Hyperlipidemia, hypertansion, microvasculer and macrovasculer complication rates (İndidences) and diabetes mellitus control of patients with diabetes mellitus

In our study, 363 diabetes mellitus patients who followed-up in Endocrinology and Metabolism Polyclinic, Farabi Hospital, Karadeniz Technical University from July 1, 2008 to July 1, 2009 and 137 Diabetes Mellitus patients who followed-up in an outer center prior to that date, and applied to us were included. Our aim in this study is to determine the proportion of reached metabolic targets in the patients who followed-up in our polyclinic, to determine treatment efficiency by comparing new admitted patients with patients were following-up(under surveillance) and to assess our works(studies) in order to provide a good metabolic control in our patients in the future.Treatments and duration of treatments (dietary, oral antidiabetic drugs, insulin), HbA1c values and FBG(fasting blood glucose) were all recorded. Hba1c value was recorded if it was studied in (the) last 3 months. Target HbA1c and fasting blood glucose (values) considered(accepted) to be under(?) %6.5 and under(?) 110, respectively (According to IDF glycemic control target levels). FBG was assessed by a blood sample which was obtained from antecubital vein, after 8 hours of fasting at morning. Lipid values of patients in routine examinations and treatment duration (dietary, statin, fibrate) if the patient was treated were (all) recorded. Lipid value was recorded if there was a lipid value studied in (the) last 3 months. Hyperlipidemia incidence(rate) was looked (at). Target values were accepted(considered as) under(?) 100 mg/dL, under(?) 150 mg/dL, over(?) 40 mg/dL in LDL, triglyceride and HDL, respectively (According to ADA metabolic control target values). Lipid levels were assessed by a blood sample which was obtained from antecubital vein, after 8 hours of fasting.If the patient has a hypertension, his/her treatment and duration of treatment was recorded. Hypertension incidence(rate) was looked (at). A systolic blood pressure of less than 130 mm/Hg and a diastolic less than 80 mm/Hg considered(accepted) as target blood pressures (target blood pressure according to ADA criteria).Microvascular complications (retinopathy, nefropathy, myopathy) and macrovascular complications (atherosclerotic heart disease, peripheral artery disease, diabetic foot, existence of cve(cerebrovascular event) were recorded and incidences(rates) were looked (at).Patients with microaneurysms alone and along with haemorrhages, exudates and vascular proliferations were chosen for retinopathy.Patients with proteinuria higher than 30 mg/day in spot urine sampling by looking total protein/creatinin rate, and without an urinary tract infection causing it and/or without other factors contributing chronic renal failure leading to a decreased creatine clearance were included to our study for diabetic nefropathy.Superficial and deep sensory examination, orthostatic hypotension was assessed(looked) for diabetic neuropathy. Erectile dysfunction was questioned in male patients.Diabetic foot and a diabetic foot history was recorded. Coronary artery disease assessed with ECG and personal history. Cerebrovascular event was assessed with personal history.Our study is a methodological study, and our results obtained in our study were evaluated(assessed) statistically by(at) the Department of Public Health, Karadeniz Technical University.146 cases with a HbA1c lower than 6,5% (29,2%), 99 cases with a fbg below(lower than) 100 (19%), 200 cases with a LDL lower than(under,below) 100 (40%), 290 with a TG below 150 (58%), 134 cases with a HDL above(higher than) 40 were determined(stated). Hyperlipidemic patient rate was 60% and the rate of patients receiving treatment was determined as 58%. 77% of the patients were hypertensive, and the rate of the patients receiving treatment was determined as 56%. Nefropathy rate was determined as 18,4%. Retinopathy rate was determined as 31,4%. CAD, CVE, PAD, DF were all determined as 7,2%, 0,8%, 8,6%, 0,8%, respectively. In order to reach metabolic targets, HbA1c was determined below 6,5% in 31,7% of the patients who followed-up in Endocrinology Polyclinic, Karadeniz Technical University, in comparison with 20,4% of the patients who followed-up besides(off, out off) Karadeniz Technical University (P= 0.013). No (statistically) significant differences determined in terms of reaching(achieving) HDL, LDL,TG, FBG target levels.In conclusion, a metabolic control couldn?t established in a considerable amount of these patients who were followed-up with a DM diagnosis. Therefore, necessary(essential, integral) modifications, about acute and chronic complications of diabetes, should be made with taking their socio-economic and cultural life into account unless the patient?s diabetes brought under control. Diabetes Centers should be constituted, developed(advanced), and diabetes team, patient his/her parents should be educated(well trained).