Mawonekedwe a chisamaliro cha unamwino kwa odwala omwe ali ndi matenda ashuga

Posamalira odwala omwe ali ndi matenda a shuga, ndikofunikira kuwonetsetsa kuchuluka pakati pa zochitika zolimbitsa thupi zokwanira, zopatsa mphamvu zomwe zimalandiridwa m'thupi ndi kuchuluka kwa insulini (kapena mapiritsi ochepetsa shuga)

Mutha kuchepetsa kudya kwa kabohaidridi ndikuwongolera mphamvu zowonjezera zopatsa mphamvu mwa kuyambitsa mankhwala, ngakhale ndi njira ina yowonjezera.

Ndi mtundu uliwonse wa matenda ashuga, ndikofunikira kudziwa shuga yanu yamagazi.

Mu mtundu woyamba, izi zimachitika pafupipafupi: m'mawa kamodzi pa sabata, ndipo ngati n`koyenera musanadye chakudya chilichonse ndi maola awiri mutatha. Mtundu wachiwiri, shuga amakhala akuyeza kangapo pamwezi. Ndikwabwino kuchita izi ndi glucometer.

Ndikofunikanso kudziwa zomwe zili mumkodzo. Chitani izi mothandizidwa ndi zingwe zoyeserera. Zambiri ziyenera kulembedwa muzolemba za wodwalayo ndi deti, nthawi, mayina a mankhwala, omwe akuwonetsa kuchuluka kwa kumwa.

Popereka mankhwala a insulin, makonzedwe ena ayenera kuonedwa. Chifukwa chake, jakisoni amachitidwa kumanja ndi kumanzere kwa m'mimba, mbali yakunja ya mkono pamwamba pa chapondera, ntchafu zakunja ndi zamkati. Ndi pafupipafupi makonzedwe a insulin, yesani kusintha malowo kuti mupeze jakisoni. Pogwiritsa ntchito mitundu iwiri ya insulini munthawi yomweyo, muyenera kugwiritsa ntchito syringe ina iliyonse ndi malo osiyana jakisoni. Pambuyo poyambitsa, ndikofunikira kufunsa wodwalayo kuti ayende pang'ono, chifukwa chake insulin imalowetsa magazi mwachangu. Hafu ya ola itatha jakisoni, wodwalayo ayenera kudya.

Posamalira odwala omwe ali ndi matenda ashuga, chisamaliro chapadera chiyenera kulipidwa paukhondo waumwini. Izi zimachulukitsa kawiri ngati wodwalayo wagona. M'pofunika kuchita kwathunthu kupewa zopsinjika zilonda, kutsuka wodwala pambuyo lililonse zokhudza thupi makonzedwe, chifukwa shuga wambiri amakwiyitsa khungu komanso amayambitsa kuyabwa. Pambuyo pakusamba, khungu limasesedwa ndipo limathandizidwa ndi ufa.

Mu shuga mellitus, kutsuka mano kumayenera kusamalidwa mwapadera, komwe kuyenera kuchitika ndi phala yapadera yotsutsa-yotupa. Chowonadi ndi chakuti odwala oterewa amadziwika ndi matenda apakhungu am'mkamwa ndi m'mkamwa mwa mawonekedwe a gingivitis ndi stomatitis. Kuphatikiza pa kutsuka pakamwa panu, nadzatsuka ndi ma infusions azitsamba ndi mano a mano.

Kusintha kulikonse kwamadongosolo a wodwala kumatha kubweretsa kwambiri pangozi kapena kusowa kwa shuga m'magazi. Chifukwa chake, pochoka mnyumbayo, wodwalayo ayenera kukhala ndi mlingo wa insulin, magawo ochepa a shuga ndi cholembera chomwe chikuwonetsa mlingo wa insulin.

Pali zizindikiro zapadera zomwe mungadziwe ngati wodwalayo ali ndi vuto losowa (hypoglycemia) kapena wowonjezera (shuga) wa hyperglycemia. Chifukwa chake hypoglycemia imadziwika ndi kufooka mwadzidzidzi, kupweteka mutu, chizungulire komanso kukokana kwa minofu. Mwina kumva kuwawa kwa njala, thukuta lalikulu, kukwiya m'maganizo. Vutoli, lomwe nthawi zambiri limayamba chifukwa cha kumwa mowa, limakula msanga ndipo limadziwika kwambiri chifukwa cha odwala matenda ashuga amtundu 1. Potere, wodwalayo amapatsidwa zidutswa za shuga 4-5, maswiti, tiyi wotentha kapena madzi otsekemera ndi mpweya amatha kuperekedwa.

Hyperglycemia (owonjezera) shuga wamagazi amakula pang'onopang'ono (kuchokera pa ola limodzi mpaka masiku angapo) ndipo amawonetsedwa m'mawonekedwe a mseru, kusanza, kusowa kudya, mawonekedwe akumva ludzu, khungu louma, kupuma movutikira. Wodwalayo amakhala woopsa, wolephera. Vutoli limayamba chifukwa cha kupsinjika kapena kufalikira kwa matenda osachiritsika. Ndi hyperglycemia, jakisoni wa insulin amapatsidwa ndikupatsidwa chakumwa. Posamalira odwala, miyezo yokhazikika ya shuga imatengedwa maola awiri aliwonse ndipo insulini imathandizidwa nthawi zonse mpaka shuga wa m'magazi amayamba. Ngati kuchuluka kwa shuga sikatsika, wodwalayo ayenera kuchipatala mwachangu.

Kupambana kwakukulu kwa matenda ashuga m'zaka makumi atatu zapitazi kwakhala gawo lochulukirapo la anamwino komanso bungwe lomwe ali nalo lodziwika bwino mu matenda ashuga, anamwino oterowo amapereka chisamaliro chapamwamba kwa odwala omwe ali ndi matenda a shuga, amakonzanso kulumikizana kwa zipatala, akatswiri azachipatala komanso othandizira odwala, komanso kuphunzitsa odwala.

Udindo wa anamwino omwe amagwira ntchito yothandizira odwala matenda ashuga ndiwofanana kwambiri ndi waupangiri.

Kuti athandize odwala kukhala ndi matenda ashuga, namwino ayenera:

• ? Fotokozani zomwe zimayambitsa matendawo ndi zovuta zake.
• ? Khazikitsani mfundo za mankhwalawa, kuyambira ndi malamulo osavuta osavuta komanso kuwonjezera pang'onopang'ono malangizo othandizira ndikuwonetsetsa, konzekerani odwala kuti azitha kuyang'anira matendawa.
• ? Apatseni odwala malangizo atsatanetsatane azakudya zoyenera komanso kusintha kwa moyo wanu.
• ? Patsani odwala zolemba zofunikira.

Chithandizo cha matenda ashuga ndikuti wodwalayo ayenera kuyimira payekha kuchitira chithandizo chovuta kwambiri pamoyo. Kuti achite izi, ayenera kukhala wodziwa zonse zokhudzana ndi matenda ake ndipo amatha kusintha chithandizo malinga ndi momwe alili - ndipo namwino ayenera kumuthandiza pamenepa.

Kuunika kwa moyo wa odwala omwe ali ndi matenda ashuga kuyenera kuchitika pokonzekera njira zochiritsira zilizonse.

Mavuto a shuga amabwera kwambiri m'moyo, njira zamphamvu zopititsira patsogolo kayendetsedwe ka zinthu za moyo sizimachepa.

Ubwino wamoyo umakhudzidwa bwino ndikupatsa wodwalayo mwayi wodziyendetsa payekha. Izi zitha kutengera omwe amapereka chithandizo chazachipatala, ndondomeko ya matenda ashuga, komanso mankhwala osachiritsika. Odwala pawokha amatha kupanga njira zoyenera ngati ogwira ntchito zachipatala amvera mawu a wodwalayo. Zochitika za ntchito zoterezi zilipo, zimachitika mothandizidwa ndi akatswiri azamisala.

Etiology, pathogenesis, magawo okula ndi zizindikiro za matendawa. Njira zamankhwala, kubwezeretsa, kupewa ndi zovuta zadzidzidzi za odwala omwe ali ndi matenda a shuga. Mfundo zoyambirira za zakudya komanso mankhwala. Ubwino wakuchita zolimbitsa thupi.

Mutu 1. Kubwereza zolemba pamutu wofufuza

1.1 Type I shuga

1.2 Gulu la anthu odwala matenda ashuga

1.3 Etiology ya matenda ashuga

1.4 Pathogenesis wa matenda ashuga

1.5 Magawo a chitukuko cha matenda a shuga 1

1.6 Zizindikiro za matenda ashuga

1.7 Chithandizo cha matenda ashuga

1.8 Zinthu zadzidzidzi za matenda ashuga

1.9 Mavuto a shuga ndi kupewa kwawo

1.10 Kuchita masewera olimbitsa thupi

Mutu 2. Gawo lothandiza

2.1 Malo ophunzira

2.2 Cholinga chophunzirira

Njira za kafukufuku wa 2.3

2.4 Zotsatira zakufufuza

2.5 Zokumana nazo za "Sukulu ya matenda ashuga" ku GBU RME DRKB

Matenda a shuga mellitus (DM) ndi amodzi mwa mavuto azachipatala komanso azikhalidwe zamankhwala zamakono. Kufalikira kofala, kulumala koyambirira kwa odwala, komanso kuchuluka kwaimfa ndizo maziko a akatswiri a WHO kuti aziona matenda ashuga ngati mliri wa matenda osapatsirana ambiri, ndipo kuthana nawo kunawonedwa ngati njira yayikulu yoyendetsera dziko.

