HUBUNGAN TINGKAT KEPARAHAN NEUROPATI DIABETIK DENGAN GANGGUAN

FUNGSI KOGNITIF PADA PENDERITA DM

1
Muhammad Reza Putra , 2Aida Fithrie, 2Fasihah Irfani Fitri
1
Residen Neurologi Universitas Sumatera Utara / RSUP Haji Adam Malik Medan
2
Staf Departemen Neurologi Universitas Sumatera Utara / RSUP Haji Adam Malik Medan

Latar Belakang: Neuropati diabetik dan gangguan fungsi kognitif merupakan komplikasi yang sering terjadi pada
penderita diabetes mellitus (DM). Kedua komplikasi tersebut memiliki mekanisme patofisiologi yang hampir sama.
Tujuan penelitian ini adalah untuk mengetahui hubungan tingkat keparahan neuropati diabetik dengan gangguan fungsi
kognitif pada penderita DM.
Metode : Penelitian ini menggunakan desain potong lintang pada pasien dengan neuropati diabetik di Poliklinik Endokrin
dan Poliklinik Neurologi RSUP.Haji Adam Malik Medan, penilaian neuropati diabetik dilakukan dengan anamnesa
pemeriksaan neurologis dan pemeriksaan kecepatan hantaran saraf dan dikategorikan menjadi ringan, sedang, berat.
Selanjutnya dilakukan pemeriksaan fungsi kognitif dilakukan dengan menggunakan Montreal Cognitive Assessment –
INA (MoCA-INA), Verbal fluency test, Trail Making Test A (TMT-A) dan Trail Making Test B (TMT-B). Untuk
menganalisa hubungan tingkat keparahan neuropati diabetik dengan fungsi kognitif digunakan uji Fisher's Exact.
Hasil : Penelitian ini melibatkan 31 subjek pasien DM yang menderita neuropati diabetik dengan jenis kelamin perempuan
26 subjek (83,9%) dan laki-laki 5 subjek (16,1%), usia seluruh subjek memiliki median sebesar 54(50 – 73) tahun.
Riwayat lama menderita DM subjek memiliki nilai median 4 (1-15) tahun, Kadar Hba1c subjek memiliki nilai median 8
(7-11.20). Dari analisa statistik didapatkan adanya hubungan yang signifikan antara tingkat keparahan neuropati diabetik
dengan keempat tools pemeriksaan kognitif, MoCA INA dengan nilai p < 0,001, TMT-A dengan nilai p <0,023, TMT-B
dengan nilai p < 0,38 dan VFT dengan p < 0,014.
Kesimpulan : Terdapat hubungan yang signifikan antara tingkat keparahan neuropati diabetik dengan gangguan fungsi
kognitif pada penderita DM.

Disclosure: Publikasi ini tidak ada berkaitan dengan produk ataupun sponsor tertentu
Funding: Penelitian ini tidak dibiayai oleh pihak tertentu.
Acknowledgement: peneliti mengucapkan terima kasih kepada semua pihak yang telah membantu dalam pengumpulan
data pada penelitian ini.
Referensi :

1. Callaghan, B.C., Cheng, H.T., Stables, C.L., Smith, A.L., and Feldman, E.L. 2012. Diabetic neuropathy: clinical
manifestations and current treatments. Lancet Neurol. 11:521 – 534
2. Kelompok Studi Fungsi Luhur Perhimpunan Dokter Spesialis Saraf Indonesia. 2010. Panduan Pemeriksaan
Neurologi dan Neurobehavior
3. Moreira, R., Soldera, A., Cury, B., Meireles, C., and Kupfer, R. 2015. Is cognitive impairment associated with
the presence and severity of peripheral neuropathy in patients with type 2 diabetes mellitus. Biomed Central.
DOI 10.1186/s13098-015-0045-0
4. Ndraha, S. 2014. Diabetes Melitus Tipe 2 dan Tatalaksana Terkini. Medicinus. 27 (2) : 9 – 16
5. Rambe, A.S., and Fitri, F.I. Correlation between the Montreal Cognitive Assessment – Indonesian Version
(MoCA – INA) and Mini Mental state Examination (MMSE) in Elderly.Macedonian Journal of Medical
Sciences.2017;1-6
6. Sjahrir, S. 2006. Diabetic Neuropathy: The Pathoneurobiology and Treatment Update. Medan: USU Press. hal
1–47
7. Smith, T., Gildeh, N. and Holmes, C. 2007. The Montreal Cognitive Assessment: Validity and Utility in a
Memory Clinic Setting. Can J Psychiatry. 52(5): 329-32.
8. Soelistijo, S.A., Novida, H., Rudijanto, A., Soewondo, P., Suastika, K., Manaf, A., dkk. 2015. Konsensus
pengelolaan dan pencegahan diabetes melitus tipe 2 di Indonesia 2015. Jakarta : Pengurus Besar Perkumpulan
Endokrinologi Indonesia (PB PERKENI). Hal 1-82
 CORRELATION BETWEEN THE LEVEL OF NEUROPATY AND COFNITIVE
FUNCTION DISORDER ON DIABETES MELLITUS
1
Muhammad Reza Putra , 2Aida Fithrie, 2Fasihah Irfani Fitri
1
Resident Neurology Universitas Sumatera Utara / Haji Adam Malik General Hospital Medan
2
Staff of Neurology Department Universitas Sumatera Utara / Haji Adam Malik General Hospital Medan

