Browsing by Author "Atmaca A."

Now showing 1 - 7 of 7
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    Impact of telephonic interviews on persistence and daily adherence to insulin treatment in insulin-naïve type 2 diabetes patients: Dropout study
    (Dove Medical Press Ltd., 2016) Yavuz D.G.; Bilen H.; Sancak S.; Garip T.; Hekimsoy Z.; Sahin I.; Yilmaz M.; Aydin H.; Atmaca A.; Sert M.; Karakaya P.; Arpaci D.; Oguz A.; Guvener N.
    Objective: The objective of this study is to evaluate the impact of sequential telephonic interviews on treatment persistence and daily adherence to insulin injections among insulin-naïve type 2 diabetes patients initiated on different insulin regimens in a 3-month period. Methods: A total of 1,456 insulin-naïve patients with type 2 diabetes (mean [standard deviation, SD] age: 56.0 [12.0] years, 49.1% were females) initiated on insulin therapy and consecutively randomized to sequential (n=733) and single (n=723) telephonic interview groups were included. Data on insulin treatment and self-reported blood glucose values were obtained via telephone interview. Logistic regression analysis was performed for factors predicting increased likelihood of persistence and skipping an injection. Results: Overall, 76.8% patients (83.2% in sequential vs 70.3% in single interview group, (P<0.001) remained on insulin treatment at the third month. Significantly higher rate for skipping doses was noted in basal bolus than in other regimens (27.0% vs 15.0% for premixed and 15.8% basal insulin, respectively, P<0.0001). Logistic regression analysis revealed sequential telephonic interview (odds ratio [OR], 1.531 95% confidence interval [CI], 1.093-2.143 P=0.013), higher hemoglobin A1c levels (OR, 1.090 95% CI, 0.999-1.189 P=0.049), and less negative appraisal of insulin therapy as significant predictors of higher persistence. Basal bolus regimen (OR, 1.583 95% CI, 1.011-2.479 P=0.045) and higher hemoglobin A1c levels (OR, 1.114 95% CI, 1.028-1.207 P=0.008) were the significant predictors of increased likelihood of skipping an injection. Conclusion: Our findings revealed positive influence of sequential telephonic interview, although including no intervention in treatment, on achieving better treatment persistence in type 2 diabetes patients initiating insulin. © 2016 Yavuz et al.
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    Out-of-reference range thyroid-stimulating hormone levels in levothyroxine-treated primary hypothyroid patients: A multicenter observational study
    (Frontiers Media S.A., 2017) Yavuz D.G.; Yazici D.; Keskin L.; Atmaca A.; Sancak S.; Saraç F.; Şahin I.; Dikbaş O.; Hekimsoy Z.; Yalin S.; Uygur M.; Yilmaz M.; Yirmibeşcik S.; Asmaz Ö.
    Objective: Although levothyroxine (LT4) replacement therapy for hypothyroidism has been established as safe, inexpensive and effective, many studies from different countries reported out-of-reference range thyroid-stimulating hormone (TSH) values for the hypothyroid patients under LT4 treatment. The aim of this study was to determine TSH levels of primary hypothyroid patients under LT4 treatment and to assess self-reported compliance with daily LT4 intake in tertiary care centers in Turkey. Design: In this cross-sectional, observational study, adult patients with primary hypothyroidism, receiving LT4 treatment for at least 6 months, were included. The patients were from 12 tertiary care centers in 9 cities of Turkey. TSH and free T4 levels were recorded from patient files and self-reported compliance with daily LT4 intake was assessed by interviewing the subjects at the last visit. Results: A total of 1,755 subjects (46 ± 13 years; F/M: 89.9/10.1%) with primary hypothyroidism were enrolled. Of the hypothyroid subjects, 44.8% had out-of-reference range serum TSH levels. TSH values were over the reference range (TSH > 4 mIU/L) in 26.2% and were under the reference range (TSH < 0.5 mIU/L) in 18.6% of the patients. Total duration of LT4 treatment was 5.9 ± 4.7 years and mean dose was 1.2 ± 0.6 μg/kg/day. Non-compliant patients (31.1%) had higher TSH levels (6.9 ± 16 vs 3.8 ± 0.9 mIU/L, P = 0.01) compared to compliant patients. Conclusion: The results of this study revealed that nearly half of the hypothyroid patients had out-of-reference range serum TSH values, despite under LT4 treatment. Compliance with LT4 treatment seems to be one of the major determinants to reach the target TSH levels in hypothyroid patients. © 2017 Yavuz, Yazici, Keskin, Atmaca, Sancak, Saraç, Şahin, Dikbaş, Hekimsoy, Yalin, Uygur, Yilmaz, Yirmibeşcik and Asmaz.
