Gestational shuga mellitus pa mimba: Zizindikiro, zakudya

Matenda a shuga opatsirana amakula nthawi yapakati (mimbulu) ndipo nthawi zambiri amatha pambuyo pobala. Monga mitundu ina ya shuga, matenda ashuga amakhudza mphamvu ya maselo anu yogwiritsa ntchito shuga (glucose). Matenda a shuga a m'mimba amayamba ndi shuga wambiri, amene amatha kuthana ndi mimba yanu komanso thanzi la mwana wanu. Pansipa tikambirana mwatsatanetsatane zamomwe matenda opatsirana am'mimba amathandizira pakakhala pakati, Zizindikiro za shuga, Zizindikiro, chithandizo, zomwe zimayambitsa ngozi, ndikuganiziranso zakudya zofunika.

Matenda a shuga a gestational amatha kukhala nthawi iliyonse yomwe ali ndi pakati, koma amakhala ochulukirapo mu theka lachiwiri la mimba. Izi zimachitika ngati thupi lanu silingatulutse insulin yokwanira (mahomoni omwe amathandiza kuwongolera shuga) kuti akwaniritse zosowa zapakati pa nthawi ya pakati.

Matenda a shuga obadwala angayambitse mavuto kwa inu ndi mwana wanu mukamabadwa. Koma chiwopsezo cha mavutowa chimatha kuchepetsedwa ngati matendawa apezeka ndikuwongolera bwino. Mayi woyembekezera amatha kuthandizira matenda ashuga pakudya zakudya zopatsa thanzi, zolimbitsa thupi, ndipo ngati pakufunika kutero, mankhwala. Kuyang'anira shuga wanu wamagazi kumathandizira kupewa kubadwa kovuta komanso kukhalabe ndi thanzi la mwana wanu komanso lokwanira.

Ndani ali pachiwopsezo cha matenda ashuga

Mkazi aliyense amatha kukhala ndi matenda ashuga pakatha nthawi yayitali, koma chiwopsezo chotenga matendawa chitha kuchuluka ngati:

• Mkulu wanu mzere wozungulira (BMI) ndi woposa 30
• Mwana wanu wakale anali wolemera makilogalamu 4.5 kapena kuposerapo pobadwa
• Munadwala matenda ashuga m'mimba m'mbuyomu
• Mmodzi mwa makolo anu kapena abale anu ali ndi matenda a shuga
• Mbiri yakubanja kwanu ndi ku South Asia, China, Pacific Caribbean, kapena Middle East

Ngati chilichonse mwa izi chikugwirira ntchito kwa inu, muyenera kupezedwa kuyezetsa matenda a shuga.

Zizindikiro za matenda a shuga

Matenda a gestational nthawi zambiri samayambitsa zizindikiro. Nthawi zambiri, shuga wambiri amayamba kupezeka m'mayendedwe a shuga. Amayi ena amangokhala ndi zisonyezo ngati shuga wawo wamagazi akwera kwambiri (hyperglycemia). Zizindikiro zake zimaphatikizapo:

• ludzu lochulukirapo
• kukodza pafupipafupi
• kamwa yowuma
• kutopa

Koma zina mwazizindikirozi ndizodziwika mokwanira panthawi yomwe muli ndi pakati, ndipo sikuti ndichizindikiro cha matenda ashuga. Lankhulani ndi mzamba wanu kapena dokotala ngati muli ndi nkhawa ndi zomwe mukukumana nazo.

