Pamene matenda a shuga amayamba kuchuluka chaka chilichonse, chiwerengero cha anthu omwe akufuna kudziwa ngati mtundu wa 2 wodwala angachiritsidwe, komanso ngati zingatheke kuti athetse dongosolo la matenda a shuga masiku onse, chikuwonjezeka.
Pakadali pano pachitukuko chidziwitso chokhudza matenda a shuga, imawerengedwa kuti ndi njira yokhayo yomwe ingathandize kupititsa patsogolo thanzi la odwala, ngati mumanga chakudya moyenera, kutsatira njira yosavuta yochitira zolimbitsa thupi ndikuchita masewera olimbitsa thupi panthawi yake.
Kuchiza matenda a shuga a mtundu wachiwiri ngati matenda a kagayidwe kachakudya kumaphatikizapo kukana kudya kwambiri, kuchepetsa kunenepa kwambiri komanso kumwa mankhwala kuti shuga akhale ndi magazi. Odwala ambiri amachiritsidwa matenda ashuga, omwe amatanthauza kuletsa kukula kwa zovuta zamatendawa ndikusungabe zochitika zina zomwe akuchita.
Kodi ndichifukwa chiyani mtundu wachiwiri wa matenda ashuga umayamba?
Zomwe zimapangitsa kuti pakhale zovuta zama metabolic a mtundu wa 2 shuga ndizochepa kwambiri zolandirira insulin kapena kapangidwe kake kosinthika, komanso zovuta za insulini palokha. Kupanga kwa kufalikira kwa mauthenga kuchokera kuma receptor kupita ku zinthu zina zapakati pa phokoso kungakhalenso.
Kusintha konseku kumalumikizidwa ndi mawu wamba - kukana insulini. Pankhaniyi, kupanga insulin kumatha kuchitika mwanjira wamba kapena zokwera. Momwe mungagonjetsere kukana kwa inulin, ndipo malinga ndi momwe, mungachiritsire matenda osokoneza bongo mpaka muyaya, asayansi samadziwabe. Chifukwa chake, ndizosatheka kukhulupirira malonjezo oti mtundu wa 2 matenda a shuga ungachiritsidwe.
Kukana insulini kumayamba kunenepa kwambiri, pomwe odwala omwe ali ndi matenda a shuga a 2, kulemera kambiri kumapezeka mu 82,5% yamilandu. Kukhazikika kwa chibadwa cha kuperewera kwa chakudya m'thupi chifukwa cha kudya kwambiri, kusuta, kuthamanga kwa magazi komanso kukhala ndi moyo wokhazikika kumabweretsa matendawa.
Omwe amatenga matenda amtunduwu ndi anthu azaka zopitilira 40, azolimbitsa thupi, omwe amakhala ndi mafuta ambiri pamimba.
Ma insulin omwe amalowa m'magazi sangathe kuzindikiridwa ndi ma receptor omwe amakhala m'misempha yodalira insulin, yomwe imaphatikizapo chiwindi, adipose ndi minofu minofu. Type 2 shuga mellitus amadziwika ndi zovuta za metabolic zotere:
- Mapangidwe a glycogen ndi okosijeni a glucose ndizolepheretsa.
- Kapangidwe ka mamolekyu a shuga m'chiwindi amapititsa patsogolo.
- Kuchuluka kwa shuga m'magazi ndi zotupa zake mkodzo.
- Mapuloteni aprotein ndi oletsedwa.
- Mafuta amadziunjikira m'matipi.
Kuwonjezeka kwa glucose m'magazi ozungulira kumayambitsa kukula kwa zovuta za mbali yamanjenje, impso, ziwalo zam'maso, komanso kuwonongeka konsekamalo la kama.
Ndipo ngati ndizovuta kuchira ku matenda ashuga, ndiye kuti pali mwayi weniweni wopewa matenda oopsa komanso oopsa omwe amagwirizana nawo.
