Isifo sikashukela yisifo esingelapheki, futhi esingalapheki kakhulu. Ezinye iziguli zikwazi ukwenza ngokwejwayelekile futhi zigcine amazinga kashukela egazini - kwezokwelapha lokhu kubizwa ngokuthi isinxephezelo sesi sifo.
Ukuthola umphumela onjalo kungenzeka kuphela ngokubonga okuyinkimbinkimbi nokunamathela ngokuqinile kuyo yonke imiyalo kadokotela. Isinxephezelo esihle sohlobo 1 noma uhlobo 2 lwesifo sikashukela sivikela ebungozini obukhona bezinkinga futhi siletha impilo yesifo sikashukela esilinganisweni kubantu abaphilile.
Ngokuya ngezigaba zesinxephezelo, izinhlobo eziningana zesifo ziyahlukaniswa:
- Isinxephezelo sikashukela esihlanganisiwe;
- Kwehlisiwe;
- Kukhokhelwe.
Ukukhokhelwa yisimo esiphakathi nendawo phakathi kwezigaba ezimbili zokuqala. Isifo sikashukela esiwohlokile siyingozi kunazo zonke - kungalesi sigaba lapho ubungozi bokuqhamuka nezinkinga ezisongela impilo yeziguli ziphakeme kakhulu.
Yini okudingeka yenziwe ukuze kufinyelele esigabeni sesinxephezelo? Iqiniso ngukuthi i-prognosis evamile yokwelashwa koshukela wanoma yiluphi uhlobo ihlala incike esigulini uqobo.
Udokotela angakwazi ukuqoka futhi anikeze izincomo - kepha kumele zenziwe yisiguli esinohlobo 1 noma 2 sikashukela ngokwakhe. Ungahlola ukuthi kuphumelela kangakanani ukwelashwa ngokulinganisa izinkomba ezilandelayo:
- Amazinga Ushukela wegazi.
- Ukuba khona kwe-acetone emchameni.
- I-urine ushukela
Uma imiphumela ingagculisi, kufanele kwenziwe izinguquko ekudleni nasekubhalweni kokulawulwa kwe-insulin.
Yini izici zesifo sikashukela esinxephekile?
Umsebenzi obaluleke kakhulu ekuhlolweni kwesifo sikashukela i-mellitus ukubuyisela nokugcina izinga leshukela likashukela elidingekayo. Uma kutholakala isifo sikashukela sohlobo 1, i-insulin eyengeziwe ngeke isatshalaliswe nayo.
Ngohlobo 2 sikashukela, akudingekile ukujova i-insulin, inqobo nje uma ukudla okuqaliwe, inqubo yansuku zonke ilandelwa ngokuqinile futhi izivivinyo zomzimba ezivunyelwe zenziwa. Uhlu lwemikhiqizo eyamukelekayo, inani lazo, imvamisa yokudla njalo kunqunywa ngudokotela ohlanganyelayo. Izici zomzimba zesiguli kanye nezinga lomsebenzi wendlela yakhe yokuphila kuyabhekwa.
Noma ngabe uluhlobo luni lwesifo sikashukela, izimiso eziyisisekelo zokudla okunempilo azishintshi:
- Ukukhishwa ngokuphelele kwemikhiqizo yebhikawozi kusuka kufulawa kakolweni we-premium, amaswidi, usawoti, ukudla okubabayo nokunamafutha;
- Ukudla kumele kubhekane nokwelashwa okushisa okuthe xaxa - ukupheka, ukuhambisa amandla, ukuhambisa, ukubamba, ezimweni ezeqile, ukubhaka ku-grill noma kuhhavini. Kufanele ushiye othosiwe emikhiqizweni kawoyela nezitsha;
- Ukudla okunempilo okudingakalayo ngomgomo wokuthi "kungcono kaningi, kepha kancane kancane";
- Ukwenqatshwa ngokuphelele kwawo wonke ama-carbohydrate aphulwe kalula - ngokuyinhloko ushukela;
- Ukusetshenziswa okulinganiselwe kukasawoti - akukho ngaphezu kwama-gramu ayi-12 avunyelwe ngosuku;
- Okuqukethwe kwekhalori kubalwa ngokuqinile kusuka emalini esetshenziswa, hhayi ngaphezulu.
Kufanele kuqondwe ukuthi irejimeni yesifo sikashukela akuyona nje ukusetshenziswa okufanele kokudla okuvunyelwe. Uhlu lwemicimbi edingekayo luhlanganisa:
- Hlola njalo ushukela wakho wegazi kanye nomchamo.
- Isimo esizinzile ngokwengqondo - imizwelo kushukela yanoma yiluphi uhlobo iyingozi enkulu.
- Ukusebenza ngokomzimba kungaphakathi kwemingcele eyamukelekayo.
Imidlalo esebenzayo kakhulu, kanye nokuntuleka okuphelele komsebenzi, kuzolimaza kakhulu kuphela ukutholwa okunjalo. Ngokufanelekile, hamba nsuku zonke, ugijime ekuseni, noma izivivinya ekuseni. Ukuzivocavoca umzimba okwenzelwe isifo sikashukela kumukelekile njalo.
