Wvqv‡ewUm

Wvt ‡gv: †ZŠwdKzi ingvbmn‡hvMx Aa¨vcK, KvwW©IjRx

RvZxq ü`‡ivM BbwówUDU I nvmcvZvj‡k‡i evsjvbMi, XvKv-1207|

Case 1

• wg‡mm ingvb, 50 eQi eqm, †ckvq GKRb M„wnbx, _v‡Kb Kzwgj v | MZ 3gvm hver j¶¨ Ki‡Qb Dwb Aí‡ZB K¬vwš— †eva K‡ib Ges AZ¨waK `ye©j jv‡M, Kv‡R †Kvb kw³ cvb bv| Dwb wbqwgZ 35 wgwbU nv‡Ub &IRb wbqš¿‡bi Rb¨| Dbvi IRb 95 †KwR | Dbvi i‡³i M y‡KvR Gi gvÎv (RBS, HBA1C) cix¶v K‡i †`Lv †Mj (RBS- 15.5mg/L, HBA1C – 9.2%) | Dbvi Lv`¨vf¨vm cwieZ©b Ges gy‡L Lvevi Anti-diabetes Gi Jla Ges Avi GKwU Bb‡RKkb †`qv nj hv Dbvi &IRb Kgv‡Z mvnvh¨ Ki‡e Ges GKB mv‡_ Wvqv‡ewUmI wbqš¿b ivL‡e | Dwb 1 gvm ci †`Lv Ki‡jb| Dbvi e vW myMvi GLb wbqš¿‡b, IRb K‡g‡Q 1 †KwR| Dbv‡K ¯^v¯’¨Ki RxebhvÎv m¤ú‡K© AviI wKQy civgk© †`Iqv nj|

Case 2

• wg‡mm Wvwjqv, 25 eQi eqm, 24 mßv‡ni Mf©eZx, _v‡Kb ivgcyiv| Dbvi i“wUb †PKAv‡c Ab¨vb¨ cix¶vi cvkvcvwk (RBS) Gi wi‡cvU© cvIqv †Mj (RBS- 11.6mg/L,) | Dbvi (Pregnancy ) Gi Av‡M (RBS) ¯^vfvweK wQj| MvBbx we‡lkÁ Dbvi cieZx© wPwKrmvi Rb¨ cvVv‡jb| Dbvi HBA1C –wi‡cvU© Avmj 7.9%, Dbvi Wvqv‡ewUm wbqš¿‡bi Rb¨ Bbmywjb †`qv nj Ges eZ©gv‡b Dbvi Wvqv‡ewUm wbqš¿‡b Av‡Q Ges wbivc‡` 39 mßvn ci GKwU Kb¨vmš—vb nj| Kb¨v mš—vb I gv Df‡qB fvj I my¯’ Av‡Qb|

ü`‡iv‡Mi mv‡_ Wvqv‡ewU‡mi m¤úK©

wK ? Wvqv‡ewUm nj K‡ivbvix ü`‡iv‡Mi Ab¨Zg cÖavb risk factor| ejv nq Wvqv‡ewUm _vK‡j †ivMxi ü`wc‡Ûi i³bvjx‡Z Pwe©i Av¯—i Rgv c‡o A_v©r K‡ivbvix ü`‡ivM Av‡Q| ZvB DbœZ we‡k¦ Wvqv‡ewU‡mi wPwKrmv mvavibZ: ü`‡ivM we‡klÁivB K‡i _v‡Kb| Wvqv‡ewUm _vK‡j K‡ivbvix ü`‡iv‡Mi cvkvcvwk †ivMxi nvZ I cv‡qi i³bvjxi e K A_ev nvU© †dBjvi †ivM n‡Z cv‡i|

