Type 2 shuga mellitus: zimayambitsa, Zizindikiro, matenda ndi chithandizo

Kodi matenda ashuga a 2 ndi otani?

Matendawa amakula nthawi zambiri ali ndi zaka 40-60. Pachifukwa ichi, amatchedwa shuga a okalamba. Komabe, ndikofunikira kudziwa kuti m'zaka zaposachedwa matendawa adayamba kuchepa, sizikulinso zachilendo kukumana ndi odwala ochepera zaka 40.

Type 2 shuga mellitus amayamba chifukwa chophwanya chiwopsezo cha maselo amthupi kupita ku insulin ya mahomoni, yomwe imapangidwa ndi "zilumba" za kapamba. Mu terminology yamankhwala, izi zimatchedwa insulin kukana. Chifukwa cha izi, insulini sitha kupereka bwino gwero lalikulu lamphamvu, glucose, m'maselo, motero, kuchuluka kwa shuga m'magazi kumawonjezeka.

Kuti achepetse kusowa kwa mphamvu, kapamba amatulutsa insulin yambiri kuposa masiku onse. Nthawi yomweyo, kukana insulini sikumatha kulikonse. Ngati pakadali pano simupereka chithandizo pakanthawi, ndiye kuti kapamba "amatha" ndipo kuchuluka kwa insulini ndikusowa. Mafuta a glucose amakwera kufika 20 mmol / L ndikukwera (wokhala ndi 3.3-5,5 mmol / L).

Kuopsa kwa matenda ashuga

Pali magawo atatu a shuga mellitus:

1. Fomu yakuwala - nthawi zambiri imapezeka mwangozi, popeza wodwalayo samamva zizindikiro za matenda ashuga. Palibe kusinthika kwakukulu mu shuga la magazi, pamimba yopanda kanthu msambo wa glycemia sudutsa 8 mmol / l. Chithandizo chachikulu ndi zakudya zomwe zimaletsa chakudya, makamaka mosavuta kugaya.
2. Matenda abwinobwino a shuga. Madandaulo ndi zizindikiro zimawoneka. Palibepo zovuta zina, kapena sizilepheretsa wodwalayo kuchita. Mankhwalawa amakhala ndi kumwa mankhwala osakaniza omwe amachepetsa shuga. Nthawi zina, insulin imapangidwa mpaka 40 magawo patsiku.
3. Njira zingapo yodziwika ndi kukwera kwambiri kwa glycemia. Chithandizo chophatikizidwa chimaperekedwa nthawi zonse: mankhwala ochepetsa shuga ndi insulin (zopitilira 40 patsiku). Pakufufuzidwa, mavuto osiyanasiyana a mtima atha kupezeka. Vutoli nthawi zina limafunanso kukonzanso mwachangu.

Malinga ndi kuchuluka kwa kubwezeretsa kwa carbohydrate metabolism, pali magawo atatu a shuga:

• Kubwezera - Mukalandira chithandizo, shuga amasungidwa mosadukiza, osapezeka mu mkodzo.
• Kubweza - glucose m'magazi sichikwera kupitirira 13.9 mmol / l, mkodzo sapitilira 50 g patsiku.
• Kubwezera - glycemia kuyambira 14 mmol / l ndi kukwera, mkodzo woposa 50 g patsiku, kukulitsa kukomoka kwa hyperglycemic ndikotheka.

Prediabetes (kuphwanya kulekerera kwa chakudya cham'magazi) amalekanitsidwa pawokha. Vutoli limapezeka kuti limayesedwa kuchipatala - mayeso a kulolera glucose kapena mayeso a glycated hemoglobin.

Mosiyana ndi Matenda A shuga Aakulu

Zomwe zimayambitsa matenda A shuga A Type 2

Chifukwa cha mtundu wanji wa matenda a shuga omwe amapezeka, asayansi samadziwa kuti pali zinthu zina zomwe zimapangitsa kuti matendawa akhalepo:

• Kunenepa kwambiri - Cholinga chachikulu cha mawonekedwe a insulin kukana. Njira zomwe zingasonyeze kulumikizana pakati pa kunenepa kwambiri ndi minofu yolimbana ndi insulin sizimamveka bwino. Asayansi ena amatsutsana kuti achepetse kuchuluka kwa ma insulin omwe amapezeka mwa anthu onenepa kwambiri poyerekeza ndi ochepa.
• Makamaka (kupezeka kwa matenda ashuga m'mbale) kumawonjezera mwayi wokhala ndi matendawa kangapo.
• Kupsinjika, Matenda Opatsirana zimatha kupangitsa kuti mitundu iwiri ya matenda ashuga ndi yoyamba.
• Mwa azimayi 80% omwe ali ndi matenda otupa a polycystic, kukana kwa insulin komanso kuchuluka kwakweza insulin kunapezeka. Kudalira kwadziwika, koma pathogenis ya chitukuko cha matendawa pakadali pano sichinafotokozedwe.
• Kuchulukitsa kwamahomoni kapena glucocorticosteroids m'magazi kungachepetse chidwi cha insulin, ndikupangitsa matenda.

Mothandizidwa ndi zinthu zingapo zoyipa, masinthidwe a insulin receptors amatha kuchitika, omwe sangathe kuzindikira insulin komanso kupititsa shuga m'maselo.

Komanso, chiopsezo cha matenda amtundu wa 2 chimaphatikizaponso anthu atatha zaka 40 okhala ndi cholesterol yambiri komanso triglycerides, wokhala ndi matenda oopsa kwambiri.

Zizindikiro za matendawa

• Kuyabwa kosasunthika kwa khungu ndi maliseche.
• Polydipsia - ozunzidwa nthawi zonse ndi kumverera kwa ludzu.
• Polyuria ndi njira yowonjezerera pokodza.
• Kutopa, kugona, kugona pang'ono.
• Matenda apakhungu pafupipafupi.
• Zouma mucous nembanemba.
• Zilonda zazitali zosachiritsa.
• Kukhumudwa mu mawonekedwe a dzanzi, kulira kwa miyendo.

Kuzindikira matendawa

Kafukufuku yemwe amatsimikizira kapena kukana kukhalapo kwa mtundu 2 wa matenda ashuga:

• kuyesa kwa shuga m'magazi;
• HbA1c (kutsimikiza kwa glycated hemoglobin);
• kusanthula kwa mkodzo matupi a shuga ndi ketone;
• kuyeserera kwa glucose.

Poyambirira, mtundu wachiwiri wa matenda ashuga ungathe kuzindikirika m'njira yotsika mtengo mukamayesa mayeso okhudzana ndi shuga. Njirayi imakhala m'lingaliro loti kuphatikiza magazi kumachitika kangapo. Pamimba yopanda kanthu, namwino amatenga magazi, pambuyo pake wodwala amayenera kumwa 75 g shuga. Pakutha kwa maola awiri, magazi amatengedwanso ndipo kuchuluka kwa shuga kumayang'aniridwa. Nthawi zambiri, zimayenera kukhala mpaka 7.8 mmol / L m'maola awiri, ndipo ndi matenda ashuga zidzaposa 11 mmol / L.

Palinso mayeso owonjezera omwe magazi amatengedwa kanayi pa theka lililonse la ola. Amawerengedwa kuti ndiwothandiza kwambiri poyesa kuchuluka kwa shuga poyankha kuchuluka kwa shuga.

Tsopano pali ma labotoreti achinsinsi ambiri, momwe magazi a shuga amatengedwa kuchokera m'mitsempha ina, ndipo ena kuchokera ku chala. Ma diagnostics akufotokozera mothandizidwa ndi ma glucometer kapena mizere yoyesera apangidwanso. Chowonadi ndi chakuti mu venous ndi capillary zizindikiro zamagazi amasiyana, ndipo nthawi zina zimakhala zofunikira kwambiri.

• Mukamayang'ana m'magazi am'magazi, kuchuluka kwa shuga kumakhala kokwanira 10-15% kuposa magazi a venous.
• Kuthamanga shuga wa magazi kuchokera m'magazi a capillary kuli kofanana ndi kuchuluka kwa shuga m'magazi. Mutatha kudya magazi a capillary, shuga ndi 1-1.1 mmol / l kuposa m'magazi a venous.

Mavuto

Pambuyo popezeka ndi matenda a shuga a 2, wodwalayo ayenera kuzolowera kupewera shuga, kumwa mapiritsi ochepetsa shuga nthawi zonse, komanso kutsatira zakudya ndikusiya zosokoneza bongo. Muyenera kumvetsetsa kuti shuga yayikulu imasokoneza mitsempha yamagazi, imayambitsa zovuta zingapo.

Mavuto onse a shuga amagawika m'magulu awiri akulu: pachimake komanso chovuta.

• Mavuto owopsa amakhala ndi chikomokere, chomwe chimapangitsa kuti wodwalayo awonongeke kwambiri. Izi zitha kuchitika chifukwa cha kuchuluka kwa mankhwala a insulin, omwe ali ndi vuto lakudya komanso osakhazikika, osamwa mosasamala. Vutoli limafunikira thandizo la akatswiri omwe akukonzekera kuchipatala.
• Mavuto aakulu (mochedwa) amakula pang'onopang'ono nthawi.

