Gestasyonel Diabetes Mellitus<\/strong><\/h3>\nGestasyonel diyabetes mellitus ilk kez gebelikte glukoz tolerans bozuklu\u011fu olarak tan\u0131mlanm\u0131\u015ft\u0131r. Ancak bu tan\u0131m bazen gebelik \u00f6ncesi ve gebelik \u00f6ncesi diyabet tan\u0131s\u0131 konan (gebelik \u00f6ncesi tan\u0131 olmamas\u0131na ra\u011fmen) olgular\u0131 ay\u0131rt etmek i\u00e7in yetersiz kalmaktad\u0131r.<\/p>\n
Artan obezite ve diyabetle birlikte, te\u015fhis edilmemi\u015f Tip 2 diyabetli hamile kad\u0131nlar\u0131n say\u0131s\u0131 da artmaktad\u0131r. Bu nedenle ilk prenatal vizitte standart kriterlere g\u00f6re diyabet tan\u0131s\u0131 konan gebelerin gestasyonel diyabet yerine ‘a\u015fikar diyabet’ tan\u0131s\u0131n\u0131n konmas\u0131 \u00f6nerilmektedir.<\/p>\n
GDM’nin gebeliklerin ortalama %10’unda g\u00f6r\u00fcld\u00fc\u011f\u00fc tahmin edilmektedir. Bu oran, \u00e7al\u0131\u015f\u0131lan pop\u00fclasyona ve kullan\u0131lan tan\u0131 y\u00f6ntemlerine ba\u011fl\u0131 olarak %1 ile %22 aras\u0131nda de\u011fi\u015fmektedir.<\/p>\n
Gestasyonel diyabet, genellikle gebeli\u011fin 24. haftadan sonra plasenta hormonlar\u0131n\u0131n ins\u00fclinin etkilerini bloke etmesi (ins\u00fclin direncini art\u0131rarak) nedeniyle geli\u015fir.<\/p>\n
Gebelikte kan \u015fekeri reg\u00fclasyon bozuklu\u011fu, \u00f6zellikle gebelik \u00f6ncesi diyabeti olan hastalarda hem anne hem de bebek i\u00e7in olumsuz sonu\u00e7lar do\u011furabilmektedir.<\/p>\n
![\"\u015eeker](\"https:\/\/turkeyistanbulmedical.com\/wp-content\/uploads\/2019\/07\/diabt.jpg\")
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Gestasyonel dans alan anne adaylar\u0131nda preeks ve erken do\u011fum riski. Yenido\u011fanda ise makrozomi, neonatal hipoglisemi, sar\u0131l\u0131k, hipokalsemi, polisitemi, \u00e7aresiz fakirlik , konjenital malformasyonlar ve \u00f6l\u00fc do\u011fuma neden olabilir.<\/p>\n
Do\u011fumdan sonra v\u00fccuttaki kullan\u0131mda tatbikatta g\u00f6r\u00fclkle gebeliklerinde gestasyonel tekrarlama riskli ( %50) y\u00fcksektir. Ayr\u0131ca ileriki ya\u015famlar\u0131nda tip 2 geli\u015fme riski de %70-80’e kadar var. Bu s\u00fcre\u00e7ten sonra haz\u0131rl\u0131k a\u015famas\u0131ndaki haz\u0131rl\u0131k s\u00fcrecini iyile\u015ftirirse safra prediyabetli olarak kabul edilir. Diyabetten korunma programlar\u0131na al\u0131nmalar\u0131 ve takip edilmeleri gereklidir.<\/p>\n
Prediyabet Nedir?<\/strong><\/h3>\nBir ki\u015finin kan \u015fekeri seviyesi normalden y\u00fcksek olmas\u0131na ra\u011fmen diyabet takt\u0131racak kadar y\u00fcksek olmasa da ki\u015fi halk aras\u0131nda prediyabet veya bazen gizli \u015feker olarak tan\u0131mlan\u0131r. Ve bu ki\u015filerde tip 2 diyabet geli\u015fme riski belirgin \u015fekilde artar.<\/p>\n
