Moyo wabwino kwa odwala matenda ashuga

Matenda a shuga ndi matenda osachiritsika. Chifukwa chake, imakhudza moyo wamunthu. Kudya, kuchepetsa kuchita masewera olimbitsa thupi, kugona ndi kugona, kumwa mapiritsi ochepetsa shuga kapena jakisoni wa insulin - zonsezi zimalangiza munthu, kumukakamiza kuti aganize kudongosolo lakelo tsiku lililonse.

Izi zitha kuwoneka zovuta kwambiri poyamba. Koma ngati mutsatira malangizo azachipatala omwe mungawagwiritse ntchito pa matenda ashuga, mumatha kudya zosiyanasiyana komanso zosangalatsa, kusewera masewera komanso kumva bwino.

Momwe angapangire chakudya?

Chiwerengero cha zakudya za odwala matenda ashuga ndi nthawi 5-6, m'magawo ang'onoang'ono. Ndikofunikira kuti zopatsa mphamvu za calorie zizikhala zochepa, ndipo index ya glycemic ndiyapakatikati kapena yaying'ono.

Izi ndizofunikira kuti munthu asakhale wonenepa kwambiri komanso kuti apewe kusintha kwakukulu kwa shuga m'magazi.

Kuphatikiza apo, magawo ang'onoang'ono a chakudya amatha kuchepetsa katundu pazakudya. Zodzaza m'mimba ndi matumbo zilibe kuchuluka kwa matenda ashuga. Akatswiri aku America amayesetsa moyenera kupewa mawu oti "zakudya", m'malo mwake ndi "dongosolo la zakudya."

Izi ndi zolondola, chifukwa mawu oti "zakudya" amatanthauza chinthu chosakhalitsa. Kupanga mndandanda woyenera wodwala, endocrinologist amaganizira zomwe amakonda, zaka, kulemera kwa thupi, komanso mawonekedwe a metabolic.

Kwa odwala ena, zakudya zoyenera zomwe zimakhala ndi zopatsa mphamvu za calorie ndizoyenera, kwa ena - chakudya chamafuta ochepa, ndipo chachitatu - chakudya chokhala ndi mafuta ochepa. Zakudya zabwino ndizoyenera munthu wina, zomwe zimachepetsa zovuta zolakwika mu zakudya komanso kusokonezedwa.

Nazi mfundo zoyambira kukonzekera zakudya:

• Chakudya cham'mawa chizikhala ndi zakudya zopatsa thupi. Izi ndizofunikira kuti thupi lidzazidwe ndi mphamvu tsiku lonse likubwera,
• nthawi yayitali pakati pa chakudya ndi maola atatu,
• ngati kuli njala yayikulu, muyenera kuyeza kuchuluka kwa glucose ndikukhala ndi zokhwasula ndi chinthu chothandiza (mwachitsanzo, idyani apulo kapena mtedza pang'ono). Ngati chipangizocho chikuwonetsa shuga wochepa, ndiye kuti muyenera kudya zakudya zokhala ndi chakudya chamafuta othamanga,
• Ndikwabwino kudya nyama yokhala ndi matenda ashuga osati ndi phala, koma ndi masamba a masamba, chifukwa ndi yabwino kwambiri,
• simungagone ndi njala. Magalasi amodzi a yogurt yopanda mafuta kapena kefir otsika mafuta usiku amathandizira kuti muchotse izi.

Zakudya monga kefir, prunes, kapena beets yophika zimathandizira kugaya. Pazomwezo, ndikofunikira kumwa 250 ml ya madzi mu mphindi 15. musanadye chakudya cham'mawa. Chakudya chizigayidwa bwino.

Kusintha koyambirira kwa zakudya kumafunika mosasamala mtundu wa shuga.

Zakudya zomwe zimapezeka mwa anthu odwala matenda a shuga omwe amadalira insulin ndizosavutirapo kwenikweni.

Wodwala amatha kuwerengetsa mlingo wa insulin kutengera zomwe akufuna kudya. Komabe, onse odwala matenda ashuga ayenera kupewa zakudya zomwe zili ndi carbohydrate yambiri. Kusiyana kwa kuchuluka kwa glucose komwe kumachitika chifukwa cha zovuta zotere kumawonjezera ngozi.

Chikhazikitso cha zakudya za munthu wodwala matenda ashuga ndi masamba. Choyamba, chifukwa zimathandizira kuti kayendedwe ka metabolism. Mu shuga, njira za metabolic zimachepetsa, motero muyenera kudya masamba 3 mpaka 4 pa tsiku. Potere, thupi limalandira zofunikira zonse za mavitamini, mchere ndi kufufuza zinthu.

Zamasamba ndi mbale zochokera kwa iwo zimakongoletsa kugaya, kuchepetsa chiopsezo chodzimbidwa komanso zokhudzana ndi kuledzera. Zipatso ndizofunikanso pankhaniyi, koma muyenera kutchera khutu ku index ya glycemic. Sayenera kukhala yokwera kwambiri.

Chomwe chimagogomezedwa kwambiri mu zakudya ndizamasamba abwino

Nsomba ndi nyama ziyenera kusankhidwa pokonza mitundu yamafuta ochepa. Ndikofunika kuwaphika mu uvuni ndi mafuta ochepa, owiritsa kapena otentha. Nsomba zizikhala pachakudya pafupifupi kawiri pa sabata, nyama - tsiku lililonse.

Mitundu yoyenera: nkhuku kapena nkhuku (yopanda khungu), nyama ya kalulu. Mitundu yofunikira kwambiri ya nsomba kwa odwala matenda ashuga ndi hake, tilapia ndi pollock. Ndiwotsekemera, wokhala ndi zinthu zofunikira.

Ndikwabwino kupewa kudya nyama yamafuta, nkhumba, abakha, nsomba zokhala ndi mafuta, chifukwa mbale zopangidwa ndi izi zimachulukitsa cholesterol "yoyipa" ndikuyika zovuta pa kapamba.

Mitundu yothandiza kwambiri ya chimanga ndi: buckwheat, pea, tirigu ndi mapira.

Mndandanda wamtundu wa glycemic wazinthu izi uli pamlingo wamba, amakhala ndi michere yambiri ndi mavitamini. Koma mpunga wopukutidwa ndi semolina kuchokera muzakudya sayenera kuphatikizidwa. Amakhala ndi zopatsa mphamvu zambiri, koma zochepa zothandiza.

Magazi amawongolera

Ichi ndi chimodzi mwazofunikira kwambiri pothana ndi matenda ashuga komanso kupewa matenda. Pogwiritsa ntchito mita nthawi zonse, mutha kuzindikira Hyper- kapena hypoglycemia kuti muchitepo kanthu.

Matenda opezeka akangopezeka kumene, njira zopitilira kuchipatala zomwe zimakhala zowonjezereka, pamakhala mwayi woti wodwalayo akhale wathanzi.

Kuti chipangizocho chiwonetse zenizeni, ndikofunikira kuti chiziwunikira nthawi ndi nthawi ndikuwongolera. Simungagwiritse ntchito timiyeso tatha, chifukwa zotsatira zake zimakhala kutali ndi chowonadi.

Ndikofunikira kusinthitsa batri pafupipafupi, popeza kutsimikizika kwa zowerengera kumadalira.

Njira zochizira

Matenda a shuga amawopa mankhwalawa, ngati moto!

Muyenera kungolemba ...

Odwala omwe ali ndi matenda amtundu wa 1 ayenera kutsatira njira ya jakisoni wa insulin.

Ndi matenda amtunduwu, ndizosatheka kupanga popanda jakisoni, chifukwa katulutsidwe ka insulin sikokwanira. Palibe zakudya zomveka bwino zomwe zingathandize wodwalayo ngati atangobayira jakisoni kapena kuwanyalanyaza.

Ndikofunikira kuti wodwalayo azitha kuwerengera kuchuluka kwa mahomoni omwe amaperekedwa, kutengera zakudya zomwe akudya. Komanso, wodwalayo amafunika kudziwa momwe mankhwalawo amasiyanirana ndi insulin yochepa komanso yayitali.

Chodabwitsa cha matenda ashuga amtundu wa 2 ndikuti kubisika kwa insulini ndikwabwinobwino, ndipo ngati kuchepetsedwa, ndikosavomerezeka. Pankhaniyi, wodwala safuna jakisoni wa mahomoni.

Chinthu chachikulu ndi matenda a shuga a 2 ndichakudya choyenera komanso maphunziro akuthupi.

Ngati izi sizokwanira kukhala ndi shuga wokwanira, mapiritsi ochepetsa shuga amapatsidwa kwa wodwala. Katswiri yekha ndi yemwe angatenge mankhwala.

Kuyeserera pakudziyesa nokha ndi kumwa mosadziletsa kumangokulitsa matenda.

Nthawi zina dokotala amalembera jakisoni wa insulin kwa odwala omwe ali ndi matenda a shuga a 2. Izi nthawi zambiri zimakhala zakanthawi, ndipo siziyenera kusiyidwa.

