Momwe Mungadziwire Matenda a Shuga
Matenda a shuga ndi matenda osatha omwe amadziwika ndi kuchuluka kwa shuga m'magazi (shuga) chifukwa cha kuchepa kwa kupanga kwa insulin, kugwira ntchito kwa insulin, kapena zonse ziwiri. Chifukwa matenda a shuga amatha kukula pang'onopang'ono popanda zizindikiro zoonekeratu, anthu ambiri amadziwa vuto lawo pokhapokha mavuto atayamba. Chifukwa chake, kumvetsetsa momwe mungadziwire matenda a shuga ndikofunikira kwambiri kuti muzindikire msanga, kulandira chithandizo choyenera, komanso kupewa zotsatirapo zake kwa nthawi yayitali. Nkhaniyi ikufotokoza zizindikiro zoti muziyang'ana, mayeso omwe amagwiritsidwa ntchito, ndi njira zodziwira matenda zomwe zimagwiritsidwa ntchito nthawi zambiri.
1. Dziwani Zizindikiro ndi Zoopsa
Kuzindikira matenda a shuga nthawi zambiri kumayamba ndi kukayikira kwa dokotala. Dokotala adzafufuza ngati munthu ali ndi zizindikiro zodziwika bwino kapena zinthu zomwe zingamubweretsere chiopsezo chachikulu.
Zizindikiro za matenda a shuga
Zizindikiro zodziwika bwino zomwe nthawi zambiri zimawonekera zimatchedwa "3Ps":
1. Polyuria: kukodza pafupipafupi, makamaka usiku.
2. Kuchuluka kwa ludzu: kumva ludzu kwambiri nthawi zambiri.
3. Polyphagia: nthawi zambiri mumakhala ndi njala ngakhale mutadya kale.
Zizindikiro zina zomwe zingachitikenso:
- Kuchepetsa thupi popanda chifukwa chomveka
- Kutopa mosavuta
- Maso osawoneka bwino
- Mabala ndi ovuta kuchiritsa
- Matenda obwerezabwereza (monga matenda a pakhungu, mkodzo, kapena bowa)
- Kumva kuwawa m'manja ndi m'mapazi (neuropathy)
Kwa anthu ena—makamaka omwe ali ndi matenda a shuga amtundu wachiwiri—zizindikiro zimatha kukhala zochepa kwambiri kapena kusakhalapo, zomwe zimapangitsa kuti kuyezetsa kwa labotale kukhale kofunika kwambiri.
Zinthu zomwe zingachititse kuti munthu akhale ndi matenda a shuga amtundu wa 2
Anthu omwe ali ndi matenda otsatirawa akulangizidwa kuti akayezedwe:
- Kunenepa kwambiri kapena kunenepa kwambiri (makamaka mafuta m'mimba)
- Mbiri ya banja la matenda a shuga
- Kusachita masewera olimbitsa thupi
- Zaka zoposa 45 (ngakhale kuti tsopano zikuchulukirachulukira kwa achinyamata)
- Kuthamanga kwa magazi kapena cholesterol yambiri
- Mbiri ya matenda a shuga a mimba (shuga panthawi ya mimba) kapena kubereka mwana woposa 4 kg
- Matenda a ovary a Polycystic (PCOS)
- Mbiri ya matenda a mtima kapena sitiroko
2. Kufufuza kwa Laboratory kuti mudziwe matenda
Kuzindikira matenda a shuga sikudalira zizindikiro zokha, koma makamaka zotsatira za mayeso a shuga m'magazi. Mayeso angapo oyamba amagwiritsidwa ntchito.
A. Kuyesa kwa Glucose wa Plasma (FG) Wosala Kudya
Kuyesa kumeneku kumayesa kuchuluka kwa shuga m'magazi mutasala kudya kwa maola osachepera 8 (nthawi zambiri kumachitika m'mawa).
