Isifo sikashukela sohlobo 2 yisifo esincike ku-insulin lapho izicubu zilahlekelwa umuzwa wazo nge-insulin ye-hormone. Isidingo sokuthuthuka kwalesi sifo ukunqwabelana kwama-lipid ngaphezulu kwama-cell receptors. Lesi simo senza kube nzima ukwengeza ushukela.
Le nqubo ye-pathological ibangela ukukhiqizwa okwandayo kwe-insulin kumanyikwe. Uma isifo sikashukela sohlobo lokuqala singafaki ukwethulwa kwe-hormone, khona-ke kulesi simo kumane kungenzeki ngaphandle kwawo.
I-World Health Organisation icacisa ukuthi lesi sifo sitholakala ngokulinganayo kuwo wonke amazwe omhlaba. Kuze kube muva nje, isifo sikashukela besithathwa njengenkinga yabantu asebekhulile, kepha kuze kube manje, isithombe sesishintshe kakhulu.
Ngokwezibalo zezokwelapha, isifo sikashukela isimo sesithathu ngobukhulu esidala ukufa. Lokhu kugula bekungokwesibili kuphela kwi-oncology kanye nezifo zenhliziyo. Emazweni amaningi, ukulawulwa kwezifo kwenzeka ezingeni lombuso.
Izici zohlobo 2 sikashukela
Lolu hlobo lwesifo sikashukela lubheka lezo zinkinga zempilo ezihlala nomuntu impilo yonke. Isayensi yanamuhla ayikafundi ukuthi ungayiqeda kanjani ngempumelelo le nkinga eyingozi. Ngaphezu kwalokho, kunamathuba amaningi aphezulu we-microangiopathy, okuvusa izinkinga ngombono, kanye nezinso zomuntu ogulayo.
Uma ubheka ushukela wegazi ngokuhlelekile nangokuhlelekile, kungenzeka ukuthi ulawule izinguquko ezahlukahlukene ezinolaka emikhunjini:
- fragility;
- imvume eyedlulele;
- ukushayeka kwegazi.
Ngokulashwa okufanele, izinguquko ze-ischemic nezifo ze-cerebrovascular zingancishiswa kaningana.
Umgomo oyinhloko wokwelapha ukunxephezela ukungalingani kwe-carbohydrate metabolism, hhayi kuphela lapho kunezinkinga nge-glucose, kepha futhi nokuvela okuvela eceleni kohlangothi lwe-metabolism.
Ngokuhamba kwesikhathi, lezo zinguquko ziba yimfuneko yokwehla okuqhubekayo kwesisindo samaseli e-beta akhiqizwa ama-pancreas.
I-Hypoglycemia yisimo esiyingozi kakhulu kwisifo sikashukela esidala. Uma, ngohlobo lokuqala lokugula, ukubuyiselwa kokungalingani ekukhiqizweni kwe-insulin kuzoholela ekubhekeni isikhathi eside kwezinga loshukela, bese kuthi ngohlobo lwesibili lwe-pathology, ukwelashwa kube yinkimbinkimbi futhi kube yinde.
Ukwelashwa kwezidakamizwa
Ezimweni lapho i-monotherapy ngendlela yokulandela ukudla okuqinile kunganikeli umphumela olindelekile, kuyadingeka ukuxhumana nemithi ekhethekile eyehlisa izinga likashukela egazini. Eminye yemithi yesimanje kakhulu engabekwa udokotela wakho kuphela ngeke ikhiphe ukusetshenziswa kwe-carbohydrate. Lokhu kwenza ukuthi sikwazi ukunciphisa izimo ze-hypoglycemic.
Ukuzikhethela kwalo muthi kuzokwenziwa kucatshangelwa zonke izici zesiguli, kanye nomlando wakhe wezokwelapha. Ukuzikhetha kwezidakamizwa okusekelwe ekuncomeni kwezinye iziguli ezinesifo sikashukela kuyindlela yokungahloniphi ngokweqile!