Momwe shuga ya gestational ingakhudzire mimba

Amayi ambiri omwe ali ndi matenda ashuga apakati amakhala ndi pakati mwakhanda ndipo ana abwinobwino amabadwa. Komabe, izi zitha kubweretsa mavuto monga:

• Mwana wanu akukula kuposa masiku onse - izi zimatha kubweretsa zovuta pakubadwa kwa mwana komanso kuwonjezeka kwa gawo la caesarean.
• Polyhydramnios - Madzi ambiri amniotic (madzimadzi ozungulira mwana) muchiberekero, omwe angayambitse kubadwa msanga kapena mavuto obeleka.
• Mwana musanabadwe - kubadwa sabata la 37 la mimba.
• Preeclampsia - Vuto lomwe limayambitsa kuthamanga kwa magazi pa nthawi ya pakati ndipo lingayambitse zovuta ngati sanalandire.
• Mwana wanu amakula ndi magazi ochepa kapena khungu lake ndi khungu (jaundice) atabadwazomwe zingafune chithandizo kuchipatala.
• Kutaya mwana (kubereka) - ngakhale izi ndizosowa.

Kukhala ndi matenda ashuga akakhala ndi pakati kumatanthanso kuti muli pachiwopsezo chotenga matenda amitundu iwiri mtsogolo.

Kuyendera matenda a shuga

Mukamayenda koyamba pakubadwa kwa milungu pafupifupi 8 mpaka 12, mzamba wanu kapena dokotala akukufunsani mafunso kuti muwone ngati muli pachiwopsezo chotenga matenda a shuga. Ngati muli ndi vuto limodzi kapena zingapo zomwe zingachitike chifukwa cha matenda ashuga, muyenera kuyesedwa.

Mayeso owunika omwe amagwiritsidwa ntchito amatchedwa glucose kulolerana mayeso (TSH), omwe amatenga pafupifupi maola awiri. Kuyeza kumeneku kumaphatikizanso kuyezetsa magazi m'mawa pomwe simunadye kapena kumwa chilichonse usiku woti mawa uyesedwe, ndikugwiritsanso ntchito zakumwa za glucose panthawi yoyeserera. Mukapuma kwa maola awiri, muyeso wina wamagazi amatengedwa kuchokera kwa inu kuti muwone momwe thupi lanu limagwiritsira ntchito shuga.

TSH imachitika kuyambira milungu 24 mpaka 28 ya bere. Ngati m'mbuyomu mudadwala matenda ashuga, mudzafunsidwa kuti mudzakhale ndi TSH kale, mutayendera dokotala, komanso TSH ina pakapita masabata 24 mpaka 28 ngati mayeso oyamba ali abwinobwino. Kuphatikiza apo, atha kupemphedwa kukayesa kuchuluka kwa shuga m'magazi anu pogwiritsa ntchito chala cham'magazi (magazi a shuga).

Chithandizo cha matenda ashuga

Ngati muli ndi vuto la matenda amiseche, kuchitika kwa mavuto am'mimba kumatha kuchepetsedwa ndikuwongolera shuga (magazi) anu. Muyeneranso kuyang'aniridwa ndi madokotala nthawi yayitali komanso pobereka, kuonetsetsa nthawi zonse momwe mankhwalawo amagwirira ntchito komanso ngati pali zovuta zina.

Kuyang'ana shuga m'magazi - zizindikiro

Mupatsidwa zida zoyesera zomwe mungagwiritse ntchito kuti muwone shuga wanu wamagazi. Kuyesedwa kwa shuga m'magazi kumaphatikizapo kugwiritsa ntchito chipangizo kuti mulowe zala zanu ndikuyika dontho la magazi pachiyeso.

• Momwe mungayang'anire shuga lanu lamagazi.
• Ndi liti komanso kangati komwe muyenera kuyang'ana shuga wanu wamagazi - azimayi ambiri omwe ali ndi vuto lodana ndi matenda ashuga amalangizidwa kuti ayang'ane shuga wawo wamagazi asanadye chakudya cham'mawa ndi ola limodzi mutatha kudya.
• Makhalidwe a 7.2-7.8 mmol / L ola limodzi mutatha kudya nthawi zambiri zimawoneka ngati zabwinobwino pofufuza zitsanzo za shuga (zingasiyane malingana ndi chipatala kapena labotale). Ngati muli ndi zizindikiro zapamwamba, ndiye kuti mutha kupezeka ndi matenda a shuga.

