TELAAH KOMPREHENSIF DIABETES MELITUS: KLASIFIKASI, GEJALA, DIAGNOSIS, PENCEGAHAN, DAN PENGOBATAN A Comprehensive Review of Diabetes Mellitus: Classification, Symptoms, Diagnosis, Prevention, and Treatment
Main Article Content
Abstract
Diabetes mellitus is a metabolic disorder characterized by hyperglycemia. In general, diabetes is classified into type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), gestational, and other specific diabetes. The causes of diabetes are genetic disorders and environmental. Common symptoms of diabetes include: polydipsia, polyphagia, glycosuria, polyuria, dehydration, fatigue, weight loss, reduced vision, cramps, constipation, and candida infection. Test for diagnosis of diabetes include: fasting plasma glucose test, plasma glucose test after 2 hours of 75 g oral glucose administration, the glycated hemoglobin test (HbA1C), and random blood glucose test. Prevention of T1DM is still difficult because of the limited knowledge of metabolic, genetic, and immunological processes in the development of T1DM. T2DM is prevented by lifestyle and medical intervention. Insulin is the only drug for T1DM, whereas T2DM is treated with metformin as drug’s primary choice for reducing blood glucose levels.
Diabetes melitus merupakan penyakit kelainan metabolisme yang ditandai dengan hiperglikemia. Secara umum, diabetes diklasifikasikan menjadi: diabetes melitus tipe 1 (DMT1), diabetes melitus tipe 2 (DMT2), gestasional, dan diabetes spesifik lain. Penyebab diabetes adalah kelainan genetik dan lingkungan. Gejala umum diabetes antara lain: polidipsia, polifagia, glikosuria, poliuria, dehidrasi, kelelahan, penurunan berat badan, daya penglihatan berkurang, kram, konstipasi, dan infeksi candida. Pemeriksaaan untuk diagnosis diabetes meliputi: pemeriksaan glukosa plasma saat puasa, pemeriksaan glukosa plasma setelah 2 jam pemberian glukosa oral 75 g, pemeriksaan hemoglobin terglikasi (HbA1C), dan pemeriksaan glukosa darah acak. Pencegahan DMT1 masih sulit karena terbatasnya pengetahuan proses metabolisme, genetik, dan imunologi pada perkembangan DMT1. DMT2 dicegah dengan intervensi gaya hidup dan intervensi medis. Insulin merupakan satu-satunya obat untuk DMT1, sedangkan DMT2 diobati dengan metformin sebagai pilihan utama dan non obat untuk menurunkan kadar glukosa dalam darah.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
References
Akcay MN, Karadeniz E, Ahiskalioglu A (2019) Bariatric/metabolic surgery in type I and type 2 diabetes mellitus. Eurasian J Med 51: 85-89. doi: 10.5152/eurasianjmed.2018.18298
Aktar N, Qureshi NK, Ferdous HS (2017) Obesity: A review of pathogenesis and management strategies in adult. Delta Med Coll J 5: 35-48. doi: 10.3329/dmcj.v5i1.31436
Al-Lawati JA (2017) Diabetes mellitus: A local and global public health emergency! Oman Med J 32: 177-179. doi: 10.5001/omj.2017.34
Allen N, Gupta A (2019) Current diabetes technology: Striving for the artificial pancreas. Diagnostics 9: 31. doi: 10.3390/diagnostics9010031
Asmat U, Abad K, Ismail K (2016) Diabetes mellitus and oxidative stress – A concise review. Saudi Pharm J 24: 547-553. doi: 10.1016/j.jsps.2015.03.013
Atkinson MA (2012) The pathogenesis and natural history of type 1 diabetes. Cold Spring Harb Perspect Med 2: a007641. doi: 10.1101/cshperspect.a007641
Basukala P, Jha B, Yadav BK, Shrestha PK (2018) Determination of insulin resistance and beta-cell function using homeostatic model assessment in type 2 diabetic patients at diagnosis. J Diabetes Metab 9: 790. doi: 10.4172/2155-6156.1000790
Baynest HW (2015) Classification, pathophysiology, diagnosis and management of diabetes mellitus. J Diabetes Metab 6: 541. doi: 10.4172/2155-6156.1000541
Bergman M, Buysschaert M, Schwarz PE, Albright A, Narayan KV, Yach D (2012) Diabetes prevention: Global health policy and perspectives from the ground. Diabetes Manag 2: 309-321. doi: 10.2217/dmt.12.34
