Abstract
Objective: The aim of present study was to determine the effects
of factors to diabetic regulation; such as, awareness of the disease,
compliance with treatment, awareness of HbA1c target, in T2DM patients whom
followed up in our clinic.
Methods: Patients with T2DM were enrolled to this retrospective study. Patient’s
data were obtained and recorded from institutional database. As well as blood
pressure, anthropometric measurements, physical examination signs, and
laboratory parameters were recorded. Study population grouped into two
according to HbA1c level; well-regulated T2DM group with a HbA1c lower than 8%
and poorly-controlled T2DM group with a HbA1c 8% or greater.
Results: A total of 150 patients with T2DM (72 men and 78 women) enrolled. Waist
circumference, body mass index, duration of diabetes, LDL-cholesterol , total
cholesterol, triglyceride and serum creatinine were significantly lower in
well-controlled compared to poorly-controlled diabetic subjects (all p<0.05).
Rate of well-regulated subjects was higher in patients living in urban compared
to subjects living in rural area (p=0.01). Diabetic regulation rate was
significantly higher in patients acknowledge the diabetic medications, in self-monitoring
blood glucose, in subjects aware of HbA1c target, and free of diabetic
complications; neuropathy, nephropathy, and diabetic foot (all p<0.05).
Conclusion: Striking result of present
study is that most important factors associated with better diabetic control
were self monitoring of blood glucose, awareness of treatment target and
acknowledgement of the diabetic medications; which all could be achieved by
education and participation of the patient to the therapeutic process.
References
- Reference 1. TEMD. Turkish Endocrinology And Metabolism Association Diagnoses Of Diabetes Mellitus And Complications, Guidance And Treatment Guidelines-2017 2017 [Available from: http://www.temd.org.tr/files/DIYABET2017_web.pdf.
- Reference 2. Danaei G, Finucane MM, Lu Y, Singh GM, Cowan MJ, Paciorek CJ, et al. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2• 7 million participants. The Lancet. 2011;378(9785):31-40.
- Reference 3. Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes research and clinical practice. 2010;87(1):4-14.
- Reference 4. Satman I, Yilmaz T, Sengül A, Salman S, Salman F, Uygur S, et al. Population-based study of diabetes and risk characteristics in Turkey. Diabetes care. 2002;25(9):1551-6.
- Reference 5. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. European journal of epidemiology. 2013;28(2):169-80.
- Reference 6. Tunbridge W, Evered D, Hall R, Appleton D, Brewis M, Clark F, et al. The spectrum of thyroid disease in a community: the Whickham survey. Clinical endocrinology. 1977;7(6):481-93.
- Reference 7. Agardh E, Allebeck P, Hallqvist J, Moradi T, Sidorchuk A. Type 2 diabetes incidence and socio-economic position: a systematic review and meta-analysis. International journal of epidemiology. 2011;40(3):804-18.
- Reference 8. Stringhini S, Tabak AG, Akbaraly TN, Sabia S, Shipley MJ, Marmot MG, et al. Contribution of modifiable risk factors to social inequalities in type 2 diabetes: prospective Whitehall II cohort study. BMJ. 2012;345:e5452.
- Reference 9. Erbil Y, Barbaros U, Salmaslıoğlu A, Yanık BT, Bozbora A, Özarmağan S. The advantage of near-total thyroidectomy to avoid postoperative hypoparathyroidism in benign multinodular goiter. Langenbeck's Archives of Surgery. 2006;391(6):567-73.
- Reference 10. Mensing C, Boucher J, Cypress M, Weinger K, Mulcahy K, Barta P, et al. National standards for diabetes self-management education. Diabetes care. 2003;26(suppl 1):s149-s56.
- Reference 11. Spijkerman AM, Dekker JM, Nijpels G, Adriaanse MC, Kostense PJ, Ruwaard D, et al. Microvascular complications at time of diagnosis of type 2 diabetes are similar among diabetic patients detected by targeted screening and patients newly diagnosed in general practice. Diabetes care. 2003;26(9):2604-8.
- Reference 12. Plantinga LC, Crews DC, Coresh J, Miller ER, Saran R, Yee J, et al. Prevalence of chronic kidney disease in US adults with undiagnosed diabetes or prediabetes. Clinical Journal of the American Society of Nephrology. 2010:CJN. 07891109.
- Reference 13. Schnell O, Alawi H, Battelino T, Ceriello A, Diem P, Felton A-M, et al. Self-monitoring of blood glucose in type 2 diabetes: recent studies. Journal of diabetes science and technology. 2013;7(2):478-88.
- Reference 14. Brunisholz KD, Briot P, Hamilton S, Joy EA, Lomax M, Barton N, et al. Diabetes self-management education improves quality of care and clinical outcomes determined by a diabetes bundle measure. Journal of multidisciplinary healthcare. 2014;7:533.
Abstract
Amaç: Bu çalışmanın amacı
kliniğimizde izlenen tip 2 diyabetik hastalarda hastalığın farkında olma, tedaviye uyum, hedef Hb A1c düzeyini bilme gibi kan
şekeri regülasyonunu etkileyebilecek faktörleri belirlemektir.
