Tip 2 Diyabetli Kadınlarda Glisemik Kontrol ile İlişkili Faktörlerin Belirlenmesi: Beslenme ve Fiziksel Aktivite Düzeyi

Öz

Amaç: Etkili diyabet yönetimi yeterli glisemik kontrol ile sağlanmaktadır. Beslenme ve fiziksel aktivitenin de glisemik kontrolü sağlamada önemli bir rolü bulunmaktadır. Bu çalışma Konya ilindeki bir devlet hastanesine başvuran 20-64 yaş arasındaki tip 2 diyabetli kadınların beslenme tutumu, Akdeniz diyeti uyumu ve fiziksel aktivite düzeylerinin glisemik kontrol ile ilişkisinin belirlenmesi amacıyla yapıldı. Gereç ve Yöntemler: İlişki arayıcı türdeki çalışma Konya’da bir hastanenin Dahiliye ve Endokrinoloji polikliniklerine başvuran 20-64 yaş arası tip 2 diyabetli 246 kadın ile gerçekleştirildi. Katılımcılar gelişigüzel örnekleme yöntemi ile belirlendi. Veriler anket formu, Sağlıklı Beslenmeye İlişkin Tutum Ölçeği, Akdeniz Diyetine Uyum Ölçeği ve Uluslararası Fiziksel Aktivite Anketi Kısa Formu (IPAQSF) kullanılarak toplandı. Bireylerle yüz yüze görüşülerek toplanan verilerin analizinde tanımlayıcı istatistikler, Ki-Kare, Fisher’in exact testi, Kruskal Wallis testi, Spearman korelasyon analizi ve lojistik regresyon analizi kullanıldı. Bulgular: Çalışmada glisemik kontrolün değerlendirilmesinde glikozillenmiş hemoglobin A1c (HbA1c) ve açlık kan glukozu esas alınmış olup, katılımcıların %55,3’ü HbA1c, %56,9’u açlık kan glukozu bakımından kötü glisemik kontrole sahipti. Lojistik regresyon analizine göre HbA1c için; 10 yıldan daha fazla süre diyabete sahip olmak (OR=0,291, %95 Cl=0,095-0,894), yüksek trigliserit (OR=0,440, %95 Cl=0,190-1,017) ve düşük yüksek yoğunluklu lipoprotein (HDL) düzeyi (OR=0,293, %95 Cl=0,114-0,753); açlık kan glukozu için ilaç ve insülin kullanımını atlama sıklığında artış (OR=2,431, %95 Cl=1,090-5,424) ile düşük HDL düzeyi (OR=0,269, %95 Cl=0,110-0,653) önemli risk faktörleridir. Katılımcıların %73,2’si sağlıklı beslenmeye ilişkin orta düzey tutuma, %46,3’ü Akdeniz diyetine yönelik orta düzey uyuma sahip ve %60,6’sı fiziksel olarak hareketsizdi. Ayrıca katılımcıların açlık kan glukozu ile Sağlıklı Beslenmeye İlişkin Tutum Ölçeği (r=-0,138) ve IPAQ-SF (r=-0,154) puanı arasında çok zayıf düzeyde negatif yönlü anlamlı bir ilişki bulunmaktadır (p<0,05). Sonuç: Sonuç olarak diyabet süresi, trigliserit düzeyi, HDL düzeyi, ilaç ve insülin atlama sıklığı glisemik kontrol için risk faktörleridir. Diyabetli bireylerin çoğunluğu orta düzey beslenme tutumuna sahip ve fiziksel olarak hareketsizdir. Bireylerin glisemik kontrollerini sağlamaları için olumlu beslenme tutumlarının desteklenmesi ve fiziksel aktivitenin artırılması gerekmektedir.

Anahtar Kelimeler

• Akdeniz diyeti
• Beslenme
• Fiziksel aktivite
• Hemşirelik
• Tip 2 diyabet

Determination of Factors Associated with Glycemic Control in Women with Type 2 Diabetes: Nutrition and Physical Activity Level

Öz

Aim: Effective diabetes management is achieved with adequate glycemic control. Nutrition and physical activity have an important role in glycemic control. This study was conducted to determine the relationship between glycemic control and nutrition attitude, Mediterranean diet adherence and physical activity levels of women with Type 2 diabetes aged 20-64 years who applied to a state hospital in Konya province. Material and Methods: This correlational study was conducted with 246 women aged 20-64 years with Type 2 diabetes who applied to the Internal Medicine and Endocrinology outpatient clinics of a hospital in Konya. Individuals were selected by random sampling method. Data were collected using a questionnaire form, Attitudes Toward Healthy Eating Scale, Mediterranean Diet Adherence Scale and International Physical Activity Questionnaire Short Form (IPAQ-SF). Descriptive statistics, Chi-Square, Fisher's exact test, Kruskal Wallis test, Spearman correlation analysis and logistic regression analysis were used to analyze the data collected by face-to-face interviews. Results: In the study, glycated hemoglobin A1c (HbA1c) and fasting blood glucose (FBG) were used to assess glycemic control. 55.3% and 56.9% of the individuals had poor glycemic control in terms of HbA1c and FBG, respectively. According to logistic regression analysis, for HbA1c; having diabetes for more than 10 years (OR=0.291, 95% Cl=0.095-0.894), high triglycerides (OR=0.440, 95% Cl=0.190-1.017) and low high density lipoprotein (HDL) (OR=0.293, 95% Cl=0.114-0.753); For FBG, increased frequency of skipping medication and insulin use (OR=2.431, 95% Cl=1.090-5.424) and low HDL level (OR=0.269, 95% Cl=0.110-0.653) were significant risk factors. Among the individuals, 73.2% had a moderate attitude towards healthy eating, 46.3% had a moderate adherence to the Mediterranean diet and 60.6% were physically inactive. In addition, there was a very weak negative significant correlation (p<0.05) between the individuals' FBG and the Attitudes Towards Healthy Eating Scale (r=-0.138) and IPAQ-SF (r=-0.154) scores. Conclusion: In conclusion, duration of diabetes, triglyceride level, HDL level, medication and insulin skipping frequency are risk factors for glycemic control. The majority of individuals with diabetes have moderate nutritional attitudes and are physically inactive. In order for individuals to achieve glycemic control, positive dietary attitudes should be supported and physical activity should be increased.

Anahtar Kelimeler

• Mediterranean diet
• Nutrition
• Physical activity
• Nursing
• Type 2 diabetes

Kaynakça

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