Matenda a shuga ndi kutenga pakati, zovuta, chithandizo

Tikukupemphani kuti muwerenge nkhaniyi pamutuwu: "Matenda a shuga ndi kutenga pakati, zovuta, chithandizo" ndi ndemanga kuchokera kwa akatswiri. Ngati mukufuna kufunsa funso kapena kulemba ndemanga, mutha kuchita izi pansipa, nkhaniyo itatha. Katswiri wathu wamtundu wa endoprinologist adzakuyankhirani.

Kanema (dinani kusewera).

Matenda a shuga oyembekezera - Zizindikiro, ndimafunikira chakudya chapadera?

Zolemba zina 15 pamutuwu: Kuthandizira kwa dokotala: Zizindikiro zowopsa pa nthawi yapakati

Matenda a shuga oyembekezera - Zizindikiro, ndimafunikira chakudya chapadera?

Ngati shuga wamagazi akwera panthawi yomwe ali ndi pakati, ndiye kuti akunena kuti shuga ya gestational yayamba. Mosiyana ndi matenda ashuga okhazikika, omwe anali asanakhale ndi pakati, amasowa kwathunthu atabadwa mwana.

Shuga wambiri angayambitse mavuto kwa inu ndi mwana wanu. Mwana amatha kukula kwambiri, zomwe zimayambitsa zovuta pakubala. Kuphatikiza apo, nthawi zambiri amakhala ndi vuto la kusowa kwa oxygen (hypoxia).

Kanema (dinani kusewera).

Mwamwayi, ndi chithandizo choyenera komanso chapanthawi yake, azimayi oyembekezera ambiri omwe ali ndi matenda ashuga ali ndi mwayi aliyense wobala mwana wathanzi palokha.

Zakhazikitsidwa kuti omwe anali ndi shuga yayikulu m'mimba amakhala ndi shuga nthawi zambiri ndi zaka. Izi zitha kuchepetsedwa kwambiri ndikuwongolera kunenepa, kudya mokwanira, komanso kuchita masewera olimbitsa thupi nthawi zonse.

Nthawi zambiri, kuchuluka kwa shuga m'magazi kumayendetsedwa ndi insulin, yomwe imabisa ch kapamba. Mothandizidwa ndi insulin, glucose kuchokera ku chakudya imalowa m'maselo a thupi lathu, ndipo mulingo wake m'magazi umachepa.

Nthawi yomweyo, mahomoni apakati omwe amatulutsidwa ndi placenta amachita mosiyana ndi insulin, ndiye kuti, amawonjezera shuga. Katundu pa kapamba amawonjezeka, ndipo nthawi zina sagwira ntchito yake. Zotsatira zake, kuchuluka kwa shuga m'magazi ndikwapamwamba kuposa zabwinobwino.

Kuchuluka kwa shuga m'magazi kumaphwanya kagayidwe ka zonse ziwiri: mayi ndi mwana wake. Chowonadi ndi chakuti glucose amalowa m'matumbo kulowa m'magazi a mwana wosabadwayo ndikuwonjezera zomwe ali nazo, zomwe zimakhalabe zazing'ono, kapamba.

Zikondamoyo za mwana wosabadwayo zimayenera kugwira ntchito ndi katundu wambiri komanso kuphatikiza insulini yambiri. Insulin yowonjezera imeneyi imathandizira kwambiri kuti mayamwidwe a shuga asanduke mafuta, zomwe zimapangitsa kuti fetal misa ikule mwachangu kuposa masiku onse.

Kupititsa patsogolo kotereku kwa mwana kumafuna mpweya wambiri, pomwe kudya kwake kumakhala kochepa. Izi zimayambitsa kuperewera kwa oxygen ndi fetal hypoxia.

Matenda a shuga a Gestational amakhala ndi pakati 3 mpaka 10% ya amayi apakati. Makamaka omwe ali pachiwopsezo chachikulu ndi amayi omwe akuyembekezera omwe ali ndi chimodzi mwazizindikiro izi:

Kunenepa kwambiri
Matenda a shuga m'mimba yapitayi,
Shuga mkodzo
Polycystic ovary syndrome
Matenda a shuga m'mabanja apafupi.

Iwo omwe ali pachiwopsezo chachikulu chokhala ndi matenda ashuga ndi omwe amaphatikiza njira zotsatirazi:

Osakwana zaka 25
Kulemera kwabwinobwino musanakhale ndi pakati,
Panalibe matenda a shuga kwa abale ake apamtima,
Sanakhalepo ndi magazi okwanira
Sipanakhalepo zovuta za pakati.

Nthawi zambiri, mayi woyembekezera satha kukayikira matenda abwinobwino, chifukwa nthawi yochepa, samadziwonetsa. Ichi ndichifukwa chake ndikofunikira kwambiri kuyezetsa magazi nthawi yake.

Pakuchepa pang'ono kwa shuga m'magazi, adotolo adzalemba kafukufuku wambiri, womwe umatchedwa "glucose kulolerana", kapena "curve shuga". Chomwe chimatsimikizira izi poyesa shuga sichiri pamimba yopanda kanthu, koma mutatha kumwa kapu yamadzi ndi shuga wosungunuka.

Shuga yofulumira yotsika magazi: 3,3 - 5.5 mmol / L.

Pre-matenda ashuga (kulekerera shuga) kusala shuga lamwazi kuposa 5.5, koma ochepera 7.1 mmol / L.

Matenda a shuga: kusala shuga m'magazi kuposa 7.1 mmol / l kapena kuposa 11.1 mmol / l mutatha kudya shuga.

Popeza kuchuluka kwa shuga m'magazi osiyanasiyana pakanthawi kochepa patsikulo, nthawi zina mwina satha kuwunika panthawi yoyeserera. Pali mayeso enanso pa izi: glycated hemoglobin (HbA1c).

Mafuta a glycated (i.e. glucose-womangidwa) sawonetsa kuchuluka kwa shuga m'masiku ano, koma m'masiku 7-10 apitawa. Ngati shuga atakwera kuposa zokhazokha panthawi imeneyi, mayeso a HbA1c azindikira izi. Pachifukwa ichi, chimagwiritsidwa ntchito kwambiri kuwunika mtundu wa chisamaliro cha matenda a shuga.

Odwala okhawo oopsa omwe ali ndi matenda ashuga, zotsatirazi zingaoneke:

Ludzu lalikulu
Pafupipafupi ndi kupemphetsa pokodza
Njala yayikulu
Kuwona koperewera.

Popeza amayi apakati nthawi zambiri amakhala ndi ludzu komanso chilakolako chokwanira, mawonekedwe a izi sizitanthauza matenda ashuga. Kungoyeserera pafupipafupi ndi kuyezetsa dokotala ndi komwe kungathandize kuti izi zisachitike pakapita nthawi.

Kodi ndikufunika kudya kwapadera - zakudya zabwino kwa amayi apakati omwe ali ndi matenda ashuga

Cholinga chachikulu pothana ndi matenda ashuga oyamwitsa ndikukhazikitsa kuchuluka kwa shuga munthawi iliyonse: musanadye komanso pambuyo chakudya.

Nthawi yomweyo, onetsetsani kuti mukubayika kangapo patsiku kuti kudya michere ndi mphamvu ndizofanana tsiku lonse kuti mupewe kuchuluka kwa shuga m'magazi.

Zakudya za anthu odwala matendawa ziyenera kupangidwira m'njira yoti zithetse chakudya chamagulu ochepa (shuga, maswiti, zoteteza, ndi zina), kuchepetsa kuchuluka kwa chakudya chambiri mpaka 50% ya kuchuluka kwa chakudya, ndi 50 zotsala % yogawidwa pakati pa mapuloteni ndi mafuta.

Chiwerengero cha zopatsa mphamvu ndi mndandanda wachilengedwe ndizovomerezeka bwino ndi katswiri wazakudya.

Choyamba, ntchito zakunja zomwe zimagwira zimathandizira kuti mpweya wabwino ubwere m'magazi, zomwe mwana wosabadwa alibe. Izi zimapangitsa kagayidwe kake.

Kachiwiri, panthawi yochita masewera olimbitsa thupi, shuga owonjezera amamwa ndipo mulingo wake m'magazi umatsika.

Chachitatu, kuphunzitsa kumathandizira kugwiritsa ntchito zopatsa mphamvu, kuchepetsa kulemera komanso kuchepetsa. Izi zimathandizira kwambiri ntchito ya insulin, pomwe mafuta ambiri amachititsa kuti zikhale zovuta.

Zakudya zophatikizidwa ndimasewera olimbitsa thupi nthawi zambiri zimatha kukuthandizani kuti mupewe zizindikiro za matenda ashuga.

Nthawi yomweyo, sikofunikira kuti mudzitopetse ndi zolimbitsa thupi tsiku ndi tsiku kapena kugula khadi yanyimbo ku masewera olimbitsa thupi kuti mupeze ndalama zomaliza.

Amayi ambiri omwe ali ndi matenda ashuga amakhala ndi pakati kuti aziyenda pafupipafupi mu mpweya wabwino kwa maola angapo katatu pa sabata. Zakudya zama calorie ndikuyenda koteroko ndizokwanira kuchepetsa shuga m'magazi, koma muyenera kutsatira zakudya, makamaka ngati simumamwa insulin.

Njira yabwinoko yoyendera ikhoza kukhala makalasi mu dziwe ndi aqua aerobics. Kuchita masewera olimbitsa thupi kotereku ndikofunikira kwa amayi omwe akuyembekezera omwe, ngakhale asanakhale ndi pakati, anali ndi vuto lokhala onenepa kwambiri, chifukwa kunenepa kwambiri kumalepheretsa insulin.

Mukagwiritsidwa ntchito moyenera pa nthawi ya pakati, insulini imakhala yotetezeka kwa onse mayi ndi mwana wosabadwayo. Palibe chizolowezi chomwe chimayamba ndi insulin, kotero pambuyo pobadwa chimatha kudzipatula kwathunthu.

Insulin imagwiritsidwa ntchito panjira yomwe zakudya ndi zolimbitsa thupi sizipereka zotsatira zabwino, ndiye kuti, shuga amakhalabe okwera. Nthawi zina, dokotalayo amasankha kuti apereke insulin nthawi yomweyo ngati akuona kuti vutolo likufuna.

