Dergiler / Güncel Hemşirelik Araştırmaları Dergisi / 2026 / Cilt: 5 Sayı: 2

Tı̇p 1 Dı̇yabetlı̇ Ergenlerde Glı̇semı̇k Kontrolün Yordayıcıları Olarak Uyku Bozukluğu ve Hı̇poglı̇semı̇ Korkusu

Sleep Disturbance and Fear of Hypoglycemia as Predictors of Glycemic Control in Adolescents with Type 1 Diabetes

Harun Özbey(ERCİYES ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ FAKÜLTESİ)0000-0001-9827-0655
Meral Bayat(ERCİYES ÜNİVERSİTESİ)0000-0002-7076-1097
Tolga Topal(ERCİYES ÜNİVERSİTESİ)0009-0002-3480-0658
Ayşe Çeri(ERCİYES ÜNİVERSİTESİ)0009-0000-2144-328X
Nihal Hatipoğlu(ERCİYES ÜNİVERSİTESİ)0000-0002-0991-6539
Sayfa
171–181
Yayın Tarihi
2025-08-31
DOI
—
🏛️Bu makalenin bibliyografik verileri ve tam metin bağlantısı DergiPark üzerinden sağlanmıştır.
DergiPark Kaydı ↗
✨

Yapay Zeka Hızlı Bakış & Çıkarımlar

AI Insight
⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Bulgular: Araştırmada T1DM’li ergenlerin total DKŞÖ ve UBÖ puan ortalamalarının sırasıyla 57,68±10,64 ve 22,86±3,25 olduğu belirlenmiştir.

📌 3 Maddede Bu Makale

🎯
Amaç & Hipotez:Amaç: Bu çalışmanın amacı, T1DM’li ergenlerde uyku bozukluğu ve hipoglisemi korkusunun glisemik kontrolü yordama düzeylerinin belirlenmesidir.
📊
Temel Bulgular & Veri:Yöntem: Çalışma, 2024-2025 yılları arasında bir üniversite hastanesinin Çocuk Endokrinoloji Polikliniği’nde takip edilen 12-17 yaş arası 114 T1DM’li ergen ile yapılmıştır.
💡
Sonuç & Katkı:Bulgular: Araştırmada T1DM’li ergenlerin total DKŞÖ ve UBÖ puan ortalamalarının sırasıyla 57,68±10,64 ve 22,86±3,25 olduğu belirlenmiştir.
🔬Tür:Modelleme & Sayısal Simülasyon
📍Kapsam:2024-2025 Verileri
⚙️Değişkenler:Ergen · Glisemik Kontrol · Hipoglisemi Korkusu

