Mavuto am'mbuyomu a shuga ndi osakhudzika (amapezeka ndi mitundu yosiyanasiyana ya matenda ashuga), awa ndi awa:

1. Micro- ndi macroangiopathy (atherosulinosis ya mitsempha yayikulu),

Choyambitsa chachikulu cha zovuta zam'mbuyo za shuga ndi hyperglycemia, hyperlipidemia ndi hypercholesterolemia. Amatsogolera kuwonongeka kwa mitsempha yamagazi ndikusokonekera kwa ziwalo zosiyanasiyana ndi minyewa pogwiritsa ntchito glycosylation ya mapuloteni, mapangidwe a sorbitol ndi activation ya atherosclerosis.

Pa glycosylation wa mapuloteni (proteinoglycans, collagens, glycoproteins) a zigawo zam'munsi, kusinthana kwawo, kulumikizana ndi kayendetsedwe kazinthu zimasokonekera, mawonekedwe apansi amakulirakulira ndipo angiopathies amakula.

Macroangiopathies amawonetsedwa mu zotupa zamatumbo akulu ndi a mtima, ubongo, m'munsi. Mapuloteni a Glycosylated a zigawo zapansi ndi matrix a cellellular (collagen ndi elastin) amachepetsa kukula kwa mitsempha. Glycosylation osakanikirana ndi hyperlipidemia wa mankhwala a glycosylated ndi hypercholesterolemia ndi omwe amachititsa kuti atherosclerosis ayambike.

Microangiopathies ndizotsatira zowonongeka kwa capillaries ndi zombo zazing'ono. Kuwonetsedwa mu mawonekedwe a nephro-, neuro- ndi retinopathy.

Nephropathy imayamba pafupifupi gawo limodzi mwa magawo atatu a odwala matenda ashuga. Chizindikiro cha magawo oyambirira a nephropathy ndi microalbuminuria (mkati 30-3000 mg / tsiku), yomwe imayamba kukhala ndi nephrotic syndrome, yodziwika ndi proteinuria yayikulu, hypoalbuminemia ndi edema.

Retinopathy, vuto lalikulu kwambiri la matenda ashuga komanso chifukwa chachikulu kwambiri chakhungu, limapezeka mu 60-80% ya odwala matenda ashuga. Mu magawo oyambilira, basal retinopathy imayamba, yomwe imadziwikika mu kukanika kwa retinal, vasodilation ya retina, ndi edema. Ngati zosintha sizikhudza macula, kutaya kwamaso nthawi zambiri kumachitika. M'tsogolomu, prinetos retinopathy yowonjezereka ikhoza kukhala, yowonetsedwa mu neoplasms ya retina ndi ziwiya za vitreous. Kuchepa mphamvu ndi kukhathamira kwamphamvu kwa ziwiya zatsopano zomwe zimapangidwa kumazindikira kutuluka kwa magazi pafupipafupi mu thupi la retina kapena thupi lamphamvu. Patsamba lamagazi, mafupa amayamba, zomwe zimapangitsa kuti pakhale zovuta kuziona komanso kuziona.

Shuga mellitus (mwachidule - matenda ashuga) amadziwika ndi njira yosakhazikika komanso yovuta ndipo, pafupifupi pazochitika zonse, posakhalitsa zimabweretsa kukula kwamavuto osiyanasiyana.

Chifukwa chachikulu chomwe chitukuko cha zovuta zilizonse zimakhalira ndi kuchuluka kwa shuga m'magazi. Akatswiri azachipatala amalimbikitsa kuti anthu onse omwe ali ndi matenda ashuga azisamaliratu magazi awo ndikukwaniritsa zofunikira zonse zodzitchinjiriza panthawi yake.

Zovuta za shuga

Mavuto owopsa a matendawa omwe akufunsidwa akuimira kuwopsa kwambiri kwa odwala matenda ashuga, chifukwa ndi omwe angayambitse kudwala.

Zovuta zowopsa zimaphatikizapo:

• Ketoacidosis. Amayamba chifukwa cha kuchuluka kwa zinthu za metabolic m'magazi. Zizindikiro zazikulu zimaphatikizapo: kusazindikira, kuwonongeka kwa ziwalo zosiyanasiyana zamkati ndi ziwalo. Ketoacidosis imayamba kugwiritsidwa ntchito kwambiri ndi anthu odwala matenda ashuga amtundu 1.
• Hypoglycemia. Itha kuyamba chifukwa cha kutsika kwakuthwa kwa glucose wa plasma. Zizindikiro: Kuperewera kwa chidwi cha ophunzira pakuwala, kusazindikira, kuwonjezeka kwambiri kwa shuga mumapulasitiki posachedwa, kukokana, thukuta kwambiri, nthawi zina, chikomokere. Hypoglycemia imatha kukhala ndi odwala matenda ashuga, odwala osati 1, komanso 2 mtundu wa shuga.
• Hyperosmolar chikomokere. Amawoneka ndi kuchuluka kwa shuga m'magazi, komanso sodium. Kukula kwake kumayendetsedwa ndi kuchepa kwa madzi m'thupi kwanthawi yayitali. Zizindikiro zazikulu zimaphatikizapo polydipsia ndi polyuria. Kukula kwa vutoli kumakhala kovuta kwambiri kwa okalamba, odwala.
• Lactacidotic chikomokere. Maziko a chitukuko ndi kudzikundikira kwa lactic acid m'magazi. Zizindikiro zake zazikulu ndi chizungulire, kulumpha mwadzidzidzi mu kuthamanga kwa magazi, kulephera kupuma, komanso kuvuta kukodza. Vutoli nthawi zambiri limapezeka mu odwala matenda ashuga okalamba (zaka 50 ndi akulu).

Ndikofunika kudziwa kuti zovuta zokhudzana ndi matenda osokoneza bongo a ana ndi akulu nzofanana, motero ndikofunikira kuwunika mosamala zaumoyo ndi zizindikiro zake zomwe zikuwoneka m'gulu la anthu odwala matenda ashuga. Mavuto aliwonse omwe atchulidwa pamwambapa amatha msanga, nthawi zina maola ochepa. Ndi kuwonongeka kwakukhalidwe labwino komanso kupezeka kwa zilizonse mwazidziwitso za zovuta za matenda ashuga, muyenera kupeza chithandizo chamankhwala mosachedwa.

Matenda a shuga

Matenda a shuga obwera chifukwa cha matendawa amayambika chifukwa cha nthendayi imatenga nthawi yayitali. Ngakhale kupenda moyenera njira zonse zothandizira odwala, matenda a shuga amakuza kwambiri thanzi la wodwala aliyense. Popeza matendawa kwa nthawi yayitali amatha kusintha magazi m'magazi, munthu angayembekezere kuwonekera kwa zovuta zina zomwe zimakhudza ziwalo zamkati ndi machitidwe a munthu.

Nthawi zambiri ndimadwala omwe amavutika kwambiri:

• Zotengera. Zowonda zawo nthawi yayitali shuga zimachepa kwambiri, ndipo makhoma awo amayamba kucheperachepera komanso kuvomerezedwa ndi zinthu zonse zofunikira kulowa thupi. Izi zimatha kupangitsa kukhazikika kwa mitundu yayikulu ya mtima.
• Impso. Ndi nthawi yayitali ya matenda, nthawi zambiri, kulephera kwaimpso kumayamba.
• Khungu. DM imatha kusokoneza khungu la munthu. Popeza magazi amatuluka mumatenda amkhungu amachepetsedwa kwambiri ndi matendawa, zilonda zam'mimba zimatha kuonekera pa iye, zomwe nthawi zambiri zimakhala gwero lalikulu la matenda osiyanasiyana ndi zotupa.
• Machitidwe amanjenje. Ndi matenda ashuga, mitsempha yamthupi imasintha kwambiri. Choyamba, kusintha koteroko kumaonekera pakuwonekera kwa vuto la kusazindikira kulimba kwa miyendo. Wodwalayo amayamba kufooka miyendo ndi miyendo yake, ndikuphatikizana ndi kupweteka kwambiri komanso kwanthawi yayitali. Nthawi zina zovuta kwambiri, kusintha kwamanjenje kungachititse kuti ziwuma ziwalo.

Mavuto abwinobwino a shuga

Mavuto ambiri obwera chifukwa cha matenda a shuga amayamba pang'onopang'ono patadutsa zaka zingapo matenda akupitilira. Kuopsa kwa zovuta zotere ndikuti pang'onopang'ono, koma kumakulitsa thanzi la odwala matenda ashuga. Akatswiri azachipatala amati ngakhale atakwanitsa kugwiritsa ntchito njira zonse zochiritsira zodziwikiratu, ndizovuta kwambiri kudziteteza ku zovuta izi.

Mavuto apambuyo pake akuphatikizapo:

• Retinopathy Amadziwikanso ndi kuwonongeka kwa retina, komwe kumatha kupangitsa kuti musangokhala chiphadzuwa, komanso kukha magazi mu fundus. Matendawa amatha kubweretsa kuwonongeka kwathunthu kwamawonedwe. Retinopathy nthawi zambiri imapezeka mwa odziwa matenda ashuga omwe ali ndi matenda amtundu uliwonse, komabe, nthawi zambiri amakupezeka mwa anthu omwe ali ndi matenda a shuga a 2.
• Angiopathy. Ndikuphwanya kwazovomerezeka. Zimatha kubweretsa mawonekedwe a thrombosis ndi atherosulinosis. Angiopathy imayamba msanga, nthawi zina osakwanitsa chaka.Odwala 1 ndi 2 mtundu wa matenda ashuga amatha kukhudzidwa ndi matenda awa.
• Polyneuropathy. Ndi matendawa, munthu amasiya kumva kupweteka komanso kutentha m'munsi komanso kumbuyo miyendo. Zizindikiro zake zimaphatikizapo kuwotcha ndi dzanzi m'manja ndi m'miyendo. Matendawa amatha kuchitika mwa aliyense wodwala matenda ashuga.
• Matenda a shuga. Kuwonongeka kwa miyendo, momwe zilonda zam'mimba ndi zotupa zimawonekera pamapazi. Nthawi zambiri, matenda amtunduwu amatsogolera pakuchitidwa opaleshoni, kuphatikizapo kudula dzanja. Popeza wodwala aliyense yemwe ali ndi matenda ashuga amatha, madokotala amalimbikitsa kuti aliyense, kupatula, azisamalira kwambiri zaukhondo ndi phazi.

Njira zochizira komanso kupewa

Chithandizo cha zovuta za shuga zimakhala, choyamba, pakupewa kwawo. Odwala matenda ashuga ayenera kutsatira mosamalitsa malangizo onse azachipatala kuti aletse kukula kwa zovuta zosiyanasiyana za shuga ndikuwunika kusinthasintha kulikonse kwa shuga m'magazi. Ngakhale ndikukula kwamavuto amtundu uliwonse, ndikofunikira kuchitapo kanthu mwachangu kuti matenda asungidwe a glucose akhale otetezedwa, chifukwa sizongotengera chikhalidwe cha matenda a shuga okha, komanso pazotsatira zomwe zidayambitsa.

Kupewa matenda ashuga kumaphatikizapo:

• magazi shuga
• kuyang'anira zachipatala pafupipafupi komanso kuyesedwa,
• kutsatira dongosolo lazakudya,
• kujambula momveka tsikulo la tsikulo (ndikofunikira kudziwa nthawi yodzuka m'mawa ndikupita kukagona, nthawi yantchito, maola othandizira jakisoni a insulin, etc.),
• zolimbitsa thupi zolimbitsa thupi komanso kupuma mokwanira,
• kukhalabe aukhondo m'nyumba
• chitetezo chokwanira komanso nthawi yake chithandizo cha chimfine ndi matenda opatsirana.

Zachidziwikire, zovuta zilizonse za shuga sizitha kuchiritsidwa ndi zonsezi pamwambapa, chifukwa vuto lililonse limafunikira kuti mugwiritse ntchito mankhwala ena ndi njira zingapo zapadera ndi njira zina zochiritsira. Komabe, kutsatira malingaliro awa sikungothandiza kukhalabe ndi njira yokhazikika ya matenda ashuga, komanso kuchepetsa kwambiri chiopsezo chotenga zovuta zilizonse za matendawa.

Chofunikira chachikulu pakupanga angiopathy mu matenda ashuga ndi hyperglycemia. Izi zikufotokozera kufunikira kwa chithandizo choyenera cha matenda a shuga, ndiko kuti, kuperekera kubwezeretsedwa kwa zovuta za kagayidwe kazakudya - Normoglycemia ndi aglycosuria. Izi zikuwoneka ndi kafukufuku wa DCCT wa nthawi yayitali (wa mtundu 1 wa matenda ashuga) ndi kafukufuku wa UKPDS.

Matenda a shuga a retinopathy. Kuphatikiza pa kubwezera okhwima kwa matenda ashuga, mankhwala owonjezera amachitidwanso malinga ndi gawo la matenda ashuga retinopathy. Pozindikira panthawi yake za magawo oyamba a retinopathy, kuwunika pafupipafupi (1 nthawi pachaka), ndipo zizindikiro zoyambirira za retinopathy zikaonekera, katswiri wa maso amafufuza wodwala wotere miyezi isanu ndi umodzi iliyonse. Odwala omwe alibe proliferative diabetesic retinopathy ndi kuchuluka kwa lipids amasonyezedwa kuti amathandizidwa ndi lipid-kuchepetsa ndi antioxidant mankhwala, otsika maselo a heparin mankhwala (sulodexide, Wessel duet F), dipyridamole.
Njira zazikulu zokhazikitsira kuyambika kwa retinopathy, motero kupewa khungu, ndikutsata kwa laser, komwe kumachitika pogwiritsa ntchito argon, krypton kapena ruby ​​laser ngati mawonekedwe am'deralo (pamaso pa hemorrhages angapo, retinal ndi preretinal hemorrhages), focal ndi retinal edema yake posterior pole) kapena panretinal (yokhala ndi prinositive retinopathy).Pokhala ndi kuchuluka kwa matenda ashuga retinopathy ophatikizika ndi kuchepa kwa magazi m'thupi komanso kupezeka kwa minofu yowonjezereka, olemba ena amalimbikitsa kusinthika kwa magazi, komwe kumatha kukonza kapena kukhazikitsa masomphenya otsalira ndikuletsa kukula kwamaso kwathunthu. Ma hemreha otsekemera ndi chisonyezo cha vitollomy.

