Odwala atakula, nthawi zambiri atatha zaka 40, zizindikiritso zoyambirira za mtundu wa matenda ashuga, zomwe zimabadwa, zimawonekera. Pafupifupi nthawi zonse, kulemera kwa thupi mwa odwala omwe ali ndi mwayi kumachulukitsidwa. Pancreatic endocrine matenda system ikuphatikiza mankhwala. Pali zofunika mwapadera zofunikira za mtundu wa matenda ashuga a 2. Nthawi yomweyo, madokotala amawona kuti ndikofunikira kuphunzitsa odwala zowerengera. Kodi mawu oti "mkate mkate" amatanthauza chiyani? Momwe mungagwiritsire ntchito deta ya tabular pazinthu za hehe? Kodi anthu odwala matenda ashuga nthawi zonse amafunika kuwerengera kuchuluka kwa chakudya chomwe amadya?
Zolemba za matenda a shuga a 2
Mtundu wapadera wa shuga umawonetsedwa mu insulin yachilendo (yotsika kapena yowonjezera) yopangidwa ndi gulu lotsogolera la endocrine. Matenda amtundu wachiwiri samalumikizidwa ndi kusowa kwa mahomoni m'thupi, monga woyamba. Maselo amtundu wa anthu okalamba odwala matenda ashuga amakhala osagwirizana ndi insulin nthawi yayitali komanso pazifukwa zingapo.
Chochita chachikulu cha mahomoni opangidwa ndi kapamba ndikuthandizira kulowetsedwa kwa shuga kuchokera m'magazi kulowa m'matumbo (minofu, mafuta, chiwindi). Mtundu wachiwiri wa matenda ashuga, mumakhala insulini m'thupi, koma maselo sawazindikira. Glucose wosagwiritsidwa ntchito umasonkhana m'magazi, hyperglycemia syndrome imachitika (shuga m'magazi imakhala yovomerezeka). Njira yolimbana ndi insulini yodwala imayamba pang'onopang'ono mwa okalamba, kuyambira milungu ingapo mpaka miyezi ngakhale zaka.
Nthawi zambiri matendawa amapezeka ndi kuyezetsa pafupipafupi. Anthu odwala matenda ashuga osadziwika amatha kuonana ndi dokotala ndi zizindikiro za:
Zakudya zamagulu a mkate + patebulo- zotupa pakhungu mwadzidzidzi, kuyabwa;
- kukhumudwa kwamaso, matsoka;
- angiopathy (zotumphukira mtima matenda);
- ma neuropathies (zovuta za ntchito ya mathero a mitsempha);
- aimpso kukanika, kusabala.
Kuphatikiza apo, madontho a mkodzo wouma woimira njira ya shuga amasiya mawanga oyera pamachapira. Pafupifupi 90% ya odwala, monga lamulo, amakhala ndi kulemera kwaku thupi kopitilira muyeso. Pobwezeretsanso, zitha kudziwika kuti wodwala matenda ashuga anali ndi vuto la chitukuko cha patatha nthawi yayitali. Zakudya zoyambirira zamkaka zosakaniza mkaka zimathandizira zolakwika pakupanga insulin. Madokotala amalimbikitsa, ngati zingatheke, kupatsa mwana yoyamwitsa.
Masiku ano, chitukuko cha zachuma chimayendera limodzi ndi chizolowezi chokhala moyo wokhala pansi. Njira zopulumutsira chibadwa zimapitiriza kudziunjikira mphamvu, zomwe zimabweretsa kukula kwamafuta, matenda oopsa komanso matenda ashuga. Kuwonongeka kwa glycemia kumawonetsa kuti pofika nthawi yake 50% ya maselo apadera a pancreatic anali atataya ntchito yawo.
Nthawi ya gawo la asymptomatic la shuga imawerengedwa ndi endocrinologists kukhala owopsa kwambiri. Munthuyo wadwala kale, koma salandila chithandizo choyenera. Pali kuthekera kwakukulu kwa kupezeka ndi kusokonezeka kwa mtima wamavuto. Matenda omwe adapezeka kumayambiriro amatha kuthandizidwa popanda mankhwala. Pali zakudya zapadera zokwanira, zolimbitsa thupi ndi mankhwala azitsamba.
Mawonekedwe a zakudya zamtundu wa 2 wodwala matenda ashuga pogwiritsa ntchito XE
Munthu wodwala matenda ashuga omwe amalandira insulin ayenera kumvetsetsa zigawo za mkate. Odwala a 2, omwe nthawi zambiri amalemera thupi, amafunika kutsatira zakudya. Kuti mukwaniritse kuchepetsa kunenepa ndikotheka poletsa kuchuluka kwa chakudya chodyedwa.
