Matenda a shuga a Metabolic Syndrome

Nkhani yolemba kuchokera ku monograph "Matenda A shuga: Kuyambira Mwana Kufika Kwa Achikulire."

Chiwopsezo chotenga matenda a mtima, chomwe chimayambitsa kukalamba, kulumala ndi kufa, chikugwirizana ndi zomwe zimatchedwa metabolic syndrome (MS).

Mpaka pano, chizindikiro chodziwikirachi chimadziwika kuti chimaphatikizapo kuphwanya kulekerera kwa ma carbohydrate kapena mtundu wa 2 shuga mellitus (DM 2), dyslipidemia, zovuta za hepatitis ndi chizolowezi cha thrombosis, matenda oopsa a arterial hypertension (AH) ndi mtundu wapakati wa kunenepa kwambiri.

Magulu opatsirana a metabolic syndrome amatha kusakhalapo kapena kupezekapo, komabe, chilichonse mwazinthu zodziimira pakokha zimayambitsa matenda a mtima. Maulalo a pathophysiological omwe amaphatikiza mawonekedwe osiyanasiyana a metabolic syndrome ndi insulin kukana (IR).

Mu 2005, IDF idasinthiratu kagayidwe kachakudya, kutengera komwe kumakhala kuphatikiza kwa m'mimba, insulin kukana, hyperglycemia, ochepa matenda oopsa, kuphwanya kwa hemostasis komanso matenda ang'onoang'ono otupa (mkuyu. 3.3).

Mkuyu. 3.3. Kumvetsetsa kwaposachedwa kwa metabolic syndrome (IDF, 2005)

Ndi kukana insulini kumatanthauza kuphwanya insulini-pakati yogwiritsa ntchito shuga m'magulu atatu (chigoba minofu, adipose minofu ndi chiwindi), pomwe kusintha kwa tizilombo kumadalira chikhalidwe cha insulin. Khalidwe losayenera (kudya kwambiri mafuta ochulukirapo komanso kuthanso kwa chakudya m'thupi m'zakudya, kulimbitsa thupi, kupsinjika kwamaganizidwe), zomwe zimapangitsa kuchuluka kwa mphamvu yogwiritsira ntchito mphamvu mwa anthu omwe ali ndi "lean" genotype (kapena genetic predisposition), kumathandizira kufalikira kwa minofu ya adipose yokhala ndi predomin. (kapena visceral) dera la thupi.

Pakadali pano, kukana insulini kumalipidwa ndi kupanga kuchuluka kwa insulini, palibe zopatuka pakugwiritsa ntchito shuga. Kuphatikiza apo, kutsegulira kwa dongosolo la mtima wachifundo kumabweretsa kuwonjezereka kwa mtima komanso kutulutsa kwa mtima, komwe kumayambitsa vasospasm komanso kuwonjezeka kwathunthu kwamitsempha yamagazi.

Kuwonjezeka kwadongosolo kwa kuthamanga kwa magazi (BP) kumathandizanso kuchuluka kwa insulin, komwe kumapangitsa kuwonjezeka kwa zovuta za lipid metabolism. Lipolysis limapezeka mu cell yamafuta, zomwe zimatsogolera kumasulidwa kwa mafuta ochulukirapo amafuta acid (FFA) ndikuchulukitsa kaphatikizidwe kamakina ochepa kwambiri a lipoproteins (VLDL).

Metabolic syndrome kwa zaka zingapo (pafupifupi 5) zitha kuchitika popanda chiwonetsero chazovuta matenda a metabolism.

Hyperglycemia mu metabolic syndrome imabweretsa kuwonjezeka kwa insulini kutsutsana ndi maziko oyambira a insulin secretion. Kukhazikika kwa FFA kumapangitsa kuti shuga awonjezeke kupanga chiwindi komanso kutsitsa shuga m'magazi.

Pafupifupi, mapangidwe a tsango lathunthu la metabolic syndrome ali ndi zaka 10. Kuwonjezeka kwa kuopsa kwa MS kumapangitsa kuti ntchito yowonjezereka ikhale yotupa, matenda a thrombosis komanso endothelial.

