Yıl: 2021 Cilt: 25 Sayı: 4 Sayfa Aralığı: 392 - 411 Metin Dili: İngilizce DOI: 10.25179/tjem.2021-85173 İndeks Tarihi: 21-02-2022

Consensus Statement of Endocrinology, Cardiology, and Nephrology(ENCARNE) Experts on Prevention, Diagnosis, and Management of Cardiovascular and Renal Complications of Diabetes

Öz:
An array of medical practitioners, including endocrinologists, family physicians, internal medicine specialists in nephrology and cardiology, unceasingly investigate, diagnose and treat over 8 million diabetic patients in Turkey. Apart from routine glycemic regulation, several frequent coexisting comorbidities such as obesity, hypertension, dyslipidemia, and their associated complications should also be promptly managed. Due to the concomitant occurrence of complications, the involvement of additional specialties in the precise management of such conditions becomes indispensable. Owing to the ever-expanding knowledge about the prevalence and clinical manifestations of diabetes, various international medical societies publish annual diabetes guidelines, which makes it too cumbersome as well as challenging for the practicing physicians to follow these comprehensive guidelines in clinical practice. There is an unmet need for an easyto-read and concise document for all physicians working for diabetes management for a standardized approach for better management of diabetes and improved patient care. This consensus report was prepared collectively by the Society of Endocrinology and Metabolism Turkey, Turkish Society of Cardiology, Turkish Society of Nephrology, Turkish Society of Hypertension and Renal Diseases to prevent cardiac and renal complications of diabetes, to timely detect these complications by using pertinent measures and to develop, implement and monitor strategies for managing them effectively.
Anahtar Kelime:

Diyabette Kardiyovasküler ve Renal Komplikasyonların Önlenmesi, Tanısı ve Tedavisi için EndokrinolojiKardiyoloji Nefroloji (ENKARNE) Uzlaşı Raporu

Öz:
Türkiye’deki 8 milyon diyabetlinin tanı ve tedavisinde endokrinoloji ve metabolizma hastalıkları uzmanları, aile hekimleri, iç hastalıkları uzmanları, nefroloji ve kardiyoloji uzmanları başta olmak üzere birçok farklı disiplin de görev almaktadır. Diyabetli bireyde iyi glisemi regülasyonunun yanı sıra, obezite, hipertansiyon, dislipidemi gibi eşlik eden hastalıkları ve gelişen komplikasyonları da uygun biçimde tedavi etmek gereklidir. Diyabet komplikasyonları arttıkça diğer branşların da tedavi yönetimine katılması gerekmektedir. Öte yandan, diyabetle ilgili bilgiler giderek artmakta, çeşitli uzmanlık dernekleri diyabet kılavuzları yayımlamakta ve bu kılavuzları sahada çalışan hekimlerin izlemesi güçleşmektedir. Diyabet tedavisinde görev alan tüm hekimler için kolay okunan, özet bir başvuru kaynağı hazırlamak ve hasta yaklaşımında standardı sağlamak önemlidir. Bu uzlaşı raporu Türkiye Endokrinoloji ve Metabolizma Derneği, Türk Kardiyoloji Derneği, Türk Nefroloji Derneği, Türk Hipertansiyon ve Böbrek Hastalıkları Derneğinin ortak gayretiyle diyabetin kardiyak ve renal komplikasyonlarını önlemek, bu komplikasyonları zamanında ve uygun yönlemlerle tespit etmek ve etkin bir şekilde yönetmek için stratejiler geliştirmek, uygulamak ve izlemek amacıyla hazırlanmıştır.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık
  • 1. Budnik LT, Adam B, Albin M, Banelli B, Baur X, Belpoggi F, Bolognesi C, Broberg K, Gustavsson P, Göen T, Fischer A, Jarosinska D, Manservisi F, O'Kennedy R, Øvrevik J, Paunovic E, Ritz B, Scheepers PTJ, Schlünssen V, Schwarzenbach H, Schwarze PE, Sheils O, Sigsgaard T, Van Damme K, Casteleyn L. Diagnosis, monitoring and prevention of exposure- related noncommunicable diseases in the living and working environment: DiMoPEx-project is designed to determine the impacts of environmental exposure on human health. J Occup Med Toxicol. 2018;13:6.
