The relevance of those with diabetes type 1. Methodical instructions for students in the 5th year of medical faculties from self-paced training to practical ones to take from pediatrics

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Relevance of diabetics

Diabetes mellitus is an important problem in organizing the protection of the health of Russia, it will be linked both with its wide distribution, as well as with a heavy inheritance: early incapacity and death. This aspect of medical and social significance, as in the middle of the endocrine system, as well as in the middle of the whole group of non-infectious diseases, served as a guide for us to evolve the dynamics of the number of new

Unimportant to those with endocrine pathology in the structure of the disease of the population of the loan is close to 1%, as of the present, it was established that the disease of the population of Russia with endocrine pathology from 1992 to 2007 grew up in the middle at 2.6. Slide to mean the uneven pace of growth over the same period in the older age groups: the incidence of children and old age (0-17 years) grew up 3.5 times, among older adults (18 years of age).

With a lot of animals, I respect myself for the lack of aging of indicators in sickness, stretching out to a period of time in both groups and іх rіzke pіdvischennya(100%) for the last rik of children. There are many indications of young streptococcus among children who have been seen in 2007 when they are receiving special medical examinations of the child population, we can talk about the fact that there is a real shortage of diseases in the population of Russia, as the pathogenic diseases of the population of Russia On the other hand, nutritional status - for the rakhunok of those who become ill themselves, there is also a growing child endocrine pathology, and what is the role of a child with diabetes? It is well known from the assessment of experts of the All-Russian Organization for the Protection of Health, when in Denmark there are 160 million sick people per child with diabetes, about to become 2-3% of the total population of the planet, that is, up to 20 million. The problem is not less serious in Russia, as it also means the development of pathology, with more than 70% of the ailments being in the state of chronic decompensation of diabetic diabetes, not only of this type. Epidemiological advances in the Russian regions, including in Russia, are about the development of ill children with diabetes (CD) type 1 in the last two decades.

On the thought of the authors, one of the main reasons, to infuse the compensation for the loss of the disease and the reduction of diabetes, to bring up to the early disability of the patients, the lack of control over the poor family of the child Therapeutically, so that the formulation of self-regulation in patients with chronic illnesses and adaptations to illnesses is seen as the basic component of illnesses with chronic illnesses. Analytical work related to the problems of training nursing staff for the implementation of the goals of therapeutic training for patients in our country, showing that the price is real before the development of the pathology of the additional availability of medical

In this rite, aktualnіst problemi viznachaєtsya health sotsіalnoyu znachuschіstyu tsukrovogo dіabetu scho harakterizuєtsya INCREASING rіvnyami of labor vtrat i ekonomіchnogo zbitku vnaslіdok zahvoryuvanostі, іnvalіdnostі that smertnostі population vitrat powers i suspіlstva, spryamovanih on lіkuvannya zahvoryuvannya i Yogo uskladnen scho vimagayut vdoskonalennya i pіdvischennya efektivnostі sistemi special qualified assistance.

Meta doslіdzhennya:

Vivchit the role of a nurse in the prevention of diabetes.

Subject of advancement: nursing process in the prevention of diabetes.

According to the date of delivery, the date of the appointment is as follows:

1. The increase in the breadth of the diabetic diabetic and the decrease in the middle age groups of the population and the epidemiological peculiarities of the incapacitation, the incapacity and mortality in contemporary social economies.

2. Take care of the nursing process in the prevention of diabetes mellitus.

Significant diabetes mellitus, etiopathogenesis

Succinic diabetes is a disease for all life. A person who is sick is constantly brought up to self-discipline and self-discipline, and it can psychologically break someone. When you are fond of looking for ailments on a child's diabetes, you also need to be light-hearted, human, and optimistic; We will not give in to help. We are ailing to a little more to cross the path of life.

Diabetes mellitus is vicious, either in case of deficiency, or in case of impaired insulinu. In both drops in the blood, the concentration of glucose increases (hyperglycemia develops), so that there are some other metabolic disorders: for example, in case of abnormal deficiency in the concentration in the blood of the growths.

Classification of red diabetes

Sugar diabetes type I (previously it was called insulinoplantine diabetes mellitus) develops in the case of destruction of r-clinin, as well as a deficiency in insulin. Mechanism of its development is immune or idiopathic.

Diabetes mellitus type II (earlier it was called insulin-free diabetes mellitus.

I and II types of reddish diabetes - the most part of the form of the primary reddish diabetes. The vision of the I and II types is not only classy (for the preparation of the disease), but also the ethological meaning, some of the causes of the I and II types of diabetes are absolutely developmental.

Diabetes mellitus type I

Type I diabetics develop during the destruction of r-clitin of the islands of the pidshlunkovoi zalozi (the islands of Langerhans), as well as the reduction of the viroblast of the insulin. Destruction of p-clitin is accompanied by an autoimmune reaction linked to one and the same factors of the midst and recessive factors in genetically sick individuals. With such a foldable nature of the development of illnesses, one can explain why the middle of identical twins of type I diabetics develop only in about 30% of cases, and type II diabetics - mayzhe in 100% of cases. Let the process of running the islands of Langerhans be repaired in a dungeon early vіtsі, For a few years before the development of key manifestations of sugar diabetes.

HLA System Stan

The antigens of the head complex of histosumnost (HLA system) visually start the strength of the people to the older types of immunological reactions. In type I diabetes mellitus, 90% of cases show DR3 and / or DR4 antigens; antigen DR2 pereshkojaє development of sugar diabetes.

Autoantitila and cellular immunity

In most cases, at the time of the appearance of type I diabetes, in ailments є antibodies to the clines of the islands of Langerhans, who step by step decrease, and through the rock of rock they stink. Not long ago, the bullets were revealed, also anti-til to the deyakie bіlkіv

Clitinus inflamed (cytotoxic T-lymphocytes and macrophages) destroy p-clitini, as well as on the cob stages of type I diabetes mellitus develop insulite . The activation of lymphocytes is enriched by macrophages of cytokines. In preschool children, it is shown that the development of type I diabetes mellitus is shown, that it is often shown that the function of Langerhans' islands is doped with immunosuppression by cyclosporine; however, won supervise the numerical side effects and not inadvertently suppressing the activity of the process. The effectiveness of prevention of diabetes type I diabetes with nicotinamide, the important activity of macrophages, has also not been reported. Frequently saved functions of cells of Langerhans' islands with the introduction of insulin; to assess the efficiency of the treatment in the Danish hour to carry out clinical vip testing.

Diabetes mellitus type II

There are no simple reasons for the development of type II diabetics, and there are fewer reasons for the development of a wide range of illnesses due to the small nature of the disease and key manifestations. Х commonness to pathogenesis: a decrease in the secretion of liver tissue (due to the deterioration of the function of Langerhans' islands in the case of increased peripheral resistance before the development of glucose intolerance) In 98% of patients, the reason for the development of type II diabetes mellitus does not seem to be significant - to talk about "idiopathic" diabetes mellitus. Yake z oddly (decrease in secretion to insulinu or resistance to insulinu) perpetually, inadvertently; Possibly, the pathogenesis of children with ailments. Most often resistance to insulin is poured over obesity; more common reasons resistance to insulin presentation

In a number of patients in patients over 25 years of age (especially due to the prevalence of obesity), non-circulating type II diabetes develops, and latent autoimmune diabetes is overgrown LADA, which is due to the prevalence of antihypertensive disease.

Diabetes mellitus of the II type is progressing by and large: the secretion of insulin gradually decreases with a stretch of ten years, inconceivably leading to an increase in glucose, as it is superbly important to normalize.

In case of obesity, the susceptibility to insulin is known to be susceptible to suppression of the expression of receptors in insulin due to hyperinsulinemia. Obesity is a sign of increased development of type II diabetes mellitus, especially with an android type of adipose tissue growth (visceral obesity; obesity "as an apple" type; growth of adipose tissue (obesity "by the type of pear"< 0,7). На формирование образа жизни, способствующего ожирению, может влиять лептин - одноцепочечный пептид, вырабатываемый жировой тканью; большое количество рецепторов к лептину имеется в головном мозге и периферических тканях. Введение лептина грызунам с дефицитом лептина вызывает у них выраженную гипофагию и снижение массы тела. Уровень лептина в плазме нарастает пропорционально содержанию в организме жировой ткани. Описано несколько единичных случаев развития ожирения, обусловленного дефицитом лептина и успешно леченого его введением, однако в большинстве случаев введение лептина не оказывает заметного биологического действия, поэтому в лечении ожирения его не используют.

Rizik factor for the development of sugar-coated diabetes type II

* Вік over 40 years old.

* Mongolian, negro, latinamerican promenade.

* Nadlishkova masa tila.

* Sugar type II diabetes in relatives.

* For women: history of gestational diabetes.

* Masa tila for populations> 4 kg.

It has not been shown for a long time that a low mass of tila during populations is supervised to develop in adulthood resistance to insulin, type II diabetics, ischemic ailments heart. Chim lower masa tila in populace and in chim more, I change the norm in vіtsi 1 roku, tim vishche rizik.

In the development of type II diabetic diabetics, a great role is played by the decline of bureaucrats, which is manifested by the high frequency of this one-hour development among identical twins, the high frequency of the same type of sickness, the high incidence of debility of the people. Pre-adolescents detect all new genetic defects, scho to develop the development of a type II diabetic diabet; The actions of them are described below.

Tsukroviy diabet II type in children with descriptions of deprivation in deyakim innumerable nationalities. Today, in the industrialized lands, the incidence of children with type II diabetes has been significantly increased: in the United States, it is 8-45% of all types of diabetes in the development of sugar-free diabetes among children who are growing and selling. Naybіlsh often ailments for children at 12-14 years old, overwhelmingly young women; as a rule, on the smallest obesity, low physical activity and the presence of type II diabetes in the family history. Young children, who do not suffer from obesity, now in advance, become diabetics of the LADA type, which is necessary to get insulin. In addition, there is more than 25% of cases of red diabetes type II in to a young person augmented with a genetic defect within the framework of MODY (div. lower) or some of the other childish syndromes.

Diabetes mellitus can also acquire resistance to insulin. In case of some rare forms of resistance to insulin, the introduction of hundreds and thousands of insulin units appears to be ineffective. Such things, as a rule, are supervised by lipodystrophy, hyperlipidem, Type A resistance to insulinumumation by genetic defects of the insulinu receptor or postreceptor internal mechanisms of signal transmission. Type B resistance to insulinumation of autoantitils to insulin receptors; it is not easy to get along with those autoimmune illnesses, for example, the systemic chervonia vovchak (especially among black women). Tsi options for diabetics are even more disgusting to get used to.

Klinichna picture of a sweet diabet

V cool paintings Sugar diabetes is seen more and more onset of the group of symptoms:

1. Symptoms, disturbed by impaired metabolism of blood, fat and carbohydrates.

2. Symptom complex urazhennya heart-vascular system.

3. Signs that characterize the level of the nervous system.

Early signs: weakness, spraga, thinning with increased appetite, sverbіzh shkіrnykh pokrivіv.

The stage of flared clinical symptomatology is characterized by a complex of symptom affecting all organs and systems.

Symptoms of organ damage in case of sugar diabetes:

· Symptoms of shkiri and pediatric clitches - dryness, peeling, maceration, tremors, xanthosis of the hollow surfaces of the hands and feet. Rubeosis on the vilitsy, pidboriddі, nadbrivny arches. Pigmentnі Plays on Gomіlki ("Plumista Gomіlka"). Lipoid necrobiosis, furunculosis, eczema, psoriasis. The hypotrophy of the pediatric fatty tissue is, for example, the extent of the disease, especially in the introduction of the insulin. When the insulin is introduced, it can help prevent and develop atrophy of the pediatric cell ("lipoatrophic syndrome"). Postin'ktsiynyh hypertrophic syndrome in vigiladiinfiltratyv can be found inn'ktsiyh children, including insulinu.

· Symptoms of the lesion of the musculoskeletal apparatus - Dupuytren's contracture. Osteoarthropathy (cubic foot), deformity of the interphalangeal joints of the fingers and nig, osteopenia and osteoporosis.

Symptoms of deterioration of the organs of the body - dryness and atrophy of the mucous membrane of the upper dikhalnyh nobles... Debility to bronchitis, pneumonia and tuberculosis.

· Symptoms of poisoning of organs of etching - from the side of the empty mouth, atrophy of the papillae of the movi, agility up to gingivitis, periodontitis, stomatitis are indicated.

· Cutting of the slurry is characterized by the setting of acidic and enzymatic functions, atrophic mucous membrane and salty apparatus.

Snakes from the side small intestine Pole in reduced enzymatic and hormone-forming functions.

· Deterioration of the intestinal dyyalnosti is characterized by a slenderness to atony, decreased motor function. At the same hour, with the development of autonomic neuropathy with damage to the vegetative energy of the intestine, the ailments are more likely to develop diarrhea, as they do not know about the intake of enzymatic preparations and astringent substances. The liver damage is characterized by the development of fatty degeneration on the decrease in glycogen reserves, impairing the metabolism of lipids and blood. Singing a moment in the pathogenesis of the defeat of the liver of the loan, the failure of the current in the connection with the disruption of the female nobles.

· Zhovchny mikhur often enlargement, stretching, sensitive on palpation. Є smartness until stagnation, setting stones, development ignition process in zhovchny mіkhury.

Diagnosis of diabetes mellitus

For dіagnostiki tsukrovogo dіabetu, otsіnki tyazhkostі that will kompensatsії zahvoryuvannya pershoryadne values toil viznachennya rіvnya tsukru in krovі natsche i povtornі Yogo viznachennya uprodovzh Dobie, doslіdzhennya glіkozurії dobovoї that fraktsіynoї in okremih portsіyah, viznachennya vmіstu ketone til in sechі i krovі, vivchennya dinamіki rіvnya glіkemії at different forms glucose tolerance test.

Doslidzhennya instead of zukru in the blood can be carried out by different methods, which are guilty of being specified for the correct interpretation of the results of the analyzes. One of the most accurate methods, which is to start the change of true glucose in the blood, є glucose oxidation, are close to the reception of the vicious orthotoluidine method and the methods based on the updated mind (Somod method)

Tsukru rin in the blood in healthy individuals according to cym methods in healthy individuals becomes 3.3 to 5.5 mmol / l (from 60 to 100 mg in 100 ml of blood); ...

Until the present hour, in some laboratories, they have to use the Hagedorn-Jensen titrometric method, based on the power of glucose. So, at a time when there are some changes in speech, the indicators of blood sugar in the blood by the cymbal method are 10% higher than that of the same level, which should be started by orthotoluidio-vim and other methods. The norm of zukru in the blood in the mother's blood according to the Hagedorn-Jensen method is 80 -120 mg%, or 4.44-6.66 mmol / l.

