Kodi chiwopsezo cha matenda ashuga pakatha nthawi yayitali ndi chiyani?

Matenda a gestational mtundu wamatenda omwe amapezeka mwa amayi apakati okha. Maonekedwe ake amafotokozedwa ndikuti m'thupi la mayi wamtsogolo mumakhala kuphwanya kagayidwe kazakudya. Pathology nthawi zambiri imapezeka mu theka lachiwiri la mawu.

Zomwe zimachitika komanso chifukwa chake matenda amiseche amachitika panthawi yomwe ali ndi pakati

Matendawa amakula chifukwa chakuti thupi la mkazi limatsitsa kamvedwe kakang'ono ka minyewa ndi maselo kupita ku insulin yake.

Chomwe chimapangitsa izi zimatchedwa kuwonjezeka kwa mahomoni m'magazi omwe amapangidwa panthawi yomwe ali ndi pakati.

Munthawi imeneyi, shuga amachepetsedwa chifukwa chakuti mwana wosabadwayo ndi placenta amafunikira.

Zikondamoyo zimayamba kutulutsa insulin yambiri. Ngati sikokwanira mthupi, ndiye kuti matenda abwinobwino amasintha pa nthawi ya pakati.

Nthawi zambiri, mwana akabadwa, msambo wamagazi wa mayiyo umakhala wabwinobwino.

Monga momwe kafukufuku ku United States akuwonetsera, matendawa amakula mu 4% ya amayi apakati.

Ku Europe, chizindikiro ichi chimachokera ku 1% mpaka 14%.

Ndizofunikira kudziwa kuti mu 10% ya milandu mwana atabadwa, zizindikiro za matenda ammimba zimadutsa mtundu wachiwiri wa matenda a shuga.

Zotsatira za GDM panthawi yapakati

Ngozi yayikulu ya matendawa ndi yayikulu kwambiri mwana wosabadwa. Itha kukhala yochokera ku 4.5 mpaka 6 kilogalamu.

Izi zimatha kubala zovuta panthawi yomwe gawo la cesarean likufunika. Ana okulirapo amawonjezera ngozi ya kunenepa kwambiri.

Zotsatira zowopsa kwambiri za matenda ashuga mwa amayi apakati ndi chiopsezo chowonjezereka cha preeclampsia.

Vutoli limadziwika ndi kuthamanga kwa magazi, kuchuluka kwamapuloteni ambiri mu mkodzo, kutupa.

Zonsezi zimadzetsa chiwopsezo pamoyo wa mayi ndi mwana. Nthawi zina madokotala amayambitsa kubadwa asanakwane.

Pogwiritsa ntchito thupi mopitirira muyeso, mwana wosabadwayo amatha kupuma movutikira, kamvekedwe ka minofu kachepa. Kuletsa kwa kuyamwa kwa Reflex kumachitikanso, kutupira, jaundice kumawonekera.

Matendawa amatchedwa matenda a shuga. Zimatha kutsogola kutsogolo kukulephera kwamtima, kusiya zotsalira m'malingaliro ndi thupi.

Zomwe zimayambitsa matenda a shuga

Kuthekera kwakukulu kwa mawonekedwe a matendawa mwa azimayi omwe ali ndi:

mapaundi owonjezera
chakudya kagayidwe kachakudya,
matenda a mtima
toxosis yoopsa
onyamula mapasa kapena maulendo atatu,
GDM m'mimba yapitayi.

Komanso, kukula kwamatendawa kumakhudzidwa ndi zaka za mayi woyembekezera. Nthawi zambiri, zimachitika mwa amayi omwe ali ndi zaka zopitilira 30. Zomwe zimayambitsa mapangidwe a matenda am'mimba zimatha kukhala matenda ashuga m'modzi mwa makolo.

Kubadwa kwa mwana wam'mbuyomo kumathanso kukhudza mapangidwe a matenda. Mwana wosabadwayo akhoza kukhala wonenepa kwambiri, wobadwa wakhanda.

Kulakwitsa kwambiri kwa mimba yapitayi kumawonekeranso.

Kuzindikira matendawa

Kafukufuku wokhudzana ndi matenda osokoneza bongo omwe ali ndi vuto lokhudzana ndi matenda a shuga panthawi ya pakati akuwonetsa kuti kuchuluka kwa shuga m'magazi kunali kwachilendo asanamve.

Palibe Zizindikiro zazikulu za matenda amiseche pa mimba.

Nthawi zambiri imadziwika pambuyo pofufuzira ya ultrasound ikaonetsa mwana wosabadwayo. Pakadali pano, chithandizo chimayambika, koma ndibwino kutenga njira zofunikira pasadakhale. Pazifukwa izi, kuyesa kwa glucose kumachitika sabata 24 ndi 28.

Komanso, ngati mayi woyembekezera akulemera kwambiri, amathanso kulankhula za kuchuluka kwa magazi.

Matendawa amatha kuonekanso ndi kukodza pafupipafupi. Koma kudalira izi sikuyenera.

Zowonetsa zasayansi

Kuyesedwa kwa magazi kumatengedwa kangapo pa maola angapo kuti ayesere kulolera shuga. Kufufuzanso kwina kumachitika pogwiritsa ntchito yankho la 50, 75 kapena 100 magalamu a shuga.

Ponyamula mwana, mkazi pamimba yopanda kanthu ayenera kukhala 5.1 mmol / l. Ola limodzi mutatha kudya - 10 mmol / L. Ndipo itatha ziwiri - 8.5 mmol / L.

Ngati chizindikirocho chiri chokulirapo, ndiye kuti matenda awupanga - matenda a shuga gestational.

Pambuyo pozindikira matendawa, muyenera kuwunika kuyanikizidwa ndi ntchito ya impso.

Kuti muwone ngati zakuphwanya, lembani zina zowonjezera magazi ndi mkodzo.

Dokotala wanu angakulangizeni kuti mugule chowunika chamagazi kuti muyeza magazi kunyumba.

Mfundo zakulera za GDM mwa amayi apakati

Pazizindikiro zoyambirira za matenda a shuga gestational panthawi yoyembekezera, chithandizo chachikulu chimayikidwa - chakudya.

Ngati pali chosowa, ndiye kuti chimathandizidwa ndi jakisoni wa insulin. Mlingo amawerengedwa payekhapayekha.

Ndi matendawa, makamaka madokotala amakupatsani zakudya 9.

Kuchita masewera olimbitsa thupi kumalimbikitsidwanso. Amakhala ndi phindu pakupanga insulini ndipo amalepheretsa kuchuluka kwa glucose mumapaundi owonjezera.

Ngati matenda adapezeka, wodwalayo ayenera kuyang'aniridwa ndi endocrinologist komanso wothandizira zakudya. Ngati ali ndi kupasuka kwamaganizidwe, kukambirana ndi sing'anga kungakhale kopanda tanthauzo.

Ndikofunika kukumbukira kuti simungamwe mankhwala omwe amachepetsa shuga.

