Chithandizo cha matenda ashuga akatha mwana

Kwa mkazi, kubereka mwana si mayeso osavuta, chifukwa pa nthawi imeneyi thupi lake limagwira ntchito mopitilira muyeso. Chifukwa chake, munthawi imeneyi, nthawi zambiri zikhalidwe zosiyanasiyana za pathological zimawonekera, mwachitsanzo, shuga ya amayi apakati. Koma kodi shuga ya gestational ndi chiyani ndipo ingakhudze bwanji thanzi la mayi ndi mwana wosabadwayo.

Matendawa amapezeka pamene kuchuluka kwa shuga m'magazi kumakhala kwakukulu pamimba. Nthawi zambiri matendawa amazimiririka mwana akangobadwa. Komabe, mtundu uwu wa matenda ashuga ndiwowopsa kwa azimayi, chifukwa maphunzirowa angatengedwe ngati chiwopsezo cha matenda a mtundu 2 mtsogolo.

Gellational matenda a shuga amachitika mu 1-14% ya akazi. Matendawa amatha kuoneka mosiyanasiyana. Chifukwa chake, mu trimester yoyamba, matenda a shuga amapezeka mu 2.1% ya odwala, lachiwiri - mu 5.6%, ndipo lachitatu - mu 3.1%

Zomwe zimayambitsa ndi zizindikiro

Mwambiri, mtundu uliwonse wa matenda ashuga ndi matenda a endocrine omwe amalephera kupezeka mu chakudya cha carbohydrate. Potengera maziko awa, pali inshuwaransi kapena insulin yokwanira, yomwe imayenera kupangidwa ndi kapamba.

Cholinga cha kuperewera kwa timadzi timeneti timatha kukhala osiyana. Mwachitsanzo, kusagwira bwino ntchito pakusintha kwa proinsulin kukhala timadzi wogwira, kuchepa kwa chiwerengero cha ma cell a beta mu kapamba, kusowa kwa kuzindikira kwa insulin ndi maselo, ndi zina zambiri.

Zotsatira za insulin pa kagayidwe kazakudya zimatsimikiziridwa ndi kukhalapo kwa enieni a glycoprotein receptors mu minofu yotengera timadzi. Akamakonzedwa, mayendedwe a shuga m'magazi amawonjezeka ndipo misempha ya magazi imachepa.

Kuphatikiza apo, insulin imayerekezera kugwiritsidwa ntchito kwa shuga komanso momwe imapangidwira monga glycogen mu minofu, makamaka minofu yamanja ndi chiwindi. Ndikofunikira kudziwa kuti kutulutsidwa kwa glucose kuchokera ku glycogen kumachitikanso mothandizidwa ndi insulin.

Homoni ina imakhudza kagayidwe kazakudya ndi mafuta. Imakhala ndi anabolic, imalepheretsa lipolysis, kuyambitsa biosynthesis ya DNA ndi RNA m'maselo omwe amadalira insulin.

Matenda a shuga akachitika, zomwe zimayambitsa zimaphatikizapo zinthu zingapo. Chofunika kwambiri pankhaniyi ndi kulephera kwa magwiridwe antchito a insulin ndi mphamvu ya hyperglycemic yomwe imapangidwa ndi mahomoni ena.

Kukaniza kwa insulin, kupita patsogolo pang'onopang'ono, kumapangitsa kuchepa kwa insulin kwambiri. Zomwe zimatithandizanso zimapangitsa izi:

kunenepa kwambiri kuposa zomwe 20% kapena kupitirira, kupezeka ngakhale musanakhale ndi pakati,
shuga wokwezeka wamwazi, womwe umatsimikiziridwa ndi zotsatira za kusanthula kwamkodzo,
kubadwa m'mbuyomu kwa mwana wolemera kilogalamu zoposa 4,
mayiko (matenda ochitika kawirikawiri ku Asia amapezeka ku Asians, ku Spain, Anthu akuda ndi Asilamu aku America),
kubadwa kwa mwana wakufa kale,
kusowa kwa glucose,
kupezeka kwa matenda a m'mimba,
polyhydramnios yodziwika ndi madzi ochulukirapo amniotic,
cholowa
zovuta za endocrine zomwe zimachitika nthawi yapitayi yapakati.

Pakati pa nthawi yayitali, kusokonezeka kwa endocrine kumachitika chifukwa cha kusintha kwa thupi, chifukwa kale gawo loyambirira la gestation, kagayidwe kamamangidwanso. Zotsatira zake, ndikusowa pang'ono kwa shuga mu mwana wosabadwayo, thupi limayamba kugwiritsa ntchito malo osungirako, kulandira mphamvu kuchokera ku lipids.

M'masiku oyambirira a kubereka, kukonzanso kotero kwa metabolic kumakwaniritsa mphamvu zonse za mwana wosabadwayo. Koma mtsogolomo, kuti tithane ndi insulin kukokana, hypertrophy ya cell pancreatic beta imapezekanso, yomwe imakhalanso yotanganidwa kwambiri.

