Mavuto a Matenda A shuga a Type 1

Matenda a shuga palokha ndi matenda oopsa. Izi zimachitika chifukwa cha zovuta zomwe zimachitika pokhapokha ngati pali chithandizo chokwanira. Mtundu wa 1 wa matenda ashuga, jakisoni wa insulin tsiku lililonse amalembera, chifukwa chaichi amatchedwa insulin. Kuphatikiza pa kuperekedwa kwa mankhwala, wodwala ayenera kutsatira malamulo ena okhudzana ndi thanzi, komanso kuchita masewera olimbitsa thupi pafupipafupi.

Ngati wodwalayo anyalanyaza mfundo zoyambirira za mankhwala ndi malangizo a dokotala, ngozi ya zovuta zimawonjezeka. Choopsa chachikulu ndichakuti matenda ashuga amakhudza pafupifupi machitidwe onse a thupi. Chifukwa chake, zovuta zitha kuwoneka motsutsana ndi maziko a zilizonse.

Kukula kwa matenda ashuga amtundu uliwonse kumalumikizidwa ndi kukhalapo kwa zinthu zambiri. Chimodzi mwazinthu zodziwika kwambiri ndi kubadwa kwa makolo. Komanso, mitundu yosiyanasiyana ya matenda oyambitsidwa ndi ma virus komanso kuvulala imatha kukhala zomwe zimayambitsa. Chifukwa cha iwo, makina a pathological immune reaction amatha, chifukwa chomwe ma cell a kapamba amayamba kuwonongeka. Amayang'anira thupi kupangira insulin. Kuperewera kwake kumabweretsa kuti kuchuluka kwa glucose m'magazi kumayamba kuchuluka.

Matendawa nthawi zambiri amakula asanakwanitse zaka 20. Mtundu woyamba sukwaniritsidwa kuthandizira, ndikofunikira kwambiri kumwa mankhwalawa onse panthawi. Tsoka ilo, izi zikuyenera kuchitika moyo usanathe. Ndikofunikira kuyimitsa zizindikiro za matendawa mothandizidwa ndi jakisoni wa insulin.

Zomwe zimayambitsa zovuta za matenda a shuga amtundu woyamba ndikuti m'chilengedwe chomwe sichitha kupanga shuga payekha, kufooka kwa ziwalo zosiyanasiyana, kuphatikizapo ubongo, kumayamba. Izi zimachitika ngakhale kuli kuchuluka kwa chakudya chomwe chimadyedwa. Ngati simukuthandizira pakupanga insulini, thupi limayamba kubwezeretsanso mphamvu zomwe zidatayika kudzera mu mafuta a metabolism. Ndipo izi zitha kutsogola kupangika kwa ma ketones, omwe amakhala ndi zovulaza komanso zowononga bongo, chifukwa cha zomwe munthu wagwa.

Matenda

Monga tafotokozera pamwambapa, matendawa atadutsa nthawi yayitali amatha kuvulaza ziwalo zambiri zofunika. Kusintha kwa momwe magazi amapangidwira, omwe amadziwika ndi matenda ashuga, amatha kuwononga ziwalo ndi machitidwe awa:

impso: motsutsana ndi maziko azovuta zoyipa za matenda ashuga, kulephera kosatha kumachitika pakapita nthawi,
Khungu: chifukwa cha kusakwanira kwa magazi, wodwala yemwe ali ndi matenda osokoneza bongo ali ndi chiwopsezo cha zilonda zam'mimba, makamaka m'munsi,
Mitsempha yamagazi: chifukwa cha matenda ashuga, kuperewera kwamatenda kumavutika makamaka, izi zimapangitsa kuperewera kwa mpweya ndi michere ina, yomwe imawonjezera chiopsezo cha matenda a mtima kapena matenda ena a mtima,
dongosolo lamanjenje: kuwonongeka kwa mitsempha kumayambitsa dzanzi lakuchepa ndi kufooka kosalekeza mkati mwake, zomwe zimatha kupweteketsa mtima.

Kupewa

Ndizosatheka kuteteza kupezeka kwa matenda a shuga 1, chifukwa zomwe zimapangitsa izi, monga lamulo, sizingatheke. Pofuna kupewa mavuto ambiri akuchitika. Chofunikira kwambiri ndikutsatira malangizo a dokotala. Zomwe zikuluzikulu ndi izi:

jakisoni wa tsiku ndi tsiku
zakudya zopezeka mokwanira, poganizira zoletsedwa za mankhwala,
zolimbitsa thupi zolimbitsa thupi
kuyang'anira kuchuluka kwa shuga (pogwiritsa ntchito glucometer),
kuyendetsa shuga kwamkodzo (monga momwe dokotala wanenera).

Chifukwa chake, kutsatira malamulo ena, mutha kupewa kuwoneka zovuta zambiri zowopsa, kuphatikizapo moyo.

Zoyambitsa ndi Zoopsa

Matenda a shuga omwe amadalira insulin amatanthauza matenda a autoimmune omwe akupita patsogolo nthawi zonse. Chowonadi chake ndichakuti maselo a beta omwe amapanga insulin amawonongeka pang'onopang'ono ndi maselo oteteza thupi.

Masiku ano sizinakhazikitsidwe bwino lomwe zomwe zimapangitsa kuti chitetezo cha mthupi chisagwire ntchito molakwika. Zomwe zimayambitsa ndi ma virus omwe angayambitse matendawa mwa anthu omwe ali ndi vuto lobadwa nalo.

Zowopsa zake ndi izi:

mavairasi a coxsackie,
kobadwa nako rubella
mumps.

Koma nthawi zambiri, shuga 1 imawoneka chifukwa cha majini. Chifukwa chake, asayansi azindikira ma genetic 18. Mwachitsanzo, IDDM1 ndi malo okhala ndi mapuloteni otulutsa ma HLA omwe ali gawo la zovuta za histocompatability. Ma genes ochokera m'derali amakhudzanso chitetezo cha mthupi.

Komabe, mwayi wolandila shuga wodalira insulin, ngakhale abale atadwala ndi matendawa, umakhala wochepa (pafupifupi 10%). Kuphatikiza apo, zamatsenga nthawi zambiri zimafalikira limodzi ndi mbali ya makolo.

Kupsinjika kwapafupipafupi, kunenepa kwambiri, kuledzera, kupezeka kwa pancreatic necrosis ndi pancreatitis kumayambitsanso matenda. Kuphatikiza apo, kugwiritsa ntchito molakwika mankhwala ena osokoneza bongo komanso zakudya zopanda thanzi zimathandizira kupanga insulin yokwanira. Inde, chakudya chochulukirapo chama carbohydrate, kuphatikizapo chokoleti ndi kuphika, chimasokoneza kagayidwe kazakudya zam'mimba ndi chakudya, zomwe zimakhudza kugwira ntchito kwa kapamba.

Zowopsa zomwe zimayambitsa kudalira kwa insulin zimaphatikizapo:

kubadwa mochedwa
kuchepa magazi m'thupi,
preeclampsia - kuchuluka kwa pakati,
multiple sclerosis
Hashimoto's chithokomiro,
Manda matenda.

Chithunzi cha kuchipatala

Chizindikiro choyamba cha matenda amtundu woyamba ndicholemetsa wopanda pake chifukwa chakudya. Komanso, wodwalayo amatopa msanga, akumva kuwawa ndipo amafunafuna kugona nthawi zonse, komanso amazunzidwa ndi ludzu lalikulu.

Odwala ambiri amakhala ndi vuto lanjala, limodzi ndi kuchepa kwa kuthamanga kwa magazi, khungu pakhungu, mawonekedwe a thukuta lozizira komanso tachycardia. Anthu odwala matenda ashuga nthawi zambiri amakhala ndi kufooka kwa minofu ndi kumva kumenyera kwa zala zawo.

Zizindikiro zazikulu zamatendawa azimayi ndi kuyimitsa kwina kwa ziwalo zakunja ndi perineum. Zizindikirozi zimayamba chifukwa cha kupezeka kwa glucose mkodzo. Inde, mutatha kukodza, madontho a mkodzo wokhala ndi shuga amagwera pamatumbo amtundu, ndikupangitsa kukwiya kwambiri.

Mwa amuna, chizindikiro chachikulu cha nthendayi ndi kusokonekera kwa magazi komanso kusakhazikika bwino. Kuopsa kwa matendawa ndi njira yobisika kapena wodwalayo samalabadira zowonetsa zazing'ono za matenda.

Zina zodziwika za matenda amtundu woyamba wa 1 ndi mabala osachiritsika osakhalitsa.

Nthawi yomweyo, odwala ambiri amakhala ndi ma thumba otupa, zilonda, chitetezo chawo chimachepa, chifukwa amamva kufooka pafupipafupi ndipo nthawi zambiri amadwala chimfine.

Zotsatira zoyipa za matenda ashuga: hypoglycemia ndi hyperglycemia

Anthu ambiri amafuna kudziwa momwe zovuta za mtundu woyamba wa 1 zimayambira. Ndi matendawa, glucose, yomwe ntchito yake ndikulowera m'maselo am'mimba ndi minofu ndikuyiyambitsa mphamvu, imatsalira m'magazi.

Ngati kuchuluka kwa shuga kumachulukitsidwa pafupipafupi, popanda mphamvu zambiri kumera, ndiye kuti kumayamba kusiya ziwonetserozo ndikudzaza zotengera, kuwononga makoma awo. Zimasokonezanso kugwira ntchito kwa ziwalo zoperekedwa ndi magazi. Chifukwa chake, zovuta zimayamba ndi matenda amtundu 1, pamene thupi limasowa insulin.

Ngati kuchepa kwa mahomoni sikulipilitsidwa ndi makina a insulin, zotsatira zake zimakula msanga.Ndipo izi zimachepetsa kwambiri chiyembekezo cha moyo wa munthu.

Mavuto acute amayamba chifukwa cha kuchepa kwadzidzidzi kapena kuwonjezeka kwa shuga m'magazi. Agawidwa m'mitundu iwiri:

hypoglycemic coma (shuga wotsika),
machitidwe a hyperglycemic (shuga wambiri).

Hypoglycemia nthawi zambiri imayamba chifukwa cha kuchuluka kwa insulini kapena ngati wodwala wasowa chakudya atatha kuyamwa. Komanso, chikomokere chimawonekera chifukwa chochita zolimbitsa thupi kwambiri, kuphatikizapo kubereka ana.

Kuphatikiza apo, hypoglycemia imatha kuchitika mukamamwa mankhwala osokoneza bongo. Mkhalidwe wina wotere umayamba chifukwa chotenga mankhwala ena (ma tetracyclines, beta-blockers, fluoroquinolones, lithiamu, calcium, vitamini B 12, salicylic acid). Kuphatikiza apo, mwa anthu odwala matenda ashuga, mwayi wochepetsetsa kwambiri wama glucose ukuwonjezeka ndikuchulukitsa kwa hepatosis kapena hepatitis, pakati, komanso matenda a impso kapena adrenal glands.

Hypoglycemia ikachitika, ndikofunikira kwambiri kudya zakudya zamafuta mkati mwa mphindi 20 (tiyi ndi chokoleti ndizotsekemera). Kupatula apo, kuchepa pang'ono kumatha kudzetsa munthu kufa kwa matenda a m'mimba. Chifukwa chake, ndikofunikira kudziwa za zizindikiro zomwe zikuwonetsa kuyambika kwa chikomokere:

Ngati dontho lamphamvu la shuga limachitika usiku, ndiye kuti munthu amayamba kulota. Popanda kudya kwambiri shuga, wodwalayo angagwe.

Pa gawo lachiwiri la hypoglycemia, zizindikiro monga kukwiya kapena kuwonda kwambiri, kugwirira ntchito bwino, kuwona kawiri ndi kuwona kwamaso, kuthamanga kwa mtima komanso kukulitsa kugunda kwa mtima. Kutalika kwa siteji ndikufupikirako, ndipo pamenepa shuga ndi maswiti amatha kulowa m'mpweya wopuma, chifukwa chomwe wodwalayo ayamba kukumana, motero ndi bwino kungomupatsa yankho lokoma.

Zizindikiro zomaliza za hypoglycemia zimaphatikizira mawonekedwe a kugwidwa khungu, khungu, lomwe limakutidwa ndi thukuta lozizira, komanso kugona. Pankhaniyi, ndikofunikira kuyimba ambulansi kuti dokotala am'thandize wodwala yankho la shuga (40%). Ngati chithandizo sichingaperekedwe mu maola 2 otsatira, kukha magazi kwa ubongo kungachitike.

