Tip 2 Diyabetli Bireylerde Diyabetik Ayak ve Hemşirelik Yaklaşımı

Yazarlar

Yakup Sarpdağı
Cantürk Çapık

Özet

Bu çalışma, 21. yüzyılın en büyük küresel sağlık sorunlarından biri olan diabetes mellitusun önemli bir kronik komplikasyonu olan diyabetik ayağı ve bu süreçteki hemşirelik yaklaşımını kapsamlı bir şekilde ele almaktadır. Dünya genelinde milyonlarca insanı etkileyen diyabetik ayak, doğru öz bakım davranışlarıyla büyük oranda önlenebilen ancak müdahale edilmediğinde ampütasyona yol açabilen ciddi bir halk sağlığı sorunudur. Kitapta, diyabetin tanımı, epidemiyolojisi, patofizyolojisi ve Wagner-Megitt sınıflandırma sistemine göre evreleri detaylı olarak incelenmektedir. Özellikle multidisipliner ekibin aktif bir üyesi olan diyabet hemşirelerinin, hastaların risk durumlarını belirleme, yara bakımı yapma, hasta ve ailesine günlük ayak kontrolü ve hijyeni konusunda eğitim verme rollerinin önemi vurgulanmaktadır. Koruyucu sağlık hizmetleri ve hasta eğitimiyle bu komplikasyonun mali yükünün ve mortalite oranlarının minimal düzeye indirilebileceğini gösteren bu eser, sağlık profesyonelleri için önemli bir rehber niteliğindedir.

This study comprehensively addresses diabetic foot, a major chronic complication of diabetes mellitus, which is considered one of the largest global health problems of the 21st century, and the corresponding nursing approach. Affecting millions worldwide, diabetic foot is a serious public health issue that can be largely prevented through correct self-care behaviors but can lead to amputation if left unmanaged. The text details the definition, epidemiology, and pathophysiology of diabetes, along with its stages according to the Wagner-Megitt classification system. It particularly emphasizes the vital role of diabetes nurses, as active members of the multidisciplinary team, in identifying risk statuses, performing wound care, and educating patients and their families on daily foot inspection and hygiene. Demonstrating that the financial burden and mortality rates of this complication can be minimized through preventive healthcare and patient education, this work serves as an essential guide for healthcare professionals.

Referanslar

ADA. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37(1):81–90.

Sperling MAIJ. Wolfsdorf RK, Menon W V, et al. Sperling Pediatric Endocrinology. In:Sperling MA (eds). Diabetes Mellitus. 5nd ed. Philadelphia, Elsevier:; 2021. 814-883. p.

Carver C, Abrahamson M. Diabetes Mellitus Overview. Educating your patient with diabete. Springer. 2009;15-27.

Abutaleb MH. Diabetes mellitus: an overview. Pharm Pharmacol Int J. 2016;4(5):406-411.

TURKDİAB. Diyabet Tanı ve Tedavi Rehberi. Retrieved from Available from: (05/12/2021 tarihinde https://www.turkdiab.org/admin/PICS/files/Diyabet_Tani_ve_Tedavi_Rehberi_2019.pdf adresinden ulaşılmıştır).

IDF. International Diabetes Federation. Diabetes now affects one in 10 adults worldwide, retrieved Nov. 2021. Available from: (21/09/2021 tarihinde https://www.idf.org/news/240:diabetes-now-affects-one-in-10-adults-worldwide.html’ adresinden ulaşılmıştır).

Bus SA, van Netten JJ, Lavery LA, et al. IWGDF guidance on the prevention of foot ulcers in at-risk patients with diabetes. Diabetes Metab Res Rev. 2016;32:16–24.

Howarth D. Preventing foot complications in people with diabetes mellitus. Nurs Stand. 2019;34(7):69–74.

IDF. IDF Diabetes Atlas Ninth Edition 2019. 9nd ed. Brussels, Belgium;2019. 176 p.

IDF. International Diabetes Federation. IDF Diabetes Atlas. 8th ed. Brussels, Belgium; 2017.

Animaw W, Seyoum Y. Increasing prevalence of diabetes mellitus in a developing country and its related factors. PLoS One. 2017;12(11):e0187670.

Shrestha M, Al-Ghareeb A, Alenazi F, et al. Association between subthreshold depression and self-care behaviour in people with type 2 diabetes: a protocol for systematic review of observational studies. Syst Rev. 2019;8(1):167.

Cho NH, Shaw JE, Karuranga S, et al. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract . 2018;138:271–81.

Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2019;157:107843.

WHO. Global Report on Diabetes . Vol. 978, Isbn. 2016. Available from: (16/09/2021 tarihinde ttps://apps.who.int/iris/handle/10665/204871 adresinden ulaşılmıştır)

TUİK. TUİK İstatistiklerle Türkiye. 2019. 1–163 p. Available from: (19/08/2022 tarihinde https://biruni.tuik.gov.tr/yayin/views/visitorPages/index.zul adresinden ulaşılmıştır)

Satman I, Omer B, Tutuncu Y, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol. 2013;28(2):169–80.

IDF. IDF Clinical Practice Recommendations on the Diabetic Foot 2017. 2017; 1-70. (13/4/2022 tarihinde https://www.idf.org/e-library/guidelines/119-idf-clinical-practice-recommendations-on-diabetic-foot-2017.html adresinden ulaşılmıştır).

TDP. Türkiye Diyabet Programı 2015-2020. Ankara; avaible from: (18/10/2022 tarihinde TUR_D1_Türkiye%20Diyabet%20Programı%202015-2020.pdf adresinden ulaşılmıştır)

Olgun N ÇS. “Diyabetin tanı kriterleri, etiyolojik sınıflaması, klinik dönemleri ve fizyopatolojisi.” In: S E, ŞÖ (eds). Diyabet Hemşireliği,. İstanbul: Nobel Tıp Kitabevleri; 2021. p. 19–36.