Kupanga kwa mahomoni kumalipiriridwa ndi kuwonongeka kwake kothamanga. Komabe, munthawi yachiwiri ya mimba, placenta imagwira ntchito ya endocrine, yomwe nthawi zambiri imakhudza kagayidwe kazachilengedwe.

Ma estrogens opangidwa ndi placenta, ma steroid ngati, mahomoni a steroid ndi cortisol amakhala okana insulin. Zotsatira zake, kale sabata 20, zizindikiro zoyambirira za matenda amiseche zimachitika.

Komabe, nthawi zina, mzimayi amawulula kusintha kochepa kwa glucose, matendawa amatchedwa pre-gestationalabetes mellitus. Pankhaniyi, kuchepa kwa insulin kumadziwika kokha ndi kuvutitsidwa kwa zakudya zamatumbo komanso kupezeka kwa zifukwa zina zoyambitsa.

Ndizofunikira kudziwa kuti matenda ashuga panthawi yomwe ali ndi pakati samayendera limodzi ndi kufa kwa maselo a beta kapena kusintha kwa molekyulu ya mahomoni. Chifukwa chake, mawonekedwe amtunduwu wa endocrine amawonedwa kuti ndi osinthika, zomwe zikutanthauza kuti pamene kubereka kumachitika, amalipidwa ndi iwo eni.

Zizindikiro za matenda amiseche zimakhala zocheperako, motero amayi nthawi zambiri amawauza kuti ali ndi machitidwe a thupi pakubala. Mawonetsero akulu omwe amapezeka nthawi iyi ndizizindikiro zamtundu uliwonse wa kusokonezeka kwa chakudya cha carbohydrate:

ludzu
dysuria
Khungu
kuchepa thupi kwambiri komanso zinthu zina.

Popeza Zizindikiro za matenda amishuga gestational sizodziwika, kuyesedwa kwa Laborate ndiye maziko othandizira matendawa. Komanso, mkazi nthawi zambiri amamutsatira ndi ma ultrasound, pomwe mutha kudziwa kuchuluka kwa kusakhazikika ndikuwonetsa matenda a mwana wosabadwayo.

Kubwezeretsa nthawi

Nthawi zambiri zimachitika kuti matenda ashuga azitha akangobadwa. Magazi a shuga m'magazi ndi abwinobwino, zizindikiro zonse za matendawa zimatheratu m'moyo watsiku ndi tsiku.

Kuzindikira kwa shuga - ingomwani tsiku lililonse.

Pakatha masabata 6 mwana atawoneke, muyenera kukayezetsa magazi kuti mupeze kuchuluka kowopsa kwa glucose. Pali mwayi wa 50% woti mtundu wachiwiri wa matenda ashuga ungakhalepo pakadutsa zaka 10 mpaka 20 pambuyo pa kutenga pakati. Itha kuwonekeranso panthawi yomwe mwana akuyembekeza - chiopsezo ndichokwera kwambiri.

Mwayi kuti mwana adwale matenda a shuga 1 ndi ochepa. Ngakhale izi, pali gawo lina la kuyambika kwa matenda ashuga amtundu wachiwiri.

Ngati mayi woyembekezera wokhala ndi GDM wakhala ndi gawo la cesarean, pamakhala zovuta zina. Nthawi zambiri mwana amabadwa wamkulu, kuposa ana wamba. Komabe, izi sizimapatula mwayi wokhala ndi mwana mwanjira yachilengedwe, popanda kuchitidwa opareshoni.

Nthawi zambiri, zakudya zapadera zimaperekedwa kwa GDM, kutsatira zomwe zingathandize. Mndandanda wazinthu zovomerezeka ndi monga:

ng'ombe (yopanda mafuta),
masamba obiriwira
zopangidwa mkaka (kuphatikizapo tchizi chamafuta ochepa),
njere zonse ndi mbewu
buledi wophika ndi ufa wa wholemeal.

Palinso mndandanda wazakudya chomwe chidzafunikire kupatula pachakudya:

Ngati matenda ashuga sangathe

Yankho la funso loti matenda ashuga azitha liti kubereka akangobadwa nthawi yomweyo kapena ayenera kupezeka. Ngati nthawi yayitali yapita kale, ndipo matendawa samachoka ngakhale atakhala kuti mahanjidwewo amakhala mwamphamvu, mankhwalawa ndi mankhwala.

Pa nthawi yoyembekezera, mankhwala omwe amachepetsa glucose sangathe kumwa. Pankhani ya postpartum GDM, zonse ndizosavuta - mutha kumwa mankhwala. Pachiwopsezo cha zovuta zazikulu, mankhwala a insulin ndi omwe amapatsidwa.

Mwambiri, matenda a gestational amatha kukhala mtundu 2. Chifukwa chake, muyenera kulumikizana ndi akatswiri. Mndandanda wa madokotala ayenera kuphatikiza ndi endocrinologist ngati mungathe kutenga pakati.

Malangizo kwa amayi achichepere

Kuphatikiza pa kutsatira zakudya zonse zofunika, pali malingaliro (ambiri aiwo sawerengedwa polemba zakudya):

Timapereka kuchotsera kwa owerenga tsamba lathu!

