sljtf ltdlN;gf,@@ jif{sL 5fqf x'g\ pgL k]zfn] u|flkms l8hfO{g/sf] sfd ul5{g, la P k|yd aif{df cWoog/t l5g\ . Ps dlxgf cl3af6 cToflws ysfO{, ef]s, ltvf{ nfUg] ug{ yfNof], lk;fa klg l56f] l56f] hfg yfNg' k¥of], d'v ;'s]sf] cg'ej x'GYof] . tf}n klg pgsf] 36]sf] /x]5 . /jLGb| k|wfg %) jif{ oL k|f}9 JolQm af/Daf/ v'§fsf] 3fpsf] nflu cf}iflw k;naf6 cf}iflw vfg] / 8]«l;Ë ug]{ ubf{ /x]5g\ . 3fp lgsf] gePsf] x'gfn] pgL lrlGtt aGb} hfg yfn] . oL b'O{ JolQmx? h;sf] ;d:ofsf] pkrf/ x'Fbf x'Fb} klg lgsf] x'g g;Sbf Ps lbg pgLx?sf] /utsf] k/LIf0f ubf{ yfx eof] sljtfsf] z/L/df lrgLsf] dfqf $@^ mg/dl lyof] t /jLGb|sf] #^) mg/dl . xf] oL b'O{ dw'd]xsf] lzsf/ eO;s]sf /x]5g\ .
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dflg;sf]
z/L/df Kofªlqmofh eGg] u|GyL x'G5, h;sf] la6f ;]naf6 OG;'lng xdf]{g
lg:sG5 . vfgfaf6 k|fKt Un'sf]h cyf{t ;'u/ /utsf] dfWodaf6 z/L/sf]
;Dk"0f{ sf]ifdf k'¥ofpg] sfd OG;'lngsf] xf] . ;fdfGotof :j:Yo
JolQmsf] z/L/df b}lgs $)–%) OG6/g]zgn o'lg6 OG;'lng pTkfbg x'G5 . oxL
OG;'lngsf] sdL eP/ jf sfd ug{ g;s]/ jf k"0f{ pTkfbg aGb eP/ /utdf lrgLsf]
cToflws dfqf a9\g] cj:yf dw'd]x -8fOj]l6h_ xf] . gf]6M /utdf
lrgLsf] dfqf ^)-!@) mg/dl -vfnL
k]6sf] nflu_ lnO{G5 .
k|sf/x?
k|sf/ Ps: OG;'lng pTkfbg g} x'Fb}g, sd pd]/ ;d"xsf
dflg;df b]lvG5 . aflx/af6 OG;'lng lbg}kb{5 . k|sf/ b'O{M OG;'lng
pTkfbg sd x'Fb} hfG5 jf ePsf] OG;'lngsf] sfd ug]{ u'0f:t/ 36\b} hfG5 .
;fdfGotof $) jif{kl5 o; k|sf/sf] dw'd]x b]lvG5 .
nIf0fx?
cToflws
ltvf{, cToflws ef]s, cToflws lk;fa, tf}n 36\b} hfg', z/L/ d'Votof of}gfË a9L g}
lrnfpg', w]/} sdhf]/ x'g', ysfO{ nfUg', xftv'§f uNg' tyf emdemd ug'{, cfFvf
wldnf] x'Fb} hfg' , 3fp nfdf] ;do;Dd lgsf] gx'g', $÷% s]hL tf}nsf aRrf
kfpg] cfdfx?
dw'd]xnfO{ lgoGq0f
s;/L ug]{
dw'd]x
cfh lbgk|ltlbg a9\bf] :jf:Yo ;d:ofsf] ?kdf b]lvFb} 5 . d'Votof of] /f]u
xf]Og of] t z/L/sf] cfkm\g} sdhf]/Lsf] pkh xf] eGg] e'Ng x'Fb}g . o;n]
/utsf gnL, d[uf}nf, cfFvf, d'6', sn]hf] h:tf dxTjk"0f{ cu+nfO{ Iflt
k'¥ofpFb} n}hfG5 . d'w'd]xsf] 8fS6/ :jo+ tkfO{ la/fdL g} xf] .
kfFrj6f d'Vo pkfox?
