Postprandial Hyperglycemia > Matenda a shuga

Matenda hyperglycemia ndizomwe zimayambitsa chitukuko ndi kupitilira kwa zovuta za matendawa, ndipo zovuta zazikulu za macroangiopathic ndizomwe zimayambitsa kufa kwa odwala matenda ashuga.

Kafukufuku waposachedwa ndi asayansi adatsimikiza kuti kuwongolera glycemic control kumachepetsa kwambiri zovuta za macroangiopathic pamavuto omwe ali ndi matenda amtundu wa 1 kapena mtundu wa 2. Mpaka posachedwa, njira yodziwika bwino ya chithandizo chamankhwala yakhala yochepetsa miyezo ya HbA1c, makamaka kutsimikizira kusala kudya kwa glycemia. Komabe, ngakhale kusala kudya kwa glycemia ndikofunikira, nthawi zambiri sikokwanira kukwaniritsa bwino glycemia. Pakadali pano, chiwerengero chokwanira cha data chalandiridwa chomwe chikuwonetsa kuti kuchepa posachedwa (mutatha kudya) shuga wa m'magazi ali ndi kutsogolera udindo komanso chofunikira kuti tikwaniritse zigoli za glycated hemoglobin (HbA1c).

Zotsatira zake, zimadziwika kuti postprandial hyperglycemia ndi chiopsezo chodziyimira pawokha pakupanga zovuta za macroangiopathic.

Chifukwa chake, glycemia ya postprandial imayambitsa zovuta zazikulu, ndipo iyenera kuwongoleredwa.

Kafukufuku wambiri watsimikizira kuti kugwiritsa ntchito mankhwala omwe amachepetsa kuchuluka kwa glucose wa postprandial plasma kumathandizanso kuchepa kwa zovuta zam'mimba. Chifukwa chake, mankhwala othandizira kuchepetsa glycemia (GKH) ndi glycemia wa postprandial ndikofunikira kwambiri kuti akwaniritse kuyendetsa bwino glycemic kudzera prism yopewa kupewa matenda ashugazovuta.

MAFUNSO OYAMBIRIRA

1. Matenda a shuga, tanthauzo.

2. Gulu la anthu odwala matenda ashuga.

3. Mitundu yayikulu ya matenda a shuga.

4. Kupeza njira za matenda a shuga a I ndi II.

5. Zizindikiro zazikulu komanso mawonetsedwe azachipatala.

6. Insulin, mphamvu ya kagayidwe.

7. Hyperglycemia ndi glucosuria.

9. Kulekerera kwa shuga.

10. Kupeza njira zowunika poyeserera shuga.

11. Wosokoneza glycemia.

12. Kuperewera kwathunthu ndi insulin.

13. Postprandial hyperglycemia

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Lingaliro la hyperglycemia - ndi chiyani

Matenda a shuga ndi kuphwanya kagayidwe kazakudya (chakudya, mapuloteni, mafuta, mchere wamchere ndi mchere). Kuwongolera kuchuluka kwa shuga mwa akulu ndi ana, mahomoni apadera, insulin, amagwiritsidwa ntchito.

Milingo ya insulin imadalira mtundu wamatenda:

Mtundu 1 - njira yopangira zinthu kapamba imasokonekera - mankhwalawa amayamba chifukwa cha kuphatikiza jekeseni ndikutsatira kwambiri zakudya.
Type 2 (shuga yosadalira insulini) imayipitsa kuzindikira mwa ziwonetsero za insulin (chifukwa chomwe glucose imadziunjikira m'magazi chifukwa sichilowa m'maselo).

Mu shuga mellitus, ntchito za kapamba (zomwe zimatulutsa insulini) ndizowonongeka. Ngati munthu amene alibe matenda ashuga, atadya chakudya chochuluka, ali ndi msinkhu wokwanira 10 mmol / l, izi zikutanthauza kuti pali choopseza chokhala ndi matenda amtundu wa 2.

Glycemia - ndi chiyani

Khalidwe liziwonjezereka kufika pa 16.4 mmol / l, ndiye kuti pali vuto la kukomoka kapena dziko lokondweretsa. Mwa omwe ali ndi matenda a shuga, pali mitundu iwiri ya hyperglycemia - postprandial (mutatha kudya zoposa 9,9 mmol / l), kusala kudya kwa hyperglycemia (ngati chakudya sichinadye kwa maola opitilira 8, ndiye kuti shuga ya glucose imakwera kuposa 6,9 mmol / l).

Ndi glycemia, shuga wamagazi amayenera kuyesedwa pafupipafupi.

Hyperglycemia imasiyanitsidwa ndi zovuta zotsatirazi:

Pa mapapu (5.9-9.9 mmol / l),
Kuopsa kwapang'ono (9.9-15.9 mmol / l),
Zambiri (zoposa 15.9 mmol / L).

Iwo omwe ali ndi matenda ashuga amayenera kuyang'anira kuchuluka kwa shuga m'magazi, chifukwa nthawi yayitali ya hyperglycemia, pamakhala chiopsezo chotenga mitsempha yamagazi, mitsempha ndi zina zoopsa (chikomokere, ketoacidosis). Chifukwa chiyani pamakhala kubwezera - nkovuta kuwachitira kapena kuchotsa zizindikiro. Kuwonjezeka kowopsa kwa shuga m'magazi kumatha kuchitika pazifukwa zingapo (mkhalidwewu ndiowopsa kwambiri ndipo umafunika kuwongolera mwachangu). Ngati shuga m'mayeso akukwera kuposa zofunikira, ndikofunikira kukayezetsa.

Kuwonjezeka kwa shuga kumatha kutsutsana ndi zochitika za nkhawa, kulimbikira, kusuta, kuchita masewera olimbitsa thupi.

Kuti zotsatira zake zikhale zodalirika, phunzirolo lisanachitike, ndikofunikira kuti musachite mantha, kusuta komanso kupewa kuchita masewera olimbitsa thupi. Kukula kwa hyperglycemia kumathandizidwa ndi kudya kwambiri, kupsinjika, kupsinjika mopitirira muyeso, kapena, kutengera zambiri m'moyo, matenda opatsirana komanso opatsirana amatithandizanso kudziwa zizindikiro za hyperglycemia. Mwazi wa magazi umakwera m'matenda monga matenda a shuga, hyperthyroidism, kapamba, komanso khansa ya kapamba, matenda a Cushing, mawonekedwe omwe amapangitsa mahomoni, kuwonjezera shuga, stroke, myocardial infarction, kugwiritsa ntchito mankhwala osokoneza bongo (angapo a psychotropic, thiazide diuretics, estrogens, glucagon) ndi ena).

Zomwe Zimayambitsa Madzi Akuluakulu a shuga

Chifukwa chachikulu chomwe hyperglycemia imakhalira ndi kuchuluka kwa insulini (mahomoni omwe amatsitsa kuchuluka kwa glucose m'magazi). Ndipo chifukwa cha kubaya jakisoni wa insulin kapena kumwa mankhwala ochepetsa shuga, hyperglycemia imatha kukhalanso.

Zizindikiro za hyperglycemia zomwe ziyenera kuthandizidwa kuti pasakhale zovuta kwambiri mtsogolo:

Udzu wambiri (shuga akamatuluka, munthu amakhala ndi chidwi chofuna kumwa - amatha kumwa mpaka malita 6 a madzi patsiku),
Pakamwa pakamwa
Kufooka kopanda mphamvu kwa thupi,
Kuchepetsa thupi ndi chakudya choyenera,
Khungu loyera
Kutaya chikumbumtima
Zowonongeka
Kutsegula m'mimba
Kudzimbidwa
Malingaliro osaganizira komanso ozizira.

