Zowonongeka pamtima mu shuga mellitus Zolemba za sayansi pazopindulitsa - Mankhwala ndi Thanzi Labwino
Bungwe | HbA 1s,% | Kuthamanga glycemia, mmol / l (mg / dl) | Postprandial glycemia, mmol / l (mg / dl) |
ADA IDF-Europe Yondani | 3.5 mmol / L (> 135 mg%). Cholinga cha ma statins m'gulu la odwala ndikuchepetsa cholesterol yonse ndi 30-40%. Popeza ndi chiopsezo chachikulu chotenga matenda a mtima ndi mtundu wautali wa matenda ashuga 1, akuti ndiwofunika kupereka mankhwala a statin kwa onse amtundu wa matenda a shuga a zaka zopitilira 40. Odwala omwe ali ndi matenda a shuga a mtundu uliwonse wa zaka zapakati pa 18 ndi 39 ndi okhazikika omwe amapezeka mu zotsatirazi: |
- nephropathy
- kubwezera
- retinopathy
- ochepa matenda oopsa
- hypercholesterolemia,
- kagayidwe kachakudya matenda kapena mbiri yakale ya matenda oyamba a mtima.
Kupsinjika kwa magazi, mmHg |
Panthawi ya kuphwanya kwaimpso, proteinuria> 1g / 24 h
≤125/75
Kuzindikira Kwambiri
Kuwongolera glycemic, Hb A1c,%
≤7.5 (135) a matenda a shuga a mtundu 2, 7.5-9.0 (135-160) a matenda amtundu 1 shuga
≤6,5
Kusuta kufafaniza
Kuchita masewera olimbitsa thupi pafupipafupi, mphindi tsiku lililonse
M'mabuku apanyumba, monga mu NCCSS, mawu oti "open frequent atrioventricular ngalande" amatengedwa chifukwa cha chilema ichi monga mawonekedwe owoneka mwamphamvu kwambiri, othandizira komanso opaleshoni.
Embolism (kuchokera ku Greek - kulowerera, kulowetsamo) ndi njira yodutsira magawo (emboli) mumtsempha wamagazi, omwe sapezeka pansi pamikhalidwe yokhazikika ndipo amatha kutsekereza zotengera, zimayambitsa kusokonezeka kwazigawo zam'magazi.
Zimayambitsa zovuta za mtima ndi zomwe zimayambitsa chiopsezo
Matenda a shuga amakhala ndi moyo waufupi chifukwa cha kuchuluka kwa shuga m'magazi. Matendawa amatchedwa hyperglycemia, yomwe imakhudza mwachindunji mapangidwe a atherosulinotic malo. Yotsirizika kapena yotseka lumen ya ziwiya, zomwe zimatsogolera ku ischemia ya minofu yamtima.
Madokotala ambiri ali ndi chitsimikizo kuti shuga yowonjezera imakhumudwitsa kusokonekera - malo okhala ndi lipid. Chifukwa cha izi, makoma azotengera amakhala mawonekedwe ovomerezeka ndi mawonekedwe.
Hyperglycemia imathandizanso kutsegula kwa kuphatikiza kwa oxidative ndikupanga ma free radicals, omwe amakhalanso ndi vuto la endothelium.
Pambuyo pa maphunziro angapo, ubale unakhazikitsidwa pakati pamatenda a mtima wamatenda a shuga ndi kuchuluka kwa hemoglobin. Chifukwa chake, ngati HbA1c iwonjezeka ndi 1%, ndiye kuti chiopsezo cha ischemia chikuwonjezeka ndi 10%.
Matenda a shuga ndi matenda amtima atha kukhala zogwirizana ngati wodwala akumana ndi zovuta zina:
- kunenepa
- ngati m'modzi wa abale a wodwalayo adwala matenda amtima.
- Nthawi zambiri kuthamanga kwa magazi
- kusuta
- uchidakwa
- kukhalapo kwa cholesterol ndi triglycerides m'mwazi.
Ndi matenda ati amtima omwe atha kukhala chopinga cha matenda ashuga?
Nthawi zambiri, ndi hyperglycemia, matenda ashuga a mtima amayamba. Matendawa amawoneka pomwe malungo osokoneza bongo a myocardium ali ndi odwala omwe ali ndi vuto la shuga.
Nthawi zambiri matendawa amakhala ngati asymptomatic. Koma nthawi zina wodwalayo amakhala ndi vuto lopweteka komanso kugunda kwa mtima (tachycardia, bradycardia).
Nthawi yomweyo, chiwalo chachikulucho chimasiya kupopa magazi ndikugwira ntchito mopangika, chifukwa cha zomwe kukula kwake kumakulira. Chifukwa chake, matendawa amatchedwa mtima wodwala. Pathology mu ukalamba imatha kuwonetsedwa ndi kuyendayenda kuzungulira, kutupa, kufupika ndi kupweteka pachifuwa komwe kumachitika pambuyo pochita masewera olimbitsa thupi.
Matenda a mtima omwe ali ndi matenda a shuga amayamba kuchulukitsa katatu kuchulukirapo kuposa kwa anthu athanzi. Ndizofunikira kudziwa kuti chiwopsezo cha matenda a mtima sichimadalira kukula kwa matenda oyamba, koma kutalika kwake.
Ischemia mu odwala matenda ashuga nthawi zambiri amapezeka popanda kutchulidwa, zomwe nthawi zambiri zimabweretsa kukula kwa kupweteka kwa minofu ya mtima. Komanso, matendawa amapitilira mafunde, pomwe kuukira kwadzaoneni kumaloledwa ndi matenda osachiritsika.
Zomwe zimachitika ndi matenda amtima wapamtima ndikuti patatha kukoka kwa magazi mu myocardium, motsutsana ndi maziko a matenda a hyperglycemia, mtima, kulephera kwa mtima, komanso kuwonongeka kwamitsempha yama mtima kumayamba kukula msanga. Chithunzi cha matenda a ischemia mu odwala matenda ashuga:
- kupuma movutikira
- arrhasmia,
- kupuma movutikira
- kukanikiza ululu mumtima
- nkhawa zokhudzana ndi mantha a imfa.
Kuphatikiza kwa ischemia ndi matenda a shuga kungayambitse kukulitsa kwa myocardial infarction. Kuphatikiza apo, kuphatikizika uku kumakhala ndi zinthu zina, monga kusokonezeka kwa mtima, edema yam'mapapo, kupweteka kwamtima kumayang'ana ku clavicle, khosi, nsagwada kapena phewa. Nthawi zina wodwala amamva kupweteka kwambiri pachifuwa, mseru komanso kusanza.
Tsoka ilo, odwala ambiri amakhala ndi vuto la mtima chifukwa samakayikira kupezeka kwa matenda ashuga. Pakadali pano, kudziwitsidwa ndi hyperglycemia kumabweretsa zovuta zakupha.
Mu odwala matenda ashuga, mwayi wopanga angina pectoris amawirikiza. Mawonetsero ake akuluakulu ndi palpitations, malaise, thukuta ndi kufupika kwa mpweya.
Angina pectoris, yomwe idawuka motsutsana ndi maziko a matenda ashuga, ili ndi mawonekedwe ake. Chifukwa chake, kukula kwake sikukhudzidwa ndi kuopsa kwa matenda oyambitsidwa, koma kutalika kwa chotupa cha mtima. Kuphatikiza apo, mwa odwala omwe ali ndi shuga ambiri, magazi osakwanira ku myocardium amakula msanga kuposa mwa anthu athanzi.
Mu anthu ambiri odwala matenda ashuga, Zizindikiro za angina pectoris ndizofatsa kapena sizipezeka konse. Kuphatikiza apo, nthawi zambiri amakhala ndi zolakwika mu nthito ya mtima, yomwe nthawi zambiri imatha ndi imfa.
