Browsing by Author "Bilen H."

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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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    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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    The Importance of DHEA-S Levels in Cushing's Syndrome; Is There a Cut-off Value in the Differential Diagnosis?
    (Georg Thieme Verlag, 2022) Ciftci S.; Soyluk O.; Selek A.; Erol S.; Hekimsoy Z.; Esen A.; Dursun H.; Sahin S.; Oruk G.; Mert M.; Soylu H.; Yurekli B.S.; Ertorer M.E.; Omma T.; Evran M.; Adas M.; Tanrikulu S.; Aydin K.; Pekkolay Z.; Can B.; Karakilic E.; Karaca Z.; Bilen H.; Canturk Z.; Cetinarslan B.; Kadioglu P.; Yarman S.
    The purpose of this study was to determine possible cut-off levels of basal DHEA-S percentile rank in the differential diagnosis of patients with Cushing's syndrome (CS) with ACTH levels in the gray zone and normal DHEA-S levels.In this retrospective study including 623 pathologically confirmed CS, the DHEA-S percentile rank was calculated in 389 patients with DHEA-S levels within reference interval. The patients were classified as group 1 (n=265 Cushing's disease; CD), group 2 (n=104 adrenal CS) and group 3 (n=20 ectopic ACTH syndrome).ROC-curve analyses were used to calculate the optimal cut-off level of DHEA-S percentile rank in the reference interval in the differential diagnosis of CS, and the effectiveness of this cut-off level in the identification of the accurate etiology of CS was assessed in patients who were in gray zone according to their ACTH levels.The DHEA-S percentile rank in the reference interval were significantly lower in group 2 compared to the other two groups (p<0.001), while group 1 and group 3 had similar levels. The optimal cut-off level of DHEA-S percentile rank in the reference interval providing differential diagnosis between group 1 and group 2 was calculated as 19.5th percentile (80.8% sensitivity, 81.5% specificity) and the level demonstrated the accurate etiology in 100% of CD and 76% of adrenal CS patients who were in the gray zone.This study showed that the cut-off value of DHEA-S level less than 20% of the reference interval could be used for differential diagnosis of CD and adrenal CS with high sensitivity and specificity, and it should be taken into the initial evaluation. © 2022 ASTM International. All rights reserved.