Prediyabet hastalar\u0131 g\u00fcn boyunca normal kan \u015fekeri seviyelerine sahiptir. Ve diyabetin temel semptomlar\u0131na sahip de\u011fildir. Prediyabet, tip 2 diyabet geli\u015ftirme riskinin artt\u0131\u011f\u0131n\u0131 g\u00f6sterir.<\/p>\n
Ayr\u0131ca kalp ve damar hastal\u0131klar\u0131na yakalanma riski 1,5 kat daha fazlad\u0131r. Prediyabet ciddiye al\u0131n\u0131rsa ve insanlar ya\u015fam tarzlar\u0131n\u0131 de\u011fi\u015ftirirlerse diyabetin ba\u015flamas\u0131n\u0131 geciktirebilir veya \u00f6nleyebilirler.<\/p>\n
Kan \u015eekeri S\u00fcrekli Y\u00fckseliyorsa Belirtileri Nelerdir?<\/strong><\/h3>\nS\u0131k idrara \u00e7\u0131kma<\/strong><\/h3>\nV\u00fccutta ins\u00fclin yap\u0131lamad\u0131\u011f\u0131nda, ins\u00fclin hormonunun normalde sorumlu oldu\u011fu i\u015flevler yerine getirilemez. Yani glikoz h\u00fccreler taraf\u0131ndan enerji olarak kullan\u0131lamaz ve kanda birikir.<\/p>\n
B\u00f6breklerden belli bir oranda \u015feker at\u0131ld\u0131ktan sonra idrar at\u0131lmaya ba\u015flar. \u0130drarla at\u0131lan \u015feker de suyu s\u00fcr\u00fckleyece\u011finden ki\u015fi \u00e7ok ve s\u0131k idrara \u00e7\u0131kmaya ba\u015flar.<\/p>\n
\u00c7ok su i\u00e7mek<\/strong><\/h3>\n\u0130drarda fazla su kayboldu\u011funda, fazla suya ihtiya\u00e7 duyulur.<\/p>\n
Kilo kayb\u0131<\/strong><\/h3>\n\u00d6te yandan al\u0131nan besinlerden yararlanamayan v\u00fccut h\u00fccreleri, depolardaki ya\u011flar\u0131 yak\u0131t olarak kullanmaya ba\u015flar ve ki\u015fiyi zay\u0131flat\u0131r.<\/p>\n
Bulan\u0131k G\u00f6rme<\/strong><\/h3>\nY\u00fcksek kan \u015fekeri seviyeleri bulan\u0131k g\u00f6rmeye neden olur. Bunun ana nedeni, artan kan \u015fekeri seviyeleri ile artan idrara \u00e7\u0131kman\u0131n neden oldu\u011fu s\u0131v\u0131 kayb\u0131d\u0131r. V\u00fccudun t\u00fcm dokular\u0131ndan su \u00e7ekildi\u011fi i\u00e7in g\u00f6z ve lens s\u0131v\u0131 kaybederek odaklanmakta g\u00fc\u00e7l\u00fck \u00e7eker.<\/p>\n
Mide Bulant\u0131s\u0131 ve Kusma<\/strong><\/h3>\nDiyabet ilerledik\u00e7e, ins\u00fclin \u00fcreten pankreas h\u00fccreleri hasar g\u00f6r\u00fcr. \u0130ns\u00fclin eksikli\u011fi de h\u00fccrelerin kan \u015fekerini kullanamamas\u0131na neden olur. Enerji \u00fcretmek i\u00e7in ya\u011f h\u00fccreleri par\u00e7alanmaya ba\u015flar ve keton cisimleri olu\u015fur.<\/p>\n
Ketonlar h\u00fccrelere enerji sa\u011flar. Bununla birlikte, kan\u0131n asitli\u011fini de artt\u0131r\u0131rlar. Buna ketoasidoz denir. Mide bulant\u0131s\u0131na neden olur. \u015eeker hastal\u0131\u011f\u0131 olan \u00e7ocuklarda bu bulant\u0131 ve kusma \u015fikayetleri \u00e7ok yayg\u0131nd\u0131r.<\/p>\n