Özet

Amaç: Bu çalışmanın amacı, T1DM’li ergenlerde uyku bozukluğu ve hipoglisemi korkusunun glisemik kontrolü yordama düzeylerinin belirlenmesidir. Yöntem: Çalışma, 2024-2025 yılları arasında bir üniversite hastanesinin Çocuk Endokrinoloji Polikliniği’nde takip edilen 12-17 yaş arası 114 T1DM’li ergen ile yapılmıştır. Etik kurul, kurum, ergen ve ebeveyn izni alınarak yapılan bu çalışmada veriler Ergen tanıtıcı özellikler formu, Virginia Üniversitesi Çocuk/Ergen Düşük Kan Şekeri Ölçeği ve DSM-5 Düzey 2 Uyku Bozukluğu Ölçeği ile toplanmıştır. Çalışmanın verileri Jamovi 2.6.13 paket programı kullanılarak değerlendirilmiştir. Uyku bozukluğu ile hipoglisemi korkusunun glisemik kontrolü yordama düzeyi ise iki aşamalı Hiyerarşik Çoklu Doğrusal Regresyon analizi ile değerlendirilmiştir. Bulgular: Araştırmada T1DM’li ergenlerin total DKŞÖ ve UBÖ puan ortalamalarının sırasıyla 57,68±10,64 ve 22,86±3,25 olduğu belirlenmiştir. Yapılan iki aşamalı hiyerarşik regresyon analizi sonucunda, Model I’ de hipoglisemi korkusunun glisemik kontrolün %33,6’sını açıkladığı, Model II’ de ise hipoglisemi korkusu ile uyku bozukluğunun birlikte glisemik kontrolün %47,2’sini açıkladığı ve modellerin istatistiksel olarak önemli olduğu belirlenmiştir (p≤ 0,001). Sonuç: T1DM’li ergenlerde hipoglisemi korkusu ile uyku bozukluğu’nun glisemik kontrolün yordayıcıları olduğu saptanmıştır. Hemşireler, hipoglisemi korkusunu azaltmak için ergenlere ve ailelerine yönelik eğitim programları geliştirilmeli, hipoglisemi semptomlarının tanınması ve glukoz izlem teknolojilerinin etkin kullanımı hakkında rehberlik sağlamalıdır. Ayrıca, uyku bozukluğunun glisemik kontrol üzerindeki olumsuz etkisi, hemşirelerin uyku hijyeni konusunda danışmanlık yapmasını ve uyku kalitesini değerlendiren araçlar kullanmasını gerektirir. Ergen odaklı bir yaklaşım benimsenerek, motivasyonel görüşme teknikleri ve psikososyal destekle öz-yönetim becerileri güçlendirilmelidir. Hemşireler, multidisipliner iş birliği içinde çalışarak, hipoglisemi korkusu ve uyku bozukluğuna yönelik erken müdahaleler planlamalıdır.

Abstract

Aim: This study aimed to determine the predictive levels of sleep disturbance and fear of hypoglycemia for glycemic control in adolescents with T1DM. Methods: The study was conducted with 114 adolescents aged 12-17 years with T1DM who were followed up in the Pediatric Endocrinology Outpatient Clinic of a university hospital between 2024-2025. Ethics committee, institutional, adolescent and parental permissions were obtained, and data were collected using the Adolescent Descriptive Characteristics Form, The University of Virginia Child/Teen Low Blood Sugar Survey and DSM-5 Level 2 Sleep Disorder Scale. The data of the study were evaluated using the Jamovi 2.6.13 software package. The level of predicting glycemic control by sleep disorder and fear of hypoglycemia was evaluated using a two-step Hierarchical Multiple Linear Regression analysis. Results: The study, it was determined that the mean scores of the children with T1DM were 57,68±10,64 and 22,86±3,25, respectively. As a result of the two-stage hierarchical regression analysis, it was determined that fear of hypoglycemia explained 33,6% of glycemic control in Model I, fear of hypoglycemia and sleep disturbance together explained 47,2% of glycemic control in Model II and the models were statistically significant (p≤ 0,001). Conclusions: In adolescents with T1DM, it has been determined that fear of hypoglycemia and sleep disturbances are predictors of glycemic control. Nurses should develop educational programs for adolescents and their families to reduce the fear of hypoglycemia, provide guidance on recognizing hypoglycemia symptoms, and ensure the effective use of glucose monitoring technologies. Additionally, the negative impact of sleep disorders on glycemic control requires nurses to provide counseling on sleep hygiene and use tools to assess sleep quality. An adolescent-focused approach should be adopted, and self-management skills should be strengthened through motivational interviewing techniques and psychosocial support. Nurses should work in multidisciplinary collaboration to plan early interventions for hypoglycemia anxiety and sleep disorders.

🔖

Bu Makaleye Atıf Yap

Özbey, H., Bayat, M., Topal, T., Çeri, A., Hatipoğlu, N. (2025). Tı̇p 1 Dı̇yabetlı̇ Ergenlerde Glı̇semı̇k Kontrolün Yordayıcıları Olarak Uyku Bozukluğu ve Hı̇poglı̇semı̇ Korkusu. Güncel Hemşirelik Araştırmaları Dergisi, Cilt: 5 Sayı: 2, 171–181. https://ajindex.com/articles/1615382

📄 Tam Metin PDF Okuyucu

📄

PDF görüntüleyici hazırlanıyor...

