Kusungabe kuchuluka kwa shuga m'magazi kumatheka kudzera mu ntchito ya endocrine system. Ngati kagayidwe kazakudya kamakhala ndi vuto, izi zimayambitsa zosokoneza pakugwira ntchito kwamanjenje, kuphatikizapo ubongo, komanso kuwonongeka kwamitsempha yamagazi.
Shuga wamwazi wokwera nthawi zonse amadziwika kuti ndiye chizindikiro chachikulu cha matenda ashuga. Kuti mudziwe, kuyezetsa magazi kumachitika pamimba yopanda kanthu komanso pambuyo pothira shuga, yomwe imakulolani kuzindikira matendawa mudakali koyambirira.
Kupitiliza kosawerengera kwa shuga wowerengera kumathandizira chithandizo chokwanira cha matenda ashuga komanso kupewa kupweteka kwambiri komanso matenda osakhazikika, omwe amaphatikizapo nephropathy, matenda a shuga, retinopathy, komanso mtima.
Kodi mndandanda wam shuga umadalira chiyani?
Kuwonetsa kupitiliza kwa mphamvu kwa maselo amthupi kumatha kukhala ndi kuchuluka kwa glucose m'magazi ndikutuluka kwake mosagwirizana ndi gawo. Kuphwanya kulikonse kwamakina awa kumadziwonetsera mu mawonekedwe a kupatuka kuchokera pazizolowezi: hypoglycemia ndi kuchepa kwa shuga wamagazi kapena hyperglycemia ndi kukula kwake.
Chizindikiro chofananira cha kagayidwe kazakudya ndi 3.3 - 5.5 mmol / l posankha kusala kwamagazi m'magazi. Kusinthasintha mkati mwa 30% ya malirewa kumawonedwa kuti ndi kochepa ndipo, ngati sikunayambitsidwa ndi matenda, thupi lidzawabweza posachedwa.
Izi zitha kukhala ndi kudya kwakatundu (hyperglycemia mutatha kudya), kutengeka mtima kapena thupi (hyperglycemia panthawi yamavuto), kapena kutsika kwa shuga munyengo yochepa yanjala.
Mwazi wa shuga wamagazi umakhazikika ndi ntchito yolumikizana ya kapamba ndi mantha am'mimba. Mahomoni a adrenal glands, mkhalidwe wamatumbo, impso ndi chiwindi zimakhudzanso msinkhu wa glycemia. Omwe amagwiritsa ntchito shuga ndi ubongo ndi minofu, komanso minyewa ya adipose.
Pali mitundu ingapo yamalamulo a carbohydrate metabolism:
- Zachisoni.
- Gwiritsani ntchito.
- Hormonal
- Renal.
Njira ya neural yolamulirira imachitika motere: pazokhumudwitsa za ulusi zomvera chisoni.
Izi zimabweretsa kuwonjezeka kwa catecholamines wamagazi, omwe amachititsa kusweka kwa glycogen ndikuwonjezera glycemia.
Ngati dipatimenti ya parasympathetic idayambika, izi zimaphatikizidwa ndi insulin yogwira ntchito komanso kulowa mwachangu kwa mamolekyu a glucose m'misempha yomwe imadalira insulin, yomwe imachepetsa shuga m'magazi.
Kukula kwa gawo la glucose metabolism kumadalira mulingo wake m'magazi. Gawo la malire a ndende pomwe mapangidwe ake mu chiwindi ndi ofanana ndi minyewa ndi 5.5-5.8 mmol / L.
Pa malo otsika, chiwindi chimayamba kupereka shuga m'magazi (kusweka kwa glycogen kumayambitsa). Ngati shuga amawerengera, ndiye kuti kapangidwe ka glycogen mu minofu ndi maselo a chiwindi ndi komwe kumachitika.
Kuwongolera kwa mahormone kumachitika chifukwa cha ntchito ya dongosolo lonse la endocrine, koma insulini imakhala ndi kupendekera kwapadera kwamankhwala a shuga, pomwe ena onse amawonjezera. Kapangidwe ka insulin kamapezeka mu molekyu yayikulu, yomwe siyigwira ntchito ndipo imatchedwa proinsulin.