Zotsatira zinanso za matenda a shuga a mtundu wachiwiri ndi kulephera kwa mtima, komwe, monga zovuta zina zamtima zomwe zimachitika chifukwa cha hyperglycemia, ndizomwe zimafotokozera. Chifukwa chake, kulephera kwa mtima ndi shuga wambiri kumakonda kumangidwa adakali aang'ono, makamaka amuna. Zizindikiro za matendawa ndi monga:
- Kutupa ndi kupindika kwa miyendo,
- Kukula kwa mtima kukula,
- kukodza pafupipafupi
- kutopa,
- kuchuluka kwa thupi, komwe amafotokozera posungiramo madzi m'thupi,
- chizungulire
- kupuma movutikira
- kutsokomola.
Diabetesic myocardial dystrophy imatithandizanso kuphwanya mtundu wa kugunda kwa mtima. Pathology imachitika chifukwa cha kusayenda bwino kwa kagayidwe kachakudya, komwe kanayambitsidwa ndi kuchepa kwa insulin, komwe kumapangitsa gawo la glucose kupyola maselo a myocardial. Zotsatira zake, mafuta ac oxidized amadziunjikira mu minofu ya mtima.
Njira ya dystrophy ya myocardial imatsogolera ku mawonekedwe a foci a kusokonezeka kwa conduction, kusinthana kwa arrhythmias, extrasystoles kapena parasystoles. Komanso, microangiopathy mu shuga imathandizira kugonjetsedwa kwa ziwiya zazing'ono zomwe zimadyetsa myocardium.
Sinus tachycardia kumachitika ndi mantha kapena thupi kwambiri. Kupatula apo, kuthamanga kwa mtima kugwira ntchito ndikofunikira kuti thupi lipereke zakudya komanso mpweya wabwino. Koma ngati shuga wamagazi akukulira pafupipafupi, ndiye kuti mtima umakakamizidwa kugwira ntchito mopitilira muyeso.
Komabe, mwa anthu odwala matenda ashuga, myocardium sangathe kudwala mwachangu. Zotsatira zake, okosijeni ndi zakudya sizimalowa mumtima, zomwe nthawi zambiri zimayambitsa matenda a mtima ndi kufa.
Ndi matenda ashuga a mtima, kusinthasintha kwa mtima kumayamba. Mwa chikhalidwe ichi, arrhythmia imachitika chifukwa cha kusinthasintha kwa kukokana kwa zotumphukira zamisempha, zomwe NS iyenera kuwongolera.
Vuto lina la matenda ashuga ndi orthostatic hypotension. Amawonetsedwa ndi kuchepa kwa kuthamanga kwa magazi. Zizindikiro za matenda oopsa ndi chizungulire, malaise, ndi kukomoka. Komanso, amadziwika ndi kufooka atadzuka ndi kupweteka kumutu kosalekeza.
Popeza kuwonjezeka kwa shuga m'magazi kumakhala zovuta zambiri, ndikofunikira kudziwa momwe mungalimbitsire mtima matenda ashuga komanso njira zamankhwala zosankha ngati matendawa adayamba kale.
Mankhwala ochizira matenda a mtima odwala matenda ashuga
Maziko amathandizidwe othandizira ndikuletsa zomwe zingachitike ndikuletsa kupitilira kwa zovuta zomwe zilipo. Kuti muchite izi, ndikofunikira kusintha glycemia, kuchepetsa kuchuluka kwa shuga ndikuletsa kuti isakwere ngakhale maola awiri mutatha kudya.
Pachifukwa ichi, ndi matenda amtundu wa 2 shuga, othandizira ochokera ku gulu la Biguanide ndi omwe amapatsidwa. Awa ndi Metformin ndi Siofor.
Mphamvu ya Metformin imatsimikiziridwa ndi kuthekera kwake kulepheretsa gluconeogeneis, kutsegula glycolysis, yomwe imapangitsa kuti khungu lizisungunuka komanso lactate minofu ndi mafuta. Komanso, mankhwalawa amalepheretsa kukula kwa kufalikira kwa minofu yosalala ya mtima ndikukhudza mtima.
Mlingo woyambirira wa mankhwalawa ndi 100 mg patsiku. Komabe, pali zotsutsana zingapo za kumwa mankhwalawa, makamaka omwe ali ndi vuto la chiwindi ayenera kukhala osamala.
Komanso, ndi matenda a shuga a mtundu 2, Siofor nthawi zambiri amalembedwa, omwe amakhala othandiza kwambiri makamaka ngati kudya komanso kuchita masewera olimbitsa thupi sizikuthandizira kuchepetsa thupi. Mlingo watsiku ndi tsiku amasankhidwa payekha kutengera kuchuluka kwa shuga.
Kuti Siofor ikhale yogwira mtima, kuchuluka kwake kumathandizidwa nthawi zonse - kuchokera pa mapiritsi 1 mpaka 3. Koma mlingo waukulu wa mankhwalawa suyenera kupitanso magalamu atatu.
Siofor imaphatikizidwa chifukwa cha matenda a shuga omwe amadalira insulin 1, kulowetsedwa kwa myocardial, pakati, kulephera kwa mtima ndi matenda akulu am'mapapo. Komanso, mankhwalawa satengedwa ngati chiwindi, impso komanso matenda a matenda ashuga sizigwira bwino ntchito. Kuphatikiza apo, Siofor sayenera kuledzera ngati ana kapena odwala opitilira 65 amathandizidwa.
Pofuna kuthana ndi angina pectoris, ischemia, kuti muchepetse kukhazikika kwa myocardial infarction komanso mavuto ena a mtima omwe amapezeka chifukwa cha matenda ashuga, ndikofunikira kumwa magulu osiyanasiyana a mankhwala:
- Mankhwala a antihypertensive.
- Ma ARB - kupewa myocardial hypertrophy.
- Beta-blockers - sinthasintha kugunda kwa mtima ndikuchepetsa kuthamanga kwa magazi.
- Ma diuretics - kuchepetsa kutupa.
- Mitsempha - siyani kugunda kwamtima.
- ACE inhibitors - ali ndi mphamvu yolimbitsa mtima,
- Ma Anticoagulants - amachepetsa magazi.
- Glycosides - yowonetsedwa kwa edema ndi atrase fibrillation.
Kuchulukitsitsa, ndi matenda a shuga a 2, omwe amayenda ndi mavuto a mtima, dokotala amapatsa Dibicor. Imayendetsa kagayidwe kachakudya minofu, kuwapatsa mphamvu.
Dibicor imakhudza bwino chiwindi, mtima ndi mitsempha yamagazi. Kuphatikiza apo, pakatha masiku 14 kuyambira chiyambi cha mankhwalawa, pali kuchepa kwa ndende yamagazi.
Kuchiza ndi vuto la mtima kumatenga mapiritsi (250-500 mg) 2 p. patsiku. Komanso, Dibikor tikulimbikitsidwa kumwa mu mphindi 20. musanadye. Mlingo wokwanira wa tsiku ndi tsiku wa mankhwala ndi 3000 mg.
Dibicor imaphatikizidwa muubwana nthawi yapakati, mkaka wa m`mawere ndi vuto la taurine tsankho. Kuphatikiza apo, Dibicor sangatengedwe ndi mtima glycosides ndi BKK.
Mankhwala othandizira opaleshoni
Ambiri odwala matenda ashuga amasamala za momwe angachitire ndi matenda a mtima opaleshoni. Chithandizo chowongolera chimachitika polimbitsa mtima ndi mothandizidwa ndi mankhwala sizinabweretse zotsatira zomwe mukufuna. Zisonyezo za opaleshoni ndi:
- kusintha kwa mtima,
- Ngati chifuwa chimakhala chowawa nthawi zonse,
- kutupa
- arrhasmia,
- amakayikira mtima
- pang'onopang'ono angina pectoris.