Kuwerengera kwa chithunzi chogwirizana ndi matendawa. Kusanthula njira zabwino kwambiri zamankhwala, zamaganizidwe ndi kukonzanso kwa odwala omwe ali ndi matenda ashuga. Chiyanjano cha moyo wapamwamba komanso zamankhwala komanso zamaganizidwe a odwala omwe ali ndi matenda ashuga.

Zolemba zofananira

Matenda a shuga monga amodzi mwa mavuto apadziko lonse lapansi masiku ano. Kusankhidwa kwa mbiri ya odwala omwe ali ndi matenda ashuga a 2005-2007. Mlingo wa kudziletsa mwa odwala omwe ali ndi matenda osokoneza bongo. Kuchepa kwa zovuta. Kuchuluka kwa cholesterol muzakudya.

mapepala 529.4 K, adaonjezera 3/11/2009

Kuwerenga ndikusanthula kukhazikitsidwa kwa ndondomeko za boma pankhani yazachipatala ndi chitetezo cha nzika zokhala ndi matenda a shuga ku Primorsky Territory. Ndondomeko zothandizira kukondera kokonda mankhwalawa kwa Precious National Health Program.

thesis 82.9 K, anawonjezera 05/14/2014

Kuwerenga kwa circadian mtundu wa ochepa matenda oopsa mwa odwala. Kuphatikiza kwa ochepa matenda oopsa ndi matenda osokoneza bongo monga chofunikira chachikulu cha imfa ya odwala kuchokera ku zovuta zamtima. Chikhalidwe chowunikira tsiku lililonse kuthamanga kwa magazi.

mchitidwe wopanga 54.9 K, owonjezera 02.10.2014

Zamankhwala pazovuta za matenda ashuga. Zamakhalidwe azikhalidwe za umunthu wa odwala omwe ali ndi matenda ashuga. Mankhwala othandizira anthu omwe ali ndi vuto la psychosomatic. Mfundo za psychotherapy zamatenda a psychosomatic.

thesis 103.6 K, owonjezera 03/17/2011

Kuwerenga momwe mphamvu ya chokoleti imakhudzira shuga, kuchuluka kwa cholesterol, kulemera kwa thupi, kuthamanga kwa magazi, kugunda kwa mtima. Kusanthula kwa ntchito ya namwino pantchito yosamalira odwala omwe ali ndi matenda ashuga a 2.

thesis 2,2 M, anawonjezera 06/16/2015

Etiology, pathogenesis, magawo okula ndi zizindikiro za matendawa. Njira zamankhwala, kubwezeretsa, kupewa ndi zovuta zadzidzidzi za odwala omwe ali ndi matenda a shuga. Mfundo zoyambirira za zakudya komanso mankhwala. Ubwino wakuchita zolimbitsa thupi.

mapepala a 637.3 K, owonjezera 10.26.2014

Matenda a shuga, mitundu yake ndi zomwe zimayambitsa. Kuunika ndi kuwunika kwa Statistics pakuwonetsa kwa omwe amachitika ndi matenda a shuga mothandizidwa ndi phukusi la STATISTIKA. Kusanthula kwa malumikizidwe ndi kuphatikizika kwakukongoletsa, ndikupanga mawonekedwe angapo osinthira.

mapepala a 1000.6 K, owonjezera 07/06/2008

Unamwino ngati maziko a chisamaliro chothandiza paumoyo. Makhalidwe a shuga. Gulu la ntchito pachipatala ndi kusamalira ana omwe ali ndi matenda ashuga m'madipatimenti apadera. Magulu a ntchito yaamwino.

pepala 470.2 K, kuwonjezera 07/10/2015

Etiology komanso mawonetsedwe azachipatala a matenda ashuga. Mitundu ya malamulo osungira insulin. Lingaliro ndi machitidwe a insulin. Kuwerenga kwa mavuto omwe amapezeka pambuyo pa jakisoni wa insulin. Udindo wa namwino pophunzitsa odwala omwe ali ndi matenda ashuga.

mapepala 30.1 K, owonjezera 1/6/2016

Makhalidwe a shuga ngati vuto lapadziko lonse lapansi. Kusanthula kwamtundu ndi magawo a kukula kwa matendawo. Zolemba za njira ya unamwino mu shuga. Tekinoloje Yosamalira Odwala. Chithandizo choyamba cha chikhalidwe cha hypoglycemic.

mapepala a 509.8 K, owonjezera 08/17/2015

Ntchito zamagulu osungirako zakale zimapangidwa mwaluso malinga ndi zofunikira zamayunivesite ndipo zimakhala ndi zojambula, zojambula, mawonekedwe, etc.
Mafayilo a PPT, PPTX ndi PDF amawonetsedwa pazakale.
Analimbikitsa kutsitsa ntchitoyi.

Zoyambitsa matenda

The etiology ya matendawa imasiyana kutengera mtundu wa matenda.

Matenda a 2 a shuga amayamba chifukwa cha izi:

• chibadwa
• osiyanasiyana kunenepa,
• mimba yoyambirira
• kumangokhala
• mavuto azakudya
• kumwa mankhwala okhala ndi mahomoni
• kutha msinkhu
• matenda a endocrine.

Gulu la matenda

Pathogenesis yamatendawa ndi yovuta pakuyamwa kwa glucose m'maselo a ziwalo, zomwe zimabweretsa kuchuluka kwake m'magazi. Izi zitha kuchitika chifukwa cha kusakwanira kaphatikizidwe ka insulin kapena pamene ma cell receptor amataya chidwi chawo ndi mahomoni.

Kutengera pakusiyana kwa makina a chitukuko cha matenda, matenda opatsirana a shuga agawidwa m'mitundu ingapo:

1. Matenda a shuga 1 amtundu wa shuga amadalira insulin. Amayamba chifukwa chakuwonongeka kwa minofu ya kapamba yomwe imayambitsa insulini. Zotsatira zake, kuchuluka kwa mahomoni osakwanira kumapangidwa ndipo kuchuluka kwa glucose m'madzi a m'magazi kumayamba kuchuluka. Matenda a shuga a Type 1 ndi matenda obadwa nawo ndipo amapezeka makamaka mwa ana ndi achinyamata kuyambira ali ndi zaka 12.
2. Matenda a 2 a shuga ndi njira yodziyimira payokha ya insulin. Pankhaniyi, palibe kuchepa kwa insulin, koma maselo amatenga mphamvu ya mahomoni ndikulowetsedwa kwa glucose mu minofu ndizovuta. Zimayambitsanso kuwonjezeka kwa shuga mthupi. Matenda a shuga a Mtundu Wachiwiri ali mwana samapezeka ndi moyo wonse. Odwala achikulire azaka zopitilira 35- 40 amatha kutenga matendawa.

Psychology imafotokozedwa molingana ndi kuopsa kwa maphunzirowo:

• 1 digiri - mawonekedwe ofatsa omwe ali ndi khola la plasma shuga osapitirira 8 mmol / l,
• 2 digiri - mkhalidwe woyenera komanso kusintha kwa mankhwala a shuga masana ndi ndende yofika 14 mmol / l,
• Giredi 3 - mawonekedwe owopsa ndi kuwonjezeka kwa glucose kuposa 14 mmol / L.

Potengera chithandizo, shuga imasiyana m'magawo:

• gawo la kubwezeretsa - munthawi ya mankhwala, zizindikiro za shuga zimasungidwa pamlingo wovomerezeka,
• gawo lamagawo - kuchuluka pang'ono kwa shuga chifukwa cha mankhwala,
• gawo lowonongeka - thupi sililandira chithandizo chanthawi zonse ndipo shuga imakhala yowonjezereka.

Malangizo a matenda a matenda a shuga ana

Matendawa matenda a shuga amakhalanso akuwonekera ali ana ndipo amakhala achiwiri pafupipafupi kwambiri pamatenda okalamba a ana.

Izi zobadwa nazo komanso zosachiritsika zam'mimba zimayambika chifukwa cha kukanika kwa metabolism ndipo zimadziwika ndi kuwonjezeka kwa kuchuluka kwa shuga m'madzi a m'magazi.

Thanzi la wodwala pang'ono komanso mwayi wokhala ndi zovuta zazikulu zimadalira kuzindikira kwakanthawi ndi chithandizo.

