Birinci basamak sağlik kuruluşlarinda takip edilen tip 2 diabetes mellitus tanili hastalarin metabolik kontrol ve tedavi parametrelerinin değerlendirilmesi

Introduction and Aim: The aim of this study was to evaluate the metabolic control and treatment parameters of patients with type 2 diabetes mellitus who were followed in primary health care centers in Şehitkamil and Şahinbey districts of Gaziantep province. With the study; The aim is to improve the quality of life in a chronic disease that affects people, family and even generations throughout their life, such as learning how to treat patients with better target metabolic values, improving disease management and diabetes. Materials and methods: A total of 496 patients with type 2 diabetes mellitus who were admitted to the family health centers in Gaziantep Şahinbey and Şehitkamil districts between 01/01/2017-01/03/2019 were included in the study. Before the study, a detailed file was presented to Gaziantep Provincial Health Directorate and permission was given to access the patient information. In our study, age, gender and known additional diseases of patients were questioned. Subsequently, the type of diabetes and its treatment were recorded. Hemogram, urea, creatinine, fasting blood glucose, satiety blood glucose, hemoglobin A1c (HGBA1C), LDL, cholesterol, HDL cholesterol, triglyceride, total cholesterol, complete urinalysis, albuminuria levels were investigated and compared in patients with diabetes mellitus. . For these purposes, the laboratory tests in the family medicine system will be examined. The patient's hypertension, coronary artery disease, history of cerebrovascular accident, the diagnosis of peripheral arterial disease was recorded in the system. Results: In our study 70.0% of the patients were female and 30% were male. In our study, the mean age of women was 55,8 ± 9,4 and the mean age was 56,9 ± 7,7 and the mean age of all patients was 56,18 ± 8,9. Hypertension was recorded in 35.4% of the patients. The mean HbA1c of the patients with hypertension was found to be7.5 and 48.2% was seen as the target value. The mean HbA1c of the patients was 7.4 ± 1.6 and no significant difference was found between HbA1C and sex. (p> 0.05). The mean fasting blood glucose level of the patients was 143.8 ± 67.6 (Lowest = 71, Highest = 512) mg / dl. 19.4% (n = 77) of the patients had proteinuria at least +1 in complete urinalysis. The HbA1c mean of the patients with proteinuria was found to be 8.36, and only 28.5% (n = 22) of the patients were HbA1c. Hyperlipidemia was detected in 17.7% (n = 88) of the patients. 36.3% (n = 32) of the patients with hyperlipidemia were target HbA1c. Coronary artery disease was associated with type 2 diabetes mellitus in 11.3% (n = 56) of the patients and 88.62% (n = 436) had no coronary artery disease. The mean value of HbA1c in patients with coronary artery disease was found to be 7.8 and 37.5% of the patients had target glycemic values. While 47.5% (n = 236) of the patients who participated in the study used single oral antidiabetic, 22.3% (n = 111) had double, 10.8% (n = 54) had triple, 2% ( n = 10) four-group oral antidiabetic. 17.1% (n = 85) of the patients were receiving treatment with insulin or insulin daoral antidiabetic combination. While 72.4% (n = 171) of the patients taking the single drug was HbA1C, this rate was 32.4% (n = 36) in the patients who used the two drugs, 24% (n = 13) in the three drug users, and 10% in the four drug users (n = 1) in patients using insulin, 12.9% (n = 11), 75% (n = 162) in patients using metformin only, 33.3% in patients using metformin and DPP4 inhibitor (n = 10), only in patients using DPP4 inhibitor 33.3% (n = 2) and 32.5% (n = 14) of the patients using metformin and sulfonylurea. Only patients receiving sulfonylurea at the target value could not be diagnosed. In patients receiving metformin and glitazone, target HbA1C value was 32.5% (n = 14), 80% in glitazone alone, 62.5% in metformin and glinid areas (n = 5), 12% in metformin and sulfonylurea and DPP4 inhibitor, 5 (n = 3) was found to be 53.7% (n = 221) in oral antidiabetic patients, and 9% (n = 5) in patients using insulin and oral antidiabetic combination. Conclusion: Diabetes mellitus requires a multidisciplinary approach in the treatment of sedation in the world and in our country, sedentary life in the face of technology, a growing public health problem due to improper nutrition and a disease affecting the whole person's life. Because of the complex nature of diabetes control, frequent and careful follow-up, and the importance of lifestyle change; It is a chronic disease process that needs to be learned both as physicians in all branches and as patients. Considering the principle of 'there is patient and no disease' the selection of appropriate treatment for the appropriate patient is particularly important for the control of microvascular complications. Keywords: Diabetes mellitus, glycemic control, target HbA1c, oral antidiabetics