavirus Disease 2019 Pandemic on People with Diabetes in Indonesia: A Cross Sectional National Scale Web-Survey. medRxiv. 2020;(165):1–13. Available from: https://doi.org/10.1101/2020.12.01.20241588
8. Verma A, Rajput R, Verma S, Balania VKB, Jangra B. Impact of Lockdown in COVID 19 on glycemic control in patients with type 1 Diabetes Mellitus. Diabetes Metab Syndr Clin Res Rev. 2020;14(January):1213–6. Available from: https://doi.org/10.1016/j.dsx.2020.07.016
9. Ledford CJW, Roberts C, Whisenant E, Walters C, Akamiro K, Butler J, et al. Quantifying Worsened Glycemic Control during the COVID-19 Pandemic. J Am Board Fam Med. 2021;34(February):S192–5. Available from: http://jabfm.org/content/34/Supplement/S192.full.
10. Tanji Y, Sawada S, Watanabe T, Mita T, Kobayashi Y, Murakami T, et al. Impact of COVID-19 pandemic on glycemic control among outpatients with type 2 diabetes in Japan: A hospital-based survey from a country without lockdown. Diabetes Res Clin Pract [Internet]. 2021;176:108840. Available from: https://doi.org/10.1016/j.diabres.2021.108840
11. Dey RK, Hilmy AI, Imad HA, Yoosuf AA, Latheef AA. COVID-19 and emergencies in patients with diabetes: two case reports. J Med Case Rep. 2021;15(1):1–5. Available from: https://doi.org/10.1186/s13256-020-02659-4
12. Forde R, Arente L, Ausili D, De Backer K, Due-Christensen M, Epps A, et al. The impact of the COVID-19 pandemic on people with diabetes and diabetes services: A pan-European survey of diabetes specialist nurses undertaken by the Foundation of European Nurses in Diabetes survey consortium. Diabet Med. 2021;38(5):1–10. Available from: https://doi.org/10.1111/dme.14498
13. Nyenwe EA, Kitabchi AE. The evolution of diabetic ketoacidosis: An update of its etiology, pathogenesis and management. Metabolism. 2016;65(4):507–21. Available from: http://dx.doi.org/10.1016/j.metabol.2015.12.007
14. Reddy PK, Kuchay MS, Mehta Y, Mishra SK. Diabetic ketoacidosis precipitated by COVID-19: A report of two cases and review of literature. Diabetes Metab Syndr Clin Res Rev. 2020;14(July). Available from: https://doi.org/10.1016/j.dsx.2020.07.050
15. Chee YJ, Ng SJH, Yeoh E. Diabetic ketoacidosis precipitated by Covid-19 in a patient with newly diagnosed diabetes mellitus. Diabetes Res Clin Pract. 2020;164(April). Available from: https://doi.org/10.1016/j.diabres.2020.108166
16. Parwanto E, Digambiro RA, Nusantara DU, Rarasati T. Coronavirus disease 2019 (COVID-19): A case report in a patient with diabetic ketoacidosis and hypertension. Bali Med J. 2020;9(3):624–9.
17. Centers for Disease Control and Prevention. National Diabetes Statistics Report 2020. Atlanta: GA: Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services; 2020.
18. Benoit SR, Zhang Y, Geiss LS, Gregg EW, Albright A. Trends in Diabetic Ketoacidosis Hospitalizations and In-Hospital Mortality — United States, 2000–2014. MMWR Morb Mortal Wkly Rep. 2018;67(12):362–5.
19. Zavaleta MJC, Florez CDA, Duenas EAP, Arroyo JCC. Diabetic ketoacidosis during COVID-19 pandemic in a developing country. Diabetes Res Clin Pract. 2020;168. Available from: https://doi.org/10.1016/j.diabres.2020.108391
20. Entwistle A, Edwards AE, Benjamin A, Gelding S V, Gunangah K. Diabetic ketoacidosis (DKA) admissions during and before the covid-19 pandemic. Diabetic Medicine : Diabetes care During covid-19. 2021;5.
21. Jacob R, Weiser G, Krupik D, Takagi D, Peled S, Pines N, et al. Diabetic Ketoacidosis at Emergency Department Presentation During the First Months of the SARS-CoV-2 Pandemic in Israel: A Multicenter Cross-Sectional Study. Diabetes Ther. 2021;12(5):1569–74. Available from: https://doi.org/10.1007/s13300-021-01049-3
22. Kamrath C, Mönkemöller K, Biester T, Rohrer TR, Warncke K, Hammersen J, et al. Ketoacidosis in Children and Adolescents with Newly Diagnosed Type 1 Diabetes during the COVID-19 Pandemic in Germany. JAMA - J Am Med Assoc. 2020;324(8):801–4.
