Gambaran Penggunaan Insulin dan Metformin pada Diabetes Mellitus Gestasional-Literature Review
Keywords:
Diabetes mellitus gestasional, insulin, metformin
Abstract
Diabetes Mellitus Gestasional (DMG) merupakan suatu gangguan intoleransi glukosa pada masa kehamilan. Terapi farmakologi yang umumnya diberikan yaitu Insulin dan obat hipoglikemik oral seperti metformin. Metformin sering digunakan pada pengobatan DMG saat ini. Metformin dapat melewati barrier plasenta, namun belum ditemukan adanya bukti kecacatan pada janin atau komplikasi pada bayi. Banyak penelitian melakukan uji coba untuk membandingkan efektivitas dan keamaan metformin pada ibu hamil. Tujuan review artikel ini yaitu untuk mengulas beberapa literature terkait efektivitas dan efisiensi penggunaan obat metformin yang dibandingkan dengan insulin pada DMG. Metode yang digunakan yaitu literature review dengan menggunakan data primer berupa artikel ilmiah atau jurnal, dilakukan penelusuran melalui database Google Scholar, Elsevier, atau PubMed dengan rentang tahun terbit 5 tahun terakhir. Hasil dari review artikel ilmiah menunjukan bahwa insulin tidak menjadi pilihan utama pada pengobatan DMG karena dapat menyebabkan peningkatan berat badan sedangkan penggunaan metformin lebih banyak digunakan. Kesimpulan dari review ini menunjukan tidak terdapat perbedaan efektivitas dalam penggunaan terapi insulin dan metformin dalam menurunkan kadar gula darah pasien DMG. Penggunaan metformin lebih efisien karena tidak menimbulkan kenaikan berat badan dan mengurangi risiko makrosomia dan neonatal hipoglikemia.
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References
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Anisya, Kharina, Robiyanto, Robiyanto, & Nurmainah, Nurmainah. (2019). Profil Penggunaan Antidiabetik pada Pasien Diabetes Melitus Gestasional di Puskesmas Wilayah Kecamatan Pontianak Kota. Indonesian Journal of Clinical Pharmacy, 8(1). https://doi.org/10.15416/ijcp.2019.8.1.72
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Aulia, Dila, Rodiani, & Graharti, Risti. (2019). Hubungan Diabetes Melitus dengan Kejadian Preeklampsia di RSUD DR . H . Relationship between Diabetes Mellitus with The Incidence of Preeclampsia in RSUD DR . H . Abdul Moeloek Lampung on The Period. 8, 180–186.
Beyuo, Titus, Obed, Samuel Amenyi, Adjepong-Yamoah, Kenneth Kweku, Bugyei, Kwasi Agyei, Oppong, Samuel Antwi, & Marfoh, Kissinger. (2015). Metformin versus insulin in the management of pre-gestational diabetes mellitus in pregnancy and gestational diabetes mellitus at the Korle Bu Teaching Hospital:A randomized clinical trial. PLoS ONE, 10(5), 1–10. https://doi.org/10.1371/journal.pone.0125712
Blumer, Ian, Hadar, Eran, Hadden, David R., JovanoviÄ, Lois, Mestman, Jorge H., Murad, M. Hassan, & Yogev, Yariv. (2013). Diabetes and pregnancy: An endocrine society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism, 98(11), 4227–4249. https://doi.org/10.1210/jc.2013-2465
Budi W, Guntur, Sriami, & Fauziah, Rizka. (2020). Ibu Diabetes Mellitus Gestational ( Dmg ) Dengan Hipoglikemia Neonatorum Guntur Budi W ., Sriami , Riska Fauziyah Jurusan Kebidanan Poltekkes Kemenkes Surabaya Alamat E-mail : Jurnal Penelitian Kesehatan Jurnal Penelitian Kesehatan. 05, 130–136.
Buschur, Elizabeth, Brown, Florence, & Wyckoff, Jennifer. (2015). Using Oral Agents to Manage Gestational Diabetes: What Have We Learned? Current Diabetes Reports, 15(2). https://doi.org/10.1007/s11892-014-0570-5
Chyad, Mohammed, & Faris Shalayel, Mohammed Helmy. (2011). Pathophysiology of Gestational Diabetes Mellitus: The Past, the Present and the Future. Gestational Diabetes. https://doi.org/10.5772/24315
Cunningham, F. Gary, Leveno, K. J., Bloom, S. L., Hauth, J. C., Rouse, D. J., & Spong, C. Y. (2010). Williams Obstetric 23rd Edition. United States: The McGraw-Hill Companies Inc.
