Ezigulini lapho sezikhulile, imvamisa emva kweminyaka engama-40, kuvela izimpawu zokuqala zesifo sikashukela somndeni, esizalwa njengefa. Cishe njalo, isisindo somzimba ezigulini ezingaba khona siyanda. Uhlelo lokulawulwa kwezifo ze-pancreatic endocrine lubandakanya ukwelashwa kokudla. Kunezidingo ezikhethekile zokudla okunesifo sikashukela sohlobo 2. Ngasikhathi sinye, odokotela bakubona kubalulekile ukufundisa iziguli ngokubalwa okuthile. Kusho ukuthini igama elithi "isinkwa unit"? Ungayisebenzisa kanjani idatha ye-tabular kwimikhiqizo ye-hehe? Ingabe abantu abanesifo sikashukela ngaso sonke isikhathi badinga ukubala inani lokudla okudliwayo?
Izici zohlobo 2 sikashukela
Uhlobo olukhethekile lwesifo sikashukela lubonakala ngokukhiqizwa kwe-insulin ejwayelekile (ephansi noma eyeqisayo) ngesitho esihola phambili sohlelo lwe-endocrine. Isifo sohlobo lwesibili asihlotshaniswa nokushoda kwama-hormone emzimbeni, njengakuqala. Amaseli wethishu ku-diabetesics asebekhulile aba namandla (angazweli) ku-insulin ngokuhamba kwesikhathi nangezizathu eziningi.
Isenzo esikhulu sehomoni ekhiqizwa yi-pancreas ukusiza ukungena kweglucose kusuka egazini kuye kwezicubu (izicubu zomzimba, amafutha, isibindi). Ngohlobo 2 sikashukela, kune-insulin emzimbeni, kodwa amangqamuzana awasayiboni. Akusetshenziswanga i-glucose esegazini, i-hyperglycemia syndrome yenzeka (ushukela wegazi udlula amazinga owamukelekayo). Inqubo yokumelana ne-insulin engasebenzi kahle iqala ukukhula kancane ezigulini ezihlobene nobudala, kusuka emavikini ambalwa kuya ezinyangeni ngisho naseminyakeni.
Imvamisa lesi sifo sitholakala ngokuhlolwa okujwayelekile. Abanesifo sikashukela esingatholakali bangaxhumana nodokotela ngezimpawu ze:
Ukudla ngamayunithi esinkwa + itafula- ukuqhuma kwesikhumba okungazelelwe, ukulunywa;
- ukungahambi kahle kokubuka, ikati;
- i-angiopathy (isifo sokuqina kwemithambo yegazi);
- i-neuropathies (izinkinga zomsebenzi wokuphelela kwezinzwa);
- ukungasebenzi kwezinso, ukungasebenzi.
Ngaphezu kwalokho, amaconsi omchamo omisiwe omelela isixazululo sikashukela ashiya amabala amhlophe elondolo. Cishe i-90% yeziguli, njengomthetho, inesisindo somzimba edlula okujwayelekile. Ekubuyiselweni emuva, kungabonakala ukuthi umuntu onesifo sikashukela wayenenkinga yokukhula kwe-intrauterine esikhathini sokubeletha. Ukudla kwasekuqaleni okuxubile ngobisi kuxhasa iziphikiso ekukhiqizweni kwe-insulin yangaphakathi. Odokotela batusa, uma kungenzeka, ukunikeza ingane ukuncelisa ibele.
Ezimweni zesimanjemanje, ukuthuthukiswa komnotho kuhambisana nokuthambekela kokuphila kokuhlala phansi. Izindlela ezilondolozwe ngofuzo ziyaqhubeka nokuqongelela amandla, okuholela ekuthuthukiseni ukukhuluphala, umfutho wegazi ophakeme nesifo sikashukela. I-dut ye-glycemia ikhombisa ukuthi ngesikhathi sayo i-50% yamaseli ekhethekile e-pancreatic ayephelelwe umsebenzi wawo.
Isikhathi sesigaba se-asymptomatic sesifo sikashukela sibhekwa yi-endocrinologists njengeyingozi kakhulu. Umuntu vele uyagula, kepha akakutholi ukwelashwa okwenele. Kukhona amathuba aphezulu okuvela nokuthuthuka kwezinkinga zenhliziyo. Ukugula okutholakala esisekuqaleni kungalashwa ngaphandle kwemithi. Kunokudla okhethekile okwanele, umsebenzi wokuzivocavoca kanye nemithi ye-herbal.
Izici zokudla okunempilo kohlobo 2 sikashukela kusetshenziswa i-XE
Umuntu onesifo sikashukela esithola i-insulin kufanele aqonde amayunithi esinkwa. Iziguli zohlobo 2, ngokuvamile ezinesisindo somzimba ngokweqile, ziyadingeka ukunamathela ekudleni. Ukufezekisa ukwehliswa kwesisindo kungenzeka ngokukhawula inani lamayunithi esinkwa esidliwayo.
