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Article ; Online: Defining the optimum HOMA-IR cut-off value for insulin resistance among ARV-treated HIV patients in Indonesia.

Harbuwono, Dante S / Nenfiati / Tahapary, Dicky L / Setiati, Siti / Yunihastuti, Evy / Tarigan, Tri Juli Edi

2023 Volume 17, Issue 2, Page(s) 102719

Abstract: Background and aims: HIV-infected patients who are treated with anti-retroviral (ARV) drugs are prone to develop insulin resistance. This study aims to determine the cut-off value of HOMA-IR score in ARV-treated HIV patients in Indonesia.: Methods: A ...

Abstract	Background and aims: HIV-infected patients who are treated with anti-retroviral (ARV) drugs are prone to develop insulin resistance. This study aims to determine the cut-off value of HOMA-IR score in ARV-treated HIV patients in Indonesia. Methods: A cross-sectional study was conducted among 234 adults with HIV who received ARV therapy in HIV Integrated Care Unit of Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia. The duration of HIV diagnosis, duration of ARV therapy, metabolic syndrome status, and calculated HOMA-IR were obtained in this study. HOMA-IR cut-off point was calculated using ROC curve analysis, along with the specificity, sensitivity and likelihood ratio (LR). Results: Among 234 subjects, 58% of subjects were on second-line ARV therapy. The prevalence of metabolic syndrome was 23.9%. The obtained HOMA-IR cut-off value was 2.705 with sensitivity and specificity approaching 70%, PPV 40.9%, NPV 87.6%, with positive LR of 2.15 and negative LR of 0.48. The insulin resistance prediction from the obtained HOMA-IR cut-off value was at moderate strength. Based on this cut-off value, 39.7% of the subjects experienced insulin resistance. Conclusions: Using the new proposed HOMA-IR cut-off point for HIV patient in Indonesia, the prevalence of insulin resistance among HIV-infected patients treated with ARV in Indonesia using optimum HOMA-IR cut-off value of 2.705 was 39.7%.
MeSH term(s)	Adult ; Humans ; Insulin Resistance ; Metabolic Syndrome/diagnosis ; Metabolic Syndrome/epidemiology ; HIV Infections/complications ; HIV Infections/drug therapy ; Indonesia/epidemiology ; Cross-Sectional Studies ; Insulin
Chemical Substances	Insulin
Language	English
Publishing date	2023-01-24
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2273766-2
ISSN	1878-0334 ; 1871-4021
ISSN (online)	1878-0334
ISSN	1871-4021
DOI	10.1016/j.dsx.2023.102719
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: ADA Diabetes Risk Test Adaptation in Indonesian Adult Populations: Can It Replace Random Blood Glucose Screening Test?

Harbuwono, Dante S / Mokoagow, Muhammad Ikhsan / Magfira, Nadya / Helda, Helda

Journal of primary care & community health

2021 Volume 12, Page(s) 21501327211021015

Abstract: Aims: The use of non-invasive and easily available assessment tools such as the ADA diabetes risk test is recommended for diabetes screening among general population. This study aims to assess the validity of the ADA diabetes risk test in screening for ... ...

Abstract	Aims: The use of non-invasive and easily available assessment tools such as the ADA diabetes risk test is recommended for diabetes screening among general population. This study aims to assess the validity of the ADA diabetes risk test in screening for screening hyperglycemia in Indonesian population. Methods: This cross-sectional study conducted at primary health care in Cibeber sub district at Cilegon city, Banten province, Indonesia. Subjects were aged ≥45 years old without a prior diagnosis of diabetes were recruited consecutively. The risk of hyperglycemia was measured using the ADA Diabetes Risk Test. Random capillary blood glucose (RcBG) with a cut-off value >140 mg/dL used as a comparison. Results: From a total of 134 subjects, 23.13% of subjects (n = 31) had hyperglycemia. The ADA Diabetes Risk Test gave an area under the ROC curve (AUC) of 0.71 (95% CI: 0.60-0.81) with an optimal cut-off of value ≥5. The sensitivity of the ADA diabetes risk test in diagnosing hyperglycemia was 68% with a false-negative rate (FNR) of 32.26%. Meanwhile, at a cut-off value ≥4, the sensitivity of the ADA Diabetes Risk Test was 93% with an FNR of 9.7%. Conclusion: ADA diabetes risk test provides a valuable result as a diabetes screening tool in the Indonesian population, thus promotes intervention strategies for population known to be at risk.
MeSH term(s)	Adult ; Blood Glucose ; Cross-Sectional Studies ; Diabetes Mellitus/diagnosis ; Diabetes Mellitus/epidemiology ; Humans ; Indonesia/epidemiology ; Mass Screening ; Middle Aged ; Sensitivity and Specificity
Chemical Substances	Blood Glucose
Language	English
Publishing date	2021-05-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2550221-9
ISSN	2150-1327 ; 2150-1319
ISSN (online)	2150-1327
ISSN	2150-1319
DOI	10.1177/21501327211021015
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Article: Lifestyle and clinical risk factors in relation with the prevalence of diabetes in the Indonesian urban and rural populations: The 2018 Indonesian Basic Health Survey.