Ngati dokotala akukulemberani insulin, musakane. Mantha ambiri omwe amagwiritsidwa ntchito ndi kugwiritsidwa ntchito sikuti amangokhala tsankho. Chofunikira chokhacho chothandizidwa ndi insulin ndikukhazikitsa mosamalitsa zomwe dokotala akukulemberani (musaphonye mlingo ndi nthawi yovomerezeka kapena kusintha nokha), kuphatikizapo kuyesedwa kwakanthawi kovomerezeka.

Ngati mumamwa insulini, muyenera kuyeza shuga m'magazi kangapo patsiku ndi chida chapadera (chimatchedwa glucometer). Poyamba, kufunikira kwa kuyeza pafupipafupi kotereku kumatha kuoneka kwachilendo kwambiri, koma ndikofunikira kuwunika mozama glycemia (shuga wamagazi). Kuwerenga kwa chipangizocho kuyenera kulembedwa mu kope ndikuwonetsa kwa adokotala ku phwando.

Amayi ambiri oyembekezera omwe ali ndi matenda ashuga amatha kubereka mwachilengedwe. Kukhalapo kwa shuga pakokha sikutanthauza kufunika kwa gawo la caesarean.

Tikuyankhula za gawo lokonzekera manda ngati mwana wanu akukula kwambiri kuti angabadwe payekha. Chifukwa chake, amayi oyembekezera omwe ali ndi matenda ashuga amapatsidwa njira yowonjezera yowonjezera ya mwana wosabadwayo.

Pa nthawi yobereka, mayi ndi mwana amafunika kuwunika mosamala:

Kuyang'anira shuga pafupipafupi kangapo patsiku. Ngati shuga wambiri ndiwokwera kwambiri, dokotala amatha kukupatsani mankhwala a insulin kudzera m'mitsempha. Pamodzi ndi iye amatha kuwerengera glucose mu dontho, musadabwe ndi izi.
Kuwunikira mosamala kuchuluka kwa kugunda kwa mtima kwa fetal ndi CTG. Pakakhala kuwonongeka modzidzimutsa, dokotalayo amatha kuchita gawo losowa mwadzidzidzi mwana akangobadwa.

Nthawi zambiri, shuga wokwera amabwereranso masiku angapo pambuyo pobadwa.

Ngati mwadwala matenda ashuga, khalani okonzeka kuti muwoneke mtsogolo. Kuphatikiza apo, muli ndi chiopsezo chokhala ndi matenda osokoneza bongo omwe amakhazikika (mtundu 2) ali ndi zaka.

Mwamwayi, kukhalabe ndi moyo wathanzi kumatha kuchepetsa izi, komanso nthawi zina ngakhale kupewa matenda ashuga. Phunzirani zonse za matenda ashuga. Idyani zakudya zathanzi zokha, kuwonjezera masewera olimbitsa thupi, muchepetse kunenepa kwambiri - ndipo matenda ashuga sangakhale owopsa!

Makanema
Matenda a shuga ndi Kulera

Matenda a shuga Pa Mimba

Akatswiri ali ndi chiyembekezo chambiri zokhuza kuthekera kwa achinyamata omwe ali ndi matenda ashuga kuti akhale ndi banja, ana athanzi, amasangalala ndi chilichonse chomwe chimabweretsa chikondi ndi kugonana m'moyo wamunthu. Matenda a shuga komanso kutenga pakati zimakhudzana. Mimba iliyonse imakhala ikufunira kwambiri thupi lake. Thupi la mkazi yemwe ali ndi matenda ashuga simalimbana ndi izi nthawi zonse, chifukwa ali ndi vuto la metabolic komanso mahomoni. Nthawi zambiri, mayi amakumana ndi zovuta za matenda ashuga nthawi yapakati, yomwe imatha kubweretsa kulumala. Chifukwa chake, ndikofunikira kwambiri kuphunzira momwe mungakonzekere kukhala ndi pakati ndikuyandikira kuyang'anira kuthamanga kwa shuga m'magazi musanachitike komanso munthawiyo. Izi ndizofunikira pakubadwa kwa mwana wathanzi ndikupewa zovuta mwa mayi.

Ponena za matenda ashuga omwe amayamba kuwonekera nthawi yoyamba kubereka, amatchedwa matenda a shuga. Amayamba chifukwa cha mphamvu inayake ya mahomoni ndi ma metabolic amimba. Mu 95% ya milandu, matenda ashuga awa amatha atabereka. Komabe, kwa azimayi ena, pafupifupi 5 peresenti yake imakhalapo. Ngati mayi anali ndi matenda ashuga panthawi yoyembekezera, chiopsezo chotenga matenda ena a shuga, omwe nthawi zambiri amakhala mtundu 2, amamuwonjezera.

Malinga ndi ziwerengero, mitundu ya azimayi oyembekezera imakhazikika pafupifupi 3% ya amayi apakati, kuwonjezera apo, imakhala yofala kwambiri mwa azimayi achikulire kuposa zaka 25. Chifukwa chake, ngati muli ndi zovuta monga: kubadwa kapena kunenepa kwambiri, kukonzekera kukhala ndi pakati mpaka zaka 25 kumachepetsa chiopsezo chotenga matenda.

Zizindikiro ndi zizindikiro za matenda ashuga mwa amayi apakati, monga lamulo, ndizofatsa ndipo siziwopseza moyo wa mayi. Komabe, vutoli limatha kubweretsa mavuto kwa mwana, kuphatikiza hypoglycemia (shuga wochepa wamagazi) komanso kupsinjika kwa m'maganizo. Komanso azimayi omwe ali ndi matenda ashuga amatha kukhala ndi toxosis, yomwe ikuwopseza mayi ndi mwana.

Kuti muthane ndi shuga wamagazi, azimayi ena amayenera kumwa insulin panthawi yovuta, koma anthu ambiri omwe ali ndi matenda a shuga a mtundu wachiwiri ndi olimbitsa thupi amatha kuthana ndi matenda a shuga.

Mayeso a Ultrasound amakupatsani mwayi kuti muwone momwe mluza umapangira ndikuwunika kukula ndi kulemera kwake. Izi zimapangitsa kuti zitheke kusankha kubereka mwanjira yokhazikika kapena ngati gawo lachiesili lingafunike.

Ndikofunika kupanga ma electrocardiogram kuti muwone momwe mtima ulili, mayeso omwe amayang'anira kugwira ntchito kwa impso, komanso kupezeka kwa ma ketoni mumkodzo. Chitani kafukufuku wamaso nthawi zonse kuti muchepetse kukula kwa matenda ashuga retinopathy. Amayi omwe ali ndi retinopathy yoyenera kapena yozama ayenera kuunikiridwa kamodzi pamwezi, chifukwa nthawi zambiri kutenga pakati kumathandizira kukula kwa matendawa.

Mayeso apadera a matenda a shuga amathanso kutumikiridwa, monga milingo ya alpha-fetoprotein, kuti mupeze vuto la msana.

Mwambiri, azimayi omwe ali ndi matenda abwinobwino kapena odwala matenda ashuga amafunikira chidwi kuchokera kwa madokotala, makamaka kuwongolera shuga wamagazi ndi zovuta zokhudzana ndi pakati.

Mavuto omwe angakhalepo pakati pa anthu odwala matenda ashuga

Mu shuga mellitus, nthawi zambiri kuposa mwa omwe alibe matendawa, njira yokhala ndi pakati imadziwika kuti:

mochedwa toxicosis
kukhazikika
polyhydramnios.

M'magawo osiyanasiyana a shuga, kuphatikiza gawo la prediabetes, pamakhala zipatso za zipatsozi pafupipafupi. M'makliniki amodzi payokha, amachokera ku 7.4 mpaka 23.1%. Komabe, mukamayang'ana zotsatira za pakati pa odwala omwe ali ndi matenda osokoneza bongo, ndikofunikira kuganizira momwe boma lingalipire pang'onopang'ono chifukwa cha zovuta za metabolic panthawi yomwe ali ndi pakati. Ndi chipukuta chomwe chafika sabata 28 zisanachitike, kufa kwa mwana wosabadwayo kunali 4.67%. Pafupipafupi imfa ya mwana wosabadwayo imachuluka kwambiri ngati kubwezeredwa kufikira pambuyo pa milungu 28 ya gestation ndikufikira 24,6%. Mu gulu la azimayi apakati omwe adabwera ndi matenda osokoneza bongo a mellitus mwachindunji kuchipinda cha amayi oyembekezera, kufa kwa fetal kunali mu 31.6%. Ndi chipukutiro chomwe chimapangidwa mu nthawi yoyambirira ya mimba ndikukhazikika nthawi yotsatila, imfa ya mwana wosabadwayo idatsikira ku 3,12%. Imfa ya fetal mu amayi apakati omwe ali ndi matenda ashuga kuwonongeka pa nthawi ya pakati wafika 12,5%.

Chimodzi mwazifukwa zazikulu zomwe zimachitika kuti mwana wosabadwayo amwalira pafupipafupi ndi azimayi omwe ali ndi matenda ashuga ndi kusintha komwe kumachitika mothandizika komanso kusintha kwachilengedwe kwa placenta, komwe nthawi zambiri kumagwirizana ndi kusintha kwa matenda m'thupi la mayi. Kwa odwala matenda a shuga mellitus, kuwonjezeka kwa kulemera kwa placenta nthawi zambiri kumawonedwa limodzi ndi kukula kwa zipatso zazikulu, pali umboni wa kuchuluka kwa lactogen ya placental m'magazi.

Maphunziro a elekitrodi a microncopic amatha kuwona kukula kwa chipinda chapansi pa capillary. Kusintha kwa Dystrophic ndi kusakhazikika kumakhalamo, zomwe zimapangitsa kuti moyo wa mwana ukhale wowopsa. Chizindikiro chosasinthika chokhudza moyo wa mwana wosabadwa ndicho kuchepa kwa kuchuluka kwa lactogen ya m'magazi ndi kuchepa kwa kwamitsempha ya estriol.

Matenda a shuga kwa matenda ashuga ndi pamene glucose wamagazi amadutsa chotchinga ndikulowa mwana wosabadwayo. Kuchuluka kwa madzimadzi m'thupi kumachepa, koma pambuyo pobadwa, chifukwa cha kuwonongeka kwa glycogen, madzimadzi amayenda kuchokera pabedi lamitsempha kupita kumalo osungirako, omwe amafotokozera edema ya minofu yaying'ono. Poyankha izi, mwana wosabadwayo amayamba hyperplasia ya kapamba. Koma popeza insulin imakhala ndi anabolic, ana nthawi zambiri amabadwa amakula, vuto la kutulutsa timadzi tomwe timayambitsa hyperinsulinemia, ndi losiyana:

ndi lamba wamkulu wamapewa,
gawo laling'ono la mutu,
thonje.

