Esihlokweni sanamuhla, kuzoqala kube nomcabango ongaqondakali. Ngemuva kwalokho sisebenzisa lo mbono ukuchaza indlela ephumelelayo yokwehlisa ushukela wegazi ngohlobo 1 bese uthayipha 2 isifo sikashukela. Awukwazi nje ukwehlisa ushukela wakho ube okwejwayelekile, kepha futhi ungawugcina ngokujwayelekile uvamile. Uma ufuna ukuphila isikhathi eside futhi ugweme izinkinga zesifo sikashukela, ke zinikeze inkathazo yokufunda le ndatshana futhi uyiqonde.
Sincoma ukulawula uhlobo 1 lwesifo sikashukela ngokudla okune-carb ephansi, ukukufaka ngemithamo ephansi ye-insulin uma kunesidingo. Lokhu kuphambana ngokuphelele nezindlela zendabuko ezisasetshenziswa odokotela.
Uzofunda:
- Yidla ekudleni okumnandi nokwanelisayo kwama-low carbohydrate, okusiza kakhulu ngohlobo 1 nohlobo 2 lwesifo sikashukela;
- Gcina ushukela wegazi lakho uvamile, umise ukugxuma kwalo;
- Yehlisa umthamo we-insulin noma usilahle ngokuphelele kuhlobo 2 sikashukela;
- Izikhathi eziningi kunciphisa ubungozi bezinkinga ezinobunzima besifo sikashukela;
- ... futhi konke lokhu ngaphandle kwamaphilisi nokudla kokudla.
Awudingi ukuthi uthathe ukholo ngemininingwane yokwelashwa kwesifo sikashukela ozokuthola kule ndatshana nakuwebhusayithi yethu. Linganisa ushukela wakho wegazi kaningi ngemitha kashukela wegazi - bese usheshe ubone ukuthi izeluleko zethu ziyakusiza yini noma cha.
Iyiphi indlela yokulayisha ekhanyayo?
Ukuzijwayeza kukhombisa okulandelayo. Uma udla i-carbohydrate encane, hhayi ngaphezu kwama-6-12 amagremu ngasikhathi, bazokwandisa ushukela wegazi wesiguli sikashukela ngenani elibikezelayo. Uma udla ama-carbohydrate amaningi ngasikhathi sinye, khona-ke ushukela wegazi ngeke nje ukhuphuke, kepha uzokuya ngokungacabangi. Uma ujova umthamo omncane we-insulin, uzokwehlisa ushukela wegazi ngenani elibikezelayo. Imithamo emikhulu ye-insulin, ngokungafani nemincane, yenza ngokungalindeleki. Umthamo omkhulu ofanayo we-insulin efanayo (amayunithi angaphezu kwama-7-8 kumjovo owodwa) uzosebenza ngokuhlukile isikhathi ngasinye, ngokuphambuka okufika kuma-± 40%. Ngakho-ke, uDkt Bernstein usungule indlela yemithwalo emincane yohlobo 1 nesifo sikashukela - ukudla ama-carbohydrate aphansi kanye nokuchithelwa ngemithamo emincane ye-insulin. Le ukuphela kwendlela yokulawula ushukela wegazi ngokunemba kwe-± 0,6 mmol / L. Esikhundleni sama-carbohydrate, sidla amaprotheni anempilo kanye namafutha emvelo anempilo.
Indlela yemithwalo emincane ikuvumela ukuthi ugcine ushukela wegazi ujwayelekile amahora angama-24 ngosuku, njengabantu abanempilo ngaphandle kwesifo sikashukela. Into esemqoka yokwenza lokhu ukulandela ukudla okune-carbohydrate ephansi kakhulu. Njengoba igxuma ushukela wegazi seliphela, abanesifo sikashukela badlula ngokushesha ukukhathala okungapheli. Futhi ngokuqhubeka kwesikhathi, izinkinga ezinzima zesifo sikashukela ziya ngokuya ziphela. Ake sibheke izisekelo zemibono lapho "indlela yokulayisha ekhanyayo" yakhelwe khona ukulawula uhlobo 1 nesifo sikashukela. Izinhlelo eziningi ze-biological (eziphilayo) nezemishini zinesici esilandelayo. Isebenza ngokuqagela lapho ivolumu "lempahla yokwakha" incane. Kepha uma umthamo wezinto zokwakha mkhulu, isb. Umthwalo kulolu hlelo luphezulu, khona-ke umphumela womsebenzi wawo uba ongalindeleki. Masiyibize ngokuthi "umthetho wokuqagelwa kwemiphumela emithwalweni ephansi."
Ake siqale ngokubheka ukuhamba kwezimoto njengesibonelo sale iphethini. Uma inani elincane lezimoto lihamba ngasikhathi sinye eceleni komgwaqo, khona-ke onke azofinyelela lapho aya khona ngesikhathi esibikezelayo. Ngoba imoto ngayinye ingagcina isivinini esifanele, futhi akekho ophazamisa omunye. Amathuba ezingozi ezivela ngenxa yezenzo ezigwenxa zabashayeli asephansi. Kwenzekani uma uphinda kabili inani lezimoto ezihamba ngasikhathi sinye emgwaqweni? Kuyavela ukuthi amathuba wokugcwala kwethrafikhi nezingozi ngeke nje kuphindwe kabili, kepha kwandise kakhulu, ngokwesibonelo, amahlandla ama-4. Ezimweni ezinjalo, kuthiwa kukhuphuka kakhulu noma ngaphandle. Uma isibalo sabahlanganyeli kule nhlangano siqhubeka nokunyuka, khona-ke kuzodlula umthamo wethrafikhi womgwaqo. Kulesi simo, ukunyakaza kuba nzima kakhulu. Amathuba ezingozi aphakame kakhulu, futhi izinkundla zomgwaqo cishe akunakugwenywa.
