Glycemic control and hypertension, hyperlipidemia, microvascular and macrovascular complication rates in diabetes mellitus patients

Totally 500 Diabetes Mellitus patients, 177 of whom had been followed by different hospitals before they applied to KTU Hospital and 323 of whom were followed by Endocrinology and Metabolism Diseases Department of KTU Hospital were evaluated between 1st Jan 2016 and 1st July 2016. The aim of this study is to compare the rates of metabolic control and the complications of the diabetic patients and to update our applications to reach better metabolic control objectives. Demographic characteristics of the patients as age, gender, settlement, diabetes type and duration, and the treatment they got were questioned. In our study population, 58.8% of the patients were female and 41.2% were male. The rate of Type 1 diabetes patients were 6.4% and that of Type 2 diabetes patients were 93.6%. HbA1c and FBG values were recorded. Average HbA1c value was 8.1%. The rate of the patients reaching the HbA1c objective was 37.8%. The rate of reaching the objective in the patients followed by KTU Hospital was 44.0%, while that in the patients who had been treated in other hospitals was 26.6%. Being statistically significant (p<0,001). The rate of the patients reaching the FBG objective was 45.2%. The rate of attaining the objective in the patients followed by KTU hospital was 50.5%, while that in the patients followed by other hospitals was 37.3%. Being statistically significant (p=0,009). Hyperlipidemia diagnosis and treatment, if they had, were questioned. The rate of dyslipidemia in whole patients group was 69.0%. Low HDL cholesterol values were found in 34.0%, high LDL cholesterol values in 66.8% and high TG values in 46.4% were determined. There was no difference between the patients followed by KTU hospital and those followed by other hospitals. The hypertension diagnosis of the patients was also recorded. The total rate of hypertensive were 70.8%. Of whom 88.4% were having treatment and 11.6% were not. Microvascular complications and macrovascular complications were recorded. The rates of atherosclerotic heart disease was 27.0%, cerebrovascular accident was 5.2%, peripheral vascular disease was 23.0%, and diabetic foot was 2.2%. Erectile dysfunction in male patients were 31.1%. The presence of retinopathy was obtained, from either the patient history, or if available, from the records in KTU Hospital. The rate of retinopathy was 33.1% in the patients followed by KTU Hospital, while that in the patients followed by other hospitals was 46.0% (p=0,043). The rate of albumin/creatinine in spot urine was calculated in the patients for diabetic nephropathy, and albuminuria was observed in 35.2% of whole patients group. The rates of the patients who were taking different treatments were; 23.0% one OAD, 19.4% two OAD, 7.0% three OAD, 0.6% four OAD, 17.8% basal insulin, 8.0% biphasic insulin and 24.2% basal bolus insulin. The only significant difference between the patients followed by KTU Hospital and those followed by other hospitals was observed in the patients taking one OAD drug. The results of our study demonstrate that the rate of the diabetic patients who cannot reach metabolic control objectives is still quite high. For the reduction and the prevention of diabetes and its complications which is an important public health problem, demand and determination in the level of national and local decision makers and health workers must be provided. Also, diabetic patient education and regular follow up must be performed without delay.