Sagwirizana ndi msinkhu wawo, kutanthauza kuti, amatsalira pakatha masabata awiri.

Ana ochokera kwa amayi omwe ali ndi matenda ashuga amakhala ndi tanthauzo la metabolic acidosis pobadwa, poyerekeza ndi ana athanzi, ndipo kagayidwe kazinthu kazakudya kamatenga nthawi. Se acid acidosis, monga lamulo, imaphatikizidwa ndi hypoglycemia yoposa zokhudza thupi za hypoglycemia ya akhanda. Ndi hypoglycemia yayikulu, zizindikiro zingapo zamitsempha zimatha kuonedwa:

Mavutowa nthawi zambiri amatha pambuyo pakupanga shuga. Pofuna kupewa machitidwe a hypoglycemic mwa akhanda omwe amayi awo ali ndi matenda a shuga, ndikofunika kupangira jekeseni ya glucose mkamwa mwawo pakapita maola awiri aliwonse. Matenda omwe amafala kwambiri mwa ana obadwa kwa amayi omwe ali ndi matenda a shuga ndi matenda opumira. Nthawi zambiri hyaline nembanemba yamapapu imayamba, yomwe imatha kupha ana akhanda. Imfa m'masiku oyamba amoyo mwa ana awa ndi 4-10%. Itha kuchepetsedwa kwambiri ndikusintha kwa matenda a metabolic wakhanda komanso kubwezeretsanso kwa shuga kwa amayi panthawi yomwe ali ndi pakati mpaka 1%.

Makanda obadwa kumene kuchokera kwa amayi omwe ali ndi matenda ashuga ndi osiyana kwambiri ndi ana athanzi. Amatha kukhala ndi kusokonezeka, chiwindi chokwanira, komanso kusinthasintha kwamitundu yosiyanasiyana. Kusintha kwawo kumachepetsedwa, minyewa yam'mapapu imapangidwira, insulin imapangidwa mopitilira muyeso, ndipo hypoglycemia imachitika. Amalembedwa kwinakwake patsiku la 10, ndipo ena amasamutsidwa kuti akalandire unesi m'zipatala zina.

M'miyezi itatu yoyambirira, azimayi ambiri oyembekezera samva kufunika koti asinthe kuchuluka kwa insulini yomwe adawalembera, komabe, azimayi ena amakumana ndi hypoglycemia panthawiyi, ndipo kuchuluka kwa insulin komwe adasankhidwa kuyenera kuchepetsedwa.

Mothandizidwa ndi kusintha kwa mahomoni m'miyezi yotsatira ya kubereka, kukana insulini kumatha kuonedwa, chifukwa chake, kuchuluka kwake kuyenera kuchuluka kuti shuga ikhale ndi magazi kuyambira 4 mpaka 6 mmol / L. Chakumapeto kwa kutenga pakati, kuchuluka kwa insulini yomwe imatengedwa nthawi zina kumatha kuwonjezeka ndi nthawi 2-3 poyerekeza ndi kuchuluka kwa mimba isanachitike. Kupatula apo, ndikudziwika bwino kuti kuchuluka kwa shuga m'magazi kumatha kusintha mwa amayi apakati omwe alibe shuga.

Pa nthawi ya pakati, simuyenera kungoyang'ana kuchuluka kwa shuga m'magazi, komanso kuchuluka kwa ma ketoni amkodzo. Maonekedwe a matupi a ketone mumkodzo amatanthauza kuchuluka kwawo m'magazi. Ndi msambo wawo wambiri, amatha kudutsa ma placenta ndikulowera mthupi la fetal, ndikusokoneza kukula kwa ubongo wake, komanso ndi ma ketoni ambiri m'magazi, mwana wosabadwayo angafe. Ichi ndi chifukwa chinanso chomwe kuwongolera shuga kwamwazi ndikofunika kwambiri panthawi yapakati.

Kuti mukhale wodalirika kwambiri, mutha kupita kuchipatala, komwe azimayi amayang'aniridwa ndi madotolo, motero, mwayi wokhala ndi pakati komanso kubereka ndi mwana wathanzi wodwala matenda a shuga ukuwonjezeka kwambiri. Pakadali pano, akatswiri azachipatala ambiri amakhulupirira kuti amathandizira odwala awiri nthawi imodzi: mayi ndi mwana wake. Dotolo amayenera kuwunikira nthawi yayitali pokhapokha ngati ali ndi thanzi la mayi wapakati, komanso chitukuko cha mwana wosabadwayo: ngati chikukula ndikukula bwino, yang'anani kugunda kwa mtima wa mwana ndi mayendedwe ake. Mwa izi, zida zapadera zimagwiritsidwa ntchito, pomwe madokotala amapeza chidziwitso cholondola pa chikhalidwe cha mwana wosabadwayo.

Pa nthawi yomwe muli ndi pakati, ndikofunikira kwambiri kuwunika kunenepa kwanu. Kudzaza kwambiri sikumakongoletsa mkazi, koma kwa odwala matenda ashuga omwe amakakamizidwa kuwonetsetsa kuti ali ndi shuga, ndiwonso owopsa. M'miyezi itatu yoyambirira ya kubereka, kulemera kumatha kuyambira 1 mpaka 2 kilogalamu.

Matenda a shuga ndi pakati: zoopsa ndi zotsatirapo zake

Matenda a shuga masiku ano ndi imodzi mwazifo matenda omwe anthu amakumanapo nawo. Mazana a asayansi apanga kafukufuku wambiri masauzande ambiri kuti apeze njira yothandizira matendawa. Pakadali pano pali zikhulupiriro zambiri zokhudzana ndi matendawa. Munkhaniyi tikambirana za mwayi wokhala ndi pakati komanso momwe mungachitire ngati mimba yachitika.

Matenda a shuga ndi matenda a endocrine system, omwe amathandizidwa ndi insulin yokwanira kapena kuperewera - inshuwaransi ya kapamba, zomwe zimapangitsa kuchuluka kwa shuga m'magazi - hyperglycemia. Mwachidule, gland yomwe ili pamwambapa imangoleka kupanga insulini, yomwe imagwiritsa ntchito glucose wobwera, kapena insulin yopangidwa, koma zimakhala kuti zimakana kulandira. Pali mitundu ingapo yamatendawa: matenda a shuga 1 kapena matenda a shuga a m'magazi, mtundu wa matenda ashuga 2 komanso matenda osokoneza bongo omwe amadalira matenda a shuga.

Type 1 shuga mellitus, wotchedwa insulin-amadalira, amakula chifukwa cha kuwonongeka kwa malo apadera - ma islets a Langerhans omwe amapanga insulin, zomwe zimapangitsa kuti pakhale kuperewera kwa insulin kwathunthu yomwe imatsogolera ku hyperglycemia ndikupereka utsogoleri wamahomoni kuchokera kunja pogwiritsa ntchito ma syringes apadera a "insulin".

Type 2 shuga mellitus, kapena osadalira insulini, samayendera limodzi ndi kusintha kwa kapamba, ndiye kuti, insulin ya mahomoni imapitilizidwa kupangika, koma panthawi yolumikizana ndi minofu, "kuperewera" kumachitika, ndiye kuti, minyewa sikuwona insulin motero glucose sagwiritsidwa ntchito. Zochitika zonsezi zimayambitsa hyperglycemia, zomwe zimafuna kugwiritsa ntchito mapiritsi omwe amachepetsa shuga.

Mwa amayi omwe ali ndi matenda ashuga, funso nthawi zambiri limabuka momwe mimba imayambira limodzi ndi matenda awo. Kuyang'anira mimbayo kwa amayi oyembekezera omwe ali ndi vuto la matenda ashuga kumatsikira kukonzekera mosamala mimba ndi kutsatira malangizo onse a dokotala panthawi yonse yoyambira: kuchititsa maphunziro owunikira panthawi yake, kumwa mankhwala omwe amachepetsa shuga, ndikutsatira zakudya zapadera za carb. Ndi matenda amtundu wa 1 shuga, kuwongolera insulin kudya kuchokera kunja ndikofunikira. Kusiyana kwake kwa mankhwalawa kumasiyanasiyana malinga ndi nthawi yomwe mayi amakhala ndi pakati.

Mu trimester yoyamba, kufunika kwa insulin kumachepa, chifukwa placenta imapangidwa yomwe imapanga mahomoni a steroid ndipo ndi mtundu wa analogue ya kapamba. Komanso glucose ndiye gwero lalikulu lamphamvu kwa mwana wosabadwayo, chifukwa chake zinthu zomwe zimakhala mthupi la mayi zimachepetsedwa. Mu trimester yachiwiri, kufunika kwa insulin kumawonjezeka. Trimester yachitatu imadziwika ndi chizolowezi chakuchepa kwa insulin chifukwa cha fetal hyperinsulinemia, yomwe ingayambitse hypoglycemia ya amayi. Type 2 shuga mellitus pa nthawi ya pakati kumafuna kufafaniza mapiritsi a mankhwala ochepetsa shuga ndi kuikidwa kwa insulin. Zakudya zamagulu ochepa zimapatsa mphamvu.

M'moyo wonse, mkazi sangasokonezedwe ndi zovuta za kagayidwe kazakudya, zisonyezo zomwe zikuwunikidwazo zimatha kukhala zopanda malire, koma akamadutsa mayeso kuchipatala cha anthala, matenda onga kuperewera kwa shuga amatha kupezeka - mkhalidwe momwe kuwonjezeka kwa shuga m'magazi kumanonekera koyamba panthawi yapakati komanso pakati kudutsa pambuyo pobereka. Amayamba chifukwa cha kusakwanitsa kwa mahomoni komwe kumayenderana ndi kukhazikitsidwa kwa mwana wosabadwayo mthupi la mkazi motsutsana ndi zomwe zimachitika chifukwa cha kunenepa kwambiri kwa insulin.

Zomwe zimayambitsa matenda a shuga gestational zingakhale:

kupezeka kwa matenda ashuga abale
ma virus omwe amakhudza ndikuwonongeka kwa kapamba,
azimayi omwe ali ndi ovary ya polycystic,
azimayi omwe akudwala matenda oopsa
azimayi azaka zopitilira 45,
azimayi osuta
azimayi omwe amamwa mowa kwambiri
azimayi omwe ali ndi mbiri yodwala matenda ashuga,
polyhydramnios
chipatso chachikulu. Zinthu zonsezi zili pachiwopsezo chotenga matendawa.

