The Analysis of Cardiovascular Disease Risk in Type 2-Diabetes Mellitus and Hypertension Patients Consuming Metformin
Abstract
Increased blood sugar levels indicate a metabolic disease known as diabetes mellitus (DM). DM is often accompanied by hypertension. Antidiabetic therapy that can be used is metformin, either monotherapy or combined with other drugs such as glimepiride. This study aimed to analyze the risk of heart disease based on creatine phosphokinase (CPK) in patients with type 2 DM and hypertension who are taking metformin and a combination of metformin and glimepiride. We conducted an analytic observational using a cross-sectional design and applied a purposive sampling technique. The study subjects were type 2 DM patients with hypertension who met the inclusion criteria. The data analysis used univariate analysis, Mann-Whitney, and Fisher’s. The results showed that women aged 60-75 years old with uncontrolled FBS, duration of DM < 5 years, and high CPL level were dominated by our respondents. We found that there was no difference in CPK values (p=0.916), and there was no relationship between the use of metformin monotherapy or the combination of metformin and glimepiride on the risk of heart disease in type 2 DM patients with hypertension (p=0.693). In conclusion, metformin consumption in type 2 DM patients has no significant association with heart disease risk.
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References
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Mildawati, Diani, N., Wahid, A. 2019. Hubungan Usia, Jenis Kelamin dan Lama Menderita Diabetes dengan Kejadian Neuropati Perifer Diabateik, Caring Nursing Journal, 3(2): 31–37.
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Prasetyo, R.D., Syafri, M., Efrida, E. 2014. Gambaran Kadar Troponin T dan Creatinin Kinase Myocardial Band pada Infark Miokard Akut, Jurnal Kesehatan Andalas, 3(3): 445–449. Crossref.
Putra, I.D.G.I.P., Wirawati, I.A.P., Mahartini, N.N. 2019. Hubungan kadar gula darah dengan hipertensi pada pasien diabetes mellitus tipe 2 di RSUP Sanglah, Intisari Sains Medis, 10(3): 797–800. Crossref.
Romadhon, R., Saibi, Y. Nasir, N.M. 2020. Kepatuhan Terhadap Pengobatan Pasien Diabetes Melitus Tipe 2 di Puskesmas Jakarta Timur, Jurnal Farmasi Galenika (Galenika Journal of Pharmacy) (e-Journal), 6(1): pp. 94–103. Crossref.
Roniawan, H.F., Octaviani D.M.P., Prabandari, R. 2021. Hubungan Kadar Gula Darah Dengan Tekanan Darah Pasien Diabetes Melitus Tipe 2 Di Puskesmas Sokaraja 1, Jurnal Farmasi & Sains Indonesia, 4(2): 74–78. Crossref.
Rosita, R., Kusumaningtiar, D.A., Irfandi, A., Ayu, I.M. 2022. Hubungan Antara Jenis Kelamin, Umur, Dan Aktivitas Fisik Dengan Diabetes Melitus Tipe 2 Pada Lansia Di Puskesmas Balaraja Kabupaten Tangerang’, Jurnal Kesehatan Masyarakat (Undip), 10(3): 364–371. Crossref.
Rumana, N.A., Sitoayu, L., SA’pang, M. 2018. Korelasi Kadar Gula Darah Puasa Terhadap Kualitas Hidup Pasien Diabetes Melitus Type 2 di Puskesmas Jakarta Barat Tahun 2018, Indonesian of Health Information Management Journal, 6(2): 41-46. Crossref.
Sari, G.P., Samekto, M., Adi, M.S. 2017. Faktor-faktor yang Berpengaruh terhadap Terjadinya Hipertensi pada Penderita Diabetes Melitus Tipe II (Studi di Wilayah Puskesmas Kabupaten Pati), Jurnal Litbang: Media Informasi Penelitian, Pengembangan dan IPTEK, 13(1): 47–59. Crossref.
Suciana, Hengky, H.K., Usman. 2021. Analisis Faktor Risiko Penyakit Jantung Korener Pada Penderita Diabetes Melitus Tipe 2 Di Rsud Andi Makkasau Kota Parepare, Jurnal Ilmiah Manusia Dan Kesehatan, 4(2): 254–265. Available at: Crossref.
