Mtundu woyamba wa shuga 1 mwa mwana wazaka 6 umayendetsedwa popanda insulini

Matenda a shuga a Mtundu woyamba ndi mtundu wachiwiri kwambiri wa matenda ashuga (amtundu wa matenda ashuga 2), koma amachedwa kwambiri. Matendawa amatchedwanso "shuga achinyamata", "shuga wowonda", ndipo m'mbuyomu mawu oti "matenda a shuga" amadalira.

Matenda a 1 a mtundu wa shuga nthawi zambiri amapezeka ubwana kapena unyamata. Nthawi zina matendawa amayambika ali ndi zaka 30-50, ndipo pamenepa amakhala ofatsa, kutayika kwa ntchito zapamba pang'onopang'ono. Fomuyi imatchedwa "mtundu wa shuga wopita patsogolo pang'onopang'ono" kapena LADA (Late-kutangat Autoimmune Diabetes of Adult).

• Limagwirira a chitukuko cha matenda 1 shuga.

Type 1 shuga mellitus ndi gulu lalikulu la matenda otchedwa autoimmune. Chomwe chimapangitsa matenda onsewa ndikuti chitetezo cha mthupi chimatenga mapuloteni ake omwe amapanga protein yachilendo. Nthawi zambiri chochititsa nthumwi ndimatenda a virus, momwe ma protein a ma virus amawoneka ngati chitetezo chathupi "chofanana" ndi mapuloteni a thupi lawo lomwe. Pankhani ya matenda a shuga a mtundu woyamba, chitetezo cha m'thupi chimagwira ma cell a pancreatic beta (kutulutsa insulin) mpaka kuwawononga kwathunthu. Kuperewera kwa insulin, mapuloteni omwe amafunikira kuti michere ilowe m'maselo, amakula.

• Chithandizo cha matenda a shuga 1.

Chithandizo cha matendawa chimakhazikika pakukhazikika kwa insulin. Popeza insulini imawonongeka pakumeza, iyenera kuperekedwa ngati jakisoni. Kumayambiriro kwa zaka za m'ma 2000 izi, makampani angapo aku America adapanga inshuwaransi kukonzekera (kupuma). Komabe, kumasulidwa kwawo posakhalitsa kunatha chifukwa chosafunikira kwenikweni. Zikuwoneka kuti, jakisoni pawokha siwovuta kwambiri mu insulin.

Tikambirana zambiri zomwe zimapezeka kawirikawiri kwa odwala omwe amapezeka ndi matenda a shuga 1.

• Kodi matenda amshuga 1 angachiritsidwe?

Masiku ano, mankhwala sangathe kusintha njira za autoimmune zomwe zawononga ma cell a pancreatic beta. Kuphatikiza apo, chizindikiro cha matendawa chikawoneka, nthawi zambiri sipamapitirira 10% yogwira maselo a beta. Njira zatsopano zikukonzekera mwachangu kupulumutsa odwala pakufunikira kuperekera insulini musanadye. Mpaka pano, zinthu zambiri zikuyenda bwino m'njira imeneyi.

Mafuta a insulin. Kuyambira mu 1990s, mapampu a insulin adayambitsidwa mchitidwewu - opatsirana omwe amavala thupi ndikupereka insulin kudzera mu catheter ya subcutaneous. Poyamba mapampu sanali achangu, malamulo onse operekera insulin amayenera kuperekedwa ndi wodwala ndikanikiza mabatani pampu. Kuyambira mu chaka cha 2010, mitundu yampweya ya "ndemanga pang'ono" yawonekera pamsika: imaphatikizidwa ndi sensor yomwe imayesa kuchuluka kwa shuga m'matumbo a subcutaneous ndipo imatha kusintha kuchuluka kwa insulini potengera izi. Koma wodwalayo sanamasulidwe konse pakufunika kokupatsani lamulo la pampu. Mitundu yolimbikitsa ya mapampu a insulini amatha kuthana ndi shuga popanda kulowererapo kwa munthu. Zikuwoneka pamsika posachedwa.

Source Source: shutterstock.com / Dinani ndi Chithunzi

Selo ya beta kapena kanyumba kapamba. Zinthu zopereka zimatha kukhala munthu. Chofunikira kwambiri pakupambana ndikuwonjezereka ndikugwiritsa ntchito mankhwala omwe amachepetsa chitetezo cha mthupi komanso kupewa kukanidwa. Zaka zaposachedwa, mankhwala awoneka kuti amasokoneza chitetezo cha mthupi - kupondera kukanidwa, koma osati chitetezo chathunthu. Mavuto aukadaulo odzipatula ndi kusunga maselo a beta adathetsedwa. Izi zimathandizira kuti ntchito yoika zina zizigwira ntchito kwambiri. Mwachitsanzo, opaleshoni yotereyi imatheka nthawi imodzi ndi kupatsirana kwa impso (komwe nthawi zambiri kumafunikira wodwala yemwe ali ndi vuto la matenda a shuga - nephropathy).

• Mwazi wamagazi anali okwera kwambiri, anandipeza ndi matenda osokoneza bongo ndipo ndinapatsidwa insulin. Koma pakatha miyezi iwiri shuga amabwerera mwachizolowezi ndipo samaphuka, ngakhale insulini singayambitse. Kodi ndachiritsidwa, kapena kodi matendawa ndi olakwika?