Lokhu kungadala umonakalo omkhulu empilweni yeziguli noma kudale nokufa isifo sikashukela.
Izindlela ezisetshenziselwa ukwelashwa ziyahlukaniswa ngesikhathi sokukhulelwa nokuqunjelwa.
Kunezizukulwane eziningana zemithi yokulwa nesifo sikashukela somlomo:
Isizukulwane sokuqala:
- I-Tolbutamide (butamide). Thatha i-500-3000 mg / ngosuku ngemithamo engu-2-3;
- I-Tolazamide (Tolinase). I-100-1000 mg / usuku lwemithamo ye-1-2;
- IChlorpropamide. Ku-100-500 mg / ngosuku kanye.
Isizukulwane II:
- INateglinide (glibenclamide). Thatha i-1.25-20 mg / ingqangi. Kungaba imithamo engu-1-2;
- I-Glipizide. I-2,5-40 mg / ngosuku yemithamo engu-1-2.
Azikho ezinye izidakamizwa ezingekho emthethweni ezisebenzayo zokwelapha uhlobo lwesibili sikashukela:
- I-Metformin. Thatha i-500-850 mg / ngosuku (imithamo engu-2-3). Lo muthi ungabekwa ukukhulisa izinga lokusebenza kahle noma ukunqoba ukumelana ne-insulin. Kuphikisiwe nethuba eliphezulu lokuhlakulela i-lactic acidosis, ukwehluleka kwezinso. Ngaphezu kwalokho, iMetformin akufanele isetshenziswe ngemuva kwama-radiopaque agents, ukusebenza, ukufakwa kwe-myocardial, ngokuvuvukala kwepancreatic, utshwala, izinkinga zenhliziyo kanye ne-tetracyclines;
- I-Acarbose. Ku-25-100 mg / ngosuku (imithamo emi-3). Umuthi udliwa ekuqaleni kokudla. Lokhu kwenza ukuthi kuvikeleke i-hyperglycemia ukukhula ngemuva kokudla. Umuthi ubekelwa ukwehluleka kwezinso, izinqubo zokuvuvukala emathunjini, i-ulcerative colitis kanye nokuvinjwa okuyingxenye kwalesi sitho.
Umkhuba wamazwe omhlaba wokuqeda uhlobo lwesibili sikashukela
Kunobufakazi obufakazelwe bokuthi ukulawula ushukela wegazi kungasiza ekwehliseni amathuba okuba nesifo sikashukela. Kulokhu, kwenziwa amaqhinga wokuphatha isifo sikashukela, esihlinzeka ngezigaba ezi-4:
- ukudla okuphansi kwe-carbohydrate
- ukusebenza komzimba ngokuya ngezinqubo ezibekiwe zokwelashwa;
- imithi;
- imijovo ye-hormonal, kepha kuphela uma kunesidingo.
Isinxephezelo sama-carbohydrate kumele senziwe kucatshangelwa izinga lesifo (i-Chronicle, exacerbation, remission). Uhlobo lwe-cyclic yesifo sikashukela lubandakanya ukusetshenziswa kwezidakamizwa, kucatshangelwa le nqubo futhi kube nezingoma zemihla ngemihla ezijikelezayo zokukhiqiza i-insulin.
Ngenxa yokudla okune-carb ephansi, ushukela ungancishiswa futhi uvunyelwe. Ezigabeni ezilandelayo, i-glycemia ibhekwa njalo. Uma umuthi unganele ngokwanele ukugcina ushukela ngokwanele, khona-ke kunconywa ukwelashwa okuyisidakamizwa okukhethekile koshukela. Kuzosiza ukususa ama-carbohydrate amaningi emzimbeni, futhi uzosebenza njengohlobo lokwelashwa.