Kutsutsa kwa insulin kumachitika chifukwa cha zinthu monga:

kuchuluka kwa adrenal kotekisi ya contra-timadzi timadzi timene timati cortisol,
kaphatikizidwe ka mahomoni amodzi aacidacidacid: estrogens, lactogen ya placental, prolactin,
kutsegula kwa placental enzyme yomwe imaphwanya insulin - insulinase.

Chizindikiro cha matendawa sichachidziwikire: mpaka sabata la 20, ndipo iyi ndi nthawi yeniyeni yomwe kupezeka kwazidziwitso zamatenda a m'mimba mwa mayi, mkazi alibe nkhawa. Pambuyo pa sabata la 20, chizindikiro chachikulu ndikuwonjezereka kwa magazi, omwe sanawoneke kale. Itha kutsimikizika pogwiritsa ntchito kuyesedwa kwapadera komwe kumapangitsa kulolera kwa glucose. Choyamba, magazi amatengedwa kuchokera m'mitsempha pamimba yopanda kanthu, kenako mkazi amatenga shuga wa magalamu 75 am'madzi ndipo madzi amatengedwa kuchokera m'mtsempha.

Kuzindikira kwa matenda a gestational matenda a shuga kumakhazikitsidwa ngati zizindikiro zoyambirira sizotsika ndi 7 mmol / L, ndipo chachiwiri sichikhala chochepera 7.8 mmol / L. Kuphatikiza pa hyperglycemia, zizindikiro monga kumva ludzu, kukodza kwambiri, kutopa, komanso kunenepa kwambiri.

Mtundu wina wa matenda ashuga a shuga, omwe, mosiyana ndi matenda amisala, amapezeka makamaka mu nthawi yoyambirira ya mimba ndipo amafanana ndi njira yodziwika yopanga matenda a shuga a mtundu woyamba ndi wachiwiri.

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

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

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

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

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

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

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

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

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

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

Kutengera ndi chithandizo chofunikira cha GDM, pali:

kuchepetsa zakudya
kulipidwa ndi zakudya mankhwala ndi insulin.

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

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

Ndani ali pachiwopsezo chotenga matenda ashuga panthawi yapakati?

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

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

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

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

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

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

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

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

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

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

Zotsatira ziwiri zomalizazi zimafuna kuti agonekere kuchipatala kwambiri.

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

Zizindikiro zazikuluzikulu za matenda ashuga akakhala ndi pakati

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

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

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

Unduna wa Zaumoyo wakhazikitsa nthawi yoyeselera magazi:

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

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

Zotsatira zakuyesa zotsatirazi zikunena za GDM:

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

Kuphatikiza apo, monga momwe zikuwonekera, kafukufuku amachitika:

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

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

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

Mosasamala mtundu wamatenda, amayi apakati amafunikira zowonera izi:

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

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

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

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

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

Zisonyezero zakuyamba insulin mankhwala ndi zizindikiro zotsatirazi shuga:

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

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

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

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

Zakudya za matenda ashuga gestational nthawi yapakati

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

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

Zakudya za amayi apakati a shuga

Zogulitsa zitha kugawidwa m'magulu atatu ovomerezeka, zoperekedwa mu tebulo 1.

Rozanov, V.V.V.V. Rozanov. Nyimbo. M'mavoliyumu 12. Gawo 2. Chiyuda. Saharna / V.V. Rozanov. - M: Republic, 2011 .-- 624 p.
Gubergrits A.Ya., Linevsky Yu.V. Mankhwala othandizira. Kiev, yosindikiza nyumba "High School", 1989.
Udovichenko, O.V. Diabetesic phazi / O.V. Udovichenko, N.M. Grekov. - M: Mankhwala Othandiza, 2015 .-- 272 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.

Gestational matenda a shuga mellitus pa mimba: zotsatira ndi zoopsa

Matenda a shuga panthawi yomwe ali ndi pakati amatha kusokoneza chitukuko cha mwana wosabadwayo. Ngati iye adawuka koyambirira pakati, chiwopsezo cha pathupi kumakulirakulira, ndipo, choyipa kwambiri - kuwonekera kwa kubadwa kwa maliseche kwa mwana. Zomwe zimakhudzidwa nthawi zambiri zimakhala ziwalo zofunika kwambiri zakunyumba - mtima ndi ubongo.

Matenda a shuga omwe amayamba pachidutswa chachiwiri kapena chachitatu mimba, imakhala chifukwa cha kudyetsa komanso kukula kwambiri kwa mwana wosabadwayo. Izi zimabweretsa hyperinsulinemia: mwana akangobadwa, pomwe mwana sangalandire kuchuluka kwa shuga kwa mayi, misempha yake ya magazi imatsika kwambiri.

Ngati matendawa sanapezeka ndi kuthandizidwa, amatha kutsogolera matenda ashuga fetopathy - mavuto mu mwana wosabadwayo, kukula chifukwa kuphwanya chakudya kagayidwe kachakudya mu thupi la mayi.

Zizindikiro za matenda a shuga

zazikulu zazikulu (zolemera makilogalamu 4),
kuphwanya kuchuluka kwa thupi (miyendo yopyapyala, mimba yayikulu),
kutupa kwa minofu, kuchuluka kwa mafuta amkati,
jaundice
kupuma
hypoglycemia ya akhanda, kuchuluka kwamitsempha yamagazi ndi chiopsezo cha magazi, kuchepa kwa calcium ndi magnesium m'magazi a mwana wakhanda.

Kodi matenda ashuga amachitika bwanji pakati pa nthawi yapakati?

Pa nthawi yomwe mayi ali ndi pakati mthupi la amayi, osati kungopangika kwa mahomoni kumachitika, koma mkuntho wonse wa mahomoni, ndipo chimodzi mwazotsatira za kusinthaku ndi kulolerana kwa shuga -munthu wamphamvu, wina wofooka. Kodi izi zikutanthauza chiyani? Mwazi wa shuga wamagazi ndiwokwera kwambiri (pamwamba pamlingo wabwinobwino), koma osakwanira kuti mupange matenda a shuga.

Mu nthawi yachitatu ya mimba, matenda ashuga amatha kupezeka chifukwa cha kusintha kwatsopano kwa ma horoni. Kapangidwe kameneka kamafalikira motere: zikondamoyo za amayi oyembekezera zimatulutsa insulin katatu kuposa anthu ena - pofuna kulipiritsa zomwe mahomoni ena amakhala pamwazi womwe umapezeka m'magazi.

Ngati samatha kugwira ntchito imeneyi ndi kuchuluka kwama mahomoni, ndiye kuti pali chinthu china monga matenda amiseche pa nthawi yapakati.

Gulu la anthu omwe ali pachiwopsezo cha matenda ashuga pamimba

Pali zinthu zina zoopsa zomwe zimawonjezera mwayi woti mayi akhoza kukhala ndi matenda ashuga panthawi yoyembekezera. Komabe, kukhalapo kwa zinthu zonsezi sikungotsimikizire kuti matenda ashuga adzachitikadi - monga momwe kulibe zinthu zoyipazi sikutsimikizira 100% kutetezedwa ku matendawa.

Kulemera kwambiri kwa thupi komwe kumawonedwa mwa mayi asanakhale ndi pakati (makamaka ngati kulemera kumapitilira zomwe 20% kapena kuposa),
Dziko Ndikupezeka kuti pali mitundu ina momwe matenda a shuga amawonedwa nthawi zambiri kuposa ena. Izi zikuphatikizapo zakuda, Hispanics, Native Americaans ndi Asia,
Mitundu yambiri ya shuga kuchokera ku mayeso a mkodzo
Kulekerera kwa shuga m'thupi (monga tafotokozera, kuchuluka kwa shuga sikwabwinobwino, koma sikokwanira kuzindikira matenda a shuga),
Khalidweli. Matenda a shuga ndi amodzi mwa matenda oyipa kwambiri obadwa nawo, chiwopsezo chake chikuwonjezereka ngati wina wochokera ku banja lanu wapamtima anali wodwala matenda ashuga,
Kubadwa koyambirira kwa mwana wamkulu (woposa makilogalamu anayi),
Kubadwa koyambirira kwa mwana wosabadwa,
Mudapezeka kuti muli ndi matenda a shuga kwa nthawi yapakati,
Madzi ambiri, ndiye kuti amniotic madzi ambiri.

Kuzindikira matenda ashuga

Ngati mutapezeka kuti muli ndi zizindikilo zingapo zomwe zikugwirizana ndi gulu lowopsa, dziwitsani dokotala za izi - mutha kupatsidwa mayeso owonjezera. Ngati palibe chilichonse choyipa chikapezeka, mupita kukawunikanso pamodzi ndi akazi ena onse. Wina aliyense amadutsa kuyesa mayeso kwa ashu a gestational pakati pa sabata la 24 ndi 28 la mimba.

Kodi zingachitike bwanji? Mukufunsidwa kuti mupange kafukufuku yemwe akuti "mayeso a glucose kulolerana". Muyenera kumwa madzi otsekemera okhala ndi magalamu 50 a shuga. Pakatha mphindi 20 padzakhala gawo losasangalatsa - kutenga magazi kuchokera mu mtsempha. Chowonadi ndi chakuti shuga amayamba msanga, pambuyo pa mphindi 30-60, koma zisonyezo zimasiyanasiyana, ndipo izi ndizomwe madokotala amachita. Chifukwa chake, amapeza momwe thupi limatha kupangira njira yotsekemera ndikupeza shuga.

Pomwe kuti mawonekedwe omwe ali mgulu la "kusanthula zotsatira" akuwoneka kuti ali ndi 140 mg / dl (7.7 mmol / l) kapena kumtunda, izi ndi kale mkulu. Kusanthula kwina kudzakuchitirani, koma panthawiyi - mutatha kusala kudya kwa maola angapo.

Chithandizo cha matenda ashuga

Kwa odwala matenda ashuga, kunena moona mtima, moyo si shuga - mowoneka komanso mophiphiritsa. Koma matendawa amatha kuthandizidwa mukamadziwa kutsatira malangizo azachipatala mosamalitsa.

Chifukwa chake, ndi chiyani chingathandize kuthana ndi matenda ashuga a m'mbuyomu panthawi yapakati?

