<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.4 20241031//EN"
        "https://jats.nlm.nih.gov/publishing/1.4/JATS-journalpublishing1-4.dtd">
<article  article-type="research-article"        dtd-version="1.4">
            <front>

                <journal-meta>
                                                                <journal-id>turk j diab obes</journal-id>
            <journal-title-group>
                                                                                    <journal-title>Turkish Journal of Diabetes and Obesity</journal-title>
            </journal-title-group>
                            <issn pub-type="ppub">2587-0335</issn>
                                        <issn pub-type="epub">2587-0572</issn>
                                                                                            <publisher>
                    <publisher-name>Zonguldak Bülent Ecevit Üniversitesi</publisher-name>
                </publisher>
                    </journal-meta>
                <article-meta>
                                        <article-id/>
                                                                <article-categories>
                                            <subj-group  xml:lang="en">
                                                            <subject>​Internal Diseases</subject>
                                                    </subj-group>
                                            <subj-group  xml:lang="tr">
                                                            <subject>İç Hastalıkları</subject>
                                                    </subj-group>
                                    </article-categories>
                                                                                                                                                        <title-group>
                                                                                                                        <article-title>Investigation of the Relationship between the Barriers and Self-Care Behaviors in the Process of Insulin Therapy in Type 2 Diabetes</article-title>
                                                                                                                                                                                                <trans-title-group xml:lang="tr">
                                    <trans-title>Tip 2 Diyabetli Bireylerin İnsülin Tedavi Sürecinde Yaşadıkları Engeller ve Öz Bakım Davranışları Arasındaki İlişkinin İncelenmesi</trans-title>
                                </trans-title-group>
                                                                                                    </title-group>
            
                                                    <contrib-group content-type="authors">
                                                                        <contrib contrib-type="author">
                                                                    <contrib-id contrib-id-type="orcid">
                                        https://orcid.org/0009-0009-5685-0411</contrib-id>
                                                                <name>
                                    <surname>Gözel</surname>
                                    <given-names>Sema</given-names>
                                </name>
                                                                    <aff>Batman Eğitim Ve Araştırma Hastanesi</aff>
                                                            </contrib>
                                                    <contrib contrib-type="author">
                                                                    <contrib-id contrib-id-type="orcid">
                                        https://orcid.org/0000-0002-4785-6610</contrib-id>
                                                                <name>
                                    <surname>Gönen Şentürk</surname>
                                    <given-names>Seher</given-names>
                                </name>