Langenberg C, Lotta LA. Genomic insights into the causes of type 2 diabetes. Lancet. 2018;391(10138):2463–74.

TEMD. Diabetes mellitus ve komplikasyonlarının tanı, tedavi ve izlem kılavuzu. 14 nd ed. Anakara: BAYT Bilimsel Araştırmalar Basın Yayın ve Tanıtım Ltd. Şti.; 2020.

ADA. Classification and diagnosis of diabetes: standards of medical care in diabetes 2021. Diabetes Care. 2021;44(1):15–33.

Viner R, White B, Christie D. Type 2 diabetes in adolescents: a severe phenotype posing major clinical challenges and public health burden. Lancet. 2017;389(10085):2252–2260.

Jaacks LM, Siegel KR, Gujral UP, et al. Type 2 diabetes: A 21st century epidemic. Best Pract Res Clin Endocrinol Metab. 2016;30(3):331–43.

ADA. Classification and diagnosis of diabetes: standards of medical care in diabetes 2018. Diabetes Care. 2018;41.

Camelo-Castillo W, Boggess K, Stürmer T, et al. Association of adverse pregnancy outcomes with glyburide vs ınsulin in women with gestational diabetes. JAMA Pediatr. 2015;169(5):452.

Feig DS, Moses RG. Metformin therapy during pregnancy. Diabetes Care. 2011;34(10):2329–2330.

ADA. Standards of medical care in diabetes. Diabetes Care. 2019;42(1):1–204.

Orbay E. Diyabetin komplikasyonları. Turkiye Klin Nutr Diet - Spec Top. 2017;3(3):135–40.

Papatheodorou K, Banach M, Bekiari E, et al. Complications of diabetes 2017. J Diabetes Res. 2018;2018:1–4.

Gedebjerg A, Almdal TP, Berencsi K, et al. Prevalence of micro- and macrovascular diabetes complications at time of type 2 diabetes diagnosis and associated clinical characteristics: A cross-sectional baseline study of 6958 patients in the Danish DD2 cohort. J Diabetes Complications. 2018;32(1):34–40.

Chinese Diabetes Society. Chinese Diabetes Society, Chinese Society of Infectious Diseases. Chinese guideline on prevention and management of diabetic foot (2019 edition)(I). Chin J Diabetes Mellitus. 2019;11(2):92–108.

Saltoğlu N, Kılıçoğlu Ö, Baktıroğlu S, et al. Diyabetik ayak yarası ve infeksiyonunun tanısı, tedavisi ve önlenmesi: Ulusal uzlaşı raporu. Klimik Derg. 2015;28(June):2–34.

Armstrong DG, Boulton AJM, Bus SA. Diabetic foot ulcers and their recurrence. Engl J Med. 2017;376(24):2367–2375. http://www.nejm.org/doi/10.1056/NEJMra1615439

Walsh JW, Hoffstad OJ, Sullivan MO, et al. Association of diabetic foot ulcer and death in a population-based cohort from the United Kingdom. Diabet Med. 2016;33(11):1493–1498.

Ahmad J. The diabetic foot. Diabetes & Metabolic Syndrome: Clin Res Rev. 2016;10:48–60.

TEMD. TEMD Diabetes Mellitus Çalışma ve Eğitim Grubu. Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Klavuzu 2019. 13th ed. Ankara; 2019. 269 p.

Banik PC, Barua L, Moniruzzaman M,et al. Risk of diabetic foot ulcer and its associated factors among Bangladeshi subjects: a multicentric cross-sectional study. BMJ Open. 2020;10(2):e034058.

Littman AJ, Knott CJ, Boyko EJ, et al. Associations between racial and ethnic groups and foot self-ınspection in people with diabetes. Diabetes Care. 2020;43(5):956–63.

Mishra SC, Chhatbar KC, Kashikar A,et al. Diabetic foot. BMJ. 2017;359:j5064

Juster-Switlyk K, Smith AG. Updates in diabetic peripheral neuropathy. F1000Research. 2016;5:738.

Bonner T, Foster M, Spears-Lanoix E. Type 2 diabetes–related foot care knowledge and foot self-care practice interventions in the United States: a systematic review of the literature. Diabet Foot Ankle. 2016;7(1):29758.

Rocha RM, Zanetti ML, Santos MA. Comportamento e conhecimento: fundamentos para prevenção do pé diabético. Acta Paul Enferm. 2009;22(1):17–23.

Karaca-Sivrikaya S, Ergün S. Diyabet eğitimi ve hemşirenin rolü. Ahi Evran Üniversitesi Sağlık Yüksekokulu Sağlık Bilim Derg. 2018;2(3):25–36.

Kır Biçer E, Enç N. Ayak bakım davranışı ölçeği türkçe formu geçerlik ve güvenirliği. Diyabet, Obezite ve Hipertans Derg. 2014;6(2):35–9.

Arıcan Ö, Şaşmaz S. Diyabetik hastalarda ayak bakımı. Türkiye Klin Derg. 2004;24(1):541–6.

Nural N, Hindistan S. The opinions of nurses graduated from faculty about bachelor’s degree education and affected factors. Anadolu Hemşirelik ve Sağlık Bilim Dergisi. 2015;18(2):118–21.

Aalaa M, Malazy OT, Sanjari M, et al. Nurses’ role in diabetic foot prevention and care; a review. J Diabetes Metab Disord. 2012;11(1):1–6.

Yayınlanan

6 Ocak 2023

Lisans

Lisans