Kodi mankhwala a insulin akaperekedwa liti?

Tikukulimbikitsani kuti muzolowere zomwe zalembedwera pamutuwu: "Mukamapaka insulin, mtundu 1 ndi mtundu 2 wofotokozedwera matenda ashuga" ndi ndemanga zochokera kwa akatswiri. Ngati mukufuna kufunsa funso kapena kulemba ndemanga, mutha kuchita izi pansipa, nkhaniyo itatha. Katswiri wathu wamtundu wa endoprinologist adzakuyankhirani.

Kanema (dinani kusewera).

Zotsatira za insulin yothandizira matenda a shuga a mellitus 1 ndi 2

Pambuyo pa endocrinologists amayesa magazi awo, akatswiri nthawi zambiri amawonetsa kuchuluka kwa shuga.

Ndi nthawi iyi pomwe munthu aliyense amakhala ndi funso: choti achite? Tsopano mukuyenera kukumana ndi zovuta zambiri zokhudzana ndi moyo wamba.

Dokotala amayenera kukulemberani mankhwala oyenera kuti muchepetse shuga. Kuphatikiza apo, nthawi yokhudzana ndi kayendetsedwe ka insulin imakhalabe yothandiza.

Amakhulupirira kuti imagwiritsidwa ntchito kusunga shuga pamlingo wamba. Kwenikweni, amawerengedwa kwa anthu omwe ali ndi mtundu woyamba wa matenda ashuga. Nthawi zina, itha kufotokozedwanso mtundu wachiwiri wa matendawa. Ndiye kodi insulin imalembedwa?

Kanema (dinani kusewera).

Anthu omwe ali ndi matenda amtunduwu ali ndi chidwi chofuna kudziwa kuchuluka kwa insulini ya magazi.

Monga lamulo, pankhaniyi, ndikofunikira kuti pakhale mphamvu ya kapamba kuti apange insulin yaumunthu. Ngati wodwala salandira chithandizo choyenera, ndiye kuti akhoza kungofa.

Matenda a shuga a mtundu wodziwika bwino ndiwovuta kwambiri kuposa matenda amtundu wachiwiri. Ngati lipezeka, kuchuluka kwa insulini yomwe imapangidwa sikungathandize kapena kulibe.

Ndiye chifukwa chake thupi la wodwala silitha kuthana ndi kuchuluka kwa shuga palokha. Mulingo wochepa wazinthu ndizowopsa - izi zimatha kubweretsa kukomoka mosayembekezereka ngakhale kufa.

Musaiwale za kuwunikira pafupipafupi za shuga komanso kupima mayeso.

Popeza munthu yemwe ali ndi mtundu woyamba wa matendawa sangakhale ndi moyo popanda kukhala ndi insulin, ndikofunikira kuti atenge vutoli mozama.

Ichi ndichifukwa chake mtundu uwu wa shuga umatchedwa kuti insulin. Tsoka ilo, kupatula mahomoni awa, palibenso njira ina yabwino.

Malangizo akulu oti asungidwe a insulin ndi vuto lalikulu la kapamba.

Popeza ichi ndiye chiwalo chofunikira kwambiri pakayendetsedwe ka ntchito za thupi kudzera m'mahomoni, kuphwanya kulikonse mwadzidzidzi pantchito yake yokhazikitsidwa kungayambitse zotsatira zosasinthika.

Amakhala ndi ma cell a β omwe amachititsa kuti pakhale insulin ya munthu. Koma, zosinthika zokhudzana ndi zaka mu chiwalo chilichonse zimadzipangitsa kumva, chifukwa chake, chaka chilichonse kuchuluka kwa maselo mu wodwala wopatsidwa kumakhala kuchepa. Malinga ndi ziwerengero, pambuyo poti dokotala womaliza adapeza - mtundu wachiwiri wa matenda ashuga, wodwalayo amamuika insulin patadutsa zaka pafupifupi khumi.

Zifukwa zomwe zimakhudza kupezeka kwa olumala pantchito yachitetezo chamkati chomwe chikuganiziridwa:

kugwiritsa ntchito mankhwala ochititsa chidwi omwe ali ndi sulfonylurea yambiri,
shuga ochulukirapo, pafupifupi 9 mmol / l,
chithandizo cha matenda ashuga mwanjira zina zilizonse.

Chizindikiro chazomwe zimapangidwira timadzi ta pancreatic iyi ndi kuyesa kwa magazi komwe kunatengedwa pamimba yopanda kanthu, ndipo zomwe zili ndi glucose, malinga ndi izo, ndizofanana ndi 14 mmol / l kulemera kulikonse.

Nanga pamakhala shuga uti wamagazi omwe amapatsidwa odwala omwe ali ndi matenda a shuga a 2?

Ngati glycemia idasungidwa mobwerezabwereza pamimba yopanda 7 mmol / l chifukwa chogwiritsa ntchito mapiritsi ochepetsa shuga komanso kudya mosamalitsa, ndiye kuti mahomoni opanga ma pancreatic awa ndi omwe amakhala ndi thupi.

Monga mukudziwa, ndi shuga wambiri wa 9 mmol / l, njira zosasintha zomwe zimasokoneza ma pancreatic β zimachokera. Glucose imayamba kuletsa kuthekera kwa thupili kudzipangira payokha mahomoni a dzina lomweli. Izi zosafunikira zimatchedwa kuti glucose toxicity.

Ndizosavuta kuganiza kuti ngati shuga atakhazikika asanadye, azikula kwambiri akangodya.

Ichi ndichifukwa chake zinthu sizimalamulidwa pomwe mahomoni opangidwa ndi kapamba sikokwanira kutsekereza shuga wambiri.

Shuga akamakhala pamlingo wambiri kwa nthawi yayitali, njira ya kufa kwa maselo a ziwalo zamkati zamkati imayamba. Kuchuluka kwa insulini yomwe imapangidwa kumachepera, ndipo shuga wambiri m'thupi amakhalanso osasinthika musanadye komanso pambuyo chakudya.

Ndiye kodi insulin imalembedwa liti kwa matenda ashuga? Thupi limafunikira insulini kuti ipirire shuga ndikupereka mpata wokonzanso maselo akufa. Mlingo wa timadzi timeneti timawerengeredwa potengera mawonekedwe a munthu aliyense ndipo amafunika yekha ndi dokotala.

Kukhazikitsidwa kwakanthawi kwa hormone iyi kumapangitsa kuti zikondazo zibwezeretsenso zonse zomwe zasungidwa za maselo apadera ndikusintha magwiridwe ake. Chifukwa chake, mankhwala atalandira chithandizo ndi insulin yochita kupanga, amayamba kupanga mahomoni akeawo. Mutha kusiya kugwiritsa ntchito mankhwalawa pokhapokha kuwunikira koyenera, komwe kumawonetsa kuchuluka kwa shuga m'magazi. Mutha kuchita izi kuchipatala chilichonse.

Pali mitundu ingapo ya mahomoni. Izi ndizomwe zimathandiza kusankha molondola kuchuluka ndi kuchuluka kwa makonzedwe kwa wodwala yemwe ali ndi matenda ashuga.

M'magawo oyamba a matendawa, majakisoni opitirira awiri a insulin patsiku amalimbikitsidwa.

Pali nthawi zina pomwe odwala amakana kupereka mankhwala omwe ali ndi insulin moyenerera, akukhulupirira molakwika kuti amangolembera gawo lomaliza la matendawa.

Koma madokotala amalimbikitsa kuti asanyalanyaze izi, chifukwa jakisoni adzakuthandizira kubwezeretsa mwachangu ntchito zotayika za chiwalo chofunikira monga kapamba. Mwazi wa shuga utatha kukhala wabwinobwino, insulini imathetsedwa ndipo mankhwala othandizira amaperekedwa kwa wodwala.

Nkhaniyi ikuyankha funso la mtundu wanji wa mankhwala a insulin omwe amalowetsedwa. Amadziwika kuti amalembera mitundu iwiri yamatendawa.

Ndi mtundu wachiwiri, pamakhala mwayi wawukulu womwe ungakhale wabwino ndikuwongolera kapamba.

Musanalembe dongosolo la mankhwala a mankhwalawa, ndikofunikira kugwiritsa ntchito mankhwala a insulin masiku asanu ndi awiri ndikulowetsa m'mawu onse a shuga.