Kuchita opaleshoni ya mtima kulephera kumaphatikizapo balloon vasodilation. Ndi chithandizo chake, kupendekera kwamtsempha, komwe kumalimbitsa mtima, kumathetsedwa. Panthawi ya ndalamayi, catheter imayikidwa m'mitsempha, pomwe baluni imabweretsa kumalo ovuta.
Kuluma kwa aortocoronary nthawi zambiri kumachitika ngati ma mesh adalowetsedwa m'mitsempha, omwe amalepheretsa mapangidwe a cholesterol. Ndipo kulumikizana kwa mitsempha yodutsa m'mitsempha yamagetsi kumapangitsa kuti magazi azikhala mwaulere, zomwe zimachepetsa kwambiri ngozi yobwereranso.
Ngati wodwala matenda a shuga a mtima, chithandizo cha opaleshoni chokhazikitsidwa ndi pacemaker chimasonyezedwa. Chipangizocho chimagwira kusintha kulikonse mu mtima ndikuwakonza nthawi yomweyo, zomwe zimachepetsa mwayi wa arrhythmias.
Pochizira mafupa, owerenga athu adagwiritsa ntchito DiabeNot bwino. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.
Komabe, musanachite izi, ndikofunikira kuti musapangitse shuga kuchuluka, komanso kulipira shuga. Popeza ngakhale kulowererapo pang'ono (mwachitsanzo, kutsegula chikopa, kuchotsedwa kwa misomali), komwe kumachitika pochiza anthu athanzi pamalopo, odwala matenda ashuga amachitidwa kuchipatala cha opaleshoni.
Komanso, asanafike opaleshoni yofunika, odwala omwe ali ndi hyperglycemia amasamutsidwa ku insulin. Pankhaniyi, kuyambitsa insulin yosavuta (3-5 Mlingo) kukuwonetsedwa. Ndipo masana ndikofunikira kuti muchepetse glycosuria ndi shuga wamagazi.
Popeza matenda amtima ndi matenda ashuga ndi malingaliro othandizana, anthu omwe ali ndi glycemia amafunika kuwunika kayendedwe ka mtima. Ndikofunikanso kuwongolera kuchuluka kwa shuga m'magazi, chifukwa ndi hyperglycemia yayikulu, vuto la mtima likhoza kuchitika, mpaka kumwalira.
Mu kanema mu nkhaniyi, mutu wa matenda a mtima mu shuga akupitilizidwa.
IHD ndi matenda ashuga
- 1 Kodi mgwirizano pakati pa ischemia ndi matenda ashuga ndi uti?
- 2 Etiology ndi pathogenesis ya ischemia mu shuga
- 3 Kodi matenda a mtima amadziwonekera motani m'matenda a shuga?
- Njira 4 zochizira matenda
- 4.1 Njira zochizira
- 4.2 Mankhwala osokoneza bongo
- 5 Kodi mungapewe bwanji chitukuko cha matenda a mtima?
Nthawi zambiri, matenda a mtima a ischemic mu matenda ashuga amapezeka ngati zovuta zofanana. Njira yofananira yamatenda awiriwa imakhala ndi vuto labwino, imafuna chithandizo chamankhwala ndi njira zingapo zosagwiritsa ntchito mankhwala. Matendawa amasokoneza wina ndi mnzake, makamaka ngati glycemia yosalamulirika imawonedwa. Nthawi zina matenda a shuga amalepheretsa kuzindikira kwa matenda a mtima, komwe kumadziwika ndi kochititsa chidwi ndipo alibe zizindikiro. Izi nthawi zambiri zimayambitsa zovuta zapakati pa moyo kapena kufa.
Kodi kulumikizana pakati pa ischemia ndi matenda ashuga ndi kotani?
Anthu omwe ali ndi matenda ashuga, makamaka mtundu 2, amakhala pachiwopsezo chachikulu chotenga mtima ischemia, nthawi zina 3-5.
Kusintha kwamankhwala am'magazi ndi njira zina mthupi zomwe zimayambitsa ubale wa matenda a shuga ndi matenda a mtima:
- kutsika kwamtundu wamtundu,
- kuwonongeka kwa mitsempha yaying'ono ndi yaying'ono,
- mgwirizano wamphamvu pakati pa C-yogwira mapuloteni ndi hemoglobin ya glycosylated,
- kuchuluka kukwiya
- kukanika kwa machitidwe omwe amayang'anira calcium,
- zida zowonetsera zamagetsi
- ma polyenoic acids sangathe kuyenda momasuka,
- kukula kwamphamvu mediocalcinosis,
- maonekedwe a kukhazikika kwa kugunda kwa mtima.
Bweretsani ku zomwe zalembedwa
Etiology ndi pathogenesis ya ischemia mu shuga
Matenda a mtima ndi chodabwitsa chifukwa cha kuchepa kwa mpweya womwe umalowa m'mitsempha. Pathology imachitika chifukwa cha zolembera, atherosclerosis, kuchepa kwa ochepa lumen. Nthawi yomweyo, mu shuga mellitus, kupanga kwa insulin kulephera, shuga wambiri m'magazi amapezeka. Izi zimayambitsa kusokonekera kwa mitsempha yamagazi, kuchepa kwa mphamvu yawo, mawonekedwe a zipsera, kuperewera kwa mpweya m'maselo. Njira zofananira zimadzetsa zovuta - matenda a mtima.
Hypodynamia imathandizira kuti kufinya kwa lumen kumitsempha ya mtima.
Myocardial pathologies amakula makamaka chifukwa cha nthawi yayitali ya matenda a shuga, osati kukula kwake komanso kuopsa kwake. Zomwe zimayambitsa ischemia mu matenda a shuga:
- magazi kwambiri
- matenda akumitsempha
- kusowa zolimbitsa thupi, macroangiopathy,
- insulin kukana, matenda ashuga nephropathy,
- cholowa, matenda oopsa kapena matenda oopsa,
- matenda ashuga
- Hypercoagulation syndrome, zizolowezi zoipa,
- ukalamba, wachikazi
- kuchuluka kwamafuta am'mafuta am'magazi,
- Hyperinsulinemia, onenepa kwambiri,
- microalbuminuria, matenda ashuga retinopathy,
- hyperglycemia, mtima pathologies,
- cholesterol yofunika, kunenepa kwambiri kwa android,
- microangiopathy, hyperlipidemia,
- owonjezera plasma homocysteine.
Bweretsani ku zomwe zalembedwa
Kodi matenda amitsempha yama coronary amawonekera bwanji mu shuga?
Pa gawo loyamba lachitukuko, matenda amtima wamatenda a shuga sangamveke kwa nthawi yayitali. Nthawi zina chizindikiro choyambirira cha matendawa ndi kulowerera m'mimba, koma nthawi zambiri zizindikiro za m'mawu zimayamba kutchulidwa pang'onopang'ono, pomwe matenda amtima akupita patsogolo. Mawonetsero akulu a ischemia mu shuga mellitus, kutengera gawo la matendawa, akuwonetsedwa pagome.
