Chithandizo cha matenda a shuga 1 amtundu wa israel

antagonist B. cepacia AB 1934 ndi mitundu 8 ya B. thailandensis 295, yomwe idadziwika ndi kutayika kwa kukana kwa kanamycin, koma idasungabe kukana kwa chloramphenicol ndipo nthawi yomweyo idapeza auxotrophy, yomwe idawonetsa kuphatikizidwa kwa Tn9 mu chromosome. Kudziwitsa zosowa zawo zopatsa thanzi malinga ndi chiwembu cha Holliday kunawonetsa kuti kuphatikiza kwa transposon kunapangitsa kusintha kwa kudalira kwa proline kapena glutamine. Popita nthawi, gawo la StK limasinthidwa kukhala prototrophy, mwina chifukwa cha kayendedwe ka transposon motsatira chromosome.

Ntchitoyi ikuwonetsa kuthekera ndi kufalikira kwa nthawi ya kulumikizidwa kwa plasmid Rts1 :: Tn9 kuchokera kwa E. coli KS 707 (Rts1 :: Tn9) kupita ku B. cepacia AB 1934 ndi B. thailandensis 295 tizilombo ta pafupipafupi 6 × 10-8 pa cell yolandila . Mitundu yosinthidwa ma genetically yokhala ndi plasmid antibiotic kukana idapezeka, zomwe zimafotokozeredwa bwino lomwe mu pulogalamu yatsopanoyo, zomwe zimakulitsa kulimbana kwa zovutazo mpaka kanamycin ndi chloramphenicol mwa katatu. Transconjugates idawonetsa kuchepa kwa virulence kwa hamsters agolide ndi cytopathogenicity kwa P aculeata. Kuthekera kophatikiza Tn9 mu chromosome kukuwonetsedwa.

Chifukwa chake, titha kunena kuti plasmid Rts1 :: Tn9, komanso ma plasmids P-1 a gulu lolumikizana, angagwiritsidwe ntchito pophunzira zamtundu wa burkholder.

1. Voronina O. L., Chernukha M. Yu., Shaginyan I.A. et al. // Molecular Genetics, Microbiology ndi Virology. - 2013. - Na. 2 - S. 22-30.

2. Kalinkina E.V., Ageeva N.P., Merinova O.A. et al. // Mavuto a matenda owopsa. - 2008. - Na. 96 - S. 32-35.

3. Molchanova E.V., Ageeva N.P. Patent yopanga No. 2485182 Njira yofufuzira mosavomerezeka zovuta za pathogenic burkholderia zochokera ku cytopathogenicity / de 23,01.2012.

4. Morozova M.V., Merinova L.K., Seimova I.K. et al. // Bulletin of the Volgograd Science Scient Center of RAMS. - 2006. - Na. 1. - S. 38-40.

5. Petros M. K., Shipovskaya N. P., Merinova L. K. // Microbiological magazine. - 1983. - T 45. - V. 3. - S. 11-14.

6. Coenye T., Vandamme P. // Environ. Microbiol. - 2003. - Vol. 5. - P 719-729.

7. Deshazer D. // FEMS Microbiol. Lett. - 2007. - Vol. 277 (1). - P 64-69.

8. Murata T., Ohnishi M., Ara T., et al. // J. Bacteriol. - 2002. - Vol. 184. - P 3194-3202.

Molchanova Elena Vladimirovna - K. b. n.,

ndi n ndi malo osungirako FKUZ Volgograd Research Anti-Pulawa Institute of Rospotrebnadzor, wothandizira wa Department of Molecular Biology and Genetics, Volgograd State Medical University imelo: [email protected]

ZOPHUNZITSIRA NDIPONSO ZOTHANDIZA KWA ANA ANA NDI DIABETES MELLITUS TYPE I: "KWA" NDI "KULAMBIRA"

N. Yu. Otto, G. R Sagitova, M. Ya. Ledyaev

Chipatala cha Dera Lachipatala cha Ana dzina lake N.N. Silishcheva, Astrakhan,

Astrakhan State Medical Academy,

Volgograd State Medical University

Chimodzi mwa zipani zomwe zimapangitsa odwala kukhala ndi moyo wabwino amadziwika kuti ndi insulin. Kutengera ndi zomwe takumana nazo m'chipatala, njira zokhudzana ndi insulin zimaperekedwa, kutengera mtundu wa mankhwala, msinkhu wa mwana, ndi kama wogona kuchipatala.

Mawu ofunikira: ana, lembani matenda a shuga a mellitus, mankhwala a insulin.

PROS NDI ZINSINSI ZOgwiritsira Ntchito Ndalama Zambiri PAKUKHUDZA KWA ANA NDI TYPE I DIABETES

N. Yu. Oio, G. R. Sagitova

Mankhwala osankhidwa bwino a insulin kwenikweni amawonedwa ngati amodzi a zofunikira pakukongoletsa moyo wa odwala. Tikuwonetsa njira zogwiritsira ntchito insulin mochenjera kutengera mtundu wa mankhwala, msinkhu wa mwana kutengera zomwe takumana nazo m'chipatala.

Mawu ofunikira: ana, lembani matenda a shuga, mankhwala a insulin.

Kafukufuku wamavuto okhudzana, nthawi yayitali, kuntchito ya dziko ndi dziko 1, 2. Matenda a shuga, makamaka ana, amadziwika kuti ndi omwe amayambitsa matenda.

Kutulutsa 4 (48). 2013 57

kwambiri insulin. Ndiye chifukwa chake kubwezeretsa insulin mankhwala kumakhalabe njira yokhayo yothandizira mtundu wa matenda a shuga a ana. Kuyambira 2012, Mndandanda wa Mankhwala ofunikira ndi ofunikira wakhala akugwira ntchito, wovomerezedwa ndi Lamulo la Boma la Russian Federation ya Disembala 7, 2011 No. 2199-r, yomwe imaphatikizapo insulin. Njira yabwino kwambiri yothandizira mtundu wa matenda a shuga I amadziwika kuti ndi yolimba kwambiri ya insulin - njira yodziwira jakisoni wambiri wa insulin yomwe imatsutsana ndi insulin. Mankhwalawa ndi subcutaneous makonzedwe a mitundu iwiri ya insulin. Nthawi zambiri izi ndizogwiritsa ntchito insulin yochepa (Actrapid kapena Humulin Regular) kapena ultrashort (NovoRapid kapena Humalog), yomwe imayang'aniridwa musanadye zakudya zazikuluzikulu (mtundu wa kutsitsa kwa chimbudzi cha chakudya chimachitika) ndi insulin yayitali (Protofan, Humulin NPH) kapena wogwira ntchito nthawi yayitali (Lantus) (Lantus) ( kutsanzira secretion yayikulu kapena ya basal yopanda chakudya). Nthawi 1-2 patsiku la 3, 5. amayamba madokotala azolowera zamankhwala amamva zambiri zokhuza zabwino za "zatsopano" za "akale", amayesetsa kuti atalikirane ndi ma insulin oyambira amtundu woyamba, monga Actrapid ndi Protofan (kampani Novo Nordisk, Denmark), Humulin Wokhazikika ndi Humulin NPH, (Eli Lilly, USA). Kusintha pakugwiritsa ntchito ma insulin a makampani omwewo, koma ofanirana ndi ultrashort kanthu (anthu akufanizira) - insulin Aspart (dzina lamalonda Novorapid) ndi insulin Lizpro (Humalog), ndi chifukwa choti akuchitapo kanthu mwachangu. Mwa ma insulin amakono omwe akhala akugwira ntchito masiku ano pazachipatala, Glargin (Lantus) (Aventis, Germany) ndi Detemir (Levemir) (Novo Nordisk, Denmark) amagwiritsidwa ntchito kwambiri pochiritsa. Ubwino wa ultrashort insulins ndikuti palibe chifukwa chofunikira kupirira nthawi isanadye, odwala amasintha mosiyanasiyana kapangidwe kake ndi nthawi yakudya, ndipo izi ndizofunikira kwambiri kuchokera kumbali yofufuza mtundu wa moyo wa odwala. Lantus ndi insulini ya maola 24 yomwe imayendetsedwa kamodzi patsiku, mosiyana ndi ma insulin apakati (Protofana ndi Humulin NPH), omwe amaperekedwa kawiri (m'mawa ndi madzulo), omwe, nawonso, amachepetsa jakisoni. Zokhazokha zomwe zimapangitsa kuti ma insulin amasiku ano ndi mtengo, mwachitsanzo, umapitilira mtengo wa Actrapid ndi Protofan ndi Humulin koposa katatu.