Bolla KN, Sri SKV, Varalakshmi KN (2015) Diabetes mellitus and its prevention. Int J Sci Technol Res 4: 119-125
Chatterjee S, Davies MJ (2015) Current management of diabetes mellitus and future directions in care. Postgrad Med J 91: 612-621. doi: 10.1136/postgradmedj-2014-133200
Chaudhury A, Duvoor C, Dendi VSR, Kraleti S, Chada A, Ravilla R, Marco A, Shekhawat NS, Montales MT, Kuriakose K, Sasapu A, Beebe A, Patil N, Musham CK, Lohani GP, Mirza W (2017) Clinical review of antidiabetic drugs: Implications for type 2 diabetes mellitus management. Front Endocrinol 8: 6. doi: 10.3389/fendo.2017.00006
Crofts CAP, Zinn C, Wheldon MC, Schofield GM (2015) Hyperinsulinemia: A unifying theory of chronic disease? Diabesity 1: 34-43. doi: 10.15562/diabesity.2015.19
Deepthi B, Sowjanya K, Lidiya B, Bhargavi RS, Babu PS (2017) A modern review of diabetes mellitus: An annihilatory metabolic disorder. J In Silico In Vitro Pharmacol 3: 14. doi: 10.21767/2469-6692.100014
Duan W, Shen X, Lei J, Xu Q, Yu Y, Li R, Wu E, Ma Q (2014) Hyperglycemia, a neglected factor during cancer progression. Biomed Res Int 2014: 461917. doi: 10.1155/2014/461917
Forbes JM, Cooper ME (2013) Mechanisms of diabetic complications. Physiol Rev 93: 137-188. doi: 10.1152/physrev.00045.2011
Forouhi NG, Wareham NJ (2014) Epidemiology of diabetes. Medicine (Abingdon) 42: 698-702. doi: 10.1016/j.mpmed.2014.09.007
Goguen J, Gilbert J (2018) Hyperglycemic emergencies in adults. Can J Diabetes 42 Suppl 1: S109-S114. doi: 10.1016/j.jcjd.2017.10.013
Gupta A, Sharma M, Sharma J (2015) A Role of insulin in different types of diabetes. Int J Curr Microbiol App Sci 4: 58-77
Harikumar K, Kumar BK, Hemalatha GJ, Kumar MB, Lado SFS (2015) A review on diabetes mellitus. Int J Novel Trends Pharm Sci 5: 201-217
Janez A, Guja C, Mitrakou A, Lalic N, Tankova T, Czupryniak L, Tabak AG, Prazny M, Martinka E, Smircic-Duvnjak L (2020) Insulin therapy in adults with type 1 diabetes mellitus: A narrative review. Diabetes Ther 11: 387-409. doi: 10.1007/s13300-019-00743-7
Kabel AM, Altowirqi R, Al Thobiti H, Althumali A, Alharthi E (2017) Pharmacological therapy of type 2 diabetes mellitus: New perspectives. EC Pharmacol Toxicol 4: 12-19
Kharroubi AT, Darwish HM (2015) Diabetes mellitus: The epidemic of the century. World J Diabetes 6: 850-867. doi: 10.4239/wjd.v6.i6.850
Kolb H, Martin S (2017) Environmental/lifestyle factors in the pathogenesis and prevention of type 2 diabetes. BMC Med 15: 131. doi: 10.1186/s12916-017-0901-x
Kumar A, Mittal R, Naidu PS (2017) Insulin resistance: Recent advances in pathogenesis, molecular mechanisms and clinical relevance. EC Pharmacol Toxicol 4: 244-262
Mane K, Chaluvaraju Kc, Niranjan Ms, Zaranappa Tr, Manjuthej Tr (2012) Review of insulin and its analogues in diabetes mellitus. J Basic Clin Pharm 3: 283-293. doi: 10.4103/0976-0105.103822
Marin-Penalver JJ, Martin-Timon I, Sevillano-Collantes C, Del Canizo-Gomez FJ (2016) Update on the treatment of type 2 diabetes mellitus. World J Diabetes 7: 353-395. doi: 10.4239/wjd.v7.i17.354
Messina J, Campbell S, Morris R, Eyles E, Sanders C (2017) A narrative systematic review of factors affecting diabetes prevention in primary care settings. PLoS One 12: e0177699. doi: 10.1371/journal.pone.0177699
Okur ME, Karantas ID, Siafaka PI (2017) Diabetes mellitus: A review on pathophysiology, current status of oral medications and future perspectives. Acta Pharm Sci 55: 61-82. doi: 10.23893/1307-2080.APS.0555
Olokoba AB, Obateru OA, Olokoba LB (2012) Type 2 diabetes mellitus: A review of current trends. Oman Med J 27: 269-273. doi: 10. 5001/omj.2012.68
Papatheodorou K, Papanas N, Banach M, Papazoglou D, Edmonds M (2016) Complications of diabetes 2016. J Diabetes Res 2016: 6989453. doi: 10.1155/2016/6989453
Paschou SA, Papadopoulou-Marketou N, Chrousos GP, Kanaka-Gantenbein C (2018) On type 1 diabetes mellitus pathogenesis. Endocr Connect 7: R38-R46. doi: 10.1530/EC-17-0347
