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Sladkorna bolezen ali diabetes melitus je patološko stanje, za katerega je značilna kronično povišana raven sladkorja v krvi. Glavni razlog za njen nastanek je bodisi popolnoma ustavljeno ali pomanjkljivo proizvajanje inzulina v pankreasu. Poznamo več tipov sladkorne bolezni, med katerimi sta najpogostejša tipa 1 in 2. Sladkorna bolezen tipa 1 je poligenska bolezen, ki prizadene manjši delež sladkornih bolnikov, ki zbolijo predvsem v obdobju pubertete. Sladkorna bolezen tipa 2 pa je heterogena patološka motnja, za katero je značilno, da nastane postopoma tekom življenja. Sladkorno bolezen spremlja veliko značilnih simptomov, med katerimi so tudi kožne spremembe. Najpogostejši razlogi za njihov nastanek, od katerih je odvisen način terapije, so avtoimunski ali neavtoimunski odzivi telesa, okužbe z različnimi organizmi in neželeni učinki zdravljenja. Za zdravljenje kožnih sprememb uporabljamo predvsem kreme in mazila z dodanimi zdravilnimi učinkovinami (npr. antibiotiki) ter druge načine terapije, kot sta foto- in fizioterapija. Pri zdravljenju lahko poleg diabetologov sodelujejo tudi kirurgi in dermatologi. V okviru diplomske naloge smo ugotavljali, kako slovenski bolniki s sladkorno boleznijo negujejo prizadeto kožo, koliko najpogostejših kožnih sprememb, povezanih z boleznijo poznajo in koliko so o njih seznanjeni. Za raziskavo smo uporabili anketni vprašalnik, ki smo ga razdelili 62 bolnikom. Anketiranje smo opravili v diabetoloških ambulantah Univerzitetnega kliničnega centra (UKC) Ljubljana. Prav tako smo opravili intervjuje z diabetologi in zaposlenimi v lekarni. Pri tem smo želeli ugotoviti, kaj najpogosteje predpisujejo oz. svetujejo za nego kože, katere kožne spremembe se pri bolnikih pojavljajo najpogosteje in kakšni so načini njihovega zdravljenja.Analiza izpolnjenih anket je pokazala, da so kožne bolezni pri slovenskih bolnikih redke, pri njihovem zdravljenju pa sodelujejo zgolj diabetologi zdravljenje je v večino primerih učinkovito. Ugotovili smo, da so slovenski sladkorni bolniki dobro seznanjeni z možnostmi nastanka kožnih sprememb. Večina bi jih ob njihovem pojavu poiskala pomoč pri diabetologu, prav tako pa bi te spremembe pripisali svoji bolezni. Po mnenju anketirancev je najpogostejši razlog za njihov nastanek kombinacija delovanja imunskega sistema, okužbe z mikroorganizmi in uporabe inzulina. Največ jih meni, da je nega kože zelo pomembna, vendar pa je ta pri večini bolnikov nezadostna. Najpogosteje uporabljajo izdelki za nego nog, predvsem kreme. Med kožnimi spremembami najpogosteje prepoznajo diabetično stopalo.Naše ugotovitve se skladajo z mnenjem strokovnih delavcev, ki ugotavljajo, da je prisotnost kožnih bolezni pri sladkornih bolnikih v Sloveniji nizka. Med njimi je najpogostejše diabetično stopalo. Sladkorni bolniki, še posebej starejši, premalo skrbijo za nego kože, pri čemer uporabljajo predvsem kozmetične izdelke, ki so dostopni na tržišču. V lekarnah pa zanje najpogosteje izdelujejo kreme, ki vsebujejo kombinacijo olivnega olja in belobaze. Diabetes or diabetes melitus is a pathological condition, commonly characterized by high blood sugar levels. The main reason for its emergence is either a complete cessation or insufficient production of insulin in the pancreas. There are many types of diabetes, amongst which type 1 and 2 are most common. Type 1 diabetes is a polygenic disease, that affects a smaller percentage of diabetes patients, whose onset occurs mainly during puberty. Type 2 diabetes is a heterogeneous pathological disorder, characterized by its gradual development during life. Diabetes is accompanied by many characteristic symptoms, amongst which are also skin lesions. The most common causes for their occurrence, which determinate course of therapy, are autoimmune and non-autoimmune responses, infections caused by various microorganisms, and side effects of the treatment. In the treatment of these skin lesions various creams or ointments with added active ingredients (e.g. antibiotics), and other types of therapies, such as photo- and physiotherapy, are used. In the course of the treatment, surgeons and dermatologists can also be present in addition to diabetologists. Within this diploma thesis, we tried to find out how the Slovene diabetes patients take care of their affected skin, how many skin lesions linked to the disease they recognize and how well are they informed about them. For this research, we used a questionnaire that was distributed among 62 patients. The survey was conducted in the diabetology clinic of University Medical Centre Ljubljana. We also conducted interviews with diabetologists and pharmacy employees. The aim was to find out which products are most often prescribed or advised for patients’ skin care, which skin lesions occur most often and what type of treatment is usually chosen. The analysis of the survey showed that skin lesions are rare in Slovene patients, but when they do occur, only a diabetologist participates in the treatment procedure, which is usually successful. It has been established that Slovene diabetics are well informed about the possibilities of occurring skin lesions. Most would get help from a diabetologist when any skin changes occurred and they would attribute these changes to their illness. According to the respondents, the most common reason for their occurrence is a combination of the immune systems' activity, infections with microorganisms and the use of insulin. The biggest percentage of patients think that skin care is very important, but is with most patients often not sufficient. The most commonly used products were feet care products, especially creams. The most recognized skin lesion was a diabetic foot. The findings were in line with the opinion of the experts who confirm that the presence of skin diseases in diabetic patients in Slovenia is low. Among them the most commonly occurring skin lesion is a diabetic foot. Diabetic patients, especially the elderly, do not have the sufficient skin care, the most commonly used skin care products are those that are already available on the market. In pharmacies they most commonly make creams that contain a combination of olive oil and belobase. |