Chotsani zoipa zonse,
osadya, zopitilira muyeso, kuchuluka kwa zopatsa mphamvu,
yambani kusewera masewera, zolimbitsa thupi m'mawa,
Gwiritsani ntchito zipatso ndi masamba ambiri,
chakudya chizikhala m'magawo ang'onoang'ono,
imwani madzi ambiri.

Moyo wothamanga, wokangalika ndi kukhala panja zimathandizira kuti kuchepa kwambiri kwa thupi, ngati kulipo. Ngati muli pachiwopsezo cha matenda ashuga, muyenera kumawunikidwa nthawi ndi nthawi kuti muwone kuchuluka kwa shuga m'magazi.

Thupi limatha kupereka "zizindikilo" m'njira yowonetsera:

zotupa
redness
matenda okayikiridwa
mabala osamveka.

Pali chiopsezo chosokonezeka ndi zizindikiro zomwe zimakonda. Komabe, tikulimbikitsidwa kuyang'ana kupezeka kwa matendawa.

Ukhondo woyenera. Izi zikutanthauza kuti muyenera kusamba tsiku ndi tsiku, kuthera nthawi kumano, ndikudula misomali yanu sabata iliyonse.

Kudzichitira nokha mankhwala popanda kudziwa dokotala mulibe vuto. Pali chiopsezo chokhumudwitsidwa pazidziwitso zolakwika, kumwa mankhwala olakwika, kapena kumwa mankhwala osaloledwa ndi thupi. Pamenepa, zinthu zomwe zili ndi GDM zidzangokulirakulira. Dokotala amatha kudziwa bwino matendawa, kupereka mankhwalawa komanso kupereka mankhwala othandizira.

Ngati simunyalanyaza thanzi lanu, kutsatira malingaliro a dokotala ndipo simukuphwanya maulamuliro, kuthekera kopeza zotsatira ndikuchira kumawonjezeka. Kupanda kutero, zinthu zidzangokulirakulira ndipo zovulaza sizingachitike ku thupi la amayi lokha, komanso kwa mwanayo.

Matenda a shuga nthawi zonse amayambitsa zovuta zakupha. Mwazi wamagazi ochulukirapo ndi woopsa kwambiri.

Aronova S.M. adafotokoza za chithandizo cha matenda ashuga. Werengani kwathunthu

Zolinga za maonekedwe

Gestationalabetes mellitus ikuwonetsedwa mu insulin kukana (kuchepa kwa chidwi) kwama cell kupita ku insulin yopangidwa ndi thupi motsutsana ndi kusinthika kwa kusintha kwa mahomoni pa nthawi yomwe ali ndi pakati - mphamvu yolepheretsa imaperekedwa ndi lactogen, estrogen, cortisol ndi zinthu zina zomwe zimapangidwa mwachangu kuyambira sabata la makumi awiri atabadwa mwana. Komabe, matenda abwinobwino samachitika mwa azimayi onse - zomwe zimayambitsa vuto ndi izi:

Kunenepa kwambiri. Zofunikira pakukula kwa matenda a shuga a mtundu wachiwiri zimatha kuyambitsa kupanga kwa GDM munthawi yovuta ya thupi la mkazi.
Zaka zoposa zaka makumi atatu. Amayi oyembekezera azimayi ali pachiwopsezo chachikulu chotenga matenda a shuga.
Matenda a shuga osagwirizana ndi m'mbuyomu. Odwala matenda ashuga m'mbuyomu amatha kudzikumbutsa momveka bwino komanso mopanda kukonzekera m'mimba yotsatira.
Makamaka. Ngati achibale a mzere wapafupi adapezeka kuti ali ndi matenda aliwonse amtundu wa shuga, ndiye kuti zoopsa zopeza GDM ziwonjezeke.
Polycystic ovary. Monga momwe zamankhwala zimasonyezera, azimayi omwe ali ndi matendawa amapezeka kawirikawiri ndi matenda a shuga.
Mbiri yoyipa yolepheretsa. Kodi mudakhalapo ndi pathupi pathupi, kubereka kapena kulumala? Kubadwa m'mbuyomu kunali kovuta, khanda linali lalikulu kwambiri kapena laling'ono, kodi zovuta zina zapezeka (mwachitsanzo polyhydramnios)? Zonsezi zimachulukitsa ngozi za GDM mtsogolo.

Zizindikiro za matenda a shuga

Zizindikiro za GDM nthawi zambiri zimagwirizanitsidwa ndi chiwonetsero cha matenda amtundu wa 2. Nthawi zambiri, wodwalayo samamva kuwonetseredwa kwakunja kwa matendawa konse, kulumikiza matenda osiyanasiyana ndikusinthidwa kwakanthawi kwa thupi ndi momwe amasinthira ndikubadwa kwamtsogolo, komabe, nthawi zina mayi wapakati amatha kuonetsa ludzu kwambiri ndikumwa kwambiri zakumwa, komanso kukakamira pafupipafupi kosafunikira, ngakhale Ngati zipatsozo zikadali zochepa. Kuphatikiza apo, matenda osokoneza bongo amadziwika ndi kuwonjezeka kwakanthawi kwa kupanikizika, kuwonekera pang'ono kwa mitsempha (kuchokera kusinthasintha kwa mtima kupita kwa makutu), nthawi zina, mzimayi amasokonezeka ndi kupweteka kwa mtima komanso kuzizira kwa malekezero.

