Mavuto a shuga: Kupewa ndi Chithandizo
Kupewa matenda ashuga kumaphatikizapo njira zingapo zopewa matenda. Tsoka ilo, izi sizingagwire ntchito mtundu 1 wa shuga (wodalira insulin), chifukwa kukula kwake kumatsimikiziridwa ndi kubadwa. Koma pankhaniyi, kutsatira malangizo azachipatala kungathandize kuimitsa matendawa.
Ponena za matenda a shuga a 2, pankhani iyi, njira zodzitetezera komanso moyo wathanzi zimathandiza kwambiri popewa matendawa. Masiku ano, pafupifupi 70% ya anthuwa ali ndi matenda ashuga ndipo kudwala kwa zaka makumi zikubwerazi ndikukhumudwitsa. Chifukwa chake, njira zodzitchinjiriza ndi cholinga chowonetsetsa kuti odwala omwe ali pachiwopsezo amatha kupewa matenda osachiritsika ndikofunikira.
Shuga mellitus: mitundu ndi makina a chitukuko
Matenda a shuga ndi matenda amtundu wa endocrine omwe amayamba chifukwa cha zovuta zomwe zimachitika chifukwa cha zovuta za shuga, kapena chifukwa chosakwanira kwenikweni kwa insulin ya mahomoni opangidwa ndi kapamba. Uku ndikovuta koopsa, komwe nthawi zambiri kumayambitsa kuphwanya mitundu yonse ya kagayidwe (chakudya, mafuta, mapuloteni, mchere wamchere) komanso zovuta zina zomwe zimakhudzana ndi kuwonongeka kwa ziwalo zamkati. Pali mitundu ingapo ya matenda:
Mtundu woyamba wa matenda a shuga 1
Zimadziwika ndi chakuti insulini yofunikira pakugwiritsidwa ntchito kwa glucose imapangidwa mosakwanira kapena silipangidwa ndi maselo achisangalalo konse. Matenda amtunduwu amapezeka nthawi zambiri ali mwana komanso unyamata. Zomwe zimayambitsa ndikobadwa kwamtsogolo, zolakwika mu zakudya, matenda opatsirana mwa tizilombo kapena matenda opatsirana.
Chifukwa chosowa insulin, maselo amakhala ndi "njala" yamphamvu. Zotsatira zake, thupi limagwiritsa ntchito mafuta osungiramo mafuta kuti athetse kusalinganika kwamphamvu. Maselo amafuta akawonongeka, matupi oopsa a ketone amayamba kulowa m'magazi. Ngati insulin singaperekedwe, chikomokere chimayamba, chowopsa.
Mtundu wachiwiri wa matenda ashuga a mellitus (osadalira insulini)
Amayamba chifukwa chakuti ma cell receptor amataya insulin. Pankhaniyi, mahomoni enieniwo amatha kupanga zochuluka zokwanira. Izi zimadzetsa kuwonjezeka kowopsa kwa shuga m'magazi. Matenda a shuga amtunduwu amawonedwa kwa okalamba (kuyambira zaka 45), ndipo zomwe zimayambitsa chitukuko ndi moyo wokhazikika, kudya zakudya zosayenera, kunenepa kwambiri, nkhawa zamavuto, zizolowezi zoipa, komanso kupezeka kwa matenda oyenda. Makamaka, mtundu wachiwiri wa matenda ashuga umakhudzanso anthu onenepa kwambiri, chifukwa minyewa ya adipose imachepetsa mphamvu ya maselo mpaka insulin.
Kupewa komanso kuchiza matenda ashuga ndi ntchito yofunika kuigwiritsa ntchito mokwanira. Njira yayikulu ndikuzindikiritsa matendawo pakati pa odwala omwe ali pachiwopsezo. Ndikofunikanso kuwongolera zoyesayesa zolimbikitsa moyo wathanzi komanso wakhama, mapangidwe a kadyedwe koyenera, komanso kulimbana ndi mapaundi owonjezera. Ndikulimbikitsidwa kuti odwala azisamalira kuchuluka kwa shuga m'magazi awo ndi kukayezetsa kawiri pachaka. Izi zikuthandizira pakapita nthawi kuti muwone kusintha kwazovuta komanso kupewa zovuta za matenda ashuga.
Kupewa 1 matenda ashuga
Matenda a shuga omwe amadalira insulin amakula makamaka mwa ana, achinyamata komanso achinyamata osakwana zaka 30. Popeza chachikulu chomwe chimayambitsa matendawa ndi kuwonongeka kwa majini kapena zotsatira za matenda a ana, palibe njira imodzi yodzitetezera yomwe ingalepheretse chitukuko cha matendawa. Odwala omwe ali pachiwopsezo ayenera kuyang'anira shuga wawo wamagazi nthawi zonse.
Njira yoyamba yolepheretsa matenda a shuga a mtundu woyamba ndikuonetsetsa kuti kuyamwa kuyamwa. Mwana wofika chaka chimodzi ayenera kulandira mkaka wa amayi, limodzi ndi omwe matupi a chitetezo mthupi amalowa mthupi, kuwateteza ku matenda oyambitsidwa ndi tizilombo komanso matenda opatsirana.
Udindo wofunikira umaperekedwa ku zakudya zoyenera, zachilengedwe. Zogulitsa zomwe zimakhala ndizotetezedwa kwambiri, mitundu yokumba ndi zina zowonjezera zamankhwala siziyenera kuperekedwa kuchakudya, kudya zakudya zamagalimoto ayenera kuchepetsedwa, kupatsa chidwi ndi zakudya zamkaka.
Muyenera kudya zamasamba atsopano ndi zipatso, zitsamba, zakumwa zoledzeretsa zamkaka. Osatengeka ndi nyama yokazinga, mafuta, zonunkhira, mafuta amchere, nyama zosuta, soseji, makeke. Gwero la mapuloteni muzakudya liyenera kukhala mitundu yochepa yamafuta a nyama ndi nsomba, mtedza, mazira, tchizi chanyumba, chimanga. Ndikwabwino kusinthitsa mafuta amanyama ndi mafuta a masamba, kuwagwiritsira ntchito kuvala masaladi kuchokera masamba atsopano. Thanzi liyenera kukhala loyenera komanso logwirizana. Chakudya chimayenera kudyedwa nthawi 5-6 patsiku, m'magawo ang'onoang'ono.
Kupewa matenda a shuga kwa ana kumaphatikizapo kuletsa kwa maswiti ndi zakudya zina zosavuta, chifukwa kuchuluka kwawo kumapangitsa kuti zikhale zolemetsa zapakumwa, kugwiritsa ntchito zachilengedwe, zakudya zapamwamba kwambiri, masewera olimbitsa thupi okwanira.
Kuyambira ndili mwana, ndikofunikira kukhazikitsa chizolowezi chokhala ndi moyo wathanzi komanso wathanzi, phunzirani kuthana ndi zotsatira za kupsinjika ndikuyankha mokwanira pazinthu zosiyanasiyana m'moyo. M'tsogolomu, ndikofunikira kusiya zizolowezi zoipa, kusiya kusuta fodya komanso kumwa mowa.
Type 2 matenda a shuga
Mosiyana ndi matenda amtundu wa 1 shuga, omwe amadziwika kuti ali ndi matenda osokoneza bongo omwe amadalira insulin amatha kuyimitsidwa ndikuchotseredwa matendawo. Njira zazikulu zodzitetezera zimaphatikizapo kuyang'anira shuga wamagazi, mayeso owonetsedwera pafupipafupi, kusintha njira yamoyo ndi zakudya, kusunga masewera olimbitsa thupi, kuchepetsa thupi. Njira ndi njira zopewera matenda a shuga a 2 ndi monga:
Kusamala kwamadzi
Thupi limasowa madzi kuti lizigwira bwino - chisokonezo chamagetsi chamagetsi chimatsogolera pakugwira ntchito kwa metabolic njira ndikupangitsa kuchuluka kwa shuga m'magazi. Kuti mugwiritse ntchito shuga, kuwonjezera pa insulini, pamafunika bicarbonate wokwanira, amene amabwera ndi mayankho amadzi. Ndikofunikira kumwa osachepera 1.5 malita a madzi akumwa oyera tsiku lililonse ndikuchepetsa kugwiritsa ntchito khofi wamphamvu, tiyi, zakumwa zotsekemera za kaboni, ndi timadziti totsekemera.
Kuthetsa madzi kumathandizidwa ndi zakumwa zoledzeretsa, chifukwa chake ziyenera kusiyidwa kwathunthu, kapena kuchepetsa kumwa pang'ono. Mulingo woyenera kwa munthu wachikulire ndi mowa wamphamvu wokwanira 100 g pa tsiku, chifukwa cha azimayi - 150 g wa vinyo wofiira.
