Zotsatira za matenda a shuga opatsirana, zizindikiro, njira zothandizira, zomwe zimayambitsa matenda ashuga komanso zizindikiro za mayeso

• pamimba yopanda kanthu - kuyambira 3.5 mpaka 5.5 mmol / l,
• Maola awiri mutatha kudya - osakwana 7.8 mmol / l,

mu plasma:

• pamimba yopanda kanthu - mpaka 6.1 mmol / l,
• Maola awiri mutatha kudya - osakwana 8.9 mmol / L.

Mmol / l - Chiyeso choyeza shuga. Zipangizo zina zimapereka zotsatira mu mg%. Kuti mupeze zotsatira za mmol / l, ndikofunikira kugawa zotsatira mu mg% ndi 18 - izi ndizowunikira (ngakhale ziyenera kudziwika kuti zida zotere sizabwino kwambiri ndipo ndizosowa kwambiri ndi ife).

Momwe mungadziwire komwe glucose adatsimikiza? Mutha kufunsa izi za othandizira ma labotale omwe akuwunikiratu, ndipo ngati mutayang'anitsitsa ndendende ndikuwona kuchuluka kwa glucose (chipangizo chothandiza kudziwa zomwe zili ndi shuga) nokha, muyenera kudziwa: ambiri mwa ma glucometer omwe amagwiritsidwa ntchito ku Europe ndipo ife timayesedwa (kukhazikika) ndi magazi athunthu, pali zosiyana. Mwachitsanzo, kampani yaposachedwa kwambiri yam'madzi Life Life - Smart Scan imayatsidwa ndi plasma, i.e. imawerengera kuchuluka kwa shuga m'magazi am'magazi, monga zida zambiri zasayansi, popeza iyi ndi njira yolondola yodziwira zomwe zili ndi shuga.
Chomwe chimatembenuza kutembenuza kuchuluka kwa shuga m'magazi athunthu kukhala ndende yofanana mu plasma ndi 1.1.

Kutalika kwa nthawi yayitali monga asymptomatic hyperglycemia kumabweretsa kuti munthu amayambira kupita kwa dokotala ndi madandaulo chifukwa cha zovuta za matenda ashuga. Izi zitha kukhala nthawi yoonana ndi ophthalmologist chifukwa cha kuchepetsedwa kwa masomphenya (chifukwa chamatumbo kapena retinopathy), nthawi yolumikizana ndi katswiri wazopweteka zam'mtima (zogwirizana ndi kukula kwa IHD), kupweteka kwa mutu (kuphatikizana ndi matenda oopsa), kucheza ndi dokotala wothandizira opweteka komanso kuzizira m'miyendo (komwe kumagwirizanitsidwa ndi atherosulinosis yamatumbo am'munsi), kuchezera kwa neuropathologist wokhudza kupweteka kwa mutu, chizungulire, kukokana komanso dzanzi m'miyendo (yolumikizana ndi atherosulinosis yamitsempha yamaubongo ndikuwonongeka kwa mitsempha yapang'onopang'ono.
Kuzindikira kusamba kwa glycemia m'maphunziro awiri obwereza omwe ali ndi shuga woposa 6.9 mmol / L m'magazi am'magazi komanso oposa 6.0 mmol / L m'magazi athunthu kapena maola awiri mutatha kudya zoposa 11 mmol / L m'magazi athunthu komanso oposa 12.1 mmol / l mu plasma, komanso kupezeka kwa shuga mumkodzo, zimapangitsa kuzindikira matenda a shuga.

Ndi matenda a shuga, nthawi zambiri palibe chomwe chimapweteka.
Ndipo izi zilidi choncho. Odwala ambiri, akudziwa za kupezeka kwawo, amakhala ndi zisonyezo zomwe zimaposa kuchuluka kwa glucose komanso kumva bwino. Koma vuto ndikuti mukadwala, nthawi zambiri imachedwa: izi zikutanthauza kuti zovuta za shuga zayamba, kuwopseza khungu, gangore, vuto la mtima kapena stroke, komanso kulephera kwa impso.

Komabe, monga zokumana nazo zambiri, odwala ambiri amawonetsa, munthu woganiza bwino yemwe amalamulira matenda ake a shuga amatha kupewa ngozi ndikukhala ndi moyo wautali.

Mukamayandikira kwambiri zomwe mukuwonetsa, shuga yanu imalipidwa bwino, zomwe zikutanthauza kuti palibe chiopsezo chobwera ndi zovuta za matenda ashuga (tebulo 2).

Monga tikuwonera patebulo pansipa, palinso chizindikiro monga glycated (glycosylated) hemoglobin. Amagwiritsidwa ntchito pozindikira matenda a shuga ndikuwongolera matendawa. Ichi ndi chiyani Tiyeni timvetse bwino.