Kwezinye izimo, amazinga wekulawulwa kwesifo sikashukela kuphela angabekwa. Amacwecwe ohlobo lwe-2 yesifo sikashukela ngendlela yamathebulethi angavezwa kuphela uma inkambo yesifo ingalawulwa, kanye nokwanda kwe-glycemia. Kwezinye izimo, kungenziwa imijovo ye-insulin eyengeziwe. Lokhu kuyadingeka ukuletha i-glucose emazingeni ajwayelekile.
Ukudla okungenamsoco kwesifo sikashukela sohlobo 2
Ukwelashwa kwalesi sifo kufanele kuqala ngokudla okwanele, okuhlala kusekelwe kule migomo:
- ukondleka okuyisicucu okungenani izikhathi ezi-6 ngosuku. Kuhle kakhulu ukudla nsuku zonke ngasikhathi sinye;
- okuqukethwe kwekhalori akunakwedlula i-1800 kcal;
- ukulungiswa kwesisindo okweqile esigulini;
- ukunciphisa inani lamafutha e-saturated aqediwe;
- ukunciphisa usawoti kokudla;
- ukunciphisa utshwala;
- ukudla ukudla ngamaphesenti aphezulu wezinto ezilandelwayo namavithamini.
Uma kunokuwohloka kokudla kwamafutha ngokumelene nesizinda se-glycemia esekhulile, khona-ke lokhu kuba yisidingo sokuqhekeka kwegazi emithanjeni. Umsebenzi we-fibrinolytic wegazi lomuntu kanye nobungako bokubonakala kwawo kungathinta izinga lamaplatelet, kanye ne-fibrinogen - lezo zinto ezibangela ukuqina kwegazi.
Ama-carbohydrate awakwazi ukususwa ngokuphelele ekudleni, ngoba yiwo abaluleke kakhulu ekugcwaliseni amaseli womzimba ngamandla. Uma kunokushoda kwalo, khona-ke amandla nokuvama kwezinkomba enhliziyweni kanye nemisipha ebushelelezi yemikhumbi kungenzeka kukhubazeke.
Ukuzivocavoca umzimba
Ngokuphikisana nesizinda sesifo sikashukela sohlobo lwesibili, ukuzivocavoca okuhlukahlukene komzimba kungafakwa ngempumelelo ukuze kusize ukubhekana kangcono nalesi sifo, futhi lokhu kuyindlela yokwelashwa ehambisana. Kungaba:
- ukubhukuda;
- ukuhamba;
- ukugibela ibhayisekili.
Ukuzivocavoca kwezokwelapha kunikeza umphumela omuhle, ukunciphisa ushukela wegazi, noma kunjalo, lo mphumela uhlala isikhathi esifushane. Isikhathi kanye nohlobo lomthwalo kufanele kukhethwe ngokuqinile kumuntu ngamunye onesifo sikashukela.
Imfundo yomzimba isetha esimweni esihle sokomzwelo futhi yenza sikwazi ukubhekana kangcono nezimo ezicindezelayo. Iphinde futhi ikhuphule izinga lama- endorphin - lawo mahomoni abhekene nobumnandi, futhi futhi andise ukuqina kwe-testosterone (i-hormone yabesilisa enkulu).
Ukuzivocavoca neminye imisebenzi engokomzimba kunganciphisa ushukela kulezo zimo lapho izinga lazo lokuqala seliseduze kuka-14 mmol / l. Uma ngabe le nkomba ingaphezulu, khona-ke umthwalo ulethwe ngokuqinile. Ngaphandle kwalokho, kungahle kube nokwenyuka kokukhuphuka kweglucose nokukhuphuka kwe-ketogeneis (ukucubungulwa kwayo). Ngaphezu kwalokho, imfundo yenyama ayikwazi ukuboniswa ushukela ongaphansi kuka-5 mmol / L. Ungafunda kabanzi mayelana nokuzivocavoca komzimba kusuka kumbhalo wethu - ezemidlalo kushukela.
Ukwelashwa kanjani?
