{"id":2175,"date":"2021-05-04T11:54:06","date_gmt":"2021-05-04T11:54:06","guid":{"rendered":"https:\/\/practicalhealthpsychology.com\/?p=2175"},"modified":"2025-11-04T14:10:57","modified_gmt":"2025-11-04T14:10:57","slug":"how-to-support-patients-to-lose-weight-and-better-manage-their-type-2-diabetes-2","status":"publish","type":"post","link":"https:\/\/practicalhealthpsychology.com\/cz\/2021\/05\/how-to-support-patients-to-lose-weight-and-better-manage-their-type-2-diabetes-2\/","title":{"rendered":"Jak podpo\u0159it pacienty zhubnout a l\u00e9pe pracovat s cukrovkou 2. typu"},"content":{"rendered":"

Leah Avery – Teesside University, UK.<\/strong><\/p>\n

Cukrovka 2. typu byla pova\u017eov\u00e1na za progresivn\u00ed onemocn\u011bn\u00ed, s\u00a0nutnost\u00ed insulinov\u00e9 terapie. Tuto pesimistickou progn\u00f3zu p\u0159esto zpochyb\u0148uje v\u00fdzkum, zam\u011b\u0159uj\u00edc\u00ed se na behavior\u00e1ln\u00ed zm\u011bnu \u017eivotn\u00edho stylu<\/a>. Spolu se zvy\u0161uj\u00edc\u00ed se prevalenc\u00ed cukrovky 2. typu p\u0159ich\u00e1zej\u00ed d\u016fkazy podporuj\u00edc\u00ed d\u016fle\u017eitou roli stravy a zm\u011bny stravov\u00e1n\u00ed pro\u00a0\u00fasp\u011b\u0161n\u00e9 zvl\u00e1dnut\u00ed tohoto stavu.<\/p>\n

Dietn\u00ed p\u0159\u00edstupy mohou b\u00fdt rozd\u011bleny na dva. Ty, kter\u00e9 se zam\u011b\u0159uj\u00ed na to, co j\u00edme (nap\u0159. cukry), abychom optimalizovali metabolismus a glykemickou kontrolu pomoc\u00ed postupn\u00e9ho sni\u017eov\u00e1n\u00ed v\u00e1hy. Ostatn\u00ed, kter\u00e9 se zam\u011b\u0159uj\u00ed na sn\u011bden\u00e9 mno\u017estv\u00ed, jako nap\u0159. n\u00edzko kalorick\u00e1 dieta obsahuj\u00edc\u00ed signifikantn\u00ed omezen\u00ed pro rychl\u00fd \u00fabytek v\u00e1hy.<\/p>\n

<\/p>\n

    \n
  1. N\u00edzko sacharidov\u00e1 dieta<\/li>\n<\/ol>\n

    V\u00a0minulosti bylo doporu\u010dov\u00e1no, aby lid\u00e9 s\u00a0cukrovkou 2. typu udr\u017eovali dietu s\u00a0n\u00edzk\u00fdm obsahem cukru v\u00a0potravin\u00e1ch bohat\u00fdch na sacharidy, proto\u017ee se p\u0159edpokl\u00e1dalo, \u017ee tyto potraviny uvol\u0148uj\u00ed cukry postupn\u011b. V\u00a0sou\u010dasnosti v\u00edme<\/a>, \u017ee potraviny bohat\u00e9 na sacharidy vylu\u010duj\u00ed cukry do krve rychleji ne\u017e j\u00eddla obsahuj\u00edc\u00ed cukr. P\u0159esto\u017ee je tento p\u0159\u00edstup st\u00e1le pou\u017e\u00edv\u00e1n u lid\u00ed s\u00a0cukrovkou 2. typu, m\u011bl by b\u00fdt odm\u00edtnut, proto\u017ee zamezuje glykemick\u00e9 kontrole.<\/p>\n

