Insulin-pump therapy pada anak dengan diabetes melitus tipe 1: Studi literatur
Bibliographic record
Abstract
Background: Diabetes Mellitus (DM) is a metabolic disease characterized by an increase in blood glucose levels above normal values. This is caused by impaired glucose metabolism due to insulin deficiency, both relative and absolute. Diabetes that is often found in children is Diabetes Mellitus Type 1 (T1DM), this case is a disease that cannot be cured and requires lifelong treatment. It is estimated that every year 128,900 children and adolescents are diagnosed with Type 1 Diabetes Mellitus (T1DM). Globally in 2019 around 1,110,000 children and adolescents were diagnosed with T1DM. Nearly 80% of diabetes deaths occur in low- and middle-income countries. According to the World Health Organization (WHO), India is the country with the largest number in the world with more than 32 million diabetes mellitus patients and this number is predicted to increase to 79.4 million by 2030.Purpose: To reduce the risk of long-term complications, maintain HbA1C on target, and provide knowledge, education and skills to care for children with T1DM until adulthood independently.Method: This research uses a literature review design, namely collecting and summarizing various results from previous research to analyze literature that has been selected from various sources to form a conclusion on new ideas or ideas. The literature study selection process was adapted from Preferred Reporting Items for Systematic Reviews (PRISMA-ScR). The journals used in this study are journals that discuss topics with three keyword categories, namely, Insulin Pump, Diabetes Mellitus Type, and Pediatrics. Search for articles via online databases, including Scopus, ProQuest, Clinical Key Nursing, Sage, and Google Scholar, published in the last five years between 2019-2023.Results: The results of the study are based on a literature review that the author found that the use of insulin pumps is very effective in children and adolescents. In several developed countries, the use of insulin pumps is funded by the local government, but in several rural areas the use of this technology still faces many obstacles and Also, the price of an insulin pump is not cheap, which is an inhibiting factor for blood sugar instability for T1DM.Conclusion: Children with T1DM need insulin throughout their lives, the use of an insulin pump is very effective in controlling blood sugar. The use of an insulin pump can reduce punctures for daily blood sugar monitoring checks and is able to read the condition of glycemic levels in the blood equipped with a sensor. However, the high price of insulin pumps makes families think twice about buying insulin pumps. Insulin pumps can only be purchased by those with above average economic conditions. In developed countries such as Canada, the use of insulin pumps is funded by the local government. However, in developing countries, low ability and purchasing power combined with difficult access to technology mean that not all T1DM sufferers receive adequate treatment. In Indonesia, not many pediatric patients use insulin pumps, only patients from well-off families can use this technology. Apart from that, this insulin pump is not covered by insurance, either government insurance such as National Health Insurance (JKN) or private insurance. So this problem needs to be of concern to various elements, both health and government. Keywords: Child; Diabetes Mellitus Type 1 (T1DM); Insulin Pump; Therapy.Pendahuluan: Diabetes Mellitus (DM) merupakan penyakit metabolik yang ditandai dengan peningkatan kadar glukosa darah diatas nilai normal. Hal ini disebabkan oleh adanya gangguan metabolisme glukosa akibat kekurangan insulin baik secara relatif maupun absolut. Diabetes yang sering ditemui pada anak-anak adalah Diabetes Mellitus Tipe 1 (DMT1), kasus ini merupakan penyakit yang belum dapat disembuhkan dan memerlukan perawatan seumur hidup. Diperkirakan setiap tahun terdapat 128.900 anak-anak dan remaja di diagnosis Diabetes Melitus Tipe 1 (DMT1). Secara global pada tahun 2019 sekitar 1.110.000 anak-anak dan remaja didiagnosis DMT1. Hampir 80% kematian diabetes terjadi di negara berpenghasilan rendah dan menengah. Menurut World Health Organization (WHO), India adalah negara yang mempunyai jumlah terbesar di dunia dengan lebih dari 32 juta pasien diabetes mellitus dan jumlah ini diprediksikan meningkat menjadi 79.4 juta pada tahun 2030.Tujuan: Untuk menurunkan risiko komplikasi jangka panjang, mempertahankan HbA1C sesuai target, dan memberikan pengetahuan, pendidikan, serta keterampilan untuk merawat anak penderita DMT1 hingga dewasa secara mandiri.Metode: Penelitian ini menggunakan rancangan literature review yaitu melakukan pengumpulan dan merangkum berbagai hasil dari penelitian sebelumnya untuk menganalisis literatur- literatur yang telah dipilih dari berbagai sumber hingga menjadi sebuah satu kesimpulan ide atau gagasan baru. Proses pemilihan studi literatur diadaptasi dari Preferred Reporting Items for Systematic Reviews (PRISMA-ScR). Jurnal yang digunakan dalam studi ini adalah jurnal-jurnal yang membahas topik dengan tiga kategori kata kunci yakni, Insulin Pump, Diabetes Mellitus Type, dan child. Penelusuran artikel melalui online database antara lain, Scopus, ProQuest, Clinical Key Nursing, Sage, dan Google Scholar yang diterbitkan lima tahun terakhir antara 2019-2023.Hasil: Hasil telaah berdasarkan literatur review yang penulis dapatkan Bahwa penggunaan insulin pump sangat efektif digunakan pada anak-anak dan remaja, di beberapa negara maju penggunaan insulin pump di biayai oleh pemerintah setempat, tetapi di beberapa daerah pedesaan penggunaan teknologi ini masih banyak mengalami kendala dan juga harga insulin pump yang tidak murah menjadi faktor penghambat ketidakstabilan gula darah untuk DMT1.Simpulan: Anak-anak dengan DMT1 membutuhkan insulin sepanjang hidup mereka, penggunaan insulin pump sangat efektif di dalam mengontrol gula darah. Penggunaan insulin pump mampu mengurangi tusukan untuk pemeriksaan monitoring gula darah harian dan mampu membaca kondisi kadar glikemik dalam darah dilengkapi dengan sensor. Tetapi harga insulin pump yang mahal membuat keluarga berpikir ulang membeli alat insulin pump, insulin pump hanya mampu dibeli oleh mereka yang mempunyai ekonomi diatas rata-rata. Di negara maju seperti Kanada penggunaan insulin pump didanai oleh pemerintah setempat. Namun di negara berkembang, kemampuan dan daya beli yang rendah ditambah sulitnya akses teknologi sehingga tidak semua penderita DMT1 mendapatkan perawatan yang memadai. Di Indonesia sendiri belum banyak pasien anak yang menggunakan insulin pump, hanya pasien yang berasal dari keluarga mampu yang dapat menggunakan teknologi tersebut. Selain itu, insulin pump ini tidak ditanggung oleh asuransi baik asuransi pemerintah seperti Jaminan Kesehatan Nasional (JKN) maupun asuransi swasta. Sehingga permasalahan ini perlu menjadi perhatian dari berbagai elemen baik kesehatan maupun pemerintahan.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".