Zochitika m'moyo 1 shuga

Mtundu woyamba wa matenda a shuga a mellitus (omwe amadalira insulini) ndi amtundu wa matenda omwe amayamba chifukwa cha matenda a metabolic. Matendawa amakhudza kwambiri achinyamata, chifukwa chake amatchedwa ana.

Ndipo kotero kuti njira yosinthira kudzakhala ku boma latsopano imachitika popanda kuchuluka kosafunikira, ndikofunikira kumvetsetsa: chifukwa chake kuchuluka kwa glucose m'magazi kumakwera, komanso kuvulaza "shuga owonjezera" kungayambitse thupi.

Kodi insulin imachokera kuti?

Zikondazo ndizoyenera kupatsa thupi insulin. Kapena, gawo laling'ono, lomwe limapanga 1-2% ya kuchuluka kwa ziwalo. Awa ndi omwe amatchedwa islets of Langerhans, akuchita endocrine ntchito.

Chilichonse mwa zisumbuzi zimakhala ndi maselo olimbitsa thupi. Ndi ochepa - ma 80-200 ma PC okha. kupita ku chisumbu. Kuphatikiza apo, maselo ocheperawa omwe amagwira ntchito m'magawo amagawika m'mitundu inayi:

1. Alefa
2. Beta
3. Delta
4. PP

Maselo a Beta amakhala 85% ya yonse. Ndi omwe amapanga insulin.

Momwe ma insulin glucose awiri amagwirira ntchito

Kwa thupi lathu, shuga ndiye gwero lalikulu lamphamvu lofunikira kuti minyewa yake yonse ndi ziwalo zake zizigwira bwino ntchito. Mlingo wa shuga m'magazi uyenera kukhala wokhazikika - iyi ndi imodzi mwazinthu zazikulu zothandizira thupi lathu.

Koma munthu wathanzi saganizira kuchuluka kwa glucose yemwe "adapereka" kwa thupi panthawi ya chakudya. Kodi thupi limasunga bwanji nthawi zonse? Apa ndipomwe ma cell a beta amasewera.

Ngati shuga wambiri alowa m'magazi ndi chakudya, kutulutsa kwamphamvu kwa insulin. Zotsatira zake:

• Zochita za kaphatikizidwe ka shuga m'thupi zimatha;
• Zowonjezera zomwe zimalandiridwa kuchokera kunja zimatumizidwa kwa zimakhala zodalira insulini - adipose, chiwindi, minofu - kutikirira.

Pakadali pano, insulin imasewera ngati kondakitala kapena kiyi, yomwe imatsegula njira yolowera mu khungu la glucose.

Mthupi lathu mulinso tizinthu tina tosadalira insulin tomwe timatha kupangira shuga m'magazi mwachindunji: awa ndi minyewa yamitsempha. Ubongo ulinso wake - ubongo ndi msana. Izi ndi zabwino komanso zoyipa: kumbali imodzi, mphamvu ya "kompyuta" yathu siyimatengera zolakwika mu kapamba, koma satetezedwa ku zotsatira zoyipa za kuchuluka kapena kusowa kwa glucose.

Ngati kufunika kowonjezera mphamvu kwachuluka (mwakumana ndi kupsinjika, mwaganiza zogwira ntchito kudziko kapena kupita kukayendera), glucose, yomwe pakali pano ili m'magazi, imayamba kudya. Malingana ndi momwe mlingo wake umagwera pansi pazovomerezeka, glucose synthesis amaphatikizidwa m'thupi:

1. Choyamba, glycogen imatumizidwa kuti ikakonzedwe - malo ake amasungidwa m'chiwindi.
2. Ngati sikokwanira, lipids ndi mapuloteni amagwiritsidwa ntchito.

Zomwe zimachitika ndi insulin

Ngati insulin yamkati sinapangidwe, palibe chinsinsi chomwe chimayendetsa glucose m'maselo. Chakudya chilichonse chimapangitsa kuti shuga azingowonjezereka, koma zimakhala zodalira insulin sizingamupangitse. Maselo amayandama mumadzi otsekemera, koma osatha kuyamwa glucose - ndipo amatumiza chizindikiro cha SOS ku ubongo: "Tilibe mphamvu yamoyo."