Zaka zaposachedwa, m'maiko onse otukuka kwabwera chiwonjezeko chachikulu cha matenda ashuga. Mtengo wazachuma pothandizira odwala omwe ali ndi matenda a shuga komanso zovuta zake amafikira zakuthambo.

Mtundu woyamba wa matenda a shuga a mellitus (wodalira insulin) ndi ena mwa matenda ofala kwambiri a endocrine ali mwana. Mwa odwala, ana amapanga 4-5%.

Pafupifupi mayiko aliwonse amakhala ndi pulogalamu yodwala matenda ashuga. Mu 1996, mogwirizana ndi Lamulo la Purezidenti wa Russian Federation "On Measure of State Support for Persons for Diabetes Mellitus", Federal Program "Diabetes Mellitus" adalandiridwa, kuphatikiza, makamaka bungwe la odwala matenda ashuga, kupereka mankhwala kwa odwala, komanso kupewa matenda ashuga. Mu 2002, feduro chandamale "Diabetes" idalandilidwanso.

Kukula kwake: vuto la matenda ashuga limakonzedweratu ndi kufalikira kwa matendawa, komanso chifukwa chake ndiye maziko olimbikitsira matenda ophatikizika a matenda ndi zovuta, kulumala koyambirira komanso kufa.

Cholinga: kuphunzira za mawonekedwe a unamwino wa odwala omwe ali ndi matenda ashuga.

1. Kuphunzira magwero azidziwitso za etiology, pathogenesis, mitundu yazachipatala, njira zamankhwala, njira zothandizira, zovuta komanso zadzidzidzi za odwala omwe ali ndi matenda a shuga.

2. Dziwani zovuta zazikulu zomwe zili ndi odwala omwe ali ndi matenda ashuga.

3. Sonyezani kufunikira kwa maphunziro a odwala omwe ali ndi matenda ashuga kusukulu ya matenda ashuga.

4. Kupanga zokambirana za njira zoyambira zamakhalidwe azakudya, kudziletsa, kusintha kwa malingaliro ndi zochitika zolimbitsa thupi.

5. Yesani zomwe mwakambirana pakati pa odwala.

6. Pangani ma memos kuti muwonjezere chidziwitso chokhudza kusamalira khungu, phindu lochita zolimbitsa thupi.

7. Kuti mudziwe zambiri za kusukulu ya matenda ashuga mellitus GBU RME DRKB.

Mutu 1. Kubwereza zolemba pamutu wofufuza

1.1 Type I shuga

Type Iabetes mellitus (IDDM) ndimatenda otchedwa autoimmune omwe amadziwika ndi kuchepa kwathunthu kapena insulin chifukwa cha kuwonongeka kwa maselo a pancreatic b. Pakukula kwa njirayi, kudziwiratu kwamtundu, komanso zochitika zachilengedwe, ndikofunikira.

Zinthu zomwe zikuthandizira kukulitsa IDDM mwa ana ndi:

matenda oyamba ndi ma virus (enteroviruses, virus rubella, mumps, virusx coxsackie B, virus virus),

matenda a intrauterine (cytomegalovirus),

kuchepa kapena kuchepetsa nthawi yodyetsa zachilengedwe,

mitundu yosiyanasiyana ya nkhawa

kukhalapo kwa oopsa othandizira mu chakudya.

Mtundu woyamba wa matenda a shuga (wodalira insulin), chithandizo chokhacho ndikupereka insulin kuchokera kunja molumikizana ndi zakudya komanso zakudya.

Matenda a shuga a Type I amapezeka azaka zapakati pa 25-30, koma amatha kuchitika zaka zilizonse: ali ana, ndi zaka makumi anai, komanso 70.

Kuzindikira kwa matenda a shuga mellitus amapangidwa malinga ndi zofunikira ziwiri: kuchuluka kwa shuga m'magazi ndi mkodzo.

Nthawi zambiri, shuga amachedwa ndi kusefedwa m'm impso, ndipo shuga mumkodzo sapezeka, chifukwa fungo la impso limasunga shuga. Ndi shuga wamagazi opitilira 8.8--9.9 mmol / L, Fyuluta ya impso imayamba kudutsa shuga mumkodzo. Kupezeka kwake mu mkodzo kumatha kutsimikizika pogwiritsa ntchito zingwe zapadera zoyeserera. Mulingo wocheperako wa shuga m'magazi womwe umayamba kupezeka mumkodzo umatchedwa chimbudzi.

Kuwonjezeka kwa shuga m'magazi (hyperglycemia) mpaka 9-10 mmol / L kumabweretsa kuphipha kwake mu mkodzo (glucosuria). Popeza amuchotsa mu mkodzo, shuga amachitika ndi madzi ambiri ndi mchere wambiri. Chifukwa chosowa insulin mthupi komanso kuthekera kwa glucose kulowa m'maselo, omaliza, pokhala ndi vuto lakusowa kwamphamvu, amayamba kugwiritsa ntchito mafuta a thupi ngati mphamvu. Zida zophulika zamafuta - matupi a ketone, makamaka acetone, amadziunjikira m'magazi ndi mkodzo, zomwe zimatsogolera kukukula kwa ketoacidosis.

Matenda a shuga ndi matenda osachiritsika, ndipo ndizosatheka kuti muzimva kudwala kwa moyo wonse. Chifukwa chake, pophunzira, ndikofunikira kusiya mawu monga "matenda", "kudwala". M'malo mwake, ziyenera kutsimikiziridwa kuti matenda a shuga si matenda, koma njira ya moyo.

Chilendo pakuwongolera odwala omwe ali ndi matenda osokoneza bongo ndikuti gawo lalikulu pokwaniritsa zotsatira zake limaperekedwa kwa wodwala. Chifukwa chake, ayenera kukhala wodziwa zonse zokhudzana ndi matenda ake kuti athe kusintha njira yochizira malingana ndi momwe alili. Odwala m'njira zambiri ayenera kukhala ndi thayo la thanzi lawo, ndipo izi zimatheka pokhapokha akaphunzitsidwa moyenera.

Makolo ali ndi udindo waukulu wokhala ndi thanzi la mwana wodwala, chifukwa osati thanzi lawo lokha komanso thanzi lawo pakadali pano, komanso kupitilizidwa kwa moyo wawo wonse kumatengera luso lawo la kuwerenga pankhani za matenda ashuga komanso machitidwe oyenera a mwana.

Pakadali pano, matenda a shuga salinso matenda omwe angalande odwala mwayi wokhala ndi moyo, kugwira ntchito ndi kusewera masewera mwachizolowezi. Ngati mutsatira zakudya komanso njira yoyenera, yokhala ndi njira zamakono zothandizira, moyo wa wodwalayo sunali wosiyana kwambiri ndi moyo wa anthu athanzi. Maphunziro a odwala pakadali pano a chitukuko cha matenda ashuga ndi gawo lofunikira komanso chinsinsi chothandizira bwino kwa odwala omwe ali ndi matenda a shuga limodzi ndi mankhwala osokoneza bongo.

Lingaliro lamakono la kasamalidwe ka shuga limawatenga matendawa ngati njira yapadera. Malinga ndi ntchito zomwe zaperekedwa pakadali pano, kukhalapo kwadongosolo labwino la chisamaliro cha matenda ashuga limapereka mwayi wokwaniritsa zolinga monga:

wathunthu kapena pafupifupi wathunthu wa kagayidwe kachakudya njira kuthetsa pachimake komanso matenda a shuga,

kukonza moyo wa wodwala.

Kuti athane ndi mavutowa pamafunika kulimbikira kwambiri kuchokera kwa ogwira ntchito osamalira oyambira. Chidwi cha maphunziro monga njira yothandiza kukonza unamwino kwa odwala chikukula m'madera onse a Russia.

1.2 Gulu la anthu odwala matenda ashuga

I. Mitundu yazachipatala:

1. Yoyamba: chibadwa, chofunikira (chokhala kapena kunenepa kwambiri).

2. Sekondale (yopanga): pituitary, steroid, chithokomiro, adrenal, kapamba (kutupa kwa kapamba, chotupa chotupa kapena kuchotsa), mkuwa (wokhala ndi hemochromatosis).

3. Matenda a shuga amayi apakati (gestational).

II. Mwa kuwopsa:

3. Inde.

III. Mitundu ya matenda a shuga (mtundu wa maphunzirowa):

Mtundu 1 - wodalira insulini (olemekezeka ndi acidosis ndi hypoglycemia, makamaka achinyamata),

Mtundu 2 - osagwirizana ndi insulin-odziyimira (okhazikika, odwala matenda a shuga).

