{"id":2175,"date":"2021-05-04T11:54:06","date_gmt":"2021-05-04T11:54:06","guid":{"rendered":"https:\/\/practicalhealthpsychology.com\/?p=2175"},"modified":"2025-11-04T14:10:57","modified_gmt":"2025-11-04T14:10:57","slug":"how-to-support-patients-to-lose-weight-and-better-manage-their-type-2-diabetes-2","status":"publish","type":"post","link":"https:\/\/practicalhealthpsychology.com\/tr\/2021\/05\/how-to-support-patients-to-lose-weight-and-better-manage-their-type-2-diabetes-2\/","title":{"rendered":"Hastalara kilo vermeleri ve tip 2 diyabetlerini daha iyi y\u00f6netmeleri i\u00e7in nas\u0131l destek olunur?"},"content":{"rendered":"<p><strong>Leah Avery &#8211; Teesside University, UK. <\/strong><\/p>\n<p>Tip 2 diyabete daha \u00f6nce ins\u00fclin tedavisine ihtiya\u00e7 duyulmas\u0131 ka\u00e7\u0131n\u0131lmaz olan ilerleyici bir durum g\u00f6z\u00fcyle bak\u0131lm\u0131\u015ft\u0131r, ancak <a href=\"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(17)33102-1\/fulltext\">ya\u015fam tarz\u0131 davran\u0131\u015f de\u011fi\u015fikli\u011fi ara\u015ft\u0131rmalar\u0131<\/a> bu karamsar prognoza meydan okuyor. Tip 2 diyabet yayg\u0131nl\u0131\u011f\u0131 artmaya devam ederken beslenmenin \u00f6nemli rol\u00fcn\u00fc destekleyen ve durumu ba\u015far\u0131l\u0131 bir \u015fekilde y\u00f6netmek i\u00e7in yediklerimizi de\u011fi\u015ftirmemize y\u00f6nelik kan\u0131tlar da artmaktad\u0131r.<\/p>\n<p>Diyet yakla\u015f\u0131mlar\u0131 kabaca ikiye ayr\u0131labilir. Yava\u015f ve istikrarl\u0131 kilo kayb\u0131 yoluyla metabolizmay\u0131 ve glisemik kontrol\u00fc optimize etmek i\u00e7in yedi\u011fimiz \u015feylere (\u00f6rne\u011fin karbonhidratlar) odaklananlar ve h\u0131zl\u0131 kilo kayb\u0131 i\u00e7in ciddi miktarda enerji k\u0131s\u0131tlamas\u0131 i\u00e7eren d\u00fc\u015f\u00fck kalorili, yenen miktara odaklanan diyetler.<\/p>\n<p><!--more--><\/p>\n<ol>\n<li><strong> D\u00fc\u015f\u00fck Karbonhidrat Diyeti<\/strong><\/li>\n<\/ol>\n<p>Daha \u00f6nceleri, tip 2 diyabet hastalar\u0131n\u0131n d\u00fc\u015f\u00fck \u015fekerli, karbonhidrattan zengin bir diyet s\u00fcrd\u00fcrmeleri \u00f6neriliyordu \u00e7\u00fcnk\u00fc bu yiyeceklerin yava\u015f yava\u015f kana \u015feker sald\u0131\u011f\u0131na inan\u0131l\u0131yordu. Art\u0131k karbonhidrat a\u00e7\u0131s\u0131ndan zengin bir\u00e7ok yiyece\u011fin \u015fekerli g\u0131dalardan daha h\u0131zl\u0131 \u015fekilde kana \u015feker sald\u0131\u011f\u0131n\u0131 <a href=\"https:\/\/www.diabetes.org.uk\/guide-to-diabetes\/enjoy-food\/carbohydrates-and-diabetes\">biliyoruz<\/a>. Buna ra\u011fmen d\u00fc\u015f\u00fck \u015feker\/karbonhidrattan zengin yakla\u015f\u0131m\u0131 hala tip 2 diyabetli bir\u00e7ok ki\u015fi taraf\u0131ndan takip edilmektedir; bu yakla\u015f\u0131m glisemik kontrol\u00fc \u00f6nleyebilece\u011fi i\u00e7in ka\u00e7\u0131n\u0131lmal\u0131d\u0131r.