zokwanira kulipirira matenda ashuga,

kupindika kwapang'onopang'ono - ndi kubwezeretsa komanso kulumikizana kwa zovuta kuchokera ku ziwalo zomwe mukufuna,

kwambiri - ndi ketoacidosis, lactic acidosis ndi hyperosmolar chikomokere.

Kuzindikiraopulumutsidwa. Munthu amakhala ndi vuto la kugona.

Kuchulukitsa kulemerawowona ndi mtundu II shuga, kuchepa kwa mtundu 1 shuga.

Chikopa: youma, hyperkeratosis, kuchepa turgor kumawonetsa kusowa kwamadzi.

Zikuwoneka rubeosis ndi matenda a masaya, chibwano, pamphumichifukwa kudula kwamakhungu apakhungu

Xanthomas pa mapiko a mphuno, ma auricles, pamafinya a miyendo, pakhosi, pachifuwa, kumaso.

Dermopathy (mawanga atrophic) - mapapo ofiira ofanana ndi 5-12 mm, omwe amasintha mawanga atrophic kutsogolo kwa miyendo, kukula kwa zilonda zam'mimba ndi zilonda zam'mimba.

Lipoid necrobiosis - makulidwe akhungu, osapweteka, ozungulira, ofiira pakhungu la miyendo, omwe amakulirakulira komanso kukula kwa mapangidwe a waxy, omwe pambuyo pake amawoneka kuti ndi androtic,

Vitiligo - malo okhala khungu.

Pofufuza nkhope: blepharitis (kutupa kwa eyelid yapamwamba), balere, kusokonezeka kwa mawonekedwe amaso chifukwa cha kufooka kwa minofu ya oculomotor.

Mwina kuwonongeka kwamawonekedwe chifukwa cha kukula kwa ma catala kapena edema ya mandala.

Kuyendera kwamphamvu kumawululira kusokoneza chifukwa chosakhazikika bwino mwendo chifukwa chophwanya mphamvu zakuya.

Pa kuyang'ana kosasintha: kupunduka kwamapazi chifukwa cha kusalinganika pakati pa ma fetors ndi extensors ndi predominance ya extensor tendon tension, kutulutsa kwa mitu ya mafupa achitsulo, mapangidwe a madera omwe akukakamizidwa.

Kupanikizika kosalekeza kumabweretsa kutsimikizira kwa minofu yofewa ndipo zilonda zam'mimba komanso matenda a shuga.

Kukwiya kwa minofu ya ng'ombe.

Kulephera kopindulitsa amapezeka pokhapokha pokhapokha pamavuto amishuga oopsa: ndi ketoacidotic chikomokere, mtundu wa matenda amtundu wa shuga komanso matenda oopsa a Hyperosmolar.

Monga matenda a shuga kuchuluka kwa kuthamanga kwa magazi: ndi DM-I mu 20% ya milandu, ndi DM-II mu 75%.

Poyambira, hyperinsulinemia, kusungidwa kwa sodium ndi insulin, nephropathy, macroangiopathy ndikofunikira.

Kuchepetsa BP kumachitika ndi ketoacidosis ndi hyperosmolar chikomokere chifukwa cha kusowa kwamadzi.

Kutsika kwa kuthamanga kwa magazi nthawi ya lactic acidosis kumalumikizidwa ndi acidosis, kusokonezeka kwa kuchepa kwa mphamvu ndi kutsika kwa myocardium, komanso kudula kwamitsempha yamagazi.

Matumbo am'mimba:

- matenda am`mimba dyspepsia - hypoacidism,

- matumbo dyspepsia syndrome,

Kuwonongeka kwa chiwindi kumadziwika ndi hepatomegaly yodziwika ndi mafuta a hepatosis.

4. Kusintha kwa ziwalo zamkati mu shuga.

Odwala omwe ali ndi matenda a shuga amapezeka nthawi zambiri kusintha kwa mtimakuphatikiza makamaka atherosulinotic zotupa zosiyanasiyana mitsempha. Myocardial infaration amapezeka mwa odwala matenda a shuga kawiri kuposa anthu amsinkhu umodzi, koma osadwala. Odwala matenda ashuga atherosulinosis obliterans a m'munsi malekezero kumabweretsa mapangidwe a zilonda zam'mapazi zamiyendo ndi miyendo (makamaka chala chakumaso) ndi kukulira kwa pang'onopang'ono.

Matumbo am'mimba ndi matenda a shuga amawonetsedwa pafupipafupi gingivitis ndi stomatitis, amachepetsa makutu ndi magalimoto ntchito zam'mimba, mafuta a chiwindi ndi steatohepatitis.

Kwa odwala matenda a shuga, nthawi zambiri amapezeka matenda ashuga nephropathykuwonetsedwa ndi protsinuria ndi ochepa matenda oopsa ndipo pamapeto pake zimabweretsa chitukuko diabetesic glomerulosulinosis (Kimmelstil-Wilson syndrome) ndi wotsatira aakulu aimpso kulephera, yomwe ndi imodzi mwazomwe zimapangitsa kuti odwala azidwala matenda ashuga.

60-80% ya odwala matenda ashuga amapezeka matenda ashuga retinopathy, yowonetsedwa ndi kukula kwa ma venological venological, kukula kwa ma micaneurysms, zotupa za m'mimba, kutuluka m'matumbo ndikuwatsogolera ku kutayika kwamtsogolo.

Ndi matenda ashuga kuwonongeka kwamanjenje atavala yunifomu matenda ashuga a m'mimba, yomwe imawonetsedwa ngati kuwoneka kwa paresthesia, kuphwanya kwa ululu ndi kutentha kwa kutentha, kuchepa kwa tendon Reflex. Zizindikiro za matenda a shuga a encephalopathy amapezekanso mwa odwala, omwe amawonetsedwa ndi kuchepa kukumbukira komanso zovuta zina zam'mimba.

Momwe mungayendetsere mayeso kunyumba kwa odwala matenda ashuga

Matenda a shuga komanso chizolowezi cha tsiku ndi tsiku zimayenderana - muyenera kukonzekera kudya mokwanira komanso kudya mokwanira komanso kudya nthawi, kupumula, kugona mokwanira, kukhala wathanzi olimbitsa thupi ndikuwonetsetsa kuchuluka kwa shuga. Koma pali chinthu chinanso chomwe chikufunika kuchitika pafupipafupi; ngati muli ndi matenda ashuga, yang'anani miyendo yanu.

Mwanjira imeneyi mutha kupewa kapena kuthana ndi mavuto ammiyendo omwe amadza chifukwa cha matenda ashuga. Sizovuta komanso zitha kuchitidwa kunyumba, chinthu chachikulu nthawi zonse. Ngati simunakhalepo ndi zovuta m'miyendo, siyani kamodzi pa sabata. Ngati mwayamba kuvulaza miyendo yanu, kukhala ndi zilonda ndi zilonda, kapena ngati mulibe kumverera m'miyendo yanu, yang'anani tsiku lililonseb!