Malo omwe amapangira proinsulin ndi timinyewa tating'ono totseguka m'mapapo. Ndi kuwonjezeka kwa shuga m'magazi, ma glucose receptors adamulowetsa. Pambuyo pa izi, molekyulu ya proinsulin ikhoza kugawidwa mu insulin ndi mapuloteni omangika otchedwa C-peptide.
Malangizo a renal amapezeka pa glucose kusefera mu glomeruli ndi mayamwidwe ake obwezeretsanso aimpso. Zotsatira zake, palibe shuga mumkodzo wachiwiri, womwe umatuluka m'thupi.
Ngati a impso masamu a m'magazi amadzaza ndi magazi am'madzi ambiri, ndiye kuti amathira mkodzo. Glucosuria imachitika pambuyo poyambira kuchuluka kwa glucose m'magazi ozungulira.
Izi zimachitika ngati shuga wamwazi apamwamba kuposa 9 mmol / L.
Kuyesa kwa shuga m'magazi
Pakuchita kafukufuku wokhudza matenda a kagayidwe kazakudya, mawonekedwe a kusala kudya glycemia ndipo mutatha kudya amafotokozedwa. Pachifukwa ichi, njira yogwiritsira ntchito labotale kapena glucometer imagwiritsidwa ntchito, yomwe imagwiritsidwa ntchito kunyumba.
Kusanthula kumachitika pambuyo pakupuma kwa maola 10 mukudya, kupatula masewera olimbitsa thupi, kusuta, kudya chakudya kapena zakumwa, ndibwino kugwiritsa ntchito madzi akumwa oyera pang'ono kuti muchepetse ludzu lanu.
Ngati wodwala agwiritsa ntchito mankhwala aliwonse, ndiye kuti kusiya kwawo kuyenera kuvomerezana kaye ndi adokotala kuti apatsidwe zotsatira zabwino. Mtengo wodziwitsa ndi kuyezetsa magazi kochitika kawiri patsiku zosiyanasiyana.
Ma shuga a mmol / l pakafukufuku wamagazi athunthu:
- Mpaka 3.3 - hypoglycemia.
- 3-5,5 - shuga wamwazi ndi wabwinobwino.
- 6-6.1 - prediabetes.
- Pamwambapa 6.1 pali shuga.
Ngati mukukayikira kuphwanya kwa kagayidwe kazachilengedwe, TSH imachitika - kuyesa kwa glucose. Muyenera kukonzekera - kupatula kupsinjika kwamalingaliro m'masiku atatu, sipayenera kusinthidwa mu zakudya ndi matenda opatsirana.
Patsiku la mayeso, osachita nawo masewera olimbitsa thupi kapena kulimbikira, musasute.
Kuyesa kulolera kwa glucose kumasonyezedwa pamaso pa zinthu zomwe zingayambitse matenda oopsa a shuga, kumachitika ndi matenda oopsa, mafuta am'thupi kwambiri, azimayi omwe ali ndi matenda osokoneza bongo, mazira a polycystic, mwana wobadwa ndi thupi lolemera kuposa 4.5 kg, onenepa kwambiri, olemedwa ndi chibadwa, atatha zaka 45.
Kuchita TSH kumaphatikizapo kuyezetsa magazi kwa glucose, kudya 75 g shuga ndi madzi, ndiye kuti wodwalayo ayenera kupumula kwa maola 2 ndipo ayenera kukayezetsanso magazi ena.
Zotsatira zoyesedwa za shuga zimayesedwa motere:
- Kulekerera kwa glucose kumayipa, matenda a shuga a m'mbuyomu: mayeso asanakwane 6.95 mmol / l, atatha kudya shuga - 7.8 - 11.1 mmol / l.
- Mafuta osokoneza bongo osokoneza bongo: muyeso umodzi - 6.1-7 mmol / L, zotsatira zachiwiri - zosakwana 7.8 mmol / L.
- Shuga mellitus: pamaso pa katundu - oposa 6.95, ndipo pambuyo - 11.1 mmol / l.
- Norm: pamimba yopanda kanthu - osakwana 5.6 mmol / l, mutatha - osakwana 7.8 mmol / l.
Mafuta otsika
Hypoglycemia imamveka ngati kuchepetsa shuga kumafikira 2.75 mmol / L. Munthu wathanzi amatha kumva kuti alibe chidwi kapena zisonyezo zake ndizochepa. Ndi shuga wokwezeka wambiri, kuwonetsa kwa hypoglycemia kumatha kuchitika ndi zomwe zili ndi shuga.
Bwinobwino kumatha kukhala kuchepa kwa thupi ndi kusokonezeka kwakutali pakudya kapena ntchito yayitali popanda kudya mokwanira. Kuchepetsa kwa shuga kwa shuga kumalumikizidwa ndi kumwa mankhwala kapena mowa, komanso ndi matenda.
Ana osabadwa obadwa nako amatha kutenga chiwopsezo cha hypoglycemia chifukwa amakhala ndi kuchuluka kwambiri kwa kulemera kwa ubongo ndi thupi, ndipo ubongo umadya shuga wambiri. Nthawi yomweyo, makanda sangathe kusintha shuga ndi matupi a ketone, chifukwa amakhala ndi organic ketogenesis.
Chifukwa chake, ngakhale shuga wocheperako, ngati ungachitike kwa nthawi yayitali, pambuyo pake umatha kudzetsa nzeru zakukula. Hypoglycemia imadziwika ndi ana akhanda asanakwane (mpaka 2,5 makilogalamu) kapena, ngati mayi ali ndi matenda ashuga.
Kusala kudya kwa hypoglycemia kumachitika ndi zotere:
- Adrenal cortex kusakwanira.
- Mankhwala osokoneza bongo a sulfonylurea kapena insulin.
- Insulin yowonjezera ndi insulinoma.
- Hypothyroidism
- Anorexia
- Matenda akulu a chiwindi kapena impso.
- Kutentha kwanthawi yayitali.
- Kusokonezeka kwa mayamwidwe m'matumbo, opaleshoni pamimba.
- Njira za tumor, kufooka kwa khansa.
Pachimake hypoglycemia akuwonetsedwa ndi kufooka, kuwona kuwonongeka, kupweteka mutu, ulesi, chizungulire, dzanzi la ziwalo za thupi, kukomoka. Zizindikirozi zimangokhala ndi kuperewera kwa ubongo.
Gulu lachiwiri lazizindikiro limayamba ndi kukakamiza kwa kutulutsidwa kwa mahomoni opsinjika: tachycardia, thukuta, palpitations, njala, manja akunjenjemera, pallor, kugwedezeka kwa zala ndi milomo. Ngati dontho la shuga likupita, ndiye kuti mumayamba kudandaula kwambiri.
Zizindikiro zamankhwala za hypoglycemia yodwalayo imayamba ndi kuchepa kwamphamvu kwa shuga, komwe kumachitika mobwerezabwereza kwa nthawi yayitali. Izi ndi monga: kusintha kwa umunthu, kuiwalaiwala, dementia, psychosis, mu ana - uku ndikuchedwa kuchepa, kubweza m'maganizo.
Hyperglycemia
Hyperglycemia imawerengedwa kuti ndiwowonjezera kuchuluka kwa glucose pamtunda wa 5.5 mmol / L. Itha kuphatikizidwa ndi kudya kwa zakudya zamafuta, zomwe zimatengedwa mwachangu. Zosiyanasiyana zimatchedwa alimentary kapena postprandial. Kupsinjika kwa shuga kumachitika chifukwa cha mphamvu ya mahomoni - glucocorticoids ndi catecholamines omwe amapangidwa panthawiyi.