    Sou\u010dasn\u00e9 studie nazna\u010duj\u00ed pot\u0159ebnost podpory lid\u00ed s cukrovkou 2. typu p\u0159i\u00a0omezen\u00ed p\u0159\u00edjmu sacharid\u016f pomoc\u00ed alternativn\u00edch potravin. To znamen\u00e1 nau\u010dit je, jak\u00e9 potraviny maj\u00ed vysok\u00fd obsah sacharid\u016f a jak m\u011b\u0159it osobn\u00ed p\u0159\u00edjem potravy (doporu\u010duje se strategie samosledov\u00e1n\u00ed). Pot\u00e9 by m\u011bl b\u00fdt pacient podporov\u00e1n ve sn\u00ed\u017een\u00ed p\u0159\u00edjmu sacharid\u016f pomoc\u00ed nastaven\u00ed c\u00edl\u016f a vytvo\u0159en\u00edm ak\u010dn\u00edch pl\u00e1n\u016f (kdy, kde a jak sn\u00ed\u017e\u00ed vysoko-sacharidov\u00e9 potraviny) a pl\u00e1n\u016f zvl\u00e1d\u00e1n\u00ed (kdy\u017e se setk\u00e1m s\u00a0p\u0159ek\u00e1\u017ekami, co pak ud\u011bl\u00e1m) a jak p\u0159ekonat p\u0159ek\u00e1\u017eky (nap\u0159. vysokosacharidov\u00e9 sva\u010diny, poku\u0161en\u00ed v\u00a0pr\u00e1ci) p\u0159i stravov\u00e1n\u00ed se\u00a0n\u00edzkosacharidov\u00fdmi potravinami. Zvy\u0161uje se po\u010det studi\u00ed podporuj\u00edc\u00edch roli sn\u00ed\u017een\u00ed sacharid\u016f<\/a> p\u0159i\u00a0\u00fasp\u011b\u0161n\u00e9m zvl\u00e1dnut\u00ed cukrovky 2. typu. Sni\u017eov\u00e1n\u00ed v\u00e1hy\u00a0n\u00edzkosacharidov\u00fdm p\u0159\u00edstupem<\/a> vede k\u00a0lep\u0161\u00edm v\u00fdsled\u016fm ne\u017e b\u011b\u017en\u00e9 sacharidov\u00e9 diety.<\/p>\n

    Ka\u017ed\u00fd pacient je unik\u00e1tn\u00ed, co\u017e p\u0159edstavuje v\u00fdzvu pro nastaven\u00ed optim\u00e1ln\u00edho sacharidov\u00e9ho p\u0159ijmu a s\u00a0t\u00edm spojen\u00fdm v\u00fdb\u011brem potravin. Nap\u0159\u00edklad, ka\u017ed\u00fd m\u00e1 vlastn\u00ed \u00farove\u0148 sacharidov\u00e9 tolerance, nap\u0159. kolik sacharid\u016f m\u016f\u017ee sn\u00edst p\u0159ed t\u00edm, ne\u017e to negativn\u011b ovlivn\u00ed jeho v\u00e1hu a glyk\u00e9mii. Podobn\u011b funguje osobn\u00ed pr\u00e1h tuku<\/a>, nap\u0159. n\u011bkte\u0159\u00ed lid\u00e9 s\u00a0cukrovkou 2. typu pot\u0159ebuj\u00ed hodn\u011b zhubnout, aby \u00fasp\u011b\u0161n\u011b korigovali sv\u00e9 glykemick\u00e9 hodnoty, zat\u00edmco jin\u00ed mohou dos\u00e1hnout glykemick\u00e9 kontroly s\u00a0men\u0161\u00edm \u00fabytkem v\u00e1hy. U n\u011bkter\u00fdch lid\u00ed se nav\u00edc vyvine cukrovka typu 2 s mnohem ni\u017e\u0161\u00edm BMI indexem ne\u017e u jin\u00fdch a osobn\u00ed pr\u00e1h tuku m\u016f\u017ee \u010d\u00e1ste\u010dn\u011b vysv\u011btlit pro\u010d. M\u00edsto, kde pacient ukl\u00e1d\u00e1 tuk (nap\u0159. predominantn\u011b kolem org\u00e1n\u016f nebo kolem vn\u011bj\u0161\u00edch okraj\u016f t\u011bla) a osobn\u00ed pr\u00e1h tuku m\u016f\u017ee pomoci vysv\u011btlit n\u011bkter\u00e9 rozd\u00edly v\u00a0reakc\u00edch na diety. Tak\u00e9 to m\u016f\u017ee pomoci vysv\u011btlit, pro\u010d diety pro jednoho funguj\u00ed, zat\u00edmco pro jin\u00e9ho ne. M\u016f\u017ee b\u00fdt u\u017eite\u010dn\u00e9 sd\u011blit tyto informace pacient\u016fm a vysv\u011btlit jim, pro\u010d p\u0159\u00edstup, kter\u00fd zvolili, pro n\u011b nemus\u00ed b\u00fdt vhodn\u00fd.<\/p>\n