IV. Carbohydrate kagayidwe kachakudya gawo:

1.3 Etiology ya matenda ashuga

SD-1 ndimatenda omwe ali ndi vuto lobadwa nalo, koma zopereka zake pakukula kwa matendawa ndizochepa (zimafotokoza kukula kwake pafupifupi 1/3) - Concordance m'mapasa ofanana mu SD-1 ndi 36% yokha. Mwayi wopanga CD-1 mwa mwana wokhala ndi mayi wodwala ndi 1--2%, bambo - 3-6%, m'bale kapena mlongo - 6%. Chizindikiro chimodzi kapena zingapo zochititsa manyazi za kuwonongeka kwa autoimmune kwa maselo a b, omwe amaphatikiza ma antibodies kuma isanc pancreatic, antibodies to glutamate decarboxylase (GAD65) ndi antibodies to tyrosine phosphatase (IA-2 ndi IA-2c), amapezeka mwa 85-90% ya odwala . Komabe, kufunikira kwakukulu pakuwonongeka kwa maselo a b kumachitika chifukwa cha chitetezo cham'mimba. CD-1 imalumikizidwa ndi HLA haplotypes monga DQA ndi DQB, pomwe ena a HLA-DR / DQ mwina atha kulosera za chitukuko, pomwe ena amateteza. Ndi ma frequency ochulukirapo, CD-1 imaphatikizidwa ndi ma autoimmune endocrine (autoimmune thyroiditis, matenda a Addison) komanso matenda omwe si endocrine monga alopecia, vitiligo, matenda a Crohn, matenda amitsempha.

1.4 Pathogenesis wa matenda ashuga

CD-1 imadziwonetsera mukuwonongeka kwa 80-90% ya ma b-cell mwanjira ya autoimmune. Kuthamanga ndi kukula kwa njirayi zimatha kusiyanasiyana.Nthawi zambiri, ndimatenda a ana ndi achinyamata, njirayi imachitika mofulumira ndikutsatiridwa ndikuwonetsa matendawa, momwe zimangopita milungu ingapo kuchokera ku chiyambi cha matenda oyamba mpaka kukula kwa ketoacidosis (mpaka ketoacidotic chikomokere).

Mwazina, milandu yachilendo kwambiri, monga lamulo, mwa anthu akuluakulu azaka zopitilira 40, matendawa amatha kuchitika posachedwapa (matenda a autoimmune shuga a akulu - LADA), kumayambiriro kwa matendawa, odwala otere nthawi zambiri amapezeka ndi DM-2, ndipo kwa zaka zingapo kubwezeretsanso kwa matenda ashuga kumatheka mwa kupereka kukonzekera kwa sulfonylurea. Koma mtsogolomo, nthawi zambiri pambuyo pazaka 3, pali zizindikiro za kuchepa kwathunthu kwa insulin (kuchepa thupi, ketonuria, hyperglycemia yayikulu, ngakhale mutamwa mapiritsi ochepetsa shuga).

Pathogenesis ya matenda a shuga a mellitus-1, monga akuwonetsera, ndizokhazikitsidwa ndi kuperewera kwathunthu kwa insulin. Kulephera kwa glucose kulowa minofu yodalira insulin (adipose ndi minofu) kumabweretsa kuchepa kwa mphamvu, chifukwa chomwe lipolysis ndi proteinolysis imakulitsidwa, zomwe zimagwirizanitsidwa ndi kuchepa thupi. Kuwonjezeka kwa glycemia kumayambitsa hyperosmolarity, yomwe imayendetsedwa ndi osmotic diuresis komanso kuchepa thupi kwambiri. Pankhani ya kuchepa kwa insulin ndi kuperewera kwa mphamvu, kupanga ma contrainsular mahormoni (glucagon, cortisol, mahomoni okula) samapangidwa, omwe, ngakhale akuwonjezeka glycemia, amayambitsa kukondoweza kwa gluconeogenesis. Lipolysis yolimbikitsidwa mu minofu ya adipose imabweretsa chiwonjezeko chachikulu cha kuchuluka kwa mafuta kwamafuta acids. Ndi kuchepa kwa insulin, kuthekera kwa liposynthetic kwa chiwindi kumapanikizidwa, ndipo mafuta amafuta aulere amayamba kuphatikizidwa ndi ketogeneis. Kudzikundikira kwa matupi a ketone kumabweretsa chitukuko cha matenda ashuga, ndipo mtsogolo - ketoacidosis. Ndi kuwonjezeka pang'onopang'ono kufooka kwa madzi m'thupi ndi acidosis, chikomokere chimayamba, pomwe pakalibe chithandizo cha insulin komanso kupatsanso madzi m'thupi kumatha.

1.5 Magawo a chitukuko cha matenda a shuga 1

1. Chidziwitso cha kutengera kwa matenda ashuga omwe amalumikizidwa ndi dongosolo la HLA.

2. Mzeru yoyambira. Kuwonongeka kwa ma cell a b ndizinthu zosiyanasiyana za diabetogenic komanso kuyambitsa chitetezo cha mthupi. Odwala ali kale ndi ma antibodies opita ku ma islet cell omwe ali ndi gawo laling'ono, koma kutulutsidwa kwa insulin sikuvutikabe.

3. Yogwira autoimmune insulin. Ma antibody titer ndi okwera, kuchuluka kwa ma cell a B kumachepa, kutulutsidwa kwa insulin kumachepa.

4. Kuchepetsa shuga. Pamavuto, wodwalayo amatha kuwona kuloza kwapang'onopang'ono kwa glucose (NTG) ndikutsitsa shuga wa plasma glucose (NGF).

5. Kuwonetsera kwa matenda a shuga, kuphatikizanso ndi gawo la "ukwati wa tchuthi". Katemera wa insulini amachepetsedwa kwambiri, monga 90% ya ma cell a B anafa.

6. Kuwonongeka kwathunthu kwa maselo a B, kusiya kwathunthu kwa insulin.

1.6 Zizindikiro za matenda ashuga

shuga wamagazi ambiri

kumva ludzu losatha

kuwonda osayambitsidwa ndi kusintha kwa zakudya,

kufooka, kutopa,

kuwonongeka kowoneka, nthawi zambiri mumakhala ngati "chophimba choyera" pamaso pa maso,

dzanzi ndi kumva kuwawa m'miyendo,

kumva kulemera m'miyendo ndi kukokana kwa minofu ya ng'ombe,

kuchiritsa pang'onopang'ono kwa mabala komanso kuchira kwakali ku matenda opatsirana.

1.7 Chithandizo cha matenda ashuga

Kudziletsa komanso mitundu ya kudziletsa

Kudziyang'anira pawokha kumatchedwa kudziyimira pawokha kwa shuga ndi mkodzo wodwalayo ndi wodwala, kusunga tsiku ndi sabata sabata yodziyang'anira payekha. M'zaka zaposachedwa, njira zambiri zapamwamba kwambiri zopangira shuga kapena mkodzo m'mitsempha mwake (mawonekedwe oyesa ndi glucometer) zidapangidwa. Munthawi yakudziletsa kuti kamvedwe koyenera ka matenda amodzi kakafike, ndipo maluso othandizira matenda a shuga amapangidwa.

Pali njira ziwiri - kudzisankhira nokha shuga ndi mkodzo. Mchere wa mkodzo umatsimikiziridwa ndi chingwe chowonekera popanda kugwiritsa ntchito zida, kungoyerekeza madontho ndi chingwe chonyowa cha mkodzo pamtunda wamtundu womwe umapezeka phukusi. Mukamadwala kwambiri, mumakhala shuga mu mkodzo. Mkodzo umafunika kupendedwa katatu pa sabata kawiri pa tsiku.

Pali mitundu iwiri ya njira yodziwira shuga wamagazi: mizere yomwe imadziwika kuti imagwiritsidwa ntchito ngati njira ya mkodzo (kuyerekezera kokhala ndi maselo amtundu), ndi zida zowoneka bwino - glucometer, zomwe zimapereka zotsatira za kuyeza mulingo wa shuga monga manambala pazenera- chiwonetsero. Mwazi wamagazi uyenera kuyesedwa:

tsiku lililonse asanagone

musanadye, zolimbitsa thupi.

Kuphatikiza apo, masiku 10 aliwonse, ndikofunikira kuti muchepetse shuga la magazi kwa tsiku lathunthu (4-7 pa tsiku).

Mita imagwiranso ntchito pogwiritsa ntchito zingwe zoyeserera, chida chilichonse chimangokhala ndi "chingwe" chake. Chifukwa chake, pogula chida, ndikofunikira, choyambirira, kuti asamalire kuperekanso kwa mayeso oyenera.

Zolakwika zofala kwambiri mukamagwira ntchito ndi zingwe zoyesa:

Pukuta chala kwambiri ndi mowa: kuphatikizika kwake kungakhudze zotsatira za kusanthula. Zokwanira kusamba m'manja ndi madzi ofunda ndikupukuta youma, antiseptics apadera safunikira kugwiritsidwa ntchito.

Kuboola sikumapangidwa kumbuyo kwa mbali ya distal phalanx ya chala, koma papilo lake laling'ono.

Dontho lalikulu lam magazi limapangidwa. Kukula kwa magazi pa ntchito yowoneka ndi zingwe zoyeserera komanso mukamagwira ntchito ndi ma glucometer ena akhoza kukhala osiyanasiyana.

