Matenda a shuga

Odwala ambiri omwe ali ndi matenda ashuga ali ndi mitundu yonse yamatenda omwe amakumana ndi vuto lomwe limakhudza munthu komanso limakhudza ziwiya zonse ndi ziwalo. Chimodzi mwazovuta izi ndi matenda a shuga.

Chinsinsi cha matendawa ndikuti dongosolo lonse la mtima limakhudzidwa. Ngati ziwiya zochepa zokha zowonongeka, ndiye kuti matendawa amatchulidwa kuti ndi diabetesic microangiopathy.

Ngati ziwiya zazikulu zokhazokha zagwidwa, matendawa amatchedwa matenda ashuga macroangiopathy. Koma siliri vuto lokhalo lomwe wodwala matenda ashuga angakhale nalo. Ndi angiopathy, homeostasis imakhudzidwanso.

Chizindikiro Chokhudza Matenda Aakulu a shuga

Mukamaganizira za zazikulu za microangiopathy, zinthu zitatu zazikulu zimadziwika, zotchedwa Virchow-Sinako triad. Zizindikiro izi ndi ziti?

1. Makoma azombo amayenda.
2. Kuphatikizika kwa magazi kumakhala kusokonekera.
3. Kuthamanga kwa magazi kumachepa.

Zotsatira za kuchuluka kwa ntchito ya magazi a m'magazi komanso kuchuluka kwa magazi, kumayamba kuchepa. Zida zathanzi zimakhala ndi mafuta apadera omwe samalola magazi kutsatira khoma. Izi zimathandizira kutuluka kwamagazi koyenera.

Zida zosokoneza sizitha kutulutsa mafuta awa, ndipo pamakhala kutsika kwa magazi. Zophwanya zonsezi zimangobweretsa kuwonongeka kwa mitsempha yamagazi, komanso mapangidwe a microtubus.

Pakupanga matenda a shuga, mtundu uwu wa kusinthika umaphatikizapo zombo zambiri. Nthawi zambiri gawo lalikulu lowonongeka ndi:

• ziwalo zamasomphenya
• myocardium
• impso
• zotumphukira zamanjenje dongosolo
• khungu mawonekedwe.

Zotsatira za kuphwanya izi, monga lamulo, ndi:

Koma zizindikiro zoyambirira zimawonekera m'munsi, zomwe zimayambika chifukwa chophwanya mitsempha yamagazi m'derali. Kulembetsa kwamilandu yotere ndi pafupifupi 65%.

Madokotala ena amakonda kunena kuti microangiopathy si matenda osiyana, ndiye kuti ndi chizindikiro cha matenda ashuga. Kuphatikiza apo, amakhulupirira kuti microangiopathy ndi zotsatira za neuropathy, zomwe zimachitika kale.

Asayansi ena amati mitsempha ya m'mimba imayambitsa neuropathy, ndipo izi siziphatikizidwa ndi kuwonongeka kwa mtima. Malinga ndi lingaliro ili, matenda a shuga amachititsa neuropathy, ndipo microangiopathy ilibe kanthu.

Koma palinso lingaliro lachitatu, omwe amatsatira omwe amati kuphwanya kwamanjenje kungathandizire mitsempha ya magazi.

Matenda a shuga a shuga a shuga amagawidwa m'mitundu ingapo, omwe amayamba chifukwa cha kuwonongeka kwakumapeto.

• Ndi zero zero yakuwonongeka khungu pakhungu la munthu kulibe.
• Mulingo woyamba - pali zolakwika zochepa pakhungu, koma sizikhala ndi zotupa ndipo zimangokhala zochepa patokha.
• Pa gawo lachiwiri, zotupa zowonekera kwambiri pakhungu zimawonekera zomwe zimatha kuzama kuti ziwononge tendon ndi mafupa.
• Gawo lachitatu limadziwika ndi zilonda za pakhungu ndi zizindikiro zoyambirira za kufa kwa minofu pamiyendo. Mavuto oterewa amatha kuchitika limodzi ndi njira zotupa, matenda, edema, hyperemia, abscesses ndi osteomyelitis.
• Pa mulingo wachinayi, gulu la chala chimodzi kapena zingapo zimayamba kukula.
• Gawo lachisanu ndi phazi lonse, kapena ambiri amakhudzidwa ndi gangrene.

Makhalidwe a macroangiopathy

Chochititsa chachikulu pakufa kwakukulu kwa odwala omwe ali ndi matenda ashuga ndi matenda ashuga macroangiopathy. Ndi macroangiopathy yomwe nthawi zambiri imapezeka mwa odwala matenda ashuga.

Choyamba, ziwiya zazikulu zam'munsi zimakhudzidwa, chifukwa cha momwe mitsempha yam'mimba komanso matenda ammimba imagwirira ntchito.

Macroangiopathy imatha kukulira njira yowonjezera kukula kwa matenda a atherosulinotic. Matendawa amagawidwa m'magawo angapo chitukuko.

1. Poyamba, m'mawa wodwalayo wawonjezera kutopa, thukuta kwambiri, kufooka, kugona, kumva kuzizira m'miyendo ndi kugona kwawo pang'ono. Izi zimawonetsera kubwezeretsedwa kwa kufalikira kwazungulira.
2. Mu gawo lachiwiri, miyendo ya munthu imayamba kugoneka, amasungika kwambiri, mawonekedwe akumisomali akuyamba kusweka. Nthawi zina lameness amapezeka pamenepa. Ndipo pamakhala kupweteka m'miyendo, poyenda komanso popuma. Khungu limakhala lotuwa komanso loonda. Kusokonezeka kwa ntchito yamalumikizidwe kumawonedwa.
3. Gawo lomaliza ndi miyendo, zala ndi mwendo wotsika.

Kodi kuchitira angiopathy

Macro ndi microangiopathy mu shuga amathandizidwanso chimodzimodzi. Choyambirira chomwe wodwala amayenera kuchita ndikubweretsa njira ya thupi yokhala bwino. Carbohydrate metabolism iyenera kubwezeretsedwa, chifukwa hyperglycemia ndiye chifukwa chachikulu cha chitukuko cha atherosulinosis yamitsempha yamagazi.

Chofunikanso kwambiri pakuthandizira mankhwalawa ndikuwunika momwe metabolidi a lipid amawonongera. Ngati miloproteins yokhala ndi zizindikiro zotsika kwambiri imachulukana mwadzidzidzi, ndipo mulingo wa triglycerides, m'malo mwake, utachepa, izi zikusonyeza kuti ndi nthawi yophatikizira mankhwala a hypolipidic pamankhwala.

Tikulankhula za ma statins, ma fibrate ndi ma antioxidants. Macro- ndi microangiopathy mu matenda osokoneza bongo amachitidwa ndi kukakamizidwa kuphatikiza achire mankhwala a metabolic kanthu, mwachitsanzo, trimetazidine.

Mankhwalawa amathandizira kuti makutidwe ndi okosijeni a glucose mu myocardium, omwe amapezeka chifukwa cha oxidation wamafuta acids. Mankhwalawa onse amtundu wa matendawa, odwala amapatsidwa anticoagulants.

Awa ndimankhwala omwe amathandizira kuthetsa kuundana kwa magazi m'magazi ndikuchepetsa ziwalo zam'magazi akapezeka ndi macroangiopathy.

Chifukwa cha zinthuzi, magazi samakhala osasinthasintha ndipo mikhalidwe yotseka mitsempha yamagazi sinapangidwe. Ma Anticoagulants akuphatikizapo:

• Acetylsalicylic acid.
• Tiklid.
• Vazaprostan.
• Heparin.
• Dipyridamole.

Zofunika! Popeza matenda olembetsa magazi nthawi zambiri amakhala alipo m'matenda a shuga, ndikofunikira kupereka mankhwala omwe amathandizira magazi. Ngati chizindikirochi ndichabwinobwino, chikulimbikitsidwa kuti chizitha kuwunikira nthawi zonse.

Mu shuga mellitus, mulingo woyenera kwambiri ndi 130/85 mm Hg. Njira zowongolera zoterezi zikuthandizira kupewa kukulira kwa nephropathy komanso retinopathy munthawi yake, kuchepetsa kwambiri chiopsezo cha kugwidwa ndi matenda a mtima.

Mwa mankhwalawa, otsutsana ndi calcium njira, othandizira ndi zoletsa zina amadziwika.

Mankhwalawa, ndikofunikira kusintha zizindikiro za autonomic homeostasis. Chifukwa cha izi, madokotala amatipatsa mankhwala omwe amalimbikitsa ntchito ya sorbitol dehydrogenase. Ndikofunikanso kuchita ntchito zomwe zimalimbikitsa chitetezo cha antioxidant.

Inde, ndibwino kupewa matendawa poyamba. Kuti muchite izi, muyenera kukhala ndi moyo wabwino ndikuwunikira thanzi lanu nthawi zonse. Koma ngati zizindikiro za matenda ashuga zikuwonekera, muyenera kufunsa kuchipatala.

Njira zamakono zochizira matenda a shuga ndikuthandizira kupewa zingathandize munthu kupewa zovuta zoyipa monga macro- ndi microangiopathy.

Kwa odwala omwe ali ndi matenda ashuga, Zizindikiro za matenda a shuga angiopathy nthawi zambiri zimawonetsedwa ngati zotengera zazing'ono zimakhudzidwa. A shuga angiopathy a m'munsi malekezero ambiri amapezeka, pomwe zovuta za mtundu uwu zimapezeka mwa odwala matenda ashuga a mtundu 1 kapena mtundu 2. Ngati mankhwalawa opaleshoni kapena yothandiza odwala matenda ashuga sangachitike pa nthawi yake, zovuta zina zowonongeka ziwalo zambiri zimatheka.

Matenda amtundu wanji?

Diabetes angiopathy imadziwika ndi kuwonongeka kwa ziwiya zazing'ono komanso zazikulu ndi mitsempha. Khodi yamatenda a MBK 10 ndi E10.5 ndi E11.5. Monga lamulo, matenda am'magazi a shuga amadziwika, koma kuwonongeka kwa ziwalo zina zamthupi ndi ziwalo zamkati ndizothekanso. Ndichizolowezi kugawa mitundu ya matenda ashuga m'mitundu iwiri:

• Microangiopathy. Amadziwika ndi kugonjetsedwa kwa capillaries.
• Macroangiopathy Zilonda zam'mimba ndi venous zimadziwika. Fomuyi siyachilendo, ndipo imakhudza anthu odwala matenda ashuga omwe akhala akudwala kwa zaka 10 kapena kuposerapo.