Matenda a shuga.
Pamodzi ndi kuwongolera kwamphamvu kwa glycemia mwa odwala omwe ali ndi matenda a shuga 1, chaka chilichonse, kuyambira chaka cha 5 kuyambira isanayambike matenda a shuga, mkodzo uyenera kuyesedwa chifukwa cha microalbuminuria, ndipo ndi zizindikiro za matenda ashuga a retinopathy, mayesowa amachitika mosatengera nthawi yayitali ya matenda a shuga. Mtundu wachiwiri wa matenda ashuga, kuyesa kwamikodzo kumachitika miyezi isanu ndi umodzi iliyonse kuyambira nthawi yomwe amadziwika. Tiyenera kukumbukira kuti ndi matenda amkodzo thirakiti, kugwiritsa ntchito zakudya zama protein ambiri, kulimbitsa thupi kwambiri, matenda opatsirana, zochitika zosiyanasiyana zovuta, pamakhala zotsatira "zabodza" mukamayesa mkodzo wa microalbuminuria. Proteinuria ikachitika, kuwunika kuwonjezereka kwa chidziwitso cha albumin kumafunikanso, komanso mwadongosolo (kamodzi pa miyezi isanu ndi umodzi, kutsimikiza kwa kuthamanga kwa magazi ndikupanga kuyesa kwa Reberg).

Pa siteji ya microalbuminuria, mankhwala ochokera ku gulu la angiotensin-otembenuza enzyme amalimbikitsidwa muyezo waukulu wa Captopril (capoten) 12,5 mg kawiri pa tsiku, enalapril (renitec, enap) 2,5 mg kawiri pa tsiku, perindopril (prestarium) 2 mg kamodzi patsiku, ramipril (tritace) 1.25 mg 1-2 kawiri pa tsiku.
Mutha kumwa mankhwalawa m'maphunziro (nthawi yayitali 2-3 miyezi, maphunziro a 2-3 pachaka) ndi ochepa microalbuminuria (ochepera 100 mg / tsiku) kapena mosalekeza (ndi Microalbuminuria kupitilira 100 mg / tsiku). Kuphatikiza apo, zotsatira zabwino zimadziwika pogwiritsira ntchito sulodexide intramuscularly (1 ml tsiku lililonse kwa masiku 20) kapena pakamwa makapisozi 2 kawiri patsiku kwa masabata a 6-8.

Pa gawo la proteinuria, chakudya chimalimbikitsidwa ndi choletsa wa sodium chloride ndi nyama mapuloteni 40 g / tsiku, ndipo pakuwonjezeka kwa kuthamanga kwa magazi, kuyang'anira angiotensin-kutembenuza ma enzyme inhibitors mu Mlingo wa achire womwe ndi wowonjezereka nthawi 2-2,5 kuposa omwe amagwiritsidwa ntchito kuchepetsa microalbuminuria. Zochizira matenda oopsa a shuga mellitus, mankhwalawa omwe amasankhidwa ndi angiotensin-converting enzyme, osagwira ntchito omwe amalimbikitsa kugwiritsa ntchito calcium antagonists (diltiazem, nifedipine kapena verapamil), kusankha p-blockers (atenolol, lokren, etc.), loop diuretics kapena furosemive mankhwala ogwirira ntchito akuluakulu (clonidine, etc.). Kuthamanga kwa magazi - osapitirira 130/85 mm Hg Kuphwanya mafuta kagayidwe kumafuna kugwiritsa ntchito mankhwala ochepetsa lipid.

Pa gawo la kulephera kwa impso, odwala amasamutsidwa kupita ku insulin mankhwala ndikupitilira chithandizo ndi angiotensin-converting enzyme inhibitors (kapena mankhwala ena a antihypertensive), pamaso pa hyperlipidemia, lipid-kuchepetsa mankhwala, enterosorbents, hemodeis ndi mankhwala, odwala akupitiliza kudya. Mu gawo la matenda a shuga, nephropathy, njira zochiritsira zakunja zimasonyezedwa (peritoneal dialysis, plasmapheresis, hemosorption, hemodialysis, kupatsirana kwa impso, mwina ndi munthawi yomweyo kufinya kwamankhwala.

Matenda a shuga. Kuzindikira kwakanthawi ndikuzindikira matenda a neuropathy ndikotheka ndikuwunika kwa wodwala pafupipafupi, komwe kumachitika chaka chilichonse, ndipo patatha zaka 3-4 kutatha kwa matenda - miyezi isanu ndi umodzi iliyonse. Kuunika kwa tendon Reflex (bondo kapena Achilles) ndi kutsimikiza kwa kugunda kwamphamvu kumachitika pogwiritsa ntchito foloko yopangira omaliza kapena biotensiometer. Pamodzi ndi izi, tactile ndi kutentha, kupweteka, kuteteza ndi kuzindikira kwa mtima kumatsimikiziridwa.M'zaka zaposachedwa, kutsimikiza mtima kwa chitetezo champhamvu pogwiritsa ntchito monofilaments kwakhala kukugwiritsidwa ntchito kwambiri. Kuperewera kwa chidwi pakuphunzira monofilament 10 g kumawonetsa kutaya kwathunthu kwa chidwi chodzitchinjiriza. Kuphwanya ntchito kwa dongosolo laumwini lamagetsi kumadziwika ndi kuphulika kwa Valsalva, kuphulika ndi kupuma kwamphamvu, ndi zina zambiri.

Chithandizo cha matenda a shuga a shuga , capsaicin, aldose reductase inhibitors (olrestatin, olredase, tolrestat, isodibut, etc.), vasodilators (Noradrenaline antagonists, calcium antagonists, prostaglandino , nitrate), ma membrane-okhazikika othandizira (lignocaine, lidocaine ndi mkamwa wake analogue megsylene), mafuta a primrose okhala ndi linolenic (75%) ndi y-linolenic acid (8-10%), gangliosides, ndi zina. pathogenetic mankhwala, makamaka thioctacid, omwe ndi-lipoic acid mu mawonekedwe a mchere wa trometamol. Thioctacid amalembedwa mawonekedwe a mapiritsi a 600 mg kapena 600 mg wa intravenous jekeseni wa isotonic sodium chloride 1 nthawi patsiku kwa masabata a 2-4. Kuti musunge zotsatira mtsogolo, ndikofunikira kuti mupitirize kumwa thioctacide mkamwa.

Zotsatira zabwino zomwezo zimaperekedwa ndi kukonzekera kwa-lipoic acid (thioctacid, espalipon, etc.). Tidagwiritsa ntchito espalipon kwa masabata atatu kudzera mu infusions (600 mg / tsiku), kenako mkati (600 mg / tsiku) kwa miyezi 3-6. Zotsatira zofananira zamankhwala zimapangidwa ndi kukonzekera kwa mafuta osungunuka a vitamini B (benfotiamine) ndi milgamma (kuphatikiza mavitamini B6, B | 2 ndi B,). Tidagwiritsa ntchito mankhwalawa-a-mar-100 pothandiza odwala 50 omwe ali ndi matenda a shuga komanso a neuropathy. Mankhwalawa anali kumwa piritsi limodzi 3 pa tsiku kwa milungu 6. Mankhwalawa adakhala othandiza kwambiri: kuchuluka ndi kupweteka kwapang'onopang'ono m'munsi yam'munsi kunachepa, mphamvu yokhudzana ndi kugwedezeka kwamphamvu idatha, paresthesia idachepa ndikuzimiririka, zomwe zidathandiza kukulitsa moyo wa odwala.

Matenda a matenda ashuga. Njira zochizira mawonekedwe a neuropathic mawonekedwe a phazi la matenda ashuga limakhala ndi mankhwala am'deralo (mankhwalawa a mabala omwe ali ndi antiseptic solution: 1% dioxidine, 0,05% chlorhexidine, mafilimu achitetezo: antisorb, inadine, hydrocol, sorbalgon, pa granulation gawo - chinangwa, hydrosorb, atrauman ndi kupitilira. magawo a epithelialization - biocclusive, hydrofilm, komanso mwatsatanetsatane kugwiritsa ntchito maantibayotiki (mandol, kapena cefmandol, metronidazole, ciprofloxacin, dalacin, kapena clindamycin). Choyenera chizikhala kutsitsa kwathunthu miyendo yomwe yakhudzidwa (chikuku kapena nsapato zapadera).

Ife, pamodzi ndi EI Sokolov et al., Taphunzira za kuyendetsa kwakanthawi kofanana kwa chimes, fetin ndi glutamic acid pa hemostasis odwala omwe ali ndi matenda osokoneza bongo. Zabwino pambuyo pomatha mwezi uliwonse kumwa mankhwalawa (piritsi limodzi la piritsi limodzi katatu pa tsiku) linakhala mpaka miyezi iwiri. Kuchepetsa lipids za seramu, tikulimbikitsidwa kupaka cholesterol inhibitors (3-hydroxy-3-methyl-glutaryl-coenzyme A-reductase): lovastatin, mevacor ndi ma analogi ena, komanso chosinthira zamagetsi chosinthira matumbo am'mimba komanso mucous membranes - "electronicizerizer " Ma antioxidants (a-tocopherol, selenium, etc.) ndi poly (ADP-riboso) ma synthase inhibitors, omwe nicotinamide ndi yake, amawonetsedwa. Iwo, kusintha kwa lipid ndikuchotsa kuchuluka kwamafulu kwama cell am'mimba, kuphatikiza ma cell a p-cell, kumathandizira magwiridwe antchito a ziwalo zosiyanasiyana ndi machitidwe.

Trental (pentoxifyline) pa mlingo wa 1000-1200 mg / tsiku pakamwa imakhala yothandiza pazinthu zazing'ono komanso njira ya microangiopathy, kuphatikizapo retinopathy. Mankhwala ena amapititsa patsogolo njira ya microangiopathy: Doxium (calcium dobsylate), dicinone, ticlopidine, etc.Monga tafotokozera, m'zaka zaposachedwa, zotsatira zabwino za njira ya microangiopathy (nephropathy, retinopathy) idapezeka pogwiritsa ntchito sulodexide, heparin yotsika molekyulu yochokera ku gulu la glycosaminoglycans, piyavit. Zoletsa za angiotensin kutembenuza enzyme tikulimbikitsidwa kuti zigwiritsidwe kale ntchito magawo a matenda ashuga nephropathy. Kukonzekera kwa gululi (capoten, elanapril, kapena ritec, ramipril, kapena tritace, perindopril, kapena prestarium) sikuti kungochotsa matenda oopsa, komanso kuthamanga kwa magazi, kutsekereza mapangidwe a angiotensin II, ndikupereka kufalikira kwa glomerular efferent arteriole ndikuchepetsa mphamvu ya hydrostatic capillom. Kuphatikizana kwa laser, komwe kukuwonetsedwa mu gawo la kuchuluka, kumagwiritsidwa ntchito kwambiri pochiza matenda ashuga a retinopathy.

Kafukufuku wambiri akuchitika kuti apange pancreas yokumba yokumba. Komabe, zovuta pakupanga zida zamtunduwu zimagwirizanitsidwa osati ndi kukula kwa kompyuta yaying'ono, komanso kupangidwa kwa sensor yomwe imatha kuzindikira kuchuluka kwa glucose mu infellular fluid popanda kusokoneza kwa nthawi yayitali, i.e., pamalo ophatikizira sensor. Pompano zida zogwiritsidwa ntchito za mtundu wotseguka, wosiyana ndi zida za mtundu wotsekedwa - biostator. Mu biostator, kulowetsedwa kwa insulin kumachitika molingana ndi zoyenera za glycemia, kutsimikizika aliyense 30 mpaka 40 s. Pazida zamtundu wotseguka (zotayidwa zotayidwa), njira yolowetsera insulin imakhazikitsidwa pamalo azachipatala adotolo, ndipo pambuyo pake, ataphunzitsidwa, wodwalayo mwiniyo amasintha regimen kutengera nthawi yakudya. Kugwiritsa ntchito kwa mitundu yotseguka kwa odwala kwazaka 2-3 kwawonetsa kuti ndikosavuta kulipirira matenda a shuga, makamaka chifukwa chokhala ndi zovuta zambiri, ndipo ndizotheka kupewa kusintha kwakukulu m'magazi a shuga masana, zomwe zimathandizira kukhazikika, ndipo nthawi zina ngakhale zotsutsana. kukula kwa microangiopathy (retiopathy, nephropathy). Mu zida za mtundu wotseguka, ndi insulin yosavuta (kapena yofulumira) yomwe imagwiritsidwa ntchito. Kusintha mtundu wa kulowetsedwa kwake, ndizotheka kuwonjezera insulinemia panthawi yomwe kuyamwa kwambiri kwa glucose kuchokera m'mimba m'mimba mutatha kudya.