Kuzindikira ndi kuchiza matenda a shuga a mtundu wachiwiri

Association of General Practitioners (Family Madokotala) a Russian Federation

DIAGNOSIS, KUTHENGA NDI KULENGA

POPHUNZITSIRA MITUNDU YA ASILI

Madivelopa: R.A. Nadeeva

2. Makhodi malinga ndi ICD-10

3. Epidemiology ya matenda ashuga a 2

4. Zinthu ndi magulu omwe ali pachiwopsezo

5. Kusanthula mtundu 2 shuga

6. Gulu la anthu odwala matenda ashuga. Zofunikira pakapangidwe kazomwe zimayambitsa matenda ashuga.

7. Mfundo zofunika kuzindikiritsa matenda akulu muzochitika. Kusiyanitsa mitundu.

8. Njira zoyesera kuti adziwe matenda oyamba

9. Kugawika kwa zovuta za matenda ashuga.

10. Mfundo zazikuluzikulu za chithandizo chamankhwala

10.1. Algorithm yosankha payekha zolinga za HbA1c

10.2. Zizindikiro za lipid metabolism control

10.3. Kuyang'anira Kuthamanga Kwa Magazi

10.4. Kusintha kwamoyo

10.5. Mankhwala

10.6. Kukonzekera kwa njira zamankhwala kutengera HbA1c yoyambirira

10.7. Mankhwala a insulin a matenda a shuga 2.

10.8. Zida zamankhwala a matenda a shuga a 2 pakukalamba.

10.9. Zokhudza chithandizo cha matenda amishuga amtundu wa 2 mwa ana ndi achinyamata.

10.10. Zida zamankhwala a shuga 2 amayi oyembekezera.

11. Zizindikiro za upangiri waukadaulo

12. Zizindikiro zakuchipatala

13. Kupewa. Maphunziro odwala

15. Kuyang'anira odwala omwe ali ndi matenda a shuga a 2 popanda zovuta

AH - matenda oopsa

aGPP-1- glucagon-ngati peptide agonists 1

HELL - kuthamanga kwa magazi

GDM - matenda a shuga

DKA - matenda ashuga ketoacidosis

DN - matenda ashuga nephropathy

DR - matenda a shuga a retinopathy

IDDP-4 - dipeptyl peptidase inhibitors

ICD - yochepa-insulin (kopitilira muyeso) insulin

BMI - index yamasamba amthupi

IPD - insulini yapakatikati (yayitali)

NGN - kuphwanya glycemia

NTG - kulolerana kwa shuga

PGTT - mayeso a kulolera glucose

PSSP - mankhwala amkamwa a hypoglycemic

RAE - Russian Association of Endocrinologists

Matenda a shuga

MSP - mankhwala ochepetsa shuga

TZD - thiazolidinediones (glitazones)

CKD - ​​matenda a impso

XE - mkate mkate

HLVP - kwambiri kachulukidwe lipoprotein cholesterol

HLNP - otsika kachulukidwe lipoprotein cholesterol

HbA1c - hemoglobin wa glycosylated

Matenda a shuga mellitus (DM) ndi gulu la matenda a metabolic (metabolic) omwe amadziwika ndi matenda a hyperglycemia, omwe amachitika chifukwa cha kubisala kwa insulin, zotsatira za insulin, kapena zina mwazinthu izi. Matenda oopsa a hyperglycemia mu shuga amaphatikizidwa ndi kuwonongeka, kusagwira ntchito komanso kusakwanira kwa ziwalo zosiyanasiyana, makamaka maso, impso, mitsempha, mtima ndi mitsempha yamagazi.

E10 wodwala matenda a shuga a insulin

E11 Matenda a shuga osadalira insulin

E12 Matenda a shuga

E13 Mitundu ina yachilendo ya matenda a shuga

E14 Matenda a shuga, osadziwika

Matenda a shuga a O24

R73 glucose wambiri

(zimaphatikizira kulekerera kwa glucose ndi kusala kudya kwa glucose)

3. Epidemiology ya matenda ashuga a 2.

Pazonse zomwe zimapangidwira shuga, mtundu 2 shuga ndi 90-95%. Pazaka 30 zapitazi, kuchuluka kwa anthu odwala matenda ashuga kwaturukira matenda opatsirana monga chifuwa chachikulu komanso kachilombo ka HIV.

Chiwerengero cha odwala matenda ashuga padziko lonse lapansi pazaka 10 zapitazi chachulukirapo kuposa pamenepo ndipo wafika anthu 371 miliyoni pofika chaka cha 2013. Kukula kwachulukidweko kudapangitsa United Nations mu Disembala 2006 kukhazikitsa lingaliro lopempha "kukhazikitsidwa kwa mapulogalamu amtundu woletsa, kuchiza komanso kupewa matenda ashuga komanso zovuta zake komanso kuphatikizidwa kwawo m'mapulogalamu azaumoyo aboma."

Malinga ndi State Register of Patients ndi matenda a shuga kuyambira Januware 2013 ku Russia, pali odwala 3.779 miliyoni omwe ali ndi matenda a shuga pankhani yofikira kuzipatala. Komabe, kuchuluka kwakeko kumakhala kokwirikiza 3-4 kuposa kolembetsa “mozungulira”. Omwe ali pafupifupi 7% ya anthu. M'madera ambiri ku Europe, kuchuluka kwa matenda ashuga a 2 ndi 3-8% (palimodzi ndi kulekerera kwa glucose - 10-15%).

Zotsatira zowopsa za mliri wapadziko lonse wa anthu odwala matenda ashuga ndizovuta zake zamitsempha - nephropathy, retinopathy, kuwonongeka kwa ziwiya zikuluzikulu za mtima, bongo, zotumphukira zamagawo am'munsi. Izi ndi zovuta zomwe ndizomwe zimayambitsa kupunduka komanso kufa kwa odwala omwe ali ndi matenda ashuga.

4. Zinthu ndi magulu omwe ali pachiwopsezo.

Zomwe zimayambitsa matenda a shuga a 2

- Kunenepa kwambiri komanso kunenepa kwambiri (BMI≥25 kg / m2 *).

- Mbiri ya mabanja a matenda ashuga (makolo kapena abale ake omwe ali ndi matenda ashuga a 2)

-Mwadzidzidzi kuchita masewera olimbitsa thupi.

- Kuchepa kwamatumbo glycemia kapena mbiri yovuta ya kulolera kwa shuga.

-Gestationalabetes mellitus kapena kubadwa kwa mwana wosabadwa m'mbiri.

-Arterial Hypertension (≥140 / 90 mm Hg kapena mankhwala a antihypertensive).

- HDL cholesterol ≤0.9 mmol / L ndi / kapena triglyceride level ≥2.82 mmol / L.

Njira yoyamwitsa ndiyofunika kwambiri m'magawo oyamba azindikira matenda a shuga kwa ana.

Namwino amathandizanso pakupeza zofunikira kuti apange chithunzi chowoneka bwino cha zomwe zimayambitsa matendawa, amatenga nawo mbali pakukonzekera wodwalayo maphunziro a labotale komanso othandizira, komanso amapereka chithandizo cha unamwino pochiza kuchipatala komanso kunyumba.

Mtundu wachiwiri wa matenda a shuga a mellitus (osadalira insulini) ndi matenda omwe amadziwika chifukwa chopanga michere m'thupi. Munthawi yabwinobwino, thupi la munthu limatulutsa insulin (mahomoni), yomwe imasokoneza glucose m'maselo opangira tinthu tathupi tathupi.

Mu maellitus osadalira shuga omwe amadalira insulin, maselo awa amasulidwa mothandizidwa kwambiri, koma insulini sogawa mphamvu molondola. Pankhaniyi, kapamba amayamba kudzipangira ndi kubwezera. Kuchuluka kwa chimbudzi kumachepetsa maselo amthupi, shuga yotsala imadziunjikira m'magazi, ndikupanga chizindikiro chachikulu cha matenda ashuga a 2 - hyperglycemia.

Type 1 matenda a shuga a insulin

Malangizo azachipatala okhudzana ndi matenda ashuga mwa ana zimadalira mtundu wa matenda omwe apezeka.

Malangizo ofunikira ndi awa:

• mankhwala
• chakudya
• zochita zolimbitsa thupi,
• physiotherapy.

Ndi matenda a mtundu 1, maziko a mankhwalawa ndi insulin. Zingwe zimapangidwa pansi pa khungu ndi syringe kapena pampu ya insulin. Khungu limatsukidwa kale ndikakonzedwa ndi zakumwa zoledzeretsa.

Homoni imayenera kuperekedwa pang'onopang'ono ndipo ndikofunikira kusintha malo omwe ali ndi jekeseni, kupewa kulowa m'thupi limodzi.

Jekeseni amatha kuchitira khola la m'mimba, ma umbilical dera, ntchafu, pamphumi ndi phewa.

Dokotala amawerengetsa kuchuluka ndi jakisoni wa tsiku ndi tsiku, ndipo dongosolo la insulin yoyang'anira liyenera kuyang'aniridwa mosamala.

Kuphatikiza apo, mankhwalawa amatha kuikidwa:

• othandizira othandizira
• anabolic steroids
• anti-yotupa ndi antibacterial mankhwala,
• anzawo ochepetsa
• Kukonzekera kwa sulfonylurea
• zovuta za mavitamini.

Kugwirizana ndi zakudya ndizofunikira pamoyo wa wodwala pang'ono.

