Njengoba isifo sikashukela senzeka njalo ngonyaka, inani labantu abafuna ukwazi ukuthi isifo sikashukela sohlobo 2 lungelapheka yini, nokuthi kungenzeka yini ukuthi kuqedwe ngokuphelele ukuphathwa kwe-insulin ngohlobo 1 sikashukela.
Njengamanje esigabeni samanje sokuthuthuka kolwazi ngesifo sikashukela, kubhekwa njenge-pathology lapho kungenzeka khona ukuthuthukisa kakhulu izinga lempilo yeziguli, uma wakhe kahle ukudla, unamathela indlela elula yokusebenza komzimba futhi uvivinya ukuqapha okufika ngesikhathi kwamazinga kashukela egazini.
Ukwelashwa kwesifo sikashukela sohlobo 2 njengesifo se-metabolic kubandakanya ukwenqatshwa kokudla ngokweqile, ukunciphisa isisindo ngokweqile kanye nokuthatha imishanguzo ukwenza ushukela wegazi ube ngokwejwayelekile. Iningi leziguli selashwa isifo sikashukela, okusho ukuvimbela ukuthuthukiswa kwezinkinga zesifo kanye nokugcina izinga elijwayelekile lomsebenzi wezenhlalo kanye nokusebenza.
Kungani uhlobo lwesibili sikashukela lukhula?
Izici eziyinhloko ekwakhiweni kokuphazamiseka kwe-metabolic ngohlobo 2 sikashukela inani elincishisiwe lama-receptor we-insulin noma isakhiwo sawo esishintshiwe, kanye nezindawo ezonakele ze-insulin uqobo. I-pathology yokudluliswa kwesiginali kusuka kuma-receptors iye ezintweni ezi-intracellular nayo ingakhula.
Zonke lezi zinguquko zihlanganiswa yigama elijwayelekile - ukumelana ne-insulin. Kulokhu, ukukhiqizwa kwe-insulin kungenzeka ngamanani ajwayelekile noma aphezulu. Ungakunqoba kanjani ukumelana ne-inulin, futhi ngokulandelana, ukuthi ungaselapha kanjani isifo sikashukela unomphela, ososayensi namanje abazi. Ngakho-ke, akunakwenzeka ukukholelwa izithembiso zokuthi uhlobo 2 sikashukela lungalashwa.
Ukumelana ne-insulin kukhula ngokukhuluphala, kuyilapho ezigulini ezinesifo sikashukela sohlobo 2, isisindo ngokweqile kutholakala ngamacala angama-82,5%. Ukuphambuka kofuzo kokuphazamiseka komzimba we-carbohydrate metabolism ngenxa yokudla ngokweqile, ukubhema, umfutho wegazi ophakeme nokuphila kokuhlala phansi kuholela kulesi sifo.
Abathinteka kakhulu kulolu hlobo lwesifo sikashukela ngabantu abaneminyaka engaphezu kwengama-40, umzimba ogcwele, abane-predominant deposition of fat in the tumbo tumbo.
I-insulin engena egazini ayikwazi ukubonwa ngama-receptors kuma-tishu ancike ku-insulin, ahlanganisa amaseli wesibindi, i-adipose namaseli emisipha. Uhlobo lwesifo sikashukela sohlobo 2 lubonakala njengokuphazamiseka kwemetabolic:
- Ukwakheka kwe-glycogen ne-glucose oxidation kuvinjelwe.
- Ukwakheka kwama-molecule eglue kusibindi kuyashesha.
- Ukhipha ushukela egazini kanye nokuphuma kwawo kumchamo.
- Ukuqanjwa kwamaprotheni akuvinjelwe.
- Amafutha aqongelela izicubu.
Ukwanda kwe-glucose egazini elijikelezayo kubangela ukuthuthukiswa kwezinkinga zohlangothi lwezinzwa, izinso, isitho sombono, kanye nomonakalo ojwayelekile embhedeni we-vascular.
Futhi uma kunzima ukuthola ushukela, khona-ke kukhona ithuba langempela lokuvimbela i-pathologies enzima futhi ebulalayo ehambisana nayo.