Kusintha zakudya zanu kumatha kuwongolera shuga lanu lamagazi. Muyenera kuperekedwa kuti mukatumize kwa akatswiri azakudya omwe angakupatseni malangizo pazakudya zanu, ndipo mutha kupatsidwa kapepala kuti kakuthandizeni kukonza zakudya zanu.

Zakudya za anthu odwala matenda ashuga amayenera kuphatikiza zakudya zambiri, monga masamba atsopano, zipatso, tirigu, ndi zakudya zopanda mafuta.

Mutha kulangizidwa:

• Idyani pafupipafupi (nthawi zambiri katatu patsiku) ndipo pewani kudumpha zakudya.
• Idyani zakudya zotsika za glycemic indexyomwe imatulutsa shuga pang'onopang'ono, monga phala lonse la tirigu, mpunga wa bulauni, buledi wopanda tirigu, mbewu zonse za chinangwa, nyemba (nyemba, nyemba, mphodza, etc.), granola ndi oatmeal.
• Idyani zipatso ndi masamba ambiri - Yesetsani kudya zakudya zosachepera zisanu patsiku.
• Pewani zakudya zotsekemera - simuyenera kupewa kudya maswiti, koma yesani kugwiritsa ntchito maswiti, monga makeke ndi makeke, ndi njira zina zofunikira monga zipatso, mtedza ndi mbewu.
• Pewani zakumwa zoopsa. -Zakumwa zopanda shuga kapena zakumwa zakumwa ndizabwinoko kuposa zakumwauzire. Dziwani kuti misuzi yazipatso ndi ma smoothie amakhalanso ndi shuga, chifukwa chake werengani zomwe zalembedweratu musanagwiritse ntchito.
• Phatikizani ndi mapuloteni otayirira (opanda mafuta) muzakudya zanumonga nsomba ndi nyama yokonda.

Zochita zolimbitsa thupi

Kuchita masewera olimbitsa thupi kumachepetsa shuga m'magazi, motero kuchita masewera olimbitsa thupi nthawi zonse kumatha kukhala njira yothanirana ndi matenda a shuga. Mudzadziwitsidwa zolimbitsa thupi mosamala mukamakhala ndi pakati. Malangizo onse ndikuwonetsa kuchita zolimbitsa thupi sabata iliyonse osachepera mphindi 150 (maola 2 ndi mphindi 30). Kuchita masewera olimbitsa thupi moyenera ndi ntchito iliyonse yomwe imakulitsa kugunda kwa mtima wanu ndikupangitsa kuti mupume mofulumira, monga kuyenda mwachangu kapena kusambira.

Mankhwala

Ngati shuga wanu wamagazi amatsika sabata kapena awiri mutasintha kadyedwe kanu ndikuchita masewera olimbitsa thupi pafupipafupi, kapena ngati shuga wanu wamagazi ndiwokwera kwambiri, mutha kulandira chithandizo. Itha kukhala mapiritsi (nthawi zambiri Metformin) kapena jakisoni wa insulin.

Mwazi wanu wamagazi ungakulitse pamene mimba yanu ikupita patsogolo, kotero ngakhale mulingo wama glucose olamulidwa bwino koyambirira, mungafunike kumwa mankhwalawa panthawi yapakati. Mankhwalawa amachotsedwa pakubala.

Metformin imwani mapiritsi katatu patsiku, nthawi zambiri mukamadya kapena mukatha kudya.

Metformin ikhoza kuyambitsa zotsatirazi:

• kumva kusasangalala
• kusanza
• m'mimba kukokana
• kutsekula m'mimba (m'mimba)
• kusowa kwa chakudya

Nthawi zina, mankhwala ena omwe mapiritsi angalembedwe - Glibenclamide.

