{"id":35,"date":"2010-10-15T16:35:51","date_gmt":"2010-10-15T13:35:51","guid":{"rendered":"http:\/\/caferabbasoglu.moldibi.com\/diyabet\/"},"modified":"2015-09-20T13:29:07","modified_gmt":"2015-09-20T10:29:07","slug":"diyabet","status":"publish","type":"page","link":"https:\/\/www.caferabbasoglu.com\/en\/diyabet\/","title":{"rendered":"Diyabet"},"content":{"rendered":"

\"\" Diyabet s\u0131k rastlanan kronik bir hastal\u0131k olup v\u00fccudun kan \u015fekerinin (glikozun) kullan\u0131labilir enerjiye \u00e7evrilememesidir. \u015eeker hastalar\u0131nda pankreas yeterli miktarda ins\u00fcl\u00fcn ad\u0131 verilen hormonu \u00fcretemez.<\/p>\n

\u0130ns\u00fclin kanda glikoz seviyesini d\u00fczenleyen bir hormondur. Yemekten sonra kanda glikoz(\u015feker) seviyeleri y\u00fckselir, artan glikoz seviyeleri normal olarak pankreastan ins\u00fcl\u00fcn salg\u0131lanmas\u0131na yol a\u00e7arak kan glikozunun h\u00fccre i\u00e7ine girmesini sa\u011flar. Diyabetli hastalarda ise pankreas yeterli miktarda ins\u00fcl\u00fcn salg\u0131layamad\u0131\u011f\u0131ndan yiyeceklerle al\u0131nan glikoz(\u015feker) v\u00fccut taraf\u0131ndan enerji \u00fcretimi i\u00e7in tam olarak kullan\u0131lamaz. Bunun yerine kandaki seviyeleri artar ve idrarla at\u0131lmaya \u00e7al\u0131\u015f\u0131l\u0131r. \u0130\u015fte bu durumdaki hasta diyabetik hastad\u0131r. Diyabetteki as\u0131l sorun pankreastan salg\u0131nanan ins\u00fcl\u00fcn glikozu h\u00fccre i\u00e7ine sokar.<\/p>\n

\"\"
\nDiyabetik ayak yaras\u0131<\/em><\/div>\n
\"\"
\nDiyabetik ayak yaras\u0131<\/em><\/div>\n
\n

\u00a0<\/p>\n<\/div>\n

\u0130ki t\u00fcr diyabet (\u015feker hastal\u0131\u011f\u0131) vard\u0131r:<\/strong> Tip 1 diyabette, v\u00fccut savunma sistemi pankreasta insulin salg\u0131layan h\u00fccreleri tahrip eder.<\/p>\n

Tip 1 diyabet gen\u00e7 ya\u015flarda daha s\u0131k g\u00f6r\u00fcl\u00fcr. Tip 1 diyabetin belirtileri a\u015f\u0131r\u0131 susuzluk hissi ve a\u011f\u0131z kurulu\u011fu, s\u0131k idrara \u00e7\u0131kma, ani kilo kayb\u0131, g\u00f6rme bulan\u0131kl\u0131\u011f\u0131, s\u0131k tekrarlayan enfeksiyonlar.<\/p>\n

Tip 2 diyabet (\u015feker hastal\u0131\u011f\u0131) ise s\u0131kl\u0131kla ya\u015fam tarz\u0131yla ili\u015fkili olup \u015fi\u015fmanl\u0131k, hareket azl\u0131\u011f\u0131 ve sa\u011fl\u0131ks\u0131z beslenmeyle ili\u015fklidir. Y\u00fcksek riskli ki\u015filerde erken tespiti \u00e7ok \u00f6nemlidir .<\/p>\n

Tip 2 diyabet belirtileri ise yorgunluk hissi, susama ve s\u0131k idarara \u00e7\u0131kma, sebebi bilinmeyen kilo kayb\u0131 s\u0131k tekrarlayan enfeksiyonlar\u2026<\/p>\n

Diyabet tedavisinin amac\u0131 kan \u015fekeri, kan bas\u0131nc\u0131, kilo ve kan ya\u011flar\u0131 seviyelerini kontrol alt\u0131na almakt\u0131r.<\/p>\n

Tedavide ya\u011fdan fakir karbonhidrattan zengin beslenme, d\u00fczenli egzersiz, sigaran\u0131n b\u0131rak\u0131lmas\u0131, kan \u015fekerini kontrol etmek i\u00e7in ins\u00fcl\u00fcn i\u011fneleri veya a\u011f\u0131zdan ila\u00e7 tedavisi uygulanmaktad\u0131r.<\/p>\n