Isibonakaliso sikashukela wegazi lesiguli sikashukela naso siziphatha ngendlela efanayo. “Izinto zokuqala” kuye inani lama-carbohydrate namaprotheni adliwayo, kanye nomthamo we-insulin owawumjovo osanda kwenziwa. Amaphrotheni adliwayo awandisa kancane futhi kancane. Ngakho-ke, sigxila kuma-carbohydrate. Kungama-carbohydrate adliwayo andisa kakhulu ushukela wegazi. Ngaphezu kwalokho, abagcini nje ngokuwukhulisa, kodwa babangela ukugxuma kwawo ngokushesha. Futhi, umthamo we-insulin uncike enanini lama-carbohydrate. Imithamo emincane yama-carbohydrate ne-insulin ayabikezelwa, kanti imithamo emikhulu ayihlelekanga. Khumbula ukuthi amafutha adliwayo awenyusi ushukela wegazi nakancane.
Uyini umgomo wesifo sikashukela
Yini ebalulekile isiguli sikashukela uma sifuna ukulawula kahle isifo sayo? Inhloso enkulu kuye ukufeza ukubikezela kohlelo. Lokho wukuthi, ukuze ukwazi ukubikezela ngokunembile izinga ushukela osegazini, kuya ngokuthi uludle amangaki nokuthi udle umjovo muni we-insulin. Khumbula "umthetho wokubikezela komphumela emithwalweni ephansi", esixoxe ngayo ngenhla. Ungafinyelela ukubikezela kushukela wegazi ngemuva kokudla kuphela uma ulandela ukudla okune-carbohydrate ephansi. Ukwelashwa okusebenzayo kwesifo sikashukela, kunconywa ukuthi ungafaki ukudla okune-carbohydrate ephezulu (uhlu lokudla olungavunyelwe), futhi udle lokho okunotha okunama protein kanye namafutha emvelo anempilo (uhlu lokudla oluvunyelwe).
Kungani ukudla okuphansi kwe-carbohydrate kusiza ngesifo sikashukela? Ngoba ama-carbohydrate amancane owadlayo, ushukela wegazi omncane uyenyuka futhi ne-insulin encane iyadingeka. Uma i-insulin ingafakwa kancane, kuba lula ukuqagela, futhi ingozi ye-hypoglycemia nayo iyancishiswa. Le mbono enhle, kepha ingabe iyasebenza? Yizame futhi uzitholele. Mane ufunde isihloko kuqala, bese uthatha isenzo :). Kukalwa kaningi ushukela wegazi lakho nge-glucometer. Okokuqala qiniseka ukuthi imitha yakho inembile (ungakwenza kanjani lokhu). Le ndlela ukuphela kwendlela yokuthola ukuthi ngabe ukwelashwa okuthile kukashukela kuyasebenza.
I-American Diabetes Association, nangemva kwayo uMnyango Wezempilo wasekhaya, iyaqhubeka nokuncoma ukudla “okulinganiselayo” kohlobo 1 nesifo sikashukela sohlobo 2. Lokhu kubhekisa ekudleni lapho isiguli sisebenzisa okungenani amagremu angama-84 ama-carbohydrate ekudleni ngakunye, isb. Ngaphezu kwama-250 g ama-carbohydrate ngosuku. Iwebhusayithi yeDiabetes-Med.Com ikhuthaza enye indlela yokudla engezansi yama-carbohydrate, hhayi ngaphezu kwama-20-30 amagremu ama-carbohydrate ngosuku. Ngoba "ukudla okulinganiselayo" akunamsebenzi futhi kulimaza kakhulu kushukela. Ngokulandela ukudla okune-carbohydrate ephansi, ungaligcina ushukela wegazi ngemuva kokudla kungabi ngaphezu kuka-6.0 mmol / L noma noma ungaphakeme ngaphezu kuka-5.3 mmol / L, njengabantu abaphilile.
Ukuthi ama-carbohydrate abangela kanjani ukunyuka ushukela wegazi
Amagremu ama-84 ama-carbohydrate angaba inani eliqukethwe epuletini le-pasta ephekiwe yobukhulu obuphakathi. Ake sithi ufunda ulwazi lokudla okunempilo kokuphakwa kwepasta. Kulula ukubala ukuthi mangaki wepasta owomile okudingeka usilinganise futhi uwapheke ukuze udle amagremu ama-carbohydrate ayi-84. Ikakhulu uma unesilinganiselo ekhishini. Ake sithi unesifo sikashukela sohlobo 1, unesisindo esingama-65 kg, futhi umzimba wakho awukhiqizi i-insulin yayo uqobo. Kulokhu, kungenzeka ukuthi i-1 gram yama-carbohydrate iphakamise ushukela wakho wegazi cishe ngo-0,28 mmol / L, kanye nama-gramu angama-84 ama-carbohydrate - ngokulandelana, ngokulingana no-23.3 mmol / L.
Ngokwe-theory, ungabala ngokunembile ukuthi udinga malini ama-insulin ukuze "ucime" ipuleti le-pasta nama-gramu angama-84 ama-carbohydrate aqukethe. Ekusebenzeni, ukubalwa okunjalo kokudla okune-carbohydrate eningi kusebenza kabi. Ngani? Ngoba izindinganiso zikuvumela ngokusemthethweni ukuphambuka kokuqukethwe kwezakhi emikhiqizweni ± 20% yalokho okubhalwe ephaketheni. Okubi kakhulu, ekusebenzeni, lokhu kuphambuka kuvame ukuba kukhulu kakhulu. Uyini u-20% wama-85 amagremu? Lokhu kungama-gramu ayi-17 ama-carbohydrate angakhuphula ushukela wegazi “wesilinganiso” sohlobo lwesifo sikashukela esingu-4,76 mmol / L.