Mawonekedwe Amphamvu
Zakudya zodwala matenda a shuga a 2 zimaphatikizira kupatula maswiti, makeke, confectionery ndi magawo ena ophweka a zakudya, omwe amapanga shuga wamagazi nthawi yomweyo. Chifukwa cha kupatula zakudya zamafuta ndi chakudya chamagulu azakudya, kuchepa thupi kumatheka, zomwe ndizofunikira kwambiri kwa odwala omwe ali ndi kunenepa kwambiri.
Zakudya zomanga thupi zopezeka m'zakudya zimasinthidwa ndi "zochedwa" zomwe zimapezeka m'masamba, zipatso, ndi chimanga. Muffin, mikate yoyera yatsopano, makeke, confectionery, mafuta ndi zakudya yokazinga, mafuta a nyama samachotsedwa muzakudya. Chakudyacho chimadalira masamba komanso zipatso, masamba ndi zakudya zina monga mkaka, zakudya zamafuta ochepa, nyama yodya, mafuta ochepa, zipatso, zitsamba, mtedza, nyemba, nyemba, ndi mbale zam'mbali zopangidwa kuchokera masamba.
Zipatso, nthochi, mphesa, zinanazi, zipatso zouma (zoumba, zipatso, nkhuyu) ndizoletsedwa. Osagwiritsa ntchito kupanikizana, jamu, chokoleti, maswiti. M'malo mwa shuga, m'malo mwa shuga mumagwiritsidwa ntchito pokonza mbale. Zakudya zochepa zimalimbikitsidwa; chakudya chimayenera kuwotchera, kuwiritsa kapena kuwotcha. Muyenera kumwa madzi oyera, tiyi wobiriwira komanso azitsamba, msuzi wa rosehip. Pansi pa chiletso, msuzi wokoma, misuzi yokhazikitsidwa, tiyi wamphamvu ndi khofi, koko. Komabe, tiyi wobiriwira amathandizira ndi matenda ashuga, popeza ali ndi zigawo za antioxidant zomwe zimapangitsa kuti maselo azikhala ndi insulin komanso kuchepetsa shuga.
M'malo mwa mafuta a batala ndi nyama, tikulimbikitsidwa kugwiritsa ntchito mafuta a masamba (mpendadzuwa, maolivi). Mutha kuzigwiritsira ntchito kuvala masaladi, nthangala zamphukira, kuwonjezera ku mbale zazikulu. Kuphatikiza apo, ndikofunikira kusiya michere yamafuta, zipatso, marinade, zonunkhira ndi zokometsera. Zoletsa zimakhazikitsidwa pazinthu zina, mwachitsanzo, siziphatikiza phala la mpunga kapena semolina mumenyu, popeza mbalezi zimakhala ndi zopatsa mphamvu zambiri.
Moyo wathanzi komanso wogwira ntchito
Kuletsedwa kwa ntchito zamagalimoto kumapangitsa kuti muchepetse kunenepa komanso kusokonezeka kwa metabolic, chifukwa chake, kupewa matenda a shuga 2, tikulimbikitsidwa kuthana ndi vuto la kusachita masewera olimbitsa thupi. Kusungitsa kuchuluka kwa shuga m'magazi panthawi yovomerezeka, ndikofunikira kuchita masewera olimbitsa thupi tsiku lililonse, kuyenda osachepera mphindi 40, komanso kuchita masewera osavuta. Kupewa kwabwino kwa matenda ashuga kumakhala masewera kapena kuyenda kwa Nordic, kuthamanga, kusambira, kulimbitsa thupi, kuyendetsa njinga.
Kuwonjezeka kwa ntchito zamagalimoto kumathandizira kuchepetsa thupi, zomwe zikutanthauza kuti chinthu china chomwe chikuthandizira pakukula kwa matendawa sichitha. Ngakhale kuyenda tsiku lililonse asanagone, kukana kuyendetsa anthu pawokha kapena pagulu mokomera kuyenda kapena kukwera masitepe pafupipafupi, osati pamalo okwera, kungapindulitse ndikuthandizira thupi kuthana ndikuwopseza matendawa.
Kuchepetsa thupi kumaphatikizidwa mu pulogalamu yothandizira kupewa matenda ashuga amtundu wa 2, popeza odwala omwe ali ndi thupi lalikulu ndiye omwe ali pachiwopsezo chachikulu. Kuphatikiza pa chithandizo chamankhwala ndikulimbitsa thupi, ndikofunikira kuti mukhale ndi moyo wathanzi. Zimatsimikiziridwa kuti kusuta ndi kumwa kumawonjezera mwayi wokhala ndi matenda a shuga ndi 60%, pomwe kusiya zizolowezi zoipa sikuti kumangochepetsa chiopsezo cha endocrine pathology, komanso kumathandizanso thanzi lathu komanso thanzi lathunthu.
Kuwongolera kuchipatala
Kupewa matenda a shuga a 2 kumaphatikiza kuwunikira thanzi lathunthu. Anthu odwala matenda ashuga komanso odwala omwe ali pachiwopsezo ayenera kupima magazi awo tsiku lililonse ndikuwerenga magazi ake. Kuti muchite izi, tikulimbikitsidwa kuti mugule zida zapadera za mankhwala apakhomo - glucometer ndi tonometer. Ngati zikwangwani zimasinthira kuti zikuwonjezereka, ndikofunikira kudziwa chifukwa chake. Mwinanso panali zolakwika zina zazakudya, nthawi zovuta komanso zinthu zina zoyambitsa. Ngati zizindikiro zikuchuluka kwambiri, muyenera kufunsa kuchipatala msanga.
Kupewera kwachiwiri kwa matenda ashuga kuli ndi cholinga chopewa kupitirira kwa matendawa komanso zovuta zomwe zingachitike. Amagwiritsidwa ntchito m'magawo oyamba a matendawa ndipo amaphatikizanso kumwa Mlingo wochepetsera shuga wochepetsera shuga, zovuta za multivitamin, komanso miyeso yokhala ndi matenda a lipid metabolism. Madongosolo onse amakapangidwa ndi adotolo, wodwalayo ayenera kutsatira zonse mosamala kuti apewe zovuta za mitundu yayikulu ya matenda ashuga.
Kupewa matenda ashuga
Matenda a shuga ndi oopsa pazotsatira zake. Mavuto owopsa amatha kubweretsa kukulira kwa maziko a kuledzera kwa thupi ndi zinthu zowola (matupi a ketone, lactic acid). Odwala omwe ali ndi insulin kapena kumwa ma hypoglycemic wothandizira ali pachiwopsezo cha kukhala ndi hypoglycemia. Mothandizidwa ndi izi, kuchepa kwambiri kwa shuga m'magazi, limodzi ndi kutsika kwa magazi. Ngati munthu sapatsidwa chithandizo chamankhwala mwachangu, amangozindikira ndipo amagwa. Ngati odwala matenda ashuga samapereka mwachangu yankho la glucose, edema yamatumbo imatha kuchitika ndi imfa yotsatira.
Pambuyo pake zovuta zimayamba pang'onopang'ono, zopitilira zaka 10 mpaka 10 kuyambira kumayambiriro kwa matendawa. Mwakutero, ziwalo zofunika zamkati (chiwindi, impso, mtima, ubongo), dongosolo lamanjenje ndi ziwalo zamawonedwe zimavutika. Vuto lodziwika bwino ndi matenda ashuga retinopathy, omwe amaphatikizidwa ndi kuwonongeka kwa retina ndikuwopseza kuti asaone. Kachiwiri pofalikira pali "phazi la matenda ashuga". Uku ndi kusokonezeka komwe zilonda zam'mimba zopanda machiritso zimakhazikika kumapazi ndi mwendo wotsika, zomwe pamapeto pake zimayambitsa minofu necrosis. Ngati vutoli likuvuta ndi sepsis kapena gangrene, wodwalayo ayenera kudula dzanja.
Kamodzi pakatha miyezi isanu ndi umodzi ndikofunikira kukaonana ndi ophthalmologist yemwe amayang'anitsitsa fundus ndikuwona ngati kupanikizika kwa intraocular kumakwera. Ngati mukuwoneka zizindikiro zowopsa - mawonekedwe osasangalatsa, maonekedwe a ntchentche patsogolo pa maso, kumverera kwa kukakamizidwa m'maso amaso, mawonekedwe a mutu - kuchezera kwa ophthalmologist sikuyenera kuchedwetsa.
Njira zopewera
Njira zopewera kupewa matenda a mtima ndi kukulitsa ntchito zamagalimoto, kusiya kusuta fodya komanso kumwa mowa, kuwongolera kunenepa, kudya mokwanira komanso wathanzi.