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    Turkish nationwide survEy of glycemic and other Metabolic parameters of patients with Diabetes mellitus (TEMD study)
    (Elsevier Ireland Ltd, 2018) Sonmez A.; Haymana C.; Bayram F.; Salman S.; Dizdar O.S.; Gurkan E.; Kargili Carlıoglu A.; Barcin C.; Sabuncu T.; Satman I.; Guldiken S.; Ayturk S.; Yilmaz M.; Asik M.; Dinccag N.; Cakmak R.; Turker F.; Idiz C.; Hacisahinogullari H.; Bagdemir E.; Yildiz B.; Yumuk V.D.; Haliloglu O.; Sancak S.; Ozsari L.; Cagiltay E.; Deyneli O.; Imre E.; Gonen S.; Boysan S.N.; Altuntas Y.; Ozturk F.Y.; Mert M.; Piskinpasa H.; Aydin H.; Imamoglu S.; Ersoy C.; Gul O.O.; Kucuksarac Kiyici S.; Cetinarslan B.; Selek A.; Dogru T.; Kirik A.; Kebapci N.; Efe B.; Kaya A.; Cordan I.; Baldane S.; Kirac C.O.; Demirci I.; Capa Z.; Cesur M.; Yetkin I.; Corapcioglu D.; Canlar S.; Bulent Yildiz O.; Sendur S.N.; Cakir B.; Ozdemir D.; Corakci A.; Kutlu M.; Bascil Tutuncu N.; Bozkus Y.; Cakal E.; Demirbas B.; Ertek S.; Altay M.; Dagdeviren M.; Abedi A.H.; Cetinkalp S.; Ozisik H.; Oruk G.G.; Yener S.; Saydam B.O.; Guney E.; Unubol M.; Yaylali G.F.; Topsakal S.; Hekimsoy Z.; Akbaba G.; Aslan I.; Balci M.K.; Dalkiran S.; Akbay E.; Gul K.; Agbaht K.; Yilmaz M.O.; Bozkirli E.; Tetiker B.T.; Cetinkaya Altuntas S.; Atmaca A.; Durmuş E.T.; Mete T.; Kutluturk F.; Kucukler F.K.; Dikbas O.; Akin S.; Nuhoglu I.; Ersoz H.O.; Bayraktaroglu T.; Sisman P.; Sahin I.; Cetin S.; Capoglu I.; Akbas E.M.; Ucler R.; Eren M.A.; Tuzcu A.K.; Pekkolay Z.; Ozkaya M.; Araz M.
    Aims: Turkey has the highest prevalence of diabetes in Europe. It is therefore essential to know the overall cardiovascular risk and reveal the predictors of metabolic control in Turkish adults with diabetes mellitus. Methods: A nationwide, multicenter survey consecutively enrolled patients who were under follow up for at least a year. Optimal control was defined as HbA1c < 7%, home arterial blood pressure (ABP) < 135/85 mmHg, or LDL-C < 100 mg/dL. Achieving all parameters indicated triple metabolic control. Results: HbA1c levels of patients (n = 5211) were 8.6 ± 1.9% (71 ± 22 mmol/mol) and 7.7 ± 1.7% (61 ± 19 mmol/mol), in Type 1 and Type 2 diabetes, respectively. Glycemic control was achieved in 15.3% and 40.2%, and triple metabolic control was achieved in 5.5% and 10.1%, respectively. Only 1.5% of patients met all the criteria of being non-obese, non-smoker, exercising, and under triple metabolic control. Low education level was a significant predictor of poor glycemic control in both groups. Conclusions: Few patients with Type 2, and even fewer with Type 1 diabetes have optimal metabolic control in Turkey. TEMD study will provide evidence-based information to policy makers to focus more on the quality and sustainability of diabetes care in order to reduce the national burden of the disease. © 2018 Elsevier B.V.
