Ciwon Diabetes > Tambayoyi

Sakamakon ciwon sukari koda yaushe yana haɓakawa tare da tsari na insulin. A wannan yanayin, cutar ta zama sannu a hankali tare da ƙara haɓaka ci gaba. Alamar farko tana bayyana bayan wasu watanni ko ma shekaru.

A cikin ƙirƙirar hanyar cututtukan ƙwayar cuta, koyaushe akwai dama a cikin jikin al'ada wanda zai iya rama ƙuntatawa. Kowane mutum yana da ajiyar kansa, kuma tare da raguwar duk hanyoyin sarrafawa, cutar tana ɗaukar matakan ci gaba.

Don nau'in ciwon sukari na 2 na sukari, muhimmin hanyar haɗin gwiwa shine haɓakar ƙwayar sel zuwa insulin, wanda ke bayyana ta cikin rashi mai narkewa a cikin kyallen takarda.

Glucose shine tushen samar da makamashi ga kowane nau'ikan sel. Idan saboda wasu dalilai sel ba su iya cinye ƙwayar glucose ba, to kuwa a hankali matakansa ke ƙaruwa a cikin jini. A wannan yanayin, jiki yana buƙatar takamaiman aikin diyya. Menene diyya?

Sakamakon ciwon sukari yana faruwa ne saboda ƙaddamar da ayyukan sarrafa gulukos a cikin babban ɓarkewar glycogen a cikin ƙwayar tsoka. Hakanan, ana ƙera hanyoyin da ake amfani da su na kitse daga carbohydrates, sakamakon abin da aka kirkiro adipose nama.

Idan matakin wucewar hankali ya wuce kodan, glucose ya bayyana a cikin fitsari, glucosuria tana haɓaka. A wannan yanayin, zamu iya magana game da sauyawa na diyya zuwa mataki na gaba na cutar.

Nau'in 2 na ciwon sukari mellitus ya ambaci matakai na hanya:

Nauyin da aka biya (glucose na al'ada ko dan ƙarami)
Wani tsari mai rikitarwa (glucosuria da haɓakar angiopathies na farkon matakin an lura),
Decompensation - matakan glucose mai haɓaka suna haifar da rikitarwa da yawa daga sauran tsarin kwayoyin halitta.

Mahimmin hanyar haɗi a cikin lura da wannan yanayin na ciwon sukari shine farkon ganewar asali. Matsayin asibiti na diyya bashi da alamu na asibiti, saboda haka yana da muhimmanci sosai don bayar da gudummawar jini don gwajin gwaje-gwaje.

Bayyanar cutar sankara ta cutar kansa

Babban hanyar bincike don ciwon sukari ana iya kiran shi gwaje-gwaje na dakin gwaje-gwaje na glucose jini. A matsayinka na mai mulkin, an hada irin wadannan karatun yayin wucewa kwamitocin lafiya.

Hakanan, ana iya aiwatar da irin wannan karatun a gida. Pharmacies suna da nau'ikan gwaji daban-daban na kayan gwaji ko na’urar lantarki don auna sukarin jini.

A cikin binciken gwaje-gwaje na dakin gwaje-gwaje, manyan alamomi sune alamomi masu zuwa:

Guban jini
Fitsari sukari
Fitsari acetone
Kasancewar glycosylated haemoglobin.

Glucose na jini a cikin lafiyar jiki ba ya wuce 3.3-5.5 mmol / L. A halin yanzu, ƙarancin ɗan raguwa ya ɗan ragu kuma an yarda da abun ciki na har zuwa 8 mmol / l. A cikin lokaci na rama, mai nuna alama na iya zama al'ada ko bai wuce 8 mmol / L ba.

Sugar a cikin fitsari yana fitowa bayan wucewa ƙimajewar glucose na ƙoshin ƙima (fiye da 14 mmol / l) kuma yana nuna ci gaba da tsarin cutar. Cikakken bincike yana nuna yanayin cutar.

Bayyanar a cikin fitsari na acetone yana faruwa ne bayan ketoacidosis a cikin jini. Ketoacidosis ko haɗin jikin ketone yana faruwa lokacin da aka fara aikin rarrabe fats tare da ƙirƙirar sassan ketone.

