Kulembetsa matenda a shuga

DALITSANI MALO OGULITSIRA MALO 46 MISONKHANO YA RUSSIA

Okondedwa madotolo,

Tikukudziwitsani za kusintha kwa adilesi kuti ifike pazosankha zamagetsi "pulogalamu ya shuga ya Observational."
Rejista ya matenda ashuga ipezeka pafupipafupi pa ulalo watsopano https://dm.astonconsulting.ru/Dm.

Webusayiti Yobweretsera Matenda a shuga http://www.diaregistry.ru amagwira ntchito mwachizolowezi.
Ntchito yokonza nyumbayo izikhala mpaka Ogasiti 7. Panthawi imeneyi, ndizotheka kuwonjezera nthawi yolowera mu Kulembetsa.

Tikupepesa chifukwa cha zovuta zomwe takumana nazo pantchito ya Kulembetsa.

Rejista ya boma ya odwala matenda ashuga: ndi chiyani?

State Record of Diabetes Patients (GRBS) ndiye chidziwitso chachikulu chomwe chili ndi kuchuluka kwathunthu kwa ziwerengero zokhudzana ndi kuchuluka kwa anthu aku Russia omwe ali ndi matenda ashuga.

Amagwiritsidwa ntchito popanga ndalama zomwe boma limagwiritsa ntchito polosera zomwe zingachitike m'tsogolo.

Pakadali pano, kalembedwe kamapezeka mu mtundu wa makina ogwiritsa ntchito pawokha omwe amawonetsa zokhudza kuwonongedwa kwa matenda ndi matenda pamlingo wapadziko lonse.

Zimaphatikizapo kuyang'anira momwe aliyense akudwala matenda ashuga, kuyambira tsiku lomwe amamuwerengera agogo ndi nthawi yonse ya chithandizo.

Izi zakonzedwa:

• mitundu yamavuto
• Zizindikiro za kagayidwe kazakudya ndi magawo ena a mayeso a labotale,
• zotsatira zamphamvu zamankhwala,
• deta yaimfa ya matenda ashuga.

Kulembetsaku ndikofunikira kwambiri monga chida chowerengera, komanso, ndizokhazokha zowerengera zamtundu wake pakuwunika magawo osiyanasiyana azachipatala, bungwe komanso sayansi omwe amalola kuwerengera ndikukonzekera bajeti yochizira, kupeza mankhwala ndi maphunziro a akatswiri azachipatala.

Matenda ofala

Zambiri zakukula kwa matenda ashuga ku Russia kumapeto kwa Disembala 2016 zikusonyeza kuti anthu pafupifupi 4.350 miliyoni ali ndi vutoli "lomwe limapanga pafupifupi 3% ya anthu onse m'boma, omwe:

• mtundu wosadalira insulini umakhala ndi 92% (pafupifupi anthu 4,001,860),
• wodwala insulin - 6% (pafupifupi 255 385 anthu),
• zamitundu ina yamatenda - 2% (75 123 anthu).

Chiwerengero chonsecho chinaphatikizanso milanduyo pamene mtundu wa matenda a shuga sunawonetsedwe muzowonetsa.

Zomwezi zimatilola kutsimikiza kuti kukwera mokwanira kwa kuchuluka kwa milandu kwatsala:

• kuyambira Disembala 2012, chiwerengero cha anthu odwala matenda ashuga chawonjezeka ndi anthu pafupifupi 5,000,
• kwa nthawi kuyambira kumapeto kwa Disembala 2015 - ndi 254,000.

Gulu la zaka (chiwerengero cha anthu 100 miliyoni)

Ponena za kuchuluka kwa zaka, matenda ashuga amtundu woyamba anali kulembedwa kwambiri mwa achinyamata, ndipo mwa iwo omwe ali ndi vuto lachiwiri la matenda, makamaka achikulire.

Kumapeto kwa Disembala 2016, zidziwitso zamagulu azaka zili motere.

• matenda a shuga omwe amadalira insulini - pafupifupi 164.19 milandu kwa anthu zana,
• shuga osadalira insulin - 2637.17 pa anthu omwewo,
• mitundu ina ya matenda a shuga: 50.62 pa 100,000.

Poyerekeza ndi ziwerengero za 2015, kukula kwake kunali:

• pa matenda ashuga 1 - 6.79 pa 100,000,
• a matenda a shuga a 2 - 118.87.

Ndi gulu lazaka za ana:

• mtundu wa matenda a shuga omwe amadalira insulin - 86.73 pa ana 100,000,
• mtundu wa shuga osadalira insulini - 5.34 pa anthu 100,000,
• mitundu inanso ya matenda ashuga: 1.0 pa 100 miliyoni ya ana.

Poyerekeza ndi ziwerengero za 2015, kuchuluka kwa odwala matenda a shuga omwe amadalira insulini kumawonjezeka ndi 16.53.

Muubwana:

• mtundu wodwala wa matenda a insulin - 203.29 pa 100 miliyoni ya achinyamata,
• osagwirizana ndi insulin - 6.82 pa anthu 100,000 aliwonse,
• mitundu ina ya matenda a shuga - 2.62 a chiwerengero chomwecho cha achinyamata.

Ponena ndi zomwe zingachitike mu 2015, kuchuluka kwa omwe adazindikira kuti ali ndi matenda amtundu wa 1 m'gululi adakwera ndi 39.19, ndikulemba 2 - ndi 1.5 pa anthu zana limodzi.

Nkhani yotsiriza, kukula kumafotokozedwa ndi zizolowezi zowonjezera kulemera kwa thupi pakati pa ana ndi achinyamata. Kunenepa kwambiri kumadziwika kuti kumayambitsa matenda osokoneza bongo omwe amadalira insulin.

Mu gulu la "akulu":

malinga ndi mtundu wodalira insulini - 179.3 pa anthu 100 miliyoni achikulire,

• mwa mitundu yopanda insulin-yodziimira payekha - 3286.6 pamtengo wofanana,
• zamitundu ina ya matenda ashuga - 62,8 milandu pa 100 miliyoni akulu.

Mugawo lino, kukula mu deta poyerekeza ndi 2015 kunali:

• mtundu 1 wa matenda ashuga - 4.1 pa 100,000,
• a matenda a shuga a 2 - 161 kwa akuluakulu omwe,
• zamitundu ina ya shuga - 7.6.

Chifukwa chake, zitha kunenedwa kuti chiwerengero cha anthu omwe apezeka ndi matenda a shuga akuchulukirachulukira. Komabe, izi zikuchitika modzichulukitsa pang'ono kuposa zaka zam'mbuyomu.

Kwa nthawi yayitali kuyambira 2013 mpaka 2016, kuchuluka kwa anthu odwala matenda ashuga kumapitirirabe, makamaka chifukwa cha mtundu wa 2 matenda.

Kapangidwe ka zomwe zimayambitsaimfa

Matenda a shuga ndi njira yoopsa komanso yoopsa yomwe anthu amamwalira.

Malinga ndi kuchuluka kwa GRBSD, kuyambira pa Disembala 31, 2016, "mtsogoleri" paimfa pa chifukwa ichi anali zovuta zamtima zomwe zinalembetsedwa m'mitundu 1 ndi 2 matenda ashuga monga:

• mavuto ndi kufalikira kwa magazi muubongo,
• kulephera kwa mtima
• kugunda kwa mtima ndi stroko.

31.9% ya anthu odwala matenda ashuga 1 ndi 49,5% okhala ndi matenda amtundu wa 2 adamwalira ndi mavuto azaumoyo.

Wachiwiri, womwe ndi woyamba kupha anthu:

• ndi mtundu 1 shuga - matenda a impso (7,1%),
• ndi mtundu 2, mavuto a oncological (10.0%).

Mukamayang'ana zovuta zakutsogolo za matenda ashuga, kuchuluka kwa mavuto monga:

• matenda a shuga (mtundu 1 - 2.7%, mtundu 2 - 0,4%),
• hypoglycemic coma (mtundu 1 - 1.8%, lembani 2 - 0%),
• poizoni wamagazi (septic) wa magazi (mtundu 1 - 1.8%, mtundu 2 - 0,4%),
• zotupa zoopsa (mtundu 1 - 1,2%, mtundu 2 - 0,7%).

Izi zikusonyeza kuti ndi fomu yodalira insulini, kuchuluka kwa zovuta zakupha kwambiri, ndizomwe zimafotokozera zaka zazifupi zomwe anthu amakhala ndi matenda ashuga 1.

Kulembetsa Mavuto

Matenda a shuga amawopa mankhwalawa, ngati moto!

Muyenera kungolemba ...

Matenda a shuga ndi oopsa ndi zovuta zomwe zimayamba chifukwa cha kuwononga kwakutali kwa matenda amthupi. Ziwerengero zakuchuluka kwawo zili motere (osaganizira zomwe zachitika ku St. Petersburg, chifukwa chosakwanira module pa intaneti).

Kwa odwala matenda ashuga amtundu 1 (peresenti ya anthu onse omwe ali ndi mavuto a "shuga"):

• vuto la neuropathic - 33.6%,
• retinopathic visualization - 27.2%,
• matenda a nephropathic - 20.1%,
• kuthamanga kwa magazi - mu 17.1%,
• matenda a shuga a ziwiya zazikulu - 12.1% ya odwala,
• "diabetes" phazi - 4,3%,
• matenda a mtima a ischemic - mu 3.5%,
• mavuto a m'matumbo - 1.5%,
• myocardial infarction - 1.1%.

Matenda a 2 a shuga:

• matenda oopsa - 40.6%,
• neuropathy ya matenda a shuga - 18,6%,
• retinopathy - mu 13.0%,
• matenda a mtima - 11.0%,
• nephropathy a matenda ashuga - 6.3%,
• macroangiopathic mtima zotupa - 6.0%,
• matenda amisala - mu 4.0%,
• myocardial infarction - 3,3%,
• diabetesic phazi matenda - 2.0%.

Ndikofunika kukumbukira kuti malinga ndi zambiri kuchokera mu renti, zovuta ndizochepa kwambiri poyerekeza ndi maphunziro omwe akukhudza kuwunika.

Izi ndichifukwa choti zidziwitso zidalowetsedwa mu GRBSD pa kusinthika, ndiye kuti, titha kungolankhula za milandu yodziwika yodziwira matenda osokoneza bongo komanso zovuta zake. Izi zikuwonetsa kuchepa chidwi kwa kuchuluka kwa kuchuluka.

Pakuwunika zomwe zalembedwa mu rentiyi, 2016 ndiyofunikira kwambiri, chifukwa madera ambiri asinthana kusunga mbiri pa intaneti. Kulembetsa kwasintha kukhala chidziwitso champhamvu chomwe chimakupatsani mwayi wowunika mwachangu komanso moyenera zidziwitso zamankhwala komanso zatsoka zamagulu osiyanasiyana.

STATE REGISTER OF DIABETES: EPIDEMIOLOGICAL CHARACTERISTIC OF INSULIN INDEPENDENT DIABETES

Yu.I. Suntsov, I.I. Dedov, S.V. Kudryakova

Endocrinology Research Center RAMS
(Dir.-Acad. RAMS I.I.Dedov), Moscow

Kufufuza njira zamatenda a shuga kumaphatikizapo kupeza zidziwitso zowerengera zokhudzana ndi miliri ya matenda a shuga. Chisankho chofuna kupanga chidziwitso choterechi chinapangidwa ndi Unduna wa Zaumoyo ku Russia Federation mu 1993. Pambuyo pake, ntchito yogwira ntchito idachitika ndikupanga dongosolo la chidziwitso la State Record of Diabetes Mellitus (GDS). Kapangidwe ka GDS kamawonetsedwa. Monga momwe maphunziro ndi maphunziro omwe adachitikira kunja komanso ku Russia Federation akuwonetsa, zovuta zazikulu zimakhalapo ndikupanga ndikusunga database ya anthu omwe ali ndi matenda osokoneza bongo omwe amadalira matenda a shuga (NIDDM).

Oposa 85% odwala ali ndi matenda osokoneza bongo omwe amadalira shuga. Mtunduwu wa matenda ashuga ndiwofalikira kuwirikiza ka 10 kuposa matenda a shuga a insulin - IDDM). Kuchulukana kwa NIDDM kukuchulukirachulukira pakati pa anthu azaka zapakati pa 40 ndi kupitirira ndipo amafikira pazofunikira kwambiri m'magulu azaka 60 ndi kupitirira. Nthawi yomweyo, kuchuluka kwa NIDDM, kojambulidwa ndi kusinthika, sikuwonetsa momwe zinthu zilili, popeza kuchuluka kwenikweni kwa odwala kumakhala kokwirikiza katatu kuposa komwe kunalembedwa. Popeza gawo lalikulu la odwala omwe ali ndi NIDDM pofika nthawi yomwe matendawa adakhazikitsidwa, nthawi yokhala ndi matendawa ili pafupifupi zaka 10, zikuwonekeratu chifukwa chake izi zikuwonetsa kuchuluka kwakukulu kwa zovuta zam'mitsempha.

Sizotheka kufufuza chiwerengero chonse cha anthu kuti pali NIDDM ya metropolis ngati Moscow, osatchulanso Russia yonse. Chifukwa chake, kuwunika momwe miliri ilili, maiko monga United States amagwiritsa ntchito maphunziro owonera za miliri m'magawo amodzi. Zotsatira za kafukufukuyu zimapangitsa kuti athe kuwunika momwe kuchuluka kwa kuchuluka kwa NIDDM kumasiyanirana ndi komwe kudalembedwa komanso zomwe zikuchitika mdziko lonse. Pachifukwachi, kafukufuku wosankha wa anthu aku Moscow adachitika ndipo zomwe adazipeza zidafanizidwa ndi kuchuluka kwa mbiri ya NIDDM.

