Evaluation of compliance with treatment recommendations of national andinternational guidelines in the treatment selection of patients with type 2diabetes mellitus at Akdeniz University Endocrinology and Metabolism Policlinic between January 1, 2018 - March 31, 2020

An important lifestyle disorder, diabetes, has become a global health problem and its prevalence is rapidly increasing all over the world. Therefore, this study based on the importance of evaluating the compliance with national and international guidelines in Type 2 DM treatment; The medical records of 1100 patients between January 1, 2018 and March 31, 2020 were reviewed. 148 patients were excluded from the study. 382 out of the 952 patients participated in the study (40.1%) were male and 570 (59.9%) were female. The average age was 61.52 years, the average diagnostic age was 48.53 years, the average disease duration was 13.69 years. In accordance with the guideline recommendations it was observed that 56.8% measurements with stable and target A1c value (≤%7%) were measured every 3-6 months, lifestyle changes were recommended to the patients during the controls, metformin was preferred as the first choice in 93% of the patients and the treatment arrangement was made in consideration of the guideline recommendations due to drug side effects. It was observed that patients with a value of A1c ≤7% tended to maintain their condition, patients with A1c value >7% were more difficult to reach the target A1c (≤7%), and in 88,7% of patients with A1c value of ≤7% medical treatment changes were not made. It was observed that our awareness of recording BMI information and hepatosteatosis was insufficient in our hospital. It can be said that our awareness of osteoporosis screening scans in the risky group is inadequate, but after the osteoporosis is detected, the choice of TZD group medication is avoided. In patients with CAD, HF, CKD and obesity T2D, especially in patients with CAD and obese T2D there was an increase in the preference of SGLT-2 inhibitor over time. In patients with CAD and HF, GLP-1 RA (semaglutide, liraglutide) which has proven CV effectiveness has not yet been covered by reimbursement in Turkey, so an assessment could not be made in this respect. It is thought that the increase in the preference of DPP-4 inhibitor linagliptin (23,7%) in T2D patients with CKD is due to less hypoglycemic side effects and no GFR dose adjustment necessary in the presence of CKD. T2D patients with obesity or CKD had an increase in the preference of GLP-1 RA over time, but this increase was not sufficient. In the absence of sufficient GLP-1 RA, it can be said that the reservations related to side effects, the fact that blood sugar regulation has been provided with existing treatments, personal characteristics, SUT restrictions, marketing strategy and the lack of GFR appropriate are effective. This study, which evaluates the suitability of T2D diagnosed patients with national and international guidelines in their follow-up and treatment, has been provided to have an opinion on the issues that we are sufficient and inadequate in patient follow-up. The consequences are important, and it is thought to increase the awareness of the guide. It will set an example for the work to be done. More patient groups, more detailed data and prospective, multi-centric studies are needed with longer periods of time. Key Words: Diabetes Mellitus, Compliance with National and International Guidelines