Chifukwa cha zotsatira zomwe zapezeka, adotolo amakulitsa chithandizo cha wodwala payekha. Pambuyo pake, wodwalayo azitha kudzilamulira pawokha magazi ndi kuchuluka kwa mahomoni ofunikira.ads-mob-2

Momwe mungapangire chiwembu chogwiritsira ntchito mahomoni a pancreatic:

choyamba muyenera kuganizira kufunika kwa insulin makamaka usiku,
Ngati kuchulukitsa kwa mankhwala a insulin kuli kofunikira, mlingo woyambirira uyenera kuwerengedwa molondola, womwe mtsogolomo umayenera kusinthidwa,
kufunikira kwa insulin yowonjezera m'mawa kumawerengedwa. Chosasangalatsa kwambiri mu njirayi ndikuti wodwala matenda ashuga ayenera kudumphira chakudya cham'mawa komanso nkhomaliro.
Ngati ndi kotheka, mahomoni owonjezera a pancreatic m'mawa, mlingo woyambirira amawerengedwa, womwe umasintha masabata angapo,
ngati insulini yachangu ikufunika pamimba yopanda kanthu, muyenera kudziwa nokha kuti ndi nthawi yanji komanso mukadya chiyani,
ndikofunikira kuwerengera pasadakhale Mlingo woyambirira wa ultrashort ndi mahomoni ofupika a kapamba pamimba yopanda kanthu musanadye mwachindunji,
ndikofunikira kusintha pafupipafupi kuchuluka kwa mahomoni malinga ndi kuchuluka kwa deta yamasiku am'mbuyomu,
ndikofunikira kuti, mothandizidwa ndi kuyeserera kwina, ndikofunikira kudziwa kuti muthe kudya insulin musanadye nthawi yayitali bwanji.

Nkhaniyi ikuyankha funso la nthawi yomwe insulin imayikidwa pa matenda ashuga. Ngati mutenga matendawa ndi mankhwala a insulin kwambiri, mutha kupewa mavuto monga matenda ashuga komanso imfa.

Novorapid ndi insulin yothandiza yomwe imachepetsa shuga. Zimayambitsa kuwonjezeka kwa mapangidwe a glycogen ndi ndondomeko ya lipogenesis.

Glucobay nthawi zambiri amaperekedwa kwa odwala omwe ali ndi matenda ashuga a 2. Madokotala amalembanso izi pofuna kupewa odwala omwe ali ndi matenda ashuga.

Ndipo kodi Angiovit adasindikizidwa kwa ndani? Mayankho a mafunso awa akhoza kupezeka apa.

Ubwino ndi kuwonongeka kwa mankhwala a insulini a mtundu 2 a shuga:

Monga titha kumvetsetsa kuchokera pazomwe takambirana pamwambapa, kusankhidwa kwa insulin yamtundu wa 2 shuga ndikofunikira kuyika mulingo wa shuga ndikubwezeretsanso ntchito ya pancreatic. Izi zimalola kukhazikitsa ntchito yotsirizira m'nthawi yochepa kupewa mavuto obwera ndi moyo.

Osataya mankhwala a insulini m'magawo oyamba, chifukwa izi zimakupulumutsani ku majekiseni a moyo wa mtsogolo. Njira yodziwika bwino yothandizira, kutsimikiza mwanzeru komanso kutsatira malangizo onse a endocrinologist kungakuthandizeni kuchotsa zovuta zonse zomwe zachitika m'thupi.

Imakhazikika pamisempha ya shuga kwa nthawi yayitali
Imabwezeretsa kapangidwe ka insulin

Mulingo wa shuga (glucose) m'magazi ndi chimodzi mwazomwe zimayimira muyezo wabwinobwino la kayendetsedwe kanu ka thupi.

Mukazindikira mtundu wa matenda a shuga 1 a mellitus (kuchepa kwa insulin), kufunika kwa jakisoni sikukayika. Komabe, pali odwala ena ambiri omwe amapezeka ndi matenda ashuga amtundu wa 2 (mpaka 90% ya onse odwala matenda ashuga), ndipo chithandizo chawo ndichotheka popanda kugwiritsa ntchito insulin.

Dokotalayo atalimbikitsa ngakhale jekeseni kanthawi kochepa kwa odwala chotere, funso limabuka: pamlingo wambiri wa shuga mumakhala insulin yotani?

Glucose wopezeka muzopangidwazo, akaphwanyidwa kukhala ma mamolekyulu m'matumbo, amalowa m'magazi, kuchokera komwe amayenera kudutsa membrane wa cell kuti apatse mphamvu maselo.

Kuti ndondomeko yomaliza isasunthidwe, ndikofunikira:

Madzi okwanira insulin
Kuzindikira kwa insulin receptors (malo olowera mu cell).

Kuti glucose alowe mu cell osasokoneza, insulini iyenera kulumikizana ndi ma receptor ake. Ndi chidziwitso chokwanira, njirayi imapangitsa kuti membala wam'mimba azipezekanso ku glucose.

Ngati mphamvu ya receptor imalephera, insulini singathe kulumikizana nawo, kapena insulini-receptor ligament simalowetsa kufunikira komwe kumafunikira. Zotsatira zake, glucose sangalowe mu cell. Vutoli limafanana ndi matenda ashuga a 2.

Zofunika! Kubwezeretsa chidwi cha insulin receptors, mutha kudya komanso kugwiritsa ntchito mankhwala. M'mikhalidwe ina yomwe dokotala yekha ndi amene angadziwe, chithandizo cha insulin (chosakhalitsa kapena chokhazikika) chikufunika. Zingwe zitha kuwonjezera kuchuluka kwa shuga omwe amalowa m'maselo ngakhale ndi chidwi chocheperako chifukwa cha kuchuluka kwa katundu pa iwo.

Mankhwala a insulin atha kufunsidwa posakhalapo kapena kuchepetsa mphamvu ya mankhwalawa ndimankhwala, zakudya komanso moyo wathanzi. Odwala akatsatira malangizo a dokotala, vuto lotere silimachitika.

Chizindikiro cha mankhwala a insulin chikhoza kukhala phindu la glycemia (chizindikiro cha shuga wamagazi) pamimba yopanda kanthu m'magazi a capillary pamwamba pa 7 mmol / L kapena kupitirira 11.1 mmol / L 2 mawola atatha kudya. Kusankhidwa komaliza, kutengera zomwe wodwala akuwonetsa, zitha kuchitidwa ndi adokotala.

Zotheka pamene jakisoni wa mankhwala amatha kuloza shuga m'magazi angayambitse chifukwa chotsatira:

Kodi shuga ndi insulin yolembedwera chiyani mukakhala ndi pakati

Mimba mwa wodwala yemwe ali ndi matenda a shuga kapena matenda a shuga (kulephera kwa mahomoni komwe kumayambitsa matenda a insulin) angayambitse vuto lomwe limapangitsa kuti pakhale kusintha kwa zakudya komanso moyo wathanzi sizikubweretsa zotsatira zabwino. Mlingo wa shuga umakhalabe wokwera, womwe umawopseza kukula kwa zovuta mwa mwana ndi amayi.

Chizindikiro cha insulin yodwala pakatha kubereka chikuwonjezereka polyhydramnios ndi zizindikiro za fetopathy mwa mwana, zomwe zimawululidwa panthawi ya kuwunika kwa ultrasound, komwe kumachitika munthawi zotsatirazi:

Masabata 15 mpaka 20 - kuthetsa zovuta zazikulu zachitukuko,
Masabata 20-23 - wowunika mtima wa mwana wosabadwa,
Masabata a 28-32 - kuti athe kuzindikira zopatuka zomwe zingatheke malinga ndi kukula kwa intrauterine.

Zizindikiro za hyperglycemia zikawoneka, endocrinologist imapereka kuchuluka kwa shuga kwa mayi wapakati maulendo 8 pa tsiku ndipo zotsatira zake zalembedwa. Kutengera mtundu waumoyo aliyense, thanzi la azimayi oyembekezera limatha kukhala 3,3-6.6 mmol / l.

Panthawi yapakati, insulin pakati pamankhwala ochepetsa shuga ndi mankhwala okhawo ovomerezeka kuti agwiritsidwe ntchito.

Zomwe zimayikidwa pobayira jakisoni wa insulini zitha kukhala zotsatira za shuga:

M'magazi a venous: pamwamba 5.1 mayunitsi (pamimba yopanda kanthu), pamwamba pa mayunitsi 6.7. (Maola 2 mutadya)
M'magazi am'magazi: pamwamba 5.6 mayunitsi. (pamimba yopanda kanthu), pamwamba pa magawo 7.3. (2 maola atatha kudya).

Kuphatikiza pa kuchuluka kwa shuga, komwe kumalimbikitsidwa kuyesedwa kangapo pa 6 mpaka 12 pa sabata, amayi apakati amafunika kuwunika:

Kupsinjika kwa magazi
Kukhalapo kwa acetone mu mkodzo
Mlingo wa zomwe zaperekedwa
Magawo a hypoglycemia.

Mimba ayenera isanafike mankhwala insulin:

M'chipatala, pezani luso lodzisamalira komanso chidziwitso chofunikira chowunikira
Pezani ndalama zodziyang'anira nokha kapena pangani zofunikira mu labotale.