Chifukwa chake, malinga ndi kafukufuku wofufuzira womwe udachitika ku Moscow, kuchuluka kwa kuchuluka kwa NIDDM kudapitilira kumene kudalembedwa mwa amuna ndi 2.0, ndipo mwa akazi ndi 2.37. Komanso, kuchuluka kumeneku kunadalira kwambiri zaka za odwala. Chifukwa chake, ngati mu gulu la zaka 40-49 panali 4,01, ndiye kuti m'gululo la zaka 60-69 panali 1.64 zokha. Kuchepa kwa kuchuluka kwa kuchuluka kwa kuchuluka kwa zolembedwa za NIDDM pakati pa okalamba kumalumikizidwa ndi kudziwika kwapamwamba kwamtunduwu wa shuga pakati pawo.

Chizindikiro chofunikira cha mtundu wa chithandizo ndi chisamaliro chodziwitsa odwala omwe ali ndi NIDDM ndi kuchuluka kwa kuchuluka komwe kunalembedwa komanso kuchuluka kwa zovuta za matenda ashuga. Njira zosasinthika zidagwiritsidwa ntchito kuyesa gulu la odwala omwe ali ndi NIDDM omwe amayang'aniridwa ndi endocrinologists am'madera. Zinapezeka kuti kuchuluka kwenikweni kwa zovuta za NIDDM monga retinopathy kudapitilira zomwe zalembedwa mu 4, 8, nephropathy ndi 8.6, polyneuropathy ndi 4.0, macroangiopathy a malekezero a 9.5 (Table 1). Palibe kusiyana kwakukulu komwe kunapezeka pakufalikira kwa matenda a mtima, kuchepa kwamitsempha, matenda oopsa, komanso ngozi ya mtima.

Kodi mbiri ya shuga ndi iti?

Kulembetsa kupewa mpaka 28.11.2018 10:00.

Tikupepesa chifukwa chazovuta

1. Adalumikiza zigawo ziwiri zatsopano za Russian Federation
2. Khazikitsani lipoti latsopano: M 3. Kugawa mapampu a insulini
3. Gawo lowonetsedwa lowoneka bwino lazotsatira za odwala
4. Mankhwala atsopano ophatikiza anawonjezera: Vipdomet ndi Solikva
5. Kulembetsa kwasamukira ku seva yatsopano yokhala ndi ntchito yayikulu

• Kudzaza kuchuluka kwa HbA1c (ngati sichoncho, glucose akusala)
• Kuchepetsa shuga yochepetsa shuga
• Lembani zambiri za zovuta za matenda ashuga
• Chiwerengero cha obwereza odwala komanso "zolakwika pazikhalidwe zikhalidwe"
• Zosintha za%% chaka chamakono *

* ndikofunikira kumaliza ulendowu woyamba pachaka, kuphatikiza kulembetsa pafupifupi 1 HbA1c mtengo (ngati sichoncho, ndiye kusala glucose), kusintha kwa kuchepetsa shuga (glucose), kukula / kupitirira kwa zovuta

Okondedwa madotolo,

Tikukudziwitsani za kusintha kwa adilesi kuti ifike pazosankha zamagetsi "Observationalabetes program".
Rejista ya matenda ashuga ipezeka pafupipafupi pa ulalo watsopano https://dm.astonconsulting.ru/Dm.

Webusayiti Yobweretsera Matenda a shuga http://www.diaregistry.ru amagwira ntchito mwachizolowezi.
Ntchito yokonza nyumbayo izikhala mpaka Ogasiti 7. Panthawi imeneyi, ndizotheka kuwonjezera nthawi yolowera mu Kulembetsa.

Tikupepesa chifukwa cha zovuta zomwe takumana nazo pantchito ya Kulembetsa.

Zakumapeto N 1. Malangizo pa National Register of matenda a shuga

Malinga ndi deta yathu (Gome 2), gawo la matenda amtima mu kapangidwe ka zomwe zimayambitsa mwachindunji zakufa kwa odwala omwe ali ndi NIDDM anali 72.6%. Nthawi yomweyo, kugundika kwa mtima ndi komwe kunali chifukwa cha kufa kwa 40.4% ya milandu, kulowetsedwa myocardial - mu 15.4%, sitiroko - mu 16,8%. Myocardial infaration monga chifukwa cha imfayi inali zofala kwambiri mwa amuna kuposa azimayi (19,8 ndi 13.4%, motsatana), pomwe amayi - osalephera amtima (36,6 ndi 42.3%, motero). Chiwopsezo cha kufa kwa odwala omwe ali ndi NIDDM kuchokera kukomoka kwa matenda ashuga ndi 3.2%, ndipo mwa akazi amafikira 4.1%.Izi ndichifukwa choti matenda osokoneza bongo omwe amadwala odwala NIDDM nthawi zambiri amakula mwa okalamba motsutsana ndi zovuta zina zovuta, monga myocardial infarction, stroke, matenda ndi matenda ena owopsa.

Gome 2 Zomwe zimayambitsa kufa kwa odwala IDDM (%)

Gangrene wa m'munsi

Zotsatira za sepsis

Tawerengera kuthekera kwa kupewa koyambirira kwa NIDDM, osati pagulu lopangidwa pazolinga izi, koma pagulu la anthu. Njira zodzitchinjiriza mwa njira zoperekera zakudya komanso kukonza zolimbitsa thupi zimachitika mu gulu la abambo azaka 20-59 (gulu lasayansi ndi loyambira ku Moscow State University lotchedwa M.I. Lomonosov). Pakuwunika koyamba, zakudya zawo ndi masewera olimbitsa thupi adaphunzira, pambuyo pake malingaliro adaperekedwa kwa anthu omwe, malinga ndi malingaliro amakono, amafunikira. Zaka zitatu zokha, kuwongolera kukhazikitsa kwawo kunachitika. Mukamayang'ana kuchuluka kwa anthu patatha zaka zitatu, kuchepa kwakukulu kwa glycemia kudapezeka pamimba yopanda kanthu komanso pambuyo pa maola 1 ndi 2 mutatha shuga a 75 g.

Glycemia wapakati posala mwachangu ndi 5.37 ± 0.03 mmol / L, komaliza - 4.53 ± 0.03 mmol / L (p

DZINA LABWINO LA MOSCOW City REGORERER WOLEMA NDIPONSO ZINSINSI ZA SUGAR
O.V. Dukhareva, L.V. Kleshcheva, V.D. Tikhomirov, O.N. Syroevova, M.B. Antsiferov

KUGWIRITSANSO KWA MTANDA WONSE NDI MUTU 1 NDI MUTU 2
MU DZIKO LA ADMINISTRATIVE LA DZIKO LA MOSCOW
KUYAMBIRA KWA 2004

Kwa zaka 10, kuyambira 1994, nkhokwe yosungiramo odwala omwe ali ndi matenda opatsirana a shuga imapangidwa pang'onopang'ono ku Moscow: kaundula wa ana omwe akudwala matenda ashuga amapangidwa koyamba, ndiye, papepala, odwala akuluakulu omwe ali ndi mtundu woyamba wa 1 ndi matenda a shuga.
Order of the Moscow Health Committee No. 415 ya pa Okutobala 4, 2000 idapangitsa kuthana ndi magawo oyambira a zida zamakono mu zigawo ndikuyambitsa pulogalamu ya State Register of matenda ashuga.

The Moscow City Register of Patients ndi Matenda a shuga (omwe amatchedwa Kalata ya Matenda a shuga) amapangidwa m'chipatala chilichonse chachigawo ndipo amamuwona ndi ziwerengero ndi kaundula wa mayendedwe okondera. Pamaziko a madipatimenti aboma endocrinological, ma regista awo amapangidwa, mgwirizano womwe umachitika motsatira Endocrinological Dispensary.

Pakadali pano pali odwala 183989 omwe ali mu database ya matenda a shuga.
Zambiri pakugawidwa kwa odwala omwe ali ndi vuto la mtundu woyamba 1 ndi mtundu 2 amachititsa kuti athe kuneneratu zakupereka ndalama kwa mankhwala, kuchuluka kwa makalasi m'masukulu odziletsa, ndi zina zambiri.
Zosafunanso kwenikweni ndizomwe zikuwonetsa kuchuluka kwa zovuta za matenda ashuga (kuchuluka kwa odwala omwe ali ndi matenda awa pa anthu 100,000), popeza ndi mawonekedwe awowo omwe amalemetsa kwambiri moyo wa anthu. Kudziwa pafupipafupi kukula kwa mitundu yamavuto osiyanasiyana komanso kudalira kwawo nthawi yayitali ya matendawa, ndizotheka kupanga njira zodziwonera nthawi yake komanso kuwunika kwa odwala. Ichi ndiye maziko a ntchito yopewetsa kusintha thanzi la odwala omwe ali ndi matenda ashuga.

Ma graphs akuwonetsa bwino kuti mwa odwala ena zovuta zovuta za matenda ashuga monga retinopathy (kuwonongeka kwa maso a shuga, omwe ali chifukwa chotsogola) Ndipo atatenga zaka zopitilira 15, wodwala aliyense wachinayi yemwe ali ndi matenda amtundu 1 amapezeka ndi retinopathy. Pofuna kupewa kukula kwambiri kwa matenda ashuga, ndizotheka pokhapokha kubwezeretsa kwakuthupi kwa glycemia kwa nthawi yayitali.

Chosangalatsa chake ndi kusanthula kwa database ya ana aku Moscow omwe ali ndi matenda ashuga kuyambira 1994.
Mu 70s, kuchuluka kwa matenda ashuga a mtundu woyamba mu ana ku Moscow kunali 5.17 pa ana zana zana, mu 80s - 9.7, mu 1994 - 11.7, mu 1995 - 12.1, ndi mu 2001 - 9.63.Kafukufuku wambiri wazaka zosiyanasiyana mu 2001, zikuwonekeratu kuti achinyamata kuyambira zaka 10 mpaka 14 amakhalabe okwera kwambiri - 13.24, akuwonjezeka mwa amuna kufika pa 15,0. Nthawi yomweyo, pali chizolowezi “chobwezeretsanso matenda ashuga,” ndiko kuti, kuchuluka kwa anthu obwera mpaka zaka 6.
Avereji ya zaka za matenda osokoneza bongo kwa ana mumzinda wa Moscow ndi zaka 6.61.

Zotsatira zake zikuwonetsa kuti zovuta za shuga zimapezeka kale muubwana ndi unyamata. Ndi nthendayi yokhala ndi nthawi yochepera zaka zisanu, kuchuluka kwawo kumakhala kotsika, kuyambira zaka 5 mpaka 10 - kumakhala kofunikira, komanso zaka zopitilira 10 - pafupipafupi zovuta zimachulukitsa katatu kapena kupitirira, mpaka 30%.

Kulembetsa kwa boma kwa odwala matenda a shuga a St.

Kusiyanaku kwakukuru pakupezeka kwa zovuta kutengera ndi jenda ndikofunikira.
Kuchulukana kwa nephropathy m'magulu a ana omwe ali ndi mtundu 1 wa shuga - zaka 5-9 ndi zaka zopitilira 10 - motero - 2.84% ndi 5.26%.

Chimodzi mwazinthu zazikulu zothandizira kulipira shuga kwa mwana ndi kukula kwa thupi. Hyperglycemia wotalikirapo, wophatikizidwa ndi chidziwitso cha matendawa kwa zaka zopitilira 10, amatha kuchedwa kukukula kwakuthupi kwamwana aliyense wachisanu.

Hyropathy ndi malire a kuyenda kwa malo ammanja, kuwululidwa pomwe nkosatheka kupukusa manja. Zimachulukirachulukira mu anyamata achichepere omwe amadwala matenda a shuga omwe amakhala zaka zoposa 10. Izi ndichifukwa choti achinyamata “amasiya” kuwongolera popanda kuchita kuzindikira kuti ayenera kupewera okha matenda ashuga.

Lipoti la Odwala Odwala Matenda a Moscow City likuwonetsa bwino lomwe momwe othandizira amafunikira kudzipenda.

About kulembetsa kwa ana omwe ali ndi kukula kwa mahomoni
Pakadali pano, palibe kukayikira kuti ana onse omwe ali ndi vuto lobadwa nalo la mahomoni angakwanitse kukula bwino mothandizidwa ndi makono amakono opangira ma genetic. Tsopano ku Moscow, ana 156 ndi achinyamata omwe ali ndi vuto la kuchepa kwa mahomoni amalandila chithandizo chofunikira kwaulere.
Kodi kuwomba alarm?

Mwana amakula msanga kwambiri chaka choyamba cha moyo: pafupi masentimita 25. Kenako kukula kumachepera: mchaka chachiwiri, mwana amakula ndi 8-12 cm, ndiye - mwa 4-6 masentimita pachaka. Mukazindikira chakumaso pakukula, ndikofunikira kuti mutumize mwanayo kwa endocrinologist.
Ana omwe ali ndi kukula komwe kumawonedwa ndi endocrinologists mu polyclinics yachigawo kuti azitha kuwongolera kukula, osawerengera ndikuwathandizira ma endocrine ndi ma somatic pathologies ena, omwe angayambenso kudandaula. Ngati vuto la kuperewera kwa mahomoni mwa mwana likuwoneka kuti ali ndi vuto, adotolo wa endocrinologist amutumiza kuchipatala kuti akamupime mayeso athunthu a endocrinological ndi kuyesedwa kwapadera kutifotokozere bwino za matendawa. Ngati endocrine matenda amatsimikiziridwa, mankhwala enaake a mahomoni amaperekedwa kwa mwana.