Tsoka ilo, ngakhale limodzi kapena lina. Izi zimatchedwa "honeymoon of shuga." Chowonadi ndi chakuti zisonyezo za matenda amtundu woyamba 1 zimawoneka pomwe 90% ya ma cell a beta amwalira, koma ma cell ena a beta akadakalipobe mpaka pano. Ndi matenda a shuga a magazi (insulin), magwiridwe antchito awo amakhala bwino kwakanthawi, ndipo insulin yotulutsidwa ndi iwo ingakhale yokwanira kukhalabe ndi shuga. Njira ya autoimmune (yomwe idapangitsa kukula kwa matenda ashuga) siyimayima nthawi imodzi, pafupifupi maselo onse a beta amafa mkati mwa chaka chimodzi. Pambuyo pake, ndizotheka kukhala ndi shuga mokhazikika pokhapokha mothandizidwa ndi insulin yomwe imachokera kunja. Mawu oti “kokasangalala” sapezeka mwa 100% odwala omwe amapezeka ndi matenda a shuga 1, koma izi zimachitika kawirikawiri. Ngati awona, endocrinologist iyenera kuchepetsa kwakanthawi mlingo wa insulin.

Nthawi zina, wodwala yemwe ali ndi matenda amafunafuna thandizo kuchokera kwa ochiritsa am'tsogolo komanso njira zina zochiritsira. Ngati kulandila kwa "wowerengeka azitsamba" kumachitika pakukonzekera kukondwerera kwachisangalalo, izi zimapangitsa kuti wodwalayo (ndi wochiritsidwayo, yemwe ndi woipa) azithandizanso. Koma, mwatsoka, izi siziri choncho.

• Ngati matenda ashuga sangachiritsike, ndipo ndadwala ndili ndi zaka 15, kodi nditha kupulumuka osachepera 50?

Kufikira 50 mpaka 70 - mosakaikira! Joslin American Foundation yakhazikitsa kale mendulo kwa anthu omwe akhala zaka 50 (kenako zaka 75) atapezeka kuti ali ndi matenda ashuga a mtundu woyamba. Padziko lonse lapansi, anthu mazana ambiri adalandira mendulozi, kuphatikizapo ku Russia. Pakanakhala kuti panali akatswiri azamankhwala ambiri ngati sikadakhala vuto laukadaulo: si aliyense amene adasunga zikalata zachipatala zaka 50 zapitazo, kutsimikizira kuti kudali koyambitsa matenda.

Koma kuti muthe kupeza mendulo ya Joslin Foundation, muyenera kuphunzira momwe mungayendetsere shuga yanu bwino. Chovuta ndichakuti mwa munthu wopanda matenda a shuga, kuchuluka kwa insulini kumasulidwa tsiku lililonse - kutengera zakudya, zolimbitsa thupi ndi zina zambiri. Munthu wathanzi amakhala ndi "automaton" yachilengedwe yomwe imayang'anira kuchuluka kwa shuga - awa ndi ma cell a beta a kapamba ndi ma cell ena ndi mahomoni ena omwe akuchita nawo izi. Mu mtundu woyamba wa 1 shuga mellitus, makinawa amathyoledwa, ndipo amayenera kusinthidwa ndi "Manu control" - kuti ayang'anire shuga musanadye chilichonse, muyenera kuganizira zamafuta onse omwe amadyedwa pogwiritsa ntchito dongosolo la "mkate" ndikuwerengera kuchuluka kwa insulin musanadye chakudya pogwiritsa ntchito algorithm yovuta kwambiri. Ndikofunikira kuti musamadalire thanzi lanu, lomwe lingakhale lopusitsa: thupi silimamverera kutentha kambiri kapena kochepa kwambiri.

Mafuta a glucose poyambirira anali mita ya shuga m'magazi, chipangizo chothandiza chomwe chimayeza shuga mu dontho la magazi kuchokera pachala. Mtsogolomo, masensa apadera adapangidwa omwe amayesa kuchuluka kwa shuga mumagazi a interellular (m'matumbo a subcutaneous). Zaka zingapo zapitazi, zida ngati izi zalowa pamsika zomwe zimakulolani kuti muzilandira mwachangu zokhudzana ndi kuchuluka kwa shuga. Zitsanzo ndi DexCom ndi FreeStyle Libre.

