Kodi matenda a shuga a mtundu 2 ndi otani (osadalira insulini)

Matenda a 2 a matenda a shuga ndi matenda a endocrine momwe mumawonjezera shuga m'magazi. Matendawa amawonekera pakusintha kwa ma cellular ndi minofu ndikutulutsa glucose wopangidwa ndi maselo a pancreatic. Matenda amtunduwu amatengedwa ngatiofala kwambiri.

Kodi matenda ashuga amtundu 2 ndi chiyani?

Type 2 shuga, ndi chiyani? Funso lofananalo limakonda kufunsidwa muofesi ya dokotala pamene wodwala afotokozedwa kuti ali ndi matenda. Pathology imachitika pazaka 40-60. Chifukwa cha chifukwa ichi, chimatchedwa matenda a okalamba. Ndikofunika kudziwa kuti m'zaka zaposachedwa, matenda ashuga a 2 ayamba kukhala achichepere, ndipo sizachilendo kuona matenda a shuga kwa odwala omwe si 40.

Mtundu wachiwiri wa matenda amadziwika ndi kusintha kwa mphamvu ya maselo amthupi kuti apange insulini yopangidwa ndi zisumbu za ma Langerhans a kapamba. Mankhwala, njirayi imatchedwa insulin kukana. Pachifukwa ichi, shuga amalephera kupereka bwino gwero lalikulu lamphamvu, shuga, m'maselo, chifukwa kuchuluka kwa glucose mumtsinje wamagazi kukuchulukirachulukira.

Kuti athe kulipirira kusowa kwa mphamvu, shuga wambiri amatulutsidwa ndi kapamba kuposa kale. Koma kukana insulini sikumapita kulikonse. Ngati simupereka mankhwala panthawiyi, ndiye kuti ziphuphu zakumimba ndipo shuga wambiri atembenuka kukhala chosowa. Mlozera wa shuga udzafika 20 mmol / L kapena kupitilira, pomwe chizolowezi chake chiri 3.3-3.5 mmol / L.

Gawo 2 shuga.

1. Pachigawo choyamba, thanzi la wodwalayo limasinthidwa ndikusintha zakudya, pogwiritsa ntchito kapu ya mankhwala patsiku, yomwe imatsitsa shuga.
2. Mu gawo lachiwiri, wodwalayo amakhala bwino ngati mumamwa makapisozi atatu patsiku la mankhwala ochepetsa shuga.
3. Digiri yachitatu - kuwonjezera pa mankhwala omwe amachepetsa shuga, insulin imayendetsedwa.

Momwe mgawo wama glucose amakhala wokwera pang'ono kuposa wabwinobwino, koma osatinso zovuta, izi zimatchedwa kulipidwa. Izi zikunena kuti thupi likadatha kuthana ndimatenda a carbohydrate metabolism.

Zomwe zimayambitsa matendawa

Kapangidwe ka matenda a shuga 2 amachititsa kuti pakhale kupangika kwachilengedwe komanso zomwe zimayambitsa thupi lonse. Pakukalamba, zovuta zomwe zimapangitsa kuti maselo azikhala ndi shuga, chifukwa chomwe sapeza insulin yokwanira.

Madokotala omwe ali ndi mtundu wachiwiri wa matenda ashuga samawerengetsa zomwe zimayambitsa, koma poyerekeza ndi kafukufuku waposachedwa, matendawa amakula mosiyanasiyana ndi kuchuluka kwa mphamvu ya glucose.

Zomwe zimayambitsa matenda a shuga 2:

• kunenepa - mafuta omwe alipo tsopano amachepetsa mphamvu ya maselo kugwiritsa ntchito shuga. Kunenepa kwambiri kumayambitsa chiwopsezo cha matenda ashuga amtundu wa 2. 1 90% ya odwala amawonetsa kunenepa kwambiri,
• kusowa kwa masewera olimbitsa thupi - chifukwa cha kusowa kwa ntchito zamagalimoto zimasokoneza kugwira ntchito kwa ziwalo zambiri ndipo kumayambitsa zoletsa zama metabolic m'maselo. Khalidwe la hypodynamic limatumizidwa pakuchepetsa shuga wambiri ndi minofu ndi kuchuluka kwake m'magazi,
• Zakudya zolakwika ndizomwe zimapangitsa kuti pakhale mtundu wa shuga wachiwiri, womwe umayimiriridwa ndi zopatsa mphamvu zopatsa mphamvu. Chifukwa china ndikuyamba kudya shuga wambiri woyengeka, yemwe amalowa m'magazi mwachangu, zomwe zimapangitsa kuti adumphe insulin,
• matenda a endocrine - mtundu wachiwiri wa matenda a shuga umayamba pa kapamba, chotupa cha kapamba, kutsika kwa pituitary,
• matenda a matenda Inde - matenda oopsa kwambiri onani chimfine, chiwindi, nsungu.

M'matenda, zoyambitsa zazikulu zomwe zimakhudza kukana kwa minofu ndimatenda am'mimba zimatha kukula msambo, mtundu, jenda (mtundu 2 matenda a shuga ndizofala kwambiri mwa azimayi), komanso kunenepa kwambiri.

Zizindikiro za matenda a shuga a 2

Kwenikweni, zizindikiritso za mtundu wachiwiri za matenda ashuga zilibe chithunzi chowoneka bwino, ndipo matenda atha kupezeka pokhapokha ngati pakuchitika kusanthula kwamanja kwa m'mimba yopanda kanthu.

Nthawi zambiri, mtundu wachiwiri wa matenda ashuga a mellitus umayamba kupezeka mwa anthu 40 atatha kunenepa kwambiri, kuthamanga kwa magazi komanso zizindikiro zina.

Zizindikiro za matenda a shuga 2 zimapezeka motere:

• kumverera kwa ludzu, kamwa yowuma
• kukodza kwambiri,
• Khungu
• kufooka kwa minofu
• kunenepa
• mabala samachiza.

Wodwala sangathe kuwona zizindikiro za matenda a shuga 2 kwa nthawi yayitali. Wodwalayo amamva zizindikiro za matenda amtundu wa 2:

• kamwa yowuma pang'ono
• Khungu
• ludzu
• Zilonda zimatuluka pakhungu, mucous nembanemba.
• kukhumudwa,
• zisa
• kutsuka mano
• kuchepa kwa masomphenya.

Izi zikusonyeza kuti shuga, popanda kulowa m'maselo, amalowa m'makoma amitsempha, kudzera m'matumba a epithelium. Ndipo pa glucose, kubereka bwino kwa mabakiteriya ndi bowa kumachitika.

Ndi shuga osakwanira shuga, minyewa, kuchuluka kwa shuga, odwala 2 amadzadziwonetsera okha pakapita maola awiri mutatha kudya. Mosasamala kanthu za kuchuluka kwa caloric intake, misa imakhalabe yofanana kapena kuchepa, popeza shuga simalowa, imachoka ndi mkodzo.

Atsikana ndi amayi omwe ali ndi mtundu wachiwiri wa matenda amakumana ndi ziwalo zoberekera, anyamata ndi abambo amadwala matenda amkodzo thirakiti. Odwala ambiri amazindikira kuti zimalira zala zawo, phazi lawo limatha. Pambuyo kudya, wodwalayo amatha kudwala, kusanza kumatha kutseguka. Pali kuwonjezeka kwa kuthamanga kwa magazi, kupweteka mutu, chizungulire nthawi zambiri zimasokoneza.