Chithandizo chokhazikika cha ana omwe ali ndi vuto la kukula kwa mahomoni ku Moscow kwachitika kuyambira 1996. Pakadali pano, akatswiri a ma endocrinologists ali ndi mankhwala apamwamba kwambiri okhala ndi mahomoni ena opanga njira zakunja. Awa ndi ma mahomoni opangidwa mwakukhala ndi chibadwa - genotropin, norditropin, ndi humatrop. Tsopano tikuyambitsa mtundu watsopano, wamakono kwambiri wa norditropin - Norditropin Simplex. Popeza mahomoni amakula ali ndi mitundu yovomerezeka yokha, njira zopangira zoyenera zapangidwira mankhwala onse - zolembera za syringe imodzi ndi singano zowonda kwambiri.

Malinga ndi kulembetsa kwa ana omwe ali ndi vuto la kuchepa kwa mahomoni, mchaka choyamba cha chithandizo, ana amakula ndi 10-12 cm, wachiwiri - mwa 7-10 cm, ndiye kuti kukula kumafanana ndi kwa mwana wathanzi ndipo ndi 4-6 masentimita pachaka.Mlingo wa mankhwalawa amawerengedwa makamaka kwa mwana aliyense, poganizira momwe zimakhazikikidwira komanso mogwirizana ndi kulemera, kutalika ndi kuchuluka kwa kusasitsa kwa thupi. Sitinazindikire zovuta zilizonse pazovuta za mankhwalawa, koma, podziwidwa mwatsatanetsatane wa chithandizo cha mahomoni, ana awa amawunikidwa pafupipafupi ndi akatswiri ochokera kuzipatala zamankhwala opita kunja komanso Endocrinology Dispensary. Mu dispensary, database ya ana omwe ali ndi matenda awa idapangidwa ndipo komiti yolangizira zamankhwala yothandizira mahomoni a kukula ikugwira ntchito kupenda milandu yovuta kwambiri.

Ndi matenda anthawi yake komanso chithandizo choyambirira, kuwonjezereka kumakula ndikofunika kale mchaka choyamba cha chithandizo, zomwe zimapewe mavuto amtundu wa anthu omwe amakhalapo chifukwa chopindika ana. Pazaka zonse zamankhwala, ana amakula ndi 25-36 cm, ndipo kukula kwawo komaliza ndi masentimita 160 mpaka 175. Ambiri mwa odwala athu amatha kusintha moyo wawo bwino, kuphunzira m'maphunziro apamwamba, ndipo amalandila zamakono.

Gome 1 Momwe kuchuluka ndi kufalikira kwa zovuta za IDDM kwa odwala azaka zapakati pa 18 ndi akulu (%) kumachitikira

Kusanthula pazomwe zimayambitsa kufa kwa odwala omwe ali ndi NIDDM kumaphatikizapo kupeza chidziwitso chofunikira pakuwongolera njira zochizira komanso zodzitetezera. Malinga ndi olemba akunja, matenda amtima komanso oyambitsa kufa chifukwa cha odwala NIDDM ndi 75.1 - 87.7%.

Zakumapeto N 1. Malangizo pa National Register of matenda a shuga

Malinga ndi deta yathu (Gome 2), gawo la matenda amtima mu kapangidwe ka zomwe zimayambitsa mwachindunji zakufa kwa odwala omwe ali ndi NIDDM anali 72.6%. Nthawi yomweyo, kugundika kwa mtima ndi komwe kunali chifukwa cha kufa kwa 40.4% ya milandu, kulowetsedwa myocardial - mu 15.4%, sitiroko - mu 16,8%. Myocardial infaration monga chifukwa cha imfayi inali zofala kwambiri mwa amuna kuposa azimayi (19,8 ndi 13.4%, motsatana), pomwe amayi - osalephera amtima (36,6 ndi 42.3%, motero). Chiwopsezo cha kufa kwa odwala omwe ali ndi NIDDM kuchokera kukomoka kwa matenda ashuga ndi 3.2%, ndipo mwa akazi amafikira 4.1%. Izi ndichifukwa choti matenda osokoneza bongo omwe amadwala odwala NIDDM nthawi zambiri amakula mwa okalamba motsutsana ndi zovuta zina zovuta, monga myocardial infarction, stroke, matenda ndi matenda ena owopsa.

Gome 2 Zomwe zimayambitsa kufa kwa odwala IDDM (%)

Gangrene wa m'munsi

Zotsatira za sepsis

Tawerengera kuthekera kwa kupewa koyambirira kwa NIDDM, osati pagulu lopangidwa pazolinga izi, koma pagulu la anthu. Njira zodzitchinjiriza mwa njira zoperekera zakudya komanso kukonza zolimbitsa thupi zimachitika mu gulu la abambo azaka 20-59 (gulu lasayansi ndi loyambira ku Moscow State University lotchedwa M.I. Lomonosov). Pakuwunika koyamba, zakudya zawo ndi masewera olimbitsa thupi adaphunzira, pambuyo pake malingaliro adaperekedwa kwa anthu omwe, malinga ndi malingaliro amakono, amafunikira. Zaka zitatu zokha, kuwongolera kukhazikitsa kwawo kunachitika. Mukamayang'ana kuchuluka kwa anthu patatha zaka zitatu, kuchepa kwakukulu kwa glycemia kudapezeka pamimba yopanda kanthu komanso pambuyo pa maola 1 ndi 2 mutatha shuga a 75 g.

Glycemia wapakati posala mwachangu ndi 5.37 ± 0.03 mmol / L, komaliza - 4.53 ± 0.03 mmol / L (p

DZINA LABWINO LA MOSCOW City REGORERER WOLEMA NDIPONSO ZINSINSI ZA SUGAR
O.V. Dukhareva, L.V. Kleshcheva, V.D. Tikhomirov, O.N. Syroevova, M.B. Antsiferov

KUGWIRITSANSO KWA MTANDA WONSE NDI MUTU 1 NDI MUTU 2
MU DZIKO LA ADMINISTRATIVE LA DZIKO LA MOSCOW
KUYAMBIRA KWA 2004

Kwa zaka 10, kuyambira 1994, nkhokwe yosungiramo odwala omwe ali ndi matenda opatsirana a shuga imapangidwa pang'onopang'ono ku Moscow: kaundula wa ana omwe akudwala matenda ashuga amapangidwa koyamba, ndiye, papepala, odwala akuluakulu omwe ali ndi mtundu woyamba wa 1 ndi matenda a shuga.
Order of the Moscow Health Committee No. 415 ya pa Okutobala 4, 2000 idapangitsa kuthana ndi magawo oyambira a zida zamakono mu zigawo ndikuyambitsa pulogalamu ya State Register of matenda ashuga.

The Moscow City Register of Patients ndi Matenda a shuga (omwe amatchedwa Kalata ya Matenda a shuga) amapangidwa m'chipatala chilichonse chachigawo ndipo amamuwona ndi ziwerengero ndi kaundula wa mayendedwe okondera. Pamaziko a madipatimenti aboma endocrinological, ma regista awo amapangidwa, mgwirizano womwe umachitika motsatira Endocrinological Dispensary.

Pakadali pano pali odwala 183989 omwe ali mu database ya matenda a shuga.
Zambiri pakugawidwa kwa odwala omwe ali ndi vuto la mtundu woyamba 1 ndi mtundu 2 amachititsa kuti athe kuneneratu zakupereka ndalama kwa mankhwala, kuchuluka kwa makalasi m'masukulu odziletsa, ndi zina zambiri.
Zosafunanso kwenikweni ndizomwe zikuwonetsa kuchuluka kwa zovuta za matenda ashuga (kuchuluka kwa odwala omwe ali ndi matenda awa pa anthu 100,000), popeza ndi mawonekedwe awowo omwe amalemetsa kwambiri moyo wa anthu. Kudziwa pafupipafupi kukula kwa mitundu yamavuto osiyanasiyana komanso kudalira kwawo nthawi yayitali ya matendawa, ndizotheka kupanga njira zodziwonera nthawi yake komanso kuwunika kwa odwala. Ichi ndiye maziko a ntchito yopewetsa kusintha thanzi la odwala omwe ali ndi matenda ashuga.

Ma graphs akuwonetsa bwino kuti mwa odwala ena zovuta zovuta za matenda ashuga monga retinopathy (kuwonongeka kwa maso a shuga, omwe ali chifukwa chotsogola) Ndipo atatenga zaka zopitilira 15, wodwala aliyense wachinayi yemwe ali ndi matenda amtundu 1 amapezeka ndi retinopathy. Pofuna kupewa kukula kwambiri kwa matenda ashuga, ndizotheka pokhapokha kubwezeretsa kwakuthupi kwa glycemia kwa nthawi yayitali.

Chosangalatsa chake ndi kusanthula kwa database ya ana aku Moscow omwe ali ndi matenda ashuga kuyambira 1994.
Mu 70s, kuchuluka kwa matenda ashuga a mtundu woyamba mu ana ku Moscow kunali 5.17 pa ana zana zana, mu 80s - 9.7, mu 1994 - 11.7, mu 1995 - 12.1, ndi mu 2001 - 9.63. Kafukufuku wambiri wazaka zosiyanasiyana mu 2001, zikuwonekeratu kuti achinyamata kuyambira zaka 10 mpaka 14 amakhalabe okwera kwambiri - 13.24, akuwonjezeka mwa amuna kufika pa 15,0. Nthawi yomweyo, pali chizolowezi “chobwezeretsanso matenda ashuga,” ndiko kuti, kuchuluka kwa anthu obwera mpaka zaka 6.
Avereji ya zaka za matenda osokoneza bongo kwa ana mumzinda wa Moscow ndi zaka 6.61.

Zotsatira zake zikuwonetsa kuti zovuta za shuga zimapezeka kale muubwana ndi unyamata. Ndi nthendayi yokhala ndi nthawi yochepera zaka zisanu, kuchuluka kwawo kumakhala kotsika, kuyambira zaka 5 mpaka 10 - kumakhala kofunikira, komanso zaka zopitilira 10 - pafupipafupi zovuta zimachulukitsa katatu kapena kupitirira, mpaka 30%.

Kulembetsa kwa boma kwa odwala matenda a shuga a St.

Kusiyanaku kwakukuru pakupezeka kwa zovuta kutengera ndi jenda ndikofunikira.
Kuchulukana kwa nephropathy m'magulu a ana omwe ali ndi mtundu 1 wa shuga - zaka 5-9 ndi zaka zopitilira 10 - motero - 2.84% ndi 5.26%.

Chimodzi mwazinthu zazikulu zothandizira kulipira shuga kwa mwana ndi kukula kwa thupi. Hyperglycemia wotalikirapo, wophatikizidwa ndi chidziwitso cha matendawa kwa zaka zopitilira 10, amatha kuchedwa kukukula kwakuthupi kwamwana aliyense wachisanu.

Hyropathy ndi malire a kuyenda kwa malo ammanja, kuwululidwa pomwe nkosatheka kupukusa manja. Zimachulukirachulukira mu anyamata achichepere omwe amadwala matenda a shuga omwe amakhala zaka zoposa 10. Izi ndichifukwa choti achinyamata “amasiya” kuwongolera popanda kuchita kuzindikira kuti ayenera kupewera okha matenda ashuga.

Lipoti la Odwala Odwala Matenda a Moscow City likuwonetsa bwino lomwe momwe othandizira amafunikira kudzipenda.

About kulembetsa kwa ana omwe ali ndi kukula kwa mahomoni
Pakadali pano, palibe kukayikira kuti ana onse omwe ali ndi vuto lobadwa nalo la mahomoni angakwanitse kukula bwino mothandizidwa ndi makono amakono opangira ma genetic. Tsopano ku Moscow, ana 156 ndi achinyamata omwe ali ndi vuto la kuchepa kwa mahomoni amalandila chithandizo chofunikira kwaulere.
Kodi kuwomba alarm?

Mwana amakula msanga kwambiri chaka choyamba cha moyo: pafupi masentimita 25. Kenako kukula kumachepera: mchaka chachiwiri, mwana amakula ndi 8-12 cm, ndiye - mwa 4-6 masentimita pachaka. Mukazindikira chakumaso pakukula, ndikofunikira kuti mutumize mwanayo kwa endocrinologist.
Ana omwe ali ndi kukula komwe kumawonedwa ndi endocrinologists mu polyclinics yachigawo kuti azitha kuwongolera kukula, osawerengera ndikuwathandizira ma endocrine ndi ma somatic pathologies ena, omwe angayambenso kudandaula. Ngati vuto la kuperewera kwa mahomoni mwa mwana likuwoneka kuti ali ndi vuto, adotolo wa endocrinologist amutumiza kuchipatala kuti akamupime mayeso athunthu a endocrinological ndi kuyesedwa kwapadera kutifotokozere bwino za matendawa. Ngati endocrine matenda amatsimikiziridwa, mankhwala enaake a mahomoni amaperekedwa kwa mwana.

Chithandizo chokhazikika cha ana omwe ali ndi vuto la kukula kwa mahomoni ku Moscow kwachitika kuyambira 1996. Pakadali pano, akatswiri a ma endocrinologists ali ndi mankhwala apamwamba kwambiri okhala ndi mahomoni ena opanga njira zakunja. Awa ndi ma mahomoni opangidwa mwakukhala ndi chibadwa - genotropin, norditropin, ndi humatrop. Tsopano tikuyambitsa mtundu watsopano, wamakono kwambiri wa norditropin - Norditropin Simplex. Popeza mahomoni amakula ali ndi mitundu yovomerezeka yokha, njira zopangira zoyenera zapangidwira mankhwala onse - zolembera za syringe imodzi ndi singano zowonda kwambiri.