Njira Yowunikira Magazi Oyang'anira Magazi

Source Source: shutterstock.com / Nata Photo

Koma, ngakhale muli ndi maukadaulo amakono, kuti muwongolere "kuwongolera" kwa shuga, mumafunikira maphunziro mu pulogalamu yapadera yotchedwa School of Diabetes. Monga lamulo, kuphunzitsa kumachitika mu gulu ndipo kumatenga pafupifupi maola 20. Chidziwitso sichokhacho chofunikira kuyendetsa bwino. Zambiri zimatengera kuyikira izi: kuzungulira kwa kuyeza shuga m'magazi ndikupereka Mlingo woyenera wa insulin. Chifukwa chake, ndikofunikira kwambiri kuti endocrinologist aziwunikira momwe wodwalayo alili komanso kusintha kwake kwa shuga m'magazi (kutengera momwe adayang'anira momwe adziwonera), amawerengera moyenera insulin komanso momwe amasinthira chithandizo. Tsoka ilo, ku Russia, odwala ambiri amakumana ndi dokotala kuti angopeza insulini yaulere, ndipo palibe nthawi yokwanira kwa dotolo ku chipatala ... Aliyense wodwala matenda ashuga ayenera kupeza endocrinologist yemwe amachititsa maphunzirowa molondola ndipo apitiliza kulimbana ndi kuwunika kwa wodwalaumoyo ndi kukonza kwake chithandizo munthawi yake. Enocrinologist wotero sikugwira ntchito nthawi zonse mokakamiza inshuwaransi yaumoyo, ndipo sikuti ndi dokotala yemweyo amene amapereka insulin yaulere.

• Ndili ndi matenda ashuga 1. Ngati ndili ndi ana, kodi nawonso adzakhala ndi matenda ashuga? Kodi matenda ashuga amatengera kwa makolo athu?

Zosadabwitsa, ndi matenda a shuga a mtundu wa 2, vuto lobadwa nalo limakhala lokwera kwambiri kuposa matenda ashuga a mtundu wa 1. Ngakhale matenda amtundu wa 2 nthawi zambiri amapezeka pamsana, amakhala ndi chibadwa chamtunduwu kuyambira pakubadwa. Ndi mtundu 1 wa matenda a shuga, kutengera kwa makolo ndi kochepa: pamaso pa matenda amtundu wa 1 m'modzi mwa makolo, kuthekera kwa matendawa kwa mwana kumachokera pa 2 mpaka 6% (pamaso pa matenda amtundu wa 1 bambo a mwana, mwayi wokhala ndi cholowa ndi wokwera kuposa matenda a shuga mayi. Ngati mwana m'modzi ali ndi matenda ashuga am'banja, ndiye kuti matenda azotheka mwa abale kapena mlongo ali 10%.

Anthu omwe ali ndi matenda ashuga amatha kukhala mayi wachimwemwe komanso kukhala bambo. Koma panjira yotetezeka yomwe mayi ali nayo mwa mayi yemwe ali ndi matenda a shuga 1, kuchuluka kwa shuga asanamve komanso kuwonekera kwa endocrinologist malinga ndi pulogalamu yapadera panthawi yonse yomwe ali ndi pakati ndikofunikira kwambiri.

Matenda a shuga ndi matenda osokoneza bongo omwe "amatha kuvulaza kwambiri." Kuwunikira pafupipafupi ndi madokotala oyenereradi, kuwunikira pafupipafupi ma labotale, kugwiritsa ntchito mankhwala ndi mankhwala amakono kwambiri - zonsezi zimathandiza kuti matenda ashuga azilamulidwa komanso kupewa zovuta zake.

Pali mawu abwino: "Matenda a shuga si matenda, koma moyo." Ngati muphunzira kusamalira matenda anu a shuga, mutha kukhala ndi moyo wautali komanso wachimwemwe nawo.

Acetone mu mkodzo wokhala ndi chakudya chamafuta ochepa

- Chinthu choyamba ndikufuna kufunsa. Tsopano mwaphunzira kuti mwana ali ndi acetone mu mkodzo, ndipo ndikukulemberani kuti apitiliza kukhalabe. Kodi mungatani pamenepa?
- Tidawonjezera madzi ambiri, mwana adayamba kumwa, tsopano palibe acetone. Lero tayesanso, koma sitikudziwa zotsatira zake.
- Kuyesedwanso? Mwazi kapena mkodzo?
- Kusanthula kwa mkodzo kwa mbiri ya glucosuric.
"Kodi mwaphunziranso zomwezi?"
- inde
- Chifukwa?
- Pomaliza, kuwunikaku kunawonetsa maubwino awiri mwa atatu acetone. Akufuna kuti aperekenso, ndipo timachita izi kuti tisakangana ndi adotolo kachiwiri.
- Chifukwa, zitatha izi, ma acetone mu mkodzo apitilizabe kukhalapo, ndakudziwitsani.
- Tsopano mwana adayamba kumwa zakumwa zambiri, ndidamuphikira zipatso. Chifukwa cha izi, palibe mkodzo mumkodzo, zingwe zoyeserera sizimachitika, ngakhale sindikudziwa zomwe mayesowa akuwonetsa.
- Kodi muli ndi acetone pamizere yoyesera?
- Inde, mzere woyezera sugwira ayi. M'mbuyomu, adachitapo kanthu pang'ono, mtundu wa pinki, koma tsopano samachita chilichonse. Koma ndikuwona kuti mwana akangomwa zakumwa zochepa, ndiye kuti ma acetone amawonekera pang'ono. Amamwa zakumwa zina zowonjezera - ndizo zonse, palibepo acetone.
- Ndipo acetone amawonetsa chiyani? Pa Mzere woyezera kapena wathanzi?
- Pokhoma pa mzere wozungulira, sitizindikira. Sichikuwoneka mmaonekedwe kapena mkhalidwe wa thanzi la mwana.

