TİP 2 DİABETES MELLİTUSLU HASTALARDA DİYABET SEMPTOMLARININ KONTROLÜ

Year 2019, Volume: 5 Issue: 2, 66 - 85, 27.06.2019

Nadire Şahin Fatma Birgili

Abstract

Araştırma, diyabet eğitiminin Tip II
Diyabetes Mellitus (T2DM)’lu hastalarda görülen diyabet belirtileri ve
yakınmaları üzerine etkisinin belirlenmesi amacıyla yarı deneysel olarak
yapılmıştır. Araştırma Muğla Sıtkı Koçman Hastanesi eğitim ve araştırma
hastanesi dahiliye kliniğinde T2DM tanısı ile yatan 213 hasta ile yapılmıştır.
Hastaların 106’sı kontrol, 107’si müdahale grubundan oluşmaktadır. Veri
toplamada, bir anket formu ve ‘Diyabet Belirtileri Kontrol Listesi Diabetes
Symptom Checklist- (DSC-R)’ Ölçeği kullanılmıştır.
Araştırmaya katılan hastaların %56,3’ü erkekti ve %36,2’si 40-54 yaş aralığındaydı.

Müdahale ve kontrol grubundaki hastaların ölçümlere göre DSC-R ölçeği ve alt boyutlarından hipoglisemi, hiperglisemi, psikoloji ve nöroloji boyutlarının puan ortalamasının istatistiksel açıdan anlamlı bir farklılık gösterdiği tespit edilmiştir (p<0.05). Sonuca göre eğitim öncesi ölçümün puan ortalamasının eğitim sonrası ölçüme göre daha yüksek olduğu belirlenmiştir. En fazla farklılık gösteren T2DM belirtisi hipoglisemi alt boyutunda “yemekten önce sinirlilik hali”, hiperglisemi alt boyutunda “Aşırı susama”, oftalmoloji alt boyutunda “bazen net bazen bulanık görme”, Psikoloji alt boyutunda hemen her bir belirtide, nöroloji alt boyutunda ise “yürürken baldırlarda ağrı”dır.

T2DM’lu hastalara verilen diyabet eğitiminin
hipoglisemi, hiperglisemi, psikoloji ve nöroloji alt boyutları üzerine etkili
olduğu belirlenmiştir. 

Keywords

T2DM, hasta, hemşire, diyabet eğitimi

Supporting Institution

Muğla Sıtkı Koçman Üniversitesi / Bilimsel Araştırma Projeleri

CONTROL OF DIABETES SYMPTOMS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Abstract

This semi-experimental study was conducted to determine the effects of diabetes education on degree of suffering from and symptoms of diabetes in patients with type 2 diabetes mellitus (T2DM). This study was carried out in Muğla Sıtkı Koçman Training and Research Hospital Internal Diseases Clinic. Among the study population of 213 patients, 106 were in the control group and 107 were in the intervention group. A general questionnaire and the revised diabetes symptom checklist scale (DSC-R) were used for data collection. Among the study population, 56.3% were males and 36.2% were between 40 and 54 years of age. Statistically significant differences were found between the control and intervention groups in DSC-R scale and its hypoglycemia, hyperglycemia, psychology, and neurology subscales (p<0.05). According to the results, it was determined that the mean score of the pre-training score was higher than the post-training score. The diabetes education program led to remarkable improvements in “irritability just before a meal” among hypoglycemia subscale, in “very thirsty” among hyperglycemia subscale, in “alternating clear and blurred vision” among ophthalmology subscale, in almost all symptoms among psychology subscale, and in “aching calves when walking” among neurology subscale. 

Efficacy of diabetes education on hypoglycemia, hyperglycemia, psychology, and neurology subscales was observed in patients with T2DM. 