Suherwin, S. 2018. Hubungan Usia, Jenis Kelamin dan Riwayat Penyakit Dengan Kejadian Penyakit Jantung Koroner Di Instalasi Gawat Darurat Rumahsakit Tk.II Dr. Ak. Gani Palembang Tahun 2016, Jurnal ’Aisyiyah Medika, 1(1): 89–97. Crossref.
Triastuti, N., Irawati, D.N., Levani, Y., Lestari, R.D. 2020. Faktor yang Mempengaruhi Tingkat Kepatuhan Konsumsi Obat Antidiabetes Oral pada Pasien Diabetes Melitus Tipe 2 di RSUD Kabupaten Jombang, Medica Arteriana (Med-Art), 2(1): 27. Crossref.
WHO. 2021. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants, World Health Organization, 398(10304): 957–980. Crossref.
Yulia, D., Miro, S., Kamil, Z.I. 2022. Gambaran Kadar Glukosa Darah Puasa dan D-dimer pada Pasien Diabetes Tipe 2 Terkontrol, Jurnal Ilmu Kesehatan Indonesia, 3(1): 1–7. Crossref.
Yuliani, F., Oenzil, F., Iryani, D. 2014. Hubungan Berbagai Faktor Risiko Terhadap Kejadian Penyakit Jantung Koroner Pada Penderita Diabetes Melitus Tipe 2, Jurnal Kesehatan Andalas, 3(1): 37–40. Crossref.
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Apriliany, F., Cholisah, E. and Erlianti, K. 2022. Efek Pemberian Metformin dan Metformin+ Glimepiride terhadap Kadar HbA1c pada Pasien Diabetes Mellitus Tipe 2, Jurnal Manajemen Dan Pelayanan Farmasi (Journal of Management and Pharmacy Practice), 12(2): 97–106. Crossref.
Ariadi, A., Jamsari, J., Yanwirasti, Y., Siregar, M.F.G., Yusrawati, Y. 2019. Correlation between Estrogen Levels with Lipid Profile in Menopause Women in West Sumatera, Open Access Macedonian Journal of Medical Sciences. 7(13): 2084-2087. Crossref.
Aujla, R.S. and Patel, R. 2022. Creatine Phosphokinase, in StatPearls. StatPearls Publishing. Crossref.
Basnet, S., Kozikowski, A., Makaryus, A.N., Pekmezaris, R., Zeltser, R. Akerman, M., Lesser, M. Wolf-Klein, G. 2015. Metformin and myocardial injury in patients With diabetes and ST-segment elevation myocardial infarction: A propensity score matched analysis, Journal of the American Heart Association, 4(10): e002314. Crossref.
Charisma, A.M. 2017. Korelasi Kadar Rata-rata Glukosa Darah Puasa dan 2 jam Post Prondial Tiga Bulan Terakhir Dengan Nilai HbA1C Pada Pasien Diabetes melitus Prolanis BPJS Kabupaten Kediri Periode Mei-Agustus 2017, J. Kesehat. Masy. Indones, 12(2): 1–11.
Dinas Kesehatan DIY. 2020. Profil Kesehatan D.I Yogyakarta tahun 2020. Jakarta: Dinas Kesehatan DIY.
Dipiro, J.T., Wells, B. G., Schwinghammer, T. L., & DiPiro, C. V. 2015. Pharmacoterapy A Phatophysiologic Approach, United State: McGraw-Hill Education.
Febriani, R. and Fitri, M. 2020. Analisis Kejadian Hipertensi Pada Lansia Dengan Diabetes Melitus, Jurnal ’Aisyiyah Medika, 4(3): 265–273. Crossref.
Goldberg, R.B., Orchard, T.J., Crandall, J.P., Boyko, E.J., Budoff, M., Dabelea, D., Gadde, K.M., Knowler, W.C., Lee, C.G., Nathan, D.M., Watson, K., Temprosa, M. 2022. Effects of Long-term Metformin and Lifestyle Interventions on Cardiovascular Events in the Diabetes Prevention Program and Its Outcome Study, Circulation, 145(22): 1632–1641. Crossref.