- Kodi mukumvetsetsa kuti ma acetone omwe amatha kuyesa mkodzo azikhala nthawi zonse? Ndipo bwanji osawopa izi?
- Inde, zoona, thupi lokha lidasinthiratu mtundu wina wa zakudya.
"Izi ndikukulemberani ... Ndiuzeni, kodi madotolo adawona zotsatira izi?"
- Chiyani?
- Kusanthula kwa mkodzo kwa acetone.
- Kodi adakhala wocheperako?
- Ayi, kuti alipo.
- Moona mtima, adokotala sanadere nkhawa izi, chifukwa glucose sanali mkodzo. Kwa iwo, ichi sichizindikiro cha matenda ashuga, chifukwa kulibe shuga. Amati, akuti, kukonza zakudya, kupatula nyama, nsomba, kudya phala. Ndikuganiza - inde, zowonadi ...
"Kodi mukumvetsa kuti simuyenera kusinthira chimanga?"
- Zachidziwikire, sititero.

Maphikidwe a chakudya chamafuta ochepa a mtundu 1 ndi matenda ashuga 2 amapezeka pano.

"Ndikudzifunsa ngati atamuyika chakudya mwana mu sukulu kuti acetone asoweke." Zidzakhala nawo. Ndili ndi mantha kuti izi zitheka.
- Amayi Tidzapita kusukulu mu Seputembala. Mu Seputembala ndimatenga tchuthi ndipo akhala akugwira ntchito kwa mwezi wathunthu kuti akonzekere ndi aphunzitsi. Ndikuganiza kuti mphunzitsiyo si dotolo, ali okwanira.
- Yembekezani. Mphunzitsi sasamala. Mwana wanu samabayira insulin, ndiye kuti mphunzitsi alibe mavuto. Mwanayo azidzadya tchizi chake chopanda mafuta, mphunzitsi wake ndi bulb wopepuka. Koma tinene kuti pali namwino mu ofesi. Amawona kuti mwana ali ndi acetone mkodzo wake. Ngakhale pali acetone pang'ono ndipo mwanayo samamva chilichonse, namwino adzakhala ndi Reflex - perekani shuga kuti acetoneyu asapezekenso.
- Abambo. Ndipo azindikira bwanji?
- Amayi. Ndikufuna kuyang'ana pazotsatira zomwe tapanga lero. Mwina sitingawonetse acetone konse. Pambuyo pake, akapempha kuti apereke mkodzo pazowoneka za glucosuric, ndiye kuti timupatsa, koma patsikuli tidzamwetsa mwana ndi madzi ambiri.
- Mukusanthula kwanu kwamkamwa chifukwa cha acetone, panali ma ploses awiri mwa atatu. Pakhoza kukhala kuphatikiza kumodzi, koma kuyenera kukhalabe ...
- Ndizabwino, chifukwa adotolo pazomwezi sanawululire nkhawa iliyonse. Anati kusintha zakudya, koma makamaka za izi sizinadandaule.
- Adakupatsani upangiri wokhazikika mu malangizo ake: ngati pali acetone - perekani chakudya. Simudzachita izi, ndikuthokoza Mulungu. Koma wina mwa zolinga zabwino amatengera mwana wanu kusukulu ndikuti, nkuti, idyani maswiti, ma cookie kapena china chilichonse kuti mumupatse acetone uyu. Izi ndiye zoopsa.
- Amayi. Kunena zowona, ndikuwopa sukulu, chifukwa ndi mwana, ndipo sangathe kupatula ....
- Chiyani?
- Kuti akhoza kudya kena kolakwika kwinakwake. Tidakhalapo nthawi imodzi yomwe tidadyako, ngakhale wokhoza kuba kunyumba. Kenako tinayamba kusinthanitsa menyu, kum'patsa walnuts, ndipo mwanjira inayake adakhala pansi.
- Izi zinali liti? Kodi munalowetsa liti insulin, kapena pambuyo pake, munasinthira liti pakudya chamafuta ochepa?
- Tinali ndi insulin kwa masiku atatu okha. Tinapita kuchipatala pa Disembala 2, tinapatsidwa insulin kuyambira tsiku loyamba, tinabayilitsa insulin kawiri, ndinapita naye kuchipatala kuchokera ku nkhomaliro. Mwanayo nthawi yomweyo amamva bwino, zomwe zimapangitsa insulini kukhala yodwala.
- Adangokhala ndi shuga wambiri, insulini ikugwirizana bwanji ndi izi ...
- Amayi Inde, pamenepo tinali ndi kuyezetsa magazi ku chipatala, shuga anali 12.7 m'malingaliro mwanga, Kenako ndidadyetsa mwana kunyumba ndi pilaf ndipo adanditengera pilaf kuchipatala. Zotsatira zake, shuga adalumphira mpaka 18.
- Ababa, ndidawerenga ndikuganiza - zidachitika bwanji? Chifukwa chiyani shuga anali 12 ndikukhala 18?
- Amayi Chifukwa choti adadya pilaf ndipo tafika kale kuchipatala ndi shuga 18.
"Ndiye, ngakhale muli ndi acetone, kodi mukupitiliza kudya zakudya zamafuta ochepa?"
- Zachidziwikire.
- Ndipo madotolo samatanganidwa makamaka pochotsa acetone iyi?
- Ayi, adotolo adawonetsa kuti palibe chochita.

