Kodi matenda amtundu wa 2 angachiritsidwe?

Matenda a shuga amatchedwa matenda ovuta, omwe amadziwika ndi kuphwanya njira zonse za metabolic zomwe zimachitika mthupi la munthu zomwe zimachitika motsutsana ndi maziko a kuchepa kwathunthu kwa insulin. Kukula kwa matendawa kuli ndi ziwerengero zazikulu, ndipo izi sizikugwira ntchito kumayiko ena aliwonse, koma kwa kuchuluka kwa mapulaneti onse.

Type 2 shuga mellitus imatenga malo otsogola pakati pa mawonetseredwe onse a endocrine pathology. Zimakhala pafupifupi 85% yamatenda onse azachipatala. Mtundu uwu wa matenda ashuga wayamba kukhala wachichepere m'zaka zaposachedwa. Ngati kale matendawa adapezeka atatha zaka 45, tsopano milandu yodziwika ngati yodziyimira payekha imadziwika ngakhale mwa ana.

Kafukufuku akuwonetsa kuti poyambirira kukaonana ndi adokotala, odwala ambiri sakayikira ngakhale pang'ono kuti ali ndi vuto liti. Amabwera ndi zodandaula za kuwonongeka kwa maonekedwe, zilonda zam'munsi zam'mimba, kupweteka kwa mtima ndi miyendo. Izi zikufotokozera kufunika kwa kudziwitsidwa koyambilira komanso kusankha chithandizo cha matendawa. Chithandizo cha matenda a shuga a mtundu wachiwiri, njira, mfundo, mawonekedwe a kasamalidwe ka odwala zakambidwa munkhaniyi.

Pang'ono pang'ono pokha pokhudza matendawa

Cholinga chachikulu cha mtundu wa "matenda okoma" chimaonedwa kuti ndi kuchepa kwamphamvu kwa maselo ndi zotumphukira za thupi pazochitika za insulin. Insulin ndi chinthu chomwe chimagwira ntchito m'matumbo a m'mapapo omwe amachititsa kuti magazi azikhala ndi shuga komanso kuti azinyamula kupita ku maselo. Pankhani iyi, chitsulo chimatulutsa insulin yokwanira, koma zimakhala zake "osaziwona".

Kuwonjezeka kwa shuga m'magazi kumachitika pamene zochitika za insulin zobisika zam'mapapo zimachepera theka. Kwa nthawi yayitali, matenda a pathology ndi asymptomatic, ngakhale kusintha pamitsempha yamagazi kumachitika kale.

Chiwopsezo chotenga zovuta zazikulu chikubwera ngati zizindikiro zoyesererazo zikuwoloka:

• kuchuluka kwa shuga musanadye chakudya kuli pamwamba pa 6.5 mmol / l;
• Zizindikiro za glycemia patadutsa maola angapo atatha kudya chakudya mthupi pamwamba pa 8 mmol / l;
• manambala a glycosylated hemoglobin apamwamba 7%.

Mwazi wamagazi ndiye chizindikiro chachikulu cha chitukuko cha matenda

Ichi ndichifukwa chake zimakhala zovuta kuyankha funso loti mtundu wa 2 matenda a shuga ungachiritsidwe. Inde, odwala ambiri samakayikira kwanthawi yayitali kuti ali ndi vuto la matenda.

Amadziwika kuti moyo wosayenera, zolakwika za pakudya, zolakwika zamthupi ndizovuta zomwe zimapangitsa kuti matendawa akhazikike poyambira kukhalapo kwa chibadwa chamtunduwu. Nthawi yomweyo, mphamvu yogwira ntchito pazinthu izi imalola, pamlingo wina, kubwezeretsa njira ya metabolic, kusunga zisonyezo za shuga pamalire ovomerezeka, komanso kupewa kupitirira kwa matendawa.

Mfundo zachithandizo

Mankhwala amakono amagwiritsa ntchito njira zotsatirazi zochizira matenda amitundu iwiri:

• chakudya
• zolimbitsa thupi;
• kumwa mapiritsi ochepetsa shuga;
• mankhwala a insulin.

Chithandizo cha zakudya

Tsoka ilo, kuthana ndi matenda amtundu wa 2 sikungatheke. Njira zamakono zochizira sah. matenda a shuga amatha kukwanitsa kulipidwa, pomwe kuchuluka kwa glycemia kumawoneka ngati kwabwinobwino, sikumapangitsa kuti pakhale zovuta. Imodzi mwa njirazi ndiyo kukonza zakudya.

