Hyperglycemia (zimayambitsa, zizindikiro, ambulansi, zotulukapo)

Kuchepetsa thupi mwadzidzidzi ndi chizindikiro chachikulu cha matenda a shuga omwe amadalira insulin. Ndi mawonekedwe odziyimira pawokha a insulin, nthawi zambiri, odwala satayika, koma kulemera kwa thupi kumawonjezeka. Munkhaniyi, tiona chifukwa chake munthu amachepetsa thupi chifukwa cha matenda ashuga amitundu iwiri.

Yang'anani! Pazigawo zapadziko lonse lapansi za matenda obwezeretsanso 10 (ICD-10), matenda osokoneza bongo omwe amadalira insulin akuwonetsedwa ndi code E11, ndipo shuga yodalira insulin ikuwonetsedwa ndi E10.

Zimayambitsa chisokonezo

Chomwe chimapangidwira mtundu 1 wa shuga mellitus (T1D) sichimamveka bwino. CD1T ndi matenda a autoimmune momwe thupi limapangira ma antibodies omwe amalunjikitsidwa osati motsutsana ndi zinthu zakunja kapena tizilombo toyambitsa matenda, koma motsutsana ndi maselo kapena zigawo za kapamba. Zotsatira zake, maselo osagwira ntchito m'thupi amalimbana ndi maselo omwe amapanga insulin. Maselo a pancreatic akawonongeka, kuchuluka kwa insulin yomwe imatulutsidwa kumachepa, zomwe zimapangitsa kuti glycemia iwonjezeke. Amakhulupirira kuti kudziwikiratu chibadwa ndi zina zachilengedwe zimathandizanso kuti matendawa athe.

Masiku ano, opanga ma genetic opitirira zana amadziwika kuti amathandizira pakukula kwa matenda ashuga. Pali kulumikizana pakati pa matenda a shuga amtundu 1 ndi mtundu 2. Komabe, matenda ashuga amtundu woyamba samabadwa pang'ono kuposa mtundu 2. Zinthu zokhala m'magazi zimatha kukhala ndi chidziwitso pakukula kwa matenda ashuga. 95% ya odwala matenda ashuga amtundu wa 1 amakhala ndi majini osokoneza bongo omwe amalimbana ndi maselo opanga insulin m'mabwalo a Langerhans. Maselo oyipa (magazi oyera) amalowa m'matumbo omwe amapanga insulini ndikupangitsa kutupa m'mapensulo. Njira zotupa zimawononga timabowo m'miyezi ingapo kapena zaka. Ngati 80-90% yazisumbu zopanga insulini zimawonongeka, matenda a shuga amapezeka.

Ofufuzawo akuganiza kuti matenda opatsirana angathandizire kukulitsa matenda a autoimmune a etiology osiyanasiyana. Izi zimaphatikizapo mumps, chikuku, rubella, matenda oyambitsidwa ndi ma virus a coxsackie. Ngakhale anthu omwe chitetezo cha mthupi chimagwira mwamphamvu kwambiri ku radiation ya ultraviolet ali pachiwopsezo chotenga matenda a insulin.

Zina zomwe zimayambitsa ngozi zitha kuwonjezera mwayi wa matenda a shuga 1:

• Kuyamwitsa kufupi kwambiri pambuyo pobadwa
• Kumwa koyambirira mkaka wa ng'ombe ndi ana,
• Kugwiritsa ntchito kwambiri zakudya zokhala ndi gluten
• Kugwiritsa ntchito nitrlsamines.

Kafukufuku waposachedwa akuwonetsanso kuti maselo am'mimba a pancreatic owonongeka amatha kutenga nawo mbali kumayambiriro kwa matendawo.

SD1T nthawi zambiri imakhudza ana, achinyamata komanso achinyamata osakwana zaka 20. Koma ngakhale odwala okalamba, matenda ashuga amatha kuchitika makamaka amtundu woyamba (matenda a LADA). Matendawa amayamba mwadzidzidzi ndipo ndi ovuta kwambiri. Kuphatikiza pazizindikiro zomwe zimayamba chifukwa cha kuchuluka kwa shuga m'magazi, zovuta zazikulu (diabetesic ketoacidosis kapena chikomokere) zimatha kuchitika. Nthawi zina, ketoacidosis imatha kubweretsa kudwala kwa wodwala.

Chifukwa cha hyperglycemia, zizindikiro zotsatirazi zingachitike:

• Ludzu kwambiri (polydipsia)
• Kukodza pafupipafupi (polyuria)
• Khungu lowuma
• Kuchepetsa thupi
• Kutopa
• Kuwona koperewera
• Kuvulala kwamabala ambiri
• Matenda a kumaliseche.

Matenda a hyperglycemia amatha kusokoneza mitsempha yamagazi ndi mtima dongosolo (CVS). Ndi CD1T, kuwonjezera pa hyperglycemia, palinso kuchepa kwathunthu kwa insulin. Chifukwa chake, maselo amthupi samapeza glucose wokwanira. Kuperewera kwa insulin kumasokonezeranso mafuta kagayidwe. Nthawi zambiri zimayambitsa matenda a mtima, sitiroko, ndi kuvulala kwina kosadziwika.

Zotsatira zakuphwanya kagayidwe ka mafuta acids, zinthu zambiri zimatha kuchitika zomwe zimawonjezera acidity ya magazi (kutsitsa mtengo wa pH). Izi zimabweretsa acidosis, yomwe ingayambitse matenda a shuga. Mu odwala matenda ashuga, matendawa amatchedwa diabetesic ketoacidosis, yomwe imadziwika ndi:

• Colic
• Kuchepetsa mseru
• Kubweza
• Mpweya wozama
• Thupi kapena kusowa kwa chikumbumtima,
• Fungo la acetone (tikamapuma kapena mkodzo).

Matenda a shuga a ketoacidosis amatha kukhala pachiwopsezo cha moyo, motero odwala amafunika kuyimba ambulansi posachedwa ndikuthandizidwa kuchipatala chachikulu.