Ngati mukupeza zizindikiro zotere m'nyumba mwanu, muyenera kuyesa mayeso a glucose. Munthu yemwe akudwala hyperglycemia ayenera kuyeza shuga (onse pamimba yopanda kanthu komanso pambuyo chakudya). Ndikofunikira kukaonana ndi dokotala ngati zikuyesa kwambiri.

Kuwonjezeka kwa shuga m'magazi kumatha chifukwa cha matenda osiyanasiyana.

Ndikofunikira kutsatira zakudya - koma pokhapokha mutakambirana ndi dokotala.

Nthawi zambiri, insulin imapangidwira chithandizo cha odwala. Ngati matendawa ndi nondiabetesic, ndiye kuti ndizachidziwikire kuti matenda oyamba a endocrine omwe amayambitsa matendawa.

Kodi hyperglycemia ndi chiyani mwa ana

Mu ana, hyperglycemia imakhala yokwanira. Ngati kusala kwa glucose kusuntha ndi 6.5 mmol / L kapena kuposa, ndipo pambuyo pa 9 mmol / L kapena kuposerapo, kuzindikira kwatsimikizika. Hyperglycemia imatha kupezekanso mwa akhanda - awa nthawi zambiri amabadwa ana olemera 1.5 kg kapena kuchepera.

Komanso omwe ali pachiwopsezo ndi omwe amayi awo adadwala panthawi yoyembekezera:

Ngati sichinachitike kwa nthawi yayitali, hyperglycemia imabweretsa mavuto akulu. Pali ma cell osowa muubongo, shuga ochulukirapo, izi zimatha kuyambitsa matenda ammimba kapena hemorrhage. Posachedwa, ana ndi achinyamata omwe ali pachiwopsezo chachikulu alowetsedwa kuchipatala, chifukwa hyperglycemia sanapezeka pa nthawi yake.

Zomwe zimapangitsa kukula kwa ana ndi kuperewera kwa zakudya m'thupi, kupsinjika kwamthupi ndi m'maganizo, kapena kusowa kwathunthu zolimbitsa thupi.

Ndikofunikira kuchepetsa zakudya zopatsa mphamvu - zimapezeka m'maswiti onse, makamaka mu zakumwa zotsekemera za kaboni. Nthawi zambiri zinthu zimayamba mwadzidzidzi ndipo zimapita patsogolo mwachangu. Glucose amatsitsidwa moyang'aniridwa ndi dokotala yemwe amapereka chithandizo chokwanira chomwe chimaphatikizapo onse mankhwala ndi zakudya. Muyenera kuyang'ana pafupipafupi shuga. Choyambitsa chachikulu cha hyperglycemia ndi kuperewera kwa zakudya m'thupi. Ndikofunikira kutsatira malamulo ena - kumwa madzi okwanira, kudya pafupipafupi pang'ono, zipatso ndi ndiwo zamasamba zambiri, kuchepetsa kudya zakudya zazonunkhira, zamafuta ndi mafuta, zakudya zimaphatikizapo mitundu yonse ya zakudya zamapuloteni (mazira, nyama, mkaka), kuchokera ku zakudya zamchere - zipatso zouma kapena zinthu odwala matenda ashuga. Kuchita zolimbitsa thupi zolimbitsa thupi (kuchita masewera olimbitsa thupi, mwachitsanzo, komanso, mwanjira iliyonse, masewera aliwonse) kumathandizira kusintha kagayidwe kazakudya mthupi ndipo izi zimathandizira kutsitsa shuga komanso kukhazikika kwazomwe zimachitika. Ngakhale theka la ntchito tsiku lililonse limabweretsa zabwino kwa thupi - limatha kukhala njinga, kuyenda, tenisi, kusewera badminton, ngakhale kungopereka kukweza, ndi abwino kwa shuga.

Etiology

Hyperglycemia wofatsa - 6.7-8.2 mmol / l,
kusakhazikika kwapakati - 8.3-11.0 mmol / l,
zolemera - zopitilira 11.1 mmol / l,
ndi chisonyezero choposa 16,5 mmol / l, kutsika kwakutulutsa,
ndi chisonyezero choposa 55,5, kukomoka kwa hyperosmolar kumachitika.

Kwa anthu omwe ali ndi vuto lalitali la carbohydrate metabolism, mfundozi zimatha kusiyana pang'ono.

Etiology

Zowopsa

Postprandial hyperglycemia ndi shuga wambiri wa 10 mmol / L kapena kuposa pambuyo chakudya wamba. Kufunika kwa postprandial ndi maziko a hyperglycemia mu pathogeneis wa zovuta zam'mbuyomu zamankhwala osokoneza bongo kumakhala kwakukulu kwambiri. Mavuto a metabolism a mtundu wa 2 shuga amapanga zinthu zingapo zowopsa m'mitsempha yamagazi ndi mtima, kuphatikiza:

Kunenepa kwambiri
Matenda oopsa.
Mitundu yambiri ya inhibitor 1 yothandizira fibrinogen ndi plasminogen.
Hyperinsulinemia.
Dyslipidemia, yomwe imadziwika kwambiri ndi cholesterol yotsika HDL (high density lipoproteins) ndi hypertriglyceridemia.
Kukana insulini.

Imfa yodwala matenda a mtima ndi ziwonetsero zomwe siziri zowopsa za matendawa kwa odwala omwe ali ndi matenda osokoneza bongo amakhala ochulukirapo katatu kuposa anthu amisinkhu imodzimodzi koma alibe matenda a shuga.

Chifukwa chake, osadziwika omwe ali pachiwopsezo komanso zomwe zimadziwika ndi mtundu wachiwiri wa matenda ashuga, kuphatikiza insulini ndi hyperglycemia, ayenera kuyang'anira kukula kwa atherosulinosis mwa odwalawa.

Zizindikiro zodziwika bwino za kuwongolera shuga (glycated hemoglobin level, glycemia level) sizofotokoza kwathunthu kuchuluka kwa zovuta za mtima ndi odwala omwe ali ndi matenda a shuga a 2. Zina zomwe zatsimikizidwa ndizopweteka:

Matenda oopsa.
Kudziletsa.
Okwatirana (amuna ndi omwe atenga mosavuta).
Dyslipidemia.
M'badwo.
Kusuta.

Postprandial shuga ndende

Koma, monga zotsatira za kafukufuku ochulukirapo zawonetsa, postprandial glycemia imathandizanso kwambiri pakukula kwa matenda a mtima ndi matenda a mtima. Kafukufuku wachipatala cha DECODE yemwe amawunika chiopsezo cha kufa kwa mitundu yosiyanasiyana ya hyperglycemia adawonetsa kuti kuzungulira kwa glucose yodziwika bwino ndi njira yodziyimira payokha yomwe imaneneratu kuposa hemoglobin ya glycated.

Kafukufukuyu adatsimikiza kuti powunika kuopsa kwa matenda osokoneza bongo a mtundu wachiwiri wa shuga, munthu ayenera kuganizira osati zokhazokha za kusala kudya kwa glycemia HbA1c, komanso kuchuluka kwa glucose m'magazi 2 maola atatha kudya.

Zofunika! Kugwirizana pakati pa kusala kudya ndi postprandial glycemia kulipo. Thupi silitha kuthana bwino ndi kuchuluka kwa chakudya chambiri chomwe chimaperekedwa panthawi ya chakudya, zomwe zimapangitsa kuti pakhale kuchuluka kapena kutsekemera pang'ono pang'onopang'ono kwa shuga. Zotsatira zake, kuchuluka kwa glycemia kumawonjezeka kwambiri mutangodya, sikugwa masana, komanso ngakhale chizolowezi chomangosala shuga ndimagazi.