Mfundo zazikuluzikulu za kadyedwe ndi izi:

• zakudya zitatu zazikuluzikulu ndi zakudya zazakudya zitatu tsiku lililonse,
• mafuta ambiri ali mu theka loyamba la tsiku,
• chotsani shuga ndikuisintha ndi zotsekemera zachilengedwe,
• kukana kudya zakudya zamafuta oopsa, maswiti ndi zakudya zamafuta,
• chotsani makeke ndi zinthu zophika ufa wa tirigu muzakudya,
• Chepetsa zipatso zako,
• yambitsani zatsopano zamasamba, masamba, zipatso ndi zipatso zopanda zipatso.
• sinthani mkate Woyera ndi rye kapena ufa wathunthu,
• nyama, nsomba ndi mkaka zizikhala zochepa m'mafuta,
• kuchepetsa mchere, zonunkhira ndi zonunkhira zotentha m'zakudya,
• Imwani tsiku lililonse madzi abwino ofunika kuti madzi asungidwe bwino, pamlingo wa 30 ml pa kilogalamu ya kulemera.

Zakudya zopatsa thanzi ziyenera kukhala njira ya moyo ndipo zikhala zofunikira kuzitsatira pafupipafupi. Mwana wachikulire ayenera kuphunzitsidwa maluso a kuwerengera XE (magulu a buledi) ndikugwiritsa ntchito syringe kapena cholembera cha insulin.

Pokhapokha ngati mutachita izi, mutha kukhalabe ndi shuga wambiri m'magazi am'magazi ndikuyembekeza moyo wa mwana.

Monga lamulo, ngati wodwala ali ndi matenda amtundu woyambirira, ndiye kuti kuvomerezedwa kwakukulu kwa dokotala kungakhale kugwiritsa ntchito insulin. Tiyenera kumvetsetsa kuti dongosolo la insulin mankhwala liyenera kukhala lothandiza komanso loyenera kwa wodwala wina.

Nthawi zambiri, insulin yokwanira imagwiritsidwa ntchito pochiza, ndiye kuti, tsiku ndi tsiku mlingo wa insulin umagawidwa ma Mlingo angapo, pomwe:

• ndi gawo limodzi la insulini, muyenera kutaya shuga onse omwe akubwera,
• Mlingo wa insulin uyenera kutengera kutuluka kwa kapamba.

Mankhwala a insulin ali ndi kuyambitsa kwa mankhwala, nthawi yomwe amasiyana.

M'mawa komanso asanagone, wodwalayo amapaka jekeseni wa insulin wa nthawi yayitali, ndipo atatha kudya, ma insulin omwe amagwiritsidwa ntchito mwachidule amagwiritsidwa ntchito. Mlingo wa insulin nthawi zonse umakhala wosiyana, ndipo zimatengera kuchuluka kwa shuga m'magazi ndi zakudya m'zakudya zomwe zimamwa.

Insulin imalowetsedwa ndi syringe yachipatala. Pitani ndi cholembera chapadera. Wodwala aliyense yemwe ali ndi matenda amtundu wa 1 azikhala ndi ma cholembera kutaya boma.

Zakudya za anthu omwe ali ndi matenda amtundu wa 1 saizi ndizosiyana ndi zomwe zimachitika, ndiye kuti, mapuloteni, mafuta ndi chakudya zimayenera kuperekedwa chimodzimodzi monga momwe zimakhalira ndi munthu wathanzi. Nthawi zambiri, kuti adziwe kuyamwa kwa chakudya chamafuta, madotolo amagwiritsa ntchito dongosolo lama mkate.

Ndi matenda amtundu woyamba 1, pafupifupi wodwala aliyense amapatsidwa masewera olimbitsa. Kugwiritsa ntchito kwake sikungachepetse shuga m'magazi, koma kumathandizira kukonza mkhalidwe wa wodwalayo. Pali nthawi zina pomwe zochitika zolimbitsa thupi zaphwanya.

Ngati mtundu wa 2 wodwala matenda a shuga ayamba kupita patsogolo, ndiye kuti madokotala amachenjeza za kufunikira kwa mankhwala a insulin.

Galvus - malangizo ogwiritsira ntchito, mayankho pamafunso omwe amafunsidwa kawirikawiri zokhudzana ndi mankhwalawa

Komanso, malangizo azachipatala omwe dokotala amapereka pofufuza matenda a shuga ndi monga kuchita zolimbitsa thupi.

Maphunziro opangidwa mwaluso amathandizira:

• yogwira kagayidwe kachakudya,
• kuwonda
• kukhalabe kwachilendo kugwira ntchito kwa mtima dongosolo.

Zochita zimasankhidwa ndi adokotala. Amawongolera magawo monga m'badwo wa wodwalayo, matendawa ndi momwe zinthu zilili. Nthawi yolipiritsa wamba imachokera ku theka la ola mpaka ola. Chiwerengero chochepa kwambiri cha zolimbitsa thupi pamlungu ndi katatu.

Galvus ndi othandizira a hypoglycemic omwe amapanga kuti azilamulira matenda a shuga a mtundu 2. Gawo loyambirira la mankhwalawa ndi vildagliptin. Mankhwala amamasulidwa monga mapiritsi. Madokotala komanso odwala matenda ashuga adalandila ndemanga zabwino kuchokera kwa Galvus.

Imayendetsa mwamphamvu kagayidwe ka insulin ndi glucagon. European Antidiabetesic Association imati Galvus mu monotherapy ndikofunikira kuti agwiritse ntchito pokhapokha ngati metformin itaperekedwa kwa wodwala. Kwa odwala matenda a shuga omwe amadalira insulin omwe ali ndi matenda amtundu wa 2, Galvus amathandizira kuchepetsa kuchuluka kwa ziwengo ndi kuchuluka kwa insulin.

4-5.11. Msonkhano wachiwiri ku Russia ndi kutenga nawo mbali padziko lonse "matenda ashuga: micro- ndi microvascular complication" udzachitika

Kuchuluka kwa shuga m'magazi kumapangitsa kuti pakhale zovuta komanso zovuta zovuta. Zotsatira zoyipa zimapangidwa m'masiku ochepa komanso maola angapo, ndipo mwanjira iyi, thandizo lachipatala lofunikira limafunikira, apo ayi chiopsezo cha kufa chikuwonjezeka.

Federal State Budgetary Institution "Endocrinological Science Science Center" ya Unduna wa Zaumoyo ku Russia ndi gulu la bungwe la "Russian Association of Endocrinologists" alengeza

Msonkhano Wachiwiri Waku Russia Ndi Kutenga Mtima Kwapadziko Lonse "Matenda A shuga: Macro- and Microvascular Complication"

DATE: Novembala 4-5

Kulandila izi: mpaka Seputembara 25,

KULAMBIRA KWA PRELIMINARY: mpaka Okutobala 01,

VENUE: Moscow, st. Dmitry Ulyanov, Kumanga 11, Kumanga 3 (FSBI Endocrinological Research Center of the Russian Ministry of Health)

Zakudya za shuga

Zakudya za anthu odwala matenda ashuga ndi njira yofunikira kwambiri yothandizira (kupewa) matendawa, kupewa zovuta komanso zovuta. Kodi mumasankha zakudya ziti, zomwe zimachitika zimadalira.

Muyenera kusankha zakudya zomwe muzidya ndi zomwe simumazipatula, kangati patsiku komanso nthawi yanji, komanso ngati mungawerengere ndi kuchepetsa zopatsa mphamvu. Mlingo wa mapiritsi ndi insulin amasinthidwa ku zakudya zomwe zasankhidwa.

Zolinga zakuchiza matenda amtundu wa 2 komanso mtundu wachiwiri wa shuga ndi:

• khalani ndi shuga m'magazi panthawi yovomerezeka,
• kuchepetsa chiopsezo cha matenda a mtima, sitiroko, zovuta zina zopweteka komanso zopweteka,
• khalani ndi khazikika, kukana chimfine ndi matenda ena,
• kuchepa thupi ngati wodwala wakulemera kwambiri.

Kuchita masewera olimbitsa thupi, mankhwala, komanso jakisoni wa insulin kumathandiza kwambiri kukwaniritsa zolinga zomwe tafotokozazi. Komabe zakudya zimabwera koyamba.

Tsamba la Diabetes-Med. Com amagwira ntchito popititsa patsogolo chakudya chamagulu am'thupi mwa odwala olankhula Chirasha omwe ali ndi matenda amtundu wa 2 komanso a 2.

Zimathandizadi, mosiyana ndi zakudya 9. Zambiri patsamba lino ndizotengera zomwe dokotala wotchuka waku America, Richard Bernstein, yemwe adakhala ndi matenda ashuga amtundu woyamba kwa zaka zopitilira 65.

Iye, wopitilira zaka 80, akumva bwino, akuchita maphunziro akuthupi, akupitilizabe kugwira ntchito ndi odwala komanso kufalitsa nkhani.

Mitundu ya Matenda A shuga

Matenda a shuga a Type 1 amadziwika ndi insulin chifukwa cha kuwonongeka kwa maselo a pancreatic beta, zomwe zimapangitsa kuti pakhale kusowa kwathunthu kwa mahomoni. Nthawi zambiri mawonekedwe amtunduwu amapezeka mwa achinyamata, amapatsa zizindikiro: polyuria, kuchepa thupi, kukula kwa ketosis, ludzu lalikulu.

