Mtundu wachiwiri wa matenda ashuga: Zakudya ndi chithandizo

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Dipatimenti ya chithandizo chamankhwala kunja ndi gulu la azaumoyo komanso azaumoyo

Pamutuwu: "Type 2 matenda a shuga, njira yofunira insulin, kubwezeretsa"

Omaliza: ophunzira 418 "gulu"

Akuwombera: Wophunzira nawo za Sayansi ya Zachipatala, Wothandizira Pulofesa E. Yamashkina

Dzina lathunthu wodwala: Besschetnov S.A.

Tsiku lobadwa: 09/20/1968

Umunthu ndi malo antchito: PJSC SPZ, wamagetsi, wolumala 3 gr.

Malo omwe amakhala: Saransk

Tsiku lolandila: 03/14/2017 pa 9.38

Ndani adawongolera: SOP monga momwe anakonzera

Dziwani koyambirira: Type 2 shuga.

Poyamba: Type 2 shuga mellitus, mawonekedwe ofuna insulini, kuwonongeka. shuga mellitus insulin-wodalira glycogen synthetase

Zovuta: Distal diabetesic symmetric polyneuropathy, sensorimotor mawonekedwe, matenda ashuga retinopathy.

Zophatikizika: Hypertension II wamkulu IV yoopsa, kunenepa kwambiri ine wamkulu, glycated chandamale

Type 2 matenda a shuga, chithandizo

M'malo mwake, palibe njira zokwanira zomwe zimapangitsa kuti shuga azikhala ndi maselo, chifukwa chake, kutsimikizika kwakukulu pamankhwala ndikuchepetsa kuchuluka kwa shuga m'magazi. Kuphatikiza apo, kuyesayesa kuyenera kukhazikitsidwa kuti muchepetse kulemera kwa wodwalayo, ndikubwezeretsanso kwazonse, popeza kuchuluka kwa minyewa ya adipose kumathandizira kwambiri pathogenesis ya matenda ashuga.

Chinthu chachikulu chomwe chikuthandizira zovuta mu mtundu wa 2 matenda a shuga ndi matenda a lipid metabolism. Kuchuluka kwa cholesterol yomwe ili yosiyana ndi chizolowezi kungayambitse kukulira kwa angiopathies.

Njira zochizira

Type 2 matenda a shuga ndi matenda omwe amafunikira chithandizo chanthawi zonse. M'malo mwake, njira zonse zomwe amagwiritsa ntchito amagawika m'magulu atatu:

• kumwa mankhwala
• chakudya
• kusintha kwa moyo.

Chithandizo chothandiza cha matenda a shuga a mtundu wachiwiri sichimangotanthauza kulimbana kokha ndi matenda omwewo, komanso matenda ophatikizika, monga:

Matenda a shuga a Mtundu Wachiwiri amachiritsidwa pang'onopang'ono komanso kunyumba. Odwala okha omwe ali ndi hyperglycemic ndi hyperosmolar coma, ketoacidosis, mitundu yoopsa ya neuropathies ndi angiopathies, ndi stroko zimayikidwa kuchipatala.

Mankhwala osokoneza bongo a shuga

M'malo mwake, mankhwala onse amagawidwa m'magulu awiri akuluakulu - omwe amakhudza kupanga insulin, ndi omwe satero.

Chithandizo chachikulu cha gulu lachiwiri ndi metformin kuchokera ku gulu la Biguanide. Mankhwalawa amakonda mankhwala a shuga a mtundu wachiwiri. Popanda kukhudza maselo a kapamba, umasunga glucose m'magazi nthawi zonse. Mankhwala sitiwopseza kuchepa kwambiri kwa glucose. Metformin imawotanso mafuta ndikuchepetsa chilakolako cha chakudya, zomwe zimapangitsa kuti wodwalayo achepetse kunenepa kwambiri. Komabe, mankhwala osokoneza bongo amatha kukhala owopsa, popeza vuto lalikulu lomwe limapangitsa munthu kufa kwambiri - lactic acidosis limatha kuchitika.

Oimira ena a gulu lina la mankhwala omwe amakhudza kupanga insulin ndi zotumphukira za sulfonylurea. Amalimbitsa mwachindunji maselo a beta a kapamba, chifukwa chake amapanga insulin yambiri. Komabe, mankhwala osokoneza bongo ochulukirapo aopseza wodwalayo ndi vuto la hypoclycemic. Zothandiza kuchokera ku sulfanylureas nthawi zambiri zimatengedwa molumikizana ndi metformin.

Palinso mitundu ina ya mankhwala. Gulu la mankhwala omwe amalimbikitsa kupanga insulini kutengera kuchuluka kwa glucose amaphatikiza ma incretin mimetics (GLP-1 agonists) ndi ma Dhib-4 inhibitors. Awa ndi mankhwala atsopano, ndipo pakadali pano ndi okwera mtengo. Amalepheretsa kaphatikizidwe ka glucagon wopititsa patsogolo shuga, kumapangitsanso zochitika za ma insretins - m'mimba ma mahomoni omwe amachititsa kupanga insulin.

Palinso mankhwala omwe amalepheretsa kuyamwa kwa glucose m'mimba yotsekemera - acarbose. Mankhwalawa sakukhudza kupanga kwa insulin. Acarbose nthawi zambiri amatchulidwa ngati njira yopewera kupewa matenda ashuga.

Palinso mankhwala omwe amalimbikitsa kuchuluka kwa shuga mumkodzo, komanso mankhwala omwe amachititsa chidwi cha maselo ku glucose.

Medical insulin sikugwiritsidwa ntchito kwenikweni pochiza matenda amtundu wa 2 shuga. Nthawi zambiri, amagwiritsidwa ntchito chifukwa chosagwiritsa ntchito mankhwala ena, mu mawonekedwe omwe ali ndi matenda ashuga, kapamba akamatha ndipo sangatulutse insulin yokwanira.

Matenda a 2 a shuga amakhalanso ndi matenda amodzimodzi:

• angiopathies
• kukhumudwa
• ma neuropathies
• matenda oopsa
• lipid kagayidwe kachakudya.

Ngati matenda ofananawo apezeka, ndiye kuti mankhwalawo amathandizidwa ndi mankhwala.

Mitundu yosiyanasiyana ya mankhwala ochizira matenda a shuga a 2

Chomwe chimasintha pakudya kwa ashuga ndikuyambitsa zakudya zomwe zimalowa mgonero. Zakudya zoyenera ziyenera kutsimikiziridwa ndi endocrinologist payekhapayekha kwa wodwala aliyense, poganizira kuopsa kwa matenda ashuga, matenda opatsirana, zaka, moyo, ndi zina zambiri.

Pali mitundu ingapo ya zakudya zomwe zimagwiritsidwa ntchito pa matenda osokoneza bongo omwe amadalira insulin (tebulo No. 9, zakudya zama carb otsika, etc.). Onsewa adziwonetsa bwino komanso amasiyana mzinthu zina. Koma amatembenuka mu mfundo yayikulu - zofunikira za kudya zamankhwala mu matenda ziyenera kukhala zochepa. Choyamba, zimakhudzana ndi zinthu zokhala ndi ma "carbohydrate" othamanga, ndiye kuti, zamafuta omwe amatengedwa mwachangu kuchokera ku m'mimba. Zakudya zamafuta othamanga zimapezeka mu shuga woyengedwa, kusunga, confectionery, chokoleti, ayisikilimu, mchere, komanso zinthu zophika. Kuphatikiza pa kuchepetsa kuchuluka kwa chakudya chamafuta, ndikofunikira kuyesetsa kuchepetsa thupi, chifukwa kuwonjezeka kwa thupi ndi chinthu chomwe chimakulitsa nthawi ya matendawa.

Mayendedwe ena

Ndikulimbikitsidwa kuwonjezera kuchuluka kwa madzi kuti mupange kutayika kwa madzimadzi ndimakokedwe pafupipafupi, omwe nthawi zambiri amaphatikizidwa ndi matenda a shuga. Pamodzi ndi izi, ndikofunikira kusiyiratu zakumwa za shuga - cola, mandimu, kvass, timadziti ndi tiyi ndi shuga. M'malo mwake, mumangomwa zakumwa zopanda shuga - mchere wopanda madzi ndi wopanda, tiyi wopanda khofi komanso khofi. Kumbukirani kuti kumwa mowa kumathanso kuvulaza - chifukwa chakuti mowa umasokoneza kagayidwe kazakudwala.

