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In Turkey, only 55% of patients with type 2 diabetes have been diagnosed, and 91% of these patients have been receiving treatment. The rate of patients reaching the treatment target is 50%. The pandemic has also affected diabetic patients. We aimed to determine the characteristics of patients with type 2 diabetes (HbA1c >=10) with poor metabolic control and to evaluate the extent to which metabolic control can be achieved in 3 months.
Patients who applied to Istanbul Medeniyet University Goztepe Prof. Dr. Suleyman Yalcin City Hospital Diabetes Polyclinics and have an HbA1c levels of >= 10% in their examinations will be admitted to the study. Detailed history, including medication usage and previous blood tests will be questioned. The patients will be asked to complete questionnaires about their eating patterns (mindful eating questionnaire), their physical activities (General practice physical activity questionnaire), and whether they have depression (Beck depression questionnaire).
Anthropometric measurements will be taken, and biochemical data will be recorded. Patients will be grouped according to their previous HbA1c values as a) newly diagnosed, b) those whose diabetes was previously controlled, c) those whose diabetes was previously not at the target range but now worsened, and d) those whose diabetes was poorly controlled from the beginning.
Diabetes follow-up will be continued by their respective physicians. The patients will be called again three months after their enrollment to record the most recent biochemical data. Patient characteristics (age, gender, educational status, depression status, eating awareness, exercise characteristics) will be evaluated in accordance with the predetermined HbA1c groups. Again, according to the patient groups, the difference in HbA1c after three months, the frequency of reaching the target, and possible factors associated with the findings will be evaluated.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Newly diagnosed diabetes | Patients who have been diagnosed with type 2 diabetes within a month | ||
| Had controlled diabetes before | Patients who had at least two HbA1c levels =<%7,5 before enrollment | ||
| Had moderately uncontrolled diabetes | Patients who had at least two HbA1c levels between %7,5 and %9,49 before enrollment | ||
| Had poorly controlled diabetes | Patients who had at least two HbA1c levels above %9,5 before enrollment |
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| Measure | Description | Time Frame |
|---|---|---|
| Changes in HbA1c levels after 3 months treatment | Changes in HbA1c levels after 3 months treatment according to the predetermined HbA1c groups. | Three months |
| Changes in HbA1c levels equal to or more than 20% | Comparison of the patient groups according to the reduction of 20% or more in HbA1c levels. | Three months |
| ratio of patients who reached the HbA1c target of equal to or below 7% | Comparison of the patient groups in their success in reaching the HbA1c target of equal to or below 7%. | Three months |
| Measure | Description | Time Frame |
|---|---|---|
| The effect of education on the HbA1c changes | The effect of education on HbA1c changes and comparisons between the patient groups. | Three months |
| The effect of depression on the HbA1c changes | The effect of depression as evaluated with Beck depression test on HbA1c changes and comparisons between the patient groups. |
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Inclusion Criteria:
Exclusion Criteria:
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Patients who have been diagnosed with type 2 diabetes and have an HbA1c level equal to or higher than 10%
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| Name | Affiliation | Role |
|---|---|---|
| Ayse N Erbakan, MD | Istanbul Goztepe Prof. Dr. Suleyman Yalcin City Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Istanbul Goztepe Prof. Dr. Suleyman Yalcin City Hospital | Istanbul | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33298417 | Background | American Diabetes Association. 6. Glycemic Targets: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021 Jan;44(Suppl 1):S73-S84. doi: 10.2337/dc21-S006. | |
| 25287012 | Background | Walraven I, Mast MR, Hoekstra T, Jansen AP, van der Heijden AA, Rauh SP, Rutters F, van 't Riet E, Elders PJ, Moll AC, Polak BC, Dekker JM, Nijpels G. Distinct HbA1c trajectories in a type 2 diabetes cohort. Acta Diabetol. 2015 Apr;52(2):267-75. doi: 10.1007/s00592-014-0633-8. Epub 2014 Oct 8. |
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| ID | Term |
|---|---|
| D003924 | Diabetes Mellitus, Type 2 |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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| Three months |
| The effect of the level of physical activity on the HbA1c changes | The effect of physical activity assessed by General practice physical activity questionnaire on HbA1c changes and comparisons between the patient groups. | Three months |
| 23665365 | Background | Nichols GA, Joshua-Gotlib S, Parasuraman S. Glycemic control and risk of cardiovascular disease hospitalization and all-cause mortality. J Am Coll Cardiol. 2013 Jul 9;62(2):121-127. doi: 10.1016/j.jacc.2013.04.031. Epub 2013 May 9. |
| 23407904 | Background | Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, Karsidag K, Genc S, Telci A, Canbaz B, Turker F, Yilmaz T, Cakir B, Tuomilehto J; TURDEP-II Study Group. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol. 2013 Feb;28(2):169-80. doi: 10.1007/s10654-013-9771-5. Epub 2013 Feb 14. |
| 22652276 | Background | Satman I, Imamoglu S, Yilmaz C; ADMIRE Study Group. A patient-based study on the adherence of physicians to guidelines for the management of type 2 diabetes in Turkey. Diabetes Res Clin Pract. 2012 Oct;98(1):75-82. doi: 10.1016/j.diabres.2012.05.003. Epub 2012 May 29. |
| D004700 | Endocrine System Diseases |