{"id":350,"date":"2017-01-18T14:52:25","date_gmt":"2017-01-18T13:52:25","guid":{"rendered":"http:\/\/www.mojidoktori.rs\/blog\/?p=350"},"modified":"2017-01-18T14:56:29","modified_gmt":"2017-01-18T13:56:29","slug":"dijabetes-tip-2","status":"publish","type":"post","link":"https:\/\/www.mojidoktori.rs\/blog\/dijabetes-tip-2\/","title":{"rendered":"Dijabetes tip 2"},"content":{"rendered":"

Dijabetes tip 2<\/span><\/h4>\n

\u0160e\u0107erna bolest tipa 2<\/a> je daleko naj\u010de\u0161\u0107i oblik \u0161e\u0107erne bolesti – javlja se u 90% slu\u010dajeva. Ve\u0107ina obolelih od tipa 2 proizvodi promenjene ili \u010dak normalne koli\u010dine insulina, ali usled poreme\u0107aja u \u0107elijama jetre i mi\u0161i\u0107a dolazi do otpornosti na delovanje insulina. Insulin se ve\u017ee za \u0107elijske receptore, ali glukozane mo\u017ee u\u0107i u stanicu i to stanje je poznato kao insulinska rezistencija.<\/span>
\nKo oboleva od \u0161e\u0107erne bolesti tipa 2?<\/span>
\nKoji su simptomi \u0161e\u0107erne bolesti tipa 2?<\/span>
\nKomplikacije \u0161e\u0107erne bolesti tipa 2<\/span>
\nKoji su dijagnosti\u010dki testovi za \u0161e\u0107ernu bolest tipa 2?<\/span>
\nKoje su op\u0161te smernice le\u010denja \u0161e\u0107erne bolesti tipa 2<\/a>?<\/span><\/p>\n


\nle\u010denje<\/span><\/h4>\n

Ostale preporuke<\/span>
\nKo oboleva od \u0161e\u0107erne bolesti tipa 2?<\/span>
\n\u0160e\u0107erna bolest, pogotovo tipa 2, dosti\u017ee razmere epidemije u \u010ditavom svetu budu\u0107i da se sve vi\u0161e poprimaju zapadnja\u010dke prehrambene navike. Tipi\u010dno se javlja nakon dobi od 40 godina. Starenje samo po sebi mo\u017ee pove\u0107ati podlo\u017enost intoleranciji glukoze i dijabetesu. Iako jo\u0161 uvek retko, prili\u010dno zabrinjava zna\u010dajno pove\u0107anje dijabetesa 2 kod dece, verovatno zbog pove\u0107anja stope gojaznosti u detinjstvu. Gojaznost je vrlo u\u010destala kod osoba sa \u0161e\u0107ernom bolesti tipa 2<\/a>, tako da \u010dak i umereni dobitak te\u017eine mo\u017ee pove\u0107ati podlo\u017enost obolevanja od \u0161e\u0107erne bolesti. Masno tkivo oko abdomena i na gornjem delu tela (oblik jabuke) dovodi se u vezu sa insulinskom rezistencijom, sr\u010danom bole\u0161\u0107u, visokim krvnim pritiskom, mo\u017edanim udarom i povi\u0161enim holesterolom. Kru\u0161kasti oblik tela, s debljinom raspore\u0111enom oko bokova i butina, manje se dovodi u vezu sa ovim bolestima. Pu\u0161a\u010di su podlo\u017eniji \u0161e\u0107ernoj bolesti tipa 2 i njegovim komplikacijama. Izme\u0111u 25% i 33% svih pacijenata ima porodi\u010dnu anamnezu bolesti, a osobe \u010diji su ro\u0111aci u prvom kolenu bili dijabeti\u010dari izlo\u017eeni su 40% riziku tokom \u010ditavog \u017eivota.<\/span><\/p>\n