Kuphunzira za mawonekedwe a insulin, poganizira kuchuluka kwa masiku omwe odwala omwe ali ndi matenda amtundu wa I amapezeka mchipatala komanso kuchuluka kwa insulin tsiku lililonse kutengera zaka.

Kuwunika mwatsatanetsatane kwa zolemba zachipatala (fomu 112, fomu 003 / y) ya ana 144 ndi achinyamata adachitika

a Type Iabetes mellitus omwe adayesedwa ndikuthandizidwa ku dipatimenti ya Endocrinology mu 2012. Malangizo omwe amagwiritsidwa ntchito kwambiri anali a insulin a m'badwo "watsopano": ultrashort action Humalog kapena Novorapid (70%) osakanikirana ndi insulin Lantus yayitali (50%) ndipo mu 1/5 ana osakanikirana ndi Levemir. "Wakale" m'badwo insulin, monga Humulin - Wokhazikika ndi NPH. oposa kotala la ana alandila, ndi Actrapid ndi Protofan 4% ya ana. Nthawi zambiri, kuphatikiza ma insulin achidule ndi apakatikati-nthawi anali kugwiritsidwa ntchito - Actrapid + Protofan, Humulin Regular + Humulin NPH, ultrashort komanso insulin-Humalog + Lantus komanso Novorapid + Levemir (95%). Zomwe zimagwiritsidwa ntchito kawirikawiri: Humulin Regular + Lantus, Actrapid + Lantus, Actrapid + Levemir, Novorapid + Lantus (5%), omwe amagwirizana ndi kupatsidwa kwa insulin pokonzekera. Mu ana ndi achinyamata a zaka 11 mpaka 17 mpaka 17, mbadwo waposachedwa wa ma insulin - Humalog ndi Lantus - adagwiritsidwa ntchito nthawi zambiri, mwa ana a zaka zapulayimale wazaka 7-10 - Novorapid ndi Levemir, mwa ana aang'ono - Humulin Regular ndi Humulin NPH. Kusankha kwa insulini m'magulu ang'onoang'ono kumachitika chifukwa cha kupezeka kwabwino kwa HumaPen ndi Novo-pen insulin syringe ndi gawo laling'ono la jakisoni la mayunitsi 0,5. Kupenda chizindikiro cha kuchuluka kwa masiku ogona mukamachira, tanena kuti pankhani yogwiritsa ntchito ma insulin oyambira pang'ono komanso achidule (Humalog, Novorapid, Actrapida, Humulin Regular), kugona pang'onopang'ono kudadziwika panthawi ya chithandizo ndi Novorapi-nyumba - pafupifupi bedi tsiku 16.6 chachikulu kwambiri - ndi chithandizo cha Humalog - 18.5. Kugona kwapafupifupi kwakanthawi kumawonedwa ndikugwiritsa ntchito Humalog pagulu la ana azaka 11 mpaka 14, Novorapida - pagulu la ana azaka 6, Humulin Regular - pagulu lazaka za 4-6, Actrapida wazaka zapakati pa 15-17. Mukamagwiritsa ntchito insulins ya sing'anga nthawi yayitali komanso nthawi yayitali yochita (Protofan, Humulin NPH, Lantus, Levemir), malo ochepa omwe adadziwika ndi mankhwala a Protofan - apakati ogonera ndi 16.2, ndipo wamkulu kwambiri ndi Lantus omwe amawagwiritsa ntchito - masiku ogona anali 18,8. Pabedi lalifupi kwambiri mukamagwiritsa ntchito Lantus adadziwika m'gulu la zaka 7-10, Levemira - pagulu la zaka 4-6 ndi zaka 15-17, Protofana - pagulu la zaka 15-17, Humulin NPH - pagulu la zaka 4-6. Tsiku lalitali kwambiri limadziwika kwa zaka 11 mpaka 14 (zomwe mwina zimalumikizana ndi nthawi ya kuchuluka kwa mahomoni) ndipo ndi masiku 20.2 pakama. Mankhwalawa ndi ma ultrashort insulins, pafupifupi tsiku ndi tsiku mlingo wa 15 (Novorapid) ndi magawo 17 (chipika cha Huma) ndipo kwa m'badwo wakale "wa insulin yofupikira, avareji ya tsiku ndi tsiku ya insulin ndi 15,8 (Humulin Regular) - magawo a 17,7 (Actrapid). Ma insulin "atsopano" omwe amakhalapo kwa nthawi yayitali sakhalanso ndi phindu lalikulu: avareji ya tsiku ndi tsiku ya 12.3 (Levemir) ndi magawo 13.1 (Lantus), ndi "insulin" yakale

Kutulutsa 4 (48). 2013

kuchuluka kwa pafupifupi tsiku lililonse kwa 12,7 (Humulin NPH) ndi magawo 13.9 (Protofan). Mwa ma insulin onse, chinthu chimodzi ndi chodziwika: mlingo umachulukana molingana ndi zaka, pali "kulumpha" kwakuthwa kwa insulin ndi 1.53 nthawi, zomwe zimagwera pa zaka 7 mpaka 14, poyerekeza ndi ana asukulu yasekondale. Kwa ana aang'ono (zaka 1-3), osachepera kuchuluka kwa tsiku ndi tsiku kwa insulin iliyonse (mayunitsi 4-8), ndi mlingo waukulu - wazaka zapakati pa zaka 17-16 (mayunitsi 17-28). Mukamagwiritsa ntchito ma insulin a Ultra-Short-insulin ndi ma insulin achidule (Humalog, Novorapid, Aktrapid, Humulin Regular), mlingo wawung'ono kwambiri wa tsiku ndi tsiku wa insulin umawonedwa mu Humalog pazaka 1-3 za moyo (mayunitsi 5.1), Novorapid wazaka 7-16 zaka (13 , 2 mayunitsi), Actrapida mzaka 7-16 (magawo 14.0). Mukamagwiritsa ntchito ma insulin a nthawi yayitali komanso nthawi yayitali (Protofan, Humulin NPH, Lantus, Levemir), pafupifupi inshuwaransi yotsika tsiku ndi tsiku ya insulin imawonedwa ndi Humulin NPH mu zaka 1-6 za moyo - mayunitsi a 4.5. Ali ndi zaka 7 - 7, mlingo wa Lantus ndi Levemir ndi wocheperako 1.5 kuposa momwe amagwiritsira ntchito ma insulins apakatikati (Protofan ndi NPH). Tikukhulupirira kuti ali ndi zaka 11 mpaka 14, ndibwino kupatsa mwayi kwa Lantus, popeza ali ndi mlingo wocheperako akamagwiritsa (mayunitsi 13.2). Pa zaka 15-17, mlingo wotsika kwambiri mukamagwiritsa ntchito Protofan (mayunitsi 17) ndi Lantus (mayunitsi 17.8).

1. Panalibe kuchepa kwakukulu pakudikika pakubedi ndi kuchepa kwa pafupifupi tsiku ndi tsiku pogwiritsa ntchito insulins "zatsopano".

2. Timalingalira za kuchuluka kwa mankhwalawa patsiku la kama komanso mankhwala a insulin tsiku lililonse, tikupangira kugwiritsa ntchito njira zotsatirazi: Humalog ikhoza kulimbikitsidwa pazaka zapakati pa zaka 1-3 ndi zaka 11 mpaka 14, Novorapid wazaka 4 mpaka 10, Humulin Regular akhoza kutsimikiziridwa mu Wazaka 4-6, NPH ali ndi zaka 1-6, Leva-dziko lapansi 4-10 ndi zaka 15-17, Lantus ali ndi zaka 7- 17, Actrapid ali ndi zaka 7- 7, Actrapid ndi Protofan (mosiyana ndi malingaliro amasiku ano) wazaka 15-17 .

1. Dedov I.I., Kuraeva T. L., Peterkova V. A., Shcherba-cheva L. N. Matenda a shuga a ana ndi achinyamata. - M: Kufalitsa Universum, 2002 .-- 203 p.