Matenda a shuga 1 amtundu wa ana amatha kuthandizidwa popanda jakisoni wa insulin tsiku lililonse, ngati mutasinthira kudya zakudya zamagulu ochepa kuyambira masiku oyamba matenda. Tsopano njirayi imapezeka mokwanira mu Russia, kwaulere.

Chakudya cha mwana yemwe ali ndi matenda ashuga amtundu woyamba ku kindergarten ndi sukulu

- Ndiye kuti, simunapite kusukulu, koma pitani, pomwe?
- Inde, pakadali pano tikuphunzira, ndipo tili ndi zonse zomwe zikuyang'aniridwa.
- Ndipo kwa a kindergarten?
- Kuchokera ku kindergarten, pomwepo tidamtenga.
- Zitangoyamba zonse?
- Inde, tidachilandira nthawi yomweyo; sanapite tsiku limodzi kupita ku sukulu ya ana.
- Chifukwa?
- Chifukwa akuti: chakudya chomwe chimaperekedwa ku kindergarten ndi choyenera kwa ana odwala matenda ashuga. Sitikuvomereza. Sichikwanira konse. Ifenso ku chipatala - tebulo 9 - amapereka compote ndi shuga.
- Ndiye kuti, pa kindergarten simungavomere kudyetsedwa zomwe mukufuna?
- Ayi, zoona, mukuyankhula chiyani ... ndimaphika mwana tsiku lililonse ...
"Ndiye mukuyenera kumusunga kunyumba?"
- Inde, timakhala kunyumba, agogo ali pachiwonetsero, ndipo mwana ali kwathu kwathu kwathu, tidamtenga kuchokera ku sukulu ya kindergarten.

Chepetsa shuga kukhala zokhazokha, kenako kwa anzathu

- Ichi ndi chakudya chanu - chimagwira ntchito mochuluka ... Mwamuna wa mnzanga ali ndi matenda a shuga a 2. Komabe, iye sanandimvere ine poyamba. Akuti titha kukhala ndi chakudya chambiri, ndi zina zambiri. Iwo adadya chakudya chambiri - ndipo shuga atatha 22. Tsopano adya chakudya chamafuta ochepa, ndipo tsopano alibe shuga. Poyamba amandiyimbira kwambiri. Amuna awo amakumba, akuti, ayimbireni, mukafunse ngati ndingapeze nawo zinthu ngati izi. Adandimvera, ndipo tsopano amadya monga momwe mwana wathu amadya.
"Kodi mwawapatsa adilesiyi?"
- Alibe intaneti
- Eya, ndikuwona.
- Sali otukuka kwambiri. Amakonzekera, inde, koma awa ndi anthu azaka zopuma pantchito, motero sizokayikitsa. Koma osachepera adandimvera ndikusiyiratu kudya zomwe madotolo adalimbikitsa. Tsopano ali ndi shuga 4-5, ndipo ali ndi bambo wamkulu.

- Ndiye kuti simunatope ndi moyo, kodi mukupangitsanso anzanu?
"Ndiyesetsa, koma anthu samvetsera kwenikweni."
"Osadandaula ndi izi." Mukuderanji nkhawa nazo? Mumadzidera nkhawa ...
"Timachita zimenezo." Nthawi zambiri pamakhala zochitika zamtsogolo. Tili ndi bwenzi - mtundu 1 wodwala matenda ashuga kuyambira ubwana. Sindikudziwa momwe ndingamfikire ndikunena izi. Amadya chilichonse motsatizana, osati amangodya ... Sizotheka kufotokozera munthu, ngakhale amakhala ndi hypoglycemia ndipo timaziwona.
"Kodi wamuuza?"
- Ayi, sindinanene kuti; komabe, sizingathandize.
"Osadandaula ndi onse." Ndani akufuna - wapeza. Mwafufuza mosamala. Tandiuza, ndi uti wauzanso wina? Nenani kuti muli ndi bwenzi la shuga. Kodi ndi yekhayo?
- Uyu ndi mnzake, ndipo pali mtsikana wina yemwe tidakumana naye kuchipatala. Ndikufuna ndimuitanire kunyumba kwanga ndikawonetse zonse. Pakadali pano adangolankhula, ndipo amatsatira zakudya zochepa zamafuta ochepa.
"Alibenso Intaneti?"
- Inde, alibe kompyuta, amabwera kuchokera pafoni. Ndinkalumikizananso ndi chipatala, tili ku Kiev, ndinakumana ndi amayi anga ochokera ku Lutsk. Adandifunsanso zambiri.

