Shuga 22 m'magazi zotsatila zake

Matenda a shuga ndi matenda omwe amadziwika ndi matenda osachiritsika ndipo amafunikira kuwunikira nthawi zonse kuti muchepetse zovuta zomwe zingayambike. Kuwongolera kumachitika ndikumwa mankhwala, insulin, zakudya.

Ngati mukupatuka pa moyo womwe mwalimbikitsa, musamwe mankhwalawo nthawi yake kapena musamamwe jakisoni, ndiye kuti pali kuwonjezeka kwa glucose mthupi la munthu, thanzi lanu likuipiraipira, ndipo chiopsezo cha chikomokere chikukula.

Mwazi wamagazi ukakhala ndi zaka 22, zotsatira zake zimakhala zosayembekezereka kwambiri. Ngati simuletsa ntchito yowonjezera glucose munthawi yake, ndiye kuti izi zingayambitse kukula kwa matenda a shuga, ketoacidosis, kulemala, ngakhale kufa.

Matenda a shuga angayambitse zotsatira zoyambirira komanso mochedwa za vuto linalake, zina zomwe sizingasinthe. Chifukwa chake, ndikofunikira kulingalira zovuta zingapo za matenda, ndikupeza momwe mungathanirane nawo.

Shuga wopitilira 22 units: zovuta pachimake

Matenda a shuga ndi matenda opatsirana, omwe amadziwika ndi kuphwanya kwa shuga m'thupi. Mitundu yodziwika bwino ya shuga ndi yoyamba komanso yachiwiri.

Muzochita zachipatala, pali mitundu ya matenda a shuga, monga Lada ndi Modi shuga, koma ndi osowa. Mwina pa chifukwa choti nthawi zambiri pamakhala zolakwika pakuzindikira kwawo.

Choopsa chachikulu komanso chowopsa ndichomwe chimayambitsa matenda oyamba. Chowonadi ndi chakuti izi ndizovuta zomwe zimawopseza moyo wa wodwalayo.

Ganizirani zovuta zamatenda a shuga:

Mwazi wamagazi wopitilira mayunitsi 22 ungayambitse kukula kwa ketoacidosis. Ndipo mkhalidwe wamtunduwu ndi chotsatira cha kuchuluka kwa zinthu za metabolic m'thupi. Nthawi zambiri amapezeka mu mtundu wa 1 odwala matenda ashuga.
Hyperglycemic mkhalidwe - kuchuluka kwa shuga m'magazi, pamwambapa omwe amadwala matenda ashuga. Vutoli limapezeka kawirikawiri kwa okalamba omwe ali ndi matenda a shuga a 2.
Mkhalidwe wa hypoglycemic umadziwika ndi kuchepa kwambiri kwa shuga mu thupi. Dzikoli lili ndi mitundu iwiri ya odwala matenda ashuga. Zifukwa: Mlingo wolakwika wa insulin, mankhwala.
Lactacidic coma imadziwika ndi kudzikundikira kwa lactic acid m'thupi la munthu. Milandu yambiri imawonedwa mwa anthu odwala matenda ashuga atatha zaka 50.

Ziyenera kunenedwa kuti mtundu wovuta wa zovuta m'matendawa umadziwoneka mu chithunzi chimodzi cha matenda, onse akulu ndi odwala ochepa. Matenda aliwonse owopsa amatha kuchitika mwadzidzidzi, kupita patsogolo mofulumira, kupita koopsa patatha maola ochepa.

Ngati thanzi lanu layamba kufooka kwambiri, zizindikiro zomwe tafotokozazi zikuzindikiridwa, ndikulimbikitsidwa kuti mupite kuchipatala msanga.

Mavuto aakulu chifukwa cha shuga

Ngati zovuta zopezeka ndi matenda osachiritsika zimatha kukhala mwadzidzidzi, chifukwa cha momwe thupi limakhalira pakukula kwambiri kwa kuchuluka kwa shuga m'thupi, ndiye kuti sizili choncho pamavuto osakhazikika.

Wodwala akakhala ndi shuga wambiri, yemwe amasintha kuchokera ku 15 mpaka 22, vutoli silimatha popanda kufufuza.

Kuchuluka kwa shuga kwa nthawi yayitali kumakhudza ziwalo zonse zamkati ndi machitidwe, kusokoneza kwambiri magwiridwe ake. Komabe, ziwalo zolimbana ndizowonongeka. Awa ndi impso, maso, ubongo.

Matenda a shuga:

Matenda a shuga a retinopathy ndi ena omwe amachitika chifukwa cha kuchuluka kwa shuga. Zochita zachipatala zimawonetsa kuti amapezeka pafupifupi 90% ya odwala. Matendawa amakhudza ziwiya za m'mimba, zomwe zimapangitsa kuti azitha kuona. Kunyalanyaza vutoli kumabweretsa khungu.
Nephropathy ndikuphwanya kovuta kwa magwiridwe antchito a impso. Amayamba chifukwa cha zovuta zomwe zimabweretsa mkati mwa ziwalo zowola zam'mimba ndi zam'mimba, zomwe zimapangidwa motsutsana ndi maziko a matenda okoma. Ziwerengero zimati kuchuluka kwa mavutowa ndi 75%.
Neuropathy - kuphwanya mafupa am'mitsempha yam'mphepete, kumachitika pafupifupi pachikondwerero chilichonse. Magawo osiyanasiyana amkati amanjenje amatha kukhala nawo pantchito yosokoneza. Ndizovuta izi zomwe zimatha kufalikira, chifukwa chomwe phazi la matenda ashuga limayamba.
Encephalopathy imadziwika ndi kuphwanya kwapang'onopang'ono kwa magwiridwe antchito a ubongo, chifukwa cha zovuta zoyipa zamavuto am'mthupi.

Zilonda pakhungu ndi shuga. Zotsatira zamtundu woyipa zimawoneka ngati kusintha kwamachitidwe mu epermermis. Mawonekedwe: kuzungulira kwa kutukuka kosiyanasiyana, mawanga amisinkhu, mawonekedwe abwinobwino.

Matenda a shuga. Izi ndizovuta kusintha kwa anatomical ndikugwira ntchito komwe kumachitika mu 30-40% ya anthu odwala matenda ashuga. Pathology imadziwoneka ngati mawanga pakhungu, zilonda zam'munsi, phazi, phalanges zala.