  • 2. Miranda JJ, Barrientos-Gutiérrez T, Corvalan C, Hyder AA, Lazo-Porras M, Oni T, Wells JCK. Understanding the rise of cardiometabolic diseases in low- and middle-income countries. Nat Med. 2019;25:1667-1679.
  • 3. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, Karsidag K, Genc S, Telci A, Canbaz B, Turker F, Yilmaz T, Cakir B, Tuomilehto J; TURDEP-II Study Group. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol. 2013;28:169-180.
  • 4. Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, Colagiuri S, Guariguata L, Motala AA, Ogurtsova K, Shaw JE, Bright D, Williams R; IDF Diabetes Atlas Committee. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2019; 157:107843.
  • 5. Malhan S, Öksüz E, Babineaux SM, Ertekin A, Palmer JP. Assessment of the direct medical costs of type 2 diabetes mellitus and its complications in Turkey. Turkish J Endocrinol Metabolism. 2014; 18:39-43.
  • 6. Braunwald E. Diabetes, heart failure, and renal dysfunction: The vicious circles. Prog Cardiovasc Dis. 2019;62:298-302.
  • 7. van der Meer IM, Ruggenenti P, Remuzzi G. The diabetic CKD patient--a major cardiovascular challenge. J Ren Care. 2010;36:34-46.
  • 8. Matheus AS, Tannus LR, Cobas RA, Palma CC, Negrato CA, Gomes MB. Impact of diabetes on cardiovascular disease: an update. Int J Hypertens. 2013;2013: 653789.
  • 9. Sonmez A, Haymana C, Bayram F, Salman S, Dizdar OS, Gurkan E, Kargili Carlıoglu A, Barcin C, Sabuncu T, Satman I; TEMD Study Group. Turkish nationwide survEy of glycemic and other Metabolic parameters of patients with Diabetes mellitus (TEMD study). Diabetes Res Clin Pract. 2018;146:138-147.
  • 10. Diabetes Control and Complications Trial Research Group, Nathan DM, Genuth S, Lachin J, Cleary P, Crofford O, Davis M, Rand L, Siebert C. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977-986.
  • 11. ACCORD Study Group, Gerstein HC, Miller ME, Genuth S, Ismail-Beigi F, Buse JB, Goff DC Jr, Probstfield JL, Cushman WC, Ginsberg HN, Bigger JT, Grimm RH Jr, Byington RP, Rosenberg YD, Friedewald WT. Long-term effects of intensive glucose lowering on cardiovascular outcomes. N Engl J Med. 2011; 364: 818-828.
  • 12. ADVANCE Collaborative Group, Patel A, MacMahon S, Chalmers J, Neal B, Billot L, Woodward M, Marre M, Cooper M, Glasziou P, Grobbee D, Hamet P, Harrap S, Heller S, Liu L, Mancia G, Mogensen CE, Pan C, Poulter N, Rodgers A, Williams B, Bompoint S, de Galan BE, Joshi R, Travert F. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;358:2560-2572.
  • 13. Katakami N. Mechanism of development of atherosclerosis and cardiovascular disease in dia betes mellitus. J Atheroscler Thromb. 2018; 25: 27-39.
  • 14. Sabuncu T, Sonmez A, Eren MA, Sahin I, Çorapçioğlu D, Üçler R, Akin Ş, Haymana C, Demirci İ, Atmaca A, Ersöz HÖ, Satman I, Bayram F; TEMD Study Group. Characteristics of patients with hypertension in a population with type 2 diabetes mellitus. Results from the Turkish Nationwide SurvEy of Glycemic and Other Metabolic Parameters of Patients with Diabetes Mellitus (TEMD Hypertension Study). Prim Care Diabetes. 2021;15:332-339.