Chakudya chizikhala chokhazikika - osachepera katatu patsiku, ndipo koposa zonse - 5-6 pa tsiku. Simuyenera kukhala patebulo lamadzulo mukatha kuchita masewera olimbitsa thupi.

Momwe mungayang'anire ndende ya magazi anu

Chinsinsi cha chithandizo cha matenda ashuwere chimadziwunikira pawokha odwala. Ndi matenda a shuga a 2, kuchuluka kwa shuga kuyenera kukhala kosadalira malire, kapena kuyandikira. Chifukwa chake, wodwalayo ayenera kuwongolera yekha shuga kuti asachulukane kwambiri. Kuti muchite izi, ndikofunikira kusunga zolemba momwe mfundo za shuga m'magazi zalembedwera. Mutha kutenga miyezo ya glucose wokhala ndi ma glucose apadera amitengo yamagazi okhala ndi mizere yoyeserera. Njira yoyezera imachitika tsiku lililonse. Nthawi yabwino yoyezera m'mawa kwambiri. Pamaso pa njirayi, ndizoletsedwa kudya chilichonse. Ngati ndi kotheka, njirayi imatha kubwerezedwa kangapo patsiku ndikuwona kuchuluka kwa shuga osati m'mawa wopanda kanthu, komanso mutatha kudya, musanagone, etc. Podziwa dongosolo la kusintha kwa glucose m'magazi, wodwalayo amatha kusintha msanga zakudya ndi machitidwe ake kuti chiwonetsero cha glucose chikhale chamagulu.

Komabe, kukhalapo kwa glucometer sikumapulumutsa wodwalayo kufunika kosanthula magazi pafupipafupi kuti akhale ndi shuga mu chipatala chachipatala, chifukwa mfundo zomwe zimapezeka mu labotale ndizolondola kwambiri.

Palibe zovuta kulamula kuchuluka kwa shuga mukamadya chakudya - zitatha zonse, zinthu zambiri zomwe zimagulidwa m'sitolo zimawonetsa mphamvu zawo komanso kuchuluka kwa chakudya chamafuta omwe ali mwa iwo. Pali mitundu ya matenda ashuga okonda zakudya zomwe chakudya chimasungidwa m'malo mwake ndimalo ochepetsa mphamvu ya calorie (sorbitol, xylitol, aspartame).

Kuthamanga shuga

Zipatso ndi masamba

Kodi zipatso ndi zipatso zingagwiritsidwe ntchito ngati mtundu wachiwiri wa shuga? Makonda ayenera kuperekedwa kwa ndiwo zamasamba, zomwe zimakhala ndi zochulukirapo, koma zothandiza kugaya, fiber ndi shuga wochepa. Komabe, masamba ambiri, monga mbatata, beets ndi kaloti, amakhala ndi wowuma yambiri, kotero kugwiritsa ntchito kwawo kuyenera kukhala kochepa. Zipatso zimatha kudyedwa pang'ono, ndipo zokhazo zomwe zilibe chakudya chambiri. Pakati pa zipatso, nthochi ndi cholembedwa cha zakudya zamatumbo, zotsatiridwa ndi mphesa ndi mavwende. Simalimbikitsidwa kuti azidya, chifukwa amatha kuwonjezera shuga.

Masewera olimbitsa thupi

Njira yothandizira yochitira masewera olimbitsa thupi ndi kuchita masewera olimbitsa thupi. Mukamachita zolimbitsa thupi zolimbitsa thupi, thupi limawotcha shuga wambiri. Metabolism imabwerera mwakale, mtima umalimbitsa. Kuchita masewera olimbitsa thupi ndikofunikira tsiku lililonse. Komabe, machitidwe olimbitsa thupi sayenera kufooketsa, chifukwa zotsatira zoyipa zokha ndi zomwe zingachitike motere. Ndi kutopa kwambiri, kulakalaka kudya, ndi chakudya chochuluka kumatha kupewetsa zotsatirapo zonse zabwino zolimbitsa thupi. Kutopa kumayambitsa kupsinjika ndi kutulutsidwa kwa mahomoni a adrenal, omwe amalimbitsa shuga. Chifukwa chake, tikulimbikitsidwa kusankha mtundu wamachitidwe olimbitsa thupi omwe angagwirizane ndi masewera othamanga - masewera olimbitsa thupi osavuta, masewera olimbitsa thupi ndi kuyenda kapena kuthamanga, kuthamanga, kusambira, kuyenda njinga.

Mtengo wamagetsi pazinthu zosiyanasiyana

M'mavuto akulu, mtundu wa 2 shuga ukakhala kuti walipirira, ndiye kuti, monga lamulo, ndizosatheka kubweretsanso matendawa ndikubwezera chizindikiro cha glucose pamlingo wabwinobwino chifukwa cha kuchepa kwa zida zapakhansa ndi thupi lonse. Chifukwa chake, lembani matenda ashuga amtundu wa 2 pamenepa ndi matenda osachiritsika. Komabe, chithandizo choyenera cha matenda a shuga a 2 chitha kuwonjezera moyo wa wodwalayo kwa zaka zambiri. Pachigawo choyamba cha mtundu wachiwiri wa matenda ashuga, ndikotheka kuwongolera kuchuluka kwa shuga m'magazi ndikuwasunga momwe mungasinthire zakudya zokha ndi moyo wanu, ndikuwonjezera zolimbitsa thupi. Zotsatira zake, wodwalayo amatha kukhala ndi moyo zaka zambiri osakumana ndi zovuta za matenda ashuga.

Zimayambitsa ndi mapangidwe a chitukuko cha mtundu wachiwiri wa matenda ashuga

Zomwe zimapangitsa kuti pakhale mtundu wa 2 matenda ashuga ndiwosatsimikizika, ndipo ndizofunika kwambiri kuposa mtundu woyamba wa matenda. Koma zidapezeka kuti kuphwanya mtundu wa glucose kumachitika chifukwa cha cholowa, zomwe sizimasinthika kukhala shuga.

Kafukufuku waposachedwa akuwonetsa kuti njira yoyamba yothandizira kukula kwa matenda amtunduwu ndi kupeza kwa maselo a minyewa omwe amatha kuyamwa shuga pokhapokha ngati insulini, ndikupanga insulin. Kuwonjezeka kwa shuga m'magazi kumachitika pambuyo pake, chifukwa cha kuphwanya kotero.

Zina zonse zomwe zimayambitsa matenda ashuga, zomwe zimatsimikizira tsogolo la wodwalayo, ndi zakunja komanso zosinthika, ndiye kuti, zimatha kusokonekera m'njira yoletsa kukula kwa matendawa. Zinthu zikuluzikulu zomwe zatulutsa mtundu wachiwiri ndi monga:

1. M'mimba mtundu wa kunenepa.
2. Kulephera kuchita masewera olimbitsa thupi.
3. Atherosulinosis
4. Mimba
5. Zotsatira zoyipa.
6. Zaka ndi zaka 45.

Kuchepetsa thupi kwa odwala omwe ali ndi kunenepa kwambiri kumabweretsa kubwezeretsanso kwina kwa shuga komanso insulin mukatha kudya. Ndipo ngati zizolowezi zakudya zikubwerera, ndipo wodwalayo amadya kwambiri, ndiye kuti matenda othamanga a hyperglycemia ndi hyperinsulinemia amapezeka mobwerezabwereza, ndipo poyankha kudya insulin amasokonezeka.

Miyezi yambiri ya insulini ndi zina mwazizindikiro zoyambirira za matenda ashuga komanso kunenepa kwambiri, pomwe sipangakhalebe zosokoneza mu kagayidwe kazakudya. Hyperinsulinemia muzochitika zotere ndi njira yowonjezera yolipira minofu kukana insulin. Thupi limayesetsa kuthana ndi insulin chifukwa chopanga mahomoni ambiri.

Ngati kunenepa kwambiri kulipo kwa nthawi yayitali mwa anthu omwe ali ndi vuto logometsa matenda a metabolism, ndiye kuti pakapita nthawi, kubisalira kwa cell ya beta kumachepa. Matenda a shuga owonekera ndi zizindikiro wamba amakula.

Ndiye kuti, kupanga insulin mu mtundu 2 wa matenda ashuga sikungakhale kwa nthawi yayitali ndipo, pakapanda kukhalapo, chithandizo cha insulini chikufunika.

Mellitus yemwe amadya matenda a shuga amatha kulipidwa pokhapokha ndi insulin, kapena amaikidwa limodzi ndi mankhwala ochepetsa shuga a mankhwala osakaniza.