Zakudya zamagulu onse komanso zochitika tsiku ndi tsiku panthawi yoyembekezera ndi GDM

Pazakudya, pali kuchepa kwa caloric kudya.

Idyani kangapo 5-6 m'magawo ang'onoang'ono kapena kudya zakudya zazikulu 3 kawiri pa tsiku, ndikupanga zokhwasula-khwasula katatu pakati pawo.

Zakudya zikuluzikulu ndi msuzi, masaladi, nsomba, nyama, zamphesa, ndipo zakudya zazakudya monga zakudya zamasamba, zipatso, zakudya zamafuta kapena zakudya zamafuta ochepa.

Posankha zakudya, mayi wamtsogolo akuyenera kuwonetsetsa kuti mwana wawo alandila mavitamini ndi michere yofunikira pakukula kwake. Chifukwa chake, ngati mayi woyembekezera nayenso atapanga chakudya, ndiye kuti ayenera kuphunzira momwe anthu omwe ali ndi matenda amtundu woyamba 1 amadyera.

Panthawi ya chakudyacho, chakudya chamafuta chimasinthidwa ndimapuloteni komanso mafuta athanzi.

Pa nthawi yonse yonyamula mwana, maswiti, mkate, masikono, pasitala ndi mbatata siziyenera kulekedwera. Mpunga ndi mitundu ina ya zipatso ziyeneranso kutayidwa.

Zakudya ziyenera kukhala zosavuta. Izi zingathandize kupewa pancreatic overload.

Yesani pang'ono momwe mungathere kudya zakudya yokazinga, zamzitini komanso zokonda zachangu. Ndikofunikira kusiya zogulitsa zomaliza.

Zopatsa mphamvu patsiku

Malangizo okhudzana ndi kudya kwa calorie tsiku ndi tsiku adzapatsidwa ndi akatswiri azakudya ndi endocrinologist.

Nthawi zambiri pamakhala ma calor 35 35 pa kilogalamu ya kulemera kwa mzimayi. Mwachitsanzo, ngati kulemera kwake ndi makilogalamu 70, ndiye kuti muyezo wake ukhale 2450-2800 kcal.

Ndikofunika kusunga buku lazodyera nthawi yonseyi. Izi zitha kutha kumapeto kwa tsikulo ngati zakhala zikuchitika.

Ngati kumverera kwa njala kumakhalapo pakati pa chakudya, ndiye kuti ndi koyenera kumwa madzi pang'ono. Tsiku lililonse ayenera kuledzera osachepera 2 malita a madzi wamba.

Njira ya kubereka ndi kuyang'anira pambuyo pa GDM

Contraindication to labour sio mtundu woyamba 1 ndi mtundu wa 2 shuga, chifukwa chake, ndi GDM, kuperekera kumalizidwa mosavuta.

Chiwopsezo ndichokhacho chachikulu kwambiri cha mwana wosabadwa, gawo lachiwerewere lingafunike pano.

Kulera mwana wodziyimira pawokha kumaloledwa ngati zinthu sizinakuipiraipira tsiku lapitalo.

Zosakanikirana zimakhudzidwa pokhapokha ngati palibe zachilengedwe kapena mkazi wapakati akungoyenda kwina ndi nthawi yoikika.

Pambuyo pobadwa, mwana amatha kukhala ndi shuga wochepa wamagazi. Imathetsedwa ndi zakudya.

Mankhwala nthawi zambiri safunika.

Nthawi zina mwana amayang'aniridwa ndi madokotala. Izi ndizofunikira kudziwa ngati pali vuto lina chifukwa cha kuperewera kwa shuga m'mayi.

Nthawi zambiri atamasulidwa placenta, mkhalidwe wa mkazi umayamba kukhala wabwinobwino. Palibe kudumpha mu shuga wamagazi. Komabe, mwezi woyamba, muyenera kutsatira zakudya zomwe mwana asanabadwe.

Kubadwa kotsatira kumakonzekera bwino pokhapokha patatha zaka zingapo. Izi zikuthandizira thupi kuchira, komanso kupewa zomwe zimachitika kwambiri.

Asanatenge pathupi, ndikofunikira kumuyesa ndikuuza dokotala wazachipatala za GDM panthawi yoyamba kubereka.

Maonekedwe a matendawa pakubala kwa mwana akusonyeza kuti mayiyo samamva bwino za insulin. Izi zimawonjezera mwayi wokhala ndi matenda ashuga komanso mtima wam'mimba pambuyo pobadwa. Chifukwa chake, ndikofunikira kuthana ndi kupewa matendawa.

Mukabereka kwa milungu 6 mpaka 12, mukuyenera kupitiliza kuyesa shuga. Ngakhale zitakhala zachilendo, ndiye kuti m'tsogolomu ziyenera kufufuzidwa zaka zitatu zilizonse.

Gestationalabetes mellitus (GDM): kuopsa kwa kutenga pakati "kokoma". Zotsatira za mwana, zakudya, Zizindikiro

Malinga ndi World Health Organisation, pali anthu opitilira 422 miliyoni omwe ali ndi matenda ashuga padziko lapansi. Chiwerengero chawo chikukula chaka chilichonse. Kuchulukirachulukira, matendawa amakhudza achinyamata.

Mavuto a shuga amayambitsa matenda opatsirana, impso, mafinya amakhudzidwa, ndipo chitetezo cha m'thupi chimachepa. Koma matendawa amatha kutha. Ndi chithandizo choyenera, zovuta zake zimachedwa nthawi. Osatinso ndipo shuga woyembekezerazomwe zimachitika pakamwa. Matendawa amatchedwa matenda ashuga.

Kanema (dinani kusewera).

Kodi mimba imatha kuyambitsa matenda ashuga
Mitundu ya matenda ashuga nthawi yapakati ndi iti
Gulu lamavuto
Kodi matenda ashuga okhudza thupi ndi chiyani mukakhala ndi pakati?
Zotsatira za mwanayo
Kodi ngozi ili bwanji kwa amayi
Zizindikiro zake zodwala m'mimba mwa amayi apakati
Mayeso ndi masiku ofikira
Chithandizo
Mankhwala a insulini: kwa omwe amawonetsedwa ndi momwe amachitidwira
Zakudya: Zololedwa komanso zoletsedwa, mfundo zoyambirira za amayi apakati omwe ali ndi GDM
Zosankha zamasabata
Chithandizo cha anthu
Momwe mungaberekere: kubadwa kwachilengedwe kapena gawo la cesarean?
Kupewera kwa matenda ashuga okhudza azimayi oyembekezera

American Diabetes Association imapereka umboni kuti 7% ya amayi apakati amakhala ndi matenda ashuga. Ena mwa iwo, atabereka, glucoseemia amabwerera mwakale. Koma mu 60% patatha zaka 10-15, mtundu wa 2 shuga (T2DM) ukuwonekera.