Ukwelashwa kwesifo sikashukela ngokudla namakhambi asemakhambi
Ukuze welaphe isiguli sohlobo lwe-2 isifo sikashukela ezimweni ezibucayi noma esigabeni sokuqala, ushintsho oluphelele ekudleni nasekunciphiseni isisindo lunganele. Kulokhu, ukuxolelwa kwesikhathi eside kwalesi sifo kungatholakala ngaphandle kokusetshenziswa kwezidakamizwa.
Isisekelo sokudla okufanele kwesifo sikashukela ukuqinisekisa ukungena ngokulinganayo kwama-carbohydrate, okuhambelana nezinga lomsebenzi womzimba, kanye nesilinganiso sabo esilinganiselayo samaprotheni namafutha ekudleni.
Ama-carbohydrate alula ekushintsheni kohlobo lwe-hypoglycemic angasetshenziswa ukwandisa ushukela wegazi; kuzo zonke ezinye izimo, imikhiqizo enenkomba ye-glycemic ephezulu yeziguli ezinesifo sikashukela inqatshelwe ngokuphelele.
Imikhiqizo elandelayo idinga ukukhishwa okuphelele kumenyu yesifo sikashukela:
- Izithelo ezimnandi neziphuzo zazo, ikakhulukazi amagilebhisi, ubhanana, amakhiwane nezinsuku.
- Ushukela, noma iyiphi i-confectionery enokuqukethwe kwayo.
- Imikhiqizo kafulawa emhlophe, amakhekhe, namakhekhe, amakhukhi, i-waffles.
- I-ayisikhilimu, ama-dessert, kufaka phakathi ushizi we-cottage shizi, ama-yogurts noshukela ongeziwe nezithelo.
- I-Semolina, ilayisi kanye ne-pasta.
- Ujamu, uju, izithelo ezikheniwe, ujamu kanye nezinhlaka.
- Okuphezulu kwe-Cholesterol Offal: Ubuchopho, Isibindi, Izinso.
- Inyama enamafutha, amafutha, ukupheka uwoyela.
Umthetho oyisisekelo wokwakha imenyu yanoma ngubani onesifiso sokuselapha kahle isifo sikashukela 2 ukubheka njalo okuqukethwe amayunithi esinkwa emikhiqizweni. Amayunithi wesinkwa (1 XE = 12 g wama-carbohydrate noma ama-20 g wesinkwa) abalwa ngokuya ngamatafula. Ukudla ngakunye akumele kube ngaphezu kwe-7 XE.
Isifo sikashukela singalapheka kuphela uma iziguli zidla ukudla okwanele okuqukethe i-fiber yokudla, i-fiber, namavithamini. Lokhu kufaka imifino, amajikijolo kanye nezithelo. Zidliwa kahle okusha. Kuyadingeka futhi ukufaka uwoyela wemifino nezinhlobo ze-nonfat yezinhlanzi, imikhiqizo yobisi ebilisiwe ngaphandle kwezithasiselo ekudleni.
Isiguli esinesifo sikashukela sidinga ukukuqonda okucacile ngokudla okwamukelekayo kuye, senze inhlanganisela futhi sitshintshe izitsha ukuze siqonde ukuthi singasiphatha kanjani isifo sikashukela sohlobo lwe-2 ngokudla kokudla. Okubaluleke futhi ukulungiswa kokudla okunempilo ngokuya ngezinga le-glycemia, ukusebenza komzimba kanye nezinguquko kwendlela ejwayelekile yokuphila.
Kunezindlela eziningi zokupheka ezichaza izindlela zokwelapha isifo sikashukela sohlobo lwe-2 unomphela ngamakhambi abantu. Noma izeluleko ezinjalo zinganikeli imiphumela ethenjisiwe, ukusetshenziswa kwomuthi wamakhambi kungaba wusizo ukwenza ngcono isimo esigcwele sesiguli, kunciphise isifiso sokudla futhi kwandise ukusebenza kwezindlela zendabuko zokwelashwa.
Itiye le-herbal lingasetshenziswa njengendlela yokwenza ngcono ukusebenza kwezinso, isibindi, i-gall bladder kanye nama-pancreas ngama-pathologies afanayo alezi zitho kanye nokufaka itiye noma ikhofi ejwayelekile. Esikhathini sikashukela i-mellitus, ama-infusions kanye nama-decoctions amakhambi anjalo anconyiwe:
- Amaqabunga e-walnut, sitrobheli wasendle, ukhula.
