Matenda a shuga: zomwe zili zoopsa, zomwe zimayambitsa, zizindikiro ndi chithandizo

Matenda ofala kwambiri okhudzana ndi matenda a endocrine ndi matenda a shuga. Ndizowopsa chifukwa zimayendera limodzi ndi kuphwanya mitundu yonse ya kagayidwe. Kuphatikiza apo, matendawa amawopseza ndi zovuta pachimake kapena mochedwa ndipo amafunikira chithandizo chanthawi zonse, kutsatira zakudya. Nthawi yomweyo, mukamalandira chithandizo, zimakhala zosatheka kuthetsa zomwe zimayambitsa matenda ashuga, ndipo chithandizo chimachepetsedwa kuti muchepetse zomwe zikuwonetsa.

Kugawika kwa masinthidwe ndi zizindikiro

Mlingo wa glucose m'magazi a shuga umakwera chifukwa cha kulowetsedwa chifukwa cha kuchepa kwa insulin. Ngati njirayi imachitika chifukwa cha kuchepa kwa kaphatikizidwe ka proinsulin chifukwa cha kuwonongeka kwa maselo a pancreatic, matendawa amatchulidwa ngati matenda a shuga 1. Nthawi zambiri amapezeka mwa anthu osakwana zaka 25.. Imadziwulula ndi zizindikiro zotsatirazi:

• ludzu lalikulu ndi chilala;
• kununkhira kwa acetone kuchokera mkamwa;
• kukodza kawirikawiri;
• machiritso a bala
• Khungu.

Mwa anthu omwe amapeza minyewa yambiri ya adipose, kuphatikiza kwakukulu kwa mahomoni kumachitika, koma mayankho a metabolic ku insulin amakhala operewera, ndipo "vuto lakelo" limachitika. Matendawa amatchedwa matenda a shuga a mtundu wachiwiri. Zimawopseza kwambiri anthu okalamba. Komanso, Zizindikiro zake sizachidziwikire kuti mwina munthu sazindikira matenda ake. Komabe, muyenera kulabadira izi:

• kutopa
• kuchepa kwa masomphenya;
• kusokonezeka kwa kukumbukira;
• ululu poyenda;
• kupweteka kwakanthawi kwa akazi.

Theka la odwala omwe ali m'migawo yoyambirira yazizindikiro alibe. Koma kenako vuto la mtima mwadzidzidzi, sitiroko, matenda a impso, kapena kulephera kuwona. Zaka khumi zilizonse, kuchuluka kwa anthu odwala matenda ashuga kumawonjezera, motero muyenera kuwona dokotala pazowonetsera koyamba.

Mwina mavuto

Choyamba, matenda ashuga ndi owopsa ndimavuto omwe amatha kupezeka m'masiku ochepa kapena maola angapo kapena kukulira kwa miyezi ndi zaka. Poyambirira, amadziwika kuti ali pachimake, chachiwiri - mochedwa. Chilichonse mwazomwe zimachitika chifukwa cha kuwonjezereka kwa glucose wamagazi ndi kusokonezeka kwa metabolic mu zimakhala zomwe zalephera kutulutsa monosaccharide.

Zovuta

Popeza minofu imagwiritsa ntchito shuga m'magazi a shuga, kuwonjezereka kwa catabolism yamafuta ndi mapuloteni kumachitika. Zinthu zomwe zimapanga metabolism yawo yapakati zimadziunjikira m'magazi, chifukwa cha ichi ketoacidosis chimayamba, chomwe chimasokoneza ntchito zofunika kwambiri za thupi.

Kukwezeka kwa magazi ndi saccharide kumawonjezera kukakamiza kwake, chifukwa choti madzi ambiri ndi ma electrolyte amatayika mkodzo. Chifukwa cha izi, ziwalo zambiri komanso minyewa yambiri imavutika, nephropathy, neuropathy, ophthalmopathy, micro- ndi macroangiopathy, komanso matenda a shuga. Njira yolerera imakhudzidwanso, amuna amatha kukumana ndi kusabereka, amayi omwe ali ndi osabereka.