Koji su simptomi \u0161e\u0107erne bolesti tipa 2?<\/span><\/h4>\n

Bolest obi\u010dno po\u010dinje postepeno i napreduje polagano. Simptomi se ne moraju pojaviti godinama, \u010dak decenijama. Kod uznapredovale bolesti javljaju se prekomerna \u017ee\u0111, poja\u010dano mokrenje, umor, zamagljen vid i gubitak te\u017eine. Kod \u017eena su \u010deste vaginalne gljivi\u010dne infekcije<\/a>. Gljivi\u010dne infekcije<\/a> mogu se pojaviti ispod dojki ili u preponama. Te\u0161ke promene na desnima, pogor\u0161anje vida, svrab, impotencija i neobi\u010dni oseti u ekstremitetima, kao \u0161to su trnci i \u017earenje, tako\u0111e mogu ukazivati na \u0161e\u0107ernu bolest tipa 2. \u0160e\u0107erna bolest tipa 2 obi\u010dno se otkrije rutinskim pregledima kod lekara (sistematski pregled) nalazom povi\u0161enih vrednosti glukoze u krvi i u urinu pre pojave simptoma.<\/span><\/p>\n

Komplikacije \u0161e\u0107erne bolesti tipa 2<\/span><\/h4>\n

Komplikacije \u0161e\u0107erne bolesti obi\u010dno se dele na kratkoro\u010dne i dugoro\u010dne. Najva\u017enija kratkoro\u010dna komplikacija je hipoglikemija. Hipoglikemija obi\u010dno nastaje kod predoziranja insulinom ili u slu\u010dajevima nedovoljnog uzimanja hrane, pove\u0107ane fizi\u010dke aktivnosti ili uzimanja alkohola uz primenu uobi\u010dajene doze insulina. Simptomi uklju\u010duju znojenje, podrhtavanje, glad i brzo lupanje srca. Kasnije se razvijaju i simptomi CNS-a kao konfuznost, slabost, dezorijentisanost, ratobornost, a u retkim i najgorim slu\u010dajevima koma, konvulzije i smrt.<\/span><\/p>\n

 <\/p>\n

Dijabeti\u010dari<\/a> bi uvek uz sebe trebali imati tvrde bombone, sok ili paketi\u0107e \u0161e\u0107era. Porodica i prijatelji moraju poznavati simptome. Ako se pojavi kriza, treba mu dati 3-5 bombona, 2-3 kesica \u0161e\u0107era ili pola \u0161oljice vo\u0107nog soka (pod uslovom da mo\u017ee da guta). \u010clanovi porodice i prijatelji mogu nau\u010diti da daje injekcije glukagona, hormona, koji za razliku od insulina, podi\u017ee koncentraciju glukoze u krvi. U dugoro\u010dne komplikacije \u0161e\u0107erne bolesti obrajaju se sr\u010dani i mo\u017edani udar kao posledica ateroskleroze, neuropatije (o\u0161te\u0107enje perifernih nerava nerava), komplikacije na o\u010dima (retinopatija s posledi\u010dnom slepo\u0107om) te o\u0161te\u0107enje bubrega.<\/span><\/p>\n

Koji su dijagnosti\u010dki testovi za \u0161e\u0107ernu bolest tipa 2?<\/span><\/h4>\n

Danas stru\u010dnjaci preporu\u010duju redovno godi\u0161nje merenje glukoze u krvi svim osobama starijim od 45 godina. Test kojim se glukoza u plazmi meri nata\u0161te (GUK) postao je standardnim dijagnosti\u010dkim testom. To je jednostavan krvni test koji se radi nakon osam sati gladovanja. Test tolerancije glukoze je slo\u017eeniji. Najpre se napravi test koncentracije glukoze nata\u0161te, a zatim se nakon dva sata uzimanja posebne rastvora glukoze testira krv. Testiranje glikoliziranog hemoglobina ispituju se koncentracije hemoglobina A1c (HbA1c). Rezultati tog testiranja govore o prose\u010dnoj koncentraciji glukoze u krvi kroz zadnjih par meseci.<\/span><\/p>\n

Koje su op\u0161te smernice le\u010denja \u0161e\u0107erne bolesti tipa 2?<\/span><\/h4>\n

