Ngabe isifo sikashukela esingu-2 singalashwa?

Isifo sikashukela sibizwa ngokuthi isifo esiyinkimbinkimbi, esibonakaliswa ukwephulwa kwazo zonke izinqubo ze-metabolic emzimbeni womuntu esenzeka ngokumelene nesizinda sokuntuleka ngokuphelele kwe-insulin. Isilinganiso se-pathology sinamanani amakhulu, futhi lokhu akusebenzi kwamanye amazwe athile, kodwa kubantu beplanethi iphela.

Uhlobo lwe-2 isifo sikashukela sithatha indawo eholayo kuzo zonke izibonakaliso ze-endocrine pathology. Ibiza cishe ama-85% azo zonke iziguli zemitholampilo. Le ndlela kashukela isisencane eminyakeni yamuva. Uma ngaphambili lesi sifo satholakala ngemuva kweminyaka engama-45, manje amacala okuvela kwefomu elizimele le-insulin ayaziwa ngisho nasezinganeni.

Izibalo zikhombisa ukuthi lapho befika okokuqala kudokotela obenayo, iziguli eziningi azisoli nakancane ukutholakala kwazo okuyikho. Beza nezikhalazo zokulimazeka okubukwayo, izilonda ezingaphansi eziphilisayo, izinhlungu enhliziyweni nasemilenzeni. Lokhu kuchaza isidingo sokutholwa kusenesikhathi kanye nokukhethwa kokwelashwa kwalesi sifo. Ukwelashwa kohlobo 2 lwesifo sikashukela, izinqubo, imigomo, izici zokuphathwa kweziguli kuxoxwa ngazo esihlokweni.

Okuncane ngalesi sifo uqobo

Isizathu esiyinhloko sohlobo lwe- "isifo esimnandi" sithathwa njengokuzwela okunciphile kwamangqamuzana nezicubu zomzimba zomzimba ezenzweni ze-insulin. I-insulin yinto esetshenziswa ngama-hormone kuma-pancreas obhekele ukwehlisa amazinga kashukela wegazi ngokuyihambisa emangqamuzaneni. Endabeni yale-pathology, i-iron ikhiqiza inani elanele le-insulin, kepha izicubu zimane "azikuboni".

Ukwanda kweglucose yegazi kwenzeka lapho umsebenzi wamaseli omfihlo we-insulin we-pancreas wehla ngesigamu. Isikhathi eside, i-pathology is asymptomatic, yize izinguquko ezisezingeni lemithambo yegazi sezivele zenzeka.

Ingozi yokuqhamuka nezinkinga ezinkulu ivela uma izinkomba zokuhlola ziwela umkhawulo olandelayo:

• izinga ushukela ngaphambi kokudla kungaphezulu kuka-6.5 mmol / l;
• izinkomba ze-glycemia emahoreni ambalwa ngemuva kokufakwa kokudla emzimbeni ngaphezulu kwe-8 mmol / l;
• Izinombolo ze-glycosylated hemoglobin ngenhla kwe-7%.

Ushukela ophezulu wegazi uwuphawu oluphambili lwentuthuko ye-pathology

Kungakho kunzima impela ukuphendula umbuzo wokuthi isifo sikashukela sohlobo 2 singalashwa yini. Ngempela, iziguli eziningi azisoli isikhathi eside kakhulu ukuthi zinesimo se-pathological.

Kuyaziwa ukuthi indlela yokuphila engafanele, amaphutha wokudla okunempilo, isisindo somzimba esingajwayelekile yizinto ezidonsela phambili ukuthuthukiswa kwalesi sifo ngokumelene nesizinda sokuba khona kofuzo olubhekiselwe kuso. Ngasikhathi sinye, ithonya elisebenzayo kulezi zinto livumela, ngandlela thile, ukubuyisela inkambiso yezinqubo ze-metabolic, ukugcina izinkomba zikashukela kungaphansi kwemingcele eyamukelekayo, futhi kuvikele ukuqhubeka kwesifo.

