Mwazi wa shuga mwa akulu ndi ana

Kuyesedwa kwa biochemical kwa shuga ndi imodzi mwazolemba zasayansi zomwe zimachitika nthawi zambiri. Izi ndizomveka. Anthu opitilira 400 miliyoni masiku ano ali ndi matenda ashuga padziko lapansi, ndipo pofika chaka cha 2030, monga akatswiri a WHO adaneneratu, matendawa adzakhala pa malo a 7 mndandanda wazomwe zimayambitsa kufa kwa anthu. Matendawa ndi obisika: amakula modabwitsa kwa nthawi yayitali, osadzidziwitsa okha isanayambike njira zowonongeka m'matumbo, mtima, maso. Pofuna kupewa zovuta. Ndikofunikira kuti mulamulire kuchuluka kwa shuga ndikuwunikira zomwe muyenera kuwonetsa nthawi yomweyo.

Zochita zachipatala zochulukirapo zapeza chidziwitso chochuluka pakuzindikira matendawa kumayambiriro, pomwe wodwalayo akhoza kukhalabe wathanzi pokhapokha ngati asintha zakudya ndi moyo. Tiyeni tikambirane mwatsatanetsatane mayeso omwe mungawone kuchuluka kwa shuga m'magazi, momwe mungayesedwe kupewa zotsatira zabodza, ndi ziwerengero ziti zomwe zikuwonetsa kukula kwa matenda ashuga komanso zovuta zina za endocrine system.

Kodi kuyezetsa magazi kwa shuga kumawonetsa chiyani

Shuga m'moyo watsiku ndi tsiku amatchedwa glucose, omwe amasungunuka m'magazi ndikuzungulira kuzungulira ziwalo zonse zamthupi ndi machitidwe a thupi. Imalowa m'magazi kuchokera m'matumbo ndi chiwindi. Kwa anthu, shuga ndiye gwero lalikulu lamphamvu. Zimagwira ntchito yoposa theka la mphamvu zonse zomwe thupi limalandira kuchokera ku chakudya, kukonza chakudya. Glucose amathandizira komanso amapereka maselo ofiira am'magazi, minofu ya m'magazi, ndi ma cell aubongo. Hormoni yapadera - insulini - yomwe imapangidwa ndi kapamba, imathandizira kuti ichite bwino. Kuphatikizika kwa shuga m'magazi kumatchedwa shuga. Shuga wochepa kwambiri amapezeka asanadye. Pambuyo podya, imadzuka, pang'onopang'ono kubwerera ku mtengo wake wakale. Nthawi zambiri, thupi laumunthu limayang'anira pawokha mozungulira: 3.5-5.5 mmol / l. Ichi ndiye chizindikiritso chabwino kwambiri kotero kuti mphamvu yamagetsi imakhala yofikira ku machitidwe ndi ziwalo zonse, imalowetsedwa kwathunthu ndipo simatulutsidwa mkodzo. Zimachitika kuti mu kagayidwe kakang'ono ka glucose kamasokonezedwa. Zomwe zili m'magazi zimachuluka kapena zimachepera kwambiri. Izi zimatchedwa hyperglycemia ndi hypoglycemia.

1. Hyperglycemia Izi ndi zomwe zili ndi shuga m'magazi am'magazi. Ndi kulimbitsa thupi kwambiri mthupi, mphamvu zamphamvu, kupsinjika, kupweteka, adrenaline kuthamanga, gawo limakwera kwambiri, lomwe limagwirizanitsidwa ndi kuwonjezereka kwa mphamvu. Kukwera kumeneku kumakhala nthawi yochepa, zizindikiro zimangobwerera zokha. Vutoli limadziwika kuti ndi la m'magazi pakamachitika kuchuluka kwa glucose m'magazi nthawi zonse, kuchuluka kwa shuga kumadutsa kwambiri kuposa momwe thupi limaphatikizira. Izi zimachitika, monga lamulo, chifukwa cha matenda a endocrine system. Chofala kwambiri ndi matenda ashuga. Zimachitika kuti hyperglycemia imayambitsidwa ndi matenda a hypothalamus - awa ndi gawo la ubongo lomwe limayang'anira kugwira ntchito kwa timimba ta endocrine. Nthawi zina, matenda a chiwindi.

Mwazi wa shuga ukakhala wambiri kuposa wabwinobwino, munthu amayamba kudwala ludzu, umachulukitsa kukodza, khungu ndi nembanemba zimafota. A kwambiri mawonekedwe a hyperglycemia limodzi ndi mseru, kusanza, kugona, kenako kukomoka kwa hyperglycemic ndikotheka - iyi ndi chiopsezo cha moyo. Ndi kuchuluka kwa shuga kosalekeza, chitetezo cha mthupi chimayamba kupereka zolephera zazikulu, magazi omwe amapezeka m'matumba amasokonekera, njira zamkati mwa zotupa zimayamba mthupi.

Dziwani zovuta zamtundu wa metabolic m'njira zosiyanasiyana zimayesa kuyesedwa kwa magazi kwa shuga. Ngati zomwe zili m'magazi zili m'munsi mwa 3.5 mmol / l, dokotala amayenera kulankhula za hypoglycemia. Ngati apamwamba kuposa 5.5 mmol / l - hyperglycemia. Pankhani yomalizayi, pamakhala kukayikira kwa matenda a shuga, wodwalayo ayenera kukayezetsanso kuti adziwe ngati ali ndi matenda olondola.

Zisonyezero zakudikirira

Kugwiritsa ntchito kuyezetsa magazi, mutha kuzindikira bwino osati matenda ashuga okha, komanso matenda ena a endocrine system, ndikukhazikitsa boma la prediabetes. Kuyesedwa kwa shuga kaamba ka shuga kumatheka mwa kufuna kwanu, musanapite kwa dokotala. Komabe, pochita, anthu nthawi zambiri amatembenukira ku labotale, motsogozedwa ndi akatswiri othandizira kapena a endocrinologist. Zizindikiro zodziwika bwino zowunikira ndi izi:

• kutopa,
• kuluma, ulesi, kusakwiya, kukokana,
• kuchuluka kwakukulutu kwa chakudya,
• kuwonda msanga
• ludzu losalekeza komanso pakamwa louma
• kukodza pafupipafupi.

Kuyesedwa kwa magazi kwa glucose ndi zina mwa zomwe ziyenera kuchitika kuti thupi lipimidwe. Nthawi zonse kuwunikira mulingo kumalimbikitsidwa kwa anthu onenepa kwambiri komanso matenda oopsa. Pangozi ndi odwala omwe achibale awo amapezeka ndi vuto la metabolism. Kuyesedwa kwa shuga kumathanso kuchitika mwa mwana. Pali mayeso ofulumira pakugwiritsira ntchito zapakhomo. Komabe, cholakwika choyeza chitha kufikira 20%. Njira yokhayo yovomerezeka ndi yodalirika. Mayeso a labotale akupezeka popanda zoletsa, kupatula mayeso apadera kwambiri, omwe atha kuperekedwa kwa anthu omwe ali ndi matenda ashuga, amayi apakati komanso gawo lakukulitsa matenda osachiritsika. Kutengera ndi kafukufuku yemwe wachitika kuchipatala, ndizotheka kudziwa momwe wodwalayo alili komanso kupereka chithandizo chamankhwala ndi zakudya.

Mitundu ya kusanthula

Kuzindikira matenda ashuga ndi matenda ena amtundu wa endocrine amachitika m'magawo angapo. Choyamba, wodwalayo amakhala ndi mayeso athunthu a shuga. Pambuyo pakuphunzira zotsatila, adotolo amafufuza zowonjezera zomwe zimathandizira kutsimikiza ndi kupeza zomwe zasintha m'magazi a shuga. Kuzindikira komaliza kumakhazikitsidwa pazotsatira zoyesa zonse molumikizana ndi zizindikiro. Pali njira zingapo zowonetsera ma labotale, iliyonse yomwe ili ndi zisonyezo zake yogwiritsira ntchito.