Zisonyezo za mankhwala a insulin mu mtundu wachiwiri wa matenda ashuga

Kugwiritsa ntchito kwakanthawi insulin kukonzekera mtundu wachiwiri wa matenda a shuga kumathandizira kubwezeretsa zovuta zitatu: kulipirira kufooka kwa insulin, kuchepetsa mapangidwe a insulin m'chiwindi komanso kubwezeretsanso kuchepa kwa minyewa.

Poika insulin, pali zizindikiritso zosakhalitsa komanso zosakhalitsa.Kupitiliza kosalekeza kuyenera kuyambika nthawi yomweyo ndi ketoacidosis, kuchepa thupi, chizindikiro cha kuchepa mphamvu kwa magazi ndi glucosuria.

Njira yotereyi imawonekera mukamakula ndi matenda a shuga a autoimmune omwe amapita pang'onopang'ono, pomwe pakufunika insulin posakhalitsa atazindikira kuti ali ndi matenda ashuga. Pankhaniyi, zizindikiro zakuwonongeka kwa maselo a pancreatic ndi ma antibodies apezeka, monga mtundu woyamba wa matenda. Nthawi zambiri

Ndi contraindication poika mapiritsi, insulin akhoza zotchulidwa. Izi ndi monga:

• Kuperewera kwa impso kapena chiwindi.
• Mimba
• Angapoopathy odwala matenda ashuga.
• Peripheral polyneuropathy yokhala ndi ululu waukulu.
• Matenda a shuga ndi matenda otupa.
• Kuperewera kwa insulin mwanjira ya ketoacidosis.

Pafupifupi gawo limodzi mwa magawo atatu aliwonse odwala samachita chilichonse akamamwa mapiritsi kuti achepetse shuga kapena izi sizochepa. Ngati chiphuphu sichingatheke m'miyezi itatu, ndiye kuti odwala amapatsirana ndi insulin. Kukana kwapakatikati kwa mankhwalawa kumachitika, monga lamulo, pakuwonetsetsa matenda a shuga mellitus, pomwe chinsinsi cha insulin chachepetsedwa.

Gawo laling'ono la odwala limalandira kukana kwachiwiri pamene kuchuluka kwa glucose kumayang'aniridwa motsutsana ndi maziko a zakudya zochizira komanso Mlingo wambiri wa mankhwala. Izi zimadziwika mwa odwala omwe ali ndi glycemia yayikulu panthawi yodziwitsa komanso mtima wake.

Mwambiri, odwalawa akhala akudwala pafupifupi zaka 15, kapamba wawo sangathe kuyambitsa kukondoweza ndi mapiritsi. Ngati shuga wa magazi aposa 13 mmol / l, ndiye kuti palibenso njira ina yothandizira, kupatula kukhazikitsidwa kwa insulin.

Koma ngati wodwalayo ali ndi kunenepa kwambiri, ndiye kuti nthawi zonse kupatsidwa insulin sikumapereka zotsatira zoyenera. Chifukwa chake, ndi glycemia osapitirira 11 mmol / l, mutha kukana mankhwala a insulini, chifukwa ndi mafuta onenepa kwambiri omwe chizindikiro chobwezeretsanso chimakhala chofanana ndikumwa mapiritsi.

Chithandizo cha insulin kwakanthawi chimachitidwa pazinthu zomwe zimatha kusintha. Izi zikuphatikiza:

1. Myocardial infaration.
2. Matenda opatsirana omwe ali ndi kutentha kwambiri kwa thupi.
3. Zotsatira zoyipa.
4. Matenda owopsa.
5. Ndi poika corticosteroids.
6. Opaleshoni.
7. Ndi matenda ashuga ketoacidosis komanso kuwonda kwambiri.
8. Kubwezeretsa zomverera m'mapiritsi ndikutsitsa ziphuphu.

Zomwe zimayikidwa poika insulin mu mtundu wachiwiri wa matenda ashuga

Type 2 shuga mellitus amatanthauza matenda omwe amadziwika ndi kupitilira kwa zizindikiro. Ndipo maphunzirowo akamapitilira, mankhwalawo am'mbuyomu a mankhwalawa amasiya kugwira ntchito. Izi zimawonjezera chiopsezo cha zovuta. Chifukwa chake, onse odwala matenda ashuga azindikira kufunika kwa ma regimens othandizira.

Muyeso womaliza wa chiphuphu cha shuga ndi kuchepa kwa hemoglobin ya glycated. Osatengera kuti kuchepetsedwa kotereku kumatheka - ndi insulin kapena mapiritsi, izi zimayambitsa kuchepa kwa chiwopsezo cha matenda amanjenje, nephropathy, retinopathy, kugunda kwa mtima ndi zina zotupa zamitsempha.

Chifukwa chake, pakalibe zotsatira za zakudya kuchokera pakudya ndikuthamanga, komanso kulimbitsa thupi, ndikofunikira kugwiritsa ntchito mankhwala mwachangu momwe mungathere.

Chitsogozo posankha njira yake ikhoza kukhala kuchepa kwa hemoglobin ya glycated. Ngati mapiritsi okha ndi okwanira, ndiye kuti wodwalayo amasankhidwa kuti alandire mankhwala a mono- kapena osakanikirana ndi mankhwala ochokera m'magulu osiyanasiyana amitundu yochepetsera shuga, kapena kuphatikiza mapiritsi ndi insulin kuphatikizidwa.

Zomwe zimaphatikizidwa monga mankhwala a insulin ndi mapiritsi a mtundu 2 a shuga ndi:

• Mankhwala, kawiri Mlingo wa insulin wofunikira umafunikira.
• Kukhudzika kosiyanasiyana: kuphatika kwa shuga ndi chiwindi, mayamwidwe amkati, kupatsidwa insulin ndikumverera kwa minofu yake.
• Mlingo wa hemoglobin wa glycated umayenda bwino.
• Mavuto ochepa a shuga.
• Chiwopsezo cha atherosulinosis chimachepetsedwa.
• Palibe kulemera kwa odwala onenepa kwambiri.

Insulin imayikidwa makamaka 1 nthawi patsiku. Yambani ndi ochepa Mlingo wa insulin wa nthawi yayitali. Mankhwalawa amatumizidwa musanadye chakudya cham'mawa kapena usiku, chinthu chachikulu ndikusunga nthawi yomweyo ya jekeseni. Nthawi zambiri ntchito insulin mankhwala ophatikiza insulin.

Ngati kuli kofunikira kuperekera insulin yoposa 40, mapiritsiwo amathetsedwa ndipo wodwalayo amasinthiratu insulin. Ngati glycemia ndi ochepera 10 mmol / l, ndipo pafupifupi magawo 30 a insulin amafunikira, ndiye kuti chithandizo cha mapiritsi chimayikidwa, ndipo insulin imalekeka.

Mankhwala a odwala onenepa kwambiri, tikulimbikitsidwa kuti makulidwe a insulin aphatikizidwe ndi mankhwala ochokera ku gulu la Biguanide, lomwe limaphatikizapo Metformin. Njira ina ikhoza kukhala acarbose (Glucobai), yomwe imasokoneza kuyamwa kwa glucose m'matumbo.

Zotsatira zabwino zidapezekanso ndikuphatikiza insulini ndi chosintha chochepa cha insulin secretion, NovoNorma. Ndi kuphatikiza uku, NovoNorm imagwira ntchito ngati yowongolera kukwera kwa glycemia mutatha kudya ndipo imayikidwa ndi zakudya zazikulu.

Kuchita insulin kwa nthawi yayitali kumalimbikitsidwa pakukhazikitsa asanagone. Amachepetsa kukhudzana ndi shuga ndi chiwindi ndikuwongolera kudya kwa magazi mwa kutsitsa maselo a insulin secretion.

Palibe ma insulin apadera omwe angachotsere matenda osokoneza bongo a shuga, koma kupanga mankhwala omwe amachepetsa glycemia atatha kudya osayambitsa hypoglycemia pakati pakudya. Kugwiritsa ntchito ma insulin otere ndikofunikira kuti muchepetse kulemera, komanso zotsatira zoyipa za metabolidi ya lipid. Kanemayo m'nkhaniyi afotokoza za matenda a shuga.

Matenda a shuga - chiwopsezo chake ndi chiani?

