laporan bb menurun kelompok 9

8/9/2019 LAPORAN BB Menurun Kelompok 9

1/19

Laporan Kelompok

MODUL 1

BERAT BADAN MENURUN

DISUSUN OLEH

KELOMPOK 9

FAKULTAS KEDOTERAN

UNIVERSITAS MUHAMMADIYAH MAKASSAR

!1


2/19

KASUS

Skenar"o 1

Seoran# lak"$lak" %m%r &! 'a(%n men#%n)%n#" *ok'er ole( karena +era'

+a*anmen%r%n ,an# *"alam" -e)ak . +%lan 'erak("r/Pen*er"'a )%#a men#alam"

ak("r$ak("r "n" -elal% mera-a lema-0 lela( *an men#an'%k/

A/ Ka'a K%n"

1/Lak"$lak" &! 'a(%n

/Bera' +a*an men%r%n *alam . +%lan 'erak("r

./Lema-

2/Lela(

&/Men#an'%k

B/ Ka'a S%l"'

1/Lema- 3mala"-e4Mala"-e a*ala( -%a'% kea*aan '%+%( ,an# mem"l"k"

'ena#a 'er+a'a- 5k%ran#n,a "n'ake ener#, ak"+a' -%pla" ok-"#en ,an# '"*ak

*"+aren#"ke+%'%(an ok-"#en ,an# men"n#ka' -e("n##a me'a+ol"-me -el men%r%n

*anener#" k%ran#/


3/19

/Lela( 36a'"#%e4Fa'"#%e a*ala( kea*aan men"n#ka'n,a ke'"*akn,amanan0

men%r%nn,ae6"-"en-" ak"+a' peker)aan +erkepan)an#an a'a% +erle+"(an *an

ke("lan#an'ena#a a'a% kemamp%an men)a7a+ ran#-an#/

8/ Per'an,aan

1/ De66eren-"al *"a#no-"- ,an# m%n#k"n

/ :ela-kan ana'om"0 6"-"olo#" or#an 'erka"'

./ D"a#no-"- -emen'ara

2/ H%+%n#an #e)ala kl"n"- *en#an DS

&/ Pa'omekan"-me DS

;/ Pena'alak-anaan *ar" DS

!$9!? pen*er"'a men#alam" o+e-"'a-/ D"a+e'e- '"pe II )%#a

en*er%n#*"'%r%nkan/

/TirotoksikosisKela"nan kelen)ar '"ro"* ,an# men,e+a+kan pen"n#ka'an

pro*%k-"'"ro"*/ Pen,e+a+ '"ro'ok-"ko-"- -e+a#"an +e-ar a*ala( pen,ak"'

@rae-0#o"'er m%l'"no*%lar 'ok-"k *an monono*%lar 'ok-"k/ Pa-"en


4/19

'"ro'ok-"ko-"-men#alam" pen"n#ka'an la)% me'a+ol"k +a-al/Ter)a*"

pen"n#ka'anpem+en'%kan pana- 3ker"n#a' +erle+"(an4 *an pen%r%nan

'oleran-"'er(a*ap pana-/ T%+%( ,an# mem+akar +a(an +akar *en#an

keepa'ana+normal men,e+a+kan men"n#ka'n,a ke+%'%(an me'a+ol"k0

7ala%p%nna6-% makan *an a-%pann,a men"n#ka' +era' +a*an +"a-an,a men%r%n

/ Ana'om"0 H"-'olo#"0 *an 6"-"olo#" or#an 'erka"'

Anatomi

1. Kelenjar Thyroid

Kelem)ar '(,ro"* 'er*"r" *ar" *%a lo+%- -"me-'r"- ,a"'% -"n"-'ra *an *ek-'ra *"mana

ke*%a lo+%- "n" *"(%+%n#kan ole( I'(m%- ,an# 'erle'ak *" 'en#a( +"a-a )%#a

'er*apa' lo+%- p,ram"*al"-/ Kelen)ar "n" *"+%n#k%- ole( 6a-"a propr"a3Tr%e

8ap-%le4 *an 6a-"a pre'rak(eal"-3Fal-e 8ap-%le40 kelen)ar "n" 'erle'ak *" +a#"an

an'er"or le(er *" +a7a( lar,n *an *" a'a- 'rak(ea ,an# *"'%'%p" ole( m%-k%l%-

-'erno(,o"*e%- *an m%-k%l%- -'erno'(,ro"*e%-/ Ba'a- ran"al *ar" kelen)ar "n"

*apa' menapa" l"nea o+l"C%e ar'"la#e '(,ro"*ea *an +a'a- a%*al 'erle'ak pa*a

"n"n 'ra(ea &$;/Kelen)ar "n" )%#a *""k-a-" ole( 'ra(ea *an ar'"la#e r"o"*ea

melal%" l"#amen'%m o6 +err,0 +a#"an -%per6""al *ar" kelen)ar "n" 'er*apa' o'o'$

o'o' "n6ra(,o"*0 +a#"an pro6%n*a *ar" kelen)ar "n" 'er*apa' ner%- lar,n#e%-

ek-'erna *an ner%- re%rren-0 +a#"an po-'ero$la'eral *ar" kelen)ar '(,ro"*

'er*apa' ara'"* -(ear'(/ Va-k%lar"-a-" *ar" kelen)ar '(,ro"* ,a"'% Ar'er"

'(,reo"*ea -%per"or ,an# mer%pakan a+an# *ar" ar'er" aro'"- ek-'erna ,an#

mempera+an#kan ram%- an'er"or ,an# men%)% ke "'(m%- *an po-'er"or -er'a

+erana-'omo-e *en#an ram%- a-en*en- ar'er" '(,ro"*ea "n6er"or0 Ar'er"