- Umuthi we wort weSt John, ukhwehlela, owenziwe ngamafindo kanye namahhashi.
- Amaqabunga obhontshisi, u-anyanisi negalikhi, i-artichoke yaseJerusalema.
- Izimpande ze-burdock, elecampane, peony ne-dandelion, i-chicory.
- Amajikijolo of aluhlaza okwesibhakabhaka, umlotha wasentabeni, amajikijolo, i-lingonberry ne-kamalibhele, i-olderberry
Thayipha amaphilisi kashukela kababili
Imithi yesifo sikashukela isetshenziselwa ukwehlisa amazinga aphezulu kashukela bese ihlinzeka ngamaseli ngokudla okunempilo namandla. Inkambo ebekiwe efanele yokwelashwa, ehlanganiswa nokudla kanye nokuzivocavoca komzimba, ingalapha iningi lesifo ngokudlulisela isifo sikashukela esigabeni sesinxephezelo.
Izidakamizwa ezisetshenziselwa ukukhuthaza ama-pancreas zinamandla okukhulisa ukukhiqizwa kwe-insulin. Inzuzo yabo ijubane lokusebenza, kepha kumarejimeni wokulashwa wanamuhla anqunywa kuphela ngokuhlobene nomphumela odumazayo kumaseli we-beta.
Indlela enjalo yokwenza izinto inezinto eziphuma ku-sulfonylurea, ezibandakanya iTolbutamide, Glibenclamide, Glyclazide, Glimepride.
Kaningi ezinhlelweni ezithuthukisiwe - "Ungasiphatha kanjani isifo sikashukela sohlobo 2 ezigabeni zokuqala", kusetshenziswa izidakamizwa eziqukethe iMetformin. Lo muthi usiza ukwandisa ukuzwela kwezicubu kwe-insulin futhi wehlise ukumuncwa kwe-glucose emathunjini.
Ngaphezu kwalokho, isenzo se-metformin sibuye sifinyelele esibindini, sandisa ukwakheka kwe-glycogen kanye nokuqongelela kwayo esibindini, ukubola kwayo kushukela kunciphisa ijubane, ukusetshenziswa kwe-metformin kuqinisa isisindo futhi, ngasikhathi sinye, i-lipid metabolism ephazamisekile iyancishiswa.
Imithi equkethe i-metformin ingena kwinethiwekhi yamakhemikhali ngaphansi kwala magama ezentengiso:
- IGlucophage, ekhiqizwe nguMerck Sante, eFrance.
- IDianormet, iTeva, ePoland.
- IMetfogamma, iDragenofarm, eJalimane.
- Metformin Sandoz, Lek, Poland.
- Siofor, Berlin Chemie, Germany.
Ukusetshenziswa kweRepaglinide neNateglinide amalungiselelo akuvumela ukuthi ulawule ukukhuphuka koshukela okwenzeka emahoreni amabili ngemuva kokudla - kuthiwa ngabalawuli be-prandial. Leli qembu lezidakamizwa libonakaliswa ukumunca ngokushesha kanye nesikhathi esifushane sokwenza.
Ukuvimbela ukumuncwa kwe-glucose emathunjini, umuthi i-Acarbose ungasetshenziswa, kukuvumela ukuthi ususe ama-carbohydrate asemathunjini, ukuvimbela ukwanda koshukela. Inzuzo yokwelashwa ngaleli thuluzi ukungabikho kwe-hypoglycemia nokukhuthaza ukwanda kwamazinga we-insulin.
Izidakamizwa ezinjenge-Avandia nePioglar zandisa ukuzwela kwe-adipose nezicubu zomzimba ku-insulin, zivuselela ukwakheka kwamaprotheni athile. Ngokusetshenziswa kwabo, okuqukethwe kwamafutha noshukela egazini kuyancipha, ukusebenzisana kwama-receptors ne-insulin kuyanda.
