Studi Kasus : Fenomena Fajar dan Efek Somogyi pada Pasien Diabetes di Lihat dari Kadar Gula Darah dan Masalah Keperawatan yang Muncul di Filipina

M. Maksum, Reza Fahmi Islami, Ratna Kurniawati
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Abstract

Early morning hyperglycaemia in diabetics can be caused by the dawn phenomenon, the Somogyi effect, or poor glycaemic control. The dawn phenomenon occurs when endogenous insulin secretion decreases or when the effect of exogenous insulin given to the patient the day before disappears, along with a physiological increase in insulin antagonist hormone. When people with diabetes eat too late at night, consume alcohol, or use insulin too late, it will cause a spike in blood sugar levels in the morning. This condition is known as the Somogyi effect and is caused by the human activity itself. The Somogyi effect is present in the case of excessive amounts of exogenous insulin. The dawn phenomenon is more common than the Somogyi effect. This research method uses a case study to explore the problem of nursing care in patients with diabetes mellitus at St Paul University Hospital, Philippines. Data were collected using interviews, observation, physical examination, and documentation. The data obtained were analysed by descriptive method, compiled from diagnosis to evaluation using three diabetic patients as sampling. To diagnose this dawn phenomenon, it is important for nurses to measure plasma glucose levels over several nights between 3 am and 5 am or use a continuous glucose monitoring system. Although the treatments are different, the best way to prevent the dawn phenomenon and the Somogyi effect is to control diabetes optimally with insulin therapy. It is hoped that nurses, clients, and families can monitor the patient's glucose levels periodically to prevent complications in diabetes. Keywords : Diabetic, Somogyi, Down Phenomenon Effect, case study
病例研究:从菲律宾出现的血糖和护理问题来看,黎明现象和Somogyi对糖尿病患者的影响
糖尿病患者的清晨高血糖可由黎明现象、Somogyi效应或血糖控制不良引起。当内源性胰岛素分泌减少或前一天给予患者的外源性胰岛素作用消失时,伴随着胰岛素拮抗剂激素的生理性增加,就会出现黎明现象。当糖尿病患者晚上吃得太晚、喝酒或太晚使用胰岛素时,都会导致早晨血糖水平飙升。这种情况被称为Somogyi效应,是由人类活动本身引起的。Somogyi效应出现在外源性胰岛素过量的情况下。“黎明现象”比“索莫吉效应”更为普遍。本研究采用个案研究的方法,探讨菲律宾圣保罗大学医院糖尿病患者的护理问题。通过访谈、观察、体格检查和文献资料收集资料。以3例糖尿病患者为样本,从诊断到评价,采用描述性方法对所得数据进行分析。为了诊断这种黎明现象,对护士来说,在凌晨3点到5点之间测量几个晚上的血糖水平或使用连续血糖监测系统是很重要的。虽然治疗方法不同,但预防黎明现象和Somogyi效应的最佳方法是通过胰岛素治疗来最佳控制糖尿病。希望护士、客户和家属能够定期监测患者的血糖水平,以预防糖尿病并发症。关键词:糖尿病;Somogyi;唐氏现象效应
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