Izimiso zokwelashwa

Umuthi wanamuhla usebenzisa izindlela ezilandelayo zokwelapha isifo sikashukela sohlobo 2:

• ukudla
• izivivinyo zokuzivocavoca umzimba;
• ukuthatha amaphilisi okwehlisa ushukela;
• ukwelashwa kwe-insulin.

Ukwelashwa kokudla

Ngeshwa, ukuqeda isifo sikashukela sohlobo 2 akunakwenzeka. Izindlela zanamuhla zokwelapha i-sah. isifo sikashukela singafinyelela isimo sesinxephezelo, lapho izinga le-glycemia libhekwa njengejwayelekile, alicunuli ukuthuthukiswa kwezinkinga. Enye yalezi zindlela ukulungiswa kokudla.

Imithetho eyisisekelo yokwelashwa kokudla kwabanesifo sikashukela esinga-insulin:

• imvamisa yokudla okungenamsoco;
• ukwenqaba ushukela nokudla okunezinombolo eziphakeme ze-glycemic index;
• ukufakwa ekudleni kwemikhiqizo ene-fiber yokudla ne-fiber ekwakhiweni kwayo;
• ukudla okwanele kwamaprotheni emzimbeni;
• ukugcinwa ngokuqinile kokudla nsuku zonke kwekhalori;
• ukusetshenziswa kwemifino nezithelo;
• ukwenqaba utshwala.

Isazi sezempilo esifanelekile sizosiza ukuthuthukisa imenyu yokuqala yomuntu ngamunye

Kubalulekile ukukhumbula ukuthi ngesikhathi sokupheka kufanele uphendukele ekwelashweni kokushisa komusi, upheke izitsha kuhhavini, ku-grill, upheke. Kungcono ukwenqaba okuthosiwe, okubhemayo, okunosawoti, kanye nama-muffin namakhekhe asuselwa kufulawa wekolweni weprimiyamu noma wokuqala.

Imikhiqizo enqatshiwe yile:

• amasoseji;
• ukudla okusemathinini ngebhotela;
• inyama enamafutha nenhlanzi;
• imayonesi, amasoso esitolo;
• amanzi acwebezelayo;
• imikhiqizo yobisi enamafutha aphezulu;
• imikhiqizo eseqedile;
• ukudla okusheshayo.

Kubalulekile ukufaka imifino, izithelo, imifino eminingi, okusanhlamvu kwimenyu yomuntu ngamunye. Inyama nenhlanzi kufanele kube izinhlobo ezinamafutha aphansi, ukudla kwasolwandle kuvunyelwe.

Umsebenzi womzimba

Umthelela omuhle wezemidlalo nokuzivocavoca impilo enempilo kanye nesimo sesifo sikashukela kudala kwaziwa. Imithwalo eyanele ayikwazi nje ukunciphisa ushukela wegazi, kodwa futhi ithuthukise ukuzwela kwezicubu ezixakile esenzweni se-hormone yamanyikwe (lokhu kubenza balusizo ngezinhlobo ezimbili eziphambili "zesifo esimnandi").

Kodwa-ke, akuzona zonke iziguli ezivivinya ukwelashwa ezibangela impendulo efanayo. Kungaba izinhlobo eziningi:

• Ama-indices kashukela awashintshiwe kakhulu noma ancishiswe kancane abe ngamazinga ajwayelekile.
• I-Glycemia yehlela ezinombolweni eziphansi kakhulu.
• Amazinga kashukela egazini ayakhuphuka.

I-Yoga - isethi evunyelwe yokuzivocavoca yesifo sikashukela

Inketho yokugcina yenzeka ebusweni bokuncipha kwesifo esiyimbangela. Ukusebenza ngokomzimba kubangela ukwephula ukusetshenziswa kwe-glucose ngamathuluzi wemisipha futhi kuthuthukisa inqubo ye-gluconeogenesis. Ososayensi bafakazele ukuthi ukwelashwa okuzivocavoca kufanelekile kuphela uma izinga le-glycemia lingadluli 14 mmol / l.