      \n
    1. N\u00edzkokalorick\u00e9 diety<\/li>\n<\/ol>\n

      To je potencion\u00e1ln\u00ed p\u0159elom pro nov\u011b diagnostikovan\u00e9 (do 6 let) pacienty s\u00a0cukrovkou 2. typu. N\u00edzko kalorick\u00e1 dieta navozuje rychl\u00fd \u00fabytek v\u00e1hy k\u00a0remisi cukrovky 2 typu (nediabetick\u00fd stav, nemus\u00ed u\u017e\u00edvat diabetick\u00e9 l\u00e9ky). Obsahuje konzumaci n\u00edzkoenergetick\u00e9 j\u00eddlo-nahrazuj\u00edc\u00ed diety (po dobu 12\u201320 t\u00fddn\u016f), jej\u00edm\u017e c\u00edlem je sn\u00ed\u017een\u00ed hmotnosti o 15 kilo. Pak n\u00e1sleduje znovu p\u0159edstaven\u00ed potravin (2\u20138 t\u00fddn\u016f) a behavior\u00e1ln\u00ed podpora od zdravotn\u00edk\u016f (nap\u0159. zdravotn\u00ed sestry) k\u00a0udr\u017een\u00ed v\u00e1hov\u00e9ho \u00fabytku. Velk\u00e9 mno\u017estv\u00ed v\u00fdzkum\u016f o t\u00e9to diet\u011b prok\u00e1zalo, \u017ee v\u00edce ne\u017e polovina \u00fa\u010dastn\u00edk\u016f dos\u00e1hla remise diabetu po 1 roce. Ned\u00e1vno publikovan\u00fd v\u00fdzkum<\/a> ukazuje, \u017ee tento efekt m\u016f\u017ee p\u0159etrv\u00e1vat po dobu 2 let.<\/p>\n

      Ot\u00e1zkou je, kter\u00fd dietn\u00ed p\u0159\u00edstup je efektivn\u011bj\u0161\u00ed? Odpov\u011b\u010f je jednoduch\u00e1: ten, kter\u00fd mohou pacienti dodr\u017eovat a nejl\u00e9pe pro n\u011b funguje. Pacienti budou m\u00edt osobn\u00ed preference a postoje spojen\u00e9 s\u00a0mo\u017enost\u00ed zm\u011bny stravov\u00e1n\u00ed, co\u017e bude ovlivn\u011bn\u00e9 jejich motivac\u00ed zhubnout. N\u011bkte\u0159\u00ed budou preferovat n\u00edzkokalorickou dietu pro rychl\u00fd \u00fabytek v\u00e1hy, a aby se vyhnuli inzul\u00ednov\u00e9 l\u00e9\u010db\u011b. Z\u00e1rove\u0148 v\u00a0po\u010d\u00e1te\u010dn\u00ed f\u00e1zi diety se nemus\u00ed p\u0159em\u00fd\u0161let o v\u00fdb\u011bru potravin a p\u0159\u00edprav\u011b j\u00eddel. Jin\u00ed mohou preferovat n\u00edzko sacharidov\u00fd p\u0159\u00edstup, proto\u017ee se cht\u011bj\u00ed nau\u010dit zdrav\u011b va\u0159it, sni\u017eovat v\u00e1hu postupn\u011b a dlouhodob\u011b zm\u011bnit zp\u016fsob stravov\u00e1n\u00ed. Tento p\u0159\u00edstup tak\u00e9 zahrnuje jezen\u00ed potravin po celou dobu a vyh\u00fdb\u00e1 se n\u00e1hra\u017ek\u00e1m.<\/p>\n