23. Chao LC, Vidmar AP, Georgia S. Spike in Diabetic Ketoacidosis Rates in Pediatric Type 2 Diabetes During the COVID-19 Pandemic. Diabetes Care. 2021;44(6):1451–3. Available from: https://doi.org/10.2337/DC20-2733
24. Han MJ, Heo JH. Increased incidence of pediatric diabetic ketoacidosis after covid-19: A two-center retrospective study in Korea. Diabetes, Metab Syndr Obes Targets Ther. 2021;14:783–90. Available from: http://doi.org/10.2147/DMSO.S294458
25. Rabbone I, Schiaffini R, Cherubini V, Maffeis C, Scaramuzza A. Has covid-19 delayed the diagnosis and worsened the presentation of type 1 diabetes in children? Diabetes Care. 2020;43(11):2870–2. Available from: https://doi.org/10.2337/dc20-1321
26. Arslanoglu I, Akcali F, Yavuzyilmaz F, Sungur MA. Short time effect of Covid 19 pandemic on HbA1c nad acute metabolic complications in children with type 1 diabetes. 2021;6. Available from: : https://doi.org/10.1101/2021.04.18.21255687
27. Alshareef R, Al Zahrani A, Alzahrani A, Ghandoura L. Impact of the COVID-19 lockdown on diabetes patients in Jeddah, Saudi Arabia. Diabetes Metab Syndr Clin Res Rev [Internet]. 2020;14(5):1583–7. Available from: https://doi.org/10.1016/j.dsx.2020.07.051
28. Fisher L, Polonsky W, Asuni A, Jolly Y, Hessler D. The early impact of the COVID-19 pandemic on adults with type 1 or type 2 diabetes: A national cohort study. J Diabetes Complications [Internet]. 2020;34(12):107748. Available from: https://doi.org/10.1016/j.jdiacomp.2020.107748
29. Koliaki C, Tentolouris A, Eleftheriadou I, Melidonis A, Dimitriadis G, Tentolouris N. Clinical Management of Diabetes Mellitus in the Era of COVID-19: Practical Issues, Peculiarities and Concerns. J Clin Med. 2020;9(7):2288.
30. Dewata DGUB, Novida H, Aryati A. Profile of Diabetic Ketoacidosis Patients At Regional Public Hospital Dr. Soetomo in 2017. J Berk Epidemiol. 2020;8(3):301.
31. Hamed ZS, Gawaly A, Abbas K, El Ahwal L. Epidemiology of infection as a precipitating factor for diabetic ketoacidosis at Tanta University Hospital. Tanta Med J. 2017;45(2):68.
32. Goldman N, Fink D, Cai J, Lee YN, Davies Z. High prevalence of COVID-19-associated diabetic ketoacidosis in UK secondary care. Diabetes Res Clin Pract [Internet]. 2020;166:108291. Available from: https://doi.org/10.1016/j.diabres.2020.108291
33. Kempegowda P, Melson E, Johnson A, Wallett L, Thomas L, Zhou D, et al. Effect of covid-19 on the clinical course of diabetic ketoacidosis (Dka) in people with type 1 and type 2 diabetes. Endocr Connect. 2021;10(4):371–7. Available from: https://doi.org/10.1530/EC-20-0567
34. Gera S, Longendyke RL, Minich NM, Malay S, Wood JR. The COVID-19 Pandemic and Associated Worsening of Diabetic Ketoacidosis Presentation in Youth. Diabet Med [Internet]. 2021;(March):e14610. Available from: http://www.ncbi.nlm.nih.gov/pubmed/34053098
2. Komite Penanganan Covid-19 dan Pemulihan Ekonomi Nasional (KPCPEN). Peta Sebaran COVID-19 [Internet]. 2021 [cited 2021 Jun 18]. Available from: https://covid19.go.id/peta-sebaran-covid19
3. Kementerian Kesehatan RI. Pedoman Pencegahan dan Pengendalian Coronavirus Disease (COVID-19). Revisi 5. 2020.
4. Singh AK, Gupta R, Ghosh A, Misra A. Diabetes in COVID-19: Prevalence, pathophysiology, prognosis and practical considerations. Diabetes Metab Syndr Clin Res Rev [Internet]. 2020;14(4):303–10. Available from: https://doi.org/10.1016/j.dsx.2020.04.004
5. Yang J, Zheng Y, Gou X, Pu K, Chen Z. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis [Internet]. 2020;94(March):91–5. Available from: https://pubmed.ncbi.nlm.nih.gov/32173574/
6. Guo W, Li M, Dong Y, Zhou H, Zhang Z, Tian C, et al. Diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes Metab Res Rev. 2020;36(7):1–9.