Chiwindi chimalandira lamulo lofufuza glycogen, ndipo imatumiza glucose wophatikizidwa pafupipafupi. Izi zikatha, njira ya gluconeogeneis imayamba - mapuloteni ndi lipids adzagwiritsidwa ntchito.

Munthu amakhala ndi njala pa thupi, koma ngakhale adya zochuluka motani, kulemera kwake kumatsika, chifukwa thupi lilibe mphamvu. Palibe zida zopangira mapuloteni ndi lipids.

Impso zikuyesetsa kukonza zinthu: zimayamba kukhathamiritsa shuga mkodzo. Kuchuluka kwamikodzo patsiku kukukula, munthu ali ndi ludzu, ndipo amamwa madzi mu malita - pamakhala zochitika zina pamene wodwala amamwa ndowa yokha usiku.

Ngati thupi silothandizidwa panthawiyi, mavuto azovuta amayamba kukula msanga.

Kodi insulin imapita kuti?

Insulin yodalira matenda a shuga imachitika pamene ma cell a pancreatic beta awonongedwa. Pazifukwa zina, chifukwa cha matenda opatsirana ndi ma virus (chimfine, rubella, paratyphoid, ndi zina), ma antibodies amawoneka m chitetezo cha mthupi, chomwe minofu ya thupi imawonedwa ngati yachilendo. Amachita nawo ngati alendo - amangowawononga.

Kuphatikiza pa ma virus, mndandanda wa "omwe akutsutsidwa" umaphatikizapo:

• Madzi akumwa oyeretsa kwambiri;
• Kuperewera kwa kuyamwitsa;
• Kuyamwitsa mwana mkaka wa ng ombe.

Ma antibodies awa (autoimmune chikhomo) amatha kuwonekera kudzera pamayeso angapo a labotale. Ngati iwo kulibe, koma maselo a beta awonongedwa, matenda a shuga 1 amakhala oyenerera ngati idiopathic - ndiko kuti, chifukwa cha kuwonongeka kwa maselo achisamba pazifukwa zosadziwika.

Kwenikweni, kulephera kwa kagayidwe kachakudya kwakachitika kale, wodwalayo sasamala chifukwa chake adataya insulin. Ali ndi njira imodzi yotsalira: kukhazikitsa kupanga insulini yopanga komanso kusintha zatsopano.

Zizindikiro Za Zipatala

Zizindikiro za matenda ashuga zimaphatikizapo:

• Polyuria - kuchuluka kwa mkodzo wa tsiku ndi tsiku mpaka malita 3-10 wokhala ndi malita 1.8-2. Zizindikirozi ndizofala kwambiri. Mwinanso ngakhale kugona;
• Polydipsia ndi ludzu losatha: kuzimitsa kumafuna madzi ambiri - kuchokera malita 8 mpaka 10, ndipo nthawi zina zochulukirapo. Nthawi zambiri chizindikiro ichi chimatsatiridwa ndi pakamwa lowuma;
• Polyphagy - kudya zakudya zochuluka kwambiri ndikumangokhala ndi njala komanso kuchepa kwa thupi;
• Kusintha kosasinthika: kutayika kwake m'miyezi iwiri yokha kumatha kufika 10 kg;
• Kugona, kutopa, kunachepetsa mphamvu zolimbitsa thupi ndikuchita;
• Kusowa tulo, chizungulire, kusakwiya komanso kuyamwa;
• Khungu ndi mucous nembanemba pafupipafupi;
• Kusweka kumawoneka pamasaya ndi pachifuwa chifukwa cha kuchuluka kwa mitsempha yaying'ono ya magazi;
• Kupweteka kwa m'mendo, kukokana kwa minofu.

Koma Zizindikiro zonse pamwambapa siziri zifukwa zopezera matenda. Kuti mutsimikizire, ndikofunikira kuyesa mayeso a labotale:

• Carbohydrate kagayidwe: shuga m'magazi wotsimikizika katatu - pamimba yopanda kanthu, maola 1.5-2 mutadya komanso musanagone;
• Glycated hemoglobin;
• Mafuta a mkodzo;
• Protein metabolism (urea, creatinine, mapuloteni);
• Lipid metabolism (cholesterol ndi ma ketones);
• Kusinthana kwa mahomoni.