Kuwongolera shuga. Izi zimachitika 4 pa tsiku - pamimba yopanda kanthu komanso maola awiri mutatha kudya. Mungafunenso macheke owonjezera - musanadye,
Urinalysis Matupi a Ketone sayenera kuwonekeramo - akuwonetsa kuti shuga sayendetsedwa,
Kutsatira ndi zakudya zapadera zomwe adokotala angakuuzeni. Tikambirana funso ili pansipa,
Zochita zolimbitsa thupi moyenera pa upangiri wa dokotala,
Kuchepetsa thupi
Mankhwala a insulin ngati pakufunika. Pakadali pano, panthawi yoyembekezera, insulin yokha imaloledwa kugwiritsidwa ntchito ngati mankhwala antidiabetes.
Kuyendetsa magazi.

Zakudya za matenda ashuga

Ngati mwapeza matenda a shuga, muyenera kuyang'ananso zakudya zanu - iyi ndi imodzi mwazomwe mungagwiritse ntchito bwino matenda anu. Nthawi zambiri, matenda a shuga amalimbikitsidwa kuti achepetse kulemera kwa thupi (izi zimathandizira kuwonjezera kukana kwa insulin), koma kubereka si nthawi yochepetsa thupi, chifukwa mwana wosabadwayo amayenera kulandira michere yonse yomwe amafunikira. Chifukwa chake, muyenera kuchepetsa zopatsa mphamvu zopatsa chakudya, osachepetsa mphamvu yake yopatsa thanzi.

1. Idyani zakudya zazing'ono Katatu patsiku ndi zina kawiri nthawi imodzi. Osadumpha chakudya! Chakudya cham'mawa chikuyenera kukhala 40-45% chakudya, chakudya chamadzulo chomaliza chimayenera kukhalanso ndi chakudya, pafupifupi 15-30 gr.

2. Pewani yokazinga ndi mafutakomanso zakudya zomwe zili ndi chakudya chamafuta ambiri. Izi zimaphatikizapo, mwachitsanzo, confectionery, komanso makeke ndi zipatso zina (nthochi, Persimmon, mphesa, yamatcheri, nkhuyu). Zinthu zonsezi zimatengedwa mwachangu ndikupangitsa kukwera kwa shuga m'magazi, zimakhala ndi michere yochepa, koma zopatsa mphamvu zambiri. Kuphatikiza apo, pofuna kusokoneza mphamvu zawo zapamwamba za glycemic, insulin yochulukirapo imafunikira, yomwe ndi shuga imakhala yosavomerezeka.

3. Ngati mukumva kudwala m'mawa, sungani chophika kapena makeke owuma amchere patebulo lanu pafupi ndi bed ndikudya ochepa asanagone. Ngati mukuthandizidwa ndi insulin ndipo mumadwala m'mawa, onetsetsani kuti mukudziwa momwe mungathanirane ndi shuga ochepa.

4. Osamadya zakudya zokha. Amayendetsa ntchito yoyambirira ya mafakitale kuti achepetse nthawi yakukonzekera kwawo, koma kuthekera kwawo pakuwonjezera chiwonetsero cha glycemic ndikokulirapo kuposa kwachilengedwe. Chifukwa chake, pewani Zakudyazi zouma, msuzi “m'mphindi 5” kuchokera m'chikwama, phala pompopompo, ndi mbatata zouma zouma.

5. Samalani zakudya zamafuta ambiri.: chimanga, mpunga, pasitala, masamba, zipatso, buledi wonse wa tirigu. Izi sizowona kwa akazi okha omwe ali ndi matenda osokoneza bongo - mayi aliyense woyembekezera ayenera kudya 20-30 magalamu a fiber patsiku. Chifukwa chiyani ma fiber amakhala opindulitsa kwa odwala matenda ashuga? Imalimbikitsa matumbo ndikuchepetsa kuyamwa kwamafuta ochulukirapo ndi shuga m'magazi. Zakudya zamafuta ambiri zimakhala ndi mavitamini ndi michere yambiri yambiri.

6. Mafuta omwe amaphatikizidwa muzakudya za tsiku ndi tsiku sayenera kupitirira 10%. Nthawi zambiri muzidya zakudya zochepa zomwe zimakhala ndi "zobisika" komanso "zowonekera". Sankhani masoseji, masoseji, masoseji, nyama yankhumba, nyama zosuta, nkhumba, mwanawankhosa. Nyama zokhomedwa ndizabwino kwambiri: nkhuku, ng'ombe, nkhuku ndi nsomba. Chotsani mafuta onse owoneka kuchokera ku nyama: mafuta ku nyama, ndi khungu ku nkhuku. Kuphika chilichonse mokoma: kuphika, kuphika, kuphika.

7. Kuphika si mafuta, komanso mafuta azomera, koma sayenera kukhala ochulukirapo.

8. Imwani 1.5 malita amadzimadzi patsiku (Magalasi 8).

9. Thupi lanu silikufuna mafuta ngati amenewamonga margarine, batala, mayonesi, kirimu wowawasa, mtedza, mbewu, tchizi tchizi, msuzi.

10. Kutopa ndikuletsa? Palinso zinthu zomwe mungathe palibe malire - amakhala ndi zopatsa mphamvu zochepa komanso zopatsa mphamvu. Izi ndi nkhaka, phwetekere, zukini, bowa, radish, zukini, udzu winawake, letesi, nyemba zobiriwira, kabichi. Idyani zakudya zazakudya zazikuluzikulu ngati chakudya, ndibwino kumaoneka ngati masaladi kapena kuwiritsa (kuwiritsa monga momwe zimakhalira kale kapena kuwotcha).

11. Onetsetsani kuti thupi lanu limapatsidwa zovuta zonse za mavitamini ndi mchereZofunikira Pakati Mimba: Funsani dokotala ngati mukufuna mavitamini ndi michere yowonjezera.

Ngati chithandizo cha zakudya sichithandiza, ndipo shuga m'magazi amakhalanso ali pamlingo wokwanira, kapena pamlingo wokhazikika wa shuga mumitsempha ya mkodzo ketoni amapezeka pafupipafupi - mudzayesedwa mankhwala a insulin.

Insulin imayendetsedwa ndi jakisoni wokha, popeza ndi puloteni, ndipo ngati muyesera kuiphatikiza m'mapiritsi, itha kugwa kwathunthu chifukwa cha michere yathu.

Ma mankhwala opha tizilombo amawonjezeredwa kukonzekera kwa insulin, chifukwa chake musapukute khungu ndi jekeseni musanalowe - mowa umawononga insulin. Mwachilengedwe, muyenera kugwiritsa ntchito ma syringe otaya ndikutsatira malamulo aukhondo. Zina zonse zobisika zamatenda a insulin zidzauzidwa ndi dokotala.

Chitani masewera olimbitsa thupi a shuga apakati

Mukuganiza kuti sizofunikira? M'malo mwake, adzakuthandizani kukhala ndi thanzi labwino, kukhala ndi kamvekedwe ka minofu, komanso kuchira msanga mukabereka mwana. Kuphatikiza apo, amasintha machitidwe a insulin ndipo amathandizira kuti asakhale onenepa kwambiri. Zonsezi zimathandiza kukhalabe ndi shuga.

Chitani zinthu zodziwika zomwe mumakonda ndikusangalala: kuyenda, masewera olimbitsa thupi, masewera olimbitsa thupi. Palibe mavuto pamimba - muyenera kuyiwala za "makina olimbitsa" omwe mumakonda pano. Osamachita nawo masewera omwe amadzaza ndi kuvulala ndikugwa - kukwera pamahatchi, kuyendetsa njinga, kukwera pachipale chofewa, kuyenda pansi, ndi zina zambiri. Werengani zambiri za machitidwe olimbitsa thupi a mayi

Mitundu yonse - yathanzi! Ngati mukumva bwino, pali ululu pamimba yakumbuyo kapena kumbuyo, siyimirani ndikugwira mpweya.

Ngati mukumwa mankhwala a insulin, ndikofunikira kudziwa kuti hypoglycemia imatha kuchitika masewera olimbitsa thupi, chifukwa zonse zolimbitsa thupi komanso insulin zimachepetsa shuga m'magazi. Onani shuga wanu m'magazi musanayambe kulimbitsa thupi komanso mukamaliza. Ngati mutayamba kuyeseza ola limodzi mutatha kudya, mukatha kalasi mumatha kudya sangweji kapena apulo. Ngati maola opitilira 2 adatha kuchokera pa chakudya chomaliza, ndibwino kuluma musanayambe maphunziro. Onetsetsani kuti mwabwera ndi shuga kapena shuga ngati muli ndi hypoglycemia.

Matenda a shuga komanso kubereka mwana

Nkhani yabwino: gestational matenda ashuga nthawi zambiri zimatha pambuyo pobadwa - imayamba matenda ashuga mwa 20-25% yokha. Zowona, kubadwa palokha kumatha kukhala kovuta chifukwa cha kuzindikira uku. Mwachitsanzo, chifukwa cha kuledzera kumene kwa mwana wosabadwayo, mwana akhoza wobadwa wamkulu kwambiri.

Ambiri, mwina, angafune "ngwazi", koma kukula kwa mwana kumatha kukhala vuto panthawi yovuta ndi kubereka: Nthawi zambiri, gawo laesesito limachitika, ndipo ngati ataberekera mwachilengedwe pamakhala ngozi yoti mapewa angavulazidwe.

Ndi matenda a shuga, ana amabadwa ndi otsika kwambiri shuga m'magazi, koma izi ndizotheka kusintha pakudya.

Ngati pakadalibe mkaka pano, ndipo colostrum sikokwanira kwa mwana, mwana amadyetsedwa ndi zosakanikirana zapadera kuti akweze kuchuluka kwa shuga kukhala kwamagulu abwinobwino. Komanso, ogwira ntchito zachipatala amayang'anira chizindikirochi poyesa kuchuluka kwa shuga nthawi zambiri, asanadye komanso pambuyo maola awiri.

Monga lamulo, palibe njira zapadera zothetsera kukula kwa shuga kwa mayi ndi mwana zidzafunika: mwa mwana, monga tanena kale, shuga amabwerera mwakale chifukwa chodyetsa, ndipo mwa mayi - ndi kutulutsidwa kwa placenta, komwe ndi "kosasangalatsa", popeza amatulutsa mahomoni.

Nthawi yoyamba pambuyo pokubereka ayenera kutsatira Zakudya ndipo nthawi ndi nthawi muyezo kuchuluka kwa shuga, koma pakapita nthawi, chilichonse chiyenera kukhala chofanana.