Kukhala wonenepa kwambiri kapena kuchepa mphamvu kungapangitse njirayi kukhala yovuta, koma ndikofunikira kuti tikufunseni kuti musachite manyazi komanso funsani thandizo kwa okondedwa. Pansipa pali njira 9 zosavuta zomwe muyenera kuchita mukamayesa mapazi anu kunyumba ya anthu odwala matenda ashuga.

Chifukwa chiyani kusamalidwa koyenera kwa phazi la matenda ashuga ndikofunikira?

Kufunika kwa kupewa komanso kusamalira miyendo ndi matenda ashuga nkovuta. Ngati malamulowa satsatiridwa, matendawa amakula mwachangu ndipo gangore iyamba.

Malinga ndi WHO, 95% yoduladula miyendo imalumikizidwa ndi matenda am'mimba.

Gangrene ndi gawo lomaliza la SDS, lomwe limatsatiridwa ndi zizindikiro zotsatirazi:

• kupweteka kwa mwendo mukamayenda, komanso kupanikizika
• kusokonezeka kwa magazi (miyendo yozizira, mitsempha yotupa, kugunda kwa thukuta, dzanzi, ndi zina).
• kuwonongeka kwa minofu kamvekedwe ka miyendo,
• maonekedwe operewera mapazi,
• chimanga chouma ndi chonyowa, zilonda,
• zilonda zakuya, matenda oyamba ndi phazi.

Palibe zovuta kuti tipewe kudwala matenda opha ziwalo ndi kudzidulira kwina, ndikokwanira kusamalira phazi la matenda ashuga kunyumba ndikumayang'ana dokotala munthawi yake ndikusokonekera pang'ono.

2. Kuyang'anitsitsa miyendo.

Kuyendera kuyenera kuchitika m'mawa kapena madzulo, mutatsuka ndikuumitsa miyendo. Ngati madera a keratinized a epidermis, chimanga ndi chimanga chimapezeka kuti sizikugwirizana ndi kuvala nsapato zatsopano kapena zosasangalatsa, komanso mabala, zilonda, madera owonda a khungu, tikulimbikitsidwanso kuti mukaonane ndi dokotala ndikugwiritsa ntchito zodzikongoletsera mwapadera pa phazi la matenda ashuga.

Zogulitsa zoterezi zimakhala ndi zopatsa mphamvu, zopatsa thanzi, zofewetsa zomwe zimathandizira kubwezeretsanso kwa khungu lanu, komanso kuteteza mapazi kuti asatenge matenda.

3. Kutsuka tsiku ndi tsiku komanso kuchiza matenda amishuga.

Chimanga chouma pamapazi chimafunika kuthandizidwa ndi mwala wa pumice. Mukatha kusamba, muyenera kupukuta mapazi anu ndi chopukutira chofewa, osati kutikita, koma kungowonda.

Onetsetsani kuti mukutsatira zonona zopatsa thanzi, zomwe zimakhala ndi zopukutira zachilengedwe. Mwachitsanzo, mzere wa DiaDerm umapereka mafuta ena apadera osamalira matenda ashuga. Mzerewu umaphatikizapo zonona "zoteteza", "Zowonjezera" ndi "Kufewetsa", zomwe ndi zabwino kugwiritsidwa ntchito tsiku ndi tsiku.

Kirimu "Kubwezeretsanso" - njira yabwino yothandizira mapazi kumapazi kwa abrasions, mabala a jekeseni wotsatira ndi kuvulala kwina. Chimodzi mwa zinthu zopangidwa ndi DiaDerm ndi kupezeka kwa urea ndi mankhwala ena azitsamba ndi mafuta omwe amapangidwa ndi 5-15%, omwe amachepetsa mphamvu, kudyetsa ndikulimbikitsa machiritso a bala ndi kubadwanso kwatsopano.

Dinani pa chithunzi chomwe chili pansipa kuti mudziwe zambiri zokhudzana ndi zitsulo zosokoneza shuga za shuga ndikulamula kuti ziziperekedwa kunyumba kapena makalata.

4. Kudula msomali koyenera.

Misomali ya Ingrown yokhala ndi matenda a shuga nthawi zambiri imayambitsa matenda komanso kutupa. Ndikofunikira kudula misomali mofatsa mzere wowongoka popanda kuzungulira. Makona akuthwa amamangidwa ndi fayilo ya msomali yofewa bwino.

Mukakonza misomali, lumo wokhala ndi malembedwe akuthwa sungagwiritsidwe ntchito. Ngati chala chakumiyendo chikuvulala pakudula, ndiye kuti malowa ayenera kuthandizidwa ndi hydrogen peroxide ndikuthira mafuta opha zilonda, mwachitsanzo, furacilin kapena potengera ndi streptocide. Mu sitolo yathu yapaintaneti mupeza zinthu zabwino komanso zotsika mtengo zosamalira msomali.

5. Kupewa matenda oyamba ndi fungus.

Ndi matenda oyamba ndi fungus, zilonda, zipsera, mabala amawoneka pamapazi. Kukhalapo kwa bowa kumakulitsa kwambiri chiopsezo cha gangore. Kupewa matenda kumatengera malamulo aukhondo.

Komanso, odwala matenda ashuga sayenera kuyenda opanda nsapato m'malo opezeka anthu ambiri, pagombe, m'nkhalango, ndi zina. Masokosi ayenera kusinthidwa tsiku ndi tsiku, kuti tipewe kuvala nsapato zonyansa, zonunkhira bwino komanso zonyowa.

Onetsetsani kuti mukugwiritsa ntchito zonona "Zoteteza" kuti muchepetse kukula kwa mabakiteriya komanso matenda oyamba ndi mabakiteriya, kubwezeretsa chotchinga.

6. Kutsatira mfundo zoyambirira za moyo wathanzi, kulimbitsa chitetezo chathupi.

Kuledzera, kumwa mowa mwauchidakwa, kusuta fodya, moyo wongokhala ndi zinthu zina zomwe zimakhudza mkhalidwe wamiyendo ya matenda ashuga. Kuti muchepetse kuchepa kwa matenda, ndikofunikira kusiya zizolowezi zoipa, kutsatira zakudya komanso kulimbitsa chitetezo chathupi.

Onse odwala matenda ashuga amawonetsedwa tsiku lililonse osapitilira mphindi 30. Anthu okalamba ndi onenepa kwambiri amatha kugwiritsa ntchito ndodo zapadera zoyendera poyenda.

7. Kuvala nsapato zapamwamba.

Nsapato ziyenera kupangidwa ndi zinthu zabwino, zopanda msoko wakukhuthala. Ndikofunika kuti anali ndi lows kapena Velcro kuti azitha kuyika miyendo yonse.

