Monga gawo la njira ya endocrine, chithokomiro chanu chimathandiza kwambiri kuti mukhazikitse ndi kusunga bwino muyezo wa shuga. Pali umboni wina wa kugwirizana pakati pa chithokomiro ndi chiopsezo cha mtundu wa shuga wa mtundu wa 2. Akatswiri ofufuza a ku Korea aphunzira mwakuya kuti aone ngati mtundu wa shuga wa mtundu wa 2 uli wotani ngati umakhudzana ndi masewera otchedwa thyroid (T4), komanso kusintha kwa TSH, free thyroxine (Free T4), komanso triiodothyronine (Free T3) ).
Kuwononga Phunziro Lophunzira
Tidziwa kuti kuchuluka kwa tizilombo toyambitsa matenda (TSH ya pamwamba pa 10), komanso subclinical hypothyroidism, imayambitsidwa ndi hyperglycemia (shuga wochuluka wa magazi) komanso kuwonjezereka kwa insulini.
Ofufuzawa anafufuza anthu opitirira 6,200 omwe anali odziwika bwino monga "euthyroid" -throjekiti, zaka zisanu ndi chimodzi. Pakati pa gululo, anthu 229 anayamba mtundu wa shuga wa mtundu wa 2. Mtundu wa shuga wa mtundu wa 2 unapezeka ngati shuga lopitirira 126 mg / dL ndi / kapena hemoglobin level A1C pamwamba pa 6.5 peresenti.
Ofufuzawa anasintha kwa hemoglobin A1C (yomwe nthawi zina imatchedwa A1C) mndandanda, komanso kusala kudya, ndipo anatsimikiza zotsatirazi:
Odwala omwe anawonetsa kuchuluka kwa chiwerengero chawo cha TSH, ngakhale m'mabuku otchulidwa, anali ndi chiopsezo chachikulu chokhala ndi shuga ya mtundu wa 2, poyerekeza ndi omwe analibe TSH.
Ophunzirawa adagawidwa m'magulu awiri, ogawanika molingana ndi chiwerengero cha zinthu zomwe zimayambitsa chiopsezo cha thupi zomwe zinayambira pachiyambi chafukufuku.
Zomwe zimayambitsa vutoli zimaphatikizapo:
- Thupi la misala ya thupi (BMI) pamwamba pa 25 kg / m 2
- Kusakaniza shuga pamwamba pa 100 mg / dL
- Maseŵera A1C pamwamba pa 5.7 peresenti
Gulu 1 (gulu lochepa pangozi) linali ndi zochepera zosachepera ziwiri zomwe zimayambitsa ngozi, ndipo gulu loopsya lalikulu 2 linali ndi zifukwa ziwiri kapena zingapo zoopsa zowonongeka.
Ophunzirawo anagawidwa kuti "akukhala bwino," "okhazikika," kapena "owonjezereka" chifukwa cha kusintha kwazifukwa zawo zoopsa.
Anthu omwe sanasinthe pazifukwa zoopsa adaikidwa kukhala olimba.
Zimene Kafukufuku Anapeza
Mwa amayi omwe anaphunzira omwe anapanga shuga ya mtundu wa 2, iwo anali ndi TSH yapamwamba kwambiri ya TSH, ngakhale adakali mkati mwawotchulidwa. Malingana ndi ochita kafukufuku, amuna ndi akazi ali ndi zotsatira zofanana: Maseŵera a TSH omwe anawonjezeka m'kupita kwa nthawi, mkati mwa zolembera, anawonjezera mtundu wa shuga wa shuga, pamene T3 wapamwamba komanso ufulu wa fT4 unachepetsa chiwopsezo cha mtundu wa shuga 2. M'magulu onse, kuwonjezeka kwa msinkhu wa TSH, ndi kuchepa kwa T3 ndi ufulu wa T4, kunagwirizanitsidwa ndi chiwerengero cha shuga la mtundu wa 2.
Zotsatira za phunziroli zikusonyeza kuti kusintha kumene kumachitika mu TSH ndi mahomoni a chithokomiro asanatulukire matenda a shuga a mtundu wa 2 ndi chinthu chomwe chimachititsa kuti pakhale vutoli. Kachitidwe kowonjezereka kowonjezera TSH, kuphatikizapo kuchepa kwa T3 ndi ufulu T4, chinali ndi chiopsezo chowonjezeka cha mtundu wa shuga wa mtundu wa 2. Chiwopsezochi chinawonekera kwa anthu ambiri ndipo sichidalira pa chikhalidwe cha chithokomiro cha amai ndi amai.
N'zochititsa chidwi kuti ngakhale kusintha kwa mahomoni a chithokomiro sikuli bwino kwambiri kusiyana ndi kusala kwa shuga kapena kuyesa HbA1c, kuchepa kwa T4 kwaulere ndi kuwonjezeka kwa TSH kunkaonedwa kuti ndizovomerezeka bwino za matenda a shuga a mtundu wa 2 kuposa BMI kapena kusintha kwa BMI.
