Matenda a shuga pamimba

Chimodzi mwazinthu zothandizira kuti mupeze bwino mankhwala a GDM ndi zakudya.

Nthawi zambiri, azimayi omwe ali ndi GDM ndi onenepa kwambiri (body boima index - BMI - opitilira 24 kg / m2, koma ochepera 30 kg / m2) kapena kunenepa kwambiri (BMI yoposa 30 kg / m2), yomwe imakulitsa kukana kwa insulin. Komabe, kubereka si nthawi yochepetsa thupi, chifukwa thupi la mayi limapereka mwana wosabadwayo ndi zinthu zofunika pakukula kwake ndi kukula kwake. Chifukwa chake, muyenera kuchepetsa zakudya zopatsa mphamvu, koma osati zopatsa thanzi. Kuletsedwa kwa mndandanda wazakudya zamagulu ena kumathandizira kukhala ndi shuga m'magazi munthawi yochepa, osanenepa kwambiri ndikupeza mavitamini ndi michere yonse yofunikira ndi chakudya.

Tsatirani malamulo otsatirawa azakudya

Pewani zakudya zomwe zili ndi chakudya chamafuta ambiri. Izi zimaphatikizapo shuga womwe umakhala ndi shuga wambiri, komanso zinthu zophikidwa ndi zipatso zina.
Zogulitsazi zimatengedwa mwachangu kuchokera m'matumbo, zomwe zimapangitsa kuti shuga azikhala ndi magazi atagwiritsidwa ntchito, zimakhala ndi ma kilocalories ambiri komanso michere yochepa. Kuphatikiza pa kukhathamiritsa mphamvu zawo kwambiri za m'magazi, ma insulin ambiri amafunikira kuti achepetse kuchuluka kwa shuga m'magazi.
Zinthu monga izi: maswiti, zosunga, shuga, uchi, jams, makeke, makeke, makeke, zakumwa zotsekemera zopanda zakumwa zoledzeretsa, chokoleti, misuzi yazipatso ndi zakumwa, mphesa, vwende, yamatcheri, yamatcheri, nthochi, ma Persimmons, nkhuyu.

Musachotsere zakudya zomwe zimaperekedwa nthawi yomweyo. Izi zikuphatikizapo zinthu zomwe zidayambitsidwa kale ndi mafakitale, zomwe zimathandizira kukonzekera kwawo, koma zimawonjezera index ya glycemic (kuthana ndi shuga) poyerekeza ndi anzawo achilengedwe.
Zina mwa zinthuzi ndi monga: Zakumwa zouma, mazira osenda, zouma, masamba osapsa, "m'mphindi 5".

Sankhani zakudya zabwino zambiri. CHIKWANGWANI (kapena zakudya zamafuta) chimalimbikitsa matumbo ndikuchepetsa kuyamwa kwa shuga owonjezera ndi mafuta m'magazi. Kuphatikiza apo, zakudya zokhala ndi fiber zambiri zimakhala ndi mavitamini ndi michere yambiri yomwe iwe ndi mwana wanu timafunikira kwambiri.
Zakudya za fiber zambiri zimaphatikizapo:
· Buledi mkate wopanda phokoso,
· Watsopano masamba ndi mazira, amadyera,
Durum tirigu pasitala
· Zipatso zatsopano, kupatula pazomwe zili pamwambazi (kupatula phwando lawo kadzutsa).

Yesani kudya zakudya zochepa zomwe zimakhala ndi mafuta "owoneka" ndi "obisika". Mafuta ndiye chakudya chamagulu kwambiri chama calorie, amathandizira kuwonjezeka kwakukulu, komwe kumapangitsa insulin kukana. GDM ndi kunenepa kwambiri palokha zimathandizira kukula kwambiri kwa fetal. Chifukwa chake:

· Sankhani masoseji, masoseji, masoseji, nyama yosuta ndi nsomba, nyama yankhumba, nkhumba, mwanawankhosa. Gulani nyama zopanda nyama: nkhuku, ng'ombe, nkhuku, nsomba.
Chotsani mafuta onse owoneka: khungu ku nkhuku, mafuta ku nyama
· Sankhani chithandizo “chofatsa” chophikira: kuphika, kuphika, kupanga kaphaka kanyumba, nthunzi.
· Gwiritsani ntchito mafuta ochepa a masamba pophika.
• Idyani zakudya zamkaka zamafuta ochepa, monga tchizi tchizi, yogati ya Vitalinea.
· Osamadya mafuta monga batala, margarine, kirimu wowawasa, mayonesi, mtedza, njere, kirimu, tchizi, zonona.

Zakudya zomwe zimatha kudyedwa popanda zoletsa monga: zukini, nkhaka, tomato, bowa, zukini, zitsamba, udzu winawake, radara, letesi, kabichi, nyemba zobiriwira.

Zakudya izi ndizochepa kwambiri zopatsa mphamvu, zochepa zamafuta. Zitha kudyedwa pamakudya oyamba komanso mukamva njala. Ndikwabwino kudya zakudya izi zosaphika (zamalonda), komanso zopaka kapena zowiritsa.

