Matenda a 2 a matenda a shuga ndiofala matenda omwe amapezeka motsutsana ndi maziko a kagayidwe kazakudya. Chifukwa cha kusintha kwa zam'thupi m'thupi, gawo la hyperglycemic (shuga m'magazi) limawonedwa.
Mwambiri, nthawi zambiri zam'mbuyomu zimapezeka mwa anthu azaka zopitilira 40, ndipo, monga lamulo, zimadziwika ndi chithunzi chamankhwala chosadziwika. Munthu sangakayikire kwanthawi yayitali kuti wadwala matenda osachiritsika.
Mu shuga mellitus wamtundu wachiwiri, kapamba amagwira ntchito mwachizolowezi, insulin ya mahomoni imapangidwa, koma njira yolowera shuga mpaka ma cellular imalephereka, popeza minofu yofewa ya thupi imatha kutenthedwa ndi mahomoni.
Ndikofunikira kuganizira zomwe zimayambitsa mtundu wachiwiri wa matenda ashuga, ndikuzindikira zomwe zimadziwika ndi matendawa. Komanso kuti mudziwe momwe matenda ashuga achiwiri amathandizira?
Etiology ya mwadzidzidzi
Monga mukudziwa, pali mitundu iwiri ya matenda ashuga - T1DM ndi T2DM, omwe ndiofala kwambiri pochita zamankhwala. Pali mitundu yanji ya matenda, koma amapezeka mwa anthu nthawi zambiri.
Ngati mtundu woyamba wamatenda umakula msanga, mtundu wachiwiri umayamba pang'onopang'ono mwa munthu, zomwe zimapangitsa kuti munthu asazindikire kusintha kwakuthupi kwa nthawi yayitali.
Kuchokera pachidziwitso ichi ndikofunikira kunena kuti patatha zaka 40, kuwunikira mosamala kuchuluka kwa glucose m'thupi kumafunikira kuti athe kuzindikira mtundu wachiwiri wa matenda kumayambiriro kwa chitukuko.
Pakadali pano, zomwe zimayambitsa matenda osachiritsika sizikudziwika. Komabe, zinthu zomwe zingagwiritsane ndi chiyambi cha matenda a matenda zimafotokozedwa:
- Kutengera kwam'tsogolo matendawa. Kuthekera kwa kufalitsa kwa matenda "ndi cholowa" kumachokera ku 10% (ngati kholo limodzi lidwala) mpaka 50% (ngati matenda ashuga ali mu anamnesis a makolo onse awiri).
- Kulemera kwambiri. Ngati wodwalayo ali ndi minyewa yambiri ya adipose, ndiye motsutsana ndi maziko a izi, ali ndi kuchepa kwamphamvu kwa minofu yofewa kuti apange insulin, yomwe imathandizira kukulitsa matendawa.
- Zakudya zopanda pake. Kuthiridwa kwakukulu kwa chakudya kumachulukitsa chiopsezo cha matenda.
- Kupsinjika ndi mantha wamanjenje.
- Mankhwala ena, chifukwa cha poizoni, amatha kubweretsa mavuto m'thupi, omwe umawonjezera mwayi wokhala ndi matenda a shuga.
Zinthu zomwe zingayambitse matenda ophatikizika zimaphatikizapo kukhala panokha. Izi zimabweretsa osati kulemera kwambiri, komanso zimakhudza mayendedwe a shuga m'thupi.
Oimira chiwerewere choyenera, chomwe ovomerezeka ya polycystic ili pachiwopsezo. Komanso amayi omwe adabereka mwana wolemera oposa kilogalamu zinayi.
Mtundu 2 shuga: Zizindikiro ndi magawo
Mtundu wachiwiri wa shuga umadziwika ndi kuchuluka kwa shuga m'thupi, zomwe zimapangitsa kuti pakhale osmotic diuresis. Mwanjira ina, madzi ndi mchere wambiri amachotsedwa m'thupi kudzera mu impso.
Zotsatira zake, thupi laumunthu limataya chinyezi mwachangu, kuchepa kwa thupi kumawonedwa, kuchepa kwa zinthu zamkati mwake kumawululidwa - ichi ndi potaziyamu, sodium, magnesium, chitsulo, phosphate. Potengera momwe njirayi imagwirira ntchito, minofu imataya gawo lawo ndipo imagwira shuga.
T2DM imayamba pang'onopang'ono. Muzochitika zambiri, pamakhala zochitika zam'mbuyomu, zomwe zimawululidwa mwangozi mukapita kukaonana ndi maso kapena mukamayeza mayeso kuchipatala.
