Yaşlı Diyabetik Hastaların Tıbbi Beslenme Tedavisine Uyumları ve Beslenme Durumlarının Değerlendirilmesi
Yıldırım, İlknur Gökçe
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Diabetes as a disease associated with aging is considered a major public health problem in the world and in our country. For the effectiveness of diabetes treatment, compliance with medical nutrition therapy is very important. As the basis, in this study aimed to evaluate in elderly diabetic patients medical nutrition therapy compliance, nutritional status and consequently the glycemic control in elderly diabetic patients. This research was conducted on 80 volunteered to participate in the study individuals, who were over 65 years and admitted to the Hacettepe University Adult Hospital, Geriatric Outpatient Clinic between February 2011-September 2011, were diagnosed with diabetes for at least one year. A questionnaire was implemented and short version of ‘Mini Nutritional Assessment’ was performed. One day food dietary record, one month food frequency questionnaire, 24-hour physical activity record and some anthropometric measurements were taken and some biochemical parameters were obtained from patients’ files. The mean age of elderly diabetics is 71.07 ± 5.00 years. Hypertension (93.8%) and cardiovascular diseases (71.3%) are the most common diseases in elderly diabetics. Among the elderly diabetics, 10.0% complies diet, 63.8% sometimes complies and 26.3% doesn’t comply. The most frequent reasons of incompliance to diet were; difficulties to comply diet (36.1%) and the control of disease with medication/insulin (34.7%). Twenty six point three percent of patients skip main meals and 20.0% of them skip snacks. The most skipped main meal is lunch. Fruits/fruit juices (90.6%), milk, yoghurt, drink made of yoghurt and water, cheese (53.1%) and bread, biscuits, cookies (43.8%) are the most preferred food and drinks as snacks. Ninety percent of patients don’t do regular exercise. Fortyeight point eight percent of elderly diabetics were under risk of malnutrition. There was no malnutrition in men but in women the percentage of malnutrition was 6.3%. Physical activity level were very similar in two groups. BMI was higher in women (30.5 ± 5.5 kg/m²) than men (29.1 ± 4.6 kg/m²) (p>0.05). Both male and female patients’ avarage fasting and postprandial blood glucose and HbA1c values were higher than recommended goal values (Fasting blood glucose < 130 mg/dL, postprandial blood glucose < 180 mg/dL, HbA1c <%7) (p>0.05). Average low density lipoprotein (LDL) and triglycerides (TG) values were appropriate to recommended goals in men, but higher than recommended goals (p>0.05) in women. Fiftytwo point five percent of participants’ glysemic control (HbA1c <7%) were fine. For elderly diabetic patients; Medical nutrition therapy (MNT) is important for both the effectiveness of treatment and providing a healthy and balanced diet of patients, therefore assessing nutritional status of elderly diabetics in routine geriatric controls and continuation of training of elderly people with their caregivers are in great of importance.