Mothandizidwa ndi insulin yayikulu kwambiri, hypoglycemia imatha kuchitika. Kuchuluka kwa insulin m'magazi kumayambitsa kuchepa kwambiri kwa glycemia. Ngati glycemia igwera pansi pa 50 mg / dl, dokotala amalankhula za hypoglycemia.

Zomwe zimayambitsa hypoglycemia:

• Mulingo wambiri wa insulin kapena othandizira ena odwala matenda ashuga,
• Zakudya zamoto zochepa
• Kuchita masewera olimbitsa thupi mopitirira malire
• Mowa
• Kusintha kapena kutsegula m'mimba
• Kufooka kwa pituitary, adrenal gland, kapena chithokomiro.

Zizindikiro za hypoglycemia yofatsa ndizophatikizira:

• Kukhumudwa, thukuta, kugwedezeka,
• Flutter
• Mantha, mantha
• Kung'ung'udza
• Mutu.

Ndi hypoglycemia, ubongo umakhudzidwa makamaka. Ndi hypoglycemia, kuwonongeka kosasinthika kwa mitsempha kumachitika pakapita kanthawi kochepa. Hypoglycemia yamphamvu imayambitsa kusazindikira, kukomoka, kapena kufa.

Pogwiritsa ntchito shuga, adokotala amatha kukhazikitsa glycemia wodwala kwakanthawi. Glucagon jakisoni wa subipaneous adipose minofu ingathenso kuwonjezera magazi ndi kusiya hypoglycemia.

Chifukwa cha kupita patsogolo kwa zamankhwala, azimayi omwe ali ndi matenda ashuga amatha kubereka popanda mavuto. Ndikofunika kumvetsetsa kuti ndizotheka kubereka mwana pokhapokha kuchuluka kwa shuga m'magazi kumakhala kosinthika musanakhale ndi pakati komanso kukhalabe pakati pazomwe zili bwino.

Mimba imasintha kagayidwe ka thupi. Kufunika kwa insulin kukupitilizabe kupitilira nthawi yonse yomwe mukukhala ndi pakati. Amayi oyembekezera nthawi zambiri amafunika jakisoni asanu a insulin. Odwala matenda ashuga amayenera kuwunika kuchuluka kwa magazi awo musanadye ndi ola limodzi pambuyo chakudya chachikulu kuti glycemia ikhale yofanana. Ngati hyperglycemia yoika moyo pangozi, mayi wapakati amayenera kugonekedwa m'chipatala nthawi yomweyo. Matenda a matenda ashuga nthawi zambiri amatha kumapeto kwa mwana wosabadwa.

Chifukwa chiyani matenda a shuga amachepa

Kodi mumachepetsa thupi kapena kunenepa ndi matenda ashuga? Hyperglycemia yodwala komanso yosasamala imayambitsa kuchepa kwa michere m'maselo. Thupi limayesetsa kulipirira kusowa kwa glucose pophwanya mafuta, zomwe zimapangitsa kuti muchepetse thupi kwambiri. Popeza glucose samakwera mwachangu ndi matenda amtundu wa 2 monga momwe amachitira ndi matenda amtundu woyamba 1, odwala nthawi zambiri sawonda.

Shuga, kapena shuga, ndiye gwero lofunikira kwambiri lamphamvu mthupi la munthu. Chifukwa cha matenda ashuga, maselo amthupi sangathenso kutenga shuga popanda insulin ndikuigwiritsa ntchito kupanga mphamvu. M'malo mwake, amazungulira m'magazi popanda cholinga. Odwala amakula ofooka kwambiri komanso kutopa.

Nthawi zambiri, odwala matenda ashuga amachepetsa thupi msanga, ngakhale amadya kwambiri. Chomwe chimachitika ndichakuti maselo amthupi opanda insulini sangatenge ndi kuwotcha shuga kuti apange mphamvu. Ndi chifukwa chake thupi likuyang'ana njira zina zamagetsi - zimayamba kutentha mafuta, mapuloteni ndi minofu yambiri.

Nthawi zambiri, misa imatsika chifukwa chokoka pafupipafupi. Zotsatira zomveka zokoka pokoka ndikuti thupi limataya pang'onopang'ono. Madzi amadzimadzi amawoneka ngati khungu lowuma, losweka komanso kuyabwa. Khungu louma komanso ma mucous membrane, kusayenda bwino kwa magazi komanso kuthamanga kwa magazi, kumatha kuyambitsa matenda opatsirana. Ngakhale mabala omwe amachiritsa mwamphamvu amatha kukhala chizindikiro cha matenda ashuga. Zilonda zam'miyendo zochepa zomwe zimapangitsa kuti munthu akhale ndi matenda osokoneza bongo a shuga komanso kuti azidulidwa.

Kuchepetsa thupi

Anthu ambiri amafunsa: momwe mungalemere kulemera kwa shuga 1? Anthu odwala matenda ashuga sayenera kuthandizidwa ndi matenda a anorexia, koma ndi matendawo. Njira zazikulu zochizira kuchepa thupi mwadzidzidzi:

• Mankhwala: Mu shuga, insulin imagwiritsidwa ntchito, yomwe, mwazinthu zina, imawonjezera chidwi cha wodwalayo. Chithandizo choyenera cha matenda a shuga chikuthandizira kukulitsa kudya komanso kupewa kunenepa.
• Psychotherapy: Matenda amisala, monga kupsinjika, amatha kuthandizidwa ndi antidepressants. Njira zamakhalidwe azidziwitso nthawi zambiri zimagwiritsidwa ntchito pochiza mavuto azakudya.
• Opaleshoni: Nthawi zina, monga kukokana kwa ndulu yamkati chifukwa cha zomatira, zotupa kapena ma gallstones, opaleshoni ndiyofunikira,
• Zakudya zokhazikika: Ndikulimbikitsidwa kudya nthawi yomweyo kuti muchepetse matenda a anorexia,
• Kusunthika: masewera olimbitsa thupi, makamaka mu mpweya watsopano, amathandizira chidwi. Kuyenda motalikirapo kungathandize kukulitsa chilimbikitso,
• Ginger amakula kudya: tikulimbikitsidwa kumwa madzi a ginger tsiku lonse - izi zimathandiza chimbudzi ndi chilakolako cha chakudya,
• Kulawa kwamantha kumakupangitsani inu kukhala ndi njala: zinthu zowawa zimapangitsa chimbudzi. Hafu ya mphesa imalimbikitsidwa m'mawa, ndi arugula kapena saladi wa chicory nthawi ya nkhomaliro.
• Zosinthika: paukalamba, luso la malingaliro limachepa - lingaliro la kukoma limacheperanso. Makamaka okalamba samakondanso chakudya. Pachifukwa ichi, zonunkhira zimatha kusintha chikhumbo,
• Nthawi zambiri, kuchepetsa thupi kumayenderana ndi kupsinjika. Njira zopumira zimathandizira chidwi chanu, kuyambira pakupuma minyewa mpaka kusinkhasinkha kapena tai chi.