Esikhathini sikashukela i-mellitus ezigulini esezikhulile, ukusebenza komzimba kudlala indima yesibili. Kubalulekile ukugcina umphumela otholakele. Ukubalwa kwemikhiqizo ye-XE kulula kakhulu futhi kulula kakhulu kunokuqukethwe kwekhalori yokudla.
Ukuze kube lula, yonke imikhiqizo ihlukaniswe ngamaqembu ama-3:
- lezo ezingadliwa ngaphandle kwemikhawulo (kungakapheli imikhawulo) futhi zingabalwa amayunithi esinkwa;
- ukudla okudinga ukugcinwa kwe-insulin;
- Kuyinto engathandeki ukusetshenziswa, ngaphandle komzuzu wokuhlaselwa kwe-hypoglycemia (ukwehla okubukhali ushukela wegazi).
Imininingwane mayelana neyunithi yesinkwa iqoqwa kumathebula noma imidwebo ekhethekile lapho ungathola khona umkhiqizo osetshenzisiwe.
Iqembu lokuqala lifaka imifino, imikhiqizo yenyama, ibhotela. Abakhuphuki nhlobo (noma baphakamise kancane) isizinda se-glucose egazini. Phakathi kwemifino, imikhawulo iphathelene namazambane wesitashi, ikakhulukazi ngesimo sesitsha esishisayo - amazambane abunjiwe. Imifino ephekiwe ebilisiwe idliwa ngokuphelele ngamafutha (uwoyela, ukhilimu omuncu). Isakhiwo esishubile somkhiqizo nezinto ezinamafutha sithinta izinga lokufakwa kwe-carbohydrate esheshayo - bayalinciphisa.
Yonke eminye imifino (hhayi ujusi kubo) 1 XE kuvela:
- beet, izaqathe - 200 g;
- iklabishi, utamatisi, isithombo - 400 g;
- amathanga - 600 g;
- ukhukhamba - 800 g.
Eqenjini lesibili lemikhiqizo kukhona ama-carbohydrate “asheshayo” (imikhiqizo yebhikawozi, ubisi, amajusi, okusanhlamvu, pasta, izithelo). Kwesithathu - ushukela, uju, ujamu, amaswidi. Zisetshenziswa kuphela ezimweni eziphuthumayo, ezinamazinga aphansi weglue egazini (hypoglycemia).
Umqondo "weyunithi lesinkwa" wethulwa ukuhlolwa okuphathelene nama-carbohydrate angena emzimbeni. Indlela efanelekile ongayisebenzisa ekuphekeni nasekondleni kokushintshana ngemikhiqizo ye-carbohydrate. Amathebula athuthukiswa esikhungweni sesayensi se-endocrinological ye-RAMS.
I-1 XE ngokwesilinganiso itholakala ku-12 g kashukela ohlanzekile (isihlabathi - 1 tbsp. L) noma i-20-25 g yesinkwa esingabhakiwe (isinkwa sonke, esivame ukusikwa)
Kunohlelo oluthile lokuguqula imikhiqizo ibe amayunithi esinkwa. Ukuze wenze lokhu, sebenzisa itafula lamayunithi esinkwa sabanesifo sikashukela. Ngokuvamile kunezigaba eziningana:
- limnandi
- imikhiqizo kafulawa neyenyama, okusanhlamvu;
- amajikijolo nezithelo;
- imifino
- imikhiqizo yobisi;
- iziphuzo.
Ukudla okuyisilinganiso se-1 XE kukhuphula ushukela wegazi cishe ngu-1.8 mmol / L. Ngenxa yezinga lemvelo elingazinzile lokusebenza kwezinqubo ze-biochemical emzimbeni phakathi nosuku, imetabolism engxenyeni yokuqala iba namandla ngokwengeziwe. Ekuseni, i-1 XE izokwandisa i-glycemia ngo-2.0 mmol / L, ntambama - 1.5 mmol / L, kusihlwa - 1.0 mmol / L. Ngokuvumelana nalokho, umthamo we-insulin uguqulwa amayunithi esinkwa esidliwayo.
Ngaphambi kwesidlo sasekuseni (3 XE) nangelantshi (4 XE), owesifazane onesifo sikashukela kufanele enze amayunithi ayi-6 e-insulin esebenza ngokushesha, ngaphambi kokudla kwakusihlwa (3 XE) - amayunithi ama-3.
Ukudla okuncane okucishe kube nomsebenzi owanele wesiguli akuvunyelwe ukuthi kuhambisane nemijovo yama-hormone. 1 noma 2 imijovo ye-insulin ende (isenzo esenziwa isikhathi eside) ngosuku, isizinda somzimba se-glycemic sigcinwa sizinzile. Isidlakela ngaphambi kokulala (1-2 XE) senziwa ukuvikela i-hypoglycemia yasebusuku. Kuyinto engathandeki ukudla izithelo ebusuku. Ama-carbohydrate asheshayo awakwazi ukuvikela ekuhlaselweni.
Inani lokudla koshukela ojwayelekile enza umsebenzi ojwayelekile limayelana ne-20 XE. Ngokusebenza okukhulu ngokomzimba - 25 XE. Kulabo abafuna ukunciphisa umzimba - i-12-14 XE. Ukudla kwesiguli kumelelwa ama-carbohydrate (isinkwa, okusanhlamvu, imifino, izithelo). Okunye, ngokulingana okulingana, ngamafutha namaprotheni (inyama egxile, ubisi, imikhiqizo yezinhlanzi, uwoyela). Umkhawulo wesilinganiso senani lokudla esidlweni esisodwa unqunywe - 7 XE.
Ngohlobo 2 sikashukela, olususelwa kwimininingwane ye-XE esetafuleni, isiguli sinquma ukuthi mangaki amaqebelengwane esinkwa angawadla ngosuku. Isibonelo, uzodla u-3-4 tbsp ngesidlo sasekuseni. l okusanhlamvu - 1 XE, usiki osikiwe osezingeni eliphakathi nendawo - 1 XE, umqulu webhotela - 1 XE, i-apula elincane - 1 XE. Ama-carbohydrate (ufulawa, isinkwa) avame ukusetshenziswa kumkhiqizo wenyama. Itiye elingaphendulwanga alidingi i-XE accounting.
Kunobufakazi bokuthi inani lohlobo lwesifo sikashukela sohlobo lwe-1 lungaphansi kunenani leziguli ezisezingeni lohlobo 2 lwe-insulin.
Abantu besaba ukujova ama-hormone ngezizathu eziningi, ikakhulukazi ezingokwengqondo
Odokotela banemigomo elandelayo lapho benquma i-insulin yabahlobo besifo sikashukela sohlobo 2:
- vimbela i-hyperglycemic coma ne-ketoacidosis (ukubukeka kwe-acetone emchameni);
- qeda izimpawu (ukoma okhathazayo, umlomo owomile, ukuchama kaningi);
- buyisela isisindo somzimba esilahlekile;
- ngcono inhlala-kahle, ikhwalithi yempilo, amandla okusebenza, amandla okwenza izivivinyo zomzimba;
- ukunciphisa ukwehla nokuvama kwezifo;
- vimbela izilonda zemithambo yegazi emikhulu nemincane.
Kungenzeka ukufezekisa izinhloso ngokudla okujwayelekile kwe-glycemia (kufika ku-5.5 mmol / L), ngemuva kokudla - 10.0 mmol / L. Idijithi yokugcina ungumbundu wezinso. Ngokukhula kweminyaka, ingakhula. Ku-diabetesics asebekhulile, ezinye izinkomba ze-glycemic zinqunywa: esiswini esingenalutho - kuze kufike ku-11 mmol / l, ngemuva kokudla - 16 mmol / l.
Ngaleli zinga le-glucose, ukusebenza kwamaseli amhlophe kwegazi kuyawohloka. Ochwepheshe bokuhola bakholelwa ukuthi kuyadingeka ukunquma i-insulin lapho izindlela zokwelapha ezisetshenzisiwe zingagcini i-glycemic level (HbA1c) engaphansi kwama-8%.
Ukwelashwa kwe-hormonal kweziguli ezinesifo sikashukela sohlobo 2 kusiza ukulungisa:
- ukungakwaneli kokukhiqizwa kwe-insulin;
- ukukhiqizwa ushukela ngokweqile kweshukela;
- ukusetshenziswa kwama-carbohydrate kwezicubu zomzimba.
Izinkomba zokwelashwa kwe-insulin kwabanesifo sikashukela esihlobene nobudala zihlukaniswe ngamaqembu amabili: ngokuphelele (ukubola ishukela ngenxa yokukhulelwa, ukuhlinzwa, izifo ezinzima) kanye nesihlobo (ukungasebenzi kahle kwemithi enciphisa ushukela, ukungabekezeleli kwabo).
Indlela echaziwe yalesi sifo iyelapheka. Isimo esiyinhloko ukuthi isiguli kufanele silandele ukudla nokudla okuqinile. Ukushintshwa kokwelashwa kwe-insulin kungaba okwesikhashana noma unomphela. Inketho yokuqala ihlala, njengomthetho, kuze kube izinyanga ezi-3. Ngemuva kwalokho udokotela ukhansula umjovo.
Isifo sikashukela sohlobo 2 sithathwa njengesihlobo esifunde kahle nesinokulawula lesi sifo. Ukuxilongwa nokwelashwa kwaso akunzima ikakhulukazi. Iziguli akufanele zenqabe ekwelashweni kwe-insulin okwesikhashana okuhlongozwayo. Amanyikwe emzimbeni womuntu onesifo sikashukela ngasikhathi sinye uthola ukwesekwa okudingekayo.