Nthawi zambiri, chifukwa cha matenda a shuga a shuga, kuchuluka kwa odwala kumakulirakulira komanso chiyembekezo cha moyo chimachepa.

Zomwe zimayambitsa matenda a shuga a shuga

Chifukwa chachikulu chomwe chitukuko cha matenda a shuga chimakhalira nthawi zambiri chimakweza shuga. Zotsatirazi zimadziwika zomwe zikutsogolera kukula kwa matenda ashuga angiopathy:

• yaitali hyperglycemia,
• kuchuluka kwa insulin m'madzi,
• pamaso pa insulin kukana,
• matenda ashuga nephropathy, pomwe aimpso kukanika kumachitika.

Zowopsa

Si onse odwala matenda ashuga omwe ali ndi vuto lotere, pamakhala zovuta zomwe zimapangitsa chiwopsezo cha minofu kuwonongeka.

• yaitali matenda a shuga,
• gulu lazaka zopitilira 50,
• njira yolakwika ya moyo
• kuperewera kwa zakudya m'thupi, kuphatikiza mafuta ndi nyama yokazinga,
• Kuchepetsa kagayidwe kachakudya,
• kunenepa kwambiri
• kumwa kwambiri mowa ndi ndudu,
• ochepa matenda oopsa
• kusintha kwa mtima,
• chibadwa.

Zida zachivalo

Ndikosavuta kuneneratu za matenda ashuga a shuga. Nthawi zambiri angiopathy am'munsi amadziwika, popeza amadzaza ndi matenda ashuga. Koma zotupa, zowonongeka, zowononga zina za thupi zimatha. Ziwalo zomwe zikuyembekezeredwa zimasiyanitsidwa, zomwe nthawi zambiri kuposa zomwe anthu ena amadwala ndi angiopathy:

Zizindikiro zamatsenga

Kuthamanga kwa matenda ashuga angiopathy sikuwonetsa zizindikiro zilizonse zapadera, ndipo munthu sangadziwe matendawa. Monga kupita patsogolo kumadziwonetsera, zizindikiro zingapo za pathological zomwe ndizovuta kuzindikira. Mawonetseredwe azizindikiro amatengera mtundu ndi gawo la zotupa za mtima. Gome limawonetsa magawo akuluakulu a matendawa ndi mawonekedwe awonekera.

Zizindikiro

A shuga angiopathy a ziwiya zamagawo am'munsi amadziwika chifukwa cha maphunziro a labotale komanso othandizira.

Ndikulimbikitsidwa kuti muonanenso ndi endocrinologist, nephrologist, neurologist, Optometrist, Cardiologist, Gynecologist, Angiologist Opaleshoni, podiatrist kapena akatswiri ena. Anthu odwala matenda ashuga amayatsidwa maphunziro ngati awa:

• kusanthula kwakanthawi kwamkodzo ndi magazi,
• kuchuluka kwa magazi m'magazi a shuga, cholesterol ndi lipids zina,
• electrocardiography
• Ultrasound ya chotengera ubongo ndi khosi, miyendo, mtima ndi ziwalo zina.
• kuthamanga kwa magazi
• glycated hemoglobin
• kuyeserera kwa shuga.

Chithandizo cha matenda a mtima

Pa matenda ashuga angiopathy, chithandizo chovuta ndichofunikira, chomwe chimaphatikizapo kumwa mankhwala a magulu osiyanasiyana ndikuwonetsetsa kuti kudya zakudya zopatsa thanzi komanso njira zina. Musanachiritse matenda, muyenera kusiya zakumwa zoledzeretsa ndi mankhwala osokoneza bongo omwe amakhudza ziwiya. Mankhwala a shuga angiopathy amwa mankhwala otsatirawa:

• Kutsitsa shuga:
  • Siofor
  • Diabetes
  • Glucophage.
• Mankhwala ochepetsa cholesterster:
  • Lovastatin
  • "Simvastatin."
• Zoponda magazi:
  • Trombone,
  • Ticlopidine
  • Warfarin
  • Clexane.
• Njira zomwe zimathandizira kutsika kwa magazi ndi kukoka kwa magazi:
  • Tivortin
  • Ilomedin
  • "Pestazolum".

Ibuprofen amalembera ululu womwe umasautsa wodwalayo.

Kuphatikiza apo, adotolo adzavomereza chithandizo cha vitamini E kapena nicotinic acid. Ngati wodwalayo akuda nkhawa ndi kupweteka kwambiri mu matenda ashuga a shuga, ndiye kuti ophatikizana amasonyezedwa: Ibuprofen, Ketorolac. Ngati chotupa chachiwiri chathandizira, ndiye kuti mankhwala a antibacterial awonetsedwa: Ciprinol, Ceftriaxone.

Matenda a shuga amatanthauza zovuta za matenda ashuga ndipo amawonetsedwa ndi kuperewera kwa ziwalo za miyendo, zomwe zimatsogolera ku necrosis. Mu matenda a shuga a shuga, ziwiya zama caliber osiyanasiyana zimakhudzidwa, koma zazing'ono kwambiri komanso zapakatikati. Osangokhala miyendo yokha yomwe imakhudzidwa, komanso ziwalo zamkati.

Kuwonongeka kwa ziwiya zing'onozing'ono za diabetes

Mitsempha yaying'ono ikakhudzidwa, kusintha kumachitika khoma lawo, kuchuluka kwa magazi kumasokonekera, ndipo magazi amayenda pang'onopang'ono. Zonsezi zimapangitsa kuti pakhale kupanga magazi. Zida zochepa za impso, retina, minofu yamtima, ndi khungu zimakhudzidwa makamaka. Kuwonetsedwa koyambirira kwa matenda ashuga angawonongeke kumapeto.

Njira zomwe zimachitika m'sitimazi ndi zamitundu iwiri: kukula kwa khoma la arterioles ndi mitsempha kapena makulidwe a capillaries. Poyamba, mchikakamizo cha zinthu zopangidwa ndi poizoni zomwe zimapangidwa pakagwiritsidwa ntchito kosakwanira kwa glucose, gawo lamkati lamitsempha yamagazi limatupa, pambuyo pake limachepa.
Mawonekedwe oyamba a matenda a shuga a shuga ndi zotupa zazing'ono pansi pa msomali wa chala chachikulu. Wodwalayo amamva kupweteka m'miyendo, amawona kuti khungu limatuluka, mawanga amawoneka, misomali imakhala yofinya, minofu ya miyendo "yowuma". Kugunda kwamitsempha yayikulu yam'munsi yam'munsi sikumasintha, koma pamapazi kumatha kukhala kofooka.

Zosintha m'mitsempha yam'mimba zimatha kupezeka ndipo mapuloteni amkodzo amatha kuwonekera. Chikhodzodzo china chopanda ululu chodzadza ndimadzi wamagazi chimatuluka pakhungu la mapazi. Amadzichiritsa pawokha, pomwe vanga sikupanga, komabe, tizilombo tating'onoting'ono timatha kulowa mu minofu ndikuyambitsa kutupa.

Kupeza matenda a shuga a shuga, njira zotsatirazi zikugwiritsidwa ntchito:

• capillaroscopy
• infrared chozizira
• kuyambitsa ma radio isotopes,
• laser fluometry
• polarography kapena oxyhemography.

Kuwonongeka kwa ziwiya zazikulu zamatenda a shuga

Ndi matenda ashuga angiopathy, ziwiya zapakatikati ndi zazikulu zimatha kukhudzidwa. Mwa iwo, zipolopolo zamkati zimadzaza, mchere wa calcium umayikidwa ndipo ma atherosranceotic malo amapangidwa.

Mawonekedwe a matenda pankhaniyi ali ofanana ndi omwe amapezeka ndi zotupa za mitsempha yaying'ono. Zowawa m'mapazi ndizosokoneza, zimakhala zozizira komanso zotumbululuka, chakudya chamthupi chomwe chimafa pakapita nthawi chimasokonekera. Minyewa ya zala imayamba, kenako phazi.
Matenda a shuga angiopathy a ziwalo zamkati

Mu shuga mellitus, zotengera za retina ndi ziwalo zamkati zimakonda kukhudzidwa ndi njira ya pathological. Izi zimachitika chifukwa cha kupangidwa kwa zinthu zopangidwa ndi poizoni ndi "kuyaka" wopanda shuga wa shuga. Pafupifupi odwala onse omwe ali ndi shuga wamagazi ambiri ali ndi matenda amtundu wotchedwa retinopathy. Ndi matendawa, kupenyerera koyambirira kumayamba kuchepa, kenako magazi amathiridwa m'madzi a retina, ndipo amachoka. Izi zimabweretsa kutaya kwamaso kwathunthu.

Chigawo chachiwiri chandamale, zotengera zomwe zimakhudzidwa ndi matenda a shuga, ndiye impso - nephropathy imayamba. Mu magawo oyamba, matendawa samadziwonetsa, kusintha kumatha kupezeka pokhapokha wodwalayo akamamuyesa. Zaka zisanu pambuyo pake, ntchito ya impso imalephera ndipo mapuloteni amawonekera mkodzo. Ngati zosinthika zadziwika pano, ndiye kuti zitha kusintha. Koma ngati chithandizo sichikuchitika, njira ya m'mitsempha ya impso imayendera, ndipo patatha zaka khumi zikuwoneka zizindikiro za matendawa.Choyamba, mapuloteni ambiri amayamba kuponyedwa mkodzo. Zimakhala zochepa m'mwazi, ndipo izi zimapangitsa kudzikundikira kwamadzi mu minofu ndi kutupa. Poyamba, edema imawoneka pansi pa maso ndi m'munsi, kenako timadzi timadzi totikatika pachifuwa komanso m'mimba.