Chithunzi cha matenda matendawa ndi motere:
- Kuchuluka kwa madzi akumwa pamene wodwala amakhala ndi ludzu pafupipafupi (munthu amatha kumwa mpaka malita 10 patsiku).
- Pakamwa pakamwa.
- Kwambiri kukodza mpaka 20 pa tsiku.
- Kulakalaka kudya, khungu louma.
- Matenda opatsirana pafupipafupi.
- Matenda ogona, kuchepetsedwa mphamvu yogwira ntchito.
- Kutopa kwambiri.
- Zowonongeka.
Mwa azimayi atatha zaka 40, matendawa nthawi zambiri amadziwika ndi dermatologist kapena gynecologist, chifukwa matenda amtunduwu amayenda ndi kuyabwa kwa khungu komanso mavuto ena a khungu, komanso kuyabwa kumaliseche.
Monga tafotokozera pamwambapa, mtundu wachiwiri wa matenda ashuga umayamba pang'onopang'ono, ndipo nthawi zambiri pakati pakupezeka kwake ndi kuzindikiridwa kwake kumakhala nthawi ya zaka ziwiri. Pankhaniyi, akapezeka, odwala amakhala ndi zovuta.
Kutengera mapangidwe, mtundu wachiwiri wa matenda ungagawidwe m'magawo ena:
- Mkhalidwe wa shuga. Palibe zizindikiro za kusokonekera mu momwe wodwalayo alili, mayeso a labotale ali mkati moyenera.
- Mtundu womaliza wa matenda. Zizindikiro zowopsa kulibe, mayeso a labotale sangathenso kuvumbula zonyansa. Komabe, kusintha mthupi kumadziwika kudzera pakuyesedwa komwe kumatsimikiza kulolera kwa glucose.
- Mtundu wodziwikiratu wa matendawa. Mwanjira iyi, chithunzi cha chipatala chimadziwika ndi zambiri zizindikiro. Ndipo matenda a shuga amtundu wa 2 amatha kuwonekera kudzera pa mayeso a labotale.
Kuphatikiza pa magawo, muzochitika zamankhwala, mtundu 2 wamatendawa umagawika m'magulu ena, omwe amawona kukula kwa mkhalidwe wa munthu. Pali atatu okha a iwo. Ndiwofatsa, odziletsa komanso ovuta.
Ndi digiri yofatsa, kuchuluka kwa shuga mthupi la wodwalayo sikupitilira magawo 10; mkodzo, suwoneka. Wodwalayo samadandaula za thanzi labwinobwino, palibe zopatuka mthupi.
Ndili ndi shuga pamlingo woposa chizindikiro cha magawo 10, pomwe mayeso amawonetsa kupezeka kwake mkodzo. Wodwalayo amadandaula za kusasamala komanso kufooka, kuyenda pafupipafupi kupita kuchimbudzi, pakamwa pouma. Komanso chizolowezi cha zotulutsa khungu.
Woopsa milandu, pali kusintha koyipa kwa kagayidwe kachakudya kamunthu mthupi la munthu. Shuga mthupi ndipo mkodzo umachoka, zizindikiro zimatchulidwa, zizindikiro za zovuta zam'mimba ndi zamitsempha zimawonedwa.
Kuchepa kwa kudwala matenda ashuga kumawonjezeka kangapo.
Njira zoyesera
Anthu ambiri amafunafuna thandizo lakuchipatala osati ndi zizindikiro komanso zizindikiro za matenda ashuga, koma ndi zovuta zake. Popeza matenda a pathology sangawonetse kuchitika kwa nthawi yayitali.
Ngati mtundu wina wa matenda a shuga wakayikiridwa, dokotalayo amakupatsani njira zodziwitsira zomwe zimathandiza kutsimikizira kapena kutsutsa matendawa, kudziwa mtundu wake komanso kuuma kwake.
Vuto lofufuza matenda am'mimba ndikuti sadziwika ndi zizindikiro zazikulu. Nthawi yomweyo, zizindikiro za matendawa zimatha kuoneka mosakondera. Ndiye chifukwa chake maphunziro a labotale ndi ofunikira kwambiri kuti azitha kudziwa matenda ashuga.
Kuzindikira matenda, dokotala amafotokozera zotsatirazi:
- Zitsanzo zam'mamwa zala (kuyesa kwa shuga). Kupenda kumeneku kumakupatsani mwayi wodziwa kuchuluka kwa shuga m'thupi la wodwala pamimba yopanda kanthu. Chizindikiro cha mpaka 5.5 mayeso ndichizolowezi. Ngati pali kuphwanya kulekerera, ndiye kuti mwina kuchulukitsa kapena kuchepa. Ngati zotsatira zake ndizoposa mayunitsi 6.1, kafukufuku woleketsa shuga amapatsidwa.
