Prediyabeti olan ve olmayan bireylerde retinopati değerlendirilmesi
Yükleniyor...
Dosyalar
Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: Prediyabet, diyabetes mellitus (DM) tanı sınırlarına ulaşmayan ara bir hiperglisemi durumudur. Prediyabet, yapılan çalışmalarla da kanıtlandığı gibi DM'ye ilerlemesi açısından önem taşımaktadır. Yapılan çalışmalarda prediyabet olan bir kişide DM'ye ilerleme oranının %70 kadar olduğu belirtilmektedir. DM'ye ilerlemesi ve sonucunda da komplikasyonların gelişmesi yönünden prediyabetin DM'ye ilerlemesini önlemek erken dönemde gelişebilecek komplikasyonların önüne geçilmesi açısından önemlidir. Retinopati, DM'nin kronik mikrovasküler komplikasyonlardan birisidir ve 20-65 yaş arasında görülen önlenebilir körlüğün en sık nedenidir. Retinopatinin erken tanı koyulması hem tedavi açısıdan hem de ilerlemesinin önlenmesi açısından önem taşımaktadır. Bu nedenle çalışmamızda prediyabet tanısı olan ve prediyabet tanısı olmayan bireylere retinopati değerlendirmesi yapılarak retinopati varlığının araştırılması amaçlanmıştır. Gereç-Yöntem: Çalışmaya Nisan 2022– Eylül 2022 tarihleri arasında Düzce Üniversitesi Tıp Fakültesi Hastahanesi'nde Aile Hekimliği Poliklinikleri'ne ayaktan başvuran, açlık plazma glukozu 100-125 mg/dl arasında olan ve HbA1c'si %5-7-6,4 arasında saptanan 56 hasta ve herhangi bir prediyabet ya da diyabet tanısı almamış olan, ek kronik hastalığının ne olduğu gözetilmeksizin 47 kişi dahil edilmiştir. Hastaların laboratuvar ölçümleri ile beraber kilo, VKİ, bel çevresi, kalça çevresi ve sistolik-diyastolik kan basınçları ölçülerek not edilmiştir. Her hasta için retinopati değerlendirmesinde görme keskinliği, göz içi basıncı ölçümü, ön segment ve fundus muayeneleri, santral fovea kalınlığı (CFT), ortalama fovea kalınlığı (MFT) ölçümleri içeren tam bir oftalmolojik muayene yapıldı. CFT ve MFT ölçümleri Spektral alan optik koherens tomografi (SD-OCT) ile yapıldı. Bulgular: Çalışmaya dahil edilen 47 prediyabet tanısı olmayan ve 56 prediyabet tanısı olan bireyler retinopati açısından değerlendirildi. Prediyabet olan 56 hastadan 1'inde diyabetik retinopati saptanırken 2'sinde hipertansif retinopati saptandı. Prediyabet olmayan grupta ise diyabetik retinopati hiç saptanmazken 2'sinde hipertansif retinopati saptandı. Prediyabet olan ve olmayan grupta retinopati açısından anlamlı bir fark bulunmadı (p=0,796). Sonuç: Çalışmamızda diyabetin kronik mikrovasküler komplikasyonu olan diyabetik retinopati prediyabet aşamasında henüz görülmediği bulunmuştur. Normal popülasyonla karşılaştırıldığında retinopati açısından anlamlı bir fark bulunmamıştır. Buna rağmen prediyabet tanısı olan hastaların tansiyon regülasyonun sağlanması, lipid panelinin takip edilmesi, kilo kontrolünün sağlanması DM'ye ilerlemeyi önleme açısından önemlidir. Hastalara retinopati tanısı koyamasak bile prediyabet tanısı alan bireylerin taranması gelişebilecek komplikasyonları geciktirme açısından önem taşımaktadır. Anahtar Kelimeler: Prediyabet, Tip 2 Diyabetes Mellitus, Retinopati
Purpose: Prediabetes is an intermediate state of hyperglycemia that does not reach the diagnostic limits of diabetes mellitus (DM). Prediabetes is important in terms of progression to DM, as evidenced by studies. Studies have shown that the rate of progression to DM in a person with prediabetes is up to 70%. It is important to prevent the progression of prediabetes to DM in terms of progression to DM and the development of complications as a result, in terms of preventing complications that may develop in the early period. Retinopathy is one of the chronic microvascular complications of DM and is the most common cause of preventable blindness between the ages of 20-65 years. Early diagnosis of retinopathy is important in terms of both treatment and prevention of progression. Therefore, in our study, it was aimed to investigate the presence of retinopathy by evaluating retinopathy in individuals with and without a diagnosis of prediabetes. Materials and Methods: 56 patients with fasting plasma glucose between 100-125 mg/dl and HbA1c between 5-7-6.4%, who applied to the Family Medicine Polyclinics of Düzce University Medical Faculty Hospital between April 2022 and September 2022, were included in the study. and 47 people who were not diagnosed with any prediabetes or diabetes, regardless of their additional chronic disease, were included. Along with the laboratory measurements of the patients, weight, BMI, waist circumference, hip circumference and systolic-diastolic blood pressure were measured and noted. A complete ophthalmologic examination including visual acuity, intraocular pressure measurement, anterior segment and fundus examinations, central foveal