Tare da ketoacidosis, ƙoshin fata da ƙanshi mai ƙanshi daga bakin ya bayyana. Irin wannan tsari halayen halayyar mahaifa ne da abun da ke cikin hawan jini.

Daya daga cikin hanyoyin ingantacciyar hanyar bincike shine binciken glycosylated haemoglobin a cikin jini. Menene wannan

Glycosylated haemoglobin yana kasancewa ta haɗuwa da haemoglobin tare da ƙwayar glucose. Wannan kwayar halitta kodayaushe kuma tana wanzu cikin jini a rayuwar rayuwar haemoglobin (kwanaki 120-125).

Wannan manuniya ya sa ya yiwu a tantance matakin glucose a cikin jini na tsawon watanni hudu tare da gudanar da nazarin kwatancen abubuwan da ya fashe.

Saboda haka, don ƙarin cikakken bincike, don gano matakan cutar ko daidaita magani, ana gabatar da jini don ƙayyade haemoglobin.

Ana amfani da gwajin haƙuri a cikin glucose a farkon matakan cutar. An ƙaddara juriya na glucose ta amfani da mafita mai ƙima a cikin nauyin 75 g da 1 kg na nauyin jiki.

Ana auna matakin sukari akan ciki mara kan gado kuma bayan sa'a ta biyu bayan shan maganin. Idan matakin glucose bai wuce 8.1 mmol / l ba, to sai su ce gwajin mara kyau.

Darajojin 8, 1 mmol / L zuwa 11.2 mmol / L suna nuna rashin haƙuri ga glucose. Saboda haka, gwajin haƙuri yana taimakawa bayyanar cututtuka a cikin raunin tsarin ciwon sukari.

Hanya da aka rama game da ciwon sukari tana da hanya mai sauƙi na tsarin cututtukan cuta. Canje-canje daga wasu gabobin da tsarin basa nan. Ana iya sarrafa sukari na jini tare da maganin rage cin abinci.

Yawancin lokaci ana gano wannan nau'in cutar a cikin nau'in masu ciwon sukari na II, saboda cutar tana haɓaka hankali da sannu-sannu. Tare da ganewar asali, yana yiwuwa a daidaita matakin glucose ta amfani da abincin da aka zaɓa daidai.

Babban hanyar warkewar cutar sankara shine raunin abinci.

Maganin ciwon sukari a cikin tsarin biyan diyya yana da ka'idodi masu zuwa:

Rage adadin adadin kuzari na yau da kullun zuwa ƙimar kwatankwacin makamashin da aka kashe,
Rage abun ciki na carbohydrates masu narkewa cikin sauki (Sweets, kayayyakin burodi, samfuran gari),
Inganta darajar abinci mai gina jiki na yau da kullun ta hanyar haɗawa da wadatattun abinci tare da bitamin da ma'adanai,
Amfani da abinci mai dauke da sinadarai masu yawa da kuma fiber mai cin abinci, yayin da suke tsoma baki ga shan glucose a cikin hanji,
Zai fi kyau a yi amfani da abinci mai rarrabe tare da raguwa a cikin rabo da karuwa a abinci kowace rana.

Maganin rage cin abinci yana taimaka wajan tsawaita lokacin diyya ga masu cutar siga da haɓaka rayuwar mai haƙuri.

A halin yanzu, akwai samfurori da yawa daban-daban a kasuwa wanda aka yarda da shi ta hanyar masu ciwon sukari. An yi su ta amfani da kayan zaki kuma basa ƙaruwa da glucose na jini.

Saboda haka, menu na mai ciwon sukari mai yiwuwa ba zai bambanta da komai daga menu na mutane masu lafiya. Zai iya haɗawa da Sweets da kayan yaji ta amfani da kayan abinci na musamman masu izini.

Babban ka'idojin asibiti don zaɓin abincin da aka zaɓa sune alamomi masu zuwa:

Valueimar glucose na yau da kullun ko ƙaramin wucewa na har zuwa 8 mm mm / L akan komai a ciki,
Rashin sukari a cikin fitsari
Rashin acetone a cikin fitsari
Glycosylated haemoglobin ba'a gano shi ba,
Lokacin gudanar da gwajin haƙuri na glucose, kawai ana gano cin zarafin haƙuri (ƙasan glucose a cikin jini bai wuce 13.9 mmol / l ba),
Alamomin asibiti na waje sune masu laushi (polydipsia, polyphagia, polyuria, itching fata, mummunan numfashi).