Chizindikiro chachikulu chachipatala, chololeza kutengera wodwala ku gulu lowopsa kuti apangidwe ndi metabolic syndrome, ndi kunenepa. Zakhazikitsidwa kuti kunenepa kwambiri kumayambiriro aubwana kumalumikizidwa ndi matenda amtima, kuphwanya kwa kusintha kwa malingaliro ndi moyo wabwino. Pafupifupi theka la achinyamata ndi gawo limodzi mwa magawo atatu a ana onenepa kwambiri azikhala ndi kunenepa kwambiri akadzakula.

Mu 2004, WHO idalembetsa ana pafupifupi 22 miliyoni osakwana zaka 5 omwe ali onenepa kwambiri kapena onenepa kwambiri. Pakadali pano, malinga ndi International Obesity Group (IOTF), ana osachepera 10% a zaka zapakati pa 5 ndi 17 ndi onenepa kwambiri kapena onenepa kwambiri, omwe ndi anthu pafupifupi 155 miliyoni. Mwa awa, pafupifupi 30-45 miliyoni (2-3%) ali ndi gawo lakuthupi lokhala ndi vuto la kunenepa kwambiri kwa admin. Izi zikuipiraipira pakapita nthawi.

Mwa anthu aku America zaka 20 zapitazi, kuchuluka kwa kunenepa kwambiri mwa ana ndi achinyamata azaka za 6 mpaka 18 kwatsala pang'ono kuwirikiza. Malinga ndi asayansi aku Russia, kunenepa kwambiri amalembedwa mwa anyamata 8 mwa anyamata azaka 12 mpaka 18 ndipo pafupifupi 10% ya atsikana azaka zomwezi. Mwa ana onenepa kwambiri, 53% ali ndi zizindikiro za MS.

Mwanjira imeneyi kunenepa kwambiri paubwana ndizomwe zimapangitsa kuti pakhale matenda osiyanasiyana komanso kufa msanga. Zinapezeka kuti mwa ana omwe ali ndi kunenepa kwambiri kwa visceral ndi kuchuluka kwakukulu kwa chiuno mpaka m'chiuno (OT / OB), chidwi cha insulini ndichotsika poyerekeza ndi odwala omwe ali ndi zotsika zotsika.

Monga mwa achikulire, muubwana ndi unyamata, kunenepa kwambiri kwam'mimba kumawerengedwa ngati cholinga komanso njira yodziyimira payokha ya IR chifukwa cha kutsimikizika kwa Glu T 4 adipocyte receptors yomwe imapereka zotsatira za insulin.

Metabolic syndrome muzaka zoyambirira za moyo wa mwana imapangidwa ndi zinthu zosiyanasiyana, zina zomwe zimakhudzabe mwana wosabadwayo.

Malinga ndi malingaliro amakono, titha kusiyanitsa izi Njira za kagayidwe kakang'ono kamene kamapangidwa muubwana.

1. Zakutsogolo:
   • kunenepa mosaganizira mtundu wake,
   • Matenda a lipoprotein Association,
   • kuwonongeka kwa kapamba pamagawo osiyanasiyana a magengenis,
   • zovuta zamtundu wa insulin receptors kapena kugonjetsedwa kwawo chifukwa cha kuwonekera kwa intrauterine.
2. Kukwaniritsa (kukonza) zinthu:
   • kudya kwambiri zam'mimba ndi lipids,
   • kumangokhala
   • kuwonetsa pafupipafupi kupsinjika.

Mosakayikira, mfundo yofunika pakupanga metabolic syndrome ndi insulin kukana, zomwe zimayambitsa kuzungulira kwa zizindikiro, zomwe zimatsogolera ku kuwonekera kwa zovuta zamtima.

Pali lingaliro la chitukuko cha matenda a insulin kukana, amene amati ana akuvutika ndi michere yokwanira ndipo amabadwa ndi kuchuluka kosakwana 2,5 makilogalamu, osakwanira kutikita minofu ndi ziwalo, kusamva bwino kwa minyewa ya insulin yomwe yapangidwa kale mu utero.

