Kulekerera kwa glucose kumayipa, ndi chiyani komanso zimayambitsa kuphwanya

Tikukulimbikitsani kuti muzidzire bwino pazomwe zili pamutuwu: "kulolera kwa glucose kumavulala, zomwe zili komanso zomwe zimayambitsa kuphwanya malamulo" ndi ndemanga zochokera kwa akatswiri. Ngati mukufuna kufunsa funso kapena kulemba ndemanga, mutha kuchita izi pansipa, nkhaniyo itatha. Katswiri wathu wamtundu wa endoprinologist adzakuyankhirani.

Kulekerera kwa shuga mkati: Zizindikiro, mankhwala, zimayambitsa. Kodi chiwopsezo cha kulekerera glucose ndi chiani?

Kulekerera kwa shuga wambiri ndi vuto lodziwika bwino. Ichi ndichifukwa chake anthu ambiri ali ndi chidwi chofuna kudziwa zambiri zomwe zimapangitsa izi. Kodi zimayambitsa kuphwanya malamulo ndi ziti? Kodi ndimatenda ati omwe amayenda ndi matenda amisala? Kodi njira zamankhwala zodziwitsira komanso njira zamankhwala zimapereka?

Kodi kulolerana kwa glucose kumapangitsa chiyani? Ndi mkhalidwe wofanana, munthu amakhala ndi kuchuluka kwa shuga m'magazi. Kuchuluka kwa shuga ndikokwera kuposa masiku onse, koma nthawi yomweyo kutsika kuposa kumene odwala amapezeka ndi mtundu wachiwiri wa matenda a shuga.

Chifukwa chake, kulekerera mosaloledwa ndi chimodzi mwazinthu zowopsa. Kafukufuku waposachedwa akuwonetsa kuti pafupifupi gawo limodzi mwa atatu mwa odwala limayamba kudwala matenda ashuga. Komabe, malinga ndi malamulo ena ake komanso mankhwala osankhidwa bwino, kagayidwe kamunthu kamafanana.

Osati nthawi zonse, madokotala amatha kudziwa chifukwa chake wodwalayo wadwala matendawa. Komabe, zinali zotheka kudziwa zomwe zimayambitsa kulekerera kwa glucose:

• Choyamba, ndikofunikira kutchulanso chibadwa chamtunduwu, chomwe chimachitika nthawi zambiri. Ngati wachibale wanu wapamtima ali ndi matenda ashuga, mwayi wokhala ndi vuto lotere umakula kwambiri.
• Mwa odwala ena, omwe amatchedwa insulin kukana amapezeka mkati mwazofufuza, momwe chidwi cha maselo kupita ku insulin chimalephera.
• Nthawi zina, kulolerana kwa glucose kumayamba chifukwa cha matenda apamba pomwe chinsinsi chake chimasokonekera. Mwachitsanzo, mavuto okhala ndi carbohydrate metabolism amatha kuwoneka motsutsana ndi maziko a kapamba.
• Zomwe zimayambitsa zimatha kuphatikizanso matenda ena a endocrine system, omwe amakhala ndi vuto la metabolic komanso shuga wowonjezera wamagazi (mwachitsanzo, matenda a Itsenko-Cushing).
• Chimodzi mwamavuto omwe ali pachiwopsezo ndi kunenepa kwambiri.
• Kukhala moyo wongokhala kumakhudzanso thupi.
• Nthawi zina kusintha kwa shuga m'magazi kumalumikizidwa ndi kumwa mankhwala, makamaka mahomoni (nthawi zambiri, glucocorticoids amakhala "osokoneza").

Tsoka ilo, matenda oterewa nthawi zambiri amakhala asymptomatic. Odwala samakonda kudandaula za kuwonongeka kwa thanzi kapena samangozindikira. Mwa njira, kwakukulu, anthu omwe ali ndi matenda ofananawa ndi onenepa kwambiri, omwe amalumikizidwa ndi kuphwanya njira yachilengedwe.

Pamene kukulira kwa vuto la kagayidwe kazakudya, mawonekedwe a mawonekedwe amayamba kuonekera, omwe amaphatikizidwa ndi kulolerana kwa shuga. Zizindikiro mu nkhaniyi ndi ludzu, kumverera kwa pakamwa pouma komanso kuchuluka kwa madzimadzi. Chifukwa chake, kukodza pafupipafupi kumawonedwa mwa odwala. Poyerekeza zakumbuyo yamavuto amthupi ndi kagayidwe kachakudya, kuchepa kwakukulu kwa chitetezo chamthupi kumawonedwa - anthu amatenga matenda oyamba ndi mafangasi.

Inde, odwala ambiri omwe ali ndi vutoli amasangalala ndi mafunso okhudzana ndi kuopsa kwa kulolera kwa glucose. Choyamba, matendawa amawonedwa ngati owopsa chifukwa, ngati sanapatsidwe, chiwopsezo chokhala ndi matenda odziwika bwino, omwe ndi mtundu wachiwiri wa matenda ashuga, ndi okwera kwambiri. Komabe, matenda oterewa amawonjezera mwayi wokhala ndi matenda amtima.

Dokotala angadziwe kuti ali ndi vuto loleza “glucose” Poyamba, katswiri adzayesa mayeso ndikutenga anamnesis (kukhalapo kwa madandaulo ena kuchokera kwa wodwala, zambiri zokhudzana ndi matenda am'mbuyomu, kupezeka kwa anthu omwe ali ndi matenda ashuga m'banja, ndi zina).