Slide memory, which is capillary (change) blood from the finger to replace in 100 ml for 1.1 mmol (20 mg) glucose is more, lower venous, and the level of glucose in the plasma is about 10-15% in food of the accumulated level of glucose in the capillary blood. Tse maє suttєve meaning in the assessment of glucose tolerance test. The manifestation of glycosuria can be yakisnim and kilkisnim. It should not be carried out either for additional reagents (Nilander, Benedikt et al.), For special, indicator papіrtsіv ("glucotest", sklіnіstіks ") and tablets (" Klinіvlyatіst "). 1 to 0.25%), with additional help, it is also possible to increase the amount of zukru in the section up to 2%.

To make sure that the zukru in the section is not checked, it should be carried out behind an additional polarimeter using any methods (Althausen's method with 10% sodium chloride or calories).

With the presence of characteristic key symptoms(Polydipsia, polyuria, nikturia) In addition to glucose and glucose, the diagnosis of diabetes is not difficult.

An obvious diabetic arises at the stage of the emergence of a baby in the blood and in the blood. The blood is on the way to the heart. Glykozurii will begin in this day, or in the port of this, in 2 years after receiving the letter. Before only rankovoi sich is not shown, in case of mild forms of sugar diabetes in sich, in children, glycosuria does not appear. With an insignificant increase in the amount of sugar in the blood, the establishment of a diagnosis can be less likely if unambiguous results are rejected, which are caused by the disease in the section or in the surrounding portions of the section. To clarify the diagnosis in such cases, additional help is given to the diagnosis of glucose throughout the day on the ailing we are sick. In case of untreated obvious red diabetes mellitus in the blood during the day I change 10 mmol / l (180 mg%), to serve as a guide for the onset of glucose, so as a normal threshold for glucose to become 9.5 mmol / l) (170-180 mg%) ...

Glycozuria is often the first symptom of diabetes mellitus, which appears in the laboratory. A slid of memory, so the appearance of a tsukru in the battle is a more wider phenomenon, less a manifestation of it in the blood. There may be a reduction in the sensitivity of the sensitivity threshold for glucose, but at the same time there may be a nircovian diabetes, in case of any vision of sugar with a cross, it may be promoted in case of physiological neoplastic diseases of glucose, as well as However, all ailments from the glikozurii are guilty but reliably in the plan of diagnostics against the congenital diabetes.

Warehouse for diabetes

· Diabetic ketoacidosis is one of the most unsafe countries for life. Through the low level of insulin, the cells of the liver grow into a dzherel of energy for the body, transforming into fat. With a whole metabolism of stiko damage. As soon as there is a small amount of acidity in the blood (and in case of diabetes of another type, it’s like that), then the cym can be controlled, even if there is an increase in ketone levels in the blood, the acidity is low, and it can be reduced to diabetic ketoacidosis... In ailing, organism grows shy, dyhannya becomes superficial, sertsebittya is accelerated. Tastes at a time of inauspicious help - the brain can grow and death can occur.

· Hyperosmolyarny mill - severely impaired metabolism, with any kind of cells they consume glucose і, drinking in the roof, they filter in nirkas і vivoditsya from the cross-section. It is necessary to carry out osmosis to the point of failure and damage, as well as to process the processes on the basis of the cell exchange. The first help is guilty of falling into the ground in order to prevent the Komi.

· Respiratory illnesses. In people who suffer for type 2 diabetes, it is significant that immunity is weakened. Tse in his own heart to bring to the inheritance at the viglyadi more often respiratory infections, Yakim piddaєtsya the organism of a sick person. Patients with diabetics often suffer from pneumonia, flu, fired up nasopharynx.

· Angiopathies - the pathology of the disease - often develop accelerated in diabetics. A high stable level of glucose, naturally, is recognized in the country of Sudin. With a significant intake of glucose from the blood, the judge will not be able to shake it off. Tse to produce until the membrane is poured, yak tovstish, and then cease to vikonuvati its function. It is also due to the fact that, as the judgment of enmity, angiopathies go to the microvascular and macrovascular.

Nephropathy - nirkova lack, Zhvavo as a result of diabetes. In case of important issues, you can know the difference.

· Neuropathies - to reach the extensions "mittens effect" - if the nerves impulses to the end of the fingers, in which case the muscles atrophy.

Retinopathy - the development of the pathology of the eyes, through the fall of the ghost of the eye, and it may be the case of the sleep.

The fate of a medical nurse in the prevention of diabetes

Medical nurse of diabetological profile - tse medical sister With the help of volodya's extended knowledge and advice on cure, knowledge, advice and consultation of ailments for diabetics, taking into account the pathology and tips of a scientific trick. given value The bulo is rendered on the basis of clinical information, information on the development of ailments on a child's diabetes, and especially, as a result of the knowledge, education and development of the system of special medical advice by the doctors, by the bodies of the middle medical staff and by the administrative authorities.

The meta to educate people with illnesses on a diabetic child is to help them translate theoretical knowledge into practical tips, and to put together an individualized plan. Yak a member of the "command the patronage of a sick person with a child with diabetes", a nurse of a diabetological profile is guilty of the widespread erudition and adolescence of a sick person with a diabetic diabetic in other regions.

The order of the ailments for a diabetic child, the medical sister, at her own level, can start the strategy and tactics of treatment and add the ailments to develop powerful plans and goals.

Requirements of a nurse of a diabetological profile

· Development of information and materials;

· Organize, conduct and assess individual and group programs for the sick;

· Provide educational and patronage programs in suspensions during visits to booths and spіvpratsі with the first lankas in the system of diabetic assistance;

· Development of educational programs for individuals, by the nature of their service, they can be in contact with people with ailments on diabetics (vicladas, patronage nurses);

· Vistupati, there it is deceptively, - and the key role - in being a sick man for a diabetic child;

· Accept, within the framework of the musical instructions, the participation in the love;

· Spіvpratsyuvati with іnіh teams of fakhіvtsіv (pedіatras, obstetricians, mentors іnvalіdіv, etc.);

Buti a friend and a radio operator for organizers to protect health

I am active in CLINIC PRACTICE, Zasnovanoi on a scientific joke; a nurse of a diabetological profile is guilty of being interested in participating and / or conducting an independent scientific study;

Take the fate of the rozrobtsі programs thoroughly medical workers socially with the leading institutes.

Nursing education for diabetology

The qualifications of the standard for the "nurse of diabetological profile" have not yet been hardened. Protest, academic and educational types of training of nurses - diabetologists in accordance with the plan, but they are connected with the current academic institutes when teaching with the medical teams of diabetologists for the time, the standard

Dozіlno feasibility of basic training for diabetes among medical nurses-scholars.

In the distribution to take in the groups of graduate training, the guilt is included in the education of ailments, її lіkuvannya, accelerated, special supplies for children with ailments for diabetics (children, children, children).

It is necessary to establish a national standard in the graduate training and education of nurses with a diabetic profile in accordance with legal norms and professional legislation.

It is important to organize the organization of groups of medical nurses, as they look after ailments for diabetics.

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Symptoms of diabetes mellitus

A special feature of diabetic diabetes is the fact that the symptoms are most often not immediately apparent. It may be a trivial hour to get sick in the body of a sick people in the so-called "passive" camp, which cannot be seen as an ordinary person. It is not easy for a lyudin to know about his own discomfort absolutely unsupported, when he is beaten up to a license, he will drive any one who is ill. For example, a ludin turns to a doctor-ophthalmologist, like looking at the bottom of the person, you can see the appearance of a sick person's diabetes.

Currently, there are two types of diabetes mellitus, symptoms and manifestations of which also develop. However, when I look at it, it’s all the same, and the symptoms can be overwhelmed. Tsukroviy diabet signifies ma nastia:

The sprague is strong.

As a rule, there is a tendency to be susceptible to problems in all cases of falling ill for diabetics. The most common symptom is one of the first. However, it is not a matter of zabuvati as well, although spragy can be found in viclikan and a number of others who are ill, for that, when a diagnosis is made, it does not become obvious only for a symptom.

Often sechovipuskannya.

For both forms of sugar diabetes, such a symptom is characteristic, such as accelerated sevipuskannya. However, I need to know how often sechovipuskannya You can signal about the destruction of the robot, for example, about the destruction of the robotic system.

Significant loss of vagi with increased appetite.

As soon as the person constantly wants to, the protest's vag will change for no reason, so also є be alert and go through the situation, so that it will allow the appearance of a diabetic diabetic.

Stomatosis is increased.

The emergence of a chronic autonomic syndrome, drowsiness - all the symptoms of supra-vomiting are great number of themselves young people... First diabetic without becoming a vignette of the third rule.

Pogirshennya zoru.

There are even more people, ailments to diabetic diabetics, to skar on such appearances, like the appearance of an unclean image, a white "shroud" in front of the ochim.

Potential problems.

For the choloviks - the denunciation of the problems to the statutory lives - the destruction or the external knowledge of the erection. Before the speech seems to be, signs of sugar diabetes in women include such a phenomenon as the dryness of the mucous membranes of pichvi.

Damage to the normal process of blood circulation in children.

Seeing oniminnya and pokryuvannya in the hands and feet of the ailing people, appearing in court in litkovy meazah- the price of building an analysis of blood for the purpose of making a price instead of a tsukru.

Reduced tissue health before regeneration

Be-like shkodzhennya shkіrnykh pokrivіv, navіt simple podryapina, to go out in the edge and in the edge of the dovgo. There are often wet wounds, and nausea.

The temperature is low.

As a rule, in people who suffer for diabetes, the temperature is lowered and the temperature rises between 35, 5 - 36 degrees.

The degree of swelling of that particular symptom is due to individual peculiarities to the organism of the skin of a sick person taken. Some of them have symptoms, and all the symptoms are overwhelmed, and it turns out to be too strong. And in some people, all the symptoms may be more severe, or they may appear from every day. Apart from individual features of the organism at the stage of the development of symptoms of diabetes, infusion and the stage of illness - the more severe the normal secretion of insulin is destroyed, the more severe the symptoms.

Atrocities for medical aid

If you think about it, if you remember it, or if your loved ones have two, if you are more likely to get sick with a symptom, try to be more vicious for medical aid before a doctor - an endocrinologist, or, at the same time, before a therapist. Only a little car can be surely due to the fact that people have diabetic diabetics. Even with diabetes, symptoms can be non-typical.

Diagnostics of the disease on the current day does not represent absolutely any difficulties. Likar visually inspect the sick people, the hearing of the mischief, for whom to acknowledge the actions of the past:

Laboratory blood monitoring.

meteyu given doslіdzhennyaє Viznachennya rivnya instead of zukru in the blood of ailing people. Pre-treatment of blood is carried out strictly on the heart, therefore, in any case, do not take off before going to the clinic.

Laboratory dosage of the battle.

The process of preliminaries is carried out in the same way - by the importance of the appearance of the tsukru in the sech.
At the present time, all of them are given a license to assess the camp of a sick people and precisely determine what kind of diabetic is possible. Zrozumilo, how would it be a lyudin, who would feel like a likar about those who have ailments for a diabetic diabetic, who fall into a panic, I don’t know how long they have lived. However, panika is the greatest ally of the fight for diabetics. In the first place, take it easy and remember about those who are not very diabetic in our days, I want it, madly, and it means that the life of a sick people is slowed down.

Lіkuvannya tsukrovy diabetu

Likuvannya of ailments needs to be repaired well, as only ailments of lyudin are aware of their ailments. It’s a pity that you’ll have to make peace with him, but on this day I’ll increase the number of diabetic children. The diabetic child will not just become ill, but a spirited way of life. In addition, Lyudin's ailment is guilty of cardinally changing his way of life and calls, attitude of harvesting and daily regimen, guilty of eating all life on a regular basis likarsky control. And in deyaky vipadnyh ailments Lyudin is guilty of all life robiti ін'єкції іnsulіnu.

Zrozumilo, fall into the mind is not so, as it is possible to grow up to grow more and more, so that the life of a person is stronger than that of a person who suffers from a diabetic diabetes. Moreover, modern medicine may not be worth it - it is regularly carried out to monitor the problem of diabetes. And at least as much as possible, very soon we will give in to know those licks, as we can help ourselves to see a diabetic once and for all.

These methods for the treatment of diabetic diabetics, as they propose modern medicine for the current day, are primed on the basis of insulin and sugar-substituting drugs introduced into the body of a sick person.

In this statistic, there will be no drugs for the treatment of diabetic diabetes, since all pharmacological conditions, the scheme of treatment and dosage of the drug are responsible for the treatment of only a doctor - an endocrinologist. Whether it’s a scheme of treatment, it’s going to be strictly individualized, because of the peculiarities of getting sick, showing the analysis of blood and blood, and the test of ailing people. Self-indulgence with a dizzy diabetic is to put a real threat not only to the self-esteem of ailing people, but to find their life.

Lіkuvalna dієta with tsukrovom diabetі

It goes without saying that a childish diabet will impose a pay-off on all the life of a sick people, and in the first place, on their races. Naymenche ruined menu in case of full diabetic - and ruining the camp will not be overwhelmed with nagadat about yourself. The first and the most important deviz of all people who are sick with diabetics - "Life without tsukru!"

In the official medical field, there are certain types of diseases, the skin is intended for people who are ill with the singing group. All children may be digital. That child, as it is recognized by people, we are sick with diabetics, is on the list under number nine. Zrozumilo, the child can be lightly perceived in the small dzherels, or the principle of becoming insensitive - about a new one, three will be said below.

By means of the recognition of the diet є the normalization of the carbohydrate metabolism, as well as the frequent improvement of the young people of the diabetic and the fat metabolism. More than one zavdannya, like standing in front of a dietary day - the price of that amount of carbohydrates, like in the snake the organism of the skin of a particular person who is ailing for diabetic diabetes.

Lyudin's ailment is guilty of being grudging differently: it is necessary to take it in small portions, however, after a short delay of an hour. The whole situation is unacceptable, when someone is sick, sick of diabetics, experiencing hunger - skipping an hour, you can turn into great troubles for a new one. As long as you have a diabetic diabetic, eating is very important for you.

First stravi.

All soups are guilty but low-fat - do not cook them on pork, it’s more reasonable to go overboard yalovichin, chicken or rabbit meat, because it’s better to eat less fat. Likewise, a little brown mushroom broths with vegetables, however, be in the region, respectfully, do not allow grubs to be cut off by unchaste mushrooms. Hurry up to prepare broth with peppers, which are sold in a supermarket.

Other stravi.

In the yakosti of other grasses in case of sugar diabetes, it is possible to pick up cereals from such cereals, yak: barley, pearl barley, Greek, wheat, vevsyana. Likewise ailing people are even more brown wheat hangings, drenched in milk. In case of sugar diabetes, the following products are possible: low-fat sir, low-fat sir, non-fat sir, rose oil and vershok oil, which can be added to the gravy.

Vegetables.

People who suffer from a sugar diabetes are allowed to live in such vegetables, like tomatoes, ogirks, lettuce, harbor, zucchini, cabbage, eggplant. All fruits should be revenged less than 5%, so that the stench does not shatter on the organism of ailing people of any negative infusion.

