{"id":25218,"date":"2016-04-12T13:02:15","date_gmt":"2016-04-12T11:02:15","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=25218"},"modified":"2016-04-12T13:02:15","modified_gmt":"2016-04-12T11:02:15","slug":"cukrovka-neboli-vetsina-lidi-na-sobe-nic-nepozna","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=25218","title":{"rendered":"Cukrovka nebol\u00ed, v\u011bt\u0161ina lid\u00ed na sob\u011b nic nepozn\u00e1"},"content":{"rendered":"

P\u0159i p\u0159\u00edle\u017eitosti ned\u00e1vn\u00e9ho Sv\u011btov\u00e9ho dne zdrav\u00ed, kter\u00fd je letos v\u011bnov\u00e1n pr\u00e1v\u011b diabetu, jsme se zeptali MUDr. V\u011bry Pr\u00fdmkov\u00e9, diabetolo\u017eky z Intern\u00edho odd\u011blen\u00ed Oblastn\u00ed nemocnice P\u0159\u00edbram, co bychom m\u011bli o tomto onemocn\u011bn\u00ed v\u011bd\u011bt.<\/strong> <\/p>\n

– Co bychom m\u011bli, pan\u00ed doktorko, v\u011bd\u011bt o cukrovce?<\/p>\n

Cukrovka, \u010dili diabetes mellitus, dostala sv\u016fj n\u00e1zev podle sv\u00e9ho nejn\u00e1padn\u011bj\u0161\u00edho projevu, a t\u00edm je zv\u00fd\u0161en\u00e1 hladina krevn\u00edho cukru a v\u00fdskyt cukru v mo\u010di. Net\u00fdk\u00e1 se jen cukru v krvi, \u010dili glykemie, a p\u0159i p\u0159ekro\u010den\u00ed ur\u010dit\u00e9 hladiny pak i cukru v mo\u010di, \u010dili glykosurie. Zm\u011bny nast\u00e1vaj\u00ed i v metabolismu tuk\u016f, lid\u00e9 s cukrovkou se velmi \u010dasto l\u00e9\u010d\u00ed tak\u00e9 s vysok\u00fdm krevn\u00edm tlakem a zv\u00fd\u0161enou kyselinou mo\u010dovou, maj\u00ed hor\u0161\u00ed funkci imunitn\u00edho syst\u00e9mu a zm\u011bny v krevn\u00ed sr\u00e1\u017elivosti.<\/p>\n

– Jak vznik\u00e1 diabetes, co je p\u0159\u00ed\u010dinou vzniku onemocn\u011bn\u00ed?<\/p>\n

P\u0159es 90 procent diabetik\u016f m\u00e1 cukrovku 2. typu, \u010dasto naz\u00fdvanou tak\u00e9 sta\u0159eck\u00e1. Ale t\u00edm, jak se zakulacuje na\u0161e populace a ub\u00fdv\u00e1 pohybu, za\u010d\u00e1tek tohoto onemocn\u011bn\u00ed se posouv\u00e1 do st\u00e1le mlad\u0161\u00edho a mlad\u0161\u00edho v\u011bku, kdy ozna\u010den\u00ed senior nesed\u00ed. Tento typ cukrovky je \u010dasto spojen s obezitou. P\u0159\u00ed\u010dinou je kombinace zhor\u0161en\u00e9 citlivosti t\u011bla k inzul\u00ednu (tzv. inzulinorezistence) a uvol\u0148ov\u00e1n\u00ed inzul\u00ednu z beta bun\u011bk slinivky b\u0159i\u0161n\u00ed. P\u0159i z\u00e1chytu tohoto typu diabetu maj\u00ed pacienti \u010dasto hladinu Cpeptidu v krvi \u2013 ukazatele tvorby vlastn\u00edho inzul\u00ednu \u2013 v\u00fdrazn\u011b zv\u00fd\u0161enou proti zdrav\u00e9 populaci, a p\u0159esto to jejich t\u011blu nesta\u010d\u00ed. Udiabetik\u016f 1. typu, kter\u00fdch je asi 7% ze v\u0161ech diabetik\u016f, do\u0161lo ke zni\u010den\u00ed v\u011bt\u0161iny beta bun\u011bk, t\u011bmto lidem inzul\u00edn chyb\u00ed, a mus\u00ed se tedy dod\u00e1vat injekcemi, p\u0159\u00edpadn\u011b inzul\u00ednovou pumpou. Tento typ diabetu m\u016f\u017ee vzniknout v jak\u00e9mkoli v\u011bku. Zbyl\u00e1 necel\u00e1 dv\u011b procenta p\u0159ipadaj\u00ed na dal\u0161\u00ed typy diabetu, kde p\u0159\u00ed\u010dinou je jin\u00e9 onemocn\u011bn\u00ed, nap\u0159\u00edklad onemocn\u011bn\u00ed slinivky b\u0159i\u0161n\u00ed nebo l\u00e9\u010dba kortikoidy. Co se zm\u011bnila krit\u00e9ria pro t\u011bhotenskou cukrovku (hodnota glykemie na la\u010dno je pro t\u011bhotn\u00e9 mnohem p\u0159\u00edsn\u011bj\u0161\u00ed ne\u017e pro zbylou populaci), p\u0159ibylo i t\u00e9to diagn\u00f3zy. Zde ale na\u0161t\u011bst\u00ed v\u011bt\u0161inou sta\u010d\u00ed jen m\u00edrn\u00e1 \u00faprava stravov\u00e1n\u00ed a s porodem se metabolismus cukr\u016f uprav\u00ed zase do norm\u00e1lu.<\/p>\n