Makonda a glycated hemoglobin pamlingo wa glycemia

Popeza nthawi yayitali ya erythrocyte, pomwe "imasonkhana" glucose, ndi miyezi iwiri, titha kudziwa molingana ndi kuchuluka kwa glucose m'magazi a glucose omwe munthu amakhala nawo panthawiyi, ndipo, motero, woweruza kukhalapo kapena kusakhalapo pobwezeredwa.
Kusanthula kwachikhalidwe (kamodzi pamwezi) kuti mupeze kuchuluka kwa shuga m'magazi kumangolankhula za zomwe zikuwonetsa pakadali pano, koma ngakhale patsiku lino mlingo wa chisonyezo umatha kusintha, monga kusintha kwa kugunda kapena kuthamanga kwa magazi.
Chifukwa chake, kupenda kudziwa shuga m'magazi, makamaka kamodzi pamwezi, sikokwanira kuti iziweruza za kagayidwe kazachilengedwe.
Chifukwa chake, mulingo wa glycated hemoglobin, womwe ndi pokhazikika, zotsatira zake sizikhudzidwa ndi kusinthasintha kwa glycemia patsiku losonkhanitsa magazi, kudya mokwanira patsiku la kusanthula, zochitika zolimbitsa thupi, lero ndi chidziwitso chowonetsa mkhalidwe wa metabolism ya carbohydrate (kubwezera, kulipira, kulipira) miyezi 2 yapitayo.
Kafukufuku wambiri ku United States of America ndi mayiko ena awonetsa kuti kuchuluka kwa hemoglobin mwachidziwikire kumawonetsa mgwirizano pakati pa kubwezeredwa kwa shuga wabwino komanso kuwopsa kwa zovuta.

Chifukwa chake, kafukufuku wamitundu yambiri waku America wokhudzana ndi matenda ashuga komanso zovuta zake DCCT (Diabetes Control and Complication T kesi), zomwe zidatenga zaka 10 (zidatha mu 1993) komanso momwe anthu 1441 amtundu 1 wa shuga adatenga nawo mbali, adawonetsa kuti zinali pafupi ndi zabwinobwino kuchuluka kwa shuga m'magazi kumathandiza kupewa kukula kapena kulepheretsa kukula kwa zovuta zonse za anthu odwala matenda ashuga:

• retinopathy wosakhazikika - 54-76%,
• proliferative reticopatitis komanso 47-56%,
• mavuto akulu a impso - mwa 44-56%,
• zovuta zamanjenje - mwa 57-69%,
• zombo zazikulu - ndi 41%.

Pafupipafupi zovuta zake zimakhala zochepa poyerekeza ndi hemoglobin ya glycated, yomwe ili pafupi kwambiri.

Chitsanzo china ndi kafukufuku wapamwamba kwambiri ku UK, UKPDS (United Kingdom Prospective Diabetes Study), yomwe idafotokozedwa mwachidule mu 1998.
Zambiri za UKPDS, zomwe zidatenga pafupifupi zaka 20 (odwala oposa 5,000 omwe ali ndi matenda amtundu wa 2 adachitapo kanthu), zikuwonetsa kuti kuchepa kwa hemoglobin wa glycated wa 1% kokha kumapangitsa kutsika kwa 30- 35% pamavuto amaso, impso ndi mitsempha , komanso amachepetsa chiopsezo chokhala ndi myocardial infaration ndi 18%, stroke - mwa 15% ndipo 25% imachepetsa kufa kumene chifukwa cha matenda ashuga.

Kutengera izi Ndikulimbikitsidwa kuti milingo ya hemoglobin HbA1c glycated asungidwe pansipa 7% ndi ulamuliro wake miyezi itatu iliyonse.
Zowonjezera za hemoglobin zowonjezereka zikuwonetsa kufunikira kwakukonzanso moyo: zakudya, masewera olimbitsa thupi, kugwiritsa ntchito mankhwala osokoneza bongo ndikusintha kudziletsa, apo ayi ndikosatheka kuletsa kukula kwa zovuta zovuta za matenda ashuga.

Chizindikiro chinanso chomwe munthu angaweruze kupezeka kwa zovuta za carbohydrate metabolism kapena chiphuphu cha shuga ndi fructosamine.

Fructosamine Kuphatikiza kwa shuga ndi mapuloteni am'madzi, omwe amachitika mkati mwa mwezi umodzi.
Mulingo wabwinobwino wa fructosamine mwa anthu athanzi ndi mpaka 285 mmol / l, ali yemweyo ndi chindapusa cha matenda ashuga.
Chizindikiro choposa 400 mmol / l chikuwonetsa kuwonongeka kwa carbohydrate metabolism. Zizindikiro zapakatikati - za zokwanira.

