Pradana Soewondo
Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta

Published : 24 Documents
Articles

Found 24 Documents
Search

A Multicenter, Prospective, Non-Interventional Evaluation of Efficacy and Safety of Using Biphasic Insulin Aspart as Monotherapy, or in Combination with Oral Hypoglycemic Agent, in the Treatment of Type 2 Diabetic Patients Before, During, & After Ramadan Soewondo, Pradana; Adam, John MF; Sanusi, Harsinen; Soeatmadji, Djoko Wahono
Journal of the Indonesian Medical Association Vol. 59 No. 12 December 2009
Publisher : Journal of the Indonesian Medical Association

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Moslems with type 2 diabetes who decide to fast during Ramadan may be subjected to metabolic changes which could lead to metabolic complications. The use of premixed insulin analogue (biphasic insulin aspart [BIAsp]) has been recently introduced to allow convenient mealtime dosing without reducing the efficacy of postprandial glycemia control and less risk of developing hypoglycemia. This study was aimed to evaluate the safety and efficacy of BIAsp (NovoMix® 30 FlexPen®, Novo Nordisk A/S, Denmark) in type 2 diabetic patients before, during, and after Ramadan fasting in normal clinical practice. A total of 152 patients were enrolled in this study with slightly more female than male. Patients’ mean age was 54.0 years (22-80 years). There were 65.1% of patients receiving insulin therapy prior to the study entry. Treatment with BIAsp significantly reduced all glycemic indices, i.e. fasting plasma glucose (FPG), 2-hour postprandial plasma glucose (2-hr PPG), and glycosilated hemoglobin (HbA1c). There were no significant changes in body weight and BMI. Hypoglycaemic event was almost not found in patients after 3-month of treatment and was significantly reduced compare to baseline events. There were 5 (3.2%) cases of non-serious adverse events during the study. In conclusion, treatment with NovoMix® 30 FlexPen® in type 2 diabetic patients who fast during the Ramadan is effective in maintaining and even in reducing glycemic parameters (FBG, 2-hrPPBG, and HbA1c) as compared to the baseline levels. These improvements were not accompanied with an increase in body weight or body mass index as often found with insulin treatment. The current treatment was also shown to be safe and well tolerated.Keywords: Ramadan fasting, glycaemic control, insulin, type 2 DM
Acromegaly Cahyanur, Rahmat; Soewondo, Pradana
Journal of the Indonesian Medical Association Vol. 60 No. 6 June 2010
Publisher : Journal of the Indonesian Medical Association

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Acromegaly is a disease that caused by pituitary adenoma. Clinical manifestation that found in patient with acromegaly is caused by tumor mass effect and growth hormone hypersecretion. Acral enlargement, maxillofacial change and headache are commonly seen clinical findings. Diagnoses of acromegaly are based on clinical finding, laboratory evaluation, and imaging. Laboratory evaluation characterized by increased in growth hormone and IGF-I level, while magnetic resonance imaging (MRI) examination of pituitary showed a pituitary adenoma. Mortality in acromegalic patients compared with general population is twofold until fourfold higher. Three approaches to manage acromegaly case are surgery, medical management, and radiotherapy. Treatment that normalizes serum IGF-I and growth hormone (GH) level leads to decrease on mortality rates comparae to those in the normal population.Keywords: acromegaly, IGF-I, growth hormone, pituitary adenoma
Statin Administration for Primary Prevention of Cardiovascular Complication Among Type 2 Diabetic Patients with Good Lipid Profile: Evidence Based Report Nursalim, Alvin; Soewondo, Pradana; Widyahening, Indah Suci
Journal of the Indonesian Medical Association Vol. 61 No. 9 September 2011
Publisher : Journal of the Indonesian Medical Association