Kusungulwe ngomuthi ukuthi i-glycosylated hemoglobin ibe umaka wokulawula wohlobo 2 sikashukela mellitus. Iphuzu lokuyinkomba lithathwa njengokuqoqwa kwale nto ebalulekile, ezolingana namaphesenti ayi-7.
Uma ngabe le nkomba yehla yaya kumaphesenti ama-6, khona-ke kulokhu kuba yisibonakaliso sokuqala ukuqeda lesi sifo. Kwezinye izimo, lokhu kugxila kungabhekwa njengokujwayelekile.
Ekuqaleni kwesifo sikashukela i-mellitus, kungenzeka ukuguqula isimo sesiguli ngosizo lokudla okunempilo nokuzivocavoca komzimba. Ukwehla kwesisindo esikhulu kwenza ukuthi i-glycemia ihlolwe. Uma lokhu akwanele, khona-ke ukuxhumana kwezidakamizwa kuyadingeka.
Ochwepheshe batusa ukusetshenziswa kwe-metformin esigabeni sokuqala. Leli thuluzi lisiza ukulawula ngokunembile ushukela wegazi. Uma kungekho okuphambana okubalulekile, khona-ke izidakamizwa ezinjalo zingaxhunywa:
- ama-biguanides. Le makhambi esifo sikashukela anomlando omuhle. Ngenxa yokungahle kwe-acidosis ngemuva kwesizinda se-lactic acid esikhona namazinga aphezulu kashukela, ukusetshenziswa kwama-Biguanides eminyakeni engama-20 kamuva kwenze ukuthi iziguli zigcine ushukela wegazi wazo ezingeni elamukelekayo. Ngokuhamba kwesikhathi, i-buformin ne-phenformin ngokutholakala kwayo kukhishwe ngaphandle kwirejimeni yokwelashwa;
- amalungiselelo e-sulfonylurea. Leli qembu lezidakamizwa libhekele ukwenziwa kwe-insulin kumanyikwe. Into enjalo ibalulekile ukuthuthukisa ukuthathwa koshukela. Ukwelashwa kohlobo lwesibili lwesifo ngamalungiselelo we-sulfonylurea kumele kuqalwe ngemithamo emincane. Uma isiguli sikhuphule ubuthi be-glucose, khona-ke isikhathi ngasinye umthamo wento ephathisiwe kufanele ukhiqizwe ngaphansi kokulawulwa kwe-glucose;
- glitazones (thiazolidinediones). Lezi zidakamizwa ziyisigaba sabamele i-hypoglycemic agents. Basiza ukukhulisa ukwanda kwamaseli. Yonke inqubo yokusebenza ukuthi ukubonakaliswa kwezinhlobo eziningi zezomzimba ezibhekene nokulawula inqubo yokucubungula ushukela namafutha acid kukhuphukile;
- glinids (abalawuli be-prandial). Izidakamizwa ezinjalo zehlisa ushukela wegazi. Isenzo sabo ukumisa iziteshi ezibucayi ze-ATP. Leli qembu lezidakamizwa lifaka i-nateglinide, kanye ne-repaglinide;
- i-alpha glucosidase inhibitors ingancintisana nama-carbohydrate. Benza inqwaba yama-enzyme wamathumbu futhi babandakanyeka ekuqhekekeni kweshukela. Ezimweni zokwelapha ezifuywayo, kusetshenziswa i-acarbose yezidakamizwa.
Kubantu abanesifo sikashukela sohlobo 2, kubalulekile ukulawula amazinga kashukela wegazi futhi kungenxa yalokhu ukuthi noma yikuphi ukwelashwa kufanele kuqalwe. Lokhu, isiguli ngasinye kufanele sibe neglucometer yaso, ngaphandle kwalokho ukwelashwa kuyinkimbinkimbi. Ukugcina ukugxila kwe-glucose kulawulwa kubaluleke kakhulu uma nje kunezifo zenhliziyo ezihlanganiswa nokushesha kakhulu kokunciphisa kwayo nomfutho wegazi ophakeme.
