Masiku ano, 7% ya anthu padziko lapansi ali ndi matenda amtunduwu. Atsogoleri omwe alipo m'gulu la odwala matenda ashuga akadali India, China ndi United States. Komabe, Russia sinapite patali, ndikutenga malo achinayi (miliyoni 9.6) atatha maiko awa.
Pokhala matenda osokonekera, matenda a shuga m'magawo oyamba amatha kudutsa asymptomatic. Ndi kupita patsogolo kwa matenda a zam'mimba, zizindikiro zoyambira zimayamba kuonekera. Komabe, kutembenukira kwa dokotala sikungakhale kwa nthawi, chifukwa matenda ashuga akhudza kale ziwalo zambiri ndipo zadzetsa zovuta.
Kuti mupewe izi, muyenera kuyang'anira mosamala zizindikilo za thupi lanu. Zizindikiro zake ndi ziti komanso momwe shuga imapezekera - nkhani yomwe imakhudza anthu ambiri.
Kodi matenda ashuga ndi chiani?
Popeza matendawa amafalikira msanga mokwanira, ndipo odwala ambiri amafa chifukwa cha zovuta, amatchedwa "mliri" wa zaka zam'ma 2000. Matenda a shuga mellitus (DM) kapena "matenda okoma", monga amanenera, ndi autoimmune pathology. Pakadali pano pali mitundu ya matendawa, monga mtundu 1 ndi mtundu 2, komanso matenda a shuga. Onsewa ali ndi chinthu chimodzi chogwirizana - shuga wambiri kapena hyperglycemia.
Matenda a shuga a Mtundu woyamba ndi njira yomwe imapanga insulin. Chifukwa cha kusokonekera kwa chitetezo cha mthupi, zimayamba kukhudza maselo a beta a pulogalamu ya islet, yomwe imayang'anira kupangika kwa timadzi timene timachepetsa shuga. Zotsatira zake, glucose simalowa m'maselo owonongeka ndipo pang'onopang'ono amayamba kudziunjikira m'magazi. Nthawi zambiri, matendawa amakula ali aang'ono, motero amatchedwa achinyamata. Chofunikira pakuchizira matendawa ndi insulin.
Type 2 shuga mellitus ndi mkhalidwe womwe mapangidwe a insulin sasiya, koma chiwopsezo cha maselo chandamale cha kusintha kwa ma cell. Zomwe zimapangitsa kukula kwa T2DM zimawonedwa ngati kunenepa kwambiri komanso genetics. Ngati palibe chomwe chingachitike pamtundu wakubadwa, ndiye kuti mapaundi owonjezera ayenera kumenyedwa. Matendawa amakhudza anthu akuluakulu kuyambira zaka 40 mpaka 40. Mu magawo oyambilira a chitukuko cha matenda ammagazi, mutha kuchita popanda kugwiritsa ntchito mankhwala osokoneza bongo (hypoglycemic), kuonetsetsa kuti mumadya komanso kuchita masewera olimbitsa thupi. Koma popita nthawi, kapamba amatha, ndipo kupanga insulini kumachepa, komwe kumafunika kugwiritsa ntchito mankhwala.
Matenda a gestational amapezeka mwa azimayi panthawi yoyembekezera. Zomwe zimapangitsa kuchuluka kwa glucose panthawi ya gestation ndi placenta. Amatulutsa mahomoni omwe amatsutsana ndi insulin. Zotsatira zake, kuchepa kwama glucose okwanira sikuchitika. Izi nthawi zambiri zimadutsa mwana akangobadwa. Komabe, ngati mulandidwa mosayenera, mutha kuyamba matenda ashuga 2.
Hyperglycemia yokhazikika mu shuga mellitus imabweretsa kuwonjezereka kwa lipids m'maselo, kusintha kwa kapangidwe kazinthu zamagetsi m'magazi, kuchepa kwa madzi, kuchepa kwa acid-base mulingo wa magazi, kuledzera ndi matupi a ketone, kumasulidwa kwa shuga ndi mkodzo, ndikuwonongeka kwa mapuloteni amitsempha yamagazi.
Ndi kuphwanya kwa nthawi yayitali kachulukidwe kazakudya, njira za pathogenic zimachitika m'matupi ambiri a anthu, mwachitsanzo, impso, chiwindi, mtima, m'maso ndi zina zambiri.
Kodi ndiyenera kukaonana ndi dokotala liti?
Chithunzi cha matenda ashuga ndichachikulu kwambiri. Munthu akasokonezedwa ndi zizindikilo zina zomwe zingakhale zovuta za "matenda okoma", chizindikiritso chake chizikhala nthawi yomweyo.
Ndiye, momwe mungadziwire matenda amtundu wa 2 kapena mtundu 2? Zizindikiro zazikulu za matendawa ndi kukodza pafupipafupi komanso ludzu losatha. Njira zotere zimachitika chifukwa cha kupsinjika kwa impso. Chifukwa cha chiwalochi, thupi limachotsa poizoni ndi zinthu zonse zovulaza.
Kuti achotse shuga owonjezera, impso zimafunikira madzi ambiri, motero amayamba kuzimatula. Ndipo popeza munthu amene sakudziwa za matendawa ali ndi matenda oopsa kwambiri, glucose amayenera kuchotsedwa pafupipafupi. Bwalo loipa loterolo limakwiyitsa maonekedwe awiriwa.
Koma palinso zizindikiro zina zochepa za shuga zomwe zimafunikanso kuthana nazo:
- Kusakwiya, chizungulire komanso kutopa. Zizindikirozi zimakhudzana ndi kugwira ntchito kwa ubongo. Zotsatira zakusokonekera kwa glucose, poizoni amatulutsidwa - matupi a ketone. Masautso awo akachuluka, amayamba kuwononga ubongo. Kuphatikiza apo, chifukwa cha kuchepa kwa glucose, komwe kumatchedwa "gwero lamphamvu", maselo amafa ndi njala, kotero munthu amafulumira kutopa.
- Kuzindikira kwa zida zowoneka. Popeza makulidwe amitsempha amapezeka mu shuga, kayendedwe kabwinobwino ka magazi kamasokonezeka. Retina imakhala ndi intaneti yake, ndipo pazosintha za pathogenic imayatsidwa. Zotsatira zake, chithunzi kutsogolo kwa maso chimakhala chosaluka, zolakwika zingapo zimawonekera. Ndi kupitilira kwa njirayi, kukulitsa kwa matenda ashuga a retinopathy ndikotheka.
- Kuwona ndi dzanzi lam'munsi. Monga momwe zimakhalira pakuwonongeka kwamawonedwe, zimagwirizanitsidwa ndi kufalikira kwa magazi. Popeza miyendo ndi malo akutali, amavutika kwambiri. Ndi chithandizo chosagwirizana ndi adotolo, zovuta zambiri zimatheka: minofu necrosis, gangrene, phazi la matenda ashuga komanso ngakhale kufa.
- Zizindikiro zina ndi pakamwa pouma, kuthamanga magazi, kuthamanga thupi, kugona mosalekeza, mavuto azakugonana, kusamba kwa msambo, zotupa pakhungu ndi kuyabwa, kuchiritsa kwa nthawi yayitali mabala ndi zilonda zam'mimba.
Pambuyo pofufuza dokotalayo, wodwalayo, yemwe chimodzi mwazizindikiro zomwe zapezeka, amatumizidwa kuti adziwe matenda a shuga.
Kuyesedwa kwa magazi
Kuti adziwe matenda a shuga msanga, katswiri amatsogolera wodwalayo kukayezetsa magazi.
Kuti muchite izi, gwiritsani ntchito chipangizo choyeza glucose - glucometer kapena mizere yoyesera.
Tiyenera kudziwa kuti ngakhale anthu athanzi labwino, WHO imalimbikitsa kuti pakhale kuyesedwa kwa shuga wamagazi kamodzi kamodzi miyezi isanu ndi umodzi.
