Mob ntshav qab zib mellitus hauv cov menyuam yaus: cov tsos mob thiab cov paib, kuaj mob, kho thiab tiv thaiv > Mob ntshav qab zib hauv cov menyuam yaus thiab cov hluas

Mob ntshav qab zib mellitus hauv cov menyuam yaus thiab cov neeg hluas, nrog rau kev tshwm sim ntawm nws cov tsos mob thiab cov cim qhia tau cuam tshuam ntau dua hauv peb lub sijhawm. Cov me nyuam mob ntshav qab zib tsawg dua lwm yam kab mob, tab sis tsis tsawg li yav tas los xav. Ntau zaus ntawm cov kab mob tsis nyob ntawm tub los ntxhais. Mob rau cov menyuam yaus ntawm txhua lub hnub nyoog, pib ntawm thawj lub hli yug. Tab sis qhov tshaj plaws ntawm ntshav qab zib yog nyob rau cov menyuam yaus hnub nyoog 6-13 xyoo. Ntau tus kws tshawb nrhiav ntseeg tias tus kabmob no feem ntau pom nyob rau lub sijhawm ntawm kev nce menyuam yaus.

Qhov tshwm sim ntawm tus mob no tau tshawb pom feem ntau tom qab kis mob:

npua
kis mob rau daim siab
Tus kab mob tonsillogenic,
mob npaws
qhua pias thiab lwm tus

Syphilis ua tus tseem ceeb ntawm tus kabmob tsis tau lees paub tam sim no. Tab sis kev mob hlwb, ob qho tib si mob thiab ntev, nrog rau kev raug mob rau lub cev, tshwj xeeb tshaj yog bruises nyob rau hauv lub taub hau thiab lub plab, kev noj zaub mov tsis txaus nrog ntau ntawm cov carbohydrates thiab cov rog rog - tag nrho cov kev cuam tshuam los cuam tshuam rau kev txhim kho ntawm lub latent tsis txaus ntawm islet apparatus ntawm lub txiav.

Lub pathogenesis ntawm ntshav qab zib yog tsis txawv txav ntawm pathogenesis ntawm tus kab mob no rau cov neeg laus.

Cov txheej txheem kev loj hlob, uas txhim kho cov synthesis protein tshwm sim, cuam tshuam nrog kev koom tes ntawm insulin thiab nws txoj kev noj nqaij ntau ntxiv. Nrog rau ib qho qis dua islet apparatus ntawm lub txiav, txiav tawm ntawm nws txoj haujlwm yuav tshwm sim, vim cov txiaj ntsig ntawm ntshav qab zib mellitus tsim.

Cov kws tshawb nrhiav kuj ntseeg hais tias somatory hormone txhawb txoj haujlwm ntawm β-hlwb ntawm islet apparatus thiab, nrog ntau lawm ntawm cov tshuaj no thaum lub sijhawm loj hlob, tuaj yeem ua (nrog lub tshuab ua kom tsis muaj zog) ua rau lub cev txo.

Qee cov kws tshaj lij nyob hauv daim teb no ntseeg tias kev loj hlob hormone ua rau lub luag haujlwm ntawm the - hlwb ntawm cov islets, uas ua rau cov hyperglycemic factor - glucagon, uas, nrog cov haujlwm tsis txaus ntawm β - hlwb, tuaj yeem ua rau ntshav qab zib. Kev lees paub ntawm kev koom tes ntawm kev tsim ntau tshaj ntawm somatory hormone hauv lub pathogenesis ntawm cov ntshav qab zib ntawm menyuam yaus yog kev ua kom sai ntawm kev loj hlob thiab txawm tias cov txheej txheem ossification hauv cov menyuam thaum pib ntawm tus kabmob.

Cov chav thiab cov tsos mob

Qhov pib ntawm tus kab mob no yog qeeb, tsis tshua muaj - sai heev, cia li tshwm sim, nrog kev kuaj pom sai sai ntawm cov tsos mob feem ntau. Thawj cov tsos mob tshwm sim ntawm tus mob yog:

nqhis dej nce ntxiv
qhov ncauj qhuav
nquag tso zis heev, ntau zaus hmo ntuj thiab txawm yog nruab hnub tso zis,
tom qab ntawd, raws li cov tsos mob, poob phaus tshwm sim nrog kev zoo, qee zaum txawm tias qab los noj mov,
feem ntau tsis muaj zog
mob taub hau
nkees.

