Okuqukethwe ushukela ohlotsheni lwesibili sikashukela kubaluleke kakhulu, ngoba ukwanda kuholela ekuthuthukisweni kwezinkinga ezinzima, futhi i-hyperglycemia engapheli ikhuthaza ukuqhubeka kwe-pathology.
Ngokwemininingwane yezokwelapha, ushukela wegazi usukela kumayunithi angama-3.3 kuya kwangama-5.5. Ngokuqinisekile, umuntu onesifo sikashukela nomuntu ophilile uzoba nezinkomba ezahlukahlukene zoshukela, ngakho-ke, onesifo sikashukela, ukuqapha njalo kuyadingeka.
Ngemuva kokudla, inani le-glucose egazini liyakhuphuka, futhi lokhu kuvamile. Ngenxa yokusabela okufika ngesikhathi kwama-pancreas, ukukhiqizwa okwengeziwe kwe-insulin kuyenziwa, ngenxa yalokho i-glycemia yenziwa yenziwa yodwa.
Ezigulini, ukusebenza kwamanyikwe kukhubazekile, ngenxa yalokho kutholwa inani elanele le-insulin (DM 2) noma i-hormone ayikhiqizwa nhlobo (isimo sivamile nge-DM 1).
Ake sibheke ukuthi liyini inani likashukela wegazi lesifo sikashukela sohlobo 2? Ungayigcina kanjani ezingeni elidingakalayo, futhi yini ezosiza ekuzinzeni ngaphansi kwemikhawulo eyamukelekayo?
Isifo Sikashukela Mellitus: Izimpawu
Ngaphambi kokuthola ukuthi yiluphi ushukela okufanele lube kwiziguli ezinesifo sikashukela, kubalulekile ukucubungula ukubonakaliswa komtholampilo kwe-psychology engapheli. Kuhlobo 1 sikashukela, izimpawu ezingezinhle ziyaqhubeka ngokushesha, izimpawu zanda ngokoqobo ezinsukwini ezimbalwa, zibonakala ngokuqina.
Kwenzeka kaningi ukuthi isiguli siqonde ukuthi kwenzekani ngomzimba wakhe, ngenxa yalokho isithombe sikhuphuka kukhubazeka sikashukela (ukulahlekelwa ukwazi), isiguli sigcina esibhedlela, lapho bethola khona lesi sifo.
I-DM 1 itholakala ezinganeni, intsha kanye nentsha, iqembu leziguli leminyaka lifinyelela eminyakeni engama-30. Ukuboniswa kwalo kwemitholampilo:
- Umile njalo. Isiguli singaphuza amalitha u-5 wamanzi ngosuku, kanti umuzwa wokoma usaqinile.
- Iphunga elithile elisuka emgodini womlomo (iphunga le-acetone).
- Ukwanda kwesifiso sokudla ngokubhekene nesizinda sokulahlekelwa isisindo.
- Ukwanda kwamandla athile omchamo ngosuku uvame ukuchama kaningi futhi usebenzise profiles, ikakhulukazi ebusuku.
- Amanxeba awapholi isikhathi eside.
- Izikhumba zesikhumba, ukuvela kwamathumba.
Isifo sohlobo lokuqala sitholakala ezinsukwini eziyi-15-30 ngemuva kokugula okunegciwane (i-rubella, umkhuhlane, njll.) Noma isimo esinamandla sokucindezela. Ukulungisa amazinga kashukela egazi ngokujwayelekile ngemuva kwesifo se-endocrine, isiguli sinconywa ukuphatha i-insulin.
Uhlobo lwesibili sikashukela lukhula kancane ngaphezulu kweminyaka emibili noma ngaphezulu. Ngokuvamile kutholakala ezigulini ezingaphezu kweminyaka engama-40. Umuntu uhlala ezwa ubuthakathaka nokunganaki, amanxeba akhe kanye nokuqhekeka kungapholi isikhathi eside, ukubona okubonakalayo kukhubazekile, kutholakala imemori.