Palibe zakudya zapadera za odwala matenda ashuga. Mutha kudya ndipo muyenera kudya pang'ono chilichonse. | Mutha kudya zakudya zilizonse pokhapokha ngati mulibe nkhawa chifukwa cha zovuta za matenda ashuga. Ngati mukufuna kukhala ndi moyo wautali komanso wathanzi, muyenera kuchepetsa zakudya zomwe mumadya. Palibenso njira ina yopeweka kupopera shuga mutatha kudya. |
Mutha kudya chilichonse, kenako ndikuthimitsa shuga ndikufinya | Ngakhale mapiritsi ochepetsa shuga kapena jakisoni wa Mlingo waukulu wa insulin samathandizira kuti shuga asadutse pambuyo chakudya, komanso momwe amadumpha. Odwala amatenga nthawi yayitali mtima wamatenda a shuga. Mokulira kuchuluka kwa mapiritsi ndi insulin, kumachitika kwambiri hypoglycemia - shuga wochepa kwambiri. Uwu ndiye zovuta zowopsa. |
Anthu odwala matenda ashuga amatha kudya shuga pang'ono | Shuga wa tebulo, kuphatikizapo bulauni, ndi imodzi mwazakudya zoletsedwa kuchokera ku chakudya chamafuta ochepa. Mitundu yonse yazakudya zomwe zilimo ndizoletsedwa. Ngakhale magalamu ochepa a shuga amachulukitsa kuchuluka kwa shuga m'magazi a odwala matenda a shuga. Dziyang'anireni ndi glucometer ndikuwona nokha. |
Mkate, mbatata, mbewu monga chimanga - pasitala - zinthu zoyenera komanso zofunika | Mkate, mbatata, chimanga, pasitala ndi zinthu zina zilizonse zomwe zimadzaza ndi mafuta mwachangu kwambiri zimachulukitsa kuchuluka kwa shuga m'magazi. Musayandikire zakudya zonse zomwe zili pamndandanda woletsedwa wamagulu ochepa a chakudya chamagulu 1 ndi matenda a shuga. |
Zakudya zomanga thupi zovuta komanso zopatsa thanzi sizabwino | Zomwe zimatchedwa zovuta za carbohydrate sizili zovulaza kuposa zosavuta. Chifukwa iwo mwachangu komanso kwambiri amawonjezera shuga wamagazi mwa odwala omwe ali ndi matenda ashuga. Pangani shuga wanu mutatha kudya ndi glucometer - mudzionere nokha. Mukamapanga menyu, osangoyang'ana pa index ya glycemic. Sungani mndandanda wazinthu zololedwa ndi zoletsedwa, ulalo womwe umaperekedwa pamwambapa, ndipo gwiritsani ntchito. |
Nyama yamafuta, mazira a nkhuku, batala - zovulaza mtima | Kafukufuku yemwe adachitika pambuyo pa chaka cha 2010 awonetsa kuti kudya mafuta azinyama osakwaniritsidwa sikuti kumakulitsa chiwopsezo cha matenda a mtima. Idyani mafuta onenepa, mazira a nkhuku, tchizi cholimba, batala. Ku Sweden, malingaliro aboma amatsimikizira kale kuti mafuta a nyama ndi otetezeka pamtima. Potsatira mzerewu ndi maiko ena akumadzulo, kenako olankhula Chirasha. |
Mutha kudya margarine chifukwa ilibe cholesterol | Margarine amakhala ndimafuta a trans, omwe ndi owopsa pamtima, mosiyana ndi mafuta achilengedwe ochokera ku nyama. Zakudya zina zomwe zimakhala ndi mafuta a trans zimaphatikizapo mayonesi, tchipisi, zinthu zophika fakitale, ndi zakudya zilizonse zopangidwa. Apatseni. Konzani chakudya chopatsa thanzi kuchokera ku zinthu zachilengedwe, popanda mafuta ndi zina zowonjezera zamankhwala. |
CHIKWANGWANI ndi mafuta amalepheretsa shuga kuudya | Ngati mumadya zakudya zomwe zimadzaza ndi chakudya, mafinya ndi mafuta zimalepheretsa kuchuluka kwa shuga mutatha kudya. Koma izi, mwatsoka, ndizochepa. Sichimapulumutsa kuchokera ku kulumikizidwa kwa glucose wamagazi ndi kukula kwa zovuta zamagazi a shuga. Simungagwiritse ntchito zophatikizidwa pamndandanda woletsedwa pansi pa mtundu uliwonse. |
Zipatso ndizathanzi | Kwa mtundu 2 ndi mtundu wa ashuga 1, zipatso, komanso kaloti ndi beets, zimapweteketsa kuposa zabwino. Kudya zakudya izi kumawonjezera shuga ndipo kumapangitsa kuti muchepetse kunenepa. Pewani zipatso ndi zipatso - khalani nthawi yayitali komanso wathanzi. Pezani mavitamini ndi michere kuchokera ku masamba ndi zitsamba zomwe zimaloledwa kudya zakudya zamagulu ochepa. |
Fructose ndi yopindulitsa, siziwonjezera shuga | Fructose amachepetsa chidwi cha zimakhala kuti apange insulini, amapanga "zinthu zomaliza za glycation", zimawonjezera cholesterol "yoyipa" m'magazi, komanso uric acid. Imalimbikitsa miyala ya gout ndi impso. Mwina amasokoneza kayendedwe ka chakudya m'maganizo, amachepetsa maonekedwe. Osamadya zipatso ndi zakudya za "matenda ashuga". Amachita zovulaza kuposa zabwino. |
Zakudya Zapulogalamu Zakudya Zimayambitsa Kulephera Kwachiwiri | Kulephera kwamankhwala kwa odwala omwe ali ndi mtundu woyamba 1 ndi shuga yachiwiri kumayambitsa shuga, osati mapuloteni odyetsa. Ku US komwe ng'ombe zimalimidwa, anthu amadya mapuloteni ambiri kuposa momwe zimapezeka kuti ng'ombe zimapezeka zochepa. Komabe, kufala kwa kulephera kwa impso ndi chimodzimodzi. Sinthani shuga lanu ndi chakudya chamafuta ochepa kuti muchepetse kukula kwa impso. Kuti mumve zambiri, onani nkhani yakuti “Zakudya za impso ndi matenda a shuga.” |
Mufunika kudya zakudya zapadera za anthu odwala matenda ashuga | Zakudya za anthu odwala matenda ashuga zimakhala ndi fructose monga zotsekemera m'malo mwa shuga. Chifukwa chomwe fructose imakhala yoyipa - tafotokozazi. Komanso, zakudya izi nthawi zambiri zimakhala ndi ufa wambiri. Pewani zakudya zilizonse zomwe zingayambitse matenda a shuga. Zimakhala zokwera mtengo komanso zopanda thanzi. Komanso, kwa odwala omwe ali ndi matenda a shuga a 2, ndikosayenera kugwiritsa ntchito zotsekemera zilizonse. Chifukwa shuga mmalo, ngakhale omwe alibe kalori, musalole kuti muchepetse kunenepa. |
Ana amafunikira chakudya chamafuta kuti chitukule | Zakudya zomanga thupi sizofunikira, mosiyana ndi mapuloteni ndi mafuta. Ngati mwana yemwe ali ndi matenda a shuga 1 amatsata zakudya zoyenera, ndiye kuti adzakulitsa komanso kuchedwa chifukwa cha shuga. Komanso, pampu ya insulin siyothandiza. Kuti atsimikizire khanda labwinobwino la mwana wotere, amafunika kusamutsidwira ku chakudya champhamvu chochepa kwambiri. Ana ambiri odwala matenda ashuga a mtundu woyamba akukhala kale ndipo akutukuka, chifukwa cha chakudya chochepa kwambiri, m'maiko olankhula Kumadzulo ndi Russia. Ambiri amatha kulumpha insulin. |
Zakudya zamafuta ochepa zimabweretsa hypoglycemia | Zakudya zamafuta ochepa zimatha kupangitsa kuti mukhale ndi hypoglycemia ngati simupatsa kuchepetsa mapiritsi ndi insulin. Mapiritsi a 2 matenda a shuga omwe angayambitse hypoglycemia ayenera kuthetsedwa kwathunthu. Kuti mumve zambiri, onani "Mankhwala a shuga." Momwe mungasankhire mlingo woyenera wa insulin - phunzirani zomwe zili pansi pa mutu "Insulin". Mlingo wa insulin umachepetsedwa ndi 2-7 nthawi, motero chiwopsezo cha hypoglycemia chimachepetsedwa. |
Zakudya nambala 9 za matenda ashuga
Zakudya nambala 9, (yotchedwanso tebulo nambala 9) ndizakudya chotchuka m'maiko olankhula Chirasha, omwe amalembera odwala omwe ali ndi shuga wambiri komanso wowonda, komanso olemera kwambiri. Zakudya nambala 9 ndizoyenera. Kutsatira izo, odwala amamwa 300-350 g wamafuta tsiku, 90-100 g mapuloteni ndi 75-80 g mafuta, osachepera 30% ndiwo zamasamba, zopanda mafuta.