2. Dedov I.I., Melnichenko G.A. Malangizo. Endocrinology. - M: Litterra, 2007 .-- 85 p.

3. Dedov I.I., Peterkova V.A., Kuraeva T. L. Russian ikugwirizana pankhani yothandizira matenda a shuga kwa ana ndi achinyamata. // Farmateka. - 2010. - Ayi. 3. - S. 7-10.

4. Ma algorithms osamalira mwapadera odwala omwe ali ndi matenda ashuga mellitus // Matenda a shuga. - 2011. - Na. 3 (adj.).

5. American Diadetes Association. Miyezo ya Chithandizo Cha Zachipatala mu shuga / Chithandizo cha Matenda a shuga. - 2009. - Vol. 32 (Suppl. 1). - P. 13-61.

Otto Natalya Yuryevna - Mtsogoleri wa Chipatala cha Ana a Chipatala cha a Ana a Chigawo cha a National Center N. N. Silishcheva ”, imelo: [email protected]

PECULIARITIES ZAKUKULUKA NDIPONSO ZOTHANDIZA ZOTHANDIZA MALO OKHALA NDI PYELONEPHRITIS KWA ANA

Smolensk State Medical Academy

Zambiri zofufuzira za prooxidant ndi antioxidant machitidwe mwa ana 79 zimawonetsedwa, mwa ana 49 omwe ali ndi pyelonephritis ana 30 komanso ana 30 athanzi azaka 1 mpaka 17. Zodabwitsa za kakulidwe ndi kupanikizika kwa oxidative mu pyelonephritis kutengera njira yake kuwululidwa.

Mawu ofunikira: pyelonephritis, ana, kupsinjika kwa oxidative, mitundu yolephera ya okosijeni, chitetezo cha antioxidant, chemiluminescence.

PECULIARITIES YA KUKUKULUKA NDIPONSO KULIMBIKITSA KWA ZINSINSI ZOTHANDIZA PYELONEPHRITIS KWA ANA

Nkhaniyi ikuwonetsa momwe kafukufuku wa prooxidant ndi antioxidant anathandizira ana 79, kuphatikiza ana 49 omwe ali ndi gawo la pyelonephritis, ndi ana 30 athanzi azaka za 1 mpaka 17. Makhalidwe a oxidative nkhawa mu pyelonephritis, kutengera nthawi yake, anali otsimikiza.

Mawu ofunikira: pyelonephritis, ana, kupsinjika kwa oxidative, mitundu ya okosijeni ya okosijeni, chitetezo cha antioxidative, chemiluminescence.

Mu kapangidwe ka matenda omwe mwapeza, kwamikodzo excretion ndi lonephritis. Njira zoyendetsera zaulere ndi imodzi mwazomwe zimayambitsa kupukusa kwamthupi mwa ana.

Type 1 shuga mellitus: Zizindikiro, kudya komanso kupewa matenda a shuga a mtundu I

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

Zaka makumi angapo zapitazo, matenda a shuga amawonedwa ngati matenda okhudzana ndi zaka - ali aang'ono, owerengeka adadwala matendawa. Tsoka ilo, posachedwa pakhala chizolowezi chakukula kwa matenda ashuga ali aang'ono. Zomwe zimayambitsa kukula kwa matendawa kwa anthu okalamba komanso achinyamata zimasiyana: ngati ndi zaka izi zimapangitsa kuti kufalikira kwa ziwalo zamthupi, kuphatikizapo zikondamoyo, ndiye kuti mthupi laling'ono limachitika chifukwa cha kuchepa kwa insulin. M'mbuyomu, mtundu uwu wa matenda a shuga umatchedwa "insulin-basedabetes mellitus." Tsopano zayamba kufala - mtundu 1 wa matenda ashuga. Ndi nthenda ya metabolic yodziwika ndi hyperglycemia.

Mndandanda wa mawu: hyperglycemia ndi chizindikiro cha matenda chosonyeza kuchuluka kwa shuga (shuga) m'mwazi wa magazi.

Kusiyanitsa kwakukulu pakati pa matenda a shuga a mtundu woyamba ndi matenda amtundu wa 2 ndikuti kwachiwiri, thupi limatha kupanga insulin popanda, pang'onopang'ono, limachepetsa shuga la magazi. Mtundu woyamba wamatenda, insulini siyipanga mwaokha ndipo wodwala amatengera mwachindunji mankhwala ochepetsa shuga ndi jakisoni wa insulin.

Type 1 shuga mellitus nthawi zambiri amayamba ndi matenda owopsa a matendawa kotero kuti wodwalayo amatha kutchulanso tsiku lomwe zizindikiro zoyambirira za hyperglycemia zitachitika:

• Pakamwa pakamwa
• W ludzu
• Kuyamwa mwachangu.

Kuchepetsa thupi kwambiri, komwe nthawi zina kumafikira makilogalamu khumi ndi anayi pamwezi, ndi chimodzi mwazizindikiro za matenda amtundu 1.

Kuti mutsimikizire matendawa, kusanthula kwamwazi ndi mkodzo ndi komwe. Ngati mayesowa akuwonetsa kukhalapo kwa shuga wambiri, ndipo pali acetone ndi glucose mkodzo, kutsimikizika kwatsimikiziridwa.

Matenda a shuga a Mtundu woyamba ndi matenda otchedwa autoimmune, ndipo nthawi zambiri amaphatikizidwa ndi matenda ofananawo - amafalitsa poizoni wothandizira (matenda a Graves), autoimmune chithokomiro.

Njira ya matendawa

Ngakhale atayamba kwambiri, matenda a shuga omwe amadalira insulin amakula pang'onopang'ono. Nthawi yotsika, yotsika nthawi zina imatha zaka zingapo. Ndipo pokhapokha kuwonongedwa kwa maselo β maselo kukafika pa 80% pomwe zizindikiro zamankhwala zimayamba kuonekera.

Mndandanda wa mawu: β - maselo - amodzi mwa mitundu ya maselo a endocrine kapamba. Maselo a Beta amatulutsa insulin ya m'magazi, yomwe imachepetsa shuga.

Pakukula kwa mtundu woyamba wa shuga, magawo asanu ndi amodzi ndi amodzi:

1. Gawo la kutengera kwa chibadwa. Dziwani kuti 2-5% yokha ya anthu omwe ali ndi vuto la chibadwa chodziyimira 1 matendawa ndiamene amapeza. Kuti mupeze zodalirika zatchulidwe la matendawa, ndikofunikira kuchita kafukufuku wamtundu wa matendawa. Kukhalapo kwa ma antigen a HLA kumawonetsa kuti chiopsezo chokhala ndi matenda okhudzana ndi insulin odabwitsa kwambiri. Mu seramu, chizindikirochi chikuwonekera zaka 5-10 zaka zisanu zoyambirira zisanachitike matenda.
2. Chiyambireni cha autoimmune process. Zinthu zakunja zomwe zimayambitsa kuyambika kwa matendawa zimatha kukhala - matenda a ma virus (mumps, rubella, cytomegalovirus), mankhwala, kupsinjika, zakudya - kugwiritsa ntchito mkaka posakanikirana ndi mapuloteni amanyama pakupanga, zinthu zomwe zimakhala ndi nitrosamines. Mu 60% ya milandu, zinali zinthu zakunja zomwe zidakhala batani loyambira la mtundu woyamba wa matenda ashuga. Pancreatic insulin secretion sichinachitike pakadali pano, koma kuyesedwa kwa immunological kumatsimikizira kale kupezeka kwa ma antibodies.
3. Kukula kwa matenda amisala. Nthawi zina amatchedwa insulin.Pakadali pano, palibe kusintha kwa metabolic, koma kuwonongeka pang'onopang'ono kwa maselo a betta kumayamba kuchitika. M'magazi mumakhala ma anti-ma antibodies osiyanasiyana pamagulu osiyanasiyana a β-cell - ma antibodies kuti insulini. Gawo lilibe mawonekedwe. Pozindikira (nthawi zambiri kuyezetsa kwa glucose), kutayika kwa gawo loyambirira la insulin kumadziwika.
4. Matenda owopsa a immunological - matenda abwinobwino a shuga. Ngakhale kulekerera kwa glucose kumakhala kovuta, komabe pakalibe zizindikiro zamatenda a shuga. Chiyeso chololera pakamwa cha glucose chikuwonetsa kuwonjezeka kwa glucose othamanga, omwe amayamba chifukwa cha kuwonongeka kwa pafupifupi theka la β-cell. Nthawi zambiri odwala pakadali pano amadandaula za malaise, mobwerezabwereza furunculosis, conjunctivitis.
5. Matenda a shuga oonekera bwino a mtundu woyamba wokhala ndi insulin. Pakadali pano, zizindikiro zonse zamatenda zimawonekera bwino. Matendawa amakhala pachimake - popanda kulandira chithandizo choyenera, pakatha milungu iwiri matenda opha - matenda ashuga ketoacidosis. Kuwonongeka kwa maselo a β-cell kufika 80-90%, komabe, kubisalira kwatsalira kwa insulin kumasungidwabe. Ngati chithandizo cha insulin chakanthawi chikuyambitsidwa, mwa odwala ena mumayamba nyengo yokhazikika ya matendawa - "kukwatirana ndi uchi", komwe kumadziwika ndi kufunikira kwapadera kwa insulin.
6. Chidziwitso cha shuga chowoneka bwino ndi kuperewera kwathunthu kwa insulin - matenda ashuga kwathunthu. Kuwonongeka kwa maselo a β-cell adafika pamlingo wovuta, chinsinsi cha insulin chimayima kwathunthu ndi thupi. Kagayidwe kachizolowezi sizingatheke popanda Mlingo wa insulin wokhazikika.

