Kuyesererana kwa glucose pakakhala pakati

Kuyesedwa kwa glucose kumayesedwa kwa odwala matenda a shuga, anthu onenepa kwambiri omwe ali ndi matenda a chithokomiro.

Mwa amayi ambiri oyembekezera, motsutsana ndi momwe masinthidwe amthupi amakhudzira, zovuta za metabolism.

Omwe ali pachiwopsezo amapatsidwa mayeso ololera a glucose popewa kukula kwa matenda ashuga, ndipo funso loti ndizofunikira kuchita panthawi yoyembekezera ndi udindo wa dokotala wazamankhwala.

Mkaziyo amapanga kuyesedwa, kutengera kuchuluka kwa nkhawa za thanzi la mwana wosabadwa.

Kuyesererana kwa glucose panthawi yapakati: kuvomerezedwa kapena ayi?

Chiyeso chololera cha glucose chiyenera kukhazikitsidwa m'makliniki ena azimayi, komanso mwa ena - pazifukwa zaumoyo.

Musanaganize zofunikira pa nthawi yomwe ali ndi pakati, ndikofunikira kufunsa katswiri wa endocrinologist, komanso kuti mudziwe yemwe amamufotokozera.

GTT ndi gawo lofunikira pofufuza thanzi la mayi woyembekezera. Kugwiritsa ntchito, mutha kudziwa kuyamwa kwa shuga ndi thupi ndikuzindikira kupatuka kwa kagayidwe kachakudya.

Ndi mwa amayi apakati omwe madokotala amazindikira matenda osokoneza bongo, omwe amawopseza thanzi la mwana wosabadwayo. Kuzindikira matenda omwe alibe zizindikiro zamankhwala koyambirira kumatheka pokhapokha ngati njira yolembera. Chitani kafukufuku pakati pa milungu 24 ndi 28 ya mimba.

Poyambirira, kuyesedwa kumayesedwa ngati:

• mkazi wonenepa kwambiri
• pambuyo pakuwunika mkodzo, shuga adapezeka m'menemo,
• Mimba yoyamba imalemedwa ndi matenda ashuga,
• mwana wamkulu adabadwa kale,
• Ultrasound idawonetsa kuti mwana wosabadwayo ndi wamkulu,
• M'banja lapafupi la mayi woyembekezera pali odwala omwe ali ndi matenda ashuga,
• Kafukufuku woyamba adawonetsa kuchuluka kwa shuga m'magazi.

GTT mukazindikira zizindikiro zomwe zili pamwambapa zimayikidwa pakadutsa masabata 16, zibwerezeni pamasabata 24-28, malinga ndi zikuwonetsa - mu trimester yachitatu. Pambuyo pa masabata 32, kutsitsa kwa shuga ndi kowopsa kwa mwana wosabadwayo.

Matenda a shuga a Gestational amadziwika ngati shuga m'magazi atayesedwa atatha 10 mmol / L ola limodzi atatha kuthana ndi vutoli ndi 8.5 mmol / L patatha maola awiri.

Matendawa amakula chifukwa chakuti mwana yemwe akukula komanso amakula amafunika kupanga insulin yambiri.

Zikondamoyo sizitulutsa timadzi tokwanira mu izi, kulekerera kwa glucose mwa mayi wapakati kuli pamlingo womwewo.

Pa nthawi yomweyo, kuchuluka kwa shuga wa seramu kumawonjezeka, matenda a shuga a m'mimba amakula.

Ngati zakudya za shuga zimawonedwa pamlingo wa 7.0 mmol / l pakuyamba kudya kwa plasma, kuyesedwa kwa glucose sikunakhazikitsidwe. Wodwala amapezeka ndi matenda a shuga. Atabereka, amalimbikitsidwanso kuti ayesedwe kuti adziwe ngati matendawo adalumikizana ndi pakati.

Dongosolo la Unduna wa Zaumoyo ku Russia

Malinga ndi dongosolo la Novembala 1, 2012 N 572н, kuwunika kwa kulolera kwa glucose sikuphatikizidwa pamndandanda wazovomerezeka azimayi onse oyembekezera. Amamulembera pazifukwa zachipatala, monga polyhydramnios, shuga, mavuto ndi kukula kwa mwana wosabadwayo.

Kodi ndingakane kuyeserera kwa glucose panthawi yapakati?

Mkazi ali ndi ufulu wokana kuchita GTT. Musanapange chisankho, muyenera kuganizira za zomwe zingachitike ndikufunsira malangizo kwa akatswiri osiyanasiyana.

Tiyenera kukumbukira kuti kukana mayeso kumatha kubweretsa zovuta zam'tsogolo zomwe zingasokoneze thanzi la mwana.

Kodi kusanthula nthawi ndi liti?

