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7/26/2019 Terapi Insulin Dm
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Memulai Terapi Insulin
pada DM tipe 2
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DIAGNOSIS DM
GD puasa > 126 mg/dl
GD 2 j pp > 200 mg/dl
Pemeriksaan dg OGTT
Puasa
2j seela! pem"erian #$ gr Gula
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insulin
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%armak& kineikinsulin
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Insulin kerja panjang
Efektitas 1 x sehariRisiko Hipoglikemi rendah
Risiko Kenaikan BB rendah
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Insulin kerja 'epa
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Insulin mi(
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T)*API INS+,IN
Indikasi mulak
DMT1
Indikasi relai- Gagal dg k&m"inasi O.O d&sis &pimum 6
"ulan
DMT2 dengan
e!amilan Dek&mpensasi mea"&lik 3 44 5GDP >2$0mg5 GDS
> 00mg5 ."A1' >7 8
T!/ Ser&id d&sis inggi
Persiapan &perasi dll
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INS+,IN ONDISI.+S+S).AMI,AN
Insulin .+MAN
Insulin ANA,OG 99SI*OSIS / .)PATITIS *ONIS
Insulin .+MAN s!&r a'ing
O*ANG T+A
.ai!ai !ip&glikemia
ST)*OID
Insulin "asal / muliple !arian / in-us
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INS+,IN ANA,OG
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INS+,IN .+MAN
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Sraegi erapi
insulin
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M)M+,AI T)*API
INSu,IN ,angka! 1
: Mulai erapi Insulin 4ASA, 3,);)MI*8 1(
se!ari: Mulai 10 + aau 051 < 052 +/g44
: Di"erikan sekali se!ari5 kapan saja di=akuang sama seiap !ari
: Periksa reraa GDP seiap !ari+3 > 110mg/dl
0 ?0 < 110
mg/dl @ ?0 m dl
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M)M+,AI T)*API
INSu,IN,angka! 2A
: jika ela! memakai insulin 4asal ."A1masi! ># pinda! ke N&B&mi( 4ID
: D&sis sama di"agi 2 ( pem"erian $0 0 $0: Tirasi d&sis seminggu sekali
:S&p Sul-&nil urea
:,anju Me-&rmin
: S&p TCD
:N&B&mi( segera se"elum makan
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M)M+,AI T)*API
INSu,IN 2A: Penesuaian d&sis Sesuaikan d&sis
seminggu sekali
Penesuaian d&sis
"edasarkan GD pre mealerenda! di !r erak!ir
Tirasi d&sis"erdasarkan GD pre
meal penunikanselanjuna
4ila .ip&glikemi d&sisidak dinaikkan
G premeal
!en"es#aian dosis
Mg/dl uni
@?0 2
?0 < 110 0
111 < 10 E2
11 < 1?0 E
> 1?0 E6
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M)M+,AI T)*APIINSu,IN,angka! 24 *egimen 4asal 4&lus: Per"aiki GDP dg Insulin 4ASA, dg arge ?0 <
10 mg/dl
: Tam"a! insulin 4O,+S "ila Targe er'apai
api ."A1' >#
:Tam"a!kan insulin 4O,+S + pada p&rsi
makan er"esar: Tirasi !ingga men'apai arge GDPP 3 1?0
mg/dl8
: S&p Sul-&nl +rea
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M)M+,AI T)*API
INSu,IN 24:D&sis Tirasi NO;O *APID
$g/dl %@ #0 1
#0 < 10 0
> 10 E1
Fika seela! "ln 5 ."A1' masi! > # dan irasimen'apai > 0+
Tam"a!kan "&lus ke 2 dan ke
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SASA*AN G,I)MI
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Gluk&sa dara! puasa 3mg/dl8
Gluk&sa dara! 2 jam 3mg/dl8
A1 38
&leser&l T&al 3mg/dl8&leser&l ,D, 3mg/dl8
&leser&l .D, 3mg/dl8
Trigliserida
IMT 3kg/m28
Tekanan Dara!
?0 < 107
?0 1
110 <
12$
1$ <
1#7
126
1?0
B&'K (E&)G B%R%K
@ 65$
@ 200@ 100
> $
@ 1$0
1?5$ < 2257
65$ < ?
200 < 27100 < 127
1$0 < 177
2 < 2$
@ 10 / ?01010/?070> 10/70
K R'*ER'& !E)GE)&'&) '&BE*E( $E'*%(
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,&kasi
injeksiinsulin
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Insulin pump
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