Phazi la matenda ashuga limafunikira kuchipatala msanga. Kuperewera kwa chithandizo chokwanira kumayambitsa matenda am'miyendo, chifukwa, kumadula kumachitika kuti apulumutse moyo wa wodwalayo.

Matenda a shuga enieniwo sawopseza moyo wa wodwalayo, zomwe sizinganenedwe pazovuta zina. Ichi ndichifukwa chake ndikofunikira kwambiri kulipirira matendawa, ndikuwonetsetsa shuga ya magazi nthawi zonse.

Mavuto obwera chifukwa cha matenda ashuga

Zotsatira zoyipa zomwe zimachitika chifukwa cha matenda osatha a shuga zimaphatikizira kuphwanya magwiridwe antchito am'thupi ndi machitidwe amthupi la munthu. Monga lamulo, mitsempha yamagazi ndi mathero amanjenje zimakhudzidwa koyamba.

Makoma otupa amitsempha yamagazi amakhala olimba, amachepetsa mphamvu komanso amakhala olimba mtima, amakhala ndi fragility yayitali, motero, amatha kuvulala mwachangu komanso mosavuta. Poona izi, kutulutsa magazi pang'ono kumawonedwa.

Pamalo omwe magazi amkamwa amatumphukira kwakanthawi, kwakanthawi, mawonekedwe a minofu yolumikizana. Zotsatira zakukulaku, mitsempha yamagazi imakhala yolimba, kuzindikira kwawo kumachepa, chifukwa chake, kuperewera kwa michere kumapezeka.

Popeza mitsempha yamagazi ndi mathero amanjenje zilipo mu chiwalo chilichonse chamkati, zitha kunenedwa kuti matenda a shuga amachititsa kuti thupi lonse lizigwira ntchito.

Matenda a shuga amatha kutsogolera ku angioretinopathy, chifukwa cha momwe zida zowonekera zimakhudzidwira. Njira yokhayo yothandizira kupewa izi ndi kubwezera kwakanthawi komanso kwakanthawi matenda a shuga.

Matenda okhalitsa amakhudza miyendo yam'munsi. Monga chiwalo chilichonse, mitsempha yamagazi ndi mathero amanjenje zimayamba kukhudzidwa. Kutengera ndi zomwe zakuphwanya, zovuta zimasiyanitsidwa:

Angiopathic complication, pamene mitsempha yamagazi imakhudzidwa kwambiri.
Neuropathic complication, pamene mitsempha imakhudzidwa kwambiri.
Mtundu wosakanikirana wa kuwonongeka kwa miyendo.

Tiyenera kudziwa kuti njira yayitali ya matenda a shuga imayambitsa kuphwanya mphamvu zam'munsi, ndipo amayamba kugonja ndi zinthu zakunja. Zotsatira zake, zikanga zazing'ono, ming'alu ndi zowonongeka zina pakhungu sizimadziwika.

Mtsogolomo, matenda opatsirana amatha kulumikizana ndi mabala kumtunda, mabala samachiritsa kwa nthawi yayitali, zomwe zimapangitsa kuti pakhale zovuta pa zotsatirapo zonse.

Ketoacidosis mu shuga

Ketoacidosis mu milandu yambiri imawonedwa mwa odwala omwe ali ndi matenda oyamba. Mkhalidwe wamtunduwu umadziwika ndi kuphwanya njira za metabolic, zomwe zimakwiya chifukwa chosowa insulini.

Ngati wodwala ali ndi glucose pafupifupi mayunitsi 22, ndiye kuti mwina, limodzi ndi shuga wambiri, matupi a ketone adzawonetsedwa mu mkodzo, ndipo acidity yamadzi yotulutsa (magazi) idzachuluka.

Vutoli limakula m'magawo angapo. Choyamba, mu mkodzo, kudzera mu mayeso a labotale, shuga amadziwika (nthawi zambiri sayenera kukhala). Pambuyo pa zochita za kagayidwe kachakudya umaonedwa, zizindikiro za poyizoni wa thupi zimapezeka.

Zizindikiro za matenda am'thupi:

Kuzindikira kwa thanzi labwino.
Kutaya chikumbumtima.
Kuperewera kwa mawonekedwe.
Stupor.

Ngati palibe chomwe chikuchitika pamlingo wa chizindikiro ichi, ndiye kuti wodwalayo ali ndi boma labwino. Ndipo gawo lomaliza ndi chikomokere. Pomaliza, pamene matenda ashuga a ketoacidosis amakula, pamakhala kulakwika kwa pafupifupi ziwalo zonse zamkati, njira za metabolic m'thupi zimasokonezeka kwathunthu.

Zomwe zimayambitsa zovuta ndi izi: kuphwanya zakudya, kumwa mankhwala. Kudzilowetsa m'malo amodzi ndi mankhwala ena, kuchuluka / kuchepa kwa mulingo wa mankhwalawa.

Dziwani kuti ketoacidosis imatha kupezeka pambuyo pa kusiya mankhwala ochepetsa shuga.

Hyperosmolar chikomokoma - zovuta za matenda ashuga

Hyperosmolar coma imasiyana ndi mitundu ina ya chikomocho pazizindikiro zake. Potengera momwe izi zidakhalira, kuwonjezereka kwa sodiumamu yokhala ndi shuga m'thupi la odwala matenda ashuga kumadziwika. Zotsatira za "izi", vuto la zoperewera zimachitika pama cellular. Ndipo izi zimayambitsa kusokonezeka kwa ziwalo zamkati, kuphatikizapo ubongo.

Mwambiri, mtundu wankhwawa umapezeka mwa anthu okalamba. Pachigawo choyambirira cha matenda, kuchepa kwa thupi, kusowa kwa timadzi timadziwika.

Kutalika kwa madzi kwakhungu kumayambitsa kukula kwa ziwonetsero zachiwiri: kusokonezeka kwa m'mimba ndi kugaya kwam'mimba, kutsutsana ndi mseru komanso kusanza, kuphwanya magwiridwe antchito amkati.

Vutoli limayenda pang'onopang'ono, ndikupanga sabata zingapo. Poyamba, zizindikiro zotsatirazi zimawonekera:

Udzu wokhazikika.
Kuchepetsa thupi.
Kuchulukana mobwerezabwereza.
Kutalika kwakanthawi kwamiyendo.

Ngati palibe chomwe chimachitika pamlingo wazizindikiro zoterezi, ndiye kuti zovuta zake zimayamba kupita mwachangu. Wodwalayo amasiya kuzindikira, kenako amakomoka.