Enfeksiyonlara E\u011filim<\/strong><\/h3>\nDiyabetli ki\u015filerde enfeksiyon olma olas\u0131l\u0131\u011f\u0131 daha y\u00fcksektir. Bunun daha kolay grip olmak gibi sonu\u00e7lar\u0131 olabilir. \u0130drar yolu enfeksiyonu da daha s\u0131k ortaya \u00e7\u0131kabilir.<\/p>\n
Cilt problemleri<\/strong><\/h3>\nDiyabetli ki\u015filerde cilt kurulu\u011fu artar. Bu ka\u015f\u0131nt\u0131y\u0131 tetikler. Ayak bak\u0131m\u0131 da \u00e7ok \u00f6nemlidir. Bu semptomlar\u0131n ortaya \u00e7\u0131kma s\u00fcresi pankreas bezi beta h\u00fccrelerinin y\u0131k\u0131m miktar\u0131na ve y\u0131k\u0131m h\u0131z\u0131na ba\u011fl\u0131d\u0131r.<\/p>\n
Y\u0131k\u0131m haftalar, aylar ve hatta y\u0131llar s\u00fcrebilir. Hasar h\u0131zl\u0131 ve k\u0131sa s\u00fcrede tamamlan\u0131nca v\u00fccut enerji ihtiyac\u0131 i\u00e7in protein ve ya\u011flar\u0131n\u0131 kullanmak zorunda kal\u0131r.<\/p>\n
\u00d6zellikle ya\u011flar\u0131n a\u015f\u0131r\u0131 y\u0131k\u0131m\u0131 ile olu\u015fan keton cisimleri ad\u0131 verilen son \u00fcr\u00fcnler v\u00fccut i\u00e7in zararl\u0131 at\u0131klard\u0131r ve v\u00fccutta birikerek ketoasidoz denilen bir acil durum tablosu olu\u015ftururlar.<\/p>\n
Ketoasidozun semptomlar\u0131 kar\u0131n a\u011fr\u0131s\u0131, h\u0131zl\u0131 nefes alma, yorgunluk ve halsizliktir. B\u00f6yle bir durumda acilen hastaneye ba\u015fvurmak gerekir.<\/p>\n
<\/p>\n
![\"\u015eeker](\"https:\/\/turkeyistanbulmedical.com\/wp-content\/uploads\/2019\/07\/asd.png\")
<\/p>\n
Diyabet\u00a0(\u015eeker Hastal\u0131\u011f\u0131) Tedavisi Nas\u0131l Yap\u0131l\u0131r?<\/strong><\/h3>\n\u015eeker hastal\u0131\u011f\u0131 gibi kronik bir hastal\u0131\u011f\u0131n\u0131z oldu\u011funu \u00f6\u011frendi\u011finizde hakl\u0131 olarak \u00fcz\u00fcleceksiniz. Ancak olumlu yan\u0131, diyabetin tedaviye \u00e7ok iyi yan\u0131t veren bir hastal\u0131k olmas\u0131d\u0131r.<\/p>\n
\u00dcstelik \u00e7evrenizdeki insanlara \u015feker hastas\u0131 oldu\u011funuzu s\u00f6yledi\u011finizde, sizinle ayn\u0131 durumda olduklar\u0131n\u0131 ve \u00e7ok normal, \u00fcretken bir ya\u015fam s\u00fcrd\u00fcklerini ne kadar bildi\u011finizi g\u00f6r\u00fcnce \u015fa\u015f\u0131racaks\u0131n\u0131z.<\/p>\n
Ayr\u0131ca, diyabetle ilgili muazzam ara\u015ft\u0131rmalar, \u00f6n\u00fcm\u00fczdeki y\u0131llarda yeni tedavilerle tan\u0131\u015fmaya devam edece\u011finiz anlam\u0131na gelir.<\/p>\n
Diyabet (\u015eeker Hastal\u0131\u011f\u0131)Tedavisinin Amac\u0131:<\/strong><\/h3>\nDiyabet tedavisinin amac\u0131 kan \u015fekerinizi ve di\u011fer risk fakt\u00f6rlerini (kolesterol ve tansiyon gibi) kontrol alt\u0131nda tutmak ve uzun s\u00fcreli komplikasyonlara neden olmamakt\u0131r.<\/p>\n
