Araştırma Makalesi
BibTex RIS Kaynak Göster

Investigation of the Relationship between the Barriers and Self-Care Behaviors in the Process of Insulin Therapy in Type 2 Diabetes

Yıl 2026, Cilt: 10 Sayı: 1 , 1 - 10 , 30.04.2026

Sema Gözel , Seher Gönen Şentürk

https://izlik.org/JA56BX83ZH

Öz

Aim: To examine the relationship between barriers experienced by individuals with type 2 diabetes during insulin treatment and their
self-care behaviors.
Material and Methods: It is descriptive, cross-sectional, and exploratory in nature. It was conducted between December 2021 and May
2022 with individuals (n:215) receiving services at the outpatient clinics and inpatient section of a state hospital located in the center
of Ankara. Data were collected using face-to-face interviews with the Patient Information Form, the Barriers to Insulin Treatment
Questionnare (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 to
insulin (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 subscale
of expected difficulties in insulin treatment (r=-0.251, p<0.000). Factors affecting diabetes self-care agency were found to be female (r=-
0.213, p=0.006) and high school graduation (r=0.192, p=0.011).
Conclusion: It has been determined that individuals with high self-care competence expect more positive results during the treatment
process, experience fear of hypoglycemia, and expect fewer difficulties during insulin treatment. By increasing the self-care competence
of individuals with diabetes, negative attitudes and behaviors toward insulin treatment can be prevented

Anahtar Kelimeler

Insulin therapy Barriers to insulin therapy Self-care Type 2 diabetes

Etik Beyan

Ethical approval was obtained from the Ethics Committee of Çankırı Karatekin University Institute of Health Sciences (Ethics Committee Meeting No: 23, Decision Date: 09.11.2021). Permission to conduct the study was obtained from Ankara City Hospital (Number: E-90739940-799-2341, Decision Date: 01.12.202). Permission was obtained via email from the authors who adapted the scales used in the study into Turkish. The study was conducted after providing the necessary information about the research to the patients and obtaining verbal consent from the volunteer patients.

Destekleyen Kurum

None.

Teşekkür

The authors thank all participants and healthcare professionals who voluntarily participated in the research.

Kaynakça

  • 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
  • 2. IDF Diabetes Atlas. 11th Edition 2025. [cited 2025 Aug 1]. Available from: https://diabetesatlas.org/
  • 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
  • 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
  • 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
  • 6. Özer E, Yıldız EA. Türkiye’de diyabet diyetisyenliği: 23 yıllık tarihsel süreç. Beslenme ve Diyet Dergisi. 2019;47:1-4.
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 15. Mogre V, Johnson NA, Tzelepis F, Paul C. Barriers to diabetic self-care: A qualitative study of patients' and healthcare providers' perspectives. J Clin Nurs. 2019; 28(11-12):2296–2308. https://doi.org/10.1111/jocn.14835
  • 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
  • 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
  • 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
  • 19. Üren Y, Karabulutlu EY. Tip 2 diyabet hastalarında diyabet kontrolünü zorlaştıran faktörlerin incelenmesi. Sağlık Bilimleri ve Meslekleri Dergisi. 2018;5(3).376-386.
  • 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
  • 21. Hartweg DL, Metcalfe SA. Orem'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
  • 22. Hartweg DL. Dorothea Orem’s self-care deficit nursing theory. In: Smith MC, Parker ME, editors. Nursing theories & nursing practice. 4nd ed. F. A. Davis Company, Philadelphia; 2015,105-133.
  • 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
  • 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
  • 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
  • 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
  • 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
  • 28. Lee NP, Fisher WP Jr. Evaluation of the Diabetes Self-Care Scale. J Appl Meas. 2005;6(4):366-81. PMID: 16192661.
  • 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
  • 30. Pituch KA, Stevens JP. Applied multivariate statistics for the social sciences: Routledge; 2012.
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 37. D'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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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

Tip 2 Diyabetli Bireylerin İnsülin Tedavi Sürecinde Yaşadıkları Engeller ve Öz Bakım Davranışları Arasındaki İlişkinin İncelenmesi