Kaynakça (30)

  1. 1 Agrawal, S., Makuch, S., Dróżdż, M., Dudzik, T., Domański, I., Poręba, R., & Mazur, G. (2022). The Impact of Hypoglycemia on Patients with Diabetes Mellitus: A Cross-Sectional Analysis. Journal of clinical medicine, 11(3), 626. https://doi.org/10.3390%2Fjcm11030626
  2. 2 Ali, L., & Alhassan, M. (2024). Challenges in achieving adequate glycemic control among children with type 1 diabetes mellitus in a resource-limited setting: A cross-sectional study from Sudan. Diabetes research and clinical practice, 208, 111113. https://doi.org/10.1016/j.diabres.2024.111113
  3. 3 Bachmann, S., Auderset, A., Burckhardt, M. A., Szinnai, G., Hess, M., Zumsteg, U., … Donner, B. (2021). Autonomic cardiac regulation during spontaneous nocturnal hypoglycemia in children with type 1 diabetes. Pediatric diabetes, 22(7), 1023-1030. https://doi.org/10.1111/pedi.13262
  4. 4 Barnard, K. D., Wysocki, T., Allen, J. M., Elleri, D., Thabit, H., Leelarathna, L., … Hovorka, R. (2014). Closing the loop overnight at home setting: psychosocial impact for adolescents with type 1 diabetes and their parents. BMJ open diabetes research & care, 2(1), e000025. https://doi.org/10.1136/bmjdrc-2014-000025 5 Berk, E., & Çelik, N. (2023). Sleep quality and glycemic control in children and adolescents with type 1 diabetes mellitus. European review for medical and pharmacological sciences, 27(10), 4633-4638. https://doi.org/10.26355/eurrev_202305_32473 6 Cherubini, V., Rabbone, I., Lombardo, F., Mossetto, G., Orsini Federici, M., & Nicolucci, A. (2019). Incidence of severe hypoglycemia and possible associated factors in pediatric patients with type 1 diabetes in the real-life, post-Diabetes Control and Complications Trial setting: A systematic review. Pediatric diabetes, 20(6), 678-692. https://doi.org/10.1111/pedi.12876
  5. 7 Donbaloğlu, Z., Barsal Çetiner, E., İnan Yüksel, A., Singin, B., Aydın Behram, B., Bedel, A., … Tuhan, H. (2024). Sleep disturbances in children and adolescents with type 1 diabetes mellitus: Prevalence, and relationship with diabetes management. Sleep medicine, 115, 55-60. https://doi.org/10.1016/j.sleep.2024.01.031
  6. 8 Fadl, N., Tayel, K., Attia, M., Mounir, G. (2024). Impact of fear of hypoglycemia on self-management practices and glycemic control among adolescents with type 1 diabetes mellitus. J Public Health. https://doi.org/10.1007/s10389-024-02201-6
  7. 9 Haynes, A., Hermann, J. M., Clapin, H., Hofer, S. E., Karges, B., Jones, T. W., … WACDD and DPV registries (2019). Decreasing Trends in Mean HbA1c Are Not Associated with Increasing Rates of Severe Hypoglycemia in Children: A Longitudinal Analysis of Two Contemporary Population-Based Pediatric Type 1 Diabetes Registries From Australia and Germany/Austria Between 1995 and 2016. Diabetes care, 42(9), 1630-1636. https://doi.org/10.2337/dc18-2448
  8. 10 Hazen, R.A., Fehr, K.K., Fidler, A.L., Cousino, M.K., Macleish, S.A., & Gubitosi-Klug, R.A. (2015). Sleep disruption in adolescents with Type 1 diabetes mellitus: relationships with adherence and diabetes control. Diabetes management, 5, 257-265.
  9. 11 Hitt, T., Hershey, J., Olivos-Stewart, D., Forth, E., Stuart, F., Garren, P., … & Gettings, J. (2023). The impact of fear of hypoglycaemia on sleep in adolescents with type 1 diabetes. Diabetic Medicine, 40(5). https://doi.org/10.1111/dme.15066
