Browsing by Author "Dikbas, O"

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    Impact of Obesity on the Metabolic Control of Type 2 Diabetes: Results of the Turkish Nationwide Survey of Glycemic and Other Metabolic Parameters of Patients with Diabetes Mellitus (TEMD Obesity Study)
    Sonmez, A; Yumuk, V; Haymana, C; Demirci, I; Barcin, C; Kiyici, S; Güldiken, S; Örük, G; Saydam, BO; Baldane, S; Kutlutürk, F; Küçükler, FK; Deyneli, O; Çetinarslan, B; Sabuncu, T; Bayram, F; Satman, I; 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; Imre, E; Sait Gonen; Boysan, SN; Altuntas, Y; Ozturk, FY; Mert, M; Piskinpasa, H; Aydin, H; Imamoglu, S; Ersoy, C; Oz Gul, O; Selek, A; Dogru, T; Kirik, A; Kebapci, N; Efe, B; Kaya, A; Cordan, I; Kirac, CO; Capa, Z; Cesur, M; Yetkin, I; Corapcioglu, D; Canlar, S; Yildiz, OB; Sendur, SN; Cakir, B; Ozdemir, D; Corakci, A; Kutlu, M; Bascil Tutuncu, N; Bozkus, Y; Cakal, E; Demirbas, B; Ertek, S; Altay, M; Dagdeviren, M; Abedi, AH; Cetinkalp, S; Ozisik, H; Yener, S; Guney, E; Unubol, M; Yaylali, GF; Topsakal, S; Hekimsoy, Z; Akbaba, G; Aslan, I; Balci, MK; Dalkiran, S; Akbay, E; Gul, K; Agbaht, K; Yilmaz, MO; Bozkirli, E; Tetiker, BT; Cetinkaya Altuntas, S; Atmaca, A; Durmus, ET; Mete, T; Dikbas, O; Akin, S; Nuhoglu, I; Ersoz, HO; Bayraktaroglu, T; Sisman, P; Sahin, I; Cetin, S; Capoglu, I; Akbas, EM; Ucler, R; Eren, MA; Tuzcu, AK; Pekkolay, Z; Ozkaya, M; Araz, M; Salman, S; Dizdar, OS; Gurkan, E; Kargili Carlioglu, A
    Background: Obesity is the main obstacle for metabolic control in patients with type 2 diabetes. Turkey has the highest prevalence of obesity and type 2 diabetes in Europe. The effect of obesity on the metabolic control, and the macro-and microvascular complications of patients are not apparent. Objectives: This nationwide survey aimed to investigate the prevalence of overweight and obesity among patients with type 2 diabetes and to search for the impact of obesity on the metabolic control of these patients. We also investigated the independent associates of obesity in patients with type 2 diabetes. Methods: We consecutively enrolled patients who were under follow-up for at least 1 year in 69 tertiary healthcare units in 37 cities. The demographic, anthropometric, and clinical data including medications were recorded. Patients were excluded if they were pregnant, younger than 18 years, had decompensated liver disease, psychiatric disorders interfering with cognition or compliance, had bariatric surgery, or were undergoing renal replacement therapy. Results: Only 10% of patients with type 2 diabetes (n = 4,648) had normal body mass indexes (BMI), while the others were affected by overweight (31%) or obesity (59%). Women had a significantly higher prevalence of obesity (53.4 vs. 40%) and severe obesity (16.6 vs. 3.3%). Significant associations were present between high BMI levels and lower education levels, intake of insulin, antihypertensives and statins, poor metabolic control, or the presence of microvascular complications. Age, gender, level of education, smoking, and physical inactivity were the independent associates of obesity in patients with type 2 diabetes. Conclusion: The TEMD Obesity Study shows that obesity is a major determinant of the poor metabolic control in patients with type 2 diabetes. These results underline the importance of prevention and management of obesity to improve health care in patients with type 2 diabetes. Also, the results point out the independent sociodemographic and clinical associates of obesity, which should be the prior targets to overcome, in the national fight with obesity. (c) 2019 The Author(s) Published by S. Karger AG, Basel
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    Turkish nationwide survEy of glycemic and other Metabolic parameters of patients with Diabetes mellitus (TEMD study)
    Sonmez, A; Haymana, C; Bayram, F; Salman, S; Dizdar, OS; Gurkan, E; Carlioglu, AK; 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, VD; Haliloglu, O; Sancak, S; Ozsari, L; Cagiltay, E; Deyneli, O; Imre, E; Gonen, S; Boysan, SN; Altuntas, Y; Ozturk, FY; Mert, M; Piskinpasa, H; Aydin, H; Imamoglu, S; Ersoy, C; Ozgul, O; Kiyici, SK; Cetinarslan, B; Selek, A; Dogru, T; Kirik, A; Kebapci, N; Efe, B; Kaya, A; Cordan, I; Baldane, S; Kirac, CO; Demirci, I; Capa, Z; Cesur, M; Yetkin, I; Corapcioglu, D; Canlar, S; Yildiz, OB; Sendur, SN; Cakir, B; Ozdemir, D; Corakci, A; Kutlu, M; Tutuncu, NB; Bozkus, Y; Cakal, E; Demirbas, B; Ertek, S; Altay, M; Dagdeviren, M; Abedi, AH; Cetinkalp, S; Ozisik, H; Oruk, GG; Yener, S; Saydam, BO; Guney, E; Unubol, M; Yaylali, GF; Topsakal, S; Hekimsoy, Z; Akbaba, G; Aslan, I; Balci, MK; Dalkiran, S; Akbay, E; Gul, K; Agbaht, K; Yilmaz, MO; Bozkirli, E; Tetiker, BT; Altuntas, SC; Atmaca, A; Durmus, ET; Mete, T; Kutluturk, F; Kucukler, FK; Dikbas, O; Akin, S; Nuhoglu, I; Ersoz, HO; Bayraktaroglu, T; Sisman, P; Sahin, I; Cetin, S; Capoglu, I; Akbas, EM; Ucler, R; Eren, MA; Tuzcu, AK; 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, nonsmoker, 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. (C) 2018 Elsevier B.V. All rights reserved.
