Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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    Previous Gestational Diabetes History is Associated with Impaired Coronary Flow Reserve
    (2015) Caliskan, Mustafa; Turan, Yasar; Caliskan, Zuhal; Gullu, Hakan; Ciftci, Faika Ceylan; Avci, Enver; Duran, Cevdet; Kostek, Osman; Caklili, Ozge Telci; Koca, Harun; Kulaksizoglu, Mustafa; 0000-0003-2579-9755; 26555575; IXD-5147-2023
    Background Gestational diabetes mellitus (GDM) is a prediabetic state that is known to increase the risk of cardiovascular diseases. We have investigated coronary flow velocity reserve (CFVR) and epicardial fat thickness (EFT), and left ventricular diastolic function in patients with a history of previous GDM (p-GDM). Methods Ninety-three women with GDM history and 95 healthy women without GDM history were recruited. We used transthoracic Doppler echocardiography to assess CFVR, EFT, and left ventricular diastolic function. Insulin resistance of each subject was assessed with homeostasis model assessment insulin resistance (HOMA-IR). Hemoglobin A1c and high-sensitivity C-reactive protein (hsCRP) were also measured in all patients. Results CFVR values were significantly lower (2.34 +/- 0.39 versus 2.80 +/- 0.24, p<0.001) and EFT values were significantly higher in patients with p-GDM than the control group (5.5 +/- 1.3 versus 4.3 +/- 1.1, p<0.001). E/E' ratio (7.21 +/- 1.77 versus 6.53 +/- 1.38, p = 0.003), hemoglobin A1c (5.2 +/- 0.4 and 5.0 +/- 0.3, p = 0.001), HOMA-IR (2.8 +/- 1.4 versus 1.7 +/- 0.9, p = 0.04), and hsCRP levels were significantly higher in the p-GDM group than the control group. Multivariate analysis revealed that gestational diabetes history is independently associated with CFVR. Conclusion Women with a GDM history may be at more risk regarding coronary microvascular dysfunction compared to the healthy ones.
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    Turkish Nationwide Survey of Glycemic and Other Metabolic Parameters of Patients with Diabetes Mellitus (TEMD Study)
    (2018) Bascil Tutuncu, Neslihan; Bozkirli, Emre; 0000-0002-1816-3903; 0000-0002-1644-6790; 30244051; ABG-5027-2020; E-9887-2014
    Aims: Turkey has the highest prevalence of diabetes in Europe. It is therefore essential to know the overall cardiovascular risk and reveal the predictors of metabolic control in Turkish adults with diabetes mellitus. Methods: A nationwide, multicenter survey consecutively enrolled patients who were under follow up for at least a year. Optimal control was defined as HbA1c <7%, home arterial blood pressure (ABP) <135/85 mmHg, or LDL-C <100 mg/dL. Achieving all parameters indicated triple metabolic control. Results: HbA1c levels of patients (n = 5211) were 8.6 +/- 1.9% (71 +/- 22 mmol/mol) and 7.7 +/- 1.7% (61 +/- 19 mmol/mol), in Type 1 and Type 2 diabetes, respectively. Glycemic control was achieved in 15.3% and 40.2%, and triple metabolic control was achieved in 5.5% and 10.1%, respectively. Only 1.5% of patients met all the criteria of being non-obese, nonsmoker, exercising, and under triple metabolic control. Low education level was a significant predictor of poor glycemic control in both groups. Conclusions: Few patients with Type 2, and even fewer with Type 1 diabetes have optimal metabolic control in Turkey. TEMD study will provide evidence-based information to policy makers to focus more on the quality and sustainability of diabetes care in order to reduce the national burden of the disease. (C) 2018 Elsevier B.V. All rights reserved.
