Ombera odwala akhoza kutenga matenda a shuga monga vuto la kuika
Mwachidule
Ngakhale matenda a shuga ndi matenda odziwika bwino komanso odziwika bwino, anthu ochepa chabe amadziwa kuti matenda a shuga angapangidwe ngati momwe amachitira ndi odwala omwe amalandira impso . Aliyense amene ali ndi matenda a impso akuganiza kuti matenda opatsirana a impso akuyenera kudziwa za chiopsezo choterechi, kudziwika bwino ngati matenda atsopano a shuga pambuyo pa kubzala (NODAT).
Ngakhale chiopsezo chiripo, nkofunika kuzindikira kuti sikuti aliyense ali pangozi, ndipo omwe ali ndi chithandizo cha mankhwala ayenera kudwala matenda a shuga opatsirana kupatsirana.
Chikoka
NODAT ndi vuto lodziŵika mwa owerengeka ambiri odwala omwe amalandira impso. Komabe, ziwerengero zomveka za nambalayi sizipezeka. Izi ndi chifukwa panalibe ndondomeko yeniyeni ya NODAT kwa nthawi yaitali, mpaka 2003. Choncho, malingana ndi momwe mukufotokozera NODAT, zotsatirazi zingakhale zosiyana.
Kafukufuku wina akusonyeza kuti pafupifupi 30 peresenti ya anthu omwe sali ndi matenda a shuga asanalandire impso angayambe kukwera msanga m'magazi a shuga akuwonetsa NODAT patatha miyezi isanu ndi umodzi atapatsirana impso. Izi zikuwoneka kuti ndi nambala yeniyeni, yomwe ikusonyeza kuti uphungu wokhudzana ndi NODAT ziyenera kukhala mbali yofunikira ya kusamalidwa kwa impso odwala omwe akufunira kulandira impso.
Zotsatira
Matenda atsopano a shuga atalandira chithunzithunzi cha impso ali ndi zotsatira zambiri, zina zomwe zimawonanso munthu wodwala shuga. Choncho, anthuwa akhoza kukhala ndi mavuto ena. Zitsanzo zingapo ndi izi:
- Ketoacidosis : kuchuluka kwa ketone ndi ma asidi m'magazi omwe amawoneka odwala omwe alibe kusowa kwa insulini, zomwe zingayambitse kusokonezeka kwambiri kwa madzi ndi kusokonezeka kwa electrolyte, komanso shuga wambiri wa magazi. Wodwala wodwalayo amakhala akudwala kwambiri.
- Neuropathy: "zikhomo ndi singano" zomwe zimapweteka m'manja ndi m'mapazi omwe amavutika ndi matenda a shuga.
- Matenda apamwamba a kachilombo kaye chifukwa shuga yambiri ya magazi ndi chifukwa chodziwika chifukwa chochotsa chitetezo cha mthupi. Izi zikhoza kuwonetsa ngati kuwonjezeka kwafupipafupi kwa matenda a mkodzo, matenda a khungu, matenda a m'mapapo, ndi zina zotero.
- Zowonjezera, NODAT idzakhala ndi zotsatira zovuta osati pa moyo wa wodwalayo komanso pangozi ya imfa, komanso kupulumuka kwa impso. Kuti azinene m'mawu ena, kugwiritsira ntchito impso wothandizira amene amapanga NODAT akhoza kukhala ndi moyo wautali ndikuwona kuti impso yofalikira imalephera.
Kodi izi zimakhudza bwanji? Chifukwa cha phunziro kuchokera ku State University of New York, pamene kupulumuka kwa odwala omwe alibe shuga kumapeto kwa zaka zisanu chigwiridwe cha impso chikhala 92 peresenti, ndizochepa pa 87 peresenti kwa omwe analandira NODAT. Mofananamo, pakhala pali umboni wochokera kufukufuku womwe umasonyeza kuti kupulumuka kwa impso yofalikira kwafupikitsidwa, ngati wolandirayo akudwala matenda a shuga atalandira impso.
Zowopsa
Ngakhale kuti zotsatira zake ndi zofunikira kwambiri, vesi loti munthu wodwala ali ndi matenda a impso omwe amapezedwa, amayamba ndi matenda a shuga ngati mankhwala osokoneza bongo.
