Bazali bezingane ngayinye eye yatholakala nesifo sikashukela bathola izincomo zokwelashwa kudokotela ukuze bathuthukise isu elifanele lokulashwa futhi belungisa indlela yokuphila yengane. Kodwa-ke, izeluleko nemiyalo kadokotela ayiqhamukanga.
Ngenqubo yokwenza ukuxilongwa kanye nezindlela zokuthola izindlela zokwelashwa, udokotela uthembela ezinkambisweni namapharamitha atholakale ngaphakathi ezweni noma izinhlangano zezokwelapha zomhlaba wonke zokulwa nesifo sikashukela.
Imihlahlandlela yemitholampilo yesifo sikashukela ezinganeni
Izincomo zodokotela maqondana nokwelashwa kohlobo 1 lwesifo sikashukela zizohluka, ngoba izinhlobo ezibalwe ngazo zezifo ziyahlukahluka enkambweni nasezindlela zokwelashwa.
Uhlobo olu-1
Ngokuvamile, izingane eziningi zinesifo sikashukela sohlobo lokuzalwa 1 Futhi, ezigulini ezincane, kutholakale uhlobo lwesifo sikashukela sokuqala, ukuthuthukiswa kwalo okuvuse ingcindezi enkulu.
Uma ingane inesifo sikashukela sohlobo 1 (kungakhathalekile ukuthi imvelaphi yayo), isincomo esiyinhloko somtholampilo sizoba ukusetshenziswa kwe-insulin.
Le ndlela iyadingeka ukuze kuzinze isimo sesiguli, kanye nokwelula impilo yakhe. Lapho nje izinyathelo ezilungile zithathwa ngabazali, izinga lempilo yengane lizoba khona, futhi amathuba okuba ne-diabetes noma iketoacidosis onomphumela olandelayo wokubulala uzokwehla.
Imvamisa, ngesikhathi senqubo yokwelashwa, iziguli zinqunywa ukwelashwa kwe-insulin okuqina, lapho umthamo wansuku zonke wezidakamizwa uhlukaniswe izingxenye eziningi. Kubalulekile ukuthi ivolumu ye-insulin efakiwe yanele ukungalingani noshukela emzimbeni, ngaleyo ndlela kulingise ukusebenza kwemvelo kwamanyikwe.
Izinhlobo ezi-2
Uhlobo lwesibili sikashukela ezinganeni luvame kakhulu kunendlela edlule.
Njengomthetho, ukuntuleka kokuzwela kwamaseli ukuya ku-insulin kanye nokwehla ekukhiqizeni kwawo kwenzeka ngenxa yezimo ezicindezelayo noma ukuphazamiseka kwe-metabolic ezinganeni ezindala. Izingane cishe azikaze zihlushwa isifo sikashukela sohlobo 2.
Isincomo esikhulu sezokwelapha sohlobo 2 sikashukela kukudla okuqinile. Kulokhu, izindlela zokwelapha zizoba ngaphezulu kokungeziwe kunendlela esemqoka. Kodwa ukwenza ngaphandle kwabo, futhi, ngeke kusebenze.
Susa imikhiqizo eyingozi ekudleni kwengane kumele kancane kancane, ukuze umzimba ungazweli ukushaqeka kokudla. Ngenkathi isiguli sisaqhubeka nokudla ukudla okuvinjelwe umthetho, kudingeka siqhubeke sisebenzisa izidakamizwa ezinciphisa ushukela.
Izindlela zokuhlonza
Isimo sikashukela wegazi yi-3.3 - 5.5 millimula ngelitha (mmol / l) ngemuva kokulala ebusuku, okuthatha amahora angama-8, lapho ingane ingadli.
Uma ukuhlolwa kukhombisa ukuthi izinga likashukela egazini elithathwe ingane esiswini esingenalutho ngu-5.6 - 6.9 mmol / l, lokhu kukhombisa izinga eliphakeme lesifo sikashukela.
Ezimweni ezinjalo, ingane yathunyelwa ukuba ihlaziywe okwengeziwe. Uma izinga likashukela lalingu-7.0 mmol / l ngesikhathi sokuhlolwa kwesibili, khona-ke isiguli sitholakala nesifo sikashukela i-mellitus.
Enye indlela yokubona ukuthi ingane inokuphazamiseka kwesifo sikashukela ukubheka ushukela wegazi osheshayo ngemuva kokudla ushukela ongu-75 g. Ukuhlolwa kunikezwa amahora amabili ngemuva kokuthi ingane iphuze amanzi anoshukela.
Indlela yokuhlola isimo kuleli cala izoba ngale ndlela elandelayo.
Inkomba ye-7.8 - 11.1 mmol / l ibonisa ukwephulwa kokubekezelelwa kwe-glucose.
Umphumela wedlula umkhawulo we-11.1 mmol / L ukhombisa ukuba khona kwesifo sikashukela i-mellitus. Uma ukuphambuka kokujwayelekile kuncane, isiguli sizokwabelwa ukuhlolwa kwesibili, okuzodingeka ukuthi kuqedwe emavikini ayi-2-3.
Izithombe zemitholampilo
Isithombe somtholampilo sikashukela sinokubonakaliswa kabili. Konke kuya ngohlobo lwesifo ingane ehlupheka. Lokhu kungenxa yokuntuleka okukhulu kwe-insulin emzimbeni.