                                                                    <aff>ÇANKIRI KARATEKİN ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ FAKÜLTESİ</aff>
                                                            </contrib>
                                                                                </contrib-group>
                        
                                        <pub-date pub-type="pub" iso-8601-date="20260430">
                    <day>04</day>
                    <month>30</month>
                    <year>2026</year>
                </pub-date>
                                        <volume>10</volume>
                                        <issue>1</issue>
                                        <fpage>1</fpage>
                                        <lpage>10</lpage>
                        
                        <history>
                                    <date date-type="received" iso-8601-date="20250812">
                        <day>08</day>
                        <month>12</month>
                        <year>2025</year>
                    </date>
                                                    <date date-type="accepted" iso-8601-date="20260416">
                        <day>04</day>
                        <month>16</month>
                        <year>2026</year>
                    </date>
                            </history>
                                        <permissions>
                    <copyright-statement>Copyright © 2017, Türkiye Diyabet ve Obezite Dergisi</copyright-statement>
                    <copyright-year>2017</copyright-year>
                    <copyright-holder>Türkiye Diyabet ve Obezite Dergisi</copyright-holder>
                </permissions>
            
                                                                                                <abstract><p>Aim: To examine the relationship between barriers experienced by individuals with type 2 diabetes during insulin treatment and theirself-care behaviors.Material and Methods: It is descriptive, cross-sectional, and exploratory in nature. It was conducted between December 2021 and May2022 with individuals (n:215) receiving services at the outpatient clinics and inpatient section of a state hospital located in the centerof Ankara. Data were collected using face-to-face interviews with the Patient Information Form, the Barriers to Insulin TreatmentQuestionnare (BITQ), and the Diabetes Self-Care Scale (DSCS). Data were analyzed using number, percentage, mean, standard deviation,Pearson correlation analysis, and multiple linear regression analysis.Results: A weak positive correlation was found between the DSCS total score average and the expectation of positive results related toinsulin (r=0.138, p=0.044) and fear of hypoglycemia (r=0.177, p=0.009), and a weak negative correlation was found between the subscaleof expected difficulties in insulin treatment (r=-0.251, p</p></abstract>
                                                                                                                                    <trans-abstract xml:lang="tr">
                            <p>Amaç: Tip 2 diyabetli bireylerin insülin tedavi sürecinde yaşadıkları engeller ve öz bakım davranışları arasındaki ilişkinin incelenmesidir.Gereç ve Yöntemler: Tanımlayıcı, kesitsel ve ilişki arayıcı tiptedir. Aralık 2021-Mayıs 2022 tarihleri arasında Ankara il merkezinde yeralan bir devlet hastanesinin poliklinik ve yataklı servislerde hizmet alan bireylerle (n=215) yürütülmüştür. Veriler yüzyüze görüşmeyöntemiyle Hasta Tanıtım Formu, İnsülin Tedavisinde Engeller Ölçeği (İTEÖ) ve Diyabet Öz Bakım Ölçeği (DÖBÖ) kullanılaraktoplanmıştır. Verilerin analizinde sayı, yüzde, ortalama, standart sapma, Pearson korelasyon analizi, multiple linear regresyon analizikullanılmıştır.Bulgular: DÖBÖ toplam puan ortalaması ile İnsülinle İlişkili Olumlu Sonuç Beklentisi (r=0,138; p=0,044) ve Hipoglisemi Korkusuarasında pozitif yönde zayıf (r=0,177; p=0,009), İnsülin Tedavisinde Beklenen Zorluk alt boyutu ile negatif yönde zayıf ilişki (r=-0,251;p=</p></trans-abstract>
                                                            
            
                                                            <kwd-group>