Malamulo oyamba a mankhwala ochizira odwala matenda ashuga omwe samadalira insulin:

• pafupipafupi zakudya zazing'ono;
• kukana shuga ndi zakudya zokhala ndi manambala amitundu yambiri ya glycemic;
• kuphatikiza mu zakudya za zinthu zokhala ndi CHIKWANGWANI chamagulu owononga;
• kudya mapuloteni okwanira mthupi;
• kutsatira kwambiri tsiku ndi tsiku calorie kudya;
• kugwiritsa ntchito masamba ndi zipatso;
• kukana zakumwa zoledzeretsa.

Katswiri woyenerera wazakudya amathandizira kukonza menyu oyamba

Ndikofunika kukumbukira kuti mukamaphika muyenera kugwiritsa ntchito mankhwalawa kutentha, kuphika mbale mu uvuni, pa grill, kuphika. Ndikwabwino kukana yokazinga, kusuta, mchere wamchere, komanso ma muffin ndi ma makeke ozikidwa pa premium kapena ufa woyamba wa tirigu.

Malonda oletsedwa ndi:

• masoseji;
• Zakudya zamzitini ndi batala;
• nyama yamafuta ndi nsomba;
• mayonesi, masitolo ogulitsa;
• madzi owala;
• mafuta apamwamba amkaka;
• mankhwala omalizidwa;
• chakudya chofulumira.

Ndikofunikira kuphatikiza masamba, zipatso, masamba ambiri, chimanga mumenyu. Nyama ndi nsomba ziyenera kukhala mitundu yamafuta ochepa, nsomba zam'madzi ndizololedwa.

Zochita zolimbitsa thupi

Kupititsa patsogolo kwamasewera ndi masewera olimbitsa thupi paumoyo komanso kudwala matenda ashuga kwadziwika. Katundu wokwanira sangangochepetsa shuga m'magazi, komanso kupititsa chidwi cha zotumphukira kuzinthu zomwe mahomoni am'mimba amapanga (izi zimawapangitsa kukhala othandiza mitundu iwiri yayikulu ya "matenda okoma").

Komabe, si odwala onse omwe amachita masewera olimbitsa thupi omwe amayambitsa yankho limodzi. Itha kukhala yamitundu ingapo:

• Indices za shuga sizisinthidwa kwambiri kapena kuchepetsedwa pang'ono kukhala zofanana.
• Glycemia amatsika kwambiri.
• Mwazi wamagazi ukuwonjezeka.

Yoga - gulu lovomerezeka la odwala matenda ashuga

Njira yotsirizayi imachitika pamaso pa kuwonongeka kwa matenda oyambitsidwa. Zochita zolimbitsa thupi zimayambitsa kuphwanya kwa kudya kwa shuga ndi zida zama minofu ndikuwonjezera njira ya gluconeogeneis. Asayansi atsimikizira kuti kuchita masewera olimbitsa thupi ndikoyenera pokhapokha ngati mulingo wa glycemia sunapitirire 14 mmol / l.

Chithandizo cha matenda a shuga a mtundu wa 2 ndi:

• Yoga
• kusambira
• Kuyenda
• kukwera njinga;
• kumayenda.

Kuchita masewera olimbitsa thupi kumakhudza munthu wodwala matenda ashuga motere:

• onjezerani zamtundu wa insulin;
• kuchepetsa triglycerides ndi cholesterol yoyipa;
• Sinthani matenda a magazi pakuwundana;
• Kuchepetsa kwamitsempha yamagazi ndi kuteteza njira zopewera kuphatikizika kwa magazi;
• kuchepetsa manambala a fibrinogen;
• kuchuluka mtima;
• Kuchepetsa kufunikira kwa myocardial oxygen;
• sinthani zizindikiro za kuthamanga kwa magazi;
• kusintha magazi.

Kugwirizana pakati pa kunenepa kwambiri ndi chisankho chamankhwala

Kulemera kwa thupi ndi zina mwazomwe zimapangitsa kuti pakhale shuga. Amadziwika kuti kufuna kuthana ndi matenda a shuga kungachitike pokhapokha pothana ndi kunenepa kwambiri. Ngati wodwala wataya 5-7 makilogalamu, wina akhoza kunena mosabisa kuti kuthekera kopeza chipukuta misozi kumawonjezereka ndi 50-60%.

Matenda a kunenepa kwambiri ndi amodzi mwa magawo azithandizo

Odwala onse omwe mtundu wachiwiri wa "matenda okoma" adapezeka woyamba amagawidwa m'magulu otsatirawa:

• Odwala omwe ali ndi vuto labwinobwino kapena locheperako (index ya body mass osakwana 25).
• Odwala onenepa (index kuchokera 25 mpaka 40).
• Odwala omwe ali ndi vuto la kunenepa kwambiri (BMI pamwambapa 40).