Smear magazi pamunda woyeserera kapena "kukumba" dontho lachiwiri. Pankhaniyi, ndizosatheka kuzindikira nthawi yoyambirira yomwe mukutchulidwa, chifukwa chomwe zotsatira zake zingakhale zolakwika.

Mukamagwira ntchito ndi ma tepe oyesa ndi ma glucetti a m'badwo woyamba musayang'anire nthawi yowonekera kwa magazi pamizere yoyeserera. Muyenera kutsata molondola chizindikiro cha mita kapena kukhala ndi wotchi yachiwiri.

Osachepetsa magazi pang'onopang'ono pamunda woyeserera. Mwazi kapena thonje lomwe latsalira pamtunda woyeserera pogwiritsa ntchito chipangizocho limachepetsa kuyeserera koyesa ndikuipitsa zenera la mita.

Wodwala amafunika kuphunzitsidwa payekha, kutulutsa magazi, kugwiritsa ntchito zingwe zoyezera, glucometer.

Ndi chiphuphu chosavomerezeka cha matenda ashuga, matupi ochulukitsa a ketone amatha kupanga munthu, zomwe zingayambitse vuto lalikulu la matenda ashuga - ketoacidosis. Ngakhale kukula kwapang'onopang'ono kwa ketoacidosis, munthu ayenera kuyesetsa kutsika magazi ngati, malinga ndi zotsatira za kuyesedwa kwa magazi kapena mkodzo, amakwezedwa. Muzochitika zokayikitsa, muyenera kudziwa ngati mulatine ali mumkodzo mothandizidwa ndi mapiritsi kapena mikwingwirima yapadera.

Mfundo yodzilamulira sikungowunikira kuchuluka kwa shuga m'magazi, komanso kuwunika zotsatira zake, kukonzekera zochita zina ngati zolinga za chizindikiro cha shuga sizikwaniritsidwa.

Wodwala matenda ashuga aliyense ayenera kudziwa zambiri pamatenda awo. Wodwala wokhazikika amatha kusanthula zifukwa zomwe zikuwonongera zizindikiro za shuga: mwina izi zimayambitsidwa ndi zolakwika zazikulu pazakudya ndipo, chifukwa chake, kuwonda? Mwina pali matenda a catarrhal, fever?

Komabe, sikuti chidziwitso ndichofunika, komanso luso. Kukhala wokhoza kupanga lingaliro labwino munthawi iliyonse ndikuyamba kuchita molondola ndi zotsatira zomwe zachitika kale osati chifukwa chodziwa zambiri za matenda ashuga, komanso kuthekera koyendetsa matenda anu, ndikupeza zotsatira zabwino. Kubwereranso ku chakudya choyenera, kuchepa thupi, komanso kusintha kudziletsa kumatanthauzadi matenda a shuga. Nthawi zina, lingaliro labwino lingakhale kufunsa dokotala nthawi yomweyo ndikukana kuyesa pawokha kuti muthane ndi vutoli.

Popeza takambirana cholinga chachikulu chodziletsa, tsopano titha kupanga njira zake:

kuwunika mphamvu ya zakudya ndi zolimbitsa thupi pa shuga,

kuyeserera kobwezeretsera matenda a shuga

kasamalidwe ka zinthu zatsopano panthawi yamatendawa,

* Kuzindikiritsa mavuto omwe amafunikira chithandizo chamankhwala ndi kusintha kwa chithandizo.

Pulogalamu yodziletsa nthawi zonse imakhala payekha payokha ndipo ayenera kuganizira za kuthekera ndi moyo wa banja la mwana. Komabe, malingaliro angapo mwapadera amatha kuperekedwa kwa odwala onse.

1. Zotsatira zowunikira nthawi zonse zimakhala bwino kujambula (ndi tsiku ndi nthawi), kukambirana ndi dokotala kugwiritsa ntchito zolemba zambiri.

2. Kwenikweni, njira zodziletsa ziyenera kuyendera dongosolo lotsatirali:

Kudziwa kuchuluka kwa shuga m'mimba yopanda kanthu ndipo mukatha kudya kwa maola 2 kawiri pa sabata, malingana ndi momwe zizindikirazo zikugwirizana ndi zomwe mukufuna, zotsatira zake ndizosowa shuga mumkodzo,

Dziwani kuchuluka kwa shuga m'magazi 1-4 patsiku, ngati kubwezeretsa kwa shuga sikokwanira (motsatana - kuwunika kwa vutolo, ngati kuli koyenera, kukambirana ndi dokotala). Kudziletsa komweku kumafunikanso ngakhale ndi shuga wokwanira, ngati chithandizo cha insulin chikuchitika,

Dziwani shuga wokwanira 4-8 patsiku munthawi yamatenda azovuta, kusintha kwakukulu pa moyo,

Nthawi ndi nthawi kambiranani njirayi (makamaka ndi chiwonetsero) cha kudziletsa komanso mawonekedwe ake, komanso sinthani zotsatira zake ndi hemoglobin ya glycated.

Wodwalayo amalowetsa zotsatira za kudzipenda payokha mu diary, mwakutero amapanga maziko othandizira payekha komanso kukambirana kwotsatira ndi adokotala. Kuwona shuga mokhazikika nthawi zosiyanasiyana masana, wodwalayo ndi makolo ake omwe ali ndi maluso ofunikira amatha kusintha mlingo wa insulin kapena kusintha zakudya zawo, kukwaniritsa zofunikira za shuga zomwe zingalepheretse kukula kwamavuto akulu mtsogolo.

Odwala ambiri omwe ali ndi matenda ashuga amasunga diary momwe amathandizira chilichonse chokhudzana ndi matendawa. Chifukwa chake, ndikofunikira kuti nthawi ndi nthawi muziwunika momwe mumalemera. Chidziwitsochi chikuyenera kulembedwa nthawi zonse muzolemba, ndiye kuti padzakhala zabwino kapena zoyipa za chidziwitso chofunikira chotere.

Kupitilira apo, ndikofunikira kukambirana za mavuto wamba mwa odwala omwe ali ndi matenda ashuga, kuthamanga kwa magazi. Odwala amafunikira kuwongolera magawo awa, ndikofunikira kuti muwazindikire m'm diary.

Pakadali pano, imodzi mwazinthu zothandizira kulipirira matenda a shuga ndi mulingo wabwinobwino wamagazi (BP). Kuwonjezeka kwa kuthamanga kwa magazi ndizowopsa makamaka kwa odwala oterewa, monga mwa iwo, AH amakula pafupipafupi katatu kuposa pafupifupi. Kuphatikiza kwa matenda oopsa ndi shuga kumabweretsa chimtolo chofanana cha matenda onse awiri.

Chifukwa chake, wothandizira (namwino) ayenera kufotokozera wodwalayo kufunika kowunikira pafupipafupi komanso kudziyimira pawokha kwa magazi, kuphunzitsa njira yoyenera yoyezera kukakamiza wodwala kuti akafunse katswiri pakanthawi.

Zipatala ndi zipatala pano zikufufuzira zomwe zidatchedwa glycated hemoglobin (HLA1c), mayesowa amakupatsitsani kufotokozera kuti shuga ya magazi yakhala bwanji masabata 6 apitawa.

Odwala omwe ali ndi matenda amtundu wa shuga amalimbikitsidwa kuti azindikire izi kamodzi miyezi itatu iliyonse.

Glycated hemoglobin index (HbA1c) imawonetsa momwe wodwala amayang'anira matenda ake.

Kodi chizindikiro cha glycated hemologlobin chimati chiyani (HLA1 s)

Zochepera 6% - wodwalayo alibe matenda a shuga kapena adazolowera moyo ndi matendawa.

6 - 7.5% - wodwalayo ali bwino (wokhutira) wosinthidwa ndi moyo ndi matenda ashuga.

7.5 -9% - wodwalayo mosakhutira (moyipa) adazolowera moyo wokhala ndi matenda ashuga.

Kupitilira 9% - wodwalayo samazolowera bwino kukhala ndi matenda ashuga.

Popeza kuti shuga ndi matenda osachiritsika omwe amafunikira kuyang'aniridwa kwa nthawi yayitali kwa odwala, chithandizo chake chothandiza pamlingo wamakono chimafuna kudziwunika koyenera. Komabe, ziyenera kukumbukiridwa kuti kudziyang'anira pawekha sikukhudza mulingo wa chiphuphu ngati wodwala wophunzitsidwa sagwiritsa ntchito zotsatira zake ngati poyambira kusintha kwa insulin.

Mfundo zoyambirira za mankhwala azakudya

Zakudya za odwala omwe ali ndi mtundu woyamba wa matenda a shuga I am kuphatikizapo kuyang'anira kudya zakudya zamagulu (mkate).

Zakudya zimakhala ndi magulu atatu azakudya zazikulu: mapuloteni, mafuta ndi chakudya. Chakudyacho chilinso ndi mavitamini, mchere wamchere ndi madzi. Chofunika kwambiri mwa zonse izi ndi chakudya chamagulu, chifukwa iwo pokhapokha atatha kudya amapangitsa shuga. Zakudya zina zonse sizimakhudzanso shuga pambuyo chakudya.

