Imithi isesigabeni sesithathu ekwelashweni kwesifo sikashukela sohlobo 2. Izigaba ezimbili zokuqala zisho ukudla okuphansi kwe-carb kanye nokuzivocavoca umzimba. Lapho zingasakwazi ukubhekana nakho, kuyasetshenziswa amaphilisi.
Kepha kwenzeka ukuthi amaphilisi awasebenzi, kulokhu, isiguli sinqunywe imijovo ye-insulin. Ake sixoxe kabanzi mayelana nokuthi uluphi uhlu lwemithi olunganikezwa namuhla kwabanesifo sikashukela.
Amaqembu Ezidakamizwa Zesifo Sikashukela
Ngokwesenzo sabo, izidakamizwa zesifo sikashukela zihlukaniswe ngamaqembu amabili:
- Izidakamizwa ezikhulisa ukuzwela kwamangqamuzana kuyi-insulin ye-hormone.
- Izinto zokwelapha ezivuselela ama-pancreas ukwandisa inani lokukhiqizwa kwe-insulin.
Kusukela maphakathi nawo-2000s, sekukhishwe izidakamizwa ezintsha zesifo sikashukela, ezibandakanya izidakamizwa ezinemiphumela ehlukile, ngakho-ke ngandlela-thile akunakwenzeka ukubahlanganisa. Ngenkathi lawa ngamaqembu amabili izidakamizwa ezinomsebenzi we-incretin, kepha, ngokweqiniso, amanye azovela ngokuhamba kwesikhathi.
Kukhona futhi amaphilisi anjenge-acarbose (glucobai), avimba ukumuncwa kwe-glucose emgodini wokugaya ukudla, kepha kuvame ukudala ukukhuphuka kokugaya ukudla. Kepha uma isiguli silandela ukudla okuphansi kwe-carb, khona-ke isidingo salomuthi siyanyamalala.
Uma isiguli singakwazi ukubhekana nokuhlaselwa yindlala futhi singakwazi ukulandela ukudla okune-carb ephansi, kufanele siphuze imishanguzo yesifo sikashukela, ongalawula ngaso isifiso sakho sokudla. Kusuka ku-glucobaia, umphumela okhethekile awubonwa, ngakho-ke, ingxoxo yayo eyengeziwe ayinangqondo. Ngezansi uhlu lwamaphilisi.
Amaphilisi kashukela
Maninil
Lawa maphilisi esifo sikashukela aziwa kakhulu namuhla, avusa amanyikwe ngamaseli we-beta.
Isifo sikashukela
Njengomuthi owedlule, uvuselela ama-pancreas ngamaseli e-beta, kepha aphansi kokuqala ngamandla. Kodwa-ke, isifo sikashukela sikhuthaza ukwanda okungokwemvelo kwe-insulin yegazi.
I-Glurenorm
Lesi sidakamizwa sikashukela sisetshenziswa yiziguli ezinenkinga yezinso noma ezinye izifo ezihlangene.
Amaril
Umuthi ungowesizukulwane esisha sezidakamizwa. Umphumela wayo uhlotshaniswa nokukhuthaza ukukhishwa kwe-insulin ye-hormone kusuka kumaseli we-beta gland. I-Amaryl isetshenziswa kaningi ngokuhlanganiswa ne-insulin.
Kusho ukuthini ukwelashwa nge-insulin?
I-Diabetes mellitus uhlobo 1 no-2 lubhekisa ezifweni ezinesifo se-metabolic, ngakho-ke umphumela wezidakamizwa, okokuqala, kufanele uhlose ukuletha izinqubo ze-metabolic zomzimba zibe ezijwayelekile.
Ngenxa yokuthi imbangela yesifo sikashukela sohlobo 1 ukufa kwamaseli we-beta akhiqiza i-insulin, leli hormone kufanele liphathwe ngaphandle. Ukugeleza kwe-insulin emzimbeni kungaqinisekiswa ngomjovo noma ngokubuyela kumpompo ye-insulin. Ngesifo sikashukela esincike ku-insulin, ngeshwa, ayikho enye indlela yokwelashwa kwe-insulin.