Kurniawan, Farid / Sigit, Fathimah S / Trompet, Stella / Yunir, Em / Tarigan, Tri Juli E / Harbuwono, Dante S / Soewondo, Pradana / Tahapary, Dicky L / de Mutsert, Renée

Preventive medicine reports

2024 Volume 38, Page(s) 102629

Abstract: Aims: To investigate the differences between Indonesian urban and rural populations in the association of lifestyle and clinical factors with diabetes prevalence.: Methods: Using database of the 2018 Indonesian Basic Health Survey, which was ... ...

Abstract	Aims: To investigate the differences between Indonesian urban and rural populations in the association of lifestyle and clinical factors with diabetes prevalence. Methods: Using database of the 2018 Indonesian Basic Health Survey, which was conducted in April-May 2018, non-pregnant respondents aged ≥15 years old with available blood glucose data (n urban = 17,129, n rural = 16,585) were included in this study. The diagnosis of diabetes was based on the combination of known diabetes, i.e., a previous history of diabetes or use of anti-diabetes medication, and unknown diabetes based on blood glucose criteria. We performed logistic regression analyses separately for the urban and rural populations to examine the association of lifestyle and clinical factors with prevalent diabetes. Results: Indonesian urban population was less physically active, had a lower proportion of adequate fruit and vegetable intake, and had higher individuals with obesity than rural population. Although there were no differences in the total prevalence of diabetes between the two populations (10.9 % vs. 11.0 %, for urban and rural, respectively), the prevalence of known diabetes was twice higher in urban than in rural population (3.8 % vs. 1.9 %). Physical activity was associated with lower risk of diabetes, especially in the urban population [prevalence OR (95 %CI): 0.91 (0.85; 0.98) for urban and 0.94 (0.89; 1.00) for rural). Obesity, hypertension, and dyslipidemia were risk factors for prevalent diabetes in both populations. Conclusions: Indonesian rural population showed relatively better lifestyle and clinical profiles compared to their urban counterparts. However, no differences were observed between the two populations in the relation between risk factors and diabetes. Special attention needs to be addressed to the high prevalence of undiagnosed and untreated diabetes in Indonesia.
Language	English
Publishing date	2024-01-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	2785569-7
ISSN	2211-3355
ISSN	2211-3355
DOI	10.1016/j.pmedr.2024.102629
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Article ; Online: ADA Diabetes Risk Test Adaptation in Indonesian Adult Populations

Dante S. Harbuwono / Muhammad Ikhsan Mokoagow / Nadya Magfira / Helda Helda

Journal of Primary Care & Community Health, Vol

Can It Replace Random Blood Glucose Screening Test?

2021 Volume 12

Abstract: Aims The use of non-invasive and easily available assessment tools such as the ADA diabetes risk test is recommended for diabetes screening among general population. This study aims to assess the validity of the ADA diabetes risk test in screening for ... ...