      Jak odborn\u00edci vyberou spr\u00e1vn\u00fd dietn\u00ed p\u0159\u00edstup pro pacienty s\u00a0cukrovkou 2. typu a jak jim daj\u00ed pot\u0159ebnou podporu?<\/p>\n

      Praktick\u00e1 doporu\u010den\u00ed:<\/p>\n

        \n
      1. Je d\u016fle\u017eit\u00e9, \u017ee odborn\u00edci jsou facilit\u00e1to\u0159i a ne instrukto\u0159i. Vyhn\u011bte se v\u00fdb\u011bru prav\u00e9ho dietn\u00edho p\u0159\u00edstupu za pacienty. Zkou\u0161ejte porozum\u011bt jejich osobn\u00ed motivaci pro sn\u00ed\u017een\u00ed v\u00e1hy, minul\u00e9 zku\u0161enosti, preference k dietn\u00edm p\u0159\u00edstup\u016fm a p\u0159ek\u00e1\u017eky, kter\u00e9 zabra\u0148uj\u00ed zm\u011bn\u011b diety.<\/li>\n
      2. Poskytn\u011bte pacient\u016fm evidence-based informace, kter\u00e9 jim pomohou porozum\u011bt, co mus\u00ed ud\u011blat\/nau\u010dit se pro ka\u017ed\u00fd dietn\u00ed p\u0159\u00edstup (nap\u0159. Diabetes UK; informa\u010dn\u00ed odkaz na n\u00edzko kalorickou dietu<\/a> a n\u00edzko sacharidovou dietu<\/a>). Informace by m\u011bly obsahovat detailn\u00ed informace o charakteristik\u00e1ch ka\u017ed\u00e9ho dietn\u00edho pl\u00e1nu, obsahuj\u00edc\u00ed mo\u017en\u00e9 vedlej\u0161\u00ed \u00fa\u010dinky, znalosti a dovednosti, kter\u00e9 si budou muset osvojit, aby byli \u00fasp\u011b\u0161n\u00ed.<\/li>\n
      3. Pokl\u00e1dejte otev\u0159en\u00e9 ot\u00e1zky, abyste zjistili preferenci pro dietn\u00ed pl\u00e1n, motivaci ke ztr\u00e1t\u011b v\u00e1hy a p\u0159ek\u00e1\u017eky zabra\u0148uj\u00edc\u00ed dietn\u00ed zm\u011bn\u011b:\n
          \n
        • Kter\u00e9 mo\u017enosti byste se pravd\u011bpodobn\u011b dr\u017eeli?<\/li>\n
        • \u010ceho si p\u0159ejete hubnut\u00edm dos\u00e1hnout?<\/li>\n
        • Co by v\u00e1m mohlo zabr\u00e1nit v dodr\u017eov\u00e1n\u00ed zvolen\u00e9ho dietn\u00edho pl\u00e1nu?<\/li>\n<\/ul>\n<\/li>\n
        • Podpo\u0159te pacienty, aby hledali soci\u00e1ln\u00ed podporu, nap\u0159. partner, rodina nebo kamar\u00e1d. Kdo by jim mohl poskytnout emo\u010dn\u00ed a praktickou podporu?<\/li>\n
        • V\u00a0p\u0159\u00edpad\u011b pot\u0159eby dodejte pozitivn\u00ed podporu. To m\u016f\u017ee obsahovat poskytnut\u00ed pozitivn\u00ed zp\u011btn\u00e9 vazby na jakoukoliv snahu, kterou pacient projev\u00ed na sv\u00e9 cest\u011b ke zm\u011bn\u011b stravov\u00e1n\u00ed (nap\u0159. vytvo\u0159en\u00ed podrobn\u00e9ho pl\u00e1nu na zm\u011bnu stravov\u00e1n\u00ed); jak\u00fdkoliv \u00fasp\u011bch (nap\u0159. skute\u010dn\u00e9 zm\u011bny diety v\u00a0minul\u00fdch dnech, t\u00fddnech); pozitivn\u00ed koment\u00e1\u0159e na prosp\u011b\u0161n\u00fd dopad t\u011bchto zm\u011bn na v\u00e1hu, glykemii (nap\u0159. jak\u00e9koliv m\u011b\u0159iteln\u00e9 zm\u011bny).<\/li>\n<\/ol>\n

