Hubungan Profil Gula Darah dengan Derajat Keparahan Covid-19 pada Pasien Diabetes Melitus Tipe 2

Abstract

Background: Insulin resistance (IR) may be a potential key factor for COVID-19 severity but in Indonesia itself, there is no data regarding relationship between insulin resistance and COVID-19 severity, especially those using HOMA IR examination. Objective: To determine correlation between insulin resistance and COVID-19 severity in type 2 Diabetes Mellitus patients Methods: This research was a cross-sectional analytic design with prospective data collection from medical records who were hospitalized in isolation room at Haji Adam Malik Hospital Medan from June 2021 – September 2021 on patients diagnosed with COVID-19 with comorbid diabetes mellitus who met inclusion and exclusion criteria. For analysis of insulin resistance based on HOMA-IR score with COVID-19 severity based on clinical manifestations (mild, moderate, severe, and critical), a chi square test was performed and assumed to be significant if p value <0.05. Results: The majority of research subjects had HOMA-IR score >3.8 as many as 35 people, 21 people (60.0%) of whom were severe COVID-19 and 8 people (22.9%) were moderate COVID-19, 6 people (17.1%) were critical degrees COVID-19. The research subjects who had a HOMA-IR score <2.6 as many as 32 people, 24 people (75.0%) of whom were moderate COVID-19, 7 people (21.9%) were severe COVID-19 and 1 person (3.1%) were critical degree COVID-19. The research subjects who had a HOMA-IR score of 2.6-3.8 were 7 people, 4 people (57.1%) of whom were moderate COVID-19, 2 people (28.6%) were severe COVID-19 degrees and 1 person (14.3%) were critical degree COVID-19 Conclusion : There is a significant difference statistically between HOMA-IR score and COVID-19 severity.

Latar Belakang : Resistensi Insulin (IR) mungkin merupakan faktor kunci potensial di balik derajat keparahan COVID-19 namun di Indonesia sendiri, belum ada data mengenai hubungan resistensi insulin terhadap derajat keparahan COVID-19, khususnya yang menggunakan pemeriksaan HOMA IR. Tujuan : Untuk mengetahui hubungan resistensi insulin dengan derajat keparahan COVID-19 pada pasien Diabetes Melitus tipe 2 Metode : Penelitian ini dengan rancangan analitik cross sectional dengan pengambilan data secara prospektif dengan sumber rekam medis yang di rawat inap isolasi RSUP Haji Adam Malik Medan dari bulan Juni 2021 – September 2021 pada pasien yang terdiagnosa COVID-19 dengan komorbid diabetes mellitus yang memenuhi kriteria inklusi dan eksklusi. Untuk analisis resistensi insulin berdasarkan skor HOMA-IR dengan derajat keparahan COVID-19 berdasarkan manifestasi klinis yang muncul (ringan, sedang, berat, dan kritis) dilakukan uji chi square dan dinyatakan bermakna apabila nilai p <0.05. Hasil : Mayoritas subjek penelitian memiliki skor HOMA-IR >3,8 sebanyak 35 orang, 21 orang (60,0%) di antaranya merupakan COVID-19 derajat berat dan 8 orang (22,9%) di antaranya merupakan COVID-19 derajat sedang, 6 orang (17,1%) di antaranya merupakan COVID-19 derajat kritis. Subjek penelitian yang memiliki skor HOMA-IR <2,6 sebanyak 32 orang, 24 orang (75,0%) di antaranya merupakan COVID-19 derajat sedang, 7 orang (21,9%) di antaranya merupakan COVID-19 derajat berat dan 1 orang (3,1%) di antaranya merupakan COVID-19 derajat kritis. Subjek penelitian yang memiliki skor HOMA-IR 2,6-3,8 sebanyak 7 orang, 4 orang (57,1%) diantaranya merupakan COVID-19 derajat sedang, 2 orang (28,6%) di antaranya merupakan COVID-19 derajat berat dan 1 orang (14,3%) di antaranya merupakan COVID-19 derajat kritis Kesimpulan : Terdapat perbedaan yang signifikan antara skor HOMA-IR dengan derajat keparahan COVID-19 secara statistic.