\"eker_hastal_yaras\"<\/p>\n

Diyabetin yol a\u00e7abilece\u011fi olaylar:<\/h3>\n

K\u00f6rl\u00fck, b\u00f6brek yetmezli\u011fi, kalp krizi, fel\u00e7 veya uzuv kayb\u0131 olabilir.<\/p>\n

Diyabetik retinopati ise g\u00f6rmeyi ciddi \u015fekilde engelleyebilir. Diyabet retinada ve g\u00f6z\u00fcn arka duvar\u0131nda bulunan k\u00fc\u00e7\u00fck k\u0131lcal damarlar\u0131 yava\u015f yava\u015f tahrip eder bulan\u0131k g\u00f6rme ve g\u00f6zde siyah noktalar\u0131n u\u00e7u\u015fmas\u0131 belirtileri k\u00f6rl\u00fckle sonu\u00e7lanabilir. \u015eeker hastal\u0131\u011f\u0131 65 ya\u015f\u0131n \u00fczerinde k\u00f6rl\u00fc\u011fe neden olan en s\u0131k sebeptir.<\/p>\n

Diyabet kalp koroner damarlar\u0131nda ya\u011f birikimine zemin haz\u0131rlar. Kalp ve di\u011fer v\u00fccut damarlar\u0131na (diz alt\u0131 atar damarlar) giderek ya\u011f ve p\u0131ht\u0131 ile bu damarlar\u0131 t\u0131kar.<\/p>\n

Diyabetik b\u00f6brek hastal\u0131\u011f\u0131 (nefropati) b\u00f6bre\u011fin s\u00fczme (glomerul) alan\u0131n\u0131 tahrip eder. Sonu\u00e7 olarak idrardan protein kayb\u0131, hipertansiyona yol a\u00e7arak b\u00f6brek fonksiyonlar\u0131n\u0131n azalmas\u0131na neden olur.<\/p>\n

Ayakta \u00fclser diyabetik aya\u011f\u0131n en \u00f6nemli hastal\u0131k belirtilerindendir. Diyabet (\u015feker) ayak damarlar\u0131nda ve sinirlerinde yapt\u0131\u011f\u0131 tahribat ile dola\u015f\u0131m\u0131n bozulmas\u0131na dolay\u0131s\u0131yla sinir hasar\u0131na, bacakta hissizlik, uyu\u015fukluk, a\u011fr\u0131, yanma ve krampa neden olur. Bu durumdaki diyabetik hastalar ufak darbe ve kesiklerin fark\u0131na varamad\u0131klar\u0131ndan ayaklar\u0131nda (diyabetik n\u00f6ropati) \u00fclserler olu\u015fabilir.<\/p>\n

Diyabetin Damar Yap\u0131s\u0131 \u00dczerine Etkisi:<\/h3>\n

Atardamarlar kan\u0131n kaslara ve di\u011fer organlara ta\u015f\u0131maktad\u0131r. Atardamar hastal\u0131klar\u0131 bu damarlar\u0131n daralmas\u0131 veya t\u0131kanmas\u0131ndan kaynaklan\u0131r. Daralma ve t\u0131kanman\u0131n nedeni ise damar duvar\u0131nda kan ya\u011flar\u0131n\u0131n birikmesidir. Buna damar sertli\u011fi veya ateroseklerozis denilmektedir. Damar sertli\u011finin en \u00f6nemli nedenleri kan ya\u011flar\u0131n\u0131n y\u00fcksek olmas\u0131, \u015feker hastal\u0131\u011f\u0131, tansiyon y\u00fcksekli\u011fi ve sigarad\u0131r.<\/p>\n

Bacak ve kollardaki atardamar sertliklerine periferik arter hastal\u0131\u011f\u0131 denilmektedir. Diyabetli ki\u015filerde kandaki glikoz ve froktozun y\u00fcksek olmas\u0131 damar duvar\u0131nda tahribat olu\u015fturur. \u015eeker ile beraber izlenen tansiyon y\u00fcksekli\u011fi ve kan ya\u011flar\u0131n\u0131n y\u00fcksekli\u011fi damarlardaki tahribat\u0131 h\u0131zland\u0131rmaktad\u0131r. Diyabetlilerde atardamar hastal\u0131klar\u0131, normal \u015fah\u0131slardakinden 2 – 4 kat daha fazlad\u0131r.<\/p>\n