Qhov tsos mob ntawm daim tawv nqaij - khaus thiab lwm tus (pyoderma, furunculosis, eczema) kuj tsis tshua muaj rau menyuam yaus. Hyperglycemia hauv cov menyuam yaus yog cov tsos mob tseem ceeb thiab ib txwm tu ncua. Glycosuria tshwm sim yuav luag tas li. Lub zawj tshwj xeeb ntawm cov zis tsis yog ib txwm piv rau qhov ntau ntawm cov suab thaj, thiab yog li tsis tuaj yeem ua kev kuaj mob. Muaj feem ntau tsis muaj kev sib txuam tiav ntawm cov ntshav qab zib thiab qib ntawm glycosuria. Hyperketonemia pib dua zaum thib ob nrog cov roj ua rau lub siab ua haujlwm, uas tshwm sim los ntawm qhov ua haujlwm lipotropic ploj ntawm kev txiav

Kev hloov pauv ntawm cov plab hnyuv siab raum thiab lub nruab nrog cev sib txawv

Rubeosis thiab xanthosis pom nyob rau hauv cov neeg laus muaj tsawg rau cov menyuam yaus. Hauv cov neeg mob uas tsis kho, daim tawv nqaij qhuav thiab tev yog sau tseg. Nrog rau qhov ua kom hnyav, mob edema yuav tshwm sim.

Tus nplaig yog qhuav ci liab nyob rau hauv cov xim, feem ntau nrog tus papillae du. Kab mob gingivitis feem ntau pom, thiab qee zaum alviolar pyorrhea, uas mob hnyav dua rau menyuam yaus dua li cov laus. Cov txheej txheem carious hauv cov hniav yog nws nquag.

Cov suab lus hauv lub plawv yog lag ntseg, qee zaum systological yws ntawm lub apex yog txiav txim siab, uas qhia txog lub suab vascular poob qis. cov mem tes yog me, muag, palate. Ntshav siab, ob leeg qhov siab tshaj plaws thiab qhov tsawg kawg nkaus, yuav luag ib txwm txo qis. Nrog capillaroscopy, ib qho xim liab keeb kwm yav dhau los thiab nthuav dav ntawm lub hauv caug ntawm lub caj dab yog pom, ib qho electrocardiogram qhia kev hloov pauv hauv myocardium.

Qee qhov xwm txheej, cov qe ntshav liab tsawg thiab cov ntshav tsawg yuav txo qis. Los ntawm sab ntawm cov ntshav dawb, cov roj ntsha leukocyte yog lub suab:

Hauv cov ntawv uas mob ntshav qab zib tsawg - lymphocytosis, uas ua rau tsawg dua nrog rau qhov ntau ntxiv ntawm tus kab mob.
Hauv kev coj ua ntej-ua pa thiab nrog coma - lymphopenia. Neutrophilic laug hloov thiab tsis muaj eosinophils.

Lub acidity ntawm lub plab kua txiv yog feem ntau txo qis. Muaj dyspeptic tshwm sim. Lub siab nyob rau hauv feem ntau ntawm cov neeg mob loj dua (tshwj xeeb tshaj yog nyob rau cov menyuam yaus uas muaj ntshav qab zib ntev.), Tuab, qee zaum mob.

Hauv cov zis, albuminuria thiab cylindruria tsis tau hais. Hauv chav kawm hnyav thiab lub sijhawm ntev, cov lej ntawm lub tog raj kheej thiab cov protein nce ntxiv, cov qe ntshav liab yuav tshwm sim. Qee qhov xwm txheej, lub peev xwm ua kom lub raum ua tsis tau zoo.

Twb tau thaum pib ntawm tus kab mob no tshwm sim:

mob taub hau
kiv taub hau
txob taus
kev xav
qaug zog,
nkees, tsis muaj zog,
nco qab tsis zoo.

Kev puas tsuaj los ntawm qhov tsis xws luag tsaj ntawm lub cev tau tshwm sim los ntawm qhov mob ntawm cov ceg, qhov teeb meem ntawm lub cev tawv nqaij thiab qhov qaug zog lossis ploj ntawm cov leeg rov ua dua.

Organs ntawm lub zeem muag

Ntawm ib feem ntawm ophthalmology hauv cov menyuam yaus uas muaj ntshav qab zib mellitus, kev nyob tsis haum yuav tsum muaj ntau dua li cov neeg laus. Hloov pauv hauv ob qho tib si ntawm hyperopia thiab rau mnopia, thiab hauv cov neeg mob hnyav, hypotension ntawm lub pob muag.