Yokhayo iyenera kukhala yolimba yokwanira kuteteza phazi kuti lisawonongeke. Amaloledwa kukhala ndi chidendene chotsika.

8. Kugwiritsa ntchito ma insoles apadera.

Kusamalira bwino phazi kwa matenda ashuga sikungatheke popanda kutsitsa wapamwamba kwambiri. Pachifukwa ichi, kutsitsa ma insoles komanso ma insoles amakono apangidwa kuti amagawana thupi ndikuletsa kupindika kwa zala ndi phazi, komanso kupewa mapangidwe a chimanga.

Ma insoles omwe ali ndi kukumbukira ali ndi machitidwe abwino, omwe amatengera mawonekedwe kutengera mawonekedwe a physico-anatomical a eni ake. Kugwiritsa ntchito matenda a shuga kuphatikiza ndi nsapato zosankhidwa bwino kungathandize kupewa kukula kwa zizindikiro zambiri za VDS.

Dinani pa chithunzi pansipa kuti mudziwe zambiri zokhudzana ndi matenda a shuga ndikuwayitanitsa kuti atumize kunyumba kapena potumiza makalata.

Kodi phazi la matenda ashuga limatha kuchiritsidwa?

Tiyenera kumvetsetsa kuti matenda ashuga ndi zotsatira za matenda ashuga. Mankhwala amakono sangathe kuchiritsa mitundu yambiri ya matenda a shuga, zomwe zikutanthauza kuti chiopsezo chokhala ndi SDS chimakhalabe moyo wonse.

Komabe, kutsatira malamulo onse omwe ali pamwambapa ndikudziwa momwe mungagwiritsire matenda a matenda ashuga, mutha kuchepetsa kwambiri mwayi wokhala ndi matendawa.

Malo athu ogulitsira omwe ali pa intaneti ali ndi mankhwala othandiza kwambiri komanso amakono a matenda ashuga. Timapereka ku Russia konse ndi otumiza kunyumba kwanu, kumalo operekera malamulo ndi makalata. Dinani pa chithunzi pansipa ndikupeza zina.

№1 Onani malo oyenera kuti ayime

Choyamba, miyendo iyenera kukhala yoyera. Pambuyo pakutsimikizira izi, khalani pampando, kama kapena chimbudzi m'chipinda chopepuka. Ikani miyendo yanu patsogolo panu. Kenako kwezani phazi limodzi mwendo umodzi ndikuyika pabondo la linalo kuti mumveke bwino. Mwendo wotsamira uyenera kupumulanso.

Ayi. 3 Onani phazi

Pogwiritsa ntchito manja anu, muzungulire chidendene kuti mutha kuwona nokha. Musati mopitirira muyeso ndipo musatambasule minyewa ya ankolo. Ngati kusunthaku sikunaperekedwe kwa inu, gwiritsani ntchito thandizo la kalilole wamthumba kuti mufufuze phazi mukuwunikira.

Zidendene - Yendani pa iwo ndi zala zanu kuti mumve ngati khungu, louma kapena loyipa. Kumbukirani kuti ngakhale ming'alu yaying'ono kwambiri imayambukiridwa mosavuta. Chifukwa chake, onetsetsani kuti mukupukuta mapazi anu ndi mafuta apadera ndi mafuta odzola omwe alibe khungu komanso fungo. Koma sizingatheke kuti musanyowetse khungu pakati pa zala, chifukwa malo achinyezi komanso otentha amakonda kwambiri mabakiteriya.

Ma poti a phazi (malo omwe zala zimakula) - Onjezerani mosamala matumba a phazi lanu ndi zala zanu kuti mukhale ndi mawonekedwe achilendo pakhungu kapena kutupa. Gawo ili la phazi limapanikizika kwambiri pakuyenda, kotero ma callus amatha pano. Mutha kupewa maonekedwe awo posankha nsapato zabwino komanso kugwiritsa ntchito njira zopewera.

Ma Soles - Komanso, onani mosamala kuti zotupa ndi zotupa, zomwe zingakhale chizindikiro cha kuwonongeka kwa fupa kapena minofu. Ngati chowunika chikuwonetsa mabala kapena zilonda, musazengereze, kukaonana ndi dokotala.

No. 5 Yang'anirani miyendo mosamala

Yang'anirani miyendo mosamala kuchokera kumbali zonse, yang'anani kusiyana kulikonse pazomwe mumakonda - chimanga, zipsera, mafupa, redness, khungu lowuma.

Gawo lakumapazi ndi mapazi - Yang'anani ngati pali kusintha kulikonse pakati pa kayendedwe ka magazi - khungu lolimba, lopepuka kapena loonda kwambiri, mawanga amdazi, kusiyana kwa kutentha. Kutuluka kwa magazi kumatha kupitilizidwa kudzera mu zochitika zolimbitsa thupi komanso kuwongolera shuga.

# 6 Onani zala zanu

Pogwiritsa ntchito zala zanu, dalitsani zala zanu pang'ono, onetsetsani zala zawo ndi khungu pakati pawo.

Kuzungulira msomalith - pezani misomali yolowera yomwe ndi yosavuta kuzindikira yofiyira ndi khungu lotupa msomali. Misomali ya Ingrown imafuna kupita kukaonana ndi dokotala wa opaleshoni (osati bwana wa pedicure!), Ndipo milandu yonyalanyazidwa imabweretsa ngozi yathanzi.

Zala - kuti muyese kuyenderera kwa magazi, pofinyani zala za sekondi, koma modekha. Ngati zonse zili m'dongosolo, khungu labwinobwino limabweza masekondi 5. Khungu losungunuka pazala zimatanthawuza kuti muli ndi mavuto oyenda.

Misomali - muyenera kuyang'ana misomali popanda varnish. Yang'anani misomali yachikasu kapena kutulutsa kapena kusungunuka kapena misomali yambiri, chifukwa kusinthaku kungakhale chizindikiritso cha miyendo. Ngati mungapeze china chonga ichi, onetsetsani kuti mukumana ndi dermatologist, osadzilimbitsa nokha, ndizowopsa!

Ayi. 7 Tsatirani izi

Lembani zotsatira za mayeso - zonse ndizofunikira: kutentha kosazolowereka, chimanga, mabala, kutupa. Fotokozani mwatsatanetsatane momwe amawonekera, kununkhira kwake komanso malo othandiza omwe angasinthe. Fananizani zolemba ngati mukuwona china chachilendo. Ngati zizindikilo zilizonse zikuwoneka zatsopano kapena zovuta zatsopano, onetsetsani kuti mwalankhula ndi dokotala nthawi yomweyo.