Mimbayo imakhala ngati yoyambitsa matenda osokoneza bongo. Makina a chitukuko cha matenda a shuga akakhala pafupi ndi T2DM. Mayi woyembekezera amakhala ndi insulin chifukwa cha zinthu zotsatirazi:

kaphatikizidwe ka mahomoni a steroid mu placenta: estrogen, progesterone, lactogen yachilengedwe,
kuchuluka kwa mapangidwe a cortisol mu adrenal cortex,
kuphwanya insulin kagayidwe ndi kuchepa kwake zotsatira zake zimakhala.
chimbudzi cha insulin kudzera mu impso,
kutsegula kwa insulinase mu placenta (ma enzyme omwe amaphwanya mahomoni).

Vutoli likuipiraipira mwa azimayi omwe amakhala ndi insulin yolimbana ndi chitetezo cha m'thupi (insulin), omwe sanawonekere kuchipatala. Zinthu izi zimakulitsa kufunikira kwa mahomoni, ma cell a beta a kapamba amaphatikizira kuchuluka. Pang'onopang'ono, izi zimabweretsa kutsika kwawo ndikukhalitsa kwa hyperglycemia - kuwonjezeka kwamagazi a shuga.

Mitundu yosiyanasiyana ya shuga imatha kutsagana ndi kutenga pakati. Kugawika kwa matenda ndi nthawi yanthawi yomwe mwadzidzidzi akutanthauza mitundu iwiri:

matenda ashuga omwe analipo asanakhale ndi pakati (matenda 1 a shuga ndi matenda ashuga a 2) ndi asanafike pakubala,
matenda a shuga (GDM) mwa amayi apakati.

Kutengera ndi chithandizo chofunikira cha GDM, pali:

kuchepetsa zakudya
kulipidwa ndi zakudya mankhwala ndi insulin.

Matenda a shuga amatha kukhala pa gawo la kulipidwa ndi kubwezeretseka. Kukula kwa matenda asanafike gestational matenda a shuga kumadalira kufunika kothandizila njira zosiyanasiyana zochizira komanso kuuma kwa zovuta.

Hyperglycemia, yomwe imakhalapo pa nthawi yobereka, siikhala nthawi zonse matenda ashuga. Nthawi zina, izi zitha kukhala mtundu wa matenda ashuga 2.

Ndani ali pachiwopsezo chotenga matenda ashuga panthawi yapakati?

Kusintha kwa ma Hormonal komwe kumatha kusokoneza kagayidwe ka insulin ndi glucose kumachitika mwa amayi onse oyembekezera. Koma si aliyense amene akusintha kukhala ndi matenda ashuga. Izi zimafunikira kudziwiratu zinthu:

kunenepa kwambiri kapena kunenepa kwambiri,
kulolerana kwa shuga
magawo a shuga amadzuka asanabadwe,
Mtundu wa shuga wachiwiri mwa makolo oyembekezera
zaka zopitilira 35
polycystic ovary syndrome,
mbiri yakubadwa kolakwika, kubereka,
Kubadwa m'mbuyomu ana omwe anali ndi makilogalamu opitilira 4, komanso kuwonongeka.

Koma ndi ziti mwa zifukwa izi zomwe zimakhudzira kukula kwa matenda a zamatenda kwakukulu sikudziwika mokwanira.

GDM imatengedwa ngati matenda omwe adakhalapo pambuyo pa masabata 15-16 atabereka mwana. Ngati matenda a hyperglycemia adapezeka kale, ndiye kuti pali matenda osokoneza bongo a latent, omwe adakhalapo asanakhale ndi pakati. Koma kuchuluka kwakukulu kumawonedwa mu 3 trimester. Chofanana pa nkhaniyi ndi matenda ashuga.

Matenda a shuga a pakati pa pakati amakhala osiyana ndi matenda osokoneza bongo chifukwa pakatha gawo limodzi la hyperglycemia, shuga amapezeka pang'onopang'ono ndipo samakhazikika. Matendawa amatenga matenda amtundu wa 1 kapena mtundu wa 2 wodwala akangobadwa kumene.

Kuti mudziwe njira zamtsogolo, azimayi onse oyembekezera pambuyo poti ali ndi GDM kumapeto kwa msambo amakhala ndi gawo la glucose yotsimikizika. Ngati sichikhala matenda ake, ndiye kuti titha kuganiza kuti mtundu 1 kapena mtundu 2 wabadwa.

Kuopsa kwa mwana yemwe akukula zimadalira kuchuluka kwa kubwezeredwa kwa matenda. Zotsatira zoyipa kwambiri zimawonedwa ndi mawonekedwe osakwanitsidwa. Zokhudza mwana wosabadwayo zikufotokozedwa motere:

Komanso, ana obadwa kwa amayi omwe ali ndi matenda a shuga amakhala ndi chiopsezo chowonjezeka cha kubadwa kwa m'mimba, matenda a mtima, matenda a kupuma, calcium ndi magnesium metabolism, komanso zovuta zamitsempha.

GDM kapena matenda ashuga omwe alipo kale amawonjezera kuthekera kwa toxicosis (gestosis), imadziwonekera mumitundu yosiyanasiyana:

azimayi oyembekezera
nephropathy 1-3 madigiri,
preeclampsia,
eclampsia.

Zotsatira ziwiri zomalizazi zimafuna kuti agonekere kuchipatala kwambiri.

Matenda oyenda mthupi omwe amayenda ndi matenda a shuga amatsogolera kumatenda a genitourinary system - cystitis, pyelonephritis, komanso kupezekanso kwa venvovaginal candidiasis. Matenda aliwonse angayambitse matenda a mwana mu utero kapena nthawi yobereka.

Zizindikiro zazikuluzikulu za matenda ashuga akakhala ndi pakati

Zizindikiro za matenda osokoneza bongo samatchulidwa, matendawa amakula pang'onopang'ono. Zizindikiro zina za mkazi zimatengedwa kuti zisinthe nthawi yapakati:

kutopa, kufooka,
ludzu
kukodza pafupipafupi
kulemera kokwanira ndi chakudya.

Nthawi zambiri hyperglycemia imapeza mwangozi nthawi yoyesa magazi. Izi zimagwira ntchito monga chidziwitso pakuwunikiridwa mwakuzama.

Unduna wa Zaumoyo wakhazikitsa nthawi yoyeselera magazi:

Ngati vuto lanu lilipo, kuyeserera kwa glucose kumachitika pakadutsa masabata 26-31. Ngati zizindikiro za matenda ashuga zikuwoneka panthawi yapakati, kuyezetsa shuga kumasonyezedwa.

Kupenda kamodzi komwe kumawulula hyperglycemia sikokwanira kungodziwitsa anthu ena. Kuwongolera ndikofunikira pakatha masiku angapo. Komanso, ndi mobwerezabwereza hyperglycemia, kufunsira kwa endocrinologist kumalembedwa. Dokotalayo amawona zofunikira komanso nthawi yakuyesa kwa mayeso a glucose. Nthawi zambiri sizikhala zosakwana sabata 1 pambuyo pa hyperglycemia yokhazikika. Kuyesaku kumachitidwanso mobwerezabwereza kuti utsimikizire kuti wapezeka.