Kupewa matenda ashuga

Palibe chitsimikizo cha 100% choti simudzakumana ndi matenda ashuga - zimachitika kuti azimayi, mwa zizindikiro zambiri zomwe zili pachiwopsezo, satenga pakati, mosiyananso, matendawa amapezeka kwa azimayi omwe, zimawoneka ngati, analibe palibe zofunikira.

Ngati mudakhalapo kale ndi matenda ashuga panthawi yomwe mudakhalapo kale, mukuyenera kubwerera. Komabe, mutha kuchepetsa chiwopsezo cha matenda ashuga pakudya momasuka mwa kupitilirabe kulemera kwanu komanso kusachulukira kwambiri m'miyezi 9 iyi.

Kuchita masewera olimbitsa thupi kumathandizanso kukhala ndi shuga mokwanira m'magazi, pokhapokha ngati ali pafupipafupi ndipo samakupangitsani kusasangalala.

Mulinso ndi chiopsezo chokhala ndi mtundu wa matenda ashuga - mtundu 2 wa matenda ashuga. Ayenera kukhala osamala kwambiri atabereka mwana. Chifukwa chake, simukufuna kumwa mankhwala omwe amalimbikitsa kukana kwa insulin: nicotinic acid, mankhwala a glucocorticoid (awa ndi monga, mwachitsanzo, dexamethasone ndi prednisolone).

Chonde dziwani kuti mapiritsi ena oteteza kubereka angakulitse chiwopsezo chanu cha matenda ashuga, monga progestin, koma izi sizikugwirizana ndi mankhwala osokoneza bongo otsika. Posankha njira yakulera pambuyo pobadwa, tsatirani malangizo a dokotala.

Mitundu ya matenda amiseche mu amayi apakati

Matenda oyambitsidwa ndi matenda ashuga, ndiko kuti, omwe adabadwa mwana asanakhale ndi mwana, ali ndi gulu:

mawonekedwe ofatsa matendawa ndi mtundu wodziyimira pawokha wa insulin (mtundu 2), womwe umathandizidwa ndi zakudya zama carb wotsika ndipo osatsatiridwa ndi ma cell pathologies.
kuopsa koopsa - mtundu wodwala kapena wopanda insulin-wodwala (mtundu 1, 2), womwe umakonzedwa ndi chithandizo chamankhwala, kapena popanda zovuta zoyambirira,
matenda oopsa - matenda, omwe amaphatikizidwa ndi kudumphadumpha shuga kwa ambiri komanso ocheperako, kuwukira pafupipafupi kwa dziko la ketoacidotic,
matenda a mtundu uliwonse, limodzi ndi zovuta zochokera impso zida, kuwunika analingalira, ubongo, zotumphukira mantha, mtima ndi mtsempha wamagazi osiyanasiyana calibers.

Matenda a shuga amakhalanso nawo:

kubwezera
ocheperako (chithunzi chowoneka bwino),
decompensated (kwambiri pathologies, pafupipafupi ma hypo- ndi hyperglycemia).

Matenda a shuga ochitika m'mimba nthawi zambiri amakula kuyambira sabata lama 20 la amayi, nthawi zambiri amapezeka ndi diagnostics a labotale. Amayi amagwirizanitsa kuyambika kwa chizindikiro cha matendawa (ludzu, kukodza kwambiri) ndi malo awo "osangalatsa", popanda kuwapatsa chidwi.

Kodi shuga wambiri amakhudza bwanji thupi la mayi

Kwa munthu aliyense, ngakhale akhale mayi, bambo wamwamuna kapena mwana, matenda oopsa a hyperglycemia amadziwika kuti ndi matenda. Chifukwa chakuti kuchuluka kwakukulu kwa glucose kumatsalira m'magazi, maselo ndi minyewa yamthupi imavutika chifukwa chosowa mphamvu. Njira zoyeserera zimakhazikitsidwa, koma, pakapita nthawi, zimachulukitsa zomwe zikuchitika.

Shuga owonjezera amakhudza mbali zina za thupi la mzimayi (ngati timalankhula za nthawi yomwe mayi ali ndi pakati). Njira zamagazi zimasinthira, chifukwa ma cell ofiira amkhala okhwima, kupangika kumalephera. Zombo zapamadzi ndi zopondaponda zimakhala zochepa, mphamvu zake zimacheperachepera chifukwa chogwirizana ndi zolembedwa za atherosselotic.

Pathology imakhudza zida za impso, zomwe zimapangitsa kuti pakhale kusakwanira, komanso masomphenya, kuchepetsa kwambiri kuuma kwake. Hyperglycemia imapangitsa mawonekedwe a chophimba patsogolo pa maso, zotupa ndi mapangidwe a micaneurysms mu retina. Kupita patsogolo kwa zamatenda kumatha kubweretsa khungu. Poyerekeza ndi matenda amishuga ya gestational, kusintha kotereku sikumachitika, koma ngati mayi ali ndi vuto lanyama, kuwongolera kumene kumafunikira.

Kuchuluka kwa shuga kumakhudzanso mtima wa mkazi. Chiwopsezo chotenga matenda a mtima chapamtima chimawonjezeka, chifukwa chotengera cham'mimba chimakumananso ndi zotupa za atherosulinotic. Pakati pake komanso zotumphukira zamanjenje zimakhudzidwa ndi pathological process. Mphamvu ya khungu la m'munsi malekezero amasintha:

kupuma pa mpumulo
kusowa kwa kupweteka
kutengeka kwa chidwi
kuphwanya kwamphamvu kutentha,
kusazindikira kwamphamvu yamagetsi kapena, mosiyana, ndizochulukirapo.

Kuphatikiza apo, vuto la ketoacidotic limatha kupezeka mwa amayi apakati nthawi inayake. Uku ndikovuta kwambiri kwa "matenda okoma", omwe amakhala ndi shuga m'magazi komanso kudzikundikira kwa matupi a ketone (acetone) m'mwazi ndi mkodzo.

Mavuto omwe angakhalepo pakati chifukwa cha matenda ashuga

Amayi omwe ali ndi mawonekedwe a matendawa amatenga matenda osiyanasiyana panthawi yobala mwana pafupipafupi kakhumi kuposa odwala athanzi. Nthawi zambiri preeclampsia, eclampsia, kutupa, ndi kuwonongeka kwa zida za impso zimayamba. Kwambiri kumawonjezera chiopsezo cha matenda a kwamikodzo, kubadwa msanga.

Kutupa kwa thupi ndi chimodzi mwazizindikiro zowala kwambiri za chestosis. Pathology imayamba chifukwa chakuti miyendo imatupa, ndiye kuti kumatupa kwa khoma lachiberekero, miyendo, nkhope ndi mbali zina za thupi. Mzimayi sangakhale ndi madandaulo, koma katswiri wodziwa zofunikira azindikira kuchuluka kwamankhwala m'thupi mwa wodwala.

pali zala zazikulu pam mphete,
mukumva kuti nsapato zazing'ono,
Usiku mzimayi amadzuka nthawi zambiri popita kuchimbudzi,
kukanikiza ndi chala m'mbali mwendo wamiyendo kumasiya konkitsa.

Zowonongeka za impso zimawonetsedwa motere:

kuchuluka kwa kuthamanga kwa magazi kumapita
kutupa kumachitika
mapuloteni ndi albumin amawonekera pakuwunika mkodzo.

Chithunzi cha chipatala chikhoza kukhala chowala kapena chochepa, komanso kuchuluka kwa mapuloteni otulutsidwa mkodzo. Kupita patsogolo kwa matenda a pathological kumawonekera ndikuwonetsa kuopsa kwa zizindikiro. Ngati zoterezi zitachitika, akatswiri amaganiza zodzapereka mwachangu. Izi zimakuthandizani kuti mupulumutse moyo wa mwana ndi mayi ake.

Vuto linanso lomwe limachitika kawirikawiri ndi matenda ashuga ndi preeclampsia. Madokotala amalingalira za kukhazikika kwake pamene zizindikiro zotsatirazi zikuwonekera:

cephalgia,
kuchepa kwakukulu kwamawonedwe owoneka,
ntchentche pamaso panu
kupweteka m'mimba
kusanza
chikumbumtima.

Amayi angavutike:

madzi akulu
kusokonezeka kwa nthawi isanakwane,
atom
kuchotsa pamimba,
kubalabala.

Zotsatira za hyperglycemia pa mwana wosabadwayo

Osangokhala thupi la mkazi, komanso khanda limadwala matenda a hyperglycemia. Ana omwe amabadwa ndi amayi odwala nthawi zambiri amakhudzidwa ndi matenda amisempha kuposa wina aliyense. Ngati mayi woyembekezera anali ndi mtundu wa matendawa asanachitike, mwanayo akhoza kubadwa ndi vuto lobadwa nalo. Poyerekeza ndi mtundu wamatenda a matenda, ana amabadwa ndi thupi lolemera, chomwe ndi chimodzi mwazinthu za fetal fetal.

Matenda a hyperglycemia a mayi amakhalanso oopsa kwa mwana chifukwa chakuti kapamba kake nthawi yomwe amapanga intrauterine amagwiritsidwa ntchito popanga insulini yambiri. Pambuyo pobadwa, thupi lake limapitilizabe kugwira ntchito mofananamo, zomwe zimapangitsa kuti zinthu zizikhala pafupipafupi kwambiri. Ana amadziwika ndi kuchuluka kwambiri kwa bilirubin m'thupi, yomwe imawonetsedwa ndi jaundice mwa makanda atsopano, ndikuchepa kwa kuchuluka kwamaselo onse am'magazi.

Vuto linanso lomwe lingakhalepo m'thupi la mwanayo ndi kupuma kwa matendawa. Mapapu a mwana alibe zochulukirapo - chinthu chomwe chimasokoneza kayendedwe ka alveoli panthawi yogwira ntchito yopuma.

Kuwongolera kwa mayi woyembekezera yemwe ali ndi matenda ashuga

Ngati wodwalayo ali ndi matenda asanafike masiku a bere, ndondomeko yachipatala yowunika odwala ikugogomezera kufunika kwa zipatala zitatu.