Ndi mayeso a mahomoni, osati kuchuluka kwa insulin kokha, koma C-peptide imatsimikiza. Zotsirizirazo zimapangidwa chimodzimodzi monga insulin. Ngati wodwalayo akutenga kale mankhwala a insulini, kuchuluka kwa insulini mkati mwake kungathe kutsimikizika pogwiritsa ntchito C-peptide ngati akupangidwabe.

Momwe mungasinthire moyo wanu

Ngakhale mudakhala athanzi, sizinakuchitikireni kuti musamale ndi nthawi zambiri zofunika: mudadya zomwe mumakonda, komanso momwe mungafunire, munathamangira kukaphunzitsira kapena kugudubuza pa sofa ndi buku - ambiri, simunamvetsetse kuti mumamasulidwa bwanji.

Pozindikira mtundu 1 wodwala matenda ashuga, muyenera kusintha moyo wanu moyenera. Kwakukulukulu, zoletsa zina sizingakhudze ufulu wanu, koma mwamavuto ndizovuta kuvomereza. Ndiye chifukwa chake achinyamata amapanduka, kuphwanya boma, kukondweretsa malingaliro awo achinyengo ndi matendawa.

Kulimbana ndi matenda ashuga motere ndi kopanda ntchito: kupambana sikungakhale kumbali yanu. Kutayika kwanu kumabweretsa zovuta zosasinthika, chifukwa chake zimakhala zolondola "kupanga anzanu" ndi matendawa. Ndipo mukangochita izi, moyo wanu ukhalapobe.

. Mothandizidwa ndi insulin, mankhwala a prophylactic, mavitamini ndi zakudya, amafunika:

• Kulipira kagayidwe kazakudya;
• Khazikitsani kagayidwe ka lipid;
• Khalani ndi magazi abwinobwino.

Munthu wodwala matenda ashuga ali ndi "zida" zingapo zogwirira ntchito:

• Mankhwala a insulin;
• Zakudya
• Zochita zolimbitsa thupi;
• Chipangizo chodziyang'anira nokha (glucometer).

Onetsetsani kuti mwadutsa pasukulu ya odwala matenda ashuga: oyamba amatayika nthawi zonse akamva kufufuzidwa, chifukwa chake amafunika thandizo la akatswiri.

Mankhwala a insulin

Pofuna kutsata katizidwe kathu kabwino ka insulin, munthu wodwala matenda ashuga ayenera kuyambitsa mankhwala opanga:

• Insulin ya basal - nthawi 1-2 patsiku;
• Bolus - asanadye chilichonse.

Ma insalins amatchedwanso kuti amakhala nthawi yayitali kapena amakhala nthawi yayitali. Ntchito yawo ndikuwerengera glucose yemwe chiwindi amapanga. Pancreas wathanzi amatulutsa magawo 24-26 a insulin tsiku lililonse. Pafupifupi kuchuluka komweko kuyenera kulowa mankhwala osakhalitsa. Dokotala angakulimbikitseni mlingo.

Koma mutha kuchita kafukufuku pawokha:

• Osamadya kwa maola asanu;
• Muzipima shuga ola lililonse;
• Ngati kudumpha kwake sikuposa 1.5 mmol / l - mlingo umatsimikiza molondola;
• Shuga amachepetsa kapena kukwera - mudzayeneranso kuchepetsa kapena kuwonjezera kuchuluka kwa insulin yayitali.

Chitani zoyesa masiku angapo:

• Pa tsiku loyamba - m'mawa;
• Lachiwiri - pa nkhomaliro;
• Lachitatu - madzulo.

Ndikofunika kuchita kafukufuku usiku. Muyenera kungoyambitsa maola 6 mukadya.

Mutha kutsimikizira kufunika koyesedwa poyesa shuga pamimba yopanda kanthu: ngati ndichulukirapo kapena mochepera 6.5 mmol / l - yambitsani phunzirolo.

Zimakhala zovuta kwambiri kuwerengera mlingo wa insulin. Zimatengera zinthu zingapo:

• Magazi a shuga m'magazi musanadye;
• Kuchuluka kwa chakudya cham'mimba zomwe mwatsala pang'ono kudya;
• Zolinga zanu mutayambitsa insulini - kodi mungopuma, kuchita masewera aluso kapena kuti mugwire ntchito zolimbitsa thupi;
• Nthawi ya tsiku (ya 1 mkate mkate - tidzakambirana za pansipa - insulin yambiri imafunika m'mawa kuposa masana kapena madzulo);
• Mkhalidwe wanu wathanzi (ngati mukuvutika ndi matenda amtundu wina, muyenera kuwonjezera kuchuluka kwa insulin ndi 20-30%)

Kuwerengeka molondola kwa Mlingo wa insulin kutha kuyang'aniridwa ndi izi:

• Kuthamanga shuga sikupitirira 6.5 mmol / l;
• Maola awiri mutatha kudya, sayenera kukwera pamwamba pa 8.0 mmol / L.