  • 15. Sonmez A, Yumuk V, Haymana C, Demirci I, Barcin C, Kıyıcı S, Güldiken S, Örük G, Ozgen Saydam B, Baldane S, Kutlutürk F, Küçükler FK, Deyneli O, Çetinarslan B, Sabuncu T, Bayram F, Satman I; TEMD Study Group. Impact of obesity on the metabolic control of Type 2 diabetes: results of the turkish nationwide survey of glycemic and other metabolic parameters of patients with diabetes mellitus (TEMD Obesity Study). Obes Facts. 2019;12:167-178.
  • 16. Bayram F, Sonmez A, Haymana C, Sabuncu T, Dizdar OS, Gurkan E, Carlioglu AK, Agbaht K, Ozdemir D, Demirci I, Barcin C, Salman S, Tetiker T, Balci MK, Kebapci N, Ersoy C, Yumuk V, Toth PP, Satman I; TEMD Study Group. Utilization of statins and LDL-cholesterol target attainment in Turkish patients with type 2 diabetes - a nationwide cross-sectional study (TEMD dyslipidemia study). Lipids Health Dis. 2020; 19:237.
  • 17. Schmidt AM. Diabetes mellitus and cardiovascular disease. Arterioscler Thromb Vasc Biol. 2019;39: 558- 568.
  • 18. Glovaci D, Fan W, Wong ND. Epidemiology of diabetes mellitus and cardiovascular disease. Curr Cardiol Rep. 2019;21:21.
  • 19. Ernande L, Derumeaux G. Diabetic cardiomyopathy: myth or reality? Arch Cardiovasc Dis. 2012;105: 218- 225.
  • 20. Liu JE, Palmieri V, Roman MJ, Bella JN, Fabsitz R, Howard BV, Welty TK, Lee ET, Devereux RB. The impact of diabetes on left ventricular filling pattern in normotensive and hypertensive adults: the Strong Heart Study. J Am Coll Cardiol. 2001;37:1943-1949.
  • 21. Jia G, DeMarco VG, Sowers JR. Insulin resistance and hyperinsulinaemia in diabetic cardiomyopathy. Nat Rev Endocrinol. 2016;12:144-153.
  • 22. Sacre JW, Franjic B, Jellis CL, Jenkins C, Coombes JS, Marwick TH. Association of cardiac autonomic neuropathy with subclinical myocardial dysfunction in type 2 diabetes. JACC Cardiovasc Imaging. 2010;3:1207- 1215.
  • 23. Negishi K. Echocardiographic feature of diabetic cardiomyopathy: where are we now? Cardiovasc Diagn Ther. 2018;8:47-56.
  • 24. Movahed MR, Hashemzadeh M, Jamal MM. Significant increase in the prevalence of non-rheumatic aortic valve disease in patients with type 2 diabetes mellitus. Exp Clin Endocrinol Diabetes. 2007;115:105-107.
  • 25. Koye DN, Magliano DJ, Nelson RG, Pavkov ME. The global epidemiology of diabetes and kidney disease. Adv Chronic Kidney Dis. 2018;25:121-132.
  • 26. Süleymanlar G, Utaş C, Arinsoy T, Ateş K, Altun B, Altiparmak MR, Ecder T, Yilmaz ME, Çamsari T, Başçi A, Odabas AR, Serdengeçti K. A population-based survey of Chronic REnal Disease In Turkey--the CREDIT study. Nephrol Dial Transplant. 2011;26: 1862-1871.
  • 27. United States Renal Data System. 2020 USRDS Annual Data Report: Epidemiology of kidney disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. 2020.
  • 28. Süleymanlar G, Ateş K, Seyahi N. Registry of the Nephrology, Dialysis and Transplantation in Turkey. Ankara: Bayt Matbaacılık; 2020. Turkish.