Izi ndizowona makamaka kwa anthu omwe ali pachiwopsezo chotenga matenda, zomwe zimaphatikizapo:
- kukhalapo kwa achibale omwe ali ndi matenda omwewo;
- onenepa kwambiri;
- gulu la zaka zoposa 40;
- anamnesis a mtima pathologies;
- azimayi omwe adabereka mwana wolemera oposa 4.1 kg, ndi zina zotero.
Maola 24 asanatengere magazi, wodwalayo ayenera kukonzekera phunzirolo. Sayenera kudzichulukitsa ndi ntchito yambiri, komanso kudya mopambanitsa. Popeza kuwunika kumachitika nthawi zambiri pamimba yopanda kanthu, simuyenera kumwa chakudya kapena chakumwa chilichonse (tiyi, khofi). Kuphatikiza apo, wodwalayo ayenera kukumbukira kuti zinthu ngati izi zimakhudza kuchuluka kwa shuga: kupsinjika, kutenga pakati, matenda osachiritsika komanso opatsirana, kutopa (mwachitsanzo, kusuntha kwa usiku). Chifukwa chake, chimodzi mwazomwe zili pamwambapa chikuwonekera, wodwala amayenera kuunikiranso mayeso kwakanthawi.
Pambuyo pobereka zakuthupi kumimba yopanda kanthu, mayeso a labotale amachitidwa. Zotsatirazi zitha kuwonetsa mtundu wabwinobwino wa shuga ngati uli pamtunda kuchokera pa 3.5 mpaka 5.5 mmol / L, mkhalidwe wa chisanadze shuga kuyambira 5.6 mpaka 6.1 mmol / L, ndipo matenda a shuga opitilira 6.1 mmol / L l Tiyenera kudziwa kuti nthawi zina kafukufukuyu amachitika mukatha kudya. Kenako phindu la shuga mwa munthu wathanzi sayenera kupitirira 11.2 mmol / L.
Kuzindikira matenda a shuga a 2 kumaphatikiza mayeso amtundu kapena, monga amatchedwanso, kuyesa kwa glucose. Imachitika m'magawo awiri. Choyamba, wodwalayo amatenga magazi a venous, kenako amupatsa kapu ya madzi otsekemera (300 ml ya madzi 100 g shuga). Kenako, kwa maola awiri, magazi amatengedwa kuchokera pachala chilichonse theka la ola. Zotsatira za phunziroli zimasiyana kwambiri malinga ndi momwe thupi liliri.
Chikhalidwe cham'mimba yopanda kanthu chimachokera ku 3.5 mpaka 5.5 mmol / L, mutamwa madzi amchere ndi shuga osakwana 7.8 mmol / L.
Zotsatira za shuga pamimba yopanda kanthu kuchokera pa 5.6 mpaka 6.1 mmol / L, mutamwa zakumwa ndi shuga wochepera 7.8 mpaka 11.0 mmol / L.
Matenda a shuga mellitus pamimba yopanda kanthu kuchokera ku 6.1 mmol / L, atatha kumwa zakumwa ndi shuga zoposa 11.0 mmol / L.
Njira zina zodziwira matenda
Kuzindikira magazi a capillary ndi venous amathandiza kuzindikira matenda ashuga, komabe, iyi si njira yokhayo. Kuyesa kolondola kwambiri ndi kuyesa kwa hemoglobin ya glycosylated. Nthawi yomweyo, kubwereranso kwake kwakukulu ndi kutalika kwa kafukufuku - mpaka miyezi itatu.
Mosiyana ndi kupereka magazi mwachizolowezi, komwe matendawa amatsimikiziridwa pambuyo poyesedwa kangapo, kuyesa kwa glycosylated hemoglobin kumathandizira kuzindikira matenda a shuga.
Kuphatikiza apo, kudziwitsa za matendawa kumaphatikizanso mkodzo tsiku lililonse. Nthawi zambiri, shuga mumkodzo mulibe kapena sachita kuchuluka kwa 0,02%. Mkodzo umayang'anidwanso chifukwa cha zomwe zili ndi acetone. Kukhalapo kwa zinthu zotere kumawonetsa kuphunzira kwa matenda a shuga nthawi yayitali komanso kupezeka kwa zovuta.