M'tsogolomu, kuyezetsa magazi ambiri pamlingo wa shuga kumachitika. Zitsanzo zimatengedwa m'mawa, pamimba yopanda kanthu. Njira yofananira imachitika m'chipatala chilichonse. Monga lamulo, kuchuluka kwa shuga mwa odwala oterowo kumaposa 5.5 mmol / L. Komabe, kuti adziwitse kuzindikira koyenera, kuyesa kwapadera kwa glucose kumafunika.

Kufufuza kotere ndi njira imodzi yofikira kwambiri yopezera matenda omwe amachititsa kuti "glucose kulolerana" Koma ngakhale kuyesa ndikosavuta, kukonzekera koyenera ndikofunikira pano.

Kwa masiku angapo asanamwe magazi, wodwalayo amalangizidwa kuti apewe kupsinjika ndikuwonjezera zochitika zolimbitsa thupi. Ndondomeko ikuchitika m'mawa komanso pamimba yopanda kanthu (osati kale kuposa maola 10 mutatha chakudya chatha). Choyamba, gawo lamwazi limatengedwa kuchokera kwa wodwala, pambuyo pake amamwa kumwa shuga wamphutu wosungunuka m'madzi ofunda. Pambuyo maola 2, kuyezetsa magazi mobwerezabwereza kumachitika. M'malo a labotale, kuchuluka kwa shuga m'masamba kumatsimikiziridwa ndipo zotsatira zake zimayerekezedwa.

Ngati shuga asanadye shuga wamagazi anali 6.1-5,5 mmol, ndipo patatha maola awiri adalumpha kwambiri mpaka 7.8-11.0 mmol / l, ndiye titha kuyankhula kale za kuphwanya kulolerana.

M'malo mwake, akatswiri amalimbikitsa kuti aliyense amayesedwa kamodzi pa zaka ziwiri zilizonse - iyi ndi njira yothandiza kwambiri yodzitetezera yomwe ingathandize kuzindikira matenda adakali achinyamata. Komabe, pali ena omwe ali pachiwopsezo chomwe kusanthula ndikofunikira. Mwachitsanzo, anthu omwe ali ndi vuto lobadwa ndi matenda ashuga, komanso odwala omwe ali ndi kunenepa kwambiri, matenda oopsa a m'magazi, cholesterol yapamwamba, atherosulinosis, neuropathy yachidziwitso chosadziwika, nthawi zambiri amatumizidwa kukayezetsa.

Ngati mayeso ololera amapereka zabwino, ndiye muyenera kulumikizana ndi endocrinologist. Katswiri wokha ndi amene amadziwa chithandizo chomwe chimafunika kulolera shuga. Chithandizo pano. Komabe, wodwalayo ayenera kusintha moyo wake mwachangu momwe angathere.

Ndikofunikira kuonetsetsa kuti kulemera kwa thupi kumadutsa malire oyenera. Mwachilengedwe, kukhala pachakudya chokhazikika kapena kukhetsa thupi ndi masewera olimbitsa thupi sikuyenera. Muyenera kulimbana ndi mapaundi owonjezera, kusintha pang'onopang'ono zakudya komanso kuwonjezera masewera olimbitsa thupi. Mwa njira, maphunziro ayenera kukhala okhazikika - katatu katatu pa sabata. M'pofunika kusiya kusuta, chifukwa chikhalidwe choipachi chimatsogolera pakuchepa kwa mitsempha yamagazi ndikuwonongeka kwa maselo a pancreatic.

Inde, muyenera kuyang'anitsitsa kuchuluka kwa shuga m'magazi, kumayesedwa pafupipafupi ndi endocrinologist ndikuyesa mayeso ofunika - izi zimapangitsa kudziwa kupezeka kwa zovuta munthawi yake.

Ngati mankhwalawa sakuthandiza, dokotala angakupatseni mankhwala ena omwe amachepetsa shuga. Koma ndikofunikira kumvetsetsa kuti panacea yapadziko lonse lapansi yamatenda kulibe.

Zachidziwikire, pochiza matenda oterewa, zakudya zimagwira ntchito yofunika kwambiri. Kulekerera kwa shuga wambiri kumafuna zakudya zapadera. Choyamba, ndikofunikira kusintha regimen yodya. Odwala amalangizidwa kuti azidya kangapo ka 5-7 patsiku, koma magawo azikhala ochepa - izi zikuthandizani kuti muthe kugaya katundu.

Ndi kusintha kwina kotani komwe kulephera kwa glucose kumafuna? Zakudya pankhaniyi ziyenera kupatula maswiti - shuga, maswiti, makeke otsekemera saloledwa. Kuphatikiza apo, ndikofunikira kuchepetsa kuchuluka kwa zinthu zomwe zimakhala ndi chakudya chamafuta ochepa - izi ndi chakudya ndi zinthu zophika buledi, pasitala, mbatata, etc. Akatswiri amalimbikitsanso kuchepetsa kuchuluka kwa mafuta - osagwiritsa ntchito nyama, mafuta, mafuta anyama. Panthawi yokonzanso, ndikuyeneranso kusiya khofi ngakhale tiyi, chifukwa zakumwa izi (ngakhale zopanda shuga) zimakonda kuwonjezera milingo yamagazi.

Kodi wodwalayo ayenera kudya chiyani? Choyamba, awa ndi masamba ndi zipatso. Zitha kuthiriridwa zosaphika, zophika, kuphika. Pulogalamu yofunikira ya mapuloteni imatha kupezeka ndikulowetsa mitundu yosiyanasiyana yamafuta am'madzi ndi nsomba, mtedza, nyemba, mkaka ndi mkaka.

Kulekerera kwa shuga wambiri kungakhale koopsa kwambiri. Ndipo pankhaniyi, ndikosavuta kupewetsa matenda amtunduwu kuposa kuthana ndi vuto la matenda ashuga. Kuti thupi lizigwira bwino ntchito, muyenera kutsatira malamulo ena osavuta.