Mavuto omwe angakhalepo

Pambuyo pakupezeka kwa shuga yemwe amadalira insulin, wodwalayo ayenera kuzolowera kupezeka kwa magazi m'magazi, kumwa mankhwala omwe amatsitsa shuga, kutsatira tebulo lamankhwala ndikuchotsa zizolowezi zoyipa.
Tiyenera kumvetsetsa kuti kuchuluka kwa shuga kumakhudzanso zotengera, zomwe zimayambitsa zovuta zingapo.

Pakusunga shuga mwabwinobwino, chiwopsezo cha zotsatira zoyipa chidzachepetsedwa kwambiri.
Mavuto amagawika m'magulu awiri - njira yovuta komanso yopweteka.

1. Kukula kwa matenda ashuga amtundu wa 2 pachaka kumaphatikizanso chikomokere, chifukwa chomwe pamagona pakuwola kwa wodwala. Izi zimachitika pakakhala kuchuluka kwa insulini, kuphwanya zakudya osagwiritsa mwadongosolo, osagwiritsa ntchito mankhwalawa.
2. Mavuto okhalitsa amakula pang'onopang'ono kwa nthawi yayitali.

Mellitus wosadalira shuga yemwe amadalira zovuta zambiri zosagawika amagawika m'magulu.

1. Microvascular - pali zotupa pamlingo wa zombo zazing'ono - ma capillaries, venule, arterioles. Diso la retina limakhudzidwa, ma aneurysms amapangidwa omwe amatha kuphulika nthawi iliyonse. Mavuto ngati amenewa amapangitsa kuti munthu asamaone. Komanso, wodwalayo amakula kuchepa kwa impso.
2. Macrovascular - zombo zazikulu zimakhudzidwa. Myocardial ischemia, ubongo, zotumphukira zamatenda zimayamba. Izi zimabweretsa kuwonongeka kwa mitsempha ya atherosselotic, kukhalapo kwa matenda a mawonekedwe a 2 kumawonjezera kuwopsa kwa maonekedwe awo kanayi. Kuwopseza kuduladula miyendo mwa odwala omwe ali ndi matenda amisempha kumawonjezeka ka 20.
3. Neuropathy - yodziwika ndi kuwonongeka kwapakati, zotumphukira zamanjenje. Hyperglycemia nthawi zonse imakhudza ulusi wamitsempha, kusokonezeka kwamankhwala am'magazi kumayamba, chifukwa chomwe magwiridwe amtundu wa chikoka kudzera mu ulusi amasintha.

Kuzindikira matendawa

Kafukufuku wotsimikizira kapena kutsutsa kukhalapo kwa matenda a shuga a degree yachiwiri.

1. Kuyesedwa kwa magazi kwa shuga.
2. Kuwerengetsa kwa glycated hemoglobin.
3. Kupima mkodzo wa shuga ndi matupi a ketone.
4. Kuyeserera kwa glucose.

M'mayambiriro oyamba, matenda a shuga a 2 amatha kuwoneka poyesa shuga. Zinthuzo zimatengedwa kangapo. Choyamba, magazi amatengedwa pamimba yopanda kanthu, kenako wodwalayo amamwa magalamu 75 a shuga. Pakadutsa maola awiri, amapanganso mpanda. Chizindikiro chabwinobwino ndi 7.8 mmol / L pambuyo pa maola 2, ngati mtundu 2 wa shuga ukuwonedwa, ndiye kuti mtengo wake ndi 11 mmol / L.

Kuti muzindikire matenda amtundu wa 2 wodwala, magazi amasinthidwa kanayi mphindi 30 zilizonse. Njirayi imakhala yothandiza kwambiri pofufuza kuchuluka kwa shuga chifukwa cha kuchuluka kwa shuga.

Type 2 shuga

Kodi kuchitira matenda a shuga a 2? Matendawa atapezeka, gome la zakudya ndi mankhwala amalembedwa kuti muchepetse shuga. Ngati gawo loyambirira la matendawa wodwalayo amatha kulikulunga, amatsatira mankhwala okhwima, ndiye kuti kumwa mankhwala kumatha.

Kuwona malingaliro onse omwe ali patebulopo komanso kuchuluka kwa zochitika, ndiye kuti mtundu wa 2 wodwala sudzapereka zovuta, zomwe zingapangitse wodwalayo kumva bwino.

Mankhwala

Mtundu wachiwiri wa matenda a shuga, mankhwalawa amachitika pogwiritsa ntchito mapiritsi ochepetsa shuga kuti maselo azitha kupanga insulin yowonjezera, kuti ikwaniritse kuchuluka kwake m'magazi. Chithandizo cha matenda a shuga a mtundu 2 chimayikidwa ndi dokotala yemwe amasankhanso mankhwalawo.

Kodi kuchiritsa matenda ashuga a 2? Pali magulu a mankhwala omwe amathandiza polimbana ndi matenda amisempha

1. Biguanides - amatha kuletsa kugwira ntchito kwa shuga ndi chiwindi, amachepetsa kukana kwa insulini komanso kuyamwa kwa shuga m'matumbo am'mimba. Gululi limaphatikizapo Glycon, Siofor, Glyukofazh, Glyformin, Langerin. Mankhwalawa amatha kuonjezera chiopsezo cha lactic acidosis, kusokoneza mayamwidwe a vitamini B12.
2. Glitazones - amakakamizidwa kugwiritsa ntchito glucose mu minofu. Mankhwala amatha kuwonjezera kulemera chifukwa cha kusungidwa kwa madzimadzi ndi kukula kwa ma adipose - Avandia, Roglit, Pioglar.
3. Zomwe zimachokera ku sulfonylureas - zimathandizira pakupanga shuga. Ngati mutenga nthawi yayitali, ndiye kuti ntchito yake imatha - Glidanil, Glidiab, Glucobene.
4. Glucosidase inhibitors - amalepheretsa kuphwanya kwa saccharides m'matumbo. Zotsatira zoyipa zimachitika chifukwa chakudya kwawo - kumatulutsa, kusanza, ndi m'mimba. Mwa mankhwala omwe Glyukobay, Diastabol amatchulidwa.
5. Protein Inhibitor - wokhoza kuchotsa glucose owonjezera kudzera mu mkodzo. Pali chiwopsezo chotenga kachilombo ka genitourinary thirakiti - Forsig, Jardins, Attokana.

Jakisoni wa insulin amalembedwa pomwe sizingatheke kubweretsa shuga pamtengo wamba ndi mankhwala. Njira imeneyi imawonedwa ndikukula kwa matendawa, limodzi ndi kuchepa kwa kapangidwe kake ka mahomoni ake.

Mankhwala a insulin ndi oyenera mukamadya zakudya ndikumamwa mankhwala omwe amachepetsa glucose, index ya glycated hemoglobin idzakhala yoposa 9%.

Njira zochizira odwala matenda ashuga

Pali mbewu ndi zinthu zomwe zimakhudza phindu la shuga wamagazi, zimawonjezera kupanga kwa insulin ndi zisumbu za Langerhans.

Chithandizo cha matenda amtundu wa 2 chikuchitika pogwiritsa ntchito zinthu zotsatirazi:

• sinamoni - kapangidwe kake kamakhala ndi zinthu zomwe zimakhudza machitidwe a metabolic. Tiyi amalimbikitsidwa powonjezera supuni ya zonunkhira,
• chicory - akulimbikitsidwa kuti agwiritse ntchito ngati prophylaxis yamatendawa. Muli michere, mafuta ofunikira, mavitamini B1, C. Chicory amalangizidwa za matenda oopsa, kupezeka kwa mafupa am'mimba, komanso matenda osiyanasiyana. Pogwiritsa ntchito chicory, decoctions amakonzekera kulimbitsa chitetezo chathupi ndikuchotsa kupsinjika,
• ma bulugiri - ndi kutenga nawo gawo pazochitikazo pali mankhwala ochizira matendawa. Decoctions amapangidwa kuchokera masamba obiriwira - spoonful wa malonda amadzazidwa ndi madzi ndikubwera kwa chithupsa. Imwani msuzi pambuyo 2 maola 3 pa tsiku.