'(,reo"*ea "n6er"or ,an# mer%pakan a+an# *ar" 'r%n%- '(reoer"al"- ,an#men-%pla" *ara( ke -e+a#"an +e-ar kelen)ar0 Ar'er" '(,reo"*ea IMA ,an#

mer%pakan a+an# *ar" ar'er" +ra("oep(al"%- a'a% lan#-%n# *ar" ar%- aor'ae/

Al"ran *ara( ena *ar" kelen)ar '(,ro"* "n" -en*"r" ,a"'% Vena '(,reo"*ea -%per"or

*an ena '(,reo"*ea me*"a +erm%ara pa*a ena )%#%lar"- "n'erna *an Vena

'(,reo"*ea "n6er"or +erm%ara pa*a ena +ra("oep(al"a/A*ap%n al"ran l,mp(e

pa*a kelen)ar '(,reo ,a"'% No*%l l,mp('"%- er"kal"- pro6%n*%- +a#"an

-%per"or *an "n6er"or *an no*%l l,mp(a'"%- para'ra(eal"-/Sela"n "'% kelen)ar


5/19

'(,ro"* men*apa'kan "nnera-" -eara -"mpa'"- ,an# men#"k%'" ar'er" '(,reo"*ea

-%per"or *an ar'er" '(,reo"*ea "n6er"or ,a"'% @an#l"on er"ale -%per"or *an

@an#l"on er"al me*"%-/

2. Pankreas

S%a'% kelen)ar en*okr"n *an )%#a mer%pakan kelen)ar eor"ne0

memp%n,a" -'r%k'%r ,an# lo+%ler *an *"+%n#k%- ole( ap-%la )ar"n#an "ka' +era'

*ar" panrea- ;


6/19

panrea'"o *%o*enal"- -%per"or ,an# mer%pakan a+an# *ar" ar'er"

#a-'ro*%o*enale *an Ar'er" panrea'"o *%o*enal"- "n6er"or ,an# mer%pakan

a+an# *ar" ar'er" me-en'r"ka -%per"or0 +a#"an 8orp%- *an 8a%*a men*apa'kan

a-k%lar"-a-" *ar" a+an# ar'er" l"enal"- ,a"'% Ar'er" panrea'"o *or-a"l a'a%

'ran-er-a0 Ar'er" panrea'"o ma#na0 Ar'e" panrea'"o a%*al"-/ Al"ran *ar( Vena

%m%mn,a men#"k%'" al"ran *ara( ar'er" ,a"'% Vena panrea'"o *%o*enal"-

-%per"or ,an# +erm%ara ke ean por'a0 Vena panrea'"o *%o*enal"- "n6er"or ,an#

+erm%ara ke aena me-en'r"ka -%per"or0 Vena panrea'"ko 'ran-er-a a'a% "n6er"or

,an# +erm%ara pa*a ena me-en'r"ka "n6er"or/ A*a p%n al"ran l,mp(e *ar"

panrea- ,a"'% 'e*apa' no*%l l,mp(a'"%- ,an# men#"k%'" ar'er" pa*a panrea-

,a"'% no*%l l,mp(a'"%- panrea'"ol"enal"-0 no*%l l,mp(a'"%- -%+p,lor""0 no*%l

l,mp(a'"%- panrea'"o*%o*enal"-0no*%l l,mp(a'"%- me-en'r""/

Histologi

1. Kelenjar Thyroid

Kelen)ar '(,ro"* a*ala( or#an en*okr"n ,an# 'er-%-%n men)a*" -'r%k'%r -el$-el

,n# +%la'0 ,a"'% 6ol"kel36oll"%l%-4/ Se'"ap 6ol"kel *"kel"l"n#" ole( -era' re'"k%lar"-

*an -%a'% an,aman kap"ler ,an# mem%*a(kan (ormon '"ro"* ma-"k ke*alam

al"ran *ara(/Ep"'el 6ol"kel *apa' +er%pa ep"'el -elap"- #epen#0 k%+o"*0 a'a%

kol%mnar ren*a(0 +er#an'%n# pa*a kea*aan ak'"6"'a- kelen)ar '(,ro"*/ Sel$-el ,an#

men#el"l"n#" 6ol"kel ,a"'% -el kol%mne"r3'(,ro,'%- T4 a'a% +"a-a *"-e+%' ell%la

pr"n"pal0 *" l%men 6ol"kel -e+a#a" -%+-'an-" #ela'"no-a a*ala( kolo"*3ollo"*%m4

,an# 'er*"r" *ar" '"ro#lo+%l"n -ela"n 6ol"kel0 kelen)ar '(,ro"* )%#a men#an*%n# -el

para6ol"l"k%lar3'(,ro,'% 84 'erp%la- p%a' ,an# le+"( +e-ar/-el$-el "n" *"'em%kan

*" 'ep" ep"'el 6ol"kel a'a% *" *alam 6ol"kel/

2. Pankreas

Pankrea- mem"lk" komponen ek-okr"n *an en*okr"n/ Komponen ek-okr"n

mem+en'%k -e+a#"an +e-ar panrea- *an 'er*"r" *ar" a-"n" -ero-a *an -el

"mo#en"k ,an# 'er-%-%n rapa' *an mem+en'%k +an,ak lo+%- ke"l0 lo+%l%-

*"kel"l"n#" ole( -ep'%m )ar"n#an "ka' "n'ralo+%lar"-0 -ara60 *an ka*an#$ka*an#


7/19

re-ep'or -en-or"k ,a"'% orp%-%l%m lamello-%m3pa"n"an orp%-le4/ D" *alam

a-"n" -ero-a 'er*apa' "n-%la panre'"a3p%la% lan#er(an-4 ,an# 'erp"-a( ,an#

mer%pakan +a#"an en*okr"n *an mer%pakan "r" k(a- panrea-

Se'"ap a-"n%- pankrea'"k%- 'er*"r" a'a- -el "no#en"k ,an# men#el"l"ln#"

