UW MEDICINE | PATIENT EDUCATION

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UW MEDICINE PATIENT EDUCATION DIABETES MELLITUS KOREAN 진성당뇨병 기본적인사실들 이책자는당뇨병에관한기본적인사실들을알려드립니다. 이것은당뇨병의주종과원인과위험이높은사람들과위험성을낮추는방법과당뇨가조절이되지않을경우에일어날수있는것들등을설명합니다. 당뇨병이란무엇인가? 진성당뇨병이란말은두개의그리스말에서나왔습니다.

1 UW MEDICINE PATIENT EDUCATION DIABETES MELLITUS KOREAN 진성당뇨병 기본적인사실들 이책자는당뇨병에관한기본적인사실들을알려드립니다. 이것은당뇨병의주종과원인과위험이높은사람들과위험성을낮추는방법과당뇨가조절이되지않을경우에일어날수있는것들등을설명합니다. 당뇨병이란무엇인가? 진성당뇨병이란말은두개의그리스말에서나왔습니다. 당뇨는 사이펀 ( 아니면수도꼭지 ) 를뜻하고멜리터스는 꿀맛이나는 이라는뜻입니다. 2 천여년전에그리스의사들은이런장애가있는사람들이많은양의소변을누고 ( 수도꼭지처럼 ) 그소변이단맛이나는것을발견했습니다! 이것은그들의혈액속에혈당 ( 설탕 ) 의수치때문이었습니다. 당뇨병은그저한가지병이아닙니다. 여러가지다른장애가한사람의혈당수치를통제할수없이올라가게하는원인이될수있습니다. 이런것이생기면우리는그들이진성당뇨병의한가지를갖고있다고말합니다. 당뇨병은얼마나흔한가? 미국의 9 퍼센트 (100 명중의 9 명 ) 이상의사람들이어떤종류의당뇨병을앓고있습니다. 이것은이천구백만명이넘는다는것입니다. 그리고미국의팔천육백만의성인들이당뇨병전증을갖고있습니다. 이것은 3 명중의 1 명이상이되는것입니다. 당뇨병전증은혈당수치가정상보다는높지만당뇨병이라고부를정도로높지는않다는뜻입니다. 혈당수치는무엇이조절하나? 우리의혈액은우리의몸이하루 24 시간내내포도당을사용하기때문에얼마간의포도당이항상있습니다. 포도당은우리가먹는음식에서나옵니다. 또한우리의간은밤사이와식사사이에우리의몸에에너지를공급하기위하여포도당을만듭니다. 인슐린이라는호르몬은우리의혈액안의포도당의양을조절합니다. 인슐린은위가까이에있는장기인췌장으로부터분비됩니다. 인슐린은포도당이에너지로사용되는우리몸의세포속으로이동하는것을돕습니다. 적어도일주일에 5 일간 30 분씩의산보로당뇨가생길위험성을감소시킬수있습니다. Page 1 of 3 진성당뇨병

2 혈당이통제불능으로오르게되는원인은? 당뇨가있는사람은그들의췌장이인슐린을전혀아니면조금밖에만들지못하거나세포들이인슐린을제대로잘사용하지못합니다. 이것이일어나는데는주로 3 가지이유가있습니다 : 그사람이체중과다나비만증이있어서간과근육과지방세포가인슐린에내성이생기는경우. 이것은몸에서인슐린이만들어지기는하지만잘사용되지못한다는뜻입니다. 그사람의췌장이혈당을낮출수있을만큼충분한인슐린을만드는것이중단된경우. 그사람의간이너무많은포도당을만들어내는경우. 당뇨병의주종류는? 1 형당뇨병 1 형당뇨병은그사람의자신의면역체계에의해서췌장의인슐린을만들어내는세포들이파괴되었을때에일어납니다. 이것은대부분아동기에주로일어나지만연령에제한없이일어날수있습니다. 1 형당뇨병이있는사람들은생명을유지하기위하여하루에 2 대이상의인슐린주사를맞아야합니다. 2 형당뇨병 2 형당뇨병은가장흔한종류의당뇨병입니다. 그것은보통성인이되서일어나지만체중과다와비만인아동에게도일어날수있습니다. 2 형당뇨병에있어서근육과간은그것들이사용해야하는대고인슐린을사용하지않습니다. 그러면췌장은이내성을극복하기위하여더많은인슐린을만듭니다. 그러나췌장은장기간에걸쳐서그렇게많은인슐린을계속만들어낼수없습니다. 시간이경과하면서 ( 보통여러해에걸쳐서 ) 췌장은인슐린을점점적게만들기시작합니다. 이것은혈당수치를오르게합니다. 이시점에서그사람은그들의혈당을조절하기위해서약 ( 알약이나인슐린주사 ) 이필요하게될수도있습니다. 2 차성당뇨병 2 차성당뇨병은췌장과관련된다른질환이나상태로인한당뇨병의원인이되는경우를말합니다. 예를들면만일어떤사람이이식수술을받으면프레드니손과같은스테로이드제나항거부제를복용하므로써인슐린에내성이생길수있습니다. 또한어떤종류의종양은혈당수치를올리는스테로이드호르몬을생산합니다. 2 차성당뇨병은다음과같이인슐린이제대로작용하지못하거나기능이중단되게하는질병이나상태에의해서일어날수있습니다 : 낭포성섬유증 췌장염 ( 췌장의염증 ) 췌장암 Page 2 of 3 진성당뇨병