Njira zina zochizira matenda ashuga a mtundu 2 monga monotherapy sizibweretsa mphamvu. Njirayi ndi yothandizira, yothandizira, kuphatikiza ndi mankhwala.

Zakudya za matenda a shuga mellitus 2 digiri

Chofunika cha kusintha kwa zakudya za mtundu wachiwiri wa matenda ashuga ndi kuphatikiza kwa michere yomwe ilowa m'matumbo am'mimba. Mtundu wa zakudya umafunika bwanji kwa wodwalayo, adokotala amawerengera payekhapayekha, poganizira kuopsa kwa matendawa, zomwe zimagwirizana ndi matenda, zaka.

Mu matenda a shuga a mellitus 2, zakudya ndi kulandira zimaphatikizapo mitundu yosiyanasiyana ya matebulo azakudya, omwe amagwiritsidwa ntchito mu mawonekedwe osagwirizana ndi insulin - No. 9, zakudya zotsika zamatumbo. Onsewa amasiyana mwatsatanetsatane, pomwe ali ofanana chifukwa chakuti kudya zamafuta ochepa sikumangokhala kwenikweni. Izi zikugwiranso ntchito pazakudya zamafuta othamanga.

1. Shuga woyesedwa.
2. Amasunga
3. Confectionery.
4. Chocolate
5. Kuphika batala.

Kuphatikiza pa kutsitsa kuchuluka kwa chakudya, amayesetsa kuchepetsa kunenepa, chifukwa kuwonjezeka kwa thupi ndizinthu zomwe zimapangitsa kukula kwa matenda.

Ngati matenda amtundu wa 2 akayamba, zizindikilo ndi chithandizo kwa odwala zimasiyana malinga ndi momwe thupi limayendera. Ndikofunikira kutsatira malingaliro onse a dokotala kuti mupewe zovuta.

Type 2 matenda a shuga

Matenda a 2 a shuga amawonetseredwa mu ukalamba. Komabe, malinga ndi WHO, chiwerengero cha odwala adakali achichepere chawonjezeka posachedwa.

Tsoka ilo, mtundu wachiwiri sutsatira insulin

• munthu amakonda kutengera matenda ashuga 2,
• amayi apakati omwe ali ndi matenda ashuga m'banja
• anthu okhala ndi mafuta ambiri
• anthu omwe ali ndi matenda oopsa.

Matenda a shuga a Type 2 ndi owopsa kwambiri, chifukwa nthawi yoyambira imatha, kupatula pang'ono shuga wamkuluOsapatsa chilichonse.

Koma izi zimapangitsa kuti pakhale zovuta:

• Matenda a shuga a retinopathy retina. Zowonongeka zimachitika m'njira zosakhudzidwa: choyamba, ma capillaries, kenako ma receptors ndi ulusi wamitsempha yama cell.
• Matenda a shugamakamaka zotumphukira zamitsempha. Vuto lalikulu la matenda ashuga. Theka la odwala ali ndi vuto lotere.
• Matenda a shuga - Uku ndikulephera kwa impso, kuwonetsedwa ndi kuwonjezeka kwa mapuloteni omwe atulutsidwa mkodzo.

Pathogenesis ya matenda osokoneza bongo omwe amadalira shuga (NIDDM)

Matenda a shuga osagwirizana ndi insulin (NIDDM) oyambitsidwa ndi kusokonekera kwa insulin katulutsidwe ndi kukana kwake. Nthawi zambiri, chinsinsi chachikulu cha insulini chimachitika modabwitsa, poyankha kuchuluka kwa shuga. Odwala omwe ali ndi matenda osokoneza bongo omwe amadalira insulin, NIDDM), kutulutsa kwa insulin kumayipa, kuyankha pakubweza kwa glucose sikokwanira, ndipo mulingo woyambira insulini umakwezedwa, ngakhale ndi wotsika kwambiri kuposa hyperglycemia.

Steady akuwonekera koyamba hyperglycemia ndi hyperinsulinemia, yomwe imayambitsa chitukuko cha matenda osokoneza bongo omwe amadalira matenda a shuga (NIDDM). Hyperglycemia wolimbikira amachepetsa mphamvu ya maselo a bandeji, zomwe zimapangitsa kuchepa kwa kutulutsa kwa insulin kwa mulingo wambiri wamagazi. Momwemonso, milingo yayikulu ya insulin inhibit receptors, imakulitsa kukana kwawo kwa insulin.

Kuphatikiza apo, popeza chidwi ndi insulin yafupika, kuchuluka katulutsidwe wa glucagon, chifukwa cha glucagon ochulukirapo kumawonjezera kutuluka kwa shuga kwa chiwindi, komwe kumawonjezera hyperglycemia. Mapeto ake, kayendedwe koyipa kameneka kamayambitsa matenda osokoneza bongo omwe samadalira insulin.

Mtundu osagwirizana ndi insulin wodwala mellitus amapezeka kuchokera kuphatikiza chibadwa cha chilengedwe komanso zinthu zachilengedwe.Kuwona komwe kumathandizira kubadwa kwamtundu wamtunduwu kumaphatikizapo kusiyana pakati pa mapangidwe amodzi ndi mapasa a chizungulire, kuchuluka kwa mabanja, komanso kusiyana kwa kuchuluka m'madera osiyanasiyana.

Ngakhale mtundu wa cholowa umawerengedwa kuti multifactorial, chizindikiritso cha majini akulu, omwe amalephereka chifukwa cha zaka, jenda, fuko, mkhalidwe wakudya, kusuta fodya, kunenepa kwambiri komanso kugawa mafuta, zakwanitsa.

Jini lathunthu kuwunika adawonetsa kuti ma polymorphic alleles obwereza tandem obwereza mu transron factor TCF7L2 amagwirizana kwambiri ndi anthu a ku Iceland omwe ali ndi matenda osokoneza bongo omwe samatengera insulin. Heterozygotes (38% ya anthu) ndi homozygotes (7% ya anthuwa) ali ndi chiwopsezo chowonjezereka cha NIDDM pachibale ndi osanyamula pafupifupi 1.5 ndi 2.5 nthawi, motsatana.

Wokwera chiopsezo muonyamula, TCF7L2 inapezekanso m'magulu a odwala aku Danish ndi aku America. Chiwopsezo cha NIDDM chokhudzana ndi chodabwitsachi ndi 21%. TCF7L2 imalembera chinthu chomwe chimakhudzidwa ndi mawu a glucagon, omwe amachititsa kuchuluka kwa shuga m'magazi, akuchita mosiyana ndi insulin, yomwe imachepetsa kuchuluka kwa shuga m'magazi. Kufufuza kwamagulu aku Finland ndi Mexico kwawonetsa vuto linanso, kusintha kwa Prgo12A1a kumtundu wa PPARG, zomwe mwachiwonekere ndi zodziwika kwa anthuwa ndipo zimapereka 25% ya chiwopsezo cha NIDDM.

Pafupipafupi allele Proline imachitika ndi pafupipafupi 85% ndipo imayambitsa chiwopsezo pang'ono (nthawi 1.25) za matenda ashuga.

Gene PPARG - Membala wa banja laukazitape wa receptor ndipo ndikofunikira pakuwongolera magwiridwe antchito ndi kusiyanitsa kwa maselo amafuta.