Chomwe chili pachakudya ndicho kuchepetsa kuchuluka kwa zopatsa mphamvu, kuchepetsa kudya zamafuta am'madzi ndi "zosavuta" zopatsa mphamvu. Shuga ndi maswiti samachotsedwa. Amasinthidwa ndi xylitol, sorbitol kapena zotsekemera zina. Odwala amalangizidwa kuti azidya mavitamini ambiri ndi fiber. Zakudya zomwe zimalimbikitsidwa ndi tchizi tchizi, nsomba zamafuta ochepa, masamba, zipatso, buledi wopanda nzeru, masamba onse.
Zakudya zambiri zomwe amadya # 9 amalimbikitsa kuwonjezera shuga m'magazi kwa odwala matenda ashuga motero zimakhala zovulaza. Mwa anthu omwe ali ndi matenda a metabolic kapena prediabetes, chakudyachi chimayambitsa njala. Thupi limachedwetsanso kagayidwe poyankha zoletsedwa za caloric. Kusokoneza kwa zakudya kumakhala kosapeweka. Pambuyo pake, ma kilogalamu onse omwe adatha kuchotsedwa mwachangu amabwerera, ndipo ndikuphatikizanso. Webusayiti ya Diabetes-Med.Com imalimbikitsa kudya zakudya zamafuta ochepa mmalo mwa chakudya # 9 cha odwala amtundu wa 1 komanso a 2.
Angati zopatsa mphamvu patsiku kuti muzidya
Kufunika ochepetsera zopatsa mphamvu, kumva kwamphamvu kwa njala - izi ndi zifukwa zomwe odwala matenda ashuga nthawi zambiri amawonongeka. Kuti muchepetse shuga m'magazi ndi chakudya chamagulu ochepa, simuyenera kuwerengera zopatsa mphamvu. Kuphatikiza apo, kuyesa kuchepetsa kuchuluka kwa zopatsa mphamvu ndizovulaza. Izi zimatha kudwala matendawa. Yesetsani kusadya kwambiri, makamaka usiku, koma idyani bwino, musafe ndi njala.
Zakudya zamafuta ochepa zimafunikira kusiya zakudya zambiri zomwe mumakonda kale. Komabe ndizosangalatsa komanso zokoma. Odwala omwe ali ndi metabolic syndrome komanso matenda a shuga amatsatira mosavuta kuposa zakudya zamafuta ochepa ". Mu 2012, zotsatira za kafukufuku woyerekeza wama korigenic wotsika komanso mafuta ochepa otsika zimafalitsidwa. Phunziroli linakhudza odwala 363 ochokera ku Dubai, 102 mwa iwo omwe anali ndi matenda a shuga a 2. Odwala omwe amatsatira zakudya zopatsa mphamvu zamankhwala ochepa, kuwonongeka kunali kosachepera 1.5-2.
Ndi zakudya ziti zomwe zili ndi thanzi komanso zomwe zili zovulaza?
Zambiri Zoyambirira - Mndandanda wa zakudya zoletsedwa komanso zoletsedwa zamagulu ochepa a chakudya. Zakudya za odwala omwe ali ndi matenda ashuga ndizovuta kwambiri kuposa zosankha zofananira ndizakudya zochepa zama carbohydrate - zakudya za Kremlin, Atkins ndi Ducane. Koma matenda ashuga ndi matenda oopsa kwambiri kuposa kunenepa kwambiri kapena metabolic syndrome. Itha kuwongoleredwa pokhapokha mutasiya kwathunthu zomwe zaletsedwa, osasankha maholide, malo odyera, pakupita maulendo ndi kuyenda.
Mankhwala omwe alembedwa pansipa ndi HARMFUL kwa odwala matenda ashuga:
- chiwopsezo cha bulauni
- pasitala
- buledi wathunthu
- oatmeal ndi maluwa ena aliwonse amphongo,
- chimanga
- zipatso zamtundu uliwonse ndi zipatso zina zilizonse,
- Yerusalemu artichoke.
Zakudya zonsezi zimadziwika kuti ndizabwino komanso zathanzi. M'malo mwake, amadzaza ndi zakudya zamafuta, zimawonjezera shuga m'magazi ndipo chifukwa chake zimavulaza kuposa zabwino. Osamadya.
Ma tiyi azitsamba a shuga ndi osathandiza kwenikweni. Mankhwala enieni oopsa nthawi zambiri amawonjezeredwa ku mapiritsi a clandestine omwe amalimbikitsa mphamvu zazimuna popanda ochenjeza. Izi zimapangitsa kulumpha mu kuthamanga kwa magazi ndi zovuta zina mwa abambo. Momwemonso, mu tiyi wazitsamba ndi zakudya zamagulu a shuga, zinthu zina zomwe zimachepetsa shuga ya magazi zimatha kuwonjezeredwa mosaloledwa. Pankhaniyi, tiyi awa amathetsa kapamba, chifukwa cha hypoglycemia.
Momwe mungadye ngati muli onenepa kwambiri
Zakudya zamagulu ochepa zimatsimikizika kuti muchepetse shuga, ngakhale wodwalayo akulephera kuchepetsa thupi. Izi zimatsimikiziridwa ndi machitidwe, komanso zotsatira za maphunziro ang'onoang'ono. Mwachitsanzo, onani nkhani yofalitsidwa mu magazini ya Chingerezi ya Nutrition and Metabolism mu 2006. Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri, kudya tsiku lililonse kwamatumbo amachepetsa 20% ya kuchuluka kwa kalori. Zotsatira zake, hemoglobin yawo ya glycated inatsika kuchoka pa 9.8% mpaka 7.6% popanda kuchepa kwa thupi. Webusayiti ya Diabetes-Med.Com imalimbikitsa zakudya zopatsa mphamvu zamagulu ochepa. Zimapangitsa kuti magazi azikhala bwino, monga mwa anthu athanzi, komanso odwala ambiri kuti achepetse thupi.
Simuyenera kupereka mafuta mwakachetechete muzakudya za wodwala yemwe ali ndi matenda ashuga. Idyani zakudya zama protein zomwe zili ndi mafuta ambiri. Ichi ndi nyama yofiira, batala, tchizi cholimba, mazira a nkhuku. Mafuta omwe munthu amadya samachulukitsa thupi komanso samachepetsa thupi. Komanso, safunikira kuchuluka kwa mankhwala a insulin.
Dr. Bernstein adayesera izi. Anali ndi odwala 8 a matenda a shuga 1 omwe amafunikira kuti akhale bwino. Amawamwetsa mafuta tsiku lililonse kwa milungu 4, kuwonjezera pa chakudya chokhazikika. Palibe wodwala aliyense amene anali ndi kulemera konse. Zitatha izi, polimbikitsidwa ndi Dr. Bernstein, odwala adayamba kudya mapuloteni ambiri, ndikupitiliza kuchepetsa kuchuluka kwawo kwa chakudya. Zotsatira zake, awonjezera minofu.