Malinga ndi lingaliro lina, kukana insulini kumatsimikiziridwa mwamaumboni, monga zikuwonekera mwa milandu ya kukhalapo kwa matendawa m'mabanja angapo achibale.

Kusintha kwa atherosulinotic kumayamba muubwana ndi unyamata, kumawonekera pakuchepa kwamphamvu kwa msempha ndi carotid artery, komanso mawonekedwe a bubule atherosclerosis yam'mitsempha yama coronary, omwe amadziwika ndi intravascular ultrasound (ultrasound). Pankhaniyi, atherosclerosis osalankhula a m'matumbo a ana ndi achinyamata amakhudzana kwambiri ndi mtundu wa kayendetsedwe ka glycemic (kuchuluka kwa umboni A).

Pali umboni wosatsutsika wa kutengera kwa chibadwa cha matenda a mtima wamitsempha. Kupezeka kwa abale omwe ali ndi matenda amtima wazaka zosakwana 55, vuto la lipid metabolism, matenda ashuga 2, matenda oopsa, komanso kusuta, kumayika wodwalayo pachiwopsezo chachikulu.

Mwanjira imeneyi kagayidwe kachakudya matenda ndi vuto lanyengo yamankhwala amakono, omwe amatsimikiziridwa ndi kufalikira kwake kwakukulu (20-25%) mwa anthu ambiri komanso chizolowezi chopita patsogolo cha "kukonzanso". Kuchokera pamawonekedwe azachipatala, cholinga chachikulu chopewa kupeweratu kagayidwe kachakudya ndiko kupatula odwala omwe ali ndi chiwopsezo chachikulu cha mtima mwa anthu, omwe kukhazikitsa njira zopewera, kuphatikizapo kusintha moyo wanu komanso kugwiritsa ntchito mankhwala okwanira, zimatha kukhudza kwambiri zizindikiro zazikulu zaumoyo. Vutoli litha kusintha, ndiye kuti, ndi chithandizo choyenera, mutha kukwaniritsa kusowa, kapena muchepetse kuwuma kwake.

Chifukwa chazovuta zamakliniki komanso chikhalidwe pamavuto, mu 2006 IDF idatengera Consensus pa MS, yomwe idatsimikiza za matendawa, njira zoyendetsera odwala, komanso magwiridwe antchito. Zizindikiro za metabolic syndrome zimaperekedwa pagome. 3.1.

Kunenepa kwambiri (komwe kumatanthauza m'chiuno ndi mawonekedwe amitundu)

Ndi BMI> 30 kg / m 2, muyeso wozungulira m'chiuno sufunika

+ Zonse mwa zinthu ziwiri zili pamwambazi:

Kuchulukitsa kwa triglycerides

≥ 1.7 mmol / L (≥ 150 mg / dL) kapena chithandizo chamankhwala a dyslipidemia

Kutsika kwa lipoprotein cholesterol yapamwamba kwambiri.

Amuna:
2, RT - 106.80 ± 10.20 cm. Mankhwalawa adapangidwira m'mawa kamodzi pa mlingo wa 0.4 mg / tsiku masabata 12. Ngati ndi kotheka, pakatha sabata, mlingo wa moxonidine unakulitsidwa mpaka 0,8 mg / tsiku. Chofunikira pakugwiritsa ntchito mankhwalawo amawonedwa ngati kuchepa kwa kuthamanga kwa magazi (BP) wochepera 140/90 mm Hg. Art. kapena osachepera 10% ya magawo oyambira.

Moxonidine monotherapy anali othandiza mu 63% ya odwala, ndipo mwa 58% ya odwala omwe ali ndi 0,4 mg. Mankhwalawa anali kuloledwa bwino ndi odwala. Odwala anayi okha anali ndi pakamwa youma (pa mlingo wa 0,8 mg / tsiku), koma palibe chifukwa chothana ndi mankhwalawo kapena kuchepetsa mlingo wake. Pogwira ntchito yake, moxonidine monotherapy idachitidwa kwa masabata 12. Odwala omwe monotherapy ndi moxonidine pa mlingo wa 0,8 mg anali osathandiza, adalembedwa mankhwala ophatikiza antihypertensive.