Pasquel FJ, Umpierrez GE (2014) Hyperosmolar hyperglycemic state: A historic review of the clinical presentation, diagnosis, and treatment. Diabetes Care 37: 3124-3131. doi: 10.2337/dc14-0984
Pathak V, Pathak NM, O’Neill CL, Guduric-Fuchs J, Medina RJ (2019) Therapies for type 1 diabetes: Current scenario and future perspectives. Clin Med Insights Endocrinol Diabetes 12: 1179551419844521. doi: 10.1177/1179551419844521
Patil SS, Mehta M, Thakare V, Shende S, Shirure PA, Swami OC (2017) Role of insulin in management of type 2 diabetes mellitus. Int J Res Med Sci 5: 2282–2292. doi: 10.18203/2320-6012.ijrms20172422
Piero MN, Nzaro GM, Njagi JM (2014) Diabetes mellitus – A devastating metabolic disorder. Asian J Biomed Pharm Sci, 04: 1-7. doi:10.15272/ajbps.v4i40.645
Punthakee Z, Goldenberg R, Katz P (2018) Definition, classification and diagnosis of diabetes, prediabetes and metabolic syndrome. Can J Diabetes 42: Suppl 1: S10–S15. doi: 10.1016/j.jcjd.2017.10.003
Rhee SY, Kim YS (2015) Peripheral arterial disease in patients with type 2 diabetes mellitus. Diabetes Metab J 39: 283-290. doi: 10.4093/dmj.2015.39.4.283
Russell WR, Baka A, Bjorck I, Deizenne N, Gao D, Griffiths HR, Hadjilucas E, Juvonen K, Lahtinen S, Lansink M, Loon LV, Mykkanen H, Ostman E, Riccardi G, Vinoy S, Weickert MO (2016) Impact of diet composition on blood glucose regulation. Crit Rev Food Sci Nutr 56: 541-590. doi: 10.1080/10408398.2013.792772
Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, Colagiuri S, Guariguata L, Motala AA, Ogurtsova K, Shaw JE, Bright D, Williams R (2019) Global and regional diabetes prevalence estimates for 2019 and projection for 2030 and 2045: Results from the international diabetes federation diabetes atlas, 9th Edition. Diabetes Res Clin Pract 157: 107843. doi: 10.1016/j.diabres.2019.107843
Setty SG, Crasto W, Jarvis J, Khunti K, Davies MJ (2016) New insulins and newer insulin regimens: A review of their role in improving glycaemic control in patients with diabetes. Postgrad Med J 92: 152-164. doi: 10.1136/postgradmedj-2015-133716
Sievenpiper JL, Chan CB, Dworatzek PD, Freeze C, Williams SL (2018) Nutrition therapy. Can J Diabetes 42: S64-S79. doi: 10.1016/j.jcjd.2017.10.009
Silver B, Ramaiya K, Andrew SB, Fredrick O, Bajaj S, Kalra S, Charlotte BM, Claudine K, Makhoba A (2018) EADSG guidelines: Insulin therapy in diabetes. Diabetes Ther 9: 449-492. doi: 10.1007/s13300-018-0384-6
Sorli C (2014) New developments in insulin therapy for type 2 diabetes. Am J Med 127: S39-S48. doi: 10.1016/j.amjmed.2014.07.006
Stubbs DJ, Levy N, Dhatariya K (2017) Diabetes medication pharmacology. BJA Education 17: 198-207. doi: 10.1093/bjaed/mkw075
Suprapti B, Widyasari N, Rahmadi M, Wibisono C (2017) Review of insulin therapy in type 2 diabetes mellitus ambulatory patients. Indones J Pharm 28: 221-231. doi: 10.14499/indonesianjpharm28iss4pp221
Uusitupa M, Khan TA, Viguiliouk E, Kahleova H, Rivellese AA, Hermansen K, Pfeiffer A, Thanopoulou A, Salas-Salvado J, Schwab U, Sievenpiper JL (2019) Prevention of type 2 diabetes by lifestyle changes: A systematic review and meta-analysis. Nutrients 11: 2611. doi: 10.3390/nu11112611
Wang CY, Neil DL, Home P (2018) 2020 vision – An overview of prospects for diabetes management and prevention in the next decade. Diabetes Res Clin Pract 143: 101-112. doi: 10.1016/j.diabres.2018.06.007
WHO (2019) Classification of diabetes mellitus 2019. World Health Organization, Geneva
Wondafrash DZ, Desalegn TZ, Yimer EM, Tsige AG, Adamu BA, Zewdie KA (2020) Potential effect of hydroxychloroquine in diabetes mellitus: A systematic review on preclinical and clinical trial studies. J Diabetes Res 2020: 5214751. doi: 10.1155/2020/5214751
Wu Y, Ding Y, Tanaka Y, Zhang W (2014) Risk factors contributing to type 2 diabetes and recent advances in the treatment and prevention. Int J Med Sci 11: 1185-1200. doi: 10.7150/ijms.10001
Zierath JR (2019) Major advances and discoveries in diabetes – 2019 in review. Curr Diab Rep 19: 118. doi: 10.1007/s11892-019-1255-x