Malinga ndi kulembetsa kwa ana omwe ali ndi vuto la kuchepa kwa mahomoni, mchaka choyamba cha chithandizo, ana amakula ndi 10-12 cm, wachiwiri - mwa 7-10 cm, ndiye kuti kukula kumafanana ndi kwa mwana wathanzi ndipo ndi 4-6 masentimita pachaka. Mlingo wa mankhwalawa amawerengedwa makamaka kwa mwana aliyense, poganizira momwe zimakhazikikidwira komanso mogwirizana ndi kulemera, kutalika ndi kuchuluka kwa kusasitsa kwa thupi. Sitinazindikire zovuta zilizonse pazovuta za mankhwalawa, koma, podziwidwa mwatsatanetsatane wa chithandizo cha mahomoni, ana awa amawunikidwa pafupipafupi ndi akatswiri ochokera kuzipatala zamankhwala opita kunja komanso Endocrinology Dispensary. Mu dispensary, database ya ana omwe ali ndi matenda awa idapangidwa ndipo komiti yolangizira zamankhwala yothandizira mahomoni a kukula ikugwira ntchito kupenda milandu yovuta kwambiri.

Ndi matenda anthawi yake komanso chithandizo choyambirira, kuwonjezereka kumakula ndikofunika kale mchaka choyamba cha chithandizo, zomwe zimapewe mavuto amtundu wa anthu omwe amakhalapo chifukwa chopindika ana. Pazaka zonse zamankhwala, ana amakula ndi 25-36 cm, ndipo kukula kwawo komaliza ndi masentimita 160 mpaka 175. Ambiri mwa odwala athu amatha kusintha moyo wawo bwino, kuphunzira m'maphunziro apamwamba, ndipo amalandila zamakono.

STATE REGISTER OF DIABETES: EPIDEMIOLOGICAL CHARACTERISTIC OF INSULIN INDEPENDENT DIABETES

Yu.I. Suntsov, I.I. Dedov, S.V. Kudryakova

Endocrinology Research Center RAMS
(Dir.-Acad. RAMS I.I.Dedov), Moscow

Kufufuza njira zamatenda a shuga kumaphatikizapo kupeza zidziwitso zowerengera zokhudzana ndi miliri ya matenda a shuga. Chisankho chofuna kupanga chidziwitso choterechi chinapangidwa ndi Unduna wa Zaumoyo ku Russia Federation mu 1993. Pambuyo pake, ntchito yogwira ntchito idachitika ndikupanga dongosolo la chidziwitso la State Record of Diabetes Mellitus (GDS). Kapangidwe ka GDS kamawonetsedwa. Monga momwe maphunziro ndi maphunziro omwe adachitikira kunja komanso ku Russia Federation akuwonetsa, zovuta zazikulu zimakhalapo ndikupanga ndikusunga database ya anthu omwe ali ndi matenda osokoneza bongo omwe amadalira matenda a shuga (NIDDM).

Oposa 85% odwala ali ndi matenda osokoneza bongo omwe amadalira shuga. Mtunduwu wa matenda ashuga ndiwofalikira kuwirikiza ka 10 kuposa matenda a shuga a insulin - IDDM). Kuchulukana kwa NIDDM kukuchulukirachulukira pakati pa anthu azaka zapakati pa 40 ndi kupitirira ndipo amafikira pazofunikira kwambiri m'magulu azaka 60 ndi kupitirira. Nthawi yomweyo, kuchuluka kwa NIDDM, kojambulidwa ndi kusinthika, sikuwonetsa momwe zinthu zilili, popeza kuchuluka kwenikweni kwa odwala kumakhala kokwirikiza katatu kuposa komwe kunalembedwa. Popeza gawo lalikulu la odwala omwe ali ndi NIDDM pofika nthawi yomwe matendawa adakhazikitsidwa, nthawi yokhala ndi matendawa ili pafupifupi zaka 10, zikuwonekeratu chifukwa chake izi zikuwonetsa kuchuluka kwakukulu kwa zovuta zam'mitsempha.

Sizotheka kufufuza chiwerengero chonse cha anthu kuti pali NIDDM ya metropolis ngati Moscow, osatchulanso Russia yonse. Chifukwa chake, kuwunika momwe miliri ilili, maiko monga United States amagwiritsa ntchito maphunziro owonera za miliri m'magawo amodzi. Zotsatira za kafukufukuyu zimapangitsa kuti athe kuwunika momwe kuchuluka kwa kuchuluka kwa NIDDM kumasiyanirana ndi komwe kudalembedwa komanso zomwe zikuchitika mdziko lonse. Pachifukwachi, kafukufuku wosankha wa anthu aku Moscow adachitika ndipo zomwe adazipeza zidafanizidwa ndi kuchuluka kwa mbiri ya NIDDM.

Chifukwa chake, malinga ndi kafukufuku wofufuzira womwe udachitika ku Moscow, kuchuluka kwa kuchuluka kwa NIDDM kudapitilira kumene kudalembedwa mwa amuna ndi 2.0, ndipo mwa akazi ndi 2.37. Komanso, kuchuluka kumeneku kunadalira kwambiri zaka za odwala. Chifukwa chake, ngati mu gulu la zaka 40-49 panali 4,01, ndiye kuti m'gululo la zaka 60-69 panali 1.64 zokha. Kuchepa kwa kuchuluka kwa kuchuluka kwa kuchuluka kwa zolembedwa za NIDDM pakati pa okalamba kumalumikizidwa ndi kudziwika kwapamwamba kwamtunduwu wa shuga pakati pawo.

Chizindikiro chofunikira cha mtundu wa chithandizo ndi chisamaliro chodziwitsa odwala omwe ali ndi NIDDM ndi kuchuluka kwa kuchuluka komwe kunalembedwa komanso kuchuluka kwa zovuta za matenda ashuga. Njira zosasinthika zidagwiritsidwa ntchito kuyesa gulu la odwala omwe ali ndi NIDDM omwe amayang'aniridwa ndi endocrinologists am'madera. Zinapezeka kuti kuchuluka kwenikweni kwa zovuta za NIDDM monga retinopathy kudapitilira zomwe zalembedwa mu 4, 8, nephropathy ndi 8.6, polyneuropathy ndi 4.0, macroangiopathy a malekezero a 9.5 (Table 1). Palibe kusiyana kwakukulu komwe kunapezeka pakufalikira kwa matenda a mtima, kuchepa kwamitsempha, matenda oopsa, komanso ngozi ya mtima.

Gome 1 Momwe kuchuluka ndi kufalikira kwa zovuta za IDDM kwa odwala azaka zapakati pa 18 ndi akulu (%) kumachitikira

Kusanthula pazomwe zimayambitsa kufa kwa odwala omwe ali ndi NIDDM kumaphatikizapo kupeza chidziwitso chofunikira pakuwongolera njira zochizira komanso zodzitetezera. Malinga ndi olemba akunja, matenda amtima komanso oyambitsa kufa chifukwa cha odwala NIDDM ndi 75.1 - 87.7%. Malinga ndi deta yathu (Gome 2), gawo la matenda amtima mu kapangidwe ka zomwe zimayambitsa mwachindunji zakufa kwa odwala omwe ali ndi NIDDM anali 72.6%. Nthawi yomweyo, kugundika kwa mtima ndi komwe kunali chifukwa cha kufa kwa 40.4% ya milandu, kulowetsedwa myocardial - mu 15.4%, sitiroko - mu 16,8%. Myocardial infaration monga chifukwa cha imfayi inali zofala kwambiri mwa amuna kuposa azimayi (19,8 ndi 13.4%, motsatana), pomwe amayi - osalephera amtima (36,6 ndi 42.3%, motero). Chiwopsezo cha kufa kwa odwala omwe ali ndi NIDDM kuchokera kukomoka kwa matenda ashuga ndi 3.2%, ndipo mwa akazi amafikira 4.1%.

Zidziwitso za GBUZ ZOTHANDIZA NDIPONSO ZOTHANDIZA ZAUTHENGA WABWINO KWA KRASNODAR REGION

Pakadali pano, kuwonongeka kwachikhalidwe komwe kumakhudzana ndi kuchuluka kwa matenda ashuga, kulumala koyambirira ndi kufa kwa izo, komanso mtengo wamankhwala komanso kukonza odwala zimawoneka zazikulu kwambiri. Izi ndizomwe zimapangitsa kuti pakhale kuyesa kwakukulu, kapena, kwathunthu, kuyezetsa matenda ashuga pambuyo pazaka 40, kukhazikitsa mfundo zowunika zaumoyo wa anthu zomwe zalimbikitsidwa ndi WHO. Njira zothetsera izi ndi njira yeniyeni yodziwira NIDDM ndi zovuta zake, kupewa kwawo. Tsopano, pakubwera koyamba kwa wodwala yemwe ali ndi matenda ashuga kwa dokotala, ndi mayeso oyenerera, pafupifupi 40% ya milandu imawonetsa IHD, retinopathy, nephropathy, polyneuropathy, komanso matenda a diabetes. Kuyimitsa njirayi ndikuvuta kwambiri, ngati kuli kotheka, ndipo kumawononga ndalama zambiri kwa anthu ambiri. Zachidziwikire, pulogalamu yotere imafuna ndalama zambiri, koma zimabwera bwino. Service Diabetesology Service iyenera kukhala yokonzeka kupatsa mamiliyoni ambiri odwala omwe ali ndi matenda ashuga ndi mankhwala amakono komanso chisamaliro choyenera.

Kalata ya boma la odwala matenda ashuga iyenera kutenga gawo lalikulu pakuphunzira kuchuluka kwa matenda ashuga, malo ake m'magawo osiyanasiyana, m'mizinda, m'mizinda ndi kumidzi, kumpoto ndi kumwera, kutengera nyengo ndi nyengo, chikhalidwe cha chakudya ndi zina zambiri.

Miyezo ya ku Europe ndi yokhazikitsidwa ndi mbiri yaku Russia, yomwe ingalole kufananizira magawo onse a shuga ndi maiko akunja, kuneneratu kuchuluka konse, kuwerengera ndalama zowonekera mwachindunji komanso zosakhudzidwa, ndi zina zambiri.

Tsoka ilo, zovuta zachuma ku Russia zimalepheretsa kukhazikitsidwa kwa State Record of Diabetes Patients, kofunikira ku Russia

Kalata ya matenda ashuga ndi njira yodziwira yokha yojambulira zotsatira zakuwunika kosalekeza kwazachipatala komanso kuwunika kwa matenda ashuga ndi kufa kwake chifukwa cha izo. Dongosololi limaperekanso mwayi wowunika wodwalayo kuyambira pomwe amaphatikizidwa m'kaundula mpaka kumwalira. Kuchulukitsa kwa zidziwitso zolembetsedwa kumadalira ntchitozo, yankho lawo lomwe amakonzekera omwe akukonza mayina.

Zotsatira zoyambirira za kusanthula kwa deta yolembetsedwa ku Moscow ndi m'chigawo cha Moscow zinawonetsa mkhalidwe womvetsa chisoni wa chisamaliro chapadera kwa odwala omwe ali ndi matenda ashuga. Ku Moscow, 15,6% yokha ya ana odwala ali ndi matenda ashuga kwambiri, ndipo kutalika kwa matendawa kwa zaka zopitilira 10, kuchuluka kwa matenda ashuga kumafika pamiyeso yayikulu kwambiri: retinopathy - 47%, cataract - 46%, kunachepetsa kugwedezeka kwamphamvu - 34%, microalbuminuria - 16%.

Bungwe la State Record of Diabetes Mellitus lidzakulitsa kwambiri mlingo ndi kuwunika, kuwonjeza zambiri, kudziwa njira zopewa matenda ashuga, njira zikuluzikulu mowerengera, komanso kukonza chithandizo chamankhwala othandizira odwala komanso moyo wawo komanso nthawi yake. WHO imalimbikitsa izi mu "Program of Action" yawo.

Mu Russian Federation, zopitilira zikuluzikulu zoposa 10 mpaka 10,000 zimachitika chaka chilichonse. Zomwe zinachitika mu dipatimenti ya "odwala matenda ashuga" ku ESC RAMS zidawonetsa kuti nthawi zambiri kuchitira opaleshoni kotereku sikuyenera. Kuchepetsa malekezero am'munsi kunapeweka mu 98% ya odwala ochokera kumadera osiyanasiyana a Russian Federation omwe adalowetsedwa ku ESC RAMS ndi matenda a neuropathic kapena osakanikirana a SDS. Odwala omwe ali ndi trophic zilonda zam'mapazi, ma phlegmons, ngati lamulo, amagwera m'manja mwa madokotala a opaleshoni omwe sakudziwa kapena sakudziwa konse zovuta zachilengedwe zowonongeka kwa phazi la matenda ashuga. Ndikofunikira kukonza gulu la zipinda za CDS ndikuphunzitsa akatswiri ashuga, i.e. bungwe la chisamaliro chapadera cha odwala chotere.