  • 29. American Diabetes Association. 4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021;44:S40-S52.
  • 30. TEMD Diabetes Mellitus Çalışma Grubu. Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Kılavuzu-2020. 14. Baskı. Ankara: Bayt Matbaacılık; 2020. Turkish.
  • 31. Thomas MC, Cooper ME, Rossing K, Parving HH. Anaemia in diabetes: Is there a rationale to TREAT? Diabetologia. 2006;49:1151-1157.
  • 32. Go AS, Yang J, Tan TC, Cabrera CS, Stefansson BV, Greasley PJ, Ordonez JD; Kaiser Permanente Northern California CKD Outcomes Study. Contemporary rates and predictors of fast progression of chronic kidney disease in adults with and without diabetes mellitus. BMC Nephrol. 2018;19:146.
  • 33. Afkarian M, Sachs MC, Kestenbaum B, Hirsch IB, Tuttle KR, Himmelfarb J, de Boer IH. Kidney disease and increased mortality risk in type 2 diabetes. J Am Soc Nephrol. 2013;24:302-308.
  • 34. Marshall SM, Flyvbjerg A. Prevention and early detection of vascular complications of diabetes. BMJ. 2006;333:475-480.
  • 35. TEMD Diabetes Mellitus Çalışma ve Eğitim Grubu. Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Kılavuzu-2017. 9. Baskı. Ankara: Bayt Matbaacılık; 2017.
  • 36. Arıcı M, Birdane A, Güler K, Yıldız BO, Altun B, Ertürk Ş, Aydoğdu S, Özbakkaloğlu M, Ersöz HÖ, Süleymanlar G, Tükek T, Tokgözoğlu L, Erdem Y; Türk Kardiyoloji Derneğ i (TKD); Türk İç Hastalıkları Uzmanlık Derneği (TİHUD); Türkiye Endokrinoloji ve Metabolizma Derneği (TEMD); Türk Nefroloji Derneği (TND); Türk Hipertansiyon ve Böbrek Hastalıkları Derneği. Türk Hipertansiyon Uzlaşı Raporu [Turkish Hypertension Consensus Report]. Turk Kardiyol Dern Ars. 2015;43:402-409. Turkish.
  • 37. Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group. KDIGO 2020 clinical practice guideline for diabetes management in chronic kidney disease. Kidney Int. 2020;98:S1-S115.
  • 38. Inker LA, Astor BC, Fox CH, Isakova T, Lash JP, Peralta CA, Kurella Tamura M, Feldman HI. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. Am J Kidney Dis. 2014;63:713-735.
  • 39. Summary of Recommendation Statements. Kidney Int Suppl (2011). 2013;3:5-14.
  • 40. Valensi P, Lorgis L, Cottin Y. Prevalence, incidence, predictive factors and prognosis of silent myocardial infarction: a review of the literature. Arch Cardiovasc Dis. 2011;104:178-188.
  • 41. Cosentino F, Grant PJ, Aboyans V, Bailey CJ, Ceriello A, Delgado V, Federici M, Filippatos G, Grobbee DE, Hansen TB, Huikuri HV, Johansson I, Jüni P, Lettino M, Marx N, Mellbin LG, Östgren CJ, Rocca B, Roffi M, Sattar N, Seferović PM, Sousa-Uva M, Valensi P, Wheeler DC; ESC Scientific Document Group. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2020;41: 255-323. Erratum in: Eur Heart J. 2020;41:4317.
  • 42. Pop-Busui R, Evans GW, Gerstein HC, Fonseca V, Fleg JL, Hoogwerf BJ, Genuth S, Grimm RH, Corson MA, Prineas R; Action to Control Cardiovascular Risk in Diabetes Study Group. Effects of cardiac autonomic dysfunction on mortality risk in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Diabetes Care. 2010;33:1578-1584.
