Browsing by Author "Saydam, BO"

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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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    A subset of patients with acquired partial lipodystrophy developing severe metabolic abnormalities
    Saydam, BO; Sonmez, M; Simsir, IY; Erturk, MS; Kulaksizoglu, M; Arkan, T; Hekimsoy, Z; Cavdar, U; Akinci, G; Demir, T; Altay, CT; Mihci, E; Secil, M; Akinci, B
    Purpose/Aim of the study: Acquired partial lipodystrophy (APL) is a rare disease characterized by selective loss of adipose tissue. In this study, we aimed to present a subset of patients with APL, who developed severe metabolic abnormalities, from our national lipodystrophy registry. Materials and Methods: Severe metabolic abnormalities were defined as: poorly controlled diabetes (HbA1c above 7% despite treatment with insulin more than 1 unit/kg/day combined with oral antidiabetics), severe hypertriglyceridemia (triglycerides above 500 mg/dL despite treatment with lipid-lowering drugs), episodes of acute pancreatitis, or severe hepatic involvement (biopsy-proven non-alcoholic steatohepatitis (NASH)). Results: Among 140 patients with all forms of lipodystrophy (28 with APL), we identified 6 APL patients with severe metabolic abnormalities. The geometric mean for age was 37 years (range: 27-50 years; 4 females and 2 males). Five patients had poorly controlled diabetes despite treatment with high-dose insulin combined with oral antidiabetics. Severe hypertriglyceridemia developed in five patients, of those three experienced episodes of acute pancreatitis. Although all six patients had hepatic steatosis at various levels on imaging studies, NASH was proven in two patients on liver biopsy. Our data suggested that APL patients with severe metabolic abnormalities had a more advanced fat loss and longer disease duration. Conclusions: We suggest that these patients represent a potential subgroup of APL who may benefit from metreleptin or investigational therapies as standard treatment strategies fail to achieve a good metabolic control.