-e+%a( l%men -en'ral ,an# ke"l/ D%k'%- ek-kre'or"%- -e'"ap a-"n" 'erl"(a' -el

-en'roa-"nar ,an# 'erp%la- p%a' *" *alam l%men0 pro*%k -ekre'or"' kel%ar +*ar"

a-"n" melal%" *%k'%- "n'erkalar"-3"n'ralo+%lar"-4/ L%men ke"l *"lap"-" ep"'el k%+o"*

ren*a(/ Sel -en'roa-"nar +er-am+%n#an *en#an ep"'el *%k'%- "n'erkalar"- /

D%k'%- "n'erk%lar"- men#al"r ke*alam *%k'%- "n'erlo+%lar"- ,an# 'er*apa' *" *alam

-ep'%m )ar"n#an "ka' "n'erlo+%lar"- /*%k'%- "n'erlo+%lar"- *"lap"-" ole( ep"'el

-elap"- k%+o"*/In-%la panrea'"a *"p"-a(kan *ar" )ar"n#an a-"n" ek-or"a

*"-ek"'arn,a ole( lap"-an '"p"- -era' re'"%lar/"n-%la le+"( +e-ar *ar"pa*a a-"n" *an

mer%pakan kelompok pa*a -el -el ep"'el ,an# *"'em+%- ole( kap"ler/

Fisiologi

1. Fisiologi Kelenjar Tyroid

Kelen)ar '"ro"* 'er*"r" *ar" *%a lo+%- )ar"n#an en*okr"n0-el -el %'ama

-ekre'or"k '"ro"* 'er-%-%n men)a*" #elem+%n# #elem+%n# +eron##a ,an# ma-"n#

ma-"n# mem+en'%k %n"' 6%n#-"onal ,an# *"-e+%' 6ol"kel/pa*a -el 6ol"kel 'er-e+%'

mel"p%'" l%men +a#"an *alm ,an# *" pen%(" kolo"*0-%a'% +a(an ,an# +er6%n#-"

-+#a" 'empa' pen,"mpanan ek-'ra -el %n'%k (ormone$(ormon ',ro"*0 kolo"* 'er*"r"

a'a- ',ro#lo+%l"n ,an# mer%pakan -%a'% #l"kopro'e"n ,an# +er"o*"n ,# mer%pakan

+en'%k -"mpanan (ormone ,an# '"*ak ak'"6/ Sel 6ol"kel men#(a-"lkan (ormon

,an# men#an*%n# "o*"%m0,an# +era-al *ar" a-am am"no ',ro-"n

'era"o*o',ron"n3T2 a'7 ',rok-"n4 *an 'r""o*o',ron"n3T.4/ Ke*%a (ormone "n" ,an#

-eara kolek'"6 *" -e+%' -e+a#a" (ormone ',ro"*0 mer%pakan re#%la'or pen'"n# +a#"

la)% me'a+ol"-me +a-al -eara ke-el%r%(an/

D" r%an# "n'er'"-"%m *" an'ara 6ol"kel 'er*apa' -el -ekre'or"k )en"- la"n0

,a"'% -el 83 *" -e+%' *em"k"an karna men#el%arkan (ormone pep'"*e kal-"'on"n4

,an# +erperan *alam me'a+ol"-m kal-"%m0 kal-"'on"n -ama -ekal" '"*ak +erka"'an

*en#an ke*%a (ormone ',ro"* %'ama *" a'a-/

2. Fisiologi Pankreas


8/19

Panrea- mer%pakan kelen)ar amp%ran ,# men#an*%n# )ar"n#an ek-okr"n

*an en*okr"n / +a#"an ek-okr"n ,an# pre *om"nan 'er*"r" *ar" kelompok -el

-ekre'or" ,an# -eper'" mem+en'%k kan'%n# a'7 a-"n%- +er(%+%n#an *en#an

*%k'%- ,an# ak("rn,a +erm%ara ke *%o*en%m/ Sel a-"n%- men#el%arkan . )en"-

en"m panrea- ,an# mamp% menerna ke '"#a ka'e#or" makanan0 ke'"#a )en"-

en"m panrea- 'er-e+%' ,a"'%

1/ En"m pro'eol"'"k

/ Am,la-e panrea-

./ L"pa-e panrea-

Komponen en*okr" panrea- 'er-e+ar *" -el%r%( or#an +er%pa p%la% -elen*okr"n ,an# *" -e+%' p%la% lan#er(an- /,an# men#(a-"lkan (ormon %'ama