Kod tre\u0107ine obolelih od \u0161e\u0107erne bolesti tipa 2 bolest se mo\u017ee kontrolisati samo dijetom i ve\u017ebanjem, \u0161to se povoljno odra\u017eava na koncentraciju glukoze i krvni pritisak. Ostali moraju uzimati lekove kojima se stimuli\u0161e izlu\u010divanje preostalog insulina ili pove\u0107ava osetljivost na insulin. Naposljetku se zalihe prirodnog insulina u pankreasu iscrpe pa ga je potrebno nadomestiti. Stroga kontrola koncentracije glukoze u krvi mo\u017ee smanjiti podlo\u017enost razvitka komplikacija, pogotovo retinopatiji, ali i o\u0161te\u0107enja bubrega i nerava. Kontrolom visokog krvnog pritiska smanjuje se opasnost od nastanka sr\u010danog udara, ali i oboljenja bubrega.<\/span><\/p>\n

le\u010denje<\/span><\/h4>\n

Za razliku od \u0161e\u0107erne bolesti tipa 1, bolesnici oboleli od \u0161e\u0107erne bolesti tipa 2 jo\u0161 uvek produciraju ne\u0161to insulina, iako ne dovoljno da bi se premostila rezistencija na insulin. Stoga bolesnici koji trebaju lekove, po\u010dinju sa sredstvima za pove\u0107anje produkcije rezidualnog insulina ili osetljivosti na insulin umesto da im se insulin direktno nadomesti, kao \u0161to je to standardno kod \u0161e\u0107erne bolesti tipa 1. Sada se za po\u010detno le\u010denje preporu\u010duju preparati sulfonilureje i metformin. Na kraju terapija tabletama obi\u010dno zataji pa bolesnicima ipak treba dati insulin.<\/span><\/p>\n

Ostale preporuke<\/span><\/h4>\n

Izri\u010dito se preporu\u010duje jednom godi\u0161nje vakcinisati protiv gripa. Dijabeti\u010dari bi se tako\u0111e trebali s lekarom posavetovati o jednokratnom vakcinaciji protiv pneumokoka, naj\u010de\u0161\u0107ih uzro\u010dnika upale plu\u0107a. Obolelima se preporu\u010duje svakodnevno uzimanje niske doze aspirina. U jednom ispitivanju je ustanovljeno da doza od 100 mg mo\u017ee smanjiti komplikacije vezane za pove\u0107ane koncentracije glukoze u krvi.<\/span><\/p>\n

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Dijabetes tip 2 \u0160e\u0107erna bolest tipa 2 je daleko naj\u010de\u0161\u0107i oblik \u0161e\u0107erne bolesti – javlja se u 90% slu\u010dajeva. Ve\u0107ina obolelih od tipa 2 proizvodi promenjene ili \u010dak normalne koli\u010dine insulina, ali usled poreme\u0107aja u \u0107elijama jetre i mi\u0161i\u0107a dolazi do otpornosti na delovanje insulina. Insulin se ve\u017ee za \u0107elijske…<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[236,237,246,243,245,249,244,247,234,239,248,240,97,235,238,242,241],"class_list":["post-350","post","type-post","status-publish","format-standard","hentry","category-blog","tag-dijabbetes-tip-2","tag-dijabetes","tag-dijabeticari","tag-gljivicne-infekcije","tag-glukoza-u-krvi","tag-glukoze-u-krvi","tag-impotencija","tag-injekcije-glukagona","tag-komplikacije-secerne-bolesti","tag-lecenje-dijabetesa","tag-ostecenje-bubrega","tag-pojacano-mokrenje","tag-secerna-bolest","tag-secerna-bolest-tipa-2","tag-simptomi-secerne-bolesti-tipa-2","tag-umor","tag-zamagljen-vid"],"yoast_head":"\nDijabetes tip 2<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.mojidoktori.rs\/blog\/dijabetes-tip-2\/\" \/>\n<meta property=\"og:locale\" content=\"sr_RS\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Dijabetes tip 2\" \/>\n<meta property=\"og:description\" content=\"Dijabetes tip 2 \u0160e\u0107erna bolest tipa 2 je daleko naj\u010de\u0161\u0107i oblik \u0161e\u0107erne bolesti – javlja se u 90% slu\u010dajeva. 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