Pongoyambira, muyenera kusintha kadyedwe. Akatswiri amalimbikitsa zakudya zopatsa chidwi - idyani katatu patsiku, koma nthawi zonse m'magawo ang'onoang'ono. Zakudya zatsiku ndi tsiku ziyenera kuchepetsa kuchuluka kwa maswiti, makeke komanso zakudya zonenepetsa kwambiri, m'malo mwake muli zipatso, masamba ndi zakudya zina zopatsa thanzi.

Ndikofunikira kuyang'anira thupi ndikuwapatsa thupi ntchito zolimbitsa thupi zofunika. Zachidziwikire, kuchita masewera olimbitsa thupi mochulukirapo kungakhalenso koopsa - katundu ayenera kuchuluka pang'onopang'ono. Zachidziwikire, maphunziro akuthupi amayenera kukhala okhazikika.

Zomwe zimalepheretsa kulekerera shuga, momwe mungachitire komanso zomwe muyenera kuchita

Kusowa kwathunthu kochita masewera olimbitsa thupi, madzulo pamaso pa kompyuta okhala ndi gawo lalikulu la chakudya chokoma kwambiri, mapaundi owonjezera ... Timatsitsa chokoleti, kukhala ndi bun kapena bar yotsekemera, chifukwa ndiosavuta kudya osasokoneza ntchito - zizolowezi zonsezi sizingatibweretsere pafupi Matenda ofala kwambiri m'zaka zam'ma 2000 ndi mitundu yachiwiri ya matenda ashuga.

Matenda a shuga sangathe. Mawu awa akumveka ngati sentensi yomwe yasintha njira yokhazikika. Tsopano tsiku lililonse muyenera kuyeza shuga m'magazi, omwe mulingo womwe ungakhale wabwino, komanso kutalika kwa moyo wanu wotsalira. Ndikothekanso kusintha chiyembekezo chosangalatsa kwambiri ngati kuphwanya kwamphamvu kwa glucose kwapezeka munthawi. Kuchitapo kanthu pakadali pano kungalepheretse kapena kusinthitsa kwambiri matenda ashuga, ndipo izi ndi zaka, kapena ngakhale zaka makumi angapo, zaumoyo wathanzi.

Zakudya zilizonse zamagetsi zomwe zimagwidwa m'mimba zimaphwanyidwa kukhala glucose ndi fructose, glucose yomweyo imalowa m'magazi. Kuchuluka kwa shuga kumapangitsa kapamba. Amatulutsa ma insulin. Zimathandizira shuga kuchokera m'magazi kulowa m'maselo a thupi - imakulitsa mapuloteni am'mimba omwe amayendetsa glucose mu cell kudzera mu membrane wamaselo. M'maselo, limagwira ntchito ngati gwero lamphamvu, limalola kayendedwe ka metabolic, popanda kugwiritsa ntchito thupi la munthu sikukanatheka.

Munthu wamba amatenga pafupifupi maola awiri kuti ayamwe gawo la glucose lomwe limalowa m'magazi. Kenako shuga amabwerera mwakale ndipo ndi ochepera 7.8 mmol pa lita imodzi yamagazi. Ngati chiwerengerochi ndi chokwera, izi zikuwonetsa kuphwanya kwa kulolera kwa glucose. Ngati shuga ndi oposa 11.1, ndiye kuti tikulankhula za matenda ashuga.

Kulekerera kwa shuga wa glucose (NTG) kumatchedwanso "prediabetes".

Ichi ndi zovuta matenda a metabolic, omwe akuphatikizapo:

• kuchepa kwa mankhwala a insulin chifukwa chosakwanira kugwira ntchito kwa kapamba,
• kuchepa kwamphamvu kwa mapuloteni a nembanemba mpaka insulin.

Kuyesedwa kwa shuga kwa shuga komwe kumachitika m'mimba yopanda kanthu, ndi NTG, nthawi zambiri kumawonetsa kuperewera (komwe shuga ndi kwabwinobwino), kapena glucose amachulukitsidwa pang'ono, chifukwa thupi limatha kusakaniza shuga onse omwe amalowa m'magazi usiku womwewo asanatenge kusanthula.

Palinso kusintha kwina kwa kagayidwe kazakudya - kuwonongeka kwa glycemia (IHF). Izi matenda amadziwika pomwe kuchuluka kwa shuga pamimba yopanda kanthu kumaposa zomwe zimachitika, koma zochepa kuposa zomwe zimakupatsani mwayi wofufuza matenda ashuga. Glucose italowa m'magazi, imakwanitsidwa kukonzedwa mu 2 hours, mosiyana ndi anthu omwe ali ndi vuto la glucose.

Palibe zizindikiro zotchulidwa zomwe zingasonyeze mwachindunji kupezeka kwa munthu kuphwanya shuga. Kuchuluka kwa shuga m'magazi a NTG kumawonjezeka pang'ono komanso kwakanthawi kochepa, kotero kusintha kwa ziwalo kumachitika pokhapokha zaka zochepa. Nthawi zambiri zizindikiro zowopsa zimawonekera pokhapokha pakuchepa kwamatenda a glucose, pomwe mutha kulankhula za kuyambika kwa matenda ashuga 2.

Yang'anirani izi:

1. Pakamwa pakamwa, kumwa madzi ambiri kuposa masiku onse - thupi likuyesetsa kuchepetsa kuchuluka kwa shuga mwa kuchepetsa magazi.
2. Kukodza pafupipafupi chifukwa cha kuchuluka kwa madzimadzi.
3. Amadzuka mwadzidzidzi m'magazi a magazi atatha kudya zopatsa mphamvu zam'thupi zomwe zimapangitsa kuti pakhale kutentha komanso chizungulire.
4. Mutu womwe umayamba chifukwa cha kuzungulira kwa ziwalo zaubongo.