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    Utilization of statins and LDL-cholesterol target attainment in Turkish patients with type 2 diabetes - a nationwide cross-sectional study (TEMD dyslipidemia study)
    (BioMed Central Ltd, 2020) Bayram F.; Sonmez A.; Haymana C.; Sabuncu T.; Dizdar O.S.; Gurkan E.; Carlioglu A.K.; Agbaht K.; Ozdemir D.; Demirci I.; Barcin C.; Salman S.; Tetiker T.; Balci M.K.; Kebapci N.; Ersoy C.; Yumuk V.; Toth P.P.; Satman I.; Guldiken S.; Ayturk S.; Yilmaz M.; Asik M.; Dinccag N.; Cakmak R.; Turker F.; Idiz C.; Hacisahinogullari H.; Bagdemir E.; Yildiz B.; Haliloglu O.; Sancak S.; Ozsari L.; Cagiltay E.; Deyneli O.; Imre E.; Gonen S.; Boysan S.N.; Altuntas Y.; Ozturk F.Y.; Mert M.; Piskinpasa H.; Aydin H.; Imamoglu S.; Gul O.O.; Kiyici S.K.; Cetinarslan B.; Selek A.; Dogru T.; Kirik A.; Efe B.; Kaya A.; Cordan I.; Baldane S.; Kirac C.O.; Capa Z.; Cesur M.; Yetkin I.; Corapcioglu D.; Canlar S.; Yildiz O.B.; Sendur S.N.; Cakir B.; Corakci A.; Kutlu M.; Tutuncu N.B.; Bozkus Y.; Cakal E.; Demirbas B.; Ertek S.; Altay M.; Dagdeviren M.; Abedi A.H.; Cetinkalp S.; Ozisik H.; Oruk G.G.; Yener S.; Saydam B.O.; Guney E.; Unubol M.; Yaylali G.F.; Topsakal S.; Hekimsoy Z.; Akbaba G.; Aslan I.; Dalkiran S.; Akbay E.; Gul K.; Yilmaz M.O.; Bozkirli E.; Altuntas S.C.; Atmaca A.; Durmuş E.T.; Mete T.; Kutluturk F.; Kucukler F.K.; Dikbas O.; Akin S.; Nuhoglu I.; Ersoz H.O.; Bayraktaroglu T.; Sisman P.; Sahin I.; Cetin S.; Capoglu I.; Akbas E.M.; Ucler R.; Eren M.A.; Tuzcu A.K.; Pekkolay Z.; Ozkaya M.; Araz M.
    Background: Attaining acceptable levels of LDL Cholesterol (LDL-C) significantly improves cardiovascular (CV) outcomes in patients with type 2 diabetes mellitus (T2DM). The LDL-C target attainment and the characteristics of patients attaining these targets were investigated in this study. Furthermore, the reasons for not choosing statins and the physicians’ attitudes on the treatment of diabetic dyslipidemia were also examined. Methods: A nationwide, cross-sectional survey was conducted in tertiary centers for diabetes management. Adult patients with T2DM, who were under follow-up for at least a year in outpatient clinics, were consecutively enrolled for the study. LDL-C goals were defined as below 70 mg/dL for patients with macrovascular complications or diabetic nephropathy, and below 100 mg/dL for other patients. Data about lipid-lowering medications were self-reported. Results: A total of 4504 patients (female: 58.6%) were enrolled for the study. The mean HbA1c and diabetes duration was 7.73 ± 1.74% and 10.9 ± 7.5 years, respectively. The need for statin treatment was 94.9% (n = 4262); however, only 42.4% (n = 1807) of these patients were under treatment, and only 24.8% (n = 448) of these patients achieved LDL-C targets. The main reason for statin discontinuation was negative media coverage (87.5%), while only a minority of patients (12.5%) mentioned side effects. Physicians initiated lipid-lowering therapy in only 20.3% of patients with high LDL-C levels. It was observed that the female gender was a significant independent predictor of not attaining LDL-C goals (OR: 0.70, 95% CI: 0.59–0.83). Conclusions: Less than 50 % of patients with T2DM who need statins were under treatment, and only a quarter of them attained their LDL-C targets. There exists a significant gap between the guideline recommendations and the real-world evidence in the treatment of dyslipidemia in T2DM. © 2020, The Author(s).
