Kuyang'ana kwa odwala omwe ali ndi matenda ashuga

Matenda a shuga - matenda osakhalitsa. Kuti akhalebe olimba pantchito komanso kupewa kutulutsa zovuta, odwala awa amafunikira kukayezetsa kuchipatala mwachangu komanso mwadongosolo. Iyenera kuyesetsa kukulitsa chiyembekezo cha wodwala aliyense matenda a shugaSD), komanso kupatsa odwala matenda aakulu mwayi wokhala ndi moyo wakhama ndi kugwira ntchito.

Kupimidwa kwa kachipatala kumafunikira kwa odwala omwe ali ndi vuto la matenda osiyanasiyana, komanso anthu omwe ali pachiwopsezo. Izi zitha kupewa, makamaka pazochitika zina, kukulira mawonekedwe a matendawa kapena kusintha kwa mitundu yake yolimba.

Ntchito yaofesi ya endocrinology yamizinda komanso yam'mizinda imaperekedwa ndi endocrinologist ndi namwino; m'malo ambiri amatauni ndi madera azitawuni, madokotala amaperekedwa mwapadera ndikukonzekera kuthana ndi mavutowa. Ntchito za dokotala wa nduna ya endocrinology zimaphatikizapo: kulandira odwala oyambira ndi azachipatala, kuyesa mayeso onse achipatala kwa odwala, kuchipatala kwawo pamaso pa zidziwitso zadzidzidzi komanso mwanjira yomwe akukonzekera.

Pofuna kudziwa ndikuchiza zovuta za matenda a shuga, matenda opezekanso, dokotala waofesi ya endocrinology amagwira ntchito mogwirizana ndi akatswiri omwe amagwirizana ndi maudindo ena (opaleshoni, neurologist, gynecologist, dotolo wamano, opaleshoni) amagwira ntchito yomweyo kapena m'mabungwe ena (madokotala apadera komanso zipatala).

Khadi lotuluka (fomu No 30) limapangidwa kwa wodwala yemwe ali ndi matenda oopsa a shuga, omwe amasungidwa muofesi.

Ntchito zazikuluzikulu za kuyesedwa kwa odwala omwe ali ndi matenda a shuga:

1. Kuthandizira kupanga njira yolembetsera wodwala tsiku ndi tsiku, yomwe imaphatikizapo njira zonse zochiritsira ndipo ndi yoyenera kwambiri malinga ndi moyo wabanja.
2. Kuthandiza pakuwongolera ntchito, malingaliro othandizira odwala ndipo, monga momwe akuwunikira, kuyesa ntchito, ndiye kuti akukonzekera zolemba zofunika ndi kutumiza kwa wodwala ku MSEC.
3. Kupewa kwamphamvu zadzidzidzi.
4. Kupewa komanso kuchiza kwamatenda a shuga a mellitus - shuga.

Njira yothetsera mavutowa imatsimikiza:

1) dongosolo mwatsatanetsatane odwala omwe ali ndi matenda osokoneza bongo omwe ali ndi zofunikira zonse zochizira (mapangidwe a hypoglycemic othandizira, magulu okwanira amitundu osiyanasiyana a insulin),
2) kuwongolera kokwanira nthawi yonse ya matendawa (kuwunikira momwe ntchito zimalipirira kagayidwe kachakudya) ndikuzindikiritsa munthawi yake zovuta za matenda a shuga (njira zapadera zoyeserera ndi upangiri waluso),
3) Kukula kwamayendedwe amodzi kwa odwala kuti azichita masewera olimbitsa thupi,
4) chithandizo chanthawi yake munthawi zadzidzidzi, kuwonongeka kwa matendawa, kuzindikirika kwa zovuta za matenda a shuga,
5) kuphunzitsa odwala momwe angayang'anire matendawa ndikuwongolera chithandizo.

Pafupipafupi mayeso a odwala ndi okadwala zimatengera mtundu wa matenda ashuga, kuopsa kwake ndi machitidwe a matendawa.

Pafupipafupi hospitalization okonzekera odwala amakhalanso chifukwa cha magawo.

Zizindikiro zazikulu zakugonekedwa kuchipatala kwa odwala omwe ali ndi matenda a shuga (nthawi zambiri izi zimagwira ntchito kwa odwala omwe ali ndi matenda osokoneza bongo):

1. Matenda a shuga, precomatose state (chisamaliro chachikulu ndi kutulutsa mphamvu, posakhalapo komaliza - chipatala cha endocrinological kapena chachipatala chachipatala chamankhwala ozungulira ndi mawotchi oyang'anira mawotchi oyambira).
2. Kubowola kwambiri kwa matenda ashuga okhala ndi ketosis kapena ketoacidosis (endocrinological).
3. Kubwezeredwa kwa matenda a shuga, kufunika kosankhidwa ndi / kapena kukonza insulin (kuchipatala cha endocrinological).
4. Matenda a shuga ndi omwe amabweza matenda ena aliwonse omwe amapezeka paliponse monga chipatala cha endoginological.
5. Mlingo wosiyanitsa wa matenda a shuga pochitika matenda enanso (chibayo cham'mimba, kuchuluka kwa cholecystitis, kapamba, ndi zina), mwina kupangitsa chiwonetsero cha matenda ashuga kuchipatala, ndipo matendawa amakhala oyamba (achire kapena ena mu mbiri yanu) chipatala).
6. Osiyanasiyana kuwonongeka kwa matenda ashuga mellitus pamaso pa mawu a angiopathy: hemorrhage mu retina kapena vitreous nthabwala, trophic zilonda kapena gangrene phazi, mawonetseredwe ena (kuchipatala kuchipatala choyenera).