Mlingo wa fructosamine umatsimikiziridwa m'magazi a venous, mosiyana ndi hemoglobin ya glycated. Sizingatheke kuwerengera kuchuluka kwa glycemia (monga timachita ndi glycated hemoglobin) ndi fructosamine.

Pafupipafupi yowunikira thanzi

Kuyang'anira zaumoyo ndikofunikira:

tsiku ndi tsiku - Kuwongolera kwamagazi a shuga (pamimba yopanda kanthu komanso maola awiri mutatha kudya), muyeso wamagazi,

kotala - kutsimikiza kwa glycosylated hemoglobin wamagazi, pitani kwa endocrinologist,

pachaka - muyeso wa cholesterol (LDL, HDL), muyeso wa cholesterol mu mkodzo, pitani kwa ophthalmologist, pitani kwa katswiri wamitsempha.

Ndikofunikira kutenga mtima kamodzi pachaka kapena pafupipafupi - kuti muwone ngati zochitika za ischemic zayamba.

Pafupipafupi (kamodzi kapena kawiri pachaka), malingana ndi kuuma kwa zovuta, onetsetsani momwe miyendo ikuyendera ndi opaleshoni ya mtima - angiologist.

Mukamachita kudziletsa, ndikofunika kusunga diary, makamaka kwa iwo omwe amagwiritsa ntchito insulin. Ndikosavuta kusunga zolemba pakompyuta, chifukwa kompyuta imakulolani kuphatikiza ndikugwiritsa ntchito mitundu yonse. Mutha kusunga buku la zolemba zakale kapena zolemba zazikulu.

Kodi ndizomwe zimapangidwira shuga

Asanayambe chithandizo cha matenda ashuga, dokotala amasankha zotsatirazi:

• Chepetsani kapena siyani kupititsa patsogolo kwa matenda owopsa owopsa - matenda ashuga, nephropathy, neuropathy ndi retinopathy,
• Pewani zovuta za pachimake (mwachitsanzo, chikomokere cha matenda ashuga, matenda, shuga m'magazi),
• Bwezeretsani moyo wabwino,
• Pewani zoopsa.

Kutengera zaka, nthawi ya moyo komanso matenda ophatikizika, zolinga zamankhwala zimasinthidwa payekha ndi dokotala limodzi ndi wodwala.

Kumayambiriro kwa chithandizo chilichonse, dokotala amakambirana zolinga za odwala ndi odwala. Maziko a chithandizo chilichonse ndikuwonjezera kulimbitsa thupi ndi kuchepa thupi komanso kudya moyenera - makamaka odwala onenepa kwambiri. Kuchepetsa thupi kumachepetsa kukana kwa insulin ndi hyperglycemia. Nthawi zambiri njirazi zimakwanira kutsitsa magazi. Zipatala zambiri za matenda ashuga zimathandizira kusintha kwa odwala matenda ashuga.

Popeza glycemia imakhudzanso moyo ndi chiyembekezo cha moyo, kukwaniritsa kuchuluka kwa shuga m'magazi ndikofunikira kwambiri pakalandira chithandizo. Ngati wodwalayo asintha moyo wake ndikutenga othandizira a hypoglycemic, chiopsezo cha zovuta zimachepetsedwa kwambiri. Si anthu onse omwe ali ndi matenda a shuga a 2 amafunikira magawo a shuga pafupipafupi. Kuchuluka kwa miyezo yomwe imayenera kuchita masana imayikidwa ndi adokotala. Kuti muyeze glycemia, muyenera kutenga magazi ochepa kuchokera pachala chanu. Mamita osiyanasiyana a glucose osiyanasiyana alipo masiku ano.

Njira zoyenera kulipira anthu odwala matenda ashuga makamaka mitundu iwiri:

• Mtengo wa HbA1c: 6.5% - 7.5%,
• Kusala kudya kwa monosaccharide (venous magazi): 100 - 125 mg / dl kapena 5.6 - 6.9 mmol / l,
• The kuchuluka kwa shuga m'magazi venous 1 mpaka 2 maola chakudya: 140-199 mg / dl kapena 7.8-11.0 mmol / l.

Matenda a shuga omwe samadalira insulin amadziwonekera mwa aliyense mwa mitundu yosiyanasiyana. Kwa odwala achichepere, ndikofunikira kuti magazi azisungika glycemia mozama momwe angathere muzochitika zosiyanasiyana kuti mavuto azidzabweranso. Achikulire (azaka zopitilira 75) ayenera kumwa mankhwala omwe angakuthandizeni kuthana ndi kukodza pafupipafupi komanso kuwonongeka pakuwonekera.