Monga tawonera pamwambapa, Zizindikiro zofananira nthawi zambiri zimakhala ndi pakati pathupi komanso njira zomwe zimagwirizana ndi matendawa (mwachitsanzo, toxicosis). "Chithunzithunzi" chosalongosoka sichimalola kuzindikira vutoli mosazindikira ndipo nthawi zambiri, odwala matenda ashuga amapezeka mothandizidwa ndi mayeso oyenera.

Zizindikiro

Malinga ndi dongosolo loyenera kuwunika lomwe limadwala odwala kuyambira masabata 22 mpaka 28 (ndiye kuti kufunikira kwa thupi kwa insulin kumawonjezeka, pafupifupi mpaka 75 peresenti ya chizolowezi), kuyesedwa kwa glucose kumachitika. Pa kusanthula kumeneku, magazi amaperekedwa koyamba kuyambira chala pamimba yopanda kanthu m'mawa. Dziwani kuti maola khumi ndi awiri musanayesedwe, ndikofunikira kukana kudya, mankhwala aliwonse omwe sanavomerezane ndi adokotala, komanso kupewa kupsinjika kwakuthupi / m'malingaliro, kupewa mowa ndi kusuta.

Atatenga magazi a capillary malinga ndi zomwe takambirana pamwambapa, woyimira kugonana mwachisawawa amapatsidwa shuga wofanana ndi magalamu 75, pambuyo pake wachigawo chachiwiri ndi chachitatu cha magazi okwanira pambuyo pa ola limodzi ndi maola awiri.

Malingaliro a kuyesedwa pamwambapa ali pamimba yopanda 5.1 mmol / L, ola limodzi pambuyo pakukonzekera kwa glucose osaposa 10 mmol / L, atatha maola 2 - osaposa 8.5 mmol / L. Monga lamulo, mfundo zoyeserera mwachangu mwa amayi apakati omwe ali ndi GDM ndizotsika kwambiri kuposa zabwinobwino, koma zimapamwamba kwambiri panthawi yochita masewera olimbitsa thupi.

Mosiyana ndi mtundu woyamba wa 1 komanso mtundu wa 2 wa matenda ashuga, kuyesa kwa hemoglobin sikumachitika ngati pakukayikira amisala, chifukwa nthawi zambiri zimakhala zabodza chifukwa cha kupangika kwapadera kwa GDM mwa akazi.

Kuphatikiza pa kusanthula kumeneku, kuti atsimikizire matendawa, dokotala ayenera kupatula matenda ena omwe amayambitsa hyperglycemia, komanso, ngati kuli koyenera, afotokoze mitundu ina ya kafukufuku.

Chithandizo cha matenda ashuga

Chifukwa cha ziwopsezo zina ku thanzi la mwana mtsogolo, chithandizo cha matenda osokoneza bongo chimachitika pogwiritsa ntchito njira zotetezeka kwambiri ndi mankhwala ochepa. Pambuyo pozindikira GDM, woyimira kugonana woyenera adzapatsidwa zakudya zapadera, komanso zolimbitsa thupi, zomwe zingamuthandize pa nthawi iyi ya chitukuko cha fetal, katundu. Tsopano, mpaka kasanu ndi kawiri patsiku, muyenera kusintha kuchuluka kwa shuga m'magazi pogwiritsa ntchito glucometer ndikusunga tsatanetsatane wazotsatira zazotsatira kuti dokotala, ngati kuli kotheka, adziwitse ziwerengero zotere ndikuwongolera njira yochiritsira.

Nthawi zina, kudya ndi kuchita masewera olimbitsa thupi sikokwanira - mwanjira imeneyi, katswiriyo amamuuza njira ya insulin yochizira mpaka nthawi yobereka. Mlingo ndi mankhwalawa enieni a mankhwalawa amaperekedwa ndi adokotala anu! Tsoka ilo, jakisoni wa insulin samapereka mphamvu kwambiri pazomwe zimachitika chifukwa cha kusazindikira bwino kwa minyewa ya minyewa iyi.

Chida china chapamwamba chochepetsera shuga ndikumamwa mankhwala ochepetsa shuga a mkamwa. Ochuluka aiwo amaletsedwa kugwiritsa ntchito panthawi yomwe ali ndi pakati chifukwa choopsa kwambiri ku thanzi ndi moyo wa mwana wosabadwa. Metformin ndiyosiyana, koma imangoyesedwa ngati njira yomaliza, yoganizira mosamala zonse zomwe zingachitike ndikuganiza zovuta zoyipa.