Kwesinye isikhathi thayipha i-2 mellitus yesifo sikashukela ayikwazi ukunxeshezelwa noma ngabe ukudla kuyalandelwa futhi ukusebenza komzimba kwanele. Ngemuva kwalokho akukho okunye ukukhetha ngaphandle kokuqala i-insulin therapy. Isiqinisekiso sokuthi isinxephezelo sesi sifo siphumelele sizoba izinkomba ezilandelayo:
- "Izindlala" hypoglycemia ekuseni - kusuka ku-0,5 kuye ku-5.5 Mmol / l;
- Umfutho wegazi - hhayi ongaphansi kwe-14090;
- I-cholesterol - hhayi ngaphezu kuka-5.2 mmol / l;
- I-hemoglobin ye-Glycated - isuka ku-6 yaya ku-6.5%;
- Ukuhlushwa ushukela emahoreni amabili ngemuva kokudla ngakunye - kusuka ku-7.5 kuye ku-8 mmol / l;
- IGlycemia ngesikhathi sokulala - kusuka ku-6.0 kuya ku-7.0 mmol / L.
Ngokuya izinkomba, amazinga wesinxephezelo nawo anqunywa.
Amazinga weSinxephezelo sohlobo 1 nesifo sikashukela sohlobo 2
Amanqanaba wesinxephezelo angubufakazi obuthembeke kakhulu bokuthi ukuphumelela kangakanani ukwelashwa sikashukela. Uma isinxephezelo, ukuqhubeka okuhle kwento efana ne-metabolic syndrome kuyema.
Kulabo abahlushwa isifo sohlobo 1, lokhu kusho ukungabikho kwezinkinga ezingathandeki njengokuhluleka kwe-renal kanye ne-retinopathy yesifo sikashukela. Ngokwesifo sikashukela sohlobo 2, ukufakwa kwe-myocardial cishe kukhishwe ngaphandle.
Njengoba kunesifo sikashukela esilinganiselwe sanoma yiluphi uhlobo, noma, ngamanye amazwi, isinxephezelo esiyingcosana, ubungozi bokukhula kwe-pathologies yesistimu yethambo lokuphefumula busephezulu.
I-mellitus yeswekile ebolile ivame ukudala ukungqamana okufana nokuqina kwe-hyperglycemia. Kulokhu, izinga loshukela wegazi lingahlala liphezulu ngokweqile isikhathi eside.
I-glucose, egcwele kakhulu egazini, ingena ekushintsheni kwamakhemikhali nezinye izinto.
Ukubhujiswa kancane kancane kwemikhumbi emincane nama-capillaries kuqala ngaphansi kwethonya lalokhu kuphendula. Ngenxa yalokhu, kuthinteka izitho eziningi zomzimba, ikakhulukazi amehlo nezinso.
Izindlela Zokulingana Zokubuyisana
Ku-mellitus yesifo sikashukela, kuyadingeka ukuthi ngaso sonke isikhathi kwenziwe izivivinyo ukuze ube nombono ocacile wokuthi lisebenza kangakanani amaqhinga wokulapha akhethiwe. Imihlahlandlela yokuthola inani lesinxephezelo yilezi zinkomba ezilandelayo ezilandelayo:
- umchamo we-acetone;
- ushukela kumchamo nasegazini;
- i-glycated hemoglobin;
- iphrofayili ye-lipid;
- fructosamine.
Ezinye zazo zikufanele ukubhekwa ngemininingwane eminingi.
IGlycated Hemoglobin
IHemoglobin iprotheni, isakhi esibalulekile segazi, umsebenzi oyinhloko okuwukuhambisa umoya-mpilo kumaseli wezicubu. Isici saso esiyingqayizivele nokuhlukile kuyikhono lokuthwebula ama-molecule we-oksijini bese uwahambisa.
Kepha ngendlela efanayo, i-hemoglobin nayo ingabamba ama-molecule eglucose. Isakhi - i-glucose + hemoglobin - ibizwa nge-glycated hemoglobin. Ihluka ngeskhathi eside kakhulu sokubakhona: hhayi amahora, hhayi izinsuku, kepha izinyanga eziphelele.
Ngakho-ke, ngokulandela izinga le-hemoglobin ye-glycated egazini, kungenzeka ukuthi kumiselwe isilinganiso esiphakeme seglucose egazini ezinyangeni ezimbili ezedlule futhi ngaleyo ndlela kulandelwe amandla esifo. Kungakho le nkomba ibaluleke kakhulu uma ufuna ukunquma izinga lesinxephezelo esigulini esinohlobo 1 noma isifo sikashukela 2.
Ukuze kutholakale ukuqoqwa kwe-hemoglobin ye-glycated egazini, kusetshenziswa izindlela ezimbili:
- Indlela ye-immunochemical;
- Ion I-chromatography eshintshwayo.