Kupanikiza kuchuluka kwa shuga m'magazi ndimankhwala kumatha kutsitsa shuga mpaka 3,3 mmol / L kapena kuchepera. Pankhaniyi, pamakhala chiopsezo cha moyo - hypoglycemia, yomwe imatha kuthana ndi kumwa yankho la shuga, kudya zakudya zopatsa thanzi, kupaka shuga kukonzekera mu minofu kapena mu mtsempha wokhala ndi 40% shuga. M'malo omaliza, jekeseni wowonjezera wa thiamine amafunikira kuti musatseke kuphipha kwa minofu.

Chifukwa cha matenda ashuga, lactic acid imakhazikika m'magazi, ndipo kufanana kumasunthira kumbali ya acidic. Poyerekeza ndi maziko a kusakwanira kwa ziwalo zina komanso kusowa kwa okosijeni kwa zimakhala, acid imadziunjikira mu minofu, ma microcirculation amasokonezeka. Zotsatira zake ndi lactic acidosis. Wodwala amakhala ndi chikumbumtima chamdima, samatha kupuma bwinobwino, kupanikizika kwake kumatsika, kukodza ndikovuta. Vutoli mu 70% ya milandu limatha muimfa, njira ziyenera kuchitidwa mwachangu. Wodwalayo amapatsidwa njira yovomerezeka ya 2% ya koloko ndipo amathandizidwa kuchipatala.

Chifukwa cha matenda ashuga, chitetezo cha mthupi chimachepa, ndipo wodwalayo amalolera matenda opatsirana moyipa, nthawi zambiri pamakhala chifuwa chachikulu cha m'mapapo.

Matenda a shuga

Kuyima pambali ndi zinthu ngati chikomokere, chifukwa cha kusowa kwa insulin. Ndizotsatira zazotsatira ziwiri:

• ketoacidosis yochokera pakuwonjezereka kwa acidity ndikugwiritsa ntchito kosakwanira kwa matupi a ketone omwe amapangidwa ndi chiwindi poyankha kufa ndi tulo timene timadalira insulin yomwe singathe kugwiritsa ntchito shuga;
• lactic acidosis, ikukula chifukwa cha kudzikundikira kwa zinthu zamagulu a zamisempha.

Coma samakula nthawi yomweyo. Tsiku loti apite, wodwalayo amayamba kudwala, kukamwa mouma, ludzu, kusowa kwa chakudya. Pankhaniyi, ndikofunikira kuyamba kulandira chithandizo mwachangu, mpaka wodwala matenda ashuga asadagonere ndipo sanataye chikumbumtima.

Ngati izi zidachitikabe, muyenera kuyimbira ambulansi, ndikuyika wodwalayo kuti kupuma kwake kusakhale kovuta. Kufika akatswiri apeza matenda okhudzana ndi matenda ashuga ndi izi:

• youma, ofunda pakhungu lakukhudza;
• kununkhira kwa maapulo kapena acetone kuchokera mkamwa;
• kukoka kofooka;
• kuthamanga kwa magazi;
• ma eye ofewa.

Wodwalayo adzapatsidwa njira yolumikizira shuga ndikuyipereka kumalo osamalira odwala kwambiri. Kukomoka kumatha kukhala nthawi yayitali kwambiri. Anthu ena amakhala zaka makumi angapo mmenemo, koma osachisiya.

Zilonda zam'mbuyo

Matenda a 2 a shuga ndi oopsa ndi retinopathy. Ili ndi dzina la kuwonongeka kwa retinal, limodzi ndi zotupa, edema, ndikupanga zombo zatsopano. Ngati matenda a pathological akukhudza fundus, retina imasokonekera. Izi ndi zomwe zimapangitsa kuti odwala asakhale ndi matenda ashuga okalamba.

Kuphulika kwa mtima kukhathamira, kuwonjezeka kwa kusokonekera kwawo, chizolowezi cha thrombosis ndi atherosclerosis pamapeto pake kumayambitsa angiopathy. Hyperglycemia mu shuga imayambitsa zovuta zama metabolic m'mitsempha. Izi zimawopseza polyneuropathy mu mawonekedwe a kutayika kwa kupweteka komanso kutentha kwa kutentha, chifukwa chomwe wodwalayo amavulala mosavuta.

