{"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\/sk\/2021\/05\/how-to-support-patients-to-lose-weight-and-better-manage-their-type-2-diabetes-2\/","title":{"rendered":"Ako podpori\u0165 pacientov k strate hmotnosti a lep\u0161ie zvl\u00e1da\u0165 ich diabetes 2. typu"},"content":{"rendered":"

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

Cukrovka 2. typu sa predt\u00fdm pova\u017eovala za postupne sa zhor\u0161uj\u00facu chorobu s nevyhnutnou potrebou inzul\u00ednovej terapie, av\u0161ak v\u00fdskum zmeny \u017eivotn\u00e9ho \u0161t\u00fdlu spochyb\u0148uje t\u00fato pesimistick\u00fa progn\u00f3zu. S pokra\u010duj\u00facim n\u00e1rastom prevalencie cukrovky 2. typu sa objavuj\u00fa \u010fal\u0161ie d\u00f4kazy, ktor\u00e9 ukazuj\u00fa, ak\u00e1 d\u00f4le\u017eit\u00e1 je \u00faloha jedla a zmeny stravovania,aby sme tento stav \u00faspe\u0161ne zvl\u00e1dli.<\/p>\n

Di\u00e9tne pr\u00edstupy sa daj\u00fa zv\u00e4\u010d\u0161a rozdeli\u0165 na dva. Tie, ktor\u00e9 sa zameriavaj\u00fa na to, \u010do jeme (napr. sacharidy), aby optimalizovali metabolizmus a glykemick\u00fa kontrolu pomocou pomal\u00e9ho a stabiln\u00e9ho chudnutia. Ostatn\u00e9, ktor\u00e9 sa zameriavaj\u00fa na konzumovan\u00e9 mno\u017estvo, napr\u00edklad n\u00edzkokalorick\u00e1 strava zah\u0155\u0148a v\u00fdrazn\u00e9 energetick\u00e9 obmedzenie energetick\u00e9ho pr\u00edjmu. Ide o r\u00fdchle chudnutie.<\/p>\n

<\/p>\n

    \n
  1. Di\u00e9ta s n\u00edzkym pr\u00edjmom sacharidov <\/strong>(<\/strong>low-carb)<\/strong><\/li>\n<\/ol>\n

    Predt\u00fdm sa odpor\u00fa\u010dalo, aby \u013eudia s cukrovkou typu 2 udr\u017eiavali stravu s n\u00edzkym obsahom cukru a prij\u00edmali potraviny bohat\u00e9 na sacharidy, preto\u017ee sa verilo, \u017ee tieto potraviny uvo\u013e\u0148uj\u00fa cukor do krvi postupne. Teraz vieme, \u017ee ve\u013ea potrav\u00edn bohat\u00fdch na sacharidy uvo\u013e\u0148uje cukor do krvi r\u00fdchlej\u0161ie ako sladk\u00e9 jedl\u00e1. Napriek tomu pr\u00edstup s n\u00edzkym obsahom cukru \/ vysok\u00fdm obsahom sacharidov st\u00e1le mnoho \u013eud\u00ed s cukrovkou 2. typu dodr\u017eiava a tento pr\u00edstup m\u00f4\u017ee zabr\u00e1ni\u0165 \u00fa\u010dinnej glykemickej kontrole a je potrebn\u00e9 sa mu vyhn\u00fa\u0165.<\/p>\n

