Zizindikiro za matenda a shuga a Lada, chithandizo, kuzindikira

Matenda a shuga a autoimmune akuluakulu (English latent autoimmuneabetes akuluakulu, LADA, "Type 1.5 kishuga") - matenda a shuga, Zizindikiro ndi koyambirira komwe kumafanana ndi chithunzi cha matenda ashuga a 2, koma etiology ili pafupi ndi mtundu 1 wa shuga: ma antibodies a cell pancreatic beta apezeka zotupa ndi glutamate decarboxylase enzyme. Malinga ndi kuyerekezera kosiyanasiyana, m'magulu osiyanasiyana, kuchokera 6% mpaka 50% ya odwala omwe amapezeka ndi matenda amtundu wa II amakhudzidwa ndimatenda a autoimmune asipent akuluakulu. Mwina LADA ndi "yofewa" m'mphepete mwa mawonetseredwe a shuga 1.

Kodi chiwopsezo cha matenda a shuga a Lada ndi chiyani - Zizindikiro zakuwoneka kwakanthawi

Matenda a latent kapena a latent - Matenda okhudza akuluakulu omwe wafika zaka 35. Kuopsa kwa matenda obwera chifukwa cha matenda obwera chifukwa cha matenda obwera chifukwa cha matenda obwera chifukwa cha matendawa kuli pangozi yovuta yozindikira matenda ndi njira zosayenera zochizira.

Dzina lasayansi la matendawa ndi LADA (LADA kapena LADO), lomwe limayimira Matenda a shuga a Acent Autoimmune mu Adult (shuga ya autoimmune mu akulu - Chingerezi).

Zizindikiro za LADA ndizosocheretsa, matendawa nthawi zambiri amasokonezedwa ndi matenda mtundu 2 shuga, zomwe zimabweretsa kuwonongeka mumkhalidwe wa odwala, nthawi zina, akumwalira.

Munkhaniyi tiyesera kukambirana za mtundu wa matenda omwe angawone ngati ali ndi mtundu wina wa matenda ashuga.

Ndi mtundu wachiwiri wa matenda ashuga, ziphuphu za wodwalayo zimatulutsa insulin yolakwika, zomwe zimapangitsa kuti magazi azikhala ndi shuga komanso mkodzo wambiri.

Njira ina ndikuti zotumphukira sizikhudzidwa ndi insulini yachilengedwe, ngakhale kupanga kwake kuli mwa malire. Ndi LADA, zinthu zimakhala zovuta kwambiri.

Ziwalo sizitulutsa insulin yolakwika, komanso sizitulutsa zomwezo, kapena kupangidwako kumatsitsidwa kuzisonyezo zosafunikira kwenikweni. Zotulutsa zotumphukira sizitha kutaya mtima, zomwe zimapangitsa kutsika kwa maselo a beta.

Munthu yemwe ali ndi matenda ashuga osafunikira amafunika jakisoni wa insulin limodzi ndi odwala matenda ashuga mawonekedwe apamwamba a matendawa.

Pokhudzana ndi njira zomwe zikuchitika mthupi la wodwalayo, zizindikiro zotsatirazi zimachitika:

• Kufooka ndi kutopa,
• Thupi, chizungulire, mwina kuwonjezera kutentha kwa thupi,
• Mwazi wamagazi ambiri
• Kuchepetsa thupi popanda chifukwa
• Ludzu lalikulu ndi diuresis,
• Maonekedwe achilala, lilime kuchokera pakamwa,

LADA nthawi zambiri imakhala yopanda chizindikiro chilichonse. Palibe kusiyana pakati pa zizindikiro zachimuna ndi zachikazi. Komabe, kuyambika kwa matenda a shuga a LADA nthawi zambiri kumachitika mwa amayi panthawi yomwe ali ndi pakati kapena kanthawi atabadwa. Amayi amadwala matenda a shuga a autoimmune ali ndi zaka 25, kale kwambiri kuposa amuna.

Kusintha kwa kapamba panthawi ya insulin katulutsidwe kumalumikizidwa makamaka ndi kubereka ana.

Matenda a shuga a Lada ali ndi chiyambi cha autoimmune, kukula kwake kumalumikizidwa ndi kuwonongeka kwa kapamba, koma njira za matendawa ndizofanana ndi mitundu ina ya matenda ashuga. Zaka zingapo zapitazo, asayansi sankaganiza kuti kuli LADA (mtundu 1.5), mtundu 1 wokha ndi mtundu wa 2 wodwala womwe udawonekera.

Kusiyana pakati pa matenda a autoimmune ndi mtundu 1

• Kufunika kwa insulini kumakhala kotsika, ndipo matendawa ndi otupa, ndipo amatha kutalika nthawi yambiri. Ngakhale popanda chithandizo chamanthawi zonse, zizindikiro za matenda ashuga 1.5 nthawi zambiri sizothandiza kwa anthu,
• Gulu la anthu omwe ali pachiwopsezo limaphatikizapo anthu azaka zopitilira 35, anthu azaka zilizonse amadwala ndi matenda amtundu 1,
• Zizindikiro za LADA nthawi zambiri zimasokonekera ndi zizindikiro za matenda ena, zimapangitsa kuti adziwe matenda olakwika.

Chikhalidwe komanso mawonekedwe a matenda a shuga amtundu woyamba amamveka bwino.

Kusiyana pakati pa matenda a shuga a autoimmune ndi mtundu 2:

• Odwala atha kunenepa kwambiri.
• Kufunika kwa mankhwala a insulini kumatha kupezeka kale miyezi isanu ndi umodzi kuchokera nthawi yomwe chitukuko chikuchitika,
• Magazi a wodwala amakhala ndi ma antibodies omwe amawonetsa matenda a autoimmune,
• Ndi zida zamakono, zodziwika za matenda amtundu 1 zitha kupezeka,
• Kuchepetsa hyperglycemia ndi mankhwala kulibe kanthu.

Tsoka ilo, ambiri a endocrinologists samasanthula mwakuya akazindikira mtundu wa matenda ashuga. Pambuyo popezeka molakwika, mankhwala amachepetsa magazi a shuga. Kwa anthu omwe ali ndi LADA, mankhwalawa ndi owopsa.

Pozindikira matenda a autoimmune shuga, njira zingapo zimawerengedwa kuti ndizothandiza kwambiri.

Pa nthawi yoyamba, wodwalayo amatsatira njira zina:

• Kuyeserera kwathunthu kwa magazi
• Urinalysis

Pankhani yokayikira ya matenda obwera chifukwa cha matenda ashuga, endocrinologist amatumiza maphunziro kuti asangidwe. Mitundu yomaliza ya shuga imapezeka ndi:

• Glycated hemoglobin,
• Kuyankha kwa gluu
• Fructosamine
• Ma antibodies a IAA, IA-2A, ICA,
• Microalbumin,
• Kufotokozera.

Kuphatikiza pa mayeso a labotale, awa akufufuzidwa:

• Wodwala ndi wamkulu kuposa 35,
• Kodi insulin imapangidwa bwanji (kafukufukuyu amatenga zaka zingapo),
• Kulemera kwa wodwala ndikubwinobwino kapena kosavuta
• Kodi ndizotheka kulipira insulin ndi mankhwala ndikusintha kwa zakudya.

Pokhapokha atazindikira mozama momwemo ndi kuphunzira kwakutali m'ma labotale, kuyang'anira wodwalayo ndi momwe mthupi lake lilili, ndizotheka kuzindikira matenda a autoimmune.

Ma sampu omwe atha kugwiritsidwa ntchito ku Russia

• Kuyeserera kwa glucose pogwiritsa ntchito prednisone. Kwa maola angapo, wodwalayo amadya prednisone ndi glucose. Cholinga cha phunziroli ndikuwunika glycemia potengera momwe ndalama zimagwiritsidwira ntchito.
• Likulu la Traugott mayesero. Pamimba yopanda kanthu m'mawa mutatha kuyeza kuchuluka kwa shuga, wodwalayo amamwa tiyi wotentha wokhala ndi dextropur. Pakatha ola limodzi ndi theka, wodwala matenda a shuga amakhala ndi glycemia, mwa anthu athanzi palibe chotere.

Njira zodziwikirazi zimawerengedwa kuti sizothandiza ndipo sizigwiritsidwa ntchito kwenikweni.

Kudziwitsa zolondola za mtundu wa matenda ashuga komanso chithandizo chotsatira chomwe sichili ndi zotsatira zoyenera zaumoyo wa wodwalayo:

• Kuwonongeka kwa autoimmune kwa maselo a beta,
• Kutsika kwamankhwala a insulin ndi kupangidwa kwake,
• Kukula kwamavuto komanso kuwonongeka kwakatundu kwa wodwalayo,
• Kugwiritsa ntchito mankhwala kwa nthawi yayitali - kufa kwa maselo a beta.

Mosiyana ndi anthu omwe ali ndi matenda a shuga a mtundu woyamba 1 kapena 2, odwala LADA muyenera kugwiritsa ntchito insulin mwachangu muyezo waung'ono popanda kugwiritsa ntchito mankhwala.

Kulemba mankhwala omwe sanayenere matenda a autoimmune kumachepetsa mwayi wowachiritsa ndi kubwezeretsa kapamba.

Odwala omwe ali ndi LADA amafunika kuwazindikira matendawa ndikugwiritsa ntchito jakisoni wa insulin.

Ndi pa kumwa kwa insulin m'malo waukulu womwe chithandizo chothandiza kwambiri chimapangidwa.

Odwala omwe adayamba mankhwala a insulin koyambirira kwa matendawa, kukhala ndi mwayi uliwonse wobwezeretsa kupanga insulin yachilengedwe pakapita nthawi.

Pamodzi ndi insulin mankhwala zotchulidwa:

• Zakudya zochepa za kaboni
• Masewera
• Kupitiliza kosamala kwa shuga wamagazi, kuphatikiza nthawi yausiku,
• Kuchotsedwa kwa mankhwalawa kwawonetsedwa kwa anthu onenepa kwambiri komanso mitundu ina ya matenda ashuga.

Ndikofunika kuchepetsa katundu pa kapamba kuti uthandizire kupanga insulin mtsogolo. Cholinga cha mankhwalawa ndikuletsa kufa kwa maselo a beta motsogozedwa ndi kusintha kwa chitetezo chathupi.

Kukonzekera kochokera ku sulfaurea kumakhudzana ndi anthu omwe ali ndi matenda osokoneza bongo a latent. Mankhwalawa amalimbitsa katemera wa pancreatic ndipo amangokulitsa kufa kwa cell ya beta.

Ndemanga za katswiri pankhani iyi:

Ku Russia, makamaka kumadera akutali, kupezeka ndi kuchiritsidwa kwa matenda a shuga LADA ali mwana. Vuto lalikulu lazidziwitso zolakwika lili pakuwonjezeka kwa autoimmune komanso kulandira chithandizo mosayenera.

M'mayiko otukuka, matenda ashuga am'mbuyomu amadziwika ndi kuthandizidwa bwino, njira zatsopano zamankhwala zikupangidwe zomwe posachedwapa zifika ku Russia.

Zizindikiro zazikulu, njira zodziwitsira matenda ndi matenda a matenda a shuga a LADA

Munkhaniyi muphunzira:

Matenda a shuga a LADA ndi matenda omwe ali ndi mbali yake yazodziwitsa ndi kulandira chithandizo.

Kufunika kwa vutoli kukuchitika chifukwa chakuti matendawa amakhala mokhazikika pamatenda atatu ofala kwambiri (atcology ndi mtima matenda). Matenda a shuga a LADA - ndi mtundu wapakati wa matenda ashuga. Nthawi zambiri pamakhala zolakwika pakuzindikira, chifukwa chake mankhwalawo ndiwodziwikiratu.

Matendawa ndi matenda a shuga a latent (latent) a autoimmune mu akulu (latent autoimmune shuga mwa akulu). Amadziwikanso kuti "wapakatikati", "1.5 - imodzi ndi theka." Izi zikusonyeza kuti mtunduwu umakhala pakati, pakati pa 1 ndi mtundu 2 wa matenda ashuga. Ili ndi chiyambi chofanana ndi chiwonetsero cha matenda amtundu wa 2, koma pambuyo pake chimakhala chodalira insulin kwathunthu, monga mtundu woyamba. Kuchokera pamenepa, zimavuta kuzindikira.

Zomwe matenda amtunduwu samadziwika bwinobwino. Zadziwika kuti matenda ashuga ndi matenda obadwa nawo. Mosiyana ndi mitundu yakale, LADA ili ndi autoimmune chiyambi. Izi ndizomwe zimasiyanitsa ndi mtundu 1 komanso matenda ashuga 2.

Mtundu wa autoimmune wamtundu wa LADA umawonetsa kuti thupi laumunthu limapanga ma antibacteries omwenso amasokoneza maselo awo athanzi, pamenepa, ma cell a pancreatic beta. Ndi zifukwa ziti zomwe zingathandizire kupanga ma antibodies sizodziwika, koma amakhulupirira kuti pali matenda a mavairasi (chikuku, rubella, cytomegalovirus, mumps, matenda a meningococcal).

Njira yakukula kwa matendawa imatha kuyambira zaka 1-2, mpaka zaka makumi. Makina amomwe matenda amachokera matenda amafanana kwenikweni ndi mtundu wa matenda a shuga a mtundu wa mellitus (mtundu 1). Ma cell a Autoimmune omwe amapanga thupi la munthu amayamba kuwononga kapamba wawo. Poyamba, pamene gawo la maselo a beta akhudzidwa laling'ono, matenda a shuga amapezeka posachedwapa (obisika) ndipo sangadziwonekere.

Ndi chiwonongeko chowonjezereka cha kapamba, matendawa amadziwoneka wofanana ndi matenda a shuga a 2. Pakadali pano, nthawi zambiri odwala amafunsa adokotala ndipo amadzazindikira molakwika.

Ndipo kumapeto kokha, zikondamoyo zikatha, ndipo ntchito yake imachepetsedwa "0", sizitulutsa insulin. Kuperewera kwenikweni kwa insulin kumapangidwa, motero, kumadziwonetsera ngati mtundu 1 wa shuga. Chithunzithunzi cha matendawa chimadzayamba kufalikira.

Ndizosadabwitsa kuti mtundu uwu umatchedwa wapakatikati kapena umodzi ndi theka (1.5). Kumayambiriro kwa chiwonetsero chake cha LADA, matenda a shuga amakumbukira mtundu 2, kenako amadziwika ngati matenda amtundu wa 1:

• polyuria (kukodza pafupipafupi),
• polydipsia (ludzu losatha, munthu amatha kumwa madzi mpaka malita 5 patsiku),
• kuwonda (chizindikiro chokhacho chomwe sichili chofanana ndi matenda amtundu wa 2, zomwe zikutanthauza kuti kupezeka kwake kumapangitsa kuti odwala matenda a shuga a LADA),
• kufooka, kutopa kwambiri, kuchepa kwa ntchito,
• kusowa tulo
• khungu lowuma,
• Khungu
• kubwereza pafupipafupi kwa matenda oyamba ndi fungus ndi pustular (nthawi zambiri mwa akazi - candidiasis),
• yaitali osachiritsa bala.

Kukula kwa matenda amtunduwu kumakhala ndi zomwe zimasiyana ndi zomwe sizigwirizana ndi chithunzi cha mitundu ya matenda ashuga. Ndikofunika kulabadira izi pazotsatira zake

• Kukula kwakanthawi kwamatenda,
• nthawi yayitali ya asymptomatic,
• kuchepa thupi kwambiri,
• Zaka zodwala zimakhala kuyambira 20 mpaka 50,
• mbiri yamatenda opatsirana.

Ndikofunikira kumvetsetsa kuti zotsatira za kuzindikiridwa kwa matendawa ziyenera kukhala zolondola momwe zingathekere, chithandizo chimatengera izi.Kuzindikira koyipa, zomwe zikutanthauza kuti kuchiritsa mosasamala kumathandizira kuti matendawo apitirire.

Kuti muzindikire matendawa, muyenera kudutsa mayeso otsatirawa:

• Kuyesedwa kwa magazi konse.
• Kuyesa kwamwazi wamagazi.
• Mayeso a kulolerana ndi shuga m'magazi (yesani ndi 75 g ya shuga wosungunuka mu 250 ml ya madzi).
• Urinalysis
• Kuyesedwa kwa magazi kwa glycated hemoglobin (HbA1C).
• Kuyesedwa kwa magazi kwa C-peptide (kumawonetsa kuchuluka kwa insulini yomwe amadziwika ndi kapamba. Chizindikiro chachikulu pakupezeka kwa matenda amtunduwu).
• Kusanthula kwa ma antibodies kuma cell a pancreatic beta (ICA, GAD). Kukhalapo kwawo m'mwazi kumawonetsa kuti akuwongolera kuti aukire ziphuphu.

Izi zikusonyeza kuti kapamba amabisa insulin yaying'ono, mosiyana ndi mtundu wachiwiri wa matenda ashuga, pomwe C-peptide ikhoza kukhala yabwinobwino komanso ngakhale ikukulira pang'ono, ndipo kutsutsana kwa insulin kumatha kuchitika.

Nthawi zambiri, matendawa samadziwika, koma amatengedwa ngati mtundu wachiwiri wa shuga ndi chinsinsi cha mankhwala osokoneza bongo - mankhwala omwe amalimbikitsa katulutsidwe ka insulin ndi kapamba. Ndi mankhwalawa, matendawa adzakula msanga. Popeza kuchulukana kwamatenda a insulin kudzathetsa msanga zosungirako kapamba ndipo mofulumira boma lidzakhala ndi insulin yokwanira. Kuzindikira koyenera ndiko chinsinsi chakuwongolera kopambana matenda.

Malangizo a algorithm a matenda a shuga a LADA amatanthauza izi:

• Zakudya zochepa za carb Izi ndizofunikira kwambiri pochiza matenda amtundu uliwonse wa shuga, kuphatikiza mtundu wa LADA. Popanda kudya zakudya, gawo la zochitika zina ndilachabe.
• Zolimbitsa thupi zolimbitsa thupi. Ngakhale palibe kunenepa kwambiri, zolimbitsa thupi zimathandizira kugwiritsa ntchito shuga ochulukirapo m'thupi, chifukwa chake, ndikofunikira kupereka katundu ku thupi lanu.
• Mankhwala a insulin. Ndiye chithandizo chachikulu cha matenda a shuga a LADA. Njira yoyamba ya bolus imagwiritsidwa ntchito. Zikutanthauza kuti muyenera kubaya insulin "yayitali" (1 kapena 2 kawiri patsiku, kutengera mankhwala), yomwe imapereka insulin. Komanso musanadye chakudya chilichonse, jekeseni insulin "yayifupi", yomwe imakhala ndi shuga m'magazi mutatha kudya.

Tsoka ilo, ndizosatheka kupewa insulin chithandizo ndi matenda a shuga a LADA. Kukonzekera kwa mapiritsi sikothandiza pano, monga matenda a shuga a 2.

Kodi ndi insulini iti yomwe musankhe komanso muyezo womwe dokotala adzakulemberani. Otsatirawa ndi ma insulin amakono omwe amagwiritsidwa ntchito pochiza matenda a shuga a LADA.

Mawuwa amagwira ntchito kokha ku matenda a shuga a LADA. Kukondwererana kwa matendawa ndi kanthawi kochepa (mwezi umodzi kapena iwiri) atazindikira, wodwala akapatsidwa insulin.

Thupi limayankha bwino mahomoni omwe amapangidwa kuchokera kunja ndipo mkhalidwe wa kuyerekezera kumachitika. Magazi a shuga m'magazi abwerera mwachangu. Palibe paliponse palokha malire a shuga. Palibe chosowa chachikulu pakuwongolera insulin ndipo zimawoneka kwa munthu kuti kuchira kwabwera ndipo nthawi zambiri insulin imathetsedwa palokha.

Chikhululukiro choterechi sichimatenga nthawi yayitali. Ndipo kwenikweni mwezi umodzi kapena iwiri, kuchuluka kwamphamvu kwa glucose kumachitika, zomwe zimakhala zovuta kudziwa.

Kutalika kwa kuchotsedwa kumeneku kumatengera zinthu izi:

• zaka odwala (okalamba wodwalayo, pomwepo kuchotsedwa kwake)
• jenda la wodwala (mwa amuna ndiwotalikirapo kuposa azimayi),
• kuopsa kwa nthendayo (pang'ono ndi pang'ono, kuchotsedwa kwa nthawi yayitali),
• mulingo wa C-peptide (pamlingo wake wokwera, kuchotsera kumatenga nthawi yayitali kuposa momwe kumatsalira zotsalira),
• mankhwala a insulini adayamba pa nthawi yake
• kuchuluka kwa ma antibodies (akapanda kuchepa, kuchotsedwa kwawo kwanthawi yayitali).

Kupezeka kwa vutoli kumachitika chifukwa chakuti pa nthawi yomwe akukonza insulin kukonzekera, pali magwiridwe antchito a pancreatic. Pa chithandizo cha insulin, maselo a beta amachira, amakhala ndi nthawi "yopuma" kenako, atatha insulin, kwakanthawi amatha kugwirabe ntchito mwaokha, kupanga mahomoni awoawo.Nthawiyi ndi "chithandiziro" cha odwala matenda ashuga.

Komabe, odwala sayenera kuyiwala kuti kupezeka kwa mawonekedwe abwino awa sikumapatula njira ina yopangira autoimmune. Ma antibodies, m'mene adapitilirabe kuwononga kanyumba, pitilizani. Ndipo patapita kanthawi, maselo amenewa, omwe tsopano amapereka moyo wopanda insulini, adzawonongedwa. Zotsatira zake, gawo la insulin Therapy ndilofunikira.

Zotsatira zake komanso kutha kwa mawonekedwe awo zimatengera kutalika kwa matenda ashuga. Mavuto akulu amtundu wa LADA, monga ena, akuphatikizapo:

• matenda a mtima dongosolo (matenda a mtima, matenda a mtima, sitiroko, mtima wamatenda a mtima),
• matenda amanjenje (polyneuropathy, dzanzi, paresis, kuwuma pamayendedwe, kulephera kuyendetsa kayendedwe ka miyendo),
• matenda amaso (kusintha kwamatumbo a fundus, retinopathy, kuwonongeka kwa khungu, khungu),
• matenda a impso (diabetesic nephropathy, kuchuluka kwa mapuloteni mu mkodzo),
• diabetesic phazi (zolakwika zamatenda am'munsi, gangrene),
• zotupa zapakhungu komanso zotupa za pustular.

Mtundu wa LADA siwofala monga momwe amawerengera, koma kuwunika koyambirira komanso kolondola kumachotsa chithandizo chosayenera ndi zotsatirapo zoyipa za matendawa. Chifukwa chake, ngati pali zizindikiro zilizonse zomwe zikuwonetsa kuti mukudwala matenda ashuga, muyenera kupita ku endocrinologist kapena dokotala wamkulu kuti muwone zifukwa zomverera.

Gawo loyambalo la shuga ndilovuta kuzindikira, chifukwa sizimadziwonetsa lokha. Wodwala samamva kusintha kulikonse m'thupi ndipo, ngakhale atatenga mayeso a shuga, amalandira zofunikira. Ndi chifukwa ichi pomwe tikulankhula za matenda a shuga omwe amatchedwa "Lada". Tikulankhula za iye mopitilira.

Matenda amtunduwu amasowa ngati latent kapena latent. Dzinalo lina ndi "Matenda a shuga [1.5]. Ino si nthawi yovomerezeka, koma zikuwonetsa kuti fret ndi mtundu wa matenda amtundu wa 1 omwe ali ndi mawonekedwe a matenda a shuga a mtundu wa 2. Monga mtundu wa matenda amtundu 1 shuga, fret imafotokozedwa ngati matenda a autoimmune pomwe chitetezo cha mthupi chimagunda ndikupha. maselo opanga insulin. Ndipo mtundu 2 umasokonezeka chifukwa fret imayamba kwakanthawi kotalikirapo kuposa mtundu woyamba wa shuga.

Zinayamba kusiyanitsidwa kuchokera ku mtundu wachiwiri waposachedwa, asayansi adazindikira kuti shuga iyi imasiyana kwambiri ndipo iyenera kuthandizidwa mosiyanasiyana. Mpaka mtunduwu utadziwika, chithandizo chinkachitika ngati matenda amtundu wa 2, koma insulin sikuyenera kuperekedwa pano, ngakhale izi ndizofunikira kwambiri ku matenda a shuga a LADA. Mankhwalawa anaphatikizaponso mankhwala omwe ankalimbikitsa maselo a beta kuti apange insulin. Koma nthawi yamatendawa, amakhala okhumudwa kale, ndipo adakakamizidwa kugwira ntchito mpaka pamapeto. Izi zidabweretsa zotsatira zoyipa:

• maselo a beta adayamba kugwa
• kupanga kwa insulin kwachepa
• nthenda ya autoimmune yayamba
• ma cell anafa.

Kukula kwa matendawa kunatha zaka zingapo - kapamba anali atatsirizika, kunali kofunikira kuperekera insulini yayikulu muyezo ndikuyang'anira kudya mosamalitsa. Apa ndipomwe asayansi akuganiza kuti akuchiritsa matenda osokoneza bongo.

Matenda a shuga a Lada amafunika insulin yowonjezera. Ndi njira yake yaulesi, maselo a kapamba amasokonezeka, kenako nkufa.

Pali zinthu zina zomwe ziyenera kupangitsa madotolo kuganiza kuti akukumana ndi wodwala yemwe ali ndi matenda ashuga, osati ndi matenda a shuga a mtundu wa 2. Izi ndi monga:

• kusowa kwa metabolic syndrome (kunenepa kwambiri, kuthamanga kwa magazi komanso kuthamanga kwa cholesterol),
• hyperglycemia yosalamulira, ngakhale akugwiritsa ntchito pakamwa.
• kukhalapo kwa matenda ena a autoimmune (kuphatikizapo matenda a Graves 'and anemia).

Odwala ena omwe ali ndi matenda osokoneza bongo amatha kudwala matenda a metabolic, omwe angapangitse kwambiri kapena kuchedwetsa kupezeka kwa matenda amtunduwu.