7. Kshanti IA, Epriliawati M, Mokoagow MI, Nasarudin J, Magfira N. The Impact of Coronavirus Disease 2019 Pandemic on People with Diabetes in Indonesia: A Cross Sectional National Scale Web-Survey. medRxiv. 2020;(165):1–13. Available from: https://doi.org/10.1101/2020.12.01.20241588
8. Verma A, Rajput R, Verma S, Balania VKB, Jangra B. Impact of Lockdown in COVID 19 on glycemic control in patients with type 1 Diabetes Mellitus. Diabetes Metab Syndr Clin Res Rev. 2020;14(January):1213–6. Available from: https://doi.org/10.1016/j.dsx.2020.07.016
9. Ledford CJW, Roberts C, Whisenant E, Walters C, Akamiro K, Butler J, et al. Quantifying Worsened Glycemic Control during the COVID-19 Pandemic. J Am Board Fam Med. 2021;34(February):S192–5. Available from: http://jabfm.org/content/34/Supplement/S192.full.
10. Tanji Y, Sawada S, Watanabe T, Mita T, Kobayashi Y, Murakami T, et al. Impact of COVID-19 pandemic on glycemic control among outpatients with type 2 diabetes in Japan: A hospital-based survey from a country without lockdown. Diabetes Res Clin Pract [Internet]. 2021;176:108840. Available from: https://doi.org/10.1016/j.diabres.2021.108840
11. Dey RK, Hilmy AI, Imad HA, Yoosuf AA, Latheef AA. COVID-19 and emergencies in patients with diabetes: two case reports. J Med Case Rep. 2021;15(1):1–5. Available from: https://doi.org/10.1186/s13256-020-02659-4
12. Forde R, Arente L, Ausili D, De Backer K, Due-Christensen M, Epps A, et al. The impact of the COVID-19 pandemic on people with diabetes and diabetes services: A pan-European survey of diabetes specialist nurses undertaken by the Foundation of European Nurses in Diabetes survey consortium. Diabet Med. 2021;38(5):1–10. Available from: https://doi.org/10.1111/dme.14498
13. Nyenwe EA, Kitabchi AE. The evolution of diabetic ketoacidosis: An update of its etiology, pathogenesis and management. Metabolism. 2016;65(4):507–21. Available from: http://dx.doi.org/10.1016/j.metabol.2015.12.007
14. Reddy PK, Kuchay MS, Mehta Y, Mishra SK. Diabetic ketoacidosis precipitated by COVID-19: A report of two cases and review of literature. Diabetes Metab Syndr Clin Res Rev. 2020;14(July). Available from: https://doi.org/10.1016/j.dsx.2020.07.050
15. Chee YJ, Ng SJH, Yeoh E. Diabetic ketoacidosis precipitated by Covid-19 in a patient with newly diagnosed diabetes mellitus. Diabetes Res Clin Pract. 2020;164(April). Available from: https://doi.org/10.1016/j.diabres.2020.108166
16. Parwanto E, Digambiro RA, Nusantara DU, Rarasati T. Coronavirus disease 2019 (COVID-19): A case report in a patient with diabetic ketoacidosis and hypertension. Bali Med J. 2020;9(3):624–9.
17. Centers for Disease Control and Prevention. National Diabetes Statistics Report 2020. Atlanta: GA: Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services; 2020.
18. Benoit SR, Zhang Y, Geiss LS, Gregg EW, Albright A. Trends in Diabetic Ketoacidosis Hospitalizations and In-Hospital Mortality — United States, 2000–2014. MMWR Morb Mortal Wkly Rep. 2018;67(12):362–5.
19. Zavaleta MJC, Florez CDA, Duenas EAP, Arroyo JCC. Diabetic ketoacidosis during COVID-19 pandemic in a developing country. Diabetes Res Clin Pract. 2020;168. Available from: https://doi.org/10.1016/j.diabres.2020.108391
20. Entwistle A, Edwards AE, Benjamin A, Gelding S V, Gunangah K. Diabetic ketoacidosis (DKA) admissions during and before the covid-19 pandemic. Diabetic Medicine : Diabetes care During covid-19. 2021;5.