Zakudya za matenda ashuga

Njira yothandiza kwambiri yolimbana ndi GDS ndi chakudya chosankhidwa bwino - iyi ndi axiom yakhala ikugwira ntchito kwazaka zoposa makumi asanu.Ngakhale kufanana kwa njira ndi njira zochizira matenda ashuga komanso mtundu wachiwiri wa matenda ashuga, njira zomwe zimapatsa thanzi ndizosiyana kwambiri. Ndi GDM, simungagwiritsire ntchito zakudya zamafuta ochepa kapena ma vegan, popeza zakudya zomwe zimakhudzidwa zimatha kusokoneza thanzi la mwana wosabadwayo. Kapangidwe ka matupi a ketone kumakhala kowopsa kwambiri atasinthira kumafuta a thupi lake. Zoyenera kuchita? Madotolo panthawiyi ya moyo wa amayi mpaka nthawi yoti abadwe, akuwonetsa kuti asinthe kukhala zakudya zabwino. Mfundo zake zazikulu:

Chakudya cham'magulu atatu, njira zitatu zoyambirira (kadzutsa, nkhomaliro, chakudya chamadzulo) ndi zakudya zitatu.
Kukana kugwiritsa ntchito zinthu zilizonse zokhala ndi ma "carbohydrate" osavuta "- ufa, maswiti, zonunkhira, chakudya mwachangu ndi mbatata mwanjira iliyonse.
Zakudya za calorie zabwinobwino pa kilogalamu imodzi yokha ya thupi.
Kugawa kwadongosolo kwa BJU ndi 25-30 peresenti ya mapuloteni, pafupifupi 30 peresenti ya mafuta, ndi mpaka 40-45 peresenti ya chakudya.
Ndikofunikira kugwiritsa ntchito zakudya zamafuta - kusintha chimbudzi ndi kukhazikika kwa peristalsis.
Kuyang'anira kuchuluka kwa shuga ndi matupi a ketone, makamaka pambuyo pa chakudya chilichonse (pambuyo pa mphindi 60).

Pazakudya zotere, phindu loyenera la mimba yonse limasiyanasiyana ma kilogalamu 11-16. Pazakudya zambiri, azimayi omwe ali ndi GDM panthawi yoyambira kuyambira pa pakati mpaka pakubadwa kwa mwana ali pafupifupi ofanana ndi zakudya zoyenera zogonana mosangalala m'malo opanda zovuta zaumoyo, koma amafunikira kuyang'anidwa mosamala kwambiri kwamatumbo a tsiku ndi tsiku komanso kuwongolera kwathunthu matupi a shuga / ketone magazi.

Zosankha sabata

Zakudya za masabata angapo zomwe zimachitika tsiku lililonse ndi zakudya za masiku asanu ndi limodzi zimapereka mayi wapakati ndi zinthu zonse zofunika, ndikuthandizira kukhalabe ndi kagayidwe kazachilengedwe komanso kuchepetsa zovuta za zovuta za GDM.

Tikhala ndi sangweji wamkulu ndi tchizi cholimba ndi tomato awiri, komanso dzira limodzi lowiritsa. Pazakudya musanadye chakudya - mbale yaying'ono yokhala ndi tchizi tchizi komanso zouma zodzaza dzanja. Timadya nkhomaliro ndi msuzi wamasamba. Khalani ndi chakudya chamasana ndi kapu yayikulu yogati yachilengedwe. Tili ndi chakudya chamadzulo ndi mbale yamasamba ndi avocado imodzi. Musanagone, mutha kugwiritsa ntchito kapu ya rosehip decoction.

Tidzadya chakudya cham'mawa chomwe timakhala ndi mkaka wa oatmeal wopangidwa mkaka. Tiluma maapulo awiri. Timadya nkhomaliro ndi msuzi wa nkhuku ndi nyama. Tili ndi chakudya chamadzulo ndi magalamu zana a tchizi chamafuta ochepa. Tidya chakudya chamadzimadzi komanso nyama yaying'ono yophika. Asanagone, timatha kumwa kapu imodzi ya kefir popanda shuga.

Tili ndi mbale ya omele yokhala ndi nkhaka ziwiri. Chakudya chamasana, kapu ya yogati. Timadya nkhomaliro ndi msuzi wa nsomba. Khalani ndi nthochi ziwiri. Tili ndi chakudya chamadzulo ndi mbale yamkaka. Asanagone, timagwiritsa ntchito saladi ya masamba.

Timadya chakudya cham'mawa chophika ndi cheesecake chophatikizidwa ndi zoumba komanso kuwonjezera 15 peresenti wowawasa zonona. Pazakumwa - ochepa walnuts. Tudya nkhomaliro ndi mbale ya msuzi wa lentili. Khalani ndi chakudya chamadzulo ndi mapeyala awiri ang'ono. Chakudya chamadzulo cha mpunga, nyama yophika nkhuku ndi tomato (magalamu 100). Musanagone, imwani tiyi.

