Diyabetik Hastalarda Yaşa Göre A1c Değişimi - Kılavuzların Güncel Uygulamalara Etkisi

Year 2018, Volume: 2 Issue: 3, 107 - 112, 28.12.2018

Özlem Polat , Meral Mert , Yıldız Okuturlar , Yasemin Şefika Akdeniz Ayşe Esen Hamide Pişkinpaşa Sogol Sadri Denis Sabriye Bozer

Abstract

Amaç:
Güncel
rehberlere göre hemoglobin A1c (HbA1c)  hedefleri hastanın yaşı ve komorbiditeleri göz
önüne alınarak kişiselleştirilmelidir. Çalışmamızda, hastanemize başvuran
diyabetik hastalarda cinsiyet ve yaşa göre HbA1c değerlerinin nasıl değiştiğini
belirlemek ve bulguları literatür eşliğinde incelemeyi amaçladık.

Gereç
ve Yöntemler: Bu çalışmamızda Sağlık Bilimleri
Üniversitesi Bakırköy Dr. Sadi Konuk Sağlık Uygulama ve Araştırma Merkezi, İç Hastalıkları
ve Endokrinoloji ve Metabolizma Hastalıkları polikliniklerine son 5 yılda ayaktan
başvuran 18 yaş üstü diyabetik hastalar retrospektif olarak değerlendirildi. Hastaların
ilk başvuruları değerlendirilerek diyabet tipleri,  yaş,  cinsiyet
ve HbA1c değerleri kaydedildi.  Hasta
yaşları dekatlara göre 18-29, 30-39, 40-49, 50-59, 60-69, 70-79, >80 olacak
şekilde gruplandırılarak sonuçlar istatistiksel olarak değerlendirildi.

Bulgular: Çalışmaya
alınan tüm hastalar (n=17.973) incelendiğinde kadın hasta oranı %63,4 iken,
erkek hasta oranı %36,6 bulundu. Tip 1 diyabetes mellitus (DM) hasta oranı %2,8
(n=498),  Tip 2 DM hasta oranı %97,2 (n=17.475)
idi. 18 yaş üstü hastalarda 10 yıllık dekatlara göre HbA1c ortalamaları karşılaştırıldığında,
9 grup arasında istatistiksel olarak anlamlı fark görüldü (p< 0,05). En
düşük Hb A1c düzeyi ortalaması (%7,01±1,78)  2.Dekatta iken, en yüksek HbA1c düzeyi
ortalaması (%7,67±2,09) 5.dekatta gözlendi. Tüm dekatlara bakıldığında hasta sayısı en çok 50-59
yaş arasında (n=5582; %31) idi. 50 yaş üstü erkek hastaların HbA1c düzeyleri kadınlardan
istatistiksel olarak anlamlı daha yüksekti (p< 0,001). 50 yaş altı Tip 2
diyabetik kadınların HbA1c değerleri erkeklerden istatistiksel olarak anlamlı daha
düşüktü (p< 0,001).

Sonuç:
En yüksek HbA1c
değerleri 5. Dekatta, en düşük 2. Dekatta görülmektedir. Yaşla beraber artmakla
birlikte özellikle 50 yaş üstü erkeklerde HbA1c değerleri daha yüksektir

Summary

Aim: According to the current guidelines, hemoglobin A1c (HbA1c) targets should be personalized taking into account patient age and comorbidities. In our study, we aimed to determine how HbA1c values ​​change according to age and sex in diabetic patients who applied to our hospital and to investigate the findings with literature

Material and Methods: In this study, Health Sciences University Bakırköy Dr. Sadi Konuk Health Application and Research Center, Internal Diseases and Endocrinology and Metabolic Diseases outpatient clinics in the last 5 years of outpatients over 18 years of age were evaluated retrospectively. Diabetes types, age, sex and HbA1c values ​​were recorded. The patient ages were grouped as 18-29, 30-39, 40-49, 50-59, 60-69, 70-79,> 80 according to the terms and the results were evaluated statistically.

Results: When all patients were included in the study (n = 17.973, mean age = 73), the rate of female patients was 63.4% and the male patient ratio was 36.6%. The rate of patients with type 1 diabetes mellitus (DM) was 2.8% (n = 498) and the rate of type 2 DM patients was 97.2% (n = 17.475). When HbA1c averages were compared according to 10 year, there was a statistically significant difference between the 9 groups (p <0.05). The lowest HbA1c level (7.01 ± 1.78%) was in the second decate, while the highest HbA1c level (7.67% ± 2.09) was observed in the 5th decate. The number of patients was 50-59 (n = 5582; 31%). HbA1c levels of male patients over 50 years were significantly higher than females (p <0.001). HbA1c values ​​of women with type 2 diabetes under 50 years of age were significantly lower than men (p <0.001).

Conclusion: The highest HbA1c values ​​are in 5th decade, the lowest is in 2nd decate. Although it increases with age, HbA1c values ​​are higher especially in males over 50 years of age.

Keywords

HbA1c, Yaş, Cinsiyet

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