Kronik Ruhsal Hastalığı Olan Bireylerde Diyabet Yönetimi ve Psikiyatri Hemşiresinin Rolü

Öz

Diabetus mellitus dirençli hiperglisemi ile karakterize kompleks metabolik bir bozukluktur. Kronik ruhsal hastalığı olan bireylerde diyabet görülme oranı sağlıklı popülasyona göre daha yüksektir. Genetik ve yaşam biçimini içeren birçok faktöre bağlı olarak geliştiği bilinen tip 2 diyabetin, ikinci kuşak antipsikotik ilaçların kilo artışı, glikoz metabolizma bozuklukları gibi yan etkisi nedeniyle kronik ruhsal hastalığı olan bireylerde görülme riski artmaktadır. Diyabet yönetiminde sağlıklı yaşam biçimini teşvik etme, tarama ve izleme tedavinin önemli parçasıdır. Kronik ruhsal hastalığı olan bireylerde diyabet oranlarındaki bu artış ve hastaların her iki hastalığı yönetmelerinde yaşadığı zorluklar sağlık bakımında yeni yaklaşımları gerektirmektedir. Bu derlemenin amacı kronik ruhsal hastalığı olan bireylerde diyabet sıklığının, yönetiminin nasıl olduğuna ve psikiyatri hemşirelerinin rollerine ışık tutmaktır. 

Anahtar Kelimeler

• Diyabetes Mellitus
• Psikiyatri Hemşireliği
• Ruhsal Hastalık

Diabetes Management in Individuals with Severe Mental Illness and the Role of the Psychiatric Nurse

Öz

Diabetes Mellitus is a complex metabolic disorder characterized by resistant hyperglycemia. The prevalence of diabetes in individuals with severe mental illness is higher than in the healthy population. Diabetes Mellitus is known to develop due to several factors including genetics and lifestyle. In addition, the risk of diabetes is increased due to the side effects of second generation antipsychotic drugs, such as weight gain, glucose metabolism disorders, used by individuals with severe mental illness. Promoting a healthy lifestyle in diabetes management, screening and monitoring patients is an important part of the treatment. This increase in the rates of diabetes in individuals with severe mental illness and the difficulties that patients have in managing both illness require new approaches in health care. The purpose of this review is to shed light on the prevalence and the management of diabetes in individuals with severe mental illness and on the roles of psychiatric nurses.

Anahtar Kelimeler

• Diabetes Mellitus
• Psychiatric Nursing
• Mental Illness

Kaynakça

1. 1. Türkiye Diyabet Vakfı. Diyabet tanı ve tedavi rehberi 2017. 2017; 14–15.
2. 2. Coşansu G. Diyabet: Küresel bir salgın hastalık. Okmeydanı Tıp Derg. 2015;31(ek sayı):1–6.
3. 3. World Health Organization. World diabetes day. [online]. 2013;2(4): 123-124. URL: http://who.int/health-topics/diabetes. 10 Ekim 2013.
4. 4. International Diabetes Federation. Diabetes atlas [online]. 2013;12-40. URL: https://www.idf.org/e-library/epidemiology-research/diabetes-atlas/19-atlas-6th-edition.html. 27 Mayıs 2013.
5. 5. Türkiye İstatistik Kurumu. İstatistiklerle Türkiye [online]. 2015; 111-112. URL: http://www.tuik.gov.tr. 12 Haziran 2015.
6. 6. Wykes TL, Lee AA, Bourassa K, Kitchen KA, McKibbin CL. Diabetes knowledge among adults with serious mental illness and comorbid diabetes mellitus. Arch Psychiatr Nurs. 2017;31(2):190–6.
7. 7. İstek N, Karakurt P. Global bir sağlık sorunu: tip 2 diyabet ve öz-bakım yönetimi. JAREN. 2018;4(3):179–82.
8. 8. Vaez K, Diegel-Vacek L, Ryan C, Martyn-Nemeth P. Evaluating diabetes care for patients with serious mental illness using the chronic care model. Heal Serv Res Manag Epidemiol. 2017;4:1-7.