Izimpawu:
- Izinkinga ngesikhumba - ukulunywa, ukuvutha, noma imaphi amanxeba awapholi isikhathi eside.
- Umile njalo - kuze kufike kumalitha ama-5 ngosuku.
- Ukuchama kaningi kanye nephrofayili, kufaka phakathi ebusuku.
- Kwabesifazane, kukhona i-thrush, okunzima ukuyelapha ngemithi.
- Isigaba sekwephuzile sibonisa ngokuncipha kwesisindo, ngenkathi ukudla okuhlala kufana.
Uma isithombe somtholampilo esichaziwe sibonwa, ukungazinaki lesi simo kuzoholela ekwandeni kwaso, ngenxa yalokho izinkinga eziningi zesifo esingelapheki zizovela kakhulu ngaphambili.
I-glycemia ephakeme kakhulu iholela ekuboneni okungaboni kahle kanye nokungaboni okuphelele, unhlangothi, ukushaya kwenhliziyo, ukwehluleka kwezinso neminye imiphumela.
Kuyini isinxephezelo se-pathology?
Ukukhuphela ngaphandle ukuthuthukiswa kwezinkinga ezinzima futhi ezingamahlalakhona, abanesifo sikashukela badinga ukuguqula ushukela wegazi labo. Ngabe yini ushukela wegazi ngohlobo 2 sikashukela, ingabe iziguli zinendaba nalo?
Imithombo yenhlangano yesifo sikashukela ikhombisa ukuthi kungenzeka ukunciphisa ingozi yokwandisa isithombe somtholampilo uma ushukela emzimbeni ngemuva kokudla usukela kumayunithi angama-5.0 kuya kwangama-7.2, amahora amabili ngemuva kokudla ngaphakathi kuka-10 mmol / l, ne-hemoglobin ye-glycated i-7% ehlanganisa futhi ephansi.
Isimo esichazwe ngenhla sibonisa ukuthi imenyu yesiguli izoba nokudla okune-carbohydrate eningi. Ngokufanelekile, lokhu kudla okuholela ekutheni umuntu akhuphuke umthamo we-insulin ukuze enze i-glycemia ibe yodwa.
Ngokuqinisekile, imithamo emikhulu ye-hormone yandisa izehlakalo zesimo se-hypoglycemic, okungeyona ingozi kangako njengokuqunjelwa kweglucose ephezulu. Ngokusekelwe kulokhu, singaphetha ngokuthi ezikhungweni zezokwelapha isilinganiselo sikashukela segazi sohlobo 2 sikashukela sikhulu kakhulu ukuze sinciphise ingozi ye-hypoglycemia, egcwele imiphumela engaphenduki nokufa.
Uma ukwelashwa kwe-pathology kwenziwa ngendlela yokudla ethuthukisa impilo, lapho ukudla okunamanani amancane we-carbohydrate kufakiwe kwimenyu, umthamo we-insulin olawulwa uyancishiswa.
Amathuba okukhula kwe-hypoglycemia nawo ancishisiwe ngaphandle kwesidingo sokugcina ushukela ophakeme. Umzimba womuntu, obekwe kulezo zimo, uqala ukusebenza ngokubikezela.
Ukunamathela ekudleni okune-carb ephansi, isiguli sizokwazi ngokuqinisekile ukuthi yini ukufundwa kwakhe ushukela wegazi kuye ngokudla okusetshenzisiwe kanye nemithamo ye-hormone.
Ngakho-ke, kungenzeka ukuhlela imenyu yakho, umsebenzi wokuzivocavoca umzimba kanye nokujova kwama-hormone, okukuvumela ndawonye ukuthi ulondoloze ushukela egreyidi okuqondiwe ngalo.