Pali zifukwa zingapo zomwe zimapangitsa kuti munthu akhale ndi matenda ashuga:

• M'badwo. Anthu ambiri (75%) okalamba ali ndi matenda ashuga, omwe amakhudza dongosolo lofooka la endocrine.
• Kukhalapo kwa kunenepa kwambiri. Matenda a shuga amawoneka ndi zakudya zosayenera, chifukwa chomwe njira za metabolic m'thupi zimasokonekera.
• Zowonongeka kwa kapamba. Ngati panali matenda oyambitsidwa ndi omwe kuphulika kwakukulu kunayikidwa pa kapamba.
• Kutengera kwa chibadwa cha matenda ashuga. Banja lili ndi abale amwazi omwe ali ndi matenda ashuga.
• Mimba Zitha kupangitsa kuti matenda ashuga apitilize, makamaka chifukwa cha chibadwa cham'mimba, choncho mayi woyembekezera ayenera kulembetsa nthawi yomweyo ndikuyang'aniridwa ndi madokotala.

Popeza matenda ashuga ndiwosasintha, ndizobisalira, nkovuta kudziwa. Komabe pali zizindikiro zina. Izi zikuphatikiza:

• kuwonda mosayembekezereka kapena kuwonda,
• Kuuma ndi kuyabwa kwa pakhungu,
• kufooka ndi malaise
• kufuna kumwa nthawi zonse,
• pali chikhumbo chosalekeza
• nebula wa chikumbumtima
• kukodza pafupipafupi
• womvera
• chizungulire
• shuga wamagazi ambiri
• kuzizira komanso kunjenjemera.

Matenda a shuga awa ali ndi zizindikiro zofanana ndi matenda amtundu wa 2, maonekedwe awo okha sadziwika.

Njira zotsatirazi zoyenera kutsata ziyenera kuchitidwa kuti mupeze matenda a shuga a LADA:

1. Pimani magazi. Wodwala sayenera kudya osachepera maola 8 asanakudziwe. Kuchuluka kwa mitengo kumaonetsa matenda.
2. Chitani kafukufuku wa glycemic. Phunziro lisanachitike, tikulimbikitsidwa kumwa kapu yamadzi okoma. Kenako kuyezetsa magazi kumatengedwa. Chizindikiro sichikuyenera kupitilira 140 mg pa desilita iliyonse. Ngati chiwerengerochi ndi chachikulu, ndiye kuti matenda am'mbuyomu amadziwika.
3. Chitani kafukufuku wa hemoglobin wa glycated. Ngati Zizindikiro zoyambirira zikuwonetsa shuga m'magazi pakadali pano, ndiye kuti amayesedwa kwa nthawi yayitali, ndiye kuti kwa miyezi ingapo.
4. Kuyesa kwa ma antibodies. Ngati zizindikirazo zikupitilira muyeso, izi zikuwonetsanso matendawa, chifukwa zimatsimikizira kuphwanya kuchuluka kwa maselo a beta mu kapamba.

Ndi chizindikiritso cha mtunduwu cha matenda ashuga chomwe chikukula, chitukuko chake chitha kuwongoleredwa. Werengani zambiri za kuzindikira matenda ashuga osatengera mtundu wake pano.

Cholinga cha mankhwalawa ndikuchedwa kuchedwetsa mavuto omwe amabwera chifukwa cha chitetezo cha mthupi pama cell a pancreatic omwe amapanga insulin. Chachikulu ndikuwonetsetsa kuti wodwalayo ayambe kupanga insulin yake. Kenako wodwalayo amatha kukhala ndi moyo wautali wopanda mavuto.

Nthawi zambiri, chithandizo cha matenda a shuga a fret chimagwirizana ndi chithandizo cha matenda amtunduwu 2, motero wodwala ayenera kutsatira zakudya zoyenera komanso kuchita masewera olimbitsa thupi. Kuphatikiza apo, insulin imayikidwa muyezo waukulu.

Udindo wawukulu wa mahandawo ndikuthandizira maselo a beta kuti asawonongedwe ndi kusatetezeka kwawo, ndipo gawo lachiwiri ndikuwonetsetsa kuti shuga ali ndi vuto lililonse.

Chithandizo chagona pamalamulo otsatirawa:

1. Zakudya. Choyamba, ndikofunikira kutsatira zakudya zopanda chakudya chambiri (kupatula zoyera, zophika ndi pasitala, maswiti, chakudya chofulumira, zakumwa za kaboni, mtundu uliwonse wa mbatata kuchokera pachakudya). Werengani zambiri za zakudya zamafuta ochepa pano.
2. Insulin. Gwiritsani ntchito insulin yocheperako, ngakhale shuga atakhala yachilendo. Wodwalayo ayenera kuwunika shuga. Kuti achite izi, ayenera kukhala ndi mita yake kuyeza shuga kangapo patsiku - asanadye, pambuyo pake, ngakhale usiku.
3. Mapiritsi. Mapiritsi a Sulfonylurea-zotumphukira ndi zinthu zina zadongo sizigwiritsidwa ntchito, ndipo Siofor ndi Glucofage savomerezeka kulemera koyenera.
4. Maphunziro akuthupi. Odwala omwe ali ndi thupi labwinobwino amalimbikitsidwa kuchita masewera olimbitsa thupi pakulimbikitsa kwathunthu thanzi. Ndi kunenepa kwambiri kwa thupi, muyenera kuzolowera zovuta zomwe mungachite kuti muchepetse kunenepa.

Chithandizo choyambitsidwa moyenera chithandiza kuchepetsa katundu pa kapamba, kuchepetsa ntchito za autoantigenic kuti muchepetse kutupa kwa autoimmune ndikusunga kuchuluka kwa shuga.

Mu kanema wotsatira, katswiriyu adzalankhula za matenda a shuga a LADA - matenda a autoimmune mu akulu:

Chifukwa chake, matenda a shuga a LADA ndi mtundu wobiriwira wa shuga womwe umavuta kuzindikira. Ndikofunikira kwambiri kuzindikira mtundu wa shuga wa fret munthawi yake, kenako ndikamayambitsa ngakhale mlingo wochepa wa insulin, mkhalidwe wa wodwalayo ungasinthidwe. Mwazi wamagazi uzikhala wabwinobwino, zovuta zapadera za matenda ashuga zitha kupewedwa.

Losent Autoimmune Diabetes of Adult, ku Russia - matenda ashuga a autoimmune mu akulu, amapezeka mwa anthu azaka 25+. Chifukwa chachikulu chomwe chikulembedwera matendawa ndi kusagwira bwino ntchito m'thupi, komwe, m'malo mochita ntchito yoteteza, amayamba kuwononga maselo ndi minyewa yake. Njira ya autoimmune yomwe imadziwika ndi matenda a shuga a Lada cholinga chake ndikuwonongeka kwa maselo a pancreatic ndikusiya kaphatikizidwe ka insulin.

Insulin ndi ma endo native mahoni (endo native), cholinga chake chachikulu ndicho kunyamula glucose ku minofu ndi maselo a thupi, monga gwero lamphamvu. Kuperewera kwa kupanga kwa mahomoni kumabweretsa kudzikundikira mu magazi a shuga kuchokera ku chakudya. Mu mtundu wachinyamata 1 shuga, insulin kaphatikizidwe imalephera kapena kuletseka muubwana ndi unyamata, chifukwa cha chibadwa cha matendawa. Kwenikweni matenda a shuga ndi mtundu wa matenda omwe amadalira insulin monga woyamba, amadzidziwitsa yekha pambuyo pake.

Chimodzi mwa matendawa ndikuti zizindikiro zake ndi zofanana ndi matenda amtundu wa 2, ndipo kachitidwe kakulidwe kamafanana ndi koyamba, koma mochedwa. Mtundu wachiwiri wa matenda amodzi umadziwika ndi kukana insulini - kulephera kwa maselo kuzindikira ndikugwiritsa ntchito insulin yomwe kapamba amatulutsa. Popeza Lada-matenda a shuga amakula mwa akulu, matendawa nthawi zambiri amapezeka molakwika.

Wodwalayo amapatsidwa udindo wokhala ndi matenda ashuga omwe ali ndi matenda a 2 a insulin. Izi zimabweretsa kusankha kolakwika kwa njira zamankhwala, chifukwa, kufoka kwake.

Popereka mankhwala ochepetsa shuga omwe amathandizira mtundu wa 2, kapamba amayamba kupanga insulini mwachangu. Kuchulukitsa kwa maselo motsutsana ndi njira ya autoimmune kumabweretsa kufa kwawo. Pali njira ina yoyendera.

Chifukwa cha zotsatira za autoimmune, maselo a gland akuvutika - kupanga kwa insulini kumachepa - mankhwala amalembedwa kuti achepetse shuga - maselo amapanga mahomoni mumachitidwe omwe amagwira - zochita za autoimmune zimawonjezeka. Pomaliza, chithandizo chosayenera chimabweretsa kutopa (cachexia) ya kapamba ndi kufunika kwa milingo yayikulu ya insulin. Kuphatikiza apo, ngati makina a autoimmune akhazikitsidwa m'thupi, mphamvu zake sizingokhala gawo limodzi lokha. Mkhalidwe wamkati umasokonezeka, zomwe zimatsogolera pakupanga matenda ena a autoimmune.

Mankhwala, matenda a shuga a Lada amatenga pakati pakati pa matenda oyamba ndi achiwiri, motero mutha kupeza dzina la "shuga 1.5". Kudalira kwa wodwalayo jakisoni wokhazikika wa insulin kumapangidwa pafupifupi pakapita zaka ziwiri.

Kusiyana kwa autoimmune pathology

Kukhazikika kwa matenda a shuga a Lada amawonekera pamaso pa mbiri yamatenda a autoimmune:

• kuwonongeka kwa malo olumikizirana mafupa (ankylosing spondylitis),
• matenda a chapakati mantha dongosolo (chapakati mantha dongosolo) - angapo sclerosis,
• granulomatous kutupa kwam'mimba chakudya (matenda a Crohn),
• Matenda a chithokomiro (Hashimoto's chithokomiro),
• zowonongeka zowononga zowonjezera (nyamakazi: mwana, rheumatoid),
• kuphwanya kwamtundu wa khungu (vitiligo),
• aakulu kutupa kwa mucous nembanemba wa colon (ulcerative colitis)
• systemic cholumikizira minofu matenda (Sjogren's syndrome).

Kuopsa kwa majini sikuyenera kuchepetsedwa.Pamaso pa autoimmune pathologies mwa abale apamtima, mwayi wopanga mtundu wa Lada. Amayi omwe ali ndi mbiri yodwala matenda ashuga amayenera kutsata shuga mopatsa chidwi. Amavomerezedwa kuti matendawa ndi osakhalitsa, koma ndi chitetezo chochepa, motsutsana ndi zomwe zachitika pakubadwa kwazomwe zimachitika, mtundu wamakono wa matenda a autoimmune ungayambike. Chiwopsezo chothekera ndi 1: 4.

Zoyambitsa (zoyambitsa) zoyambitsa zochitika za autoimmune m'thupi zitha kukhala:

• Matenda opatsirana. Chithandizo chochepa cha mabakiteriya ndi matenda amtunduwu chimapangitsa kuchepa kwa chitetezo chokwanira.
• HIV ndi Edzi. Kachilombo komwe kumayambitsa chitetezo cha mthupi komanso matenda oyambitsidwa ndi kachilomboka amachititsa kuti chitetezo cha mthupi chizitayika.
• Mowa. Mowa umawononga kapamba.
• Matenda owopsa
• Psychopathology ndi kupsinjika kwamanjenje kwamanjenje.
• Mankhwala ochepa a hemoglobin akucheperachepera chifukwa cha kusadya bwino. Kuperewera kwa mavitamini ndi mchere kumachepetsa chitetezo cha mthupi.
• Matenda a Hormonal ndi endocrine. Kuphatikizika kwa machitidwe awiriwa ndikuti timadzi tambiri ta endocrine timatulutsa timadzi timene timayendetsa zochitika za chitetezo cha mthupi, ndipo ma cell ena a chitetezo cha mthupi amakhala ndi mphamvu ya mahomoni. Kuwonongeka kwa amodzi mwa machitidwe awa kumangobweretsa kusoweka kwina.

Kuphatikizika kwa zinthu izi kumakhala chifukwa cha matenda ambiri a autoimmune, kuphatikizapo Lada-shuga.

Matenda a shuga a mtundu wa Lada amatha kuonetsa zizindikiro kuyambira miyezi ingapo mpaka zaka zingapo. Zizindikiro zamatenda zimawonekera pang'onopang'ono. Zosintha mthupi zomwe zimayenera kuzindikira;

• polydipsia (ludzu losatha),
• polakiuria (pafupipafupi kufuna kutulutsa chikhodzodzo),
• kusokonezeka (vuto la kugona), kuchepa kwa magwiridwe antchito,
• Kuchepetsa thupi (popanda zakudya komanso katundu wochita masewera) kutengera zakumbuyo ya polyphagy (kuchuluka kwa chilakolako),
• kuchiritsidwa kwakanthawi kwa kuwonongeka kwamakina pakhungu,
• psycho-mtima kusakhazikika.

Zizindikiro zoterezi sizimapangitsa kuti odwala matenda ashuga afunefune chithandizo chamankhwala. Kupatuka kwa zisonyezo zam'magazi a plasma kumapezeka mwangozi mukamayesedwa kuchipatala kapena chifukwa cha matenda ena. Kudziwitsa mwatsatanetsatane sikumachitika, ndipo wodwalayo amapezeka molakwika ndi matenda osagwirizana ndi insulin, pomwe thupi lake limafunikira odwala a insulin.

Nthawi ya mawonetseredwe a matenda a shuga a Lada imayamba patatha zaka 25. Malinga ndi miyambo ya digito ya shuga m'magazi, gulu lazaka zapakati pa 14 mpaka 60 limafanana ndi zizindikiro kuchokera pa 4.1 mpaka 5.7 mmol / l (pamimba yopanda kanthu). Kuzindikira kwa matenda ashuga kumayesanso magazi ndi mkodzo mayeso:

• Mulingo wamagazi.
• Kuyeserera kwa glucose. Kuyeserera kwa glucose ndi njira imodzi yoperekera magazi kawiri: pamimba yopanda kanthu, ndi maola awiri mutatha "katundu" (madzi akumwa otsekemera). Kuwunika kwa zotsatira kumapangidwa malinga ndi tebulo la miyezo.
• Kuyesedwa kwa magazi kwa HbA1c ndi glycated hemoglobin. Kafukufukuyu amathandiza kutsata kusintha kwa kagayidwe kazakudya kwa nthawi yayikulu ya masiku 120 poyerekeza kuchuluka kwa glucose ndi protein (hemoglobin) m'magazi am'magazi. Chiwerengero cha hemoglobin wa glycated pazaka ndi: zaka mpaka zaka 30 - mpaka 5.5%, mpaka zaka 50 - mpaka 6.5%.
• Urinalysis Glycosuria (shuga mkodzo) wokhala ndi matenda ashuga amaloledwa pamitundu yambiri ya 0.06-0.083 mmol / L. Ngati ndi kotheka, kuyesedwa kwa Reberg kungawonjezeredwe kuti muwone kuchuluka kwa protein ya metabolinine (metabolic product) ndi proteinin ya albumin.
• Kuyesa kwamwazi wamagazi. Choyamba, hepatic enzymes AST (aspartate aminotransferase), ALT (alanine aminotransferase), Alpha-Amylase, ALP (alkaline phosphatase), bile pigment (bilirubin) ndi cholesterol imayesedwa.

Cholinga chachikulu chodziwitsira matenda ndikuw kusiyanitsa matenda a Lada-shuga kuchokera ku mtundu woyamba komanso wachiwiri wa matenda. Ngati matenda a shuga a Lada akuwakayikira, njira zowonjezera zowunikira zimavomerezedwa.Wodwalayo amayesedwa magazi kuti adziwe kuchuluka kwa ma immunoglobulins (Ig) kupita ku ma antigen - ma enzyme omwe amagwirizana ndi ma immunosorbent assay kapena ELISA. Kuzindikira kwa Laborator kumawunika mitundu itatu yayikulu ya ma antibodies (IgG class immunoglobulins).

ICA (ma antibodies kupita ku ma pancreatic islet cell). Zisumbuzo ndizopendekera mchira wa ndulu ya maselo a endocrine. Autoantibodies to islet cell antigen akatsimikiza pamaso pa shuga mu 90% ya milandu. Anti-IA-2 (kwa tyrosine phosphatase enzyme). Kupezeka kwawo kukuwonetsa kuwonongeka kwa maselo a pancreatic. Anti-GAD (kwa enzyme glutamate decarboxylase). Kukhalapo kwa ma antibodies (kusanthula kwabwino) kumatsimikizira kuwonongeka kwa autoimmune kwa kapamba. Zotsatira zoyipa siziphatikiza mtundu 1 wa shuga, ndi mtundu wa Lada.

Mlingo wa C-peptide umatsimikiziridwa payokha monga chizindikiro chokhazikika cha kupanga kwa insulin m'thupi. Kusanthula kumachitika m'magawo awiri, ofanana ndi kuyesa kwa glucose. C-peptide yochepetsedwa ikuwonetsa kupanga kwa insulin pang'ono, ndiko kuti, kukhalapo kwa matenda ashuga. Zotsatira zomwe zimapezeka panthawi yodziwikiratu zitha kukhala zotsatirazi: Anti-GAD yotsutsa - palibe matenda a Lada, Anti-GAD yotsutsana ndi zomwe zikuwonetsa zochepa za C-peptide - kukhalapo kwa matenda a shuga a Lada.

Muzochitika pamene ma antibodies kuti glutamate decarboxylase apezekepo, koma C-peptide sapitilira dongosolo loyendetsera, wodwalayo amafunikira kuunikiridwa kowonjezereka mwa kudziwa zolembera. Popanga matenda, chidwi chimaperekedwa kwa gulu la odwala. Kuzindikiritsa kowonjezereka ndikofunikira kwa achinyamata achinyamata. Onetsetsani kuti mumayeza ma index am'mimba (BMI). Mu mtundu wosadalira insulini wodwala, chizindikiro chachikulu ndi cholemetsa, odwala matenda a Lada ali ndi BMI yachilendo (kuyambira 18.1 mpaka 24.0) kapena osakwanira (kuyambira 16.1 mpaka) 17.91.

Chithandizo cha matendawa chimatengera kugwiritsa ntchito mankhwala, kudya, kuchita zolimbitsa thupi.

Chithandizo chachikulu cha mankhwalawa ndikusankha Mlingo wa insulin wofanana ndi gawo la matendawa, kupezeka kwa matendawo, kulemera ndi msinkhu wa wodwalayo. Kugwiritsira ntchito koyamba kwa mankhwala a insulin kumathandizira kukhazikika kwa shuga, osadzaza ma cell a kapamba (ndi ntchito yayikulu, amawonongeka mwachangu), kusiya njira za autoimmune, ndikusunga magwiridwe antchito a insulin.

Minyewa yake ikasungidwa, zimakhala zosavuta kuti wodwalayo azikhala ndi shuga wamagulu ena ake. Kuphatikiza apo, "nkhokwe" iyi imakupatsani mwayi wochedwetsa zovuta za matenda ashuga, komanso kuchepetsa chiopsezo cha kutsika kwamphamvu kwa shuga (hypoglycemia). Kukhazikitsidwa kwa insulin koyambirira ndi njira yokhayo yolondola yothetsera matendawa.

Malinga ndi maphunziro azachipatala, chithandizo choyambirira cha insulin ndi matenda a shuga a Lada chimapatsa mpata kubwezeretsa kapamba kuti apange insulin yake, ngakhale yaying'ono. Njira zochizira, kusankha kwa mankhwala ndi kuchuluka kwake kumatsimikiziridwa ndi endocrinologist. Kudzichitira nokha mankhwala sikovomerezeka. Mlingo wa mahomoni koyambirira kwamankhwala amachepetsedwa. Kuphatikiza mankhwala omwe ali ndi insulin yochepa komanso yayitali.

Kuphatikiza pa mankhwala osokoneza bongo, wodwalayo ayenera kutsatira zakudya zomwe anthu odwala matenda ashuga amachita. Zakudya zaukhondo zimakhazikitsidwa ndi zakudya zamankhwala "Table No. 9" malinga ndi gulu la Professor V. Pevzner. Chomwe chikutsimikizidwa kwambiri menyu tsiku ndi tsiku ndi zamasamba, zipatso, chimanga ndi nyemba zokhala ndi index ya glycemic (GI) yotsika. GI ndi gawo la kusweka kwa chakudya kulowa mthupi, kumasulidwa kwa glucose, ndi kuyamwa kwake (mayamwidwe) kuzungulira kwazinthu. Chifukwa chake, kukwera kwa GI, glucose wofulumira amalowa m'magazi ndipo kuwerenga kwa shuga kumadumpha.

Pazithunzi zazifupi zazinthu zomwe zimakhala ndi glycemic index

Ndi zoletsedwa kugwiritsa ntchito zakudya zosavuta zophatikiza ndi chakudya: zokometsera zophikira, chokoleti cha mkaka ndi maswiti, makeke ochokera puff, pastry, pastcrust past, ayisikilimu, marshmallows, kupanikizana, jamu, timadziti totsekedwa ndi tiyi.Ngati simusintha momwe mumadyera, chithandizo sichingakupatseni zotsatira zabwino.

Njira ina yofunika kwambiri yopezera matenda a shuga ndi kuchita masewera olimbitsa thupi pafupipafupi. Zochita zamasewera zimathandizira kulolerana kwa glucose, chifukwa maselo amalemeretsedwa ndi mpweya panthawi yolimbitsa thupi. Zochita zomwe zalimbikitsidwa zimaphatikizapo masewera olimbitsa thupi, kulimbitsa thupi, kuyenda kwa Chifinishi, kusambira mu dziwe. Kuphunzitsa kuyenera kukhala koyenera kwa wodwalayo, osadzaza thupi.

Monga mitundu ina ya matenda ashuga, odwala ayenera kutsatira upangiri wachipatala:

• pezani glucometer, ndipo yang'anirani kuwerengera kwa glucose kangapo mu ulesi,
• kudziwa njira ya jakisoni ndikujambulitsa insulin munthawi yake,
• tsatirani malamulo a mankhwala azakudya,
• Chitani masewera olimbitsa thupi pafupipafupi
• Sungani buku la odwala matenda ashuga, momwe nthawi ndi muyeso wa insulin, komanso kuchuluka kwa zakudya zomwe zadyedwa, zalembedwa.

Ndikosatheka kuchiritsa matenda ashuga, koma munthu amatha kuyang'anira matenda othandizira kuti azitha kukhala ndi moyo wabwino komanso kuti akhale ndi nthawi yayitali.

1. 
   Elena Yuryevna Lunina Cardiac autonomic neuropathy mu mtundu 2 matenda a shuga, LAP Lambert Academic Publishing - M., 2012. - 176 p.
2. 
   Sazonov, Andrey. Maphikidwe a solo azakudya zabwino za shuga / Andrey Sazonov. - M: "Nyumba yofalitsa AST", 0. - 192 c.
3. 
   Mazovetsky A.G. Matenda a shuga a mellitus / A.G. Mazowiecki, V.K. Velikov. - M: Mankhwala, 2014 .-- 288 p.

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 pamalowo kuti athetse zovuta osati ntchito. Zinthu zonse za tsambalo amazisonkhanitsa ndikuzikonza mosamala kuti athe kufotokoza zambiri zofunikira. Musanagwiritse ntchito zomwe zikufotokozedwa pa webusaitiyi, kufunsana ndi akatswiri ndizofunikira nthawi zonse.

Mtundu woyamba wa matenda ashuga ndi kapamba

Endocrinologists nthawi zambiri amatcha mtundu wa LADA 1.5 matenda ashuga, ponena kuti momwemo umafanana ndi matenda amtundu 1, ndipo zizindikiro zake ndizofanana ndi mtundu wachiwiri. Komabe, zomwe zimayambitsa ndi makina a chitukuko zimapangitsa kutanthauzira ngati mtundu 1. Kusiyanako ndikuti, mosiyana ndi matenda akale aubwana, LADA ikuyimira pang'onopang'ono pang'onopang'ono.

LADA ndi autoimmune m'chilengedwe, ndiye kuti, imayamba chifukwa cha kusachita bwino kwa chitetezo chathupi. Mwanjira imeneyi, maselo oteteza thupi amayamba kuukira maselo a beta a kapamba, omwe amachititsa kuti ziwalo zina ziziwalika pang'onopang'ono. Popeza chithokomiro chimayambitsa kuphatikizidwa kwa insulini, ndi kupitilira kwa matendawa, timadzi timene timakhala tating'onoting'ono ndipo munthu amakumana ndi vuto lakelo. Mwachitsanzo, kwa odwala oterewa, komanso odwala matenda ashuga achinyamata, kuchepa thupi m'malo modzaza ndi vuto, chiopsezo cha hyperglycemia chikuchulukitsidwa, ndipo chithandizo cha matenda ashuga omwe amapezeka ndi mapiritsi ochepetsa shuga sichimapereka zotsatira.

Kusiyana pakati pa LADA ndi matenda a shuga a 2

Popeza LADA ikupita patsogolo pang'onopang'ono ndipo kutha kwa ntchito za kapamba kumachitika munthu akadzakula (zaka 30-45), matendawa nthawi zambiri amapezeka molakwika ngati matenda a shuga 2. Komanso, malinga ndi ziwerengero, 15% ya onse odwala matenda ashuga akuluakulu ndi LADA. Kodi chiwopsezo chotere pakusokonezeka kotere ndi chiyani? Chowonadi ndi chakuti mitundu iyi yamatenda ndiyosiyana:

• Mtundu 2 umadalira insulin kukana - minofu chitetezo chokwanira ku insulin. Ndipo popeza ndiye ali ndi vuto lotumiza shuga kumaselo, nthendayo imadziwika chifukwa chakuti glucose komanso insulin yonse imasungidwa m'magazi.
• LADA ndiyosiyana kwenikweni, chifukwa imayambitsa matenda a kapamba, ofanana ndi matenda amtundu 1, momwe insulin katulutsidwe amachepetsa ndipo pamapeto pake imasiya. Makamaka, chimodzi mwazomwe zimachitika mwanjira imeneyi ndi kuchepa kwa C-peptide, mapuloteni omwe amachititsa kuti insulini ipangidwe. Chifukwa chake, ndimatenda otere, shuga wamagazi amakwera, chifukwa palibe mahomoni omwe amatha kupititsa ku maselo.

Mwachidziwikire, kusiyana kotereku kumafuna njira zosiyanasiyana pochiza matenda ashuga. Popeza m'nthawi yoyamba kuchepa kwa insulin kukana kumafunikira, ndipo ndi LADA, insulin yowonjezera ndiyofunikira.