Chilimbikitso zinthu Zachilengedwe zimaphatikizapo kuperewera kwa 100% concordance m'mapasa a monozygotic, kusiyanasiyana pakugawidwa pamitundu yofanana, ndikuyanjana ndi moyo, zakudya, kunenepa kwambiri, kutenga pakati komanso kupsinjika. Zatsimikiziridwa kuti mwina chibadwa chamtundu wa chibadwa ndichofunikira kuti chitukuko cha matenda osokoneza bongo chimadalira osagwiritsa ntchito insulin, chiwonetsero chachipatala cha odwala omwe samadalira matenda a shuga a mellitus (NIDDM) amadalira kwambiri mphamvu ya zinthu zachilengedwe.

Phenotype ndi chitukuko cha odwala omwe samadalira matenda a shuga (NIDDM)

Nthawi zambiri osagwirizana ndi insulin wodwala mellitus (NIDDM) imapezeka mwa anthu onenepa kwambiri azaka zapakati kapena zopitilira, ngakhale chiwerengero cha ana odwala ndi achichepere chikukula chifukwa cha kuchuluka kwa anthu onenepa komanso osakwanira pakati pa achinyamata.

Type 2 shuga ili ndi poyambira pang'onopang'ono ndipo nthawi zambiri imadziwika ndi misempha yokwezeka ya shuga ndikuwunika koyenera. Mosiyana ndi odwala omwe ali ndi matenda ashuga a mtundu woyamba, odwala omwe samadwala matenda a shuga amelitos (NIDDM) nthawi zambiri samakhala ndi ketoacidosis. Kwenikweni, kukula kwa matenda osakhudzana ndi matenda a shuga omwe amachokera ku insulin (NIDDM) amagawika m'magawo atatu azachipatala.

Glucose ndende yoyamba magazi amakhalanso abwinobwino ngakhale ali ndi ma insulini okwera kwambiri, kuwonetsa kuti minofu ya insulin imakhalabe yolimbana ndi mphamvu ya mahomoni. Ndipo, ngakhale atakhala ndi insulin yambiri, hyperglycemia imayamba pambuyo pochita masewera olimbitsa thupi. Pomaliza, kusokonezeka kwa insulin kutulutsa kumayambitsa njala hyperglycemia komanso chithunzi cha matenda ashuga.

Kuphatikiza pa hyperglycemia, metabolic zovutachifukwa islet b-cell kukanika ndi insulin kukana amayambitsa atherosulinosis, zotumphukira neuropathy, aimpso matenda, cataracts ndi retinopathy. Mu mmodzi mwa odwala asanu ndi mmodzi omwe ali ndi matenda osokoneza bongo omwe amadalira matenda a shuga (NIDDM), kulephera kwa impso kapena matenda akulu amitsempha yama cell omwe amafunidwa.

Kukula kwa izi zovuta chifukwa cha chibadwa komanso mtundu wa kagayidwe kachakudya. Matenda a hyperglycemia atha kupezeka mwa kudziwa kuchuluka kwa hemoglobin ya Hlycosylated (HbA1c). Olimba, pafupi kwambiri ngati momwe zingathere, kukhalabe ndi shuga wama glucose (osapitirira 7%), motsimikiza kuchuluka kwa HbA1c, kumachepetsa chiopsezo cha 35-75% ndipo kungakulitse moyo wabwinowu, womwe pakali pano ndi zaka 17 atakhazikitsidwa matenda kwa zaka zingapo.

Muli phenotypic mawonetsero a shuga osadalira insulin:
• Zaka zoyambira: kuyambira ubwana mpaka kukhala wamkulu
• Hyperglycemia
• Kuchepa kwa insulin
• Kutsutsana ndi Insulin
• kunenepa kwambiri
• Acanthosis wa khungu kudetsedwa

Chithandizo cha matenda osakhudzana ndi matenda a shuga a insulin (NIDDM)

Kukana kulemera kwa thupiKuchulukitsa zolimbitsa thupi ndi kusintha kwa kadyedwe kumathandiza odwala ambiri omwe ali ndi vuto losagwirizana ndi insulin - NIDDM) kusintha kwambiri kwa insulin. Tsoka ilo, odwala ambiri sangathe kapena safuna kusintha kwambiri moyo wawo kuti achite bwino, ndipo amafunika kulandira chithandizo chamankhwala a hypoglycemic, monga sulfonylureates ndi biguanides. Gulu lachitatu la mankhwala, thiazolidatediones, amachepetsa kukana kwa insulin pomangiriza ku PPARG.

Muthanso kugwiritsa ntchito wachinayi gulu la mankhwala - cy-glucosidase inhibitors, pochita pang'onopang'ono matumbo a glucose. Iliyonse yamakalasi a mankhwalawa amavomerezedwa ngati monotherapy ya osachiritsika omwe amadalira matenda a shuga (NIDDM). Ngati m'modzi wa iwo sakuletsa kukula kwa matendawa, mankhwala ochokera ku kalasi ina amatha kuwonjezeredwa.

Hypoglycemic yamlomo kukonzekera osati ogwira mtima pakukwaniritsa kuyang'anira kwa glucose monga kuchepa thupi, kuwonjezera zolimbitsa thupi, komanso kusintha kwa zakudya. Kuti akwaniritse kuwongolera kwa glucose ndikuchepetsa zovuta, zovuta zina odwala amafunikira chithandizo cha insulin, komabe, zimathandizira kukana kwa insulin, kuchuluka kwa hyperinsulinemia ndi kunenepa kwambiri.

Kuwopsa kwa cholowa cha matenda osokoneza bongo omwe amadalira shuga (NIDDM)

Chiwopsezo cha anthu osachiritsika omwe amadalira shuga (NIDDM) imadalira kwambiri anthu omwe awerengera, mwa anthu ambiri izi zimachokera ku 1 mpaka 5%, ngakhale ku USA kuli 6-7%. Ngati wodwalayo ali ndi abale ake omwe akudwala, chiwopsezocho chikuwonjezeka mpaka 10%, kupezeka kwa abale anu odwala ndi achibale ena oyamba kumawonjezera ngozi mpaka 20%, ngati mapasa a monozygotic akudwala, chiopsezo chimakwera mpaka 50-100%.

Kuphatikiza apo, popeza mitundu ina ya osagwiritsa ntchito insulin yomwe imadalira matenda a shuga (NIDDM) imadzaza ndi matenda amtundu 1, ana a makolo omwe ali ndi matenda osokoneza bongo omwe amadalira matenda a shuga a mellitus (NIDDM) ali ndi chiopsezo cha 1 mwa 10 chifukwa chotengera matenda ashuga 1.

Chitsanzo cha matenda osokoneza bongo omwe amadalira shuga. M.P., bambo wazaka 38 wathanzi, fuko la Indian Indian Pima, amalingalira za ngozi yotenga matenda osokoneza bongo omwe amadalira matenda a shuga (NIDDM). Onse a makolo ake adadwala matenda a shuga omwe amadalira insulin, bambo ake adamwalira ndi 60 kuchokera ku myocardial infarction, ndipo amayi ake ali ndi zaka 55 kuchokera ku matenda a impso. Agogo a abambo ndi mlongo wina wachikulire adadwalanso matenda a shuga omwe samadalira insulini, koma iye ndi abale ake anayi ali ndi thanzi.

