Gülsüm Şahin, Yasemin Atik Altınok, Alev Keser

TİP 1 diabetes mellitus’lu bireylerde yeme davranışı bozukluğu: Diyabulimia

Tip 1 diabetes mellitus (Tip 1 DM), tedavisinde beslenmenin önemli rol oynadığı, prevalansı gün geçtikçe artan metabolik bir bozukluktur. Öğün planları, öğün saatleri ve yasak yiyecek kavramı, diyabetli bireylerin zihnini sürekli meşgul edip vücut ağırlığı kontrolü üzerine düşünmelerine neden olabilmektedir. Bu durum özellikle Tip 1 DM’li kız adölesanlarda yeme davranışı bozukluğu insidansını artırabilmektedir. Oluşumunda genetik, biyolojik ve çevresel faktörlerin rol oynadığı düşünülen ve henüz DSM-V sınıflandırmasında yer almayan ‘diyabulimia’, Tip 1 DM’li bireylerin ağırlık kontrolünü sağlamak amacıyla insülin dozunu azaltması veya bilinçli olarak atlaması olarak tanımlanmaktadır. Diyabulimia, diyabete bağlı komplikasyon riskini ve mortalite oranını artırmakla birlikte geç puberteye, düzensiz menstrüasyon siklusuna, anksiyete problemlerine, depresif ataklara ve intihar girişimine neden olabilmektedir. Diyabulimia tedavisi diğer yeme davranışı bozukluklarında olduğu gibi alanında uzman doktor, psikiyatr, diyetisyen, hemşire ve psikoloğu içeren multidisipliner bir ekip çalışmasını gerektirmektedir. Tedavinin uzun sürmesi ve hastalığın tekrarlama riskinin son derece yüksek olması nedeniyle, bu konuda duyarlı olunması ve gelişiminin önlenmesi oldukça önemlidir. Diyabetliler arasında tanısı henüz konulamamış diyabulimia vakalarının olduğu tahmin edilmektedir. Bu nedenle derleme olarak hazırlanan bu makalede, diyabulimianın diyetisyen perspektifinden tedavisinin ve izleminin literatür ışığında tartışılması ve sağlık personelinin konu ile ilgili farkındalığının artırılması amaçlanmıştır.

Anahtar Kelimeler:

Tip 1 diabetes mellitus, adölesan, diyabulimia, yeme davranışı bozukluğu

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