Anthu nthawi zambiri amamva za matenda ashuga, koma owerengeka amaganiza kuti ndi chiyani. Tiyenera kudziwa kuti lingaliro la shuga ndi chithunzi chophatikiza. Pansi pa nthawi iyi matenda angapo a endocrine system aphatikizidwa. Zomwe zimayambitsa kupezeka kwawo ndizambiri, koma, monga lamulo, kusokonezeka kwa endocrine ndiye mwala wapangodya wa matendawa, makamaka kuperewera kwa insulin. China chomwe chingakhale kulephera kuyamwa kwa shuga ndi chiwindi ndi minofu ya thupi. Nthawi yomweyo, mulingo wake mthupi umadzuka, womwe umayambitsa zovuta zingapo zama metabolic.

Matenda a shuga - mitundu yake

Mankhwala amakono amasiyanitsa mitundu iwiri yamatenda. Kukula kwake kumachitika malinga ndi kuchepa kwa insulin - wachibale kapena mtheradi - kufotokozedwa ndi mbiri yachipatala. Type 2 matenda a shuga, monga lamulo, samagwirizana ndi kuperewera kwa insulin ya mahomoni, kapangidwe kake komwe ndiko kapamba. Nthawi zambiri, chomwe chimapangitsa kukula kwake ndikuchepa kwa chidwi cha ziwalo ndi minyewa yake. Matenda a shuga omwe amadalira insulin - mtundu woyamba - amagwirizana mwachindunji ndi kuchepa kwa insulin m'thupi. Kuperewera kwa mahomoniwa kumapangitsa kuti glucose olowa mthupi asakonzeke, kapena kumachitika mosakwanira, pomwe mulingo wake m'magazi umakulirakulira nthawi zonse, ndipo pofuna kupulumutsa moyo, odwala oterewa amakakamizika kulandira ma insulin owonjezera.

Mbiri yazachipatala - mtundu 2 shuga

Matendawa amatchedwanso osapatsa insulin. Malinga ndi ziwerengero, pali odwala ambiri omwe ali ndi matenda amtunduwu kuposa woyamba. Ndi zaka, chiopsezo chakuti matendawa adziwonetsa yekha chikuwonjezeka. Nthawi zambiri, chitukuko chake chimachitika mosazindikira, ndipo wodwalayo kwa nthawi yayitali sadziwa za matenda awa, mbiriyakale ya matendawa sikuwonetsa zambiri zomwe zimalola kukayikira. Type 2 shuga mellitus amadziwika kuti "mwangozi" panthawi yoyeserera. Chizindikiro chachikulu chomwe chimakupatsani mwayi wokayikira kupezeka kwa matenda awa ndi kuyesa kwa magazi komwe glucose imakulitsidwa. Kenako, mbiri yakale ikapangidwa, mtundu wachiwiri wa matenda ashuga umagawika:

• kukulira odwala olemera,
• opezeka odwala onenepa kwambiri.

Zoyambitsa matenda ashuga

Ngakhale pa maphunziro, madokotala achichepere amatchula mbiri yakale yophunzitsa za matendawa, yomwe imayambitsa matenda a shuga a 2 omwe amayamba chifukwa zingapo. Zambiri mwa izo ndi:

• kumwa kwa mafuta oyengedwa bwino (shuga, chokoleti, makeke, mbatata) zochulukirapo komanso kusowa kwa ulusi wazomera pazakudya,
• cholowa - pamaso pa matenda amodzimodzi mwa makolo, chiopsezo cha matenda ashuga chimaposa 40%,
• kunenepa kwambiri, makamaka mtundu wa visceral (madipoziti amapezeka makamaka pamimba),
• matenda oopsa
• kusowa kwa masewera olimbitsa thupi.

Kodi chikuchitika ndi chiani? Pathogenesis

Mbiriyakale ya matendawa imalongosola matenda amtundu wa 2 monga zovuta zingapo za metabolic. Zimakhazikitsidwa ndi kukana kwa insulin - kulephera kwa minofu kuti muzindikire insulin, kumbali imodzi, ndikuphwanya kapangidwe ka timadzi timeneti m'maselo a pancreatic - mbali inayo. Nthawi zambiri, ndi kuchuluka kwa shuga komwe kumachitika mukangotha ​​kudya, kapamba amayamba kupanga insulini mwachangu. Mwa anthu omwe ali ndi matenda a shuga a 2, izi sizichitika, ndipo insulini imayamba kupangidwa pokhapokha kuchuluka kwa shuga kwayamba kale kuchuluka. Komabe, ngakhale pali kukhalapo kwa insulini, kuchepa kwa shuga mu vutoli pamlingo womwe ukufunikira sikumachitika. Kuchulukana kosalekeza kwa insulin kumabweretsa kuti ma cell amalephera kuyankha ndipo pakadali pano, ngakhale timadzi timene timatha kulumikizana ndi cell receptor, palibe chomwe chimachitika. Poona zakusintha kumeneku, maselo a chiwindi amayamba kupanga magazi mwachangu, ndikupangitsa kuchuluka kwake m'magazi. Zonsezi sizopita popanda zotsatira. Popita nthawi, mothandizidwa ndi kuchuluka kwa glucose, mpweya wambiri umayamba, womwe umakhudza kwambiri ma cell a pancreatic omwe amapanga insulin, ndipo, chifukwa chake, kuchepa kwake kumayamba. Chifukwa chake, mbiri yachipatala imakulitsidwa. Mtundu wachiwiri wa matenda ashuga a mellitus insulin-ofuna mawonekedwe pamene insulin ikukonzekera sichikufunika. Matenda a wodwalayo akuipiraipira.

Mu chipatala cha matenda ashuga, ndichikhalidwe kusiyanitsa magulu awiri azizindikiro za matendawa - oyamba ndi owopsa. Zomwe zikuluzikulu ndi izi:

• polyuria - mkodzo wambiri umatulutsidwa (glucose, kulowa mkati mwake, kumakulitsa kwambiri zovuta za osmotic),
• ludzu (polydyspepsia) - kufunikira kosalekeza, kosamwa kotero,
• njala (polydysphagia) - chifukwa cha kulephera kwa maselo kutulutsa glucose pogwiritsa ntchito insulin, thupi limakumana ndi kufunikira kwa mphamvu nthawi zonse,
• kuwonda mwadzidzidzi - kumachitika motsutsana ndi maziko a chidwi chambiri.

Zizindikiro zonsezi ndizodziwika bwino pa mtundu woyamba wa matenda ashuga. Mtundu wachiwiri ungakhale wa asymptomatic kapena woyambitsa zizindikiro zachiwiri:

• kuyabwa kwa pakhungu ndi mucous nembanemba - kaŵirikaŵiri pofufuza wodwalayo ndi kukayikira kwa mtundu wachiwiri wa matenda osokoneza bongo (mbiri yakale), mzimayi amatha kuzindikira kuyamwa kwamtundu wamkati,
• kufooka wamba ndi mutu,
• zotupa pakhungu zomwe zimakhala zovuta kuchiza,
• kuchepa kwa masomphenya.

Monga lamulo, ambiri samalabadira zisonyezozo, ndipo matendawa amatha kuonekera pokhapokha pamavuto.

Ana ndi matenda ashuga

Tsoka ilo, matenda ashuga tsopano amadziwika kuti ndi matenda achiwiri ofala kwambiri. Ndizomwe madokotala a ana amaganiza. Matenda a shuga (mtundu 2). Mbiri yaumoyo wa mwana nthawi zambiri imayika matenda oopsa kwambiri m'gululi. Izi ndichifukwa choti njira yake imasiyana ndi ya munthu wamkulu pakukula msanga ndipo nthawi zambiri imakhala yoyipa kwambiri. Komabe, pankhaniyi, zonse zimadalira kuthekera kwa makolo kusintha kadyedwe ka mwana ndikuwunika kudya kwakanthawi kwa mankhwala. Kuphatikiza apo, ndikofunikira kuzindikira matendawa nthawi. Ngati mwana ali ndi zizindikiro zotsatirazi, kufunsira mwachangu ndi endocrinologist ndikofunikira:

• mwana amakhala ndi ludzu pafupipafupi
• amapita kuchimbudzi kawiri kawiri (kusukulu kapena ku sukulu yaukatswiri amakakamizidwa kuti azichotsa kangapo kusukulu),
• kulemera kwa thupi kumachepa
• kutopa kwambiri kumawonedwa.

Zizindikiro

Dziwani matenda a shuga potengera mkodzo ndi magazi. Mwa munthu wathanzi, shuga samapezeka mkodzo, ndipo mulingo wake m'magazi sapitirira 5.5. Pazotsatira zodalirika, magazi amatengedwa kuchokera ku chala kapena mtsempha (chakudya chomaliza chimayenera kutengedwa osachepera maola 8 njira isanachitike), simuyenera kumwa tiyi, khofi kapena msuzi musanachitike. Tiyenera kudziwa kuti shuga yodwala matenda a shuga imapezeka pamitengo yoposa 7. Ngati zizindikirozo zikuyambira 4 mpaka 7, ndiye kuti kuphwanya kwa kulekerera kwa glucose kwalembedwa.