Thupi limayamba kugwiritsa ntchito yake mapuloteni amoyo, ndipo odwala amachepetsa thupi msanga. Amakhala ndi kufooka, mutu. Komanso panthawiyi, kuthamanga kwa magazi kumakwera, komwe kumangokhala pamiyala yambiri ndipo sikumachepetsedwa ndi mankhwala.

Zotsatira zakutha kwa matenda ashuga aimpso ndi gawo lomaliza la kulephera kwa aimpso. Impso zimalephera kwathunthu, sizikwaniritsa ntchito yawo, ndipo mkodzo suthiridwa. Poizoni wa thupi ndi metabolism ya protein.

Matenda a shuga Chithandizo cha magawo osiyanasiyana a matendawa

Kuchita bwino kwa matenda a shuga a shuga kungachitike pokhapokha ngati pali kotheka misempha yamagazi. Izi ndi zomwe endocrinologists amachita.

Kuti tipewe kusintha kosasintha mu minofu ndi ziwalo, ndikofunikira:

• kuwongolera shuga ndi mkodzo
• onetsetsani kuti kuthamanga kwa magazi sikudutsa 135/85 mm. Hg. Art. odwala popanda mapuloteni mu mkodzo, ndi 120/75 mm. Hg. Art. mwa odwala omwe protein yawo yatsimikizika,
• kuwongolera njira mafuta kagayidwe.

Pofuna kukhalabe ndi kuthamanga kwa magazi pamlingo woyenera, odwala matenda ashuga ayenera kusintha moyo wawo, kuchepetsa kudya kwawo kwa sodium mankhwala ena, kuonjezera zolimbitsa thupi, kukhala ndi thupi labwino, kuchepetsa kudya zakudya zamafuta ndi mafuta, komanso kupewa kupsinjika.

Mukamasankha mankhwala omwe amachepetsa kuthamanga kwa magazi, muyenera kuwonetsetsa ngati akukhudza kagayidwe kazakudya ndi mafuta, komanso ngati ali ndi mphamvu yoteteza impso ndi chiwindi. Njira zabwino kwambiri zothandizira odwala ndi captopril, verapamil, valsartan. Beta-blockers sayenera kumwedwa, chifukwa amathandizira kupititsa patsogolo shuga.
Odwala omwe ali ndi matenda ashuga angiopathy amawonetsedwa akutenga ma statins, michere, komanso mankhwala omwe amasintha kagayidwe ka mafuta. Pofuna kukhalabe ndi shuga m'magazi, ndikofunikira kutenga glycidone, repaglimid. Ngati matenda a shuga akupita patsogolo, odwala ayenera kusinthana ndi insulin.

A shuga angiopathy amafuna kuwunika pafupipafupi kuchuluka kwa shuga, mafuta kagayidwe ndi mtima. Pamene necrosis ya minofu ya miyendo imagwiritsidwa ntchito, ntchito zowachotsa zimachitika. Pankhani yolephera kupweteka kwa impso, njira yokhayo yotalikitsa moyo wa wodwalayo ndi impso "yopanga". Ndi kufinya kwam'mbuyo chifukwa cha matenda a shuga, angafunikire opaleshoni.

Cholinga chachikulu cha kupezeka kwa zovuta zilizonse za shuga ndikuwonongeka kwa glucose pazinthu zathupi, makamaka ulusi wamitsempha ndi makoma amitsempha. Kugonjetsedwa kwa mitsempha ya mitsempha, matenda a shuga, amatsimikizika mu 90% ya odwala matenda ashuga kale zaka 15 pambuyo pa matenda.

Ndikofunikira kudziwa! Nkhani yatsopano yomwe ikulangizidwa ndi ma endocrinologists a Kuwunika Kwachisawawa Kokulu! Ndi zofunika tsiku lililonse.

M'magawo owopsa, milanduyo imatha ndi kulumala chifukwa chodulidwa, kuchepa kwa ziwalo, khungu. Tsoka ilo, ngakhale madokotala abwino amatha pang'ono pang'onopang'ono kupitilira kwa angiopathy. Wodwala yekhayo yekha ndi amene angalepheretse zovuta za matenda ashuga. Izi zikufunika kufuna chitsulo komanso kumvetsetsa komwe kumachitika mthupi la odwala matenda ashuga.

Matenda a shuga ndi kupsinjika kudzakhala chinthu chakale

Matenda a shuga ndi omwe amayambitsa pafupifupi 80% yonse yamikwingwirima ndi kuduladula. Anthu 7 mwa anthu 10 amafa chifukwa cha mitsempha ya mtima kapena ubongo. Pafupifupi nthawi zonse, chifukwa chomaliza chomaliza ndi chimodzimodzi - shuga wamwazi.

Shuga akhoza ndipo amayenera kugwetsedwa, apo ayi. Koma izi sizichiritsa matendawa, koma zimangothandiza kulimbana ndi kufufuza, osati zomwe zimayambitsa matendawa.

Mankhwala okhawo omwe amavomerezeka pamankhwala othandizira odwala matenda ashuga komanso amagwiritsidwa ntchito ndi ma endocrinologists pantchito yawo ndi awa.

Kugwiritsa ntchito bwino kwa mankhwalawa, kuwerengera malinga ndi njira yokhazikika (kuchuluka kwa odwala omwe achiwonjezere kuchuluka kwa odwala omwe ali pagulu la anthu 100 omwe adachitiridwa chithandizo):

• Matenda a shuga - 95%
• Kuthetsa kwa mitsempha thrombosis - 70%
• Kuthetsa kwa kugunda kwamtima kwamphamvu - 90%
• Kuthana ndi kuthamanga kwa magazi - 92%
• Kulimbitsa tsiku, kukonza kugona usiku - 97%

Opanga si bungwe lazamalonda ndipo amalipidwa ndi chithandizo cha boma. Chifukwa chake, tsopano wokhala aliyense ali ndi mwayi.

Khoma lamkati la ziwiya limalumikizana ndi magazi. Imayimira maselo a endothelial omwe amaphimba pansi lonse limodzi. Endothelium imakhala ndi oyimira pakati komanso mapuloteni omwe amalimbikitsa kapena kuletsa magazi kuundana. Imagwiranso ntchito ngati chotchinga - imadutsa madzi, mamolekyulu ochepera 3 nm, mosankha zinthu zina. Njirayi imapereka kutuluka kwa madzi ndi chakudya m'thupi, ndikuyeretsa zinthu za metabolic.

Ndi angiopathy, ndiye endothelium yomwe imavutika kwambiri, ntchito zake ndizodwala. Ngati matenda a shuga samayang'aniridwa, shuga wambiri amayamba kuwononga maselo a mtima. Kusintha kwachilengedwe kwapadera kumachitika pakati pa mapuloteni a endothelial ndi shuga wa magazi - glycation. Zochita za kagayidwe kakang'ono ka glucose zimayamba kudziunjikira m'makoma amitsempha yamagazi, amayamba kuzikika, kutupa, kusiya kugwira ntchito ngati cholepheretsa. Chifukwa chophwanya njira zosakanikira, ma magazi amayamba kupanga, chifukwa - m'mimba mwake mumachepa ndipo kayendedwe ka magazi kamachepa mkati mwake, mtima umayenera kugwira ntchito ndi katundu wowonjezereka, kuthamanga kwa magazi kumakwera.

Zombo zazing'onoting'ono kwambiri ndizowonongeka kwambiri, kusokonezeka kwazinthu mkati mwake kumabweretsa kutsekeka kwa mpweya ndi zakudya m'thupi lathu. Ngati madera omwe ali ndi vuto lalikulu la angiopathy mu nthawi yake palibe omwe atha kusintha ma capillaries omwe awonongedwa ndi atsopano, zimakhalazi zimalira. Kuperewera kwa mpweya kumalepheretsa kukula kwamitsempha yatsopano yamagazi ndikuthamanga kuchuluka kwa minofu yolumikizika yowonongeka.

Njira izi ndizowopsa m'm impso ndi maso, magwiridwe antchito awo amakhala opuwala mpaka kuwonongeka konse kwa ntchito zawo.

A shuga angiopathy a ziwiya zazikulu nthawi zambiri limodzi ndi atherosulinotic njira. Chifukwa cha kuperewera kwa mafuta m'thupi, ma cholesterol cholembera amayikidwa pamakoma, kuwonda kwa ziwiya kumachepa.

Zokhudza chitukuko cha matenda

Angiopathy imayamba mwa odwala omwe ali ndi mtundu woyamba wa 2 ndi shuga wachiwiri ngati shuga ya m'mwazi imakwezedwa nthawi yayitali. Kutalika kwa msambo ndi kukwera msanga, msanga zisinthidwe zimayamba. Zinthu zina zimangokulitsa matendawa, koma osayambitsa.

Zochitika Zachitukuko cha Angiopathy	Limagwirira a chikoka pa matenda
Kutalika kwa matenda ashuga	Kuchepa kwa angiopathy kumawonjezeka ndi chidziwitso cha matenda ashuga, monga kusintha m'matumbo kumadziunjikira kwakanthawi.
M'badwo	Okalamba akadwala, amatha kutenga matenda a ziwiya zazikulu. Achinyamata odwala matenda ashuga nthawi zambiri amakhala ndi vuto lochepa ziwalo zina.
Matenda a mtima	Matenda ophatikizika amitsempha yamagetsi amawonjezera zovuta za angiopathy ndipo amathandizira kuti ikule kwambiri.
Kupezeka	Miyezo yambiri ya insulin m'magazi imathandizira kupanga mapangidwe pazitseko zamitsempha yamagazi.
Nthawi yocheperako	Kuchulukitsa kwina komwe kumapangitsa magazi kuwundana komanso kupweteka kwa mauna.
Kulemera kwambiri	Mtima umatopa, mulingo wa cholesterol ndi triglycerides m'magazi umakwera, ziwiya zimachepetsedwa mwachangu, ma capillaries omwe ali kutali ndi mtima amapatsidwa magazi kwambiri.
Kuthamanga kwa magazi	Imawonjezera kuwonongeka kwa makoma amitsempha yamagazi.
Kusuta	Zimasokoneza ntchito ya antioxidants, zimachepetsa kuchuluka kwa mpweya m'magazi, zimawonjezera chiopsezo cha atherosulinosis.
Ntchito yoweruka, kugona pakama.	Onse osachita masewera olimbitsa thupi komanso atatopa kwambiri mwendo amathandizira kukulitsa angiopathy m'munsi.