Matenda A shuga

Kwa zaka zambiri osalimbana ndi ma DIABETES?

Mutu wa Bungwe: “Mudzadabwitsidwa kuti kumakhala kovuta motani kuchiritsa matenda a shuga tsiku lililonse.

Lero tikulankhula za syndromes a shuga. Anthu ambiri amasokoneza lingaliro la "matenda" ndi "chizindikiro". M'malo mwake, ndi ofanana. Chizindikiro chokha ndi kuphatikiza kwa zizindikiro zingapo nthawi imodzi, zomwe zimalumikizidwa ndi chifukwa chomwechi cha zomwe zimachitika (etiology) ndi njira mu thupi (pathogenesis).

• Matenda A shuga
• Syndrome ya Moriak
• Metabolic syndrome
• Somoji syndrome
• Mawa m'mawa matenda
• Nephrotic syndrome
• Ululu wammbuyo
• Coronary syndrome

Ma syndromes omwe ali ndi matenda a shuga, nawonso, amapezekanso, chifukwa popanda iwo palibe matenda omwe angapitirize. Njira ya pathological mu thupi, yomwe imayamba chifukwa cha matenda ashuga, imapangitsa kusintha kwa kayendetsedwe ka machitidwe onse.

Matenda A shuga

Mitundu yayikulu ya ma syndromes a matenda a shuga a mtundu 1 ndi 2 ndi awa:

• Matenda a Moriak
• kagayidwe
• somoji syndrome
• m'mawa kutacha matenda
• nephrotic
• zopweteka
• korona

Tiyeni tiwalingalire mwatsatanetsatane, momwe amodzi a iwo amadziwikirira komanso zomwe zimakhala zowopsa kwa odwala matenda ashuga?

Syndrome ya Moriak

Patathology inayamba kudziwika ndi dzina la dotolo waku France yemwe adamdziwa. Vutoli limachitika mwa ana okha, makamaka kwa iwo omwe adapezeka ndi matenda a shuga adakali aang'ono.

Amadziwika ndi kukula kwa makanda m'makanda, komanso nkhope ya mwezi wokhala ndi masaya ofiira. Ana awa amakhala ndi mafuta owonjezera pamimba, pachifuwa ndi ntchafu, osati ngati thupi lonse.

Matenda a Moriak amapezeka chifukwa chosowa chithandizo chokwanira. Mwanjira ina, mankhwala a insulin akaperekedwa pamalo olakwika, mulingo woyenera, kapena mankhwalawa amangokhala opanda pake. Chifukwa chamankhwala abwino amakono othandizira miyoyo ya odwala otere, matendawa akhala ocheperako posachedwa.

Metabolic syndrome

Ma syndromes omwe ali ndi matenda a shuga amakhudzana ndi kusintha kwa thupi. Mwachitsanzo, metabolism imalumikizidwa ndi matenda a metabolic. Pankhaniyi, maselo amangoleka kuzindikira insulini, motero mahomoni sangathe kugwira ntchito zake. Izi zimakhudza machitidwe onse amthupi.

Pamaso pa matenda amtunduwu (omwe, mwa njira, si matenda osiyana), munthu amadwala matenda angapo nthawi imodzi. Mwakutero:

• Kuchokera kunenepa kwambiri
• Kuchokera kwa odwala matenda a shuga omwe amadalira insulin,
• Kuchokera pa matenda oopsa
• Kuchokera ku ischemia.

Pathology ndiyowopsa, sizachidziwikire kuti madokotala amazitcha "laki imodzi". Zimayambitsa kulephera kudya, kusachita ntchito, nthawi yovuta komanso kusakwanira kwa kuthamanga kwa magazi.