Qee lub sij hawm muaj mob ntshav qab zib retinopathy thiab cataract, nquag nquag. Mob ntshav qab zib retinitis, qhov muag txhawm rau txham hauv cov menyuam yaus yog qhov tsis tshua muaj neeg pom.

Cov qauv ntawm tus kabmob

Mob ntshav qab zib hauv cov menyuam yaus tsis txawv rau ib tus neeg laus, nws tau muab faib ua peb hom:

Tab sis daim ntawv me hauv cov menyuam yaus yog qhov tsis tshua muaj neeg pom. Cov ntawv nruab nrab thiab cov hnyav feem ntau kuaj tau ntau dua, nrog rau tom kawg, daim siab puas yog tsis yooj yim dua, tshwj xeeb tshaj yog nws cov roj tsis haum. Qhov no yuav yog vim qhov poob ntawm tsis tsuas yog insulin, tab sis kuj yog lipocaine. Thiab tseem, ntau kev yug me nyuam ntawm kev loj hlob hormone, uas muaj adipokinetic kev ua haujlwm thiab ua rau lub siab rog.

Cystic fibrosis (cystic fibrosis) hauv cov menyuam yaus

Mob ntshav qab zib mellitus hauv cov menyuam yaus vim yog cystic fibrosis feem ntau yog vim muaj cov tshuaj insulin tsis txaus. Tab sis theem nrab insulin tsis kam nyob rau hauv mob ceev vim kis tau yooj yim thiab siv cov tshuaj pharmacological (bronchodilators thiab glucocorticoids) tuaj yeem ua rau muaj kev txhim kho ntawm cov tsis ua rau muaj ntshav qab zib thiab ntshav qab zib mellitus.

Mob ntshav qab zib vim cystic fibrosis nyhav tshwm sim tom qab ntawm tus kabmob, feem ntau yog menyuam yaus thiab menyuam hluas thaum ntxov. Yog tias muaj kab mob siab, qhov no ua rau muaj peev xwm tiv thaiv cov tshuaj insulin. Kev loj hlob ntawm cov ntshav qab zib vim yog cystic fibrosis yog qhov kev ua tsis zoo thiab ua rau muaj kev xiam oob qhab thiab kev tuag ntau dua. Kev tswj ntshav qab zib tsis zoo muaj feem cuam tshuam nrog kev tiv thaiv kab mob rau kev kis mob thiab ua kom mob catabolism.

Cov lus pom zoo los soj ntsuam muaj los ntawm kev soj ntsuam ntshav qab zib nyob rau txhua xyoo rau txhua tus menyuam mob cystic fibrosis (cystic fibrosis) ≥ 14 xyoos mus rau kev kuaj ntshav qabzib hauv lub qhov ncauj txhua txhua xyoo rau cov menyuam muaj hnub nyoog tshaj 10 xyoo, tab sis kev ntsuas ib txwm muaj xws li yoo ntshav ntshav qabzib, PGTT, thiab HbA1c tej zaum yuav tsis tsim nyog rau kev kuaj mob ntshav qab zib rau cov neeg mob cystic fibrosis.

Thaum pib, kev kho tshuaj insulin tsuas yog tsim nyog rau kev ua pa ntawm tus mob ua pa, mob hnyav lossis mob sib kis, tab sis dhau sijhawm, kev kho tshuaj insulin yog qhov tsim nyog tas li. Thawj zaug kev txhaj tshuaj ntawm cov tshuaj insulin feem ntau yog me me (ntau dua li qhov kev hloov kho siv tshuaj insulin). Hauv qee tus neeg mob, kev kho mob insulin thaum ntxov ua ntej pib ntawm cov tsos mob ntawm hyperglycemia ua rau cov pa uas muaj txiaj ntsig zoo uas txhim kho kev loj hlob, lub cev nyhav thiab kev ua haujlwm ntsws.

Mob Ntshav Qab Zib hauv cov menyuam yaus

Feem ntau, cov menyuam yaus raug kuaj pom tias muaj ntshav qab zib latent (mob ntshav qab zib), uas feem ntau tuaj yeem ua nrog exogenously - kev rog dhau los lossis kab mob kis:

mob npaws
mob plab zawv
kab mob siab kis, thiab lwm yam.

Cov neeg mob feem ntau tsis qhia kev tsis txaus siab. Kev yoo mov cov ntshav qab zib yog qee zaum ib txwm muaj, tsis muaj qab zib hauv cov zis, qee zaum muaj hloov hyperglycemia thiab glycosuria. Tab sis, raws li txoj cai, lawv tsis yooj yim rau kev cuam tshuam nrog kev kuaj ib zaug.