Ndi ziwalo ziti zomwe zimakhudzidwa ndi matenda a shuga

Kutengera ndi zotengera zomwe zimavutika kwambiri chifukwa cha shuga mu shuga yopanda tanthauzo, angiopathy imagawidwa m'mitundu:

1. - akuimira kugonjetsedwa kwa capillaries mu glomeruli impso. Zotengera zoterezi ndi zina mwa zoyambirira kuvutika, chifukwa zimagwira ntchito mokhazikika ndikudutsa magazi ambiri kudzera mwaiwo. Zotsatira zake za kupangika kwa angiopathy, kufooka kwa impso kumachitika: kusefedwa kwa magazi kuchokera ku zinthu za metabolic kumachepa, thupi silimachotsa konse poizoni, mkodzo umachotsedwa pang'onopang'ono, edema, ziwalo zopangika zimapangidwa thupi lonse. Kuopsa kwa matendawa kuli m'kusowa kwa zizindikiritso zake m'magawo oyambawo ndi kuwonongeka kwathunthu kwa impso kumapeto kwake. Nambala yamatenda malinga ndi gulu la ICD-10 ndi 3.
2. A shuga angiopathy a m'munsi malekezero - nthawi zambiri zimayamba chifukwa cha mphamvu ya matenda ashuga pazombo zazing'ono. Mavuto oyenda m'magazi omwe amatsogolera zilonda zam'mimba ndi gangore amatha kukhala ndi zovuta zazing'ono m'mitsempha yayikulu. Zimakhala zodabwitsazi: pali magazi m'miyendo, ndipo minofu ikufa ndi njala, chifukwa ma network a capillary awonongedwa ndipo alibe nthawi yochira chifukwa cha kuchuluka kwa shuga m'magazi. Angiopathy yamtunda wapamwamba imapezeka mu milandu yakutali, popeza manja a munthu amagwira ntchito ndi zochepa mphamvu ndipo amakhala pafupi ndi mtima, chifukwa chake, zotengera mkati mwake sizowonongeka ndikuchira msanga. Khodi ya ICD-10 ndi 10.5, 11.5.
3. - kumabweretsa zowonongeka m'matumbo a retina. Monga nephropathy, ilibe zizindikiro mpaka magawo akuluakulu a matendawa, omwe amafunikira chithandizo chamankhwala odula komanso opaleshoni ya laser ku retina. Zotsatira zakuwonongeka kwa mtima mu retina ndizosawona bwino chifukwa chotupa, mawanga amaso kutsogolo kwa maso chifukwa cha zotupa, kupindika kwa retina kutsatiridwa ndi khungu chifukwa cha kuwonongeka pamalo owonongeka. Angiopathy yoyambirira, yomwe imatha kupezeka muofesi ya ophthalmologist, imachiritsidwa yokha payokha ndikulipira shuga kwa nthawi yayitali. Khodi H0.
4. Matenda a shuga a mtima - imayambitsa angina pectoris (code I20) ndipo ndiyomwe imayambitsa kufa chifukwa cha matenda ashuga. Atherosulinosis yamitsempha yama coronary imayambitsa kuperewera kwa mtima kwa minofu ya mtima, komwe imayankha ndikumakanikiza, kupweteka kowawa. Kuwonongeka kwa ma capillaries ndikuwonjezereka kwa minofu yolumikizana imasokoneza ntchito ya minofu ya mtima, kusokonezeka kwa milomo kumachitika.
5. - kuphwanya magazi kupita ku ubongo, pachiwonetsero cha mutu ndi kufooka. Hyperglycemia yotalikirapo, ndichoperewera cha kuperewera kwa okosijeni, ndipo makamaka imakhudzidwa ndi kusintha kwaulere.

Zizindikiro ndi angiopathy

Poyamba, angiopathy ndi asymptomatic. Ngakhale chiwonongeko sichili chinyengo, thupi limatha kukulitsa zombo zatsopano kuti zithetse zina zowonongeka. Poyamba, gawo loyambirira, zovuta za metabolic zitha kutsimikizika pokhapokha kuwonjezera cholesterol m'magazi komanso kuwonjezeka kwa kamvekedwe ka mtima.

Zizindikiro zoyambirira za matenda a shuga a shuga zimachitika pakanthawi kogwira, pamene zotupa zimachulukirachulukira ndipo alibe nthawi yochira. Mankhwalawa omwe adayamba panthawiyi amatha kusintha njirayi ndikuthandiziratu ntchito ya mtima.

• kupweteka kwa mwendo pambuyo pamtolo wautali -,
• dzanzi ndi kumva kuwawa m'miyendo,
• kukokana
• khungu lozizira pamapazi
• mapuloteni mumkodzo mutatha kuchita masewera olimbitsa thupi kapena kupsinjika,
• mawanga ndi mawonekedwe osalala,
• mutu wofooka, osatsitsimutsidwa ndi analgesics.

Zizindikiro zofotokozedwa bwino zimapezeka kumapeto komaliza, organic, gawo la angiopathy. Pakadali pano, kusintha kwa ziwalo zomwe zakhudzidwa kale sikungasinthe, ndipo chithandizo chamankhwala chitha kuchepetsa kukula kwa matendawa.

1. Kupweteka kosalekeza m'miyendo, kuwonda, kuwonongeka pakhungu ndi misomali chifukwa cha kusowa kwa chakudya, kutupa kwa miyendo ndi ana amphongo, kulephera kukhazikika kwakanthawi yayitali ndi angiopathy am'munsi.
2. Mkulu, osagwiritsidwa ntchito pochiza, kuthamanga kwa magazi, kutupa pa nkhope ndi thupi, kuzungulira ziwalo zamkati, kuledzera ndi nephropathy.
3. Kutaya kwamaso kwakumaso ndi retinopathy, chifunga pamaso pa maso chifukwa cha edema yokhudzana ndi matenda a shuga a pakati pa retina.
4. Chizungulire komanso kukomoka chifukwa cha kufinya, kufinya komanso kufupika chifukwa cha kulephera mtima, kupweteka pachifuwa.
5. Kusowa tulo, kusokonezeka kwa kukumbukira ndi kuyendetsa kayendedwe, kuchepa kwa luso la kuzindikira mu angiopathy ya ubongo.

Zizindikiro za zotupa zam'mimba mu miyendo

Zizindikiro	Chifukwa
Paka, khungu lozizira la kumapazi	Kusokonezeka kwa capillary kudakali kothekera
Kufooka kwa minofu ya mwendo	Kusakwanira kwa minofu, kuyambitsa angiopathy
Kufupika pamapazi, khungu lotentha	Kutupa chifukwa cholumikizana ndi matenda
Kuperewera kwa miyendo	Kuchepetsa kwakukulu kwa mitsempha
Yaitali edema	Mitsempha yambiri
Kuchepetsa ng'ombe zazing'ono kapena ntchafu, kuletsa kukula kwa tsitsi pamiyendo	Kutalika kwa mpweya kwa oxygen
Mabala osachiritsa	Zowonjezera zambiri za capillary
Mtundu wakuda zala	Mtima angiopathy
Khungu lozizira lamtambo m'miyendo	Zowonongeka zazikulu, kusayenda kwa magazi, kuyamba gangrene.

Mkati wamkati

Komanso, chosanjikiza ichi chimapereka chinsinsi cha kupumula kwa endothelial. Ndi wopanda izi (zomwe zimawonedwa ndi matenda ashuga ) kuunikira kwa endothelium kumachepa komanso kukana kwa zotengera kumawonjezeka. Chifukwa chake, chifukwa cha kapangidwe kazinthu zingapo zachilengedwe, khoma lamkati lazombo limagwira ntchito zingapo zofunika.

• imalepheretsa mapangidwe amitsempha yamagazi m'mitsempha yamagazi,
• amawongolera mawonekedwe a khoma la mtima,
• imayendetsa magazi
• imagwira ntchito yotchinga, kupewa kuti pasalowe zinthu zakunja,
• amatenga nawo mbali pakukwiya, kuphatikiza okhazikika pakati.

Ndi matenda ashuga, ntchitozi zimachepa. Kutsekeka kwa khoma la mtima kumawonjezera, ndipo glucose amalowa kudzera mu endothelium kukhoma la chotengera. Glucose amasangalatsa mapangidwe a glycosaminoglycans, glycosylation wa mapuloteni ndi lipids. Zotsatira zake, khoma lam'mimba limatupa, kuwala kwake kumachepa, komanso kuthamanga kwa magazi m'mitsempha kumachepa. Kuchuluka kwa magazi kuchepetsedwa kumatengera mwachangu kukula kwa matenda ashuga. Zikakhala zowopsa, magazi amayenda m'matumbo amachepetsedwa kotero kuti amaleka kulimbitsa minofu yoyandikana nayo ndikuyamba kufa ndi njala.

Limagwirira kuwonongeka kwa mtima mu shuga

Komanso, chifukwa cha kuwonongeka kwa khoma lamasamba, njira yokhazikika imayambitsidwa (kuundana kwa magazi ), popeza capillary endothelium imadziwika kuti imatulutsa magazi. Izi zimawonjezera magazi mu ziwiya. Chifukwa chophwanya kapangidwe ka endothelium, imasiya kukhazikitsa gawo lopuma la endothelial, lomwe nthawi zambiri limayang'anira kupendekera kwa zotengera.
Chifukwa chake, ndi angiopathy, Virchow triad imawonedwa - kusintha kwa khoma lamitsempha, kuphwanya kwamphamvu kachitidwe kazinthu komanso kuchepa kwa magazi.

Chifukwa cha njirazi pamwambapa, mitsempha yamagazi, makamaka yaying'ono, yopapatiza, kuunikira kwawo kumachepa, ndipo magazi amayenda mpaka atayima. M'misempha yomwe amapereka magazi, hypoxia imawonedwa (kusowa kwa mpweya ), atrophy, komanso chifukwa chachulukidwe chokwanira ndi edema.

