Tip 1 diyabetli adölesanlarda diyabete bağlı stresin diyabet takibi üzerindeki etkileri

Yıl 2025, Cilt: 50 Sayı: 4, 972 - 982, 22.12.2025

Basak Ceren Arslan , Emine Demet Akbaş , Asena Ünal , Seda Bozduman Çelebi , Orkun Tolunay

https://doi.org/10.17826/cumj.1720329

https://izlik.org/JA86CN34XB

Öz

Amaç: Bu çalışmanın amacı, Pediatrik Endokrinoloji polikliniğinde takip edilen tip 1 diabetes mellitus (T1DM) hastası ergenlerde diyabetle ilişkili sıkıntıların (DRD) diyabet yönetimine etkilerini değerlendirmektir.
Gereç ve Yöntem: Şubat 2021–Şubat 2022 döneminde Adana Şehir Eğitim ve Araştırma Hastanesi’nde yürütülen kesitsel çalışmada, ardışık T1DM’li adölesanlar dâhil edildi (N=124). DRD, klinisyen tarafından uygulanan Diyabet Stres Ölçeği (DDS-17) ile ölçüldü; katılımcılar Grup 1 (madde ortalaması <2; düşük/hiç sıkıntı) veya Grup 2 (≥2; klinik olarak anlamlı sıkıntı) olarak sınıflandırıldı. Birincil sonlanımlar HbA1c, hastaneye yatış sayısı ve düzenli SMBG idi (çalışma-içi operasyonel eşik: günde ≥4 kapiller ölçüm).
Bulgular: T1DM’li 124 adölesanın 27’si (%21,8) Grup 1, 97’si (%78,2) Grup 2’de yer aldı. Grup 2, Grup 1’e kıyasla daha yüksek ortalama HbA1c (%8,51±1,17’ye karşı %9,22±1,72), daha fazla hastaneye yatış (1,15±0,95’e karşı 2,04±1,40) ve daha az düzenli SMBG (%63,0’a karşı %39,2) ile karakterizeydi. Sürekli analizlerde HbA1c, DDS-17 toplam puanı ile ve Duygusal Yük, Rejimle İlişkili Sıkıntı ve Kişilerarası Sıkıntı alt boyutlarıyla pozitif orelasyon gösterdi.
Sonuç: Klinik olarak anlamlı DRD, T1DM’li adölesanlarda oldukça yaygındır ve daha yüksek ortalama HbA1c, daha fazla hastaneye yatış ve daha az düzenli SMBG ile ilişkilidir. Bu bulgular, duygusal yük ve günlük tedavi gerekliliklerini hedefleyen rutin DRD taraması ve odaklı psikososyal müdahalelerin uygulanmasını desteklemektedir.

Anahtar Kelimeler

Diyabete Bağlı Stres , Adölesan , HbA1c , Diyabet Stres Ölçeği (DDS-17) , Tip 1 Diabetes Mellitus

Etik Beyan

Çalışma, Adana Şehir Eğitim ve Araştırma Hastanesi Klinik Araştırmalar Etik Kurulu tarafından onaylanmıştır (Tarih: 13.01.2021, Toplantı No: 74, Karar No: 1253). Çalışma öncesinde hem hastalardan hem de ailelerinden yazılı onam alınmıştır. Araştırma, Helsinki Bildirgesi’nde belirtilen etik ilkeler doğrultusunda yürütülmüştür. Katılımcıların mahremiyetini korumak amacıyla tüm veriler anonimleştirilmiştir.

Effects of diabetes-related distress on diabetes follow-up in adolescents with type 1 diabetes mellitus

https://izlik.org/JA86CN34XB

Öz

urpose: The aim of this study was to evaluate the effects of diabetes-related distress (DRD) on diabetes management in adolescents with type 1 diabetes mellitus (T1DM) followed in the Pediatric Endocrinology outpatient clinic.
Materials and Methods: Cross-sectional study at Adana City Training and Research Hospital (February 2021–February 2022) of consecutive adolescents with T1DM (N=124). DRD was measured with the clinician-administered Diabetes Distress Scale (DDS-17); participants were classified as Group 1 (mean item score <2; little/no distress) or Group 2 (≥2; clinically significant distress). Primary outcomes were HbA1c, number of hospitalizations, and regular SMBG (study-defined operational cutoff: ≥4 capillary checks/day).
Results: Among 124 adolescents with T1DM, 27 (21.8%) were in Group 1 and 97 (78.2%) in Group 2. Compared with Group 1, Group 2 had higher mean HbA1c (8.51±1.17% vs 9.22±1.72%), more hospitalizations (1.15±0.95 vs 2.04±1.40) and less regular SMBG (63.0% vs 39.2%). In continuous analyses, HbA1c correlated positively with the DDS-17 total score and with the Emotional Burden, Regimen-Related Distress and Interpersonal Distress subscales.
Conclusion: Clinically significant DRD is common in adolescents with T1DM and is associated with higher average HbA1c, greater hospitalization burden and less regular self-monitoring of blood glucose. These findings support routine DRD screening alongside targeted psychosocial interventions that address emotional burden and day-to-day regimen demands.

Anahtar Kelimeler

Diabetes-Related Distress , Adolescent , HbA1c , Diabetes Distress Scale (DDS-17) , Type 1 Diabetes Mellitus

Etik Beyan

The study was approved by the Adana City Training and Research Hospital Clinical Research Ethics Committee (Date: 13.01.2021, Meeting Number: 74, Decision No: 1253). Informed consent was obtained from both the patients and their families prior to participation. The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. All data were anonymized to ensure participant confidentiality.

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