Kafukufuku akuchitika kuti apange insulin ya pakamwa yomwe idapangidwira pamilosomes. Komabe, zidakali kutali ndi kugwiritsa ntchito mankhwalawa pazochita zamankhwala. Pali uthenga wolengeza za kugwiritsa ntchito bwino insulin mwa ma aerosols. Ku Russia ndi kunja, ma cell opatsirana a pancreatic islet B amachitika kwa odwala omwe ali ndi vuto la matenda a shuga a 1. Awonetsedwa kuti zotsatira zochulukirapo kapena zosakhutira zomwe zidapezeka zidapangidwa mu chiwindi ndikuyimitsidwa kwa chikhalidwe cha B-cell kudalowetsedwa m'mitsempha ya portal (portal). Kuchita kotereku kumatha kuchepetsa kwambiri peresenti ya 30% ya insulin, komabe, zotsatira zabwino za kufalikira kwa maselo a B ndizosakhalitsa (miyezi 3-4).

Ngakhale kuphatikiza kosavuta kwa njira yosinthira maselo a p-maselo kapena ma islets (allotransplantation kapena xenotransplantation), magwiridwe antchito omwe adasindikizidwa a B-cell amakhala osakhalitsa, chifukwa chake, kugwira ntchito mobwerezabwereza ndikofunikira. Palibe zomwe zingatheke kuti izi zitheke mu metabolism ya carbohydrate yomwe silingafune jakisoni wa exuliner insulin (mlingo wa insulin ukhoza kuchepetsedwa). Kusindikiza kulikonse kwa ma islet cell (mapuloteni akunja) ndi mtundu wina wama katemera omwe amathandizira chitetezo cha mthupi ndi matenda a autoimmune a mtundu wa 1. Chifukwa chake, posankha zakuwongolera kwa ma islets kapena ma cell a p, ma histocompatability antigen a omwe adzapatsidwe mtsogolo komanso olandila anzawo akuyenera kuzindikiridwa.

Chofunikira ndikusankhidwa kwa maselo opereka omwe ali ofanana mu maselo olandila mitundu ya HLA system.Kuphatikiza apo, maselo osasunthika omwe amafunikira amafunikira (osachepera 340,000-360,000), komanso kugwiritsa ntchito mankhwala a immunosuppression. Kuyika pang'ono kapena konkire kumuika nthawi zambiri kumachitika nthawi yomweyo ndikuwonjezera impso. Kupambana kwakukulu kwakwaniritsidwa m'derali, koma vuto lakukana ziwalo zomwe zalowetsedwa likadali lalikulu. Lingaliro lake lomaliza limalumikizidwa ndi kupambana kwina kwa ziwalo ndi minofu kuphatikizidwa. Cholimbikitsa pankhaniyi ndi chithandizo cha majini, kuthekera kwa kugwiritsa ntchito komwe kwatsimikiziridwa ndi kupita patsogolo kwa matekinoloje a maselo.

Handbook of diabetes Svetlana Valerevna Dubrovskaya

Kupewa matenda ashuga

Pofuna kupewa kuyambika kwa matenda ashuga, wodwalayo ayenera kutsatira malangizo onse a madokotala, azitsatira zakudya zokhwima, komanso achepetsa thupi. Nthawi zina, madokotala amalimbikitsa odwala awo kuti azichita mapangidwe olimbitsa thupi nthawi ndi nthawi.

Physiotherapy imakhala yopindulitsa mu zovuta zosavuta za matenda a shuga, limodzi ndi angiopathy kapena neuropathy (chifukwa cha ketoacidosis). Cholinga cha njirazi zimayenderana ndi kufunika kolimbikitsa ntchito za kapamba, kusintha kayendedwe ka magazi ndikuwonjezera kamvekedwe ka thupi la wodwalayo.

Sinusoidal moderate currents (SMT) imayambitsa kuchepa kwapang'onopang'ono m'magazi a shuga, kukhazikika kwa lipid metabolism ndikuletsa kupangika kwa angiopathies azosiyanasiyana. Njira yonse ya chithandizo nthawi zambiri imachokera ku njira 10 mpaka 15.

Kuphatikiza kwa SMT ndi electrophoresis nthawi zambiri amalembera mtundu II matenda ashuga, nthawi yomweyo ndi yogwira mankhwala (mannil, adebite, ndi zina). Nthawi zina, adokotala atha kupangira ma electrophoresis okhala ndi nicotinic acid, omwe amathandizira kugwira ntchito kwa kapamba, komanso amathandizira kukulitsa lumen ya mitsempha yaying'ono komanso yayikulu.

Mwa electrophoresis wamba, kukonzekera kwa magnesium kumagwiritsidwa ntchito (komwe kumapangitsa kuchepa kwapang'onopang'ono kwa kuthamanga kwa magazi ndikuchotsa hypercholesterolemia), potaziyamu (yomwe imakhala ndi anticonvulsant zotsatira ndikuwongolera ntchito ya chiwindi), mkuwa (kuteteza kukula kwa angiopathy komanso nthawi yomweyo kutsika kwamagazi a shuga), heparin (monga prophylactic motsutsana ndi retinopathy), proserin ndi galantamine (kusintha minofu ndi ntchito yamanjenje, kupewa minofu fiber atrophy).

Mankhwala onse omwe ali pamwambawa ayenera kutumizidwa ndi katswiri, kudzidziwitsa nokha pazinthu zotere kungayambitse kukulitsa zovuta zoyipa. Dokotala amawonetsanso kutalika kwa njira ya munthu komanso njira yonse yothandizira.

Kuthamanga kwambiri kwa ma ultrasound (UHF) kumalimbitsa chiwindi ndi kapamba, kuletsa zovuta zina za matenda ashuga. Nthawi zambiri njira yonse ya chithandizo imaphatikizapo njira za 13-15. Kuphatikiza apo, mphamvu ya ultrasound m'thupi imakhala ndi kupindika pang'onopang'ono ndipo imalepheretsa kukula kwa lipodystrophy m'magawo a thupi ogwiritsira ntchito jakisoni.

Ultraviolet irradiation (UV) imathandizira kagayidwe kake ka thupi, imapangitsa kuti mayamwidwe athunthu a calcium ndi phosphorous, imalepheretsa kuwonongeka kwa minofu, kutsitsa shuga m'magazi ndikulimbikitsanso kupangika kwa chotchinga cha khungu lanu chomwe chimateteza minyewa yamkati kuti ilowe mkati mwa tizilombo tating'onoting'ono.

Hyperbaric oxygenation (HBO) ndi chithandizo cha okosijeni pogwiritsa ntchito kuchuluka kwapanopo. Njira yoletsa matendawa matenda a shuga amalepheretsa kuchepa kwa mpweya, imathandizira kupewa kupitilira kwa neuropathy komanso phazi la matenda ashuga. Nthawi zambiri, maphunziro athunthu a mankhwalawa amaphatikizapo chithandizo cha 10 mpaka 15.Claustrophobia ndikubowoleza kumeneku pamanomano (popeza nthawi yamankhwala wodwalayo ayenera kukhala m'chipinda chopondera, chomwe chili malo osungika).

Electros sleep imayikidwa pamaso pa matenda okhudzana ndi matenda a shuga - matenda oopsa komanso matenda a mtima. Njira zochizira zimathandizira kupewa kukula kwa zovuta zam'magazi komanso kuthetsa ululu.

Kuchokera m'buku lakuti Clinical Nutrition for Diabetes lolemba Alla Viktorovna Nesterova

Chithandizo cha zovuta zamatenda a shuga ngati matenda ashuga ali ndi zovuta za ketoacidosis, wodwalayo amamuika mankhwala osavuta a insulin, ndipo mlingo uyenera kukhala payekha. Mankhwala othandizira pakudya amachepetsedwa pazinthu zotsatirazi: muzakudya, mafuta omwe amakhala ochepa

KULIMA KWA ZIWANDA ZOSAVUTA Pomaliza chaputala ichi, tafika pamfundo yokhumudwitsa kuti matenda a kapamba, ngati sanatenge njira zodzidzimutsa, atha kubweretsa mavuto osaneneka komanso omvetsa chisoni. Mwachitsanzo, matenda ashuga sangathe

Kupewa shuga

Chiwopsezo chotenga matenda a shuga kwa ana ndi kupewa kwake Chiwopsezo chachikulu chotenga matenda ashuga ndi chimodzi mwa ana obadwa kwa amayi omwe ali ndi matenda ashuga. Mwayi wokulirapo wa kukhala ndi shuga umapezeka mwa mwana yemwe makolo ake onse ndi odwala matenda ashuga.

Mutu 3 Chithandizo cha matenda ashuga ndi zovuta zake Kuchiza matenda ashuga kumakhala mbali zingapo. Kwa mtundu wina uliwonse wa matenda ashuga, wodwalayo ayenera kumwa mankhwala ochepetsa shuga. Kuphatikiza pa iwo, jakisoni wa insulini amatchulidwa, womwe umayenera

Chithandizo cha zovuta za matenda a shuga Kuthana ndi zovuta za matenda a shuga makamaka kumathandiza kupewa, ndiko kuti kubwezeretsedwa konse kwamatendawa. Ngakhale ndi zovuta zomwe zayamba kale, kusintha shuga m'magazi kumatha kusintha njira.

Kupewa matenda ashuga Bukuli lakonzedwa kwa odwala matenda ashuga, koma ndikufuna ndikhulupirire kuti liziwerengedwa ndi omwe sanakumanepo ndi matendawa. Chifukwa chiyani? Chifukwa ndiye, mwina, chiwopsezo chotenga matenda akulu mwa anthu ambiri

Kupewa mavuto ndi kukonzekera kubadwa kwa mwana Tinanenanso kale kangapo kuti thupi la mkazi, likusintha kukhala lobala mwana, limasintha kwambiri. Tizilombo ta mammayi timakulitsa kukula komanso kulemera, ndikukweza mapewa patsogolo, omwe amafupikitsa minofu ya chifuwa ndikukula

KUPIRIRA KWA ZIWANDA KWA ANA NDI ZINSINSI ZA ANA Ana omwe adabadwa kuchokera kwa amayi omwe ali ndi matenda ashuga ali ndi chiopsezo chachikulu chotenga matenda a shuga. Chofunika kwambiri ndi mwayi wokhala ndi shuga kwa mwana yemwe makolo ake onse ali ndi matenda ashuga. Mu ana obadwa

ZOCHITITSA ZA KUDZIPEREKA KWA ANA NDI KUTETEZA KWA DZUWA KUTI MUZIPATSA Dokotala kapena matenda ake mosayenera kumabweretsa mavuto obwera kwakanthawi kochepa kapenanso zaka. Mtundu woyamba ndi matenda ashuga a ketoacidosis (DKA), wachiwiri -

KUTHENGA KWA ZIWEREWERE NDIPONSO ZOPHUNZITSA KUTI Mellitus aperekedwe kwa matenda ashuga amaperekedwa mbali zingapo. Ndi mtundu uliwonse wa matenda ashuga (IDDM ndi NIDDM), wodwalayo ayenera kumwa mankhwala ochepetsa shuga. Kuphatikiza pa iwo, jakisoni wa insulini amatchulidwa, womwe umayenera

KULIMA KWA ZOIPA ZIWANDA Kulimbana ndi zovuta za matenda ashuga makamaka kumathandiza kupewa, ndiye kuti, kulipira anthu ashuga nthawi zonse. Ngakhale zovuta zomwe zayamba kale, kusintha shuga m'magazi kumatha kusintha njirayi,

KUTSITSA NDI KULULA KWA ZINTHAZO ZINA ZOKHUDZIRA KUSOWA KWA HOMEOPATHY Kuthana ndi matenda a homeopathic kungathe kuchepetsedwa kapena kuchepetsedwa mothandizidwa ndi mankhwala apadera a homeopathic. Pamene kuvomereza kuyenera kukhala mosamalitsa

KULIMBITSA KWA ZINSINSI ZA DIABETIC Zochita zolimbitsa thupi za zikondamoyo zothandizira kupanikizana zitha kuchitidwa nthawi iliyonse masana. Nthawi - mphindi 5. 1. Malo oyambira: akugona pamimba pake, masokosi ndi zidendene palimodzi, miyendo

PATHOGENESIS WA SUGAR DIABETES AKUFUNA

Mavuto owopsa amakhala ndi chikomokere, Matenda osapezekanso akuphatikiza micangiangiathi, microangiopathies (M&P ndi MAP), insulin, neuropathy, nephropathy, immunodeficiencies. Kwa NIDDM, hyperosmolar ndi hyperlactacidemic coma ndizodziwika bwino.

Mapu ndiwofala kwambiri ndipo amawonetsedwa ndi matenda amtima wamphamvu, ngozi ya m'magazi ndi kugwa kwamitsempha yam'munsi yamitsempha. Mu pathogenesis ya MAP, kukula kwapadera kwa atherosulinosis ndikofunikira kwambiri, pomwe ku M&P ndi hyperglycemia. Njira zopititsa patsogolo chitukuko cha atherosulinosis zimakhala zingapo - hyperlipoproteinemia, matenda oopsa, hyperglycemia, hyperinsulinism, thrombophilic syndrome.