Yıl 2026, Cilt: 10 Sayı: 1 , 1 - 10 , 30.04.2026

Sema Gözel , Seher Gönen Şentürk

https://izlik.org/JA56BX83ZH

Öz

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 yer
alan bir devlet hastanesinin poliklinik ve yataklı servislerde hizmet alan bireylerle (n=215) yürütülmüştür. Veriler yüzyüze görüşme
yöntemiyle Hasta Tanıtım Formu, İnsülin Tedavisinde Engeller Ölçeği (İTEÖ) ve Diyabet Öz Bakım Ölçeği (DÖBÖ) kullanılarak
toplanmıştır. Verilerin analizinde sayı, yüzde, ortalama, standart sapma, Pearson korelasyon analizi, multiple linear regresyon analizi
kullanılmıştır.
Bulgular: DÖBÖ toplam puan ortalaması ile İnsülinle İlişkili Olumlu Sonuç Beklentisi (r=0,138; p=0,044) ve Hipoglisemi Korkusu
arasında pozitif yönde zayıf (r=0,177; p=0,009), İnsülin Tedavisinde Beklenen Zorluk alt boyutu ile negatif yönde zayıf ilişki (r=-0,251;
p=<0,001) belirlenmiştir. Diyabet öz bakım gücünü etkileyen faktörler kadın olma (r=-0,213; p=0,006) ve lise mezunu olma (r=0,192;
p=0,011) olduğu saptanmıştır.
Sonuç: Diyabet öz bakım gücü yüksek bireylerin tedavi sürecinde daha olumlu sonuçlar bekledikleri, hipoglisemi korkusu yaşadıkları
ve insülin tedavisi sürecinde daha az zorluk bekledikleri saptanmıştır. Diyabetli bireylerin öz bakım gücü artırılarak insülin tedavisine
karşı olan olumsuz tutum ve davranışları engellenebilir.

Anahtar Kelimeler

İnsülin tedavisi İnsülin tedavisinde engeller Öz bakım Tip 2 diyabe

Etik Beyan

Çalışma için Çankırı Karatekin Üniversitesi Sağlık Bilimleri Enstitüsü Etik Kurulu'ndan etik onay alınmıştır (Etik Kurul Toplantı No: 23, Karar Tarihi: 09.11.2021). Çalışmanın yürütülmesi için Ankara Şehir Hastanesi'nden izin alınmıştır (Numara: E-90739940-799-2341, Karar Tarihi: 01.12.2022). Çalışmada kullanılan ölçekleri Türkçeye uyarlayan yazarlardan e-posta yoluyla izin alınmıştır. Çalışma, hastalara araştırma hakkında gerekli bilgiler verildikten ve gönüllü hastalardan sözlü onay alındıktan sonra gerçekleştirilmiştir.

Destekleyen Kurum

yoktur.

Teşekkür

Yazarlar araştırmaya gönüllü katılım sağlayan tüm katılımcılara ve sağlık çalışanlarına teşekkür etmektedirler.

Kaynakça

  • 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
  • 2. IDF Diabetes Atlas. 11th Edition 2025. [cited 2025 Aug 1]. Available from: https://diabetesatlas.org/
  • 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
  • 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
  • 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
  • 6. Özer E, Yıldız EA. Türkiye’de diyabet diyetisyenliği: 23 yıllık tarihsel süreç. Beslenme ve Diyet Dergisi. 2019;47:1-4.
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 15. Mogre V, Johnson NA, Tzelepis F, Paul C. Barriers to diabetic self-care: A qualitative study of patients' and healthcare providers' perspectives. J Clin Nurs. 2019; 28(11-12):2296–2308. https://doi.org/10.1111/jocn.14835
  • 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
  • 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
  • 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
  • 19. Üren Y, Karabulutlu EY. Tip 2 diyabet hastalarında diyabet kontrolünü zorlaştıran faktörlerin incelenmesi. Sağlık Bilimleri ve Meslekleri Dergisi. 2018;5(3).376-386.
  • 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
  • 21. Hartweg DL, Metcalfe SA. Orem'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
  • 22. Hartweg DL. Dorothea Orem’s self-care deficit nursing theory. In: Smith MC, Parker ME, editors. Nursing theories & nursing practice. 4nd ed. F. A. Davis Company, Philadelphia; 2015,105-133.
  • 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
  • 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
  • 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
  • 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
  • 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
  • 28. Lee NP, Fisher WP Jr. Evaluation of the Diabetes Self-Care Scale. J Appl Meas. 2005;6(4):366-81. PMID: 16192661.
  • 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
  • 30. Pituch KA, Stevens JP. Applied multivariate statistics for the social sciences: Routledge; 2012.
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 37. D'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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
Toplam 51 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular İç Hastalıkları
Bölüm Araştırma Makalesi
Yazarlar

