V \u010cesk\u00e9 republice se l\u00e9\u010d\u00ed s diabetem 2. typu p\u0159es 940 tis\u00edc lid\u00ed, tedy p\u0159ibli\u017en\u011b ka\u017ed\u00fd jeden\u00e1ct\u00fd \u010dlov\u011bk, u diabetu 1. typu je to okolo 60 tis\u00edc. D\u00edky neust\u00e1l\u00e9mu v\u00fdvoji nov\u00e9 l\u00e9\u010dby maj\u00ed pacienti daleko v\u00edce mo\u017enost\u00ed ne\u017e kdy p\u0159edt\u00edm. St\u00e1le obl\u00edben\u011bj\u0161\u00ed je n\u00edzkosacharidov\u00e1 dieta.
„S cukrovkou 1. typu od d\u011btstv\u00ed bojuje dnes \u010dty\u0159iadvacetilet\u00e1 Zuzana Franzov\u00e1, u kter\u00e9 byla diagnostikov\u00e1na v osmi letech. „Nemoc se projevovala velkou \u00fanavou, p\u0159i ka\u017ed\u00e9m pohybu jsem si musela velmi brzy sednout. Tak\u00e9 ji doprov\u00e1zela neuti\u0161iteln\u00e1 \u017e\u00edze\u0148, kter\u00e1 se nedala zahnat, tak\u017ee jsem po\u0159\u00e1d chodila na toaletu. \u00dabytek t\u011blesn\u00e9 v\u00e1hy, kter\u00fd je dal\u0161\u00edm z typick\u00fdch p\u0159\u00edznak\u016f, se m\u011b net\u00fdkal, jeliko\u017e mi nemoc byla diagnostikov\u00e1na velmi brzy,“ popisuje.
V sou\u010dasn\u00e9 dob\u011b se Zuzana l\u00e9\u010d\u00ed pomoc\u00ed inzulinov\u00e9 pumpy, kterou m\u00e1 nest\u00e1le u sebe, v\u010detn\u011b kanyly. Tou se j\u00ed do t\u011bla dost\u00e1v\u00e1 inzulin. Hladinu cukru v t\u011ble si tak m\u016f\u017ee kontrolovat 24 hodin denn\u011b pomoc\u00ed senzoru Freestyle Libre, kter\u00fd nos\u00ed na pa\u017ei. „D\u00edky senzoru se mi neskute\u010dn\u011b zlep\u0161ila kompenzace moj\u00ed nemoci. M\u00e1m podrobn\u00fd p\u0159ehled o tom, jak mi hladina cukru v t\u011ble stoup\u00e1 \u010di kles\u00e1 b\u011bhem sp\u00e1nku, j\u00eddla i p\u0159i sportu. M\u016f\u017eu se tak h\u00fdbat bez starost\u00ed,“ \u0159\u00edk\u00e1.