Momwe mungadziwire matenda

LADA kapena matenda a shuga 2 - mungawasiyanitse bwanji? Momwe mungadziwire wodwala moyenera? Ambiri a endocrinologists safunsa mafunso awa chifukwa samakayikira kupezeka kwa matenda a shuga a LADA konse. Amadumphira mutuwu mkalasi pasukulu ya zamankhwala, kenako ndikumapitiliza maphunziro awo. Ngati munthu ali ndi shuga wambiri pakati komanso okalamba, amapezeka ndi matenda a shuga a mtundu wachiwiri.

Chifukwa chiyani ndikofunikira kuchipatala kusiyanitsa pakati pa LADA ndi matenda a shuga a 2? Chifukwa ma protocol azithandizo ayenera kukhala osiyana. Mtundu wachiwiri wa matenda ashuga, nthawi zambiri, mapiritsi ochepetsa shuga amadziwika. Awa ndi sulfonylureas ndi dongo. Odziwika kwambiri a iwo ndi maninyl, glibenclamide, glidiab, diabepharm, diabeteson, glyclazide, amaryl, glimepirod, glurenorm, novonorm ndi ena.

Mankhwalawa ndi owopsa kwa odwala omwe ali ndi matenda a shuga a 2, chifukwa "amamaliza" kapamba. Werengani nkhani yokhudza mankhwala a shuga kuti mumve zambiri. Komabe, kwa odwala omwe ali ndi matenda a shuga a autoimmune LADA amakhala owopsa nthawi 3-4. Chifukwa kumbali imodzi, chitetezo cha mthupi chimagunda kapamba wawo, ndipo, mapiritsi owopsa. Zotsatira zake, maselo a beta amatha mofulumira. Wodwala amayenera kupita ku insulin pambuyo pazaka zapakati pa 3-4, koposa, atatha zaka 5-6. Ndipo kumeneko "bokosi lakuda" kuli pafupi kumakona ... Ku boma - kupulumutsa kosalekeza osati ndalama za penshoni.

Momwe LADA imasiyanirana ndi mtundu wachiwiri wa matenda ashuga:

1. Monga lamulo, odwala alibe kulemera kwambiri, ndi ochepa thupi.
2. Mlingo wa C-peptide m'magazi umatsitsidwa, zonse pamimba yopanda kanthu komanso pambuyo poyambitsa ndi shuga.
3. Ma antibodies kuma cell a beta amapezeka m'magazi (GAD - pafupipafupi, ICA - zochepa). Ichi ndi chizindikiro kuti chitetezo cha mthupi chikuukira ziphuphu.
4. Kuyesa kwa majini kumatha kuwonetsa chizolowezi chomenyera autoimmune pama cell a beta. Komabe, izi ndizokwera mtengo ndipo mutha kuchita popanda iwo.

Chizindikiro chachikulu ndikupezeka kapena kusapezeka kwa kunenepa kwambiri. Ngati wodwala ndi woonda (woonda), ndiye kuti alibe matenda ashuga a 2. Komanso, kuti adziwe molimba mtima, wodwalayo amatumizidwa kukayezetsa magazi a C-peptide. Mukhozanso kusanthula ma antibodies, koma ndimtengo wokwera mtengo ndipo samapezeka nthawi zonse. M'malo mwake, ngati wodwala ali wochepa thupi kapena wodwala thupi, ndiye kuti kuwunika sikofunikira kwambiri.

Ndikulimbikitsidwa kuti mumayetse magazi omwe ali ndi maselo a beta a GAD odwala omwe ali ndi matenda a shuga 2 omwe ali onenepa kwambiri. Ngati ma antibodies awa amapezeka m'magazi, ndiye kuti malangizowo akuti - amapangika kuti apatsidwe mapiritsi ochokera ku sulfonylureas ndi ma dongo. Mayina a malembawa alembedwa pamwambapa. Komabe, mulimonsemo, simuyenera kuwalandira, ngakhale atayesedwa bwanji. M'malo mwake, sinthani matenda anu a shuga ndi zakudya zamafuta ochepa. Kuti mumve zambiri, onani njira yochepetsera matenda a shuga a 2. Ma nuances othandizira matenda a shuga a LADA akufotokozedwa pansipa.

Chithandizo cha matenda a shuga a LADA

Chifukwa chake, tidaganizira za matendawa, tsopano tiyeni tiwone zovuta za mankhwalawa. Cholinga choyambirira chothandizira matenda a shuga a LADA ndikusunga kapangidwe ka insulin. Ngati cholinga ichi chitha kukwaniritsidwa, ndiye kuti wodwalayo amakhala ndi moyo wokalamba kwambiri popanda mavuto a mtima komanso mavuto osafunikira. Kupanga bwino kwa cell ya beta-cell kumasungidwa, momwe shuga iliyonse imayambira mosavuta.

Ngati wodwala ali ndi matenda amtunduwu, chitetezo cha mthupi chimatsutsana ndi kapamba, ndikuwonongera maselo a beta omwe amapanga insulin. Njirayi imayamba pang'onopang'ono kuposa matenda ashuga amtundu woyamba. Maselo onse a beta akamwalira, matendawa amakula. Shuga "kukulira", muyenera kubaya Mlingo waukulu wa insulin. Kudumpha kwa shuga m'magazi kumapitirirabe, jakisoni wa insulin sangathe kuwaletsa. Mavuto a shuga akupanga mwachangu, chiyembekezo cha moyo wa wodwalayo chimakhala chochepa.

Kuti muteteze maselo a beta ku zovuta za autoimmune, muyenera kuyamba kubaya insulin mwachangu momwe mungathere.Zabwino koposa zonse - atangozindikira. Jakisoni wa insulin amateteza kapamba kuti asawonongedwe ndi chitetezo cha mthupi. Amafunikira makamaka pamlingowu, komanso pang'ono - kusintha magazi shuga.

LADA matenda a shuga algorithm:

1. Sinthani ku chakudya chochepa chamafuta. Iyi ndiyo njira yoyamba yothanirana ndi matenda ashuga. Popanda chakudya chamafuta ochepa, zinthu zina zonse sizithandiza.
2. Werengani nkhani yokhudza insulin dilution.
3. Werengani nkhani zokhudzana ndi insulin Lantus, Levemir, protafan ndi kuwerengetsa kwa Mlingo wa insulin mwachangu musanadye.
4. Yambani kubayirira insulin yayitali yayitali, ngakhale, chifukwa cha zakudya zamafuta ochepa, shuga samakwera pamwamba pa 5.5-6.0 mmol / L pamimba yopanda kanthu ndikatha kudya.
5. Mlingo wa insulin adzafunika wotsika. Ndikofunika kuti mupeze jekeseni Levemir, chifukwa imatha kuchepetsedwa, koma Lantus - ayi.
6. Insulin yowonjezereka imafunikira jekeseni ngakhale shuga pamimba yopanda kanthu ndikatha kudya sakwera pamwamba 5.5-6.0 mmol / L. Ndipo ngakhale zowonjezereka - ngati ziwuka.
7. Yang'anirani mosamala momwe shuga yanu imakhalira masana. Muziyesa m'mawa m'mimba yopanda kanthu, nthawi iliyonse musanadye, ndiye kuti maola awiri mutatha kudya, usiku musanagone. Muyenera kamodzi pa sabata komanso pakati pausiku.
8. Pankhani ya shuga, onjezani kapena chepetsani Mlingo wa insulin yayitali. Mungafunike kumudula kawiri pa tsiku.
9. Ngati, ngakhale jakisoni wa insulin yotalikilapo, shuga amangokhalira kudya pambuyo pake, muyenera kubayanso insulin mwachangu musanadye.
10. Palibe vuto kuti musamwe mapiritsi a shuga - zochokera sulfonylureas ndi ma dongo. Mayina a odziwika kwambiri alembedwa pamwambapa. Ngati endocrinologist ikuyesani kukupatsirani mankhwala awa, muwonetseni malowa, chitani ntchito yofotokozera.
11. Mapiritsi a Siofor ndi Glucofage ndi othandiza kwa odwala matenda ashuga. Ngati mulibe kulemera kwambiri - musatenge.
12. Kuchita masewera olimbitsa thupi ndi chida chofunikira kwambiri chothandizira odwala omwe ali ndi kunenepa kwambiri. Ngati muli ndi thupi labwinobwino, ndiye zolani kuchita masewera olimbitsa thupi kuti mukhale wathanzi.
13. Simuyenera kukhala wotopetsa. Onani cholinga cha moyo, khalani ndi zolinga. Chitani zomwe mumakonda kapena zomwe mumanyadira. Cholimbikitsira chimafunikira kuti mukhale ndi moyo wautali, apo ayi palibe chifukwa choyesera kuthana ndi matenda ashuga.

Chida chachikulu chothanirana ndi matenda ashuga ndichakudya chamoto chochepa. Maphunziro akuthupi, insulin ndi mankhwala osokoneza bongo - pambuyo pake. Mu matenda a shuga a LADA, insulin iyenera kubayidwa mulimonse. Uyu ndiye kusiyana kwakukulu ndi chithandizo cha matenda ashuga amtundu wa 2. Jekeseni wa Mlingo waung'ono wa insulin uyenera kuchitika, ngakhale shuga atakhala wamba.

Yambani ndi jakisoni wa insulin wautali waung'ono. Ngati wodwalayo amatsatira zakudya zamafuta ochepa, ndiye kuti mapiritsi a insulin ndi ofunika kwambiri, titha kunena, homeopathic. Komanso, odwala matenda a shuga LADA nthawi zambiri sakhala onenepa kwambiri, ndipo anthu owonda amakhala ndi insulin yokwanira. Ngati mumatsatira regimen ndi jakisoni wa insulin mosamala, ntchito ya ma cell a pancreatic beta ikupitirirabe. Chifukwa cha izi, mudzatha kukhala ndi moyo mpaka zaka 80-90 kapena kupitilira - ndi thanzi labwino, popanda kudumpha mu shuga komanso zovuta zam'mimba.

Mapiritsi a shuga, omwe ali m'magulu a sulfonylureas ndi dongo, ndi owopsa kwa odwala. Chifukwa amataya kapamba, ndichifukwa chake ma cell a beta amafa mwachangu. Kwa odwala omwe ali ndi matenda a shuga a LADA, ndi owopsa nthawi 3-5 kuposa odwala omwe ali ndi matenda a shuga a mtundu wachiwiri. Chifukwa mwa anthu omwe ali ndi LADA, chitetezo chawo chamthupi chimawononga ma cell a beta, ndipo mapiritsi owopsa amawonjezera kuukiridwa kwake. Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri, kulandira chithandizo mosayenera "kumapha" kapamba pazaka 10-15, komanso kwa odwala omwe ali ndi LADA, nthawi zambiri amakhala wazaka 3-4. Kaya muli ndi matenda ashuga otani - perekani mapiritsi owononga, tsatirani zakudya zamafuta ochepa.

Zowopsa zomwe zingayambitse matenda a shuga a LADA

Akatswiri azindikira njira zisanu zomwe zingapangitse kuti endocrinologist azikayikira wodwala LADA:

• M'badwo. LADA ndimatenda achikulire, koma amakula mpaka zaka 50.
• Woonda. Kunenepa kwambiri, komwe ndi mtundu wa 2 odwala matenda ashuga, ndikosowa kwambiri pankhani iyi, m'malo mwake, monga kupatula.Kukhazikika kwa munthu wamkulu poyerekeza ndi shuga wamkulu ndi chizindikiro cha matendawa mwakuti ndi yekha endocrinologist ayenera kukayikira LADA.
• Kuyambika kwa matendawa. Wodwalayo amakhala ndi ludzu lotchulidwa, pafupipafupi kukodza, kuchepa kwambiri thupi, ndi zina zotero.
• Matenda onena za autoimmune. Chiwopsezo cha matenda a shuga chikuwonjezereka mwa iwo omwe ali ndi vuto la nyamakazi, matenda a Bazedovy, lupus, chithokomiro ndi zina.
• Matenda a Autoimmune mwa abale apamtima. LADA ikhoza kukhala cholowa.

Ngati pali zifukwa ziwiri, mwayi woti wodwalayo ali ndi mtunduwu wa shuga ukuwonjezeka ndi 90%. Chifukwa chake, wodwalayo ayenera kufunsidwa ndipo posachedwa amafufuza.

Kuzindikira koyenera ndi LADA

Kwa munthu wamkulu wokhazikika m'magazi a glucose, ma endocrinologists ambiri amazindikira mtundu wa shuga. Komabe, wodwalayo, makamaka pakakhala zinthu zoopsa, amalimbikitsidwa kuti ayese mayeso ena. Kuti mutsimikizire kapena kupatula LADA, munthu ayenera kukayezetsa magazi:

• Kwa ma antibodies kuti glutamate decarboxylase (anti-GAD). Kufufuza koyambira, popeza ndi zotsatira zoyipa, chiopsezo cha matenda obadwa nawo a autoimmune amachepetsa.
• Kuzindikira kuchuluka kwa C-peptide. Odwala omwe ali ndi mtundu wachiwiri, monga mwa anthu athanzi, mapuloteni amakhala ochulukirapo, koma ndi LADA, monga ndi achinyamata mtundu 1 shuga, mulingo wake udzachepetsedwa.

Malinga ndi zotsatira za mayeso awiri awa, ndizotheka kudziwa momwe matendawa aliri matendawa komanso kutha kwa ntchito ya kapamba. Ngati zotsatira zili zotsutsana, mwachitsanzo, kuyesa kwa anti-GAD kuli bwino, ndipo kuchuluka kwa C-peptides kumakhalabe kwabwinobwino, kuwunika kowonjezereka kwa magazi kuyenera kuperekedwa kwa wodwala. Makamaka, magawo otsatirawa amawunikira:

• Ma antibodies ophatikiza maselo a kapamba (ICA).
• Ma antibodies kuma cell a beta. Kuwunika kofunikira kwa iwo onenepa kwambiri koma akuwaganizira LADA.
• Ma antibodies kupita ku insulin (IAA).
• Zolemba za genetic za mtundu I wa shuga zomwe sizimapezeka mwa anthu omwe ali ndi insulin.

Chithandizo cha Matenda A shuga: Insulin

LADA isanatuluke, endocrinologists sanathe kufotokoza chifukwa chake chiwonongeko cha pancreatic chimayenda mosiyanasiyana mwa odwala matenda ashuga. Kwa odwala ambiri, mapiritsi a hypoglycemic anali othandiza; mankhwalawa a shuga omwe anali ndi jakisoni wa insulin amafunikira patatha zaka makumi angapo kapena ayi. Koma mu gawo laling'ono la odwala, kufunika kwa jakisoni kumatha kuchitika patatha zaka 2-4, ndipo nthawi zina pambuyo pa miyezi 6 ya chithandizo.

Kuzindikiritsa LADA kunapereka yankho ku funso ili. Anthu omwe ali ndi matenda amtunduwu amafunika kutsitsa kapamba atazindikira kale, ndiye kuti ayenera kulandira insulin kale koyamba kwa chithandizo cha matenda ashuga. Mlingo wochepa wa mahomoni nthawi yomweyo amathetsa mavuto angapo:

• Matenda a shuga.
• Kuchepetsa katundu pama cell a beta, chifukwa safunika kutulutsa insulini yofanana ndi yopanda jakisoni.
• Kuchepetsa kutupa kwa kapamba. Izi ndichifukwa choti ma cell osatulutsidwa komanso osagwira ntchito kwenikweni sakhala ndi vuto la autoimmune.

Tsoka ilo, odwala omwe ali ndi LADA nthawi iliyonse yamatendawa ayenera kulandira jakisoni wa insulin. Ngati mankhwala ayambitsidwa mwachangu, mankhwalawa amakhala ochepa, amawongolera, ndikuthandizira kukhalabe ndi kapamba kwa zaka zambiri. Ngati munthu akana chithandizo chotere, kwa zaka zingapo amakakamizidwa kupirira zovuta zonse za insulin ndikulandila Mlingo waukulu wa insulin. Izi zimathandizanso kukulitsa zovuta zowopsa za matenda ashuga, makamaka myocardial infarction ndi stroko.

Odwala omwe ali ndi LADA amaletsedwa kwathunthu kuti asinthe mankhwalawa ndi mankhwala a odwala omwe ali ndi matenda a shuga a 2. Makamaka owopsa ndi kukonzekera kwa sulfonylurea komwe kumawonjezera kupanga kwa insulin. Kukopa kumeneku kumabweretsa kuwonjezeka kwa kuyankha kwa autoimmune ndipo, motero, kuti tifulumizitse kuwonongeka kwa minofu ya pancreatic.

Chitsanzo cha moyo

Mkazi, wazaka 66, kutalika 162 masentimita, kulemera kwa makilogalamu 54-56. Shuga zaka 13, autoimmune chithokomiro - zaka 6. Shuga wamagazi nthawi zina amafika 11 mmol / L. Komabe, mpaka nditadziwana ndi tsamba la Diabetes-Med.Com, sindinatsatire momwe limasinthira masana. Madandaulo a matenda a m'mimba a matenda ashuga - miyendo ikuyaka, ndiye kuti kukuzizira. Heredity ndi yoyipa - abambo anali ndi matenda osokoneza bongo komanso odwala mwendo. Asanayambe chithandizo chatsopano, wodwalayo amatenga Siofor 1000 kawiri patsiku, komanso Tiogamm. Insulin sanabale.

Autoimmune chithokomiro ndimafooketsa a chithokomiro chifukwa chakuwopsezedwa ndi chitetezo cha mthupi. Kuti athane ndi vutoli, endocrinologists adasankhira L-thyroxine. Wodwala amatenga, chifukwa momwe mahomoni a chithokomiro m'magazi amakhala achilendo. Ngati autoimmune chithokomiro chimaphatikizidwa ndi matenda ashuga, ndiye kuti mwina ndi mtundu woyamba wa shuga. Ndizodziwikanso kuti wodwala samanenepa kwambiri. Komabe, akatswiri angapo a endocrinologists adziyimira okha matenda amtundu wa 2. Anatumizidwa kuti atenge Siofor ndikutsatira zakudya zama calorie otsika. Mmodzi mwa madotolo osautsa adati zingathandize kuthana ndi mavuto a chithokomiro ngati mutachotsa kompyuta mnyumba.

Kuchokera kwa wolemba malowa Diabetes-Med.Com, wodwalayo adazindikira kuti alidi ndi matenda a shuga a LADA 1 mu mawonekedwe ofatsa, ndipo akuyenera kusintha mankhwalawo. Kumbali ina, zinali zoipa kuti adachitiridwa zinthu molakwika kwa zaka 13, chifukwa chake matenda amitsempha ya matenda ashuga amakula. Komabe, anali ndi mwayi wodabwitsa kuti sanapereke mankhwala omwe amalimbikitsa kupangika kwa insulin ndi kapamba. Kupanda kutero, lero sikukadakhala kosavuta motere. Mapiritsi olakwika "amaliza" kapamba wazaka 3-4, pambuyo pake shuga imayamba kukhala yayikulu.

Zotsatira zakusintha kwa chakudya chamafuta ochepa, shuga wodwalayo adachepa. M'mawa pamimba yopanda kanthu, komanso mutadya kadzutsa ndi nkhomaliro, idakhala 4.7-5.2 mmol / l. Mukatha kudya chakudya mochedwa, pafupifupi 9 p.m. - 7-9 mmol / l. Patsamba, wodwalayo adawerenga kuti ndikofunikira kudya chakudya cham'mawa kwambiri, maola 5 asanagone, ndikuyika chakudya cham'mawa kwa maola 18 mpaka 19. Chifukwa cha izi, shuga madzulo atatha kudya komanso asanagone adagona pa 6.0-6.5 mmol / L. Malinga ndi wodwalayo, kutsatira kwambiri zakudya zamafuta ochepa sikophweka kuposa kufa ndi chakudya chamagulu owerengeka omwe madokotala amupatsa.

Kulandila kwa Siofor kunathetsedwa, chifukwa palibe nzeru kwa odwala owonda komanso oonda kuchokera kwa iye. Wodwalayo anali atatsala pang'ono kuyamba kubaya insulin, koma sanadziwe momwe angapangire molondola. Malinga ndi zotsatira za kuyang'anira shuga mosamala, zidapezeka kuti masana zimakhazikika, ndipo zimadzuka madzulo, pambuyo pa 17.00. Izi sizachilendo, chifukwa odwala matenda ashuga ambiri amakhala ndi mavuto akuluakulu a shuga m'mimba yopanda kanthu.

Pofuna kuchepetsa shuga m'mawa, adayamba ndi jakisoni wa 1 IU wa insulin yowonjezera nthawi ya 11 a.m. Ndizotheka kuyimba mlingo wa 1 PIECE mu syringe kokha ndikupatuka kwa ± 0,5 PIECES mbali imodzi. Mu syringe padzakhala ZINSINSI za 0,5-1,5 za insulin. Kuti mupeze mlingo molondola, muyenera kuchepetsa insulin. Levemir adasankhidwa chifukwa Lantus saloledwa kuchepetsedwa. Wodwalayo amawonjezera insulin maulendo 10. M'mbale zoyera, amathira ma PISCES a 90 a saline yanyama kapena madzi a jakisoni ndi ma PIECES 10 a Levemir. Kuti mupeze mlingo wa inshuwaransi 1 ya insulin, muyenera kubaya ma PISCES a 10 osakaniza awa. Mutha kuyisunga mufiriji kwa masiku atatu, kotero yankho lake limakhala kutayika.

Pambuyo pa masiku 5 a regimen iyi, wodwalayo adanena kuti shuga yamadzulo idayamba kuyenda bwino, koma atatha kudya, idakwera mpaka 6.2 mmol / L. Panalibe zigawo za hypoglycemia. Zochitika ndi miyendo yake zikuwoneka kuti zikuyenda bwino, koma akufuna kuti athane ndi matenda ashuga a mtima. Kuti muchite izi, ndikofunikira kusunga shuga pambuyo chakudya chilichonse osaposa 5.2-5.5 mmol / L. Tidaganiza zowonjezera kuchuluka kwa insulin mpaka 1.5 PIERES ndikuyimitsa nthawi ya jakisoni kuyambira maola 11 mpaka maola 13. Pa nthawi yolemba izi, wodwala ali munjira iyi. Malipoti oti shuga atatha kudya samasungirako kuposa 5.7 mmol / l.

Cholinga china ndikuyesa kusintha insulin. Choyamba yesani gawo limodzi la Levemire, kenako 2 mayunitsi. Chifukwa mlingo wa 1.5 E sugwira ntchito mu syringe.Ngati insulini yosaoneka bwino imagwira ntchito mwachizolowezi, ndikofunika kukhalabe. Munjira iyi, ndizotheka kugwiritsa ntchito insulin popanda zinyalala komanso osafunikira kusokoneza ndi dilution. Mutha kupita ku Lantus, zomwe ndizosavuta kupeza. Kuti mugule Levemir, wodwalayo amayenera kupita ku republic yoyandikana nawo ... Komabe, ngati misempha ya shuga ikulirakika chifukwa cha insulini wopanda pake, mubwereranso ku shuga wothira mchere.

Kuzindikira ndi kuchiza matenda a shuga LADA - mawu:

1. Chaka chilichonse, odwala masauzande ambiri a LADA amafa chifukwa amapezeka kuti ali ndi matenda osokoneza bongo a 2 ndipo amathandizidwa molakwika.
2. Ngati munthu alibe kulemera kwambiri, ndiye kuti alibe mtundu wa matenda ashuga 2!
3. Odwala omwe ali ndi matenda a shuga a 2, kuchuluka kwa C-peptide m'magazi ndikwabwinobwino kapena kukweza, ndipo mwa odwala LADA, ndiye kuti amatsika.
4. Kuyesedwa kwa magazi kwa ma antibodies kuma cell a beta ndi njira yowonjezerapo yodziwira mtundu wa matenda ashuga. Muyenera kuchita izi ngati wodwalayo wanenepa kwambiri.
5. Diabetes, manninil, glibenclamide, glidiab, diabepharm, glyclazide, amaryl, glimepirod, glurenorm, novonorm - mapiritsi owopsa a matenda a shuga a 2. Osawatenga!
6. Kwa odwala matenda a shuga, mapiritsi a LADA, omwe alembedwa pamwambapa, ndi owopsa kwambiri.
7. Chakudya chopatsa thanzi ndi njira yeniyeni yothetsera matenda alionse a shuga.
8. Mlingo wofunikira wa insulin ndiwofunikira kuti muwongolere matenda a shuga a 1 LADA.
9. Ngakhale mulingo wocheperako, ayenera kubayidwa mwaulemu, osatinso jekeseni.

Ndili ndi matenda ashuga a 2, ndili ndi nkhani yanu yatsopano pa shuga lada. Za ndekha mwachidule - zaka 50, kutalika 187 cm, kulemera 81, 2 kg. Miyezi ingapo pa chakudya chamafuta ochepa, masewera olimbitsa thupi, ndi mapiritsi a Erturgliflozin. Mlingo wa shuga - unakhala ngati anthu wamba. Kunenepa kunachepa chifukwa cha chithandizo. Funso - lada - kodi matenda ashuga achilengedwe ndiwotheka ndi ine? Chifukwa chake sindikufuna kulakwitsa ndikuzindikira ndi kulandira chithandizo. Zoonadi, zovuta za shuga ndizopweteka kwambiri - zakupha. Zoyenera kuchita Ndangodabwitsidwa. Kodi matenda ashuga ndi owoneka motani komanso osiyanasiyana. Ndimaliza nditawerenga nkhani yanu - mdziko lililonse timafuna anthu amishuga amodzi ofanana ndi omwe amakhala osokoneza bongo. Kupatula apo, kuyambira shuga (mankhwala) ndi chakudya (chemistry) mavuto onse. Yekhayekha, palibe amene angathe kupirira matendawa. Zosokoneza ndizotheka. Anthu monga inu, magulu otsogola (ophunzitsa) padziko lonse lapansi, komanso matenda a shuga a Kaput. Ndipo kotero - ndizovuta kwambiri. Masiku ano, anthu sanakonzekere kulimbana ndi matenda ashuga. Timadyetsedwa ndi adotolo enieni, komanso opanga chakudya, komanso nkhani - shuga ya LADA. Ndizomvetsa chisoni kuti kusagwirizana koteroko, chifukwa MOYO NDI WABWINO KWAMBIRI. Ndipo zikomo - ndizosangalatsa nthawi zonse kumva mawu a CHOONADI. Chinthu chimodzi koma - zambiri zomwe mumapereka - zokwera mtengo komanso zodula - kuyang'anira shuga ndi ma shuga okwanira maola 24, chakudya chamafuta ochepa. Chinthu chachikulu ndi CHAKUTI, KUDZIPEREKA.