Monga mukuwonera, Zizindikiro izi siziri mwachindunji ndipo ndizosavuta kuzindikira NTG pamaziko awo. Zizindikiro za glucometer yakunyumba sikuti nthawi zonse imakhala yothandiza, kuchuluka kwa shuga komwe kumawululidwa ndi chithandizo chake kumafuna kutsimikiziridwa mu labotale. Pozindikira NTG, kuyezetsa magazi kwapadera kumagwiritsidwa ntchito, kutengera momwe munthu angadziwire ngati munthu ali ndi vuto la metabolic.

Kuphwanya kulolerana kungakhazikike modalirika pogwiritsa ntchito kuyesa kwa glucose. Pakuyesa uku, magazi othamanga amatengedwa kuchokera mu mtsempha kapena chala ndipo zomwe zimatchedwa "kusala kwa shuga" ndizotsimikizika. Pomwe kuwunikirako kubwerezedwa, ndi shuga kupitanso muyeso, titha kulankhula za matenda ashuga okhazikika. Kuyesa kwinanso pankhaniyi ndikosatheka.

Ngati shuga pamimba yopanda kanthu ndi kwambiri (> 11.1), kupitilizanso sikungakutsatireni, chifukwa kuunikanso mopitilira kungakhale kosavulaza.

Ngati shuga yosala imatsimikizika mkati mwa malire oyenera kapena kupitirira pang'ono, zomwe zimadziwika kuti zimachitika: amapatsa kapu yamadzi ndi 75 g ya shuga kuti amwe. Maola awiri otsatira adzayenera kukhala mkati mwa labotale, kudikirira kuti shuga ayambe kugaya. Pambuyo pa nthawi iyi, ndende ya glucose imatsimikizidwanso.

Kutengera ndi deta yomwe yapezeka chifukwa cha kuyesedwa kwa magazi, titha kulankhula za kukhalapo kwa kusokonezeka kwa kagayidwe kazakudya kwa michere:

Norm

Chiyeso chololera cha glucose chimakhala chovomerezeka panthawi ya pakati, pa masabata 24-28. Tithokozetse, amupeza matenda ashuga, omwe amapezeka mwa amayi ena nthawi yobala mwana ndikusowa okha atabereka mwana. Kulekerera kwa shuga mkati mwa mimba ndi chizindikiro cha kutetemera kwa NTG. Chiwopsezo cha matenda ashuga a 2 mwa azimayi awa ndiwokwera kwambiri.

Zomwe zimayambitsa kusintha kwa kagayidwe kazakudya zam'mimba komanso kupezeka kwa kulolerana kwa shuga ndikupezeka kwa chimodzi kapena zingapo mwa mbiri ya munthu:

Choopsa chachikulu cha NTG ndichopezeka ndi mtundu wa matenda a shuga 2. Malinga ndi ziwerengero, pafupifupi 30% ya anthu, kulolerana kwa glucose kumatha nthawi yayitali, thupi limadalira zovuta za metabolic.70% yotsala imakhala ndi NTG, yomwe pakapita nthawi imayamba kuvuta ndikukhala ndi matenda ashuga.

Matendawa amakhalanso ndi mavuto angapo chifukwa chosintha kowawa m'matumbo. Molekyu yambiri yamagazi m'magazi amachititsa thupi kuyankha m'njira yowonjezera kuchuluka kwa triglycerides. Mlingo wamagazi ukuwonjezeka, umakhala wonenepa kwambiri. Zimakhala zovuta kuti mtima uyendetse magazi kudzera m'mitsempha, amakakamizidwa kugwira ntchito mwadzidzidzi. Zotsatira zake, matenda oopsa amathanso, zolembera ndi zophuka m'matumba zimapangidwa.

Zombo zing'onozing'ono sizimamva bwino motere: makoma awo amaphulika, zombo zimaphulika chifukwa cha kusokonekera kwambiri, ndipo zotupa zazing'ono zimachitika. Thupi limakakamizidwa kuti likulire pafupipafupi mtima, ziwalo zimayamba kupatsidwa mpweya wabwino.

Vutoli limatenga nthawi yayitali - zotsatira za kuyamwa kwa glucose ndizomangira thupi. Kuti mupewe izi, muyenera kuyesa mayeso a glucose chaka chilichonse, makamaka ngati muli ndi zovuta za NTG.

Ngati mayeso (mayeso) okhudza kulolera kwa glucose akuwonetsa zovuta za kagayidwe kazakudya, muyenera kupita kwa endocrinologist. Pakadali pano, njirayi imatha kuyimitsidwa ndikulekerera kumaselo a thupi. Chofunikira pankhaniyi ndikutsatira kwambiri zomwe dokotalayu akuwonetsa komanso chidwi chachikulu.

Kuyambira pano, muyenera kusiya zizolowezi zambiri zoyipa, kusintha mfundo zamakhalidwe abwino, kuwonjezera kusintha kwa moyo, mwinanso masewera. Madokotala amatha kuthandizira kukwaniritsa cholinga, koma wodwalayo payekha ayenera kuchita ntchito yayikulu yonse.

Kusintha kwa zakudya kwa NTG ndikofunikira. Kupanda kutero, shuga sangakhale wamba.

Vuto lalikulu la kulolera shuga m'magazi ndi kuchuluka kwa insulini yomwe imapangidwa poyankha shuga kulowa m'magazi. Kubwezeretsa chidwi cha maselo kwa iwo ndikuwathandiza kulandira shuga, insulini iyenera kuchepetsedwa. Kutetezedwa kwaumoyo, izi zitha kuchitidwa mwa njira yokhayo - kuchepetsa kuchuluka kwa zakudya zomwe zili ndi shuga.