Z\u00e1rove\u0148 je aplikace i jeho pou\u017e\u00edv\u00e1n\u00ed jednoduch\u00e9, nen\u00ed pot\u0159eba p\u00edchat se do prstu, jako je tomu u glukometru. „Jenom p\u0159ilo\u017e\u00edm \u010dte\u010dku k senzoru a v\u00edm, jakou hladinu cukru v t\u011ble m\u00e1m. L\u00edb\u00ed se mi, \u017ee a\u0165 jsem kdekoli, t\u0159eba ve vlaku, nemus\u00edm a\u017e tak \u0159e\u0161it \u010distotu rukou, prost\u011b jen p\u0159ilo\u017e\u00edm \u010dte\u010dku a je to,“ pochvaluje si Zuzana. D\u00edky tomu, \u017ee m\u00e1 neust\u00e1l\u00fd p\u0159ehled o sv\u00e9 nemoci, m\u016f\u017ee i p\u0159edch\u00e1zet r\u016fzn\u00fdm zdravotn\u00edm obt\u00ed\u017e\u00edm, kter\u00e9 se s diabetem poj\u00ed.<\/p>\n\n\n\n
Zdravotn\u00ed komplikace<\/p>\n\n\n\n
Od chv\u00edle, kdy propukla koronavirov\u00e1 pandemie a l\u00e9ka\u0159i upozor\u0148ovali diabetiky, \u017ee pat\u0159\u00ed mezi ohro\u017eenou skupinu s vy\u0161\u0161\u00edm rizikem v\u00e1\u017en\u00e9ho pr\u016fb\u011bhu onemocn\u011bn\u00ed, se cukrovk\u00e1\u0159i v\u00edce zaj\u00edmaj\u00ed o dal\u0161\u00ed mo\u017enosti l\u00e9\u010dby jejich nemoci. „Krom\u011b z\u00e1jmu o modern\u00ed metody s vyu\u017eit\u00edm nap\u0159\u00edklad prepar\u00e1t\u016f typu GLP-1 agonist\u016f \u010di SGLT 2 jsme zaznamenali zv\u00fd\u0161en\u00fd z\u00e1jem o obecn\u00e9 zp\u016fsoby zlep\u0161en\u00ed imunity a aktivn\u00edho zdrav\u00ed, a to i v p\u0159\u00edpad\u011b, \u017ee nejsou hrazeny zdravotn\u00edmi poji\u0161\u0165ovnami. P\u0159\u00edkladem jsou ozonoterapie, lipozom\u00e1ln\u00ed forma vitaminu C a vitamin D,“ \u0159\u00edk\u00e1 zl\u00ednsk\u00fd diabetolog Emil Z\u00e1humensk\u00fd.
Probl\u00e9mem je u diabetik\u016f zv\u00fd\u0161en\u00e1 hladina krevn\u00edho cukru, kter\u00e1 vede k srde\u010dn\u011b-c\u00e9vn\u00edm onemocn\u011bn\u00edm. D\u0159\u00edve u nich vznik\u00e1 tzv. ateroskler\u00f3za, kornat\u011bn\u00ed tepen, p\u0159i n\u011bm\u017e doch\u00e1z\u00ed k ukl\u00e1d\u00e1n\u00ed tukov\u00fdch \u010d\u00e1stic, v\u00e1pn\u00edku a dal\u0161\u00edch l\u00e1tek do c\u00e9vn\u00ed st\u011bny. Rozs\u00e1hlej\u0161\u00ed po\u0161kozen\u00ed tepen a v\u011bt\u0161\u00ed n\u00e1chylnost k prask\u00e1n\u00ed vznikl\u00fdch pl\u00e1t\u016f vede k vy\u0161\u0161\u00edmu po\u010dtu akutn\u00edch infarkt\u016f. \u010cast\u011bj\u0161\u00ed je t\u00e9\u017e posti\u017een\u00ed mal\u00fdch tepen vedouc\u00ed nap\u0159\u00edklad typicky k po\u0161kozen\u00ed ledvin nebo naru\u0161en\u00ed sta\u017eliv\u00e9 funkce srdce a n\u00e1sledn\u00e9mu vy\u0161\u0161\u00edmu riziku vzniku srde\u010dn\u00edho selh\u00e1n\u00ed.<\/p>\n\n\n\n