Ntchito yayikulu ya mankhwala a insulin panthawiyi ndi kupewa zovuta. Mosasamala mtundu wa matenda, njira yoyenera yothandizira ndi kuyika insulin yochepa musanadye komanso mankhwala a nthawi yayitali musanayambe kugona (kukhazikitsa glycemia usiku).

Kugawa tsiku ndi tsiku insulin imaganizira kufunika kwa mankhwalawa: usiku - 1/3, nthawi ya masana - 2/3 ya kuchuluka kwa mankhwalawa.

Zofunika! Malinga ndi ziwerengero, pa nthawi ya pakati, mtundu woyamba wa shuga umakhala wofala kwambiri, chifukwa umakula ubwana ndi unyamata. Matenda a Type 2 amakhudza azimayi patatha zaka 30 ndipo ndiosavuta. Pankhaniyi, kuthekera kokukwaniritsa bwino zizindikiro za chakudya, zakudya zopatsa thanzi ndi kuchita zolimbitsa thupi zolimbitsa thupi ndizambiri. Matenda a shuga amisala ndi osowa kwambiri.

Palibe phindu lililonse la shuga m'magazi omwe mankhwalawa amaperekedwa, chifukwa lingaliro limapangidwa pamaziko angapo. Dokotala wokha wa endocrinologist ndi amene angawaganizire.

Kukhazikitsidwa kwa mankhwala a insulin sikulephera kuzindikirika ndi 12 mmol / L pambuyo osagwiritsa ntchito mapiritsi kapena kudya kwambiri. Popanda maphunziro owonjezera (kokha ndi shuga), insulin imalowetsedwa pazinthu zomwe zimawopseza thanzi kapena moyo wa wodwala.

Wodwala akakumana ndi chosankha (jekeseni insulini ndikupitiliza moyo wake kapena kukana ndikudikirira zovuta), aliyense akhoza kusankha pawokha.

Kodi chingachitike ndi chiyani ngati simupaka jakisoni wa shuga?

Matenda a shuga amakhala m'gulu la matenda a endocrine omwe amapezeka pamene kapamba amasiya kutulutsa insulin. Ichi ndi mahomoni ofunikira kuti thupi lonse lizigwira ntchito. Imasinthasintha kagayidwe kazigawo - gawo lomwe limakhudzidwa ndi ntchito ya ubongo ndi ziwalo zina.

Ndi chitukuko cha matenda ashuga, wodwalayo amayenera kumangotenga ma insulin. Chifukwa chake, odwala matenda ashuga ambiri akufunsa ngati angayambe kugwiritsa ntchito insulin. Kuti mumvetsetse nkhaniyi, muyenera kudziwa za matendawa ndikumvetsetsa komwe milandu ya insulin imayikidwa.

Pali mitundu iwiri yayikulu ya matenda a shuga - 1 ndi 2. Mitundu yamatendawa imasiyana. Pali mitundu ina yamatenda, koma ndiyosowa.

Mtundu woyamba wa shuga umadziwika ndi kuperewera kwa proinsulin komanso boma la hyperglycemic. Chithandizo cha matenda amtunduwu matenda a shuga chimaphatikizira mankhwala obwezeretsera m'magawo a insulin.

Ndi matenda amtundu 1, simuyenera kusiya kubaya jakisoni. Kukana kwa izo kumatha kubweretsa kukula kwa chikomokere komanso ngakhale kufa.

Mtundu wachiwiri wa matenda ndiofala. Amapezeka mwa 85-90% ya odwala azaka zopitilira 40 omwe ali onenepa kwambiri.

Ndi matenda amtunduwu, kapamba amatulutsa timadzi tating'onoting'ono, koma sitingathe kupanga shuga, chifukwa maselo amthupi satenga pang'ono kapena kutulutsa insulin kwathunthu.

Pancreas imatha pang'ono ndi pang'ono ndipo imayamba kupanga mahomoni ochepa.

Malangizo pakuyambitsa insulin mu mtundu 2 wa shuga

Malangizo akulu okonzera insulin ndi vuto la kapamba.

Popeza ili ndiye chiwalo chofunikira kwambiri mthupi lanu lonse, kusayendetsedwa bwino pantchito yake kungapangitse zotsatira zoyipa.

Zikondwererozi zimakhala ndi maselo otchedwa β, omwe amachititsa kuti insulin ipangidwe. Komabe, pofika zaka, kuchuluka kwa maselo kumachepa. Malinga ndi ziwerengero zamankhwala, atazindikira - mtundu wachiwiri wa matenda a shuga, wodwalayo amamuika insulin popanda kulephera pambuyo pa zaka 7-8.

Zimayambitsa Kukhudzana ndi Pancreatic Degree

shuga wambiri, woposa 9 mmol / l,
kumwa mankhwala akuluakulu okhala ndi sulfonylurea,
Chithandizo cha matenda ndi njira zina.

Mwazi wamagazi ambiri

Glucose toxity ndikupanga insulin ndi kapamba poyankha shuga m'magazi.

Madokotala amati ngati shuga ali pamimba yopanda kanthu, ndiye kuti mukatha kudya imakulabe kwambiri. Ndipo zinthu zimatheka pomwe insulini yopangidwa ndi kapamba sikokwanira kuti isokoneze shuga yayikulu magazi.

Milandu pomwe shuga yambiri imakhala yokhazikika, njira ya kufa kwa maselo a pancreatic imayamba. Insulin imapangidwa pang'ono komanso yocheperako. Mafuta ochulukirapo amakhala nthawi yayitali asanadye kapena atadya.

Pofuna kuthandiza kapamba kuthana ndi shuga ndikulola maselo kuti achire, wodwala amatha kupatsidwa insulin. Mlingo wa mankhwalawa uyenera kuwerengeredwa mosamalitsa malinga ndi momwe wodwalayo alili ndi shuga.

Kuyendetsa insulin kwakanthawi kumathandizira kubwezeretsa kapamba ndikuyamba kupanga insulin yokwanira. Mutha kuletsa kukhazikitsidwa kwa insulin pamaziko a kuyezetsa magazi pazomwe zili ndi shuga. Kusanthula koteroko kutha kuchitika ku chipatala chilichonse mumzinda.

Mankhwala amakono, pali mitundu ingapo ya insulin. Izi zikuthandizira kusankha mlingo woyenera komanso kuchuluka kwa makonzedwe kwa wodwala, omwe ali ndi matenda amtundu 1 komanso wachiwiri. Pa gawo loyambirira la matendawa, wodwalayo amawonjezeranso majakisoni awiri a insulin patsiku.

Nthawi zambiri odwala amakana mankhwala okhala ndi insulin, akukhulupirira kuti adayikidwa kumapeto kwa matendawa. Koma madokotala amalangiza kuti asasiye kugwiritsa ntchito insulin, chifukwa jakisoni wake amathandizira kubwezeretsanso chimbudzi cha pancreatic. Pambuyo pakuchita kusintha kwa shuga, insulin imathetseka ndipo wodwalayo amapatsidwa mapiritsi omwe amakhala ndi shuga.

Mlingo waukulu wa sulfonylurea

Nthawi zambiri, makonzedwe okhala ndi sulfonylurea amagwiritsidwa ntchito kubwezeretsa ntchito za maselo a pancreatic β. Zimathandizira kupanga insulini ndi kapamba ndipo zimathandizira kukhala ndi shuga. Mankhwalawa akuphatikizapo:

diabetone
glimiperide kapena fanizo lake,
manin.

Mankhwalawa ali ndi zabwino zolimbikitsa ku kapamba. Komabe, milingo yayikulu ya mankhwalawa imatha kubweretsanso vuto.

Popanda kupereka mankhwalawa, kapamba amatha kudzipangira pawokha kwa zaka 10, atapereka mankhwala kwa zaka 8, koma ngati mankhwala akulu kwambiri agwiritsidwa ntchito, kapamba amatha kupanga insulin kwa zaka 5 zokha.

Mankhwala aliwonse kusintha ziphuphu angagwiritsidwe ntchito popanda kupititsa muyeso womwe umalimbikitsa. Kuphatikiza ndi zakudya zoyenera, izi zingathandize kuchepetsa shuga. Njira yayikulu yazakudya iyenera kukhala kugwiritsidwa ntchito kwa chakudya pang'ono, makamaka zopezeka m'maswiti.

Njira zosavomerezeka zochizira matenda ashuga

Nthawi zina odwala okalamba amakhala ndi chiwopsezo chambiri mu shuga. Ngakhale kudya kapena kumwa mankhwala kungachepetse mulingo wake. Poyerekeza ndi kuchuluka kwa shuga, kulemera kwa munthu kumathanso kusintha. Anthu ena akulemera msanga, ndipo ena akuchepetsa thupi.

Ndi zizindikiro za matendawa, adotolo ayenera kuzindikira zomwe zimayambitsa matendawa ndikupereka yankho loyenera. Zikatero, zomwe zimayambitsa kuchuluka kwa shuga zimatha kukhala pancreatitis kapena matenda a autoimmune, omwe amapezeka mwa akulu okha.