Yin amfani da magunguna masu rage sukari yana farawa bayan an gano babban matakin glucose ta fuskar wani tsarin maganin abinci. Wadannan alamu suna nuna canjin cutar zuwa kashi na gaba - lokaci na ƙaddamarwa.

Tsawon lokaci na diyya na iya zama muhimmi kuma har da tsawon rai. Bayyanar cutar ta farko da cutar da kuma magance ta lokaci-lokaci na rage haɗarin haɓakar rikice-rikice na ciwon sukari.

A cikin mutane masu ciwon sukari na 1, ci gaban cutar tana walƙiya cikin sauri, don haka matakin diyya ya wuce da sauri. Ba tare da yin amfani da insulin ba, kwayoyin cuta daga gabobin da yawa suna haɓaka.

An bayyana matakin diyya a nau'in ciwon sukari na 2 wanda kuma shine muhimmin bangare na tsarin ilimin sa. Tsarin lokaci na abinci mai gina jiki na iya ragewa yayin cutar da haɓaka rikice-rikice.

Bada diyya ga wannan cuta

Marasa lafiya tare da raunin masu ciwon sukari yana da matakin glucose na jini kusa da al'ada. Ana iya samun wannan yanayin idan ka bi tsarin abinci, tsarin kula da masu ciwon sukari kuma kayi ayyukan motsa jiki sosai. Abinci na kowane mai haƙuri yana haɓaka daban-daban, la'akari da ayyukan jiki da aiki. Abincin yau da kullun ya kamata ya zama mai isa don rufe farashin makamashi. Wajibi ne a ci abinci sau 5 - 5-6 a rana, cin ɗan ƙaramin rabo a lokaci guda. Ana cire sukari da carbohydrates gaba daya.

Wasu lokuta waɗannan matakan basu isa ba don kiyaye matakan glucose na yau da kullun. Sa'an nan, don tsara matakin cutar ta glycemia, ana gudanar da insulin ga mara haƙuri ko an tsara magunguna masu rage sukari.

Asalin diyya

Sakamakon ciwon sukari yana tare da ma'aunin jini na al'ada. Don cimma wannan jihar, gyaran abinci da kuma riko da tsari na musamman yana taimakawa. Babu karamin mahimmanci shine aikin da aka auna.

A wasu yanayi, waɗannan matakan basu isa su kula da yawan glucose na al'ada ba.

Matakan diyya

Dangane da yanayin mai haƙuri, akwai nau'ikan cututtukan cuta. Likitocin sun rarrabe matakai masu zuwa na raunin ciwon sukari:

Ya rama - a cikin wannan halin, yana yiwuwa a kula da sigogi na glucose na yau da kullun. Hadarin rikitarwa a cikin wannan halin yana da ƙarancin gaske. Don ramawa game da ilimin cututtukan, ana amfani da magungunan kwamfutar hannu, gudanarwar insulin, gyaran abinci da kuma nauyin wasanni.
Subcompensated - yana da halin matsakaiciyar yanayi wanda sigogi na glucose yake tsakanin matakan da aka biya da kuma rikitarwa. Barazanar mummunan sakamako yana nan. Amma ga abin da ya faru na alamun sakamako mara kyau, yana ɗaukar lokaci fiye da matakin lalata.
Decompensated - tare da ƙara yawan glucose. Halin yana halin babban barazanar rikitarwa.

Zaɓuɓɓukan Lissafi

Domin biyan diyya na cin nasara, dole ne a dauki wasu gwaje-gwaje akai-akai. Sharuddan diyya na masu dauke da cutar sun hada da:

Yawan glucose - wanda aka ƙaddara a jini da fitsari,
Glycated haemoglobin,
Acetone a cikin fitsari
Fructosamine
Lipidogram.

Glycated haemoglobin

Hemoglobin wani sinadari ne wanda yake cikin jini. Wannan kashi yana da alhakin rarraba iskar oxygen a jiki. Siffar halayyar wannan kashi shine ikon kame kwayar oxygen kuma tabbatar da cigaba da motsi.

