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Teemad. Veresuhkru head v??rtusedMis on HbA1c? Mida see anal??s n?itab?Milliseid anal??se tuleks patsiendile teha?Milliseid uuringuid tuleks patsiendile teha?Kokkuv?teK?simused patsientidele. Kui k?rged peaksid olema Teie veresuhkrud?. EDMOND Kliinik. Head veresuhkru v??rtused. Kui tihti tuleks veresuhkruid m??ta?.
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1. Kuidas hoida oma tervist kui olete juba haigestunud 2 tpi diabeeti? Verner Fogel
2010
2. Teemad Veresuhkru head vrtused
Mis on HbA1c? Mida see anals nitab?
Milliseid analse tuleks patsiendile teha?
Milliseid uuringuid tuleks patsiendile teha?
Kokkuvte
Ksimused patsientidele
3. Kui krged peaksid olema Teie veresuhkrud?
4. Head veresuhkru vrtused
5. Kui tihti tuleks veresuhkruid mta? Kui 2 tpi diabeet on alles diagnoositud vi veresuhkrud ei ole normipiirides
Mtke veresuhkrut le peva
Hommikul enne ski
Enne luna-ja htuski
2 tundi peale ski
Enne uinumist
Veresuhkru vrtused kirjutage pevikusse
Pevik vtke alati arsti vastuvtule kaasa, sest veresuhkru vrtustest sltub Teie edasine ravi
6. Kui tihti tuleks veresuhkruid mta? Kui Teie veresuhkrud on normipiirides
Mtke veresuhkrut 1-2 korda ndalas
Hommikul enne ski
Enne luna-ja htuski
2 tundi peale ski
Enne uinumist
Veresuhkru vrtused kirjutage pevikusse
Pevik vtke alati arsti vastuvtule kaasa sest veresuhkru vrtustest sltub Teie edasine ravi
7. Thjakhu krgete veresuhkrute thtsus diabeedi kompensatsioonis This study analysed the diurnal glycaemic profiles of 290 patients with T2DM investigated at different levels of HbA1c. The patients were treated with diet or oral hypoglycaemic agents (not acarbose).
Plasma glucose (PG) concentrations were determined at fasting and during postprandial and post absorptive periods.
The areas under the curve above fasting PG concentrations and >6.1 mmol/l (110 mg/dl) were calculated for further evaluation of the relative contributions of postprandial and fasting PG increments to the overall diurnal hyperglycaemia. The value of 6.1 mmol/l (110 mg/dl) was chosen because this threshold has been defined as the upper limit of normal PG at fasting or preprandial times by the American Diabetes Association. The data were compared over quintiles of HbA1c.
The main contributor to overall hyperglycaemia in patients with poorly controlled T2DM was found to be fasting hyperglycaemia. Fasting hyperglycaemia was the dominant factor in patients who were furthest from HbA1c target.
Monnier L, et al. Diabetes Care 2003;26:881?5.This study analysed the diurnal glycaemic profiles of 290 patients with T2DM investigated at different levels of HbA1c. The patients were treated with diet or oral hypoglycaemic agents (not acarbose).
Plasma glucose (PG) concentrations were determined at fasting and during postprandial and post absorptive periods.
The areas under the curve above fasting PG concentrations and >6.1 mmol/l (110 mg/dl) were calculated for further evaluation of the relative contributions of postprandial and fasting PG increments to the overall diurnal hyperglycaemia. The value of 6.1 mmol/l (110 mg/dl) was chosen because this threshold has been defined as the upper limit of normal PG at fasting or preprandial times by the American Diabetes Association. The data were compared over quintiles of HbA1c.
The main contributor to overall hyperglycaemia in patients with poorly controlled T2DM was found to be fasting hyperglycaemia. Fasting hyperglycaemia was the dominant factor in patients who were furthest from HbA1c target.
Monnier L, et al. Diabetes Care 2003;26:881?5.
8. Suremus ja sgijrgne veresuhkur In this study, PPG was found to be an independent and progressive risk factor for mortality.
1. DECODE Study Group. Lancet 1999; 354: 61721.In this study, PPG was found to be an independent and progressive risk factor for mortality.