cfxf/,
laxf/,
;bfrf/,
pkrf<,
Follow
up
cfxf/
dw'd]xsf
la/fdLn] vfgfnfO{ d'Vo Wofg lbg' h?/L 5 . vfgf vfFbf Wofg lbg'kg]{
s'/fx?df, vfgfsf] u'0f:t/ -Quality of Food_,vfgfsf]
dfqf -Quantity of Food _,vfgfsf]
;do -Time_; oL s'/fx?nfO{ cjnDag ub}{
lgoldt ?kdf vfgf vfg' k5{ . vfgf vfFbf ;Gt'lnt ef]hg ldnfP/ h:t} vfgf,
/f]6L, l98f]+, ds}sf] eft, bfn, t/sf/L, vfg' /fd|f] dflgG5 . k|z:t xl/of]
;fukft, u]8fu'8Lx?, kmnkm"nx?, cgf/, df};d, ;'Gtnf, d]jf vfg ;lsG5 .
t]nsf]
k|of]u sd ug'{ kb{5 . vfhf vfFbf yf]/} Ro"/f, b'w, u]8fu'8L, ds},
/f]6L vfg ;lsG5 . yf]/} dfqfdf df5f, df;' klg vfg' kb{5 . lrgL /
o;af6 ag]sf vfB kbfy{x?M lrof, xln{S;, dx, lr;f] k]o kbfy{, rsn]6, la:s'6x?,
v'bf], rfs' vfg' x'Fb}g . u'lnof] lrof vfg dg nfu]sf :oflqmgsf] k|of]u
pko'Qm b]lvG5 . eftM c?jf rfdn / pl;gf rfdndf s'g} km/s 5}g . ds} jf
ux'Fdf rf]s/÷ e';sf] dfqf a9L x'gfn] l9nf] kRg], sd Sofnf]/L lbg] / k]6 c3fPsf]
cg'ej x'g] x'Fbf eft eGbf oL vfgfx? pko''Qm x'G5g\ . /]zfbf/M v;|f] vfgf
h:t} v;|f] lk7f], af]s|f ;lxtsf] kmnk"mn, 6';f pdf/]sf] u]8fu'8L vfg'
kb{5 . v;|f] vfgf kRg / cfGb|fåf/f ;f]Rg l9nf] x'g] x'Fbf o:tf] vfgfn]
lrgLsf] zf]if0f l9nf] u/fO{ /utdf lrgLsf] dfqf a9\g lbFb}g .
Jofofd
ofu],Wofg
dfq gu/L rnfodfg Jofofd h:t} lx8g', bf}l8g', kf}8L v]Ng', 8f]/L v]Ng' pko'Qm
x'G5 . o;n] lrgLsf] pkof]u a9fO{ lrgLsf] dfqf /utdf sd kf5{ ;fy} z/L/n]
lrgL pkof]u ug]{ Ifdtfdf a[l4 u5{, ;fy;fy} tf}n 36fpF5 . /Qm ;~rfngdf
;'wf/ NofpF5 . Jofofd ubf{ 8fS6/sf]
;Nnfx lng' kb{5 .
Jofofd
ug'{ cufl8 cfkm\gf] /Qm k/LIf0f ug'{k5{ . Jofofd kZrft klg /Qm k/LIf0f
ug'{xf]; / leGgtf yfx kfpg'xf]; . klxnf] k6s ;'? ub}{ x'gx'G5 eg] b}lgs
%–!) ldg]6 ub}{ qmdzM a9fpFb} nfg'kb{5 . k|;:t kfgL vfg' / d'v ;'Vvf
x'gaf6 /f]Sg' . /f]uLn] laxfg vfhf of kmnkm"n vfPsf] !% ldg]6 kl5
Jofofd ug'{ k5{ . ljxfg @) ldg]6 b]lv ! 306f lx8\g' pko'Qm dflgG5 .
Jofofd ubf{ h'Qf / n'uf cfkm"nfO{ ;lhnf] / ;'xfpFbf] x'g' k5{ .
;bfrf/
sljtf
ltldlN;gf cfk"mnfO{ dw'd]x ePsf] yfx kfPkl5 lrlGtt b]lvg], cfkm\gf]
JolQmTj, k9fO{, sfd / cfTd;Ddfgdf rf]6 k'Ug] eof] eGb} ;f]lr/xg] / ?g]
uly{g\ . To:t} /jLGb| k|wfg 3fp lgsf] gx'g] 8/n] zf]sdf kl//xGy] .