• Kuyesa kwa shuga m'magazi. Phunziro loyambilira komanso lodziwika bwino. Kuyesedwa kwa shuga kumachitika ndi zitsanzo za zinthu kuchokera mu mtsempha kapena chala. Kuphatikiza apo, shuga m'magazi a venous ndi ochepa kwambiri, pafupifupi 12%, omwe amakhudzidwa ndi othandizira ogwira ntchito.
• Kutsimikiza kwa fructosamine ndende. Fructosamine ndi gulu la glucose lomwe limakhala ndi mapuloteni (makamaka ndi albumin). Kusanthula kwapangidwira kuti apeze matenda a shuga ndikuwonetsetsa momwe mankhwalawo alili. Kufufuza kwa fructosamine kumapangitsa kuwona zotsatira za mankhwala pambuyo pa masabata awiri. Iyi ndi njira yokhayo yomwe imakupatsani mwayi wowunika wokwanira kuchuluka kwa glucose ngati mutayika kwambiri maselo ofiira am'magazi: kuchepa kwa magazi ndi kuchepa kwa magazi m'thupi. Zosathandiza ndi proteinuria komanso hypoproteinemia. Pa kusanthula, wodwala amatenga magazi kuchokera m'mitsempha ndikupanga maphunziro pogwiritsa ntchito chosanthula chapadera.
• Kusanthula pamlingo wa hemoglobin wa glycated. Glycated hemoglobin ndi gawo la hemoglobin lomwe limagwirizanitsidwa ndi glucose. Chizindikirocho chimayeza. Shuga wambiri m'magazi, kuchuluka kwa hemoglobin kumathiriridwa. Ndikofunikira kuwunikira kwakanthawi kokwanira kwa chithandizo cha odwala omwe ali ndi matenda a shuga, kudziwa kuchuluka kwa chiphuphu. Kafukufuku wolumikizana wa hemoglobin ndi glucose amatilola kuyerekeza kuchuluka kwa glycemia miyezi 1-3 isanachitike. Magazi a Venous amatengedwa kuti akafufuze. Osamakhala mu amayi apakati komanso ana mpaka miyezi isanu ndi umodzi.

• Kuyesererana kwa glucose ndi glucose othamanga ndikatha kuchita masewera olimbitsa thupi pambuyo pa maola awiri. Kuyesereraku kumakupatsani mwayi wowunika momwe thupi limayankhira kudya shuga. Pa kusanthula, othandizira ogwira ntchito amawayeza kuchuluka kwa shuga pamimba yopanda kanthu, kenako ola limodzi ndi maola awiri mutatha shuga. Kuyeseraku kumagwiritsidwa ntchito kutsimikizira matendawa ngati kuwunika koyambirira kwawonetsa kale kuchuluka kwa shuga. Kuwunikaku kumawonetsedwa mwa anthu omwe ali ndi vuto lopanda kanthu m'mimba mwa glucose woposa 11.1 mmol / l, komanso omwe achita opaleshoni yaposachedwa, infarction ya myocardial, kubala mwana. Magazi amatengedwa kuchokera kwa wodwala kuchokera mumitsempha, kenako amapatsidwa magalamu 75 a shuga, magazi amakokedwa pambuyo pa ola limodzi komanso pambuyo pa maola awiri. Nthawi zambiri, kuchuluka kwa shuga kumayenera kukwera kenako ndikuyamba kutsika. Komabe, mwa anthu omwe ali ndi matenda ashuga, glucose akangolowa mkatikati, maphunzirowo salinso obwerera kuzomwe anali kale. Kuyesaku sikumachitika kwa ana ochepera zaka 14.
• Kuyesererana kwa glucose ndi kutsimikiza kwa C-peptide. C-peptide ndi kachidutswa ka molekyu ya proinsulin, kakhalidwe kamene kamapanga insulin. Kafukufukuyu amatilola kuti tigwirizanitse ntchito ya maselo a beta omwe amapanga insulini, kusiyanitsa matenda a shuga kukhala odalira insulin komanso osadalira insulin. Kuphatikiza apo, kusanthula kumachitika kuti ndikonzenso chithandizo chamankhwala a matenda amtundu 1 komanso 2. Gwiritsani ntchito magazi a venous.
• Kudziwitsa za ndende ya lactate m'magazi. Mlingo wa lactate, kapena lactic acid, umawonetsa momwe minofu yambiri imakwanira ndi mpweya. Kusanthula kumakupatsani mwayi wodziwa zovuta zamagazi, kudziwa hypoxia ndi acidosis mu kulephera kwa mtima ndi matenda a shuga. Owonjezera lactate amakhumudwitsa kukula kwa lactic acidosis. Kutengera ndi mulingo wa lactic acid, adokotala amapangitsa kuti adziwe ngati akufuna kudziwa zina kapena ayi. Mwazi umatengedwa kuchokera mu mtsempha.
• Kuyesererana kwa glucose pakakhala pakati. Matenda a shuga a gestational amapezeka kapena amapezeka koyamba panthawi yomwe ali ndi pakati. Malinga ndi ziwerengero, zamatenda zimakhudza azimayi 7%. Polembetsa, dokotala wazachipatala amalimbikitsa kuti azichita kafukufuku wokhudza kuchuluka kwa shuga m'magazi kapena glycated hemoglobin. Mayesowa akuwonetsa chiwonetsero cha matenda osokoneza bongo owoneka bwino (a). Kuyesedwa kwa glucose kumachitika pambuyo pake, kuyambira pa 24 mpaka 28 milungu isanachitike, pokhapokha kutchulidwa koyeserera kale. Ndondomekozi ndizofanana ndi mayeso ololera a glucose. Kuyamwa magazi kumachitika pamimba yopanda kanthu, ndiye ola limodzi mutatha kutenga magalamu 75 a shuga komanso pambuyo maola 2.

Mlingo wa shuga m'magazi umakhudzana mwachindunji osati ndi thanzi la wodwalayo, komanso machitidwe ake, momwe akumvera komanso zochita zake. Mukamapangira ma diagnostics a labotale, kukonzekera koyenera kwa njirayo ndikutsatira zomwe ziyenera kuperekedwa kwa biomaterial pakufufuza kwantchito ndikofunikira kwambiri. Kupanda kutero, pamakhala chiopsezo chachikulu chotenga zotsatira zosadalirika.

Zomwe zimaperekedwa ndi magazi posanthula shuga

Lamulo lalikulu lomwe limagwira pa mayeso onse, kupatula kuwunika kwa hemoglobin wa glycated, ndikupereka magazi pamimba yopanda kanthu. Nthawi yopewa kudya iyenera kukhala kuyambira maola 8 mpaka 12, koma nthawi yomweyo - osapitilira maola 14! Nthawi imeneyi, imaloledwa kumwa madzi. Akatswiri azindikira zina mwa zinthu zomwe ziyenera kudziwika:

• Mowa - ngakhale mlingo wocheperako, woledzera tsiku lakale, akhoza kupotoza zotsatira zake.
• Zizolowezi zakudya - Musanazindikire, simuyenera kudalira maswiti ndi chakudya.
• Zochita zolimbitsa thupi - Kuchita masewera olimbitsa thupi patsiku la kusanthula kungayambitse kuchuluka kwa shuga.
• Zinthu zovuta - Kuzindikira kuyenera kukhala pamalo abata komanso osasamala.
• Matenda opatsirana - pambuyo pa SARS, fuluwenza, tonsillitis ndi matenda ena, kuchira kumayenera mkati mwa masabata awiri.

Masiku atatu kusanachitike, zakudya zimayenera kuthetsedwa (ngati panali zina), zifukwa zomwe zingayambitse kuchepa kwa madzi m'thupi, mankhwala ayenera kuyimitsidwa (kuphatikiza kulera kwamlomo, glucocorticosteroids, vitamini C). Kuchuluka kwa chakudya cham'mawa chakumayambiriro kwa phunziroli kuyenera kukhala osachepera magalamu 150 patsiku.

Chisamaliro chapadera chiyenera kulipidwa pakuyesedwa kwa glucose mayeso. Popeza akuwonjezera kudya kwa glucose pophunzira, njirayi iyenera kuchitidwa pamaso pa katswiri wodziwa ntchito yake. Ndikofunikira kuti athe kuyesa momwe wodwalayo alili komanso kusankha kuchuluka kwa "mphamvu zamagetsi" zomwe zimayenera kudya. Vutoli pano likuwopseza ndi zotsatira zosadalirika, komanso kuchepa kwambiri pakubwera kwa wodwala.

Kutanthauzira kwa zotsatira: kuchokera ku chizolowezi kupita ku matenda

Kusanthula kulikonse kumakhala ndi zomwe zimasintha, kupatuka komwe kumawonetsa matenda kapena kukulitsa kwa mitundu yofanana. Chifukwa cha diagnostics a labotale, adokotala amathanso kuwunika momwe mankhwalawo amathandizira ndikusintha kwakanthawi.

• Kuyesa kwa shuga m'magazi. Zizindikiro zofunikira za shuga zimaperekedwa pagome 1.

