Investigation of the prevention of glycemic control and chronic complication in diabetic patient population as A third step training and research hospital

İntroduction and aim: The aim of this study is to determine the point of glycemic control in patients admitted to our hospital and to investigate the frequency of chronic complications. Thus, we aimed to evaluate our treatment efficacy and to update our practices in order to reach the metabolic control targets by seeing our deficiencies. Materials and Methods: In the period between 01/06/2018 and 01/08/2018, a total of 351 patients with diabetes mellitus who were admitted to the outpatient clinic of Gaziantep University Faculty of Medicine Şahinbey Research and Application Hospital Endocrinology and Metabolism Diseases Clinic were included in the study. In our study, age, gender and known additional diseases of patients were questioned.Subsequently, the type of diabetes mellitus and treatment of patient were recorded. Cbc, urea, creatinine, fasting blood glucose, hemoglobin A1C (HGBA1C), LDL, HDL, triglyceride, total cholesterol, complete urine analysis, creatinine in spot urine, microalbumin and micrototal protein levels in patients with diabetes mellitus were retrospectively analyzed and compared. For these purposes, the availabla laboratory tests in the hospital system will be examined. Patients diagnosed with hypertension were questioned and treatment was recorded. The patient was questioned and recorded for microvascular complications (retinopathy, nephropathy, myopathy) and macrovascular complications (atherosclerotic heart disease, peripheral artery disease, cerebrovascular accident). Results: The total number of patients in our study was 351.59% of the patients were female and 41% were male. 7.1 of patients % had type 1 diabetes mellitus and 92.9% had type 2 diabetes mellitus. Average HbA1c value was determined to be 8.2% when HbA1c values and fasting blood glucose were evaluated. The ratio of patients who reached the target HbA1c value was 35.3%. The target fasting blood glucose level of the patients was determined as 26.8%. Diagnosis, duration and treatment of hypertension in patient were recorded. The rate of total hypertensive patients was determined as 35.9%. 92.9% of hypertensive patients were receiving treatment, 7.1% were not receiving treatment.Presence of hypertension was significantly detected higher in female patients than in male patients(p=0,001). Hypertension was detected in 43% of women and in 25.7% of men. The diagnosis and treatment of hyperlipidemia in patients were questioned.HDL level was determined as %51.6. LDL level was determined as %89.5. TG was determined as %66.1. The presence of retinopathy was determined and recorded by the patient during the recent examination and examination by the specialist ophthalmologist in our hospital. Retinopathy was present in 28.2% of patients, 71.8% did not. While 92.9% of patients with retinopathy had nonproliferative retinopathy, 7.1% had proliferative retinopathy. For the rate of diabetic nephropathy, the ratio of albumin / creatinine in spot urine was examined and albuminuria was found in 28.8% of the patients and no albuminuria was observed in 71.2% of the patients. Microalbuminuria was found in 79.2% of the patients with albuminuria and 20.8% of them had macroalbuminuria. Microvascular complications and macrovascular complications were recorded and evaluated. Coronary artery disease was found in 20.2% of the patients and 79.8% had no coronary artery disease. 51.6% of the patients with diabetes mellitus included in the study had polyneuropathy and 48.4% had no. While 26.8% of the patients were smoking, 73.2% were non-smokers. Smoking was significantly higher in male patients than in female patients(P=0.000). 52.1% of males and 9.2% of females were smoking. While 49.8% of the patients used oral antidiabetic drugs, 49.3% were using insulin. While all patients with type 1 diabetes mellitus(100%) were using insulin, 53.7% of patients with type 2 diabetes mellitus used oral antidiabetic, 45.4% used insulin, and 0.9% did not. Of the patients using insulin, 52.6% were using basal bolus insulin, 27.7% were mixed insulin, and 19.7% were using basal insulin. Conclusions: As a result of this study, the rate of patients who could not reach the metabolic control targets in diabetic patients is still high. Demand and determination at the level of national and local decision-makers should be ensured to prevent and reduce diabetes and its complications, a major public health problem; diabetic patient education and regular follow-up should be done without interruption. Keywords: Diabetes mellitus,glycemic control,chronic complication