Koyaya, haemoglobin zai iya ɗaukar kwayoyin glucose. Sakamakon haka, ana yin glycated haemoglobin, wanda shine babban ƙarfin ƙarfi. Wannan manuniya ce ta bamu damar kimanta matsakaicin matsar glucose a cikin watanni 2 da suka gabata.

Don haka, wannan matakin yana da amfani matuƙar mahimmanci don gano tsananin cutar da tasirin magani. Yana taimakawa wajen tantance hanyar biyan diyya ga cutar.

Don tantance matakin wannan nau'in haemoglobin, ana amfani da wata dabara ta immunochemical ko chromatography na ion-exchange. A bisa ga al'ada, bayan binciken farko, wannan alamar tana 4.5-7.5%, bayan na biyu - 4.5-5.7%.

Sakamakon ciwon sukari yana tare da sigogi na 6-9%. Idan aka gano wani kaso mai yawa, wannan yana tabbatar da rashin ingancin aikin jiyya da kuma ɗimbin glucose.

Lipidogram

Wannan ingantaccen tsarin aikin bincike yana taimakawa wajen tantance yawan abubuwan da ke cikin jiki.

Don aiwatar da lipidogram, ana amfani da hanyar photometric mai launi mai launi. Don yin wannan, ba da gudummawa jini daga jijiya.

Don samun sakamako abin dogara, dole ne a bi waɗannan shawarwarin:

Dakatar da shan sigari minti 30 kafin binciken,
Guji damuwa
Kada ku ci sa'o'i 12 kafin bincike.

Godiya ga aikin, yana yiwuwa a ƙayyade jimlar cholesterol, mai nuna atherogenicity, matakin triglycerides, lipids of the densities daban-daban. Cikakken diyya ga masu ciwon sukari na 2 ana nuna su:

Kasuwancin jiki - 0-2.25 mmol / L,
Atherogenicity - 2.2-3.5,
Cholesterol - 0-5.2 mmol / L,
Lowarancin wadataccen lipoproteins - 0.13-1.63 mmol / L,
Poarancin lipoproteins mai yawa - 0-3.3 mmol / L,
Babban lipoproteins mai yawa - 1.03-1.55 mmol / L

Comparancin kuɗi da rarrabuwar ƙwayar cuta ana nuna su ta hanyar mafi girman yanayi. Wannan yana tabbatar da haɗarin ban sha'awa na atherosclerosis, bugun jini, cututtukan koda, ciwon zuciya.

Arar sukari

Ana buƙatar sigogi na glucose har zuwa sau 5 a rana. Amma ba kowane mai haƙuri ba ne zai iya yin gwaji da yawa. Sabili da haka, mafi ƙarancin hanyoyin shine sau 2 - da safe da dare. Don gudanar da wannan binciken, yi amfani da glucometer.

Cutar sankara mai kyau irin ta 2 na buƙatar binciken kowane wata. Idan matakin glucose a cikin fitsari ya kasance 12-15 mmol / l, yakamata a yi aikin sau da yawa. A yadda aka saba, sukari bai kamata ya ƙunshi fitsari ba. Idan ya kasance, ana nuna ƙarin nazarin akan abubuwan acetone a cikin fitsari.

Don kimanta sharuɗɗan don rama irin nau'in ciwon sukari na 2, ana amfani da hanyoyin gwaji da ke canza launi yayin fitsari. Idan launi ya ishe ta cikakke, wannan yana nuna wucewar acetone a cikin fitsari. Ba wai inuwa mai haske ba tana nuni da karancin kudi.

Yin rigakafin rikice-rikice

Don hana ci gaban mummunan sakamako, yana da matukar mahimmanci don al'ada da kuma kula da mafi yawan adadin sukari a cikin jini. Sakamakon sakamako mai mahimmanci ga masu ciwon sukari na 1 ba zai yiwu ba tare da insulin ba. Tare da nau'in cutar ta 2, wannan ba lallai ba ne, a ƙarƙashin tsarin yau da kullun, abinci da motsa jiki.