Kugawidwa kwa odwala matenda ashuga m'magulu kumapangitsa wopezeka m'magazi kuti awonenso mphamvu ya kapamba, ndikusankha njira zoyenera zochizira.

BMI yochepera 25

Mankhwala Amakono a shuga a Type 2

Poyesa kuchiza matenda amtundu wa 2 odwala mwa njira zotere, mankhwala othandizira pakudya ndi masewera olimbitsa thupi ayenera kugwiritsidwa ntchito. Ndikotheka kugwiritsa ntchito mankhwala a insulin, popeza pali kuthekera kwakukulu kwa kukhalapo kwathunthu kwa insulin. Monga lamulo, jakisoni wa insulin amagwiritsidwa ntchito kokha kuti aletse kuwonekera kwa matenda.

Kenako gwiritsani ntchito mankhwalawa Metformin mu mawonekedwe a monotherapy kapena osakanikirana ndi ma protein. Pakutha kugwira ntchito, amasinthanso kubaya ma hormone kapena kugwiritsa ntchito insulin pump.

BMI 25-40

Gulu la odwala ndiwokulira. Apa, kukonza zakudya, masewera olimbitsa thupi komanso kusintha kwa moyo kumaonedwa kuti ndi amisala pakuchira. Kafukufuku wazachipatala atsimikizira kuti pokhapokha ngati akusintha m'miyoyo yawo, wodwala aliyense khumi amatha kukana kugwiritsa ntchito mapiritsi ochepetsa shuga chaka chilichonse.

Kwa odwala omwe ali ndi BMI a 25 mpaka 40, magulu otsatirawa a mankhwala ndi omwe amaperekedwa:

• Metformin;
• alpha glucosidase zoletsa;
• analogi ya ma insretins.

Kamodzi mwa kotala kapena miyezi isanu ndi umodzi, malamulowo akuyenera kuwunikiridwa malinga ndi momwe wodwalayo amathandizira. Ngati kuchuluka kwa shuga m'magazi kungakhalebe ndi kuchuluka kwambiri komanso kulemera kwa wodwala kumachulukirachulukira, mapiritsi ena ochepetsa shuga atha kukhala opanda chifukwa. Dokotala akuyenera kupereka chithandizo chokwanira. Mwina gawo la ndalama, m'malo mwake, likuyenera kuthetsedwa.

Endocrinologist - katswiri yemwe angathandize kulimbana ndi endocrinopathy

Ngati wodwala wakwanitsa kuchepa kapena kulemera kwake kumakhalabe pamlingo womwewo, mwayi wofotokozera kukonzekera kwa insulin uyenera kuganiziridwa, pokhapokha ngati kusowa kwa ma concomitant pathologies kwatsimikiziridwa. Tikulankhula za matenda otsatirawa:

• chifuwa chachikulu
• HIV
• zotupa njira;
• kusakwanira kwa adrenal cortex.

BMI pamwamba 40

Odwala, monga lamulo, amakhala ndi moyo wopanda ntchito, wogwiritsa ntchito zakudya zopanda pake. Ndizovuta kwambiri kuchiza odwala matenda ashuga. Ndikofunikira kusankha mankhwala omwe sangangowongolera glycemia, komanso kuchepetsa thupi, kapena osachepera okhazikika.

Endocrinologists amasankha kuphatikiza kwa Metformin ndi glucagon-ngati peptide-1 analogues.

Mankhwala

Pali zochitika zina pamene kuli kofunikira kufotokozera wodwalayo momwe muliri komanso momwe magawo ake amakirinidwe ndi metabolic. Pachifukwa ichi, sankhani mitundu yotsatirayi:

• infusions ndi Reopoliglukin njira;
• kuikidwa kwa hepatoprotectors (mankhwala omwe amateteza chiwindi ku mavuto) - Essentiale-forte, Carsil;
• enzymatic mankhwala - Mezim, Panzinorm;
• Mavitamini a B ndi mavitamini a ascorbic mu mawonekedwe a jakisoni;
• mankhwala pamaso pa concomitant bakiteriya matenda kuchokera impso;
• sedative (pamaso pa kusowa tulo);
• symptomatic mankhwala (mwachitsanzo, chithandizo cha thrush, chithandizo cha zilonda zam'mimba, kubwezeretsanso kwa potency).

Gulu lalikulu ndimapiritsi ochepetsa shuga. Kusankhidwa kwa kuphatikiza kwawo kumatengera kuzunzika kwa wodwalayo, msinkhu wake ndi malamulo ake, kulemera kwa thupi, ziwerengero za glycemia.