Keywords

Type 2 diabetes mellitus, patient, nurse, diabetes education

References

• Aba, N.,& Tel, H. (2012). Depression and Self-Care Agency Among the Diabetes Mellitus Patients. Cumhuriyet Nursing Journal, 1(1), 18-23. Turkey.
• Acemoğlu, H., Ertem, M., Bahçeci, M., & Tuzcu, A. (2006). Levels of Health Care Utilization in Patients with Type 2 Diabetes Mellitus. The Eurasian Journal of Medicine EAJM, 38, 89-95.
• Albuquerque, C.,Correia, C., &Ferreira, M. (2015). Adherence to the therapeutic regime in person with type 2 diabetes. Procedia-Social and Behavioral Sciences, 171, 350-358. https://doi.org/10.1016/j.sbspro.2015.01.132
• Arbuckle RA, Humprey L, Vardeva K, Arondekar B, Danten-Viala M, Scott JA, Snoek FJ. (2009) Psychometric evaluation of the diabetes symptom checklist revised (DSC-R)-A measure of symptom distress. Value in Health, 12 (8): 1168- 1175. https://doi.org/10.1111/j.1524-4733.2009.00571.
• Bayrak, G., & Çolak, R. (2012). Patient education in treatment of diabetes. Journal of Experimental and Clinical Medicine, 29(1s), 7-11. http://doi:10.5835/jecm.omu.29.s1.003
• Brar, B. K.,& Sethi, N. (2015). Skin manifestations of diabetes mellitus from dermatology OPD of a tertiary care Hospital of North India. Scholars Journal of Applied Medical Sciences (SJAMS), 3(8A):2786-2789.
• Brown, S. A.,García, A. A., Zuñiga, J. A., &Lewis, K. A. (2018). Effectiveness of work place diabetes prevention programs: A systematic review of the evidence. Patient education and counseling. 1036-1050. https://doi.org/10.1016/j.pec.2018.01.001
• Cooper, H. C., Booth, K., & Gill, G. (2003). Patients’ perspectives on diabetes health care education. Health education research, 18(2), 191-206. https://doi.org/10.1093/her/18.2.191
• Diabetes Care and Research in Europa: The St Vincent Decleration Action Programme 1989 and Istanbul commitment 1999. http://www.codex.vr.se/texts/SVD.pdf (date of access: 02.08.208)
• Erer, S., Bakar, M., Turan, F., Akgöz, S. (2007). Evaluation of cognitive functions in patients with diabetes mellitus by neuropsychological-neurophysiological tests. Turk J Neurol. 2007; 13(6): 400-408 Turkey
• Ejtahed, H. S.,Naslaji, A. N., Mirmiran, P., Yeganeh, M. Z., Hedayati, M., Azizi, F., & Movahedi, A. M. (2015). Effect of camel milk on blood sugar and lipid profile of patients with type 2 diabetes: a pilot clinical trial. International journal of endocrinology and metabolism, 13(1). Int J Endocrinol Metab. 2015 Jan; 13(1): e21160. https://doi: [10.5812/ijem.21160]
• Eroğlu, S. Ç., Şensoy, F., Beydağ, K. D., & Kıyak, M. (2014). Compliance with diabetic patients with diabetes and requirements of taking education. Procedia-Social and Behavioral Sciences, 152, 457-464. https://doi:10.1016/j.sbspro.2014.09.231
• Gonzalez, J. S.,Safren, S. A., Cagliero, E., Wexler, D. J., Delahanty, L., Wittenberg, E., Blaıs, M., Meigs, J.,& Grant, R. W. (2007). Depression, self-care, and medication adherence in type 2 diabetes: relationships across the full range of symptom severity. Diabetes care.1-14. https://doi.org/10.2337/dc07-0158
• Grillo, M. D. F. F.,Neumann, C. R., Scain, S. F., Rozeno, R. F., Gross, J. L., & Leitão, C. B. (2013). Effect of different types of self-management education in patients with diabetes. Revista da Associação Médica Brasileira, 59(4), 400-405. http://dx.doi.org/10.1016/j.ramb.2013.02.006
• İnkaya, B. V.,& Karadağ, E. (2016). Review of disease self-management strategies among diabetic individuals and their caretaker nurses: a qualitative study/Diyabetli bireyler ve onlara bakım veren hemşirelerin hastalık özyönetim stratejilerine bakışı: kalitatif bir çalışma." Journal of Education and Research in Nursing, 14(1), 31-37. https://doi:10.5222/HEAD.2017.031