The kusokonezeka kagayidwe kwa chakudya ndi mafuta mu zimakhala zimakhudza ziwalo zotsatirazi:

• impso: albumin imachotsedwamo mkodzo, proteinuria imachitika, kenako matenda aimpso;
• Maso: kufukiza kwa mandala kumachitika, ndipo nganga zimayamba kumayambiriro.

Kuphatikiza pa kuperewera kwa metabolism, microcirculation imachitika molakwika, ischemic necrosis imawonetsedwa ndi arthropathy yokhala ndi ululu wolumikizika komanso kusuntha pang'ono. Kusintha kwa maatomiki ndi kachitidwe kumatha kuchitika kumapazi. Njira zoyipa za purulent necrotic mmenemo, zilonda zam'mimba komanso zotupa za m'mimba zimawonjezera matenda am'magazi a shuga, omwe muzochitika zapamwamba amafunika kudula. Matenda a shuga amakhalanso oopsa chifukwa amavulaza thanzi la psyche. Chifukwa cha izo, kusintha kwamkati kosinthika kumawonedwa, kukhumudwa, zovuta zamavuto zimachitika, encephalopathy imapezeka.

Komanso, motsutsana ndi maziko a shuga, omwe amawononga thupi ndikusintha kapangidwe ka magazi, matenda opatsirana amatha. Zaka makumi ambiri zakusowa kwa glucose kwakanthawi zikuwonekera pamatumbo. Kuwala kwawo kumapangidwa pang'ono, ndipo makhoma amayamba kuvomerezedwa ndi michere. Minofu imasowa okosijeni ndi thanzi, motsutsana ndi izi, sitiroko, matenda a mtima, matenda a mtima amatha. Kuperewera kwa magazi pakhungu kumayambitsa maonekedwe a zilonda zam'mimba, zomwe pambuyo pake zimayambitsa matenda. Kuthandizidwa ndi kusintha kwakukulu, mphamvu yamanjenje imadziwoneka ngati kufooka kosalekeza m'miyendo ndi kupweteka kosatha.

Njira zochizira

Matenda a shuga ndi owopsa, motero muyenera kuyamba kulandira chithandizo munthawi yake. Kuchulukitsa kwamikodzo, vuto lakudya, kuchepa thupi kuyenera kukhala koopsa komanso kuyenera kukhala mwayi wodziwa mulingo wa monosaccharide m'magazi ndikuyesa mayeso okhudzana ndi shuga. Ngati kutsata kwa glucose ndi glycohemoglobin kuli kwakukulu, shuga amapezeka mumkodzo, ndipo acetone amapezekanso, matenda a shuga amapezeka.

Monga gawo la mankhwalawa, zizindikiro zamatenda zimachotsedwa, kuwongolera kwa metabolic kumachitika, miyeso imatengedwa kuteteza zovuta ndipo cholinga ndikuwonetsetsa kuti moyo wabwino. Wodwala amafunika kumwa mankhwala, kutsatira zakudya zapadera, kuchita masewera olimbitsa thupi komanso kudziletsa.

Mankhwala a insulin komanso mankhwala a hypoglycemic

Mu mtundu woyamba wa matenda, zovuta za carbohydrate metabolism zimalipiridwa ndi insulin mankhwala, momwe munthu amakakamizika kubaya ma hormone tsiku lililonse. Njira yochizira imasankhidwa ndi dokotala atayang'anitsitsa mosalekeza ndikuwongolera kuchuluka kwa shuga m'magazi. Mlingo wamba ndi magawo 0.5-1 pa kilogalamu imodzi patsiku.