Mu shuga mellitus mwa okalamba, zolimbitsa thupi zimathandizanso. Ndikofunika kusamalira momwe zimakhalira. Kuwerenga kwa zinthu za XE ndikosavuta komanso kosavuta kuposa chakudya chamagulu.
Kuti zitheke, malonda onse amagawidwa m'magulu atatu:
- Zomwe zimatha kudyedwa popanda choletsa (m'malire osavomerezeka) osawerengeka;
- chakudya chofuna insulin yokonza;
- Ndi osafunika kugwiritsa ntchito, pokhapokha ngati nthawi ya matenda a hypoglycemia (kuchepa kwambiri kwa shuga m'magazi).
Zambiri zokhudzana ndi mkate zimasonkhanitsidwa muma tebulo apadera kapena zojambula momwe mungapezeko zinthu zomwe zikugwiritsidwa ntchito.
Gulu loyamba limaphatikizapo zamasamba, nyama, batala. Samachulukitsa konse (kapena kukweza pang'ono) maziko a shuga m'magazi. Pakati pa masamba, zoletsa zimakhudzana ndi mbatata yotsika, makamaka pamtundu wa mbale yotentha - mbatata yosenda. Zophika mizu yophika bwino zimadyedwa kwathunthu ndi mafuta (mafuta, kirimu wowawasa). Kapangidwe kake ka mankhwala ndi zinthu zamafuta zimakhudza kuchuluka kwa mayamwidwe othamanga - amachepetsa.
Zotsatira zamasamba (osati juisi kuchokera kwa iwo) 1 XE zimapezeka:
- beets, kaloti - 200 g;
- kabichi, phwetekere, radish - 400 g;
- maungu - 600 g;
- nkhaka - 800 g.
Mu gulu lachiwiri la zinthu muli zakudya “zamafulumira” (zopangira makeke, mkaka, timadziti, chimanga, pasitala, zipatso). Mu lachitatu - shuga, uchi, kupanikizana, maswiti. Amagwiritsidwa ntchito pokhapokha ngati pali mavuto, okhala ndi shuga m'magazi (hypoglycemia).
Lingaliro la "mkate mkate" linayambitsidwa kuti liwunike zakudya zamagulu olowa m'thupi. Choyenererachi ndichotheka kugwiritsa ntchito kuphika ndi zakudya kuti muthe kusinthanitsa ndi zakudya zamafuta. Matala amapangidwa mkati mwa sayansi endocrinological Center ya RAMS.
1 XE pafupifupi imakhala mu 12 g ya msuzi wopanda msuzi (mchenga - 1 tbsp. L.) kapena 20-25 g ya mkate wopanda chotupitsa (wonse, nthawi zambiri umadula mkate)
Pali dongosolo linalake losinthira zinthu kukhala zigawo za mkate. Kuti muchite izi, gwiritsani ntchito patebulo la mkate kwa odwala matenda ashuga. Nthawi zambiri imakhala ndi magawo angapo:
- lokoma
- ufa ndi nyama, mbewu monga chimanga;
- zipatso ndi zipatso;
- masamba
- zopangidwa mkaka;
- zakumwa.
Zakudya zokhala ndi gawo limodzi la 1 XE zimakweza shuga wamagazi pafupifupi 1.8 mmol / L. Chifukwa cha kusakhazikika kwachilengedwe kwamachitidwe amthupi mwa masana, kagayidwe kachakudya gawo loyamba limakulirakulira. M'mawa, 1 XE idzakulitsa glycemia ndi 2.0 mmol / L, masanawa - 1.5 mmol / L, madzulo - 1.0 mmol / L. Kutero, mulingo wa insulin umasinthidwa ndimagawo a mkate omwe amadya.
Asanadye kadzutsa (3 XE) ndi nkhomaliro (4 XE), mayi wodwala matenda ashuga ayenera kupanga zigawo 6 za insulin yochepa, asanadye chakudya (3 XE) - magawo atatu.
Zakudya zazing'ono zazing'ono zomwe zimakhala ndi ntchito yofunikira ya wodwala zimaloledwa kuti zisayende ndi jakisoni wa mahomoni. 1 kapena 2 jakisoni wa insulin yotalikilapo (nthawi yayitali) patsiku, kumbuyo kwa glycemic kwamthupi kumakhala kosasunthika. Kamwe zoziziritsa kukhosi asanagone (1-2 XE) kumachitika kupewa usiku wa hypoglycemia. Ndiosafunika kudya zipatso usiku. Zakudya zomanga thupi mofulumira sizingateteze ku matenda.