Kuyesedwa kwina kuti mupeze matendawa ndikumveketsa bwino mfundo zoyipa ndi kuyesa kwa glucose test (GTT). Zimakupatsirani mwayi wofufuza kuchuluka kwa glucose, komanso maola awiri atatha kugwiritsa ntchito shuga. Nthawi zambiri, shuga atatha, m'magazi ake sayenera kupitirira 7.8. Kuyeza kumeneku sikuchitika pamene glucose apamwamba kuposa 6.1 musanayesedwe, ngati wodwalayo ali ndi mbiri yamatenda owopsa, njira zopangira opaleshoni, kulowetsedwa kwa myocardial, kuvulala, komanso kumwa mankhwalawa omwe amalimbikitsa shuga. Zambiri izi zikuwonetsa mbiri yachipatala.

Lemberani matenda ashuga a 2 shuga, othandizira

Monga matenda aliwonse, matenda ashuga amakonda kupanga ndi kukulitsa zizindikiro. Munjira yake, magawo atatu ndi osiyana. Gawo lamalipiro limakhazikitsidwa pamene Zizindikiro za wodwalayo zikafika pofikira. Ngati zinthu sizinatenge nthawi, kapena sizibweretsa zomwe zikuyembekezeka, ndiye kuti matendawa amalowerera. Pankhaniyi, zomwe wodwala ali nazo, sizabwino kwambiri, komanso sizotsutsa. Patsiku lomwe wodwala amataya ndi mkodzo mopitilira magalamu makumi asanu a shuga, ndipo mulingo wake m'magazi ndi pafupifupi 13.8, mulibe acetone mkodzo. Kukula kwa hyperglycemic coma pakadali pano ndikothekanso. Gawo lapakatikati pakati pa chipukutiro ndi kuvunda limatumizidwa gawo lakulipira, pomwe gawo la chiphuphu, kuchuluka kwa glucose 7.5, kuchuluka kwa hemoglobin ya glycated ndi 6.5% ndipo glucose yothamanga ndi yochepera 6.1. Gawo la kuwonongeka limakhazikitsidwa ngati zizindikirozo zikuposa zotsatirazi:

• kuchuluka kwa glucose kuposa 9,
• glycated hemoglobin - kuposa 9%,
• kusala shuga - opitilira 7.

Zosintha pazowonetsa izi komanso kugwiritsa ntchito bwino kwa mankhwalawa kumathandizira kuti adziwe mbiri ya zamankhwala. Type 2 shuga mellitus, njira yoopsa yomwe imakhala yovuta kuthandizira kapena kukhumudwitsidwa ndi zinthu zina, imayamba kugundika.

Zinthu zomwe zimapangitsa kubwezeretsa

Inde, chamoyo chilichonse chimakhala payokha, ndipo zomwe zikukukulitsa matendawa zimatha kukhala zosiyana, koma zimapezeka nthawi zambiri:

• kudya kwambiri, kuphwanya zakudya,
• cholakwika posankha mankhwalawo, mlingo wake kapena kukana chithandizo,
• kudzichiritsa nokha kapena kugwiritsa ntchito m'malo mwa mankhwalawa
• kukana kusinthira ku mankhwala a insulin,
• matenda amadzimadzi
• mavuto.

Zinthu zonsezi, payekhapayekha kapena mophatikizana, zimakhudza kwambiri momwe ma metabolic amaperekera, ndipo, chifukwa chake, pakuwonjezeka kwa kuchuluka kwa glucose, komwe kunalembedwa ndi mbiri yachipatala.Type 2 shuga mellitus, gawo lomwe limawonjezera kuchuluka kwa ziwopsezo kuchokera ku ziwalo ndi machitidwe a thupi, zimakhala zowopsa ndipo ngati sizingagwiritsidwe ntchito moyenera, zitha kukhala zowopsa pamoyo wa wodwalayo. Pankhaniyi, zovuta zimatha kuchedwa komanso kuchedwa kwakanthawi pamaola ochepa.

Kubweza

Pamene kuchuluka kwa shuga kumawonjezeka, ndikusintha kwake kumafunikira miyezo yayikulu, mbiri yachipatala imakulitsidwa. Matenda a shuga (mtundu 2), kuwonongeka komwe kumadziwika ndi chiwopsezo chachikulu cha zovuta, kumafunikira kukhala osamala kwambiri. Izi ndichifukwa choti zingakhale zovuta kwambiri kusintha kuchuluka kwa shuga mothandizidwa ndi chakudya komanso kugwiritsa ntchito mankhwala osokoneza bongo. Zotsatira zake, ndikofunikira kuyang'anitsitsa momwe wodwalayo alili, chifukwa pakakhala kuti palibe chithandizo chamankhwala mukamagwiritsa ntchito mankhwala, kusintha kwa ziwalo zosiyanasiyana zimachitika mwachangu kwambiri. Chifukwa chake, odwala awa amafunikira kuyang'aniridwa kuchipatala, ndipo nthawi zambiri amakhala kuchipatala chodzidzimutsa.

Chofunika kwambiri apa ndikutha kuyang'anira pawokha zinthu zomwe ali. Mwamwayi, mankhwala amakono ali ndi zida zokwanira zosankhira izi. Mayeso osiyanasiyana ndi zida zomwe zimazindikira kuchuluka kwa shuga zimapangitsa wodwala matenda ashuga kuti adziwe momwe aliri ndipo, kutengera zotsatira zake, amukonza.

Insulin mu chithandizo cha matenda ashuga

Matendawa akamapitirira, kufooka kwa maselo a pancreatic omwe amathandizira kupanga insulin amakulanso. Njirayi imafunikira nthawi yomweyo kupatsidwa kwa mahomoni. Monga momwe maphunziro amakono akusonyezera, nthawi zina izi zimangokulolani kukhalabe ndi glucose pamlingo woyenera. Ngakhale zili choncho, simuyenera kuganiza kuti kuikidwa kwa insulin ndi moyo wonse. Nthawi zambiri, mtundu wachiwiri wa matenda ashuga, wodalira insulin, mbiri yakale yachipatala yomwe, zimawoneka ngati, ikukonzekera kukonza kwa insulini, poyesetsa kwa wodwala, atha kulowa m'gulu ngati chithandizo chamankhwala chamtunduwu sichofunikira. Pankhaniyi, shuga mellitus amatanthauza ma pathologies omwe, pofuna kukwaniritsa zochizira, kuwongolera ndi kuyesetsa kwa wodwala ndikofunikira kwambiri. Chifukwa chake, kuchuluka kwake pobwezeretsa matendawa kumatengera kulanga kwake pokhudzana ndi kadyedwe, kudziyang'anira pawekha pa shuga komanso kuperekera mankhwala kwakanthawi. Komabe, nthawi zina, kuyang'anira insulin ndi njira yovomerezeka. Izi zimachitika:

• pa mimba
• ngati mikwingwirima kapena matenda a mtima,
• nthawi ya opaleshoni,
• ndi matenda opatsirana a purulent-septic chikhalidwe,
• ndi kuchuluka kwawoko matenda.

Chifukwa china chofunikira chovomerezeka cha insulin chikhoza kukhala kusowa momveka bwino kwa hormone iyi, yomwe imatsimikizira mbiri yachipatala. Mtundu wachiwiri wa matenda ashuga a mellitus, gawo lowumbiramo lomwe limadziwika ndi kunenepa kwambiri komanso kuwonjezereka kwa ketoacidosis, ndi chitsanzo chowoneka bwino cha izi.

Tiyenera kudziwa kuti masiku ano mankhwala akuchulukitsa kwambiri kuchuluka kwa kugwiritsa ntchito mankhwala a insulin, ndipo kwatsimikiziridwa mwatsatanetsatane kuti kugwiritsa ntchito monotherapy ndi mankhwala amkamwa kumatha zaka zosakwana 6. Kenako muyenera kupereka mankhwala angapo. Malinga ndi zomwe zachitika posachedwa pochotsa matenda ashuga, kugwiritsa ntchito insulin pazinthu zotere kumawoneka ngati kothandiza kwambiri.