I na prvn\u00ed pohled nesouvisej\u00edc\u00ed po\u0161kozen\u00ed nerv\u016f m\u016f\u017ee v\u00e9st k nebezpe\u010dn\u00fdm situac\u00edm, kdy pacient-diabetik nemus\u00ed c\u00edtit varovnou bolest p\u0159i infarktu a akutn\u00ed l\u00e9ka\u0159sk\u00e1 pomoc pak p\u0159ich\u00e1z\u00ed pozd\u011bji. Pr\u00e1v\u011b na srde\u010dn\u011b-c\u00e9vn\u00ed onemocn\u011bn\u00ed zem\u0159elo v lo\u0148sk\u00e9m roce 43 procent diabetik\u016f. Podle l\u00e9ka\u0159\u016f by ale toto \u010d\u00edslo mohlo b\u00fdt daleko ni\u017e\u0161\u00ed pr\u00e1v\u011b d\u00edky modern\u00ed l\u00e9\u010db\u011b.<\/p>\n\n\n\n
Nov\u00e9 mo\u017enosti l\u00e9\u010dby<\/p>\n\n\n\n
V l\u00e9\u010db\u011b diabetu 2. typu jsou nov\u011b k dispozici takov\u00e9 mo\u017enosti, kter\u00e9 dok\u00e1\u017eou p\u0159edch\u00e1zet po\u0161kozen\u00ed srdce, c\u00e9v a ledvin diabetem, a to jak ve form\u011b tablet, tak injek\u010dn\u00ed. Podle v\u00fdvoje nemoci mohou l\u00e9ka\u0159i vyu\u017e\u00edvat ji\u017e zm\u00edn\u011bn\u00e9 GLP-1 agonisty. Podle \u010cesk\u00e9 diabetologick\u00e9 spole\u010dnosti je vhodn\u00e9 tyto l\u00e9ky nasadit jako prvn\u00ed injek\u010dn\u00ed l\u00e9\u010dbu. Probl\u00e9mem b\u00fdv\u00e1 jejich \u00fahrada.<\/p>\n\n\n\n
„V \u010cesk\u00e9 republice bohu\u017eel nen\u00ed l\u00e9\u010dba GLP-1 agonisty hrazena v\u0161em pacient\u016fm. Riziko srde\u010dn\u011b-c\u00e9vn\u00edch onemocn\u011bn\u00ed je p\u0159itom vy\u0161\u0161\u00ed prakticky u v\u0161ech diabetik\u016f 2. typu. C\u00edlem \u010cesk\u00e9 diabetologick\u00e9 spole\u010dnosti je toto zm\u011bnit. Do t\u00e9 doby je ale nutn\u00e9 zd\u016fraz\u0148ovat pacient\u016fm pot\u0159ebu zapojit se do \u00fahrady za l\u00e9\u010dbu s t\u00edm, \u017ee \u010d\u00e1st vynalo\u017een\u00fdch n\u00e1klad\u016f jim bude uhrazena d\u00edky ochrann\u00e9mu limitu poji\u0161\u0165oven,“ \u0159\u00edk\u00e1 l\u00e9ka\u0159ka Eva Ra\u010dick\u00e1, m\u00edstop\u0159edsedkyn\u011b \u010cesk\u00e9 diabetologick\u00e9 spole\u010dnosti.
„Nar\u016fstaj\u00edc\u00ed po\u010det nemocn\u00fdch s diabetem a zvy\u0161uj\u00edc\u00ed se n\u00e1klady na modern\u00ed l\u00e9\u010dbu jsou d\u016fvodem neochoty pl\u00e1tc\u016f zdravotn\u00ed p\u00e9\u010de hradit \u0161\u00ed\u0159eji n\u011bkter\u00e9 revolu\u010dn\u00ed l\u00e9ky a technologie. Tuto skute\u010dnost mus\u00ed vn\u00edmat pacientsk\u00e9 organizace a sna\u017eit se p\u0159edkl\u00e1dat relevantn\u00ed argumenty a d\u016frazn\u011bji zastupovat sv\u00e9 z\u00e1jmy. L\u00e9ka\u0159i nemaj\u00ed dostate\u010dnou s\u00edlu prosadit nutn\u00e9 zm\u011bny bez zapojen\u00ed pacient\u016f,“ dopl\u0148uje ji diabetolog Jan \u0160oupal z V\u0161eobecn\u00e9 fakultn\u00ed nemocnice v Praze.<\/p>\n\n\n\n