<\/p>\n<p>Mevcut kan\u0131tlar, alternatif g\u0131da se\u00e7imleri yaparak karbonhidrat al\u0131m\u0131n\u0131 azaltmalar\u0131 i\u00e7in tip 2 diyabet hastalar\u0131n\u0131n desteklenmesine ihtiya\u00e7 oldu\u011funu g\u00f6stermektedir. Bu, hangi yiyeceklerin karbonhidrat bak\u0131m\u0131ndan y\u00fcksek oldu\u011funu \u00f6\u011frenmeyi ve zaman i\u00e7inde ki\u015fisel karbonhidrat al\u0131m\u0131n\u0131 \u00f6l\u00e7meyi i\u00e7erir (bu pratik stratejiye \u00f6z-izleme denir). Sonras\u0131nda daha az y\u00fcksek karbonhidratl\u0131 yiyecekler yemenin \u00f6n\u00fcndeki engellerin (\u00f6rne\u011fin i\u015f yerinde karbonhidrat a\u00e7\u0131s\u0131ndan zengin cezbedici at\u0131\u015ft\u0131rmal\u0131klar) \u00fcstesinden gelmek i\u00e7in hedefler belirleyerek ve eylem planlar\u0131 (<em>y\u00fcksek karbonhidratl\u0131 yiyecekleri ne zaman, nerede ve nas\u0131l azaltacaklar\u0131<\/em>) ve ba\u015fa \u00e7\u0131kma planlar\u0131 yaparak (<em>herhangi bir engelle kar\u015f\u0131la\u015f\u0131rsam bir \u015feyler yapaca\u011f\u0131m<\/em>) hastan\u0131n karbonhidrat al\u0131m\u0131n\u0131 azaltmas\u0131 desteklenmelidir. Tip 2 diyabeti ba\u015far\u0131l\u0131 bir \u015fekilde y\u00f6netmek i\u00e7in kilo vermeyi te\u015fvik ederek <a href=\"https:\/\/www.bmj.com\/content\/363\/bmj.k4583\">d\u00fc\u015f\u00fck karbonhidrat i\u00e7eren yakla\u015f\u0131mlar\u0131n<\/a> orta karbonhidrat i\u00e7eren diyetlerden daha iyi sonu\u00e7 vermesiyle <a href=\"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/1900510\">karbonhidratlarda azalmay\u0131 destekleyen kan\u0131tlar<\/a> artm\u0131\u015ft\u0131r.<\/p>\n<p>Bununla birlikte her hasta biriciktir, bu da optimum karbonhidrat al\u0131m\u0131n\u0131 ve ili\u015fkili g\u0131da se\u00e7eneklerini bulmak i\u00e7in bir zorlu\u011fu temsil eder. Bireylerin kendi ki\u015fisel karbonhidrat tolerans seviyeleri, yani kilolar\u0131n\u0131 ve glisemik kontrollerini olumsuz etkilemeden \u00f6nce ne kadar karbonhidrat yiyebileceklerine dair farkl\u0131l\u0131klar vard\u0131r. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6399621\/\">Ki\u015fisel ya\u011f e\u015fi\u011fi benzer \u015fekilde \u00e7al\u0131\u015f\u0131r<\/a>, yani baz\u0131 tip 2 diyabetli ki\u015filerin glisemik seviyelerini ba\u015far\u0131l\u0131 bir \u015fekilde y\u00f6netmek i\u00e7in \u00e7ok fazla kilo vermeleri gerekirken di\u011ferleri daha az kilo kayb\u0131yla glisemik kontrol\u00fc sa\u011flayabilir. Ayr\u0131ca baz\u0131 insanlar di\u011ferlerine g\u00f6re \u00e7ok daha d\u00fc\u015f\u00fck bir Beden Kitle \u0130ndeksine (BK\u0130) sahipken tip 2 diyabet geli\u015ftirebilir ve ki\u015fisel ya\u011f e\u015fi\u011fi bunun nedenini k\u0131smen a\u00e7\u0131klayabilir. Bir hastan\u0131n ya\u011flar\u0131 nerede depolad\u0131\u011f\u0131 (a\u011f\u0131rl\u0131kl\u0131 olarak organlar\u0131n\u0131n i\u00e7inde, \u00e7evresinde veya v\u00fccudunun d\u0131\u015f kenarlar\u0131nda) ve ki\u015fisel e\u015fikleri, diyetlere tepkilerdeki baz\u0131 farkl\u0131l\u0131klar\u0131 a\u00e7\u0131klamaya yard\u0131mc\u0131 olabilir. Ayr\u0131ca diyetlerin neden baz\u0131 insanlar i\u00e7in i\u015fe yaray\u0131p di\u011ferleri i\u00e7in yaramad\u0131\u011f\u0131n\u0131 a\u00e7\u0131klamaya yard\u0131mc\u0131 olabilir. Hastalara se\u00e7tikleri yakla\u015f\u0131m\u0131n neden kendileri i\u00e7in i\u015fe yaramayabilece\u011fine dair bir a\u00e7\u0131klama sa\u011flamak i\u00e7in bu bilgileri payla\u015fmak faydal\u0131d\u0131r.