    S\u00fa\u010dasn\u00e9 d\u00f4kazy nazna\u010duj\u00fa potrebu podpori\u0165 \u013eud\u00ed s cukrovkou 2. typu, aby zn\u00ed\u017eili pr\u00edjem sacharidov a rozhodli sa pre in\u00e9 potraviny. Mali by rozozn\u00e1va\u0165, ktor\u00e9 potraviny maj\u00fa vysok\u00fd obsah sacharidov a mera\u0165 ich pr\u00edjem v priebehu ur\u010dit\u00e9ho \u010dasu (t\u00e1to praktick\u00e1 strat\u00e9gia sa ozna\u010duje ako sebamonitorovanie). Potom by mal by\u0165 pacient podporovan\u00fd v zni\u017eovan\u00ed pr\u00edjmu sacharidov stanoven\u00edm cie\u013eov a vypracovan\u00edm ak\u010dn\u00fdch pl\u00e1nov (kedy, kde a ako zn\u00ed\u017eia obsah sacharidov) a zvl\u00e1dac\u00edch pl\u00e1nov, ako prekona\u0165 v\u0161etky prek\u00e1\u017eky. Je potrebn\u00e9 pom\u00f4c\u0165 pacientom vypracova\u0165 konkr\u00e9tne pl\u00e1ny, \u010do robi\u0165, ke\u010f naraz\u00ed na prek\u00e1\u017eku (napr. na poku\u0161enie da\u0165 si ob\u010derstvenie bohat\u00e9 na sacharidy v pr\u00e1ci). D\u00f4kazy podporuj\u00face zn\u00ed\u017eenie pr\u00edjmu sacharidov na \u00faspe\u0161n\u00e9 zvl\u00e1dnutie cukrovky typu 2 podporou chudnutia sa mno\u017eia, pri\u010dom pr\u00edstupy s n\u00edzkym obsahom sacharidov ved\u00fa k lep\u0161\u00edm v\u00fdsledkom ako mierne di\u00e9ty s obsahom sacharidov.<\/p>\n

    Ka\u017ed\u00fd pacient je v\u0161ak jedine\u010dn\u00fd, \u010do predstavuje v\u00fdzvu pre h\u013eadanie optim\u00e1lneho pr\u00edjmu sacharidov a s t\u00fdm spojen\u00fdch mo\u017enost\u00ed v\u00fdberu stravy. Napr\u00edklad jednotlivci maj\u00fa svoju vlastn\u00fa osobn\u00fa hladinu tolerancie k sacharidom, t. j. ko\u013eko sacharidov m\u00f4\u017eu zjes\u0165, k\u00fdm to negat\u00edvne ovplyvn\u00ed ich hmotnos\u0165 a kontrolu glyk\u00e9mie. Prahov\u00e1 hodnota osobn\u00e9ho tuku funguje podobn\u00fdm sp\u00f4sobom, to znamen\u00e1, \u017ee niektor\u00ed \u013eudia s cukrovkou 2. typu musia chudn\u00fa\u0165, aby \u00faspe\u0161ne zvl\u00e1dli svoje glykemick\u00e9 hladiny, zatia\u013e \u010do in\u00ed m\u00f4\u017eu dosiahnu\u0165 glykemick\u00fa kontrolu pri men\u0161om schudnut\u00ed. Okrem toho u niektor\u00fdch \u013eud\u00ed vznik\u00e1 cukrovka typu 2 s ove\u013ea ni\u017e\u0161\u00edm indexom telesnej hmotnosti (BMI) ako u in\u00fdch a osobn\u00e1 prahov\u00e1 hodnota tuku m\u00f4\u017ee \u010diasto\u010dne vysvetli\u0165 pre\u010do. To, kde sa pacientovi uklad\u00e1 tuk (tj. predov\u0161etk\u00fdm v org\u00e1noch a okolo nich alebo okolo vonkaj\u0161\u00edch okrajov tela) a jeho osobn\u00e1 hranica tuku definuj\u00fa a vysvet\u013euj\u00fa niektor\u00e9 rozdiely v reakcii na stravu. M\u00f4\u017ee to tie\u017e ozrejmi\u0165, pre\u010do di\u00e9ty funguj\u00fa pre niektor\u00fdch, ale nie pre druh\u00fdch. Je u\u017eito\u010dn\u00e9 ozn\u00e1mi\u0165 tieto inform\u00e1cie pacientom s cie\u013eom poskytn\u00fa\u0165 vysvetlenie, pre\u010do by pr\u00edstup, ktor\u00fd si vybrali, pre nich nemusel fungova\u0165.<\/p>\n