Fruit for sugar diabetes.

Fruits and people, ailments for diabetics, can vzhivati іnzhir, rods, bananas, grapes, fіnіki. Any kind of fruit is not cooked, so as the stench will take revenge on a large number of fructose, as if I can prevent the loss of health I will become healthy people.

Drink.

Allow kawi with milk for drinking liquor, tea - lightly, without candied milk, milk and be-as-you-like fermented milk products, Juices from permissible fruits and vegetables, strictly without adding zukru, vіdvar sipshini and mineral water.

Strictly fence products

There is a wide range of products that are suvoro proto-shown to people who are suffering from diabetes. Zaboroneni products in case of sugar diabetes:

Cowboys virobi, especially smoked.
Be-like canned food.
Fat sort of ribi.
Ribna іkra.

In addition, in order to eat food, it is necessary to increase the amount of fat - like roslinna, as well as food, mayonnaise, margarine, sour cream. Guest and salty products are also not cooked - salted and pickled vegetables, hot chives, peppers, cakes.

Zrazkov menu for people who are sick with diabetes

At the first glance, you can build up, when the suvor’s child is full of diabetics, race to finish the wretched and one-year-old. However, this is not the case. Mayuchi singing fantasies and bazhannyam, the menu can be completed by those who are interested. The butt of the mozhlivy menu for one day is pointed at the bottom, so you can serve as a dzherelnenya for you:

The first priyom of їzhі is low-fat sir, milk.
Another trick of їzhі is Greek porridge with roselinn butter.
The third priyom of їzhі is yalovichinoy, cooked in rose-linseed oil.
Quarterly priyom їzhі - one banana.
P'yyom priyom їzhі - vegetable cutlet і made from riba, tea from sucrozamіnnikіv.
Shosty priyom yizhi - one glass of kefir.

You can, the first hour of sickness, people will see the difficult times of such a child, and just for an hour, they will be able to tighten them up, so that they will become an incomparable part of life. An adzhe tsukroviy diabet is one of the quiet ones who do not get sick, with any kind of child, the life of an ailing people is hidden.

Folk methods for the treatment of diabetics

People who are ill for a diabetic diabetic, cheer for a certain way to polish their self-esteem. It’s the most important thing to go for the help of the correct treatment, taking into account the children and all the recommendations of the doctor. However, there is one more way to avoid getting sick - the recipes of folk medicine. Itself about them and below. However, if you want to know about them, it is necessary to make a mistake - it is not guilty that you are not guilty of using a diabetic innocent people. traditional lіkuvannya... As long as you have a diabetic diet, herbs can be used as excellent additions to the main treatment.

The first even more important point is that you are trying to find vicarious methods for treating a diabetic diabetic; Adzhe golovna meta lіkuvannya - I will seek polіshennya, and not allow it to perish. Otzhe, folk medicine - the treatment of sugar diabetes:

Blackberry pea berries.

The berries of the black-leafed pea in the edge are brown for people who are hungry for a child's diabetes, so as in them there is a great amount of sorbitol, the most agreeable rank infused on the organism of the sick. The best way to get the berries is the next step: rinse the berries, put them in a casserole, lightly shake them with a fork. Pour the sprinkle over the paint, and fill it with one part of the yagid chotiri part of the water. It is necessary to cover the casserole with a crush and fill the berries for 5 years. Obsessions of nastіy ailments lyudin is guilty of vipivati throughout the day, and berries are necessary for the heart.

Nastіy zvіtіyu zvychanyy.

To prepare the infusion, you need one spoonful of dry herb with an animal zvichy and one liter of sprinkle. Put the grass in a thermos and fill it with sprinkles. Close the thermos and fill it up. When finished, add the process and add it to the memory. It is necessary to store the item in the refrigerator. Lyudin's ailment is guilty of vipivati skin for three years, one hundred grams of infusion. The course of lіkuvannya is guilty of trivati tizhden. Repeat the course of treatment is necessary.

Anastasia from a sprinkling of a house and a leaf of chernitsa.

To prepare a batch, you need to add two tablespoons of sprinkling and one tablespoon of sprinkling leaves. Syrovina can be vikoristovuvati yak dry, so and fresh. However, in this case, if you vikoristovuet from the sprinkling and leaves of the cinnamon, it is necessary two times less - to write and half a tablespoon, apparently. Place them in an enamel casserole, for which pour one liter of sprinkle. Cover the casserole with krishka, insist for two years. For the sake of this process for additional gauze fabrics or sieves. Lyudin's ailment is guilty of taking five tablespoons each before the skin treatment. The course of lіkuvannya is guilty of a trivial month, if it is necessary to make a monthly break.

Vidvar wasp measles.

The osiki is even more efficiently known inappropriate symptoms, Yaki viklikak is a child of diabetes. However, it is necessary to go right ahead - to go to the edge of the game. If you still see it, try it out, you need to refine the bark as much as possible, put it in a casserole, fill it with water and bring it to a boil. Let the vidvara brew 30 khvili, for which it is really possible to proceed. Lyudin's ailment is guilty of vipivati during the day, yak minimum 500 grams. The course of lіkuvannya is guilty of trivati 21 days. It is necessary to carry it out not earlier than once every three months.

Vidvar zholudiv.

To prepare such a product, you need to go ahead and prepare dry acorns. Put zvychayny acorns for one year in the oven, rosіgrіt up to 250 degrees. To cool down the acorns, clean them from the skins and pass them through a meat grinder. Pour 1, 5 liters of water and bring to a boil, for which to change the fire and boil close to the year. Let the second brew for a minimum of 12 years, for which 30 minutes to drink again. Let it cool down, proceed with it, and give one bottle of the bottle. Pour it into a pan, put it in the refrigerator for thirty dib.

To get sick people on the cob, it is necessary to undergo an intensive course of treatment. For the whole you need to take 14 dB three times a day, take one tablespoon each day. Accept yogo bazhano in front of the hedgehog, and not write. After completing the course of intensive therapy, Lyudin's ailment is generally guilty of taking the same tables twice a day. Podibny zhid not allow zukru in the blood of growing critical signs.

The finger is upright.

An upright finger can be used for trimati rivn tsukru before control. To prepare the infusion, you need to add 25 grams of herb, pour half a liter of the burner, put it in the refrigerator. Nastia will be ready before implantation not earlier, not in three days. For a complete process, save it only in the refrigerator. The sickness for a diabetic diabet is guilty of accepting a lie, natchesertsa, five drops of a tincture of tincture. A break in lіkuvannі can not be robotic.

Vіdvar root cycorіyu.

The root of cycorium in case of diabetic diabetics is the most ineffective rank of the knowledge of the post-spragia and normalization of the disease. To prepare an item, you need to add two tablespoons of cicory root, boil half a liter of water, and drink in her cicory and boil about 10 quills on a common water. Cool down, go for extra gauze fabric. Lyudin's ailment is guilty of taking 200 grams a day, vrantzi on the heart that in the evening, before going to bed. The course of lіkuvannya is guilty of trivacy stretching out three months. However, beastful to respect - Daniy zasib cannot be accepted by people who suffer wiry ailment slunk і twelve-fingered intestine.

Nastya burdock leaf.

Anastasia of a burdock leaf has given a complex positive infusion on the entire body of a person who is sick with diabetes. To prepare the infusion, pick up one tablespoon of burdock, put it in a thermos and pour a liter of sprinkle. Infuse approximately three years to start. Nastiy is ready to be implanted. Accept this ailment, Lyudin is guilty of half a bottle of three for doba, about 15 khvili before the day. The course of alcoholism is to blame for 14 days, for which it is necessary to make a break.

Welcome to the Lyon.

It is even more effective to heal wounds in people who are ill for diabetic diabetes, so as to improve tissue health before regeneration. To prepare a drink for a lion, you need to powder two tablespoons of the apple, pour half a liter of water and a bottle of water on a small bottle of about 15 quill. If you want to see it, shout it with a cry and insist on it for a year.

Lyudin's ailment is guilty of vipity tsei obsyag vіdvaru with a stretch of dob, in small portions. The course of lіkuvannya is guilty of trivacy until quiet feast, since the wound does not become overwhelmed. Throughout the whole hour of treating Lyudin's ailment, he was guilty of taking one tablet of ascorbic acid. It seems like people who are sick, as they tried a recipe, will be able to burn wounds approximately 3 times faster, not very much.

Vіdvar grains vіvsa.

The revival of grains increases the living tone and patronage of the sick person for the sickly diabetic of the people. To prepare it, put 6 tablespoons of the weight into the casserole, pour it with one liter of water and boil it for two years. If you want to go for additional gauze cloth, give one bottle of milk and again boil it with five quilins. Lyudin's sickness is guilty of vipivati viyshov lіtr vіdvara stretching out one dobi, right away from priyomіv yizhі. Lіkuvannya is guilty of 30 days, for which it is recommended to spend 30 days interruption.

Nastya linden blossom.

Zrozumіlo, the fact that the lipovy color є a miraculous way from the cold, but for whom it is not a secret. And the axis of those who have a lipovy color dopomagaє sberіgati normal rіvn tsukru in the blood when falling into diabetic diabetic, few people see it. Gotuєtsya vіdvar by the most extravagant rank: pour two tablespoons of spoons with two bottles of sprinkling, insist pіvgodini. Drink nastіy vrantsі, replace tea, natchesertsi. To drink it, you need about two times - until quiet times, as long as it does not normalize the blood in the blood.

Smoked egg and lemon.

In order to quickly reduce the level of zukru in blood, take one chicken egg, Take a tablespoon of lemon and stir it thoroughly. Lyudin's ailment is guilty of vipiti sumish;

Regional oil.

At the same time, if the symptoms of diabetic diabetes in women appear at the sight of dryness, mucous pits, tampons with oil of the region will significantly reduce the situation. It is clear to squeeze the oil from the regions of the extraordinary hygienic tampon and insert it into the woods, leaving it out for the rest of the night. The course of treatment must be continued for a minimum of 10 days. Before speech, folk recipes lіkuvannya tsukrovogo diabetic vimagayut regular їх victoriannya - in general, you don’t know any positive dynamics.

People's ways of treating sugar-coated diabetes are even worse. And melodiously, if you bazhanna, you can come up with the very recipe that suits you. It is more correct to eat, to have a healthy way of life, to have permanent medical control and to help nature itself singing out your life more comfortably.

Entry

Chapter 1. Review of the literature on the topic

1.1 Diabetes mellitus type I

1.2 Classification of diabetes

1.3 Ethiology of diabetes

1.4 Pathogenesis of diabetes mellitus

1.5 Stages of development of type 1 diabetes

1.6 Symptoms of diabetes mellitus

1.7 Lіkuvannya tsukrovaya diabeta

1.8 Uninvolved beds for diabetics

1.9 Dealing with diabetics and prevention

Chapter 2. Practical part

2.1 Miscellaneous

2.2 About

2.3Method of lingering

2.4 Results until the end

2.5 Dosvid robots "School for Diabetes" in GBU RME DRKB

visnovok

literature

supplements

Entry

Diabetes mellitus (CD) is one of the provincial medical and social problems of modern medicine. The wide breadth, early invalidization of patients, and the mortality rate became a preference for the experts of the OOZ in the development of children with diabetes as the epidemic of a special non-infectious preservation of health in the fight against

In the rest of the rock in these high-ruined lands, there is a turn of the growth of ill-health on a child of diabetes. Financial vitrati on the liking of ailments on children of diabetics, and so quickly reach astronomical figures.

Sugar type I diabetics (insulin-free) є one of the most widespread endocrine discomforts in childish... Among ailing children, they store 4-5%.

Mayzhe kozhna krajina has a national program to fight diabetes. In 1996, according to the Decree of the President of the Russian Federation "About the state pedagogues of people who are ill on the child's diabetes", the federal program "Cured diabetics" In 2002, the Federal Zilov program "Cukrovy Diabetes" was adopted again.

relevance: The problem of diabetic diabetes is zoomed in by the significant widening of the disease, as well as the basis for the development of folding fellow sickness and acceleration, early disability and mortality.

meta: Vivchity specialties I’ll look at my sister for patients with a baby with diabetes.

zavdannya:

1. Vivchiti Dzherela Information about etiology, pathogenesis, key forms, Methods of treatment, preventive rehabilitation, accelerated and incapacitated camps for diabetics.

2. Find out the main problems of children with diabetes.

3. Show the need for children with diabetes in school for diabetes.

4. Development of professional messages about the basic reception of therapy, self-control, psychological adaptation and physical adaptation.

5. To test the danі of besіdi srednykh patsієntіv.

6. Creation of memorials for advancing knowledge about the look behind the curvy curvatures, the corpses of the physical navantazhennya.

7. Get to know with the help of a robot school for a child with diabetes GBU RME DRKB.

Chapter 1. Review of the literature on the topic

1.1 Diabetes mellitus type I

Diabetes mellitus type I (ІЗЦД) - tse autoimmune disease, It is characterized by an absolute abnormal deficiency ?-klitin pidshlunkovoy zalozi. The development of this process may have a genetic strength, as well as a factor of the most recent middle ground.

Provide factors for the development of ІЗСД in children, є:

viral infections (enterovirus, rubella virus, parotitis, virus Koksaki B, virus influenza);
internal uterine infections (cytomegalovirus);
visibility or change in terms of natural vigor;
see the stress;
the presence of toxic agents in їzhі.

In case of type I diabetes (insulin-fallow), one method is used to regularly introduce insulin in the same way, in addition to the old one, by the feeding mode.

Diabetes of the I type is diagnosed in children up to 25-30 years, or it can manifest itself in any child: in children, in forty, or in 70 years.

The diagnosis of "diabetic diabetes" should be based on two main indicators: let’s replace the sugar in blood and in the battle.

Normally, glucose will be absorbed during filtration in nirkas, but tsukor will not appear in the section, as a nirk filter will absorb all glucose. And when the sugar in the blood is more than 8.8-9.9 mmol / l, the nirkovy filter starts to let the sugar in the slaughter. The appearance in the section is possible due to the addition of a special test-woman. Minimal rivn instead of zukru in the blood, with any attempt to appear in the battle, is called a nirk threshold.

The increase in the amount of glucose in the blood (hyperglycemia) is up to 9-10 mmol / L before the blood glucose is seen (glucose). Seeing from the cross section, glucose will flood with itself a great amount of water and mineral salts. As a result of instability in the body, insulin, and ill health, glucose was consumed all over the middle of the cell, being overwhelmed in the camp of energetic hunger, as the energy was replenishing to fix the fat of the body. The products of fat breakdown - ketone thyl, and acetone, accumulated in the blood and in the section, produce ketoacidosis until development.

Sugar diabetes is a chronic disease, and we feel sick to ourselves of all our lives. To that, when navchanni it is necessary to be aware of such words, such as "ailment", "ailment". Replacing the need for accentuates, but a child's diabetes is not a disease, but a way of living.

