Tip 1 Diyabetes Mellitusta Hemşirelik Bakımı
Özet
Tip 1 Diyabetes Mellitus pankreasta bulunan beta hücrelerinin harabiyetine bağlı ortaya çıkan insülin salgısının olmaması ya da yetersiz olması sonucu gelişen ve ömür boyu süren bir durumdur. Tip 1 DM, gelişen ve gelişmekte olan ülkelerde ciddi bir sorun teşkil etmektedir. Tip 1 DM’nin sayısal olarak arttığı ve en riskli hastalıklar sıralamasında 3’üncü sırada olduğu bilinmektedir. Hastalığın başlama yaşı değişken olmakla beraber 5-7 yaş arası ve adölesan dönem en sık tanı alınan dönemlerdir. Çocuk ve ailesine verilen eğitim ve tedavi ile hayat boyu diyabet yönetimi sağlanabilir. Tip 1 DM tedavisi, kan glikoz seviyesinin takibi, tıbbi beslenme tedavisi ve yaşam boyu ekzojen insülin replasmanını gerekli kılmaktadır. Bu sebeple optimal glisemik kontrol sağlanması Tip 1 DM yönetimindeki temel ilkedir. Kötü glisemik kontrol kısa vadede hipoglisemi, hiperglisemi ya da diyabetik ketoasidoz gibi durumlara yol açarken, uzun vadede retinopati, nöropati ya da nefropati gibi komplikasyonlara yol açabilmektedir. Diyabet yönetiminin köşe taşlarından biri olan diyabet hemşireleri bireysel izlem, insülin tedavisi, beslenme planı, fiziksel aktivite/egzersiz ve komplikasyonlar hakkında eğitimler vermektedir. Aynı zamanda çocuk ve ailesinden biri ihtiyaç duyduğunda ya da o konudaki eksiklik fark edildiğinde eğitim yinelenmelidir. Artan diyabetli birey sayısı ile birlikte diyabet hemşirelerinin sayısının artırılması, eğitimlerin toplum düzeyinde olması, hasta ve yakınları ile işbirliği içinde hareket edilmesi oldukça önemlidir.
Type 1 Diabetes Mellitus is a lifelong condition that develops as a result of the absence or insufficient secretion of insulin due to the destruction of beta cells in the pancreas. Type 1 DM is a serious problem in developing and developing countries. It is known that Type 1 DM is increasing numerically and ranks 3rd among the most risky diseases. Although the age of onset of the disease is variable, 5-7 years of age and adolescence are the most frequently diagnosed periods. Lifelong diabetes management can be achieved with education and treatment given to the child and his/her family. Treatment of type 1 DM requires monitoring of blood glucose levels, medical nutrition therapy and lifelong exogenous insulin replacement. Therefore, optimal glycemic control is the main principle in the management of Type 1 DM. Poor glycemic control may lead to hypoglycemia, hyperglycemia or diabetic ketoacidosis in the short term, while in the long term it may lead to complications such as retinopathy, neuropathy or nephropathy. Diabetes nurses, one of the cornerstones of diabetes management, provide trainings on individual follow-up, insulin treatment, nutrition plan, physical activity/exercise and complications. At the same time, education should be repeated when the child and his/her family members need it or when a deficiency in that subject is noticed. With the increasing number of individuals with diabetes, it is very important to increase the number of diabetes nurses, to provide education at the community level, and to act in cooperation with patients and their relatives.
Referanslar
American Diabetes Association (ADA). Children and adolescents: Standards of medical care in diabetes. Diabetes Care. 2018; 41(1): 126-136. doi: 10.2337/dc18-S012.