,an# men#a'%r ka*ar #l%ko-a *an me'a+ol"-m #l%ko-a/ (ormon 'er-e+%' a*ala(

#l%a#on *an "n-%l"n/#l%ka#on -e+a#a" re-pon 'er(a*ap ka*ar #l%ko-a *ara( ,an#

ren*a(0#l%a#on men"#ka'kan ka*ar #l%ko-a *ara( *en#an memperepa'

per%+a(an #l"ko#en0 a-am am"no *an a-am lemak *" (epa'o-"' men)a*" #l%ko-a/

Pelepa-n "n-%l"n* ran#-an ole( ka*ar #l%ko-a *ara( ,an# men"#ka' -e'ela( makan/

In-%l"n men%r%nkan ka*ar #l%ko-a *ara( ,an# men"n#ka' *en#an 'ran-por'

mem+rane #l%ko-a ke *alam (epa'o-"' o'o' *an -el a*"po-e/ In-%l"n )%#a

memperepa' kon6er-" #l%ko-a men)a*" #l"ko#en *" (epa'o-"'/ E6ek "n-%l"n

'er(a*ap ka*ar #l%ko-a *ara( +erla7anan *en#an e6ek #l%a#on/

Sela"n ke*%a (ormone 'er-e+%' )%#a 'er*apa' (ormone -oma'o-'a'"n

,an# +er6%n#-" men%r%nkan *an men#(am+a' ak'"6"'a- pen#(a-"l #l%a#on

*an "n-%l"n melal%" pen#ar%( loal *" *alam p%la% lan#er(an-

Hormone pol"pep'"*a panrea- ,an# men#(am+a' pem+en'%kan en"m

panrea- *an -ekre-" alkal"/

./*"a#no-a -emen'ara/

Diabetes melitus 3DM40 ,a"'% -%a'% kelompok pen,ak"' me'a+ol"k ,an#

*"'an*a" ole( men"n#ka'n,a ka*ar #l%ko-a *alam *ara( -e+a#a" ak"+a' a*an,a

*e6ek -ekre-" "n-%l"n *an a'a% a*an,a re-"-'en-" "n-%l"n/ Apa+"la pen,ak"' "n"

*"+"arkan '"*ak 'erken*al"0 maka akan men"m+%lkan kompl"ka-" ,an# *apa'

+erak"+a' 6a'al0 'erma-%k pen,ak"' )an'%n#0 #"n)al0 ke+%'aan *an


9/19

amp%'a-"/Mekan"-me pen%r%nan +era' +a*an pa*a pen*er"'a DM a*ala( -e+a#a"

+er"k%'

Ole( karena 'er)a*" *e6ek -ekre-" "n-%l"n 3"n-%l"n k%ran#4 ma%p%n a*an,a

#an##%an ker)a "n-%l"n 3re-"-'en-" "n-%l"n4 men#ak"+a'kan #l%ko-a *ara( '"*ak

*apa' ma-%k ke*alam -el o'o' *an )ar"n#an lemak/ Ak"+a'n,a %n'%k memperole(

-%m+er ener#" %n'%k kelan#-%n#an ("*%p *an men)alankan 6%n#-"n,a0 maka o'o'

*an )ar"n#an lemak akan memea(kan a*an#an ener#" ,an# 'er*apa' *alam

*"r"n,a -en*"r" melal%" pro-e- #l"ko#enol"-"- *an l"pol"-"-/ Pro-e- #l"ko#enol"-"-

*an l"pol"-"- ,an# +erlan#-%n# 'er%- mener%- pa*a ak("rn,a men,e+a+kan ma--a

o'o' *an )ar"n#an lemak akan +erk%ran# *an 'er)a*"la( pen%r%nan +era' +a*an/

@e)ala kl"n"k DM a*ala( Pol"%r" 3+an,ak ken"n#40 pol"6a#" 3-elal% lapar40

pol"*"p-" 3-elal% (a%-40 #a'al$#a'al 'er%'ama pa*a *aera( l"pa'an k%l"'0 pera-aan

lema-0 men#an'%k *an +era' +a*an men%r%n/

Pa*a pen*er"'a DM '"pe #e)ala$#e)ala 'er-e+%' +erlan#-%n# -eara perla(an$

la(an *an -amar$-amar -e("n##a '"*ak *"-a*ar" ole( pen*er"'a *an +a(kan

*"an##ap (al ,an# l%mra( -e("n##a +"a-an,a '"*ak mem+a7a pen*er"'a

men#%n)%n#" *ok'er/ T"*ak )aran# pen*er"'a DM '"pe *"'em%kan -eara

ke+e'%lan pa*a pemer"k-aan ke-e(a'an r%'"n a'a% pen*er"'a *a'an# *en#an kel%(an

%'ama ak"+a' kompl"ka-" *"a+e'e- 3 kram$kram0 #a#al #"n)al0 l%ka ,an# '"*ak ma%

-em+%( *-+4/ Se+al"kn,a pa*a pen*er"'a DM '"pe 10 #e)ala kl"n"- +"a-an,a )ela-

ole( karena 'er)a*" kek%ran#an "n-%l"n -eara a+-ol%'e -eara -"n#ka' 3 ker%-akan

panrea- ole( pro-e- a%'o"mm%m *lm 7ak'% -"n#ka' 4

2/ Pa'omekan"-me *ar" *"a#no-e -emen'ara

In-%l"n *"(a-"lkan ole( pankrea- *an *" *alarnn,a 'er*apa' k%mp%lan -el

,an# +er+en'%k -eper'" p%la% pa*a pe'a0 karena "'% *"-e+%' p%la%$p%la%

Lan#er(an- ,an# +er"-" -el +e'a ,an# men#el%arkan (ormon "n-%l"n ,an# -an#a'

