shuga
November ndi mwezi wa National Diabetes. Iyi ndi nthawi yomwe anthu m'dziko lonselo amagwirizana kuti awonetsetse za matenda a shuga.
Kotero, chifukwa chiyani November? Wokondwa inu anafunsa.
Chifukwa chachikulu ndi chifukwa November 14 ndi tsiku lobadwa Frederick Banting. Dokotala wa ku Canada ameneyu ndi gulu lake la asayansi anachita chinthu chodabwitsa kalelo mu 1923. Iye anaona kuchokera ku ntchito za ena kuti agalu amene anachotsedwa kapamba awo mwamsanga anadwala matenda a shuga ndi kufa. Choncho, iye ndi ena ankadziwa kuti pali china chake chomwe chinapangidwa mu kapamba chomwe chimathandiza kuti thupi lisamayende bwino ndi shuga (glucose). Iye ndi gulu lake anatha kuchotsa mankhwala mu “zilumba” za maselo (zotchedwa Langerhans) ndi kuzipereka kwa agalu opanda kapamba, ndipo anapulumuka. Liwu lachilatini la chilumba ndi "insula". Kumveka bwino? Ayenera, uku ndiye chiyambi cha dzina la mahomoni omwe timawadziwa ngati insulin.
Banting ndi wasayansi wina, James Collip, adayesa zomwe adalemba pa Leonard Thompson wazaka 14. Kalelo, mwana kapena wachinyamata amene anali ndi matenda a shuga ankakhala pafupifupi chaka chimodzi. Leonard anakhala ndi moyo mpaka zaka 27 ndipo anamwalira ndi chibayo.
Banting adalandira Mphotho ya Nobel ya Zamankhwala ndi Physiology ndipo adagawana mwachangu ndi gulu lake lonse. Iye ankakhulupirira kuti hormone yopulumutsa moyoyi iyenera kupezeka kwa odwala matenda a shuga, kulikonse.
Izi zinali zenizeni zaka 100 zapitazo. Kale, matenda a shuga ankadziwika kuti mwina ndi mitundu iwiri yosiyana. Zinkaoneka kuti ena anafa mofulumira kwambiri ndipo ena zingatenge miyezi kapena zaka. Ngakhale zaka pafupifupi XNUMX zapitazo, madokotala ankafufuza mkodzo wa wodwala kuti amvetse chimene chinkawachitikira. Izi zinaphatikizapo kuyang'ana mtundu, matope, momwe zimanunkhira, inde, nthawi zina ngakhale kulawa. Mawu akuti "mellitus" (monga mu shuga mellitus) amatanthauza uchi mu Chilatini. Mkodzowo unali wotsekemera mwa odwala matenda a shuga. Tapita kutali m'zaka zana.
Zomwe tikudziwa tsopano
Matenda a shuga ndi matenda omwe amapezeka pamene shuga m'magazi, wotchedwanso shuga, ndi wokwera kwambiri. Zimakhudza pafupifupi 37 miliyoni aku America, kuphatikiza akulu ndi achinyamata. Matenda a shuga amapezeka pamene thupi lanu silipanga mahomoni okwanira otchedwa insulin, kapena ngati thupi lanu siligwiritsa ntchito insulini moyenera. Ngati sichitsatiridwa, chikhoza kuyambitsa khungu, matenda a mtima, sitiroko, kulephera kwa impso ndi kudula ziwalo. Theka lokha la anthu omwe ali ndi matenda a shuga ndi omwe amapezeka chifukwa chakuti matenda a shuga atangoyamba kumene, zizindikiro zimakhala zochepa, kapena zizindikiro zimakhala zofanana ndi matenda ena.
Kodi zizindikiro zoyamba za matenda a shuga ndi ziti?
