Matenda a shuga ndi pakati (chiwopsezo cha matenda ashuga)

Mimba imakhala ndi katundu wambiri mthupi la amayi, inali nthawi ino kuti matenda ambiri omwe anali ndi zovuta amawonjezeka, mavuto atsopano adawonekera. Pakati pa zovuta za metabolic mwa amayi omwe ali ndi mwana, gestationalabetes mellitus (GDM) ndiofala kwambiri. Matendawa amakhala ndi 4% ya amayi apakati, 80% awo amapezeka ndi zovuta kwa amayi, mu 45% ya milandu imayambitsa gestosis.

Matenda a shuga samachitika popanda kufunikira kwa mwana: chifukwa cha kuchuluka kwa kubadwa kwa mwana, 20% ya ana ali ndi vuto la kufalikira kwa ziwalo, 19% ali ndi vuto la kufooka. Pambuyo pobala, amasintha kapangidwe ka magazi, akhazikika pathupi ndikuchiza matenda amitsempha.

Imfa mwa ana obadwa kwa amayi omwe ali ndi GDM ndiwambiri kuposa kawiri.

Matenda a shuga ndi kupsinjika kudzakhala chinthu chakale

• Matenda a shuga -95%
• Kuthetsa kwa mitsempha thrombosis - 70%
• Kuthetsa kwa kugunda kwamtima kwamphamvu -90%
• Kuthana ndi kuthamanga kwa magazi - 92%
• Kuwonjezeka kwa mphamvu masana, kukonza kugona usiku -97%

Kuchuluka kwa zovuta zomwe zimabweretsa mwa mayi ndi mwana zimadalira kutengera kwa nthawi yayitali matenda ashuga, chithandizo choyenera komanso lingaliro loyenera la mayi wamtsogolo pamatenda ake.

Matenda a shuga pamimba - ndi chiyani?

Pakubala kwa mwana, kufunikira kwa glucose kumawonjezera, thupi limasunga m'magazi kuti likwaniritse mphamvu za fetal, chifukwa chake chitetezo cha thupi chimayamba. Izi zikakanika, matenda ashuga okalamba amayamba. Nthawi yakumayambiriro kwake ndi theka lachiwiri la pakati, pamene mwana ali kale wamkulu, nthawi zambiri kuyambira 16 mpaka 32 milungu.

Mosiyana ndi matenda a shuga ochitika pafupipafupi, nthawi zambiri mchitidwe wamtumbo suyenda ndi hyperglycemia. Matenda a azimayi oyembekezera, monga momwe amatchedwanso, amatha kuwonetsedwa osati pakuwonjezera shuga, komanso kuphwanya kulekerera kwa shuga. Izi zikutanthauza kuti kusala machitidwe a shuga a magazi kumapitilira, koma osati kwambiri kotero kuti kuphwanya kumeneku kumawonedwa ngati shuga.

Kusiyananso kwina kwa matenda ashuga ndi mawonekedwe ake osakhalitsa. Zizindikiro zonse za matendawa zimazimiririka pambuyo pobereka. Mtsogolomo, azimayi oterewa ali pachiwopsezo chachikulu cha zovuta zofananazi panthawi yapakati yapakati (zopitilira 60%), mwayi wokhala ndi matenda amtundu wa 2 ukuwonjezeka.

Mkulu shuga sangatanthauze GDM, koma chiwonetsero cha matenda abwinobwino a shuga, omwe amakhalabe ndi mkazi moyo wonse. Mutha kusiyanitsa pakati pamavuto awiriwa powunika momwe magazi amaphatikizidwira ndikuwunika mkhalidwe wa kapamba.

Njira yodziwitsa matenda ashuga:

Malinga ndi gulu la matendawa, matendawa amalembedwa ngati mellitus wa gestational, ICD code ndi 10 O24.4.