Kupewa kwabwino kwa chitukuko cha hypoglycemic coma ndi masewera. Koma musanayambe makalasi, muyenera kuwonjezera kuchuluka kwa chakudya chamagulu ndi 1-2 XE, muyeneranso kuchita izi mukamaliza kulimbitsa thupi.

Chakudya chamadzulo, ndikofunikira kudya zakudya zama protein. Amasintha pang'onopang'ono kukhala shuga, zomwe zimapangitsa kuti odwala matenda ashuga agone mwamtendere usiku wonse.

Amalangizidwanso kusiya mowa kwathunthu. Pazipita tsiku lililonse mowa sayenera kupitirira 75 magalamu.

Vuto linanso lalikulu la matenda a shuga omwe amadalira insulin ndi kukomoka kwa hyperglycemic, omwe amagawidwa m'mitundu itatu:

ketoacidotic,
lactic acidotic
hyperosmolar.

Zisokonezo zotere zimawoneka ndi kuchuluka kwa shuga m'magazi. Mankhwalawa amachitika m'malo osakhalitsa.

Zotsatira zambiri za matenda amtundu woyamba 1 ndi ketoacidosis. Amayamba ngati malamulo a insulini samatsatiridwa, motsutsana ndi maziko a njira zopatsirana kapena zotupa komanso kuchulukitsa kwa matenda osachiritsika. Komanso kuvulala, stroko, kugunda kwa mtima, sepsis, kugwedezeka ndi chithandizo chosafunikira cha opaleshoni zimathandizira pamenepa.

Ketoacidosis imachitika motsutsana ndi maziko azovuta za carbohydrate metabolism, yomwe imawoneka chifukwa chosowa insulini.

Nthawi yomweyo, kuchuluka kwa matupi a ketone ndi glucose m'magazi kumakulanso. Popanda kupumula kwakanthawi, kumachitika ketoacidotic.

Vutoli limakhudza ntchito ya mtima, ubongo, mapapu, matumbo ndi m'mimba. Pali magawo anayi a ketoacidosis, limodzi ndi zizindikiro zingapo:

Ketosis - kuyanika kwa khungu ndi mucous nembanemba, ludzu, kugona, malaise, kupweteka kwa mutu, kusowa kudya komanso kuchuluka kukodza.
Ketoacidosis - kugona, kununkhira kwa acetone kuchokera mkamwa, palpitations, kutsika magazi, kusanza, kuchepa mkodzo.
Precoma - kusanza kwofiirira, kusintha kwa kupuma, kupweteka pamimba, kuwoneka ngati kutukutira m'masaya.
Coma - kupuma kwamkamwa, kutsekeka kwa khungu, kusazindikira, kukoma kwa acetone mkamwa.

Chithandizo cha ketoacidotic chikomacho cholinga chake ndi kufewetsa insulin, kudzera pakulowetsa microdoses yake mosalekeza. Komanso, kuti abwerenso madzi, wodwalayo amapaka jekeseni wamadzi ndi ayoni.

Hyperosmolar ndi lactic acidotic coma nthawi zambiri zimayamba ndi mtundu wachiwiri wa matenda osokoneza bongo a shuga.

Machedwe mavuto

Nthawi zambiri matenda a shuga amakhudza ntchito ya impso. Ziwalo izi zimadutsa 6 l magazi kudzera mwa iwo eni tsiku lililonse, kusefa.

Kuchuluka kwa madzi akumwa kumabweretsa unyinji wa impso. Kuphatikiza apo, amadziunjikira shuga wambiri.

Ngati kuchuluka kwa shuga m'magazi kuli pamwamba pa 10 mmol / l, ziwalo zimasiya kugwira ntchito yochita kusefa ndipo shuga amalowa mkodzo. Mkodzo wotsekemera umunjikana mu chikhodzodzo, ndikukhala malo oyenera kwambiri opangira tizilomboti. Zotsatira zake, kutupa kumachitika m'm impso, ndikuthandizira kukulira kwa nephritis ndi nephropathy, yomwe imawonetsedwa ndi kulephera kwa impso, kuchuluka kwa mapuloteni mkodzo ndikuwonongeka m'mitsempha yamagazi.

Popewa mavuto a impso, ndikofunikira kuyang'anitsitsa shuga ndi magazi. Ndi albuminuria, mankhwala ochokera ku magulu a ARB ndi ACE amatha kutumikiridwa.

Ngati matenda a impso akupita patsogolo, zakudya zotsika za protein ziyenera kutsatiridwa. Komabe, panthawi yotsika ya kulephera kwa impso, mapuloteni ochulukirapo angafunike, chifukwa chake, mawonekedwe azakudya ayenera kuvomerezedwa ndi adokotala.

Nthawi zambiri mtundu 1 wa matenda a shuga, zovuta zomwe zimapangidwa modabwitsa, zimawonekera mu ntchito ya mtima. Zotsatira zoyipa kwambiri ndizo matenda a mtima, kuphatikizira mtima, angina pectoris, ndi arrhythmia. Mavuto onsewa amapezeka ndi njala ya okosijeni, ndipo ngati magazi atatupa, myocardium imafa.

Kuopsa kwa vuto la mtima kwa odwala matenda ashuga ndikuti mwina sikungayende ndi matenda, chifukwa kumverera kwa minofu yamtima sikunyalanyazidwa.

Mavuto ambiri amabwera chifukwa cha kuchuluka kwa mitsempha yamagazi. Chifukwa chake, kugonjetsedwa kwa chotengera chachikulu pamtima, kumenyedwa kumachitika. Ndipo matenda a "mtima wa matenda ashuga" amawonetsedwa ndi kusokonekera kwa myocardial kugwira ntchito komanso kukula kwa ziwalo.

Ndikulimbikitsidwa kuti odwala omwe ali ndi chiopsezo chambiri chotenga matenda amtima wabwino amatenga Aspirin mu 65-160 mg patsiku ngati njira yodzitetezera. Komabe, mankhwalawa ali ndi zovuta zambiri, choncho chithandizo chikuyenera kuvomerezedwa ndi adokotala.

Zotsatira zinanso zomwe zimachitika chifukwa cha matenda a shuga omwe amadalira insulin ndi retinopathy.

Mitsempha yamagazi ikawonongeka, maselo amayamba kuzimiririka, zomwe zimapangitsa kuti khungu lipangidwe, khungu komanso khungu.

Mitsempha yamagazi ikasefukira - kukha magazi kumachitika m'maso. Nthawi zambiri, odwala matenda ashuga amapanga barele, ndipo nthawi zina minofu imamwalira. Chithandizo chotsogola cha retinopathy ndi matenda a shuga a m'mimba ndi opereshoni ya laser.

Nthawi zambiri, shuga wambiri amakhala ndi mfundo yoti mathero amtsempha amasiya kumva, izi zimamvekedwa makamaka m'miyendo. Matendawa amatchedwa matenda a shuga.

Mankhwalawa, mankhwalawa amagwiritsidwa ntchito:

anticonvulsants
ma analcics
antidepressants
opalesa pachipala.

Neuropathy imatha kudzetsa zotsatilapo zingapo zowonongeka - kudziletsa mosasamala ndikutulutsa chikhodzodzo, kudumpha kuthamanga kwa magazi. Chifukwa chake, ndi paresis yam'mimba, Erythromycin kapena Metoclopramide ndi mankhwala.

Matenda ena a shuga omwe amadalira insulin amatha kukhala ndi vuto la mano.Kupatula apo, kusakwanira kwa magazi kumayambitsa njira yotupa pamlomo wamkamwa. Chifukwa chake, ma caries, periodontitis kapena gingivitis amawonekera. Dokotala wamano ayenera kuthana ndi zotulukazi.

Odwala ambiri omwe ali ndi matenda amtundu wa 1 amadwala matenda a shuga kapena a Charcot, omwe amapezekanso chifukwa chosayenda bwino m'magazi. Mkhalidwe uwu umadziwika ndi totupa pamiyendo (monga pachithunzichi), kufooka kwa minofu yokweza, kunachepetsa chidwi chazinthu zokhumudwitsa, chiwonongeko cha mafupa ndi mafupa a phazi.

Kusachiza kwa phazi la matenda ashuga kumatha kuduladula miyendo. Chifukwa chake, kupewa mavuto a matenda a shuga 1 amakhala ndi chisamaliro chamiyendo mosamala:

kupenda kwa tsiku ndi tsiku
kuchapa mapazi kawiri pa tsiku,
kugwiritsa ntchito pafupipafupi ma moisturizer,
kuvala nsapato zabwino,
kukanidwa kwa zingwe ndi masokosi omwe amafinya phazi.

Insulin, yomwe siyipangidwe mtundu wa 1 shuga, imakhudzidwa ndikupanga madzi a m'mimba, chifukwa kuchuluka kwake kumachepetsedwa. Zotsatira zake, gastritis, kutsekula m'mimba, ndi dysbiosis zimayamba. Pankhaniyi, muyenera kulumikizana ndi gastroenterologist, yemwe akupatseni mankhwala ena apadera omwe amateteza kugaya.

Ndi magazi osakwanira, kutupa kwamalumikizidwe kumatha kuchitika. Izi zimabweretsa crunching pa nthawi yolimba manja, zilonda komanso kuchepa mphamvu. Nthawi zambiri, ludzu ndi kukodza pafupipafupi ndimomwe zimayambitsa kukoka kwa calcium kuchokera m'mafupa, ndikupangitsa mafupa.

Kuti muchepetse zovuta za matenda obwera chifukwa cha matenda ashuga amtundu wachiwiri ndi woyamba, ndikofunikira kuti mukhale ndi moyo wathanzi, kuchitira matenda oyamba ndi tizilombo komanso munthawi yake ndikupewa kupsinjika. Komanso, zakudya zomwe zimakhala ndi zosungirako komanso zowonjezera zowonjezera ziyenera kuchotsedwa muzakudya.

Mu kanema munkhaniyi, zakudya za anthu odwala matenda a shuga zimadalira, zomwe zingathandize kuthana ndi shuga komanso kuthana ndi zovuta za matendawa.

Mtundu woyamba wa shuga Zizindikiro, chithandizo, zimayambitsa

| Zizindikiro, chithandizo, zimayambitsa

Zamkatimu

• Amayambitsa ndi Zizindikiro za matenda amtundu 1 • Zochita zolimbitsa thupi ndi matenda a shuga 1

• Kuzindikiritsa matenda amtundu 1 matenda a shuga

• Chithandizo cha matenda amtundu 1 shuga

• Insulini (mitundu, kuwerengetsa kwa mlingo, kutsata) • Kupewa kwa matenda ashuga amtundu 1

Mtundu woyamba wa matenda a shuga a mellitus (wodalira insulin) ndi matenda osatha a endocrine omwe amadziwika ndi kuwonjezeka kwa shuga m'magazi.

Shuga amawonjezeka chifukwa cha kufa kwa maselo a beta omwe ali m'mapamba, chifukwa chake insulin (mahomoni opangidwa ndi kapamba) sangathe kupanga kuchuluka kofunikira kapena sikupangidwa konse. Matenda a shuga a Type 1 amakula makamaka mwa makanda, achinyamata, ndi anthu osakwana zaka 30.

Zomwe zimayambitsa matenda A shuga A Type 1

Zomwe zimayambitsa matenda amtundu woyamba wa shuga sizimamveka bwino, koma zifukwa zake zakukula kwa matendawa ndi:

Kubadwa kwamtundu (cholowa),
Njira za Autoimmune - pazifukwa zosadziwika, chitetezo cha mthupi chimagwira maselo a beta, omwe pambuyo pake amawola, zomwe zimatsogolera pakupangika kwa matendawa.
Viral, matenda opatsirana (chimfine, rubella, chikuku),
Zovuta mwatsatanetsatane.

Zizindikiro za matenda a shuga 1

Zizindikiro za matenda a shuga 1 amtundu wa mankhwalawa amatchulidwa, kotero, mapangidwe a matendawa amatha kuzindikirika m'mayambiriro ake. Zizindikiro zazikulu za matenda a shuga omwe amadalira insulin:

Polyuria - kukodza pafupipafupi,
Kumva ludzu kokhazikika, kuwuma pamkamwa, pomwe munthu amamwa malita 3-5 patsiku, kumverera kwa ludzu ndi kuuma sikumatha.
Kufooka minofu
Kulakalaka kwambiri - ndizovuta kukhutiritsa kumverera kwa njala,
Kuchepa kwa thupi - ngakhale mutamadya kwambiri, kutopa kumawonedwa,
Kusakwiya, mantha, kusinthasintha,
Kuwona koperewera
Mwa akazi, matenda oyamba ndi fungus (thrush), kutupa kwamikodzo, komwe kumakhala kovuta kuthandizira, kumawonedwa.