Ukwelashwa kwesifo sikashukela sohlobo 2 kufaka:

• Yoga
• ukubhukuda
• Ukuhamba ngezinyawo
• ukugibela ibhayisekili;
• ukushushuluza.

Ukuzivocavoca kuthinta umuntu onesifo sikashukela:

• khulisa ukuzwela kwe-insulin;
• ukunciphisa i-triglycerides kanye ne-cholesterol embi;
• shintsha isimo sohlelo lokujija kwegazi;
• ukunciphisa ukubonwa kwegazi futhi kuvimbele izinqubo ze-pathological of adhesion;
• ukunciphisa izinombolo ze-fibrinogen;
• khuphula ukuphuma kwenhliziyo;
• ukunciphisa isidingo se-oksijini yomoya;
• shintsha izinkomba zomfutho wegazi;
• ngcono ukuhamba kwegazi.

Isixhumanisi phakathi kokukhuluphala nokukhetha ukwelashwa

Isisindo somzimba we-pathological ngesinye sezici ezivusa inkanuko yesifo sikashukela esingavikelekile nge-insulin. Kuyaziwa ukuthi isifiso sokuqeda isifo sikashukela singabonakala kuphela esimeni sokulwa nokukhuluphala. Uma isiguli sesilahlekelwe ngama-5-7 kg, umuntu angasho ngokuphephile ukuthi amathuba okuthola isinxephezelo akhuphuka ngo-50-60%.

Ukuhlelwa ngokweqile kwesisindo kungenye yezigaba zokwelashwa

Zonke iziguli okuthathwe kuzo isifo sokuqala esingu-2 esi “hlangothi” zihlukaniswe ngamaqembu alandelayo:

• Iziguli ezinesisindo esijwayelekile noma esinciphile (inkomba yesisindo somzimba esingaphansi kwama-25).
• Iziguli ezikhululekile (inkomba isukela ku-25 iye ku-40).
• Iziguli ezinokukhuluphala okune-morbid (BMI ngaphezulu kwe-40).

Ukuhlukaniswa okunjalo kwabanesifo sikashukela kumaqembu kuvumela i-endocrinologist ukuthi ihlole amakhono okungenzeka kwamakhankethi, bese ukhetha irejimeni elifanele lokwelashwa.

BMI engaphansi kwama-25

Imithi Yesimanje Yesibili Yesifo Sikashukela

Ukuzama ukwelapha isifo sikashukela sohlobo lwe-2 ezigulini ezinjalo, kufanele kusetshenziswe ukwelashwa kokudla nokuzivocavoca. Kungenzeka ukusebenzisa ukwelashwa kwe-insulin, ngoba kunamathuba aphezulu okukhona kokuntuleka ngokuphelele kwe-insulin. Njengomthetho, imijovo ye-insulin isetshenziswa kuphela ukumisa ukudonsa kwesimo se-pathological.

Ngemuva kwalokho sebenzisa isidakamizwa iMetformin ngesimo se-monotherapy noma ngokuhlanganiswa nama -retretin. Lapho zingasebenzi, ziphinde zishintshe ukujova i-hormone noma ukusebenzisa iphampu ye-insulin.

BMI 25-40

Leli qembu leziguli yilona ebanzi kakhulu. Lapha, ukulungiswa kokudla okunempilo, ukusebenza ngokomzimba kanye nokuguqulwa kwendlela yokuphila kubhekwa njengokunqunyelwe ekutholeni ukwelashwa. Izifundo zemitholampilo zikuqinisekisile ukuthi kuphela ngokushintsha kwendlela yabo yokuphila, zonke iziguli eziyishumi zingenqaba ukusebenzisa amaphilisi anciphisa ushukela minyaka yonke.

Ezigulini ezine-BMI engama-25 kuya kwengama-40, kunqunywa amaqembu alandelayo emithi:

• I-Metformin;
• i-alpha glucosidase inhibitors;
• iziphikiso zama -retretins.