Choyamba, mfundo zotsatirazi zowunikira odwala omwe atumizidwe kupewa ziyenera kuthandizidwa mwamphamvu: kuyang'ana miyendo nthawi iliyonse kukaonana ndi adotolo, kuyezetsa mitsempha kamodzi pachaka kwa onse odwala matenda ashuga, kuwunika kwa magazi m'magawo am'munsi mwa odwala omwe ali ndi IDDM -1 pachaka pambuyo pa zaka 5-7 kuyambira kumayambiriro kwa matendawa, odwala omwe ali ndi NIDDM - 1 nthawi pachaka kuyambira nthawi yodziwika bwino.

Pamodzi ndi zofunikira kuti pakubwezeretsedwe kwa matenda ashuga pofuna kupewa matenda ashuga, ndizovuta kuzindikira kufunika kwa maphunziro a shuga mu pulogalamu yapadera.

Kuphunzitsanso maulendo 5-7 kumachepetsa odwala omwe amapita kukaonana ndi dokotala ndipo, koposa zonse, kumachepetsa chiopsezo cha kuwonongeka kwa phazi.

Mu gulu lomwe lili pachiwopsezo, maphunziro amachepetsa pafupipafupi zilonda zapazi ndi 2, ndikuchepetsa pafupipafupi kukoka kwa 5-6.

Tsoka ilo, ku Russia Federation mulibe zipinda zambiri za CDS zoyipa zomwe kuphunzitsira odwala, kuwunika, njira zodzitetezera ndikugwiritsira ntchito matekinoloje amakono podziwitsa ndi kuchiza matenda osiyanasiyana a CDS kumachitika.

Tsoka ilo, nthawi zambiri munthu amamva za kusowa kwa ndalama kapena mtengo wokwera wokonza zipinda zapadera za SDS. Pankhaniyi, ndizoyenera kupereka deta pamitengo yomwe ikukhudzana ndi njira zosalekeza zosungira miyendo ya wodwalayo.

Mtengo wa nduna "odwala matenda ashuga"

2-6 madola zikwi (kutengera makonzedwe)

Mtengo wa maphunziro ndi madola 115.

Ndalama Zowonera Zamphamvu

(Wodwala 1 pachaka) - $ 300

Mtengo wa chithandizo kwa wodwala m'modzi

Fomu la Neuropathic - $ 900 - $ 2 zikwi

Fomu ya Neuroischemic - madola 3,000,5 madola.

Mtengo wa opaleshoni

Kukonzanso kwamasamba - madola 10-13 miliyoni

Kudulidwa kwa dzanja - madola 9-12 miliyoni.

Chifukwa chake, mtengo wa kudula mwendo umodzi umafanana ndi mtengo wodziyang'anira wokha wodwala wazaka 25 kapena bungwe ndikugwirira ntchito kwa maofesi a 5 Diabetesic Foot kwa zaka 5.

Ndizodziwikiratu kuti gulu la zipinda zapadera "phazi la shuga" ndiyo njira yokhayo yothandiza kwambiri kupewa komanso kuchiza odwala matenda ashuga omwe ali ndi SDS. Malo opangira "matenda ashuga" akupangika chifukwa cha zipatala zambiri zamizinda komanso malo ofufuzira komwe amathandizira kudziwa, komanso kuyan'anila kwa odwala kumachitika ndi ma endocrinologists kapena akatswiri ochokera kumaofesi a "Diabetesic foot" mothandizidwa ndi angiosurgeons. Njira zoterezi zimachepetsa chiopsezo chodulidwa miyendo mwa odwala matenda a shuga 2 kapena kangapo.

Ma Algorithms adapangidwa kuti azindikire, kuchiza komanso kupewa matenda ashuga, ndi cholinga chothandizira panthawi yake vutoli komanso kuthekera kochedwetsa kukula kwa siteji. Chithandizo chachikulu cha insulin chimatheka pokhapokha pogwiritsa ntchito njira zamakono zowongolera glycemic komanso kudziyang'anira pawokha.

Kuchuluka kwa retinopathy kumawonjezeka kwambiri ndi milingo ya glycogemoglobin (Hb A1c) yoposa 7.8%. Ndikofunika kuti kuchuluka kwa glycogemoglobin 1% yokha kumawonjezera mwayi wokhala ndi matenda ashuga retinopathy ndi 2! Pali kudalira kokhazikika kwa kulowetsedwa kwa myocardial mwa odwala NIDDM pamlingo wa glycogemoglobin komanso kutalika kwa matendawa. Kwambiri kuchuluka kwa glycogemoglobin ndi kutalika kwa matendawa, kumakhala pachiwopsezo chotenga myocardial infarction. Kuchokera pamenepa tifanizire kuti ndalama zikuyenera kuyang'aniridwa pokonza zowongolera, kukulira kakang'ono kwamakono, ma glucometer odalirika ndi mikwingwirima yodziwira shuga ndi mkodzo. Tiyenera kudziwa kuti glucometer zoweta ndi zingwe zimakwaniritsa zofunikira zamakono, kusintha kwawo kumafunikira thandizo la boma. Kampani yakunyumba "Phosphosorb" yakwanitsa kupanga zida zogwiritsira ntchito glycogemoglobin, yomwe ndi gawo lofunikira kwambiri pakupanga matenda ashuga, kuphatikizapo njira yothandizira.

Chifukwa chake, chinsinsi chowunikira thanzi la odwala omwe ali ndi matenda ashuga ndizowonetsetsa nthawi zonse ndi glycemia. Chidziwitso chothandiza kwambiri pakubwezeretsanso kwa shuga masiku ano ndi kuchuluka kwa hemoglobin ya glycated. Omalizirawa amalola osati kungoyesa kuchuluka kwa kubwezeretsa kwa chakudya cha m'mimba kwa miyezi iwiri yapitayi, komanso, komwe ndikofunikira kwambiri, kulosera kukula kwa zovuta zam'mimba.

Mwa kuchuluka kwa glycogemoglobin pagulu losankhidwa la anthu ena, ndizotheka kuyesa bwino ntchito ya ntchito zamatenda a dera, mzinda, etc., kuphatikizapo zida zamagetsi, thandizo la mankhwala, maphunziro a odwala, kudziyang'anira, ndi kuphunzitsa akatswiri.

Tiyenera kudziwa kuti ntchito zachipatala zaku Moscow zathandizira nawo kwambiri polimbana ndi matenda ashuga mzaka ziwiri zapitazi, ndikupereka ndalama zambiri ku pulogalamu ya matenda a shuga. Kuyambira 1997, Territorial Program "Disabetes Mellitus" idapangidwa mu Primorsky Territory.

Njira ya masiku ano yothana ndi zovuta ndiz njira zopewetsa, i.e. mwanjira iliyonse yofunikira popewa kapena kusiya ntchito yomwe yayamba kale. Kupanda kutero, tsoka silitha. Zowopsa zazikulu zomwe zimapangitsa kuti munthu akhale ndi diabetesic nephropathy (DN) ndi:

- chindapusa cholakwika cha matenda a shuga (HBA1c),

- Matenda a shuga

M'zaka zaposachedwa, kafukufuku wakuzama wasayansi wachitika pa majini - omwe akufuna kuchita nawo DN. Magulu awiri akuluakulu amitundu yoyimiridwa amaimiriridwa: yoyamba imaphatikizapo majini omwe akufuna kudziwa kuchuluka kwa matenda oopsa, ndipo chachiwiri - iwo omwe ali ndi vuto la kuchulukitsa kwa mesangium komanso scomosis yotsatira ya glomerulosis.

Pakadali pano, kusaka kukuchitika pakati pa majini omwe ali ndi zifukwa zachitukuko cha DN. Zotsatira zamaphunzirowa zibwera ku matenda ashuga posachedwa.

Kuwonekera kwa albumin ngakhale m'magawo ochepera (oposa 300 mcg / tsiku), omwe amatchedwa microalbuminuria, ndiwopseza kwambiri kwa dokotala komanso woleza, chizindikiritso cha chiyambi cha zochita zamphamvu kwambiri! Microalbuminuria ndiwonetseratu, harbinger wa DN. Ndi nthawi iyi yomwe chitukuko cha DN chikuyimitsidwa. Pali njira zina zoyambirira za DN, koma microalbuminuria ndi chizindikiro chofunikira, ndipo chimatha kutsimikiziridwa ndi madokotala ndi odwala omwe ali kunja kapena malo okhala. Mothandizidwa ndi chingwe chapadera, chotsitsidwa mumtsuko wa mkodzo, kupezeka kwa microalbuminuria kumadziwika kwenikweni mkati mwa mphindi imodzi. Zowonjezerazo zikapezeka, kuphatikiza pa zochita zomwe zimapangidwira kubwezeretsa bwino kwa carbohydrate metabolism, zoletsa za ACE ziyenera kuyikidwa nthawi yomweyo mu zovuta zochiritsira ndikuwunika magazi pafupipafupi kuyenera kukonzedwa.

Zochitika zikusonyeza kuti kuikidwa kwa mankhwala m'gululi kumatsogolera ku kutha kwa albinuria komanso kufalikira kwa magazi. Ma inhibitors a ACE amawonetsedwa kwa microalbuminuria komanso kuthamanga kwa magazi, omaliza osasinthika panthawi ya chithandizo.

Ngati "amayang'anitsitsa" gawo la microalbuminuria, ndiye kuti panthawi ya proteinuria ndizosatheka kuyimitsa chitukuko cha DN. Ndi masamu mwatsatanetsatane, nthawi ya kupitirira kwa glomerulosulinosis ndi kukula kwa aimpso kulephera ndi zotsatira zakupha kutha kuwerengera.

Ndikofunikira nthawi zonse kuti musaphonye magawo oyamba a DN ndipo, koposa zonse, gawo lomwe limapezeka mosavuta la microalbuminuria. Mtengo wochizira odwala matenda ashuga kumayambiriro kwa NAM ndi $ 1.7 miliyoni ndi moyo wathunthu ndi $ 150,000 pamlingo wa uremia ndipo wodwalayo wagona. Ndemanga pazowona izi, zikuwoneka, ndizosafunikira.

Kuwongolera kwa kuthamanga kwa magazi mu shuga kuyenera kuchitika mofulumira mutazindikira kuwonjezereka kwa izo.Mankhwala osankhidwa ndi oletsa enviotensin-kutembenuza: Renitec, Prestarium, Tritace, Kapoten, calcium motsutsana ndi magulu a Verapamil ndi Diltiazem, pakati pa okodzetsa Arifon omwe adakonda, posachedwa mankhwala atsopano amphamvu - Losartan, Cint, etc. Kuchita zoterezi kungachepetse kuchuluka stroko, zimawonjezera nthawi yayitali komanso moyo wa odwala omwe ali ndi matenda ashuga.

Kuti muwone kusintha koyambirira kwa fundus ya odwala omwe ali ndi matenda a shuga, ndikofunikira kuchita kafukufuku ndi ophthalmologist osachepera 1 pachaka. Pamaso pa matenda a shuga a retinopathy: katatu pachaka kuchitira chithandizo cha panthawi yake m'malo opezeka. Mu diabetesic retinopathy (DR), malinga ndi deta yoyambira, mtundu wa catalase uli ndi chitetezo chake. Mphamvu zoteteza za 167 allele zimawonetsedwa mokhudzana ndi DR ku NIDDM: odwala osakhala ndi DR okhala ndi nthawi yayitali yoposa zaka 10, pafupipafupi zomwe zimachitika mwanjira imeneyi zimakhala zapamwamba kwambiri poyerekeza ndi odwala omwe ali ndi nthawi yakuyamba ya DR omwe amakhala nthawi yayitali ya NIDDM.

Zomwe zimachitika kuti ziwonekere zamtundu wamtundu wa ntchofu zachilengedwe zimafunikira mosakayikira, zimafunanso kafukufuku wina wazakafukufuku, koma kale lero amalimbikitsa chiyembekezo kwa odwala ndi madokotala.

1. Kuzindikira chibadwa cha mtundu wa matenda ashuga nephropathy komanso kuzindikira mtundu wa polymorphism wa angiotensin-1-kutembenuza enzyme ngati gawo la chiopsezo cha angiopathy komanso ngati gawo lochita bwino pa antiproteinuric therapy.

2. Kukhazikitsa zodzitchinjiriza za imodzi mwazomwe zimayambitsa mtundu wa matenda am'mimba molingana ndi mitundu iwiri ya matenda ashuga a mellitus ndi matenda ashuga nephro- ndi retinopathies.

3. Kupanga njira yodziwika yophunzirira chibadwa kapena kutsutsana ndi matenda ashuga a shuga ndi kupanga maziko a ntchito ina mbali iyi.

Tsiku Lonjezedwa: 2015-05-28, Views: 788,

»Chiritsani matenda a shuga

Kulembetsa matenda a shuga

Kulembetsa matenda a shuga

Kalata Yachikhalidwe ya Matenda A shuga yakhazikitsidwa ndi Federal State Budgetary Institution Endocrinological Science Science Center molumikizana ndi Aston Consulting CJSC ngati gawo la kuwunika ndi matenda omwe amayambitsa matenda ashuga ku Russian Federation.