      \n
    1. N\u00edzkokalorick\u00e1 di\u00e9ta<\/strong><\/li>\n<\/ol>\n

      \u00a0<\/strong>Toto je potenci\u00e1lny prostriedok na ve\u013ek\u00fa zmenu pre \u013eud\u00ed s novodiagnostikovanou (do 6 rokov) cukrovkou 2. typu. N\u00edzkokalorick\u00e1 di\u00e9ta vyvol\u00e1va r\u00fdchle chudnutie, v\u010faka ktor\u00e9mu sa cukrovka 2. typu dostane do remisie (nediabetick\u00fd stav a u\u017e sa nepou\u017e\u00edvaj\u00fa antidiabetik\u00e1). Zah\u0155\u0148a to konzum\u00e1ciu n\u00edzkoenergetickej n\u00e1hrady stravy (po dobu 12 a\u017e 20 t\u00fd\u017ed\u0148ov), ktorej cie\u013eom je dosiahnu\u0165 cie\u013e \u00fabytku hmotnosti 15 kg. Nasleduje op\u00e4tovn\u00e9 zavedenie potrav\u00edn (2 a\u017e 8 t\u00fd\u017ed\u0148ov) a podpora zdrav\u00e9ho spr\u00e1vania od zdravotn\u00edckeho pracovn\u00edka (napr. zdravotnej sestry) na udr\u017eanie chudnutia. Rozsiahla \u0161t\u00fadia tejto di\u00e9ty zistila, \u017ee takmer polovica \u00fa\u010dastn\u00edkov dosiahla remisiu cukrovky po 1 roku. Ned\u00e1vno publikovan\u00fd v\u00fdskum uk\u00e1zal, \u017ee tieto \u00fa\u010dinky je mo\u017en\u00e9 udr\u017ea\u0165 po dobu 2 rokov.<\/p>\n

      Ak\u00fd stravovac\u00ed pr\u00edstup je v\u0161ak \u00fa\u010dinnej\u0161\u00ed? Odpove\u010f je \u00faplne jednoduch\u00e1: t\u00e1, ktorej sa m\u00f4\u017eu pacienti dr\u017ea\u0165, a ktor\u00e1 pre nich funguje najlep\u0161ie. Pacienti bud\u00fa ma\u0165 osobn\u00e9 preferencie a postoje spojen\u00e9 s mo\u017enos\u0165ami zmeny stravovania, ktor\u00e9 bud\u00fa ovplyvnen\u00e9 ich motiv\u00e1ciou pri chudnut\u00ed. Niektor\u00ed bud\u00fa uprednost\u0148ova\u0165 n\u00edzkokalorick\u00fa stravu, aby r\u00fdchlo schudli a vyhli sa progresii k inzul\u00ednovej lie\u010dbe. Po\u010diato\u010dn\u00e1 f\u00e1za di\u00e9ty zabr\u00e1ni nutnosti prem\u00fd\u0161\u013ea\u0165 o v\u00fdbere jedla a pr\u00edprave jedla. In\u00ed m\u00f4\u017eu uprednostni\u0165 pr\u00edstup s n\u00edzkym obsahom sacharidov, preto\u017ee sa chc\u00fa nau\u010di\u0165 vari\u0165 zdrav\u00e9 jedl\u00e1, postupne chudn\u00fa\u0165 a meni\u0165 sp\u00f4sob stravovania dlhodobo. Tento pr\u00edstup tie\u017e znamen\u00e1 jes\u0165 jedlo po\u010das cel\u00e9ho obdobia a nie v\u00fdrobky nahr\u00e1dzaj\u00face jedlo.<\/p>\n

      Ako <\/strong>maj\u00fa <\/strong>odborn\u00edci ur\u010di<\/strong>\u0165<\/strong> spr\u00e1vny stravovac\u00ed pr\u00edstup pre pacientov s cukrovkou 2. typu a n\u00e1sledne im poskytn\u00fa<\/strong>\u0165<\/strong> primeran\u00fa podporu?<\/strong><\/p>\n