Wvqv‡ewUm wK ? Wvqv‡ewUm GKwU wecvKRwbZ †ivM|

G †ivM n‡j i‡³ ¯’vqxfv‡e M y‡KvR Gi cwigvb †e‡o hvq| Avgv‡`i kix‡i AMœ¨vkq †_‡K

Bbmywjb bvgK GKwU ni‡gvb wbtm„Z nq| GB Bbmywj‡bi KvR n‡”Q i‡³i M y‡KvR †K †f‡½

Zv kix‡ii wewfbœ Kv‡R jvMv‡Z mvnvh¨ Kiv| †Kvb Kvi‡Y GB Bbmywjb ni‡gvb‡I

m¤úyb© ev Av‡cw¶K NvUwZi Kvi‡Y wecvKRwbZ mgm¨vi m„wó n‡q M y‡KvR †e‡o hvIqv Ges AwZwi³ M y‡KvR cÖkªv‡ei mv‡_ †ei n‡q AvmvB n‡”Q Wvqv‡ewUm |

Wvqv‡ewUm †iv‡Mi j¶b wK wK ?

1. Nb Nb cÖkªve nIqv, 2. Lye †ekx wccvkv jvMv, 3. AwZwi³ ¶zav cvIqv,

4. ch©vß LvIqvi c‡iI IRb K‡g hvIqv, 5. Aí‡ZB K¬vwš— I `ye©jZv †ea Kiv, 6. kix‡ii †Kvb ¶Z¯’vb ïKv‡Z †`ix nIqv,

7. wewfbœ Pg©‡ivM †hgb †Lvuk-cvuPov BZ¨vw` †ekx cwigv‡Y †`Lv †`Iqv |

Kv‡`i Wvqv‡ewUm nIqvi m¤¢vebv ?

‡h †Kvb eq‡m, ‡h Kv‡iv Wvqv‡ewUm n‡Z cv‡i, Z‡e hv‡`i G †iv‡M Avµvš— nevi m¤¢vebv †ekx Zviv n‡jb :

• 1. hv‡`i es‡k G †ivM Av‡Q | †hgb t evev, gv, `v`v, `v`x hv‡`i G †ivM Av‡Q |

• 2. hv‡`i IRb †ekx Ges hviv kvixwiK cwikª‡gi †Kvb KvR K‡ib bv|

• 3. Mf©ve¯’vq G †iv‡Mi cÖKvk NU‡Z cv‡i |

Wvqv‡ewUm n‡j wbqš¿‡bi Rb¨ wK wK Kiv DwPZ ?

• Wvqv‡ewUm wbivgq ev m¤ú~Y©i“‡c mviv‡bv hvq bv | Z‡e G †ivM m¤ú~b©fv‡e wbqš¿b ivLv hvq| K‡qKwU wel‡q †ivMx‡K wbqg gvb‡Z n‡e|

• 1.k„•Ljv t †ivMx‡K Aek¨B GKUv my›`i myôz, k„•Lj Rxebhvcb Ki‡Z n‡e|

• 2. Lv`¨ e¨e¯’v t †ivMx‡K wKQ~ Lv`¨ MÖn‡Yi bxwZ †g‡b Pj‡Z n‡e|

• 3. Jla t k„•Ljv I Lv`¨ e¨e¯’vi cvkvcvwk A‡bK †¶‡ÎB Wv³v‡ii civgk©gZ Jla I Bbmywbj‡bi cÖ‡qvRb n‡Z cv‡i|

• 4. †ivM m¤§‡Ü wk¶v t †h‡nZz Wvqv‡ewUm †ivM‡K mywbqwš¿Z Kiv hvq †m‡nZz G †ivM m¤§‡Ü fv‡jvfv‡e wk¶vMÖnb K‡i Ges G †iv‡Mi RwUjZv m¤§‡Ü fv‡jvfv‡e †R‡b mn‡RB G †ivM‡K wbqš¿b ivLv hvq|

• 5. wbqwgZ nvuUv-Pjv, nvjKv e¨vqvg Ges kvixwiK cwikªg G †ivM‡K wbqš¿‡b ivL‡Z mvnvh¨ K‡i |

Wvqv‡ewUm n‡j wK wK LvIqv DwPZ bq ?