Chifukwa matenda amtundu wa 2 amayambitsidwa ndi zifukwa zingapo ndipo nthawi zambiri amayenda ndi matenda oopsa komanso hyperlipidemia, zolinga zamankhwala zimaphatikizanso kuchepa kwa magazi ndi lipids. Anthu odwala matenda ashuga ayenera kukayezetsa pafupipafupi. Zolinga zochizira izi ziyeneranso kusinthidwa pawokha malinga ndi zaka, chiyembekezo cha moyo, komanso mikhalidwe yokhudzana ndi wodwalayo.

Njira Zowerengera Ndalama

Dokotala wofunsayo amatipatsa chithandizo chofunikira. Ngati ndi kotheka, amakambirana ndi akatswiri ena, mwachitsanzo, ndi mitsempha (mitsempha), aimpso (nephrology), mtima (mtima) kapena matenda amitsempha.

Pambuyo pofufuza ndikuwerenga mbiri yachipatala, dokotala angavomereze zolinga za chithandizo ndi wodwalayo. Cholinga chachikulu ndikuchepetsa magazi. Chizindikiro chofunikira kwambiri chodziwitsa ndi HbA1c (glycated hemoglobin), yomwe imalola kuwunika kwakanthawi kwa wodwala.

Kuphatikiza apo, wodwalayo amalembera mayeso osala kudya ndi pambuyo pa chakudya chama glucose (postprandial level). Izi zimatha kuwerengedwa ndi wodwala kangapo patsiku. Zolinga zina zimaphatikizapo kuthamanga kwa magazi ndi lipids yamagazi. Mabungwe azachipatala apereka malingaliro othandizira osamalira odwala matenda ashuga. Komabe, mitundu ya zomwe tikutsata zingasiyane. Pakadutsa pake komanso matenda omwe alipo kale, njira zina zochiritsira zikufunika.

Kumayambiriro kwa zamankhwala, adokotala amalimbikitsa odwala kuti asinthe miyoyo yawo: achotse kunenepa kwambiri, asiye kusuta fodya kapena kuchita masewera olimbitsa thupi.Dokotala amakambirana ndi wodwalayo njira zomwe akufunika komanso njira zomwe akuyenera kuchita kuti athetse vuto la metabolism. Pakatha miyezi itatu, wodwalayo amayendera. Kutengera ndi njira ya chithandizo, mayeso azachipatala pafupipafupi amafunikira.

Malangizo abwino a odwala matenda ashuga akuluakulu atatha miyezi itatu ya chithandizo:

Akatswiri amapatsa odwala chidziwitso cha momwe chipepeso cha matenda ashuga a 2 chiyenera kupangidwira. Ndikofunikira kuti muzitha kuyesa ndi kuwunika mozungulira ma monosaccharide pafupipafupi. Anthu odwala matenda ashuga a Mtundu 1 ayenera kuyeza zomwe zili m'matumbo a ketone kuti mupewe zovuta - chikomokere.

Pochotsa kudalira kwa mankhwala, muyezo woyenera wa insulin kapena matenda pamatenda owopsa amakambidwa mwatsatanetsatane. Maphunziro a odwala amafunika kuwonjezera pang'onopang'ono udindo wa wodwala.

Kudya wathanzi komanso kuchita masewera olimbitsa thupi pafupipafupi kumathandizira kuchepetsa kuchuluka kwa glycemia m'magawo oyamba a shuga osadalira insulin. Pochiza matenda amishuga amtundu wa 2, masewera olimbitsa thupi komanso kudya ndiwo maziko azithandizo.

Kuchepetsa glycemia, magulu atatu akuluakulu a mankhwala amagwiritsidwa ntchito:

• m`kamwa hypoglycemic wothandizira
• incretin mimetics
• kukonzekera insulin.

Mukamagwiritsa ntchito mankhwala omwe ali pamwambawa, wodwalayo ayenera kuyeza glycemia pafupipafupi. Cholinga ndikupewa kwambiri hyper- kapena hypoglycemia. Chithandizo cha insulini chimadziwika ndi dokotala ngati zikondamoyo sizipanga insulin yokwanira.

Matenda oopsa a hyperglycemia angayambitse kuwonongeka kwachiwiri kwa ziwalo. Izi zimabweretsa kuchuluka kwakuthupi komanso ziwengo mu anthu odwala matenda ashuga kuposa athanzi. Chiwopsezo cha atherosulinosis kwa odwala omwe ali ndi matenda ashuga ndi 4-5 nthawi zambiri kuposa odwala athanzi.