Kugwiritsira ntchito kuchipatala kwa odwala omwe ali ndi matenda oopsa a shuga, makamaka a mtundu 2, sikofunikira chifukwa chodwala, kupezeka kwa ketosis, glycemia wambiri (11-12 mmol / l pamimba yopanda kanthu komanso tsiku lonse) komanso glucosuria, kusowa kwa matendawa. mawonetseredwe a matenda osiyanasiyana a shuga angiopathies, kuthekera kopeza chipukuta cha matenda osokoneza bongo popanda insulin mankhwala poika mankhwala azakudya kapena mankhwala othandizira pakudya mapiritsi ochepetsa shuga (Tsp).

Kusankhidwa kwa njira yochepetsera shuga pamankhwala ena kuli ndiubwino pamankhwala ochepetsa ululu, popeza amakupatsani mankhwala omwe amachepetsa shuga, poganizira njira yomwe wodwala amayenda nayo tsiku ndi tsiku. Kuchiza kwa odwala motere kuli kotheka ndikuwongolera kwa labotale, pogwiritsa ntchito kudziyang'anira nokha ndikuwunika kwa odwala ndi akatswiri ena kuti athe kuzindikira momwe ziwiya zam'magulu osiyanasiyana zimayendera.

Pamagwiritsidwe ntchito othandizira odwala omwe ali ndi matenda osokoneza bongo omwe amawalandira kale, omwe adalandira kale chithandizo, kuphatikiza pa ndondomeko yoyesera zamankhwala, mikhalidwe iyi ndi iyi:

1. Kukhazikika kwa matenda a shuga kapena a hypoglycemic, precomatous state (kuchipatala cholimbitsa odwala kwambiri kapena kuchipatala cha endocrinological).
2. Kubwezera kwa matenda a shuga, matenda a ketoacidosis, pakafunika kuwongolera mankhwala a insulin, mtundu ndi mapiritsi omwe amachepetsa shuga mu chitukuko, mwina kwachiwiri kutsutsana ndi TSP.

Odwala omwe ali ndi matenda a shuga, makamaka a mtundu wa 2 mwamphamvu, okhala ndi ketosis popanda zizindikiro za ketoacidosis (okwaniritsa zonse, mawonekedwe a glycemia ndi glucosuria tsiku lililonse, kuyankha kwamkodzo tsiku ndi tsiku mpaka kutsekeka kwathunthu), ndikotheka kuyambitsa njira zake kuti athetse.

Amachepetsedwa ndikuchotsa chifukwa cha ketosis (kubwezeretsa zakudya zosemphana ndi kumwa ndikuchepetsa mankhwala osokoneza bongo, kuletsa biguanides ndikuyamba kuchiza matenda omwe amagwirizana), malingaliro kuti achepetse kwakanthawi kuchuluka kwa mafuta m'zakudya, kuwonjezera kumwa ndi zipatso zachilengedwe, kuwonjezera alkalizing othandizira (zakumwa zamkati, kutsuka soda enemas). Odwala omwe amalandila chithandizo cha insulin amatha kuwonjezeredwa ndi jakisoni wowonjezera wa insulin yochepa mu gawo la magawo 6 mpaka 12 panthawi yofunikira (tsiku, madzulo) kwa masiku atatu. Nthawi zambiri, izi zimatha kuchotsa ketosis mkati mwa masiku awiri mobwerezabwereza.

3. Kupita patsogolo kwa matenda ashuga angiopathies a kutanthauzira kosiyanasiyana ndi polyneuropathies (chipatala cha mbiri yofananira - ophthalmologic, nephrological, opaleshoni, ndi upangiri wa endocrinologist, endocrinological mosasamala kanthu za njira ya metabolic). Odwala omwe ali ndi matenda osiyanasiyana a shuga angiopathy, makamaka siteji ya retinopathy, nephropathy okhala ndi vuto lofooka aimpso, ayenera kuthandizidwa kuchipatala katatu pachaka komanso pafupipafupi. Pamaso pa matenda a shuga a mellitus, ndikofunikira kukonza mlingo wa mankhwala ochepetsa shuga mu chipatala cha endocrinological, pomwe maphunziro ena onse akhoza kuchitika m'madipatimenti apadera.

4. Shuga mellitus mumtundu uliwonse wa chipukutiro ndi kufunikira kwa kuchitira opaleshoni (ngakhale atachitidwa opareshoni yaying'ono, chipatala cha opaleshoni).
5. Shuga mellitus mumtundu uliwonse wamalipidwe ndi kukulitsa kapena kufalikira kwa matenda okhathamira (chibayo, kapamba, cholecystitis, urolithiasis, ndi ena, chipatala cha mbiri yoyenera).
6. Matenda a shuga ndi matenda apakati (maofesi a endocrinological ndi oletsedwa, mawu ndi zidziwitso zimapangidwa motsatira malangizo).

Ku chipatala, njira zamankhwala zothandizira pakudya, ma insulin Mlingo amayesedwa, kufunikira kumakhudzidwa ndipo magawo olimbitsa thupi amasankhidwa, malingaliro amaperekedwa kuti athandizidwe ndikuwongolera nthawi ya matendawa, komabe, wodwala yemwe amakhala ndi matenda osokoneza bongo amakhala kunyumba ndipo amayang'aniridwa ndi dokotala wa polyclinic. Matenda a shuga amafunika kuchita zambiri komanso zoletsa kuchokera kwa odwala ndi mabanja, zomwe zimapangitsa kuti zikhale zofunikira kusiya moyo wawo wamba kapena kusintha. Achibale ali ndi zovuta zambiri pankhaniyi.