Lembani Development Concept:

• 100% Kuphunzira mitu yamgwirizano
• Chitsimikiziro ndi kusanthula kwakasayansi

• Kapangidwe ka kaundula wa zovuta ndi matenda okhudzana ndi kapangidwe ka kaundula wa matenda a shuga
• kuchita maphunziro a pharmacoeconomic

• Kukula kwa portal kwa endocrinologists
• Malipoti asayansi pamabungwe apadziko lonse lapansi molingana ndi kuchuluka kwa Kalata wa matenda ashuga

Kwa akatswiri azachipatala:

• kumanga tsamba lanu la odwala
• kumasuka kolowera ndi kugwiritsa ntchito
• kuwunikira kufunika kwa mankhwala, zida zamankhwala
• mafomu okonzekela

Kwa FSBI Endocrinology Research Center:

• chida chambiri chomwe chimakupatsani mwayi wokhudzana ndi kuwunikira ntchito zamankhwala komanso matenda
• zogwirizana, cholinga cha matenda, matenda ndi matenda a shuga ku Russian Federation
• mwayi wofotokozera za Unduna wa Zaumoyo wa Russia

Kufalikira kwa matenda ashuga amtundu 1 ku Russian Federation pa 01/17/2018

(Madera 4 malinga ndi Rosstat: Krasnoyarsk Territory, Udmurt Republic, Sakhalin Region, Chukotka Autonomous Region)

* idayika madera malinga ndi Rosstat kwa g

Kukula kwa matenda ashuga amtundu wa 2 ku Russian Federation pa 01/17/2018

(Madera 4 malinga ndi Rosstat: Krasnoyarsk Territory, Udmurt Republic, Sakhalin Region, Chukotka Autonomous Region)

* idayika madera malinga ndi Rosstat kwa g

Miyezo yamadera (ON 01/17/18)

mothandizidwa ndi Endocryonological Science Science Center

Serkov Alexey Andreevich

Nambala yaofesi: +7 499 124-10-21

Kusankhidwa zochitidwa ku registry kapena pa foni: +7 495 500-00-90

Dipatimentiyi ili ku Federal State Budgetary Institution Research Center for Endocrinology ku ul. Dm Ulyanova, 11

117036, Moscow,

st. Dmitry Ulyanov, d.11

115478, Moscow,

st. Moskvorechye, d.

State Record of Diabetes Patients ndiye njira yayikulu yowerengera ndalama zomwe boma limapeza chifukwa cha matenda ashuga komanso momwe aliri

Epidemiology ndi Kulembetsa kwa matenda ashuga

State Record of Diabetes Patients ndiye njira yayikulu yowerengera ndalama zomwe boma limapeza chifukwa cha matenda ashuga komanso momwe aliri

Yu.I. Suntsov, I.I. Agogo

ГУ Endocrinological Science Science Center 1 (dir. - Acad. RAS and RAMS II Dedov) RAMS, Moscow |

Dongosolo lakafukufuku wakuchipatala-samalola kupeza chidziwitso chokhudzana ndi matenda a shuga mellitus (DM). Kukonzekera chisamaliro chapadera cha odwala, kupereka mankhwala, kupereka odwala omwe ali ndi zida zothandizira odwala matenda ashuga, kuwongolera zochitika zamatsenga, kuchuluka kwa chithandizo ndi chisamaliro chothandizira, ndi zina zambiri, kuphatikizapo kuphunzitsa ndi kupereka akatswiri, amafunikira chidziwitso chodalirika komanso chapanthawi yake. Pamenepa, vuto la kuwerengera kwathunthu komanso mwadongosolo osati zokhazokha zodwala kapena kufa, komanso zisonyezo zaumoyo wa odwala, kuchuluka kwa moyo wawo, kupezeka kwa zovuta za matenda ashuga, zambiri zokhudzana ndi chithandizo cha odwala komanso kulandira mankhwala ochepetsa shuga, chidziwitso pazomwe zimapangitsa kulemala ndi kufa kwa odwala kwakhala kwachangu. ndi zina zambiri.

Pochita mdziko lapansi, mavutowa amathetsedwa ndikupanga mayina a matenda ashuga. M'mawonedwe amakono, kulembetsa kwa odwala omwe ali ndi matenda osokoneza bongo, choyambirira, ndi njira yowerengera yokha yowunikira momwe boma lakhalira ndi odwala omwe ali ndi matenda osokoneza bongo, kuchuluka kwa chisamaliro chachipatala komanso kupewa komanso zochitika zokhudzana ndi matendawa. Dongosolo limapereka kuyang'anira wodwala kuyambira pomwe akudwala mpaka nthawi yakufa kwake.

Tiyenera kudziwa kuti kuwonjezera pazofunikira zenizeni, zambiri zomwe zalembedwa ndizofunikira kwambiri pakuwona mtengo wamankhwala ochizira matenda a shuga, ndi chidziwitso chofunikira pakuwunikira maphunziro a zovuta zingapo za matenda ashuga, kuphatikizapo zachuma ndi zamankhwala komanso chikhalidwe.

Cholinga chachikulu chobweretsera tekinoloje yatsopano yochizira matenda ashuga sichingangokhala chindalama chokwanira komanso chothandiza kwambiri kwa matenda a carbohydrate metabolism, koma mokulira kuchepetsa chiopsezo chokhala ndi zovuta zake, kusintha mtundu ndi chiyembekezo cha moyo wa odwala ndipo, chifukwa chake, mtengo wokhudzana ndi kuchiza zovuta, mabala

kulemala ndi kufa kwa odwala.

Amadziwika kuti ndalama zazikulu zomwe zimakhudzana ndi matenda ashuga sizothandiza mankhwalawa payekha, koma chithandizo cha zovuta zake, zomwe zimayambitsa kulumala koyambirira komanso kufa kwa odwala. Komanso gawo la ndalamazi limafikira 90% yazinthu zonse zokhudzana ndi chithandizo cha odwala omwe ali ndi matenda ashuga. Chifukwa chake, magawo azachuma pochiza zovuta za matenda ashuga ndi amodzi mwamagwiritsidwe ofunikira kwambiri malinga ndi chiyembekezo chotsatira chachuma chobweretsa mankhwala atsopano ndi matekinoloje azithandizo ambiri.

Chidwi chokulirapo cha ofufuza chidayamba kukopa mavuto azachuma a matenda ashuga a mtundu 2. Izi ndichifukwa choti kuchuluka kwa odwala omwe ali ndi matenda ashuga a 2 kuthamanga kwambiri kuposa kuchuluka kwa matenda ashuga 1, mtengo wa mankhwala, njira zamankhwala, mayeso ndi magulu ena azachipatala ndi omwe akuwonjezeka, omwe, akuphatikizira kuwonjezeka kwa mitengo yolumikizidwa mwachindunji kapena m'njira zina. ndi matenda ashuga. Zatsopano, zothandiza kuchepetsa matenda a shuga sizotsika mtengo. Mitundu yamtundu wa chithandizo monga opareshoni malekezero (kuphatikiza mafupa opanga maumboni), ma coronary artery bypass grafting, kupatsirana kwa impso, hemodialysis ndi ena enanso pano akuwonedwa kuti ndiofala, koma mtengo wake umakhalabe wokwera, chifukwa chake kupezeka kwa mitundu iyi kwa odwala ambiri, makamaka pano mdziko muno muli vuto.

Chifukwa chake, kuchokera pakuwona zachuma, ndikofunikira kwambiri kumvetsetsa zomwe ndalama zomwe zapatsidwa ndizopereka lero komanso zomwe zikuchedwa kutha ngati mavuto omwewo atha kuthetsedwa chiwerengero cha odwala chikakula kwambiri, komanso kuchuluka kwa zovuta pakati pawo kumakhalabe kofanana.

Mu pepala ili, kuyesayesa kumawerengera mtengo wokhawo wakuchiritsira matenda ashuga komanso zovuta zake, kutengera, pogwiritsa ntchito mitundu yolosera yomwe imavomerezedwa, kuwunika momwe chuma chikuyendera masiku ano. Ziwerengerozi zimatengera deta ya State Record ya odwala omwe ali ndi matenda ashuga ku Russia.

Zipangizo ndi Njira

Poyamba, zitsanzo zosasinthika za odwala 500 omwe ali ndi matenda a shuga adayesedwa m'malo 15 a Russian Federation. Malinga ndi kufunsa kwapadera, chidziwitso chinasonkhanitsidwa chokhudzana ndi chithandizo cha odwala awa ponseponse pompopompo komanso kunja. Mitengo ya mankhwala osokoneza bongo idafotokozedwa ngati gawo lolemedwa pakati pazomwe amagulitsa omwe amagulitsa mankhwala a federal (PMs), komanso malinga ndi JIC Price Register. Mtengo wa ntchito zachipatala zosavuta unakhazikitsidwa malinga ndi "Malipiro azithandizo zamankhwala" omwe amaperekedwa kwa akuluakulu malinga ndi mitengo ya inshuwaransi yazachipatala yoyenera. Nthawi yomweyo, mtengo wamasiku ogona sunaphatikizepo mtengo wazidziwitso, njira zamankhwala ndi JIC. Gawo lachiwiri, pamaziko a mtundu wa Diabetes Mellitus Model (DMM) mtundu wa matenda osokoneza bongo ndi chidziwitso cha GDS, komanso mtengo wa kuchiritsa zovuta za matenda ashuga, kulosera kwakubwera kwa zovuta za matenda ashuga komanso mtengo wapachaka wodwala 1 adatsimikizika.

Pa gawo lachitatu, kutengera ndi kuchuluka kwa State Register of Patients ndi matenda ashuga ku Russia, mtengo wokwanira wowerengetsa odwala matenda ashuga ku Russia panthawi yophunzirayo ndi kwa zaka 10 kuyambira pachiyambire kafukufukuyo atawerengedwa, bola kuchuluka kwa glycoHbA1c kumatsika ndi 1.0% yokha. Dziwani kuti chifukwa cha izi ndikofunikira kuti tisinthire bwino zomwe zili kale pankhani ya matenda ashuga komanso zovuta zake komanso kugwiritsa ntchito njira zatsopano za matenda ashuga kulikonse. Mukamawerengera mtengo wamankhwala, mtengo wowerengeka wa mankhwala ndi ntchito zamankhwala panthawi yophunzirayo amawerengedwa. Poyerekeza mtengo wamankhwala odwala, njira yodulira ndalama idagwiritsidwa ntchito molingana ndi kakhazikitsidwe: ot = 1 / (1 + ^) ', komwe kuli kuchotsererana, ndi chiwerengero cha nthawiyo, n ndiye kuchotsera kwa nthawi ya i-th munthawi yazigawo .

Zotsatira ndi zokambirana

Zambiri pa kuchuluka kwa matenda ashuga amtundu 1 (kuchuluka kwa kusinthasintha kwa zigawo za Russia) kukufotokozedwa mu mkuyu. 1. Kuchuluka kwa zovuta zamagulu ochepa mwa odwala omwe ali ndi matenda amtundu wa 1 ndi apamwamba kuposa matenda ashuga amtundu wa 2, ndipo zovuta zazikulu m'magazi ndizochepa. Chifukwa chake, izi zimawerengedwa m'mawerengero azaka

Wakhungu w 2.3 45.4

Macroangiopathy n / a ^ ishinnshinninnn 35.6 •

Matendawa odwala matenda ashuga ■unso a m'thupi la shuga a 11.9 pct

Kudzicheka mkati mwa phazi c * 2.1 ® max.

Zolemba pamlingo wa shin ndipo pamwamba pa w2,1

Myocardial infarction | vmsh | 6.1 Stroke 7 6

Matenda oopsa 37.4 L,

.1 10 20 30 40 50 60 70

Blindness Nephropathy Gender ndi neuropathy Autonomous neuropathy Macroangiopathy n / a Diabetesic phazi Kulupika mkati mwa phazi Ndikulupidwa kunsi kwa mwendo ndi kumtunda kwa CHD

Myocardial infarction Stroke Hypertension

10 20 30 40 50 60

Mkuyu. 2. Kufalikira (kochepa komanso kokwanira) kwa zovuta za matenda amtundu wa 2 m'magawo a Russia.

kugwiritsa ntchito mankhwalawa matenda a shuga komanso zovuta zake.

Mwa odwala omwe ali ndi matenda ashuga, pamatha kukhala anthu omwe amaphatikiza

2-3 komanso zovuta zina. Timawonetsa mtengo wa zovuta izi panthawi ya kafukufuku, i.e. mu 2003

Ziwerengero zakuchiritsa kwa odwala omwe ali ndi matenda ashuga mu 2003 akuphatikiza zovuta zonse za matenda ashuga, kuphatikizapo matenda ashuga komanso a hypoglycemic, matenda ashuga othamanga, matenda amtima komanso aimpso, komanso ena. Mtengo wa zovuta zochepa chabe umawonetsedwa mu mkuyu. 3.

Kutengera ndi kuchuluka kwa dipatimenti ya boma la matenda a shuga a State on the kuongezeka kwa zovuta za shuga zomwe zikuphatikizidwa pakuwunika kwachuma, mtengo wawo wamankhwala mu 2003 ndi kwa zaka 10 anawerengedwa poganizira kugwiritsa ntchito njira zamakono. Kuwona zizindikiro zodziwikiratu za matenda okhudzana ndi matenda ashuga komanso kutengera zovuta zake sizingasinthe kwambiri pakubwera

Zaka 3-5, kudalirika kwakukulu, tatsimikiza nyengo yolosera zaka 10.

Ndipo ngati tiwerengera mtengo wathunthu wa wodwala 1 pachaka, tipeze zambiri kapena zochepa poyerekeza. Chifukwa chake, ku United States, ndalama zowonongera wodwala pachaka zinali $ 5,512,5 mu 1997, $ 3080 ku England, $ 3209 ku Finland, $ 2060 ku Australia, ndi $ 353 kokha ku Central ndi South America chaka. Zikuwonekeratu kuti

Myocardial infarction $ 1395

Nephropathy 1350 S

Retinopathy 1200 S

Polyneuropathy 960 S

Matenda oopsa 1070 S

1000 2000 3000 4000 5000

Mkuyu. 1. Kufalikira (kochepa komanso kokwanira) kwa zovuta za matenda amtundu 1 m'magawo a Russia.

