Zomwe muyenera kudziwa zokhudza matenda ashuga: mndandanda wazomwe mungapeze kuchokera kwa endocrinologist

Zomwe zachitika ndi katswiri wazolimbitsa thupi wa ku Canada Frederick Bunting zasintha matenda a shuga kuchoka ku matenda oopsa kukhala matenda osachiritsika.

Mu 1922, Banting adapereka jakisoni wake woyamba wa insulin kwa mnyamata wodwala matenda ashuga ndikupulumutsa moyo wake. Papita zaka pafupifupi XNUMX kuchokera nthawi imeneyo, ndipo asayansi apita patsogolo kwambiri pomvetsetsa mmene matendawa amakhalira.

Masiku ano, anthu omwe ali ndi matenda a shuga - ndipo pali pafupifupi 70 miliyoni padziko lapansi, malinga ndi WHO, - akhoza kukhala ndi moyo wautali komanso wathanzi, malinga ngati malangizo azachipatala akutsatiridwa.

Koma matenda a shuga akadali osachiritsika, komanso, matendawa akucheperachepera posachedwapa. Mothandizidwa ndi katswiri, tapanga chiwongolero cha matenda a shuga kwa owerenga Healthy Food Near Me, kusonkhanitsa mfundo zothandiza zomwe aliyense ayenera kudziwa, chifukwa ambiri aife tili pachiwopsezo.

Chipatala chachipatala "Avicenna", Novosibirsk

Kodi matenda a shuga ndi chiyani ndipo ndi owopsa bwanji? Kodi pali kusiyana kotani pakati pa mitundu iwiri ikuluikulu ya matendawa?

Matenda a shuga mellitus (DM) ndi gulu la matenda omwe amadziwika ndi kuchuluka kwa glucose (nthawi zambiri amatchedwa shuga) m'magazi. Zingayambitse kuwonongeka ndi kusagwira ntchito kwa ziwalo zosiyanasiyana - maso, impso, mitsempha, mtima ndi mitsempha ya magazi. 

Mtundu wodziwika bwino wa matenda a shuga a 2 ndi 90% mwa onse omwe amapezeka ndi matendawa.

Mu mtundu wakale, mtundu uwu wa matenda a shuga umapezeka mwa akuluakulu onenepa kwambiri omwe ali ndi matenda amtima. Koma posachedwapa, akatswiri a endocrinologists padziko lonse lapansi akhala akuwona chizolowezi "choyambitsanso" matendawa.

Type 1 shuga mellitus imayamba makamaka ali mwana kapena unyamata ndipo imadziwika ndi kuyambika kwa matendawa, komwe nthawi zambiri kumafunikira kuchipatala.

Kusiyana kwakukulu pakati pa mtundu woyamba ndi wachiwiri wa matenda ashuga ndi kukhalapo kapena kusapezeka kwa insulin yakeyake. Insulin ndi mahomoni opangidwa ndi kapamba poyankha kuchuluka kwa shuga m'magazi.

Mwachitsanzo, munthu akadya apulo, ma carbohydrate ovuta amagawanika m’chigayocho n’kukhala shuga wamba n’kulowa m’magazi. Mlingo wa shuga m'magazi umayamba kukwera - ichi chimakhala chizindikiro kuti kapamba apange mlingo woyenera wa insulini, ndipo pakapita mphindi zingapo shuga wamagazi amabwerera mwakale. Ndi chifukwa cha makinawa kuti mwa munthu wopanda matenda a shuga komanso vuto lililonse la kagayidwe kachakudya, kuchuluka kwa shuga m'magazi kumakhalabe kwabwinobwino, ngakhale atadya maswiti ambiri. Ndinadya kwambiri - kapamba adatulutsa insulin yambiri. 

Chifukwa chiyani kunenepa kwambiri komanso matenda a shuga amagwirizana? Kodi chimodzi chimakhudza bwanji chinzake?