Zomwe zimayambitsa GDM

Kuyambira kuyambira pakati pa pakati, kusintha kwakukulu kwa mahomoni kumachitika m'thupi la mayi: kupanga progesterone, lactogen ya placental, estrogen, cortisol imayendetsedwa. Onsewa ndi odana ndi insulin, zomwe zikutanthauza kuti kuchuluka kwawo kumakhala chifukwa chakufooka. Kuphatikiza apo, lactogen yaphatikizidwa ndi placenta imachulukitsa kuchuluka kwamafuta acid m'magazi, zomwe zimawonjezera kukana kwa insulin. Thandizani kuwonjezeka kwa glucose komanso kusintha kwawamba m'moyo wa mayi wapakati - kuchuluka kwa kudya kwa calorie, kuchepa kwa zochitika zolimbitsa thupi komanso kusuntha, kuwonjezeka kwa thupi.

Mwa mkazi wathanzi, kukana kwa insulini kumalipidwa. Kuphatikizika kwa insulin kumawonjezeka chifukwa cha hypertrophy ya cell pancreatic beta, kagayidwe kake ka chiwindi kamachepa. Matenda a shuga opatsirana amakula mwa amayi apakati ngati mtundu wina wa njira yolipirira sungagwire ntchito.

Nthawi zambiri zimachitika zotsatirazi:

1. Kunenepa kwambiri mwa mayi woyembekezera (> 20% kuposa yachilendo), wopezeka kale.
2. Zakudya zopatsa mphamvu zambiri zopatsa mphamvu.
3. Njira yokhala panokha, kuphatikizapo musanakhale ndi pakati.
4. Kusuta.
5. Shuga mellitus kapena kwambiri insulin kukana achibale.
6. GDM m'mimba yapitayi.
7. Ana oyamba anali ndi kulemera koposa 4 kg pakubadwa.
8. Polyhydramnios.
9. Polycystic ovary.
10. Zaka zopitilira 30. Pofika zaka 40, chiopsezo cha matenda osokoneza bongo chikuwonjezeka kawiri.
11. Kukhala wa liwiro la a Mongoloid ndi Negroid.

Zizindikiro ndi matenda amiseche

Zizindikiro za matenda a gestational matenda a shuga ndi monga:

• pafupipafupi pakamwa youma;
• kulakalaka;
• kuchuluka kwa madzi akumwa, pafupipafupi komanso kukodza kwakukulu;
• kuchuluka kwa kapangidwe ka gasi m'mimba;
• kuyabwa, makamaka pamimba ndi perineum;
• kutopa, kugona;
• candidiasis wowoneka bwino;
• kunenepa kwambiri.

Monga mukuwonera, Zizindikiro zonsezi ndizosazindikira, zonse zimatha kuyambitsa zifukwa zina, kuphatikiza pakati pathupi. Matenda a gestational alibe zizindikiro zoonekeratu, zodziwika, kotero, mayi aliyense, atatha kulembetsa, amayesedwa moyenera kuti adziwe matenda omwe ali ndi vuto la shuga.

Njira zoyesera

Paulendo woyamba kupita kwa adotolo, azimayi onse oyembekezera amapatsidwa mayeso a shuga. Ndi glucose othamanga pamwamba pa 7 mmol / L ndi hemoglobin wa glycated wopitilira mlingo wa 6.5%, kuthekera kwa matenda ashuga kumakhala kwakukulu. Ngati kuchuluka kwa magazi m'magazi kuphatikizidwa ndi zizindikiro za hyperglycemia, kuzindikira kwake kumayesedwa. Ngati palibe chizindikiro chowoneka cha kuchuluka kwa shuga, kupenda mobwerezabwereza kumachitika kuti mupewe zolakwika. Wodwala yemwe wapezeka ndi matenda ena a shuga amapita kwa endocrinologist yemwe amapanga maphunziro owonjezera, amawonetsa mtundu ndi gawo la matendawo, ndikuwapatsa chithandizo. Pa nthawi yomwe mayi ali ndi pakati mwa amayi, omwe pazifukwa zingapo amatha kuwerengetsa gulu la kuchuluka kwamatenda a shuga, kuyesedwa koteroko kumachitika patadutsa milungu ingapo pambuyo pake.

Nthawi yabwino yopeza matenda a shuga a gestational nthawi kuyambira milungu 24 mpaka 26 ya mimba. Malinga ndi malingaliro a chipatala a Unduna wa Zaumoyo, kuyesa kwa glucose kumagwiritsidwa ntchito pozindikira. Ngati mayi ali ndi chiwopsezo chachikulu cha matenda ashuga, mwana wosabadwayo wamkulu, zizindikiro za fetopathy, kuwunika kungachitike pambuyo pake. Tsiku latha 32, pambuyo pake mayesowo amatha kukhala owopsa chifukwa cha kukwera kwamphamvu kwa shuga m'magazi.

