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Prevence je d\u016fle\u017eit\u00e1, proto\u017ee diabetes mellitus m\u016f\u017ee prob\u00edh\u00e1 skryt\u011b po mnoho let. Pokud nen\u00ed toto onemocn\u011bn\u00ed diagnostikov\u00e1no a l\u00e9\u010deno v\u010das nebo pacient nedodr\u017euje l\u00e9\u010dbu, m\u016f\u017ee doj\u00edt ke\u00a0vzniku z\u00e1va\u017en\u00fdch pozdn\u00edch komplikac\u00ed onemocn\u011bn\u00ed<\/b>\u00a0(rozvoj ateroskler\u00f3zy, vznik srde\u010dn\u00edho infarktu, mozkov\u00e9 mrtvice a ischemick\u00e9 choroby doln\u00edch kon\u010detin, po\u0161kozen\u00ed nerv\u016f \u2013 diabetick\u00e1 neuropatie, poruch\u00e1m funkce ledvin \u2013 diabetick\u00e1 nefropatie, po\u0161kozen\u00ed zraku \u2013 diabetick\u00e1 retinopatie, kter\u00e1 m\u016f\u017ee v\u00e9st a\u017e ke ztr\u00e1t\u011b zraku).<\/p>\n
Co je diabetes mellitus?<\/b><\/p>\n
Diabetes mellitus neboli cukrovka\u00a0<\/b>vznik\u00e1 nedostate\u010dnou tvorbou inzulinu ve slinivce nebo nedostate\u010dnou odpov\u011bd\u00ed bun\u011bk na jeho p\u0159\u00edtomnost v\u00a0krvi<\/b>\u00a0(tzv. inzulinov\u00e1 rezistence). Inzulin je\u00a0hormon tvo\u0159en\u00fd \u00df-bu\u0148kami ve slinivce b\u0159i\u0161n\u00ed, kter\u00fd umo\u017e\u0148uje vstup gluk\u00f3zy \u2013 krevn\u00edho cukru \u2013 z\u00a0krve do bun\u011bk. P\u0159i nedostate\u010dn\u00e9m p\u016fsoben\u00ed inzulinu doch\u00e1z\u00ed ke sn\u00ed\u017een\u00e9mu p\u0159esunu cukru do bun\u011bk, kter\u00e9 tak nemaj\u00ed dostatek energie. Z\u00e1rove\u0148 doch\u00e1z\u00ed ke zv\u00fd\u0161en\u00ed hladiny cukru v\u00a0krvi, tzv. hyperglyk\u00e9mii. P\u0159i\u00a0velmi vysok\u00e9 hladin\u011b cukru v\u00a0krvi se objevuje tak\u00e9 gluk\u00f3za v\u00a0mo\u010di.<\/b>\u00a0Diabetes m\u016f\u017ee b\u00fdt vrozen\u00fd (1.\u00a0typu) a z\u00edskan\u00fd (2.\u00a0typu).<\/p>\n
Onemocn\u011bn\u00ed mohou prov\u00e1zet specifick\u00e9 p\u0159\u00edznaky, mezi kter\u00e9 pat\u0159\u00ed nadm\u011brn\u00e1 \u017e\u00edze\u0148 (polydipsie), nadm\u011brn\u00fd hlad, \u010dast\u00e9 mo\u010den\u00ed (polyurie), opakovan\u00e9 infekce poko\u017eky, mal\u00e1tnost a\u00a0\u00fanava, \u00fabytek hmotnosti bez jasn\u00e9 p\u0159\u00ed\u010diny (1. typ) nebo naopak nadv\u00e1ha (2. typ) atd.<\/b><\/p>\n
Jak\u00fd je rozd\u00edl mezi cukrovkou 1. typu a 2. typu?<\/b><\/p>\n
Diabetes 1. typu\u00a0<\/b>vznik\u00e1 po\u0161kozen\u00edm bun\u011bk produkuj\u00edc\u00edch inzulin vlastn\u00edm imunitn\u00edm syst\u00e9mem. Sklon k\u00a0tomuto typu diabetu je v\u011bt\u0161inou d\u011bdi\u010dn\u00fd<\/b>.<\/p>\n
