Komorbiditas di bidang

agromedis
 Komorbiditas

Penampilan bersamaan
dari dua penyakit atau lebih

Sebab-akibat
Kerentanan
Diabetes Mellitus
CARDIOVASCULAR DISEASE
(CVD)

Neurologi

IKLIM
 Diabetes Mellitus
± 7% penduduk dunia
Cina : 100 juta
Indonesia : 10 juta

Jepang : 7,2 juta

Australia: 1,2 juta 

penderita sebenarnya 2 x

Satu orang meninggal Watkins P. The diabetic foot.

per 6 detik BMJ 2003;326:977-979
 DM
Faktor Risiko

Rokok

Obesitas

Physical inactivity

Alkohol

Hipertensi
 Fakta yang terkait dengan DM

Hiper kolesterol
Aging
Poor Diet
????

Obesitas Diabetes mellitus

????
Rokok
Physical inactivity Hiper tensi
RPK
Fakta yang terkait dengan DM

Penggunaan
OAD >>>

Obes >50%
penderita

CVD : 3/5
Patogenesis DM

Kagar glukosa darah

tinggi

Energi hilang Sel lapar

Komplikasi
Diet vs DM

Chen et al., 2010

 CVD

Faktor Risiko
–Rokok
–Diet
–Physical inactivity
–Obesitas
–Hipertensi
–Hiperkolesterolemia
–Diabetes
–Alkohol
–Aging
- Stress oksidatif
 Permasalahan di rural (termasuk
agroindutri)

Mortalitas : 20% lebih tinggi

Later treatment worsens survival

Treatment first 1 to 2 hours decreases mortality by half2

Rural patients tend to present later with

emergencies

Rural patients present later with chest pain

 PARKINSON’S DISEASE

Progressive neurodegenerative disease

affecting movement

Cardinal signs: tremor, bradykinesia,

rigidity, postural instability

Symptoms: stooped posture, shuffling

gait, soft voice, small handwriting

Rural residence, well water, smoking

farming, pesticides
 Pestisida & Gangguan Neurobehavioral

1930 –organophosphate pesticides & nerve agents

produced
1951 – UK : warns of dangers of chronic exposure

1997 –chronic exposure  neuropsychiatric damage

2013 Ross- association between organophosphate & impaired

Neurobehavioral (memory, response, fine motor skills control)

Occupational use of pesticides associated with 80% greater

risk of Parkinson’s and Alzheimers Disease
EFFECTS CLIMATE CHANGE