Odwala amakonda: momwe mungakhalire bwino ndi mankhwala? Kulemera ndi mapiritsi osavomerezeka. Pancreatin, ma antidepressant komanso ma antipsychotic amatha kupangitsa kuti mukhale ndi chidwi chachikulu. Komabe, ma antipsychotic omwe atenga nthawi yayitali amatha kubweretsa pancreatitis, shuga wowonjezereka (monga momwe zimakhalira ndi Ziprexa, kapena quetiapine), kutayika kwa libido ndi zovuta zina.

Uphungu! Ngati muli ndi vuto la kulakalaka, muyenera kudya chakudya chomwe dokotala amalimbikitsa. Kutsatira zakudya (zakudya) kumathandizira kuti munthu akhale ndi mafuta mofulumira (akhale bwino). Zakudya zomwe zimachitika mlungu uliwonse kwa abambo ndi amai zimathandizira kuti akhale wathanzi labwino. Ngati simungathe kunenepa, muyenera kumwa mankhwala.

Ndi matenda a shuga kapena kusamba, sizikulimbikitsidwa kuti muchepetse thupi. Musanayambe kudya, muyenera kufunsa dokotala.

Kodi hyperglycemia ndi chiyani?

Hyperglycemia simatenda, koma chizindikiro cha chipatala, chomwe ndi kuwonjezeka kwa kuchuluka kwa shuga m'magazi a m'magazi pamwambapa. Omasuliridwa kuchokera ku Chigriki, mawuwa amatanthauza "magazi okoma kwambiri."

Manambala a shuga wabwinobwino adapezeka chifukwa cha kuyesa kwamagazi kwa gulu lalikulu la anthu athanzi: kwa akulu - kuyambira 4.1 mpaka 5.9 mmol / l, kwa okalamba - 0,5 mmol / l more.

Kusanthula kumaperekedwa m'mawa, pamimba yopanda kanthu komanso musanamwe mankhwala - momwe mungaperekere magazi a shuga. Kuchuluka kwa shuga mutatha kudya kumakhalanso mtundu wamatenda ndipo amatchedwa postprandial hyperglycemia. Nthawi zambiri, pakudya mafuta ochulukirapo, ayenera kuyamwa mkati mwa maola awiri, pomwe kuchuluka kwa glucose kutsikira pansi 7.8 mmol / L.

Mitundu ya hyperglycemia molingana ndi kuopsa kwa matenda:

Kuwonongeka kwa chiwalo kumayambira pomwe shuga ali pamwamba pa 7 mmol / L. Ndi chiwonetsero chazaka 16, zodziwika bwino zowoneka bwino zimatha kuzindikirika. Ngati shuga apamwamba kuposa 33 mmol / L, wodwalayo amatha kugwa.

Zifukwa zazikulu

Glucose ndiye mafuta oyamba a thupi lathu. Kulowa kwake m'maselo ndi cleavage ndi gawo lofunikira la metabolism ya carbohydrate. Woyendetsa shuga wamkulu kuchokera m'magazi kupita ku minofu ndi insulin, mahomoni omwe amapanga kapamba. Thupi limapanganso mahomoni omwe amatsutsana ndi insulin. Ngati dongosolo la endocrine likugwira ntchito moyenera, pali mahomoni okwanira ndipo maselo amawazindikira bwino, shuga yamagazi imasungidwa mkati mozungulira, ndipo minofu imapeza chakudya chokwanira.

Nthawi zambiri, hyperglycemia ndi chifukwa cha matenda ashuga. Mtundu woyamba wa matendawa umadziwika ndi kusintha kwa matenda mu kapamba, maselo omwe amachititsa kuti insulini iwonongeke. Akakhala ochepera 20%, insulini imayamba kuchepa kwambiri ndipo hyperglycemia imakula msanga.

Mtundu wachiwiri wa shuga umadziwika ndi kuchuluka kwa insulini, mwina kumayambiriro kwa matendawa. Hyperglycemia pamenepa imachitika chifukwa cha kukana insulini - kusafuna kwa maselo kuzindikira insulin ndikulola shuga kudutsamo.

Kuphatikiza pa matenda ashuga, matenda ena a endocrine, mankhwala ena, matenda opweteka kwambiri m'thupi, zotupa, komanso kupsinjika kwambiri kungayambitse hyperglycemia.

Mndandanda wa matenda omwe hyperglycemia imatheka:

1. Type 1, Type 2 matenda ashuga komanso pakati pakati pawo LADA shuga.
2. Thirotooticosis. Ndi iyo, pali kuchuluka kwama mahomoni a chithokomiro, okonda insulin.
3. Acromegaly. Ntchito ya insulin pankhaniyi imalephereka ndi kukula kwama mahomoni ambiri.
4. Cushing's syndrome ndi kuphatikiza kwa cortisol.
5. Ma tumors omwe amatha kutulutsa mahomoni - pheochromocyte, glucagon.
6. Kutupa ndi khansa ya kapamba.
7. Kupsinjika ndi kuthamanga kwa adrenaline. Nthawi zambiri, imayambitsa stroke kapena vuto la mtima. Kuvulala komanso kuchitapo kanthu pakuchita opaleshoni amathanso kuvutitsa nkhawa.
8. Zambiri matenda a impso kapena chiwindi.