Pathological hyperglycemia imayamba ndikuwonjezeka kwa ntchito kapena chotupa mu ziwalo za endocrine - the gitu gland, pancreas, gren adrenal kapena gland. Matenda a shuga ndi chimodzi mwazomwe zimayambitsa kuchuluka kwa shuga.
Limagwirira a chitukuko cha hyperglycemia mu matenda a shuga zimatengera zomwe zimachititsa. Mtundu woyamba wa matendawa umachitika motsutsana ndi maziko a chiwonongeko cha autoimmune cha maselo oteteza insulini. Kwa matenda ashuga amtundu wachiwiri, gawo lalikulu limaseweredwa ndi kukana insulin komwe kumachitika pakachitika vuto la metabolic, wamkuluyo kukhala wonenepa kwambiri.
Ndi mawonekedwe a hyperglycemia, chizindikiro chotsatira chikukula mthupi:
- Kuchulukitsa ludzu.
- Kukomoka, ngakhale kuti munthu amadya bwino.
- Pafupipafupi komanso potulutsa mkodzo wambiri.
- Mutu.
- Kufooka, kutopa.
- Mawonedwe otsika.
- Khungu loyera ndi youma mucous nembanemba.
Kusinthasintha kwa kulemera kwa thupi kumatha kuwonetseredwa osati kokha ndi kuchepa thupi (ndi matenda a shuga 1), komanso mwa kupitiliza kunenepa kwambiri mu mtundu wachiwiri wa matenda. Izi ndichifukwa choti insulini imalimbikitsa kuyika kwamafuta m'matumbo a subcutaneous. Ndi matenda amtundu wa 1 shuga, ochepa m'magaziwo, ndipo mtundu wachiwiri umadziwika ndi hyperinsulinemia, makamaka kumayambiriro kwa matendawa.
Kuchuluka kwa shuga kwa nthawi yayitali kumabweretsa kuchepa kwa chitetezo chokwanira, kukula kwa matenda opatsirana, candidiasis, komanso kuchiritsa pang'onopang'ono mabala ndi zofooka zoperewera. Kuchepa kwa magazi ndi kuwonongeka kwa ulusi wamitsempha kumayambitsa kuchepa kwamphamvu kwa mapangidwe apansi, kukula kwa polyneuropathy.
Mavuto amishuga a shuga omwe amapezeka ndimagazi ochulukirapo m'magazi amawonongeka kwa impso, m'maso, komanso kuwonongeka kwa makoma amitsempha yayikulu komanso yaying'ono.
Hyperglycemia imayambitsanso zovuta zovuta za matenda ashuga, kuphatikizapo ketoacidosis, hypersmolar coma, momwe milingo ya glucose imatha kufika 32 mmol / L ndi kukwera.
Hyperglycemia ndi yosiyanasiyana malinga ndi kuchuluka kwa shuga m'magazi (mmol / l):
- Kuwala - 6.7-8.2.
- Kusakhazikika kwapakati - 8.3-11.
- Kulemera - Pamwamba pa 11.1
- Precoma imachitika pa 16.5, mitengo yapamwamba imayambitsa kukomoka.
Hyperglycemia mu diabetesics imachitika mukadumphira kumwa mapiritsi kuti muchepetse shuga kapena jekeseni insulini, komanso ngati mlingo wawo uli wosakwanira.
Vutoli limatha kuchitika pogwiritsa ntchito zakudya zamafuta ambiri, kudziphatikiza kwa matenda opatsirana kapena matenda ena, kupsinjika, kuchepa kwa chizolowezi chochita zolimbitsa thupi.
Kuziyang'anira pawekha
Mukamagwiritsa ntchito chipangizo choyeza shuga m'magazi, muyenera kutsatira sayansi yolondola pophunzira magazi komanso pafupipafupi mayeso. Mu matenda a shuga a mtundu woyamba, odwala ayenera kudziwa glycemia osachepera kanayi pa tsiku: katatu musanadye komanso asanagone.
