Abstract | Ciljevi: Glavni cilj ovog istraživanja je analizirati obilježja i terapiju bolesnika sa šećernom bolešću tipa 2 u ambulanti dijabetologa.
Ispitanici i postupci: U istraživanje je uključeno 80 ispitanika s dijagnozom šećerne bolesti tipa 2, starijih od 18 godina, koji se liječe u Centru za dijabetes, endokrinologiju i bolesti metabolizma KBC Split. Podaci o bolesnicima su prikupljeni iz BIS-a. Prikupljeni podaci uključuju informacije o spolu, dobi, ITM-e, HbA1c, komplikacijama šećerne bolesti i terapiji.
Rezultati: Udio bolesnika sa prekomjernom tjelesnom težinom je bio 74%. Prosječna vrijednost HbA1c bila je 7,2%, a udio bolesnika s lošom regulacijom glikemije bio je 90%. Najzastupljenije komplikacije šećerne bolesti bile su kardiovaskularne (62,5%), potom bubrežne (27,5%), retinopatija (21,25%) i polineuropatija (2,5%). Nije bilo značajne razlika među skupinama s dobrom i loše reguliranom glikemijom u prevalenciji kardiovaskularnih komplikacija (P=0,612), dijabetičke bolesti bubrega (P=0,436), retinopatiji (P=0,622) i polineuropatiji (P=0,659). Najveći udio ispitanika bio je liječen metforminom (78,8%), potom DPP4 inhibitorima (38,75%), SGLT2 inhibitorima (37,25%), sulfonilureom (22,5%), GLP1 RA (18,75%), pioglitazonom (15%). Udio bolesnika koji su liječeni inzulinom bio je 26,25%. Bolesnici sa šećernom bolesti tip 2 koji su imali lošiju regulaciju glikemije u usporedbi sa skupinom koji su imali dobru regulaciju glikemije imali su značajno veći udio u terapiji DPP4- inhibitora (P=0,026) i SGLT2 inhibitora (P=0,021). Utvrđena je statistički pozitivna povezanost između broja peroralnih hipoglikemika i vrijednosti HbA1c (p=0,286, P=0,010).
Zaključci: U bolesnika sa šećernom bolesti tip 2 pronađena je visoka prevalencija pretilosti, a prema vrijednostima HbA1c regulacija glikemije nije bila zadovoljavajuća. Najčešće kronične komplikacije šećerne bolesti su bile kardiovaskularne bolesti, a prevalencija komplikacija šećerne bolesti tipa 2 nije se razlikovala među skupinama ispitanika s lošom i urednom regulacijom glikemije. Najveći udio bolesnika sa šećernom bolesti tip 2 liječi se metforminom. Bolesnici sa šećernom bolesti tip 2 koji su imali lošiju regulaciju glikemije u usporedbi sa skupinom koji su imali dobru regulaciju glikemije imali su veći udio u terapiji DPP4- inhibitora i SGLT2 inhibitora. Regulacija glikemije je bolja kod bolesnika sa šećernom bolesti tip 2 koji se liječe s više peroralnih hipoglikemika. |
Abstract (english) | Objectives: The main goal of this research is to analyse the characteristics and therapy of patients with type 2 diabetes in a diabetologist's clinic.
Subjects and methods: Eighty participants diagnosed with type 2 diabetes, aged over 18, who are treated at the Diabetes, Endocrinology and Metabolic Diseases Centre of University Hospital of Split were included in the study. Data on the patients were collected from the BIS. The collected data include information on gender, age, ITM, HbA1c, diabetes complications, and therapy.
Results: The proportion of overweight patients was 74%. The average HbA1c value was 7.2%, and the proportion of patients with poor glycaemic control was 90%. The most common diabetes complications were cardiovascular (62.5%), followed by renal (27.5%), retinopathy (21.25%), and polyneuropathy (2.5%). There were no significant differences between the groups with good and poor glycaemic control in the prevalence of cardiovascular complications (P=0.612), diabetic kidney disease (P=0.436), retinopathy (P=0.622), and polyneuropathy (P=0.659). The majority of participants were treated with metformin (78.8%), followed by DPP4 inhibitors (38.75%), SGLT2 inhibitors (37.25%), sulfonylureas (22.5%), GLP1 RAs (18.75%), and pioglitazone (15%). The proportion of patients treated with insulin was 26.25%. Patients with type 2 diabetes who had poorer glycaemic control, compared to the group with good glycaemic control, had a significantly higher proportion of DPP4 inhibitor (P=0.026) and SGLT2 inhibitor (P=0.021) therapy. A statistically positive correlation was found between the number of oral hypoglycaemics and HbA1c levels (p=0.286, P=0.010).
Conclusions: In patients with type 2 diabetes, a high prevalence of obesity was found, and glycaemic control was not satisfactory based on HbA1c values. The most common chronic complications of diabetes were cardiovascular diseases, and the prevalence of type 2 diabetes complications did not differ between groups of patients with poor and good glycaemic control. The majority of patients with type 2 diabetes are treated with metformin. Patients with type 2 diabetes who had poorer glycaemic control, compared to the group with good glycaemic control, had a higher proportion of DPP4 inhibitor and SGLT2 inhibitor therapy. Glycaemic control is better in patients with type 2 diabetes who are treated with more oral hypoglycaemics. |