Zotsatira zoyeserera zinali zabwinobwino, kupatula mwana kunenepa, kuthamanga kwa shuga m'magazi ndikwabwinobwino, komabe, kuchuluka kwa insulin ndi shuga m'magazi pambuyo papezeka kuchuluka kwa glucose wamlomo. Zotsatira izi ndizogwirizana ndikuwonetsa koyambirira kwa dziko la metabolic, mwina kumatsogolera ku matenda osokoneza bongo omwe samadalira insulin. Dokotala wake adalangiza wodwalayo kusintha moyo wawo, kuti achepetse thupi ndikuwonjezera zolimbitsa thupi. Wodwalayo adachepetsa kwambiri mafuta ake, adayamba kuyenda njinga kuti azigwira ntchito komanso kuthamanga katatu pa sabata, thupi lake limachepa ndi 10 kg, ndipo kulolera kwake kwa glucose komanso kuchuluka kwa insulin kunabwezeretsa nthawi zonse.

Zolinga za maonekedwe

Cholinga chachikulu cha mawonekedwe a matendawa ndi kukana insulini - kuchepa kwakukulu kwa chidwi cha maselo kuti apange insulin.

Kasitomala amataya mwayi wake wopanga insulin yachilengedwe mu milandu yayikulu ya matendawa.

M'magawo oyamba, magazi a wodwalayo amakhalabe ndi insulini yachilengedwe, koma samathanso kuchepetsa shuga, chifukwa maselo sazindikira zotsatira za mahomoni.

Chofunikira ndi kunenepa kwambiri, komwe minofu yamafuta imadziunjikira zochuluka kwambiri, potero kumachepetsa chidwi cha maselo, ndipo izi zimapangitsa kuti kunenepa kwambiri.

Mwayi wodwala wodwala matenda ashuga uchulukirapo:

• ndi chakudya chopanda malire, kusowa kwa zinthu zofunika mu chakudya kapena kukhalapo kwa chakudya chamagulu ambiri pazogulitsa
• onenepa kwambiri
• wokhala ndi moyo wongokhala
• ndi matenda oopsa.

Magulu owopsa

Magulu otsatirawa aanthu ali m'gulu langozi:

• omwe ali ndi matenda ashuga m'banja
• onenepa
• azimayi omwe anali ndi matenda am'mimba panthawi yoyembekezera, kapena amene anabereka ana olemera kuposa kilogalamu zinayi,
• odwala omwe ali ndi chotupa cha adrenal gland, acromegaly, kapena chotupa cha pituitary,
• odwala atherosulinosis, matenda oopsa, angina pectoris,
• anthu omwe amayamba kupanga zowopsa
• odwala ndi matenda ena ake
• anthu omwe adakumana kale ndi kuchuluka kwa shuga chifukwa cha vuto la mtima, sitiroko, matenda osiyanasiyana kapena pakati.

Zizindikiro za mtundu wachiwiri wa matenda a shuga ndi njira zotsimikiza

Matenda a shuga amawopa mankhwalawa, ngati moto!

Muyenera kungolemba ...

Monga lamulo, matendawa samayenda ndi zizindikiro zotchulidwa, ndipo matendawa amatha kukhazikitsidwa pokhapokha ngati kafukufuku wa zasayansi akukonzekera.

Ndikofunikira phunziroli lisanadye chakudya - pokhapokha pamimba yopanda kanthu.

Popeza ndi matendawa, odwala amakhala ndi zovuta zosiyanasiyana, amapita kuchipatala kuti akalandire chithandizo ndipo pakachitika izi amayamba chifukwa cha matenda ashuga. Mwachitsanzo, odwala amapita kukaonana ndi ophthalmologist chifukwa cha mavuto amaso ndipo nthawi zambiri chomwe chimayambitsa vutoli ndi kuwonongeka kwa maso ndi matenda ashuga.

Makamaka, mtundu wachiwiri wa matenda ashuga umakumana ndi anthu omwe ali onenepa kwambiri, matenda oopsa komanso matenda ena. Pazaka zakubadwa - ambiri ali ndi zaka zopitilira 40.

Zizindikiro zapadera za matendawa zimaphatikizira kukoka usiku uliwonse, kusowa kwa madzi m'thupi (chikhumbo chofuna kumwa nthawi zonse), matenda a pakhungu. Zomwe zimawonekera mwa zizindikiro izi zimawerengedwa kuti ndi kuchepa kwa maselo a beta ochuluka, chifukwa matendawa akuyenda kale, kapena matenda oopsa monga stroko kapena vuto la mtima.

Pathology imagawidwa m'magawo otsatirawa:

• kusinthidwa
• zosintha pang'ono
• siteji yovuta kusintha mu chakudya kagayidwe.

Madigirii otsatira a shuga amtundu wachiwiriwo ndi amodzi:

Pankhani yamilandu yofatsa, mkhalidwe wa wodwalayo ukhoza kupititsidwa bwino ndikutenga ndalama zomwe zimachepetsa shuga (kapisozi imodzi idzakhala yokwanira), kapena chifukwa chakusintha kwofunikira m'zakudya. Pankhani ya digiri yapakati, kuti athetse vuto, ndikofunikira kuwonjezera kuchuluka kwa mapiritsi awiri kapena atatu patsiku. Ngati matendawa akula kwambiri, kuphatikiza ma kapisozi omwe amachepetsa shuga, muyenera kufunikanso kuyambitsa insulini.

Kodi matenda ashuga amtundu 2 ndi chiyani?

Mankhwala, mitundu iwiri ya shuga imasiyanitsidwa: wodalira insulin komanso osadalira insulin. Matenda a 2 a shuga samadalira insulin. Mosiyana ndi matenda amtundu woyamba, omwe ali ndi mtundu wachiwiri, kapamba amakhalabe wolimba, ndipo mabulangete a Langerhans (magawo a kapamba omwe amapanga maselo a insulin) amagwira bwino ntchito zawo.

Choyambitsa chachikulu cha matenda a shuga a 2 ndikuchepa kwa chidwi cha insulin receptors muma cell minofu.

Zomwe mtundu wachiwiri wa matenda ashuga umachitika: asayansi apeza zomwe zimayambitsa matenda

Chomwe chimayambitsa kuphwanya ndi mahomoni a adiponectin (GBP-28), opangidwa ndi adipocytes - maselo amtundu wa adipose wa ziwalo zamkati. Ntchito yayikulu ya adiponectin ndikuphwanya kwamafuta amthupi kupita ku boma la amino acid. Ndi njirayi yomwe imalepheretsa kunenepa kwambiri. Kuphatikiza apo, timadzi timatseka mapangidwe a atherosulinotic plaques, sinthanso cholesterol, ndikuchepetsa mwayi wa thrombosis.

Pali kulumikizana mwachindunji pakati pa kuchuluka kwa adiponectin yopangidwa ndi index ya thupi. Munthu akakhala wowonda kwambiri, ndiye kuti timadzi tambiri timene timapanga thupi lake. Ndipo mosinthanitsa: kulemera kwambiri kwa thupi kumakhudzana mwachindunji ndi kuchepa kwa kuchuluka kwa GBP-28.

Hormoniyo idapezeka mchaka cha 1994, mpaka nthawi imeneyo, njira ya matenda a shuga wachiwiri siyidaphunziridwe ndipo, chifukwa chake, sizingatheke kuthandizidwa, chifukwa chake, kupezeka kwa matenda a shuga a 2 kunali kofanana ndi kundende yonse. Kafukufuku waposachedwa awonetsa kuti adiponectin imakhudza mwachindunji kagayidwe kakang'ono ka glucose, zomwe zimakhudza chitukuko cha matenda a shuga. Kupeza kumeneku kumapereka njira yatsopano yochizira matenda osokoneza bongo omwe amadalira shuga.

