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    Comparison of group-based and individually training in patients with diabetes mellitus: 2-year follow-up study
    (2019) Ozkan Sevencan, Nurhayat; Tunc, Ulku Aybuke; Ertinmaz Ozkan, Aysegul; Sahin, Fatime; Yalim, Gulay
    Keywords: key, between March/2016 and March/2018. The HbA1c levels of 96 patients who were trained in a diabetes school and 99 patients who were individually trained in the outpatient clinic were measured. The treatments of the patients trained in the outpatient clinic had also recently been changed, either by the addition of a new medication (oral anti-diabetic drugs or insulin) and/or by increasing the dosages of their current medications.br /Results: The mean HbA1c level was 9.29±1.90 for the diabetes school patients and 9.73±1.22 for the individually trained group patients (p0.05). It was found that HbA1c regressed to 8.25±1.84 three months after the training in a school, while the regression was 8.34±1.66 in the outpatient trained group (p0.05). No difference was detected between groups in terms of lowering HbA1C. Group-based training provided a more efficient HbA1c decrease in male patients, who had a body mass index (BMI) of ≥30, and in those who received intensive insulin therapy. However, at the first year follow up, HbA1c showed a tendency to increase again in the diabetes school group.br /Conclusion: Group-based training is a cost-effective method that may also decrease anti-diabetic requirement and provides more patient satisfaction, along with higher patient compliance. However, for long-term success, the training should be continuous and should be held at least once a year to provide up-to-date information.br / Diabetes mellitus, group-based training, individual training, Hemoglobin A1c.
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    Gender-dependent relationship between metabolic syndrome and HOMA-IR index in patients with impaired fasting glucose
    (2021) Ozkan Sevencan, Nurhayat; Ertinmaz Ozkan, Aysegul
    Aim: This study aimed to assess whether metabolic syndrome (MetS) criteria varied by gender and whether the homeostatic model assessment of insulin resistance (HOMA-IR) index could be used as a new MetS predictor. Materials and Methods: We performed a standard oral glucose tolerance test (OGTT) in 316 patients with impaired fasting glucose (IFG) and investigated the presence of impaired glucose tolerance (IGT), type 2 diabetes mellitus (T2DM), and MetS. Results: We found that MetS was higher in females than males. The obesity rate was 57.0% and 36.8% for females and males, respectively. Of the patients who reached stage 3 obesity,13.4% were females and 0.9% were males. The HOMA-IR score was not an independent predictor for MetS. However, sensitivity was 91% and specificity was 100% for the cut-off value of HOMA-IR ≥ 2.38 in diabetic females with MetS. Abdominal obesity (91.2%), hyperglycemia (81.5%), hypertension (71.8%), hypertriglyceridemia (62.0%), and low high-density lipoprotein (HDL) (57.8%) were found in MetS patients. Conclusion: Abdominal obesity and impaired glucose metabolism are powerful predictors demonstrating the presence of MetS. Females are at greater risk than males for obesity, T2DM, and MetS. Although the HOMA-IR score is not a new MetS predictor, it may be an effective indicator of the combination of MetS and diabetes in females.
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    A severe adrenal crisis occurred in late diagnosed Sheehan’s syndrome developed in a 17-year-old woman
    (2020) Ozkan Sevencan, Nurhayat; Erem Basmaz, Seda; Ertinmaz Ozkan, Aysegul; Kayhan, Burcak
    Sheehan’s syndrome occurs as a result of severe postpartum hemorrhage and is characterized by varying degrees of anterior pituitary dysfunction. It is an important health problem especially for women who deliver at home in developing countries. In this report, we presented a 17-year-old female patient who gave her second birth at home. During her delivery severe vaginal hemorrhage occurred and she applied to a healthcare facility too late. Since then, she hasn’t had menstruation and hasn’t been able to get pregnant. She was diagnosed with Sheehan’s syndrome 16 years after giving birth. The patient didn’t use her medicine regularly after the diagnosis because she wasn’t properly informed about the disease, and she has stopped taking it for the last six months. In the current conditions; the 69-year-old patient is presented with hypocortisolemia, hypoglycemia, hyponatremia, and advanced osteoporosis. The patient with severe adrenal crisis was taken in treatment by us.