Zowonjezera zina zitha kufunikanso usiku, pambuyo kuchita zolimbitsa thupi kwambiri kapena kusintha kwakukulu pakudya. Ndikulimbikitsidwanso kuti nthawi zina muziwonetsetsa nokha shuga atadya (pambuyo maola 2).
Mtundu wachiwiri, odwala atha kukhala pa insulin mankhwala kapena kumwa mapiritsi olimbana ndi matenda ashuga, ndipo kuphatikiza chithandizo chokhala ndi insulin yayitali komanso mapiritsi ochepetsa shuga kumachitidwanso.
Ngati wodwalayo watchulidwa kuti walimbitsa insulin, ndiye kuti mfundoyi ndi yofanana ndi mtundu woyamba wa matenda ashuga. Ngati amalandira jakisoni imodzi patsiku kapena mapiritsi okha, ndiye kuti nthawi zambiri zimakhala zokwanira kuyeza shuga kamodzi, koma nthawi zosiyanasiyana za tsiku.
Mukamagwiritsa ntchito insulin, yomwe imakhala ndi insulin yayitali komanso yayifupi, kayendetsedwe kameneka kamachitika kawiri pa tsiku. Mwa njira iliyonse ya chithandizo, tchati chikuyenera kujambulidwa kamodzi pa sabata, kuwonetsa magawo anayi a glycemia.
Ngati njira ya matenda ashuga imayendera limodzi ndi kusinthasintha kwaukali mu msinkhu wa shuga, ndiye kuti kuchuluka kwa pafupipafupi kuyenera kukhala kokulirapo, muyenera kulangizidwa ndi dokotala. Amatsimikiziranso kuchuluka kwa shuga kwa wodwala aliyense, kutengera zaka, njira, kulemera kwa thupi.
Malamulo oyambilira opanga magazi pawokha:
- Magazi abwino ndi oyenera kusanthula; tsamba la punations liyenera kusinthidwa.
- Jakisoni amachitidwa kuchokera kumbali, kuya sayenera kupitirira 2-3 mamilimita.
- Zakudya zonse ndizoyenera kukhala zosabala komanso nthawi zonse.
- Ndi magazi osayenda bwino, musanapendeke, tsitsani chala chanu ndikusamba m'manja ndi madzi ofunda ndikuuma.
- Musanayeze, muyenera kutsimikizira nambala yomwe ili pa botolo ndi mizere yoyesera komanso pazenera la mita.
- Dontho loyamba lofufuzira silikugwiritsidwa ntchito, likuyenera kuchotsedwa ndi poto louma la thonje.
- Kukakamira kwamphamvu kwa chala kumabweretsa kusakanikirana kwa magazi ndi minyewa yamatenda, yomwe imasokoneza zotsatira zake.
Ikani dontho la magazi kokha m'mphepete mwa mzere woyezera, womwe umakhala wakuda. Asanayeze, mzere woyeserera uyenera kukhala mu botolo lotsekedwa mwamphamvu, chifukwa limakhala chinyezi. Sizingatenge kuchokera m'botolo ndi zala zonyowa. Komanso, simungasinthe malo osungirako a mizere yoyeserera, chifukwa choyikiratu choyambirira chimakhala ndi desiccant.
Zingwe ziyenera kusungidwa m'malo owuma firiji, musanagwiritse ntchito muyenera kuwonetsetsa kuti tsiku lotha ntchito lomwe lasonyezedwe pamaphukusi silinadutse. Akamaliza, mikwingwirima yoyeserayi imatha kupotoza zotsatira za muyeso.
Pazidziwitso zowonetsera, mizere yowoneka imagwiritsidwa ntchito pozindikira shuga yamagazi.Itha kugwiritsidwa ntchito popanda glucometer. Mutha kuyang'ananso pazotsatira zakutsimikiza kugwiritsa ntchito mapanga amenewo mukazindikira matupi a ketone m'magazi ndi mkodzo.
Kanema yemwe ali munkhaniyi akuwonetsa momwe angadzipangire pawokha magazi.
