Matenda a shuga

Maminiti 9 Irina Smirnova 3769

Matenda a shuga ndi matenda amtundu wa endocrine omwe amapanga mphamvu ya insulini kapena amatha kudziwa zomwe zimapangitsa kuti ziwalo zake zikhale zowonongeka. Ndi matenda awa, mitundu yonse ya kagayidwe imavutika: mapuloteni, mafuta ndi chakudya. Kuwonongeka kwa ziwalo ndi machitidwe omwe ali ndi kuchepa kwapang'onopang'ono muumoyo wamoyo kumayamba, zochitika zowopsa mwadzidzidzi zimatha kuchitika.

Mu matenda a shuga, wodwalayo ayenera kumwa mankhwala nthawi zonse, kuyeza shuga ndi zinthu zina zamagazi, mkodzo, kumvetsetsa bwino zomwe zakudya ndi masewera olimbitsa thupi ndizovomerezeka, lingaliranipo kukonzekera pakati. Koma ngakhale atalandira chithandizo moyenera, si odwala onse omwe amatha kupewa kuwonongeka.

Nthawi zina, matenda a shuga amabweretsa kulumala, mwa ana - kufunika kolamulira pakanthawi kogwira ntchito kwa kholo, kumakulitsa njira zina zamatenda okalamba. Kenako wodwalayo amafunsa kuti: kodi zimapereka chilema chifukwa cha matenda ashuga, kodi pali zolemba zina zilizonse kapena mapindu omwe anganene?

Kuyang'ana odwala omwe ali ndi matenda ashuga

Pali mitundu iwiri yayikulu ya endocrine pathology. Mtundu woyamba wa matenda a shuga ndi mtundu womwe munthu amadwala insulin. Matendawa amapanga kuwonekera kwake mwa ana ndi achinyamata. Kuperewera kwake kwa mahomoni ake mu zochuluka zokwanira kumapangitsa kufunikira kuti mupeze jakisoni. Ichi ndichifukwa chake mtundu 1 umatchedwa insulin-wodwala kapena wowononga insulin.

Odwala oterowo nthawi zambiri amapita kukaonana ndi endocrinologist ndikuwapatsa insulin, mizere yoyesera, miyendo ku glucometer. Kuchuluka kwa makonda angayang'anire ndi adokotala omwe amapita nawo: amasiyanasiyana m'malo osiyanasiyana. Matenda a 2 a shuga amakula mwa anthu opitilira zaka 35. Zimagwirizanitsidwa ndi kuchepa kwa chidwi cha maselo kuti apange insulin, kupanga mahomoni sikusokonezedwa poyambirira. Odwala otere amakhala moyo waufulu kuposa anthu odwala matenda ashuga a mtundu woyamba.

Maziko a chithandizo ndikuwongolera zakudya komanso kugwiritsa ntchito mankhwala ochepetsa shuga. Wodwalayo amatha kulandira chisamaliro panthawiyi kapena chifukwa cha mankhwala. Ngati munthu akudwala yekha ndikupitilizabe kugwira ntchito kapena kusamalira mwana yemwe ali ndi matenda ashuga, amalandila pepala lolemala kwakanthawi.

Maziko opereka tchuthi chodwala atha kukhala awa:

• mayiko omwe ali ndi matenda ashuga,
• wodwala matenda ashuga
• hemodialysis
• kusokonezeka pachimake kapena kuchulukitsa kwa matenda osachiritsika,
• kufunika kogwirira ntchito.

Matenda a shuga ndi Olumala

Ngati matendawa akuyenda limodzi ndi kuwonongeka m'moyo, kuwonongeka kwa ziwalo zina, kuchepa kwapang'onopang'ono kwa ntchito komanso luso lodzisamalira, amalankhula za kulumala. Ngakhale ndi chithandizo, wodwalayo angakulire. Pali madigiri atatu a shuga mellitus:

• Zosavuta. Mkhalidwewo umalipiriridwa pokhapokha pokhazikitsa chakudya, mulingo wa kusala kudya kwa glycemia sunapitirire 7.4 mmol / l. Kuwonongeka kwa mitsempha yamagazi, impso kapena dongosolo lamanjenje la 1 degree ndikotheka. Palibe kuphwanya ntchito zolimbitsa thupi. Odwala awa sapatsidwa gulu lolumala. Wodwala akhoza kulembedwa kuti sangathe kugwira ntchito yayikulu, koma atha kukagwira ntchito kwina.
• Yapakatikati. Wodwala amafunikira chithandizo cha tsiku ndi tsiku, kuwonjezeka kwa shuga mpaka 138 mmol / l ndikotheka, kuwonongeka kwa retina, zotumphukira zamitsempha, komanso impso mpaka 2 digiri. Mbiri yakale komanso yonyansa siyikupezeka. Odwala oterewa ali ndi zilema komanso olumala, mwina olumala.
• Zovuta. Odwala omwe ali ndi matenda ashuga, kukwera kwa shuga pamwamba pa 14.1 mmol / L kumawerengedwa, matendawa amatha kukulira ngakhale motsutsana ndi maziko a mankhwala omwe asankhidwa, pali zovuta zina. Kuopsa kwa kusintha kwa ma pathological mu ziwalo zoberekera kumatha kukhala koopsa, ndipo matendawa (mwachitsanzo, kulephera kwa aimpso) akuphatikizidwanso. Samalankhulanso za mwayi wogwira ntchito, odwala sangathe kudzisamalira. Amapatsidwa matenda a shuga.

Ana amafunikira chisamaliro chapadera. Kuzindikira matendawa kumatanthauza kufunikira kopitilira chithandizo ndi kuwunika kwa glycemia. Mwanayo amalandira mankhwala osokoneza bongo kuchokera ku bajeti yakomweko. Pambuyo polemala polemala, akuti amapindulanso zina. Lamulo la federal "Pension pension in the Russian Federation" limapereka kuperekera penshoni kwa munthu amene akusamalira mwana wotere.

Kodi kulumala

Wodwalayo kapena womupangira amafunsira wachikulire kapena wa ana endocrinologist kumalo komwe amakhala. Maziko otumizira ITU (Health Expert Commission) ndi awa:

• kubwezeredwa kwa matenda ashuga osagwira ntchito bwino,
• matenda oopsa
• magawo a hypoglycemia, ketoacidotic coma,
• kuwoneka kwa kuphwanya ntchito za ziwalo zamkati,
• kufunika kwamalingaliro antchito kuti asinthe machitidwe ndi mtundu wa ntchito.

Dokotala adzakuuzani njira zomwe muyenera kuchita kuti mumalize zolemba zanu. Nthawi zambiri, odwala matenda ashuga amayeserera:

• kuyezetsa magazi konse
• Kuyeza magazi m'mawa ndi masana,
• maphunziro a biochemical omwe akuwonetsa kuchuluka kwa malipiro: glycosylated hemoglobin, creatinine ndi urea wamagazi,
• muyeso wa cholesterol
• urinalysis
• kutsimikiza mkodzo wa shuga, mapuloteni, acetone,
• mkodzo malinga ndi Zimnitsky (vuto laimpso)
• electrocardiography, kuyesa kwa maola 24 kwa ECG, kuthamanga kwa magazi kuti ayesetse mtima,
• EEG, kuwerenga kwa ziwiya zamagulu a khansa pakupanga matenda a shuga.

Madokotala amawunika ntchito zokhudzana ndi izi: ophthalmologist, neurologist, opaleshoni, urologist. Kusokonezeka kwakukulu kwa ntchito zamunthu wazidziwitso ndi mawonekedwe ndi chizindikiro cha kafukufuku woyeserera wamaganizidwe ndi kufunsira kwa wamisala. Atatha mayeso, wodwalayo amapita kuchipatala komwe amamuwonera.

Ngati zizindikiro zalemala kapena kufunika kopanga pulogalamu yothandiziramo anthu ena zapezeka, dokotala yemwe amalowa amalowa zonse zokhudzana ndi wodwalayo mu fomu 088 / у-06 ndikutumiza ku ITU. Kuphatikiza pa kunena za ntchitoyo, wodwalayo kapena abale ake amatenga zikalata zina. Mndandanda wawo umasiyana malinga ndi omwe amadwala matenda ashuga. ITU imawunika zolembedwazo, zimawunika ndikusankha ngati sangapatse gulu la olumala kapena ayi.

Njira zopangira

Akatswiri amawunika kukula kwa kuphwanya malamulo ndikugawa gulu linalake lazolumala. Gulu lachitatu limapangidwira odwala omwe ali ndi matenda ofatsa kapena olimbitsa. Zowonongeka zimaperekedwa ngati zikulephera kukwaniritsa ntchito yawo yopanga pantchito yomwe ilipo, ndipo kusamutsidwira kumachitidwe kosavuta kumabweretsa chiwongola dzanja chachikulu.

