Mowa hypoglycemia - kapangidwe ka chitukuko ndi momwe mungathetsere

Kuledzera ndi chimodzi mwazomwe zimayambitsa hypoglycemia, makamaka ngati mowa umamwa pamimba yopanda kanthu kapena ndi chakudya chosakwanira. Zoterezi zimapangidwanso pakumwa zakumwa zoledzeretsa pambuyo pothira minofu yayitali kapena kupumira pakudya. Gawo lodziwitsa limasewera ndi zomwe zakumwa zaledzera zomwe zalowa mthupi ndi mawonekedwe ake.

Hypoglycemia wopangidwa ndimankhwala nthawi zambiri amakula motsutsana ndi maziko a kuledzera. Ethanol imatha kuchepetsa mita ya shuga m'magazi ndi zowopsa komanso zowopsa.

Momwe mowa umapangitsira hypoglycemic syndrome

Khalidwe la ethanol m'magazi ndi losamveka:

• Choyamba, zimawonjezera ntchito ya insulin ndi mapiritsi ochepetsa shuga.
• Kuletsa chiwindi, Mowa umalepheretsa kupanga kwa glucogen - gwero lina la shuga.
• Limagwirira a mowa ndi ofanana ndi ntchito lipids: Kutha mafuta, kumawonjezera kuchuluka kwa mafuta maselo. Kudzera m'matumbo owonjezera, glucose wochokera m'magazi amalowa mu cell. Zomwe zili m'magazi zimagwa, njala yofunikira imawoneka.

Kuphatikiza apo, ethanol imakonza magwiridwe antchito a kukula kwa mahomoni ndipo imasokoneza kuyankha koyenera kwa thupi pakusintha kwa shuga wa plasma. Ichi ndi chimodzi mwazomwe chimayambitsa hypoglycemia mwa anthu omwe amamwa mowa mopitirira muyeso, chifukwa mahomoni amakula amawongolera glucometer.

Chifukwa cha "zopanda kanthu" zopatsa mphamvu zomwe ethanol imakhala, zimalepheretsa kugwiritsa ntchito mafuta m'thupi.

Limagwirira kukula kwa chidakwa hypoglycemia

Anthu odwala matenda ashuga omwe ali ndi "chidziwitso" cholimba cha matendawa amadziwa za kuchepa kwa mowa. Mlingo wa glucose umakwera m'njira ziwiri: kudya mafuta ochulukirapo ndi chakudya komanso kupanga glycogen ndi chiwindi. Kukhazikika kwa glucose kosakhazikika kumachirikiza shuga osatsika kuposa 3,3 mmol / L Ngati mowa ungalepheretse gluconeogeneis poletsa chiwindi, taganizirani zomwe zimachitika m'thupi pamene shuga sayipitsidwa. Mwayi wopeza hypoglycemia ndiwopamwamba mu odwala matenda a shuga omwe amadalira insulin, popeza kusintha mlingo woganizira zakumwa sikophweka.

Ethanol imayambitsa hypoglycemia chifukwa cha kusokoneza njira ya gluconeogeneis ndikusintha kwa chiyezo cha cytosolic cha NADH2 / NAD. Kukonza mowa mu chiwindi kumapangitsa mowa dehydrogenase. Cofactor ya enzyme, NAD (nicotinamide adenine dinucleotide) ndi gawo lofunikira la glucogenesis. Mowa wambiri m'magazi am'magazi umayambitsa kugwiritsidwa ntchito kwa NAD komanso kuletsa kwa glycogen kupanga chiwindi.

Mwachiwonekere, mowa hypoglycemia umayamba motsutsana ndi kumbuyo kwa kuchepa kwa zinthu za glycogen, pomwe kuthekera kwa chiwindi kwa glucogenesis ndikofunikira kwambiri kuti matenda a shuga asinthe. Pangozi ndi anthu omwe amamwa mowa pafupipafupi ndi zakudya zochepa.