Chithandizo cha zovuta izi ndi njira yovuta yochizira, yomwe imaphatikizapo kumwa mankhwala, kuthana ndi mavuto.

Cholinga sikuti kungochepetsa zizindikirozo, komanso kuchotsa zomwe zinayambitsa.

Nephropathy monga chifukwa cha matenda ashuga

Matenda a shuga a nephropathy amakhala ndi vuto laimpso, zomwe zimapangitsa kuti impso iziperewera. Monga lamulo, matenda amtunduwu amapezeka mu 80% ya odwala omwe adwala matenda ashuga kwa zaka zoposa 10.

Tiyenera kudziwa kuti kuphatikiza pamenepa ndiwopseza kwambiri moyo wa wodwala wodwala matenda ashuga. Kafukufuku akuwonetsa kuti ndi mtundu woyamba wa matenda ashuga, matenda awa ndi omwe akuchititsa imfa.

Matenda a shuga a nephropathy amakhala m'magawo atatu. Gawo loyamba limadziwika ndi kukhalapo kwa mapuloteni ochepa mumkodzo. Mu gawo lachiwiri, kuchuluka kwa mapuloteni kumawonjezeka. Gawo lachitatu ndi kulephera kwa impso.

Chithandizo cha matenda ashuga nephropathy ndi motere:

Kumwa mankhwala omwe amachepetsa kuthamanga kwa magazi.
Lamula mapiritsi kuti magazi azisintha mu impso.
Zakudya zaumoyo.
Kukhazikitsidwa kwa insulin.

Kuchepetsa mwayi wokhala ndi zovuta zambiri, kungoyang'anira matenda ashuga kokha ndi komwe kungakuthandizeni. Zimaphatikizapo kutsatira malingaliro onse a dotolo - uwu ndi mankhwala ochizira matenda a shuga komanso zolimbitsa thupi zolimbitsa thupi.

Kuti mupewe mavuto, muyenera kusamala ndi zomwe muli nazo, osanyalanyaza zizindikiro zomwe zimawonekera mukadwala. Kufikira dokotala moyenera kumathandizira kuti ayambe kulandira chithandizo chokwanira, ndipo nthawi zina umapulumutsa

Mu kanema munkhaniyi, njira zochizira wowerengeka zamagazi zimaperekedwa.

Sonyezani shuga yanu kapena sankhani jenda kuti muyimikize.

Zomwe Zimayambitsa Madzi Akuluakulu a shuga

Pali njira ziwiri zopangira hyperglycemia: wamkulu (wogwira ntchito) ndi wowongolera. Executive njira za chitukuko (zolephera mwachindunji mu njira ya kagayidwe kazakudya):

Alimentary hyperglycemia imayamba ndi mafuta ochulukirapo kuchokera ku chakudya, imakhala yochepa (yochepa) komanso yokhazikika (nthawi zambiri imawonedwa ndi bulimia),
glycogenolysis yolimbikitsidwa ndikuphwanya glycogen - chakudya chopatsa mphamvu chopangidwa kuchokera ku glucose yowonjezera kuti usungidwe kena mthupi,
kuletsa kutembenuka kwa shuga wambiri kukhala glycogen (glycogeneis),
kuchuluka kwa mashuga omwe amapezeka m'mipweya yopanda shuga, makamaka kuchokera ku lipids ndi glucogenic amino acid (kuchuluka kwa gluconeogeneis),
shuga yayamba kuchepetsedwa ndi minofu,
chopinga wa glycolysis - shuga kuphwanya njira,
kuwonongeka mu kuwonongeka kwa chakudya zamagulu ochulukitsa kuchokera mthupi, makamaka ndi kuwonjezeredwa kwa mphamvu yake m'mitsempha yaimpso kapena chifukwa chosakwanira kusefedwa kwazomwe zimagwira mu mawonekedwe a impso.

Malamulowa njira chitukuko cha hyperglycemia (zolephera mu mantha dongosolo):

kukhumudwa kwa chapakati mantha dongosolo, makamaka malo achifundo,
kuchuluka kwa ntchito ya mtima wamanjenje, yomwe imayendetsa njira zonse mthupi (kuphatikizapo kagayidwe kachakudya) pantchito ya parasympathetic mantha dongosolo, yomwe imayang'anira ntchito ya ziwalo zamkati pakupuma,
kutsegula kwa dongosolo la chisoni.
kuchuluka kwachulukidwe kapenanso kuchuluka kowonjezera kwamahomoni olimbana (omwe amawoneka m'matenda osiyanasiyana a endocrine system), momwe thupi limayang'anizirana mwachindunji ndi insulin, ndiye kuti, amathandizira pakuwonjezera shuga.
zoletsa kupanga kapena kuchepa kwa mankhwala a insulin.

Kuperewera kwa insulini kungakhale mwa mitundu iwiri yoyambira - pancreatic kapena extrapancreatic. Pancreatic insulin akusowa chifukwa cha mitundu yambiri ya kapamba yomwe imakhudza kupanga kwa insulin kapena kapangidwe kake ka mankhwala:

kutupa
kuvulala ndi zotupa m'matumbo a chiwalo,
chifuwa chachikulu ndi ma syphilitic,
autoimmune lesion,
machitidwe a hypoxic omwe amapanga ma cell a isanger a Langerhans chifukwa cha kuphipha kapena atherosulinosis yamitsempha yamagazi, yomwe imayambitsa kuchepa kwa kupanga kwa insulin komanso kusintha kwa mankhwala ake.
kusokonekera kwa ntchito ya glyco-receptors - maselo apadera omwe ali ndi chidwi ndi kusintha kwa shuga wamagazi,
kuwonongeka kwa zida zamagetsi zomwe zimapangidwa ndi kapamba chifukwa chakuti kwakanthawi yayitali imagwira ntchito molingana ndi kuthekera kwake chifukwa chomwa mafuta ochulukirapo,
cholowa cholowa m'malo a insulin, zomwe zimachepetsa kupanga insulini.

Matenda ndi machitidwe omwe hyperglycemia imawonekera

Shuga wamagazi okwera limodzi ndi matenda otsatirawa:

matenda a endocrine matenda - matenda a shuga, chithokomiro,
bulimia
matenda a chiwindi (makamaka hemochromatosis),
njira zopatsirana kwambiri
matenda a pituitary, mwachitsanzo, matenda a Itsenko-Cushing ndi acromegaly,
zotupa za ubongo wosanjikiza kapena adrenal cortex (mwachitsanzo pheochromocytoma),
kukula kwa adrenal cortical syndrome,
kuwonongeka kwa diencephalic dera laubongo (ndi ma syphilis apamwamba, zotupa, matenda oopsa).