Zizindikiro ndi hyperglycemia

Hypoglycemia ofooka alibe pafupifupi zisonyezo. Kutopa kosafunikira komanso kuchuluka kwa madzi kumawonedwa. Nthawi zambiri, kuwonetsa kwa shuga wambiri kumayamba kuwonekera pokhapokha poyambira matenda oopsa a hyperglycemia. Ndi matenda 2 a shuga ndi matenda ena osachiritsika, kukula kwa shuga m'magazi kumayamba pang'onopang'ono, pakupitilira milungu ingapo.

Hyperglycemia yosalala imakhalapo, zimakhala zovuta kwambiri kuzizindikira mwa zizindikiro.

Munthu amazolowera vuto lakelo ndipo samaziganiza kuti ndi zam'magazi, ndipo thupi limayesetsa kuzolowera kugwira ntchito movutikira - limachotsa glucose owonjezera mumkodzo. Nthawi yonseyi, matenda osokoneza bongo a shuga samadziwika bwino ziwalo: ziwiya zazikulu zimakhazikika ndipo zazing'ono zimawonongeka, kuwonongeka kwa maso kumayipa ndipo minyewa imagwira ntchito.

Ngati mumvera thupi lanu mosamala, matendawo a shuga amatha kutsimikizika ndi zizindikiro zotsatirazi:

1. Madzi akumwa amapitilira malita anayi patsiku, ndi hyperglycemia yayikulu - mpaka 10.
2. Kukoka pafupipafupi, kufuna kukodza kangapo usiku.
3. Matenda osweka, owopsa, kugona, makamaka chakudya cham'mawa kwambiri.
4. Ntchito yolakwika yotseka khungu - pakhungu limatulutsa, mabala amatenga nthawi yayitali kuposa masiku.
5. Kuseweretsa bowa - thrush, candidiasis pamlomo patsekeke, dandruff.

Matendawa akamakula ndipo matenda a hyperglycemia akukula kwambiri, zizindikiro zotsatirazi zimawonjezeredwa pazizindikiro zam'mbuyomu:

• matenda ammimba - m'mimba kapena kudzimbidwa, kupweteka pamimba,
• Zizindikiro za kuledzera - kufooka kwambiri, nseru, mutu,
• kununkhira kwa zipatso za acetone kapena zipatso zowonongeka mu mpweya womwe watha chifukwa cha ketoacidosis,
• chophimba kapena chosunthira patsogolo pa maso ndi kuwonongeka kwa ziwiya zamaso,
• matenda opatsirana omwe ali ndi zotupa zosachotsa bwino,
• Kusokonekera mu mtima ndi m'mitsempha yamagazi - kumverera kukanikizika pachifuwa, khungu; kuchepa kwa magazi, kutsekeka kwa khungu, milomo.

Zizindikiro zoyambirira za chikomokere zomwe zimayandikira ndi hyperglycemia ndichisokonezo ndi kutayika kwa chikumbumtima, kukhudzika, kusachita zambiri.

Werengani zambiri za matenda a shuga pano - diabetiya.ru/oslozhneniya/diabeticheskaya-koma.html

Thandizo Loyambirira Loyenera

Wodwala akakhala ndi zizindikiro za hyperglycemia, ndipo pakukayikira kuti ali ndi matenda ashuga, amafunika kuyeza shuga m'magazi. Njira yosavuta yochitira izi ndikugwiritsa ntchito glucometer yonyamula. Aliyense wodwala matenda ashuga ali nawo mu labotale yamalonda iliyonse, komanso m'maofesi a akatswiri othandizira odwala matenda am'mimba.

Ngati mulingo wambiri wa glucose ndiwokwera pang'ono kuposa wabwinobwino, ndipo mutatha kudya maola opitilira 2, muyenera kupangana ndi adokotala. Ngati chizindikirocho chili pamwamba pa 13 mmol / l, itanani ambulansi. Vutoli litha kukhala mtundu woyamba wa matenda ashuga amene akupita patsogolo kwambiri ndipo mwina akuwopseza moyo.

Ngati matenda a shuga apezeka kale, shuga yayikulu ndi nthawi yolipira kwambiri chipukutamisozi chake, werengani mabukuwo pamatendawa, pitani ku dokotala ndikulembetseni pasukulu ya matenda ashuga kuchipatala.

Thandizo loyamba la hyperglycemia yayikulu isanafike ambulansi:

Doctor of Medical Science, Mutu wa Institute of Diabetesology - Tatyana Yakovleva

Ndakhala ndikuphunzira matenda a shuga kwa zaka zambiri. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russia Academy of Medical Science idatha kupanga mankhwala omwe amachiritsiratu matenda ashuga. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 98%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipira mtengo wa mankhwalawo. Ku Russia, odwala matenda ashuga mpaka Meyi 18 (kuphatikiza) nditha kuipeza - Kwa ma ruble 147 okha!

1. Patsani wodwala malo abwino, chotsani kuwala kowala, tsegulani zenera kuti mupeze mpweya wabwino.
2. Imwani odwala ambiri kuti shuga atulutse mkodzo.
3. Osapatsa zakumwa zotsekemera, musadyetse.
4. Konzani zinthu zoti zitha kugonekedwa kuchipatala.
5. Pezani khadi yakuchipatala, mfundo, pasipoti, mayeso aposachedwa.

Popanda manambala olondola a shuga, musayese kupereka chithandizo chamankhwala, ngakhale ngati inunso muli ndi matenda ashuga. Osamabailira insulin, osapatsa mankhwala omwe amachepetsa shuga. Zizindikiro za hypo- ndi hyperglycemia mu magawo akulu ndi ofanana. Ngati asokonezeka, kugwiritsa ntchito molakwika mankhwala osokoneza bongo kumatha kubweretsa imfa.

Kodi mankhwala mankhwala

Acute hyperglycemia amachotsedwa ndi makonzedwe a insulin. Nthawi yomweyo, amathandizira zovuta zoyipa zomwe zachitika chifukwa cha shuga wambiri, - kudzaza madzi otayika oyamba ndi otsitsira, ndiye, atatha kumwa wodwalayo, amayambitsa ma electrolyte osowa ndi mavitamini. Malinga ndi magulu apadziko lonse lapansi, matendawa amapatsidwa nambala ya R73.9 - hyperglycemia yosadziwika. Pambuyo pakuwongolera kapangidwe ka magazi, kuyezetsa kwathunthu kumachitika kuti mupeze zomwe zimayambitsa kuchuluka kwa shuga.