Pofuna kupewa matenda a shuga, nephropathy, kuwonjezera pa moyo wathanzi komanso kuyeza kuchuluka kwa shuga, ndikofunikira kuyang'anira kuthamanga kwa magazi ndi lipids yamagazi. Ndi zizindikiro ziti zomwe ziyenera kuchenjeza? Maonekedwe a edema pankhope ndi malekezero apansi, kuwonjezeka kwa khungu, khungu la kuyabwa, nseru, kusowa kwa chakudya, zomwe zikuwonetsa kuledzera kwamthupi kungasonyeze kuwonongeka kwa impso. Pankhaniyi, muyenera kufunsa upangiri wa nephrologist.
Kudumpha mukupanikizika, kuwoneka kwa edema, kuchepa kwa mphamvu m'mphepete, kupweteka kwa mutu kumatha kuwonetsa kuwonongeka kwa mtima mu matenda a shuga. Pankhaniyi, ndikofunikira kuyesedwa ndikugwiritsanso ntchito mankhwala olimbitsa mtima kuti muthe kukhazikika mtima, kutsitsa cholesterol, mankhwala omwe amachepetsa chiopsezo cha kuundana kwa magazi ndi mankhwala ena omwe amaletsa kukula kwa atherosulinosis.
Kupewa kwa phazi la matenda ashuga kumaphatikizapo kuvala nsapato zomasuka, kusamalira bwino miyendo, komanso kuteteza miyendo yanu kuvulala komwe kungachitike. Ngakhale zowonongeka zazing'ono zimatha kukhala chilonda chosachiritsa, chifukwa cha matenda a shuga mabala aliwonse amachiritsa pang'ono komanso pang'ono ndi pang'ono.
Khungu la malekezero am'munsi limakhala losatetezeka kwambiri, chifukwa limatha kuwonongeka mutavala nsapato zolimba kapena zosasangalatsa. Mavalidwe aliwonse mwendo nthawi zambiri amayambitsa zilonda, zomwe pamapeto pake zimadula dzanja ndi kulumala. Chifukwa chake, chilichonse, ngakhale kuwonongeka kwakung'ono (abrasions, scratches), kufiira pakhungu ndi nthawi yamuwone dokotala ndikuchitapo kanthu kupewa popewa kukula kwa zovuta zazikulu.
Kuwonongeka kwa matenda a shuga mellitus, chithandizo cha matenda ashuga retinopathy
Chochititsa chachikulu chomwe chimapangitsa khungu kukhala ndi matenda ashuga retinopathy. Ili ndi mitundu iwiri:
- Retinopathy a digiri yoyamba. Kuwonongeka kwa ziwiya za retina amaso - kuwonongeka kwa magazi m'mitsempha, mapangidwe a aneurysms pamakoma awo, kukulitsa kwa edema.Masomphenya samavutika kwambiri, pokhapokha ngati nthawi zomwe edema imagwira pakati penipeni pa retina.
- Retinopathy a digiri yachiwiri. Kuchulukitsa kwa mitsempha yatsopano yamagazi kulipirira kusayenda bwino kwa magazi. Zombo zatsopano zimakhala ndi kufooka komanso kuchenjera, chifukwa chomwe nthawi zambiri zimakhazikika komanso kukha magazi. Izi, tsoka, nthawi zambiri zimayambitsa kuyang'anitsitsa kwamaso komanso kuiwaliratu kwamaso.
Ndi kuyamba kwakanthawi kwamankhwala, chiwopsezo cha khungu chakhungu chitha kuchepetsedwa ndi magawo makumi asanu ndi anayi, chifukwa chake, zizindikiro zilizonse zokhudzana ndi kuwonongeka kwa mawonekedwe ziyenera kukhala mwayi wochezera katswiri.
Matenda a shuga a retinopathy. Chithandizo
Njira yotetezeka komanso yothandiza kwambiri yopewera kupitilira kwa matendawa ndi kuwala kwa laser. Chifukwa cha kulimbikitsidwa kwa capillaries a fundus pogwiritsa ntchito mtengo, kupangika kwa ziwiya zatsopano zofooka sikusiyidwa. Zotsatira zake nthawi zonse zimatengera nthawi yake.
Chitetezo cha matenda a shuga a retinopathy
Kupewera kwa matenda amaso a shuga kumaphatikizapo:
- Kuwongolera shuga lamwazi (osapitirira 8 mmol / l).
- Pressure control (zosaposa 130/80).
- Kuyendera pafupipafupi ndi a ophthalmologist.
- Kusuta kufafaniza.
Kupewa komanso kuchiza matenda a shuga - nephropathy - momwe mungapewere kuwonongeka kwa impso?
Mavuto omwe amayamba chifukwa cha impso ndi owopsa. Chifukwa zizindikiro za zovuta sizikuwoneka kwa nthawi yayitali - palibe kusasangalala kapena kupweteka - mpaka zotsatira sizisintha.
Zizindikiro za matenda a shuga a Nephropathy pamagawo ake osiyanasiyana:
- Microalbuminuria: kusapeza bwino komanso chilichonse.
- Proteinuria: kutupa pansi pa maso ndi kutupa m'miyendo, kukula kwa matenda oopsa komanso kuchepa magazi.
- Kulephera kwamayiko: Zizindikiro za kuledzera (kusanza ndi mseru, mawonekedwe a kuyabwa pakhungu).
Mwachidule, impso zimakhala "chete" mpaka gawo la matenda litakula kwambiri.
Chithandizo cha odwala matenda ashuga a Nephropathy
- Ndi microalbuminuria: kulipira shuga, kuchotsedwa kwa kusokonekera kwa mafuta kagayidwe, mankhwala.
- Ndi proteinuria: aimpso zakudya, kuletsa mchere (ndi matenda oopsa), kubwezera shuga, mankhwala osokoneza bongo kapena insulin.
- Ndi kulephera kwa aimpso: kulipira matenda a shuga, kuyang'aniridwa kwa achipatala (nephrologist / endocrinologist), kudya ndi kuwongolera kuthamanga kwa magazi, kugwiritsa ntchito mankhwala osokoneza bongo, kuthetsedwa kwa poizoni ndi chithandizo cha aimpso, hemodialysis (ndi creatinine 600-700 mmol / l).
Matenda a shuga ndi mtima: matenda a matenda a shuga
Ndi matenda a shuga, chiopsezo chotenga matenda a coronary amachulukitsidwa pafupifupi kasanu. Vutoli limatengera nthawi yayitali kuposa zovuta za matenda ashuga, ndipo nthawi zambiri zimachitika popanda chizindikiro. Popeza kuti shuga pakokha imaphatikiza zinthu zingapo zowopsa pamtima, njira ziyenera kuchitidwa munthawi yovomerezeka.
Kupewa matenda a matenda a shuga kumaphatikizapo:
- Kuchepetsa thupi (kuchepa).
- Mlingo wa zolimbitsa thupi.
- Kuchulukitsa kwa magalimoto.
- Kuthetsa kwathunthu kusuta.
- Chakudya chokhwima.
Ponena za mankhwalawo, maziko ake ndikusunga kuchuluka kwa glucose pakati pazomwe zikuchitika, kutsitsa kuthamanga kwa mankhwala ovomerezeka, a insulin kapena a hypoglycemic, antihypertensive ndi anticoagulant mankhwala, etc.
Kuwonongeka kwa mtima mu shuga mellitus - kupewa ndi kuchiza matenda a shuga
Kutalika kwa nthawi yayitali ya matenda a shuga, ((kutsimikiziridwa)) kumakhala pachiwopsezo cha kuwonongeka kwa mtima.
Zoyipa za angiopathy kukhala:
- Zovuta zambiri.
- Kuperewera kwa zakudya zolimbitsa thupi komanso kuchita zolimbitsa thupi.
- Kusuta.
Nthawi zambiri, ndimatenda a shuga, atherosulinosis imayamba, chifukwa cha kuchuluka kwa cholesterol m'makoma amitsempha yamagazi. Mapulogalamu a cholesterol, nawonso, amatseka njira ya oksijeni kupita ku minofu ya mtima. Ndi kupatukana kwa cholesterol plaque, mitundu yamagazi, yomwe pambuyo pake ingayambitse stroko ndi gangore.
Zizindikiro za kuwonongeka kwa mtima mu shuga:
- Masomphenya osasangalatsa ndikuwuluka pamaso.
- Kutupa kwa nkhope, miyendo.
- Zilonda pamiyendo.
- Kutayika kwa miyendo.
- Ululu m'miyendo ndi m'munsi.
- Zithope / phokoso la mkodzo.
- Kuchulukitsa kwa kupsinjika.
- Zowawa pachifuwa.
Matenda a diabetes angiopathy amatha kuchitika mosiyanasiyana: ena - kwa zaka zambiri, mwa ena - mwachangu kwambiri. Zonse zimatengera mtundu wa njira ya matenda ashuga.