Bunu ne \u00f6l\u00e7\u00fcde ba\u015farabilece\u011finiz, ya\u015f\u0131n\u0131za, kilonuza, diyet ve egzersiz al\u0131\u015fkanl\u0131klar\u0131n\u0131za, \u00e7al\u0131\u015fma program\u0131n\u0131za, \u00f6nceki sa\u011fl\u0131k sorunlar\u0131n\u0131za ve diyabetinizin Tip 1 veya Tip 2 olmas\u0131na ba\u011fl\u0131 olarak de\u011fi\u015fecektir.<\/p>\n
T\u00fcm fakt\u00f6rleri dikkate alan ki\u015fisel bir tedavi plan\u0131 uygulaman\u0131z gerekir.\u00a0 Diyabetli bir\u00e7ok insan i\u00e7in bu, kan \u015fekeri d\u00fczeylerini s\u00fcrekli olarak izlemek, belirli yiyecekleri k\u0131s\u0131tlamak, kilo vermek ve oral veya enjeksiyon yoluyla ila\u00e7 almak anlam\u0131na gelir.<\/p>\n
\u0130ns\u00fclin V\u00fccuda Nas\u0131l Enjekte Edilir?<\/strong><\/h3>\n\u0130ns\u00fclin deri alt\u0131 ya\u011f dokusuna, derinin hemen alt\u0131na ve kas\u0131n hemen \u00fcst\u00fcne enjekte edilir.<\/p>\n
V\u00fccudunuzda deri alt\u0131nda ya\u011f dokusu olmas\u0131na ra\u011fmen enjeksiyon s\u0131ras\u0131nda damar ve sinirlerin yo\u011fun olmas\u0131 tercih edilmez. Bu nedenle \u00f6nerilen b\u00f6lgeler kar\u0131n \u00fcst k\u0131sm\u0131, kollar ve bacaklar ve kal\u00e7alard\u0131r.<\/p>\n
\u0130ns\u00fclin kalemi kullan\u0131yorsan\u0131z; Kalemi \u00f6nceden haz\u0131rlay\u0131n.<\/p>\n
\n- Ellerini y\u0131ka.<\/li>\n
- Kalemin \u00fcst ucundaki \u00f6l\u00e7ekten ins\u00fclin dozunu ayarlay\u0131n.<\/li>\n
- Kalem kapa\u011f\u0131n\u0131 a\u00e7\u0131n.<\/li>\n
- \u0130ns\u00fclini ters \u00e7evirin.<\/li>\n
- Kalemin alt ucundaki i\u011fne kapa\u011f\u0131n\u0131 \u00e7\u0131kar\u0131n.<\/li>\n
- \u0130\u011fnenin ucunun bir ins\u00fclin damlas\u0131 ile \u00e7\u0131kt\u0131\u011f\u0131ndan emin olun.<\/li>\n
- \u0130\u011fnenin ucunda damlac\u0131k g\u00f6rm\u00fcyorsan\u0131z 1-2 \u00fcnite ins\u00fclini bo\u015fa harcayarak olas\u0131 havay\u0131 al\u0131n.<\/li>\n<\/ul>\n
Diyabette\u00a0(\u015eeker Hastal\u0131\u011f\u0131) Erken Te\u015fhis \u0130\u00e7in Ge\u00e7 Kalmay\u0131n!<\/strong><\/h3>\nDiyabet \u015f\u00fcphesi olan hastalarda kesin tan\u0131 konulmas\u0131 i\u00e7in 8 saatlik a\u00e7l\u0131k sonras\u0131 kan \u015fekeri \u00f6l\u00e7\u00fcmlerine bak\u0131l\u0131r. A\u00e7l\u0131k kan \u015fekeri 126 mg\/dl ve \u00fczerinde \u00e7\u0131karsa \u015feker hastal\u0131\u011f\u0131 te\u015fhisi konulur.<\/p>\n
Te\u015fhisin kesinle\u015fmesi i\u00e7in birka\u00e7 g\u00fcn sonra tekrar kan \u015fekerine bak\u0131l\u0131r. \u0130kinci \u00f6l\u00e7\u00fcmde de 126 mg\/dl den fazla ise kesin diyabet hastal\u0131\u011f\u0131 te\u015fhisi konulur.<\/p>\n