Mwazi wamwazi umakwezedwa kwakanthawi pazinthu zotsatirazi:

kumwa kwambiri chakudya chamafuta ambiri
kupsinjika kwa malingaliro
kupweteka
pachimake myocardial infaration,
khunyu
amayaka
kuvulala kwamitsempha kwa ubongo komwe kumakhudza hypothalamus,
chiwindi
moyo wongokhala komanso wonenepa kwambiri,
zolimbitsa thupi,
kusuta
mimba

Mankhwala omwe amachititsa shuga wa magazi kwakanthawi:

thiazide okodzeya,
ma steroid (mankhwala amakonzekera) ndi mahomoni a steroid (glucocorticoids), komanso adrenaline ndi chithokomiro.
kulera kwamlomo
mankhwala a psychotropic.

Zizindikiro za Mafuta Aakulu

Kuphatikiza pa zomwe zimayambitsa matendawa, hyperglycemia ili ndi zizindikiro zake:

ludzu losalekeza
kamwa yowuma
Kuuma ndi kuyabwa kwa pakhungu ndi mucous nembanemba (kuphatikizira maliseche ndipo, chifukwa chake, matenda amkhungu ndi zotupa pa zotupa za mucous, makamaka matenda amkazi),
polyuria - kukodza pafupipafupi,
nocturia - kukodza usiku,
kuwonda kapena mosiyanitsa - kuchuluka kwa thupi,
chizungulire, kupweteka mutu,
kuwonongeka kwamawonekedwe ndi kuchepa kwakachepa kwake,
kuthamanga kwa magazi ndi mavuto ena a mtima
kuchiritsa koyipa kwamikwingwirima ndi mabala (njira zomwe zachedwa kusinthika),
kufooka kwapafupipafupi, kutopa kwambiri, kufooka, kuchepa mphamvu komanso kugona.
njala yosalekeza
minofu yamatumbo
pafupipafupi matenda opatsirana.

Zotsatira za hyperglycemia wautali

Ngati shuga wambiri amakhala m'magazi kwa nthawi yayitali, machitidwe onse a thupi amayamba kuvutika. Koma pali ziwalo zomwe cholinga chake chimakhudzidwa makamaka ndi hyperglycemia:

Maso. Kukhalitsa kwa glycemia kungayambitse kuyambiranso, pambuyo pake kumachitika ndipo khungu limayamba.
Impso. Chiwalo chachikulu chomwe chimachotsa glucose wambiri m'thupi. Popita nthawi, impso zimaleka kuthana ndi ntchito yawo, kuthekera kwazomwe zimasefukira. Mapuloteni, maselo ofiira am'magazi, ndi zinthu zina zofunika pakugwira bwino ntchito zimayamba kuchotsedwa m'thupi ndi mkodzo. Kulephera kwamkati kumayamba.
Miyendo Yotsika. Kuwonongeka kwa kufalikira kwa magazi ndi mkhalidwe wamakoma amitsempha yamagazi kumayambitsa khungu louma, kusowa bwino kwa minofu ndikuwonongeka pakukonzanso kwawo. Zovulala zazing'ono zimachiritsa pang'onopang'ono. Ndi kuchuluka kosalekeza kwa shuga pakapita nthawi, njira yosasintha imatha - gangrene (minofu necrosis).

Hyperglycemia, ngakhale imakhala yochepa, nthawi zambiri chimakhala chizindikiro choyamba chakuti kulephera kwachitika m'thupi. Ngakhale palibe matenda pakadali pano, muyenera kuganizira za zifukwa zomwe zidawonjezera kuchuluka kwa shuga m'magazi, ndipo choyamba sinthani zakudya zanu ndi regimen.

Ngati shuga wamagazi achoka pa 19 mpaka 19,9: muyenera kuchita chiyani?

Ngati magazi a shuga 19, muyenera kuchita chiyani? Funso silothandiza, ndipo moyo wa munthu wodwala matenda ashuga umadalira yankho lake, popeza kuchuluka kwakukula kwa glucose kumalepheretsa kugwira ntchito kwa thupi lonse lathunthu, kumayambitsa chitukuko cha zovuta komanso zovuta.

Matenda a shuga ndi njira ya endocrine yomwe imayamba chifukwa chophwanya shuga m'magazi m'thupi motsutsana ndi kusowa kwathunthu kwa mahomoni m'thupi - insulin.

Zonsezi zimabweretsa boma la hyperglycemic, lomwe limadziwika ndi kuwonjezereka kosalekeza kwa kuchuluka kwa shuga mthupi la munthu. Matendawa ndi osakhazikika mwachilengedwe, zomwe zimayambitsa kuphwanya chakudya, mafuta, mapuloteni, madzi ndi metabolism yamchere.

Kodi shuga itayima pamagawo 19, izi zikutanthauza chiyani? Zomwe zimayambitsa kuwonjezeka kwa shuga wamagazi ziyenera kulingaliridwa. Komanso kuti mudziwe zotsatira zomwe boma la hyperglycemic limabweretsa?

Magawo a shuga 19, izi zikutanthauza chiyani?

Ngati shuga akwera mpaka 19 mmol / l, izi zikuwonetsa kuthekera kwakukulu kokhala ndi zovuta zapakhosi monga ketoacidotic kapena lactacidic coma, pomwepo imatha kuyambitsa mavuto osasintha mu thupi, chifukwa, kulumala kapena kufa sikungathetsedwe.

Zinthu zokhala ndi shuga mthupi la munthu zikachuluka, zimalimbikitsidwa nthawi yomweyo kukaonana ndi dokotala, komanso kusintha menyu. Ndi mwayi waukulu kwambiri, titha kuganiza kuti vuto la kuchuluka kwa shuga ndi kudya kosayenera.

Zakudya zamafuta ochepa, zomwe zimaphatikizapo zakudya zamafuta ochepa othamanga, mafuta owuma, opangidwa ndi mavitamini, mchere ndi fiber, zimathandizira kuchepetsa magazi.