Kanye kanye nekota noma izinyanga eziyisithupha, uhlelo kufanele lubukezwe ukuthi isiguli selashwa kanjani. Uma izinga likashukela egazini lihlala linamanani aphezulu futhi isisindo sesiguli sanda ngokushesha, ukuqokwa kwamathebhulethi ongezekele ushukela kungahle kungabi nalusizo. Udokotela kufanele aphakamise ukwelashwa ngokweqile. Mhlawumbe ingxenye yezimali, kunalokho, idinga ukukhanselwa.

I-Endocrinologist - uchwepheshe ozosiza ukulwa ne-endocrinopathy

Uma isiguli sikwazile ukwehlisa isisindo noma isisindo sakhe sihlala sisezingeni elifanayo, kungenzeka ukuthi kunqunywe amalungiselelo we-insulin, kodwa kuphela uma ukungabi bikho kwe-concomitant pathologies kuqinisekisiwe. Sikhuluma ngezifo ezilandelayo:

• isifo sofuba
• Igciwane lesandulela ngculaza
• izinqubo zesimila;
• ukunganele kwe-adrenal cortex.

BMI ngenhla 40

Lezi ziguli, njengomthetho, ziphila impilo yokungasebenzi, zisebenzisa kabi ukudla okungenamsoco. Kunzima kakhulu ukwelapha isifo sikashukela ezigulini zeqembu. Kubalulekile ukukhetha izidakamizwa ezingeke zilawule i-glycemia kuphela, kepha futhi nokunciphisa isisindo somzimba, noma okungenani ukusigcina sisezingeni elizinzile.

Ama-endocrinologists akhetha ukuhlanganiswa kwe-Metformin ne-glucagon-like peptide-1 analogues.

Ukwelashwa ngezidakamizwa

Kunezimo lapho kunesidingo sokushintsha ngokushesha isimo sesiguli kanye nezinga lemitholampilo yalo yomtholampilo ne-metabolic. Ngale njongo, khetha uhlobo olulandelayo lokwelashwa:

• infusions nge solution Reopoliglukin;
• ukuqokwa kwe-hepatoprotectors (izidakamizwa ezivikela isibindi emiphumeleni emibi) - i-Essentiale-forte, Carsil;
• Ukwelashwa kwe-enzymatic - Mezim, Panzinorm;
• Amavithamini e-B-Series ne-ascorbic acid ngendlela yemijovo;
• ama-antibiotic lapho kukhona ama-bacterium ama-pathologies wezinso aphuma ezinso;
• sedatives (phambi kokuqwasha);
• ukwelashwa okubonakalayo (isb., ukwelashwa kwe-thrush, ukuphathwa kwezilonda ezinamahlwili, ukubuyiselwa kwe-potency).

Iqembu elikhulu ngamathebhulethi anciphisa ushukela. Ukuzikhethela kokuhlanganiswa kwabo kuya ngokuqina kwesimo sesiguli, iminyaka yakhe nomthethosisekelo, isisindo somzimba, izibalo ze-glycemia.

I-Alpha Glucosidase Inhibitors

Le mishanguzo kuhloswe ngayo ukubambezela ukumuncwa kwama-saccharides ngokusebenzisa izindonga zethumbu lamathumbu egazini. Ikhambi elisebenzayo yiGlucobai esekwe ku-acarbose. Umuthi unqunyelwe ngokuphathwa kabi kwezinkomba ze-glucose ngokuhambisana nokwelashwa kokudla, uma kwenzeka ukungasebenzi kahle kwe-Metformin therapy, nge-hyperglycemia enzima ngemuva kokudla ngokumelene nesendlalelo sokufakwa kwamalungiselelo we-insulin.

Umkhiqizo waseJalimane osebenza kahle

Umuthi awukwazi ukwengeza ushukela wegazi ngemuva kokudla. Kepha futhi wehlise izinga le-cholesterol "embi" ne-triglycerides. Kubalulekile ukuthi umuthi ungabangeli ukwehla okubucayi kwe-glycemia yegazi, okuvumela ukuthi isetshenziswe ekwelapheni iziguli esezikhulile.

Amalungiselelo weSulfonylurea

Uma isifo sikashukela singalapheki, khona-ke okungenani isinxephezelo singatholakala, amalungiselelo asuselwa ku-sulfonylurea avumela. Izinkomba zokuqokwa kwabo:

• ukungasebenzi kahle kwenhlanganisela yokudla kanye nokuzivocavoca okwanele komzimba;
• ukuba khona kohlobo lwe-2 pathology ezigulini ezinenkomba ejwayelekile noma ephezulu yomzimba, lapho isinxephezelo sitholwe ngemithamo emincane ye-hormone insulin.

Contraindication:

• Uhlobo lwe-1 "isifo esimnandi";
• isikhathi sokuzala nengane;
• coma;
• ukubola lapho kukhona izifo zemvelaphi ethelelekayo;
• isifiso sokuncipha okubucayi kwe-glycemia;
• ukungenelela kokuhlinzwa.

Abamele iqembu:

• I-Gliburide;
• I-Gliclazide;
• Tolbutamide;
• IChlorpropamide.

IBiguanides

Kusetshenziswe kahle isisindo somzimba we-pathological wesiguli, uma kwenzeka ukungasebenzi kahle kokuqokwa kwezinye izindlela. Abamele - Metformin, Buformin. Izidakamizwa zinciphisa i-gluconeogeneis, zinciphisa ukumunca ushukela emgodini wokugaya ukudla, zithuthukise isenzo se-insulin, zandisa inani lama-receptors abucayi kumaseli nezicubu.

Ungasiphatha kanjani isifo sikashukela sohlobo 2 esihambisana naleli qembu lezidakamizwa, kuzokutshela udokotela ofanele we-endocrinologist ofanele. Ukuhlanganiswa kweMetformin nama-sulfonamides kungenzeka.

Ukwelashwa kwe-insulin

Ukufakwa komjovo we-hormonal ku-regimen yokwelashwa kuboniswa ezimweni ezilandelayo:

• ukukhulelwa
• ukuba khona kwe-vascular pathology;
• izinkinga zenhliziyo;
• ukunciphisa isisindo kanye nokwanda kwe-ketoacidosis;
• imisebenzi;
• izifo ezithathelwanayo;
• ukuntuleka kokusebenza kahle kokwelashwa ngemithi ye-hypoglycemic.

I-insulin ifakwa ngokungagudli udonga lwangaphakathi lwesisu, izigaxa, amahlombe, okhalweni

Udokotela ohambela i-endocrinologist angakhetha irejimeni ende noma yesikhashana yokusebenzisa umuthi we-hormonal. Abamele i-insulin efakwe ohlelweni:

• I-Actrapid;
• Insulrap;
• Humulin P;
• Ithiphu;
• Humulin L;
• I-Ultralent BOC;
• I-Depot-N-Insulin.

ASD

Singalapha isifo sikashukela sohlobo 2 noma cha, futhi iziguli zizama ngazo zonke izindlela ukufeza umphumela owufunayo wokwelashwa sisebenzisa amakhambi abantu, izindlela ezingezona ezendabuko. I-ASD (ivuseleli yama-antiseptic kaDorogov) imane nje iyindlela engajwayelekile.

Ukulungiselela kwenziwa ngesisekelo sokudla kwe-musculoskeletal kwezilwane ezitholwe ngenxa yokwelashwa okushisa. Siqukethe ama-carboxylic acid, ama-hydrocarbons, isibabule, polyamide namanzi. Ithuluzi kuhloswe ngalo ukwenza amandla omzimba womzimba, ukuvuselela amaseli emfihlo we-insulin, nokwenza izinqubo ezijwayelekile ze-metabolic.

Umbuzo wokuthi ngabe isifo sikashukela sohlobo 2 singalashwa yini sihlushwa yizo zonke iziguli ezihlangabezane nalesi sifo esinamandla. Ngeshwa, kulesi sigaba sezokwelapha azikho izindlela ezinganciphisa i-100% inkinga yokwelashwa. Uma amacala anjalo eyaziwa ukuthi othile welapha isifo sikashukela sohlobo 2, ngokunokwenzeka, sikhuluma ngokudluliswa kwezitho nokushintsha ngokuphelele kwendlela yokuphila.