Somoji syndrome

Mwanjira ina, uku ndi kuwongolera kwanthaŵi yayitali ya insulin yayikulu, ndiko kuti, kuchuluka kwa mahomoni ambiri. Matendawa adatchedwa asayansi aku America. Amadziwikanso kuti hyperglycemia.

Somoji syndrome imadziwika ndi chilakolako chofuna kudya komanso kuchuluka kwa thupi, masana kuchuluka kwa glucose kumasintha, kutsika kwambiri kapena kukwera kwambiri, komanso kuyesa kuchuluka kwa insulin kumangokulitsa mkhalidwe wa wodwalayo.

Mawa m'mawa matenda

Tikulankhula za syndromes ya shuga, izi sizingayang'anitsidwe. Amachitcha choncho ndendende chifukwa munthawi imeneyi kuchuluka kwa shuga kwa munthu wodwala kumadzuka m'mawa kwambiri. Izi zimachitika ndi matenda amtundu 2 komanso matenda ashuga 2.

Zomwe zimayambitsa kupezeka kwake sizimadziwika bwino. Amakhulupirira kuti matenda a m'mawa otentha ndi chiwonetsero cha thupi. Komabe, ndizofala.

Nephrotic syndrome

Amadziwika ndi supretion wamkulu wa mapuloteni limodzi ndi mkodzo. Mwachidule: kuchuluka kwa mapuloteni mumkodzo sikuchitika. Nephrotic syndrome ndi chizindikiro cha kuwonongeka kwa impso.

Matendawa amatenga gawo limodzi mwa magawo atatu mwa odwala omwe ali ndi matenda ashuga. Ndizowopsa m'moyo wa anthu, chifukwa kuchiza impso pankhaniyi ndi ntchito yovuta kwambiri. Kuphatikiza apo, poyamba matendawa amatuluka posachedwapa, ndipo amawapeza, monga lamulo, kale mochedwa.

Amakhulupirira kuti chikhalidwe cha kupezeka kwa matendawa ndi immuno-kutupa.

Ululu wammbuyo

Ma syndromes a shuga ndi osiyana kwambiri. Ngakhale omwe siali a matendawa. Matendawa pawokha sangathe kupweteka, koma ma concomitant pathologies amatha izi. Nthawi zambiri, ichi ndi chotupa cha mtsempha wamagazi am'munsi.

Zomwe zimayambitsa kupweteka mu shuga sizochepa, koma chinthu chachikulu chimakhalabe chimodzi - kutsogolera moyo woyenera. Njira yokhayo yopewa zovuta ndi chizindikiro monga kupweteka.

Coronary syndrome

Acute coronary syndrome panthawi ya matenda a shuga ndi chizindikiro cha chipatala chomwe chimapangitsa kuti munthu azitha kukayikira wodwala matenda amtima kapena angina pectoris.

Kukula kwake kumalimbikitsidwa ndi kusokonezeka kwa kayendetsedwe ka kagayidwe kachakudya ka thupi, kusinthasintha kowopsa mu shuga m'magazi, kuwonongeka kwa mitsempha ya mtima, impso, ubongo, ndi kuyambitsa kwa milingo yayikulu ya insulin.

Kuti athane ndi vutoli, wodwalayo amapatsidwa chakudya chokhacho, amakhala ndi mlingo wabwino wa insulini, ndipo, pamachitika zinthu zochotsa mtima.

Kodi metabolic syndrome: kufotokozera, Zizindikiro ndi kupewa matenda ashuga

Masiku ano, atsogoleri pambiri yaimfa ndi matenda amtima wam'mimba (matenda a sitiroko, matenda am'mimba) ndi matenda amtundu 2, kotero umunthu wautali wautali wakhala wolimbana ndi zovuta izi. Pa mtima wa njira zodzitetezera ku matenda aliwonse ndikuchotsa zoopsa.

Metabolic syndrome ndi mawu omwe amagwiritsidwa ntchito pochita zamankhwala pozindikira koyambirira ndikuchotsa zovuta zomwe zimayambitsa matenda ashuga ndi mtima. Pakatikati pake, metabolic syndrome ndi gulu lomwe limayambitsa matenda a shuga ndi mtima.