Chithandizo cha matenda a shuga a Angiopathy
Ngati misempha yawonongeka mu shuga, chithandizo chimaphatikizapo kuwunika magazi ndi shuga wamagazi,kudya, kugwiritsa ntchito mankhwala osokoneza bongo (insulin, etc.), kutsitsa cholesterolMagazi ovala magazi opaleshoni mankhwala a zilonda zam'mimba ngati alipo.
Kupewa kuwonongeka kwa mtima mu shuga
- Kusinthira ku moyo woyenera (kusuta fodya, kuchita masewera olimbitsa thupi, kudya, ndi zina).
- Kupenda mokwanira miyendo kuti muone zilonda zam'mimba, kugwiritsa ntchito zida zapadera pakhungu lowuma, kupewa kupweteka pakhungu.
- Kuyang'anira shuga ndi kupsinjika.
- Zakudya zosasunthika - kukana mafuta, kuchepetsa mchere, kukonza zoyenera.
- Kupewa magazi kuundana (aspirin).
- Kuyenda kwamasiku onse osachepera mphindi 50 ndikuvala nsapato zabwino.
Matenda a shuga, matenda ashuga a m'mimba - momwe mungapulumutsire miyendo ya odwala matenda ashuga?
Chimodzi mwazinthu zowopsa kwambiri za matenda ashuga ndi phokoso la matenda ashuga. Matendawa amakula pomwe chithandizo ndi kuwongolera kwa glucose m'magazi sikokwanira. Mawuwa amatanthauza kusinthika kwakukuru kwa pathological m'munsi mwa phazi, komwe kumatha kudzetsa gangore ndipo, chifukwa chake, kutaya thupi lonse.
Mtundu wa phazi la matenda ashuga zimatengera kuwonongeka kwa ziwiya / mitsempha ya malekezero:
- Neuropathic:Kusintha kwa mafupa a phazi, phazi lathyathyathya, kuwonongeka kwa khungu, kuchepa / kusenda kwa khungu, kuchepa thukuta.
- Ischemic:kutupa kwa phazi, kuwonda ndi kupweteka m'miyendo, matuza, khungu pakhungu.
Matenda obwera chifukwa cha matenda ashuga
Matendawa amatha kukhala zovuta kwa wodwala aliyense, koma chiwopsezo chachikulu chimayamba ndi izi:
- Matenda amtsempha wamagazi.
- Zilonda kapena zilonda miyendo yomwe kale.
- Mowa.
- Kuchuluka kwa cholesterol ndi kupanikizika.
- Zowonongeka.
Matenda a matenda ashuga zimatengera kunyalanyaza kwa matendawo komanso kuthekera kwa chipatala china. Zimaphatikizaponso mankhwala osokoneza bongo osakanikirana ndi zakudya, kutsitsa miyendo (nsapato za mafupa, kupuma kwambiri - kupsinjika pang'ono), chithandizo cha opereshoni molingana ndi mawonekedwe, chithandizo cha zilonda zam'mimba.
Matenda a shuga a matenda ashuga
Njira zopewa izi zomwe zachitika chifukwa cha matenda ashuga zikuphatikiza malamulo osamalidwa:
- Valani nsapato zapamwamba zokhasizimasokoneza magazi oyenda mwaulere.
- Kuchepa kwaukali, seamsndi zina mwa mawonekedwe amkati mwa nsapato (insole).
- Kusamalira msomali mosamala (mdulidwe sunalandilidwe - ndibwino kupaka misomali osakupera ngodya).
- Kuteteza mapazi - kukana masewera omwe amatha kuvulaza miyendo, kuyenda kokha mu nsapato, kunyowetsa mapazi ndi kirimu, etc.
Tiyenera kukumbukira kuti kuvulazidwa pang'ono kwa mapazi athu kumathandizanso kukulitsa zilonda. Chifukwa chake pakukula kapena zilonda zilizonse, funsani katswiri.
Mavuto a shuga
Mwa anthu omwe akudwala matendawa, kagayidwe ka zinthu m'thupi kamasokonekera: matendawa amakakamiza munthu kuti azifufuza mosamala kuchuluka kwa shuga m'magazi, zakudya, komanso zochita zolimbitsa thupi. Komanso, odwala matenda ashuga ayenera kuyang'anira glycated hemoglobin (wabwinobwino - pansipa 8%) ndi insulin (4-6,6 mmol / l). Kuwunika manambala kumathandiza wodwala kupewa kuwoneka ngati ali ndi zovuta komanso zovuta.
Mavuto
Kodi zifukwa zoyipa za odwala matenda ashuga ndi ziti? Chowonadi ndi chakuti ndi matendawa, glucose amakhalabe m'magazi ndipo samapatsa minofu yathupi mphamvu yofunikira, ndipo ndikulowerera kwawo kosalekeza m'matumbo, makoma awo ndi ziwalo zamkati zimawonongeka. Umu ndi momwe zovuta zovuta zimakhalira. Zikakhala kuti pali insulin yakuthwa kwambiri, izi zikuwopseza maonekedwe a zovuta kwambiri zomwe zimakhala zoopsa pamoyo wamunthu.
Kuperewera kwa insulin kumawonedwa mu mtundu woyamba wa matenda, chifukwa chake, ma jakisoni ndi ofunika kuti mumalize thupi. Ngati wodwala sachita izi mwadongosolo, kuwonongeka kwa thanzi kumakulirakulira msanga ndikuyambitsa kuchepa kwa moyo wa munthu.
Mu mtundu wachiwiri wa matenda a shuga, chomwe chimayambitsa zovuta ndichakuti ma cell sangathe "kuzindikira" insulin, yomwe imaperekedwa mwa jakisoni, motero wodwala ayenera kumwa mankhwala kuti achulukitse kagayidwe. Kukana kugwiritsa ntchito mankhwala osokoneza bongo kumabweretsanso mavuto omwe amakumana nawo ndipo kumakulitsa kwambiri thanzi la munthu.
Hypoglycemia
Hypoglycemia ndi imodzi mwazovuta kwambiri za matenda osokoneza bongo, omwe munthu amafunika kuthandizidwa mwachangu. Thupi la shuga m'thupi likachepa, wodwala matenda ashuga amayamba kuona zizindikiro zotsatirazi: kufooka, kunjenjemera m'manja mwake, mutu wake umayamba kumva chizungulire, thukuta limachitika, milomo yake imayamba kugontha, khungu lake limasunthika. Pankhaniyi, muyenera kupanga kufooka kwa glucose, apo ayi munthu atha kulowa chikhalidwe cha hypoglycemic coma. Wodwala akasiya kuzindikira, kukomoka kwayamba, ndikofunikira kwambiri kuyimbira gulu la ambulansi, kapena kupeza katswiri wazachipatala yemwe angabayire wodwala jakisoni wa 40% m'magazi. Kulephera kupereka thandizo panthawi yake kumatha kubweretsa mavuto osaneneka, kuphatikizapo imfa.
Munthu yemwe akudwala hypoglycemia amayenera kupita kuchipatala mwachangu, amafunikira kuwunikira nthawi zonse ndi ogwira ntchito kuchipatala.
Hyperglycemia
Dzinali limatchula zovuta zingapo zowopsa, zomwe zimaphatikizapo ketoacidosis, hyperosmolar ndi lactic acidosis coma. Chodziwika kwambiri mwa izi ndi ketoacidosis, momwe glucose imadzipikira kwambiri m'magazi osalowa m'maselo. Impso zimayesetsa kuchotsa shuga owonjezera m'magazi, ndikuchotsa ndi ma electrolyte - sodium, chloride, etc., omwe amatenga madzi nawo. Zotsatira zake, thupi limasowa madzi, ziwalo zamkati zimayamba kudwala chifukwa chosowa magazi. Komanso, ndi ketoacidosis, ma acetone amapanga m'magazi a munthu, zomwe zimapangitsa kuwonongeka kwakukulu kwa kupuma, minyewa yam'mimba, komanso zimapangitsa kugwira ntchito kwa mtima ndi ubongo.
Zizindikiro za kuphatikizika uku ndi machitidwe anayi otsatizana:
- Ndi ketosis (gawo loyambirira), wodwalayo amakhala ndi ludzu lamphamvu, chilakolako chake chimachepa, kugona ndi mutu kumawonekera.
- Ndi mkhalidwe wa ketoacidosis, munthu amasokonezeka, fungo la acetone limawonekera, kuthamanga kwa magazi ndi kuthamanga kwa mtima.
- Precoma - wodwalayo amagona, kugona pang'ono kumachitika, phokoso limapumira mofulumira, palpation pamimba imayambitsa kuyankha kovuta mu matenda ashuga.