Background: Diabetic neuropathy and cognitive function disorder is a complication which frequently occurs on diabetes
mellitus (DM) patients, both of these complication have pathophysiology mechanism which is almost the same. The
purpose of this research is to find out the correlation between the level of diabetic neuropathy and cognitive function
disorder on DM patients.
Method: This research used cross section design on DM and diabetic neuropathy at endocrine Polyclinic and Neurology
Polyclinic RSUP Haji Adam Malik Medan. Diabetic neuropathy is divided into light, medium, bad. Furthermore, the
examination on cognitive function was conducted by using MoCA INA, Verbal fluence, TMT-A, TMT-B. In order to
analyze the data of the correlation between the level of diabetic neuropathy and cognitive function disorder, fisher exact
test was used.
The Result: This research involve 31 subjects. They are DM patients who sufferred diabetic neuropathy. They consist of
26 female patients (83,9%), and 5 male patients (16,1%), the ages of all subjects had median in the amount of 54 (50-73)
years old. The history of suffering DM, subjects have median value 4 (1-15) years, divided into <5 years 16 subjects
(51,6%), 5-10 years in the amount of 12 subjects (38,7%), and >10 years in the amount of 3 subjects (9,7%). The level of
subjects’ Hba1c has median value 8 (7-11.20). From the statistical analysis, it obtains that there is significant correlation
between the level of diabetic neuropathy and four tools of cognitive examination, MoCA INA with p value < 0,001, TMT-
A with p value <0,023, TMT-B with p vlaue < 0,38 and VFT with p value < 0,014.
Conclusion: There is significant correlation between the level of diabetic neuropathy and cognitive function disorder on
DM patients.

Disclosure: all authors have nothing to disclose

Funding: No financial conflict of interest to disclose
Acknowledgement: authors would like to thank all those who have helped in the collection of data in this study
References:

1. Callaghan, B.C., Cheng, H.T., Stables, C.L., Smith, A.L., and Feldman, E.L. 2012. Diabetic neuropathy: clinical
manifestations and current treatments. Lancet Neurol. 11:521 – 534
2. Kelompok Studi Fungsi Luhur Perhimpunan Dokter Spesialis Saraf Indonesia. 2010. Panduan Pemeriksaan
Neurologi dan Neurobehavior
3. Moreira, R., Soldera, A., Cury, B., Meireles, C., and Kupfer, R. 2015. Is cognitive impairment associated with
the presence and severity of peripheral neuropathy in patients with type 2 diabetes mellitus. Biomed Central.
DOI 10.1186/s13098-015-0045-0
4. Ndraha, S. 2014. Diabetes Melitus Tipe 2 dan Tatalaksana Terkini. Medicinus. 27 (2) : 9 – 16
5. Rambe, A.S., and Fitri, F.I. Correlation between the Montreal Cognitive Assessment – Indonesian Version
(MoCA – INA) and Mini Mental state Examination (MMSE) in Elderly.Macedonian Journal of Medical
Sciences.2017;1-6
6. Sjahrir, S. 2006. Diabetic Neuropathy: The Pathoneurobiology and Treatment Update. Medan: USU Press. hal
1–47
7. Smith, T., Gildeh, N. and Holmes, C. 2007. The Montreal Cognitive Assessment: Validity and Utility in a
Memory Clinic Setting. Can J Psychiatry. 52(5): 329-32.
8. Soelistijo, S.A., Novida, H., Rudijanto, A., Soewondo, P., Suastika, K., Manaf, A., dkk. 2015. Konsensus
pengelolaan dan pencegahan diabetes melitus tipe 2 di Indonesia 2015. Jakarta : Pengurus Besar Perkumpulan
Endokrinologi Indonesia (PB PERKENI). Hal 1-82