Thandizani banja kuphunzira "kukhala ndi matenda ashuga" - Gawo lofunikira kwambiri la ntchito ya dokotala wa chipatala. Chofunikira kwambiri pakuthandizira mankhwalawa ndicho kulumikizana ndi mwayi wolankhulana patelefoni ndi banja la wodwalayo. Kudziwa mawonekedwe a zakudya, momwe amakhalira komanso mkhalidwe wamavuto m'banjamo zithandizira adotolo kuti abweretse malingaliro ake pafupi kwambiri ndi zikhalidwe za banja, ndiye kuti, zizipangitsa kuti zikhale zothandiza kwambiri kuti zizigwiritsidwa ntchito. Nthawi yomweyo, kulumikizana pafoni kumalola wodwala, anthu am'banja kukhala pamavuto kuti agwirizane ndi zochita zawo ndi adokotala ndipo potero aletse kukula kwa kuwonongeka kwa matendawa kapena kuchepetsa mawonekedwe ake.

Kusiyanitsa kosiyanitsa sikotchipa kwenikweni

Ngati ife mwa anthu akuluakulu, titatsimikizira kuchuluka kwa zaka 30 ndi kuposerapo, komanso tili m'gulu la anthu onenepa kwambiri - kuyambira zaka 18, timayang'ana shuga wokhazikika kamodzi pachaka, tidzatha kudziwa matenda ashuga panthawi yake ndikuletsa zovuta zambiri kuti tisunge mabiliyoni ambiri . Momwemonso ndi kuyeza kuthamanga kwa magazi, kudziwa kuchuluka kwa cholesterol.

Ubwino wopimidwa kuchipatala

Kudziwona koyipa kwa thupi m'thupi la glucose kumakupatsani mwayi woyambira chithandizo kumayambiriro, kupewa matenda a prediabetesic boma kukhala matenda. Ntchito yayikulu yoyesa matenda a shuga ndikuwunika chiwerengero chokwanira cha anthu. Atawulula za matenda, wodwalayo adalembetsa, pomwe odwala amalandila mankhwala pansi pamapulogalamu okondera ndipo nthawi zambiri amayesedwa ndi endocrinologist. Ndi kuchulukitsa kwa wodwalayo kutsimikiza mu chipatala. Kuphatikiza pa mayeso okonzekera kuchipatala, udindo wa wodwala umaphatikizanso zochita zomwe zimathandizira kukhala ndi moyo wautali komanso wathunthu:

Shuga amachepetsedwa nthawi yomweyo! Matenda a shuga m'kupita kwa nthawi angayambitse matenda ambiri, monga mavuto amawonedwe, khungu ndi tsitsi, zilonda zam'mimba, zilonda zam'mimba komanso matenda otupa! Anthu amaphunzitsa zinzake zowawa kuti azisintha shuga. werengani.

kutsatira malangizo a dokotala
kupereka kwakanthawi mayeso ofunikira,
chakudya
zolimbitsa thupi,
shuga poyesa kugwiritsa ntchito glucometer
kudziletsa matenda.

Mtundu wofatsa wa shuga umaphatikizapo kupita kukaonana ndi katswiri kamodzi miyezi itatu, ndipo ndi matenda ovuta, tikulimbikitsidwa kuyesedwa pamwezi.

Kuyesedwa kwa matenda a shuga kumaphatikizapo kuzindikiritsa anthu omwe akudwala komanso amakonda matenda. Madokotala amayang'anira kwambiri kuyang'anira kulolera kwa shuga mwa odwala motere:

ana omwe makolo awo ali ndi matenda ashuga
azimayi amene amabereka ana akuluakulu (kulemera kwa 4-5,5 kg),
woyembekezera ndi amayi atabereka,
anthu onenepa, onenepa kwambiri
odwala ndi kapamba, matenda amkati a puritis, dermatological pathologies, matenda amkati.

Anthu azaka zopitilira 40 azikhala ndi chidwi chapadera ndi mayeso a kupewa ndi endocrinologist. Pakadali pano, matenda amtundu wa 2 amawopsa. Matendawa amatha kubisika mobisa. Mwa anthu achikulire, zovuta zomwe zimayambitsidwa ndi matenda amowonekera. Mukamayesedwa ku chipatala, ndikofunikira kuti muziyesedwa pafupipafupi, pezani upangiri pakugwiritsa ntchito mankhwala komanso mawonekedwe a zakudya.

Chinsinsi cha kuyesedwa kwa matenda ashuga

Kuyang'anitsitsa kwa odwala omwe ali ndi matenda ashuga kumatha kukhala ndi thanzi laumunthu m'malo abwino, kukhalabe ndi magwiridwe antchito komanso moyo wabwino. Kufufuza kuchipatala kumaulula zovuta zomwe zingachitike poyambira. Njira zochizira zimachitika kunja kwa chipatala, ndipo wodwalayo sayenera kusintha mzere wamoyo. Kuyesedwa koyenera kwa achipatala kumatha kupewa zovuta zazikulu (ketoacidosis, hypoglycemia), kubwezeretsa kulemera kwa thupi komanso kukhala kwachidziwikire. Odwala amatha kulandira malingaliro kuchokera kwa akatswiri m'magawo osiyanasiyana.

Madokotala Amayendera

Anthu odwala matenda ashuga amayang'aniridwa ndi endocrinologist. Potsatira mayeso oyamba, funsani dokotala, gynecologist, Optometrist ndi neurologist. Odwala amatenga kuyesa kwa magazi ndi mkodzo, kuchita x-ray ndi electrocardiogram, kutalika kwa muyeso, kulemera kwa thupi, komanso kuthamanga. Akatswiri a maseche, a neurologist ndi gynecologist (kwa akazi) amalimbikitsidwa kuti azichezera chaka chilichonse. Atazindikira zovuta za matenda ashuga, akatswiri adzalembetsani mankhwala malinga ndi zotsatira zake. Matenda owopsa a matendawa amaphatikizapo kufunsira kwa dokotala wa opaleshoni ndi otolaryngologist.

Kafukufuku

Njira zoyesera zoyeserera matenda a shuga ndi kuchepa thupi, pakamwa pouma, kukodza mopitilira, kumeta m'mwamba ndi m'munsi. Njira yosavuta komanso yotsika mtengo yodziwira matenda am'mayesero ndi kuyesa kusala kwa plasma glucose. Asanapendeketsedwe, wodwalayo akulangizidwa kuti asadye chakudya kwa maola 8.