- Kuphunzira kulekerera kwa gluyose. Kuyeza kumeneku ndikofunikira kuti mudziwe kuchuluka kwa matenda a carbohydrate metabolism m'thupi la wodwalayo. Kuchuluka kwa mahomoni ndi shuga kumatsimikiziridwa pamimba yopanda kanthu, komanso mutatha kudya shuga, yomwe kale imasungunuka ndi madzi (75 shuga yowuma pa 250 ml ya madzi).
- Kusanthula kwa glycated hemoglobin. Kudzera mu kafukufukuyu, mutha kudziwa kuchuluka kwa matendawo. Mitengo yayikulu ikuwonetsa kuti wodwalayo ali ndi vuto losowa chitsulo kapena matenda amtundu wa 2. Ngati chizindikirocho ndichoposa 7%, matenda a shuga akupezeka.
Ndizofunikira kuti mupereke mayeso a mkodzo kuti pakhale matupi a ketone ndi shuga mkati mwake. Munthu wathanzi sayenera kukhala ndi shuga mkodzo.
Njira zowonjezera zodziwikirazi ndi monga kupenda khungu ndi miyendo yodwala, kuyendera kwa ophthalmologist, ECG.
Type 2 matenda a shuga: chithandizo
Chithandizo cha matenda a shuga 2 am'magawo oyambilira amaperekedwa ndi njira yosagwiritsa ntchito mankhwala. Pamagawo enawo, akatswiri a zamankhwala amalimbikitsa chithandizo chamankhwala, zomwe zingaphatikizepo kumwa mapiritsi kuti muchepetse shuga.
Ngati wodwala ali ndi matenda ochepa kapena owonjezera, ndiye kuti njira zochiritsira zimagwiritsidwa ntchito poika zakudya, thanzi, masewera. Zochita zamankhwala zikuwonetsa kuti ndikokwanira kugwiritsa ntchito theka la ola tsiku lililonse pazinthu zamasewera kuti muwone zabwino zomwe zikuchitika polimbana ndi matenda.
Zakudya zoyenera ndizomwe zimayambira chithandizo chathanzi. Komabe, izi sizitanthauza kuti wodwalayo ayenera kusiya zakudya zonse, kudya zakudya zosasunthika ndikuchotsa mapaundi owonjezera.
Kuchepetsa thupi kuyenera kuchitika pang'onopang'ono, ndipo kuchepa kwambiri m'masiku asanu ndi awiri - osapitilira 500 magalamu. Zakudya ndi menyu zimapangidwa nthawi zonse pamtundu uliwonse wamankhwala.
Mfundo zazikuluzakudya zaku T2DM:
- Zakudya zololedwa zokha zomwe sizipangitsa kuchuluka kwa shuga m'thupi la wodwalayo ndizovomerezeka kudya.
- Muyenera kudya pafupipafupi (kangapo patsiku 5-7), komanso m'magawo ang'onoang'ono, malinga ndi dongosolo lomwe mwapangidwa kale.
- Kanani kapena kuchepetsa kumwa mowa, mchere.
- Ngati wodwalayo ndi wonenepa kwambiri, ndiye kuti ndi bwino kuti muzidya zakudya zosapitirira 1800 zopatsa mphamvu patsiku.
- Zakudya ziyenera kuphatikizapo kuchuluka kwa mavitamini, michere ndi michere.
Monga lamulo, mtundu wachiwiri wa matenda ashuga ukapezeka, dokotala nthawi zonse amayamba mankhwala olimbitsa thupi komanso kudya moyenera. Ngati njira yothanirana ndi mankhwalawa singayang'anidwe, imangoyenera kulandira mankhwala osokoneza bongo.
Zochizira matenda a mtima, Mankhwala omwe ali m'magulu otsatirawa akhoza kulimbikitsidwa:
- Zochokera ku sulfonylureas. Mankhwalawa amathandizira kupanga mahomoni m'thupi ndipo amachepetsa kufooka kwa minofu.
- Biguanides. Gulu la mankhwalawa limachepetsa kupanga shuga mu chiwindi, limachepetsa kuyamwa kwake m'mimba, komanso limapangitsa chidwi cha minyewa kuti chichitike ndi mahomoni.
- Zotulutsira za Thiazolidinone zimathandizira kuwonjezeka kwa zochitika za ma cell receptors, chifukwa chomwe kuchuluka kwa glucose m'thupi la munthu kumachepa.