lgoldt vfgf gvfg], lgb|f gkg]{ / 8/ qf;n] cf}iflwsf] ;xL ;]jg gubf{ /utdf
lrgLsf] dfqf lgoGq0f x'g ;s]sf] lyPg\ kl5 lgoldt r]s ck, cf}iflw, OG;'lngsf]
k|of]u, cfxf/ , laxf/ cflbn] hLjgz}nLdf kl/jt{g NofP/ lrgLsf] dfqf lgolGqt
x'Fbf b'j} v';L 5g\ / b}lgsLnfO{ v';L ;fy lg/Gt/tf lbO{ /x]sf 5g\ . ;fbf
vfgkfg, ;/n p7a;, ;fbf hLjg, kfl/jfl/s d]n, cfkm"df g} k"0f{ ePsf]
cg'ej, nf]e nfnr / 3[0ffaf6 d'lQm, b}lgs ;/;kmfO{, lx8fO{, k|fy{gf, ;'tfO{df
;lhnf]kg cflb ckgfpg] ;Defljt hf]lvdaf6 aRg ;lsG5 .
pkrf<
dw'd]xsf
/f]uLx?n] /f]usf] k|sf/, pd]/ tyf cj:yf cg';f/ ljleGg cf}iflw -8fS6/sf] ;Nnfx
cg';f/_ k|of]u ug'{ h?/L 5 . d'vaf6 vfg] cf}iflwx? (Oral
Hypoglycemic agent) 1º ;Nkmf]gfOno'l<ofh2º d]unLl^gfO*3º
gfl^lUnLgfO*4º jfOUjfgfO* 5º yfof]hf]nLl*g]*fof]G;6º Psf<jf]h
OG;'lng
olb
d'vaf6 vfg] cf}iflwn] dfq sfd gu/]df jf k|sf/ Ps dw'd]xdf jf ue{jtL dw'd]x
/f]uLn] o;sf] k|of]u ug]{k5{ . :d/0fLo s] 5 eg], OG;'lng nufpg] 7fpFdf
vfg] cf}iflw dfq}n] k'Ub}g . OG;'lngn] b}lgs hLjgdf s'g} klg gsf/fTds
k|efj kfb}{g / afFRg] cjlw klg 36fpFb}g . lrlsT;ssf] ;Nnfx adf]lhd
OG;'lngsf] k|sf/ lng] ljlw / 7fpF, vfgf;Fusf] ;DaGw /utdf lrgL PSsf;L sd x'g]
cj:yf -xfOkf]UnfO;f]ldof_ yfx kfpg' kb{5 . olb cf}iflwsf] lgoldt ;]jg ug'{
ePsf] 5 t/ kmnf] ckdf hfg' ePsf] 5}g . lgoldt lrgLsf] hfFr ul/Psf] 5}g eg]
pkrf/ k|lqmof k|efjsf/L gx'g ;S5 . l/u6f nfUg], vnvnL kl;gf cfpg],
xftuf]8f sfDg], d'6'sf] w8\sg t]h;Fu a9\g] nIf0f b]vf k/]df /utdf lrgLsf] dfqf
cToflws sd ePsf] cj:Yff xfOkf]UnfO;]ldof
klg ePsf] x'g ;S5 .o:tf] cj:yfdf t'?Gt lrgL, dx, rsn]6 vfg'÷v'jfpg' k5{ /
t'?Gt c:ktfn nfg' kb{5 .
v'§f ;DaGwL x]/rfx
dw'd]xsf]
sf/0fn] v'§fsf g;fx? gi6 x'g] k|jn ;Defjgf x'G5 . xftv'§f emDemdfpg],
5f]Psf] yfx gx'g], rf]6k6s nfu]sf] yfx gx'g], 3fp a9\b} hfg], df;' ;8\g] /
slxn]sfxL v'§f u'dfpg' kg]{ gfh's cj:yf cfpg ;Sb5g\ . h;sf] pbfx/0f /jLGb|
k|wfg x'g\ .ug'{kg]{ s'/fx? Mv'§f ;kmf
/fVg] / ;fa'gn] g/d u/L ldr]/ w'g] . g'xfPkl5 v'§fnfO{ g/d tf}lnofn]
k'5\g] . v'§fsf gËx? ldnfP/ sf6\g] / w]/} ulx/f] u/L gsf6\g] .