Momwe mungaphunzitsire mwana wanu zakudya

- Mwamuna uja adakupeza pomwepo, tsiku loyamba. Tinapita kuchipatala Lolemba, ndipo kumapeto kwa sabata tinali tayamba kale kukana insulini. Nthawi yoyamba yomwe adakana, chifukwa pobaya insulin ngati mwana ali ndi shuga 3.9?
- Papa Anamdyetsa ndi borsch ndi kabichi, ndiye kuti adalowetsa insulin, monga momwe amayembekezeredwa ndi mfundo zamankhwala, ndipo mwana adayamba hypoglycemia. Kufikira pomwe tidali ndi shuga wa 2.8 malinga ndi glucometer, yomwe imadutsa pang'ono.
- Amayi. Mwana anali pamavuto akulu, ndinali wamantha kwambiri.
"Ndimafuna kufunsa kuti: mwandipeza bwanji panthawiyo?" Pa funso liti, simukumbukira?
- Papa sindikukumbukira, ndimayang'ana chilichonse motsatira, ndimasakatula intaneti kwathunthu m'maso mwanga. Adakhala masiku atatu, akuwerenga zonse.
- Amayi. Momwe tidakupezerani, simukumbukira, chifukwa panthawiyo sitidathe kuganiza, koma tidangolira.

- Munali mwayi kwambiri, chifukwa malowo akadali ofowoka, ndizovuta kupeza. Kodi mwana wanu azichita bwanji kusukulu? Pamenepo adzakhala ndi ufulu wambiri kuposa tsopano, ndipo mayesero adzawonekera. Pa dzanja limodzi, m'modzi mwa akulu adzayesa kumudyetsa kuti pasakhale acetone. Mbali inayi, mwana adzayesa kena kake. Mukuganiza kuti azichita bwanji?
- Tili ndi chiyembekezo cha iye, chifukwa ndi wozama komanso wodziimira payekha. Poyamba, aliyense amasirira kupirira kwake. Ana ena m'chipinda chachipatala adadya maapulo, nthochi, maswiti, koma iye adangokhala pamenepo, adangoyendetsa bizinesi yake ndipo sanachitepo kanthu. Ngakhale chakudya pachipatalacho chinali chovuta kwambiri kuposa kunyumba.
"Kodi anakana modzifunira zabwino zonsezi, kapena mumamukakamiza?"
- Udindo udachitika chifukwa choti amadwala kwambiri chifukwa cha insulin. Adakumbukira izi kwanthawi yayitali ndipo adavomera ku chilichonse, zikadapanda kulowetsedwa ndi insulin. Ngakhale tsopano, adakwera pansi pa tebulo, akumva mawu akuti "insulin." Kuti mukhale wabwino popanda insulini, muyenera kudziletsa. Amadziwa kuti amafunikira. Zakudya zoyenera - izi ndi za iye, osati ine ndi abambo, komanso zolimbitsa thupi.
- Zidzakhala zosangalatsa kukuwonerani mukugwa, momwe zonse zimapitilira, pomwe adzakhala ndi ufulu kusukulu pankhani ya zakudya.
"Tidziyang'anira tokha ndikupatseni mwayi wotiwona."

Kodi makolo a mwana yemwe ali ndi matenda ashuga angagwirizane bwanji ndi madokotala?

"Kodi udawauza adotolo china chokhudza khitchini yonseyi?"
Ndipo safuna kumvera. ” Ku Kiev, ndidalemba pang'ono, koma ndidazindikira kuti sizotheka kunena izi ayi. Adandiuza izi: ngati mankhwala achulukitsa shuga kwa mwana, ndiye kuti suyenera kukana chinthu chilichonse mwanjira iliyonse. Bekerani insulin yambiri, koma kudyetsa mwana.
- Chifukwa?
- Amayi, sindikumvetsa.
- mlongo wanga ndi dokotala yekha, dokotala, ndipo pano tidatemberera koyamba. Ananenetsa kuti posachedwa tisintha ku insulin. Zidatilimbikitsira ndi lingaliro lakuti muli ndi mwana wodwala matenda ashuga ndipo muli ndi njira imodzi - ya insulin.
"Mwanjira, ukunena zowona, zitha kuchitika pakapita nthawi, koma tikuyembekeza zabwino koposa." Funso lofunika: kodi azidyetsa mwana wanu zinthu zosaloledwa popanda iye? Muyenera kukhala osadandaula ndi zomwe amakulimbikitsani, koma za momwe adzadyetsere mwana iyeye.
- Izi sizichitika, chifukwa amakhala kudera lina.

- Iwe adakuwuza kuti uyese mayeso ndikuwonetsa kwa adotolo pafupipafupi, eti?
- Kamodzi pamwezi, pitani kwa dokotala ndikutenga hemoglobin wa glycated miyezi itatu iliyonse.
- Kodi mumapita kwa dotolo popanda mayeso? Ingopita ndi onse?
"Inde, kungoyenda."
"Ndiye chikuchitika ndi chiani kumeneko?"
- Zikuchitika - anamvera, anayang'ana, anafunsidwa. Mukudyanji? Mukumva bwanji? Kodi mumathamangira kuchimbudzi usiku? Kodi mukufuna madzi? Kodi simukudandaula? Mwana amakhala ndipo sakudziwa choti anene za madzi, chifukwa m'malo mwake ndimamukakamiza kuti amwe. Zakudya zamapuloteni - zikutanthauza kuti mumafunikira madzi ambiri. Ndipo tsopano sakudziwa choti anene. Kunena kuti sindimwa kapena kunena kuti ndamwa kwambiri ndiye yankho lolondola? Ndimamuphunzitsa - mwana, nenani monga momwe ziliri. Nanga zamomwe ndimadyetsa ... Amakufunsani zomwe mumadyetsa? Ndiyankha - ndimadyetsa aliyense: sopo, borscht, masamba ...
- Mwachita bwino. Ndiye kuti, ndikwabwino kusachita chibwibwi pa khitchini yonseyi, eti?
- Ayi, safuna kumvera chilichonse. Amuna anga, kwa masiku oyamba, adayamba kuchita misala. Kupatula apo, adokotala ayenera kukhala ndi malingaliro osinthika, koma palibe. Sindingathe kukopa ngakhale mlongo wanga. Koma zotsatira zazikulu kwa ife. Mu Disembala chaka chatha, hemoglobin ya mwana anali 9,8%, kenako kudutsa mu Marichi - idakwana 5.5%.