The peculiarity of the treatment of illnesses on the child's diabetes is that the main role in the achieved results of the treatment is introduced to the patient himself. I am guilty of this because of the good knowledge about all aspects of vlast malady, so that the scheme of treatment in fallowness in a specific situation is correct. We are sick enough in what to bring the brothers on themselves to the status of their health, but it is possible to deprive them of that, as the stench of the new rank of navchenia.

On the shoulders of the fathers, the greatness of the health of a sick child is great, because of the correctness of the child’s nutrition, it’s not just health and self-respect for the whole of life.

In the given hour, the diabetic has not yet become ill, as it would have helped the children to live a normal life, practice and play sports. With the right childishness and the correct regime, with the dreadful possibilities of living, life is not enough for the sick healthy people... Navchannya patients on the current stage of development of diabetology є the necessary warehouse and lock-up of successful treatment of sick people for diabetics with drug therapy.

The current concept of the introduction of ailments to the diabetic treaty to the dan of illnesses is the singular way of life. Welcome to the staff, we will put it at this hour, effective system diabetological assistance in the transmission of such goals, such as:

povna abo mayzhe povna normalization of communication processes for the usunenia of hospitality and chronic acceleration of diabetics;
the promotion of the quality of the life of the sick.

Virіshennya tsikh zavdan vimagah of the great Zusils from the ancestors of the primordial Lanka protect health. Uvaga until navchannya yak dієvu zasobu polіpshennya yakostі nurseskoy help we grow up sick in all regions of Russia.

1.2 Classification of diabetes

I. Клінічні forms:

1. Pervinny: genetic, essential (with obesity<#"justify">II. Beyond the degree of gravity:

1.easy;

2. average;

3. important perebіg ..

Type 1 - insulin-algal
1. compensation;

2. subcompensation;

1.3 Ethiology of diabetes

SD-1 є to fall ill due to declining schlichnity, ale of insertions in the development of illnesses is small (the size of the growth is approximately 1/3) - Concordance in identical twins according to SD-1 becomes 36% in total. The imovability of development of SD-1 in a child with a sick mother becomes 1-2%, dad - 3-6%, brother or sister - 6%. One or more humoral markers of autoimmune disease ?-clitin, to which antibodies are carried to pancreatic erythematosus, antibodies to glutamate decarboxylase (GAD65) і antibodies to tyrosine phosphatase (IA-2 і IA-2?), appear in 85-90% of patients. Protect the main value in destruction ?-clitin rely on clitinous immunity factors. SD-1 associations with such HLA haplotypes, such as DQA and DQB, with a single HLA-DR / DQ allele, can lead to the development of discomfiture, while the latter are protected. With the increased frequency of CD-1, one should go with the other autoimmune endocrine (autoimmune thyroiditis, Addison's ailment) and non-endocrine disabilities, such as alopecia, vitiligo, rheumatoid arthritis.

1.4 Pathogenesis of diabetes mellitus

SD-1 manifestu with ruined autoimmune process 80-90% ?-clitin. The fluidity and intensity of the process can be quite varied. Often, with a typical interruption of incapacitation in children and young people, the process of preventing this quickly with a fierce manifestation of incapacitation, when the first key symptoms appear before the development of a

In the largest, significantly larger age groups, as a rule, in adults over 40 years of age, the disease can be latently (latent autoimmune diabetes of the older age - LADA), when in the debut there are no such diseases Diabetes mellitus can be reached with the signs of drugs in sulfonylsecovini. Ale, in general, almost 3 times later, there are signs of absolute deficiency in insulin (thinning, ketonuria, hyperglycemia, non-invasive on the intake of tabletted sucrose preparations).

In the basis of the pathogenesis of CD-1, as it was introduced, there is an absolute deficiency in insulin. The inability of adequate glucose in the insulin-alimentary tissue (fat and myazov) to lead to an energetic deficiency as a result of which the lipolysis and proteolysis, which is linked to the loss of fatty tissue, is intensified. Increased hyperosmolarity, which leads to osmotic duresis and hyperosmolarity. In the minds of insulin deficiency and energetic deficiencies, the production of counterinsular hormones (glucagon, cortisol, growth hormone), yak, which does not affect the build-up of glycemia, is disinhibited by the stimulation of gluconeogenesis. Strengthening lipolysis in adipose tissue to produce a significant increase in the concentration of fatty acids. In case of deficiency in insulin, the liver's liposynthetic health will appear to be impacted, and fatty acids will be repaired to be included in ketogenesis. The accumulation of ketone cells can lead to the development of diabetic ketosis, and in general - ketoacidosis. With progressive growth of heat and acidosis, a coma develops, and when there is a lack of insulin therapy and rehydration, death will inevitably end.

1.5 Stages of development of type 1 diabetes

1. Genetic strength to diabetes, associated with the HLA system.

2. Hypothetical starting moment. pooshkojennya ?-clitin by different diabetogenic factors and triggered immune processes. The ailments already have antibodies to acute cells in a small titre, but the secretion is not yet suffering.

3. Active autoimmune insult. The titer is antithil high, the number is changing ?-clitin, the secretion of insulin decreases.

4. Decrease in glucose secretion by glucose insulin. V stressful situations in a sick person, it is possible to reduce the loss of tolerance to glucose (IGT) and damage instead of glucose to plasma (NGPN).

5. Clinical manifestation for diabetics, including the "honeymoon" episode. The secretion of insulin is greatly reduced, so how did it go down more than 90%? - clitin.

6. povna destruction ?-clitin, on top of the secretion insulin.

1.6 Symptoms of diabetes mellitus

high rivn zukru in the blood;
often sechovipuskannya;
zamorochennya;
Feeling nevgamovnim sprague;
vrata masi tila, not pummeled by the snarl of harachuvannya;
weakness, lumpiness;
ruined dawn, often at the viglyadi of the "white shroud" in front of the ochim;
onіміння that pokolyuvannya in pictures;
the feeling of gravity in the feet and the court and litkovy mu'yaziv;
For the most part, wounds and diseases for infectious diseases.

1.7 Lіkuvannya tsukrovaya diabeta

Self-control і vid and self-control

Self-control in case of sugar diabetes is taken to determine the self-control of the self-control. In the rest of the rock, there has been a lack of high-quality supplies of express blood supply or blood tests (test-smart and glucometers). Itself in the process of self-control to come to the correct mind of their illnesses, and to use the tips for managing diabetes.

There are two possibilities - self-determination of blood and blood. Tsukor viznachayut for visual test-smugs without additional help attaching, simply tied down with a soggy cross-section of smudges with a color scale, evidently on the packaging. Chim is intensively prepared, Tim is vishy instead of zukru in the village. I cut it up until it’s 2-3 times a day, two to three times a day.

There are two types of cattle for the purpose of blood tests: this is how they call the visual test-smugs, so they do it themselves, like the smarties for the slaughter (the test of the blood flow is based on the color scale), and if you add a small amount of glucometry to the result, you can see the result -display. Sugar blood is required for:

before bedtime;
in front of him, physical navantazhennyam.

In addition, for 10 days, it is necessary to control the blood supply by pulling out a whole lot of blood (4-7 times a day).

The glucometer pratsyuє is also used for test-smuggling, moreover, the skin attachment shows only "own" smuggle. To that, kuyuchi adjusts, it is necessary, persh for everything, podbati about the further protection of all test smugs.

best types of gratuities with robots with test smiles:

Clearly rub your finger with alcohol: the house can be inserted into the result of the analysis. It is not necessary to supply, beforehand, vimiti hands with warm water and dry water, special antiseptics.
To cope with a puncture is mute on the bichny surface of the distal phalanx of the finger, and on the cushion.
Form a lack of large blood drops. Blood size for visual robots with test men and for robots with glucometers can be flexible.
To smear the shelter on the test field, or to "finish" my friend dribble. At the same time, it is not possible to accurately indicate the last hour of the meeting, as long as the result of the change may be pardonable.
With robots with visual test males and glucometers of the first generation, it is not possible to see an hour of blood vitrimation on a test males. It is necessary to accurately follow the sound signals of the blood glucose meter for the second hand.
It is not enough to cleanly shelter from the test field. The part that has been overshadowed on the test-field is sheltered or cotton wool at the end of the glucometer.
The patient needs to be self-aware, viral blood sampling, visual test-males, glucometer.

If there is a lack of compensation for diabetes, people can get a lot of ketone levels, which can lead to an important acceleration of diabetes - ketoacidosis. Unimportant for the general development of ketoacidosis, it is necessary to reduce the amount of blood in the blood, if the results of blood tests are followed, or else we will appear to be affected. In general situations, it is necessary to have a significant amount of acetone in addition to special pills or a small woman.

self-control

The sense of self-control is not only in the periodical reconversion of the blood sugar, but in the correct estimation of the results, in the planned singing actions, as the aim of the indicators of the blood supply is not reached.

A dermal ailment on diabetics needs knowledge in the area of their ailment. A literate patient can analyze the reasons for the destruction of indicators of the tsukru: can it be that they overwhelmed the serious losses in the harvest, and what is the result of the loss of wagons? Maybe bootie, є chills, Has the temperature changed?

However, it is not only knowledge that is important, but cleverness. Consider taking in any situation in the first place and in order to do the right thing - the result is not just a high level of knowledge about diabetes, but how to manage your ailments well, while you have good results. Turning around to the correct eating, getting overwhelmed by the excess vagi and reaching the level of self-control means a fair control of diabetes. In a number of vipadki in vіrіnny decisions, there will be innocuous destruction to the lіkar and vіdmov from independent attempts to tackle the situation.

Having discussed, I am heading for self-control, we can now formulate the following:

assessment of the intake and physical activity for indicators of blood sugar;
assessment of the diabetes compensation rate;
management of new situations in the overcoming of ailments;
problems, such as demanding food and drink.

self-control program

The program of self-control is always individual and guilty of the child's ability and way of living. However, a number of out-of-the-box recommendations can be made available to all patients.

1. The results of self-control should be written more beautifully (from the designated date and hour), for discussion with the doctor, more reports will be made.

Vlasne self-control regime is guilty of approaching the offensive scheme:

to start in the place of birth in the blood and after 1-2 years or go 2-3 times per day for the witness, that the indicators show the whole life; with a good result, the visibility of the tsukru in the section will be taken into account;
to start in the place of blood 1-4 times a day, as compensation for diabetes is not adequate (in parallel - analysis of the situation, if necessary, consultation with a doctor). The same mode of self-control is required to be used in case of pre-existing indicators of zukru, when insulinotherapy is carried out;
to start in the place of birth in blood 4-8 times a day during the period of the family's illnesses, the hundredths of life in the form of life;
Periodically discuss the technique (more cleverly with demonstration) self-control and its mode, as well as the performance of its result with an indicator of glycated hemoglobin.

self-control

The results of the self-control of ailments should be brought into the schodennik, flashing, in such a rank, the basis for an independent treatment and for a second discussion with a doctor. Visually start the tsukor continuously in the early hour with a stretch to finish, so that in the middle of the rosary, the children themselves can change the dosi to insulin, or to take the important values of the zukru

Bagato ailing on diabet leads schodenniki, kudi bring in everything that is introduced before becoming ill. So, even more importantly, periodically assess your vagu. Tsі vіdomosі vіdomostі vіrto kozhenny once fіksuvati in a schodennik, tіtі matimemo, besides, the dynamism of such an important indicator is rotten.

Further it is necessary to discuss, such is often the case for ailing diabetic problems, such as an increase in arterial grip, an increase in blood cholesterol. Patients need to control their parameters, docily and individually in schoolchildren.

At this point, one of the criteria for compensating for diabetes is a normal level of arterial vise (AT). The adjustment of the arterial grip is especially not safe for such patients, because they develop AG in 2-3 times more than the average. day arterial hypertensionі to produce a reddish diabetes to a tight fit both get sick.

The feldsher (nurse) is responsible for explaining to the patient the need for regular and self-control of the arterial grip, to find the correct methodology to keep the grip on the sick person and turn it over to the doctor.

In drugs and polyclinics, the infection of the so-called hemoglobin hemoglobin (HbA1c); The whole test allows you to clarify what kind of blood supply the last 6 days.

The indicator of glycated hemoglobin (HbA1c) is indicative of those who are very kind to their patients.

To talk about the indicator of glycated hemologlobin (HbA1 c)

Less than 6% - the patient's diabetic is dumb, or wonderfully adapting to life with ailments.

7.5% - the patient is kind (in good faith) addicted to life with diabetes.

7.5 -9% - the patient is not happy (filthy) addicted to life with diabetes.

More than 9% - the patient is even nasty adapting to living with diabetes.

I’ll look at who is sick of diabetes for chronic ailments, like a tricky outpatient care for ailments, which is an effective therapy on a daily basis for transferring self-control. However, it is necessary to remember that self-control itself does not pour into the level of compensation, as well as the failure of ailments not victorious results in the quality of the right point for adequate adaptation of the dosage to the insulin.

Basic principles of therapy

Harchuvannya of patients with type I diabetics includes continuous control over the care of carbohydrates (hlibnі odinitsі).

Harchovy products are three main groups living talk: Bilki, fat and carbohydrates. There are also vitamins, mineral salts and water. samiy head component from those who are pererakhovanih - the price of carbohydrates, splinters of only stench without a mediocre spill over to the receiving end of the day to grow rivn tsukru in the blood. All of the other components of the food are not injected into the rivin of the tsukru of the food.

Isnu also understandable, like calorie. Calorie is a bit of energy, as it is to establish itself in the cell of organism when it is "burned out" in any given speech. It is necessary to learn, so that there is a direct connection between the calories and the growth of sugar in the blood. Rivn zukru in the blood to bring only products to avenge in carbohydrates. This means that we will only have products in the races.

For the sake of being healthy, the pidrachunks of those who use carbohydrates are crushed by such understandings, like a hlibna odinitsya (XO). It is accepted to respect that 10-12 g of carbohydrates consumed in one XE should be brought in; Knowing the XE system, it is possible to see it from a high quality product. XE allows the amount of carbohydrates to be consumed per eye, without prior to taking it. The price of knowledge is lack of practical and psychological problems.

For one reception of a їzhі, for one іn'єktsіyu short іnsulіnu, it is recommended to give not more than 7 XE (in the fallowness of the vіku). Under the words "one welcome yizh" mi maєmo on uvazi sіdanok (first and another at once), about a supper.
Between two houses it is possible to give one XE, but it is not insulin (for thinking, that the sugar in the blood is in the norm and continuously monitored).
One XE vimagє for its mastery is approximately 1.5-4 units of insulin. The need for insulin on XE can be set only for the additional self-control.

