20/01/2013
1月17日盛岡糖尿病眼科疾患スモールミーティングと題する、本当に二十人に診たない内科医と眼科医との、それぞれの立場からの口演を伴う交流の時(酒無しね)、に行ってきました。内科医と眼科医の病状の説明の方向性が合っていないと患者さんが混乱することや、糖尿病眼手帳の活用について話されました。内科医は本当に大変だと思います。私のところでは、必ずヘモグロビンA1cをうかがって、眼底所見と併せて患者さんにお話しし、また次回はいつ頃というふうにしていますが、それだけでは必ずしも十分とはいえないようです。また、食事療法のみでコントロールのつく糖尿病患者さんでも網膜症が出るケースも少なくなく(私も社会的失明例を経験しています)、食事療法だから治った、或いは気をつければ良いということではなく、継続的な監視が必要であることを再認識しました。
当院では網膜症のない方の場合、JDSでヘモグロビンA1cが7%未満なら半年毎、8%未満で硝子体剥離の無い人は四ヶ月毎、8%以上の方は硝子体剥離があれば三～四ヶ月毎、無ければ三ヶ月ごとにみていました。また、前増殖網膜症以上の方は、年に一度はフルオレセイン蛍光眼底造影をしています。
I perticipated it in (there is no liquor) at the time of diseases with a few physician and the presentation from each viewpoint with the ophthalmologist which I really ment to less than 20 people entitled the Morioka diabetes ophthalmology disease, Small meeting on January 17. It was talked about the utilization of a patient being confused when directionality of the explanation of the condition of the ophthalmologist did not fit a physician and the diabetes sick eye notebook. I think that the physician is really serious. At me, I watch hemoglobin A1c by all means and talk to a patient in conjunction with fundus views and it seems to be said again with when on the next time and does it, but with that alone it does not seem to be able to be necessarily. In addition, there were a lot of cases which a retinopathy appeared in the diabetics who arrived of the control only by a diet control (I experience a social loss of eyesight example) and realized that continuous monitoring was necessary again not I was cured or being careful because it was a diet cure.
If hemoglobin A1c 7% were within it, semiannual 8% were within it, and, in the case of one without the retinopathy, the person whom there was not of the posterior vitreous detachment watched the 8% more than it in JDS in our office every three months for every 3-4 months for every four months if there was posterior vitreous detachment if there was not it. In addition, the one with more than of previous increase retinopathy does fluoresceine angiography once a year.