International Diabetes Federation (IDF). Dıabetes Atlas, 2019. https://diabetesatlas.org/idfawp/resource-files/2019/07/IDF_diabetes_atlas_ninth_edition_en.pdf (Erişim Tarihi: 8.9.2024)
Mayer-Davis EJ, Kahkoska AR, Jefferies C, et al. ISPAD Clinical Practice Consensus Guidelines 2018. Definition, epidemiology, and classification of diabetes in children and adolescents. Pediatr Diabetes. 2018;19 (27):7–19. doi: 10.1111/pedi.12773
Danne T, Phillip M, Buckingham BA, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Insulin treatment in children and adolescentes with diabetes. Pediatric Diabetes. 2018;19(27): 115–135. doi:10.1111/pedi.12718
American Diabetes Association (ADA). Children and adolescents: standards of medical care in diabetes. Diabetes Care. 2021; 44(1):180-199. doi:10.2337/dc22-S014.
Weber DR, Jospe N. Classification of diabetes mellitus. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF. (eds.), Nelson Textbook of Pediatrics. 21th ed. . Philadelphia: Elsevier Saunders; 2019. p. 11814-11822.
Green A, Hede SM, Patterson CC, et al. Type 1 diabetes in 2017: global estimates of incident and prevalent cases in children and adults. Diabetologia. 2021;64:2741-2750. doi:10.1007/s00125-021-05571-8
Maffeis C, Birkebaek NH, Konstantinova M, et al. SWEET Study Group. Prevalence of underweight, overweight, and obesity in children and adolescents with type 1 diabetes: Data from the international SWEET registry. Pediatric Diabetes. 2018;19(7):1211-1220. doi: 10.1111/pedi.12730.
International Diabetes Federation (IDF). Diabetes Atlas, 2022, https://diabetesatlas.org/idfawp/resource-files/2022/12/IDF-T1D-Index-Report.pdf (Erişim Tarihi: 8.9.2024)
Katsarou A, Gudbjörnsdottir S, Rawshani A, et al. Type 1 diabetes mellitus. Nature Reviews Disease Primers. 2017;3(1):1-17. doi: 10.1038/nrdp.2017.16
Tan SY, Wong JLM, Sim YJ, et al. Type 1 and 2 diabetes mellitus: A review on current treatment approach and gene therapy as potential intervention. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2019; 13(1): 364-372. doi: 10.1016/j.dsx.2018.10.008
Giwa AM, Ahmed R, Omidian Z, et al. Current understandings of the pathogenesis of type 1 diabetes: genetics to environment. World Journal of Diabetes. 2020;11(1):13-25. doi:10.4239/wjd.v11.i1.13
Besser RE, Bell KJ, Couper JJ, et al. ISPAD Clinical Practice Consensus Guidelines 2022: Stages of type 1 diabetes in children and adolescents. Pediatric Diabetes. 2022;23(8):1175-1187. doi:10.1111/pedi.13410
Rewers M, Hyöty H, Lernmark Å, et al. The Environmental Determinants of Diabetes in the Young (TEDDY) study: 2018 update. Current Diabetes Reports. 2018;18(12):136. doi: 10.1007/s11892-018-1113-2
Couper JJ, Halle MJ, Greenbaum CJ, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Stages of type 1 diabetes in children and adolescents. Pediatric Diabetes. 2018;19:20-27. doi: 10.1111/pedi.12734
Craig ME, Kim KW, Isaacs SR, Penno, et al. Early-life factors contributing to type 1 diabetes. Diabetologia. 2019;62:1823-1834. doi:10.1007/s00125-019-4942-x
Riikonen A, Hadley D, Uusitalo U, et al. Milk feeding and first complementary foods during the first year of life in the TEDDY study. Maternal & Child Nutrition. 2018;14(4):e12611. doi: 10.1111/mcn.12611
Sağlık Bakanlığı (SB). Birinci Basamak Sağlık Kurumlarında Tip 1 Diyabet Tanı Tedavi İzlem Rehberi, Ankara, 2018.
Çocuk Endokrinolojisi ve Diyabet Derneği. Çocukluk Çağı Diyabeti Tanı Ve Tedavi Rehberi 2018: 1-141.