Kuzindikira matenda ashuga amtundu 1

Mapeto a mtundu 1 shuga mellitus amayikidwa pamaziko a madandaulo a wodwala, mbiri ya zamankhwala, pakuwunika, kutengera zotsatira za mayeso a laborat:

Kuyesedwa kwa shuga kwa shuga, m'mimba yopanda kanthu (7.0 mmol / l ndi pamwamba),
Kuyesedwa kwa maola awiri shuga (11.1 mmol / L ndi pamwamba),
Kusanthula kwa hemoglobin ya glycated - pafupifupi miyezi itatu yapitayi (6.5 ndi pamwamba),
Fructosamine - kuyezetsa magazi komwe kumawona kuchuluka kwa shuga m'milungu iwiri yapitayi,
Ma antibodies kuma cell a beta - kuwunika kumawonetsa kuwonongeka kwa maselo a beta,
Glucosuria - kukhalapo ndi msuzi wa shuga mkodzo (pamwambapa 7-9 mmol / l),
Kusanthula kwa C-peptides - kudziwa kupanga insulin ndi kapamba, kagwiritsidwe ntchito ka maselo a beta,
Ma antibodies ku insulin - akuwulula cholinga chofuna insulini,
Kuyeza shuga m'magazi pogwiritsa ntchito glucometer, chingwe choyesera (mutha kuyeseza nokha, kunyumba).

Mtundu woyamba wa shuga

Zolinga zakuchiza matenda amtundu wa shuga ndikukhazikitsa shuga m'magazi, zomwe wodwalayo ali nazo komanso kupewa.

Njira yayikulu yothandizira ndi insulin - kukhazikitsidwa kwa insulin m'thupi kuchokera kunja. Ndi nthawi yoyambitsa chithandizo, kusankha kolondola kwa mankhwalawa, muyezo uwu umathandiza kupewa zovuta, kukhalabe ndi zotsalira za kapamba. Mankhwala a insulin, pali mitundu ingapo ya mankhwalawa, makamaka pogwiritsa ntchito ma insulin a nthawi yayitali.

The endocrinologist amaika insulin mankhwala chiwembu, chiwembucho chizikhala payekha malinga ndi zotsatira za kudzipenda kwathunthu kwa shuga (wodwalayo amayang'anira kuchuluka kwa shuga masiku 7, kumayeza pafupipafupi ndikulemba zolemba). M'dongosolo, wodwalayo akuti:

Kodi shuga imatuluka nthawi yanji komanso pambuyo pake
Zakudya zingati komanso zomwe zidadyedwa,
Nthawi yakudya,
Kodi katundu wazathupi, nthawi yanji
Kutalika kwa mapiritsi a shuga, mlingo.
Makhalidwe abwino a shuga m'mawa musanadye chakudya cham'mawa komanso asanagone (amafunika kudziwa kuwonjezeka kapena kuchepa kwa shuga usiku uliwonse).

Mitundu ya insulini pochita zinthu

Ultrashort insulin (wogwira ntchito mwachangu), amayamba kugwira ntchito atangoyendetsa, amafika pazomaliza pambuyo pakatha maola 1-1,5. Zovomerezeka kwa maola 3-4.
Mwachidule - akuyamba kugwira ntchito pambuyo 20-30 mphindi. pambuyo jekeseni, ukufika malire pambuyo 2-3 maola.

Zovomerezeka kwa maola 5-6. Kutalika kwapakatikati - kukhudzana pambuyo pa maola 2-3 pambuyo pakuyang'anira, kuzunzika kwakukulu, pambuyo pa maola 6-8. Zotsatira za maola 12-16.

Yaitali (ya nthawi yayitali) - imagwira ntchito maola 4-6 pambuyo pa kupangika, imadziunjikira mthupi, nsonga ya 2-3 patatha masiku operewera.

Kuwerengetsa kwa insulin

Dokotalayo amasankha mankhwalawo payekhapayekha, poganizira izi:

Wochedwa insulin. Asanakhazikitsidwe, kuyeza kwa glucose kumachitika, patatha maola awiri pambuyo pa jekeseni, shuga ayenera kukhalabe mulingo womwewo (izi zikuonetsa mlingo wosankhidwa bwino). Ndikofunikira kuyendetsa mlingo wa mankhwalawa masiku angapo: patsiku loyamba, chakudya cham'mawa chimayikidwa - magawo a shuga amayesedwa maola onse a 1-2, tsiku lachiwiri - nkhomaliro imakhazikitsidwa, miyeso imachitika ndi pafupipafupi. Tsiku lachitatu - idyani chakudya chamadzulo, chachinayi - muyeso usiku. Ngati shuga amasinthasintha ndi 1-2 mmol / l, izi zimatengedwa kuti ndizovomerezeka.
Mwachidule kuchita insulin. Amayendetsa mphindi 30.musanadye chakudya, posankha mlingo, muyenera kudya zakudya zokhala ndi index yotsika ya glycemic. Kuti mupeze mlingo, shuga amawayetsa musanadye, ndiye kuti insulin imayikidwa, chakudya chimadyedwa, ndiye kuti shuga imayesedwa pambuyo maola 1.5-2 ndi maola 3-4 mutatha kudya. Shuga pambuyo pa maola 2-3 mutatha kudya chakudya muyenera kukhala 2-3 mmol / L kuposa kuposa chakudya musanadye, ngati zili pansipa izi - mankhwala osokoneza bongo a insulin, ngati apamwamba - kuletsa. Maola 3-4 atatha kudya, shuga azikhala chimodzimodzi asanadye.

Ndikofunikira kuganizira kuti kuchuluka kwa insulin kungasinthe kapena kudwala panthawi ya matenda, kupsinjika, kusamba, motsutsana ndi maziko akusintha kwa zochitika zolimbitsa thupi komanso kusintha kwina.

Makulidwe a insulin

Insulin imalowetsedwa pansi pa khungu, pasadakhale muyenera kutisiritsa bwino jakisoniyo. Tsamba la jakisoni liyenera kusinthidwa tsiku ndi tsiku.

Kapangidwe ka insulin kumachitika pogwiritsa ntchito cholembera cha insulin kapena cholembera. Cholembera chindapusa ndi njira yabwino kwambiri, imakhala ndi singano yapadera, yomwe imapereka njira yovulala yopanda ululu. Itha kunyamulidwa nanu, pomwe insulin yomwe ili mu syringe cholembera sichikuwonongeka mothandizidwa ndi chilengedwe, kutentha kumasintha.

Muzidya chakudya pambuyo pa jakisoni musanathe mphindi 30. Ndondomeko yoyendetsera ntchito yomwe imagwiritsidwa ntchito kwambiri ndi iyi:

M'mawa, chakudya cham'mawa chisanachitike, insulin yochepa komanso yayitali imayendetsedwa,
Asanadye chakudya chamadzulo - kukhudzana kwakanthawi,
Pamaso chakudya chamadzulo - chakudya chochepa,
Usiku - kuchitapo kanthu.

Mavuto a Insulin Therapy

Nthawi zina, zotsatirazi zingaoneke:

Hypoglycemic state - kutsika kwamwadzidzidzi m'magazi a magazi, kumadziwika ndi jakisoni wamkulu wa insulin, kupanikizika kwambiri, kudya kosakwanira,
Momwe thupi lawo siligwirizana, kuyabwa, malovu pakayendetsedwe ka mankhwala - osagwirizana ndi insulin (singano yayikulu, yolira yotsekemera, insulin yozizira, malo olakwika a jekeseni),
Post-insulin lipid dystrophy (kusintha kwa khungu, kuchepa kwa mafuta osakanikira kumalo opangira jakisoni) - kapangidwe kolakwika ka jakisoni - kusakwanira, kukonzekera kuzizira, jakisoni ambiri m'malo amodzi.

Kuchita masewera olimbitsa thupi a matenda a shuga 1

Ndi matenda a shuga omwe amadalira insulin, zolimbitsa thupi zolimbitsa thupi zimakhala ndi zotsatirapo zabwino, ndikofunikira kuchita katatu pa sabata. Makalasi amakonzedwa pasadakhale, muyenera kudya ndi jakisoni insulin 1-2 musanachite masewera olimbitsa thupi.

Kuchita masewera olimbitsa thupi kumabweretsa kuti shuga yamagazi amachepetsedwa, musanayambe kuchita masewera olimbitsa thupi, muyenera kuyeza kuchuluka kwa shuga kuti musatchule kukula kwa hypoglycemia, muyenera kudya mukamaphunzira.

Pambuyo pa maphunziro a 1-1,5, muyenera kubwereza muyeso (ngati shuga wafika 4-4,5 kapena kutsika kuposa izi, muyenera kudya zakudya zopatsa mphamvu - caramel, chidutswa cha shuga).

Shuga amachepetsa osati kokha pakulimbitsa thupi, komanso kwa kanthawi pambuyo pawo.

Patsiku laukalasi, ndikofunikira kuti muchepetse kayendedwe ka insulin yayifupi komanso yayitali. Simungathe kuchita nawo masewera olimbitsa thupi ngati shuga aposa 12 mmol / l (katundu pazomwe zimakhazikika pamitima ya mtima, kuchuluka kwina kwa shuga kungadziwike). Ngati wodwalayo ali ndi zovuta, zolimbitsa thupi ndi nthawi ya kalasi imasankhidwa.

Mtundu wa 1 shuga wodwala

Zakudya za matenda amtundu 1 shuga ziyenera kukhala zopatsa thanzi, zopatsa thanzi, muyenera kudya zakudya zosachepera 5-6 patsiku. Ndikofunikira kuti musamadye zakudya zomwe zimapangitsa kuti shuga azikula, kukhazikika kwa zovuta (zovuta zamatumbo). Ndikofunikira kuphatikiza muzakudya zanu kuchuluka kwa fiber, zopatsa mphamvu.

Zakudya zoletsedwa za matenda amtundu 1	Zakudya Zololedwa za T1DM
Mkaka, yogati, zonona wowawasa kwambiri, Ayisikilimu, chokoleti, maswiti, Kuzifutsa, kusuta, mchere wamchere, Zakumwa za kaboni Bouillon msuzi Zipatso zokhala ndi shuga wambiri (nthochi, mphesa ndi zina), Utsi, confectionery, Malonda omalizidwa.	Mtsinje, nsomba zam'nyanja, nsomba zamzitini, nsomba zam'nyanja, Mitundu ya ufa wosalala Nyama yotsika Masamba opanda zipatso, zipatso, Porridge, chimanga, Wokondedwa, Supu pamasamba, msuzi wa nkhuku, Madzi, zakumwa zopanda shuga, Zipatso zouma monga mawonekedwe a zakudya, chakumwa cha zipatso, ndi shuga wopanda ma compote.

Yang'anirani moyenera kumwa kwa zinthu zotsatirazi: mbatata, pasitala, mkate, mkaka, mkaka.

Mavuto a matenda ashuga amtundu 1

Ngati simukuchepetsa shuga, zotsatirazi zingakhale:

Kuwonongeka kwa impso - kulephera kwa impso,
Angiopathy - kuphwanya kwa mtima kuphatikizika, kutumphuka kwawo, chiyembekezo cha thrombosis, atherosclerosis,
Glaucoma - magazi m'mitsempha ya maso, kutsikira pamagalasi, ndolo,
Polyneuropathy - kutayika kwa kupweteka, kutentha m'miyendo,
Matendawa odwala matenda ashuga - mawonekedwe a zilonda zotseguka, zotupa za purcines, malo a khungu la necrotic (akufa),
Kusokonezeka kwamitsempha yamitsempha - kufooka kwa minofu mu miyendo, kupweteka kosalekeza.

Zovuta zopweteka:

Ketoacidosis - kusazindikira, kusokonezeka kwa ziwalo zofunika (zopangika pakudzikundikira kwa matupi a ketone),
Hypoglycemia - kuchepa kwa chikumbumtima, kuchepa kwambiri kwa mishuga, kusowa kwa zochita kwa ophunzira kuyatsa. Kuchulukitsa thukuta, kukomoka, kukomoka kumatha kupangika (insulin yochulukirapo, kuchita masewera olimbitsa thupi, kudya zosafunikira, mowa),
Lactic acidosis chikomokere - mitambo, kupuma, kuchepa kwa magazi (kuthamanga kwa magazi), kusowa pokodza (ndi kudzikundikira kwa lactic acid),
Hyperosmolar coma ndi ludzu losasunthika, kukodza kochulukirapo (ndi kuwonjezeka kwa sodium ndi glucose m'magazi).