Ukwelashwa kwesifo sikashukela sohlobo 2, odokotela banquma izidakamizwa ezahlukahlukene ezisiza ukwehlisa ushukela wegazi. Asikho isidingo sokuthatha i-insulin kuleli qembu labanesifo sikashukela.
Thayipha imithi yesifo sikashukela sesi-2
Imithi yesifo sikashukela sohlobo 2 ingahlukaniswa ngezigaba eziningana. Yize kudingekile ngokushesha ukwenza ukubhuka ukuthi alikho ikhambi eliphelele lesifo sikashukela. Ngezindlela eziningi, impumelelo yokwelashwa kwesifo sikashukela ixhomeke:
- kusuka ekuzimiseleni kwesiguli ukulwa nenkani isifo;
- kusuka kwendlela yeziguli.
Uma ukuvivinya umzimba nokudla kungakhange kube nemiphumela emihle, uchwepheshe unquma izidakamizwa zesifo sikashukela, ezihlukaniswe ngezigaba eziningana. Udokotela angabeka umuthi owodwa noma inhlanganisela yezidakamizwa ezinamakilasi ehlukene.
Esikhathini sokuqala kwesifo sikashukela, i-a-glucosidase inhibitors isebenza kakhulu, isiza ukunciphisa ukumuncwa kwe-glucose yamathumbu. Ama-Derivatives we-sulfonylureas anqunyelwe, njengomthetho, lapho kuba nesidingo sokuvuselela ukucasulwa kwe-insulin ngamaseli e-beta.
Kepha le mishanguzo inezinto eziningi eziphikisana, ezibandakanya:
- ukusebenza kwesisu;
- i-pancreaticabetes mellitus noma uhlobo 1 sikashukela;
- ukukhulelwa nokuqunjelwa;
- ukulimala
- izifo ezithathelwanayo;
- zonke izinhlobo zokubonakaliswa komzimba.
Uma igazi lesiguli licebile ngokwanele ku-insulin, i-endocrinologist inganikeza isiguli neqembu elikhuluuanide. Le mishanguzo yesifo sikashukela ayikhuthazi ukukhiqizwa kwe-insulin, kepha yandisa umphumela wayo kwezicubu ezithambile.
AmaBiguanides anciphisa ukukhiqizwa koshukela isibindi, ukumuncwa kwawo ngamathumbu, isifiso sokudla. Kepha lapho ubamisa, kufanele kubhekwe imibiko eminingi ehlukene:
- isimo se-hypoxia;
- umsebenzi wezinso ongonakalisiwe;
- ubunzima bezinkinga zesifo sikashukela, njll.
Ukusetshenziswa kwezithako zokudla zesifo sikashukela sohlobo 2
Ukuthatha amaphilisi anciphisa ushukela wegazi kushukela akunakugwenywa. Ngakho-ke, isiguli kuzofanela sivumelane neqiniso lokuthi ukusebenzisa nsuku zonke izidakamizwa konakalisa isisu, isibindi kanye negazi.
Kepha noma kunjalo kunethuba lokulungisa umthamo wamakhemikhali we-antidiabetic, uma uphathisa umsebenzi wokunciphisa ushukela ngezindlela zemvelo. Lokhu, yiqiniso, elikhathazayo ngohlobo 2 sikashukela esinga-insulin. Lapha kuyadingeka ukusebenzisa i-TC yegazi likashukela egazini, ngokwesibonelo.
Ezimweni eziningi, udokotela angakwazi ukwengeza ukwelashwa ngokudla ngokuthatha izithasiselo zokudla (izithasiselo zokudla), ezisiza ukwehlisa izinga le-glucose egazini. Labo ababheka ukuthi izithasiselo zokudla njengekhambi lesifo sikashukela banephutha.
Njengoba kushiwo ngenhla, okwamanje alikho iphesenti elilodwa lekhambi lalesi sifo. Noma kunjalo, izithasiselo zokudla zinezakhi zemvelo kuphela, lapho ekwelashweni okunesifo sikashukela sohlobo 2 kunomphumela obonakalayo kakhulu.
Isibonelo, i- "Insulin" iyisengezo sokudla, oku:
- Yehlisa ukugcwala kweglucose egazini ngokunciphisa ukumuncwa kwamathumbu.
- Kuthuthukisa izinqubo ze-metabolic.