Mankhwala ena ndi zina zomwe zimayambitsa chiopsezo zimapangitsa kuti mliri wina amene ali ndi NODAT akutheke. Ena mwa awa ndi awa:
- Mankhwala: Izi zimaphatikizapo glucocorticoids (mwachitsanzo, prednisone) ndi mankhwala ena omwe timagwiritsa ntchito kuthetsa chitetezo cha mthupi cha wobwezeretsa mankhwala kuti tipewe kukanidwa kwa impso zokha (popeza wodwala chitetezo cha mthupi amawona kuti impso monga "bungwe lachilendo") . Zitsanzo za mankhwalawa zikuphatikizapo mankhwala omwe amatchedwa "calcineurin inhibitors" (mwachitsanzo tacrolimus ndi cyclosporine, omwe poyamba anali odwala matenda a shuga), ndi sirolimus. Chonde dziwani kuti sikuti mankhwala onse opatsirana omwe amatsutsa mankhwalawa amachititsa kuti anthu asatenge kachilombo ka HIV. Izi zimaphatikizapo mankhwala ena omwe amagwiritsidwa ntchito ngati a mycophenolate mofetil, omwe amadziwika kuti CellCept).
- Matendawa ndi chifukwa chodziwika. Izi zikuphatikizapo kachilombo ka Hepatitis C (HCV), matenda a cytomegalovirus (CMV).
- Kuwonjezera pazifukwa zoopsa za mankhwala / matenda omwe ali nawo, mtundu wa African-American, kunenepa kwambiri, ndi mbiri ya banja la matenda a shuga kumawonjezera ngozi ya NODAT.
Kulimbana ndi Ngozi Yokanidwa ndi Kuopsa kwa NODAT
Monga momwe tingaphunzire kuchokera pazokambirana pamwambapa, mankhwala omwe timagwiritsa ntchito kuti tipeze chitetezo chokwanira cha chitetezo cha m'thupi (kuti asakane impso zatsopano), komanso chiopsezo cha shuga. Mwa kuyankhula kwina, kodi mungakonde kukaniza chiwalo, kapena mungakonde kutenga matenda a shuga? Mwanjira iliyonse, mungamve ngati mukusunga impso yanu, kubwereketsa kwanu kwatsopano, pangozi. Kulimbitsa mgwirizano wa zigawo ziwirizi ndizofunikira kwambiri, nanga mumatani?
Pano pali uthenga wotenga kunyumba: Kukana kwa impso yoberekedwanso ndi chinthu chachikulu chomwe chimatsimikizira kuti akhoza kukhala ndi moyo komanso kugwira ntchito mwa wodwalayo, ngakhale kuposa chiopsezo cha shuga yatsopano yomwe yayamba kumene .
Choncho, malangizo ambiri amasonyeza kuti kupititsa patsogolo kuteteza thupi kumateteza kukanidwa, ngakhale kutanthauza kuwonjezeka kwa chiwopsezo chotenga kachilombo ka NODAT.
Kudziwa
Popeza timadziwa bwino zinthu zomwe zimayambitsa ngozi zomwe zimawonjezera chiopsezo cha NODAT, kuyang'anira odwala omwe ali ndi chiopsezo chachikulu ndikulangizidwa kwambiri. Malo abwino okumbera adzakulangizani za chiopsezo cha NODAT ngakhale asanalandire impso kuti muthe kusankha chisankho.
Komabe, mutayang'aniridwa mutatha kulandira impso yobzalidwa, ziganizo zotsatirazi zidzagwiritsidwa ntchito kuti mupeze matenda a shuga atsopano pambuyo pa kusintha. Malingaliro ameneŵa aperekedwa ndi gulu la akatswiri padziko lonse:
- Zizindikiro za matenda a shuga kuphatikizapo pulogalamu yamadzimadzi yamadzimadzi kuposa mlingo wa 200 mg / dL
- Kusambira kwa plasma shuga kwambiri kuposa kapena kufanana ndi 126 mg / dL
- Mlingo wa maola awiri wamadzimadzi amadzimadzi oposa 200 mg / dL panthawi yoyezetsa magazi
- Mwinanso mungadziwe mayeso omwe amachititsa kuti tizirombo toyambitsa matenda a shuga a11 , omwe timagwiritsa ntchito pofufuza matenda a shuga. Kugwiritsa ntchito kwake ngati chida chodziwiritsira ntchito sikuvomerezedwa pakatha miyezi itatu yoyambirira kuchotsa impso. Komabe, pambuyo pake, tanthawuzo lomwelo la matenda a shuga monga momwe amagwiritsidwira ntchito kwa anthu ambiri likugwira ntchito. Izi zikhoza kukhala hemoglobini A1c zikuluzikulu kuposa kapena zofanana ndi 6.5 chaka choyamba kuti azindikire NODAT.