The pathogenesis wa zovuta pachimake shuga. Ketoacidotic chikomokere. Monga matenda a shuga akukulira, njira zonse zogwiritsira ntchito acetyl-CoA zimatsekedwa, kupatula zomwe zimatsogolera ketosis ndi cholesterol synthesis, metabolic acidosis, kutayika kwa madzi ndi ma elekitirodiya, kuchuluka kwa magazi, kuperewera kwa magazi, kupunduka. Compensatory metabolic acidosis imayamba ndi kuwonongeka kwa sodium mu mkodzo ndi kutuluka kofulumira kwa maselo a proton, omwe amakulitsa acidosis. Chifukwa cha hypoxia yakuya ya chapakati mantha dongosolo, ntchito za pneumotactic Center m'malo mwa gasi-malo, kupuma Kussmaul, hyperventilation, hypocapnia, hypobicarbonatemia kukulitsa, komwe kumakulitsa acidosis. Chifukwa cha hypoxia, lactate yowonjezera imadziunjikira mu minofu yaubongo, zomwe zimapangitsa kuti acidosis iwonjezeke. Acidosis mu matenda ashuga monga nyengo yoipa imapangitsa kuchuluka kwa insulin, chifukwa insulin yomwe imakhala m'malo a acid imataya chiyanjano chake. Kuphatikiza apo, kukana insulini kumayambitsidwa ndi kuchuluka kwa FFA komanso kumasulidwa kwa mahomoni opanga - insulin antagonists (adrenaline, glucocorticoids, glucagon, vasopressin). Matenda ashuga (ketonemic, acidotic) chifukwa cha poizoni wa matupi a ketone ndi minofu hypoxia pama cell apakati amanjenje, kuchepa kwamadzi, acidosis. Catabolism yolimbikitsidwa imayambitsa kuwonjezeka kwa zomwe zimapezeka mu ammonia ndi urea, kupanga hyperazotemia, yomwe imakulitsa kuledzera kwa ubongo ndi hypoxia. Hypoxia of neurons imabweretsa kupuma, kutsika kwa mtima, kuchepa kwa minofu, komanso kuphwanya GNI.

Lactic acidosis ndi hyperlactacidemic chikomokere. Ndiofala kwambiri (poizoni wa dystrophies, chifuwa cha chiwindi), kulephera kwa mtima ndi matenda ena, ndipo nthawi zambiri amakhala mawonekedwe owopsa - ndi kuwonongeka kwa NIDDM, omwe ankathandizidwa ndi Biguanides - gluconeogeneis blockers.

M'magazi, mulingo wa lactate umakwera pamwamba pa 5 mmol / l, pomwe mawonekedwe ali mpaka 1.5 mmol / l, mtengo wa pH wa magazi ochepa ndi magawo 7.25. komanso zochepa. Lactic acidosis ndi chifukwa cha hypoxia komanso kulimbitsa thupi kwambiri. Kupuma kwa Kussmaul, hypotension, hypothermia, kuchepa kwa madzi, acidosis, kugwa kwa magazi, komanso kusapezeka kwa ketonuria kuli kakhalidwe.

Hyperglycemic (hyperosmolar) chikomokere Ketoacidotic sichachilendo pakati pa odwala azaka zopitilira 50, nthawi zambiri osathandiza. Zimakwiyitsidwa ndi kuchepa kwa madzi m'thupi (kusanza, kutsegula m'mimba, chithandizo chamankhwala, kuchepetsa magazi. Ketoacidosis kulibe, hyperglycemia imatha kukula mpaka nthawi yayitali (55 mmol / l kapena kuposa). Mu pathogenesis, zinthu zotsatirazi ndizothandiza:

Hyperglycemia 55-200 mmol / l (1000-3600 mg / dl).

· Hypernatremia, hyperchloremia (chifukwa cha kuchepa kwa vuto chifukwa cha kuchepa mphamvu kwa madzi m'thupi),

Hyperazotemia (chifukwa cha urea) chifukwa cha kutsekeka kwa diuresis.

Kuchepa kwa kupuma kwa Kussmaul, kununkhira kwa acetone.

The pathogenesis wa zovuta zovuta. Matenda a shuga a shuga ndi zovuta zazikulu za matenda ashuga, kulemala ndi kufa kwa odwala (Chiwembu 3.1). Lingaliro la "angiopathy" limaphatikizapo ma microangiopathies (kuwonongeka kwa capillaries, venule, arterioles, makamaka ma membrane apansi) ndi macroangiopathies (kuwonongeka kwamitsempha yayikulu).

Pa matenda a shuga amtundu uliwonse, angiopathy ophatikizidwa amawonedwa ndi mtundu wa IDDM wa mtundu wa microangiopathy mwa anthu achichepere, mwa anthu opitilira zaka 40 ndi mtundu wa IDDM wa macroangiopathy wopitilira patsogolo chitukuko cha atherossteosis. Pafupifupi M&P yazonsezi ndi ma capurary aneurysms, kukula kwa makoma a arterioles, capillaries, venules chifukwa cha kudzikundikira kwa homogenible kapena magawo a zinthu m'chipinda chapansi, mpaka kuponderezedwa kwamphamvu mu minyewa yam'mimba (mpaka kumaliza kufalikira), komanso kugundika kwa maselo a minofu. Chifukwa chake, mwachitsanzo, IDDM ndiyomwe imayambitsa khungu komanso imodzi mwazomwe zimayambitsa kuperewera kwa impso.

Pathogenesis ya microangiopathies. Mu pathogenesis ya angiopathies, choyambirira, non-enzymatic glycosylation yama proteinine ambiri akunja (mapuloteni amkati mwa chipinda chapansi pa zida za impso, malensi amaso, vitreous fluid yamaaso, ndi zina). Kachiwiri, kusinthidwa kwa glucose kwa sorbitol kenako fructose mkati mwa maselo ena. Zinthu zomaliza zomwe sizingasinthike kwambiri glycation zimakhudzanso minofu yolumikizana.

Zomwe zimayambitsa zovuta mu mtundu 1 ndi matenda ashuga 2

Mulimonse momwe zovuta za munthu wodwala matenda ashuga zilili, pali chifukwa chake. Kwa zaka makumi angapo, madotolo akhala akukambirana pazinthu zomwe zimayambitsa zovuta, koma mpaka pano sanathe kudziwa bwinobwino zomwe zimachitika. Nthawi yomweyo, zochitika zingapo zimadziwika kuti zimakondweretsa mawonekedwe osintha a thupi. Zodziwika kwambiri zalembedwa pansipa:

• zakudya zosayenera, zomwe zimayambitsa matenda a metabolic,
• glucose owonjezera ndi / kapena sodium,
• kuchuluka kwa magazi,
• kudzikundikira kwa lactic acid mthupi.

Mitundu yamavuto

Matenda a shuga, monga matenda ena amtundu wa endocrine, siziwopseza thanzi la munthu. Matendawa ndi owopsa chifukwa amadzetsa zovuta zambiri zomwe sizimadziwika. Chifukwa cha kafukufuku wapamwamba kwambiri wasayansi, zamankhwala zalandira zambiri zothandiza zokhudzana ndi njira iliyonse yomwe ingagwiritsidwe ntchito pakukulitsa vutoli.

Mavuto a shuga oopsa amakhala oopsa kwambiri pamoyo. Izi zimaphatikizapo njira zomwe zimakula mwachangu komanso zimayambitsa kuwonongeka kwa wodwala, ngakhale kovuta kwambiri. Pabwino kwambiri, kuyambika kwa kutulutsa kumatenga masiku angapo. Mavuto omwe amabwera pakangopita maola ochepa. Onse ndi ena pakakhala kuti palibe chithandizo chamankhwala chodzidzimutsa mosakayikira adzafa. Tebulo lomwe lili pansipa lili ndi zambiri zokhudzana ndi zovuta zilizonse za matenda a shuga:

Kuwonjezeka kowopsa kwa kuchuluka kwa zinthu za metabolic m'magazi. Zowopsa zake ndi matupi a ketone. Zochitika zoterezi zimawonedwa pambuyo pa machitidwe a opaleshoni, munthu amalandila kuvulala kwambiri komanso kusadya bwino.

Kuwonongeka kwa chikumbumtima, kudzidzimuka mwadzidzidzi kwa ziwalo zofunika.

Anthu omwe adapezeka ndi matenda amtundu 1. Ketoacidosis wa mtundu 2 wa shuga ndi osowa kwambiri.

Kuchepetsa kwambiri shuga.Izi zimatha kudzetsa mankhwala osokoneza bongo ochuluka, kumwa kwambiri, kuchita zolimbitsa thupi kwambiri.

Kusintha kwakuthwa msinkhu wa shuga, kusiya kuzindikira, kusowa kwa zomwe ana asinthira kuwala, kuchuluka thukuta, kukomoka. Njira yayikulu yodutsayi ndi insulin coma. Kuopsa kopezeka ndi vutoli kumakhudzana mwachindunji ndi zomwe zimapangitsa kuti makolo azikumbukira.

Kuwonjezeka kwa kuchuluka kwa shuga ndi sodium m'magazi. Nthawi zonse, izi zimachitika motsutsana ndi maziko am'madzi othamanga.

Ludzu losagonjetseka (polydipsia), kuchuluka kukodza (polyuria).

Kuchuluka kwa lactic acid wambiri. Amawonedwa mwa anthu omwe ali ndi vuto la impso, mtima ndi chiwindi.

Chisokonezo, dontho lakuthwa la kuthamanga kwa magazi, kulephera kupuma, kusakhalapo pokodza.

Akuluakulu omwe ali ndi matenda a shuga 1 amitundu.

Matenda (mochedwa)

Mavuto obwera chifukwa cha matenda ashuga amadziwika chifukwa chakukula pang'onopang'ono kwa miyezi yambiri kapenanso zaka. Samawopseza kuchulukana, koma nthawi imodzimodziyo amapititsa patsogolo thanzi labwinobwino. Ngakhale mutakhala kuti munalandira chithandizo chamankhwala mwadongosolo, chitetezo chodalirika ku zovuta zamtunduwu sichimakhala chotsimikizika. Muphunzira zambiri za aliyense wa iwo powerenga pansipa.

Kutayika kwa mapuloteni ndi magazi mu retina chifukwa chosayendetsa bwino magazi komanso kuthamanga kwa shuga.

Kuwonongeka kwa zowoneka bwino mpaka nthawi yakhungu. Mapangidwe a micaneurysms. Kupanga kwamkati ndi / kapena glaucoma.

Anthu omwe ali ndi matenda a shuga a mtundu wa 1/2, omwe adakhazikitsidwa zaka 10 zapitazo.

Kuwonongeka kwa ziwiya zing'onozing'ono kumabweretsa kutsekeka kwa mapuloteni kudzera mkodzo.

Matenda aimpso. Pakupita kwa zaka, kulephera kwakanthawi kumayamba. Impso zimalephera kuyeretsa ndi kuwononga magazi, motero zinthu zapoizoni zimayamba kudziunjikira.

Anthu odwala matenda a shuga adapezeka zaka zopitilira 10 zapitazo.

Mavuto a metabolism omwe amayambitsidwa ndi matenda a shuga. Kukonzekera kwakukulu kwa kuphatikizaku kumawonedwa mwa okalamba.

Kusokonekera kwa dongosolo lamkati lamanjenje, chifukwa cha kuwonongeka kwa mitsempha ya ubongo. Encephalopathy imayambitsa kupweteka kwambiri pamutu, kukhumudwa, migraines, kusokonezeka kwa malingaliro.

Anthu omwe adapezeka ndi matenda amtundu 1.

Kugonjetsedwa kwamapeto am'mitsempha ya mitsempha yomwe imayambitsidwa chifukwa cha kuchepa kwa mpweya ndi zinthu zina zofunika.

Kuchepa kwapang'onopang'ono kwa chidwi cha miyendo mpaka kutentha ndi kupweteka. Nthawi zambiri, izi zimayamba chifukwa cha "magolovu ndikusunga" - nthawi yomweyo zimayamba pazala ndi zala. Pa nthawi yomweyo, kumva kutentha ndi kusowa kwa miyendo kumadziwika. Polyneuropathy nthawi zambiri imayambitsa kuvulala kowonjezereka.

Anthu omwe adapezeka ndi matenda osokoneza bongo a mellitus gawo lachiwiri / lachitatu kuposa zaka 50.

Khungu, monga chinthu chachikulu kwambiri, limakumana ndi vuto la michere lomwe limachitika chifukwa cha kusokonezeka kwa metabolic. Chinthu chachikulu chomwe chikuthandizira kukulitsa matenda a pakhungu ndi metabolism yoyenera ya chakudya.

Dermatosis, zilonda zam'mimba, mawanga am'mimba (mawonekedwe amtunduwu pamutu, kuchepa kwa tsitsi kumayamba). Matendawa amawononga zigawo zamkati za khungu, zimapangitsa kuti nthaka ikhale yoyipa komanso youma.

Kusintha kwa kapangidwe ka magazi, zomwe zimayambitsa kuphwanya kwa hemostasis ndikuwonongeka kwa makoma a mitsempha yamagazi yaying'ono.

Microangiopathy mu shuga imayamba mu 90% ya milandu. Potere, odwala amakhala ndi zotupa zofupika zam'mphepete (nthawi zambiri zimakhala zazifupi).Mikwingwirima yayikulu, chifukwa cha izi, miyendo imatayiratu kugwira ntchito kwake, komwe kumafunika kudula mwachangu.

Anthu odwala matenda a shuga adapezeka zaka zopitilira 10 zapitazo.

Matendawa amapezeka chifukwa cha zilonda zam'mimba pakhungu la mapazi.

Kutupa, redness, chilliness, kumva kulira, kukokana. Zilonda zam'mimba zimapezeka pakhungu la mapazi (monga zikuwonekera pachithunzichi). Samayambitsa kupweteka, popeza zambiri mathero am'malo awa amwalira kale. Chifukwa cha zovuta izi, mwendo umatha kutupa kwambiri kotero kuti kuchipatala chofunikira kuchipatala kumafunikira.

