Novosti pri zdravljenju bolnikov s sladkorno boleznijo ob akutni hiperglikemiji : pregled literature

Čuk, Neža (avtor), Bobnar, Albina (mentor)

Uvod: Akutna hiperglikemija se lahko pojavi pri zdravem človeku ali pri bolniku s sladkorno boleznijo. Če bolnik pravočasno ne opazi povišane koncentracije glukoze v krvi, pride do zapletov, kot sta diabetična ketoacidoza ali diabetični aketotični hiperosmolarni sindrom. Zapleta sta življenjsko ogrožujoča, zato se pogosto raziskuje načine preprečevanja njunega nastanka in zdravljenja. Namen: Namen diplomskega dela je predstaviti novosti zdravljenja bolnika s sladkorno boleznijo ob akutni hiperglikemiji. Metode dela: Uporabljena je bila deskriptivna metoda s pregledom izvirnih in preglednih znanstvenih člankov, objavljenih v zadnjih 10-ih letih. Uporabljena literatura je bila iskana po podatkovnih bazah CINAHL, The Cochrane Collaboration, Science Direct, Medline (PubMed) in COBIB.SI. Rezultati: Na podlagi pregleda literature smo ugotovili, da je poleg samokontrole na voljo veliko tehničnih pripomočkov za učinkovito preprečevanje akutne hiperglikemije. Bolniki s sladkorno boleznijo uporabljajo kontinuirano infuzijsko inzulinsko črpalko in senzor za merjenje glukoze v krvi. Razvija se še umetna trebušna slinavka z zaprto zanko in mikro kontinuirana infuzijska inzulinska črpalka. Prav tako strokovnjaki razvijajo razne senzorje, ki bi uporabnika obvestili o nepravilnem delovanju katerega izmed omenjenih pripomočkov. Raziskave kažejo, da so diagnostični in klinični kriteriji za prepoznavo akutne hiperglikemije nespremenjeni. Zdravljenje je v zadnjih petih letih zelo napredovalo: ugotovili so kolikšen odmerek inzulina je najbolj primeren ob pojavu akutne hiperglikemije, dokazali učinkovitost subkutanega hitrodelujočega inzulina, razlike v izidu zdravljenja ketoacidoze glede na toničnost tekočine in možnost uporabe dializnega zdravljenja. Razprava in sklep: Sladkorna bolezen je ena najpogostejših kroničnih bolezni, kar pomeni tudi povišano tveganje za pojav akutne hiperglikemije. Raziskave so pokazale, da se ljudje zavedajo resnosti problema, saj vedno znova iščejo nove možnosti za preprečitev hiperglikemije. Poleg tega se v večini bolnišnic ravnajo po najnovejših znanstvenih dokazih ter opozarjajo na slabo poučenost nekaterih zdravstvenih delavcev, ki so ključni pri prepoznavi in zdravljenju hiperglikemije. Prav tako raziskujejo kakšen način zdravljenja zapletov akutne hiperglikemije je najmanj invaziven in hkrati najbolj učinkovit.

• Jezik: Slovenski jezik
• Ključne besede: pripomočki, ukrepi za uravnavanje krvnega sladkorja, načini aplikacije inzulina
• Vrsta gradiva: Diplomsko delo/naloga
• Organizacija: ZF - Zdravstvena fakulteta
• Leto izida: 2017
• PID: 20.500.12556/RUL-95905
• COBISS.SI-ID: 5326443
• Datum objave v RUL: 23.09.2017

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: Innovations in treating patients with diabetes in case of acute hyperglycaemia : literature review

Izvleček

Introduction: Acute hyperglycaemia may occur at a healthy person or a patient with diabetes. If the patient does not notice a high level of blood glucose, complications such as diabetic ketoacidosis or diabetic hyperosmolar acetic syndrome may occur. Both complications are life-threatening, therefore ways of preventing and treating them are often being investigated. Purpose: Purpose of the thesis is to present innovations in treating patients with diabetes in case of acute hyperglycaemia. Methods: A descriptive method has been used, with an overview of the original and transparent scientific articles published over the past 10 years. The literature used was searched by the CINAHL, The Cochrane Collaboration, Science Direct, Medline (PubMed) and COBIB.SI databases. Results: Based on the literature review it was found that, in addition to self-control, many technical devices for preventing acute hyperglycaemia are available. Patients with diabetes use a continuous infusion insulin pump and a sensor for blood glucose measurement. In a few years, an artificial pancreas with a closed loop and a micro continuous infusion insulin pump will come onto the market. Also, experts are developing various sensors to inform the user about the improper operation of one of these devices. Research shows that diagnostic and clinical criteria are unchanged. Moreover, treatment has progressed greatly over the last five years: they found out the appropriate dose of insulin in case of acute hyperglycaemia, demonstrated the efficacy of the subcutaneous fasting analogue of insulin, the differences in the outcome of ketoacidosis treatment with respect to the tonicity of the fluid and the possibility of using dialysis treatment. Discussion and conclusion: Diabetes is one of the most common chronic diseases which also means an increased risk of acute hyperglycaemia. Research has shown that people are aware of the severity of the problem, as they are constantly looking for new solutions to prevent hyperglycaemia. Also, the majority of hospitals is following the latest scientific evidence. At the same time, they are drawing attention to the poor knowledge of some healthcare professionals who are the key in identifying and treating hyperglycaemia. They also investigate which treatment of acute complications is the least invasive and at the same time most effective.

• Ključne besede: aids, blood sugar control measures, insulin administration methods