Komabe, matenda ashuga amtundu 1 amatha kuchitika pazaka zilizonse, ndikupita patsogolo pang'onopang'ono. Ndi matenda a shuga a autoimmune mu akulu, kuperewera kwa insulin kumakula pakapita zaka. Odwala omwe amapanga ma pancreatic beta-cell autoantibodies, chiwonetsero cha matenda oopsa a shuga kapena kukula kwake kosachedwa kutha kuonedwa.

Matenda a 2 a mtundu wa 2 amadziwika chifukwa cha kusowa kwa maselo a beta, omwe amadziwika ndi kunenepa kwambiri kosiyanasiyana, kumangokhala. Poyamba, mapangidwe a insulini amakhala ndi vuto, lomwe limayambitsa matenda a postprandial hyperglycemia. Pambuyo pa izi, kusala kudya kwa hyperglycemia kumachitika.

Matenda a 2 a mtundu wa shuga nthawi zambiri amapezeka mwa odwala okalamba, pafupifupi 90% ya odwala matenda ashuga ali ndi matenda amtunduwu. Pamene kunenepa kwambiri kufalikira, madokotala amati:

1. wachichepere asanayambike matenda a shuga 2,
2. chiwonetsero choyambirira cha matendawa.

Pali mtundu wina wa matenda ashuga - gestational, umayamba mwa azimayi panthawi yoyembekezera. Chiwopsezo chokhala ndi matenda a shuga a 2 chikuwonjezereka mwa azimayi omwe anali ndi vuto la shuga m'magazi atanyamula mwana.

Mitundu ina yapadera yamatendawa: matenda amodzi omwe amasintha, matenda ashuga, shuga kapena mankhwala osokoneza bongo.

National Register of Diabetes imangotsimikizira izi.

Kodi zingakhale zovuta ziti

ShugaManWomenSomenShuga yanu kapena sankhani jenda kuti mupeze ndemangaLevel0.58 Kuyang'ana osapezedwaTchulani zaka za manAge45 KusakaNot anapezaYambirani zaka za mkaziAge45

Monga momwe zadziwika kale, ngozi sikuti ili ndi matenda omwewa, koma ndi zovuta zake, ndipo matendawa atha kukhala osiyanasiyana mosiyanasiyana. Nthawi zambiri, wodwalayo amadandaula chifukwa cha kuwonongeka msanga kwa kukumbukira zinthu, kusokoneza ubongo, kusintha thupi.

World Health Organisation (WHO) imati wodwala yemwe ali ndi matenda ashuga posachedwa amasokoneza momwe amagwirira ntchito urogenital, azimayi omwe ali ndi msambo amatha kusokonezeka msambo, mkazi amatha kukhala osabereka, ndipo bambo amatha kubereka.

Vuto lowopsa la matendawa lidzakhala kuchepa kwamawonedwe, kutayika kwake konse ndi khungu sizikuwonetsedwa. Ndi kusokonezeka kwa shuga m'magazi, mavuto akulu amayamba ndi mano, mkamwa, khungu, chiwindi, impso. Wodwala posakhalitsa amasiya kumva kutentha ndi kutentha kochepa, kupweteka kwamitundumitundu yosiyanasiyana.

Odwala omwe ali ndi vuto lakale la matenda ashuga:

• kuyanika kwambiri pakhungu,
• mawonekedwe a zilonda, ming'alu ndi zotupa zina pakhungu.

Kuphatikiza apo, kufalikira kwa magazi kumachepa kwambiri, mapangidwe amitsempha yamagazi amatayika. Mwa odwala matenda ashuga, patapita zaka, malekezero ochepa amakhala opunduka, mavuto akulu amapezeka mbali ya mtima. Chifukwa cha kufooka kwa magazi, pali chiopsezo chokhala ndi matenda am'mimba, matenda am'mimba, ndipo chifukwa chake - kudulanso mwendo. Monga lamulo, izi zimachitika ndikupanga matenda ashuga oyambilira kapena achiwiri mwa amuna okulirapo zaka 50.

Ngati kuli kovuta kupewa matenda a shuga a mtundu woyamba, ndiye kuti ndizotheka kupewa matenda amtundu wachiwiri, chifukwa bungwe la WHO lapereka malangizo kwa odwala omwe ali ndi matenda a shuga komanso kwa odwala omwe akufuna kuletsa kupitirira kwa vuto la matenda. Izi ndizowona makamaka kwa odwala omwe ali ndi vuto la glycemia komanso kuwonjezereka kwa ndende yamagazi, izi zimachitika:

1. ndi chikhalidwe cholakwika
2. ndi matenda a kapamba.

Mutha kudziteteza ku matenda a shuga a 2 ngati mungatsatire malangizo onse a madokotala.

Njira zopewera matenda ashuga

Ngati mumangotaya zomwe zimayambitsa hyperglycemia, zomwe munthu sangathe kuzikopa, ndiye kuti zingatheke kupewa matenda ashuga pafupifupi 99% ya milandu. Endocrinologists amalimbikitsa kuti odwala amayesera kuchepetsa thupi ngati pali zochuluka.

Ngati muchepa thupi ndi kilogalamu osachepera 5, mutha kuthana ndi matenda 70% nthawi yomweyo.

Madokotala amalangiza anthu kuti azitsatira moyo wathanzi, masewera olimbitsa thupi, chifukwa njira zotere nthawi zonse zimakhala zopindulitsa.

Zitha kukhala zokwanira tsiku lililonse:

• kuyenda kwakutali
• kukwera njinga
• kuthamanga.

Katundu wotere amalimbitsa zida zathupi zam'mimba, komanso zimathandizira kuti ziwonetsero zamagulu zikhale bwino. Madokotala amatsimikizira kuti njira zomwe zafotokozedwerazi zimachepetsa chiopsezo cha matenda ashuga. Kuchita masewera olimbitsa thupi kwa mphindi 30 patsiku kumachepetsa mwayi wokhala ndi shuga ndi 80%.

Mukamayenda, kukhathamiritsa kwa insulin ya mahomoni kumayenda bwino, kumalowa mkati mwa maselo. Chifukwa chake, kudzikundikira kwa glucose kumaphwasulidwa ndikuchotsedwa ndi gluing makoma amitsempha yamagazi.

Njira inanso yomwe yalimbikitsidwa ndi WHO (World Health Division) ndikugwiritsa ntchito mbewu zosagwiritsidwa ntchito ngati chimanga. Koma musanagwiritse ntchito chakudya chotere, muyenera kuzolowera momwe zimapangidwira, pezani index ya glycemic, shuga. Pali maupangiri ena a odwala matenda ashuga momwe angapewere matenda ashuga ndi zovuta zake.

Kukula kwa matenda ashuga a mtundu wachiwiri kungathandize kupewe kusiya chizolowezi chodya zakudya zosavuta, chifukwa chakudya chotere sichingovulaza. Ndikofunikanso kupatula:

• chakudya chofulumira
• Zakudya zamtundu uliwonse
• zinthu zina zamafakitale.

Zimafunikira kusiya nyama yamafuta, ndikuisintha nkhuku, masamba osaphika. Madokotala amati kulumikizana pakati pa shuga ndi nyama zamafuta kuyenera kufunidwa mu cholesterol yambiri. Pokhapokha zinthuzi m'magazi, zimatha kukhala bwino komanso kupewa matenda ashuga.

Cinnamon imathandiza anthu ambiri omwe ali ndi matenda ashuga, kutha kwake kwatsimikiziridwa ndi maphunziro ambiri asayansi. Kwa iwo omwe amamwa sinamoni, kuthekera kwa matenda a shuga ndi kusintha kwamatenda a glycemic kutsika pafupifupi 10%. Zotsatira zabwino zoterezi zitha kufotokozedwa mosavuta ndi kukhalapo kwa puloteni yapadera pakupanga sinamoni, yomwe imakhudza thupi, komanso imathandizira kuti maselo azigwirizana bwino ndi insulin. Chifukwa chake, kulimbikitsidwa ndi madokotala - ndikofunikira kuphatikiza sinamoni muzakudya kuti muchepetse matenda a shuga.

Ndikofunikanso kupumula nthawi zonse, kupeza nthawi yogona, komanso kupewa nkhawa, zomwe zingathandizenso wodwalayo. Ngati simutsatira lamulo lotere, thupi limayamba kudziunjikira mphamvu yankho, limangokhalira kusokonezeka, kupweteka kwa munthuyo kumakulirakulira, mutu wake umapweteka, ndipo kukhumudwa kopanda pake kumatha. Njira yomwe akutsimikizirayo ndiyabwino kwambiri popewa zoyambitsa ndi zizindikiro za matenda ashuga odwala azaka zilizonse.

Kuthana ndi nkhawa kungakuthandizeni:

• makalasi a yoga (ochita masewera olimbitsa thupi adzadzutsa thupi, kukhazikitsa ntchito yoyenera),
• chitani chilichonse osathamangira (musanachite chilichonse chikusonyezedwa kuti mupuma pang'ono ndi kutulutsa mpweya),
• kupatula nthawi yopuma (kamodzi pa sabata ndikofunika kuti muchotse tsiku popanda kuganizira mavuto).

