TİP 1 DİYABETLİ ADÖLESAN BİREYLERDE UYKU KALİTESİ VE BESLENME DURUMU ARASINDAKİ İLİŞKİNİN BELİRLENMESİ

Yıl 2020, Cilt: 29 Sayı: 1, 7 - 13, 04.05.2020

Büşra Aslan , Mendane Saka

https://doi.org/10.34108/eujhs.572914

Cited By: 1

Öz

Amaç:
Bu çalışma Tip 1
diyabetli adölesanlarda uyku kalitesi ve beslenme durumu arasındaki ilişkinin
değerlendirilmesi amacıyla yapılmıştır.

Gereç
ve Yöntem: Çalışmaya,
Kasım 2018-Şubat 2019 tarihleri arasında Erciyes Üniversitesi pediatri endokrin
bölümüne başvuran 76 Tip 1 diyabetli adölesan dahil edilmiştir. Araştırmanın
verileri; anket formu, 3 günlük besin tüketim kaydı, Pittsburgh Uyku Kalitesi
İndeksi (PUKİ) ve Epworth Uykululuk Ölçeği kullanılarak toplanmıştır. Katılımcıların
beden kütle indeksi (BKİ), boy ve ağırlık ölçümü kullanılarak hesaplanmıştır. Hemoglobin
A1c (HbA1c), total kolesterol, yüksek dansiteli lipoprotein (HDL), düşük
dansiteli lipoprotein (LDL), trigliserid (TG) ve kan glukoz düzeyleri değerlendirilmiştir.

Bulgular: Çalışmaya katılan Tip 1 diyabetli adölesanların
%43,4’ü kız ve % 56,6’sı erkektir. Katılımcıların yaş ortalaması 14,88±2,16 yıldır. Adölesanların
%67,1’i normal BKİ’ye sahiptir. Pittsburgh uyku kalitesi indeksine göre Tip
1 diyabetli adölesanların %40,8’i kötü ve %59,2’si iyi uyku kalitesine sahiptir.
Kötü uyku kalitesine sahip
adölesanların iyi uyku kalitesine sahip olanlara göre yağ tüketimlerinin daha
yüksek olduğu belirlenmiştir (p=0.117). İyi uyku kalitesine sahip olan Tip 1
diyabetli adölesanların kötü uyku kalitesine sahip olanlara göre, daha uzun
süre uyuduğu (p=0.001) ve daha kısa sürede uykuya daldığı (p=0.000)
belirlenmiştir. İyi uyku
kalitesine sahip adölesanların HbA1c (p=0.238), total kolesterol (p=0.620), LDL
kolesterol (p=0.565), trigliserid (p=0.230) ve kan glukoz düzeyleri (p=0.238) kötü
uyku kalitesine sahip adölesanlardan daha düşüktür. Uyku süresi ile HbA1c
düzeyi (r=-0.254,
p=0.027), bazal metabolizma hızı (r=-0.234, p=0.042), fiziksel
aktivite faktörü (r=-0.241, p=0.036) ve günlük enerji harcaması (r=-0.261,
p=0.023) arasında negatif yönlü anlamlı zayıf
bir korelasyon saptanmıştır.

Sonuç: Tip 1 diyabetli
adölesanlarda uyku süresinin kısalması HbA1c’yi etkileyerek glisemik kontrolün
bozulmasına yol açabilir. Tip 1 diyabetli adölesanlarda beslenme ve insülin tedavisinin
yanı sıra uyku süresi ve kalitesi de metabolik kontrol üzerine olumlu etkiler
yapabilir.

Anahtar Kelimeler

Adölesan, beslenme, tip 1 diyabet, uyku kalitesi

Destekleyen Kurum

BAŞKENT ÜNİVERSİTESİ

Proje Numarası

KA18/327

Teşekkür

Verilerin toplanmasında destek olan başta Prof. Dr. Mustafa KENDİRCİ olmak üzere tüm Erciyes Üniversitesi Mustafa Eraslan ve Fevzi Mercan Çocuk Hastanesi Endokrinoloji Bilim Dalı ekibine teşekkürlerimizi sunarız.