Chithandizo cha matenda a shuga ndi zakudya komanso mankhwala azitsamba
Pofuna kuchiritsa wodwala mtundu wa 2 matenda a shuga m'magawo ochepera kapena gawo loyambirira, kusintha kwathunthu pakudya ndi kunenepa kwambiri kungakhale kokwanira. Pankhaniyi, kuchotsedwa kwa matendawo kwa nthawi yayitali kumatheka popanda kugwiritsa ntchito mankhwala.
Chomwe chimapatsa thanzi odwala matenda ashuga ndikuwonetsetsa kuti zakudya zamtundu umodzi ndizofanana, zomwe zimagwirizana ndi kuchuluka kwa zochitika zolimbitsa thupi, komanso kuchuluka kwake kwamapuloteni ndi mafuta muzakudya.
Zakudya zamafuta osavuta mu mtundu wa hypoglycemic zimatha kugwiritsidwa ntchito kuwonjezera shuga; nthawi zina, zinthu zomwe zimakhala ndi glycemic index kwa odwala matenda ashuga ndizoletsedwa.
Malonda otsatirawa amafunika kuti asamachotseretu pazosankha za matenda ashuga:
- Zipatso zokoma ndi zipatso zake, makamaka mphesa, nthochi, nkhuyu ndi masiku.
- Shuga, confectionery iliyonse ndi zomwe zili.
- Zopera zoyera za ufa, makeke, makeke, makeke, ma waffle.
- Ice cream, mchere, kuphatikizapo kanyumba tchizi, yogurts ndi shuga wowonjezera ndi zipatso.
- Semolina, mpunga ndi pasitala.
- Kupanikizana, wokondedwa, zipatso zamzitini, kupanikizana ndi kupanikizana.
- High Cholesterol Offal: Ubongo, Chiwindi, Impso.
- Mafuta onenepa, mafuta, mafuta ophikira.
Lamulo lalikulu pakumanga menyu kwa aliyense amene ali ndi chidwi ndi momwe angathanirane ndi matenda amtundu wa 2 ndikuwunikira zomwe zili mumagawo azakudya. Magawo a mkate (1 XE = 12 g wamafuta kapena 20 g ya mkate) amawerengedwa malinga ndi matebulo. Chakudya chilichonse chimayenera kukhala osaposa 7 XE.
Matenda a shuga amathanso kuchiritsidwa ngati odwala adya zakudya zokwanira zomwe zimakhala ndi fiber, fiber, ndi mavitamini. Izi zikuphatikiza masamba, zipatso ndi zipatso. Amadyedwa mwatsopano. Ndikofunikanso kuphatikiza mafuta a masamba ndi nsomba zamitundu ina, nsomba zamkaka zopanda zowonjezera pazakudya.
Wodwala wodwala matenda a shuga ayenera kumvetsetsa bwino chakudya chovomerezeka kwa iye, kuphatikiza ndikusinthira mbale kuti amvetsetse momwe angachitire mtundu wa 2 shuga mellitus ndi chithandizo cha zakudya. Chofunikanso ndikukhazikitsidwa kwa zakudya malinga ndi kuchuluka kwa glycemia, zochitika zolimbitsa thupi komanso ndikusintha kwanjira yamoyo.
Pali maphikidwe ambiri omwe amafotokoza njira zochizira matenda ashuga amtundu wa 2 kwathunthu ndi mankhwala wowerengeka. Ngakhale upangiri wotere suupereka zotsatira zolonjezedwa, kugwiritsa ntchito mankhwala azitsamba kungakhale kothandiza kusintha kwa wodwalayo, kuchepetsa kulakalaka komanso kuwonjezera mphamvu ya njira zamankhwala zochiritsira.
Mankhwala azitsamba angagwiritsidwe ntchito ngati njira yowongolera kugwira ntchito kwa impso, chiwindi, chikhodzodzo ndi zikondamoyo ndi zina zofanana ndi ziwalozi, komanso m'malo mwa tiyi kapena khofi wokhazikika. Mu shuga mellitus, kulowetsedwa ndi decoctions a zitsamba motere akulimbikitsidwa:
- Masamba a mtedza, sitiroberi wamtchire, nettle.
