Prediyabet Tanılı Hastaların Sosyodemografik ve Klinik Durumları ve Engellilik ile İlişkisi

Amaç: Bu çalışmada 3. basamak iç hastalıkları polikliniğine başvuran prediyabetik hastalarda sosyodemografik ve klinik verileri tanımlamayı ve engellilik ile ilişkisini araştırmayı amaçladık. Yöntem: Kayseri Şehir Hastanesi İç Hastalıkları polikliniğine Haziran-Aralık 2018 tarihleri arasında başvuran ve prediyabet tanısı alan, 18-65 yaş arası hastalar çalışmaya alındı (n=96). Hastaların yaşı, cinsiyeti, evlilik durumu, maaşı, eğitim durumu, işi, emeklilik durumu, sigara ve alkol kullanım durumu, boy, kilo ve vücut kitle indeksi (VKİ), insulin direnci varlığı kaydedildi. Bulgular: Prediyabetik hastaların yarısında (n=50) bozulmuş açlık glukozu (BAG) mevcutken 14 hastada bozulmuş glukoz toleransı vardı. Diğer hastalarda hem BAG hem de BGT vardı (n=32). Hastaların 71'i (74%) kadındı. 23 hasta sigara içiyordu ve ortalama 27.78 ( ss: 23.55) paket-yıl sigara kullanmışlardı. 93 hasta (96.7%) hiç alkol almamıştı. 15 hasta emekli iken sadece biri maluliyet nedeni ileydi. Hastaların yarısında insulin direnci vardı. 1 hasta bekar, 5 hasta dul,1 hasta boşanmış ve diğer hastalar evliydi. VKİ'ye göre obezite durumu sırasıyla VKİ≤ 18.5 kg/m2 %1 hasta; VKİ = 18.6-24.9 kg/m2 %9 hasta; VKİ=25.0-29.9 kg/m2 %18 hasta; VKİ≥30 kg/m2 %68.76 hasta idi. Ortanca HAQ-DI skoru 0.125 (IQR: 0-0.625) idi ve 67 (69.9%) hastada engellilik durumu yoktu (HAQ-DI score was 0-0.375). Sonuç: Prediyabet gittikçe artan sıklıkta görülen yaygın bir hastalık olup ciddi morbidite sebebi olabilir. Hastaların çoğunluğu kadın ve obezdir. Kadın prediyabetik hastaların da çoğu ev hanımı idi. Bu hastalarda erken tanı ve uygun tedavi ile ciddi bir halk sağlığı sorunu olan aynı zamanda engellilik, ciddi morbidite ve mortalite sebebi de olan diyabet gelişmesinden korunulabilir.

Anahtar Kelimeler:

engellilik, prediyabet, sosyodemografik durum

Sociodemographic and Clinical Status and Its Associations with Disability in Patients With Prediabetes

Objective: We aimed in this study that to describe the sociodemographic and clinical status of the patients with prediabetes in a tertiarry internal medicine outpatient clinic.Method: Participants in this study are from Kayseri City Hospital in 2018 between June and December. This study was restricted to participants who were aged 18-65, had blood glucose levels in prediabetic range (n=96). Participants' age, gender, marital status, wage, education, profession, employment, smoking status, alcohol use, height, weight, body mass index, insulin resistance were based on self-report and our measurements.Results: The half of the patients with prediabetes was IFG (n=50) and the least subgroup was IGT (n=14) in our study also. Combined group was higher (n=32). 71 of them were female (74%). 23 patients smoked at any time and mean packet-year was 27.78 (min:1, max: 95, sd: 23.55), 93 patients (96.7%) never used alcohol. 15 patients were retired and only one of them was caused by disablement. The rate of insulin resistant patients was 50%. Marital status were single (n=1), married (n=89), widow/widower (n=5), divorced (n=1). There is a higher rate of obesity in prediabetic patients in our study. BMI are respectively 1% (≤ 18.5 kg/m2); 9% (18.6-24.9 kg/m2); 18% (25.0-29.9 kg/m2); 68.76% (≥30 kg/m2). Conclusion: Prediabetes is an increasingly common disease, leading to serious morbidities. Most patients are obese and female. Most female patients of prediabetic patients are housewives. Early diagnosis and appropriate treatment of people with these characteristics, especially those with high risk of prediabetes, can prevent the development of diabetes.

Keywords:

disability, prediabetes, sociodemographic,

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Bilandzic A, Rosella L. The cost of diabetes in Canada over 10 years: applying attributable health care costs to a diabetes incidence prediction model. Health Promot Chronic Dis Prev Can 2017;37:49-53.
Häring HU. Novel phenotypes of prediabetes? Diabetologia. 2016 Sep;59(9):1806-18.
American Diabetes Association. Standards of medical care in diabetes-2017. Diabetes Care 2017;40:S11–24.
Menke A, Casagrande S, Geiss L, et al. Prevalence of and Trends in Diabetes Among Adults in the United States, 1988-2012. JAMA. 2015 Sep 8;314(10):1021-9.
Wang L, Gao P, Zhang M, et al. Prevalence and Ethnic Pattern of Diabetes and Prediabetes in China in 2013. JAMA. 2017 Jun 27;317(24):2515-2523.
Middelbeek RJW, Abrahamson MJ. Diabetes, prediabetes, and glycemic control in the United States: challenges and opportunities. Ann Intern Med 2014; 160:572–3.
Alberti K, Zimmet P, Shaw J. International Diabetes Federation: a consensus on type 2 diabetes prevention. Diab Med. 2007;24:451-263.
Stefan N, Fritsche A, Schick F, et al. Phenotypes of prediabetes and stratification of cardiometabolic risk. Lancet Diabetes Endocrinol. 2016;4(9):789-798.
Australian Institute of Health and Welfare. Diabetes and disability: impairments, activity limitations, participation restrictions and comorbidities. Canberra: AIHW, 2013.
World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 2000; 894: i–xii, 1–253.
Ramey DR, Raynauld JP, Fries JF. The health assessment questionnaire 1992: status and review. Arthritis Care Res. 1992;5:119–129.
Küçükdeveci AA, Sahin H, Ataman S, et al. Issues in cross-cultural validity: example from the adaptation, reliability, and validity testing of a Turkish version of the Stanford Health Assessment Questionnaire. Arthritis Rheum. 2004;51(1):14-9.
Odding E, Valkenburg HA, Stam HJ, et al. Determinants of locomotor disability in people aged 55 years and over: the Rotterdam Study. Eur. J. Epidemiol. 2001;17:1033–1041.
Haffner SM, Miettinen H, Stern MP. The homeostasis model in the San Antonio Heart Study. Diabetes Care. 1997;20(7):1087-92.
Kelestimur F, Cetin M, Paşaoğlu H, et al. The prevalence and identification of risk factors for type 2 diabetes mellitus and impaired glucose tolerance in Kayseri, central Anatolia, Turkey. Acta Diabetol. 1999;36(1-2):85-91.
Satman I, Yilmaz T, Sengül A, et al. Population-based study of diabetes and risk characteristics in Turkey: results of the turkish diabetes epidemiology study (TURDEP). Diabetes Care. 2002;25(9):1551-6.
Satman I, Omer B, Tutuncu Y, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults (TURDEP-II). Eur J Epidemiol. 2013;28(2):169-80.
Lee JE, Jung SC, Jung GH, et al. Prevalence of diabetes mellitus and prediabetes in Dalseong-gun, Daegu City, Korea. Diabetes Metab. J. 2011;35:255-263.
Graham E, Gariépy G, Burns RJ, et al. Demographic, lifestyle, and health characteristics of older adults with prediabetes in England. Prev Med. 2015;77:74-9.
Logue J, Walker JJ, Colhoun HM, et al. Do men develop type 2 diabetes at lower body mass indices than women? Diabetologia. 2011;54(12):3003-6.
Vistisen D, Witte DR, Tabák AG, et al. Patterns of obesity development before the diagnosis of type 2 diabetes: the Whitehall II cohort study. PLoS Med. 2014;11(2):e1001602.
Onat A, Hergenç G, Türkmen S, et al. Discordance between insulin resistance and metabolic syndrome: features and associated cardiovascular risk in adults with normal glucose regulation. Metabolism. 2006;55(4):445-52.
Ariel D, Reaven G. Modulation of coronary heart disease risk by insulin resistance in subjects with normal glucose tolerance or prediabetes. Acta Diabetol. 2014;51(6):1033-9.
Stojanović N, Krunić J, Cicmil S, et al. Oral health status in patients with diabetes mellitus type 2 in relation to metabolic control of the disease. Srp Arh Celok Lek. 2010;138(7-8):420-4.
Rumball-Smith J, Barthold D, Nandi A, et al. Diabetes associated with early labor-force exit: a comparison of sixteen high-income countries. Health Aff (Millwood). 2014;33(1):110-5.
Bucheli JR, Manshad A, Ehrhart MD, et al. Association of passive and active smoking with pre-diabetes risk in a predominantly Hispanic population. J Investig Med. 2017;65(2):328-332.
Modan M, Meytes D, Rozeman P, et al. Significance of high HbA1 levels in normal glucose tolerance. Diabetes Care. 1988;11(5):422-8.
Janzon L, Berntorp K, Hanson M, et al. Glucose tolerance and smoking: a population study of oral and intravenous glucose tolerance tests in middle-aged men. Diabetologia. 1983;25(2):86-8.
Wang X, Wang M, Shao S, et al. Analysis of influencing factor of coexisting prediabetes and prehypertension in adult residents of Jilin Province. BMC Endocr Disord. 2018;18(1):89.
Su J, Qin Y, Shen C, et al. Association between smoking/smoking cessation and glycemic control in male patients with type 2 diabetes. Zhonghua Liu Xing Bing Xue Za Zhi. 2017;38(11):1454-1459.
Amiri P, Jalali-Farahani S, Karimi M, et al. Factors associated with pre-diabetes in Tehranian men and women: A structural equationsmodeling. PLoS One. 2017;12(12):e0188898.
Koruk İ, Şahin TK. Konya Fazilet Uluışık Sağlık Ocağı Bölgesinde 15-49 yaş grubu ev kadınlarında obezite prevalansı ve risk faktörleri. Genel Tıp Derg 2005;15(4):147-155.
Ünal Ş, Çetin M, Ergin A, et al.. Kayseri Bölgesi Kentsel Populasyonunda Aterosklerotik Risk Faktörleri. Türk Kardiyol Dern Arş 1997;25:77-83.