Goyal, R. and Jialal, I. 2022. Diabetes Mellitus Type 2 - StatPearls - NCBI Bookshelf, in StatPearls. Available at: Crossref.
Han, Y., Xie, H., Liu, Y., Gao, P., Yang, X., Shen, Z. 2019. Effect of metformin on all-cause and cardiovascular mortality in patients with coronary artery diseases: A systematic review and an updated meta- analysis, Cardiovascular Diabetology, 18(1): 1–16. Crossref.
Hardianto, D. 2021. Telaah Komprehensif Diabetes Melitus: Klasifikasi, Gejala, Diagnosis, Pencegahan, Dan Pengobatan, Jurnal Bioteknologi & Biosains Indonesia (JBBI), 7(2): 304–317. Crossref.
Hassan, M.H. and Abd-Allah, G.M. 2015. Effects of metformin plus gliclazide versus metformin plus glimepiride on cardiovascular risk factors in patients with type 2 diabetes mellitus, Pak J Pharm Sci., 28(5); 1723–1730.
Husni, H., Wahyudin, E., Kasim, H. 2022. Hubungan Tekanan Darah Sistolik dengan Kadar HBa1c pada Pasien Hipertensi dan Diabetes Melitus Type 2 di RS Unhas Makassar, Majalah Farmasi dan Farmakologi, 26(2): 84–87. Crossref.
IDF (2021) Type 2 diabetes, International Diabetes Federation. Available at: https://www.idf.org/aboutdiabetes/type-2- diabetes.html (Accessed: 21 May 2023).
Jacob, R. and Khan, M. 2018. Cardiac Biomarkers: What Is and What Can Be, Indian journal of cardiovascular disease in women WINCARS, 3(4): 240-244. Crossref.
Lee, J.A., Rotty, L., Wantania, F.E. 2015. Profil Lipid Pada Pasien Dengan Penyakit Jantung Koroner Di Blu Rsup Prof. Dr. R. D. Kandou Tahun 2012, e-CliniC, 3(1). Crossref.
Mildawati, Diani, N., Wahid, A. 2019. Hubungan Usia, Jenis Kelamin dan Lama Menderita Diabetes dengan Kejadian Neuropati Perifer Diabateik, Caring Nursing Journal, 3(2): 31–37.
Milita, F., Handayani, S., Setiaji, B., 2021. Kejadian Diabetes Mellitus Tipe II pada Lanjut Usia di Indonesia (Analisis Riskesdas 2018 ), Jurnal Kedokteran dan Kesehatan, 17(1): 9–20. Crossref.
Nanda, O.D., Wiryanto, B., Triyono, E.A. 2018. Hubungan Kepatuhan Minum Obat Anti Diabetik dengan Regulasi Kadar Gula Darah pada Pasien Perempuan Diabetes Mellitus, Amerta Nutrition, 2(4): 340. Crossref.
PERKENI. 2021. Pedoman Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 Dewasa di Indonesia 2021. Jakarta: PB Perkeni.
Poluan, O.A., Wiyono, W.I., Yamlean, P.V.Y. 2020. Identifikasi Potensi Reaksi Obat pada Pasien Diabetes Melitus Tipe 2 Rawat Inap di Rumah Sakit Gunung Maria Tomohon Periode Januari-Mei 2018,Pharmacon, 9(1): 38–46. Crossref.
Prasetyo, R.D., Syafri, M., Efrida, E. 2014. Gambaran Kadar Troponin T dan Creatinin Kinase Myocardial Band pada Infark Miokard Akut, Jurnal Kesehatan Andalas, 3(3): 445–449. Crossref.
Putra, I.D.G.I.P., Wirawati, I.A.P., Mahartini, N.N. 2019. Hubungan kadar gula darah dengan hipertensi pada pasien diabetes mellitus tipe 2 di RSUP Sanglah, Intisari Sains Medis, 10(3): 797–800. Crossref.