1. Khalidwe

Pali kuonedwa kuti mtundu woyamba wa shuga umangobadwa ndi mayi wa 3-7% kuchokera kwa amayi ndipo mwina 10% kuchokera kwa bambo. Ngati makolo onse akudwala, ngozi ya matendawa imawonjezeka kangapo mpaka 70%.

Matenda a shuga a Mtundu Wachiwiri amabadwa ali ndi mwayi wokhala ndi 80% pa mayi ndi mbali ya abambo, ndipo ngati makolo onse ali ndi vuto losagwirizana ndi insulin, chiwonetsero chake cha ana chimafikira 100%, koma, monga lamulo, pakukula.

Inde, pankhaniyi, madokotala amasiyana peresenti yokha, mwinanso agwirizana: chibadwidwe ndichomwe chimayambitsa matenda ashuga.

2. Kunenepa kwambiri

Kuchokera pamalingaliro opanga matenda ashuga, ndizowopsa kwambiri ngati index yam'mimba yoposa 30 kg / m2 ndipo kunenepa kwambiri pamimba, ndiko kuti, mawonekedwe a thupi amatenga mawonekedwe a apulo. Chofunika kwambiri ndi kukula kwa chiuno.

Chiwopsezo cha matenda a shuga chikuwonjezereka ndikuzungulira m'chiuno kwa amuna opitilira 102 masentimita, kwa amayi oposa masentimita 88. Zapezeka kuti m'chiuno cha aspen sikuti ndi fash komanso njira yotsimikizika yokuzitetezera ku matenda ashuga.

Mwamwayi, izi zitha kusankhidwa ngati munthu, akudziwa zoopsa zonse, alimbana ndi kunenepa kwambiri (ndikupambana nkhondoyi).

4. Matenda opatsirana ndi ma virus

Rubella, chikuku, matenda a chiwindi ndi matenda ena angapo, kuphatikizapo chimfine, amachulukitsa matenda a shuga. Matendawa amatenga gawo la zinthu zomwe zimayambitsa matenda, ngati kuti ndiwotsutsa matendawa. Mwachionekere, kwa anthu ambiri, chimfine sichikhala chiyambi cha matenda ashuga.

Koma ngati uyu ndi munthu wonenepa kwambiri wokhala ndi chibadwa cholakwika, ndiye kuti kachilombo kosavuta kamamuopseza. Munthu yemwe m'mabanja mwake munalibe odwala matenda ashuga amatha kudwalanso chimfine komanso matenda ena opatsirana, ndipo nthawi yomweyo, mwayi wokhala ndi matenda ashuga ndi wocheperako kuposa wa munthu yemwe ali ndi vuto lotenga matenda ashuga.

Chifukwa chake kuphatikiza pazinthu zoopsa kumawonjezera chiwopsezo cha matendawa kangapo.

5. Moyo woipa

Matenda a shuga omwe amatchulidwa mumtunduwu sangachitike ngati chimodzi mwatsatanetsatane sichikuyambitsa: kuvutikira kwamanjenje, moyo wongokhala, kudya zopanda thanzi, kulephera kupuma mpweya wabwino komanso kukhala ndi nthawi yachilengedwe, kusuta.

Mavuto onse “am'mizinda” amenewa amangochulukitsa ngozi.

Onjezerani kukuwonjezereka kwa chiyembekezo chamoyo (chiwopsezo chachikulu cha matenda ashuhu alembedwa mwa anthu opitilira 65), ndipo timapeza kuchuluka kwakukulu kwa odwala matenda ashuga.

Kupewa matenda a shuga ndikuchotsa kwa zinthu zomwe zingayambitse matendawa. Munthawi yonseyi, kupewa matenda a shuga 1 kulibe. Matenda a 2 a shuga amatha kupewedwa mwa odwala 6 mwa 10 omwe ali pachiwopsezo.

Chifukwa chake, ngakhale kuli kwakuti pali zidziwitso zapadera za katemera, mothandizidwa ndi zotheka kuti munthu wathanzi labwino azindikire kuthekera kwa mtundu woyamba wa matenda ashuga kumayambiriro koyambira, palibe njira zomwe zingalepheretse chitukuko chake. Komabe, pali zinthu zingapo zomwe zingachedwetse kukula kwa njirayi. (1)

Kusamala kwamadzi

Nthawi zambiri, popewa matenda amtundu uliwonse wa shuga, malo oyamba amaperekedwa ku dongosolo lolondola la zakudya, ngakhale izi sizowona. Choyamba, ndikofunikira kuti madzi azikhala wathanzi mthupi.

Choyamba, kapamba, kuphatikiza insulini, amafunika kupanga njira yamadzimadzi ya michere ya bicarbonate kuti achulukitse zidulo zachilengedwe. Ngati kuchepa kwa madzi kumachitika, patsogolo kumaperekedwa pakupanga bicarbonate, motero, kupanga kwa insulin kumachepetsedwa kwakanthawi. Koma kukhalapo kwa shuga wambiri woyeretsedwa bwino mu zakudya ndizomwe zimayambitsa matenda ashuga.
Kachiwiri, njira ya kulowa kwa glucose m'maselo imangofunika osati insulin, komanso kukhalapo kwa madzi. Maselo, monga thupi lonse, ali 75 peresenti madzi. Gawo lamadzi awa pachakudya chambiri lidzagwiritsidwa ntchito popanga bicarbonate, gawo lomwe limayamwa michere. Zotsatira zake, njira yopangira insulini ndikuyang'anitsitsa kwa thupi lake imavutikanso.

Pali lamulo losavuta: kumwa magalasi awiri a masika omwe amakhalabe madzi m'mawa komanso chakudya chisanachitike. Izi ndizofunikira zochepa. Nthawi yomweyo, zinthu zotchuka zotsatirazi sizingaganizidwe ngati zakumwa zomwe zimabwezeretsa madzi:

Kulemera kwa thupi

Njira imodzi yofunika kwambiri yodzitetezera ndikuyang'anira kuwongolera kunenepa komanso kuchepetsedwa kwake! Kuti izi zitheke, anthu onse omwe thupi lawo lolozeka (BMI) lopitilira zizindikiro zovomerezeka ayenera kuganiziranso zomwe amadya, komanso kuwongolera zoyesayesa zawo zambiri zolimbana ndi moyo wosachita masewera olimbitsa thupi mothandizidwa ndi masewera olimbitsa thupi. Njira izi zikangotengedwa, mwayi wochulukirapo wodwala matenda a shuga 2.

Zakudya zoyenera

Kwa iwo omwe ali pachiwopsezo cha matenda a shuga kapena ali kale ndi mavuto ena ndi shuga wamagazi, muyenera kuphatikiza muzakudya zanu za tsiku ndi tsiku:

Mitundu
Tomato
Walnut
Tsabola
Switzerlande
Nyemba
Zipatso za citrus.

Malamulo oyamba azakudya polimbana ndi kunenepa kwambiri:

Gawani nthawi yokwanira pachakudya chilichonse komanso kutafuna chakudya chokwanira.
Osadumpha chakudya. Tsiku muyenera kudya osachepera 3-5 pa tsiku. Nthawi yomweyo, kudya zipatso ndi kapu ya madzi kapena kefir kumaganiziridwa.
Osamva njala.
Kupita ku malo ogulitsira, idyani, ndipo lembani mndandanda wazogula zofunika.

Osatembenuza zakudya kukhala mphotho ndi chilimbikitso, musadye kuti musinthe.

Ndikulimbikitsidwa kuti mutsatire lamulo - chakudya chotsiriza pasanathe maola 3 musanagone.

Chowonjezera chazogulitsa chikuyenera kukhala chosiyanasiyana, komanso magawo ang'ono. Moyenera, muyenera kudya theka la magawo oyambawo.

Osamadya ngati mulibe njala.

Zochita zolimbitsa thupi

Udindo waukulu polimbana ndi kunenepa kwambiri ndikuchita masewera. Kukhala moyo wongokhala kumapangitsa kuti ukhale ndi mapaundi owonjezera. Kulimbana ndi zoletsa pazokha sizowona, ndipo sizothandiza kwenikweni, makamaka zikafika nthawi yomwe kunenepa kwambiri kuli kale ndi malo.

Kuchita masewera olimbitsa thupi pafupipafupi ndi njira yotsimikizika yopewa matenda aliwonse. Chifukwa chodziwikiratu chokhudza chibwenzichi ndi katundu wokwera kwambiri wa cardio. Koma palinso zifukwa zina.

Maselo amafuta amachepetsa voliyumu mwachilengedwe komanso pamlingo woyenera, ndipo maselo am minofu amasungika athanzi komanso athanzi. Nthawi yomweyo, shuga sayenda m'magazi, ngakhale atakhala owonjezera.

Ndikofunikira osachepera mphindi 10-20 pa tsiku kuchita nawo masewera aliwonse. Sichiyenera kukhala chogwira ntchito zolimbitsa thupi komanso chotopetsa. Kwa ambiri, ndizovuta kupirira theka la ola la katundu, ndipo ena sangapeze theka la ola. Potere, mutha kugawa zolimbitsa thupi zanu m'magawo atatu a mphindi khumi patsiku.

Palibenso chifukwa chogulira aphunzitsi kapena matikiti a nyengo. Mukungoyenera kusintha pang'ono zomwe mumachita tsiku ndi tsiku. Njira zabwino zosungitsira thupi lanu ndi ma toni ndi:

Kuyenda masitepe m'malo mogwiritsa ntchito eleti.
Kuyenda paki ndi abwenzi m'malo mochita usiku.
Masewera olimbitsa thupi ndi ana m'malo mwa kompyuta.
Kugwiritsa ntchito mayendedwe pagulu mmalo mongopita paulendo wamawa.

Pewani kupsinjika

Kuchita koteroko ndi njira yabwino yopewera matenda onse, osati matenda ashuga okha. Pewani kucheza ndi anthu osalimbikitsa. Ngati izi sizingalephereke, dzipangeni ndipo khalani odekha. Maphunziro azolimbitsa thupi kapena maphunziro apaulendo ndi kukambirana ndi akatswiri amatha kuthandizira pa izi.

Upangiri weniweni kuchokera kudera lomwelo - palibe ndudu. Amangopanga chinyengo chotsimikizika, koma kwenikweni sizili choncho. Nthawi yomweyo, maselo am'mitsempha ndi kuchuluka kwa mahomoni kumavutikabe, ndipo chikonga chimalowa m'thupi, zomwe zimapangitsa kukula kwa matenda ashuga komanso zovuta zake zotsatirapo.

Kupsinjika kumagwirizana mwachindunji ndi kuthamanga kwa magazi. Muziwongolera. Kuthamanga kwa magazi kumasokoneza kagayidwe kachakudya koyamwa. Nthenda iliyonse yamtima imawonjezera chiopsezo cha matenda a shuga.

Kudziyang'anira pawokha

Kwa iwo omwe ali ndi chiwopsezo chachikulu cha matenda ashuga (pamakhala kunenepa kwambiri kapena achibale ambiri akudwala nthendayi), pofuna kupewa matenda ashuga, ndikofunika kulingalira njira yosinthira kuzakudya zamasamba, muyenera kumangokhala pamenepo nthawi zonse.

Kulandira chithandizo kungabweretse mavuto. Mankhwala amphamvu amatha kukhala ndi mahomoni. Mankhwala nthawi zambiri amakhala ndi mphamvu yokhudza ziwalo, ndipo kapamba "wamenyedwa" imodzi yoyambirira. Kudzikundikira kwa ma virus komanso matenda mthupi kumapangitsa kuti zochita za autoimmune.

Type 1 shuga mellitus: zoopsa ndi njira zopewera

Matenda aliwonse samakhala okha. Pamaonekedwe ake, momwe zimayambitsa ndi zomwe zimayambitsa vuto zimafunikira.

Matenda a shuga ndi osiyana - kuwonjezeka kwachilengedwe kwa shuga wamagazi monosaccharide. Ndani angayambitse matenda a shuga 1: ziwopsezo zomwe zimayambitsa matenda omwe tikambirane.

"Chifukwa chiyani ndikudwala?" - Funso lomwe limadetsa nkhawa onse odwala

Zambiri zokhudzana ndi matendawa

Mtundu woyamba wa matenda a shuga 1 a mtundu wa shuga, mtundu wa IDDM ndi matenda a autoimmune a endocrine gland system.

Zofunika! Pathology imatha kupezeka mwa aliyense, koma nthawi zambiri imapezeka mwa achinyamata (ana, achinyamata, anthu ochepera 30). Komabe, kusintha komwe kukuchitika pakadali pano, ndipo odwala opitirira zaka 35 mpaka 40 amadwala ndi IDDM.