Chomwe chimayesedwa ndikuwunika kuchuluka kwa magazi a venous pamimba yopanda kanthu, kenako pambuyo pa mphindi 60 ndi 120 pambuyo pa "katundu" wamatumbo othamanga. Zakudya zomanga thupi ndi 75 g za glucose anhydrite kapena 82,5 g ya glucose monohydrate. Amasungunuka mu kapu yamadzi ofunda ndikupatsidwa kwa mayi wapakati kuti amwe. Kuyesedwa kwa glucose kumalongosola molondola kuchuluka kwa kuyamwa kwa shuga m'magazi, chifukwa chake zotsatira zoyipa imodzi ndizokwanira kuzindikira GDM.

Kuti mutsimikizire kulondola kwa mayesowo, ndikofunikira kuyang'anitsitsa kukonzekera kopereka magazi: m'mawa musanawunike, mutha kumwa madzi okha. Osasuta fodya, palibe mankhwala. Kwa masiku atatu, sioyenera kusintha chilichonse mwaumoyo kapena zakudya.

Zifukwa zochedwetsera mayeso:

• toxicosis;
• ntchito zochepa, kugona pogona;
• kutupa kapena pachimake;
• matenda am'mimba thirakiti, momwe mayamwidwe shuga.

Momwe mungachiritsire matenda ashuga mwa amayi apakati

Kuzindikira matenda a shuga panthawi yapakati si chifukwa chilichonse choopsa. Mukayamba kulandira chithandizo munthawi yake, kupita kwa dokotala mosamala ndikutsatira malangizo ake onse, mutha kuthetsa zotsatirapo zoyipa za mwanayo, kupewa zovuta za m'mayi, ndikulamula kuti matenda ashuga m'tsogolo.

Kuwongolera izi, amayi apakati amasunga diary yomwe amalembera tsiku ndi tsiku: shuga ya magazi - osachepera 8 miyezo patsiku, kupezeka kwa ma ketoni mum'mawa musanadye, kupanikizika, kulemera, ntchito za fetal, menyu ndi zakudya zam'mimba mwake.

Kuwona pa nthawi yoyembekezera kumachitika nthawi yomweyo ndi dokotala wazamankhwala ndi endocrinologist. Madokotala amayenera kuchezeredwa kawiri pamwezi mpaka sabata la 29 ndi sabata pambuyo pake. Monga lamulo, kudya komanso kuchita masewera olimbitsa thupi mokwanira ndikwanitsa kusintha shuga. Nthawi zina, mankhwala a insulin amawonjezeranso mankhwala.

Kugwiritsa ntchito mankhwala

Mankhwala ochepetsa shuga, omwe amalembedwa mtundu wa shuga wachiwiri, amaletsedwa kwambiri panthawi yoyembekezera, chifukwa amachititsa kuti mwana wosabadwayo asakhale ndi thanzi labwino. Chifukwa chake, njira yokhayo pakali pano yolamulira glycemia ndi mankhwala - insulin mwa jakisoni.

Insulin imayikidwa pawiri. Choyamba, ngati zakudya ndi zolimbitsa thupi zinali zopanda mphamvu, shuga wamagazi sangathe kukwaniritsidwa masabata awiri kuyambira chiyambi cha mankhwala. Kachiwiri, ngati zotsatira za ultrasound zikuwonetsa kuchuluka kwa mwana wosakhazikika wa shuga: kulemera kwakukulu, kuthamanga kwa mafuta ochulukirapo, kutupa kwa minofu, polyhydramnios.

Dokotala amasankha dongosolo la insulin mankhwala malinga ndi cholembera chodziletsa. Kugwiritsa ntchito insulin nthawi yayitali mukakhala ndi pakati, monga lamulo, sikofunikira, popeza imasowa mahomoni akeawo. Chifukwa chake, insulin yochepa chabe kapena ma analogi ake a ultrashort amayenera kuyikiridwa. Insulin imalowetsedwa m'mimba kapena ntchafu pogwiritsa ntchito syringe kapena cholembera - onani momwe mungabayire insulin molondola.