Zotsatira zakuyesa zotsatirazi zikunena za GDM:

kudya glucose wamkulu kuposa 5.8 mmol / l,
ola limodzi mutatha kudya shuga - pamwamba pa 10 mmol / l,
patatha maola awiri, kupitilira 8 mmol / l.

Kuphatikiza apo, monga momwe zikuwonekera, kafukufuku amachitika:

glycosylated hemoglobin,
kuyesa kwa mkodzo,
cholesterol ndi mbiri ya lipid,
kuyesa kwamwazi wamagazi,
coagulogram
mahomoni am'magazi: progesterone, estrogen, lactogen yachilengedwe, cortisol, alpha-fetoprotein,
Kusanthula kwa mkodzo malinga ndi Nechiporenko, Zimnitsky, mayeso a Reberg.

Amayi oyembekezera omwe ali ndi pre-gestational ndi gestationalabetes amapitiliza ku fetal kuchokera ku 2nd trimester, dopplerometry ya placenta ndi ma umbilical, nthawi zonse CTG.

Njira ya kubereka ndi shuga yomwe ilipo imadalira kuchuluka kwa kudziletsa komwe kungachitike ndi mkazi komanso kukonza kwa hyperglycemia. Omwe anali ndi matenda ashuga isanatenge pakati amayenera kudutsa Sukulu ya Matenda a shuga, makalasi apadera omwe amawaphunzitsa momwe angadye moyenera, momwe angayendetsere pawokha matenda a shuga.

Mosasamala mtundu wamatenda, amayi apakati amafunikira zowonera izi:

kupita ku gynecologist milungu iwiri iliyonse kumayambiriro kwa bere, sabata - kuyambira theka lachiwiri,
kufunsa kwa endocrinologist kamodzi pa sabata ziwiri zilizonse, zowola - kamodzi pa sabata,
wowonera wowerengera - nyengo iliyonse, komanso pakudziwika kwa zowonjezera zam'mimba,
ophthalmologist - kamodzi trimester ndi pambuyo kubereka,
neurologist - kawiri pa mimba.

Kugonekedwa kuchipatala kwa mayeso ndi kukonza kwa amayi apakati omwe ali ndi GDM amaperekedwa:

1 nthawi - mu trimester yoyamba kapena kuzindikira matenda,
2 - pakadutsa milungu 19 mpaka 20 kuti muthane ndi vutoli, pezani kufunika kosintha mankhwala,
Nthawi zitatu - ndi mtundu wa 1 komanso matenda a shuga a 2 - pamasabata 35, GDM - pakatha masabata 36 kuti mukonzekere kubadwa kwa ana ndikusankha njira yobereka.

Ku chipatala, kuchuluka kwa maphunziro, mndandanda wazoyeserera ndi pafupipafupi pa kafukufuku zimatsimikiziridwa payekhapayekha. Kuyang'anira tsiku ndi tsiku kumafunikira kuyesa kwamkodzo kwa shuga, glucose wamagazi, ndi kuwongolera kuthamanga kwa magazi.

Kufunika kwa jakisoni wa insulin kumatsimikiziridwa payekhapayekha. Sikuti zochitika zonse za GDM zimafuna njira imeneyi;

Zisonyezero zakuyamba insulin mankhwala ndi zizindikiro zotsatirazi shuga:

kusala shuga m'magazi ndi zakudya zopitilira 5.0 mmol / l,
ola limodzi mutadya pamwamba 7.8 mmol / l,
Maola awiri atatha kumwa, glycemia pamtunda wa 6.7 mmol / L.

Yang'anani! Amayi oyembekezera komanso oyembekezera amaletsedwa kugwiritsa ntchito mankhwala aliwonse ochepetsa shuga, kupatula insulin! Ma insulin omwe amakhala nthawi yayitali sagwiritsidwa ntchito.

Maziko a mankhwalawa ndi insulin yokonzekera yochepa komanso ya ultrashort. Mtundu woyamba wa matenda ashuga, chithandizo chachikulu cha bolus chimachitika. Kwa matenda a shuga a 2 ndi GDM, ndizothekanso kugwiritsa ntchito njira zamtunduwu, koma mwa kusintha kwina komwe munthu wa endocrinologist amatsimikiza.

Mwa amayi apakati omwe sangathe kuwongolera hypoglycemia, mapampu a insulin amatha kugwiritsidwa ntchito, omwe amathandizira kutsata kwa mahomoni.

Zakudya za matenda ashuga gestational nthawi yapakati

Zakudya za mayi wapakati wokhala ndi GDM ziyenera kutsatira mfundo izi:

Nthawi zambiri pang'onopang'ono. Ndikofunika kudya zakudya zazikulu zitatu ndi zitatu zazing'ono.
Kuchuluka kwa zovuta zamankhwala okhala ndi chakudya kumakhala pafupifupi 40%, mapuloteni - 30-60%, mafuta mpaka 30%.
Imwani pafupifupi 1.5 malita amadzi.
Kuchulukitsa kuchuluka kwa fiber - imatha kutsatsa glucose kuchokera m'matumbo ndikuwachotsa.

Mawu osavuta onena za kupezeka kwa matenda ashuga a gestational nthawi ya pakati

Gestational matenda a shuga mellitus pa mimba (HD) - Mtundu wa shuga womwe umapezeka mwa amayi mokhudzana ndi kusokonekera kwa mahomoni mu trimester yachitatu. Zotsatira zake, shuga yamagazi amatuluka pambuyo pa kudya ndikuchepera pamimba yopanda kanthu.

Pathology imawopseza mwana, chifukwa imatha kupangitsa kuti matenda aberekedwe.

Kuti izi zisachitike, pakadutsa milungu 24-28, mayi akulimbikitsidwa kuti apange mayeso okhudza matenda ashuga, ndipo akapezeka ndi matendawa, atsatira malamulo ena a zakudya komanso moyo. Nthawi zina, mankhwala othandizira amafunikira, omwe angapangidwe ndi dokotala.

Matenda a shuga a Gestational amapatsidwa nambala ya ICD ya 10 - O 24.

Zomwe zimayambitsa matenda a shuga kwa amayi apakati sizikudziwika. Komabe, akatswiri ochulukirachulukira amatengera mtundu womwe chiphunzitso cha matenda chimapanga motsutsana ndi maziko a kulephera kwa mahormone. Zotsatira zake, mahomoni amaletsa kupanga insulin. Komabe, thupi silingalole izi, popeza mayi ndi mwana amafunika shuga kuti magwiritsidwe ake a ziwalo ndi machitidwe azikhala. Zotsatira zake, pali kuchuluka kowonjezera pa insulin synthesis. Umu ndi momwe matenda a shuga a gestational amakulira.

Autoimmune pathologies ndi amodzi mwazomwe zimayambitsa HD. Matenda ngati amenewa amakhudza mkhalidwe wa kapamba. Zotsatira zake ndi kuchepa kwa kapangidwe ka insulin.