Pali lingaliro kuti, pakuwunika chiopsezo cha matenda amtima wamagazi, kuchuluka kwa kuchuluka kwa shuga m'magazi a shuga mellitus omwe amagwirizanitsidwa mwachindunji ndi kudya zakudya ndizofunikira kwambiri kuposa kusala kudya kwa glucose.

Ngati wodwala ali ndi vuto la mitsempha komanso ma microcirculatory pamavuto a 2 mtundu, izi zikuwonetsa kuti postprandial hyperglycemia zinachitika kale zisanachitike zizindikiro zamatenda a shuga, ndipo chiopsezo chokhala ndi zovuta zambiri kwakanthawi yayitali.

Pali lingaliro lamphamvu pazokhudza zomwe zimachitika kuti matenda ashuga aposachedwa. Zomwe zimayambitsa matenda a shuga a 2 ndizoperewera insulin komanso insulin kukaniza, Kukula kwake komwe kumadalira kuphatikizika kwa zinthu zomwe zapezeka kapena zobadwa nazo.

Mwachitsanzo, zidapezeka kuti zimapangidwira kuti homeostasis imadalira momwe amagwirira ntchito mogwirizana ndi zovuta za chiwindi - zotulutsidwa minofu - ma cell a pancreatic beta. Mu pathogenesis ya matenda a shuga, kusakhalapo kwa gawo loyambirira la insulin ndikofunikira kwambiri.

Si chinsinsi kuti glycemia amasintha masana ndi kufikira pazofunikira kwambiri mutatha kudya. Njira yamatulutsidwe a insulin mwa anthu athanzi imakhazikika bwino, kuphatikizapo kuyankha ku mawonekedwe ndi kununkhira kwa chakudya, zomwe zimapangitsa kutulutsa shuga m'magazi.

Mwachitsanzo, mwa anthu omwe alibe vuto la kulolera m'magazi (shuga) kapena matenda ashuga, kubwezeretsanso kwa glucose kumayambitsa kubisala kwa insulin, komwe patatha mphindi 10 kumakhala kofunikira kwambiri. Zitatha izi gawo lachiwiri, nsonga zake zimapezeka mphindi 20.

Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri ndi NTG, amalephera m'njira imeneyi. Kuyankha kwa insulini kulibe kwathunthu kapena pang'ono (gawo loyambirira la insulin, mwachitsanzo, sikokwanira kapena kuchedwa. Kutengera ndi kuopsa kwa matendawa, gawo lachiwiri limatha kusokonekera kapena kusungidwa. Nthawi zambiri, ndizofanana ndi kulolerana kwa glucose, ndipo nthawi yomweyo palibe kulekerera kwa glucose.

Tcherani khutu! Gawo loyambirira la insulin katulutsidwe limathandizira kukonzekera kwa zotumphukira panthawi yogwiritsa ntchito shuga ndikugonjetsedwa ndi insulin.

Kuphatikiza apo, chifukwa cha gawo loyambirira, kupanga shuga kwa chiwindi kumapanikizidwa, zomwe zimapangitsa kupewa glycemia ya postprandial.

Matenda a hyperglycemia

Matendawa akamakula, pomwe gawo lotsogolera limaseweredwa ndi hyperglycemia, maselo a beta amasiya kugwira ntchito ndipo maselo otulutsa zimawonongeka, chikhalidwe cha insulin secretion chimasokonekera, ndipo izi zimakulitsa glycemia.

Chifukwa cha kusintha kwatsiku, zovuta zimayamba msanga. Maonekedwe a matenda a shuga a shuga atenga mbali:

Kupanikizika kwambiri.
Glycation wopanda enzymatic wa mapuloteni.
Autooxidation wa shuga.

Hyperglycemia imagwira ntchito yayikulu pakuwonekera kwa njira izi. Zimatsimikiziridwa kuti ngakhale asanazindikire hyperglycemia yachangu kwambiri, 75% ya maselo a beta amalephera kugwira ntchito. Mwamwayi, njirayi imasinthidwanso.

Asayansi apeza kuti ma cell a pancreatic beta ali munkhalidwe wamphamvu, ndiye kuti amasinthidwa pafupipafupi komanso ma cell a beta-cell amakwaniritsa zosowa za thupi zofuna za insulin ya mahomoni.

Koma ndi kupirira kosatha kwa hyperglycemia, kupulumuka kwa maselo a beta kuyankha mokwanira ndi insulin kuyambitsa kukoka kwa glucose kumachepetsedwa kwambiri.Kusakhalapo kwa yankho ili pakubweza kwa glucose kumachitika chifukwa cha kuphwanya gawo la 1 komanso 2 la insulin secretion. Nthawi yomweyo, matenda oopsa a hyperglycemia amawonjezera mphamvu ya amino acid pamaselo a beta.

Mankhwala oopsa a glucose

Kupanga kwa insulin yopanda matenda a hyperglycemia ndi njira yosinthira, pokhapokha ngati kagayidwe kazakudya kamapangika. Kutha kwa hyperglycemia aakulu kusokoneza kupanga insulin kumatchedwa glucose toxity.

Izi matenda, omwe amapangidwa motsutsana ndi maziko a matenda oopsa a hyperglycemia, ndi chimodzi mwazomwe zimayambitsa kukana insulini. Kuphatikiza apo, kunenepa kwa glucose kumayambitsa kuwonongeka kwa maselo a beta, omwe amawonetsedwa ndi kuchepa kwa ntchito yawo yachinsinsi.

Nthawi yomweyo, ma amino acid, mwachitsanzo, glutamine, amakhudza kwambiri zochita za insulin, kusintha kukamwa kwa shuga. Zikatero, kuzindikirika komwe kumapezeka ndi chifukwa cha kupangika kwa zinthu za metabolic - hexosamines (hexosamine shunt).

Kutengera izi, zikuwonekeratu kuti hyperinsulinemia ndi hyperglycemia imatha kuchita zinthu monga chiopsezo cha matenda amtima. Postprandial ndi maziko a hyperglycemia amachititsa njira zingapo zomwe zimakhudzana ndi zovuta za matenda ashuga.

Matenda a hyperglycemia amatanthauza kupangika kwakanthawi kwa ma free radicals, omwe amatha kumangiriza ku mamolekyulu a lipid ndikuyambitsa kukula kwa atherosclerosis.

Kumangidwa kwa NO molekyulu (nitric oxide), yomwe ndi vasodilator wamphamvu wobisika ndi endothelium, imathandizira kusokonekera kwakukhazikika kwa endothelial ndikuthandizira kukulitsa kwa macroangiopathy.

Chiwerengero cha ma radicals aulere chimapangidwa nthawi zonse mthupi mu vivo. Nthawi yomweyo, mulingo womwe umasungidwa pakati pa ntchito ya antioxidant chitetezo ndi mulingo wa ma oxidants (ma free radicals).

Koma pansi pazinthu zina, mapangidwe osakanikirana othandizira amawonjezereka, zomwe zimayambitsa kupsinjika kwa oxidative, motsatana ndi kusalinganika pakati pa machitidwe awa ndi kuwonjezeka kwa oxidants, omwe amatsogolera kugonjetsedwa kwachilengedwe ma cell mamolekyulu.

Ma mamolekyulu owonongeka awa ndi chizindikiro cha oxidative kupsinjika. Kulengedwa kwamphamvu kwaulere kwamphamvu kumachitika chifukwa cha hyperglycemia, kuchuluka kwa glucose komanso kutenga nawo gawo pa mapuloteni a glycation.

