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Presentation 1. Group 8a Sri Puspita Lingga Sri Muninggar Amalia Nur Pratiwi Harsya Dwindaru Gunardi Rienna Diansari. Case Ilustration.

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  1. Presentation 1 Group 8a Sri Puspita Lingga Sri Muninggar Amalia Nur Pratiwi Harsya Dwindaru Gunardi Rienna Diansari

  2. Case Ilustration • Mr.X, 72 years, with DM type 2 was administered by insulin injection for more than 10 years. Now, he complains that he has recurrent bleeding stool since 3 months ago. He lost 5kg in two months and had general weakness. From the biopsy, he was diagnosed with colorectal cancer. He then ask to the doctor whether this cancer is becaused by the diabetes that he have been had before?

  3. Background • The prevalence of DM has been increasing for the last 20 years • For Indonesia, WHO predicted the cases increment from 8,4 million in 2000 to ± 21,3 million in 2030 • Potential health burden • Colorectal cancer is the second leading cause of cancer-related deaths in the United States and the third most common cancer in men and in women. Powers AC. Diabetes Mellitus. In: Kasper DL, Fauci AS, Longo DL, Braunwald E, Hauser SL, Jameson JL, editors. Harrison's Principles of Internal Medicine. 16th ed: McGraw-Hill; 2005. p. 2152-79. Konsensus Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 di Indonesia;2011 Colorectal (Colon) Statistics. Centers for Disease Control and Prevention; 2012; Available from: http://www.cdc.gov/cancer/colorectal/statistics/ A Murdani, Sudoyo AW, Utomo AR, Fauzi A, Rani AA. Molecular profile of colorectal cancer in Indonesia: is there another pathway?GastroenterolHepatol Bed Bench 2012;5(2):71-8.

  4. Pharmacology intervention • Oral hypoglicemic medicine • Insulin injection • Indication for Insulin therapy • Failure with the optimal dose of oral hypoglicemic medicine • Stressful (MCI, stroke) • Diabetic ketoacidosis • Gestational DM • Severe liver or kidney dysfunction • Contraindication or allergy to Oral hypoglicemic medicine • Chronic insulin therapy was associated with a statistically significantincrease in colorectal cancer risk among patients with type 2 diabetes Konsensus Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 di Indonesia;2011 Yang YX, Hennessy S, Lewis JD. Insulin therapy and colorectal cancer risk among type 2 diabetes mellitus patients. Gastroenterology 2004 ; 127 : 1044 – 50

  5. PICO

  6. Methods

  7. Search Strategy

  8. diabetes mellitus OR diabetes mellitus type 2 AND colorectal cancer OR colon cancer OR colorectal malignancy Pubmed Cochrane Ebsco 231 10 74061 Inclusion: 10 years, human, systematic review, english 11 11 Major heading: Diabetes mellitus type 2, diabetes mellitus Free full text availability 5 20 0 Screening title & abstract Search date: May 24th, 2012 Useful 3 articles

  9. References • Powers AC. Diabetes Mellitus. In: Kasper DL, Fauci AS, Longo DL, Braunwald E, Hauser SL, Jameson JL, editors. Harrison's Principles of Internal Medicine. 16th ed: McGraw-Hill; 2005. p. 2152-79. • Konsensus Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 di Indonesia;2011 • Colorectal (Colon) Statistics. Centers for Disease Control and Prevention; 2012; Available from: http://www.cdc.gov/cancer/colorectal/statistics/ • Yang YX, Hennessy S, Lewis JD. Insulin therapy and colorectal cancerrisk among type 2 diabetes mellitus patients. Gastroenterology 2004 ; 127 :1044 – 50 • A Murdani, Sudoyo AW, Utomo AR, Fauzi A, Rani AA. Molecular profile of colorectal cancer in Indonesia: is there another pathway?GastroenterolHepatol Bed Bench 2012;5(2):71-8.

  10. THANK YOU

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