Moni. Ndili ndi zaka 33. Kukula 168, kulemera kwa makilogalamu 61. Kwa zaka zisanu ndi zitatu ndinamva kusowa kwa thanzi ndipo shuga m'mimba yopanda kanthu zinali zabwinobwino (sindinayesere nditatha kudya). Amaponya thukuta atatha kudya, manja ake amanjenjemera pamimba yopanda kanthu ndipo mikono ndi miyendo yake imazizira. Pali ludzu lochuluka .. Kuyesa kwa magazi kuchokera m'mitsempha pamimba yopanda kanthu kunkakhala 6.1 .. Anadutsa mayeso ndi magazi a shuga. Pamimba yopanda 4.7, pambuyo pa 10.5 maola awiri 8. Dokotala adayika kuzindikira kwa kulolera kwa shuga. Ndinayamba kuyeza shuga nditatha kudya komanso maswiti imakwera mpaka pa 9.2 ndipo mu ola 5.9-5.5. Kubzala zakudya zanu shuga nthawi yomweyo zidatsikira ku 4.7-5.5 (atangodya koma osatha ola limodzi) .. Kwa masiku anu azakudya zanu panali kufooka kwakukulu komanso kupweteka mutu, kugona kunali koopsa. , ngakhale sindinachitepo izi kale. Ndili ndi chakudya chotsekemera (ngati chidakwa). Sakhae 4.5-4.7, ndili ndi nkhawa komanso ndili ndi kufooka mwamphamvu, ndikufuna kunama. Kodi nditha kusiya kudya zam'tsogolo kwambiri? Nanga matenda anga ndi chiyani? (matenda ashuga) ngati ndili woonda komanso shuga ndichokwera? Ndikuganiza autoimmune.

Wamwamuna, wazaka 41, kulemera kwa makilogalamu 83, kutalika kwa 186 cm.Mwezi wa Novembala, atatha kupha poyizoni ndikusanza kamodzi komanso kutentha pang'ono, kuchuluka kwa shuga kochokera m'mitsempha kunawululidwa - 6.5 mmol / L.Kuyesedwa kwa shuga kwa glucose kunachitika - chizindikiro choyamba chinali 6.8, ndiye pambuyo ponyamula katundu pambuyo pa ola 10.4, pambuyo pa maola 2 - 7.2. Modziyimira adadutsa C-peptide ndi glycosylated hemoglobin pamimba yopanda kanthu pafupifupi 12pm. Ndipo tapeza zotsatirazi: C-peptide 0.83 (chizolowezi 1.1-4.4 ng / ml), HbA1C 5.47% (chizolowezi 4.8 - 5.9). Anayamba kutsatira zakudya zamafuta ochepa, pafupifupi milungu itatu itadutsa. Masiku awiri mzere m'mawa shuga 7.3, 7.2 anali wotsimikiza ndi glucometer. Koma zingwe zoyeserera zidatha ntchito pafupifupi chaka chimodzi. Kodi njirayi ndi iti? Kodi zingakhale matenda a shuga a LADA? Zikomo

> Kodi zingakhale matenda a shuga a LADA?

Mwachidziwikire inde.

Nkhaniyi ikufotokozedwa mwatsatanetsatane. Padzakhala mafunso ena - afunseni.

Moni, kumayambiriro kwa chaka ndidapezeka ndi matenda ashuga amtundu wa 2, shuga wa 9.5. Kulemera kwa thupi makilogalamu 87 ndi kutalika kwa masentimita 168. Siofor 500 ndi zakudya zinayikidwa. Pambuyo pamiyezi ingapo kumwa mankhwala ndi zakudya - kulemera kwa makilogalamu 72, HbA1C 7.0%, T4 yaulere 13.4 pmol / L, TSH 1.12 mU / L, C-peptide 716 pmol / L. Kenako kwakanthawi ndidapitilira kutenga Siofor, koma shuga sanatsike pansi pa 6.5. Kwa miyezi ingapo, sindimamwa mankhwala aliwonse. Shuga m'mawa kuyambira 6 mpaka 7.5, masanawa 5-7. Chonde ndiuzeni mtundu wa matenda ashuga komanso momwe ndingathane nawo? Zikomo

> ndimtundu wanji wa matenda a shuga ndikuthana nawo?

Moni Ndili ndi zaka 37, kutalika 178, kulemera pakali pano makilogalamu 71. Matenda a shuga a mtundu woyamba 1 adapezeka mu Okutobala. Adalemba mankhwala a insulin, ndipo popeza ndimakhala ku Belarus, monga onse odwala matenda ashuga mdziko lathu, adandiyika ku insulin ya Belarusi - otchedwa Monoinsulin ndi Protamine ndi fanizo la Actrapid ndi Protofan. Sindimakonda kudya zakudya zamafuta ochepa, zimakhala zovuta chifukwa chantchito, ndimadya monga kale, kupatula shuga ndi zina zokhala ndi shuga - zomwe amamwa ndizochepa. Ndimabaya mayunitsi 6-8 a insulin musanadye komanso magawo 8 a insulin yayitali usiku - nthawi ya 22-00. Shuga ndi glucometer m'mawa wopanda kanthu 5.3-6.2, ola limodzi mutatha kudya 8-8.2, awiri 5.3-6.5. Funso ndiloti ngati izi ndizowonetsa bwino komanso ngati kuli koyenera kusinthira ku ultrashort ndi ma insulin omwe amakhala nthawi yayitali, mutapatsidwa kuti insulin ya Belarusi ndi yaulere, ndipo omwe amafikitsidwa amtundu wake amalipira mtengo ...

>>>>>>>>>> i> i> i>>>>>>>>>> A> i> i>>>>>>>>>>> A> i> i>>>>>>>>>> i> i>>>>>>>> i> S>

Ayi. Zabwinobwino - mutatha kudya pambuyo pa maola 1 ndi 2, shuga sakhala apamwamba kuposa 5.5 mmol / L.

> ndiyofunika kusinthira ku ultrashort
> ndi insulin yambiri

Njira yayikulu yochepetsera ndi zakudya zamafuta ochepa. Ngati simutsatira, ndiye kuti china chilichonse sichothandiza. Kuchuluka kwa insulin ya Belarusi imasiyana bwanji ndi yomwe idatumizidwa - ndilibe zambiri.

Nditawerenga nkhani yokhudza LADA (zizindikiro zanga), nthawi yomweyo ndinakana mapiritsi a glibomet, omwe ndakhala ndimamwa kawiri pa tsiku kwa chaka chopitilira, nditazindikira kuti ndili ndi matenda ashuga. Panali kuchitapo kanthu pachipatalachi - adachita mayeso a shuga kwaulere, kotero ndidali ndi 10 pamimba yopanda kanthu m'mawa. Ndidapatula shuga wokha ndikuwerengera XE pafupifupi, ndinayang'ana glucometer, imawonekeranso kuti ikuwoneka chimodzimodzi. Shuga adayandama kuyambira 5 mpaka 7, samatha kumvetsetsa, mwanjira ina zidayamba kukulira. Tsopano patha masiku awiri pa chakudya chamafuta ochepa, osamwa mapiritsi, sindinathetse vutoli ndi insulin. Usiku watha zinali 6.8, usikuuno zinali kale 6.3 ndipo magulu ankhondo adawonekera. Kupusa, kumene, kunena malingaliro aliwonse kale, koma shuga sichimayambira, ndikuganiza kuti ilumikizidwa. Ndikufuna kufunsa - chifukwa jekeseni wa insulin ngati zakudya zamagulu ochepa zimapatsa shuga kale? Sindiopa kusinthira ku insulin, koma nditha kudya zokwanira ndikuwunika shuga? Kupatula apo, chilichonse chikuwoneka kuti sichinayambike. Ndili ndi zaka 47, kutalika 163 masentimita, kulemera kwa 64 kg. Kuphatikiza apo, ndili ndi zovuta ndi chithokomiro cha chithokomiro, ndalembetsa zaka 6 tsopano, ndakhala ndikumwa Eutirox ndipo chaka chilichonse ndikuyang'ana - pakadali pano, zikuwoneka ngati zabwinobwino. Ndikufunanso kufunsa - Sindinawone chilichonse chokhudza mafuta a mandimu ndi masamba omwe amakhala ndi zakudya zamagulu ochepa, zomwe ndizotheka komanso kuchuluka kwake. Zikomo

Chifukwa chani jekeseni wa insulin ngati mafuta ochepa
> Zakudya ndipo motero shuga amawongolera?

Shuga wabwinobwino - osapitirira 5.5 mmol / l mukatha kudya, komanso pamimba yopanda kanthu, kuphatikiza m'mawa. Ngati shuga wanu amakhala motere, simungathe kubaya insulini. Koma ngati shuga mutatha kudya ndi ngakhale 6.0 mmol / L komanso kwambiri, muyenera kupaka insulin pang'ono, monga tafotokozera m'nkhaniyi, pogwiritsa ntchito chitsanzo cha wodwala wachikulire yemwe ali ndi matenda a shuga LADA.

> Ndili ndi vuto ndi chithokomiro cha chithokomiro,
> kale 6 zakalembetsa, kumwa Eutiroks

Iyi ndi mfundo yowonjezereka kuti muyamba kubayila insulini pang'onopang'ono, monga tafotokozera m'nkhaniyi.

> mafuta a mandimu ndi masamba

Ndimu - kulibwino. Mafuta ophikira - chilichonse chomwe mungafune. Simungadye margarine.

Moni, ndakhala ndikulandila pafupifupi zaka 1.5, matenda anuwo ndi matenda a shuga 2, ndinamwa mapiritsi a sulfonylureas ndi metformin. Nditawerenga nkhani yokhudza matenda a shuga a LADA mwa inu, ndidawona zisonyezo zake ndekha. Anadutsa mayeso a C-peptide ndi insulin. Ndinayamba zakudya zama carb ochepa. Sindingathe kupita kukadwala dokotala ndi funso lokhudza mankhwala a insulin - pali ma coupons ochepa. Masiku atatu pachakudya chamafuta ochepa - shuga 5.5 - 5.8 mmol / l. Ndikumva bwino. Ndiuzeni choti ndichite? Zikomo

> Zoyenera kuchita

Sanjani nkhaniyi mosamala ndikutsatira zomwe zalembedwa pamenepo. Padzakhala mafunso - afunseni.

> Kuofesi ya adotolo ndi funso lokhudza mankhwala a insulin
> mpaka simungathe kupeza

Mumangofunika insulini yaulere kuchokera kwa dokotala, ngati mutapatsidwa, ndi zina zomwe mungapeze. Osati zoyambitsa matenda ashuga.

Moni Sergey!
Ndili ndi zaka 54, kutalika 174 cm, kulemera 70 kg. Matenda a shuga a Type 2 adapezeka chaka chatha. Ndimadya zakudya zamafuta ochepa.
Mwazi wa magazi unabwezeretsa mwakale. Pomaliza, adotolo adachotsa mankhwala onse.
Koma pali vuto limodzi: atatha kusewera masewera, glucose amakwera mpaka 8.2 mmol / L (ski) mpaka 7.2 mmol / L (masewera olimbitsa thupi), ngakhale asanaphunzitsidwe, ndi 5.2 mmol / L.
Kodi mungandiwuza kuti nkhani ndi chiyani ndikuyithetsa?

> Matenda a shuga a Type 2 adapezeka
> atatha kusewera masewera
mulingo wa glucose umakwera

Mukudziwa kale kuti muli ndi LADA, osati Type 2 shuga. Chifukwa kulemera kwake ndikwabwinobwino. Maphunziro akuthupi amayambitsa shuga - komanso chithunzi wamba cha matenda ashuga 1.

Izi zikutanthauza kuti insulini yaying'ono Mlingo uyenera kubayidwa. Chifukwa chake konzekerani jakisoni wanu wa insulin pasadakhale kuti muchepetse mphamvu yamakalasi apamwamba am'tsogolo. Mlingo wa insulin mudzafunika ochepa kwambiri. Yambani ngakhale ndi zigawo za 0,25 za insulin yofulumira. Izi zikutanthauza kuti muyenera kuphunzira momwe mungachepetsera. Werengani nkhani zomwe zili pamutu wa "Insulin". Padzakhala mafunso - afunseni.

Moni, moni. Chonde ndiuzeni ngati ndili ndi antibodies a GADA IgG

> ngati ndili ndi antibodies a GADA IgG, ndiye kuti ndilibe LADA?

Choyamba, muyenera kuyang'ana kutalika ndi kulemera.

Wokondedwa Sergey Kushchenko, chonde nenani izi zikufanana ndi LADA:
Zaka 34
160 cm
66 kg
HbA1c 5.33%
shuga 5.89
insulin 8.33
c-peptide 1.48
Gadi

> izi zikufanana ndi LADA

> Ndikukupemphani - yankho

Malinga ndi zomwe mudabweretsa, sindiri wokonzeka kuunika. Koma kwenikweni, izi sizofunika kwambiri. Pewani shuga m'mawa m'mimba yopanda kanthu komanso mukatha kudya. Ngati ichulukitsa zikhalidwe zomwe zanenedwa munkhaniyi, jekeseni insulin pang'ono. Chinthu chachikulu - musamwe mapiritsi owopsa a shuga 2.

> HbA1c 5.33%
> matenda ashuga

Munakwanitsa bwanji kudzipanga kuti mukhale ndi matenda ashuga okhala ndi GH yotsika komanso pamsana?

Moni Kutalika kwanga ndi 158 cm, kulemera 44 kg, zaka 27. Amayika mtundu wa shuga 1 pa c-peptide miyezi itatu yapitayo. Adatinso kungomamatira ku chakudya. Kuthamanga shuga 4.7-6.2, mutatha kudya 7-8. Kuphatikiza apo, adati ndili ndi kuchepa kwa thupi, motero mafuta amafuta amayenera kudyedwa osachepera magalamu 150 patsiku. Izi ndi malingaliro onse a Moscow Science Scient End Endin Center Center. Ndichite chiyani ndi kulemera? Ndipo ngati ndili ndi zaka 27 - kodi nawonso ndi LADA? Kodi ndiyenera kupempha insulini?

Inde, ili ngati LADA, chifukwa shuga siwambiri kwambiri

> Kodi ndikuyenera kufunsa insulini?

Onetsetsani kuti mumawadulira kwakanthawi shuga atatha kudya amaposa zomwe amakonda.

> Ndichite chiyani ndi kulemera?

Pazakudya zamafuta ochepa, mukamasankha kuchuluka kwa insulini ndikukhalanso ndi shuga, thupi lanu pang'onopang'ono limayamba kubwerera mwakale. Mafuta sakunyentchera.

> Ndili ndi vuto lalikulu lonyumba,
>, chifukwa chake, mafuta ayenera kudya
> magalamu osachepera 150 patsiku.

Zakudya zomanga thupi popanda jakisoni wa insulin sizingakuthandizeni kukhala bwino.Ndipo pakudya chamafuta ochepa, pang'ono ndi pang'ono mudzabwezeretsa thupi popanda kudya zakudya zovulaza.

> Izi ndi malingaliro onse azasayansi.
> Moscow endocrinology likulu

Anthu zikwizikwi abweretsa malingaliro awa kumanda. Mukufuna kuwatsata? Sindikusunga pano.

Pewani shuga m'mawa m'mimba yopanda kanthu komanso mukatha kudya. Ndipo mudzawona mwachangu kuti ndani ali wolondola ndi yemwe alibe. Chilichonse ndichopepuka.

Wokondedwa Sergey, zikomo yankho! Chonde ndiuzeni chidziwitso chiti chomwe sichikwanira kupanga matenda - ndikuwonjezera kapena kupereka mayeso ena! Izi ndizofunika kwa ine, chifukwa nditawerenga nkhani yanuyi ndidakhala pamayeso omwe adotolo sanandiyankhe. Sindipita kwa iye kuti ndikafotokozere zomwe zachitika - inu ndiye chowonadi chomaliza ...

> ndizosowa

Muyenera kusunga diary ya zakudya zanu, komanso zofunikira za shuga mukatha kudya komanso m'mawa pamimba yopanda kanthu. Kwa masiku angapo motsatana, koma m'malo mopitilira. Nayi chitsanzo:

Ndipo nthawi yomweyo zonse zimamveka - momwe zinthu ziliri, momwe zinthu zosiyanasiyana zimakhudzira shuga, kuchuluka kwa insulin yomwe muyenera kupopera komanso nthawi yanji.

Mu diary yomweyi, mutha kuwonjezeranso mzere wokhudza majakisoni a insulin - omwe insulin idalowetsedwa komanso mlingo uti.

Chofunikira kwambiri kwa inu si kukhazikitsa kuzindikira koyenera, koma kutsatira mosamala malangizo omwe ndafotokozera yankho lomaliza.

Wokondedwa Sergey, ndili wokondwa kwambiri yankho! Ndikuchitapo kanthu mwatsatanetsatane kuti ndikwaniritse zomwe mwatsimikiza - mu sabata limodzi ndidzapereka lipoti! Zikomo kwambiri chikwi chifukwa chisamaliro ndi chisamaliro chanu!

> Zikomo chifukwa chondidera nkhawa!

Zaumoyo, zikadangokhala zothandiza.

Masana abwino Ndili ndi zaka 55, anandipeza ndi matenda a shuga 2 mu Novembala 2013. Dokotala adakhazikitsa metformin. Ndimamwa glucophage wautali 750 mg. Panthawi yondipima, thupi langa linali lolemera makilogalamu 68 komanso kutalika kwa 163 cm. Ndinkawoneka bwino. Matenda a shuga akhala akuchitika kwa chaka chimodzi ndi miyezi itatu. Poyamba panali mantha ... Ndipo tsopano kulemera kwanga ndi makilogalamu 49, adotchera adandichotsa metformin, tsopano ndadya zakudya zolimbitsa thupi. Kuletsa metformin kwa mwezi umodzi, ndiye ndipita kukakambirana. Nditawerenga za matenda a shuga a LADA, ndinali ndi funso: kodi zingachitike? Glycated hemoglobin 7.0%. Sindinapereke mayeso a C-peptide ndi ena onse.

> Ndinali ndi funso: mwina ndi ili?

Simunafotokoze chifukwa chake mwachepa thupi. Zakudya ndi Glucophage akhala akugwira ntchito? Kapena kodi kulemera kwina kunachoka? Kuzindikira kumatengera izi.

> Sindinapereke mayeso a C-peptide ndi ena onse.

Ziyenera kuchitika.

Moni, Sergey.
Posachedwa mwezi, monga ndimakumana mwangozi njira yanu komanso osapezeka nanu.
Ndinayamba chidwi ndi chithandizo cha matenda ashuga, chifukwa ndimafunabe moyo. Adalembetsa.
Pafupifupi imodzi idagwa, amakana chakudya chosafunikira chilichonse. Adayamba kudya zowonjezera.
Ndakulemberani zakupambana kwanga osati kuchita bwino. Nthawi zina ndimapeza mayankho. Koma mafunso ambiri sanayankhidwe ndipo atsopano anawonjezedwa.
Ndikukhulupirira kupeza thandizo kuchokera kwa inu pano.
Mwachidule (ngati nkotheka) za inu:
Ndili ndi zaka 57. Kutalika kwa 176 cm, kulemera kwa 83 kg. Amayi anali odwala matenda oopsa, mikwingwirima iwiri, matenda ashuga (atakhala pa insulin), mphumu, etc. Adakhala zaka 76.
Ndatengera cholowa chonse kwa iye ndikuwonjezera "maluwa" athunthu.
Kwina kwazaka 20 ndinazindikiridwa ngati matenda oopsa, koma sindinachite nawo chidwi. Pakadali pano, ali ndi zaka 43, sanalandire stroke. Ulemelero kwa Mulungu udasunthika ndipo kenako ndikuyamba "kuchira".
Ndili ndi zaka 45- 47, ndidalembetsa ngati odwala matenda ashuga, ndipo ndidakhala membala. Amati Siofor komanso zakudya. Mlingo wa mapiritsi, monga shuga m'magazi, unakula nthawi yayitali.
Popita nthawi, ndinazindikira kuti prostatitis (adenoma idapezeka kapena ayi). Kenako gout adawonekera.
Tsopano ndikumvetsa kuti mavuto onsewa pamodzi "anatuluka" mwa ine kale. Khalidwe loipa, moyo wosayenera, malo okhalamo (kumpoto), kusowa kwa zakudya m'thupi.
Ndi maluwa oterewa, nthawi zina safuna kukhala ndi moyo. Mukudziwa, mankhwala athu sayenera kuyankhula. Malinga ndi malingaliro awo, zonse zimaphatikizidwa kwa ine, kupatula mapiritsi.
Zomwe sindinayese. Nayi tsamba lanu. Zinkawoneka ngati zotsimikiza. Pafupifupi, ndinayamba kugwiritsa ntchito malingaliro anu onse.
Kodi zinthu zikuwayendera bwanji: Kupanikizika kwatsika, ngakhale kwambiri.Pafupifupi ndinakana mapiritsi (ndimamwa bisoprolol m'mawa ndi doxazosin madzulo).
Shuga ankakonda kukwera mpaka 12, koma pano agweranso mpaka 5.4 - 7. Ngakhale pamimba yopanda kanthu sizimachepera, ngakhale ndimadya pang'ono madzulo 4 maola asanagone. Ndiye maola ena awiri sinditha kugona m'mimba mwanga. Ndimamwa m'mawa ndi madzulo Gliformin 1000 mg.
Pazifukwa zina, kulemera sikuchepa.
Ndipo komabe, chisangalalo: gout sinayambitsidwe posachedwapa, ngakhale ndimadya nyama "yoletsedwa", zakudya zamafuta, bowa.
Dzulo ndidawerenga nkhani yanu yatsopano ya shuga ya LADA.
Ndiuzeni, Sergei, ine, angakhale? Ndikumvetsetsa kuti ndiyenera kuchita mayeso ena.
Ndikuyembekeza kuyankha. Ndikhala othokoza kwambiri.

> kwa ine, zingachitike?

Ayi, si LADA iyi, muli ndi vuto la metabolic.

Komabe, ndikofunikira kuti mupeze insulin pang'ono kuti shuga m'mimba yopanda kanthu ndipo mutatha kudya simaposa 5.5 mmol / L. Monga momwe wodwala LADA amachitira, yemwe mlandu wake wafotokozedwa m'nkhaniyi. Koma zonena zanu ndizabwino. Amakhala ndi mwayi wowonjezera kuchuluka kwa insulin pakanthawi kochepa.

Muyenera kusankha - jakisoni wa Mlingo wochepa wa insulin kapena kuthamanga ndi chisangalalo. Ndi matenda a shuga a LADA, insulini imafunikira, ngakhale munthu akuthamanga.

> mvetsani zomwe ndikufuna
> pitani mayeso ena.

Simungathe kuzitenga. Zolemba zowerengera bwino za kuwerengera kuchuluka kwa insulin yayitali komanso yochepa ndikuyamba kubayidwa pang'onopang'ono.

> mafunso ambiri sanayankhidwe

Ndidawona funso limodzi lokhalo pamalemba atali, ndikuyankha.

Zikomo, BIG!
Sergey, ndidafunsa mafunso ochulukirapo, koma sindinawerenge komwe ndidafunikira.
Ndidafunsabe:
1) Taurine ndi mankhwala osokoneza bongo. Kodi ndingathe? Ndili ndi gout komwe ma diuretics amatsutsana.
2) Mukuti chiyani za Yerusalemu artichoke? Iwo amalangizidwa mu mankhwala azikhalidwe zamakhalidwe azikhalidwe. Ndidagula ngati ufa mu kampani yodziwika bwino ya Siberian Health, yomwe imapanga yokha ndikugulitsa zowonjezera pazakudya.

> Taurine ndi okodzetsa.
> Kodi ndingatenge?

Chifukwa chiyani? Mukukhala ngati mwaponya dontho labwino, momwe ndikumvera?

Zokhudza matenda oopsa komanso impso. Yesetsani kuyesa, kuwerengetsa kuchuluka kwanu kosakwanira. Palibe njira popanda icho.

> Mukuti chiyani za Yerusalemu artichoke?

Yerusalemu artichoke amatsitsa shuga - izi ndi nthano. Pangani shuga wanu mutatha kudya - mudzionere nokha.

> Ndinagula mu ufa

Zingakhale zabwino ngati mutanditumizira ndalama zina.

Moni, Sergey. Tithokoze yankho. Ndikuganiza kuti kuchepa thupi kumakhudzana ndi zakudya ndi mapiritsi a glucophage. Ndipo ndimachita masewera olimbitsa thupi m'mbuyomu. Ndikhala ndikuyesa mu Marichi. Kulemera kwanga kunali koyenera izi zisanachitike.

> Ndikuganiza kuti kuchepa thupi kumakhudzana ndi zakudya
> ndi kumwa mapiritsi a glucophage

Muyenera kusintha kusanthula kwa hemoglobin wa glycated ndikuupatsira C-peptide. Kupanda kutero, ndizovuta kulangiza china chake.

Zikomo, Sergey. M'malo ena ndidafunsabe kuti:
1) Chifukwa chiyani, ndikamatsata zakudya zamafuta ochepa, ndikumwa mankhwala othandizira, ndipo ngati nkotheka, kuchita masewera olimbitsa thupi, kulemera kwanga sikuchepa konse (mwezi wapita).
2) Nthawi zambiri ndimakhala ndi kuthamanga kwambiri "kotsika" kwa 120/95, 115/85. Kodi chingalankhule za chiyani?

> Sindimachepera thupi

Msiyeni iye yekha. Musachepetse pafupipafupi, nthawi zambiri mumayeza shuga ndi glucometer.

> kuthamanga "kotsika" kwambiri 120/95, 115/85.
> Zingalankhule chiyani?

Za matenda a impso.

Ndakupatsani kale ulalo wamagazi ndi mkodzo mayeso omwe amayesa impso.

Moni. Ndili ndi zaka 40, kutalika 168 cm, kulemera kwa 66 kg. Mtundu wachiwiri wa matenda ashuga wazaka 8. Ndimamwa metformin katatu patsiku ndi trezhenta. Kuthamanga shuga - mpaka 7, mutatha kudya - 8-9, HbA1c 6.7%. Polyneuropathy, hypothyroidism. Nditawerenga nkhani yanu, ndidadutsa AT ku GAD, IgG> mayunitsi 1000 / ml, C-peptide 566 pmol / L. Kodi ndiye Lada?