M’chenicheni, mawu achigiriki akuti matenda a shuga amatanthauza “siphon.” Kunena zoona, madzi amadzimadzi anali kutulutsidwa m’thupi. Zizindikiro zake zingaphatikizepo ludzu lambiri, kukodza pafupipafupi, kuwonda mosadziwika bwino, kusawona bwino komwe kumasintha tsiku ndi tsiku, kutopa kwachilendo, kugona, kumva kuwawa kapena dzanzi m'manja kapena kumapazi, khungu pafupipafupi kapena mobwerezabwereza, matenda a chingamu kapena chikhodzodzo.
Ngati muli ndi zizindikiro izi, itanani dokotala wabanja lanu nthawi yomweyo.
Kuwonongeka kungakhale kale kukuchitika m'maso, impso, ndi dongosolo la mtima musanayambe kuzindikira zizindikiro. Chifukwa cha izi, othandizira azaumoyo amakonda kuyang'ana matenda a shuga mwa anthu omwe amawoneka kuti ali pachiwopsezo chachikulu. Kodi zimenezi zikuphatikizapo ndani?
- Ndiwe wamkulu kuposa 45.
- Ndinu onenepa kwambiri.
- Simumachita masewera olimbitsa thupi nthawi zonse.
- Makolo anu, mchimwene wanu kapena mlongo wanu ali ndi matenda a shuga.
- Munali ndi mwana yemwe amalemera mapaundi oposa 9, kapena munali ndi matenda a shuga pamene munali ndi pakati.
- Ndiwe Black, Hispanic, Native American, Asia kapena Pacific Islander.
Kuyezetsa, komwe kumatchedwanso "kuwunika," nthawi zambiri kumachitika ndi kusala magazi. Mudzayesedwa m'mawa, kotero musamadye chilichonse mukatha kudya usiku watha. Zotsatira zoyezetsa shuga wamagazi ndizotsika kuposa 110 mg pa dL. Zotsatira zoyezera kuposa 125 mg pa dL zikuwonetsa shuga.
Anthu ambiri amakhala ndi matenda a shuga kwa zaka pafupifupi zisanu asanasonyeze zizindikiro za matenda a shuga. Pa nthawiyo, anthu ena amakhala atawonongeka kale ndi maso, impso, chingamu kapena mitsempha. Palibe mankhwala a matenda a shuga, koma pali njira zokhalira athanzi komanso kuchepetsa chiopsezo cha zovuta.
Ngati mumachita masewera olimbitsa thupi kwambiri, yang'anani zakudya zanu, kuchepetsa kulemera kwanu, ndi kumwa mankhwala aliwonse omwe dokotala akukuuzani, mukhoza kupanga kusiyana kwakukulu mu kuchepetsa kapena kuteteza kuwonongeka kumene matenda a shuga angapangitse. Mukangodziwiratu kuti muli ndi matenda a shuga, m'pamene mungasinthe mwamsanga moyo wanu.
Mitundu iwiri (kapena kuposerapo) ya shuga?
Type 1 shuga mellitus imatanthauzidwa ngati kuchuluka kwa shuga m'magazi chifukwa chosowa insulini chifukwa cha autoimmune process. Izi zikutanthauza kuti thupi likuukira ndikuwononga ma cell a kapamba omwe amapanga insulin. Chithandizo chamankhwala ndi jakisoni wa insulin kangapo tsiku lililonse (kapena kudzera papampu) ndiye chithandizo chachikulu chamankhwala. Ngati muli ndi matenda a shuga a Type 1, muyenera kuyezetsa magazi pafupipafupi komanso zovuta zina.
Prediabetes? Type 2 shuga mellitus?