Osati nthawi zonse zamatenda a shuga 1, matendawo amawonekera kwambiri.

Chithandizo cha matenda a shuga a insulin

Chithandizo cha matenda a shuga amtundu woyamba ndicho kudya kwambiri komanso jakisoni wokhazikika wa insulin kapena kumwa mankhwala ochepetsa shuga. Tsoka ilo, matenda a shuga siachiritsi. Cholinga cha mankhwalawa ndikuthandizira kuti thupi lizigwira ntchito komanso kupewa zotulukazo.

Ngati mlingo wa insulin amawerengedwa molondola, palibe kusiyana kwapadera kuchokera ku menyu a munthu wamba. Kusiyana kwakukulu ndikofunikira kuwerengera kuchuluka kwa chakudya chamafuta omwe amadya mosavuta. Izi zimakuthandizani kuti muwerenge kuchuluka kwa insulini molondola momwe mungathere.

• Chakudya chizikhala chosiyanasiyana momwe mungathere.
• Zakudya zoyenera - osachepera kanayi pa tsiku, m'magawo ang'onoang'ono,
• Gawo wamba pa chakudya ndi 500-600 zopatsa mphamvu, ngati pakufunika kuchepetsa thupi, ndiye kuti ngakhale kuli kochepa
• Kuchuluka kwa chakudya chamafuta kumatha kuwonjezeredwa panthawi yolimbitsa thupi - kupita kudzikolo, kukaphunzitsira,
• Ndikofunikira kupatsa chidwi ndi mbale zonyowa. Mafuta, okazinga, onunkhira, osuta - ochepa okha.

Zofunika! Osadumpha chakudya ndi matenda ashuga mulimonse. Monga kudya kwambiri.

Makamaka chidwi chake chikuyenera kulipidwa ku zinthu zomwe zimakhala ndi zotsekemera - zina zimakhala ndi zopatsa mphamvu pang'ono kuposa shuga. Zokometsera zama-calorie otsika zimaphatikizapo aspartame, saccharide, stevioside, cyclamate. Fructose, xylitol ndi sorbitol zili ndi zopatsa mphamvu zambiri. Musaiwale kuti zotsekemera zimawerengedwa ngati mukuwerenga Mlingo wa insulini, kuphatikiza si zonse ndizosavuta, kuvulaza ndi mapindu a fructose ali ofanana!

Zimakhala zovuta kwambiri kutsatira zakudya za ana odwala komanso achinyamata. Kumbali ya makolo, kuyang'anira nthawi zonse ndikofunikira kuti mwana asadye zakudya zoletsedwa komanso kuti asayambitse zovuta zazikulu.

Zogulitsa zomwe zaletsedwa kwambiri m'matenda a shuga a mitundu yoyamba: chokoleti, mabisiketi, shuga, kupanikizana, ndi maswiti ndi zina zambiri, zomwe zimakhala ndi chakudya chamagulu am'mimba. Zipatso - mphesa.

Mlingo wa insulini uyenera kuwerengedwa pachakudya chilichonse komanso tsiku lililonse, ngakhale zakudya zomwe dzulo sizinasinthe kwambiri masiku ano. Izi zimachitika makamaka chifukwa chakuti kufunika kwa insulini kumasintha masana.

Yang'anani! Mowa!

Mlingo wochepa wa mowa wapa matenda amtundu wa 1 saletsa. Kuopsa kokumwa mowa ndikutsatira - mukamwa, munthu sangathe kudziletsa ndipo sazindikira nthawi zonse kuchuluka kwa shuga m'magazi ndipo samatha kupanga jakisoni wa insulin.

Kuphatikiza apo, boma la hypoglycemic ndi zizindikiro zake zimagwirizana ndi zizindikiro za kuledzera - kuyankhula kosokoneza, kusokonekera kwa kayendetsedwe ka kayendedwe. Ndipo ngati izi zidayamba pagulu, kununkhira kwa mowa sikulola ena kuti awone kuyipa kwa moyo wa anthu panthawi. Chifukwa chake, nthawi yofunika kupulumutsa moyo imasowa.

Zochita zolimbitsa thupi

Zochita zolimbitsa thupi ndizofunikira kwambiri pamoyo wamunthu aliyense. Mu matenda a shuga, kuchita masewera olimbitsa thupi sikutsutsana, koma pali malamulo ena kuti apangitse kuti azitha kuthandiza thupi.

1. Lamulo loyamba. Zochita zolimbitsa thupi zitha kuchitidwa pokhapokha poyambira kubwezeretsedwa kwa shuga kwa nthawi yayitali. Pa shuga wambiri wa 15 mmol / l, masewera olimbitsa thupi amatsutsana.
2. Lamulo lachiwiri. Ndi katundu wogwira - maphunziro akuthupi, kusambira, ngakhale disco - muyenera kudya 1 X.E. theka lililonse la ola. Komanso. Ikhoza kukhala chidutswa cha mkate, apulo.
3. Lamulo lachitatu. Ngati zolimbitsa thupi ndizokwanira, ndikofunikira kuchepetsa mlingo wa insulin ndi 20-50%. Ngati hypoglycemia idadzipangitsabe, ndiye kuti ndibwino kuti izilipira pakumamwa chakudya chambiri - chakudya, zakumwa zotsekemera
4. Lamulo Lachinayi Kuchita masewera olimbitsa thupi kumachitika bwino patatha maola angapo chakudya chachikulu. Pakadali pano, mwayi wokhala ndi hypoglycemia ndiwotsika.
5. Lamulo lachisanu. Zochita zolimbitsa thupi zimayenera kuganizira za zomwe wodwalayo ali nazo - m'badwo, kulimba, thanzi lathunthu.

Onetsetsani kuti mumamwa madzi okwanira, chifukwa panthawi yolimbitsa thupi thupi limachepa. Muyenera kumaliza makalasi pochepetsa mphamvu zolimbitsa thupi, kusamukira kumadera ena omasuka. Izi zimathandizira kuti thupi lizizizira pang'onopang'ono ndikuyenda mochita bwino.

Turmeric yamtundu 1 komanso matenda ashuga 2

• Zokhudza zabwino za turmeric
• Za ntchito
• About maphikidwe

Matenda a shuga amayenera kulandira chithandizo, chomwe chimaphatikizapo kugwiritsa ntchito osati mankhwala ovomerezeka ndi katswiri, komanso kugwiritsa ntchito njira zina zachikhalidwe zamankhwala. Chithandizo chotere chiyenera kuonedwa ngati chokwanira kwambiri kwa matenda amtundu wa 1 komanso mtundu wa 2, kuthandiza kupewa insulin. Pankhaniyi, ziyenera kudziwidwa kuti zonunkhira monga turmeric zimathandizira kwambiri pakuchira matenda a shuga. Pazinthu zake zothandiza, ma nuances ogwiritsira ntchito ndi zina zambiri malembawo.