3 임신당뇨 임신당뇨는임신이전에는당뇨병이없던임신부에게임신중에생길수있는종류의당뇨병입니다. 대부분의경우에아이를출산하고나면없어집니다. 하지만산모와아이양쪽다에게좋은건강을보장하기위하여검사를하고임신당뇨를치료하는것이중요합니다. 또한임신당뇨가있었던여성분들은나중에 2 차성당뇨병이생길위험요인이더큽니다. 당뇨병이생길위험요소가있는사람은? 체중과다나비만인것은 2 형당뇨병에걸릴위험성을증가시킵니다. 육체적으로비활동적인것은 2 형당뇨병에걸릴위험성을증가시킵니다. 근친중에당뇨병환자가있는것또한위험성을증가시킵니다. 다음과같은인종이나민족들은유전적이유로당뇨병이걸릴위험성이더높습니다 : 미국의인디안들 미국의아프리카인들 히스페닉들과라틴인들 미국의아시안들 환태평양섬주민들 당뇨가걸릴위험성을줄이려면? 설탕을너무많이섭취하는것으로인해당뇨병이온다는증거는없습니다. 하지만다음과같은것들로당뇨병에걸릴위험성을낮출수있습니다 : 체중과다인경우에최소한 10 파운드정도를감량시킴. 문의사항? 귀하의질문은중요합니다. 문의사항이나우려되는것이있으면주치의나의료제공자에게전화하십시오. 내분비과와당뇨관리센타의환자분이시면 로전화하십시오. 다른환자분들은주치의에게전화해주십시오 : 건강식을먹음. 적어도 30 분씩일주일에 5 일을걸음. 당뇨병이조절이되지않으면어떤것들이일어나나? 수년에걸쳐서너무높거나낮은혈당은그사람의심장과혈관과신경을손상시킬수있습니다. 그결과로올수있는것들은다음과같습니다 : 발이나다리의감각상실 시력의변화 신장문제 잇몸문제나치아가빠짐 감염이더잘되고상처가잘낫지않음 University of Washington Medical Center Diabetes Mellitus Korean Published PFES: 10/2007, 04/2009, 08/2014 Clinician Review: 08/2014 Translation by UWMC Interpreter Services Reprints on Health Online: 이런문제들이일어날위험을줄이기위해서는가능한한혈당을되도록정상수치로유지하십시오. Page 3 of 3 진성당뇨병

4 UW MEDICINE PATIENT EDUCATION Diabetes Mellitus Basic facts This handout gives basic facts about diabetes. It explains the main types of diabetes, what causes it, who is most at risk, how to lower your risk, and what can happen if diabetes is not controlled. What is diabetes? The term diabetes mellitus comes from 2 Greek words. Diabetes means siphon (or faucet), and mellitus means honey-flavored. Over 2,000 years ago, Greek doctors found that people with this disorder passed large amounts of urine (like a faucet) and that the urine was sweet to the taste! This was due to the level of glucose (sugar) in their blood. Diabetes is not just one disease. Many different disorders can cause a person s blood glucose level to rise out of control. When this happens, we say they have some form of diabetes mellitus. How common is diabetes? Over 9% of people in the U.S. (9 out of 100 people) have some type of diabetes. This is more than 29 million people. And, 86 million adults in the U.S. have pre-diabetes. This is more than 1 out of 3 people. Pre-diabetes means that a person s blood sugar level is higher than normal, but it is not high enough to be called diabetes. What controls blood glucose level? Your blood always has some glucose in it because your body uses glucose for fuel 24 hours a day. Glucose comes from the food you eat. Your liver also makes glucose to supply your body with energy overnight and between meals. The hormone insulin controls the amount of glucose in your blood. Insulin is released from the pancreas, You can help lower your risk for diabetes by walking for 30 minutes at least 5 days a week. Page 1 of 3 Diabetes Mellitus