Kutanthauzira kwa zotsatira zonse:
– Wamba: <100 mgdL - Prediabetes (shuga wosadya bwino): 100–125 Matenda a shuga: ≥126 (amatsimikiziridwa ndi mayeso obwerezabwereza tsiku lina ngati palibe zizindikiro) Mayesowa amagwiritsidwa ntchito kwambiri chifukwa ndi osavuta komanso otsika mtengo. Komabe, zotsatira zake zimatha kukhudzidwa ndi matenda oopsa monga matenda, kupsinjika maganizo kwambiri, kapena kugwiritsa ntchito mankhwala ena. B. Mayeso a HbA1c (Hemoglobin A1c) HbA1c amafotokoza kuchuluka kwa shuga m'magazi m'miyezi 2-3 yapitayi. Sikutanthauza kuti kusala kudya ndi njira imodzi yothandiza kwambiri yowunikira ndi kuzindikira matenda a shuga. Kutanthauzira zotsatira zonse: Wamba: <5,7% Prediabetes: 5,7–6,4% ≥6,5% (nthawi zambiri kumafuna kutsimikizira zizindikiro) HbA1c ndi yothandiza kwambiri powonetsa kuwongolera kwa nthawi yayitali. Kulondola kwake kungasokonezedwe ndi kuchepa kwa magazi m'thupi, hemoglobinopathy, matenda a impso C. Mayeso Ololera Shuga M'kamwa (OGTT) Pankhaniyi, wodwalayo akusala kudya kenako amayesedwa kusala kudya, kenako amamwa yankho la magalamu 75). Shuga amayesedwanso patatha maola awiri. shuga: <140 (kulekerera kosatha): 140–199 ≥200 nthawi zambiri zimakhala zokayikitsa, zomwe zimazindikira kulekerera kwa shuga kosatha. Choyipa chake ndichakuti zimafuna nthawi yayitali yokonzekera mosamala. D. Plasma Yosakhazikika (Glucose Yosakhazikika) Mayesowa amachitidwa nthawi iliyonse yosala kudya. Kuzindikira matenda a shuga kumatsimikiziridwa ngati:
- Kuchuluka kwa shuga m'magazi mwachisawawa ≥200 mg/dL ndipo kumayendera limodzi ndi zizindikiro za matenda a shuga (3Ps) kapena vuto la hyperglycemic. Kuyeza kumeneku n'kothandiza pazochitika zadzidzidzi kapena pamene wodwala akuwonetsa zizindikiro zomveka bwino. Ngati palibe zizindikiro wamba, mayeso otsimikizira ndi GDP kapena HbA1c nthawi zambiri amalimbikitsidwa. 3. Mfundo Zotsimikizira Kuzindikira Matenda a shuga M'malangizo ambiri azachipatala, kuzindikira matenda a shuga mwa anthu opanda zizindikiro nthawi zambiri kumafuna kutsimikizira. Izi zikutanthauza kuti ngati mayeso amodzi akuwonetsa kuchuluka kwa shuga, dokotala adzachita izi: - Kubwereza mayeso omwewo tsiku lina, kapena - Kuchita mayeso osiyana (monga GDP kenako HbA1c). Kutsimikizira ndikofunikira chifukwa kuchuluka kwa shuga kumatha kukwera kwakanthawi chifukwa cha kupsinjika, matenda, kusowa tulo, kapena kugwiritsa ntchito mankhwala ena (monga corticosteroids). 4. Kuzindikira Matenda a shuga: Gawo Lomwe Siliyenera Kunyalanyazidwa Matenda a shuga m'magazi ndi vuto lomwe shuga m'magazi ndi okwera kuposa mwachizolowezi koma sakukwaniritsa zofunikira za matenda a shuga. Iyi si gawo "lotetezeka"—kwenikweni, gawoli ndi mwayi wabwino kwambiri wopewera matenda a shuga mwa kusintha moyo. Matenda a shuga asanakwane amatha kuzindikirika kudzera mu: - GDP 100–125 mg/dL - HbA1c 5,7–6,4% - OGTT ya maola awiri 140–199 mg/dL Pa gawoli, madokotala nthawi zambiri amalimbikitsa kuchepetsa thupi, kudya zakudya zoyenera, komanso kuchita masewera olimbitsa thupi nthawi zonse, komanso kuwunika pafupipafupi. 5. Kuyezetsa Kwina Pambuyo Pozindikira Matenda a shuga, madokotala nthawi zambiri amachita kuyezetsa kwina kuti awone momwe thupi lonse lilili ndikuyang'ana mavuto msanga, kuphatikizapo: - Ma lipid profile (cholesterol yonse, LDL, HDL, triglycerides) - Kugwira ntchito kwa impso (urea-creatinine, eGFR) - Kuyezetsa mkodzo kuti awone ngati pali albuminuria/microalbumin - Kuyezetsa maso (fundoscopy) kuti awone ngati pali matenda a shuga - Kuyezetsa mitsempha ndi mapazi (kumva, mabala, kuyenda kwa magazi) - Kuyezetsa kuthamanga kwa magazi ndi kuchuluka kwa thupi Cholinga chake ndikupanga dongosolo loyenera la chithandizo ndikupewa mavuto monga matenda a mtima, sitiroko, kulephera kwa impso, khungu, komanso kuduladula ziwalo.