Zakudya zamagulu ochepa zimapangitsa shuga m'magazi onse odwala matenda ashuga, ngakhale sizithandiza aliyense kuchepa thupi. Komabe, njira yabwino kwambiri yochepetsera thupi kulibe. Zakudya zamafuta ochepa komanso "mafuta ochepa" amagwira ntchito moipa kwambiri. Nkhani yotsimikizira izi idalembedwa mu magazini ya Diabetesic Medicine mu Disembala 2007. Phunziroli lidakhudza odwala 26, theka la omwe ali ndi matenda a shuga a 2, ndipo theka lachiwiri ndi metabolic syndrome. Pambuyo pa miyezi itatu, mu gulu lamagulu ochepa a chakudya, kuchepa kwakukulu kwa thupi kunali 6.9 makilogalamu, ndipo m'gululi lama calorie otsika, ndi 2.1 kg okha.
Mtundu wachiwiri wa matenda ashuga
Zomwe zimayambitsa matenda a shuga 2 ndizosokoneza minyewa ya insulin - kukana insulini. Odwala, nthawi zambiri osati kutsitsidwa, koma kuchuluka kwa insulin m'magazi. Muzochitika zotere, kusungabe zakudya zoyenera komanso kumwa jakisoni wa insulin - izi zimangokulitsa vutolo. Zakudya zamafuta ochepa a shuga 2 amakuthandizani kuti muchepetse shuga ndi insulini m'magazi, tengani insulin yolamulidwa.
Zakudya zama calorie ochepera 2 a shuga sizithandiza, chifukwa odwala safuna kupirira njala, ngakhale atakumana ndi mavuto. Pakapita nthawi, pafupifupi chilichonse chimayamba kudya. Izi zimakhala ndi zowononga thanzi. Komanso, thupi poyankha kukhazikitsidwa kwa calorie kumachepetsa kagayidwe. Zimakhala zosatheka kuti muchepetse thupi. Kuphatikiza paanjala yodwala, wodwalayo amamva kuwawa, kufunafuna kubisala.
Chakudya chamafuta ochepa ndi chipulumutsi kwa anthu odwala matenda ashuga a 2. Zili ndi chitsimikiziro chosintha shuga m'magazi, ngakhale mutakhala kuti simuchepetsa thupi. Mutha kukana mapiritsi ovulaza. Odwala ambiri safuna jakisoni wa insulin. Ndipo kwa iwo omwe akuwafuna, mlingo umachepetsedwa kwambiri. Pangani shuga wanu pafupipafupi ndi glucometer - ndipo onetsetsani kuti zakudya zamafuta ochepa sizigwira ntchito, ndipo chakudya 9 sichoncho. Izi zikutsimikiziranso kusintha kwa thanzi lanu. Zotsatira za kuyesa kwa magazi kwa cholesterol ndi triglycerides ndizofanana.
Tanthauzo la vutoli
Matenda a shuga ndi matenda osachiritsika pomwe kapamba (kapamba) samatulutsa kuchuluka kwa timadzi timene timatulutsa timadzi timene timayambitsa matenda a shuga.
Pakadali pano, ali ndi chizolowezi chowonjezera kuchuluka kwake. Chifukwa chake, ngati mchaka cha 1980 4.7% ya mapulaneti oposa 18 akuvutika ndi matenda, ndiye pambuyo pa 2014 chiwerengerochi chidakwera mpaka 8,5%.
Mu 90% ya milandu, hyperglycemia amayamba chifukwa cha matenda ashuga a 2.
Tcherani khutu! Akatswiri a WHO amatcha matenda a hyperglycemia mtundu 2 wosachiritsika wa zaka za XXI. Ndipo monga Komarovsky adafotokozera shuga mellitus - kanemayo ndiyotsika pang'ono.
Mavuto ambiri a matendawa ndi zotupa za mtima. Pafupifupi 60% ya milandu, kufa kwa wodwala matenda a shuga kumachitika chifukwa cha matenda a mtima.
- mpaka 80% ya anthu odwala matenda ashuga amakhala ndi matenda oopsa oopsa,
- Kuchuluka kwa matenda amitsempha yama mtima kwa odwala kumakhala kokwanira kawiri ndi kawiri kuposa kuchuluka kwa anthu omwe ali ndi shuga wamagazi,
- Chiwopsezo cha matenda a mtima m'gulu lino la odwala ndichulukirachulukidwe 8-10, amakwiririka katatu.
Matendawa amakhala ndi zovuta zambiri.
Zotsatira za matenda ashuga kuzungulira dongosolo
Kodi shuga imawononga bwanji mitsempha yamagazi ndi mtima? Izi ndi zofunikira pangozi yodziyimira payokha yopanga matenda a CVD.
Kuwonongeka kwa mtima mu shuga kumachitika motsutsana ndi maziko a:
- mwachindunji hyperglycemia,
- mtima endothelial kukanika,
- zovuta zamagulu a chakudya, komanso mapuloteni ndi zamtundu wa lipid,
- kuyanʻanila zamatsenga magazi
- Kukula kwa oxidative nkhawa.
Kutupa kwa minofu ndi mtima kumachitika mu shuga yachiwiri
Zomwe zimayambitsa chiopsezo cha mtima ndi matenda a shuga:
- kuwonjezera zomwe zili "zoipa" LDL cholesterol,
- kuchepa kwa anthu ambiri a "cholesterol" cha HDL,
- hyperglycemia wolimba komanso kuchuluka kwa hemoglobin wa glycosylated,
- ochepa matenda oopsa
- kunenepa (makamaka pamimba).
Dyslipidemia ndiye mdani wamkulu waumoyo Glucose owonjezera amawononga mwachindunji khoma lamitsempha Ndi matenda oopsa, kuwala kwa mitsempha kumachepa kwambiri Kunenepa kwambiri - katundu wina ku CCC
Tcherani khutu! Chinanso chowopsa ndicho kusuta. Khalidwe loipali limawonjezera mwayi wokhala ndi matenda a CVD ndi 41%.
Macroangiopathy
Matenda a shuga a macroangiopathies ndiofala kwambiri a matenda a shuga, momwe mumakhala chotupa chachikulu cha zotumphukira m'mitsempha - matumbo, chithokomiro, impso, etc.
Makamaka, macroangiopathy amawonetsedwa:
- mitundu ingapo ya angina pectoris,
- pachimake coronary syndrome ndi myocardial infaration,
- ONMK,
- Kukonzanso kwamphamvu kwamphamvu
- odwala matenda ashuga.
Zofunika! Atherosclerosis ndi mnzake wina wodwala matenda ashuga. Matendawa amaphatikizidwa ndi kuphwanya kwa metabolid ya lipid ndipo amadziwika ndi kuwonjezeka kwa ndende ya magazi. Mu matenda a shuga, matenda a pathology ali ndi zinthu zingapo zofunika: zimayamba zaka khumi ndi zisanu m'mbuyomo kuposa mwa anthu omwe alibe vuto la mahomoni, ndipo zimakhudza nthambi zonse zazikulu zamitsempha zamagazi zomwe zimadyetsa ziwalo zamkati.
Cholesterol plaque chitha kutchinga kwathunthu lumen ya mtsempha wamagazi
Kuwonjezeka kwa kuchuluka kwa cholesterol yoipa m'magazi ndikusintha kwa mtima kumapangitsa kuti ma lipids agundike pamitsempha, mawonekedwe awo ndi kuwerengera kwa mapangidwe okhwima pathanthwe.
Kuchepa kotereku kwamitsempha yamagazi m'magazi a shuga kumawonekera ndikukula kwa zovuta za ischemic ndi zovuta zowopsa:
- Matenda a mtima - Matenda ogwirizana ndi zotupa za mitsempha ya m'mimba. Zizindikiro zake zikukanikiza, kupweteka kupweteka kumbuyo kwa sternum, kukulitsidwa ndi kupsinjika kwakuthupi kapena kwamalingaliro, kuchepa kwa kulolerako masewera olimbitsa thupi, kufupika.