Shuga yamayunitsi 19 ikuwonetsa kuti wodwalayo ali pachiwopsezo chachikulu ngati vutolo silinyalanyazidwa ndipo chithandizo choyenera sichiyamba munthawi. Pakhoza kukhala zotsatirazi zowopsa:

Lactacidotic chikomokere. Pakakhudzidwa kwambiri lactic acid mthupi la munthu, izi zimapangitsa kuti munthu asokonezeke maganizo, zimavuta kupuma, ndipo kuthamanga kwa magazi kumatsika kwambiri.
Ketoacidosis ndi mkhalidwe wamavuto chifukwa cha momwe matupi a ketone amadziunjikira m'thupi la munthu. Nthawi zambiri matendawa amapezeka ndi mtundu woyamba wa matenda a shuga, pamakhala chiopsezo cha kusowa kwa ziwalo zambiri zamkati.
Hyperosmolar coma imachitika chifukwa cha kuchuluka kwa glucose, motsutsana ndi izi, kuchuluka kwa sodium m'magazi. Mwambiri, imawonedwa ndi matenda a shuga 2 mwa anthu atatha zaka 50.

Mafuta owopsa amakhala oopsa, chifukwa amadzala ndi zovuta kwambiri zomwe zimatha kupezeka patangopita maola ochepa. Kuphatikiza apo, kuthamanga kwa shuga m'magazi kumabweretsa chifukwa chakuti zovuta zovuta zimayamba msanga. Ndizovuta kwambiri ndipo ndizosatheka kuti muchepetse kuwerenga kwa glucose.

Ndipo zoyesayesa pawokha sizitulutsa zotsatira, zinthu zidzaipiraipira, zomwe zingayambitse kudwala kwa wodwalayo.

Shuga amadzuka: zoyambitsa ndi zina

Zachidziwikire, shuga m'thupi la munthu siwokhazikika, nthawi zambiri zimasiyanasiyana masana. Mwachitsanzo, mukatha kudya, mutatha kuchita masewera olimbitsa thupi, panthawi yovuta komanso yamanjenje.

Ngati mwa munthu wathanzi kuchuluka kwake sikumayambitsa zovuta, pomwe shuga amawonjezeka ndimayunitsi ochepa, kenako amachepetsa mwachangu, ndiye kuti wodwala matenda ashuga ali chimodzimodzi.

Mwa anthu omwe akudwala matenda a shuga a 2, kuwonjezeka kwa shuga kumayambitsa kuwoneka kwa zinthu zoipa, zomwe zikuipiraipira thanzi lonse. Kuphatikiza apo, kutsitsa shuga sikuvuta konse.

Tikuwonetsa zina mwazomwe zimatsogolera kudumpha kwa glucose:

Zakudya zambiri zamafuta. Pambuyo podya, shuga amatuluka kwambiri, monga chakudya chimakonzedwa ndipo glucose, yemwe amabwera ndi chakudya, amalowa m'magazi.
Khalidwe labwino. Kuchita kumawonetsa kuti zolimbitsa thupi zilizonse zimapereka kuchuluka kwa shuga m'mimba.
Kutengeka mtima. Pakupsinjika kwambiri kapena kuda nkhawa, kudumpha kuzizindikiro za glucose kumapezeka.
Kumwa mowa, kusuta.
Kusintha kwa mahomoni azimayi pa nthawi yoyembekezera, kusintha kwa thupi kapena mtundu wina wa matenda.

Zomwe zalembedwa pamwambapa ndi zinthu zakunja zomwe zingakhudze shuga la magazi. Komabe, shuga amatha kuwonjezera mpaka magawo 19 ngati pali "mavuto azaumoyo".

Ganizirani za pathological zomwe zikuwonjezera kuchuluka kwa shuga:

Matenda a Endocrine amatha kubweretsa kusowa kwa mahomoni, zomwe zimayambitsa matenda a shuga 2, matenda a Cushing. Mu chithunzi ichi cha chipatala, pakhala kuwonjezeka kwa shuga poyerekeza ndi kuchuluka kwa mahomoni m'magazi.
Matenda a pancreatic. Mwachitsanzo, kapamba kapena mitundu ina ya chotupa yomwe imathandizira kuchepa kwa kuchuluka kwa insulin m'magazi, yomwe imawonetsedwa ndi zolephera mu njira ya metabolic.
Mankhwala ena amasokoneza kuyamwa kwa glucose, chifukwa, shuga wamagazi amawonjezeka kwambiri. Mwachitsanzo, mankhwala a steroid, mapiritsi a mahomoni, mapiritsi oteteza kubala.
Pathologies omwe amagwirizana ndi vuto la chiwindi, lomwe limasungira glycogen. Mwachitsanzo, matenda amitsempha, matenda a chiwindi ndi matenda ena.

Ngati matenda omwe ali pamwambawa atha kukhala omwe amachititsa kuti shuga azikula, ndiye kuti mpaka muzuwo utachotsedwa, shuga sangakhale wofanana.

Kenako, ngati kudumpha kotereku kumawonedwa mwa munthu wathanzi - ichi ndi chizindikiro chochokera m'thupi kuti ndi nthawi yoganizira za moyo wanu, kadyedwe, ntchito zolimbitsa thupi ndi zina zina.

Chakudya chopatsa thanzi shuga

M'mazithunzi ambiri azachipatala, matenda ashuga amtundu wa 2 amapezeka motsutsana ndi maziko onenepa kwambiri kapena kunenepa kwambiri pa gawo lililonse. Chifukwa chake, gawo loyamba la kusintha magazi m'magazi ndi kukonza menyu.

Zosankha ziyenera kuphatikiza zakudya zama carb zochepa zokha, poganizira zomwe zili m'mbale zopatsa mphamvu. Madokotala amati muyenera kuchepetsa thupi ndi ma kilogalamu 6, ndi njira yabwino - mwa 10% ya kulemera koyambirira. Nthawi yomweyo, chitani chilichonse chotheka kuti musanenenso kulemera kwambiri.

Momwe thupi la wodwalayo lili mkati moyenera, kuchuluka kwa chakudya chomwe mumadya kumayenera kuyenderana ndi zolimbitsa thupi zomwe zimaganizira zaka za munthu, kulemera kwake, zolimbitsa thupi.