Pali zinthu zomwe zimawonjezera chiopsezo cha HD:

Kunenepa kwambiri
Chiyanjano cha dziko. Asayansi atsimikizira kuti mayiko ena amadwala matenda ashuga kwambiri nthawi zambiri kuposa ena. Izi zikuphatikizapo akuda, aku Asiya, Spain, ndi Asilamu aku America.
Kuchuluka kwa shuga mumtsempha.
Kulekerera kwa shuga.
Mitundu. Ngati wina m'banjamo adadwala matenda amtunduwu, ndiye kuti mwina matendawa amapezeka mwa mkazi.
Kubadwa m'mbuyomu, ngati kulemera kwa mwana kumaposa 4 kg.
Mimba yapitayi idaphatikizidwa ndi matenda a shuga.
Kuchuluka kwamadzi amniotic.

Pali Zizindikiro zina zomwe zikusonyeza mosawoneka bwino komwe kumachitika matenda a shuga:

kulemera kwakukulu

kukodza pafupipafupi komanso kununkhira kwa acetone kuchokera mkodzo,

kutopa ngakhale kupumula kwanthawi yayitali komanso kusachita masewera olimbitsa thupi,

kufunika kosowa kwa chakumwa

kusowa kwa chakudya.

Ngati mumanyalanyaza izi ndipo simukuonana ndi dokotala, matendawa amapita patsogolo ndipo zizindikiro zotsatirazi zidzachitika:

chisokonezo,
kukomoka
kuthamanga kwa magazi
kupweteka mumtima, komwe kungayambitse kugunda,
mavuto a impso
kuwonongeka kwamawonekedwe
kuchiritsa pang'onopang'ono pa khungu
dzanzi lam'munsi.

Kuti mupewe izi, ndikulimbikitsidwa kuchezera akatswiri nthawi zonse.

Kuti adziwe matenda a shuga, wodwala amayesedwa kuti ayesedwe magazi. Kuti zotsatira zake zikhale zodalirika, tikulimbikitsidwa kutsatira malamulo operekera zotsalira zazomera:

masiku atatu lisanachitike phunziroli, sikulimbikitsidwa kuti musinthe zakudya zofunikira m'thupi ndipo muyenera kutsatira zolimbitsa thupi zanu,
amapereka magazi pamimba yopanda kanthu, kotero mukatha kudya chakudya cham'mawa komanso m'mawa simungathe kudya, komanso kumwa tiyi ndi zakumwa zina kupatula madzi oyera opanda mpweya.

Kusanthula kumachitika motere:

biomaterial imachotsedwa kwa wodwala,
mkazi amamwa madzi ndi shuga,
Pambuyo maola awiri, biomaterial imasonkhanitsidwanso.

Magazi a shuga:

kuchokera chala - 4.8-6 mmol / l,
kuchokera mtsempha - 5.3-6.9 mmol / l.

Chifukwa chake, matenda amishuga amadziwika kuti ali ndi zizindikiro zotsatirazi:

kuyambira chala kupita pamimba yopanda kanthu - pamtunda wa 6.1 mmol / l,
kuyambira mtsempha mpaka pamimba yopanda kanthu - pamwamba pa 7 mmol / l,
mutamwa madzi ndi shuga - pamwambapa 7.8 mmol / l.

Ngati phunziroli likuwonetsa kuchuluka kwa shuga kapena kuchepera kwa shuga, ndiye kuti pakatha milungu 24 mpaka 28 mayeso achiwiri amayesedwa. Izi ndichifukwa choti kumayambiriro koyambirira kusanthula kungawonetse zotsatira zosadalirika.

Matenda a shuga pa nthawi ya pakati amakhala ndi mitundu yambiri, kutengera nthawi yomwe yakwana:

matenda ashuga

matenda a shuga kapena matenda ashuga azimayi oyembekezera.

Matenda a shuga omwe amachitika pakadali pano, ali ndi gulu lake, kutengera mankhwala omwe apatsidwa:

kulipidwa ndi mankhwala,
kulipidwa ndi zakudya mankhwala ndi insulin.

Mankhwalawa amalembedwa, kutengera mtundu wa shuga komanso kuopsa kwa matenda ake.

Kodi kuchitira matenda ashuga? Pali njira ziwiri zazikulu - zakudya mankhwala ndi mankhwala a insulin. Dokotala yekha ndi amene angadziwe ngati wodwalayo amafunikira malangizo ake.

Mankhwala a insulin amadziwika ngati ngati kudya sikubweretsa zotsatira zomwe mukufuna ndipo glucose wamagazi sabwerera mwakale kwa nthawi yayitali.

Pankhaniyi, kuyambitsa insulin ndi gawo loyenera lomwe limalepheretsa kuchitika kwa fetopathy.

Dokotala amafotokozeranso chithandizo chamtunduwu ndi shuga wambiri, koma ndi kulemera kwakukulu kwa mwana, ndi madzi ambiri amniotic kapena kutupa kwa minofu yofewa.

Kukhazikitsidwa kwa mankhwalawa kumalimbikitsidwa kuchitidwa pamimba yopanda kanthu komanso musanagone usiku. Komabe, kuchuluka kwake ndi kuchuluka kwa jakisoni kumatsimikiziridwa ndi adotolo, kutengera kuwuma kwa matenda ndi mawonekedwe a wodwalayo.
Jakisoni wa insulin amachitika ndi syringe yapadera. Mankhwalawa amaperekedwa mosavuta. Nthawi zambiri, mkazi amadzipangira yekha jakisoni atafunsira katswiri.

Ngati insulin ikuwonjezeka tsiku lililonse, dokotalayo amatha kupaka insulin.

Chofunikira kwambiri pakupambana kwa matenda a zam'thupi ndi kusungidwa kwa malamulo ena azakudya. Izi zimathandiza kuti matendawa azikhala ndi shuga. Nayi mfundo zachakudya zomwe zimalimbikitsidwa kuti zitsate ndi mtundu uwu wa matenda:

Kodi chiwopsezo cha matenda obadwa nacho kwa mwana wosabadwa ndi chiani? Tiyeni tiwone.

Matenda a shuga pakapita nthawi yayitali amakhudza kukula kwa khanda.

Ngati matendawa adapezeka m'masabata oyambilira, ndiye kuti pamakhala vuto lodzidzimutsa mwadzidzidzi. Matendawa amathanso kubweretsa matenda obadwa nawo mwa makanda.

Nthawi zambiri, ubongo ndi mtima zimadwala matenda.

Ngati matendawa adayamba mu trimester yachiwiri kapena yachitatu, ndiye kuti izi zimabweretsa kukula kwambiri kwa mwana komanso kulemera kwake. Zotsatira zake, mwana akabadwa, shuga wa mwana amatsika pansi, zomwe zimayambitsa mavuto azaumoyo.

Ngati mayi woyembekezera akayamba kudwala matenda ashuga, koma palibe chithandizo chokwanira, kuleza mtima kwa fetal kumakhala kotheka.
Matenda oterewa amawopseza mwana zotsatirazi:

kulemera kwa makilogalamu oposa 4,
kusakhazikika kwa thupi
kuchuluka kwa mafuta m'malo ochepa,
minofu yofewa,
mavuto kupuma
jaundice
mavuto ndi kuthamanga kwa magazi ndi magazi.