  • 43. Diabetes Canada Clinical Practice Guidelines Expert Committee, Poirier P, Bertrand OF, Leipsic J, Mancini GBJ, Raggi P, Roussin A. Screening for the Presence of Cardiovascular Disease. Can J Diabetes. 2018;42:S170-S177.
  • 44. From AM, Scott CG, Chen HH. The development of heart failure in patients with diabetes mellitus and preclinical diastolic dysfunction a population-based study. J Am Coll Cardiol. 2010;55:300-305. Erratum in: J Am Coll Cardiol. 2010;56:1612.
  • 45. Marso SP, Bain SC, Consoli A, Eliaschewitz FG, Jódar E, Leiter LA, Lingvay I, Rosenstock J, Seufert J, Warren ML, Woo V, Hansen O, Holst AG, Pettersson J, Vilsbøll T; SUSTAIN-6 Investigators. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2016;375:1834-1844.
  • 46. Marso SP, Daniels GH, Brown-Frandsen K, Kristensen P, Mann JF, Nauck MA, Nissen SE, Pocock S, Poulter NR, Ravn LS, Steinberg WM, Stockner M, Zinman B, Bergenstal RM, Buse JB; LEADER Steering Committee; LEADER Trial Investigators. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016;375:311-322.
  • 47. Zinman B, Wanner C, Lachin JM, Fitchett D, Bluhmki E, Hantel S, Mattheus M, Devins T, Johansen OE, Woerle HJ, Broedl UC, Inzucchi SE; EMPA-REG OUTCOME Investigators. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med. 2015;373:2117-2128.
  • 48. Gerstein HC, Colhoun HM, Dagenais GR, Diaz R, Lakshmanan M, Pais P, Probstfield J, Riesmeyer JS, Riddle MC, Rydén L, Xavier D, Atisso CM, Dyal L, Hall S, RaoMelacini P, Wong G, Avezum A, Basile J, Chung N, Conget I, Cushman WC, Franek E, Hancu N, Hanefeld M, Holt S, Jansky P, Keltai M, Lanas F, Leiter LA, Lopez-Jaramillo P, Cardona Munoz EG, Pirags V, Pogosova N, Raubenheimer PJ, Shaw JE, Sheu WH, TemelkovaKurktschiev T; REWIND Investigators. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. Lancet. 2019; 394:121-130.
  • 49. Neal B, Perkovic V, Mahaffey KW, de Zeeuw D, Fulcher G, Erondu N, Shaw W, Law G, Desai M, Matthews DR; CANVAS Program Collaborative Group. Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. N Engl J Med. 2017;377:644-657.
  • 50. Wiviott SD, Raz I, Bonaca MP, Mosenzon O, Kato ET, Cahn A, Silverman MG, Zelniker TA, Kuder JF, Murphy SA, Bhatt DL, Leiter LA, McGuire DK, Wilding JPH, Ruff CT, Gause-Nilsson IAM, Fredriksson M, Johansson PA, Langkilde AM, Sabatine MS; DECLARE-TIMI 58 Investigators. Dapagliflozin and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2019;380:347-357.
  • 51. Perkovic V, Jardine MJ, Neal B, Bompoint S, Heerspink HJL, Charytan DM, Edwards R, Agarwal R, Bakris G, Bull S, Cannon CP, Capuano G, Chu PL, de Zeeuw D, Greene T, Levin A, Pollock C, Wheeler DC, Yavin Y, Zhang H, Zinman B, Meininger G, Brenner BM, Mahaffey KW; CREDENCE Trial Investigators. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. N Engl J Med. 2019;380:2295-2306.
  • 52. American Diabetes Association. 11. Microvascular Complications and Foot Care: Standards of Medical Care in Diabetes-2021. Diabetes Care. 202; 44:S151-S167. Erratum in: Diabetes Care. 2021; 44:2186-2187.