Sinthani mapulani anu azakudya!
Idyani nthawi zambiri, koma pang'ono.
Kudya chakudya chochepa maola atatu aliwonse kumapewetsa kuchuluka kwa shuga m'magazi mukatha kudya. Zakudya zazikulu zitatu nthawi zambiri zimalimbikitsidwa - chakudya cham'mawa, nkhomaliro, ndi chakudya chamadzulo, ndi zakudya zina zitatu - nkhomaliro, chakudya chamadzulo, komanso nkhomaliro. Zakudya zazing'ono zimachepetsa njala komanso kupewa kudya kwambiri zakudya zazikulu. Mafuta opezeka mu zakudya zamapuloteni amathandiza kuti muzikhala bwino poyerekeza ndi zakudya zamafuta ambiri. Izi zimaletsa njala. Kulowerera pafupipafupi kwa chakudya chochepa kumachepetsa zizindikiro monga nseru ndi palpitations, zomwe nthawi zambiri zimayambitsa kusasangalatsa kwa azimayi panthawi yoyembekezera.

Chifukwa chake, nayi malamulo ochepa okonzekera zakudya:
1) Idulani chakudya chambiri nthawi 5-6 patsiku: chakudya cham'mawa, nkhomaliro, nkhomaliro, nkhomaliro yamadzulo, chakudya chamadzulo, chakudya chamadzulo chachiwiri
2) Chakudya chilichonse chimayenera kukhala ndi zakudya zomanga thupi - mafuta ochepa, nkhuku, nsomba, tchizi chotsika mafuta, tchizi choyera (Adyghe, suluguni, tchizi cha feta), mazira.
3) Zakudya zowonjezera siziyenera kukhala ndi magalamu oposa 24 a chakudya.

Amadziwika kuti m'mawa, kukana insulini m'mimba yapakati kumatchulidwa kwambiri. Chifukwa chake, m'mawa mwa azimayi omwe ali ndi GDM, shuga wamagazi nthawi zambiri amakhala okwera kuposa masana. Chifukwa chake, kadzutsa uyenera kukhala wochepa komanso wotsika mu chakudya. Zakudya za zipatso ndi timadziti (zilizonse, ngakhale zongolowa kumene m'mawa) siziyenera kuphatikizidwa, popeza zimachulukitsa shuga. Ngati kudya mkaka pakudya yam'mawa kumabweretsa kuwonjezeka kwa shuga m'magazi, ndiye kuti ziyenera kuchepetsedwa kapena kupatulidwa. Muesli, mitundu yosiyanasiyana ya phala iyenera kuyikidwanso. Ndikofunikira m'mawa kudya zakudya zokhala ndi mapuloteni (mazira, tchizi cha kanyumba), chimanga kuchokera ku mbewu zonse, mkate kuchokera ku ufa wa Wholemeal kapena chinangwa.

Chifukwa chake, tsatirani malamulo otsatirawa:
1) Osamadya chakudya choposa 12-24 g.
2) Chotsani zipatso ndi timadziti.
3) Musaiwale za zakudya zama protein.

Mayi woyembekezera wonenepa amatha kuchepetsa kuchuluka kwa zopatsa mphamvu tsiku ndi tsiku mpaka 1800 zopatsa mphamvu pothana ndi mafuta, zomwe zimapezeka m'mimba mosavuta. Pankhaniyi, matupi a ketone amatha kuwoneka mkodzo - zinthu zomwe zikuwonjezera kuwonongeka kwa mafuta a ma cell. Muyenera kuti mwachepetsa kuchuluka kwa chakudya chamagulu pamenyu anu kwambiri chifukwa choopa kuchuluka kwa shuga. Izi ndi zolakwika. Kuchuluka kwa chakudya m'zakudya za tsiku ndi tsiku kuyenera kukhala 55-60%, popeza ndiye gwero lamphamvu. Mukachepetsa kudya zamafuta, ndiye mapuloteni am'magazi ndi mafuta amayamba kuthyoka ndikupatsa khungu mphamvu. Ndi kuphwasika kwamafuta am'magazi, matupi a ketone amawoneka m'magazi ndi mkodzo. Maonekedwe a matupi a ketone sayenera kuloledwa, chifukwa amalowa momasuka mu placenta ndipo pambuyo pake akhoza kukhala ndi vuto lakumakula kwa mwana. Chifukwa chake, pakuwonekera kwa matupi a ketone mu mkodzo, ndikofunikira kuwonjezera kuchuluka kwa chakudya chamagetsi - zipatso, ndiwo zamasamba, chimanga, koma kuwongolera kuchuluka kwa shuga m'magazi.
An endocrinologist ikuthandizani kuwerengera zofunikira tsiku ndi tsiku zama kilocalories ndikugawa kwa chakudya, mapuloteni ndi mafuta.
Ngati mankhwala othandizira pakudya satha ntchito, shuga m'magazi akakhazikika kapena matupi a ketone amakhala akupezeka pafupipafupi motsutsana ndi standardoglycemia, ndikofunikira kupereka chithandizo cha hypoglycemic, komwe kungokhala ndi insulin yothandizira kumachitika pokhapokha pakati. Mapiritsi ochepetsera shuga panthawi yoyembekezera amalekanitsidwa, chifukwa amalowera m'chikumbumtima cha mwana ndipo amatha kukhala ndi vuto pakakula.