Nws muaj peev xwm kuaj pom cov ntshav qab zib latent hauv menyuam yaus nkaus xwb los ntawm kev suav cov ntshav qab zib nkhaus tom qab cov piam thaj hauv qab (rau cov menyuam muaj hnub nyoog kawm ntawv, 50 liv ntawm cov piam thaj txaus). Kev nce siab nrog kev nyeem ntawv qeeb ntawm qib siab tshaj plaws thiab qhov qeeb poob qis, tom qab 3 teev tsis nce mus txog thawj cov lej ntawm cov ntshav qab zib, yog cov yam ntxwv ntawm mob ntshav qab zib latent.

Thaum ntxov paub txog tus kab mob ntshav qab zib latent yog qhov tseem ceeb heev, vim nws ua rau nws muaj peev xwm ua kev kho mob thaum ntxov ntawm kev txhim kho thiab tiv thaiv kab mob ntshav qab zib latent los ntawm kev ua kom pom tseeb.

Nws tau nyaij ntau dua li cov neeg laus, nws muaj mob. Nrog kev tiav nkauj tiav nraug, cov txheej txheem normalizes, tej zaum yog vim qhov tsis muaj (nrog rau qhov pib ntawm kev txhim kho tag nrho cov kabmob thiab cov tshuab) ntawm kev noj ntau dhau ntawm kev loj hlob hormone hauv lub cev.

Teeb meem

Txheeb xyuas thaum nyuam qhuav pib ntawm kev txhim kho thiab kho cov ntshav qab zib kom raug rau cov menyuam yaus hauv 90% ntawm cov neeg tsis muaj teeb meem. Nrog rau kev kho tsis raug, daim duab hauv tsev kho mob tau loj dua, thiab muaj ntau cov teeb meem tshwm sim:

kev loj hlob sai, qhov tseeb tshaj qhov ntshav qab zib ua ntej tsim los ntawm lub hnub nyoog,
kev sib deev raug tsim txom,
polyneuritis
cataract
lub raum tsis ua hauj lwm zoo,
cirrhosis ntawm daim siab.

Thaum tseem yog menyuam yaus thiab tub ntxhais hluas muaj ntshav qab zib thiab mob ntshav siab rau tuberculosis, yuav tsum saib xyuas cov ntsws tas mus li ntawm lub ntsws. Vim paub hais tias muaj ntshav qab zib ua ntej thiab kho tau kom raug, tuberculosis tsis tshua pom muaj tsawg.

Cov cim ntawm ntshav qab zib hauv cov menyuam yaus

Kev kuaj mob ntshav qab zib hauv cov menyuam yaus feem ntau tsis tau lig.

kev nqhis dej
qhov ncauj qhuav
nquag tso zis
poob phaus
kev ua kom tsis muaj zog yog qee thaum suav tias yog kev tawm tsam helminthic lossis zoo li lwm yam kab mob.

Kev kuaj mob sib txawv

Nrog lub raum mob ntshav qab zib, nrog rau muaj piam thaj, tso zis tawm los, tab sis feem ntau tus neeg mob uas mob ntshav qab zib raum tsis qhia kev tsis txaus siab, ntshav qab zib, raws li txoj cai, yog qhov qub, thiab qee zaum txawm tias txo qis me ntsis. Lub nkhaus glycemic tsis hloov pauv. Cov piam thaj hauv cov zis yog tawm hauv kev sim thiab tsis nyob ntawm qhov ntau ntawm cov khoom noj uas tau txais nrog cov zaub mov. Mob raum ntshav qab zib hauv cov hluas tsis tas yuav muaj kev kho mob tshwj xeeb nrog insulin. Yuav tsum tau saib xyuas tus neeg mob tas li, qee tus ntseeg tias ntshav qab zib raum hauv cov menyuam yaus pib mob ntshav qab zib, lossis nws daim ntawv nruab nrab.

Cov tsos mob tseem ceeb ntawm ntshav qab zib insipidus tsis txawv ntawm qab zib, nws yog nce nqhis dej, qhov ncauj qhuav, tso zis heev, poob ceeb thawj. Cov ntshav qab zib thiab nkhaus glycemic hauv ntshav qab zib insipidus tsis yog tus tsis muaj kev ntseeg.

Tus mob ncaj qha nyob ntawm lub sijhawm kuaj mob. Ua tsaug rau cov kev kuaj mob ua dhau los thiab kev kho mob tsis tu ncua hauv kev saib xyuas mob nkeeg tas li, menyuam tuaj yeem coj lub neej tsis txawv ntawm cov menyuam yaus noj qab nyob zoo thiab kawm tiav hauv tsev kawm ntawv.