Endabeni yokuntuleka kwe-insulin kwengqondo enganeni, kutholakala lezi zimpawu ezilandelayo:
- ukukhipha ukuphuma komchamo;
- ukuba khona komchamo wamanani amakhulu eglucose;
- ukukhuphuka kashukela wegazi;
- ukoma okungapheli;
- ukunciphisa umzimba phakathi nendlala engapheli.
Izimo ezimbi ngokweqile ezibonisa ukuntuleka kwe-insulin okuyi-acute yi-ketoacidosis ngisho nesifo sikashukela.
Uma ukuntuleka kwe-insulin kungapheli, isithombe somtholampilo sizobukeka kanjena:
- ukwephulwa komsebenzi woMkhandlu Kazwelonke;
- ukuthuthukiswa kokuhluleka kwezinso;
- ukwephulwa kokujikeleza kwegazi ngenxa yokwehla kwethoni ye-vascular;
- ukuphazamiseka kwe-metabolic;
- ukulimala kwemithambo emincane yobuchopho.
Izimo ezisohlwini esimweni sesimo esingapheli sesi sifo sizokhula kancane kancane.
Protocol ukuphathwa kweziguli ezinesifo sikashukela
Ngemuva kokutholwa kwengane, udokotela ugcwalisa umthetho okhombisa ukuthi:
- uhlobo lwesifo sikashukela;
- isigaba sesifo (isinxephezelo noma ukubola, ne-ketosis, i-coma noma ngaphandle kwayo;
- ukuba khona kwama-microangiopathies okubangelwa yilesi sifo;
- ukuba khona kwezinkinga;
- ubude besikhathi sezifo (eminyakeni);
- hlangana nezinye izifo zohlelo lwe-endocrine.
Izici zokwelapha
Ukwelashwa kwesifo sikashukela kuziguli ezisencane ku-multilevel ngokwemvelo futhi kufaka phakathi okulandelayo:
- ukudla
- ukusetshenziswa kwemijovo ye-insulin;
- ukusebenza komzimba okulinganiselayo;
- ukufundisa ingane amakhono adingekayo;
- Ukuziqapha isimo ekhaya;
- ukwesekwa kwengqondo.
Ukwelashwa kokudla kungenye yezinto ezibaluleke kakhulu kulolu hlu. Ngaphandle kokulungiswa kokudla, akunakwenzeka ukufeza isinxephezelo ngalesi sifo.
Imigomo yesimanje yokudla kwengane yesifo sikashukela imi ngalendlela elandelayo:
- isilinganiso esifanele sezakhamzimba: ama-carbohydrate - 50-60%, amafutha - 25-30%, amaprotheni - 15-20%;
- ukwenqatshwa ngokuphelele kwama-carbohydrate acwengekile naphakathi;
- cishe ukufakwa okuphelele kwamafutha ezilwane ngamafutha emifino;
- ukudla okwanele okuqukethe amavithamini ne-fiber yokudla okunempilo;
- ukuhlinzeka ngokudla okunempilo (kufika izikhathi ezi-6 ngosuku).
Ukuhlukaniswa kwezinkinga zesifo sikashukela ezinganeni
Isimo, izinkinga ezibangelwa yisifo sikashukela ezinganeni zingahlukaniswa zibe yisikhathi futhi kube sekwephuzile.Izinkinga ezibangelwa yi-acute (ketoacidosis ne-coma) ziyingozi kakhulu emvelweni, ngoba imvamisa kuthatha amahora ambalwa ukuthuthukisa, futhi amathuba okuba nomphumela obulalayo aphakeme impela.
Ngesikhathi se-ketoacidosis, inani elikhulu lamafutha kanye nemizimba ye-ketone inqwabelana egazini, ngenxa yalokho umzimba uzilimaza.
Ngokuqondene ne-coma, kungadala ukwanda koshukela wegazi ngenxa yokuphelelwa ngamandla, noma ukwanda kokuxineka kwe-lactic acid okubangelwa ukuqina kwe-renal, vascular noma kwesibindi.
Izinkinga zasemuva kwesikhathi zenzeka ngemuva kweminyaka engama-4-5 ukusuka ekuqaleni kokukhula kwesifo enganeni. Kulokhu, ukuwohloka komsebenzi wesitho noma kohlelo oluthile kwenzeka kancane kancane.
Izinkinga ezifika sekwephuzile zihlanganisa:
- i-retinopathy (ukulimaza okubukwayo kancane kancane);
- angiopathy (ukuncipha kwezindonga zemithambo yegazi, okuholela ku-thrombosis noma isifo sokuqina kwemithambo yegazi);
- i-polyneuropathy (ukulimala kancane kancane kwezinzwa zohlelo lwe-peripheral);
- unyawo lwesifo sikashukela (ukubukeka kwamanxeba nama-microcracks ebusweni bonyawo).
Ukuhambisana nezindlela zokuthibela kunganciphisa, futhi kwezinye izimo kuvimbela ngisho nokwanda kwezinkinga sekwephuzile.
Amavidiyo ahlobene
UDkt Komarovsky ngesifo sikashukela ezinganeni:
Ubunzima bokuthola i-mellitus yesifo sikashukela ezinganeni bulele eqinisweni lokuthi iziguli ezincane zihlala zikwazi ukubachazela kahle abazali bazo ukuthi yini imizwa aba nayo.
Ngenxa yalokhu, lesi sifo ezimweni eziningi sitholakala sesisezingeni lokukhula sekwedlule isikhathi, lapho ingane iba nokukhohlakala. Ukuze ugweme ukuthuthuka okunjalo kwemicimbi, abazali kudingeka ukuthi baqaphele indlela yokuziphatha nenempilo yezingane zabo.