Ukuphambuka okungenzeka kwe-± 4.76 mmol / L kusho ukuthi ngemuva kokudla ipuleti le-pasta futhi "ukuliphindisela" nge-insulin, ushukela wakho wegazi ungaba noma yikuphi ukusuka phezulu kakhulu kuya ku-hypoglycemia enzima. Lokhu ngokwezigaba akwamukeleki uma ufuna ukulawula kahle ushukela wakho. Izibalo ezingenhla ziyisikhuthazo esinamandla sokuzama ukudla okuphansi kwe-carb sikashukela. Uma lokhu akwanele, bese ufunda. Sizobuye sihlaziye ukuthi ukuhlukahluka kanjani kokuqukethwe kwezakhi zokudla okugqagqene nokungalingani kwemithamo emikhulu ye-insulin.
Funda ngemiphumela yama-carbohydrate ne-insulin ushukela wegazi ezihlokweni:
Ama-carbohydrate ekudleni kwesiguli sohlobo 2 sikashukela
Manje ake sibheke esinye isibonelo esiseduzane nesimo sabafundi abaningi balesi sihloko. Ake sithi unesifo sikashukela sohlobo 2 futhi ukhuluphele. Amanyikwe akho asaqhubeka nokukhiqiza i-insulin, noma ngabe akwanele ukulawula ushukela wegazi ngemuva kokudla. Uthole ukuthi i-1 gram ye-carbohydrate inyusa ushukela wegazi lakho ngo-0.17 mmol / L. Esigulini esinesifo sikashukela sohlobo 1, ukuphambuka koshukela wegazi ngemuva kokudla kwe-pasta kuzoba ± 4.76 mmol / L, futhi kuwe ± 2.89 mmol / L. Ake sibheke ukuthi kusho ukuthini kulokhu.
Kumuntu omncane onempilo, ushukela wegazi ngemuva kokudla awudluli ku-5.3 mmol / L. Umuthi wethu wendabuko ukholelwa ukuthi isifo sikashukela silawulwa kahle uma ushukela ngemuva kokudla ungeqi ku-7.5 mmol / L. Hlola ushukela wakho wegazi. Kusobala ukuthi i-7.5 mmol / L icishe ibe ngu-1.5 izikhathi eziphakeme kunalokho okujwayelekile kumuntu ophilile. Ngolwazi lwakho, izinkinga zesifo sikashukela zikhula ngokushesha uma ushukela wegazi ngemuva kokudla udlula i-6.5 mmol / L.
Uma ushukela wegazi ngemuva kokudla ukhuphuka ufike ku-6.0 mmol / L, khona-ke lokhu akusongeli ubumpumputhe noma ukunqunywa komlenze, kepha i-atherosclerosis yathuthuka noma kunjalo, okungukuthi, izimo zokuhlaselwa yinhliziyo nokushaywa unhlangothi ziyadalwa. Ngakho-ke, ukulawulwa okujwayelekile kwesifo sikashukela kungabhekwa uma ushukela wegazi ngemuva kokudla uhlale ungaphansi kuka-6.0 mmol / l, futhi futhi kangcono - hhayi ngaphezulu kwe-5.3 mmol / l, njengabantu abanempilo. Futhi amazinga asemthethweni kashukela asezingeni eliphakeme kakhulu lokuthethelela ukungasebenzi kodokotela kanye nokuvilapha kweziguli ukuzibandakanya.
Uma ubala umthamo we-insulin ukuze ushukela wegazi ngemuva kokudla u-7.5 mmol / L, khona-ke esimweni esibi kakhulu uthola u-7.5 mmol / L - 2.89 mmol / L = 4.61 mmol / L Okusho ukuthi, i-hypoglycemia ayikusongeli. Kepha sixoxe ngenhla ukuthi lokhu akunakuthathwa njengokulawula okuhle kwesifo sikashukela, futhi eminyakeni embalwa kuzofanela ukuthi ujwayele izinkinga zako. Uma ufaka i-insulin engaphezulu, uzama ukwehlisa ushukela ube ngu-6.0 mmol / l, khona-ke esimweni esibi kakhulu, ushukela wegazi lakho uzoba ngu-3.11 mmol / l, futhi lokhu sekuyi-hypoglycemia. Noma, uma ukuphambuka sekuphakeme, ushukela wakho uzoba ngaphezulu komkhawulo owamukelekayo.
Lapho nje isiguli sishintshela ekudleni okune-carbohydrate encane ukulawula ushukela, konke ngokushesha kushintsha kube ngcono. Ukugcina ushukela wegazi ngemuva kokudla ngaphansi kuka-6.0 mmol / L kulula. Ukuyokwehlisela ku-5.3 mmol / L kubuye kube namaqiniso uma usebenzisa ukudla okuphansi kwe-carbohydrate nokuzivocavoca ngentokozo yokulawula uhlobo 2 sikashukela. Ezimweni eziyinkimbinkimbi zesifo sikashukela sohlobo 2, sifaka amaphilisi weSiofor noma we-Glucofage, kanye nemijovo yemithamo emincane ye-insulin, ekudleni nasekuzivocavoca.
I-Carbohydrate Diet ephansi yohlobo 1 ne-Type 2 Diabetes
Kungani ukudla okune-carbohydrate ephansi kwenza sikwazi ukulawula kahle isifo sikashukela:
- Kulokhu kudla, onoshukela udla ama-carbohydrate amancane, ngakho-ke ngokomqondo ushukela wegazi awukwazi ukukhuphuka kakhulu.