Mankhwala a insulin

Ngati pachakudya chanu pakatha sabata 1 sizotheka kukwaniritsa zotsatira zomwe mukufuna - kusala shuga m'magazi Ј 5.2 mmol / l, ola limodzi mutatha kudya Ј 7.8 mmol / l, ndi maola awiri mutadya Ј 6.7 mmol / l, ndiye kuti mayi woyembekezera wokhala ndi GDM adayikidwa insulin mankhwala kuti ateteze kukula kwa diabetesic fetopathy (DF).
Kukhazikitsidwa kwa insulin mu GDM ndikothekanso motsutsana ndi maziko a shuga wamba, ngati zizindikiro za DF zapezeka pamtunda wa mwana wosabadwayo (mawonekedwe am'mimba akupitilira mutu, pali zotupa za fetal zofewa, polyhydramnios).

Njira za Insulin Therapy

Kukonzekera kwa insulin kumayendetsedwa ndi jakisoni yekha, chifukwa insulin ndi mapuloteni ndipo akatengedwa pakamwa amawonongeka kwathunthu ndi ma enzyme am'mimba.
Mulingo wabwinobwino wa inshuwaransi masana mwa munthu wathanzi ndi motere:
Kutulutsa insulin mosalekeza masana,
b) Kutulutsa kwa insulini m'magazi poyankha chakudya.

Insulin imalowetsa magaziwo mokwanira kuti mukhale ndi shuga m'magazi momwe mulili. Kuti muthane ndi katemera wa insulin wabwino ndi kapamba masana, ndikofunikira kuphatikiza mitundu ingapo ya insulin: kanthu kochepa "pazakudya" komanso kuchitapo kanthu nthawi yayitali kuti mupeze insulini m'magazi pakati pa chakudya ndi usiku.

Zikondazo zimangotulutsa insulin yochepa chabe. Kubisala kwake kumachitika mosalekeza, ndipo nthawi yogwirayo ndi mphindi zingapo. Ngati wodwala yemwe ali ndi matenda osokoneza bongo amangogwiritsa ntchito mankhwala ochepa a insulin, ayenera kupereka jakisoni maola awiri aliwonse kuti akhale ndi shuga. Chifukwa chake, kuti mufotokozere kupanga kwa insulin nthawi zonse masana, zinthu zapadera zimawonjezeredwa ndi insulin yochepa, yomwe imakulitsa mphamvu yake. Zinthu zoterezi zimatchedwa prolongators. Kuchita kwa prolongators ndikuti mamolekyulu a insulin amawayika pa mamolekyulu awo, ndipo kuyamwa kwake m'magazi kumayamba pang'onopang'ono kuposa kwa insulin yochepa. Zinthu izi zimapereka yankho la insulin ya nthawi yayitali ngati "yamtambo", yomwe imasiyanitsa ndi insulin yayifupi ndi yomwe idapangidwa kale. Insulin yolimbitsidwa imayenera kusakanikirana nthawi 20 musanayipidwe mpaka penipeni pakayimitsidwa, ndiye kuti mutha kupaka insulin yochepa mu syringe, yomwe ingayambitse hypoglycemia.
Ma virus ndiwonjezeranso kukonzekera kwa insulin. Chifukwa chake, kutengera malamulo a ukhondo waumunthu komanso kugwiritsa ntchito ma syringe a disposer a insulin, palibe chifukwa chopukutira khungu ndi zakumwa musanalowe jakisoni. Mowa umapangitsa kuwonongeka kwa insulin ndipo umayambitsa khungu kapena kusokoneza khungu.

Kuti musankhe bwino ndi kusintha mlingo wa insulin, muyenera kuyeza shuga m'magazi 7-8 patsiku: pamimba yopanda kanthu, musanadye, maola 1-2 mukatha kudya, pogona komanso 3 koloko m'mawa.

Kuti mukwaniritse zomwe mukufuna kusaka shuga okwanira 7.8 mmol / L kapena 2 mawola mutatha kudya> 6.7 mmol / L, ngakhale mutadya mosamalitsa, mphindi 30 mpaka 40 musanadye, insulin yokhazikika imayikidwa. Insulin iyi imayamba kugwira ntchito patatha mphindi 30 kuchokera pakukonzekera kwachilendo, imafika pachimake pambuyo pa maola 2-3 ndikuchita kwa maola 5-7, kutsika magazi pambuyo kudya. Insulin yochepa imagwiritsidwanso ntchito kuchepetsa hyperglycemia masana (mwachitsanzo, ngati magazi a m'magazi atatha kudya ndi apamwamba kuposa 6.7 mmol / L).