DiPiro, Joseph T., Yee, Gary C., Posey, L. Michael, Haines, Stuart T., Nolin, Thomas D., & Ellingrod, Vicki. (2020). Pharmacotherapy: A Pathophysiologic Approach, Eleventh Edition. Mc-Graw Hill.
Dipiro, Joseph T., Talbert, Robert L., Yee, Gary C., Matzke, Gary R., Wells, Barbara G., & Posey, L. Michael. (2014). Pharmacotherapy: A Pathophysiologic Approach, ed. McGraw-Hill Medical, New York.
Feig, Denice S., Murphy, Kellie, Szwiega, Krystyna, et al. (2016). Metformin in women with type 2 diabetes in pregnancy (MiTy): A multi-center randomized controlled trial. BMC Pregnancy and Childbirth, 16(1), 1–8. https://doi.org/10.1186/s12884-016-0954-4
Galal, Mohammad, El Bassiou, Walaa Mohammad, & Sherif, Lobna. (2019). Metformin Versus Insulin in Treatment of Gestational Diabetes Mellitus: A Randomized Controlled Trial. Research Journal of Obstetrics and Gynecology, 12(1), 23–27. https://doi.org/10.3923/rjog.2019.23.27
Gante, Inês, Melo, LuÃs, Dores, Jorge, Ruas, LuÃsa, & Do Céu Almeida, Maria. (2018). Metformin in gestational diabetes mellitus: Predictors of poor response. European Journal of Endocrinology, 178(1), 129–135. https://doi.org/10.1530/EJE-17-0486
Ghomian, Nayereh, Vahed, Seyede Houra Mousavi, Firouz, Samaneh, Yaghoubi, Mohammad Ali, Mohebbi, Masoud, & Sahebkar, Amirhossein. (2019). The efficacy of metformin compared with insulin in regulating blood glucose levels during gestational diabetes mellitus: A randomized clinical trial. Journal of Cellular Physiology, 234(4), 4695–4701. https://doi.org/10.1002/jcp.27238
Goh, J. E. L., Sadler, L., & Rowan, J. (2011). Metformin for gestational diabetes in routine clinical practice. Diabetic Medicine, 28(9), 1082–1087. https://doi.org/10.1111/j.1464-5491.2011.03361.x
Hajagos-Tóth, Judit, Ducza, Eszter, Samavati, Reza, Vari, Sandor G., & Gaspar, Robert. (2017). Obesity in pregnancy: A novel concept on the roles of adipokines in uterine contractility. Croatian Medical Journal, 58(2), 96–104. https://doi.org/10.3325/cmj.2017.58.96
Imron, Riyanti, & Nurulicha, Nurulicha. (2020). Faktor - Faktor Yang Berhubungan Dengan Kejadian Ruptur Perineum Pada Ibu Bersalin. Jurnal Kesehatan, 7(2), 815–820. https://doi.org/10.38165/jk.v7i2.124
Malin, Steven K., & Kashyap, Sangeeta R. (2014). Effects of metformin on weight loss: potential mechanisms. Current Opinion in Endocrinology, Diabetes, and Obesity, 21(5), 323–329. https://doi.org/10.1097/MED.0000000000000095
Marie Chisholm-Burns, Schwinghammer, Terry, Malone, Patrick, Kolesar, Jill, Lee, Kelly C., & Bookstaver, P. Brandon. (2019). Pharmacotherapy Principles and Practice, Fifth Edition 5th Edition. New York: Mc Graw-Hill Companies.
Mohammed, Ali Abd Al latif G., Al-aaragi, Ali Neamah Hasan, & Merzah, Mohammed Abdulridha. (2018). Knowledge , Attitude , and Practice Regarding Diabetic Mellitus among a Sample of Students at Technical Institute of Karbala. Medical Journal of Babylon, 15(2), 164–168. https://doi.org/10.4103/MJBL.MJBL
Najafian, Mahin, Barati, Mojgan, Masihi, Sara, Fardipor, Ailin, & Shajirat, Zeinab. (2017). Investigation the Effects of Metformin versus Insulin on Neonatal and Maternal Outcomes in Women with Gestational Diabetes Mellitus : A Randomized Clinical Trail. Global Journal Of Health Science, 9(4), 272–278. https://doi.org/10.5539/gjhs.v9n4p272
Pazzagli, Laura, Abdi, Lamya, Kieler, Helle, & Cesta, Carolyn E. (2020). Metformin versus insulin use for treatment of gestational diabetes and delivery by caesarean section: A nationwide Swedish cohort study. European Journal of Obstetrics and Gynecology and Reproductive Biology, 254(September), 271–276. https://doi.org/10.1016/j.ejogrb.2020.09.037
Perkeni. (2019). Pedoman pengelolaan dan pencegahan diabetes melitus tipe 2 dewasa di Indonesia 2019. Perkumpulan Endokrinologi Indonesia, 1–117.