+erperan *alam men#a'%r ka*ar #l%ko-a *ara(/

In-%l"n ,an# *"kel%arkan ole( -el +e'a 'a*" *apa' *""+ara'kan -e+a#a" anak


10/19

k%n" ,an# *apa' mem+%ka p"n'% ma-%kn,a #l%ko-a ke *alam -el0 %n'%k

kem%*"an *" *alam -el #l%ko-a 'er-e+%' *"me'a+ol"-a-"kan men)a*" 'ena#a/ B"la

"n-%l"n '"*ak a*a0 maka #l%ko-a *alam *ara( '"*ak *apa' ma-%k ke *alam -el

*en#an ak"+a' ka*ar #l%ko-a *alam *ara( men"n#ka'/ Kea*aan "n"la( ,an# 'er)a*"

pa*a *"a+e'e- mel"'%- '"pe 1/

Pa*a *"a+e'e- mel"'%- '"pe )%mla( "n-%l"n normal0 mala( m%n#k"n le+"(

+an,ak 'e'ap" )%mla( re-ep'or "n-%l"n ,an# 'er*apa' pa*a perm%kaan -el ,an#

k%ran#/ Re-ep'or "n-%l"n "n" *apa' *""+ara'kan -e+a#a" l%+an# k%n" p"n'% ma-%k

ke *alam -el/ Pa*a kea*aan 'a*" )%mla( l%+an# k%n"n,a ,an# k%ran#0 ("n##ame-k"p%n anak k%n"n,a 3"n-%l"n4 +an,ak0 'e'ap" karena l%+an# k%n"n,a

3re-ep'or4 k%ran#0 maka #l%ko-a ,an# ma-%k -el akan -e*"k"'0 -e("n##a -el akan

kek%ran#an +a(an +akar 3#l%ko-a4 *an #l%ko-a *" *alam pem+%l%( *ara(

men"n#ka'/ Den#an *em"k"an kea*aan "n" -ama *en#an pa*a *"a+e'e- mel"'%-

'"pe10 +e*an,a a*ala( pa*a *"a+e'e- mel"'%- '"pe *" -amp"n# ka*ar #l%ko-a

'"n##"0 ka*ar "n-%l"n )%#a '"n##" a'a% normal/ Pa*a *"a+e'e- mel"'%- '"pe )%#a

+"-a *"'em%kan )%mla( "n-%l"n %k%p a'a% le+"( 'e'ap" k%al"'a-n,a k%ran# +a"k0

-e("n##a #a#al mem+a7a #l%ko-a ma-%k ke *alam -el/ D" -amp"n# pen,e+a+ *"

a'a-0 *"a+e'e- mel"'%- )%#a +"-a 'er)a*" ak"+a' #an##%an 'ran-por' #l%ko-a *" *alam

-el -e("n##a #a#al *"#%nakan -e+a#a" +a(an +akar %n'%k me'a+ol"-me ener#"/

Pa*a *"a+e'e- mel"'%- '"pe )%mla( -el +e'a +erk%ran# -ampa" &!$;!?

*ar" normal/ :%mla( -el al6a men"n#ka'/ Yan# men,olok a*ala( a*an,a

pen"n#ka'an )%mla( )ar"n#an am"lo"* pa*a -el +e'a ,an# *"-e+%' am"l"n/

Ba"k pa*a *"a+e'e- mel"'%- '"pe 1 ma%p%n pa*a *"a+e'e- mel"'%- '"pe ka*ar

#l%ko-a *ara( )ela- men"n#ka' *an +"la ka*ar "'% mele7a'" +a'a- am+an# #"n)al0

maka #l%ko-a "'% akan kel%ar melal%" %r"n/ M%n#k"n "n"la( -e+a+n,a pen,ak"' "n"

)%#a *"-e+%' pen,ak"' ken"n# man"- 3S%,ono0 !!&4/

Gejala Klinis Diabetes Melitus

A*an,a pen,ak"' *"a+e'e- "n" pa*a a7aln,a -er"n#kal" '"*ak *"ra-akan *an '"*ak

*"-a*ar" ole( pen*er"'a/ Be+erapa kel%(an *an #e)ala ,an# perl% men*apa'

per(a'"an *alam Soe#on*o *kk 3!!4 "ala(

Kel%(an Kla-"k


11/19

1/ Pen%r%nan +era' +a*an 3BB4 *an ra-a lema( 'anpa -e+a+ ,an# )ela-

/ Ban,ak ken"n# 3pol"%r"a4

./ Ban,ak m"n%m 3pol"*"p-"a42/ Ban,ak makan 3pol"6a#"a4

Kel%(an La"n

1/ @an##%an -ara6 'ep" 5 ke-em%'an

/ @an##%an pen#l"(a'an 3ka+%r4

./ @a'al 5 +"-%l ,an# ("lan# '"m+%l

2/ @an##%an Erek-"

&/ Kep%'"(an

;/ @a'al *aera( #en"'al


12/19

:%mla( kalor" ,an# *"+er"kan *"-e-%a"kan *en#an -'a'%- #"" *an ak'"6"'a-

pen*er"'a *an *"mak-%*kan %n'%k menapa" *an memper'a(ankan +era' +a*an

"*aman/

!. "atihan #asmani

D"-arankan la'"(an )a-man" -eara 'era'%r 3 .$2 kal" -em"n##% 4 -elama

k%ran# le+"( .! men"'/ La'"(an )a-man" ,an# *"an)%rkan a*ala( )o##"n#0

+er-epe*a *an renan# ole( karena )en"- ola( ra#a "n" memen%(" kr"'er"a 8RIPE

3continous, rhythmical, interval, progressive, endurance training).Se*apa'

m%n#k"n la'"(an menapa" ona -a-aran ,a"'% menapa" & ? *ar" *en,%'

na*" mak-"mal 3! $ %m%r 40 nam%n (ar%- *"-e-%"akan *en#an kemamp%an *an

a*a a'a% '"*akn,a pen,ak"' pen,er'a/

Pa*a *a-arn,a pen#elolaan DM 'anpa *ekompen-a-" me'a+ol"k0 -e+a"kn,a

*"m%la" *en#an pen#a'%ran makan *"-er'a" la'"(an )a-man" ,an# %k%p -elama

+e+erapa 7ak'% 32$> m"n##%4/ B"la -e'ela( "'% ka*ar #l%ko-a *ara( ma-"( +el%m

memen%(" ka*ar -a-aran me'a+ol"k ,an# *""n#"nkan0 +ar% *"+er"kan o+a'

