Inhloso yokwelashwa kwesifo sikashukela ukugcina amazinga kashukela asondele kokujwayelekile isikhathi eside. Uma lokhu kwehluleka, bathi isiguli sisinciphisile isifo sikashukela. Ukufinyelela isinxephezelo sesikhathi eside kungenzeka kuphela ngosizo lokuyala okuqinile. Indlela yokwelashwa ifaka: ukuhambisana nohlobo lokudla nokwakheka, ukusebenza, kepha hhayi imfundo yokuzivocavoca ngokweqile, ukudla izidakamizwa okwehlisa ushukela, ukubalwa okufanele nokulawulwa kwe-insulin.
Imiphumela yokwelashwa ibhekelwa nsuku zonke nge-glucometer. Uma umuntu onesifo sikashukela ekwazi ukuthola isinxephezelo sesikhathi eside, ubungozi bakhe bokuthi ubunzima obunzima futhi obungamahlalakhona buncishiswa kakhulu, futhi isikhathi sokuphila siyanda.
Izilinganiso zesinxephezelo sikashukela
Ngokwezindinganiso zaseRussia, ushukela uhlukaniswe ama-degree ama-3:
Isifo sikashukela nokucindezela kuzoba yinto yesikhathi esedlule
- Ukwehlela ushukela -95%
- Ukuqedwa kwe-vein thrombosis - 70%
- Ukuqedwa kokushaya kwenhliziyo okuqinile -90%
- Ukuqeda umfutho wegazi ophakeme - 92%
- Ukwanda kwamandla ngesikhathi sosuku, ngcono ukulala ebusuku -97%
- Isinxephezelo - Izinkomba zikashukela esigulini zisondele kokujwayelekile. Ngohlobo 2 sikashukela, iphrofayili ye-lipid yegazi kanye nomfutho wegazi kuyabuye kuhlolwe. Lapho isinxephezelo sitholakala, ubungozi bezinkinga buncane.
- Ukubuyiselwa - ushukela ukhuphuka njalo, noma izinga lawo lishintsha kakhulu phakathi nosuku. Izinga lempilo lesiguli liwohloka kakhulu, ubuthakathaka buzwakala njalo, ukulala kuyaphazamiseka. Ukudilizwa kuyingozi ngengozi enkulu yezinkinga ezinzima, ukuthuthukiswa okusheshayo kwe-angiopathy ne-neuropathy. Isiguli sidinga ukulashwa ngokwelashwa, izivivinyo ezengeziwe.
- Ukukhokhelwa - Uthatha isikhundla esimaphakathi phakathi kwesinxephezelo kanye nokubola kwesifo sikashukela. Izinga likashukela liphakeme kancane kunokujwayelekile, ngakho-ke ubungozi bezinkinga buphakeme. Uma ukunxeshezelwa kungasuswa ngesikhathi, ukwephulwa kwe-carbohydrate metabolism nakanjani kuya esigabeni sokubuyiselwa kwemali.
Lokhu kuhlukaniswa kusetshenziselwa ukuhlola ukusebenza kahle kokwelashwa. Isibonelo, lapho ungeniswa esibhedlela, ngaphezu kohlobo lwe-mellitus yesifo sikashukela, ukuxilongwa kukhombisa "esigabeni sokubuyiselwa kwemali". Uma isiguli sikhishwa ngemali engaphansi, lokhu kubonisa ukwelashwa okulungile.
Ukushintshwa okusheshayo kusuka kushukela ophezulu kuye kokujwayelekile kuyinto engathandeki, ngoba kuholela ku-neuropathy yesikhashana, ukhubazeka okubukwayo nokuvuvukala.
Ezenzweni zamazwe omhlaba, izinga lesinxephezelo alisetshenziswa. Isifo sikashukela i-mellitus sihlaziywa sisendaweni yokuba sengozini yezinkinga (ephansi, ematfuba aphezulu we-angiopathy ne-microangiopathy).
Izindlela Zokuxolelwa
Ngenxa yentuthuko yezokwelapha, ngayo yonke iminyaka eyishumi, abanesifo sikashukela banamathuba amaningi okuletha izibalo zabo zegazi eduze nokujwayelekile, okuye kwandisa kakhulu isikhathi sabo sokuphila futhi kwehlisa inani lezinkinga. Kanye nokwanda kwezidakamizwa ezintsha nokuzixilonga, izidingo zesifo sikashukela ziyaqina.