Pali zinthu ngati zopatsa kalori. Kalori ndi mphamvu yochuluka yomwe imapangidwa mu khungu la thupi panthawi ya "kuyaka" mkati mwake. Tiyenera kumvetsetsa kuti palibe ubale wachindunji pakati pa zakudya zopatsa mphamvu ndi kuchuluka kwa shuga m'magazi. Zakudya zopatsa mphamvu zokha zopatsa mphamvu zokha zomwe zimatulutsa shuga m'magazi anu. Chifukwa chake, tikambirana zinthu izi zokha m'zakudya.

Kodi ndingawerenge bwanji chakudya chomwe chimapezeka ndi chakudya?

Posavuta kuwerengera chakudya cham'mimba, amagwiritsa ntchito lingaliro longa mkate (XE). Ndizovomerezeka kuti 10-12 g yazakudya zamagetsi zamagetsi pa XE ndi XE siziyenera kufotokoza nambala iliyonse, koma imathandizira kuwerengera kwa zakudya zomwe zimadyedwa mu chakudya, zomwe zimakupatsani mwayi kuti musankhe kuchuluka kwa insulin. Kudziwa dongosolo la XE, mutha kusiya zolemetsa zoperewera za chakudya. XE imakulolani kuwerengera kuchuluka kwa chakudya kwa diso, nthawi yomweyo musanadye. Izi zimachotsa mavuto ambiri othandiza komanso amisala.

Maupangiri ochepa azakudya zopatsa thanzi:

Pakudya kamodzi, pa jakisoni imodzi ya insulin yayifupi, tikulimbikitsidwa kuti musadye mopitilira 7 XE (kutengera zaka). Mwa mawu oti "chakudya chimodzi" tikutanthauza chakudya cham'mawa (choyamba ndi chachiwiri pamodzi), nkhomaliro kapena chakudya chamadzulo.

Pakati pa zakudya ziwiri, mutha kudya XE imodzi popanda kukanikiza insulini (bola kuti shuga ya magazi ikhale yachilendo komanso kuyang'aniridwa nthawi zonse).

XE imodzi imafunikira pafupifupi magawo 1.5-4 a insulini kuti itengeke. Kufunika kwa insulin pa XE kumatha kukhazikitsidwa pokhapokha polemba momwe mumadziwonera nokha.

Dongosolo la XE limakhala ndi zovuta zake: kusankha zakudya malinga ndi XE kokha sikungokhala kwachilengedwe, popeza mbali zonse zofunika za chakudya ziyenera kupezeka m'zakudya: chakudya, mapuloteni, mafuta, mavitamini, ndi michere. Ndikulimbikitsidwa kugawa zakudya za tsiku ndi tsiku zopatsa mphamvu motere: 60% chakudya, 30% mapuloteni ndi 10% mafuta. Koma simuyenera kuwerengera kuchuluka kwa mapuloteni, mafuta ndi zopatsa mphamvu. Ingodyani mafuta ochepa ndi nyama yamafuta momwe mungathere ndi masamba ndi zipatso zambiri momwe mungathere.

Nayi malamulo osavuta omwe muyenera kutsatira:

Chakudya chimayenera kumadyedwa m'magawo ang'onoang'ono ndipo nthawi zambiri (4-6 pa tsiku) (chakudya chamasana chokakamiza, chakudya chamadzulo masana, chakudya chachiwiri).

Tsatirani zakudya zokhazikitsidwa - yesetsani kuti musadumphe zakudya.

Musadye kwambiri - idyani monga momwe adotolo adokotala kapena anamwino

Gwiritsani ntchito mkate wopanda mkate kapena mkate wa chinangwa.

Idyani masamba tsiku lililonse.

Pewani kugwiritsa ntchito mafuta, shuga.

Pankhani ya matenda a shuga omwe amadalira matenda a shuga a insulin (mtundu woyamba wa matenda a shuga), kudya zakudya zamafuta m'magazi kuyenera kuvala yunifolomu tsiku lonse komanso kuchuluka kwa insulinemia, i.e. Mlingo wa insulin.

Kuchiza matenda a shuga kumachitika pamoyo wonse motsogozedwa ndi endocrinologist.

Odwala ayenera kudziwainsulin imeneyo ndi mahomoni opangidwa ndi kapamba omwe amachepetsa shuga. Pali mitundu ya kukonzekera kwa insulin komwe kumasiyana, nthawi yochitapo kanthu. Odwala ayenera kudziwa zochita zazifupi, zazitali, zophatikiza zochita, mayina amalonda azokonzekera kwambiri pamsika wa Russia ndikutsindika pakusinthana kwa mankhwalawa nthawi yayitali. Odwala amaphunzira kusiyanitsa pakati pa insulin "yifupi" ndi "yayitali", yogwiritsidwa ntchito kuchokera kumalamulo osungika, osungirako insulin, machitidwe omwe amapezeka kwambiri pakugwiritsa ntchito insulin: syringe - zolembera, mapampu a insulin.

Mankhwala a insulin akuchulukirachulukira akuchitika, pomwe ma insulin omwe amagwira ntchito kwa nthawi yayitali amathandizidwa kawiri patsiku, ndipo insulini yokhala ndi nthawi yochepa imaperekedwa musanadye chakudya chilichonse ndipo amawerengera moyenera ma carbohydrate omwe adalandiridwa nawo.

Zisonyezo za mankhwala a insulin:

Mtheradi: lembani matenda ashuga a shuga, chikomokere ndi chikomokere.

Wothandizana naye: mtundu II shuga mellitus, osakonzedwa ndi kukonzekera kwamlomo, ndi ketoacidosis, kuvulala kwambiri, chithandizo cha opaleshoni, matenda opatsirana, matenda oopsa a somatic, kutopa, zovuta zam'mimba za matenda ashuga, mafuta a hepatosis, matenda ashuga a m'mimba.

Wodwala amayenera kudziwa luso la insulin yoyenera kuti athe kugwiritsa ntchito bwino zabwino zonse zomwe zimachitika pokonzekera insulin.

Ana onse ndi achinyamata omwe ali ndi matenda a shuga a mtundu woyamba ayenera kupatsidwa majakisoni a insulin.

Kupanga kwa zolembera za syringe poperekera insulin kwathandizira kwambiri kuperekera mankhwala. Chifukwa chakuti zolembera izi za syringe ndi machitidwe odziyimira palokha, palibe chifukwa chosakira insulin kuchokera ku vial. Mwachitsanzo, mu cholembera cha syvoge ya NovoPen 3, katoni ina yotchedwa Penfill imakhala ndi insulin yomwe imatenga masiku angapo.

Ma singano owoneka ngati owonda kwambiri, opindika a silicone amapangitsa kuti jakisoni wa insulin akhale wopanda ululu.

Ma cholembera a syringe amatha kusungidwa kutentha nthawi yayitali kuti azigwiritsa ntchito.

Zokhudza insulin

Insulin yogwira ntchito yayifupi iyenera kuperekedwa kwa mphindi 30 asanadye (mphindi 40 ngati kuli kofunikira).

Ultra-yochepa-insulin (humalog kapena Novorapid) imayendetsedwa musanadye, ngati n`koyenera - nthawi kapena mukangomaliza kudya.

Wobayira jakisoni wa insulin akukhazikika mu minofu yam'mimba, yapakati-nthawi ya insulin - mosakakamira matako kapena matako.

Kusintha kwatsiku ndi tsiku malo amodzi a insulin m'dera lomwelo ndikulimbikitsidwa kuti muchepetse kukula kwa lipodystrophy.

Malangizo a kayendetsedwe ka mankhwala

Musanayambe. Choyambirira kusamalira ndikuyeretsa kwa manja ndi malo a jekeseni. Ingosambitsani manja anu ndi sopo komanso shawa tsiku ndi tsiku. Odwala kuwonjezera mankhwalawa jekeseni ndi antiseptic khungu njira. Pambuyo pa chithandizo, tsamba la jakisoni wofunidwa liyenera kupukuta.

Insulin yomwe imagwiritsidwa ntchito pakadali pano iyenera kusungidwa kutentha.

Mukamasankha jekeseni, ndikofunikira kukumbukira zofunikira zonse ziwiri:

1. Momwe mungatsimikizire kuchuluka kwa kuyamwa kwa insulin m'magazi (kuchokera m'malo osiyanasiyana a thupi, insulin imayamwa mwachangu kuthamanga).

2. Momwe mungapewere jakisoni wambiri malo amodzi.

Mlingo. Madzi a insulin amatengera:

kuchokera m'malo ake: pakulowetsedwa m'mimba, mankhwalawa amayamba kugwira ntchito kwa mphindi 10-15, pamapewa pambuyo pa mphindi 15-20, ntchafu pambuyo pa mphindi 30. Ndikulimbikitsidwa kubayirira insulin yochepa m'mimba, ndikuyamba kupanga insulin m'matako kapena matako,

pochita zolimbitsa thupi: ngati wodwalayo wavulaza insulin ndikuchita masewera olimbitsa thupi, mankhwalawa amalowa m'magazi mwachangu kwambiri.

kutentha kwa thupi: ngati wodwalayo ali wozizira, insulin imayamwa pang'onopang'ono, ngati atangosamba kumene, ndiye kuti mwachangu,

kuchokera kuchipatala komanso njira zopititsira patsogolo magazi zomwe zimapangitsa kuti magazi azisungunuka m'malo obayira

Kugawa malo a jakisoni. Kusamalidwa kuyenera kutengedwa kuti apange jakisoni pa mtunda wokwanira kuchokera pa woyamba. Kusinthana kwa malo a jakisoni kupewa kupewa zisindikizo pansi pa khungu (kumalowa).