("po#l"kem"k oral a'a% "n-%l"n -e-%a" *en#an "n*"ka-"/ Dalam kea*aan

*ekompen-a-" me'a+ol"0 m"-aln,a ke'oa-"*o-"-0 -'re-- +era'0 ka*ar #l%ko-a *ara(

,an# -an#a' '"n##"0 +era' +a*an ,an# men%r%n *en#an epa' *ll0 maka "n-%l"n a'a%

o+a' +erk(a-"a' ("po#l"kem"k *apa' -e#era *"+er"kan pa*a ke-empa'an per'ama/

2/ $bat hipoglikemik

Ter*apa' kelompok o+a' +erk(a-"a' ("po#l"kem"k ,a"'% o+a'

("po#l"kem"k oral 3OHO4 *an "n-%l"n/

A/ O+a' ("po#l"kem"k Oral

Saa' "n" 'er*apa' & )en"- OHO ,an# 'er-e*"a *"pa-aran/ OHO 'er-e+%'

*"me'a+ol"-me *an *"ekre-"kan *" (a'" *an #"n)al/ Ole( karena "'% '"*ak *"an)%rkan

*"+er"kan pa*a pen*er"'a *en#an #ann#%an 6%n#-" (a'" *an #"n)al0 karena *apa'

men,e+a+kan mem+%r%kn,a 6%n#-" ke*%a or#an 'er-e+%' *an *apa' men,e+a+kan

'er)a*"n,a ak%m%la-" o+a' *alam '%+%(/


13/19

1/ Golongan %ul&onilurea/

Mekan"-me ker)a %'ama *ar" o+a' "n" a*ala( meran#-an# pen"n#ka'an

-ekre-" "n-%l"n pankrea-/Dapa' men,e+a+kan reka-" ("po#l"kem"a *an -er"n#

'"m+%l pera-aan lapar -e("n##a mer%pakan p"l"(an %'ama %n'%k pen*er"'a DM

*en#an +era' +a*an k%ran#/ Un'%k men#("n*ar" re-"ko ("po#l"kem"a ,an#

+erkepan)an#an0 maka #olon#an -%l6on,l%rea *en#an 7ak'% ker)a pan)an#

-e+a"kn,a *"("n*ar" pa*a pen*er"'a %-"a lan)%'/

2. Golongan Meglitini'e

O+a' #olon#an "n" )%#a meran#-an# -ekre-" "n-%l"n panrea-0 nam%n 7ak'%

ker)an,a -an#a' -"n#ka'0 -e("n##a mer%pakan o+a' 'erp"l"( %n'%k pen*er"'a DM

*en#an ka*ar #l%ko-a *ara( Po-' pran*a"l 3 )am -e-%*a( makan4 ,an# '"n##"/

!. Golongan (iguani'e )Met&ormin*

@olon#an o+a' memp%n,a" ker)a %'ama %n'%k menekan pro*%k-" #l%ko-a

(a'" *an memper+a"k" re-"-'en-" "n-%l"n/ O+a' '"*ak menekan na6-% makan *an

+a(kan *apa' men"m+%lkan ra-a m%al -e("n##a ook *"+er"kan pa*a pen*er"'a

,an# #em%k/ E6ek -amp"n# ,an# *"'ak%'kan *ar" o+a' "n" a*ala( 'er)a*"n,a lak'"k

a-"*o-"-0 ole( karena "'% '"*ak *"an)%rkan %n'%k pen*er"'a DM *en#an

keen*er%n#an ("pok-"em"a 3m"-aln,a pen,ak"' )an#'%n# *an #an##%an per6%-"

par% ,an# +era'4/O+a' "n" +"-a *"+er"kan -e+el%m makan0 nam%n +"la 'er*apa'

m%al maka *apa' *"+er"kan pa*a -aa' +er-amaan a'a% -e-%*a( makan/

2/ Golongan al&a glukosi'ase +nhibitor )Aarbose*.

O+a' "n" +eker)a -e+a#a" competitive inhibitor*en#an kar+o("*ra' *"%-%-0

-e("n##a men#(am+a' a+-or+-" kar+o("*ra'/ 8ook *"+er"kan pa*a pen*er"'a DM

*en#an na6-% makan ,an# -%l"' 'erkon'rol *an )%#a +erman6aa' %n'%k menekan

ka*ar #l%ko-a *ara( po-' pran*"al/ O+a' "n" +"-a men"m+%lkan ra-a '"*ak enak

pa*a per%' -eper'" kem+%n# *an 6la'%len -e("n##a pem+er"ann,a -e+a"kn,a pa*a

7ak'% makan/

&/ Golongan Thyo,oli'in'iones

@olon#an o+a' "n" memp%n,a" peran %'ama -e+a#a" nsulin sensiti!er,

memper+a"k" re-"-'en-" "n-%l"n *"per"6er0 -e("n##a ook *"+er"kan pa*a pen*er"'a


14/19

*en#an *%#aan re-"-'en-" "n-%l"n 3#em%k4/B"la *"+er"kan o+a' "n" maka (ar%-

*"lak%kan peman'a%an 6%n#-" (a'" ,an# ke'a' 3-e'"ap . +%lan4 ole( karena +er-"6a'

