Üçüncü Basamak Bir Hastaneye Başvuran Riskli Popülasyonda Oral Glukoz Tolerans Testi ile Diabetes Mellitus ve Prediyabet Prevalansının Tespiti

Amaç: Diabetes mellitus, sıklığı ve yarattığı sorunlar nedeniyle tüm dünyada önemi gittikçe artan toplumsal bir sağlık sorunudur. Burada bilinen diyabet hikayesi olmayan ve Oral Glukoz Tolerans Testi (OGTT) yapılacak risk faktörlü bireylerde prediyabet ve diabetes mellitus prevalansının araştırılmasını amaçladık.Gereç ve Yöntemler: Üçüncü basamak bir hastaneye başvuran ve diabetes mellitus açısından risk faktörü bulunduran bireylere OGTT yapılarak diyabetik ve prediyabetik (bozulmuş açlık glisemisi, bozulmuş glukoz toleransı) olguların oranı belirlendi. Olguların yaş, cinsiyet, açlık kan glukozu, OGTT 2.saat kan glukozu ve glikozile hemoglobin (A1C) değerleri belirlenerek cinsiyete göre farklılıklar araştırıldı. Glisemik tablo alt gruplarına göre karşılaştırmalar yapıldı.Bulgular: Oral glukoz tolerans testi ile risk faktörü bulunduran 187 olguda (%36,5) glukoz toleransı normal bulundu. Yeni diyabet tanısı 48 (% 9.4) olguda saptandı. Ayrıca 150 olguda (%29,3) Bozulmuş Açlık Glukozu (BAG), 48’inde (%9.4) Bozulmuş Glukoz Toleransı (BGT) ve 79’unda (%15.4) BAG ve BGT birlikteliği tespit edildi. Erkeklerin yaş, açlık kan glukozu, OGTT 2. saat glukozu ve A1C ortalamaları ile diabetes mellitus oranı kadınlara göre anlamlı olarak yüksekti (p<0.05). Diyabetik ve prediyabetiklerin yaş ortalamaları, açlık kan glukozu, OGTT 2. saat kan glukozu ile A1C ortalamaları anlamlı olarak yüksekti (p<0.05). Bu arada normal glukoz toleranslı ve prediyabetikler içerisinde kadın cinsiyet oranı belirgin yüksek iken diyabetiklerde erkek cinsiyet oranı daha yüksek bulundu.Sonuç: Diabetes mellitus ve prediyabet tanısı için OGTT tek başına önerilen bir testtir. Diyabet için risk faktörü pediyabet prevalansı toplumda yüksek ve cinsiyete göre farklılıklar göstermektedir. Oral glukoz tolerans testi yapılmış riskli gruplarda diabetes mellitus tanı prevalansımız toplumumuza ait bildirilenlere benzer oranda görünmektedir.

The Prevelance of Diabetes Mellitus and Prediabetes by Oral Glucose Tolerance Test in Risk Population Applying to a Tertiary Hospital

Aim: Diabetes mellitus is an increasingly public health problem all over the world, due to the frequency and problems it creates. We aimed to investigate the prevalence of prediabetes and diabetes mellitus in individuals with no known history of diabetes and risk factors for Oral Glucose Tolerance Test (OGTT).Material and Methods: The proportion of diabetic and prediabetic (impaired fasting glycemia, impaired glucose tolerance) cases was determined by performing OGTT on those who applied to a tertiary care hospital and had a risk factor for diabetes mellitus. The age, sex, fasting blood glucose, OGTT 2nd hour blood glucose and glycosylated hemoglobin (A1C) values of the cases were determined and differences according to sex were investigated. Comparisons were made according to glycemic subgroups.Results: Glucose tolerance was normal in 187 cases (36.5%) with risk factor by oral glucose tolerance test. New diabetes was diagnosed in 48 (9.4%) cases. Together Impaired Fasting Glycemia (IFG) and Impaired Glucose Tolerance (IGT) were detected in 79 cases (15.4%). IFG in 150 cases (29.3%), and IGT 48 cases (9.4%). Men’s age, fasting blood glucose, OGTT 2nd hour glucose and A1C averages and diabetes mellitus ratio were significantly higher than women (p<0.05). Mean averages of diabetic and prediabetic patients, fasting blood glucose, OGTT 2nd hour blood glucose and A1C averages were significantly higher than normal group (<0.05). Meanwhile, the female sex ratio was significantly higher in normal glucose tolerant and prediabetics, while the male sex ratio was higher in diabetics.Conclusion: OGTT is a stand-alone test for the diagnosis of diabetes mellitus and prediabetes. The prevalence of prediabetes, a risk factor for diabetes, can be detected at high levels in society and varies according to sex.

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