Tesis

Prevalensi Small Intestinal Bacterial Overgrowth (SIBO) pada Diabetes Melitus tipe 2: sebuah telaah sistematis = Prevalence of Small Intestinal Bacterial Overgrowth (SIBO) in Diabetes Mellitus type 2: A Systematic Review.

Latar belakang. Gejala gastrointestinal pada pasien diabetes sekitar 50-70yo, menyebabkan ketidakseimbangan komposisi mikrobiota. Neuropati otonom bersifat ireversibel, menyebabkan enteropafi diabetik yang dapat menuju kondisi small intestinal bacterial overgrowth (SIBO). SIBO dapat menyebabkan dekonjugasi asam empedu, diare, steatorea, malabsorpsi vitamin dan mikronutrien, penurunan berat badan, injuri mukosa, translokasi bakteri, dan semakin memperburuk motilitas usus. Malabsoprsi karbohidrat berperan besar dalam pathogenesis komplikasi makrovaskular diabetik. Tujuan. Mengetahui prevalensi SIBO pada pasien DM tipe2 Metode. Telaah sistematis ini berdasarkan PRISMA. Kata kunci menggunakan "small intestinal bacterial overgfowth", "small bowel bacterial overgrowth", "diabetes mellitus t:'ype 2", "type 2 DM", "NIDDM". Pencarian melalui Proquest, CINAHL, SCOPUS, ScienceDirect, PubMed,4\4EDLINE dan juga pencarian manual di asosiasi diabetes dunia seperti ADA, EASD, EFSD, IDF, FASEB, PERKENI. Penilaian risiko bias menggunakan Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Analisis data menggunakan STATA 16. Hasll. Enam artikel mencakup lA72 sampel pasien DM tipe 2 di klinik dan rumah sakit. Didapatkan pooled prevalence sebesar 24.39% SD 15,31, dengan nilai minimum 7,42yo dan nilai maksimum 53.85% , IK 95o/o 9,97'38,86, dengan I2 97,17oh. Kadar llbAlc lebih tinggi pada pasien DM tipe 2 dengan SIBO (50,02) dan kadar insulin darah lebih rendah pada pasien DM tipe 2 dengan SIBO (p:0,001). Studi yang didapatkan sangat heterogen dan ada. bias publikasi. Penilaian hasil temuan berdasarkan GRADE adalah sedang. Kesimpulan. Prevalensi SIBO pada pasienDM tipe 2 sebesar 24,39o/o. Kondisi SIBO pada pasien DM tipe 2 memperberat morbiditas pasien, ditunjukkan dengan kadar insulin yang lebih rendah dan F{bAlc yang lebih tinggi. Pemeriksaan F{BT dan pertimbangan pemberian probiotik disarankan rutin dilakukan pada pasien DM tipe 2, terutama dengan durasi penyakit DM > 5 tahun.
Kata kunci. small intestinal bacterial overgrowth, SIBO, DM tipe 2, prevalensi


Background. Gastrointestinal symptoms in diabetic patients are about 50-70oh, causing an imbalance in the microbiota composition. Autonomic neuropathy is irreversible, causing diabetic enteropathy which can lead to small intestinal bacterial overgrowth (SIBO). SIBO can cause bile acid de-conjugation, diarrhea, steatorrhoea, vitamin and micronutrient malabsorption, weight loss, mucosal injury, bacterial translocation, and worsening intestinal motility. Carbohydrate malabsorption plays a major role in the pathogenesis of diabetic macrovascular complications Objective. Knowing the prevalence of SIBO in type 2 DM patients Method. This systematic review is based on PRISMA. The keywords used "small intestinal bacterial overgrowth", "small bowel bacterial overgrowth", "ffpo 2 diabetes .tyry mellitus", 2 DMu, "NIDDMU. Search through Proquest, CINAHL, SCOPUS, ScienceDirect, PubMed / MEDLINE as well as manual searches in world diabetes associations such as ADA, EASD, EFSD, IDF, FASEB, PERKENI. Bias risk assessment uses the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Data analysis using STATA 16. Results. Six articles included 1072'samples of We 2 DM patients in clinics and hospitals. Obtained a pooled prevdence of 24.51o/a SD + 18.08, with a minimum value of 8.5o/o and a maximum value of 53.85o/o, CI95% 5.53-43.48, with 12 99.40%. FIhAlc levels were higher in type 2 DM patients with SIBO (p : 0.02) and blood insulin levels were lower in type 2 DM patients with SIBO (p :0.001). The studies obtained were heterogeneous and there was publication bias. Assessment of findings based on GRADE is moderate. Conclusions. The prevalence of SIBO in type 2 DM patients is 24.51%. The condition of SIBO in type 2 DM patients exacerbates the patient's morbidity, indicated by lower insulin levels and higher F{bAlc levels. HBT examination and probiotic prescripion is recommended to routinely be carried out in type 2 DM patients, especially those with DM disease duration > 5 years.
Keywords: small intestinal bacterial overgrowth, SIBO, DM type 2, prevalence