Nthawi yoyamba yomwe mayi amagonekedwa m'chipatala atangolumikizana ndi dokotala wazamalonda zakulembetsa zam'mimba. Wodwalayo amawunikira, mkhalidwe wa metabolic umasinthidwa, regimen ya chithandizo cha insulin imasankhidwa.
Nthawi yachiwiri - masabata makumi awiri. Cholinga chakugonekedwa kuchipatala ndikuwongolera vutoli, kuwunika amayi ndi ana mwamphamvu, kukhazikitsa njira zomwe zingalepheretse zovuta zosiyanasiyana.
Nthawi yachitatu ndi masabata 35-36. Mayi woyembekezera akukonzekera kubadwa kwa mwana.

Pali zidziwitso zadzidzidzi kuti mkazi akhoza kupita kuchipatala. Izi zikuphatikiza kuwoneka bwino kwamatendawo chifukwa cha matenda, ketoacidotic state, kuchuluka kwa glycemic (mmwamba ndi pansi), komanso kukula kwa zovuta zovuta.

Momwe kubereka kumachitika pamaso pa matenda

Nthawi yobereka imatsimikiziridwa payekhapayekha. Madokotala amawunika kukula kwa matenda, kuchuluka kwa shuga m'magazi, kupezeka kwa zovuta kuchokera mthupi la mayi ndi mwana. Onetsetsani kuti mukuwonetsetsa momwe zikuwonekera zikuyambira Ngati kuwonjezereka kwa kuwonongeka kwa zida za impso kapena masomphenya kumachitika, zoletsa za m'mimba-gynecologists zimaganizira zobereka pakatha masabata 37.

Kukhala ndi pakati kwabwinobwino, kulemera kwa makilogalamu 3.9 makilogalamu ndiko chizindikiro cha kubadwa kwake koyambirira kudzera mu gawo la cesarean. Ngati mayiyo ndi mwana sanakonzekere kubereka, ndipo kulemera kwa mwana wosabadwa sikupitirira 3,8 kg, mimbayo imatha kupitilira apo.

Wadi amayi

Kusankha kwabwino kwambiri ndikuwonekera kwa mwana kudzera mu ngalande yakubadwa kwachilengedwe, ngakhale mayi ali ndi "matenda okoma". Kubadwa kwa mwana ku matenda a shuga kumachitika ndi kuwunika kosalekeza kwa magazi ndi jakisoni wa insulin.

Ngati ngalande yakubereka ya mkazi wapakati yakonzeka, kubereka mwana kumayamba ndi kupumira kwa chikhodzodzo cha amniotic. Kugwira ntchito moyenera kumawerengedwa ngati chisonyezo kotero kuti mawonekedwe a mwana amapezeka mwanjira yachilengedwe. Ngati ndi kotheka, mahomoni oxytocin amaperekedwa. Zimakupatsani mwayi wolimbikitsa chiberekero.

Zofunika! Matenda a shuga enieni osati chidziwitso cha gawo la caesarean.

Ngati pakufunika kutumiza mwachangu:

mawu olakwika a mwana wosabadwa,
macrosomy
kuphwanya kwa mpweya ndi kugunda kwa mtima wa mwana,
kubwezeredwa kwa zomwe zimayambitsa matenda.

Routine Kaisare wa Matenda A shuga

Kuyambira 12 koloko, mkazi sayenera kudya madzi ndi chakudya. Maola 24 asana opaleshoni, mayi woyembekezera adachotsa jakisoni wa insulin yayitali. M'mawa kwambiri, glycemia imayesedwa pogwiritsa ntchito zingwe zowonekera. Njira imodzimodzi imabwerezedwa mphindi 60 zilizonse.

Ngati glucose m'magazi apitilira gawo la 6.1 mmol / l, mayi woyembekezera amapititsidwa kukapumira kwa insulin kosalekeza. Kuwunika glycemia kumachitika modabwitsa. Njira yothandizira opaleshoni ndikulimbikitsidwa kuti ichitike m'mawa.

Nthawi ya pambuyo

Pambuyo pobala, adokotala amachotsa jakisoni wa insulin mwa mkazi. M'masiku ochepa oyamba, zizindikiro za shuga zamagazi zimayang'aniridwa kuti, ngati kuli koyenera, kukonza matenda a metabolic kumachitika. Ngati wodwalayo anali ndi matenda a shuga a m'matumbo, amangokhala membala wamagulu omwe ali pachiwopsezo cha matenda omwe amadzimira pawokha a insulin, zomwe zikutanthauza kuti ayenera kulembetsa ndi endocrinologist woyenerera.

Pambuyo pa 1.5 ndi miyezi itatu atabadwa, mayiyo aperekanso magazi kuti awone kuchuluka kwa glycemic. Ngati zotsatirapo zake zimapangitsa dokotala kukayikira, kuyesedwa koyesa ndi shuga kumayikidwa. Wodwalayo akulimbikitsidwa kutsatira zakudya, kukhala ndi moyo wakhama, ndipo ngati mukufuna kukhala ndi pakati, pendani bwino thupi ndikukonzekera bwino kutenga pakati ndi kubereka mwana.

Mimba komanso matenda ashuga

Mukamakumba, m'mimba mumapezeka zinthu zambiri zamafuta m'magazi osavuta, monga wowuma, sucrose kapena glucose. Kenako glucose amalowetsedwa m'magazi. Pamenepo, insulin, timadzi tomwe timapangidwa ndi kapamba, timapezamo mamolekyulu am'magazi "ndikuwakankhira" m'maselo kuti agwiritsidwe ntchito ngati mphamvu.

Ngati thupi lipanga insulini yochepa kwambiri kapena maselo samalabadira moyenera, shuga amayamba kudziunjikira m'magazi.

Khadi la Matenda Aberekeredwe

Mu kukula kwa matenda ashuga mwa amayi apakati Chofunikira ndikusintha kwa mahomoni m'thupi. Panthawi yapakati, maselo amayamba kugonjetsedwa ndi insulin - ndipo safuna "kumasula" glucose mkati, chifukwa chake kuchuluka kwa mahomoni awa kumawonjezeka.

Kwa azimayi ambiri, izi sizovuta - kapamba amangowonjezera kupanga kwa insulin. Komabe, zimachitika kuti kapamba sangathe kuthana ndi kutulutsidwa kwa insulin yambiri.

Amayi ambiri pambuyo pobadwa amadzichiritsa okha matenda a shuga komanso matenda a shuga amayambanso kukhala abwinobwino.

Zimayambitsa komanso zowopsa za matenda ashuga mwa amayi apakati

Ofufuzawo sagwirizana kwenikweni pofufuza zomwe zimayambitsa matenda ashuga mwa amayi apakati. Kuti mumvetsetse zomwe zimayambitsa matendawa, muyenera kuyang'ana mozama zamomwe limapangika mamolekyulu a shuga m'thupi.

At matenda a shuga pa nthawi yomwe ali ndi pakati Thupi la mzimayi limatulutsa kuchuluka kwa insulini, komabe, zochita za insulin zimatsekedwa pang'ono ndi mahomoni ena, kuchuluka kwake komwe kumawonjezeka kwambiri panthawi yapakati (monga, progesterone, prolactin, estrogen, cortisol).

Kukula kwa insulin kukaniza kumachitika, ndiye kuti, kumva kwa maselo kuchitira insulin kumachepa. Maselo a pancreatic amatulutsa insulin yochulukirapo kuti ikhalebe yokhazikika m'magazi a glucose, ngakhale pali zovuta.

Zotsatira zake, monga lamulo, pofika masabata 24-28 oyembekezera, amadzaza ndikulephera kuyendetsa kagayidwe kazakudya. Ndipo pamene placenta ikukula, mahomoni ochulukirachulukira amapangidwa, zomwe zimapangitsa kuti insulin ikane. Mwazi wamagazi umakwera pamwamba pamiyeso yapano. Matendawa amatchedwa hyperglycemia.

Zomwe Zimayambitsa Matenda Abereki Zovuta komanso zosamveka bwino. Zikuwonekeratu kuti kusintha kosiyanasiyana kogwira ntchito komanso kosinthika kumachitika m'thupi la mayi wapakati, komwe mwa amayi ena kumatha kubweretsa kuwoneka kwa shuga wokwezeka wamagazi.

Matenda a shuga oyembekezera amatha kuchitika mwa mayi aliyense woyembekezera, komabe pali zina zinthu zoopsazomwe zimawonjezera mwayi wokhala ndi matenda ashuga mwa amayi apakati.

Izi ndi monga:

zaka zopitilira 35
kuchulukitsa
asanabadwe m'mbuyomu pazifukwa zosadziwika
Maonekedwe a mwana wolumala,
Kubadwa kwa mwana wolemera makilogalamu opitilira 4 pamimba yapita,
kunenepa
lembani matenda ashuga 2, kapena matenda ashuga azimayi apakati,
shuga ya amayi apakati m'mimba yapitayi,
matenda oopsa

Zowongolera Zokhudza Matenda Abereki

Madokotala ena amakhulupirira kuti pagulu linalake la amayi oyembekezera mutha kukana kuzindikira matenda ashuga.

Kuti mukhale m'gululi, muyenera kukwaniritsa zonsezi:

khalani ochepera zaka 25,
kukhala ndi thupi loyenera
Musakhale a fuko lililonse kapena fuko lomwe lili pachiwopsezo chachikulu cha matenda ashuga (Spain, Afirika, Native American and South America, nthumwi za Southeast Asia, Islands Islands, mbadwa za nzika zaku Australia),
osakhala ndi abale apamtima omwe ali ndi matenda ashuga m'banja,
sanakhalepo ndi magazi okwanira kwambiri omwe adalembedwa kale
sanawululire zovuta za matenda osokoneza bongo a amayi apakati m'mimba yapitayi komanso mwana yemwe ali ndi kulemera kwakubadwa kuposa 4 kg,5 kg.

Momwe shuga imakhudzira mimba

Matenda osagwirizana ndi matenda a shuga, ngakhale atawoneka kokha atangoyamba kubereka kapena atapezeka kale, zimawonjezera mwayi wolakwika. Ana omwe amalandila shuga wambiri kuchokera ku thupi la mayiyo amakhala ndi vuto la kunenepa kwambiri, macrosomia, ndiye kuti intrauterine hypertrophy.

Vutoli ndikuti mwana amakula kwambiri m'mimba. Ana olemera makilogalamu opitirira 4-4,5 ndi imodzi mwazofunikira za macrosomia. Ana omwe ali ndi vuto lakelo amakhala ndi mawonekedwe - nthawi zambiri thupi limakhala lalikulupo poyerekeza ndi mutu, khungu limayatsidwa, ndipo ubweya umawonekeranso m'makutu.