Kafukufukuyu anapeza kuti kusintha kosasunthika kwa mahomoni a chithokomiro, omwe kale sanazindikiridwe ngati chinthu chowopsa, kumawoneka kuti ndiwowopsa kwa mtundu wa shuga wa mtundu wa 2, ngakhale anthu omwe ali ndi "chizoloŵezi" cha chithokomiro ndipo palibe preexisting matenda a chithokomiro kapena chithokomiro autoimmunity.
Kodi Shuga ndi Insulini Zimagwira Ntchito Bwanji?
Ndikofunika kumvetsetsa momwe shuga ndi insulini zimagwirira ntchito.
Gulukosi-mtundu wa shuga-umapatsa mphamvu maselo anu. Kutupa kumachokera ku chakudya chanu ndi chiwindi chanu, chomwe chimapangitsa ndi kusunga shuga. Kawirikawiri, pamene mazira anu a shuga akugwa, chiwindi chanu chimatengera mtundu wa shuga-glycogen-ndipo amaipasula kuti apitirize kutulutsa shuga.
Insulini ndi mahomoni opangidwa ndi zikondamoyo. Ziphuphu-kuphatikizapo chithokomiro-ndi mbali ya dongosolo lanu la matope. Insulini imatulutsa shuga kuchokera m'magazi anu ndipo imathandiza kuti isamuke mumaselo kuti mupereke mphamvu. Monga madontho a shuga m'magazi, momwemonso mlingo wa insulini wanu makoswe umabisala.
Ngati muli ndi matenda a shuga a mtundu wa 2, monga shuga imamangirira m'magazi anu, kapangidwe kanu sikangathe kutulutsa insulini yokwanira, kapena maselo anu samayankha insulini, yotchedwa insulin. Ngati mulibe vuto la chithokomiro, koma mutakhala ndi zotsatira zapamwamba zowonjezera TSH-ngakhale ngati zikupezeka m'zinthu zolembera-mungafunike kufufuza nthawi ndi nthawi za chiopsezo chanu cha mtundu wa shuga.
Chinthu chachiwiri cha matenda a shuga ndi zizindikiro
Kuphatikiza pa kuwonjezeka kwa ma seti a TSH, zifukwa zina zoopsa za mtundu wa shuga wa mtundu wa 2 ndizo:
- Kukhala wonenepa kwambiri
- Mafuta ochuluka a m'mimba
- Kupanda ntchito ndi kuchita masewera olimbitsa thupi
- Mbiri ya munthu kapena banja la mtundu wa shuga 2
- Kukhala African-American, Hispanic, American American, kapena Asian-American
- Zaka: chiopsezo chikukwera pambuyo pa zaka 45
- Mbiri ya prediabetes (shuga wochuluka wa magazi)
- Mbiri yokhudzana ndi matenda a shuga
- Mbiri ya matenda a polycystic ovarian (PCOs)
Muyeneranso kudziwa za zizindikiro ndi zizindikiro zoyambirira zomwe mwakhala mukukumana ndi matenda a shuga a mtundu wa 2 omwe angaphatikizepo:
- Ludzu lowonjezeka
- Mlomo wouma
- Kuthamanga mobwerezabwereza
- Kuwonjezeka kwa njala, makamaka atadya
- Kutopa ndi kutopa
- Kunjenjemera ndi kugwedeza m'manja ndi m'mapazi
- Ululu mu ana anu a ng'ombe
- Kuchepetsa machiritso ndi mabala
- Masomphenya obisika
- Kukhumudwa, kuvutika maganizo
- Kusadziwika kosalemera kapena kulemera kwapadera
- Yowuma, khungu lopweteka
- Matenda ambiri a yisiti nthawi zambiri
- Kulephera kwa Erectile (kusowa mphamvu)
Kuzindikira ndi Kuchiza Mtundu Wachiwiri wa Shuga
Dokotala wanu akhoza kuyesa kawirikawiri kuti adziwe kuti ali ndi matenda a shuga a mtundu wa 2. Mayeserowa ndi awa:
- Kusala magazi magazi
- Kuyezetsa magazi pamimba
- Kuyeza kwa Hemoglobin A1c (HbA1c), yomwe imapereka mlingo wa shuga wamagazi m'masiku angapo apitawo
Chithandizo cha mtundu wa shuga wa mtundu wa 2 chimalimbikitsa kuchepetsa shuga wa magazi, mwa kuphatikizapo mankhwala omwe amathandiza kuti thupi likhale lodziwitsidwa ndi insulini, komanso kusintha kwa zakudya, kuchita masewero olimbitsa thupi, ndi kusintha kwa moyo zomwe zingathandize kuchepetsa shuga m'magazi . Ngati mwapezekapo, mungadabwe ndikudabwa. Gwiritsani ntchito ndi dokotala kuti mupeze mayina anu ndikusamalira thanzi lanu.
> Chitsime:
> Kusangalala, J. Jee, H. et al. "Kugwirizana Pakati pa Kusintha kwa Mahomoni a Chithokomiro ndi Mtundu Wachiwiri wa Matenda a Shuga: Phunziro Lakale la Zaka Zisanu ndi ziwiri," Chithokomiro. January 2017, 27 (1): 29-38. do: 10.1089 / thy.2016.0171.