• Karakurt, P., Aşılar, R. H., Yıldırım, A., & Sevinç, H. (2017). Knowledge levels and attitudes of diabetic patients about their disease European Journal of Therapeutics, 23: 165-172. https://doi: 10.5152/EurJTher.2017.67
• Lin, E. H.,Katon, W., VonKorff, M., Rutter, C., Simon, G. E., Oliver, M., ... &Young, B. (2004). Relationship of depression and diabetes self-care, medication adherence, and preventive care. Diabetes care, 27(9), 2154-2160. https://doi.org/10.2337/diacare.27.9.2154
• Mezuk, B.,Eaton, W. W., Albrecht, S., & Golden, S. H. (2008). Depression and type 2 diabetes over the lifespan: a meta-analysis. Diabetes care, 31(12), 2383-2390. https://doi.org/10.2337/dc08-0985
• Mollaoğlu, M.,& Beyazıt, E. (2009). Influence of diabetic education on patient metabolic control. Applied nursing research, 22(3), 183-190. https://doi.org/10.1016/j.apnr.2007.12.003
• Nathan, D. M., Buse, J. B., Davidson, M. B., Ferrannini, E., Holman, R. R., Sherwin, R., & Zinman, B. (2009). Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes care, 32(1), 193-203. https://doi:10.2337/dc08-9025
• Nicolucci, A. (2010). Epidemiological aspects of neoplasms in diabetes. Actadiabetologica, 47(2), 87-95. https://doi:10.1007/s00592-010-0187-3
• Norris, S. L.,Lau, J., Smith, S. J., Schmid, C. H., &Engelgau, M. M. (2002). Self-management education for adults with type 2 diabetes: a meta-analysis of theeffect on glycemiccontrol. Diabetes care, 25(7), 1159-1171. https://doi.org/10.2337/diacare.25.7.1159
• Olgun, N., Yakın, H., & Demir, H. G. (2011). Diagnosis And Risk Determination Of Diabetes Dealing With Diabetes. Turkish Family Physcian, 2(2), 36-44. Turkey
• Paterson, B.,&Thorne, S. (2000). Expert decision making in relation to unanticipated blood glucose levels. Research in Nursing & Health, 23(2), 147-157. https://doi.org/10.1002/(SICI)1098-240X(200004)23:2<147::AID-NUR7>3.0.CO;2-S
• Ridgeway, N. A.,Harvill, D. R., Harvill, L. M., Falin, T. M., Forester, G. M., &Gose, O. D. (1999). Improved control of type 2 diabetes mellitus: a practical education/ behavior modification program in a primary care clinic. Southern medical Journal, 92(7), 667-672. PMID:10414474
• Saatci, E.,Tahmiscioglu, G., Bozdemir, N., Akpinar, E., Ozcan, S., & Kurdak, H. (2010). The well-being and treatment satisfaction of diabetic patients in primary care. Health and quality of life outcomes, 8(1), 1-8. https://doi.org/10.1186/1477-7525-8-67
• Scain, S. F., Friedman, R., & Gross, J. L. (2009). A structured educational program improves metabolic control in patients with type 2 diabetes. The Diabetes Educator, 35(4), 603-611. https://doi:10.1177/0145721709336299
• Selvais, P. L.,Amoussou-Guenou, K. D., & Hermans, M. P. (2008). Belonging to a diabetes patients’ association is predictive of better metabolic control. Diabetes & metabolism, 34(3), 279-282. https://doi.org/10.1016/j.diabet.2008.01.006
• Sigurðardóttir, Á. K. (2005). Self‐care in diabetes: model of factor saffecting self‐care. Journal of clinical nursing, 14(3), 301-314. https://doi.org/10.1111/j.1365-2702.2004.01043.x
• Spann, S. J., Nutting, P. A., Galliher, J. M., Peterson, K. A., Pavlik, V. N., Dickinson, L. M., & Volk, R. J. (2006). Management of type 2 diabetes in the primary care setting: a practice-based research network study. The Annals of Family Medicine, 4(1), 23-31. https://doi:10.1370/afm.420.
• Sugüneş, T. (2013). Uluslararası Diyabet Liderler Zirvesi, SGK, https://www.diabetesforum.com/ (date of access: 10.08.208)
• Terkeş, N., Bektaş, H. (2016). Psychometric evaluation of the Diabetes Symptom Checklist–Revised in patients with type 2 diabetes in Turkey. Japan Journal of Nursing Science, 13, 273–283. https://doi:10.1111/jjns.12104
• Ünal, E., Akan, O., & Üçler, S. (2015). Diabetes and neurological diseases. Okmeydanı Medical Journal, 31, 45-51. https://doi:10.5222/otd.2015.045