Ngati kuchuluka kwa shuga pambuyo pa chakudya cham'mawa kulibe malire, ndipo chakudya chamasana chisaposa 5.8 mmol / l, ndiye m'mawa (nthawi zambiri ku 8-900), jekeseni wa insulin yayitali.

Masewera olimbitsa thupi.

Kuchita masewera olimbitsa thupi tsiku ndi tsiku kumakuthandizani kuti muzimva bwino mukakhala ndi pakati, kukhalabe ndi kamvekedwe ka minofu, ndikubwezeretsanso mawonekedwe ndi kulemera pambuyo pobereka. Kuphatikiza apo, masewera olimbitsa thupi amathandizira kusintha kwa insulini, kuthandizira kuti musakhale wolemera kwambiri. Zonsezi zimakhala ndi magazi abwinobwino. Muzichita nawo zinthu zomwe zimakonda kucheza ndipo zimakusangalatsani. Amatha kuyenda, masewera olimbitsa thupi, masewera olimbitsa thupi kunyumba.
Mukamachita masewera olimbitsa thupi, pewani kupsinjika kwambiri pamimba yam'mimba - ndikukweza miyendo kuti ikhale pansi, ndikukweza torso pamalo osavuta.
Pewani zochitika zolimbitsa thupi zomwe zingayambitse kugwa (kuyendetsa njinga, kugwedezeka pansi, skating, rollingblading, kukwera mahatchi)
Musatope. Mimba si nthawi yantchito. Imani, gwiritsani ntchito kupuma, ngati mukumva bwino, pali ululu kumbuyo kapena m'mimba.
Ngati mwapatsidwa insulin, dziwani zoopsa za hypoglycemia pochita masewera olimbitsa thupi. Onse a insulin komanso masewera olimbitsa thupi amachepetsa shuga la magazi. Onetsetsani kuti mulibe kuchuluka kwa shuga musanayambe kuchita masewera olimbitsa thupi. Ngati mutayamba kuyeseza ola limodzi mutatha kudya, mutha kudya apulo kapena sangweji mukalasi. Ngati chakudya chomaliza chatha kuposa maola awiri, ndiye kuti ndibwino kuluma musanayambe kuchita masewera olimbitsa thupi. Onetsetsani kuti mwabweretsa shuga kapena msuzi ngati muli ndi hypoglycemia.

Zizindikiro za hypoglycemia
Malingaliro anu: kupweteka mutu, chizungulire, njala, kuwonongeka kwa mawonekedwe, kuda nkhawa, kuluka, thukuta, kunjenjemera, kupuma, kugwa, kugona pang'ono, chisokonezo.
Ena angazindikire: kukwiya, kugona, kusokonezeka pakulankhula, kuda nkhawa, kukwiya, kusokonezeka kwa chidwi ndi chidwi.
Zowopsa: Kutha kwa chikumbumtima (chikomokere), kuthamanga kwa magazi, kukomoka, kusokonekera kwa magwiridwe antchito a mwana wosabadwayo.

Algorithm yochitira zizindikiro za hypoglycemia:
Lekani kuchita masewera olimbitsa thupi. Dziwani kuchuluka kwa shuga - kodi ndizotsika kwenikweni.
Mukangotenga chakudya cham'mimba chambiri mu 24 g ya chakudya (200 ml ya madzi, chakumwa choziziritsa kukhosi kapena magawo anayi a shuga (amatha kusungunuka m'madzi) kapena supuni ziwiri za uchi).
Pambuyo pake, muyenera kudya zakudya zamafuta olimbitsa thupi okwanira 12 g wamafuta (chidutswa cha mkate, kapu ya kefir, apulo).

Musakhale ndi chiyembekezo chilichonse kuti shuga yanu imatuluka nokha!

Champhamvu hypoglycemia:
Hypoglycemia yayikulu ndi hypoglycemia, limodzi ndi kuwonongeka. Pa hypoglycemia yayikulu, ena ayenera kuyimba ambulansi.

Onaninso:

Kalendala Yokhala ndi Mimba Pakutha milungu ingapo, ndikufotokozerani za kukula kwa mwana wosabadwayo, momwe umuna umachitikira, ziwalo zazikuluzo zikagonekedwa, kugunda kwa mtima ndi mayendedwe ake, momwe imakula, ndi zomwe ikhoza kumva. Mukaphunzira momwe malingaliro anu ndi moyo wanu zingasinthire, pezani malingaliro pazomwe mungathane ndi mavuto omwe akutuluka.

Pangani kalendala yanu ya pakati. Mutha kuyiyika mu siginecha yanu pa forum kapena msonkhano, komanso ikani patsamba lanu kapena tsamba lanu.