Rahayu, Anita, & Rodiani. (2016). Efek Diabetes Melitus Gestasional terhadap Kelahiran Bayi Makrosomia. Majority, 5(4), 17–22.
Riskesdas, Kemenkes. (2018). Hasil Utama Riset Kesehata Dasar (RISKESDAS). Journal of Physics A: Mathematical and Theoretical, 44(8), 1–200. https://doi.org/10.1088/1751-8113/44/8/085201
Saleh, Hend S., Abdelsalam, Walid A., Mowafy, Hala E., & Elhameid, Azza A. Abd. (2016). Could Metformin Manage Gestational Diabetes Mellitus instead of Insulin? International Journal of Reproductive Medicine, 2016. https://doi.org/https://doi.org/10.1155/2016/3480629
Shamsi, Uzma, Hatcher, Juanita, Shamsi, Azra, Zuberi, Nadeem, Qadri, Zeeshan, & Saleem, Sarah. (2010). A multicentre matched case control study of risk factors for Preeclampsia in healthy women in Pakistan. BMC Women’s Health, 10. https://doi.org/10.1186/1472-6874-10-14
Simmons, David. (2010). Metformin treatment for type 2 diabetes in pregnancy? Best Practice and Research: Clinical Endocrinology and Metabolism, 24(4), 625–634. https://doi.org/10.1016/j.beem.2010.05.002
Sun, Yi Ying, Juan, Juan, Xu, Qian Qian, Su, Ri Na, Hirst, Jane E., & Yang, Hui Xia. (2020). Increasing insulin resistance predicts adverse pregnancy outcomes in women with gestational diabetes mellitus. Journal of Diabetes, 12(6), 438–446. https://doi.org/10.1111/1753-0407.13013
Wasim, Tayyiba, Shaukat, Shysta, Javaid, Lubna, Mukhtar, Saima, & Amer, Wasim. (2019). Comparison of metformin and insulin for management of gestational diabetes mellitus: A randomized control trial. Pakistan Journal of Medical and Health Sciences, 13(3), 823–827.
Wibawa, I. Made Bagus Cahya, Putra, Agus Indra Yudhistira Diva, & Tandiono, Erick Kusuma. (2018). Potensi Curcumin dalam Ekstrak Rimpang Kunyit (Curcumma Domestica L.) sebagai Modalitas Pencegahan Preeklamsia pada Ibu Hamil. Essence of Scientific Medical Journal, 16(2), 38–42.
American Diabetes Association. (2020). Management of diabetes in pregnancy: Standards of medical care in diabetes-2020. Diabetes Care, 43(January), S183–S192. https://doi.org/10.2337/dc20-S014
Anisya, Kharina, Robiyanto, Robiyanto, & Nurmainah, Nurmainah. (2019). Profil Penggunaan Antidiabetik pada Pasien Diabetes Melitus Gestasional di Puskesmas Wilayah Kecamatan Pontianak Kota. Indonesian Journal of Clinical Pharmacy, 8(1). https://doi.org/10.15416/ijcp.2019.8.1.72
Ashoush, Sherif, El-Said, Mourrad, Fathi, Hisham, & Abdelnaby, Mohamed. (2016). Identification of metformin poor responders, requiring supplemental insulin, during randomization of metformin versus insulin for the control of gestational diabetes mellitus. Journal of Obstetrics and Gynaecology Research, 42(6), 640–647. https://doi.org/10.1111/jog.12950
Aulia, Dila, Rodiani, & Graharti, Risti. (2019). Hubungan Diabetes Melitus dengan Kejadian Preeklampsia di RSUD DR . H . Relationship between Diabetes Mellitus with The Incidence of Preeclampsia in RSUD DR . H . Abdul Moeloek Lampung on The Period. 8, 180–186.