Kusiyana kwa pathogenesis ya mtundu 1 ndi shuga yachiwiri

Zina mwazizindikiro zake zazikulu ndi:

hyperglycemia
polyuria - kukodza kwambiri,
ludzu
kuwonda mwadzidzidzi
kusintha pakudya (kungakhale kochulukirapo kapena,, kochepetsedwa),
kufooka, kutopa kwambiri.

Pakamwa pakamwa ndi ludzu ndizizindikiro zodziwika bwino za matenda.

Mosiyana ndi matenda amtundu wa 2 (NIDDM), amadziwika kuti sangasokonezedwe ndi wachibale) kuchepa kwa insulin, komwe kumachitika chifukwa cha chiwonongeko chachindunji cha kapamba.

Tcherani khutu! Chifukwa cha njira zingapo za chitukuko, zomwe zimayambitsa matenda a shuga 2 ndi IDDM, ngakhale zili ndi kufanana, ndizosiyana.

Mtundu woyamba wa shuga

Kudalira kwa insulin ndi zotupa za endocrine system, pomwe thupi limapanga insulin yaying'ono. Potsutsana ndi izi, kuchuluka kwa shuga mumagazi, zizindikiro zoyambirira za matenda a shuga zimawonekera - kuwonda popanda chifukwa komanso ludzu losalekeza.

Matendawa ndi osachiritsika, kupita patsogolo kwake kungathe kupewedwa pokhapokha kuwunikira shuga, komanso kutsatira mfundo za moyo wathanzi. Odwala omwe ali ndi matenda a shuga 1 ayenera kumwa mankhwala omwe amachepetsa shuga, komanso kuwunika thanzi lawo. Njira zokhazo ndi zomwe zingathandize kupewa zovuta za matendawa.

Zowonongeka za matenda ashuga kwa thupi la mtundu woyamba zimadziwika ndi kukhala ndi moyo wopitilira zaka 35, malinga ndi upangiri wa dokotala komanso makonzedwe apakanthawi a mankhwala.

Kodi matenda ashuga osawerengeka ndi ati ndipo chifukwa chiyani ndiwowopsa?

Matenda a shuga - matenda ofala kwambiri omwe amapezeka ngati kapamba wa munthu sakugwira ntchito bwino - samatulutsa insulini (mtundu 1), kapena insulin chiwopsezo chimachepa (mtundu 2).

Matenda a shuga owoneka bwino, chithandizo chokwanira, kuwunika momwe wodwalayo alili komanso kuyesedwa kwa mayeso sikulola kuti matendawa achuluke.

Zomwe zimayambitsa kubwereza matenda a shuga:

Kuphwanya zakudya ndi zakudya.
Chithandizo chosakwanira kapena chosakwanira.
Kugwiritsa ntchito zakudya zamagulu m'malo mwa mankhwala, makamaka popanda upangiri wa endocrinologist.
Kuyeserera pakudziyesa nokha.
Kukana kusintha kwa mankhwala a insulin kapena mlingo woyenera wa insulin.
Matenda opatsirana, matenda amanjenje, pakati komanso zina zomwe zimasokoneza magwiridwe antchito amthupi.

Kunenepa kwambiri

Kunenepa kwambiri komanso kunenepa kwambiri ndi chinthu chinanso choopsa cha matenda ashuga. Pankhaniyi, BMI yopitilira 30 kg / m2 imawoneka yoopsa, komanso mtundu wam'mimba, momwe chithunzi chimapangidwira mawonekedwe a apulo.

Kunenepa kwambiri ndi zovuta zapadziko lonse m'zaka zam'ma 2000 zino

Dziyang'anireni. Tengani kuyesa kosavuta kwa chiwopsezo cha shuga poyesa mawonekedwe a OT - m'chiuno. Ngati chizindikirochi chimaposa 87 cm (kwa akazi) kapena masentimita 101 (kwa amuna), ndi nthawi yolira alarm ndikuyamba kulimbana ndi kunenepa kwambiri. Mchiuno mwanu sikungolipira mafashoni okha, komanso njira imodzi yothanirana ndi matenda a endocrine.

Njira yosavuta yodziyesera nokha

Pancreatitis yovuta komanso yosatha, khansa ya kapamba, kuvulala ndi zina zina zimayambitsa maselo a chiwalo, omwe posachedwa amachititsa insulin.

Zomwe zimachitika

Mankhwala sanakhazikitse zomwe zimayambitsa matenda 1 a shuga, chibadwidwe chamtsogolo chimadziwika kuti ndiye gwero lenileni la matendawa.

Kuphatikiza apo, zinthu zotsatirazi ndizotheka:

Zakudya zopanda pake, zomwe zimaphatikizapo kumwa kwambiri ma muffin ndi maswiti, mafuta ndi mafuta osavuta, omwe pang'onopang'ono amabweretsa zovuta za metabolic. Kusagwirizana kwamafuta ndi chakudya kumasokoneza kugwira ntchito kwa kapamba, yemwe amayang'anira kupanga insulin.
Kupsinjika kwakukuru ndi kufuula mwamtimamu komwe kumayimitsa mphamvu yamanjenje.
Kunenepa kwambiri kapena kuchuluka kwa kunenepa kwambiri.
Pancreatic necrosis kapena kapamba, amene amakhala ndi chilengedwe.
Kukhalapo kwa zizolowezi zoyipa, makamaka, kumwa mowa mwauchidakwa.
Matenda opatsirana omwe adasamutsidwa kale.
Zovuta za chithokomiro, makamaka ngati zidachitika chifukwa cha kusalinganika kwa mahomoni.
Kugwiritsa ntchito mankhwala okhazikika kapena kwakanthawi komwe kumawononga magwiridwe antchito a kapamba.

Mavuto obwera chifukwa cha matenda ashuga nthawi zambiri amapezeka chifukwa cha kuchepa kwa mphamvu ya thupi yopanga payokha glucose. Potengera maziko awa, pali kufooka kwa ziwalo zina.

Mawonekedwe amoyo

Zomwe zingayambitsenso matenda ashuga: zovuta zomwe zimayambitsa matenda nthawi zambiri zimagwirizanitsidwa ndi moyo wosayenera:

kupsinjika, zovuta zopweteka,
moyo wongokhala, wosagwira ntchito,
Zakudya zopanda pake (kulakalaka kwambiri maswiti, chakudya chofulumira komanso zakudya zina zam'mimba zosavuta),
kukhala m'malo ovuta zachilengedwe,
kusuta, kumwa mowa mwauchidakwa komanso zizolowezi zina zoyipa.

Zovuta zowonjezera zomwe zimatha maola osatha pa TV Kukonda maswiti Makhalidwe osavomerezeka

Tcherani khutu! Chifukwa cha kuchuluka kwa anthu okhala m'tauni, chiwopsezo cha matenda ashuga chakwera kwambiri. Ku Russia kokha, chiwerengero cha odwala chimafika pa 8.5-9 miliyoni.

Tsoka ilo, palibe njira zoletsa zomwe zingalepheretse kukula kwa matenda a zamatenda ndi 100%. Izi ndichifukwa choti mankhwalawa sangakhudze zomwe zimayambitsa matenda a shuga 1 - kubadwa mwabadwa komanso chibadwa.

Komabe, pali zinthu zingapo zomwe zingachepetse kuthekera kapena kuchedwetsa kukula kwa kayendedwe ka thupi m'thupi.

Gome: Njira Zokupetsera IDDM:

Mtundu wa kupewa	Njira
Poyamba	Kupewa matenda oyambitsidwa ndi mavairasi, Kuyamwitsa ana mpaka miyezi 12-18., Kuphunzira kuyankha moyenera mukapanikizika, Zakudya zabwino komanso zopatsa thanzi.
Sekondale	Mayeso a chitetezo chaka ndi chaka, Kuwongolera shuga Maphunziro m'masukulu apadera azaumoyo.

Matenda a shuga lero si chiganizo, koma matenda omwe mungakhale nawo moyo wautali komanso wachimwemwe. Ndikofunikira kuti munthu aliyense adziwe zazomwe zimayambitsa ndi kupangika kwa hyperglycemia m'thupi, komanso kusunga mfundo za moyo wathanzi kuti muchepetse kusintha kwa zochita za thupi.

Kubadwa mwamwayi ndiye chifukwa chachikulu, koma osati chifukwa chokha

Moni Nthawi zonse ndimakhulupirira kuti mtundu woyamba wa matenda ashuga umabadwa, ndipo posachedwapa ndidazindikira kuti matendawa adapezeka mwa mwana wa mnzake (palibe amene ali ndi matenda ashuga m'banjamo). Kodi zitha kupangika mwa wina aliyense?

Moni Indedi, kubadwa kumene komwe kumanenedwa kuti ndi chimodzi mwazinthu zoyambitsa kukulitsa matendawa. Komabe, sikutali ndiokhawo (onani tsatanetsatane mu nkhani yathu).

Pakadali pano, kuyesedwa kwapadera kwakonzedwa kuti kuwunikire kuopsa komwe kungapangidwe kwa matenda a matenda amiseche kwa aliyense.

Koma popeza anthu ambiri sadziwa ngati ali ndi jini "yophwanyika" yomwe imayambitsa matenda a shuga 1 kapena ayi, ndikofunikira kuti aliyense azitsata njira zoyambirira zopewera.

Kufala kwa matenda kuchokera kwa makolo

Mwamuna wanga ali ndi matenda ashuga kuyambira ndili mwana, ndili ndi thanzi labwino. Tsopano tikuyembekezera oyamba kubadwa. Kodi pali chiopsezo chotani kuti akapezanso shuga m'tsogolo?

Moni Ana obadwa kwa makolo omwe ali ndi vuto lofananitsa la endocrine ali ndi mwayi wopeza IDDM poyerekeza ndi anzawo. Malinga ndi kafukufuku, kuthekera kopezeka ndi matendawa kwa mwana wanu kuli pafupifupi 10%. Chifukwa chake, ndikofunikira kuti iye azitsatira magawo onse a kupewa koyambirira komanso kwachiwiri, komanso kumangoyesa mayeso a labotale (1-2 kawiri pachaka).

Mavuto osokoneza bongo a matenda amtundu woyamba: ndi ziti komanso momwe mungapewerere kuti zisachitike?

Matenda a shuga amayamba chifukwa chosowa chinthu chapadera mthupi - insulin. Kuthamanga kapena matenda a shuga omwe sanalandireke kumapangitsa kuti pakhale njira zingapo zoyambira matenda.

Kuchuluka kwa shuga m'magazi ndiko vuto lalikulu la zovuta za matenda amtundu 1, zomwe zimapezeka kawirikawiri kwa ana ndi achinyamata.

Kodi zovuta za matenda ashuga zimachitika liti?

Ndi matenda amtundu 1, thupi la wodwalayo limasowa kwambiri insulin, chifukwa chitetezo cha mthupi chimawononga maselo apadera a beta omwe amapanga mtundu wamahomoni awa.

Chomwe chimapangitsa "chikhalidwe" cholakwika ichi kukhala ndi chitetezo chathupi.

Chiwerengero cha maselo akufa chikufika pachimake (80-90%), kaphatikizidwe ka insulini pafupifupi amayima, ndipo glucose amayamba kudziunjikira m'magazi m'malo motengeka ndi maselo amisempha.

Potengera maziko awa, zovuta zingapo za matenda ashuga zimapangidwa: kuthamanga kwa magazi, kuwonongeka kwa ziwiya zam'mimba komanso mitsempha. Zotsatira zake, kusabala kumakula mwa amuna omwe ali ndi matenda ashuga, ndipo azimayi amakhala ndi vuto lotenga pakati.