Gereç
ve Yöntem: Kliniğimizde izlenen tip 2 diyabetik hastalar çalışmaya
alındı. Hasta verileri hastane veri tabanı ve dosyalardan elde edildi. Antropometrik ölçümler, kan basıncı, fizik
muayene bulguları ve laboratuvar sonuçları kaydedildi. HbA1c seviyesine göre
(%8’in altı ve üstü) hastalar iyi kontrollü ve kötü kontrollü diyabetikler
olarak 2 gruba ayrıldı.
Bulgular: Toplamda 150 hasta (72’si erkek ve 78’i bayan) çalışmaya alındı. Bel çevresi, beden kitle
indeksi, diyabet süresi, LDL- kolesterol, total kolesterol, trigliserid ve
serum kreatinini iyi kontrollü diyabetiklerde kötü kontrollü olanlara kıyasla
anlamlı derecede düşüktü (hepsi için p<0.05).
Kentsel alanda yaşan hastalarda iyi kontrol oranı kırsalda yaşayanlardan
belirgin olarak daha fazlaydı (p=0.01). İlaçlarını tanıyanlarda, kan şekerini
evde kendi ölçenlerde, hedef HbA1c düzeyinin farkında olanlarda ve diyabetik nefropati, nöropati ve diyabetik ayak bulunmayanlarda diyabetik
regülasyon anlamlı derecede daha iyiydi (hepsi için p<0.05).
Sonuç: Bu çalışma daha iyi
diyabetik kontrol için, en önemli faktörlerin kendi kendine ölçümlerle kan
şekerini takip etmek, tedavi hedef değerlerinin
farkında olmak ve kullandığı ilaçları bilmek olduğunu göstermiştir. Bu
faktörlerin hepsine iyi bir hasta eğitimi ve hastaların tedavi sürecine
katılımları ile elde edilebileceğini düşünmekteyiz.
References
- Reference 1. TEMD. Turkish Endocrinology And Metabolism Association Diagnoses Of Diabetes Mellitus And Complications, Guidance And Treatment Guidelines-2017 2017 [Available from: http://www.temd.org.tr/files/DIYABET2017_web.pdf.
- Reference 2. Danaei G, Finucane MM, Lu Y, Singh GM, Cowan MJ, Paciorek CJ, et al. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2• 7 million participants. The Lancet. 2011;378(9785):31-40.
- Reference 3. Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes research and clinical practice. 2010;87(1):4-14.
- Reference 4. Satman I, Yilmaz T, Sengül A, Salman S, Salman F, Uygur S, et al. Population-based study of diabetes and risk characteristics in Turkey. Diabetes care. 2002;25(9):1551-6.
- Reference 5. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. European journal of epidemiology. 2013;28(2):169-80.
- Reference 6. Tunbridge W, Evered D, Hall R, Appleton D, Brewis M, Clark F, et al. The spectrum of thyroid disease in a community: the Whickham survey. Clinical endocrinology. 1977;7(6):481-93.
- Reference 7. Agardh E, Allebeck P, Hallqvist J, Moradi T, Sidorchuk A. Type 2 diabetes incidence and socio-economic position: a systematic review and meta-analysis. International journal of epidemiology. 2011;40(3):804-18.
- Reference 8. Stringhini S, Tabak AG, Akbaraly TN, Sabia S, Shipley MJ, Marmot MG, et al. Contribution of modifiable risk factors to social inequalities in type 2 diabetes: prospective Whitehall II cohort study. BMJ. 2012;345:e5452.
- Reference 9. Erbil Y, Barbaros U, Salmaslıoğlu A, Yanık BT, Bozbora A, Özarmağan S. The advantage of near-total thyroidectomy to avoid postoperative hypoparathyroidism in benign multinodular goiter. Langenbeck's Archives of Surgery. 2006;391(6):567-73.
- Reference 10. Mensing C, Boucher J, Cypress M, Weinger K, Mulcahy K, Barta P, et al. National standards for diabetes self-management education. Diabetes care. 2003;26(suppl 1):s149-s56.
- Reference 11. Spijkerman AM, Dekker JM, Nijpels G, Adriaanse MC, Kostense PJ, Ruwaard D, et al. Microvascular complications at time of diagnosis of type 2 diabetes are similar among diabetic patients detected by targeted screening and patients newly diagnosed in general practice. Diabetes care. 2003;26(9):2604-8.
- Reference 12. Plantinga LC, Crews DC, Coresh J, Miller ER, Saran R, Yee J, et al. Prevalence of chronic kidney disease in US adults with undiagnosed diabetes or prediabetes. Clinical Journal of the American Society of Nephrology. 2010:CJN. 07891109.
- Reference 13. Schnell O, Alawi H, Battelino T, Ceriello A, Diem P, Felton A-M, et al. Self-monitoring of blood glucose in type 2 diabetes: recent studies. Journal of diabetes science and technology. 2013;7(2):478-88.
- Reference 14. Brunisholz KD, Briot P, Hamilton S, Joy EA, Lomax M, Barton N, et al. Diabetes self-management education improves quality of care and clinical outcomes determined by a diabetes bundle measure. Journal of multidisciplinary healthcare. 2014;7:533.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Articles |
| Authors | |
| Publication Date | August 15, 2018 |
| Acceptance Date | June 18, 2018 |
| Published in Issue | Year 2018 |