Kuphwanya komwe kumachitika mkati mwa metabolic syndrome kumakhala kosadziwika kwa nthawi yayitali. Nthawi zambiri, amayamba kupanga ubwana kapena unyamata ndikupanga zomwe zimayambitsa matenda ashuga, matenda atherosclerotic, matenda oopsa.

Nthawi zambiri, odwala omwe ali ndi kunenepa kwambiri, kuchuluka kwamphamvu kwa glucose m'magazi, kuthamanga kwa magazi, komwe kuli kumtunda kwa chizolowezi, samalandira chidwi. Wodwala amalandila chithandizo chokhacho pokhapokha ngati pali zoopsa zomwe zingaphatikizidwe ndi matenda oopsa.

Ndikofunikira kuti zinthu zotere zizindikiridwe ndikuwongoleredwa koyambirira, osati mtima

Kuti athandizidwe ndi akatswiri komanso odwala okha, njira zomveka zakhazikitsidwa zomwe zidapangitsa kuti azindikire metabolic syndrome ndi mayeso ochepera.

Masiku ano, akatswiri ambiri azachipatala amatengera tanthauzo limodzi lomwe limadziwika ndi metabolic syndrome mwa amayi ndi abambo.

Linaperekedwa ndi International Diabetes Federation: kuphatikiza kwa kunenepa kwam'mimba ndi njira zina ziwiri zowonjezera (matenda oopsa, kuchepa kwa kagayidwe kazakudya, dyslipidemia).

Zizindikiro zodziwika

Poyamba, ndikofunikira kuganizira za metabolic syndrome, momwe zimakhalira ndi zizindikiro zake mwatsatanetsatane.

Chizindikiro chachikulu komanso chofunikira ndi kunenepa kwambiri pamimba. Ichi ndi chiyani Ndi kunenepa kwambiri pamimba, minofu ya adipose imayikidwa makamaka pamimba. Kunenepa kotereku kumatchedwanso "android" kapena "mtundu wa apulo." Ndikofunika kuzindikira kunenepa kwambiri mu shuga.

Kunenepa kwambiri "gynoid" kapena "mtundu wa peyala" kumadziwika ndi kufalikira kwa minofu ya adipose pamtchafu. Koma kunenepa kwamtundu wamtunduwu sikuti ndi zotsatira zoyipa ngati zomwe zidachitika kale, chifukwa chake sizikugwirizana ndi zomwe zimapezeka mu metabolic syndrome ndipo sizingaganizidwe pamutuwu.

Kuti mudziwe kuchuluka kwa kunenepa kwambiri kwam'mimba, muyenera kutenga masentimita ndikuyeza voliyumu mkati mw mtunda pakati pa malekezero a ilium ndi ma arches okwera mtengo. Kukula kwa chiuno kwamunthu wa fuko la Caucasus, wopitilira 94 masentimita, ndi chizindikiro cha kunenepa kwambiri pamimba. Mzimayi amakhala ndi chiuno chotalika masentimita 80, chimayimira chimodzimodzi.

Kuchuluka kwa kunenepa kwambiri ku fuko la Asia ndikovuta kwambiri. Kwa amuna, voliyumu yovomerezeka ndi 90 cm, kwa akazi imakhalabe yomweyo - 80 cm.

Tcherani khutu! Zomwe zimayambitsa kunenepa sizingokhala zongonenepa kwambiri komanso moyo woipa. Matenda akulu a endocrine kapena ma genetic angayambitse matenda awa!

Chifukwa chake, ngati zizindikiro zotsatirazi zilipo zokha kapena zikuphatikizika, muyenera kulumikizana ndi kuchipatala posachedwa kuti mumupime ndi endocrinologist yemwe angatchule kapena kutsimikizira mitundu yachiwiri ya kunenepa:

• khungu lowuma,
• kutupa
• kupweteka kwa mafupa
• kudzimbidwa
• Tambalala pakhungu,
• kuwonongeka kwamawonekedwe
• khungu limasintha.