Zovuta zazikulu za matenda amtundu 1

Kuperewera kwa chithandizo kumabweretsa zovuta zambiri .ads-mob-1

Mavuto owopsa kwambiri amakhala ndi awa:

malonda-pc-1ketoacidosis. Mkhalidwe wowopsa, wodziwika ndi kuchuluka kwambiri kwa matupi a acetone (kapena matupi a ketone) m'magazi a wodwalayo. Ichi ndichifukwa thupi lomwe lili ndi matenda ashuga lilibe insulin yokwanira, motero mphamvu. Kenako amayamba kuphwanya mafuta omwe amasonkhanitsidwa ndi thupi mothandizidwa ndi matupi a ketone. Chiwerengero chawo pakuchitika kwa kagayidwe kameneka chikukula nthawi zonse. Acetone, chopangidwa ndi zinthu zake, chimadetsa thupi ndipo zimabweretsa zovuta zazikulu. Popeza matupi a ketone sangathe kulowa mu cell popanda thandizo la insulin, amachotsedwa kudzera mu impso. Matendawa ndi amtundu wa matenda ashuga a mtundu woyamba (wachinyamata),
hypoglycemia. Amayamba motsutsana ndi maziko a kuchepa kwakukuru mu kuchuluka kwa shuga m'magazi (mwa dongosolo la 3 Mmol / L kapena kuchepera). Chimawonekera pazifukwa zingapo: kupsinjika kwakuthupi, kukhazikitsidwa kwa mlingo waukulu wa insulin, kusowa kwa zakudya m'zakudya, ndi zina. Zikuwoneka ngati njala ndi kufooka, thukuta limawonjezeka komanso kuwona kwamaso, mutu. Muzovuta kwambiri, kukomoka ngakhale kukomoka kumachitika.
hyperosmolar coma. Kuphatikizika uku kumachitika motsutsana ndi maziko a hyperglycemia ndipo amadziwika ndi kuchepa kwa minofu. Chowonadi ndi chakuti thupi likuyesera "kuchepetsa" shuga yayikulu potenga madzi kuchokera m'maselo ndikuwabwezeretsanso magazi. Zotsatira zake, pamakhala kuchepa kwa maselo aubongo, kuthamanga kwa magazi kumachepetsa, ndipo wodwalayo amayamba kuzindikira. Pathology pa gawo loyambirira limadziwoneka lokhala ndi ludzu losatha komanso, chifukwa chake, diuresis imawonedwa. Pang'onopang'ono pang'onopang'ono m'malo mwake mumatha kukhetsa,
lactic acidotic chikomokere. Pokhala ndi insulini, palruvic acid imadziunjikira m'magazi. Zowonjezera zake zimayambitsa kuwonjezeka kwa kaphatikizidwe ka lactic acid. Zizindikiro: kudumphadumpha m'magazi, kukhudzika mtima, kulephera kukodza komanso kulephera kupuma.

Tisaiwale kuti mawonetseredwe azovuta za matenda ashuga ndi ofanana mu ana ndi akulu. Chifukwa chake, ndikofunikira kuyang'anira thanzi la odwala matenda ashuga.Zizindikiro zokhudzana ndi matenda amtunduwu zikuwoneka, muyenera kufunsa chithandizo chamankhwala, popeza zovuta zomwe zimatchulidwa zimayamba msanga (nthawi zina mumaola ochepa).

Dzina lenileni la zovuta limafotokoza kuti limayenda pang'onopang'ono (mpaka zaka zingapo). Ndipo uwu ndi ngozi yake. Matendawa pang'onopang'ono (popanda zizindikiro zoopsa) amadetsa thanzi, ndipo zimakhala zovuta kwambiri kuchitira zovuta zotere.

Mavuto amtsogolo akuphatikizapo:

angiopathy. Pankhaniyi, kukula kwa mtima kumaphwanyidwa. Zotsatira zake, mawonekedwe a atherosclerosis plaques, thrombosis amakula,
retinopathy. Ndalama zimavutika, ma retina amachoka, kumveka bwino kwa masomphenya kumachepa, ndipo ngongole zimayamba. Izi zimawopseza wodwala ndikuwonongeka. Chifukwa chake, ndikofunikira kuti odwala matenda ashuga awoneke pafupipafupi ndi ophthalmologist. Monga zovuta zilizonse za matenda ashuga, kusokonezeka kwa thupi ndi kuvulala kwina kumayambira nthawi yayitali kusanawonedwe kowoneka, ndikofunikira kuti shuga ikhale ndi magazi nthawi zonse,
polyneuropathy. Amadziwika ndi kusamva bwino kupweteka, dzanzi. Miyendo imamva kutentha kapena kutentha. Chomwe chimapangitsa izi ndi kuwonongeka kwa mitsempha yaying'ono yamagazi yomwe imadyetsa ulusi wamitsempha. Polyneuropathy imatha kukhudza chiwalo chilichonse ndipo chimachitika nthawi iliyonse. Komabe, mukakhala ndi matenda ashuga, mumatha kuchita ngozi zambiri. Mitsempha yowonongeka singabwezeretsedwe, koma chiwonongeko chawo chowonjezereka chitha kupewedwa,
matenda ashuga. Amatha kukhala ndi matenda ashuga aliwonse. Zizindikiro: zotupa ndi zilonda zimawoneka pamapazi. Kusavomerezeka m'miyendo ndizowopsa chifukwa mabala kapena matuza sangathe kuzindikiridwa ndi nthawi, zomwe zingapangitse kuti matenda afalikire thupi lonse. Vutoli limakonda kudula dzanja.

Zotsatira zapadera za matenda ashuga mwa ana

Ana amapezeka kuti nthawi zambiri amakhala ndi vuto la matenda. Amakula m'thupi la mwana mwachangu ngati simuyamba kulandira chithandizo pa nthawi.

Kuphatikiza apo, zaka za mwana zimakhala zochepa, zomwe zimayambitsa matendawa .ads-mob-2

Insulin m'thupi imakhala yosasinthika, chifukwa kapamba mwa ana sanapangidwe kokwanira, glucose amadziunjikira mu minofu, ndipo maselo samalandira zakudya zoyenera. Mchitidwe wamisempha wosakhazikika umakhudzanso kagayidwe.

Poyamba, mwana amatha kusintha kwambiri miyezo ya shuga masana, zomwe zimakhala zoopsa pakoma. Ngati matendawa ayambitsidwa, mwana amachedwa kukula ndikukula m'maganizo.

Nayi ndandanda yayifupi ya zovuta zaubwana:

mtima matenda. Nthawi zina, chiopsezo cha angina pectoris chimawonjezeka. Ngakhale ana atha kukhala ndi vuto la mtima kapena matenda opha ziwalo, amakhala atherosulinosis, ngakhale izi sizichitika kawirikawiri.
mitsempha. Odwala ang'onoang'ono akumva kugwa m'miyendo,
khungu lotayidwa ndi bowa ndi mabakiteriya,
ngati mwana ali ndi mapapu ofooka, chifuwa chachikulu chikukula.
mafupa olimba chifukwa chosowa mchere. Osteoporosis imatha kubereka chifukwa cha zovuta za kukula kwa intrauterine kapena kutengedwa, mwachitsanzo, chifukwa chodyetsa maupa.

Kuwongolera matenda ashuga tsiku ndi tsiku ndi zomwe makolo amafunika kugwiritsa ntchito nthawi ndi mphamvu zake. Izi zikuthandizira kuchepetsa kuopsa kwa zovuta komanso kupatsa mwayi mwana kukula bwino.

Izi ndi zotsatira zenizeni za matenda ashuga zomwe makolo ayenera kudziwa ndipo akuyenera kuzilingalira ndi madokotala akamachiza. Mwana yemwe ali ndi matenda a shuga a mtundu woyamba amayenera kuwunikidwa kuti awone zovuta za ocular komanso aimpso.

Njira izi zitha kuyimitsa kukula kwa matenda. Koma chinthu chofunikira kwambiri ndikuyesetsa kuti shuga asakhale ndi malire .ads-mob-1

Lembani 1 ndi matenda ashuga 2: owopsa kwambiri ndi ati?

Komabe, matendawa amapangitsa munthu kuyambira ali wachinyamata kukhala ndi thanzi labwino.

Amayang'anira zakudya, amadzinyamula yekha ndikuwona mankhwalawa amathandizira ndi insulin. Mikhalidwe yonseyi imalola wodwalayo kukhala ndi moyo wathunthu, ndipo nthawi zambiri amakhala ndi thanzi labwino poyerekeza ndi anthu omwe alibe shuga.

Matenda a shuga a Type 2 ndi njira yomwe ikupanga pang'onopang'ono, yochokera ku zizolowezi zoyipa za munthu: kukonda zakudya zotsekemera, zamafuta ndi zopatsa mphamvu. Zonsezi zimabweretsa kunenepa kwambiri. Koma Zizindikiro zazikulu, monga polyuria, kumayambiriro kwa matendawa sizingakhale.

Nthawi zambiri, kuchepa thupi msanga kumayenderana ndi kugwiritsidwa ntchito moyenera kwa mankhwalawa pofuna kuchepetsa thupi, osaganizira kuti izi ndi zovuta za matenda ashuga. Zotsatira zake, wodwalayo amapita kwa dokotala mochedwa kwambiri, ndipo chithandizo nthawi zambiri chimatenga nthawi yayitali.

Matenda a shuga ndi achinyengo pa mtundu uliwonse wamavuto. Koma kusiyana pakati pa awiriwa ndikuti matenda osokoneza bongo omwe amadalira insulin amatha kupewedwa. Chofunikira ndi kuyesetsa kuchita izi.

Mawonekedwe a mankhwalawa a zovuta za shuga

Njira zochizira matenda ashuga zovuta zimaphatikizapo zinthu zitatu izi:

glycemic control (4.4-7 mmol / l) ndi mankhwala kapena jakisoni wa insulin,
Kubwezeretsa metabolic njira: makonzedwe a mtima kukonzekera ndi thioctic acid,
Chithandizo cha zovuta zokha. Chifukwa chake, retinopathy yoyambirira amathandizidwa ndi laser, ndipo ovuta kwambiri - vitrectomy. Mavitamini a B amawayikidwa kuti awononge mitsempha.

Wodwalayo ayenera kumvetsetsa kufunika kochita njira zonse zomwe wapangidwira ndikuti athe kudziimira pawokha magazi. Ichi ndiye chikhalidwe chofunikira kwambiri, kulephera kwake komwe kumabweretsa zovuta zazikulu. Ads-mob-2

Njira zopewera matenda ashuga

Kupewa kwa odwala matenda ashuga:

kuyang'anira kwamankhwala mosalekeza
glycemic control
udindo ndi kutsatira kwambiri zochitika zatsiku ndi tsiku: ndikofunikira kudziwa nthawi yakudzuka ndi kugona, osaphonya jakisoni maola, etc.,
masewera olimbitsa thupi,
ukhondo
Zakudya zamafuta ochepa
kulimbitsa chitetezo chokwanira: kudya, kuumitsa.

Zokhudza ngozi zomwe zimayambitsidwa ndi zovuta za shuga mu kanema:

Zachidziwikire, kuti simungathetse matenda ashuga ndi njira zomwe zalembedwa nokha, mufunika thandizo la mankhwala ndi njira zapadera. Koma kutsatira malingaliro awa ndikokwanira kuti tiletse kukula kwa matenda komanso kuti tisalole zovuta zina kuti zikuwonongere moyo.

Kuzindikira ndi kuchiza matenda a shuga a mtundu wachiwiri

Matenda a shuga ndi matenda osatha a endocrine system.

Mtundu wachiwiri wa matenda a shuga a mellitus (osadalira insulini) ndi matenda omwe amadziwika chifukwa chopanga michere m'thupi. Munthawi yabwinobwino, thupi la munthu limatulutsa insulini (mahomoni), omwe amasintha glucose m'maselo opangira tinthu tathupi tathupi.

Mu maellitus a shuga omwe amadalira insulin, maselo amenewa amatulutsidwa mothandizidwa kwambiri, koma insulini sogawa mphamvu molondola. Pankhaniyi, kapamba amayamba kudzipangira ndi kubwezera. Kuchuluka kwa chimbudzi kumachepetsa maselo amthupi, shuga yotsalayo imadziunjikira m'magazi, ndikupanga chisonyezo chachikulu cha matenda ashuga a 2 - hyperglycemia.

Kuzindikira ndi kuchiza matenda amitundu iwiri

Amathandizira mitundu yamavuto kwambiri m'chipinda choperekera odwala kwambiri, chifukwa paliwopseza kwambiri moyo wa wodwalayo.

Pansi pokhapokha, odwala omwe ali ndi zovuta zamatendawa, omwe amaphatikizidwa ndi mapangidwe a acidosis, amalumikizidwa ndi saline ndi insulin.

Mankhwala onse ochizira matenda amachitika mogwirizana ndi zomwe zimakhudzidwa mkati. Nephropathy imafuna kuwongolera zizindikiro zamagazi, intrarenal hemodynamics imakonzedwa. Ngati kulephera kwa impso kumayamba, ndiye kuti wodwalayo wavulazidwa ndi insulin, impso zimatsukidwa.

