Mankhwala osokoneza bongo amachepetsa shuga. Zomwe muyenera kudya kuti muchepetse thupi?

Nkhani ya mapaundi owonjezera imadetsa nkhawa anthu omwe ali ndi matenda ashuga. Anthu ambiri amadziwa kuti ngati achepetsa thupi, amatha kusintha mkhalidwe wawo. Popanda kuthandizidwa ndi katswiri, ndipo si aliyense amene angakwanitse kugula, ndizovuta kupeza chakudya chogwira ntchito komanso chothandiza kuti muchepetse kunenepa, chifukwa chake anthu akufunafuna njira zosavuta ndikusamala mapiritsi azakudya. Pakadali pano, kudziyimira pawokha kwa mankhwalawa kumadzaza ndi ngozi zazikulu. Tidafunsa katswiri wathu wa endocrinologist wokhazikika Olga Pavlova kuti alankhule mwatsatanetsatane "mapiritsi azakudya."

Dokotala endocrinologist, wodwala matenda ashuga, wazakudya, katswiri wazakudya masewera Olga Mikhailovna Pavlova

Omaliza maphunziro ku Novosibirsk State Medical University (NSMU) omwe ali ndi digiri ku General Medicine ndi ulemu

Anamaliza maphunziro apamwamba ndi ulemu kuchokera kudziko lapansi la endocrinology ku NSMU

Amaliza maphunziro apamwamba ku Dietology yapadera ku NSMU.

Anadutsanso ukadaulo mu Sports Dietology ku Academy of Fitness and Bodybuilding in Moscow.

Anapitiliza maphunziro otsimikizika pa psychocorrection ya kunenepa kwambiri.

Matenda a shuga ndi kuphwanya kagayidwe kazakudya, ndipo kuchepa kwa kagayidwe kake, kupeza kulemera kambiri ndikosavuta, makamaka pakakhala insulin kukana ndi hyperinsulinemia, ndiko kuti, ndi mtundu wachiwiri wa matenda ashuga. Odwala a shuga amtundu 1 nawonso nthawi zambiri amakhala onenepa kwambiri. Ndi matenda a shuga 1, kugwiritsa ntchito mankhwala a insulin mosalekeza ndikofunikira kudumphira chakudya kumatha kubweretsa hypoglycemia (kutsika kwa shuga m'magazi), motero odwala, poopa kuti ali ndi vutoli, amadya kwambiri, ndipo kudya kwambiri motsutsana ndi maziko a insulin.

Nthawi zambiri, odwala matenda a shuga omwe amapezeka ku phwando amadandaula kuti zakudya ndi zakudya sizithandiza, ndipo amafunsa kuti akupatseni "mapiritsi azakudya", nthawi zambiri amawonjezera kuti: "Mapiritsiwa ndi otere: (dzina), bwenzi langa limataya makilogalamu 10 mpaka 20-30 pa iwo ndipo nanenso ndikufuna. " Anthu ambiri saganiza kuti mankhwalawa amachepetsa thupi, makamaka mankhwala amphamvu, ali ndi zisonyezo zawo, zotsutsana, zantchito ndi zotsatira zoyipa, zomwe odwala omwe ali ndi matenda a shuga amatha kuwonetsa kwambiri. Ndipo piritsi lozizwitsa, lomwe bwenzi la wodwalayo lataya kulemera kwake komanso zomwe wodwalayo amafunafuna, lingathe kuvulaza wodwala wathu.

Mankhwala ochepetsa mphamvu ya shuga m'thupi angathandizenso polimbana ndi vuto lalikulu - shuga wambiri.

Lero tikambirana za mankhwala ochepetsa thupi.

Ngati tilingalira za mulingo wakuchipatala wothandizira kunenepa kwambiri, ndiye kuti pakadali pano magulu anayi a mankhwala amagwiritsidwa ntchito mwalamulo kuchepetsa thupi ku Russian Federation. Munkhaniyi, sindiganizira zowonjezera zakudya komanso zowonjezera zamasewera - tikungolankhula zamankhwala zovomerezeka ndi zotsimikiziridwa.

Zofunika! Mankhwala ochepetsa thupi ali ndi zotsutsana zambiri komanso zoyipa ndipo amangoikidwa ndi dokotala atayeza thupi lonse.

Popeza matenda a shuga, kaya ndi matenda a shuga 1 kapena matenda a shuga, mavuto angathe kuchitika kuchokera ku impso (diabetesic nephropathy), dongosolo la mtima ndi m'mimba thirakiti (autonomic neuropathy), ndiye kuti muyenera kufufuzidwa mosamala musanapereke mankhwala kuti muchepetse kunenepa. kuposa odwala opanda matenda a shuga.