Zambiri

Matenda a shuga ochitika m'mimba omwe amakhala ndi pakati - amakhala ndi hyperglycemia (glucose okwera). Nthawi zina, kuphwanya kumeneku kwa matenda a carbohydrate kumatha kutsogola kutenga pakati ndipo kumatha kupezeka (kupezeka) koyamba panthawi yopanga mimba iyi.

Mthupi la mayi panthawi yomwe ali ndi pakati, kusintha kwa thupi (zachilengedwe) kumachitika, kumakhala kotheka kukula kwa mwana wosabadwayo - makamaka kuphatikiza kwa michere kudzera mwa placenta.

Mphamvu yayikulu yopangira mwana wosabadwayo ndikugwira ntchito kwa maselo a thupi lake ndi glucose, yemwe mwaulere (kudzera mwa kulowetsedwa) umalowa mu placenta, mwana wosabadwayo sangathe kudzipanga yekha. Udindo wa wochititsa shuga m'magazi umaseweredwa ndi "insulin" ya timadzi, yomwe imapangidwa mu β-cell a kapamba. Insulin imathandizanso "kusunga" kwa glucose mu chiwindi cha fetal.

Amino acid - chinthu chachikulu chomangira cha kapangidwe kazakudya zomanga thupi mu fetus, ndikofunikira pakukula ndi magawikidwe a maselo - azibwera modalira mphamvu, i.e.kudzera yogwira kusuntha kudutsa placenta.

Pofuna kukhalabe ndi mphamvu, makina oteteza thupi amapangidwa mthupi la mayi ("vuto la kufa ndi njala"), lomwe limatanthawuza kukonzanso kwa metabolism - kupatsirana kwakukulu (lipolysis) kwa minyewa ya adipose, m'malo momagawaniza chakudya chochepa kwambiri cha mitsempha ya m'magazi kupita kwa mwana wosabadwayo - matupi a ketone amachulukitsa m'magazi (zinthu zopangidwa ndi ketone) mafuta kagayidwe kachakudya kwa mwana wosabadwayo), amenenso momasuka kudutsa placenta.

Kuyambira m'masiku oyamba a kubereka kwakuthupi, azimayi onse amamva kuchepa kwa shuga m'magazi chifukwa chakuthamanga kwa mkodzo, kuchepa kwa kaphatikizidwe ka shuga m'chiwindi, komanso kugwiritsa ntchito shuga.

Nthawi zambiri, pa nthawi yobereka, glucose othamanga sapitirira 3.3-5.1 mmol / L. Magazi a glucose 1 ola pambuyo chakudya mwa amayi apakati amakhala apamwamba kuposa azimayi osakhala oyembekezera, koma osapitilira 6.6 mmol / L, omwe amalumikizidwa ndi kuchepa kwa ntchito ya galimoto m'matumbo am'mimba komanso kuyamwa kwa nthawi yayitali kwa chakudya chamafuta.

Mwambiri, mwa amayi apakati athanzi, kusinthasintha kwa shuga m'magazi kumachitika mkati mwa malire ochepa: pamimba yopanda kanthu pafupifupi 4.1 ± 0.6 mmol / L, atatha kudya - 6.1 ± 0,7 mmol / L.

Mu theka lachiwiri la kutenga pakati (kuyambira sabata la 16 mpaka 20), kufunikira kwa fetal ndizinthu zofunikira kwambiri zimakhalabe zofunikira kwambiri poyerekeza ndi kukula kwa ziwerengero zomwe zikukula msanga. Udindo wotsogola pakusintha kwa kagayidwe ka akazi munthawi imeneyi ya mimba ndi placenta. Pamene chikhodzodzo chikukula, pali kuphatikiza kwama mahomoni a fetoplacental zovuta zomwe zimakhalabe ndi pakati (makamaka mwa lactogen ya placental, progesterone).

Ndi kuwonjezeka kwa nthawi ya mimba chifukwa cha kukula kwa thupi la mayi, kupanga mahomoni ngati estrogens, progesterone, prolactin, cortisol - amachepetsa chidwi cha maselo kuti apange insulin. Zinthu zonsezi motsutsana ndi maziko a kuchepa kwa zinthu zolimbitsa thupi za mayi wapakati, kulemera, kuchepa kwa insulin, komanso kuchepa kwa zotupa za insulin ndi impso zimayambitsa kukulira kwa insulin kukaniza (kusamva bwino kwa insulin) - njira yachilengedwe yopangira mphamvu zamagetsi m'magawo a adipose minofu thupi la amayi, ngati kuli kwanjala, kupatsa mwana wosabadwayo chakudya.

Mkazi wathanzi amakhala ndi kuchuluka kwa insulin chifukwa cha kapamba katatu, (kuchuluka kwa ma cell a beta kumawonjezeka ndi 10-15%) kuthana ndi insulin yoletsa thupi ndikusunganso kuchuluka kwa shuga m'magazi pathupi. Chifukwa chake, m'magazi a mayi aliyense wapakati mudzakhala kuchuluka kwa insulini, yomwe ndi njira yodziwika bwino panthawi yoyembekezera!