<\/p>\n<ol start=\"2\">\n<li><strong> D\u00fc\u015f\u00fck Kalorili Diyet Yakla\u015f\u0131m\u0131 <\/strong><\/li>\n<\/ol>\n<p>Bu, yeni tan\u0131 konmu\u015f (6 y\u0131la kadar) tip 2 diyabetli ki\u015filer i\u00e7in potansiyel bir ezber bozand\u0131r. D\u00fc\u015f\u00fck kalorili diyet, tip 2 diyabeti remisyona sokmak (diyabetik olmama ve antidiyabetik ila\u00e7 kullanmama durumu) i\u00e7in h\u0131zl\u0131 kilo kayb\u0131 sa\u011flar. Bunun i\u00e7in 15 kg kilo verme hedefine ula\u015fmay\u0131 ama\u00e7layan d\u00fc\u015f\u00fck enerjili \u00f6\u011f\u00fcn de\u011fi\u015fimleri diyetini (12 ila 20 hafta boyunca) t\u00fcketmek gerekir. Sonras\u0131nda g\u0131daya yeniden ba\u015flama (2 ila 8 hafta) ve kilo kayb\u0131n\u0131 s\u00fcrd\u00fcrmek i\u00e7in bir sa\u011fl\u0131k uzman\u0131ndan (\u00f6rne\u011fin hem\u015fire) davran\u0131\u015fsal destek al\u0131n\u0131r. Bu diyetle ilgili geni\u015f kapsaml\u0131 bir \u00e7al\u0131\u015fma, kat\u0131l\u0131mc\u0131lar\u0131n neredeyse yar\u0131s\u0131n\u0131n 1 y\u0131l sonra diyabet remisyonuna ula\u015ft\u0131\u011f\u0131n\u0131 g\u00f6stermi\u015ftir. <a href=\"https:\/\/www.thelancet.com\/journals\/landia\/article\/PIIS2213-8587(19)30068-3\/fulltext\">Son zamanlarda yay\u0131mlanan ara\u015ft\u0131rmalar<\/a> bu etkilerin 2 y\u0131l boyunca s\u00fcrd\u00fcr\u00fclebilece\u011fini g\u00f6stermi\u015ftir.<\/p>\n<p>Peki hangi beslenme yakla\u015f\u0131m\u0131 daha etkilidir? Cevap olduk\u00e7a basit: Hastalar\u0131n uyabilece\u011fi ve onlar i\u00e7in en iyi sonucu veren yakla\u015f\u0131m. Hastalar\u0131n beslenme d\u00fczenlerini de\u011fi\u015ftirme ve se\u00e7enekleriyle ili\u015fkili ki\u015fisel tercihleri ve tutumlar\u0131 olacakt\u0131r, bu da kilo verme motivasyonlar\u0131ndan etkilenecektir. Baz\u0131 ki\u015filer h\u0131zl\u0131 kilo vermek ve ins\u00fclin tedavisinden ka\u00e7\u0131nmak i\u00e7in d\u00fc\u015f\u00fck kalorili bir diyet tercih edecek ve diyetin ilk a\u015famas\u0131, yiyecek se\u00e7enekleri ve yemek haz\u0131rlama hakk\u0131nda d\u00fc\u015f\u00fcnme ihtiya\u00e7lar\u0131n\u0131 ortadan kald\u0131racakt\u0131r. Baz\u0131lar\u0131 d\u00fc\u015f\u00fck karbonhidratl\u0131 bir yakla\u015f\u0131m\u0131 tercih edebilir \u00e7\u00fcnk\u00fc sa\u011fl\u0131kl\u0131 yemekler pi\u015firmeyi \u00f6\u011frenmek, yava\u015f yava\u015f kilo vermek ve uzun vadede yeme bi\u00e7imlerini de\u011fi\u015ftirmek istiyorlard\u0131r. Bu yakla\u015f\u0131m ayn\u0131 zamanda \u00f6\u011f\u00fcn yerine ge\u00e7en \u00fcr\u00fcnleri de\u011fil, t\u00fcm \u00f6\u011f\u00fcnlerde yemek yemek anlam\u0131na gelir.<\/p>\n<p>Hekimler tip 2 diyabeti olan hastalar i\u00e7in do\u011fru beslenme yakla\u015f\u0131m\u0131n\u0131 nas\u0131l belirler ve sonras\u0131nda onlara uygun deste\u011fi nas\u0131l sa\u011flar?<\/p>\n<p><strong>Pratik \u00d6neriler<\/strong><\/p>\n<ul>\n<li>Uygulay\u0131c\u0131lar\u0131n e\u011fitmen de\u011fil, kolayla\u015ft\u0131r\u0131c\u0131 olmas\u0131 \u00f6nemlidir. Hastalara hangi diyet yakla\u015f\u0131m\u0131n\u0131n kendileri i\u00e7in do\u011fru olaca\u011f\u0131n\u0131 s\u00f6ylemekten ka\u00e7\u0131n\u0131n. Kilo kayb\u0131 i\u00e7in ki\u015fisel motivasyonlar\u0131n\u0131, ge\u00e7mi\u015f deneyimlerini, diyet yakla\u015f\u0131m\u0131 tercihlerini ve diyet de\u011fi\u015fikli\u011fi i\u00e7in \u00f6n\u00fcndeki engelleri anlamaya \u00e7al\u0131\u015f\u0131n.