Magulu anayi akuluakulu a mankhwala ochepetsa thupi

1. Omwe akuchita mankhwala oledzera - sibutramine (mayina amalonda Reduxin, Goldline).

Limagwirira zake mankhwala: kusankha chopinga wa serotonin ndi norepinephrine reuptake, mu gawo dopamine mu ubongo. Chifukwa cha izi, kumverera kwanjala kumatsekedwa, kutentha kwa mafuta (kuchepa kwa kutentha) kumakulirakulira, chikhumbo chikuwoneka ngati chikuyenda mwachangu - tikuthawa kupita kukaphunzira mosangalala.

• Mankhwalawa amakhudzanso zakumaso: nthawi zambiri pamakhala kusintha kwamkati, kupangika kwa mphamvu. Odwala ena amakhala ndi mtima wankhanza, wamantha.
• Kusokonezeka kwa kugona nthawi zambiri kumadziwika: munthu safuna kugona, kugona nthawi yayitali, ndi kudzuka m'mawa.
• Sibutramine imakhala ndi zotsutsana zambiri. (kukanika kwa mtima, chiwindi, mitsempha) ndi zovuta zambiri, chifukwa chake zimangoyang'aniridwa ndi dokotala. Kugulitsa ndi mankhwala.
• Mu shuga mellitus, sibutramine imatha kuthandizira kupezeka kwa hypoglycemia (shuga m'magazi) chifukwa chowonjezereka cha metabolic komanso kuwonjezeka kwa zochitika zolimbitsa thupi, chifukwa chake, mukamagwiritsa ntchito mankhwalawa, kuyang'anira pafupipafupi kwa glycemic komanso, mwachidziwikire, kukonza kwa hypoglycemic chithandizo pamodzi ndi endocrinologist kumafunika.

2. Lipase blockers - orlistat (mayina amalonda a Listat, Xenical).

Limagwirira zake mankhwala: kutsekera pang'ono kwa michere yomwe imagaya mafuta m'mimba. Zotsatira zake, gawo la mafuta (pafupifupi 30%, mpaka 50%) silimamwa, koma amatuluka ndi ndowe, motero, timachepetsa thupi ndipo cholesterol yathu imachepa.

• Mbali yayikulu yotsatira ndiyotheka chopondapo. Ngati timadya mafuta ochulukirapo, mafuta sakhazikika, inde, padzakhala kutsekula m'mimba. Pankhani ya matenda otsegula m'mimba, ndimakonda leafa, chifukwa ili ndi stool stabilizer - mankhwalawo ndi chimpfumbu, kotero mawonekedwe a chimbudzi chogwiritsa ntchito leafa ndiwosowa.
• Mankhwalawa amalembedwa ndi dokotala, wogulitsidwa popanda mankhwala.
• Mu shuga mellitus, mankhwalawa ndi osangalatsa chifukwa chakutha kuchepetsa mafuta m'thupi (chifukwa odwala matenda ashuga nthawi zambiri amadwala cholesterol), komanso chifukwa chogwira ntchito yofatsa (imagwira mu lumen ya m'mimba popanda zotsatira zoyenda mwadongosolo) mwachindunji mphamvu) mtsempha wamagazi, impso, mtima, ndiye kuti ndi otetezeka).

Lipase blockers itha kugwiritsidwa ntchito pa matenda ashuga ndi mtundu 1 ndi 2.

3. Analogs of GLP-1 (glucagon-like peptide-1) - liraglutide (mayina amalonda Saksenda - mankhwala olembedwa pochiza kunenepa kwambiri, ndipo Victoza - liraglutide yemweyo adalembetsa zochizira matenda a shuga mellitus 2).

Limagwirira zake mankhwala: liraglutide - analogue of our intestinal mahormone (analogue of GLP 1), omwe amapangidwa atatha kudya ndikuletsa njala (makamaka pambuyo pawo sitikufuna kudya mafuta komanso zakudya zotsekemera), ngakhale shuga ya magazi ndikupititsa patsogolo kagayidwe.