Kuphatikiza pa kagayidwe ka cellular, ethanol imalepheretsa kuyamwa kwa chiwindi cha zinthu zomwe zimakhudzidwa ndi kapangidwe ka glycogen (lactate, alanine, glycerin). Zomwe zili ndi alanine m'magazi zimatsikanso chifukwa cholepheretsa kutuluka kwa minofu.

Matenda a hypoglycemic state

Mowa ndi chizoloŵezi chofunikira kuti chitukuko cha hypoglycemia chithandizire kwa omwe amapezeka popanda matenda a shuga. Poyamba, ziwerengero zotere zidalungamitsidwa ndi zosayenera zomwe zimakhala ndi zakumwa zoledzeretsa zamtengo wapatali. Koma atayesa mafuta oyera a ethanol, omwe adaperekedwa kwa odzipereka athanzi labwino omwe adakhala ndi njala kwa masiku awiri kapena atatu ndikuwonetsa zotsatira zofananira, malingaliro awa adayenera kusintha.

Mowa hypoglycemia nthawi zambiri umapezeka pakati paokonda zakumwa zoledzeretsa omwe amapita popanda kudya kwa tsiku limodzi kapena awiri. Vuto limayamba patatha maola 6 mpaka 24 Mowa atalowa m'magazi, ndiye kuti sizingatheke kuzindikira vuto la fungo lochokera mkamwa. Pali mbiri ya zizindikiritso pakusanza mobwerezabwereza, izi zikuwonetsa kukwiya kwamanjenje ndi m'mimba ndi mowa, kuchepa kwa kalori, pomwe zakudya zomwe zimakhala ndi ethanol zimalowa m'mimba.

Ziwopsezo, chifukwa chotenga kachilombo ka HIV chifukwa chomwa mowa:

• Odwala odwala matenda a shuga a insulin;
• Odwala omwe ali ndi matenda a pituitary-adrenal system;
• Ana omwe ali ndi mwayi wakumwa mowa mwangozi.

Kuopsa kwa khunyu komanso chizolowezi cha hypoglycemia kumakhalapo kwa ana osaposa zaka 5. Mlingo wowopsa wa ethanol weniweni wa ana ndi 3 g / kg (mwa akulu - 5-8 g / kg).

Hypoglycemia woledzera wa mowa nthawi zambiri umatha. Ndikosavuta kusiyanitsa vutoli ndi poyizoni wa mowa wamphamvu.

Mowa hypoglycemia amadziwika ndi zofunika zizindikiro matenda:

• Hypothermia (chifukwa cha hypoglycemia);
• Kupuma movutikira (ndi concomitant lactic acidosis);
• Kuphatikizika kwa ethanol m'magazi kumakhala kosavuta kwa kuledzera kwamphamvu (mpaka 1000 mg / l);
• Mlingo wa shuga - mpaka 300 mg / l (ndikuyambitsa glucagon, zotsatira zake sizisintha);
• Mafuta a insulin ndi ochepa, pali zizindikiro za ketonoturia;
• Mowa ketoacidosis chifukwa cha kuchuluka kwa lactic acid.

Kuyesedwa kwa hepatatic kumawonetsa chizolowezi, ndikotheka kuzindikira momwe ziliri pokhapokha mbiri yakale yomwa mowa yotchulidwa mu anamnesis. Pambuyo pobwezeretsa chuma cha glycogen, kutsitsimutsa mowa sikuyambitsa hypoglycemia.

Hypoglycemia wokhala ndi zakumwa zoledzeretsa zimadalira mlingo: makamaka pamene wovutikayo watenga, glucogenesis yotalikirapo imapindika. Choopsa chachikulu ndi mtundu wachedwa wa hypoglycemia. Ngati madzulo adamwa zakumwa zoledzeretsa, vuto limatha usiku. Chifukwa cha kuchuluka kwa glycogen m'chiwindi, izi sizovuta kuchiza. Kuledzera kwauchidakwa kumathandizira kunyalanyaza zizindikiritso zam'mbuyomu za hypoglycemia, kotero njira zopewera panthawi yake sizitengedwa.

