Ankara Med J. 2021; 21(4): 658-671 | DOI: 10.5505/amj.2021.47048

Ýnsülin Kullanan Diyabetli Hastalarda Hipoglisemi Sýklýðý ve Þiddetini Etkileyen Faktörler

Birgül Genç¹, Ayþegül Koç^2
1Ankara Þehir Hastanesi, Endokrinoloji ve Metabolizma Hastalýklarý Kliniði, Ankara
²Ankara Yýldýrým Beyazýt Üniversitesi, Saðlýk Bilimleri Fakültesi, Ýç Hastalýklarý Hemþireliði Anabilim Dalý, Ankara

GÝRÝÞ ve AMAÇ: Bu çalýþma insülin kullanan diyabetli hastalarda hipoglisemi sýklýðý, þiddeti ve hipoglisemiyi etkileyen faktörleri belirlemek amacýyla yapýlmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþma kliniðimizde tedavi olan veya Polikliniðe ayaktan baþvuran, 18 yaþ üzeri insülin kullanan diyabet tanýlý 1038 hasta ile yapýlmýþtýr.
BULGULAR: Araþtýrma bulgularýna göre çalýþmaya alýnan bireylerin yaþ ortalamalarýnýn (53,50±9,44 yýl) yüksek ve çoðunluðunun kadýn olduðu tespit edilmiþtir. Olgularýn çoðunluðunun; ilköðretim mezunu, þehir merkezinde yaþayan, sosyal güvencesi olan, ev hanýmlarýndan oluþan, sigara ve alkol kullanmayan, T2DM (Tip 2 Diyabet)’li, ek hastalýk olarak da en çok hipertansiyon ve hiperlipidemi görülen bireyler olduðu belirlenmiþtir. Diyabet taný süresi yüksek olan olgularýn çoðunluðu diyabet ve insülin eðitimi almýþ, diyet ve egzersiz yapmayan, son iki yýlda insülin baþlanmýþ, karýþým insülin tedavisi alan bireylerden oluþmaktadýr. Hipoglisemi deneyimleme oraný yüksek olup hipoglisemilerin nadir ve hafif yaþandýðý görülmüþtür. Olgularýn tamamýna yakýnýnýn glukometresinin bulunduðu, ölçüm yaptýðý, insülin enjeksiyonunu kendisinin uyguladýðý, enjeksiyonlarda 8 mm iðne ucu kullandýðý ve bölge deðiþtirdiði tespit edilmiþtir. Metabolik ölçümlerde BKÝ, AKÞ ve TKÞ’ler, bel çevreleri ve HbA1c’lerin yüksek olduðu belirlenmiþtir.
TARTIÞMA ve SONUÇ: Araþtýrmada yapýlan analizlerde meslek, diyabet tipi, insülin tipi, retinopati, glukoz takibi, diyabet süresi, insülin kullanma süresinin hipoglisemi varlýðý açýsýndan; yaþ ve insülin kullanma süresinin hipoglisemi sýklýðý açýsýndan; insülin kullanma süresinin hipoglisemi þiddeti açýsýndan anlamlý olduðu tespit edilmiþtir.

Anahtar Kelimeler: Diyabet, hemþirelik, hipoglisemi, insülin

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Factors That Affect Hypoglycemia Frequency and Severity in Diabetic Patients Using Ýnsulin

Birgül Genç¹, Ayþegül Koç^2
1Ankara City Hospital, Department of Endocrinology and Metabolism, Ankara
²Ankara Yildirim Beyazit University, Faculty of Health Sciences, Department of Internal Medicine Nursing, Ankara

INTRODUCTION: This study was conducted in order to determine the frequency and severity of hypoglycemia and factors affecting hypoglycemia in diabetic patients.
METHODS: The patients hospitalized in the endocrinology ward or admitted to our outpatient clinics were included. All patients were above 18 years of age and had diabetes who were receiving insulin treatment. A total of 1038 patients were enrolled.
RESULTS: According to our findings, the patients in the study group were mostly female and relatively older. Most patients had low education levels and social status, and they were mostly living in the city suburbs. Most female patients in that group were housewives, and the most common accompanying comorbidities were hypertension and hyperlipidemia. The patients had a long duration of diabetes history and had received "diabetes and insulin education" before. Despite education, they didn't make the appropriate lifestyle changes such as diet and exercise. The mean insulin usage time was two years, and premixed insulins were the most common ones that were being used. Although hypoglycemia was frequent, the rate of severe attacks was low. Almost all cases had glucometer at home and were making self blood glucose monitoring. Moreover, almost all patients were injecting insulin to themselves, and the most common needle diameter was 8 mm. In our study, the enrolled patients' mean BMI, FPG, PPG were above the target range.
DISCUSSION AND CONCLUSION: In the analysis made in the research, occupation, diabetes type, insulin type, retinopathy, glucose follow-up, duration of diabetes, the duration of insulin treatment were found to be significant in terms of the presence of hypoglycemia; age and duration of insulin treatment were found to be significant in terms of frequency of hypoglycemia; duration of insulin treatment was significant in terms of severity of hypoglycemia.

Keywords: Diabetes, hypoglycaemia, insulin, nursing

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ATIF KOPYALA