Chifukwa chake, chithandizo cha matenda ashuga chimaphatikizapo mayeso azachipatala pafupipafupi kuti azindikire komanso kuchitira zovuta panthawi yake. Kuti mupewe zovuta za matenda ashuga, ndikofunikira kuti musangolamulira glycemia, komanso kuthamanga kwa magazi.

Mavuto omwe adakwaniritsa kapena kuwononga matenda ashuga angayambitse:

• Kukhumudwa kwa minofu yamtima
• Matenda otumphukira a mtima
• Ischemic stroke
• Matenda a impso (nephropathy),
• Matenda a shuga, etc.

Pochiza matenda ashuga, kuikidwa nthawi yayitali kuchipatala ndi mayeso ndikofunikira. Wodwala matenda ashuga azisunga zolemba za glycemic. Izi zithandiza dokotalayo moyenera kukonza mankhwalawo.

Uphungu! Ndi kuwonongeka kwa matenda ashuga (gestational kapena mtundu wina), wodwalayo ayenera kufunsa dokotala. Matenda a matendawa komanso kuwonongedwa kwa matendawa ndi matenda kumathandizira pang'ono kapena kubwezeretsa bwino moyo wa wodwalayo. Pazizindikiro zoyambirira za hyperglycemia, wamkulu komanso mwana, wachinyamata, ayenera kupita kwa dokotala. Chithandizo choyambirira chimathandizira kupewa zovuta zakusiyanasiyana.

Kuzindikira (kugwiritsa ntchito mayeso a labotale) komanso kuwongolera matenda ashuga kuyenera kuchitika ndi katswiri woyenera. Kulipiritsa matenda ashuga pakanthawi kochepa ndikotheka kokha ndi chithandizo choyenera. Matenda a shuga omwe sanapatsidwe angayambitse wodwalayo. Chifukwa chake, chithandizo chiyenera kuyambitsidwa kumayambiriro kwa chitukuko cha matenda a pathological.

Glycated hemoglobin

Glycosylated hemoglobin imapangidwa chifukwa chakuti kachigawo kakang'ono ka hemoglobin kamamangika ku glucose (okwera kwambiri, pomwe kuchuluka kwa magawo a glycated). Ndipo erythrocyte, yomwe ili ndi kachigawo kakang'ono ka glycosylated, imakhala ndi moyo pafupifupi masiku 120, kotero kuwunikako kumatha kuwonetsa mkhalidwe wa kagayidwe kazakudya m'miyezi itatu yapitayo.

Fructosamine

Fructosamine amapangidwa chifukwa chomangiriza mapuloteni a plasma ku shuga, amawonetsa kuchuluka kwa glucose m'milungu iwiri yapitayi. Nthawi zambiri, kuchuluka kwa fructosamine sikuyenera kukhala okwera kuposa 285 μmol / L. Ngati zizindikirozo ndizapamwamba, izi zikuwonetsa kukhalapo kwa shuga wambiri kapena wowonongedwa, momwe chiopsezo cha zovuta zimakulira.

Lipidogram

Kusanthula uku kumapereka chidziwitso cha magawo a lipid m'magawo osiyanasiyana a magazi. Mwa njirayi, magazi amatengedwa kuchokera mu mtsempha. Asanayambe kudandaula, wodwalayo sayenera kudya chakudya kwa maola 12, osasuta, yesetsani kuti musakhale ndi mantha kwa mphindi 30 musanayesedwe. Kugwiritsa ntchito kusanthula uku, triglycerides, cholesterol yathunthu, otsika komanso okwera milps, kuchuluka kwa atherogenicity (kuchuluka kwa "koyipa" ndi "wabwino" cholesterol) kutsimikiza.

Kudziyesa nokha kwa shuga wamagazi ndi kukhalapo kwa acetone mkodzo

Kuti mupeze shuga kunyumba, gwiritsani ntchito glucometer kapena zingwe zoyeserera. Amathandizira kuyang'anira zizindikiritso ziwiri nthawi imodzi: izi ndi kuchuluka kwa shuga pamimba yopanda kanthu ndi chizindikiro cha 1.5-2 mawola atatha kudya chakudya (postprandial glycemia).

Njira yoyamba ndiyofunika kuyang'ana tsiku lililonse m'mawa, nthawi yachiwiri 4-5 tsiku lonse. Njira zoterezi zimathandizira kukhazikika pamlingo wa glucose, komanso pakupatuka pang'ono - kukonza ndi chakudya kapena mankhwala. Wodwala aliyense amasankha kuchuluka kwa zinthu zomwe ayenera kudya patsiku, koma mulimonse, ndikofunikira kuchita mankhwalawa katatu - m'mawa pamimba yopanda kanthu ndikatha kudya koyamba.