  10. 12 Huerta-Uribe, N., Chueca-Guindulain, M. J., Berrade-Zubiri, S., Burillo-Sánchez, E., Izquierdo, M., & García-Hermoso, A. (2023). Is fear of hypoglycemia a major barrier to an active lifestyle in children and adolescents with type 1 diabetes? The Diactive-1 Study. Scandinavian journal of medicine & science in sports, 33(8), 1431–1438. https://doi.org/10.1111/sms.14369
  11. 13 International Diabetes Federation. IDF Diabetes Atlas. Brussels, Belgium: 2022. Available at: https://www.diabetesatlas.org
  12. 14 Jaser, S. S., Foster, N. C., Nelson, B. A., Kittelsrud, J. M., DiMeglio, L. A., Quinn, M., … T1D Exchange Clinic Network (2017). Sleep in children with type 1 diabetes and their parents in the T1D Exchange. Sleep medicine, 39, 108-115. https://doi.org/10.1016/j.sleep.2017.07.005
  13. 15 Küpçü, Z., Özdemir, F.K., Baykal, D.Ç. (2024). Examination of Sleep Disturbance and Sleep-Related Problems in Children with Type 1 Diabetes. Cyprus Journal of Medical Sciences, 9(1), 19-27. https://doi.org/10.4274/cjms.2023.2023-33
  14. 16 Lynn, P. (2019). The Advantage and Disadvantage of Implicitly Stratified Sampling. Methods, data, analyses: A journal for quantitative methods and survey methodology (mda), 13(2), 253-266. https://doi.org/10.12758/mda.2018.02
  15. 17 Mazarello Paes, V., Barrett, J. K., Dunger, D. B., Gevers, E. F., Taylor-Robinson, D. C., Viner, R. M., & Stephenson, T. J. (2020). Factors predicting poor glycemic control in the first two years of childhood onset type 1 diabetes in a cohort from East London, UK: Analyses using mixed effects fractional polynomial models. Pediatric diabetes, 21(2), 288-299. https://doi.org/10.1111%2Fpedi.12950
  16. 18 Meltzer, L. J., & Moore, M. (2008). Sleep disruptions in parents of children and adolescents with chronic illnesses: prevalence, causes, and consequences. Journal of pediatric psychology, 33(3), 279-291. https://doi.org/10.1093/jpepsy/jsm118
  17. 19 Monzon, A., McDonough, R., Meltzer, L. J., & Patton, S. R. (2019). Sleep and type 1 diabetes in children and adolescents: Proposed theoretical model and clinical implications. Pediatric diabetes, 20(1), 78-85. https://doi.org/10.1111/pedi.12797
  18. 20 Quattrin, T., Mastrandrea, L. D., & Walker, L. S. K. (2023). Type 1 diabetes. Lancet, 401(10394), 2149-2162. https://doi.org/10.1016/s0140-6736(23)00223-4
  19. 21 Reutrakul, S., Thakkinstian, A., Anothaisintawee, T., Chontong, S., Borel, A. L., Perfect, M. M.,. Knutson, K. L. (2016). Sleep characteristics in type 1 diabetes and associations with glycemic control: systematic review and meta-analysis. Sleep medicine, 23, 26-45. https://doi.org/10.1016/j.sleep.2016.03.019
  20. 22 Roberts, A. J., Taplin, C. E., Isom, S., Divers, J., Saydah, S., Jensen, E. T., … Pihoker, C. (2020). Association between fear of hypoglycemia and physical activity in youth with type 1 diabetes: The SEARCH for diabetes in youth study. Pediatric diabetes, 21(7), 1277-1284. https://doi.org/10.1111/pedi.13092 23 Silva, R. A. E., Ganen, A. P., Fernandes, V. F. T., Evangelista, N. M. A., Figueiredo, C. C., Pacheco, L. A., & Colares Neto, G. P. (2021). Evaluation of sleep characteristics of children and adolescents with type 1 diabetes mellitus. Revista paulista de pediatria: orgao oficial da Sociedade de Pediatria de Sao Paulo, 40, e2020407. https://doi.org/10.1590%2F1984-0462%2F2022%2F40%2F2020407