Chiwerengero chachikulu cha ma radicals aulere ndi cytotoxic pamene mapangidwe awo amakhala ochulukirapo. Amayesetsa kulanda ma elekitro achiwiri kapena owonjezera kuchokera ku mamolekyulu ena, mwakutero amawapangitsa kusokonekera kwawo kapena kuwononga kapangidwe ka maselo, minofu, ziwalo.

Kukhazikitsidwa kuti pakukula kwa matenda a shuga ndi atherosclerosis, ndimomwe ndimagulu owopsa kwambiri komanso nkhawa za oxidative zomwe zimachitika, zomwe:

limodzi ndi insulin,
kumabweretsa hyperglycemia.

Hyperglycemia ikhoza kukhala chizindikiro chachikulu cha ntchito ya m'matumbo a m'matumbo.

Chithandizo cha postprandial hyperglycemia

Kuti tikwaniritse chindapusa cha kagayidwe kazakudya, zimakhala zomveka kugwiritsa ntchito njira zingapo:

mu chakudya chamagulu
zolimbitsa thupi,
pa mankhwala.

Tcherani khutu! Chofunikira pakuthandizira kwa anthu odwala matenda ashuga ndichakudya chamagulu owerengeka komanso kuchita masewera olimbitsa thupi mokwanira. Zakudya ziyenera kukhala ndi cholinga choletsa chakudya chambiri chamafuta kwambiri. Izi zimalepheretsa kukula kwa postprandial hyperglycemia komanso zimakhudza kudwala tsiku lonse.

Monga lamulo, kudya ndi kuchita masewera olimbitsa thupi pokhapokha sangathe kuthana ndi shuga wamphamvu womwe umapangidwa ndi chiwindi, zomwe zimayambitsa kusala kwambiri komanso matenda a postprandial glycemia.

Popeza hyperglycemia ndiye cholumikizira chachikulu chomwe chimakhudza katulutsidwe ka insulin, funso la mankhwala a matenda a matenda a shuga a 2 limabuka nthawi zonse. Nthawi zambiri, zotumphukira za sulfonylurea zimagwiritsidwa ntchito pamenepa.

Mankhwala omwe ali mgululi amalimbikitsa katemera wa insulin komanso amachepetsa kudya glycemia. Koma zimakhudza kwambiri postprandial hyperglycemia.

Ubale wapakati pakati pa mtima wamankhwala wovuta ndi postprandial hyperglycemia umabweretsa madokotala ndi wodwala, kumbali ina, ntchito yowunika mosalekeza kwa hyperglycemia ya postprandial, ndipo, kwinaku, kugwiritsa ntchito kwa owongolera prandial kukonza glycemia.

Kupewera kwa postprandial hyperglycemia popanda kuwonjezera katulutsidwe ka mankhwala amkati mwa insulin kumatha kupezeka pochepetsa adsorption ya chakudya m'matumbo aang'ono pogwiritsa ntchito acarbose.

Kudalira deta yofufuza yotsimikizira gawo lofunikira la amino acid (kupatula glucose) pakapangidwe ka insulin katulutsidwe ka maselo a beta pakudya, kafukufuku adayamba pazotsatira zomwe zimapangitsa shuga kuphatikizika kwa benzoic acid, phenylalanine, yomwe idafika pakupanga kwa repaglinide ndi nateglinide.

Katemera wa insulini yemwe amakondweretsedwa ndi iwo ali pafupi ndi chilengedwe chake choyambirira mwa anthu athanzi akamaliza kudya. Izi zimabweretsa kutsika koyenera kwa milingo yayikulu ya glucose panthawi ya postprandial. Mankhwalawa amakhala ndi yochepa, koma mwachangu, chifukwa chake mutha kupewa kuwonjezeka kwa shuga mutatha kudya.

Posachedwa, zikuwonetsa kuti jakisoni wa insulin kwa odwala omwe ali ndi matenda a shuga a 2 akwera kwambiri. Malinga ndi kuyerekezera kopitilira muyeso, pafupifupi 40% ya odwala omwe ali ndi matenda a shuga a 2 amafunikira chithandizo cha insulin. Komabe, mahomoniwa amalandila ochepera 10%.

Kuyambitsa insulin yothandizira matenda a shuga a 2, zomwe zikuwonetsa miyambo ndi:

zovuta zazikulu za matenda ashuga
Opaleshoni
pachimake ubongo
pachimake myocardial infaration,
mimba
matenda.

Masiku ano, madokotala amadziwa bwino kufunika kwa jakisoni wa insulin kuti achepetse vuto la glucose ndikuyambiranso ntchito ya beta-cell mu hyperglycemia yokhazikika.

Kuchepa kwenikweni kwa shuga mu chiwindi mu mtundu 2 wa shuga kumafuna kuyambitsa njira ziwiri:

Popeza mankhwala a insulini amachepetsa gluconeogenesis, glycogenolysis m'chiwindi komanso imapangitsa chidwi cha insulin, izi zimatha kukonza njira za matenda a shuga.

Zotsatira zabwino za insulin mankhwala a shuga zimaphatikizapo:

kutsika kwa kudya kwa hyperglycemia ndipo mutatha kudya,
kuchepa kwa shuga wama chiwindi ndi gluconeogeneis,
kuchuluka kwa insulin monga yankho la kukhudzana ndi shuga kapena kudya,
kutseguka kwa kusintha kwa antiatherogenic mu mbiri ya lipoproteins ndi lipids,
kusintha kwa anaerobic ndi aerobic glycolysis,
kutsika kwa glycation wa lipoproteins ndi mapuloteni.

Kodi postprandial glycemia (hyperglycemia): tanthauzo ndi kufotokoza

Kuwonjezeka kopitilira kwa odwala omwe ali ndi matenda a shuga a 2 komanso zovuta zake zam'mbuyo zam'mimba, kumatchula matendawa ngati vuto lapadziko lonse lapansi.

Matenda a shuga samateteza kumayiko otukuka ndi osakhwima, kapena mayiko otukuka. WHO ikuyerekeza kuti pali anthu pafupifupi 150 miliyoni omwe ali ndi matenda ashuga padziko lonse lapansi. Ndipo kuchuluka pachaka kwa matendawa ndi 5-10%.

Mavuto ambiri omwe amachitika chifukwa cha matenda ashuga ndi matenda amtima, omwe mu 70% mwa milandu amabweretsa mavuto osaneneka. Pachifukwa ichi, American Association of Cardiology adaigwiritsa ntchito ngati matenda a mtima.

Ngati shuga wanu wamagazi ndiwokwera kwambiri

Malinga ndi ziwerengero, anthu pafupifupi 9 miliyoni amadwala matenda a shuga ku Russian Federation. Chaka chilichonse kuchuluka kwa odwala kumangokulira.

Matenda a shuga ndi matenda opatsirana kwambiri. Kuopsa kwake kumachitika chifukwa chakuti mpaka pamlingo wina matendawa ndi asymptomatic. Musaiwale za zovuta zotheka, monga kufinya kwam'mimba, matenda a impso ndi mtima.

Kuthekera kokula ndi mavuto mtsogolo ndikuchitika chifukwa chakulipira bwino kwa matenda ashuga. Shuga ya wodwalayo imatha kutsimikiziridwa ndi index ya glycated hemoglobin. Chizindikirochi chimathandizira kutsatira kusinthasintha konse kwamlingo wa shuga kupitirira miyezi itatu.