Mukamagwiritsa ntchito mankhwala atsopano a shuga, kapena zolakwika m'zakudya, ndikofunikira kuti muthidwe monga momwe mungathere.

Ndi muyezo Zizindikiro za shuga m'magazi, n`zotheka kudziwa shuga mu mkodzo osapitirira 1-2 pa mwezi. Koma ngati shuga ali pamwamba pa 12 mmol / L, ndikofunikira kuyang'ana kuchuluka kwa shuga mumkodzo nthawi yomweyo. Tiyenera kukumbukira kuti ndi shuga yemwe amalipidwa shuga ayenera kusowa, ndipo ngati alipo, izi zikuwonetsa gawo la zolipirira, kapena kuwonongeka.

Zikatero, ndikofunikira kufunsa dokotala kuti musinthe kuchuluka kwa mapiritsi ochepetsera shuga kapena insulini. Pakudzipenda nokha mkodzo, timizere ta mayeso apadera okhala ndi chizindikiro cha utoto timagwiritsidwa ntchito. Mtundu woyambira wa mzere woyerekezera umayerekezeredwa ndi mawonekedwe apadera amtundu (womwe umayikidwa pakuyika mayeso).

Ngati pali shuga mumkodzo, muyenera kuyezetsa kuti mupeze kupezeka kwa matupi a acetone (matupi a ketone). Pakusanthula kumeneku, mizera yapadera yoyeserera imagwiritsidwanso ntchito (mtundu wokhazikika umatanthawuza kukhutira kwa acetone, njira zochepa zomwe zimakhala zochepa. Kudzinyenga kotereku kumangotenga mphindi zochepa, koma zizindikiro zake zimakupatsani mwayi woti muyambe kulandira chithandizo mwachangu ndikuletsa zovuta zambiri.

Zomwe zimaperekera chindapusa

Pambuyo pamapeto omaliza "shuga mellitus" adotolo amasankha njira zamankhwala kutengera mtundu wa matenda. Mtundu woyamba wa shuga, mankhwala a insulini amagwiritsidwa ntchito; mu mtundu 2 wa shuga, matendawa amalipiridwa ndi zakudya zamankhwala, zolimbitsa thupi, ndi mankhwala a hypoglycemic.

Zakudya ziyenera kutsatiridwa mosamalitsa kwa mtundu uliwonse wa matenda ashuga. Kwa wodwala aliyense, chakudya chimasankhidwa payekha, kutengera mtundu wa magalimoto ake, koma pali mfundo zamakonzedwe, zomwe ndi zofanana kwa onse odwala matenda ashuga:

• Ndikofunikira kuphika mbale ndi kudyetsa, kuwira, kuphika,
• Idyani zakudya nthawi zambiri, m'magawo ochepa,
• Maswiti, ufa, confectionery (kuchokera ku ufa oyera), mchere, utsi, mafuta amafuta,
• Muyenera kudya zakudya zochuluka monga momwe zimatha mphamvu patsiku,
• Mchere patsiku kudya osaposa 12 magalamu.

Zomwe zimayambitsa matenda ashuga:

• Mlingo wa insulin molondola,
• Kuchulukitsa, kuphwanya mfundo za mankhwala ochiritsira,
• Kukana chithandizo
• Psycho-overstrain,
• Kukana kusinthira ku insulin,
• Kugwiritsa ntchito zakudya zamagulu owonjezera (m'malo othandizira zakudya) m'malo mwa mankhwala,
• Kudzisankhira mankhwala
• Mitundu ina ya matenda opatsirana omwe amayambitsa kuledzera kwa thupi.

Mavuto a shuga ophatikizika

Kubwezeredwa kwa matendawa kumapangitsa kuti pakhale zovuta komanso zopweteka kwambiri. Mavuto owopsa amatha pakanthawi kochepa, patangopita mphindi zochepa kapena maola. Pankhaniyi, ndikofunikira kupereka chithandizo chamankhwala mwachangu, chifukwa zotsatira za mikhalidwe yotereyi imatha kubweretsa imfa.

Zovuta zowopsa zimaphatikizapo:

• Hypoglycemia - kugwa mwadzidzidzi m'magazi a shuga. Zimayamba mwachangu, wodwalayo amawona kufooka koopsa, kumverera kwanjala. Ngati thandizo la panthawi yake siliperekedwa, munthuyo amakomoka. Amachotsedwa mu boma la hypoglycemic mothandizidwa ndi chakudya chambiri (tiyi wokoma, maswiti).
• Hyperglycemia ndikuwonjezeka kwadzidzidzi kwa shuga m'magazi. Wodwalayo amamva kufooka, njala, ludzu. Ndizotheka kuchoka pamenepa pokhapokha pobayira jakisoni.
• Matenda a shuga akuphatikizira mitundu itatu: hyperosmolar, lactic acid, mawonekedwe a ketoacidotic. Pali kuphwanya kwamadzi - electrolyte metabolism, acid-base usawa. Zizindikiro zimadalira mtundu wa chikomokere ndipo zimafunikira kuchipatala mwachangu kuchipatala.