Adiponectin imakhudza njira zambiri zofunika, izi zikufotokozera kuchuluka kwakukulu pamavuto odwala matenda ashuga okhala ndi mahomoni ochepa. Makamaka, GBP-28:

• imaletsa mapangidwe a mafuta m'chiwindi,
• imakhalabe yolumikizira bwino komanso mtima womasuka,
• imalepheretsa mafuta owoneka kuti asungidwe pansi ziwalo zamkati,
• imathandizira kuzindikira atherosclerosis, chifukwa ma cell am'mimba amaikidwa mu microtraumas ya mtima,
• kumawonjezera kagayidwe kachakudya ndikulimbikitsa kuchepa thupi,
• amachepetsa kutupa kwamitsempha yamagazi ndi mitsempha,
• amateteza myocardium ku necrosis ngati vuto la oxygen.

Ndi kuchepa kwa kuchuluka kwa mahomoni awa, munthu amadwala, ndipo njira zingapo zimasokonekera m'thupi lake.

Chibale cha kunenepa kwambiri ndi matenda a shuga a 2

Choyambitsa mtundu wa matenda a shuga a 2 nthawi zambiri ndi mafuta a visceral. Awa sindiye mafuta omwe amaikidwa pambali ndi m'chiuno mukamalemera kwambiri. Zomwe zimawoneka ngati mafuta a visceral ndi kulakwitsa pakati pa chakudya ndi mphamvu zowonongera zomwe zidalowa m'thupi.

Zakudya zamafuta kwambiri komanso zopatsa mphamvu zimakhala ndi mphamvu zambiri, choncho kulakalaka kwa ufa ndi confectionery, mbatata yokazinga ndi pasitala ndi msuzi wa nyama kumadzaza ndi mafuta olemera kwambiri. Mphamvu yowonjezera yosagwiritsa ntchito mafuta imadutsa m'mafuta osungirako thupi, mwachitsanzo, m'magazi amkati ndi mafuta ochulukitsa.

• Mafuta a subcutaneous ali ndi mawonekedwe apadera. Imagawidwa m'chiuno, m'chiuno, khoma pamimba, pamiyendo ya akazi. Kupangitsa kuti ziwonjezeke mozungulira, koma m'malo oganiza bwino, "kubwezeretsanso" koteroko sikumayambitsa ngozi thanzi. Mafuta awa, omwe ali ndi kagayidwe kazakudya komanso zakudya, ndizosavuta kusiya momwe zimakhalira.
• Mtundu wamafuta (wam'mimba) wamafuta owopsa ndi owopsa panjira yachipatala. Pazinthu zochepa, thupi limafunikira, chifukwa imateteza ziwalo zamkati kuwonongeka kwamakina, komanso malo owerengera ngati pakutha mphamvu. Koma zochulukirapo zake zili kale tsoka kwa thupi.

Mimba yam'mimba imadziunjikira pansi pamimba ya serous - membrane woonda wozungulira mbali iliyonse. Nthawi zambiri, mafuta am'mimba amakhala pamwamba pamimba, kotero mawonekedwe a vutoli ndi m'mimba omwe amatuluka, omwe amakhala ochepa mbali zina za thupi. Nthawi zambiri, kuchuluka kwa mafuta ngati amenewo sikuyenera kupitirira 15% ya kuchuluka kwa mafuta m'thupi. Ngati ndichulukirachulukira, magazi ochulukirapo amayenda m'chiwindi, amakonzedwa mu mafuta m'thupi. Pali chiopsezo chotenga matenda a atherosulinosis, omwe amatsogolera ku stroko kapena mtima.

Mafuta am'mimba amachepetsa kuchuluka kwa adiponectin wobisika, ndipo amakhudza mwachindunji mphamvu zamaselo kuti insulini. Zotsatira zake, munthu amayamba kudwala insulin ndipo matenda a shuga a 2 amakula.

Kodi pali kusiyana kotani pakati pa matenda ashuga amtundu wa 2 ndi shuga 1

Ngakhale kufanana kwa mayina ndi zizindikiro zina, matenda amtundu wa 1 ndi mtundu wa 2 amakhala ndi chikhalidwe chosiyana.

Kodi matenda ashuga amachokera pamaswiti?

Osayerekeza maswiti a ubwana wanu ndi maswiti amakono. Amakhala ndi zopatsa mphamvu zambiri komanso zovulaza. Podzipaka, mafuta amafuta, ma preservatives, utoto umagwiritsidwa ntchito, ndipo izi ndizowonjezera pamatumbo.

Kukonda kwa ana m'masewera apakompyuta kumabweretsa kusachita masewera olimbitsa thupi ndipo, chifukwa chake, kuwonjezeka kwa mafuta a visceral. Ndipo ndiye chifukwa chachikulu pakupanga matenda a shuga a 2. Chifukwa chake, madokotala samadabwitsanso kuti ana a msinkhu wa sukulu ya pulayimale akuvutika ndi matenda "akalamba" awa.

Gulu lachiwopsezo cha matenda a shuga a 2

Asayansi ananeneratu kuti mtundu wa shuga wachiwiri udzachitika kangapo pofika zaka za m'ma 2000 kuposa 2000s. Izi zikuchitika chifukwa cha kuwonongeka kwa zachilengedwe, kutchuka kwa chakudya mwachangu, kusachita masewera olimbitsa thupi, komanso chifukwa choti m'badwo udzakhala wamkulu yemwe ubwana wake udadutsa popanda zosokoneza kuchokera pakompyuta. Mwanjira ina, gulu lowopsa ndi la achinyamata onse amakono omwe amanyalanyaza kudya wathanzi ndi masewera.

Gulu lachiwopsezo limaphatikizaponso:

Anthu azaka zopitilira 40. Ngakhale munthu aliyense ali ndi thupi lake, msinkhu wazaka 40 makamaka ndi malire wopanga zizindikiro zowoneka bwino za matenda ashuga.

• Akazi. Pakatha zaka makumi anayi, amayi omwe akukonzekera kusintha kwa kubereka amatulutsa mahomoni ocheperako pachaka chaka chilichonse omwe amathandizira njira zama metabolic.
• Amuna. Ali ndi zaka 40, pachimake chimayi chimayamba, chomwe pazifukwa zina amuna ambiri sanamvepo. Pazaka izi, thupi laimuna limachepetsa ntchito ya mahomoni.

Ndi kumayambiriro kwa kusintha kwa thupi, ngakhale omwe adakhala ochepa moyo wawo wonse amayamba kunenepa. Ndiye chifukwa chake, patatha zaka 40, muyenera kuchepetsa kuchuluka kwa zopatsa mphamvu ndikuyamba kuyang'anira kuwonda.

Anthu omwe ali ndi chikhazikitso chachikulu cha thupi (BMI). Ichi ndi chisonyezo chomwe World Health Organisation chidayesa kuwerengera kuchuluka kwa kulumikizana pakati pa kukula ndi kulemera kwa munthu. Mikhalidweyo ndi yotsutsana, chifukwa samaganizira zaka ndi ntchito za munthu. Komabe, ayenera kutsatira nthawi yoti ayime ndikuyamba kuchepetsa thupi.

• Pafupifupi, njira yake ndi motere: (kukula kwa masentimita - 100) ± 10%. Ine.e. Kutalika kwa 162 cm, mayi nthawi zambiri sayenera kupitirira 68 kg kuti asakhale ndi mavuto azaumoyo.
• Chofunikanso ndikuzungulira gawo. Mwa amuna, chiwerengero chokwanira ndi masentimita 102, mwa akazi - 88 cm. Ngati chiuno ndichokwera kwambiri, izi zikuwonetsa kuchuluka kwamafuta a visceral, omwe amawaika ziwalo.