Onse odwala matenda ashuga.

Kodi zovuta ndi zovuta za matenda ashuga kwa ana ndi achinyamata ndi ziti?

Mavuto mu ana amawonetsedwa pang'ono, pokhapokha chifukwa cha "chidziwitso" chochepa. Imfa zosakwana zaka 18 zatsala pang'ono kukwana zero. Komabe, ngati mwana wapezeka ndi matenda a shuga, izi zikutanthauza kuti kubwezeretsa kwayamba kale. Madotolo amati pali zovuta zingapo zomwe zimayambitsa matenda a shuga kuubwana / unyamata:

• microalbuminuria,
• matenda ashuga nephropathy,
• angiopathy (nthawi zina),
• retinopathy.

Mavuto a matenda ashuga ali aang'ono ndi owopsa chifukwa chobisalira. Zizindikiro zomwe zimawonedwa mwa mwana nthawi zambiri zimadziwika ndi matenda ena, owonjezera komanso ofala. Kupereka nthawi yake pa chithandizo chamankhwala chofunikira, ndizotheka kukwaniritsa chindapusa chonse cha matenda osokoneza bongo kwakanthawi ndikuwonetsetsa kuti pali zovuta zomwe zikuchitika.

Kusamalira miyendo

Mu shuga, muyenera kusamalira bwino mapazi anu. Kufalikira koyipa phazi kumatha kubweretsa zovuta zazikulu. Pakasokonezeka ka magazi, dzanzi ndi kupweteka m'miyendo zikuwoneka ngati mukuyenda, kapena popumula, kapena kugona, miyendo imakhala yozizira, yotuwa kapena yotupa, kudula miyendo kumachita bwino.

Kusamalira mapazi anu, muyenera :

• Sambani mapazi anu tsiku lililonse pogwiritsa ntchito madzi ofunda (osatentha) ndi sopo wofatsa,
• Pukuta bwino mapazi, makamaka pakati pa zala zakumaso,
• fufuzani ming'alu, khungu lowuma kapena kudula kumapazi,
• gwiritsani ntchito zonona emollient kuti khungu lisasalala
• chepetsa zosewerera mzere wowongoka,
• Valani nsapato zabwino. Onetsetsani kuti mulibe nsapato kapena miyala mu nsapato,
• Valani masokosi oyera tsiku ndi tsiku.

• mapazi okwera
• ikani zonona kumadulira kapena pakati pa zala,
• gwiritsani ntchito zinthu zakuthwa kudulira khungu pamiyendo,
• gwiritsani ntchito mankhwala azamba kuti muchotse chimanga,
• kuyenda nsapato
• gwiritsani ntchito compress kapena potentha mapiritsi.

Ngati abrasions, mabala, mabala m'miyendo apezeka, muyenera kufunsa dokotala!

Kusamalira maso

Kusamalira maso ndi gawo lofunikira kwambiri loyang'anira madokotala ambiri. Anthu omwe ali ndi matenda ashuga ali ndi chiopsezo kwambiri chowonongeka ndi maso kuposa anthu wamba. Onetsetsani kuti mumayang'ana maso anu pafupipafupi. Mu shuga, ndikofunikira kuyang'ana maso chaka chilichonse, makamaka kamodzi miyezi isanu ndi umodzi. Kupewa zovuta zamatenda a shuga kumachitika makamaka pakudziyang'anira pawokha. Ngati mukufuna kukhala wathanzi, onetsetsani kuti mwatsata malangizo onse azachipatala.

Popewa zovuta za shuga, malamulo ena ayenera kuwonjezeredwa:

• Pitilizani mankhwala a insulin panthawi yomweyo, musataye jakisoni wa insulin. Kufunika kwa insulin panthawi yamatendawo sikuti kumangopitiliza, komanso kumawonjezereka. Pankhaniyi, mlingo wa insulin suyenera kuchepetsedwa, ngakhale kufunika kwa chakudya kumachepetsedwa, popeza vuto lomwe limapangitsa (matenda) limabweretsa kuchuluka kwa shuga m'magazi.
• Ngati muli ndi matenda a shuga a 2, pitilizani kugwiritsa ntchito mapiritsi a shuga.
• Yang'anani magazi anu am'magazi ndi ma cell a kwamikodzo. Hyperglycemia (woposa 13 mmol / l) imafuna kuchuluka kwa insulin,
• Lumikizanani ndi endocrinologist wanu ngati matendawa amakhala nthawi yayitali kuposa tsiku (kusanza, kupweteka kwam'mimba, kupumira mwachangu).

1. Tsatirani chakudyacho.
2. Yang'anani shuga wanu wamagazi nthawi zonse ndi.
3. Ngati hyperglycemia idutsa 13 mmol / l, onetsetsani kuti mumayesa mkodzo kuti muone matupi a ketone.
4. Monitor cholesterol yamagazi ndi triglycerides (osachepera 1 mu miyezi 6-8).
5. Pewani zizolowezi zoipa (kusuta, mowa).
6. Samalira bwino mapazi anu, khungu lanu, maso.

Matenda a shuga. 500 mayankho pamafunso ofunikira kwambiri Pavel Aleksandrovich Fadeev

Mutu 9 Mavuto Omaliza a shuga

198 Kodi matenda a shuga amachedwa bwanji?

Mavuto obwera chifukwa cha matenda ashuga ndi matenda omwe amayamba chifukwa cha nthawi yayitali ya shuga m'magazi ndi m'thupi lathu.

199 Ndi matenda ati omwe amagwirizana ndi zovuta za matenda ashuga omwe amachedwa?

Kuti zovuta mochedwa shuga mellitus imaphatikizapo kusintha kwa m'matumbo m'matumbo (angiopathy )mitsempha ).

Matenda a shuga amakhudza ochepa (michereopathies ndi chachikulu (macroangiopathies ) zombo.

Kuti michereopathies phatikizani kuwonongeka kwa ziwiya zazing'ono za diso (retinopathy ) ndi impso (nephropathy ).

Kuti macroangiopathy phatikizani: matenda a mtima (angina pectoris, myocardial infaration ) komanso chifukwa cha izi kulephera kwa mtima.

200 Kodi pali ngozi yotani ya shuga m'maso?

Kuchuluka kwa shuga m'magazi kumapangitsa kuti matenda osiyanasiyana amaso apangike, zomwe zimapangitsa kuti aziona pang'ono, mpaka atayika. Chofala kwambiri (cha 90% cha milandu), chowopsa komanso chovuta kwambiri ndi matenda ashuga retinopathy .

201 Kodi ndiyenera kuyang'ana maso anga pafupipafupi ngati palibe chizindikiro cha matenda amaso?

Inde, ndikofunikira. Kusintha kwamasomphenya sikungawoneke poyamba, koma kuyezetsa kuchipatala komwe kumachitika mothandizidwa ndi zida zapadera kudzakuthandizani kulembetsa kumayambiriro kwa matendawa, chifukwa chake zitheke kuchitapo kanthu moyenera munthawi yake.

202 Kodi matenda ashuga a retinopathy ndi ati?

Matenda a shuga retinopathy Ndi matenda omwe amakhudza ziwiya zam'maso.

203 Kodi matenda ashuga a chifuwa amayamba bwanji?

Zifukwa zofunika kwambiri zomwe zimapangitsa kuti chiwopsezo cha retinopathy chidziwike komanso kuchuluka kwa shuga ndi kuchuluka kwa shuga. Zina zofunika monga zaka, kupezeka komanso kuchuluka kwa matenda oopsa, kusokonezeka kwa lipid, kusuta, matenda a impso komanso pakati.

204 Kodi zizindikiro za matenda ashuga retinopathy ndi ziti?

Matenda a shuga retinopathy kuwonetsedwa ndi kuchepa kwa zithunzi zowoneka bwino m'maso amodzi kapena onse, mawonekedwe a ntchentche, mawanga, ma tiketi, masomphenya awiri, etc. Ngati chimodzi mwa zomwe zalembedwa Zizindikiro muyenera kufunsa dokotala!

205 Kodi wodwala matenda ashuga ayenera kuchita chiyani kuti ateteze kukula kwa masomphenya?

Ndikofunikira kuyeserera pafupipafupi ndi akatswiri, ngakhale patakhala kuti palibe zowonetsa. Maphunziro otere a matenda ashuga amtundu woyamba ayenera kuchitika patadutsa zaka 5 atazindikira kuti ali ndi matenda ashuga amtundu wa 2 akangomupeza (izi zili choncho chifukwa aliyense mwa atatu ali ndi matenda amtundu wa 2 shuga). Kutengera ndi zomwe zadziwika m'chipatalachi, kuchuluka kwa mayeso kumatsimikiziridwa ndi adotolo, koma ayenera kukhala osachepera 1 nthawi yayitali zaka 1-2.

Kafukufuku wasonyeza kuti njira yothandiza kwambiri yopewa kusokonezeka kwa shuga m'magazi.

Chisamaliro chiyenera kutengedwa ngati mukumwa mankhwala omwe amatha kukulitsa milingo glycemia ndi kuponderezedwa kwapakati.

Kusamalitsa mosamala matenda a concomitant pathology (matenda oopsa, kuwonongeka kwa lipid metabolism) kumathandizanso kuchepetsa chiopsezo cha chitukuko retinopathies .

206 Kodi mungapewe bwanji vuto la matenda ashuga retinopathy?

Pofuna kuti zisayambitse kuyambitsanso kwa retina retinopathies , muyenera kupewa kuchita masewera olimbitsa thupi olemera, torso (osangokhala chete, koma squat!).

207 Kodi kuwonongeka kowoneka kumathandizidwa bwanji ndi odwala omwe ali ndi matenda ashuga?

Chithandizo cha mwachindunji cha kuwonongeka kwakuthupi ndikuyenda kwa akatswiri ndipo zimatengera nthawi yayitali yamankhwala. Komabe, ziyenera kunenedwa kuti ayi, ngakhale zamakono kwambiri, zamankhwala zimagwira bwino popanda kuthana ndi zinthu zowopsa - popanda kukonza shuga wamagazi, chithandizo cha matenda amtunduwu (matenda oopsa, kuchuluka kwa matenda muyezo lipids magazi). Chithandizo chanthawi yake cha matenda ashuga chimachepetsa chiopsezo chakhungu ndi 90%!

208 Kuopsa kwa shuga m'magazi a impso ndi chiani?

Wokwera shuga m'magazi owopsa impso kukhala ndi matenda ashuga nephropathy . Izi ndizowonongeka kwakanthawi kwamatumbo a impso, omwe amaphatikizira njira ya matenda ashuga. Zotsatira zake.

Kwa zaka 20, wodwala aliyense wachiwiri yemwe ali ndi matenda a shuga (mtundu 1 kapena mtundu 2) amakhala ndi vuto la impso zingapo.

209 Kodi matenda ashuga ndi neopropathy ndi chiyani?

Matenda a shuga nephropathy Ndi matenda a impso chifukwa cha matenda osokoneza bongo.

210 Nchiyani chimayambitsa kuwonongeka kwa impso mu shuga?

Kuwonongeka kwa impso m'matenda a shuga ndi chifukwa chotsatira:

Mwazi wamagazi ambiri. Zoyipa zoyendetsedwa shuga m'magazi , kwambiri mwayi wokhala ndi matenda ashuga.

Kutalika kwa matenda ashuga. Matendawa amatenga nthawi yayitali, ndiye kuti akuwonjezeka kwambiri.

Kuphwanya lipid kagayidwe (hyperlipidemia) kumabweretsa kuchotsedwa kwa atherosulinotic malo, kuphatikizanso mu mafungo amitsempha, omwe amaphwanyanso kuchulukitsa kwawo.

Kusuta. Zinthu zapoizoni zomwe zili mu utsi wa fodya zimasokoneza mitsempha ya magazi a impso ndikuwonjezera kuchuluka kwa shuga m'magazi.

Makamaka. Pali makonzedwe achilengedwe opangitsa matenda ashuga nephropathy.

211 Kodi matenda a impso amakula bwanji mwa odwala matenda ashuga?

M'mitsempha yapadera ya impso, magazi amasefa kuti asunge zinthu zofunikira ndikuyeretsa thupi la poizoni lomwe limatulutsa mkodzo. Mashuga amtundu wautali wokweza amachititsa kusintha kwa mtima, ndipo zinthu zopindulitsa zimayamba kuchotsedwa m'thupi. Pulogalamu ya Albumin imayamba kuchoka choyamba, koyamba pazinthu zazing'ono, motero izi zimatchedwa microalbuminuria (kutaya gologolo kuyambira 30 mpaka 300 mg / tsiku). Ili ndiye gawo loyambira, asymptomatic. nephropathy , yomwe, pakapita nthawi, imadutsa mawonekedwe otchuka, omwe amawonekera kale ndi kutayika kwakukulu gologolo . Gawo ili limatchedwa macroalbuminuria , kapena proteinuria . Kutengera ndalama zomwe zaperekedwa gologolo kusiyanitsa magawo angapo proteinuria : modekha proteinuria mukamasula mpaka 1 g gologolo patsiku, digiri yoyamba imachokera ku 1 mpaka 3 g gologolo patsiku ndi lolemera - kupitilira 3 g gologolo patsiku.

Gawo lotsatira la matenda a shuga a nephropathy likuyandikira - kulephera kwa aimpso, komwe kumadziwika ndi kuchotsedwa kwa zinthu zopindulitsa m'thupi komanso kuchedwa kwa zovulaza.