  21. 24 The jamovi project (2024). jamovi (Version 2.6.13) [Computer Software]. Retrieved from https://www.jamovi.org
  22. 25 Troncone, A., Piscopo, A., Zanfardino, A., Chianese, A., Cascella, C., Affuso, G.,. Iafusco, D. (2024). Fear of hypoglycemia in parents of children with type 1 diabetes trained for intranasal glucagon use. Journal of psychosomatic research, 184, 111856. https://doi.org/10.1016/j.jpsychores.2024.111856
  23. 26 Urakami T. (2020). Severe Hypoglycemia: Is It Still a Threat for Children and Adolescents With Type 1 Diabetes? Frontiers in endocrinology, 11, 609. https://doi.org/10.3389/fendo.2020.00609 27 Urakami, T. (2023). The advanced diabetes technologies for reduction of the frequency of hypoglycemia and minimizing the occurrence of severe hypoglycemia in children and adolescents with type 1 diabetes. Journal of Clinical Medicine, 12(3), 781. https://doi.org/10.3390/jcm12030781
  24. 28 Van Name, M., Hilliard, M., Boyle, C., Miller, K., DeSalvo, D., Anderson, B., … & Tamborlane, W. (2018). Nighttime is the worst time: parental fear of hypoglycemia in young children with type 1 diabetes. Pediatric diabetes, 19(1), 114-120. https://doi.org/10.1111/pedi.12525
  25. 29 von Schnurbein, J., Boettcher, C., Brandt, S., Karges, B., Dunstheimer, D., Galler, A.,. Vetter, C. (2018). Sleep and glycemic control in adolescents with type 1 diabetes. Pediatric diabetes, 19(1), 143-149. https://doi.org/10.1111/pedi.12538
  26. 30 Zhang, L., Xu, H., Liu, L., Bi, Y., Li, X., Kan, Y., … Zhang, Y. (2022). Related factors associated with fear of hypoglycemia in parents of children and adolescents with type 1 diabetes - A systematic review. Journal of pediatric nursing, 66, 125-135. https://doi.org/10.1016/j.pedn.2022.05.022
  27. 21 Reutrakul, S., Thakkinstian, A., Anothaisintawee, T., Chontong, S., Borel, A. L., Perfect, M. M.,. Knutson, K. L. (2016). Sleep characteristics in type 1 diabetes and associations with glycemic control: systematic review and meta-analysis. Sleep medicine, 23, 26-45. https://doi.org/10.1016/j.sleep.2016.03.019
  28. 22 Roberts, A. J., Taplin, C. E., Isom, S., Divers, J., Saydah, S., Jensen, E. T., … Pihoker, C. (2020). Association between fear of hypoglycemia and physical activity in youth with type 1 diabetes: The SEARCH for diabetes in youth study. Pediatric diabetes, 21(7), 1277-1284. https://doi.org/10.1111/pedi.13092 23 Silva, R. A. E., Ganen, A. P., Fernandes, V. F. T., Evangelista, N. M. A., Figueiredo, C. C., Pacheco, L. A., & Colares Neto, G. P. (2021). Evaluation of sleep characteristics of children and adolescents with type 1 diabetes mellitus. Revista paulista de pediatria: orgao oficial da Sociedade de Pediatria de Sao Paulo, 40, e2020407. https://doi.org/10.1590%2F1984-0462%2F2022%2F40%2F2020407
  29. 25 Troncone, A., Piscopo, A., Zanfardino, A., Chianese, A., Cascella, C., Affuso, G.,. Iafusco, D. (2024). Fear of hypoglycemia in parents of children with type 1 diabetes trained for intranasal glucagon use. Journal of psychosomatic research, 184, 111856. https://doi.org/10.1016/j.jpsychores.2024.111856
  30. 29 von Schnurbein, J., Boettcher, C., Brandt, S., Karges, B., Dunstheimer, D., Galler, A.,. Vetter, C. (2018). Sleep and glycemic control in adolescents with type 1 diabetes. Pediatric diabetes, 19(1), 143-149. https://doi.org/10.1111/pedi.12538