Kuyeza ndi kulemala kwa matenda ashuga amtundu 1

"Sipitanso kuchipatala kuchipatala, sichoncho?"
- ayi.
- Zikuwonekeratu kuti simukuzifuna. Funso nlakuti, kodi madokotala amakukakamizani kupita kuchipatala nthawi ndi nthawi kapena ayi?
- Amatha kukakamiza okhawo olumala. Sanatipatse chilema, motero sangatikakamize kupita kuchipatala. Pamaziko otani?
-Ulemala umaperekedwa kwa okhawo omwe ali ndi zotsatira. Osangokhala mtundu 1 wa shuga, koma ndi zovuta.
- Ayi, amazipereka nthawi yomweyo kwa aliyense amene amalowetsa insulin.
"Mowolowa manja kwambiri ..."
- Popeza Kiev sanatipangire insulin, sitikhala ndi chilema. Kiev adati: mwana kwambiri kotero kuti ndikumumvera chisoni kupatsa insulin. Adationera kwa sabata. Tidalibe insulini pachakudya chopatsa mphamvu chamafuta. Komabe, adotolo akuti sakanatha kupeza nthawi yanthawi yakuwombera insulini yaying'ono.
- Kulumala nthawi zambiri ndi chinthu chachikulu, sizingamupweteke kukhala nazo.
- Inde, tidaganiziranso za izi.
Ndiye ukalankhula nawo kumeneko. ”
- Ndi dokotala wathu?
- Eya, inde. Palibe amene amati mwana amafunika kukonzekera shuga kuti apereke mankhwala a insulini, ndi zina zotero. Koma kuvomereza - zingakhale zabwino kwa inu, chifukwa zimapereka zabwino. Ndinaganiza kuti kulumala kumaperekedwa kokha kwa iwo omwe ali ndi zotsatira za matenda a shuga. Ndipo mukanena kuti amapatsa aliyense mzere ...
- Inde, adapereka, nawonso akupita kwa ife. Tikadapanda kupita ku Kiev, tikadakhala olumala. Tsopano sindingathe kupita ku Kiev, ndikudziwa zomwe ndikudziwa kale. Tinakhala sabata yovuta chifukwa cha kuperewera kwa zakudya m'chipatala.

Kuwongolera matenda amtundu wa shuga 1 kwa ana popanda jakisoni tsiku lililonse ndi insulin. Koma muyenera kutsatira mosamalitsa boma. Tsoka ilo, zochitika m'moyo sizimathandizira izi.

Kuchita masewera olimbitsa thupi a mtundu woyamba wa ana

- Tinadutsa ku Kiev kuwunika kwa ma antibodies GAD ndi chisonyezo cha chiwonongeko cha autoimmune cha maselo a pancreatic beta, amapezeka mwa odwala ambiri omwe ali ndi matenda a shuga 1. Ndipo mchaka tilinganiza kupatsanso kuwunikaku.
- Chifukwa?
- Choyamba, tapereka C-peptide. Ngati ikukwera kuposa momwe ziliri tsopano, ndiye kuti ndi zomveka kuyang'ana ma antibodies aponso - pali ochulukirapo, ochepa kapena omwewo omwe atsala.
"Mukumvetsa, palibe chomwe chingachitike tsopano kuti muwasonkhezere." Sitikudziwa chifukwa chake amabwera. Ikhoza kukhala mtundu wina wamavuto kapena tsankho la gluten. Kodi mukudziwa kuti gluten ndi chiyani?
- Inde, inde.
- Gluten ndi mapuloteni omwe amapezeka mu tirigu ndi mbewu zina. Pali malingaliro oti odwala matenda ashuga sawalekerera bwino, ndipo izi zimayambitsa chitetezo cha mthupi pamafinya.
- Abambo. Ndili ndi deta ina. Mwakutero, kuti momwe zimachitikira sizimapezeka pa gluten, koma pa casein - mapuloteni amkaka wa ng'ombe.
- Inde, ndipo mapuloteni amkaka nawonso alipo, iyi ndi mutu wachiwiri pambuyo pa gluten. Ndiye kuti, mwanjira yabwino, mutha kuphatikiza chakudya chamafuta ochepa ndi zakudya zopanda gluten komanso zopanda vuto kwa mwana. Koma malingaliro awa onse adalembedwabe ndi pitchfork.
"Koma mutha kuyesa."
"Inde, koma pali zotupa zambiri zam'mimba." Ngati mukukana tchizi, ndiye kuti ndizovuta kuzitsatira.
- Sitimakana tchizi. Timachita masewera olimbitsa thupi. Wolemba Zakharov akulemba kuti ngati pafupifupi magazi a tsiku ndi tsiku amakhala ochepera 8.0, ndiye kuti mutha kugwira ntchito ndi munthu. Limbani kuukira kwa autoimmune ndi masewera olimbitsa thupi - ndipo maselo a beta ayambanso kupanga. Tsopano ndaphatikiza zolimbitsa thupi pakupuma pa Strelnikova. Amawononga ma antibodies oopsa.
- Zonsezi zalembedwa ndi pitchfork pamadzi. Ngati wina apeza njira yothanirana ndi matenda ashuga amtundu woyamba, amalandila Mwayi wa Nobel. Tikudziwa motsimikiza kuti zakudya zamagulu ochepa zimapatsa shuga. Koma kodi matenda ashuga a 1 amachokera kuti - tiribe lingaliro. Malingaliro ena okha amapangidwa. Mukuyesa zolimbitsa thupi, koma musakhale ndi chiyembekezo chachikulu cha izi.