- Zitsamba za wort wa St. John, wokomera, wotupa komanso wamahatchi.
- Masamba a nyemba, anyezi ndi adyo, ku Yerusalemu artichoke.
- Mizu ya burdock, elecampane, peony ndi dandelion, chicory.
- Zipatso za mabulosi abulu, phulusa la kumapiri, mabulosi akutchire, lingonberry ndi mabulosi, elderberry.
Lembani mitundu iwiri ya matenda ashuga
Mankhwala a shuga amagwiritsidwa ntchito kuti achepetse kuchuluka kwa shuga m'magazi ndipo amapatsa maselo zakudya komanso mphamvu. Njira yochiritsidwira yoyenera, yomwe imaphatikizidwa ndi zakudya komanso zolimbitsa thupi, imatha kuchiritsa matenda ambiri pochotsa matenda ashuga kukhala gawo lobwezeretsa.
Mankhwala omwe amagwiritsidwa ntchito polimbikitsa kapamba amatha kutulutsa insulin. Ubwino wawo ndi kuthamanga kwa kuchitapo kanthu, koma m'malamulo amakono amathandizira amathandizira pokhapokha pakuwonongeka kwa maselo a beta.
Njira zoterezi zimapangidwira ndi zotumphukira za sulfonylurea, zomwe zimaphatikizapo Tolbutamide, Glibenclamide, Glyclazide, Glimepride.
Nthawi zambiri mu mapulogalamu omwe adapangidwa - "Momwe mungachiritsire matenda amtundu wa 2 m'magawo oyamba", mankhwala omwe ali ndi Metformin amagwiritsidwa ntchito. Mankhwalawa amathandizira kuwonjezera chidwi cha insulin ndikuchepetsa kuyamwa kwa glucose m'matumbo.
Kuphatikiza apo, zochita za metformin zimafikiranso ku chiwindi, zimawonjezera kaphatikizidwe ka glycogen ndi kuchuluka kwake kwa chiwindi, kutsika kwake kwa glucose kumachepetsa, kugwiritsa ntchito metformin kumalimbikitsa kulemera ndipo, munthawi imodzimodzi, lipid metabolism yotsika imachepetsedwa.
Mankhwala okhala ndi metformin amalowa m'madongosolo azachipatala pansi pa mayina awa:
- Glucophage, yopangidwa ndi Merck Sante, France.
- Dianormet, Teva, Poland.
- Metfogamma, Dragenofarm, Germany.
- Metformin Sandoz, Lek, Poland.
- Siofor, Berlin Chemie, Germany.
Kugwiritsa ntchito kwa Repaglinide ndi Nateglinide kukonzekera kumakupatsani mwayi wolamulira kukwera kwa shuga komwe kumachitika patangotha maola awiri mutatha kudya - amadziwika kuti prandial regators. Gulu la mankhwalawa limadziwika ndi kuyamwa mwachangu komanso kwakanthawi kochepa.
Popewa kufinya kwa glucose m'matumbo, mankhwalawa Acarbose angagwiritsidwe ntchito, amakupatsani mwayi wamafuta ochulukitsa m'matumbo, kupewa kukula kwa shuga. Ubwino wa mankhwala omwe ali ndi chida ichi ndi kusowa kwa hypoglycemia komanso kukondoweza kwa kuchuluka kwa insulin.
Mankhwala osokoneza bongo monga Avandia ndi Pioglar amalimbikitsa chidwi cha adipose ndi minofu minofu kulowa insulin, zomwe zimapangitsa kuphatikizika kwa mapuloteni enaake. Ndi kugwiritsa ntchito kwawo, zomwe zimakhala zamafuta ndi glucose m'magazi zimachepa, kulumikizana kwa ma receptor ndi insulin kumawonjezeka.