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

One of the most fatal complications in diabetic patients is diabetic heart disease. Dyslipidemia becomes one of many risk factors that contribute to the occurrence of cardiovascular complication among diabetic patients. Some studies showed the effectiveness of statin in improving lipid profile among type 2 diabetic patients with dyslipidemia, which finally reduce the occurrence of cardiovascular complication. This report aims to identify whether statin is effective in preventing cardiovascular complication among diabetic patients with normal lipid profile. A search was conducted on PubMed and Google. After the selection of title and abstract was done using inclusion and exclusion criteria. Eleven original articles were found, but only three studies were used. All selected studies were critically appraised for its validity, importance and applicability.All three studies showed the reduction in cardiovascular complication and mortality related to cardiovascular. The relative risk reduction ranged from 18-37.5%. The absolute risk reduction ranged from 1.9%-3% and number needed to treat ranged from 33-53. Beside the reduction in cardiovascular complication, statin therapy was also proven to decrease the occurrence of cerebrovascular complication among type 2 diabetic patients. The administration of statin is effective in reducing the risk of cardiovascular complication among type 2 diabetic patients with normal lipid profile. J Indon Med Assoc. 2011;61:363-7.Keywords: Type 2 Diabetes mellitus, dyslipidemia, statin, normal lipid profile, cardiovascular disease.
Current Practice in the Management of Type 2 Diabetes in Indonesia: Results from the International Diabetes Management Practices Study (IDMPS) Soewondo, Pradana
Journal of the Indonesian Medical Association Vol. 61 No. 12 December 2011
Publisher : Journal of the Indonesian Medical Association

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Increasing obesity, sedentary lifestyle and aging population have significantly contributed to the explosion of type-2 diabetes. In addition, the consequences of its complications have caused substantial morbidity and mortality. The major goal of diabetes treatment is to achieve good metabolic control, thus preventing the onset of the long-term complications. Unfortunately, there is still insufficient data on the quality of care of diabetic patients especially on type-2 diabetic patients in Indonesia. This study focused on diabetic patients seen by general practitioners, internists and endocrinologists, to assess its management, HbA1c achievement, and resources used. This study was part of The International Diabetes Management Practices Study (IDMPS) wave 2006, which was a cross-sectional study and also longitudinal follow up. Sixty eight physicians, consisted of 48 general practitioners (GPs)/internists and 20 endocrinologists, have reported 674 patients with type-2 diabetes mellitus who are currently receiving varied diabetes mellitus treatment. Among those patients, 21 patients only treated with lifestyle modification, 523 patients received only Oral Glycaemic Lowering Drug (OGLD), and 130 patients received insulin with or without OGLD. The average HbA1c in this study was 8.27% and only 37.4% reached the target value of HbA1c less than 7%. The majority of patients did not attain the recommended glycaemic target. This indicates the presence of a gap between recommendations of most recent guidelines and the actual practices. J Indon Med Assoc. 2011;61:474-81.Keywords: Diabetes, Indonesia, Type of medication, Target achievement
Glycemic Control in Switching Insulin-based Regimen Among Type 2 Diabetic Patients Soewondo, Pradana; Subekti, Imam
Journal of the Indonesian Medical Association Vol. 61 No. 11 November 2011
Publisher : Journal of the Indonesian Medical Association

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Appropriate diet and physical activity, maintaining a healthy body weight and propercontrol of diabetes using oral anti diabetic (OAD) in people with diabetes type 2 will helpreduce its complications. However, some advance diabetic cases need insulin-based regimen toaggressively lower blood glucose level. Local data was insufficient to determine whether type 2diabetes patients on insulin were indeed attaining glycemia goals. The aim of this study was toassess the clinical response of type 2 diabetic patients who were switched to another insulinregimen to achieve glycemic control. The study was performed as a non-interventional prospective disease registry that mirror real life management of these subjects after a 3 month follow up. To assess the clinical response, we performed measurement of fasting blood glucose level, HbA1c, waist circumference and body weight. One hundred and fifteen type 2 diabetes patients who were already on insulin therapy with unsatisfactory control of glycaemia parameters were admitted in this study of an actual clinical setting. Only 93 cases have been examined in a 3 month follow up. Premix, Short-acting and Intermediate-acting insulin were the most popular insulin-based regimens that previously been prescribed, while basal analogue insulin is the most common regimen for switching therapy. The newly prescribed insulin-based regimen showed significant reduction of important glycaemia parameters such as fasting blood glucose level and HbA1c. Serum blood glucose was decreased 61.76 mg/dL (p<0.001) and the level of HbA1c was also decreased 1.39 unit (p<0.001). In addition, waist circumference was significantly reduced for 0.70 cm (p=0.041). However, there was a slight increase of body weight althoughnot statistically significant (p=0.389). We concluded that switching insulin-based regimen for unsatisfactory although glycemic control patient gave the probability to improve clinical response. J Indon Med Assoc. 2011;61:429-34.Keywords: Type 2 diabetes, Indonesia, insulin-based, switching regimen, Glycemic control
Capacity for Management of Type 2 Diabetes Mellitus (T2 DM) in Primary Health Centers in Indonesia Widyahening, Indah Suci; Soewondo, Pradana
Journal of the Indonesian Medical Association Vol. 62 No. 11 November 2012
Publisher : Journal of the Indonesian Medical Association