Diyabete ba\u011fl\u0131 \u00f6l\u00fcmlerin y\u00fczde 75 nedeni atardamar hastal\u0131klar\u0131d\u0131r. Orta ya\u015fl\u0131 diyabetiklerin \u00f6l\u00fcm oran\u0131 normal pop\u00fclasyonun 2 kat \u00fcst\u00fcndedir. Diyabetlilerin y\u00fczde 60-65’inde hipertansiyon mevcuttur. Diyabetik ayak diyabet hastalar\u0131n\u0131n en \u00f6nemli problemlerindendir.<\/p>\n

Diyabetik Ayak Nas\u0131l Korunmal\u0131d\u0131r?<\/h3>\n

\"\u015eeker<\/p>\n

    \n
  • Dar olmayan deri ayakkab\u0131lar tercih edilmelidir, ayakkab\u0131n\u0131n i\u00e7inde yabanc\u0131 cisim olmamal\u0131d\u0131r.<\/li>\n
  • Burnu a\u00e7\u0131k ayakkab\u0131lar giyilmelidir (\u00e7arpma ve tramvaya\u0131 \u00f6nlemek i\u00e7in)<\/li>\n
  • Ayak temizli\u011fine \u00e7ok dikkat edilmeli, (her g\u00fcn \u0131l\u0131k su ile ayaklar y\u0131kanacak daha sonra kurulanacak),<\/li>\n
  • Her ak\u015fam yatmadan \u00f6nce ayak parmaklar\u0131n\u0131n aras\u0131 temiz pamuk ile silinmeli,<\/li>\n
  • T\u0131rnak temizli\u011fine dikkat edilmeli, oje kullanmamal\u0131,<\/li>\n
  • t\u0131rnak batmalar\u0131na ve nas\u0131rlar\u0131na dikkat edilmelikurcalanmamal\u0131<\/li>\n
  • D\u00fczenli olarak ve ayaklarda olu\u015fan en k\u00fc\u00e7\u00fck yara i\u00e7in bile mutlaka doktora ba\u015fvurulmal\u0131d\u0131r.<\/li>\n<\/ul>\n

    Diyabetik hastalar\u0131n tedavileri:<\/h3>\n
      \n
    1. Medical<\/li>\n
    2. “Sigaraya dur, y\u00fcr\u00fcy\u00fc\u015fe devam” bu \u015fekilde y\u00fcr\u00fcy\u00fc\u015f mesafesinin 6 ayda iki kat\u0131na \u00e7\u0131kt\u0131\u011f\u0131 saptanm\u0131\u015ft\u0131r.<\/li>\n
    3. Balon ve stent uygulamalar\u0131 (dar olan b\u00f6lgeleri balon veya stent ile a\u00e7mak, kans\u0131z b\u00f6lgelere kan vermek)<\/li>\n
    4. Cerrahi tedaviler, damar bay-passlar\u0131, damar ameliyatlar\u0131<\/li>\n
    5. Damar i\u00e7i oksijen tedavisi<\/li>\n
    6. Damar i\u00e7i d\u00fc\u015f\u00fck enerjili lazer tadevisi<\/li>\n
    7. Kombine damar i\u00e7i oksijen ve d\u00fc\u015f\u00fck enerjili laser tedavisi<\/li>\n
    8. Amputasyonlar<\/li>\n<\/ol>\n

      \"\"Diyabetik ayaklarda genellikle her iki bacakta bacak atar damarlar\u0131n\u0131n i\u00e7i (l\u00fcmeni) ba\u015ftan ba\u015fa daral\u0131p t\u0131kanmaktad\u0131r. Dolay\u0131s\u0131yla kan\u0131n ayak b\u00f6lgelerine gelememesi dokunun ve aya\u011f\u0131n beslenememesinden kaynaklan\u0131r. Ayak ve bacak beslenemedi\u011finde ve oksijenlenmedi\u011finde \u015fiddetli a\u011fr\u0131lar, y\u00fcr\u00fcy\u00fc\u015f mesafesinde k\u0131salmalar, \u015fi\u015fmeler ve en ufak yaralar\u0131n iyile\u015fememesi g\u00f6r\u00fclmektedir.<\/p>\n

      Biz kalp damar cerrahlar\u0131 \u00f6ncelikle hastan\u0131n diyabet uzmanlar\u0131 taraf\u0131ndan \u015fekerlerinin, tansiyon y\u00fcksekliklerinin, kan ya\u011flar\u0131n\u0131n d\u00fc\u015f\u00fcr\u00fclmesini, diyetlerinin d\u00fczenlemesini y\u00fcr\u00fcy\u00fc\u015f ve egzersizlerini yapmalar\u0131n\u0131 \u00f6nermekteyiz.<\/p>\n

