The Frequency of Hypoglycemia and Hypoglycemia Fear in Type 2 Diabetes Mellitus Patients with Followed-up from Diabetes Center

Öz

Introduction: This study aimed to compare the frequency of hypoglycemia and related factors in type 2 diabetes mellitus DM) patients followed up by a family practice-oriented diabetes center (FPODC) and hospital-oriented diabetes center (HODC). Method: Type 2 DM patients who applied to two diabetes centers affiliated with the same hospital between 1 December 2017-31 December 2019 were included in the study. The DM center located in the hospital and managed by the Internal Medicine Clinic was accepted as HODC, while the DM center located outside the hospital campus and manage by the Family Practice Clinic was accepted as FOPDC. Patients with fasting plasma glucose levels determined to be below 70 mg/dL at least twice in both centers were included in the case group. Subsequently, patients in the case group in each center were matched in terms of age and gender, and T2DM patients without hypoglycemia were accepted as the control group. Besides, the Hypoglycemia Fear Scale (HFS) was applied to the case group patients in both centres. Results: Of the 240 patients included in the study, 150 (62.5%) were female. While hypoglycemia was detected in 53 (1.2%) of patients in HODM, hypoglycemia was detected in 27 (0.31%) patients participating in FOPDC. The duration of DM, frequency of insulin use and insulin dose were higher in both centers cases than in the control group (p=0,049, p<0,001, p=0,001 for HODC; p=0,014, p<0,001, p=0,010 for FOPDC, respectively). Moreover, the frequency of hypoglycemia education and the perception that hypoglycemia education is sufficient in the case group in the FOPDC were higher than in HODC (p=0.029 and p=0.046, respectively). There was no difference in HFS scores between both centres (p>0,05). Conclusion: Evaluation of hypoglycemia is necessary for type2 2DM patients who use insulin and have a long duration of DM. In addition, educating patients about hypoglycemia by their family physicians may reduce the frequency of hypoglycemia.

Anahtar Kelimeler

• type 2 diabetes mellitus
• hypoglycemia
• fasting hypoglycemia

Diyabet Merkezden Takipli Tip 2 Diabetes Mellitus Hastalarında Hipoglisemi Sıklığı ve Hipoglisemi Korkusu

Öz

Giriş: Bu çalışma aile hekimliği yönelimli diyabet merkezi (AHYDM) ile hastane yönelimli diyabet merkezi (HYDM)’den takipli tip 2 diabetes mellitus (DM) hastalarında hipoglisemi sıklığı ve ilişkili faktörlerin karşılaştırılmasını amaçlamaktadır. Yöntem: Bu çalışmaya 1 Aralık 2017– 31 Aralık 2019 tarihleri arasında aynı hastaneye bağlı olan iki diyabet merkezine başvuran Tip 2DM hastaları dahil edilmiştir. Çalışmada hastane içerisinde yer alan ve İç Hastalıkları Kliniği tarafından yürütülen DM merkezi HYDM olarak kabul edilirken, hastane kampüsü dışında bulunan, Aile Hekimliği Kliniği tarafından yürütülen DM merkezi ise AHYDM olarak kabul edilmiştir. Her iki merkezdeki açlık plazma glukozu düzeyi en az iki defa 70 mg/dL’nin altında saptanan hastalar vaka grubuna dahil edilmiştir. Ardından, her bir merkezde vaka grubundaki hastalara yaş ve cinsiyet açısından eşleştirilmiş, hipoglisemi atağı bulunmayan Tip 2 DM hastaları kontrol grubu olarak kabul edilmiştir. Ayrıca, Hipoglisemi Korku Ölçeği (HKÖ) iki merkezdeki vaka grubuna da uygulanmıştır. Bulgular: Çalışmaya dahil edilen 240 hastanın 150 (%62,5)’si kadın idi. HYDM’deki tüm hastaların 53(%1,2)’ünde hipoglisemi saptanmışken, AHYDM’den katılan tüm hastaların 27(%0,31)’sinde hipoglisemi tespit edilmiştir. Her iki merkezdeki vaka grubunda DM süresi, insülin kullanım sıklığı ve toplam insülin dozu kontrol grubundan yüksekti (sırasıyla, HYDM için p=0,049, p<0,001, p=0,001; AHYDM için p=0,014, p<0,001, p=0,010). Ayrıca AHYDM'deki vaka grubunda hipoglisemi eğitimi alma sıklığı ve hipoglisemi eğitiminin yeterli olduğu algısı HYDM'ye göre daha yüksekti (sırasıyla p=0,029 ve p=0,046). İki merkezde de HKÖ’de fark bulunmamıştır (p>0,05). Sonuç: DM hastalarında, özellikle insülin kullanan ve T2DM süresi uzun olan hastalarda hipoglisemi açısından dikkatli değerlendirilmesi gereklidir. Ayrıca hastaların aile hekimleri tarafından hipoglisemi ile ilgili eğitilmesi hipoglisemi görülme sıklığını azaltabilir.

Anahtar Kelimeler

• Tip 2 diabetes mellitus
• hipoglisemi
• açlık hipoglisemisi

Kaynakça

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