5 an organ near the stomach. Insulin helps move glucose into your body s cells, where it is used for energy. What causes blood glucose to rise out of control? In a person with diabetes, their pancreas makes little or no insulin, or their cells do not use insulin very well. There are 3 main reasons this occurs: The person is overweight or obese, causing the liver, muscles, and fat cells to become insulin resistant. This means that the body produces insulin but does not use it well. The person s pancreas stops producing enough insulin to lower blood glucose. The person s liver makes too much glucose. What are the main types of diabetes? Type 1 Diabetes Type 1 diabetes occurs when the insulin-producing cells in the pancreas are destroyed by the person s own immune system. This occurs most often in children, but it can occur at any age. People with type 1 diabetes must take 2 or more daily insulin shots (injections) in order to live. Type 2 Diabetes Type 2 diabetes is the most common type of diabetes. It usually occurs in adults, but it can also occur in overweight and obese children. In type 2 diabetes, the muscles and liver do not use insulin as they should. The pancreas then makes more insulin to overcome this resistance. But, the pancreas cannot keep making so much insulin long-term. Over time (usually years), the pancreas begins to make less and less insulin. This raises blood glucose levels. At this point, the person may need medicine (pills or insulin injections) to control their blood glucose. Secondary Diabetes Secondary diabetes is diabetes caused by another disease or condition that involves the pancreas. For example, if a person has a transplant surgery, insulin resistance can result from taking steroid medicines, such as prednisone, or anti-rejection drugs. Also, some kinds of tumors produce steroid hormones, which raise blood glucose levels. Secondary diabetes can also be caused by diseases or conditions that keep insulin from working well, such as: Cystic fibrosis Pancreatitis (inflammation of the pancreas) Pancreatic cancer Page 2 of 3 Diabetes Mellitus

6 Gestational Diabetes Gestational diabetes is a type of diabetes that can develop in pregnant women who do not already have diabetes. In most cases, it goes away after the baby is born. But, it is important to diagnose and treat gestational diabetes to ensure good health for both mother and baby. Also, women with gestational diabetes are at greater risk of developing type 2 diabetes later in life. Who is at risk for diabetes? Being overweight or obese increases your risk of getting type 2 diabetes. Being physically inactive increases your risk of getting type 2 diabetes. Having a close relative with diabetes also increases your risk. For genetic reasons, these racial and ethnic groups have a greater chance of getting diabetes: American Indians African Americans Hispanics/Latinos Asian Americans Pacific Rim Islanders Questions? Your questions are important. Call your doctor or health care provider if you have questions or concerns. If you are a patient at Endocrine & Diabetes Care Center, call Other patients, please call your healthcare provider: How can I lower my risk for diabetes? There is no evidence that diabetes is caused by eating too much sugar. But you can lower your risk of getting diabetes by: Losing as little as 10 pounds, if you are overweight Eating healthy foods Walking for 30 minutes at least 5 days a week What can happen if diabetes is not controlled? Over many years, blood glucose that is too high or too low can damage a person s heart, blood vessels, and nerves. As a result, they can have: Loss of feeling in their feet or legs Vision changes Kidney problems Gum problems or tooth loss More infections and slower wound healing Keep your blood glucose as close to normal levels as possible to lower your risk of having these problems. University of Washington Medical Center Published PFES: 10/2007, 04/2009, 08/2014 Clinician Review: 08/2014 Reprints on Health Online: Page 3 of 3 Diabetes Mellitus

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본문01 Ⅱ 논술 지도의 방법과 실제 2. 읽기에서 논술까지 의 개발 배경 읽기에서 논술까지 자료집 개발의 본래 목적은 초 중 고교 학교 평가에서 서술형 평가 비중이 2005 학년도 30%, 2006학년도 40%, 2007학년도 50%로 확대 되고, 2008학년도부터 대학 입시에서 논술 비중이 커지면서 논술 교육은 학교가 책임진다. 는 풍토 조성으로 공교육의 신뢰성과