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    Prevalence of Vitamin D Deficiency and Hypervitaminosis D Among Adult Patients Admitted to the Tertiary Care Hospitals in Turkey
    (Turkiye Klinikleri, 2022) Yavuz D.G.; Ersoy R.; Altuntaş Y.; Bilen H.; Pamuk B.; Apaydın T.; Temizkan Ş.; Altuntaş H.; Mert M.; Akalın A.; Sert M.; Şimşir I.Y.; Hekimsoy Z.; Cantürk Z.; Üç Z.A.; İplikçi S.; Yaşar M.; Unubol M.; Sezer K.; Toplaoğlu Ö.; İyidir Ö.T.; Pekkolay Z.; Atmaca A.; Dikbaş O.; Özdemir N.; Gül K.; Deniz F.; Ertörer E.; Karaca Z.; Elbüken G.; Arpacı D.; Ağbaht K.; Turan E.; Anaforoğlu İ.; Bayraktaroğlu T.; Haklar G.; Dağlıoğlu G.; Tuzcu A.; Şahin İ.; Çetinkalp Ş.
    Objective: Vitamin D deficiency is a common health problem around the world. This study aimed to evaluate the nationwide prevalence of vitamin D status in tertiary care hospitals in Turkey. Methods: Retrospectively, the data on vitamin D levels from 33 tertiary care hospitals’ clinical biochemistry laboratories around Turkey between January and December were collected. Results: In total, 706 434 serum samples from adult subjects (female/male: 469 028/237 406; 66.4%/33.6%) were included. While vitamin D levels were sufficient in 20.3% (n = 14 222), they were insufficient in 21.9% (n = 154 360) and deficient in 57.8% (n = 408 882). We observed the highest rates of deficiency in those aged between 18 and 29 years (62.9%, n = 70 235) and lowest rates between 60 and 69 years (52.3%, n = 61 121) and between 70 and 79 years (52.3%, n = 32 397). Hypervitaminosis D was detected in 5.5% of adult subjects; highest rates of hypervitaminosis D were observed in those who were over 80 years (6.6%) and 70-79 years (6.5%) and the lowest in 18-29 years (2.8%). Discussion: In this cohort, over half of the subjects admitted to the tertiary care hospitals in Turkey had vitamin D deficiency and required vitamin D supplementation. The elderly population had the lowest prevalence of vitamin D insufficiency and the highest prevalence of hypervitaminosis D. © Author(s).
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    Evaluation and follow-up of patients diagnosed with hypophysitis: A cohort study
    (Oxford University Press, 2024) Hacioglu A.; Karaca Z.; Uysal S.; Ozkaya H.M.; Kadioglu P.; Selcukbiricik O.S.; Gul N.; Yarman S.; Koksalan D.; Selek A.; Canturk Z.; Cetinarslan B.; Corapcioglu D.; Sahin M.; Sah Unal F.T.; Babayeva A.; Akturk M.; Ciftci S.; Piskinpasa H.; Dokmetas H.S.; Dokmetas M.; Sahin O.; Eraydln A.; Fenkci S.; Ozturk S.; Akarsu E.; Omma T.; Erkan B.; Burhan S.; Pehlivan Koroglu E.; Saygili F.; Kilic Kan E.; Atmaca A.; Elbuken G.; Alphan Uc Z.; Gorar S.; Hekimsoy Z.; Pekkolay Z.; Bostan H.; Bayram F.; Yorulmaz G.; Sener S.Y.; Turan K.; Celik O.; Dogruel H.; Ertorer E.; Turhan Iyidir O.; Topaloglu O.; Cansu G.B.; Unluhizarci K.; Kelestimur F.
