İNSÜLİN KULLANAN DİYABETLİ HASTALARDA HİPOGLİSEMİ SIKLIĞI VE ŞİDDETİNİ ETKİLEYEN FAKTÖRLER

Amaç: Bu çalışma insülin kullanan diyabetli hastalarda hipoglisemi sıklığı, şiddeti ve hipoglisemiyi etkileyen faktörleri belirlemek amacıyla yapılmıştır. Materyal ve Metot: Çalışma kliniğimizde tedavi olan veya Polikliniğe ayaktan başvuran, 18 yaş üzeri insülin kullanan diyabet tanılı 1038 hasta ile yapılmıştır. Bulgular: Araştırma bulgularına göre çalışmaya alınan bireylerin yaş ortalamalarının (53,50±9,44 yıl) yüksek ve çoğunluğunun kadın olduğu tespit edilmiştir. Olguların çoğunluğunun; ilköğretim mezunu, şehir merkezinde yaşayan, sosyal güvencesi olan, ev hanımlarından oluşan, sigara ve alkol kullanmayan, T2DM (Tip 2 Diyabet)’li, ek hastalık olarak da en çok hipertansiyon ve hiperlipidemi görülen bireyler olduğu belirlenmiştir. Diyabet tanı süresi yüksek olan olguların çoğunluğu diyabet ve insülin eğitimi almış, diyet ve egzersiz yapmayan, son iki yılda insülin başlanmış, karışım insülin tedavisi alan bireylerden oluşmaktadır. Hipoglisemi deneyimleme oranı yüksek olup hipoglisemilerin nadir ve hafif yaşandığı görülmüştür. Olguların tamamına yakınının glukometresinin bulunduğu, ölçüm yaptığı, insülin enjeksiyonunu kendisinin uyguladığı, enjeksiyonlarda 8 mm iğne ucu kullandığı ve bölge değiştirdiği tespit edilmiştir. Metabolik ölçümlerde BKİ, AKŞ ve TKŞ’ler, bel çevreleri ve HbA1c’lerin yüksek olduğu belirlenmiştir. Sonuç: Araştırmada yapılan analizlerde meslek, diyabet tipi, insülin tipi, retinopati, glukoz takibi, diyabet süresi, insülin kullanma süresinin hipoglisemi varlığı açısından; yaş ve insülin kullanma süresinin hipoglisemi sıklığı açısından; insülin kullanma süresinin hipoglisemi şiddeti açısından anlamlı olduğu tespit edilmiştir.

FACTORS THAT AFFECT HYPOGLYCEMIA FREQUENCY AND SEVERITY IN DIABETIC PATIENTS USING İNSULIN

Objectives: This study was conducted in order to determine the frequency and severity of hypoglycemia and factors affecting hypoglycemia in diabetic patients. Materials and Methods: The patients hospitalized in the endocrinology ward or admitted to our outpatient clinics were included. All patients were above 18 years of age and had diabetes who were receiving insulin treatment. A total of 1038 patients were enrolled. Results: According to our findings, the patients in the study group were mostly female and relatively older. Most patients had low education levels and social status, and they were mostly living in the city suburbs. Most female patients in that group were housewives, and the most common accompanying comorbidities were hypertension and hyperlipidemia. The patients had a long duration of diabetes history and had received "diabetes and insulin education" before. Despite education, they didn't make the appropriate lifestyle changes such as diet and exercise. The mean insulin usage time was two years, and premixed insulins were the most common ones that were being used. Although hypoglycemia was frequent, the rate of severe attacks was low. Almost all cases had glucometer at home and were making self blood glucose monitoring. Moreover, almost all patients were injecting insulin to themselves, and the most common needle diameter was 8 mm. In our study, the enrolled patients' mean BMI, FPG, PPG were above the target range. Conclusion: In the analysis made in the research, occupation, diabetes type, insulin type, retinopathy, glucose follow-up, duration of diabetes, the duration of insulin treatment were found to be significant in terms of the presence of hypoglycemia; age and duration of insulin treatment were found to be significant in terms of frequency of hypoglycemia; duration of insulin treatment was significant in terms of severity of hypoglycemia.

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