Tare da kowane nau'in ciwon sukari, ƙa'idojin yin abinci ba su canzawa. Yana da mahimmanci a bi irin waɗannan shawarwarin:

Usearyata sukari da abinci mai ƙiba,
Bayar da fifiko ga nau'ikan jiyya na zafi - tafasa, gasa,
Mealsauki abinci matsakaici,
Cire sukari gaba daya,
Rage yawan cin gishiri - volumeararsa kada ya wuce 12 g kowace rana,
Daidaita adadin kuzari na samfura da yawan kuzarin da aka cinye.

Don ramawa ga nau'in ciwon sukari na 2 na mellitus don cin nasara, ban da daidaita cin abincin, kuna buƙatar aiwatar da ayyuka masu zuwa:

A lokaci-lokaci kimanta ƙimar glucose,
Bayar da kyakkyawan yanayin tunanin mutum,
Shiga ciki don wasanni.

Yana da mahimmanci a la'akari da cewa isasshen motsa jiki ko wuce kima yana da lahani sosai a cutar sankara. Ba su cutar da ƙa'idodi don biyan diyya ga nau'in 1 na ciwon sukari, wanda ke haifar da karuwa a cikin glucose. Masana sun ba da shawara kowace rana don yin motsa jiki ko yin gajeren gudu.

Kasancewa ga shawarar likita, yanayin haƙuri yana inganta. Diyya type 2 ciwon sukari yana da alamomi masu zuwa:

Glycated haemoglobin 6-7%,
Matsi ba kasa da 140-90 mm Hg. Art.,
Kwayoyin cuta na yau da kullun
Hypoglycemia da safe 5.5 mol,
Mafi kyawun abun ciki na sukari bayan cin abinci.

Sakamakon ciwon sukari yana tare da sigogi mai kyau na glucose. Wannan yanayin ba ya haifar da rikice-rikice kuma yana ba ka damar jagorancin salon rayuwa na yau da kullun. Don cimma sakamako mai kyau, yana da matukar muhimmanci a bi alƙawarin likita.

Digiri na diyya

Ka'idodi don kimanta ciwon sukari shine fructosamine da glycated haemoglobin. Lokacin kulawa da wata cuta, mayar da hankali kan digiri ne wanda aka rama shi.Tun da cutar metabolism a matsayin rikitarwa ta haɓaka sannu a hankali a cikin tsarin ramuwa na cutar, to, nau'in ciwon sukari na 1 na ciwon sukari ba ya haifar da rauni na gani da rashin aiki na koda. Kuma nau'i na diyya da aka samu a nau'in ciwon sukari na 2 na mellitus yana taimakawa rage haɗarin infarction myocardial.

Tare da ciwon sukari wanda ba a san shi ba, ƙwayar cuta ta jiki na haɓaka, wanda ke haɗuwa da babban taro na sukari a cikin jini. Sakamakon haka, glucose ta haɗu da abubuwa daban-daban waɗanda ke gudana cikin jini. Irin waɗannan abubuwan da ke tattare da ayyukan sunadarai na glucose ana nuna su da farko a cikin idanu da kodan.

Samfurin glucose mai amsawa yana dauke da gemoclobin. Sakamakon abu ne wanda ke ɗaure glucose zuwa ƙwayoyin haemoglobin wanda ke faruwa a cikin sel jini. Cutar haemoglobin tana cikin haɗuwa da hauhawar jini tsawon watanni 4. Wannan shine adadin ƙwayoyin jan jini suke rayuwa. Wato, idan, a ƙarshen rayuwarsu, haemoglobin ya kasance mai narkewa, wannan yana nuna cewa tsawon watanni 4 aka lura da yawan hawan glucose a cikin jini.

Ana amfani da wannan manuniya don tantance tsananin cutar, tasirin maganin, da kuma matsayin diyya ga masu ciwon suga.

Yadda ake tantance matakin hawan jini

Don tantance maida hankali na glycosylated haemoglobin, ana amfani da hanyar ion musayar china ko hanyar immunochemical.

A cikin binciken farko, matakin glycosylated haemoglobin a cikin mutane masu cikakken lafiya shine 4.5-7.5% na jimami na haemoglobin. A cikin binciken na biyu, waɗannan alamun suna 4.5-5.7%.