Zakudya zotsatirazi siziyenera kuphatikizidwa kuchokera kumenyu ya odwala matenda ashuga:

Zinthu zomwe zimaphatikizapo mafuta ambiri: soseji, mayonesi, kirimu wowawasa, tchizi chamafuta, mkaka wapamwamba wa kalori.
Zakudya zomwe zimaphatikizapo mafuta a trans: margarine, mafuta a confectionery, kufalitsa (cholowa m'malo mwa batala), chakudya chofulumira.
Zinthu zomwe zimakhala ndi shuga wonenepa: koloko, kupanikizana, maswiti, caramel, makeke, makeke.

Ndikulimbikitsidwa kuti muphatikize mitundu yamafuta ochepa a nsomba ndi nyama, mazira a nkhuku (zosaposa zidutswa ziwiri patsiku), phwetekere, kabichi yamtundu uliwonse, sipinachi, nkhaka, letesi, masamba, nkhaka, maapulo, zipatso zosaphatikizika, nyemba zobiriwira, kaloti mumenyu yanu.

Njira yophika imachita mbali yofunika kwambiri. Makonda ayenera kuperekedwa kuwira m'madzi, kuwotcha, kutsatsa ndi kuwonjezera kwa madzi osati mafuta, kuphika mu uvuni.

Pofuna kupewa shuga wambiri m'magazi, wodwala matenda ashuga ayenera kudya zakudya zowafunikira tsiku lililonse, kugawa chakudya, kuwerengera chakudya, komanso kuganizira mndandanda wazakudya.

Ubwino wakuchita zolimbitsa thupi mu shuga

Zochita zolimbitsa thupi zimawoneka ngati gawo lofunika la mankhwala pochiza matenda amtundu wa 2. Chifukwa cha katundu wachilengedwe, zimatha kuwonjezera chiwopsezo cha maselo kupita ku insulin ya mahomoni, motero, kukana kwa insulin kumachepa.

Zachidziwikire, pali mankhwala omwe angakuthandizeni kuthana ndi ntchitoyi, mwachitsanzo, Glucofage. Komabe, zakhala zikutsimikiziridwa kale kuti ngati wodwala matenda ashuga akwaniritsa malingaliro onse omwe adokotala amakhudzana ndi zolimbitsa thupi, mutha kukana kumwa.

Kukana kwa insulini kumalumikizana pakati pazowerengeka zama minofu ndi mafuta omwe amakhala m'chiuno ndi pamimba. Ngati thupi lili ndi mafuta ochulukirapo motsutsana ndi kumbuyo kwa minofu yaying'ono, chidwi champhamvu chomwe chimapangitsa maselo kupita ku hormone chimawonedwa.

Zochita zotsatirazi ndizothandiza kwa odwala matenda ashuga:

Cardio kulimbitsa thupi kumathandizira kuchepetsa shuga, kuchepetsa magazi, kuchepetsa chiopsezo cha kugunda kwa mtima, komanso kulimbitsa mtima. Izi ndi monga kupalasa njinga, kuthamanga pang'onopang'ono, kusambira.
Kulimbitsa mphamvu: Kukweza thupi, kulimbitsa thupi.
Yoga odwala matenda ashuga.

Tiyenera kukumbukira kuti ngati maphunziro a Cardio ali oyenera pafupifupi aliyense, ndiye kuti katundu wolemera kwambiri akhoza kukhala ndi zotsutsana. Chifukwa chake, masewerawa amakambidwa pazachithunzithunzi chilichonse payekhapayekha.

Zadziwika kuti kwenikweni miyezi iwiri yokhazikika pamasewera olimbitsa thupi amapereka zotsatira zodabwitsa: shuga imachepetsedwa, thanzi limasinthidwa, maziko am'maganizo amakhala osinthika, wodwala amakhala ndi mphamvu komanso nyonga.

Njira zotchuka zolimbana ndi shuga

Omwe ali ndi chithandizo chamankhwala amalimbikitsa kugwiritsa ntchito maphikidwe potengera mankhwala azitsamba ndi zosakaniza zachilengedwe zomwe zimachepetsa shuga ndikubwezeretsa zinthu polimbana ndi shuga.

Chiuno cha Rose mwachangu komanso moyenera matenda a shuga. Kukonzekera mankhwala opangidwa ndi Homemade, muyenera kutenga magalamu asanu a phokoso losweka mu ufa, kutsanulira theka la lita imodzi ya madzi otentha.

Ikani madzi osamba, kuwira kwa mphindi 20. Mukathira madzi onse mu thermos, onjezerani tsiku lina. Muyenera kumwa 100 ml kawiri patsiku mphindi makumi atatu musanadye.

Mkulu wamagazi akakhala magawo 19 kapena kuposerapo, maphikidwe otsatirawa angakuthandizeni:

Sakanizani muzu wa horseradish ndi mkaka wowawasa muyezo wa 1 mpaka 10. Tengani supuni imodzi katatu patsiku.
Decoction kutengera bay tsamba. Thirani mapepala 10 a 500 ml a madzi otentha, onjezerani kwa maola asanu, tengani 50 ml katatu patsiku.

Kuchita bwino kwa wowerengeka azitsamba sikukayika, koma nthawi zina amatha kutsutsana ndi chithandizo chomwe adokotala adalandira. Chifukwa chake, musanachite zithandizo zothandizira nokha, muyenera kufunsa dokotala.

Zithandizo za Folk zimachita bwino komanso pang'onopang'ono, kotero chithandizo chimatenga nthawi.

Koma chophatikizacho ndikuti sizivulaza thupi, musakhale ndi zotsatila.

Momwe mungachepetse shuga msanga?

Monga tafotokozera pamwambapa, wowerengeka azitsamba amadziwika ndi kuthamanga pang'onopang'ono pazizindikiro za shuga, chifukwa chake, ngakhale zimatha zomaliza, amagwira ntchito pang'onopang'ono.

Komabe, pali mankhwala wowerengeka omwe angathandize msanga kutulutsa shuga m'thupi la odwala matenda ashuga. Mwachitsanzo, anaphika anyezi. Mwina iyi ndi njira yachangu kwambiri komanso yothandiza kwambiri pokonza malo a hyperglycemic.

Anyezi ayenera kuphika mu uvuni ndi mankhusu. "Mlingo" woyamba umalimbikitsidwa kudya m'mawa musanadye, pambuyo pake nthawi iliyonse yamadzulo. Kuchuluka kwa zinthu zomwe zimagwiritsidwa ntchito patsiku sikokwanira.

Ndemanga ya odwala matenda ashuga akuwonetsa kuti chithandizo cha masiku 10 chimapereka zotsatira zabwino, zothandiza kuti osati kuchepetsa shuga mwachangu, komanso zimakhazikika pamlingo wofunikira.