Mavuto aakulu amatengera kuphwanya kwakukulu pakugwira ntchito kwa ziwalo ndi machitidwe:

Kupewa kwa Mavuto

Kuphatikiza pa kudziwunikira komwe thanzi lanu limakhala labwino, wodwala matenda ashuga amayenera kupita ku endocrinologist ndikupita kukayezetsa kuchipatala. Choyamba, izi ziyenera kuchitidwa ndi odwala omwe kulowererapo kwa shuga.

Nthawi ndi nthawi, ndikofunikira kumayesedwa kwa anthu omwe ali ndi vuto lotengera, makolo omwe ali ndi mwana wakufa, kapena mwana wolemera kwambiri (makilogalamu 4). Odwala matenda ashuga ayenera kukhala ndi kupindika kwa impso, ECG yamtima, kuyang'anira momwe zotengera zilili, ndikutenga chifuwa cha X-ray.

Wodwala matenda ashuga ayenera kuwonedwa osati ndi endocrinologist, komanso akatswiri ena opanikizika - a mtima, dotolo wamano, katswiri wa matenda opatsirana, ndi dermatologist.

Malipiro a shuga

Uwu ndi njira yofatsa ya matenda ashuga, momwe zizindikiro za kuyeserera zimakhala zabwinobwino kapena zochepa monga momwe zingathere kwa iwo, BMI ili kunja kwa kufunika kwa kupunduka, kuthamanga kwa magazi - kufikira pamlingo wowonjezera hypertonic. Mwa manambala, kubwezeredwa kwakukulu kwa mtundu wa 2 shuga ndi motere:

• Magazi a m'magazi a capillary (glycemia). Pamimba yopanda kanthu - pansipa 6.1 mmol / L, maola awiri mutatha kudya - pansi pa 7.5 mmol / L.
• Glycated hemoglobin - mpaka 6.5%.
• Fructosamine - mpaka 285 μmol / L.
• Mlingo wa Lipid. Cholesterol pafupipafupi. - pansipa 5.2 mmol / l. Triglycerides ali pansi pa 1.7 mmol / L. High density lipoproteins (HDL) - pamtunda wa 1.03-1.55 mmol / l. Low density lipoproteins (LDL) - pansipa 3 mmol / L. Lipoproteins otsika kwambiri (VLDL) - m'lifupi 0,13-1.63 mmol / l. Mgwirizano wa atherogenic ndi 2,2,3,5.
• Glucose mumkodzo (glucosuria) - 0% kapena 0 mmol / L.
• BMI Amuna - mpaka 25, azimayi - mpaka 24.
• HELL - osati pamwamba kuposa 139/89 mm Hg

Pakufufuza kwaposachedwa (kwakukulu), zomwe zimakhala ndi cholesterol yathunthu ndi triglycerides imatsimikizika. Zizindikiro zomwe zatsala ndi zomwe adokotala amapeza.

Ndi zizindikirozi, kuphatikizapo zonse zokhutiritsa, kusakhala ndi ludzu (polydipsia) komanso kukokoloka pafupipafupi (polyuria), kuyabwa kwa khungu ndi / kapena kuwonongeka kwamawonekedwe, pazochitika zokhazikika kwa nthawi yayitali pazikhalidwe zonse za shuga (miyezi ingapo), titha kunena kuti izi ndi kuchuluka kwa matenda ashuga othandizira odwala matenda ashuga, pomwe chiopsezo cha zovuta ndizochepa .Mulipidwe kwambiri, zotulukapo zotere zimatheka popanda kugwiritsa ntchito mankhwala ochepetsa shuga. Zakudya zokwanira ndikuwongolera chakudya chamafuta.

Kupanikizika kwamtundu wakuthupi ndi waluntha, moyo wovomerezeka komanso chizolowezi chatsiku ndi tsiku zimathandizanso kulipira matenda a shuga pamlingo wapamwamba. Makamaka koyambirira kwamatenda.