• Pa mankhwalawa, odwala amamva kuti ali ndi zonse, zolakalaka zawo zamafuta ndi zotsekemera zimaletseka.
• Mankhwalawa amathandizira kuchepetsa thupi makamaka chifukwa cham'mimba mafuta, ndiye kuti, timachepetsa thupi m'chiuno. Mukatha kugwiritsa ntchito mankhwalawo, chithunzi chimasanduka chokongola.
• Mankhwalawa amagwira ntchito paz kulemera zilizonse - osachepera 120 makilogalamu, osachepera 62 - mulimonsemo, mukasankha mlingo woyenera ndikusintha zakudya pang'ono, zotsatira zake zingakondwere.
• Mankhwalawa ndi olimba, koma okwera mtengo ndipo ali ndi ma contraindication, omwe ali oyamba kwambiri kukhala kapamba wam'mimba, aimpso komanso chiwindi.
• Zotsatira zoyipa kwambiri ndikumva kupweteka pang'ono. Ngati, pamtunda wakudya liraglutide, mwadya mafuta kapena okoma, makamaka madzulo, mutha kumva kudwala kwambiri, ngakhale kusanza. Odwala ena amakonda izi - asanza katatu, sindikufunanso kuphwanya chakudyachi.
• Mankhwalawa amalembedwa ndi dokotala, wogulitsidwa popanda mankhwala. Mlingo umasankhidwa ndi adokotala okha - ndizovuta kwambiri kusankha payekha mlingo.
• Mukamamwa mankhwalawa, chiwindi, impso ndi magawo ena zimayang'aniridwa pafupipafupi (monga adanenera dokotala, kuyezetsa magazi ndi zamankhwala ambiri mwazachipatala kuyenera kuchitika pafupipafupi), popeza mankhwalawo ndi amphamvu.
• Kwa odwala matenda ashuga, Lyraglutide ndi fanizo lake ndizosangalatsa chifukwa zotsatira zawo pa mulingo wa glycemia (shuga wamagazi) zimafotokozedwanso kuposa kulemera. Chifukwa chake, mankhwalawa ndi amodzi mwa mankhwala omwe amakonda kwambiri odwala omwe ali ndi matenda a shuga a 2. Ndi matenda a shuga 1 amtunduwu sagwira ntchito!

4. Nthawi zambiri pa matenda a kunenepa kwambiri, ngati limodzi ndi matenda a insulin, omwe ali mtundu wachiwiri wa shuga, mankhwalawa amagwiritsidwa ntchito metformin (mayina amalonda Siofor, Glucofage).

Kukana kwa insulin kumawonedwa mu 80-90% ya odwala onenepa, chifukwa chake, mankhwalawa amagwiritsidwa ntchito pochiza kunenepa kwambiri ngakhale kwa odwala opanda matenda a shuga.

Limagwirira ntchito a metformin: kuchuluka kwa chidwi ndi insulini, kusintha kagayidwe komanso kusintha kwa micobiota (microflora m'mimba). Chifukwa cha izi, kulemera kwa thupi kumachepa pang'ono ndipo shuga amakhala m'mawonekedwe. Ngati shuga wamagazi anali abwinobwino, sasintha. Ngati shuga atakwezedwa, amatsika pang'ono.

• Zoyipa zazikuluzikulu zotenga metformin zimachepa chiwindi, impso, kuchepa magazi, komanso matenda amtima.
• Choyipa chachikulu ndi chopondapo masiku oyamba ndipo, ngati chikugwiritsidwa ntchito kwa nthawi yayitali, ndi kuchepa kwa mavitamini a B (ngati timamwa metformin nthawi yayitali, timagwiritsa ntchito mavitamini a B kawiri pachaka).
• Mankhwalawa amalembedwa ndi dokotala, wogulitsidwa popanda mankhwala.

Mankhwalawa amatha kugwiritsidwa ntchito payekhapayekha komanso mosagwirizana ndi magulu ena a mankhwalawa (pochiza matenda osokoneza bongo, kupititsa patsogolo ntchito ya chiwindi, impso, ndi zitsamba).

Kuphatikizika kwabwino kumapezeka ndi kuphatikiza kwa mankhwalawa kuti muchepetse kulemera ndi detox, sorbents, mankhwala osokoneza bongo kuti muchepetse ntchito ya chiwindi.

Mankhwala ochepetsa shuga a shuga ayenera kusankhidwa kokha ndi dokotala kuti athe kuwunika molondola momwe thupi liliri komanso osavulaza.

Ndi mankhwala ati omwe mungasankhe kuti muchepetse kunenepa ku T1DM, ndi T2DM iti?

Ndi matenda a shuga 1 mankhwala apakati ndi lipase blockers ndizokondedwa kwambiri. Metformin sagwiritsidwa ntchito pa matenda a shuga 1, popeza chimodzi mwazochita zake zazikulu ndikuchiza kwa insulin, ndipo ndizosowa kwambiri kwa matenda ashuga 1. Ma Analogs a GLP 1 omwe ali ndi matenda a shuga 1 sagwiritsidwa ntchito.

Ndili ndi DM 2 analogues ya GLP 1 ndi metformin ndizofunikira kwambiri (chifukwa timagwira limodzi ndi insulin kukana komanso kulemera). Koma omwe akuchita pakatikati pa mankhwala osokoneza bongo ndi ma lipase blockers nawonso amatha kugwiritsa ntchito, ndiye kuti, ndi matenda a shuga a 2 palinso mankhwala ena osankhidwa.

Kuphatikiza kulikonse kwa mankhwala osankhidwa ndi adotolo atatha kufufuza bwino!
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Zaumoyo, kukongola ndi chisangalalo kwa inu!