- Myocardial infaration - Kuphwanya kovuta kwa matenda a mtima, omwe amadziwika ndi necrosis wosasintha (kufa) kwa minofu yamtima. Imafuna chithandizo chadzidzidzi.
- Discirculatory encephalopathy - ngozi yamitsempha yamitsempha, yomwe imayendetsedwa ndi kuchepa kwamatumbo, kupweteka mutu, chizungulire. Fomu lomaliza la matendawa ndi kuchepa kwa mitsempha, kapena kuchepa kwa mtima.
- Stroko, kapena sitirokondi matenda ashuga, imodzi mwazinthu zovuta kwambiri za mtima. Amadziwika ndi ischemic necrosis ya gawo laubongo lomwe limafanana ndi mitsempha yofananira.
- Stenosing atherosulinosis yamitsempha ya NK. Matenda a ziwiya zamiyendo mu matenda osokoneza bongo ndi owopsa pakukula kwa zovuta zamagazi mpaka mapangidwe a zilonda zam'mimba ndi zilonda zam'mimba.
Tcherani khutu! Stroke mu shuga mellitus ndi zotsatira zake, komanso njira zodziwira matenda ndi kulandira chithandizo ndi nkhani zofunika mu endocrinology. Vutoli lili ndi mwayi waukulu wodwala komanso wolemala.
Mavuto aliwonse ndiosavuta kupewa kuposa kuchiza.
Microangiopathy
Ma Microangiopathies, kapena zovuta zazosokoneza bongo za matenda a shuga, ndi gulu la pathologies momwe ziwiya za ICR zimakhudzidwira. Choyamba, nawo, magazi amawagwiritsa ntchito pazowona ndi impso.
Matenda a shuga a retinopathy ndi ovuta kwambiri a shuga, omwe amadziwika ndi retinal angiopathy. Mwachikhalidwe, imakhalabe yolimba kwa nthawi yayitali ndipo imadziwonetsera pokhapokha posachedwa ndi kuwonongeka kwakuthwa m'masomphenya kapena kutayika kwathunthu.
Chimawoneka ngati retina chosinthika mwanjira
Tcherani khutu! Izi matenda amapezeka 90% ya odwala matenda ashuga patatha zaka zochepa kuchokera ku matenda.
Matenda a diabetes nephropathy ndimavuto amisala omwe amachitika mu ziwalo za mkodzo mu shuga. Zimaphatikizidwa ndi kuwonongeka kwa mitsempha, ma arterioles, komanso kapangidwe kazinthu zamagulu a impso - nephron. Imadziwonekera mu magawo omaliza a matendawa ndi edema komanso matenda aimpso.
Njira zodziwira matenda a CVD
Kupimidwa kwa mtima ndi gawo loyenera lakafukufuku wa pachipatala wa odwala omwe ali ndi matenda a shuga.
- mayeso wamba a labotale (OAC, OAM),
- shuga m'magazi
- kuyesa kwamwazi wamagazi,
- kutsimikiza kwa GFR,
- mbiri ya lipid
- ECG
- Echocardiography,
- makulidwe
- Dopplerografia ndi ultrasound yamitsempha yamagazi - ya matenda osokoneza bongo amachitika malinga ndi malo a chotupa,
- X-ray ndi MR angiography,
- Ultrasound a impso
- CT, MRI ya ziwalo zamkati.
Dotolo amapanga dongosolo la munthu payekha
Chithandizo cha matenda a mtima
Chithandizo cha mtima mavuto a shuga chikuchitika kwathunthu, moyang'aniridwa ndi dokotala. Nthawi yonseyi komanso mukamaliza, ndikofunikira kuwongolera shuga, lipoproteins ndi michere ya chiwindi. Kuphatikiza apo, mankhwala othandizira odwala matenda a shuga amatanthauza kuti wodwalayo ayenera kutsatira zakudya zotsika ndi (ngati zikuwonetsedwa) zakudya za hypolipidemic.
Kutsuka kwa mtima wamisempha kumayambira potsatira mfundo za moyo wathanzi ndi chithandizo chamankhwala:
- Zolimbitsa thupi zokwanira masana, kulimbana ndi kuchita masewera olimbitsa thupi.
- Kugona kwathunthu osachepera maola 7-8 patsiku.
- Kuyenda mumweya watsopano.
- Kutsatira zochitika za tsiku ndi tsiku.
- Chakudya chamagulu pang'ono magawo ang'onoang'ono.
- Kutsatira ndi boma lakumwa.
- Chokhazikitsidwa choletsa mu zakudya zam'mimba zopatsa mphamvu mosavuta ndi mafuta a nyama.
- Kudya masamba abwino ndi zipatso zabwino (kuphatikiza zokoma - mphesa, nthochi).
Kukonzanso kwamakhalidwe ndi kadyedwe ndiye chinthu choyamba chofunikira polimbana bwino ndi matendawa
Endocrinologists amavomereza momwe angachiritsire matenda ashuga - kuyeretsa magazi kumaphatikizapo kumwa mankhwala ovuta.
Gome: Kukonzekera kwa mtima:
Cholinga | Oimira otchuka a gulu la pharmacological |
Sintha shuga m'magazi |
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Kuchepa kwa mafuta m'thupi, kubwezeretsanso kwa matenda a lipid |
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Kukondoweza impso |
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Matenda a kuthamanga kwa magazi |
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Kupititsa patsogolo kukongoletsa |
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Kupewa kwambiri kwa thrombosis |
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Zofunika! Kukonzekera kwa mtima kwa mtundu wachiwiri wa matenda ashuga kungasiyane ndi mankhwala omwe amagwiritsidwa ntchito ku IDDM (mtundu 1). Musanayambe, onetsetsani kuonana ndi dokotala.
Mu matenda a shuga a retinopathy, mankhwala amathandizidwa kuti apititse patsogolo matenda a retinal trophism kapena laser. Bwino kuyeretsedwa kwa shuga kwa odwala matenda a shuga mothandizidwa ndi njira zowonjezera zolimbitsa thupi - kutikita minofu, malo osambira, otsikira, ma compression.
Woopsa milandu (mwachitsanzo, chithandizo cha zotupa zam'miyendo ndi stenotic atherosulinosis kapena ACS), opaleshoni ikuwonetsedwa:
- kununkha
- opaleshoni yodutsa
- angioplasty
- endarterectomy,
- kudula miyendo, etc.
Malinga ndi umboni, opareshoni imachitika.
Kupewa:
Kupewa matenda a mtima wamatenda a shuga kumakhala mukutsatira malamulo awa:
- kuyang'anira pafupipafupi shuga
- mayeso okonzanso mwadongosolo ndi endocrinologist ndi akatswiri ena odziwa ntchito,
- kudziwunikira, kuyeza kuthamanga kwa magazi, kuzindikira mtima zaumoyo,
- kuvala nsapato zapamwamba kukula kwake.
Kutsukidwa pafupipafupi kwa ziwiya kumakhudzira wodwala matenda ashuga. Kumvetsetsa kwazonse zoopsa zomwe zimachitika chifukwa cha matendawa komanso kudzipereka kwambiri kwa odwala kuthandizira ndizofunikira kwambiri pakukonzanso bwino.
Tachycardia mu shuga
Moni Ndili ndi zaka 54, ndapezeka kuti ndayamba kudwala matenda a shuga 2, tsopano ndikupitilira chithandizo chamankhwala ndimamwa mapiritsi. Adazindikira kuti nthawi zambiri ndimayamba kudwala tachycardia. Kodi ndizogwirizana ndi matenda anga, nanga ndingawachotse bwanji?