- Munthu wophweka amataya chikumbumtima, khungu limasunthika, kupuma kumachitika pafupipafupi, ndikumveka phokoso, kununkhira kwa acetone mumlengalenga kumamveka bwino.
Mwanjira imeneyi, ndikofunikira kuyitanitsa "ambulansi". Njira zochizira zowonjezereka zimachitika m'chipinda chopangira chisamaliro chachikulu ndipo zimayambitsa kupezeka kwa mankhwala apadera ndi njira zamkati zodzaza ndi ion.
Mavuto obwera chifukwa cha matenda ashuga
Kuphatikiza pachimake, palinso zovuta za matendawa zomwe zimakhalapo kwa nthawi yayitali: zimaphatikizapo retinopathy, nephropathy, atherosclerosis, macroangiopathy a m'munsi, etc. zovuta za matenda a shuga zimadzetsa zovuta za moyo wa wodwalayo, zimabweretsa zovuta zowonjezera komanso kuvutikira. Amapezeka, monga lamulo, mu odwala matenda ashuga omwe ali ndi zaka zambiri zokumana nazo. Cholinga cha mapangidwe awo ndi gawo lokhazikika la shuga m'magazi a anthu.
Kuzindikira zovuta zamatenda a shuga kumapeto kwa msambo kumafunikira thandizo ndi kuyang'anira madokotala - akatswiri a magawo osiyanasiyana: akatswiri a zamankhwala, endocrinologists, ophthalmologists, nephrologists, etc.
Zowonongeka
Retinopathy ndi imodzi mwazomwe zimayambitsa matenda. Vutoli ndi loopsa chifukwa nthawi ikamakula, munthu amayamba kuona. Glucose wamkulu mu retina amachititsa vasoconstriction. Chipolopolo cha maso chimafunikira okosijeni, mchere ndi lipids zimayikidwamo, m'malo mwake, monga lamulo, zisindikizo zimatuluka. Kulephera kulandira chithandizo chamankhwala panthawi yake kumabweretsa chiopsezo cha kufinya, zomwe zingayambitse khungu.
Chizindikiro cha zovuta zamtunduwu ndi motere: Mawonedwe a wodwala akuwonongeka, minda yake ikuchepa. Wodwala yemwe ali ndi matenda ashuga ayenera kuyang'anitsitsa momwe masomphenyawo awonekera, kuyang'aniridwa ndi ophthalmologist ndikutsatira malingaliro ake.
Matenda a shuga
Mtundu wamavuto amtunduwu amapezeka kwambiri kwa odwala matenda a shuga (mpaka 3/4 a milandu yonse). Ndi matendawa, impso zimaleka kugwira ntchito yawo mwachizolowezi, chifukwa magazi amayeretsedwa bwino, zinthu zopweteka zodetsa nkhawa zimadziunjikira. Magazi a wodwalayo amakwera, kutupika kumawonekera, nseru ndi kusanza kumatha kuchitika. Zowopsa kwambiri zomwe zimachitika chifukwa cha matenda ashuga nephropathy zimatha kukhala kulephera kwa impso, pamene impso zimaleka kugwira ntchito konse, ndipo munthu amafunikira njira ya dialysis kapena chothandizira kupatsirana.
Chithandizo cha zovuta za matenda a shuga omwe amayamba chifukwa cha matenda ashuga nephropathy ndiwodula komanso opweteka, chifukwa amafunika kuchitapo kanthu opaleshoni. Odwala ayenera kuwunika momwe impso imagwirira ntchito, pochita zosavuta zingapo:
- Nthawi zonse muziyang'anira ma glucose am'magazi, pangani ndondomeko zamankhwala,
- pereka magazi pafupipafupi kuti mumayesere kuyesa kuyendetsa impso,
- pangani mwadongosolo miyezo ya kuthamanga kwa magazi.
Ngati mukuwona kuthamanga kwa magazi, ndiye kuti mukufunikira kukaonana ndi dokotala yemwe akupatseni mankhwala othandizira a antihypertensive. Kusintha kwakhalidwe, kuwongolera shuga ndi magazi kumakupatsani mwayi woti musakumane ndi zovuta zazikulu.
Matenda a matenda a shuga
Kukulumikiza kambiri kwa shuga m'magazi kumabweretsa kuwonongeka kwa makoma a mitsempha yamagazi, kupindika kwake kwapakati, ndi zikwangwani zimawonekera zomwe zimasokoneza kayendedwe kamagetsi koyenda mthupi. Odwala amamva kufooka kwa minofu, amatupa, kufupika, kufulumira, chizungulire, kupweteka mutu, komanso kuthamanga kwa magazi. Atherossteosis ndi imodzi mwazomwe zimayambitsa matenda a mtima (mtima), omwe amatha kupha. Ubongo umadwalanso ndi magazi osakwanira, omwe amakhala ndi sitiroko. Poterepa, ndikofunikira kwambiri kwa wodwala matenda ashuga kuti azilamulira mafuta m'thupi.
Chithandizo cha atherosulinosis mu matenda a shuga ndi zovuta kwambiri ndipo chikuyimira njira zingapo zochizira, motero, kupewa mavuto a shuga mellitus, omwe adanenedwa koyambirira, ayenera kuchitika: kuwunika shuga wamagazi, kuyeza magazi pafupipafupi, kuchita zolimbitsa thupi zolimbitsa thupi.
Mavuto Ochepa a shuga
Odwala omwe ali ndi matenda amtundu wa 1 ndi mtundu wa 2 amakhala ndi matenda a matenda ashuga, choyambirira cha matenda a shuga omwe amakhudza mitsempha yamipweya yam'munsi. Poyamba, zimadziwonetsa ngati kupweteka kwakanthawi m'miyendo, koma kenako zodabwitsazi zimakhala zopanda malire komanso zimabweretsa chisokonezo chachikulu. Phazi limayamba kuwona katundu waukulu ndi kusinthika, kupanikizika kosiyanasiyana m'malo osiyanasiyana kumachitika, komwe kumabweretsa mawonekedwe a chimanga, ming'alu, zilonda. Zilonda zimachitika ndi mwadongosolo phazi lopunduka, ndipo nzoopsa chifukwa matenda osiyanasiyana amalowa mthupi kudzera mkatimo. M'matenda apamwamba, osteomyelitis imatha kuchitika, komanso mitundu yodziwika bwino kwambiri yam'makoma, yomwe ingayambitse kucheka kumadera akumunsi.
Kuthandizira zilonda zam'mimba, monga lamulo, kumachitika bwino, kumachitika pang'onopang'ono pogwiritsa ntchito mafuta opha maantibayotiki, yankho la ayodini ndi wobiriwira wanzeru.
Kupewa kwa matenda ashuga kumapeto ndikosavuta: muyenera kuyang'anitsitsa miyendo, kutsuka mapazi anu m'madzi ofunda, komanso kupewa kuyenda osavala nsapato. Ndikofunikira kuvala nsapato zapamwamba zomwe zimapatula kupindika kwa phazi komanso kupanikizika kwambiri kwa makina.
Zakudya zabwino kwa odwala matenda ashuga
Mfundo yofunika kwa odwala matenda ashuga ndikutsatira zakudya, ndiye kuti, kudya mokwanira. Zakudya za pafupipafupi zimasonyezedwa kwa odwala (mpaka nthawi 5-6 patsiku), ndikofunikira kudya masamba, zakudya zamafuta ambiri (nyemba, nandolo). Anthu odwala matenda ashuga amalimbikitsidwa kusiya kudya zakumwa zopangidwa ndi shuga, confectionery. Masiku ano, pali kuchuluka kwa shuga mmalo ambiri - uchi, aspartame, sodium cyclamate, etc. Ndikofunikira kuchepetsa mchere, kuwonjezera zipatso ndi ndiwo zamasamba zatsopano (koma osati zotsekemera!) Kuti mupeze mavitamini ndi michere yofunikira m'thupi.
Makina osokoneza
Mu shuga mellitus, gawo la glucose, lomwe limayenera kulowa m'maselo a adipose ndi minofu minofu, yomwe imapangika 2/3 ya kuchuluka kwa maselo mthupi, amakhalabe m'magazi. Ndi chiwopsezo chowonjezereka cha glucose popanda kusintha kwachangu, kukhala ndi kuthekera kopanga zikhalidwe za hyperosmolarity (madziwo akasiya minyewa ndikalumikizana ndi magazi, motero kusefukira kwamitsempha yamagazi), kumabweretsa kuwonongeka ndi kuwonongeka kwa makoma amitsempha yamagazi ndi ziwalo zomwe zimaperekedwa ndi magazi oterewa. Ndi maphunzirowa, zotsatira zoyipa zimayamba. Ngati insulin ikusowa kwambiri, njira yokhazikitsira zovuta za pachimake imayamba. Mavuto oterewa amafunikira chithandizo chamankhwala mwadzidzidzi, chomwe popanda chiopsezo cha kufa.