Ekuhlaziyeni kokuqala, izinga le-hemoglobin ye-glycated emzimbeni onempilo lisuka ku-4,5 liye ku-7.5%. Ekuhlaziyeni kwesibili, i-4.5-5.7%. Uma isinxephezelo esihle siphawulwa, inkomba yalolu hlobo lwe-hemoglobin ku-diabetesics yi-6-9%. Kusho ukuthini uma, ngokwemiphumela yokuhlaziya, i-hemoglobin ye-glycated idlula amanani abonisiwe?
Lokhu kuphakamisa ukuthi amaqhinga wokulapha akhethwe ngokungalungile, ukuthi ushukela wegazi lesiguli usephezulu kakhulu, futhi uba nesifo sikashukela esibolile. Isizathu kungaba:
- Ukwehluleka ukuhambisana nohlelo lokufakwa kwemijovo ye-insulin noma umthamo onganele wesidakamizwa;
- Ukuphazamiseka ekudleni;
- Ukuntuleka kokuzivocavoca umzimba;
- Ukungawunaki umuthi kadokotela.
Njengoba ukuhlanganiswa kwe-hemoglobin ne-glucose kuhlala egazini isikhathi eside kakhulu, ukuhlaziya kabusha kwenziwa emavikini ambalwa ngemuva kokulungiswa kwonyango.
I-Fructosamine
Lesi yisinkomba esilandelayo esibaluleke kakhulu esetshenziswa ukuthola inani lesinxephezelo sikashukela sanoma yiluphi uhlobo. Le nto yenziwa ngokubopha amaprotheni e-plasma ku-glucose. Uma inani le-plasma le-fructosamine lenyuswa, lokhu kukhombisa ukuthi emasontweni asanda kwedlula izinga likashukela wegazi lidlule okwejwayelekile.
Okusho ukuthi, izinkomba zokuqukethwe kwe-fructosamine zisiza hhayi kuphela ukuhlola kahle isimo sesiguli sohlobo 1 noma isifo sikashukela sesi-2, kodwa futhi nokuthola umbono wenkambo yesifo.
Iqoqo elijwayelekile le-fructosamine egazini alikho ngaphezu kwama-285 μmol / l. Kulokhu, isiguli singathokoziswa - uthole isinxephezelo esihle ngalesi sifo.
Uma inkomba iphezulu, singakhuluma ngokwakhiwa kwesifo sikashukela esilinganiselwe noma esibolile. Kuyafaneleka ukukhumbula ubungozi obukhulu bokubekeka phansi kwe-myocardial infarction kanye nezinye izifo zesistimu yezinhliziyo.
I-Lipidogram
Le nkomba ayibalulekanga kangako, kodwa futhi isetshenziselwa ukunquma inani lesinxephezelo ngalesi sifo. Ibonisa inani lama-lipids (amafutha) ezingxenyeni zegazi ezihlukile. Lapho unikeza ukuhlaziywa, ifomu ngokuvamile libonisa ukuphawula kukadokotela. Ekuhlaziyweni, kusetshenziswa indlela ye-colometric Photometric. Amayunithi angamamilimitha ngelitha.
Ukuze wenze lolu hlobo lokuhlaziywa, isampula yegazi ithathwa emthanjeni. Ngaphambi kwalokhu awukwazi:
- Yidla amahora ayi-12;
- Ukubhema;
- Yiba novalo nengcindezi.
Uma lezi zidingo zingafinyelelwanga, kungcono ukuhlehlisa ukuhlaziywa. Lokhu kuhlola kuzonquma izinkomba ezinjenge-cholesterol ephelele, i-triglycerides, i-atherogenic coefficient and high, low and low density lipids.
Uma amanani avumelekile edlulwa, ubungozi bezifo ezinjenge-atherosclerosis, infarction ye-myocardial, unhlangothi, kanye nokungasebenzi kwengqondo kukhuphuka.
Ushukela kumchamo nasegazini
Ukuqashwa njalo kwe-glucose kumchamo nasegazini, kanye ne-acetone kumchamo, kuyimfuneko yokwelashwa okuphumelelayo. Ushukela wegazi ungalinganiswa ekhaya usebenzisa ithuluzi elikhethekile, udinga ukukwenza lokhu okungenani izikhathi ezi-5 ngosuku.
Uma lokhu kungenzeki, kuzodingeka uthathe izilinganiso okungenani kabili ngosuku: ngokushesha ngemuva kokuvuka ekuseni, esiswini esingenalutho, ngaphambi kokudla, nangaphambi kokulala, ngemuva kwesidlo sakusihlwa.
Noma ngabe kungenzeka ukufezekisa i-mellitus yesinxephezelo, kuyanconywa ukuthi uqhubeke ngokuhambela njalo ochwepheshe abanjengochwepheshe wezinhliziyo, udokotela wamazinyo, udokotela wamazinyo, uchwepheshe wezifo ezithathelwanayo ukuze ahlolwe.