– Kdo je nejv\u00edc ohro\u017een vznikem t\u00e9to nemoci?<\/p>\n

Jsou to lid\u00e9, jejich\u017e bl\u00edzc\u00ed p\u0159\u00edbuzn\u00ed u\u017e cukrovkou trp\u00ed \u010di trp\u011bli. D\u00e1le lid\u00e9 s kily nav\u00edc, a \u010d\u00edm v\u00edce t\u011bch kil je, t\u00edm je riziko v\u00fdrazn\u011bj\u0161\u00ed. Ve zv\u00fd\u0161en\u00e9m riziku jsou tak\u00e9 ti, kte\u0159\u00ed se vyh\u00fdbaj\u00ed p\u0159im\u011b\u0159en\u00e9 fyzick\u00e9 aktivit\u011b. A t\u00edm nemysl\u00edm, \u017ee bychom museli tvrd\u011b sportovat, sta\u010d\u00ed naj\u00edt si \u010das alespo\u0148 na p\u016fl hodinky souvisl\u00e9 ch\u016fze denn\u011b. Nechat si pravideln\u011b zkontrolovat hladinu sv\u00e9ho krevn\u00edho cukru by m\u011bli tak\u00e9 lid\u00e9 trp\u00edc\u00ed zv\u00fd\u0161en\u00fdm krevn\u00edm tlakem, maj\u00edc\u00ed poruchu ve slo\u017een\u00ed krevn\u00edch tuk\u016f \u010di jsou l\u00e9\u010deni pro dnu. Cukrovkou jsou v\u00edce ohro\u017eeni tak\u00e9 milovn\u00edci sekund\u00e1rn\u011b zpracovan\u00e9ho masa, \u010dili uzenin, klob\u00e1s, pa\u0161tik, hamburger\u016f atp.<\/p>\n

– Mohu sama poznat, \u017ee m\u00e1m cukrovku, nebo je to onemocn\u011bn\u00ed, kter\u00e9 takzvan\u011b nebol\u00ed, a nemus\u00edm o n\u011bm v\u011bd\u011bt?<\/p>\n