Mkuyu. 3. Mtengo wapachaka wowerengetsera zovuta zina za wodwala m'modzi wodwala (mu IIB About).

Kuchulukitsa kwa mitengo imeneyi kumadalira kuchuluka kwa chisamaliro chachipatala kwa wodwala ndipo mwina sizingafanane ndi mtengo wokwanira komanso wokwanira wa matenda ashuga.

Kuwerengera kwanu kwamtengo

Kwa odwala matenda ashuga, tidamanga mtengo womwe udalipo ku Russia mtengo wamankhwala, zida zodziyang'anira, zida, chithandizo kuchipatala komanso nthawi yanthawi, maphunziro a odwala, ndi zina zambiri. Komanso, tidazindikira kuti mitengo iyi imadalira kwambiri kuwonongeka kwa matenda ashuga odwala komanso kuwopsa kwawo. Chifukwa chake, pafupifupi $ 68.6 pachaka amathera pa chisamaliro cha maso kwa wodwala yemwe ali ndi retinopathy yoyambirira, ndipo $ 1030.0 imagwiritsidwa ntchito pamitundu yolimba kwambiri, ndiye kuti, maulendo 15 ochulukirapo. $ 245.0 pachaka imagwiritsidwa ntchito pochiza wodwala yemwe ali ndi nephropathy poyambira gawo, ndipo $ 2012.0 popanda hemodialysis, kupatsirana kwa impso, ndi zina zambiri, kumagwiritsidwa ntchito pazovuta za aimpso (CRF). Poyerekeza, mtengo wochizira matenda a impso ku United States ndi $ 45,000 pachaka.

Avereji ya chiwongola dzanja cha munthu m'modzi pa chaka, poganizira zovuta zomwe zimachitika mu shuga

Mtundu 1 wopanda zovuta wafika $ 1,124.0, wokhala ndi matenda ashuga

Mitundu iwiri - $ 853 pachaka. Amachulukirachulukira kumayambiriro kwa zovuta za matenda ashuga, pomwe chiwongola dzanja chazovuta kwa wodwala amtundu wa 1 chimawonjezeka kufika $ 2146.0, ndikulemba matenda ashuga 2 - mpaka $ 1786.0 pachaka. Ngati odwala ali ndi zovuta zazikulu monga kuperewera kwa impso, khungu komanso matenda a khungu, odwala matenda ashuga omwe samangofunika kungokhala othandizira komanso opaleshoni (pulasitiki yamitsempha, kudzicheka kutsatiridwa ndi ma prosthetics), kulowerera m'mitsempha, ngozi yamatenda - chindapusa chimawonjezeka kwambiri. Pafupifupi, amakhala $ 24,276.0 pachaka kwa 1 wodwala wokhala ndi matenda amtundu 1 komanso $ 8,630.0 a mtundu 2 shuga.

Kutengera ndi kuchuluka kwa matenda am'matenda, tidawerengera mtengo wowonjezera wa matenda ashuga ku Russia. Pofika pa 01.01.04, ana 15 918, achinyamata 10 288 ndi akulu 239 132 omwe ali ndi matenda amtundu 1, ana 503 ndi achinyamata, 1 988 228 akuluakulu omwe ali ndi matenda a shuga a 2 adalembetsa mdziko muno.

Type 1 and Type 2abetes, Type 1 and Type 2abetes, Type 1abetes, Type 2abetes, ana, achinyamata, akulu, akulu

Mkuyu. 4. Zowongolera mwachindunji ku Russia mu 2003 kwa odwala matenda a shuga (m'mamiliyoni a IBS).

Zambiri pamitengo yapachaka pachaka cha odwala omwe aku Russia akuwonetsedwa ku mkuyu. 4. Chifukwa chake, zolipira mwachindunji kwa ana odwala matenda amtundu woyamba 1 ndi shuga 2 zimakwana $ 28,7 miliyoni pachaka, kwa achinyamata omwe ali ndi matenda ashuga

Lembani 1 ndi mtundu 2 - $ 23,4 miliyoni pachaka, kwa akulu omwe ali ndi matenda amtundu 1 - $ 2,345.3 miliyoni pachaka, ndi mtundu wa 2 shuga - $ 6,120.8 miliyoni pachaka. Chifukwa chake, kuwerengetsa kumawonetsa kuti ndalama zachindunji zomwe zimakhudzana ndi matenda a shuga ku Russia mu 2003 ziyenera kukhala $ 8518.2 miliyoni. Kuchuluka kwake kuchuluka kwake ndi ndalama zenizeni ndi nkhani yofufuza mwakuya. Komabe, ngati muwerengedzeranso kuchuluka kwa pafupifupi kwa mtengo uliwonse pamlingo wodwala ku Russia, mumapeza ndalama zofanana ndi zotengera zomwezi ku mayiko aku Europe - $ 3,745.6 pachaka. Pankhaniyi, ziyenera kukumbukiridwa kuti phindu limatha kuchepa ngati ndalama zitha kugwiritsidwa ntchito moyenera.

Ndalama Zochizira

zochizira matenda a shuga

Mkuyu. 5. Kuyerekeza ndalama zomwe zimaphatikizidwa ndi chithandizo cha matenda osokoneza bongo ndi mtengo wa kuthana ndi zovuta.

yogwira, poganizira momwe kupita patsogolo kwa matenda ashuga. Koma amatha kukula ngati ndalama zatsopano zamakono zamankhwala ndikupewera sizinali zokwanira.Cholemetsa chachikulu pazotchipa ndi kuchiza kwa zovuta za matenda ashuga. Tiyenera kukumbukira kuti ndalama zokhudzana ndi matenda a shuga zimangokhala 40-50% yokha ya mtengo wonse wa matenda ashuga, kuphatikiza mtengo wosalunjika. Chifukwa chake, akuwonetsedwa ku mkuyu. 3 zolunjika ziyenera kuchulukitsidwa kuwirikiza

Mavuto a Microvessel

Chida chachikulu cha Macro chimadziwika bwino

0 200 400 600 800 1000 1200 1400 1600 1800

Mkuyu. 6. Kuchepetsa ndalama zochizira matenda ashuga

pang'onopang'ono kutsika kwa 1% pakati pa glycogen1c

Mtengo wa boma la odwala omwe ali ndi matenda ashuga pakukonzekera ntchito ya matenda ashuga

Zida za IV All-Russian Congress of Endocrinologists

Yu.I. Suntsov, S.V. Kudryakova, L.L. Chisamba

Pochita mdziko lapansi, mavuto awa amathetsedwa ndikupanga mayina a odwala omwe ali ndi matenda ashuga. Ku Russia, kukhazikitsidwa kwa State Register of Patients ndi matenda a shuga (GDS) kuyandikira.

Pakadali pano, opitilira theka la odwala onse (1200.0 zikwi) akuphatikizidwa mu State Register ndipo zina mwazidziwitso zake adzapatsidwa m'nkhaniyi.

Masiku ano, kaundula wa anthu odwala matenda ashuga ndi njira yowerengera yokha yowunikira yomwe ikukhudzana ndi matenda ashuga, mkhalidwe waumoyo wa odwala, mtundu wa chisamaliro, ndikuwonetseratu zochitika zachipatala, zachikhalidwe komanso zachuma.

Kapangidwe ka kaundula ndi mtengo wa momwe ntchitoyo idzakhalire mu zaka 5 zikubwerazi, ngati nkhokwe yosungidwa imasungidwa molondola, ndipo koposa zonse, kuti zidziwitso zomwe zalandira zimagwiritsidwa ntchito mwachangu osati pakatikati, komanso kwanuko, zigawo.

Kodi kulengedwa kwa GDS ku Russia ndi gawo liti? Kwa akatswiri omwe amasunga kulembetsa kwa matenda ashuga, masemina amachitika kumadera. Cholinga cha zokambirana

Choyamba, ndikuphunzitsa, kudziwana ndi zomwe zatsopano zikuchitika mumapulogalamu, njira zothandizira kuthetsa mavuto osonkhanitsa zidziwitso zapamwamba, kuyimilira komanso kuwongolera, kukambirana mavuto omwe amakumana nawo m'magawo popanga ndikugwiritsa ntchito mayina a odwala omwe ali ndi matenda ashuga.

Oimira zigawo 70 adachita masemina oterowo, madera 74 adalandira mapulogalamu, ndipo pakadali pano malo opitilira 60 a GDS apangidwa ndipo akugwira ntchito ku Russia. Zikukonzekera kumapeto kwa chaka chino molingana ndi dongosolo la Unduna wa Zaumoyo kuti amalize kulenga.

State Institution Endocrinological Research Center (Dir. - Acad. RAMS I.I.Dedov) RAMS, Moscow

malo akumagawo onse a Russian Federation. Chaka chilichonse, Bungwe la Unduna wa Zaumoyo limawunika zotsatira za pulogalamu ya feduro ya "Diabetes Mellitus", kuphatikizapo ntchito yokhazikitsa malo amtundu wa GDS. Atsogoleri a oyang'anira mabungwe azaumoyo apemphedwa kuti apereke ndemanga ya pulogalamuyo.

Thandizo laukadaulo ndiukadaulo limaperekedwa mwachindunji komanso kudzera pa intaneti, pomwe malo apadera, "Dongosolo la Matenda A shuga", amakhala otseguka. Tsambali lili ndi pulogalamu yonse, komanso zosintha zaposachedwa zomwe mungathe kutsitsa ndikukhazikitsa pakompyuta yanu.

Pulogalamu yatsopano (2nd) ya pulogalamu ya "matenda a shuga a 2002" idapangidwa, yomwe imaganizira zokhumba zonse zomwe zalandira kuchokera kumagawo munthawi yogwiritsira ntchito mtundu wa 1, womwe ndi: kuwongolera mwanzeru mukalowa ndikuphatikiza nkhokwe, kulumikizidwa kwa makhodi a OKATO ndi madera ndi kuchuluka kwajambulidwe, mphamvu yazowonetsa anthu ndi zowerengera, zidakulitsa kuthekera kwa zitsanzo zamagulu ndi matebulo opanga, ndi zina zambiri.

Chomwe chikuwonetsa kwambiri za kufalikira kwa matenda ashuga ndi kuchuluka. Kukula kwa matenda amtundu woyamba 1 komanso mtundu wa 2 wodwala m'magawo osiyanasiyana a Russia kumasiyana kwambiri ndi zisonyezo zonse za ku Russia, zomwe 01.01.2001 zimakwana 224,5 pa zana lililonse la 1 matenda amtundu wa 1 komanso 1595.4 pa 100 zikwi za mtundu 2

Bryansk dera hn h

Republic Mari El 75.3

Nizhegorol. reg. 112.2

Dera la Perm 122.2

Dziko la Komi 156.2

Dera la Oryol 175.4

D F 1ZH1

Pa NYU 000 anthu okhala ndi I g l

Mkuyu. 1. Kufalikira kwa matenda a shuga amtundu 1 ndi 2 kumadera ena a Russia mu 2000

anthu oyenerera. Poyerekeza, tinaphunzira kufalikira kwa matenda ashuga a mtundu woyamba 1 kumadera a Bryansk ndi Saratov.

Mchigawo cha Saratov, kuchuluka kwa matenda ashuga amtundu wa 1 mwa akulu ndi 4 kuchulukirapo kuposa m'chigawo cha Bryansk ndipo alipo 66,5 ndi 249.1 pa anthu zikwizikwi zana limodzi, malinga ndi ziwerengero za boma, 260.8 ndi 252.1 pa 100 miliyoni .Akuluakulu).

Kusiyanaku kwakukuru pakati pa mbiri yakalembera ndi ziwonetsero zofunikira kumafunikira maphunziro a miliri. Zomwe zimasiyanitsa izi ziyenera kufotokozedwa, zomwe zimachepetsa kwambiri odwala omwe ali ndi matenda amtundu wa 1 m'magawo omwe ali ndi kuchuluka kwake.

Kuti tiyerekeze kufalikira kwa matenda ashuga a 2, tinayang'ana zigawo za Oryol ndi Nizhny Novgorod. Kudera la Nizhny Novgorod, malinga ndi kaundula, kuchuluka kwa matenda ashuga a 2 kukuwonjezeka katatu kuchulukirapo kuposa dera la Oryol, ndipo ndi 685.4 ndi 1345.1 pa akulu chikwi zana.

Malinga ndi ziwonetsero zakale, kuchuluka kwa matenda ashuga a 2 m'maderawa ndi 1591.4 ndi 1967.4 pa anthu zikwizikwi zana limodzi. Vutoli likufanana ndi la mtundu woyamba wa matenda ashuga.

Wina akuganiza kuti ziwonetserozi zimakwezedwa kwambiri. Ngati izi zikuchitika chifukwa chobwereza zidziwitso zokhudzana ndi odwala, kulembetsa sikulephera izi, chifukwa kuyang'anira aliyense kumachitika.

Zomwe zimachitika (pafupipafupi) ndi chimodzi mwazofunikira kwambiri zokhudzana ndi matenda ashuga.

Malinga ndi ziwonetsero zakale, pa 01.01.2001, kuchuluka kwa matenda ashuga ku Russia anali 13.3, mtundu wachiwiri wa matenda ashuga anali 126.0 pa akuluakulu 100,000. Ngati tingayerekeze madera a Bryansk ndi Saratov, titha kuwona kuti m'dera la Saratov kuchuluka kwa matenda ashuga a mtundu woyamba kumakulirakuli katatu kuposa 3 m'chigawo cha Bryansk ndipo akukwana 6.54 ndi 2.08 pa zana la achikulire.