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Introduction: According to WHO data, the prevalence of type 2 diabetes mellitus (T2 DM) inIndonesia will be increasing 154% in year 2030. Therefore all the primary health centres areneeded to improve with good capacity of T2DM management. Since there is no data available,the aim of this study was to describe the capacity of primary health centers in Indonesia inmanagement of T2DM.Methods: A questionnaire survey was conducted from January to December 2007 to generalpractitioners working in primary health centres in eight provinces of Indonesia. Data collectedinclude availability of health personnel, laboratory, and supporting facilities to diagnose T2DMand it’s complications and medication. A total of 272 primary health centre (PHCs) participated.Results: Laboratory facilities exist in 82% of the PHC. Most do not have equipments to diagnose complications such as ophthalmoscope (72%), electrocardiogram (92%) and radiology tools (96%). Oral hypoglycaemic agents available in 94% of the PHCs. Sulphonylurea (glybenclamide) is available in all while biguanide is available in 29%. Most PHC (97%) do not provide insulin. Only 6% have facility to manage diabetic foot, and only 21% able to conduct T2DM education.Conclusion: Ability to diagnose T2DM in the PHCs is sufficient, but the capacity in the treatment, detections and management of complications are limited. Special effort by the Ministry of Health and professional organizations will be needed to improve the capacity. J Indon Med Assoc. 2012;62:439-43.Keywords: diabetes mellitus, primary health care, management
The correlation between hs C-reactive protein and left ventricular mass in obese women Alwi, Idrus; Harun, S.; Sukmoko, Satrio; Soewondo, Pradana; Waspadji, Sarwono; Soegondo, Sidartawan
Medical Journal of Indonesia Vol 15, No 2 (2006): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (120.996 KB) | DOI: 10.13181/mji.v15i2.223

Abstract

Plasma C-reactive protein (CRP) concentrations are increased in obese individuals. In this study, we examined the correlation between hsCRP and left ventricular mass (LV mass). Fourty five healthy obese women and fourty five healthy non obese women as the controls group were studied by echocardiography and hsCRP. There was no significant correlation between hsCRP and left ventricular mass in obese women (r = 0.29, p 0.06). There was a significant correlation between hs CRP and body mass index (r = 0.46, p 0,002), and also hsCRP and visceral fat (r= 0.33, p 0.03). (Med J Indones 2006; 15:100-4) Keywords: hs C-reactive protein, LV mass, obese women
Non-psychogenic polydipsia in 45-year-old man with primary hyperparathyroidism and recurrent bilateral nephrolithiasis Cahyanur, Rahmat; Sarwono, Johannes; Armelia, Linda; Marbun, Maruhum B.H.; Soewondo, Pradana
Medical Journal of Indonesia Vol 21, No 4 (2012): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (446.727 KB) | DOI: 10.13181/mji.v21i4.506

Abstract

Non-psychogenic polydipsia with hyponatremia is a rare clinical presentation. Primary hyperparathyroidism is a disorder of calcium, phosphate, and bone metabolism caused by increased level of parathyroid hormone (PTH). It is estimated the incidence of primary hyperparathyroidism are 21.6 per 100,000 person a year. This case report describe a 45-year-old man presented with non-psychogenic polydipsia. This patient drank a lot of water out of the fear of recurrent kidney stones. He had history of recurrent nephrolithiasis with hypercalcemia. We investigate further the cause of hypercalcemia and we diagnosed primary hyperparathryoidism as the cause. (Med J Indones. 2012;21:230-4)Keywords: Hyponatremia, non-psychogenic polydipsia, primary hyperparathyroidism
The DiabCare Asia 2008 study – Outcomes on control and complications of type 2 diabetic patients in Indonesia Soewondo, Pradana; Soegondo, Sidartawan; Suastika, Ketut; Pranoto, Agung; Soeatmadji, Djoko W.; Tjokroprawiro, Askandar
Medical Journal of Indonesia Vol 19, No 4 (2010): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (159.097 KB) | DOI: 10.13181/mji.v19i4.412