Türkiye Endokrinoloji ve Metabolizma Derneği (TEMD). Diabetes Mellitus Ve Komplikasyonlarının Tanı, Tedavi Ve İzlem Kılavuzu, 2020:15-77.
Haynes, A., Hermann, J. M., Miller, K. M., Hofer, S. E., Jones, T. W., Beck, R. W., ... & T1D Exchange, WACDD and DPV registries. (2017). Severe hypoglycemia rates are not associated with HbA1c: a cross‐sectional analysis of 3 contemporary pediatric diabetes registry databases. Pediatric Diabetes, 18(7), 643-650. doi: 10.1111/pedi.12477
Abraham MB, Jones TW, Naranjo D, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Assessment and management of hypoglycemia in children and adolescents with diabetes. Pediatric Diabetes. 2018;19(27):178-192. doi: 10.1111/pedi.12698
Raghupathy P. Diabetic ketoacidosis in children and adolescents. Indian Journal of Endocrinology and Metabolism. 2015;19(1): 55-57. doi: 10.4103/2230-8210.155403.
Fayfman M, Pasquel FJ, Umpierrez GE. Management of hyperglycemic crises: diabetic ketoacidosis and hyperglycemic hyperosmolar state. Medical Clinics. 2017;101(3):587-606. doi:10.1016/j.mcna.2016.12.011
Wolfsdorf JI, Glaser N, Agus M, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Diabetic ketoacidosis and the hyperglycemic hyperosmolar state. Pediatric Diabetes. 2018;19(27):155-177. doi: 10.1111/pedi.12701
Donaghue KC, Marcovecchio ML, Wadwa RP, et al. ISPAD clinical practice consensus guidelines 2018: microvascular and macrovascular complications in children and adolescents. Pediatric Diabetes. 2018;19(27):262–274. doi:10.1111/pedi.12742
Birol L, Olgun N, Çelik S. Pankreas Hastalıkları ve Hemşirelik Bakımı. Akdemir N (ed.). İç Hastalıkları ve Hemşirelik Bakımı içinde. Ankara: Akademisyen Kitabevi; 2018. p. 937-968.
Smith A, Harris C. Type 1 diabetes: management strategies. American Family Physician. 2018;98(3): 154-162.
Smart CE, Annan F, Higgins LA, et al. ISPAD Clinical Practice Consensus Guidelines 2018: nutritional management in children and adolescents with diabetes. Pediatric Diabetes. 2018;19(27):136-154. doi:10.1111/pedi.12738
Tascini G, Berioli MG, Cerquiglini L, et al. Carbohydrate counting in children and adolescents with type 1 diabetes. Nutrients. 2018;10(1):109-119. doi:10.3390/nu10010109
Telek UDM. Karbonhidrat sayımını hastaya nasıl öğretebilirim?. Klinik Tıp Bilimleri. 2017;5(4): 5-7.
Mendoza JA, Haaland W, D'Agostino RB, et al. Food insecurity is associated with high risk glycemic control and higher health care utilization among youth and young adults with type 1 diabetes. Diabetes Research and Clinical Practice. 2018;138:128–137. doi: 10.1016/j.diabres.2018.01.035
Frohnert BI, Chase H, Rewers M. Diabetes mellitus. In: Bunik M, Hay WW, Levin MJ, Abzug MJ. (eds.). Current Diagnosis & Treatment Pediatrics. 24th ed. Colorado: McGraw-Hill Education;2018. p.1054-1064.
Cameron D, Harris FM, Evans J. Patterns of self-monitoring of blood glucose (SMBG) in insulin-treated diabetes: analysis of a Scottish population over time (Research Letter). Diabetes, Obesity and Metabolism. 2016;18(7):729-731.
Referanslar
American Diabetes Association (ADA). Children and adolescents: Standards of medical care in diabetes. Diabetes Care. 2018; 41(1): 126-136. doi: 10.2337/dc18-S012.
