Isifo sikashukela mellitus sisho izifo zemvelo ye-endocrine. Lesi sifo sivezwa ukuphazamiseka kwezinqubo ze-metabolic, ngenxa yokuthi ama-carbohydrate angena emzimbeni awephuliwe ngendlela ejwayelekile.
Ngakho-ke kukhona ukwanda kokugcotshwa kwe-glucose egazini, engafinyelela amanani asongelayo.
Kunezinhlobo ezimbili zesifo sikashukela:
- I-1st - i-insulin incike;
- I-2nd - ukuthembela okungasebenzisi i-insulin.
Yikuphi ukwelashwa okudingekayo kwesifo sikashukela sohlobo 2?
Ukwelapha isifo sikashukela sohlobo 2 kuqukethe izigaba eziningana:
- inhlangano yokudla okufanele;
- ukuhlela ukuzivocavoca okusesilinganisweni;
- ukuthatha izidakamizwa ezinciphisa ushukela wemithi;
- ukuvimbela noma ukwelashwa ezigabeni zokuqala zezinkinga zezifo ezihambisanayo nesifo sikashukela;
- Ukuziqapha kwe-glycemia.
Ukwelashwa ngezidakamizwa kuholela emizameni yokuqeda isifo sikashukela sohlobo 2. Esigabeni sokuqala sokwelashwa, isiguli kufanele siguqule indlela yaso yokuphila, ngokusho kwe-metformin.
Uma isiguli sine-contraindication yalo muthi, kusetshenziswa okuphuma ku-sulfonylurea. Ngokuwohloka okukhanyayo, kunconywa ekuqaleni ukunquma i-insulin, bese udlulisela ekwelapheni ushukela olwehlisa ushukela kungenzeka.
Nge-monotherapy engasebenzi kahle yesifo sikashukela, isigaba sesibili sokwelashwa kufanelekile, lapho kunhlanganiswa khona izidakamizwa. Ukwelapha okuhlanganisiwe kuqukethe inhlanganisela yezidakamizwa, ngezindlela ezihlukile ze-hypoglycemic effect.
Ngale ndlela yokwelapha, ukusetshenziswa kwe-insal insulin kufanelekile. Izidakamizwa zilawulwa ngezikhathi ezimfishane kuze kube yilapho sekusungulwa ukugcotshwa koshukela.
Amandla okuthola ukwelashwa kwe-insulin sikashukela kunqunywa ngamaphuzu alandelayo:
- ukuntuleka kwamandla ashukumisayo kusuka ekwelashweni kokudla kanye nedosi ephezulu yezinye izidakamizwa ezinciphisa ushukela;
- ketoacidosis;
- ukungabekezeleli noma ukuphikisana nokuqokwa kwezidakamizwa zomlomo ezinciphisa ushukela;
- ukwanda kwezifo ezingalapheki nezishukumisayo;
- ukungenelela kokuhlinzwa;
- ukukhulelwa, lapho i-insulin inqunywa khona okwesikhashana bese kungenzeka ukubuyela ekwelashweni nezidakamizwa zomlomo ze-hypoglycemic;
- ukudluliselwa kwesikhashana ekwelashweni kwe-insulin).
Umthamo we-insulin unqunywe ngokuhlukile. Ukwanda kancane kancane kwemithamo kungenzeka kuze kube yilapho imigomo ye-glycemic ngayinye izuzekile.
Njengasifo sikashukela sohlobo loku-1, lapha ukuphumelela kokulashwa kuhlolwa, kunalokho, ngokuxhuma ushukela egazini, iziguli ezingalinquma ngokuzimela ekhaya.
Izifo ezihambisana nazo
- I-neuropathy yesifo sikashukela. Ngalesi ukugula, ukulimala kwenzeka kuzo zonke izinhlobo zama-nerve fibers (autonomic, motor, sensory), okuvela ngenxa yokuphazamiseka komzimba.
- Ukutheleleka ngegciwane (inkukhu, ummbila, isimungumungwane, irubella) lapho kukhona into eyindlalifa yifa elimnyama elimelelwa yisici esivusayo sokungasebenzi kahle komzimba.
- Isifo sikashukela yisifo esivamile semithambo yegazi, i-glomeruli, i-arterioles kanye ne-renal tubules.