Matenda onse osokoneza bongo a matenda a shuga a 2 agawidwa m'magulu atatu:

1. Microvascular - zotupa pamlingo wa zombo zazing'ono - ma capillaries, venule ndi arterioles. Zida za retina zamaso (diabetesic retinopathy) zimavutika, aneurysms zimapangidwa zomwe zimatha kuphulika nthawi iliyonse. Pamapeto pake, kusintha koteroko kumatha kuchititsa kuti anthu asamaone. Zida za aimpso glomeruli zimasinthanso, chifukwa cha mawonekedwe amomwe aimpso amalephera.
2. Macrovascular - kuwonongeka kwa mitsempha yamagazi yamphamvu yayikulu. Ischemia ya Myocardial ndi matenda am'mimba imachitikanso, komanso zotumphukira zamatenda zam'mimba zimatha. Izi ndi chifukwa cha kuwonongeka kwa mitsempha ya atherosselotic, ndipo kupezeka kwa shuga kumawonjezera mwayi wawo wopezeka katatu. Chiwopsezo chodulidwa miyendo mwa anthu omwe ali ndi matenda osokoneza bongo ndi 20 kupezeka !;
3. Matenda a shuga. Kuwonongeka kwa chapakati ndi / kapena zotumphukira zamanjenje kumachitika. Mitsempha yama minyewa imadziwika nthawi zambiri ndi hyperglycemia, kusintha kwazinthu zingapo kumachitika, chifukwa chomwe kupendekera kwofananira kudzera mu ulusi kumasokonekera.

Chithandizo

Pochiza matenda a shuga a mtundu wachiwiri, njira yolumikizira ndiyofunika kwambiri. M'mbuyomu, kudya kamodzi kumakhala kokwanira kukhazikika kwa glucose, ndipo pambuyo pake, mankhwala amodzi omwe amasemphana ndi insulin amatha kusintha kukhala kuphwanya kwa hyperglycemic.

Zakudya ndi masewera olimbitsa thupi

Choyamba, mosasamala kanthu za zovuta za matendawa, zakudya zimayikidwa. Anthu onenepa amafunika kuchepetsa zopatsa mphamvu, poganizira zolimbitsa thupi ndi masana.

Mowa umaletsedwa, chifukwa kuphatikiza ndi mankhwala ena hypoglycemia kapena lactic acidosis imatha kupanga. Kupatula apo, ili ndi zopatsa mphamvu zambiri zowonjezera.

Kufunika kusintha ndikulimbitsa thupi. Chithunzi chomwe chimangokhala chovuta chimakhudza kulemera kwa thupi - chimayambitsa matenda amitundu iwiri komanso zovuta zake. Katunduyo ayenera kuperekedwa pang'onopang'ono, kutengera mtundu woyamba. Kuyambira kwabwino ndikuyenda kwa theka la ora katatu patsiku, komanso kusambira momwe mungathere. Popita nthawi, katundu pang'onopang'ono amawonjezeka. Kuphatikiza pa masewera omwe amalimbitsa thupi kuchepa thupi, amatsitsa kukana kwa insulin m'maselo, kuletsa matenda ashuga kupita patsogolo.

Mankhwala ochepetsa shuga

Ndi chakudya chopanda ntchito komanso zolimbitsa thupi, mankhwala osokoneza bongo amasankhidwa, omwe tsopano ndi ochuluka kwambiri. Ndi ofunika kukhalabe ndi shuga. Mankhwala ena, kuphatikiza pazofunikira zawo, amakhudzanso kukoka kwam'mimba komanso kayendedwe ka hemostatic.

Mndandanda wamankhwala ochepetsa shuga:

• biguanides (metformin);
• zotumphukira za sulfonylurea (glyclazide);
• glucosidase zoletsa;
• glinides (nateglinide);
• SGLT2 mapuloteni odziletsa;
• glyphlosins;
• thiazolidinediones (pioglitazone).

Mankhwala a insulin

Ndi kuwonongeka kwa matenda a shuga a mtundu wachiwiri ndikukula kwa zovuta, insulin yotsimikizika imalembedwa, popeza kupanga kwa mahomoni a pancreatic palokha kumachepa ndi kupitirira kwa matendawa. Pali ma syringe apadera ndi syringe pensulo yoyendetsera insulin, yomwe ili ndi singano yopyapyala komanso kapangidwe komveka. Chipangizo chatsopano kwambiri ndi pampu ya insulin, kupezeka kwake komwe kumathandizira kupewa jakisoni tsiku lililonse.

Zithandizo zothandiza za anthu

Pali zakudya ndi mbewu zomwe zimatha kuthana ndi shuga wamagazi, komanso zimawonjezera kupanga kwa insulin ndi zisumbu za Langerhans. Ndalama zotere ndi anthu.