Mankhwalawa amapaka jekeseni musanadye chilichonse chomwe mumakhala chakudya, muyezo wake amawerengedwa kutengera kuchuluka kwa mkate mu chakudya. Mukapita kwa dokotala, mulingo wake umasinthidwa nthawi iliyonse kutengera deta ya glycemia sabata yatha. Ngati kuchuluka kwa insulini patsiku ofunika kwa magazi abwinobwino kupitirira mayunitsi 100, pampu ya insulini ikhoza kukhazikitsidwa kwa wodwala, mothandizidwa ndi yomwe mankhwalawa amathandizidwa mosalekeza.

Zakudya zoyenera komanso zakudya zoyenera

Zothandiza kwambiri: Zakudya za matenda a shuga kwa amayi apakati

Kuunikanso menyu panthawi yonse yomwe muli ndi pakati ndi chimodzi mwazinthu zazikulu zothana ndi matenda ashuga. Amayi ambiri oyembekezera omwe ali ndi matendawa ndi onenepa kwambiri, chifukwa chake muyenera kuchepetsa kudya calorie.

Ma caloriyamu Olimbikitsidwa:

Kuti thupi lilandire mavitamini onse ofunikira pa calorie yochepetsedwa, menyu amayenera kukhala ndi masamba, masamba, nyama ndi nsomba, zipatso.

Zomwe zipatso ndi ndiwo zamasamba zimaloledwa: mitundu yonse ya kabichi, nkhaka, anyezi, amadyera onse, raduchu, zukini, biringanya, kaloti yaiwisi, mapeyala, mandimu, maapulo, yamatcheri, sitiroberi, mphesa.

Choletsedwa: mbatata, kaloti owiritsa, deti, mavwende, nthochi, mphesa, makamaka mphesa zokhala ndi shuga wambiri.

Zakudya za anthu odwala matenda ashuga ayenera kukwaniritsa izi:

1. Zakudya Zabwino. Kufikira kasanu ndi kamodzi m'magawo ang'onoang'ono mosiyanasiyana.
2. Nthawi zonse. Osadumpha kapena kuchedweratu nthawi yoikika yokhazikika kwa nthawi yayitali.
3. Kuchotsera kwa chakudya chamaofesi othamanga. Kuletsedwa kwathunthu kwa shuga, mchere wambiri ndi zakudya zake, kuphika, zakudya zomwe zimapezeka pompopompo - pafupi chakudya chofulumira komanso chosakwiya cha mafuta //diabetiya.ru/produkty/bystrye-i-medlennye-uglevody.html.
4. Onjezani kuchuluka kwa fiber mu menyu. Masamba atsopano amawakonda kuposa masamba omwe amathandizira kutentha - zakudya zamafuta ambiri.
5. Chepetsa mafuta okwanira mpaka 10%. Kusintha kuti muzitsatira nyama, kuphika ndi mafuta a masamba osati mafuta a nyama.
6. Zakudya zokwanira zamadzimadzi. Pa nthawi ya pakati, muyenera kumwa osachepera 1.5 malita patsiku.
7. Kudya mavitamini owonjezera.

Kuwerengera kwa michere (BJU) ya matenda ashuga wamagetsi kuyenera kuwoneka ngati: mapuloteni = 20-25%, mafuta <30%, chakudya chamafuta = 38-45%.

Masewera olimbitsa thupi komanso maphunziro olimbitsa thupi kwa matenda osokoneza bongo

Kuchita minofu pafupipafupi kumathandiza kuchepetsa kukana kwa insulini komanso kupewa kuchulukitsa kwambiri, chifukwa chake masewera olimbitsa thupi sayenera kunyalanyazidwa chifukwa cha matenda ashuga. Pulogalamu yophunzirayi imapangidwira mzimayi aliyense payekha, kutengera thanzi ndi luso lake. Nthawi zambiri masewera olimbitsa thupi ochepa - kuyenda, kusambira kapena aerobics yamadzi. Simungathe kuchita masewera olimbitsa thupi kumbuyo kapena m'mimba, kukweza thunthu ndi miyendo ndizoletsedwa. Masewera omwe ali ndi kuvulala sayenera: mahatchi, njinga, masiketi kapena odzigudubuza.