21. Jacob R, Weiser G, Krupik D, Takagi D, Peled S, Pines N, et al. Diabetic Ketoacidosis at Emergency Department Presentation During the First Months of the SARS-CoV-2 Pandemic in Israel: A Multicenter Cross-Sectional Study. Diabetes Ther. 2021;12(5):1569–74. Available from: https://doi.org/10.1007/s13300-021-01049-3
22. Kamrath C, Mönkemöller K, Biester T, Rohrer TR, Warncke K, Hammersen J, et al. Ketoacidosis in Children and Adolescents with Newly Diagnosed Type 1 Diabetes during the COVID-19 Pandemic in Germany. JAMA - J Am Med Assoc. 2020;324(8):801–4.
23. Chao LC, Vidmar AP, Georgia S. Spike in Diabetic Ketoacidosis Rates in Pediatric Type 2 Diabetes During the COVID-19 Pandemic. Diabetes Care. 2021;44(6):1451–3. Available from: https://doi.org/10.2337/DC20-2733
24. Han MJ, Heo JH. Increased incidence of pediatric diabetic ketoacidosis after covid-19: A two-center retrospective study in Korea. Diabetes, Metab Syndr Obes Targets Ther. 2021;14:783–90. Available from: http://doi.org/10.2147/DMSO.S294458
25. Rabbone I, Schiaffini R, Cherubini V, Maffeis C, Scaramuzza A. Has covid-19 delayed the diagnosis and worsened the presentation of type 1 diabetes in children? Diabetes Care. 2020;43(11):2870–2. Available from: https://doi.org/10.2337/dc20-1321
26. Arslanoglu I, Akcali F, Yavuzyilmaz F, Sungur MA. Short time effect of Covid 19 pandemic on HbA1c nad acute metabolic complications in children with type 1 diabetes. 2021;6. Available from: : https://doi.org/10.1101/2021.04.18.21255687
27. Alshareef R, Al Zahrani A, Alzahrani A, Ghandoura L. Impact of the COVID-19 lockdown on diabetes patients in Jeddah, Saudi Arabia. Diabetes Metab Syndr Clin Res Rev [Internet]. 2020;14(5):1583–7. Available from: https://doi.org/10.1016/j.dsx.2020.07.051
28. Fisher L, Polonsky W, Asuni A, Jolly Y, Hessler D. The early impact of the COVID-19 pandemic on adults with type 1 or type 2 diabetes: A national cohort study. J Diabetes Complications [Internet]. 2020;34(12):107748. Available from: https://doi.org/10.1016/j.jdiacomp.2020.107748
29. Koliaki C, Tentolouris A, Eleftheriadou I, Melidonis A, Dimitriadis G, Tentolouris N. Clinical Management of Diabetes Mellitus in the Era of COVID-19: Practical Issues, Peculiarities and Concerns. J Clin Med. 2020;9(7):2288.
30. Dewata DGUB, Novida H, Aryati A. Profile of Diabetic Ketoacidosis Patients At Regional Public Hospital Dr. Soetomo in 2017. J Berk Epidemiol. 2020;8(3):301.
31. Hamed ZS, Gawaly A, Abbas K, El Ahwal L. Epidemiology of infection as a precipitating factor for diabetic ketoacidosis at Tanta University Hospital. Tanta Med J. 2017;45(2):68.
32. Goldman N, Fink D, Cai J, Lee YN, Davies Z. High prevalence of COVID-19-associated diabetic ketoacidosis in UK secondary care. Diabetes Res Clin Pract [Internet]. 2020;166:108291. Available from: https://doi.org/10.1016/j.diabres.2020.108291
33. Kempegowda P, Melson E, Johnson A, Wallett L, Thomas L, Zhou D, et al. Effect of covid-19 on the clinical course of diabetic ketoacidosis (Dka) in people with type 1 and type 2 diabetes. Endocr Connect. 2021;10(4):371–7. Available from: https://doi.org/10.1530/EC-20-0567
34. Gera S, Longendyke RL, Minich NM, Malay S, Wood JR. The COVID-19 Pandemic and Associated Worsening of Diabetic Ketoacidosis Presentation in Youth. Diabet Med [Internet]. 2021;(March):e14610. Available from: http://www.ncbi.nlm.nih.gov/pubmed/34053098
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2021-12-18
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Wiryansyah, M., & Retnaningrum, Y. R. (2021). Karakteristik Pasien Ketoasidosis Diabetik Sebelum dan Saat Pandemi COVID-19 di RSUD Abdul Wahab Sjahranie Samarinda. Baphomet University : Situs Slot Online Gacor Terbaik Hari Ini Server Thailand Gampang Maxwin 2024, 10(3), 615–624. https://doi.org/10.29303/jku.v10i3.554
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