Kuperewera kwa oxygen m'misempha kumayendetsa ma cell a cell, omwe amapanga minyewa yolumikizana.Chifukwa chake, hypoxia ndiyomwe imapangitsa kukula kwa mtima. Choyamba, zombo zazing'ono kwambiri - capillaries za impso - zimavutika.
Chifukwa cha sclerosis mwa capillaries awa, ntchito yaimpso imalephera ndipo kulephera kwa impso kumayamba.

Nthawi zina, mitsempha yaying'ono imatsekeka chifukwa cha magazi, pomwe mumitundu ingapo ya aneurysms (bulging mtima wa bulging ) Zombozi zimasokonekera, zimakhala zocheperako, zomwe zimabweretsa kutaya kwakanthawi (nthawi zambiri pa retina ).

Zizindikiro za matenda a shuga A shuga

Mitundu ya angiopathy ya matenda ashuga:

• matenda ashuga retinopathy (retinal mtima kuwonongeka ),
• matenda ashuga nephropathy (kuwonongeka kwa impso ),
• matenda ashuga angiopathy kuwonongeka kwa capillaries ndi mtima mitsempha,
• matenda a shuga a m'munsi malekezero,
• matenda ashuga encephalopathy (matenda amisala ).

Zizindikiro za matenda a shuga a retinopathy

Kapangidwe ka maso
Diso limakhala ndi mawonekedwe amaso, mitsempha ya maso ndi zinthu zothandizira (minyewa ya minofu ) Diso lamaso palokha limakhala ndi chipolopolo chakunja (ziphuphu ndi sclera ), pakati - mtima ndi wamkati - retina. Retina kapena "retina" imakhala ndi intaneti yake, yomwe umalimbana ndi matenda a shuga. Imayimiridwa ndi mitsempha, arterioles, mitsempha ndi capillaries. Zizindikiro za matenda a shuga a angiopathy amagawidwa pachipatala (zomwe zimaperekedwa ndi wodwala ) ndi ophthalmoscopic (zomwe zimapezeka pamayeso a ophthalmoscopic ).

Zizindikiro zamankhwala
Kuwonongeka kwa ziwiya za retina mu matenda osokoneza bongo sikumapweteka ndipo pafupifupi asymptomatic kumayambiriro. Zizindikiro zimawonekera pang'onopang'ono, zomwe amafotokozeredwa ndi kuchezera kwadokotala.

Madandaulo opangidwa ndi wodwala yemwe ali ndi matenda ashuga retinopathy:

• kuchepa kowoneka bwino,
• mawanga amaso pamaso
• kutulutsa, kuwalira pamaso,
• chophimba kapena nsalu yotchinga pamaso.

Chizindikiro chachikulu cha matenda a shuga a shuga ndikuchepa kwamawonedwe owonekera mpaka khungu. Munthu amataya kutha kusiyanitsa pakati pazinthu zazing'ono, kuwona patali. Chodabwitsachi chimaphatikizidwa ndi kupotoza mawonekedwe ndi kukula kwa nkhaniyo, kupindika kwa mizere yowongoka.

Ngati retinopathy imakhala yovuta ndi zotupa zakumaso, ndiye zimawonetsedwa ndi kukhalapo kwa malo oyandama pamaso pake. Masamba awa amatha kuzimiririka, koma mawonekedwe amatha kulephera. Popeza thupi lamphamvu nthawi zambiri limawonekera, kupezeka kwa magazi mkati mwake (chifukwa chotupa cha mitsempha yamagazi ) ndipo imakwiyitsa mawonekedwe amdima m'munda wamasomphenya. Ngati munthu sankaonana ndi dokotala panthawi, ndiye kuti pakati pa thupi lamphamvu ndi retina, zingwe zimapangidwa zomwe zimakoka retina, zomwe zimapangitsa kuti zimve. Kukhazikika kwa retinal kumawonetsedwa ndi kuchepa kowoneka m'maso (mpaka khungu ), mawonekedwe akuwoneka ndi kunyezimira pamaso pa maso.

Komanso, matenda a shuga a retinopathy amatha kuchitika ndi chitukuko cha edema. Potere, wodwalayo amakhala ndi chophimba pamaso pake, kutayika kwa zithunzi. Chophimba chopitilira patsogolo pa maso kapena mtambo wakomweko ndimalo akuwonetsera edema kapena exudates pa retina.

Zizindikiro za ophthalmoscopic
Zizindikirozi zimapezeka pamayeso a ophthalmoscopic, omwe amakhala ndikuwona momwe fundus ikugwiritsira ntchito ophthalmoscope ndi mandala. Pakuchita kafukufukuyu, adotolo amawunika ziwiya za mtima, zamitsempha. Zizindikiro za kuwonongeka kwa mtima kwa retina zimawonekera kale kwambiri kuposa zodandaula za wodwala.

Nthawi yomweyo, mitsempha yopapatiza imawonedwa pa fundus, ndipo ma micaneurysms amapezeka m'malo. Pakati penipeni kapena m'mitsempha yayikulu pali zotupa zochepa ngati mawonekedwe a madontho. Edema imadziwika kumtunda m'mitsempha kapena pakatikati pa macula. Ma exudates ofewa angapo amadziwika pa retina (kumanga kwamadzi ) Nthawi yomweyo, mitsempha ndiyosungunuka, ndikudzaza magazi ambiri, ochulukitsa, ndipo mawonekedwe ake adalongosoledwa momveka bwino.

Nthawi zina mu vitreous thupi hemorrhages ambiri amawonekera. Pambuyo pake, zingwe zazingwe zimapangidwa pakati pake ndi retina. Mitsempha ya optic imalowa m'mitsempha yamagazi (optic neovascularization ) Nthawi zambiri, zizindikirazi zimayendera limodzi ndi kuchepa kwakuthwa m'masomphenya. Nthawi zambiri, pakadali pano, odwala omwe samanyalanyaza mayeso olimbitsa thupi amapita kuchipatala.

Zizindikiro za matenda a shuga a Nephropathy

Kapangidwe ka impso
Gawo logwira ntchito la impso ndi nephron, lomwe limakhala ndi glomerulus, kapisozi ndi tubules. Glomerulus ndi kudzikundika kwa ma capillaries ambiri momwe magazi amthupi amayenda. Kuchokera magazi am'mapazi kupita m'matumba, zinthu zonse zofunika kwambiri zimapangidwa, ndipo mkodzo umapangidwanso. Ngati khoma la capillary lawonongeka, ntchitoyi imaphwanyidwa.

Zizindikiro za matenda a shuga a nephropathy akuphatikizira madandaulo kuchokera kwa wodwala, komanso Zizindikiro zakuzindikira koyambirira. Kwa nthawi yayitali kwambiri, matenda a shuga a nephropathy amakhala asymptomatic. Zizindikiro zambiri za matenda a shuga amayamba kudziwikiratu.

Zizindikiro zodziwika bwino za matenda ashuga:

• ludzu
• kamwa yowuma
• Khungu
• kukodza pafupipafupi.

Zizindikiro zonsezi zimachitika chifukwa cha kuchuluka kwa glucose m'matupi komanso m'magazi. Pazochitika zina za shuga m'magazi (oposa 10 mmol / lita ) akuyamba kupatsira chotchinga. Kupita ndi mkodzo, glucose amanyamula madzi limodzi ndi iwo, omwe amafotokozera chizindikiro cha kukodza pafupipafupi komanso koperewera (polyuria ) Kutulutsa kwamphamvu kwamadzi kuchokera mthupi kumapangitsa kuti khungu lisokonezeke (chomwe chimayambitsa pakhungu ) ndi ludzu losatha.

Mawonetsero owoneka bwino a matenda a diabetes a nephropathy amawonekera zaka 10 mpaka 15 atazindikira kuti ali ndi matenda ashuga. Izi zisanachitike, pali chizindikiro cha labotale chokha cha nephropathy. Chizindikiro chachikulu chotere ndi mapuloteni mu mkodzo (kapena proteinuria ), yomwe imatha kupezeka mukamayesedwa.

Nthawi zambiri, kuchuluka kwa mapuloteni mu mkodzo watsiku ndi tsiku sikuyenera kupitirira 30 mg. Mu magawo oyamba a nephropathy, kuchuluka kwa mapuloteni mu mkodzo patsiku kumayambira 30 mpaka 300 mg. M'magawo amtsogolo, zizindikiro zamankhwala zikaonekera, kuchuluka kwa mapuloteni kumaposa 300 mg patsiku.

Amayendedwe a chizindikirocho ndi kuwonongeka kwa fungo la impso (kupezeka kwake kumachuluka ,, chifukwa chomwe zimangoyambira zochepa, kenako mamolekyulu akuluakulu.

Matendawa akamakula, zizindikiro za kulephera kwa impso zimayamba kulumikizana ndi zizindikiritso zambiri.

Zizindikiro za nephropathy mu shuga:

• kuthamanga kwa magazi
• Zizindikiro zambiri za kuledzera - kufooka, kugona, nseru.

Kutupa
Poyamba, edema imapezeka kumtunda kwa periorbital (mozungulira maso ), koma matendawa akamakula, amayamba kupangika m'mitsempha yathupi (m'mimba, m'mapazi ) Edema yokhala ndi matenda ashuga nephropathy ndi wotumbululuka, ofunda, ofanana, amawoneka m'mawa.

Kupanga kwa edema kumalumikizidwa ndi kuchepa kwa mapuloteni m'magazi, omwe amachotsedwera limodzi ndi mkodzo. Nthawi zambiri, mapuloteni am'magazi amapanga kupanikizika kwa oncotic, ndiye kuti, amasunga madzi mkati mwa bedi lamitsempha. Komabe, pakutha kwa mapuloteni, madziwo samasungidwamo m'matumbo ndipo amalowa m'matipi. Ngakhale kuti odwala matenda ashuga nephropathy amachepetsa thupi, kunja amawoneka edematous, chifukwa cha edema yayikulu.

Kuthamanga kwa magazi
M'magawo apambuyo, odwala matenda a shuga a nephropathy amakhala ndi kuthamanga kwa magazi. Kuchulukitsa kwa magazi kumalingaliridwa pamene kupanikizika kwa systolic kudutsa 140 mmHg ndipo kuthamanga kwa diastolic kupitirira 90 mmHg.