Chithandizo cha zovuta zili zotsatirazi:

Matendawa odwala matenda ashuga amatha kuthandizidwa ndimankhwala, komanso kulowererapo. Njira yoyamba ikuphatikiza kugwiritsa ntchito antiseptics, antibacterial therapy, kuvala nsapato zapadera. Pachiwonetsero chachiwiri, pakayamba kukula, ndiye kuti muchotse minofu yosavulaza.
Kuti muchepetse kuchuluka kwa shuga mthupi, jakisoni wa insulin amalimbikitsidwa, kapena mapiritsi amayikidwa kuti achepetse shuga la magazi.
Kuwongolera odwala omwe ali ndi mtima wamtundu wamatumbo sikusiyana ndi chikhalidwe chovomerezeka chovomerezeka.
Matenda a diabetesic polyneuropathy amathandizidwa mosiyanasiyana kuti wodwalayo akhale bwino. Gulu la vitamini B, ma immunomodulators amalembedwa.

Maziko a njira zodzitetezera ndikusunga shuga wamagazi mwa odwala pamlingo wofunikira. Kuti muchite izi, muyenera kumwa mankhwala, kutsatira zakudya zamafuta ochepa, ndikuwongolera kunenepa kwambiri.

Pofuna kupewa zovuta za matendawa, muyenera kupita kukaonana ndi dokotala pafupipafupi, kukayesa mayeso ofunika. Aspirin imapereka kufinya, komwe kumathandiza kupewa matenda amtima, mtima wam'mimba, stroko.

Amayang'aniridwa makamaka kumadera akumunsi kuti athe kuzindikira mabala, ming'alu ndi zilonda kumayambiriro. Ngati patapezeka zolakwika zazing'onoting'ono kwambiri pakhungu, ndikulimbikitsidwa kuti mupite kuchipatala msanga.

Kodi mukuganiza bwanji pamenepa? Kodi njira zodzitetezera zithandizanso kudziwitsa mavuto amtsogolo?

Chowopsa mawonekedwe

Matenda a polyneuropathy ndi ofala kwambiri a matenda a shuga 2. Mawonekedwe ake amaphatikizidwa ndi kuwonongeka kwa mitsempha ya zotumphukira ndi zotumphukira zamagetsi. Zizindikiro zimatsimikiziridwa ndi tsamba la zotupa.

Chofunikira kwambiri popewa zovuta za matenda ashuga ndikusunga shuga yanu (munthu) shuga. Monitor hemoglobin wa glycated kamodzi miyezi itatu. Chizindikirochi chikuwonetsa kuchuluka kwa shuga m'magazi atatu.

Ndikofunikira kumayesedwa ndi katswiri wazachipatala kamodzi pachaka.

Kusanthula kwamkodzo tsiku lililonse kwa mapuloteni ndi impso kuyenera kutengedwa miyezi isanu ndi umodzi iliyonse.

Popewa kukula kwamatenda am'mimba, njira ya kukonzekera kwa alpha-lipoic acid, ma antioxidants ndi anticoagulants kuchipatala cha tsiku kapena chipatala amafunikira.

Kupatula matenda a chithokomiro, kufunsa ndi endocrinologist ndi kuphunzira kuchuluka kwa mahomoni a chithokomiro ndikofunikira. Mu shuga mellitus wamtundu woyamba, autoimmune thyroiditis imakonda kukhazikika, ndipo m'magazi osadalira insulini, hypothyroidism imadziwika. Kuchepa kwa ntchito ya chithokomiro kungayambitse matenda a hypoglycemia.

Kanemayo munkhaniyi akupitiliza mutu wa mavuto a shuga.

Mosasamala mtundu wa shuga, matendawa amaphatikizidwa ndi kuwonjezeka kwa shuga m'magazi. Ngati insulin yokwanira kapena kuchepa kwa chidwi cha ziwopsezo kwa izo, amalimbikira komanso kwambiri hyperglycemia imayamba, yomwe imapezeka pakumayesedwa magazi.

Ngati izi zachitika mosalamulirika, mwayi wokhala ndi zovuta zotsatirazi ndi wapamwamba:

chiwopsezo cha matenda a mtima komanso sitiroko,
kuwonongeka kwa khoma la mtima ndi mawonekedwe a atherosulinosis,
matenda a chiwindi ndi impso,
kuwonongeka m'maso, mpaka khungu lathunthu,
zovuta zamitsempha
kusowa pogonana,
Zizindikiro za matenda a matenda ashuga mpaka gululi wazonse.

Pambuyo pakuzindikira, wodwalayo ayenera kuyesetsa kupewetsa zovuta. Izi zifunikira udindo waukulu ndikuwonetsetsa zinthu izi:

Matendawa zakudya. Kudyetsa chakudya ndi njira yofunika kwambiri yochepetsera shuga yanu yamagazi.Zakudya za anthu odwala matenda ashuga ayenera kukhala ndi maswiti ochepa, zakudya zopatsa mphamvu, zakudya zophika mkate. Muyeneranso kusiyiratu kumwa mowa. Ndikofunikanso kuti musamadye kwambiri komanso kudya zakudya zazing'ono 5-6 pa tsiku.
Kuchulukitsa kwa magalimoto. Kuchita zinthu zolimbitsa thupi kumathandizira kuti magazi azithamanga komanso kulimbikitsa kuchepa kwa shuga m'thupi.
Kutsatira kwambiri mankhwala. Pambuyo pakupezeka kwa matenda a shuga, dotolo amupatsa mankhwala. Chiwembuchi chikuphatikiza kumwa mankhwala angapo omwe amathandizira kupanga insulin, kukulitsa chidwi cha minofu, komanso kufulumizitsa kuthamanga kwa shuga. Ndikofunikira kuti muzitsatira mosamalitsa mankhwala omwe mumamwa ndikugwiritsanso ntchito mankhwala molingana ndi chiwembu chopangidwa ndi adokotala.
Magazi amawongolera. Kunyumba, ndikofunikira kukhala ndi kachipangizo (glucometer) kofotokozera msanga kuchuluka kwa shuga m'magazi. Izi zimapewera hyperglycemia ndikupanga njira zachangu zokulitsira shuga.
Zaukhondo. Chofunikira pa maphunziro a shuga ndikuchepetsa kuchira kwa mabala ndi kuvulala. Ndikofunika kuyang'anira ukhondo ndi kulondola pofuna kupewa matenda a bala. Malangizowa ndi othandizira makamaka pamapazi, chifukwa kuphatikizika kwa shuga ndi phazi la matenda ashuga.

Mutha kupeza zambiri mwatsatanetsatane popewa zovuta za matenda ashuga polumikizana ndi dipatimenti ya endocrinology ya Diana Medical Center.

Pangani nthawi yoonana ndi dokotala wa gynecologist kudzera pa foni 7 (812) 528-88-65, kuyitanitsa kuyimba foni kapena lembani fomu yolembetsera patsamba!

Mavuto a mtundu 1 wa shuga am'mimba amakhala pachimake ndipo amakula msanga. Nthawi zambiri, odwala matenda ashuga amafunika thandizo la dokotala.

1. Ketoacidosis - ndi dontho la insulin, matupi a ketone m'magazi ndi glucose owonjezera amapezeka. Ngati kuchepa kwa insulini sikulipilitsidwa panthawi, ndiye kuti ketoacidotic chikomokere mu nthawi yochepa.

2. Hyperosmolar chikomokere. Chomwe chimapangidwira ndikuwonjezera shuga. Maselo amataya madzi, madzi am'mimba amapezeka, ndipo popanda chithandizo mankhwalawa amatha kuchitika.

Ndi matenda 2 a shuga, matendawa amatha kusadziwika kwa zaka zambiri. Nthawi zambiri matendawa amapezeka mosayembekezereka, kwinaku akumayesa chifukwa china kapena pokhapokha panthawi yopezeka ndi zovuta.

Pofika mochedwa zovuta zimatanthawuza mawonetseredwe azachipatala omwe amapezeka zaka zingapo pambuyo poti matendawa atayamba. Mavuto otere, mwatsoka, posachedwa amapezeka pafupifupi mwa odwala onse, osatengera mtundu wa shuga.

Ndi matenda 2 a shuga, anthu ambiri amaphunzira za matenda awo pokhapokha atakumana ndi zovuta izi.

1. Angiopathy. Kusintha kwa mtima kumayambitsa matenda a mtima, kuthamanga kwa magazi, stroko, komanso thrombosis.

2. retinopathy. Kuphwanya kwamitsempha yamagazi m'matumbo amaso kumatha kuyambitsa khungu komanso khungu.

3. Nephropathy. Amakhala chomwe chimayambitsa matenda oopsa komanso kulephera kwaimpso.

4. Polyneuropathy. Kusintha kotupa ndi masoka m'thupi la mitsempha. Kumatanthauzanso kusiyiratu kumva komanso kuwoneka ngati ululu wopanda pake.

5. Mapangidwe a matenda ammimba a shuga. Chifukwa choti matenda ashuga amakhudza minyewa yam'mitsempha ndi ziwiya zazing'onoting'ono za miyendo, miyendo imalephera kumva, ndipo magazi amayenda. Wodwala matenda ashuga sangamve kuwonongeka, kutentha kumasintha, kuvala nsapato zomwe zimamukakamiza, etc.

Zotsatira zake, mafomu owonongeka omwe samachira kwa nthawi yayitali.Chifukwa cha kuperewera kwa metabolic, kusayenda bwino kwamagazi, mabala sangathenso kusintha msanga, ndipo "kutsekemera" kowonjezera magazi ndiye chakudya chabwino kwambiri cha tizilombo.

Kulowa ndi matenda kumachepetsa kuchira kwambiri. Zovala zimatha kufa kwathunthu. Mchitidwewo umafika poti munthu ayenera kudula zala kapena miyendo yonse.

Anthu odwala matenda ashuga amayenera kupita ku endocrinologist pafupipafupi ndikuyesa mayeso kuti awone momwe ziwalo zomwe akuwombera ziriri.

Ambiri a endocrinologists amakhulupirira kuti shuga ndi njira yapadera ya moyo. Kupewa kwamavuto kumakhala mu chakudya chapadera, kudya insulin kapena mankhwala pafupipafupi, komanso kuwunika kwamisempha tsiku lililonse.

Kutsatira kwambiri malamulo awa ndi komwe kungathandize kuti pasakhale zovuta. Ndi matenda a shuga, omwe amayamba chifukwa cha kunenepa kwambiri, ndikokwanira kuchepa thupi komanso kuchuluka kwa shuga kubwerera kwazonse.

(Adayang'ana nthawi 2 634, maulendo 1 lero)

Decryption mayeso pa intaneti - mkodzo, magazi, ambiri komanso zamankhwala osokoneza bongo.
Kodi mabakiteriya ndi ma inclusions amatanthauza chiyani mu urinalysis?
Mungamvetsetse bwanji kusanthula kwa mwana?

Mawonekedwe a kusanthula kwa MRI
Mayeso apadera, ECG ndi ultrasound
Mitundu pa nthawi yomwe muli ndi pakati komanso mfundo za zopatuka ..

Kuchotsera kwa kusanthula

Matenda a shuga ndi limodzi mwa matenda omwe ali pachiwopsezo cha kukula kwa zovuta. Matendawa ali ndi mndandanda waukulu wazotsatira zomwe zimakhudza ziwalo zosiyanasiyana za thupi.

Pambuyo pakutsimikizira matendawa, wodwalayo amakakamizika kukhazikitsa zakudya zatsopano zopatsa thanzi - kuwongolera zoyeserera zonse popewa zovuta.

Kuti muchepetse chiopsezo chokhala ndi vuto la matenda a shuga 1, ndikofunikira kuwongolera kuchuluka kwa shuga m'magazi ndikuyendera dokotala pafupipafupi kuti mumupime.

Komabe, anthu omwe ali ndi matenda amtundu woyamba ali pachiwopsezo chotenga zovuta zina. Komabe, ambiri mwa mavutowa amatha kupewedwa kapena kuthandizidwa mosamala ngati apezeka koyambirira.

Kuchiza kovutirapo kwa matenda ashuga kuyenera kuyambitsidwa mwachangu, atapezeka kuti ali ndi matenda, ndipo izi zimachepetsa chiopsezo cha zovuta ndikukulitsa thanzi.

Odwala osamala kwambiri amakhala ndi shuga omwe amakhala pafupi ndi nthawi zonse ngati amamwa jakisoni atatu a insulin tsiku lililonse, ndipo amayang'aniranso kuchuluka kwa shuga m'magazi awo pafupipafupi. Kuchiza kwambiri kumapangidwira kusunga glycated hemoglobin A1c (HbA1c), yomwe imawonetsa kuchuluka kwa glucose m'magazi kwa miyezi iwiri kapena itatu, pafupi kwambiri ngati momwe kungathekere.