Zokhudza zabwino za turmeric

M'malo mwake, ndizotheka kutchula zifukwa zonse zotengera turmeric kwa nthawi yayitali, chifukwa ndichikhalidwe chothandiza kwambiri chomwe chitha kukhala chothandiza kwa mtundu uliwonse wa matenda osokoneza bongo ndipo sichingayambitse insulini. Chithandizo ndi izo ziyenera kuchitika, chifukwa:

• Matendawa magazi
• Amachepetsa kuchuluka kwa cholesterol yoyipa ndikupanga kuteteza kwa atherosulinosis,
• kumaonjezera chitetezo chokwanira
• zimateteza ku chimfine, chimawagwira bwino - ma insulin ma insulin angagwiritsidwenso ntchito pochiza,
• imapereka kugwira ntchito kwamphamvu kwa mtima.

Kuphatikiza apo, turmeric ndi imodzi mwamafuta amphamvu kwambiri opangidwa mwachilengedwe. Sangathe kuvulaza microflora yam'mimba. Komanso, kutenga zonunkhirazi kumachitikanso chifukwa chakuti imakhala ndi machitidwe othana ndi kutupa ndipo imatha kuchepetsa osati chikhumbo chodya zakudya zamafuta zokha, komanso kuthana ndi zotsatira za njirayi, kuonetsetsa kuti insulin ikusungidwa. Zonsezi, zachidziwikire, ndizothandiza kwa odwala matenda ashuga, oyamba komanso oyamba.

Akatswiri azindikira kuchepa kwa kuchuluka kwa shuga m'magazi ndi kuchepa kwa kuchuluka kwa minyewa ya adipose, kumene, kumakhudza kwambiri mkhalidwe wa odwala matenda ashuga. Ichi ndichifukwa chake iyenera kutayidwa, komanso mavuto ndi thupi omwe amapanga insulin. Kuphatikiza apo, mankhwalawa a turmeric omwe ali ndi matenda osokoneza bongo amasiya kapena salola kuti pakhale zovuta zilizonse pamaso pa shuga. Makamaka, izi sizikugwira ntchito kokha ku atherosulinosis, komanso kwa nyamakazi.

Mndandanda wazinthu za turmeric umaphatikizapo mavitamini omwe ali m'gulu B, C, E ndi K, komanso zinthu zina, antioxidants achilengedwe ndi mafuta ofunikira, limodzi ndi curcumin. Ichi ndichifukwa chake zokometsera zomwe zafotokozedwerazi ziyenera kutengedwa ndi aliyense wa odwala matenda ashuga.

Zomwe zimapangidwira motere zimakhudza machitidwe onse a metabolic omwe amapezeka m'thupi la munthu, motero ndikofunika kuti muzigwiritsa ntchito tsiku lililonse. Chithandizo chotere chiyenera kuchitika chifukwa cha:

1. kupewa matenda osiyanasiyana,
2. onjezani "mtundu" wa chitetezo chokwanira.

Za ntchito

Pakukonzekera kugwiritsa ntchito turmeric, malamulo ena ayenera kutsatiridwa.

Popeza kuti iyi ikadali yokometsera ndi kukoma kotchulidwa, simuyenera kunyamulidwa ndi kugwiritsidwa ntchito kwake.

Nthawi yomweyo, matenda a shuga amtundu uliwonse akaphatikizidwa ndi mavuto am'mimba, ndikofunikira kugwiritsa ntchito turmeric pokhapokha mutakambirana ndi katswiri.

Kuchiza ndi curcumin kumatsegula mwayi wochepetsera kuchuluka kwa cholesterol m'magazi ndikuwongolera kapangidwe ka magazi. Nthawi yomweyo, simumatsukidwa kokha, komanso kupanga maselo ofiira a m'magazi kumakonzanso, ndipo kuchuluka kwa maplatinamu kumathandizidwanso. Pankhaniyi, zonunkhirazi ziyenera kukhala mosamala komanso anthu omwe ali ndi vuto la magazi.

Popeza amatha kuthana ndi zinthu zoyipa ndi poizoni m'thupi, amalangizidwa kuwonjezera pa chakudya ndi kugwiritsa ntchito mankhwala osokoneza bongo kwa nthawi yayitali kapena kuthandizira chithandizo cha matenda ashuga. Komanso, chithandizo chitha kukhala chofunikira poizoni ndi mankhwala osiyanasiyana ophera tizilombo.

Chifukwa cha machiritso ake, othandizira odwala matenda ashuga amtundu uliwonse:

• samangochepetsa kuchuluka kwa shuga m'magazi,
• Komanso zimathandizira kuti kuchira kwathunthu kwakuthupi.

Kuphatikiza apo, kugwiritsa ntchito zonunkhira zomwe zimafotokozedwazo kumapangitsa kuti pasakhale matenda oyambukira shuga omwe ali pachiwopsezo. Ichi ndichifukwa chake turmeric mu shuga imayenera kukhala gawo lofunikira pakudya. Kodi maphikidwe ndi ntchito yake ndi chiyani?

About maphikidwe

Kwa mtundu uliwonse wa matenda ashuga, maphikidwe a turmeric amakhalabe yemweyo. Mwachitsanzo, mutha kupanga tiyi wathanzi kwambiri, yemwe amaphatikizapo izi: supuni zitatu za tiyi wakuda, supuni ya kotala ya sinamoni, supuni ziwiri za turmeric ndi magawo atatu a ginger.

Komanso, kefir, uchi ndi mkaka kulawa ziyenera kuphatikizidwa ndi tiyi - zinthu zonse ndizofunikira kwa matenda ashuga.

Kuphika kumachitika molingana ndi algorithm otsatirawa: turmeric imathiridwa ndimadzi otentha, komanso tiyi wakuda, sinamoni, ginger ndi uchi. Zonsezi ndizosakanikirana bwino, kozizira ndi kefir zimawonjezeredwa. Chovomerezeka kugwiritsa ntchito tiyi m'mawa kapena madzulo, chikho chimodzi. Mutha kukonzanso nyama pudding ndi turmeric, yomwe ndi yabwino kwa odwala matenda ashuga.

Anyezi wosankhidwa ndi nyama (makamaka yophika ng'ombe) ndi chopukusira kapena nyama. Zonsezi zimayikidwa mu poto ndi mafuta a masamba ndi yokazinga kwa mphindi khumi. Chotsatira:

1. nyama yowiritsa ndi anyezi imasakanikirana ndi zina zonsezo (dzira, zitsamba, turmeric, kirimu wowawasa ndi batala),
2. atagona mu kudya kwapadera.

Mbale imaphikidwa ndi kutentha kosachepera madigiri a 180 kwa mphindi 50. Zitha kukhala zothandiza kwambiri kwa matenda ashuga komanso zimapereka mwayi osati kungodzaza thupi, komanso kuupatsa mphamvu ndi zinthu zothandiza.

Kuthandiza mwana wa matenda a shuga a mtundu woyamba 1 omwe ali ndi insulin Humalog: Zomwe zaku Poland

Tikukufotokozerani kumasulira kuchokera ku Chingerezi cha nkhani yomwe madokotala aku Poland adalemba mu Seputembara 2012. Ichi ndi chimodzi mwazinthu zothandiza kwambiri za insulin dilution. Owerenga tsamba lathu, kuphatikiza achikulire omwe amawongolera matenda awo a shuga ndi zakudya zamafuta ochepa, ayenera kuchepetsa insulini, chifukwa mukapanda apo matendawa amakhala okwera kwambiri. Tsoka ilo, mankhwala ovomerezeka, komanso omwe amapanga insulin ndi ma syringe, amanyalanyaza nkhaniyi. Werengani malingaliro athu kumapeto kwenikweni, mutatha kuwerenga nkhaniyo.

Kwa ana aang'ono kwambiri omwe ali ndi matenda amtundu wa 1, mlingo wa insulin tsiku lililonse umakhala wocheperako mpaka 5-10 magawo. Izi zikutanthauza kuti odwala oterewa patsiku amafunikira kulowa osakwana 0,05-0.1 ml ya insulin pochita 100 PIECES / ml. Ana ena amangofunika ma insulin a 0-0-0.3 a inshuwaransi (yaifupi) kuti abise 10 magalamu a chakudya chomwe amadya. Uwu ndi woperewera, microscopic mlingo wa 0.002-0.003 ml wa yankho la insulin pamsasa wa 100 PIECES / ml.