Kuchuluka kwa zakudya zabwinobwino odwala matenda ashuga akuchita ntchito yanthawi zonse ndi pafupifupi 20 XE. Ndi ntchito yayikulu yathanzi - 25 XE. Kwa iwo omwe akufuna kuchepa thupi - 12-14 XE. Hafu ya chakudya cha wodwalayo imayimiriridwa ndi chakudya (mkate, chimanga, masamba, zipatso). Zotsalira, pafupifupi zofanana, ndi mafuta ndi mapuloteni (nyama yokhazikika, mkaka, nsomba, mafuta). Malire a kuchuluka kwa chakudya mu chakudya chimodzi amatsimikiza - 7 XE.
Mtundu wachiwiri wa matenda ashuga, malinga ndi data ya XE yomwe ili patebulopo, wodwalayo amasankha kuchuluka kwa zakudya zomwe angadye patsiku. Mwachitsanzo, amadya 3-4 tbsp chakudya cham'mawa. l phala - 1 XE, woboola pakati - 1 XE, mpukutu wa batala - 1 XE, apulo yaying'ono - 1 XE. Zakudya zomanga thupi (ufa, mkate) nthawi zambiri zimagwiritsidwa ntchito popanga nyama. Tiyi yopanda mafuta sinakufunikira kuceza kwa XE.
Pali umboni kuti kuchuluka kwa odwala matenda ashuga amtundu wa 2 ndiotsika poyerekeza ndi kuchuluka kwa odwala omwe ali pa mtundu wa 2 insulin.
Anthu amawopa kubayitsa mahomoni pazifukwa zingapo, makamaka zamaganizidwe
Madotolo ali ndi zotsatirazi popereka mankhwala a insulin a 2 odwala matenda ashuga:
- kupewa hyperglycemic chikomokere ndi ketoacidosis (mawonekedwe a acetone mkodzo);
- kuthetsa zizindikiro (ludzu losasangalatsa, pakamwa lowuma, kukodza pafupipafupi);
- kubwezeretsa thupi lotayika;
- khazikitsani thanzi, moyo wabwino, luso logwira ntchito, luso lochita masewera olimbitsa thupi;
- kuchepetsa kuuma ndi pafupipafupi kwa matenda;
- mupeze zotupa zamagazi akulu ndi ang'ono.
Ndizotheka kukwaniritsa zolingazo mwa kudya mwachangu glycemia (mpaka 5.5 mmol / L), mutatha kudya - 10.0 mmol / L. Chiwerengero chomaliza ndi cholowa chaimpso. Ndi zaka, zimatha kuchuluka. Mu odwala matenda ashuga okalamba, zizindikiro zina za glycemic zimatsimikiza: pamimba yopanda kanthu - mpaka 11 mmol / l, mutatha kudya - 16 mmol / l.
Ndi mulingo wamtunduwu, ntchito yama cell oyera imachepa. Akatswiri otsogola amakhulupirira kuti ndikofunikira kupereka insulin ngati njira zogwiritsidwa ntchito pochiritsa sizisunga glycemic level (HbA1c) yochepera 8%.
Machitidwe a mahomoni a odwala omwe ali ndi matenda a shuga a 2 amathandiza kukonza:
- kuperewera kwa insulin;
- kuchuluka kwa chiwindi shuga;
- kugwiritsidwa ntchito kwa chakudya chamafuta mu zotumphukira za thupi.
Zizindikiro za insulin mankhwala okhudzana ndi anthu okalamba odwala matenda ashuga amagawika m'magulu awiri: Mtheradi (kuwonongeka kwa mashuga chifukwa cha mimba, opaleshoni, matenda oopsa) komanso wachibale (kusakwanira kwa mankhwala ochepetsa shuga, kulekerera kwawo).
Mtundu wofotokozedwawu wadwala. Chofunikira kwambiri ndikuti wodwalayo ayenera kutsatira zakudya komanso zakudya zopatsa thanzi. Kusintha kwa mankhwala a insulin kungakhale kwakanthawi kapena kokhazikika. Njira yoyamba imakhala, monga lamulo, mpaka miyezi itatu. Kenako adokotala amachotsa jakisoni.
Matenda a 2 a shuga amatengedwa ngati mtundu wophunziridwa bwino. Kuzindikira kwake komanso chithandizo chake sichovuta. Odwala sayenera kukana njira yongoyembekezera yoperekera insulin. Zikondwerero zomwe zili mthupi la odwala matenda ashuga nthawi yomweyo zimalandira chithandizo chofunikira.