Ngati zikutsimikizika kuti glucose amatuluka chifukwa cha matenda ashuga, chithandizo chamankhwala nthawi yayitali ndi mankhwala. Munthu wodwala matenda ashuga amawonedwa ndi endocrinologist ndipo amayendera akatswiri ena miyezi isanu ndi umodzi iliyonse kuti apewe zovuta. Adzafunika kugula gluceter ndi kuyeza shuga tsiku lililonse, kudula chakudya chomanga thupi, kuonetsetsa kuti amamwa komanso kuonetsetsa kuti amamwa mankhwalawo osasiyidwa, ngakhale imodzi.

Mtundu wachiwiri wa matenda ashuga (code for ICD-10 E11), mankhwala omwe amachepetsa kukokana ndi insulin kapena kuphatikiza insulin kaphatikizidwe kawirikawiri amagwiritsidwa ntchito kuchokera ku mankhwala. Zakudya zamafuta ochepa, kuchepa thupi, komanso moyo wokangalika zimafunikanso.

Mitundu ya 1 ya odwala matenda ashuga (code E10) amafuna insulin. Mlingo woyambirira amasankhidwa ndi dokotala, ndiye kuti amatha kusinthidwa malinga ndi zomwe zikuwonetsa shuga. Pofuna kupewa hyperglycemia, wodwalayo amayenera kuwerengera chakudya chisanadye kuchuluka kwa mafuta omwe ali nawo patebulo ndikulembera mlingo woyenera wa mankhwalawo.

Ngati chifukwa cha shuga wamphamvu sichinali matenda ashuga, koma nthenda ina, hyperglycemia imazimiririka payokha itatha. Mankhwala atha kutumizidwa kuti achepetse ntchito ya chithokomiro kapena kuletsa kaphatikizidwe ka kukula kwa mahomoni. Ndi kapamba, amayesera kutsitsa zikondwerero momwe angathere, kupereka mankhwala okhwima, ovuta kwambiri, kugwiritsa ntchito opaleshoni. Ma tumor amachotsedwa, ndiye kuti chemotherapy imayikidwa.

Zotsatira zake

Zotsatira za hyperglycemia ndi matenda amthupi lonse. Kuchuluka kwa shuga kumawopseza wodwala matenda ashuga. Hyperglycemia imakhalanso yoopsa m'mitsempha yamagazi ndi mitsempha - imawonongeka, zimapangitsa kulephera kwa ziwalo, thrombosis, gangrene ya malekezero. Kutengera ndi kuthamanga kwa chitukuko, zovuta zimagawidwa kumayambiriro komanso kutali.

Momwe Mungapewere Hyperglycemia

Popewa hyperglycemia, odwala matenda ashuga ayenera kutsatira mosamalitsa malangizo othandizira - musaiwale kumwa mankhwala, kuwonjezera zolimbitsa thupi koma zolimbitsa thupi m'moyo wanu, kumanganso zakudya zanu kuti chakudya chamagulu azilowa mthupi mokwanira komanso pafupipafupi. Ngati izi zachitika kangapo motsatira mzere wa hyperglycemia, muyenera kupita kwa dokotala kuti musinthe mankhwalawo. Kufunsira kwa endocrinologist ndikofunikanso pakachitika njira yopangira opaleshoni, matenda oopsa, kutupa kwambiri, komanso pakati.

Kupewa kwamphamvu kwa hyperglycemia kwa anthu athanzi kumakhala ndi zochitika zolimbitsa thupi popanda kupanikizika kwambiri, kupewa kupsinjika, kukhalabe ndi thanzi labwino, kudya wathanzi. Sichikhala chopanda pake kupatula kukwera msanga m'magazi, chifukwa izi, maswiti amafunika kudya pang'ono masana, osati gawo limodzi lalikulu.

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Hyperglycemia

Hyperglycemia ndi chikhalidwe cha munthu wodwala matenda ashuga, pamene kuchuluka kwa shuga m'magazi kumakwera kwambiri.

Mulingo wabwinobwino wamagazi ndi 8-10 mmol / l (kwa anthu azaka zopitilira 65, shuga samawerengedwa ngati wapamwamba kwambiri ndi 11-12 mmol / l).

Mutha kuyankhula za hyperglycemia ngati kuchuluka kwa shuga kupitirira 13.2-15 mmol / L. Muzovuta kwambiri, kuchuluka kwa glucose kumatha kufika 26-28 mmol / L.

Choopsa china cha hyperglycemia ndi chakuti nthawi zambiri samamva wodwala. Wodwala matenda a shuga amamva ngati wabwinobwino ngakhale ali ndi shuga 16-16 mmol / L, makamaka ngati ziwerengero zomwe sizili bwino chifukwa cha matendawa azolowera kapena zimakonda kubwerezedwa. Komabe, pali zizindikiro zomwe zingathandize kudziwa kuti hyperglycemia yachitika:

Choyambitsa chachikulu cha hyperglycemia ndikusowa kwa insulin mthupi. Pakakhala insulin yokwanira, shuga m'magazi amakwera. Magazi a shuga m'magazi amapitilira kulumikizana kwa impso, shuga amayamba kutsitsidwa mkodzo, pokodza amakhala pafupipafupi. Thupi limataya madzimadzi. Kuthetsa madzi kumapangitsa ludzu lochulukirapo. Popeza ndi mkodzo zinthu zambiri zofunikira zimachotsedwa m'thupi - sodium, mchere wa potaziyamu, etc., wodwalayo amamva kufooka, nseru ndi mutu.