Mtundu wachiwiri wa matenda ashuga, muyeso wotere sufunikira nthawi zonse, nthawi zambiri mankhwalawa amagwiritsidwa ntchito omwe amachepetsa mayamwidwe a glucose ndikuwonjezera mphamvu ya minofu ya insulin (metmorphine, rosiglitazone), komanso mankhwala omwe amalimbikitsa katulutsidwe wa mahomoni (vildagliptin, glibenclamide). Ma michere am'kati omwe amawononga chakudya chamaguluchuchuchucia amalepheretsa acarbose, ndipo mafuta a metabolism amakhala ngati fenofibrate.

Kudya

Kulipira kwathunthu kwa kagayidwe kazakudya sikungatheke popanda chakudya. Kuphatikiza apo, nthawi zina zimakhala zokwanira kulandira chithandizo ndipo mutha kuchita popanda mankhwala poyambira matenda a shuga 2. Zakudya zopanda pake ndizowopsa ndi mtundu woyamba, chifukwa zimatha kubweretsa kukomoka ndi zotsatira zoyipa.

Pazakudya zoyenera za matenda, michere yamagetsi imachotsedwa pakudya. Kuchuluka kwa mafuta ochulukitsa omwe amalowa m'thupi amalamulidwa mwamphamvu. Amayezedwa m'magawo a mkate (1XE = 10-12 g ya chakudya cham'madzi = 20-25 g ya mkate). Asanagwiritse ntchito, wodwala matenda ashuga amafufuza kuchuluka kwa mkate mu tebulo yapadera pogwiritsa ntchito tebulo lapadera. Kwa tsiku limodzi, amatha kugwiritsa ntchito kuchokera 12 mpaka 25 XE, koma pachakudya chimodzi kuchuluka kwawo sayenera kupitirira 7. Mowa umaphatikizidwa.

Zakudya zonse zimadyedwa patsiku ziyenera kulembedwa mu diary yapadera. Izi zimathandizira kuwerengera ndikuti zitha kulowa mkati mwa kuwonongeka kuti mutenge mwachangu mlingo woyenera wa insulin kapena mankhwala ochepetsa shuga.

Opaleshoni ya metabolism

Pogwiritsa ntchito njira zoletsa, matendawa sangathe kuchiritsidwa. Koma opaleshoni yokhala ndi mwayi wambiri ukhoza kupulumutsa munthu ku matenda ashuga a 2. Opaleshoniyo imakhala ndi chapamimba ndi biliopancreatic shunting, momwe malo ochepa osungirako amapangidwira kumtunda kwam'mimba, komwe kumakhala ndi ma kilogalamu 30 a chakudya cholimba. Chakudya chimadutsa kwambiri m'mimba ndi jejunum.

Chifukwa cha kulowererapo, kulemera kwa thupi kumachepa, chakudya sichidutsa mu duodenum, koma imatumizidwa kwa ileum, mucosa yomwe imabisala peptide chifukwa chogwirizana ndi chakudya, chomwe chimapangitsa kupanga insulin komanso kukula kwa maselo a pancreatic. Mu milandu ya 80−98%, izi zimabweretsa kuchira.

Njira zopewera

Kupewa kwamavuto, omwe ali pachiwopsezo chachikulu cha matenda ashuga, kumaphatikizapo kuyang'anira kuthamanga kwa magazi ndi kukonza kwake ndi mankhwala ngati kuli kofunikira, komanso ndi lipid-kuchepetsa mankhwala. Zotsirizirazi zimaphatikizanso kumwa mankhwala omwe amawongolera ma triglycerides otsika komanso ochepera mphamvu ya lipoprotein, omwe amachepetsa kupitilira kwa matenda a ischemic, kuwonongeka kwa retina ndi mitsempha. Ngati pali chiopsezo chachikulu cha zovuta zazikulu, izi zimaphatikizidwa ndi fenofibrate.

Moyo wapamwamba kwambiri kwa odwala ndiwotheka pokhapokha kuwunikira zizindikiro, chithandizo, kuchitapo kanthu mwachangu ndi kuwonongeka. Ichi ndichifukwa chake ndikofunikira kwambiri kuzindikira zizindikiro za matenda ashuga panthawi ndikutsatira mosamalitsa malingaliro onse a dokotala.