CURICULUM VITAE

Nama
Tempat & tgl lahir
Jabatan sekarang

: Prof . Dr. dr. Darmono, SpPD,K-EMD, FINASIM

: Tuban, 8 Oktober 1945
: Kepala Sub Bagian Endokrin-Metabolik, Bagian Ilmu Penyakit Dalam
FK Undip / RSUP Dokter Kariadi, Semarang
Riwayat pendidikan : - Dokter Umum FK Undip,1973
- Spesialis Penyakit Dalam FK Undip,1980
- Konsultan Endokrin Metabolik Diabetes FK Undip Perkeni, 1990
- Doktor (topik diabetes malnutrisi) FK Undip, FK UGM, FK Unair, FKUI,
Int Med Dept, Univ Hosp, Med Fac, Free Univ Amsterdam, 1990
Organisasi profesi
:
Anggota Ikatan Dokter Indonesia (IDI) tahun 1973 sekarang.
Anggota Perhimpunan Dokter Spesialis Penyakit Dalam Indonesia (PAPDI) tahun 1980 sekarang.
Member of Asean federation of Endocrine Society (AFES) since 1980.
Sekretaris Perkumpulan Endokrinologi Indonesia (PERKENI) Cabang Semarang tahun 1980 2007.
Wakil Ketua I Perkumpulan Endokrinologi Indonesia (PERKENI) Cabang Semarang tahun 2007
2013
Ketua Perkumpulan Endokrinologi Indonesia (PERKENI) Cabang Semarang tahun 2013 - sekarang
Anggota Perkumpulan Andrologi Indonesia tahun 1984 sekarang.
Ketua Persatuan Diabetes Indonesia (PERSADIA) Cabang Semarang tahun 1980 2002.
Member of International Diabetes Federation (IDF) since 1985.
Anggota Tim Pengendalian Defisiensi Iodium FK Undip, RSUP Dr Kariadi, Depkes RI, tahun 1990
sekarang
Anggota Konsultan Pengendalian Defisiensi Iodium Depkes RI tahun 1993 sekarang.
Member of West Pacific Region (WPR) of Diabetes Educator since 1995.
Sekretaris kelompok Studi Tiroidologi FK Undip, RSUP Dr kariadi tahun 1996 sekarang.
Ketua Umum Pengurus Besar Persatuan Diabetes Indonesia (PERSADIA) tahun 2002 2005.
Penasehat Pengurus Persatuan Diabetes Indonesia (PERSADIA) tahun 2005 sekarang.
Anggota Kelompok Studi Sexual Ambiguous FK Undip, RSUP Dr Kariadi, tahun 2002 sekarang.
Anggota Perkumpulan Obesitas Indonesia tahun 2003 sekarang.
Anggota Tim Operasi Penyesuaian Kelamin RSUP Dr Kariadi tahun 2003 sekarang.
Anggota Tim Kajian Pengembangan Sumber Daya Manusia FK Undip tahun 2003 sekarang.
Ketua Bidang Organisasi Kelompok Studi Sito Genetik (Ambiguous Genetalia) FK Undip RSUP Dr
Kariadi
tahun 2006 Penghargaan
sekarang. : Tanda Kehormatan Satyalancana Karya Satya dari Presiden RI tahun 2002

ATHEROGENIC DYSLIPIDEMIA
AND TYPE 2 DIABETES
MACROVASKULAR RISK

Prof Darmono MD PhD, Internist, Endocrinologist

Div of Endocrinology and Metabolism
Dept of Medicine, Med Fac, Diponegoro Univ, Kariadi Hospital, Semarang
Education and Development of Medical Profession
DOCLink (Diabetes Obesity Cardiovascular Link)
Jakarta, August 2014