                                                    <kwd>Insulin therapy</kwd>
                                                    <kwd>  Barriers to insulin therapy</kwd>
                                                    <kwd>  Self-care</kwd>
                                                    <kwd>  Type 2 diabetes</kwd>
                                            </kwd-group>
                                                        
                                                                            <kwd-group xml:lang="tr">
                                                    <kwd>İnsülin tedavisi</kwd>
                                                    <kwd>  İnsülin tedavisinde engeller</kwd>
                                                    <kwd>  Öz bakım</kwd>
                                                    <kwd>  Tip 2 diyabe</kwd>
                                            </kwd-group>
                                                                                                        <funding-group specific-use="FundRef">
                    <award-group>
                                                    <funding-source>
                                <named-content content-type="funder_name">None.</named-content>
                            </funding-source>
                                                                    </award-group>
                </funding-group>
                                </article-meta>
    </front>
    <back>
                            <ref-list>
                                    <ref id="ref1">
                        <label>1</label>
                        <mixed-citation publication-type="journal">1.	Türkiye Endokrinoloji ve Metabolizma Derneği (TEMD). Diabetes mellitus ve komplikasyonları tanı, tedavi ve izlem klavuzu 2024. [cited 2025 Aug 1]. Available from:https://file.temd.org.tr/Uploads/publications/guides/documents/diabetesmellitus2024.pdf</mixed-citation>
                    </ref>
                                    <ref id="ref2">
                        <label>2</label>
                        <mixed-citation publication-type="journal">2.	IDF Diabetes Atlas. 11th Edition 2025. [cited 2025 Aug 1]. Available from: https://diabetesatlas.org/</mixed-citation>
                    </ref>
                                    <ref id="ref3">
                        <label>3</label>
                        <mixed-citation publication-type="journal">3.	Zheng Y, Ley SH, Hu FB. Global etiology and epidemiology of type 2 diabetes mellitus and its complications. Nature reviews endocrinology. 2018; 14(2): 88–98. https://doi.org/10.1038/nrendo.2017.151</mixed-citation>
                    </ref>
                                    <ref id="ref4">
                        <label>4</label>
                        <mixed-citation publication-type="journal">4.	Satman I, Yilmaz T, Sengül A, Salman S, Salman F, Uygur S, Bastar I, Tütüncü Y, Sargin M, Dinççag N, Karsidag K, Kalaça S, Ozcan C, King H. Population-based study of diabetes and risk characteristics in Turkey: results of the turkish diabetes epidemiology study (TURDEP). Diabetes care. 2002;25(9):1551–1556. https://doi.org/10.2337/diacare.25.9.15511</mixed-citation>
                    </ref>
                                    <ref id="ref5">
                        <label>5</label>
                        <mixed-citation publication-type="journal">5.	Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, Karsidag K, Genc S, Telci A, Canbaz B, Turker F, Yilmaz T, Cakir B, Tuomilehto J, TURDEP-II Study Group. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol. 2013;28(2):169–180. https://doi.org/10.1007/s10654-013-9771-5</mixed-citation>
                    </ref>
                                    <ref id="ref6">
                        <label>6</label>
                        <mixed-citation publication-type="journal">6.	Özer E, Yıldız EA. Türkiye’de diyabet diyetisyenliği: 23 yıllık tarihsel süreç. Beslenme ve Diyet Dergisi. 2019;47:1-4.</mixed-citation>
                    </ref>
                                    <ref id="ref7">