Njira yopangira kuthamanga kwa magazi imakhala ndi maulalo angapo a pathogenetic. Choyamba, ndikusunga madzi ndi mchere mthupi. Chachiwiri ndi kuyambitsa kwa renin-angiotensin. Renin ndi chinthu chogwira ntchito mwaubwino wopangidwa ndi impso ndipo, mwa njira yovuta, imayendetsa magazi. Renin amayamba kupangidwa mwachangu pamene minyewa ya impso imakumana ndi vuto la mpweya. Monga mukudziwa, capillaries a impso mu shuga mellitus ndi sclerotic, chifukwa chomwe impso imaleka kulandira magazi ofunikira, komanso ndi mpweya. Poyankha hypoxia, renin yowonjezera imayamba kupangidwa. Iwonso, imayendetsa angiotensin II, yomwe imapangika m'mitsempha yamagazi ndikuthandizira kubisala kwa aldosterone. Mfundo ziwiri zomaliza ndizofunikira pakupanga matenda oopsa.

Zizindikiro zodziwika za kuledzera - kufooka, kugona, nseru
Kufooka, kugona, ndi nseru ndizizindikiro zakuchedwa za matenda a shuga. Amakula chifukwa cha kuchuluka kwa zinthu zopangidwa ndi poizoni m'thupi. Nthawi zambiri, zinthu zofunika kwambiri mthupi (ammonia, urea ) amasulidwa ndi impso. Komabe, pogonjetsedwa ndi ma capillaries a nephron, ntchito ya impso imayamba kuvutika.

Zinthu izi zimaleka kuyeretsedwa ndi impso ndikudziunjikira m'thupi. Kudzikundikira kwa urea mthupi kumapatsa odwala omwe ali ndi matenda ashuga nephropathy. Komabe, chowopsa kwambiri ndi kudzikundikira kwa poizoni wa amoni m'thupi. Imalowerera mkati mwa dongosolo lamanjenje ndikulipweteka.

Zizindikiro za Hyperammonemia (mkulu ammonia ):

• nseru
• chizungulire
• kugona
• kukokana ngati kuchuluka kwa ammonia muubongo kufika 0,6 mmol.

Kuopsa kwa kuledzera ndi kagayidwe kachakudya thupi zimatengera kuchuluka kwa impso.

A shuga angiopathy a m'munsi malekezero

Zizindikiro za matenda a shuga a m'munsi mwa malekezero:

• kumverera kwa dzanzi, kuziziritsa, mapokoso,
• ululu, kukokana mwendo komanso kupindika pang'ono,
• kusintha kwa khungu la miyendo,
• zilonda zam'mimba.

Kuchuluka kwa dzanzi, kuziziritsa, ma goosebumps
Kudzimva kutopa, kuzizira komanso kupindika m'miyendo ndi chizindikiro choyamba cha matenda ashuga a m'munsi. Amatha kuwoneka m'malo osiyanasiyana - m'dera la phazi, m'miyendo m'munsi, minofu ya ng'ombe.

Kupanga kwa chitukuko cha zizindikiro izi makamaka chifukwa cha kusakwanira kwa magazi ku zimakhala, komanso kuwonongeka kwa mitsempha. Kuzizira, kuzizira m'miyendo chifukwa chakuyenda bwino kwa magazi, makamaka ndikulimbitsa thupi kwakanthawi. Goosebumps, kumva kuwotcha, kumva kwa thukuta kumachitika chifukwa cha kuwonongeka kwa mitsempha ya zotumphukira (matenda ashuga a m'mimba ), komanso vasospasm.

Ululu, miyendo kukokana komanso kupindika pang'ono
Ululu umayamba pamene minofu ya miyendo imayamba kwa nthawi yayitali kuti muwoneke mpweya wabwino. Izi ndichifukwa chakuchepa kwakukulu kwa lumen ya mtsempha wamagazi ndikuchepa kwa magazi kulowa mkati mwake. Poyamba, ululu umachitika poyenda, zomwe zimakakamiza munthu kuti ayime. Kupweteka kwakanthawi kumeneku kumatchedwa kuchepa kwa nyengo. Zimaphatikizidwa ndi kumverera kwovuta, kulemera m'miyendo. Akasiya kukakamiza, ululu umatha.

Kukokana kwamiyendo kumachitika osati poyenda, komanso kupumula, nthawi zambiri kugona. Amakhala chifukwa chakuchepa kwa potaziyamu mthupi. Hypokalemia imayamba m'matenda a shuga chifukwa cha kukodza pafupipafupi, popeza potaziyamu amatha kwambiri mkodzo.

Kusintha kwa Dystrophic pakhungu la miyendo
Poyambirira, khungu limakhala lotuwa, kuzizira, tsitsi limagwera. Nthawi zina khungu limasuluka. Misomali imachepetsa, kukhala wopunduka, kukhala wonenepa komanso wokhazikika.
Kusintha kumayamba chifukwa cha kusapeza bwino kwa minofu, chifukwa magazi amapereka minofu osati ndi mpweya, komanso michere yambiri. Minofu, popanda kulandira zofunikira, imayamba kulimba. Chifukwa chake, mwa anthu odwala matenda ashuga angiopathy, mafuta onunkhira nthawi zambiri amawonongeka.

Zilonda zam'mimba
Zilonda za trophic zimakhazikika m'mitundu yosinthika ya matenda osokoneza bongo ndipo ndi gawo lomaliza la matenda ashuga am'magawo am'munsi. Kukula kwawo kumalumikizidwa ndi kuchepetsedwa kwa minofu, kuchepa kwathunthu komanso kwanuko. Nthawi zambiri zimayamba chifukwa cha kuyimitsidwa kwam'madzi.

Kukula kwa zilonda, monga lamulo, kumayendetsedwa ndi mtundu wina wovulala, mankhwala kapena makina, nthawi zina amatha kukhala choyambirira. Popeza minofuyo samathandizidwa bwino ndi magazi ndipo chakudya chawo chimasokonekera, kuvulala sikuchira kwa nthawi yayitali. Malo omwe kuvulala kumafalikira, kumakulira kukula. Nthawi zina kachilomboka kamalowa, komwe kamachepetsa machiritso. Kusiyana pakati pa zilonda zam'mimba zam'mimba m'mimba ndikosapweteka kwawo. Ichi ndi chifukwa choyendera mochedwa kwa dokotala, ndipo nthawi zina odwala nawonso kwa nthawi yayitali sazindikira mawonekedwe awo.

Nthawi zambiri, zilonda zimakhazikitsidwa kumapazi, gawo lotsika lachitatu la mwendo, m'dera la chimanga chakale. M'mitundu yosiyanasiyana ya matenda ashuga, zilonda zam'mimba zimatha kudutsa m'magawo.

Matenda a shuga
Phazi la matenda ashuga ndilovuta kusintha kwa phazi la pathological lomwe limachitika kumapeto kwa matenda ashuga, chifukwa cha kupita patsogolo kwa matenda ashuga angiopathy. Zimaphatikizapo kusintha kwa ma trophic ndi osteoarticular.

Ndi phazi la matenda ashuga, zilonda zam'mimba zakufika pamatumbo ndi mafupa zimawonedwa.
Kuphatikiza ndi zilonda zam'mimba, phazi la matenda ashuga limadziwika ndi kusintha kwa mafupa ndi mafupa. Kukula kwa matenda a shugaCharcot phazi ), yomwe imawonetsedwa ndi kufalikira komanso mafupa a mafupa a phazi. Pambuyo pake, izi zimabweretsa kuwonongeka kwa phazi. Komanso, phazi la matenda ashuga limayendera limodzi ndi Menkeberg syndrome, yomwe imakhala yofinya ndi kuwerengera ziwiya zam'mphepete motsutsana ndi maziko a matenda ashuga.

Zizindikiro za matenda a shuga a Encephalopathy

Zizindikiro za matenda a shuga a encephalopathy amakula pang'onopang'ono. Zonse zimayamba ndi kufooka wamba komanso kutopa kwambiri. Odwala nthawi zambiri amakhala ndi nkhawa chifukwa cha mutu womwe suyankha kwa opweteka. Pambuyo pake, zovuta za kugona zimalumikizana. Encephalopathy imadziwika ndi kusokonezeka kwa tulo usiku, komanso kugona nthawi yomweyo masana.
Kupitilira apo, mavuto amakumbukiro ndi chidwi - odwala amakhala oiwalika ndi osokonezedwa. Kuganiza pang'ono, kosasunthika, kuchepa kwa masinthidwe kumawonedwa. Zizindikiro zowoneka bwino zimawonjezeredwa ndi zizindikiritso za ubongo.

Zizindikiro za matenda a shuga a matenda amitsempha:

• kayendedwe ka kayendedwe,
• shaky gait
• anisocoria (m'mimba mwake ),
• vuto losinthika
• zamatsenga.

Madzi a nitrogen otsalira

Urea
M'mwazi wa anthu athanzi, ndende ya urea imachokera ku 2.5 mpaka 8.3 mmol / lita. Ndi diabetesic nephropathy, urea ndende imawonjezeka kwambiri. Kuchuluka kwa urea kumatengera mwachindunji gawo la kulephera kwa impso mu shuga. Chifukwa chake, kuchuluka kwa impso kwama 49mmol / lita kumawonetsa kuwonongeka kwa impso. Odwala omwe ali ndi vuto la aimpso kulephera chifukwa cha matenda ashuga, nerea ingafikire 40-50 mmol / lita.

Creatinine
Monga urea, ndende ya creatinine imalankhula za impso. Nthawi zambiri, kuphatikiza kwake m'magazi mwa akazi ndi 55-100 micromol / lita, mwa amuna - kuyambira 62 mpaka 115 micromol / lita. Kuwonjezeka kwa ndende pamtunduwu ndi chimodzi mwazomwe zimayambitsa matenda ashuga nephropathy.Mu magawo oyamba a matenda a shuga, nephropathy, kuchuluka kwa creatinine ndi urea kumawonjezeka pang'ono, komabe, pomaliza, gawo la nephrosocolotic, kutsata kwawo kumawonjezeka kwambiri.