-Ngati tisunge chakudya chamafuta ochepa, ndiye kuti titha kudya motere moyo wathu wonse.
- Inde, ziyenera kukhalabe chomwecho, zomwe zonse zikuchitidwa. Muyenera kungofotokozera mwana chifukwa chake sikoyenera kudya zakudya zovomerezeka. Mukangodya bun - gawo la insulin lomwe lili pafupi ndi ife.
- Inde, chilichonse chili mufiriji yathu.
- Chabwino, ndizabwino. Zikomo pazomwe ndimafuna kudziwa kuchokera kwa inu tsopano, ndazindikira. Sindimayembekezera kuti odwala matenda ashuga ali ndi vuto loyipa la intaneti ku Kirovograd.
- Inde, anzathu alibe, zidachitika.
"... kotero ndizovuta kwambiri kuti ndifike kwa iwo." Zikomo chifukwa cha kuyankhulana, ndizofunika kwambiri pamalowa. Timalankhulana komanso kulemberana makalata, palibe amene watayika.
- Ndipo zikomo.
- Chonde musatengeke ndi ma compotes a zipatso, amakhalanso ndi ma carbohydrate, apatseni mankhwala azitsamba.
- Tonse timayesa, shuga samachuluka.
- Kuchokera pazipatso ndi zipatso, chakudya chamafuta chimagwidwa ndi kusungunuka m'madzi. Imakhwimitsa ziphuphu, ngakhale zitakhalabe.
- Zabwino, zikomo.
- Zikomo, mwina kuyankhulana kwathu lero - ingakhale bomba lazidziwitso.

Chifukwa chake, mwana ndi abale ake amakhala nthawi yabwino kwambiri yotsekemera, ali ndi shuga wabwinobwino popanda jakisoni wa insulin konse. Makolo akuti palibe mwana aliyense yemwe ali ndi matenda ashuga amtundu woyamba omwe amagona ndi mwana wawo kuchipatala yemwe alibe chilichonse chotere. Onse achinyamata odwala matenda ashuga amadya mokhazikika, ndipo palibe amene anasiya jakisoni, ngakhale mabuku amawonetsa kuti izi zimachitika nthawi ya chikondwerero.

Banjali lidachotsa fayilo popempha papa, idakondwera kwambiri ndi zotsatira zomwe chakudya chochepa chamafuta chimapatsa. Ngakhale kuopa kwa acetone mu mkodzo, sasintha njira zamankhwala.
Dr. Bernstein akuwonetsa kuti kugwiritsa ntchito zakudya zamagulu ochepa zimatha nthawi yayitali kukakhala popanda jakisoni wa matenda a shuga 1 kwa zaka makumi ambiri, kapena ngakhale kwa moyo wonse. Tikukhulupirira kuti izi zichitika. Tipitiliza kuwunikira momwe zinthu ziliri.

Mutu wa banja ukuyesera kuyesa chithandizo cha matenda amtundu wa 1 poyeserera. Ndimakayikira izi. Palibe amene anatha kutsimikizira kuti zolimbitsa thupi zilizonse zimaletsa kuukira kwa autoimmune pama cell a beta a kapamba. Ngati wina achite bwino mwadzidzidzi - ndikuganiza kuti Mphotho ya Nobel imaperekedwa kwa munthu wotere. Mulimonsemo, chinthu chachikulu ndikuti mwana satenga zakudya zamagulu ochepa, zomwe timadziwa kale kuti zimathandiza. Mwanjira imeneyi, kuyambira sukulu ndi chiopsezo chachikulu. Mukugwa, ndiyesanso kulumikizanso banja langa kuti ndidziwe momwe zidzakhalire. Ngati mukufuna kulembetsa ku nkhani ndi maimelo, lembani ndemanga pa izi kapena nkhani ina iliyonse, ndikuwonjezera adilesi yanu pamndandanda wamakalata.