          \u00a0<\/em><\/p>\n

          [P\u0159elo\u017eila Krist\u00fdna Anna \u010cern\u00edkov\u00e1]<\/em><\/p>\n

           <\/p>\n","protected":false},"excerpt":{"rendered":"

          By Leah Avery, Teesside University, UK. Type 2 diabetes was previously considered a progressive condition, with an inevitable need for insulin therapy, however lifestyle behavioural change research challenges this pessimistic prognosis. As prevalence of type 2 diabetes continues to increase, […]<\/p>\n","protected":false},"author":1,"featured_media":2222,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[28,7,27,20],"tags":[],"class_list":["post-2175","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-communication","category-incentives","category-motivation","category-social-support"],"translation":{"provider":"WPGlobus","version":"3.0.2","language":"cz","enabled_languages":["en","id","my","bg","zh","hr","cz","da","de","es","fr","gr","he","it","ja","kr","lv","lt","hu","nl","no","pl","pt","ro","ru","sk","fi","sv","tr","uk"],"languages":{"en":{"title":true,"content":true,"excerpt":false},"id":{"title":true,"content":true,"excerpt":false},"my":{"title":true,"content":true,"excerpt":false},"bg":{"title":true,"content":true,"excerpt":false},"zh":{"title":true,"content":true,"excerpt":false},"hr":{"title":false,"content":false,"excerpt":false},"cz":{"title":true,"content":true,"excerpt":false},"da":{"title":true,"content":true,"excerpt":false},"de":{"title":true,"content":true,"excerpt":false},"es":{"title":true,"content":true,"excerpt":false},"fr":{"title":true,"content":true,"excerpt":false},"gr":{"title":true,"content":true,"excerpt":false},"he":{"title":true,"content":true,"excerpt":false},"it":{"title":true,"content":true,"excerpt":false},"ja":{"title":true,"content":true,"excerpt":false},"kr":{"title":false,"content":false,"excerpt":false},"lv":{"title":true,"content":true,"excerpt":false},"lt":{"title":false,"content":false,"excerpt":false},"hu":{"title":false,"content":false,"excerpt":false},"nl":{"title":true,"content":true,"excerpt":false},"no":{"title":true,"content":true,"excerpt":false},"pl":{"title":true,"content":true,"excerpt":false},"pt":{"title":false,"content":false,"excerpt":false},"ro":{"title":false,"content":false,"excerpt":false},"ru":{"title":true,"content":true,"excerpt":false},"sk":{"title":true,"content":true,"excerpt":false},"fi":{"title":true,"content":true,"excerpt":false},"sv":{"title":false,"content":false,"excerpt":false},"tr":{"title":true,"content":true,"excerpt":false},"uk":{"title":true,"content":true,"excerpt":false}}},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/posts\/2175","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/comments?post=2175"}],"version-history":[{"count":45,"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/posts\/2175\/revisions"}],"predecessor-version":[{"id":4575,"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/posts\/2175\/revisions\/4575"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/media\/2222"}],"wp:attachment":[{"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/media?parent=2175"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/categories?post=2175"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/tags?post=2175"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}