Kwa munthu wathanzi, chizolowezi chomwa magazi othamanga ndi 3.8-5,5 mmol / L, ngati zotsatira zake zili zofanana kapena zazikulu kuposa 7.0 mmol / L, kuzindikira kwa matenda a shuga kumatsimikiziridwa. Kuzindikira kumafotokozedwa ndikuyesa kulekerera kwa glucose nthawi iliyonse. Chizindikiro cha 11.1 mmol / L ndikukwera ndi njirayi chikuwonetsa matenda. Pozindikira amayi apakati, komanso kupezeka kwa matenda a prediabetes ndi matenda ashuga 2, kuyesedwa kwa kuyamwa kwa glucose kwachitika.

Ndikofunikira kuti wodwalayo azilamulira payekha shuga mumagazi.

Kulembetsedwa kwa odwala omwe ali ndi matenda ashuga ndikofunikira, kuyezetsa kuchuluka kwa glycosylated hemoglobin A1c kapena HbA1c m'mwazi ndikofunikira. Njira iyi ndikudziyang'anira nokha kuchuluka kwa shuga kunyumba ndikofunikira pakuwongolera chithandizo. Odwala opatsirana, maso ndi mapazi amayenera kuwunika kawiri pachaka. Kuzindikira koyambirira kwa kusagwira bwino kwa ziwalozi zomwe zili pachiwopsezo cha matenda ashuga kumathandizira chithandizo. Kuyang'anira kuchuluka kwa shuga m'magazi ndikumaliza ntchito zomwe dokotala amateteza kumakhala ndi thanzi komanso moyo wabwino.

Zomwe zimachitika pakuwunika kwa ana

Kuphwanya kwa kulolerana kwa glucose komwe kumawonekera kumawunikira kumawonetsa kulembetsa kwa mwana.Ndi zowerengera zoterezi, tikulimbikitsidwa kukaona endocrinologist miyezi itatu iliyonse ndi ophthalmologist kamodzi miyezi isanu ndi umodzi. Njira zoyeserera zimaphatikizira kuyang'anira kuchuluka kwa thupi, chiwindi, kuwunika kwa khungu. Mawonetsedwe ena amatendawa amayang'aniridwa: bedwetting, hypoglycemia.

Nthawi zotsatila, ana omwe ali ndi matenda ashuga amayenderedwa ndi endocrinologist mwezi uliwonse; kamodzi miyezi isanu ndi umodzi, muyenera kufunsa dokotala wazachipatala (wa atsikana), wa ophthalmologist, wamisala, ndi wamano. Panthawi yoyesedwa, kutalika ndi kulemera, mawonekedwe a shuga (polyuria, polydipsia, kununkhira kwa acetone panthawi yanthawi yotupa), mawonekedwe a khungu, chiwindi chimayang'aniridwa nthawi zonse. Kuyang'aniridwa kwakukulu kumayendetsedwa ku malo a jakisoni mwa ana. Mu atsikana, maliseche amawunikidwa kuti awonetse mawonekedwe a vulvitis. Ndikofunikira kupeza upangiri wa udokotala pakubaya jekeseni kunyumba ndi zakudya zakudya.

Kodi zikuwonekabe zosatheka kuchiritsa matenda ashuga?

Poona kuti mukuwerenga izi tsopano, kupambana polimbana ndi shuga wambiri sikuli kumbali yanu.

Ndipo mudaganizapo kale za chithandizo kuchipatala? Ndizomveka, chifukwa matenda ashuga ndi matenda oopsa, omwe, ngati sanapatsidwe, amatha kufa. Udzu wokhazikika, kukodza mwachangu, masomphenya osalala. Zizindikiro zonsezi mumazidziwa nokha.

Koma kodi ndizotheka kuchitira zomwe zimayambitsa m'malo mothandizira? Timalimbikitsa kuwerenga nkhani yokhudza matenda a shuga omwe alipo masiku ano. Werengani nkhani >>

Maphunziro a shuga

DM ndi matenda osakhalitsa omwe nthawi zina amatha kuchitika pafupifupi tsiku lililonse omwe amafunikira kusintha kwamankhwala. Komabe, ndizosatheka kupereka chithandizo chazachipatala cha tsiku ndi tsiku kwa odwala omwe ali ndi matenda a shuga, chifukwa chake pali zofunika kuphunzitsa odwala njira zoletsa matenda, komanso kuwatenga nawo gawo pantchito yachipatala.

Pakadali pano, maphunziro a odwala akhala gawo la chithandizo cha matenda amtundu uliwonse, maphunziro othandizira odwala amapangidwa ngati njira yoyenera yodziwira zamankhwala. Matenda osiyanasiyana, pali masukulu ophunzitsa odwala, koma matenda ashuga ndi amodzi mwa atsogoleri osakhazikitsidwa komanso zitsanzo zothandiza pakupanga ndi kuwunika njira zophunzitsira. Zotsatira zoyambirira zomwe zikuwonetsa luso la maphunziro a matenda a shuga zidawoneka koyambirira kwa zaka za m'ma 1970.

Kwa 1980-1990 Mapulogalamu ambiri ophunzitsira adapangidwira magulu osiyanasiyana odwala omwe ali ndi matenda ashuga ndikuwonetsetsa kwawo. Zatsimikizika kuti kuyambitsa maphunziro azachipatala kwa odwala omwe ali ndi matenda ashuga komanso njira zodziyang'anira amachepetsa kuchuluka kwa matenda, ketoacidotic ndi hypoglycemic coma ndi 80%, kudula miyendo ndi pafupifupi 75%.