Nrog rau cov tshuaj tiv thaiv acidotic hnyav, nrog rau cov ntawv nyuaj, qhov kev kwv yees tau qis dua. Qhov tshwm sim tsis zoo tshwj xeeb tshaj yog nyob rau hauv cov tsev neeg uas tus me nyuam tsis raug muab kev saib xyuas txaus rau hauv kev cuam tshuam nrog cov kev tswj dav, kev noj zaub mov kom raug thiab cov khoom noj muaj txiaj ntsig, thiab kev tswj hwm cov tshuaj insulin. Cov menyuam yaus uas muaj ntshav qab zib feem ntau yuav mob ntau yam dua li cov menyuam muaj lub dag zog zoo. Cov kab mob tuaj yeem mob hnyav dua thiab ua rau tuag taus.

Kev tshem tawm lossis theem ntawm "ua honeymoon" hauv ntshav qab zib hom 1

Hauv thaj tsam li 80% ntawm cov menyuam yaus thiab cov tub ntxhais hluas, qhov yuav tsum tau siv tshuaj insulin yog ib ntus tom qab pib siv tshuaj insulin. Txog thaum tsis ntev los no, lub ntsiab lus ntawm theem ntawm qee feem ntawm kev zam tsis tau qhia meej; tam sim no feem ntau lees txais yuav xav txog theem ntawm kev zam ib nrab thaum tus neeg mob xav tau qis dua 0.5 units ntawm insulin rau ib kg ntawm lub cev hnyav ib hnub ntawm theem ntawm glycated hemoglobin.

Cov neeg mob xav tau lub cev kev noj haus txaus thiab kev kho tshuaj insulin. Txhua tus neeg mob xav tau ib tus neeg txoj kev ua kom haum los ntawm kev kho ib txoj kev kho mob, nyob ntawm qhov xwm txheej nws nyob hauv kev saib xyuas mob, thiab hnub nyoog. Nrog cov ntshav qab zib latent, tsuas yog lub cev kev nyab xeeb lub cev nrog qhov tseeb qhov tseeb ntawm cov protein, cov rog thiab carbohydrates yog cov tshuaj.

Tsis pom muaj ntshav qab zib tsawg rau cov menyuam yaus hauv lub cev me, kev noj zaub mov hauv lub cev kuj tseem raug kho. Hauv qee qhov hyperglycemia thiab glycosuria yuav nyob twj ywm, tsis pub tshaj 5-10% ntawm cov piam thaj muaj nuj nqis ntawm cov zaub mov (carbohydrates + 1/2 proteins). Hauv qhov no, yuav tsum muaj kev noj qab haus huv zoo, kev tiv thaiv tag nrho ntawm kev ua haujlwm muaj peev xwm, hnyav ib txwm.

Noj ntshav insulin

Cov neeg mob feem ntau raug yuam kom tau txais insulin nrog rau kev tawm dag lub zog. Insulin yog muab tshuaj subcutaneously, raws li qhov kev xav tias ib chav txhawb nqa qhov nqus ntawm 5 g ntawm carbohydrates. Hauv qee kis, qhov kev sib tiv tauj ntawm no yog tawg vim qhov tsis ua haujlwm ntawm insulin hauv lub cev. Tshuaj insulin yuav tsum tau muab rau hauv ib qho nyiaj uas muab cov ntsiab lus ua kom tiav ntawm carbohydrates. Nws raug nquahu kom tawm txhua hnub glycosuria txog 20 g suab thaj, xws li glycosuria tsis muaj kev phom sij thiab tib lub sijhawm ceeb toom rau tus neeg mob los ntawm hypoglycemia. Txhawm rau kom txo hyperglycemia rau cov lej ib txwm yuav tsum tsis txhob muaj.

Kev faib zaub mov rau thawm hnub yuav tsum ua kom suav nrog cov tshuaj insulin. Txhawm rau tsim cov koob tshuaj ntawm cov tshuaj insulin thiab nws qhov kev faib tawm ntau dua thaum nruab hnub, ib hnub glycosuric profile yuav tsum tau nqa tawm (glycosuria hauv txhua 3 teev ntawm cov zis thiab tag nrho glycosuria hauv ib hnub yog txiav txim siab).