1. DECODE Study Group. Lancet 1999; 354: 61721.
9. Mis asi on glkohemoglobiin?Mida see anals nitab?
10. Mida nitab HbA1c? A1c nitab kui palju veresuhkrust on seotud punalibledes hapnikku transportiva valguga
Nitab 2-3 kuu keskmist veresuhkru taset
A1c tase sltub hommikusest thjakhu veresuhkru vrtusest
A1c on hea, siis tuleks veresuhkruid kontrollida ka 2 tundi peale ski
Ei anna informatsiooni madalate veresuhkrute ja lhiaegsete veresuhkru muutuste kohta
11. HbA1c ehk anals mis nitab Teie 3 kuu keskmist veresuhkrut Diabeet on hsti ravitud
HbA1c on antud juhul alla 7%
Kontrollitakse 2 korda aastas
12. HbA1c ehk anals mis nitab Teie 3 kuu keskmist veresuhkrut Diabeet on halvasti ravitud
HbA1c on antud juhul le 7%
Kontrollitakse 4 korda aastas
13. HbA1C ja vikeste veresoonte tsistuste tekkimise risk Good glycaemic control is essential to reduce the risk of diabetic complications
Based on the Diabetes Control and Complications Trial data, the relative risk for microvascular complications such as diabetic retinopathy, nephropathy, neuropathy, and microalbuminuria increases with increasing levels of A1C1-3
The relative risk of complications is set to 1 for an A1C of 6%1
It is important to note that the risk gradient is continuous, with no glycaemic threshold for developing complications1Good glycaemic control is essential to reduce the risk of diabetic complications
Based on the Diabetes Control and Complications Trial data, the relative risk for microvascular complications such as diabetic retinopathy, nephropathy, neuropathy, and microalbuminuria increases with increasing levels of A1C1-3
The relative risk of complications is set to 1 for an A1C of 6%1
It is important to note that the risk gradient is continuous, with no glycaemic threshold for developing complications1
15. HbA1c langetamine vhendab tsistuste riski Data from the UKPDS demonstrated the substantial impact of good glycemic control on microvascular and macrovascular complications.
In an analysis of these data, it was estimated that a 1% decrease in HbA1c, which reflects a measure of glycemia over the past 23 months, correlates with:
21% reduction in the risk of deaths related to diabetes (P < 0.0001)?
37% reduction in the risk of microvascular complications (P < 0.0001)?
14% reduction in the risk of myocardial infarction (P < 0.0001).
These striking reductions in risk form the basis for diabetes management guidelines recommending aggressive targets for HbA1c in individuals with type 2 diabetes.
Stratton IM, et al. BMJ 2000; 321:405412.Data from the UKPDS demonstrated the substantial impact of good glycemic control on microvascular and macrovascular complications.
In an analysis of these data, it was estimated that a 1% decrease in HbA1c, which reflects a measure of glycemia over the past 23 months, correlates with:
21% reduction in the risk of deaths related to diabetes (P < 0.0001)?
37% reduction in the risk of microvascular complications (P < 0.0001)?
14% reduction in the risk of myocardial infarction (P < 0.0001).
These striking reductions in risk form the basis for diabetes management guidelines recommending aggressive targets for HbA1c in individuals with type 2 diabetes.
Stratton IM, et al. BMJ 2000; 321:405412.