                        <label>7</label>
                        <mixed-citation publication-type="journal">7.	Li Y, Teng D, Shi X, Qin G, Qin Y, Quan H, Shi B, Sun H, Ba J, Chen B, Du J, He L, Lai X, Li Y, Chi H, Liao E, Liu C, Liu L, Tang X, Tong N, Wang G, Zhang J, WangY, Xue Y, Yan L, Yang J, Yang L, Yao Y, Ye Z, Zhang Q, Zhang L, Zhu J, Zhu M, Ning G, Mu Y, Zhao J, Teng W, Shan Z. Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study. BMJ. 2020;369:m997. https://doi.org/10.1136/bmj.m997</mixed-citation>
                    </ref>
                                    <ref id="ref8">
                        <label>8</label>
                        <mixed-citation publication-type="journal">8.	American Diabetes Association (ADA). 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2019. Diabetes care. 2019;42(1):13–28.  https://doi.org/10.2337/dc19-S002</mixed-citation>
                    </ref>
                                    <ref id="ref9">
                        <label>9</label>
                        <mixed-citation publication-type="journal">9.	Petrak F, Stridde E, Leverkus F, Crispin AA, Forst T, Pfützner A. Development and validation of a new measure to evaluate psychological resistance to insulin treatment. Diabetes care. 2007;30(9):2199–2204. https://doi.org/10.2337/dc06-20422</mixed-citation>
                    </ref>
                                    <ref id="ref10">
                        <label>10</label>
                        <mixed-citation publication-type="journal">10.	Petrak F, Herpertz S, Stridde E, Pfützner A. Psychological insulin resistance in type 2 diabetes patients regarding oral antidiabetes treatment, subcutaneous insulin injections, or inhaled insulin. Diabetes Technol Ther. 2013;15(8):703-11. https://doi.org/10.1089/dia.2012.025</mixed-citation>
                    </ref>
                                    <ref id="ref11">
                        <label>11</label>
                        <mixed-citation publication-type="journal">11.	Holmes-Truscott E, Pouwer F, Speight J. Assessing psychological ınsulin resistance in type 2 diabetes: a critical comparison of measures. Curr Diab Rep. 2017;17(7):46. https://doi.org/10.1007/s11892-017-0873-4</mixed-citation>
                    </ref>
                                    <ref id="ref12">
                        <label>12</label>
                        <mixed-citation publication-type="journal">12.	Yasa MK. Tip 2 diyabetli bireylerde insülin tedavisindeki engellerin ve etkileyen faktörlerin yaşam kalitesi ile ilişkisi (Yüksek Lisans Tezi), Balıkesir, Balıkesir Üniversitesi Sağlık Bilimleri Enstitüsü, 2022, 1-142, Available from: https://tez.yok.gov.tr/UlusalTezMerkezi/tezSorguSonucYeni.jsp</mixed-citation>
                    </ref>
                                    <ref id="ref13">
                        <label>13</label>
                        <mixed-citation publication-type="journal">13.	Boye KS, Shinde S, Kennedy-Martin T, Robinson S, Thieu VT. Weight change and the association with adherence and persistence to diabetes therapy: a narrative review. Patient Prefer Adherence. 2022;6(16):23-39. https://doi.org/10.2147/PPA.S328583</mixed-citation>
                    </ref>
                                    <ref id="ref14">
                        <label>14</label>
                        <mixed-citation publication-type="journal">14.	Russell-Jones D, Pouwer F, Khunti K. Identification of barriers to insulin therapy and approaches to overcoming them. Diabetes Obes Metab. 2018;20(3):488–496. https://doi.org/10.1111/dom.13132</mixed-citation>
                    </ref>
                                    <ref id="ref15">
                        <label>15</label>
                        <mixed-citation publication-type="journal">15.	Mogre V, Johnson NA, Tzelepis F, Paul C. Barriers to diabetic self-care: A qualitative study of patients&#039; and healthcare providers&#039; perspectives. J Clin Nurs. 2019; 28(11-12):2296–2308. https://doi.org/10.1111/jocn.14835</mixed-citation>
                    </ref>
                                    <ref id="ref16">
                        <label>16</label>