9. 9. Vancampfort D, Correlli CU, Gallin B, Probst M, De Hert M, Ward PB, et al. Diabetes mellitus in people with schizophrenia, bipolar disorder and major depressive disorder: a systematic review and large scale meta‐analysis. World Psychiatry. 2016;15(2):166–74.
10. 10. Liu NH, Daumit GL, Dua T, Aquila R, Charlson F, Cuijpers P, et al. Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas. World Psychiatry. 2017;16:30–40.
11. 11. Kurdyak P, Vigod S, Duchen R, Jacob B, Stukel T, Kiran T. Diabetes quality of care and outcomes: Comparison of individuals with and without schizophrenia. Gen Hosp Psychiatry. 2017;46:7–13.
12. 12. Holt RIG. Diabetes in psychiatric disease. Med (United Kingdom). 2015;43(1):51–3.
13. 13. Vinogradova Y, Coupland C, Hippisley-Cox J, Whyte S, Penny C. Effects of severe mental illness on survival of people with diabetes. Br J Psychiatry. 2010;197(4):272–7.
14. 14. Stubbs B, Vancampfort D, De Hert M, Mitchell AJ. The prevalence and predictors of type two diabetes mellitus in people with schizophrenia: a systematic review and comparative meta-analysis. Acta Psychiatr Scand. 2015;132(2):144–57.
15. 15. Subashini R, Deepa M, Padmavati R, Thara R, Mohan V. Prevalence of diabetes, obesity, and metabolic syndrome in subjects with and without schizophrenia (CURES-104). J Postgrad Med. 2011;57(4); 272–277.
16. 16. Leopold K, Reif A, Haack S, Bauer M, Bury D, Löffler A, et al. Type 2 diabetes and pre-diabetic abnormalities in patients with bipolar disorders. J Affect Disord. 2016;189:240–245.
17. 17. Chen S, Chien Y, Kang C, Jeng C, Chang W. Comparing self-efficacy and self-care behaviours between outpatients with comorbid schizophrenia and type 2 diabetes and outpatients with only type 2 diabetes. J Psychiatr Ment Health Nurs. 2014;21(5):414–422.
18. 18. Scott D, Happell B. The high prevalence of poor physical health and unhealthy lifestyle behaviours in individuals with severe mental illness. Issues Ment Health Nurs. 2011;32(9):589–97.
19. 19. Tek C, Kucukgoncu S, Guloksuz S, Woods SW, Srihari VH, Annamalai A. Antipsychotic-induced weight gain in first-episode psychosis patients: a meta-analysis of differential effects of antipsychotic medications. Early Interv Psychiatry. 2016;10(3):193–202.
20. 20. Holt RIG. Association between antipsychotic medication use and diabetes. Curr Diab Rep. 2019;19(10).
21. 21. Yılmaz S, Şahin G, Buzlu S. Psikofarmakolojik Tedaviler ve Fiziksel Sağlık. İçinde Bilgin H, Ruh Sağlığı ve Psikiyatri Hemşireliğinde Fiziksel Sağlık. 1.Basım. Türkiye Klinikleri, Ankara; 2019:19–29.
22. 22. Correll CU, Detraux J, Lepeleire J De, De Hert M. Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder. World Psychiatry. 2015;14:119–136.
23. 23. Yoon JM, Cho E, Lee H, Park SM. Antidepressant use and diabetes mellitus risk: a meta-analysis. Korean J Fam Med. 2013;34(4):228–240.
24. 24. Mangurian C, Newcomer JW, Vittinghoff E, Creasman JM, Knapp P, Fuentes-Afflick E, et al. Diabetes screening among underserved adults with severe mental illness who take antipsychotic medications. JAMA Intern Med. 2015;175(12):1977-1979.
25. 25. Ince SÇ, Günüşen NP, Özerdem A, Özışık S. Diabetes self-care views of individuals with severe mental illness and comorbid type 2 diabetes and of those only with type 2 diabetes. Arch Psychiatr Nurs. 2017;31(4): 386-393.
26. 26. Çelik Ince S, Partlak Günüşen N, Serçe Ö. The opinions of Turkish mental health nurses on physical health care for individuals with mental illness: A qualitative study. J Psychiatr Ment Health Nurs. 2018;25(4):245–57.
27. 27. De Hert M, Cohen D, Bobes J, Cetkovich-Bakmas M, Leucht S, Ndetei DM, et al. Physical illness in patients with severe mental disorders. II. Barriers to care, monitoring and treatment guidelines, plus recommendations at the system and individual level. World Psychiatry. 2011;10(2):138–51.
28. 28. Mulligan K, McBain H, Lamontagne-Godwin F, Chapman J, Haddad M, Jones J, et al. Barriers and enablers of type 2 diabetes self-management in people with severe mental illness. Heal Expect. 2017;20(5):1020–30.
29. 29. Hultsjö SM, Hjelm K. Organizing care for persons with psychotic disorders and risk of or existing diabetes mellitus type 2. J Psychiatr Ment Health Nurs. 2012;19(10):891–902.
30. 30. Meetoo DD. Dangerous liaisons: the relationship between schizophrenia and diabetes. J Diabetes Nurs. 2013;17(3):104-111.
31. 31. Kayar Erginer D, Partlak Günüşen N. Kronik psikiyatri hastalarının fiziksel sağlık durumu: ihmal edilen bir alan. DEUHFED. 2013;6(3):159–64.
32. 32. Bradshaw T, Pedley R. Evolving role of mental health nurses in the physical health care of people with serious mental health illness. Int J Ment Health Nurs. 2012;21(3):266–73.
33. 33. WHO Guidelines. Management of physical health conditions in adults with severe mental disorders [online]. 2018:1–94 URL: http://apps.who.int/iris/bitstream/handle/10665/275718/9789241550383-eng.pdf. 07 Kasım 2018.