Tip 2 Diyabette Psikolojik İnsülin Direnci ve Tükenmişlik: Hasta Merkezli Eğitime Rehberlik Eden Çok Değişkenli Bir Analiz

Abstract

Amaç: Bu araştırma, tip 2 diyabetli bireylerde psikolojik insülin direnci ile diyabet tükenmişliği arasındaki ilişkiyi araştırmak ve çok değişkenli modeller aracılığıyla tükenmişliği öngören demografik, klinik ve davranışsal değişkenleri belirlemek amacıyla yürütülmüştür. Araştırma, hasta merkezli eğitim stratejilerine katkıda bulunmayı amaçlamaktadır.

Gereç ve Yöntemler: Araştırmanın evrenini, Mersin Üniversitesi Hastanesi’nde en az altı aydır tip 2 diyabet tanısı ile takip edilen erişkin yatan hastalar oluşturmakta olup, bu kesitsel araştırmaya tip 2 diyabet tanısı almış 177 birey katılmıştır. Veriler, Mersin Üniversitesi Hastanesi’nin Dahiliye Servisleri’nden 24 Mart ve 26 Temmuz 2025 tarihleri arasında toplanmıştır. Katılımcılarla Psikolojik İnsülin Direnci Ölçeği ve Diyabet Tükenmişliği Ölçeği kullanılarak görüşmeler yapılmıştır. Veriler korelasyon analizleri, t-testleri, ANOVA ve hiyerarşik regresyon analizleri kullanılarak analiz edilmiştir.

Bulgular: Psikolojik insülin direnci ile diyabet tükenmişliği arasında güçlü ve anlamlı bir ilişki bulunmuştur (r=0,726, p<0,001). Psikolojik insülin direnci, tükenmişliğin en güçlü yordayıcısı olarak belirlenmiştir (β=0,357, p<0,001). Yaş (β=-0,211, p=0,006), eşlik eden kronik bir hastalığın varlığı (β=0,115, p=0,038) ve diyabet eğitimi (β=-0,108, p=0,041) da anlamlı etkiler göstermiştir.

Sonuç: Diyabet tükenmişliği çok boyutlu bir yapıya sahip olsa da, psikolojik insülin direnci önemli bir belirleyici olarak öne çıkmaktadır. Diyabet yönetimindeki psikolojik engellerin değerlendirilmesi ve bireyselleştirilmiş müdahale stratejilerinin geliştirilmesi klinik öneme sahiptir. Sonuçlar, psikolojik değerlendirmelerin diyabet bakımına entegre edilmesinin gerekliliğini vurgulamaktadır.

Keywords

• Tip 2 diyabet
• psikolojik insülin direnci
• diyabet tükenmişliği
• hastaların eğitimi
• sağlık iletişimi

Psychological Insulin Resistance and Diabetes Burnout: A Multivariate Study to Inform Patient-Centered Education Strategies

Abstract

Aim: This study was conducted to investigate the relationship between psychological insulin resistance and diabetes burnout in individuals with type 2 diabetes and to identify demographic, clinical and behavioural variables that predict burnout through multivariate models. The study aims to contribute to patient-centred education strategies.

Material and Methods: The study population consisted of adult inpatients diagnosed with type 2 diabetes who had been followed at Mersin University Hospital for at least six months. 177 individuals diagnosed with type 2 diabetes participated in this cross-sectional study. Data were collected from the Internal Medicine Department of Mersin University Hospital between March 24 and July 26, 2025. The data were analysed using correlation analyses, t-tests, ANOVA and hierarchical regression analyses.

Results: A strong and significant association was found between psychological insulin resistance and diabetes burnout (r=0.726, p<0.001). Psychological insulin resistance was identified as the strongest predictor of burnout (β=0.357, p<0.001). Age (β=-0.211, p=0.006), the presence of a comorbid chronic disease (β=0.115, p=0.038) and diabetes education (β=-0.108, p=0.041) also showed significant effects.

Conclusion: While diabetes burnout has a multidimensional structure, psychological insulin resistance stands out as a key determinant. The assessment of psychological barriers to diabetes management and the development of individualised intervention strategies are of clinical importance. The results emphasise the need to integrate psychological assessments into diabetes care.

Keywords

• Diabetes mellitus
• Type 2
• psychological insulin resistance
• diabetes burnout
• education of patients
• health communication

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