Zakudya zamagetsi zamagetsi zomwe zimapangitsa kuti magazi azikhala ochepa. Ndikofunikira kwambiri kupatula zakudya zokhala ndi index yayikulu ya glycemic momwe ndingathere, chifukwa shuga kuchokera kwa iwo imalowetsedwa m'magazi mwachangu, m'magawo akulu.

Zakudya zotsutsana ndi kulekerera ziyenera kupangidwa motere:

Chakudya chizikhala cholowererapo, magawo 4-5 ofanana, chakudya chamoto chambiri chimagawidwa tsiku lonse. Samalani kuchuluka kwamadzi okwanira. Kuchuluka kwake kumawerengeredwa potengera kuchuluka kwake: 30 g yamadzi pa kilogalamu ya kulemera kwa tsiku.

Mfundo yayikulu yochepetsera kunenepa ndikuchepetsa kudya kwanu kwa tsiku ndi tsiku.

Kuti mupeze zofunika pazopatsa mphamvu, muyenera kudziwa phindu la kagayidwe kake kofunikira:

Kulekerera kwa shuga m'magazi ndi momwe zimakhalira ndi kuchuluka kwa shuga m'magazi, koma chizindikiro ichi sichikufika pamlingo womwe kupezeka kwa matenda a shuga kumapangidwira. Gawo ili la matenda a metabolism a carbohydrate limatha kubweretsa chitukuko cha matenda a shuga 2, chifukwa chake nthawi zambiri amapezeka kuti ali ndi matenda osokoneza bongo.

M'magawo oyamba, zamatsenga zimayamba modabwitsa ndipo zimapezeka chifukwa chokhacho cha mayeso a kulolera kwa glucose.

Kulekerera kwa glucose wolumikizika komwe kumalumikizidwa ndi kuchepa kwa mayamwidwe am'magazi ndimizimba ya thupi kumanenedwa kukhala gawo loyambirira la matenda ashuga (latentabetes mellitus), koma posachedwapa akuti ndi matenda osiyana.

Kuphwanya kumeneku ndi gawo limodzi la metabolic syndrome, komwe kumawonekeranso ndikuwonjezeka kwa kuchuluka kwa mafuta a visceral, ochepa oopsa komanso hyperinsulinemia.

Malinga ndi ziwerengero zomwe zilipo, kulekerera kwa glucose komwe kunapezeka ndi anthu pafupifupi 200 miliyoni, pomwe matendawa amapezeka nthawi zambiri limodzi ndi kunenepa kwambiri. Matenda a shuga ku United States amawonedwa mwa mwana aliyense wachinayi wazaka 4 mpaka 10, ndipo mwana aliyense wachisanu azikhala wazaka 11 mpaka 18.

Chaka chilichonse, 5-10% ya anthu omwe ali ndi vuto loleza glucose amatha kusintha kwa matendawa kukhala matenda a shuga (nthawi zambiri kusintha kumeneku kumawonedwa kwa odwala onenepa kwambiri).

Glucose monga gwero lenileni lamphamvu limapereka njira za metabolic mthupi la munthu. Glucose imalowa m'thupi chifukwa chomwa ma carbohydrate, omwe pambuyo poti amola amachoka m'matumbo am'magazi.

Insulin (mahomoni omwe amapangidwa ndi kapamba) amafunikira kuti glucose akhale ndi minofu yambiri. Chifukwa cha kuchuluka kwa madzi am'mapapo a plasma, insulin imalola kuti minofu igwire glucose, ndikuchepetsa magazi ake patatha maola 2 mutadya.

Zomwe zimalepheretsa shuga kuloleza mwina chifukwa cha cholowa kapena chikhalidwe. Zomwe zikuthandizira pakukula kwa matendawa ndi:

• chibadwa chamtsogolo (kupezeka kwa matenda a shuga kapena prediabetes mwa abale apafupi),
• kunenepa
• ochepa matenda oopsa
• kukwezeka kwa magazi lipids ndi atherosclerosis,
• matenda a chiwindi, mtima dongosolo, impso,
• gout
• hypothyroidism
• insulin kukana, momwe kudziwa zotumphukira zimakhala zotsatira za insulin amachepetsa (anati ndi kagayidwe kachakudya matenda),
• kutupa kwapancreatic ndi zinthu zina zomwe zimapangitsa kuti insulini ipangidwe.
• cholesterol yayikulu
• kumangokhala
• matenda a endocrine dongosolo, momwe mahomoni olimbana ndi mahomoni amapangidwa mopitirira muyeso (Itsenko-Cushing's syndrome, etc.),
• kugwiritsa ntchito molakwika zakudya zomwe zimakhala ndi mafuta ambiri osavuta,
• kumwa glucocorticoids, njira zakulera za pakamwa komanso mankhwala ena a mahomoni.
• zaka 45

Nthawi zina, kuphwanya shuga kuloleza azimayi oyembekezera kumawonekeranso (matenda oopsa a shuga, omwe amawonekera mu 2.0-3,5% ya milandu yonse yomwe imachitika pathupi). Zowopsa zomwe zimabweretsa amayi apakati ndizophatikiza:

• Kunenepa kwambiri, makamaka ngati kulemera kwambiri kumawonekera patatha zaka 18,
• chibadwa
• zaka zopitilira 30
• kupezeka kwa matenda ashuga akaka m'mimba yapitayi,
• polycystic ovary syndrome.

Kulekerera kwa glucose kumachitika chifukwa cha kuphatikizika kwa insulin yotupa komanso kuchepa kwamphamvu kwa minofu.