212 Kodi kulephera kwa impso ndi chiyani?

Kulephera kwa aimpso kuwonongeka kwa impso kapena kuchepa kwa ntchito yawo kwa miyezi itatu kapena kupitilira apo.Kulephera kwa impso kumayamba pang'onopang'ono ndikuchitika, nthawi zambiri zobisika. Palibe zodandaula, kapena kutopa kumachitika pakulimbitsa thupi, kufooka komwe kumawonekera madzulo, kusowa kwa chilimbikitso, komanso pakamwa pouma. Zizindikiro zomveka zamatenda zimawonekera pokhapokha omaliza. Amoni kuchokera mkamwa, mutu. Khungu limakhala lofiirira, louma, lopepuka. Kusokonezeka kwa ziwalo zonse - kuwonongeka kwa mtima, dongosolo lamanjenje, kupuma, ndi m'mimba, ndi zina - zimadziwika. Mkhalidwe uwu umatchedwa uremia (mkodzo m'magazi).

213 Kodi zizindikiro za matenda ashuga nephropathy ndi ziti?

Matenda a shuga imayamba ndikuwunikira gologolo mkodzo (panthawiyi, maphunzirowa ndi asymptomatic). Gawo lomaliza la njirayi ndi chitukuko aakulu aimpso kulephera (poizoni samatulutsidwa mkodzo ndikuwononga thupi). Pali magawo atatu a matenda a impso. Choyamba ndi obisika , kapena kapangidwe . Palibe zizindikiro pakadali pano. Chachiwiri gawo lodzisunga yodziwika ndi kutopa mkati mwa ntchito yolimbitsa thupi, kufooka komwe kumawonekera madzulo, kusowa chilimbikitso, nseru, kuchepa thupi, pakamwa pouma. Zizindikiro zomveka zamatenda zimawonekera pokhapokha, siteji . Amoni kuchokera mkamwa, mutu. Khungu limakhala lofiirira, louma, lopepuka. Pali kuwonongeka mu ntchito ya ziwalo zonse: kuwonongeka kwa mtima, dongosolo lamanjenje, kupuma, matumbo, zina zambiri zotayidwa m'thupi zomwe zimayenera kutulutsidwa mkodzo zimangokhala m'magazi.

214 Momwe mungapewere kukula kwa matenda a impso mwa anthu omwe ali ndi matenda ashuga?

Poyambirira kupewa kupewa impso kumayambira, kukwera kwakeko. Muli zigawo izi:

Zokhudza shuga. Izi zikuweruzidwa ndi mulingo glycosylated hemoglobin , kuyesetsa kuti zisapose 6.5-7%. Chithandizo chabwino glycemia Kafukufuku akuwonetsa kuti zitha kuchepetsa zomwe zimachitika yaying'ono ndi macroalbuminuria (proteinuria ), komanso zochitika za zovuta zazikulu za matenda a shuga a mtundu wachiwiri. Poganizira zovuta zakukwaniritsa izi, ziyenera kutsimikiziridwa kuti kuchepetsedwa kwakukulu kwa glycosylated hemoglobin adzapindula. Osachepera 1% pochepetsa Hba1c kumabweretsa kuchepetsa kwakukulu pangozi yakukula kwa matenda a shuga.

Kuwongolera microalbuminuria iyenera kuyambira pomwe azindikira kuti ali ndi matenda ashuga ndipo ayenera kuchitika pafupipafupi kwa odwala onse. Izi ziyenera kuchitika chaka chilichonse, ngakhale kwa iwo omwe, panthawi yophunzirayo, amawona zomwe zili bwino mu albumin mkodzo. Ngati wapezeka microalbuminuria kapena proteinuria Pafupipafupi mayeso amayendetsedwa ndi adokotala.

Kuyang'anira kuthamanga kwa magazi ndi chithandizo cha matenda oopsa. Ndikofunikira kuyesetsa kuonetsetsa kuti kuthamanga kwa magazi sikupitilira 130/80 mm RT. Art. Kuwongolera kumachitika ndi mankhwala am'magulu. ACE zoletsa kapena sartani .

Ngakhale kuthamanga kwa magazi ndikwabwinobwino (i.e. zosaposa 130/80 mmHg), kusankha mankhwala omwe ali m'gululi ACE zoletsa kapena sartani Nchofunikanso, koma muyezo zazing'ono, kuti muteteze impso ku zotsatira zoyipa za shuga m'magazi. Kafukufuku wasonyeza kuti kuchepa kwa kuthamanga kwa magazi a 10 mm RT. Art., Ndi m'munsi 5mm RT. Art. amachepetsa kuchulukana kwa misempha yokhala ndi 35%. Mukalandira mankhwalawa, mwayi nephropathy yafupika ndi 65%.

Chakudya chokwanira, chopatsa thanzi ndi zopatsa mphamvu zokwanira, ndi chakudya, mapuloteni, mafuta, zakudya mavitamini ndi michere. Pankhani ya kupezeka proteinuria kuletsa akulimbikitsidwa gologolo mu chakudya, mpaka 0,8 g / kg pa kulemera kwake patsiku. Mwachitsanzo, ngati wodwala akufika 100 kg, ndiye kudya ndi chakudya gologolo sayenera kupitirira 80 g patsiku.

215 Kodi matenda a impso amathandizidwa bwanji mwa anthu omwe ali ndi matenda ashuga?

Chithandizo matenda ashuga nephropathy zimatengera gawo lachitukuko cha ndondomeko ya zamankhwala. Koma munthawi zonse ndikofunikira kuchita izi:

Kubwezera shuga la magazi, kuyang'ana kwambiri msinkhu wa glycosylated hemoglobin ndikuyesera kuti izi zisapose 6.5-7%,

Kuchepetsa kuthamanga kwa magazi mpaka 130/80 mm RT. Art. ndi zochepa, ndipo liti proteinuria zosakwana 125/75 mm RT. Art.

Kugwiritsa ACE zoletsa kapena sartani Mlingo wocheperako womwe umakhala ndi kuthamanga kwa magazi kapena kuchuluka kwa mankhwalawa, ngati matenda oopsa atachitika,

Lipid kagayidwe kachakudya,

Zakudya zoletsedwa gologolo ndi mchere

Kuchepetsa kumwa kapena kukana mowa.

Mu gawo la Conservative aakulu aimpso kulephera, kuwonjezera, ndikofunikira:

Ndi kuchuluka creatinine e kuyang'anira njira zingapo zopewera kugwiritsa ntchito mankhwala osokoneza bongo. Makamaka, mlingo wa metformin uyenera kuchepetsedwa. Ngati kuli kotheka, pewani ntchito. mankhwala osapweteka a antiidal (zimachulukitsa kuthamanga kwa magazi ndikuwonjezera njira ya kulephera kwaimpso) ndi kugwiritsa ntchito glibenclamide - zimatha kupangitsa kuti pakhale zovuta kwambiri hypoglycemia kovuta kuchitira

Mankhwala othandizira insulin,

Onani nthawi zonse hemoglobin m'magazi - miyezi isanu ndi umodzi iliyonse.

Mu gawo la kudwala kwa aimpso kulephera, njira zapadera za kuyeretsa magazi (hemodialysis, peritoneal dialysis) kapena kumuika impso zimagwiritsidwa ntchito.

216 Kodi matenda ammimba a matenda ashuga ndi chiyani?

Syndrome diabetesic phazi ndi lingaliro losonyeza chiwonetsero cha matenda amiyendo mu matenda a shuga. Matenda onsewa amaphatikizidwa ndi kuwonongeka kwa khungu, minofu yofewa, mafupa ndi mafupa.

217 Kodi ndi njira ziti zomwe zingapangidwe ndi matenda a matenda ashuga?

Kutengera ndi kuphwanya malamulo komwe kumachitika, pali zosankha zingapo matenda :

Kuwonongeka kwa mitsempha (mawonekedwe a neuropathic), omwe amatha kutsatiridwa ndi matenda a osteoarticular zida kapena popanda kuwononga mafupa,

Kuwonongeka kwa mtima (mawonekedwe a angiopathic, kapena ischemic, mawonekedwe), chifukwa chomwe magazi amayenda m'miyendo amachepa,

Mawonekedwe osakanikirana a neuroischemic.

218 Kodi zizindikiro za matenda ashuga odwala matenda ammimba ndi ziti?

Syndrome diabetesic phazi limawonekera mu mawonekedwe a trophic zilonda, zolumikizana zolowa pakhungu ndi njira ya purulent-necrotic. Ichi ndichifukwa cha kusokonezeka kwa mitsempha komwe kumachitika chifukwa cha matenda osokoneza bongo komanso kuchepa kwa magazi m'magazi am'munsi mwa kuzungulira kosiyanasiyana. 85% ya milandu, zovuta zimayamba ngati zilonda zam'mimba.

219 Matenda a chifuwa cha matenda ashuga afala motani?

Ili matenda amapezeka mwa wodwala aliyense wa 8-10 wodwala matenda ashuga, ndipo sekondi iliyonse amakhala pachiwopsezo. Ndi matenda a shuga a 2, izi matenda Amakhala nthawi zambiri kuposa mtundu woyamba wa matenda ashuga, ndipo amatha kuchitika kuyambira pachiyambi cha matenda (ndipo nthawi zina ndimakhala chizindikiro choyamba cha matenda ashuga, chomwe chimakopa chidwi). Ndi matenda a shuga amtundu 1, awa matenda amakula pofika chaka cha 7000 cha matenda.

220 Kodi chimapangitsa kukula kwa matenda ashuga ndi chiyani?

Mwa mawonekedwe a neuropathic phazi la matenda ashuga, zinthu zomwe zitha kukhala zowopsa ndi motere:

Sikokwanira kubwezera kuchuluka kwa shuga m'magazi.Kuchuluka kwa ziwerengero zomwe zimayendetsedwa, ndizowonjezereka izi matenda Ndipo akubwera mwachangu.

Kutalika kwa matenda ashuga. Matendawa amatenga nthawi yayitali, pomwepo pamakhala mwayi wokhala ndi vutoli,

M'badwo. Ndi ukalamba, matendawo amawonjezeka,

Mowa wambiri, womwe umakhala ndi poizoni m'maselo a mitsempha.

Zinthu ziwiri zoyambirira zimagwira ntchito yayikulu mwadzidzidzi matenda diabetic phazi osati pa mtundu wa neuropathic, komanso angiopathic.

Kuphatikiza apo, kukhalapo kwa matenda monga matenda oopsa ndipo digiri yake imatenga gawo lofunikira pakuchitika kwa mawonekedwe a angiopathic. kubwezera kuphwanya lipid kagayidwe (dyslipidemia), kukula kwa atherosulinotic zotupa zam'mimba ziwiya, komanso kusuta fodya.

Chifukwa chiyani odwala matenda ashuga amayamba?

Syndrome Matendawa odwala matenda ashuga amakula chifukwa:

1) zotupa za zotumphukira mantha dongosolo (neuropathy),

2) zotupa za mitsempha yam'munsi yam'mphepete (angiopathy) ndi kuwonongeka kwa magazi,

3) kujowina motsutsana ndi maziko a izi matenda a matenda.

222 Kodi zizindikiro za matenda ashuga apakati ndi ziti?

Kutengera ndi kuwonekera kwa kuwonongeka kwa mitsempha (mitsempha) kapena mitsempha yamagazi (angiopathy) pakukula kwa izi, chithunzi cha chipatala chili ndi mawonekedwe ake. Pali mitundu iwiri yamawonekedwe a neuropathy:

Fomu yopanda ululu - yotsatiridwa ndi kuchepa kwa chidwi cha kupweteka (ndizofala kwambiri komanso zowopsa, chifukwa mabala ndi kuvulala zimatha kusadziwika),

Mawonekedwe a ululu - amadziwonetsa ndi zizindikiro zosiyanasiyana: kumva, kupsya, kupweteka, kupumula.

Khungu lomwe limakhala ndi mawonekedwe a neuropathic ndi louma, ma chimanga ndi zilonda zopanda ululu zimapangidwa m'malo opsinjika mopitirira muyeso.

Fomu ya angiopathic imadziwika ndi mtundu wotuwa wa khungu la kumapazi kapena ndi hule wa cyanotic. Zilonda zopweteketsa mwadzidzidzi zimapanga nsonga za zala kapena m'mphepete mwa zidendene. Mukamayenda, kupweteka kwa m'miyendo kumazindikirika, mogwirizana ndi momwe mawonekedwe a gait, otchedwa intermittent claudication, amapangidwira.

Ngati pali zotupa za matenda a m'mimba (diabetesic osteoarthropathy, kapena olowa nawo a Charcot), ndiye kuti chithunzi chotsatira cha chipatala chimawonetsedwa: khungu limatentha, limawotchedwa, popanda zizindikiro zowonongeka, phazi limatupa, monga lamulo, kupweteka kumadziwika.

223 Ndi chiani chomwe chimakhudza kuchuluka kwa kukula kwa matenda a shuga?

Kukula kwa gawo loyamba matenda shuga phazi zimatengera digiri kubwezera kuchuluka kwa shuga m'magazi. Bwino kulipidwa glycemia , sichingakhale chitukuko chamatchulidwe azachipatala matenda matenda ashuga.

224 Kodi mungapewe bwanji chitukuko cha matenda ashuga othamanga?

Udindo waukulu wopewa matenda phazi la matenda ashuga limasewera kwambiri ndikuwunika shuga wamagazi ndi zovuta zina za metabolic (i.e. lipids magazi). Kafukufuku wambiri wawonetsa motsimikiza kuti ngati shuga m'magazi kwa zaka zingapo sichidutsa 9 mmol / l, ngakhale angiopathy ndi (kapena) neuropathy ikuchitika, mkhalidwe umakhala bwino - zizindikiro zamankhwala zimachepa kapena kutha, machiritso a mabala amakhala bwino. Chofunikira kwambiri choletsa kukula kwa phazi la matenda ashuga mwa odwala omwe ali ndi matenda a shuga 2 ndiko kusintha kwamawu insulin Popeza mphamvu ya kumwa mapiritsi. Chofunika kwambiri ndikuwonetsetsa kuti malamulo akusamalira miyendo (onani mafunso No. 502-510).