Alpha Glucosidase Inhibitors

Mankhwalawa amathandizira kuti achepetse kuyamwa kwa masalacides kudzera m'makoma amatumbo kulowa m'magazi. Njira yothandiza ndi Glucobai yozizira pa acarbose. Mankhwala wolembedwa ngati sangathe kuyendetsa ma glucose malinga ndi zakudya, ngati kusowa kwa Metformin mankhwalawa, kwambiri hyperglycemia atatha kudya motsutsana ndi maziko oyamba a insulin.

Chothandiza kwambiri ku Germany

Mankhwalawa sangathe kuphatikiza shuga wamagazi atatha kudya. Komanso muchepetse kuchuluka kwa cholesterol "yoyipa" ndi triglycerides. Ndikofunika kuti mankhwalawa sayambitsa kuchepa kwambiri kwa magazi a glycemia, omwe amalola kuti agwiritsidwe ntchito pochiza odwala okalamba.

Kukonzekera kwa Sulfonylurea

Ngati matenda a shuga sanachiritsidwe, ndiye kuti kubwezeredwa kumatheka pokhapokha, kukonzekera kochokera ku sulfonylurea kumalola. Zisonyezero zakudikirira kwawo:

• kusowa kwa kuphatikiza kwa chakudya komanso zolimbitsa thupi zokwanira;
• kukhalapo kwa mtundu wa 2 matenda kwa odwala omwe ali ndi chizolowezi chambiri kapena chambiri thupi, pomwe chiphuphu chimapezedwa ndi mtundu waukulu wa insulin.

Zoyipa:

• 1 mtundu wa "matenda okoma";
• nthawi yobereka mwana ndi yoyamwitsa;
• chikomokere;
• kuwonongeka pamaso matenda matenda oyambira;
• kukonzekera kwa kuchepa kwambiri kwa glycemia;
• othandizira opaleshoni.

Oimira gulu:

• Gliburide;
• Gliclazide;
• Tolbutamide;
• Chlorpropamide.

Biguanides

Kugwiritsidwa ntchito moyenera kwa matenda am'magazi a wodwala, ngati sangathe kugwiritsa ntchito njira zina. Oimira - Metformin, Buformin. Mankhwalawa amachepetsa shuga.

Momwe mungagwiritsire matenda amisipitala a 2 a shuga ndi gulu ili la mankhwalawa, katswiri wodziwa za matendawo amadziwitsa. Kuphatikiza kwa Metformin ndi sulfonamides ndikotheka.

Mankhwala a insulin

Kuphatikizidwa kwa jakisoni wa mahomoni mu regimen yamankhwala akuwonetsedwa motere:

• mimba
• kukhalapo kwa mtima matenda;
• zovuta za mtima;
• kuwonda komanso kuwonjezereka ketoacidosis;
• magwiridwe;
• matenda opatsirana;
• kusowa kwa chithandizo cha mankhwala a hypoglycemic.

Insulin imalowetsedwa pang'onopang'ono khoma lamkati, matako, mapewa, m'chiuno

Wopezeka ku endocrinologist amatha kusankha njira yayitali kapena yayifupi yogwiritsira ntchito mankhwala a mahomoni. Oimira insulin omwe aphatikizidwa mu chiwembu:

• Actrapid;
• Insulrap;
• Humulin P;
• Matepi;
• Humulin L;
• Ultralent BOC;
• Depot-N-Insulin.

ASD

Titha kuchiritsa matenda amtundu wa 2 kapena ayi, ndipo odwala amayesetsa ndi zina zonse kuti akwaniritse zotsatira zomwe mukufuna pogwiritsa ntchito mankhwalawa. ASD (chopatsa chidwi cha a Dorogov) ndi njira yachilendo.

Kukonzekera kumapangidwa pamaziko a chakudya cha minofu ndi mafupa a nyama omwe amapezeka chifukwa cha kutentha. Muli ma carboxylic acids, ma hydrocarbons, sulfure, polyamide ndi madzi. Chida chake ndicho kuyendetsa mphamvu ya chitetezo cha mthupi, kulimbikitsa maselo achinsinsi a insulin, kusintha njira zama metabolic.

Funso loti mtundu wa shuga wachiwiri ungachiritsidwe umadandaula ndi wodwala aliyense amene wakumana ndi matenda oopsa. Tsoka ilo, panthawiyi ya mankhwala palibe njira zomwe 100% zitha kuthetsera vuto la machiritso. Ngati zoterezi zadziwika kuti wina adachiritsa matenda amtundu wa 2 shuga, ndiye kuti tikulankhula zakupatsirana kwa ziwalo komanso kusintha kwathunthu m'moyo.