DM

IGT

Tendency of
atherosclerosis

Insulin
resistance

Glucose
Lipid

Insulin
(IGF-1)
mediator

Underlying
Pathogenic factors

Diabetic risk factors

Dyslipidemia
Hypertension
Hyperinsulinemia
Obesity

Brain
Heart
Peripheral artery

75% CVD

Mortality
80%

stroke
25%
PAD

Early detection
and treatment
hyperglicemia
dyslipidemia

MACROANGIOPATHY

Heart
Brain
Peripheral artery

( Prothrombotic )
atherosclerotic
occlusive disease

Platelet
activity

fibrinolysis

Endothelial
dysfunction

plasma
coagulability
Prostacyclin
production

 Hyperglycemia
Hyperinsulinemia

Vasc. growth
promoting factor
Diabetic serum
growth factor 1

Proliferation
of vasc smooth
muscle

Insulin-like
Growth factor
Vasc complication

AGEP
Atheroma

LDL

Atherosclerosis

Connect tissue
Proliferation

Lipid profile
disorders

Artherial
sub intima

Lipid filled plaques

/ fatty plaques
/ atheroma

Fibrotic
Calsified
Ulceration

Tryglyseride
LDL
HDL

Vasc
complication

Thrombosis
Emboli

Risk factors

CRP
Fibr
Homocyst
APO-L-B
L-A
Visk Plasma

Atherosclerotic
Occlusive disease

Age
DM
peripheral neuropathy

Endothelial
receptor
(marker of inflammation)

Procoagulant tissue factor

Leucocyte
adhession molecules
Chemostatic substances
Compounds impairing
fibrinolysis
(Plasminogen activator)

Endothelial cell
nitric oxyde
Stimulator vasodilation
Inhibitor Inflammation
Proliferation
Platelet
aggregation

Regulation disorder
of vasc tone

Lipid profile as risk factors of CVD

in diabetic patients
Risk

LDL
cholesterol
(mg/dl)

HDL
cholesterol
(mg/dl)

Tryglyseride
(mg/dl)

High

130

< 40

400

100 129

40 59

150 399

< 100

60

< 150

Moderate
Low

Correlation of lipid profile

and risk of CVD
Ideal

Special
attention

High risk

Total
Cholesterol

< 200

200 239

240

LDL
Cholesterol
CVD ( - )
CVD ( + )

< 130
< 100

130 159
130 159

160

HDL
Cholesterol

> 45

36 45

< 35

< 200
< 150

200 399
200 399

400

Tryglyseride
CVD ( - )
CVD ( + )

160

400

Criteria of Diabetic Control

Well
controled

moderate

Poor
controled

Fasting glucose (mg/dl)

80 109

110 125

126

Post prandial glucose

80 144

145 - 179

180

HbA1c (%)

< 6.5%

6.5 8.0

>8

Total cholesterol (mg/dl)

< 200

200 239

240

LDL (mg/dl)

< 100

100 129

130

HDL (mg/dl)

Male > 45, female > 50

< 150

150 199

200

18.5 22.9

23 25

> 25

130/80

> 130-140/ > 80-90

> 140/90

Tryglyseride (mg/dl)
BMI (kg/m2)
Blood pressure (mmHg)
Note : venous plasma material

DM
Fasting Lipoprotein

LDL 100 mg/dl

Trygl 150 mg/dl
HDL 40 mg/dl

LDL < 100 mg/dl

Trygl < 150 mg/dl
HDL > 40 mg/dl
Diabetic control
Lipid control

Trygl > 150 mg/dl

LDL > 100 mg/dl
HDL > 40 mg/dl
Fibrate
Statin
Fibrate + resin

monitoring of lipid profile

( 1 yr )

Tryg > 150 mg/dl

LDL > 100 mg/dl

Fibrate

Statin
Fibrate

monitoring of lipid profile

( 3 6 month )

Pharmacological treatment for correction of lipid profile

Preparations
Statin

Drugs

Lipoprotein effect

Contra Indication

Lovastatin
Pravastatin
Simvastatin
Fluvastatin
Atorvastatin
Rosuvastatin
Pitavastatin

LDL 18-55%

Acute or chronic liver

dysfunction

Ezetimibe

HDL 5-15%
Tryglyseride 7-30%

LDL 15-20%
HDL 1-4%

Bile acid
squestrants

Cholestyramine
Colestipol
Colesevalam

Nicotinic acid

Tryglyseride 5-10%
LDL 15-30%
HDL 3-5%
Tryglyseride sqa
LDL 5-25%

In combination with statin (contra

indikation for acute and chronic
hepatic dysfunction)
Dysbetaliproteinemia
Tryglyseride > 400 mg/dl
Chronic hepatic dysfunction

HDL 15-35%
Fibric acid
derivatives

Gemfibrozil
Fenofibrate

Tryglyseride 20-50%
LDL 5-20% ( in patients
with high tryglyseride)
HDL 10-20%
Tryglyserid 20-50%

Severe hepatic dysfunction

Severe renal dysfunction