Pezani zikhalidwe za kusanthula pa intaneti, yerekezerani ndi zotsatira zanu ndi kutsimikiza.

Masana abwino, Sergey!
Ndili ndi zaka 32, kutalika 187 cm, kulemera makilogalamu 81. Sabata yapitayo adadutsa magazi opanda kanthu m'mimba yopanda shuga pamimba yopanda kanthu. Zotsatira zake ndi 5.55 mmol / L. Ndinadabwa ndi izi, chifukwa ndimachita zambiri, ndimaphunzitsanso kwambiri. Zowona, ndili ndi matenda oyipa - a tenillitisitis.Malinga ndi zomwe zili patsamba lanu, ndili ndi matenda osokoneza bongo osachepera pang'ono, ndipo monga pazokwanira, nditapatsidwa kuti kulemera kwanga ndizabwinobwino, kenako LADA. Ndiuzeni, chonde, ndingadziwe bwanji matenda, prediabetes kapena LADA? Kodi ndizowona kuti mukamatenga magazi kuchokera m'mitsempha, shuga amawonjezera kuposa njira ya capillary? Kodi mitengo yomwe ikuwonetsedwa patsamba lanu ikugwirizana ndi njira ya capillary kapena mukatenga magazi kuchokera mu mtsempha?
Tikukuthokozani musanayankhe.

> Ndiuzeni, chonde, ndingadziwe bwanji

Chitani kafukufuku wa magazi a hemoglobin wa glycated. Kapena mugule glucometer ndi masiku osiyanasiyana, muyesere shuga maola awiri mutatha kudya.

> ndizowona kuti mukatenga magazi
> shuga kuchokera m'mitsempha ndi wokwera

Sindikudziwa bwino izi. Mulimonsemo, kusiyana kwake sikwakukulu. Ndipo matenda ashuga sayenera kuzindikirika ndi mayeso a shuga a magazi. Muyenera kugwiritsa ntchito njira zina, monga momwe ndidalemba pamwambapa.

Moni, ndili ndi zaka 45, ndinapezeka ndi matenda a shuga 2 miyezi 1.5 yapitayo. Kuthamanga shuga kwa magazi kunali 18 mmol / L. Anayesedwa kuyesa kwa magazi kwa TSH yovuta (ya chithokomiro chopatsa mphamvu cha chithokomiro) - 2.4900 andIU / ml ndi glycosylated hemoglobin - 9.60%. Kuchokera pamapiritsi - Diabeteson ndi Creon. Nditawerenga tsamba lanu, nthawi yomweyo ndidawasiya. Sanandilandire chithandizo china chilichonse kupatula mapiritsi awa. Kenako, ndinadzidalitsa ndekha pa C-peptide - 0.523. Ndinazindikira kuti mwina ndili ndi LADA. Panalibe zovuta zomwe zidapezeka mpaka pano: anali ndi ophthalmologist, kuwunika kwa ultrasound kuwonetsa hepatosis yaying'ono, ndipo, mwatsoka, sanayang'ane impso zake.
Ndinasinthira zakudya zamafuta ochepa, shuga pang'onopang'ono amachepera mpaka 5.0 pamimba yopanda kanthu, nthawi zina yotsika. Mukatha kudya, pambuyo 2 maola 6.1. Masabata awiri kale samakula pamwamba pa 7. Ndawerenga ndi inu kuti ndi matenda amtundu 1 wa shuga muyenera kubaya insulini, ngakhale utakhala ndi shuga. M'mawa ndimakantha Levemir, koma pakadali pano sindingathe kusankha pamtengowo, kuyambira 2 mpaka 5 mayunitsi. Ndimawopa kubaya usiku chifukwa cha hypoglycemia. Ndimamwa Arfazetin theka la ola ndisanadye. M'miyezi iwiri yokha adataya 5 kg. Tisanazindikire kuti anali ndi matendawa 68, tsopano anali 63 kg. Ndikuganiza kuti izi ndichifukwa chakudya, thupi limatenga mafuta ake omwe. Koma kodi izi zimatsogolera pakupanga matupi a ketone? Ndinaganiza zogula mizera kuti nditsimikizire ma ketoni mkodzo. Zoyenera kuchita ngati mulingo wawo uli wokwera? Ndasokonezeka ....

> Ndinaganiza zogula zingwe
> kudziwidwa kwa mkodzo wa ketone

Ndikwabwino osachita izi komanso osayang'ananso ma ketoni mumkodzo - mudzakhala wodekha

> Zoyenera kuchita ngati mulingo wawo
> adzakhala okwera?

Osamachita kalikonse ngakhale shuga m'magazi atadutsa malire

> Ndimawopa kubaya usiku chifukwa cha hypoglycemia

Ngati shuga m'mawa wopanda kanthu ndi 5.0 kapena kutsika - insulin yowonjezera sikufunika.

> Pambuyo kudya pambuyo 2 maola 6.1. Masabata awiri
> sichikukwera pamwamba pa 7.

Izi ndizovomerezeka, komabe muyenera kuyesetsa kuchita bwino. Tsatirani zakudya kwambiri ndikuyesa kumwa kwa m'mawa a Levemir.

Zikomo chifukwa cha mayankho, ndinu munthu wamtima wabwino))) ngati muli ndi nthawi yokwanira. Madotolo, mwachiwonekere, alibe zokwanira ... Ndidagulabe timizere ndipo ndidakwiya - pali ma ketones, ndikuweruza ndi mtundu kwinakwake m'chigawo kuyambira 4 mpaka 8. Palibe mkodzo m'mkodzo ... ndimayesetsa kumwa madzi ambiri. Sindikufuna madzi okha ... Chifukwa chake ndikufuna kufunsa. Kodi chakumwa choterocho chimaloledwa pa chakudya chochepa chamafuta: madzulo, kudula maapulo, ndimu ndi kuthira madzi otentha, kumwa m'mawa musanadye chakudya cham'mawa?
Dzulo ndidaganiza zowunika gluu ya AccuChek Performa Nano kuti iwone molondola. Adalangizidwa ndi dokotala. Dzulo usiku ndikudya chamadzulo 6 koloko (ndimagwiritsa ntchito dontho lachiwiri la magazi kuyang'ana):
20:53 - 6.8 (mphete ya dzanja lamanzere)
20:56 - 6.0 (mphete ya dzanja lamanja)
20: 58 - 6.1 (chala chaching'ono cha dzanja lamanja)
20:59 - 5.0 (chala chaching'ono cha dzanja lamanzere!) Ndikudabwitsidwa, kuwerenga kwa dzanja lamanzere kuchokera ku chala cha mphete ndi chala chaching'ono ndikosiyana ndi pafupifupi 1,8 mmol!
Lero m'mawa ndidabwereza kuyesaku, pamimba yopanda kanthu:
5:50 - 5.7 (chala chaching'ono cha dzanja lamanja)
5:50 - 5.5 (wopanda chala cha dzanja lamanzere)
5:51 - 5.9 (kachiwiri chala cha dzanja lamanja)
Kodi mukuganiza kuti izi sizabwinobwino?
Zikomo patsogolo.

Inde, pitilizani kugwiritsa ntchito mita iyi. Kusokera kumachitika nthawi zonse m'mitundu yonse.

> Kodi zakumwa zotere ndi zololeka?

Ayi! Zakudya zomanga thupi zimaphika kuchokera ku zipatso ndikugwera compote. Chimakhala chofanana ndi kumwa msuzi wa zipatso.

Imwani azitsamba azitsamba popanda shuga ndi othandizira.

Ndili ndi zaka 64, kutalika kwa 165 cm, kulemera kwa 55 kg. Kuthamanga hemoglobin A1C-6.0%, cholesterol-267mg / dL yonse, cholesterol yoyipa (LDL) -165mg / dL, mapuloteni onse L 6.4. Pakamwa pakamwa kumachitika usiku, pomwe simenti imathiridwa mkamwa ndi pakhosi, koma osati kangapo.
Kuphatikiza pa kadyedwe ka shuga, iwo sanandipatse chilichonse ndipo sanandifotokozere bwino. Achibale anga alibe matenda ashuga. Adotolo adati: "Sindikuganiza kuti mudzayamba kudwala matenda ashuga. Ndimatenga ma statins a cholesterol. Zomwe ndawerenga patsamba lanu ndizofanana kwambiri ndi matenda a shuga a LADA. Mukuganiza bwanji?

> Mukuganiza bwanji?

Simunapereke chidziwitso chokwanira, motero ndilibe lingaliro.

Gulani glucometer wabwino, yemwe nthawi zambiri mumayeza shuga mutatha kudya komanso m'mawa pamimba yopanda kanthu.

Ndili ndi zaka 54, kutalika 164 cm, kulemera ndi 56 kg. Matenda a shuga a Type 2 adapezeka zaka 2 zapitazo. Kuthamanga shuga kunali 7.2, ndipo kulemera 65 kg. Adapereka zakudya zamafuta ochepa ndipo nthawi yomweyo Siofor 1000. Kwa miyezi iwiri, adataya 9 kg. Siofor adatenga miyezi 9, kenako adapempha adotolo kuti asinthe kuti amwe ndipo amamwa pafupifupi chaka - shuga anali 6,6,5 pamimba yopanda kanthu mpaka mpaka 8 nditatha kudya. Pambuyo pa kumwalira kwa makolo ndi mavuto ena, shuga adakwera kufika pa 12-16. Ndinayamba kumwa glucophage 500 kawiri pa tsiku. Sindingakhale bwino. Tsopano shuga amachokera ku 5.5-6.5 ndipo atatha kudya mosiyanasiyana 7-8. Ndasindikiza malingaliro anu - ndikufuna kuwonetsa adotolo. Malinga ndi zomwe mwawonetsa, ndili ndi matenda ashuga, sindikufuna kudzipweteka nokha. Koma nditha kuzitsimikizira bwanji kwa madotolo? Sawerenga Intaneti ndipo safuna kudziwa zinthu zatsopano. Ndikufunsa kufunsa kwanu. Zikomo patsogolo!

> Koma nditha kuzitsimikizira bwanji kwa madotolo?

Asiye okha.

Mumafunikira dokotala kuti angotenga insulin kwaulere. Mwinanso maubwino ena.

Sangakupatseni insulin yaulere yabwino - mugule nokha mumsika.

Kuphatikiza pakupeza mapindu, dokotala sangathenso kuthandizanso. Zakudya ndi jakisoni wa insulin zili ndi inu.

Moni. Ndine gastroenterologist. Anthu omwe ali ndi matenda osokoneza bongo amabwera kudzandipeza ndi mafunso okhudza zakudya. Ndimawerenga tsamba lanu mosamalitsa ndipo ndine wokondwa kwambiri chifukwa chatsatanetsatane .. ndili ndi mafunso angapo.
1. Chakudya chamafuta ochepa -mapuloteni ambiri - sichilivulaza kwa impso? Nanga zina zoyipa ndi ziti?
2. Mukumva bwanji za Yerusalemu artichoke, makamaka ndi matenda a shuga a LADA?
3. Kodi mbewu zotsitsa shuga ndizovulaza ku shuga za LADA ngati mankhwala amkamwa?
4. Kodi ndizomveka kupewera zovuta za matenda a shuga a LADA omwe ali ndi antioxidants ndi alpha lipoic acid, selenium ndi zinc?

Kutsimikizika kwa matenda a shuga a LADA, chifukwa mzanga wapamtima amadwala matendawa kwa zaka 1.5 ndipo tsopano ali pamtunda wa 28 LU, akuwonjezeka mu chaka chimodzi. Tsopano ife tisinthana ndi ma jakisoni awiri azakudya zam'madzi ndi zakudya zamagulu ochepa (ngakhale zakudya zinali kale zopatsa mphamvu, zakudya zopatsa thanzi ndi masewera olimbitsa thupi zimakhala zokwanira, palibe kulemera kowonjezera, mwamunayo ali ndi zaka 50).

Ndili wokondwa chifukwa cha mayankho
Alexandra

> Zakudya zamafuta ochepa -
> mapuloteni ambiri -
> Kodi ndizowononga impso?

Werengani nkhani yakuti, “Impso Zakudya.”

>>>>>>>>>>?

Ngati mumamwa madzi okwanira, ndiye osamwa. Kwa nthawi yayitali, odwala matenda ashuga omwe akudziwa kale amakhala ndi vuto la kusokonekera chifukwa choti shuga imatsika kwambiri.

> Mukuwona bwanji za Yerusalemu artichoke,
> makamaka ndi matenda a shuga a LADA?

Amadzaza ndi zakudya zamafuta ndipo motero zimakhala zovulaza.

> Zomera zotsitsa shuga,
> komanso zovulaza matenda a shuga a LADA,
> ngati mankhwala amkamwa?

Palibe mankhwala azitsamba odziwika masiku ano omwe amachepetsa shuga.

> Kodi nkwanzeru kupewa zovuta
> ndi LADA antioxidants a shuga
> ndi alpha lipoic acid, selenium ndi zinc?

Choyamba, muyenera kutsatira kwambiri zakudya zamafuta ochepa komanso jekeseni wa insulin ngati pakufunika. Ngati ndalama zilola, ndiye kuti mutha kutenga zomwe zikuwonetsedwa ndi inu. Palibe zovulaza kuchokera kwa iwo, koma mapindu ake ndi osakwanira.

Zinc ndi yothandiza kwa amuna ndi akazi kuti athetse mavuto ena osakhudzana ndi matenda a shuga, onani nkhani yatsatanetsatane pa zinc.

Moni Ndili ndi zaka 52, kutalika 169 masentimita, kulemera makilogalamu 70, koma patatha pafupifupi zaka 40 m'mimba mwanga munayamba kukula. Komanso, ndi yozungulira, yotanuka komanso yosalala, ngati mayi wapakati. Myoma, etc., sanaphatikizidwe ndi ultrasound. Kugwiritsidwa ntchito kuchokera ku thrush - ndiwopanda ntchito, osati nthawi zambiri, koma kuyambitsa. Nthawi zambiri ndimapita kuchimbudzi pang'ono. Sabata yapitayo, atayang'aniridwa, shuga adawonetsa 10,6 mmol / L. Anazindikira ndi matenda a shuga a 2. Dokotala adakhazikitsa metformin. Anadutsa mayesowo, zotsatira zake: TSH - 0.33 pamlingo wa 0.4-3.77 μIU / ml, hemoglobin wa glycated - 8.01% pa 4.8-5.9%, c-peptide - 2.29 pa ponseponse ndi 1.1-4.4 ng / ml, prolactin ndi 14.36; chizolowezi ndi 6.0-29.9 ng / ml. Sindinamwe mapiritsi, ndimadikirira zotsatira za kusanthula. Nditawunika tsamba lanu, masiku awiri apitawa ndidasintha chakudya chamagulu ochepa. Maphunziro akuthupi sanayambe, koma anayamba kuyenda. Ndiuzeni, kodi ndili ndi LADA?

100% inde, ngakhale C-peptide yabwinobwino.

Muyenera kubaya insulini, osati chakudya chochepa cha thupi komanso kuchita masewera olimbitsa thupi.

Komanso, mwina muli ndi hypothyroidism - kusowa kwa mahomoni a chithokomiro. Tsatirani kwambiri zakudya zamafuta ochepa opanda gluten - izi zimachepetsa kuukira kwa autoimmune ku chithokomiro cha chithokomiro. Ngati mukuda nkhawa ndi zizindikiro, imwani mapiritsi a mahomoni omwe adapangidwa ndi endocrinologist. Ndikofunikira kuyang'anira mahomoni onse a chithokomiro m'magazi, makamaka T3 yaulere, osati TSH yokha.

Moni
Chonde ndithandizeni kuti ndidziwe mtundu wa shuga womwe agogo anga ali nawo. Ali ndi zaka 80, kulemera kwa 46 kg, kutalika 153 cm.
Shuga m'mawa pamimba yopanda kanthu kuyambira 14 mpaka 19, mutatha kudya, ukuwonjezeka mpaka 25.
Zikomo kwambiri chifukwa chofunsirachi.
Zambiri
Victoria

agogo anga ali ndi mtundu wanji wa shuga?

Matenda akulu a shuga osaphunzitsidwa. Jakisoni wa insulin amafunikira mwachangu.

Moni
Ndili ndi zaka 48, kulemera kwa makilogalamu 72 ndi kutalika kwa masentimita 174. Ndikupeza shuga zaka 4 zapitazo. Munali shuga mu mkodzo ndi glycated hemoglobin 6.5%. Tinachita mayeso okhala ndi katundu wambiri pafupifupi 10. Kenako tinkalemera pafupifupi 79-80 kg. Anayimitsa kudya ufa ndi shuga. Kuchepetsa kulemera kwa 74 kg. Chilichonse chidayambiranso, koma patatha miyezi isanu ndi umodzi, chidasinthiratu - 6.2-6.9 ndipo matendawa adasinthasintha kuchoka pa 6.2% mpaka 6.9%. Kwa miyezi isanu ndi umodzi, adayesanso ndi katundu wa 9,8. Mwafika pa tsamba lanu - idapitilira kadyedwe, shuga misempha atsika ndipo ndi zabwinobwino. Ndataya 2 kg. Koma ndikufuna kuthana ndi mtundu wa matenda ashuga. C-peptide 443 - yabwinobwino, palibe GAD yomwe yapezeka, IAA 5.5. AT kwa maselo a beta ndichabwino. Endocrinologist akuti palibe Lada. Maganizo anu? Ndi funso linanso. Ngati shuga samakwera pamwamba pa 5.5 pachakudya, mwina simuyenera kuda nkhawa kuti ndi mtundu wanji wa matenda ashuga, ingotsatira chakudya?

Izi zili pafupi ndi malire apafupi.

mwina simuyenera kuda nkhawa kuti ndi mtundu wanji wa matenda ashuga, ongotsatira kadyedwe?

Kulondola. Pankhaniyi, muyenera kuyeza shuga pafupipafupi kuti muyambe kubayirira insulin panthawi yake ngati chakudya sichokwanira.

Zikomo chifukwa cha tsamba labwino kwambiri komanso upangiri. Pambuyo powerenga zokhudzana ndi LADA, funso lotere linabuka.
Matenda a shuga anapezeka ali ndi pakati ndi GTT. Pambuyo pa kubadwa, GTT yachiwiri idapezeka ndi matenda ashuga. Adandiuza kuti ndiziwunika izi pachaka chilichonse ndikulola))
Ndili wochepa thupi - kutalika 168 cm, kulemera - 52 kg. Zaka 36 zakubadwa. Nthawi ndi nthawi pamakhala kuwonda kwambiri mpaka 47 kg. Izi zikuchokera kuubwana.
Ndikukumbukira kuti matenda asanakwane shuga ndikadayamba zaka 6 zapitazo - kufooka kwathunthu ndi tachycardia nditatha kudya, kumwa kwambiri ndikuthamangira kuchimbudzi. Zinandipweteka m'dera la impso. Zotsatira zake, madotolo adazindikira kuti ali ndi VVD) ndikumasulidwa mumtendere. Mkhalidwe wanga unayamba kuyenda pang'onopang'ono. Ndipo patapita zaka zochepa ndidayamba kumva bwino. Koma pa mimba ikani shuga. Palibe insulin yomwe idalembedwa. Kutsutsa zakudya. Koma panali ma ketoni ambiri mumkodzo.
Tsopano, ngati nditha kudya chakudya chamafuta ochepa (kabichi), ndiye kuti ma ketoni amapezeka mkodzo. Ngati ndadya chakudya chamagulu (mwachitsanzo, buckwheat), ma ketoni amachoka, koma ndikatha kudya shuga ndikulumphira magawo 8-12.
Ndimamwa madzi ambiri. Kuyamwitsa.
Kodi mungalangize chiyani? Momwe mungadye ndikuyamba kuyambitsa insulin ngati mukukayikira LADA?

1. Siyani ma ketoni okha. Zitha kuwerengedwa pokhapokha ngati shuga ndi apamwamba kuposa 12 mmol / l, koma ndibwino kuti musayeze konse.
Tsatirani zakudya zamafuta ochepa
3. Ikani shuga pafupipafupi, makamaka mukatha kudya.
4.Ngati ndi kotheka, jekeseni insulini pang'ono.
5. Imwani madzi ambiri - 30 ml pa 1 makilogalamu a thupi patsiku.

Palibe chochita. Ngati tachycardia ikukuvutitsani, yesani kutenga Magnesium-B6.

Moni Sergey!
Choyamba, zikomo zambiri chifukwa cha ntchito yanu! Ndapeza zambiri zothandiza patsamba lanu, zomwe ndidadzipeza mwamwayi komanso posachedwa.

Pa 32, panali matenda a shuga. Pambuyo pa mimba - miyezi itatu pambuyo pake, adachitanso kuyesa kwachiwiri kwa maola awiri. Zizindikiro pambuyo pa maola awiri zinali 9.4, ngakhale zizindikiritso ziwiri zoyambirira - kudya shuga asanadutse ndi ola limodzi - zinali zachilendo.

Pambuyo pa kuyesedwa uku, kuyesa kwa antibody (GAD ICA) kunachitika - zoipa, koma C-peptide ndiyotsika (sichiri LADA?). Ndi izi, aliyense anapezeka ndi mtundu woyamba wa prediabetes.
Insulin sanalembedwe, popeza glucose yothamanga ndi HbA1c ali mkati mwazolunga. Amati kuchepetsa shuga ndi kudya moyenera komanso kuchita masewera olimbitsa thupi. Cholinga chomwe endocrinologist adandipatsa ndi shuga nditatha kudya osaposa 140 mg / dl. Kuyambira Meyi mpaka Seputembala chaka chino, chifukwa cha umbuli, ndidatsatira mosazindikira mayendedwe ake. Mwazi wamagazi, makamaka pambuyo pa nkhomaliro, nthawi zonse amakhala pakati pa 100 ndi 133 mg / dl. Osachepera 100 mg / dl. Panali nsonga mpaka 145-165.

Nditawerenga zolemba zanu patsamba lanu, ndidazindikira kuti mulingo wazizindikiro zama glu siwoyenera, wokwera kwambiri. Kuyambira pakati pa Seputembala, adasinthira kudya zakudya zamafuta ochepa. Patatha masiku 2-3, shuga anagwa kwambiri mpaka kukhala wathanzi. Koma kusinthanso kumeneku kunali kovuta kwa thupi - ndi zizindikiro za hypoglycemia, ngakhale shuga sanali otsika kuposa 68 asanadye komanso osaposa 104 pambuyo pake. Mpaka pano, shuga wamkulu kwambiri mawola 2 atatha chakudya akhala 106 mg / dl. Nthawi yomweyo, LDL-cholesterol idalumpha - ndikofunikira kuwunika mafuta pazakudya.

Pakadali pano, endocrinologist wanga samanena kalikonse za insulin ndipo sindikudziwa ngati izi ndi zolondola? Ngati ndili ndi matenda a mtundu woyamba wa prediabetes, ndiye kodi sindikufunika "kuthandiza" kapamba ndi jakisoni wa insulin?

Zikomo kachiwiri ndipo ndikufuna kumva malingaliro anu.
Zambiri
Irina

Izi ndichifukwa choti mwayesa kuchepetsa zakudya zopatsa mphamvu. Zakudya zololedwa zimayenera kudyetsedwa bwino.

Nthawi yomweyo, LDL-cholesterol idalumpha - ndikofunikira kuwunika mafuta pazakudya

Ayi, werengani zambiri apa.

Kodi simuyenera "kuthandiza" kapamba wanu ndi jakisoni wa insulin?

Ndikofunikira kokha ngati zowonetsa za shuga ndizapamwamba kuposa zabwinobwino. Ndipo ngati zili zabwinobwino, ndiye kuti jakisoni wa insulin amayambitsa hypoglycemia.

Tithokoze yankho.

Ndilinso ndi funso loti ndizotheka kudya anyezi waiwisi makamaka adyo ndi NU-zakudya? Nkhani yokhudza zakudya zololedwa imati mutha kupatsa anyezi pang'ono mu saladi, kuti mumve. Kodi ndikumvetsa molondola kuti anyezi wokazinga ndiwotsutsana?

Kodi ndizotheka kudya anyezi waiwisi makamaka adyo wokhala ndi zakudya za NU?

Kodi anyezi wokazinga amatsutsana?

Tsoka ilo, mankhwala atatha kutentha, chakudya chamagulu anyezi chimapangitsa kudumpha mu shuga m'magazi odwala matenda ashuga. Kuthamanga kwa kunyengerera kwawo kumawonjezeka.

Masana abwino, Sergey!
Tithokoze chifukwa cha chithandizo chomwe tsamba lanu limagwira. Za ine - wazaka 34, kulemera 57 kg, kutalika 172 cm.
Matenda a shuga adapezeka pomwe shuga ya magazi idalipo 17 mmol / L. Miyezi isanu ndi umodzi zisanachitike, adapereka magazi kuti aunike zamankhwala amuzolengedwa, zomwe akuti zimawonongeka m'kaundula, koma pambuyo pake zidatumizidwanso mozizwitsa m'khadi ndi kaundula yemweyo. Pa iye pali shuga 14.8.

Kusanthula kudutsa:
C-peptide - 1.16 ng / ml (yachilendo 0.5 - 3.2 ng / ml),
glycated hemoglobin 12,6%.

The endocrinologist imazindikira mtundu 2 wa matenda ashuga, mankhwala a metformin. Ndimamwa glucophage 1000 kawiri pa tsiku, piritsi limodzi. Palibe kukaikira kuti awa ndi matenda amtundu wa 2 shuga.

Chifukwa cha chakudya chamafuta ochepa, shuga adachepetsedwa pamimba yopanda 5.7 mmol / L. Koma atatha kadzutsa, amadzutsa 2 unit. Chakudya cham'mawa: 50 g ya avocado (malingana ndi tebulo la chakudya) ndi 4.5 g), 80 g la tchizi tchizi (4 g yamafuta), dzira lomwe limakhala ndi supuni ya salon caviar, 30 g ya tchizi cholimba.

Panthawi ya nkhomaliro zinthu sizinkadziwika. Asanadye shuga 5.1. Chakudya chamasana: msuzi wamasamba 300 g (kabichi ndi zukini pamsuzi wa nkhuku), ng'ombe kuwaza 100 g Pambuyo maola 2, shuga 7.8, patatha maola anayi - 8.9. Ndipo atatha maola asanu ndi limodzi adagwera 6.8.Kodi vuto ndi chiyani? Kodi kabichi idapereka shuga?

