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Öğe A Cross-Sectional Study of the Prevalence of Cardiovascular Disease in Adults with Type 2 Diabetes in Turkiye: The CAPTURE Study(Aves, 2022) Bayram, Fahri; Bayraktaroglu, Taner; Sargin, Mehmet; Sahin, Ibrahim; Guldiken, Sibel; Dalbeler, Aysegul; Sonmez, AlperObjective: The primary objective of the CAPTURE study was to estimate the prevalence of cardiovascular disease (CVD) in adults with Type 2 diabetes mellitus (T2DM) across 13 countries from 5 continents. Here, we present the findings from Turkiye. Material and Methods: The non-interventional, cross-sectional CAPTURE study (NCT03811288; NCT03786406) was conducted across 15 centers in Turkiye. Standardized demographic and clinical data were collected from adults with T2DM who were treated by primary or specialist care physicians. The prevalences of CVD and its 7 subtypes were estimated. Descriptive statistics were used for data analysis. Results: Amongst the 801 participants (n=200 from primary care, n=601 from specialist care) with T2DM enrolled, 250 had established CVD, an estimated weighted prevalence of 31.2% (28.0-34.4) 95% confidence interval. Atherosclerotic CVD contributed to the majority (85.6%) of the CVD cases. An estimated 24.0% of the Turkiye sample had coronary heart disease (CHD). Heart failure was the second most predominant CVD subtype in Turkiye is correct sample (5.4%), followed by cardiac arrhythmia and conduction abnormalities (4.7%). Sodium-glucose co-transporter 2 inhibitors and glucagon-like peptide-1 receptor agonists with cardiovascular (CV) benefits were prescribed to 17.5% and 0.1% of the patients, respectively. Conclusion: Approximately 30% of participants with T2DM had established CVD in the CAPTURE Turkiye population, comparable to the global pooled prevalence. CHD was the major contributor and encompassed approximately 75% of the CVD cases. The use of glucose-lowering medication with CV benefits was low compared to the global pooled population, which may be due to the lack of reimbursement of these medications in Turkiye.Öğe Impact of Obesity on the Metabolic Control of Type 2 Diabetes: Results of the Turkish Nationwide Survey of Glycemic and Other Metabolic Parameters of Patients with Diabetes Mellitus (TEMD Obesity Study)(Karger, 2019) Sonmez, Alper; Yumuk, Volkan; Haymana, Cem; Demirci, Ibrahim; Barcin, Cem; Kiyici, Sinem; Guldiken, SibelBackground: Obesity is the main obstacle for metabolic control in patients with type 2 diabetes. Turkey has the highest prevalence of obesity and type 2 diabetes in Europe. The effect of obesity on the metabolic control, and the macro-and microvascular complications of patients are not apparent. Objectives: This nationwide survey aimed to investigate the prevalence of overweight and obesity among patients with type 2 diabetes and to search for the impact of obesity on the metabolic control of these patients. We also investigated the independent associates of obesity in patients with type 2 diabetes. Methods: We consecutively enrolled patients who were under follow-up for at least 1 year in 69 tertiary healthcare units in 37 cities. The demographic, anthropometric, and clinical data including medications were recorded. Patients were excluded if they were pregnant, younger than 18 years, had decompensated liver disease, psychiatric disorders interfering with cognition or compliance, had bariatric surgery, or were undergoing renal replacement therapy. Results: Only 10% of patients with type 2 diabetes (n = 4,648) had normal body mass indexes (BMI), while the others were affected by overweight (31%) or obesity (59%). Women had a significantly higher prevalence of obesity (53.4 vs. 40%) and severe obesity (16.6 vs. 3.3%). Significant associations were present between high BMI levels and lower education levels, intake of insulin, antihypertensives and statins, poor metabolic control, or the presence of microvascular complications. Age, gender, level of education, smoking, and physical inactivity were the independent associates of obesity in patients with type 2 diabetes. Conclusion: The TEMD Obesity Study shows that obesity is a major determinant of the poor metabolic control in patients with type 2 diabetes. These results underline the importance of prevention and management of obesity to improve health care in patients with type 2 diabetes. Also, the results point out the independent sociodemographic and clinical associates of obesity, which should be the prior targets to overcome, in the national fight with obesity. (c) 2019 The Author(s) Published by S. Karger AG, BaselÖğe The Level of Serum High Sensitive C-Reactive Protein in Women with Hyperthyroidism(Galenos Yayincilik, 2005) Guldiken, Sibel; Demir, Muzaffer; Arikan, Ender; Tugrul, ArmaganHigh-sensitive C-reactive protein (hs-CRP) levels, a marker of subclinical inflammation, have been identified as an independent predictor of atherosclerosis. Although it is well known that thyroid hormones play an important role in cardiovascular hemodynamics, the association between elevated thyroid hormones and low grade inflammation is still unclear. We aimed to investigate the serum hs-CRP in women patients with hyperthyroidism. Twenty-five women with hyperthyroidism and 25 healthy-control subjects who were age (31.3 +/- 12.3 years, 29.6 +/- 7.7 years respectively, p> 0.05) and body mass index-matched (24.0 +/- 3.6 kg/m(2), 24.3 +/- 4.5 kg/m2, p> 0.05) were included into this study. Patients were evaluated at the time of diagnosis. Serum concentrations of free T4 (fT4), fT3, TSH, and lipid parameters (total cholesterol, triglyceride, high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C) were measured in all subjects. Serum hs-CRP levels were assessed by ELISA method. Mean total cholesterol and LDL-C levels of hyperthyroid group were lower than control group (p= 0.001, p< 0.01). There were no statistically significant differences in hs-CRP levels between hyperthyroid and control groups (0.05 +/- 0.032 mg/l, 0.04 +/- 0.038 mg/l, p> 0.05; 2.3 +/- 1.5, 1.4 +/- 0.5, p> 0.05, respectively) and also had not been found any correlation between levels of hs-CRP and thyroid hormones. In this study, these results shown that the elevated thyroid hormones have no effect on the serum hs-CRP level. We conclude that hyperthyroidism do not induce low grade inflammation of atherosclerosis in women.Öğe Management of endocrine surgical disorders during COVID-19 pandemic: expert opinion for non-surgical options(Springer-Verlag Italia Srl, 2022) Agcaoglu, Orhan; Sezer, Atakan; Makay, Ozer; Erdogan, Murat Faik; Bayram, Fahri; Guldiken, Sibel; Raffaelli, MarcoPurpose The COVID-19 pandemic brought unprecedented conditions for overall health care systems by restricting resources for non-COVID-19 patients. As the burden of the disease escalates, routine elective surgeries are being cancelled. The aim of this paper was to provide a guideline for management of endocrine surgical disorders during a pandemic. Methods We used Delphi method with a nine-scale Likert scale on two rounds of voting involving 64 experienced eminent surgeons and endocrinologists who had the necessary experience to provide insight on endocrine disorder management. All voting was done by email using a standard questionnaire. Results Overall, 37 recommendations were voted on. In two rounds, all recommendations reached an agreement and were either endorsed or rejected. Endorsed statements include dietary change in primary hyperparathyroidism, Cinacalcet treatment in secondary hyperparathyroidism, alpha-blocker administration for pheochromocytoma, methimazole +/- beta-blocker combination for Graves' disease, and follow-up for fine-needle aspiration results of thyroid nodules indicated as Bethesda 3-4 cytological results and papillary microcarcinoma. Conclusion This survey summarizes expert opinion for the management of endocrine surgical conditions during unprecedented times when access to surgical treatment is severely disrupted. The statements are not applicable in circumstances in which surgical treatment is possible.Öğe Summary of Bariatric Surgery Guideline of the Society of Endocrinology and Metabolism of Turkey(Aves, 2017) Sabuncu, Tevfik; Kiyici, Sinem; Eren, Mehmet Ali; Sancak, Seda; Sonmez, Alper; Guldiken, Sibel; Kutluturk, FarukObesity is a common condition affecting approximately one-third of the adult population worldwide. Obesity results in a number of medical, psychosocial and economical problems, in many patients, it is usually difficult to achieve the desired weight loss with medical therapies, several surgical approaches for weight loss have been developed in the recent years and are described as bariatric or metabolic surgery. Though bariatric surgery promotes dramatic and reliable improvement in obesity and related complications, yet proper patient selection and careful selection of the bariatric method along with good pre- and post-operative management is very important for a successful therapy. Therefore, the authors aim to present a short review on the Bariatric Surgery Guideline of the Society of Endocrinology and Metabolism of Turkey. The indications and contraindications for bariatric surgery, description of commonly used bariatric surgical methods, preoperative preparation of obese patients prior to the surgery, early and late postoperative management and follow-up of the patients have been summarized in this review. This review has been written in accordance with the opinions and recommendations of the Hypertension, Lipid Metabolism and Obesity Study Group of the Society of Endocrinology and Metabolism of Turkey.