Diabetes 2. typu vznik\u00e1 b\u011bhem \u017eivota a jedn\u00e1 se o poruchu \u00fa\u010dink\u016f inzulinu\u00a0<\/b>v\u00a0c\u00edlov\u00fdch tk\u00e1n\u00edch. I\u00a0kdy\u017e je inzulin v\u00a0t\u011ble p\u0159\u00edtomen, bu\u0148ky na n\u011bj nedostate\u010dn\u011b reaguj\u00ed. Z\u00e1rove\u0148 zpravidla n\u00e1sledn\u011b doch\u00e1z\u00ed i ke sn\u00ed\u017een\u00ed tvorby inzulinu slinivkou. Velmi \u010dasto vznik\u00e1 na z\u00e1klad\u011b nezdrav\u00e9ho \u017eivotn\u00edho stylu spojen\u00e9ho s\u00a0nadv\u00e1hou a nedostatkem pohybu.<\/p>\n
Kdy a jak \u010dasto se nechat vy\u0161et\u0159it?<\/b><\/p>\n
U nerizikov\u00fdch pacient\u016f prob\u00edh\u00e1 prvotn\u00ed vy\u0161et\u0159en\u00ed diabetu\u00a0<\/b>(v\u010dasn\u00fd z\u00e1chyt diabetu mellitu)\u00a0v\u00a0r\u00e1mci preventivn\u00ed prohl\u00eddky<\/b>\u00a0(1x\u00a0za\u00a02\u00a0roky)\u00a0u\u00a0v\u0161eobecn\u00e9ho praktick\u00e9ho l\u00e9ka\u0159e.<\/b><\/p>\n
U pacient\u016f se zv\u00fd\u0161en\u00fdm rizikem by m\u011bl v\u0161eobecn\u00fd praktick\u00fd l\u00e9ka\u0159 prov\u00e1d\u011bt vy\u0161et\u0159en\u00ed c\u00edlen\u011b.\u00a0<\/b>Za\u00a0rizikov\u00e9 pacienty jsou pova\u017eov\u00e1ni poji\u0161t\u011bnci s\u00a0prediabetem, s\u00a0kardiovaskul\u00e1rn\u00edm onemocn\u011bn\u00edm v\u00a0osobn\u00ed anamn\u00e9ze, s\u00a0diabetem v\u00a0rodinn\u00e9 anamn\u00e9ze, ob\u00e9zn\u00ed pacienti atd.<\/p>\n
U pacient\u016f se z\u0159ejm\u00fdmi p\u0159\u00edznaky\u00a0<\/b>(polyurie, polydipsie atd.)\u00a0by vy\u0161et\u0159en\u00ed v\u00a0ordinaci v\u0161eobecn\u00e9ho praktick\u00e9ho l\u00e9ka\u0159e m\u011blo prob\u011bhnout bez odkladu<\/b>.<\/p>\n
Jak prob\u00edh\u00e1 vy\u0161et\u0159en\u00ed diabetu mellitu?<\/b><\/p>\n
V\u0161eobecn\u00fd praktick\u00fd l\u00e9ka\u0159 s\u00a0poji\u0161t\u011bncem nejprve absolvuje anamnestick\u00fd rozhovor, kdy zji\u0161\u0165uje podrobnou anamn\u00e9zu a p\u0159\u00edpadn\u00e9 zdravotn\u00ed obt\u00ed\u017ee<\/b>.\u00a0N\u00e1sledn\u011b poji\u0161t\u011bnci vyp\u00ed\u0161e\u00a0\u017e\u00e1danku na\u00a0laboratorn\u00ed odb\u011br krve, ze kter\u00e9 se\u00a0m\u011b\u0159\u00ed glyk\u00e9mie<\/b>\u00a0(hladina cukru\/gluk\u00f3zy v krvi), nebo provede toto vy\u0161et\u0159en\u00ed p\u0159\u00edmo ve sv\u00e9\u00a0ordinaci glukometrem metodou POCT.\u00a0Na z\u00e1klad\u011b v\u00fdsledk\u016f vy\u0161et\u0159en\u00ed krve v\u0161eobecn\u00fd praktick\u00fd l\u00e9ka\u0159 stanov\u00ed diagn\u00f3zu a rozhodne o\u00a0zah\u00e1jen\u00ed l\u00e9\u010dby.<\/b><\/p>\n