(epa'o'ok-"k/

%-T+KA +%-"+

In*"ka-" pem+er"an "n-%l"n pa*a pen*er"'a DM a*ala(

1/ DM '"pe 1

/ DM '"pe *en#an

a/ Ke'o a-"*o-"-0 koma ("pero-moler0 lak'"k a-"*o-"-

+/ S're-- +era' 3 "n6ek-" +era'5-"-'em"k0 opera-" +era'0 -'roke *ll4

/ Bera' +a*an ,an# men%r%n *en#an epa'

*/ T"*ak +er(a-"l *"kelola *en#an OHO *en#an *o-"- mak-"mal a'a%

a*a kon'ra "n*"ka-" pem+er"an OHO/

./ DM @e-'a-" *en#an ka*ar #l%ko-a *ara( ,an# '"*ak 'erken*al"

*en#an perenanaan makan/

P"l"(an pen#o+a'an (ar%- memper'"m+an#kan kon*"-" pen*er"'a/Dapa'

p%la *"lak%kan kom+"na-" .maam OHO *en#an mekan"-me ker)a ,an#

+er+e*a0 +a(kan ak("r ak("r "n" *"pop%lerkan kom+"na-" 'erap" an'ara OHO

*en#an "n-%l"n/

(. T/0AP+ T+0$T$K%+K$%+%

=ala%p%n *a-ar 'er)a*"n,a pen,ak"' @rae- a*ala( pro-e- a%'o"mm%ne0

nam%n '%)%an %'ama 'erap" pen,ak"' "n" a*ala( men#on'rol (,per'"ro"*"-me/

Ter*apa' . mo*al"'a- 'erap" -aa' "n" ,a"'% O+a' an'" '"ro"*0 opera-" *an ra*"o'erap"/

1/ Obat anti tiroid3OAT4 / @olon#an o+a' "n" 'er*"r" *ar" prop,l'(,o%ra-"l 3PTU40

Me'"maol *an 8ar+"maole 3*"r%+a( *en#an epa' men)a*" me'"maole -e'ela(

*"m"n%m4 +"a-an,a *"+er"kan pa*a *en#an *o-"- a7al 1!! 1&! m# per enam

)am 3 PTU 4 a'a% .! 2! m# 3Me'"maole5ar+"maole4 per 1 )am/ B"a-an,a

rem"-" -pon'an akan 'er)a*" *alam 7ak'% 1 +%lan/ Pa*a -aa' "'% *o-"- o+a'

*apa' *"'%r%nkan men)a*" &!$!!m# 3*alam *o-"- 'er+a#"5 kal" -e(ar"4 %n'%k


15/19

PTU a'a% & ! m# 3*o-"- 1$ kal" -e(ar"4 %n'%k Me'"maole/ Do-"-

ma"n'enane "n" *apa' *"+er"kan ("n##a 'a(%n %n'%k mene#a( relap-/

Mekan"-me ker)a o+a' "n" a*ala( men#(am+a' koner-" T2 3'"*ak ak'"64

men)a*" +en'%k ak'"6 3T.4 *an )%#a mem+lok ak'"6"'a- (ormon '"ro"*/E6ek

-amp"n# o+a' "n" a*ala( a#ran%lo-"'o-"-0 reak-" aller#" *an (epa'o'ok-"k/Pa*a

pen*er"'a ("per'"ro"* ,an# -e*an# (am"l maka p"l"(an o+a' a*ala( PTU0 ole(

karena o+a' "n" k%ran# *apa' mele7a'" +arr"er pala-en'a 3("*ro6"l"k40 ke%al" +"la

)%#a 'er)a*apa' 'an*a$'an*a 'ok-"k pa*a )an"n maka *apa' *"p"l"( o+a' Me'"maole

3l"po6"l"k4/

/ Operasi. B"a-an,a *"lak%kan -%+'o'al '"ro"*ek'om" *an mer%pakan

p"l"(an %n'%k pen*er"'a *en#an pem+e-aran kelen)ar #on*ok ,an# -an#a'

+e-ar a'a% m%l'"no*%ler/

Opera-" (an,a *"lak%kan -e'ela( pen*er"'a e%'(,ro"* 3+"a-an,a -e'ela( ;

m"n##% -e'ela( pem+er"an OAT4 *an *%a m"n##% -e+el%mn,a (ar%-

*"per-"apkan *en#an pem+er"an lar%'an kal"%m ,o*"*a 3l%#ol4 & 'e'e- kal"

-e(ar" 3*"an##ap *apa' men#%ran#" a-k%lar"-a-" -e("n##a memperm%*a(

opera-"4

./ Terapi Yodium Radioaktif ( I131). Pem+er"an ra*"a-" -eara oral

3m"n%m4 *"lak%kan apa+"la a*a kon'ra "n*"ka-" pem+er"an o+a' OAT0 '"*ak

+ere-pon *an -er"n# relap- *en#an OAT/ Ra*"oak'"6 (ar%- *"+er"kan +"la

6%n#-" )an'%n# normal *an *"kon'ra"n*"ka-"kan pa*a pen*er"'a (am"l/

Terap" ra*"a-" *"an##ap *apa' men#(en'"kan pro-e- a%'o"mm%ne pa*a

pen,ak"' @rae- nam%n memp%n,a" e6ek -amp"n# ("po'"ro"*"-me ,an#

permanen'/

2/ Pilihan obat lainnya.