Marasa lafiya tare da mellitus na ciwon sukari tare da diyya na al'ada suna da 6-9% glycated haemoglobin. Idan wannan alamar ta zarce kashi 9%, wannan yana nuna cewa cutar sankara ta haɓaka. Menene ma'anar wannan? Wannan yana nufin cewa matakin al'ada na glucose a cikin jini ba za'a iya kiyaye shi ta kowace hanya ba. Matsalar lalacewa na iya zama sakamakon kurakurai a cikin abincin, amfani da tsari na yau da kullun na rage sukari, da sauransu.

Carbohydrate metabolism ramuwa ramukan:

kashi kashi na haemoglobin tare da diyya shine 6-7%, tare da ƙaddamarwa - 7.1-7.5%, tare da yankewa - fiye da 7.5%,
kashi na glycemia na azumi tare da diyya shine 5.0-6.0%, tare da ƙaddamarwa - 6.1-6.5%, tare da lalata - fiye da 6.5%,
kashi na postprandial glycemia tare da diyya shine 7.5-8%, tare da subcompensation - 8.1-9.0%, tare da decompensation - fiye da 9.0%,
yawan glycemia a lokacin bacci a rama shine 6.0-7.0%, tare da subcompensation - 7.1-7.5%, tare da zubar da ciki - fiye da 7.5%.

Manuniya ta biyu wanda ta ƙaddara matsayin diyya ga masu ciwon sukari shine fructosamine. An gina wannan abu yayin ɗaurin glucose zuwa ƙwayoyin plasma. Idan taro na fructosamine a cikin jini yana ƙaruwa, wannan yana nufin cewa a cikin kwanakin 14-21 na ƙarshe, an lura da ƙara yawan glucose a cikin jini. Saboda iyawar ƙayyade matakin fructosamine, ana iya kula da yanayin haƙuri.

A yadda aka saba, fructosamine a cikin jini baya wuce 285 μmol / L. Ta hanyar adadin fructosamine da glycated haemoglobin a cikin jini, mutum zai iya yin hukunci game da hadarin haɓakar cututtukan cututtukan zuciya da jijiyoyin jini. Tare da matakin diyya na ciwon sukari, wannan haɗarin ba shi da ƙima, tare da nau'in subcompensated yana da matsakaici, kuma tare da nau'in discompensated yana da girma.

Eterayyade glucose a cikin jini da fitsari

Halin lafiyarsa ya dogara ne da yadda mai haƙuri ya iya koyon sarrafa cutar tasa. Yakamata mara lafiya yakamata a tantance matakin glucose a cikin jini, tattarawar glucose a cikin fitsari da kuma yawan acetone a cikin fitsari.

Ana duba glucose na jini sau 4-5 a rana. Amma wannan shi ne manufa. Ba kowane mutum bane zai iya yin wannan binciken sau da yawa, amma dole ne a tuna cewa mafi ƙarancin bincike yakamata a yi sau 2 a rana: da safe akan komai a ciki da maraice. Gilashin glucose da kwalliyar gwaji na iya taimaka wa mai haƙuri a cikin wannan.

Marasa lafiya da ke da ƙarancin ciwon sukari na mellitus na iya auna fitsari fitsari sau ɗaya a wata. Koyaya, idan matakan gwaji sun ƙaddara kasancewar sukari a cikin fitsari a cikin taro na 12-15 mmol / l, irin waɗannan karatun ya kamata a gudanar da su akai-akai. Zai fi dacewa, sukari a cikin fitsari kada ya kasance kwata-kwata, kasancewar sa yana nuna cigaban matakin lalacewar cutar sankara. Idan aka gano sukari fitsari, mai ciwon sukari yakamata ya sake duba tsarin abincinsa, kuma likita ya kamata ya rubanya wani sashi na insulin ko kuma canza kwamfutar hannu da aka tsara.

Idan an gano sukari a cikin fitsari, ƙarin bincike ya zama dole don taimakawa gano jikin ketone (acetone) a cikin fitsari. Don wannan binciken, ana kuma amfani da tsararren gwaji na musamman. Ta hanyar rage irin wannan tsiri a cikin fitsari, zaka iya ganin yadda take canza launi. Ya danganta da satifiket ɗin launi, an ƙaddara abubuwan acetone a cikin fitsari. Dangane da waɗannan alamun, likitan ya tsara maganin da zai taimaka inganta yanayin mai haƙuri.

Tare da raunin ciwon sukari mellitus, ana lura da alamun masu zuwa: