Katswiri wa zamankhwala, kusankha mankhwala a shuga kwa wodwala, akuyenera kuwongoleredwa ndi zinthu zingapo, zomwe zimaphatikizapo zaka komanso kuuma kwa njira ya pathological, kukhalapo kwa matenda opatsirana. Kuphatikiza apo, kutengera mtundu wa matenda, njira zakuchiritsira matendawa zimatha kusintha.
Tiyenera kudziwa kuti kumwa kokha mapiritsi a shuga mellitus sikungathandize kwenikweni, chifukwa mankhwalawa ayenera kukhala ovuta. Kuphatikiza zakudya zamafuta ndi moyo wokangalika kumakhala zinthu zofunika kwambiri.
Tsoka ilo, matenda ashuga ndi matenda omwe sangathe kuchiritsidwa kwathunthu. Ngati munthu wapatsidwa chithandizo ichi, zikutanthauza kuti muyenera kusintha kwambiri moyo wanu kukhala watsopano ndikuwatsatira nthawi zonse.
Chithandizo chamankhwala a matenda a shuga masiku ano chimapereka mankhwala ochulukirachulukira omwe alibe vuto loipa mthupi la munthu ngati mankhwala akale.
Kodi matenda ndi chiyani?
Pakukonzekera matendawa, kuphwanya kwapang'onopang'ono kwa njira zonse za metabolic m'thupi kumachitika. Cholinga chachikulu cha kulephera uku sikuti kupanikizika komwe kumapanga kuchuluka kwa insulini ya mahomoni, yomwe imayang'anira kuchuluka kwa glucose m'magazi.
Zotsatira zake, maselo amthupi sangalandire mphamvu yofunikira ndi zinthu zina zofunika, ndipo kuchuluka kwazowonjezera kwa shuga kumayambitsa matenda ena a ziwalo zamkati kuwonekera.
Masiku ano, pali mitundu iwiri yayikulu yamatenda:
- Mtundu woyamba wa shuga. Chizindikiro chachikulu cha matenda amtunduwu ndikulephera kwa kapamba kuti apange insulin payokha. Ndiye chifukwa chake, anthu omwe adazindikira izi (zamtundu woyamba) amafunikira jakisoni wambiri wa mahomoni kuti azigwira ntchito zofunika.
- Matenda a shuga a Mtundu Wachiwiri ndiwo mtundu wofala kwambiri wamatendawa. Malinga ndi ziwerengero zamankhwala, azimayi ali pachiwopsezo chotenga matenda amisala kuposa abambo. Kuphatikiza apo, okalamba ali pachiwopsezo. Chofunikira pakukula kwa mawonekedwe amtunduwu ndi kulephera kwa kapamba kuti apange insulini yofunikira thupi.
Nthawi zina, mtundu wa matenda monga matenda a gestational matenda amathanso kuchitika. Zifukwa zake zazikulu zakukonzekera kwake zimaphatikizaponso izi:
- nthawi yobereka mwana mwa mkazi;
- kukula kwa hyperglycemia.
Zomwe zimayambitsa chitukuko cha matendawa zimaphatikizapo:
- chibadwa kapena chibadwa;
- kunenepa kwambiri komanso kunenepa kwambiri;
- kupsinjika kwakukulu ndi mantha amanjenje;
- moyo wongokhala ndi kusowa zochita zolimbitsa thupi;
- malowedwe olowa mthupi la akazi matenda osiyanasiyana opatsirana ndi ma virus.
Kuphatikiza apo, zomwe zimayambitsa chiwonetsero cha matendawa zimatha kuphatikizapo zinthu monga zaka, chilengedwe, kugwira ntchito kwa kapamba, kukhalapo kwa kupumula koyenera.
Ndi zizindikiro ziti zomwe zikuwonetsa kukula kwa matenda?
Ziribe kanthu kuti ndi matenda amtundu wanji omwe amapezeka, zizindikilo za matenda ashuga ndizofanana.
Mu matenda a shuga amtundu wachiwiri, zizindikilo zoyambirira zimawoneka zodwala kwa wodwala. Nthawi zambiri kudziwika kwa matenda kumachitika pamene matendawa akula msanga.
Khalidwe lamakono, kuthamanga komanso kukhudzana komwe kumachitika nthawi zambiri kumabweretsa kuti munthu sazindikira zoyamba za matendawa.
Zizindikiro zazikulu zodwala matenda a shuga zingakhale motere:
- Kutopa, kusweka ndi kukhumudwa nthawi zonse kumatha kukhala zizindikiritso zoyambirira zomwe zimawoneka ndi matenda amtundu wa 2. Monga lamulo, malingaliro ofooka samasiya munthu ngakhale atapuma komanso kugona mokwanira.