  • 53. Belfort R, Harrison SA, Brown K, Darland C, Finch J, Hardies J, Balas B, Gastaldelli A, Tio F, Pulcini J, Berria R, Ma JZ, Dwivedi S, Havranek R, Fincke C, DeFronzo R, Bannayan GA, Schenker S, Cusi K. A placebo-controlled trial of pioglitazone in subjects with nonalcoholic steatohepatitis. N Engl J Med. 2006;355:2297-2307.
  • 54. Armstrong MJ, Gaunt P, Aithal GP, Barton D, Hull D, Parker R, Hazlehurst JM, Guo K; LEAN trial team, Abouda G, Aldersley MA, Stocken D, Gough SC, Tomlinson JW, Brown RM, Hübscher SG, Newsome PN. Liraglutide safety and efficacy in patients with non- alcoholic steatohepatitis (LEAN): a multicentre, double-blind, randomised, placebo-controlled phase 2 study. Lancet. 2016;387:679-690.
  • 55. Bloomgarden Z, Handelsman Y. How does CKD affect HbA1c? J Diabetes. 2018;10:270.
  • 56. Güngör Ö, Ulu MS, Arıkan IH, Kutlay S, Arıcı M, Altun B, et al. Diyabetik Böbrek Hastalarında Hipergliseminin İlaçlarla Yönetimi: Türk Nefroloji Derneği Uzman Görüşü Raporu 2020. 2020. Turkish.
  • 57. Chapter 2: Pharmacological cholesterol-lowering treatment in adults. Kidney Int Suppl (2011). 2013;3: 271- 279.
APA Sonmez A, Ozdogan O, ARICI M, Salman S, DERICI U, Deger S, Altay H, Caliskan M, Ates K (2021). Consensus Statement of Endocrinology, Cardiology, and Nephrology(ENCARNE) Experts on Prevention, Diagnosis, and Management of Cardiovascular and Renal Complications of Diabetes. , 392 - 411. 10.25179/tjem.2021-85173
Chicago Sonmez Alper,Ozdogan Oner,ARICI Mustafa,Salman Serpil,DERICI ULVER,Deger Serpil Muge,Altay Hakan,Caliskan Mustafa,Ates Kenan Consensus Statement of Endocrinology, Cardiology, and Nephrology(ENCARNE) Experts on Prevention, Diagnosis, and Management of Cardiovascular and Renal Complications of Diabetes. (2021): 392 - 411. 10.25179/tjem.2021-85173
MLA Sonmez Alper,Ozdogan Oner,ARICI Mustafa,Salman Serpil,DERICI ULVER,Deger Serpil Muge,Altay Hakan,Caliskan Mustafa,Ates Kenan Consensus Statement of Endocrinology, Cardiology, and Nephrology(ENCARNE) Experts on Prevention, Diagnosis, and Management of Cardiovascular and Renal Complications of Diabetes. , 2021, ss.392 - 411. 10.25179/tjem.2021-85173
AMA Sonmez A,Ozdogan O,ARICI M,Salman S,DERICI U,Deger S,Altay H,Caliskan M,Ates K Consensus Statement of Endocrinology, Cardiology, and Nephrology(ENCARNE) Experts on Prevention, Diagnosis, and Management of Cardiovascular and Renal Complications of Diabetes. . 2021; 392 - 411. 10.25179/tjem.2021-85173
Vancouver Sonmez A,Ozdogan O,ARICI M,Salman S,DERICI U,Deger S,Altay H,Caliskan M,Ates K Consensus Statement of Endocrinology, Cardiology, and Nephrology(ENCARNE) Experts on Prevention, Diagnosis, and Management of Cardiovascular and Renal Complications of Diabetes. . 2021; 392 - 411. 10.25179/tjem.2021-85173
IEEE Sonmez A,Ozdogan O,ARICI M,Salman S,DERICI U,Deger S,Altay H,Caliskan M,Ates K "Consensus Statement of Endocrinology, Cardiology, and Nephrology(ENCARNE) Experts on Prevention, Diagnosis, and Management of Cardiovascular and Renal Complications of Diabetes." , ss.392 - 411, 2021. 10.25179/tjem.2021-85173