- Alfa glucosidase inhibitors amapereka kuphwanya mayamwidwe kwa chakudya chamafuta m'mimba, chifukwa chomwe shuga amachepetsa.
Mankhwala osokoneza bongo nthawi zonse amayamba ndi kugwiritsa ntchito mankhwala amodzi, omwe amayenera kumwa kamodzi patsiku. Ngati matendawa ali pachiwopsezo chachikulu, kusatha kwa chithandizo chotere kumadziwika, dokotala amatha kuphatikiza mankhwala.
Nawonso, ngati kuphatikiza kwa mankhwala angapo sikungathandize, akhoza kuthandizidwa ndi insulin. Titha kunena kuti jakisoni wa mahomoni ndi ntchito ina ya kapamba, yomwe, ikagwira ntchito mokwanira, imazindikira kuchuluka kwa shuga, kubisa kuchuluka kwa timadzi tambiri timene timagwira.
Dziwani kuti malingaliro a dotolo siwokhazikika kwakanthawi kuti shuga akhale magazi, ndi moyo womwe umayenera kupitilizidwa.
Matenda opatsirana
Type 2 shuga mellitus siziwopseza moyo wa wodwalayo, mosiyana ndi zovuta zomwe zimapezeka mwa odwala mu 98% yazochitika zonse zamankhwala.
Matenda obwera pang'onopang'ono, pang'onopang'ono amawononga magwiridwe amkati ndi ziwalo zamkati, zomwe zimabweretsa zovuta zingapo pakapita nthawi.
Odwala omwe ali ndi mtundu wachiwiri wa matenda ashuga, kuchuluka kwa matenda amtima kumawonjezeka kangapo. Poterepa, kuphwanya kufalikira konsekonse kwa magazi mthupi kumapezeka, matenda oopsa akuwonekera, malekezero am'munsi amataya chidwi chawo.
Mtundu wachiwiri wa matenda ashuga, mavuto obwera otsatirawa akhoza kukhala:
- Matenda a shuga a shuga a shuga, chifukwa chake makoma amitsempha yamagazi ochepa amakhudzidwa. Macroangiopathy imatsogolera pakugonjetsedwa kwamitsempha yayikulu yamagazi.
- Polyneuropathy ndikuphwanya magwiridwe antchito amkati wamanjenje.
- Arthropathy, yomwe imatsogolera kupweteka kwambiri kwapawiri. Popita nthawi, pali kuphwanya kwamiseche.
- Zosokoneza zowoneka: mphaka, glaucoma imayamba.
- Kulephera kwina.
- Zosintha mu psyche, lability yamunthu wamalingaliro.
Ngati zovuta zapezeka, chithandizo chamankhwala chimalimbikitsidwa nthawi yomweyo, chomwe chimayikidwa ndi endocrinologist ndi dokotala wofunikira (ophthalmologist, cardiologist ndi ena).
Kupewa matenda a shuga
Madokotala amatha kuneneratu za matendawa kale asanachitike. Chifukwa cha "nthawi yochenjeza", nthawi yochepa ikuwoneka kuti ikuchita zinthu zina zoyambirira zodzitchinjiriza.
Ngati matenda a mtundu wachiwiri wapezeka kale, ndiye kuti zovuta za matendawa zitha kuyembekezedwa pakatha zaka 10 kapena pang'ono. Pankhaniyi, kupewa kwachiwiri ndikofunikira.
Kutengera maphunziro ambiri omwe anachitidwa popewa njira zodzitetezera, ena anena kuti:
- Ngati mukukhalanso ndi moyo wachangu, kusewera masewera komanso kusuntha kwambiri, ndiye kuti izi zingachedwetse matendawo.
- Ngati muphatikiza zolimbitsa thupi mokwanira ndi matenda ashuga komanso zakudya zoyenera, simungachedwe osati zamomwe zimachitika zokha, komanso zovuta zake.
- Kuti muchepetse zovuta, ndikofunikira kuyang'anira kuchuluka kwa shuga mthupi, komanso kuthamanga kwa magazi.
Tiyenera kukumbukira kuti pakadali pano, "matenda okoma" amatenga malo wachitatu pakati pa omwe amafa. Chifukwa chake, pazisonyezo zilizonse za matendawa, tikulimbikitsidwa kuti tisazinyalanyaza, poyembekezera kuti zinthu zitha kudzikhudza tokha.
Kuphatikiza apo, simukuyenera kuyesetsa kuthana ndi vuto lanu pogwiritsa ntchito njira za "agogo anu" kapena njira zina, chifukwa kulakwitsa kosakhululukidwa kungawononge moyo wanu. Kanemayo munkhaniyi akufotokoza za moyo ndi matenda ashuga a 2.