thickness (CFT), and mean foveal thickness (MFT) measurements was performed for each patient in the evaluation of retinopathy. CFT and MFT measurements were made with Spectral field optical coherence tomography (SD-OCT). Conclusion: Included in the study, 47 individuals without prediabetes diagnosis and 56 individuals with prediabetes diagnosis were evaluated in terms of retinopathy. Diabetic retinopathy was found in 1 of 56 patients with prediabetes, and hypertensive retinopathy was found in 2 patients. In the non-prediabetes group, diabetic retinopathy was not detected at all, while hypertensive retinopathy was found in 2 of them. There was no significant difference in terms of retinopathy in the group with and without prediabetes (p=0.796). Results: In our study, it was found that diabetic retinopathy, which is a chronic microvascular complication of diabetes, has not yet been seen in the prediabetes stage. There was no significant difference in terms of retinopathy compared to the normal population. Despite this, providing blood pressure regulation, monitoring the lipid panel, and maintaining weight control in patients with prediabetes are important in terms of preventing progression to DM. Even if we cannot diagnose patients with retinopathy, screening individuals diagnosed with prediabetes is important in terms of delaying possible complications. Keywords: Prediabetes, Type 2 Diabetes Mellitus, Retinopathy
Purpose: Prediabetes is an intermediate state of hyperglycemia that does not reach the diagnostic limits of diabetes mellitus (DM). Prediabetes is important in terms of progression to DM, as evidenced by studies. Studies have shown that the rate of progression to DM in a person with prediabetes is up to 70%. It is important to prevent the progression of prediabetes to DM in terms of progression to DM and the development of complications as a result, in terms of preventing complications that may develop in the early period. Retinopathy is one of the chronic microvascular complications of DM and is the most common cause of preventable blindness between the ages of 20-65 years. Early diagnosis of retinopathy is important in terms of both treatment and prevention of progression. Therefore, in our study, it was aimed to investigate the presence of retinopathy by evaluating retinopathy in individuals with and without a diagnosis of prediabetes. Materials and Methods: 56 patients with fasting plasma glucose between 100-125 mg/dl and HbA1c between 5-7-6.4%, who applied to the Family Medicine Polyclinics of Düzce University Medical Faculty Hospital between April 2022 and September 2022, were included in the study. and 47 people who were not diagnosed with any prediabetes or diabetes, regardless of their additional chronic disease, were included. Along with the laboratory measurements of the patients, weight, BMI, waist circumference, hip circumference and systolic-diastolic blood pressure were measured and noted. A complete ophthalmologic examination including visual acuity, intraocular pressure measurement, anterior segment and fundus examinations, central foveal thickness (CFT), and mean foveal thickness (MFT) measurements was performed for each patient in the evaluation of retinopathy. CFT and MFT measurements were made with Spectral field optical coherence tomography (SD-OCT). Conclusion: Included in the study, 47 individuals without prediabetes diagnosis and 56 individuals with prediabetes diagnosis were evaluated in terms of retinopathy. Diabetic retinopathy was found in 1 of 56 patients with prediabetes, and hypertensive retinopathy was found in 2 patients. In the non-prediabetes group, diabetic retinopathy was not detected at all, while hypertensive retinopathy was found in 2 of them. There was no significant difference in terms of retinopathy in the group with and without prediabetes (p=0.796). Results: In our study, it was found that diabetic retinopathy, which is a chronic microvascular complication of diabetes, has not yet been seen in the prediabetes stage. There was no significant difference in terms of retinopathy compared to the normal population. Despite this, providing blood pressure regulation, monitoring the lipid panel, and maintaining weight control in patients with prediabetes are important in terms of preventing progression to DM. Even if we cannot diagnose patients with retinopathy, screening individuals diagnosed with prediabetes is important in terms of delaying possible complications. Keywords: Prediabetes, Type 2 Diabetes Mellitus, Retinopathy
Açıklama
Anahtar Kelimeler
Prediyabet, Tip 2 Diyabetes Mellitus, Retinopati, Prediabetes, Type 2 Diabetes Mellitus, Retinopathy, Aile Hekimliği, Family Medicine