Momwe mungathetsere hypoglycemia ya mowa

Popanda chidziwitso chanthawi yake komanso chithandizo chokwanira, anthu omwe amamwalira mu vutoli amawona 25% ya ana komanso 10% ya achikulire omwe akuchitiridwa nkhanza.

Kukhazikitsidwa kwa glucagon sikuthetsa vuto lomwe limachitika chifukwa cha kuledzera, chifukwa kulibenso nkhokwe za glycogen, komanso momwe thupi limachitikira ndi timadzi timeneti. Jakisoni wa glucose ndiwothandiza kuchepetsa milingo ya lactate komanso kusintha momwe mulili acid-base. Mosiyana ndi mtundu wa hypoglycemia, wodwala safuna kulowetsedwa kwa shuga. Mu ana omwe ali ndi zizindikiro zotere, amayamba ndi shuga, ndipo dontho lokhala ndi glucose-electrolyte solution imakwaniritsa.

Monga chithandizo choyambirira (ngati wozunzidwayo akudziwa) amaloledwa kugwiritsa ntchito zakudya zamafuta - maswiti, msuzi wokoma. Kupumanso kwa hypoglycemia kumaletsedwa ndi chakudya chamagulu. Mapiritsi a glucose ali ndi kuchuluka kwa chakudya chambiri.

Njira zabwino zothanirana chikomokere ndi kupewa:

1. Anthu odwala matenda ashuga ayenera kuchepetsa kumwa mowa.
2. Mowa sungakhale njira yochepetsera glycemia.
3. Ndi chiwindi chathanzi, amaloledwa kudya 50 g ya mowa wamphamvu ndi cognac kapena 150 mg wa vinyo wouma (chofunikira chachikulu cha chakumwa ndi kusowa kwa shuga ndi zoperewera pang'ono).
4. Nthawi zina mumatha kumwa mowa - mpaka 300 g (kuvulaza kwa chakudya chamafuta kumalipidwa ndi zabwino za yisiti yofulula).
5. Zakumwa zonse zokoma zaukali ndizoletsedwa - zotsekemera ndi viniga wokhala ndi mipanda yolimba, zakumwa zoledzeretsa, zamatsenga, etc. Kwa amayi oyembekezera, palibe chosankha: mowa umaletsedwa pachikhalidwe.
6. Kumbukirani kuti mowa umatseka zizindikiro za hypoglycemia, kuphatikizapo kuchedwa. Chenjerani za mavuto anu kwa omwe ali pakali pano.
7. Zakudya zoledzeretsa ziyenera kudyedwa mukatha kudya.
8. Musanagone, onetsetsani kuti mumawerengera za shuga ndikudya china ndi chakudya.
9. Mukamawerengera zakudya zanu zopatsa mphamvu, gwiritsani ntchito zakumwa za calorie: 1 g mapuloteni kapena chakudya - 4 kcal, 1 g yamafuta - 9 kcal, 1 g ya ethanol - 7 kcal.
10. Khalani okonzekera kuti mowa udzaonjezera kuchuluka kwa triglycerides, kuwonjezera chiwonetsero cha matenda amitsempha ya matenda a shuga.

Zakumwa zoledzeretsa (40% mowa), mlingo wa chiopsezo cha hypoglycemia ndi 50-75 g pamaso pa zokhwasula-khwasula monga mbatata ndi zakudya zina. Kwa ma vinolo okhala ndi ethanol ochepera komanso kuchuluka kwa chakudya chambiri (vinyo wouma, brut), chiopsezo cha 50 ml. Werengani zidziwitso zomwe zalembedwa ndipo muzilembapo zomwe dokotala wanu sanakulembeni ndi "mankhwala" omwe akumwa.