Abstract

Aim: To collect information on diabetes management, diabetes complications, and awareness of self-control in diabetic population of the country. This study also evaluated the physician perspectives, psychological aspects, and quality of life of diabetic patients.Methods: This was a non-interventional, cross-sectional study, which recruited 1832 patients from secondary and tertiary medical centers across Indonesia. Data on demography, medical history, risk factors and clinical examination reports including laboratory assessments were collected from medical records of patients. Blood samples of all patients were collected for centralized HbA1c measurements.Results: Among 1832 patients, 1785 individuals were eligible for analysis. The mean age of the patients was 58.9+9.6 years. The mean duration of diabetes was 8.5+7.0 years. Majority (97.5%) of the patients had type 2 diabetes. 67.9% had poor control of diabetes (A1c:8.1 ± 2.0%). 47.2% had FPG>130 mg/dL (161.6±14.6 mg/dL). Dyslipidemia was reported in 60%  (834/1390) and 74% (617/834) of those received lipid lowering treatment. Neuropathy was most common  complication (63.5%); other complications were: Diabetic retinopathy 42%, nephropathy 7.3%, severe late complications 16.9%, macrovascular complications 16%, microvascular complications 27.6%. About 81.3% of patients were on OADs (± insulin), 37.7% were on insulin (±OADs). Majority used biguanides followed by sulfonylureas. Human insulin was used by 73.2%, premix regimen 58.5%, analogues usage was 24.9%. Majority of the WHO-5 well being index responses fell in positive territoryConclusion: Poor glycaemic control in majority of patients is a concern. There is a need for a large proportion of patients to be adjusted to more intensive pharmacotherapy and a multi-disciplinary approach for management should be adopted. The study fi ndings should be communicated to policymakers and physicians to help them provide proper healthcare and its facilities in Indonesia. (Med J Indones 2010; 19:235-44)Keywords: DiabCare, DiabCare Indonesia, Diabetes complications, Dyslipidaemia, Glycaemic control, Hypertension.
Prevalence, characteristics, and predictors of pre-diabetes in Indonesia Soewondo, Pradana; Pramono, Laurentius A.
Medical Journal of Indonesia Vol 20, No 4 (2011): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1041.548 KB) | DOI: 10.13181/mji.v20i4.465

Abstract

Background: Pre-diabetes is a state where glucose level higher than normal, but not satisfy the criteria for diabetes. This condition is very critical, so that if subject don’t do lifestyle modification and pharmacology therapy, they could fall to diabetes. This research objective is to describe the prevalence and predictors of pre-diabetes in Indonesia.Methods: A cross-sectional study was conducted by Metabolic Endocrinology Division, Department of Internal Medicine FMUI/RSCM and Jakarta Diabetes and Lipid Center using secondary data from National Health Survey 2007. Total  respondents are 24417 subjects from 33 provinces in Indonesia. We analyze characteristics, correlation, predictors, and  attributable risks for some predictors of pre-diabetes and diabetes.Results: Prevalence of pre-diabetes (based on impaired glucose tolerance data) in Indonesia is 10%. Predictors of pre-diabetes are male, old-age, high socio-economic status, low education level, hypertension, obesity, central obesity, and smoking. Priority for pre-diabetes and diabetes prevention in Indonesia directed to decrease blood pressure (Attributable Risk/AR  56.5%), reduce waist circumference (AR 47.3%), and stop smoking (AR 44.4%).Conclusion: Prevalence of pre-diabetes in Indonesia is high so that we need a prevention strategy for pre-diabetes and the development from pre-diabetes to diabetes. The implementation of those strategies is compiled in the Indonesian Diabetes Prevention Program.(Med J Indones 2011; 20:283-94)Keywords: diabetes, Indonesian diabetes prevention program, pre-diabetes