Evaluation of metabolic control of patients with Type 2 Diabetes Mellitus

This study aims to retrospectively evaluate the demographic, clinical, and biochemical characteristics of 1000 patients diagnosed with Type 2 Diabetes Mellitus (DM) who applied to the Endocrinology and Metabolism Diseases outpatient clinic of Karadeniz Technical University (KTU) Farabi Hospital between January 1 and December 31, 2024. The primary goal is to analyze patients' age, gender, body mass index (BMI), duration of diabetes, and treatment modalities, and to determine the rates of achieving metabolic control targets and their relationship with the development of diabetic complications. Among the patients included in the study, 52% were male and 48% were female, with a mean age of 62.2 ± 12.0 years. The mean duration of diabetes was 8.5 ± 7.6 years, and the mean BMI was calculated as 31.4 ± 5.8 kg/m², indicating that the majority of the patients were overweight or obese. In the evaluation of biochemical parameters, the mean HbA1c level was found to be 8.4 ± 1.9%, suggesting inadequate metabolic control in a large proportion of the cohort. Only 26.3% of the patients had HbA1c levels below 7%, while the remaining 73.7% had values above the recommended target. The mean fasting plasma glucose (FPG) was 167.1 ± 73.9 mg/dL, mean LDL cholesterol was 117.5 ± 39.2 mg/dL, mean HDL cholesterol was 49.1 ± 12.5 mg/dL, and mean triglyceride level was 161.5 ± 95.6 mg/dL. When comparing sexes, HDL levels were significantly higher in female patients compared to males (51.8 ± 12.6 mg/dL vs. 46.1 ± 11.5 mg/dL; p<0.001), whereas the complication rate was significantly higher among male patients (52.5% vs. 36.7%; p<0.001). Overall, 44.9% of the patients had developed at least one chronic diabetic complication. The most common complications were atherosclerotic cardiovascular disease (ASCVD) (57.3%), albuminuria (32.5%), and diabetic retinopathy (25.1%). Additionally, cerebrovascular events were observed in 5% of the patients, and diabetic foot complications were present in 2.3%. No statistically significant relationship was found between BMI and complication development (p=0.612), suggesting that factors other than BMI (e.g., disease duration, glycemic control) may be more influential in the development of complications. Regarding treatment modalities, 41.9% of the patients were on oral antidiabetic drugs (OAD) only, 17.2% were managed with medical nutrition therapy alone, 13.8% were using multiple types of insulin, and 15.2% were treated with a combination of insulin and OAD. These results indicate that a significant portion of the cohort required intensive therapy and emphasize the importance of treatment adherence. In terms of age-specific HbA1c distribution, the highest mean values were observed in the 30–39 age group (10.1 ± 2.5%), followed by the 40–49 (8.8 ± 1.7%) and 50–59 (8.4 ± 1.8%) age groups. The lowest mean HbA1c was seen in patients aged 70 years and above (8.1 ± 1.6%). This suggests that younger patients may have more difficulty achieving adequate glycemic control, potentially due to poor treatment adherence or inadequate lifestyle modifications. In conclusion, this study demonstrates that the rate of achieving glycemic targets in patients with T2DM is suboptimal, with male patients exhibiting a higher risk of complications. Younger patients showed poorer glycemic control compared to older age groups. These findings underscore the need for individualized treatment strategies and more effective management of metabolic parameters to prevent complications. Keywords: Complications, Diabetic, Retinopathy, Metabolic Control, Type 2 Diabetes Mellitus.