                        <mixed-citation publication-type="journal">16.	Urgancı DB. İnsülin tedavisine yeni başlayan ve tedavileri 2-5 yıldır devam eden hastaların tedaviye yönelik algısı, uyumu, aile desteği ve akut komplikasyon gelişme oranlarıının karşılaştırılması (Yüksek Lisans Tezi), Amasya, Amasya Üniversitesi Sağlık Bilimleri Enstitüsü, 2022, 1-118, [cited 2025 Aug 1]. Available from: https://tez.yok.gov.tr/UlusalTezMerkezi/tezSorguSonucYeni.jsp</mixed-citation>
                    </ref>
                                    <ref id="ref17">
                        <label>17</label>
                        <mixed-citation publication-type="journal">17.	Sağlam FS. Tip 2 diyabetli bireylerin insülin tedavisine ve diyabet komplikasyonlarına ilişkin risk algıları (Yüksek Lisans Tezi), Antalya, Akdeniz Üniversitesi Sağlık Bilimleri Enstitüsü, 2022, 1-148, [cited 2025 Aug 1]. Available from: https://tez.yok.gov.tr/UlusalTezMerkezi/tezSorguSonucYeni.jsp</mixed-citation>
                    </ref>
                                    <ref id="ref18">
                        <label>18</label>
                        <mixed-citation publication-type="journal">18.	Brazeau AS, Nakhla M, Wright M, Henderson M, Panagiotopoulos C, Pacaud D, Kearns P, Rahme E, Da Costa D, Dasgupta K. Stigma and ıts association with glycemic control and hypoglycemia in adolescents and young adults with type 1 diabetes: cross-sectional study. J Med Internet Res. 2018;20(4):e151 https://preprints.jmir.org/preprint/9432</mixed-citation>
                    </ref>
                                    <ref id="ref19">
                        <label>19</label>
                        <mixed-citation publication-type="journal">19.	Üren Y, Karabulutlu EY. Tip 2 diyabet hastalarında diyabet kontrolünü zorlaştıran faktörlerin incelenmesi. Sağlık Bilimleri ve Meslekleri Dergisi. 2018;5(3).376-386.</mixed-citation>
                    </ref>
                                    <ref id="ref20">
                        <label>20</label>
                        <mixed-citation publication-type="journal">20.	Yıldırım TB. Tip 2 diyabetli bireylere akıllı telefonları aracılığı ile verilen video eğitiminin öz bakıma ve metabolik kontrole etkisi (Yüksek Lisans Tezi), Kırklareli, Kırklareli Üniversitesi Sağlık Bilimleri Enstitüsü, 2022, 1-102, [cited 2025 Aug 1]. Available from: https://tez.yok.gov.tr/UlusalTezMerkezi/tezSorguSonucYeni.jsp</mixed-citation>
                    </ref>
                                    <ref id="ref21">
                        <label>21</label>
                        <mixed-citation publication-type="journal">21.	Hartweg DL, Metcalfe SA. Orem&#039;s self-care deficit nursing theory: relevance and need for refinement. Nurs Sci Q. 2022;35(1):70-76. https://doi.org/10.1177/08943184211051369</mixed-citation>
                    </ref>
                                    <ref id="ref22">
                        <label>22</label>
                        <mixed-citation publication-type="journal">22.	Hartweg DL. Dorothea Orem’s self-care deficit nursing theory. In: Smith MC, Parker ME, editors. Nursing theories &amp; nursing practice. 4nd ed. F. A. Davis Company, Philadelphia; 2015,105-133.</mixed-citation>
                    </ref>
                                    <ref id="ref23">
                        <label>23</label>
                        <mixed-citation publication-type="journal">23.	Rodriguez KM. Intrinsic and extrinsic factors affecting patient engagement in diabetes self-management: perspectives of a certified diabetes educator. Clin Ther. 2013;35(2):170-8. https://doi.org/10.1016/j.clinthera.2013.01.002</mixed-citation>
                    </ref>
                                    <ref id="ref24">
                        <label>24</label>
                        <mixed-citation publication-type="journal">24.	Woodward A, Walters K, Davies N, Nimmons D, Protheroe J, Chew-Graham CA, Stevenson F, Armstrong M. Barriers and facilitators of self-management of diabetes amongst people experiencing socioeconomic deprivation: A systematic review and qualitative synthesis. Health Expect. 2024;27(3):e14070. https://doi.org/10.1111/hex.14070</mixed-citation>