Chakudya cham'mawa, konzekerani omelet ndi sangweji (batala, tchizi cholimba, mkate wa rye). Musanadye, imwani kapu ya phwetekere. Timadya nkhomaliro ndi chakudya chamasamba ndi magalamu 100 a nyama yonyongedwa. Khalani ndi masana awiri yamapichesi. Chakudya chamadzulo - mbale ya spaghetti kuchokera ku tirigu wa durum ndi kuwonjezera kwa msuzi wa phwetekere. Musanagone, mungamwe kapu ya tiyi ya zitsamba.

Tili ndi kadzutsa ndi tchizi tchizi komanso kuwonjezera zipatso. Tili ndi kuluma ndi sangweji imodzi yaying'ono ndi kagawo ka tchizi cholimba. Tili ndi mbale ya buckwheat ndi mphodza, saladi ya masamba ndi tiyi wobiriwira. Khalani ndi kapu yamasana atsopano. Tili ndi chakudya chamadzulo ndi saladi wa masamba ndi magalamu 100 a chifuwa cha nkhuku ndi tomato. Musanagone, mungamwe kapu ya 1 peresenti mkaka.

Tidzadya chakudya cham'mawa ndi mbale yamphaka yamkaka yokhala ndi maapricots owuma. Tiluma maapulo awiri. Chakudya chamadzulo chokhala ndi saladi wapamwamba wa tomato / nkhaka ndi msuzi wa kabichi. Khalani ndi masana ochepa zipatso zouma. Chakudya chamadzulo chamadzimadzi pa zukini ndi kuwonjezera kwa kirimu wowawasa, komanso kapu yamadzi. Musanagone, mungamwe kumwa rosehip.

Tikukulimbikitsani kuti amayi onse apakati omwe apezeka ndi matenda a shuga oyembekezera sakhala ndi nkhawa - matendawa, monga akuwonetsera ndi ziwerengero zamankhwala padziko lonse lapansi, amapezeka chaka chilichonse mwa azimayi oyembekezera. Inde, ili ndi "belu" lowopsa kuti sizinthu zonse zomwe zimadongosolo ndi thupi, koma nthawi zambiri, GDM imasowa pambuyo pobala. Mwachilengedwe, pakapita zaka ziwiri ndi theka kuchokera pamene mayi wabereka, mkazi amayenera kuwunika momwe thupi limaperekera, kupereka magazi pafupipafupi ndi shuga ndikuyesetsa kupewa kutenga pakati pa nthawi yayikazi - zoopsa zobwereza matendawa komanso kusintha kwake kukhala mtundu woyamba wa 2 kapena 2 wa shuga.

Idyani moyenera komanso molondola, khalani ndi nthawi yochulukirapo mu mpweya wabwino, chitani masewera olimbitsa thupi ndikulimbikitsidwa ndi dokotala - kubadwa kwanu kumayenda bwino ndipo mutha kuyamwitsa mwana wanu, kuyang'anira mosamala mawonetseredwe a shuga mtsogolo.

Kodi matenda ashuga owopsa ali ndi vuto liti?

GDM imakhala ndi zoopsa zina kwa mwana wosabadwayo komanso mayi. Oyimira kugonana koyenera monga kupsinjika kwa GDM atha kukhala ndi matenda ashuga a m'mimba komanso preeclampsia, omwe amachititsa kuti mwana asamve bwino komanso kuti magazi asamayendetsedwe kwa mayiwo. Kuphatikiza apo, kuchuluka kwambiri kwa shuga m'magazi kumapangitsa kuti mwana akhale wakhanda, makamaka pomaliza nthawi yomwe ali ndi pakati, komwe kumawonjezera ngozi za kubadwa msanga komanso zovuta kwambiri kubadwa kwachilengedwe. Ngakhale izi ndizowopsa, ziwerengero zamakono zamankhwala zimawonetsa kuti ana ochepera ana amwalira chifukwa cha matenda ashuga - 1% yokha ndiyokwanira kuposa azimayi athanzi ndi ana awo osabadwa.

Ndili ndi matenda a shuga. Kodi zakhudza bwanji mwana wosabadwa?

Pankhani yakuwongolera kwathunthu matendawa, kuwunika momwe mayiyo akukhalira pano ndi mwana wosabadwayo, kukonza zakudya komanso njira zina zothandizira, GDM sikhala ndi vuto lalikulu kwa mwana wanu wosabadwa - kubereka kumayambira nthawi komanso kumachitika mwachilengedwe. Ngati mayi ali ndi zovuta (nephropathy, zipsera pa chiberekero, preeclampsia, pelvis yopapatiza, etc.), zosankha zingapo ndizotheka - kuyambira nthawi yobadwa isanakwane mpaka gawo la cesarean. Mulingo wambiri wa glucose ungapangitse kuti mwana akhanda kupanga macrosomia - kukula kwa fetal komanso kuchuluka kwa kuchuluka kwake, zomwe zimathandizanso kuopsa kwa kubereka mwana ndi kuvulala koyambirira panthawi yobereka, ponseponse mwa wakhanda ndi amayi ake. Kusankha kwina pankhaniyi kumapangidwa ndi kuonana ndi madokotala akatswiri.

Kodi ndi chiyani chomwe sichingadye ndi shuga?

