Follow-Up and Community Care of the Child With a Chronic Disease

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DOI :10.26650/B/CH32.2024.010.031   IUP :10.26650/B/CH32.2024.010.031    Full Text (PDF)

Follow-up and Community Care of the Child with Type 1 Diabetes Mellitus

Özge Bayrak Demirel, Melek Yıldız

Type 1 diabetes mellitus (T1DM) is a chronic metabolic disease with a high prevalence among children and adolescents. Its incidence is increasing worldwide. Mostly due to autoimmunity, pancreatic beta cells are chronically destroyed resulting in insulin deficiency. Environmental triggers initiate T1DM in children predisposed to T1DM with multifactorial and polygenic inheritance. Classic signs of T1DM are polyuria, polydipsia, and weight loss. A random plasma glucose level ≥ 200 mg/dL is diagnostic. Late diagnosis progress to diabetic ketoacidosis (DKA). During follow-up of T1DM, an optimum glycemic control should be achieved by educating the patients and their families about diabetes. Follow-up is conducted by team consisting of a pediatric endocrinologist, diabetes nurse, dietitian, and psychologist. As nutrition is of great importance in the management of diabetes, a comprehensive knowledge on nutrition is urgently needed by the patients and their families. Moreover, regular physical activity improves the quality of life and contributes to normal growth and development. Children with diabetes can safely participate in sports activities like their healthy peers when necessary arrangements are made, for example, achieving glycemic control at school. An individualized program should be prepared, considering physical education classes and exams. To prevent the development of acute and serious complications such as hypoglycemia and DKA, family education programs should be expanded. As T1DM management is a lifelong process. psychosocial support should be given to the patients and their families along with regular and continuous communication with the diabetes team.


Keywords: Type 1 diabetes mellitus, pediatric endocrinology, diabetes education, diabetes team, follow-up
DOI :10.26650/B/CH32.2024.010.031   IUP :10.26650/B/CH32.2024.010.031    Full Text (PDF)

Ti̇p 1 Di̇abetes Melli̇tus Olan Çocuğun İzlemi̇ ve Toplumda Bakımı

Özge Bayrak Demirel, Melek Yıldız

Tip 1 diabetes mellitus , çocuk ve ergenlerde en sık görülen diyabet şekli olup, kronik metabolik bir hastalıktır. Tip 1 diabetes mellitus insidansı tüm dünyada giderek artmaktadır. Çoğunlukla otoimmünite nedeniyle pankreas beta hücreleri kronik yıkıma uğrar ve insülin eksikliği gelişir. Multifaktöriyel poligenik kalıtım gösteren Tip 1 diabetes mellitus’e yatkın olan çocuklarda çevresel tetikleyiciler hastalığı başlatır. Klasik Tip 1 diabetes mellitus bulguları poliüri, polidipsi ve tartı kaybıdır. Karakteristik semptomların varlığında rastgele alınan plazma glukoz düzeyinin ≥ 200 mg/dL olması tanı koydurucudur. Erken fark edilmeyen olgular diyabetik ketoasidoz ile başvurabilir. Tip 1 diabetes mellitus izleminde optimum glisemik kontrol sağlamak amaçlanır. Çocuğa ve aileye diyabet eğitimi vermek amaca ulaşmada önemli bir rol oynar. Tip 1 diabetes mellitus tanısı olançocuk endokrinoloji uzmanı, diyabet hemşiresi, diyetisyen ve psikologdan oluşan diyabet ekibi tarafından takip edilmelidir. Diyabet tedavisinde beslenme büyük öneme sahiptir. Tip 1 diabetes mellitus tanısı konan çocuklara ve ailelerine en erken zamanda kapsamlı bir beslenme eğitimi verilmelidir. Düzenli fiziksel aktivite yaşam kalitesini artırır, büyüme ve gelişmeye katkı sağlar. Diyabetli çocuklar, gerekli düzenlemeler yapıldığında, sağlıklı akranları gibi güvenle spor yapabilirler. Okulda glisemik kontrolün sağlanabilmesi diyabet yönetimi için çok önemlidir. Beden eğitimi dersleri ve sınavlar göz önünde bulundurularak, her çocuk için bireyselleştirilmiş bir program hazırlanmalıdır. Hipoglisemi ve diyabetik ketoasidoz, Tip 1 diabetes mellitus’ün akut ve ciddi komplikasyonlarıdır. Komplikasyon gelişmesini engellemek için aile eğitimi programları yaygınlaştırılmalıdır. Tip 1 diabetes mellitus tanısı alan çocuk ve ailesi psikososyal açıdan da takip edilmeli ve desteklenmelidir. Diyabet ekibinin, çocuklar ve aileleri ile iletişimi düzenli ve sürekli olmalıdır. Tip 1 diabetes mellitus tedavisi yaşam boyu devam edecek bir süreçtir. 


Keywords: Tip 1 diabetes mellitus, çocuk endokrinoloji, diyabet eğitimi, diyabet ekibi, diyabet izlemi

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