The XE system of its own shortcomings: the selection of the diet according to the XE is not physiological, the skills in the process of cultivating the fault are present in all life's important components: carbohydrates, carbohydrates, drinks. It is recommended to add additional calories to the next rank: 60% in carbohydrates, 30% in alcohol and 10% in fat. If you do not need a special dietary intake, there are a lot of bites, fat and calories. Just live yakomog less oil and fatty meat and yakomog more vegetables and fruits.

spindle axis simple rules, Yakim needs to follow:

I need to take it in small portions and often (4-6 times a day) (for another meal, midday, another supper).
Dotrimuvatisya established by the regime of food - namagatisya not to miss the reception of the їzhі.
If you do not pass it - give the style, but it is recommended to be recommended by a doctor or a nurse.
Vikoristovuvati khlib from a rough broom or a hanging.
Vegetables to live at home.
Unikati vzhivannya zhiv, zukru.

In case of insulin-free sugar diabetes (type I diabetes), the adequate intake of carbohydrates in the roof of the blood is equal to an equal amount and in general, which is indicative of insulinemia, so that the dose of insulin was administered.

drug therapy

Lіkuvannya tsukrovogo diabetus is carried out by stretching the life of the patient under the visual endocrinologist.

Patients guilty of the nobility, Scho insulin is a tse hormone, scho vyroblyatsya pіdshlunkovuyu zolozu and reduce the level of tsukru in the blood. Find out and see the preparations in the insulin, which are developed for walking, trivial activities. Patients guilty of the nobility of a short, prolonged, combined action; trade name the most frequently occurring Russian market drugs in insulin with an emphasis on the interchangeability of drugs with the same triviality. Patients begin to visually see the "short" insulin from the "old", appearing before the implantation of the written; rules for obtaining insulin; the most extended systems and introduction of insulin: syringe - pens, insulin pumps.

insulinotherapy

In the given hour, insulin therapy is carried out, when two times it is necessary to introduce insulin trivalo, and insulin for a short period is administered before the cutaneous intake with a precise rosary on the right side of it.

Shown before insulinotherapy:

Absolute: type I diabetics, precomatose and comatose.

Indications: type II diabetes, uncorrected by oral drugs, with the development of ketoacidosis, important injuries, Hirurgichesky engagement, Infectious diseases, Important somatic sickness, visceral, microsudinal acceleration of diabetes, fatty hepatosis, diabetic neuropathy.

The patient is guilty of getting the tips of the correct introduction to the insulin, and in the whole world he is speeding up all the changes of the current insulin preparations and attachments for their introduction.

All children and children who are on guard for type I diabetes are guilty of being safe from insulin (syringe pens).

The system of syringe-pens for the introduction of insulin allowed the injection of the drug to be significantly reduced. Due to the fact that a syringe-pen is given - there is a chain of autonomous systems, there is no need in a set of insulin from a bottle. For example, in the syringe-handle Novopo 3 change cartridge, the title of Penfill, to avenge a number of insulin, which is a visitor for a few days.

Over-thin, use the power to protect the insulin practically painlessly.

Syringe pens can be taken at room temperature for an entire hour during the week.

Features introduced to insulin

Insulin for a short period is guilty of being introduced 30 min before the reception (if necessary - 40 min).
Insulin ultrashort dії (humalog abo novorapіd) is introduced without the middle before taking the drug, if necessary - every hour or just at once.
It is recommended for the Ін'єкції Insulation of a short day to work in the pediatric cell of the abdomen, the insulin in the middle triviality of the child - to the child in the area of stegon or a child.
It is recommended to introduce a small amount of insulin in the boundaries of the same area to increase the development of lipodystrophies.

Rules for the introduction of the drug

Persh nіzh pochati. Perche, about the next step, is the cleanliness of the hands and the message of the inking. Just reach your hands with a sweetheart and take a shower. Patients dodatkovo obroblyayut mіsce ін'єкції with shkin antiseptic wrinkles. When the peeling is done, the mice will dry out.

Insulin, which is victorious in the Danish hour, went on to take over at room temperature.

Vibrating mіsce ін'єкції, it is necessary to remember in the first place about two zavdannya:

1. You need to take care of the need for quickness to instill in the shelter (from the small regions of the insulin to get wet from the growing up).

2. Yak uniknuti zanadto frequent ін'єкцій in one and the same time.

shvidkist vmoktuvannya... Is it possible for insulin to deposit:

from the moment of its introduction: when the drug is introduced into the life, the drug will be repaired after 10-15 quills, in the shoulder - after 15-20 quills, in stegno - after 30 quills. It is recommended to work in a short action in the abdominal area, and in a trivalo action in a stegna or a child;
from physical design: as a patient viv insulin and zdіysnyu physical design, Drink the drug into the shelter on nagato shvidshe;
from the temperature of the room: if the patient is frozen, the insulin will start to get started more, if only after taking a hot bath, then it will be better;
from medical and health-improving procedures, how to add microcirculation of blood in іn'єktsіy: massage, bathhouse, sauna, physiotherapy procedures to accelerate insulin recovery;

Rozpodil місць ін'єкцій.Slide a bit of information about those who are going to be able to get enough visuals in front of them. Cherguvannya mіsts ін'єкцій to allow the uniqueness of the establishment of a prejudice by the school (інфільтраів).

Nybіlsh zruchnymi dіlyankami shkіri є zovnіshnya surface of the shoulder, pіdlopatkova area, the antero-outer surface is quilted, bichna is the surface of the cranial wall. In the midst of the skies of the shkira, it is good to get into the fold and every day of the day is not safe from the mind, nerves and surroundings.

Preparation before ін'єкції

Persh nіzh zrobiti іn'єktsіyu insulinu prodzhennogo dії, it is necessary to kindly change. For a syringe-pen with a cartridge refilling, turn it over-burn-down not less than 10 times. Pislya change insulin is guilty of being equally bilim and kalamutny. The insulin short story (insight of the differences) does not need to be changed before the one.

Miscellaneous and Technique for Insulinu

Insulin is prompted to enter pidshkirno for a vignette of special situations, if it is introduced internally or internally (injecting in a lykarny). Even in the center of education, the adipose ball is even thinner, or the head of the zanadotovga, when introduced, the insulin can get into the muff. The introduction of insulin into the house is not safe, protest insulin at all gets wet in the roof shvidshe, not at the child's house.

1.8 Uninvolved beds for diabetics

In the process of employment, the value of the normal level of zukru in the blood is induced in the blood before it (3.3-5.5 mmol / l), and also after 2 years, when it is written (<7,8 ммоль/л); вводятся понятия «гипогликемия» и «гипергликемия»; объясняется, чем опасны эти состояния (развитие ком, поздних осложнений). Тогда становится понятна цель лечения - поддержание нормальных или близких к таковым значений уровня сахара в крови. Пациентов просят перечислить все симптомы, появляющиеся при высоком уровне сахара в крови; обучающий поправляет и дополняет пациента, подчеркивая, что в основе симптомов лежит именно гипергликемия.

Hyperglycemic stagnation (diabetic ketoacidosis) develops when: inadequate with small doses of insulin, overwhelming implantation of carbohydrates, fat, starvation, and infections.

Symptoms develop in steps, for years and days. Weakness grows, headache, appetite decreases, dryness in mouth, spraga, nudity, blues, poured pain in the abdomen, vessels smack about meazovyh groups. Shkira is dry, bleed. Hypotony of full-time apples. The smell of acetone from the mouth. Takhikardia. Hypotonia. Mova is dry. Lives around the swelling, painful in all cases. Symptoms of teasing of negativity. In blood: leukocytosis, hyperglycemia. Glycozuria, ketonuria.

It’s not easy to get sick, the symptomatology changes. The blues are old bagatorazovyu, I will not fall ill. Pain in the abdomen will be tolerated to gostrich, symptoms of a teasing sequence of positive or sumnivni (pseudoperitonitis). Weakness, drowsiness, drowsiness grows, ailments grow baiduzhim, testimony of wandering. Stupor, coma. Shkira duzhe blida, dry. Ochі zapalaі, rice revealing zagostrenі, turgor shkіri rіzko reductions. Tony is deaf. The pulse is soft, parts. Hypotonia. Mova is dry, coated with brown nallot. Lives blows, some stresses. You can be the manifestation of peritonism.

Hyperglycemia up to 15-35-50 mmol / l. In sechі - glycosuria up to 3-10%, ketonuria.

A person who is sick with diabetes should be informed about the symptoms of ketoacidosis: when spraga is strong enough, dryness appears in the mouth and a positive reaction to acetone, he is guilty of reducing the fatty diet, drinking a lot of water. If symptoms of ketoacidosis appear, then the yakomoga will turn to a doctor for the correction of a later treatment.

Unavoidable additional aid for hyperglycemic stagnation(Diabetic ketoacidosis):

patsієnta uklasta;
calmness;
hold a glucometer;
viclikati lykarya.

Hypoglycemic stan - an excess of insulin in the body, dressing with a lack of adequate carbohydrates in the absence of (s) or endogenous dzherel (production of glucose by the liver), as well as in case of accelerated utilization of carbohydrates.

Bagato patients with diabetes, as they are vicious insulin, periodically see some form of hypoglycemic reactions, if the blood sugar is getting low. Tse can be at any hour. It is often necessary to see the price before taking a loan or for a physical appointment, and you can see it in 10 years after such a proposal.

causes of hypoglycemia:

overdose of insulin;
the introduction of a variable dosage to insulin in case of lack of carbohydrates in the food;
fatty hepatosis in sick people with diabetes;
physical re-entanglement;
taking alcohol;
mental trauma;
deterioration of the function of the stove and nirok

Symptoms.The behavior of ailments is inadequate (aggressiveness, screaming, crying, smirk), a trick of the move, amazement and weakness, heart rate, feeling hungry, food, paresthesia, the smell of acetone, Hvory blidiy, shkira vologa. Tachycardia, labial arterial vice. Tendon reflexes. You can mix it up. In case of hypoglycemic Komi ailments of blidy, cover with profuse potim. Tendon reflexes of movement. Sudomny syndrome. The level of glucose, as a rule, is lower than 3.0 mmol / l. Aglikozuryi.

Unavailable assistance... The patient is guilty of being responsible for taking glucose tablets or small pieces of sugar. With the first diagnostics of early symptoms, there is a high intake of easily absorbed (simple) carbohydrates in a quantity of 1-2 HO: tsukor (4-5 shmatki, more colorless in tea); honey or boiled (1-1.5 style, spoons); 100 ml of liquorice fruit juice or lemonade (pepsi-coli, fanti); 4-5 great glucose tablets; 2 chocolate zukerki. If the hypoglycemia is caused by the insulin of an advanced stage, then 1-2 XE slowly assimilated carbohydrates (shmatok khlib, 2 tablespoons of porridge, etc.).

When I am buried, I will become a viclikati of a lykar. Before the arrival of an uncomfortable patient, the driver will go to the bik, the company will go empty and empty. If there is a lack of quality, the sick person cannot be poured into the empty company of licorice roschini (not safe asphyxia!).

1.9 Dealing with diabetics and prevention

Diabetes mellitus will appear on the first day by frequency. Prior to diabetic microangiopathy, the following should be applied:

diabetic nephropathy;
diabetic retinopathy.

Prior to diabetic macroangiopathies, the following applies:

ischemic ailment of the heart;
cerebrovascular disease;
peripheral angiopathies.

diabetic nephropathy

Diabetic nephropathy (DN) is a specific lesion of nirok in case of diabetic diabetes, which is characterized by the development of sclerosis of nirkovy glomeruli (glomerulosclerosis), which leads to the deterioration of the function of deficiency of nircovascular disease.

In case of type I diabetes mellitus, the breadth of DN in a child is 5-20%. The most early clinical and laboratory signs of DN appear in 5-10 years from the debut of the disease.

It’s not safe to have a quick glance in the fact that it’s developing to complete the whole and deed, diabetic struggle, it’s uncomfortable for a long time, some of it’s not really a problem in a sick person’s discomfort. And only at the turn (not quite thermal) of the pathology stage, the sick person has scarg, tied to the intoxication of the body with nitrogenous slags, protest at the whole stage can not be radically supported by the sick person.

Clinical symptoms of DN:

stike pidvischennya arterial vise;

block in the section;

damage to the visual function of nirok.

That is so important:

inform the patient about the potential for children with accelerated diabetes;

Informati about the links between hypertensives and diseases of nirok;

change in the need for regular adjustment of the arterial grip of the day, the importance of the reduction of hypertension, the reduction of the salt and the bottle in the household, stimulate you to come in by the decrease of the pressure, the reduction of the rate

explain the relationship between weak control of glucose level and development of nirok ailments with diabetes;

navchit the patient to the animals for medical assistance if symptoms of infection appear on the side of the secular system;

navchit the patient to assess the potential nephrotoxicity of the drugs taken;

discuss the need for regular follow-up of the battle.

When there is a proteinuria, it is necessary to see the microalbuminuria:

in ailments of type I diabetes not earlier than once a day after 5 years from the ear of the disease and not earlier than once a day at the time of the diagnosis of diabetic diabetes in children up to 12 years;

diabetic retinopathy

Diabetic retinopathy - microangiopathy of the swelling in case of diabetic diabetics. Symptoms: decrease in quality, fuel consumption, unclearness of the image, floating beaches, straight lines.

Among the patients who are suffering from type I diabetes for more than 10 years, DR appears in 50%, after 15 years - in 75-90% of those who are satisfied. I want to grow up as the head rank among the grown-ups, the stench is not a minute away from children and children.

An important regular, planned control will stand in the eyes of ailing diabetics. Inspection frequency:

the first look around to carry out not less than 1.5-2 years from the moment of the establishment of the diagnosis of diabetic diabetes;

when there is a diabetic retinopathy - not earlier than once by 1-2 times;

if it is evident, the sign of diabetic retinopathy is not less than once a day, but once consumed and more often.

Diabetic foot syndrome. Rules to keep an eye on your feet

Syndrome of diabetic foot is a pathological stump of the foot in case of diabetic diabetics, which is characterized by lesions of children and small tissues, cysts and loams, and manifests itself as trophic worms, necrotic-process-shaped snakes.

There are three main forms of diabetic foot syndrome:

a) the feet are affected by the foot, which is characterized by a trivial anamnesis of diabetes, an apparent sensitivity, some types of peripheral sensitivity, as well as pain syndrome;

b) ischemic gangrenous foot with swelling of pain syndrome, sharp changes in the main blood flow and saving sensitiveness;

c) a change in the form (neuro-hemic), if a decrease in the main blood flow is superimposed on a decrease in all types of peripheral sensitivity.

Diabetes Foot Syndrome (SDS) - one of the most severe early onset of diabetic diabetes, as a condition of the sick, type of diabetes and triviality, develop in the form of diabetes in 30-80% of children. Amputations of the lower characteristics of this group of patients are violated 15 times more often than in the settlement of the population. According to a number of authors, from 50 to 70% of all the original amputations of lower symptoms fall on a part of ailments on a diabetic diabetes. Risks of traumatization of the lower images are advancing, and the processes of suppressing any kind of ear can be adjusted. It is associated with diabetic polyneuropathy, such as the deterioration of the sensitivity of the lower symptoms, deformity of the feet, the formation of zones of excess pressure on the foot and the decrease in the power of the brain, and the deterioration of peripheral blood circulation.