Mosiyana ndi matenda a shuga a Type 1, omwe amayenera kulandira chithandizo ndi insulin, matenda amtundu wa 2 angafunikire kapena sangafunikire insulini. Prediabetes si matenda a shuga, komabe. Koma madotolo ndi ena opereka chithandizo atha kudziwa poyezetsa magazi anu ngati mukuyenda motsatira matenda a shuga. Kuyambira 2013 mpaka 2016, 34.5% ya akuluakulu aku US anali ndi prediabetes. Wothandizira wanu amadziwa ngati muli pachiwopsezo ndipo angafune kukuyesani kapena kukuwonetsani. Chifukwa chiyani? Chifukwa zasonyezedwa kuti kuchita masewera olimbitsa thupi komanso kudya zakudya zopatsa thanzi kumapitirizabe kukhala maziko a kupewa matenda a shuga. Ngakhale palibe mankhwala omwe amavomerezedwa ndi Food and Drug Administration (FDA) popewa matenda a shuga, umboni wamphamvu umathandizira kugwiritsa ntchito metformin mwa akuluakulu omwe ali ndi matenda a shuga. Kuchedwetsa kuyambika kwa matenda a shuga ndikwambiri chifukwa anthu 463 miliyoni padziko lonse lapansi ali ndi matenda ashuga. Makumi asanu mwa anthu XNUMX alionse anali asanawazindikire.
Zowopsa za prediabetes kapena Type 2 shuga mellitus?
Popeza matenda a shuga akamayambika amakhala ndi zizindikiro zochepa, pali zinthu zina zomwe zimapangitsa kuti mukhale ndi mwayi wokhala ndi matenda a shuga.
- Kumwa zakumwa zotsekemera shuga nthawi zonse komanso zakumwa zotsekemera ndi madzi a zipatso.
- Kwa ana, kunenepa kwambiri ndi chiopsezo chachikulu.
- Zakudya zokhala ndi mafuta ambiri komanso shuga.
- Khalidwe longokhala.
- Kuwonetsedwa kwa matenda a shuga a amayi komanso kunenepa kwambiri kwa amayi mu utero.
Nkhani yabwino? Kuyamwitsa kumateteza. Komanso, kuchita masewera olimbitsa thupi komanso kudya zakudya zopatsa thanzi zawonetsedwa kuti ndizofunikira kwambiri popewa matenda a shuga.
Zakudya zosiyanasiyana zathanzi ndizovomerezeka kwa odwala omwe ali ndi prediabetes. Idyani masamba osakhuthala; kuchepetsa kudya kwa shuga wowonjezera ndi tirigu woyengedwa; sankhani zakudya zonse m'malo mwa zakudya zosinthidwa; ndi kuthetsa kumwa zakumwa zongopeka kapena zotsekemera shuga ndi timadziti ta zipatso.
Kwa ana ndi achinyamata omwe ali ndi matenda a shuga, ADA imalimbikitsa kuchita masewera olimbitsa thupi kwa mphindi 60 patsiku kapena kupitilira apo kapena kuchita masewera olimbitsa thupi olimbitsa thupi komanso zolimbitsa thupi komanso zolimbitsa mafupa osachepera masiku atatu pa sabata.
Dokotala wanu angafune kuti muzidziwonera nokha glucose wamagazi. Zimakuthandizani kumvetsetsa bwino kukwera ndi kutsika kwa shuga m'magazi anu tsiku lonse, kuwona momwe mankhwala anu akugwirira ntchito, ndikuwunikanso momwe kusintha kwa moyo wanu kumathandizira. Dokotala wanu akhoza kulankhula nanu za zolinga, zomwe zimaphatikizapo chinachake chotchedwa A1c yanu. Izi zimakupatsani inu ndi adotolo anu ndemanga za momwe matenda a shuga akuyendera pakapita nthawi, ngati miyezi itatu. Izi ndizosiyana ndi kuyang'anira kwatsiku ndi tsiku kwa glucose wanu wam'magazi.
Ngati muli ndi matenda a shuga a mtundu wa 2 ndipo mukulephera kuwongolera ndi kusintha kwa moyo wanu, dokotala wanu akhoza kukupatsani mankhwala otchedwa metformin. Izi zasintha chisamaliro cha matenda a shuga popangitsa kuti ma cell a thupi lanu azitha kumva kwambiri insulin m'dongosolo lanu. Ngati simukukwaniritsabe zolinga zanu, wothandizira wanu akhoza kuwonjezera mankhwala achiwiri, kapena angakulimbikitseni kuti muyambe insulin. Kusankha nthawi zambiri kumadalira matenda ena omwe mungakhale nawo.