- I-retinopathy yesifo sikashukela, eqala ngenkambo yesifo esivele isikhathi eside futhi ilawulwa ngokungafanele. Le pathology iholela ekunciphiseni kwe-acuity ebonakalayo.
- I-Ketoacidotic coma iyinkimbinkimbi yesifo sikashukela, ehambisana nokuphazamiseka okukhulu kwe-homeostasis kanye nokungasebenzi kahle kwazo zonke izitho nezinhlelo.
Ungasusa kanjani isifo sikashukela sohlobo 2 ekhaya
I-mellitus yesifo sikashukela enganciki i-insulin ilashwa kakhulu ekhaya. Kepha okokuqala, isiguli sifakwa esibhedlela ukuze sihlolwe ngokuphelele kanye nokuqokwa kwenkambo yokwelapha.
Noma kunjalo, i-endocrinologist kufanele ibheke isiguli kukho konke ukugula. Kunezinto ezingaphoqa udokotela ukuthi abeke isiguli esibhedlela:
- uhlobo olunzima lwe-ketoacidosis noma i-coma (hypoglycemic, hyperosmolar, ketoacidotic);
- ukubekelwa phansi kwe-carbohydrate metabolism, edinga ukuguqulwa kokulashwa kwe-insulin;
- ukuthuthukiswa kwezinkinga ze-vascular;
- imfundo yeziguli esikoleni sikashukela, esenzeka esibhedlela sosuku.
Kubalulekile! Ukwelashwa ngezidakamizwa ngeke kuveze imiphumela uma isiguli sikashukela singanamatheli ekudleni okuqinile. Kuhlobo 2 sikashukela mellitus, lokhu kudla kufanele kuhloswe ngakho ukuqeda amaphawundi amaningi nokuvimbela i-glycemia ye-postprandial, engakhula ushukela ngemuva kokudla.
Ukusebenza ngokomzimba okwenziwe iphutha kunomphumela omuhle ekuthuthukiseni ukuzwela komzimba ku-insulin, okubandakanya ukwenziwa kwe-metabolism ye-carbohydrate.
Thayipha imithi yesifo sikashukela sesi-2
Izidakamizwa zomlomo zesizukulwane sokuqala
- IChlorpropamide.
- I-Tolazamide (Tolinase).
- I-Tolbutamide (butamide).
Izidakamizwa zesibili zomlomo zesifo sikashukela:
- I-Glipizide.
- INateglinide (glibenclamide).
Ama-Analog
I-Metformin
Inikezwe ama-500-850 mg / ngosuku kumthamo we-2-3. Umuthi uyadingeka ukunqoba ukumelana noma ukwandisa ukusebenza kwe-insulin. I-Metformin iqondiswe ku:
- amathuba aphezulu okuthola ukuhluleka kwe-renal noma i-lactic acidosis;
- infarction myocardial;
- imisebenzi yokuhlinzwa;
- ukusetshenziswa kwama-radiopaque agents;
- i-hypoxia;
- i-pancreatitis.
Ngokunakekelwa okukhulu, i-metformin inqunyelwe:
- ngokwehluleka kwenhliziyo;
- iziguli zokuguga;
- ngotshwala;
- kuhlangene ne-tetracyclines.
I-Acarbose
Ngo-3 ngomlomo, 25-100 mg ngosuku ngokushesha ngaphambi kokudla. Lokhu kuyadingeka ukuvikela ukukhula kwe-postprandial hyperglycemia.
I-Acarbose icutshwe ku:
- i-ulcerative colitis;
- ukwehluleka kwezinso;
- ingxenye ethile yamathumbu;
- ukuvuvukala kwamathumbu isifo.
Thayipha isifo sikashukela sesi-2 nemithi yendabuko
Noma yikuphi ukusetshenziswa kwezindlela zabantu kufanele kuvunyelwane nodokotela. Akunakusho ukuthi kufanele usizindle sikashukela.
Indlela eyinhloko yokwelapha nokuvikela lesi sifo ithathwa njengeyokwelashwa, futhi umuthi ohlukile ungahambisana nawo.
Okufanayo kuhamba ngokudla nokuzivocavoca, ngaphandle kwezidakamizwa akunakwenzeka ukuqeda izinkinga zesifo sikashukela. Imvamisa, amakhambi esintu asetshenziselwa ukuguqula amazinga kashukela egazini.