Dilanki traumatization can ignite, develop infection. The firing process in the minds of decreased sensitivity against pain without pain, which can lead to an underestimation of ailments. Self-control does not occur, as compensation for diabetes is not satisfactory, and in important, neglected, the process can progress, leading to the development of the gnarly process - phlegmon. With a great option, the development of the development of the day and during the day of the disease can lead to the formation of dead tissue - gangrene.

Prevention of lower symptoms in case of diabetes mellitus includes some of the main stages:

1. Vyavlennya osіb, as may be advances risik development of the SDS.

2. The navchannya was ill with the correct look behind the legs.

Basically, we are a nurse (paramedic) who is ill with the SDS - the process of mobilization of the ailing to self-conscious look after himself and the step-by-step approach of problems associated with ailments. Special visits to the SDS prevention include:

looking around at the feet;
look behind the footsteps, pidbir swelled.

looking around the feet is guilty of being held today.
the plantar surface must be looked at behind the additional mirror.
Reliably obmatsuvat feet with the mark of the appearance of deformities, bumps, calluses, dylyanok hyperkeratosis, as well as wet dylyanok, as well as the value of sensitivity of the feet and temperature of the shkiri.

Do not soar your feet, hot water and dryness. Thermal physiotherapeutic procedures We have a problem with SDS;

Do not go barefoot;

Can't get stuckalcohol, iodine, manganese and brilliant green, such as tanning the skin and trusting it.

Patient Slid Navchiti Gymnastics for Nig. Non-folding to the right, as it is possible to visit and sit, with a systematic zasosuvanny significantly reduce the blood circulation of the lower symptoms and change the risk of development of fatal acceleration.

spilo with a patient, it is necessary to look around at its swelling and finding possible traumatic factors: litter, high-quality fabrics, high schools, high school, etc .;

Carry it with a swollen shkarpeta with a weak humkoy.

Correctly navchannya sick and literate, respectful look of the average medical staff allow to reduce the number of amputations with SDS by 2 times.

3. The third important point in the prevention of SDS is to regularly monitor the camp of ailing and lower children. Inspection of nig is guilty of being carried out for skin care once an hour to visit a sick person for a diabetic diabetes to a doctor, but not earlier than 1 time per 6 months.

The basis for the treatment of all options for diabetic foot syndrome, such as for all the acceleration of diabetic diabetics, for achieving compensation in carbohydrate metabolism. In the overwhelming majority of cases, it is necessary to correct the insulinotherapy.

All patients with diabetic diabetics with diabetic peripheral polyneuropathy, impaired peripheral blood flow, decreased sensitivity in the area of lower symptoms, decreased vision, the presence of acute defects in the history of the disease I need to regularly, not less than 2-3 times per ric, view the “Diabetic foot” cabinet, the frequency of the change to the first choice. Before any changes or changes in the feet of ailments, a child's diabetes should be put even more seriously.

It is necessary to take special care, signs of physicality, we have the right to be ill with already obvious accelerated diseases, such as proliferative retinopathy, nephropathy and incapacitation of the heart-vascular system.

Fix it more beautifully from small physical navantages and actions to improve your skills. Be guilty of being aerobny (with little support, for example, walking, riding a bike), and not isometric (important athletics).

There is no need for intensive sports activities, for example, it is important to regularly reconcile physical activity.

It is more beautiful to proponuvate an ailing individual to take an individual graph, busy with friends, relatives, or in a group for the preparation of motivation. A sick person needs to be blown up, for example, sneakers for a big guy.

In case of any unacceptable symptoms (pain in the heart, legs, etc.), the physical nasalization is fixed. Explain to the patients that if the blood sugar level is more than 14 mmol / l, physical replacement is indicated, so that it is necessary to motivate the patient to carry out self-control before physical replacement.

If you are sick on an insulin-free CD, you need to take into account the fact that they need a supplementary intake of carbohydrates before, every hour, and when they are intensively physically active, and they also have to be busy with the development of healthy sports.

All principles of systematic control of blood glucose. A slide of memory, so that the children of hypoglycemia can develop through a few years of active physical development.

Ailments are always guilty of mothers with sugars (for example, they are easily consumed in carbohydrates, for example, ice cakes, caramel).

If the child is involved in sports, then it is surely possible to keep up the mind, so that the child is in good control.

Chapter 2. Practical part

2.1 Miscellaneous

The pre-session was held on the basis of the Sovereign Budgetary Establishment of the Republic of Mary EL "Child of the Republic of Klinichna Likarnya".

GBU RME "Child of the Republican Clinical Medicine" - specialization of the medical mortgage in the Republic of Mary El, as it is safe to provide outpatient, advisory, and diagnostic assistance to children who are seized Also DRKB is a wonderful base for passing virobnicheskoy practice for students of medical universities and medical college. The lykarnya is equipped with modern medical facilities and equipment, which will provide a high level of comprehensive diagnostics.

The structure of the child republican clinical school

1. advisory policy

allergological cabinet

gynecological office

urology office

ophthalmology office

otorhinolaryngology office

surgical cabinets

pediatric rooms

Office of speech therapist-defectologist and audiologist.

2. Stationary - 10 per person per 397 slots

Anesthesia-reanimation for 9 patients

4 surgical indications (surgical indications for 35 illnesses, indications of gross surgical procedures for 30 illnesses, traumatological and orthopedic indications for 45 illnesses, otolaryngology for 40 illnesses)

6 pediatric profile (pulmonology for 40 patients, cardio-rheumatology for 40 patients, gastroenterology for 40 patients, neurology for 60 patients)

3.Indication of rehabilitation for 30 days

4.Child psychiatrically seen for 35 days

5.recognizable diagnostics

6.operating unit

7.Likuvalno-diagnostic and іnshі pіdrozdіli

Introduction of functional diagnostics

Announcement of the main policy

Clinical diagnostic laboratory

radiological evidence

Introduction of prevention of internal carnial infections from CSO

Pharmacy ready-made lykarsky forms

Transfusion therapy cabinet

Operational information

harchoblock

Organizational and methodical review with the office of medical statistics and the group of automated control systems

Center for the main education of schoolchildren at the center of education No. 18

We spent the pre-session in the cardio-rheumatology department, yak roztashovani on the third version of the head corps of the child republican clinical school. Dana was given a 50-month insurance fee.

At the visitor's office, you can find a way for the next steps:

cardiology

rheumatology

endocrinology

The ad structure includes:

Cabinet manager

resident

Senior nurse's office

nursing post

Sister-master's office

Bath room

soul

Rooms

Room of the cleaning inventory

Sanitary universities for boys and girls

sister

Іgrova room

farther

buffet

Navchalna room

2.2 About

In this given, 10 children took part with a child with diabetes, who were in the cardio-rheumatological examination. In the midst of the children living in the midst of the week between 9 and 17 years. Ale kozhen wants to remove more knowledge about his own illness.

2.3 Method of follow-up

For the given prelude robots, the Vikorists used the following methods:

Theoretical analysis of special literature with a glance behind the children with diabetes
questionnaire
dough
Method of mathematical processing of results
empirical - with caution, additional methods of advancement:
organizatsionny (individual, complex) method;
sub-active method of clinical treatment of a patient (taking anamnesis);
ob'ktivnі methods of providing a patient (physical, instrumental, laboratory);
biographical (analysis of anamnestic medical records, medical documentation);
psychodiagnostic (besida).

In order to understand the significance of a baby diabetic, the table is clear, in which information is given about the number of ailments on a baby diabet 1, 2 type, and children with a future baby diabetics.

Table 2.1 Statistics of incidence of diabetes for 2012-2013 rock

Type of disease 2012 2013 year SD 1 type109120 SD 2 type11 First manifestations SD1620

For example, diagrams 2.1, mi bachimo, but the number of children with type 1 diabetes increased by 11 people, so to become 10%.

Diagram 2.1. Primary children with type 1 diabetes

Diagram 2.2. Above the appearance of diabetics

Such a rank on diagram 2.2 shows, for a long time, that the number of children from the first developing diabetic becomes 4 people, with a 25% increase.

Having looked through the diagrams, one can say that there is a diabetic for progressive illnesses, that on the basis of the State Budgetary Institution of the RME DRKB in the cardio-rheumatology department a number of wards has been introduced for the treatment of children with children.

As a basis for the assessment, the knowledge about the diabetes mellitus is stored in our test (supplement 1).

2.4 Results until the end

Having vivchivshi dzherela, we started the disorder-lectures: prevention of diabetic foot syndrome (look behind the legs, pidbir bloated); physical therapy for red diabetes (supplement 2.3 і 4); booklets. Ale for the ear, we spent a second time at the viglyad's questionnaire. It would be desirable to mean that the children with a child with diabetes, as pass the education in the cardio-rheumatological education, pass the new course in the school for the child with diabetes.

2.5 Dosvid robots "school for diabetics"

For the new children, the sick of the IZSD, and the members of these families for the first time in 2002 in the cardio-rheumatology department of the State Institution of the Republic of Moldova "Child of the Republican Likarnya" and Yoshkar-Oli gave the robot "School for Diabetes".

Medical nurses regularly advise their professional training at seminars with a "baby diabetes", which is carried out by endocrinologist N.V. Makuvoji. A dermal medical nurse is navchenna dіnthotherapy (pіdrakhunka in carbohydrates according to hlіbny units (XE)), methods of self-control, prevention of early and early development.

Seeing off busy, medical nurses assess the patient's need for information and as soon as possible until the beginning of the day, assess progress in the camp of the sick, in addition to helping to see the reverse likuvannya.

One of the main goals of the modernization is to help the patients manage their trips, to learn or to line up the development of young people.

An important role in the treatment of patients from SD and prevention of early illness is brought in by a medical nurse, so that you look forward to seeing the patients.

Medical sisters start a level of glucose in the blood, like according to a visual test-male, so for an additional glucometer lasting 5 seconds, but in extra cases it allows you not to go into the services of a laboratory assistant and promptly need additional help. It also independently vibrates the control of glucose and ketone cells in the section behind an additional test-smoot, conduct a dose of insulin, run after the wrinkle of dobi. Regardless of the indicators of blood glucose, at the time of the day of the doctor (at least one hour and every other day), the medical sisters take a dose of insulin, which should be administered, so that the development of the hypo- and hyperglycemic devices is possible. Harchuvannya of the patients is carried out clearly, by the sign of the XE doctor, under the supervision of a medical nurse.

All of the pererakhovani data about the patients to be entered in the sister's list of dynamical caution, which was broken up in 2002 by the head of the department. viddilenyam L.G. Nuriev and the doctor-endocrinologist N.V. Makuvoji. I will improve the quality of the medical process, develop therapeutically as a doctor, as a medical nurse and as a patient.

For carrying out take the possession of the head room. It was a style and a style to stand like this, so that the listeners sat down to accusations until the very beginning, a small board is visible, on which license, or a medical sister, will write down the topic of busyness, important terms and indications. The class of equipments with head-ups, posters, stands, є a projector and a screen for holding on the slides, є the ability to show video materials. Smolder - it’s necessary to kill everything more and more, so the patient saw himself vіdnuvvіvuvnuvuyuvuyu, sho can fit in with ailments.

The work will be carried out by a doctor and a medical nurse in advance of the planned course of the day. There are groups and individual busyness.

Lykar-endocrinologist N.V. Makєєva rozpovіdaє:

about zhvoryuvannya and the reason for the development of the ІZSD;
about the specialties of food with diabetes and individual development of a child's race with vicarious priest "hlibna odinitsya";
about inconsistent mills - hypothesis of hyperglycemia (causes, symptoms, treatment, prophylaxis (dose correction));
about the correction of doses of insulin, which should be administered every hour of inter-competitive ailments;
about physical navantazhennya.

Nurses spend their time on the topics:

take self-control
introduction of syringe pens into insulin
rules for obtaining insulin
technology and frequency of introduction
preventive maintenance
Persha additional help in case of non-loose mills (hypothesis of hyperglikemia) in home minds.

Go to self-study glucose in the blood for an additional glucometer, glucose and ketone levels in the section for an additional visual test.

An individual learning of the re-ride is seen when the first ІZSD is introduced, that is why psychological adaptation is most important here, a large detailed course of learning.

The group is now going to pass children and children, children who are ill at the IWSD, as well as the members of their families. One of the most exciting new developments in the group is the opening of a friendly atmosphere, which helps to absorb material. Patients and fathers may conceive of the possibility of spilkuvatisya one by one, exchanging admittance, fixing ailments in a different perspective, changing a little bit of self-reliance. At this stage, the nurses and the doctor-endocrinologist receive information about the "novelties" in the clinic, repeating and fixing practical self-control tools. During the whole program, there are those children who have gone through 2-4 months individually and psychologically ready to receive information about children with diabetes in general.

Much more important is the importance of the management of the patient. One of the occupations, which is carried out by nurses, is assigned to prophylactics, early detection and quick treatment is accelerated (For example, "Diabetic foot syndrome. Rules to look behind the feet").

We have an updated memory for children and fathers. With the same rules, meaning in the memorials, it is possible to recognize the sinister acceleration, which can be diagnosed with diabetes and living with chronic ailments without taking care of oneself as a chronically ill one.

After completing the course, the nurses conduct a conversation with fathers and children, assessing the knowledge and guidance for the additional solution of the situation of the buildings, test control. There is also a questionnaire for a patient and a member of the family to assess the quality of the newcomer in the "School of Diabetes". Everything should serve to assess the effectiveness of the conduct to take up the steps of mastering the material.

It will be shown that as a result of the function of the "School for Diabetes", the number of accelerations has decreased, as well as the average transfer of the sick person to the ski, which will bring the economical efficiency of this into consideration.

Deviz of the given school: "Diabetes is not a disease, but a way of life"

However, a one-time navchannya ailment is not enough for a trivial compensation. It is necessary to re-navchannya in schools for diabetics, the robot is comfortable with seven ailing children. To expand the “School for Diabetes” in the outpatient service system, until a stable level of good compensation is provided by the IZTSD.

In such a rank, the system of offensiveness is the interconnection of inpatient and outpatient care with self-control of illnesses with the maximum possible self-control of illnesses by self-control of illnesses (SKZ) are the main factors in the development of the effectiveness of medication.

Vivchayuchi dosvid robots and schools conducted a questionnaire for the middle of the students passed through the school. In the course of the analysis, they determined that 25% of the experience was incapacitated 1 ric, more than 25% the experience was incapacitated 2 rocky, 50% of the experience was incapacitated 3 rocky (diagram 3).

Diagram 2.3. Experience of being ill for diabetes.

With such a rank we were considered, as half of the surviving children have experience of being ill of more than 3 rockies, and a quarter of children who are sick 1 and 2 rocky are suspicious.

In the midst of the nursing children, they were given a 100% booth є glucometry for vimіryuvannya іvnya zukru in the blood (Diagram 2.4).

Diagram 2.4. Revealability of the glucometer.