Yikuphi ukwelashwa kokuthathwa kokukhubazeka kwe-glucose?
Ukwelashwa okuhloswe ukuqeda i-malabsorption ye-glucose kufanele kube ngempumelelo. Zonke izici ze-pathophicalological zalesi sifo zenza kube nokwenzeka ukugcina amazinga okuhlosiwe glycemia.
Ucwaningo lwezokwelapha, okuhloswe ngalo ukubheka ukusebenza kwe-insulin therapy ezigulini ezinesifo sikashukela sohlobo lwe-2, luveze ukuthi ngokugxila kakhulu koshukela akunakwenzeka ukuwenza ngendlela ejwayelekile ngemithi yomlomo ngaso sonke isikhathi.
Lapho uthatha isinqumo ngezindlela zokwelapha, kubalulekile ukuqonda ukuthi kuzodingeka ususe lesi sifo isikhathi eside ngokwanele. Uma sikhuluma ngokwelashwa okuhlanganisiwe, khona-ke kungenziwa kuyo yonke impilo yesiguli esinjalo.
Ucwaningo luye lwabonisa ukuthi ngokuhamba kwesikhathi, isifo sikashukela siyaqhubeka kuphela. Ukukhuphula i-pathologies kuqala, okubandakanya ukwelashwa ngezinye izindlela kunalezo eziboniswe ngaphezulu.
Thayipha isifo sikashukela esingu-2 esigulini ngasinye. Uma esigulini esisodwa ngisho nangemva kweminyaka eyi-10 ngeke kube nomonakalo odongeni lwemikhumbi, khona-ke kwesinye isiguli esigulisayo semikhawulo engezansi kungaqala ngokushesha ngesifo sikashukela.
Uma lesi sifo siqhubeka njalo, khona-ke lokhu akufanele kushiywe ngaphandle kokunakwa nokulawulwa kwe-glycosylated hemoglobin. Uma kwenzeka noma ukuncipha kwawo okungenalutho, khona-ke kuleli cala izidakamizwa ezinamaphawu noma i-insulin therapy.
Ngokwezibalo, ukuqeda i-pathology, kuyadingeka ukukhulisa umthamo womuthi njalo ngonyaka olandelayo wesifo. Ukusebenza okujwayelekile kwamaseli we-pancreatic beta kuzokonakala njalo ngamaphesenti ama-5. Kulabo abathembele kwi-insulin, ukusebenza kuzoncipha kakhulu.
Akuyona indima encane ekwelashweni ezodlalwa ngokuthi isiguli sihambisana kanjani nezincomo nemiyalelo kadokotela wakhe owelashayo, kanye nokulawula ushukela wegazi nokusetshenziswa kwezidakamizwa. Abanye abakhiqizi bangakhiqiza amalungiselelo okuhlanganisa, aqukethe izakhi eziningana zomsebenzi ophezulu.
Ekuphetheni, kufanele kuphawulwe ukuthi:
- lapho uqeda isifo sikashukela sohlobo lwesibili, kuyadingeka ukubheka njalo i-glycemia;
- uma isigaba sesifo sesiqala, khona-ke inqwaba yeziguli izokwazi ukubhekana nalesi sifo ngokudla okuphansi kwe-carb kanye nokuzivocavoca ngokomzimba;
- uma amaphuzu okuqala engasebenzi, khona-ke imithi ixhumekile;
- ukwelashwa kwe-insulin kungabekwa;
- uma kwenzeka kuvela izimpawu ezingejwayelekile, amalungiselelo okuhlanganisa kufanele asetshenziswe.
Akumele sikhohlwe ukuthi imininingwane enikeziwe yenzelwe ulwazi futhi ayikwazi ukuba yimfuneko yokuzibusa kwezidakamizwa. Ngenxa yokuthola okukhulu kwezinkinga, kubalulekile ukufuna usizo kudokotela kuphela.