Ngati mayi woyembekezera wapezeka ndi matenda a shuga, ndiye kuti pa nthawi yovutikira, mayi ayenera kutsatira malangizo a dokotala. Ndi matenda amtunduwu, mayi amagonekedwa kuchipatala masabata 37-38.

Ngakhale kuvutikaku sikuchitika, kumakhudzidwa mwaukadaulo, koma pokhapokha ngati mwana akuti ndi wanthawi yonse. Izi zimapewa kuvulala.

Kutumiza kwachilengedwe sizotheka nthawi zonse. Ngati mwana ndi wamkulu kwambiri, ndiye kuti madokotala amamulembera gawo loti acesere.

Kutsatira malangizo a dokotala pazokhudza matenda a shuga kumapereka chiyembekezo chabwino kwa mayi woyembekezera komanso mwana. Ngati nkotheka kusungitsa kuchuluka kwa shuga pamlingo wabwinobwino, ndiye kuti izi zithandiza kuti mayi athe kubereka ndi kubereka mwana wathanzi.
Pewani kupezeka kwa matenda a shuga a gestational sizotheka nthawi zonse, komabe mutha kuchepetsa chiopsezo cha matendawa.
Njira zotsatirazi zothandizira kupewa izi zingakuthandizeni kuchita izi:

kuchepetsa thupi mpaka mulingo wovomerezeka,
kusintha kwa mfundo za zakudya zoyenera,
kukana moyo wotchedwa kugona ndi kuwonjezera zochita zolimbitsa thupi, ngati izi sizikuwopseza kutenga pakati,
Kugonekedwa pachipatala molimbikitsidwa ndi dokotala.

Amayi oyembekezera omwe ali ndi HD nthawi zambiri amafunsidwa mafunso osiyanasiyana: sabata iti yomwe amabereka, kupezeka kuti wapezeka ndi vuto lotani, kubereka atabereka mwana ndi zomwe angayang'ane pambuyo pobadwa.
Takusankhirani kanema wokhala ndi ndemanga za katswiri, ndi kanema wa amayi amtsogolo omwe ali ndi matenda a HD:

Ngati matenda amishuga apezeka ndi nthawi ya bere, sikuti chifukwa chakuwopsa kapena kusokoneza mayiyo. Kutengera mfundo zina za kadyedwe ndikutsatira malangizo a dokotala, mayi ali ndi mwayi uliwonse wobereka ndi kubereka mwana wathanzi popanda kuwopseza thanzi lake.

Matenda a shuga a Gestational ndi mtundu wa shuga womwe umapezeka mwa amayi okha panthawi yoyembekezera. Pambuyo pobereka, patapita kanthawi, nthawi zambiri amadutsa. Komabe, ngati kuphwanya kotereku sikumathandizidwa, kuyambitsa, ndiye kuti vutoli limatha kukhala matenda oopsa - matenda ashuga a 2 (ndipo izi ndizovuta zambiri komanso zotsatira zosasangalatsa).

Mkazi aliyense wokhala ndi pakati kumayi amalembedwa kuchipatala cha anakubala komwe amakhala. Chifukwa cha izi, munthawi yonse yobereka mwana, thanzi la mayiyo ndi mwana wake limayang'aniridwa ndi akatswiri, ndipo kuyang'anira magazi ndi mkodzo nthawi ndi nthawi kumakhala kofunikira kuwunikira.

Ngati mwadzidzidzi kuchuluka kwa glucose kwapezeka mkodzo kapena magazi, ndiye kuti mlandu womwewo suyenera kuchititsa mantha kapena mantha aliwonse, chifukwa kwa amayi apakati izi zimawerengedwa ngati chizolowezi cha thupi. Ngati zotsatira zoyeserazi zidawonetsa zoposa ziwiri zotere, ndi glucosuria (shuga mkodzo) kapena hyperglycemia (shuga m'magazi) osapezeka atatha kudya (zomwe zimadziwika kuti ndizofala), koma atangokhala pamimba yopanda kanthu m'mayesedwe, ndiye kuti titha kulankhula zokhudzana ndi matenda a shuga a m'mimba mwa amayi apakati.

Zomwe zimayambitsa matenda amtundu wa shuga, chiwopsezo chake ndi zizindikiro zake

Malinga ndi ziwerengero, pafupifupi azimayi 10% amavutika ndi zovuta panthawi yomwe ali ndi pakati, ndipo pakati pawo pali gulu lowopsa lomwe lingayambitse matenda a shuga. Izi zikuphatikiza azimayi:

ndi chibadwa
onenepa kwambiri kapena wonenepa kwambiri,
ndi matenda a m'mimba (mwachitsanzo, polycystic)
ndi pakati komanso pobereka mwana atakwanitsa zaka 30,
ndi obadwa m'mbuyomu ophatikizidwa ndi matenda a shuga.

Pakhoza kukhala zifukwa zingapo zomwe zimayambitsa GDM, komabe, izi zimachitika makamaka chifukwa cha kukhulupirika kwa glucose (monga matenda a shuga a 2). Izi zimachitika chifukwa cha kuchuluka kwa kapamba m'mapazi azimayi oyembekezera, omwe mwina sangathe kuthana ndi kupanga insulin, mwachitsanzo amawongolera shuga mthupi. "Choyipa" cha izi ndi placenta, yomwe imapangitsa ma mahomoni omwe amakana insulin, pomwe akuwonjezera kuchuluka kwa glucose (insulin kukana).

"Kulimbana" kwamahomoni a placental kwa insulin nthawi zambiri kumachitika masabata 28-36 oyembekezera ndipo, monga lamulo, izi zimachitika chifukwa cha kuchepa kwa zinthu zolimbitsa thupi, zomwe zimachitikanso chifukwa cha kuchuluka kwachilengedwe pakulemera.

Zizindikiro za matenda amiseche pa nthawi ya mimba ndiofanana ndi mtundu wachiwiri wa matenda ashuga:

kumva ludzu kwambiri
kusowa kudya kapena kumangokhala ndi njala,
kusasangalala ndi kukodza pafupipafupi,
kuonjezera magazi,
kuphwanya kwamasulira (omveka).

Ngati chimodzi mwazizindikiro zomwe zili pamwambazi zilipo, kapena muli pachiwopsezo, onetsetsani kuti mwamuuza dokotala wanu za matendawo kuti akuyezeni za GDM. Kuzindikira komaliza sikumapangidwa pokhapokha ngati pali chizindikiro chimodzi kapena zingapo, komanso pamaziko a mayeso omwe amayenera kupatsiridwa moyenera, ndipo chifukwa cha ichi muyenera kudya zinthu zomwe zili patsamba lanu latsiku ndi tsiku (musazisinthe musanayambe kuyesa!) Ndikupeza njira yodziwika .

Izi ndi zomwe zimachitika kwa amayi apakati:

4-5.19 mmol / lita - pamimba yopanda kanthu
zosaposa 7 mmol / lita - Patatha maola awiri mutadya.