Chifukwa chiyani ndikufunika kuchepetsa insulini?

Ngati mulingo wochepetsetsa kwambiri wa insulin amafunikira kuchiza matenda a shuga, izi zimabweretsa mavuto poyesa kutsimikizira insulin yolimba komanso yolimba ya insulin kapena pampu ya insulin. Pakupopera, ma alarm nthawi zambiri amayamba.

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

Matenda a shuga amtundu woyamba amapezeka mwa ana adakali ang'ono. Chifukwa chake, vuto la kuperekera mankhwala ochepa kwambiri a insulin limakhudzanso odwala ambiri. Nthawi zambiri, insulin lyspro (Humalog), yothiriridwa ndi madzi apadera omwe amapangidwa ndi wopanga, amagwiritsidwa ntchito popopa insulin mankhwala mu makanda. M'nkhani ya lero, timapereka chidziwitso chogwiritsa ntchito lyspro insulin (Humalog), kuchepetsedwa ndi saline maulendo 10 - kuchuluka kwa ma PIECES / ml, pakugwiritsira ntchito insulin mankhwala a mwana wakhanda.

• Mtundu woyamba wa chithandizo cha matenda a shuga kwa akulu ndi ana
• Mtundu wa 1 shuga wodwala
• Nthawi ya tchuthi ndi momwe mungakulitsire
• Njira ya jakisoni wopweteka wa insulin
• Matenda a shuga 1 amtundu wa mwana amathandizidwa popanda insulin pogwiritsa ntchito zakudya zoyenera. Mafunso ndi banja.
• Momwe mungachepetse kuwonongeka kwa impso

Chifukwa chiyani mudaganiza zoyesa kuthira Humalog ndi saline?

Mnyamata wazaka 2.5, wakhala akudwala matenda ashuga amtundu woyamba kwa miyezi 12 kale, kuyambira pachiwonetsero pomwe adalandira chithandizo cha insulin. Choyamba adagwiritsa ntchito NovoRapid insulin, kenako adasinthana ndi Humalog. Mwanayo anali ndi vuto losowa chakudya, ndipo kutalika kwake ndi kulemera kwake zinali pafupi ndi gawo labwinobwino la msinkhu wake komanso jenda. Glycated hemoglobin - 6.4-6.7%. Mavuto aukadaulo ndi pampu ya insulin amachitika pafupipafupi - kangapo pa sabata. Chifukwa cha izi, kulowetsedwa kulikonse kumatha kugwiritsidwa ntchito osaposa masiku awiri. Kusintha kwa shuga m'magazi anali okwera (9.6 ± 5.16 mmol / L), shuga anali kuyesedwa kangapo 10-17 patsiku. Mlingo wa insulin anali 4.0-6.5 IU patsiku (0.41-0.62 IU / kg thupi), omwe 18-25% anali oyambira.

• Chithandizo cha matenda a shuga ndi insulin: yambani apa. Mitundu ya insulin ndi malamulo ake kuti isungidwe.
• Insulin yamtundu wanji kuti mupeze jakisoni, munthawi yanji komanso mulingo uti. Njira za matenda ashuga amtundu 1 ndi matenda amitundu iwiri.
• Momwe mungapangire jakisoni wa insulin mopweteka. Njira Ya Insulinane Insulin
• Ma insulin, ma syringe zolembera ndi singano kwa iwo. Ndi ma syringe omwe ndi bwino kugwiritsa ntchito.
• Lantus ndi Levemir - omwe akukhala insulin. Sinthani shuga m'mawa pamimba yopanda kanthu
• Ultrashort insulin Humalog, NovoRapid ndi Apidra. Insulin yochepa yaumunthu
• Kuwerengera mlingo wa insulin musanadye. Momwe mungachepetse shuga kuti akhale wabwinobwino ngati adalumpha
• Momwe mungapangire insulin kuti mupeze molondola Mlingo wotsika
• Pampu ya insulini: zabwino ndi zowopsa.Chithandizo cha insulin

Mavuto omwe adatipangitsa kuyesa kuchepetsa insulin ndi saline anali awa:

• Mafuta osungidwa "odziwika" a insulin ochokera kwa wopanga sanali kupezeka.
• Wodwalayo adawonetsa kuchepa kwapang'onopang'ono mu mulingo wa bilirubin ndi bile acid m'magazi. Izi zitha kutanthauza kuti zoteteza ku insulin ndi proprietary dilution fluid (metacresol ndi phenol) ndizovuta kwa chiwindi chake.

Komiti ya Ethics inavomereza kuyesa kugwiritsa ntchito insulin yothira mchere ndi mankhwalawa. Makolo adasaina chikalata chodziwitsa. Adalandila malangizo atsatanetsatane amomwe angapangitsire insulin ndi saline komanso momwe angakhazikitsire phukusi la insulin.

Zotsatira zamapulogalamu a insulin

Makolo adayamba kugwiritsa ntchito mankhwala othandizira pampu ndi insulin, kulowetsedwa ndi saline maulendo 10, pamtunda wowonekera, i.e. kunyumba, osayang'anira nthawi zonse akatswiri. Njira yothetsera insulin Humalog yovutitsidwa idakonzedwanso masiku atatu aliwonse. Tsopano, pogwiritsa ntchito insulin pampu, madzi ena khumi adalowetsedwa m'thupi la mwana kuposa momwe insulin inaliri.

Kuyambira m'masiku oyamba a matenda a shuga pansi pa regimen yatsopano, pafupipafupi mavuto aukadaulo ndi pampu ya insulin anachepa kwambiri. Magazi a shuga m'magazi anachepa ndikuyamba kudziwikiratu, mpaka 7.7 ± 3.94 mmol / L. Izi ndi zizindikiro molingana ndi zotsatira za kuyeza shuga m'magazi 13 mpaka 14 patsiku. M'miyezi 20 yotsatira, kufalikira kwa cannula ya pampu ndi makhristulo a insulin kumachitika katatu kokha. Chigawo chimodzi cha hypoglycemia choopsa chinachitika (shuga wamagazi anali 1.22 mmol / L), omwe amafunikira kuyamwa kwa glucagon. Pankhaniyi, mwana adatha kuzindikira kwa mphindi 2-3. Glycated hemoglobin m'miyezi 15 yoyambirira inali 6.3-6.9%, koma m'miyezi isanu yotsatira idakwera mpaka 7.3-7,5% motsutsana ndi maziko a matenda oyamba ndi chimfine.

Mlingo wa Humalog insulin, kuchepetsedwa maulendo 10, ndikugwiritsiridwa ntchito ndi pampu, anali 2.8-4.6 U / tsiku (0.2-0.37 U / kg kulemera kwa thupi), komwe 35-55% anali oyambira kutengera chidwi cha kudya komanso kupezeka kwa matenda opatsirana. Mwanayo amakhalabe ndi njala, ndipo izi zimakhudza kuwongolera kwake shuga. Koma ikukula mwachizolowezi, yopezeka kutalika ndi kulemera, ngakhale zizindikirozi zimakhalabe pamunsi pamiyeso ya zaka. Mlingo wa bilirubin ndi ma asidi a bile m'magazi unachepa kukhala wabwinobwino. Kukula kwa mavuto aukadaulo ndi pampu ya insulin kwatsika kwambiri. Makolo ndi okondwa. Amakana kusamutsa mwana kupita ku insulin pamsasa wa 100 IU / ml.

Tangowerenga mlandu umodzi wokha, koma zomwe takumana nazo zingakhale zothandiza pamachitidwe ena. Tikuwonetsa kuti kuphatikiza humalog insulin maulendo 10 kuti mugwiritse ntchito ndi insulin-based insulin therapy kungakhale kothandiza pakuthana ndi zovuta zamaluso. Njira iyi ya chithandizo idakhala yotetezeka kwa mwana yemwe akufunika insulin yochepa kwambiri. Chofunikira kwambiri pakuthandizira bwino ndikugwirizana ndi makolo ndikuwunika mosamala njirayi ndi akatswiri. Njira ya insulin dilution imatha kukhala yothandiza ngati njira zotsekedwa ndi insulin zikukonzekera ana aang'ono kwambiri. Kuti mumve mawu omaliza, kafukufuku wambiri akufunika, komanso ndemanga kuchokera kwa opanga insulin.