Cholinga cha kuphunzira sikuti ndikungodzaza kuchepa kwa chidziwitso kwa odwala omwe ali ndi matenda ashuga, koma kuti apange chisonkhezero cha kusintha kotereku pamakhalidwe awo ndi momwe amaonera matendawa omwe amalola kuti wodwalayo azitha kuyimira payekha pazinthu zosiyanasiyana m'moyo, kusunga kuchuluka kwa glucose paziwerengero zomwe zikugwirizana ndi kubwezerera kwa njira za metabolic. Pa maphunzirowa, ndikofunikira kuyesetsa kukhazikitsa malingaliro omwe amapangitsa kuti wodwalayo akhale ndi gawo logwira ntchito yathanzi. Wodwala iyemwini ali ndi chidwi ndi njira yopambana matendawa.

Zikuwoneka kuti ndizofunikira kwambiri kukhazikitsidwa kwa odwala kumayambiriro kwa matendawa, liti lembani matenda ashuga 1SD-1) kulibe mavuto a mtima, ndipo lembani matenda ashuga 2SD-2) sichinafotokozedwe. Pophunzitsa mobwerezabwereza maphunziro muzaka zotsatila, makulidwe omwe ali ndi odwala omwe ali ndi matenda ashuga amakhazikika.

Njira yophunzitsira odwala omwe ali ndi matenda ashuga imapangidwa mwapadera mapulogalamu, omwe amatchedwa kuti opangidwe. Awa ndimapulogalamu omwe amagawidwa m'magulu ophunzira, ndipo mkati mwake - kukhala "njira zophunzitsira", pomwe kuchuluka kwake ndikuwunikira kumawongoleredwa moonekeratu, cholinga cha "gawo" lililonse chimakhazikitsidwa. Amakhala ndi zida zoyenera zowonekera ndi njira zophunzitsira zomwe cholinga chake ndi kutengera, kubwereza, kuphatikiza chidziwitso ndi luso.

Mapulogalamu ophunzitsira amasiyanitsidwa mosiyanasiyana kutengera magulu a odwala:

1) odwala omwe ali ndi matenda a shuga 1,
2) kwa odwala omwe ali ndi matenda a shuga a 2 omwe amalandila zakudya kapena mankhwala amkamwa ochepetsa shuga,
3) kwa odwala omwe ali ndi mtundu wa 2 omwe amalandila isulin therapy,
4) kwa ana omwe ali ndi matenda ashuga ndi makolo awo,
5) odwala omwe ali ndi matenda oopsa,
6) kwa amayi apakati omwe ali ndi matenda ashuga.

Iliyonse ya mapulogalamu awa ali ndi mawonekedwe ake komanso kusiyana kwakukulu, chifukwa chake ndizosamveka komanso zosavomerezeka kuchita molumikizana (mwachitsanzo, odwala omwe ali ndi matenda ashuga a mtundu 1 ndi mtundu wa 2 matenda a shuga.

Mitundu yayikulu ya maphunziro:

gulu (magulu a anthu osaposa 7-10),
payekha.

Zotsirizazi zimagwiritsidwa ntchito pophunzitsa ana, komanso m'mankhwala aposachedwa a shuga, akuluakulu a shuga, ndi amayi omwe ali ndi vuto. Maphunziro a odwala omwe ali ndi matenda ashuga amatha kuchitika m'masiku awiri (masiku a 5-7) komanso nthawi yapadera (chipatala cha tsiku). Pophunzitsa odwala omwe ali ndi matenda a shuga 1, muyenera kuwakonda, komanso pophunzitsa odwala matenda a shuga - 2 - outpatient. Kuti akwaniritse zomwe akudziwa pophunzitsidwa, odwala ayenera kupatsidwa njira yodziletsa. Pokhapokha ngati ali ndi vutoli, zimatha kukopa wodwala kuti azitenga nawo mbali mankhwalawa matenda ake ndikupeza zotsatira zabwino.

Kudziletsa komanso udindo wake pothandizira matenda ashuga

Kugwiritsa ntchito njira zamakono zowonetsera shuga wa magazi, mkodzo, mkodzo acetone, odwala amatha kuyesa pawokha magawo ofunikira kwambiri a metabolic molondola pafupi ndi labotale. Popeza izi zimatsimikiziridwa muzochitika za tsiku ndi tsiku kwa wodwala, ndizofunikira kwambiri pakuwongolera chithandizo chamankhwala kuposa glycemic ndi mbiri ya glucosuric yoyesedwa kuchipatala.

Cholinga chodziletsa ndikulipira machitidwe olimba a kagayidwe kachakudya, kupewa matendawa mochedwa komanso kukhazikitsa moyo wabwino kwambiri kwa odwala omwe ali ndi matenda osokoneza bongo.

Kubwezeretsedwa kwa matenda ashuga kumatheka pokhazikitsa njira zotsatirazi kuti zitheke:

1) kukhalapo kwa njira za sayansi za kagayidwe koyenera - zofunika pa glycemia, milingo ya lipoprotein, ndi zina zambiri. (Miyezo Yadziko Kaamba ka Chithandizo cha Matenda A shuga),
2) akatswiri ambiri azachipatala omwe amapereka thandizo kwa odwala omwe ali ndi matenda a shuga (endocrinologists, akatswiri a matenda ashuga, opaleshoni ya mtima, ochita masewera olimbitsa thupi, oculists) komanso ogwira ntchito mokwanira m'magawo onse, i.e. kupezeka kwa chisamaliro chokwanira cha odwala
3) kupatsa odwala omwe ali ndi mitundu yapamwamba kwambiri ya insulin, mankhwala amakono ochepetsa shuga (zimatengera kagawidwe ka ndalama zothandizira pulogalamu ya feduro "Matenda A shuga"),
4) Kukhazikitsa njira yophunzitsira odwala omwe ali ndi matenda osokoneza bongo pa kudziletsa kwa matenda awo (dongosolo la sukulu la odwala matenda ashuga),
5) kupereka njira yodziletsa kuti mudziwe njira zosiyanasiyana zamankhwala komanso zamankhwala kunyumba.