1. Matenda oopsa a arterial - matenda amtundu amadziwika ngati magazi a systolic ali ofanana kapena opitilira 130 mm Hg. Art., Ndi diastolic ndi wofanana kapena wamkulu kuposa 85 mm RT. Art.
2. Kuphulika kwa mawonekedwe a lipid. Kuti mudziwe izi, kuyesedwa kwa magazi pamagazi kumafunika, komwe kuli kofunikira kudziwa mulingo wa cholesterol, triglycerides ndi lipoproteins yapamwamba. Njira za matendawa zimafotokozedwa motere: kuchuluka kwa triglycerides kupitirira 1.7 mmol / l, chizindikiro cha lipoprotein yapamwamba kwambiri ndiosakwana 1.2 mmol mwa akazi komanso ochepera 1.03 mmol / l mwa amuna, kapena chowonadi chakhazikitsidwa cha dyslipidemia.
3. Kuwonongeka kwa kagayidwe kazakudya. Izi zimatsimikiziridwa ndikuti shuga yothamanga magazi imaposa 5.6 mmol / l kapena kugwiritsa ntchito mankhwala ochepetsa shuga.

Kuzindikira

Ngati zizindikiro sizikuwoneka bwino komanso matenda ake sanadziwike bwinobwino, dokotala amafunsira mayeso ena. Kuzindikira kagayidwe ka metabolic ndi motere:

• Mayeso a ECG
• kuyang'anira kuthamanga kwa magazi tsiku ndi tsiku,
• Ultrasound yamitsempha yamagazi ndi mtima,
• mtima magazi lipids,
• Kutsimikiza kwa shuga 2 pambuyo chakudya,
• kuphunzira impso ndi chiwindi ntchito.

Momwe tiyenera kuchitira

Choyamba, wodwalayo ayenera kusintha kwambiri moyo wake. Kachiwiri ndi kugwiritsa ntchito mankhwala osokoneza bongo.

Pochizira mafupa, owerenga athu adagwiritsa ntchito DiabeNot bwino. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Kusintha kwakhalidwe ndi:

• kusintha kwa zakudya ndi zakudya,
• kusiya zizolowezi zoipa,
• kuchuluka zolimbitsa thupi ndi zolimbitsa thupi.

Popanda malamulowa, kulandira mankhwala osokoneza bongo sikungabweretse zotsatira zoyenera.

Upangiri wa zaumoyo

Zakudya zokhwima kwambiri, makamaka, kusala ndi metabolic syndrome sikulimbikitsidwa. Kulemera kwa thupi kuyenera kuchepa pang'onopang'ono (5 -10% mchaka choyamba). Ngati kulemera kumachepera mofulumira, zimakhala zovuta kwambiri kuti wodwalayo azisungabe pazomwe akwaniritsa. Ndataya kwambiri ma kilogalamu, nthawi zambiri, mumabwereranso.

Kusintha zakudya kumakhala kothandiza komanso kothandiza:

• kusintha mafuta nyama ndi mafuta masamba,
• kuchuluka kwa ulusi ndi ulusi wazomera,
• kuchepa kwa mchere.

Msuzi, chakudya mwachangu, makeke, mikate yoyera siyiyenera kuperekedwa kuchakudya. Supu yophika masamba iyenera kukula, ndipo nyama zamphaka zosafunikira zimagwiritsidwa ntchito ngati nyama. Nkhuku ndi nsomba zikuyenera kuwotchera kapena kuwiritsa.

Mwa njere, tikulimbikitsidwa kugwiritsa ntchito buckwheat ndi oatmeal; mpunga, mapira, ndi barele ndizololedwa. Koma semolina ndiyofunika kuchepetsa kapena kuthetseratu. Mutha kuyesa cholozera cha glycemic cha chimanga kuti muwerengere bwino chilichonse.