Gome 1. Magazi a glucose potengera zaka za wodwalayo (pamimba yopanda kanthu)

M'badwo wodwala

Mtengo wabwinobwino, mmol / l

Kodi shuga ndi chiyani, ntchito zake zazikulu

Glucose ndi chakudya chopepuka, chifukwa chomwe khungu lililonse limalandira mphamvu yamoyo. Pambuyo polowa m'matumbo am'mimba, imayamwa ndikukutumiza kumagazi, kudzera mmalo mwake imatumizidwa kwa ziwalo zonse ndi minyewa.

Koma sikuti glucose onse yemwe amachokera ku chakudya amasinthidwa mphamvu. Gawo laling'ono la ilo limasungidwa mu ziwalo zambiri, koma zochulukazo zimasungidwa mu chiwindi monga glycogen. Ngati ndi kotheka, imatha kugawikanso shuga ndikupanga kusowa kwa mphamvu.

Glucose m'thupi imagwira ntchito zingapo. Zomwe zikuluzikulu ndi izi:

• kukhala wathanzi lamthupi mokwanira,
• gawo lama cell
• kukhathamira mwachangu
• kusunga kagayidwe kachakudya,
• kusinthanso mphamvu zokhudzana ndi minofu,
• detoxification ngati pali poyizoni.

Kupatuka kulikonse kwa shuga mumagazi kumatengera kuphwanya ntchito zomwe tatchulazi.

Mfundo za kayendedwe ka shuga m'magazi

Glucose ndiye amathandizira kwambiri pakupanga selo lililonse mthupi; Kusungitsa kuchuluka kwa shuga m'magazi munthawi yokhazikika, maselo a pancreatic beta amatulutsa timadzi - insulin, yomwe imatha kutsitsa shuga ndikufulumizitsa mapangidwe a glycogen.

Insulin imayambitsa kuchuluka kwa shuga omwe amasungidwa. Chifukwa chakuchita bwino kwa kapamba, kulephera kwa insulin kumachitika, ndiye kuti shuga ya magazi imakwera kuposa masiku onse.

Mulingo wothamanga wamagazi

Mndandanda wamalingaliro akulu.

Ngati mulingo wa glycemia mukatha kudya kapena shuga kuchokera pa 7.8 mpaka 11.1 mmol / l, ndiye kuti matendawa amapezeka ndi vuto la kulera

Ngati chizindikirocho chiri pamwamba 11.1 mmol / l, ndiye kuti ndi matenda ashuga.

Mitsempha yachilendo yamitsempha yamagazi

Mndandanda wazizindikiro zakubadwa.

M'badwo

Matenda a shuga, mmol / l

Makanda obadwa kumene (tsiku 1 la moyo)2,22-3,33 Makanda obadwa kumene (masiku 2 mpaka 28)2,78-4,44 Ana3,33-5,55 Akuluakulu ochepera zaka 604,11-5,89 Akuluakulu wazaka 60 mpaka 90 wazaka4,56-6,38

Mulingo wa shuga wamagazi mwa anthu okulirapo zaka 90 ndi 4.16-6.72 mmol / l

Magazi a shuga (shuga)

Kwa kusanthula, magazi athunthu kuchokera pachala amafunikira. Nthawi zambiri, phunziroli limachitika pamimba yopanda kanthu, kupatula kuyesa kwa shuga. Nthawi zambiri, kuchuluka kwa shuga kumatsimikiziridwa ndi njira ya glucose oxidase. Komanso, kuti mupewe mofulumira pazovuta zadzidzidzi, ma glucometer amathanso kugwiritsidwa ntchito.

Chikhalidwe cha shuga m'magazi ndi chimodzimodzi kwa amayi ndi abambo. Glycemia sayenera kupitirira 3,3 - 5.5 mmol / L (m'magazi a capillary).

Glycated Hemoglobin (HbA1c)

Kusanthula kumeneku sikutanthauza kukonzekera kwapadera ndipo kumatha kunena motsimikiza za kusinthasintha kwa shuga m'magazi m'miyezi itatu yapitayo. Nthawi zambiri mtundu uwu wa mankhwalawa umapangidwira kuti azitsimikizira momwe shuga yayendera kapena kuti adziwe tsogolo la matendawa.

Mlingo wa hemoglobin wa glycated ndi kuchokera 4% mpaka 6%.

Mayeso a Glucose kulolerana (GTT)

Mwa anthu wamba, "shuga wokhala ndi katundu" amagwiritsidwa ntchito pozindikira matenda a prediabetes (kulekerera kwapadera kwa ma carbohydrate). Kusanthula kwina kumaperekedwa kwa amayi apakati kuti adziwe matenda a shuga. Chofunikira chake chimakhala chakuti wodwalayo amapatsidwa sampuli ziwiri zamagazi, ndipo nthawi zina katatu.

Zitsanzo zoyambirira zimachitika pamimba yopanda kanthu, ndiye magalamu 75-100 a shuga owuma (kutengera thupi la wodwalayo) amasakanikirana ndi madzi mwa wodwalayo, ndipo pambuyo pa maola 2 kuwunikiranso kumatengedwanso.

Nthawi zina endocrinologists amati ndikulondola kuchita GTT osati 2 maola mutatha kutsitsa shuga, koma mphindi 30 zilizonse kwa maola awiri.

Thupi lomwe limayamba chifukwa cha kuwonongeka kwa proinsulin limatchedwa c-peptide. Proinsulin ndiyotsogolera kwa insulin. Imagawika pazinthu ziwiri - insulin ndi C-peptide muyezo wa 5: 1.

Kuchuluka kwa C-peptide kumatha kuweruza mwachindunji mkhalidwe wa kapamba. Kafukufuku amadziwika kuti mtundu woyamba wa matenda a shuga a mtundu woyamba ndi wachiwiri ukhale wofanana kapena insulinomas.

Chikhalidwe cha c-peptide ndi 0.9-7.10 ng / ml

Ndi kangati komwe muyenera kuyang'ana shuga kwa munthu wathanzi komanso odwala matenda ashuga

Kuyeserera pafupipafupi kumadalira thanzi lanu kapena kudziwiratu kwanu kwa matenda ashuga. Anthu odwala matenda ashuga nthawi zambiri ndimayenera kuyeza glucose mpaka kasanu patsiku, pomwe shuga II imaganiza kuti izifufuza kamodzi kokha patsiku, ndipo nthawi zina kamodzi masiku awiri.

Kwa anthu athanzi, kuyesedwa kwamtunduwu kuyenera kuchitika kamodzi pachaka, ndipo kwa anthu azaka zopitilira 40, chifukwa cha ma concomitant pathologies ndi cholinga chopewa, ndikofunika kuchita izi kamodzi miyezi isanu ndi umodzi.

Zizindikiro za glucose amasintha

Glucose imatha kuwonjezeka kwambiri ndi insulin yokwanira kapena cholakwika m'zakudya. Chifukwa chake, ndikofunikira kuti musankhe katswiri yemwe angakufotokozereni mitundu yonse yamankhwala anu.

Ganizirani chilichonse payekhapayekha.

Hypoglycemia

Mkhalidwe wa hypoglycemia umayamba ndi ndende ya magazi yopanda 3.3 mmol / L. Glucose ndiwothandiza pakulimbitsa thupi, makamaka maselo aubongo amatero kwambiri ndikusowa kwa glucose, ndipo kuchokera pano munthu amatha kulingalira zomwe zachitika m'thupi.

Zifukwa zochepetsera shuga ndizokwanira, koma zofala kwambiri ndiz:

• insulin
• masewera olemera
• Kuledzera
• kusowa kwa chimodzi mwazakudya zazikulu.

Chipatala cha hypoglycemia chimakula msanga. Ngati wodwalayo ali ndi zizindikiro zotsatirazi, ayenera kudziwitsa wachibale wake kapena aliyense wodutsapo izi:

• chizungulire mwadzidzidzi
• mutu wakuthwa
• thukuta lozizira
• kufooka kopanda malire
• kuyera mumaso
• chisokonezo,
• kumva kwamphamvu njala.

Ndikofunika kudziwa kuti odwala omwe ali ndi matenda ashuga nthawi zambiri amatha kuzolowera izi ndipo samawunikira moyo wawo wonse. Chifukwa chake, ndikofunikira kuyeza glucose mwadongosolo pogwiritsa ntchito glucometer.

Ndikulimbikitsidwanso kuti onse odwala matenda ashuga azikhala ndi lokoma nawo, kuti aletse kuchepa kwa glucose kwakanthawi komanso asapatse chidwi pakukula kwa vuto ladzidzidzi.