Zovuta zazovuta

Mavuto owopsa a gawo lowumbirali ndi mikhalidwe yomwe imawopseza wodwalayo. Nthawi zambiri zimachitika chifukwa cha kuchuluka kwamphamvu kwa shuga komanso mavuto okhudzana ndi metabolic. Zinthu zotere zikachitika, thandizo la panthawi yake ndilofunika ndipo, popeza si madokotala okha komanso anamwino ayenera kudziwa zizindikilo za izi, mbiri ya mlongoyo yodwala matenda ashuga 2 komanso zovuta zake zafotokozedwa motere.

1. Hyperglycemic coma (hyperosmolar and ketoacidotic) - chizindikiritso chawo ndikukula pang'onopang'ono. Zomwe zimawalimbikitsa ndi kuchuluka kosakwanira kapena kudya insulin, kuphwanya zakudya (kumwa kwambiri), zochita zolimbitsa thupi motsutsana ndi maziko a hyperglycemia, kulephera kuwongolera kuchuluka kwa shuga, mowa kapena mankhwala ena ake. Makamaka, amawonetsedwa ndi ludzu lochulukirapo ndi polyuria kwa masiku angapo (kuchuluka kwa mkodzo), koonetsedwa ndi kusowa kwamadzi. Kupanikizika kwa magazi kumachepetsedwa, tachycardia. Ngati vutolo likukulirakulira, kukhudzika kapena kukhumudwa kumatha kuchitika. Khungu louma, kukanda ndikotheka, kununkhira kwa acetone panthawi ya kuphipha. Potere, wogwiridwayo amafunikira kuchipatala mwachangu komanso chisamaliro chamankhwala.
2. Hypoglycemic coma - imayamba chifukwa cha kuchepa kwambiri kwa shuga m'magazi (zosakwana 3 mmol / l), chifukwa chomwe ubongo umakumana ndi kuperewera kwamphamvu kwa michere. Vutoli limatha kupsinjika ndi kuchuluka kwa insulin, kudumpha kamodzi pachakudya kapena zakudya zosankhidwa bwino, kumwa mowa kapena mankhwala osokoneza bongo. Mwachidule, kuukira kumayamba mofulumira. Thukuta lozizira pamphumi, kufooka, manja akunjenjemera, kupweteka kwa mutu, dzanzi la milomo limadziwika. Wodwala ndi waukali, samayendetsa bwino kayendedwe kake, palpitations, masomphenya awiri, chisokonezo. M'magawo apambuyo, kutaya chikumbumtima, kukhudzika. Pa nthawi ya prevospital, odwala otere amatha kupatsidwa chakumwa chokoma kapena china choti adye, kutentha ndikumapita kuchipatala kukalandira chithandizo chamtsogolo.

Machedwe mavuto

Mavuto omwewo amayamba mwa matenda osokoneza bongo omwe adatha zaka zingapo atadwala. Kuopsa kwawo kuli poti pang'onopang'ono komanso moperewera zimawonjezera vuto la wodwalayo. Kuphatikiza apo, nthawi zambiri ngakhale akatswiri othandiza odwala matenda ashuga sangatsimikizire kuti posakhalitsa sadzaonekanso.

1. Retinopathy imadziwika ndi kuwonongeka kwa retinal. Tsoka ilo, ngakhale atakwaniritsa zinthu zamakono zamankhwala, kupezeka kwa retinopathy kwa odwala omwe ali ndi matenda a shuga a 2, omwe amakhala zaka zoposa 20, amapita 100%. Izi zimayambitsa zotupa mu fundus ndipo pamapeto pake zimapangitsa kuwonongeka kwathunthu kwamawonedwe.
2. Angiopathies - ndikuphwanya kwa mtima kukhathamira, komwe kumakhala chifukwa cha thrombosis ndi atherosulinosis. Itha kuyamba pakanthawi kochepa (pafupifupi chaka), mosiyana ndi zovuta zina zomwe zimachedwa, zomwe nthawi zambiri zimapangitsa mbiri ya udokotala.
3. Type 2 shuga mellitus, matenda ashuga polyneuropathy omwe amakhalanso ovuta, amawalembetsa mu 90% ya milandu. Mwachizolowezi, izi zimafotokozeredwa mu zotupa zamitsempha zomwe zimayendetsa minofu ndi ziwalo zamkati. Polyneuropathy imatha kuwonetsedwa ndikumverera kochulukirapo, zowawa mwadzidzidzi (kuwombera), kuyaka. Komanso, kuwonetsa kwa neuropathy kumatha kukhala dzanzi, kuchepa mphamvu, komwe kumayambitsa kuvulala kambiri. Kuchokera kumbali ya ziwalo zamkati pamatha kukhala ndi m'mimba, kutsekeka kwamkodzo, kupweteka mutu, chizungulire, kusokoneza ntchito ya mtima.
4. Diabetesic phazi - yodziwika ndi zilonda zam'mimba, ma abscesses, madera a necrotic pamapazi ndipo, makamaka, pamapazi a wodwala matenda ashuga. Ichi ndichifukwa chake odwala omwe ali ndi matenda amtunduwu amalimbikitsidwa kuti azisamala kwambiri pakusankhidwa kwa nsapato.

Ndizachisoni, koma mankhwala amakono sangathetse matenda a shuga. Komabe, itha kukhala okonza zopatuka munthawi yake chifukwa cha kuchuluka kwa shuga m'thupi la munthu, ndiko kuti, mtundu wachiwiri wa matenda ashuga. Mbiri ya matendawa, kudziwikiratu kwa matendawa m'njira zambiri, ngati mulibe chilichonse, zimadalira momwe wodwalayo akumvera. Ndi kuwunika mosamala mbali yake ya mulingo wa shuga ndi zizindikiro zina, kukonza mankhwala kofunikira, zakudya ndi malingaliro a madokotala, kukula kwa zovuta kungapewe kwa zaka zambiri.

Gangrene wa m'munsi malekezero a shuga

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

Chimodzi mwazinthu zovuta kwambiri za matenda a shuga mellitus (DM) amadziwika kuti ndi gangore. The psychology yomwe ikuphatikizidwa ndi chitukuko cha omwe amadziwika kuti "diabetesic foot syndrome", monga lamulo, amapezeka odwala matenda ashuga omwe akudziwa zaka zoposa 5-10. Ndi chiyani chomwe chimatsogolera pakupanga gangore ndi momwe mungapewere kuti zisachitike?

• Gangrene ndi zomwe zimayambitsa
• Mavuto a matenda ashuga: phazi la matenda ashuga ndi gangrene (kanema)
• Momwe mungazindikire gangore: zizindikiro zazikulu za matenda
• Matendawa
• Gangrene wa m'munsi
• Njira zochizira
• Kuthetsa kwaulere kwa matenda a gangrene (kanema)
• Momwe mungapewere kukula kwa matenda osokoneza bongo: njira zopewera

Gangrene ndi zomwe zimayambitsa

Gangrene ndi necrosis wa zimakhala za thupi la munthu. Kuopsa kwa vutoli kukuchitika chifukwa choti zikachitika, zinthu zapoizoni zomwe zimapangitsa kuti thupi lonse lizilowerera m'magazi ake. Kulowa kwawo m'magazi kumadzetsa mavuto ambiri ndi ziwalo zofunika kwambiri ndi machitidwe awo. Choyamba, impso, chiwindi, minofu ya mtima, mapapu amavutika.

Chiwopsezo chotenga gangore chikuwonjezeka nthawi zina ngati shuga wambiri m'magazi apitilira kwa nthawi yayitali kapena ngati pali "kulumpha" komwe kumakhalako. Mu 90% ya milandu, zovuta zowopsa zimapezeka mwa odwala matenda ashuga omwe samalabadira thanzi lawo, osatsatira zomwe dokotala akutsimikiza, ndikuphwanya zakudya zomwe amadya.

Zotsatira zakupha - pafupipafupi chifukwa cha matenda ashuga osapezekanso mankhwalawa.