Kukhala wonenepa kwambiri kumayambitsa zopinga za adiponectin, zomwe zimapangitsa kuti insulini ikhale ndi mphamvu ndikuperekera ku cell,

Hypodynamia - kusowa kwa mayendedwe . Masewera ndi masewera olimbitsa thupi kumawonjezera kufunikira kwa glucose minofu. Popanda kuyenda, glucose owonjezera amakhalabe m'magazi, zomwe zimapangitsa kuchepa kwa chidwi cha insulin. Umu ndi momwe matenda a shuga amakulira.

Kuperewera kwa zakudya m'thupi - kumwa kosalekeza kwa chakudya "chothamanga". Chakudya chofulumira, mipiringidzo chokoleti, chakudya chodyera, zinthu zabwino za McDonald, tchipisi, ndi sodas zili ndi mafuta ndi mafuta ambiri omwe amapezeka mosavuta. Zakudya zomanga thupi zimalowerera m'magazi mwachangu, zimawakakamiza kuti apange insulin yambiri. Ngati muchita izi pafupipafupi, insulin kukana imapangidwa.

Zovuta zapafupipafupi. Pakupsinjika, kuchuluka kwa adrenaline kumamasulidwa mthupi - ma insulin antagonist. Chifukwa chake, kuchuluka kwa adrenaline m'magazi, kumalimbitsa shuga. Mwazi wa shuga umakwera, koma maselo sangathe kupeza mphamvu kuchokera pamenepo. Mafuta ochulukirapo amathandizidwa kudzera mu impso, zomwe zimawononga ntchito yawo. Chifukwa chake imayamba mtundu wachiwiri wa matenda ashuga, womwe munthu akadatha kupewa.

Mtundu wachiwiri wa shuga wapezeka: kuzindikira

Chovuta chomwe chazindikira mtundu wa shuga wachiwiri ndichakuti matendawa amatha kuonekera kwa zaka. Komabe, vutoli litayamba kuzindikira, mwayi wopezeka kuti wodwalayo wayambiranso.

• Kuyesedwa kwa magazi kwa shuga. Kuyesa kosavuta ndikutenga magazi a shuga. Amachitika pamimba yopanda kanthu, ndipo wodwalayo amatengedwa magazi kuchokera pachala. Mafuta ambiri a shuga a 3.3 mpaka 5.5 mmol / L amadziwika kuti ndi abwinobwino. Chilichonse pamwambapa, ngakhale magawo khumi, kale ndi chifukwa chodetsa nkhawa. Komabe, kusanthula koteroko sikumapereka chithunzi chonse. Ndizotheka kuti wodwalayo adapita ku tsiku lake lobadwa tsiku latha, ndikuwunikira zomwe zidachitika pamwambowo. Ndikofunika kuti musadalire confectionery tsiku lisanafike magazi.
• Kusanthula kwa glycemic hemoglobin. Chizindikiro chowoneka bwino kwambiri cha glycemic hemoglobin. Imazindikiritsa matendawa kumayambiriro kwa chitukuko, komanso imazindikiritsa anthu omwe ali ndi chiyembekezo cha matenda a shuga. Kusanthulaku kumachitika chifukwa chakuti maselo ofiira a m'magazi, omwe amakhala ndi hemoglobin, "amakhala" m'thupi kwa pafupifupi masiku 120, kenako ndikuphwanya ndulu kuti bilirubin. Panthawi imeneyi, zimatulutsa mpweya m'maselo ndikuchotsa mpweya woipa.

Kusanthula kwa hemoglobin ya glycated kumawonetsa njira ya kagayidwe kazakudya. Ngati kuchuluka kwa hemoglobin ya glycemic ndikokwera kwambiri kuposa kwazonse, koma kuyezetsa magazi kwa glucose kumakhalabe kwabwino, izi zikuwonetsa gawo loyambirira la shuga kapena prediabetes.

Endocrinologists ku Diana Medical Center amalimbikitsa odwala onse azaka zopitilira 40 kuyezetsa magazi pafupipafupi ndikuwonetsetsa mayeso a shuga m'magazi awo. Izi zikuthandizani kudziwa ngati muli ndi matenda ashuga komanso kupewa mavuto.

Magazi a shuga: magazi ndi kuphwanya

Kodi a 2 matenda a shuga amathandizidwa bwanji?

Choyambirira chomwe chimaperekedwa kwa wodwala pambuyo pakupezeka kwa matenda ashuga ndi chakudya chokhwima. Zakudya za calorie za tsiku ndi tsiku siziyenera kupitirira 2000. Nthawi yomweyo, lingaliro ngati XE (mkate magawo) limayambitsidwa.

1 XE ndi 25 magalamu a mkate kapena magalamu 12 a chakudya chamafuta. Wodwala matenda a shuga a 2 sayenera kudya zosaposa 20 XE patsiku. Ndi kunenepa kwambiri, chizolowezi chimatsika mpaka 10 CB, ndipo ndikamagwira ntchito zolimbitsa thupi zolimba zimakwera mpaka 25 XE.

Wodwalayo amagawa chakudya chamafuta ambiri tsiku lonse. Zogulitsa zomwe zimakhala ndi kuchuluka kwa XE zimaphatikizapo uchi, ma apricots owuma, buledi ndi wakuda, chimanga, pasitala, maswiti. motero, izi zimayenera kudyedwa pang'ono.

XE ilibe nsomba, nyama ndi mazira konse. Little XE mumasamba, zipatso ndi zitsamba. Kutengera izi, zakudya za wodwala wodwala matenda ashuga a 2 ziyenera kukhala ndi nyama ndi nsomba, komanso masaladi ndi magawo a zipatso.

Ngati matenda a shuga akupita patsogolo, wodwalayo amapatsidwa mankhwala.

• glitazones (Roglit, Avandia) imathandizira njira yochotsa shuga m'maselo,
• biguanides (Langerin, Siofor) amachulukitsa chidwi cha maselo ku glucose,
• zotumphukira za sulfonylurea (Glidiab, Glucobene) zimathandizira kupanga insulin ndi kapamba,
• protein inhibitor SGLT2 (Invocana, Jardins) amachotsa glucose owonjezera m'thupi).

Mankhwalawa onse ali ndi zovuta zoyipa. Komanso, pakapita nthawi, kutha kwawo kumatsika. Popita nthawi, odwala matenda ashuga okalamba, wodwalayo amapatsidwa jakisoni wa insulin, ndipo matenda a shuga 2 amakhala mtundu woyamba wa 1. Ichi ndichifukwa chake ndikofunikira kwambiri kuzindikira matendawa nthawi kuti ayambe kulandira chithandizo ndikuletsa kupita patsogolo kwa matendawa.

Komwe mungakapeze mayeso a matenda a shuga ku St.

Kuyesedwa kwa matenda a shuga a 2 kungachitike ku chipatala cha St. Apa mutha kupeza ultrasound ya kapamba pamipangizo yatsopano yaukatswiri. Pambuyo pake, mutha kulandira upangiri wa akatswiri odziwa za ma endocrinologist.

Endocrinologists ku Diana Clinic kwathunthu amafika pochiza matenda osagwirizana ndi insulin omwe amadalira shuga, kuphatikiza zakudya zoyenera, kukana zizolowezi zolakwika ndi masewera olimbitsa thupi ndi mankhwala osankhidwa bwino.

Pangani nthawi yolumikizana ndi gynecologist ku 8-800-707-1560, kuyitanitsa kuyimba foni kapena lembani fomu yolowera patsamba!

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Khodi ya ICD-10

Pa gulu la matenda padziko lonse lapansi, matendawa ndi a gulu la IV ndipo amapezeka pa matenda a shuga mellitus (E10-E14) pandime E11.