Mafunso ochepa.
1. Ngati mungathe kusunga shuga pamlingo wa 5 mmol / l, ndiye kuti mukubayirabe insulin?
2. Momwe mungadziwire mtundu wa shuga? Ndi mayeso ati oti adutsemo? Kodi ma antibodies kupita ku cell za beta?

Kapena kudya kwa masiku 10 - izi ndi zotulukapo zake, ndiye kuti shuga mwangotsika insulin yokha?
Tithokoze yankho!

Palibe kukaikira kuti awa ndi matenda amtundu wa 2 shuga.

Ngati mungathe kusunga shuga pamlingo wa 5 mmol / L, ndiye kuti mukubayirabe insulin?

Sizokayikitsa kuti mudzatha kusunga zizindikirozo mutatha kudya komanso m'mawa pamimba yopanda jakisoni wa insulin.

Ndi mayeso ati oti adutsemo? Kodi ma antibodies kupita ku cell za beta?

Ndikamalankhula kwambiri ndi odwala, ndimakhala wotsimikiza kuti mayeserowa sakupindulira kwenikweni.

Tsatirani zakudya kwambiri. Pangani kuyeza shuga ndi glucometer. Ngati ndi kotheka, jekeseni insulin pang'ono, monga tafotokozera m'nkhaniyi. Tsatirani malamulo osungira insulin. Ndalama zowonjezera zimagwiritsidwa ntchito bwino pazoyesa za mita.

Masana abwino Ndinakumana ndi tsamba lanu (ndinayenera kudziwa :)) pafupifupi chaka chapitacho. Pazithunzi zingapo. Mu 2013, ali ndi pakati, ал adalumpha 'shuga. Insulin sanatchulidwe - madokotala adakhulupirira kuti zonse zidzabwereranso pambuyo pobadwa. Pakutha kwa pakati, atotchi scotoma inaonekera. Pa milungu 38 - cesarean. Pambuyo pa opareshoni, mkhalidwe sunali wabwino kwambiri - zovuta zamagazi zinali zambiri motero sizinakhalepo ndi shuga. Pambuyo pa miyezi 7, kuyesa kwa glucose kunachitika - 9.8 pambuyo pa maola awiri. Adazindikira matenda a prediabetes. Chotsatira chinali chaka cha mitundu yonse ya mayeso. Ndiye nthabwala ndipo pambuyo pokhazikika shuga wambiri. Ndidayesa mwanjira inayake nditadya ndulu - ndipo ndi 14.7 :(. Kuyesedwa - glycated hemoglobin 7.2%, glucose othamanga 10.1, C-peptide 0.8, insulini 2.7. Dotolo adaika fret. Magawo awiri a insulin yausiku. Kenako ndinachita mantha kwambiri, ndinatsegula tsamba lanu ndikumapita! Tsopano ndikusala kudya shuga 5.2-5.7, glycated hemoglobin 5.9%. Komabe sindingasankhebe za insulin. - Zaka 1.8 zapita.kapena vutoli ndi losiyana ndipo matenda ashuga apita. Ndipo thanzi lathu lonse likhala bwino. Nowa zikomo chifukwa malo anu. Ndipo zotsatira 100%. Nthawi zina uyenera kukhala ndi kuyesa ndi 0,5 teaspoons phala ndi zina chakudya, wokonzedwera kwa mwanayo.

Sindingathe kusankha insulin

Muli ndi matenda a autoimmune omwe sangachokere mpaka mtundu watsopano wa mankhwala utawonekere. Zikuwonekeratu. Chifukwa chake, insulin imayenera kuyilowetsedwa pang'onopang'ono.

Zikomo, Sergey!
Tidalankhula ndi endocrinologist wina, kukayikira kudatsimikiziridwa, ndili ndi LADA.
Levemir adayamba kubaya kawiri patsiku, m'mawa 1 IU, usiku 0.5 IU. Koma m'mawa pamimba yopanda kanthu komanso popanda Levemir, mogwirizana ndi zakudya, shuga samakwera pamwamba 5 mmol / l. Ngati usiku ndimatsika 0,5 IU wa Levemir, ndiye pamimba yopanda 3.8 mmol. Funso nlakuti, kodi ndizomveka kumumenya Levimir usiku?
Chakudya chimalipira Ultra-yochepa insulin NovoRapid.

Funso nlakuti, kodi ndizomveka kumumenya Levimir usiku?

Ndi shuga wamagazi anu osonyezedwa, simuyenera jekeseni Levemir usiku wonse.

Mwinanso, zidzafunikira pakapita nthawi, chifukwa shuga m'mawa pamimba yopanda kanthu imakula.

Masana abwino Agogo anga aamuna (a zaka 78, kutalika kwa 150 cm, kulemera kwa makilogalamu 50) adapezeka ndi matenda ashuga koyamba sabata ziwiri zapitazo. Glycated hemoglobin 12,6%, shuga m'magazi 18, glucose mu mkodzo 28, c-peptide ndiyachilendo, kuyesa kwa chiwindi ndikwabwinobwino. Mbale ndi wodwala matenda ashuga omwe wadulidwa mwendo. Endocrinologist adamupatsa mtundu wachiwiri wa matenda ashuga, mapiritsi a sulfonylurea komanso kudya moyenera. Ndinkamwa mapiritsi kwa sabata limodzi. Kenako ndidapita kutsamba lanu - ndipo tidathetsa mapiritsiwo, ndikugula glucometer, ndikukhala pachakudya chamafuta ochepa. Pakadali pano, sabata limodzi lokha ladutsa. Mwazi wamagazi 5.5 - 6.5 mmol. Kodi ndimatenda amtundu wanji? LADA kapena mtundu umodzi? M'mimba yopanda kanthu m'mawa, monga m'nkhani yanu, agogo anga alibe chochitika m'mawa. Kodi mukufunikira insulin yowonjezera?

Kodi ndimatenda amtundu wanji? LADA kapena mtundu umodzi?

Izi zili chimodzimodzi ndi inu.

Zimatengera shuga m'mawa pamimba yopanda kanthu komanso maola awiri mutatha kudya, komanso chidwi cha wodwalayo.

Moni Sergey. Zikomo kwambiri popanga tsamba loyenerera. Ndili ndi zaka 69. Ndinapezeka kuti ndili ndi matenda ashuga mu 2006, matenda ashuga 2.Shuga siwokwera kwambiri, Glick. grmogmobin 6.5-7.0% Sindimamwa konse ayi. Chizindikiro chikakwera, ndimalimbitsa chakudya changa. Koma, posachedwa, glitch. hemoglobin inayamba kukula, koma adotolo sanandipatse mankhwala, chifukwa akudziwa kuti ndili ndi malingaliro olakwika kwa iwo.koma ndidayamba kufunafuna momwe ndingapherere shuga. Mwangozi ndidapita patsamba lanu, ndipo pomwepo ndidazindikira kuti ndikuzifuna, ndidayamba kutsatira zomwe mwatsimikiza, ndipo shuga adayamba kukhala wabwinobwino. Pazonse zomwe ndadwala matenda ashuga, Zizindikiro zanga sizinafotokozedwe, Kulemera kwanga ndi 60-62 kg., Ndi kutalika kwa masentimita 160. Ndikulemberani ndemanga kangapo, koma simunalandire mayankho. Ndipo ndimawerenga ndemanga za anthu ena ndi mayankho anu. Ndipo apa ndidazindikira kuti pali mtundu wina wa matenda ashuga, LADA, ndipo zizindikiro zake ndizofanana ndi zanga. Ndimakhala ku Germany. Dokotala wanga ndi wodwala matenda ashuga wokhala ndi mbiri yayitali yantchito, ndipo amawoneka ngati dokotala wabwino .. Nthawi yotsiriza yomwe ndinakhala naye anali pakati pa Disembala, adandiyamika kwambiri, tsiku lomwelo ndinali ndi glyc.Hemoglobin anali 6.1 (wabwinobwino ku Germany 4.1 - 6.2). Ndidati ndili ndi zizindikiro za LADA ndikuti ndifunika kupaka jakisoni (ndidamuwonetsa zambiri za LADA yaku Germany, yomwe imanenanso za insulin). Ananenanso kuti 5-8% okha ndi omwe ali ndi LADA. Ndidapempha kuti andiyesere magazi a C-Peptide ndi antibody (GAD, ICA), adavomera, ndipo tsiku lomwelo ndidachita mayeso awa. Masiku angapo apitawa ndidakumananso ndi phwando, ndipo yankho kuchokera pamayeso awa linali C - PEPTID 1.45 (chizolowezi 1.00 - 4.00), GAD GLUTAMATDECARBOX - 52.2 (chizolowezi -

Moni, moni. Zikomo chifukwa cha zolemba zanu, zothandiza kwambiri. Koma zambiri sizimveka. Ndine wazaka 62, wocheperako .kuwonjezeka kwa 1.60 / 56kg. (asanafike matenda ashuga, adalinso owonda 56-60) Ndadwala kwa zaka pafupifupi 20, ndikulipiritsa matenda ashuga a 2, nthawi yomweyo, madotolo adatsimikiza ndikumwa shuga 60. Adayikira zakudya zopanda mafuta, adayesetsa kudya shuga, zotchulidwa 12-14XE ndipo sanadye mafuta aliwonse, sanachiritsidwe. Sizinalowetse insulin. Ndili ndi chakudya chochepa cha carb kwa mwezi umodzi. 2-4XE, ndikumva bwino, ndiri ndi thanzi labwino. Ndikukhala ndi kulemera pang'ono, monga momwe zimakhalira 58 (zikundikwanira) Koma ndimamwa shuga. Masana ndiye kuti shuga ndi -5-5.5. Koma m'mawa pamimba yopanda kanthu imakhazikika 6,6,5. Mwina ndili ndi matenda a shuga a Lada? Kupatula apo, ndine wochepa thupi ndipo palibe kulemera kowonjezera, koma mosemphanitsa. Zaka 20 zakale pamapiritsi ndipo mwina "zibzalidwe" zimayatsidwa pamoto. chitsulo choti uchite? Kodi ndizomveka kusinthira ku insulin? Kapena zakudya zosanja shuga? Sindinayesere kumwa osati theka, koma theka la ashuga, shuga pamwamba pazitsulo.6-7 (nditatha kudya) Ndiyenera kuchita chiyani? Momwe mungayesere mayeso a c-peptyl ndi insulin, kenako lingalirani za insulin. Kodi ndikalangize pati? Ndikuyembekezera mwachidwi uphungu wanu. Chonde yankhani, pazifukwa zina, sindinalandire yankho koyambirira.

Mwamuna wake ali ndi zaka 40, kutalika190, kulemera kwa 92. Asanachitike opareshoni, adayesa kudya shuga kuchokera mu mtsempha wa 6.8, cholesterol-5.9, HDL-1.06, LDL-3.8, triglycerides-2.28, kuchuluka kwa bilirubin. Anadutsa glycolysis.hem-n-6.5. Tsopano kuyesa kudya zakudya zotsika pang'ono. Kuthamanga shuga kuyambira 5.5 mpaka 6.1. Mutatha kudya kuyambira 5–3 mpaka 6.5. Kodi ndi matenda a shuga a LADA kapena prediabetes? Ndi mayeso enanso ati omwe amafunikira kudutsidwa?

Moni Upangiri wanu ndi wofunikira kwambiri, chifukwa palibe chiyembekezo kwa madotolo am'deralo, ndipo palibe pabwino.

Zathu: amalume anga ali ndi zaka 75, kutalika 165, onenepa kwambiri palibe gramu, yopyapyala. Amadwala matenda ashuga kuyambira chaka cha 99. Tsopano, atapita kuchipatala, adapezeka kuti ali ndi matenda a shuga a 2 (mutawerenga nkhani zanu zambiri, ndikukayika kwambiri kuti izi ndi mtundu wa 2, makamaka Lada, sichoncho? Amakhala wowonda popanda kulemera kwambiri), ndipo pokhapokha adalembedwa jekeseni wa "Farmasulin HNP" - n / mayunitsi 16, n / a 6 (monga kwalembedwa patsamba lantchito). Panthawi yopita kuchipatala, shuga anali ndi 17, ndiye kuti adachepetsedwa.
KOMA - pali mulu wonse wamavuto. Ena mwa iwo: matenda a shuga a nephropathy ndi neuropathy, hr. pyelonephritis ndi kapamba, colitis. Chithokomiro chotupa chimakulitsidwa pang'ono = kupukusa goiter, mavuto ena a mtima.
Moona mtima, palibe madokotala omwe amaganizira izi ....
Aliyense akungoyesera kuti abweretse kuthamanga kwambiri kwa 180/80 (kugunda kwa mtima

60), yomwe ndi yokhazikika.
Kupanikizika kwachulukitsidwa koposa chaka chimodzi, panali ma microstrokes 1 kapena 2 nthawi.
Ndikumvetsetsa kuti ziwerengero zoterezi zimalankhula za Isolated Systolic Hypertension, koma palibe amene amalabadira izi - Bisoprolol ndi Ebrantil adalembedwa - kuweruza malangizowa, ali otsutsana kwathunthu pamenepa.

Ngakhale Coprenes 8 / 2,5 (1t / d), Lerkamen 20 mg (1t / d), Moksogama 0.4 (2t / d) - onse mankhwalawa amatchulidwa muyezo waukulu.
Kapena (posankha zathu) Triplexam 10 / 2.5 / 10 m'malo mwa Coprenes + Lerkamen - ngati izi sizothandiza (koma ngati mungayang'ane momwe akupangidwira, ndiye kuti zonse ndi zofanana ...)
Dialipon ina 300 (2t / d) yochepetsa shuga - ndikufunika?

Ndayamba kale kugwiritsa ntchito intaneti yonse, ndipo, momwe ndikumvera, palibe mwanjira iliyonse mankhwalawa (mwina, kupatula Moksogama?) Ndiwothandiza pachipatala cha matenda oopsa - muyenera kungochepetsa kuthamanga kwa magazi a Systolic, osakhudza Diastolic ndi kugunda ...

Chifukwa chake, NDIKUfunsani kuti mupereke malingaliro ena amomwe mungachite ndi zonsezi!
Zachidziwikire, sitidzathamangira ku pharmacy kuti ndikagule chilichonse nthawi imodzi - motsimikizika, tiyesa kufunsa madokotala, koma tikufuna mayina azamankhwala omwe angakhale othandiza kwambiri kuposa omwe atchulidwa pamwambapa, mankhwala omwe angaganiziridwebe!
Kodi pali mankhwala ena oteteza impso? - mayesowo ndi oyipa ...
Zachidziwikire, "timakhala" amalume pazakudya kwambiri, koma ndizovuta - zovuta kwambiri .. Koma timayesetsa.

MUZIPEMBEDZA MOSAKHALA NDI THANDIZO Lanu. (zotheka ndi imelo)

Moni. Ndikufuna thandizo lanu. Matenda a gestational adayikidwa mu mimba yoyamba komanso yachiwiri. Chiyeso chololera glucose sichinachitike. Mimba yoyamba nditapereka shuga pamimba yopanda kanthu kamodzi ndi chizolowezi ndipo sindinadandaule ndikudya zakudya zonse. Mimba yachiwiri, shuga akusala anali 6 mmol / L. The endocrinologist adalangiza kudya zochepa zotsekemera ndipo ndizo. Kugona kuchipatala shuga amatengedwa katatu patsiku. Zinali zabwinobwino (4.6-5.8). Panali zovuta ndi chithokomiro. Anaona Eutiroks. Tsopano zabwinobwino. Pa tsiku lachitatu pambuyo pobadwa, shuga wosala ndi 6 mmol / L, atatha kudya 7 mmol / L. Adalangiza kudya. Kenako adapereka shuga m'mwezi umodzi pamimba yopanda kanthu komanso m'miyezi itatu. Zinali zabwinobwino. Ndinali wotsimikiza kuti zonse zili bwino. Mwezi watha, ndidaphunzira za kusanthula kwa glycosylated hemoglobin. Kusanthula kunawonetsa 6.02. Anayamba kuyeza shuga ndi glucometer asanadye komanso maola awiri atatha kudya. Nthawi zonse ankawonetsa zikhalidwe. Koma nditayeza ola limodzi nditatha kudya phala la buckwheat, glucometer adawonetsa 7.3, ndipo patatha maola awiri 5.5. Ndikanapitilizabe kuyeza pambuyo maola awiri, ndikutsimikiza kuti zonse zili mu dongosolo. The endocrinologist adati ngakhale atadzuka atangodya, chinthu chachikulu ndikuti maola awiri atatha kudya pansipa 6.1. Ndapeza tsamba lanu ndipo ndakhala ndikudya chakudya chochepa chamafuta kwa milungu iwiri tsopano. Shuga pambuyo pa ola limodzi osaposa 5.8, pambuyo maola awiri nthawi zambiri 5.3 -5.5. Ndidawerenga nkhani ya LADA ndipo ndidachita mantha kwambiri. Ndili ndi thupi loonda. C-peptide inayesedwa kwa 1.22 NG / ml pamlingo wa 1.1 -4.4 ng / ml. Glycosylated hemoglobin 5.8%. Kuthamanga shuga 4.5 mmol / L. Chonde thandizirani. Kodi ndi LADA kapena matenda ashuga? Kodi ndidzangokhala ndi chakudya chamafuta ochepa? Ngati sichoncho, momwe mungawerengere kuchuluka kwa insulini, ngati shuga ndichabwinobwino?

Moni Sergey. Ndakulembera kuti ndili ndi LADA. Ndikufuna kukambirana ndi inu. Sabata yatha ndidakhala ndi wazachipatala wodwala matenda ashuga .Tsikulo, pamimba yopanda kanthu, ndinali ndi shuga 89 mg / dl., Kwa chakudya cham'mawa ndidadya mazira okhazikika (mazira awiri + kirimu pang'ono), kabichi. magawo a tchizi ndi batala Patatha maola awiri, dokotala anali ndi 92mg / dl, ndi glycirs. hemoglobin-6.1%. Nditamufunsa za insulin, iye anati ayi. Ndidamuwuza kuyeza shuga kasanu patsiku, tsiku limodzi pa sabata, komanso masabata 4, kuti ndibwere kwa iye mwezi umodzi ndizotsatira zake. Ndidamuuza kuti shuga ikhoza kuwonjezereka, koma ndimayesetsa kudya magawo ang'onoang'ono kuti shuga azikhala ochepa, ndipo ndikufuna kudya, makamaka madzulo, kuti tikadye chakudya chamadzulo. Nthawi zambiri (maola 18) pamakhala shuga wowonjezera 135-140. Adanenanso kuti ndiyenera kudya zopatsa thanzi, ndikuyang'ananso zidindo. Madzulo ndidadya msuzi wamasamba ndi mkate umodzi wochepa thupi wa mkate wa mapuloteni (pa 100g. Yogulitsa chakudya cha 7.5g., Shuga 0,9g. Mapulogalamu 22g.) Ndi batala, ndipo sindinali odzaza. Ndipo pambuyo 2 maola 136mg7dl. Ndipo musanagone, maola 22.30 - 113 mg / dl. Kodi mungayankhe bwanji pamawu? Kodi ndichifukwa chiyani pali shuga wamkulu pakudya kwamadzulo? Ndikulakwitsa pati ?. Tsiku lotsatira ndinadya pafupifupi zomwezo, koma zowona zinali zosiyana, komanso ndi mafuta ochepa, ndipo zisonyezo zinali zokulirapo tsiku lonse. Chifukwa chiyani? Wokondedwa Sergey, zikomo, mwaulemu, Rita.

Masana abwino Chonde ndiuzeni ngati mumzinda wathu samayesa ma antibodies a cell beta kuti adziwe mtundu wa matenda ashuga, kodi C - peptide yokwanira?

Moni, Sergey. Mwezi watha, mwamwayi, ndi thanzi labwino kwambiri, shuga 7.0 adapezeka. Kupsinjika komanso pakatha sabata 12.4. Ndine 58l, kutalika 164cm, kulemera kwa 64kg.Ndili ndi moyo wabwino (Yoga, kusinkhasinkha), sindinadye nyama kwa zaka 10. Ndipo pomwepo chizindikiritso ndi matenda a shuga a 2. Metamorphine adalembedwa. Ndinayamba kuwerenga za matenda ashuga patsambalo lanu, kudya zakudya, shuga adatsikira 6.5-7 pamimba yopanda kanthu, chimodzimodzi atatha kudya nditatha maola awiri. Sindinadziwe kuchuluka kwa mafuta ochulukirapo pano, koma ndikufuna kudya nthawi zonse. Ndimadya zololedwa zokha, sindingathe kudya nyama, ndimazisakaniza ndi nsomba. Zidutsa mayeso
C-peptide-0.848 ng / ml, antibodies to glutamic acid decarboxylase-1881 (pafupipafupi kuposa 10), insulin 2.34 IU / L, HbA1-8.04%. Ndidayendera ma endocrinologists enanso atatu, sindingathe kutsimikizira chilichonse. Amayika mtundu wachiwiri wokha. Dzulo, dokotala wabwino kwambiri (malinga ndi ndemanga) ku Odessa adayambitsa Dimaril.
Matenda a shuga samadziwika kuti alipo.
Funso ndilakuti, kuchuluka kwa Lantus kapena Levemir kuyenera kuyambira kutengera kusanthula kwanga. Ma syringe omwe ali ndi fission yochepa tsopano akhoza kugulidwa ku Ukraine popanda mavuto. Kapenanso pitilizani kudya, yesani kukonza zotsatirazo. Ndi burashi
-TTG-2.79 μmU / ml
St. T4-1.04ng / dl
AT ku TPO-2765.88 IU / ml. Cefasel Wosankhidwa 100. Zomwe mungachite ndi izi, tengani. Zikomo chifukwa cha ntchito yanu. Inde, kangapo ndidayesa kuphika, palibe chomwe chimabwera makalata.

Moni Ndikhala 66 mu June. 165 cm. Weight-64. Mu 2009 adakumana ndi vuto la mtima lotsatiridwa ndi CABG. Pambuyo pa opaleshoni, panthawi yotsata magazi, adawulula shuga wokwera, adapereka CD-2, adapita kuchipatala ku Krasnodar zaka zingapo zapitazo, adalipiritsa shuga m'mawa kuyambira 5.3 mpaka 7.0, mutatha kudya mpaka 7.8, madzulo kuyambira 6.0- mpaka 6.8
Palibe mavuto ena alionse a mtima (ndimatenga concor, prestarium ndi rosucard kuti muchepetse cholesterol). Adali wokonda kwambiri, motero adasiya ntchito, adayamba kutopa ndikudumphira shuga, ndimayamba kuchita mantha. Koma ndidakumana ndi tsamba lanu ndipo ndidakwiya. Zikhala kuti m'mbali zonse ndili ndi Lada, ndipo nthawi yonseyi sindinangomuthandiza, komanso kuwononga ndi galvus ndi metformin? Ndiuzeni chonde? Mu chipatalachi, ma endocrinologists amasintha ngati magolovu, koma kodi aliyense amavala mtundu wachiwiri? Ndimakhala ku Anapa.

Moni, Sergey. Ndine 58 l, kutalika 164 masentimita, kulemera kwa 63 kg. Zodabwitsa ndizakuti, ndili ndi thanzi labwino kwambiri, mu Marichi 2016, shuga wamagazi a 7.03 adapezeka. Pambuyo pa sabata, 12.5 (kupsinjika) .. tidapezeka kuti tili ndi matenda a shuga 2. Ndinayesa HbA1-8.04%, insulin 2.34ME / L, C-peptide 0.848NG / ML, antibodies to glutamic acid decarboxylase-1881. (Ndidaziyambitsa ndekha nditayambitsa tsamba lanu). Ndinatsimikiza kuti Lada ndi matenda a shuga. Koma mmodzi mwa endocrinologists abwino kwambiri a Odessa nthawi yomweyo adanditsimikizira kuti uwu ndi mtundu wachiwiri ndikuyika Dimaril. Tsopano pakudya, m'mawa m'mimba yopanda kanthu, shuga ndi 6.1-7.0, masana ndi magawo ang'onoang'ono mkati mwa malire awa. Koma nthawi yonse yomwe ndikufuna kudya. (Wamasamba wazaka 10, pomwe ndimayesetsa kuchita popanda nyama) Ngati madzulo ndimachulukitsa voliyumu, m'mawa shuga-7.6. Ndikumvetsetsa kuti ndikofunikira kusinthira ku insulin. Koma sindingathe kuzidziwa. Ku Odessa kuli Lantus kokha, Levemir ikhoza kupezeka kuchokera ku Kiev. Lantus ndi wotsika mtengo. Koma ma phukusili ali ma cartridge, ndi cholembera. 100ED / ml, 3ml, 5 *. Ndawerenga mosamala mitu yonse ya ma syringe, etc., komabe sindimamvetsetsa. Kodi njira iyi ndiyabwino kwa ine?
Ndikuganiza kuti tikuyenera kuyamba 1U. m'mawa, ngati m'mimba mulibe kanthu, ndiye kuti nthawi yamadzulo. Kodi ndikumvetsetsa bwino. Ndi burashi
- TTG-2.79 μMU / ml, St. T4-1.04 NG / dL, AT to TPO-antibody-2765.88 IU / ml. Cefasel (100) woperekedwa kawiri pa tsiku. Vomerezani kapena ayi. Zikomo patsogolo

Moni Sergey! Zikomo chifukwa chatsambali. Chifukwa cha chidziwitso ichi, pamapeto pake ndidayamba mayeso. Kangapo ndinayesa shuga pamimba yopanda kanthu zaka 10 zapitazo - idakulitsidwa, koma pang'ono. Wothandizira adati palibe chifukwa chodera nkhawa, tsopano aliyense ali nazo. Tsopano Zizindikiro zili zomveka, ndipo kale, mwatsoka, zimayambitsa autonomic neuropathy (gawo lonse la m'mimba ndi mavuto: kuyambira esophageal spasm ndi gastroparesis - chakudya m'mimba 9 maola atatha kudya pa FGDS, ndikutha ndi rectum, adayesedwa ngakhale kwa Hirschsprung). Popeza sinditha kugwira ntchito, ndimadya chakudya chapadera chamadzimadzi. Palibe amene anaganiza kuti ayang'anire shuga momwe ayenera, kapena mwina muzu wa choyipacho.Dzulo ndidapambana mayeserowo ndipo sindingathe kumasulira molondola, sichili bwino, endocrinologist yandibwera ndipo sizowona kuti ndi zabwino, koma nthawi ikusewera monditsutsa.
Ndikukhulupirira kuti muthandizanso kumvetsetsa zomwe zidachitika ndikupitiliza mayeso molondola pamaso pa dokotala kuti musataye nthawi ndi moyo.
Ndine 39, kutalika 163 masentimita, kulemera kwa 45 kg. Mtundu wachiwiri wa matenda a shuga sugwira ntchito, wakhala wowonda nthawi zonse.
Mahomoni a chithokomiro ankakhala abwinobwino kale, tsopano sindikudziwa, ndikutenga, koma zikuwoneka ngati hyperthyroidism.
Estradiol imawoneka kuti ndi matenda osokoneza bongo, koma sindine woyembekezera, ambiri cysts ya ovari amapatsa. Mwinanso ichi ndi chifukwa chake, ndifufuzidwa pamutuwu kuti ndikwaniritse zomwe zimayambitsa.
C-peptide glucose kulolerana mayeso, + estradiol.
Kuphatikiza apo iye anayeza ndi glucometer, monga momwe mudalangizira - glucometer ndi yolondola, kusiyana kwa ma labotale ndi 0.0-0.2.
Glucose (fluoride) - pamimba yopanda kanthu - 3.9 mmol / l - zamakhalidwe abwino 4.9-5.9
(glucometer - asanayambe - 3,9 mmol / l
glucometer - atatha kumwa ga 75 ga shuga wawonetsa kuwonjezeka pang'onopang'ono
mita - nsonga pambuyo ola limodzi - 12.9, kenako kutsika pang'onopang'ono)
C-peptide - pamimba yopanda kanthu - 347 pmol / l - mfundo zabwinobwino 370-1470
Glucose (fluoride) - itatha mphindi 120 - 9.6 mmol / L - 11.1 - DM
(glucometer - pambuyo pa mphindi 120 - 9.4)
C-peptide - itatha mphindi 120 - 3598 pmol / L (osati cholakwika!) - mfundo zabwino 370-1470
Estradiol - masiku 35 ozungulira - 597.8 pg / ml - gawo luteal - 43.8-211.0

Chonde thandizirani kuyendayenda, komwe mungayang'ane. Musaganize kuti ndikukuimbani mlandu pachilichonse, ndikhulupirira kuti kudziwa kwanu komanso kutha kusanthula (abambo ndi omwe angathe izi), ndidzadzipangira ndekha.
Pepani kukhala motalika.
Mulungu atakupatseni thanzi.