Kuwonjezeka kwa shuga m'magazi a anthu opanda shuga kumachitika mutatha kudya. Mulingo wapamwamba wa shuga wamagazi mwa anthu opanda matenda a shuga sakonda kupitirira 7.81 mmol, ndipo umatsikanso mpaka 5.51 mmol mkati mwa maola 2.1-3.1 mutatha kudya.

Ngati tikuchita ndi anthu omwe adapezeka kuti ali ndi matenda a shuga, ndiye kuti kuchuluka kwa shuga m'magazi sikumatsika maola 2.1 atatha kudya ndipo akadali ofanana ndi chiwerengero chokwanira.

Kutengera uphungu wa International Diabetes Federation, titha kunena kuti postprandial glycemia ikhoza kuvulaza thupi lonse ndipo imafunikira kuwongolera mwachangu ngati zingachitike.

Kuwonjezeka kosagwiritsidwa ntchito kwa glucose wa plasma kumakhalanso koopsa chifukwa kumatha kuyambitsa vuto la atherosclerosis m'tsogolo chifukwa cha kuwonongeka kochepa kwa makhoma amitsempha yamagazi kuchokera mkati.

Postprandial glycemia imakhalanso yoopsa pakukula kwa matenda a mtima. Ndi gulu lazophwanya izi lomwe limakhala chifukwa chofala. Kuphatikiza apo, BCP imasokoneza ubongo wogwira ntchito mwa okalamba.

Kafukufukuyu adatsimikiza kuti powunika kuopsa kwa matenda osokoneza bongo a mtundu wachiwiri wa shuga, munthu ayenera kuganizira osati zokhazokha za kusala kudya kwa glycemia HbA1c, komanso kuchuluka kwa glucose m'magazi 2 maola atatha kudya.

Si chinsinsi kuti glycemia amasintha masana ndi kufikira pazofunikira kwambiri mutatha kudya. Njira yamatulutsidwe a insulin mwa anthu athanzi imakhazikika bwino, kuphatikizapo kuyankha ku mawonekedwe ndi kununkhira kwa chakudya, zomwe zimapangitsa kutulutsa shuga m'magazi.

Tcherani khutu! Gawo loyambirira la insulin katulutsidwe limathandizira kukonzekera kwa zotumphukira panthawi yogwiritsa ntchito shuga ndikugonjetsedwa ndi insulin.

Kuphatikiza apo, chifukwa cha gawo loyambirira, kupanga shuga kwa chiwindi kumapanikizidwa, zomwe zimapangitsa kupewa glycemia ya postprandial.

Onani kuchuluka kwa shuga. Ngati magazi a shuga ndi okwera, ndikofunikira kukhazikitsa kukonza, ndiye kuti, magawo owonjezera a insulin.

Kuthandizanso kupenda mkodzo wa ma ketones. Matupi a Ketone amachitika pamene insulin ilibe. Chakudya chotsatira chisanachitike, yang'anani kuchuluka kwa shuga ndikusintha mlingo wa insulin ngati pakufunika.

Zochita tsiku ndi tsiku zimathandizira kupewa shuga ambiri. Nthawi zambiri zimakhala zotheka kukhala ndi shuga wokwanira wokwanira chifukwa cha jakisoni wokhazikika wa insulin, nthawi yopumira komanso masewera olimbitsa thupi nthawi zonse.

Kumbali inayi, ngati mumakonda kupangira kuchuluka kwa shuga ndikuwongolera mlingo wa insulin yanu kuchuluka ndi nthawi yakudya komanso masewera olimbitsa thupi, dokotala angakulorere kukhala ndi moyo wopuma.

Mulingo wothamanga wa glycemia molingana ndi muyezo ndi wochepera 126 mg / dl.
Mlingo woyenera wa postprandial glycemia sapitilira 120 mg / dl. Kufikira ku 140 mg / dl ndikuloledwa.
Pafupifupi ola limodzi mutatha kudya, shuga a shuga amatha kupitirira 160 mg / dl. Mwa anthu achikulire, mfundo izi ndizokwera pang'ono.

Zotsatira zoyenera ndizosachepera 140 mg / dl ya kusala ndi 180 mg / dl mukatha kudya. Postprandial hyperglycemia imapezeka pamilingo ya mg / dl.

Matenda a shuga odwala matenda ashuga 2 mawola atatha kudya oposa 200 mg / dl angasonyeze matenda a shuga.

Kuchepetsa kuchuluka kwa shuga mukatha kudya, i.e. hypoglycemia, ndi ochepera 50 mg / dl maola 4 mutatha kudya.

Odwala omwe amalandira jakisoni wambiri wa insulin kapena kulowetsedwa kosalekeza insulin ayenera kulowetsedwa tsiku ndi tsiku, kuphatikiza shuga: m'mimba popanda kanthu, ola limodzi ndi mphindi 60 pambuyo pa chakudya chachikulu chilichonse, komanso musanagone.

Wodwalayo amatha kudziwa kuchuluka kwa macheke okha.

Kugwiritsa ntchito njira yokhazikika yolamulira shuga (CGMS) monga chowonjezera pakuwunika komwe mukuwunika kumawonetsedwa mwa odwala omwe ali ndi matenda amtundu wa 1 omwe ali ndi chikhalidwe chokhazikika komanso zochitika zodziwika bwino za hypoglycemia ndi kusazindikira, chifukwa izi zimawonjezera chitetezo ndikuchita bwino kwa mankhwalawa.

Kuti mudziwe bwino shuga m'magazi, tikulimbikitsidwa kugwiritsa ntchito shuga m'magazi, zomwe chifukwa cha izi zimayang'ana kuchuluka kwa shuga m'magazi am'magazi, cholakwika chomwe chimafotokozedwa pazosindikiza ndi zida za wopanga ndizosachepera 15% pakuyang'anitsitsa kwa shuga ≥ 100 mg / dl (5.6 mmol / l) ndi 15 mg / dl (0,8 mmol / L) pamatenda a glucose

Postprandial glycemia (BCP) ndi kuchuluka kwa shuga wamagazi atatha kudya. Oposa 250 miliyoni padziko lapansi komanso pafupifupi 8 miliyoni ku Russia ali ndi matenda a shuga. Chiwerengero cha odwala chikupitilira kuchuluka pachaka, ngakhale atakhala zaka komanso dziko liti.

Moyo wawo umaphimbidwa ndi kupezeka kwa mavuto akulu kuchokera ku maso, impso, mitsempha ndi mtima, komanso "phazi la matenda ashuga". Zomwe zimayambitsa mavutowa ndizosayang'anira bwino glycemic, yomwe imayesedwa ndi kuchuluka kwa hemoglobin HbA1c, yomwe imawonetsa kusinthasintha kwa shuga m'magazi kwa miyezi itatu.

Odwala omwe ali ndi matenda a shuga, kuchuluka kwa shuga m'magazi 2 pambuyo poti chakudya chayandikira kwambiri ndi kuchuluka kwa chiwonetsero cha BCP.

Zochita zamankhwala zawonetsa kuti kuwonjezeka kwakukulu mu zovuta zonse za shuga kumawonedwa ngati mulingo wa glycated hemoglobin (HbA1c) upambana 7%, pomwe 70% yaopereka pamlingo wa HbA1c imapangidwa ndi msambo wa glycemia 2 mawola atatha kudya (BCP)> 7.8 mmol / L .

Maupangiri akuongolera kwa Postprandial Glycemia ndi International Diabetes Federation (IDF, 2007), potengera umboni wambiri, akutsimikizira kuti BCP ndiowopsa ndipo iyenera kuwongoleredwa.