Tsiku labwino Tachycardia imatha kutsagana ndi matenda ashuga chifukwa cha kuwonongeka kwa kutulutsa kwamkati kwa minofu ya mtima. Komabe, chizindikiro ichi chikhoza kukhala chimodzi mwazomwe chikuwonetsa kusokonezeka kwa chithokomiro cha mtima, mtima womwe, komanso ANS. Onetsetsani kuti mumayesedwa (ECG, ECHOX, magazi a mahomoni a chithokomiro) ndi kufunsa dokotala.
Njira ya IHD mu shuga
Moni Abambo ali ndi zaka 72, ali ndi matenda ashuga a 2, amatenga Glucophage. Posachedwa, mtima wake wakhala ukumvutitsa: amadandaula za kupweteka pachifuwa, kufupika, kufooka. Nthawi zonse kudumpha kukakamiza. Chifukwa cha izi, pafupifupi sachoka mnyumbamo. Ndikumvetsa kuti uno ndi m'badwo, koma ndingamuthandize bwanji?
Moni Onetsetsani kuti muwawonetsa abambo kwa akatswiri azamankhwala ndi a mtima. Zizindikiro zomwe mumalongosola ndizomwe zimayambitsa matenda a mtima ndi matenda oopsa. Ndikofunikira kuyesedwa (ECG, ECHOX, mbiri ya lipid, kuyesa kwamwazi wamagazi). Ndipokhapo pokhapokha pomwe pakhala chidziwitso chokwanira ndikupereka mankhwala.
Kulephera kwina
Kulephera kwamkati kwa odwala matenda a shuga sikuchitika chifukwa cha mapuloteni a zakudya, koma chifukwa cha kuchuluka kwa shuga m'magazi. Odwala omwe sangathe kuyendetsa bwino matenda awo a shuga, matenda a impso amayamba kuwonongeka pang'onopang'ono. Nthawi zambiri izi zimatsagana ndi matenda oopsa - kuthamanga kwa magazi. Zakudya zamafuta ochepa zimakupatsani mphamvu kuti muchepetse shuga motero kutilepheretsa kukula kwa impso.
Shuga akamadwala odwala matenda ashuga abwereranso mwakale, kukulira kulephera kwaimpso kumayimira, ngakhale kuwonjezeka kwa mapuloteni (protein) muzakudya. Mothandizidwa ndi Dr. Bernstein, pakhala pali nthawi zambiri zomwe odwala amakhala ndi impso, monga momwe zimakhalira ndi anthu athanzi.Komabe, pali mfundo yoti palibe kubwerera, pambuyo pake chakudya chamafuta ochepa sichithandiza, koma imathandizira kusintha kwa dialysis. Dr. Bernstein alemba kuti izi posabweleranso ndiye kuchuluka kwa impsozo (kulengedwa kwa creatinine) pansipa 40 ml / min.
Kuti mumve zambiri, onani nkhani yakuti “Zakudya za impso ndi matenda a shuga.”
Mafunso Ofunsidwa Kawirikawiri
The endocrinologist amalimbikitsa zotsutsana - ndiyenera kukhulupirira ndani?
Phunzirani momwe mungasankhire mita yoyenera. Onetsetsani kuti mita yanu sinama. Pambuyo pake, onetsetsani momwe njira zosiyanasiyana zamankhwala othandizira (kasamalidwe) ka matenda a shuga zimathandizira. Mukasinthira zakudya zamafuta ochepa, shuga amachepetsa pakatha masiku atatu. Akukhazikika, kuthamanga kwake kwatha. Zakudya 9 zomwe zalimbikitsidwa movomerezeka sizipereka zotere.
Muthawitsa bwanji kunja kwa nyumba?
Konzekerani zokhwasula musanachitike, mudzawakonzekerere. Kunyamula nkhumba yophika, mtedza, tchizi cholimba, nkhaka zatsopano, kabichi, amadyera. Ngati simukonzekera chakudya, ndiye kuti mukakhala ndi njala, simupeza chakudya chokwanira msanga. Monga chomaliza, gulani ndikumwa mazira aiwisi.
Kodi m'malo mwa shuga mumaloledwa?
Odwala omwe ali ndi mtundu wa 1 wodwala matenda a insulin amatha kugwiritsa ntchito stevia, komanso zotsekemera zina zomwe sizikuwonjezera shuga. Yesani kupanga chokoleti chopangira tokha ndi zotsekemera. Komabe, ndi matenda a shuga a mtundu wachiwiri, ndikosayenera kugwiritsa ntchito malo aliwonse a shuga, kuphatikiza ndi stevia. Chifukwa amachulukitsa kupanga insulin ndi kapamba, kuletsa kuchepa kwa thupi. Izi zatsimikiziridwa ndi kafukufuku ndi machitidwe.
Kodi mowa umaloledwa?
Inde, kumwa pang'ono zipatso za zipatso zopanda shuga ndizololedwa. Mutha kumwa mowa ngati mulibe matenda a chiwindi, impso, kapamba. Ngati mumamwa mowa, ndizosavuta kuti musamwe konse kuposa kuyesetsa kukhala odziletsa. Kuti mumve zambiri, werengani nkhani yakuti “Mowa Pazakudya za Anthu A shuga.” Osamamwa usiku kuti mukhale ndi shuga wabwino m'mawa wotsatira. Chifukwa si lalitali kwambiri kugona.
Kodi ndikofunikira kuchepetsa mafuta?
Simuyenera kuchepetsa mafuta. Izi sizikuthandizani kuti muchepetse kunenepa, muchepetse shuga, kapena mukwaniritse zolinga zina zilizonse za matenda ashuga. Idyani nyama yofiira yamafuta, batala, tchizi cholimba modekha. Dzira la nkhuku ndilabwino kwambiri. Amakhala ndimapangidwe osakanikirana bwino a amino acid, amathandizira cholesterol "yabwino" m'magazi ndipo ndiokwera mtengo. Wolemba malowa Diabetes-Med.Com amadya mazira pafupifupi 200 pamwezi.
Ndi zakudya ziti zomwe zimakhala ndi mafuta abwinobwino achilengedwe?
Mafuta achilengedwe achinyama samadwalanso kuposa masamba. Idyani nsomba zam'madzi am'madzi kawiri pa sabata kapena kumwa mafuta a nsomba - izi ndi zabwino kwa mtima. Pewani margarine ndi zakudya zilizonse zopangidwa kuti musawononge mafuta owopsa. Chitani kuyesedwa kwa magazi kwa cholesterol ndi triglycerides yomweyo, ndipo pakatha masabata 6-8 mutasintha zakudya zamagulu ochepa. Onetsetsani kuti zotsatira zanu zikuyenda bwino ngakhale mutadya zakudya zamafuta a nyama. M'malo mwake, amasinthadi ndendende ndikugwiritsira ntchito zakudya zomwe zimakhala ndi cholesterol "yabwino".
Kodi mchere uyenera kukhala wopanda malire?
M'masiku oyambira nditasinthira kudya zakudya zamagulu ochepa, thanzi langa lidayamba kuwipira. Zoyenera kuchita
Zomwe zimayambitsa kudwala:
- shuga m'magazi adatsika kwambiri
- madzimadzi owonjezera adachoka m'thupi, ndipo ndi ma-electrolyte a mchere,
- kudzimbidwa
Zoyenera kuchita ngati shuga m'magazi amatsika kwambiri, werengani nkhani "Zolinga za chithandizo cha matenda ashuga: zomwe shuga imayenera kukwaniritsidwa." Momwe mungathanirane ndi kudzimbidwa pazakudya zama carb ochepa, werengani apa. Kuti mupeze kufooka kwa electrolyte, tikulimbikitsidwa kuti timwe nyama yothiridwa mchere kapena msuzi wa nkhuku. Pakupita masiku ochepa, thupi lidzazolowera moyo watsopano, thanzi lidzabwezeretsedwa ndikukhala bwino. Osayesa kuchepetsa kuchuluka kwa zopatsa mphamvu potsatira chakudya chamafuta ochepa.