Hyperglycemia

Malinga ndi malingaliro aposachedwa ndi WHO (World Health Organisation), kuwunika koyesedwa kumaganiziridwa kuti ndi shuga komwe kumafika pa 7.8 mmol / L ndikukwera pamimba yopanda kanthu komanso maola 11 mmol / L 2 atatha kudya.

Kuchuluka kwa shuga m'magazi kungayambitse vuto ladzidzidzi - hyperglycemic coma. Pofuna kupewa kufalikira kwa izi, muyenera kukumbukira zinthu zomwe zimatha kuwonjezera shuga. Izi zikuphatikiza:

• Mlingo wambiri wa insulin,
• kudya kosafunikira kwa mankhwala osagwiritsidwa ntchito mwanjira imodzi,
• kudya zakudya zopatsa mphamvu zochuluka kwambiri,
• mavuto
• chimfine kapena matenda aliwonse
• kugwiritsa ntchito moyenera zakumwa zoledzeretsa.

Kuti mumvetsetse mukafunikira kuyimba ambulansi, muyenera kudziwa zizindikiro zakukula kapena hyperglycemia yapamwamba. Mitu ikuluikulu ndi:

• ludzu lochulukirapo
• kukodza pafupipafupi
• kupweteka kwambiri mu akachisi,
• kutopa,
• kukoma kwa maapulo wowawasa mkamwa
• kuwonongeka kwamawonekedwe.

Hyperglycemic coma nthawi zambiri imayambitsa kufa, ndi chifukwa ichi ndikofunikira kuti azitha kuchiza matenda ashuga.

Kodi mungapewe bwanji kusintha kwadzidzidzi?

Njira zabwino zochizira matenda amwadzidzidzi ndikuletsa chitukuko chawo. Ngati mungazindikire kuwonjezeka kapena kuchepa kwa shuga m'magazi, ndiye kuti thupi lanu silingathe kulimbana ndi vutoli lokha, ndipo mphamvu zonse zosungira ndatha. Njira zosavuta kwambiri zopewera zovuta zimaphatikizapo izi:

1. Yang'anirani shuga pogwiritsa ntchito shuga m'magazi. Kugula glucometer ndi zingwe zoyeserera sizikhala zovuta, koma kukupulumutsani ku zotsatira zosasangalatsa.
2. Imwani mankhwala a hypoglycemic kapena insulin pafupipafupi. Ngati wodwalayo ali ndi kukumbukira koipa, amagwira ntchito kwambiri kapena samangokhala, dokotalayo angamulangize kuti azilemba bukuli, komwe amayang'ana mabokosi pafupi ndi nthawi yomwe adasankhidwa. Kapenanso mutha kuyika chidziwitso pafoni.
3. Pewani kudumpha zakudya. M'banja lililonse, chakudya chambiri chodyedwa kapena chodyera chimakhala chizolowezi chabwino. Wodwala akakakamizidwa kudya kuntchito, ndikofunikira kukonzeratu chidebe ndi chakudya chopangidwa kale.
4. Zakudya zabwino. Anthu omwe ali ndi matenda ashuga ayenera kulabadira zomwe amadya, makamaka zakudya zamafuta ambiri.
5. Moyo wathanzi. Tikuyankhula zamasewera, kukana kumwa zakumwa zoledzeretsa zamphamvu ndi mankhwala osokoneza bongo. Zimaphatikizanso kugona mokwanira kwa maola asanu ndi atatu ndikuchepetsa zochitika zovuta.

Matenda a shuga angayambitse zovuta zambiri, mwachitsanzo, phazi la matenda ashuga komanso kuchepetsa moyo. Ichi ndichifukwa chake ndikofunikira kuti wodwala aliyense awone momwe alili, kupita njira zodzitetezera kwa asing'anga wake komanso munthawi kuti agwirizane ndi zonse zomwe akulangizidwa.

Seramu shuga

Magazi a shuga ndi ofanana kwa onse azimayi ndi abambo. Kwa akulu onse, izi zikuwonetsa chimodzimodzi ndipo sizisintha mosasamala kanthu za moyo komanso kuchuluka kwa zochita zolimbitsa thupi. Mwa amuna, kuchuluka kwa glucose kumakhala kosakhazikika, chifukwa pakugonana koyenera, kuyendetsedwa kwa chinthu kumasintha pakubala kwa mwana komanso kusamba.

Kuchita kumeneku kumalumikizidwa ndi kusintha kwa kuchuluka kwa mahomoni ndikuwonjezera nkhawa kwa thupi pakubala. Chokhacho chomwe chimakhudza kuchuluka kwa shuga ndi zomwe zimachitika m'badwo. Magawo a shuga m'magazi amaperekedwa pagome:

Moyenera, chisonyezo sichiyenera kupitirira mtengo wa 5.5 mmol / L. Kuchuluka kwa shuga kumeneku kumapereka lingaliro loti munthu alibe njira iliyonse yokhudzana ndi shuga.

Nthawi zambiri panthawi yoyembekezera

Popeza thupi la mzimayi limasinthika kwambiri mahomoni pa nthawi yomwe ali ndi pakati ndipo amatha kukhala ndi insulin, chidwi cha chinthucho chimadzuka. Mwazi wa magazi panthawi yomwe mayi ali ndi pakati sayenera kupitirira mtengo wa 7.0 mmol / L ndikuchepera 3.3 mmol / L.

Kuyesedwa kwa shuga panthawi ya pakati kumadziwika kuti ndi chimodzi mwazofunikira kwambiri, choncho ziyenera kuchitika osachepera 2. Nthawi zambiri, kuyezetsa magazi kumachitika ndi masabata 8-12, kenako pakatha milungu 30 ya bere.

Zizindikiro zakusanthula

Nthawi zambiri, madokotala amapereka mayeso a shuga m'magazi otsatirawa:

• amaganiza kuti ali ndi matenda ashuga
• kukonzekera opaleshoni, pomwe opaleshoni ya mankhwalawa idzagwiritsidwa ntchito,
• wodwalayo ali ndi matenda amtima monga matenda a m'matumbo, matenda oopsa,
• matenda a chiwindi
• kuwunika mphamvu ya mankhwala mankhwala mankhwala a matenda a shuga,
• kuledzera kwa thupi ndi mankhwala ndi mowa.

Komanso kuwunikira miyezi isanu ndi umodzi iyenera kutengedwa ndi anthu omwe ali pachiwopsezo, omwe kuchuluka kwake kwa glucose kungakhale kosakhazikika. Omwe amayambitsa kuphwanyidwa kotere ndi monga:

• matenda am'mimba thirakiti
• onenepa kwambiri
• chibadwa
• kubala mwana
• kugwiritsa ntchito glucocorticosteroids nthawi yayitali,
• kutupa kwa adrenal gland kapena pituitary gland.

Madokotala amalimbikitsa kuyesedwa ngati prophylaxis ngati zizindikiro zotsatirazi zizichitika:

• kuwonda msanga kapena kulemera kwakukulu ndi zakudya zomwezo,
• kutopa kosalekeza ndi kusagwira bwino ntchito,
• kuwonongeka kwamawonekedwe ndi kumveka bwino, mawonekedwe a nebula,
• redness, mkwiyo ndi kuwuma kwambiri pakhungu.
• kukodza pafupipafupi,
• kuchiritsa pang'onopang'ono kwa khungu ndi mabala,
• youma mucous nembanemba.

Momwe mungakonzekerere kusanthula

Kuti mupeze zotsatira zolondola kwambiri, muyenera kudziwa momwe mungakonzekere kuyezetsa magazi kwa shuga. Kukonzekera kuyesa ndikosavuta ndipo sikuyenda ndi zoletsa zazikulu. Za malamulo ati omwe muyenera kutsatira asanakudziwitse zinthu zachilengedwe, auzeni dokotala yemwe analamula kuti phunzirolo liphunzire. Mukanyalanyaza malangizowo, kuyesa kuwonetsa zotsatira zolakwika.

Malamulo okonzekera kusanthula kuchuluka kwa shuga m'magazi ndi ofanana kwa odwala akuluakulu ndi ana:

• tsiku loti tsambalo lifike, ndikofunikira kuti musatenge nkhawa m'malo osachita mantha,
• Masiku awiri musanalandire magazi, muyenera kukana kupita kokachita masewera olimbitsa thupi ndi dziwe, komanso kupewa kupewa masewera olimbitsa thupi,
• dzulo lake lisanachitike, aletsedwa kumwa mowa ndi kusuta,
• kutenga magazi kuchokera m'mitsempha kumachitika m'mimba yopanda kanthu, kotero chakudya chomaliza sichenera kuchitika pasanathe maola 12,
• m'mawa wa tsiku la kusanthula, saloledwa kudya ndi kumwa, kutsuka mano ndi kutafuna chingamu.