Bohu\u017eel pro v\u011bt\u0161inu lid\u00ed s nov\u011b zji\u0161t\u011bnou cukrovkou plat\u00ed druh\u00e1 \u010d\u00e1st va\u0161\u00ed ot\u00e1zky. Cukrovka nebol\u00ed, a pokud hodnoty krevn\u00edho cukru nejsou zv\u00fd\u0161en\u00e9 v\u00fdrazn\u011b, v\u011bt\u0161ina lid\u00ed na sob\u011b nic nepozn\u00e1. Nej\u010dast\u011bji se diabetes odhal\u00ed v r\u00e1mci preventivn\u00ed prohl\u00eddky \u010di p\u0159edopera\u010dn\u00edho vy\u0161et\u0159en\u00ed. Proto je pro mnoh\u00e9 t\u011b\u017ek\u00e9 uznat, \u017ee je t\u0159eba cukrovku l\u00e9\u010dit, dos\u00e1hnout hodnot co nejbli\u017e\u0161\u00edch hodnot\u00e1m norm\u00e1ln\u00edm, kdy\u017e jim v\u016fbec nic nen\u00ed! Mezi klasick\u00e9 p\u0159\u00edznaky pat\u0159\u00ed \u017e\u00edze\u0148 a nutnost v\u00edce p\u00edt, m\u011bla jsem i nemocn\u00e9, kte\u0159\u00ed ud\u00e1vali kolem 8 litr\u016f a v\u00edce za den. S t\u00edm souvis\u00ed \u010dast\u00e9 mo\u010den\u00ed, a to i v no\u010dn\u00edch hodin\u00e1ch, co\u017e v\u00fdrazn\u011b naru\u0161uje sp\u00e1nek. Tito nemocn\u00ed ud\u00e1vaj\u00ed velkou \u00fanavnost, mal\u00e1tnost, pocit vy\u010derp\u00e1n\u00ed. Typick\u00e9 jsou i zm\u011bny zrakov\u00e9 ostrosti, na\u0161t\u011bst\u00ed se jedn\u00e1 o poruchu p\u0159echodnou a s normalizac\u00ed glykemie se zrakov\u00e1 ostrost zase zlep\u0161\u00ed. Ob\u010das cesta k n\u00e1m vede p\u0159es jin\u00e9 odbornosti, kdy prvn\u00ed p\u0159\u00ed\u010dinou n\u00e1v\u0161t\u011bvy l\u00e9ka\u0159e jsou opakovan\u00e9 mo\u010dov\u00e9 \u010di genit\u00e1ln\u00ed infekce, nehoj\u00edc\u00ed se defekt na plosce nebo prstech na nohou nebo z\u00e1va\u017en\u00e9 infek\u010dn\u00ed posti\u017een\u00ed nohy, nep\u0159\u00edjemn\u00e9 pocity v doln\u00edch kon\u010detin\u00e1ch hlavn\u011b v noci, posti\u017een\u00ed srdce \u010di tepen doln\u00edch kon\u010detin<\/p>\n

– Je cukrovka vyl\u00e9\u010diteln\u00e1? A co je na n\u00ed tak z\u00e1va\u017en\u00e9ho?<\/p>\n

Cukrovka se pova\u017euje za chorobu nevyl\u00e9\u010ditelnou. Zp\u00e1tky do normy se m\u016f\u017ee vr\u00e1tit takzvan\u00e1 poru\u0161en\u00e1 glukozov\u00e1 tolerance, kde jsou hodnoty glykemie jen m\u00edrn\u011b zv\u00fd\u0161en\u00e9 a nespl\u0148uj\u00ed je\u0161t\u011b krit\u00e9ria pro diabetes mellitus. Ve sv\u00e9 praxi jsem vid\u011bla n\u011bkolik vz\u00e1cn\u00fdch p\u0159\u00edpad\u016f, kdy u ob\u00e9zn\u00edho \u010dlov\u011bka pot\u00e9, co se mu poda\u0159ilo upravit j\u00eddeln\u00ed\u010dek, zv\u00fd\u0161it fyzickou aktivitu a shodit p\u0159ebyte\u010dn\u00e1 kila tak, \u017ee se dostal do normy svou v\u00e1hou, dos\u00e1hly norm\u00e1ln\u00edch hodnot i laboratorn\u00ed v\u00fdsledky. K vymizen\u00ed cukrovky m\u016f\u017ee doj\u00edt u pacient\u016f po bariatrick\u00e9 operaci (operaci kv\u016fli obezit\u011b).<\/p>\n

(Autorem rozhovoru je mluv\u010d\u00ed p\u0159\u00edbramsk\u00e9 nemocnice Jitka Kalouskov\u00e1. Cel\u00fd rozhovor si m\u016f\u017eete p\u0159e\u010d\u00edst na webu: www.pribramsky.denik.cz)<\/p>\n

P\u0159\u00edbramsk\u00fd den\u00edk
\nhttp:\/\/www.pribramsky.denik.cz<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

P\u0159i p\u0159\u00edle\u017eitosti ned\u00e1vn\u00e9ho Sv\u011btov\u00e9ho dne zdrav\u00ed, kter\u00fd je letos v\u011bnov\u00e1n pr\u00e1v\u011b diabetu, jsme se zeptali MUDr. V\u011bry Pr\u00fdmkov\u00e9, diabetolo\u017eky z Intern\u00edho odd\u011blen\u00ed Oblastn\u00ed nemocnice P\u0159\u00edbram, […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":6331,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-25218","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/25218","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=25218"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/25218\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/6331"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=25218"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=25218"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=25218"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}