Ndi chitukuko cha matenda a shuga 1, thupi silipanga insulin yokwanira. Ngati kusowa kwa mahomoni omwe alibe chifukwa cha jakisoni, zovuta zimayamba kukulira mwachangu ndikuchepetsa kwambiri mwayi wokhala ndi moyo wamunthu.
Type 2 shuga mellitus amasiyana ndi yoyamba chifukwa chakuti insulin yake imapangidwa ndi thupi, koma maselo sangathe kuchitapo kanthu. Zikatero, chithandizo chimachitika pogwiritsa ntchito mapiritsi omwe amakhudza maselo a minyewa, ngati kuti amawaunikira insulini, chifukwa chake, kagayidwe kamakonzedwe kamakhala kofanana mpaka mankhwala atagwira.
Mavuto owopsa a mtundu wachiwiri wa matenda osokoneza bongo amakula pafupipafupi. Nthawi zambiri zimachitika kuti munthu amaphunzira za kukhalapo kwa matenda opatsirana osati ndi zizindikiro zodziwika bwino - ludzu kapena kuchezera pafupipafupi kuchimbudzi (chifukwa chakumwa madzi ochulukirapo), koma mavuto atayamba mochedwa.
Type 2 shuga mellitus amadziwikanso kuti thupi silimangotenga chiwopsezo chake chokha, pomwe jakisoni wa mahomoni amabweretsa matenda a metabolism. Chifukwa chake, ndikofunikira kukumbukira kuti ngati kudya kwamankhwala ochepetsa shuga komanso kudya kwapadera sikukwanitsa kupititsa shuga mkati mwa 7 mmol / L, ndibwino kuti mutenge mlingo wofunika wa insulin yomwe ingabayidwe ndi jakisoni ndikuyibayira nthawi zonse kuposa kuchepetsa nthawi yayitali ya moyo wanu komanso nthawi yake khalidwe kudzera banal kukanika. Mwachiwonekere, chithandizo choterechi chitha kuperekedwa ndi katswiri wodziwa bwino za endocrinologist, yemwe angatsimikizire kaye kuti chakudyacho chilibe zotsatira, ndipo samangolekeredwa.
Zovuta zazovuta
Mawuwa amatanthauza mikhalidwe yomwe imayamba chifukwa chakuchepa kwambiri kapena kuchuluka kwa shuga m'magazi. Popewa kufa, mikhalidwe yotere iyenera kuchotsedwa munthawi yake. Zovuta za pachimake zimagawika m'magulu:
hypoglycemic chikomokere - kuchepa kwa shuga m'magazi.
Hyperglycemic mkhalidwe
Mitundu itatu yaukoma ndi mikhalidwe yabwino pano:
Mavuto onse owopsa omwe atchulidwa pamwambapa amakula chifukwa cha kuchuluka kwa shuga. Chithandizo chimachitika kuchipatala, nthawi zambiri kuchipinda chothandizira kwambiri komanso kuchipatala.
Ichi ndi chimodzi mwazovuta zambiri za matenda ashuga amtundu 1. Nthawi zambiri zimakhala:
Pambuyo podzilipira nokha mankhwala omwe dokotala watulutsa,
Pakadutsa nthawi yayitali pakati pa mapiritsi a mapiritsi ochepetsa shuga kapena insulini, nthawi zambiri amasanza ndi mseru, malungo, kusowa kudya,
kufalikira kwa matenda osachiritsika (aliwonse),
Mlingo wokwanira insulin,
kukula kwa matenda oopsa a kutupa, makamaka ngati amayamba ndi matenda opatsirana,
kumwa mankhwala ochepetsa shuga kapena kugwiritsa ntchito insulin tsiku lomaliza litatha,
ngati mankhwalawa (chifukwa cha ziwengo-anaphylaxis, kuchepa kwa magazi, kuchepa kwa madzi, kuwola kwa tizilombo tambiri titamwa mankhwalawa),
ntchito iliyonse, makamaka zadzidzidzi,
Ndikusowa kwambiri kwa insulin, shuga simalowa m'maselo ndipo amayamba kudziunjikira m'magazi. Izi zimabweretsa mphamvu yanjala, yomwe imangokhala yodetsa thupi. Potengera kupsinjika kotero, kumasulidwa kwa "mahomoni opsinjika" (glucagon, cortisol, adrenaline) m'magazi amayamba. Chifukwa chake, kuchuluka kwa shuga m'magazi kumachulukanso. Kuchuluka kwa gawo lamadzi kumaonjezera. Izi zimachitika chifukwa chakuti glucose, monga tanena kale, ndi chinthu chomwe chimagwira, motero chimakoka madzi omwe ali m'magazi.
Kuwonjezeka kwa kuchuluka kwa shuga m'magazi ngakhale atawonjezeka, kotero impso zimayamba kudzetsa chakudya. Komabe, adapangidwa mwanjira yoti, pamodzi ndi glucose, ma calcium (calcium, fluorine, potaziyamu, chloride, sodium) nawonso amathandizidwa mu mkodzo, monga mukudziwa, omaliza amakopa madzi okha. Chifukwa chake, thupi limayang'anizana ndi madzi am'madzi, ubongo ndi impso zimayamba kudwala chifukwa cha kusakwanira kwa magazi. Kuperewera kwa okosijeni kumapatsa thupi chizindikiro choti chiwonjezeke cha lactic acid, chifukwa chomwe pH ya magazi imayamba kupita kumbali ya acidic.
Kufanana ndi izi, thupi liyenera kudzipatsa lokha mphamvu, ngakhale pali mpweya wambiri, sungathe kufikira ma cell. Chifukwa chake, thupi limayendetsa njira ya kusweka kwamafuta mu minofu ya adipose. Chimodzi mwazotsatira zoperekera maselo ndi mphamvu ya "mafuta" ndikutulutsa kwa ma acetone (ketone) m'magazi. Omwe amaphatikiza magazi kwambiri, komanso amakhala ndi poizoni m'mimba:
kwa kupuma, kumayambitsa matenda a kupuma,
pamimba, kutulutsa kosaletseka komanso kupweteka, komwe kumafanana ndi zizindikiro za appendicitis,
pamtima - kusokonezeka kwanyimbo,
pa ubongo - zomwe zimapangitsa kukhumudwa.
Ketoacidosis amadziwika ndi gawo lomwe lili ngati magawo anayi otsatizana:
Ketosis Zouma zam'mimba zotupa ndi khungu, ludzu lalikulu, kugona kwambiri komanso kufooka, kupezeka kwa mutu, kunachepetsa chilimbikitso. Kuchuluka kwa mkodzo wambiri kumachulukanso.
Ketoacidosis. Imanyamula acetone kuchokera kwa wodwalayo, amasokonezeka, kuyankha m'malo, kwenikweni "kugona panjira." Kupsinjika kwa magazi kumatsika, kusanza, tachycardia kumawonekera. Kuchuluka kwa mkodzo womwe umachotsedwa kumachepetsedwa.
Precoma. Wodwala ndiwovuta kwambiri kudzuka, pomwe nthawi zambiri amasanza pamiyeso yambiri yofiirira. Pakati pa kugunda kwa mseru, mutha kuwona kusintha kwa kupuma kwamphamvu: phokoso, pafupipafupi. Khungu limaoneka pamasaya. Kukhudza pamimba kumayambitsa kupweteketsa mtima.
Coma Kutayika kokwanira. Wodwalayo amanunkhiza acetone, kupuma kwamaso, masaya ndi blush, khungu lonse limakhala lotumbululuka.
Kuzindikira za matendawa kumachitika m'njira zofunikira kudziwa kuchuluka kwa shuga m'magazi, ndikofunikanso kudziwa kuti kukhalapo kwa matupi a ketone ndi shuga mumkodzo ndi mawonekedwe. Mitembo ya Ketone imatha kuwonekera ngakhale kunyumba ndi thandizo la zingwe zapadera zoyeserera zomwe zimayikidwa mkodzo.
Chithandizo chimachitidwa muchipinda chopangira chisamaliro chachikulu ndi chisamaliro chamankhwala ndipo chimaphatikizanso kubwezeretsanso kwa insulin chifukwa cha mankhwala osakhalitsa, omwe amalumikizidwa mosalekeza m'mitsempha yaying'ono. Gawo lachiwiri la chithandizo ndikubwezeretsanso madzi omwe adasowa mothandizidwa ndi mayankho ion olemera omwe amaperekedwa kudzera m'mitsempha.
Vutoli limadziwika ndi akazi achikulire ndi amuna omwe ali ndi matenda a shuga a 2. Amayamba chifukwa cha kuchuluka kwa sodium ndi glucose m'magazi - zinthu zomwe zimadzetsa kuchepa mphamvu kwa maselo komanso kuchuluka kwa madzi am'magazi m'magazi.