Beyuo, Titus, Obed, Samuel Amenyi, Adjepong-Yamoah, Kenneth Kweku, Bugyei, Kwasi Agyei, Oppong, Samuel Antwi, & Marfoh, Kissinger. (2015). Metformin versus insulin in the management of pre-gestational diabetes mellitus in pregnancy and gestational diabetes mellitus at the Korle Bu Teaching Hospital:A randomized clinical trial. PLoS ONE, 10(5), 1–10. https://doi.org/10.1371/journal.pone.0125712
Blumer, Ian, Hadar, Eran, Hadden, David R., JovanoviÄ, Lois, Mestman, Jorge H., Murad, M. Hassan, & Yogev, Yariv. (2013). Diabetes and pregnancy: An endocrine society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism, 98(11), 4227–4249. https://doi.org/10.1210/jc.2013-2465
Budi W, Guntur, Sriami, & Fauziah, Rizka. (2020). Ibu Diabetes Mellitus Gestational ( Dmg ) Dengan Hipoglikemia Neonatorum Guntur Budi W ., Sriami , Riska Fauziyah Jurusan Kebidanan Poltekkes Kemenkes Surabaya Alamat E-mail : Jurnal Penelitian Kesehatan Jurnal Penelitian Kesehatan. 05, 130–136.
Buschur, Elizabeth, Brown, Florence, & Wyckoff, Jennifer. (2015). Using Oral Agents to Manage Gestational Diabetes: What Have We Learned? Current Diabetes Reports, 15(2). https://doi.org/10.1007/s11892-014-0570-5
Chyad, Mohammed, & Faris Shalayel, Mohammed Helmy. (2011). Pathophysiology of Gestational Diabetes Mellitus: The Past, the Present and the Future. Gestational Diabetes. https://doi.org/10.5772/24315
Cunningham, F. Gary, Leveno, K. J., Bloom, S. L., Hauth, J. C., Rouse, D. J., & Spong, C. Y. (2010). Williams Obstetric 23rd Edition. United States: The McGraw-Hill Companies Inc.
DiPiro, Joseph T., Yee, Gary C., Posey, L. Michael, Haines, Stuart T., Nolin, Thomas D., & Ellingrod, Vicki. (2020). Pharmacotherapy: A Pathophysiologic Approach, Eleventh Edition. Mc-Graw Hill.
Dipiro, Joseph T., Talbert, Robert L., Yee, Gary C., Matzke, Gary R., Wells, Barbara G., & Posey, L. Michael. (2014). Pharmacotherapy: A Pathophysiologic Approach, ed. McGraw-Hill Medical, New York.
Feig, Denice S., Murphy, Kellie, Szwiega, Krystyna, et al. (2016). Metformin in women with type 2 diabetes in pregnancy (MiTy): A multi-center randomized controlled trial. BMC Pregnancy and Childbirth, 16(1), 1–8. https://doi.org/10.1186/s12884-016-0954-4
Galal, Mohammad, El Bassiou, Walaa Mohammad, & Sherif, Lobna. (2019). Metformin Versus Insulin in Treatment of Gestational Diabetes Mellitus: A Randomized Controlled Trial. Research Journal of Obstetrics and Gynecology, 12(1), 23–27. https://doi.org/10.3923/rjog.2019.23.27
Gante, Inês, Melo, LuÃs, Dores, Jorge, Ruas, LuÃsa, & Do Céu Almeida, Maria. (2018). Metformin in gestational diabetes mellitus: Predictors of poor response. European Journal of Endocrinology, 178(1), 129–135. https://doi.org/10.1530/EJE-17-0486
Ghomian, Nayereh, Vahed, Seyede Houra Mousavi, Firouz, Samaneh, Yaghoubi, Mohammad Ali, Mohebbi, Masoud, & Sahebkar, Amirhossein. (2019). The efficacy of metformin compared with insulin in regulating blood glucose levels during gestational diabetes mellitus: A randomized clinical trial. Journal of Cellular Physiology, 234(4), 4695–4701. https://doi.org/10.1002/jcp.27238
Goh, J. E. L., Sadler, L., & Rowan, J. (2011). Metformin for gestational diabetes in routine clinical practice. Diabetic Medicine, 28(9), 1082–1087. https://doi.org/10.1111/j.1464-5491.2011.03361.x
Hajagos-Tóth, Judit, Ducza, Eszter, Samavati, Reza, Vari, Sandor G., & Gaspar, Robert. (2017). Obesity in pregnancy: A novel concept on the roles of adipokines in uterine contractility. Croatian Medical Journal, 58(2), 96–104. https://doi.org/10.3325/cmj.2017.58.96
Imron, Riyanti, & Nurulicha, Nurulicha. (2020). Faktor - Faktor Yang Berhubungan Dengan Kejadian Ruptur Perineum Pada Ibu Bersalin. Jurnal Kesehatan, 7(2), 815–820. https://doi.org/10.38165/jk.v7i2.124
Malin, Steven K., & Kashyap, Sangeeta R. (2014). Effects of metformin on weight loss: potential mechanisms. Current Opinion in Endocrinology, Diabetes, and Obesity, 21(5), 323–329. https://doi.org/10.1097/MED.0000000000000095
Marie Chisholm-Burns, Schwinghammer, Terry, Malone, Patrick, Kolesar, Jill, Lee, Kelly C., & Bookstaver, P. Brandon. (2019). Pharmacotherapy Principles and Practice, Fifth Edition 5th Edition. New York: Mc Graw-Hill Companies.