Pansipa, matenda a shuga amabwera kwa inu. Ndinu olamulira, ndipo mutha kuchita izi.
- Phunzirani momwe mungathere za matenda anu ndipo kambiranani ndi wothandizira wanu za momwe mungapezere chithandizo chomwe mukufunikira kuti mukwaniritse zolinga zanu.
- Sinthani matenda a shuga mwachangu momwe mungathere.
- Pangani dongosolo losamalira matenda a shuga. Kuchitapo kanthu mwamsanga mutapezeka kungathandize kupewa matenda a shuga-mavuto monga matenda a impso, kutaya masomphenya, matenda a mtima, ndi sitiroko. Ngati mwana wanu ali ndi matenda a shuga, muthandizeni ndipo muzimulimbikitsa. Gwirani ntchito ndi wothandizira wamkulu wa mwana wanu kuti mukhazikitse zolinga zenizeni kuti mukhale ndi thanzi labwino komanso moyo wabwino.
- Pangani gulu lanu losamalira matenda a shuga. Izi zingaphatikizepo katswiri wodziwa za zakudya kapena mphunzitsi wovomerezeka wa matenda a shuga.
- Konzekerani kudzacheza ndi omwe akukupatsani. Lembani funso lanu, onaninso dongosolo lanu, lembani zotsatira za shuga lanu la magazi.
- Lembani zolemba zanu, funsani chidule cha ulendo wanu, kapena onani tsamba lanu la odwala pa intaneti.
- Yesani kuthamanga kwa magazi, kuyeza phazi, ndi kulemera. Lankhulani ndi gulu lanu za mankhwala ndi njira zatsopano zothandizira, komanso katemera omwe muyenera kupeza kuti muchepetse chiopsezo chanu chodwala.
- Yambani ndi zosintha zazing'ono kuti mupange zizolowezi zabwino.
- Pangani masewera olimbitsa thupi ndi kudya kopatsa thanzi kukhala gawo lazochita zanu zatsiku ndi tsiku
- Khazikitsani cholinga ndikuyesera kukhala otanganidwa masiku ambiri a sabata
- Tsatirani dongosolo lazakudya za shuga. Sankhani zipatso ndi ndiwo zamasamba, mbewu zonse, nyama zowonda, tofu, nyemba, njere, ndi mkaka wopanda mafuta kapena wopanda mafuta ochepa ndi tchizi.
- Ganizirani zolowa m'gulu lothandizira lomwe limaphunzitsa njira zothanirana ndi kupsinjika ndikufunsani thandizo ngati mwakhumudwa, mukumva chisoni, kapena mukutopa.
- Kugona kwa maola asanu ndi awiri kapena asanu ndi atatu usiku uliwonse kungakuthandizeni kusintha maganizo anu ndi mphamvu zanu.
Sindinu wodwala matenda ashuga. Mwinanso muli ndi matenda a shuga komanso makhalidwe ena ambiri. Pali ena okonzeka kubwera nanu kuti mukwaniritse zolinga zanu. Mukhoza kuchita izi.
Kolb H, Martin S. Zinthu zachilengedwe / moyo pathogenesis ndi kupewa matenda amtundu wa 2. BMC Med. 2017;15(1):131
American Diabetes Association; Miyezo ya chithandizo chamankhwala mu shuga-2020 yafupikitsidwa kwa opereka chithandizo choyambirira. Clin Diabetes. 2020; 38(1):10-38
American Diabetes Association; Ana ndi Achinyamata: Miyezo ya Chithandizo cha Matenda a shuga-2020. Kusamalira Matenda a Shuga. 2020; 43(Zowonjezera 1):S163-S182
aafp.org/pubs/afp/issues/2000/1101/p2137.html
American Diabetes Association; Kuzindikira ndi kagawidwe ka shuga mellitus. Kusamalira Matenda a Shuga. 2014;37(Zowonjezera 1):S81-S90