Kapangidwe ka insulin kamakhudzidwa ndi kudya kwa zakudya (sikuyenera kukhala chakudya), ndipo kumasulidwa kwake kumachitika pamene kuchuluka kwa shuga m'magazi kukwera.

Insulin secretion imatheka chifukwa cha amino acid (arginine ndi leucine) ndi mahomoni ena (ACTH, HIP, GLP-1, cholecystokinin), komanso ma estrogens ndi sulfonylureas. Kuchulukitsa katulutsidwe ka insulini komanso kuwonjezereka kwa plasma ya calcium, potaziyamu kapena mafuta aulere acids.

Katemera wa insulin amene amayamba chifukwa cha mphamvu ya glucagon, timadzi tating'onoting'ono tomwe timatulutsa ma cell.

Insulin imayambitsa transmembrane insulin receptor, yomwe imanena za glycoproteins. Zomwe zimapangidwa ndi cholandirachi ndi zigawo ziwiri za alpha ndi zigawo ziwiri za beta zolumikizidwa ndi ma bond disulfide.

Ma receptor alpha subunits amapezeka kunja kwa cell, ndipo transmembrane protein beta subunits amawongoleredwa mkati mwa cell.

Kuwonjezeka kwamankhwala a glucose nthawi zambiri kumayambitsa kuwonjezeka kwa ntchito ya tyrosine kinase, koma ndi prediabetes pali kuphwanya pang'ono kwa insulin kumanga kwa receptor. Chomwe chimayambitsa kuphwanya kumeneku ndi kuchepa kwa chiwerengero cha ma insulin receptors komanso mapuloteni omwe amapereka ma glucose mayendedwe mu cell (ma glucose transport).

Zida zazikulu zomwe zimayang'aniridwa ndi insulin zimaphatikizapo chiwindi, adipose ndi minofu minofu. Maselo amtunduwu amakhala osaganizira (osagwirizana) ndi insulin. Zotsatira zake, kukoka kwa glucose mu minofu yamipweya kumachepa, kapangidwe ka glycogen kamachepa, ndipo prediabetes imayamba.

Mitundu yomaliza ya shuga imayamba chifukwa cha zinthu zina zomwe zimakhudza chitukuko cha insulin:

• kuphwanya kuchuluka kwa ma capillaries, zomwe zimayambitsa kuphwanya kwamtundu wa insulin kudzera mu mtimaotothelium,
• kuchuluka kwa lipoproteins zosinthika,
• acidosis
• kudzikundikira kwa michere yamagulu a hydrolase,
• kukhalapo kwa matenda oyamba a kutupa, etc.

Kukana kwa insulini kumatha kuphatikizidwa ndi kusintha kwa molekyulu ya insulin, komanso kuwonjezeka kwa zochitika za mahomoni otsutsana kapena mahomoni apakati.

Kuphwanya kwa kulolerana kwa glucose kumayambiriro kwa chitukuko cha matendawa sikuwonetsedwa. Odwala nthawi zambiri amakhala onenepa kapena onenepa kwambiri, ndipo mayesowo amawulula:

• kusala kwa proteinoglycemia (glucose m'magazi otumphukira ndikwabwinobwino kapena pang'ono kuposa momwe zimakhalira),
• kusowa kwa glucose mkodzo.

Matenda a shuga amatha kutsatiridwa ndi:

• furunculosis,
• magazi m`kamwa ndi matenda osakhalitsa,
• Khungu ndi kuyamwa
• zotupa zopanda machiritso
• kufooka pakugonana, kusamba kwa msambo (amenorrhea ndikotheka),
• angioneuropathy (zotupa zazing'onoting'ono zimayenda ndi magazi osokonezeka, komanso kuwonongeka kwa mitsempha, yomwe imayendera limodzi ndi kuwonongeka kwa zovuta) zosiyanasiyana zovuta ndi kutengera kwawoko.

Pamene kuphwanya kukukulira, chithunzi cha chipatala chitha kuphatikizidwa:

• kumva ludzu, kamwa yowuma ndi kuchuluka kwa madzi,
• kukodza pafupipafupi
• kuchepa kwa chitetezo chathupi, komwe kumayendetsedwa ndimatenda a kutupa ndi fungus pafupipafupi.

Kuwonongeka kwa kulolera kwa glucose nthawi zambiri kumadziwika mwangozi, popeza odwala sapereka madandaulo aliwonse. Maziko omwe amadziwika ndi matendawa nthawi zambiri amayambitsa kuyezetsa magazi kwa shuga, komwe kumawonetsa kuchuluka kwa glucose othamanga mpaka 6.0 mmol / L.

• kusanthula kwa mbiri yakale (zomwe zimafotokozedwa pamatenda ophatikizana ndi achibale akufotokozedwa),
• kuwunika kambiri, komwe nthawi zambiri kumawulula kukhalapo kwa thupi kapena kunenepa kwambiri.

Zomwe zimayambitsa matenda a prediabetes ndi kuyesa kwa glucose, komwe kumayesa momwe thupi limayamwa shuga. Pamaso pa matenda opatsirana, kuwonjezeka kapena kuchepa kwa ntchito zolimbitsa thupi masana tsiku loyesa lisanachitike (sikugwirizana ndi chizolowezi) ndikumwa mankhwala omwe amakhudza shuga, mayesowo sanachitike.

Musanayesere kuyesedwa, ndikulimbikitsidwa kuti musachepetse zakudya zanu kwa masiku atatu, kotero kuti kudya kwa mafuta osachepera 150 g patsiku. Zochita zolimbitsa thupi siziyenera kupitirira katundu wamba. Madzulo, musanadye kusanthula, kuchuluka kwa chakudya chamafuta omwe azigwiritsidwa ntchito kuyenera kukhala kuyambira 30 mpaka 50 g, pambuyo pake chakudya sichimadyedwa kwa maola 8 mpaka 14 (madzi akumwa amaloledwa).