      Bunlara ra\u011fmen hasta \u015fikayetleri devam ediyorsa muayene veya dopler ultrason tetkikinde damar t\u0131kan\u0131kl\u0131\u011f\u0131 ve damar daralmalar\u0131n\u0131 tespit ve te\u015fhisi varsa hastalara anjio ile tetkik \u00f6nermekteyiz .<\/p>\n

      G\u00fcn\u00fcm\u00fczdeki anjiolar bilgisayarl\u0131 tomografi anjiosu, mr anjiosu veya klasik anjiodur. Bu anjio tetkikleri sonucunda bacak damarlar\u0131n\u0131n nerde ve hangi seviyede darald\u0131\u011f\u0131n\u0131 ve t\u0131kand\u0131\u011f\u0131n\u0131 tespit etmekteyiz.<\/p>\n

      Damar darl\u0131\u011f\u0131 ve t\u0131kanmalar\u0131nda hastan\u0131n stent veya balon \u015fans\u0131 varsa stent veya balon; bay-pass \u015fans\u0131 varsa bay- pass yapmaktay\u0131z. Bay-paslarda suni damar veya kendi baca\u011f\u0131ndan ald\u0131\u011f\u0131m\u0131z damar\u0131n\u0131 kulanarak kans\u0131z b\u00f6lgeye kan vermekteyiz.<\/p>\n

      Bu durumda kans\u0131z, oksijensiz bacak ve ayak dokular\u0131 beslenerek hastan\u0131n a\u011fr\u0131 \u015fikayeti, bacak \u015fi\u015fli\u011fi giderilmekte, yaras\u0131 iyle\u015fmekte, y\u00fcr\u00fcy\u00fc\u015f mesafesi artmaktad\u0131r.<\/p>\n

      Damar \u0130\u00e7i Oksijen Tedavisi:<\/h3>\n

      \"\" E\u011fer bay-pass ve stent \u015fans\u0131 da yoksa hastaya damari\u00e7i oksijen tedavisi uygulamaktay\u0131z. Damar i\u00e7i oksijen tedavisi son y\u0131llarda \u00f6zellikle, Avrupa \u00fclkelerinin en fazla kulland\u0131\u011f\u0131 \u00f6nemli alternatif tedavilerden biridir. Damar i\u00e7i oksijen tedavisinde oksijen bir makineye verilmekte ve o makine bu oksijeni kan\u0131n i\u00e7ine direkt olarak g\u00f6ndermektedir. B\u00f6ylelikle bacaktaki kans\u0131z b\u00f6lgede ameliyat ve stent \u015fans\u0131 olmayan hastaya uygulanan damar i\u00e7i oksijen tedavisinde kans\u0131z b\u00f6lgelere direkt oksijen vermek suretiyle dokular beslenerek hasta rahatlamakta; diyabetik yaralar\u0131 iyle\u015fmekte; a\u011fr\u0131lar\u0131, bacak \u015fi\u015flikleri azalmakta, bacak ve organlar\u0131 kesilmeden hayat standartlar\u0131 y\u00fckselmektedir.<\/p>\n

      Damar \u0130\u00e7i D\u00fc\u015f\u00fck Enerjili Laser Tedavisi:<\/h3>\n

      \"\" Son y\u0131llarda Avrupa \u00fclkelerinde \u00e7ok s\u0131k uygulanan \u00fclkemizde ise yeni bir y\u00f6ntem olan damar i\u00e7i d\u00fc\u015f\u00fck enerjili lazer tedavisi diyabetik ayaklarda en \u00f6nemli ve en son tedavi y\u00f6ntemlerindendir. Damar i\u00e7i d\u00fc\u015f\u00fck enerjili lazer tedavisinde kans\u0131z, b\u0131\u00e7aks\u0131z seans \u015feklinde olmak \u00fczere hastalar\u0131n damar t\u0131kan\u0131kl\u0131\u011f\u0131 ve t\u0131kan\u0131kl\u0131k seviyeleri g\u00f6z \u00f6n\u00fcnde bulundurularak hastaya verilecek lazer seanslar\u0131 ayarlanmaktad\u0131r.<\/p>\n