Makamaka, nthawi zambiri, hyperglycemia imawonedwa mwa odwala omwe ali ndi matenda osokoneza bongo omwe sakudziwa za matenda awo ndipo samamwa mankhwala a hypoglycemic. Chifukwa chake, ngati mukuwona zina mwa zizindikiro za hyperglycemia, pimani shuga ndikuwonana ndi dokotala. Ngati mukukhudzidwa ndi polyuria (kuchuluka kwamkodzo mpaka malita angapo patsiku), ludzu ndi pakamwa pouma (makamaka usiku), ngati chilako chanu chacheperachepera kapena, m'malo mwake, chulukitsani, ngati mukusamala ndi kuyimbira kwa khungu, makamaka m'deralo perineum, komanso chizolowezi cha matenda a pustular, kuchiritsa koopsa kwa bala - muyenera kuwona dokotala nthawi yomweyo. Ngati matenda ashuga samalandiridwa, ngati kuchuluka kwa shuga m'magazi sikuchepetsedwa, zovuta zazikulu kwambiri ndizosapeweka.

Zachidziwikire, hyperglycemia imatha kudwala wodwala yemwe wakhala akupanga insulin kwa zaka zambiri ndipo akuwoneka kuti akudziwa zonse za matenda ake. Izi zitha kuchitika ngati mutagwiritsa ntchito insulin yotsika mtengo (mwachitsanzo, mazira kapena yotayika) ndipo sinagwire. Hyperglycemia imatha kuchitika chifukwa cha zolakwa zakudyazo (mwachitsanzo, ngati mumamwa molakwika kapena mosasamala kumwa msuzi wokoma m'malo mwachilengedwe, wopanda shuga). Nthawi zina odwala mwakufuna kwawo amachepetsa mlingo wa insulin yomwe adalimbikitsidwa ndi adokotala, kapena m'malo mwamankhwala ena. Zosakhazikika mu thupi zimatha kudzetsa hyperglycemia. Matenda aliwonse, makamaka oopsa (stroko, vuto la mtima, matenda opatsirana) angayambitse glycemia. Ngakhale matenda oyamba a catarrhal amakhala ndi zoopsa chotere. Chowonadi ndi chakuti mwapadera (mwachitsanzo, panthawi yapakati) kapena zovuta zopweteka, insulin siyichita monga mwa masiku onse. Amadziwika kuti kuwonjezeka kwa kutentha kwa thupi kwa degree imodzi imodzi yokha yowonjezera makumi atatu ndi zisanu ndi zitatu kumawononga 20% ya insulin. Hyperglycemia imatha kudzetsa nkhawa kwambiri, kuvutika m'maganizo, ndi zovuta zina. Pofuna kupewa kukula kwa hyperglycemia pa matenda opatsirana, musalepheretse insulin komanso musachepetse mlingo wake. Mulimonsemo, samanani ndi dokotala yemwe amayeza matenda anu, komanso ndi endocrinologist yemwe amayang'anira matenda anu a shuga. Imwani mankhwala omwe munalandira panthawi yake, tsatirani zakudya (ndipo ngati zasokonekera, muchepetseni shuga ndi insulin yowonjezera komanso zochita zolimbitsa thupi) - mudziteteza ku hyperglycemia.

Matenda a shuga ketoacidosis

Matenda a shuga a ketoacidosis ndi oopsa omwe amabwera chifukwa cha hyperglycemia. Zotsatira zakusowa kwa insulin mthupi komanso shuga wambiri m'magazi, shuga samalowa m'maselo. Maselo amayamba kufa ndi njala ndipo ali ndi vuto lanjala, amagwiritsa ntchito mafuta ngati gwero lamphamvu. Pogwiritsa ntchito mafuta omwe amapezeka m'thupi, matupi omwe amatchedwa ketone amapangidwa. Zinthu zosokonekera zamafuta - matupi a ketone, makamaka acetone, amadziunjikira m'magazi ndi mkodzo. Kamodzi m'magazi, matupi a ketone amasokoneza asidi. Ma ketones amapangitsa magazi kukhala acicids m'chilengedwe (chifukwa chake mawu akuti - ketoacidosis).

Acetone imadziwika ngakhale ndi fungo lochokera mkamwa mwa wodwalayo (uku ndiye kununkhira kwa zipatso zowawasa). Maonekedwe a acetone mkodzo ndi chizindikiro cha kuvutika kwambiri m'thupi. Mkoyo imayang'aniridwa kupezeka kwa ma ketones m'njira ziwiri: mothandizidwa ndi mapiritsi apadera omwe amasintha mtundu wa mkodzo kutengera kuchuluka kwa ma ketoni omwe amapangidwa, komanso mothandizidwa ndi mbale zomwe zimapangidwa ndi mawonekedwe apadera ndikusintha mtundu wawo utamizidwa mu mkodzo pakuwunikira. Ngati acetone wapezeka mkodzo, zikutanthauza kuti mkati mwathupi la thupi mumapezeka asidi - ketoacidosis, yomwe imatsogolera kuphaka ndi kufa. M'masiku amenewo pamene insulin inali isanadziwikebe, ketoacidosis nthawi zonse imatsogolera kuphedwa kwa wodwalayo. Masiku ano, anthu odwala matenda ashuga samakonda kufa ndi ketoacidosis chikomokere, ndipo madotolo amatha kukuthandizani.

Pofuna kupewa kutulutsa ketoacidosis, ndikofunikira kupewa hyperglycemia. Ngati mukumva zizindikiro monga kununkhira kwa acetone, kufooka, kupweteka mutu, kusandulika chakudya, kupweteka m'mimba, kusanza, kutsegula m'mimba, mseru, phokoso, lakuya, komanso mofulumira kupumira - mwachangu imbani ambulansi. Kukula kwa ketoacidosis kumalepheretsedwa ndi kuwopsa kwa insulin kuchipatala.