Njira zina zochizira GDM

Mimba ndi nthawi yowonjezera chiopsezo kwa mayi ndi mwana. Chifukwa chofuna kupewa mankhwala, azimayi ambiri panthawiyi amasinthana ndi mankhwala azitsamba. Pakadali pano, kuyesa kuchiritsa matenda a shuga, osadziwa mwapadera, malinga ndi maphikidwe ochokera pa intaneti amatha kumapeto.

Phukusi zambiri zokhala ndi zida za chomera, mimba imalembedwanso pamndandanda wa contraindication. Chifukwa chake, muyenera kupanga lamulo: chithandizo chatsopano chilichonse chiyenera kukhala ovomerezeka ndi dokotala.

Njira yokhayo wowerengeka yomwe kugwiritsidwa ntchito kwake mu matenda osokoneza bongo sikumatsutsana ndi kulowetsedwa kwa rosehip. Idzathetsa kusowa kwa vitamini C, kuchepetsa kuchuluka kwa ma radicals aulere, komanso kuchepetsa kutupa. Chinsinsi chake ndi chosavuta: ochepa m'chiuno cha rose amaikidwa mu thermos asanagone, kutsanulira lita imodzi ya madzi otentha. M'mawa, zonunkhira zonunkhira zakonzeka. Imwani kapu imodzi ya theka musanadye.

Zotsatira za matenda ashuga panthawi yokhala ndi pakati

Kukwera kwa shuga kwa magazi kwa mayi wapakati, kumakhala kowopsa kwambiri kwa mwana. Ngati chithandizo sichinaperekedwe chisamaliro chokwanira, fetus ya fetal imayamba: mwana amabadwa wamkulu kwambiri, ndi zikondamoyo zokulirapo, mafuta ochulukirapo. Amatha kukhala ndi mavuto opuma, hypoglycemia, kuphwanya kagayidwe ka lipid. M'tsogolomu, ana oterewa ali ndi chiopsezo chowonjezereka cha kunenepa kwambiri komanso matenda ashuga.

Makanda obadwa ndi matenda ashuga nthawi zambiri amakhazikitsidwa pamasabata 38. Ngati mwana ali ndi kulemera kambiri, gawo laesesan limachitika. Mosiyana ndi ana wamba, amayi omwe ali ndi matenda ashuga amafunikira chakudya kuchokera mphindi zoyambirira za moyo, monga kapamba wawo, wozolowera kuthana ndi shuga wambiri, akupitiliza kutulutsa insulini yambiri kwakanthawi. Ngati zakudya sizingatheke kapena kusakwanira kutulutsa glycemia, mwana amapaka jekeseni wamagazi.

Kodi chiwopsezo cha mayeso owopsa ndichani kwa mayi: pa mimba - edema, kuthamanga kwa magazi, toxicosis wachedwa. Pa nthawi yobereka - chiopsezo chowonjezeka chifukwa cha mwana wosabadwa. Pambuyo pawo pamakhala chiopsezo chachikulu cha matenda amiseche pakatha nthawi yotsatira ndikukhala ndi matenda ashuga 2.

Kodi ndikufunika kuwonedwa nditabadwa mwana

Kawonedwe ka zachipatala ndi kuwunika kwa azimayi kumaonetsa kuti shuga yayikulu yambiri imatha mwana akangobadwa. Kutuluka kwa placenta, komwe ndi chiwalo chachikulu kwambiri chotulutsa timadzi pa nthawi ya pakati, shuga m'magazi amayamba. Mpaka azimayi atachotsedwa, amapitiliza kuyang'anira kuchuluka kwa shuga.Pambuyo pa miyezi iwiri, mudzafunikiranso kuyesa mayeso a glucose kuti mudziwe ngati pali zovuta zilizonse zamagulu a carbohydrate metabolism ndipo ngati mukukumana ndi matenda ashuga posachedwa.

Kuti achepetse ngozi, azimayi omwe ali ndi GDM amafunika kuchepa thupi kunenepa, kupewa mafuta othamanga, ndikuwonjezera zolimbitsa thupi. Pokonzekera mimba yotsatira, onetsetsani kuti mwayesedwa ndi endocrinologist.