Kuwonjezeka kosalamulirika kwa glucose mutatha kudya kumawonongera mkati mwa ziwiya - endothelial minofu, kuchititsa kukula kwa micro- ndi macroangiopathy. Mitengo yayikulu ya PPG imayendera limodzi ndi zovuta za glucose, komanso lipotoxicity, zomwe zimathandizira pakukula kwa atherosclerosis.

BCP ndi chiopsezo chodziyimira pawokha pakupanga matenda a macroangiopathy ndi mtima ndi mtima mwa anthu omwe ali ndi matenda osokoneza bongo a mellitus (DM) mtundu 1 ndipo makamaka mtundu 2 (womwe umayambitsa kufa kwa odwala). BCP imagwirizanitsidwa ndi chiopsezo chowonjezereka cha retinopathy, matenda angapo a oncological, ziwopsezo zamaganizidwe okalamba.

Kuphatikiza apo, pali kulumikizana pakati pa kayendetsedwe koyipa ka glycemic ndi kukula kwa kukhumudwa, komwe, kumakhala chopinga chachikulu pakusintha chithandizo cha matenda ashuga.

Glucose wa plasma pa maola 2 mutatha kudya sayenera kupitirira 7.8 mmol / L pomwe kuli koyenera kupewa hypoglycemia (nthawi ya maola awiri ndi 2 imatsimikizidwa malinga ndi malingaliro a mabungwe ambiri azachipatala komanso azachipatala).

Kudziyang'anira wekha ndi njira yoyenera yowonera shuga. Kwa odwala omwe ali ndi mtundu 1 ndi mtundu wa 2 wodwala matenda a shuga a insulin, kudziwunikira kumayenera kuchitika katatu konse patsiku. Kwa odwala omwe alibe mankhwala a insulin, kudzipenda pawokha ndikofunikanso, koma mawonekedwe ake amasankhidwa payekha kutengera glycemia ndi mtundu wa hypoglycemic therapy.

Konzani glycemia mu odwala matenda ashuga

Kuti tikwaniritse chindapusa cha kagayidwe kazakudya, zimakhala zomveka kugwiritsa ntchito njira zingapo:

mu chakudya chamagulu
zolimbitsa thupi,
pa mankhwala.

Mankhwala omwe ali mgululi amalimbikitsa katemera wa insulin komanso amachepetsa kudya glycemia. Koma zimakhudza kwambiri postprandial hyperglycemia.

Kuyambitsa insulin yothandizira matenda a shuga a 2, zomwe zikuwonetsa miyambo ndi:

zovuta zazikulu za matenda ashuga
Opaleshoni
pachimake ubongo
pachimake myocardial infaration,
mimba
matenda.

Masiku ano, madokotala amadziwa bwino kufunika kwa jakisoni wa insulin kuti achepetse vuto la glucose ndikuyambiranso ntchito ya beta-cell mu hyperglycemia yokhazikika.

Popeza mankhwala a insulini amachepetsa gluconeogenesis, glycogenolysis m'chiwindi komanso imapangitsa chidwi cha insulin, izi zimatha kukonza njira za matenda a shuga.

Zotsatira zabwino za insulin mankhwala a shuga zimaphatikizapo:

kutsika kwa kudya kwa hyperglycemia ndipo mutatha kudya,
kuchepa kwa shuga wama chiwindi ndi gluconeogeneis,
kuchuluka kwa insulin monga yankho la kukhudzana ndi shuga kapena kudya,
kutseguka kwa kusintha kwa antiatherogenic mu mbiri ya lipoproteins ndi lipids,
kusintha kwa anaerobic ndi aerobic glycolysis,
kutsika kwa glycation wa lipoproteins ndi mapuloteni.

Posthyperglycemia ndi mkhalidwe pamene, atatha kusala kudya kwa nthawi yayitali (osachepera maola 8), msempha wamagazi uli pamwamba pa 7.28 mmol / L.

Postprandial hyperglycemia (shuga wokwera atatha kudya) imapezeka ngati shuga m'magazi apitilira 10,0 mmol / L. Mwa anthu opanda matenda a shuga, atatha kudya, shuga sakonda kupitirira 7.84 mmol / L.

Komabe, nthawi zina mukatha kudya chakudya chochuluka, shuga m'magazi mkati mwa maola 1-2 atatha chakudya amatha kufika 10,0 mmol / L. Izi zikuwonetsa kukhalapo kwa matenda a shuga a 2 kapena kuopsa kwakukulu kokhala nacho posachedwa.

Ngati mukumva zizindikiro zilizonse zoyambirira za hyperglycemia, onetsetsani kuti mumayeza shuga ndikuwuzani dokotala. Wopereka chithandizo chaumoyo angafunikire kuyeza mbiri yanu ya glucose, chifukwa chake yambani kujambula zonse zomwe mumadya, kuchuluka kwa insulin (kapena kuchuluka kwa mapiritsi omwe mumamwa), ndi shuga lanu lamagazi.

Yesani kuyeza shuga osachepera 5-7 patsiku, musanadye komanso maola awiri mutatha kudya. Izi zithandiza dokotala wanu kudziwa zomwe zimayambitsa hyperglycemia ndikusintha mankhwala anu.

Thandizo loyamba la hyperglycemia ndikuchepetsa kuchuluka kwa chakudya chamagulu m'zakumwa ndi kumwa kwambiri. Komanso, ndi chisamaliro chachikulu, mutha kuwonjezera mlingo wa mankhwala a hypoglycemic.

Malangizo othandizira ochizira matenda a hyperglycemia ndi awa:

Imwani madzi ambiri. Madzi amathandiza kuchotsa shuga owonjezera m'magazi kudzera mkodzo komanso kupewa kutaya madzi m'thupi.
Muzichita masewera olimbitsa thupi. Kuchita masewera olimbitsa thupi kumatha kuthandizira kuchepetsa shuga m'magazi, koma, pazochitika zina, amatha kupangitsa kuti kukwera kwambiri!

Ngati muli ndi matenda osokoneza bongo omwe amadalira matenda a shuga ndipo shuga mumagazi anu ndi okwera, muyenera kuwunika mkodzo wanu ngati ma ketones. Ngati ma ketoni amapezeka mu mkodzo, ndiye kuti kuchita zinthu zolimbitsa thupi koletsedwa pamkhalidwewu, kumangowonjezera shuga m'magazi.

Ndi mtundu 2 wa shuga komanso shuga wamagazi ambiri, mukuyenera kudziwa kuti mulibe ketonuria komanso kuti mumamwa madzi ambiri. Ngati mukumva bwino nthawi yomweyo, mutha kuchita masewera olimbitsa thupi mosamala.

Sinthani zomwe mumadya ndi kusintha mlingo wanu wa insulin. Hyperglycemia imakhudzana mwachindunji ndi kuchuluka kwa chakudya chamafuta omwe amaperekedwa, chifukwa ndi omwe amawonjezera kuchuluka kwa shuga m'magazi. Zakudya zamafuta sikuletsedwa, koma mlingo weniweni wa insulin kapena mankhwala ena ochepetsa shuga ayenera kuwerengedwera iwo. Muzochita zamakono zochizira matenda a shuga, ma carbohydrate nthawi zambiri amawaganiziridwa m'magawo a mkate (XE), pomwe 1 XE imagwirizana ndi magalamu a chakudya. Pa 1 XE, mlingo wanu wa insulin uyenera kutsimikiziridwa, nthawi zambiri kuyambira 1 mpaka 2 PIECES pa 1 XE. Mwachitsanzo, mlingo wanu wa insulin ndi 1.5 PISCES pa 1 XE. Pa nkhomaliro, mudadya magalamu 60 am'madzi kapena 5 XE. Mlingo wowerengeka wa insulin udzakhala: 5 * 1.5 = 7.5 maunitsi. Izi zonse zimaperekedwa mwachitsanzo mwachidule, nkhani za insulini zochiritsira ziyenera kuganiziridwa m'nkhani ina.