Ngati wodwala yemwe ali ndi matenda ashuga achulukitsa shuga m'magazi, koma mulibe acetone mu mkodzo, ndikofunikira kuti muwonjezere insulin "yochepa" ndi 10% ya kuchuluka kwa tsiku lililonse kapena, osasintha mlingo wa insulin yayitali, perekani jakisoni wa "ifupi "wazigawo zinayi. maola asanu ndi anayi aliwonse kwa nthawi yonse ya matenda anu. Ngati shuga wamagazi ndiwokwera kwambiri ndipo ma acetone amawonekera mu mkodzo, muyenera kuwonjezera kuchuluka kwa insulin "yochepa" ndi 20% ya okwanira tsiku ndi tsiku. Nthawi yomweyo, kupewa hyperglycemia, muyenera kulipira gawo la insulin mothandizidwa ndi maswiti: chakumwa chochulukirapo, chotsekemera ndichofunika. Ngakhale mutakhala kuti mulibe vuto la kudya (zomwe zimakhala zachilengedwe pakadwala), muyenera kudya kapena maswiti osamwa. Kwa masiku atatu, kawiri pa tsiku, muyenera kuyika soda. Ma supuni anayi a koloko amatengedwa pa lita imodzi yamadzi (kutentha kwa madzi kuyenera kukhala kofanana ndi kutentha kwa thupi pakadali pano). Njira imeneyi iyenera kutha ngati zizindikiro zowopsa monga kupweteka m'mimba, kutsegula m'mimba ndi kusanza zawonekera. Pankhaniyi, itanani ambulansi nthawi yomweyo.

Zoyambitsa Hyperglycemia

Kuwonjezeka kwa shuga m'magazi kumatha kuchitika pazifukwa zosiyanasiyana, makamaka chifukwa chosagwirizana ndi zakudya zomwe adokotala amafunsa. Wodwala matenda ashuga akamadya chakudya chochuluka, mkati mwa theka la ola m'magazi ake wamagazi amapezeka mwachangu.

Ngakhale kuti glucose ndi gwero labwino la mphamvu, kuchuluka kwake kumayipa kwambiri kuposa momwe kumawonekera poyamba.

Popita nthawi, hyperglycemia imasokoneza machitidwe a metabolic, omwe amawonekera:

• onenepa
• kuphwanya kwamtima dongosolo,
• kulolerana kwa shuga,
• kuchuluka triglycerides.

Wodwala akapezeka ndi 2 kapena kuposerapo mwa zizindikirozi komanso kunenepa kwambiri, amapezeka kuti ali ndi matenda a metabolic. Popanda chithandizo chakanthawi, mtundu 2 wa matenda a shuga umayamba pang'onopang'ono.

Kunenepa kwambiri kumayambitsa kukana kwa insulini, makamaka nthawi zambiri ndi m'mimba kunenepa kwambiri, mafuta akaikidwa m'chiuno. Ambiri mwa odwala matenda ashuga ndi onenepa kwambiri (BMI yoposa 25).

Njira zopangira matenda ashuga mwa anthu onenepa aphunziridwa bwino.Kuchuluka kwa minofu ya adipose kumawonjezera kuchuluka kwamafuta acids omasuka - gwero lalikulu lamphamvu. Ndi kuchuluka kwa mafuta acids m'magazi, hyperinsulinemia, insulin kukana kumachitika. Kuphatikiza apo, mafuta achilengedwe aulere amapweteka kwambiri maselo a pancreatic beta, chifukwa amatsitsa ntchito zachinsinsi za chiwalo.

Chifukwa chake, pakuwonetsetsa koyambirira kwa matenda amitundu iwiri, matenda a plasma omwe ali pamlingo wa FFA akuwonetsedwa, mopitirira muyeso wa zinthu izi tikukamba za kukhazikika kwa kulolera kwa glucose, hyperglycemia.

Zomwe zimayambitsa hyperglycemia: pafupipafupi zinthu zovuta, kumwa mankhwala ena, matenda opatsirana kapena matenda, kuchepa kwa insulin.

Choopsa kwambiri ndichakuti kusowa kwa insulini, mahomoni oyendera omwe amalimbikitsa kugawa mphamvu mthupi lonse. Ndi kusakwanira kwake, mamolekyulu a glucose adzadziunjikira m'magazi, gawo lamphamvu zowonjezera limasungidwa mu chiwindi, gawo limapangidwa ndikukhala mafuta, ndipo chotsalacho chimachoka ndi mkodzo pang'onopang'ono.

Ngati kapamba sangathe kupanga insulin yokwanira:

1. shuga amaipitsa magazi
2. imakhala poizoni.

Ndi matenda a shuga a shuga omwe amadalira insulin, ndikofunikira kuyang'anira kuchuluka kwa insulin, yomwe imayikidwa kangapo patsiku. Mlingo weniweni wa mahomoni nthawi zonse umatengera chakudya cha wodwalayo, zaka zake komanso magawo ena ambiri. Ndi insulin yokwanira, hyperglycemia imayamba.

Osati gawo lomaliza pakupanga matenda a hyperglycemia ndi matenda a shuga a 2 amapatsidwa mwayi wokhala wolowa m'badwo. Asayansi afotokoza mitundu yoposa zana yomwe imalumikizidwa ndi mwayi wokhudzana ndi insulin, kunenepa kwambiri, kuperewera kwa glucose komanso mafuta a metabolism.

Hyperglycemia ndi zizindikiro zake zimayambitsanso kuwonongeka kwa ma cell a pancreatic beta, omwe ndi:

Monga taonera, zomwe zimayambitsa zovuta ndi shuga m'magazi zimaphatikizapo kugwiritsa ntchito mankhwala kwa nthawi yayitali: mahomoni a adrenal cortex (glucocorticosteroids), diuretics (thiazides), mankhwala osokoneza bongo, arrhythmias, kupewa matenda a mtima (beta-blockers (antipsychotic), mankhwala a anticholesterol (ma statins).

Kafukufuku yemwe adachitika mabanja akulu ndi mapasa adatsimikizira kuti ngati m'modzi mwa makolo ali ndi matenda a shuga a 2, mwana adziwe kuti glycemia ili ndi mwayi wotani mpaka 40%.

Kuwongolera kwa glycemia: miyambo ndi zomwe zimayambitsa kupatuka

Mlingo wa shuga umatsimikiziridwa mu ma labotale pamaziko a kusanthula kwa capillary kapena venous magazi kapena kugwiritsa ntchito glucometer. Chipangizochi ndichabwino kwambiri kuwunikira chizindikiritso kunyumba. Kuyeza kwa kuchuluka kwa shuga kumachitika pamimba yopanda kanthu pambuyo pakusala kudya pafupifupi maola 8-14.