№8 Tetezani thanzi pamapazi pamsewu

Anthu ambiri amakonda nyengo yofunda, koma kumbukirani kuti imagwirizanitsidwa ndi kuwonjezeka zolimbitsa thupi, dzuwa komanso osati nsapato zabwino nthawi zonse.

• Onetsetsani kuti mukuvala nsapato zapadera za aqua pagombe kapena m'madzi. Ngakhale mchenga wocheperako kwambiri umatha kuyambitsa zovuta ndi ming'alu zosavuta kuphonya panthawi.
• Valani nsapato mumsewu - nthawi zonse. Mchenga wotentha ndi phula zimatha kuwononga khungu la miyendo yanu nthawi yomweyo. Ndiosavuta osazindikira zinthu zakuthwa zikugona mochenjera muudzu komanso panjira.
• Nthawi zonse gwiritsani ntchito mawonekedwe a dzuwa pamapazi anu. Kuwotcha makamaka matuza kumatenga mosavuta.
• Pewani nsapato ndi nsapato zokhala ndi zingwe zopyapyala komanso mbama. Chifukwa chiyani? Chifukwa mikangano imabweretsa mabala, ndipo mitundu yotseguka siyiteteza miyendo yanu kuti isawonongeke.
• Mutabwerako mumsewu, yang'anani mapazi anu. Kuwotcha chomera, kulumidwa ndi tizirombo ndi zikhadabo ndizitseko zotseguka za matenda. Sambani ndikuchiritsa mabala onse ndi kuvulala nthawi imodzi.

No. 9 Dulani misomali yayikulu ndi ma pulasitala

Ma-tweilers a msomali ndiosavuta kugwira ngakhale ndi dzanja limodzi, ndipo kugwiritsa ntchito kwawo kumatha kukupulumutsani ku mawonekedwe a misomali yolowera komanso kuwonongeka kwa khungu.

Ngati mukukhala ndi vuto la maso, nthawi ina mumakhala ndi zilonda kapena kumva kuwonongeka m'miyendo, ngati kuli kotheka, muyenera kuyang'anira chisamaliro cha mapazi anu kwa madotolo aluso - akatswiri a matenda am'mimba.

Kusamalidwa koyenera kwamapazi ndikofunikira kwa anthu odwala matenda ashuga. Nthawi ndi nthawi muzifufuza nokha mavuto anu ndikuwona dokotala pafupipafupi kuti athetse mavuto onse asanakhale pamavuto akulu. Za Ndi zinthu ziti zomwe ndizoyenera kusamalira khungu ndikusamalira khungu lanu chifukwa cha matenda ashugawerengani apa.

Zizindikiro ndi chithandizo cha matenda ashuga, phazi kusamalira matenda ashuga

Matenda a shuga ndi matenda oopsa osachiritsika, omwe amakhala ndi zovuta zambiri. Zowopsa kwambiri za izo zimadziwika kuti ndi matenda ashuga othamanga (SDS). Malinga ndi World Health Organisation, matenda amtunduwu amapezeka mwa 15% ya odwala matenda a shuga a zaka 5 kapena kuposerapo.

Diabetesic phazi matenda - pathological kusintha mu mantha dongosolo, ochepa ndi capillary mabedi, zomwe zingayambitse mapangidwe a zilonda zam'mimba njira ndi gangrene.

Pafupifupi 85% ya milandu yotereyi ndi zilonda zam'mapazi za trophic, zotsalazo ndi ma abscesses, phlegmon, osteomyelitis, tendovaginitis ndi nyamakazi ya purulent. Izi zimaphatikizanso zowonongeka zopanda mafupa kwa mafupa amipweya - matenda ashuga a psychoarthropathy.

Zomwe zimayambitsa matenda a diabetesic phokoso

Mu matenda a shuga, kupangika kwa mahomoni - insulin, ntchito yomwe ikuthandizira shuga (shuga) kufikira maselo amthupi kuchokera m'magazi, kotero ikakhala yochepa, glucose amatuluka m'magazi, pamapeto pake akusokoneza kuyenda kwa magazi m'matumbo, zomwe zimakhudza ulusi wamitsempha. Ischemia (kusowa kwa magazi) kumabweretsa kuchiritsa kwamabala, ndipo kuwonongeka kwa mitsempha kumayambitsa kuchepa kwamphamvu.

Matendawa amathandizira kukulitsa zilonda zam'mimba, zomwe zimayamba kukhala pang'onopang'ono. Ming'alu iliyonse, abrasions imasanduka zilonda zotseguka, komanso zokhala ndi zilonda zobisika pansi pa mafinya ndi zigawo za keratinized.

Chomwe chimayamba mochedwa kuchiza ndikuduladula malekezero ndikuti wodwalayo kwanthawi yayitali sazindikira kusintha komwe kumachitika, chifukwa nthawi zambiri samayang'anira mapazi ake. Chifukwa cha kusowa kwa magazi m'miyendo ngakhale kuti kuchepa kwa chidwi, kupweteka kumadukiza komanso kuchekeka sikumamveka kwa wodwala ndipo ngakhale chilonda chitha kupezeka kwa nthawi yayitali.

Nthawi zambiri, phazi limawonongeka m'malo momwe katundu onse amafunikira poyenda, ming'alu imakhazikika pansi pa khungu, momwe matendawa amalowera, ndikupanga mawonekedwe abwino owoneka ngati bala loyera. Zilonda zoterezi zimatha kukhudza miyendo mpaka mafupa, tendon. Chifukwa chake, pamapeto pake, pakufunika kufunika kwa kudulidwa.

Mdziko lapansi, 70% ya zinthu zonse zomwe zimadulidwa zimayenderana ndi matenda ashuga, ndipo ndi chithandizo chanthawi ndi nthawi, pafupifupi 85% ikhoza kupewedwa. Masiku ano, pamene maofesi a Diabetesic Foot akugwira ntchito, kuchuluka kwa zomwe zadulidwa, chiwerengero chaimfa chatsika, ndipo chithandizo chothandizira ndi 65%. Komabe, chiwerengero chenicheni cha odwala omwe ali ndi matenda a shuga chimakhala chambiri kuposa katatu poyerekeza ndi ziwerengero, chifukwa ambiri sakayikira kuti akudwala.