Zomwe zimayambitsa gangore mu shuga

• Atherosulinosis "Choyambitsa" chachikulu cha kufalikira kwamitsempha yamagazi, kusowa kwa mpweya ndi michere kwa ma cell, kufa kwawo pang'onopang'ono. Ndi matenda omwe amasokoneza kayendedwe ka magazi, amabweretsa zovuta monga ischemic gangrene.
• Zilonda za matenda ammimba a shuga. Zotsatira za kuwonongeka kwa khungu, zilonda zazitali zosachiritsa zimatha kukhazikika pansi. Matendawa akamalumikizana, kukula kwawo kumakulirakulira, wodwalayo amayamba kudwala matenda opatsirana (onaninso - momwe angathandizire mabala a shuga).
• Polyneuropathy. Zimachitika ngati pali kuphwanya njira ya kupanga shuga m'thupi, ndikuwongolera kuwonongeka kwa maselo a masisitimu amanjenje, kukalamba kwawo kusanachitike.
• Zilonda zam'mimba. Poyerekeza ndi kuchuluka kwa shuga m'magazi, misempha yayikulu ndi yaying'ono imavutika, yaying'ono kapena macroangiopathy imayamba. Kusintha kwachulukidwe ka mtima komanso patency kumabweretsa kufa kwa maselo ndi minofu ya thupi.
• Anachepetsa chitetezo chokwanira. Poyerekeza ndi kufooka kwa ntchito yoteteza thupi, zotupa zowonjezereka ndi matenda (mabakiteriya, ma virus, mafangasi, ndi zina) zimawonedwa, zomwe zimayambitsa chitukuko cha matenda opatsirana.
• Njira yolakwika ya moyo. Zizolowezi zovulaza, kudya mopitirira muyeso, kunenepa kwambiri, nsapato zolimba zolimba ndizovutikira nthawi yayitali komanso kukulira msanga kwa zovuta za matenda ashuga (onaninso - momwe mungasankhire nsapato za odwala matenda ashuga).

Nthawi zambiri, odwala matenda a shuga amayamba chifukwa osati amodzi, koma zimayambitsa zingapo, zomwe zimalimbikitsana, zimasokoneza njira zochizira.

Momwe mungazindikire gangore: zizindikiro zazikulu za matenda

"Mabelu oyamba" (zizindikiro zoyambirira). Poyamba, kusintha kulikonse kwamkati pakhungu kumakhala kovuta kuwonekera kumaso wamaliseche ndikuchitika popanda chizindikiro. Zizindikiro zoyambazo monga gangrene zingakhale izi:

• kugona ndi miyendo,
• kutentha kapena kumva
• kutopa kwa miyendo, ngakhale kuchita zolimbitsa thupi pang'ono kapena kuyenda (nthawi zambiri wodwalayo amazunzika ndi zowawa m'misempha ya ng'ombe),
• kukula kwa vuto la phazi.

Madokotala amatcha matenda omwe amatsogolera isrogenia yovuta kwambiri. Amadziwika ndi mapangidwe a zilonda zam'mimba zoyambirira pakhungu ndikuwoneka ngati sanali ofunika kwambiri a necrosis. Pakadali pano, munthu wayamba kale kumva kupweteka kwambiri kumadera akumunsi, omwe amakhala osapirira panthawi yomwe amakhala m'malo opingika.

Ischemia yovuta ndi chikhalidwe chomwe sichimangokhala chokha. Ngakhale kumwa mankhwala sangathe kusintha vutolo. Kuti kuthetsere, kubwezeretsa mwachangu kwa magazi mu miyendo kumafunikira, apo ayi matendawo a wodwalayo amakhala osavomerezeka - kudzicheka chaka chamawa.

Zizindikiro zakuchedwa kwa gangrene. Popita nthawi, Zizindikiro zimachulukanso, ndipo mumatha kuzizindikira ngakhale ndi maliseche: kutentha ndi khungu la malekezero akumunsi zimasintha. Miyendo imayamba kuzizira, khungu limakhala lofiira kapena lofiirira. Odwala ena amadandaula za kutupa ndi mawonekedwe a chimanga chachikulu.

Zizindikiro zakuchedwa kwa gangrene zimaphatikizapo:

• ngakhale khungu likuda kwambiri (kuthina kapena lakuda),
• kusowa kwina kapena kuperewera kwa magazi (kungatsimikizidwe ndi kukhalapo kapena kusapezeka kwa magazi m'magazi a zotumphukira),
• kuchepa kwamatenda, kufooka, zizindikiro za kuledzera, kutentha thupi ndi zizindikiro zina zakufalikira kwa matenda m'thupi,
• mapangidwe a purulent (pachitukuko cha chonyansa chonyowa),
• fungo la fetid ku mabala amachiritso a nthawi yayitali.

Youma komanso chonyowa gangore

Pali mitundu iwiri yayikulu yamavuto monga gangore. Chifukwa chake, zitha kukhala:

Zouma. Kusokonezeka kumachitika motsutsana ndi maziko pang'onopang'ono kupendekera kwamitsempha. Nthawi zambiri, kukula kwa khungu louma kumachitika pakatha zaka zochepa. Munthawi imeneyi, odwala matenda ashuga amapeza njira zothanirana ndi zovuta za matendawa ndikuzolowera matendawa.

Mu 90% ya milandu, malo owuma amakhudza zala zakumapeto. Imfa yamatumba imachitika popanda kudziphatika ndi matenda achinzake.

Chizindikiro chachikulu cha chilonda chowuma ndi kupweteka kwambiri m'miyendo, yomwe imayamba kuzimiririka. Mukamayang'ana miyendo, mutha kuwona kusiyana pakati pa madera omwe akhudzidwa pakhungu ndi minofu yathanzi. Fungo losasangalatsa kuchokera m'miyendo silibwera. Potere, wodwalayo samva kuwawa m'thupi lonse, chifukwa kupanikizika kumachitika popanda matenda komanso kuledzera kwa thupi lonse.

Nthawi zambiri, matenda owuma sakhala pachiwopsezo cha wodwala. Kudula dzanja kumachitika pokhapokha ngati chiwopsezo chachikulu cha matenda ndi kusintha kwa khungu louma kuti chonyowa.

Zabwino. Vuto lalikulu lomwe limabweretsa chiwopsezo osati thanzi, komanso moyo wa odwala matenda ashuga. Wet gangrene ali ndi chizindikiro chotchulidwa, chosatheka kunyalanyaza kapena kusokoneza china chake. Kuwonongeka kulikonse kwa minofu kumachitika molumikizana ndi matenda. Zotsatira zake, gawo la dera lomwe lakhudzidweli likuchulukirachulukira, nthambi imapeza tinthu tofiirira. Pakapita nthawi yochepa, kuwumbidwa kumayamba, komwe kumafalikira kumankhwala oyandikira, omwe kale anali amoyo pakatha masiku.

Chizindikiro chodziwikiratu cha chonyowa m'mimba ndikudzazidwa kwa malo okhala ndi hydrogen sulfide. Zotsatira zake, mukadina m'dera lomwe lakhudzidwalo khungu, mumatha kumva phokoso lomwe limatchedwa kutumbwa.Komanso ku chonyansa chamagulu nthawi zonse ndimanunkhira wosasangalatsa wa fetid. Wodwalayo "amafota" pamaso pathu: chikhalidwe cha munthu chokhala ndi chonyansa chimalira osati ndi tsiku, koma pofika ola limodzi chifukwa chakupha thupi ndi zinthu zam'kati.

Mu 98% ya milandu, mwayi wokha wopulumutsa moyo wamunthu ndi chonyansa chodukiza ndikuduladula dzanja.

Momwe mungapewere kukula kwa matenda osokoneza bongo: njira zopewera

Kuti mupewe vuto lalikulu ngati gangore, ndikofunikira kuchitapo kanthu moyenera. Kodi achite chiyani?

• Khazikitsani shuga m'magazi (konzekerani kuchepa kwa cholembedwaku kumikhalidwe yoyenera, ndipo yeserani kuisunga nthawi yomweyo).
• Pitani kuchipatala pafupipafupi kuti mumupimidwe ndi dokotala (nthawi zina, zizindikiro zoyambirira za gululi, zomwe sizioneka kwa wodwala, zitha kutsimikiziridwa ndi katswiri).
• Chitani zosamalika za tsiku ndi tsiku komanso mokwanira (kutsukidwa kwathunthu ndi sopo wa antibacterial, kusisita kosavuta, kupaka mafuta tsiku ndi tsiku pakhungu la mapazi).
• Chitani zolimbitsa thupi kuti mukonzenso ndikubwezeretsa magazi m'miyendo.
• Chitani masewera olimbitsa thupi tsiku ndi tsiku (mukangoyamba kutopa m'miyendo, muyenera kuvula nsapato zanu ndikumanga tsitsi lanu kwamphindi kwa mphindi 5 mpaka mbali kuchokera kumapazi kupita m'chiuno).
• Pomwe zingatheke, perekani miyendo yanu pamalo okwera (kukulitsa kutulutsa miyendo ndikuwongolera kutuluka kwa magazi kupita kunsonga).