DETERMINATION OF THE RELATIONSHIP BETWEEN SLEEP QUALITY AND NUTRITIONAL STATUS IN ADOLESCENTS WITH TYPE 1 DIABETES

Öz

Aim: This study was carried out to
investigate the relationship between sleep quality and nutritional status in
adolescents with Type 1 diabetes.

Subjects
and Methods: 76 adolescent
with type 1 diabetes who consulted Erciyes University department of pediatric
endocrine between November 2018 and February in 2019 were included in the
study. The data were collected by using questionnaire, three-day nutrient
consumption record, Pittsburgh Sleep Quality Scale (PSQI) and Epworth
Sleepiness Scale.

Results:
40.8% of
adolescents with type 1 diabetes have poor sleep quality. It was determined
that adolescents with poor sleep quality consumed higher amounts of fat than
those with good sleep quality (p>0.05). It was found that adolescents with
Type 1 diabetes who had good sleep quality were sleeping longer and fell asleep
in less time than those with poor sleep quality (p<0.05). HbA1C, total
cholesterol, LDL cholesterol, triglycerides and blood glucose levels of
adolescents with good sleep quality were lower than adolescents with poor sleep
quality (p>005). A significant negative correlation was found between sleep
duration and HbA1c level, basal metabolic rate, physical activity factor and
daily energy expenditure (p<0.05).

Conclusions:
Sleep duration in
adolescents with type 1 diabetes may affect HbA1c and lead to impaired glycemic
control. In adolescents with type 1 diabetes, sleep time and sleep quality
should also be considered, as well as nutrition and insulin therapy.