Thayipha isifo sikashukela sohlobo 2: ishukela likashukela egazini
Kwabesifazane nabesilisa abangenazo izinkinga zempilo, ukushintshashintsha kweshukela kuyabonakala ezinhlwini zamayunithi angama-3.3-5,5. Njengomthetho, ngobuningi bamacala, ushukela uyama cishe ngo-4.6 mmol / L.
Ngemuva kokudla, ngisho nakumuntu ophile kahle, ukugcotshwa kukhuphuka, kungafinyelela kumayunithi angama-8,0 kufakiwe. Ngemuva kwamahora ambalwa, iyancipha, ime ngenani elijwayelekile.
Amanani kashukela egazini ngemuva kwesifo "esimnandi" asebangeni lamayunithi angama-4.5-6.5. ngemuva kokudla. Umphumela ongemuhle impela uvame ukukhombisa amanani kusuka kumayunithi angama-6.5 kuya kwangama-7.5. 2 amahora emva kokudla, izinga kufanele libe ngaphansi kwamayunithi angama-8,0 - lokhu kufanelekile, kepha ukwanda kuya ku-10 mmol / l kuyamukeleka.
Kuyaphawuleka ukuthi izibalo ezinje zinganciphisa amathuba okuba nezinkinga ezingezinhle njengokushintshwa kwe-atherosulinotic emithanjeni yegazi, isifo sikashukela, i-neuropathy, i-nephropathy nabanye.
Izinga lokuqondisa lihlala linqunywa ngawodwana, kuya ngeqembu lesiguli; alihlukile phakathi kwabesifazane nabesilisa.
Kumele kwaziwe ukuthi ushukela wegazi lesifo sikashukela sohlobo 2 uthathwa ngokweqile uma uqhathaniswa nezibalo kumuntu ophilile. Njengoba sekuphawuliwe, odokotela bayasaba i-hypoglycemia enzima, futhi ngenxa yalokho bakweqile.
Kepha iningi labodokotela baseMelika nabakwa-Israyeli bancoma ukuthi zonke iziguli zisungule izinkambiso ezibonwa kumuntu onempilo. Kulesi simo kuphela lapho kuzokwazi ukugwema imiphumela emibi ngokuzayo.
Ileveli yokuqondisa kwabesifazane nabesilisa kuya ngeminyaka:
- Ku-diabetesics young, izinga olifunayo lingu-6.5 esiswini esingenalutho futhi lifinyelela kumayunithi angama-8,0. ngemuva kokudla.
- Iqembu eliphakathi kweziguli kufanele lithambekele ku-7.0-7.5 esiswini esingenalutho futhi lifike ku-10 mmol / l ngemuva kokudla.
- Kwabesifazane nabesilisa asebekhulile, amanani aphakeme ayamukeleka. Ushukela 7.5-8.0 mmol / L ngaphambi kokudla - kwanelise, futhi kuze kufinyelele amayunithi ayi-11 ngemuva kokudla.
Abesifazane abakhulelwe badinga ukuqondiswa ngenani lika-5.1 mmol / L ekuseni, ngesikhathi sasemini izinombolo akufanele zedlula amayunithi ayi-7.0. Uma zishintsha phakathi kwale mikhawulo, ubungozi bokukhula nesifo sikashukela bungakhishwa.
Ehlelweni lokulawulwa kwezifo, umehluko phakathi kwe-glucose ngaphambi nangemva kokudla kubaluleke ngokulinganayo. Ngokufanelekile, i-amplitude of oscillations ayidluli amayunithi ama-3.
Ungayifeza kanjani inhloso?
Ngakho-ke, ngemuva kokuthola ukuthi ushukela kufanele abe ushukela wesifo sikashukela esingakanani, sizobheka ukuthi yiziphi izindlela ezizosiza ukufeza le nhloso. Njengoba wazi, i-glucose ibonakala iyinzuzo eguquguqukayo, ingashintshashintsha kuye ngokudla okuqediwe, ukusebenza ngokomzimba, isimo sokomoya somguli nezinye izinto.