Zakudya zamasiku ano zimalimbikitsa kudya moyenera zakudya za GDM. Zakudya za tsiku ndi tsiku ziyenera kukhala ndi mapuloteni (25-30 peresenti), mafuta (30 peresenti) ndi chakudya (40-45 peresenti), komanso zopatsa mphamvu zama calorie siziyenera kuchepetsedwa - yang'anani pa 35 kcal malinga ndi kilogalamu imodzi ya kulemera kwanu kwakanthawi.

Zakudya zochepa-carb makamaka zakudya za vegan panthawi yoletsedwa ndizoletsedwa! M'pofunika kusiyiratu ndi zakudya zopangidwa ndi ufa wokha, maswiti, maapozi, mbatata, chakudya chothamanga, zonse yokazinga ndi zakudya zina zopezeka m'mapangidwe osavuta othamanga a chakudya, komanso cholesterol yoyipa. Zosatchulidwa pamndandandawu zitha kugwiritsidwa ntchito, komabe, pang'ono komanso pang'ono. Gawani zakudya za tsiku ndi tsiku muzakudya zisanu ndi chimodzi - chakudya cham'mawa cham'mawa, chakudya chambiri, chakudya chamasana, chakudya chosavuta masana, chakudya chamadzulo komanso chakudya chachiwiri musanayambe kugona.

Kodi kubadwa kumagwirizanitsidwa bwanji ndi matenda a shuga a gestational?

Munjira zosiyanasiyana. Zimatengera nyengo ndi zinthu zambiri. Ndi GDM ndi shuga achizolowezi chosala, komanso kudziwikiratu matendawa miyezi yonse yapitayo, mkazi nthawi zambiri amanyamula mwana mpaka tsiku lobadwa. Kuperekera kwakuthupi popanda gawo la cesarean la matenda osokoneza bongo kumaloledwa kumalo osakhalitsa, ndi kulemera kwa fetal osaposa ma kilogalamu anayi komanso mwayi wowunikira zenizeni zofunikira zonse za mayiyo / mwana. Ngati mayi ali ndi matenda ashuga a nephropathy, ali ndi khungu lopyapyala kapena khungu limakhala ndi chotupa pa chiberekero. Malinga ndi ziwerengero, azimayi anayi mwa anayi alionse omwe ali ndi GDM amabereka pawokha. Mulimonsemo, lingaliro limapangidwa ndi mgwirizano wamankhwala.

Anandipeza ndi matenda osokoneza bongo. Kodi izi zikutanthauza chiyani?

GDM ndikuphwanya kwa kagayidwe kazakudya, kamene kamawonetsedwa mu kuchepa kwa chidwi cha maselo am'mimba kupita ku insulin. Poyerekeza ndi kuphwanya koteroko, kuchuluka kwa shuga m'magazi kumachulukana mwatsatanetsatane ndipo zizindikiritso zingapo zimayambira - ludzu, kukodza pafupipafupi, kupanikizika, kupindika komanso kutupa kwa miyendo, kusinthasintha mwachangu, thukuta.

Mawonetsedwe omwe ali pamwambawa ndi ofanana ndi mtundu wachiwiri wa matenda ashuga, komabe, nthawi zambiri amawonongeka mwana akangobadwa, chifukwa amayamba chifukwa cha kusintha kwa mahomoni m'thupi la mzimayi masabata 22- 28 (estrogen, lactogen ndi cortisol) amachepetsa mphamvu ya minyewa ya insulin) limodzi ndi zovuta zingapo - kuchokera ku kunenepa kwambiri komanso zopitilira zaka makumi atatu pamaso pa ovary ya polycystic, kutengera kwa chibadwa komanso mbiri yakale yotsalira.

Momwe mungachepetse shuga m'magazi apakati?

Choyamba, ndi njira zachilengedwe - zakudya zoyenera, zomwe zimachepetsa kumeza "chakudya" chofulumira "ndikuwongoletsa zochitika zolimbitsa thupi. Kugwiritsa ntchito mankhwala ndizoletsedwa popanda chilolezo cha adokotala. Mowopsa kwambiri, mayi woyembekezera amatha kupatsidwa jekeseni wa insulin kapena kumwa mankhwala ochepetsa shuga (metformin), osamala mosamala zoopsa zomwe zingachitike paumoyo wa mwana wosabadwa komanso phindu lomwe lingakhalepo pogwiritsa ntchito mankhwalawo. Werengani zambiri za momwe mungachepetse shuga pano.

Magulu owopsa

Nthawi zambiri, matenda a shuga ammimba amapezeka mwa azimayi omwe:

onenepa kwambiri,
Ali mgulu lazoposa zaka 40,
anali ndi matenda ashuga panthawi yapambuyo pake,
anali ndi vuto losowa m'mimba (mwachitsanzo, polycystic)
anabereka ana okulirapo (oposa 4 kg),
khalani ndi ma pathologies apakati, mwachitsanzo, polyhydramnios.