Zotsatira zokayikitsa (i.e., kuwonjezeka pang'ono), kuyezetsa magazi ochulukitsa kumachitika (mphindi 5 pambuyo poyesa kusala, wodwalayo amamwa kapu yamadzi pomwe 75 g ya shuga yowuma itasungunuka) - kuti athe kudziwa bwino lomwe matenda a GDM.

Gestationalabetes mellitus: chiopsezo chazomwe mungadziwe nthawi yomwe muli ndi pakati pa mayi ndi mwana

Nthawi zambiri pakukwatirana, mayi amakumana ndi mavuto omwe anali asanaganizirepo kale. Kwa ambiri, zimadabwitsidwa pamene matenda ashuga apakati pa nthawi ya pakati apezeka mukamayesedwa. Pathology ndi chiopsezo osati kwa amayi okha, komanso kwa mwana. Chifukwa chiyani matendawa amatuluka komanso zoyenera kupanga kuti mwana akhale wathanzi?

Matenda a gestational amapezeka nthawi zambiri kwa iwo omwe ali ndi vuto la metabolic asanafike pathupi, komanso ngati ali ndi chiyembekezo chodwala matenda ashuga a 2, mwachitsanzo, ngati abale ake apamtima amadwala matendawa. Matendawa ndi ochenjera chifukwa mkazi samavutitsa chilichonse, ndipo mwana amadwala. Kuzindikiritsa munthawi yake kusintha kwamthupi kumathandiza kupewa zovuta.

Gestationalabetes mellitus (GDM) ndimatenda omwe amasintha kagayidwe kazakudya komanso mayamwidwe olakwika a chakudya. Mawu akuti shuga woyembekezera (DB) amagwiritsidwa ntchito pofotokoza matenda. Matendawa amaphatikizapo matenda ashuga omwewo komanso prediabetes - kuphwanya kulekerera kwa glucose (sensitivity). Matenda amapezeka nthawi zambiri kumapeto kwa 2 ndi 3 trimesters.

GDS pazawonetsero zamankhwala, maupangiri oyang'anira amakumbutsa matenda ashuga amtundu wachiwiri. Komabe, mahomoni a placenta ndi fetus amatenga gawo lofunikira pakukula kwake. Ndi kuchuluka kwa kubadwa kwa gestational, pali kuchepa kwa insulin mthupi. Zinthu zotsatirazi zikuthandizira izi:

kuchuluka kwa insulinase - mu placenta (enzyme yowononga insulin),
kuwonongeka kwa insulin ndi impso za mkazi,
kuchuluka kwa mapangidwe a cortisol ndi tiziwalo tamadontho tambiri,
kuchuluka kwa insulin kagayidwe - chifukwa kapangidwe ka placenta ndi estrogen, progestogen ndi lactogen.

Insulin imagwira ntchito yofunika kwambiri pakugwiritsa ntchito shuga. "Imatsegula" njira ya glucose kulowa mu cell. Popanda kuyanjana kotero, shuga amakhalanso m'magazi, zomwe zimapangitsa kuti insulini ipangike kwambiri. Pakatha mphamvu yakeyake, kusowa kwa insulin kumachitika, monga chotulukapo, kuchuluka kwa shuga m'magazi. Bwalo loipa, kuthyoka komwe sikophweka nthawi zonse.

Zizindikiro za matenda amiseche kwa amayi apakati nthawi zambiri amapezeka mwa azimayi awa:

patatha zaka 30
ngati achibale apafupi akudwala matenda ashuga,
ngati mayi yemwe ali ndi pakati m'mbuyomu anali ndi GDM,
ndi pathological kulemera,
Ndi kunenepa koyambirira mwa mkazi,
ngati ana akuluakulu abadwa m'mbuyomu,
ngati panali polyhydramnios mu izi kapena m'mbuyomu m'mimba,
vuto la shuga kuloleza,
ndi matenda oopsa
ndi gestosis mu izi kapena zam'mbuyomu zam'mimba.

Kuwunika momwe mayi aliri wathanzi ndikuzindikiritsa zinthu zomwe zimayambitsa vuto kumapangitsa kuzindikira zizindikiro za GDM panthawi yapakati.

Choopsa chonse cha matendawa ndikuti mayi sazindikira kusintha kwayekha, ndipo GDM imatha kukayikiridwa kokha mwa kuyezetsa magazi. Ndipo kokha ndi kuchuluka kwa shuga komwe kumachitika chiwonetsero chazachipatala. Zizindikiro zotsatirazi zitha kuvutitsa mkazi:

ludzu lochulukirapo
kulakalaka maswiti
thukuta kwambiri
Khungu loyera paliponsepi,
kufooka kwa minofu
zotupa zapakati, bakiteriya vaginosis,
kuchepa kwamtima.

Matenda a shuga oyembekezera ndi owopsa kwambiri kwa mwana wosabadwayo. Kuchepa kwa zovuta kumadalira kuchuluka kwa shuga m'magazi - kukwera kwakukulu. Nthawi zambiri, zotsatirazi matenda.

Mavuto obwera chifukwa cha matenda ashuga mwana ali ndi pakati amakhalanso amalumikizana ndi kuchuluka kwa kuchuluka kwa shuga m'magazi. Ana otere nthawi zambiri amabadwa ndi unyinji waukulu. Izi ndichifukwa choti glucose owonjezera amachokera m'magazi a mayi kupita kwa mwana, pomwe zotsatira zake amasintha kukhala mafuta osungira. Mwana wosabadwayo, kapamba akadali mu utero amagwira ntchito mwamphamvu, akuyesera kuyamwa glucose onse obwera. Chifukwa chake, atangobereka, ana otere nthawi zambiri amakhala ndi hypoglycemia (kuchepa koopsa kwa shuga m'magazi).

Pambuyo pake, nthawi zambiri amakumana ndi vuto lamadzi pambuyo pobadwa, lomwe limatenga nthawi yayitali ndipo limavuta kuchiza. M'chaka choyamba cha moyo, ana otere amakhala ndi matenda osiyanasiyana opatsirana chifukwa cha kusokonezeka kwa ma gren adrenal.
Mwa ana obadwa kwa amayi omwe ali ndi GDM, kupangika kwa mankhwala osokoneza bongo kumasokonezeka - kuyanika kwamkati m'mapapu am'mimba alveoli, komwe kumalepheretsa mapapu kuti asatsike ndi "kumamatira". Zotsatira zake, chizolowezi cha chibayo.

Ngati mayi sabwezera glucose pa nthawi yapakati, matupi a ketone amapanga thupi lake. Amalowa mu placenta momasuka komanso poizoni wama cell a ubongo ndi msana. Chifukwa chake, kwa mwana akamadwala matenda ashuga panthawi yoyembekezera amawopseza zotsatirazi:

matenda oopsa
Kupanga zolakwika zamkati,
Imachedwetsa kukhumudwa komanso kukula kwa thupi,
kukonda matenda opatsirana,
kudziwitsa zamatenda a metabolic,
chiwopsezo cha matenda a shuga
intrauterine atamwalira pambuyo pake,
kumwalira koyambirira kwamasiku oyambira.