Kutengera maphunziro apadziko lonse lapansi, omwe ali ndi zikhalidwe zapadziko lonse zosamalira odwala omwe ali ndi matenda osokoneza bongo komanso njira zothandizira kubwezera njira za metabolic. Akatswiri onse amaphunzitsidwa ndikuchita chithandizo potsatira njira izi. Odwala amadziwa bwino za glycemia, glucosuria, kuthamanga kwa magazi, kudutsa kanthawi kofanana panthawi yamatendawa: "Matenda a shuga ndi njira ya moyo".

Chimodzi mwazotsatira zofunika kwambiri zamaphunziro m'masukulu a odwala matenda a shuga ndikumakhala kolimbikitsa kwa odwala kutenga nawo mbali pa chithandizo cha matenda awo podziyang'anira okha magawo ofunikira kwambiri, makamaka kagayidwe kazachilengedwe.

Magazi poyang'ana pang'onopang'ono

Mafuta a m'magazi amayenera kutsimikiziridwa kuti adzabwezera kangapo pamimba yopanda kanthu, nthawi yopuma atatha kudya komanso musanadutse usiku. Chifukwa chake, mbiri ya glycemic iyenera kukhala ndi matchulidwe 6 a glycemia masana: m'mawa mutagona (koma musanadye chakudya cham'mawa), musanadye chakudya chamadzulo, musanadye chakudya chamadzulo komanso musanagone. Postprandial glycemia idzatsimikiziridwa maola 2 mutatha kadzutsa, nkhomaliro komanso chakudya chamadzulo. Miyezo ya Glycemia iyenera kukwaniritsa njira zomwe zimalimbikitsidwa ndi dziko.

Kutsimikiza kwamiseche kwa wodwalayo kuyenera kuchitika pochitika matenda a hypoglycemia, kutentha thupi, kuchulukitsa kwa matenda osachiritsika kapena matenda owopsa, komanso ndi zolakwika pakudya ndi mowa.

Ziyenera kukumbukiridwa ndi dokotala ndikufotokozera odwala kuti kuchuluka kwa shuga m'magazi sikukugwirizana ndi zomwe wodwala amayenera kuchita.

Odwala omwe ali ndi matenda a shuga 1 amtundu wa 2 komanso omwe amakhala ndi shuga wachiwiri omwe amalandila chithandizo cha insulin ayenera kuyeza shuga wawo wamagazi tsiku lililonse, asanadye komanso atatha kudya, kuti adziwe kuyenera kwa kuchuluka kwa insulini ndipo ngati kuli koyenera, muwongolere.

Kwa odwala matenda a shuga a 2(osalandira ngakhale insulin) pulogalamu yotsatirayi yoyang'anira ikulimbikitsidwa:

Odwala omwe amalipidwa bwino amakhala ndi kudziyang'anira wokha wa glycemia katatu pa sabata (pamimba yopanda kanthu, asanadye chakudya chachikulu komanso usiku) - masiku osiyanasiyana kapena mfundo zofananira tsiku limodzi, nthawi 1 pa sabata.
odwala osapatsidwa ndalama zambiri amayendetsa kudya glycemia, mutatha kudya, musanadye chakudya chachikulu, komanso usiku tsiku lililonse.

Njira zamanja zoyezera misempha yamagazi: Pakadali pano, ma glucometer amagwiritsidwa ntchito - zida zosunthika zokhala ndi mizere yotheka kuyesa. Ma glucometer amakono amayesa shuga m'magazi athunthu ndi madzi a m'magazi. Tiyenera kukumbukira kuti zizindikiro za plasma ndizokwera pang'ono kuposa zomwe zili m'magazi athunthu, pali matebulo a makalata. Glucometer molingana ndi limagwirira ntchito agawidwa kukhala chithunzi-calorimetric, kuwerenga kwawo komwe kumadalira makulidwe amtsempha wamagazi pamizere yoyeserera, ndi ma electrochemical, opanda izi zomwe zingabwezeretse. Ma glucometer ambiri am'badwo wamakono ndi electrochemical.

Odwala ena amagwiritsa ntchito mawayilesi oyesa kuti awone ngati ali ndi glycemia, pomwe, dontho la magazi likaikidwa kwa iwo atasintha nthawi yowonekera, amasintha mtundu wawo. Poyerekeza mtundu wa mzere woyesera ndi muyeso wa miyezo, titha kuwerengera nthawi yamagulu amtundu wa glycemia, omwe pano adalandira kuwunikiridwa. Njirayi siyolondola kwenikweni, koma imagwiritsidwabe ntchito chifukwa zotsika mtengo (odwala matenda a shuga a mellitus samaperekedwa kwaulere njira zodziletsa) ndipo imapereka chidziwitso chokwanira pamlingo wa glycemia.

Mwazi wamagazi, womwe umatsimikiziridwa ndi glucometer, amawonetsa glycemia pakalipano, tsiku lopatsidwa. Kuti mupeze phindu la kubwezeretsa, kutsimikiza kwa glycated hemoglobin kumagwiritsidwa ntchito.

Minyewa ya shuga ya mkodzo payekha

Kafukufuku wama glucose mu mkodzo akuonetsa kuti pofika pazomwe akufuna kupereka pobwezeretsa kagayidwe kazakudya (komwe tsopano ndi kotsika kwambiri kuposa cholowa cha impso), aglycosuria imachitika.