Komabe, ngati mayi woyembekezera ali ndi vuto lotenga matenda ashuga, kunenepa kwambiri (BMI zoposa 30 kg / m2), ndi zina zambiri. kubisalira kwa insulin sikulola kuthana ndi kukhudzana kwa thupi kwa insulin yomwe ikupanga theka lachiwiri la kubereka - glucose sangalowe m'maselo, zomwe zimapangitsa kuti shuga azithamanga komanso kukula kwa matenda ashuga. Ndi mtsempha wamagazi, glucose amapezeka nthawi yomweyo osasunthidwa kudzera mu placenta kupita kwa mwana wosabadwayo, zomwe zimapangitsa kuti apange insulin yake. Insulin ya mwana wosabadwayo, yomwe imakhala ndi "kukula", imapangitsa chidwi chake cha kukula kwa ziwalo zake zamkati motsutsana ndi kukula kwa ntchito yawo, ndipo kutuluka kwa glucose konse kuchokera kwa mayi kupita kwa mwana kudzera mu insulin yake kumayikidwa m'chigawo chokhazikitsidwa ndi mafuta.

Zotsatira zake, matenda a hyperglycemia amakumana ndi vuto la mwana wosabadwayo ndipo zimayambitsa kupangika kwa matenda otchedwa diabetes - fetal matenda omwe amachitika kuyambira sabata la 12 la moyo wa fetal mpaka isanayambike ntchito: kulemera kwakukulu kwa fetal, kusalinganika kwa thupi - belu lalikulu, lamba m'apewa ndi miyendo yaying'ono , kukula kwa pakati pa ana - ndi ultrasound, kuchuluka kwa fetal poyerekeza ndi msinkhu wothamanga, kutupa kwa minofu ndi mafuta ochulukirapo a mwana wosabadwayo, matenda oopsa a fetal hypoxia ndipo mu placenta chifukwa chotenga nthawi yayitali osawerengeka a hyperglycemia mwa mayi wapakati), akuchedwa kupanga mapapu, kupwetekedwa pobereka.

Mavuto azaumoyo ndi matenda a shuga

Chifukwa chake pakubadwa kwa ana omwe ali ndi fetopathy, pali kuphwanya kwawo kuzolowera moyo wamtundu wa extrauterine, womwe umawonetsedwa ndi kusakhazikika kwa wakhanda ngakhale ndi nthawi yayitali yokhala ndi pakati komanso kukula kwake kwakukulu: macrosomia (kulemera kwa ana oposa 4000 g), kupuma kwamatenda mpaka asphyxiation (kuperewera), organomegaly (kukulira ndulu, chiwindi, mtima, kapamba), matenda a mtima (kuwonongeka kwakukulu kwa minofu ya mtima), kunenepa kwambiri, jaundice, kusokonezeka kwa dongosolo la kuphatikizika kwa magazi, zomwe zili m'maselo ofiira a magazi (magazi ofiira) m'magazi ovi, komanso zovuta za metabolic (mphamvu zochepa za shuga, calcium, potaziyamu, magnesium yamagazi).

Ana obadwa kwa amayi omwe ali ndi vuto la matenda ashuga osapezekanso amatha kukhala ndi matenda amitsempha yamaukwati (matenda amkati, matenda a khunyu), kutha msinkhu komanso kuwonjezereka kwa chiopsezo chokhala ndi kunenepa kwambiri, vuto la metabolic (makamaka, carbohydrate metabolism), matenda amtima.

Kumbali ya amayi apakati ndi gestational matenda a shuga, polyhydramnios, poyizoni woyamba, kwamikodzo matenda opatsirana, mochedwa toxicosis (njira yodwalitsa yomwe imadziwonetsa ngati edema, kuthamanga kwa magazi ndi proteinuria (mapuloteni mu mkodzo) amapezeka wachiwiri ndi wachitatu trimester mpaka preeclampia - kufalikira kwamatumbo, komwe kumatha kuyambitsa matenda a ziwongo, kuwonjezereka kwa magazi, kusokonezeka kwa mitsempha), kuyambitsa kusanachitike, kupanga modzipereka kumadziwika kwambiri. Fulakesi kuchotsa mimbayo, yobereka cesarean, ntchito nthenda, mabvuto kubadwa.

Mavuto a kagayidwe kazakudya amatha kupezeka mwa mayi aliyense woyembekezera, poganizira kusintha kumene kumachitika m'thupi ndi ma metabolic omwe amachitika pafupipafupi pamagawo osiyanasiyana a pakati. Koma chiwopsezo chachikulu cha matenda amiseche kwa azimayi omwe ali ndi kunenepa kwambiri / kunenepa kwambiri komanso azaka zopitilira 25, kupezeka kwa matenda ashuga m'mabanja awo apamtima, omwe ali ndi vuto la metabolism wama carbo, matenda osokoneza bongo osokoneza bongo, shuga mimba yapitayi), glucosuria pa nthawi yoyembekezera (mawonekedwe a shuga mumkodzo).