Sema Gözel 0009-0009-5685-0411

Seher Gönen Şentürk 0000-0002-4785-6610

Gönderilme Tarihi 12 Ağustos 2025
Kabul Tarihi 16 Nisan 2026
Yayımlanma Tarihi 30 Nisan 2026
IZ https://izlik.org/JA56BX83ZH
Yayımlandığı Sayı Yıl 2026 Cilt: 10 Sayı: 1

Kaynak Göster

APA Gözel, S., & Gönen Şentürk, S. (2026). Investigation of the Relationship between the Barriers and Self-Care Behaviors in the Process of Insulin Therapy in Type 2 Diabetes. Turkish Journal of Diabetes and Obesity, 10(1), 1-10. https://izlik.org/JA56BX83ZH
AMA 1.Gözel S, Gönen Şentürk S. Investigation of the Relationship between the Barriers and Self-Care Behaviors in the Process of Insulin Therapy in Type 2 Diabetes. Turk J Diab Obes. 2026;10(1):1-10. https://izlik.org/JA56BX83ZH
Chicago Gözel, Sema, ve Seher Gönen Şentürk. 2026. “Investigation of the Relationship between the Barriers and Self-Care Behaviors in the Process of Insulin Therapy in Type 2 Diabetes”. Turkish Journal of Diabetes and Obesity 10 (1): 1-10. https://izlik.org/JA56BX83ZH.
EndNote Gözel S, Gönen Şentürk S (01 Nisan 2026) Investigation of the Relationship between the Barriers and Self-Care Behaviors in the Process of Insulin Therapy in Type 2 Diabetes. Turkish Journal of Diabetes and Obesity 10 1 1–10.
IEEE [1]S. Gözel ve S. Gönen Şentürk, “Investigation of the Relationship between the Barriers and Self-Care Behaviors in the Process of Insulin Therapy in Type 2 Diabetes”, Turk J Diab Obes, c. 10, sy 1, ss. 1–10, Nis. 2026, [çevrimiçi]. Erişim adresi: https://izlik.org/JA56BX83ZH
ISNAD Gözel, Sema - Gönen Şentürk, Seher. “Investigation of the Relationship between the Barriers and Self-Care Behaviors in the Process of Insulin Therapy in Type 2 Diabetes”. Turkish Journal of Diabetes and Obesity 10/1 (01 Nisan 2026): 1-10. https://izlik.org/JA56BX83ZH.
JAMA 1.Gözel S, Gönen Şentürk S. Investigation of the Relationship between the Barriers and Self-Care Behaviors in the Process of Insulin Therapy in Type 2 Diabetes. Turk J Diab Obes. 2026;10:1–10.
MLA Gözel, Sema, ve Seher Gönen Şentürk. “Investigation of the Relationship between the Barriers and Self-Care Behaviors in the Process of Insulin Therapy in Type 2 Diabetes”. Turkish Journal of Diabetes and Obesity, c. 10, sy 1, Nisan 2026, ss. 1-10, https://izlik.org/JA56BX83ZH.
Vancouver 1.Sema Gözel, Seher Gönen Şentürk. Investigation of the Relationship between the Barriers and Self-Care Behaviors in the Process of Insulin Therapy in Type 2 Diabetes. Turk J Diab Obes [Internet]. 01 Nisan 2026;10(1):1-10. Erişim adresi: https://izlik.org/JA56BX83ZH

Zonguldak Bülent Ecevit Üniversitesi Obezite ve Diyabet Uygulama ve Araştırma Merkezi’nin bilimsel yayım organıdır.

Web: https://obdm.beun.edu.tr/  Twitter: https://twitter.com/obezite_diyabet     Instagram: https://www.instagram.com/zbeuobezitediyabet/