Masana abwino, ndili ndi zaka 24, wolemera makilogalamu 60 (ndinataya kilogalamu 8 pachaka chatha chifukwa chasewera masewera), Kukula kunali 176. Ndinayesedwa, koma sindinaphumelele mayeso theka ndipo ndinapeza kuti ndalipira. glycated hemoglobin 6.3%, shuga 7.0, c-peptide 0.74 ndi wabwinobwino 0.81.-3.85. Kuzindikira kwalembedwa pansi pafunso la 1 shuga? matenda a shuga? kulekerera chakudya chamoto? kusala kudya glycemia? ndipo adatumizidwa kuti atenge anti-gad ndi ma insulin antibodies ndi mayeso okhalitsa a glucose. Koma ngakhale kulibe ndalama zoyeserera, ndidaganiza zokulembera. Shuga ali ndi zaka pafupifupi 5 pamimba yopanda kanthu kuyambira 6.0 mpaka 6.8 masana mutadya chakudya, pambuyo pa maola 2 amatha kutsika mpaka 5.5 (kawirikawiri nthawi zambiri 6.0-6-4). Pambuyo pa mgonero, 7.8 (sanawukenso pamwamba pa 7.8) m'mawa kachiwiri, 6.8. Mungalangize chiyani? Ndipo kodi nditha kudzizindikira nditatha kuyesa mayeso ndikuyamba kudzipanga mwanjira ina? Chifukwa ndimakhala m'mudzi ndipo ndikupita kuchipatala ndiye mwayi woti ndidikire miyezi inayi. Ndipo dotolo wakomweyu sakudziwa kuti shuga ya Lada ndi chiyani ndipo sakhulupirira kuti iliko, ndichifukwa chake palibe mtima wofuna kuyankhulana naye. Ndingakonde kwambiri malangizowo. Mwa njira, ndimatsatira zakudya kwa miyezi isanu ndi umodzi kale yomwe muli nayo patsambalo koma shuga samasintha kwenikweni pa tchuthi chokha).

Masana abwino, ndili ndi zaka 24, wolemera makilogalamu 60 (ndinataya kilogalamu 8 pachaka chatha chifukwa chasewera masewera), Kukula kunali 176. Ndinayesedwa, koma sindinaphumelele mayeso theka ndipo ndinapeza kuti ndalipira. glycated hemoglobin 6.3%, shuga 7.0, c-peptide 0.74 ndi wabwinobwino 0.81.-3.85. Kuzindikira kwalembedwa pansi pafunso la 1 shuga? matenda a shuga? kulekerera chakudya chamoto? kusala kudya glycemia? ndipo adatumizidwa kuti atenge anti-gad ndi ma insulin antibodies ndi mayeso okhalitsa a glucose. Koma ngakhale kulibe ndalama zoyeserera, ndidaganiza zokulembera. Shuga ali ndi zaka pafupifupi 5 pamimba yopanda kanthu kuyambira 6.0 mpaka 6.8 masana mutadya chakudya, pambuyo pa maola 2 amatha kutsika mpaka 5.5 (kawirikawiri nthawi zambiri 6.0-6-4). Pambuyo pa mgonero, 7.8 (sanawukenso pamwamba pa 7.8) m'mawa kachiwiri, 6.8. Mungalangize chiyani? Ndipo kodi nditha kudzizindikira nditatha kuyesa mayeso ndikuyamba kudzipanga mwanjira ina? Chifukwa ndimakhala m'mudzi ndipo ndikupita kuchipatala ndiye mwayi woti ndidikire miyezi inayi. Ndipo dotolo wakomweyu sakudziwa kuti shuga ya Lada ndi chiyani ndipo sakhulupirira kuti iliko, ndichifukwa chake palibe mtima wofuna kuyankhulana naye. Ndingakonde kwambiri malangizowo. Mwa njira, ndimatsatira zakudya pafupifupi miyezi isanu ndi umodzi kale yomwe muli nayo patsambalo koma shuga samasintha kwenikweni pakakhala tchuthi chokha).

Masana abwino
Sergey, chonde ndithandizeni kudziwa ngati mayi anga apezeka molondola.
Wazaka 64, 182 cm, chakudya chisanachitike makilogalamu 86, nthawi zambiri chimawoneka chochepa, koma ndi mafuta am'mimba. Hypertension, tachycardia, miyezi isanu ndi umodzi yapitayo, kupuma movutikira ndi ludzu zinaonekera.
Kuyambira Meyi, adayamba kuyesa, kusala kudya:
1. 9.7 ndi shuga mumkodzo, wothandizira adatsimikiza Diabeteson (sizinatenge)
2.2.2 (atatha kudya chamafuta ochepa).
3. 10 (ndi mita ya shuga ndi namwino).
4.Kwatani. hemoglobin 5.41% (Sinevo, ndikukayika zolondola)
Mayeso a kulolera kwa glucose: 7.04 => 12.79 => 12.95 (izi zisanachitike masiku atatu osadya popanda kukakamira kwa endocrinologist), shuga mu mkodzo sanapezeke, creatinine m'magazi 57.3 (Ref.zn. 44-80).
TSH ndizabwinobwino, (T3 ndi T4 ndi zaulere. Palibe dokotala wanena).

Anayamba kutenga mankhwala azitsamba "Sadifit", zakudya zapamwamba kwambiri za carb + maphunziro owoneka bwino kuti akhale athanzi. Sabata yatha ndidagulira mayi anga gluceter, ndikayifufuze, monga mukulangizira patsamba. Kuthamanga shuga kudatsikira

5.4, ​​ndi maola awiri mutadya chakudya chamadzulo

5.9. Kupuma pang'ono kunayamba kutha, tachycardia imatha, palibe mavuto apadera amtima (owunika). Anawonjezera masewera olimbitsa thupi. Dzulo, shuga maola 2 mutatha kudya ndi masewera olimbitsa thupi - 4.5 (Hurray!)
Lero m'mawa adapereka mayeso:
Kusala shuga - 6.0 (Ref. 4.1-6) - anali wamanjenje / wamantha panthawi yoperekera, glucometer wake adawonetsa 6.4
Glik. hemogl. - 5.9% (4.8-5.9%)
C-peptide 1.42 (0.81-3.85)
C-yogwira mapuloteni

Masana abwino, ndili ndi zaka 50, kutalika kwa 158 masentimita, kulemera kwa 50 makilogalamu, mu Januware 2015 ndinapezeka kuti ndine matenda a shuga 2, mapiritsi a Glucofage, kumwa pang'ono, ndinayamba kuchepa thupi. Nditayesa mayeso a hemoglobin wa glycated ndi c-peptide, anandipeza ndi matenda ashuga amtundu 1, Apydra ali ndi XE ndi Lantus usiku kwa mayeso 6. Ndinaganiza zoyesa zakudya zamagulu ochepa. Lantus 6ed yekha ndi amene anayamba kubaya. Masabata awiri SK anali mgulu la 4.0-7.0. Ndimachita masewera olimbitsa thupi m'mawa uliwonse, ndimasambira m'mawa ndi madzulo. Masiku atatu omaliza, SK idayamba kuchuluka 8.0-9.0. Ndimadya nyama, nsomba, mazira, masamba. Palibe china. Kodi chifukwa chomwe akuwonjezerawa ndi chiani?

Masana abwino Ndine wazaka 30, kutalika 156 masentimita, kulemera 60kg, miyezi 8 yapitayo ndidapezeka kuti ndili ndi matenda a chithokomiro cha matenda a chithokomiro komanso matenda a shuga a MODI, kodi ndi chimodzimodzi ndi LADA? Anatinso pali mitundu isanu ndi itatu ya matenda a shuga a MODI, amodzi mwa majini asanu ndi atatuwo, ndipo wina atha kunena kuti munthu samakonda mu “kagawidwe” ka majini. Nthawi yomweyo amasinthira ku chakudya chamafuta ochepa, kuchepa thupi, kutupa, kutopa, kukumbukira bwino, komanso mwayi wokhazikika. Siofor-850 anali kutumikiridwa kawiri patsiku ndipo Eutiroks 50mkg patsiku, Siofor sanagwirizane ndi thupi langa (kulimbikira kutsegula m'mimba, kusanza komanso kusanza), ndikusinthidwa ndi Glucophage miyezi iwiri pambuyo pake, zomwezo zimayambira, kotero sindimwa mapiritsi tsopano. Ndinali ndi ludzu lochokera ku kalasi yoyamba, kulimbikitsa kukodza kudawoneka ndili ndi zaka 11, ndikupitabe pansi, ndikufika poti ndingagone kuntchito, panali "chifunga" m'mutu mwanga, ngati kuti kulibe nzeru zotsalira, kukumbukira kuli ngati 90- mkulu wa chilimwe, chabwino, "zithumwa" zotsala za shuga. Funso langa ndiloti - panthawi yomwe ndidapezeka ndi matenda ashuga - khungu limadetsedwa, mawonekedwe amaso anali onyansa, ndipo zikondwerero, mawonekedwe ndi khosi zidali zakuda (!), Zidapezeka chifukwa cha insulin yayitali, shuga osala anali 7, 2, patatha maola awiri atachita masewera olimbitsa thupi 16. Amakhala kuti zaka zonsezi za chitukuko cha matenda a shuga, koma popanda chithandizo chake, katemera wa insulin adalimbikira. Chifukwa chiyani? Kodi ndili ndi matenda ashuga otani?

Masana abwino, Sergey!
Chonde ndiuzeni, ndili ndi zaka 30, a Paul M.
Kuyambira pa chiyambi, matenda a uritisaria amawonekera. Idakula pang'onopang'ono kwa miyezi isanu ndi umodzi. Poyamba sindinatchere khutu, koma pamene zotupa zimaphimba timabowo, miyendo ndi thupi zimasokonezeka.
Ndidakhala pampando wanjala (pamadzi) kwa masiku 7 (urticaria adasowa pamgunda wanjala), pomwe idayamba kutuluka timadziti tosungunuka, idawonekeranso. Ingomwa madziwo pali kufooka kowopsa, urticaria imataya kwina patatha theka la ola. Apa ndayamba kale kuda nkhawa kuti ndi matenda ashuga, chifukwa ndikangomwa madziwo, ndi zoipa. Anasiyanso kugwidwa ndi njala kwa sabata limodzi, kenako adayamba kudya kabichi, zipatso, masamba, nsomba.

Patatha sabata limodzi adapereka magazi m'manja ndikusala kudya kuchokera kumunwe kuchipatala. Zotsatira 5.8.Adotolo anati kupitiliratu, mwina adachita mantha. Koma ndimakhalabe ndi nkhawa, chifukwa ndimawerenga za tsamba lanu, momwe ndimakhalira ndimikhalidwe yosiyanasiyana! Ndizotheka, mwachidziwikire, kuti zotsatira zake zakonzedwa, chifukwa chakuti ndinali kugwedezeka ndi mantha nditapita kukapereka magazi (ndili ndi mantha kwambiri kupereka, sindikudziwa chifukwa). Koma osati chowonadi. Tinapita sabata lotsatira ku labotale ya in-vitro, ndikupereka shuga kuchokera m'mitsempha kumimba yopanda kanthu:
Mafuta a m'magazi - 5.2 (Ref. 4.1 - 5.9)
HbA1c - 4.8

Patatha mwezi umodzi, adapereka mayeso mumtambo wamtambo (ali ndi zowonetsa mpaka ma zana):
Glucose - 5.15 (Ref. Doroslі: 4.11 - 5.89)
HbA1c - 4.82 (Ref 4.8 - 5.9)
C-peptide - 0.53 ng / ml (Ref. 0.9 - 7.10) Sindinanyalanyaze
(GADA), ma antibodies a IgG -

Moni Sergey! Zikomo chifukwa cha tsamba lothandiza! Mkazi, wa zaka 43, 166. Chaka chapitacho, shuga 6.6 (kuchokera pachala). Anayambiranso mu labotale ina - 5.2 (kuchokera pamsempha). Adatsitsidwa. Koma patatha chaka, kuchipatala chapayekha, poyeza shuga ndi glucometer, mulingo wake unakwaniritsidwa 6.7. Kupatuka kwina - kupanikizika - 140/90, cholesterol yathunthu - 6.47., Cholecystin yosatha - chikhodzodzo chambiri. (Adadwala matenda onenepa kwambiri okhathamiritsa). Kulemera kwake kunali makilogalamu 64, koma mafuta a visceral anali ochulukirapo. Zitha kumveka ngati metabolic syndrome. Koma kunenepa kwambiri kumawoneka kuti sikokwanira kwa matenda ashuga / prediabetes 2. Ndidaphunzira tsamba lanu. Adakhala pakudya chamafuta ochepa, adayamba kuchita masewera olimbitsa thupi. Komanso zinapanga kulira kwa duodenal. Pambuyo pa masabata awiri, kulemera - 60, kukakamiza 130/80, cholesterol - 5.3. shuga - 4,7., glycated hemoglobin - 5.26 yokhala ndi gawo - 4,8 - 5.9., insulini - 7.39. (muyezo 2.6 - 24.9). Zikuwoneka ngati deta yabwino ya shuga, koma C-peptide ndi 0.74 (yokhala ndi 0,9 - 7.10) Koma C-peptide yotsika ndi chizindikiro cha matenda ashuga 1. Ndiuzeni, kodi ndingakhale ndi LADA? Kapena metabolic syndrome yophatikiza ndi LADA? Ngati hemoglobin wabwinobwino, insulin yabwino, bwanji c-peptide imatsitsidwa? Prediabetes 1.5 (latent autoimmune)? Zikomo kwambiri chifukwa cha tsamba labwino kwambiri ndi upangiri wofunika kwambiri.

Masana abwino Ndili ndi zaka 33, wamtali (188cm) komanso wochepa thupi (75kg). Pafupifupi zaka ziwiri zapitazo ndidapezeka kuti ndili ndi matenda ashuga, ndipo, mosayembekezereka, kuyesa magazi kuchokera mumsempha ndi mkodzo pamimba yopanda kanthu. Panali 12 mmol / L m'magazi, glucose anapezekanso mkodzo. Adapititsa kuwunika kwa hemoglobin wa glycated, 8.7% adatuluka. Ilembetsedwa ngati matenda a shuga a mtundu wachiwiri. Amamva bwino, samadwala, samangokhala ndi ludzu lamadzulo ndi usiku, ndimaganiza chifukwa ndimapumira pakamwa panga. Dotolo wakulendo adandipatsa mapiritsi (galvus, metformin) komanso zakudya zama carb ochepa. Pambuyo kanthawi, adamukakamiza kuti afufuze za C-Peptide pamimba yopanda kanthu, anali m'malire a 1.32 ng / ml. Pambuyo pamankhwala omwe ndimalandira ndi mapiritsi (sizotheka nthawi zonse kutsata zakudya zama carb ochepa), kuchuluka kwa shuga kosala kudya kumachepera pafupifupi mpaka 6-7 m'mawa (nthawi zina zabwinobwino 4-5), ndipo pambuyo pake, kuukira kwa hypoglycemia kumachitika pafupipafupi (kutsika kuposa 3.9, kuchotsa mapiritsi m'mawa) , pafupi ndi shuga zamadzulo ndizabwinobwino, nthawi yamadzulo imakwezedwa pang'ono (7-8), nthawi zina zimachitika. Kudumpha kosawoneka kumachitika mpaka 11-12, koma izi zimachitika chifukwa cha zosagwirizana ndi zakudya. Glycated hemoglobin 6.0 (wabwinobwino). Kenako, nditatha mayeso apachaka, ndidatembenukira kwa endocrinologist kuntchito, adandiuza kuti ndikaunike za C-peptide ndi insulin asanafike komanso atachita masewera olimbitsa thupi. Zotsatira zake, C-peptide isanatsike inali 1.20 ng / ml (yotsika malire), itatha katundu wa 5.01 (overestimated), insulin, motsatana, 4.50 ndi 19.95 μMU / ml (yachibadwa). Glycated hemoglobin 6.3. Zokakamiza 115/70. Amamva bwino, komabe, nthawi zambiri amakhala ndi ludzu madzulo, ndimamwa madzi ambiri ndipo zidendene zanga zimakhala zowuma kwambiri, makamaka ndikatsuka (shuga ndi 7-8).
Pakadwala adokotala pakatha sabata limodzi. Nditawerenga nkhani yanu ndidadziwa za matenda a shuga a LADA, zizindikiro zitatu mwa zisanu zimagwirizanitsidwa, koma C-peptide ndiyachilendo, ndipo ngakhale adakulitsa pang'ono atachita masewera olimbitsa thupi. Palibe amene anali ndi matenda ashuga m’banjamo. Ndili ndi matenda a gastritis, panali zilonda zam'mimbamo zaka 16. Mwina ndili ndi matenda a shuga a LADA kapena ndi mtundu wina wa matenda ashuga? Zikomo

Masana abwino, ndili ndi zaka 53, kutalika 173, kulemera kwa 94. Ndinapeza shuga m'magazi a 7.8 momwe ndingathere. Madzulo asanadye 6.0 anali. Kulemera, zikuwoneka kuti pali mitundu iwiri ya matenda ashuga.Koma abambo anga anali ndi matenda ashuga komanso abale ndi alongo, ndipo ali ndi thupi lathanzi. Kuphatikiza apo, chaka chino ndidapeza nyamakazi, i.e. Ndili kale ndi matenda amodzi a autoimmune. Kodi ndizomveka kuti ndikamayesa mayeso a LADA kapena zakudya zamafuta ochepa, tsiku lachiwiri ndimatsatira?

Masana abwino, kutalika kwanga ndi 173, kulemera kwamasamba 94, zaka zaka 53. Mwezi watha, ndidapeza koyamba magazi. Kenako inali 6.9. Tsopano m'mawa kwambiri pamimba yopanda kanthu ndi 7.8. Mutatha kadzutsa popanda chakudya, ngakhale pang'ono chabe chimakhala 7.6 pambuyo maola 1.5. Madzulo chakudya chamadzulo chisanachitike, itatha kuyenda kumakhala 6.0. Ndi kulemera kwanga, zingakhale zomveka kukaikira mtundu wachiwiri wa matenda ashuga, koma pali zochitika ziwiri zomwe zimapangitsa kuti ndikayikire. Loyamba ndi loti bambo anga, komanso azichimwene ake, adawonetsa matenda ashuga atakula, ndipo onse anali omangidwa. Chachiwiri - chaka chino ndili ndi nyamakazi, ndili ndi kukayikira kuti matenda ashuga angayanjane ndi izi, chifukwa Ndili kale ndi matenda amodzi a autoimmune. Funso limakhala ngati ndikufuna kuyesa mayeso a LADA kapena kuti ndichepetse chakudya cha NU.

moni
thandizirani kuzindikira.
matenda a shuga opatsirana adapezedwa pakadutsa milungu 26. patsani chakudya chamafuta ochepa. patatha sabata limodzi atasiya kuyesa:
fructosamine 275 (205-285)
c-peptide 0.53 (0.81-3.85)
kusala shuga 3.8
glycated hemoglobin 5.1
insulin 3.6 (3-25)
Wazaka 24 zakubadwa 178 masentimita 52 kg

Masana abwino Ndili ndi zaka 27, kutalika 160, kulemera 55. Zowonjezera zazikazi kuzikhala ndi matenda ashuga mbali zonse ziwiri. mwezi ndi theka lapitalo, shuga kuchokera kumitsempha anali 5.9, adalimbikitsidwa kumwa glucophage nthawi yayitali 750 panthawi ya chakudya chamadzulo ndikutsatira zakudya zamagulu ochepa, pambuyo masiku 10 atamwa mankhwalawa - shuga adatsalira 5.9.
Ndilibe glucometer ndipo sindinakonzekere kuti ndikhale nayo, koma ndikufuna.
mbiri yakale ya pyelonephritis.
Ndiuzeni, ndi mayeso ati omwe angakhale abwino kuti mupezeke kuti mukudziwa bwino komanso kuti mudzindikire bwino.

Masana abwino 32 zaka, kulemera 95 makilogalamu, shuga 19, acetone mu mkodzo 10, shuga mu mkodzo 56. ikani mtundu wa 2, galvus ndi metformin 1000 usiku. kg

Masana abwino, chonde thandizani izi. Amuna anga anali ndi matenda a shuga kwa nthawi yayitali, pafupifupi zaka 3-4, sitinadziwe chomwe anali. Zhor yokhazikika, ntchito yolimba itagwedeza chilichonse, idalowa ndikufuna chakudya mwachangu, ndipo zonse zimadutsa, adalumbira kwambiri, mitsuko yowongoka imatsanulidwa, kudyedwa popanda zidebe zopitilira muyeso, theka la paketi la pasitala, masoseji 4-5, saladi yankhuku ndi theka-vwende ndizofala. , ndikadatha kuphika makeke amphikawo Komanso, nthawi zonse zimakhala zowonda.
Pa usiku wachaka chatsopano, wa 5 wa alendo adakwera; masomphenya adatayika kwambiri. Adapita kuchipatala. Sabata lomwe adabaya jakisoni m'maso, adalandira opaleshoni ya maso. Mwinanso palibe amene adayang'ana kusanthula. Pakulimbikitsidwa ndi amayi anga, adakankhira pansi mayeso a shuga kwa namwino. Januware 13th zinali. Shuga 19. Tinapita kwa endocrinologist yemwe analipira, adapereka jakisoni, amapanga dontho. Madzulo, shuga anali 14.5, m'mawa 10, madzulo 7. Pa tsiku lachiwiri 5.5. Kuyambira pamenepo iwo anayeza iwo m'mawa, asanadye, maola awiri atatha kudya. Sizinakhalepo pamwamba pa 5.4 .. Miyezi iwiri zonse zili chimodzimodzi. February 23, adayamba kudya keke. Mosakhalitsa pambuyo pa keke, kapena pambuyo pa maola a 2 pomwe shuga sanakwere kuposa 4.5.
Koma vuto lalikulu ndi ma hyps opitilira. Amadya mwachizolowezi, kupatula yokazinga ndi okoma. Kutumizira kacitsulo kakang'ono ndi zakudya zopatsa thanzi. M'mawa amadya oatmeal ndi apulo, atatha maola 2 chidutswa cha brisket, mkate, saladi, nkhomaliro, msuzi, nkhuku, mkate wa saladi, casserole yamadzulo. Koma theka zochuluka monga kale. Ndipo pa katundu wocheperako (chipale chofalikira pa garaja), ndiye hypoglycemia. Ili ndi vuto lalikulu kwa ife. Ali ndi ntchito yovuta kwambiri. Mu Disembala, pomwe adadya mapiri a maswiti, adatenga chitseko cha 80 kg kumbuyo kwake ndikuyika pamapazi 16, ndikuyiyika kumeneko kwa maola awiri ndikuyenda kunyumba kwa maola 4. Kuwononga ma cookie gingerbread makeke ndi masangweji. Zakudya zamtundu woyenera zafooketsa kwambiri, kutaya mapaundi 10 m'miyezi iwiri, khungu ndi mafupa, sangathe kukweza chitseko yekha. Ndi ma hyps osatha. Shuga samadumpha, m'mawa 4.3, masana palibe kuposa 4,7. Sichikula kafika pa 5.
Sabata yapitayo tidagona mokhazikika ku Sechenovka.Ndipo shuga adalumphira mpaka 10 (mwamunayo ali wamanjenje, sakonda anthu ambiri ndipo amagona kunja kwa nyumba, ndizovuta zake), kudali shuga patsiku la 7. Adapita ku chipatala cha tsiku ndipo sadadzukenso. Kuzindikira kunapangidwa ndi Lada kapena mtundu 1. Anatinso mpaka pano sanganene chilichonse, chifukwa shuga samakula. Palibe kulumpha. Kutumizidwa kwa miyezi isanu ndi umodzi kuti muziyenda, dikirani mashuga akulu. Koma timatani ndi ma tchuthi osatha? Kwa munthu wamba, amadwala, kwa iye, amaperewera. Akadakhala ngati kale, pali mabeseni. Sitikudziwa choti tichite. Adayesetsa kuchotsa chakudya chambiri komanso kudya mapuloteni ambiri. Sikwilira m'mimba mwanga, ndipo nditatha ola limodzi ndimva njala. Adayesa kudya zakudya zamafuta okha, zamkhutu zomwezi. Ndizofanana ndi kudya mateche. Ndikunena kuti idyani zowonjezereka, zayamba kuchepa, kufooka, kuwopa kufulumizitsa kufa kwa kapamba. Ndipo timachita chiyani? Ndipo kodi kuchuluka kwa kufa kwa pancreatic kumadalira kuchuluka kwa chakudya?