- Amaprotheni ekudleni nawo andisa ushukela wegazi, kodwa akwenze kancane nangokucabanga, futhi kulula “ukucima” ngemithamo emincane ye-insulin.
- Ushukela wegazi uziphatha ngokuqagela.
- Imithamo ye-insulin incike enanini lama-carbohydrate ohlela ukuwadla. Ngakho-ke, ekudleni okuphansi kwe-carbohydrate, isidingo se-insulin sincishisiwe.
- Njengoba imithamo ye-insulin incipha, ingozi ye-hypoglycemia enkulu nayo iyancipha.
Ukudla okune-carbohydrate ephansi kunciphisa ukuphambuka okungenzeka kashukela wegazi kusuka endaweni okuhlosiwe ngayo kwiziguli ezinesifo sikashukela sohlobo 1 kusuka ku-± 4.76 mmol / L, esixoxe ngakho ngenhla, kuya ku-± 0.6-1.2 mmol / L. Ezigulini ezinesifo sikashukela sohlobo 2 eziqhubeka zakha i-insulin yazo, lokhu kuphambuka kuncane kakhulu.
Yini ungamane nje unciphise ingxenye evela kupuleti owodwa wepasta iye kumapuleti ayi-0.5 epasta efanayo? Le inketho embi, ngenxa yezizathu ezilandelayo:
- Ukudla okugcwele ama-carbohydrate kubangela ukugcwala kushukela wegazi, noma ngabe kudliwe ngemithamo engathandeki.
- Uzohlala unomuzwa wokuhlala wendlala, ngoba uzophuka kungekudala. Asikho isidingo sokuzihlupha ngendlala, ungabuyisa ushukela wegazi kube yinto evamile ngaphandle kwawo.
Ukudla okunama-carbohydrate aphansi yimikhiqizo yezilwane ehlanganiswe nemifino. Bheka uhlu lwemikhiqizo evunyelwe Ama-carbohydrate akhuphula ushukela wegazi ngamandla futhi ngokushesha, ngakho-ke sizama ukungawadli. Esikhundleni salokho, sizidla kancane, emifino enempilo futhi emnandi. Amaprotheni nawo andisa ushukela wegazi, kepha kancane futhi kancane. Ukwanda ushukela obangelwa yimikhiqizo yamaprotheni kulula ukubikezela futhi ukuqeda ngokunembile ngemithamo emincane ye-insulin. Imikhiqizo yamaphrotheni ishiya umuzwa omnandi wokuqaqanjelwa isikhathi eside, ofana kakhulu nabantu abanesifo sikashukela sohlobo 2.
Ngokwethi, isiguli sikashukela singadla noma yini uma sikala konke ukudla ngesilinganiso sekhishi kuye kwigamu eliseduze, bese sibala isilinganiso se-insulin sisebenzisa imininingwane ematafuleni ezakhiwayo. Eqinisweni, le ndlela ayisebenzi. Ngoba ematafuleni nasekufakweni kwemikhiqizo kukhonjiswa imininingwane ecishe ibe yodwa. Empeleni, okuqukethwe kwe-carbohydrate ekudleni kungahluka kakhulu kumazinga. Ngakho-ke, isikhathi ngasinye lapho ucabanga ukuthi udlani ngempela, nokuthi lokhu kuzoba naliphi ushukela egazini lakho.
Ukudla okuphansi kwe-carbohydrate yesifo sikashukela kuyindlela yangempela yokusindiswa. Kuyanelisa futhi kuyamnandi, kepha kumele kubhekwe ngokucophelela. Sengathi kungaba yinkolo yakho entsha. Ukudla okunama-carbohydrate aphansi kukunikeza umuzwa wokugcwala noshukela wegazi ojwayelekile. Imishanguzo ye-insulin iyancishiswa, ngaleyo ndlela inciphise ingozi ye-hypoglycemia.
Amachibi amancane kakhulu futhi amakhulu omsebenzi we-insulin
Ngithanda ukucabanga ukuthi umthamo ofanayo we-insulin isikhathi ngasinye wehlisa ushukela wakho wegazi. Ngeshwa, lokhu akunjalo. Abantu abanesifo sikashukela "abanesipiliyoni" bazi kahle ukuthi umthamo ofanayo we-insulin ngezinsuku ezahlukene uzosebenza ngendlela ehlukile. Kungani lokhu kwenzeka:
- Ngezinsuku ezahlukahlukene, umzimba unokuzwa okuhlukile kwesenzo se-insulin. Esikhathini sezulu esifudumele, le mizwa ivame ukwanda, futhi esimweni sezulu esibandayo, kunalokho, iyancipha.
- Akuwona wonke ama-insulin afakiwe afinyelela egazini. Njalo lapho kuthathwa inani elihlukile le-insulin.
I-insulin ifakwe isirinji, noma ngitsho nepompo le-insulin, ayisebenzi njenge-insulin, evame ukuhlanganisa ama-pancreas. I-insulin yomuntu esigabeni sokuqala sokuphendula kwe-insulin ingena ngokushesha egazini futhi ngokushesha iqala ukwehlisa amazinga kashukela. Esikhathini sikashukela, imijovo ye-insulin imvamisa yenziwa emafutheni angaphansi kwenhliziyo. Ezinye iziguli ezithanda ubungozi kanye nenjabulo, zakha imijovo ye-insulin (ungakwenzi lokhu!). Kunoma yikuphi, akekho umuntu olimaza i-insulin ngaphakathi.