Kuti athane ndi vutoli - momwe mungachiritsire matenda ashuga amtundu wa 2, makampani opanga mankhwala akupanga mankhwala atsopano, imodzi mwazinthu zomwe zapangidwa posachedwa ndi madokotala - Bayetta ndi Januvia.
Exenatide (Bayetta) imayerekezera kapangidwe ka mahomoni m'migawo yamagayidwe okhudzana ndi ma insretins. Amatha kulimbikitsa mapangidwe a insulin chifukwa cha kudya kwa glucose kuchokera ku chakudya, komanso amakonda kuletsa kutsekeka kwa m'mimba, zomwe zimathandiza odwala omwe ali ndi kunenepa kwambiri kuti achepetse chidwi ndi kunenepa.
Januvia (sitagliptin) ali ndi katundu wolimbikitsa kupanga kwa insulini komanso kuletsa kutulutsa shuga, komwe kumapangitsa kutsika kwamphamvu m'magazi a glucose, ndikuthandizira mosavuta kubwezera mtundu wa shuga wachiwiri.
Kusankha kwa mankhwala ochizira matenda a shuga kungaperekedwe kwa adokotala, omwe, atawunika kwathunthu, angasankhe njira yoyenera yolandirira, ndipo ngati kuli kotheka, asamutseni wodwala kuchokera pamapiritsi kupita ku insulin.
Njira zosinthira ku insulin mankhwala a shuga zingakhale:
- Mulingo waukulu wa mankhwala ochepetsa shuga, omwe pamodzi ndi zakudya sangathe kutsata zomwe glycemia ikufuna.
- M'mayeso a labotale: glucose yothamanga imaposa 8 mmol / l, ndipo hemoglobin ya glycated sichepa m'munsi mwa 7.5% ndi kafukufuku wapawiri.
- Ketoacidotic, Hyperosmolar zinthu
- Mavuto a shuga mu mawonekedwe a mitundu yayikulu ya polyneuropathy, nephropathy, retinopathy.
- Matenda opatsirana omwe ali ndi koopsa komanso osagwiritsa ntchito maantibayotiki.
Mankhwala opaleshoni a mtundu 2 wa shuga
Popeza kunenepa kwambiri komanso matenda ashuga ndi matenda omwe amathandizira kuwonetsera kwa wina ndi mnzake, komanso kuchepa kwa thupi, zisonyezo zabwino zokhazikika pamtunda wa matenda a shuga zitha kupezeka, komanso kuti palibe njira zopitilira muyeso zochizira matenda ashuga, njira zopangira opaleshoni ya metabolic zakonzedwa.
Ntchito monga gastric banding, gastroplasty ndi gastroshunting zimathandizira kulipiritsa matenda a shuga mu 60-80% ya milandu. Kusankha kwa njira yochepetsera kuchuluka kwa m'mimba kumatengera kuchuluka kwa kunenepa kwambiri kwa wodwala.
Tiyenera kumvetsetsa kuti ngakhale kulemera kwa makilogalamu 90 mu ukalamba, pamaso pa chibadwa chamtsogolo kumayambitsa matenda a shuga.
Zotsatira zabwino kwambiri pochiza matenda osokoneza bongo zimatheka mu opaleshoni ya biliopancreatic bypass - 95%, pogwiritsa ntchito njira iyi, gawo la duodenum, momwe bile ndi pancreatic juice limalowera. Zimapezeka musanalowe m'matumbo akulu.
Ngakhale kugwira ntchito kotere kumayambitsa kusokonezeka kwakukulu kwa metabolic, hypovitaminosis, makamaka mavitamini osungunuka mafuta, kuchepa kwa calcium, komanso kukula kwa matenda a chiwindi chamafuta, opaleshoni iyi imadziwika lero ngati kulowererapo kwamphamvu kwambiri komwe kumatha kuyimitsa kunenepa kwambiri ndikulemba matenda a shuga. Kanemayo munkhaniyi akuwonetsa zochizira matenda amtundu wa 2.