Ngati mankhwala oledzera a venous amachitika mwa mwana wochepera zaka 2, makolo amatha kutsatira malamulo atatu okha: osadyetsa mwana kwa maola 8, osampatsa mwana mankhwala, komanso pewani kupsinjika. Madokotala amachenjeza kuti ngati kuphatikiza magazi kumachitika motsutsana ndi maziko a mantha akulu, mwachitsanzo, ndikadula mano kapena tsiku la colic, zotsatira zake zimatha kukhala zosatsimikizika.

Kodi zitsanzo zosinthika mwazomwe zili

Kuti muzindikire kuchuluka kwa shuga, magazi amatengedwa kuchokera m'mitsempha. Ndondomeko imachitika motere:

• Wodwala ayenera kukhala pampando kuti akhale wochezeka,
• pitilizani dzanja lanu ndi kuyiyika patebulo.
• wogwira ntchito akuwakanikizira miyendo ndi mwendo wapadera wokhala pamwamba pake,
• wodwalayo ayenera kufufuta ndi kuzindikira kuti
• Mitsempha ikaonekera bwino, dokotala amadzalowetsa singano mkati mwake ndi chubu chapadera.
• Pambuyo paulendo womasuka ndi magazi kulowa mu chubu,
• magazi okwanira ataphatikizidwa mu chubu choyesera, adotolo amaika chopukutira chakumwa pamalo opezeka jakisoni ndikuchotsa malo operekera alendo.

Pambuyo pa kusanthula, tikulimbikitsidwa kuti tidye msuzi wa apulo kapena chokoleti. Izi zingathandize kukonzanso nyonga mwachangu. Kutuluka kumalimbikitsidwa pambuyo pa mphindi 10-15. Kudziwitsa zotsatira zake sizimaposa masiku awiri, pambuyo pake dotolo azidzazindikira.

Ngati kuwunika kukuwonetsa kuti kuchuluka kwa shuga kumaposa mtengo wa 5.6 mmol / L., Dokotala akuwonetsa kuti wodwalayo amayesedwa - kuyesedwa kwa glucose. Izi ndichifukwa choti kuchuluka kwa shuga kotereku kumawoneka ngati boma la matenda ashuga ndipo kumafunikira chithandizo chamomwe.

Zifukwa za shuga wambiri

Mkhalidwe womwe kuwonjezeka kwa glucose amadziwika umatchedwa hyperglycemia. Hyperglycemia ndi njira yoopsa yomwe ingayambitse kusokonezeka kwa kagayidwe kachakudya, komanso kupangitsa kuti thupi lizigwira ntchito komanso ziwalo zina. Zonsezi zimabweretsa kupanga ndi kusungira poizoni, zomwe zimawononga thanzi la thanzi.

Kuwonjezeka kwa kuchuluka kwa shuga m'magazi nthawi zambiri kumayenderana ndi zifukwa izi:

• shuga kwa akulu ndi ana,
• kusokoneza chiwindi,
• kapamba amisala yosiyanasiyana, zotupa za m'mimba ndi zotupa zina.
• matenda a endocrine dongosolo, monga thyrotooticosis, gigantism, Cushing's syndrome,
• matenda a impso
• matenda a mtima aposachedwa kapena stroke,
• kupezeka kwa ma seramu a antibodies kwa insulin receptors,
• kumwa mankhwala a glucocorticosteroids ndi mankhwala okhala ndi estrogen.

Hyperglycemia nthawi zambiri simapita modabwitsa ndipo amayamba limodzi ndi kuphwanya lamulo:

• kupweteka mutu pafupipafupi ndi chizungulire,
• Pakamwa pakamwa ndi ludzu losatha,
• kutopa, kusachita bwino, kugona.
• kuwonongeka kwamawonekedwe.

Nthawi zambiri, odwala amapezeka ndi hyperglycemia ya thupi - vuto lomwe limachitika chifukwa chokhala ndi mphamvu kwambiri, kupsinjika kapena kusakhazikika mtima, kutulutsidwa kwa adrenaline m'magazi. Ngati hyperglycemia imayambitsidwa ndi zoyambitsa zathupi, shugayo amabwerera mwachizolowezi, patatha masiku ochepa atachotsa zomwe zimayambitsa.

Zoyambitsa za shuga

Mchere wochepa wa seramu yamwazi ndimwadzidzidzi womwe umadziwika kuti hypoglycemia m'chinenedwe cha akatswiri. Nthawi zambiri hypoglycemia imachitika motsutsana ndi maziko a zotere:

• Kapangidwe kazotupa kamene kamayambitsa kupweteka,
• hepatitis, limodzi ndi chiwonongeko champhamvu cha maselo a chiwindi,
• kukomoka kwa adrenal,
• machitidwe a oncological mu ziwalo zosiyanasiyana,
• kuchuluka kwa thupi, kutentha thupi,
• mankhwala osokoneza bongo a hypoglycemic ndi insulin,
• kugwiritsidwa ntchito kwakutali kwa anabolic steroids.

Magazi ochepera a glucose nthawi zambiri amapezeka mwa akhanda.Nthawi zambiri izi zimachitika ngati mayi wa mwana amadwala matenda a shuga.

Zotsatira za kupatuka kwakukulu kuchokera ku chizolowezi

Ngati kuwunika kwa magazi omwe atengedwa kunawonetsa kuti kuchuluka kwa glucose kwatalikiratu panjira, ndikofunikira kuyambitsa matenda ena, omwe angakuthandizeni kudziwa chomwe chinayambitsa kuphwanya ndi kupereka mankhwala oyenera. Monga momwe masewera amasonyezera, odwala ambiri omwe ali ndi glucose ochepa sanyalanyaza izi chifukwa amaziona kuti sizowopsa.

Koma akatswiri akuchenjeza kuti kuchepa kungakhale koopsa kuposa shuga wambiri ndipo nthawi zambiri kumayambitsa kusintha kosasintha.

• mulingo wochepera 2.8 mmol / l - ungayambitse kusokonezeka kwamakhalidwe ndi kuchepa kwa ntchito zamaganizidwe,
• dontho mpaka 2-1.7 mmol / l - pakadali pano, mavuto mu magwiridwe antchito am'thupi amadziwika, munthu amakhala ndi kufooka nthawi zonse,
• dontho mpaka 1 mmol / l - wodwalayo amakula kwambiri, ma encephalogram amalemba zosokoneza mu ubongo. Kukhazikika kwa nthawi yayitali m'bomali kumayambitsa kukomoka,
• ngati shuga agwera pansi 1 mmol / l, njira zosakonzanso zimachitika mu ubongo, pambuyo pake munthuyo akafa.

Ponena za kuchuluka kwa shuga, nthawi zambiri kumakhala komwe kumayambitsa matenda monga matenda a shuga. Komanso kuphwanya malamulo kungayambitse kuwonongeka, kufooka kwa chitetezo chathupi, kusagwira kwa ziwalo zamkati ndi machitidwe.

Pomaliza

Ngati mayeso a shuga awonetsa kupatuka kwambiri pamakhalidwe amodzi m'mbali zonse, muyenera kupita kukawona kwa endocrinologist ndikukuwonetsetsa. Pambuyo pa mayeso, adotolo azindikiranso zomwe zingayambitse kupatuka ndikupereka njira yoyenera yamankhwala yomwe ingathandize kubwezeretsa thanzi komanso kupewa zovuta zamtsogolo.

Glucose

Kwa anthu amisinkhu iri yonse komanso msinkhu, miyezo ya shuga m'magazi a venous imasala kudya (mmol / l):

• m'magazi - kuyambira 3,3 mpaka 5.5,
• seramu - kuyambira 4.0 mpaka 6.1.

Kusanthula kwa shuga m'mitsempha yabwinobwino kwa ana mu masabata awo oyamba amoyo:

• magazi - 2.5 - 4.1 mmol / l,
• seramu - 2.8 mmol / l mpaka 4,4.

Kupatuka pakuwunika

Kupitilira muyeso kumatanthawuza mkhalidwe wa hyperglycemia. Zizindikiro zochepa poyerekeza ndi malire a masiku wamba zimakhala ndi hypoglycemia.

Pochita, nthawi zambiri mumayenera kuthana ndi hyperglycemia. Vutoli limayamba pang'onopang'ono, nthawi zambiri silimadziwika.

Kuwonjezeka kwa glucose kumachitika koyambirira kochepa, popanda kuwonetsa zizindikiro zowopsa, kupita patsogolo kwa nthawi.