Zizindikiro zowonjezera zamkati pachimake zimaphatikizira:

kulimbikira
chizungulire
kupweteka m'mimba.

Poterepa, kuyesa kusintha mulingo wa shuga mothandizidwa ndi mapiritsi sikungathandize. Miyezo ya shuga ipitilira kukwera, ndipo izi zimatha kubweretsa zotsatirapo zomvetsa chisoni, kuphatikizapo imfa.

Mu chilonda chachikulu cha pancreatitis, wodwalayo amapatsidwa mlingo wa insulin. M'pofunika jakisoni insulini ndi matenda moyo. Komabe, iyi ndi gawo lofunikira, apo ayi munthu akhoza kufa ndi kuchuluka kwa shuga mthupi.

Ngati munthu ali ndi matenda a shuga a autoimmune, zimakhala zovuta kwambiri kupereka chithandizo choyenera kuposa mtundu uliwonse wa matenda ashuga, makamaka ngati matendawa achedwa msanga.

Chowonadi ndi chakuti mu thupi la munthu mumakhala ma antibodies kuma β cell a kapamba, insulin ndi ma receptor ake. Zochita zawo cholinga chake ndikupondereza ntchito za maselo a ziwalo; kachipangizidwe kameneka ndi mtundu wa matenda ashuga 1.

Zotsatira za matenda a shuga a autoimmune ndi mtundu 1 wa shuga ndizofanana pomwe ma cell a kapamba omwe amayambitsa kupanga insulin amafa mitundu iwiri iyi yamatenda.

Ngati uwu ndi mtundu 1 wa shuga, kugwira ntchito kwa kapamba kumatha kusokonezeka ngakhale muli mwana, ndipo insulin ikhoza kulembedwa, ndiye kuti matenda a shuga a autoimmune, kuwonongeka kwa maselo a β kumachitika zaka zopitilira 30 mpaka 40. Komabe, zotsatira zake zidzakhala zofanana - wodwalayo adapangidwa jakisoni wa insulin.

Tsopano pakakhala kutsutsana pakati pa madokotala za momwe gawo la matenda liyenera kukhalira insulin. Odwala ambiri amayesa kutsimikizira madokotala kuti safuna insulin ndikuwakakamiza kuti ayambe kulandira mapiritsi. Madokotala ena amalingaliranso kuti chithandizo cha insulin chiyenera kuyamba mochedwa momwe angathere.

Odwala akakhala ndi mantha a insulin, amatha kuwafotokozera. Komabe, kuikidwa kwake pambuyo pake kwa matendawa sikuti nthawi zonse kumakhala kolondola. Kusamalira munthawi yake mankhwalawa kumathandizira kuti shuga akhalenso ndi chizolowezi chake kwakanthawi kochepa ndikusiya kugwiritsa ntchito kwakanthawi.

Wodwala aliyense ayenera kukumbukira kuti dokotala samapereka mankhwala a insulin popanda chifukwa chomveka. Jakisoni wa insulin sasokoneza moyo wathunthu ndikukhala ndi moyo wokangalika. Nthawi zina, wodwala akapatsidwa insulin, wodwalayo amatha kupewa zovuta za matendawo.

Kodi insulin imalembedwa liti ndipo ndiyotheka kuikana?

Mtundu woyamba wa matenda ashuga, chithandizo cha insulin ndizofunikira, chifukwa chake mtundu wamtunduwu umatchedwanso kuti insulin. Mtundu wachiwiri wa matenda, kwanthawi yayitali, simungathe kubaya insulin, koma muthane ndi glycemia potsatira zakudya komanso kumwa othandizira a hypoglycemic. Koma ngati vuto la wodwalayo likuipiraipira ndipo malingaliro azachipatala sanatsatidwe, chithandizo cha insulin ndi njira yotheka.

Komabe, kodi ndizotheka kusiya kubayirira insulin mtsogolomo pomwe vutolo limakhala lolimba? Mwanjira yoyamba ya matenda ashuga, kubaya insulin ndikofunikira. Mosiyana ndi izi, kuchuluka kwa shuga m'magazi kumafika pazovuta, zomwe zimabweretsa zotsatira zoyipa. Chifukwa chake, ndizosatheka kusiya kubaya insulin mu mtundu woyamba wa matenda a shuga.

Koma ndi mtundu wachiwiri wa matenda, kukana insulini ndikotheka, chifukwa nthawi zambiri chithandizo cha insulin chimangoperekedwa kwakanthawi kochepa kuti magazi azikhala ndi magazi.

Milandu yofunikira kakulidwe ka mahoni

pachimake insulin,
stroko kapena myocardial infaration,
glycemia woposa 15 mmol / l kulemera kulikonse,
mimba
kuwonjezeka kwa shuga osala kudya kumaposa 7.8 mmol / l wokhala ndi thupi labwinobwino kapena kuchepetsedwa,
othandizira opaleshoni.

Zikatero, majakisoni a insulini amaperekedwa kwakanthawi mpaka zinthu zobvuta zitathetsedwa. Mwachitsanzo, mayi amasunga glycemia potsatira chakudya chapadera, koma atakhala ndi pakati amayenera kusintha zakudya zomwe amadya. Chifukwa chake, kuti asavulaze mwana ndikumupatsa zinthu zonse zofunika, dokotala amayenera kuchitapo kanthu ndikupereka mankhwala kwa insulin.

Koma chithandizo cha insulin chimawonetsedwa pokhapokha thupi likakhala lopanda mahomoni. Ndipo ngati insulin receptor siyikuyankha, chifukwa chomwe ma cell sazindikira mahomoni, ndiye kuti chithandizo sichikhala ndi tanthauzo.

Chifukwa chake, kugwiritsa ntchito insulin kumatha kuimitsidwa, koma kokha ndi matenda a shuga a 2. Ndipo ndikofunikira chiyani kukana insulini?

Siyani kuyendetsa mahomoni potengera uphungu. Pambuyo pokana, ndikofunikira kutsatira zakudya ndikuyamba kukhala ndi moyo wathanzi.

Chofunikira pakuthandizira matenda a shuga, kukulolani kuti muchepetse glycemia, ndi zochitika zolimbitsa thupi. Masewera samangowongolera mawonekedwe a thanzi komanso thanzi la wodwalayo, komanso amathandizira pakuwonjezera mphamvu kwa glucose.

Kusungitsa kuchuluka kwa glycemia mwachizolowezi, kugwiritsa ntchito njira zowonjezera wowerengeka ndizotheka. Kuti izi zitheke, amagwiritsa ntchito mankhwala osokoneza bongo komanso kumwa zakumwa zoziziritsa kukhosi.

Ndikofunikira kusiya kupatsa insulin pang'onopang'ono, ndikuchepetsa mosalekeza.

Wodwala akakana mwadzidzidzi ndiye kuti adzalumpha mwamphamvu kuchuluka kwa shuga m'magazi.

Pakati pa odwala matenda ashuga, malingaliro ambiri abwera okhudza insulin. Chifukwa chake, odwala ena amaganiza kuti mahomoniwo amathandizira kulemera, pomwe ena amakhulupirira kuti kuyambitsa kwake kumakupatsani mwayi woti musamatirire zakudya. Ndipo zinthu zilidi bwanji?

Kodi jakisoni wa insulin angachiritse matenda ashuga? Matendawa ndi osachiritsika, ndipo chithandizo chamankhwala chimangokulolani kuwongolera matendawa.

Kodi chithandizo cha insulin chimachepetsa moyo wa wodwalayo? Mukatha kusintha kanthawi kochepa ndikukazolowera ndondomeko ya jakisoni, mutha kuchita zinthu za tsiku ndi tsiku. Kuphatikiza apo, masiku ano pali mapensulo apadera a syringe ndi mapampu a insul Combo Culin a insulin omwe amathandizira kwambiri pakupanga mankhwala.

Anthu ambiri odwala matenda ashuga amakhudzidwa ndi kupweteka kwa jakisoni. Jakisoni wodziwikiratu amadzetsa zovuta, koma ngati mugwiritsa ntchito zida zatsopano, mwachitsanzo, zolembera za syringe, ndiye kuti sipadzakhala zosasangalatsa.

Zabodza zokhudzana ndi kunenepa kwambiri sizinso zowona. Insulin imatha kukulitsa chidwi cha chakudya, koma kunenepa kwambiri kumayambitsa kusowa kwa zakudya m'thupi. Kutsatira zakudya zomwe zimaphatikizidwa ndi masewera kumathandizira kuti muchepetse kunenepa.

Kodi chithandizo cha mahomoni chimawonjezera? Aliyense amene amatenga mahomoni kwa zaka zambiri amadziwa kuti kudalira insulin sikuwonekera, chifukwa ndi chilengedwe.