Nthawi zambiri, matenda ashuga amayamba chifukwa cha matenda osachiritsika. Chifukwa chake, madokotala amalimbikitsa kwambiri kuti mukonzekere kukhala ndi pakati pasadakhale. Makamaka olabadira thanzi lanu ayenera kukhala omwe ali ndi shuga mumkodzo wawo woposa chovomerezeka. Udindo wofunikira umaseweredwa ndi mtundu wa amayi. Asayansi apeza kuti oimira mpikisano wa Negroid, Hispanics, Native America komanso azimayi aku Asia amakhala ndi matenda osokoneza bongo kangapo kuposa azungu.

Ngozi kwa mwana

Ngati matenda ashuga amachitika m'mimba koyambirira, nthawi zambiri zimapangitsa kuti asokonezeke kapena kuwonongeka kwa kubereka. Nthawi zambiri, mtima ndi ubongo wa zinyalala zimavutika.

Ndi chitukuko cha matenda ashuga wachiwiri kapena wachitatu trimester, imakhala chifukwa cha kukula kwambiri kwa fetal komanso kupezeka kwa hyperinsulinemia. Pambuyo pobadwa, mwana amasiya kulandira kuchokera kwa amayi kuchuluka kwa shuga omwe amawagwiritsa ntchito. Izi zimadzetsa kuti kuchuluka kwa shuga m'magazi ake kumatsikira kwambiri. Ana otere ayenera kuyang'aniridwa ndi dokotala. Ngati mwana akudyetsa mwakudya, ndiye kuti zosakaniza zapadera zimagwiritsidwa ntchito kuti apange insulin.

Ndikofunika kukumbukira: ngati mayi woyembekezera ali ndi matenda ashuga, ayenera kuchitapo kanthu mwachangu. Kuperewera kwa chithandizo kungayambitse kukula kwa matenda a shuga mu fetus. Chifukwa chakuti m'thupi la mayiyo muli zosokoneza zama kagayidwe kachakudya, mwana amatha kuwonetsa zina monga kuphwanya kuchuluka kwa thupi (m'mimba komanso miyendo yopyapyala), kutupa, kunenepa kwambiri (zoposa 4-5 makilogalamu), jaundice, mavuto kupuma. hypoglycemia.

Kodi kulemera kwabwinobwino kwamimba ndi chiyani?

Kodi shuga amadziwika bwanji panthawi yoyembekezera?

Kodi kukhalapo kwa acetone mu mkodzo panthawi yapakati kumawonetsa chiyani?

Kupereka

Njira zomwe zimachitidwa pa nthawi yake kuti mupeze matenda osokoneza bongo amapewe mavuto ambiri. Komabe, nthawi zambiri matendawa amatsogolera kubadwa asanakwane kapena gawo la cesarean. Zisonyezero za izo amatchulidwa zizindikiro za matenda ashuga za mwana wosabadwayo (kukula kwakukulu makilogalamu 4), matendawa m'chiberekero, matenda oopsa ndi zina zomwe sizikugwirizana ndi matenda ashuga. Kuwunika kwa glycemia kumachitika musanachite opareshoni, musanachotse mwana, mutachotsa placenta, kenako maola 2 aliwonse. Pakubadwa kwachilengedwe, kuwunika kuchuluka kwa shuga mwa amayi omwe ali pantchito kumachitika nthawi iliyonse ya maola 1-2. Ngati mayi woyembekezera anali pa mankhwala a insulin, pakubadwa kwa mwana amapaka jekeseni ndi mankhwala pogwiritsa ntchito infusomat.

Kutsatira Pambuyo

Nthawi zambiri, mwana akangobadwa kumene, mkazi amachotsedwa ndi insulin. Koma asanadutse masiku atatu, ayenera kuyang'anira shuga. Nthawi zambiri, pambuyo pobadwa, zizindikiro zonse za matenda ashuga zimatha popanda kufufuza. Komabe, mkazi ali pachiwopsezo cha matenda amtsogolo. Chifukwa chake, amalangizidwa kuti azicheza pafupipafupi ndi a endocrinologist ndi kukayezetsa.

Ndi matenda a shuga, mwana amabadwa ndi shuga wochepa wamagazi. Koma chifukwa cha kudya koyenera, vutoli litha kukonza posachedwa. Ngati mayi alibe colostrum yokwanira, ndipo mkaka sunayambe kubereka, mwana ayenera kudyetsedwa ndi zosakaniza zapadera. Pofika nthawi yochoka kuchipatala, ogwira ntchito pachipatalachi adzauza mayiwo momwe angayang'anire moyenera magazi a mwana kuti abwezeretse bwino.

Matenda a shuga okomoka ndi matenda oopsa. Komabe, podziwitsa mayi wake ndi mwana wake zonse, zonse zimachitika m'njira yabwino. Komabe, mwana ali pachiwopsezo cha kufa kwa makanda ndipo amafunika kuyang'aniridwa ndi dokotala wa neonatologist ndi a komweko. Komabe, amayi amatha kukumana ndi mavuto patapita zaka zingapo atabadwa. Kuti mupewe mavuto, khalani ndi moyo wathanzi: yang'anirani zakudya zanu, onetsetsani kunenepa komanso muchite masewera olimbitsa thupi pafupipafupi.