Kwa odwala matenda ashuga oyamba, zomwe tafotokozazi zimadzutsa mafunso ambiri.

Ngati matenda a shuga adapezeka koyamba, chiwerengerochi chidzakhala 0.4-0,5 U / kg. Pokhala ndi chidziwitso choposa chaka chimodzi ndi kubwezeredwa kwabwino pakawerengedwa, zosowa za tsiku ndi tsiku zikhala 0.6, ndipo pankhani ya kuwonongeka, 0.8 U / kg.

Mwachitsanzo, wodwala wolemera makilogalamu 75 mchaka choyamba cha matenda ashuga adzafunika mayunitsi 0,5 x 75 = 37,5 patsiku la insulin. Ndikovuta kugwira theka, motero timazungulira 38.

Mwa awa, 50% adzagawana gawo la insulin yowonjezera (10 mwa iwo - m'mawa, 9 - usiku), ndipo 19 yotsalayi adzagawidwa motere:

• Magawo 8 - chakudya cham'mawa chisanafike;
• Mayunitsi 6 - chakudya chamadzulo chisanachitike;
• Magawo asanu - asanadye.

Tsopano ikukonza menyu kuti ikhale ndi magawo omwe ali ndi buledi wokwanira kubwezera insulin. Poyamba, tiyeni tiwone kuti XE ndi chiyani - magawo a mkate, ndi momwe mungafotokozere zomwe mumadya.

Kodi gawo la mkate ndi chiyani (XE)

Chipinda cha mkate ndimtengo wokwanira ma gramu 10 a chakudya (kuphatikiza michere yazakudya).

Pafupifupi mankhwala aliwonse amakhala ndi chakudya chamafuta. Mwa ena, chiwerengero chawo chimakhala chochepa kwambiri kotero kuti powerenga insulin mlingo amatha kunyalanyazidwa. Zomwe zimapezekanso zamagalimoto ndi shuga, ufa, chimanga, zipatso, mbatata ndi maswiti - zakumwa zokhala ndi shuga, maswiti, chokoleti.

Koma pali chenjezo limodzi: omwe akupanga chikalata chofunikachi akuwonetsa kuchuluka kwa zinthu zomwe zimagwera pa XE imodzi mwanjira yake. Mwachitsanzo, mkate umodzi umafanana ndi magalamu 15 a Buckwheat.

Zimakhalabe kuti mudziwe momwe mungalumikizitsire zonsezi ndi phala lomalizidwa? Kupatula apo, imatha kukhala yotentha kapena yowoneka bwino. Ndipo ndi maso simungadziwe kuchuluka kwa chakudya chambiri chomwe chimabwera ndi mbale pathupi lanu.

Poyamba, inu (kapena okondedwa anu) muyenera kulimbikira ndi kugwira ntchito yotsatirayi:

1. Gulani masikelo khitchini;
2. Muyesetse mosamala chimangacho, ndikusintha kulemera kwake kukhala magawo a buledi;
3. Lembani kuchuluka komwe mumatenga madzi ndi tirigu;
4. Ganizirani poto lomwe phala imaphika;
5. Muziyesa ndi mbale yokonzedwa ndikuchotsa kulemera kwa poto yopanda kanthuyo;
6. Gawani zotsatila ndi manambala a mkate (onani ndime 2).

Tiyerekeze kuti mwaphika phala mu chiyezo cha 1: 4, ndipo kulemera kwa mkate umodzi kwamalizo kumakhala 60 magalamu. Tsopano yikani mbaleyo pamlingo ndikuwadzaza ndi chakudya: ikani 120 g - idyani 2 XE, onjezani gawo kukhala 180 g - pezani 3 XE.

Ngati mungakonze zonse zomwe mwachita papepala, ndipo simusintha kuchuluka, mtsogolomo muyenera kungoyesa kuchuluka kwa phala la phala lopanda phala.