Malo osavuta kwambiri pakhungu ndi kunja kwa phewa, dera lothandizira, kunja kwakunja kwa ntchafu, ndi mbali yina ya khoma lam'mimba. M'malo awa, khungu limagwidwa bwino m'khola ndipo palibe chiopsezo chowonongeka m'mitsempha yamagazi, mitsempha ndi periosteum.

Kukonzekera kwa jekeseni

Musanapange jakisoni wa insulin yokhala nthawi yayitali, muyenera kusakaniza bwino. Pazomwezi, cholembera cha syringe ndi cartridge yodzazidwa imatembenuzidwa ndikusewera osachepera 10. Pambuyo pa kusakaniza, insulin iyenera kukhala yoyera komanso yamitambo. Insulin yofupikira (yankho lomveka) sifunikira kusakanizika musanalowe.

Malo ndi luso la jakisoni wa insulin

Insulin nthawi zambiri imayendetsedwa popanda kupanikizika, pokhapokha ngati ili ndi mankhwala apadera kudzera mu intramuscularly kapena kudzera m'mitsempha (nthawi zambiri mu chipatala). Ngati subcutaneous mafuta wosanjikiza ndi wochepa thupi pamalo a jakisoni kapena singano yayitali kwambiri, insulini imatha kulowa minofu pakakonzedwe. Kukhazikitsidwa kwa insulin mu minofu sikowopsa, komabe, insulin imalowetsedwa m'magazi mwachangu kuposa kubayidwa jekeseni wa subcutaneous.

1.8 Zinthu zadzidzidzi za matenda ashuga

Pa phunziroli, kuchuluka kwa shuga m'magazi pamimba yopanda kanthu komanso musanadye (3.3-5.5 mmol / L), komanso maola awiri mutatha kudya (

Zolemba zofananira

Kuwerenga momwe mphamvu ya chokoleti imakhudzira shuga, kuchuluka kwa cholesterol, kulemera kwa thupi, kuthamanga kwa magazi, kugunda kwa mtima. Kusanthula kwa ntchito ya namwino pantchito yosamalira odwala omwe ali ndi matenda ashuga a 2.

thesis 2,2 M, anawonjezera 06/16/2015

Zamankhwala pazovuta za matenda ashuga. Zamakhalidwe azikhalidwe za umunthu wa odwala omwe ali ndi matenda ashuga. Mankhwala othandizira anthu omwe ali ndi vuto la psychosomatic. Mfundo za psychotherapy zamatenda a psychosomatic.

thesis 103.6 K, owonjezera 03/17/2011

Matenda a shuga monga amodzi mwa mavuto apadziko lonse lapansi masiku ano. Kusankhidwa kwa mbiri ya odwala omwe ali ndi matenda ashuga a 2005-2007. Mlingo wa kudziletsa mwa odwala omwe ali ndi matenda osokoneza bongo. Kuchepa kwa zovuta. Kuchuluka kwa cholesterol muzakudya.

mapepala 529.4 K, adaonjezera 3/11/2009

Unamwino ngati maziko a chisamaliro chothandiza paumoyo. Makhalidwe a shuga. Gulu la ntchito pachipatala ndi kusamalira ana omwe ali ndi matenda ashuga m'madipatimenti apadera. Magulu a ntchito yaamwino.

pepala 470.2 K, kuwonjezera 07/10/2015

Makhalidwe a shuga ngati vuto lapadziko lonse lapansi. Kusanthula kwamtundu ndi magawo a kukula kwa matendawo. Zolemba za njira ya unamwino mu shuga. Tekinoloje Yosamalira Odwala. Chithandizo choyamba cha chikhalidwe cha hypoglycemic.

mapepala a 509.8 K, owonjezera 08/17/2015

Matenda a shuga, mitundu yake ndi zomwe zimayambitsa. Kuunika ndi kuwunika kwa Statistics pakuwonetsa kwa omwe amachitika ndi matenda a shuga mothandizidwa ndi phukusi la STATISTIKA. Kusanthula kwa malumikizidwe ndi kuphatikizika kwakukongoletsa, ndikupanga mawonekedwe angapo osinthira.

mapepala a 1000.6 K, owonjezera 07/06/2008

Kuwerenga ndikusanthula kukhazikitsidwa kwa ndondomeko za boma pankhani yazachipatala ndi chitetezo cha nzika zokhala ndi matenda a shuga ku Primorsky Territory. Ndondomeko zothandizira kukondera kokonda mankhwalawa kwa Precious National Health Program.

thesis 82.9 K, anawonjezera 05/14/2014

Zizindikiro ndi matenda a shuga, zotheka zomwe zingachitike. Gulu la zochitika zolimbitsa thupi kwa ana omwe ali ndi matenda ashuga. Zotheka pakukula kwa zochitika za hypoglycemic. Zakudya zopatsa thanzi kwa mwana wodwala. Kupereka chithandizo cha unamwino kuchipatala cha dipatimenti yapadera.

thesis 509.5 K, anawonjezera 01/08/2015

Gulu la matenda ashuga. Insulin-wodwala matenda a shuga. Otsamira a shuga osadalira insulin. Etiology. Pathogenesis. Chithunzi cha chipatala. Matenda a shuga Khomali la shuga odwala odwala matenda ashuga. Hyperglycemic chikomokere.

Abstract 41.6 K, anawonjezera pa Epulo 6, 2007

Kapangidwe ka molekyulu ya insulin. Udindo ndi kufunikira kwa kapamba m'mimba. Limagwirira ntchito ya timadzi timeneti kudzera mu mapuloteni olandirira. Kugwiritsa ntchito mankhwala ambiri a insulin pofuna kuchiza odwala matenda a shuga. Matenda omwe amayamba chifukwa cha insulin.

Abstract 175.0 K, kuwonjezera pa 04/12/2015

Udindo wa ukhondo kwa wodwala yemwe ali ndi matenda ashuga. Malangizo apakati pazosamalira pamlomo, miyendo ndi chimbudzi m'moyo watsiku ndi tsiku. Ubwino wa psychotherapy yothandiza. Njira zodziyang'anira pawokha komanso njira zowunikira mtundu wa chithandizo cha matenda ashuga kwa nthawi yayitali.

Kutumiza ntchito yanu yabwino pamaziko azidziwitso ndikosavuta. Gwiritsani ntchito mawonekedwe pansipa

Ophunzira, ophunzira omaliza, asayansi achichepere omwe amagwiritsa ntchito chidziwitso m'maphunziro awo ndi ntchito adzayamika kwambiri.

Bungwe lanyumbachipatalakomaposamalira odwalankhukudIbet

Zaukhondo ndizofunikira m'moyo wa munthu aliyense, koma zimathandiza kwambiri odwala omwe ali ndi matenda ashuga. Izi sizimangotengera ukhondo wamunthu, kusunga ukhondo wam'nyumba, ukhondo wa zovala, zakudya, komanso chitukuko cha zolimbitsa thupi, zolimbitsa thupi, kuumitsa, ndikuchotsa zizolowezi zoyipa.

Pofuna kupewa kukula kwa vuto la hypoglycemic odwala omwe akupereka insulin m'mawa, jekeseni iyenera kuchitidwa pambuyo pa masewera olimbitsa thupi, atatha kuwongolera msanga.

Kuchita masewera olimbitsa thupi komanso njira zina zamadzi zotsatira (kupukuta, kusamba, kusamba kapena kusamba) kumalimbikitsa thupi.

Ukhondo wamlomo

Mu matenda a shuga, matenda a mano ndi mano amakula nthawi zambiri ndipo amakhala ovuta, chifukwa chake kusamalira mkamwa kumayenera kuthandizidwa kwambiri. Wodwala wodwala matenda ashuga ayenera kupita pafupipafupi (nthawi imodzi m'miyezi isanu ndi umodzi) kukayendera dokotala wamano, kuchitira mano ake kuwola, kuwachotsa.

Kuopsa kwa kuwonongeka kwa phazi mu matenda ashuga kumakhala kwambiri. Palinso lingaliro la odwala matenda ashuga. Ndi kuwonongeka kwa zotumphukira za mitsempha, mitsempha yamagazi, chidwi ndi magazi kupita kumadera akumunsi mozama kumachepa kwambiri. Muzochitika izi, nsapato wamba zimatha kuyambitsa kupunduka kwamapazi, zilonda zam'mimba, komanso kukula kwa matenda osokoneza bongo. Kusintha kwa phazi kumayambitsa mapangidwe a madera owonjezeka oponderezedwa pamtunda. Zotsatira zake, chotupa chofiyira cha zofewa za phazi chimachitika, ndikutsatira kupangika kwa zilonda zam'mimba. Kuphatikiza apo, kuwonongeka kulikonse pakhungu ndi kuchuluka kwa glycemia ndi kusapeza bwino kwa magazi kumayambitsa matenda ambiri omwe amafalikira kwa zida za ligamentous ndi osteoarticular. Chithandizo cha phazi la matenda ashuga ndi njira yovuta komanso yayitali. Koma matenda ndi zovuta zitha kupewedwa mwa kuchitapo kanthu njira zopewera kusamalira mapazi.