Abstract	Aims The use of non-invasive and easily available assessment tools such as the ADA diabetes risk test is recommended for diabetes screening among general population. This study aims to assess the validity of the ADA diabetes risk test in screening for screening hyperglycemia in Indonesian population. Methods This cross-sectional study conducted at primary health care in Cibeber sub district at Cilegon city, Banten province, Indonesia. Subjects were aged ≥45 years old without a prior diagnosis of diabetes were recruited consecutively. The risk of hyperglycemia was measured using the ADA Diabetes Risk Test. Random capillary blood glucose (RcBG) with a cut-off value >140 mg/dL used as a comparison. Results From a total of 134 subjects, 23.13% of subjects (n = 31) had hyperglycemia. The ADA Diabetes Risk Test gave an area under the ROC curve (AUC) of 0.71 (95% CI: 0.60-0.81) with an optimal cut-off of value ≥5. The sensitivity of the ADA diabetes risk test in diagnosing hyperglycemia was 68% with a false-negative rate (FNR) of 32.26%. Meanwhile, at a cut-off value ≥4, the sensitivity of the ADA Diabetes Risk Test was 93% with an FNR of 9.7%. Conclusion ADA diabetes risk test provides a valuable result as a diabetes screening tool in the Indonesian population, thus promotes intervention strategies for population known to be at risk
Keywords	Computer applications to medicine. Medical informatics ; R858-859.7 ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2021-05-01T00:00:00Z
Publisher	SAGE Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Redefining diabetes: is it really necessary?

Harbuwono, Dante S

Acta medica Indonesiana

2011 Volume 43, Issue 2, Page(s) 79–81

MeSH term(s)	Blood Glucose ; Diabetes Mellitus/classification ; Diabetes Mellitus/diagnosis ; Diabetes Mellitus/pathology ; Glycated Hemoglobin A/analysis ; Humans
Chemical Substances	Blood Glucose ; Glycated Hemoglobin A
Language	English
Publishing date	2011-04
Publishing country	Indonesia
Document type	Editorial
ZDB-ID	2474707-5
ISSN	2338-2732 ; 0125-9326
ISSN (online)	2338-2732
ISSN	0125-9326
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Article: Adherence to the healthy lifestyle guideline in relation to the metabolic syndrome: Analyses from the 2013 and 2018 Indonesian national health surveys.

Sigit, Fathimah S / Trompet, Stella / Tahapary, Dicky L / Harbuwono, Dante S / le Cessie, Saskia / Rosendaal, Frits R / de Mutsert, Renée

Preventive medicine reports

2022 Volume 27, Page(s) 101806

Abstract: In this study, we aimed to investigate differences in lifestyle factors and prevalence of metabolic syndrome (MetS) in the Indonesian population between 2013 and 2018. In addition, we investigated whether adherence to the 2015-released national healthy ... ...

Abstract	In this study, we aimed to investigate differences in lifestyle factors and prevalence of metabolic syndrome (MetS) in the Indonesian population between 2013 and 2018. In addition, we investigated whether adherence to the 2015-released national healthy lifestyle guideline ('GERMAS') is associated with MetS in different sex, age, urban/rural, and BMI categories. We performed cross-sectional analyses in individuals aged >15 of the 2013 (n = 34,274) and 2018 (n = 33,786) Indonesian National Health Surveys. A stratified, multi-stage, systematic random sampling design and the probability proportional to size method were used to select households in the 34 provinces across the country
Language	English
Publishing date	2022-04-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	2785569-7
ISSN	2211-3355
ISSN	2211-3355
DOI	10.1016/j.pmedr.2022.101806
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Article ; Online: Diagnosing metabolic syndrome in a multi-ethnic country: is an ethnic-specific cut-off point of waist circumference needed?

Tahapary, Dicky L / Harbuwono, Dante S / Yunir, Em / Soewondo, Pradana

Nutrition & diabetes

2020 Volume 10, Issue 1, Page(s) 19

Abstract: The definition of Metabolic Syndrome (MS) required an ethnic-specific cut-off point for waist circumference (WC). We aim to assess the optimal ethnic-specific WC cut-off point for MS in Indonesia, a multi-ethnic country. Three population-based studies in ...