      Praktick\u00e9 odpor\u00fa\u010dania<\/strong>
      \n1) Je d\u00f4le\u017eit\u00e9, aby odborn\u00edci boli sprostredkovate\u013emi a nie in\u0161truktormi. Nerozpr\u00e1vajte pacientom, ak\u00fd stravovac\u00ed pr\u00edstup by bol pre nich vhodn\u00fd. Sna\u017ete sa porozumie\u0165 ich osobn\u00fdm motiv\u00e1ci\u00e1m pri chudnut\u00ed, minul\u00fdm sk\u00fasenostiam, preferenci\u00e1m stravovacieho pr\u00edstupu a prek\u00e1\u017ekam pri zmene stravovania.
      \n2) Poskytnite pacientom inform\u00e1cie zalo\u017een\u00e9 na d\u00f4kazoch, ktor\u00e9 im pom\u00f4\u017eu pochopi\u0165, \u010do by museli robi\u0165 \/ nau\u010di\u0165 sa pri ka\u017edom stravovacom pr\u00edstupe (napr. pozrite si inform\u00e1cie o n\u00edzkokalorickej di\u00e9te a n\u00edzkosacharidovej di\u00e9te v Diabetes UK). To by malo obsahova\u0165 podrobn\u00e9 inform\u00e1cie o vlastnostiach ka\u017ed\u00e9ho stravovacieho pl\u00e1nu vr\u00e1tane mo\u017en\u00fdch ved\u013eaj\u0161\u00edch \u00fa\u010dinkov, ktor\u00e9 m\u00f4\u017eu o\u010dak\u00e1va\u0165, a vedomost\u00ed a zru\u010dnost\u00ed, ktor\u00e9 je potrebn\u00e9 z\u00edska\u0165, aby sa dostavil \u00faspech.
      \n3) Sp\u00fdtajte sa otvoren\u00e9 ot\u00e1zky, aby ste u pacientov uprednostnili konkr\u00e9tny stravovac\u00ed pl\u00e1n, motiv\u00e1ciu pri chudnut\u00ed a prek\u00e1\u017eky pri zmene stravovania:<\/p>\n

      * Ktorej mo\u017enosti by ste sa dr\u017eali s v\u00e4\u010d\u0161ou pravdepodobnos\u0165ou?<\/p>\n

      * \u010co d\u00fafate, \u017ee dosiahnete chudnut\u00edm?
      \n* \u010co by v\u00e1m mohlo zabr\u00e1ni\u0165 dr\u017ea\u0165 sa zvolenej stravy?<\/p>\n

      4) Povzbu\u010fte pacientov, aby h\u013eadali soci\u00e1lnu podporu, napr\u00edklad maj\u00fa partnera, \u010dlena rodiny alebo priate\u013ea, ktor\u00fd by im mohol poskytn\u00fa\u0165 emocion\u00e1lnu a praktick\u00fa podporu?
      \n5) V pr\u00edpade potreby poskytnite pozit\u00edvne posilnenie. To m\u00f4\u017ee zah\u0155\u0148a\u0165 poskytnutie pozit\u00edvnej sp\u00e4tnej v\u00e4zby o akomko\u013evek \u00fasil\u00ed, ktor\u00e9 pacient vyvinie pri zmene stravovania (napr. za vypracovanie podrobn\u00fdch pl\u00e1nov zmeny stravovania); ak\u00e9ko\u013evek \u00faspechy (t. j. skuto\u010dn\u00e9 zmeny stravovania v priebehu nieko\u013ek\u00fdch dn\u00ed alebo t\u00fd\u017ed\u0148ov); a pozit\u00edvne komentovanie priazniv\u00e9ho dopadu t\u00fdchto zmien na v\u00e1hu a glykemick\u00fa kontrolu (t. j. ak\u00e9ko\u013evek merate\u013en\u00e9 zmeny).<\/p>\n

       <\/p>\n

      Prelo\u017eil Michal Dankulinec<\/em><\/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":"sk","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\/sk\/wp-json\/wp\/v2\/posts\/2175","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/comments?post=2175"}],"version-history":[{"count":45,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/posts\/2175\/revisions"}],"predecessor-version":[{"id":4575,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/posts\/2175\/revisions\/4575"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/media\/2222"}],"wp:attachment":[{"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/media?parent=2175"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/categories?post=2175"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/tags?post=2175"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}