Ngenxa yalokho, ngisho ne-insulin eshesha kakhulu iqala ukusebenza kuphela emva kwemizuzu engama-20. Futhi ukusebenza kwawo okugcwele kuboniswa kungakapheli amahora angama-1-2. Ngaphambi kwalokhu, amazinga kashukela wegazi ahlala ephakeme kakhulu.Ungakuqinisekisa kalula lokhu ngokulinganisa ushukela wakho wegazi nge-glucometer njalo ngemizuzu eyi-15 ngemuva kokudla. Lesi simo silimaza izinzwa, imithambo yegazi, amehlo, izinso, njll. Izinkinga zesifo sikashukela zikhula ngokushintshana okugcwele, naphezu kwezinhloso ezinhle zikadokotela neziguli.
Ake sithi isiguli sikashukela sizilimaza nge-insulin. Ngenxa yalokhu, kwavela into emzimbeni wezicubu ezingaphansi, okuyiwona amasosha omzimba abona njengangaphandle futhi aqala ukuhlasela. Amasosha omzimba ahlala ebhubhisa enye ye-insulin evela kumjovo ngaphambi kokuthi ibe nesikhathi sokungena kwegazi. Ngiyiphi ingxenye ye-insulin engathathi hlangothi, futhi engasebenza, kuncike ezintweni ezimbalwa.
Ukuphakama umthamo we-insulin ungene, ukucasuka okukhulu nokulimazeka okubangelwa lokho. Lapho ukuvuvukala kuqina, amangqamuzana “amaseli” omzimba omzimba amaningi akhangwa indawo yomjovo. Lokhu kuholela eqinisweni lokuthi elikhudlwana umthamo we-insulin ulifakile, akunakubikezelwa okungatheni. Futhi, iphesenti lokufakwa kwe-insulin kuncike ekujuleni nasendaweni yomjovo.
Eminyakeni eminingana edlule, abacwaningi e-University of Minnesota (USA) basungula okulandelayo. Uma ugwaza i-20 U ye-insulin ehlombe, khona-ke ngezinsuku ezahlukahlukene isenzo sayo siyohluka nge-± 39%. Lokhu kuphambuka kutholakala kokuqukethwe okuguqukayo kwama-carbohydrate ekudleni. Ngenxa yalokhu, iziguli ezinesifo sikashukela zizwa “ukwedlula” ushukela wegazi. Ukuze ulondoloze ushukela wegazi ojwayelekile, shintshela ekudleni okune-carbohydrate ephansi kancane. Ama-carbohydrate amancane owadingayo, i-insulin encane iyadingeka. Lapho wehlisa umthamo we-insulin, kulapho kuqagela khona. Konke kulula, kuyabiza futhi kuyasebenza.
Abaphenyi abafanayo baseMinnesota bathola ukuthi uma ufaka i-insulin esiswini, khona-ke ukuphambuka kwehla kuye ku-± 29%. Ngenxa yalokho, ngokwemiphumela yocwaningo, kunconyelwe ukuthi iziguli ezinesifo sikashukela zishintshe imijovo esiswini. Sinikeza ithuluzi eliphumelela kakhudlwana lokulawula ushukela wegazi futhi lisuse “kuzuba” kwalo. Lokhu kudla okuphansi kwe-carbohydrate okuvumela ukuthi unciphise umthamo we-insulin futhi ngaleyo ndlela wenze umphumela wawo uzinze ngokwengeziwe. Futhi elinye iqhinga, elichazwe esigabeni esilandelayo.
Ake sithi isiguli esinesifo sikashukela silimaza amayunithi angama-20 e-insulin esiswini sakhe. Kumuntu omdala onesisindo esingu-72 kg, isilinganiso esingu-1 SESIKHATHI se-insulin sehlisela ushukela wegazi ngo-2.2 mmol / L. Ukuphambuka esenzweni se-insulin 29% kusho ukuthi inani likashukela wegazi lizophambuka ngo-± 12.76 mmol / L. Le yinhlekelele. Ukuze ugweme i-hypoglycemia enkulu ngokulahlekelwa ukwazi, iziguli ezinesifo sikashukela ezithola imithamo emikhulu ye-insulin ziyaphoqelelwa ukuba zilondoloze ushukela wegazi ophakeme ngaso sonke isikhathi. Ukwenza lokhu, bavame ukudla ukudla okuyingozi okugcwele ama-carbohydrate. Ngokuqinisekile bayoba nokukhubazeka kusenesikhathi ngenxa yezinkinga zesifo sikashukela. Yini okufanele uyenze? Ungasithuthukisa kanjani lesi simo? Okokuqala, shintsha kusuka ekudleni “okunokulinganisela” kuya ekudleni okuphansi kwe-carbohydrate. Hlaziya ukuthi imfuno yakho ye-insulin yehla kanjani nokuthi usondele kangakanani ushukela wegazi lakho.
Ungawujova kanjani imithamo emikhulu ye-insulin
Iziguli eziningi zesifo sikashukela, noma zidla ekudleni okuphansi kwe-carbohydrate, kusadingeka ukuthi zifake imithamo emikhulu ye-insulin. Kulokhu, hlukanisa umthamo omkhulu we-insulin ube yimijovo eminingana, eyenziwa ngemuva kwezingxenye ezihlukene zomzimba. Prick kumjovo ngamunye kungadluli ama-PIECES ayi-7 we-insulin, futhi okungcono - kungabi ngaphezu kwezi-6 IZITHOMBE. Ngenxa yalokhu, cishe yonke i-insulin idonswa ngokuqinile. Manje-ke akunandaba ukuthi ungayibamba kuphi - ehlombe, ethangeni noma esiswini. Ungenza imijovo eminingana ngokulandelana ngesirinji efanayo, ngaphandle kokuphinda uqoqe i-insulini kusuka ku-vial, ukuze ungayonakalisi. Funda ukuthi ungakuthola kanjani ukudubula kwe-insulin ngaphandle kobuhlungu. Ukwehlisa umthamo we-insulin kumjovo owodwa, kuzosebenza ngokwengeziwe.