Hyperosmolar coma imapezekanso pomwe zifukwa zake zoyambira zimaphatikizidwira ndi madzi am'mimba chifukwa cha kutsegula m'mimba ndi kusanza chifukwa cha matenda am'mimba, kuchepa kwa magazi, kapamba, cholecystitis, poyizoni, komanso kupukusira m'mimba. Nthawi yomweyo, thupi liyenera kuvutika ndi vuto la insulin, lomwe limachulukitsidwa ndi mahomoni, kulowererapo, komanso kuvulala.
Matendawa amakula pang'onopang'ono masiku angapo kapena masiku angapo. Zonse zimayamba ndi kuchuluka kwa zizindikiro za matenda ashuga: kuchepa thupi, mkodzo wowonjezera, ludzu. Kugwetsa minofu yaying'ono kumachitika, pang'onopang'ono kumasintha kukhala kukokana. Kusanza ndi kusanza kumawonekera, ndipo chopondapo chimasokonekera.
Patsiku loyamba kapena pang'ono pang'ono, kusokonezeka kwa thupi kumawonekera. Poyamba, izi ndizosokoneza, zomwe zimasintha pang'onopang'ono kukhala malingaliro onyenga ndi malingaliro. Pambuyo pake zimawoneka zofanana ndi encephalitis kapena stroko: kusuntha kwa maso, kusalankhula bwino, kufooka. Pang'onopang'ono, munthu amadzuka, pang'ono komanso kupuma pafupipafupi kumaonekera, koma palibe fungo la acetone.
Chithandizo cha matendawa chimakhala kubwezeretsa kuchepa kwa ma electrolyte ndi madzi, ndipo koposa zonse - insulin, ndi kuchiza kwa matenda omwe amachititsa kuti matenda ashuga ayeneranso kuchitika. Chithandizo cha mankhwalawa chimachitika m'chipinda chopangira chisamaliro chachikulu.
Mavutowa nthawi zambiri amakula mwa anthu omwe ali ndi matenda a shuga a 2, makamaka ngati ali okalamba (woposa zaka 50). Cholinga chake ndikuwonjezereka kwa zomwe zili ndi lactic acid m'magazi. Vutoli limachitika motsutsana ndi maziko a mapapu ndi mtima dongosolo, momwe mpweya kufa ndi minyewa amapezeka m'thupi, amene amapezeka mosakhazikika.
Vutoli limawonekera ngati njira ya kubwereza matenda a shuga:
kuchuluka kwa mkodzo wothira,
kutopa ndi kufooka
Kukula kwa lactic acidosis kumatha kuganiziridwa chifukwa cha kupezeka kwa kupweteka kwa minofu, komwe kumakhudzidwa ndi kuchuluka kwa lactic acid m'maselo a minofu.
Komanso, mwachangu (koma osati mwachangu kwambiri monga hypoglycemia), kuphwanya boma kumachitika:
kutsitsa magazi
kusokonezeka kwa mtima
kusintha kwa phokoso
Vutoli limatha kubweretsa mwadzidzidzi kufa chifukwa cha kulephera kwa mtima kapena kumangidwa, chifukwa chake, kugonekedwa kuchipatala kumafunikira.
Kuzindikira ndi kuchiza matenda
Ndizotheka kusiyanitsa mtundu wamtunduwu wa hyperglycemic coma mu chipatala momwe, nthawi yomweyo atazindikira kuti wodwalayo amalandira thandizo mwadzidzidzi mwanjira: kukhazikitsidwa kwa insulin ndi mayankho omwe amakhala ndi ma electrolyte ndi madzi, kuchuluka kwa koloko ya soda kumayambitsidwanso (kuphatikiza magazi, kuchepetsa pH acidity) kukhalabe ndi mtima.
Diabetesic Hand and Foot Syndrome
Matendawa amadziwika ndi kuphatikiza kwa mafupa ndi mafupa, minofu yofewa, mitsempha yamagazi, khungu. Amayamba mu 30-80% ya anthu odwala matenda a shuga ndipo amatha kuwoneka m'njira zosiyanasiyana, kutengera mtundu wa matendawa.
Fomu la Neuropathic
Amayamba mu 60-70% ya odwala omwe ali ndi phokoso la matenda ashuga ndipo amachitika chifukwa cha kuwonongeka kwa mitsempha, omwe amachititsa kuti magazi azingokhala ndi dzanja ndi phazi.
Chizindikiro chachikulu ndikukula kwa khungu m'malo opsinjika (nthawi zambiri, iyi ndi gawo lokhalo pakati pa zala), pambuyo pake kutupa pakhungu ndi zilonda zotseguka. Kutupa kwa phazi kumawoneka, kumakhala kotentha kukhudza, ndipo mafupa ndi mafupa a phazi amathandizidwanso, zomwe zimapangitsa kuti pakhale kuwonongeka kokhazikika. Kuphatikiza apo, zilonda zam'mimba zokha, komanso kuwonda sikungayende ndi ululu konse chifukwa cha kuwonongeka kwa mitsempha.
Fomu ya Ischemic
Zomwe zimayambitsa izi ndikuphwanya kayendedwe ka magazi kudzera m'mitsempha yayikulu yomwe imapereka zakudya kumapazi. Pankhaniyi, khungu la phazi limapeza penti yotumbululuka kapena yamtambo, imakhala yozizira kukhudza. Pamphepete mwam'mphepete ndi zala zam'manja zimapangira ululu.
Mavuto am'mbuyo omwe ali ndi mitundu yosiyanasiyana ya matenda ashuga
Zolemba za matendawa
Matenda a mtundu woyamba amakhala ndi achinyamata ndi ana. Matenda a shuga a Type 2 nthawi zambiri amapezeka mwa anthu achikulire. Chifukwa cha njira zodziwitsira za panthawi yake, kupititsa patsogolo matendawa kumatha kupewedwa ndi mankhwala osagwiritsa ntchito mankhwala.
Mavuto a mtundu 1 ndi mtundu wachiwiri wa matenda ashuga siosiyana kwambiri.
Kupezeka molakwika ndi chithandizo chamankhwala osakonzekera kungayambitse zovuta. Kuphatikiza apo, mawonekedwe awo amatha kuchitika koyambirira, komanso patatha zaka makumi ambiri kuchokera pakupezeka kwa matenda. Mavuto a shuga amagawidwa koyambirira komanso mochedwa.
Mtundu woyambirira wamavuto
Mavuto oterewa amatchedwanso pachimake, ndipo amabweretsa chiopsezo pamoyo. Amadziwika ndi chitukuko mwachangu, chomwe chimatenga nthawi kuchokera maola angapo mpaka sabata limodzi. Kunyalanyaza chithandizo chamankhwala kapena kuchipeza mosagwiritsa ntchito nthawi zambiri kumabweretsa imfa.
Pakati pamavuto owopsa a matenda osokoneza bongo amadziwika kwambiri ndi munthu - zomwe zimapangitsa kuti zochita za anthu zikuchepa. Zochita za njirazi zimachepa, ndipo mawonekedwe, zimatha. Kuphatikiza apo, pali kuphwanya zochitika za mtima ndi mtundu wake, zovuta zomwe zingakhale ndi kupuma kwakanthawi ndizotheka.
Ndikosavuta kuwona zamtsogolo ngati mtundu wachiwiri wa matenda ashuga. Amapangidwa mwachangu kwambiri, motero, pamafunika kuti wina akhale pafupi ndi wodwalayo.Izi ziyenera kukhala m'bale yemwe angapereke thandizo kapena ogwira ntchito kuchipatala. Kuchiza odwala kumayenera kuchitika pokhapokha kuyang'aniridwa ndi madokotala kuchipatala. Poyamba, wodwalayo amatumizidwa kuti akalandire chithandizo chachikulu. Pambuyo pazosintha zina, amasamutsidwa ku dipatimenti yapadera.
Tiyeni tikambirane mwatsatanetsatane mtundu uwu wamavuto obwera chifukwa cha matenda ashuga.
Mankhwala, chikomokoma chimagawika m'magulu awiri:
- Hyperglycemic mtundu com.
- Hypoglycemic mtundu com.
Kodi ndizomwe zimayambitsa zovuta za shuga zamtunduwu? Hypoglycemic chikomokere chimachitika chifukwa cha kutsika lakuthwa kwamisempha. Amadziwika ndi kukula kwazinthu izi kwakanthawi kochepa. Hyperglycemic coma imagawidwa kukhala ketoacidosis, komanso mawonekedwe a hyperosmolar ndi hyperlactacidemic.
Mavuto a mtundu woyamba wa shuga afotokozedwa pansipa.