I-WHO kanye ne-Federation of Diabetes sebeke izindlela ezilandelayo zesifo sohlobo 1:
| Ukuhlwaya | Norm | Ukulawula okuhle | Ukulawula okunganele, isifo sikashukela esibolile | |
| IGlucose, mmol / L | Ngaphambi kokudla | 4-5 | kufika ku-6.5 | > 6,5 |
| Ubukhulu ngemuva kokudla | 4-7,5 | kufinyelela ku-9 | > 9 | |
| Ngaphambi kokulala | 4-5 | kufika ku-7.5 | > 7,5 | |
| I-Glycated hemoglobin, GG,% | kufika ku-6.1 | kufika ku-7.5 | > 7,5 | |
Isifo sikashukela sohlobo 2 sihlala sihambisana nokuwohloka kokudla kwamafutha, ngakho-ke, iphrofayili ye-lipid yegazi ifakiwe kumikhawulo yokunxephezela:
| Izingqinamba, mmol / L | Izinkinga | |||
| amathuba aphansi | angiopathy | i-microangiopathy | ||
| GG,% | ≤ 6,5 | ngaphezulu kuka-6.5 | ngenhla 7.5 | |
| Ukuzila ushukela, ukuhlaziya kwelabhoratri | ≤ 6,1 | ephakeme kune-6.1 | ngaphezulu kwe-7 | |
| Iglucose yokulinganisa i-glucometer | ngaphambi kokudla | ≤ 5,5 | ngenhla 5.5 | ephakeme kune-6.1 |
| esiphezulu ngemuva kokudla | ≤ 7,5 | ngenhla 7.5 | ngaphezulu kwe-9 | |
| I-Cholesterol | ejwayelekile | ≤ 4,8 | ngaphezulu kuka-4.8 | ngaphezulu kuka-6 |
| kwabantu abaphansi | ≤ 3 | ngaphezulu 3 | ngaphezulu 4 | |
| ukuxinana okuphezulu | ≥ 1,2 | ngaphansi kwe-1,2 | ngezansi 1 | |
| Triglycerides | ≤ 1,7 | ngaphezulu 1.7 | ngaphezulu kwe-2.2 | |
Izindlela zokunxephezela ezingeziwe zohlobo 2 sikashukela:
| Izindlela | Isinxephezelo | |||
| kuhle | akwanele (okuncane) | kubi (ukubola) | ||
| BMI | abesifazane | kufika ku-24 | 24-26 | ngaphezulu kwama-26 |
| amadoda | kufika ku-25 | 25-27 | ngaphezulu kwama-27 | |
| Umfutho wegazi | kufika ku-130/85 | 130/85-160/95 | ngaphezu kwe-160/95 | |
Izindlela zokunxeshezelwa azifani kuwo wonke amaqembu eziguli. Abantu abadala beminyaka yokusebenza kufanele balwele ikholamu "evamile" uma inani le-hypoglycemia lingakhuphuki. Ezinganeni, abanesifo sikashukela se-senile, iziguli ezinokuncipha kokuzwa kwe-hypoglycemia, amazinga kashukela okuhlosiwe angaba ngaphezulu kancane.
Amanani okuhlosiwe anqunywa udokotela ohambelayo. Kunoma yikuphi, zingaphakathi kwemikhawulo yesinxephezelo noma ukunxephezelwa. Ukwehliswa kwemali akunakulungiswa kunoma yisiphi isiguli.
Amandla wokulawula ekhaya
Ukugwema ukubola kwesifo sikashukela, ukuhlolwa kwelabhoratri akwanele ngaphambi kokuvakashela udokotela. Dinga ukubhekwa nsuku zonke kwegazi nokucindezelwa. Ikhithi elincane elidingwa isifo sikashukela: i-glucometer, ukuqapha umfutho wegazi, imichilo yokuhlola yomchamo ngekhono lokunquma izinga lama-ketones. Iziguli ezikhuluphele zizodinga nesikali saphansi. Izinsuku, isikhathi nemiphumela yazo zonke izindlela zokulinganisa ikhaya kufanele zifakwe kubhukwana elikhethekile - idayari yesifo sikashukela. Imininingwane eqoqiwe izosivumela ukuthi sihlaziye inkambo yesifo futhi siguqule ukwelashwa ngendlela okufika ngayo ngesikhathi ukuvimbela ukubola.
Ushukela wegazi
Ukulawula ushukela, i-glucometer elula kunazo zonke, imindililo nemichilo yokuhlola yanele. Ukuthenga amadivayisi abizayo anemisebenzi eminingi eyengeziwe akudingekile, vele ukhethe umenzi onokwethenjelwa futhi uqiniseke ukuthi okutholakalayo kwemitha kuhlale kuthengiswa.
Ushukela kufanele ulinganiswe ekuseni ngesisu esingenalutho, ngemuva kwanoma yikuphi ukudla, ngaphambi kokulala. Isifo sikashukela esibolile sidinga ukulinganisa okuvama kakhulu: ebusuku nangokukhohlakala kwenhlala-kahle. Abashukela kuphela abanohlobo 2 lwesifo esinobunzima abangakwazi ukukala ushukela kaningi.
I-acetone noshukela emchameni
Ushukela kumchamo ubonakala kakhulu ngokuncipha kwesifo sikashukela, lapho izinga laso esegazini likhulu kunesibalo sezinso (cishe ama-9 mmol / l). Kungakhombisa nezinkinga zezinso, kufaka phakathi isifo sikashukela se-nephropathy. Ushukela womchamo ulinganiswa kanye ngenyanga.
Ngesikhathi sokubola kwesifo sikashukela, ubungozi be-ketoacidosis ne-coma kuphezulu. Ngokuhamba kwesikhathi, lezi zingqinamba zingabonakala ngokuhlaziya umchamo wama-ketones. Kumele kwenziwe noma nini lapho ushukela usondela embundwini ka-13 mmol / L.