Matenda a shuga amawopa mankhwalawa, ngati moto!

Muyenera kungolemba ...

Popeza mayi amayenera kumwa njira yotsekemera kwambiri asanaperekedwe magazi, ndipo izi zimatha kuyambitsa kusanza, kuyezetsa sikulembedwera ngati pali zizindikiro zazikulu za toxosis yoyambirira.

Contraindication pakuwunikira ndi monga:

• Matenda a chiwindi, kapamba pakachulukitsa,
• aakulu yotupa njira m'mimba
• zilonda zam'mimba
• pachimake matenda am'mimba
• contraindication pambuyo opaleshoni pamimba,
• kufunika kwa kugona pakama pamalangizo a dokotala,
• matenda opatsirana
• trimester yomaliza ya mimba.

Simungathe kuchititsa kafukufuku ngati kuwerengera kwa glucose mita pamimba yopanda kanthu kupitirira mtengo wa 6.7 mmol / L. Kudya kowonjezera kwamaswiti kumatha kupangitsani kukomoka kwa hyperglycemic coma.

Ndi mayeso ena ati omwe amayenera kuperekedwa kwa mayi woyembekezera

Pa nthawi yonse yomwe mayi ali ndi pakati, mayi amakhala pansi pa madokotala ambiri.

Mayeso otsatirawa amalimbikitsidwa makamaka kwa amayi apakati:

1. woyamba trimester. Mukalembetsa mayi woyembekezera, muyeso wokhazikika wa maphunziro umafotokozedwa: kusanthula kwamkodzo ndi magazi. Onetsetsani kuti mwazindikira gulu la magazi ndi Rh factor yake (ndikuwunikira kosavomerezeka, imaperekedwanso kwa mwamunayo). Phunziro la biochemical ndilofunika kuti muwone mapuloteni onse, kupezeka kwa urea, creatinine, kudziwa kuchuluka kwa shuga, bilirubin, cholesterol. Mzimayi amapatsidwa coagulogram kuti adziwe kuchuluka kwa magazi ndi kutalika kwa njirayi. Kupereka koyenera kwa magazi a syphilis, kachilombo ka HIV ndi chiwindi. Pofuna kupewetsa matenda opatsirana pogonana, swab yochokera ku nyini imatengedwa kuti akupanga, gonococci, chlamydia, ureaplasmosis, ndikuwunika kwa cytological. Mapuloteni a Plasma atsimikiza kupatula kulakwitsa kwambiri, monga Down syndrome, Edward syndrome. Kuyesa kwa magazi kwa rubella, toxoplasmosis,
2. wachiwiri trimester. Asanapite ku gynecologist, mayi amapenda magazi, mkodzo, ndi coagulogram ngati akuwonetsedwa. Biochemistry imachitika amayi asananyamuke, cytology pamene mavuto apezeka mukadutsa kusanthula koyamba. Wofufuza kuchokera ku nyini, khomo pachibelekeropo limalengezedwanso. Bwerezani kuwunikira kachilombo ka HIV, chiwindi, syphilis. Pereka magazi kuma antibodies
3. wachitatu trimester. Kusanthula kwapadera kwamkodzo, magazi, kupaka gonococci pakatha milungu 30, kuyezetsa magazi, matenda a chiwindi amawerengedwa. Malinga ndi zikuwonetsa - rubella.

About mayeso a shuga wamagazi ndi katundu pa nthawi yomwe muli ndi vidiyo mu kanema:

Kuyesedwa kwa glucose kumayesedwa kwa amayi apakati omwe ali ndi vuto la shuga. Pangozi ndi odwala onenepa kwambiri omwe ali ndi matenda a endocrine, okhala ndi achibale omwe ali ndi matenda ofananawo. Simungachite kusanthula ndi toxosis yayikulu, mutachitidwa opaleshoni pamimba, ndikuchulukirachulukira kwa kapamba ndi cholecystitis.

Kuyesedwa kwa glucose pakumeta sikuphatikizidwa pamndandanda wazophunzirira zomwe zimafunikira; zimayikidwa molingana ndi zisonyezo. Mzimayi yemwe amadzisamalira yekha ndi mwana wake amatsatira malangizo onse a dokotala ndipo amapambana mayeso ofunika.

Ngati kuchuluka kwachulukidwe ka shuga m'magazi mwapezeka, zovuta za metabolic zomwe zapezeka munthawi yake zithandiza kupewa mavuto azaumoyo pakubala, komanso kupewa kupezeka kwa mwana wosabadwa.

