Tı̇p 1 Dı̇yabetlı̇ Ergenlerde Glı̇semı̇k Kontrolün Yordayıcıları Olarak Uyku Bozukluğu ve Hı̇poglı̇semı̇ Korkusu

Öz

Amaç: Bu çalışmanın amacı, T1DM’li ergenlerde uyku bozukluğu ve hipoglisemi korkusunun glisemik kontrolü yordama düzeylerinin belirlenmesidir. Yöntem: Çalışma, 2024-2025 yılları arasında bir üniversite hastanesinin Çocuk Endokrinoloji Polikliniği’nde takip edilen 12-17 yaş arası 114 T1DM’li ergen ile yapılmıştır. Etik kurul, kurum, ergen ve ebeveyn izni alınarak yapılan bu çalışmada veriler Ergen tanıtıcı özellikler formu, Virginia Üniversitesi Çocuk/Ergen Düşük Kan Şekeri Ölçeği ve DSM-5 Düzey 2 Uyku Bozukluğu Ölçeği ile toplanmıştır. Çalışmanın verileri Jamovi 2.6.13 paket programı kullanılarak değerlendirilmiştir. Uyku bozukluğu ile hipoglisemi korkusunun glisemik kontrolü yordama düzeyi ise iki aşamalı Hiyerarşik Çoklu Doğrusal Regresyon analizi ile değerlendirilmiştir. Bulgular: Araştırmada T1DM’li ergenlerin total DKŞÖ ve UBÖ puan ortalamalarının sırasıyla 57,68±10,64 ve 22,86±3,25 olduğu belirlenmiştir. Yapılan iki aşamalı hiyerarşik regresyon analizi sonucunda, Model I’ de hipoglisemi korkusunun glisemik kontrolün %33,6’sını açıkladığı, Model II’ de ise hipoglisemi korkusu ile uyku bozukluğunun birlikte glisemik kontrolün %47,2’sini açıkladığı ve modellerin istatistiksel olarak önemli olduğu belirlenmiştir (p≤ 0,001). Sonuç: T1DM’li ergenlerde hipoglisemi korkusu ile uyku bozukluğu’nun glisemik kontrolün yordayıcıları olduğu saptanmıştır. Hemşireler, hipoglisemi korkusunu azaltmak için ergenlere ve ailelerine yönelik eğitim programları geliştirilmeli, hipoglisemi semptomlarının tanınması ve glukoz izlem teknolojilerinin etkin kullanımı hakkında rehberlik sağlamalıdır. Ayrıca, uyku bozukluğunun glisemik kontrol üzerindeki olumsuz etkisi, hemşirelerin uyku hijyeni konusunda danışmanlık yapmasını ve uyku kalitesini değerlendiren araçlar kullanmasını gerektirir. Ergen odaklı bir yaklaşım benimsenerek, motivasyonel görüşme teknikleri ve psikososyal destekle öz-yönetim becerileri güçlendirilmelidir. Hemşireler, multidisipliner iş birliği içinde çalışarak, hipoglisemi korkusu ve uyku bozukluğuna yönelik erken müdahaleler planlamalıdır.

Anahtar Kelimeler

• Ergen
• Glisemik Kontrol
• Hipoglisemi Korkusu
• Tip 1 Diyabet
• Uyku Bozukluğu

Sleep Disturbance and Fear of Hypoglycemia as Predictors of Glycemic Control in Adolescents with Type 1 Diabetes

Öz

Aim: This study aimed to determine the predictive levels of sleep disturbance and fear of hypoglycemia for glycemic control in adolescents with T1DM. Methods: The study was conducted with 114 adolescents aged 12-17 years with T1DM who were followed up in the Pediatric Endocrinology Outpatient Clinic of a university hospital between 2024-2025. Ethics committee, institutional, adolescent and parental permissions were obtained, and data were collected using the Adolescent Descriptive Characteristics Form, The University of Virginia Child/Teen Low Blood Sugar Survey and DSM-5 Level 2 Sleep Disorder Scale. The data of the study were evaluated using the Jamovi 2.6.13 software package. The level of predicting glycemic control by sleep disorder and fear of hypoglycemia was evaluated using a two-step Hierarchical Multiple Linear Regression analysis. Results: The study, it was determined that the mean scores of the children with T1DM were 57,68±10,64 and 22,86±3,25, respectively. As a result of the two-stage hierarchical regression analysis, it was determined that fear of hypoglycemia explained 33,6% of glycemic control in Model I, fear of hypoglycemia and sleep disturbance together explained 47,2% of glycemic control in Model II and the models were statistically significant (p≤ 0,001). Conclusions: In adolescents with T1DM, it has been determined that fear of hypoglycemia and sleep disturbances are predictors of glycemic control. Nurses should develop educational programs for adolescents and their families to reduce the fear of hypoglycemia, provide guidance on recognizing hypoglycemia symptoms, and ensure the effective use of glucose monitoring technologies. Additionally, the negative impact of sleep disorders on glycemic control requires nurses to provide counseling on sleep hygiene and use tools to assess sleep quality. An adolescent-focused approach should be adopted, and self-management skills should be strengthened through motivational interviewing techniques and psychosocial support. Nurses should work in multidisciplinary collaboration to plan early interventions for hypoglycemia anxiety and sleep disorders.

Anahtar Kelimeler

• Adolescent
• Fear of Hypoglycemia
• Glycemic Control
• Sleep Disorder
• Type 1 Diabetes

Kaynakça

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