L\u00e9\u010dba stravou<\/p>\n\n\n\n
\u010c\u00edm d\u00e1l obl\u00edben\u011bj\u0161\u00ed je p\u0159i l\u00e9\u010db\u011b cukrovky tak\u00e9 n\u00edzkosacharidov\u00e1 dieta, kter\u00e1 je zalo\u017een\u00e1 na vy\u0161\u0161\u00edm p\u0159\u00edjmu b\u00edlkovin a zdrav\u00fdch tuk\u016f a zejm\u00e9na na sn\u00ed\u017een\u00ed p\u0159\u00edjmu cukru a sacharid\u016f, \u010d\u00edm\u017e doch\u00e1z\u00ed ke zlep\u0161en\u00ed cukrovky. „U diabetik\u016f 1. typu dojde k podstatn\u00e9mu sn\u00ed\u017een\u00ed d\u00e1vek inzulinu aplikovan\u00e9ho p\u0159ed j\u00eddly, u \u0159ady diabetik\u016f 2. typu m\u016f\u017ee doj\u00edt a\u017e k vysazen\u00ed inzulinu. U pacient\u016f s krat\u0161\u00ed dobou trv\u00e1n\u00ed diabetu 2. typu, kter\u00fdm se p\u0159i n\u00edzkosacharidov\u00e9 strav\u011b poda\u0159\u00ed zhubnout, m\u016f\u017ee doj\u00edt k \u00faprav\u011b glykemie do normy bez nutnosti u\u017e\u00edvat l\u00e9ky. Tomu \u0159\u00edk\u00e1me remise diabetu,“ vysv\u011btluje diabetolo\u017eka Hana Krej\u010d\u00ed, odbornice na n\u00edzkosacharidovou dietu z V\u0161eobecn\u00e9 fakultn\u00ed nemocnice v Praze.
Tento typ stravov\u00e1n\u00ed je podle l\u00e9ka\u0159ky vhodn\u00fd pro v\u0161echny typy diabetu s v\u00fdjimkou pacient\u016f, u kter\u00fdch byl diabetes zp\u016fsoben\u00fd chronick\u00fdm z\u00e1n\u011btem slinivky (pankreatitidou) nebo po jej\u00edm chirurgick\u00e9m odstran\u011bn\u00ed. „Tito pacienti maj\u00ed vlivem nedostatku tr\u00e1vic\u00edch enzym\u016f, kter\u00e9 slinivka produkuje, pot\u00ed\u017ee s tr\u00e1ven\u00edm tuk\u016f, na kter\u00e9 je n\u00edzkosacharidov\u00e1 strava bohat\u0161\u00ed. N\u00edzkosacharidov\u00e1 strava tak\u00e9 nen\u00ed vhodn\u00e1 u vrozen\u00fdch poruch metabolismu tuk\u016f,“ up\u0159es\u0148uje Krej\u010d\u00ed.<\/p>\n\n\n\n
Dieta se d\u011bl\u00ed na p\u0159\u00edsn\u011bj\u0161\u00ed a m\u00edrn\u011bj\u0161\u00ed formu. B\u011bhem p\u0159\u00edsn\u00e9 diety sn\u00edte m\u00e9n\u011b ne\u017e 50 gram\u016f sacharid\u016f denn\u011b a doch\u00e1z\u00ed k p\u0159irozen\u00e9 tvorb\u011b ketol\u00e1tek (jako n\u00e1hradn\u00edho zdroje energie), proto se j\u00ed tak\u00e9 \u0159\u00edk\u00e1 ketogenn\u00ed. Ze zdroj\u016f sacharid\u016f je za\u0159azov\u00e1na prakticky jen zelenina a mal\u00e9 mno\u017estv\u00ed m\u00e9n\u011b sladk\u00e9ho ovoce (maliny, bor\u016fvky). Tato varianta je vyu\u017e\u00edv\u00e1na sp\u00ed\u0161e kr\u00e1tkodob\u011b k dosa\u017een\u00ed redukce nadm\u011brn\u00e9 hmotnosti. Dlouhodob\u011bji je udr\u017eiteln\u00e1 m\u00edrn\u011bj\u0161\u00ed forma n\u00edzkosacharidov\u00e9ho stravov\u00e1n\u00ed, kdy m\u016f\u017eete a\u017e 130 gram\u016f sacharid\u016f denn\u011b.<\/p>\n\n\n\n