Magazi a lipid

Kuchuluka kwa cholesterol kumasiyana mwa anthu osiyanasiyana m'njira zosiyanasiyana. Malingaliro ovuta pankhani imeneyi pakati pa akatswiri. Ena amalimbikitsa kuti musapitirire cholesterol pamwamba pa 7.5 mmol pa lita. Chomwe chimavomerezedwa masiku ano sioposa 5.5 mmol pa lita. Kuwonjezeka kwa cholesterol pamtunda wa 6 mmol kumawoneka ngati chiwopsezo chakukulitsa macroangiopathy.

Njira zothandizira kuphunzira matenda ashuga angiopathy:

• mayeso okwanira a ophthalmological, omwe amaphatikizapo mwachindunji ophthalmoscopy, gonioscopy, kufufuza kwa fundus, kujambula kwa stereoscopic reticism komanso kuyanjana kwamalingaliroOCT ).
• electrocardiogram
• echocardiography
• angiography
• Kulemba madera akumunsi,
• Zojambula zam'munsi,
• ultrasound a impso
• Kutulutsa ziwiya za impso,
• mphamvu zamatsenga zakutsogolo.

Kufotokozera zam'madera akumunsi

Njirayi ndiyovomerezeka kwa anthu omwe ali ndi phazi la matenda ashuga, zilonda zam'mimba kapena zodwala zam'munsi. Amasanthula kuchuluka kwa kuvulala konse ndi njira zina zochiritsira. Ngati palibe magazi okwanira amitsempha yamagazi, ndipo magazi atha kubwezeretsedwanso, ndiye kuti lingaliro limachitika pokomera chithandizo chosasamala. Ngati, pa dopplerography, kuphatikizira kwathunthu kwamatumbo kwapezeka, popanda kuthekera kobwezeretsa magazi, ndiye kuti izi zimalankhula ndikuthandizidwenso.

Zoyambitsa Angiopathy

Ndi njira yayitali ya matenda a shuga, mothandizidwa ndi kuchuluka kwa shuga omwe amadutsa m'matumba, makoma a mitsempha, mitsempha ndi ma capillaries ang'onoang'ono amawonongeka. M'malo ena amakhala ochepa thupi komanso opunduka, pomwe ena amawonda. Kuletsa magazi oyenda ndi kagayidwe pakati pa zimakhala. Pankhaniyi, zikuwoneka hypoxia (kukhumudwa ndi mpweya) wama minofu yoyandikana ndipo amakhudza ziwalo zambiri za wodwala.

Mwa ziwiya zazikulu, miyendo (mu 70% ya angiopathies onse) ndi mtima zimakhudzidwa kwambiri. Zambiri zomwe zimayikidwa pama gawo amthupi, kotero njira yosinthira ziwiya pano imathandizira. Pakati michereopathies Nthawi zambiri zotupa za fundus (retinopathy). Vutoli limawonedwa mosiyana.

Ndi nthawi yayitali ya angiopathy yokhala m'munsi komanso ngati palibe chithandizo choyenera, mavuto amatha kuchitika komwe kumayambitsa kulumala kwa munthu.

Zizindikiro

Zizindikiro za matenda a shuga a shuga zimatengera kukula kwa zotengera zomwe zimakhudzidwa komanso kuchuluka kwa zotupa izi.

Microangiopathy imagawidwa m'magawo 6:

• 0 digiri. Wodwala samawonetsa madandaulo, komabe, podziwitsa ena za matendawa, dokotala amapeza kusintha koyambirira m'matumbo
• 1 digiri. Khungu la miyendo limapindika, kuzizira mpaka kukhudza. Mutha kuwona zilonda zazing'onoting'ono zomwe zilibe malo otupa, zowawa pang'ono
• 2 digiri. Zilonda zam'madzi zimakulitsidwa. Zingakhudze minofu ndi mafupa, kuvutitsa wodwala ndi zowawa
• 3 digiri. Mphepete ndi pansi pa zilonda zili ndi malo a necrosis (imfa) mwanjira ya zidutswa zakuda. Pali kutupa kwa malowa, kufiyanso. Osteomyelitis (kutupa kwa mafupa ndi m'mafupa), ma abscesses ndi phlegmon (matenda oyipa a pakhungu ndi zigawo zoyambira)
• 4 digiri. Necrosis amafikira kupitirira pachilonda (mpaka chala kapena kumayambiriro kwa phazi)
• 5 digiri. Necrosis amakhala pafupi phazi lonse. Kuduladula ndiye kuti ndi kosatheka

Macroangiopathy imagawidwa m'magawo:

• Gawo 1. Wodwalayo amakhala ndi nkhawa chifukwa chotopa m'miyendo, kuwuma nthawi yayitali m'mamawa, kudzimbidwa kumiyendo, kutalika kwa misomali. Miyendo ya odwalawa imazizira mosavuta, thukuta kwambiri. Kulimbana kwapakati pakanthawi kumatha kupezeka nthawi zosiyanasiyana mpaka 0,5-1 km.
• 2a siteji. Wodwalayo amakhala ndi nkhawa chifukwa cha dzanzi, miyendo amaundana ngakhale chilimwe. Khungu la miyendo ndiyotuwa, ndikutuluka thukuta kwambiri. Kulankhula mosaloledwa kumachitika pang'onopang'ono - kuchokera 200 mpaka 500 m.
• 2b siteji. Madandaulo akupitilirabe kuvutika chimodzimodzi, koma lameness imachitika pambuyo pa 50-200 m.
• 3a siteji. Zowawa zam'mawa, zoyipa kwambiri usiku, kukokana mwendo, kulowa nawo madandaulo apitawa. Khungu pamiyendo yanga likuwoneka ngati likuyaka kapena kuluma. Pothina, khungu limakhala ndi mtundu wotumbululuka, ndipo pokhazikika ndi miyendo pansi (nditakhala, ndikuyimirira), zala zimapeza mtundu wamtambo. Khungu limakhala louma komanso lotupa. Lameness amapezeka pamtunda wosakwana 50 m.
• 3b siteji. Ululu wamiyendo ndiwokhazikika. Miyendo yatupa. Mutha kupeza zilonda zam'modzi kapena zingapo zomwe zimakhala ndi necrosis.
• Gawo 4. Kutha kwa zala kapena ngakhale phazi lonse ndi chikhalidwe. Imayendera limodzi ndi kufooka kwambiri, kutentha thupi (matenda amalowa).

Chithandizo cha matenda a shuga a Angiopathy

Poyamba, ndikofunikira kusamala mulingo wa shuga m'magazi.

Chithandizo chodziwika bwino ndi monga:

• Statins - atorvastatin, simvastatin.
• Antioxidants - Vitamini E (antioxidant wachilengedwe yemwe amakhala ndi zotsatira zabwino m'mitsempha yamagazi).
• Mankhwala a metabolic - trimetazidine, bonolo ,ateatriazolin.
• Magazi owonda - clopidogrel, heparin, fraxiparin, cardiomagnyl.
• Angioprotectors - parmidin, dobesylate, anginin, dicinone.
• Zopatsa mphamvu za Biogenic - thupi lamphamvu, aloe, FiBS.
• Kuchekacheka kwa gawo la phazi kapena mwendo (pamaso pa gangrene).

Ndi chithandizo cha panthawi yake komanso moyenera, ndizotheka kuti musapweteketse phazi. Komabe, ngati malingaliro a dokotala samatsatiridwa, gangore imayamba mkati mwa zaka 5 kuchokera kutha kwa angiopathy mu 90% ya odwala onse omwe ali ndi matenda awa. Ndipo, pafupifupi 10-15% amafa ndi poyizoni wamagazi ndi poizoni wa necrosis, ndipo ena onse amakhalabe olumala.

Impso Ultrasound

Matenda a shuga a nephropathy amadziwika ndi kupukusa ndi nodular nephrossteosis. Mbali yoyamba, kukula kwa minofu yolumikizika kumawonedwa mosasinthika. Mu malo achiwiri sclerosis amadziwika mu mawonekedwe a mafupa. Pa ultrasound, malo awa a sclerosis amawonekera mwa mawonekedwe a hyperechoic foci (mawonekedwe opepuka amawonekera pa polojekiti ).

Malipiro a mankhwala osokoneza bongo

Kutola nambala 2
Kulowetsa zitsamba kotereku kumayenera kutengedwa pasanathe sabata limodzi, kupuma pang'ono ndikofunikira. Muyenera kugwiritsa ntchito decoction gawo limodzi mwa magalasi atatu (65 mamililita ) mphindi khumi asanadye.

Zofunikira pakukonzekera zopereka:

• mbewu za fulakesi - magalamu khumi,
• muzu wa elecampane - 20 magalamu,
• masamba a nettle - 30 magalamu,
• mahatchi - 30 magalamu.

Mosasamala kanthu za mawonekedwe azitsamba omwe amagwiritsidwa ntchito pokonzekera kusamba, malamulo awa ayenera kutsatiridwa pambuyo pa njira zamadzi:

• siyani masewera olimbitsa thupi kwa maola awiri mutatha kusamba,
• pewani kudya zakudya zozizira kapena zakumwa pambuyo pa njirayi.
• kupatula kugwiritsa ntchito mankhwala oyipa ndi oopsa mkati mwa maola 24 mutatha kusamba.

Kusamba kwa Wheatgrass
50 magalamu a mizu yowuma ya tirigu wosirikiza amathira madzi otentha (imodzi mpaka malita awiri ) ndikukhala pamoto kwa mphindi khumi mpaka khumi ndi zisanu. Thirani msuzi mubafa wadzaza ndi madzi, kutentha kwake osapitirira 35 digiri. Kutalika kwa njirayi sikupitilira mphindi khumi ndi zisanu. Njira yosambira imakhala tsiku lililonse kwa milungu iwiri, pambuyo pake yopuma sabata imafunikira.

Malo osamba oyera
Dzazani 50 magalamu a chomera ndi madzi (magalasi awiri kapena atatu ) ndikukakamira angapo (awiri kapena atatu ) maola. Kenako, ikani moto ndi kulowetsa moto pang'ono kwa mphindi makumi awiri. Sesa msuzi ndikuwonjezera pakusamba ndi madzi (35 - 37 madigiri ) Njira yamadzi imeneyi iyenera kuchitidwa asanagone kwa masiku khumi mpaka khumi ndi awiri.