M'badwo wovuta kwambiri kwa akazi ndi zaka 45 - 50, pomwe, chifukwa cha kusintha kwa thupi, kusintha kwakulu kwa mahomoni kumachitika komwe kungathandizire kukulitsa shuga.

Kuyesedwa kwa shuga kopanda tanthauzo

Malinga ndi dongosolo la WHO, kutengera kuchuluka kwa zochulukirapo, amapezeka (mmol / l):

• pokambirana za venous, capillary magazi,
  • prediabetes - 5.5 - 6.1,
  • shuga - zopitilira 6.1,
• magazi a m'magazi
  • prediabetes - 6.1 - 7,
  • matenda ashuga - oposa 7.

Ku Europe ndi USA, ndichikhalidwe chawo kuyeza kuwunika kwa shuga mu mg / dl. Poyeneranso, kuchuluka kwa shuga kumagwera pamitundu 60 mg / dl - 100 mg / dl.

Kupatuka kuchoka pazizolowezi (mg / dl):

• magazi athunthu
  • prediabetes - 100 - 111,
  • shuga - zopitilira 111,
• magazi a m'magazi
  • prediabetes - kuyambira 111 mpaka 127,
  • matenda ashuga - opitilira 127.

Masewera a glucose akaposa 25 mmol / L kapena 455 mg / dl, amadziwika kuti hyperglycemia. Kukula kwambiri kwa shuga kumatanthauza kukula kwa zovuta zoopsa, kuphatikizapo matenda ashuga a ketoacidosis.

Ngati shuga ndi ochepera kuposa masiku onse

Mkhalidwe pamene kuchuluka kwa shuga mthupi kumakhala kochepa poyerekeza ndi 3.3 mmol / L kumaopseza makamaka ubongo. Shuga wochepera 2.2 mmol / L amatanthauza kwambiri hypoglycemia.

Kutsika kwamtunduwu kwa shuga kumakhala kowopsa makamaka kwa makanda ndi okalamba, popeza mawonekedwe akunja a hypoglycemia samagwirizana ndi kusinthika kwa kusintha.

Wodwalayo wasokoneza chikumbumtima, kugona. Kuti asagwere mu chikomokere cha hypoglycemic, muyenera kukakamiza wovutayo kumwa tiyi wokoma ndikuitcha "chisamaliro chodzidzimutsa".

Amakakamizidwa kutero, popeza wodwalayo nthawi zambiri sazindikira kuopsa kwa vuto lakelo, amakana kuthandizidwa. Imakhalanso ngati chimodzi mwazizindikiro za shuga wochepa kwambiri.

Matenda A shuga Omwe Amakhala Nawo

Pa nthawi yoyembekezera, kupatuka kwa chizolowezi kumatheka m'njira yowonjezera shuga m'thupi, komanso kukula kwa matenda ashuga. Matenda a gestational amakhala ndi sabata 16 mpaka 32 mwa amayi 4 mpaka 6%.

Mwa amayi apakati, miyezo pakayezetsedwe ka magazi kuchokera m'mitsempha kapena chala ndizosiyana pang'ono. Ndi zotsatira zoyeserera za 5.1 mmol / L, shuga wokhudzana ndi chiberekero wakuperekedwa kale ndipo maphunziro owonjezera akulembedwa.

Kupatula kuzindikiritsa, kuyesa kwa glucose kumachitika. Matenda a shuga omwe amachitika m'mimba amadziwika kuti amatsimikizira ngati, atamwa njira yothira shuga, mulingo wake m'magazi:

• 1 h oposa 10 mmol / l,
• pambuyo 2 maola - oposa 8.5.

Pambuyo pobadwa, kuyesedwa kwa shuga m'magazi kumatha kukhala kwabwinobwino, komabe, malinga ndi ziwerengero, 20-30% ya amayi omwe ali ndi gestational matenda a shuga amapanga shuga.

Zoyambitsa shuga

Kuchuluka kwa shuga mthupi kumayendetsedwa ndi mahomoni:

• kukweza msana wake,
  • adrenal glands - adrenaline, cortisol, glucocorticosteroids,
  • kapamba - glucagon,
• kuchepetsa ndende - insulin.

Zifukwa zopitilira muyeso wakusanthula ndi:

1. Matenda a shuga
2. Akuchepetsa kuchuluka kwa insulin mu kapamba, zotupa za m'mimba
3. Kuchuluka kwa mahomoni a adrenal m'thupi ndi chithokomiro, matenda a Cushing's, acomegaly
4. Kupsinjika, kupweteketsa mtima, kuvulala
5. Chitani masewera olimbitsa thupi

Pogwiritsa ntchito zolimbitsa thupi pang'ono, shuga yemwe amapezeka kuchokera ku glycogen yosungidwa m'misempha, amalowanso m'magazi.

Zopanda pomwe shuga ali pansi pazomwe zimachitika chifukwa cha:

1. Kusala kudya
2. Matenda a Benign komanso oopsa a pancreatic okhala ndi insulin yayikulu
3. Matenda a chiwindi - cirrhosis, khansa, kuledzera
4. Kutsitsa kupanga mahomoni a adrenal - hypothyroidism, matenda a Addison
5. Mavuto a kaphatikizidwe ka michere ina - tsankho kuti achulukane, galactosemia, matenda a Girke
6. Ntchito zolimbitsa thupi
7. Matenda a malabsorption mu malabsorption syndrome
8. Kutentha kwambiri

Kuchuluka kwa zowunikira kumathandizira:

• kusuta
• kumwa mankhwala - okodzetsa, adrenaline, glucocorticoids, morphine, mankhwala osokoneza bongo,
• kugwiritsa ntchito khofi.

Kutsika kwa glucose m'thupi kumachitika chifukwa cha:

• kutenga anabolic steroids
• Chithandizo cha beta-blocker Propranolol, Anaprilin,
• kumwa mankhwala a anti-Parkinsonia Levodopa,
• ntchito amphetamine.

Zizindikiro zonyansa

Mkulu shuga akhoza kuthandizidwa ngati zizindikiro zimadziwika:

• ludzu losalekeza
• kupukusa kwambiri komanso pafupipafupi, makamaka usiku,
• Khungu
• kumangokhala wotopa
• abrasions yayitali osachiritsa, mabala,
• kusintha kosakhudzana ndi zakudya, zosadziwika,
• pafupipafupi matenda apakhungu
• magazi m`kamwa.

Shuga wovuta amayamba chifukwa cha zovuta za chopondapo. Wodwala amakhala ndi matenda otsekula m'mimba, akusinthana ndi kudzimbidwa, fecal kuterera.

Memory ndi luntha amadwala shuga wambiri. Wodwalayo amadandaula kuti amamva ngati "amathamanga tsekwe", kumva kulira, kugona tulo. Edema ya mapazi ndi kudzikundikira kwa madzimadzi m'mimba ndizodziwika ndi shuga yayikulu.

Ngati zochulukazo ndizosafunikira, wodwalayo sangakayikire ngakhale pang'ono za matenda ake. Shuga wapamwamba nthawi zambiri amapezeka mwangozi akamayesedwa ngati ali ndi matenda ena kapena mukamayesedwa.

Ngati shuga wamitsempha ali pakati pa 5.9 ndi 6.1 mmol / L, vuto la "matenda ashuga" limayamba m'magazi.

Kuopsa kwa matendawa ndikuti kumakhala pafupifupi asymptomatic, komwe kumakhudza mitsempha ya magazi a impso, ubongo, mtima.

Ma capillaries amataya kunenepa, kukhala wocheperapo, wopanda pake. Pofika matenda a shuga, wodwala nthawi zambiri amapezeka kuti ali ndi matenda oopsa oopsa chifukwa cha kusintha kwamitsempha yamagazi m'mitsempha yamagazi.

Zizindikiro zakuchepa kwa shuga m'thupi

Mchere ukakhala wocheperako, pamakhala vuto lowopsa lotchedwa hypoglycemic coma. Zizindikiro za mkhalidwewu ndizofunikira kuti aliyense adziwe, chifukwa chikomokere chimakula msanga, ndipo moyo wa munthu umadalira momwe ena amvera.

Zizindikiro za chikomokere m'mimba ndi izi:

• kupuma kosakhazikika
• Kuyenda kwamtima pang'ono
• kuthamanga kwa magazi
• khungu lozizira la kumapazi,
• kusowa poyankha pakuwala.

Zomwe zimayambitsa kuperewera kwa hypoglycemic sitingangokhala mlingo woyenera wa insulin pochiza matenda ashuga, komanso mphamvu zolimbitsa thupi, kumwa mowa kwambiri.