Mu Januware, GG inali pafupifupi 9, c-peptide 498, insulin 6.7. Chifukwa cha kupatula kwa GG lokoma, tsopano ikhala 4, osatinso. Chikhumbo chakugonana chazirala, mkhalidwe wachisoni ndi wopanda chidwi. Sindikusangalala ndi chilichonse. Mwinanso ali ndi china chonga mpukutu kapena chokoma pang'ono asanagwire ntchito zolimba? Amasilira kuvala. Imatha kukumba dzenje 2 ndi 3 patsiku, ndi kutalika kwake. KOMA ndi maswiti, izi zidachitika mosavuta, ndipo tsopano maulalo 10 ali ndi fosholo ndi kolowera ((Tili ndi mantha, osati zabwino, sitikudziwa momwe tingachitire. Ndipo madotolo adandigwira. Ndikhululukireni, nde kwanthawi yayitali)

Moni Endocrinologist adandiuza kuti kudya ochepa-carb ndi njira yachidule yowonjezera ma ketones am'magazi, acidosis.

Moni. Ndili ndi zaka pafupifupi 42, miyezi isanu ndi umodzi yapitayo, ndidwala ndi matenda osakhazikika. Zamoyo zonse zimawoneka. Zinayamba ndi kutentha, ma lymph node, pharyngitis, miyezi isanu ndi umodzi ya kufooka koopsa komanso thukuta la usiku, tachycardia, kutsika kwa chitetezo chazisoni komanso ma cell ochepa (NK). Tinnitus ndipo tsopano wafika pakuwonjezeka kwa shuga. Zolimbitsa thupi zinali zolimba, koma osati zonenepa. Ndikadwala, kwa theka la chaka ndidataya 10 kg. Shuga adayamba kukwera mpaka 6.4-6.5 m'mawa. Ndinawerenga - prediabetes. Ndinapita ku polyclinic kukayezetsa magazi. Anayezera asanatuluke 6.4 Magazi awo osakanizidwa adawonetsa 4,9 asanayesedwe, 5.8 atatha katundu pambuyo maola awiri. The endocrinologist adati mita yanga si yolondola. Adapita kukayang'anana ndi labotale, cholakwika cha mayunitsi 0,2-0.3 potengera kuwonjezeka kwa mita. Ndikuganiza kuti iyi ndi mita yolondola ya magazi. Ndinaganiza zodzichitira ndekha, kopanda kwina. Ndidaliwerenga pa intaneti, komanso malingaliro anu, ndikukhala pachakudya chopanda chakudya chopatsa mphamvu, kuphatikiza glucophage 500mg usiku. Oyambira nthawi yomweyo adagwa. Koma popita nthawi, arrhasmia idawoneka, ngati kuti mtima ukugunda, ndiye kuti zikupita, ngati chowonjezera (sindikudziwa motsimikiza). Popeza ndimachotsa ma carbohydrate, nyama ndi ndiwo zamasamba zokha, ndimaganiza kuti mwina chifukwa cha izi?! Ndidayesa kudya phala la oatmeal, languor yosangalatsa komanso mphamvu zamafuta ochulukira thupi langa. Koma shuga, zachidziwikire, nthawi yomweyo adadzipangitsa kuti azimva. Mumandilangiza chiani, ndipo kodi ndilidi ndi matenda ashuga? Osadziwika. Pa C-peptit kawiri. Mpaka pomwe adayamba kudya, anali 1060 (298-2350), ndipo patatha mwezi umodzi nditagwira galimoto yaying'ono, ngati Spar, koma ndidadutsa pamimba yopanda kanthu 565 (260-1730). M'mavoti, koma osakwanira - kodi izi ndi zovuta? Chonde yankhani?

Moni, chonde ndithandizeni kutero. Ndili ndi zaka 45, kutalika 162, kulemera kwa makilogalamu 45. Sindinakhalepo woonda kuyambira ndili mwana. Chaka chatha ndinayamba kumva bwino kuti ndatopa kupita kwa madotolo. Sanawonetsetse ngati ndili ndi matenda tsiku lililonse. Khungu loyera, kumbuyo, pachifuwa, nthawi zina miyendo. Ndikumva kupindika m'malo osiyanasiyana. Zimakhala zoyipa kwambiri ndikapanda kudya, zikuwoneka kuti ndizophweka ndikatha kudya .. Kunali ndimutu, koma tsopano mutu wanga wayamba kutonthola. zaka komanso malingaliro Amakhala amphamvu komanso ofooka koma pafupifupi nthawi zonse. Mayeso oyamba adawonetsa 8.8 pakusala magazi kuchokera m'mitsempha ya shuga. Patatha masiku awiri ndidawupereka kuchokera kumunwe wanga udali kale 3.6.Ndipo ndidapereka shuga mu seramu 4.47. Glycosylated hemoglobin 4.3 C-peptide 1.23. ayi
Ndidakhala chete, koma ndimamva bwino. Mwina nditha kuyesanso zina kuti nditsimikizire kuti ndili ndi matenda ashuga kapena nditsimikizire))

Moni, mwatsoka, m'dziko langa sindinapeze madokotala omwe amathandizira pakudya kwa NU ndipo, chifukwa chake, sindinalumikizane ndi aliyense, ndikufuna kudziwa kuchokera kwa inu, kutalika-178, kulemera pamaso zizindikilo za CD-2 zimawoneka ngati makilogalamu 105, wazaka 43. Koma zizindikiro zodziwikiratu zitawoneka (pafupipafupi kufuna kukodza, kununkhira kwa mkodzo mumkodzo, shuga mkodzo, kumwa madzi ambiri), kulemera kwa DM kudatsika kwambiri mpaka 96 kg, kwa pafupifupi mwezi umodzi ndi miyezi iwiri idasungidwa mkati mwa 94-96 kg, pomwe sikunamatira iliyonse Zakudya, chifukwa sindimadziwa kuti ndili ndi matenda ashuga, Pambuyo pake ndidazindikira kuti ndili ndi matenda. Anali ku endocrinologist adalipira, panali kuyesa kopitilira muyeso, adayesa mayeso okhazikika a shuga m'mitsempha, shuga m'magazi adayamba kukhala 9 mm mu labotale imodzi, ndipo 14 mm adapezeka mu labotale ina, shuga mumkodzo adadutsa, mayeso adatengedwa miyezi iwiri itatha kuyambika kwa chizindikiro DM, pakadali pano, ma acetone mkodzo anatha. Endocrinologist adalangiza kuti azitsatira zakudya-9 ndipo adayambitsa Asformin m'mawa komanso madzulo ndipo adandiuza kuti ayesere magazi a glycated hemoglobin patatha mwezi umodzi, mwezi umodzi pambuyo pake kuwunika kwa hemoglobin ya glycated anali 9 mm. Popeza ndimafuna kusewera mosamala ndidayang'ana mwakuya pa intaneti ndikuwona malo awiri achilankhulo cha Chirasha omwe amalimbikitsa kudya kwa NU, kotero imodzi mwamasamba anu ndi tsamba lanu, mawebusayiti awa akhala malangizo kwa ine, ambiri chifukwa cha masamba awa, komanso makamaka kwa inu, pantchito yanu. Pakadali pano ndikuyamba kumvetsetsa kuti endocrinologist adachita mankhwalawo ndipo sanapereke mayeso ofunikira panthawi yake ndipo ndinayamba kutenga mayesowa posachedwa. Nditayamba kudya chakudya cha NU, ndinasiya kumwa mankhwala, magazi a m'magazi abwerera mwakale, kuyambira 4.5 mpaka 5.5 pamimba yopanda kanthu ndipo nditatha kudya mpaka 6.00 pamene ndimapitiriza kudya Zakudya za NU, mafuta onse omwewo akangolowa mthupi, ndiye kuti shuga imakwera mpaka 9.1 mm, motero Panthawi yamagetsi opepuka mkati mwa mphindi 3-5 imachepetsa shuga kufika pa 5.5 mm nthawi yomweyo kapena shuga m'magazi amatsika pambuyo pa maola awiri, lero kulemera kwakhala kusewera kwa nthawi yayitali pakati pa 84-85 kg, pomwe ndikupitilirabe kuchepa thupi osachepetsedwa, ndipo tsopano mafunso: 1. Kuchepetsa kwambiri kunenepa kwambiri Chizindikiro cha matenda a shuga a LADA choyambirira kunenepa? 2. Pankhani yakusintha kwakanthawi ku chakudya cha NU, kodi ndizotheka kubwezeretsa maselo a beta otayika? 3. Kodi mudakhalapo ndi machitidwe omwe adachiritsidwa kwathunthu a DM-2, ndipo ngati ndi choncho, zidali zovuta bwanji kwa odwalawa?

Masana abwino
Pa GTT panthawi yoyembekezera, matenda osokoneza bongo amadziwika kuti ndi shuga (ma curve anali: 4 pamimba yopanda kanthu, 11 pambuyo pa ola limodzi, 8 pambuyo pa maola awiri). Chakudya cholamulidwa ndi HD komanso kugwiritsa ntchito mphamvu zolimba.
Pambuyo pa mimba, adawona kuwonjezeka kwa shuga wamagazi atatha kudya, mwachitsanzo, makeke, mkate, maapulo mpaka 8-9 ola limodzi atatha kudya.
mayeso apasa:
Glycated hemoglobin 5.17, glucose kudya 3.58, c-peptide 0.64 (yachilendo kuchokera ku 1.1)

insulin 1.82 (yachilendo kuchokera ku 2.6). Pa AT-GAD ndikuyembekezera zotsatira ... ndikuyembekezeranso endocrinologist
Zikuwoneka kuti ndili ndi matenda a shuga a LADA? Ndili ndi zaka 30. Asanakhale ndi pakati komanso panthawi yomwe ali ndi pakati, shuga wosala kudya anali wabwinobwino.

Moni, posachedwapa ndidayesedwa kuchipatala. Kuzindikira kwanga kwa matenda ashuga kwatsimikiziridwa. C peptide 1.77. Shuga m'mawa pamimba yopanda kanthu mpaka 5.7. Glycated hemoglobin 5.2. Ma antibodies okwera ku GAD 18 adapezeka atapezeka ndi ochepera 5. Masabata 2 atatha kudya kuchokera ku 4.5 mpaka 7. uchi wa Galvus 50 mg kawiri pa tsiku. Ndawerenga malingaliro anu ndipo tsopano ndikukaikira ngati ndingamwe mapiritsiwo. Dotoloyo adati athandizira kupititsa pancreatic ntchito kwa nthawi yayitali. Chonde ndiuzeni zoyenera kuchita.

Moni. Posachedwa ndinayesedwa kuchipatala. C peptide 1.77. Gliked 5.2. Ma antibodies opita ku GAD 18 adapezeka atawoneka osaposa 5. Shuga 2 maola atatha kudya kuchokera ku 4.7 mpaka 7. Adalamulidwa kumwa uchi wa Galvus 50 mg kawiri pa tsiku. Chonde ndikulangizeni zomwe ndiyenera kumwa mankhwalawa

Masana abwino Chonde ndiuzeni, mkazi wazaka 46, kutalika 175, kulemera pafupifupi 59-60. Kuchepetsa thupi kwambiri popanda zakudya. Ludzu losalekeza, kamwa yowuma, kukoka pafupipafupi, kufooka. Amasenda shuga m'mawa wopanda kanthu 14.5. Zoyenera kuchita Kodi pali njira iliyonse popanda insulin?

Masana abwino Ndili ndi zaka 34. Ana atatuKuyamwitsa mwana tsopano. Ali ndi pafupifupi chaka.
Panali gulu lowopsa la matenda ashuga ali mwana. Panali balere wolimbikira, wotupa, makamaka pakhungu. Pamene kusanza kunkapezeka zisanu ndi chimodzi mutatha kudya, kuphwanya kwa kagayidwe kazakudya kunapezeka, ndipo chishango chinakulitsidwa. Amatsatira zakudya zamafuta ochepa. Osaba jakisoni. Ali ndi zaka 15, ali m'chipatala cha achikulire, dokotala wina wa "endocrinologist" adati
Pambuyo pobereka koyamba mu 25, panali ziphuphu zakumaso. Kubadwa kwachiwiri kunali ndi zaka 31. Pamapeto pa pakati, iwo adapereka mawu a 2 tbsp. Mwana adabadwa wolemera 3450 wathanzi. Apanso panali ziphuphu zopweteka kumaso. Kuyamwitsa. Mbale yamafuta inasokonezedwanso. M'moyo wanga wonse ndimalemera 47-49 kg. Kukula 162. Atamaliza kudyetsa (mchaka chimodzi ndi zitatu) anayamba kulemera mwachangu kwambiri. Zambiri zomwe ndidapeza 63 kg. Ali ndi zaka 33, wachitatu ali ndi pakati. Pa milungu 10 ya mimba ndidadutsa kuyesa kwa magazi. Zotsatira 5.7 Zopitilira 5.0 komanso zokongoletsedwa 6.0 Wotsiriza wa endocrinologist adati kuchepetsa chakudya. Ndinkamva bwino kwambiri. Adagona kwambiri, panali kufooka kwamphamvu. Kukhazikika pa chakudya chamafuta ochepa. Ndakhala bwino. Pazaka zonsezo, iye adaponya zoposa 10 kg. Zotsatira zake, kubadwa kusanachitike kunali 62 kg. Mwanayo anapatsidwanso mawu a 2 tbsp. Adabadwa wathanzi, koma wolemera kale wocheperako wakale: 3030 kg. Ndidakhala pachakudya kwa miyezi 9 nditabereka. Ndinadutsa owoneka 4.75. Kulemera 46 kg. Ndili ndi nephroptosis 3 tbsp., Aiwala kutchula. Kupanikizika kunayamba kutsika kwambiri. Ndinaganiza zoyesa kudya mwachizolowezi. Popeza adotolo andipeza ndi matenda a shuga. Zomwe ndimakayikira. Zotsatira za miyezi itatu ya zakudya zopanda zakudya. Kulemera 52. Kuluma kwamutu, ziphuphu kumaso, kuwawa kwa miyendo m'mawa. Mu sabata yatha ndimakhala wofooka komanso kugona. Tsiku loti asambe msambo womaliza, kukakamiza m'mawa kudagwa kwambiri kotero kuti samatha kugona. Ndikumvetsa bwino komanso momveka bwino kuti ndili ndi matenda ashuga. Funso: kodi simukuganiza kuti ngakhale LADA si choncho? Amada nkhawa kwambiri ndi ana. Kuti mudziwe ngati ali ndi matenda ashuga: kodi angapatsidwenso shuga? Ndingayamikire kwambiri chifukwa cha kufunsana.

Moni Marina, wazaka 38, wolemera 63, kutalika 173. Mu 2017, zizindikilo zimawoneka (zikuwuma komanso kuyabwa thupi lonse, nthawi zambiri amapita kuchimbudzi, kupuma movutikira, kutopa kwambiri, kuchepa kuwona, kutopa kwa chala chachikulu chakumiyendo) .Ndinapita kuchipatala. Kuthamanga magazi 8.6. Endocrinologist idadutsa GH ya 4.6 yokhala ndi ma indices a (4-6.4) mu nerma, ceptide ya 0.899 (pa 1.1-4.4) kuchepa kwa peptide, mahomoni a TTg, T4 ali mkati mozungulira, pafupi ndi kuchepa. Endocrinologist adati kubwezeretsanso c-peptide miyezi 4. Kwa miyezi inayi ndimatsatira NUDIETA, koma ndikupatuka kwa iyo. Retook, zotsatira za c-peptide ndi 1.33, GG - 4.89 (mkati mwa malire abwinobwino). Dotolo wakuchipatalaku adati osachita chilichonse, chepetsa lokoma, ndikubwereza mayeso onse mchaka chimodzi. Ndinapitilizabe kuwerenga tsamba lanu, koma nthawi zina ndinasiya kudya kuti ndizichita nawo ziwonetsero, zipatso, nthawi zina mkate. Ndiye patha chaka. Ndipo nditangodya 0,5 makilogalamu amumiyendo, ma tangerine atatu ndi chokoleti, kumeza thupi langa lonse, kuyambira pamenepo, impso zanga zinayamba kupweteka ndipo maso anga anayamba kuwona bwino, ndinayamba kununkhiza kuchokera mkamwa mwanga. Ndipo ndinamvetsetsa zonse. Pambuyo pa masiku atatu, zizindikiro zonsezi zidachepa chifukwa cha Nudieta. Kwa sabata tsopano, ndakhala ndili pa NUDIET yokhazikika, ndimayetsetsa magazi ndi glucometer (nditayang'ana gluceter wanga), (3.8 4.7-5.2, 5.4) nditatha kudya, pamimba yopanda kanthu komanso madzulo. Ndikangoyamba kudya, zizindikirozi zimabwereranso. Ndinazindikira kuti ichi ndi matenda a LADA, ngakhale GH adawonetsa kawiri konse. Patsamba lanu, mu gawo la "Analysis for GG" kwalembedwa kuti kuwunikaku kungasinthidwe ndi hemoglobinopathies (ndangokhala ndi hemoglobin 90-110 (m'malo mwa 120-140) ndi kuchepa kwa magazi m'thupi (adanenanso kuti kulibe chitsulo m'thupi) zokwanira.) Ndikhulupirira kuti GG siyimandipatsa chidziwitso cha kusowa kwa magazi m'thupi, GG 4.89 Uku ndi kuwunika kwa GG ndipo kunali kosokoneza, koma Zizindikiro zomwe zimabwereranso ndimalo abwinobwino komanso kuchuluka kwa mita (apamwamba kwambiri) 8.6-8.4 pomwe panali kusokonekera kochokera ku NUDIETS) sikulimbikitsa konse .. Ndikuganiza iyi ndi LADA. Funso langa ndi lotani, malingaliro anu ndi otani? Online ndinazindikira kuti zobisika Inde a shuga ayenera Mlingo ka insulin (mwanjira).Funso ndiloti, sindikumvetsetsa mtundu wa insulini yomwe ndimafunikira, yochepera kapena yowonjezereka, kapena zonse ziwiri, ndazindikira kuti zimafunika kuchepetsedwa. Funso ndilakuti, glucose tsopano (3.8-5.4) ali pachakudya kwambiri, sindichita mantha, ndakhala kunyumba. Kodi mumalangiza chiyani za momwe mungachitire ndi insulin? Ndikhulupilira yankho lanu. Zikomo!

Masana abwino, Sergey. Ndakhala ndikulembetsedwa ndi endourinologist kwa zaka 10, koma ndidayamba kulabadira kwambiri za matendawa pokhapokha. Mu Novembala, adandilowetsa kuchipatala ndi phlegmon burashi, pomwe shuga adalowetsa 20.5. Pambuyo pa opaleshoni, magawo 6 a actrapid adayikidwa nthawi yomweyo pa insulin. katatu patsiku ndi magawo anayi. kwa usiku. Anati atachira amachotsa insulini. Izi zisanachitike, sindinamwe mapiritsi, koma ngakhale ndi insulin sindinatsitse shuga pansi pa 8.4. Nditatulutsa, ndinapeza tsamba lanu ndikuyamba kumatira ku chakudya. Shuga adatsikira ku 4.3. Dzanja lidachira ndipo ndidasinthidwa ku glucophage kutalika mapiritsi 500, mapiritsi awiri 1 nthawi imodzi patsiku. Tsopano shuga m'mawa kuyambira 4.5 mpaka 5.2. Mutatha kudya masana mpaka 6.5, ndipo pansipa. Ndinaona kuti ndinali ndikusintha mpaka nditawerenga za matenda ashuga. Kulemera kwanga ndi 163cm. - 60 kg. Mlanduwu, opareshoni isanachitike, anali ndi makilogalamu 65. Adatulutsidwa kuchipatala cholemera 62 kg. Ndipo, pakudya, kulemera kwakhala 60kg. Tsopano ganiziraninso za insulin? Ndipo ndinali wokondwa kuti ndimatha kulumpha. Zoyenera kuchita Ndikumva bwino, palibe ludzu kapena pakamwa pouma, palibe kumverera kwanjala, ndimapita tsiku lambiri, shuga amawoneka ngati wabwinobwino. Pakadali pano funso liri ndi insulin ndi mapiritsi?
KUTHANDIZA KWAMBIRI KWA DZINA LAKO NDI LOTHANDIZA. Wogwiritsa ntchito endocrinologist akulangizani kuti musazunzike ndi zakudya, akuti timakhala kamodzi ndipo muyenera kudya chilichonse chomwe mungafune ndipo shuga alipo mpaka 10 mutatha kudya, komanso pamimba yopanda kanthu mpaka 8. Sizothandiza kukangana ndikutsimikizira.

zaka 66 zaka, kutalika kwa 170cm, kulemera 78kg. shuga 6-7- sikawirikawiri mpaka 11 (zakudya zosinthidwa), ndi zaka 60 wodwala yemwe amadalira shuga 2 (matenda a shuga - sindimwa). Ndikuwona kuti mfundo ziwiri ndizosiyana. Kodi izi zikutanthauza chiyani? zikomo pasadakhale

Zotsatira zoyeserera Tsiku lovomerezeka: 03/05/2018 Mayeso
Zotsatira Zoyezera Zotsatira
Glycated Hemoglobin (D-10, Bio-Rad S.A.)
Glycated Hemoglobin (HBA1C) 6.30% 4.00 - 6.20
IFA (Sunrise, Tecan, Austria)
Ma antibodies kuma cell a beta a pancreas Positive mg / g Negative
Immunochemistry (IMMULITE 2000 XPI, Motorola)
C - peptide 1.96 ng / ml 0.90 - 7.10

Masana abwino Ndine 39, kutalika 158, kulemera 58, chaka chapitacho ndidapezeka kuti ndimalephera kuyamwa kwa glucose ndimayeso a GTT (4.7-10-6.8), kuyambira pamenepo ndakhala ndikudya, machitidwe olimbitsa thupi. katundu ndi zakumwa metformin, ndimayendetsa magazi ndi glucometer, ndatsika ma kilogalamu 6. Pamimba yopanda kanthu ndili ndi shuga 4.2-4.8, glycated hemoglobin 4.7. Ndidayambitsanso mayeso a GTT 4.8-13-14. Kupanga kwa insulin kunachepa - kuyambira pa 10 pamimba yopanda kanthu mpaka 4,4 ndapezeka kuti ndili ndi matenda ashuga a 2. Siziphatikiza m'mutu mwanga - chithandizo chaka chimodzi, ndikuwonetsa zabwino za glucometer yanga ndi glycated hemoglobin komanso nsonga yotere pa GTT. Kodi ichi chingakhale chiwonetsero cha matenda a shuga a LADA? Agogo anga aakazi anali ndi matenda amtundu woyamba ndipo msuwani wanga ali nawo. Kodi ndizomveka kusinthanso kuwunikira kwa GTT?

Moni Sergey! Kukula 174, kulemera 64, zaka 52. Mu 2015, mwangozi anapeza shuga 10,8 akusala. Zaka 1.5 NUD (zikomo kwambiri kwa inu ndi tsamba lanu.) Ndipo homeopathy yakwanitsa kukhalabe ndi shuga osaposa 7. Kuyambira Januware 2018, shuga yakhala 11-13. Ndinatembenukira kwa endocrinologist, koma kusankhidwa kwake kunali kukayikira. Ndidayesa mankhwala osokoneza bongo ndipo, kuphatikiza mtengo wotsika wa C-peptide, ndinazindikira kuti ndili ndi matenda a shuga a Lada. Dokotala adalemba insulin yayitali, novonorm (sindikuvomereza), glucophage ndi galvus.
Pambuyo pa kuyamba kwa jakisoni wa Levemir (m'mawa 5 mayunitsi, usiku magawo 4), shuga yofulumira ndi 5.4-6.3, chakudya chamadzulo chisanachitike komanso 6.3-7.7. Mukatha kudya, pambuyo pa maola 2 amakwera 9,8 (ndi NUD). Ndiuzeni, chonde, kodi ndikofunikira kuthyola muyeso wa Levemir m'magawo awiri (2 mayunitsi) kapena kukulitsa mlingo wa m'mawa? Inenso ndimazindikira kuti ndikofunikira kugwiritsa ntchito insulin. Ndiuzeni chonde, ndibwino kuti ndiyambireni?

Moni, ndinapeza zambiri zatsamba langa patsamba lino, zokhudza ine: Ndili ndi zaka 43, kutalika 162cm, kulemera kwa 55 kg, matenda ashuga adawonekera nthawi ya pakati ali ndi zaka 40 ngati phokoso, shuga anali 5.8 pamimba yopanda kanthu, mayeso ololera : pamimba yopanda kanthu -4.0, pambuyo pa ola limodzi -10.5, pambuyo pa maola 2 -11.8.
Ndipo, patatha chaka, adayambiranso mayeso olekerera: pamimba yopanda kanthu -4,99, pambuyo pa ola limodzi 12,122, atatha maola 2 -13.28. Ndili ndi pakati, ndinasinthira ku chakudya chochepa chamafuta pamalingaliro omwe ali pamalowo ndikumakhalabe nawo.
Posachedwa ndinachita lendi Glick. hemog. 4,3%, kuthira shuga-4.9, C-peptide 365 (260-1730 yachilendo), glucometer muyeso wa shuga m'dera la 4.8-6.2, adokotala safuna kundilembera insulin, akuti ndimalipira matenda a shuga , ngakhale poyamba adayambitsa mtundu wa 2 wa matenda ashuga ndikulembera mapiritsi a Diabetes, sindinawamwe, ndikuganiza Lada, koma mukuganiza bwanji?

Moni Amayi ali ndi zaka 80, kutalika 1.68 m, kulemera makilogalamu 48 (adataya kulemera kwambiri zaka ziwiri), kulemera 65-70 kg. Kuthamanga shuga 5.0-5.3 (kutsatira zakudya zamafuta ochepa). Koma, mutatha kudya Buckwheat, oatmeal, mpunga - shuga umakwera maola awiri mpaka 8-, 9, kapena ngakhale mayunitsi 10 .. Mayeso omwe adapita: Glycated hemoglobin 5.6.
Double Peptide (C-Peptide) 1.43.
Glutamic acid decarboxylase
(GADA), ma antibodies a IgG