ECE2023 Poster Presentations Diabetes, Obesity, Metabolism and Nutrition (159 abstracts)
Five-year trends of Turkish nationwide survEy of glycemic and other Metabolic parameters of patients with type 2 Diabetes (TEMD-2 study), 2017-2022
Alper Sonmez 1 , Cem Haymana 2 , İbrahim Demirci 3 , Berrin Cetinarslan 4 , Sait Gönen 5 , Emin Murat Akbas 6 , Gulsah Yenidunya Yalin 7 , Ugur Avci 8 , Ilker Tasci 9 , Serpil Salman 10 , Fahri Bayram 11 , Ilhan Satman 7 & TEMD-2 Study Group 12
1Ankara Guven Hospital, Endocrinology and Metabolism, Ankara, Turkey; 2University of Health Sciences, Gulhane Faculty of Medicine, Endocrinology and Metabolism, Ankara, Turkey; 3Gulhane Training and Research Hospital, Endocrinology and Metabolism, Ankara, Turkey; 4University of Kocaeli, Faculty of Medicine, Endocrinology and Metabolism, Kocaeli, Turkey; 5University of Istanbul, Cerrahpasa Faculty of Medicine, Endocrinology and Metabolism, Istanbul, Turkey; 6Erzincan Binali Yildirim University, Faculty of Medicine, Endocrinology and Metabolism, Erzincan, Turkey; 7Istanbul University, Istanbul Faculty of Medicine, Endocrinology and Metabolism, Istanbul, Turkey; 8Recep Tayyip Erdogan University, Faculty of Medicine, Endocrinology and Metabolism, Rize, Turkey; 9University of Health Sciences, Gulhane Faculty of Medicine, Internal Medicine, Ankara, Turkey; 10Medica Medical Center, Endocrinology and Metabolism, Istanbul, Turkey; 11Erciyes University, Faculty of Medicine, Endocrinology and Metabolism, Kayseri, Turkey; 12Turkey
Objective: Establishing good metabolic control is essential to prevent morbidity and mortality in patients with type 2 diabetes (T2DM). This nationwide survey is performed five years after the first national TEMD study, to search for any improvement in attaining glycemic and metabolic targets in Turkish patients with T2DM.
Methods: The nationwide, multicenter survey consecutively enrolled patients who were under follow up for at least a year in tertiary centers specialized for diabetes care. Optimal control was defined as HbA1c <7%, home arterial blood pressure (ABP) <135/85 mmHg, or LDL-C <100 mg/dl or <70 mg/dl or <55 mg/dl according to the risk factors of patients.
| Variable | TEMD-1 (n=4756) | TEMD-2 (n=4956) | p |
| Age, years, mean±SD | 58.5±10.5 | 58.9±10.0 | 0.030 |
| Gender (female), n (%) | 2799 (58.9) | 2965 (59.8) | 0.332 |
| Diabetes duration, years, mean±SD | 10.9±7.5 | 13.1±8.1 | <0.001 |
| BMI, kg/m2, mean±SD | 32.1±6.5 | 31.7±6.6 | 0.002 |
| SBP (home), mmHg, mean±SD | 125.8±13.7 | 124.8±13.6 | 0.004 |
| DBP (home), mmHg, mean±SD | 77.6±8.8 | 76.9±9.0 | 0.002 |
| HbA1c, %, mean±SD | 7.7±1.7 | 7.9±1.9 | <0.001 |
| LDL-C, mg/dL, mean±SD | 113.9±36.2 | 109.5±41.0 | <0.001 |
| HDL-C, mg/dL, mean±SD | 46.5±12.9 | 47.9±13.6 | <0.001 |
| Triglyceride, mg/dL, mean±SD | 182.1±128.7 | 178.2±130.6 | 0.141 |
| eGFR (ml/min/1.73m2), mean±SD | 87.4±29.9 | 85.7±27.6 | 0.006 |
| Macrovascular complications, n (%) | 1152 (24.2) | 1266 (25.5) | 0.133 |
| Microvascular complications, n (%) | 2258 (47.5) | 2541 (51.3) | <0.001 |
| Obesity (BMI ≥30 kg/m2), n (%) | 2749 (58.6) | 2717 (54.8) | <0.001 |
| Achieving Targets | |||
| BMI < 30 kg/m2, n (%) | 1945 (41.4) | 2238 (45.2) | <0.001 |
| LDL < 100 mg/dL, n (%) | 1679 (37.3) | 2184 (44.1) | <0.001 |
| HbA1c < 7%, n (%) | 1857 (40.0) | 1819 (36.7) | 0.001 |
| Regular exercise, n (%) | 1513 (31.8) | 2077 (41.9) | <0.001 |
Results: A total of 4956 patients (female 2965 (59.8%); median age (IQR) 59(13) years) were enrolled. The clinical and sociodemographic characteristics of patients in previous and current surveys are given in table. The recent survey showed that HbA1c levels are significantly higher, and the HbA1c target attainment rates are poorer (P<0.001 for both). Also, mean BMI, systolic and diastolic ABP, and LDL-C levels were significantly lower (P<0.05 for all). Macrovascular complication rates were similar while nephropathy rates increased and retinopathy and neuropathy rates decreased in the recent survey (P<0.001 for all).
Conclusion: The results of the TEMD-2 Survey show that the glycemic control rates were poorer while other metabolic parameters (BMI, blood pressures, LDL-C) were better five years after the first TEMD survey.
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