                    </ref>
                                    <ref id="ref25">
                        <label>25</label>
                        <mixed-citation publication-type="journal">25.	Captieux M, Pearce G, Parke HL, Epiphaniou E, Wild S, Taylor SJC, Pinnock H. Supported self-management for people with type 2 diabetes: a meta-review of quantitative systematic reviews. BMJ Open. 2018;8(12):e024262. https://doi.org/10.1136/bmjopen-2018-024262</mixed-citation>
                    </ref>
                                    <ref id="ref26">
                        <label>26</label>
                        <mixed-citation publication-type="journal">26.	Lee AA, Piette JD, Heisler M, Rosland AM. Diabetes distress and glycemic control: the buffering effect of autonomy support from ımportant family members and friends. Diabetes Care. 2018;41(6):1157-1163. https://doi.org/10.2337/dc17-2396</mixed-citation>
                    </ref>
                                    <ref id="ref27">
                        <label>27</label>
                        <mixed-citation publication-type="journal">27.	Sarıtaş SC, Erci B, Şahin İ, Timocin E. Validity study of the Turkish version of the barriers to insulin treatment questionnaire. International Journal of Diabetes in Developing Countries. 2019;39(2):247–253. https://doi.org/10.1007/s13410-018-0670-x</mixed-citation>
                    </ref>
                                    <ref id="ref28">
                        <label>28</label>
                        <mixed-citation publication-type="journal">28.	Lee NP, Fisher WP Jr. Evaluation of the Diabetes Self-Care Scale. J Appl Meas. 2005;6(4):366-81. PMID: 16192661.</mixed-citation>
                    </ref>
                                    <ref id="ref29">
                        <label>29</label>
                        <mixed-citation publication-type="journal">29.	Karakurt P. Tip 2 diyabetli hastalara verilen eğitimin öz-bakım üzerine etkisi (Doktora Tezi), Erzurum, Atatürk Üniversitesi Sağlık Bilimleri Enstitüsü, 2008, 1-87, [cited 2025 Aug 1]. Available from: https://tez.yok.gov.tr/UlusalTezMerkezi/tezSorguSonucYeni.jspp</mixed-citation>
                    </ref>
                                    <ref id="ref30">
                        <label>30</label>
                        <mixed-citation publication-type="journal">30.	Pituch KA, Stevens JP. Applied multivariate statistics for the social sciences: Routledge; 2012.</mixed-citation>
                    </ref>
                                    <ref id="ref31">
                        <label>31</label>
                        <mixed-citation publication-type="journal">31.	Hussein A, Mostafa A, Areej A, Mona AM, Shimaa A, Najd AG, Futoon A. The perceived barriers to insulin therapy among type 2 diabetic patients. Afr Health Sci. 2019;19(1):1638-1646. doi: 10.4314/ahs.v19i1.39</mixed-citation>
                    </ref>
                                    <ref id="ref32">
                        <label>32</label>
                        <mixed-citation publication-type="journal">32.	Pilv L, Vermeire EIJJ, Rätsep A, Moreau A, Petek D, Yaman H, Oona M, Kalda R. Diabetes-related quality of life in six European countries measured with the DOQ-30. Eur J Gen Pract. 2021;27(1):191-197. https://doi.org/10.1080/13814788.2021.1954615</mixed-citation>
                    </ref>
                                    <ref id="ref33">
                        <label>33</label>
                        <mixed-citation publication-type="journal">33.	Nam S, Chesla C, Stotts NA, Kroon L, Janson SL. Factors associated with psychological insulin resistance in individuals with type 2 diabetes. Diabetes Care. 2010;33(8):1747-9. https://doi.org/10.2337/dc10-0099</mixed-citation>
                    </ref>
                                    <ref id="ref34">
                        <label>34</label>
                        <mixed-citation publication-type="journal">34.	Caner E. Tip 2 diyabetli hastalarda öz-bakım ile tedavi uyumu arasındaki ilişkinin değerlendirilmesi (Yüksek Lisans Tezi). Erzurum, Atatürk Üniversitesi Sağlık Bilimleri Enstitüsü, 2023, 1-72,  [cited 2025 Aug 1]. Available from: https://tez.yok.gov.tr/UlusalTezMerkezi/tezSorguSonucYeni.jsp</mixed-citation>