16. Milliseid analse tuleks veel teha diabeeti pdevatele patsientidele?
17. Teised vajalikud analsid Kolesteroolid
Valk hommikuses uriinis
Vajadusel mikroobide anals uriinist
18. Kolesteroolide kontroll
19. Teised vajalikud analsid Kolesteroolide vrtused 2 tpi diabeetikul:
ldine kolesterool alla 4,5 mmol/l
Hea kolesterool ( ehk HDL) le 1,1 mmol/l
Halb kolesterool ( ehk LDL) infarkti vi insuldi anamneesita alla 2,5 mmol/l
Halb kolesterool ( ehk LDL) infarkti vi insuldi anamneesiga alla 1,8 mmol/l
Trigltseriidid( ehk rasvhapped) alla 1,7 mmol/l
20. Teised vajalikud analsid Kolesterool koguneb veresoonte seintesse
Tekivad naastud, mis halvendavad verevarustust
Suured naastud lhevad katki ja sinna piirkonda tekib tromb
Trombi tekkimine phjustab infarkti, insulti ja jalgade gangreeni
22. Teised vajalikud analsid Kui Teie kolesteroolid on raviga vi ravita normipiirides, siis korratakse analse 1 kord aastas
Kui Teie kolesteroolid ravil vi ravita on krged, siis korratakse analse 3 kuu tagant
Kui kolesteroolid ei ole normipiirides, siis tuleks ravi muuta vi ravi alustada
23. Neerude kontroll
24. Teised vajalikud analsid Valk uriinis nitab, kas Teil esineb neerude kahjustust vi mitte
Diagnoosimiseks peab olema 2 analsi le normi
Albumiini kreatiniini suhe meestel peaks olema alla 2 ja naistel alla 3
25. Teised vajalikud analsid Kui esimene anals ei ole korras, siis tuleks teha teine anals 2-3 kuu prast
Kui 2 analsi olid korras vi juba varasemalt neerude kahjustus teada, siis korratakse analsi 1 kord aastas
26. Teised vajalikud analsid Kuidas parandada vi ra hoida valgu sattumist uriini
Teie veresuhkrud peavad olema normipiirides
Teie vererhk peab olema normipiirides
Pletiku ravimine neerudes vi kusepies
27. Teised vajalikud analsid 1 kord aastas tuleb kontrollida neerude analse verest ( kreatiniin ja uurea)
28. Teised vajalikud analsid Mikroobide kontroll uriinist
Kui esinevad kaebused sagedale urineerimisele, seljavalule, krvetustundele urinineerimisel
Analsi tuleks korrata kaebuste taastekkimisel
Raviks kasutatakse antibiootikume
29. Milliseid uuringuid tuleks teha 2 tpi diabeetikul?
30. Vajalikud uuringud Igal vastuvtul tuleks mta vererhku
Neerukahjustuseta patsiendil peaks vererhk olema alla 130/80 mmHg
Neerukahjustusega patsiendil peaks vererhk olema alla 125/75 mmHg
31. Vajalikud uuringud 1 kord aastas tuleb kia silmaarsti juures
Silmaarst vaatab, kas Teil on muutusi silmaphjades
Silmaarst vaatab, kas Teil on kaed vi silmasisese rhu tusu
32. Vajalikud uuringud 1 kord aastas katsutakse pulsse jalgadel ja kontrollitakse haavandite olemasolu jalgadel
Vajalik veresoontes olevate ahenemiste varajaseks leidmiseks
Vajalik nrvikahjustuse uurimiseks
Vajalik haavandite varajaseks avastamiseks ja gangreeni ning amputatsiooni rahoidmiseks
33. Soovitused patsiendile Kui tulete arsti vastuvtule, siis
Vtke oma kingad vi saapad jalast
Vtke kaasa oma koduste vererhkude nidud
Rkige oma kodustest probleemidest ( jalad, vererhk, silmad)
34. Kokkuvte Hoidke veresuhkrud normipiirides
Hoidke vererhk normipiirides
Kige regulaarselt arsti juures kontrollis
Kui veresuhkrud vi vererhud on le normi, siis prduge perearsti vi endokrinoloogi juurde
Kige regulaarselt silmaarsti juures
35. Ksimused Kui krged peaksid olema Teie veresuhkrud, et diabeet oleks hsti ravitud?
Kui krge peaks olema Teie HbA1c, et diabeet oleks hsti ravitud?
Kui tihti peaksite kima arsti juures, kui HbA1c on alla 7%?
Kui tihti peaksite kima arsti juures, kui HbA1c on le 7%?
36. Ksimused Mida nitab HbA1c?
Milliseid analse ja uuringuid tuleks teha 2 tpi diabeetikul?
Kui tihti tuleks kia silmaarsti vastuvtul?
Kas krget kolesterooli on vaja ravida?
37. Ksimused Milleks on vaja kolesterooli ravida?
Kui kolesterool ei ole korras ravil, millal tuleks uuesti kontrollida?
Kui krge viks olla diabeetikul vererhk, et lugeda seda normipiirides olevaks?
Kui tihti tuleks teha neeruanalse?
Kas peaksite arsti juurde minnes kaasa vtma kodused veresuhkrud ja vererhud?
38. Hoidke oma tervist!Teie elate ainult he korra!
39. Tnan!