Mndandanda wazoletsa ntchito zalembedwa mu Order No. 302-n wa Unduna wa Zaumoyo wa Russia. Gulu lachitatu lilinso ndi achinyamata omwe akuphunzitsidwa. Gulu lachirema lachiwiri limapangidwira mozungulira matenda. Mwa zina mwa njira:

• kuwonongeka kwammbuyo kwa digiri ya 2 kapena 3,
• Zizindikiro zoyambira kulephera kwa impso,
• dialysis aimpso kulephera,
• ma neuropathies a madigiri 2,
• encephalopathy mpaka madigiri 3,
• Kuphwanya kosuntha mpaka madigiri 2,
• kuphwanya kudzisamalira mpaka madigiri 2.

Gululi limaperekedwanso kwa odwala matenda ashuga omwe amawonetsa matendawa moyenera, koma ndi kulephera kukhazikika panjira ndi chithandizo chanthawi zonse. Munthu amadziwika kuti ndi olumala wa gulu 1 ndi kuthekera kwa kudzisamalira. Izi zimachitika ngati chiwopsezo chachikulu cha ziwalo zomwe zikuwadwala matenda ashuga:

• khungu m'maso onse
• kukula kwa ziwalo ndi kuwonongeka kwa kuyenda,
• kuphwanya kwakukulu kwamalingaliro,
• kukula kwa mtima kulephera 3 madigiri,
• matenda ashuga kapena ovulala am'munsi,
• kulephera kwa impso,
• pafupipafupi chikomokere ndi vuto la hypoglycemic.

Kupanga chilema cha mwana kudzera pa ITU ya ana. Ana otere amafunika jakisoni wa insulin nthawi zonse komanso kuwongolera glycemic. Kholo kapena kholo la mwana limapereka chithandizo ndi chithandizo chamankhwala. Gulu lolemala pamenepa limaperekedwa mpaka zaka 14. Pofika zaka zino, mwanayo amawunikiranso. Amakhulupilira kuti wodwala yemwe ali ndi matenda a shuga kuyambira zaka 14 amatha kubayira jekeseni ndikuwongolera shuga, motero, safunika kuwonedwa ndi munthu wamkulu. Ngati izi zikutsimikiziridwa, kulumala kumachotsedwa.

Pafupipafupi kukonzanso kwa odwala

Pambuyo pakufufuzidwa ndi ITU, wodwalayo amalandila malingaliro pazomwe amamuzindikira munthu wolumala kapena kukana ndi malingaliro. Pakupereka penshoni, wodwala matenda ashuga amadziwitsidwa kwa nthawi yayitali kuti amadziwika kuti sangathe. Mwachizolowezi, kulumala koyambirira kwa magulu 2 kapena 3 kumatanthauza kuyesedwanso chaka chimodzi pambuyo polembetsedwa kwatsopano.

Kukhazikitsidwa kwa gulu la 1 la olumala m'matenda a shuga kumayenderana ndi kufunikira kwa zaka ziwiri, pamaso pamavuto akulu mu terminal siteji, penshoni imatha kuperekedwa mwachangu. Mukamayang'ana penshoni, kulumala kumachitika nthawi zambiri. Ngati matendawo akuipiraipira (mwachitsanzo, kukula kwa encephalopathy, kukula kwa khungu), dokotala yemwe amapezekapo angamuperekeze kuti ayang'anenso kuti awonjezere gululo.

Dongosolo lokonzanso komanso kusanja anthu

Pamodzi ndi satifiketi yakulemala, wodwala matenda a shuga amalandira pulogalamu yamanja m'manja mwake. Amapangidwa pamaziko a zosowa zaumunthu mu mtundu wina kapena wina wa zamankhwala, zothandizira anthu. Pulogalamuyi ikuwonetsa:

• Olimbikitsidwa pafupipafupi azachipatala okonzekera chaka chilichonse. Bungwe la azaumoyo lomwe wodwala amayang'aniridwa ndi amene amachititsa izi. Ndi kukula kwa aimpso kulephera, malingaliro a dialysis akuwonetsedwa.
• Kufunika kolembetsa njira zaukadaulo ndi zaukhondo. Izi zikuphatikiza maudindo onse opangidwira mapepala a ITU.
• Kufunika kwa chithandizo chaukadaulo, mwa quota (ma prosthetics, opangidwira ziwalo zamasomphenya, impso).
• Malangizo othandizira paubwenzi ndi ovomerezeka.
• Malangizo pazofunsidwa ndi mtundu wa ntchito (mndandanda wazokonzekera, mtundu wa maphunziro, momwe mulili ndi mtundu wa ntchito).