Abstract	The definition of Metabolic Syndrome (MS) required an ethnic-specific cut-off point for waist circumference (WC). We aim to assess the optimal ethnic-specific WC cut-off point for MS in Indonesia, a multi-ethnic country. Three population-based studies in Indonesia were included for analysis [Flores (n = 1227, Floresian), Depok (n = 904, Sundanese), and Jakarta (n = 1574, Javanese)]. All subjects were 25-65 years old. The receiver operator characteristic curve analysis and Youden index method was used to determine the optimal cut-offs of WC to predict two or more risk factors of MS. In Flores, the cut-offs were 80 cm (Sensitivity and Specificity, AUC, 84% and 73%, 0.86) and 77 cm (86% and 68%, 0.85), for men and women, respectively. While in Depok, the values were 87 cm (87% and 67%, 0.85) and 79 cm (94% and 54%, 0.79), for men and women, respectively. While in Jakarta, the values were 83 cm (92% and 60%, 0.85) and 81 cm (84% and 60%, 0.77), for men and women, respectively. The optimal WC cut-off values for MS were different in those three ethnicities, and in general were lower than the currently used cut-off points for Asian population.
MeSH term(s)	Adult ; Aged ; Blood Glucose/analysis ; Cholesterol, HDL/blood ; Ethnic Groups ; Female ; Humans ; Hypertension/epidemiology ; Indonesia/epidemiology ; Male ; Metabolic Syndrome/diagnosis ; Metabolic Syndrome/epidemiology ; Metabolic Syndrome/ethnology ; Middle Aged ; Obesity, Abdominal/epidemiology ; Prevalence ; ROC Curve ; Reference Values ; Risk Factors ; Sensitivity and Specificity ; Triglycerides/blood ; Waist Circumference/ethnology
Chemical Substances	Blood Glucose ; Cholesterol, HDL ; Triglycerides
Language	English
Publishing date	2020-06-08
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2609314-5
ISSN	2044-4052 ; 2044-4052
ISSN (online)	2044-4052
ISSN	2044-4052
DOI	10.1038/s41387-020-0123-8
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The impact of Ramadan fasting on glucose variability in type 2 diabetes mellitus patients on oral anti diabetic agents.

Harbuwono, Dante S / Kurniawan, Farid / Sudarsono, Nani C / Tahapary, Dicky L

PloS one

2020 Volume 15, Issue 6, Page(s) e0234443

Abstract: Ramadan fasting is associated with changes in eating, physical activity, sleeping patterns, and medication. Unfortunately, only limited studies examine glucose variability in subjects with type 2 diabetes who fast in Ramadan. Our study aims to evaluate ... ...

Abstract	Ramadan fasting is associated with changes in eating, physical activity, sleeping patterns, and medication. Unfortunately, only limited studies examine glucose variability in subjects with type 2 diabetes who fast in Ramadan. Our study aims to evaluate glucose variability in subjects with type 2 diabetes on oral antidiabetic agents using continuous glucose monitoring system (CGMS) during and after Ramadan fasting. This observational study was done in The Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia, which recruited 10 subjects with type 2 diabetes who underwent Ramadan fasting in 2019. These subjects were free from cardiovascular disease, kidney disease, severe liver disease, chronic gastrointestinal disease and autoimmune disease. Insertion of CGMS for measuring interstitial glucose was performed after at least 2 weeks of Ramadan fasting and 4 weeks after the end of the Ramadan fasting, with a minimum of 3 days observation. The mean amplitude of glycemic excursion (MAGE) during and after Ramadan were similar (p = 0.94). In line with this, the average interstitial glucose (p = 0.48), the maximum interstitial glucose (p = 0.35), the minimum interstitial glucose (p = 0.24), and the duration of hypoglycemia (p = 0.25) were also similar in both periods. Overall, nutritional intake and energy expenditure during both periods were comparable. Ramadan fasting is not associated with increased glucose variability in subjects with type 2 diabetes. Thus, Ramadan fasting is safe in subjects with type 2 diabetes with no complications.
MeSH term(s)	Administration, Oral ; Blood Glucose/analysis ; Blood Glucose/drug effects ; Blood Glucose/physiology ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/physiopathology ; Energy Metabolism/physiology ; Fasting/physiology ; Female ; Humans ; Hypoglycemic Agents/administration & dosage ; Indonesia ; Islam ; Longitudinal Studies ; Male ; Middle Aged ; Monitoring, Ambulatory ; Prospective Studies
Chemical Substances	Blood Glucose ; Hypoglycemic Agents
Language	English
Publishing date	2020-06-29
Publishing country	United States
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0234443
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: The impact of Ramadan fasting on Fetuin-A level in type 2 diabetes mellitus.

Harbuwono, Dante S / Sazli, Brama I / Kurniawan, Farid / Darmowidjojo, Budiman / Koesnoe, Sukamto / Tahapary, Dicky L

Heliyon

2021 Volume 7, Issue 5, Page(s) e06773

Abstract: Background/aims: Ramadan fasting creates changes in lifestyle, causing biochemical alterations that affect glucose metabolism and insulin sensitivity. This study aims to assess the impact of Ramadan fasting on glycemic control and Fetuin-A, a ... ...