Chifukwa chiyani kuyesedwa kwa shuga m'magazi kumayikidwa?

Zakudya zomanga thupi zonse, sucrose, lactose, maltose disaccharides omwe amalowa mthupi ndi chakudya amasinthidwa kukhala glucose. Ndipo kuti molekyu ya glucose ilowe mkati mwa cell, ndikofunikira:

• kupezeka kwa insulin,
• zolandirana polumikizana ndi insulin pamwamba pa nembanemba.

Pali zinthu zambiri zoterezi pama cell aanthu athanzi. Gawo lofunika kwambiri la iwo atalephera kucheza ndi insulin:

• glucose amakhalabe m'magazi
• khungu sililandira gwero lamphamvu ndipo likufa ndi njala.

Kuwonjezeka kwa shuga m'magazi kumatanthauza:

• kuchepetsa insulini
• kulolera kwa shuga kapena prediabetes
• kuphwanya shuga.

Kulekerera kwa glucose kumakhalapo kwakanthawi mwa amayi apakati, chifukwa shuga ndi yofunikira pakukula kwa mwana wosabadwayo.

Zitsanzo zakuyeza magazi

Kuti muwone shuga, magazi amawunika:

• kuchokera m'mitsempha
• capillary chala
• mitsempha yampira
• seramu zitsanzo kuchokera mu mtsempha.

Plasma ndi gawo lamadzi kuchokera komwe zimapangidwa - ma cell ofiira, ma cell am'magazi, maselo oyera am'magazi - amachotsedwa. Ngati fibrinogen protein imapangidwira ndi ma reagents apadera mu plasma, ndiye kuti seramu yamagazi imapezeka.

Mitundu ya glucose m'masampweya imasiyanasiyana pang'ono. Poyerekeza ndi magazi athunthu ochokera m'mitsempha, ndiye zowonjezera shuga:

1. Mu capillaries, momwe muyeso amachotsedwa kuchokera ku chala, ndende imakhala yotalika mutatha kudya, kusiyana kuli 15 - 20%
2. Seramu - yokwera nthawi zonse pofika 11 - 14%
3. Mu plasma - 5% otsika kuposa seramu, koma apamwamba kuposa venous magazi athunthu

Kuthandiza kwa odwala matenda ashuga, omwe amakakamizidwa kuti azigwiritsa ntchito shuga, ndiye muyezo wowunikira shuga m'magazi a capillary pamimba yopanda kanthu, komanso kuyerekeza kwawo ndi kusanthula kwa magazi a venous.

Zotsatira zoyesa zala ndi 0,1 mmol / L zapamwamba kuposa kusanthula kwa minyewa. Izi zikutanthauza kuti miyambo ya kuwunika kwa shuga m'magazi a capillary komanso kuchokera m'mitsempha sikufanana.

Shuga amakhala okwera kwambiri poyesa magazi kuchokera chala chala ngati wodwalayo wasokonezeka pang'ono, i.e., kusinthana kwa zamitsempha ndi magazi m'matumbo oyipa. Chifukwa chake, kusala kudya kwa magazi m'magazi a venous ndikulondola kwambiri.

Kuyesedwa kwa magazi a venous kumawonetsa zenizeni zomwe zili m'magazi ndipo sikumakhudzidwa ndi kusokonezeka kwa ma microcirculation pazotsatira.

Mukamafulumira shuga mumalamulidwa

Kuwongolera shuga osati kwa anthu odwala matenda ashuga okha kuyesa kwa magazi kuchokera mu mtsempha wosankhidwa ngati:

• opaleshoni yomwe ikubwera
• kuchuluka kwa matenda a mtima,
• mankhwalawa kunenepa, atherosulinosis.

Kuzindikiritsa kupatuka kuzinthu wamba kumachitika ngati gawo la mayeso a zamankhwala kwa anthu onse omwe afika zaka 45, komanso omwe ali ndi matenda ashuga m'banjamo.

Sampulu yamitsempha imatengedwa m'mawa pamimba yopanda kanthu. Musanayesedwe magazi kuchokera ku chala kapena mtsempha, simungathe:

• pali maola 8 - 14,
• kumwa madzi m'mawa
• kusuta
• khalani ndi mantha kapena kuchita masewera olimbitsa thupi.

Kuyesedwa kwa shuga ndi chiyani?

Chomwe chimadziwika kuti mayeso a shuga, madokotala amachitcha kuyesa kwa shuga. Chakudya chopatsa mphamvu chamafuta omwe anthu amadya chimakhala ma monosaccharides, 80% omwe ali ndi glucose (izi ndizomwe amatanthauza mukamakamba za shuga). Imapezeka mu zipatso, zipatso, uchi, chokoleti, beets, kaloti, ndi zina. Mumalowa m'magazi kuchokera m'matumbo ndi chiwindi. Insulin imathandizira kuyamwa glucose. Katunduyu amakhala m'magazi asanadye, koma pang'ono. Pambuyo podya, ndende yake imadzuka, kenako imatsikanso (kufikira chakudya chotsatira).

Glucose ndiyofunikira kwambiri pa thanzi la munthu, chifukwa ndiye gwero lalikulu lamphamvu, mafuta a maselo, minofu ndi ziwalo. Glucose imapereka 50% ya mphamvu zonse zochokera ku chakudya.

Glycemia ndi muyezo wama glucose. Zimakhudza kwambiri thanzi komanso thanzi la munthu.

Shuga wochepa

Mkhalidwe womwe glucose wotsika umatchedwa hypoglycemia. Amachokera ku thupi kapena m'maganizo mopitirira muyeso, osagwirizana ndi zakudya, matenda osachiritsika. Pankhaniyi, hypoglycemia yakanthawi kochepa sikubweretsa zotsatira zoyipa.

Anthu omwe ali ndi shuga wotsika magazi nthawi zonse amayenera kukhala ndi zakudya kapena zakumwa zomwe zimatulutsa shuga, monga maswiti, madzi otsekemera, ndi zina zotere. Muyenera kupewa kupsinjika, kupsinjika, kupumula kwambiri, kusunga zakudya zamasiku onse ndi zakudya, kudya chakudya chovuta kwambiri.

Zizindikiro za hypoglycemia

Ngati munthu wachepetsa kuchuluka kwa shuga m'magazi, ndiye kuti nthawi zambiri amakhala akumva njala. Palpitations - kufulumira, thukuta - kuchuluka, malingaliro amtundu - osakhazikika (chisangalalo, kusakwiya, nkhawa zosalamulirika). Kuphatikiza apo, kutopa, kufooka, ulesi kumamveka nthawi zonse, kulibe mphamvu yogwira ntchito. Nthawi zina pamakhala chizungulire komanso kukomoka.

Mwazi wamagazi ambiri

Milandu yowonjezera plasma glucose - hyperglycemia - imakhala yodziwika kwambiri kuposa hypoglycemia.

Kuwonongeka kwakukuru kumakhalanso kwakanthawi chifukwa cha katundu ndi nkhawa zomwe zimadzaza moyo wamunthu wamakono. Ndi kukula kwa phokoso ndi moyo, malingaliro a m'magazi, kutsekemera kwa glucose kumabwereranso kwachilendo, popanda kuwononga thupi.

Zizindikiro za Hyperglycemia

Ndi hyperglycemia, monga ndi hypoglycemia, kutopa ndi kugona, malingaliro osakhazikika amamva. Kuphatikiza apo, anthu omwe ali ndi mpweya wambiri wamkamwa wowuma, kuganiza kwakumatha, khungu louma, kupumira mwachangu. Kuwala kwamasamba kumachepa, mabala amachiritsa bwino, zotupa za puroses zimawoneka pakhungu, ndipo kulemera kumachepa kwambiri. Hyperglycemia imawonetsedwanso ndikukoka pafupipafupi, ludzu losatha, komanso chizolowezi cha matenda opatsirana. Woopsa milandu, nseru ndi kusanza zimawonedwa.

Amayambitsa kusalinganika mu shuga

Hypoglycemia ya nthawi yayitali imachitika chifukwa cha kuperewera kwa zakudya m'thupi ndimaswiti, chakudya chochuluka chopanda mafuta. Mwanjira imeneyi, kapamba amapanga insulin yambiri, ndipo glucose imadziunjikira m'matipi.

Matenda a hypothalamus, impso, ma adrenal glands amathanso kupititsa ku hypoglycemia.

Choyambitsa chimakhalanso kuphwanya ntchito ya kapangidwe ka insulin mu kapamba kapena chotupa chake (popeza kuchuluka kwa maselo ndi minyewa ya chithokomiro kumapangitsa kuti pakhale insulini).