Chifukwa chake, zomwe zimayambitsa kukula kwa matenda a diabetesic syndrome ndi:

• kuchepa kwamphamvu kwa miyendo (matenda ashuga a m'mimba)
• kuzungulira kwa matenda am'mitsempha komanso ma capillaries ang'onoang'ono (diabetesic micro- and macroangiopathy)
• kufooka kwa phazi (chifukwa cha motor neuropathy)
• khungu lowuma

Kuchepa kwa Mphamvu - Matenda a shuga a shuga a shuga

Choyambitsa chachikulu cha kuwonongeka kwa mitsempha ndizovuta zomwe zimachitika m'magazi a mitsempha yayikulu. Matenda oterewa pakokha samayambitsa necrosis ya minofu. Zilonda zimachitika pazifukwa zina, zosadziwika:

Zilonda zopangidwa pambuyo pa mikrossadin, mabala ndi mafinya, zimachiritsa kwambiri, kukhala ndi vuto. Kuvala nsapato zosasangalatsa komanso zolimba kumakulitsa kuwonongeka pakhungu. Zilonda zam'mimba, zomwe zimakula ndikukula, zimadutsa minofu ndi mafupa. Malinga ndi kafukufuku, kukula kwa zilonda za neuropathic mu 13% ya milandu kumabweretsa kukula kwambiri kwa stratum corneum ya epermermis (hyperkeratosis), mu 33% - kugwiritsa ntchito nsapato zosakwanira, 16% - chithandizo cha phazi ndi zinthu zakuthwa.

Kutaya kwa magazi - matenda ashuga macroangiopathy

Kuwonongeka kwa magazi m'mitsempha yamiyendo kumalumikizidwa ndi ma atherosulinotic plaque (onani momwe mungachepetse cholesterol popanda mankhwala). Atherossteosis, yomwe imapangitsa kuwonongeka kwa ziwiya zazikulu, zokhala ndi shuga ndizovuta ndipo zimakhala ndi zinthu zingapo.

• Zokhudza m'munsi mwendo (m'miyendo yam'munsi)
• kuwonongeka kwamitsempha ya miyendo yonse iwiri komanso m'malo angapo nthawi imodzi
• amayamba m'mbuyomu kuposa odwala omwe alibe matenda ashuga

Atherosulinosis wodwala yemwe ali ndi matenda osokoneza bongo angayambitse kufa kwa minofu ndi kupangika kwa zilonda zam'mimba zokha, popanda kupsinjika ndi makina. Okosijeni wosakwanira amalowa pakhungu ndi mbali zina za phazi (chifukwa kuphwanya kowopsa kwa magazi), chifukwa chake, khungu limamwalira. Ngati wodwalayo samatsata njira zopewera ngozi ndikuwonjezera khungu, ndiye kuti malo owonongeka akufalikira.

Zizindikiro zamankhwala ndizopweteka kumapazi kapena zilonda zam'mimba, kuuma ndi kuwonda kwa khungu, komwe kumagwiritsidwa ntchito kwambiri ndi microtrauma, makamaka zala. Malinga ndi kafukufuku, zida zoyambitsa zotupa za neuroischemic zili mu 39% ya zotupa zam'mapazi kumapazi, 14% chithandizo cha miyendo ndi zinthu zakuthwa, mu 14% - kuchotsa mosasamala kwa misomali yovomerezeka ndi dokotala.

Zotsatira zochititsa chidwi kwambiri za SDS ndikudula kwa dzanja (laling'ono - mkati mwa phazi ndi kukwera - pamlingo wam'munsi ndi ntchafu), komanso imfa ya wodwalayo chifukwa cha zovuta za purulent-necrotic process (mwachitsanzo, kuchokera ku sepsis). Chifukwa chake, aliyense yemwe ali ndi matenda ashuga ayenera kudziwa zizindikiro zoyambirira za phazi la matenda ashuga.

• Chizindikiro choyamba cha zovuta ndi kuchepa kwa chidwi:
  • kumanjenjemera poyamba
  • ndiye kutentha
  • ndiye zopweteka
  • komanso wamanyazi
• Komanso, maonekedwe a kutupa kwamiyendo ayenera kukhala atcheru (zoyambitsa)
• Kutsika kapena kuwonjezeka kwa kutentha kwa phazi, i.e. ozizira kwambiri kapena phazi lotentha, ndiye chizindikiro cha kusokonezeka kwa magazi kapena matenda
• Kuchulukitsa mwendo kutopa mukamayenda
• Ululu wamkamwa - popuma, usiku, kapena poyenda mtunda wina
• Kubowola, kuzizira, kuwotcha kumapazi ndi zina zomveka zachilendo
• Sinthani khungu la miyendo - mataso akhungu, ofiira kapena ofiira
• Kuchepetsa tsitsi
• Sinthani mawonekedwe ndi mtundu wa misomali, mikwingwirima pansi pa misomali - zizindikiro za matenda oyamba ndi fungus kapena kuvulala kwa msomali komwe kungayambitse necrosis
• Kuchiritsa kwakatalika kwa mabala, mabala, chimanga - m'malo mwa masabata 1-2 miyezi itatu, atachira mabala pali mawonekedwe amdima osasowa
• Zilonda pamapazi - osachiritsidwa kwa nthawi yayitali, atazunguliridwa ndi khungu lowonda, lowuma, nthawi zambiri lakuya

Sabata lililonse, mumayenera kuyang'ana miyendo, mutakhala pa mpando pakalilore pansi kuchokera pansi - zala ndi gawo lakumapazi limatha kuyang'aniridwa, kulabadira malo omwe ali pakati, kumva ndikumayang'ana zidendene komanso kokha ndi galasi. Ngati kusintha kwasintha, ming'alu, mabala, zilonda zam'mimba zopanda mafupa zikapezeka, muyenera kulumikizana ndi podiatrist (katswiri wamapazi).

Odwala omwe ali ndi matenda ashuga amayenera kupita kwa akatswiri osachepera kamodzi pachaka ndikuwunika madera awo otsika. Ngati masinthidwe apezeka, wothandizira poloat amakhazikitsa mankhwala othandizira pamapazi, angiologist amagwira ntchito pamatumbo amiyendo, ngati ma insoles apadera amafunikira, ndiye kuti angiosurgeon amafunikira, ndipo nsapato zapadera - orthopedist.

Kutengera kufalikira kwa chifukwa chimodzi kapena zingapo, matendawa amagawidwa m'mitundu ya neuropathic ndi neuroischemic.

KUKONZEKA KWA ZOPHUNZITSIRA MU DIABETES MellITUS

Odwala omwe ali ndi matenda ashuga ayenera kuwunika momwe alili osati kunyumba kokha, komanso pogwiritsa ntchito mayeso a labotale.

Cholinga chachikulu cha kafukufuku wapadera ndi:

• kudziwa matenda oyamba,

• wodwalani azigwira ntchito,

• kukonza bwino ndikuwonjezera chiyembekezo chodwala wodwala matenda ashuga.

Ndani makamaka ayenera kuyang'anira mayeso azachipatala nthawi zonse, osadalira njira zodziyang'anira yekha? Choyamba, kwa odwala omwe asokoneza kulolera kwa glucose, ndiye kuti, omwe shuga imatha kusintha kukhala labu (yosalamulira mothandizidwa ndi insulin) miniti iliyonse.

