Tip 1 Diyabetes Mellituslu Hastaların Tanı Anındaki Klinik ve Laboratuvar Özelliklerinin Metabolik Kontrole Etkisi

Year 2019, Volume: 19 Issue: 4, 753 - 760, 28.11.2019

Özlem Kara

https://doi.org/10.17098/amj.651991

Abstract

Amaç: Tip 1 diabetes mellitus (T1DM) çocukluk yaş grubunda sık görülen kronik metabolik bir hastalıktır. İyi metabolik kontrol ile diyabetle ilişkili mikrovasküler komplikasyonların ilerlemesi yavaşlar hatta gelişimi önlenebilmektedir. Bu nedenle metabolik kontrolü etkileyen faktörlerin belirlenmesi önemlidir. Bu çalışmada ile tanı anındaki T1DM’li çocuk ve ergenlerin demografik, klinik ve laboratuvar özelliklerinin metabolik kontrol üzerindeki etkisini değerlendirilmesi amaçlandı.
Materyal ve Metot: Hastalar son 1 yıllık ortalama hemoglobinA1c (HBA1c) düzeylerine göre metabolik kontrol düzeyleri belirlendi. Ortalama HBA1c düzeyi <%7,5 iyi kontrol, %7,6-9 orta kontrol ve >%9 kötü kontrol olarak tanımlandı. Hasta verileri ile ortalama HBA1c düzeyleri karşılaştırıldı.
Bulgular: Toplam 144 hasta çalışmaya alındı. Pik tanı yaşı 4-6 yaş (%21,51) ve 12-14 yaş (%20,83) olarak saptandı. Hastaların %10’unda birinci derece akrabalarında T1DM mevcuttu. Ortalama HBA1c düzeyleri kızlarda %7,7 (7,2-8,8), erkeklerde %7,8 (7,0-8,6) idi. Hastaların %38,19’i iyi, %41,68’si orta ve %20,13’si kötü kontrollüydü. İyi kontrollü hastaların tanı yaşı 9,13±4,30 yıl iken kötü kontrollülerin 10,19±4,26 yıldı (p=0,252). Çalışmada ailesinde T1DM mevcut olan grubun iyi metabolik kontrol düzeyine sahip olduğu görüldü (p=0,002).
Sonuç: Çalışmada ailesinde diyabet olanların daha iyi metabolik kontrole sahip olduğu saptandı. Bu durum hasta ve ailelerinin tanıdan sonra diyabet yönetimini önemsedikleri, yaşam tarzlarını diyabete uygun düzenledikleri düşündürmektedir. Bu sonuca göre aile içinde diyabet farkındalığının artırılması ve hastalara verilen eğitimlerin motive edici olması diyabet yönetiminde olumlu etki sağlayacaktır.

Keywords

Çocuk, Farkındalık, Metabolik kontrol, Tip 1 diabetes mellitus

Effect of Baseline Clinical and Laboratory Characteristics of Patients with Type 1 Diabetes Mellitus on Metabolic Control

Abstract

Objectives: Type 1 diabetes mellitus (T1DM) is a chronic metabolic disease that is common in childhood. Good metabolic control slows down and even prevents development of diabetes-related micro-vascular complications. Therefore determination of the affecting factors for metabolic control is important. To evaluate effect of at the time of diagnosis demographic, clinical and laboratory characteristics of children and adolescents with T1DM on metabolic control.
Materials and Methods: The metabolic control status was evaluated according to the mean hemoglobin A1c (HbA1c) values of the recent one year as good (HbA1c <7.5%), moderate (HbA1c 7.5-9%) and poor (HbA1c >9%). The patient data and the mean HbA1c levels were compared.
Results: Data were collected on 144 patients with T1DM. The peak ages at diagnosis were determined to be 4-6 years (21.52%) and 12-14 years (20.83%). The first-degree relatives had the diagnosis of T1DM in 10% of the patients. The mean HbA1c value was determined as 7.7% (7.2-8.8) in girls and 7.8% (7.0-8.6) in boys. Metabolic control was good in 38.19%, moderate in 41.68% and poor in 20.13%. The mean age at diagnosis was 9.13±4.30 years in the patients with good metabolic control and 10.19±4.26 years in patients with poor metabolic control (p=0.252). Metabolic control was found to be better in the patients who had T1DM in the family (p=0.002).
Conclusion: Metabolic control was found to be good in patients who had DM in the family. It is thought that patients and their families care about diabetes management after diagnosis, regulate their lifestyle according to diabetes. According to the result, increasing the awareness of diabetes in the family and continuing the motivating trainings for the patients will have a positive effect on the management of diabetes.

Keywords

Awareness, Childhood, Metabolic control, Type 1 diabetes mellitus

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