Pengaruh Penggunaan Kombinasi Insulin dan Obat Anti Hiperglikemik terhadap Konversi Sputum Penderita Tuberkulosis Paru Komorbid Diabetes Melitus
Abstract
Abstract. Pulmonary tuberculosis (TB) with comorbid diabetes mellitus (DM) presents a challenge in treatment due to metabolic complications that can affect immune response and the success of TB therapy. This study aims to evaluate the effectiveness of insulin therapy and oral hypoglycemic agents (OHO) on sputum conversion in pulmonary TB patients with DM comorbidity. The study employed an observational design. Sputum conversion was assessed based on the results of acid-fast bacilli (AFB) examinations conducted in the second and fifth months. Pulmonary TB patients with DM comorbidity were treated either with oral hypoglycemic agents alone or in combination with insulin. It was found that the combination therapy of insulin and oral hypoglycemic agents was relatively more effective than oral hypoglycemic agents alone. This suggests that controlling the patient’s blood glucose levels may relatively accelerate sputum conversion. However, the primary factor accelerating sputum conversion remains the regular use of anti-TB drugs. In conclusion, this study indicates that the combination of insulin and oral hypoglycemic agents (OHO) achieves similar sputum conversion rates as OHO therapy alone. This demonstrates that both treatment strategies are equally effective in managing blood glucose levels and enhancing treatment responses in diabetic patients with TB.
Abstrak. Tuberkulosis (TB) paru komorbid diabetes melitus (DM) merupakan tantangan dalam pengobatan karena komplikasi metabolik yang dapat memengaruhi respons imun dan keberhasilan terapi TB. Penelitian ini bertujuan untuk mengetahui efektivitas terapi insulin dan obat anti-hiperglikemik oral (OHO) terhadap konversi sputum pada pasien TB paru komorbid DM. Penelitian ini menggunakan desain observasional. Konversi sputum adalah melihat hasil Pemeriksaan bakteri tahan asam (BTA) dilakukan pada bulan kedua dan kelima. Pasien TB paru dengan komorbid DM ada yang diterapi obat antihiperglikemik saja dan ada yang dengan kombinasi insulin-obat antihiperglikemik. Ternyata pengobatan kombinasi insulin-obat antihiperglikemik relatif lebih baik daripada hanya menggunakan obat antihiperglikemik saja. Artinya dapat mengendalikan kadar gula darah pasien sehingga relatif mempercepat terjadinya konversi sputum. Walaupun factor utama mempercepat terjadinya konversi sputum adalah penggunaan obat anti TB secara rutin. Kesimpulannya, penelitian ini menunjukkan bahwa terapi kombinasi insulin dan obat anti-hiperglikemik oral (OHO) memiliki konversi sputum yang sama dengan terapi OHO saja. Hal ini menandakan terapi kombinasi insulin dan OHO dengan terapi OHO saja memiliki kesamaan dalam mengelola kadar glukosa darah dan meningkatkan respon pengobatan pada pasien diabetes yang juga menderita TB.
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