Jakisoni wa insulin

Insulin akhoza kukhala olimbikitsidwa ngati:

• Simungatenge metformin kapena imayambitsa mavuto.
• Shuga wamagazi anu samayendetsedwa ndi Metformin.
• Muli ndi shuga kwambiri.
• Mwana wanu ndi wamkulu kwambiri kapena muli ndi madzi ambiri m'mimba mwanu (polyhydramnios).

Insulin imatengedwa ngati jakisoni ndipo muwonetsedwa momwe mungachitire nokha. Kutengera mtundu wa insulin yomwe mwalandira, muyenera kupatsidwa jakisoni musanadye, nthawi yogona, kapena mutadzuka.

Mudzauzidwa kuchuluka kwa insulin yomwe muyenera kupereka. Magazi a shuga m'magazi nthawi zambiri amachulukirachulukira pamene mimba ikupita patsogolo, kotero mlingo wa insulin ungafunike kuwonjezereka pakapita nthawi.

Insulin ingayambitse kuchepa kwambiri kwa shuga m'magazi (hypoglycemia). Zizindikiro za shuga wochepa wamagazi zimaphatikizapo:

• kumverera kwa kusakhazikika komanso kusakhazikika
• thukuta
• njala
• blanching
• kuyang'ana mozama

Ngati mukukumana ndi chilichonse mwazizindikirozi, muyenera kuyang'ana kuchuluka kwa shuga m'magazi anu - funsani dokotala nthawi yomweyo ngati ali otsika kwambiri.

Kuwongolera mimba

Matenda a shuga amtunduwu amatha kukulitsa chiwopsezo cha mwana wanu kukulira mavuto, monga kunenepa kwambiri. Chifukwa cha izi, mudzapatsidwa chisamaliro chowonjezera kuti mwana wanu athe kuyang'aniridwa bwino.

Nawa maulendo omwe mungapereke:

• Ultrasound scan (ultrasound) pa nthawi ya masabata a 18-20 kuti muwone zomwe mwana wanu ali ndi zotupa.
• Ultrasound pa 28, 32 ndi masabata a 36kuwunika kukula kwa mwana wanu ndi kuchuluka kwa madzimadzi am'madzi, komanso macheke pafupipafupi kuchokera masabata 38.

Kubala mwana

Nthawi yabwino yobala azimayi omwe ali ndi matenda osokoneza bongo nthawi zambiri amakhala masabata 38 mpaka 40. Ngati shuga wanu wamagazi ali mkati moyenerera ndipo mulibe mavuto azaumoyo kapena thanzi la mwana wanu, mutha kudikirira mpaka kubadwa kumayamba mwachilengedwe.

Koma ngati simunabadwe isanakwane tsiku la 6 la sabata la 40, mutha kufunsidwa kuti mubadwe kapena kukhala ndi gawo la cesarean. Kubadwa koyambirira kumatha kulimbikitsidwa ngati mukukhudzidwa ndi thanzi lanu kapena thanzi la mwana wanu, kapena ngati shuga wanu wamagazi suyendetsedwa bwino. Muyenera kubereka kuchipatala, komwe othandizira azaumoyo amatha kupereka chisamaliro choyenera kwa mwana wanu maola 24 patsiku.

Mukapita kuchipatala kuti mukabereke, tengani magazi anu okonzekera shuga komanso mankhwala aliwonse omwe mumamwa. Nthawi zambiri, muyenera kupitiliza kuyang'ana shuga wanu wamagazi ndikumwa mankhwala anu kufikira mutafika tsiku lanu lobadwa. Nthawi yobereka, kuchuluka kwa shuga m'magazi kumayang'aniridwa ndi madokotala. Amayi ena angafunike dontho la insulini kuti awongole magazi awo.

Pambuyo pobadwa

Nthawi zambiri mumatha kuwona, kugwira ndi kudyetsa mwana wanu mukangobadwa. Ndikofunikira kuti muyambe kudyetsa mwana wanu akangobadwa kumene (mkati mwa mphindi 30), kenako maola awiri aliwonse mpaka magazi ake azikhala okhazikika. Shuga ya mwana wanu imayesedwa maola awiri kapena anayi pambuyo pobadwa. Ngati ili yotsika, ingafune kudyetsedwa kwakanthawi kudzera pa chubu kapena dontho.