- Kuwonetsedwa kwa ulesi, kugona ndi kuwonongeka kwa mphamvu mukatha kudya, makamaka ngati izi zimachitika ndipo zimadziwonetsa zokha.
- Udzu wokhazikika, womwe umatsatana ndi kuyanika kwambiri pamlomo wamkamwa. Tiyenera kudziwa kuti, ngakhale kumwa madzi ambiri, munthu sangathe kuthetsa ludzu lake. Ndi chizindikiro cha mtundu wachiwiri wa matenda ashuga omwe amadziwika kwambiri ndipo akuyenera kuwonetsa ngati akufunika kukaonana ndi dokotala.
- Kufunsira pafupipafupi kukhetsa komanso kuthana ndi madzi kuchokera mthupi, kumawonetsa kukula kwa matendawa komanso kuphwanya kwamadzi kagayidwe.
- Kulemera kwambiri kumasokoneza mayamwidwe a shuga. Ndiye chifukwa chake kunenepa kwambiri ndi chimodzi mwazinthu zazikulu zowopsa zomwe zimapangitsa kuti matendawa akule. Zizindikiro za mtundu wachiwiri wa matenda ashuga zitha kuphatikizira mafuta mthupi mchiuno ndi m'mimba.
- Nthawi zonse kuchulukirapo kwa magazi.
- Kulakalaka kosaletseka kwa maswiti komanso kulakalaka kudya. Nthawi yomweyo, ngakhale atadya zakudya zambiri, munthu amatha kuchepa.
- Kuwonekera kwa mavuto ndi khungu komanso kuwonjezereka kwa vutolo. Kuphatikiza apo, azimayi nthawi zambiri amadandaula ndi kuyabwa kwawo mthupi lonse, makamaka m'malo opangira mafuta. Komanso, ma pustule osiyanasiyana ndi ziphuphu zimatha kutuluka pakhungu. Popita nthawi, khungu m'manja ndi pamapazi limasintha - amasintha kwambiri. Chidziwitso chiyeneranso kulipidwa pakusintha kwa misomali yamatumbo, chikasu chawo ndi kuumitsa.
- Mutu wopitilira, womwe umatha kutsagana ndi mseru komanso kusanza.
- Kuwonongeka kwakuthwa m'masomphenya.
- Maonekedwe a zowawa za ng ombe ndi kukokana.
- Mukamadutsa mkodzo kuti muunikidwe, zotsatira zake zitha kuwonetsa kukhalapo kwa acetone.
- Pali mavuto ndi msambo.
Ngakhale pali zifukwa zomwe zidapangitsa kuti matendawa atukuke, ngati zizindikiro zotere zikuchitika, muyenera kulumikizana ndi achipatala ndikupita maphunziro ofunikira.
Kodi chithandizo chamankhwala cha matenda am'mimba ndi chiani?
Mankhwala othandizira odwala matenda ashuga amaperekedwa ngati njira zosagwiritsa ntchito mankhwala (zomwe ndi, chithandizo cha zakudya ndi zochita zolimbitsa thupi) sizibweretsa zotsatira zoyenera.
Chifukwa chakuti pali kuphwanya kwapa kapamba, shuga m'magazi sangasinthidwe popanda chithandizo chamankhwala.
Masiku ano, pali mitundu yambiri yosiyanasiyana ya mankhwalawa yomwe imagwiritsidwa ntchito molimbika kutulutsa glycemia.
Zonsezi zimagawika m'magulu ena ndipo zimagwiritsidwa ntchito molingana ndi mawonekedwe a matendawa wodwala wina:
- Ma secagog ndi mankhwala a shuga omwe amathandizira kubisalira kwa insulin. Gulu la mankhwalawa limaphatikizanso magulu awiri akuluakulu - sulfonylureas ndi meglitinides.
- Sensitizer ndi mankhwala osokoneza bongo omwe ali ndi phindu popititsa chidwi cha maselo ndi minofu ya thupi kupita ku insulin yopangidwa ndi kapamba. Ndi mapiritsi a shuga ngati amenewo omwe nthawi zambiri amagwiritsidwa ntchito popanga insulin. Gulu la mankhwalawa limaphatikizapo kukonzekera kwamagulu awiri - biguanides ndi thiazolidatediones.
- Mankhwala a shuga, omwe ali alpha-glucosidiaz inhibitors, omwe ali ndi udindo wololeza komanso kuyamwa mwachizolowezi wamafuta obwera m'matumbo, komanso kutulutsa kwawo. Mankhwala a shuga, omwe ali oyimira gulu lalikulu ndi Acarbose.
- Mankhwala atsopano a shuga ndi ma insretins, omwe amathandizira kupanga insulin ndipo nthawi yomweyo akuletsa kupanga kwa glucogen.