ISNAD Sonmez, Alper vd. "Consensus Statement of Endocrinology, Cardiology, and Nephrology(ENCARNE) Experts on Prevention, Diagnosis, and Management of Cardiovascular and Renal Complications of Diabetes". (2021), 392-411. https://doi.org/10.25179/tjem.2021-85173
APA Sonmez A, Ozdogan O, ARICI M, Salman S, DERICI U, Deger S, Altay H, Caliskan M, Ates K (2021). Consensus Statement of Endocrinology, Cardiology, and Nephrology(ENCARNE) Experts on Prevention, Diagnosis, and Management of Cardiovascular and Renal Complications of Diabetes. Turkish Journal of Endocrinology and Metabolism, 25(4), 392 - 411. 10.25179/tjem.2021-85173
Chicago Sonmez Alper,Ozdogan Oner,ARICI Mustafa,Salman Serpil,DERICI ULVER,Deger Serpil Muge,Altay Hakan,Caliskan Mustafa,Ates Kenan Consensus Statement of Endocrinology, Cardiology, and Nephrology(ENCARNE) Experts on Prevention, Diagnosis, and Management of Cardiovascular and Renal Complications of Diabetes. Turkish Journal of Endocrinology and Metabolism 25, no.4 (2021): 392 - 411. 10.25179/tjem.2021-85173
MLA Sonmez Alper,Ozdogan Oner,ARICI Mustafa,Salman Serpil,DERICI ULVER,Deger Serpil Muge,Altay Hakan,Caliskan Mustafa,Ates Kenan Consensus Statement of Endocrinology, Cardiology, and Nephrology(ENCARNE) Experts on Prevention, Diagnosis, and Management of Cardiovascular and Renal Complications of Diabetes. Turkish Journal of Endocrinology and Metabolism, vol.25, no.4, 2021, ss.392 - 411. 10.25179/tjem.2021-85173
AMA Sonmez A,Ozdogan O,ARICI M,Salman S,DERICI U,Deger S,Altay H,Caliskan M,Ates K Consensus Statement of Endocrinology, Cardiology, and Nephrology(ENCARNE) Experts on Prevention, Diagnosis, and Management of Cardiovascular and Renal Complications of Diabetes. Turkish Journal of Endocrinology and Metabolism. 2021; 25(4): 392 - 411. 10.25179/tjem.2021-85173
Vancouver Sonmez A,Ozdogan O,ARICI M,Salman S,DERICI U,Deger S,Altay H,Caliskan M,Ates K Consensus Statement of Endocrinology, Cardiology, and Nephrology(ENCARNE) Experts on Prevention, Diagnosis, and Management of Cardiovascular and Renal Complications of Diabetes. Turkish Journal of Endocrinology and Metabolism. 2021; 25(4): 392 - 411. 10.25179/tjem.2021-85173
IEEE Sonmez A,Ozdogan O,ARICI M,Salman S,DERICI U,Deger S,Altay H,Caliskan M,Ates K "Consensus Statement of Endocrinology, Cardiology, and Nephrology(ENCARNE) Experts on Prevention, Diagnosis, and Management of Cardiovascular and Renal Complications of Diabetes." Turkish Journal of Endocrinology and Metabolism, 25, ss.392 - 411, 2021. 10.25179/tjem.2021-85173
ISNAD Sonmez, Alper vd. "Consensus Statement of Endocrinology, Cardiology, and Nephrology(ENCARNE) Experts on Prevention, Diagnosis, and Management of Cardiovascular and Renal Complications of Diabetes". Turkish Journal of Endocrinology and Metabolism 25/4 (2021), 392-411. https://doi.org/10.25179/tjem.2021-85173