Malingaliro a mibadwo yosiyana ndi yosiyana pang'ono:

Kwa zaka zambiri ndakhala ndikuphunzira za zovuta za DIABETES. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russia Academy of Medical Science idatha kupanga mankhwala omwe amachiritsiratu matenda ashuga. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 100%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipilira mtengo wonse wa mankhwalawo. Ku Russia ndi mayiko a CIS odwala matenda ashuga kale Julayi 6 alandire mankhwala - ZAULERE!

• makanda mpaka mwezi - 28.8-4.4 mmol / l,
• ana osakwana zaka 14 - 3,3-5.6 mmol / l,
• achikulire - 4.1-5.9 mmol / l,
• amayi oyembekezera - 4.6-6.7 mmol / l.

Zomwe zimayambitsa hyperglycemia nthawi zambiri zimakhala za endocrine. Izi zikuphatikizapo matenda a shuga a mellitus, pheochromocyte, glucagonoma, tereotoxicosis, acromegaly.

Matendawa amapezekanso chifukwa chovuta kupanikizika, kudya kwambiri, zovuta za kudya, pamatenda oyambitsidwa ndi matenda opatsirana kapena osakhazikika.

Akuluakulu

Kupezeka kwa hyperglycemia mwa akulu kungadziwike ndi zotsatirazi:

Ndili ndi zaka 47, ndinapezeka kuti ndili ndi matenda ashuga a 2. M'masabata angapo ndinapeza pafupifupi 15 kg. Kutopa nthawi zonse, kugona, kumva kufooka, kuwona kunayamba kukhala pansi.

Nditakwanitsa zaka 55, ndinali nditadzibaya kale ndi insulin, zonse zinali zoipa kwambiri. Matendawa adapitilirabe, kukomoka kwakanthawi kunayamba, ambulansi imandibwezera kuchokera kudziko lina. Nthawi zonse ndimaganiza kuti nthawi ino ikhala yomaliza.

Chilichonse chinasintha mwana wanga wamkazi atandilola kuti ndiwerenge nkhani imodzi pa intaneti. Simungayerekeze m'mene ndimamuyamikirira. Nkhaniyi inandithandiza kuthana ndi matenda ashuga, omwe amati ndi osachiritsika. Zaka 2 zapitazi ndidayamba kusuntha zowonjezereka, nthawi yamasika ndi chilimwe ndimapita kumayiko tsiku lililonse, ndikumalima tomato ndikugulitsa pamsika. Azakhali anga amadabwa ndimomwe ndimapangira chilichonse, komwe ndimapeza mphamvu zambiri, sakhulupirira kuti ndili ndi zaka 66.

Ndani akufuna kukhala ndi moyo wautali, wamphamvu komanso kuiwalako za matenda oyipawa kwamuyaya, tengani mphindi 5 ndikuwerenga nkhaniyi.

• chizungulire ndi mutu
• kukodza pafupipafupi
• ludzu lochulukirapo
• kugona ndi kutopa kwambiri,
• womvera
• thukuta
• kuchepa kwa chidwi,
• kuwonda
• nseru
• mphwayi
• Khungu.

Mwa ana omwe ali ndi matenda a shuga a mtundu wachiwiri, zizindikiro za hyperglycemia nthawi zambiri sizikupezeka, popeza matendawa ndi ofatsa. Zizindikiro zimadziwika makamaka ndi mtundu woyamba wa matenda. Nthawi zambiri umatha ludzu komanso kukodza pafupipafupi.

• kuthamanga kwa magazi pankhope,
• mutu
• kamwa yowuma
• masomphenya osalala
• khungu lowuma
• kupuma movutikira
• kusanza ndi kusanza
• kugona ndi ulesi,
• kukomoka mtima,
• kupweteka kwam'mimba.

Pa nthawi yoyembekezera

Mwa amayi apakati, zizindikiro zina za hyperglycemia zimatha kusokonezeka ndi zizindikiro za kutenga, mwachitsanzo, kukodza mwachangu.

Kuphatikiza pa zodziwika bwino, azimayi oyembekezera amatha kupuma movutikira, kugona movutikira, kulimbitsa chidwi nthawi yomweyo monga kuchepa thupi, komanso kupweteka kwamisempha.

Muzochitika izi, thandizo lachipatala ladzidzidzi likufunika. Poyerekeza ndi matendawo ndi kufooka kwa chitetezo chokwanira, mwayi wokhala ndi matenda ndi matenda ena ndi wokwera.

Kodi chifukwa chiyani shuga wambiri ndi woopsa?

Hyperglycemia imatha kubweretsa zotsatira zoyipa, chifukwa chake ndikosavomerezeka kukhazikitsa vutoli, ndikofunikira nthawi yomweyo kulandira chithandizo.

Nanga ngozi yake ndi iti?

Choyamba, kuthamanga kwa shuga kumabweretsa kuphwanya kagayidwe kazakudya, pambuyo pake pamakhala mavuto ndi madzi, mapuloteni, lipid bwino.

Zotsatira zake zimakhala zopanda chakudya cha maselo, chifukwa chomwe amayamba kugwirira ntchito ndikufa. Khungu lowuma, kutsitsi, kukula kwa tsitsi kumachepa, kupoleka kwa mabala, kupenya kwamaso kumakulirakulira. Vuto la minyewa imawonedwanso, atherosulinosis imayamba. Chifukwa cha minofu necrosis, lameness kapena gangrene ndizotheka.

Kwa minofu ya minofu, hyperglycemia imabweretsa mavuto monga kupweteka, kukokana, kupukusa minofu, kutopa msanga. Vutoli limaperekanso kuchepa kwa madzi m'thupi, kuchepa kwakukulu kwa thupi, chifukwa cha zomwe zimapangitsa kuti endocrine system ipangike.

Choyamba thandizo la kugunda kwa hyperglycemic

Mukazindikira zizindikiritso za vuto la hyperglycemic, chinthu choyamba kuchita ndikuyeza kuchuluka kwa shuga m'magazi.

Ngati shuga ndiwambiri kwambiri, ndiye kuti muyenera nthawi yomweyo kumwa zamadzi zambiri.