Pali malingaliro oti pambuyo poti ntchito ya insulini iyambike, mudzafunika kupaka jakisoni pafupipafupi. Ndi matenda a shuga 1 amtundu wa insulin, mankhwala a insulin amayenera kukhala mwadongosolo komanso mosalekeza, chifukwa kapamba sangathe kutulutsa timadzi tambiri. Koma mu mtundu wachiwiri wa matenda, chiwalo chija chimatha kutulutsa timadzi timatenda, komabe, mwa odwala ena, maselo a beta amataya mphamvu yake ndikubisala pakadutsa matenda. Komabe, ngati nkotheka kukwaniritsa kukhazikika kwa msambo wa glycemia, ndiye kuti odwala amapatsidwa mankhwala otsitsa shuga a pakamwa.

Zikhulupiriro zina zokhudzana ndi mankhwala a insulin:

Pofotokoza insulin akuti munthuyu sanathe kupirira mayendedwe a shuga. Izi sizowona, chifukwa wodwala wokhala ndi mtundu woyamba 1 wodwalayo alibe mwayi wosankha, ndipo amakakamizidwa kuti ajambule mankhwalawa kwa moyo wonse, ndipo vuto la mtundu wachiwiri, mahomoni amaperekedwa kuti azilamulira shuga.
Insulin imawonjezera chiopsezo cha hypoglycemia. Nthawi zina, jakisoni amatha kukulitsa mwayi wochepetsa shuga, koma masiku ano pali mankhwala omwe amaletsa kuyambika kwa hypoglycemia.
Ziribe kanthu komwe malo oyang'anira mahomoni ali. M'malo mwake, kuchuluka kwa mayiyo kumatengera malo omwe jakisoni idzapangidwire. Kuthiridwa kwamphamvu kwambiri kumachitika pamene mankhwalawo alowetsedwa m'mimba, ndipo ngati jakisoni wachitika m'timabowo kapena ntchafu, mankhwalawo amakwiriridwa pang'onopang'ono.

Ndi munjira ziti momwe insulin imayidwira ndikuchotseredwa ndi katswiri muvidiyoyi.

Mtundu wachiwiri wa matenda ashuga ndi insulin, mukafuna kusinthira ku insulin, mitundu ya mankhwala a insulini a mtundu 2 wa shuga

M'zaka zaposachedwa, lingaliro la matenda ashuga ndi matenda amodzi payekha, momwe njira zochiritsira komanso zolipirira ziyenera kuganizira zaka za wodwalayo, chakudya chake ndi ntchito, matenda okhudzana, ndi zina zambiri. Ndipo popeza kulibe anthu ofanana, sipangakhale malingaliro ofananiratu othandizira odwala matenda ashuga.

Wofunsidwa wa Sayansi Yamankhwala

endocrinologist wapamwamba kwambiri

Ndi mtundu 1 wa shuga, ndizodziwikiratu kapena pang'ono: chithandizo cha insulini ndichofunikira kuyambira pachiyambi cha matenda, ndipo malingaliro ndi Mlingo amasankhidwa payekhapayekha. Koma ndi matenda ashuga amtundu wa 2, pamakhala njira zambiri zochiritsira, kungoyambira pongotsatira zakudya ndikumaliza ndikusintha kwathunthu ku insulin ndi kapena osamwa mapiritsi, ndipo pakadali pano pali njira zambiri zochiritsira pamodzi. Ndinganene kuti chithandizo cha matenda ashuga a mtundu 2 ndi gawo lenileni la adokotala ndi odwala, pomwe mungagwiritse ntchito kudziwa kwanu konse komanso chidziwitso chanu.Koma mwamwambo, ambiri mwa mafunso ndi mavuto amatuluka pakafunika kusamutsa wodwala kupita ku insulin.

Zaka zingapo zapitazo, m'nkhani yanga, ndimakhala mwatsatanetsatane pazovuta zamaganizo zomwe zimakhudzana ndi chiyambi cha matenda a insulin. Tsopano ndikungobwereza kuti malingaliro olondola a dokotala amafunikira pano, pamene chithandizo cha insulini sichimaperekedwa ngati "chilango" chifukwa chakhalidwe loipa, kudya zakudya zoperewera, ndi zina zambiri, koma ngati gawo lofunikira la chithandizo. Ndikamawafotokozera odwala anga omwe ali ndi matenda a shuga 2 omwe ali ndi nthendayi, ndimanenanso kuti chithandizo chamankhwala chachiwiri chimayenera kusintha - chakudya choyamba, kenako mapiritsi, kenako insulin. Kenako wodwalayo amakhala ndi malingaliro olondola komanso kumvetsetsa kasamalidwe ka matenda a shuga ndipo ngati kuli koyenera, zimakhala zosavuta m'maganizo kuti amwe mankhwala a insulin. Chithandizo cha mabanja ndi okondedwa ndichofunikanso pankhaniyi, popeza pali malingaliro atsankho pakati pa anthu okhudzana ndi matenda a shuga. Wodwalayo amatha kumva mawu a anthu ena: "Adzakupangitsani ndi singano. Mudzaphatikizidwa ndi jakisoni, "etc. Chifukwa chake, posamutsa insulin, dokotalayo samadandaula kuti alankhule ndi abale a wodwalayo, afotokozereni kufunika kwa gawo latsopano la chithandizo, funani thandizo lawo, makamaka ngati wodwalayo ndi wokalamba kale ndipo akufunika thandizo ndi insulin.

Chifukwa chake, tiyeni tiwone ngati mankhwala a insulin amafunikira mtundu 2 wa shuga, komanso zomwe zimachitika. Mitundu ya mankhwala a insulin a matenda a shuga 2:

Kumayambiriro kwa zamankhwala

* kuyambira panthawiyi kuti adziwe

* matendawa akamakula, pakatha zaka 5 mpaka 10 kuchokera pamene matenda adayamba

Ndi mtundu wa mankhwala

* kuphatikiza (mapiritsi + a insulin) - akhoza kuphatikizira jakisoni imodzi mpaka zingapo za insulin patsiku,

* kutanthauzira kwathunthu kokha pa insulin

Chithandizo cha insulin chakanthawi kochepa chimaperekedwa kwa odwala omwe ali ndi matenda a shuga a 2 omwe ali ndi vuto lalikulu la concomitant (kwambiri chibayo, kulowetsedwa kwa myocardial, ndi zina zotere), mukamayang'anitsitsa shuga wa magazi pamafunika kuchira msanga. Kapena muzochitika zomwe wodwalayo sangathe kumwa mapiritsi (matenda amkatikati mwa m'mimba, kumapeto kwa operekera opaleshoni, makamaka pamimba, ndi zina zambiri).

Matenda akulu amawonjezera kufunika kwa insulin m'thupi la munthu aliyense. Mwina munamvapo za hyperglycemia wopanikizika pamene magazi a magazi amatuluka mwa munthu wopanda matenda a shuga panthawi ya chimfine kapena matenda ena omwe amapezeka ndi kutentha kwambiri komanso / kapena kuledzera.

Madokotala amalankhula za nkhawa ya hyperglycemia yokhala ndi kuchuluka kwa shuga m'magazi okwanira 7.8 mmol / L mwa odwala omwe ali kuchipatala chifukwa cha matenda osiyanasiyana. Malinga ndi kafukufuku, 31% ya odwala omwe ali m'mawodi othandizira komanso kuchokera 44 mpaka 80% ya odwala omwe ali m'mawodi a postoperative ndi malo osamalidwa kwambiri amakhala atakweza shuga m'magazi, pomwe 80% ya iwo omwe kale alibe matenda a shuga. Odwala oterowo amatha kuyamba kupatsa insulini kudzera m'mitsempha kapena pang'onopang'ono mpaka mawonekedwe atalipidwa. Nthawi yomweyo, madokotala samazindikira msanga matenda a shuga, koma amayang'anira wodwalayo.

Ngati ali ndi hemoglobin yapamwamba kwambiri (HbA1c pamwambapa 6.5%), yomwe imawonetsa kuchuluka kwa glucose m'miyezi itatu yapitayi, ndipo glucose wamagazi samatulutsa nthawi yomweyo akamachira, ndiye kuti akupezeka ndi matenda a shuga komanso amamuthandizira mankhwala ena. Pankhaniyi, ngati ali ndi matenda a shuga a 2, mapiritsi ochepetsa shuga atha kutumizidwa kapena insulin ikhoza kupitilizidwa - zonse zimatengera matenda omwe amakhalapo. Koma izi sizitanthauza kuti opaleshoni kapena zochita za madotolo zidayambitsa matenda ashuga, monga momwe odwala athu amafotokozera nthawi zambiri ("adanenanso shuga ...", ndi zina). Zimangowonetsa komwe kukonzekera kuli. Koma tidzakambirana za izi pambuyo pake.