Ndemanga patsamba la Diabetes-Med.Com

Kwa mitundu yazifupi ndi ya insulin, inshuwarayi silivomerezedwa ndi opanga, komanso siyoletsedwa. M'mabwalo a shuga, mutha kudziwa kuti zimapereka zambiri kapena zochepa zotsatira zabwino. Mutha kusintha kuchokera ku Humalog kupita ku Actrapid musanadye chakudya chomwe chimayamba pang'onopang'ono komanso bwino. Koma ngati mukufuna kuthana ndi matenda ashuga mwa mwana, muyenera kuyipiranso.

Zatsimikiziridwa mwatsatanetsatane kuti ana aang'ono omwe ali ndi matenda amtundu woyamba wa shuga ayenera kuchepetsedwa ndi insulin kuti athe kubaya jekeseni yaing'ono mwachizolowezi. Ndipo ngati tichita pulogalamu yathu yachiwiri ya matenda ashuga kapena mtundu wa matenda ashuga 1, ndiye kuti, kutsatira zakudya zamagulu ochepa, ndiye kuti mwina ndi ana okha komanso akuluakulu adzafunikira kuchepetsa insulin. Chifukwa ngati mutayambitsa kuchuluka kwa insulin yayikulu, imayambitsa spikes mu shuga ndi magazi pafupipafupi a hypoglycemia.

Tsoka ilo, mankhwala ovomerezeka samanyalanyaza mutu wa insulin dilution. Mpaka pano, buku lovomerezeka kwambiri lazithandizo la matenda osokoneza bongo ku mayiko olankhula Chirasha ndi buku la mavidiyo awiri la 2011 lomwe linasankhidwa ndi I. I. Dedov ndi M. V. Shestakova.

Ili ndi mtundu wolimba, pafupifupi masamba 1,400. Kalanga, silinenapo kanthu za momwe mungathandizire insulin, ngakhale pagawo la chithandizo cha matenda a shuga 1 kwa ana aang'ono kwambiri. Osanena za akulu. Olembawo amanyalanyaza kwathunthu zakudya zamafuta ochepa, ngakhale kuti iyi ndi njira yothandiza kwambiri yothanirana ndi shuga komanso kupewa zovuta za matenda ashuga. Uku ndi kupenga konse.

Mwachilungamo, tikuwona kuti misala yomweyo yomweyo ikuchitika kunja. Zolemba zatsopano za chilankhulo cha Chingerezi komanso mabuku owerengera za chithandizo cha matenda a shuga samayankhulanso za zakudya zamagetsi pang'ono kapena insulin dilution. Ndikukupemphani kuti muphunzire nkhani yathu yayikulu, "Momwe Mungapangire Insulin Kuti Mukhale Ndi Mankhwala Opanda Mankhwala Oyenera." Gwiritsani ntchito njira zomwe zikuwoneka kuti zikuthandizadi, ndipo dziyeseni.

Mu 1970s, mankhwala ovomerezeka ankakana maonekedwe a magazi a kunyumba kwa zaka zosachepera zisanu, zomwe zimapangitsa kuti odwala matenda ashuga azitha kuyeza shuga wawo wamagazi. Zaka zonsezi, madotolo anena kuti ngati munthu ali ndi matenda ashuga, kukhala ndi shuga wambiri ngati momwe anthu athanzi labwino kulili kulibe ntchito ndipo koopsa. Werengani mbiri ya Dr. Bernstein mwatsatanetsatane. Masiku ano, mbiriyakale imadzibwereza yokha ndi zakudya zama carb ochepera kuwongolera mtundu woyamba wa 1 ndikulemba matenda ashuga a 2.

Werengani chifukwa chomwe sitipangira izi kuti muthe kugwiritsa ntchito insulin pump, ngakhale kwa ana aang'ono omwe ali ndi matenda a shuga 1. Tengani mwana wanu pachakudya chamoto chochepa kwambiri mukamamuyamwitsa. Kusintha ma insulini ndi insulini kudzakhala koyenera pokhapokha mapampu akaphunzira kuyeza shuga m'magazi ndikusintha mwanjira ya insulin molingana ndi zotsatira za izi. M'nkhaniyi, mapampu a insulin apamwamba amtsogolo amatchedwa "machitidwe otsekeka." Ndipo komabe, mavuto ena osaneneka omwe amachititsa satha.

Mudzathandizira gulu lalikulu la anthu olankhula Chirasha odwala matenda ashuga ngati mungagawane zotsatira za zoyesa zanu pa insulin dilution m'mawu omwe alembedwa.

Doctor Commentary

Pambuyo pakuchotsa, makolo adasinthanitsa ndi tebulo 9 yomwe idalimbikitsidwa ndi zakudya zamafuta ochepa a X XE, ndikuchotseratu chimanga, mkate, zipatso zotsekemera, shuga, zakumwa zonse ndi shuga. Kuphatikiza apo kumwa zamchere ndi masewera olimbitsa thupi.

Kuyambira pa 04/07/2016, pofuna kubwezeretsa chitetezo chokwanira m'thupi, Phoenix Fohow cell zakudya (monosaccharides, disaccharides, cordyceps-okhala ndi zinthu zachilengedwe) zakhala zikugwiritsidwa ntchito molingana ndi malamulo, kuyeretsa, komanso dongosolo lazakudya.

Pang'onopang'ono, pamene glycemia imachepa, milingo ya insulin yoyendetsedwa imachepa. Pambuyo pa miyezi iwiri, wodwalayo adatha kuthetseratu insulin mankhwala. Kuchokera palemba la amayi: "Juni 10 Tidakana insulin kwathunthu, pomwe shuga adakhalabe okhazikika: kuyambira 4.8 mpaka 7 mmol / l, mpaka kufika pa 8.5-9 mmol / l atatha kudya. "

09/10/2016 miyezi itatu atachotsa insulin: glycated hemoglobin 6 %C peptide 0,53 ng / ml, yokhala ndi 0,79 - 4.19. Zizindikiro zikuwonetsa kubwezeretsa kupanga awo insulin.

Kumbukirani mayi mwana

08.10.2016
Pomaliza, ndikukulemberani zotsatila zake.
Wachinyamata wazaka 14, chiwonetsero cha matenda amtundu wa 1 pa February 27, 2016, Glycated hemoglobin 13.8, mayeso a antibody onse ndiabwino (chitsimikiziro cha matenda amtundu 1). Mankhwala a insulin adayikidwa: magawo 10 a lantus (1 nthawi patsiku) ndi magawo 6-7 a apidra pa chakudya (katatu pa tsiku). Kutulutsidwa kuchipatala pa Marichi 3 ndi shuga wamagazi a 6 mpaka 12 mayunitsi.

Atangomaliza kudya, masinthidwe adasinthidwa: 6-8 XE patsiku m'malo mwa 18-20 XE wolimbikitsidwa patsiku, chimanga, mkate, zipatso zotsekemera, shuga, zakumwa zonse za sukari sizinaperekedwe konse. Pazonse, maziko a zakudya anali: nyama, nsomba, masamba, nsomba zam'nyanja, tchizi tchizi, yogati, mtedza ndi mbewu.

Pa Epulo 7, mogwirizana ndi Dr. Tetyuk, kuyang'anira kukonzekera kwa Fohow kunayambika. Nthawi yomweyo, adachita maphunziro olimbitsa thupi ndipo adayambitsa zakudya komanso masewera.

Mlingo wa insulin anali kuchepa mosalekeza, zomwe zimachitika makamaka chifukwa cha njira yolumikizidwa komanso "chisa cha uchi", chomwe nthawi zina chimachitika pambuyo pa kuwonekera kwa matenda ashuga.

Pa Meyi 25, 2016, hemoglobin ya glycated inali pa 6.8. Magazi a shuga anali okhazikika bwino popanda hyper- ndi hypoglycemia.

Pa Juni 10, tinasiyiratu insulin, pomwe shuga anali osakhazikika pamtunda kuchokera pa 4.8 mpaka 7, mpaka kufika pazilumba za 8.5-9 patatha kudya. Zakudya za Fohow za mankhwala osokoneza bongo komanso kutsatira zakudya sizinasinthidwe.