                    </ref>
                                    <ref id="ref35">
                        <label>35</label>
                        <mixed-citation publication-type="journal">35.	Mumcu CD. Tip 2 diyabeti olan kadınlarda web tabanlı eğitimin öz yönetimine ve aile desteğine etkisinin incelenmesi (Yükek Lisans Tezi), Ankara, Ankara Yıldırım Beyazıt Sağlık Bilimleri Enstitüsü, 2021, 1-107, [cited 2025 Aug 1]. Available from: https://tez.yok.gov.tr/UlusalTezMerkezi/tezSorguSonucYeni.jsp</mixed-citation>
                    </ref>
                                    <ref id="ref36">
                        <label>36</label>
                        <mixed-citation publication-type="journal">36.	Gerçek A. Tip 2 hastaların hastalığı kabullenme ve öz bakım durumlarının belirlenmesi (Yüksek Lisans Tezi), Erzincan, Erzincan Üniversitesi Sağlık Bilimleri Enstitüsü, 2017, 1-84, [cited 2025 Aug 1]. Available from: https://tez.yok.gov.tr/UlusalTezMerkezi/tezSorguSonucYeni.jsp</mixed-citation>
                    </ref>
                                    <ref id="ref37">
                        <label>37</label>
                        <mixed-citation publication-type="journal">37.	D&#039;Souza MS, Karkada SN, Parahoo K, Venkatesaperumal R, Achora S, Cayaban ARR. Self-efficacy and self-care behaviours among adults with type 2 diabetes. Appl Nurs Res. 2017;36:25-32. https://doi.org/10.1016/j.apnr.2017.05.004</mixed-citation>
                    </ref>
                                    <ref id="ref38">
                        <label>38</label>
                        <mixed-citation publication-type="journal">38.	Azami G, Soh KL, Sazlina SG, Salmiah MS, Aazami S, Mozafari M, Taghinejad H. Effect of a nurse-led diabetes self-management education program on glycosylated hemoglobin among adults with type 2 diabetes. J Diabetes Res. 2018;2018:4930157. https://doi.org/10.1155/2018/4930157</mixed-citation>
                    </ref>
                                    <ref id="ref39">
                        <label>39</label>
                        <mixed-citation publication-type="journal">39.	Terkeş N. Tip 2 diyabetli bireyler için web tabanlı eğitim programı geliştirilmesi ve programın diyabet yönetimine etkisi (Doktora Tezi), Antalya, Akdeniz Üniversitesi Sağlık Bilimleri Enstitüsü, 2018, 1-153, [cited 2025 Aug 1]. Available from: https://tez.yok.gov.tr/UlusalTezMerkezi/tezSorguSonucYeni.jsp</mixed-citation>
                    </ref>
                                    <ref id="ref40">
                        <label>40</label>
                        <mixed-citation publication-type="journal">40.	Tutino GE, Yang WY, Li X, Li WH, Zhang YY, Guo XH, Luk AO, Yeung RO, Yin JM, Ozaki R, So WY, Ma RC, Ji LN, Kong AP, Weng JP, Ko GT, Jia WP, Chan JC; China JADE Study Group. A multicentre demonstration project to evaluate the effectiveness and acceptability of the web-based Joint Asia Diabetes Evaluation (JADE) programme with or without nurse support in Chinese patients with Type 2 diabetes. Diabet Med. 2017;34(3):440-450. https://doi.org/10.1111/dme.13164</mixed-citation>
                    </ref>
                                    <ref id="ref41">
                        <label>41</label>
                        <mixed-citation publication-type="journal">41.	Selen F. Web tabanlı tip 2 diyabet eğitiminin diyabet öz yönetimine etkisi (Doktora Tezi), Ankara, Gazi Üniversitesi Sağlık Bilimleri Enstitüsü, 2019, 1-157, [cited 2025 Aug 1]. Available from: https://tez.yok.gov.tr/UlusalTezMerkezi/tezSorguSonucYeni.jsp</mixed-citation>
                    </ref>
                                    <ref id="ref42">
                        <label>42</label>
                        <mixed-citation publication-type="journal">42.	Doupis J, Festas G, Tsilivigos C, Efthymiou V, Kokkinos A. Smartphone-based technology in diabetes management. Diabetes Ther. 2020;11(3):607-619. https://doi.org/10.1007/s13300-020-00768-3</mixed-citation>
                    </ref>
