Pengaruh Puguntano terhadap HOMA-IR Pada Pasien Diabetes Melitus yang Baru Didiagnosis

Abstract

Resistensi insulin sangat penting pada diabetes melitus sebagai prediktor yang kuat terhadap perkembangan diabetes melitus dan target terapi saat hiperglikemia sudah terjadi. HOMA-IR merupakan suatu metode yang telah tervalidasi dalam menilai resistensi insulin pada pasien diabetes melitus. Puguntano suatu tanaman budidaya yang terdapat di Sumatra Utara diketahui memiliki efek antidiabetes. Sampel diambil dari tahun 2015-2016 di Rumah Sakit Haji Adam Malik Medan. Studi ini mencoba menilai pengaruh puguntano sebagai tanaman budidaya di Sumatera Utara terhadap resistensi insulin pada pasien Diabetes Melitus tipe 2. Untuk mengetahui pengaruh pemberian serbuk puguntano terhadap HOMA-IR pada pasien DM tipe 2 yang baru didiagnosis. Dilakukan uji klinis terbuka dengan desain paralel selama 12 minggu pada 24 pasien (12 pasien dan 12 kontrol) Diabetes Mellitus tipe 2 yang baru terdiagnosa  yang dibagi dalam 2 grup masing-masing diberikan puguntano dan metformin selama 12 minggu. HOMA-IR dan HbA1c diperiksa pada awal dan akhir pengobatan (minggu ke 12). Didapatkan penurunan HOMA-IR rata-rata pada grup puguntano 1,71 (±2,29) (p=0,034). Tidak didapatkan perbedaan penurunan HOMA-IR rata-rata antara kedua grup puguntano vs metformin 1.71 (±2,29) vs 0,80 (±1,47) (p=0,402). Didapatkan penurunan nilai HOMA-IR dengan pemberian puguntano pada penderita Diabetes Mellitus tipe 2 yang baru didiagnosis. Simpulan, efek puguntano dalam mengontrol gula darah terutama dalam perannya memperbaiki sensitifitas insulin tidak jauh berbeda dengan metformin yang telah menjadi obat standar dalam pengobatan lini pertama diabetes melitus tipe 2. [MKB. 2017;49(2):67–72]
 
Kata kunci: Diabetes melitus, HOMA-IR, puguntano
 
 
Effect of Puguntano on HOMA-IR in Newly Diagnosed Type 2 Diabetes Mellitus
 
Insulin resistance is important not only as a powerful predictor of future development of type 2 diabetes mellitus but also as a therapeutic target once hyperglycemia is present. HOMA-IR is a method for assessing insulin resistance that has been validated worldwide. Puguntano is one of the traditional plants found in North Sumatera that has been recognized for its anti-diabetic effect. Samples were taken from 2015–2016 at H. Adam Malik General Hospital Medan. This study tried to assess the effect of puguntano as a traditional plant in North Sumatera on insulin resistance in type 2 diabetes melitus patients and aimed to determine the effect of puguntano treatment on HOMA-IR in newly diagnosed type 2 diabetes mellitus patients. This was a randomized open clinical trial on 24 newly diagnosed type 2 diabetes mellitus patients (12 patients and 12 controls) divided into 2 groups who were assigned to receive  puguntano or Metformin for 12 weeks. HOMA-IR and Hba1c were determined at baseline and at the end of 12 weeks. In puguntano group, the mean decrease of HOMA-IR was 1.71 (± 2.29) (p=0.034). There was no difference in terms of the mean decrease of HOMA-IR between the puguntano and Metformin group, which was 1.71 (±2.29) vs 0.80 (±1.47) (p=0.402). There was a decrease mean of HOMA-IR level with puguntano treatment in newly diagnosed type 2 diabetes mellitus patients which was statistically significant. In conclusions, the effect of puguntano in controlling blood sugar especially in its role of improving insulin sensitivity is not much different from metformin which has become a standard drug in the first-line treatment of type 2 diabetes mellitus. [MKB. 2017;49(2):67–72]
 
Key words: Diabetes mellitus, HOMA-IR, puguntano