Hyperglycemia wa nthawi yayitali umawonetsa matenda a endocrine system yokhudzana ndi hyperthyroidism (kuchuluka kwa kutulutsidwa kwa insulin kumakhala kwakukulu kuposa kuchuluka kwa mayamwidwe), mavuto a hypothalamus, njira zosalekeza zotupa mthupi, komanso zochepa, zovuta za chiwindi. Nthawi zambiri hyperglycemia ndi chizindikiro cha matenda ashuga.

Malangizo pokonzekera kuwunikirako

Monga tanena kale, kuwunika kwa kupewa kuyenera kuchitika kwa aliyense osachepera miyezi isanu ndi umodzi.Komabe, ngati zizindikiro za hyper- kapena hypoglycemia zilipo, kuchuluka kwa shuga wamagazi kuyenera kuyesedwa ndithu.

Kuti zotsatira ziwonekere zenizeni zaumoyo, ndipo pakakhala vuto la glucose, kunali kotheka kupereka chithandizo cholondola, malamulo ena ayenera kuyang'aniridwa.

Magazi a shuga amaperekedwa nthawi zonse pamimba yopanda kanthu (kuchokera kumitsempha ndi chala) atasiya kudya kwa maola eyiti (ochepa). Kupuma kumatha kukhala maola 8 mpaka 12, koma osapitirira 14, chifukwa chakudya chimatsogolera kuchuluka kwa shuga. Ndikosavuta kupereka magazi m'mawa.

Asanapange kusanthula, sikulimbikitsidwa kuti muzidalira maswiti ndi zakudya zamafuta (simungathe kusintha kadyedwe kanu). Zakudya ziyenera kutayidwa m'masiku atatu.

Zochitika zokhudzana ndi kutaya mtima zimakhudzanso zotsatira za kusanthula, chifukwa chake muyenera kupita ku chipatala muli m'malo modekha.

Ngakhale kuyenda mwachangu kupita kuchipatala kumatha kupotoza zotsatira, chifukwa chake masewera ndi zosangalatsa zilizonse zimakanenedwa musanawunike: gawo lokwezeka lingachepe, ndipo hyperglycemia singadziwike.

Zizolowezi zoyipa ziyeneranso kutayidwa: musasute osachepera maola awiri musanawunikidwe, musamwe mowa kwa masiku awiri.

Pambuyo matenda opatsirana (mwachitsanzo, SARS, chimfine, zilonda zapakhosi) milungu iwiri iyenera kudutsa. Ngati mukufunikirabe kupititsa kusanthula koyambirira, ndiye kuti muyenera kuchenjeza adokotala, othandizira ma labotale, kuti izi zithembedwe mukamayala.

Ngakhale kutikita minofu, ma x-ray, physiotherapy imasintha magawo powunikira.

Muyenera kuchenjezanso za kumwa mankhwala (ngakhale monga njira zakulera pakamwa), ndipo ngati mutha kuzikana kwakanthawi, ndibwino osazitenga masiku awiri musanawunike.

Ulendo wautali, kugwira ntchito kosinthana kwausiku kumathandizira zotsatira zabodza. Kufunika kugona.

Madokotala ena samalimbikitsa kuti kutsuka mano ndi kutafuna chingamu, chifukwa shuga amalowetsedwa m'thupi kudzera m'mkamwa, kukulitsa kuchuluka kwa shuga.

Gulu lamavuto

Gulu lachiwopsezo limaphatikizapo anthu omwe ali ndi mwayi wopezeka ndi matenda omwe amayamba chifukwa cha kuchepetsedwa kapena kuchuluka kwa shuga m'magazi am'magazi.

Izi zimaphatikizapo odwala onenepa kwambiri komanso omwe akudwala matenda oopsa (kuthamanga kwa magazi). Komanso, anthu omwe achibale awo (makamaka makolo) amapezeka ndi vuto la carbohydrate metabolism ndi mavuto a dongosolo la endocrine ali pachiwopsezo. Pankhaniyi, chikhalidwe chobadwa nacho chimatenga gawo.

Amayi omwe ali ndi maudindo nawonso ali pachiwopsezo. Mwa amayi apakati, magawo a shuga ochokera m'mitsempha amasiyana ndi omwe amavomerezeka.

Kuunikira zotsatira za kusanthula: Kusala miyezo ya shuga kuchokera kumitsempha

Zizindikiro zake zimatengera zaka, mawonekedwe amwazi ndi njira zachitsanzo. Miyezo ya shuga yochokera m'mitsempha ndi chala ndizosiyana, chifukwa magazi a venous ndi akulu kuposa magazi a capillary, motero amakhala ndi shuga.

Mulingo wovomerezeka wa glucose kuchokera mu mtsempha ndi 3.5-6.1 mmol / l (millimol pa lita). Muli m'malo monga momwe kuchuluka kwa shuga kumayiko omwe kale anali Soviet Union kumayesedwa. Ndi chizolowezi chotere, glucose amapita ku machitidwe ndi ziwalo zonse, kukamweka, sikumatulutsidwa mkodzo.

Ngati mulingo uli m'munsi mwa shuga m'magazi (3.5 mmol / L), ndiye kuti hypoglycemia yapezeka, ngati apamwamba - hyperglycemia (apamwamba kuposa 6.1 mmol / L - prediabetes state, apamwamba kuposa 7.0 mmol / L - matenda ashuga). Matenda a shuga ndi vuto lomwe thupi lotha kudya limatha kukhazikitsa shuga ndi insulin, kenako osatero. Ndiye kuti, palibenso matenda ashuga, koma ndiyofunika kuchitapo kanthu kuti muchepetse shuga.

Mlingo wa kusanthula shuga kuchokera m'mitsempha mwa ana ndiwosiyana. Kuyambira kubadwa mpaka chaka, chizolowachi ndi 2.8-4,4 mmol / L; kuyambira mmodzi mpaka asanu, 3.3-5.0 mmol / L; ana kuyambira wazaka 5 ndi kupitilira, ndi chimodzimodzi kwa akulu . Pakuyesa kwina, kuchuluka kwa shuga kuyenera kukhala kosiyana.

Posankha kuchuluka kwa fructosamine, chizolowezi chosala kudya kwamitsempha mu amuna ndi akazi ndi 205- 285 µmol / L, ndipo mwa ana a zaka 0 mpaka 14, 195-271 µmol / L. Ngati zizindikirozo zafotokozedwa pamwambapa, izi zitha kuwonetsa matenda a shuga, kuvulala kapena zotupa za muubongo, kuchepa kwa chithokomiro, ndipo ngati kutsika, ndi nephrotic syndrome.

Ngati ndi kusanthula kwamtunduwu, monga mayeso ololera a glucose, zizindikiritso zimapitilira shuga kuchokera kumitsempha ndikusinthasintha pamtunda kuchokera pa 7.8 mpaka 11.0 mmol / l, izi zikuwonetsa kuphwanya kulekerera kwa glucose, ndipo ngati aposa 11.0 mmol / l - za matenda ashuga.

Mulingo wovomerezeka wa glucose panthawi yoyeserera kutsimikiza kwa C-peptides ndi 0.5-3 ng / ml pamaso pa katundu, 2.5-15 ng / ml pambuyo pake. Posankha kuchuluka kwa lactate, kuchuluka kwa shuga kuchokera m'mitsempha mwa abambo ndi amayi ndi 0.5-2.2 mmol / l, mwa ana ndi ochepa kwambiri. Zizindikiro zowonjezera zikuwonetsa kuchepa kwa magazi, kuchepa - cirrhosis, kulephera mtima.

Mokulira, Zizindikiro zamagalamu sizodalira jenda, koma pa nthawi yomwe mayi ali ndi pakati, shuga mu mtsempha amayenera kupitilira - 4.6-6.7 mmol / l. Ndi chizindikiro pamwambapa, mumapezeka matenda - matenda a shuga, omwe amachokera ku zovuta za endocrine. Ngati mulingo wovomerezeka udapitilira, chithandizo chamankhwala chimafunikira kuti chikhale ndi thanzi la mayi ndi mwana, komanso kuyang'anira kuwerengera magazi nthawi zonse.

Onse kuchuluka ndi kutsika kwa plasma glucose kumatha kuwonetsa matenda oyambitsidwa ndikuwadzetsa zovuta zambiri ngati sanazindikiridwe komanso kuthandizidwa panthawi yake. Munthu aliyense amatha kuletsa izi pongodutsa kuyesa kwa magazi ndikuwongolera msinkhu wake.