                                    <ref id="ref43">
                        <label>43</label>
                        <mixed-citation publication-type="journal">43.	Yu CH, Parsons JA, Mamdani M, Lebovic G, Hall S, Newton D, Shah BR, Bhattacharyya O, Laupacis A, Straus SE. A web-based intervention to support self-management of patients with type 2 diabetes mellitus: effect on self-efficacy, self-care and diabetes distress. BMC Med Inform Decis Mak. 2014;14:117. doi: 10.1186/s12911-014-0117-3. PMID: 25495847; PMCID: PMC4272538. http://www.biomedcentral.com/1472-6947/14/117</mixed-citation>
                    </ref>
                                    <ref id="ref44">
                        <label>44</label>
                        <mixed-citation publication-type="journal">44.	Çevik Aktura S, Özden G. Psychological insulin resistance and affecting factors in patients with type 2 diabetes. Journal of Human Sciences, 2022;19(4):559–568. https://doi:10.14687/jhs.v19i4.6319</mixed-citation>
                    </ref>
                                    <ref id="ref45">
                        <label>45</label>
                        <mixed-citation publication-type="journal">45.	Bilgehan T, Vardar İnkaya B, Altunsoy A, Aytemur M. Perceptions of diabet in type 1 diabetes and type 2 diabetes:a mixed-methods comparative insight. Turk J Diab Obes 2025; 9(2): 147-163. doi: 10.25048/tudod.1684480</mixed-citation>
                    </ref>
                                    <ref id="ref46">
                        <label>46</label>
                        <mixed-citation publication-type="journal">46.	Alhaiti AH, Senitan M, Dator WLT, Sankarapandian C, Baghdadi NA, Jones LK, Da Costa C, Lenon GB. Adherence of Type 2 Diabetic Patients to Self-Care Activity: Tertiary Care Setting in Saudi Arabia. J Diabetes Res. 2020;2020:4817637. https://doi.org/10.1155/2020/4817637</mixed-citation>
                    </ref>
                                    <ref id="ref47">
                        <label>47</label>
                        <mixed-citation publication-type="journal">47.	Lin MH, Ou HY, Wang RH, Lin CH, Liao HY, Chen HM. Glycaemic control mediates the relationships of employment status and self-stigma with self-care behaviours in young adults with type 2 diabetes. J Clin Nurs. 2022;31(5-6):582-591. https://doi.org/10.1111/jocn.15915</mixed-citation>
                    </ref>
                                    <ref id="ref48">
                        <label>48</label>
                        <mixed-citation publication-type="journal">48.	Zhou Y, Liao L, Sun M, He G. Self-care practices of Chinese individuals with diabetes. Exp Ther Med. 2013;5(4):1137-1142. https://doi.org/10.3892/etm.2013.945</mixed-citation>
                    </ref>
                                    <ref id="ref49">
                        <label>49</label>
                        <mixed-citation publication-type="journal">49.	Aytemur M, Vardar İnkaya B. Diabetes mellituslu bireylerde diyabet komplikasyon risk algısının ve diyabet öz yönetim becerilerinin incelenmesi. Turk J Diab Obes. 2022; 2:121-130. https://10.25048/tudod.1099172</mixed-citation>
                    </ref>
                                    <ref id="ref50">
                        <label>50</label>
                        <mixed-citation publication-type="journal">50.	AlQahtani AH, Alzahrani AS, Alzahrani SH, Alqahtani SM, AlOtaibi AF, Khan AA. Levels of Practice and Determinants of Diabetes Self-Care in Primary Health Care in Jeddah City, Saudi Arabia. Cureus. 2020;12(6):e8816. https://doi.org/10.7759/cureus.8816</mixed-citation>
                    </ref>
                                    <ref id="ref51">
                        <label>51</label>
                        <mixed-citation publication-type="journal">51.	Ayele K, Tesfa B, Abebe L, Tilahun T, Girma E. Self care behavior among patients with diabetes in Harari, Eastern Ethiopia: the health belief model perspective. PLoS One. 2012;7(4):e35515. https://doi.org/10.1371/journal.pone.0035515</mixed-citation>
                    </ref>
                            </ref-list>
                    </back>
    </article>