<\/li>\n<li>Hastalara her diyet yakla\u015f\u0131m\u0131 i\u00e7in ne yapmalar\u0131 \/ \u00f6\u011frenmeleri gerekti\u011fini anlamalar\u0131na yard\u0131mc\u0131 olmak i\u00e7in kan\u0131ta dayal\u0131 bilgiler sa\u011flay\u0131n (\u00f6rne\u011fin <a href=\"https:\/\/www.diabetes.org.uk\/guide-to-diabetes\/enjoy-food\/eating-with-diabetes\/whats-your-healthy-weight\/low-calorie-diets\">d\u00fc\u015f\u00fck kalorili diyet<\/a> ve <a href=\"https:\/\/www.diabetes.org.uk\/guide-to-diabetes\/enjoy-food\/eating-with-diabetes\/meal-plans\/low-carb\">d\u00fc\u015f\u00fck karbonhidrat diyeti<\/a> hakk\u0131ndaki Diabetes UK bilgilerine bak\u0131n). Bu, her bir diyet plan\u0131n\u0131n \u00f6zellikleri hakk\u0131nda ayr\u0131nt\u0131l\u0131 bilgileri, ne t\u00fcr potansiyel yan etkileri olabilece\u011fini ve ba\u015far\u0131l\u0131 olmak i\u00e7in edinilmesi gereken bilgi ve becerileri i\u00e7ermelidir.<\/li>\n<li>Hastalara belirli bir diyet plan\u0131 i\u00e7in tercihlerini, kilo verme motivasyonunu ve diyetle ilgili davran\u0131\u015f de\u011fi\u015fikli\u011fi i\u00e7in bariyerlerini ortaya \u00e7\u0131karmak i\u00e7in a\u00e7\u0131k sorular sorun:<\/li>\n<li><em>Hangi se\u00e7ene\u011fe ba\u011fl\u0131 kalman\u0131z daha olas\u0131d\u0131r?<\/em><\/li>\n<li><em>Kilo vermekten ne elde etmeyi umuyorsunuz?<\/em><\/li>\n<li><em>Se\u00e7ti\u011finiz diyete ba\u011fl\u0131 kalman\u0131z\u0131 neler engelleyebilir?<\/em><\/li>\n<li>Hastalar\u0131 sosyal destek aramaya te\u015fvik edin, \u00f6rne\u011fin onlara duygusal ve pratik destek sa\u011flayabilecek bir partneri, aile \u00fcyesi veya arkada\u015flar\u0131 var m\u0131?<\/li>\n<li>Uygun oldu\u011funda olumlu peki\u015ftirme sa\u011flay\u0131n. Bu, hastan\u0131n beslenme d\u00fczenini de\u011fi\u015ftirmek i\u00e7in g\u00f6sterdi\u011fi her t\u00fcrl\u00fc \u00e7aba hakk\u0131nda olumlu geri bildirim sa\u011flamay\u0131 (\u00f6rne\u011fin de\u011fi\u015fim i\u00e7in ayr\u0131nt\u0131l\u0131 planlar geli\u015ftirmek); ba\u015far\u0131lar\u0131 (yani diyette birka\u00e7 g\u00fcn veya hafta i\u00e7inde yap\u0131lan de\u011fi\u015fiklikler) ve bu de\u011fi\u015fikliklerin (\u00f6l\u00e7\u00fclebilir de\u011fi\u015fiklikler) kilo ve glisemik kontrol \u00fczerindeki faydal\u0131 etkileri hakk\u0131nda olumlu yorum yapmay\u0131 i\u00e7erebilir.<\/li>\n<\/ul>\n<p><em>[Translated by Ece Gunduz]<\/em><\/p>\n<p><em>[Edited: National Editor Selen Ozbek, Health Psychologist, MSc]<\/em><\/p>\n<p><em>\u00a0<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Leah Avery, Teesside University, UK. Type 2 diabetes was previously considered a progressive condition, with an inevitable need for insulin therapy, however lifestyle behavioural change research challenges this pessimistic prognosis. As prevalence of type 2 diabetes continues to