Zofunika! Mukamagwiritsa ntchito zomwe zalimbikitsidwa kwa wodwala, IPRA zamankhwala ndi mabungwe ena amaika chizindikiro pakukhazikitsa ndi sitampu yawo. Ngati wodwala akukana kukonzanso: kuchipatala chomwe wakonzekera, sapita kwa dokotala, samamwa mankhwala, koma akuumirira kuti azindikire munthu yemwe ali ndi matenda osokoneza bongo ngati nthawi yayitali kapena kukweza gulu, ITU ikhoza kusankha kuti nkhaniyi siyabwino.

Phindu la olumala

Odwala omwe ali ndi matenda a shuga amawononga ndalama zambiri kugula kwawo mankhwala osokoneza bongo othandizira glycemic control (glucometer, lancets, strips test). Anthu olumala sikuti ali ndi ufulu kulandira chidziwitso chaulere chokha, komanso mwayi wonamizira kukhazikitsa pampu ya insulin ngati gawo lokonzekera chithandizo chamankhwala chamtundu wapamwamba kudzera inshuwaransi yokakamiza yachipatala.

Njira zaukadaulo ndi zaukhondo zimakonzedwera palokha. Muyenera kuzolowera mndandanda wa malo omwe analimbikitsidwa musanatumize zikalata zakulemala muofesi ya akatswiri. Kuphatikiza apo, wodwala amalandira thandizo: penshioni yodwala, ntchito yanyumba yochitira ntchito yantchito, kulembetsa zothandizidwa ndi ngongole zothandizira, chithandizo chaulere cha spa.

Kuti athane ndi vuto lopewa chithandizo cha spa, ndikofunikira kufotokozera m'thumba la Insurance Fund komwe magulu omwe anthu olumala angathe kuwapatsa chilolezo. Nthawi zambiri, kupita ku sanatorium kwaulere kumaperekedwa m'magulu 2 ndi 3 a olumala. Odwala omwe ali ndi gulu 1 amafunikira wothandizira yemwe sadzapatsidwa tikiti yaulere.

Thandizo kwa ana olumala ndi mabanja awo limaphatikizapo:

• kulipiritsa penshoni yapa mwana,
• malipiro kwa amene amasamalira omwe akukakamizidwa kuti asagwire ntchito,
• kuphatikiza nthawi yochoka pantchito,
• kuthekera kosankha sabata lalifupi,
• kuthekera kwa mayendedwe aulere kudzera m'njira zosiyanasiyana zoyendera,
• phindu la msonkho,
• kupanga magawo ophunzirira kusukulu, kupasa mayeso ndi mayeso,
• kuvomerezedwa mwachisangalalo ku yunivesite.
• malo okhalamo anthu, ngati banja liziwoneka kuti likufunika nyumba yabwino.

Kulembetsa kwakukulu kwa kukalamba muukalamba nthawi zambiri kumayenderana ndi matenda a shuga a 2. Odwala oterewa akufunsa ngati angapatsidwe phindu lililonse. Njira zoyambira zothandizira sizosiyana ndi za anthu odwala omwe ali ndi zilema. Kuphatikiza apo, ndalama zowonjezera zimaperekedwa kwa iwo opuma pantchito, kuchuluka kwake komwe kumatengera kutalika kwa ntchito ndi gulu la olumala.

Komanso, munthu wokalamba amatha kukhalabe ndi mwayi wogwira ntchito, wokhala ndi ufulu wofupikitsa tsiku logwira ntchito, kupatsidwa tchuthi chapachaka cha masiku 30 komanso mwayi wopuma tchuthi popanda kusunga miyezi iwiri. Kulembetsa kulemala kwa matenda opatsirana a shuga kumalimbikitsidwa kwa anthu omwe ali ndi vuto lalikulu la matendawa, kusowa kwa chipukutiro nthawi ya mankhwala, ngati nkosatheka kupitiliza kugwira ntchito pazomwe zidachitika kale, komanso kwa ana ochepera zaka 14 chifukwa chakufunika koyang'anira chithandizo. Anthu olumala amapeza mwayi wogwiritsa ntchito maubwino ndikufunsira chithandizo chamtengo wapatali chautali.