Chifukwa chake, ngati munthu yemwe ali ndi matenda a shuga a 2 atenga matenda oopsa, malo ake osungirako insulin sangakhale okwanira kuti akwaniritse kufunika kotsutsana ndi kupsinjika, ndipo asamutsira insulin mankhwala, ngakhale atakhala kuti sanafunenso insulin kale. Nthawi zambiri, akachira, wodwalayo amayambanso kumwa mapiritsi. Mwachitsanzo, ngati adachitidwa opareshoni pamimba yake, ndiye kuti adzalangizidwa kuti apitirize kupaka insulini, ngakhale ngati chitetezo chake cha insulin chitasungidwa. Mlingo wa mankhwalawa udzakhala wocheperako.

Kumbukirani kuti mtundu wa 2 shuga ndi matenda opita patsogolo, pomwe mphamvu ya ma cell a pancreatic beta imayamba kuchepa. Chifukwa chake, mlingo wa mankhwalawa umasinthasintha, nthawi zambiri umapitilira, mpaka pang'onopang'ono umafikira pamlingo wambiri pomwe zotsatira zoyipa za mapiritsi zimayamba kupambana pazotsatira zawo zabwino (zochepetsa shuga). Kenako ndikofunikira kusinthira ku chithandizo cha insulin, ndipo chidzakhala chokhazikika, mlingo ndi mawonekedwe a insulin okha ndi omwe angasinthe. Inde, pali odwala otere omwe kwa nthawi yayitali, kwa zaka, amatha kukhala pachakudya kapena chochepa cha mankhwala ndikulipirira. Izi zitha kuchitika, ngati matenda a shuga a mtundu 2 adapezeka koyambirira ndipo ntchito ya beta-cell idasungika bwino, ngati wodwalayo atha kuchepetsa thupi, amawunika zakudya zake ndikumayenda kwambiri, zomwe zimathandiza kukonza kapamba - mwa kuyankhula kwina, ngati insulin yanu sinawonongeke ndiyosiyana zakudya zovulaza.

Kapena mwina wodwalayo analibe matenda ashuga, koma panali prediabetes kapena hyperglycemia (onani pamwambapa) ndipo madotolo adathamangira kuchipatala. Ndipo popeza matenda ashuga enieni sawachiritsa, nkovuta kuchotsa kuzindikira komwe kale kudali kale. Mwa munthu wotere, shuga wa magazi amatha kutuluka kangapo pachaka motsutsana ndi kupsinjika kapena matenda, ndipo nthawi zina shuga amakhala wabwinobwino. Komanso, mankhwalawa amachepetsa shuga kwa odwala okalamba omwe amayamba kudya pang'ono, amachepetsa thupi, monga ena amanenera, "kuwuma", kufunikira kwawo kwa insulin kumachepa ndipo ngakhale chithandizo cha matenda ashuga sichitha. Koma pazambiri zambiri, mlingo wa mankhwalawa nthawi zambiri umakulira.

Monga momwe ndawonera kale, mankhwala a insulin a 2 mtundu wa shuga nthawi zambiri amadziwika pambuyo pa zaka 5 mpaka 10 kuchokera nthawi yopezeka ndi matenda. Dokotala wodziwa bwino, akaona wodwala atafufuza “mwatsopano,” amatha kudziwa moyenera nthawi yomwe angafune chithandizo cha insulin. Zimatengera gawo lomwe matenda a shuga adapezeka. Ngati glucose wamagazi ndi HbA1c panthawi yofufuza sakhala wambiri (glucose mpaka 8-10 mmol / L, HbA1c mpaka 7-7,5%), izi zikutanthauza kuti insulin yosungidwa idapulumutsidwa ndipo wodwala amatha kumwa mapiritsi kwa nthawi yayitali. Ndipo ngati shuga m'magazi ndi apamwamba kuposa 10 mmol / l, pamapezeka mkodzo, ndiye kuti pazaka 5 zotsatira wodwalayo angafunikire insulini. Ndikofunika kudziwa kuti insulini ilibe zotsatira zoyipa pakugwira ntchito kwa ziwalo zamkati. "Mbali yake" yokhayo ndi hypoglycemia (kuchepa kwa shuga m'magazi), omwe amapezeka ngati mlingo wambiri wa insulin waperekedwa kapena ngati sanadye bwino. Odwala ophunzitsidwa bwino, hypoglycemia ndiyosowa kwambiri.!

Zimachitika kuti wodwala yemwe ali ndi matenda a shuga a 2, ngakhale opanda matenda ena, amawayikira insulin mokwanira, monga mtundu woyamba. Tsoka ilo, izi sizosowa. Izi ndichifukwa choti mtundu wachiwiri wa matenda ashuga umayamba pang'onopang'ono, munthu amatha kuwona pakamwa lowuma, kukodza pafupipafupi kwa zaka zingapo, koma osafunsa dokotala pazifukwa zosiyanasiyana. Zosungidwa zomwe munthu amapanga zimatulutsa insulin yake, ndiye kuti amatha kupita kuchipatala pomwe magazi a shuga apitilira 20 mmol / l, acetone wapezeka mkodzo (chizindikiro cha kukhalapo kwa vuto lalikulu - ketoacidosis). Ndiye kuti, chilichonse chimapita molingana ndi mtundu wa matenda ashuga amtundu woyamba ndipo ndikovuta kuti madokotala azindikire kuti ndi mtundu wanji wa matenda a shuga. Panthawi imeneyi, mayeso ena owonjezera (ma antibodies to cell a beta) ndi mbiri yakale yotenga thandizo. Ndipo pomwepo zimapezeka kuti wodwalayo amayamba kunenepa kwambiri kwanthawi yayitali, pafupifupi zaka 5-7 zapitazo adawuzidwa kachipatala koyamba kuti shuga ya magazi imachulukitsidwa pang'ono (kuyambika kwa matenda ashuga). Koma sanazindikire kufunika kulikonse kwa izi, sanakhale moyo wolimba kwambiri ngati kale.

Miyezi ingapo yapitayo zidafika poipa: kufooka kosalekeza, kunenepa kwambiri, etc. Iyi ndi nkhani yeniyeni. Pazonse, ngati wodwala wathunthu wa mtundu wachiwiri wa shuga ayamba kuchepa thupi popanda chifukwa chomveka (osatsatira kadyedwe), ichi ndi chizindikiro cha kuchepa kwa ntchito ya pancreatic. Tonsefe timadziwa kuchokera pazomwe takumana nazo kuti zimavuta kuti muchepetse thupi m'magawo oyamba a matenda ashuga, pomwe malo a beta-cell amasungidwa. Koma ngati munthu wodwala matenda a shuga a 2 akuchepetsa, ndipo shuga akumakulabe, ndiye kuti ndi nthawi yokwanira insulin! Ngati wodwala wodwala matenda a shuga a mtundu wachiwiri wakhazikitsidwa mwachangu insulin, ndiye kuti mwina angathe kuimitsidwa mtsogolomo, ngati ena osungidwa m'thupi atadzisunga mu insulin. Kumbukirani kuti insulin si mankhwala, sichidakwa.

Maksimova Nadezhda Diabetesic foot syndrome, LAP Lambert Academic Publishing - M., 2012. - 208 p.
Gurvich Mikhail Matenda a shuga a mellitus. Zakudya zamatenda, Eksmo -, 2012. - 384 c.
Nkhani zamakono za endocrinology. Nkhani 1, State Publishing House of Medical Literature - M., 2011. - 284 c.

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.

Pa mulingo wambiri wa shuga mumakhala insulin

Kwa zaka zambiri osalimbana ndi ma DIABETES?

Mutu wa Bungwe: “Mudzadabwitsidwa kuti kumakhala kovuta motani kuchiritsa matenda a shuga tsiku lililonse.

Mulingo wa shuga (glucose) m'magazi ndi chimodzi mwazomwe zimayimira muyezo wabwinobwino la kayendetsedwe kanu ka thupi.

Dokotalayo atalimbikitsa ngakhale jekeseni kanthawi kochepa kwa odwala chotere, funso limabuka: pamlingo wambiri wa shuga mumakhala insulin yotani?

Matenda a shuga ndi insulin

Glucose wopezeka muzopangidwazo, akaphwanyidwa kukhala ma mamolekyulu m'matumbo, amalowa m'magazi, kuchokera komwe amayenera kudutsa membrane wa cell kuti apatse mphamvu maselo.

Kuti ndondomeko yomaliza isasunthidwe, ndikofunikira:

Madzi okwanira insulin
Kuzindikira kwa insulin receptors (malo olowera mu cell).

Kuti glucose alowe mu cell osasokoneza, insulini iyenera kulumikizana ndi ma receptor ake. Ndi chidziwitso chokwanira, njirayi imapangitsa kuti membala wam'mimba azipezekanso ku glucose.