;'/lIft, cf/fdbfoL, /fd|f] ldNg] / k'/f v'§f 9fSg] h'Qf nufpg] / e/;s rKkn
gnufpg] . g/d lrNnf] kbfy{ yf]/} nufP/ /fd|/L dfln; ug]{ . ;Fw} ;kmf
df]hfsf] k|of]u ug]{ . v'§fnfO{ w]/} leh]sf] cyjf ;'Vvf cj:yfdf
g/fVg] . 5fnf plSsPsf] 5 eg] slxn] klg tfGg] sfd gug]{
cfFvf ;DaGwL x]/rfx
dw'd]xsf
/f]uLx?nfO{ cfFvfsf] ;d:of x'g;S5, ;d:of a9\b} uPdf cGwf]kg ;d]t lgDTofpg
;S5 . s'g} nIf0f gb]lvOsg cfFvf v/fa x'g] cj:yf w]/} cg'ej ul/Psf]
5 . ug'{kg]{ s'/fx? McfFvfdf
s]xL hl6ntf 5 eg] uuN; cyjf ;'/lIft r:df k|of]u ug]{ . s8f 3fddf ;g Unf;
k|of]u ug]{ . /ftf] tyf b'Mv]sf] cfFvfsf] t'?Gt pkrf/ ug]{ .
pRRf <Qmrfk < dw'd]o
pRr
<Qmrfk sf] cj:yf bLw{sfnLg <xFbf o;n] d'^'n] ug'{kg]{ sfddf cˆ^f<f]
dfq kfb}{g <QmgnLx?NffO{ klg s*f agfpFb} n}hfG% M h;n] d'^' < dl:tsnfO{
c;< ub}{ nu]< d[To" ;d]t u<fpFb% M olb dw'd]x klg ePsf] v)*df t
emg oL cj:yfx? eofex x'G%g\ To;}n] tkfO{x?n] lgoldt ?kdf Jn* k|];< hfFr
u<fpg'k%{ h'g 130/80 mm Hg eGbf sd x'g' kb{% M
<utdf lrlgsf] dfqf hfFr u<fpg]
JolQmx?nfO{ cfjZos hfgsf<L
1.
h'g;'s} a]nf <utdf lrgLsf] dfqf hfFr ug'{nfO{ RBS elgG%
M olb dw'd]xsf nI)fx? ;lxt 200 Mg/dl ePdf dw'd]x ePsf]
x'g;S% M 2. <ftL xNsf vfg vfO{,laxfg lrof ;d]t gvfO{ ul<g] lrgLsf] dfq
hfFr ug'{nfO{ FBS elgG% M dw'd]x gePsf
JolQmdf of] 100 mg/dL eGbf sd x'g'
h?<L % M dw'd]x ePsf lj<fdLdf of] 126 mg/dL
eGbf a(L b]lvG% M 3. vfgf vfPsf] l^s 2 #)^f df g} <utdf ul<g] lrgLsf]
dfqf hfFrnfO{ PP elgG% Mdw'd]xsf
lj<fdLdf of] 200 mg/dl x'G% M 4. HbA1C
(UnfO{sf];fOn]^]* x]df]Unf]ljg)
Pp^f o:tf] <utdf lrgLsf] dfqf hfFr xf] h;n] ljut 3 dlxgfsf] hfgsf<L lbG%
o;sf] vfgf;Fu ;DaGw gePsf]n] of] hfFr k|efjsf<L b]lbG% M dw'd]xsf lj<dfLdf of] 7 eGbf sd x'g' kb{% M
5
C-peptide - 24 )^f sf] lk;fa ;_sng ug'{kb{% <
OG;'lng aGg] k|lsofdf c-peptide lg:sG% ,
o;n] z<L<df OG;'lngsf] dfqf slt % yfxf lbG% M OG;'lng lnO{ <x]sf
la<fdLdf OG;'lngsf] dfqf yk#^ ug{ of] kl<If)f Psbd} k|efjsf<L % M
;f+/fz
dw'd]xsf
la/fdLx?n] clgjfo{ ?kdf k|To]s tLg dlxgfdf UnfO{sf];fOn]6]6
x]df]Unf]ljg k/LIf0f ug]{, Fasting Blood
Sugar 100 mg Idl eGbf sd <fVg] sf]zLz u<f}_ <
cfjZostf cg';f< k<LIf)f u<f}_ M HbA1c %
eGbf sd <fVg] < k|To]s 3-3 dlxgfdf k<LIf)f u<f}_ M LDL
sf]n]:^]<f]n 100 mgldl
eGbf sd kf<f}_ M Jn* k|];< 130/80 mm
Hg eGbf sd kf<f}_ M k|To]s 6
dlxgfdf cfFvf tyf lk;fj œd[uf}nfº PNa'ldgsf] hfFr u<f}_ M
cGTodf dw'd]x
/f]uLn] cfkm\gf] ;fydf ;b}j ld7fO{, Un'sf]h, kl/ro kq /fVg] afgLsf] yfngL
ug'{xf]; .