U zdrav\u00e9ho \u010dlov\u011bka je mno\u017estv\u00ed gluk\u00f3zy v\u00a0krvi st\u00e1l\u00e9 a pohybuje se\u00a0nala\u010dno mezi 3,8\u20135,6 mmol\/l<\/strong><\/b>.\u00a0Zv\u00fd\u0161en\u00e9 (hrani\u010dn\u00ed) hodnoty glyk\u00e9mie se\u00a0pohybuj\u00ed<\/b>\u00a0nala\u010dno v\u00a0rozmez\u00ed 5,6\u20136,9 mmol\/l<\/strong>\u00a0\u2013 tento stav ozna\u010dujeme jako prediabetes (pozn. ji\u017e v\u00a0tomto st\u00e1diu je pacient sledov\u00e1n v\u0161eobecn\u00fdm praktick\u00fdm l\u00e9ka\u0159em).\u00a0Diabetes je\u00a0diagnostikov\u00e1n p\u0159i hodnot\u00e1ch >7 mmol\/l nala\u010dno.<\/b><\/p>\n Kdo m\u00e1 diabetika v\u00a0p\u00e9\u010di?<\/b><\/p>\n Diabetici 1. typu a nedostate\u010dn\u011b kompenzovan\u00ed diabetici 2. typu jsou p\u0159ed\u00e1n\u00ed do dispenz\u00e1rn\u00ed p\u00e9\u010de l\u00e9ka\u0159e specialisty \u2013 diabetologa<\/b>\u00a0(odbornost 103 \u2013 diabetologie).\u00a0Zdravotn\u00ed p\u00e9\u010di o\u00a0kompenzovan\u00e9 diabetiky 2.\u00a0typu bez p\u0159idru\u017een\u00fdch komplikac\u00ed zaji\u0161\u0165uje zejm\u00e9na v\u0161eobecn\u00fd praktick\u00fd l\u00e9ka\u0159.<\/b><\/p>\n Pacienti s\u00a0onemocn\u011bn\u00edm diabetes mellitus maj\u00ed \u010dasto i jin\u00e1 p\u0159idru\u017een\u00e1 onemocn\u011bn\u00ed. Z\u00a0tohoto d\u016fvodu o\u0161et\u0159uj\u00edc\u00ed l\u00e9ka\u0159 b\u011bhem l\u00e9\u010dby spolupracuje i s\u00a0dal\u0161\u00edmi specializovan\u00fdmi l\u00e9ka\u0159sk\u00fdmi obory \u2013 nap\u0159. kardiologi\u00ed, nefrologi\u00ed, neurologi\u00ed, oftalmologi\u00ed, gynekologi\u00ed atd.<\/p>\n Jak prob\u00edh\u00e1 l\u00e9\u010dba cukrovky?<\/b><\/p>\n L\u00e9\u010dba diabetu mellitu typu 1 a typu 2 se li\u0161\u00ed. U obou typ\u016f se jedn\u00e1 o komplexn\u00ed l\u00e9\u010debn\u00fd postup, kter\u00fd by m\u011bl pacient dodr\u017eovat, tzn. vy\u017eaduje se spolupr\u00e1ce pacienta.<\/b>\u00a0C\u00edlem l\u00e9\u010dby je dosa\u017een\u00ed normoglyk\u00e9mie (norm\u00e1ln\u00ed hladiny cukru v\u00a0krvi), a t\u00edm zabr\u00e1n\u011bn\u00ed rozvoji chronick\u00fdch komplikac\u00ed. L\u00e9\u010debn\u00fd pl\u00e1n by m\u011bl b\u00fdt volen s\u00a0ohledem na individu\u00e1ln\u00ed pot\u0159eby pacienta, s\u00a0ohledem na\u00a0dosavadn\u00ed \u017eivotn\u00ed styl, v\u011bk, hmotnost, p\u0159idru\u017een\u00e1 onemocn\u011bn\u00ed atd.<\/p>\n Dle typu onemocn\u011bn\u00ed l\u00e9ka\u0159 pacientovi doporu\u010d\u00ed dietn\u00ed opat\u0159en\u00ed, p\u0159edep\u00ed\u0161e l\u00e9\u010div\u00e9 p\u0159\u00edpravky<\/b>\u00a0(peror\u00e1ln\u00ed antidiabetika\/PAD).\u00a0Ned\u00edlnou sou\u010d\u00e1st\u00ed l\u00e9\u010dby je tak\u00e9 edukace pacienta o pou\u017e\u00edv\u00e1n\u00ed zdravotnick\u00fdch prost\u0159edk\u016f\u00a0<\/b>(nap\u0159. glukometr)\u00a0k\u00a0m\u011b\u0159en\u00ed glyk\u00e9mie doma\u00a0<\/b>(selfmonitoring)\u00a0a jeho dokumentaci\u00a0<\/b>atd. U\u00a0informovan\u00e9ho a\u00a0spolupracuj\u00edc\u00edho pacienta se sni\u017euje riziko dal\u0161\u00edch zdravotn\u00edch obt\u00ed\u017e\u00ed.