Kuchokera pamwambapa, titha kunena kuti gangrene, youma komanso yonyowa, ndi vuto lalikulu la matenda ashuga, kuwonekera motsutsana ndi matenda ammimba a matenda ashuga. Ngati mukugwira nawo ntchito yoletsa matendawa ndikutsatira zomwe dokotala akutsimikiza, nthawi zambiri mutha kupewa kupitilira kwa zovuta komanso mtsogolo.

Mtundu wachiwiri wa matenda a shuga a mellitus insulin: chithandizo cha matenda oopsa

• Imakhazikika pamisempha ya shuga kwa nthawi yayitali
• Imabwezeretsa kapangidwe ka insulin

Matenda a shuga amaphatikiza mitundu iwiri yosiyanasiyana ya chitukuko cha matendawa, mawonetsedwe ake omwe ndiwowonjezereka pamagazi a shuga. Mu matenda a shuga a mtundu woyamba, kuperewera kwa insulin kotheratu kumayamba chifukwa cha kuwonongedwa kwa maselo a kapamba, omwe amafunikira kuikidwa kwa mankhwala a insulini kuyambira pachiyambi cha matenda.

Type 2 shuga mellitus imagwirizanitsidwa ndi kukula kwa kukana kwa minyewa yolandila minofu kupita ku insulin. Pankhaniyi, kuyambika kwa matendawa kumachitika ndi insulin yokhazikika kapena yowonjezereka, chifukwa chake njirayi imatchedwa kuti insulin yosadalira shuga.

Popeza shuga wambiri m'magazi akupitiliza kulimbikitsa kutulutsa kwa insulin ndi maselo a beta, pakapita nthawi, zotsalira za kapamba zimatha pang'onopang'ono ndipo mtundu wa 2 shuga umayamba kukhala wovuta.

Kodi ndizothandiza kwa mtundu woyamba wa 2 ndi matenda ashuga 2 kukhala masiku osala kudya

• Pazabwino za kusala kudya
• Zokhudza mitengo yanjala
• Pazosankha

Ambiri akutsimikiza kuti kusala kudya ndi imodzi mwanjira zabwino kwambiri zoyeretsera thupi. Komabe, kodi zitha kuwerengeka ngati chithandizo cha matenda ashuga a mtundu woyamba kapena wachiwiri? Zingakhale zopindulitsa bwanji kwa thupi la onse omwe ali ndi matenda ashuga? Za izi ndi mochedweranso malembawo.

Pazabwino za kusala kudya

Ofufuza ambiri akukhulupirira kuti kufa ndi njala kapena kuchepa kwa kuchuluka kwa chakudya patsiku, makamaka zipatso zouma, kumachepetsa kuuma kwa matendawa, kapena kuchiritsa matenda ashuga kotheratu. Amadziwika kuti insulini imalowa m'magazi pambuyo poti chakudya chalowetsedwa m'thupi. Pankhani imeneyi, odwala matenda a shuga oyamba ndi a chachiwiri amatsutsana mukudya pafupipafupi chakudya ndi msuzi, zomwe zimakulitsanso kuchuluka kwa insulin m'magazi.

Iwo omwe amathandizira odwala matenda ashuga ndi njala amasonyezeranso kufanana pakati pa zigawo za magazi osati magazi okha komanso mkodzo mu gawo lililonse la omwe ali ndi matenda ashuga komanso omwe ali ndi njala. Zomwe zimabweretsa kusintha komweko pamapangidwe achilengedwe amakhalanso chimodzimodzi:

• m'malo a chiwindi, malo osungirako zinthu zambiri amachepetsedwa, kuphatikizapo glycogen, wobwezeredwa ndi tomato,
• Thupi limayamba kulimbikitsa zinthu zonse zamkati,
• mafuta ochulukidwa amaphatikizidwa mu chakudya,
• ma ketulo komanso fungo la "acetone" silimapangidwa mkodzo wokha, komanso mavu.

Kupewa izi, kuyeretsa kwapadera kwa thupi kwapangidwa, komwe ndi njala, kukana kwa pomelo ndi matenda amtundu uliwonse.

Zokhudza mitengo yanjala

Akatswiri padziko lonse lapansi akutsimikiza kuti chithandizo chothamanga cha matenda ashuga sichili chovomerezeka, komanso chothandiza kwambiri. Nthawi yomweyo, kuchiritsa kwakanthawi kochepa ndi matenda omwe aperekedwa (ndiye kuti, kuyambira tsiku mpaka atatu) kungapereke zotsatira zochepa, monga mandarins.

Aliyense amene akufuna kuthana ndi matenda ake oyamba kapena oyamba, amangokakamira kuchita zinthu zosiyanasiyana: kuyambira nthawi yayitali mpaka nthawi yayitali. Nthawi yomweyo, muyenera kukumbukira kuti kugwiritsa ntchito madzi, osati madzi ena aliwonse, kuyenera kukhala kokwanira - mpaka malita atatu maola 24 aliwonse. Pokhapokha ngati izi, chithandizo chamatenda chomwe chimayamba kusala komanso kukhazikitsa shuga chidzakhala chokwanira.

Ngati munthu ali ndi njala kwa nthawi yoyamba, akuyenera kuchita izi kuchipatala.

Izi ziyenera kukhala chipatala chapadera, chifukwa kuwongolera kwachakudya ndichofunikira kwambiri, makamaka pankhani ya matenda ashuga 2.

Musanayambe chithandizo, zimakhala zolondola kwa masiku awiri kapena atatu:

1. Idyani zakudya zomwe zimangolimbikitsidwa zokha
2. kumwa osachepera 30 osaposa 50 g wamafuta azitona patsiku.

Koma musanalowe chithandizo chanthawi yanjala, muyenera kupanga enema yodziyeretsa. Ithandizira kuti chithandizo chomwe chimayenda limodzi ndi kusala shuga chizikhala chokwanira komanso, nthawi yomweyo, chikhala chosavuta.

Pambuyo pamavuto a hypoglycemic (nthawi zambiri izi zimachitika pakapita masiku anayi kapena asanu ndi limodzi atatha kufa ndi njala), fungo loipa la acetone lochokera pamkamwa limatha. Izi zikutanthauza kuti chiŵerengero cha ma ketones m'magazi a anthu adayamba kuchepa. Kuchuluka kwa shuga pankhaniyi kumakhazikika mokwanira ndipo kumakhalabe koyenera panthawi yonse yosala kudya.

Pakadali pano, njira zonse za metabolism zomwe zimachitika mthupi la odwala matenda ashuga zimakhala zokhazikika, ndipo kuchuluka kwa katundu pa kapamba ndi chiwindi kumachepetsedwa kwambiri. Zizindikiro zamtundu uliwonse wamatenda a shuga zimatha.

Chofunikira ndikuti mulowe mu njala. Chikhala cholondola kwambiri kuyambitsa izi pogwiritsa ntchito madzi ena akudya:

• msuzi wamasamba, womwe umasungunulidwa ndi madzi,
• juisi zachilengedwe kuchokera masamba,
• Whey mkaka kuchokera,
• decoction masamba.

M'masiku ochepa kuchokera pamenyu, muyenera kusiyanitsa kwathunthu ndi mchere monga mchere, komanso zakudya zomwe zimakhala ndi mapuloteni ambiri. Zitha kukhala zothandiza mtundu uliwonse wa matenda ashuga. Masamba a masamba ndi zipatso, msuzi wamafuta ochepa, ma walnuts apangitsa kuti zitheke kukhalabe ndi zotsatira zomwe zidachitika chifukwa chotsala kudya kwathunthu. Amatha kukhala chida chabwino popewa mavuto ndi miyendo ngati phazi la matenda ashuga ndi ena ambiri. Kupatula apo, chithandizo chawo ndikofunikira.

Madokotala ambiri amalimbikitsa kuti kusiya masamba a shuga (ndipo ngati kungatheke, m'tsogolo) musadye kawiri patsiku. Kocheperako kuchuluka kwa zakudya, kocheperako ndizomwe zimapangitsa kuti magazi azikhala ndi magazi.

Nthawi yomweyo, kuchuluka kwa mahomoni omwe amabwera m'magazi nthawi yambiri kuchokera pakudya sikukula, koma m'malo mwake, kumachepera.

Chifukwa chake, chithandizo chothandizira kupha anthu odwala matenda ashuga si njira imodzi yothanirana. Itha kukhala njira yabwino yopulumutsira matenda a shuga amtundu uliwonse, momwe malingaliro ndi miyambo yonse ziyenera kuonedwa.