Mardarowicz Grazyna, Łopatyński Jerzy
Primary Health Care Department of Family Medicine Department, Medical University of Lublin.
Ann Univ Mariae Curie Sklodowska Med. 2002;57(1):550-5.
The authors discuss epidemics of diabetes in the world and in Poland. In the Lublin region (eastern Poland), for instance, they found type 2 diabetes (DM 2) in 15.6% of the examined aged over 35 (according to the WHO criteria of 1985). The health care system reform in Poland has made more difficult the access of the diabetic to a specialist that treats this disease. Therefore doctors and nurses of primary health care have become more responsible for diabcare than before. The authors believe that the systematic education of primary health care doctors by specialists so that they can treat patients according to the modern standards of practical diabetology as well as sharing of tasks and responsibilities between primary and specialist diabetologic care, are very important. Primary health care would be in charge of prevention and early diagnosis of DM 2 as well as prevention and early diagnosis of concomitant complications of the disease. Specialists would have consultation on the patients at the moment of diagnosis and then at least once a year. They would also take care of search for and diagnosis of remote diabetes complications. Primary health care doctors would still treat most of diabetics with DM 2; specialist centres doctors would treat most of diabetics with DM type 1, patients with complications and from special risk groups (e.g. women with gestational diabetes).
作者们讨论了全球及波兰的糖尿病流行情况。例如，在波兰东部的卢布林地区，他们发现35岁以上受检者中2型糖尿病（DM 2）的患病率为15.6%（依据1985年世界卫生组织标准）。波兰的医疗体系改革使糖尿病患者获得专科治疗变得更加困难。因此，初级医疗保健的医生和护士在糖尿病护理方面比以往承担了更多责任。作者认为，由专科医生对初级医疗保健医生进行系统培训，使其能够按照现代实用糖尿病学标准治疗患者，以及在初级和专科糖尿病护理之间分担任务和责任，非常重要。初级医疗保健将负责DM 2的预防和早期诊断以及该疾病并发并发症的预防和早期诊断。专科医生将在诊断时以及之后至少每年一次对患者进行会诊。他们还将负责查找和诊断远期糖尿病并发症。初级医疗保健医生仍将治疗大多数DM 2患者；专科中心的医生将治疗大多数1型糖尿病患者、有并发症的患者以及来自特殊风险群体的患者（如妊娠期糖尿病妇女）。