Ukuze unxephezele i-pathology, ngamanye amagama, ukuzinzisa okuqukethwe kwe-glucose ezingeni elidingekayo, udinga ukunamathela ngokusobala kukho konke ukunconywa kukadokotela.
Okokuqala, udinga ukulandela ukudla okuthile. Ngaphandle kwemikhawulo efanelekile kumenyu, ukufeza izinhloso akuyona into enengqondo.
Esikhathini sikashukela sohlobo lokuqala, isiguli sinqunywe ukwethulwa kwe-insulin kumthamo othile, kunconywe ngamunye. Ngeshwa, le ukuphela kwendlela yokugcina i-glucose ejwayelekile, ukuvimbela ukuguquguquka kwayo.
Ku-DM 2, amaphuzu aphambili ezokwelapha anokulandelayo:
- Ukudla okuphansi kwe-carb. Ngokwesisindo ngokweqile, kunconywa ukunciphisa umkhawulo wamakhalori asetshenzisiwe.
- Umsebenzi womzimba. Umthwalo wezemidlalo uthuthukisa ukuhamba kwegazi emzimbeni, ukhulisa ukuzwela kwezicubu ezithambile ku-insulin.
- Imodi efanelekile yosuku. Kufanele sidle ngezikhathi ezithile, ngasikhathi sinye silale uvuke ekuseni, njll.
Kubalulekile ukulawula amanani akho kashukela emzimbeni, futhi ungathembi imizwa yakho, kepha emiphumeleni yokuhlolwa kwegazi usebenzisa i-glucometer. Njengoba ukuzivocavoca kubonisa, iziguli eziningi ekugcineni zijwayela ukoma nomlomo owomile onesifo sikashukela, ngenxa yalokho okungenzeka ukuthi azizwa sinesimo se-hyperglycemic.
Ukulawulwa kwesifo sikashukela kudinga ukunakekelwa kwezokwelapha. Isiguli kufanele sivakashele i-endocrinologist kanye ngenyanga, sihlole umchamo ojwayelekile kanye nokuhlolwa kwegazi. Hlola i-hemoglobin ye-glycated njalo ezinyangeni eziyisithupha.
Inkomba Yomkhiqizo ye-Glycemic
Lapho ukhetha imikhiqizo yokudla ngemuva kwesifo "esimnandi", umuntu kufanele anake inkomba yabo ye-glycemic - lokhu kuyindlela ekhombisa ukuthi umkhiqizo othile uguqula kangakanani ukuhlushwa kweglucose.
Ama-carbohydrate aqukethe ekudleni ahlukaniswe ngokushesha futhi kancane. Ama-monosaccharides amunca ngokushesha ngokwanele, avuse ukugxuma ku-glycemia. Ama-carbohydrate ahamba kancane amuncwa isikhathi eside, kancane kancane ahlinzeka umzimba ngamandla.
Kwi-Intanethi ungathola itafula lemikhiqizo lapho inkomba yabo ye-glycemic inqunywa khona. Ukudla okunenkomba ephezulu kunezinzuzo zazo. Noma kunjalo, ngaphandle kwalesi sici, akunconyelwe ukufakwa kumenyu, njengoba:
- Umzimba unikezwa ama-carbohydrate wesikhathi esifushane.
- Kukhona amathuba aphezulu we-glycemia.
- Kukhuphuka isisindo somzimba ngenxa yokwakheka kwama-deposits angamafutha.
Iziguli zidinga ukufaka ekudleni kokudla okunenkomba ephakathi nephansi ukuze kungabandakanyi ubungozi besimo se-hyperglycemic ngemuva kokudla. Iyiphi inkomba ye-glycemic ebhekwa njengephansi?