Kukonzekera

• Kuyesaku kumachitika motsutsana ndi maziko azakudya wamba, zopanda malire, zopezeka ndi zakudya zosakwana 150 g zamagulu m'zakudya (izi siziphatikiza shuga wokha, komanso zakudya zambiri zam'mera) patsiku.
• Kuyesedwa kuyenera kupitilira kusala kudya madzulo, usiku ndi m'mawa - maola 8-14 (koma mutha kumwa madzi).
• Chakudya chomaliza sichikhala ndi magalamu oposa 50 a chakudya (timakumbukira kuti izi siziphatikiza maswiti okha (zipatso ndi maswiti), komanso masamba).
• Kwa theka la tsiku lisanafike mayeso, simungathe kumwa mowa - monga nthawi yonse ya mimba.
• Komanso, musanayesedwe, simungathe kusuta osachepera maola 15 musanayesedwe, ndipo, makamaka, panthawi yonse yomwe muli ndi pakati.
• Kuyesedwa kumachitika m'mawa.
• Simungathe kuyesa kumbuyo kwa matenda aliwonse opatsirana.
• Simungathe kuyesa mukamamwa mankhwala omwe amalimbikitsa kuchuluka kwa glucose m'magazi - amaletsedwa masiku atatu tsiku lachiyeso lisanachitike.
• Simungathe kuyesa kwa masabata oposa 32 (pambuyo pake, kutsitsa kwa shuga kumakhala koopsa kwa mwana wosabadwayo), ndipo pakati pa 28 ndi 32 milunguyo, mayesowo amachitika pokhapokha ngati mwalandira dokotala.
• Ndizoyenera kuchita mayeso pakati pa masabata 24 mpaka 26.
• Kuthira shuga kungachitike kale, koma ngati mayi woyembekezera ali pachiwopsezo: ali ndi BMI yochulukirapo (mayunitsi opitilira 30) kapena iye kapena abale ake anali ndi zizindikiro za matenda ashuga.

Kuti mudziwe, BMI, kapena index ya body mass, imawerengeredwa mophweka: kugwiritsa ntchito masamu wamba - kuti mupeze BMI yanu muyenera kutalika mumtunda (ngati muli wamtali wa masentimita 190, ndiye mita 1.9 - ndiye 1.9) ndi kulemera kwama kilogalamu (mwachitsanzo, akhale ma kilogalamu 80),

Kenako muyenera kuchulukitsa nokha pawokha (muchitsanzo ichi, 1.9 kuchulukitsa ndi 1.9), ndiye kuti mukulikulire ndi kugawa kulemera kwanu ndi nambala yakutsogolo (pa ichi, 80 / (1.9 * 1.9) = 22.16).

• Mulimonsemo, kusanthula sikumachitika kwa nthawi yochepera sabata khumi ndi zitatu, chifukwa shuga ya amayi apakati sakhazikika lachiwiri asanachitike.
• Ngakhale mayesowo atachitika kwa nthawi mpaka masabata 24- 28, pamasabata a 24- 28 amabwerezedwa popanda kupatula, makamaka ngati zidachitidwa kale.
• Ngati ndi kotheka, kuyezetsa magazi kungachitike nthawi yachitatu, koma adotolo adzaonetsetsa kuti izi zikuchitika, osatinso masabata 32.

Kuchitika

1. Mayi woyembekezera yemwe wakonzekera kuyesedwa amakhala ndi sampuli ya m'mamawa kuchokera kumtsempha wopanda kanthu (izi zimapangitsa kuchuluka kwa glucose m'magazi omwe thupi lomwe lingathe kuthandizira ndikusala kudya kwakanthawi). Ngati zotsatira zakonzedwa kale, kuyezetsa sikumapitilizidwa, koma kuwunikako kumachitika ndi amayi oyembekezera omwe ali ndi matenda ashuga.
2. Kenako dotolo amapatsa mayi woyembekezera madzi okoma, omwe ali ndi 75-100 g shuga. Yankho laledzera mu gulp imodzi ndipo osaposa mphindi 5. Ngati mayi pa chifukwa chimodzi kapena chimodzi samatha kumwa madzi otsekemera, amawachotsa ngati njira yosavomerezeka mu mtsempha.
3. Magazi amachotsedwa kuchokera mu mtsempha pambuyo pa ola limodzi komanso mobwerezabwereza maola awiri.
4. Ngati kupatuka kuzizolowereka ndikosafunikira, koma komabe, kuyesa magazi kuchokera m'mitsempha kumatha kuchitidwanso pambuyo pa maola atatu, koma izi ndizosowa.

Anthu ambiri amati njirayi si yopweteka, ndipo ena amatengera njira “yokoma”.

Zotsatira zoyeserera za Glucose:

Kuti mupeze cholinga, ndikofunikira kudziwa zambiri zake:

• kuchuluka kwa shuga komwe kumapezeka m'magazi a venous,
• kuchuluka kwa glucose komwe kulipo pambuyo pa GTT pambuyo pa mphindi 60,
• kuchuluka kwa shuga pambuyo pa mphindi 120.