Ngati mphamvu ya receptor imalephera, insulini singathe kulumikizana nawo, kapena insulini-receptor ligament simalowetsa kufunikira komwe kumafunikira. Zotsatira zake, glucose sangalowe mu cell. Vutoli limafanana ndi matenda ashuga a 2.

Zofunika! Kubwezeretsa chidwi cha insulin receptors, mutha kudya komanso kugwiritsa ntchito mankhwala. M'mikhalidwe ina yomwe dokotala yekha ndi amene angadziwe, chithandizo cha insulin (chosakhalitsa kapena chokhazikika) chikufunika. Zingwe zitha kuwonjezera kuchuluka kwa shuga omwe amalowa m'maselo ngakhale ndi chidwi chocheperako chifukwa cha kuchuluka kwa katundu pa iwo.

Zomwe zikuwonetsa shuga za insulin

Zotheka pamene jakisoni wa mankhwala amatha kuloza shuga m'magazi angayambitse chifukwa chotsatira:

Kubwezera kwakutali. Kuchuluka kwa shuga m'magazi kwa odwala ambiri kumatha kuonekera osayang'aniridwa, popeza zizindikiro zimatengedwa ngati chizindikiro cha matenda ena,
Kuchulukitsa kwapanikizika, kuchepa kowoneka bwino, kupweteka kwa mutu, kuchuluka kwa mitsempha yamagazi. Pankhaniyi, dokotala atha kukulemberani maphunziro a insulin panthawi yovuta kwambiri - mpaka magazi atachepa,
Matenda a shuga a LADA. Matenda a autoimmune ndi mtundu woyamba wa matenda ashuga, omwe amapezeka wofatsa. Chifukwa chofanana ndi zizindikiro, imatha kupezeka kuti ndi matenda a shuga 2 ndikuthandizidwa ndimankhwala omwe amafunsidwira, ngakhale imafunikira chithandizo chapadera. Zotsatira zake, kusintha kwa insulin kumachitika msanga - patatha zaka 3-4,
Kutopa kwamatenda. Izi zimatengedwa ngati zokhudzana ndi zaka, chifukwa zimawonedwa kwambiri mwa odwala pambuyo pa zaka 45. Chifukwa cha kuchuluka kwa shuga (oposa 9 mmol / l), ma cell a pancreatic beta omwe amachititsa insulin synthesis amachepetsa ntchito zawo (zomwe zimatchedwa kuti glucose toxity zimachitika). Kukhazikitsidwa kwa mankhwala a insulini kumachepetsa shuga komanso kumasula kapamba kwakanthawi. Zizindikiro za kawopsedwe wa glucose amatsitsimuka, ndipo chithandizo chowonjezereka chimachitika popanda insulin,
Misozi yambiri. Pa gawo lokhazikika kwa mtima wamatenda (kuwonongeka kwa impso, mantha amthupi, ziwonetsero zazikulu, ziwiya zazikulu), mankhwala a insulini amatha kuletsa kupitilira kwawo kapena kupewa kuwoneka kwa pafupifupi 50-60%,
Zovuta pachimake mu matenda akulu. Pakutentha thupi, ngati kuli kotheka, opaleshoni, zoopsa kapena zam'mitsempha yamavuto (stroke, vuto la mtima), chithandizo cha insulin chakanthawi chimakupatsani mwayi wokhala ndi shuga m'magazi ndipo potero thupi limatha kuthana ndi vuto lalikulu.

Kodi mukufunikira shuga yanji?

Palibe phindu lililonse la shuga m'magazi omwe mankhwalawa amaperekedwa, chifukwa lingaliro limapangidwa pamaziko angapo. Dokotala wokha wa endocrinologist ndi amene angawaganizire.

Wodwala akakumana ndi chosankha (jekeseni insulini ndikupitiliza moyo wake kapena kukana ndikudikirira zovuta), aliyense akhoza kusankha pawokha.

Kugwiritsa Ntchito Insulin mu Matenda Awiri

Kupezeka kwa matenda osokoneza bongo a shuga chifukwa cha kulumikizana kosayenera kwa insulin ndi minofu ikakwanira imafotokozedwa ngati mtundu wachiwiri. Nthawi zambiri, matendawa amawonekera ali ndi zaka zapakati, nthawi zambiri atatha zaka 40. Poyamba, wodwalayo amawonjezera kapena kuchepetsa thupi. Munthawi imeneyi, thupi limayamba kumva kuperewera kwa insulin, koma zizindikiro zonse za matenda ashuga sizimawoneka.

Kufufuza kumawonetsa kuti maselo omwe amapanga insulini alipo ambiri, koma pang'onopang'ono amatha. Kuti mupeze chithandizo choyenera, muyenera kubaya insulin mu shuga, koma choyamba mumawerengera kuchuluka kwa jakisoni wa insulin ndi mavoliyumu ake.

Insulin ya matenda a shuga a 2 amasonyezedwa pamikhalidwe yotere:

glycemia wosadziwika akamamwa mankhwala ochepetsa shuga,
kukula kwa zovuta pachimake (ketoacidosis, thoroma, chikomokere),
zovuta zovuta (gangrene),
kuchuluka kwa shuga mwa anthu omwe apezeka ndi matenda ashuga okha,
kusalolera kwa mankhwala kuti muchepetse shuga,
kubwezera
shuga mu amayi apakati ndi oyamwitsa,
nthawi ya opaleshoni.

Chifukwa chiyani jekeseni mahomoni okhala ndi matenda ashuga a 2

Insulin ya matenda a shuga a mtundu 2 imagwiritsidwa ntchito ngati odwala akuyamba kudalira insulini ndipo mahomoni awoawo sakwanira. Mutha kutsatira kadyedwe, masewera olimbitsa thupi, koma popanda jakisoni, shuga yanuyo imakhalabe yokwera. Mavuto amatha kuchitika ndipo matenda ena aliwonse amatha kudwala. Kuwerenga kuchuluka kwa insulin kuyenera kuchitika ndi endocrinologist.

Koma ndikofunikira kuti dokotala aphunzitse odwala matenda ashuga momwe angawerengere mlingo wake molondola komanso kusinthira kwa insulin mopweteka. Kuti tinene insulini yabwino, mutha kugwiritsa ntchito njira yosankhira. Kupatula apo, mtundu wokhawo womwe ungakhale wokwanira kwa wina, ndipo kwa wina kuphatikiza kwa zochulukira ndi zazifupi.

Njira zotsatirazi zilipo, kupezeka kwake komwe kumafunikira kuti wodwala yemwe ali ndi matenda a shuga a mtundu wachiwiri akhale ndi insulin:

ngati matenda a shuga akukayikiridwa, kuchuluka kwa shuga kwa munthu ndi kupitirira 15 mmol / l,
glycated hemoglobin imakwera kuposa 7%,
Mlingo wokwanira wa mankhwala omwe amachepetsa shuga sangathe kusunga glycemia pansi pa 8 mmol / l, ndipo mutatha kudya pansipa 10 mmol / l,
Plasma C-peptide sapitilira 0,2 nmol / L pambuyo poyeserera kwa glucagon.

Nthawi yomweyo, ndikofunikira kuwunika pafupipafupi komanso pafupipafupi kuchuluka kwa shuga m'magazi komanso kuwerengera zamagulu azakudya.

Kodi ndingathe kubwerera kumapiritsi

Chomwe chitukuko cha matenda ashuga amtundu 2 chimachitika ndikusamva bwino kwa maselo a thupi kulowa insulin. Mwa anthu ambiri omwe ali ndi vutoli, timadzi timabadwa timatulutsidwa. Ngati apezeka kuti shuga akwera pang'ono mukatha kudya, mutha kuyesa kulowetsa insulin ndi mapiritsi. Kwa izi, "Metformin" ndiyabwino. Mankhwalawa amatha kubwezeretsa maselo, ndipo amatha kudziwa insulin yomwe thupi limatulutsa.

Odwala ambiri amagwiritsa ntchito njira imeneyi poperekera jakisoni tsiku lililonse. Koma kusinthaku ndikotheka pokhapokha ngati gawo lokwanira la maselo a beta lisungidwe lomwe lingakhalebe ndi glycemia mokwanira motsutsana ndi maziko a mankhwala ochepetsa shuga, omwe amachitika ndikulandila insulin kwakanthawi kochepa pokonzekera opareshoni, panthawi yapakati. Zingachitike kuti mukamamwa mapiritsiwo shuga msanga umakulabe, ndiye kuti jakisoni sangachite.

Ndondomeko yolandirira

Mukamasankha insulin yokhala ndi matenda a shuga, ndikofunikira kuganizira momwe zakudya zimayendera komanso zinthu zomwe thupi limachita. Ngati zakudya zama carb otsika komanso zolemetsa zopepuka zimatsimikizika, muyenera kumayang'anira pawekha kuchuluka kwa shuga sabata, zomwe zimachitika bwino ndi glucometer ndikusunga diary. Njira yabwino ndiyo kusintha kwa mankhwala a insulin kuchipatala.