Kufotokozera kwazomwe zikuwunikira komanso kusanthula

Kusanthula kwa magawo aliwonse omwe kuphatikizidwa kwa shuga kumatsimikiziridwa kumachitika malinga ndi ndandanda yake. Ena mwa iwo amatha kusintha m'maola ochepa, ena m'milungu yochepa kapena miyezi. Koma kuphatikiza kwawo, poyerekeza ndi maphunziro am'mbuyomu komanso zovuta zamankhwala, zimapereka lingaliro lomveka bwino kwa sing'anga wopezekapo ponena kuti, makamaka, pali chipepeso, chotenga nthawi yayitali bwanji komanso mpaka pati.

Ndalama Zothandizira

Ichi ndi chikhalidwe chomwe chimachitika ndikuphwanya njira zokhazikitsidwa: zakudya, kuwongolera mafuta amthupi, thupi komanso / kapena luntha komanso kutengeka. Zingathenso kuwonetsa osayenera kapena osakwanira a mankhwala a hypoglycemic. Kuwonetsedwa kotheka kuzungulira kumbuyo kwa matenda ena omwe amasintha kagayidwe kazomwe thupi limapanga.

Mlingo wolipirira anthu odwala matenda a shuga umachepetsedwa, monga zikuwonekera ndi kuwonjezeka kwa zisonyezo zonse (kupatula HDL), mikhalidwe yoipira ndikuwoneka / kukulitsa kwa zizindikiro. Choyamba, izi zimagwira ntchito pazosala komanso kudya pambuyo pa chakudya. Kuphatikiza apo, ngati kuphwanya kwa boma kunali kwa nthawi imodzi komanso kwakanthawi kochepa, ndiye kuti ikabwezeretsedwa, magawo omwe atsala amakhalabe osasinthika. Kukonza chithandizo chofunikira sikofunikira. Mutha kuchita popanda kuyendera katswiri, koma mu "diary ya shuga" onani izi.

Pophwanya boma mwatsatanetsatane komanso / kapena osagwirizana ndi kugwiritsa ntchito ma hypoglycemic othandizira, madigiri okhazikika a mtundu wa 2 amakhazikitsidwa. Kuwonongeka kumatha kuyambitsidwa ndikukula kwa matenda ena aliwonse, omwe amakhudza, makamaka, kagayidwe kazakudya. Pankhaniyi, kuwonjezereka kwa zikhazikitso zokhazikika. Ndipo chizindikiro choyamba cha kusintha kwa gawo la mankhwalawo ndikuwonekera kwa glucosuria (mpaka 0,5% kapena 28 mmol / l). Kufunsira kwa adotolo, kuwunika kowonjezereka, kukonza njira komanso mankhwala othandizira ndikofunikira.

Zizindikiro zolipilira zimachokera kuzowonjezera mpaka zolipiridwa.

Kuwononga Matenda A shuga A 2

Mkhalidwe wowopsa wa matenda. Amaonedwa ndikuphwanya boma, mosayenera kapena chithandizo chakusowa, chitukuko cha nthenda ina iliyonse yayikulu. Ndi kuwonongeka, kuwonongeka kumachitika m'matumbo, ziwalo zamkati ndi machitidwe awo, kukulitsa zovuta zazikulu (asanafe). Miyezo yoyambira:

• Magazi a m'magazi a capillary (glycemia). Kusala -7.8 ndi mmol / l pamwamba. Maola 2 mutatha kudya - 10 ndi kukwera mol / l.
• Glycated hemoglobin -7,5% komanso kuposa,
• Fructosamine - pamwambapa 285 μmol / L,
• Mlingo wa Lipid. C cholesterol chonse -6.5 ndi mol mol l. Triglycerides - 2.2 ndi okwera mol / L. High density lipoproteins (HDL) - pansipa 1.0 mmol / L. Low density lipoproteins (LDL) - pamwambapa 3 mmol / L. Osachepera mphamvu kwambiri aopoproteins (VLDL) - pamwambapa 1.63 mmol / L. Kuthekera kwa atherogenicity - kupitilira 3.5.
• Glucose mumkodzo (glucosuria) - kuchokera ku 0,5% kapena 28 mmol / l.
• BMI Amuna - opitilira 27, azimayi - oposa 26.
• HELL -159 / 99mm Hg ndi zina zambiri.

Zomwezi zimafotokoza kuti kubwezeretsa koteroko kwa matenda a shuga omwe ali ndi insulin kumakhala kotsika kwambiri.

Anazindikira kuti ali ndi nthawi, akuwongolera, matenda a shuga a 2 sangayambitse vuto kwa nthawi yayitali. Moyo wabwino wa odwala omwe ali ndi mtundu wofanana wa mtundu wa 2 shuga amakhala pafupi ndi moyo wamunthu wathanzi. Ndipo koposa zonse, dziko la chiphuphu ndi kupewa zovuta zovuta za shuga komanso chinsinsi chokhalira ndi moyo.