Zizindikiro zoyenerazi zitha kufananizidwa ndi mndandanda wa "Mayeso a mayeso ololera wa glucose panthawi yapakati" ndi "Gestationalabetes mellitus", omwe aperekedwa pansipa:

Mitundu ya mayeso okhudzana ndi shuga:

• Kusala - osakwana 5.1 mmol / L.
• Ola limodzi pambuyo pa GTT, osakwana 10.0 mmol / L.
• Maola awiri pambuyo pa GTT, osakwana 8.5 mmol / L.
• Maola atatu pambuyo pa GTT, osakwana 7.8 mmol / L.

Matenda a shuga

• Pamimba yopanda kanthu - oposa 5.1 mmol / l, koma ochepera 7.0 mmol / l.
• Ola limodzi pambuyo pa GTT, oposa 10,0 mmol / L.
• Maola awiri pambuyo pa GTT, oposa 8.5 mmol / L, koma ochepera 11.1 mmol / L.
• Maola atatu pambuyo pa GTT, oposa 7.8 mmol / L.

Mayi woyembekezera akhoza kukhala ndi vuto lina, lalikulu kwambiri ngati zisonyezozo ndizambiri kuposa momwe azimayi apakati omwe ali ndi matenda ashuga.

Zotsatira zabodza, ndiye kuti kuwonetsa kuchuluka kwa glucose, ngakhale kuti chilichonse ndichachilendo, titha kuonanso ndi matenda aposachedwa kapena omwe alipo kale kapena mtundu wina wa matenda.

Zotsatira zoterezi sizachilendo, pambuyo pakuchita opaleshoni ya dongosolo lina chifukwa chotsatira cha zovuta za thupi la mayi wapakati, komanso kumwa mankhwala.

Mankhwalawa ndi monga glucocorticoids, mahomoni a chithokomiro, ma thiazides ndi ma beta-blockers - mutha kudziwa nokha ndi gulu la mankhwalawa mogwirizana ndi malangizo ake - ndibwino kukaonana ndi katswiri wazachipatala kapena dokotala wazachipatala kuchipatala cha anthu okonzekera kubereka.

Zotsatira zabodza, ndiye kuti awa ndi data omwe amawonetsa glucose wabwinobwino, ngakhale kuti mayi wapakati amakhala ndi matenda ashuga.

Izi zitha kuonedwa chifukwa chanjala yambiri kapena kuchita zolimbitsa thupi kwambiri, kufupi ndi kuyeserera komanso tsiku lathali, komanso chifukwa chotenga mankhwala omwe amachepetsa kuchuluka kwa shuga m'magazi (mankhwalawa amaphatikizapo insulin komanso mankhwala ena ochepetsa shuga).

Pofuna kufotokoza bwino za matendawa glycated hemoglobin iyeneranso kuyesedwa - mayeso oyenera kwambiri, olondola komanso osasangalatsa, omwe amayenera kuperekedwa kwa wina aliyense yemwe akuwonetsetsa kuti shuga yolekerera.

Bwerezani kuphatikiza: ngakhale kuti pali zovuta zopanda pake komanso zopanda chiyembekezo komanso malingaliro opanda pake a amayi ena apakati ndi abambo awo kuti mayeso a shuga angawakhumudwitse kapena mwana wawo wosabereka, mayesowo ndi otetezeka pokhapokha ngati pali zotsutsana, zomwe ziyenera kufunsidwa ndi katswiri.

Nthawi yomweyo, kuyesaku ndi kofunika, kofunikira, komanso kofunikira kwa mayi wamtsogolo wopanda chidwi, popeza kukana kuwunika kumeneku kumakhala ndi zoopsa: kusokonezeka kwa kagayidwe kachakudya sikungasokoneze mayendedwe abambo komanso moyo wamtsogolo wa mayi ndi mwana.

Kuphatikiza apo, ngakhale amayi atakhala ndi matenda ashuga, gawo yaying'ono la shuga silingavulaze iye ndi mwana wake wosabadwa. Palibe chifukwa chodera nkhawa.

Chifukwa chake, munkhaniyi tawona zomwe zabisika pansi pa mawu ooneka ngati ovuta komanso owopsa a GTT, momwe mayi woyembekezera ayenera kukonzekera iye, ngakhale atadutsa mu izi, zomwe akuyembekeza kuchokera kwa iye, ndi momwe angatanthauzire zotsatira zake.

Tsopano, podziwa kuyesedwa kwa glucose pa nthawi yomwe muli ndi pakati, momwe mungatengere ndi zina zambiri za njirayi, simudzakhala ndi mantha ndi tsankho. Ndikufuna ndikulakalaka nthawi yabwino ya kubereka, musakhale ndi nkhawa pang'ono ndikukhala odzaza ndi malingaliro abwino.