Kusamba ndi Yerusalemu artichoke
Kukonzekera kusamba ndi Yerusalemu artichoke, konzekerani kilogalamu imodzi ndi theka yosakaniza nsonga, maluwa, tubers (zatsopano kapena zowuma ) Thirani Yerusalemu artichoke ndi ndowa imodzi yamadzi otentha (malita khumi ) ndi kuvala pang'ono moto. Pakatha mphindi khumi kapena khumi ndi zisanu za chithupsa chaching'ono, chotsani pamoto ndikusiya kuti mumupatse mphindi makumi awiri. Sesa msuzi ndikuwonjezera pakusamba kwamadzi (35 - 40 madigiri ) Kusamba ndi Yerusalemu artichoke ayenera kukhala kamodzi masiku awiri kwa masabata awiri kapena atatu.

Kusamba kwawoko
Tengani magalamu 50 a malo owuma a phula ndipo mudzaze ndi lita imodzi (4 makapu ) madzi otentha. Pambuyo maola awiri kulowetsedwa, onjezerani kusamba, kutentha kwa madzi komwe sikuyenera kupitirira madigiri 37. Ndikofunikira kuchita njirayi musanayambe kugona milungu iwiri. Kutalika kwa bafa kumatenga mphindi khumi mpaka khumi ndi zisanu.

Mavalidwe azitsamba
Kukonzekera compress, pogaya chophatikizacho mu Chinsinsi ndikugwiritsira ntchito zilonda zanu. Unyinji umakhazikitsidwa ndi bandeji. Musanagwiritse ntchito phazi lanu, muzisamba ndi madzi ofunda. Mukachotsa bandeji, muzimutsuka ndi kuvala masokosi athonje odera. Pafupipafupi pazitsamba zazitsamba mumakhala kawiri kapena katatu patsiku.

Zopangira compress:

• Masamba ophatikizika ndi masamba atsopano a marigold,
• Masamba ophwanyidwa ndipo pafupifupi mawonekedwe a mtima wowongoka,
• nettle louma limasiya fumbi.

Mafuta compress
Ma compress otengera mafuta, zitsamba ndi zinthu zina zopindulitsa zimakhala ndi mphamvu yochiritsa zilonda zam'mimba ,fewetsani khungu ndikuchepetsa ululu.

Zopangira uchi compress:

• Mafuta oyengedwa masamba - 200 magalamu,
• utomoni wa paini kapena spruce - 50 magalamu (utomoni uyenera kugulidwa ku malo ogulitsa mankhwala kapena m'masitolo apadera ),
• njuchi - 25 g.

Ikani mafutawo mu mbale yachifundo pamoto ndikubweretsa. Onjezani sera ndi utomoni ndikuyatsa moto kwa mphindi zina 5 mpaka 10. Tizilitsa kapangidwe ka kutentha kwa firiji, kuvala bandeji. Tsekani pachilonda ndikuchoka kwa mphindi makumi awiri mpaka atatu. Ndondomeko ziyenera kuchitika tsiku lililonse.

Kuwongolera shuga

Pambuyo pakupezeka kwa matenda a shuga, kupewa kumalimbana ndi kupewa zovuta. Mlingo wa cholesterol m'mwazi ndizowonetsera zomwe zimayenera kuyang'aniridwa, popeza kuchuluka kwake kumakwiyitsa mtima wamitsempha ndikuwonongeka kwa minofu. Miyezi ya shuga ikakwera pamwamba pa 10 mmol / lita, imalowa mu fungo la impso ndikuwonekera mkodzo. Chifukwa chake, tikulimbikitsidwa kuti tisalole kuwonjezeka kwa kusala kwa glucose pamtunda wa 6.5 mmol / lita. Nthawi yomweyo, munthu sangalole kutukuka komanso kutsika kwa shuga m'magazi, chifukwa kusinthasintha kwenikweni kwa glycemia komwe kumawononga mitsempha ya magazi.

Ma paramu omwe amayenera kutsatidwa mu matenda a matenda ashuga:

• kudya kwa glucose: 6.1 - 6.5 mmol / lita,
• glucose maola awiri mutatha kudya: 7.9 - 9 mmol / lita,
• glycosylated hemoglobin: 6.5 - 7.0% ya hemoglobin yonse,
• cholesterol: 5.2 - 6.0 mmol / lita,
• kuthamanga kwa magazi: osapitirira 140/90 mmHg.

Ngati matenda ashuga angiopathy ali ovuta ndi kukula kwa matenda a mtima kapena matenda a hypoglycemic, ndiye kuti magawo amasiyanasiyana pang'ono.

Magawo omwe amayenera kutsatidwa ndi matenda ashuga a shuga omwe amaphatikizika ndi matenda a mtima, komanso zochitika pafupipafupi za hypoglycemic:

• kudya kwa glucose: 7.8 - 8.25 mmol / lita,
• glycosylated hemoglobin: 7 mpaka 9 peresenti,
• kusinthasintha kwa glycemic pakatha tsiku osapitilira 10 - 11 mmol / lita.

Chakudya

Lamulo la zopewera polimbana ndi matenda ashuga a shuga:

• osapatula ntchito yokazinga ndi kusuta zakudya,
• onjezani anyeziyophika kapena yophika ),
• onjezani zipatso zosaphika ndi ndiwo zamasamba zodyeka,
• Zakudya zathanzi, zophika kapena zophika ziyenera kupezeka m'zakudya
• nyama zamafuta (mwanawankhosa, nkhumba ) ayenera m'malo mwa konda (nkhuku, nkhuku, nkhuku ),
• mukaphika nkhuku, khungu liyenera kuchotsedwa mnofuyo,
• zakudya zamzitini ndi zopatsa thanzi zimafunika kuchepetsedwa
• kukonza njira yogaya mafuta, zonunkhira ziyenera kuwonjezeredwa ku chakudya (kupatula tsabola wotentha ).

Ndi chikhumbo chachikulu chokoma, chokoleti ndi zinthu kuchokera mmalo mwake zitha kusinthidwa ndi marmalade kapena marshmallows. Mutha kutsekemera compote ndi zakumwa zina ndi chimanga, mabulosi akutchire, rasipiberi. Zogulitsanso ndizinthu zapadera za confectionery pomwe shuga amasinthidwa ndi kupanga kapena zotsekemera zachilengedwe. Tiyenera kukumbukira kuti kuchuluka kwa mitundu ingapo yopanga shuga kumavulaza thanzi.

Zakudya zopewera matenda a matenda ashuga:

• mankhwala okalamba
• mpunga, chakudya chambiri ndi barele, oatmeal,
• oat, tirigu, mpunga, chinangwa,
• mbatata ndi zakudya zina zambiri zapamwamba.

Kupukusa chakudya chamafuta kumafuna nthawi yambiri kuposa zakudya zina. Zotsatira zake, shuga amapita pang'onopang'ono m'magazi ndipo kapamba amakhala ndi nthawi yokwanira yopanga insulin, ndipo thupi limatha kuyamwa. Pali zakudya zingapo zomwe zimachepetsa shuga m'magazi, zimalimbikitsa kupanga insulin, komanso zimathandizira magwiridwe antchito a kapamba.

Zinthu zopatsa mphamvu za pancreatic:

• sauerkraut,
• mabuluni
• nyemba zobiriwira
• sipinachi
• udzu winawake.

Kusamala kwamadzi
Kusungabe madzi athanzi ndi njira imodzi yofunika kwambiri yopewera matenda ashuga. Madzi okwanira amalimbikitsa kupanga insulin ndi kuyamwa kwake ndi thupi. Kuti maselowo azikhala ndi chinyezi chofunikira, muyenera kumwa pafupifupi malita awiri amadzimadzi patsiku (magalasi asanu ndi atatu ) Mumakonda mchere womwe umakhalabe wamadzi, wopanda zitsamba wazitsamba ndi zipatso. Popewa matenda a shuga a shuga, ndikofunika kuti muthe madzi a makangaza, nkhaka yatsopano, madzi a maula.
Zakudya zamafuta zimayenera kuchepetsedwa ngati vuto laimpso, ochepa matenda oopsa.

Kusamalira miyendo

Malamulo osamalira odwala ashuga am'munsi miyendo:

• Madzulo aliwonse, mapazi ayenera kutsukidwa ndi madzi ofunda ndi potaziyamu permanganate ndi sopo wa ana,
• Pambuyo pa njira zamadzi, miyendo iyenera kuphimbidwa ndi thaulo, kugwiritsa ntchito kirimu ya bactericidal ndikudzoza khungu pakati pa zala ndi mowa,
• muyenera kudula zoseweretsa kamodzi pa sabata pamakona akumanja,
• osatengera njira zopopera ndi kufewetsa khungu la miyendo,
• osayika mapazi pafupi ndi moto, poyatsira moto kapena zida zina zotenthetsera,
• Musayike nsapato zatsopano popanda phazi,
• osagwiritsa ntchito nsapato za anthu ena, masokosi, matawulo amiyendo,
• m'malo a anthu onse (hotelo, dziwe, sauna ) gwiritsani ntchito nsapato zotayidwa.

Ngati mukuwona msomali woloza, ming'alu kapena mabala kumapazi, ngati mukumva kupweteka poyenda komanso kutayika kotheratu kapena pang'ono pang'ono kwa phazi, muyenera kulumikizana ndi katswiri.

Zochita zolimbitsa thupi

Mitundu yochita zolimbitsa thupi mu matenda a shuga:

• amayenda m'mapaki, mabwalo,
• kuyendera dziwe losambira
• kuyendetsa njinga
• Kuyenda masitepe m'malo mokweza,
• kutsitsa mayendedwe akugwiritsa ntchito mayendedwe ofuna kuyenda,
• kuyenda m'nkhalango.

Mukakhala mu mpweya watsopano, kagayidwe kamthupi kamayenda bwino, kapangidwe ka magazi kamasinthidwa. Maselo amafuta amawonongeka mwachilengedwe, ndipo glucose samayenda m'magazi. Ngati pali zovuta zowoneka kuti ndinu wonenepa kwambiri, muyenera kupereka mphindi makumi atatu patsiku pa zamasewera. Masewera olimbikitsidwa ndi mtundu wa katundu ziyenera kusankhidwa malinga ndi momwe thupi liliri, pokambirana ndi dokotala.