Gestationalabetes mellitus, yomwe imayamba pa nthawi ya pakati, nthawi zambiri sikhala ndi mawonetseredwe azachipatala omwe amakhudzana ndi hyperglycemia (pakamwa pouma, ludzu, kutulutsa mkodzo tsiku lililonse, kuyabwa, ndi zina zambiri) ndipo kumafunikira kupezeka pang'onopang'ono (kuwunikira) pa nthawi yoyembekezera !

Zofunika kusanthula

Ndikofunikira kuti amayi onse oyembekezera ayesere glucose posala kudya kwamadzi am'magazi mu labotale (sangayesedwe pogwiritsa ntchito njira yodziwunikira ya glucose - glucometer!) - motsutsana ndi zakudya zoyenera komanso zolimbitsa thupi - mukayamba kulumikizana ndi chipatala chothandizira kale!), koma pasanathe milungu 24 ya mimba. Tiyenera kukumbukira kuti panthawi yoyembekezera, shuga wa magazi amatsika, ndipo pambuyo kudya kwambiri kuposa pakati kunja!

Amayi oyembekezera omwe magazi a shuga amawonetsa malinga ndi malingaliro a WHO amakwaniritsa zomwe zimapezeka kuti apezeka ndi matenda a shuga kapena operewera shuga. Ngati zotsatira za phunzirolo zikugwirizana ndi zizindikiro zapakati pa nthawi yomwe ali ndi pakati, ndiye kuti mayeso okhudzana ndi glucose pakamwa - PHTT ("test test" yokhala ndi glu gose) ndizovomerezeka kwa masabata 24-28 oyembekezera kuti muzitha kudziwa zovuta zomwe zimatha kukhala ndi kagayidwe kazakudya. Padziko lonse lapansi, PHTT yokhala ndi glucose 75 ndiye njira yoyenera kwambiri komanso yokhayo yodziwira kuti mupeze vuto la kagayidwe kazachilengedwe pamimba!

Pambuyo pakupezeka kwa matenda a shuga akakhazikitsidwa, azimayi onse amafunika kuwunikira pafupipafupi ndi endocrinologist molumikizana ndi a grenecologist. Amayi oyembekezera ayenera kuphunzitsidwa mfundo za kadyedwe kabwino, kudziletsa komanso kusintha momwe zinthu ziliri kwa iwo (mwachitsanzo, pakubwera koyesedwa komanso kuyendera akatswiri - kamodzi pa masabata awiri).

Zakudya za mayi wapakati ziyenera kukhala zopatsa mphamvu mokwanira komanso zofunikira pazakudya zazikulu kupatsa mwana wosabadwayo zakudya zonse zofunika. Komanso, azimayi omwe ali ndi vuto la matenda a shuga, chifukwa cha zovuta zomwe zimachitika, matenda amayenera kusintha. Mfundo zazikuluzikulu zakuthandizira pakudya zimaphatikizanso kuonetsetsa kuti matenda a proteinoglycemia ndi okhazikika (ndikusunga kuchuluka kwa shuga m'magazi), komanso kupewa ketonemia (maonekedwe a zinthu zosokonekera zamafuta - ma ketoni a "njala" - mkodzo), omwe adanenedwa pamwambapa.

Kuwonjezeka kwa shuga wamagazi mutatha kudya (pamtunda wa 6.7 mmol / L) kumalumikizidwa ndi kuchuluka kwakuchulukirapo kwa fetal macrosomia. Chifukwa chake, mayi woyembekezera sayenera kupatula chakudya cham'mimba chambiri (chomwe chimayambitsa kukwera kosakhazikika kwa glucose) ndikupereka chisangalalo m'zakudya zamafuta osakanikirana okhala ndi michere yambiri (mwachitsanzo, masamba ambiri, nyemba) omwe ali ndi glycemic yotsika. mlozera. Mndandanda wa glycemic (GI) ndiwomwe umapangitsa kuti pakhale chakudya chamagulu ambiri.

Zakudya za matenda ashuga

yotengeka mwachangu kuchokera m'matumbo ndikukulitsa kuchuluka kwa shuga mkati mwa 10-30 maminiti atatha kutsata

Zamasamba, nyemba, zipatso zowawasa ndi zipatso, mkate, pasitala, mbewu monga chimanga

michere yokugaya imagundika m'matumbo kwa nthawi yayitali kuti igaye shuga, yomwe imalowetsedwa m'magazi pang'onopang'ono popanda kuyambitsa kwambiri shuga

Zinthu zomwe zimakhala ndi chakudya chamafuta kwambiri zomwe sizikhala ndi zakudya zophatikiza tsiku lililonse, siziyenera kupitilira 45% ya zakudya zopatsa mphamvu za tsiku ndi tsiku, ziyenera kugawidwa tsiku lonse (chakudya 3 chofunikira kwambiri komanso zokhwasula-tsitsa 2-3) zokhala ndi chakudya pang'ono m'mawa, ngati The anti-insular kuchuluka kwa kuchuluka kwa mahomoni azimayi ndi zovuta-placental m'mawa kumawonjezera insulin kukana kwa zimakhala. Kuyenda kwamasiku onse mukatha kudya m'magawo awiri a mimba kumathandizira kukula kwamisempha ya magazi.

