IDEA21(국제 당뇨병 교육 협회) : 교육자의 장



		Educate other patient Step Care [ Educate other patient ] Someone who does not know about diabetes well could not educate other diabetic patient. but there are big difference between little better knowledge and little less knowledge in concerning diabetes. For example, one patient who does not know how to treat low sugar symptoms, then he has trouble when he feel low sugar symptoms. the patient became panic and suffering painful symptoms and doing nothing. but if someone who know about it beside him, he can help giving orange juice or sugar candy or anything to recover from this trouble. It does not mean well known patient could be act like doctor, but he could teach and help other patient as much as he known. It is good experience to learn something from teaching other patient. When someone teach other patient, the first thing to emphasis is the changing life style. Recommend him to stop for smoking, or drinking alcoholic beverage. And also recommend that the performing exercise regularly and good habit for food consumption like amount of food, match meal time etc. It is not easy to see that long time diabetic patient can pick up sugar food easy if someone say to him it is ok. Let the patient know don't let take any sugar food unless feel symptoms of low sugar level. The second, recommend to test blood sugar level or urine often. If the test result are good (120mg/dl before meal and 170mg/dl after meal), it is enough to check 1-2 times a week. If the test result are above normal level, the patient must find the reason why sugar level above normal. There are many reason involve include over eating, less exercise, or underdose of medication. There are many other reasons involve include stress, not enough sleeping, worry, sickness etc. Evaluate life style and correct any irregular activities while continue to check test. The third, the patient should consult with Doctor if need medication use. Right medication and dosage chose are very important because if he use overdosage diabetic agent, can suffering low sugar symptoms. The life style change, good meal pattern, regular sugar level check and right dosage of medication, those are all important part of the diabetic patient's life. [ Step Care for Diabetic Patients ] < Medication > - Sulfornylurea: Micronase, Glucotrol, Amaryl, Prandin - Metformin: Glucophage, - Thiazolidinedione: Actos, Avandia - Arcarbose: Pricose < Combination medicine > Sulfonylurea(Glyburide) + metformin : Glucovance 1 step - Do not use medication, only perform a change in life style, diet, exercise, and continue to test regularly -> Keep watch, continue test - Go to Step 2 if not controled well 2 step - Normal weight patient (Sulfonylurea, Arcarbose etc use) - Overweight patient (Metformin, Aarcarbose etc use) -> Keep watch, continue test - Go to Step 3 if not controled well 3 step - combination 2 medication (Sulfonylurea + Metformin) or (Sulfonylurea + Thiazolidinedione) - combination 3 medication (Sulfonylurea + Metformin + Thiazolidinedione) -> Keep watch, continue test - Go to Step 4 if not controled well 4 step - Insulin only use (NPH once a day or Humulin 70/30 once a day) or ( 70/30 at AM and Regular at PM) - Insulin + oral Pill(Metformin) - Insulin + oral Pil (Metformin) + oral Pill (Thiazolidinedione) -> Keep watch, continue test