Ndikofunikanso kugona mokwanira, kugona sikofunikira kwambiri kwa munthu, ndi muyeso wabwino kwambiri kupewa matenda a shuga. Pafupifupi, muyenera kugona kuyambira maola 6 mpaka 8 patsiku, ngati munthu sagona mokwanira, mwayi wokhala ndi matenda osokoneza bongo ukuwonjezeka pafupifupi kawiri. Komanso, kugona nthawi yayitali kumavulazanso, kukhala nthawi yogona maola opitilira 8 patsiku kumakulitsa chiopsezo cha hyperglycemia nthawi katatu.

Kuyankhulana pafupipafupi ndi anthu am'banja kungathandize ndi matenda a shuga a 2. Madokotala azindikira kuti odwala omwe ali osungulumwa amakhala ndi vuto lochulukirapo, izi zimangokulitsa mkhalidwe wawo.

Ndikulimbikitsidwa nthawi ndi nthawi kuyeza zizindikiro za shuga m'magazi, zimachitika kuti matenda ashuga amapezeka mwanjira yaposachedwa, samapereka mawonekedwe. Kuti mudziwe zam'mbuyomu m'miyeso yoyambirira, muyenera kuchita zoyeserera za shuga.

Ndikwabwino kupereka magazi kamodzi pachaka.

Diagnostic Algorithm

Wodwala amayenera kuwunika glycemia tsiku lililonse, osachepera kanayi pa tsiku. Pereka magazi osachepera 1 pa kotala lililonse kuti mupeze hemoglobin wa glycated. Pakupita miyezi isanu ndi umodzi, mudzafunika kuyesa magazi ndi mkodzo wa shuga. Kamodzi pachaka, wodwalayo amapereka magazi kuti apange biochemistry.

Maupangiri a matenda ashuga amtunduwu amagwirizana ndi malangizo a WHO. Kafukufuku wa WHO adawonetsa kuti matenda ashuga si amtundu wokha, komanso chodabwitsa chapadziko lonse lapansi. Bungweli lakhazikitsa malangizo othandizira odwala matenda amtundu wa matenda a shuga 1 ndi mtundu wa 2 paumoyo wawo. Malangizowa amapereka njira zoyenera zodziwira matenda ashuga komanso kupereka thandizo kwa odwala. Mu 2017, gulu logwira ntchito la asing'anga linapanga kope la 8 la "Algorithms la chithandizo chapadera chazachipatala kwa odwala matenda ashuga."

Ndi matenda omwe apezeka, anthu odwala matenda ashuga ayenera kutsatira malangizo a madokotala. M'pofunika kuchepetsa kulumpha mu kuthamanga kwa magazi. Algorithm yodziwitsa amatanthauza kukhazikika kwa odwala matenda ashuga moyang'aniridwa ndi dokotala. Dokotala atha kukupatsirani mankhwala. Kuti mupeze matenda olondola, muyenera kuyesedwa. Anthu odwala matenda ashuga amafunika kuwunika kwa peritoneum, kuwongolera magazi kwa a Holter. Ndikofunika kuti wodwalayo azitha kukaonana ndi ophthalmologist, cardiologist, gynecologist kapena urologist, neurologist ndi geneticist (ngati pali zovuta zina).

Zakudya za Matenda A shuga

Masiku osala kudya ndi kudya, omwe ali ndi matenda amtunduwu, amaphatikizidwa pazofunikira.

Lamulo lalikulu sikuti muzilumpha kudya ndi kudya pang'ono, koma nthawi zambiri (nthawi 5-6 patsiku). Masiku okusala a shuga amafunika. Kwa odwala omwe amadalira insulin, ndikofunikira kuti mulingo wa insulin ukhale wokhazikika. Wodwala amafunika kupatula zakudya zomwe zili ndi shuga mu zakudya. Pankhani yokhala ndi matenda a shuga a mtundu wachiwiri, amatsata zakudya zapadera - tebulo Na. 9. Chakudya choterocho chimalola kukula kwa shuga m'magazi.

Samalani kuchuluka kwa mafuta, mapuloteni komanso chakudya chamagulu menyu. Chakudya chopatsa thanzi sichikhala choposa 60% cha zakudya zomwe zimadyedwa, ndipo mapuloteni ndi mafuta sayenera kukhala oposa 20%. Wodwalayo samasiyanitsidwa ndi mafuta a nyama ndi zakudya zosavuta zamagulu. Mwa ana omwe ali ndi matenda ashuga, chakudyacho chimatha kusenda. Anthu odwala matenda ashuga amakonda zakudya monga chimanga (buckwheat, mpunga, tirigu), masamba ndi zipatso zopanda shuga.

M'malo mwa shuga, ndibwino kugwiritsa ntchito shuga mmalo - xylitol ndi sorbitol, saccharin kapena fructose. Anthu odwala matenda ashuga amawerengetsa zakudya zopatsa mphamvu ndikusunga diary ya chakudya. Mukatha kudya, wodwala matenda ashuga amatha kumwa insulin pambuyo mphindi 15. Type 1 shuga mellitus imakupatsani mwayi woti nthawi zina mumamwa 100-150 g owuma kapena vinyo wa patebulo (osaposa 5% mphamvu). Mtundu wachiwiri wa matenda ashuga, mowa umapindika. Zogulitsa zapadera za anthu odwala matenda ashuga zimagulidwa m'misika.

Zakudya za anthu odwala matenda ashuga - zotsekemera, maswiti, m'malo mwa mkaka - ndizoyenera kwa odwala omwe ali ndi matenda amtundu uliwonse. Amakulolani kuti musiyanitse mndandanda wa anthu odwala matenda ashuga.

Matenda a shuga mwa amayi apakati

Kwa amayi apakati omwe ali ndi matenda amtundu woyamba, kufunika kwa insulin panthawi zosiyanasiyana za pakati ndikusiyana. Ndizotheka kuti kwa nthawi yayitali mkazi amatha kupanga jakisoni.

Ndi dokotala yekhayo amene angasinthe kuchuluka kwa jakisoni ndikusankha mankhwala.

Kusintha kwa zakudya kukufunanso, chifukwa munthawi ya bere, kufunika kwa michere kumachulukanso. Gulu lina ndi matenda ashuga omwe amachitika nthawi yoyembekezera. Pankhaniyi, insulini sinafotokozedwe, ndipo shuga yokhazikika imakhazikika pogwiritsa ntchito chakudya.

Ngati mayi wapakati azitsatira zonse zomwe dokotalayo walonjeza, zimapatsa mphamvu kagayidwe kazomwe zimaberekanso zimakhazikika mwana akabadwa.

Matenda a shuga

Matenda a shuga ndi amodzi mwa zovuta za matenda ashuga. Chizindikiro chake chachikulu ndikusintha kapangidwe ka minofu ya miyendo. The oyamba oyambitsa matendawa akumwetulira m'miyendo, kusinthika kwa khungu, pang'ono kuwonongeka.

Ngati palibe chochitapo, matendawa amapita patsogolo. Zilonda zopyapyala zimawoneka pamiyendo, kuchiritsa movuta kwambiri. Kujowina kachilomboka kungapangitse kukula kwa gangore, mpaka pakufa kwa wodwalayo.

Kupewa kwa matenda ashuga kumaphatikizapo.

• ukhondo wabwino wamapazi
• kudzilimbitsa tsiku ndi tsiku kuti magazi azisinthasintha,
• kupenda pafupipafupi miyendo ngati abrasions yaying'ono ndi kuvulala,
• kuvala nsapato zabwino popanda chidendene,
• Kuthira khungu la kumapazi pafupipafupi ndi lothira kapena mafuta osiyanasiyana kuti musayime.

The endocrinologist pa kufunsira amawunika momwe khungu limakhalira ndipo ngati kuli koyenera, amapereka mankhwala omwe amapangitsa kuti magazi azikhala mwamtambo.

Zovuta za impso ndi maso: momwe mungapewere

Vuto linanso la matenda ashuga ndi matenda ashuga. Masewera amadzimadzi ambiri, mamasukidwe amwazi amawonjezereka, ndikusintha ndi impso ndizovuta.

Ngati izi zimayendera limodzi ndi matenda oopsa, pamakhala chiopsezo chachikulu chotenga kulephera kwa impso. Poterepa, wodwalayo adzafunika zida "zopangira impso" kuti akhale ndi moyo.

Kuti mupewe zovuta, muyenera:

• khalani ndi shuga pamulingo womwe umayang'aniridwa, kuyang'anira shuga nthawi zonse,
• kuchepetsa kuchuluka kwa mchere womwe umatha. Izi zimapewa edema ndikukhalabe ndi magazi abwinobwino,
• pewani cholesterol yambiri "yoyipa" m'magazi,
• musiyiretu kusuta ndi kumwetsa mowa.

Izi ndi njira zabwino zopewera mtima ndi matenda a mtima.