Inkomba ephansi kakhulu ingafika kumayunithi angama-55, okujwayelekile kuyahlukahluka kusuka kumayunithi angama-56 kuye kwangama-69, kanti okuphezulu kakhulu kuqala kusuka kuma-70 noma ngaphezulu. Ukwakha imenyu ngayinye, ungasebenzisa amatafula akhethekile akhombisa hhayi i-GI kuphela, kodwa nokuqukethwe kwekhalori.
Isifo sikashukela yisifo esibi sohlelo lwe-endocrine okunzima ukuselapha futhi okuholela ekushintsheni okungenakulungiswa.
Ukuzivikela emiphumeleni, udinga ukuthi unake imikhiqizo ye-GI nokuqukethwe kwabo kilojoule.
Ukudla okuphansi kwe-carb
Ukwelashwa okusebenzayo, iziguli eziningi zidinga nje ukuguqula indlela ezidla ngayo. Lesi sitatimende sisebenza kubantu abanesifo sikashukela sohlobo 1 nohlobo 2. Kwenzeka kaningi ukuthi abantu abalimele i-insulin, noma abathathe amaphilisi ukuze baguqule izinqubo ze-metabolic emzimbeni, bathola ukuthi ukulungiswa komsoco kunciphisa kakhulu umthamo we-hormone nezidakamizwa.
Kunemithetho ethile enconyelwe zonke iziguli. Kuyadingeka ukususa ama-carbohydrate asheshayo asuka kwimenyu. Lokhu akubandakanyi ushukela obunjiwe kuphela, kepha namazambane, i-pasta, equkethe isitashi, esicishe siguquke ngokushesha kube ushukela bese kuholela ku-hyperglycemia.
Kubalulekile ukuthi udle ukudla okuncane kuze kube izikhathi ezingama-5-6 ngosuku - izidlo ezintathu ezigcwele, ukudla okulula okuncane ngesikhathi sosuku. Kunqatshelwe ngokuphelele ukulamba nesifo sikashukela sohlobo 2 kanye nohlobo 1 sikashukela, ngoba lokhu kuholela ekwandeni kwesithombe sasemtholampilo.
Iziphakamiso zesifo sikashukela:
- Khawulela umthamo we-carbohydrate ukuya kuma-20-30 amagremu ngosuku. Lokhu kuzosusa ukungena kweglucose futhi kulondoloze ukusebenza kwamaseli we-pancreatic beta.
- Ukushiya itafula kuyadingeka nomuzwa wokulamba okuncane. Kwenqatshelwe ukudla ngokweqile, ngoba lokhu kuzoholela esimweni se-hyperglycemic, noma ngabe isiguli sidle ukudla okuvunyelwe kuphela.
- Umphumela omuhle kakhulu wokulawulwa kwezifo ngokusebenzisa izakhamzimba eziphansi ze-carb utholakala lapho isiguli senza uhlelo lokudla okunempilo lwesonto lonke, sinamathela ngokuqinile.
Kwenqatshelwe ngokuphelele ukudla izithelo noju, ngoba aqukethe ama-carbohydrate amaningi ashesha ukusebenza. Ukwenqaba lemikhiqizo kunzima ngokwanele, kepha kungenzeka. Usebenzisa i-glucometer, ungaqiniseka ukuthi bakhuthaza ukwanda okukhulu kwe-glucose.
Ukunamathela ekudleni okufanele, umuntu akufanele akhohlwe ukudlala imidlalo. Ukusebenza ngokomzimba kunika amandla namandla, kuthuthukisa ukumuncwa kwe-glucose ngokushesha, kuthuthukisa izinqubo ze-metabolic emzimbeni.
Ukulawulwa kwesifo sikashukela akuyona into yesikhashana, kodwa indlela yokuphila ezohlala ilandelwa. I-glucose emikhawulweni eyamukelekayo iyisiqinisekiso sempilo ende ngaphandle kwezinkinga.
Yiziphi izinkomba zoshukela wegazi kushukela ezijwayelekile ezizotshela uchwepheshe kuvidiyo ekulesi sihloko.