Cabanga ngesibonelo esisebenzayo. Kuneziguli ezinesifo sikashukela sohlobo 2 ezinesisindo esikhulu futhi, ngokufanele, ngokumelana ne-insulin enamandla. Washintshela ekudleni okuphansi kwe-carbohydrate, kepha usadinga amayunithi angama-27 we-insulin "enwetshiwe" ubusuku bonke. Okokukholisa ukwenza imfundo yomzimba ukuze kwandiswe ukuzwela kwezicubu ze-insulin, lesi siguli asikaze sihoxe. Uhlukanisa izingxenye ezingama-27 ze-insulin yakhe ngemijovo emi-4, ayenza enye emva kwenye yezingxenye zomzimba ezihlukene nge-syringe efanayo. Ngenxa yalokhu, isenzo se-insulin sesiqageleke kakhulu.
I-insulin emfishane ne-ultrashort ngaphambi kokudla
Lesi sigaba senzelwe iziguli ezinesifo sikashukela sohlobo 1 nohlobo 2 kuphela ezothola imijovo ye-insulin esebenza ngokushesha ngaphambi kokudla. Ukwanda koshukela wegazi ngemuva kokudla "kucishiwe" ngomjovo we-insulin emfushane noma ye-ultrashort. Ama-carbohydrate ekudleni abangela ngokushesha - empeleni, ngokushesha (!) - gxuma ushukela wegazi. Ebantwini abaphilile, it hlanganyiswa isigaba sokuqala secretion se-insulin lapho kuphendulwa ukudla. Lokhu kwenzeka kungakapheli imizuzu engama-3-5. Kodwa nganoma yiluphi uhlobo lwesifo sikashukela, isigaba sokuqala soku secretion se-insulin siphulwa okokuqala.
I-insulin emfushane noma ye-ultrashort ayiqali ukwenza izinto ngokushesha ukuze iphinde ikhulule isigaba sokuqala secretion evamile ye-insulin. Ngakho-ke, kungcono ukuhlala kude nokudla okunama-carbohydrate amaningi. Faka esikhundleni samaprotheni akhulisa ushukela wegazi kancane futhi abushelelezi. Ekudleni okune-carbohydrate ephansi, kunconywa ukuthi ungasebenzisi i-ultra-iDemo, kodwa i-insulin emfushane, uyijova imizuzu engama-40-45 ngaphambi kokudla. Okulandelayo, sizohlola kabanzi ukuthi kungani le ndlela engcono kakhulu.
Iziguli ezinesifo sikashukela esidla ukudla okune-carbohydrate eningi zidinga imithamo ephansi kakhulu ye-insulin esebenza ngokushesha ngaphambi kokudla kunaleyo edla ukudla okulinganiselayo. Imithamo emikhulu ye-insulin iqala ukusebenza ngokushesha, futhi umphumela wayo uhlala isikhathi eside. Kunzima futhi ukubikezela ukuthi umphumela womthamo omkhulu we-insulin uzophela nini. Imithamo emincane ye-insulin emfushane iqala ukusebenza kamuva, ngakho-ke kufanele ulinde isikhathi eside ngaphambi kokuqala ukudla. Kepha uzoba noshukela wegazi ojwayelekile ngemuva kokudla.
Eqinisweni, lokhu kusho okulandelayo:
- Ngokudla kwendabuko okune-high-carbohydrate yokudla, ama-insulin "ama-ultrashort" atholiswa ngemithamo emikhulu ngaphambi kokudla, futhi aqala ukwenza isenzo ngemuva kwemizuzu engu-5-15. Ngokudla okune-carbohydrate ephansi, ama-insulin afanayo "we-Ultra-iDemo" emithanjeni emincane aqala ukwenza isenzo kungekudala - ngemuva kwemizuzu eyi-10-20.
- Ngokudla okune-carbohydrate ephezulu, ama-insulin "amafushane" adingeka ngaphambi kokudla emithanjeni enkulu ngakho-ke aqala ukuthatha isinyathelo ngemuva kwemizuzu engama-20-30. Ngokudla kwe-carbohydrate ephansi, adinga ukushaywa kumithamo emincane imizuzu engama-40 ukuya ku-5 ngaphambi kokudla, ngoba aqala ukwenza ngokuhamba kwesikhathi.
Okokubala, sicabanga ukuthi isenzo somjovo we-ultrashort noma we-insulin esifushane siphela ngemuva kwamahora angama-5. Eqinisweni, umphumela wayo uzohlala amahora angama-6-8. Kepha emahoreni okugcina kuncane kakhulu ukuthi kunganakwa.
Kwenzekani ezigulini ezinesifo sikashukela sohlobo 1 noma 2 esidla ukudla okunokulinganisela? Ama-carbohydrate adlayo abangela ukuba akhuphuke ngokushesha ushukela wegazi, ophikelela kuze kube yilapho i-insulin emfushane noma i-ultrashort iqala ukwenza isenzo. Isikhathi ushukela omningi ungahlala imizuzu engu-15-90, uma usebenzisa i-insulin esheshayo ye-ultrashort. Ukuzijwayeza kukhombisile ukuthi lokhu kwanele ukuthola ubunzima besifo sikashukela embonweni, emilenzeni, ezinso, njll. Ukukhulisa eminyakeni embalwa.
Isifo sikashukela esikhohlisayo singalinda kuze kuqalise isidlo sakhe “esilinganiselayo” kuze kube yilapho insulin eqala ukusebenza. Siyakhumbula ukuthi wajova umthamo osindayo we-insulin ukumboza ingxenye eqinile yama-carbohydrate. Uma ephuthelwa okuncane futhi aqale ukudla imizuzu embalwa kamuva kunokuba kufanele, khona-ke ngokuthola okuphezulu uzoba ne-hypoglycemia enzima. Ngakho-ke kwenzeka kaningi, futhi isiguli ngokwethuka siginya amaswidi ngokushesha ukuze siphakamise ushukela wegazi futhi sigweme ukwehluleka.