Kuphatikiza pa mayeso a labotale (Gawo 7), odwala matenda ashuga amayenera kukakumana ndi mitundu ina ya mayeso pogwiritsa ntchito zida zowunikira (Table 8).

Kufufuza pafupipafupi kumathandizira kuzindikira zovuta kumayambiriro koyambirira pomwe matendawa atha kubwezeretsedwanso. Koma mayeso awa okha siokwanira kutsimikiza kwathunthu kuti palibe kusintha kwakukuru paumoyo. Kuphatikiza apo, odwala amafunika kuyendera madokotala aluso m'malo osiyanasiyana omwe amayesa khungu, mucous nembanemba, mano, mano, kumvera mtima, kupanga ma electrocardiogram, kutalika kwa muyeso ndi kulemera kwake, m'mawu amodzi, kuyezetsa kachipatala kokwanira komanso kudziwa momwe wodwalayo alili .

Chifukwa chake, ndi matenda ochepetsa shuga a shuga, kuyesedwa kwathunthu kwamankhwala kumachitika kamodzi miyezi isanu ndi umodzi, ndi njira yodziwika bwino ya matendawa - kamodzi miyezi itatu, ndi matenda oopsa a shuga, madokotala amayenera kumuwunika wodwalayo mwezi uliwonse. Anthu omwe akudwala matenda ashuga amayenera kuwunikidwa pafupipafupi ndi akatswiri awa: endocrinologist, oculist, neurologist, opaleshoni, gynecologist, cardiologist.

Popeza kuti shuga imatha kukhala mwa anthu, makamaka okonzekereratu, ndikupita patsogolo modabwitsa, anthuwa amayenera kupita kuchipatala.

Ngati munthu alibe, koma pali zifukwa zingapo zomwe zingayambitse matenda ashuga, ayenera kupita ku endocrinologist kamodzi pachaka, makamaka 2 pachaka. Kuphatikiza apo, paulendo wanu woyamba kuchipatalachi, muyenera kuyesedwa ndi katswiri wa zamitsempha. Kuyendera kwina kwa akatswiri awa kumachitika pofunikira. Dotolo wamanoyu amayenera kuchezeredwa pachaka. Pankhaniyi, muyenera kuyang'ana kuchuluka kwa shuga m'magazi, kutsika kwa shuga mkodzo tsiku lililonse ndikupanga mayeso a kulolera kwa glucose - osachepera 1 pachaka.

Gome la mayeso okhazikika a labotale kwa odwala onse omwe ali ndi matenda ashuga

Mndandanda wa mayeso wokhazikika wokhudzana ndi odwala omwe ali ndi matenda ashuga

Pankhani ya kulekerera kwa glucose, endocrinologist imayenera kuchezeredwa katatu pachaka, ndipo wamisala, ophthalmologist ndi mano - 1-2 pachaka. Nthawi zambiri, odwala oterowo amayenera kupimidwa mayeso a Laborator kwa mkodzo wa magazi ndi mkodzo (patsiku) - kanayi pachaka, mayeso okhudzana ndi shuga - 1 kamodzi pachaka, kuyezetsa magazi ambiri ndi kuyesa mkodzo wapafupipafupi - komanso nthawi 1 pachaka , kutsimikiza kwa lipids m'magazi - 1 pachaka, chitani electrocardiogram - 1 nthawi pachaka.

Kusamalira miyendo chifukwa cha matenda ashuga: ndikotheka kutulutsa ndi momwe mumapumira?

Anthu odwala matenda a shuga amadziwa kuti miyendo ndi ziwalo zomwe zimawonetsa shuga wambiri. Kupatula apo, mavuto akulu kwambiri omwe amakhalapo ndi matenda am'mimba a chifuwa chachikulu ndi zilonda zam'mimba, mabala osachiritsika osachiritsika komanso ovulala.

Komanso, odwala ali ndi zizindikiro zina zosasangalatsa - dzanzi, kuyaka ndi kumva kulira m'miyendo. Nthawi zambiri pamakhala mawonekedwe osafunikira kwenikweni, koma osasangalatsa, monga kupukuta kunja kwa khungu, matenda a misomali. Ndipo chifukwa cha matenda ophatikizika, kusinthika kwa phazi ndikuthekanso.

Amakhulupirira kuti ndi matenda amtundu wa 2 shuga, kuwonongeka kwa phazi kumachitika chifukwa cha zovuta zamitsempha yama mtima. Komabe, izi sizowona konse.

Zomwe zimatsogolera pakukula kwa matenda a diabetesic phokoso ndi angiopathy (kugwa kwamitsempha yamagazi) komanso neuropathy (kuwonongeka kwamitsempha yamanjenje). Komanso, matenda omaliza amakula kawiri kapena katatu. Chifukwa chake, ndikofunikira kudziwa momwe mungasamalire miyendo yanu ndi matenda a shuga.

Popewa kukula kwa zilonda, ndikofunikira kupereka chisamaliro choyenera chamapazi kwa odwala matenda ashuga. Koma musanatenge chilichonse, muyenera kupenda miyendo kuti muwone:

1. chimanga,
2. zipsera
3. ming'alu
4. bowa
5. mawanga
6. redness ndi zowonongeka zina.

Panthawi yowunikira, kuyang'anira kuyenera kulipidwa osati kokha kuzitsulo, komanso zala. Kupatula apo, ngakhale matenda amatha kulowa pang'ono pang'onopang'ono. Kuphatikiza apo, kupanikizika kwapang'onopang'ono kwa neuropathy ndi matenda a shuga sizingabweretse mavuto ambiri, koma kwa munthu wathanzi ndizopweteka kwambiri.

Malonda osamalira othandizira phazi aku Urea ayenera kugwiritsidwa ntchito kawiri pa tsiku. Izi zimathandiza kukoka khungu loyipa ndikutuluka hydrate. Ndipo mutatha kuthira mafuta, kuti muwonjezere zochita zake, muyenera kuvala masokosi.

Komabe, ndizoletsedwa kuyika mafuta amenewo pamalo ocheperako komanso osalala pakati pa zala. Kupatula apo, khungu pakadali pano silikukokomeza. Nthawi zambiri, miyendo yokhala ndi matenda a shuga imakololedwa ndi othandizira monga Uroderm, Mikospor, Fungoterbin Neo, Cleore ndi ena.

Ngati palibe zovulala, ming'alu, zilonda, kapena zolakwika zina pamapazi anu, zilowerereni osamba. Pakati pa njirayi, ndikofunikira kuwongolera kutentha kwa madzi, kuyenera kuchokera ku madigiri 30 mpaka 36.

Kuti muthe kugwirira ntchito komanso muzisangalala, ndikofunikira kuwonjezera mafuta ofunikira (madontho 1-3), mchere wamchere kapena mankhwala azitsamba pakusamba. Koma popewa kudwala matenda ashuga a m'mimba, kudzakhala kokwanira kukweza miyendo yake kamodzi patsiku m'madzi ofunda.