A\u00e7l\u0131k kan \u015fekeri 100 ile 126 mg\/dl aras\u0131nda \u00e7\u0131karsa bu ki\u015filere de \u015feker y\u00fckleme testi yap\u0131l\u0131r. 75 gr \u015fekerli su,10-16 saatlik a\u00e7l\u0131k sonras\u0131 ve sabah i\u00e7irilir. Ve 2. saat kan \u015fekerine bak\u0131l\u0131r. 2. saat kan \u015fekeri 200 mg\/dl \u00fczerinde ise diyabet hastal\u0131\u011f\u0131 tan\u0131s\u0131 konulur.<\/p>\n
Prediyabet Nas\u0131l Te\u015fhis Edilir?<\/strong><\/h3>\nA\u00e7l\u0131k kan \u015fekeri 100-125 mg\/dL aras\u0131nda ise \u015feker y\u00fckleme testi (OGTT: Oral glukoz tolerans testi) yap\u0131larak prediyabet ara\u015ft\u0131r\u0131lmal\u0131d\u0131r.<\/p>\n
\u00c7ocuklarda Te\u015fhis Nas\u0131l Konur?<\/strong><\/h3>\nTip 1 diyabet ani ba\u015flang\u0131\u00e7l\u0131 bir problem oldu\u011fundan ve genellikle \u015fiddetli semptomlarla ortaya \u00e7\u0131kt\u0131\u011f\u0131ndan \u00e7ocuklarda tan\u0131 zor de\u011fildir. \u00c7\u00fcnk\u00fc \u00e7ok su i\u00e7mek, \u00e7ok idrara \u00e7\u0131kmak, kilo vermek \u00f6nemli ipu\u00e7lar\u0131d\u0131r.<\/p>\n
Ayr\u0131ca herhangi bir zamanda \u00f6l\u00e7\u00fclen y\u00fcksek kan \u015fekeri de\u011ferlerinin 200’\u00fcn \u00fczerinde olmas\u0131 tan\u0131 i\u00e7in yeterlidir. Klinik bulgularla tan\u0131 konulam\u0131yorsa ve herhangi bir zamanda y\u00fcksek kan \u015fekeri seviyelerinde yeti\u015fkinlerde oldu\u011fu gibi a\u00e7l\u0131k kan \u015fekerine bak\u0131l\u0131r.<\/p>\n
Diyabet, 126 miligram\u0131n \u00fczerinde tekrarlanan kan \u015fekeri \u00f6l\u00e7\u00fcmlerinin bir sonucu olarak te\u015fhis edilir. Bu zorluklara ra\u011fmen te\u015fhis hala zor ise y\u00fckleme testi uygulan\u0131r.<\/p>\n
\u015eeker y\u00fckleme testi \u00e7ocuklarda diyabet tan\u0131s\u0131nda nadiren kullan\u0131l\u0131r. \u00c7\u00fcnk\u00fc \u00e7o\u011fu vaka bu olmadan te\u015fhis edilir. Bir \u00e7ocu\u011fun ikinci saat kan \u015fekeri seviyesinin 200 mg daha y\u00fcksek olmas\u0131 i\u00e7in challenge testini ge\u00e7mesi yeterlidir.<\/p>\n
Oral Glukoz Tolerans Testi Nas\u0131l Yap\u0131l\u0131r?<\/strong><\/h3>\nA\u015fama 1:<\/strong><\/h4>\n10-12 saatlik a\u00e7l\u0131ktan sonra kan \u015fekerini \u00f6l\u00e7\u00fcn.<\/p>\n
A\u015fama 2:<\/strong><\/h4>\n\u00d6zel haz\u0131rlanm\u0131\u015f 75 gr \u015fekerli s\u0131v\u0131 i\u00e7ilir. Ve 2 saat sonra kan \u015fekeri tekrar \u00f6l\u00e7\u00fcl\u00fcr. \u015eeker y\u00fckleme testi yap\u0131lm\u0131\u015f ki\u015filerde 2 saatte 140 mg\/dL’nin \u00fczerindedir.<\/p>\n