Isigaba sokuqala esisheshayo se-insulin secretion ekuphenduleni ukungena kokudla sithintekile kuzo zonke izinhlobo zesifo sikashukela. Ngisho ne-insulin eshesha kakhulu ye-ultrashort iqala ukwenza sekwephuze kakhulu ukuyiphinda. Ngakho-ke, kuzoba nengqondo ukudla imikhiqizo yamaprotheni ekhuphula ushukela wegazi kancane futhi kahle. Ukudla okune-carbohydrate ephansi ngaphambi kokudla, i-insulin emfushane ingcono kune-ultra-short. Ngoba isikhathi sesenzo saso sivumelana kangcono nesikhathi lapho amaprotheni okudla enyusa ushukela wegazi kunesikhathi sokwenza kwe-ultrashort insulin.
Ungasifaka kanjani isicelo sendlela yemithwalo emincane
Ekuqaleni kwendatshana, sihlele "Umthetho wokubikezela umphumela emithwalweni ephansi." Cabanga ukusetshenziswa kwaso okusebenzayo kokulawula ushukela wegazi ngohlobo 1 nesifo sikashukela esingu-2. Ukuze uvikele ukuhlasela kushukela, kufanele usebenzise inani elincane kakhulu lama-carbohydrate. Lokhu kusho ukudala umthwalo omncane kumanyikwe. Yidla kuphela ama-carbohydrate ahamba kancane. Zitholakala ngemifino kanye namantongomane kusuka kuhlu lokudla okuvunyelwe. Futhi uhlale kude ngangokunokwenzeka kusuka kuma-carbohydrate anejubane eliphezulu (uhlu lokudla olunqatshelwe). Ngeshwa, ngisho nama-carbohydrate "ahamba kancane", uma edliwa kakhulu, angakhuphula ushukela wegazi kakhulu.
Ukuncoma okujwayelekile ukunciphisa umkhawulo wokudla kwe-carbohydrate yesifo sikashukela: kungabi ngama-6 amagremu we-carbohydrate "aphambili" esidlweni sasekuseni, bese kungadluli amagremu ayi-12 kwasemini, kanye namagremu ayi-6-12 ngaphezulu kwesidlo sakusihlwa. Faka amaprotheni amaningi kuyo ukuze uzizwe ugcwele, kepha ungadli ngokweqile. Ama-carbohydrate amukelekile kwabanesifo sikashukela atholakala kwimifino namantongomane, asohlwini lokudla okuvunyelwe. Ngaphezu kwalokho, ngisho nalokhu kudla kwe-carbohydrate kumele kudliwe ngenani elilinganiselwe. Isihloko esithi “Ukudla Okuphansi Kwama-Carbohydrate Diabetes: Isinyathelo Sokuqala” sichaza ukuthi ungahlela kanjani ukudla futhi wakhe imenyu yesifo sikashukela.
Uma ulawula ngokucophelela ukuthathwa kwama-carbohydrate, njengoba kunconywe ngenhla, ushukela wegazi lakho ngemuva kokudla uzokhuphuka kancane. Mhlawumbe ngeke aze akhule nakancane. Kepha uma uliphinda kabili inani lama-carbohydrate adliwayo, ushukela osegazini ngeke weqe kabili, kodwa uqine. Futhi ushukela wegazi ophakeme ubangela umjikelezo omubi oholela ushukela ophakeme kakhulu.
Iziguli ezinesifo sikashukela sohlobo 1 nohlobo 2 ezifuna ukulawula ushukela wazo kufanele zigcwaliswe kahle imichilo yokuhlola ushukela. Yenza okulandelayo kaningana. Kala ushukela wakho wegazi ngemuva kokudla ngezikhathi ezithile zemizuzu engu-5. Landelela ukuthi iziphatha kanjani ngaphansi kwethonya lemikhiqizo ehlukahlukene. Bese ubheka ukuthi i-insulin ishesha kangakanani nokuthi yokwehlisa kangakanani. Ngokuhamba kwesikhathi, uzofunda ukubala ngokunembile inani lokudla okuphansi kwe-carbohydrate esidlweni kanye nethamo le-insulin emfushane ukuze "gxuma" ushukela wegazi ume. Umgomo wokugcina ukuqinisekisa ukuthi ngemuva kokudla ushukela wegazi awudluli ku-6.0 mmol / L, noma okungcono, u-5.3 mmol / L, njengabantu abaphilile.
Ezigulini eziningi ezinesifo sikashukela sohlobo 2, ukushintshela ekudleni okune-carbohydrate engaphezulu kungakhipha ngokuphelele imijovo ye-insulin ngaphambi kokudla futhi zilondoloze ushukela wegazi ojwayelekile. Abantu abanjalo bangahalaliselwa. Lokhu kusho ukuthi bazinakekela ngokuhamba kwesikhathi, kanti isigaba sesibili sokuqashelwa kwe-insulin besingakabi namandla okuwohloka. Asethembisi muntu kusengaphambili ukuthi ukudla okunama-carbohydrate azokuvumela ukuthi 'ungene' ngokuphelele kusuka ku-insulin. Kepha ngokuqinisekile kuzonciphisa isidingo sakho se-insulin, futhi nokulawulwa kwakho ushukela wegazi kuzothuthuka.