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    Prevalence and predictors of gestational diabetes mellitus: a nationwide multicentre prospective study
    Aydin, H; Çelik, Ö; Yazici, D; Altunok, Ç; Tarçin, Ö; Deyneli, O; Sancak, S; Kiyici, S; Aydin, K; Yildiz, BO; Çakiroglu, AY; Özer, A; Tuzcu, AK; Kan, A; Çelik, A; Uysal, A; Atmaca, A; Evren, B; Taskiran, B; Bilir, BE; Duran, C; Arpaci, D; Tüzün, D; Kavak, EÇ; Aydeniz, E; Akbas, EM; Üstünyurt, E; Bil, E; Güney, E; Akbaba, E; Gürkan, E; Çagliyan, E; Karakiliç, E; Karakas, E; Kilinç, F; Söylemez, F; Küçükler, FK; Yorulmaz, G; Akbaba, G; Uysal, G; Kurt, G; Yaylali, GF; Selimoglu, H; Sari, H; Piskinpasa, H; Çelik, H; Peynirci, H; Bilal, I; Sahin, I; Gözükara, I; Anaforoglu, I; Senyuva, I; Ugur, K; Dogan, K; Keskin, L; Mert, M; Adas, M; Tonguç, M; Eroglu, M; Kulaksizoglu, M; Özcan, M; Çinar, N; Kutbay, NÖ; Dikbas, O; Bakiner, O; Turhan, ÖT; Tütüncüoglu, P; Sari, R; Melekoglu, R; Ayaz, R; Emral, R; Mumusoglu, S; Görar, S; Keskek, SÖ; Tosun, SA; Çetinkaya, SE; Temizkan, S; Ünsal, S; Demir, T; Yüce, T; Aksoy, Ü; Çinkir, Ü; Simsek, Y; Uyar, Y; Türk, Y; Pekkolay, Z; Hekimsoy, Z; Cantürk, Z; Üç, ZA
    Aim Prevalence rates of gestational diabetes mellitus (GDM) show considerable variation among different countries and regions of the world. The primary aim of this study was to determine the nationwide prevalence and predictors of GDM in Turkey. Methods We conducted prospective nationwide screening among pregnant women. Between August 2016 and November 2017, a total of 2643 pregnant women from 51 centres in 12 different regions were enrolled. A two-step screening method and Carpenter and Coustan criteria were used in the diagnosis of GDM. Clinical and biochemical data were obtained using electronic database software. Results The national prevalence of GDM was found to be 16.2% [95% confidence intervals (CI) 15.0% to 17.4%] without a significant difference between urban and rural regions. Women with GDM were older (mean age: 32 +/- 5 vs. 28 +/- 5 years, P < 0.001) and heavier (mean BMI: 27.2 +/- 5.1 vs. 24.7 +/- 4.7 kg/m(2), P < 0.001) than their counterparts without GDM. The prevalence of GDM tended to increase with age (< 25 years, 6.9%; 26-35 years, 15.6%; and 36-45 years, 32.7%; P < 0.001). Maternal age, maternal BMI, history of previous GDM and family history of diabetes mellitus were independent predictors of developing GDM (P < 0.05 for all). Low-risk women (age < 25 years, BMI < 25 kg/m(2), no family history of diabetes) comprised 10.7% of the total population and the prevalence of GDM in these women was 4.5% (95% CI 2.4% to 7.8%). Conclusion The results of this nationwide study indicate that GDM is very common, affecting one in seven pregnancies in Turkey. Implementation of international guidelines on screening and management of this public health problem is required.
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    Out-of-Reference Range Thyroid-Stimulating Hormone Levels in Levothyroxine-Treated Primary Hypothyroid Patients: A Multicenter Observational Study
    Yavuz, DG; Yazici, D; Keskin, L; Atmaca, A; Sancak, S; Saraç, F; Sahin, I; Dikbas, O; Hekimsoy, Z; Yalin, S; Uygur, M; Yilmaz, M; Yirmibescik, S; Asmaz, ÖO
    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 mu g/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.
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    Prevalence of Vitamin D Deficiency and Hypervitaminosis D Among Adult Patients Admitted to the Tertiary Care Hospitals in Turkey
    Yavuz, DG; Ersoy, R; Altuntas, Y; Bilen, H; Pamuk, B; Apaydin, T; Temizkan, S; Altuntas, H; Mert, M; Akalin, A; Sert, M; Simsri, IY; Hekimsoy, Z; Cantürk, Z; Üç, ZA; Iplikci, S; Yasar, M; Unubol, M; Sezer, K; Toplaoglu, Ö; Iyidir, ÖT; Pekkolay, Z; Atmaca, A; Dikbas, O; Özdemir, N; Gül, K; Deniz, F; Ertörer, E; Karaca, Z; Elbüken, G; Arpaci, D; Agbaht, K; Turan, E; Anaforoglu, I; Bayraktaroglu, T; Haklar, G; Daglioglu, G; Tuzcu, A; Sahin, I; Çetinkalp, S
    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 bio-chemistry 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.