Publication: Hipoglisemi yaşayan tip 1 diyabetli çocuklarda farklı kan şekeri düzeylerinde uygulanan müdahalenin hipoglisemi sonrası kan şekeri düzeyine etkisi
Abstract
Hipoglisemi yaşayan tip 1 diyabetli çocuklarda farklı kan şekeri düzeylerinde uygulanan müdahalenin hipoglisemi sonrası kan şekeri düzeyine etkisi Amaç: Bu çalışmada çocuk diyabet polikliğine kayıtlı tip 1 diyabetli çocuklarda 65 mg/ dl ve 70 mg/ dl kan şekeri düzeylerinde uygulanan hipoglisemi tedavisi sonrasındaki 2. saatteki kan şekeri düzeylerinin karşılaştırılması amaçlanmıştır. Gereç ve Yöntem: Çalışma, Aralık 2024- Şubat 2025 tarihleri arasında bir eğitim ve araştırma hastanesinin çocuk diyabet eğitim polikliniğinde takipli 33 çocuk ile çapraz tasarım düzeninde yapılmıştır. Çalışmada aynı hastalara iki farklı tedavi uygulanmıştır. Deney grubunda hastanenin rutin uygulaması olan hipoglisemi tedavisi için 65 mg/ dl kapiller kan şekeri eşik değeri alınmış olup, kontrol grubunda ise literatürde belirtildiği gibi hipoglisemi tedavisi için 70 mg/ dl kapiller kan şekeri eşik değeri alınarak hipoglisemi tedavisi uygulanmış ve 1. ve 2. saatlerde kapiller kan şekeri ölçümü yapılmıştır. Bulgular: Çalışmaya katılan çocukların %54,5’i (n=18) kız, %45,5’i (n=15) erkektir. Katılımcıların ortalama yaşı 11,61 ± 3,48 olarak belirlenmiştir. Kontrol ve deney grupları arasında yapılan müdahaleler arasında 15. dk, 1. ve 2. saatte anlamlı düzeyde farklılık saptanmıştır (p=0,009; p=0,046; p=0,023). Grup içi müdahaleler kıyaslandığı zaman her iki grupta da zamanlara göre kan şekeri ölçümleri arasında istatistiksel olarak anlamlı bir fark vardır (p<0,001). Her iki grupta da 1. ve 2. saat kan şekeri ölçümleri arasında fark yok iken her iki grubun sonucunun da 180 mg/ dl altında olduğu saptanmıştır. Sonuç: Araştırma sonucunda tip 1 diyabetli çocuklarda kapiller kan şekeri 65 mg/ dl altında yapılan müdahale ile 70 mg/ dl altında yapılan müdahale arasında anlamlı düzeyde kan şekeri farkı saptanmıştır. Ancak her iki grupta da ortalama kapiller kan şekeri değerleri hiperglisemi eşik değeri olan 180 mg/ dl altında ölçülmüştür. Bu durumda tip 1 diyabetli çocukların erken müdahale edilmeyen hipoglisemiden kaynaklı ileride oluşabilecek komplikasyonlardan korunmaları adına, hipoglisemiye zamanında müdahale için 70 mg/ dl kapiller kan şekeri eşik değeri alınmalıdır.
The effect of the intervention applied at different blood sugar levels in children with type 1 diabetes experiencing hypoglycemia on blood sugar levels after hypoglycemia Objective: The aim of this study was to compare the blood glucose levels at the 2nd hour after hypoglycemia treatment at blood glucose levels of 65 mg/ dl and 70 mg/ dl in children with type 1 diabetes registered in a pediatric diabetes outpatient clinic. Materials and Methods: The study was conducted in a crossover design with 33 children who were followed up in the pediatric diabetes education outpatient clinic of a training and research hospital between December 2024-February 2025. Two different treatments were applied to the same patients in the study. In the experimental group, a capillary blood glucose threshold value of 65 mg/ dl was taken for hypoglycemia treatment, which is the routine practice of the hospital, and in the control group, a capillary blood glucose threshold value of 70 mg/ dl was taken for hypoglycemia treatment as stated in the literature and hypoglycemia treatment was applied and capillary blood glucose was measured at the 1st and 2nd hours. Results: Of the children who participated in the study, 54.5% (n=18) were female and 45.5% (n=15) were male. The mean age of the participants was 11.61 ± 3.48 years. There was a significant difference between the interventions between the control and experimental groups at the 15th, 1st and 2nd hour (p=0,009; p=0.046; p=0.023). When in-group interventions were compared, there was a statistically significant difference between blood glucose measurements according to time in both groups (p<0.001). While there was no difference between the 1st and 2nd hour blood glucose measurements in both groups, the results of both groups were below 180 mg/ dl. Conclusion: As a result of the study, a significant blood glucose difference was found between the intervention performed with capillary blood glucose below 65 mg/ dl and the intervention performed below 70 mg/ dl in children with type 1 diabetes. However, the mean capillary blood glucose values in both groups were below the hyperglycemia threshold of 180 mg/ dl. In this case, a capillary blood glucose threshold value of 70 mg/ dl should be taken for timely intervention for hypoglycemia in order to protect children with type 1 diabetes from future complications that may occur due to hypoglycemia that is not intervened early.
The effect of the intervention applied at different blood sugar levels in children with type 1 diabetes experiencing hypoglycemia on blood sugar levels after hypoglycemia Objective: The aim of this study was to compare the blood glucose levels at the 2nd hour after hypoglycemia treatment at blood glucose levels of 65 mg/ dl and 70 mg/ dl in children with type 1 diabetes registered in a pediatric diabetes outpatient clinic. Materials and Methods: The study was conducted in a crossover design with 33 children who were followed up in the pediatric diabetes education outpatient clinic of a training and research hospital between December 2024-February 2025. Two different treatments were applied to the same patients in the study. In the experimental group, a capillary blood glucose threshold value of 65 mg/ dl was taken for hypoglycemia treatment, which is the routine practice of the hospital, and in the control group, a capillary blood glucose threshold value of 70 mg/ dl was taken for hypoglycemia treatment as stated in the literature and hypoglycemia treatment was applied and capillary blood glucose was measured at the 1st and 2nd hours. Results: Of the children who participated in the study, 54.5% (n=18) were female and 45.5% (n=15) were male. The mean age of the participants was 11.61 ± 3.48 years. There was a significant difference between the interventions between the control and experimental groups at the 15th, 1st and 2nd hour (p=0,009; p=0.046; p=0.023). When in-group interventions were compared, there was a statistically significant difference between blood glucose measurements according to time in both groups (p<0.001). While there was no difference between the 1st and 2nd hour blood glucose measurements in both groups, the results of both groups were below 180 mg/ dl. Conclusion: As a result of the study, a significant blood glucose difference was found between the intervention performed with capillary blood glucose below 65 mg/ dl and the intervention performed below 70 mg/ dl in children with type 1 diabetes. However, the mean capillary blood glucose values in both groups were below the hyperglycemia threshold of 180 mg/ dl. In this case, a capillary blood glucose threshold value of 70 mg/ dl should be taken for timely intervention for hypoglycemia in order to protect children with type 1 diabetes from future complications that may occur due to hypoglycemia that is not intervened early.