Nws raug nquahu kom txhaj cov insulin ntau dua ua ntej noj tshais thiab noj su, zam rau kev txhaj tshuaj yav tsaus ntuj lossis ua rau nws me me. Cov khoom noj tau zoo tshaj plaws muab faib ua 5 kev txais tos: noj tshais, cog lus thiab noj hmo, thiab khoom noj ntxiv 3 teev tom qab qhia tshuaj insulin, noj tshais thib ob thiab noj khoom txom ncauj thaum tav su. Xws li cov zaub mov fractional muab kev faib tawm ntau tshaj ntawm cov carbohydrates thiab tiv thaiv qhov ua tau ntawm hypoglycemia.

Kev ntshav siab

Kev mob ntshav qab zib feem ntau yog qhov tshwm sim ntawm qhov tsis sib xws ntawm qhov nyiaj ntawm cov tshuaj insulin thiab cov carbohydrates tau txais nrog cov zaub mov, qee zaum nws tshwm sim tom qab ntau qhov kev tawm dag zog. Kev tsim tawm nrawm:

tsis muaj zog tshwm
tes co
zoo nkaus cov tshav kub thiab txias me ntsis,
nrog cov cim hnyav dua - lub ntsej muag tsaus nti,
qaug dab peg,
ua tiav poob ntawm kev nco qab - hypoglycemic coma.

Hauv thawj theem ntawm tus neeg mob, koj tuaj yeem yooj yim tshem tawm ntawm lub xeev ntawm kev mob ntshav qab zib, muab nws yooj yim nqus carbohydrates: tshuaj yej qab zib, qhob cij, jam. Thaum poob ntawm kev nco qab, cov piam thaj tau muab tso rau cov tshuaj (40% daws ntawm 20-40 ml), nyob ntawm qhov mob hnyav ntawm cov ntshav qab zib tsawg. Yog tias cov kua nplaum tsis tuaj yeem siv, piv txwv, thaum qaug dab peg, koj tuaj yeem nkag 0.5 ml ntawm 1: 1000 kua adrenaline (ua ib qho chaw kawg!).

Cov neeg mob feem ntau tuaj hauv kev saib xyuas ntawm tus kws kho mob hauv lub xeev ntawm hyperglycemic coma, uas yog qhov txiaj ntsig ntawm kev kho tsis zoo, kev noj zaub mov tsis zoo, kev ua kom rog, cuam tshuam hauv insulin tswj hwm. Coma tshwm sim qeeb, nyob rau hauv coma, cov neeg mob yws ntawm:

tsis muaj zog
tin mob
tsaug zog
qab los noj mov tau zuj zus
xeev siab thiab ntuav tshwm sim.

Qhov pib ntawm coma nyob rau hauv cov menyuam nyob rau qee kis yog nrog mob hnyav hauv plab.
Yog hais tias tus neeg mob worsens:

tsis nco qab
muaj qhov muaj qhov tsis hnov tsw ntawm acetone los ntawm lub qhov ncauj,
ntshav qab zib thiab ketone lub cev tau pom muaj zog nce ntxiv,
glycosuria ntau zog
cov tshuaj tiv thaiv acetone hauv cov zis yog qhov zoo,
nqaij leeg thiab cov qog ntawm pob muag raug txo,
ua pa yog nquag thiab nrov.

Hauv cov xwm txheej zoo li no, nws yog ib qho sai heev uas yuav tsum tau pib tswj fwm cov tshuaj insulin subcutaneously txhua ib nrab teev, suav txog tus neeg mob tus mob thiab cov tshuaj insulin tau txais yav tas los. Tib lub sij hawm nrog kev qhia ntawm insulin, nws yog qhov yuav tsum tau qhia qhov ntau ntawm carbohydrates nyob rau hauv daim ntawv ntawm qab zib compote, tshuaj yej, kua txiv, yog tias tus neeg mob haus tau. Hauv lub xeev tsis nco qab zoo, qabzib yog tswj hwm dej (40% daws) thiab subcutaneously (5% kev daws). Ib qho txiaj ntsig zoo heev tau muab los ntawm kev tswj hwm cov tshuaj ntawm 10% daws ntawm sodium chloride. Tus neeg mob yuav tsum tau ua kom sov zoo. Raws li qhov ntsuas, ntshav mob lub plawv yog tshuaj kho.

Mob ntshav qab zib heev

Hauv cov qauv acidotic hnyav ntshav qab zib nrog cov rog rog, kev noj zaub mov carbohydrate ntau nrog kev txwv cov rog, txwv tsis pub muaj cov tshuaj insulin yog qhov tsim nyog. Cov zaub mov yuav tsum nplua nuj nyob hauv cov vitamins. Kev siv tshuaj qeeb qeeb tuaj yeem siv tau rau cov menyuam yaus hnub nyoog uas tsis muaj tshuaj lom acidosis thiab nyiam ua kom muaj ntshav qab zib tsawg dua.