Yak to food often vi otrimuєte statsіonarne spetsіalіzovane lіkuvannya in Dityachіy respublіkanskіy klіnіchnіy lіkarnі in kardіorevmatologіchny vіddіlennі 75% opitanih vіdpovіv scho lіkuvannya in statsіonarі otrimuyut 2 Year in Razi, Reshta 25% vіdpovіli scho otrimuyut lіkuvannya 1 per Year (dіagrama 2.5).

Diagram 2.5. Stationary specialization.

With the rank of mi bachimo on the diagrams, ¼ A part of the patients will be taken out of the stationary specialization 1 time on the river, and the part of the patients will go through the stationary course 2 times on the river. Tse talk about those who are great part of the paciєntіv prydіlyayut proper respect for their zhvoryuvannya.

At the cardio-rheumatological education є school for diabetics and our offensive nutrition sounded like this: who passed through the school for diabetics? All 100% passed the questionnaire for admission, as well as passed the navchannya in the school of diabetics (Diagram 2.6).

Diagram 2.6. Navchannya in schools for diabetics.

We also found out that all children (100%) of mali were aware of their illness at school for children with diabetes (Diagram 2.7).

Diagram 2.7. Help from newcomers to schools for diabetics.

Two children from the graphs, just bachimo, all the children with a child with a child, who passed the test in cardio-rheumatology, went through the school of a child with a child about a child.

We propounded the list of tims to the patients, and the staff members bulo vibrate the best tsikavu theme for them. 25% of patients were treated with the prevention of non-removable machines (hypothesis of hyperglycemic coma); more 25% - XE rozrahunok; 20% bullets for prevention of diabetic foot; sieve 30% evolved with new technologies in the development of diabetics (Diagram 2.8).

Diagram 2.8. Nybіlsh tsіkavі those.

With such a rank, we knew that for the children in Persha Chergu it is important to learn about the new technologies of development and development of the CD. Others were distributed by those, such as the prevention of non-attachment mills and XE rods. At the third month, the patients were given the prophylaxis of diabetic feet, but through those who, due to their stench, did not yet understand the importance of those.

Spend the pre-session in the cardio-rheumatology organization of the nurse's look after the patient, we have a look at a particular patient.

Anamnesis of life: patient A, 2003 to the age of the nation, from the third vaginosity, which passed on the same health facility in the 1st trimester, anemia in the 3rd trimester, the canopy of the first on the term 39th, which was born by the mass of 3944 grams, with the same amount of 59 9 points An early anamnesis without any particularities, pic and development behind the vik. On the dispensary area at the іnshih fakhіvtsіv, except for the endocrinologist.

Anamnesis of ailment: sickness of type 1 diabetics with diabetes from May 2008, the disease is labile, with frequent hypothesis of hyperglycemia, ale without a state of emergency. The debut of overdose in the camp of diabetic ketoacidosis of the 2nd stage. It is normal to be hospitalized in the KRO, before the death of the child, there is no evidence of diabetes, in 2013, the date of birth was indicated on the EMG, but during the control of the breast from 2013 it was without pathologies. In this hour, I will take away insulinotherapy: Lantus 13 Odes before evening, Novorapid before Yizhey 3-3-3 Odes. Hospitalized in a planned manner.

Postponed illness: ORVI - 1 time in rіk, epіdemic parotit - lutiy 2007, anemia.

Allergological history: not tight

Spadkovy history: not tight

Objectively: the zagalny camp when looking at the average severity, proportional statue, rear grub, height 147 cm, weight 36, IMT 29.7 kg / m 2... The deformation of the cyst-m'yazovoy system does not start, shkirni twist, we see the muffled bloom, clean. Pidshkirno-fatty cells from gaps in the muscles of the іn'ktsіy (the mensh is rotated on the shoulders, more is rotated on the abdomen, both sides). Nabryakiv is dumb. Lymphatic universities of a soft consistency, not welded with navkolishny fabrics, painless. In the legends, the dyhannya is vesicular, wheezing is mute, the HR is 18 for chilin, the heart is clear, rhythmic, AT is 110/60, the heart rate is 78 in chilin. On palpation, soft, painless lives. The pechin is along the edge of the costal arch, the spleen is not palpable. Styles, dures in the norm. Pasternatsky's symptom is negative. Pulse on the arteries of the feet of the rear bones. Vibratsіyna sensitivity nіg 7-8 points. Thyroid disease is not improved, euterosis. HBO for cholovich type, Tanner II. Apparently oncopathology is not revealed.

Likarem bulo is designated likuvannya:

mode: gagalny

Stil No. 9 + supplementary food: milk 200.0; meat 50.0;

Kharchuvannya: snidanok - 4 XE

obid - 5 XO

supper - 5 XE

friend's supper - 2 XO

Situation plan: UAC, OAM, biochemical blood analysis: ALT, AST, KEK, thymol test, sechovina, creatinine, excess nitrogen, gallbladder, cholesterol, B-lipid, amylase. Glycemic curve, EKG, Zimnitskiy's test for glucose values in the skin portion, dobova cut for biloks, MAU, ultrasound of the nirok and sehovivi systems, shlunkovo-intestinal tract; glucosylation of hemobglobin, stimulated by EMG.

Consultation of fakhivts: oculist, neuropathologist.

Likuvannya: Lantus 13 OD about 17:30

Novorapid 3-4-3 OD

Electrophoresis with lidase in the abdominal region and stegon No. 7

Massage місць ін'єкцій №7

As a result, the following problems have emerged:

Patient problems:

Reference: lack of knowledge about the therapy, dryness in rotis, spraga, dryness of shkinny crooks, appetite adjustments

Potential: hypothesis of hyperglikemichna Komi

Priority problems: marriage, knowledge about therapy, dryness of shkirny crooks, appetite

1. Problem: marriage knowledge about medicine

Short-line meta: the patient will demonstrate knowledge about the special features of the child №9.

Dovgostrokova meta: the patient will be taken to the day to write the whiskey to the stationary.

1. conduct of patsієntom besіdu about osoblivostі dієti №9 (s Dієta pomіrno znizhenoyu kalorіynіstyu for rakhunok legkozasvoyuvanih vuglevodіv i tvarinnih zhirіv. Bіlki vіdpovіdayut fіzіologіchnіy normі. Viklyuchenі Zukor i solodoschі. Pomіrno obmezhena vmіst natrіyu chloride, cholesterol, ekstraktivnih rechovin. Zbіlsheno zmіst lіpotronnih rechovin , vitamins, grain fibers (sir, low-fat riba, seafood, vegetables, fruits, cereals from whole grain, bread from coarse pomegranate). for sorbitol, as it is in the calorific value of the day. The temperature of the herbs is very high.)

2.conduct a conversation with the patient's relatives about the change of product transmissions by means of attention to the purpose of activity and control of product transmission

3.conduct a restoration of control of the blood supply to the reception

Nursing Activity Protocol:

1. vikonannya sign of a lykar:

Lantus 13 OD about 17:30

Novorapid 3-4-3 OD

Massage місць ін'єкцій №7

3. paciєnt received a child in sufficient quantity

4. control of product transfers

5. virobleno cleaning the ward

6. Problem: dryness of skinny curves

Short-line meta: the patient will demonstrate the knowledge about the look behind the school.

Dovgostrokova meta: the patient will dotrimuvatisya rules to look after the school of writing whiskey from the stationary.

1. to conduct a conversation with the patient about the specialness of looking behind the school, the empty company, the middle for the purpose of preventing the children from getting sick.

2. vikonuvati sign of the doctor-pediatrician

3. secure access to fresh food by way of food 30 quills 3 times a day

Nursing Care Protocol:

1.vikonannya sign of a lykar:

Lantus 13 OD about 17:30

Novorapid 3-4-3 OD

Electrophoresis with lidase in the abdominal region and stegon No. 7

Massage місць ін'єкцій №7

2.patient to see the sign of your birthday

3.transmission control

4.paciєnt accepted rіdin in sufficient amount

5.the patient is looking for his own school according to the rules

6.virobleno tested primitiveness

7.rіven zukru in the blood of registrations in the "Journal of rіvnya glucose and insulinu, where we get sick with diabetes"

visnovok

Correctly organizing a sister's mind seeks to play a particular role and a positive effect in organizing the political process. With the introduction of the peculiarities of a sister's glance, we learned about the information dzherela, learned about the structure of the DRKB, cardio-rheumatological information, with the help of the robot and the school of the child's diabetes. We carried out an analysis of the statistical tribute to the death of a diabetic for the last two years. To find out about their illness, the main needs and problems of children with a child with diabetes, we conducted a questionnaire for the middle of the children who had passed the moment when they passed the school for children. Practically all new technologies for diagnostics and treatment of diabetes mellitus have been introduced, the main principle of health care, prevention is accelerated. To that, we broke up preventive troubles:

Prevention of diabetic foot syndrome. Watching the legs;

Prevention of diabetic foot syndrome. Pidbir blotted out;

Physical design for a full diabetic booklet:

Also a child with diabetes;

Kharchuvannya with insulin-dependent diabetes).

The main problems of a patient with a child with diabetes were selected on a specific clinical application with the setting of goals, a plan and a protocol of nursing activity.

With such a rank, the aim and success of the boules were reached.

literature

1. Didiv I.I., Balabolkin M.I. Diabetes mellitus: pathogenesis, classification, diagnosis, treatment. - M., Medicine, 2003.

2. Didiv I.I., Shestakova M.V., Maksimova M.A. Federal Zilov program "Cukrovy Diabetes" - methodical recommendations. - M., 2003.

3. Chuvakiv G.I. Allowance for the effectiveness of the development of ailments for type I diabetes self-control of illnesses / nutrition for the life of ailments for diabetics. - S-Pb., 2001.-121 p.

4. Pediatrics: Pidruchnik / N.V. Єzhova, E.M. Rusakova, G.I. Kascheev-5th species. - Mn.: Vish. Shk., 2003. - 560 p., L.

supplement number 1

Test. About vivchennya of the knowledge of the patients about their ill-health

1. To prevent hypoglycemia with a short physical appearance, it is necessary to keep the product in place:

a) barvnik_v

b) salt
c) in carbohydrates
d) acids

2. It is necessary to take stock of insulin:

a) with a pillow

b) in the freezer
c) in the intestine
d) in the refrigerator

3. Dose of what kind of insulin as a result of growth, as well as hyperglycemia developed for a child:

a) short - in front of the snidank

b) prolonged (before bedtime)
c) all insulin for 1 OD
d) all options are valid

4. If you missed the insulin with the help of the nastane:

a) hypoglycemia

b) euphoria
c) hyperglycemia
d) diarrhea

5. At any temperature, it is necessary to take a test (vicorization) insulin:

a) +30

b) -15
c) at the room
d) all people are re-secured

5. You can take up sports in case of diabetes mellitus for better blood sugar:
a) pіd hour training
b) before training
c) for training
d) all options are valid

6. It is necessary to regularly monitor for diabetes:

a) legs

b) ochі
c) nirki
d) all options are valid

7. Yaky blood sugar (mmol / l) is to blame for this:

a) 5.0-10.0

b) 7.3 - 9.5
c) 5.3-7.5
d) 1.3- 3.5

8. In any number of products, it is possible to have products that do not give rise to blood sugar;

a) it is not possible

b) z rorahunku
c) less snazzy
d) in a snazzy

9. The amount of XE in the finished product is insured for the amount of carbohydrates per 100 g. You can know the necessary information:

a) on the Internet

b) on packaging
c) in catalosis
d) in the presenter

supplement number 2

Prevention of diabetic foot syndrome. Watching your legs.

Today, mity feet with warm water and sweet;

Do not soar your feet, hot water and dryness. Thermal physiotherapy procedures are suggested through the high risk of thermal opyka;

Do not go barefoot;

Stop and dab the mіzhpaltsevu with a soft towel.

shkіru feet pislya soaked zmastiti non-greasy cream.

nigty on the legs pidstrigati straight, not rounding off. Vikoristannya tweezers and other government tools are not recommended.

-"Rough" skin in the area of corn and corn needs to regularly see for additional pumice or special cosmetic files for dry processing.

If there are any problems, bulbs, scuffs, the term should be turned up to the medical personnel, do not go to self-cleaning;

after trimming the rules of wound dressing and dressing technique. In case of pores, sadness, abrasions in the area of the feet, the wound should be treated with an antiseptic (the most acceptable and available 0.05% chlorhexidine and 25% dioxidine) plaster.

It is not possible to consume alcohol, iodine, manganese and brilliant green, which can be used to tan the skin and hope to be consumed.

Gymnastics is even more important. Non-folding to the right, as it is possible to visit and sit, with a systematic zasosuvanny significantly reduce the blood circulation of the lower symptoms and change the risk of development of fatal acceleration.

supplement 3

Prevention of diabetic foot syndrome. Pidbir blotted out.

-it is necessary to look around and see if there are any possible traumatic factors: litter, visible seams, high schools, high pidbori, etc .;

-vzuttya bazhano pidbirati in the evening, so stop until the evening to get up and go down;

-blotted out the guilt of a good natural shkiri;

Before dermal dressing, swallow up with a hand, which is dumb in the middle of swollen third-party objects;

Carry it with a swollen shkarpeta with a weak humkoy. A literate and respectful look allows for a decrease in the number of amputations in case of diabetic foot syndrome by 2 times.

An important point in the prevention of SDS is the regular medical supervision of the camp of the lower children. Inspection nig is guilty of being carried out for skin care once before an hour visit to the doctor, but not earlier than once every 6 months.

The basis for the treatment of all options for diabetic foot syndrome, such as for all the acceleration of diabetic diabetics, for achieving compensation in carbohydrate metabolism.

Before any changes and strokes of the feet on a child's diabetes should be set even more seriously, do not miss the visit to the lykar, do not miss the introduction of insulin, see the children, see the rules to look at the school nig, vikonaniya!

supplement 4

Physically increasing the sensitivity of the tissue to the body to insulin and, hence, reducing the level of sugar in the blood. For physical options, you can play a robot around the house, a walk around the house, or a big kid. Perevagu goes to regular and dosed physical rights: rapta and intensive nagging of possible problems with the appearance of normal numbers of zukru.

Physics have the right to increase sensitivity to insulin and reduce the level of glucose, which can lead to the development of hypoglycemia.

The risky of the hypothesis is moving forward with a stretch of physical design and in the nearest 12-40 years for trivial and important physical sales.

In case of light and moderate physical changes, it is not more than 1 year that it is necessary to take additional intake of carbohydrates before and when they go in for sports (15 g of easily consumed carbohydrates on the skin for 40 minutes to do sports).

With a decrease in physical pressure for more than 1 year and for intensive sports, it is necessary to reduce the dose of insulin, for every hour and for 6-12 years for physical quality, by 20-50%.

The level of glucose in the blood is required for up to, before, hour and after physical delivery.

In case of decompensated sugar diabetes, especially in ketosis, physical anti-indications are possible.

