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    Clinically relevant depression in patients with type 1 and type 2 diabetes; A nationwide study (TEMD-2 depression)
    (Springer Nature Link, 2026) Yüksel Güler, Bağdagül; Demirci, İbrahim; Haymana, Cem; Akbay, Esen; Evren, Bahri; Dizdar, Oğuzhan Sıtkı; Demir, Orhan; Ağbaht, Kemal; Salman, Serpil; Sönmez, Alper
    Purpose Depression is a common but underrecognized comorbidity in individuals with diabetes and is associated with adverse clinical outcomes. This nationwide study aimed to determine the prevalence of clinically relevant depression (CRD) among adults with type 1 and type 2 diabetes in Türkiye and to identify clinical and metabolic factors independently associ ated with CRD. Methods This cross-sectional analysis was conducted within the Turkish nationwide survEy of glycemic and other Meta bolic parameters of patients with Diabetes mellitus-2 (TEMD-2), a multicenter study including adults followed in tertiary endocrinology centers across Türkiye. CRD was defined as a Patient Health Questionnaire-9 score ≥ 10 and/or current anti depressant use. Results A total of 5.266 patients were included. The prevalence of CRD was similar in type 1 and type 2 diabetes (29.4% vs. 27.6%, p = 0.345). In both diabetes types, CRD was significantly more common among women. Patients with CRD had higher body mass index, poorer glycemic control, higher rates of hypoglycemia, and lower achievement of metabolic targets. Microvascular and macrovascular complications were more frequent in patients with CRD. In multivariable analyses, female sex, smoking, and polypharmacy were independently associated with CRD in both diabetes types, while obesity, poor glyce mic control, and vascular complications were additional independent associates in type 2 diabetes. Conclusion CRD affects nearly one-third of adults with diabetes, regardless of diabetes type, and is associated with greater comorbidity burden and suboptimal metabolic control. These findings support routine depression screening as an integral component of comprehensive diabetes care. The study is registered at ClinicalTrials.gov (NCT06347445).
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    Suboptimal LDL-cholesterol control under the 2019 ESC/EAS dyslipidemia guidelines: Results from the nationwide TEMD-2 study in type 2 diabetes
    (Wiley, 2026) Telci Çaklılı, Özge; Haymana, Cem; Demirci, İbrahim; Kebapçı, Medine Nur; Sarıakçalı, Barış; Evren, Bahri; Dizdar, Oğuzhan Sıtkı; Salman, Serpil; Ersoy, Canan; Satman, İlhan; Bayram, Fahri; Sönmez, Alper
    Background: Lowering LDL cholesterol (LDL-C) decreases cardiovascular risk substantially in type 2 diabetes. Despite stricter LDL-cholesterol targets in the 2019 ESC/EAS dyslipidemia guidelines, target achievement in clinical practice remains insuffi cient. TEMD-2 is designed to evaluate LDL-cholesterol target attainment in Turkish patients with type 2 diabetes in the context of the updated 2019 ESC/EAS guidelines. Methods: This multicenter cross-sectional study included adults with type 2 diabetes followed in 70 tertiary endocrine clinics across 36 cities between October 2022 and January 2023. Sociodemographic characteristics, comorbidities, lifestyle factors, com plications, laboratory measurements, and lipid-lowering therapies were assessed using standardized questionnaires and clinical evaluations. LDL-C target was assigned according to cardiovascular risk categories. Independent predictors of goal attainment were identified using multivariable logistic regression. Results: Among 4956 adults with type 2 diabetes, 99.5% required statin therapy, whereas 37.1% were on treatment. Overall, 8.3% of the cohort achieved LDL-cholesterol targets, with attainment lowest in those at very high risk (5.8%). Target achievement among statin users was 57.7% in moderate-risk, 18.1% in high-risk, and 9.4% in very-high-risk patients. Individuals on target had lower body mass index, haemoglobin A1c (HbA1c), triglycerides, and a lower prevalence of microvascular complications. Statin therapy was the strongest positive predictor of success (odds ratio 2.39), while smoking, presence of neuropathy, nephropathy, female sex, older age, and higher HbA1c were associated with lower likelihood of achieving LDL-cholesterol goals. Therapeutic inertia was present in 87.2% of patients, defined as no intensification of lipid-lowering therapy despite LDL-cholesterol levels above target.