Atazindikira hyperglycemia, adokotala ayenera kudziwa mtundu wa matenda. Diagnosis ya matenda a shuga a mtundu 1 ndi 2 amachitika chifukwa cha kafukufuku pa C-peptides. Mfundo zamtundu wanthawi zonse ndizoyimira jenda kapena zaka komanso kuyambira 0.9 mpaka 7.1 ng / ml. Kuphatikiza apo, kafukufuku pa C-peptides amathandiza mtundu wa odwala matenda ashuga kudziwa kuchuluka kwa jakisoni wa insulin.
Njira zodziwikirazi zimapereka chitsimikiziro chokwanira cha matenda a shuga komanso kuuma kwake.
Kuzindikira matenda ashuga aubwana
Kwenikweni, matenda a shuga kwa ana amapezeka ali ndi zaka 5 mpaka 12. Madandaulo a mwana amagwirizana kwathunthu ndi zomwe akulu amatanthauza.
Nthawi zina, matenda ashuga amakula mwa akhanda. Kuzindikira matenda amtundu woyamba wa ana mu ana oyambilira poyamba kumaphatikizapo kuwayang'anira. Zotupa zosakhwima zimachitika mwa makanda, kuphwanya kwa chopondapo kumachitika, mkodzo umakhala womata, kutupa kumawonekera pakhungu.
Chifukwa chake zomwe zimayambitsa matenda ashuga mu ana sizingakhale zakudya zopanda malire komanso kumwa koyambirira kwa zakumwa zoledzeretsa, komanso zamaganizidwe ndi thupi.
Izi ndi izi:
- Kuchulukitsa kwa malingaliro.
- Kupsyinjika.
- Kusintha kwa mahomoni.
M'malo mwake, kupezeka kwa matenda ashuga mwa ana sikufanana kwenikweni ndi kupezeka kwa akuluakulu. Nthawi zambiri, katswiri wokhala ndi "matenda okoma" omwe amakayikira amapatsa mwana mwayi wopititsa kukayezetsa magazi. Misingo ya shuga ndi yosiyana ndi akuluakulu. Chifukwa chake, mwa ana osakwana zaka 2, chizolowezi chimachokera ku 2.8 mpaka 4,4 mmol / L, wazaka kuyambira 2 mpaka 6 - kuyambira 3.3 mpaka 5.0 mmol / L, muunyamata, Zizindikiro zimayenderana ndi akulu - kuyambira 3 , 3 mpaka 5.5 mmol / L.
Ndi kuchuluka kwakuwonetsa, matenda ashuga amapezeka mwa ana. Ngati zotsatira za kafukufukuyo zikuchokera 5.6 mpaka 6.0 mmol / l, ndiye kuti adokotala amakupatsani mayeso ololera a glucose. Pambuyo pa kumwa maola awiri, chizindikiritso cha 7 mmol / L chimadziwika. Momwe zikhalidwe zimachokera ku 7.0 mpaka 11.0 mmol / L, ichi ndi prediabetes; kupitirira 11.0 mmol / L, matenda a shuga kwa ana.
Atatha maphunziro angapo, katswiri amatha kutsimikizira kapena kutsutsa zomwe akuti wapezeka. Kuti mudziwe matendawa, ndi ana otani, monga nthawi zonse, kuwunika kwa C-peptides kumachitika.
Kuzindikira komanso kuchiza matenda ashuga mwa ana ndi akulu onse kumaphatikizaponso kumwa mankhwala kapena mankhwala a insulin, kusunga zakudya zoyenera, kuyang'anira glycemia nthawi zonse komanso masewera.
Kuti adziwe matenda ashuga oyamba, makolo, makamaka amayi, ayenera kuyang'ana mwana mosamala.
Ngati zizindikiro zazikulu za shuga zikuwoneka, ndiye muyenera kufunsa dokotala posachedwa ndikukumbukira kuti simungathe popanda kusanthula mwanjira iliyonse. Kudziwa momwe mungadziwire matenda a shuga, mutha kudziteteza nokha ndi okondedwa anu pamavuto ambiri.
Mu kanema mu nkhaniyi, mutu wa njira zodziwira matenda a shuga ukupitilizidwa.
