21. Yüzyılın Sağlık Krizi: Diyabet

Yıl 2009, Cilt: 17 Sayı: 2, 115 - 122, 17.09.2014

Gülhan Coşansu

Öz

Diyabet yaflad›¤›m›z yüzy›l›n en ciddi sa¤l›k sorunlar›ndan biridir. Dünyada ortalama her 100 eriflkinden alt›s›n›n diyabetli
oldu¤u tahmin edilmektedir. 2007 y›l›n›n bafl›nda 230 milyonun üzerinde olan diyabetli say›s›n›n 2025 y›l›nda 380
milyona ulaflmas› beklenmektedir. Dünya üzerinde yaklafl›k her 10 saniyede 1 kifli, y›lda yaklafl›k 3.8 milyon kifli diyabete
ba¤l› nedenlerle yaflam›n› kaybetmektedir. Diyabetin ve komplikasyonlar›n›n tedavisi ve rehabilitasyonu için harcanan
para hem bireyler, hem de sa¤l›k bak›m sistemleri için ciddi boyutlardad›r. Oysa yüksek diyabet riski tafl›yan bireylerde
yaflam tarz› de¤ifliklikleri ile diyabetin büyük ölçüde önlenebildi¤i ya da bafllamas›n›n geciktirilebildi¤i belirtilmektedir.
Diyabette birincil koruma diyabet geliflimini önlemek, diyabet risk faktörlerinin say›s›n› azaltmak amac› ile yap›lan
e¤itim ve yaflam tarz› de¤iflikliklerini, ikincil koruma erken tan› ve tedavi uygulamalar›n› kapsar. Hemflireler diyabetle
mücadelede kilit konumda olmalar›na karfl›n yeterince etkin olamamaktad›rlar. Hemflirelerin yan›s›ra, di¤er sa¤l›k
çal›flanlar›n›n ve politikac›lar›n diyabetin önlenmesi ve erken tan›s› için daha fazla çaba harcamas› gereklidir.
Anahtar Kelimeler: Diyabet, birincil koruma, yaflam tarz›, tarama, kan›ta dayal› öneri.

