Metabolic parameters at diagnosis of newly diagnosed type 2 diabetes mellitus patients

Introduction and objective: Type 2 diabetes mellitus (DM) is an significant reason of mortality and morbidity all over the world and its diagnosis is still delayed. In this study, we intended to analyse the risk factors, demographic characteristics and metabolic parameters of newly diagnosed diabetic patients at the time of diagnosis, to raise awareness about the significance of early diagnosis, and to stress the importance of developing strategies to diagnose diabetes mellitus earlier. Materials and Methods: This study was designed as a retrospective archive screening. The study included 200 patients aged 18 years and over who were diagnosed with DM within the last 6 months and who applied to the Endocrinology and Metabolic Diseases outpatient clinic of Balıkesir University Faculty of Medicine Hospital between 1 January 2018 and 31 December 2022 after ethics committee approval. Patients with known diabetes mellitus were excluded from the study. Demographic characteristics, diabetic symptom status and metabolic parameters of the patients at the time of presentation were collected by analysing medical records. Descriptive statistics (mean, max, standard deviation) of values related to continuous variables in patients diagnosed with diabetes were examined. Frequency (f) and percentage (%) values of the distributions of discontinuous variables in patients diagnosed with diabetes were calculated. T-test was performed to compare HbA1c values according to symptom status. Before the t-test analysis, the skewness kurtosis values of the HbA1c values were examined and determined to be within the range of ±1. Therefore, the assumption of normal distribution was met. Results: Medical records of 200 patients were analysed. Mean age was 54.18 years, mean body mass index (BMI) was 34.66 kg/m2, mean waist circumference was 102.07 cm, mean fasting blood glucose (FBS) was 196.97 mg/dL, mean HbA1c was 8.78 mmol/mol, mean total cholesterol level was 206.97 mg/dL, mean low-density lipoprotein (LDL) was 124.95 mg/dL. The mean systolic blood pressure was 136.55 mmHg and the mean diastolic blood pressure was 84.45 mmHg. The mean HbA1c was 8.22 mmol/mol (mean) in asymptomatic patients (n=160) and 11.03 mmol/mol in patients with DM symptoms (n=40). The difference between the mean HbA1c values of symptomatic and asymptomatic groups was found to be significant. According to the data, 158 (79%) of the patients were diagnosed with DM with AKI (≥126 mg/dl). It was found that all patients newly diagnosed with diabetes had at least 1 risk factor and 96% of the patients had 2 or more risk factors, which increased the risk for the development of diabetes. Among the patients with HbA1c value of 6.5 mmol/mol and above (n=158, 79%), 121 were asymptomatic patients (76.58%) and 37 were symptomatic patients (23.41%). This distribution of HbA1c values higher than 6.5 mmol/mol according to symptom status also shows a meaningful difference (.ꭕ2 =5.49 , p= 0.02). Discussion and Conclusion: In the light of these results, it was observed that the majority of the patients newly diagnosed with DM were asymptomatic, although they already had many of the risk factors determined for DM screening at the time of diagnosis, their diabetes was detected incidentally, not by the diabetes screening tests performed, and considering the HBA1c values of our patients at the time of diagnosis, there was still a significant delay in diagnosis. There is a need to regulate diabetes screening programmes and initiatives to raise awareness of the community and healthcare professionals. Key words: Newly Diagnosed Diabetes, HBA1c, Diabetes Screening Programme