Anahtar Kelimeler

Adolescent, nutrition, sleep quality, type 1 diabetes

Proje Numarası

KA18/327

Kaynakça

• International Diabetes Federation Diabetes Atlas (8 th ed); 2017.
• Tascini G, Berioli MG, Cerquiglini L, et al. Carbohydrate Counting in Children and Adolescents with Type 1 Diabetes. Nutrients 2018; 10(1):1-11.
• Smart CE, Annan F, Higgins LA, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Nutritional management in children and adolescents with diabetes. Pediatr Diabetes 2018; Supply 27:115-135.
• Paruthi S, Brooks LJ, D’Ambrosio C, et al. Recommended Amount of Sleep for Pediatric Populations: A Consensus Statement of the American Academy of Sleep Medicine. J Clin Sleep Med 2016; 12(6):785-786.
• Brooks DM, Brooks LJ. Interactions between sleep, sleep difficulties, and quality of life. J Clin Sleep Med 2019; 15(4):541-542.
• Barone MT, Menna-Barreto L. Diabetes and sleep: a complex cause-and-effect relationship. Diabetes Research and Clinical Practice 2011; 91(2):129-137.
• Rafalson L, Donahue RP, Stranges S, et al. Short sleep duration is associated with the development of impaired fasting glucose: the Western New York Health Study. Ann Epidemiol 2010; 20(12):883-889.
• Farabi SS, Carley DW, Quinn L. EEG power and glucose fluctuations are coupled during sleep in young adults with type 1 diabetes. Clin Neurophysiol 2016; 127(8):2739-2746.
• WHO. Growth reference data for 5-19 years; 2007. Erişim Tarihi:2018, https://www.who.int/childgrowth/en/.
• Buysse DJ, Reynolds CF, Monk TH, et al. The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Res 1989; 28(2):193-213.
• Ağargün YM, Kara H, Anlar Ö. Pittsburg Uyku Kalitesi İndeksi’nin geçerliliği ve güvenirliği. Türk Psikiyatri Dergisi 1996; 7(2):107-111.
• Johns MW. A New Method for Measuring Daytime Sleepiness: The Epworth Sleepiness Scale. Sleep 1991; 14(6):540-545.
• Ağargün MY, Çilli AS, Kara H, ve ark. Epworth Uykululuk Ölçeğinin Geçerliği ve güvenirliği. Türk Psikiyatri Dergisi 1999; 10(4):261-267.
• Frye SS, Perfect MM, Silva GE. Diabetes management mediates the association between sleep duration and glycemic control in youth with type 1 diabetes mellitus. Sleep Med 2019; 1389-9457(18)30417-9.
• Steck AK, Rewers MJ. Genetics of Type 1 Diabetes. Clin Chem 2011; 57(2):176-185.
• Patton SR. Adherence to Diet in Youth with Type 1 Diabetes. J Am Diet Assoc 2011; 111(4):550-5.
• T.C. Sağlık Bakanlığı Türkiye Beslenme Rehberi 2015 (TÜBER). Ankara, 2016.
• Helgeson VS, Viccaro L, Becker D, et al. Diet of adolescents with and without diabetes: Trading candy for potato chips?. Diabetes Care 2006; 29(5):982-7.
• Lodefalk M, Aman J. Food habits, energy and nutrient intake in adolescents with Type 1 diabetes mellitus. Diabet Med 2006; 23(11):1225-32.
• Faulkner MS, Chao WH, Kamath SK, et al. Total homocysteine, diet, and lipid profiles in type 1 and type 2 diabetic and nondiabetic adolescents. J Cardivasc Nurs 2006; 21(01):47-55.
• Wilson MA, Smith CB. Nutrient intake, glycemic control, and body mass index in adolescents using continuous subcutaneous insulin infusion and those using traditional insulin therapy. Diabetes Educ 2003; 29(2):230-238.
• Mackey ER, O'Brecht L, Holmes CS, et al. Teens with Type 1 Diabetes: How Does Their Nutrition Measure Up?. J Diabetes Res 2018; 5094569.
• Wiltshire EJ, Hirte C, Couper JJ. Dietary Fats Do Not Contribute to Hyperlipidemia in Children and Adolescents With Type 1 Diabetes. Diabetes Care 2003; 26(5):1356-1361.
• Gezmen Karadağ M, Aksoy M. Uyku regülasyonu ve beslenme. Göztepe Tıp Dergisi 2009; 24(1):9-15.
• Frank S, Gonzalez K, Lee-Ang L, et al. Diet and Sleep Physiology: Public Health and Clinical Implications. Front Neurol 2017; 8:393.
• St-Onge MP, Mikic A, Pietrolungo CE. Effects of Diet on Sleep Quality. Adv Nutr 2016; 7(5):938-49.
• Monzon A, McDonough R, Meltzer LJ, et al. Sleep and type 1 diabetes in children and adolescents: Proposed theoretical model and clinical implications. Pediatr Diabetes 2019; 20(1):78-85.
• Von Schnurbein J, Boettcher C, Brandt S, et al. Sleep and glycemic control in adolescents with type 1 diabetes. Pediatr Diabetes 2018; 19(1):143-149.
• Perfect MM, Patel PG, Scott RE, et al. Sleep, Glucose, and Daytime Functioning in Youth with Type 1 Diabetes. Sleep 2012; 35(1):81-88.
• Adler A, Gavan MY, Tauman R, et al. Do children, adolescents, and young adults with type 1 diabetes have increased prevalence of sleep disorders?. Pediatr Diabetes 2017; 18(6):450-458.
• Borel AL, Pepin JL, Nasse L, et al. Short sleep duration measured by wrist actimetry is associated with deteriorated glycemic control in type 1 diabetes. Diabetes Care 2013; 36(10):2902-2908.
• Patel NJ, Salvin KL, Kahanda SN, et al. Sleep habits in adolescents with type 1 diabetes: Variability in sleep duration linked with glycemic control. Pediatric Diabetes 2018; 19:1100-1106.
• Koren D, Levitt Katz LE, Brar PC, et al. Sleep architecture and glucose and insulin homeostasis in obese adolescents. Diabetes Care 2011; 34(11): 2442-7.