Kuopsa ndi kukula kwa zovuta za thupi la mkazi ndizochepa kwambiri kuposa mwana. Pa nthawi yoyembekezera, gestosis ndi kupitilira kwake (preeclampsia ndi eclampsia), kuwonongeka kwa impso kumatha kuwopseza moyo ndi thanzi. Pambuyo pa kubala, amayi apakati omwe ali ndi matenda ashuga amakonda kukhala ndi matenda ashuga 2 pasanathe zaka zisanu ndi ziwiri mpaka khumi. Komanso azimayi omwe ali ndi GDM amakonda zinthu zotsatirazi:

metabolic syndrome ndi kunenepa kwambiri,
ochepa matenda oopsa
kuwonongeka kwamawonekedwe
kupititsa patsogolo kwa atherosulinosis.

Mutha kuchepetsa mwayi wopanga zovuta zonsezi posintha moyo wanu, kusintha kadyedwe kanu komanso zochita zolimbitsa thupi.

Kuzindikira kwa GDM kumachitika pofuna kudziwa kuchuluka kwa shuga m'magazi. Kuti muchite izi, maphunziro otsatirawa amachitidwa.

Kuyesedwa kwa magazi konse. Chala chimatengedwa pamimba yopanda kanthu. Kuchuluka kwa shuga sikuposa 5.5 mmol / l. Pa nthawi yoyembekezera, odzipereka pakulembetsa, kenako masabata 18-20 ndi 26-28. Pamitengo yapamwamba - nthawi zambiri.
Mayeso a kulolera a glucose. Tanthauzo lake ndikuzindikira kusowa kwa insulini. Pazifukwa izi, amayi apakati "amadzazidwa" ndi shuga - amapatsidwa 50 g kapena 100 g shuga osungunuka m'madzi. Pambuyo pake, milingo ya shuga ya magazi imayeza pambuyo pa ola limodzi, awiri ndi atatu. Kupitilira muyeso munjira ziwiri kumawonetsa shuga wodwala mwa amayi apakati. Zimachitika kokha kutsimikizira GDM.
Glycated hemoglobin. Glucose owonjezera amalumikizidwa pang'ono ndi maselo ofiira amkazi. Pakudziwa mulingo wosalunjika, mutha kuweruza kuti kuchuluka kwa shuga kwamwazi kwakweza motani. Nthawi zambiri sayenera kupitirira 6.5%. Mu GDM, hemoglobin wa glycated amatsimikiza miyezi iwiri kapena itatu iliyonse.
Kudziwitsa kwa lactogen waachilengedwe. Mfundo zochepetsera zikuwonetsa kufunikira kwakukulu kwa insulini. Si mayeso okakamiza.

Pambuyo podziwitsa za GDM kukhazikitsidwa, mayi wapakati amayesedwa mozama kuti adziwe zovuta zake komanso kuti adziwe momwe matimuwo amagwirira ntchito. Izi zimachitika nthawi zonse:

kuyesa kwamwazi wamagazi, coagulogram,
mayeso a akatswiri a maso,
kuwerenga kwa ntchito ya impso (ultrasound, Reberg test, mkodzo malinga ndi Zimnitsky),
Ultrasound ya mwana wosabadwayo, chithokomiro England ndi ziwalo zam'mimba,
kuthamanga kwa magazi.

Chinsinsi cha kubereka kopambana ndi kuchuluka kwamisempha yamagazi. Chifukwa chake, mankhwalawa gestational shuga mellitus amaphatikizira kukonzanso kwa shuga wamagazi panthawi yapakati. Izi ndizotheka ndi kudya komanso kuchita masewera olimbitsa thupi, ndipo ngati mukulephera, jakisoni wa insulini amatchulidwa.

Ndemanga za madotolo ndi amayi zimatsimikizira kuti mu 95% ya milandu, kuchuluka kwa shuga m'magazi panthawi ya bere kumatha kupezeka mwa kusintha kadyedwe. Mfundo zazikuluzikulu ndi izi.

Chepetsani zopatsa mphamvu. Chiwerengero chofunikira cha zopatsa mphamvu chimawerengeredwa pafupifupi 20-25 kcal / kg kulemera kwa thupi poyambirira kuchuluka kwa thupi. Ngati kulemera musanakhale ndi pakati kunali kwabwinobwino, 30 kcal / kg patsiku amaloledwa. Komanso, kuchuluka pakati pa mapuloteni, mafuta ndi chakudya ayenera kukhala motere - b: w: y = 35%: 40%: 25%.
Kuchepetsa chakudya. Choyamba, ndikofunikira kupatula zonse zakudya zam'mimba zosavuta - masikono, mkate, chokoleti, zakumwa zozunguliridwa ndi mpweya, pasitala. M'malo mwake, muyenera kuphatikiza masamba, zipatso (kupatula zabwino kwambiri - nthochi, mapeyala, zipatso zouma), chimanga, nyemba. Muli michere yambiri yovuta yopangitsa kukwera kwamphamvu m'magazi a magazi.
Sinthani momwe mumaphikira. Amayi oyembekezera omwe ali ndi GDM ayeneranso kutsatira zakudya zopatsa thanzi ndikusankha maphikidwe okazinga, grill, kusuta fodya, ndi mchere. Ndizothandiza kwa mphodza, nthunzi, kuphika.
Zakudya zakumwa. Masana, muyenera kudya pang'ono kapena zisanu. Mwa izi, ziwiri kapena zitatu ndizofunikira kwambiri, ndipo zina zonse ndi zokhwasula-khwasula. Ngati simukulola kumva kuti muli ndi njala, ndizosavuta kuyendetsa shuga. Kuchuluka kwa mapuloteni, mafuta ndi chakudya chamagulu ambiri zimayenera kugawidwa tsiku lonse. Mwachitsanzo, chiwembu choterechi chikulimbikitsidwa: 30% pa chakudya cham'mawa, 40% pa nkhomaliro, 20% pa chakudya chamadzulo, ndi 5% pamakudya awiri.

Ndikofunika kuyang'anira zochitika zolimbitsa thupi - kukwera maulendo, kusambira, masewera a yoga, masewera olimbitsa thupi. Kugwiritsidwa ntchito kwa minofu kumathandizira kugwiritsa ntchito glucose owonjezera. Kuti muwone bwino kuchuluka kwa shuga m'magazi kunyumba, ndikofunikira kuti mugule glucometer yonyamula. Mutha kuyang'ana pazomwe zikuwonetsedwa ndi chipangizochi pogwiritsa ntchito tebulo lotsatirali.

Gome - Cholinga cha glucose m'magazi a GDM

Russell, Mavitamini a Jesse a shuga / Jesse Russell. - M: VSD, 2013 .-- 549 p.
Chithandizo cha matenda a endocrine mwa ana, Perm Book Publishing House - M., 2013. - 276 p.
Sukochev Goa syndrome / Sukochev, Alexander. - M: Ad Marginem, 2018 .-- 304 c.

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