Kubala mwana mwanjira zachilengedwe sikulimbikitsidwa ngati mwana ali ndi macrosomia. Tsoka ilo, kuwonjezera pa kuvulala, mwana yemwe ali ndi macrosomia amakhalanso amawoneka ngati encephalopathy, ndiye kuti, amawononga ubongo. Encephalopathy imabweretsa kubwereranso m'maganizo kapena kumwalira kwa mwana.

Kuphatikiza apo, mwana amadwala kwambiri hypoglycemia (yomwe ingayambitse matenda a shuga), polycythemia (i., Okwera kwambiri m'magazi ofiira a magazi (maselo ofiira) komanso hyperbilirubinemia (kuchuluka kwambiri kwa bilirubin m'magazi).

Macrosomia imawonjezera chiopsezo cha matenda ena mtsogolo mwa mwana. Awa ndi mavuto omwe amabwera chifukwa cha kunenepa kwambiri komanso kunenepa kwambiri, metabolic syndrome, matenda oopsa, kulolera shuga, kukana insulini.

Matenda a shuga zimawonjezera chiopsezo cha mwana kuchitika, komanso zofooka, monga:

kupunduka kwa mtima
zonyansa
zolakwika zamanjenje,
matenda am'mimba thirakiti
ziwalo kapangidwe kapangidwe.

Matenda a shuga osalankhulidwa kapena osazindikira angayambitse:

polyhydramnios
kutupa
matenda a kwamkodzo thirakiti
pyelonephritis,
poyizoni wa pakati.

Momwe shuga imakhudzira kubadwa

Mwana akapanda macrosomia, yomwe imapezeka mosavuta pogwiritsa ntchito ma ultrasound, ndiye kuti kubereka kwachilengedwe kumakhala koopsa kwa mayiyo komanso kwa mwana wosabadwayo.

Ana akulu sangathe kudutsa mu ngalande yakubadwa kwachilengedwe. Chifukwa chake, vuto lodziwika ndi kutalika kwa ntchito komanso ngakhale kusiya kwawo. Amayi omwe ali ndi intrauterine hypertrophy, atony yachiwiri ya chiberekero, kuwonongeka kwa ngalande yakubadwa, ndipo ngakhale kuwombana kumachitika.

Mavuto amakhudzana ndi mwana yemwe wosabadwa, yemwe amakhala ndi vuto lachilengedwe pakubala.

kulakwitsa kwa mapewa ndi ziwalo zokhudzana ndi brachial plexus kapena phrenic nerve,
kusunthasuntha kwa phewa
kukhumudwa kwa sternum
mafupa a mapewa.

Mavuto onse omwe ali ndi pakati amawonjezera mwayi wamavuto pakubereka. Popewa aliyense wa iwo, ndikofunika kukumbukira kuphunzira za kuchuluka kwa glucose panthawi yomwe muli ndi pakati, ndipo ngati muli ndi matenda ashuga, sinthani shuga pamlingo woyenera mpaka pobereka.

Kuthandiza odwala matenda ashuga panthawi yomwe ali ndi pakati kumakhudza kwambiri njira ya pakati komanso pakubala.

Kuzindikira matenda ashuga mwa amayi apakati

Kafukufuku wa azimayi oyembekezera amachitika molingana ndi chiwembu cha ADA. Samafunanso kuti nkhaniyi sanadye chilichonse kwakanthawi. Kuyesedwa kumachitika mosasamala kanthu za kudya ndi nthawi ya tsiku.

Pamaulendo oyamba a gynecologist, mayi aliyense woyembekezera ayenera kukhala ndi cheke magazi. Ngati zotulukapo sizikhala zachilendo, ndiye kuti phunzirolo liyenera kubwerezedwa. Zotsatira zinzake zopatuka zimapatsa ufulu kuzindikira matenda a shuga.

Kuyeserera kumakhala ndi kugwiritsidwa ntchito kwa 50 g ya shuga osungunuka mu 250 ml ya madzi, ndipo patatha ola limodzi (60 min.) Kuyeza kuchuluka kwa shuga m'magazi.

Kuyesaku kuyenera kuchitika pamimba yopanda kanthu:

Zotsatira zake zimakhala zolondola pamene ndende ya glucose: 200 mg% imawonetsa shuga.

Ndi zotsatira zoyenera za mayesowa, kafukufuku wotsatira amachitika sabata la 32. Zotsatira zosawoneka bwino zikuwonetsa mwayi wa matenda ashuga.

Zimachitika kuti dokotala amadumpha poyesa ndikuwonetsa mayeso apakati a glucose apakati.

Chithandizo cha shuga woyembekezera

Pankhani yopezeka ndi matenda ashuga mwa amayi apakati, chithandizo chimachitika, cholinga chake ndicho kupeza kuchuluka kwa shuga m'magazi a amayi.

Chithandizo chimayamba ndi matenda ashuga omwe amakhala ochepa shuga. Ngati kudya patatha masiku 5-7 osapeza kufanana kwamagazi a shuga, kumayambiriro kwa mankhwala a insulin tikulimbikitsidwa.

Jakisoni wa insulin ndi chinthu chosapeweka kwa odwala matenda ashuga ambiri

Chilolezo cha Zithunzi: CC BY

Kuzindikira koyambirira ndi chithandizo cha matenda apakati a shuga kungalepheretse zovuta zovuta panthawi yapakati, monga:

preeclampsia,
matenda am'mimba
gawo la cesarean,
imfa ya fetal,
matenda a perinatal mwa mwana.

Chithandizo cha matenda ashuga oyamwitsa zimakhazikika pakukhazikitsa chakudya komanso makonzedwe a insulin.

Zakudya za amayi apakati omwe ali ndi matenda ashuga

Zakudya za matenda ashuga panthawi ya mimba ziyenera kukhala payokha komanso kutsimikiziridwa ndi:

kulemera kwa thupi
milungu ya mimba
zolimbitsa thupi.

Mayi yemwe ali ndi matenda ashuga ayenera kulumikizana ndi katswiri wazopeza zakudya kapena matenda ashuga omwe angamupangire pulogalamu yapaderadera yopatsa thanzi. Komabe, malangizo oyendetsera zakudya ndizofanana ndi anthu omwe ali ndi matenda a shuga a 2.

Izi zikuphatikiza:

chakudya panthawi inayake, maola awiri aliwonse (kuyambira masiku 4 mpaka 5 masana),
chakudya sichiyenera kukhala chochulukirapo: magawo ang'onoang'ono,
Zakudya za odwala matenda ashuga azimayi oyembekezera ziyenera kukhala zambiri zamafuta, zomwe zimachokera, zoyambirira, zinthu zonse, tirigu, masamba ndi zipatso,
zopatsa mphamvu zamafuta zomwe zimapezeka m'maswiti, sodas ndi zakudya zina ziyenera kukhala zochepa muzakudya,
kugwiritsa ntchito zipatso ziyenera kuchepetsedwa chifukwa cha zomwe zimakhala zosavuta dzuwa,
ziyenera kupewedwa: zakudya zamkaka zonse, tchizi wabuluu, nyama yambiri yamafuta ndi nyama zotsekemera, mbalame zamafuta (abakha, atsekwe), offal, batala, kirimu wowawasa, margarine wolimba, confectionery, zakudya zopezeka mwachangu ndi zakudya zina zamafuta,
Zakudya zoletsedwa ziyenera kulowedwa m'malo ndi izi: buledi wa tirigu ndi zakudya zina zonse, mkaka wopanda mkaka (makamaka zakudya zopatsa mphamvu), nyama yochepa mafuta, nkhuku, nsomba, zakudya zabwino zonunkhira, mafuta a masamba, margarine wofewa komanso masamba ambiri,
Zakudya za amayi ziyenera kukhala ndi mchere wochepa mpaka magalamu 6 patsiku, choncho muyenera kuchepetsa kuchuluka kwa nyama, masoseji, zakudya zamzitini, tchizi zolimba, chakudya chokonzeka, soseji, zosakaniza zonunkhira monga masamba ndikusiya kuwonjezera chakudya pathey,
mukuyenera kukumbukira kuchuluka kwa zakudya zopezeka m'zakudya, momwe mapuloteni amayenera kupatsa mphamvu 15-20%, chakudya chopatsa mphamvu chokhala ndi glycemic index ya 50-55%, ndi mafuta 30-35%.

Ngati sabata limodzi ndi odwala matenda ashuga alephera matenda a glycemia, ndikofunikira kuyamba kulandira mankhwala a insulin. Cholinga cha mankhwalawa ndikwaniritsa momwe thupi la mayi wapakati limayendera.

Kugwiritsa ntchito insulin pa mimba

Insulin panthawi yapakati, Mlingo wake ndi nthawi ya jakisoni, amapangidwa poganizira kuchuluka kwa glucose m'magazi, kulimbikira ntchito, mawonekedwe a machitidwe a kudya komanso nthawi yakudya. Insulin imagwiritsidwa ntchito mwachangu komanso kwa nthawi yayitali.

Chifukwa chake, tsamba la jakisoni limasankhidwanso. Dokotala amawona kuchuluka kwa insulini kuti kusinthasintha kwa glycemia kuchepetsedwa. Ndikofunikira kwambiri kutsatira nthawi yomwe jakisoni, zakudya, masewera olimbitsa thupi.

Insulin yolimbikira imaperekedwa kwa mphindi 15 isanayambe kapena itangotha chakudya. Lamuloli limalola kuti insulin igwire bwino ntchito ndipo imalepheretsa kudumpha mwadzidzidzi mu hypoglycemia. Kuwonjezeka kwa kulimbitsa thupi kumafuna kuwonjezeka kwa mlingo wa insulin. Mlingo wawukulu umafunikiranso kuti mupeze ma ketones mumkodzo kapena m'magazi. Matenda, kuphatikizapo kusanza ndi kukana chakudya, osamasuka kumwa insulin.

Akazi ogwiritsa mankhwala a insulin panthawi yoyembekezeraKuthekera kwa hypoglycemia kuyenera kukumbukiridwa, ngakhale atatsatira nthawi yina ya jakisoni.

Izi zitha kuchitika chifukwa cha:

kudumpha chakudya
insulin yochuluka kwambiri
chakudya chopatsa thanzi kwambiri,
zochita zolimbitsa thupi,
Kutentha khungu (pankhani iyi, kuchuluka kwa mayamwidwe kumapangitsa kuti insulin iwonjezeke).

Ngati zizindikiro zoyambirira zikuwoneka, muyenera kumwa kapena kudya kena kena kake posachedwa.