Ukuxazulula le nkinga - ukuthi ungalapha kanjani isifo sikashukela sohlobo 2, izinkampani ezenza amakhemikhali zakha izidakamizwa ezintsha, okungenye yezentuthuko esetshenziswa odokotela - iBayetta neJanuvia.
I-Exenatide (Bayetta) ilingisa ukuvela kwama-hormone emgodini wokugaya ohlobene nama-incretins. Zingavusa ukwakheka kwe-insulin ukuphendula ukudonswa koshukela ekudleni, futhi zivame ukuvimbela ukungagcwele kwesisu, okusiza iziguli ezikhuluphele ukuthi zinciphise isifiso sokudla nesisindo sazo.
UJanuvia (sitagliptin) unempahla yokuqhakambisa ukukhiqizwa kwe-insulin futhi kuvimbele ukukhishwa kwe-glucagon, okuholela ekwehlelweni okuzinzile kwamazinga kashukela egazini, futhi kusiza ukufeza kalula isinxephezelo sesifo sikashukela sohlobo 2.
Ukukhethwa kwesidakamizwa ekwelapheni isifo sikashukela kunganikezwa kuphela kudokotela oholayo, ongathi ngemuva kokuhlolwa okugcwele angakhethe inkambo efanele yokwelashwa, futhi uma kunesidingo, udlulisela isiguli kusuka ezibhebheni siye kwi-insulin.
Izindlela zokushintshela ekwelashweni kwe-insulin sikashukela kungaba:
- Umthamo omkhulu wezidakamizwa ukwehlisa ushukela, okuhambisana nokudla awukwazi ukusekela amanani atholakalayo we-glycemia.
- Ekuhlolweni kwelabhoratri: glucose wokuzila ungaphezu kwama-8 mmol / l, futhi i-hemoglobin ye-glycated ayinciphisi ngaphansi kuka-7.5% ngokutadisha okuphindwe kabili.
- Izimo ze-Ketoacidotic, hyperosmolar
- Izinkinga zesifo sikashukela ngendlela yezimo ezinzima ze-polyneuropathy, nephropathy, retinopathy.
- Izifo ezithathelwanayo ngenkambo ebucayi kanye nokwelashwa okungasebenzi kwe-antibiotic.
Ukwelashwa kokuhlinzwa kwesifo sikashukela sohlobo 2
Njengoba ukukhuluphala nesifo sikashukela kuyizifo ezithuthukisa ukubonakaliswa komunye nomunye, kanye nokwehla kwesisindo somzimba, izinkomba ezinhle zokuzinzisa inkambo yesifo sikashukela zingatholakala, kanye neqiniso lokuthi azikho izindlela zokuqikelela ezelashayo zokwelapha isifo sikashukela, izindlela zokuhlinzwa ze-metabolic sezakhiwe.
Imisebenzi efana ne-gastric banding, gastroplasty kanye ne-gastroshunting kusiza ukunxephezela isifo sikashukela kuma-60-80% wamacala. Ukukhethwa kwendlela yokunciphisa umthamo wesisu kuya ngezinga lokukhuluphala kweziguli.
Kufanele kuqondwe ukuthi ngisho nesisindo samakhilogremu angama-90 ebudaleni, lapho kukhona into eyindlalifa yofuzo iholela kushukela.
Imiphumela ephezulu kakhulu ekwelashweni kwesifo sikashukela i-mellitus yatholakala ngesikhathi kusetshenziswa ukuhlinzwa kwe-biliopancreatic bypass - 95%, ngale ndlela, okuyingxenye ye-duodenum, lapho i-bile ne-pancreatic juice ingena khona. Zitholakala kuphela ngaphambi kokungena emathunjini amakhulu.
Yize ukusebenza okunjalo kuholela ekuphazamiseni okukhulu kwe-metabolic, i-hypovitaminosis, ikakhulukazi amavithamini ancibilikayo, ukuntuleka kwe-calcium, kanye nokuthuthukiswa kwezifo ezinamafutha, lolu hlelo lwaziwa njengokungenelela okunamandla kakhulu okungamisa ukukhuluphala futhi kuthayiphe isifo sikashukela esingu-2. Ividiyo ekulesi sihloko ikhombisa ukwelashwa kwesifo sikashukela sohlobo 2 kuphela.