increase, [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":2222,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[28,7,27,20],"tags":[],"class_list":["post-2175","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-communication","category-incentives","category-motivation","category-social-support"],"translation":{"provider":"WPGlobus","version":"3.0.2","language":"tr","enabled_languages":["en","id","my","bg","zh","hr","cz","da","de","es","fr","gr","he","it","ja","kr","lv","lt","hu","nl","no","pl","pt","ro","ru","sk","fi","sv","tr","uk"],"languages":{"en":{"title":true,"content":true,"excerpt":false},"id":{"title":true,"content":true,"excerpt":false},"my":{"title":true,"content":true,"excerpt":false},"bg":{"title":true,"content":true,"excerpt":false},"zh":{"title":true,"content":true,"excerpt":false},"hr":{"title":false,"content":false,"excerpt":false},"cz":{"title":true,"content":true,"excerpt":false},"da":{"title":true,"content":true,"excerpt":false},"de":{"title":true,"content":true,"excerpt":false},"es":{"title":true,"content":true,"excerpt":false},"fr":{"title":true,"content":true,"excerpt":false},"gr":{"title":true,"content":true,"excerpt":false},"he":{"title":true,"content":true,"excerpt":false},"it":{"title":true,"content":true,"excerpt":false},"ja":{"title":true,"content":true,"excerpt":false},"kr":{"title":false,"content":false,"excerpt":false},"lv":{"title":true,"content":true,"excerpt":false},"lt":{"title":false,"content":false,"excerpt":false},"hu":{"title":false,"content":false,"excerpt":false},"nl":{"title":true,"content":true,"excerpt":false},"no":{"title":true,"content":true,"excerpt":false},"pl":{"title":true,"content":true,"excerpt":false},"pt":{"title":false,"content":false,"excerpt":false},"ro":{"title":false,"content":false,"excerpt":false},"ru":{"title":true,"content":true,"excerpt":false},"sk":{"title":true,"content":true,"excerpt":false},"fi":{"title":true,"content":true,"excerpt":false},"sv":{"title":false,"content":false,"excerpt":false},"tr":{"title":true,"content":true,"excerpt":false},"uk":{"title":true,"content":true,"excerpt":false}}},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/practicalhealthpsychology.com\/tr\/wp-json\/wp\/v2\/posts\/2175","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/practicalhealthpsychology.com\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/practicalhealthpsychology.com\/tr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/tr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/tr\/wp-json\/wp\/v2\/comments?post=2175"}],"version-history":[{"count":45,"href":"https:\/\/practicalhealthpsychology.com\/tr\/wp-json\/wp\/v2\/posts\/2175\/revisions"}],"predecessor-version":[{"id":4575,"href":"https:\/\/practicalhealthpsychology.com\/tr\/wp-json\/wp\/v2\/posts\/2175\/revisions\/4575"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/tr\/wp-json\/wp\/v2\/media\/2222"}],"wp:attachment":[{"href":"https:\/\/practicalhealthpsychology.com\/tr\/wp-json\/wp\/v2\/media?parent=2175"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/tr\/wp-json\/wp\/v2\/categories?post=2175"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/tr\/wp-json\/wp\/v2\/tags?post=2175"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}