Mankhwala ambiri amakono omwe ndi othandiza kwambiri ndipo samakhala ndi vuto lililonse m'thupi la wodwalayo (m'njira zosiyanasiyana zoyipa) amakhala ndi mtengo wokwanira. Popeza kuti kugwiritsa ntchito kwawo kuyenera kuchitika kwa moyo wonse, odwala ambiri sangathe kugula mankhwala atsopano a shuga. Ichi ndichifukwa chake mankhwalawa omwe amagwiritsidwa ntchito kwambiri pa matenda a shuga a 2 ali m'magulu a sulfonylurea ndi Biguanide. Monga lamulo, mankhwala a shuga oterowo amakhala ndi mtengo wotsika ndikuthandizira kukwaniritsa kuchuluka kwa glycemia.
Kuphatikiza apo, chithandizo chamankhwala chitha kuphatikiza kuphatikiza kwakanthawi kwamankhwala kuchokera kumagulu osiyanasiyana (malangizo a shuga omwe angagwiritsidwe ntchito) kuti akwaniritse zotsatira zabwino.
Mankhwala kuchokera pagulu la sulfonylurea
Zochokera ku Sulfonylurea zakhala zikugwiritsidwa ntchito kuyambira kalekale pochiza matenda am'magazi.
Mphamvu ya gululi la mankhwala pathupi la munthu imalumikizidwa ndi kayendedwe ka maselo a beta a kapamba, omwe amalumikizana ndi kukondoweza ndikuwonjezera kupanga kwa insulin.
Kugwiritsa ntchito mankhwala a sulfonylurea kumachitika pamaso pa maselo a beta ogwira ntchito mokwanira m'thupi.
Amayendedwe a gulu la mankhwala awa akuwonetsa zotsatirazi:
- kukondoweza kwa maselo a pancreatic beta ndikuwonjezera kwawo pakumverera kwa ma cellꓼ
- kuchuluka kwa insulin ndi kuponderezana kwa mahomoni omwe amaswa (insulinase) ꓼ
- kufooketsa ubale wa insulin ndi mapuloteni, kuchepetsa kuchuluka kwa insulin kumanga ma antibodiesꓼ
- amathandizira kukulitsa chidwi cha minofu ndi lipid minofu zolandirira insulinꓼ
- onjezani kuchuluka kwa zolandilira m'matumbo am'mimba
- zimathandizira kuti magwiritsidwe ntchito a shuga agwiritsidwe ntchito mu chiwindi ndi minofuꓼ
- sinthani ndondomeko ya gluconeogenesis mu chiwindi
- mu lipid zimakhala zimachepetsa lipolysis komanso zimachulukitsa mayamwidwe ndi oxidation wa glucose.
Mpaka pano, pali mitundu ingapo ya mankhwala omwe amachokera ku sulfonylureas.
Mankhwala a gulu loyamba, omwe sagwiritsidwe ntchito ngati mankhwala amakono, ndi Tolazamide, Carbutamide. Adakhala oimira sulfonylurea kumayambiriro kwa zaka za zana la makumi awiri, koma chifukwa cha kuchuluka Kwakukulu pazotsatira zoyipa za ziwalo zina ndi machitidwe amunthu, sagwiritsidwanso ntchito ndi mankhwala amakono.
Gulu lachiwiri, lomwe Glibenclamide, Gliclazide ndi Glipizide ndikuyimira. Mankhwala otere nthawi zambiri amaperekedwa kwa odwala kuti achepetse shuga. Kugwiritsa ntchito mankhwalawa, ndikofunikira kuyang'anitsitsa mkhalidwe wa glycemia, chifukwa mlingo wosankhidwa molakwika ungayambitse kukula kwa hypoglycemia. Glimepiride ndi gulu lachitatu.
Mankhwala ochokera ku gulu la Biguanide
Mankhwala osokoneza bongo a diabetes mellitus sangathe kulingaliridwa popanda kugwiritsa ntchito ma biguanides, omwe adayamba kugwiritsidwa ntchito pazachipatala zoposa theka la zaka zapitazo. Ena mwa oimira gululi ndi achikale opanda chiyembekezo.
Poterepa, gawo lalikulu la zigawo zamakono zamakono ndi pophika metformin hydrochloride. Pamaziko ake, mankhwala ambiri osiyanasiyana ogulitsa amapezeka, omwe amatha kukhala ndi mitundu yosiyanasiyana.
Mankhwala oterewa a shuga samangothandiza hypoglycemic, komanso amathandiza kuchepetsa thupi, zomwe ndizofunikira kwa odwala matenda ashuga ambiri omwe amakhala ndi matenda a insulin. Chimodzi mwazabwino za metformin hydrochloride ndikuti chimatsitsa shuga popanda kuyambitsa hypoglycemia.
