Kuzindikira matenda a shuga ndikovuta kungoyang'ana chabe pazamankhwala azachipatala, chifukwa palibe amodzi mwa iwo omwe samadziwika chifukwa cha matendawa. Chifukwa chake, njira yayikulu yodziwira ndi shuga wambiri.
Njira yachikhalidwe yoonera (matenda owunika) ya shuga ndi kuyesa magazi, komwe kumalimbikitsidwa pamimba yopanda kanthu.
Ambiri odwala matenda ashuga sangawonetse zodetsa nkhawa nthawi yoyamba ya matenda atatenga magazi musanadye, koma atatha kudya, hyperglycemia yapezeka. Chifukwa chake, muyenera kudziwa tanthauzo la shuga m'magazi 2 ndi 3 mutatha kudya munthu wathanzi kuti muzindikire shuga pakapita nthawi.
Kodi chimakhudzana ndi kuchuluka kwa shuga m'magazi ndi chiyani?
Thupi limasunga kuchuluka kwa shuga m'magazi mothandizidwa ndi malamulo a mahomoni. Kutalika kwake ndikofunikira kuti ziwalo zonse zizigwira ntchito, koma ubongo umazindikira kwambiri kusinthasintha kwa glycemia. Ntchito yake idalira kwathunthu pazakudya ndi shuga, chifukwa maselo ake amalephera kudziunjikira nkhokwe zomwe amapanga.
Chikhalidwe kwa munthu ndichoti shuga ya m'magazi izipezeka mwa kuchuluka kwa 3.3 mpaka 5.5 mmol / L. Kutsika pang'ono kwa shuga kumawonetsedwa ndi kufooka wamba, koma ngati mumachepetsa glucose mpaka 2.2 mmol / l, ndiye kuti kuphwanya kwa chikumbumtima, delirium, kukopeka kumayamba ndi vuto loopsa la hypoglycemic.
Kukula kwa glucose nthawi zambiri sikuti kumayambitsa lakuthwa, chifukwa zizindikiro zimayamba kukula pang'onopang'ono. Ngati shuga m'magazi ndi apamwamba kuposa 11 mmol / l, ndiye kuti shuga amayamba kuthiridwa mkodzo, ndikuwonetsa kupita patsogolo kwa thupi m'thupi. Izi ndichifukwa choti, malinga ndi malamulo a osmosis, kuthamanga kwa shuga kumakopa madzi kuchokera ku zimakhala.
Izi zimaphatikizidwa ndi ludzu lochulukirapo, mkodzo wowonjezera, ziwalo zowuma zamkati, ndi khungu. Ndi hyperglycemia yayikulu, nseru, m'mimba, kufooka, kununkhira kwa acetone mu mpweya wotuluka, womwe umatha kukhala matenda a shuga.
Mulingo wa glucose umasungidwa chifukwa cha malire pakati pakulowa kwake mthupi ndi mayamwidwe am'mimba. Glucose imatha kulowa m'magazi m'njira zingapo:
- Glucose muzakudya - mphesa, uchi, nthochi, masiku.
- Kuchokera pazakudya zomwe zimakhala ndi galactose (mkaka), fructose (uchi, zipatso), chifukwa shuga amapangidwa kuchokera kwa iwo.
- Kuchokera m'malo ogulitsa chiwindi glycogen, omwe amaphulika mpaka glucose mukatsitsa shuga.
- Mwa zovuta za chakudya m'zakudya - wowuma, zomwe zimaphwanya shuga.
- Kuyambira amino acid, mafuta ndi lactate, shuga amapangidwa m'chiwindi.
Kuchepa kwa glucose kumachitika pambuyo poti insulini yatulutsidwa kuchokera ku kapamba. Izi zimathandizira kuti mamolekyu a glucose alowe mkati mwa selo momwe limagwiritsidwira ntchito kuti apange mphamvu. Ubongo umadya shuga wambiri (12%), pamalo achiwiri ndi matumbo ndi minofu.
Magazi ena onse omwe thupi silifunikira pakadali pano amasungidwa m'chiwindi mu glycogen. Glycogen malo osungirako akuluakulu amatha kukhala g 200. Amapangidwa mwachangu komanso pang'onopang'ono kudya zakudya zamafuta, kuwonjezeka kwa shuga m'magazi sikuchitika.
Ngati chakudyacho chili ndi chakudya chambiri cham'mimba chambiri, ndiye kuti kuchuluka kwa shuga kumawonjezera ndikupanga kutulutsidwa kwa insulin.
Hyperglycemia yomwe imachitika mutatha kudya imatchedwa chakudya chamagulu kapena postprandial. Imafika mpaka pakadutsa ola limodzi, kenako imachepa pang'onopang'ono, ndipo patatha maola awiri kapena atatu mchilimbikitso cha insulin, zomwe zili m'magaziwo zimabwereranso kuzisonyezo zomwe zidali chakudya chisanachitike.
Mwazi wa magazi ndi wabwinobwino, ngati pambuyo ola limodzi mutatha kudya gawo lake limakhala pafupifupi 8.85 -9.05, pambuyo pa maola awiri chizindikiro chizikhala chochepa kuposa 6.7 mmol / l.
Kuchita kwa insulin kumabweretsa kuchepa kwa shuga m'magazi, ndipo mahomoni oterewa amatha kuyambitsa:
- Kuchokera pamisempha ya kapamba (maselo a alpha),
- Adrenal glands - adrenaline ndi glucocorticoids.
- Gland ya chithokomiro ndi triiodothyronine ndi thyroxine.
- Kukula kwa mahomoni a pituitary gland.
Zotsatira za mahomoni ndi kuchuluka kwa glucose mosasinthasintha.
Chifukwa chiyani muyenera kudziwa kuchuluka kwa shuga mutatha kudya?
Kuzindikira matenda ashuga kumachitika pokhapokha podziwa kuchuluka kwa shuga m'magazi. Ngati wodwalayo wanena za kusokonekera kwa kagayidwe, ndiye kuti vutoli silovuta.
Zikatero, zimawongoleredwa ndi zizindikiritso zoonekeratu: kukhathamira kwa chakudya ndi ludzu, kukodza mopitirira muyeso komanso kusinthasintha kwamphamvu kwa thupi. Nthawi yomweyo pamakhala kuchuluka kowonjezera kwa shuga m'magazi 7 mmol / L, nthawi iliyonse ili pamwamba 11.1 mmol / L.
Kukula kwa matenda a shuga a mtundu 2 nthawi zambiri sikumapereka matchulidwe a matenda ndipo kumawonetsedwa ndi hyperglycemia asanadye komanso pambuyo pake (mutatha kudya) kuchuluka kwa shuga.
Kafukufuku wokhudzana ndi milandu yomwe ingachitike chifukwa cha kuchuluka kwa shuga m'magazi kwatsogolera kuti azindikire zovuta zingapo zamatenda a carbohydrate: kusala kudya kwa hyperglycemia, mutatha kudya, kapena kuphatikiza zonsezi. Nthawi yomweyo, kuwonjezeka kwa glucose musanadye komanso mutatha kudya kumachitika m'njira zosiyanasiyana.
Kusala kudya kwa hyperglycemia kumalumikizidwa ndi chiwindi ndikuwonetsa kukana kwa maselo ake ku insulin. Sizitengera kupangika kwa insulin ndi kapamba. Kuwonjezeka kwa shuga wamagazi mukatha kudya kumawonetsa kukana kwa insulin, komanso kubisala kwa secretion ya timadzi timeneti.
Choopsa chachikulu chokhudzana ndi kukula kwa zovuta za matenda a shuga ndizofunikira kwambiri kuchuluka kwa shuga mutatha kudya. Njira idapezeka pakati pa msambo wa glycemia mutatha kudya komanso chiopsezo chotenga matenda otere:
- Kuwonongeka kwa khoma la mtima la mitsempha ndi ma capillaries.
- Myocardial infaration.
- Matenda a shuga a retinopathy.
- Matenda a oncological.
- Kuchepetsa kukumbukira ndi luso la malingaliro. Matenda a shuga ndi dementia amalumikizidwa mosagwirizana.
- Mikhalidwe yovuta.
Mphamvu yamagalasi
Pofuna kupewa kuwonongedwa kwa mitsempha yamagazi ndi matenda a shuga, sikokwanira kukwaniritsa kusala kudya kwa matenda. Ndikofunikira kuyeza shuga maola awiri mutatha kudya. Nthawi imeneyi imalimbikitsidwa ndi akatswiri ambiri omwe amachiza matenda ashuga.
Kuchepetsa shuga m'magazi kumatheka ndi njira zingapo: insulin, kumwa mapiritsi ochepetsa shuga, kugwiritsa ntchito insulin ndi mapiritsi (a mtundu 2 wa shuga), njira zosagwiritsa ntchito mankhwala.
Njira yayikulu yothanirana ndi matenda a shuga ndikugwiritsa ntchito pamodzi mankhwala othandizira komanso mankhwala. Odwala amalangizidwa kuti azitsatira zakudya zomwe sizimaphatikizidwa ndi mafuta ochepa ndi mafuta a nyama.
Zakudya zoletsedwa ndizophatikiza:
- Shuga ndi zinthu zomwe zimalowa.
- Ufa wa tirigu, makeke, mkate, kupatula mkate wa bulauni.
- Mpunga, pasitala, msuweni, semolina.
- Zipatso zokoma, timadziti kuchokera kwa iwo, makamaka mphesa.
- M nthochi, wokondedwa, masiku, zoumba zoumba.
- Mafuta onenepa, wochotsa.
- Zakudya zamphaka, soseji, timadziti ndi zakumwa zozizilitsidwa ndi shuga.
Kuti muchiritse bwino matenda a shuga mellitus, tikulimbikitsidwa kuti tiziphatikiza zolimbitsa thupi zolimbitsa thupi tsiku ndi tsiku munjira zamakalasi azolimbitsa thupi, kusambira, kuyenda kapena masewera aliwonse, poganizira kuchuluka kwa thanzi lanu komanso thanzi lathunthu.
Ngati mankhwalawa amachitika molondola, zotsatira zake zimakhala zokhazikika pamlingo wa glycemia mutatha kudya, pomwe maola 2 sapitilira 7.8 mmol / l ndipo palibe kuukira kwa hypoglycemia.
Kuwunika kwa glucose kumachitika ku chipatala chifukwa cha njira yoyenera yolandirira, ndipo kunyumba, kudzipenda wekha kuli bwino. Ndi mtundu 1 wa shuga komanso mankhwala a insulin odwala omwe ali ndi matenda a shuga a 2, glycemia iyenera kuyang'aniridwa katatu patsiku.
Ngati wodwalayo amangomwa mankhwala oikidwa pokhapokha, ndiye kuti amadziyang'anira wokha malinga ndi kusinthasintha kwa kusinthasintha kwa shuga m'magazi ndi gulu la mankhwalawa omwe amagwiritsidwa ntchito. Kukula kwa miyeso kuyenera kukhala kotero kuti zitheke kukwaniritsa zomwe mukufuna pamimba yopanda kanthu komanso maola awiri mutatha kudya.
Njira zoyendetsera kasamalidwe kabwino ka shuga zomwe zimaperekedwa ndi International Federation of Diabetes ndi monga: kusala glucose wosaposa 6.1 mmol / l, pambuyo maola awiri kuchokera pachakudya chochepera 7.8 mmol / l, glycated hemoglobin pansipa 6.5%.
Masana munthu amakhala kuchokera 3.00 mpaka 8.00 mu "kusala kudya", nthawi yonseyo - mutatha kudya kapena poyambitsa.
Chifukwa chake, kuyesa glucose musanadye chakudya cham'mawa sikuthandizira kuwunika, kubwezeretsa chithandizo ndi mankhwala.
Mankhwala othandizira pambuyo pa chakudya
Popeza udindo wa shuga wambiri pambuyo poyambitsa zovuta za matenda ashuga wakhazikitsidwa, gulu lapadera la mankhwala limagwiritsidwa ntchito kuti likonze - prandial glucose regators.
Chimodzi mwa izo ndi mankhwala acarbose (Glucobay). Zimalepheretsa kuwonongeka kwa zovuta zam'mimba, kuphatikiza kwa glucose pazomwe zili m'matumbo. Popeza hyperglycemia simachitika mutatha kudya, kutulutsa insulini kumachepetsedwa, komwe kumapangitsa njira zama metabolic, makamaka kunenepa kwambiri. Ubwino wa mankhwalawa umaphatikizapo chiopsezo chochepa chokhala ndi hypoglycemia.
Pakadali pano, mankhwalawa amagwiritsidwa ntchito mwachangu omwe amathandizira kupewa kuchuluka kwa shuga wamagazi mukatha kudya, osatsitsa mpaka kuchuluka kwa hypoglycemia. Izi zikuphatikiza zotumphukira za amino acid nateglinide ndi repaglinide. Amamasulidwa pansi pa mayina ogulitsa Starlix ndi Novonorm.
Starlix imathandizira kubisalira kwa insulin, yomwe imakhala pafupi ndi thupi ndikudziwonetsa lokha pamaso pa hyperglycemia. Novonorm imachitanso chimodzimodzi, koma ikatengedwa, palibe kumasulidwa kwa mahomoni okula ndi glucagon, omwe ali ndi zotsutsana nazo. Chiyambireni chochita zake m'mphindi 10, ndipo nsonga imachitika mkati mwa ola limodzi.
Kugwiritsa ntchito mankhwalawa kunatsimikizira kugwira ntchito kwake, komwe kunawonetsedwa pakuchepetsa hemoglobin wa glycated, ndikugwiritsa ntchito pokhapokha ndi chakudya kumathandizira odwala omwe ali ndi mavuto omwe amadza chifukwa chakudya.
Zithandizo zamankhwala zimachulukana ndikumalumikizana ndi Metformin, chifukwa zimathandizira kagayidwe kazakudya. Kanemayo munkhaniyi afotokoza chifukwa chake mukufunika kuyezetsa magazi a shuga.