Mohammed, Ali Abd Al latif G., Al-aaragi, Ali Neamah Hasan, & Merzah, Mohammed Abdulridha. (2018). Knowledge , Attitude , and Practice Regarding Diabetic Mellitus among a Sample of Students at Technical Institute of Karbala. Medical Journal of Babylon, 15(2), 164–168. https://doi.org/10.4103/MJBL.MJBL
Najafian, Mahin, Barati, Mojgan, Masihi, Sara, Fardipor, Ailin, & Shajirat, Zeinab. (2017). Investigation the Effects of Metformin versus Insulin on Neonatal and Maternal Outcomes in Women with Gestational Diabetes Mellitus : A Randomized Clinical Trail. Global Journal Of Health Science, 9(4), 272–278. https://doi.org/10.5539/gjhs.v9n4p272
Pazzagli, Laura, Abdi, Lamya, Kieler, Helle, & Cesta, Carolyn E. (2020). Metformin versus insulin use for treatment of gestational diabetes and delivery by caesarean section: A nationwide Swedish cohort study. European Journal of Obstetrics and Gynecology and Reproductive Biology, 254(September), 271–276. https://doi.org/10.1016/j.ejogrb.2020.09.037
Perkeni. (2019). Pedoman pengelolaan dan pencegahan diabetes melitus tipe 2 dewasa di Indonesia 2019. Perkumpulan Endokrinologi Indonesia, 1–117.
Rahayu, Anita, & Rodiani. (2016). Efek Diabetes Melitus Gestasional terhadap Kelahiran Bayi Makrosomia. Majority, 5(4), 17–22.
Riskesdas, Kemenkes. (2018). Hasil Utama Riset Kesehata Dasar (RISKESDAS). Journal of Physics A: Mathematical and Theoretical, 44(8), 1–200. https://doi.org/10.1088/1751-8113/44/8/085201
Saleh, Hend S., Abdelsalam, Walid A., Mowafy, Hala E., & Elhameid, Azza A. Abd. (2016). Could Metformin Manage Gestational Diabetes Mellitus instead of Insulin? International Journal of Reproductive Medicine, 2016. https://doi.org/https://doi.org/10.1155/2016/3480629
Shamsi, Uzma, Hatcher, Juanita, Shamsi, Azra, Zuberi, Nadeem, Qadri, Zeeshan, & Saleem, Sarah. (2010). A multicentre matched case control study of risk factors for Preeclampsia in healthy women in Pakistan. BMC Women’s Health, 10. https://doi.org/10.1186/1472-6874-10-14
Simmons, David. (2010). Metformin treatment for type 2 diabetes in pregnancy? Best Practice and Research: Clinical Endocrinology and Metabolism, 24(4), 625–634. https://doi.org/10.1016/j.beem.2010.05.002
Sun, Yi Ying, Juan, Juan, Xu, Qian Qian, Su, Ri Na, Hirst, Jane E., & Yang, Hui Xia. (2020). Increasing insulin resistance predicts adverse pregnancy outcomes in women with gestational diabetes mellitus. Journal of Diabetes, 12(6), 438–446. https://doi.org/10.1111/1753-0407.13013
Wasim, Tayyiba, Shaukat, Shysta, Javaid, Lubna, Mukhtar, Saima, & Amer, Wasim. (2019). Comparison of metformin and insulin for management of gestational diabetes mellitus: A randomized control trial. Pakistan Journal of Medical and Health Sciences, 13(3), 823–827.
Wibawa, I. Made Bagus Cahya, Putra, Agus Indra Yudhistira Diva, & Tandiono, Erick Kusuma. (2018). Potensi Curcumin dalam Ekstrak Rimpang Kunyit (Curcumma Domestica L.) sebagai Modalitas Pencegahan Preeklamsia pada Ibu Hamil. Essence of Scientific Medical Journal, 16(2), 38–42.
Published
2021-08-18
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Copyright (c) 2021 Tyas Septiana Anggreini, Elis Susilawati, Ika Kurnia Sukmawati
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