Kutalika kwa gawo limodzi ndi mphindi 5 mpaka 15. Pambuyo pa njirayi, khungu limafooka ndikuyamba kunenepa kwambiri. Kusintha kwake, khungu lofewa pamiyendo liyenera kuchotsedwa mosamala tsiku lililonse pogwiritsa ntchito pumice.

Kumapeto kwa njirayi, miyendo imapukuta, kuphatikiza madera pakati pa zala, chifukwa chinyezi chowonjezera chimathandiza kuchepetsa kuteteza kwa khungu. Kenako zonona zapadera zimayikidwa kumbuyo kwa phazi ndi kumbuyo.

Ngati zilonda, mabala ndi abrasions zikuwoneka, khungu la miyendo liyenera kuthandizidwa ndi hydrogen peroxide kapena antibacterial othandizira monga Aquazan, Dioxidine kapena Miramistin.Zinthu zokhala ndi zakumwa zoledzeretsa, kuphatikizapo zelenka ndi ayodini, sizingagwiritsidwe ntchito, chifukwa zimapukusa kwambiri khungu ndipo zimathandizira kuti pakhale ming'alu.

Kwa chisamaliro cha tsiku ndi tsiku, ndikofunikanso kusankha sopo wopanda mowa, womwe umagwirizana ndi mulingo wa pH pakhungu. Kwa mapazi owuma, muyenera kusankha zonona zonona, zopatsa thanzi mwachilengedwe.

Ikhoza kukhala chinthu chomwe chili ndi lanolin ndi pichesi, mafuta a azitona kapena ma sea buckthorn.

Ma algorithms a matenda, mankhwalawa komanso kupewa matenda a shuga

Diabetesic foot Diabetesic foot syndrome (SDS) imaphatikiza kusintha kwamatenda mu zotumphukira zamanjenje, ma arterial ndi microvasculature, zochitika za osteoarthropathy, zomwe zimawopseza chitukuko cha

Matenda a shuga a matenda ashuga (SDS) amaphatikiza kusintha kwa ma pathological mu zotumphukira zamanjenje, ma arterial ndi microvasculature, zochitika za osteoarthropathy, zomwe zimawopseza chitukuko cha ma ulcerative necrotic process ndi gangrene phazi. SDS ndi imodzi mwazovuta zovuta za matenda osokoneza bongo a mellitus (DM), omwe akupezeka mwaoposa 70% ya odwala. Ngakhale kuti kuwonongeka kumadera otsika sikumakhala chifukwa chachindunji cha imfa kwa odwala, nthawi zambiri kumabweretsa kulumala. Pafupipafupi kuduladula miyendo kwa odwala matenda ashuga ndi 15-30 kuchulukirapo kuposa chizindikiro ichi pamawerengero a anthu 50-70% onse omwe sanadulidwe. Komabe, ziyenera kudziwidwa mwapadera kuti mu mtundu II shuga mellitus (insulin-yodziyimira payokha), panthawi yomwe amadziwika, kuyambira 30% mpaka 50% odwala ali ndi zizindikiro zowonongeka pamunsi yotsika ya digiri imodzi kapena imzake.

Mtengo wachuma womwe ungafunike pakulandila odwala ambiri ndiwambiri, koma ziyenera kukumbukiridwa kuti mukamagwiritsa ntchito njira, mitengo iyi imachulukitsa kawiri mpaka 4. Izi zimachitika chifukwa cha kukwera mtengo kwa maopaleshoniyo pakokha, komanso kuwonjezeka kwa ndalama zomwe zingachitike pakukonzanso (ma prosthetics, kulumala kwathunthu). Kuduladula nthambi imodzi kumabweretsa kukulira katundu winayo, ndipo, chifukwa cha izi, chiopsezo chotenga zilonda zam'mimba m'chiwalo chamkati chikukula kwambiri.

M'magawo azachipatala a padziko lonse omwe othandizira ndi opanga opaleshoni apanga, gulu la odwala matenda ashuga latengedwa, malinga ndi momwe pali mitundu itatu yayikulu yamankhwala.

• neuropathic
• ischemic
• neuroischemic (wosakanizidwa).

Kugawikaku kwatengera malingaliro amakono pankhani ya pathogenesis ya SDS ndi predominance ya imodzi mwazomwe zimalumikizana (neuropathy, micro- and macroangiopathy) pankhani inayake yamankhwala. Mtundu uliwonse wamankhwala wa SDS umafuna njira zochiritsira mosiyanasiyana.

Chimodzi mwazomwe zikuwonetsa matenda a diabetesic neuropathy ndi matenda a shuga. Masinthidwe otchulidwa kwambiri mu kapangidwe ka mafupa ndi minyewa ya phazi amatchedwa Charcot olowa kapena phazi. Kuphatikiza pa kuphatikizika kwa Charcot koyenera, mitundu ina ya zotupa zam'mimba m'magazi a shuga imasiyanitsidwa: mafupa am'mimba, hyperostosis, osteolysis, patological fractures ndi kudzipatula kwazomwe zimachitika. Mwakuchita, mitundu yosiyanasiyana ya mitundu yomwe ili pamwambapa imawonedwa mwa wodwala yemweyo, yemwe amalumikizana ndi zofala za zomwe ali nazo pathogenetic ndikuzindikira. Poganizira izi, olemba ambiri amalinganiza kuphatikiza mitundu ya kusintha kwa ma pathological m'mafupa ndi mafupa pansi pa mawu akuti "phazi la Charcot."

Kuti muzindikire zilonda zam'munsi kwambiri mwa odwala omwe ali ndi matenda ashuga, njira inayake yodziwitsira matenda ndi yofunika, yomwe ili ndi njira zotsatirazi.

1. Mbiri yopambana ikutenga. Kutalika kwa matendawa, mtundu wa matenda ashuga (mtundu I kapena mtundu II), chithandizo cham'mbuyomu, komanso kupezeka kwa zizindikiro za neuropathy panthawi ya mayeso kapena koyambirira, monga kupindika kapena kupweteka m'miyendo, kukokana mu minofu ya ng'ombe, dzanzi, parasthesia, ndikofunikira . Kudandaula kwodandaula kwa pang'onopang'ono kudandaula ndi chizindikiro cha macroangiopathy. Nthawi ya kuyambika kwa ululu, mtunda womwe wodwalayo amadutsa asanayambike kupweteka koyamba, kupezeka kwa kupweteka kumatengedwa. Mosiyana ndi kupweteka kwa ischemic, komwe kumatha kupezekanso usiku, minyewa yam'mitsempha yam'mimba imayendayenda poyenda. Kupweteka kwa Ischemic kumachepera pamene kupindika miyendo kuchokera m'mphepete mwa kama. Mbiri ya zilonda zam'mimba kapena chodulira ndi chizindikiro chofunikira chidziwitso cha kukula kwa zotupa zatsopano phazi. Ndi zovuta zina zomwe zimachitika posachedwa matenda ashuga, monga retinopathy ndi nephropathy (makamaka gawo lakelo), mwayi wokhala ndi vuto la zilonda zam'mimba ndizambiri. Pomaliza, pakupeza anamnesis, ndikofunikira kudziwa kuzindikira kwa wodwalayo kuti mwina amatha kuwonongeka kwa phazi mu shuga, zomwe zimayambitsa komanso njira zodzitetezera.