<\/p>\n Diabetes mellitus typ 1<\/u><\/p>\n Pacient s\u00a0touto diagn\u00f3zou se\u00a0l\u00e9\u010d\u00ed injek\u010dn\u00ed aplikac\u00ed inzulinu, p\u0159\u00edpadn\u011b prost\u0159ednictv\u00edm inzulinov\u00fdch pump.<\/p>\n Diabetes mellitus typ 2<\/u><\/p>\n Nov\u011b zji\u0161t\u011bn\u00fd diabetes typu 2 lze l\u00e9\u010dit nefarmakologicky \u2013 \u00fapravou diety, \u017eivotn\u00edho stylu, za\u0159azen\u00edm vhodn\u00e9 fyzick\u00e9 aktivity<\/b>.\u00a0Redukc\u00ed hmotnosti pacienta doch\u00e1z\u00ed ke zlep\u0161en\u00ed inzulinov\u00e9 rezistence.\u00a0V\u00a0p\u0159\u00edpad\u011b, \u017ee\u00a0nefarmakologick\u00e1 l\u00e9\u010dba nezab\u00edr\u00e1, p\u0159edepisuje l\u00e9ka\u0159 pacientovi l\u00e9\u010div\u00e9 p\u0159\u00edpravky (PAD).<\/b><\/p>\n Zdravotnick\u00e9 prost\u0159edky<\/b><\/p>\n \u00dahradu z ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed a pravidla preskripce zdravotnick\u00fdch prost\u0159edk\u016f pro diabetiky stanovuje z\u00e1kon o ve\u0159ejn\u00e9m zdravotn\u00edm poji\u0161t\u011bn\u00ed (p\u0159\u00edloha \u010d. 3 z\u00e1kona \u010d. 48\/1997 Sb.) \u2013 viz\u00a0bli\u017e\u0161\u00ed informace<\/a>.<\/p>\n \u00dahrada z\u00a0ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed<\/b><\/p>\n Ve\u0161ker\u00e1 vy\u0161et\u0159en\u00ed, kter\u00e1 jsou pacientovi indikov\u00e1na, jsou hrazena z ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed. V\u0161echna vy\u0161et\u0159en\u00ed je nutn\u00e9 prov\u00e9st ve\u00a0smluvn\u00edch zdravotnick\u00fdch za\u0159\u00edzen\u00edch<\/b>\u00a0(tedy u\u00a0poskytovatele zdravotn\u00edch slu\u017eeb, kter\u00fd m\u00e1 smlouvu se\u00a0zdravotn\u00ed poji\u0161\u0165ovnou pacienta).<\/p>\n (vzp)<\/strong><\/p>\n <\/p>\n","protected":false},"excerpt":{"rendered":" OT\u00c1ZKA: Kdy <\/p>\n","protected":false},"author":2,"featured_media":342770,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"gallery","meta":{"footnotes":""},"categories":[88],"tags":[],"jetpack_featured_media_url":"https:\/\/zakrasnejsivimperk.cz\/wp-content\/uploads\/2025\/04\/14\/ram-vzp.jpg","_links":{"self":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts\/342769"}],"collection":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=342769"}],"version-history":[{"count":1,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts\/342769\/revisions"}],"predecessor-version":[{"id":342771,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts\/342769\/revisions\/342771"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/media\/342770"}],"wp:attachment":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=342769"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=342769"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=342769"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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