6. Mtundu 1, Mtundu 2, ndi Matenda a Shuga Oyembekezera: Kodi Kuzindikira Matendawa Kumasiyana? Kawirikawiri, miyezo ya shuga m'magazi imakhalabe yofanana, koma njira yochizira imatha kusiyana. - Matenda a shuga a mtundu 1 nthawi zambiri amapezeka mofulumira, nthawi zina mwa ana kapena achinyamata, ndi zizindikiro zoopsa komanso kuchepa thupi mwachangu. Madokotala amatha kuwunika ketoacidosis ndipo, nthawi zina, amafufuza ma antibodies kapena C-peptide kuti athandize kugawa. - Matenda a shuga a mtundu 2 amakula pang'onopang'ono, nthawi zambiri amagwirizanitsidwa ndi kunenepa kwambiri komanso kukana insulin. Nthawi zambiri amapezeka powunika nthawi zonse. - Matenda a shuga oyembekezera amapezeka panthawi ya mimba kudzera mu mayeso apadera (nthawi zambiri OGTT yokhazikika). Chithandizo ndi chofunikira kuteteza mayi ndi mwana. 7. Kodi Kuwunika Kuyenera Kuchitika Liti? Kuwunika matenda a shuga kumalimbikitsidwa kwa: - Anthu azaka 45 kapena kuposerapo, makamaka ngati pali zinthu zoopsa - Achinyamata omwe ali onenepa kwambiri/onenepa kwambiri ndipo ali ndi zinthu zoopsa (kuthamanga kwa magazi, mbiri ya banja, PCOS, ndi zina zotero) - Amayi oyembekezera omwe akukonzekera kuunika matenda a shuga asanabadwe (kuti adziwe matenda a shuga oyembekezera) Kuwunika nthawi zambiri kumatha kukhala zaka 1-3 zilizonse kutengera zotsatira zam'mbuyomu komanso zinthu zoopsa. Pomaliza: Kuzindikira matenda a shuga kumaphatikizapo kuphatikiza kuwunika zizindikiro, zinthu zomwe zingawopseze, ndi mayeso a labotale monga shuga wosala kudya, HbA1c, mayeso olekerera shuga, ndi shuga wosasankhidwa. Kuti muwonetsetse kuti ndi wolondola, zotsatira zosazolowereka nthawi zambiri zimafunika kutsimikiziridwa, makamaka kwa anthu omwe alibe zizindikiro. Kuzindikira msanga ndikofunikira, chifukwa matenda a shuga omwe sanapezeke angayambitse mavuto akulu. Ngati muli ndi zizindikiro kapena zinthu zomwe zingawopseze, fufuzani shuga m'magazi mwanu ndipo funsani katswiri wanu wazaumoyo kuti akupatseni chithandizo choyenera msanga. Ngati mukufuna, nditha kusintha nkhaniyi kukhala yasayansi kwambiri (ndi mawu otsatira malangizo a ADA/WHO) kapena mtundu wotchuka kwambiri wamabulogu azaumoyo.