General hom thiab tsev kawm ntawv

Qhov kev tswj hwm dav dav yog qhov zoo ib yam li cov menyuam noj qab nyob zoo. Cov kev ua si kis las yuav tsum pom zoo nrog koj tus kws kho mob.

Ua haujlwm hauv tsev kawm yog tsis contraindicated. Ua raws li cov chav kawm ntawm tus kab mob, qee kis qee hnub ntxiv hnub so yuav tsum ua. Lub caij so haujlwm pab tau raws li qhov kev cais.

Kev kho mob ntawm cov kev mob nyhav thiab cov kab mob sib kis yog nqa tawm hauv qhov ib txwm. Tawm tsam keeb kwm yav dhau los ntawm kev kho mob nrog kev noj haus thiab cov tshuaj insulin, tsis muaj contraindications rau txoj kev phais mob ntawm kev kho. Kev tsim kom muaj zog dav dav yog qhov xav tau: kev noj zaub mov kom zoo yam tsis muaj kev yaum. Nrog txoj kev muaj mob hnyav thiab muaj ntshav qab zib hauv ntau tsev neeg, nws yog qhov tsim nyog tias cov menyuam yaus no yuav tsum tau saib xyuas los ntawm kws kho mob tas li. (kuaj cov ntshav thiab zis rau cov ntsiab lus qab zib).

Tseem ceeb tshwj xeeb yog kev tiv thaiv tus mob ntshav qab zib muaj teeb meem. Cov niam txiv ntawm cov menyuam uas muaj qhov kev kuaj mob no yuav tsum paub txog cov teeb meem tseem ceeb uas cuam tshuam txog kev kho mob ntshav qab zib, kev noj zaub mov noj, insulin, thiab lwm yam. Txhua tus menyuam yaus uas kuaj pom tus mob ntshav qab zib, nws raug nquahu kom muab tso rau hauv tsev kho mob txhua xyoo, txhawm rau ntxaws ntxaws ntxaws. Nrog rau kev ua kom tsis tu ncua, tus neeg mob yuav tsum tau mus pw hauv tsev kho mob tam sim ntawd.

Cov lus nug rau kev sib tham nrog cov neeg ua haujlwm hauv tsev kawm

Tus Neeg Hu Xov Xwm Kub Ceev

Kuv yuav hu leej twg yog tus mob huam sai?
Tus xov tooj ntawm lwm tus neeg hauv tsev neeg yog tias koj hu tsis tau koj.

Kev siv tshuaj hypoglycemia

Kuv pom cov tsos mob dab tsi thiab dab tsi yuav tsum tau ua nrog cov tsos mob no?
Dab tsi yog cov khoom siv kho mob thaum maj nrawm rau hypoglycemia zoo li thiab nyob qhov twg?
Lub tsev kawm ntawv puas muaj chaw khomob? Lub sijhawm ntawm nws txoj haujlwm? Puas muaj cov kabmob glucagon hauv chaw ua haujlwm (ib yam tshuaj siv los ntawm cov neeg ua haujlwm kho mob los kho tus mob ntshav qab zib)?
Puas yog tus kws qhia ntawv tau nkag mus hauv chav ua haujlwm thaum lub sijhawm tsis ua haujlwm thiab nws puas tuaj yeem muab tus kabmob glucagon rau tus menyuam yog tias tsim nyog?

Khoom noj thiab khoom noj txom ncauj

Yog tias tus menyuam yaus yuav tsum tau noj thaum lub sijhawm teev nruj me ntsis, yuav ua li cas qhov no tau teeb tsa kom nkag mus rau hauv chav kawm?
Cov menyuam puas nqa khoom noj nrog lawv tom tsev lossis noj mov hauv tsev noj mov?
Puas yog tus menyuam yaus xav tau kev pab neeg laus hauv kev suav cov khoom noj (carbohydrate units)?
Tus menyuam puas xav noj khoom txom ncauj ua ntej kev tawm dag zog?

Ntshav qab zib

Thaum twg tus menyuam yuav tsum ntsuas ntsuas ntshav qab zib? Puas yog nws xav tau kev pab?
Tus me nyuam puas tuaj yeem txhais cov kev ntsuas ntsuas lossis ntsuas cov neeg laus xav tau?