Zamasamba monga: beets, kaloti, mbatata, akatswiri azakudya zamtunduwu amalimbikitsa kudya zosaposa 200 gr. patsiku. Koma zukini, radishi, letesi, kabichi, tsabola belu, nkhaka ndi tomato zitha kudyedwa popanda malamulo. Izi zamasamba zimakhala ndi fiber zambiri ndipo ndizothandiza kwambiri.

Zipatso ndi zipatso zimatha kudyedwa, koma osapitirira 200-300 gr. patsiku. Mkaka ndi mkaka uyenera kukhala wopanda mafuta ambiri. Tchizi tchizi kapena kefir patsiku zitha kudyedwa magalasi 1-2, koma zonona mafuta ndi kirimu wowawasa ziyenera kumudya nthawi zina.

Mwa zakumwa, mutha kumamwa khofi wofooka, tiyi, msuzi wa phwetekere, msuzi ndi zipatso zabwino zowawasa popanda shuga komanso makamaka zopangidwa kunyumba.

Mankhwala

Pofuna kuchiritsa matendawa, muyenera kuthana ndi kunenepa kwambiri, matenda oopsa, kusokonezeka kwa kagayidwe kazakudya, dyslipidemia.

Masiku ano, metabolic syndrome imathandizidwa pogwiritsa ntchito metformin, mlingo womwe umasankhidwa pakuwongolera kuchuluka kwa shuga m'magazi. Nthawi zambiri kumayambiriro kwa chithandizo, ndim 500-850 mg.

Tcherani khutu! Kwa anthu okalamba, mankhwalawa amadziwitsidwa mosamala, ndipo odwala omwe ali ndi vuto la chiwindi ndi impso, metformin imatsutsana.

Nthawi zambiri mankhwalawa amalekeredwa bwino, koma mavuto obwera chifukwa cha m'mimba amakalipo. Chifukwa chake, tikulimbikitsidwa kugwiritsa ntchito metformin mukatha kudya kapena munthawi yake.

Ndi kuphwanya zakudya kapena mankhwala osokoneza bongo, hypoglycemia imayamba. Zizindikiro za mkhalidwewo zimawonetsedwa ndi kunjenjemera ndi kufooka mthupi lonse, kuda nkhawa, kumverera kwanjala. Chifukwa chake, mulingo wa shuga m'magazi uyenera kuyang'aniridwa mosamala.

Zabwino, wodwalayo ayenera kukhala ndi glucometer kunyumba, yomwe imakupatsani mwayi wowunika kuchuluka kwa shuga kunyumba, mutha kugwiritsa ntchito Aychek glucometer, mwachitsanzo.

Pochiza kunenepa kwambiri, Orlistat (Xenical) ndiyotchuka lero. Musamalandire kangapo katatu patsiku, pachakudya chachikulu.

Ngati zakudya zomwe zili pachakudya sichakudya, mutha kudumphira kumwa mankhwalawo. Zotsatira za mankhwalawa zimakhazikitsidwa ndi kuchepa kwa mayamwidwe amafuta m'matumbo. Pachifukwa ichi, pakuwonjezeka kwamafuta m'zakudya, zotsatira zoyipa zingachitike:

• zolakalaka zambiri popanda kanthu
• chisangalalo
• mafuta amatuluka kuchokera ku anus.

Odwala omwe ali ndi dyslipidemia, ndi kusagwira ntchito kwa nthawi yayitali mankhwala, amapatsidwa mankhwala ochepetsa lipid omwe amachokera m'magulu a fibrate ndi ma statins. Mankhwalawa ali ndi zoperewera komanso zovuta zake zoyipa. Chifukwa chake, ndi adokotala okhawo omwe akuyenera kulandira mankhwala omwe ayenera kulandira.

Kuchepetsa kwa magazi komwe kumagwiritsidwa ntchito mu metabolic syndrome kumakhala ndi angiotensin kutembenuza ma enzyme inhibitors (lisinopril, enalapril), imidosaline receptor agonists (moxonidine, rilmenidine), calcium channel blockers (amlodipine).

Kusankhidwa kwa mankhwala onse kumachitika palokha.