Introduction: Diabetes mellitus is a non-transmitted pandemic disease which had spreaded on a global scale. The prevalence of diabetes mellitus in the world according to the International Diabetes Federation (IDF) is 1.9% and diabetes mellitus is ranked seventh as the cause of death in the world, around 95% in the world is type 2 diabetes mellitus. According to Riset Kesehatan Dasar (Riskesdas) in 2013, the prevalence of diabetes mellitus in Indonesia is 6,9%. Type 2 diabetes mellitus that is not well controlled will increase the risk of chronic complications, both microangiopathies such as nephropathy, and macroangiopathy such as hypertension. The aim of the study was to determine correlation between HbA1c levels with eGFR (Estimated Glomerulus Filtration Rate) and blood pressure (systolic and diastolic).Methods: An analytic observational cross-sectional study, collecting the data from 94 patients with type 2 diabetes mellitus, Dr. Soetomo General Hospital, Surabaya, from January to May 2018. The variables were collected from patient’s medical records. Analysis using Spearman’s Rank Correlation test. To determine normality of the data, we use Kolmogorov-smirnov test.Results: The results showed that there are 134 (57,8%) patients with type 2 diabetes mellitus are female more than male. Patients with greater than or equal to 45 years old were 203 (87,5%) patients, more than under 45 years old. The correlation test showed that there was no significant correlation between HbA1c and systolic blood pressure (r=-0,127; p=0,054). Also there was no significant correlation between HbA1c and diastolic blood pressure (r=-0,111; p=0,093). Analysis on other factor showed a significant correlation between HbA1c and eGFR (r=0.341; p=0.000).Conclusion: There was no significant correlation between HbA1c and systolic blood pressure, also there was no significant correlation between HbA1c and diastolic blood pressure. But, there was a significant correlation between HbA1c and eGFR. This is because the data retrieval does not consider the drug consumption and therapy that has been done by the patient, as well as examination of HbA1c, serum creatinine eGFR, and blood pressure not at the same time.

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Introduction: Diabetic ketoacidosis (DKA) is a complication of diabetes mellitus which has a high risk of mortality. Mortality in DKA patients in developed countries is less than 5%, some other sources mention 5-10%, 2-10%, or 9-10%. Mortality events at clinics with simple facilities and elderly patients can reach 25-50%. The mortality rate of DKA patients is generally higher in infection conditions, especially in developing countries and in septic patients. Several factors such as age, sex, and high blood glucose can increase mortality risk of DKA patients. Other risk factors such as history of discontinued insulin therapy, impaired bicarbonate levels, pH, and increased leukocytes of DKA patients due to infection, abnormal albumin levels, electrolyte disturbances, and Serum Creatinine (SK) were thought to affect mortality of DKA patients. The purpose of this study was to determine the risk factors associated with mortality of DKA patients in Dr. Soetomo General Hospital Surabaya. Methods: The method used in this study was observational analytic involving 63 adult patients diagnosed with DKA with analysis using Chi-Square test. Results: From 63 patients included in this study, 37 patients diagnosed with DKA died and 26 patients lived. In a multivariate analysis, DKA severity with p = 0.001 (p < 0.005) was identified as having a relationship with mortality of DKA patients Dr. Soetomo General Hospital Surabaya. Conclusion: Severity is the only risk factor associated with mortality of DKA patients in Dr. Soetomo General Hospital Surabaya.

Background: Early identification of arterial stiffness in Type 2 diabetes mellitus (T2DM) patients before the manifestation of atherosclerosis would be clinically beneficial. Our study aimed to explore the correlation of lipid profiles and ratios with arterial stiffness, and construct a predictive model for arterial stiffness in T2DM patients using those parameters. Methods: One hundred and eighty-four adult T2DM patients in the diabetes outpatient clinic at the Dr. Soetomo general academic hospital were enrolled in this cross-sectional study in 2015 and 2019. Sociodemographic, glycosylated hemoglobin (HbA1c), lipid profiles, and brachial-ankle pulse wave velocity (ba-PWV) data were collected from all subjects. The subjects were divided into a group with arterial stiffness (ba-PWV > 18 m/sec) and without arterial stiffness (ba-PWV ≤ 18 m/sec). A correlation test was used to evaluate the association, and receiver operator characteristics (ROC) curves analysis were used to determine the cut-off value, sensitivity, and specificity. The risk analysis model was calculated using bivariate logistic regression analysis. Results: The group with arterial stiffness had higher lipid profiles: total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and lipid ratios. A significant positive correlation was found between TC, TG, LDL-C, and all lipid ratios with ba-PWV. A negative correlation was found between HDL-C and ba-PWV. All lipid ratio parameters can be used as predictors of arterial stiffness, especially non-HDL-C with cut-off value: 150 mg/dL (sensitivity 96.8% and specificity 52.9%) and TG/HDL-C ratio with cut-off value: 4.51 (sensitivity 81.0% and specificity 74.2%). Elevated TG/HDL-C ratio and non-HDL-C displayed higher risk (OR: 12.293 and 16.312; p < 0.05) of having arterial stiffness compared to other lipid ratios. Conclusions: Lipid profiles and lipid ratios, especially TG/HDL-C ratio and non-HDL-C, are potential biochemical markers for arterial stiffness in T2DM patients.

Growth hormone (GH) is a hormone responsible for the regulation of somatic cell growth, including the development of the heart and blood vessels, and their functions. GH deficiency is a clinical condition characterized by impaired activity, decreased quality of life, as well as the impaired composition of substances in the body. GH improves cardiac metabolism, reduces oxygen consumption and energy requirements, even in patients with heart failure who have increased wall stress and impaired glucose metabolism that is characterized by insulin resistance and fasting hyperinsulinemia. Patients with GH deficiency also suffer from abnormalities in coagulation factors, such as increased levels. In another study, young adult patients with GH deficiency were found to experience a decrease in left ventricular mass, decreased ejection fraction, as well as abnormal diastolic filling patterns. GH therapy significantly reduces low-density lipoprotein (LDL) cholesterol but does not affect triglyceride (TG). Growth hormone deficiency can increase the risk of cardiovascular disease by affecting the prevalence of risk factor-related events, such as central obesity, fat, and carbohydrate metabolism disorders, increased proinflammatory cytokines, endothelial dysfunction and oxidative stress, and morphological and cardiac dysfunction.