Abstract	Background/aims: Ramadan fasting creates changes in lifestyle, causing biochemical alterations that affect glucose metabolism and insulin sensitivity. This study aims to assess the impact of Ramadan fasting on glycemic control and Fetuin-A, a glycoprotein that affects insulin resistance, in patients with type 2 diabetes mellitus (T2DM). Materials and methods: This was a prospective study done among 37 patients with T2DM from Internal Medicine Polyclinic in a hospital in Jakarta, Indonesia. Anthropometric data as well as Hemoglobin A1c (HbA1c), Fasting Blood Glucose (FBG), and Fetuin-A levels of the subjects were measured in three time points: before, during, and after Ramadan fasting. A bivariate analysis was done to see the effect of Ramadan fasting on those parameters. Results: Ramadan fasting reduced Fetuin-A levels [median (minimum-maximum), 5.35 (2.91-7.81) vs. 3.22 (2.35-5.60) mg/dl; p = 0.039] four weeks after the end of Ramadan compared to pre-Ramadan. After two weeks of Ramadan fasting, we found a significant reduction in body weight, BMI, FBG, and HbA1c levels which rebounded to baseline level after Ramadan. Conclusion: Ramadan fasting was associated with a significant decrease in Fetuin-A level post Ramadan.
Language	English
Publishing date	2021-05-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2835763-2
ISSN	2405-8440
ISSN	2405-8440
DOI	10.1016/j.heliyon.2021.e06773
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Article: Impact of Sodium Butyrate Treatment in LPS-Stimulated Peripheral Blood Mononuclear Cells of Poorly Controlled Type 2 DM.

Wibowo, Heri / Harbuwono, Dante S / Tahapary, Dicky L / Kartika, Rona / Pradipta, Saraswati / Larasati, Rahma A

Frontiers in endocrinology

2021 Volume 12, Page(s) 652942

Abstract: Type 2 diabetes mellitus (T2DM) is associated with chronic low-grade inflammation, which is marked by the dysregulation of innate and adaptive immune responses. Therefore, reducing inflammation, possibly through an immunoregulatory agent, may play a role ...

Abstract	Type 2 diabetes mellitus (T2DM) is associated with chronic low-grade inflammation, which is marked by the dysregulation of innate and adaptive immune responses. Therefore, reducing inflammation, possibly through an immunoregulatory agent, may play a role in T2DM treatment. Butyrate is the most potent short-chain fatty acid (SCFA), and it exerts anti-inflammatory properties by inhibiting histone deacetylase activity. As an immunoregulatory agent, sodium butyrate can inhibit nuclear factor kB (NF-kB) activation and reduce the production of pro-inflammatory cytokines in immune cells. The aim of the study was to measure the level of plasma butyrate in poorly controlled T2DM and normoglycemic participants and to compare the response of peripheral blood mononuclear cells (PBMCs) to sodium butyrate treatment between the groups by measuring production of the following cytokines: tumor necrosis factor (TNF)-α, interleukin (IL)-6, interferon (IFN)-γ, IL-13, and IL-10. The
MeSH term(s)	Adult ; Anti-Inflammatory Agents/pharmacology ; Butyric Acid/pharmacology ; Cytokines/metabolism ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/immunology ; Female ; Humans ; Inflammation ; Interferon-gamma/metabolism ; Interleukin-10/metabolism ; Interleukin-13/metabolism ; Interleukin-6/metabolism ; Leukocytes, Mononuclear/cytology ; Leukocytes, Mononuclear/drug effects ; Lipopolysaccharides/chemistry ; Lipopolysaccharides/metabolism ; Male ; Middle Aged ; NF-kappa B p50 Subunit/metabolism ; Tumor Necrosis Factor-alpha/metabolism
Chemical Substances	Anti-Inflammatory Agents ; Cytokines ; IFNG protein, human ; IL10 protein, human ; IL13 protein, human ; IL6 protein, human ; Interleukin-13 ; Interleukin-6 ; Lipopolysaccharides ; NF-kappa B p50 Subunit ; NFKB1 protein, human ; TNF protein, human ; Tumor Necrosis Factor-alpha ; Butyric Acid (107-92-6) ; Interleukin-10 (130068-27-8) ; Interferon-gamma (82115-62-6)
Language	English
Publishing date	2021-07-29
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2592084-4
ISSN	1664-2392
ISSN	1664-2392
DOI	10.3389/fendo.2021.652942
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