MEHMET ZAHİD KOÇAK, GÜLALİ AKTAŞ, Edip ERKUŞ, TUBA TASLAMACIOĞLU DUMAN, Burcin Meryem ATAK, Haluk ŞAVLI

Üniversite Kliniğimizde İzlenen Tip 2 Diyabetik Hastaların Analizi

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.

Anahtar Kelimeler:

Tip 2 Diyabet, Diyabetik Regülasyon, Hasta Eğitimi, HbA1c

Analysis of the Type 2 Diabetic Patients Followed in a University Clinic

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.

Keywords:

type 2 diabetes mellitus, diabetic regulation, patient education, HbA1c,

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ISSN: 1309-3878
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 2009
Yayıncı: Düzce Üniversitesi Tıp Fakültesi Aile Hekimliği AD adına Yrd.Doç.Dr.Cemil Işık Sönmez