Scoping Review: Hubungan Kadar HbA1c terhadap Pasien Diabetes Melitus dengan Tuberkulosis

Ahmadillah Firdaus, Gatot Candra Pratama, Mia Yasmina Andarini

Abstract


Abstract. The dual burden of diabetes mellitus (DM) and tuberculosis (TB) is one of the challenges of health problems in the world. DM causes immunosuppression as a result of hyperglycemia conditions that can be monitored with HbA1c levels, where HbA1c levels are directly proportional to blood glucose concentrations. In DM sufferers, phagocytes have known chemotaxis, phagocytosis, and antigen presenting disorders against M. tuberculosis. As a result, M. tuberculosis is easy to infect, causing TB. The purpose of this study was to conduct a literature review to determine how the relationship between HbA1c and DM-TB. Artikel search was conducted from the Springer Link, Science Direct, and Pubmed as databases. The filtering steps for articles follow the PRISMA flow. In the final stage, eligible articles were selected based on patient, intervention, comparison, outcome, and study (PICOS) criteria, namely TBDM patients, assessment of HbA1c levels, influence of HbA1c levels, and the original study. The results of this study obtained nine articles from an initial number of 1,415 journals which showed there was a relationship between HbA1c levels in DM and tuberculosis including: Higher HbA1c levels in DM patients (HbA1c ≥7%) were a risk factor for TB to more easily infected, HbA1c is an independent risk factor for resistance and an important predictor of successful treatment of DM-TB, and high levels of HbA1c can exacerbate infection caused by TB. The conclusion of this study found that there was a relationship between HbA1c levels in DMTB.

Keywords: HbA1c, Diabetes Mellitus, Tuberculosis

Abstrak. Beban penyakit ganda diabetes mellitus (DM) dan tuberkulosis (TB) menjadi salah satu tantangan masalah kesehatan di dunia. penyakit DM menyebabkan kondisi imunosupresi akibat dari kondisi hiperglikemia yang bisa dipantau dengan kadar HbA1c, dimana kadar HbA1c berbanding lurus dengan konsentrasi glukosa darah. Pada penderita DM, diketahui terjadi gangguan kemotaksis, fagositosis, dan antigen presenting oleh fagosit terhadap  bakteri M. tuberculosis. Akibatnya bakteri M. tuberculosis mudah menginfeksi sehingga timbul penyakit TB. Tujuan penelitian ini adalah melakukan literature review untuk mengetahui bagaimana hubungan HbA1c terhadap pasien DM dengan TB. Pencarian artikel dilakukan secara online dari database Springer Link, Science direct, dan Pubmed. Tahapan penyaringan artikel mengikuti alur PRISMA. Pada tahap akhir, artikel yang eligible dipilih berdasarkan kriteria patient, intervention, comparison, outcome, and study (PICOS), yaitu pasien TBDM, penilaian kadar HbA1c, pengaruh kadar HbA1c, dan original study. Hasil penelitian ini mendapatkan sembilan artikel dari jumlah awal 1.415 jurnal yang menunjukkan bahwa terdapat hubungan antara kadar HbA1c terhadap pasien diabetes melitus dengan tuberkulosis diantaranya: kadar HbA1c yang tinggi pada pasien DM (HbA1c ≥7%) menjadi faktor resiko TB untuk lebih mudah menginfeksi, kadar HbA1c merupakan faktor risiko resistensi independent dan faktor prediktor penting untuk keberhasilan pengobatan DM-TB, dan tingginya kadar HbA1c dapat memperparah infeksi yang diakibatkan oleh TB. Kesimpulan dari penelitian ini menemukan bahwa terdapat hubungan kadar HbA1c terhadap pasien DMTB.

Kata kunci: HbA1c, Diabetes Melitus, Tuberkulosis


Keywords


HbA1c, Diabetes Melitus, Tuberkulosis

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DOI: http://dx.doi.org/10.29313/kedokteran.v7i1.26341

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