Matenda a mtima ndi stroko odwala matenda ashuga amakhala olimba kwambiri ndipo amawopseza zotsatira zoyipa. Pafupipafupi komanso zovuta zomwe zimagwirizanitsidwa ndi maso. Kusintha kwa retina motsutsana ndi maziko a matenda ashuga kumayambitsa kutsika kwa mawonekedwe, mpaka khungu. Retinopathy sitingapewe, koma kupititsa patsogolo kwake kumachepetsedwa.

Makanema okhudzana nawo

Zokhudza njira zopewera matenda a shuga mu kanema:

Matenda a shuga ndi matenda omwe amasinthiratu moyo wa munthu. Komabe, kutsatira malingaliro a madotolo ndikuwongolera kukhala bwino kumakupatsani mwayi wophunzirira momwe mungakhalire ndi izi. Ndi matenda opatsirana a shuga, thanzi la wodwalayo limakhala labwino, ndipo zovuta zake ndizochepa.

Zolemba Zina

Padziko lapansi lero pali mliri wa matenda osokoneza bongo - kuchuluka kwa milandu kukukula mwachangu, pomwe zaka zopezeka ndi matendawa zikuchepa. Izi zikufunika kuti boma liyambitse mapulogalamu apadera olimbikitsira moyo wathanzi komanso kupewa matenda ashuga ndi matenda ena okhudzana nawo.

Matenda a shuga ndi matenda oopsa a metabolic omwe amakhala ndi shuga wambiri.

Izi zimachitika mwina chifukwa chophwanya kapangidwe ka insulin ndi kapamba, kapena chifukwa chophwanya zochita za insulin, kapena chifukwa cha zinthu zonsezi.

Tikukuwuzani matenda ashuga, malingaliro azachipatala omwe amathandiza katswiri kudziwa ndi kuperekera chithandizo choyenera, chomwe chingapangitse wodwalayo kukhala ndi moyo wabwino.

Zizindikiro za matenda ashuga za ICD-10

Njira yodwala matenda ashuga

Mayendedwe amtundu wa shuga wachiwiri akuphatikizanso kutsatidwa kwa odwala. Ma regimenti a tsiku ndi tsiku amakulolani kuti muzisonkhanitsidwa, osati kudya kwambiri komanso kukhala olimbitsa thupi tsiku lonse. Dzuka ndipo ukagone nthawi yomweyo. Chakudya chimawerengeredwa kwa odwala omwe ali ndi pakati pawo. Wodwala matenda a shuga sangathe kuvutika m'maganizo komanso m'thupi. M'mawa, ndikofunikira kuti mupumule kapena kuyendera masewera olimbitsa thupi. Masana, makamaka masiku asanagone, ndikofunikira kuyenda, kupuma mpweya wabwino. Kuwona regimen, wodwala matenda ashuga amatha kukhala ndi moyo wabwino womwe umakhala pafupi kwambiri ndi njira yodziwika ndi moyo wathanzi ndipo sizosiyana.

Matenda a shuga: malangizo azachipatala

Matenda oopsa a hyperglycemia mu matenda a shuga amachititsa kuwonongeka, kusagwira ntchito komanso kukhazikika kwa ziwalo zosiyanasiyana ndi machitidwe - maso, mtima, impso, mitsempha, mitsempha yamagazi.

DM imayamba ndi kutenga nawo mbali zingapo za pathogenetic - kuchokera kuwonongeka kwa autoimmune kupita ku β-maselo a kapamba ndikupanga kutalika kwathunthu kwa insulini ku zovuta zomwe zimayambitsa kukulira kwa insulin kukokana kwa ziwalo zopota.

Gulu la matenda ashuga

Pali mitundu iwiri ya matenda ashuga:

Mtundu woyamba (kuwonongeka kwa maselo a β-cell amayamba, zomwe nthawi zambiri zimayambitsa kuperewera kwa insulin kwathunthu):

• immuno-mkhalapakati
• chidziwitso.

Mtundu 2 (wokhala ndi insulin yambiri komanso kuchepa kwa insulin kapena kuphwanya kwambiri insulin chifukwa cha insulin kapena popanda kukana insulini).

☆ Matekinoloje a m'manja pa mankhwalawa matenda a shuga. Pazakuwonera madera akutali, tatiuza mu "Chief Chief Doctor"

Mitundu ina ya matenda ashuga:

1. Zofooka zotsimikizika mu chibadwa cha ma β-cell.
2. Zotsatira zolakwika zokhudzana ndi chibadwa cha insulin.
3. Matenda a exocrine kapamba.
4. Endocrinopathy.
5. Matenda a shuga, okwiyitsidwa ndi kugwiritsa ntchito mankhwala kapena mankhwala ena.
6. Matenda opatsirana.
7. Mitundu yachilendo ya matenda ashuga olimbana ndi matenda.
8. Ma syndromes ena amtundu wotsimikizika ophatikizidwa ndi shuga.
9. Gestationalabetes mellitus (amapezeka mwa azimayi omwe ali ndi pakati).

Zizindikiro zakukula kwamagazi m'magazi:

• onjezera kukodza pafupipafupi,
• ludzu losalekeza
• Kuchepetsa thupi popanda kuyang'anitsitsa, nthawi zina kuphatikizidwa ndi chilimbikitso chowonjezeka,
• ogwira ntchito ochepa, kutopa, kufooka,
• kuyabwa pakhungu ndi mucous nembanemba,
• kuchepa kowoneka bwino,
• kukula kwakula (mwa ana ndi achinyamata),
• utachepa chitetezo chokwanira, chiwopsezo cha matenda.

Type 2 shuga

Matenda a 2 a shuga ndi 95% ya matenda onse a shuga. Masiku ano, izi zafalitsa ngakhale matenda oopsa monga HIV komanso chifuwa chachikulu. Pazaka 10 zapitazi, kuchuluka kwa odwala omwe adapezeka ndi matenda ashuga kwachulukanso.

Pachifukwa ichi, ochokera kumayiko ambiri padziko lapansi, mapulogalamu apadziko lonse lapansi akupangidwira kupewa ndi kuchiza matenda ashuga ndi zovuta zake, zomwe zimaphatikizidwa ndi mapulogalamu azaumoyo aboma.

Malangizo azachipatala-2019 pa matenda a shuga amaganizira mbali zotsatirazi zochizira matendawa:

• kusintha kwa moyo wanu, kuphatikizapo kuwunika zakudya komanso kuchita zolimbitsa thupi zolimbitsa thupi,
• kumwa mankhwala ochepetsa shuga,
• kupewa mavuto, kuwongolera zinthu zoopsa (kuthamanga kwa magazi, matenda a impso, ndi zina).
• maphunziro oleza mtima, kudziletsa.

Chithandizo cha matenda osokoneza bongo chimapangidwira kuteteza matenda a metabolism ndi mafuta, komanso kuchepetsa magazi.

Mankhwala azakudya

Kuwongolera zakudya ndi gawo lofunikira kwambiri pochiza matenda ashuga. Zakudya ziyenera kutsatiridwa ndi odwala onse, ngakhale atagwiritsa ntchito mankhwala ochepetsa shuga.

Nthawi yomweyo, odwala omwe ali ndi kulemera koyenera safunika kuchepetsa kuchuluka kwa zopatsa mphamvu tsiku lililonse.

Malangizo Pabwino:

1. Ndi onenepa kwambiri, chofunikira ndicho kuchepa thupi pang'onopang'ono kwa 5-7% ya kulemera koyambirira kwa thupi kwa miyezi isanu ndi umodzi mpaka chaka, izi zimatheka chifukwa cha kuchepa kwa calorie 500-1000 kcal patsiku, koma osachepera 1500 kcal patsiku kwa amuna ndi 1200 kcal patsiku azimayi.
2. Muyenera kuchepetsa kuchuluka kwamafuta pang'ono ndi mafuta, ndikulimbikitsidwa kuti muzitsatira zakudya zomwe zimadziwika kuti "Mediterranean" zomwe zimakhala ndi masamba, masamba, nsomba.
3. Ndi zoletsedwa kufa ndi njala.
4. Odwala omwe ali ndi matenda a shuga 1, ogwiritsira ntchito insulin yocheperako, amawonetsedwa kuti awunikire zomwe zimapezeka m'magulu a nyama malinga ndi dongosolo la XE.
5. Nthawi zina mumatha kudya magawo a shuga osapatsa thanzi.
6. Ndikulimbikitsidwa kuti muphatikize muzakudya za tsiku ndi tsiku zomwe zili ndi zakudya zamafuta ambiri (masamba onse, zitsamba, masamba, chinangwa) ndi mafuta osakanizidwa amkati (nsomba, mafuta a masamba m'magawo ochepa).
7. Ndikofunikira kuchepetsa kuchuluka kwa mafuta omwe ali ndi mafuta ambiri (sayenera kupitirira 7% ya zonse zopatsa mphamvu zopatsirana), trans mafuta.
8. Kumwa mowa ndikotheka m'malo osakwanira 1 ochiritsira kamodzi pa tsiku kwa akazi ndi magawo awiri ochiritsira kwa amuna (1 ochiritsira gawo = magalamu 15 a mowa wopanda ethyl), malinga ndi momwe wodwalayo alibe kapamba, neuropathy, hypertriglyceridemia, uchidakwa.
9. Sitikulimbikitsidwa kuti mutenge mavitamini C ndi D ngati antioxidants chifukwa choti zotsatira za nthawi yayitali za oyang'anira sizinaphunzire.