International Diabetes Federation (IDF). Dıabetes Atlas, 2019. https://diabetesatlas.org/idfawp/resource-files/2019/07/IDF_diabetes_atlas_ninth_edition_en.pdf (Erişim Tarihi: 8.9.2024)
Mayer-Davis EJ, Kahkoska AR, Jefferies C, et al. ISPAD Clinical Practice Consensus Guidelines 2018. Definition, epidemiology, and classification of diabetes in children and adolescents. Pediatr Diabetes. 2018;19 (27):7–19. doi: 10.1111/pedi.12773
Danne T, Phillip M, Buckingham BA, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Insulin treatment in children and adolescentes with diabetes. Pediatric Diabetes. 2018;19(27): 115–135. doi:10.1111/pedi.12718
American Diabetes Association (ADA). Children and adolescents: standards of medical care in diabetes. Diabetes Care. 2021; 44(1):180-199. doi:10.2337/dc22-S014.
Weber DR, Jospe N. Classification of diabetes mellitus. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF. (eds.), Nelson Textbook of Pediatrics. 21th ed. . Philadelphia: Elsevier Saunders; 2019. p. 11814-11822.
Green A, Hede SM, Patterson CC, et al. Type 1 diabetes in 2017: global estimates of incident and prevalent cases in children and adults. Diabetologia. 2021;64:2741-2750. doi:10.1007/s00125-021-05571-8
Maffeis C, Birkebaek NH, Konstantinova M, et al. SWEET Study Group. Prevalence of underweight, overweight, and obesity in children and adolescents with type 1 diabetes: Data from the international SWEET registry. Pediatric Diabetes. 2018;19(7):1211-1220. doi: 10.1111/pedi.12730.
International Diabetes Federation (IDF). Diabetes Atlas, 2022, https://diabetesatlas.org/idfawp/resource-files/2022/12/IDF-T1D-Index-Report.pdf (Erişim Tarihi: 8.9.2024)
Katsarou A, Gudbjörnsdottir S, Rawshani A, et al. Type 1 diabetes mellitus. Nature Reviews Disease Primers. 2017;3(1):1-17. doi: 10.1038/nrdp.2017.16
Tan SY, Wong JLM, Sim YJ, et al. Type 1 and 2 diabetes mellitus: A review on current treatment approach and gene therapy as potential intervention. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2019; 13(1): 364-372. doi: 10.1016/j.dsx.2018.10.008
Giwa AM, Ahmed R, Omidian Z, et al. Current understandings of the pathogenesis of type 1 diabetes: genetics to environment. World Journal of Diabetes. 2020;11(1):13-25. doi:10.4239/wjd.v11.i1.13
Besser RE, Bell KJ, Couper JJ, et al. ISPAD Clinical Practice Consensus Guidelines 2022: Stages of type 1 diabetes in children and adolescents. Pediatric Diabetes. 2022;23(8):1175-1187. doi:10.1111/pedi.13410
Rewers M, Hyöty H, Lernmark Å, et al. The Environmental Determinants of Diabetes in the Young (TEDDY) study: 2018 update. Current Diabetes Reports. 2018;18(12):136. doi: 10.1007/s11892-018-1113-2
Couper JJ, Halle MJ, Greenbaum CJ, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Stages of type 1 diabetes in children and adolescents. Pediatric Diabetes. 2018;19:20-27. doi: 10.1111/pedi.12734
Craig ME, Kim KW, Isaacs SR, Penno, et al. Early-life factors contributing to type 1 diabetes. Diabetologia. 2019;62:1823-1834. doi:10.1007/s00125-019-4942-x
Riikonen A, Hadley D, Uusitalo U, et al. Milk feeding and first complementary foods during the first year of life in the TEDDY study. Maternal & Child Nutrition. 2018;14(4):e12611. doi: 10.1111/mcn.12611
Sağlık Bakanlığı (SB). Birinci Basamak Sağlık Kurumlarında Tip 1 Diyabet Tanı Tedavi İzlem Rehberi, Ankara, 2018.
