Burcin Meryem Atak Tel's research while affiliated with Bolu Abant Izzet Baysal University and other places

Objectives: Serum uric acid to HDL-cholesterol ratio (UHR) was presented as a novel parameter of inflammatory and metabolic diseases such as metabolic syndrome, diabetes mellitus, thyroiditis, and non-alcoholic hepatosteatosis, recently. In the present study, we aimed to show the diagnostic role of UHR in diabetic kidney injury (DKI), a condition characterized with chronic, low grade inflammation. Methods: We retrospectively analyzed data of 287 patients who already had diabetes mellitus in outpatient clinics of our institution. The study population was divided into two groups according to the presence of DKI. We compared UHR levels between these groups. Results: The UHR level was significantly elevated in diabetic patients with DKI compared to diabetic patients who do not have DKI (p<0.001). Median UHR was clearly and positively correlated with urine albumin creatinine ratio (UACR), serum creatinine and HbA1c, and inversely correlated with GFR. Logistic regression analysis confirmed that a 0,1 point increase in UHR increases DKI odds by 2,3 times. UHR was also correlated with serum creatinine, GFR and UACR, which are important signs for diabetic kidney injury. Conclusion: In conclusion, we suggest UHR can be used a diagnostic tool of diabetic kidney injury in patients with type 2 DM.

Introduction While T2DM increase the risk of cardiac complications, diabetes treatment choice may increase or decrease the rates of cardiac events. In the present review, we comprehensively discussed the treatment options of diabetic subjects with cardiac conditions. Areas covered Current evidence related to diabetes treatment in cardiac situations has been reviewed. Clinical trials and meta-analyses on cardiac safety of anti-diabetic medicines is discussed. Treatment choices with proven benefits and those at least without associated increased cardiac risk were drawn from clinical trials, meta-analyses and cardiac safety studies in the recent medical literature were the basis of the suggestions in present review. Expert opinion We can suggest that hypoglycemia and extreme hyperglycemia should be avoided in acute ischemic heart conditions. Certain diabetic treatment options, especially SGLT2 inhibitors, can reduce overall cardiovascular mortality and hospitalization due to heart failure. Therefore, we suggest that physicians should choose SGLT2 inhibitors as the first-line treatment option in diabetic patients with heart failure or those who have a high risk of heart failure development. Type 2 DM increases the risk of atrial fibrillation (AF) and metformin and pioglitazone seem to reduce the risk of AF in diabetic population.

Aim In this study, we aimed to evaluate the effectiveness of long-acting insulin analogs in the treatment of type 2 diabetes mellitus (T2DM) in our clinic. Methods Patients with T2DM who were prescribed long-acting insulin analog therapy in our internal medicine outpatient clinic between November 2017 and December 2019 were included in the study. Patients’ age, gender, duration of diabetes, HbA1c values, insulin doses and injections in previous treatment, and fasting blood glucose levels before the initiation of long-acting insulin analog were recorded. Fasting blood glucose levels after the initiation of long-acting insulin analog therapy, HbA1c values, total insulin doses in the new treatment and the number of injections, and follow-up times were also recorded from the institutional database. Data of the patients during previous treatment and novel treatment were compared. Results Forty patients were included in our study. Six patients who did not attend their controls and two patients who were observed to be non-compliant even though they presented to control visit were excluded from the study. The remaining 32 patients were enrolled in the study. The average treatment follow-up period of the patients was 6 (3–8) months. Fasting blood glucose (p = 0.014) and HbA1c (p = 0.004) values were significantly reduced after long-acting insulin analog therapy compared to the values during previous treatment. Similarly, total daily insulin dose was decreased after long-acting insulin analog treatment compared to the insulin dose before long-acting insulin analog treatment (p < 0.001). The decrease in the number of daily insulin injections after long-acting insulin analogs treatment compared to the number of injections before long-acting insulin analog treatment was statistically significant (p < 0.001). Conclusion We think that the addition of new long-acting insulin analogs to the treatment in patients with T2DM may be beneficial in achieving the target blood glucose, A1c, and may also be associated with treatment compliance.

Background . Hashimoto’s thyroiditis (HT) is an auto-immune condition characterized with lymphocytic and fibroblastic infiltration of the thyroid gland. The rate of uric acid and HDL cholesterol; so called as uric acid to HDL ratio (UHR) has been shown to be elevated in inflammatory conditions diseases. We aimed to compare UHR and other laboratory parameters of the patients with HT to those values in healthy controls. Methods . The patients whom diagnosed with HT by medical history, physical examination, elevated thyroid autoantibodies in serum and characteristic sonographic findings in outpatient internal medicine clinics of our institution were enrolled to the present retrospective study. Age and sex matched healthy volunteers were enrolled as controls. UHR of the HT patients and control subjects were compared. Results . Mean UHR of the HT group was 11% ± 4 %, while UHR of the control group was 8% ± 2% (p<0.001). UHR was significantly and positively correlated with thyroid stimulating hormone (TSH) (r=0.26, p=0.01) and negatively correlated with free T4 (FT4) (r=-0.22, p=0.04) levels. The sensitivity and specificity of the UHR level greater than 8.3% were 74% and 52%, respectively (AUC: 0.74, p<0.001, 95% CI: 0.64-0.84). Conclusion . We suggest that UHR is a reliable and useful marker for HT. Therefore, it may be helpful in establishing the diagnosis of HT in addition to other diagnostic tools.

Coronaviruses, a large family of single-stranded RNA viruses, can infect humans and animals, and can cause neurological, gastrointestinal and hepatic diseases as well as causing various lung diseases, including pneumonia, with shortness of breath, cough and fever. At the end of December 2019, a group of health authorities reported unidentified cases of pneumonia in a seafood market in Wuhan, China. The World Health Organization (WHO) used term 2019 novel coronavirus (COVID-19) to refer to a coronavirus that affected the lower respiratory tract of patients with pneumonia in Wuhan, China on 29 December and the WHO announced that the official name of the 2019 novel coronavirus was coronavirus disease (COVID-19). COVID-19 is seen in many countries around the World and has been accepted as a pandemic by WHO. It is defined as a suspicious case with fever, sore throat, cough, and people with a history of traveling to China or some parts of the country, or someone who contact with a patient who has a history of travel in China or contact with a confirmed COVID-19 infection patient. Currently, there is no proven vaccine or antiviral therapy that can be used against animal or human coronavirus. To control the outbreak, the drugs must be developed as soon as possible. Various drugs have been used in the treatment of COVID-19 and the main ones are chloroquine, remdesivir, lopinavir/ritonavir, oseltamivir, favipiravir. Since the virus affects the whole World, vaccines and/or new curative antiviral drugs are needed to end the pandemic. For this purpose, large-scale observational studies are needed.