• kusala magazi magazi kusanthula shuga,
• Kulandila kwa shuga (chifukwa cha 75 ga shuga 250-300 ml ya madzi ndikofunikira),
• mobwerezabwereza sampuli ya magazi kusanthula kwa shuga 2 mawola kumwa shuga.

Nthawi zina, zitsanzo zowonjezera za magazi zimatengedwa mphindi 30 zilizonse.

Mukamayesedwa, kusuta kumaletsedwa kuti zotsatira zake zisinthe.

Kuphwanya shuga kulolera kwa ana kumatsimikizidwanso kugwiritsa ntchito mayesowa, koma "kuchuluka" kwa glucose pamwana kumawerengeredwa kutengera kulemera kwake - 1.75 g ya glucose imatengedwa pa kilogalamu, koma kwathunthu osapitirira 75 g.

Kulekerera kwa glucose kosavomerezeka panthawi yoyembekezera kumayesedwa pogwiritsa ntchito mayeso apakamwa pakati pa masabata 24 mpaka 28 a mimba. Kuyesaku kumachitika pogwiritsa ntchito njira imodzimodzi, koma zimaphatikizanso muyeso wina wamagulu m'magazi patatha ola limodzi njira yothetsera shuga itachitika.

Nthawi zambiri, kuchuluka kwa glucose pakubwerezedwa kwa magazi sayenera kupitirira 7.8 mmol / L. Mkulu wama glucose a 7.8 mpaka 11.1 mmol / L amawonetsa kuloleza kwa glucose, ndipo mulingo wapamwamba kwambiri wa 11.1 mmol / L ndi chizindikiro cha matenda ashuga.

Ndikupeza msanga wama glucose opezeka 7.0 mmol / L, kuyesaku sikothandiza.

Kuyesaku kumawonetsedwa mwa anthu omwe kusala kudya glucose kumadutsa 11.1 mmol / L, ndi omwe adachita kupsinjika kwaposachedwa, opaleshoni kapena kubala mwana.

Ngati kuli kofunikira kudziwa malo osungira insulin, dokotala amatha kutsimikiza kuchuluka kwa C-peptide mogwirizana ndi kuyeserera kwa shuga.

Chithandizo cha prediabetes chimakhazikitsidwa pazotsatira zosagwiritsa ntchito mankhwala. Therapy imaphatikizapo:

• Kusintha kwa zakudya. Zakudya zopatsa mphamvu za glucose zosafunikira zimafunikira kupatula maswiti (maswiti, makeke, ndi zina), kudya zochepa zam'mimba zophatikizika (ufa ndi pasitala, mbatata), kumwa pang'ono kwamafuta (nyama yamafuta, batala). Zakudya zazing'ono zimavomerezedwa (zosungidwa zazing'ono kangapo patsiku).
• Kulimbitsa zolimbitsa thupi. Olimbikitsidwa zolimbitsa thupi tsiku ndi tsiku, mphindi 30 - ola (masewera ayenera kuchitidwa katatu katatu pa sabata).
• Kuchepetsa thupi.

Palibe achire zotsatira, pakamwa hypoglycemic mankhwala zotchulidwa (a-glucosidase inhibitors, sulfonylureas, thiazolidinediones, etc.).

Njira zochizira zimachitidwanso kuti muchepetse chiopsezo (chithokomiro cha chithokomiro chimakonza, kagayidwe ka lipid kakonzedwe, etc.).

Mu 30% ya anthu omwe ali ndi vuto lolephera kuloza glucose, misempha ya m'magazi pambuyo pake imabweranso yokhazikika, koma mwa odwala ambiri ali ndi chiopsezo chachikulu cha matenda amtunduwu.

Matenda a shuga amatha kuthandizira pakukula kwa matenda a mtima.

Kupewa matenda a shuga kumaphatikizapo:

• Chakudya choyenera, chomwe chimachotsa kugwiritsidwa ntchito kosalamulika kwa zakudya zotsekemera, ufa ndi mafuta ochulukirapo, ndikuwonjezera kuchuluka kwa mavitamini ndi michere.
• Kuchita masewera olimbitsa thupi mokwanira (masewera aliwonse kapena kuyenda kwamtali.) Katundu sayenera kukhala wambiri (kuchuluka ndi kutalika kwa masewera olimbitsa thupi kumawonjezeka pang'onopang'ono).

Kuwongolera kunenepa kwambiri kumafunikanso, ndipo patatha zaka 40, kuwunika pafupipafupi zaka 2-3 zilizonse.

NTG - kulolerana kwa glucose: zomwe zimayambitsa, zizindikiro ndi njira zokonzanso

Kulekerera kwa shuga wambiri ndi vuto lenileni masiku ano. Milandu yokuwona kuphwanya kotereku yakhala ikucitika kawiri kawiri ndipo chifukwa cha ichi ndikusintha kwa mtundu wamoyo wamakono.

Choyambitsa chachikulu ndicho kutokomeza kwakuthupi. Pakatha tsiku logwira ntchito molimbika, munthu alibe mphamvu zoyenda kapena kupita ku malo olimbitsa thupi ndipo zimakhala zosavuta kuti athe kupumula pa sofa yabwino pamaso pa TV yake.

Chinthu chotsatira, chomwe chimakhazikika pa cham'mbuyo, ndikusowa kwa chakudya. Chakudya chamadzulo chopatsa thanzi komanso chamafuta, chomwe chimakupatsani chakudya chambiri chimakupatsani mwayi wothana ndi njala yomwe singathe kukhuta masana.