• Cinnamon imakhala ndi zinthu zake zomwe zimakhudza kagayidwe kachakudya ka matenda ashuga. Kukhala kothandiza kumwa tiyi ndi kuwonjezera supuni ya zonunkhira izi.
• Chicory Ndikulimbikitsidwa kupewa matenda a shuga. Ili ndi mchere wambiri, mafuta ofunikira, mavitamini C ndi B1. Ndikulimbikitsidwa kwa odwala oopsa omwe ali ndi mitsempha yamatumbo ndi matenda osiyanasiyana. Pamaziko ake, mitundu yambiri ya mankhwala ndi kulowetsedwa zakonzedwa, zimathandiza thupi kuthana ndi kupsinjika, kulimbitsa dongosolo lamanjenje.
• Blueberries Kutengera ndi mabulosi awa, palinso mankhwala osokoneza bongo. Mutha kupanga decoction wa masamba a mabulosi: kuthira supuni imodzi yamasamba ndi madzi ndikutumiza ku chitofu. Mukawiritsa, chotsani nthawi yomweyo pamoto, ndipo patatha maola awiri mutha kumwa zakumwa zomwe mwakonzekera. Quoction yotere imatha kudyedwa katatu patsiku.
• Walnut - pamene idya, pamakhala zotsatira za hypoglycemic chifukwa cha zinc ndi manganese. Mulinso calcium ndi vitamini D.
• Tiyi wa Linden. Imakhala ndi vuto la hypoglycemic, komanso kukhala ndi mphamvu yochiritsa thupi. Kuti mukonze zakumwa zotere, muyenera kuthira supuni ziwiri za linden ndi kapu imodzi ya madzi otentha. Mutha kuwonjezera zimu mandimu pamenepo. Muyenera kumwa zakumwa zotere katatu tsiku lililonse.

Zakudya zabwino kwa odwala matenda ashuga amtundu wa 2

Cholinga chachikulu chakukonzanso kwa zakudya kwa odwala omwe ali ndi matenda ashuga ndikuwonetsetsa kuti shuga ali ndi magazi okhazikika. Kudumpha kwake kwadzidzidzi ndikosavomerezeka, muyenera kutsatira dongosolo lazakudya nthawi zonse ndipo musadumphe chakudya chotsatira.

Kupatsa thanzi kwa matenda a shuga a 2 ndikuyenera kuchepetsa chakudya chamagulu. Zakudya zamafuta onse zimasiyana m'magazi, zimagawidwa mwachangu komanso pang'onopang'ono. Pali kusiyana pamapangidwe azinthu ndi zopatsa mphamvu za zinthu. Poyamba, zimakhala zovuta kuti odwala matenda ashuga azindikire kuchuluka kwa chakudya chamagulu. Kuti zitheke, akatswiri adazindikira lingaliro la gawo la mkate, lomwe lili ndi magalamu 10-12 a zakudya, mosasamala kanthu za chinthucho.

Pafupifupi, mkate umodzi umakulitsa kuchuluka kwa shuga ndi 2.8 mmol / L, ndipo magawo awiri a insulin amafunikira kuti amwe shuga. Kutengera ndi mkate womwe wadyedwa, mlingo wa insulin womwe umafunikira makonzedwe amawerengedwa. 1 buledi mkate umafanana ndi theka kapu ya buckwheat porridge kapena apulo imodzi yaying'ono.

Kwa tsiku limodzi, munthu ayenera kudya pafupifupi 18-18 mkate, womwe uyenera kugawidwa zakudya zonse: pafupifupi 3-5 mkate nthawi. Anthu odwala matenda a shuga amauzidwa zambiri za izi m'masukulu apadera a shuga.

Kupewa

Kupewa matenda ambiri, kuphatikizapo matenda ashuga amtundu umodzi, agawika m'magulu:

• choyambirira;
• sekondale.

Yoyambirira ikulepheretsa kukula kwamatenda pafupipafupi, ndipo yachiwiriyo imapewetsa zovuta zomwe zadziwika kale.Cholinga chachikulu ndikukhazikitsa shuga m'magazi munthawi yoyenera, kuti muchepetse zinthu zonse zomwe zingayambitse matenda ashuga a 2.

1. Zakudya - zimalimbikitsidwa makamaka kwa anthu omwe ali ndi thupi lochulukirapo. Chakudyacho chimaphatikizapo nyama ndi nsomba, masamba komanso zipatso zokhala ndi chisonyezo chochepa (chochepa mbatata, nthochi ndi mphesa). Osamadya pasitala, mikate yoyera, chimanga ndi maswiti tsiku lililonse.
2. Moyo wokangalika. Chachikulu ndichowonjezera komanso kuthekera kochita zolimbitsa thupi. Kuyenda kapena kusambira ndikokwanira poyambira.
3. Kuthetsa, ngati nkotheka, zonse zofunika za matenda. Amayi omwe ali ndi polycystic ovary amawonetsedwa pafupipafupi ndi gynecologist.
4. Pewani zinthu zovuta ngati zingatheke.