Malangizo. Ngati muli ndi mafunso ofuna kusintha momwe mungapangire insulin kapena mankhwala ochepetsa shuga, pitani kuchipatala. Kudzisankhira mlingo, osadziwa bwino, kumatha kuyambitsa mavuto ambiri, uyenera kuchitika moyang'aniridwa ndi dokotala.

"Insulin ndi machiritso a anzeru, osati opusa, ngakhale madokotala kapena odwala" (E. Jocelyn, dokotala wotchuka wa endocrinologist waku America).

Ngati muli ndi matenda a shuga a mtundu woyamba 1 ndipo shuga yanu yamagazi ili pa 14 mmol / L kapena kuposa, yang'anani mkodzo wanu kapena magazi a ketonuria.

Popewa hyperglycemia, onetsetsani kuti mumadya moyenera, kumwa mankhwalawa okwanira a insulin kapena mapiritsi ochepetsa shuga, komanso kuyang'anira shuga yanu yamagazi nthawi zonse. Malangizo onse ndi awa:

Penyani zakudya zanu, nthawi zonse werengani kuchuluka kwa chakudya chambiri chomwe chimaperekedwa mu chakudya.
Onani shuga wanu wamagazi pafupipafupi ndi mita yamagazi.
Onaninso dokotala wanu ngati muwona kuti magazi ake amawerengetsa kwambiri.
Onetsetsani kuti muli ndi chibangili cha matenda ashuga, pendant, kapena njira zina zokuzindikirani ngati wodwala matenda ashuga. Chifukwa chake, mutha kupeza chithandizo choyenera pangozi.

Kuti muchepetse mavuto onse oyipa, ndikofunikira kukwaniritsa kuchuluka kwa shuga m'magazi pamimba yopanda kanthu komanso maola awiri mutatha kudya, komanso kupewa hypoglycemia pakadutsa zakudya. Izi zimatheka pogwiritsa ntchito mitundu yosiyanasiyana yochepetsera shuga kuphatikiza zakudya ndi masewera. Madzi a m'magazi a plasma pambuyo maola 2.1 atatha kudya sayenera kupitirira 7.81 mmol.

Pokhapokha podziletsa pakokha mutha kuchuluka kwa glucose wokwanira musanadye komanso pambuyo pake. Kulipira shuga mwakuwongolera komanso kuwongolera kuchuluka kwa glucose ndikofunikira nthawi zonse monga momwe matenda anu akufunira.

Kwa maola 24, munthu amangokhala pamimba yopanda kanthu, mwa nthawi pakati pa 3.00 ndi 8.00. Kupumula kwa tsikulo, monga lamulo, wodwalayo ali mkhalidwe mwina asanadye kapena pambuyo pake.

Kufunika kwachipatala ndi chikhalidwe cha anthu odwala matenda ashuga kumakhala ndi kulumala koyambirira komanso kufa chifukwa cha zovuta zam'mbuyo za matenda ashuga: micangiopathies (nephropathy, retinopathy ndi neuropathy), macroangiopathies (matenda am'mimba, infarction ya myocardial, gangrene yam'munsi yotsika).

Umboni wokhudzana ndi chikhalidwe cha anthu komanso kufunika kwachuma ndi kuwonjezereka kwa kuwononga ndalama. Mwachitsanzo, ku USA, zovuta za shuga ku 1984 zidakwana 14 biliyoni, mu 1987 - 20.4 biliyoni, ndipo zidachitika kale mu 1992.

- 105.2 biliyoni madola, omwe ndi 14.6% ya bajeti yonse yogwiritsira ntchito ndalama zothandizira odwala. Ngati United States imawononga $ 2604 pachaka kwa wodwala amene alibe matenda ashuga, ndiye kuti $ 4949 imagwiritsidwa ntchito kwa wodwala matenda ashuga, komanso kwa madola okhala ndi matenda oopsa.

glucose mayamwidwe zoletsa (acarbose, miglitol),
ultrashort insulin analogues (novorapid, humalog),
oyang'anira prandial hyperglycemia (repaglinide, nateglinide).

Kodi izi zikutanthauza chiyani? Ku USA, amapitilizabe kuwonerera usiku wautoto wachilendo

Kuchokera ku USA, ambiri owonera ndi maso akupitilizabe kulandira malipoti akuwoneka mwadzidzidzi mlengalenga usiku usiku, kulowa kwadzuwa kwachilendo, ndi thambo lachilendo usiku.

Malinga ndi mboni zowona ndi maso, ma radiation achilendo awa ndi ofanana ndi mafunde omwe amayenda kuthambo, koma sikuti nyali zakumpoto, ndichinthu china, koma chiyani.

Mauthenga ochokera ku Georgia, Pennsylvania ndi mayiko ena a USA. Ma radiation achilendo amatenga mphindi 40 mpaka ola limodzi. Onse omwe awona zodabwitsa izi akuti sanawonepo izi ngati kale.

Nyengo? Inde, sizili ngati izi. kenako chiyani?

Ndimasewera amtundu wanji?

Kapena kukopa kwa tinthu tating'onoting'ono ochokera kunja?

Mwachidule! Sindimakonda zonsezi, oh momwe sindimakondera.

Mwina zizindikiro za YellowSmp3?

Zizindikiro za Hyperglycemia

Shuga wambiri amakupangitsani kuti mufune kumwa ndi kukodza pafupipafupi. Muthanso kukhala ndi chidwi chambiri kuposa masiku onse. Nthawi zambiri mumatopa komanso kugona. Mutha kukhala ndi zosokoneza zowoneka bwino komanso miyendo. Zizindikirozi ndizofanana ndi zoyamba za matenda ashuga.

Mawonetsedwe azachipatala a matendawa amafanana kwambiri ndi zizindikiro za ochepa hypotension ndipo amaphatikizapo:

makatani, palpitations,
kugona, kutopa,
kutuluka thukuta kwambiri
chizungulire, kupweteka mutu,
mavuto ndi malankhulidwe ndi mawonekedwe (chithunzi "chamaso" pamaso),
kupweteka pachifuwa ndi malo a mtima,
chikhalidwe chachilendo, ulesi, kukomoka mutatha kudya.

Ngati muli ndi matenda ashuga, muyenera kudziwa zizindikiro zoyambirira za hyperglycemia. Ngati hyperglycemia singachiritsidwe, imatha kukhala ketoacidosis (ngati muli ndi matenda amtundu 1) kapena mu hypersmolar coma (ngati muli ndi matenda a shuga a 2). Mikhalidwe imeneyi ndiyowopsa kwa thupi.

Zizindikiro zoyambirira za hyperglycemia mu shuga zimakhala motere:

Kuchulukitsa ludzu.
Mutu.
Kukhumudwa.
Kuwona koperewera.
Kukodza pafupipafupi.
Kutopa (kufooka, kumva kuti watopa).
Kuchepetsa thupi.
Magazi a shuga a magazi amapitilira 10,0 mmol / L.

Hyperglycemia wautali wa matenda ashuga ndi owopsa, chifukwa kumabweretsa izi:

Vaginal ndi matenda a pakhungu.
Kuchiritsa kwakatalika kwa zilonda ndi mabala.
Chepetsani kuona.
Kuwonongeka kwa mitsempha komwe kumayambitsa kupweteka, kumverera kuzizira, ndi kuwonongeka kwa miyendo, kuchepa kwa tsitsi kumalekezero am'munsi komanso / kapena kukokoloka kwa erectile.
Mavuto am'mimba ndi m'mimba, monga kudzimbidwa kosatha kapena kutsegula m'mimba.
Zowonongeka m'maso, mitsempha yamagazi, kapena impso.

