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Tip 1 diyabetli hastalarda karbonhidrat sayımının metabolik kontrol üzerine etkisi

The effect of carbohydrate counting on metabolic control in patients with type 1 diabetes mellitus

Journal Name:

  • Gülhane Tıp Dergisi

Publication Year:

  • 2009

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Abstract (2. Language): 
We aimed to investigate the effect of carbohydrate counting on metabolic and clinical parameters in patients with type 1 diabetes mellitus (DM) who were on flexible multiple daily insulin therapy. Nine volunteer adolescent patients using intensive insulin treatment (short acting insulin before meal plus two doses of long acting insulin (NPH) per day) were enrolled in the study. Clinical and metabolic parameters of these patients were retrospectively recorded from their files. The mean diabetes duration and age were 4.23±3.53 years and 15.45±1.47 years, respectively. Median HbA1C levels before and after carbohydrate counting were 9.26% and 8.26%, respectively. Total insulin dose, total cholesterol, HDL cholesterol and triglyceride levels were not different between before and after carbohydrate (CH) counting. However the LDL cholesterol levels decreased significantly with the treatment (p=0.036). The differences in the frequency of hypoglycemia and mean body mass index standard deviation scores were not significant before and after CH counting. The present study suggests that treatment with CH counting and two doses of intermediate-acting NPH plus short-acting insulin analogues may be an alternative treatment method for type 1 DM patients who are unable to use insulin pump due to financial problems also providing flexibility in meal-planning especially for adolescent type 1 DM patients.
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Abstract (Original Language): 
Bu çalışmada esnek çoklu insülin enjeksiyon tedavisi almakta olan tip 1 diyabetes mellituslu hastalarda karbonhidrat sayımının metabolik ve klinik parametreler üzerine olan etkisini araştırmayı amaçladık. Yoğun insülin tedavisi alan (öğün öncesi kısa etkili insülin ve günde iki doz uzun etkili insülin [NPH] ) dokuz gönüllü adölesan hasta çalışmaya alındı. Hastaların klinik ve metabolik parametreleri hasta kayıtlarının geriye dönük olarak incelenmesi sonucu elde edildi. Ortalama diyabet süresi 4.23±3.53 yıl ve ortalama hasta yaşları 15.45±1.47 yıl olarak saptandı. Karbonhidrat sayım öncesi ve sonrası ortalama HbA1c de- ğerleri sırasıyla %9.26 ve %8.26 olarak saptandı. Karbonhidrat sayım öncesi ve sonrası total insülin dozu, total kolesterol, HDL kolesterol ve trigliserid dü- zeylerinde istatistiksel olarak anlamlı farklılıklar saptanmadı. Ancak, tedaviyle beraber LDL kolesterol düzeylerinde anlamlı azalma saptandı (p=0.036). Karbonhidrat sayım öncesi ve sonrası hipoglisemi sıklığında ve vücut kitle indeksi standart sapma skorlarında istatistiksel olarak anlamlı farklılıklar saptanmadı. Bu çalışma, karbonhidrat sayımının iki doz uzun etkili NPH ve çok kısa etkili insülin tedavisi ile beraber özellikle adölesan tip 1 diyabetes mellituslu hastalarda öğünde esneklik de sağlayarak maddi nedenlerle insülin pompası kullanamayanlarda alternatif bir tedavi yöntemi olabileceğini göstermiştir.
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