Ketoacidosis
Vutoli limadziwika ndi odwala omwe amapatsidwa matenda oyamba. Ketoacidosis ndimatenda a metabolic, omwe amayambitsa vuto lalikulu ndi kusowa kwa insulin. Kuphwanya kukuwonetsedwa pakukula kwa glucose ndi matupi a ketone, komanso kumayendetsedwa ndi kuwonjezeka kwa acidity yamagazi. Mapangidwe a ketoacidosis, monga lamulo, amadutsa m'magawo angapo. Poyamba, zovuta mu ma laboratori amasanthula mkodzo mumawuzo zimawulula shuga. Pakapanda kusokera kulikonse, shuga mumkodzo sayenera kukhalapo.
Pa gawo lachiwiri, ntchito zosokoneza za metabolic zimawonedwa. Izi kapena zizindikiro zina za kuledzera siziphatikizidwa. Nthawi yomweyo, munthu amakhala wopsinjika, ndipo kuzindikira kwake kumasokonezeka. M'mayeso a labotale, acetone imapezeka mkodzo. Gawo lotsatira limasiyanitsidwa ndi zizindikiro zotere:
- Zovuta.
- Milandu yakutha kwa chikumbumtima.
- Mkhalidwe wonyinyirika mwa anthu.
Ndi zovuta za matenda ashuga, thandizo liyenera kuperekedwa nthawi yomweyo.
Gawo lachitatu la ketoacidosis limatchedwa kholo. Chotsatira, ndikuwopseza moyo, popeza chayamba kupsa mtima. Pakadali pano, pali chisokonezo cha pafupifupi ziwalo zonse, komanso kusokonezeka kwa chikumbumtima komanso njira yoperewera ya kagayidwe kachakudya. Zomwe zimayambitsa izi ndizovuta ndikuphwanya zakudya ndi mankhwala, kudzisintha nokha muyezo wa mankhwala kapena kuwakana. Ketoacidosis imatha kuonekera patapita nthawi atasiya kugwiritsa ntchito mankhwala ochepetsa shuga. Kuphatikiza apo, izi zimatha kudzutsa matenda amtundu kapena matenda opatsirana. Pa nthawi ya pakati, pamakhala chiopsezo cha kuchepa kwa insulin, komwe kumayambitsanso kukomoka.
Hypoglycemic chikomokere
Mavuto a mtundu 2 a shuga ndi ofala ngati mtundu woyamba wa matenda.
Vuto longa hypoglycemic coma limawonekera mwa odwala omwe ali ndi matenda ashuga, osayang'ana mtundu wake. Mosiyana ndi ketoacidosis, izi zimakwiyitsa maonekedwe a insulin yowonjezera. Zowona, pali milandu yodziwika yomwe imachitika pambuyo pokumwa kwambiri kapena kumwa kwambiri mowa. Mtundu wamtunduwu umadziwika ndi kutaya mtima kwathunthu komanso kutuluka thukuta kwambiri. Poterepa, kuwunika kotsika kwa ophunzira kumadziwika. Pakumayambiriro koyamba, matendawa amatha kupewedwa ngati mugwiritsa ntchito chakudya chofunikira.
Vuto la matenda osokoneza bongo a shuga kapena hypoglycemic coma limatha kuchitika mwadzidzidzi. Amatsogozedwa ndi zizindikiritso monga njala yayikulu limodzi ndi nkhawa, kuda nkhawa kwambiri, kukakamizidwa komanso kuwonjezeka kwa ana. Zomwe sizimadziwika kawirikawiri ndi zizolowezi zadzidzidzi zomwe zimasinthasintha mwadzidzidzi, kupweteka mutu, komanso kuwonongeka kwa mawonekedwe. Pali ngozi yakufa ngati wodwalayo sanachotsedwe pakukomoka kwa ola limodzi. Munthawi imeneyi, edema ya m'magazi imapangidwa ndipo zovuta za metabolic zimachitika. Zotsatira zake, kufa kwa cortex ya ubongo kumawonedwa.
Hyperosmolar coma mu shuga
Kuphatikizika kwamtunduwu kumasiyanitsidwa ndi zizindikiro zake. Ndi iyo, kuwonjezereka kwa sodium wophatikizana ndi shuga m'magazi kumadziwika. Chifukwa cha kuphatikiza uku, ndikuphwanya zakudya zama cell a thupi. Nthawi zambiri, izi zimachitika pakati pa anthu okalamba.
Pa gawo loyambirira la hyperosmolar coma, kuchepa kwa madzi ndi kusowa kwa insulin kumawonedwa. Kutopa kwakanthawi kumayambitsa zizindikiro zachiwiri, monga kusokonezeka kwa chopondapo ndi mseru komanso kusanza, palinso kusokonezeka kwa zochitika zamkati mwa mtima, limodzi ndi kuchepa kwa magazi. Kukula kotereku kumatenga milungu ingapo. Choyamba, zizindikiro za matenda ashuga zimawonekera:
- Kumva ludzu kwamphamvu.
- Kuchepetsa thupi.
- Kukodza pafupipafupi.
Kutaya chikumbumtima. Kuphatikiza apo, pakuyamba koyamba, kupezeka kwa kukhudzika kwakanthawi ndikugwinya miyendo.
M'tsogolomu, matendawa amakhala ndi machitidwe opita patsogolo. Kuwonongeka kwa chikumbumtima kumachitika pafupipafupi ndikukhala wovuta. Ena amakhalanso ndi zovuta zina. Zizindikiro za hyperosmolar coma ndizosiyanasiyana. Itha kukhudzana ndi dongosolo lamanjenje ndipo limafotokozeredwa mwa kukhudzidwa, motsatana ndi kusakhalapo konse kapena kusuntha konse. Palinso zovuta kulankhula. Zizindikiro zotere zimawonekeranso kuphwanya ubongo.
Chithandizo cha zovuta zamatenda a shuga zimagwiritsidwa ntchito popanga mankhwala, njira zingapo zothetsera matenda oledzera. Therapy iyenera kukhala yokwanira. Kufanana ndi kuchepa kwa chiwonetsero cha hyperosmolar coma, pamafunika kukopa zomwe zimayambitsa.
Ganizirani mavuto a shuga.
Matenda a shuga ndi zovuta zake zomaliza
Mavuto ena obwera chifukwa cha matendawa ndi monga nephropathy, retinopathy, ndi matenda am'mimba a shuga omwe amapezeka kwa nthawi yayitali matenda a shuga. Mwinanso kuwonekera kwawo patatha zaka makumi awiri kuchokera pakuzindikiridwa.
Zinthu zotere zimachitika pang'onopang'ono ndipo zimadziwika makamaka kwa odwala omwe ali ndi matenda a shuga a 2. Nthawi zambiri, mavuto obwera chifukwa cha matenda ashuga amapezeka ali ana.
Kuwonetsedwa kwa matenda ashuga nephropathy
Vutoli limawonekera chifukwa cha kuwonongeka kwa impso ndipo zimayambitsa kulephera kwa aimpso. Matenda a mtima amawonekera patatha zaka khumi kuchokera pamene munthu wapezeka ndi matenda ashuga. Ndi matenda amtundu 1, kupsinjika kumeneku ndi komwe kumayambitsa imfa. Matenda a diabetes nephropathy nthawi zambiri amakhala m'magawo atatu otsatirawa:
- Kuwona mapuloteni ochepa mkodzo.
- Kuwona kuchuluka kwamapuloteni mu mkodzo.
- Maonekedwe aimpso kulephera.
Kuchiza kuyenera kuchitika kale koyambirira kwa matenda. Cholinga chake ndikuti magazi akhale magazi. Pachifukwa ichi, mankhwala amagwiritsidwa ntchito omwe amapangitsa kuti magazi azikhala athanzi komanso kusintha magazi kulowa impso. Mbali yotsatira, kukonzekera kwa insulin kumagwiritsidwa ntchito, zakudya zopanda mchere zimayikidwa. Kuphatikiza apo, amamwa mankhwala kuti achulukitse kuthamanga kwa magazi, mulingo woyenera momwe sayenera kupitirira mamilimita 130/80 a mercury. Pofuna kulephera kugwiritsa ntchito mankhwalawa, ena amasankhidwa.
Kulephera kwa impso kumagawika m'mitundu iwiri: chosasinthika ndi kudwala. Mtundu woyamba, chithandizo chake chimachitika popanda mankhwala. Chithandizo chake ndicho kutsatira kwambiri zakudya komanso kupewetsa mchere. Nthawi zina, insulin ikhoza kutumikiridwa.
Chithandizo cha mtundu wachiwiri chikuchitika mu chipatala moyang'aniridwa ndi madokotala. Njira zimapangidwira kukonza mkhalidwe wa wodwalayo ndikuphatikizira hemodialysis. Mokulira kwambiri, kupatsirana kwachiwalo ndikofunikira.