Njira zopewera kupewa hyperglycemia zimaphatikizanso kuyang'ana shuga wamagazi, kudya moyenera, masewera olimbitsa thupi komanso kupuma wodwala yemwe ali ndi matenda ashuga kuyenera kuonedwa.

Kodi postprandial hypotension ndi chiyani?

Pankhaniyo munthu akakhala ndi magazi ochepa (a systolic ndi diastolic) (mpaka 100 mmHg ndi 60 mmHg, motsatana), amalankhula za ochepa hypotension.

Ndi zisonyezo zoterezi, magazi sawakwanitsa kupereka zofunikira zathupi.

Hypotension imadziwoneka mosiyanasiyana: anthu ena amadzimva bwino, ena amavutika ndi zizindikiro zosasangalatsa.

Zambiri patsamba lino ndizongowatsogolera zokha ndipo ASATSOGOLA zochita!
DOCTOR Yokhayo yomwe ingapereke Dongosolo LABWINO kwa inu!
Tikukupemphani mokoma KUTI musasamalire, koma kuti mulembetse katswiri!
Zaumoyo kwa inu ndi okondedwa anu!

Kuthamanga kwa magazi kuthana ndi:

kufooka kwakukulu ndi kugona,
kuzunza kosalekeza
kuwonongeka kwamawonekedwe, kutanthauzira kolakwika,
Kuchepetsa magwiridwe
chizungulire, kupweteka mutu,
kupweteka m'dera la mtima, arrhasmia.

Ndizosangalatsa kuti kwa anthu otsika a thupi ofooka, kuthamanga kwa magazi ndichizolowezi. Komabe, izi sizimawalepheretsa kuti azikhala moyo wakhazikika. Amanena za anthu otere kuti ndizachilendo kwa iwo mwachilengedwe, ndipo izi ndizotheka.

Ngati kupsinjika kwapang'onopang'ono kumachitika chifukwa cha kusayenda bwino kwa ma horoni (mwachitsanzo, ndi kuperewera bwino kwa timadzi tambiri tomwe timapanga tithito ta adrenal), muyenera kuyamba kuchita.

Hypotension, yomwe imadziwoneka yokha mutatha kudya, ndiyenera kuyang'aniridwa mwapadera. Amatchedwa postprandial (kuchokera ku liwu la Chingerezi "prandial" - "nkhomaliro").

M'mabwalo azachipatala, kuphwanya koteroko kudadziwika kalekale, koma udindo wodziyimira pawokha adamupatsa yekha mu 1977 - atasindikiza lipoti la kuwunika momwe wodwala akudwala matenda opuwala.

Kusanthula kwathunthu kwa zomwe wodwalayo adawonetsa kunafotokozeredwa kwathunthu zamatendawo za matenda osowa awa.

Pambuyo kanthawi, zinali zotheka kudziwa kuti munthu wathanzi lathunthu komanso ngakhale hypertonic imatha kuchepa kwambiri magazi atatha kudya. Mwa anthu otere, chizungulire, kusanza kwambiri, kusandukanso kusanza, komanso kuwona kwamaso. Mwambiri, kupanikizika kumatsika ndi 20 mmHg.

Zosankhazo zingaphatikizepo zakumwa zokhala ndi khofi (tiyi, koko, khofi), zokometsera zosiyanasiyana, zonunkhira, mafuta. Muyenera kudya m'magawo ang'onoang'ono kangapo patsiku, kudya mafuta kwambiri sikuloledwa. Madzi osachepera awiri malita a madzi oyera ayenera kumwa. Zakumwa zomwe zimakhala ndi shuga kapena zotsekemera ziyenera kukhala zochepa.

Wodwala ayenera kutsatira moyo wathanzi, kuchita zolimbitsa thupi, kusuntha momwe angathere. Ndi matenda otere, masewera olimbitsa thupi, masewera olimbitsa madzi, kuyenda pafupipafupi mu mpweya watsopano ndikothandiza. Zizolowezi zoipa sizinafotokozedwe.

Njira zopewera mitundu yosiyanasiyana ya hypotension zikufotokozedwa patsamba lino.

Mawonekedwe a kutikita minofu kwa hypotension amatha kupezeka pano.

Mwa mankhwalawa, madokotala nthawi zambiri amapereka Levodopa, Ibuprofen, Midodrin. Kulandila mankhwala aliwonse kungatheke pokhapokha ngati adokotala akupanga, kudzipereka nokha sikuloledwa.

Zizindikiro

Kuti adziwitse matenda moyenerera komanso kuti asiyanitse mitundu inayake, wina sangangoyang'ana zoyezera zokha. Munthawi zonsezi, kuyang'anira kuthamanga kwa magazi ndikukhazikika pazomwe mukumwa mankhwala, kuchita ndendende ndi kupuma (pakugona) kumafunika.

Zochita zapadera zimaphatikizapo kudya, masewera olimbitsa thupi, ndi kuyimirira. Nthawi zina, kuyesedwa kwapadera kumapangidwa kuti kukhazikitse matenda, mothandizidwa ndi komwe kungalembedweko kwakanthawi kochepa kojambulidwa.

Arterial hypotension singakhale matenda odziyimira pawokha, koma chisonyezo chokhacho chomwe chimagwira kwambiri pakuwunika kwa amyloidosis, matenda a impso, syncope yoyipa ya chikhalidwe cha neurogenic ndi zina. Ndikofunikira kwambiri kukhazikitsa chomwe chimayambitsa izi hypotension ngati syncope ikachitika.

Cholinga chachikulu cha njira zopezera matenda ndikuwunika zomwe zimayambitsa hypotension, kuzindikira mawonekedwe auzimu, kutsimikizira kapena kuthetsa chizindikiro cha genesis.

Dokotala amamvetsera madandaulo a wodwala, amatenga anamnesis, amachititsa maphunziro kuti azindikire kapena kuletsa kulephera kwa mtima, matenda opatsirana, kuchepa magazi, kusowa kwa chithokomiro, ndi zina zambiri.

Lingaliro lokhudza amyloidosis limapangidwa pamaziko amachitidwe a matendawa omwe amapezeka m'matumbo a mtima, impso, chiwindi, ndulu, kuphatikizidwa kwa dongosolo la autonomic ndi zotumphukira mu dongosolo la matenda.

Kuzindikira kumatsimikiziridwa ngati ma antiocodonal a monoclonal apezeka m'magazi ndi mkodzo, komanso ngati amyloid apezeka ndi biopsy ya adipose minofu ndi mucous nembanemba

Komanso, wodwalayo ayenera kupereka magazi ndi mkodzo kuti adziwe kuchuluka kwa sodium ndi potaziyamu mkati mwake. Izi ndizofunikira kuti azindikire kulephera kwa adrenal, yomwe siili ntchito yosavuta kwa madokotala (makamaka ngati palibe melasma).

Chifukwa chake, kuzindikira kwa "postprandial hypotension" kumapangidwa mu milandu yotsatirayi:

ngati maola awiri mutadya, ndiye kuti magazi amachepa ndi 20 mmHg (kapena kuposa),
mukatha kudya, mtengo wopondera ndi pafupifupi 90 mmHg (ndi mtengo woyambirira musanadye zoposa 100 mm),
ngati mutatha kudya kukakamiza sikutsika, koma panthawi imodzimodziyo munthu ali ndi zonse zomwe akuganiza.