Malinga ndi chiwembuchi, mutha kuwerengera molondola kulemera kwa XE imodzi ya mbale iliyonse. Madokotala ena a matenda ashuga amayesa kudziwa kufunika kwa diso, zomwe zimabweretsa zotsatira zowawa: mwina hypoglycemia kapena hyperglycemia.

Kukonzekera katundu

Dziwani kuti zochitika zolimbitsa thupi zimasinthasintha kumva kwamisempha yodalira insulin. Thupi lathanzi nthawi ngati izi limachepetsa kutulutsira insulin ndi theka.

Anthu odwala matenda ashuga ayenera kulinganiza mosamala chilichonse chomwe amachita. Ngati akufuna kuonetsa thupi lake kuti azichita masewera olimbitsa thupi kwa nthawi yayitali, ayenera kupeza kaye kuchuluka kwa shuga m'magazi panthawi yoyamba kuchitapo kanthu. Akadalemba:

• 4.5 mmol / l, ayenera kudya 1-4 XE musanayambe kuchita masewera olimbitsa thupi;
• 5-9 XE - ingowonjezerani 1-2 XE koyambirira, koma ola lililonse muyenera kudya mkate umodzi umodzi;
• 10-14 mmol / l - palibe chakudya.

Mavuto a Matenda A shuga a Type 1

Mavuto a shuga angathe kugawidwa m'magulu atatu:

• Lakuthwa;
• Pambuyo pake;
• Matenda

Pachimake kuphatikiza zovuta zomwe zimatha kupangitsa munthu kufa. Amakula msanga, ndipo thandizo la panthawi yake lokha ndi lomwe lingapulumutse odwala matenda ashuga. Izi zikuphatikiza:

• Ketoacidosis: imachitika chifukwa chodzikundikira m'thupi la matupi a ketone (acetone);
• Hypoglycemia: Kutsika kwamphamvu kwa shuga m'magazi. Cholinga chakugwa kotereku kungakhale kuchuluka kwa insulin, mowa wamphamvu, kusinza, kulimbitsa thupi kwakukulu, osalipidwa ndi kuchuluka kwa chakudya;
• Hyperglycemia: shuga wambiri. Itha kuchitika pamimba yopanda kanthu - osaleka kudya nthawi yayitali, kapena mutatha kudya, ngati kumwa kwa insulin sikugwirizana ndi kuchuluka kwa mikate yomwe amadya.

Mavuto apambuyo pake akuphatikizapo:

• Retinopathy, momwe retina imakhudzidwira, kukha kwa magazi kumachitika mu fundus, ndipo, chifukwa chake, kutayika kwamaso;
• Angiopathy - otchedwa kuphwanya kwa mtima kupindika;
• Polyneuropathy - yomwe imawonetsedwa mu kuchepa kwa chidwi cha miyendo kuti itenthe, kuzizira komanso kupweteka. Choyamba, kumakhala kowopsa m'miyendo: kumamveka bwino usiku - ichi ndiye chizindikiro choyamba cha polyneuropathy;
• Matendawa odwala matenda ashuga - chophatikizika, chomwe chimaphatikizidwa ndi mawonekedwe a purulent abscesses, zilonda zotseguka komanso malo osasakanika pamiyendo ya odwala matenda ashuga. Mapazi amafunikira kupatsidwa chisamaliro chapadera: ukhondo, kusankha nsapato zoyenera, kuvala masokosi omwe alibe mabatani ophatikizira, etc.

Mavuto osapweteka osatha amaphatikizapo kuwonongeka kwa mitsempha yamagazi, khungu ndi impso. Zilonda zam'mimba, kugunda kwa mtima, stroko, matenda amtima, komanso nephropathy ndizodziwika bwino kwa odwala matenda ashuga.

Koma odwala matenda ashuga ayenera kumvetsetsa chinthu chimodzi chofunikira kwambiri: mu mphamvu yake yoyandikira kapena yochedwetsa nthawi yowonetsera zovuta izi. Ngati atenga nthenda yake mozama, ndiye kuti yofewa. Koma mukuyenera kugwedeza dzanja lanu paulamuliro ndi kuwongolera - ndipo mudzapeza zovuta zochedwa mochedwa patangotha ​​zaka zochepa pambuyo pa matenda ashuga.