Tip 2 diyabetes mellitus hastalarında insülin tedavisine geç başlama

Year 2020, , 685 - 688, 01.08.2020

Semih Kalyon , Perihan Özkan Gümüşkaya Neslihan Özsoy Mustafa Özcan Ayşe Pala Ayşe Basmakçı Yücel Arman , Tufan Tükek

https://doi.org/10.28982/josam.776346

Abstract

Amaç: Diabetes mellitus hastalarında gerekmesine rağmen insülin başlatılmasıyla ilgili birçok sorun vardır. Bu çalışmanın amacı hastaların niçin zamanında insülin tedavilerini alamadıklarını saptamak ve bu sorunlara değinmektir.
Yöntemler: Tek merkezde kesitsel yapılan bu çalışma için etik kurul’dan izin ve gönüllülerden onam alındı. 18 yaşından büyük, tip 2 diyabetes mellituslu hastalar çalışmaya dahil edildi. Hamileler, 18 yaşından küçükler, dekompanse karaciğer hastalığı olanlar, psikiyatrik bozukluğu olanlar, Tip 1 diyabeti olanlar çalışmaya alınmadı. Veri toplanması için anket kullanıldı. İstatistiksel analiz SPSS 18.0'da yapıldı.
Bulgular: Toplam 1062 hasta çalışmaya alındı. Hastaların %34’ü regüle idi. İnsülin kullanması gerektiği halde kullanmayan hasta sayısı 105’di. 105 hastadan 34 hastaya hekimler hiç insülin tedavisi önermemişken 33 hasta enjeksiyon korkusu nedeniyle insülin istememiş ve 32 hasta ise insülin hakkında yanlış bilgileri olduğu için insülin kullanmaya başlamamıştı. İnsülin kullanırken insülin tedavisine son veren 36 hasta sorgulandığında 8 hastanın insülin tedavisi hekimleri tarafından durdurulmuştu. Kalan 28 hasta ise insülin tedavilerini en sık enjeksiyon zorluğu ve insülin hakkında duyduğu yanlış bilgiler nedeni ile kendileri bırakmıştı.
Sonuçlar: Hasta hekim diyalogunu artıran poliklinik şartlarının sağlanması, enjeksiyon kaleminin ve iğnesinin bizzat hasta tarafından görülüp denenmesi, yanlış bilgi edinilmesinden kaçınmak için hastalara ve doktorlara yönelik konferanslar diyabetes mellitus’ta insülinin geç başlanmasına çözüm olabilir.

Keywords

Diyabetes Mellitus, İnsülin, Erken tedavi

Delay in starting insulin therapy in patients with type 2 Diabetes Mellitus

Abstract

Aim: There are many problems with insulin initiation though required in diabetes mellitus patients. This study aims to determine why patients are unable to receive insulin treatments on time.
Methods: Approval from the ethics committee and consent from the volunteers was obtained for this cross sectional, single center study, in which patients with type 2 diabetes mellitus over the age of 18 years were included. Pregnant women, patients with cirrhosis, and psychiatric disorders were excluded. A questionnaire was used for data collection. Statistical analysis was performed with SPSS 18.0.
Results: A total of 1062 patients were included in this study. Diabetes mellitus was regulated in 34% of the patients. The number of patients who did not use insulin even though they should was 105. While physicians did not recommend any insulin treatment to 34 patients, 33 patients did not want insulin treatment due to fear of injection and 32 patients did not start insulin treatment because they had incorrect information regarding insulin. When 36 patients who stopped insulin treatment while they were using were questioned for the reason, it was learnt that 8 patients' insulin treatment was stopped by their physicians. The remaining 28 patients, on the other hand, stopped their insulin treatments most frequently because of the difficulty of injection and incorrect information they heard about insulin.
Conclusions: Providing outpatient conditions that increase patient-physician dialogue, ensuring that the injection pen and needle are seen and tested by the patient in person, and conferences for the patients and medical doctors to prevent getting the incorrect information would be the solution of the delay in starting insulin in diabetes mellitus.

Keywords

Diabetes Mellitus, Insulin, Early Treatment

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