2. Kuyang'ana kumapazi - Njira yosavuta kwambiri komanso yothandiza yopezera zotupa za phazi. Ndikofunika kulabadira zizindikiro monga mtundu wa miyendo, khungu ndi tsitsi, zofooka, edema, madera oopsa komanso malo, zilonda zam'mimba, mkhalidwe wa misomali, makamaka m'malo ophatikizana, omwe nthawi zambiri samayang'aniridwa. Palpation amatsimikiza ndi pulsation mu mitsempha ya phazi.

3. Kuunika momwe minyewa imaphatikizira:
a) Kusanthula kwamphamvu yamagetsi pogwiritsa ntchito foloko yomaliza maphunziro. Kwa chotupa cha neuropathic, kuwonjezeka kwa gawo losuntha kwa chidwi ndi chikhalidwe, chifukwa kuwonongeka kwa ischemic, zizindikiro zikugwirizana ndi nyengo yanthawi.
b) Kutsimikiza kupweteka, ma tactile komanso kutentha kwa kutentha kutengera njira zofananira. M'zaka zaposachedwa, minyewa yamankhwala yotulutsa minyewa yatchuka kwambiri, kulola kudziwa motsimikiza molondola kuchuluka kwa kuphwanya kwa chidziwitso chazovuta.
c) Tanthauzo la tendon Reflex.
d) Electromyography ndiyo njira yophunzitsira kwambiri yokhudza momwe mitsempha yamapazi ilili, koma kugwiritsidwa ntchito kwake kumakhala kochepa chifukwa chovuta kwambiri komanso mtengo wokwera phunziroli.

4. Kuunika kwa magazi ochepa. Njira zogwiritsidwa ntchito kwambiri zomwe sizowukira pakuwunika momwe magazi akutumphukira - Doppler, dopplerography. Kupsinjika kwa systolic mu mitsempha ya ntchafu, m'munsi mwendo ndi phazi kumayesedwa - mulingo wa occlusion umatsimikiziridwa ndi kukakamizidwa kwa gradient. Zisonyezero za ankolo-brachial index (LPI) zimawonetsa kuchepa kwa kuthamanga kwa magazi ochepa (LPI = RAG / RPA, pomwe RAG imapanikizika ndi systolic mu mitsempha ya kumapazi kapena miyendo, RPA imapanikizika ndi systolic mu brachial artery). Zowonetsera za kupanikizika kwa systolic ndi LPI zimatsimikiza njira yowfufuzira yowunika. Ngati ndi kotheka, kutsimikiza kwa minofu ya okosijeni kumachitika, ndipo angiography imagwiritsidwa ntchito kuthana ndi funso loti mwina angiosuction chithandizo. Zizindikiro za kuponderezedwa kwa systolic zimatha kukhala chitsogozo china malinga ndi kuthekera kochizira, amakupatsaninso mwayi woneneratu za kuchiritsidwa kwa zilonda zam'mapazi.

5. Kujambula kwanyimbo ndi mapazi limakupatsani kuzindikira zizindikiro za matenda am'mimba a shuga, kudziwa kuwonongeka kwa mafupa ochepa a phazi, kukayikira kukhalapo kwa osteomyelitis, kupatula kapena kutsimikizira kukula kwa guleini.

6. Kafukufuku wazikhalidwe wakhala Chofunika kwambiri pakusankhidwa kwa maantibayotiki okwanira.

Magulu otsatirawa a odwala ali pachiwopsezo chotenga SDS:

• akudwala distal polyneuropathy,
• akudwala zotumphukira zamatenda,
• mbiri ya zilonda zam'mapazi,
• Zizindikiro
• kudwala matenda oopsa komanso hypercholesterolemia,
• khungu
• akudwala matenda ashuga nephropathy, makamaka pa matenda a impso,
• okalamba osungulumwa
• oledzera, osuta.

Odwala omwe ali pachiwopsezo amayesedwa kuti atenge mayeso pamwambapa kamodzi pa miyezi isanu ndi umodzi. Kuunika kuyenera kuchitika ndi akatswiri ophunzitsidwa bwino a endocrinologist kapena gulu la akatswiri (endocrinologist, dokotala wa opaleshoni, radiologist, katswiri pakuwunika) mu polyclinics komwe amakhala. Odwala omwe ali ndi mitundu yosiyanasiyana ya matenda am'magazi a matenda ashuga ayenera kupita ku madipatimenti apadera azachipatala kapena ku malo osungirako matenda a Diabetes, omwe amakhala m'magulu a zipatala zam'mizinda yosiyanasiyana. Njira zamankhwala zochizira wodwala aliyense zimatsimikiziridwa kutengera mtundu ndi zovuta za matenda ashuga, kupezeka kwa zovuta zina za matenda ashuga ndi matenda okhudzana ndi izi.

1. 
   Gurvich M. Mankhwala othandizira odwala matenda ashuga. Moscow, 1996. Kulemba: Moscow, Sovetsky Sport Publishing House, 2001, masamba 285, kufalitsa makope 10,000.
2. 
   Kamensky A. A., Maslova M. V., Chiwerengero A. V. Ma Horone amalamulira dziko. Endocrinology yotchuka, Buku la AST-Press - M., 2013. - 192 c.
3. 
   Watkins P.J. Matenda a shuga (kutanthauzira kuchokera ku Chingerezi). Moscow - St. Petersburg, Binom Publishing House, Nevsky Dialect, 2000, 96 pp., Makope 5000.

Ndiloleni ndidziwitse. Dzina langa ndi Elena. Ndakhala ndikugwira ntchito ya endocrinologist kwa zaka zoposa 10. Ndikukhulupirira kuti pakadali pano ndili katswiri pantchito yanga ndipo ndikufuna kuthandiza alendo onse omwe amapezeka pamalowo kuti athetse zovuta osati ntchito. Zinthu zonse za tsambalo amazisonkhanitsa ndikuzikonza mosamala kuti athe kufotokoza zambiri zofunikira. Musanagwiritse ntchito zomwe zikufotokozedwa pa webusayiti, kukambirana ndi akatswiri ndizofunikira nthawi zonse.