Munthu amakhulupirira kuti sanadye tsiku lonse, koma adangogwiritsa ntchito zopatsa mphamvu, ndiye kuti azitha kulipira. Koma thupi siligwirizana naye.

Kuwonongeka kwa kulolera kwa glucose ndikusintha kwa pathological, mawonetseredwe omwe amatha kupewedwa, momwe angachitire ndipo koposa zonse, momwe mungazindikire kusintha kwa nthawi? Mayankho ku mafunso akuluakulu amaperekedwa kwa owerenga.

Zakuti shuga ndi matenda osachiritsika amadziwika kwa aliyense. Koma chiwopsezo chake nthawi zambiri sichinyalanyazidwa. Anthu samvetsetsa kuti shuga ndiyofunikira kuyang'anira shuga wamagazi nthawi zonse pamoyo wawo, ndipo kukhala bwino kwathunthu kumatengera kuchuluka kwa mita.

Ambiri saganiza za zovuta za matendawa zomwe zimachitika ngati osagwirizana ndi zoyambira zoyambira odwala ashuga. Ndikosatheka kuchiritsa matenda a shuga, koma ndizotheka kupewa chitukuko chake.

Pankhaniyi, njira zoyenera kwambiri zopewera ndi kuzindikira kwapakati pa kulolerana kwa shuga. Ndi kudziwitsidwa koyambirira ndi kukhazikitsidwa kwa zofunikira, mutha kuletsa kukula kwa matenda oopsa kapena kuchedwa kuwonekera kwa matendawa kwa zaka zambiri.

Zakudya zomanga thupi zomwe zimadyedwa mu chakudya zimagawika mu glucose ndi fructose panthawi yopukusa. glucose amalowa m'magazi nthawi yomweyo. Kuchulukitsa kwa ndende yamagazi kumathandizira zochitika za kapamba, amapanga insulin, yomwe imathandiza shuga kutuluka m'magazi kupita m'maselo a thupi. Glucose m'maselo ndi gwero lamphamvu ndipo imapereka njira yokwanira ya kagayidwe kachakudya.

Kodi matenda ofananawo amatanthauza chiyani?

Kwa munthu wathanzi, nthawi yanthawi yomwe amapatsidwa gawo la glucose sichitha kuposa 2 maola. Pambuyo pa nthawi imeneyi, zizindikiro za shuga zimabwereranso mwakale. Ngati matendawa apitirira, kuphwanya kuleza kumapezeka.

Yang'anani! Matenda a shuga amatha kupezeka ngati, atatha maola awiri atayesedwa, vuto la shuga silinakhazikike, koma likadali pafupifupi 11 mmol / L.

Kusakaniza kwa shuga ndikuphwanya kukhululuka kwa shuga. Kuphwanya kotereku kumatanthauza kuwonekera kwa kusintha kwakukulu:

• motsutsana ndi kuyambika kwa kuphwanya njira ya kupangira insulin ndi maselo a kapamba, kuchuluka kwa mahomoni m'thupi kumachepa,
• chidwi cha ma protein a membrane kupita ku insulin amachepetsa kwambiri.

Ndikofunika kukumbukira kuti kuyezetsa magazi kwa shuga ndi NTG yoperekedwa pamimba yopanda kanthu kumawonetsa zambiri.

Izi ndichifukwa choti usiku, thupi la munthu limatha kupitiliza kupanga shuga yemwe walowa m'magazi. Kutengera ndi chidziwitso ichi, titha kunena kuti kafukufuku wotereyu sikokwanira kuzindikira prediabetes.

Glycemia wosokonekera wasokonezeka akapezeka kuchuluka kwa shuga m'magazi, koma osafika pamlingo womwe ungadziwitse kukula kwa matenda a shuga.

Zomwe zimayambitsa NTG zitha kukhala chifukwa cha zinthu zingapo:

1. 
   Bogdanova, O. Bukhu Lalikulu la odwala matenda ashuga. Chilichonse chomwe muyenera kudziwa zokhudza matenda ashuga / O. Bogdanova, N. Bashkirova. - M: AST, AST Moscow, Prime-Evroznak, 2008. - 352 p.
2. 
   Yurkov, I.B. Bukhu la zovuta za mahomoni ndi matenda / I. B. Yurkov. - M: Phoenix, 2017 .-- 698 p.
3. 
   Zakharov Yu.L. Matenda a shuga - kuchokera ku kukhumudwa kufikira chiyembekezo. Moscow, Yauza Publishing House, 2000, masamba 220, kufalitsa makope 10,000.
4. Kalyuzhny, I. T. Hemochromatosis: kuchepa kwa khungu, kutulutsa khungu la chiwindi, matenda a shuga "a mkuwa". Kalyuzhny, L.I. Kalyuzhnaya. - M.: ELBI-SPb, 2018 .-- 543 p.
5. Ntchito ya Korkach V.I. Ntchito ya ACTH ndi glucocorticoids pakukhazikitsa mphamvu kagayidwe, Zdorov'ya - M., 2014. - 152 p.

Ndiloleni ndidziwitse. Dzina langa ndi Elena. Ndakhala ndikugwira ntchito ya endocrinologist kwazaka 10. Ndikukhulupirira kuti pakadali pano ndili katswiri pantchito yanga ndipo ndikufuna kuthandiza alendo onse omwe amapezeka pamalowo kuti athetse zovuta osati ntchito. Zinthu zonse za tsambalo amazisonkhanitsa ndikuzikonza mosamala kuti athe kufotokoza zambiri zofunikira. Musanagwiritse ntchito zomwe zikufotokozedwa pa webusaitiyi, kufunsana ndi akatswiri ndizofunikira nthawi zonse.