Repair from small physical navantazhen and step by step. Be guilty of being aerobny (with little support, for example, walking, riding a bike), and not isometric (important athletics).

The vibe of the physical has the right to be guilty of advice, health and interests. There is no need for intensive sports activities, for example, it is important to regularly reconcile physical activity.

It is necessary to start the pulse rate for an hour to take, you are guilty of folding about 180 minus and not guilty of overvolting 75% of the maximum for a whole life.

I am guilty of taking an individual graph, busy with friends, relatives, or in a group to improve motivation. It is necessary to swell up, for example, sneakers for a big guy.

In case of any unacceptable appearances (pain in the heart, legs, etc.), physical tightening up. If the blood sugar level is more than 14 mmol / L, the physical replacement is indicated, so that self-control is required before physical replacement.

As long as the program of the physicists has the right to take sulfonylsecovine drugs to develop the hypoglycemia in the child, it is necessary to change the dose.

Also, the necessary additional intake of carbohydrates before, before, hour and after intensive physical activity, as well as the development of health, is balanced after the start of taking part in sports, therapy.

All principles of systematic control of blood glucose. A slid of memory, which one of the hypoglycemia can develop through a few years of active physical development. Ditina is always guilty of her mother when she has suckers (for example, they are easily consumed in carbohydrates, for example, ice cakes, caramel).

If the child is involved in sports, then it is surely possible to prodovzhuvati tse for the mind, so that the child is in good control.

Tutoring

Need additional help for vivchennya be-lybi those?

Our fahivtsi advise or give tutoring services on topics.
Submit an application from those who are designated directly at the same time, so that they know about the possibility of rejecting consultations.

Nutrition strategy to fight with widely expanding endocrinological disabilities є in the order of the day bagatokh regular medical conferences of the most expensive ryvnya. There are no less pressing problems of diabetes.

One of the leading fields is that it is clear that a person can be identified by a single ailment. Fakhivtsi save, so in a large number of vipadks you can ask for a stable compensation of blood glucose (blood sugar). Why did the essence of the old ailment change, or did it transform before the beginning of the disease?

A special category of ailments for diabetics - tse children

The growth of the number of insulin-dependent diabetics is growing with the skin rock. Up to a group of ailments of type 2, as they do not spend time on insulinotherapy, most often people enter from 45 years of age. Oh, the problem is that we will grow up to the children, but it is important to remember in conjunction with ailments grubs, ways of living. Medical statistics are as follows, for spіvdnoshennya 1 and 2 groups viglyadє yak 10 and 90 vіds.

Prior to the main diagnosis of a viral patient, there is a breakdown in the body: dysfunction of the organs in the intestinal tract, obesity, hypertension. Pathology in the form of ailing swollen in grub components ("fast" in carbohydrates, food fat). Ale in the arsenal of diabetics of a different type є life and knowledge, in which it is necessary to competently speed up.

In such ailments, a late period is late, such as, navpaki, in front of young people. Children with a diagnosis need to be able to accurately diagnose the "hlibny odinitsi", to indicate on the set: 12 g of bread before the product is given and a dose of insulin for a short period. You can choose between different types of hormone therapy, marketing, types, and the use of zelogenic hormones.

Until that moment, for a new price of guilt, the daddy, or people, like їkh zamіnyut. Harchuvannya a sick little one does not come across as an evil one. Yogo organism grows and develops, so the necessary set of living words. Young lyudin collapses when she is full.

There is a great sense of hypoglycemia (rapid fall of the tsukru), which can lead to the Komi. The patient in the coma of the term requires high quality medical assistance (the introduction of glucose control, the development of vital organs in the working mode).

Often the strategy of identifying with a low rank is one of the reasons for diagnosing diabetes. Triva hyperglykemia (the growth of zukor in the blood) is pummeled by the non-stagnant hormone of the fledgling zolozi. For in the body, officials are thinking, as opposed to the activity of insulin. The characteristic of endocrine malaise is chronic overload and deterioration of all types of metabolism (carbohydrate, protein, fat, water-salt, mineral).

There are 10-12 years of age in a special zone of risk of becoming ill, which are on the ear of puberty - a series of revolutions in the hormonal revolution. To provoke insulin-free type 1 diabetes often in seasonal seasonal sleep. Specialized clientele of the underworld, called the "Isles of Langerhans", are considered to be synthesized (viroblates) insulin.

It’s up to date that it’s in general that beta-cellin is the immune system. In case of damaged functions in the blood, the anti-virus is repaired. The stench is straightened against the wet fabrics in the body of people. Everything that is negatively associated with the immune system, can be reduced to diabetic illness.

Medical statistics by Volodya are given about those who are diagnosed with another type of diabetes, 80%, the first - 10%, where there is only one ailment.

"Group Riziku" diagnosis of the first type of diabetes

The main factor in the risk of knowledge is genetic, especially in the case of a decline in insulin-independent type of diabetes. The remaining effective sciences have been informed about those who, when the people follow the results of the genetic special analysis, establish the potential for mental health before diabetes. And that means that the people are worried about the power of their development.

The main ways to minimize the development of diabetes in young people with the "group risk":

Correct the other vaccination plan. Spirniy kolis nutrition will be taken away more and more at the sight of the registered change in the manifestation of the first type of sugar-coated diabetes.
In a child's kindergarten, schools are especially unique for the diagnosis of herpes-viral illnesses (stomatitis, vitriana, rubella). Infections are often asymptomatic, latent, and with atypical symptoms for a few hours.
Regularly carry out prophylaxis of intestinal dysbacteriosis, deterioration of robotic enzymes.
Deal with stress in accessible ways (psychological blocking, dichotomous right, medication on a Russian basis).

Uwaga! Vvazhaєtsya, scho deyaki viruses (vispi, adenomi, Koksaki) may have a path to fabrics. The stench of destructive (ruin) islet tissue With viral diabetes, circulating antibodies appear in the blood. If the therapy is correct, it will stink in 1-3 rocks. Even in the middle of the 19th century, there was a relationship between diabetes of the first type and epidemic parotitis. Symptoms were on the 3rd - 4th stage of the disease suffered by the child.

It is important for people who are mentally smart to be diagnosed with a diabetic to follow their lives in any future. Formally, the normal value is taken as a result of growth, change in cm, and efficiency 100. The figure is analyzed with the actual weight, in kg. For a baby child of the period (up to 1 rock), it is normal to get paid for special tables.

An alternative to insulinotherapy ?!

Syntheses, otrimaniyah with a piece way, analogous to the human, the hormone of the pidshlunkovaya zalozi є the insane leader among the zukroznzhuvalnyh zasobіv. Ін'єкції іnsulіynu shvidko and effectively reduce the level of blood glucose. There are a number of reasons for a number of reasons, which are unacceptable for a particular patient (individual intolerance to the drug, uncomfortable control of glucose).

In addition to the problems of diabetic diabetics in children, in lіkuvannya sickness stuck to food, which can be substituted for insulinotherapy, so as to vikoristovuvati almost parallel with it. Great efficiency, for example, is famous for its high quality. Ale yak and be it the only method, win maє deyaki, practically unconnected nutrition.

Patients, who were respected on this victorian, the goiters were knitted by the nobility about:

The procedure is guilty of being admitted by an admitted Fakhivite strictly according to the hourly graph.
A spraying session of golkotherapy is painless. Bil not be referred to as so-called "we will give a message".
Psychologically, it is important to blame the appearance of the heads and the whole procedure.

Vikoristannya zyomіv phіtotherapy is more recommended for lіtnіm patients. Diya of Likarskih roslin є m'yakim and stretched out for his dynya. Whatever kind of patient is guilty, be careful and respectful with the knowledge of new techniques, so that 100% of the liking of ailments is achieved.

The traditional format of the diet for diabetics: drugs that reduce the level of glucose in the blood;

On the current day, medicine is not in its own right way, but it allows to increase the deterioration of the function of the diet - viroblyatization of insulin. We have also tested some of the virgin methods and helped to correct the grown ryvnya of sugar in the blood. Smells add to the admiration of a person's self-esteem and self-respect.

To them are admitted:

homeopathic zasobi;
mineral speech and vitamins (group B, ascorbic acid, A, PP);
electrical assets of water rozchini (attachment "eksperi");
point massage and acupuncture (golkovkolyuvannya);
physical and mental right (Florov's simulator);
aromatherapy and reflexotherapy with vicarious honey, p'avok, metal virobes and іn.

Increase tolerance to glucose chemical elements (chromium, vanadium, magnesium). Recommended roslinny complexes, where to place in your warehouse parts of herbs hypooglycemic diy (GALEGA, cycorii, kvassol). Deyakі physical and dykhalny right for diabetics are taken from the old health systems of yogіv (complex "Privitannya sontsyu"), gymnastics Strelnikova.

Before you start getting a specific method, you need to consult a doctor-endocrinologist. Only diplomas and advices of the fakhivtsy can remember the established scheme of treatment on the basis of non-traditional methods of therapy with obvious signs of polishing.

The greatest effect is to appear on the cob of getting sick, in case of an easy form of this repression, which is victorious for prevention by people from the "group of rhizik". Reaching the result is unwise to put on the "pause" function. Winning at a steady dimmed rational activity, normal vagi, muscular activity.

So, the non-traditional methods of treating diabetes, in spite of the official ones, additionally help to improve the indicators of sickness by 25-30%. I am altogether substituting insulin and other medicinal antihyperglycemic drugs, no stench є.

Children and young people demand special respect: when they are ill with less than one rock, they often bring health to the team. By those who are ill and we ourselves are ill, we can graciously take away yak absolutely tame. Slowing down the intake of sugar-free drugs or self-lowering doses should be done until the development is accelerated. Vіdbuvaєatsya vzhachke farther out of the way to get rid of ailments.

Achievement of pharmacology, medical technology and the development of ailments in cases of glucose correction with diabetics allow them to lead a life of a practically wicked people

Excellent insulinotherapy

Most often, diabetic illnesses in people of a different type are put in front of the doctor and patient about the transition to insulinotherapy. It’s worth it, if you don’t cope with their functions, if you don’t use the tablets in your eyes. At the same time, the level of glucose becomes progressively high (more than 7-8 mmol / L but more than 10-12 mmol / L after 2 years or after receiving the increase).

The relevance of the problem of diabetes in the whole period is linked to psychological barriers. Able to chew for whatever methods are used, they often trawl on viverti of pseudocylites, abi not vikonuvati іn'єktsії synthetic hormone fodder. A large-scale educational robot about the possibilities of insulinu, yogo perevagi is required.

The category of "optimistic hearing" includes information on the development of oral insulin. The folding of the stem, similar to the drug, is due to the fact that the hormone is of a biological nature. Yogo structure collapses when passing through the shlunkovo-intestinal tract. You need a capsule for insulin, which allows you to take care of yourself until the necessary moment.

Know the storage of a portable device under the name insulin pump. Vona immediately replace the syringe and the glucometer (device for vimіryuvannya blood supply). The sensor is attached to the height of the person on the belt. In the abdominal area, the most common flakes are the most thin and the most painful. Rookie a puncture, an adjunct to take indicators of blood at a time. The electronic "stuffing" allows you to process information, and to display is adequate to the information.

The lack of hand ties to the neat wearers of the pump, the quick replacement of vitreous materials for her (batteries, insulin sleeves, heads). At the beginning of the day or before the hour of taking water procedures, it’s okay to know. Yogo is the main point of the transformation of the field in the fact that it is given to unique stripes in the glakemic background.

It means that the sick person has more opportunities to uncover the unfailing children of the diabetic accelerated:

waste the dawn;
gangrene nig;
zhvoryuvan heart, nirok.

The creation of the Insulin Pomp is a revolutionary streak in diabetology. The attachment permits the elimination of hypoglycemia. The classic signs of a deadly camp (fatigue, tremors of the hands, weakness, spoiled) can be wrong if we are sick, and if we have passed them through different reasons.

Dozens of rockets in vcheny doctors have been trying to solve the problems of children with diabetes

An important role is played by the insulin pomp of the pole in the ability to preserve life for active people, who lead the way, vagit women, who want to prevent the people from being healthy.

A cob of victorious technologies has been laid in a liqueur driven by robotic endocrine fields. Systematic vip testing is conducted along the stem:

physiological options for replacing fabrics with “non-working” beta-cells;
piece slurry;
non-invasive blood glucose meter, blood analysis without puncture of the capillary.

The relevance of a diabetic diabetic in the midst of an affliction of complications is not surrounded by the extremes of fakhivts. A great success in the struggle with ailments to trace the behavior of the patient himself, he sees from the shkidlivyh calls, especially kurinnya. Judge kurtsya piddajutsya "tricky blow" from the side of shkidlivy chants, cigarettes, zukru and cholesterol. And that means, at an accelerated pace, the development is developing.

It’s hard to correctly tackle the broken down special activities for diabetics without getting into the basics. Patient about otochenya goiters'kazanі nobility about:

"Shvidkikh" and "povilnyh" in carbohydrates;
hlibnykh odinitsyah (XE);
glycemic index of products (GI).

It should be prepared in a special way, uniquely strong oiled, boiled and prepared (fruit juices, mashed potatoes, manna porridge). Diabetic literacy is allowed to be victorious in the rationalization of products. Hurrying like extravagant people, diabetics wanting less to drive shkoduvati for the loss of health, trim and emotional stance on a positive level.

Uwaga! It has been experimentally shown that the state of mind for the stabilization of normal blood glucose has been shown. Diabetic spirits, in their turn, will help to quickly establish contact with a sick person and a consultant, who will explain the available my algorithm for solving the problem.

Last update: April 18, 2018

With a whole lot of animals, I respect the lack of aging of the indicators of sickness in both groups and the growth of growth (by 100%) for the last risk of children. There are many indications of young streptococcus among children who have been seen in 2007 when they are receiving special medical examinations of the child population, we can talk about the fact that there is a real shortage of diseases in the population of Russia, as the pathogenic diseases of the population of Russia On the other hand, nutritional status - for the rakhunok of those who become ill themselves, there is also a growing child endocrine pathology, and what is the role of a child with diabetes? It is well known from the assessment of experts of the All-Russian Organization for the Protection of Health, when in Denmark there are 160 million sick people per child with diabetes, about to become 2-3% of the total population of the planet, that is, up to 20 million. The problem is not less serious in Russia, as it also means the development of pathology, with more than 70% of the ailments being in the state of chronic decompensation of diabetic diabetes, not only of this type. Epidemiological advances in the Russian regions, including in Russia, are about the development of ill children with diabetes (CD) type 1 in the last two decades.

Meta doslіdzhennya:

Vivchit the role of a nurse in the prevention of diabetes.

Subject of advancement: nursing process in the prevention of diabetes.

According to the date of delivery, the date of the appointment is as follows:

1. The increase in the breadth of the diabetic diabetic and the decrease in the middle age groups of the population and the epidemiological peculiarities of the incapacitation, the incapacity and mortality in contemporary social economies.
2. Take care of the nursing process in the prevention of diabetes mellitus.