Maphikidwe ena othandiza:

Amenya mazira atatu a zinziri, onjezerani mandimu amodzi. Imwani pamimba yopanda kanthu kwa masiku atatu. Pakatha sabata ndi theka, mankhwalawa amabwerezedwanso. Poyerekeza ndi maziko a chithandizo chotere, kutsika msanga kumawonedwa.
Thirani supuni ya masamba owuma a mabulosi kuti akhale 250 ml, ofunda mumadzi osamba ola limodzi. Kulisefa, phwando limachitika mpaka kanayi pa tsiku mu 50 ml.

Shuga wofika mpaka mayunitsi 19, ndiwowopsa panjira yovuta kwambiri yomwe ingayambitse kuwonongeka kwa thanzi, imayambitsa matenda osiyanasiyana, olumala ngakhale kufa.

Lamulo lalikulu la odwala matenda ashuga ndikuwunika shuga wamagazi pafupipafupi, komanso kukhazikitsa zochitika zonse zofunika kuzikhazikitsa.

Zambiri pa hyperglycemia ndi njira zothetsera izi zidzafotokozedwa mu kanema munkhaniyi.

Sonyezani shuga yanu kapena sankhani jenda kuti muyimikize.

Mwazi wamagazi kuchokera pamagulu 23.1 mpaka 23,9: momwe mungabweretsere?

Magawo a shuga 23 ndi njira yodziwika bwino yokhudzana ndi kuchuluka kwa shuga m'magazi. Kuopsa kwa zizindikiro zotere kuli pachiwopsezo chachikulu cha zovuta, komanso kumawonjezera mwayi wokhala ndi zovuta zoyipa.

Matenda a shuga ndi njira yomwe imafunikira kuwunikira mosamala komanso mosamala kuti muchepetse zovuta zomwe zingachitike. Pachifukwa ichi, odwala amawunika kuchuluka kwa glucose m'magazi, amatsata zakudya zamtundu wapadera.

Maziko a chithandizo cha matenda a shuga mellitus ndi katundu wambiri, zomwe zimapangitsa kuti chiwopsezo cha minofu yofewa chikhale ndi insulin. Kuphatikiza apo, mankhwala osokoneza bongo kapena insulini angalimbikitsidwe.

Talingalirani chifukwa chomwe shuga amakwera magazi, ndipo muyenera kuchita chiyani pamenepa? Momwe mungabweretsere pansi shuga, ndipo ndi njira ziti zomwe zingathandize?

Momwe mungasinthire zizindikiro?

Chifukwa chake, ndichitenji ngati magazi anga atasiya 23 kapena kupitirira? Choyambirira, ndi zizindikiro za glucose zotere, muyenera kufunsa thandizo kwa katswiri, chifukwa izi zomwe zili m'magazi zimatanthawuza zovuta zambiri.

Kachiwiri, ndikofunikira kuwerenganso menyu. Zochita zachipatala zimawonetsa kuti kuchuluka kwa shuga mthupi la munthu ndi zotsatira za kuperewera kwa thupi, kulephera kutsatira zakudya zomwe amalimbikitsa. Mwachitsanzo, kugwiritsa ntchito zakudya zamafuta, zakudya zotsekemera, ndi zina zambiri.

Ndikulimbikitsidwa kuti muchepetse glucose kudzera muzakudya zomwe zimaphatikizapo zakudya zomwe sizikhala ndi zakudya zopezeka nthawi yomweyo. Masewera a glucose akapezeka mwa wodwala, chakudya chochepa kwambiri cha carb ndipo palibe chomwe chingamuthandize.

Monga tafotokozera pamwambapa, shuga wamagazi pamwamba pa mayunitsi 20 amatanthauza kuti pali kuphwanya magwiridwe antchito a kapamba, omwe amakhala ndi zotsatirapo zingapo zoyipa, kuphatikiza osasinthika - kulumala, ngakhale kufa.

Chizindikiro chamagulu oposa 23 chimayimira zoopsa zomwe zimawopseza anthu odwala matenda ashuga, chifukwa chake muyenera kulumikizana ndi dokotala. Malinga ndi zotsatira za mayeso a labotale, adotolo azikupatsirani mankhwala oyenera, omwe ali ndi mankhwala osokoneza bongo, chakudya chamagulu, zochitika zamasewera, mwina insulin.

Nthawi zambiri, insulin imalimbikitsidwa panthawi yomwe zakudya, masewera olimbitsa thupi, komanso mankhwala ochepetsa shuga sizithandiza kukwaniritsa kuchuluka kwa glucose m'magazi.

Zochita zimawonetsa kuti zakudya zosachepera carb mu shuga zimapereka kusintha kwa wodwalayo, mosasamala mtundu wa matenda ake. Matenda a shuga amawonekera pakatha masiku 3-4 atasintha menyu.

Chifukwa chake, ndizotheka kuchepetsa shuga m'magazi, komanso kuchuluka kwa matekinoloje, omwe mu zithunzi zambiri zamankhwala amatsagana ndi matenda okoma.

Kuti musinthe menyu anu, muyenera kugwiritsa ntchito njira yapadera yophikira.

Sizimangoyambitsa kutsika kwa glucose, komanso zimathandizira kusintha kwathunthu.

Chifukwa chiyani shuga amakwera magawo 23?

Magawo a shuga m'thupi la munthu amatha kusiyanasiyana chifukwa cha kubereka kwa mwana, zovuta zina, mavuto amanjenje, matenda am'mimba ambiri komanso zinthu zina.

Mphindi yabwino ikhoza kupezekanso pakukula kwa glucose, chifukwa umu ndi momwe thupi la munthu limawonetsera kuphwanya magwiridwe ake, motero, chidwi chokwanira pa thanzi lanu chimafunikira.

Monga lamulo, kuchuluka kwa shuga kumawonedwa mu zithunzi zamatendawa pamene wodwala ali ndi mbiri yovuta pakukonza chakudya.