Malinga ndi ziwerengero zalamulo, palibe kusiyana kwakukulu pakati pa zigawozi, ndipo ziwonetserozo ndi 13.1 ndi 12,2 mwa akuluakulu zana, motsatana.

logo ya anthu (mdera la Bryansk, zochitika za matenda amtundu wa 1 zikukwera pang'ono kuposa dera la Saratov). Poyerekeza zisonyezo za zigawo za Oryol ndi Nizhny Novgorod pazomwe zimayambitsa matenda a shuga 2, zitha kuwoneka kuti ndizochulukirapo ka 4.5 kuposa m'dera la Oryol ndipo, malinga ndi kalembedwe, ndi 33, motsatana.

5 ndi 111.9 pa akulu 100,000. Malinga ndi ziwonetsero zakale, kuchuluka kwa matenda ashuga amtundu wa 2 m'dera la Oryol ndiokwera kwambiri kuposa dera la Nizhny Novgorod.

Chifukwa chake, zomwe zimachitika ndi ziwopsezo zofanana ndizofanana ndi momwe kuchuluka kwa matenda ashuga kumadera komwe kumayerekezedwera.

Palibe chidziwitso chotsimikizika chokhudza kufa kwa odwala omwe ali ndi matenda ashuga. Zambiri zaimfa pogwiritsa ntchito rejista yomwe imapezeka koyamba.

Kulembetsa kumakupatsani mwayi wodziwa zotsatira zaimfa kwa odwala matenda ashuga. Dera la Bryansk silinapereke chidziwitso pakufa kwa odwala omwe ali ndi matenda amtundu wa 1, m'dera la Saratov ndi otsika kwambiri - 1.7 pa 100 zikwi za anthu (mkuyu.

3). Pafupifupi anthu 7 pachaka amadwala matenda ashuga, ndipo ochepera awiri amafa.

Ili likhoza kukhala yankho ku funso loti bwanji m'dera la Saratov kuli anthu ambiri odwala matenda ashuga 1 (pali mtundu wa "kudziunjikira" kwa odwala matenda ashuga).

M'madera a Oryol ndi Nizhny Novgorod, imfa za odwala omwe ali ndi matenda a shuga a 2 anali 5.14 ndi 76.66 pa akuluakulu 100,000, motero (ziwonetsero ndi 26.0 ndi 116.0). Ngati ziwonetsero zomwe zikuchitika mdera la Nizhny Novgorod zinali zochulukirapo ka 4,5, ndiye kuti anthu akufa anali okwanira maulendo 15 kuposa a Oryol.

Kudera la Oryol, kwa 1 wodwala yemwe ali ndi matenda a shuga a 2, pali anthu 5 omwe ali ndi matenda a 2, pomwe kudera la Nizhny Novgorod kuli odwala ochepera 2 pa munthu 1 womwalira. Zikuwonekeratu kuti ndi chiwerengero chomwecho cha kufa, kuchuluka kwa kuchuluka kwa anthu m'dera la Oryol kukwera kwambiri, koma sizikhala chifukwa chakuwonongeka kwa chisamaliro cha odwala kapena kuwonjezeka kwa vuto.

Kwa nthawi yoyamba, zambiri zimapezeka pazakufa pakati pa odwala omwe ali ndi matenda ashuga m'madera a Russia. Mu mkuyu. Chithunzi 4 chikuwonetsa kuti odwala omwe ali ndi matenda a shuga a mtundu woyamba 1 amakhala okwera kuposa omwe ali ndi matenda amtundu wa 2. Chizindikiro cha

Bryansk dera 2.0 Ndine Republic Mari El I1 02

Kalmykia Tambov dera Nizhny Novgorod reg. Dera la Perm Republic of Komi, Dera la Oryol Tver dera Dera la Saratov

Mkuyu.2. Chiwopsezo cha matenda amtundu 1 komanso 2 matenda a shuga m'magawo ena a Russia mchaka cha 2000

Republic Mari El 0.52

Dera la Oryol 4. Ndi

Republic Kalmykia (4

Dera la Saratov 1.7

Dera la Perm 5.54

Dziko La Komi 12.5

Nizhny Novgorod reg. * .14

Mkuyu. 3. Imfa ya odwala omwe ali ndi matenda amtundu woyamba 1 komanso 2 mtundu wa shuga m'magawo ena a Russia mu 2000

Madera amasiyana kwambiri. Ngati dera limodzi ndi dera lina lidachita ntchito yabwino yopanga ma database, ndiye kuti titha kunena kuti kuchuluka kwa ntchito zachipatala m'dera la Nizhny Novgorod ndi kotsika kuposa momwe kungathere. Kuunikaku kukuwunikiritsa zigawo zomwe sizili bwino ndipo pofunika njira zokuwongolera.

Chiyembekezo cha moyo wapakati (LSS) cha odwala matenda ashuga chimawonetsa zinthu zambiri zachipatala komanso chikhalidwe. SG ya odwala omwe ali ndi matenda a shuga 1 (mkuyu.

5) Zaka 12 zochepa kuposa kuchuluka kwa odwala omwe ali ndi matenda ashuga a 2. Kutalika kwa moyo wa abambo omwe ali ndi matenda amtundu woyamba sikunakwanitse zaka 5 kuposa amayi, ndipo kwa odwala omwe ali ndi mtundu 2 sikusiyana kwakukulu.

Kutalika kwa nthawi yomwe azimayi amakhala ndi moyo zaka 10 kuposa amuna, omwe ali ndi matenda amtundu wa 2 kwambiri kuposa omwe ali ndi matenda amtundu 1, kusiyana kumeneku kumachitika. Tiyenera kudziwa kuti LSS ya odwala omwe ali ndi matenda ashuga a 2 ndiokwera kwambiri poyerekeza ndi kuchuluka kwa anthu ambiri.

Kukula kwa matenda ashuga a mtundu woyamba 1 mwa iwo omwe adwala ali ana akuwonetsedwa mu mkuyu. 6. Kuchuluka kwa matenda ashuga m'gulu lino la odwala omwe ali ndi zaka zimachepa kwambiri. Pofika zaka 60, odwalawa sakhala pagulu. Chiyembekezo cha moyo ndi zaka 28.3 zokha.

ndi mtundu wa 2 matenda ashuga, kusiyana kumeneku sikofunika. Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri amakhala ndi moyo zaka pafupifupi 5 kuchokera nthawi yoyamba matendawa kusiyana ndi odwala omwe ali ndi matenda a shuga 1, koma izi zimachitika chifukwa chakuti odwala omwe ali ndi matenda ashuga a mtundu woyamba amakhala ocheperako poyerekeza ndi omwe ali ndi matenda a shuga a 2.

Monga LNG, chizindikirochi chikuwoneka kuti ndi chofunikira kwambiri, chifukwa chimalola munthu kuti athe kuwunika momwe alili pamankhwala komanso mtundu wa moyo wa odwala malinga ndi mphamvu zake.

Ndikosavuta kuyerekezera kuwunika kwakadali kofunika kwambiri kwa mtundu wa chithandizo popanda data yomwe odwala angakwanitse kukhalabe yolipira matenda ashuga. Zambiri (mkuyu.

Kafukufuku wowongolera akuwonetsa kuti mkhalidwe wa chithandizo ndi chisamaliro cha prophylactic kwa odwala omwe ali ndi matenda ashuga, makamaka ana, amakhalabe osakhutira. Chifukwa chake, 56% odwala omwe ali ndi matenda ashuga 1 ku Moscow, 65% m'chigawo cha Moscow ndi 72% ku Tyumen ali m'malo obvutika.

Matenda a ana oterewa ndi osavomerezeka, kufunikira kwa njira zothetsera vutoli. Gawo la ana omwe ali ndi matenda opatsirana a shuga ndi ochepa: ku Moscow - 18%, ku Tyumen - 12%, m'chigawo cha Moscow - 4.

Mkuyu. 4. Imfa pakati pa odwala omwe ali ndi matenda amtundu woyamba 1 komanso 2 mtundu wa shuga m'magawo ena a Russia mu 2000 (%)

18-19 wazaka 20-29 zaka 30- 39 zaka L

Amuna □ Akazi ■ Gulu lonse

Mkuyu. 6. Kulandila matenda a shuga amtundu woyamba, opangidwa kuubwana.

Mkuyu. 5. Nthawi yayitali yomwe odwala amakhala ndi mtundu woyamba 1 ndi matenda ashuga 2, poganizira za jenda.

Mkuyu. 7. Nthawi yayitali yomwe odwala amakhala ndi moyo kuyambira pachiwonetsero cha matenda amtundu woyamba 1, ndikuganizira za jenda.

Republic Dera la Mari El Oryol Republic, Kalmykia, Bryansk dera Dera la Saratov Dera la Perm Republic of Komi Nizhny Novgorod. reg.

Kuchuluka kwa zovuta za matenda ashuga ndizosiyana kwambiri ndi zenizeni zake. Mphamvu yazizindikiro ndiyofunikira pano.

Kuchulukana kwa retinopathy kukukula, kuchuluka kwa kufalikira komanso kuchuluka kwenikweni kukukulirakulira - chizindikiro cha otsika pantchito yakuchipatala komanso njira zothandizira. Odwala omwe ali ndi matenda amtundu wa 1, retinopathy amapezeka pang'onopang'ono (mkuyu.

9a), cataract - 1/5, neuropathy - 1/3, nephropathy - 1/2, matenda a mtima - 1/3, macroangiopathy - 1.17, matenda oopsa

Ziwerengero zina (mkuyu. 9, b) zimawonedwa mwa odwala omwe ali ndi matenda ashuga a 2. Retinopathy imapezeka mu 1/5 ya odwala, a cataract - mu 1/4, nephropathy - mu 1/8, neuropathy - mu 1/3, macroangiopathy n / a - mu 1/8. Vutoli limakhala ndi vuto la mtima.

Kukonzekera thandizo la mankhwala kwa odwala omwe ali ndi matenda ashuga ndi gawo lofunikira kwambiri pantchito ya matenda ashuga. Njira yokonzekera deta pamndandanda wofunikira wa mankhwalawa imatenga nthawi yayitali.

Ngati pali database ya regista, kupeza chidziwitso pakufuna kwa kotala kapena kwapachaka kwa odwala omwe ali ndi matenda ashuga, poganizira mayina a mankhwalawa, mtundu wawo wamachitidwe umatenga mphindi zingapo, ndi mindandanda yayikulu kwa 60,000 odwala - maola 1-2.

Tiyenera kukumbukira kuti database imayenera kukhala ndi zidziwitso zenizeni zokhudzana ndi odwala za chaka chino.

Chifukwa chake, pakukula kwa ntchito ya matenda ashuga, kulembetsa kwa matenda ashuga ndikofunikira kwambiri. Palibe chidziwitso, chidziwitso cha momwe zinthu ziliri, kapena njira zokwanira.

Kulembetsa kwa odwala matenda a shuga kumathetsa mavuto osati kokha ku boma kapena kuofesi, koma kwakukulukulu kumathetsa mavuto am'magawo ngakhale dokotala wamba, kumamupulumutsa pokonzekera satifiketi zosiyanasiyana, malipoti, ntchito, ndi zina zambiri. Poterepa, adokotala angadalire kulandira mwachangu zidziwitso zirizonse za odwala ake.

Avereji ya HLA1-13.1 2.8%

Mlingo wapakatikati

Mkuyu. 8. Kuchuluka kwa malipiro a shuga 1 kwa ana aku Moscow, Moscow ndi Tyumen.

NDINachokera ku Zenizeni

lembani matenda ashuga 1 (a) ndi matenda a shuga a 2 (b) mwa odwala akulu (%)

Kukula kwa State Register ya odwala matenda ashuga ana ndi achinyamata

UDC 616. 379 - 008. 64 - 053. 2 - 06: 617. 735 616. 61 - 07 (470. 41)

Chipatala cha Republican cha ana (dokotala wamkulu - woyimira wa sayansi ya zamankhwala E.V. Karpukhin) MH RT, Kazan

Matenda a shuga ndi limodzi mwa matenda oopsa kwambiri ndipo samangofunika kuyesetsa kwakuthupi komanso mwamphamvu kuchokera kwa odwala ndi makolo awo, komanso chidwi chapadera kuchokera kwa oyang'anira zaumoyo ndi gulu lonse.

Kugwiritsira ntchito kukonzekera ma genetic kukonzekera insulin yaumunthu, njira zamakono zodziletsa zimapangitsa kuti izi zitheke osati monga kuvutika, koma monga njira yatsopano ya banja komwe wodwala wodwala matendawa adawonekera.

Mwana, yemwe amasamutsidwa m'gulu la anthu olumala kuyambira nthawi yomwe amadziwika kuti ali ndi matenda, amatha kukonza tsogolo lake, akuganiza zosankha ntchito, kupanga banja. Chimodzi mwazinthu zofunikira kuti izi zitheke ndikuwongolera vuto lalikulu kwambiri monga zovuta za matenda ashuga.

Kuzindikiritsa zovuta pamayambiriro a matendawa ngakhale kuneneratu za chitukuko chawo m'magulu ena a odwala kumakhala kofunikira kwambiri pamlingo wa chitukuko cha sayansi yopanga chisamaliro chapadera cha odwala omwe ali ndi matenda ashuga.

Chifukwa chake, tikamawerengera mayina a matenda am'madzi a shuga, opangidwa ndi akatswiri ku DRCH of the Ministry of Health of the Republic of Tajikistan, tidaganizira kwambiri za vuto la matenda a shuga 1.