Chofunikira kwambiri pakukhalabe ndi thanzi ndikusungabe nthano m'moyo watsiku ndi tsiku. Choyamba, tikulankhula zakusinthana kwa ntchito ndi kupumula, kukhala maso ndi kugona. Mwa mitundu yonse ya zosangalatsa, chofunikira kwambiri pakumanga ndi kugona. Mavuto ogona amachepetsa mphamvu ya chisamaliro cha matenda a shuga. Kuonetsetsa kuti kugona tulo komanso kugona kwambiri, ndikulimbikitsidwa:

chakudya chomaliza osachepera maola 2 asanagone (kusiyanitsa chololedwa kokha kwa odwala omwe amagwiritsa ntchito insulin yowonjezera ndipo amakhala ndi vuto la hypoglycemic - ndikofunika kuti odwala oterowo aziwonjezera chakudya champhindi 30 mpaka 40 maminiti asanagone - zipatso, kefir),

Ma 30 - mphindi zamadzulo kuyenda mumlengalenga,

mugone m'malo abwino mpweya wabwino

khalani omasuka, zodziwa malo, pumulani,

kugwiritsa ntchito malingaliro opangira auto!

Funso la kufunika kogwiritsira ntchito mapiritsi ogona ndi zosinkhira amasankhidwa payekha ndi dokotala.

Matenda a shuga ndi matenda okhalitsa, motero, kwa ambiri, kupanga matenda otere kumayambitsa kukhumudwa, kulephera chidwi ndi zakunja. Wothandizira endocrinologist ayenera kumayankhulana pafupipafupi ndi odwala komanso anthu am'banja lake, ndikugogomezera kuti machitidwe ndi chithandizo choyenera, wodwalayo atha kukhala moyo wabwinobwino, akwaniritse ntchito zomwe akuchita ndipo osadziona kuti ndi wotsika.

Wodwala ayenera kudziwa bwino kuphunzitsidwa kokha, ngati kuli kotheka, katswiri wa zamaganizo kapena wamisala ayenera kuchita nawo mankhwalawo.

Ndikofunikira kuti pakhale zovuta pamtundu wa wodwala kuntchito, m'banjamo, kuti azungulire ndi kumvetsetsa, chisamaliro.

Njira yophunzitsira komanso kudziletsa ndiyofunika kwambiri, chifukwa imakupatsani mwayi woperekera chipukutira komanso kupewa kutetemera kwa angiopathies ndi neuropathies. Kuphunzitsa ndi kudziletsa kumaphatikizapo:

kudziwa tanthauzo la nthendayi, njira zake za kakulidwe, matenda, mfundo zamankhwala,

kutsatira njira yolondola yantchito ndi kupuma,

bungwe la zakudya zoyenera,

kuwongolera pafupipafupi thupi lanu,

kuphunzira kuchipatala chokomera komanso njira zowalepheretsa, komanso kuperekera chithandizo chadzidzidzi,

kuphunzira njira zama insulin.

kudziyang'anira nokha mu magazi ndi mkodzo (pogwiritsa ntchito zingwe zamtundu, glucometer). Njira zotsatirazi zimagwiritsidwa ntchito poyesa shuga wapakati komanso nthawi yayitali.

Kuwona mulingo wa HbA1 kapena HbA1c kumagwiritsidwa ntchito poyesa mtundu wa chithandizo cha matenda a shuga kwa nthawi yayitali (miyezi itatu). Mitundu iyi ya hemoglobin imapangidwa ndikumanga shuga wamagazi ndi molekyulu ya hemoglobin. Kumangika koteroko kumakhalanso m'thupi la munthu wathanzi, koma popeza shuga m'magazi a shuga amawonjezereka, kumangika kwake ku hemoglobin kumakhala kowonjezereka. Mwambiri, mpaka 5-6% ya hemoglobin m'magazi imachitika chifukwa cha shuga. Kuphatikiza apo, shuga akakwera kwambiri, HbA1 kapena HbA1c kwambiri imapangidwa. Poyamba, kulumikizana kumeneku ndi "kofooka", i.e. Zimasinthanso, koma mkaka wokwera wamagazi ukakhala kwa maola angapo, kulumikizana kumakhala "kolimba" - kumapitilira mpaka ma cell ofiira am'magazi omwe amakhala ndi hemoglobin atawonongeka. Popeza nthawi yayitali ya erythrocyte ndi pafupifupi milungu 12 (kapena miyezi itatu), mulingo wa hemoglobin wokhudzana ndi shuga (HbA1 kapena HbA1c) umawonetsa kuchuluka kwa wodwala yemwe ali ndi matenda ashuga nthawi imeneyi, i.e. miyezi itatu. Kuchuluka kwa hemoglobin yomwe imalumikizana ndi molekyulu ya glucose imapereka lingaliro lakuwonjezeka kwa shuga wamagazi: ndiwokwera kwambiri, wokwera kwambiri wa shuga wamagazi ndi mosemphanitsa. Kusintha kwakukulu m'magulu a HbA1 kumachitika ndi shuga wosakhazikika (labile), makamaka kwa ana omwe ali ndi matenda ashuga kapena odwala. Koma shuga wamagazi akakhala wokhazikika, kumbali inayo, pamakhala ubale wolunjika pakati pa mitengo yabwino kapena yoipa ya metabolic ndi mitengo yotsika kapena yapamwamba ya HbA1 kapena HbA1c.

Masiku ano, zikutsimikiziridwa mosatsimikiza kuti shuga yayikulu m'magazi ndi imodzi mwazifukwa zazikuluzomwe zimayambitsa zovuta za matenda ashuga, omwe amadziwika kuti amachedwa. Chifukwa chake, mitengo yayikulu ya HbA1 ndi chizindikiro chosadziwika bwino cha zovuta zomwe zimachitika chifukwa cha matenda ashuga.

Momwe mugwiritsire ntchito mankhwalawa pochiza matenda a shuga malinga ndi HbA1 ndi HbA1c ndi izi: kagayidwe kabwino - 5.5-7.6%, 3.5-6.1%, kubwezera kwabwino kapena kwabwino kwambiri kwa kagayidwe kazinthu - 7.0-9.0%, 6, 0-8.0%, malipiro osinthika okwanira - 9.0-10.5%, 8.0-9.5%, malipiro osakwaniritsidwa osinthira 10.5-13.0%, 9.5-12.0%, kuwonongeka kagayidwe ka 13.0-15%, 12-14%.

Izi pamwambazi ndizowonetsa, makamaka popeza mtundu wawo umadalira njira yotsimikizirira ndipo zizindikilo zokha zomwe zimapezeka ndi njira imodzi zomwe zitha kufananizidwa.

Njira inanso yoyesera momwe mankhwalawa amathandizira odwala matenda ashuga ndi kudziwa magazi omwe ali mu fructosamine, yomwe ndi albin yokhala ndi shuga m'magazi. Miyezo ya Fructosamine imawonetsa kuchuluka kwa shuga m'magulu opitawa 2-3. Dziwani kuti fructosamine alibe chochita ndi fructose.

Popeza kusintha kwakukulu pazomwe zimapezeka m'magazi a fructosamine kumachitika mu masabata 2-3, poyerekeza ndi HbA1 mulingo wake umakulolani kuyendayenda ngati chithandizo pakanthawi kochepa (masabata a 6-8). Chifukwa chake, kuyendetsa bwino kwa shuga m'magazi kumabweretsa kutsika kwamphamvu kwakutali muzoyambirira za Fructosamine m'magazi. Pachifukwa ichi, kuphunzira kwa fructosamine ndikofunikira kwambiri kwa odwala omwe angopezeka kumene, pomwe chithandizo chokwanira chikuwonjezeka msanga ndipo ndikofunikira kuti mudziwe zambiri za kuchuluka kwa chiphuphu cha shuga m'milungu iwiri yapitayi ya chithandizo.

Fructosamine - mulingo wabwinobwino205-285 mmol / L

Zokhudza chisamaliro cha shuga

Njira zazikuluzikulu za matenda ashuga zimapangidwa kuti apange kuchuluka koyenera pakati pa chakudya chamafuta, masewera olimbitsa thupi ndi kuchuluka kwa insulin (kapena mapiritsi ochepetsa shuga).

Zakudya zamankhwala - kuchepetsa chakudya chamafuta, kuwongolera kuchuluka kwa chakudya chamafuta. Ndi njira yothandizira ndipo imagwira ntchito pokhapokha pothandizidwa ndi mankhwala.

Zochita zolimbitsa thupi - kuonetsetsa kuti ntchito ikhale yokwanira komanso kupumula, kuonetsetsa kuchepa kwa thupi kuti munthu azitha kupeza bwino, kuwongolera mphamvu ndikugwiritsa ntchito mphamvu.

Kuthana ndi insulin - kusankha koyambira kwa insulin komanso kuyimitsa kukwera kwa shuga wamagazi mutatha kudya ndi insulin yochepa komanso ya ultrashort.