      D\u00fc\u015f\u00fck enerjili lazer direk damar yoluyla verilmektedir.<\/p>\n

      Verilen lazer \u0131\u015f\u0131n\u0131 kan\u0131n deveran\u0131 ve cereyan\u0131 etkisi alt\u0131nda ve kan h\u00fccresine \u00f6zelikle hemoglobine emilir. Hemoglobin veya kan h\u00fccrelerinin yard\u0131m\u0131yla oksijensiz b\u00f6lgeye gider. B\u00f6ylece oksijensiz b\u00f6lgede dokunun y\u00fcksek seviyede oksijenlenmesini sa\u011flayarak kans\u0131z ve oksijensiz dokuyu besler.<\/p>\n

      Lazer tedavisi sonuncunda beslenen ve oksijenlenen dokular zamanla ince k\u0131lcal damar olu\u015fturur. v\u00fccudun yapt\u0131\u011f\u0131 bu ince k\u0131lcal damar neticesinde lazerin etki mekanizmas\u0131 alt\u0131nda dokular beslenir kanlan\u0131r. Bu sayede hastan\u0131n bacaklar\u0131 ve uzuvlar\u0131 kesilmeden, a\u00e7\u0131k bacak yaralar\u0131 u\u011fra\u015fmadan k\u0131sa s\u00fcrede kapan\u0131r. Bacak \u015fi\u015fmeleri azal\u0131r ve a\u011fr\u0131lar\u0131 yok olmu\u015f olur . Bu tedavi sonucunda hastalar\u0131n ortalama \u015feker tahlilleri d\u00fc\u015fmekte ve hastalar kendi bacaklar\u0131yla ya\u015fam standartlar\u0131n\u0131 y\u00fckselterek g\u00fcnl\u00fck ya\u015fant\u0131lar\u0131na devam etmektedirler.<\/p>\n

      Kombine Damar \u0130\u00e7i Oksijen Tedavisi<\/h3>\n

      Diyabetik ayak tedavilerinde e\u011fer hastada her iki bacakta diyabete ve damar sertli\u011fine ba\u011fl\u0131 damar t\u0131kan\u0131kl\u0131\u011f\u0131, kritik bacak iskemisi mevcut ise hastalar\u0131m\u0131za kombine tarzda intravenoz d\u00fc\u015f\u00fck enerjili lazer tedavisi ve intravenoz oksijen tedavisi uygulanmaktad\u0131r. B\u00f6ylelikle her iki bacakta kritik iskemik bacak sendromunda g\u00f6r\u00fclen dokunun oksijensizli\u011fine ba\u011fl\u0131 \u015fidetli a\u011fr\u0131lar giderilmekte ve hastalar biran \u00f6nce sa\u011fl\u0131\u011f\u0131na kavu\u015fmaktad\u0131r.<\/p>\n","protected":false},"excerpt":{"rendered":"

      Diyabet s\u0131k rastlanan kronik bir hastal\u0131k olup v\u00fccudun kan \u015fekerinin (glikozun) kullan\u0131labilir enerjiye \u00e7evrilememesidir. \u015eeker hastalar\u0131nda pankreas yeterli miktarda ins\u00fcl\u00fcn ad\u0131 verilen hormonu \u00fcretemez. \u0130ns\u00fclin kanda glikoz seviyesini d\u00fczenleyen bir hormondur. Yemekten sonra kanda glikoz(\u015feker) seviyeleri y\u00fckselir, artan glikoz seviyeleri normal olarak pankreastan ins\u00fcl\u00fcn salg\u0131lanmas\u0131na yol a\u00e7arak kan glikozunun h\u00fccre i\u00e7ine girmesini sa\u011flar. Diyabetli hastalarda […]<\/p>\n","protected":false},"author":5,"featured_media":0,"parent":0,"menu_order":11,"comment_status":"closed","ping_status":"closed","template":"","meta":{"two_page_speed":[],"footnotes":""},"class_list":["post-35","page","type-page","status-publish","hentry"],"translation":{"provider":"WPGlobus","version":"3.0.0","language":"en","enabled_languages":["tr","en"],"languages":{"tr":{"title":true,"content":true,"excerpt":false},"en":{"title":false,"content":false,"excerpt":false}}},"yoast_head":"\nDiyabet - Opr.Dr.Cafer Abbaso\u011flu<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.caferabbasoglu.com\/diyabet\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Diyabet - Opr.Dr.Cafer Abbaso\u011flu\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.caferabbasoglu.com\/diyabet\/\" \/>\n<meta property=\"og:site_name\" content=\"Opr.Dr.Cafer Abbaso\u011flu\" \/>\n<meta property=\"article:modified_time\" content=\"2015-09-20T10:29:07+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"8 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.caferabbasoglu.com\/diyabet\/\",\"url\":\"https:\/\/www.caferabbasoglu.com\/diyabet\/\",\"name\":\"Diyabet - 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