Retrospective for glicemic regulation in Adıyaman provincial patients with insulin indication and type 2 diabetus mellitus patients with insulin-started and patients taking oral antidiabetic due to insulin rejection

Introduction and Aim: Diabetes mellitus is a chronic disease that increases the risk of mortality with its macrovascular and microvascular complications and its frequency is increasing. Microvascular and macrovascular complications create high care costs for patients with diabetes, and the treatment of complications is costly. Short- and long-term glycemic variability are risk factors for diabetes complications. In our study, it was aimed to investigate HbA1c levels, which is a glycemic control criterion, among patients who were started insulin and refused to use insulin in Type 2 diabetes mellitus patients with an indication for insulin initiation. Materials and methods: Patients who applied to Adıyaman University Training and Research Hospital Internal Medicine outpatient clinic between 01 January 2020 and 31 December 2022 and whose HbA1c levels were greater than 10% were included in the study. The total of 200 patients with Type 2 diabetes mellitus with insulin indication, 100 patients who refused to use insulin and 100 patients who were started on insulin at the same time, were included in the study.. Data was obtained by retrospective examination of patient files. Demographic characteristics of the patients such as gender, age, HbA1c from laboratory measurements, blood glucose, hemoglobin, white blood cell (WBC), number of thrombocytes (PLT), urea, creatinine, AST and ALT levels from liver function tests were measured in the same laboratory. Results: While the average of HbA1c values at the first admission was 13.06±2.00 in patients using insulin, the average of HbA1c values measured at the next control was 9.05±2.40 (p value<0.01). There was a 4.01% HbA1c reduction under insulin therapy. In the OAD group, which refused insulin use, the mean HbA1c values of the patients at the first admission were 11.64±1.31, while the mean HbA1c values were 9.62±1.85 at the next follow-up (p value <0.01). There was a 2.02 HbA1c decrease in the OAD group. Conclusion: In our study, a better glycemic control was achieved in patients using insulin. Keywords: Type II diabetes, HbA1c, Insulin