Ngati wodwala ali ndi aglycosuria, ndiye kuti pakalibe glucometer kapena mawonedwe oyesa kuti adziwe glycemia, mkodzo wa mkodzo uyenera kutsimikiziridwa 2 kawiri pa sabata. Ngati mkodzo wambiri mu mkodzo umakwezeka mpaka 1%, miyezo iyenera kukhala ya tsiku ndi tsiku, ngati kuli - kangapo patsiku. Nthawi yomweyo, wodwala wophunzirayo amasanthula zomwe zimayambitsa glucosuria ndikuyesetsa kuti athetse, nthawi zambiri, izi zimatheka mwa kukonza zakudya komanso / kapena insulin. Kuphatikiza kwa glucosuria kopitilira 1% komanso thanzi losauka ndiye maziko othandizira kuchipatala mwachangu.

Kudziletsa kwa ketonuria

Matupi a Ketone mu mkodzo amayenera kutsimikiziridwa ndi zizindikiro zamatenda zowonjezera kagayidwe kazakudya (polydipsia, polyuria, ma mucous membrane, etc.) ndi mawonekedwe a nseru, kusanza - zizindikiro za matenda a ketosis. Zotsatira zabwino, thandizo lachipatala limafunikira. Matupi a Ketone mu mkodzo amayenera kutsimikiziridwa ndi hyperglycemia yomwe imakhalapo kwa nthawi yayitali (12-14 mmol / L kapena glucosuria 3%), omwe ali ndi matenda osokoneza bongo omwe amapezeka posachedwa (kukafika koyamba kwa dokotala), pazovuta za matenda okhudzana ndi matenda osachiritsika kapena owopsa, malungo, komanso zolakwika pakudya (kudya zakudya zamafuta), kumwa kwambiri.

1) ketonuria wodwala yemwe ali ndi matenda a shuga nthawi zina amatha kuyang'aniridwa ndi kuwonjezeka pang'ono kwa shuga m'magazi,
2) kupezeka kwa ketonuria kumatha kukhala ndi matenda a chiwindi, kuvutika ndi njala kwa nthawi yayitali, komanso kwa odwala omwe alibe matenda a shuga.

Zomwe zimapangidwira nthawi zambiri pazoyambira, magawo a kudziletsa ndi chizindikiro cha kagayidwe kazakudya: kuthamanga ndi pambuyo pa chakudya glycemia, shuga mu mkodzo ndi ketonuria.

Kubwezera njira za metabolic pakadali pano ndi mulingo wa kuthamanga kwa magazi, index ya thupi. Odwala akuyenera kuwongoleredwa ndikuwunika magazi kunyumba tsiku lililonse, kawiri pa tsiku (poganizira kuchuluka kwa kuthamanga kwa magazi tsiku lililonse) ndikuyerekeza kuthamanga kwa magazi ndi zomwe mukufuna, komanso kuwongolera (muyeso) kwa kulemera kwa thupi.

Zambiri zomwe zimapezeka panthawi yodziletsa, zambiri zamagetsi ndi mtundu wa chakudya cha glycemic chodyedwa patsikulo, kuchuluka kwa kuthamanga kwa magazi ndi antihypertensive chithandizo panthawiyi, zochitika zolimbitsa thupi ziyenera kulembedwa ndi wodwala muzolemba zodziletsa. Zolemba za kudziletsa zimakhala ngati maziko a kudzikonza okha ndi odwala omwe amamuchita komanso pokambirana ndi adotolo.

Chitsogozo cha ntchito kwa odwala omwe ali ndi matenda ashuga

Njira yayitali yodwala matenda osokoneza bongo a shuga imasiya chidwi chachikulu pamavuto azakudwala, makamaka pantchito. Endocrinologist wa chigawo amatenga gawo lalikulu pakuwona momwe wodwalayo amayang'anira, makamaka wachichepere, kusankha ntchito. Kuphatikiza apo, mawonekedwe a matendawa, kupezeka kwake komanso kuopsa kwa matenda ashuga a shuga, zovuta zina ndi zina zokhudzana ndi matenda ndizofunikira. Pali malangizo apadera amitundu yonse ya matenda ashuga.

Kugwira ntchito molimbika komwe kumakhudzana ndi kupsinjika kwamthupi ndi kwakuthupi kumatsutsana pafupifupi odwala onse. Odwala omwe ali ndi matenda osokoneza bongo samalimbikitsidwa kuti azigwira ntchito m'masitolo otentha, nthawi yozizira kwambiri, komanso kutentha kosinthika, ntchito yolumikizidwa ndi mankhwala kapena makina, zomwe zimakwiyitsa pakhungu ndi mucous nembanemba. Kwa odwala matenda a shuga mellitus, ma profesenti omwe ali pachiwopsezo chowonjezeka ku moyo kapena kufunikira kosungirako chitetezo chawo (woyendetsa ndege, wolondera malire, woyendetsa padenga, wozimitsa moto, wamagetsi, wokwera, wokweza kwambiri) sayenera.

Odwala omwe amalandila insulin sangakhale oyendetsa magalimoto wamba kapena onyamula katundu ambiri, amagwira ntchito poyenda, kudula njira, kutalika. Ufulu woyendetsa magalimoto achinsinsi kwa odwala omwe ali ndi shuga okhazikika omwe amalipiritsa popanda chikhazikitso cha hypoglycemia akhoza kupatsidwa payekhapayekha, malinga ndi momwe odwala angamvetsetsere kufunika kwa kuchiza matenda awo (WHO, 1981).Kuphatikiza pa ziletso izi, anthu omwe amafunikira chithandizo cha insulin amalekanitsidwa ndi ma profesiti okhudzana ndi maola olemba ntchito osagwirizana, maulendo aku bizinesi.

Odwala achichepere sayenera kusankha mafotokozedwe omwe amasokoneza kuyang'anitsitsa zakudya (wophika, wophika makeke). Ntchito yabwino ndiyomwe imalola kusinthana kwakanthawi kantchito ndi kupumula ndipo sikugwirizana ndi kusiyanasiyana pakugwiritsa ntchito mphamvu ndi kulimbitsa thupi. Makamaka mosamala komanso payekhapayekha, aliyense ayenera kuwunika mwayi wosintha ntchito zomwe anthu adwala atakula, atakhala kale ndi udindowu. Muzochitika izi, choyambirira, ndikofunikira kuganizira za thanzi la wodwalayo komanso mikhalidwe yomwe imamupatsa mwayi wokhala ndi chiphuphu chokwanira cha shuga kwa zaka zambiri.