Ancak 200 mg\/dL’nin alt\u0131nda olan plazma glukoz d\u00fczeyi de bozulmu\u015f glukoz tolerans\u0131 olarak adland\u0131r\u0131l\u0131r.<\/p>\n
A\u00e7l\u0131k kan \u015fekeri 100-126 mg \/ dL aras\u0131nda oldu\u011funda veya \u015feker y\u00fckleme testi 2 saatte 140-200 mg \/ dL tokluk de\u011ferine sahip oldu\u011funda prediyabet buradad\u0131r.<\/p>\n
Diyabet (\u015eeker Hastal\u0131\u011f\u0131) Dikkat Edilmesi Gerekenler Nelerdir?<\/strong><\/h3>\n\n- Diyabet hastas\u0131 rutin olarak kontrol edilmelidir. Ve d\u00fczenli olarak kullan\u0131lmal\u0131d\u0131r. Verilen diyete de\u00a0 uyulmal\u0131d\u0131r\u00a0 ve ins\u00fcline duyarl\u0131 olunmal\u0131d\u0131r.<\/li>\n
- Y\u0131lda en az bir kez g\u00f6z ve b\u00f6brek muayenesi, 2 y\u0131lda bir d\u0131\u015f muayene yap\u0131lmal\u0131d\u0131r.<\/li>\n
- Ayaklar diyabet hastalar\u0131 i\u00e7in de \u00f6nemlidir. Ve her g\u00fcn \u0131l\u0131k sabunlu su ile y\u0131kan\u0131p\u00a0 kurutulmal\u0131d\u0131r.<\/li>\n
- Cilt kurulu\u011fu i\u00e7in nemlendirici krem \u200b\u200bkullan\u0131lmal\u0131d\u0131r. Yaz\u0131n \u00e7\u0131plak ayakla dola\u015fmay\u0131n ve \u00e7orap giymeyin. Baca\u011f\u0131 s\u0131kmayan ve iz b\u0131rakmayan \u00e7orap se\u00e7iminde pamuk tercih edilmelidir.<\/li>\n
- Ayaklarda nas\u0131r olu\u015fumu ba\u015flad\u0131\u011f\u0131nda deriye bak\u0131m yap\u0131lmal\u0131 ve tedavi edilmelidir. Ayak t\u0131rnaklar\u0131 d\u00fcz kesilmelidir.<\/li>\n
- Ayakkab\u0131 se\u00e7iminde ise tam oturan, s\u0131kmayan ve \u00e7arpmayan ayakkab\u0131lar tercih edilmelidir.<\/li>\n
- Sigara ve alkolden uzak durulmal\u0131d\u0131r. Stres ve s\u0131k\u0131nt\u0131dan ka\u00e7\u0131n\u0131lmal\u0131d\u0131r. Bir glikoz \u00f6l\u00e7er sa\u011flanmal\u0131 ve d\u00fczenli olarak izlenmelidir.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"
Diyabet (\u015eeker Hastal\u0131\u011f\u0131) Nedir? Bu hormonlardan biri de ins\u00fclindir. \u0130ns\u00fclin hormonunun eksikli\u011fi veya etkisizli\u011fi sonucu ortaya \u00e7\u0131kan ve kan \u015fekeri y\u00fcksekli\u011fi ile seyreden kronik ve ilerleyici bir hastal\u0131kt\u0131r. \u0130ns\u00fclin v\u00fccudumuzda pankreas taraf\u0131ndan salg\u0131lan\u0131r. Ve besinlerden al\u0131nan \u015fekerin h\u00fccreye enerji olarak girerek kullan\u0131lmas\u0131nda anahtar g\u00f6revi g\u00f6r\u00fcr. \u0130ns\u00fclinin yoklu\u011fu veya etkisizli\u011fi sonucunda \u015feker h\u00fccre i\u00e7ine giremez. Ve […]<\/p>\n","protected":false},"author":3,"featured_media":1217,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[738],"tags":[1972,754],"yoast_head":"\n
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