„Zat\u00edmco u ketogenn\u00ed varianty je jedin\u00fdm omezen\u00edm p\u0159\u00edjem sacharid\u016f a p\u0159\u00edjem tuk\u016f zpravidla nen\u00ed nutn\u00e9 nijak omezovat, u m\u00edrn\u011bj\u0161\u00ed varianty n\u00edzkosacharidov\u00e9 stravy by neregulovan\u00fd p\u0159\u00edjem tuk\u016f mohl v\u00e9st ke zhor\u0161en\u00ed v\u00fdsledk\u016f. Za\u0159azovan\u00e9 zdroje sacharid\u016f by m\u011bly b\u00fdt v kvalitn\u00ed podob\u011b, tedy ne b\u00edl\u00e9 pe\u010divo, b\u00edl\u00e9 p\u0159\u00edlohy a sladkosti, ale sp\u00ed\u0161e ovoce, lu\u0161t\u011bniny, celozrnn\u00e9 p\u0159\u00edlohy a kvalitn\u00ed kv\u00e1skov\u00fd chl\u00e9b. Co se t\u00fdk\u00e1 striktnosti stravy \u2013 nen\u00ed d\u016fle\u017eit\u00e9, co sn\u00edme sv\u00e1te\u010dn\u011b, ob\u010das, ale co j\u00edme pravideln\u011b a \u010dasto,“ popisuje dietu diabetolo\u017eka Krej\u010d\u00ed.<\/p>\n\n\n\n
Z\u00e1kladn\u00ed pravidla j\u00eddeln\u00ed\u010dku<\/p>\n\n\n\n
Pro spr\u00e1vnou hladinu cukru v krvi je d\u016fle\u017eit\u00e9: j\u00edst pravideln\u011b a v p\u0159im\u011b\u0159en\u00e9m mno\u017estv\u00ed, j\u00edst zdrav\u011bj\u0161\u00ed potraviny, za\u0159adit dostatek vl\u00e1kniny (celozrnn\u00e9 potraviny, zeleninu), z j\u00eddeln\u00ed\u010dku, pokud mo\u017eno, vylou\u010dit uzeniny a sladkosti. D\u016fle\u017eit\u00e9 je tak\u00e9 pou\u017e\u00edvat zdrav\u011bj\u0161\u00ed postupy va\u0159en\u00ed, m\u00edsto fritovac\u00edho hrnce d\u00e1t p\u0159ednost sma\u017eic\u00edmu pap\u00edru (vydr\u017e\u00ed vy\u0161\u0161\u00ed teploty ne\u017e pe\u010dic\u00ed) nebo teflonov\u00e9 p\u00e1nvi.<\/p>\n\n\n\n
Alena Ben\u00ed\u0161kov\u00e1<\/p>\n\n\n\n
N\u00e1chodsk\u00fd den\u00edk<\/p>\n\n\n\n
https:\/\/nachodsky.denik.cz\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":" V \u010cesk\u00e9 republice se l\u00e9\u010d\u00ed s diabetem 2. typu p\u0159es 940 tis\u00edc lid\u00ed, tedy p\u0159ibli\u017en\u011b ka\u017ed\u00fd jeden\u00e1ct\u00fd \u010dlov\u011bk, u diabetu 1. typu je to okolo […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":27909,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-35859","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\/35859","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=35859"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/35859\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/27909"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=35859"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=35859"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=35859"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}