Kunenepa kwambiri komanso kunenepa kwambiri ndizomwe zimayambitsa matenda amtundu wa 2. Kuyika kwa mafuta osungira pamimba ndikowopsa kwambiri. Ichi ndi chizindikiro cha kunenepa kwambiri kwa visceral (mkati), komwe kumayambitsa kukana kwa insulini - chifukwa chachikulu cha matenda a shuga 2. Komano, kuchepa thupi mu shuga kungakhale kovuta kwambiri, chifukwa matendawa amachititsa kuti thupi likhale lovuta kwambiri la kusintha kwachilengedwe. omwe ali ogwirizana kwambiri. Chifukwa chake, ndikofunikira kwambiri kuwongolera chithandizo osati kuti muchepetse shuga m'magazi, komanso kuchepetsa thupi. 

Kodi jakisoni wa insulin ndi wofunikira liti, ndipo angapewedwe liti?

Mu mtundu 1 shuga, maselo a kapamba omwe amapanga insulin amawonongeka. Thupi lilibe insulini yakeyake, ndipo palibe njira yachilengedwe yochepetsera shuga wambiri m'magazi. Pankhaniyi, chithandizo cha insulin ndichofunikira (kuyambitsa insulini pogwiritsa ntchito zida zapadera, zolembera za syringe kapena mapampu a insulin).

Pafupifupi zaka 100 zapitazo, insulini isanapangidwe, nthawi yomwe odwala omwe ali ndi matenda a shuga 1 amayenera kukhala ndi moyo kuyambira miyezi ingapo mpaka zaka 2-3 chiyambireni matendawa. Masiku ano, mankhwala amakono amalola osati kuonjezera nthawi ya moyo wa odwala, komanso kuchotsa zoletsa kwambiri kwa iwo.

Ndi matenda amtundu wa 2, mulingo wa insulin yake simachepetsedwa, ndipo nthawi zina ngakhale wokwera kuposa wamba, koma sugwira ntchito moyenera. Nthawi zambiri izi zimachitika chifukwa cha kuchepa kwa chidwi cha maselo amthupi ku mahomoni awa, insulin kukana kumachitika. Chifukwa chake, chithandizo cha matenda amtundu wa 2 chimachokera ku mankhwala osagwiritsa ntchito insulin - piritsi ndi mankhwala obaya, omwe cholinga chake, mwa zina, kuti apange insulini yanu kukhala yothandiza kwambiri.

Ndi mtundu wanji wa matenda a shuga omwe amayi okha amakumana nawo?

Mtundu wina wa matenda a shuga mellitus ndi gestational shuga mellitus. Uku ndikuwonjezeka kwa shuga m'magazi pa nthawi ya mimba, zomwe zingathe kutsatiridwa ndi zovuta kwa mwana wosabadwayo ndi mkazi. Kuti adziwe matendawa, amayi onse apakati amayesedwa kuti asala kudya shuga kumayambiriro kwa mimba ndipo kuyezetsa kulolera kwa shuga kumachitika pakadutsa milungu 24-26 ya mimba. Ngati zovuta zapezeka, gynecologist amatumiza wodwalayo kuti akambirane ndi endocrinologist kuti athetse vuto la chithandizo.

Kuzindikira kwinanso kwachikazi komwe kumakhudzana ndi matenda amtundu wa 2 ndi matenda a polycystic ovary, omwe, monga momwe amachitira ndi matenda a shuga a 2, amakhalanso ndi insulin kukana. Chifukwa chake, ngati mayi awonedwa ndi matenda awa ndi gynecologist, ndikofunikira kusiya shuga ndi prediabetes. 

Palinso "mitundu ina yeniyeni ya matenda a shuga" omwe amabwera motsutsana ndi maziko a matenda ena, kumwa mankhwala komanso chifukwa cha kuwonongeka kwa majini, koma powerengera ndi osowa.

Ndani ali pachiwopsezo? Kodi ndi zinthu ziti zomwe zingayambitse matenda a shuga?

Matenda a shuga ndi matenda omwe ali ndi cholowa, ndiye kuti, chiopsezo chodwala chimakhala chachikulu mwa anthu omwe achibale awo apamtima amadwala matendawa. Mwachitsanzo, mwayi wa mwana kukhala ndi matenda a shuga 1 ndi 6% ngati abambo ake ali ndi matendawa, 2% - mwa amayi, ndi 30-35% ngati makolo onse ali ndi matenda a shuga 1.

Komabe, ngati m’banjamo mulibe matenda a shuga, zimenezi sizitanthauza chitetezo ku matendawo. Palibe njira zopewera matenda amtundu woyamba.