1. Matenda a mtima ndi chithokomiro

Amadziwika kuti magawo awiri mwa atatu a anthu odwala matenda a shuga amamwalira ndi matenda a mtima kapena matenda ena amitsempha yamagazi. Amakhala pafupifupi kasanu mwina atakhala ndi stroke.

Odwala odwala matenda ashuga ayenera kulabadira kupewa matenda a mtima ndi chithokomiro. Zimaphatikizapo: kusiya kusuta, kusunga magazi moyenera komanso mafuta a m'magazi, kudya mafuta ochepa, kuchita masewera olimbitsa thupi nthawi zonse.

2. Matenda amaso

Anthu omwe ali ndi matenda a shuga ali pachiwopsezo chachikulu chotenga vuto lakumawona. Vuto lotchuka kwambiri ndi matenda ashuga retinopathy, omwe amayamba chifukwa cha kuwonongeka kwa mitsempha yamagazi yomwe imadyetsa mitsempha mu retina.

Retinopathy ndiye chifukwa chachikulu chakhungu la matenda ashuga. Amathandizidwa ndi opareshoni ya laser, koma amayenda bwino atangoyamba kumene.

Odwala onse omwe ali ndi matenda amtundu woyamba 1 amayenera kukayezetsa pachaka ndi a ophthalmologist.

Anthu omwe ali ndi matenda a shuga ali ndi chiopsezo chowonjezereka cha matenda amkati (kutsitsa ma mandala a maso) ndi glaucoma (kuthamanga kwa kuthamanga kwa madzi amkati amomwe amawononga mitsempha ya optic). Kafukufuku wamaso wapachaka amawulula matendawa. Ma Cataracts amawongolera modabwitsa, ndipo glaucoma amathandizidwa ndi mankhwala apadera.

3. Mphamvu yamanjenje

Mavuto amtunduwu, omwe amatchedwanso "pachimake", amabweretsa chiwopsezo ku moyo wa munthu. Amadziwika ndi kukula msanga, amatenga nthawi kuchokera maola angapo mpaka sabata.

Kunyalanyaza chithandizo chamankhwala kapena kuchipeza mosagwiritsa ntchito nthawi zambiri kumabweretsa imfa.

Mwa zovuta zambiri, ma comas omwe amayamba ndi matendawa amasiyanitsidwa. Ndi chikomokere amatanthauza mkhalidwe wa wodwala, momwe machitidwe onse aumunthu amachepetsedwa.

Munthawi imeneyi, zochitika za njirazi zimachepa, mawonekedwe amatsirizika, ntchito ya mtima, mtundu wake umasokonekera, ndikuvuta kupuma pakokha kumatheka.

Mtundu wachiwiri wa matenda ashuga, vuto lomwe kale limachitika ndi matenda ashuga a ketoacidosis, zomwe zimachitika chifukwa choti mafuta amawonongeka (matupi a ketone) amadziunjikira m'thupi la munthu.

Chomwe chimapangitsa kuti izi zichitike ndikulephera kutsatira zakudya zomwe dokotala amafunsa, kapena zimagona chifukwa chakuti mankhwalawa adayikidwa molakwika.

Matupi a Ketone amatha kupangitsa kuti minyewa ikhale yodetsa nkhawa, chifukwa chomwe munthu amasiya kudziwa. Ndipo muzovuta kwambiri, mumakhala chikomokere. Chizindikiro ndi fungo linalake kuchokera kumkamwa wamkamwa.

Mavuto am'mbuyomu kapena matenda a shuga a 2 amachitika chifukwa cha kuwonongeka kwa mitsempha. Kutengera kuphwanya magwiridwe antchito a chinthu china kapena dongosolo, pamakhala zovuta zingapo za matenda ashuga.

Matenda a chithokomiro ndi njira yotupa yomwe imachitika mu kapamba. Ndi pachimake, subacute, aakulu komanso autoimmune. Zizindikiro zazikulu ndikumverera kwa kupsinjika khosi, zovuta kumeza chakudya, ndikusintha kwa mawu.

Nephropathy ndi chifukwa cha kuwonongeka kwa impso. Poyerekeza ndi za m'matenda amtunduwu, mapuloteni amapezeka mumkodzo wa wodwalayo, kutupa kwa m'munsi kwambiri kukukulirakulira, zomwe zimachitika ngati matenda oopsa.

Matenda a shuga a retinopathy amatanthauza matenda ammaso. Malinga ndi ziwerengero, pafupifupi theka la odwala omwe ali ndi matenda a shuga a 2 amapezeka. Matendawa amakula chifukwa chakuti mitsempha yamagazi yaying'ono ya retina imawonongeka. Choyamba, kupenyerera kwamawonedwe kumachepa, ndipo mukanyalanyaza zinthu, khungu.

Matenda a shuga ndi monga amodzi mwa matenda ovuta. Komanso, si matenda omwewo omwe amayambitsa nkhawa, koma zovuta za matenda a shuga. Kukula kwa zovuta posachedwa kumatha ndi kulumala, nthawi yayitali komanso yovuta yomwe imayambitsa kulumala, ndikuchepetsa kosasangalatsa kwambiri m'moyo.

Zimayambitsa zovuta

Cholinga chachikulu cha zovuta zonse za matenda a shuga ndi kuchuluka kwa shuga m'thupi. Hyperglycemia yosalamulirika, kukulira kwa vuto la metabolic m'thupi kumapangitsa kukulitsa kwa matenda. Kuphatikiza apo, kuchuluka kwambiri kwa insulin m'magazi ndizowonongeka kwa zigawo zoonda zamitsempha yamagazi.

Ndi shuga ochulukirachulukira m'magazi, maselo amthupi amakhala ndi chimphepo champhamvu cha shuga, zomwe zimayambitsa zovuta za shuga.

Kuchiza ndi kupewa zovuta

Pambuyo pofotokoza zomwe zimayambitsa kukula kwa matenda, titha kupitiriza kufunsa momwe tingapewere matenda ashuga pokopa zomwe zimayambitsa matenda. Kuphatikizika konse kwa njira zodzitetezera kuli ndi zinthu izi.

Kupewa kwa matenda ashuga amtundu woyamba:

kupewa ndi kuperekera nthawi yake matenda a virus,
kusintha kwakhalidwe
kukana kumwa mowa ndi fodya,
kukonza zakudya
kuwunika pafupipafupi shuga m'magazi mukamayesedwa.

Kupewa kwa matenda ashuga a 2:

kutsika kwa kuchuluka kwa chakudya chamagulu ochulukirapo m'zakudya,
kuchuluka zolimbitsa thupi,
kulimbitsa thupi
kupezeka pafupipafupi kwa ziwerengero zamatenda a glycemic panthawi yoyesedwa kuchipatala.

Amayi oyembekezera nawonso amadwala matenda ashuga. Ndi osiyana mawonekedwe - gestational. Matenda amtunduwu ali ndi makina otukuka ofanana ndi mtundu 2 wa matenda. Ma cell a mkazi motsutsana ndi tsogolo lakubala mwana amataya chidwi chake ndi zomwe zimachitika mu timadzi ta m'mapapo.

Zofunika! Mwana akabadwa, matendawa amachoka paokha, koma mayiyo amakhala akumwa mankhwala a insulin nthawi yonse yoyembekezera kuti apewe zovuta.

Kupewera kwa matenda ashuga mwa abambo, amayi ndi ana kumaphatikizapo gawo la kukonza kwa menyu pawokha. Malamulo ochepa oyambira adzakuthandizani kuti mudziteteze ku matenda ashuga komanso okondedwa anu.

Zokonda Zonse za Mchere

Kafukufuku wazachipatala awonetsa kuti zopangidwa ndi tirigu wathunthu zimachepetsa chiopsezo cha matenda, pomwe zopatsa zam'thupi, m'malo mwake, zimachulukitsa kangapo. Mbewu zonse zimapangidwa ndi mitundu yophatika ya chakudya - mafuta omwewo, koma omwe ali m'gulu la "zovuta".

Ma saccharides ovuta amapakidwa kwa nthawi yayitali m'matumbo am'mimba ndikuwonjezera shuga pang'onopang'ono mukatha kudya. Komanso, malonda awa amakhala ndi manambala ocheperako a glycemic, zomwe ndizofunikira kuziganizira mukamapanga menyu.

Mbewu zonse zimakhala ndi mavitamini ambiri, kufufuza zinthu, phytochemicals, zomwe ndizofunikira ngati kupewa kwachiwiri kwa matenda ashuga kuchitika. Tikulankhula za anthu omwe ali kale ndi matendawa, koma akuyesera kuti ateteze kudutsa kwake komanso kukula kwa zovuta.

Zofunika! Pewani kugwiritsa ntchito zinthu zomwe mwazikidwa ndi ufa wa tirigu wapamwamba kwambiri komanso woyamba, ufa wa mitundu yatsopano ya mpunga.

Kukana zakumwa zotsekemera

Kukana zakumwa zoledzeretsa kungakuthandizeni kupewa matenda ashuga. Amakhala ndi index yayikulu ya glycemic. Kuphatikiza apo, kafukufuku wazachipatala awonetsa kuti zoyipa zakumwa zakumwa motere:

kulemera kwa thupi kumachuluka
matenda opatsirana amakula,
triglycerides ndi "zoyipa" cholesterol zochuluka
kudziwa kwa maselo ndi minyewa pakuchitapo kanthu ka insulin kumachepa.

Kuphatikizidwa kwa mafuta "abwino" muzakudya

Ponena za mafuta "abwino", tikutanthauza gulu lawo la polyunsaturated. Zinthu izi zimachepetsa cholesterol m'mwazi, zimathandizira kupewa kukula kwa matenda a mtima. Mafuta abwino amapezeka mu:

nsomba
mtedza
nyemba
nyongolosi ya oats ndi tirigu,
mafuta a masamba.

Sankhani zina mwazogulitsa

Pofuna kuti musadwale ndi matenda ashuga, m'khitchini ya anthu omwe ali ndi vuto la matenda, payenera kukhala ndi mndandanda wokhala ndi mndandanda wazinthu zololedwa ndi zomwe ziyenera kukhala zochepa. Maziko azakudya ndi:

supu zamasamba
nyama zamafuta ochepa, nsomba,
mazira
zopangidwa mkaka,
phala
masamba ndi zipatso.

Kukana kapena kuletsa kumwa kumathandiza kupewa matenda ashuga:

nyama yamafuta ndi nsomba,
chakudya zamzitini
mankhwala osuta
masoseji
maswiti
mafupa.

Zolemba za matendawa

Chofunikira kwambiri cha 1st mtundu ndikuti matendawa amakhudza achinyamata. Kukula kwake kumapezeka mwa achinyamata osakwana zaka 30. Ndikotheka kudziwa kudalira kwa insulin kumayambiriro kwa chitukuko cha matendawa poyesa kuchuluka kwa shuga m'magazi oyenda.

Matenda a shuga a Type 1 ndi njira yatsamba yomwe imafunikira kukakamizidwa kuchipatala. Momwe chofunikira cha matendawa ndicho kuwonongeka kwa maselo a endocrine omwe ali ndi chikhalidwe chachikulu cha kapamba. Miyezo ya insulin ikamatsikira mpaka pamlingo wovuta, kusagwira ntchito komwe kuli ndi chiopsezo cha zovuta zazikulu.

Kuzindikira kwa shuga - ingomwani tsiku lililonse.

Zotsatira za kusachiza matenda amtundu 1 shuga

Kuperewera kwa chithandizo chamankhwala panthawi yake chifukwa chodalira insulin kumatha kubweretsa mavuto, kuyambira zotupa za ziwalo zofunika ndikumatha ndi chikomokere chotsatira imfa.

Nthawi yomweyo, ndikofunikira kumvetsetsa kuti matenda ashuga si chilango cha kupha, chinthu chachikulu ndikupezeka kwa dokotala panthawi yake.

Momwe mungachepetse chiopsezo cha zovuta

Moyo wautali wokhala ndi matenda amtundu woyamba amakhala enieni, malinga ndi malamulo otsatirawa omwe amachepetsa zovuta:

luso la insulin mankhwala,
kusintha kwa zakudya
Moyo wathanzi komanso kusiya zizolowezi zoyipa,
magulu olimbitsa thupi.

Wodwala wa 1st akhoza kukhala ndi moyo mpaka kukalamba, malinga ndi malamulowa.

Chithandizo cha matenda ovuta a shuga chimaphatikizaponso zinthu izi:

ndikofunikira kubwezeretsa kagayidwe kachakudya pakumwa mankhwala kuti musunge mtsempha wamagazi,
kuyang'anira pafupipafupi mankhwala a glycemia,
kuvomerezedwa chithandizo cha zovuta palokha, kutengera ndi omwe akhudzidwa.