    Objective: Primary hypophysitis might be challenging to diagnose, and there is a lack of evidence regarding optimal treatment strategies due to rarity of the disease. We aim to investigate the clinical features and compare the outcomes of different management strategies of primary hypophysitis in a large group of patients recruited on a nationwide basis. Design: A retrospective observational study. Methods: The demographic, clinical, and radiologic features and follow-up data were collected in study protocol templates and analyzed. Results: One hundred and thirteen patients (78.8% female, median age: 36 years) were included. Lymphocytic (46.7%) and granulomatous hypophysitis (35.6%) were the prevailing subtypes out of 45 patients diagnosed after pathologic investigations. Headache (75.8%) was the most common symptom, and central hypogonadism (49.5%) was the most common hormone insufficiency. Of the patients, 52.2% were clinically observed without interventions, 18.6% were started on glucocorticoid therapy, and 29.2% underwent surgery at presentation. Headache, suprasellar extension, and chiasmal compression were more common among glucocorticoid-treated patients than who were observed. Cox regression analysis revealed higher hormonal and radiologic improvement rates in the glucocorticoid-treated group than observation group (hazard ratio, 4.60; 95% CI, 1.62-12.84 and HR, 3.1; 95% CI, 1.40-6.68, respectively). The main indication for surgery was the inability to exclude a pituitary adenoma in the presence of compression symptoms, with a recurrence rate of 9%. Conclusion: The rate of spontaneous improvement might justify observation in mild cases. Glucocorticoids proved superior to observation in terms of hormonal and radiologic improvements. Surgery may not be curative and might be considered in indeterminate, treatment-resistant, or severe cases. © 2024 The Author(s). Published by Oxford University Press on behalf of European Society of Endocrinology. All rights reserved.
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    Effectiveness and Safety of Initiation and Titration of Insulin Glargine 300 U/mL in Insulin-Naive Patients with Type 2 Diabetes Mellitus Uncontrolled on Oral Antidiabetic Drug Treatment in Turkey: The EASE Study
    (AVES, 2024) Çetinarslan B.; Çetinkalp Ş.; Kaya A.; Ersoy C.; Kebapçı N.; Çömlekçi A.; Tütüncü N.B.; Deyneli O.; Oğuz A.; İlkova H.; Yılmaz T.; Hekimsoy Z.; Ünübol M.; Balcı M.K.; Atmaca A.; Dağdelen S.; Yetkin İ.; Güler S.; Ötünç G.; Özhan L.
    Objective: The aim of the study was to evaluate the effectiveness and safety of insulin glargine 300 U/ mL (Gla-300) in insulin-naive patients with type 2 diabetes mellitus (T2DM) inadequately controlled on oral antidiabetic drug (OADs) treatment in Turkey. Methods: One hundred eight patients from 20 centers enrolled in the study. Starting from baseline, Gla-300 was self-administered subcutaneously and once daily in the evening. The primary outcome was the mean change in glycated hemoglobin A1c (HbA1c) from baseline to week 24. Results: The mean (±SD) Hb1Ac level of 9.4% (±0.8) at baseline decreased to 7.5% (±0.9) at week 12 (P <.1) and to 7.3% (±0.9) at week 24 (P <.1). Although none of the patients were within the target Hb1Ac level of ≤7% at baseline, the percentage of patients who achieved the target Hb1Ac level was 30.4% at week 12 and increased to 42.9% at week 24. Gla-300 treatment achieved the Hb1Ac target in 21 (19.4%) patients without experiencing a hypoglycemic event and in 27 (25.0%) patients who experienced at least one hypoglycemic event. For each self-monitoring blood glucose time point, significant improvements were observed as compared to baseline (P <.001). Statistically significant improvement (P <.001) was seen in the treatment satisfaction questionnaire – status version scores between baseline and week 24. Conclusion: This study indicated that Gla-300 is effective to provide a successful glycemic control with low risk of hypoglycemia added to OADs in insulin-naive patients with T2DM, and it has the potential to improve the quality of life of patients. © Author(s).