Anahtar Kelimeler

Diyabet, birincil koruma, yaşam tarzı, tarama, kanıta dayalı öneri

Kaynakça

• medical care in diabetes- 2008. Diabetes Care, 31: 12-54. American Diabetes Association (ADA) (2008b). Diagonosis and classification of diabetes mellitus. Diabetes Care, 31: 55-60.
• American Diabetes Association (ADA) (2008c). Nutrition Reccomentation and interventions for diabetes. Diabetes Care, 31: 61-78.
• Centers for Disease Control and Prevention (CDC) (2008). Diabetes Projects, http://www.cdc.gov/diabetes/projects/cda2.htm (06.04.2008).
• Diabetes Atlas (2003). Second Ed. Elektronic version. International Diabetes Federation. http://www.eatlas.idf.org/(30.03.2008) Diabetes Prevention Program Research Group (DPPRG 2002).
• Reduction in the incidance of type 2 diabetes with lifestyle intervention or metformin. N. Engl. J. Med, 344(6): 393-403.
• Disease Control Priorities Project (DCPP) (2006). The Growing Diabetes Pandemic, www.dcp2.org/file/65/DCPP-Diabetes.pdf (01.04.2007).
• Erefe, ‹. (1998). Halk sa¤l›¤› hemflireli¤ine girifl. Erefe. ‹. (Ed.). Halk Sa¤l›¤› Hemflireli¤i El Kitab›. Vehbi Koç Vakf› yay›nlar›, Birlik Ofset, ‹stanbul.
• Gruber, A. ve ark (2006). Diabetes prevention: Is there more to it than lifestyle changes? Int J Clin. Pract, 60(5): 590-594
• Hjelm, K. ve ark (2003). Preparing nurses to face the pandemic of diabetes mellitus: A literature review. Journal of Advanced Nursing, 41(5): 424-434.
• Howard, J. R., Williamson, K. M. (1990). Community Health Nursing. Springhouse Co., Pennsylvania.
• Hussain, A., Claussen, B., Ramachandran, A., Williams, R. (2007). Prevention of type 2 diabetes: A review. Diab. Res. Clin. Pract., 76( 3): 317-326.
• International Diabetes Federation (IDF) (2005). Screening and diognosis in Global Guideline for Type 2 Diabetes, Brussels. http://www.idf.org/home/index.cfm?node=1457 (01.04.2008).
• International Diabetes Federation (IDF) (2008). Diabetes Facts and Figures. http://www.idf.org/home/index.cfm?node=6 (28.03.2008).
• King, H., Aubert, R. E., Herman, W. H. (1998). Global burden of diabetes, 1995-2025: Prevalence, numerical estimates, and projections. Diabetes Care, 21(9): 1414-1431.
• Kulbok, P. A., Laffrey, S. C., Geoppinger, J. (2004). Integrating multilevel approaches to promote community health.
• Stanhope, M., Lancester, J. (Eds.) In Community & Public Health Nursing. Sixth Ed., Mosby, St Louis.
• Lauritzen, T., Borch-Johnsen, K., Sandboek, A. (2007). Is prevention of type-2 diabetes feasible and efficient in primary care? A systematic PubMed review. Primary Care Diabetes, 1: 5-11.
• Naser, K. A., Gruber, A., Thamson, G. A. (2006). The emerging pandemic of obesity and diabetes: Are we doing enough to prevent a disaster? Int J Clin. Pract , 60(9): 1093- 1097.
• Özcan, fi. (1999). Diyabetli Hastalarda Hastal›¤a Uyumu Etkileyen Faktörlerin De¤erlendirilmesi. ‹stanbul Üniversitesi Sa¤l›k Bilimleri Enstitüsü Yay›nlanmam›fl Doktora Tezi, ‹stanbul. Pan, X. R. ve ark (1997). Effects of diet and exercise in prevention NIDDM in people with impaired glucose tolerance. Diabetes Care, 20(4): 537-544.
• Population Health Promotion Practice in the Primary Prevention of Type 2 Diabetes (1999). Echo Valley Centre, Fort Qu’Appella, Saskatchewan Health, Canada. www.health.gov.sk.ca/ type2- diabetes-prevention
• Riccardi, G., Giacco, R., Parillo, M. (2003). Lifestyle modification to prevent type 2 diabetes. ‹nternational Congress Series, 1253: 231-236.
• Satman, ‹. ve ark (2002). Risk characteristics in Turkey Results of the Turkish Diabetes Epidemiology Study (TURDEP). Diabetes Care, 25: 1551–1556.
• Tuomilehto, J. ve ark (2001). Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N. Engl. J. Med, 344(18): 1343-1350.
• United Nations General Assembly 61/225 World Diabetes Day (2006) http://www.un.org/depts/dhl/resguide/r61.htm (Eriflim Tarihi: 09.02.2007)
• Whittemore, R. ve ark (2003). Promoting lifestyle change in the prevention and management of type 2 diabetes. Journal of the American Academy of Nurse Practitioners, 15(8): 341- 349.
• Wild, S., Roglic, G., Gren, A., Sicree, R., King, H. (2004) Global Prevalance of diabetes estimates for the year 2000 and projection for 2030. Diabetes Care , 27(5): 1047-1053.
• Williams, R. ve ark (2004). The prevention of tyep 2 diabetes: general practitioner and practice nurse opinions. British Journal of General Practice, 54: 531-535.
• World Diabetes Foundation (WDF) (2008). Diabetes Facts, www.worlddiabetesfoundation.org (29.03.2008).
• World Health Organization (WHO) (1994). Prevention of diabetes mellitus. Report of a WHO Study Group Technical Report Series No: 844, Geneva.
• World Health Organization (WHO) (2008a). Prevalence of diabetes in the WHO European Region. http://www.who.int/diabetes/facts/world_figures/en/index4.html
• World Health Organization (WHO) (2008b). Diabetes Fact Sheet No.312, http://www.who.int/mediacentre/factsheets/fs312/en/ (01.04.2008)
• World Health Organization and International Diabetes Federation (WHO&IDF) (2003). Screening for Type 2 Diabetes Refort of World Health Organization and International Diabetes Federation meeting . World Health Organization Department of Noncommunicable Disease Management, Geneva.
• Yamaoka, K., Tango, T. (2005). Efficacy of lifestyle education to prevent Type 2 Diabetes: A meta-analysis of randomized controlled trials. Diabetes Care, 28(11): 2780-2786.
• Zimmet, P. (2000). Globalization, coca-colanization and the chronic disease epidemic: Can the Doomsday screnio be averted? J. ‹ntern. Med, 247(3): 301-310.