Kungani ungeke udle ngisho nemikhiqizo evunyelwe
Uma udle imifino eminingi evunyelwe kanye / noma amantongomane uselule izindonga zesisu sakho, ushukela wegazi lakho uzokhuphuka ngokushesha, njengokudla okuncane okwenqatshelwe i-carbohydrate ephezulu. Le nkinga ibizwa ngokuthi "imiphumela yokudlela yamaShayina," futhi ukuyikhumbula kubaluleke kakhulu. Bheka i-athikili ethi "Kungani Abagibeli BeShukela Bebengaqhubeka Kokudla Ukudla Okuphansi, nokuthi Ungayilungisa Kanjani." Ukuhlukumeza ngohlobo 1 nesifo sikashukela sohlobo 2 akunakwenzeka neze. Ukuze ugweme ukudla ngokweqile, ngesifo sikashukela sohlobo 2 kungcono ukungadli amahlandla ama-2-3 ngosuku, kepha amahlandla ama-4 kancane. Lesi sincomo sisebenza ezigulini ezinesifo sikashukela sohlobo 2 ezingalashwa nge-insulin emfishane noma ye-Ultra-iDemo.
Ukuhlaselwa ngokweqile kanye / noma ubudlova yisici esibonakalayo seziguli ezinesifo sikashukela sohlobo 2. Imikhiqizo yamaphrotheni inika umuzwa ohlala njalo wokuthamba futhi ngaleyo ndlela inciphise ubukhulu benkinga. Kepha ezimweni eziningi lokhu akwanele. Thola ezinye izinto ezijabulisayo empilweni ezizokubeka esikhundleni sokudla ngokweqile. Jwayela ukuvuka etafuleni ulambile kancane. Bheka futhi isihloko esithi “Ungayisebenzisa kanjani imithi yesifo sikashukela ukulawula isifiso sakho sokudla.” Mhlawumbe ngenxa yalokhu kuzokwazi ukulahla ngokuphelele i-insulin. Kepha asikuthembisi lokhu kunoma ngubani kusengaphambili. Kungcono ukujova i-insulin kunokuthola ukwelashwa kwesifo sikashukela emehlweni akho, izinso, noma imilenze.
Ngohlobo 2 sikashukela, ukudla ngezingxenye ezincane kuvumela ukuthi ulawule ushukela wegazi kahle nesigaba sesibili secretion se-insulin, esisaqinile. Kuzoba kuhle uma ungashintshela kulesi sitayela sokudla, naphezu kokuphazamiseka okukulethayo. Ngaso leso sikhathi, iziguli ezinesifo sikashukela sohlobo 1 nohlobo 2 ezijova i-insulin isikhathi ngasinye ngaphambi kokudla kufanele zidle kathathu ngosuku. Ukudla umthambo phakathi kokudla akuseluleki ngabo.
Iziphetho
Le ndatshana yaphenduka yaba yinde, kepha ngethemba ukuthi ingasebenziseka kuwe. Ake sakhe iziphetho ezimfishane:
- Ama-carbohydrate amancane owadingayo, ushukela wegazi omncane uyenyuka futhi i-insulin encane iyadingeka.
- Uma udla kuphela inani elincane lama-carbohydrate, lapho-ke ungakwazi ukubala ngokunembile ukuthi ushukela wegazi uzoba njani ngemuva kokudla nokuthi kungakanani i-insulin. Lokhu akunakwenziwa ekudleni okulinganiselwe okune-carbohydrate ephezulu.
- Uma uthola i-insulin encane, kuba lula ukuqagela, futhi ingozi ye-hypoglycemia nayo iyancipha.
- Ukudla okune-carbohydrate ephansi kakhulukazi koshukela kusho ukungadli ama-gramu ayi-6 we-carbohydrate ngesidlo sasekuseni, akukho ngaphezu kwama-12 amagremu abo kwasemini, nenye amagremu ayi-6-12 esidlweni sakusihlwa. Ngaphezu kwalokho, ama-carbohydrate angadliwa kuphela lawo atholakala kwimifino namantongomane kusuka ohlwini lokudla oluvunyelwe.
- Ukulawula ushukela ngokudla okuphansi kwe-carbohydrate akusho ukuthi udinga ukuzibulala. Yidla amaphrotheni amaningi kanye namafutha emvelo anempilo ukuze uzizwe ugcwele, kepha hhayi ukudla ngokweqile. Bheka i-athikili "I-Low-Carbohydrate Diet for Diabetes: Izinyathelo Zokuqala" ukufunda ukuthi ungakha kanjani imenyu emnandi enothe ngezakhi zomzimba, amavithamini, amaminerali, nezinto zokulandela ...
- Ukuhlukumeza ngokweqile akunakwenzeka. Funda ukuthi ithini imiphumela yokudlela yamaShayina nokuthi ungakugwema kanjani.
- Musa ukujova amayunithi we-insulin angaphezu kuka-6-7 ngomjovo owodwa. Hlukanisa umthamo omkhulu we-insulin emijozweni eminingana, eyenziwa ngokushesha emva komunye ezingxenyeni ezihlukene zomzimba.
- Ngohlobo 2 sikashukela, uma ungayifaki i-insulin ngaphambi kokudla, zama ukudla ukudla okuncane amahlandla amane ngosuku.
- Iziguli ezinesifo sikashukela sohlobo 1 nohlobo 2, ezithola i-insulin isikhathi esifushane ngaphambi kokudla, kufanele zidliwe izikhathi ezintathu ngosuku ngokuphumula kwamahora angama-5 futhi ungadli phakathi kokudla.
Uzokuthola kukuhle ukugcina lo mbhalo kumabhukumaka ukuze ukwazi ukuwafunda futhi. Bheka futhi izindatshana zethu ezisele ekudleni okuphansi kwe-carb yesifo sikashukela. Ngizojabula ukuphendula imibuzo yakho emazwaneni.