Mwana wanu samva bwino kapena akufunika kuwayang'anitsitsa, adzam'samalira m'dipatimenti yapadera ya akhanda. Mankhwala alionse omwe mumamwa kuti muchepetse shuga wanu wamagazi nthawi zambiri amatha pambuyo pobadwa. Nthawi zambiri mumalangizidwa kuti mupange shuga wanu wamagazi tsiku limodzi kapena awiri atabereka.

Ngati inu ndi mwana wanu muli athanzi, nthawi zambiri mumatha kubwerera kunyumba pambuyo maola 24. Masabata 6 mpaka 13 atabereka, muyenera kuyezetsa magazi kuti muwone ngati ali ndi matenda ashuga. Izi ndichifukwa chakuti azimayi ochepa omwe ali ndi matenda ashuga amakula shuga pambuyo magazi.

Ngati zotsatira zake ndizabwinobwino, nthawi zambiri mumalangizidwa kuti mudzayezetsa matenda ashuga apachaka. Izi ndichifukwa choti azimayi omwe ali ndi matenda osokoneza bongo ali pachiwopsezo chotenga matenda a shuga a 2.

Zotsatira zazitali za matenda a shuga

Matenda a shuga okomoka nthawi zambiri amachoka mwana akangobadwa, koma azimayi omwe amadwala matendawa amatha kupezekanso:

• Matenda a shuga okomoka amabwezanso m'mimba zamtsogolo.
• Matenda a 2 a shuga ndi mtundu wonse wa matenda ashuga.

Muyenera kuyezetsa magazi masabata 6-13 mutabereka kuti mupeze matenda a shuga. Ngati shuga wanu wamagazi ndi wabwinobwino, mudzalangizidwa kuyezetsa magazi anu chaka chilichonse. Ngati mukukhala ndi shuga wambiri, monga ludzu lochulukirapo, kufunikira kukodza pafupipafupi kuposa masiku onse, komanso pakamwa pouma - musadikire kuyesedwa kwa matenda ashuga.

Muyenera kuyezetsa magazi ngakhale mukumva bwino, chifukwa anthu ambiri omwe ali ndi matenda ashuga alibe zizindikiro za matendawa. Adzadziwitsidwanso pazomwe mungachite kuti muchepetse vuto lanu la matenda a shuga, mwachitsanzo, sungani thupi lanu bwino, idyani moyenera komanso pafupipafupi, etc.

Zotsatira zamaphunziro ena, akuti ana omwe amayi awo anali ndi matenda osokoneza bongo nthawi ya pakati amatha kupezeka ndi matenda a shuga kapena kunenepa kwambiri akamakalamba.

Kukonzekera Kwa Mtsogolo

Ngati kale mudadwala matenda ashuga komanso mukufuna kukhala ndi pakati, muyenera kuyezetsa matenda a shuga. Ngati muli ndi matenda ashuga, muyenera kupita ku chipatala musanatenge mimba kuti muonetsetse kuti matenda anuwo ndi olamulidwa bwino.Ngati muli kale ndi pakati, lankhulanani ndi dokotala ndikuti munkakhala ndi matenda a shuga panthawi yomwe mumakhala kale.

Ngati mayesowa akuwonetsa kuti mulibe matenda a shuga, mudzapemphedwa kukayezetsa shuga mukangofika ku chipatala, ndipo tikulimbikitsidwa kuti mudzayesedwenso pambuyo pa masabata 24-28 ngati mayeso oyamba ali abwinobwino.

Mutha kufunsidwanso kuti muyambe kuyesa kuchuluka kwa shuga m'magazi anu pogwiritsa ntchito chida chakudulira chala, monga momwe mudachitira m'mbuyomu panthawi ya shuga.