Amayi oyembekezera nthawi zonse amafunika kuwunika matupi a ketone mumkodzo wawo (kapena magazi) kuti azitha kupeza chakudya chamafuta ambiri, makina a "kusala kudya" ndikuwonetsetsa kuti kufalikira kwa mafuta kumatha kuyamba (onani ndemanga pamwambapa). Ngati matupi a ketone amawonekera mumkodzo (magazi), ndiye kuti ndikofunikira kudya kuwonjezera

12-15 g zamakoko komanso

Amayi oyembekezera omwe ali ndi vuto la matenda amiseche amayenera kudziyang'anira pafupipafupi - kuyeza glycemia pogwiritsa ntchito zida zodziyang'anira (m'magazi a shuga) - pamimba yopanda kanthu komanso ola limodzi mutatha kudya chilichonse, ndikulemba zolemba zanu pang'onopang'ono. Komanso, bukulo liyenera kuwonetsa mwatsatanetsatane: zopatsa thanzi (kuchuluka kwa chakudya chodyedwa) pachakudya chilichonse, mulingo wa ma ketoni mumkodzo (malinga ndi miyeso yamikodzo yamatumbo), kulemera kwake komanso kuthamanga kwa magazi komwe kumayeza kamodzi pa sabata, kuchuluka kwa madzimadzi omwe amamwe ndikuwachotsa.

Ngati motsutsana ndi maziko azakudya mankhwala sizingatheke kukwaniritsa zofunika za shuga wamagazi mkati mwa masabata 1-2, ndiye kuti mayi woyembekezera amapatsidwa mankhwala a insulin (piritsi la hypoglycemic piritsi limaperekedwa panthawi yapakati!). Mankhwala, kukonzekera kwa insulin komwe kwadutsa magawo onse oyesedwa azaumoyo ndikuvomerezedwa kuti mugwiritse ntchito panthawi yoyembekezera mumagwiritsidwa ntchito. Insulin sikuwoloka placenta ndipo sichikhudza mwana wosabadwayo, koma shuga wambiri m'magazi a mayi amapita kwa mwana wosabadwayo ndikuwathandiza kukulitsa zovuta zomwe zatchulidwa pamwambapa (kutaya kwa pang'onopang'ono, matenda ashuga, matenda a m'mimba).

Matenda a shuga ochitika m'mimba mwa mayi pakakhala palokha sichizindikiro cha gawo la caesarean kapena kubereka koyambirira (mpaka sabata la 38 la mimba). Ngati kutenga pakati kumayenderana ndi maziko a kulipidwa kwa kagayidwe kazakudya (kuphatikiza kuchuluka kwa shuga m'magazi ofanana ndi omwe ali ndi pakati pathupi) ndikutsatira malangizo onse a dokotala wanu, ndiye kuti matendawo kwa mayi ndi mwana wosabadwa ndi abwino ndipo sizisiyana ndi zomwe zimachitika pakubala kwanthawi zonse!

Mu amayi apakati omwe ali ndi gestational shuga mellitus, atabereka ndikuwonetsa kwa placenta (placenta), mahomoni amabwereranso ku magawo abwinobwino, chifukwa chake, chidwi cha maselo ku insulin chimabwezeretseka, zomwe zimayambitsa matenda a metabolism ya carbohydrate. Komabe, azimayi omwe ali ndi matenda osokoneza bongo ali ndi chiwopsezo chachikulu chotenga matenda ashuga m'moyo wam'tsogolo.

Chifukwa chake, kwa azimayi onse omwe ali ndi vuto la metabolism wa carbohydrate metabolites yomwe imachitika pathupi, kuyesedwa kwa glucose pakamwa ("test test" yokhala ndi glu gose) kumachitika pakatha masabata asanu ndi atatu pambuyo pobereka kapena pambuyo poti abereki kuti athetsenso vutoli kugawana.

Amayi onse omwe adakhala ndi vuto la matenda amiseche amalangizidwa kuti asinthe mayendedwe awo (zakudya komanso zolimbitsa thupi) kuti akhale ndi thupi loyenera, chizolowezi chokhazikika (nthawi 1 m'zaka zitatu) mayeso a shuga.

Ana obadwa kwa amayi omwe ali ndi vuto la shuga pakapita nthawi yoyenera ayenera kuyang'aniridwa ndi akatswiri oyenera (endocrinologist, dokotala wothandizira, katswiri wa zakudya ngati kuli koyenera) kuti ateteze kukula kwa kunenepa kwambiri komanso / kapena kusokonezeka kwa kagayidwe kazakudya (kufooketsa shuga).