Malamulo a insulin makonzedwe aperekedwa pansipa.

Ndikofunikira kudziwa ngati mungabayire mahomoni usiku, omwe angamvetsetsedwe poyesa kuchuluka kwa shuga usiku, mwachitsanzo, nthawi ya 2-4 a.m. Kuchuluka kwa insulin yomwe yatengedwa imatha kusintha nthawi yamankhwala.
Dziwani jakisoni m'mawa. Pankhaniyi, muyenera kupanga jakisoni pamimba yopanda kanthu. Odwala ena amagwiritsa ntchito mankhwala okwanira, omwe amaperekedwa pa 24-25 magawo / tsiku kamodzi m'mawa.
Muyenera kudziwa momwe mungapatsire jakisoni musanadye. Pachifukwa ichi, wogwiritsa ntchito mwachidule amagwiritsidwa ntchito. Kuchuluka kwake kumawerengeredwa potengera kuti 1U imakhudza 8 g yamafuta, 57 g ya mapuloteni imafunanso gawo limodzi la mahomoni.
Mlingo wa ultrashort insulin uyenera kugwiritsidwa ntchito mwadzidzidzi.
Odwala onenepa kwambiri, kuchuluka kwa mankhwala omwe amathandizidwa nthawi zambiri kumawonjezereka poyerekeza ndi kuchuluka kwa anthu omwe ali ndi kunenepa kwenikweni.
Therapy ya insulin ikhoza kuphatikizidwa ndi mankhwala ochepetsa shuga, omwe amayenera kutsimikiziridwa ndi dokotala okha.
Pimani kuchuluka kwa shuga m'magazi ndikuwona kuti nthawi yayitali bwanji musanadye, muyenera kubaya insulin.

Onetsetsani kuti wodwalayo akuyenera kumvetsetsa kuti kudya zakudya zamafuta kumalipidwa ndi kuperekedwa kwa insulin. Ngati munthu agwiritsa ntchito kuphatikiza mapiritsi ochepetsa shuga ndi insulin, ndiye kuti mahomoni samangolowa mthupi, komanso minofu yake imatenga shuga wokwanira.

Mitundu ya mankhwala

Pakadali pano, ma insulini amasiyanitsidwa ndi nthawi yowonekera kwawo. Izi zikutanthauza kuti mankhwalawa amatha kutsika magazi. Musanalembe mankhwala, munthu akasankhidwa kuti atenge mlingo wa mankhwalawo.

Kuchita mofulumira kwambiri kotchedwa ultrashort, komwe amayamba kukwaniritsa ntchito yawo mphindi 15 zoyambirira.
Pali tanthauzo la "lalifupi", kutanthauza kuti zomwe sizikuchitika mwachangu. Iyenera kuwerengedwa musanadye. Pambuyo pa mphindi 30, mphamvu zawo zimawonekera, nsonga imafika mkati mwa maola 1-3, koma pambuyo pa maola 5-8 zotsatira zawo zimatha.
Pali lingaliro la "pafupifupi" - kusintha kwawo kuli pafupifupi maola 12.
Ma insulin omwe amakhala nthawi yayitali masana amaperekedwa nthawi 1. Izi zimapangitsa kuti gawo loyambira lizibisalira.

Pakadali pano, insulini imapangidwa, yomwe imapangidwa pamtundu wa engineering genetic. Sichimayambitsa ziwengo, zomwe zimakhala zabwino kwambiri kwa anthu. Kuwerengera kwa mlingo ndi magawo pakati pa jakisoni kuyenera kutsimikizidwa ndi katswiri. Izi zitha kuchitika kuchipatala kapena kunja kwa nthawi, kutengera thanzi la wodwalayo.

Kunyumba, kutha kuwongolera kuchuluka kwa shuga m'magazi ndikofunikira. Kusintha kwa mankhwalawa mtundu wa matenda ashuga a 2 ndikofunikira mothandizidwa ndi dokotala, ndipo ndikwabwino kuchita izi kuchipatala. Pang'onopang'ono, wodwalayo mwiniyo amatha kuwerengera mlingo wa mankhwalawo komanso kusintha kwake.

Malangizo

Pochizira mafupa, owerenga athu adagwiritsa ntchito DiabeNot bwino. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Mothandizidwa ndi mtundu uwu wa mankhwalawa, zimamveka kuti mitundu yonse ya mankhwala imawerengeredwa kale, kuchuluka kwa zakudya patsiku kumakhala kosasinthika, ngakhale mndandanda wazakudya ndi kukula kwake zimayikidwa ndi wazakudya. Imeneyi ndi njira yokhwima kwambiri ndipo imagawidwa kwa anthu omwe, pazifukwa zina, sangathe kuwongolera shuga wawo wamagazi kapena kuwerengera kuchuluka kwa insulin potengera kuchuluka kwa chakudya mu chakudya chawo.

Choipa cha njirayi ndikuti sizitengera mawonekedwe a thupi la wodwalayo, kupsinjika kothekera, kuphwanya zakudya, kuwonjezera zolimbitsa thupi. Nthawi zambiri, amalamula odwala okalamba. Mutha kuwerenga zambiri za iye m'nkhaniyi.

Kwambiri insulin mankhwala

Njirayi imakhala yachilengedwe, imaganizira za thanzi ndi katundu wa munthu aliyense, koma ndikofunikira kuti wodwalayo azigwiritsa ntchito moyenera maudindo ake mosamala. Thanzi lake komanso thanzi lake zimadalira izi. Chithandizo chachikulu cha insulin chitha kuphunziridwa mwatsatanetsatane ku ulalo womwe unaperekedwa kale.

Palibe jakisoni chithandizo

Anthu ambiri odwala matenda ashuga satembenuka jakisoni chifukwa ndiye kuti simungathe kuwachotsa. Koma chithandizo chotere sichothandiza nthawi zonse ndipo chimayambitsa zovuta zazikulu. Zilonda zimakupatsani mwayi wokwanira wa mahomoni pamene mapiritsi sangathenso kupirira. Ndi matenda a shuga a 2, pali kuthekera kwakuti kusinthira mapiritsi ndikotheka. Izi zimachitika pokhapokha jakisoni akaperekedwa kwa nthawi yochepa, mwachitsanzo, pokonzekera opareshoni, mukamanyamula mwana kapena mkaka wa m'mawere.

Jakisoni wa mahomoni amatha kuchotsa katundu kuchokera kwa iwo ndipo ma cell ali ndi mwayi wopuma. Nthawi yomweyo, kudya komanso kukhala ndi moyo wathanzi kumangoyambitsa izi. Kuwayikira kwa njirayi kumakhalapo pokhapokha ngati mukutsatira kwathunthu zakudya zomwe dokotala akutsimikiza. Zambiri zimatengera mawonekedwe a thupi.

Matenda a shuga a Type 2 amatha kuthandizidwa ndi zakudya kapena mankhwala ena, koma pali zochitika zina pomwe simungathe kuchita popanda kugwiritsa ntchito insulin.

Zingwe zitha kutumikiridwa:

Ngati mulingo woyenera wa mankhwala osabweretsa zotsatira zake,
pa opaleshoni,
Pa nthawi ya bere, kukomoka,
pakabuka mavuto.

Ndikofunikira kwenikweni kuwerengetsa nthawi ndi jakisoni. Kuti muchite izi, kufufuza kumachitika kwa sabata limodzi. Wodwala aliyense amasankhidwa payekha pamankhwala.

Ndikulimbikitsidwa kuti mugule mita ya glucose yoyang'anira magazi anu nthawi zonse. Njira zoterezi zithandiza kudziwa bwino kuchuluka kwa insulini ndikuwunika momwe mankhwalawo amasankhidwa.

Ngati insulin imayikidwa: ngati pali mtundu 1 wa shuga wachiwiri ndi wofanana

Zotsatira za kuyesedwa kwa shuga zikuwonetsa kuchuluka kwa glucose m'magazi. Munthu aliyense ali ndi funso chochita munthawiyi komanso mankhwala omwe mungamwe kuti muchepetse, mukamamwa insulin.

Amakhulupirira kuti insulini, mankhwala omwe amagwiritsidwa ntchito pokhalitsa shuga wambiri, amangoperekedwa kwa anthu odwala matenda a shuga 1. Komabe, nthawi zina, insulin imatha kupatsidwa mtundu wa 2 wa matenda.

Momwe mungadziwire ngati munthu akufunika insulin? Pali zonena pakati pa madotolo kuti kwa wodwala aliyense yemwe ali ndi matenda ashuga pali nthawi yokwanira kumwa insulini. Pochiza matenda a shuga amtundu uliwonse, chinthu chachikulu sikuti muphonye mphindi yomwe idakhazikitsidwa. Nthawi zina pamakhala zochitika zomwe wodwalayo amangomwalira, osadikirira kuikidwa kwa mankhwalawa.