Zotsatira zosiyanasiyana za mankhwala a greatuanide ndizolinga:
- Pamodzi ndi insulin, imathandizira kuchepetsa kupanga kwa chiwindi ndi chiwindi, pamene ikukulitsa kuchuluka kwa kumva kwa hepatocides. Kuphatikiza apo, kuphatikiza uku kumabweretsa kuwonjezeka kwa kapangidwe ka glycogen komanso kuchepa kwa glycogenolysis.
- Zimalimbikitsa kukhudzana ndi insulin.
- Zothandiza pakuchotsa mofulumira shuga m'thupi.
- Zimalepheretsa mayamwidwe a shuga m'matumbo.
- Zimawongolera njira yogwiritsira ntchito shuga m'thupi.
Mankhwala osankhidwa bwino a shuga opangidwa ndi metformin hydrochloride, samangotsitsa shuga wamagazi, komanso amathandizira kuwonjezeka kwake mtsogolo. Kuphatikiza apo, Biguanides amalekerera mosavuta ndi odwala ambiri ndipo alibe chiwerengero chambiri chotsutsana ndi zovuta zomwe zimachitika.
Dziwani kuti mankhwala atsopano a shuga amawoneka, omwe pang'onopang'ono amachotsa ntchito za Biguanides.
Nthawi yomweyo, mapiritsi a Metformin amathandizira kuchepetsa matendawa panjira yolimbana ndi matenda ashuga ndipo ndi mankhwala omwe angakwanitse kugula m'magulu ambiri odwala.
Kodi ndizotheka kupewa kukula kwa matendawa?
Pali magulu ena owopsa kwa anthu omwe amatha kukhala omwe amathandizira kukulitsa matenda a shuga.
Izi zikuphatikiza, choyamba, azimayi ndi abambo omwe ali ndi vuto lotengera pakubadwa kwa matendawa, anthu omwe ali onenepa kwambiri, anthu omwe ali ndi mtima wamatenda kapena matenda oopsa, azimayi, ngati ali ndi pakati amawonetsa matenda ashuga kapena kuleza mtima shuga, azimayi omwe m'mbuyomu adasokonekera.
Malangizo akulu omwe angathandize kupewa matendawa ndi motere:
- Kulemba pafupipafupi kuchuluka kwa shuga m'magazi.
- Unikani bwino chakudya chanu, pewani kudya kwambiri komanso kusala kudya. Zakudya zizikhala ndi kukana kwathunthu zakudya zotsekemera ndi shuga, mankhwala ophika buledi, mafuta ndi zakudya yokazinga. Zinthu zokhazikika monga kabichi, udzu winawake, sipinachi, chimanga (kupatula mpunga ndi semolina), nthangala. Zakudya zamagulu azakudya za shuga wambiri ziyenera kupangidwa ndi katswiri wazachipatala powaganizira za wodwala aliyense.
- Pewani zoipa.
- Tsatirani moyo wokangalika, sewera masewera. Kuchita masewera olimbitsa thupi ndikofunikira kuti muwongolere shuga. Nthawi zina zimakhala zokwanira kumangoyenda tsiku ndi tsiku pamtunda wosiyanasiyana komanso m'njira zosiyanasiyana. Malo abwino oti "masewera" oterowo akhale nkhalango kapena paki. Muthanso kuchita masewera olimbitsa thupi kunyumba kapena masewera olimbitsa thupi. Poterepa, ndikofunikira kulingalira za kuthekera ndi mawonekedwe a thupi lanu osati kuwonongera.
- Pewani zochitika zopsinja, pumulani bwino ndipo vomerezani zovuta zilizonse.
Ngati pali zovuta zina zosokoneza, muyenera kufunsa dokotala ndikuyang'ana shuga. Kuzindikira matendawa kumaphatikizapo mayeso awiri akuluakulu - magazi ndi mkodzo.
Kuti mudziwe kuchuluka kwa shuga, magazi amayenera kutengedwa m'mawa m'mimba yopanda kanthu. Pankhaniyi, chakudya chotsiriza chiyenera kukhala osachepera maola khumi musanabadwe.Kukonzekera koyenera kokha ndi komwe kungathandize kupeza chidziwitso chodalirika. Ngati zotsatira za mayesowa zikuwonetsa kuti ndi matenda omwe angakhalepo, wodwalayo atha kutumizidwa kukayezetsa ziphuphu. Kuzindikiritsa ndi kuchiza kwa matenda am'mimba kumachitika ndi endocrinologist.
Kanemayo munkhaniyi akufotokoza zomwe mankhwala a shuga amathandizadi.