Chithandizo cha mankhwalawa kwa odwala omwe ali ndi matenda amtundu wa II amaphatikizanso gulu lalikulu la mankhwala omwe dokotala amasankha ndikupanga.

Wodwala matenda a shuga amafunika kuwunika pafupipafupi zizindikiritso zofunika.

Tanthauzo la shuga la magazi liyenera kuchitidwa ndi mtundu 1 wa shuga: kamodzi pa sabata m'mawa. Ngati ndi kotheka, masana: musanadye chakudya chilichonse komanso maola awiri mutadya, m'mawa ndi usiku.

Mtundu wachiwiri wa matenda ashuga, ndikokwanira kuchita miyezo kangapo pamwezi pa nthawi zosiyanasiyana za tsiku. Ngati mukumva kusowa - nthawi zambiri.

Kuti mupewe zosavuta, sungani diary momwe simumalemba zolemba za shuga zokha, nthawi ndi tsiku, komanso mulingo wa mankhwala omwe adamwa komanso zakudya.

Njira yolondola komanso yamakono imachitidwa ndi glucometer. Ndikokwanira kuyika dontho la magazi pachifuwa chowoneka bwino cholumikizidwa ndi zida za glucose oxidase biosensor, ndipo patapita masekondi angapo gawo la glucose m'magazi (glycemia) limadziwika.

Kulemera kwa thupi. Ndikofunikira kuyeza wodwala tsiku lililonse kuti awone momwe mankhwalawo amathandizira komanso amawerengera insulin.

Kutsimikiza kwa shuga mkodzo. Kuyeza kumachitika ndi zingwe zoyeserera. Kuti mupeze kusanthula, mwina mkodzo womwe umatengedwa patsiku kapena gawo la theka la ola ntchito (mutatha kukodza kuchimbudzi, muyenera kumwa kapu yamadzi ndikuchotsa mu chidebe chofufuzira theka la ola pambuyo pake).

Glycolized hemoglobin index imachitika kamodzi kotala malinga ndi kuyesa kwa magazi.

(!) Momwe mungayendetse bwino jakisoni wa insulin.

Ngati kuchuluka kwa shuga mu mkodzo patsiku kupitirira 10% ya chakudya chambiri chopezeka mu chakudya, makonzedwe a insulin ndi omwe amapatsidwa.

Ngati mapiritsi ndi zakudya zinakhala zopanda ntchito mu mtundu II wa shuga, ngati chiwopsezo cha matendawa kapena pokonzekera kuchita opareshoni, insulin yotsimikizika imalembedwanso.

Pakalipano, pali kuchuluka kwamankhwala ambiri okonzekera insulini, omwe ali osiyana nthawi yayitali (ultrashort, yochepa, yapakatikati, yowonjezeredwa), malinga ndi kudziyeretsa (monopic, monocomponent), mitundu ya mitundu ya anthu (nyama, nkhumba, bovine, genetically engineering, etc.)

Dokotala amatha kukupatsani nthawi yomweyo kapena mitundu ingapo ya mitundu iwiri ya kukonzekera kwa insulin: Kutalika kwakanthawi kochepa komanso kwapakatikati kapena nthawi yayitali.

Nthawi zambiri, kukonzekera kwanthaŵi yochepa ka insulin kumathandizidwa katatu patsiku (asanadye chakudya cham'mawa, chakudya chamadzulo komanso chakudya chamadzulo). Kukonzekera kwa insulin yayitali - 1 kapena 2 pa tsiku.

Kukonzekera kwa insulin kumayikidwa mu magawo a zochita kapena mamililita 0,5 ml = 4 mayunitsi.

Insulin imasungidwa kutentha. Ngati wadi wanu amasunga mufiriji, ndiye kuti jakisoni musanawonetsetse kuti mumawotha m'manja.

Ntchito jakisoni:

• syringes yapadera, kutsiriza kwake komwe kumakupatsani mwayi wowerengera mpaka 2 mayunitsi.
• cholembera cha syringe - "penfil", pakuyambitsa kukonzekera kwambiri kwa insulini (penfil, 0.1 ml = 10 ED)
• Pampu ya insulin ndi chida chaching'ono zamagetsi chomwe chimamangirizidwa ndi zovala za wodwalayo. Pompo imapereka milingo yaying'ono ya insulin kudzera mu catheter kuzungulira koloko. Izi zimachepetsa chiwopsezo cha zovuta za usiku, zimamasula wodwala pakufunika kwamiyeso yambiri ndi jakisoni.

Malo a jakisoni a insulin:

• • Mbali zamanja ndi zamanzere zam'mimba, pamwambapa kapena pansi m'chiuno (pewani malo a 5cm kuzungulira batani la m'mimba)
  • Ntchafu za kutsogolo ndi zakunja (10 cm pansi pa matako ndi 10 cm pamwamba pa bondo)
  • Kunja kwa mkono kuli pamwamba pa nsonga.
    1. itanani ambulansi nthawi yomweyo
    2. gonekerani wodwala pansi, mutembenukire kumbuyo kwake,
    3. penyani kupuma kwanu, kuthamanga kwa magazi ndi kugunda,
    4. sangakakamizidwe kudya kapena kumwa
    5. Ngati ndi kotheka, perekani jakisoni wotsekemera: sungunulani 1 mg ya glucagon hydrochloride mu 1 ml ya solvent.
    • Pimani shuga yanu.
    • Funsani wodwala nthawi yomaliza yomwe adalowetsa insulin kapena kumwa piritsi.
    • Ngati ward ili pafupipafupi komanso kukodza, imwani, kuti madzi asathere.
    • Wodwala akayamba kukomoka: kusayang'anira kwathunthu zomwe zikuchitika, kusungika kwamikodzo, kununkhira kwa ma acetone (maapozi akhathamira) kuchokera mkamwa, kutsika magazi, kupuma mwamphamvu (kupuma kwakanthawi komanso kupumira kwakanthawi), chikumbumtima chovulala, nthawi yomweyo itanani ambulansi.
    • Lowani pang'onopang'ono kukonzekera kwa insulini mwachidule kwa 0,3 PIECES / kg, i.e 15-16 PISCES kwa munthu wolemera 70 kg.

Sinthani dera la jekeseni sabata iliyonse kuti muchepetse kutupa ndi kutupa.

M'dera lomwelo, sankhani majekisiti osiyanasiyana kuti musavulaze khungu.

Ngati mukufunikira mitundu iwiri ya insulini nthawi yomweyo, gwiritsani ntchito syringe ndi malo a jakisoni (simungathe kuwasakaniza).

Ngati wodwala ali ndi mwayi wosunthira jakisoni, mufunseni za izi. Insulin imalowera m'magazi mwachangu.

Kumbukirani kuti mphindi 20-30 jakisoni, wadi ayenera kudya kuchuluka kwa zakudya zomwe adokotala akuwonetsa.

Zowopsa kwa wodwala matenda ashuga.

Kuphwanya lamulo lililonse kumatha kubweretsa kuchepa (hypoglycemia) kapena kuchuluka kwambiri kwa shuga m'magazi, zomwe zikuwopseza moyo.

Ngati wadi wanu wachoka mnyumbayo, onetsetsani kuti ali ndi cholembera m'thumba mwake chosonyeza nthendayo, mlingo wa insulin ndi zidutswa za shuga. Wodwala yemwe amalandira insulin amafunika kudya magawo a shuga chizindikiro choyamba cha hypoglycemia.

Momwe mungasiyanitsire kuperewera ndi kuchuluka kwa shuga m'magazi:

Chizungulire, kufooka mwadzidzidzi, mutu. Kugwedezeka thupi lonse, minofu kukokana

Sipirira mseru komanso kusanza

Khungu limazizira, kunyowa, thukuta.

Khungu lowuma. Milomo yopondaponda.

Mphamvu yanjala.

Ludzu losatha, kusowa kudya.

Kuyankha kumakhala kwabwinobwino kapena kosafunikira.

Kukwiya mwadzidzidzi (kukwiya, kufuna kukangana, kukayikira, mikangano).

Kutopa, ulesi, ulesi.

Vutoli limakula mofulumira m'mphindi zochepa.

Amakula pang'onopang'ono kuyambira ola limodzi mpaka masiku angapo.

Nthawi zambiri amakula usiku, popeza kufunikira kwa insulini ndikokwanira m'mawa kwambiri.

Odwala omwe ali ndi matenda a shuga 1 amayamba kuwonongeka.

Mowa umadzetsa vuto.

Zimabweretsa kupsinjika, matenda oopsa kapena kukokomeza kwa matenda osachiritsika.

Kusamalira mwadzidzidzi kwa hypoglycemia.

Mupatseni shuga wadiyo (zidutswa 4-5 mu mawonekedwe owuma kapena mawonekedwe a manyuchi), uchi, maswiti, tiyi wowotcha otentha, msuzi wa zipatso, madzi otsekemera. Pambuyo pa mphindi 5 mpaka 10, zizindikirizo zizichoka.

Ngati wodwalayo ataya chikumbumtima:

Pambuyo mphindi 10-15, wadi ayenera kuyambiranso kuzindikira. Ngati izi sizingachitike, bwerezani jakisoni.