Utsogoleri
Choyamba Chosungira Ntchito
Kodi mukuyenera kukhala ndi NODAT (makamaka pazifukwa zomwe zatchulidwa pamwambapa), njira yoyendetsera ntchito yoyamba imayambika kuti athetse shuga yambiri yamagazi. Nazi zina zomwe muyenera kudziwa:
- Kuonetsetsa bwino kwa NODAT mwachiwonekere ndi gawo la chisamaliro chosamalitsa cha wopatsidwa mankhwala a impso. Shuga ya magazi imayesedwa kawirikawiri pamlungu pamwezi woyamba, ngakhale kuti nthawi zambiri mayesero amachepetsedwa.
- Njira imodzi yochepetsera chiopsezo cha NODAT, komanso kuchepetsa kuopsa kwake kamodzika kale, ndikofuna kuchepetsa mlingo wa steroids (imodzi mwa mankhwala a rejection prophylaxis). Komabe, popeza chiopsezo cha kukana chiwalo chogwiritsidwa ntchito chimawonjezeka kwambiri ngati steroid imaimitsidwa palimodzi, kuthetsa kwathunthu sikoyenera.
- Mofananamo, mlingo wa tacrolimus (mankhwala omwe amachititsa kuti munthu asatengeke mosavuta), monga momwe amaloledwera ndi chiopsezo chokana, angalingalire kuchepetsa. Ngati zina zonse zikulephera ndipo wodwalayo ali ndi zizindikiro zina za NODAT, kusintha kwa mankhwala omwewo otchedwa cyclosporine kungakhale kofunikira.
Thandizo labwino la mankhwala
Ngati zowonongeka zomwe zanenedwa pamwambazi sizithandiza komanso matenda a shuga akupitirizabe kukula ndi kuwonjezereka kwambiri pakatha kufalikira kwa impso, wobwezeretsa wopatsirana ndi shuga watsopanoyo angafunike kulongosola bwino matenda a shuga. Mofanana ndi munthu wina aliyense wodwala shuga, nthawi zambiri timayambitsa mankhwala.
Zitsanzo zambiri zimakhala ndi mankhwala otchedwa glipizide (nthawi zina amasankhidwa chifukwa mankhwala ake osagwirizana ndi impso, sagwirizana kwambiri ndi impso '; ngati sizinali choncho, mankhwala a shuga angapangitse odwala matenda a impso ndikuwopsa ma shuga a magazi). Ngati mankhwala ena sali okwanira, mankhwala ena amawonjezedwa mpaka potsiriza, jekeseni wa subcutaneous insulin ikhoza kukhala yofunikira kuti muwone bwino shuga la magazi.
Kupewa
Podziwa za chiopsezo, mwina mumadabwa ngati pali chilichonse chimene mungachite kuti muchepetse. Monga mbali yothandizira, mabungwe ena amachititsa kuti tizirombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda (diabetes) Ndi maphunziro ena omwe amasonyeza kuti ndondomeko imeneyi imakhala ndi moyo wabwino komanso wautali.
Izi zikugwirizana ndi njira yaikulu yothetsera vuto la shuga la mtundu wa 1 (lomwe limamanga pafupifupi "kuchiza" kwathunthu kwa matendawa chifukwa cha mapulaneti ophatikizidwa), koma sipanakhalebe njira zowonongeka koteroko nkhani ya NODAT, chifukwa chodziwika kuti mwakutanthauzira, wodwalayo wa NODAT sakanakhala ndi shuga isanafike.
Mawu Ochokera
Zowonjezereka, chiopsezo chokhala ndi NODAT chingakhale chovuta kuvomereza ndipo chingayambe kukayikira ngati muyenera kupitako. Onetsetsani kuti mubwere ndikukambirana ndi dokotala wanu nkhawa zanu. Iye adzakuthandizani kupanga chisankho chabwino kwa inu. Kawirikawiri, kupatsidwa njira zoyendetsera matenda ngati shuga ikupangidwa, ubwino wotsatsa moyo umatha kupitirira chiopsezo cha NODAT.
> Zotsatira:
> Matenda atsopano a shuga pambuyo pa kusindikizidwa (NODAT): kuyesa malingaliro m'mayesero a zachipatala. Choyamba MR, et al. Kusindikiza. 2013.
> Matenda atsopano a shuga pambuyo pa kusindikiza (NODAT): mwachidule. Phuong-Thu T Pham. Matenda a shuga a Syndr Obes. 2011.
> Katemera Watsopano Wosagwirizana ndi Matenda Atawunikira Kutsekemera kwa Impso: Zowopsa. Emilio Rodrigo. Journal of American Society of Nephrology. 2006.