a/ Be'a +loker/ Propranolol 1! 2! m#5(ar" 3'"*4 +er6%n#-" %n'%k

men#on'rol #e)ala 'a("kar*"a0 ("per'en-" *an 6"+r"la-" a'r"%m/ Dapa' p%la

-e+a#a" o+a' pem+an'% OAT ole( karena )%#a men#(am+a' koner-" T2

ke T./


16/19

+/ Bar+"'%ra'e / P(eno+ar+"'al *"#%nakan -e+a#a" o+a' penenan#

3 -e*a'a"64 *an )%#a *apa' memperepa' me'a+ol"-me T2 -e("n##a *apa'

men%r%nkan ka*ar T2 *alam *ara(/


17/19

Terap" %'ama a*ala( pem+er"an De'ro-e & ? "n'raena -e+an,ak 1

6laon 3 &$&! 4 *an *"lan)%'kan *en#an "n6%-e *e'ro-e & 1! ?

-ampa" ka*ar #l%ko-a *ara( -'a+"l/

b. Komplikasi Kronik 'er*"r" *ar"3

1/ Kompl"ka-" M"kro *an makroa-k%ler mel"p%'" Pen,ak"' :an'%n#

koroner0 -'roke0 pen,ak"' ar'er" okl%-"6 per"6er 3 PAOD4/ Da-ar 'er)a*"n,a

kompl"ka-" makroa-k%ler a*ala( a*an,a perepa'an pro-e-

a'ero-klero-"- *an *"-6%n#-" en*o'el/

/ Kompl"ka-" M"kroa-k%ler mel"p%'" Re'"nopa'" *an Ne6ropa'"

*"a+e'"/

./ Neropa'" *"a+e'"k mel"p%'" ne%ropa'" per"6er 3kram$kram para-'e-"

'%n#ka" 5n%m+ne--4 *an ne%pa'" o'onom 3#an##%an "rama )an'%n#0

"nkon'enen'"a %r"n *an al" -er'a #a-'ropa'" *"a+e'"k4/

2/ Kompl"ka-" amp%ran0 +"a-an,a mer%pakan #a+%n#an an'ara

kompl"ka-" ne%ropa'" *an a-k%lopa'" -eper'" "mpo'en-" *an kak"

*"a+e'" 3*"a+e'" 6oo' 4/ In6ek-" -er"n# 'er)a*" *an -%l"' -em+%( pa*a

pen*er"'a DM ole( karena ka*ar #l%ko-a *ara( ,an# '"n##" mer%pakan

me*"a ,an# +a"k %n'%k per'%m+%(an k%man *an )%#a a*an,a a-%lopa'"

*an ne%ropa'"/

B/ K$MP"+KA%+ T+0$T$K%+K$%+%

1/ Pen,ak"' )an'%n# '"ro"* 3P:T4 / D"a#no-"- *"'e#akkan +"la 'er*apa' 'an*a$

'an*a *ekompen-a-" )an'%n# 3-e-ak0 e*em *ll40 ("per'"ro"* *an pa*a

pemer"k-aan EK@ ma%p%n 6"-"k *"*apa'kan a*an,a a'r"%m 6"+r"la-"/

/ Kr"-"- T"ro"* 3T(,ro"* S'orm4/ Mer%pakan -%a'% kea*aan ak%' +era' ,an#

*"alam" ole( pen*er"'a '"r"'ok-"ko-"- 3l"6e$'(rea'en"n# -eer"',4/ B"a-an,a

*"p"% ole( 6ak'or -'re-- 3"n6ek-" +era'0 opera-" *ll4/ @e)ala kl"n"k ,an#

k(a- a*ala( ("perp"rek-"a0 men#am%k *an 'an*a 'an*a$'an*a ("per'"ro"*

+era' ,an# 'er)a*" -eara '"+a$'"+a/

./ Per"o*" paral,-"- '(,ro'o-"o-"- 3 PPT4/


18/19

Ter)a*"n,a kel%mp%(an -eara '"+a$'"+a pa*a pen*er"'a ("per'"ro"* *an +"a-an,a

(an,a +er-"6a' -emen'ara/Da-ar 'er)a*"n,a kompl"ka-" "n" a*ala( a*an,a

("pokalem" ak"+a' kal"%m 'erlal% +an,ak ma-%k ke*alam -el o'o'/ I'%la(

-e+a+n,a kel%(an PPT %m%mn,a 'er)a*" -e'ela( pen*er"'a makan

3kar+o("*ra'40 ole( karena #l%ko-a akan *"ma-%kkan ke*alam -el( ole(

"n-%l"n +er-ama$-ama *en#an kal"%m 3K (annel ATP$a-e4/

2/ Kompl"ka-" ak"+a' pen#o+a'an/ Kompl"ka-" "n" +"a-an,a ak"+a'

oer'rea'men' 3("po'"ro"*"-me4 *an ak"+a' e6ek -amp"n# o+a'

3a#ran%lo-"'o-"-0 (epa'o'ok-"k4/

DAFTA0 P-%TAKA

(uku Ajar Pato&isiologi. /G4

+lmu Penyakit Dalam. /G4


19/19

Guyton 5 Hall. 2667.Buku !ar "isiolo#i $edokteran %disi 11. #akarta3

/G4.

%etia'i. 2668.natomi dan "isiolo#i &anusia. ogyakarta 3 Graha +lmu.

Pro&. D0. Dr. A. (oe'isantoso 0anakusuma9%pPD:K/9 'kk. 1;;;.

Penatalaksanaan Diabetes Melitus Terpa'u. #akarta 3 4

laporan bb menurun kelompok 9

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