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    Turkish Nationwide Survey Of Glycemic And Other Metabolic Parameters Of Patients With Diabetes Mellitus (Temd Study)
    (2018) Bascil Tutuncu, Neslihan; Bozkirli, Emre; https://orcid.org/0000-0002-1644-6790; 30244051; E-9887-2014
    Aims: Turkey has the highest prevalence of diabetes in Europe. It is therefore essential to know the overall cardiovascular risk and reveal the predictors of metabolic control in Turkish adults with diabetes mellitus. Methods: A nationwide, multicenter survey consecutively enrolled patients who were under follow up for at least a year. Optimal control was defined as HbA1c <7%, home arterial blood pressure (ABP) <135/85 mmHg, or LDL-C <100 mg/dL. Achieving all parameters indicated triple metabolic control. Results: HbA1c levels of patients (n = 5211) were 8.6 +/- 1.9% (71 +/- 22 mmol/mol) and 7.7 +/- 1.7% (61 +/- 19 mmol/mol), in Type 1 and Type 2 diabetes, respectively. Glycemic control was achieved in 15.3% and 40.2%, and triple metabolic control was achieved in 5.5% and 10.1%, respectively. Only 1.5% of patients met all the criteria of being non-obese, nonsmoker, exercising, and under triple metabolic control. Low education level was a significant predictor of poor glycemic control in both groups. Conclusions: Few patients with Type 2, and even fewer with Type 1 diabetes have optimal metabolic control in Turkey. TEMD study will provide evidence-based information to policy makers to focus more on the quality and sustainability of diabetes care in order to reduce the national burden of the disease. (C) 2018 Elsevier B.V. All rights reserved.
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    Short-Term Effect of Hypergastrinemia Following Esomeprazole Treatment On Well-Controlled Type 2 Diabetes Mellitus: A Prospective Study
    (2020) Bozkus, Yusuf; Mousa, Umut; Iyidir, Ozlem T.; Kirnap, Nazli; Demir, Canan C.; Nar, Asli; Tutuncu, Neslihan B.; 0000-0002-1816-3903; 0000-0002-6976-6659; 0000-0002-8078-9376; 0000-0001-5305-6807; 0000-0003-0998-8388; 31995024; ABG-5027-2020; AAA-5419-2021; AAK-4857-2021; I-1735-2018; K-7904-2019; AAA-2743-2021
    Objective: Proton pump inhibitor (PPI) drugs reduce gastric acid secretion and lead to an increase in serum gastrin levels. Many preclinical and some clinical researches have established some positive effects of gastrin or PPI therapy on glucose regulation. The aim of this study was to prospectively investigate the short term effects of esomeprazole on glycaemic control in patients with type 2 diabetes mellitus. In addition, the presence of an association between this effect and gastrin levels was evaluated. Methods: Thirty-two subjects with type 2 diabetes mellitus were enrolled and grouped as intervention (n=16) and control (n=16). The participants in the intervention group were prescribed 40 mg of esomeprazole treatment for three months. At the beginning of the study and at the 3rd month, HbA1c level (%) and gastrin levels (pmol/L) of participants were assessed. Then, the groups were compared in terms of their baseline and 3rd month values. Results: In the intervention group, the mean gastrin level increased significantly from 34.3 +/- 14.4 pmol/L to 87.4 +/- 43.6 pmol/L (p<0.001). The mean HbA1c level was similar to the pre-treatment level (6.3 +/- 0.7% vs. 6.4 +/- 0.9%, p=0.441). There were no statistically significant differences in all parameters of the control group. The majority of individuals were on metformin monotherapy (65.6 %). The subgroup analysis of metformin monotherapy revealed that, in intervention group, there was a significant increase in gastrin levels (39.9 +/- 12.6 vs. 95.5 +/- 52.5, p=0.026), but the HbA1c levels did not change (6.0 +/- 0.4 % vs. 5.9 +/- 0.6 %, p=0.288); and in control group, gastrin levels did not change (37.5 +/- 26.7 vs. 36.1 +/- 23.3, p=0.367), but there was an increase in HbA1c levels (6.1 +/- 0.50 vs. 6.4 +/- 0.60, p=0.01). Conclusion: Our study demonstrates that esomeprazole has no extra benefit for the controlled diabetic patient in three months. However, in only the metformin-treated subgroup, esomeprazole may prevent the rise in HbA1c level.