• wgwó RvZxq Lvevi †hgb wgwó RvZxq we¯‹zU wPwb w`‡q ˆZwi Kiv †KK, †cwóª, R¨vg, †Rjx, †LRy‡ii im, Zv‡ji im, †KvKv‡Kvjv, †ccwm, Aviwm †Kvjv, K‡ÛÝ wgé, ¸o, M y‡KvR LvIqv DwPZ bq

Wvqv‡ewUm n‡j wK wK wRwbm †ekx †L‡Z n‡e ?

• me iKg kvK †hgb cvjskvK, jvjkvK, cyBkvK, KjwgkvK, WvUvkvK, KPzkvK †ekx †L‡Z n‡e|

• UK RvZxq dj, KvjRvg, Avgov, †jey, Rv¤^yiv, Rvgi“j, AvgjwK I KwP Wv‡ei cvwb LvIqv hv‡e|

• wPbvev`vg mvgyw`ªK gvQ †ekx †L‡Z n‡e|

Wvqv‡ewUm n‡j wK wK ai‡bi Jla e¨envi Kiv nq ?

• Wvqv‡ewUm n‡j gy‡L Lvevi Jla I Bbmywjb Bb‡RKkb e¨envi Kiv nq|

Wvqv‡ewU‡mi wPwKrmvq gy‡L Lvevi Jla wK wK ai‡bi e¨envi Kiv hvq ?

• Wvqv‡ewUm wPwKrmvq gy‡L Lvevi Jla wnmv‡e mvavibZ : `yB ai‡bi Jla e¨envi Kiv nq|

• GK ai‡bi Jla †ivMxi kix‡i AMœ¨vkq bvgK MÖwš’ †_‡K Bbmywjb wbimb K‡i Ges

• Aci ai‡bi Jla Bbmywjb hv‡Z kix‡i fvjfv‡e KvR Ki‡Z cv‡i I Bbmywjb †iwRôvÝ hv‡Z Kgvq †mfv‡e dvjy K‡i |

Wvqv‡ewU‡mi wPwKrmvq †Kvb †Kvb ai‡bi gy‡L LvIqvi Jla Bbmywjb wbmib K‡i ?

• Wvqv‡ewU‡mi wPwKrmvq gy‡L hviv Jla wbtmib Kivq Zviv nj M vBK¬vRvBR RvZxq Jla (†hgb- WvB‡gij, Kw¤cÖW, KbmyKb, Wvqv‡cÖv, M vBwRW BZ¨vw`) wM vgwcivBW RvZxq Jla (†hgb - A¨vgwij) |

†Kvb †Kvb ai‡bi Jla Bbmywjb †iwRóvÝ Kgvq ?

• ‡gBdiwgb RvZxq Jla (†hgb - †Kv‡gU , M vBwgb, Bbdi‡gU cÖf„wZ) I

• wM UvRb RvZxq Jla (†hgb- cvB‡ivwe UvRb , iwm wM UvRb) Bbmywjb †iwR÷vÝ Kgvq|

‡gvUv †ivMx‡`i mvavibZ: †Kvb ai‡bi Wvqv‡ewUm nq Ges wPwKrmvq †Kvb ai‡bi

Jla e¨envi Kiv nq ?

• ‡gvUv †ivMx‡`i mvavibZ: UvBc-2 ai‡bi Wvqv‡ewUm nq Ges GB †ivMx‡`i wPwKrmvi Rb¨ †gUdiwgb RvZxq Jla fvj KvR K‡i|

gy‡L Lvevi Jla fvj bv Bbmywjb fvj ?

• UvBc-1 Wvqv‡ewUm †ivMx‡`i †¶‡Î Aek¨B Bbmywjb e¨envi Ki‡Z n‡e|

• UvBc-2 Wvqv‡ewUm †ivMx‡`i †¶‡Î Wvqv‡ewU‡mi gvÎv Kg n‡j gy‡L Lvevi Jla w`‡q wbqš¿b Kiv nq|

• gvÎv A‡bK †ekx n‡j cÖ_‡g Bbmywjb w`‡q †gvUvgywU wbqš¿b K‡i gy‡L Lvevi Jla w`‡q cieZx©‡Z wbqšÎ†bi †Póv Kiv nq|

• †ivMxi IRb †ekx n‡j †gUdiwgb RvZxq Jla w`‡q wbqš¿b Kiv nq|

†Kvb †Kvb †¶‡Î gy‡L Lvevi Jla †`qv nq ?