Kodi muyenera kuchita chiyani kuti muwone kuyambika kwa phazi la matenda ashuga nthawi?

Kuti muwone kuyambika kwa chitukuko cha phazi la matenda ashuga mu nthawi, ndikofunikira kuchita mayeso pafupipafupi ndi katswiri.Ndi kupewa komwe kumathandiza kwambiri poletsa kudula miyendo ndi manja. Tsoka ilo, samalandira chisamaliro choyenera ndipo osachepera theka la odwala samayamba kulandira chithandizo pa nthawi. Dziwani kuti kuchitapo kanthu mwachangu njira zothanirana zimachepetsa pafupipafupi kudula kwa odwala mpaka 90%. Pakadali pano, masekondi 30 aliwonse padziko lapansi, kudula matendawa chifukwa cha matenda ashuga kumachitika, ndipo odwala ambiri akangochita opaleshoni amadziwa kuti ali ndi matenda ashuga.

Udindo wofunikira, kuwonjezera pa kuphatikiza shuga m'magazi, ndi wa kukonza kwakanthawi kake pazinthu zina zowopsa, komanso chithandizo choyenera cha zilonda zam'mimba komanso zolakwika zina phazi.

226 Kodi vuto lalikulu la matenda ashuga wodwala ndi lotani?

Vuto lalikulu kwambiri la phazi la matenda ashuga ndi kukula kwa matenda osokoneza bongo.

227 Kodi wodwala matenda ashuga ndi chiyani?

Matenda a matenda ashuga ndi necrosis ya minofu yakuda kapena yakuda kwambiri (nthawi zambiri malekezero am'munsi) omwe amapezeka motsutsana ndi maziko a matenda osokoneza bongo.

228 Ndi zinthu ziti zomwe zimayambitsa kukula kwa matenda ashuga?

Kukhazikika kwa matenda osokoneza bongo omwe amayamba chifukwa cha matenda ashuga amayambitsidwa ndi zinthu zotsatirazi: a

229 Mu milandu iti yomwe ndiyenera kumuwona dokotala?

Dokotala amayenera kuthandizidwa pazochitika zotsatirazi: kutupa (ngakhale pang'ono), kuvulala, kuwotcha, chisanu, mabala, mabala, zilonda zam'mimba, kupatsirana, kuyimbira khungu, kuwoneka ngati ululu kapena kuchepa kwa khungu. Munthawi iliyonse yokayikira komanso kusintha kulikonse komwe kudalipo.

230 Chifukwa chiyani kuli kofunikira kufunafuna thandizo munthawi yake?

Ngati chilonda chachitika, chithandizo choyenera komanso chapanthawi yake mu 95% cha milandu chimapewa kuduladuka kwa dzanja.

231 Kodi chithandizo chamankhwala a matenda ashuga ndi chiyani?

Chithandizo chimaphatikizira kukonza matenda a metabolic, mankhwala am'deralo komanso ambiri antimicrobial, kupuma kwathunthu ndi kutsitsa miyendo.

Pakakhala kuwonongeka kwakukulu m'mitsempha yamagazi ndikuchepetsa mphamvu ya ziwiya, opaleshoniyo amachitidwa mwina kuti akuwonjezera chotengera kapena kupachika mlatho wamitsempha wapamtunda.

Kuchokera m'buku lakuti Clinical Nutrition for Diabetes lolemba Alla Viktorovna Nesterova

Zovuta za matenda ashuga Zovuta za shuga zimaphatikizira izi: - matenda ashuga ketoacidosis, - hyperosmolar coma, - hyperglycemic

Mavuto obwera chifukwa cha matenda ashuga Mochedwa matenda a shuga ndimatenda a ziwalo zonse zamthupi ndi machitidwe amthupi, omwe amayamba chifukwa cha kuchuluka kwa shuga kwa magazi kwa nthawi yayitali, ndiko kuti, hyperglycemia. Momwe magazi anu amapezeka kwambiri, ndiye kuti mumakhala shuga wambiri.

Mavuto a matenda a shuga m'matumbo a ana Ndi matenda omwe sanayambike nthawi yomweyo, matenda ashuga amatha msanga ndikukhala mtundu wophatikizika, zikavuta kusankha chithandizo chofuna kuchepetsa shuga

Phunziro No. 7. Mavuto a matenda ashuga. Ketoacidosis pachimake zovuta za shuga imabweretsa chiwopsezo m'miyoyo ya odwala. Mavuto owopsa amakhala ndi chikomero cha hyperglycemic ndi hypoglycemic. Nthawi zambiri, mkhalidwe wa hypoglycemia umayamba,

Mutu 11. Vutoli limabwera ndi matenda ashuga. Matenda a shuga angiopathy ndi zotumphukira zotupa zomwe zimafalikira ku ziwiya zazing'onoting'ono komanso zapakatikati ndipo

Gawo II Mavuto a shuga 136 Kodi zovuta za shuga ndi ziti? Mavuto onse agawidwa pachimake, omwe amayamba chifukwa cha kuwonongeka msanga kwa kagayidwe kazakudya, komanso matenda (amatchedwanso mochedwa) - chifukwa chotsatira

Mutu 8 Mavuto azovuta za matenda a shuga 137? Zovuta za pachimake (zotupa zowonongeka) za shuga zimaphatikizapo kusintha kwa shuga m'magazi momwe amawonjezera (omwe amatchedwa hyperglycemic coma - ketoacidotic,

Mutu 9 Mavuto a shuga a m'mapeto a 198 Kodi mavuto obwera chifukwa cha matenda ashuga ndi otani? Mavuto ena obwera chifukwa cha matenda a shuga ndi matenda opatsirana kuyambira nthawi yayitali shuga m'magazi ndi m'thupi lathu.

Mavuto azovuta za matenda a shuga a mellitus A shuga ndi oopsa osati ndi shuga wambiri, omwe amatha kukhala ndi chithandizo chokwanira, koma zovuta zake zam'mimba, zomwe ndi zomwe zimayambitsa kulumala ndi kufa pakati pa

Mavuto obwera chifukwa cha matenda ashuga Nthawi zina zimachitika kuti ngati matenda ashuga samawerengeka kwa nthawi yayitali (mwachitsanzo, wodwalayo mwina satha kukayikira matenda ashuga amtundu wachiwiri), zitha kuyambitsa zovuta pafupifupi ziwalo zonse zamkati. Mavuto obwera chifukwa cha matenda ashuga,

Mavuto azovuta za matenda a shuga Kupezekapezeka kwa nthawi yake kumakulitsa mtundu wa shuga ndi mtundu wachiwiri wa II ndipo zimapangitsa kukulira. Zovuta pachimake ndi ketoacidosis, hypoglycemic mamiriro, ketoacidotic, hypoglycemic ndi

Zovuta zakuchepera kwa shuga Nthawi zina, amatha kupewedwa poyang'anira

ACUTE COMPLICATIONS of DIABETES Matenda a shuga ndi oopsa osati ndi shuga wambiri, omwe amatha kukhala ndi chithandizo chokwanira, koma ndi zovuta zake zam'mimba, zomwe ndi zomwe zimayambitsa kulumala ndi kufa pakati pa

KUTENGA KWA ZIWEREWERE ZAMBIRI (KIDNEYS, EYES, ZOTHANDIZA NDIPO ENA) NDI ZOFUNIKIRA ZAULEMERERE Matenda am'mbuyomu omwe amabwera chifukwa cha matenda a shuga ndi matenda a ziwalo zonse zamthupi ndi machitidwe amthupi, omwe amayamba chifukwa cha kuchuluka kwa shuga m'magazi, ndiko kuti, hyperglycemia. Zoposa

Mavuto a shuga mellitus mwa anthu omwe ali ndi malamulo a ntchofu. Pokhala ndi matenda ashuga, magazi otsekemera amathandizira kupanga zotupa zamitundu mitundu, kuchokera ku lipo-adipose yopanda vuto mpaka mapangidwe a polyps ndi neoplasms yayikulu. Kwa zaka zambiri odwala matenda a shuga

Matenda a shuga ndi imodzi mwamatenda oopsa pankhani ya zovuta. Ngati mukusamala zaumoyo wanu, osatsata chakudya, matendawa amabwera ndi mwayi waukulu. Ndipo kusowa kwa chithandizo kudzawonekeranso kwakukulu zovuta zovuta omwe agawidwa m'magulu angapo:

Zotsatira zake

Pambuyo pake zovuta zina zimayamba kudutsa zaka zingapo. Chiwopsezo chawo sichiri pakuwonekera kwathunthu, koma chifukwa iwo pang'onopang'ono zimayamba kuvuta wodwala. Ngakhale kupezeka kwa chithandizo choyenera nthawi zina sikungatsimikizire kutetezedwa ku zovuta zamtunduwu.

Mavuto apambuyo a shuga akuphatikizaponso matenda :

1. - kuwonongeka kwa retina, komwe kumayambitsa kukhumudwa mu fundus, retina detachment. Pang'onopang'ono kumabweretsa kuwonongeka kwathunthu kwamawonedwe. Matenda omwe amafala kwambiri retinopathy amapezeka mwa odwala omwe ali ndi matenda ashuga a 2. Kwa wodwala yemwe ali ndi "zaka" zopitilira 20, chiopsezo cha retinopathy chikuyandikira 100%.
2. . Poyerekeza ndi zovuta zina zomwe zimachedwa, zimayamba msanga, nthawi zina osakwanitsa chaka. Ndikuphwanya kwa mtima kukhathamira, amakhala osakhazikika. Pali chizolowezi cha thrombosis ndi atherosulinosis.
3. . Kuyiwalika pakumva kupweteka komanso kutentha m'miyendo. Nthawi zambiri, amakula molingana ndi mtundu wa "magolovesi ndi masheya", amayamba kuwoneka nthawi yomweyo m'miyendo yakumunsi ndi kumtunda. Zizindikiro zoyambirira ndikumverera kwa dzanzi ndikuwotcha miyendo, zomwe zimakulitsidwa kwambiri usiku. Kuchepetsa chidwi kumapangitsa ambiri kuvulala.
4. . Vuto lomwe mabala otseguka, zotupa zam'mimba, ndi malo oonda (akufa) amawoneka pamapazi ndi malekezero ochepa a wodwala matenda a shuga. Chifukwa chake, odwala matenda ashuga ayenera kuyang'anira kwambiri ukhondo wamapazi ndi kusankha nsapato zoyenera zomwe sizipondereze mwendo. Mugwiritsanso ntchito masokosi apadera popanda kufinya chingamu.

Chifukwa chiyani zovuta zimayambika mu shuga

Zomwe zimayambitsa kuwoneka kwa zovuta zodwala zimatengera mtundu wamatenda. Mtundu wa I wa matenda a shuga ndimakomoka, mavuto amakula pamene wodwala sapereka insulin panthawi yake.

Wodwalayo amatha kupatuka mwadongosolo kuchokera pa jakisoni, zomwe zimapangitsa kuti matenda awonekere.

Njira zopangira zovuta:

1. Kuchuluka kwa insulin m'magazi kumachepa, ndipo shuga amawonjezeka.
2. Pali kumverera kwamphamvu kwa ludzu, polyuria (kuchuluka kwa mkodzo).
3. Kuchuluka kwamafuta m'magazi kumachuluka chifukwa cha lipolysis yayikulu (kuwonongeka kwamafuta).
4. Njira zonse za anabolic zimachepetsedwa, minofu sikulinso kutha kuwonongeka kwa matupi a ketone (acetone opangidwa m'chiwindi).
5. Pali kuledzera kwa thupi.

Ndi mtundu II matenda a shuga a mellitus (osadalira insulin), mavuto amayamba chifukwa chakuti odwala safuna kutsatira zakudya ndipo samamwa mankhwala ochepetsa shuga. Kuwongolera zakudya ndizovomerezeka pochiza matenda a hyperglycemia (kuchuluka kwa shuga m'magazi) ndi insulin kukana (kuchepa kwamphamvu kwa maselo otengera insulini).

Mavuto a matenda a shuga a mtundu wachiŵiri amatuluka motere:

1. Mwazi wamagazi pang'onopang'ono umachuluka.
2. Chifukwa cha kuchuluka kwa shuga, ntchito ya ziwalo zamkati imayamba kuwonongeka.
3. Intracellular hyperglycemia imayamba, zomwe zimapangitsa kuti gluoto azindikire (kusokonekera kwa dongosolo lamanjenje) ndi matenda ena.