M'chilimwe, zipatso ndi ndiwo zamasamba zinayambitsidwa (ndizovuta kukana, popeza ana ena onse amadya zonse). Panali mapichesi, ndi mavwende, ndi mitundu yonse ya zipatso. Mbatata sizimawonjezera shuga (makamaka ozizira mu saladi), koma sitimadya mbatata yosenda bwino.

Zotsatira zonse za Seputembara 10: magawo 6 a glycated hemoglobin 6, mayunitsi a c-peptide 0,53, okhala ndi mawonekedwe a 0.79 - 4.19. Kulandilidwa kwa zinthu za Fohow tsopano kwakhala vuto osati kwa wachinyamata wofotokozedwayo, komanso kwa ana athu ena awiri.

Kusintha kwa 10,09.2016 miyezi itatu pambuyo pakuchotsedwa kwa insulin: glycated hemoglobin 6,0 % mwachizolowezi (2.0 - 6.0), C-peptide 0,53 ng / ml pa chizolowezi (0.79 - 4.19).

12/17/2016 Amasinthitsa miyezi 6 atachotsa insulin: glycated hemoglobin 5,6 % (2.0 - 6.0), C-peptide 0.88 ng / ml (0,79 – 4,19). Zizindikiro zonsezi ndizabwinobwino, zikuwonetsa kubwezeretsedwa kwathunthu kwa ntchito ya pancreatic. Ntchito ndikukulitsa chakudya moyenera ndikusunga zotsatira.

Pathogeneis wa matenda ashuga amtundu 1

1. Chiphunzitso cha Gene - mitundu iwiri yosinthika pa 6 chromosome. Amalumikizidwa ndi HLA-system, yomwe imasankha kuyankha kwamthupi ndi ma beta maselo osiyanasiyana oopsa.
2. Chiphunzitso cha Viral (kachilombo komwe kachilombo komwe kali pakati pa anthu odwala matenda ashuga kamatha kuwononga kwambiri maselo a beta kapena kumabweretsa kupitiliza kwa kachilomboka ndikupanga zochitika za autoimmune m'matumbo a islet.)

Maziko ake ndi kuperewera kwenikweni kwa insulin.

Kulephera kwa glucose kulowa minofu yodalira insulini kumabweretsa kuchepa kwa mphamvu, zomwe zimapangitsa kuti lipolysis yowonjezereka komanso proteinolysis, yomwe imalumikizidwa ndi kuchepa kwa thupi. Mikhalidwe ya kuchepa kwa insulin ndi kuperewera kwa mphamvu, kupanga mahomoni opanga ma contrainsular samatulutsa, pomwe, ngakhale kuchulukana kwa glycemia, kumayambitsa kukondoweza kwa GNG. Kuchulukitsa kwa lipolysis mu minofu ya adipose kumabweretsa chiwonjezeko chachikulu cha kuchuluka kwa ma FA. Ndi kuchepa kwa insulin, mphamvu ya liposenthetic ya chiwindi imapanikizidwa, ndipo maulere aulere amayamba kuchita nawo ketogeneis. Kudzikundikira kwa matupi a ketone kumabweretsa chitukuko cha matenda ashuga, ndipo mtsogolo - ketoacidosis. Ndi kuwonjezeka pang'onopang'ono kufooka kwa madzi m'thupi ndi acidosis, chikomokere chimayamba, pomwe pakalibe chithandizo cha insulin komanso kupatsanso madzi m'thupi kumatha.

- Kugwira ntchito nthawi yayitali - Lantus (kuyamba kwa maola 4, kutalika kwa nthawi - mpaka maola 28).

ZOPHUNZITSA ZA INSULIN
■ Kusintha kuchokera ku insulin yongokhala mwachidule kupita ku insulin analogue (mwachitsanzo, Lizpro insulin) kumakupatsani mwayi woperekera zakudya kwa odwala omwe amakakamizidwa kusintha chifukwa chogwira ntchito.
■ Mphamvu ya Lizpro insulin imayamba yomweyo jakisoni, motero, mankhwalawa amatha kutumikiridwa musanayambe kapena pakudya.
M'mayesero azachipatala, a Lizpro insulin sanawonetse kusintha kwa kayendetsedwe ka matenda a shuga poyerekeza ndi insulini yokhala ndi majini osakhalitsa.
■ Ma analogi a insulini sanapangidwebe kuti azigwiritsidwa ntchito mwa ana ochepera zaka 12 ndi amayi apakati.
MALANGIZO OTHANDIZA A INSULIN
■ khola la khungu liyenera kupangidwira pamalo opangira jakisoni kuti singano ipite pansi pa khungu ndipo isalowe m'misempha. Khola lazikopa liyenera kukhala lalikulu, singano iyenera kulowa pakhungu pakona pa 45-60 °.
Malo okhala ndi khungu lolimba ayenera kupewedwa posankha malo a jakisoni. Masamba obayira sangasinthidwe mwachisawawa.
■ Osabailanso pansi pa khungu la phewa.
■ Ma insulin omwe amangokhala pakanthawi kochepa ayenera kubayidwa m'matumbo am'mimba a khomo lakunja kwam'mimba mphindi 20-30 musanadye chakudya (analogi ya insulin imaperekedwa musanadye).
■ Ma insulin omwe amakhala nthawi yayitali amalowetsedwa m'mafuta a matako kapena matako.
■ Jakisoni wocheperako-mwachidule wa insulin (humalog kapena Novorapid) amaperekedwa musanadye chakudya, ndipo ngati ndi kotheka, mukadya kapena atangomaliza kudya.
■ Wodwalayo afotokozeredwe kuti kutentha ndi masewera olimbitsa thupi kumawonjezera kuchuluka kwa kuyamwa kwa insulin, ndipo kuzizira kumachepetsa.
■ syringe ndi singano yomweyo zitha kugwiritsidwa ntchito 4-6 m'masiku 2-3.
Ana onse ndi achinyamata omwe ali ndi matenda a shuga 1, azimayi oyembekezera omwe ali ndi matenda ashuga, odwala omwe ali ndi vuto lowona ndikuduladula malekezero ena chifukwa cha matenda ashuga ayenera kupatsidwa majekeseni a insulini!
ZOTHANDIZA KUTI MUZIKHALA NDI ZOFUNIKIRA ZA INSULIN
■ Matenda apakati komanso kupsinjika kwina kumawonjezera kufunika kwa insulin.
Kuchita masewera olimbitsa thupi kumawonjezera kugwiritsidwa ntchito kwa glucose ndipo kumatha kuthandizira ku hypoglycemia ngati mlingo wa insulini sunachepe kapena mafuta ena owonjezera atengedwa.
■ Phenomenon ya Somogy: Hypoglycemia yomwe imayambitsa insulin imayambitsa kutulutsa kwa mahomoni opatsirana (adrenaline, cortisol, mahomoni okula ndi glucagon), omwe amadziwika kuti ndi chifukwa cha hyperglycemia. Kusazindikira izi chifukwa cha hyperglycemia ndi kuchuluka kwa insulin kumabweretsa kwambiri hypoglycemia. Hypoglycemia nthawi yogona ikhoza kukhala chifukwa chosagwirizana ndi kuchuluka kwa kuthamanga kwa shuga m'magazi, mwina mwanjira iyi, kuchepa kwa insulin kumakupatsani mwayi wolondola hypoglycemia wam'mawa.
■ Zodabwitsa za "m'mawa kutacha" (zimawonedwa zonse mu shuga komanso zabwinobwino) - kuchuluka kwambiri kwa shuga m'magazi pakati pa 5 ndi 7 am, chifukwa cha hypersecretion ya kukula kwa mahomoni m'masiku oyambira popanda hypoglycemia yam'mbuyo.
MALANGIZO OTHANDIZA MALO OIPA
■ Hypoglycemia.
■ Zochitika mderalo komanso mwatsatanetsatane zomwe zimapangitsa (zosowa kwambiri ndi kuyambitsa kwa insulin ya anthu).
■ Mitundu ya tumor yokhala ndi minyewa ya fibrous ndi adipose imatha kupezeka malo a jekeseni wa insulin, mwina chifukwa cha lipogenic yokhudza insulin m'maselo a mafuta. Mapangidwe amatha kuchepera kukula pakubayidwa jakisoni pamasamba a lipohypertrophy.