Ukufakwa kweqabunga le-Bay
- Amaqabunga ayi-10 bay athela amanzi abilayo ngesilinganiso sama-250 ml.
- Phikelela amahora angama-2-3.
- Cindezela ukumiliselwa okusele ngokusebenzisa i-cheesecloth bese uhlukanisa ube izingxenye ezintathu ezilinganayo.
Thatha lesi siphuzo imizuzu engama-30 ngaphambi kokudla.
Ubisi lweHorseradish
- Okokuqala udinga ukupheka ukhilimu owenziwe nge-Homemade (ubisi luvundisiwe endaweni yokushisa yasekamelweni).
- Grate i-horseradish ku-grater enhle bese ufaka 1 tbsp. ukhezo ku isiphuzo okuholela.
- Hlanganisa kahle futhi esiqandisini amahora angama-6-8 ukumiliselwa.
Thatha imizuzu engama-30 ngaphambi kokudla izikhathi ezi-3 ngosuku nge-1 tbsp. ukhezo.
I-Currant
- Udinga ukuthatha u-1 tbsp. i-spoonful yamaqabunga we-currant owomile (ukunambitha, ungangeza amajikijolo amancane).
- Thela ingilazi yamanzi abilayo bese ushiya imizuzu engama-30.
- Cindezela ukumnika.
Lo mhluzi kufanele uthathwe izikhathi ezingama-4-5 ngosuku ngenkomishi ye-½, kungakhathalekile ukuthi kudliwani.
Uhlobo 2 sikashukela nokukhulelwa
Ngesifo sikashukela, ukukhulelwa, kunjalo, kungenzeka, kepha owesifazane kufanele abhekwe udokotela njalo. Lokhu kungenxa yokuthi owesifazane onesifo sikashukela unengozi eyandayo yokukhulelwa nezinkinga zokuzala.
Nazi izinkinga ezivame ukwenzeka lapho uzala ingane kowesifazane onesifo sikashukela sohlobo 2:
- I-toxicosis ebambezeleka.
- Usongo lokuphuphuma kwesisu.
- Izinkinga zezinso.
Isifo sikashukela sohlobo 2 sitholakala ngamaphesenti angama-25% (uma kungukuthi umzali oyedwa kuphela onalesi sifo). Ngenxa yokuthi i-glucose inqamula ngokushesha kwi-placenta, abesifazane abanesifo sikashukela bazalwa benesisindo esiningi, kepha bangaba abangakavuthi.
Kubalulekile! Owesifazane ophethwe yisifo sikashukela kufanele aye esibhedlela ayohlolwa okungenani amahlandla ama-3 ngesikhathi sokukhulelwa.
Ukulaliswa esibhedlela kuyadingeka kusenesikhathi ukuze kuxazululwe inkinga yezeluleko zokulondolozwa kokukhulelwa, ngoba kushukela kunemibandela eminingana ephathelene nokuzala umntwana:
- ukumelana nokwelashwa kwe-insulin;
- izinkinga ze-vascular;
- ukuba khona kwesifo sikashukela kumyeni.
Ngesikhathi esibhedlela sokuqala, ukwelashwa ngezidakamizwa nokudla kuyalungiswa. Ngesikhathi sokukhulelwa, awukwazi ukuthatha izidakamizwa ze-antidiabetic ukunciphisa ushukela kumathebulethi. Zingavusa ukungasebenzi kahle enganeni engakazalwa.
Ukulaliswa esibhedlela ngamaviki angama-24 kubangelwa ukuwohloka kwesifo ngalesi sifo, esivame ukubonakaliswa yizinkinga ezivela emikhunjini yendawo engezansi, i-retina. Uma isiguli singakutholi ukwelashwa okwanele, sizibeka engcupheni yokuba nesifo sikashukela.
Emavikini angama-36- 37 okukhulelwa, amathuba okuzalwa ngaphambi kwesikhathi aphezulu. Kungakho abesifazane abakhulelwe abanesifo sikashukela bengavami ukuya ekuvuthweni. Ukubeletha kwengane ngaphambi kwamaviki angama-37 ngenxa yokungavikeleki kwe-fetus kuyinto engathandeki, kodwa ngesonto ngalinye elilandelayo ingozi kumama inyuka kakhulu.
