Comparison Of HbA1c Levels in Type II Diabetes Mellitus Patients Receiving A Combination of Oral Hypoglycemic Drugs and Insulin Degludec-Aspart Versus Insulin Degludec-Aspart Monotherapy
DOI:
https://doi.org/10.20527/jps.v12i2.22242Keywords:
Type II Diabetes Mellitus, HbA1c, Insulin Degludec-Aspart, Oral Hypoglycemic Drugs, Combination TherapyAbstract
Diabetes melitus tipe II merupakan penyakit kelebihan glukosa yang disebabkan oleh menurunnya kinerja insulin dalam tubuh. Kriteria utama dalam manajemen glukosa darah adalah kadar HbA1c. Penelitian ini bertujuan mengevaluasi perbedaan kadar HbA1c pada pasien diabetes melitus tipe II yang mendapatkan terapi kombinasi obat hipoglikemik oral dan insulin degludec-aspart dibandingkan dengan pasien yang menerima monoterapi insulin degludec-aspart. Metode yang digunakan dalam penelitian yaitu cross-sectional secara retrospektif pada bulan Januari-Desember 2023 dengan jumlah sampel sebanyak 66 pasien yang dibagi menjadi 2 kelompok. Nilai HbA1c yang diperoleh dari bulan pertama hingga bulan ketiga dianalisis secara statistik menggunakan independent sample t-test dengan uji SPSS versi 21. Hasil penelitian menunjukkan penurunan kadar HbA1c pada kombinasi terapi obat hipoglikemik oral + insulin degludec-aspart sebelum dan sesudah dengan selisih nilai ± SD sebesar (1,565 ± 1,10)% dan penurunan nilai HbA1c ± SD pada monoterapi insulin degludec-aspart sebelum dan sesudah dengan selisih nilai (1,05 ± 0,74)% dengan nilai p (<0,05). Kesimpulan penelitian ini adalah terdapat perbedaan penurunan nilai HbA1c pada kedua kelompok dengan nilai p (<0,05). Hal ini menunjukkan bahwa penggunaan kombinasi oral lebih efektif daripada monoterapi.  Kata Kunci: Diabetes Mellitus Tipe II, HbA1c, Insulin Degludec-Aspart, Obat Hipoglikemik Oral, Kombinasi Terapi. Type II diabetes mellitus is a condition marked by hyperglycemia due to reduced effectiveness of insulin within the body.The main criterion in blood glucose management is HbA1c level. The objective of this research was to assess the difference in HbA1c levels between type 2 diabetes patients treated with a combination of oral hypoglycemic agents and insulin degludec-aspart versus insulin degludec-aspart alone. This research method uses a retrospective cross-sectional research design in January-December 2023 with a total sample of 66 patients divided into 2 groups. HbA1c values collected from the first to the third month were analyzed using the independent sample t-test in SPSS version 21. The Medical Research Ethics Commission of Ulin Banjarmasin Regional General Hospital South Kalimantan has approved this study. HbA1c levels in the combination of oral hypoglycemic drug therapy and insulin degludec-aspart pre- and post- with a difference in ± SD value of (1.565 ± 1.10)% decrease and a decrease in HbA1c ± SD value in insulin degludec-aspart mono-therapy pre- and post- with a difference in value (1.05 ± 0.74)% with a p-value (<0.05).This study concludes that the reduction in HbA1c levels between the two groups differs significantly, as indicated by a p-value of less than 0.05. This implies that the use of oral combination is more effective than mono-therapy.References
American Diabetes Association. (2015). Standards of medical care in diabetes 2015 abridged for primary care providers. Diabetes Care, 38(1), 1–30. https://doi.org/10.2337/dc15-S001
American Diabetes Association. (2022). Standards of medical care in diabetes 2022 abridged for primary care providers. Diabetes Care, 45(1), 1–4. https://doi.org/10.2337/dc22-S001
Artini, K., Listyani, T., & Puspitasari, G. (2023). Rationality of antidiabetic drug use in type 2 diabetes mellitus outpatients at Dr. Moewardi General Hospital Surakarta. MEDFARM: Journal of Pharmacy and Health, 12(1), 9–18. https://doi.org/10.48191/medfarm.v12i1.160
Dayan Hisni, N., Damayanti, N. I., & Lubis, R. (2025). The relationship between age, dietary patterns, and physical activity with the incidence of type 2 diabetes mellitus. Journal of Applied Holistic Nursing Science, 1(2), 52–58. https://doi.org/10.70920/jahns.v1i2.182
Franek, E., HaluzÃk, M., Varzic, S. C., Sargın, M., Macura, S., Zacho, J., & Christiansen, J. S. (2016). Twice-daily insulin degludec/insulin aspart treatment provides superior fasting plasma glucose control and a reduced rate of hypoglycaemia compared with biphasic insulin aspart 30 in insulin-naïve adults with type 2 diabetes. Diabetic Medicine, 33(4), 497–505. https://doi.org/10.1111/dme.12982
Fulcher, G. R., Christiansen, J. S., Bantwal, G., Polaszewska-Muszynska, M., Mersebach, H., Andersen, T. H., & Niskanen, L. K.; BOOST: Intensify Premix I Investigators. (2014). Comparison of insulin degludec/insulin aspart and biphasic insulin aspart 30 in uncontrolled, insulin-treated type 2 diabetes: A phase 3a, randomized, treat-to-target trial. Diabetes Care, 37(8), 2084–2090. https://doi.org/10.2337/dc13-2908
International Diabetes Federation. (2019). IDF diabetes atlas (9th ed.). International Diabetes Federation.
Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., Peters, A. L., Tsapas, A., Wender, R., & Matthews, D. R. (2015). Management of hyperglycemia in type 2 diabetes, 2015: A patient-centered approach: Update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetologia, 58(3), 429–442. https://doi.org/10.1007/s00125-014-3460-0
Kahn, S. E., Cooper, M. E., & Del Prato, S. (2014). Pathophysiology and treatment of type 2 diabetes: Perspectives on the past, present, and future. The Lancet, 383(9922), 1068–1083. https://doi.org/10.1016/S0140-6736(13)62154-6
Kesavadev, J., Gowda, A., Kumar, H., Yalamanchi, S. R., Lodha, S., Singh, K. P., Basu, D., Asirvatham, A., Shah, N., Pathan, M. K., Revanna, M., & Mukherjee, J. J. (2021). Safety of insulin degludec/insulin aspart in patients with diabetes mellitus over a period of 1 year during routine clinical care in India: SMART (Study of management of diabetes with Ryzodegâ„¢ treatment). Medical Sciences (Basel), 10(1), 1. https://doi.org/10.3390/medsci10010001
Kim, H. S., Kim, D. M., Cha, B. S., Park, T. S., Kim, K. A., Kim, D. L., Chung, C. H., Park, J. H., Jang, H. C., & Choi, D. S. (2014). Efficacy of glimepiride/metformin fixed-dose combination vs metformin uptitration in type 2 diabetic patients inadequately controlled on low-dose metformin monotherapy: A randomized, open label, parallel group, multicenter study in Korea. Journal of Diabetes Investigation, 5(6), 701–708. https://doi.org/10.1111/jdi.12201
Moon, S., Chung, H.-S., Kim, Y.-J., Yu, J.-M., Jeong, W.-J., Park, J., & Oh, C.-M. (2021). Efficacy and safety of insulin degludec/insulin aspart compared with a conventional premixed insulin or basal insulin: A meta-analysis. Metabolites, 11(9), 639. https://doi.org/10.3390/metabo11090639
PERKENI. (2019). Guidelines for the management and prevention of type 2 diabetes mellitus in Indonesia 2019. Indonesian Endocrinology Society.
PERKENI. (2021). Guidelines for the management and prevention of adult type 2 diabetes mellitus in Indonesia 2021. Indonesian Endocrinology Society.
Rimadani, L. D., & Wati, H. (2022). Comparison of the effectiveness of reducing blood glucose levels of insulin Levemir® and insulin degludec-aspart in type II diabetes mellitus patients at Ulin Banjarmasin Hospital (Unpublished undergraduate thesis). University of Borneo Lestari, Banjarbaru.
RISKESDAS. (2018). Basic health research results 2018. Ministry of Health Research and Development Agency.
Samuel, V. T., & Shulman, G. I. (2016). The pathogenesis of insulin resistance: Integrating signaling pathways and substrate flux. Journal of Clinical Investigation, 126(1), 12–22. https://doi.org/10.1172/JCI77812
Tonolo, G. (2021). Sex-gender awareness in diabetes. Diabetology, 2(2), 117–122. https://doi.org/10.3390/diabetology2020010
Wati, H., Astuti, K. I., Ramadhani, S., Kurniawan, G., Rahmadina, A., & Wahyunita, S. (2023). Comparison of plasma glucose and HbA1c levels with glargine and detemir insulin in diabetes mellitus 2 patients at Ulin Regional Public Hospital, Banjarmasin. Pharmaceutical Scientific Journal, 01(01), 44–49. https://doi.org/10.12345/psj.v1i1.56789
Wikannanda, I. A. A. D., Sari, N. L. P. E. K., & Aryastuti, A. A. S. A. (2023). Overview of the use of metformin-sulfonylurea oral combination therapy in type 2 DM patients in Denpasar. E-Journal AMJ (Aesculapius Medical Journal), 3(2), 224–232. https://doi.org/10.22225/amj.3.2.2023.224-232
Wulan, F. W., Astuti, L. W., Rilawati, F. D., & Syam, A. F. (2024). Evaluation of insulin rationality in type 2 diabetes mellitus outpatient patients at RSUD Kota Madiun during the 2022 period. Termometer: Journal of Health and Medical Sciences, 2(3), 74–80. https://doi.org/10.55606/termometer.v2i3.4054
Timur, W., & Pradesti, A. (2024). Perbedaan efektivitas penggunaan metformin-insulin versus metformin-vildagliptin terhadap profil glikemik pasien DMT2 di instalasi rawat jalan RSISA periode 2022. JPSCR: Journal of Pharmaceutical Science and Clinical Research, 9(1), 1–10. https://doi.org/10.20961/jpscr.v9i1.71945
Wahyuni, K. I., Prayitno, A. A., & Wibowo, Y. I. (2019). Efektivitas edukasi pasien diabetes mellitus tipe 2 terhadap pengetahuan dan kontrol glikemik rawat jalan di RS Anwar Medika. Jurnal Pharmascience, 6(1). https://doi.org/10.20527/jps.v6i1.6069
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Jurnal Pharmascience
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
.jpg)
