Diabetes mellitus (당뇨)

본문내용

, hypertension)
② 뇌졸중(cerebrovascular disease)
: Microvascular (소혈관변화)
① Ritinopathy (당뇨병성 망막증)
: retinal circulation의 장애
: glaucoma(녹내장), cataract(백내장), 시력흐림, 실명
② Nephropathy (당뇨병성 신증)
: ★UTI, ★Microalbuminuria(단백뇨),edema , CRF (만성신부전), 신증후군
③ Neuropathy (당뇨병성 신경증)
: 말초신경장애, ★Foot infection, Paresthesias, Impotence(발기부전), 배뇨부전, 설사
★★ Foot Care
: 신경병증과 말초혈관 질환에 의해 발생
* 당뇨병 환자의 발관리가 중요한 이유
1) 당뇨병 환자의 절단환자중 50%가 비외상성 즉, 괴사(necrosis)로 인한 것이다.
2) 당뇨병의 합병증으로 입원한 환자중 가장 많은 수를 차지하는 것이 발과 다리 의 괴사이다.
① 해야할일 O
1. 매일 발관찰 (Inspect feet daily)
-> redness, swelling, break in skin이 있다면 즉시 의사에게 알린다
2. 매일 따뜻한 물(★warm)을 사용하여 깨끗하게 씻는다
3. 발과 발가락 사이의 물을 잘 닦고 건조하면 lanolin 크림등을 바른다
-> ★ 발가락 사이(between the toes)엔 크림을 바르지 않는다
4. 발톱은 바짝 깍지 않고 일직선을 똑바로★(stright acros)자른다
5. 잘맞는(well-fitting) 편한 신발을 신는다 (운동화, ★가죽(leather) 신발은 좋다)
-> open toe shoes는 신지 않는다
6. 간단한 발운동을 매일한다
7. 면양말을 매일 갈아 신는다
② 하지 말아야할일 X
1. smoke
2. hot water
3. 하지에 더운물 주머니(heating pad)를 사용하지 않는다
4. corn(티눈)이나 굳은살, blisters (물집)을 함부로 제거하지 않는다
5. barefoot(맨발)로 다니지 않는다
6. ★soak feet (발을 물에 담그지 말아라)
7. 다리를 cross (꼬지) 않는다
- Wash your feet every day with lukewarm (not hot) water and mild soap.
- Dry your feet well, especially between the toes.
- Use a soft towel and pat gently; don't rub.
- Keep the skin of your feet smooth by applying a cream or lanolin lotion, especially on the heels. If the skin is cracked, talk to your doctor about how to treat it.
- Keep your feet dry by dusting them with nonmedicated powder before putting on shoes, socks or stockings.
- Check your feet every day. You may need a mirror to look at the bottoms of your feet. Call your doctor at the very first sign of redness, swelling, pain that doesn't go away, or numbness or tingling in any part of your foot.
- Don't treat calluses, corns or bunions without talking to your doctor first.
- Cut toenails straight across to avoid ingrown toenails. It might help to soak your toenails in warm water to soften them before you cut them.
- Don't let your feet get too hot or too cold.
- Don't wear shoes without socks.
- Don't wear sandals or other open-toed shoes.
- Avoid high-heeled shoes and shoes with pointed toes.
- Wear well-padded socks or stockings that are 1/2 inch longer than your longest toe. Don't wear stretch socks, nylon socks, socks with an elastic band or garter at the top, or socks with inside seams.
- Don't wear uncomfortable or tight shoes that rub or cut into your feet. If you've had problems before because of shoes that didn't fit, you may want to be fitted for a custom-molded shoe.
- Talk to your doctor before you buy special shoes or inserts.
- Shop for new shoes at the end of the day when your feet are a little swollen. If shoes are comfortable when your feet are swollen, they'll probably be comfortable all day.
- Break in new shoes slowly by wearing them for no more than an hour a day for several days.
- Change socks and shoes every day. Have at least 2 pairs of shoes so you can switch pairs every other day.

키워드

당뇨,   DM,   인슐린,   혈당