Ngokwesilinganiso sasekhaya sama-ketones noshukela emchameni, udinga ukuthenga imichilo yokuhlola, isibonelo, iKetogluk noma iBioscan. Ukuhlaziywa kulula kakhulu futhi kuthatha imizuzu embalwa kuphela. Qiniseka ukuthi ufunda i-athikili yethu ku-acetone kumchamo.
IGlycated Hemoglobin
Lesi sikhombisi sibonisa ngokunembile inani lesinxephezelo sikashukela futhi likuvumela ukuthi unqume ushukela ojwayelekile eminyakeni yamuva. Ukuhlaziywa kwembula iphesenti le-hemoglobin evezwe i-glucose yezinyanga ezintathu. Lapho ephakeme, ushukela usondele ekunqobeni. I-Glycated (inguqulo ye-glycosylated nayo iyasetshenziswa) i-hemoglobin ekhaya ingalinganiswa kusetshenziswa amagajethi akhethekile okokulayisha noma abahlaziyi abathintekayo. Lawa madivaysi ayabiza futhi anephutha eliphakeme lokulinganisa, ngakho-ke kunengqondo ngokwengeziwe ukuthatha ngekota ukuhlaziya elabhorethri.
Ingcindezi
Ishukela elibolile lihambisana nokushintshwa kwe-pathological emikhunjini nokwanda komfutho wegazi. Umfutho wegazi ophakeme uholela ekukhuleni ngokushesha kwe-angiopathy ne-neuropathy, ngakho-ke, ezigulini ezinesifo sikashukela, indlela yokucindezela evamile iminyene kunabantu abanempilo - ifinyelela ku-130/85. Ukuphindaphinda okwedlulele kwaleli zinga kudinga ukuqokwa kokwelashwa. Kuyinto efiselekayo ukukala ingcindezi nsuku zonke, kanye nesiyezi kanye nekhanda.
Izici zokubuyiselwa kwemali
Ukuvusa ukuguquguquka kwesifo sikashukela kwifomu elibolile kunga:
- umthamo ongafanele wamathebulethi ne-insulin;
- ukungahambisani nokudla, ukubalwa okungalungile kwama-carbohydrate ekudleni, ukusetshenziswa kabi koshukela osheshayo;
- ukuntuleka kokwelashwa noma ukuzelapha ngemithi yabantu
- inqubo engalungile yokusebenzisa i-insulin - okuningi kulokhu;
- ukuguqulwa okungafanele kusuka kumathebulethi kuya ekwelashweni kwe-insulin yohlobo 2 sikashukela;
- ukucindezela okukhulu;
- ukulimala okungathi sína, ukungenelela kokuhlinzwa;
- umkhuhlane, izifo ezingalapheki;
- ukuqina kwesisindo kuya esigabeni sokukhuluphala.
Izinkinga ezingaba khona
I-mellitus yesifo sikashukela engakhokhwanga iholela ezinkingeni zezinhlobo ezi-2: i-acute and chronic. I-acute ikhula ngokushesha, emahoreni ambalwa noma ezinsukwini, ngaphandle kokwelashwa kuholela ekhefeni nasekufeni. Lokhu kufaka phakathi i-hypoglycemia enzima, i-ketoacidosis, i-lactic acidosis ne-hyperosmolarity.
I-Hypoglycemia iyingozi kakhulu kunezinye izinkinga, ngoba iholela ezinguweni ezingenakulungiswa esikhathini esifushane kakhulu. Izimpawu zokuqala yindlala, ukuthuthumela, ubuthakathaka, ukukhathazeka. Esigabeni sokuqala, imiswa ama-carbohydrate asheshayo. Iziguli ezinesifo sokuwa kanye nethambo ziyadingeka ukulaliswa esibhedlela ngokushesha kanye ne-glucose ye-intravenous.
Ushukela omningi kakhulu uholela ekushintsheni kwezibalo zegazi zezinhlobo eziningana. Ngokuya ngezinguquko, i-hyperglycemic coma ihlukaniswe nge-ketoacidotic, lactic acidotic ne-hyperosmolar. Iziguli zidinga ukwelashwa okuphuthumayo, ukwelashwa kwe-insulin empeleni kuyingxenye yokwelashwa.
Izinkinga ezingalapheki zingakhula ngokuhamba kweminyaka, isizathu sabo esiyinhloko ukuwohloka kwesikhathi eside kwesifo sikashukela. Ngenxa kashukela omningi, imithambo emikhulu (angiopathy) kanye nemikhumbi emincane (microangiopathy), yingakho izitho ziphazamisekile. Ezisengozini kakhulu zazo yi-retina (diabetesic retinopathy), izinso (nephropathy), kanye nobuchopho (encephalopathy). Futhi, isifo sikashukela sohlobo olubolile siholela ekubhujisweni kwama-nerve fibers (neuropathy). Ukushintshwa kwezinguquko emikhunjini nasezinhlungwini kuyimbangela yokwakheka konyawo lwesifo sikashukela, ukufa kwezicubu, i-osteoarthropathy, nezilonda ezisesimweni sokuqina.