Kev ua rau hyperglycemia

Yuav ua li cas nrog ntshav qab zib cov ntshav? (Qhov tshuaj insulin!)
Koj tus menyuam puas yuav tsum txhaj tshuaj insulin thaum nws nyob hauv tsev kawm ntawv? Puas yog nws xav tau kev pab ntawm neeg laus?
Yog tias tus menyuam yaus siv lub tshuab nqus insulin, nws puas tuaj yeem siv nws tus kheej?
Puas yog nws siv tau hauv tub yees los ntim cov insulin yog tias tsim nyog (piv txwv, hauv huab cua kub)?
Puas muaj lwm chav nyob qhov twg koj tuaj yeem txhaj tshuaj insulin? Koj yuav tsum paub tseeb tias koj tus menyuam tau ua txhua yam raws li txoj kev kho mob tau hais tseg nyob rau hnub kawm ntawv. Koj yuav tsum kuaj koj cov insulin tsis tu ncua thiab rov ntim cov khoom ntxiv yog tsim nyog.

Cov hluas muaj ntshav qab zib li cas cuam tshuam rau cov kwv tij

Tus mob ntshav qab zib muaj feem tsis yog rau tus menyuam xwb, tab sis rau tag nrho tsev neeg. Ua niam txiv, koj yuav pib siv sijhawm ntau nrog koj tus menyuam, vim nws muaj ntau yam uas koj yuav tsum tau tham, tshwj xeeb yog thaum pib mob. Koj tus menyuam yuav xav tias nyob ib leeg, tsis zoo li txhua tus neeg, poob siab lossis tsis paub tseeb txog nws lub neej yav tom ntej thiab, nkag siab, yuav muaj kev saib xyuas thiab kev saib xyuas ntxiv nyob ib puag ncig. Yog tias koj muaj menyuam ntau tus, ces qhov tsis txaus ntseeg no tuaj yeem ua rau qee qhov ntxhov siab hauv tsev neeg. Nws yog ib qho tseem ceeb kom faib koj lub sijhawm kom txhawm rau txo kev cuam tshuam ntawm cov ntshav qab zib hauv koj tus menyuam rau koj kev sib raug zoo nrog lwm tus neeg hauv tsev neeg, nrog rau kev sib raug zoo ntawm cov kwv tij thiab cov muam.

Rivalry ntawm cov me nyuam

Nws tsis yog ib qho yooj yim kom ua tiav qhov sib npaug ntawm kev faib lub sijhawm ntawm cov menyuam, txij li txoj cai, tus menyuam muaj ntshav qab zib xav tau kev saib xyuas thiab kev saib xyuas ntxiv. Txaus siab rau txoj kev xav ntawm tag nrho koj cov menyuam. Lwm tus menyuam yaus yuav xav tias lawv tso lawv tseg, tsis tseem ceeb, lossis tsis nco qab lawm. Ib txhia ntshai rau lub neej tom ntej ntawm lawv tus tij laug lossis tus muam thiab txhawj xeeb tias lawv thiab lawv yuav muaj ntshav qab zib. Txawm tias lawv yuav xav tias lawv ua txhaum vim tias lawv tsis muaj ntshav qab zib, lossis liam lawv tus kheej rau khoom qab zib rau lawv cov kwv tij lossis cov muam yav dhau los.

Kev muaj niam thiab txiv nrog cov menyuam uas mob zoo yuav ua rau lwm tus menyuam khib. Lawv puas xav tias lawv tsis tau txais lub ntsej muag zoo ib yam li yav dhau los? Lwm tus menyuam yuav tsum mob siab rau nus / kwv lossis muam uas muaj ntshav qab zib. Tus me nyuam muaj mob yuav mloog zoo li nws sab heev lossis nws xav tias nws ib txwm saib ntsoov nws.

Dua li lwm cov menyuam, tej zaum yuav khib vim tus menyuam muaj mob tau txais ntau qhov cai lossis cov ntawv tau ua si. Yog li, nws yog qhov yuav tsum muaj kev sib koom tes ntawm cov kwv tij thiab cov muam hauv kev sib tham qhib lub ntsiab lus ntawm cov ntshav qab zib thiab tham qhov no nrog tag nrho tsev neeg. Piav qhia rau koj cov menyuam txhua yam ntshav qab zib yog dabtsi thiab nws cuam tshuam licas rau lawv lub neej. Nws yog ib qho tseem ceeb kom xa cov ntaub ntawv rau txhua tus menyuam, nyob ntawm nws lub hnub nyoog thiab qib kev txhim kho. Ua kom lwm tus hauv tsev neeg koom tes pab tu tus menyuam mob ntshav qab zib.