Kwa matenda a shuga amtundu wa 2, akatswiri amazindikira zinthu zowopsa zomwe sitingathe kuziwongolera. Izi zikuphatikizapo: zaka zoposa 45, kukhalapo kwa achibale omwe ali ndi matenda a shuga a mtundu wa 2, matenda a shuga m'mbuyomu (kapena kubadwa kwa ana olemera makilogalamu 4).

Ndipo zomwe zingasinthidwe pachiwopsezo ndi monga kunenepa kwambiri kapena kunenepa kwambiri, kuchita masewera olimbitsa thupi ochepa, kuthamanga kwa magazi komanso kuchuluka kwa cholesterol. M'machitidwe, izi zikutanthauza kuti kuchepetsa thupi ndi normalizing kuthamanga kwa magazi kungachepetse chiopsezo chokhala ndi matenda amtundu wa 2. 

Kodi muyenera kuyezetsa chiyani ngati mukukayikira matenda a shuga mellitus?

Kuti mutsimikizire za matendawa, muyenera kuyezetsa magazi a glucose osala kudya. Chizindikiro chodziwika bwino chidzakhala kuchuluka kwa shuga m'magazi ochepera 6,1 mmol / L ngati mupereka magazi kuchokera m'mitsempha ndi kuchepera 5,6 mmol / L ngati mupereka magazi kuchokera chala.

Mutha kudziwanso kuchuluka kwa glycosylated hemoglobin m'magazi, zomwe zikuwonetsa kuchuluka kwa shuga m'miyezi itatu yapitayi. Ngati muli ndi zopotoka pazigawo izi, funsani endocrinologist, adzapereka mayeso owonjezera ndikukupatsani chithandizo chofunikira. 

Bwanji ngati katswiri watsimikizira za matendawa?

Ngati mwapezeka kuti muli ndi matenda a shuga mellitus, musachite mantha, koma muyenera kuganizira mozama izi, ndipo chinthu choyamba kuchita ndikupeza endocrinologist yemwe muzikhala naye pafupipafupi. Kumayambiriro kwa matendawa, dokotala adzadziwa mtundu wa matenda a shuga, mlingo wa insulini katulutsidwe, kukhalapo kwa zovuta kapena matenda okhudzana ndi matenda a shuga ndipo adzapereka chithandizo choyenera.

Kuphatikiza pa chithandizo chamankhwala, zakudya ndi masewera olimbitsa thupi zimakambidwa ndi endocrinologist, omwe amathandizira kuchiza matenda a shuga. Kunyumba, kudziwunika kwa shuga m'magazi kumachitika ndi chipangizo chapadera - glucometer, kuti awone momwe mankhwalawo amathandizira. Muyenera kukaonana ndi endocrinologist kamodzi pa miyezi 1-3, kutengera momwe matendawa alili, ndikusunga shuga m'magazi moyenera, kuchedwetsa kochepa kwa dokotala kumafunika. 

Kodi pali mankhwala atsopano a shuga?

Ngakhale zaka 10 zapitazo, mtundu wa shuga wa 2 unkawoneka ngati matenda opita patsogolo, ndiko kuti, ndi kuwonongeka kwapang'onopang'ono, kukula kwa zovuta; kaŵirikaŵiri zinadzetsa kulemala. Tsopano pali magulu atsopano a mankhwala omwe amachepetsa shuga m'magazi ndikuchepetsa chiopsezo cha zovuta.

Opaleshoni ya Metabolic ndi mtundu wa opaleshoni ya m'mimba ndi m'matumbo ang'onoang'ono, omwe amatsogolera kusintha kwa mayamwidwe a chakudya komanso kupanga mahomoni ena ndi michere, yomwe imakuthandizani kuti muchepetse thupi ndikuchepetsa shuga wamagazi.

Kukhululukidwa kwa matenda amtundu wa 2 kumachitika mu 50-80%, kutengera mtundu wa opaleshoni yomwe yachitika. Pakadali pano, chithandizo cha opaleshoni ndiyo njira yabwino kwambiri yochizira matenda a shuga. Chizindikiro cha opaleshoni ya metabolic amtundu wa 2 shuga ndi index mass index (BMI) yoposa 35 kg / m2 kapena kusatheka kukonza matenda a shuga ndi mankhwala komanso BMI ya 30-35 kg / m2.

Siyani Mumakonda