Zinthu zomwe zimawonjezera chiopsezo cha zovuta

Matenda a wodwala samakonda kuvuta popanda chifukwa. Zinthu zomwe zimawonjezera chiopsezo cha zovuta za matenda ashuga:

• Makamaka. Chiwopsezo chokhala ndi zovuta mwa wodwala chimawonjezera nthawi 5-6 ngati m'modzi mwa makolo ake adadwala kwambiri matenda ashuga.
• Kulemera kwambiri. Izi ndizowopsa makamaka kwa matenda amtundu 2. Kuphwanya kawirikawiri zakudya kumabweretsa kukuwonjezeka kwa mafuta m'thupi. Ma cell receptor enieni sangathenso kulumikizana ndi insulin, ndipo pakapita nthawi kuchuluka kwawo kwamankhwala am'mimba kumachepa.
• Kumwa mowa. Anthu omwe ali ndi matenda amtundu uliwonse a shuga ayenera kusiya mowa. kumayambitsa hypoglycemia, kumachepetsa mphamvu ya mtima.
• Kulephera kudya. Ndi matenda a shuga a mtundu 2, ndizoletsedwa kudya zipatso zotsekemera ndi zakudya zokhala ndi chakudya chamafuta othamanga komanso mafuta amkati (ayisikilimu, chokoleti, margarine, ndi zina). Ndi matenda amtundu uliwonse, simungathe kudya chakudya mwachangu. Anthu omwe ali ndi matenda a shuga a "Insulin" ayenera kuthetseratu maswiti pazakudya. Ngati zakudya sizitsatiridwa, shuga msanga amadzuka ndikugwa kwambiri.
• Kulephera kuchita zolimbitsa thupi. Kunyalanyaza zolimbitsa thupi ndi physiotherapy kumayambitsa kutsika kwa kagayidwe. Zinthu zowola zimakhala zazitali kwambiri m'thupi ndipo zimayambitsa poizoni.
• Matenda a mtima. Ndi matenda oopsa, matenda a mtima, kuchepa kwa mitsempha, chiwopsezo cha minyewa mpaka insulin chimachepa.
• Kupsinjika, kupsinjika kwamphamvu kwamaganizidwe. Adrenaline, noradrenaline, glucocorticoids zimawononga kwambiri ntchito kapamba ndi insulin.
• Mimba Tizilombo ta thupi la akazi timalandira zochepa insulin yawo chifukwa cha mahomoni opanga nawo.

Hyperglycemic zinthu

Kuchuluka kwa shuga m'magazi kungaphe munthu wodwala matenda a shuga. Mikhalidwe ya Hyperglycemic imalimbikitsa kugonekedwa kuchipatala kuti muthandizenso. Amabwera m'mitundu itatu:

Hypoglycemia

Kukula kwa matendawa kumakwiyitsa shuga m'magazi. Kuti achepetse wodwalayo, madokotala amayika shuga. Hypoglycemia imatha kuyambitsa kuchuluka kwa insulin, mowa, kudya kwambiri, kuchita masewera olimbitsa thupi mopitirira malire. Zizindikiro za matendawa:

• nkhanza, mkhalidwe wamantha wopanda nkhawa kapena nkhawa,
• thukuta kwambiri, khungu
• kuchuluka kwa mtima - kuchokera pa 100 mpaka 400 pamphindi,
• minofu ikunjenjemera kapena kukokana
• kusanza, kusanza,
• "Kuwona kawiri" m'maso,
• mutu, chizungulire chachikulu.

Matenda a shuga

Sikuti mavuto onse omwe ali ndi vuto la metabolic amawonekera nthawi yomweyo. Matenda angapo amapezeka ndi kusokonekera kwa nthawi yayitali komanso kuledzera. Organs ndi maselo amasiya kugwira ntchito yawo. Mavuto a matenda a shuga am'mbuyomu:

• Kutaya kwamaso. Pazidziwitso zoyambirira za matendawa, 32% ya odwala amapeza retinopathy (kuwonongeka kwa retina). Ngati sanachiritsidwe, wodwalayo amatha msanga, kenako khungu.
• Matenda a shuga. Dongosolo la impso limakhudzidwa. Satha kusefa madzi a m'magazi nthawi zambiri, ndipo mapuloteni amapezeka mkodzo. Matendawa amakula pafupifupi asymptomerate mpaka kukomoka.
• Kugonjetsedwa kwamadongosolo azizungulira. Type 2 shuga mellitus ndi chimodzi mwazomwe zimayambitsa kudula kwamiyendo, osakhudzana ndi kuvulala kwamthupi kapena ngozi. Matendawa omwe ali ndi matendawa amakula pang'onopang'ono. Kwa nthawi yayitali, wodwalayo sangathe kuyang'anira chidwi cha necrosis mpaka atadula phazi kapena dzanja lonse likufunika.
• Zowonongeka kwa chapakati mantha dongosolo (CNS).
• Angiopathy.

Ndi shuga yemwe amadalira insulin, wodwalayo atha kukhala ndi zovuta zotsatirazi:

• Kulephera kwina. Pa siteji yodwala, wodwalayo amafunika kumuwonjezera impso.
• Kugonjetsedwa kwa mtima wamtima. Choyambitsa chachikulu cha imfa kwa odwala omwe ali ndi matenda a shuga a 2 ndi stroke kapena matenda a mtima. Zida za mtima ndi ubongo mothandizidwa ndi glucose owonjezera zimayamba kutsika, zotupa za atherosulinotic zimawonekera pamtunda wawo.
• Mavuto ndi chapakati mantha dongosolo ndi zotumphukira mantha dongosolo.
• Kuphwanya magazi kumadera akumunsi.
• Mavuto amawonedwe.

Angiopathy

Matenda amaphatikizidwa ndi kuwonongeka kwa ziwiya zazikulu komanso zazing'ono. Ndi angiopathy, kufalikira kwa magazi kumadera otsika, ntchito ya impso, maso, mtima, ubongo zimasokonekera.

Matenda amathandizidwa ndimankhwala kuti achepetse cholesterol, kupewa magazi, kusintha kagayidwe kazomwe zimakhala.

• kukodza pafupipafupi
• khungu
• arrhasmia,
• makonda edema,
• kutsika kwamawonedwe owoneka,
• kulumikizika kwamphamvu ndikukumbukira,
• kuthamanga kwa magazi.

Kuwonongeka kwa dongosolo lamanjenje lamkati

Ndi matenda a shuga, kuthira kwa magazi kwa ziwalo zonse kumasokonezeka. Kuwonongeka kwa dongosolo lamanjenje kumasonyezedwa pakukula kwa encephalopathy. Odwala ali ndi asthenia, vegetovascular kukanika, neurosis, kukomoka. Mutha kuzindikira matendawa pogwiritsa ntchito MRI ndi electroencephalography.

Zochizira encephalopathy mu shuga mellitus, zotchulidwa:

• Mankhwala osokoneza bongo kuti akhale ndi magazi ambiri.
• Mankhwala othandizira kukweza magazi m'magazi, ma nootropics.
• Mankhwala omwe amachepetsa kuthamanga kwa magazi.
• Mavitamini B, alpha lipoic acid, vitamini E pakugwirira ntchito kwamkati kwamanjenje.
• Sedatives, bata.

Matenda a matenda ashuga

Kusintha kwamankhwala ndi makina kumachitika motsutsana ndi maziko a osteoarthropathy, neuropathy, angiopathy. Zovuta za phazi la matenda ashuga zimayamba kumadera akumadera akum'munsi, i.e. pa zala ndi mapilitsi. Njira zoyipa za necrotic zimakhudza minofu yofewa komanso mafupa. Pafupifupi 90% ya mawonetseredwe amtunduwu amapezeka mwa odwala omwe ali ndi matenda a shuga a 2. Matenda a shuga amakhalapo amitundu itatu:

• Neuropathic. Amayamba motsutsana ndi maziko a matenda ashuga omwe amachititsa zotumphukira zamafungo (polyneuropathy).
• Neuroischemic. Choyambitsa matendawa ndi matenda angiopathy.
• Osteoarthropatic. Fomu ili ndi magawo atatu: pachimake, subacute, aakulu. Choyambitsa matendawa ndi mafupa.

Zotsatira za matenda ashuga mwa ana

Chifukwa chachikulu chakuonekera kwa matendawa ali aang'ono ndi kupangika kwamtundu. Mwana akamadwala matenda opatsirana pafupipafupi, amakhala ndi chitetezo chofooka, ndiye kuti ali pachiwopsezo cha matenda a shuga. Ana ali ndi mavuto awa:

• Mavuto a impso. Matendawa amakula chifukwa chakuti kuchuluka kwa glucose kumawononga zinthu zosefera. Proteinuria (mawonekedwe a mapuloteni mumkodzo) ndiye chizindikiro chachikulu cha nephropathy. Odwala omwe ali ndi matenda a impso akuwonetsedwa zakudya zomwe zimachepetsa kuthamanga kwa magazi ndi kagayidwe ka lipid. Kwa matenda amtundu wa genitourinary, maantibayotiki ndi omwe amapatsidwa mankhwala.
• Kuchepetsa maonedwe owoneka. Ndi milingo yayikulu yamagazi, mitsempha yamagazi ndi minyewa ya m'maso imawonongeka. Poyerekeza ndi machitidwe awa, kuwona kumatsika. Wodwalayo amadandaula kuti akuuma, "akuwuluka" pamaso pake. Chithandizo chimakhala poteteza magazi ku fundus pogwiritsa ntchito mankhwala, kutsitsa shuga.

Chithandizo cha mavuto a shuga

Popanga dongosolo la chithandizo, momwe wodwalayo alili ndi gawo lofunikira. Mbali zazikuluzikulu za chithandizo ndi zitatu:

1. Kuchepa kwa shuga. Odwala onse ayenera kutsatira zakudya zamafuta ochepa. Ndi matenda a mtundu woyamba, mankhwala a insulin amasonyezedwa, ndipo ndi mtundu 2, kugwiritsa ntchito mankhwala ochepetsa shuga.
2. Kubwezera kwa kagayidwe kachakudya njira. Pulogalamu yamunthu yokhazikika imapangidwira wodwala, jakisoni wa mavitamini ndi ma acid opindulitsa amalembedwa. Zochita zolimbitsa thupi zimafunikira.
3. Chithandizo. Njira yakuchiritsira imapangidwa motsatira mtundu ndi kuuma kwa matenda omwe ali pafupi. Mwachitsanzo, zotupa zopweteka za miyendo kapena genitourinary system zimathandizidwa ndi maantibayotiki.

Matenda a shuga ndi matenda oopsa omwe njira za metabolic, kuphatikizapo kagayidwe kazakudya zimasokonekera. Matendawa ali ndi matenda osachiritsika, ndipo sangathe kuthandizidwa kwathunthu, koma amalipiridwa.

Kuti musakhale ndi zovuta za matenda ashuga, ndikofunikira kupita pafupipafupi ndi endocrinologist ndi akatswiri othandizira odwala. Ndikofunikira kuyang'anira kuchuluka kwa shuga, omwe amayenera kukhala kuyambira 4 mpaka 6.6 mmol / l.

Aliyense wodwala matenda ashuga ayenera kudziwa kuti zotsatira za matenda a hyperglycemia nthawi zambiri zimayambitsa kulumala ngakhale kufa kumene, mosasamala mtundu wa matenda. Koma ndi zovuta ziti za matenda ashuga zomwe zingayambike ndipo chifukwa chiyani zimawonekera?

Matenda a shuga: njira zopititsira patsogolo

Mwa munthu wathanzi, shuga ayenera kulowa m'magazi amafuta ndi minofu, kuwapatsa mphamvu, koma mu shuga amakhalabe mumtsinje wamagazi. Ndi shuga wambiri wambiri, chomwe ndi chinthu cha hyperosmolar, makoma a mtima ndi ziwalo zamagazi owonongeka.

Koma awa ndi mavuto obwera chifukwa cha matenda ashuga kale. Ndi kuperewera kwambiri kwa insulin, zotsatira zoyipa zimawoneka zomwe zimafuna chithandizo chamanthawi, chifukwa zimatha kupha.

Mtundu woyamba wa matenda ashuga, thupi limasowa insulin. Ngati kuchepa kwa mahomoni sikulipilitsidwa ndi insulin, zovuta za shuga zimayamba kukula msanga, zomwe zimachepetsa kwambiri chiyembekezo cha moyo wa munthu.

Mtundu wachiwiri wa matenda ashuga, kapamba amapanga insulin, koma maselo amthupi pazifukwa zosiyanasiyana sakudziwa. Pankhaniyi, mankhwala ochepetsa shuga amalembedwa, komanso mankhwala omwe amalimbikitsa kukana kwa insulin, omwe angapangitse kuti kagayidwe kazinthu kazikhala nthawi yayitali.

Nthawi zambiri, mavuto akulu a matenda a shuga 2 samawonekera kapena amawoneka osavuta. Koma nthawi zambiri, munthu amangodziwa za kukhalapo kwa matenda ashuga akamakula, ndipo zotsatirapo zake sizisintha.

Chifukwa chake, zovuta za shuga zimagawika m'magulu awiri:

Kupewa komanso kuchiza matenda ashuga

Mavuto oyambilira komanso mochedwa amathandizidwa m'njira zosiyanasiyana. Chifukwa chake, kuti muchepetse vuto la matenda obwera chifukwa cha matenda ashuga kumayambiriro koyambirira, ndikofunikira kuyang'anira kuchuluka kwa glycemia, ndipo ngati chitukuko cha matenda a hypoglycemic kapena hyperglycemic, chitani njira zoyenera zanthawi yake.

Kuchiza kumazikidwa pazinthu zitatu zamankhwala. Choyamba, ndikofunikira kuwongolera kuchuluka kwa glucose, omwe amayenera kuchokera ku 4,4 mpaka 7 mmol / l. Kuti izi zitheke, amamwa mankhwala ochepetsa shuga kapena amagwiritsa ntchito mankhwala a insulin.

Ndikofunikanso kulipira njira za metabolic zomwe zimasokonezeka chifukwa cha kuchepa kwa insulin. Chifukwa chake, odwala amawapatsa mankhwala a alpha-lipoic acid ndi mankhwala a mtima. Ndipo vuto la atherogenicity yayikulu, adokotala amatipatsa mankhwala omwe amachepetsa cholesterol (fibrate, statins).