- Kukhuthaza ukufihla kwe-pancreatic.
- Isiza ukunciphisa isisindo futhi iguqule izinqubo ze-metabolic.
Izithasiselo zingabekwa njengesidakamizwa esisodwa ukuvimbela isifo sikashukela sohlobo 2, futhi singaba yingxenye yokwakheka kwezinqubo zokwelapha. Ngokusetshenziswa isikhathi eside kwe "Insulin" ezigulini kukhona ukwehla okuzinzile kwenkomba ye-glycemic.
Ngokulandela ngqo isengezo sokudla kanye nohlobo lokudla, amathuba ezinga likashukela wegazi asondela kwizinkomba ezingelona isifo sikashukela ayanda.
Izinga likashukela elifanele
| Esiswini esingenalutho | 5.0-6.0 mmol / L. |
| 2 amahora emva kokudla | 7.5-8.0 mmol / L. |
| Ngaphambi kokulala | 6.0-7.0 mmol / L. |
Isidingo semijovo ye-insulin
Imvamisa, uma okuhlangenwe nakho kwesifo sikashukela kudlula iminyaka engama-5 ukuya kwengama-10, ukudla kanye nokuphuza imithi sekuvele akwanele. Kukhona ukwelashwa kwe-insulin okuhlala njalo noma okwesikhashana. Kepha udokotela angayinikeza i-insulin kusenesikhathi uma ezinye izindlela zingakwazi ukulungisa izinga likhuphuka egazini.
I-insulin, njengendlela yokwelapha isifo sikashukela sohlobo 2, ngaphambili yabonwa njengendawo yokugcina. Namuhla, odokotela banamathela komunye umbono ohlukile.
Phambilini, iningi leziguli ezazi ukudla imishanguzo ezinesifo sikashukela zazinezinkomba eziphakeme ze-glycemic isikhathi eside, ezazibeka ingozi enkulu empilweni, futhi ngesikhathi sokuphathwa kwe-insulin, iziguli zase zinenkinga enkulu yesifo sikashukela.
Umkhuba wanamuhla wokwelapha isifo sikashukela ukhombisile ukuthi i-insulin ingenye yezidakamizwa ezisiza ukwehlisa ushukela. Umehluko wayo kumathebhulethi usendleleni yokuphatha (umjovo) kuphela kanye nentengo ephezulu.
Phakathi kweziguli ezinesifo sikashukela sohlobo 2, ama-30- 40% eziguli adinga ukwelashwa kwe-insulin. Kungakanani futhi kungakanani ukuqala kokusebenza kwe-insulin, yi-endocrinologist kuphela enganquma, ngoba konke kuncike ebuntwini bomzimba.
Ngingaphila impilo ephelele yesifo sikashukela?
Namuhla, umuntu onesifo sikashukela unamathuba onke okuvimbela ukuthuthukiswa kwezinkinga ezahlukahlukene futhi alondoloze impilo ephezulu. Iziguli zikhona izidakamizwa ezitholakalayo zemvelaphi yokwenziwa neyamakhambi, ukulungiswa kwe-insulin, ukuzithiba nezindlela ezahlukahlukene zokuphatha.
Ngaphezu kwalokho, kuvulwe "izikole zesifo sikashukela", ezifundisa abantu abanesifo sikashukela nemindeni yabo. Lo msebenzi uhlose ukuqinisekisa ukuthi isiguli sazi okuningi ngangokunokwenzeka ngokugula kwakhe futhi sikwazi ukubhekana naso sodwa, ngenkathi silondolozela injabulo yempilo ejwayelekile.
Inkinga enkulu evimba izindlela zokunciphisa ushukela amathuba okuba ne-hypoglycemia. Ngakho-ke, kwezinye iziguli kunconywa ukuthi kugcinwe i-glycemia isezingeni eliphakeme, kuze kufike ku-11 mmol / l phakathi nosuku. Lokhu kuqapha kuzosiza ukuvikela ushukela omningi ukuba ungawi.
Ezimweni eziningi, ukwesaba kwe-hypoglycemia kuhaba futhi akunasisekelo, kepha izinga likashukela okufanele livimbele livame ukukhuphukela ku-10-15 mmol / l phakathi nosuku, okuyingozi enkulu kakhulu.