Çocuk Endokrinolojisi ve Diyabet Derneği. Çocukluk Çağı Diyabeti Tanı Ve Tedavi Rehberi 2018: 1-141.
Türkiye Endokrinoloji ve Metabolizma Derneği (TEMD). Diabetes Mellitus Ve Komplikasyonlarının Tanı, Tedavi Ve İzlem Kılavuzu, 2020:15-77.
Haynes, A., Hermann, J. M., Miller, K. M., Hofer, S. E., Jones, T. W., Beck, R. W., ... & T1D Exchange, WACDD and DPV registries. (2017). Severe hypoglycemia rates are not associated with HbA1c: a cross‐sectional analysis of 3 contemporary pediatric diabetes registry databases. Pediatric Diabetes, 18(7), 643-650. doi: 10.1111/pedi.12477
Abraham MB, Jones TW, Naranjo D, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Assessment and management of hypoglycemia in children and adolescents with diabetes. Pediatric Diabetes. 2018;19(27):178-192. doi: 10.1111/pedi.12698
Raghupathy P. Diabetic ketoacidosis in children and adolescents. Indian Journal of Endocrinology and Metabolism. 2015;19(1): 55-57. doi: 10.4103/2230-8210.155403.
Fayfman M, Pasquel FJ, Umpierrez GE. Management of hyperglycemic crises: diabetic ketoacidosis and hyperglycemic hyperosmolar state. Medical Clinics. 2017;101(3):587-606. doi:10.1016/j.mcna.2016.12.011
Wolfsdorf JI, Glaser N, Agus M, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Diabetic ketoacidosis and the hyperglycemic hyperosmolar state. Pediatric Diabetes. 2018;19(27):155-177. doi: 10.1111/pedi.12701
Donaghue KC, Marcovecchio ML, Wadwa RP, et al. ISPAD clinical practice consensus guidelines 2018: microvascular and macrovascular complications in children and adolescents. Pediatric Diabetes. 2018;19(27):262–274. doi:10.1111/pedi.12742
Birol L, Olgun N, Çelik S. Pankreas Hastalıkları ve Hemşirelik Bakımı. Akdemir N (ed.). İç Hastalıkları ve Hemşirelik Bakımı içinde. Ankara: Akademisyen Kitabevi; 2018. p. 937-968.
Smith A, Harris C. Type 1 diabetes: management strategies. American Family Physician. 2018;98(3): 154-162.
Smart CE, Annan F, Higgins LA, et al. ISPAD Clinical Practice Consensus Guidelines 2018: nutritional management in children and adolescents with diabetes. Pediatric Diabetes. 2018;19(27):136-154. doi:10.1111/pedi.12738
Tascini G, Berioli MG, Cerquiglini L, et al. Carbohydrate counting in children and adolescents with type 1 diabetes. Nutrients. 2018;10(1):109-119. doi:10.3390/nu10010109
Telek UDM. Karbonhidrat sayımını hastaya nasıl öğretebilirim?. Klinik Tıp Bilimleri. 2017;5(4): 5-7.
Mendoza JA, Haaland W, D'Agostino RB, et al. Food insecurity is associated with high risk glycemic control and higher health care utilization among youth and young adults with type 1 diabetes. Diabetes Research and Clinical Practice. 2018;138:128–137. doi: 10.1016/j.diabres.2018.01.035
Frohnert BI, Chase H, Rewers M. Diabetes mellitus. In: Bunik M, Hay WW, Levin MJ, Abzug MJ. (eds.). Current Diagnosis & Treatment Pediatrics. 24th ed. Colorado: McGraw-Hill Education;2018. p.1054-1064.
Cameron D, Harris FM, Evans J. Patterns of self-monitoring of blood glucose (SMBG) in insulin-treated diabetes: analysis of a Scottish population over time (Research Letter). Diabetes, Obesity and Metabolism. 2016;18(7):729-731.