Mukamaganiza za kulemala, mtundu wa matenda ashuga, kupezeka kwa matenda ashuga angio- ndi polyneuropathies, ndi matenda opatsirana amakhudzidwa. Matenda ofala a shuga nthawi zambiri sindiwo omwe amayambitsa kulumala kosatha. Wodwalayo atha kugwira ntchito zamaganizidwe komanso zolimbitsa thupi, osagwirizana ndi kupsinjika kwakukulu. Zoletsa zina pantchito mwanjira yokhazikitsa tsiku logwirira ntchito mwachisawawa, kupatula masiku osinthana, kusinthitsa kwakanthawi kuntchito yina kutha kuchitidwa ndi aphungu a akatswiri ndi akatswiri.

Odwala omwe ali ndi shuga wambiri wodwala, makamaka ndi kuwonjezera kwa angiopathies, mphamvu yogwira ntchito nthawi zambiri imachepetsedwa. Chifukwa chake, ayenera kulimbikitsa kugwira ntchito ndi kupsinjika kwakuthupi ndi mwamalingaliro, popanda kusintha kosuntha usiku, maulendo abizinesi, ndi zina zochulukitsa ntchito. Kuleza kumagwira ntchito pa mitundu yonse ya ntchito yomwe imafuna chisamaliro chokhazikika, makamaka kwa odwala omwe amalandira insulin (kuthekera kwa hypoglycemia). Ndikofunikira kuonetsetsa kuti jakisoni wa insulini komanso kutsatira zakudya muzinthu zamafakitale.

Mukasamukira kuntchito yokhala ndi ziyeneretso zochepa kapena kuchepetsedwa kwakukulu kwa kuchuluka kwa ntchito yopanga, odwala amatsimikiza kukhala ndi kulumala kwa gulu la III. Kutha kugwirira ntchito anthu omwe ali ndi ntchito yamaganizidwe komanso opepuka kumakhala kosungidwa, zoletsa zina zofunikira zitha kukhazikitsidwa ndi lingaliro lauphungu ndi katswiri wa bungwe lachipatala.

Tebulo 14. Katswiri wazachipatala wa gulu la olumala mu DM-1

Ndi kuwonongeka kwa matenda ashuga, wodwalayo amapatsidwa pepala lolemala. Zinthu zoterezi, zomwe zimachitika kawirikawiri, zosagwira bwino, zimatha kuyambitsa kulumala kwanthawi zonse kwa odwala komanso kufunika kokhazikitsa kulumala kwa gulu lachiwiri. Kuchepetsa kwakukulu kwa kulumala komwe kumachitika mwa odwala omwe ali ndi matenda oopsa a shuga kumachitika osati chifukwa chophwanya mitundu yonse ya kagayidwe, komanso kupezeka ndi kupitilira msanga kwa angio ndi polyneuropathy, komanso matenda opatsirana.

Tebulo 15. Katswiri wazachipatala wa gulu la olumala mu DM-2

Kukula msanga kwa nephropathy, retinopathy, atherosulinosis kungayambitse kuchepa kwa masomphenyawo, kukula kwa kulephera kwambiri kwaimpso, kugunda kwa mtima, sitiroko, gangore, ndiko kuti, kulumala kosatha ndikusamutsa ku gulu lolumala II kapena ine mwa lingaliro la komiti ya akatswiri azachipatala komanso chikhalidwe.

Kuyesa kwa kuchuluka kwa kulumala kwa odwala omwe ali ndi vuto la kuwonongeka chifukwa cha matenda ashuga retinopathy kapena matenda amhuga kumachitika pambuyo pofunsidwa ndi katswiri wa zamankhwala mu bungwe lapadera lazachipatala ndi chikhalidwe cha anthu paz matenda a chiwalo cha masomphenyawo. Pakadali pano, pokhudzana ndi kukhazikitsidwa pamlingo wa boma pulogalamu ya feduro "Diabetes Mellitus" (1996-2005), ntchito yapadera ya matenda ashuga yapangidwa. Ntchito yayikulu ya odwala matenda ashuga pachipatala chachigawo ndikuwathandiza odwala omwe ali ndi matenda ashuga ndikuwayang'anira.

Dongosolo la mafunso asanachitike

Izi ndizotsimikizika: tikamayesa munthu, amayamba kuganiza ndikuwunika zomwe sangazikumbukire akuyankhula ndi dokotala. M'kati mwa funso lokodza, mwachitsanzo, pali mafunso: "Kodi mumakodza kangati patsiku? Kodi mumadzuka usiku? Kangati? ”Dokotala akafunsa funso lachikhalidwe" Mukudandaula za chiyani? ", Ndi anthu ochepa omwe amakumbukira kuti amadzuka kukodza katatu pausiku, ndipo ichi chingakhale chizindikiritso cha matenda ashuga. Kapena, mwachitsanzo, pali funso ngati ili: "Kodi mkodzo umayenda wofanana kapena muyenera kuvutikira kangapo chifukwa ndiwotupa?"

Muyenera kuyang'ana pawokha kutengera mafunso

Chinthu chinanso chofunikira pakuwongolera koyeserera: dotolo ayenera kukhala ndi nthawi yopenda mosamala munthu, osachepera 30, ndipo makamaka mphindi 60 (muyenera kupenda ndi kuwerengetsa kuti ndi nthawi ingati yomwe dokotala amafunikira kupenda wodwala m'modzi). Kudzifufuza mwakuthupi ndi maziko a zoyambira, ndipo lero tamugwedeza.