Kalasi E11 imaphatikizapo matenda a shuga (onse onenepa komanso osakhala nawo) pazinthu zotsatirazi:

• mwa achinyamata
• Kubwera kwa ukalamba,
• ndi maonekedwe achikulire,
• ngati palibe lingaliro la ketosis,
• ndi njira yokhazikika yamatenda.

Matenda a 2 a shuga sawerengedwa:

• ngati nthendayo yatuluka chifukwa cha chakudya chosakwanira,
• pa nthawi yobereka, nthawi yobereka komanso nthawi yobereka.
• mwa makanda,
• ngati pali glycosuria,
• ngati kulolera kwa shuga kumalephera,
• ndi kuchuluka kwa insulin yogwira ntchito m'magazi a insulin.

Kuopsa komanso zovuta

Type 2 shuga mellitus imasokoneza kwambiri mtima wamagetsi.

Matenda a shuga ndi omwe amayambitsa matenda osiyanasiyana a mtima ndi mtima

Kuphatikiza kuti wodwalayo atha kukumana ndi ma pathologies a mtima dongosolo la ziwalo, zina zodziwika zimakhazikikanso:

• Tsitsi likugwera
• khungu lowuma
• kuwonongeka kwa misomali,
• kuchepa magazi
• kuchepetsedwa kwa cholembera.

Mavuto akulu kwambiri odwala matenda ashuga ndi awa:

• kukulitsa kwa atherosulinosis, komwe kumayambitsa kusokonezeka m'magazi a coronary, komanso kupatsira magazi ku minyewa ya muubongo ndi miyendo,
• zovuta zamagazi ozungulira muubongo,
• kuwonongeka kwaimpso,
• kuwonongeka kwa retinal
• bungwe losavuta la ulusi wamitsempha ndi minofu,
• kukokoloka ndi zilonda m'munsi,
• zovuta kuchiza matenda oyambitsidwa ndi bacteria kapena bowa,
• chikomokere.

Kuzindikira ndi chithandizo

Poyambirira kwamatenda omwe amakula, zidzakhala zokwanira kuwona zakudya zoyenera, komanso kuchita masewera olimbitsa thupi osagwiritsa ntchito mankhwala.

Ndikofunikira kwambiri kuti kulemera kwa thupi kumakhala munthawi yochepa, yomwe ingakhudze kubwezeretsa kwa kagayidwe kazakudya komanso kukhazikika kwa shuga. Pankhani ya matenda ena a shuga a mtundu womwe mukufunsidwa, mankhwala amafunikira kale.

Njira zodziwika bwino zothandizira matenda ndi:

• Tolbutamidekukhudzana ndi kapamba ndipo potero kuyambitsa chinsinsi cha insulini. Mankhwalawa ndi oyenera kwa okalamba omwe ali ndi vuto la matendawa. Mukamagwiritsidwa ntchito, khungu limatha kugundana komanso kumakhalitsa pang'onopang'ono, pomwe khungu limakhala lachikasu,
• Glipizidentchito pa matenda a shuga mu okalamba, komanso odwala ofooka chitetezo chokwanira komanso ntchito adrenal gland ntchito,
• Maninil, kukulitsa chidwi cha zolandilira zomwe zimazindikira insulin. Mankhwalawa amakhazikika pakupanga insulin. Poyamba, amamwa piritsi limodzi, koma m'tsogolomo, ngati kuli kofunikira, mlingo utha kuchuluka.
• Metformin, yomwe imasintha mphamvu zamankhwala chifukwa cha kukhazikika kwa chiŵerengero cha insulin yomangidwa ndi mitundu yaulere. Omwe amagwiritsidwa ntchito kwambiri ndi odwala omwe onenepa kwambiri komanso onenepa kwambiri. Mankhwala ndi contraindised mu aimpso kulephera.
• Acarbose, kuletsa chimbudzi ndi kulowetsedwa kwa matumbo m'matumbo ang'onoang'ono, potero kumachepetsa kuchuluka kwa shuga m'magazi mukamadya ndi chakudya chamafuta ambiri. Mankhwalawa amadziwikiratu ngati akudwala matumbo komanso nthawi yapakati.

Mtundu wachiwiri wa matenda ashuga

Odwala ayenera kudya kasanu kapena sikisi patsiku m'magawo ang'onoang'ono, samangomenya nkhondo, komanso yolimbitsa shuga.

Kuchepa kwa hypoglycemia kumachepetsedwa. Mofanananso ndi izi, ndizovomerezeka kudya katatu patsiku, osakhala ndi nkhawa kuti zotsatira zake, mawonekedwe a thupi la wodwalayo atenganso gawo limodzi pano.

Ndikofunika kulabadira njira yosinthira zinthu - kuchotsa mafuta munyama ndi khungu ku nkhuku, komanso kuphika, kuyambitsa kuphika ndi kudyetsa.

Malonda Oletsedwa:

• soseji
• mayonesi
• mankhwala omalizidwa
• wowawasa zonona
• nkhumba ndi nyama yamwana
• mafuta amkaka,
• tchizi cholimba chokhala ndi mafuta ambiri.

Zololedwa ndi Zoletsedwa

Zinthu zololedwa zazing'ono:

Zovomerezeka:

• zopangira masamba
• skim mkaka ndi mkaka wowawasa
• nsomba zopanda nyama ndi nyama,
• mankhwala a mbewu
• masamba ndi zipatso (ngati ali ndi shuga wochepa, monga tomato ndi maapulo).

Glycemic Index Chakudya Chosankha

Zogulitsa zonse zimakhala ndi index ya glycemic yomwe imachitika:

• otsika (mayunitsi 0-55),
• wapakatikati (mayunitsi 55-70),
• okwera (mayunitsi 70 kapena kuposerapo).

Zogulitsa zomwe zili ndi kuchuluka kwambiri kwa mndandanda wa gulu sizoyenera kwa odwala matenda ashuga, chifukwa kugwiritsa ntchito kwawo kungapangitse kuti agwidwe, ndipo pazovuta kwambiri, wodwalayo amakhala ali pachiwopsezo. Kugwiritsa ntchito ndizovomerezeka pazochitika zachilendo kwambiri komanso zoletsa zina.

Kupewa

Popewa matendawa, ndikofunikira kutsatira mfundo za kadyedwe koyenera.

Kudya zakudya zopanda vuto kungakhale njira yabwino kwambiri yopewera matenda omwe amafunsidwa, komanso matenda ena.

Ndikulimbikitsidwa kuti magawo omwe akukhudzidwawo asakhale ndi cholinga chongochepetsa, koma kuchotsa chakudya chilichonse choyipa m'zakudya. Kuphatikiza apo, ndikofunikira kuyang'anira ntchito zolimbitsa thupi. Ngati zolimbitsa thupi kapena zolimbitsa thupi sizili zoyenera kwa wodwala, mutha kusankha njira zina zamtundu, monga kuvina, kuyenda, kuyendetsa njinga ndi zina zambiri.

Nthawi zambiri kuyenda, mmalo mongoyenda ndi mayendedwe, kuyiwalako za pamalo okwera komanso kukwera masitepe kupita pansi momwe mungafunire.

Makanema okhudzana nawo

Pa zikwangwani za matenda a shuga a 2 omwe akuwonetsedwa pa TV "Live wathanzi!" Ndi Elena Malysheva:

Matenda a shuga, makamaka amtundu omwe akuwaganizidwawo, ndi matenda oopsa, zomwe zimayambitsa zomwe sizidziwika kale. Kuzindikiritsa munthawi yake komanso chithandizo chokwanira kumathandiza kwambiri polimbana ndi matendawa, chifukwa mwanjira imeneyi mavuto akulu amatha kupewedwa.