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Öğe Diabetes Care, Glycemic Control, Complications, and Concomitant Autoimmune Diseases in Children with Type 1 Diabetes in Turkey: A Multicenter Study(Galenos Yayincilik, 2013) Şimşek, Damla Göksen; Aycan, Zehra; Özen, Samim; Çetinkaya, Semra; Kara, Cengiz; Abalı, Saygın; Darcan, ŞükranObjective: Epidemiologic and clinical features of type 1 diabetes mellitus (T1DM) may show substantial differences among countries. The primary goal in the management of T1DM is to prevent micro- and macrovascular complications by achieving good glycemic control. The present study aimed to assess metabolic control, presence of concomitant autoimmune diseases, and of acute and long-term complications in patients diagnosed with T1DM during childhood and adolescence. The study also aimed to be a first step in the development of a national registry system for T1DM, in Turkey. Methods: Based on hospital records, this cross-sectional, multicenter study included 1 032 patients with T1DM from 12 different centers in Turkey, in whom the diagnosis was established during childhood. Epidemiological and clinical characteristics of the patients were recorded. Metabolic control, diabetes care, complications, and concomitant autoimmune diseases were evaluated. Results: Mean age, diabetes duration, and hemoglobin A1c level were 12.5 +/- 4.1 years, 4.7 +/- 3.2 years, and 8.5 +/- 1.6%, respectively. Acute complications noted in the past year included ketoacidosis in 5.2% of the patients and severe hypoglycemia in 4.9%. Chronic lymphocytic thyroiditis was noted in 12%, Graves' disease in 0.1%, and celiac disease in 4.3% of the patients. Chronic complications including neuropathy, retinopathy, and persistent microalbuminuria were present in 2.6%, 1.4%, and 5.4% of the patients, respectively. Diabetic nephropathy was not present in any of the patients. Mean diabetes duration and age of patients with neuropathy, retinopathy and microalbuminuria were significantly different from the patients without these long-term complications (p<0.01). A significant difference was found between pubertal and prepubertal children in terms of persistent microalbuminuria and neuropathy (p=0.02 and p<0.001, respectively). Of the patients, 4.4% (n:38) were obese and 5% had short stature; 17.4% of the patients had dyslipidemia, and 14% of the dyslipidemic patients were obese. Conclusions: Although the majority of the patients in the present study were using insulin analogues, poor glycemic control was common, and chronic complications were encountered.Öğe Response to growth hormone treatment in very young patients with growth hormone deficiencies and mini-puberty(Walter De Gruyter Gmbh, 2018) Çetinkaya, Semra; Poyrazoğlu, Şükran; Baş, Firdevs; Ercan, Oya; Yıldız, Metin; Adal, Erdal; Darendeliler, FeyzaBackground: The aim of the study was to assess the response to growth hormone (GH) treatment in very young patients with GH deficiency (GHD) through a national, multi-center study. Possible factors affecting growth response were assessed (especially mini-puberty). Methods: Medical reports of GHD patients in whom treatment was initiated between 0 and 3 years of age were retrospectively evaluated. Results: The cohort numbered 67. The diagnosis age was 12.4 +/- 8.6 months, peak GH stimulation test response (at diagnosis) as 1.0 +/- 1.4 ng/mL. The first and second years length gain was 15.0 +/- 4.3 and 10.4 +/- 3.4 cm. Weight gain had the largest effect on first year growth response; whereas weight gain and GH dose were both important factors affecting second year growth response. In the multiple pituitary hormone deficiency (MPHD) group (n = 50), first year GH response was significantly greater than in the isolated GH deficiency (IGHD) group (n = 17) (p = 0.030). In addition first year growth response of infants starting GH between 0 and 12 months of age (n = 24) was significantly greater than those who started treatment between 12 and 36 months of age (n = 43) (p < 0.001). These differences were not seen in the second year. Delta Length/height standard deviation score (SDS), Delta body weight SDS, length/height SDS, weight SDS in MPHD without hypogonadism for the first year of the GH treatment were found as significantly better than MPHD with hypogonadism. Conclusions: Early onsets of GH treatment, good weight gain in the first year of the treatment and good weight gain-GH dose in the second year of the treatment are the factors that have the greatest effect on length gain in early onset GHD. The presence of the sex steroid hormones during minipubertal period influence growth pattern positively under GH treatment (closer to the normal percentage according to age and gender).Öğe Survey to Investigate Adherence to Growth Hormone Treatment in Children: The Impact of COVID-19 Pandemic(Karger, 2022) Eren, Erdal; Çetinkaya, Semra; Ongen, Yasemin Denkboy; Tercan, Ummuhan; Darcan, Sukran; Turan, Hande; Aydın, Murat[Bastract Not Available]