• ‡ivMxi Wvqv‡ewU‡mi gvÎv Kg _vK‡j ev †ivMxi IRb AZ¨vwaK †ekx n‡j Avgiv gy‡L Lvevi Jla w`‡q Wvqv‡ewUm wbqš¿b Kwi, A_ev Bbmywj‡bi cwigvb Lye †ekx cÖ‡qv&Rb n‡j A_¨v© Bbmywjb †iwRóvm _vK‡jI gy‡L Lvevi Jla Bbmywj‡bi cvkvcvwk e¨envi Kiv nq |

• Bbmywjb w`‡b KZevi e¨envi Kiv DwPZ ?

• nvmcvZv‡j fwZ© †ivMx‡`i †¶‡Î A_ev cÖ_gevi Bbmywjb e¨env‡ii †¶‡Î A_ev Acv‡ik‡bi mgq Bbmywjb e¨envi Ki‡j Avgiv ¯^íKvjxb ¯’vqx (short acting ) Bbmywjb e¨envi Kwi, †m‡¶‡Î w`‡b 3evi Bbmywjb e¨envi Kiv nq|

• Bbmywjb (Mixtard) e¨envi Ki‡j w`‡b 2evi Kiv DwPZ| `xN© Kvjxq ¯’vqx (Long acting) Bbmywjb e¨envi Kiv nq mvavibZ: iv‡Z 1evi (Bbmywjb M viwRb)|

Bbmywjb ev gy‡L Lvevi Jla †L‡j wK wK mZK©Zv †bIqv DwPZ ? • Bbmywjb ev gy‡L Lvevi Jla †L‡j KLbI KLbI

Wvqv‡ewU‡mi gvÎv A‡bK K‡g wM‡q nvB‡cv M vB‡mwgqv n‡Z cv‡i, Z‡e gvivZœK mgm¨v †`Lv w`‡Z cv‡i| ZvB G‡¶‡Î mZK©Zv Aej¤^b Kiv DwPZ|

• cÖ‡Z¨K †ivMxi evmvq Wvqv‡ewUm gvcvi Rb¨ e¨w³MZ hš¿ _vKv DwPZ| †Kvb m‡›`n n‡jB wi‡c v cix¶v Kiv DwPZ|

• ZvQvov Wvqwiqv n‡j ev †c‡Ui cxov n‡j A_ev †Kvb †Lvjv Lvevi bv †L‡j ev †ivRvi mgq Bbmywjb Gi gvÎv wVK Ki‡Z n‡e ev gy‡L hviv Jla cÖ‡qvR‡b eÜ ivL‡Z n‡e|

nvB‡cvM vB †mwgqv n‡j wK Ki‡Z n‡e ?• nvB‡cvM vB †mwgqv n‡j AwZmËi e vW

myMvi †PK Kiv cÖ‡qvRb| e vW myMvi cix¶v Kiv m¤¢e n‡j Ges Zv Kg gvÎvi n‡j A_ev †PK Kiv m¤¢e bv n‡j wPwb cvwb‡Z ¸wj‡q †L‡Z n‡e A_ev glucometer cix¶vq M y‡Kv‡Ri gvÎv Lye Kg n‡j KvQvKvwQ nvmcvZv‡j fwZ© n‡Z n‡e Ges wkivq M y‡KvR Bb‡RKkb ev m¨vjvBb wb‡Z n‡e|

nvB‡cj vB‡mwgqv n‡j wKfv‡e eySv hvq ?

• nvB‡cM vB‡mwgqv n‡j AZ¨vwaK Nvg †ei nq cvkvcvwk eyK aodo Kiv, Aw¯’iZv jvMv, GgbwK AÁvb nIqv Ges wLPzbx I n‡Z cv‡i|