Diyabetik Hastalarda Yaşa Göre HbA1c Değişimi - Kılavuzların Güncel Uygulamalara Etkisi
Amaç: Güncel rehberlere göre glikolize hemoglobin A1c (HbA1c) hedefleri hastanın yaşı ve komorbiditeleri göz önüne alınarakkişiselleştirilmelidir. Çalışmamızda, hastanemize başvuran diyabetik hastalarda cinsiyet ve yaşa göre HbA1c değerlerinin nasıldeğiştiğini belirlemeyi ve bulguları literatür eşliğinde incelemeyi amaçladık.Gereç ve Yöntemler: Bu çalışmamızda İç Hastalıkları ve Endokrinoloji ve Metabolizma Hastalıkları polikliniklerine son beş yıldaayaktan başvuran 18 yaş üstü diyabetik olgular retrospektif olarak değerlendirildi. Hastaların ilk başvuruları değerlendirilerek diyabettipleri, yaş, cinsiyet ve HbA1c değerleri kaydedildi. Olgular yaşlarına göre 18-29, 30-39, 40-49, 50-59, 60-69, 70-79, >80 olacak şekildegruplandırılarak sonuçlar istatistiksel olarak değerlendirildi.Bulgular: Çalışmaya alınan tüm olgular (n=17.973) incelendiğinde kadın oranı %63,4 iken, erkek oranı %36,6 bulundu. Tip 1diabetes mellitus (DM) oranı %2,8 (n=498), Tip 2 DM oranı %97,2 (n=17.475) idi. 18 yaş üstü olgularda on yıllık dekatlara göreHbA1c ortalamaları karşılaştırıldığında, dokuz grup arasında istatistiksel olarak anlamlı fark görüldü (p< 0,05). En düşük Hb A1cdüzeyi ortalaması (%7,01±1,78) ikinci dekatta iken, en yüksek HbA1c düzeyi ortalaması (%7,67±2,09) beşinci dekatta gözlendi. Tümdekatlara bakıldığında olgu sayısı en çok 50-59 yaş arasında (n=5582; %31) idi. 50 yaş üstü erkek olguların HbA1c düzeyleri kadınlardanistatistiksel olarak anlamlı daha yüksekti (p< 0,001). 50 yaş altı Tip 2 diyabetik kadınların HbA1c değerleri erkeklerden istatistikselolarak anlamlı daha düşüktü (p< 0,001).Sonuç: En yüksek HbA1c değerleri beşinci yaş grubunda, en düşük ikinci yaş grubunda görülmektedir. Yaşla beraber artmakla birlikteözellikle elli yaş üstü erkeklerde HbA1c değerleri daha yüksektir. Optimal şartlar sağlandığı takdirde her yaşta HbA1c hedefleri daha sıkıkontrole tabi tutulabilir. Ancak yaşa ve bireysel özelliklere göre kişisel hedefler belirlenmelidir.
Distribution of HbA1c by Age in Diabetic Patients - The Effect of Guidelines on Current Practices
Aim: According to the current guidelines, Glycated hemoglobin A1c (HbA1c) targets should be personalized taking into account patient age and comorbidities. In our study, we aimed to determine how HbA1c values change according to age and sex in diabetic cases who applied to our hospital and to investigate the findings with literature. Material and Methods: In this study, Internal Diseases and Endocrinology and Metabolic Diseases outpatient clinics in the last five years of diabetic cases over eighteen years of age were evaluated retrospectively. Diabetes types, age, sex and HbA1c values were recorded. The cases ages were grouped as 18-29, 30-39, 40-49, 50-59, 60-69, 70-79,> 80 according to the terms and the results were evaluated statistically. Results: When all cases were included in the study (n = 17.973, mean age = 73), the rate of female was 63.4% and the male ratio was 36.6%. The rate of type 1 diabetes mellitus (DM) was 2.8% (n = 498) and the rate of type 2 DM cases was 97.2% (n = 17.475). When HbA1c averages were compared according to ten year in the cases over eighteen years of age, there was a statistically significant difference between the nine groups (p
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