Ndondomeko ya zochita zathupi

Zochita zolimbitsa thupi zimatha kusintha kagayidwe kazachilengedwe. Zimathandizanso kuchepetsa kuchepa kwa thupi komanso kukhalabe ndi thanzi labwino.

Malangizo azachipatala a mtundu 2 wa matenda a shuga amalangiza tsiku lililonse masewera olimbitsa thupi (50-70% ya okwera kwambiri pamtima) kwa mphindi zosachepera 150 pa sabata.

Kuchita zolimbitsa thupi mochulukirapo kapena kupitilira nthawi yayitali kumatha kudzutsa matenda oopsa kapena ochedwa. Ndi shuga wamagazi pamwamba pa 13 mmol / l, zochitika zolimbitsa thupi ndizoletsedwa.

Chithandizo cha matenda a shuga 2 amachokera ku:

• kusintha kwa moyo, mwachitsanzo, kuwunika zakudya komanso kuchuluka kwa zochita zolimbitsa thupi.
• stratization wa chithandizo chamankhwala malinga ndi gawo loyambirira la glycated hemoglobin wapezeka pa matenda,
• mphamvu ya kutsitsa shuga imayang'aniridwa ndi kuchuluka kwa hemoglobin wa glycated pakatha miyezi itatu iliyonse,
• kuwunika kwa kuchepa kwa glycated hemoglobin,
• kusintha kwa hypoglycemic mankhwala ndi kusakwanira kwake (pakukwaniritsidwa zolinga za glycated hemoglobin) sikuchitika pasanathe miyezi isanu ndi umodzi pambuyo pake.

Mankhwala a insulin a matenda a shuga 2

Zisonyezero zosankhidwa ndi jakisoni wa insulin wokhala ndi matenda a shuga omwe angopezedwa kumene:

• glycated hemoglobin woposa 9% wophatikizidwa ndi zovuta zamatenda akuwola,
• Kulephera kukwaniritsa zolinga za glycemic control kuphatikiza mankhwala omwe ali ndi mitundu yambiri yolekerera ya shuga,
• kukhalapo kwa contraindication kuikidwa kapena tsankho la mankhwala ena ochepetsa shuga,
• ketoacidosis
• kufunika kwa opaleshoni, pachimake zochitika zina ndi kuchuluka kwa matenda osachiritsika, limodzi ndi kuwonongeka kwa kagayidwe kazakudya (kusintha kwakanthaŵi kwa insulin chithandizo ndikotheka).

Mavuto a matenda ashuga: zoyambitsa matenda

Mavuto akulu kwambiri komanso owopsa a matenda ashuga, omwe amachititsa kuti wodwalayo amwalire ndi kufa, ndi zotupa zamitsempha yama mtima:

1. Nephropathy
2. Retinopathy
3. Kugonjetsedwa kwa zombo zapamtunda.
4. Kuwonongeka kwa ziwiya zaubongo.
5. Kugonjetsedwa kwa ziwiya zotumphukira za m'munsi.

Zomwe zimayambitsa matenda a shuga a 2:

• zaka 45 kapena kuposerapo,
• kunenepa kwambiri, kunenepa kwambiri,
• cholowa chamadwala a shuga,
• kumangokhala
• glycemia wovulala pamimba yopanda kanthu, kulolerana kwa shuga,
• shuga wa gestational, mwana wosabadwa wamkulu m'mbiri,
• ochepa matenda oopsa
• magazi akulu mtima
• polycystic ovary syndrome,
• kukhalapo kwa matenda a mtima ndi mitsempha yamagazi.

Nsapato za odwala matenda ashuga

Pali nsapato zopangidwa makamaka kwa odwala matenda ashuga, chifukwa miyendo imakonda kuvulala.

Type 2 Diabetes Guide imati thanzi la munthu wodwala matenda ashuga limadalira kusankha nsapato. Nsapato zolimbikitsa ziyenera kuvalidwa. Popeza wodwala wodwala matenda a shuga ali ndi miyendo - malo ofooka, nsapato zolimba zimawonjezera chiopsezo kumadera akumunsi. Mapazi amayenera kutetezedwa, chifukwa pali mathero amitsempha ndi mitsempha yaying'ono ya magazi. Mukafinya miyendo ndi nsapato zolimba, pamakhala kuphwanya magazi kumapazi. Chifukwa chake, phazi limakhala losaganizika, nthawi zambiri limavulala, ndipo mabala amachiritsidwa kwa nthawi yayitali. Zilonda zimawoneka pamapazi kuyambira mwadongosolo ovala nsapato zolimba. Izi zimawopseza gangore ndi kudulidwa kwamadera akumunsi. Wodwala angagwiritse ntchito malangizo osavuta kuti athandize kupewa mavuto ndi zigawo zotsika:

• musanavale nsapato, yesani nsapato,
• tsiku lililonse kuyang'ana miyendo patsogolo pagalasi.
• pewani nsapato zolimba kapena zomwe zimakupaka mafupa,
• Chitani zolimbitsa thupi tsiku ndi tsiku kapena zolimbitsa thupi pamiyendo,
• chepetsa misomali yako pang'ono osadula ngodya za mbale ya msomali,
• Osagwiritsa ntchito nsapato za anthu ena
• nsapato zonyowa kuti fungus isafalikire,
• gwiritsani ntchito fungus ya msomali panthawi yake,
• ngati mukumva kupweteka m'miyendo, onetsetsani kuti mwapita kwa dokotala.

Anthu odwala matenda ashuga amakakamizika kuvala zidendene zapamwamba. Chosiyana ndi odwala ndi neuropathy, amaletsedwa kuvala nsapato kuthamanga kwambiri. Mukamasankha nsapato, pali malingaliro otere kwa odwala omwe ali ndi matenda ashuga, omwe akuyenera kutsatiridwa:

• yesani nsapato kangapo,
• muziyenda mozungulira sitolo muli nsapato zatsopano.
• ma insoles okha amasankha khungu losalala, losakhala losautsa.

Masewera ndi masewera olimbitsa thupi

Mukazindikira matenda a shuga 1, malingaliro amasewera amayenera kutsatiridwa. Zochita zolimbitsa thupi sizoletsedwa, koma zimawonedwa ngati mankhwala owonjezera. Mukamasewera masewera amtundu wa odwala matenda ashuga, kuchepa kwa insulin kumawonedwa. Ndi shuga wodalira insulin, mlingo wa insulin womwe umadyedwa umachepetsedwa. Kugwira ntchito moyenera kumawonjezera ziwalo zamkati. Kwa odwala matenda ashuga, kuwumba, kuyenda mwachangu komanso kulimbitsa thupi kumawonedwa kuti ndi kopindulitsa kwambiri. Ndikwabwino kuchita nawo masewera olimbitsa thupi ndi ophunzitsa. Amasankha masewera olimbitsa thupi kapena kudzikonzera mwachindunji kwa munthu. Masewera amatsutsana kwa odwala omwe ali ndi zovuta zamatenda. Chifukwa chake, ndi retinopathy, thupi limakulitsa zovuta ndi zotupa m'miyendo, kukulira vutoli. Amaphatikizidwa kuchita masewera olimbitsa thupi kwa odwala omwe ali ndi matendawa osawonekera.

Malangizo othandizira pakuwukira

Matenda amafunikira kutsatira dongosolo lazakudya, popeza momwe njala imatha kupha wodwala.

Kuukira kwa hypoglycemic kumayambitsidwa ndi njala. Matendawa ndi owopsa kwa odwala matenda ashuga. Achibale a wodwalayo ayenera kudziwa mfundo zofunika zothandizira wodwalayo - njira yofunika. Ndi vuto la hypoglycemic, odwala matenda a shuga omwe amadalira insulin ayenera kupatsidwa chakudya. Wodwala matenda ashuga ayenera kukhala ndi "chakudya chake" - 10 ma PC. shuga woyengeka, mtsuko wa lita imodzi ya mandimu, 100 g yotsekemera, 1 apulo, masangweji awiri. Wodwala matenda ashuga ayenera kupatsidwa chakudya chofunikira kwambiri (chakudya, shuga). Mutha kuchepetsa shuga ya 5% m'madzi 50 g. Podwala kwambiri hypoglycemia, ndibwino kuti wodwalayo agone m'mbali mwake; sipayenera kukhala chilichonse pakamwa. 40% yankho la glucose (mpaka magalamu 100) jekeseni wambiri kwa wodwalayo. Ngati njirayi sinathandizire kuchira, wodwalayo amapatsidwa dontho la mtsempha ndipo njira ina ya 10% ya shuga imaperekedwa. Anthu odwala matenda ashuga adzafunika kugonekedwa.