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    Clinical Characteristics and Outcomes of COVID-19 Patients with Overweight and Obesity: Turkish Nationwide Cohort Study (TurCObesity)
    (Georg Thieme Verlag Kg, 2022) Sahin, Ibrahim; Haymana, Cem; Demir, Tevfik; Demirci, Ibrahim; Tasci, Ilker; Atmaca, Aysegul; Cakal, Erman
    Purpose While obesity is related to more severe outcomes of coronavirus disease 2019 (COVID-19), factors leading to poor prognosis still remain unclear. The present study evaluated the outcomes of COVID-19 patients who were overweight or obese and variables associated with severe disease in a large group of consecutive cases. Methods A nationwide retrospective cohort study was performed using the Turkish National Healthcare Database. Demographic characteristics, laboratory tests, comorbidities, and medications of patients registered between March 11 and May 30, 2020, were recorded. Results A total of 14,625 patients (median age:42, IQR:26 years; female 57.4%) with normal weight (34.7%), overweight (35.6%), and obesity (29.7%) were included. Hospitalization, ICU admission, intubation/mechanical ventilation, pulmonary involvement, and mortality were significantly higher in patients who were overweight or obese. In adjusted analyses, both overweight (OR, 95% CI: 1.82, 1.04-3.21; p=0.037) and obesity (OR, 95% CI: 2.69, 1.02-1.05; p<0.001) were associated with a higher intubation/mechanical ventilation rate but only obesity was associated with increased mortality (OR, 95% CI: 2.56, 1.40-4.67; p=0.002). Old age, male gender, chronic kidney disease, and high C reactive protein levels were independently associated with COVID-19 mortality in overweight or obese patients. Conclusions COVID-19 patients who were overweight or obese were more likely to have adverse outcomes but only obesity was a predictor of mortality. Such patients should receive urgent medical attention and active management, especially the elderly, men, and people with chronic kidney disease.
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    Current Position of Gliclazide and Sulfonylureas in the Contemporary Treatment Paradigm for Type 2 Diabetes: A Scoping Review
    (Springer Heidelberg, 2024) Sahin, Ibrahim; Bakiner, Okan; Demir, Tevfik; Sari, Ramazan; Atmaca, Aysegul
    The increasing burden of type 2 diabetes (T2D), in relation to alarming rise in the prevalence; challenges in the diagnosis, prevention, and treatment; as well as the substantial impact of disease on longevity and quality of life, is a major concern in healthcare worldwide. Sulfonylureas (SUs) have been a cornerstone of T2D pharmacotherapy for over 60 years as oral antidiabetic drugs (OADs), while the newer generation SUs, such as gliclazide modified release (MR), are known to be associated with low risk of hypoglycemia in addition to the cardiovascular neutrality. This scoping review aimed to specifically address the current position of gliclazide MR among other SUs in the contemporary treatment paradigm for T2D and to provide a practical guidance document to assist clinicians in using gliclazide MR in real-life clinical practice. The main topics addressed in this paper include the role of early and sustained glycemic control and use of SUs in T2D management, the properties of gliclazide MR in relation to its effectiveness and safety, the use of gliclazide therapy in special populations, and the place of SUs as a class and gliclazide MR specifically in the current T2D treatment algorithm.
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    Evaluation of Coronavirus Disease 2019-Related Morbidity and Mortality in Lipodystrophy Patients During the Pandemic Period
    (Aves, 2024) Semiz, Gokcen Gungor; Demir, Tevfik; Simsir, Ilgin Yildirim; Selimoglu, Ismail; Yilmaz, Muege; Ellidokuz, Huelya; Onay, Hueseyin
    Objective: Coronavirus Disease 2019's (COVID-19) impact on rare disease populations such as lipodystrophy syndromes is unknown. We assessed COVID-19 infection outcomes in lipodystrophy syndromes and aimed to investigate the effect of restricted access to the hospital during the pandemic on metabolic parameters. Methods: A survey form consisting of descriptive questions about the situation of the patients during the COVID-19 pandemic was created. The survey was performed by phone in February and March 2021; all patients gave verbal consent. Patients diagnosed with lipodystrophy syndromes participated in our study. Demographic parameters were recorded. They were asked if they were diagnosed with COVID-19; if so, the hospitalization, intensive care unit need, oxygen requirement, and COVID-19 treatment were questioned. Laboratory data were recorded from the hospital records. Results: Seventy-one patients were investigated. Lipodystrophy patients in our study had at least 1 comorbid disease. Diabetes mellitus was the most common (87.1%). Six patients stated they had a COVID-19 infection (6/71, 8.5%). Three cases (50.0%) were hospitalized, and 1 (16.6%) patient was followed up in the intensive care unit. There were no deaths in our cohort. When the laboratory parameters of the entire group were evaluated, spot urine microalbumin increased significantly compared to the prepandemic period (P P = .013). Conclusion: Lipodystrophy patients may experience COVID-19 more severely due to their numerous comorbidities. Further research should be conducted with larger patient cohorts to investigate this relationship.
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    No association of Gaucher disease with COVID-19-related outcomes: a nationwide cohort study
    (Wiley, 2022) Demirci, Ibrahim; Demir, Tevfik; Dagdelen, Selcuk; Haymana, Cem; Tasci, Ilker; Atmaca, Aysegul; Ertugrul, Derun
    Background It is well documented that patients with chronic metabolic diseases, such as diabetes and obesity, are adversely affected by the COVID-19 pandemic. However, when the subject is rare metabolic diseases, there are not enough data in the literature. Aim To investigate the course of COVID-19 among patients with Gaucher disease (GD), the most common lysosomal storage disease. Methods Based on the National Health System data, a retrospective cohort of patients with confirmed (polymerase chain reactionpositive) COVID-19 infection (n = 149 618) was investigated. The adverse outcomes between patients with GD (n = 39) and those without GD (n = 149 579) were compared with crude and propensity score-matched (PSM) groups. The outcomes were hospitalisation, the composite of intensive care unit (ICU) admission and/or mechanical ventilation and mortality. Results The patients with GD were significantly older and had a higher frequency of hypertension (HT), Type 2 diabetes mellitus (T2DM), dyslipidaemia, asthma or chronic obstructive pulmonary disease, chronic kidney disease, coronary artery disease, heart failure and cancer. Although hospitalisation rates in Gaucher patients were found to be higher in crude analyses, the PSM models (model 1, age and gender matched; model 2, matched for age, gender, HT, T2DM and cancer) revealed no difference for the outcomes between patients with GD and the general population. According to multivariate regression analyses, having a diagnosis of GD was not a significant predictor for hospitalisation (P = 0.241), ICU admission/mechanical ventilation (P = 0.403) or mortality (P = 0.231). Conclusion According to our national data, SARS-CoV-2 infection in patients with GD does not have a more severe course than the normal population.