Ganizirani zomwe zimayambitsa kuchuluka kwa shuga m'magawo 23 kapena kupitilira:

Chakudya chopanda malire: Zakudya zambiri zopatsa thanzi, chakudya, shuga. Pambuyo pa chakudya, munthu (ngakhale munthu wathanzi) nthawi zonse amakhala ndi chiwopsezo cha shuga, popeza pali makonzedwe othandizira a chakudya omwe amamwa.
Zochita zamagalimoto ochepa. Zochita zilizonse zolimbitsa thupi zimakhudzanso shuga mu thupi, chifukwa chomwe amachepetsedwa.
Kutengeka mtima. Ngati munthu ali wamanjenje, akukumana ndi kupsinjika kwamphamvu kwamalingaliro, ndiye kuti kusiyanasiyana kwa shuga ndi kuwonongeka m'moyo wabwino kumatha kupezeka.
Kumwa mowa, kusuta fodya ndi zinthu ziwiri zomwe sizongolepheretsa kugwira ntchito kwa thupi lathunthu, komanso zimapangitsa kuchuluka kwa shuga m'magazi.
Kuperewera kwa mahomoni. Mwachitsanzo, mwa azimayi, nthawi ya kusamba, shuga wamagazi amawuka.

Chifukwa chake, zochitika zonsezi pamwambapa zimatha kusintha kusintha kwa glucose m'thupi la munthu. Monga lamulo, m'mafanizo azachipatala awa, kudumpha mu shuga ndi kwakanthawi.

Ngati tichotsa zomwe zimayambitsa kuchuluka kwa shuga, ndiye kuti kwakanthawi kochepa, shuga azitha kukhala magawo a 5.0-6.0, ndiye kuti, abwerera mwakale.

Shuga wapamwamba komanso thanzi la anthu

Mitundu yonse yamatenda amtundu wa anthu imatha kubweretsa kuchuluka kwa shuga, omwe amagawidwa malinga ndi gawo lomwe lakhudzidwa.

Mwachitsanzo, mavuto amtundu wa endocrine chifukwa cha kupsinjika kwa mahomoni angapangitse kuti pakhale matenda "okoma" amtundu uliwonse, matenda a Cushing. Mu chithunzi ichi cha chipatala, zomwe zimakhala m'magazi zimachuluka komanso kuchuluka kwa mahomoni.

Matenda a kapamba, mwachitsanzo, kapamba ndi mitundu ina ya chotupa, amathandizira kuchepa kwa maselo a insulin, omwe amasokoneza ma metabolic a mthupi.

Matenda ngati amenewa amachititsa kuti shuga awonjezeke:

Kumwa mankhwala ena omwe amakupangitsa kuchuluka kwa shuga m'magazi. Izi zimaphatikizapo mitundu yosiyanasiyana ya mapiritsi a mahomoni, diuretics, mankhwala a steroid, makapisozi othandizira kubereka, etc.
Matenda a chiwindi, pomwe shuga amasungidwa mu mawonekedwe a glycogen. Ntchito ya chiwalochi ikasokonekera, glucose imadziunjikira m'magazi a munthu. Matenda - matenda a chiwindi, chiwindi, zotupa ndi matenda ena.

Ngati wodwala wodwalayo alumpha pazifukwa izi, ndiye kuti ndikofunikira kuchitapo kanthu poyang'ana gwero lake.

Zachidziwikire, ngati munthu ali ndi kuchuluka kwa shuga kukhala magulu 23 kamodzi kokha - izi sizikutanthauza kukula kwa mtundu 1 kapena mtundu wa 2 wodwala, koma muyenera kusamala kwambiri ndi thanzi lanu.

Muyenera kuwunika zakudya zanu, kudya zakudya zamafuta ochepa, kuchita masewera olimbitsa thupi tsiku ndi tsiku.

Ndikulimbikitsidwa kwambiri kuti muziwongolera shuga ndi mita yapadera - glucometer.

Nanga bwanji ngati shuga ali pamtunda wama 23?

Choyamba, wodwalayo ayenera kusintha menyu. Ndi kuchuluka kwa shuga, kuthira zakudya zapadera kumalimbikitsidwa, zomwe zimatanthawuza kuphatikizidwa kwa chakudya chofulumira, wowuma.

Wodwala akayamba kunenepa kwambiri kapena amayamba kunenepa kwambiri chifukwa cha madontho a shuga, ndikofunikira kuganizira za kudya calorie, ndiye kuti, muyenera kudya zakudya zamafuta ochepa. Nthawi yomweyo, zinthu zomwe zimalemedwa ndi zinthu zofunikira, mavitamini ndi michere yamafuta zimaphatikizidwa menyu.

Ngati shuga wambiri wapezeka, dokotalayo poyamba amalimbikitsa njira zosagwiritsa ntchito mankhwala osokoneza bongo, ndiko kuti, zakudya ndi masewera. Ngati pakatha miyezi isanu ndi umodzi sikutheka kulandira chithandizo chamankhwala, ndiye kuti mankhwala ochepetsa shuga ndi omwe amapatsidwa mtundu wa matenda a shuga a II.

Zomwe zimapatsa thanzi ndi shuga wambiri:

Menyuyi imalimbikitsa kuphatikizapo zakudya zomwe zimakhala ndi mapuloteni okwanira, mafuta ndi chakudya.
Mukamasankha zakudya, muyenera kuyang'ana pa index ya glycemic ya chinthu china. Gome ili likhoza kutsitsidwa pa intaneti.
Ndikofunikira kudya pafupipafupi, koma m'magawo ang'onoang'ono, ndiye, chakudya chamagulu. Monga lamulo, njira yabwino kwambiri ndiyo chakudya 5-7 patsiku.
Pewani zinthu zoyipa kuchokera pamenyu: zakumwa zoledzeretsa, zakumwa zoziziritsa kukhosi, chakudya mwachangu, etc.
Zakudya zazikulu zimaphatikizapo zipatso ndi masamba, zitsamba, zipatso, mapuloteni.

Kuchita kumawonetsa kuti kudya moyenera komanso moyenera sikuti kumangochepetsa kuchuluka kwa shuga m'magazi, komanso kumachotsa zisonyezo zoyipa zomwe zimawoneka motsutsana ndi maziko a shuga okwanira.

Magazi a glucose amatha kuwongoleredwa kudzera muzakudya ndi masewera. Chithandizo choterechi chimathandizira kuti shuga asamafalikire, motero, mwayi wopanga njira zam'mbuyo zomwe zimawonekera motsutsana ndi matenda osokoneza bongo amachepetsedwa.

Zambiri pazomwe zimayambitsa komanso chithandizo cha hyperglycemia zimaperekedwa mu kanema munkhaniyi.

Sonyezani shuga yanu kapena sankhani jenda kuti muyiyikire.