Romadhon, R., Saibi, Y. Nasir, N.M. 2020. Kepatuhan Terhadap Pengobatan Pasien Diabetes Melitus Tipe 2 di Puskesmas Jakarta Timur, Jurnal Farmasi Galenika (Galenika Journal of Pharmacy) (e-Journal), 6(1): pp. 94–103. Crossref.
Roniawan, H.F., Octaviani D.M.P., Prabandari, R. 2021. Hubungan Kadar Gula Darah Dengan Tekanan Darah Pasien Diabetes Melitus Tipe 2 Di Puskesmas Sokaraja 1, Jurnal Farmasi & Sains Indonesia, 4(2): 74–78. Crossref.
Rosita, R., Kusumaningtiar, D.A., Irfandi, A., Ayu, I.M. 2022. Hubungan Antara Jenis Kelamin, Umur, Dan Aktivitas Fisik Dengan Diabetes Melitus Tipe 2 Pada Lansia Di Puskesmas Balaraja Kabupaten Tangerang’, Jurnal Kesehatan Masyarakat (Undip), 10(3): 364–371. Crossref.
Rumana, N.A., Sitoayu, L., SA’pang, M. 2018. Korelasi Kadar Gula Darah Puasa Terhadap Kualitas Hidup Pasien Diabetes Melitus Type 2 di Puskesmas Jakarta Barat Tahun 2018, Indonesian of Health Information Management Journal, 6(2): 41-46. Crossref.
Sari, G.P., Samekto, M., Adi, M.S. 2017. Faktor-faktor yang Berpengaruh terhadap Terjadinya Hipertensi pada Penderita Diabetes Melitus Tipe II (Studi di Wilayah Puskesmas Kabupaten Pati), Jurnal Litbang: Media Informasi Penelitian, Pengembangan dan IPTEK, 13(1): 47–59. Crossref.
Suciana, Hengky, H.K., Usman. 2021. Analisis Faktor Risiko Penyakit Jantung Korener Pada Penderita Diabetes Melitus Tipe 2 Di Rsud Andi Makkasau Kota Parepare, Jurnal Ilmiah Manusia Dan Kesehatan, 4(2): 254–265. Available at: Crossref.
Suherwin, S. 2018. Hubungan Usia, Jenis Kelamin dan Riwayat Penyakit Dengan Kejadian Penyakit Jantung Koroner Di Instalasi Gawat Darurat Rumahsakit Tk.II Dr. Ak. Gani Palembang Tahun 2016, Jurnal ’Aisyiyah Medika, 1(1): 89–97. Crossref.
Triastuti, N., Irawati, D.N., Levani, Y., Lestari, R.D. 2020. Faktor yang Mempengaruhi Tingkat Kepatuhan Konsumsi Obat Antidiabetes Oral pada Pasien Diabetes Melitus Tipe 2 di RSUD Kabupaten Jombang, Medica Arteriana (Med-Art), 2(1): 27. Crossref.
WHO. 2021. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants, World Health Organization, 398(10304): 957–980. Crossref.
Yulia, D., Miro, S., Kamil, Z.I. 2022. Gambaran Kadar Glukosa Darah Puasa dan D-dimer pada Pasien Diabetes Tipe 2 Terkontrol, Jurnal Ilmu Kesehatan Indonesia, 3(1): 1–7. Crossref.
Yuliani, F., Oenzil, F., Iryani, D. 2014. Hubungan Berbagai Faktor Risiko Terhadap Kejadian Penyakit Jantung Koroner Pada Penderita Diabetes Melitus Tipe 2, Jurnal Kesehatan Andalas, 3(1): 37–40. Crossref.
Authors
Sari, T. M. F. I., Gollumawo, S. S. D., Co’o, M. D., Virginia, D. M., Hendra, P. and Pramono, Z. D. (2024) “The Analysis of Cardiovascular Disease Risk in Type 2-Diabetes Mellitus and Hypertension Patients Consuming Metformin”, Farmasains : Jurnal Ilmiah Ilmu Kefarmasian, 11(1), pp. 1–11. doi: 10.22236/farmasains.v11i1.13057.
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