Mob ntshav qab zib thiab kis las

Mob ntshav qab zib mellitus, manifested los ntawm tus txheeb ze lossis tsis muaj qhov tsis txaus insulin, yog ib qho muaj mob heev. 347 lab tib neeg thoob ntiaj teb muaj ntshav qab zib.

Cov neeg mob feem ntau tuaj yeem muaj kev nyab xeeb hauv kev tawm dag zog thiab kev ntaus kis las, nrog rau theem siab. Txhawm rau tiv thaiv teeb meem thiab tswj kev ua haujlwm ntawm lub cev, cov ntshav qabzib feem ntau yog qhov tseem ceeb. Nrog rau cov teeb meem xws li nephropathy, neuropathy, thiab retinopathy, kev ua kis las-hnyav tsis tau pom zoo, tab sis kev tawm dag zog lub cev tsis tu ncua yuav tsum muaj kev txhawb nqa. Hauv cov neeg mob uas mob ntshav qab zib mellitus, feem ntau, rau ntau dua li cov neeg muaj kev noj qab haus huv, cuam tshuam rau kev noj qab nyob zoo, lub cev nyhav, lipid profile thiab lwm yam kev pheej hmoo rau atherosclerosis. Kev txo qis hauv cov ntshav hauv cov ntshav txhaws txo qhov kev pheej hmoo ntawm microangiopathic cov teeb meem, nrog rau kev tuag los ntawm ntshav qab zib thiab kev tuag tag nrho (los ntawm 35%, 25% thiab 7%, feem, nrog txo qis hemoglobin A, ntawm 1%). Vim tias lub cev tsis tshua mob calorie tsawg noj, kev tawm dag zog lub cev thiab yog li ntawd, qhov hnyav poob thiab cov tshuaj tiv thaiv insulin, ib qib ze rau qhov cov ntshav qabzib feem ntau ua tiav.

Cov txiaj ntsig ntawm kev ua kis las hauv ntshav qab zib tsis tuaj yeem tsis lees paub, tab sis muaj teeb meem loj heev tau. Qhov tseem ceeb tshaj plaws yog cov khoom noj hauv lub cev tsis txaus siab, feem ntau hypoglycemia, uas tuaj yeem tsim kho thaum lub sijhawm thiab tom qab ua si, yog tias kev noj zaub mov noj lossis tshuaj ntau npaum li cas tsis raug hloov sijhawm. Hauv cov neeg mob tau txais cov tshuaj insulin lossis sulfonylureas, kev cuam tshuam ntawm metabolic yog qhov ntau dua. Kev mob ntshav qab zib tuaj yeem tshwm sim nws tus kheej hauv kev sib txawv, tab sis tus yam ntxwv tshaj plaws yog lub teeb pom kev, tsis muaj zog, tsis pom kev, tsis pom kev, tawm hws, xeev siab, tawv nqaij txias thiab paresthesia ntawm tus nplaig lossis ob txhais tes. Cov lus pom zoo rau kev tiv thaiv ntawm cov qog ntshav qab zib hauv cov neeg mob ntshav qab zib uas koom nrog kev ua kis las tau teev tseg hauv qab no:

Kev tiv thaiv ntawm hypoglycemia thaum kawm

• Kev ntsuas ntshav cov ntshav ua ntej, thaum lub sijhawm thiab ua si tawm dag zog
• Kev tawm dag zog ua ntu zus thaum sawv ntxov (as txwv tsis ua li niaj zaus) ua rau kev hloov kho ntawm kev noj zaub mov zoo thiab tshuaj insulin
• Txhua lub sijhawm nqa khoom noj tau yooj yim zom zom cov carbohydrates lossis glucagon, 1 mg (rau sc lossis intramuscular tswj)
• Qhov tshuaj insulin thiab kev kho kev noj zaub mov kom haum
• Kev kho cov tshuaj insulin ua ntej kev tawm dag zog
  • Ua ntej kev tawm dag zog, insulin yuav tsum tsis txhob raug txhaj rau hauv txhais caj npab lossis txhais ceg, qhov chaw txhaj tshuaj zoo tshaj plaws yog lub plab
  • Nws yog qhov tsim nyog los txo qhov koob tshuaj luv luv ntawm kev ua yeeb yam insulin raws li kev npaj qhia lub sijhawm: 90 feeb - los ntawm 50%, lub nra hnyav yuav xav tau ib qhov ntau dua qhov txo qis
  • Qhov koob tshuaj ntawm nruab nrab-ua haujlwm insulin (insulin NPH) yuav tsum raug txo los ntawm ib feem peb
  • Nws yog qhov zoo dua los siv lyspro-insulin (nws muaj kev nrawm dua thiab lub sijhawm luv luv ntawm kev nqis tes ua)
  • Thaum siv cov khoom sib txuas ntawm tus neeg siv, qhov ntsuas cov tshuaj insulin yog txo los ntawm 50% rau 1-3 teev ua ntej cov chav kawm thiab rau lub sijhawm kawm
  • Yog tias kev tawm dag zog lub cev yog npaj tam sim ntawd tom qab noj mov, txo qhov kev siv tshuaj insulin ua ntej noj mov los ntawm 50%
• Kev noj haus kom haum
  • Noj mov tag nrho 2-3 teev ua ntej kev tawm dag zog
  • Cov khoom noj txom ncauj carbohydrate ua ntej kev tawm dag zog yog tias cov ntshav qabzib hauv lub hnub nyoog yog 35 xyoo
  • Hom 1 mob ntshav qab zib mellitus kav ntev> 15 xyoo
  • Hom 2 mob ntshav qab zib mellitus kav ntev> 10 xyoo
  • Tshaj Xo
  • Lwm yam kev pheej hmoo ntxiv rau atherosclerosis (txog hlab ntsha tawg, haus luam yeeb, ua rau muaj kev tsis txaus ntseeg, hyperlipoproteinemia)
  • Cov teeb meem microangiopathic nyuaj
  • Atherosclerosis ntawm peripheral leeg
  • Autonomic Neuropathy

  Qhov teeb meem loj rau cov neeg mob ntshav qab zib, ua lub neej nquag, tuaj yeem yog tus kab mob ntawm txhais taw. Peb yuav tsis nyob ntawm cov teeb meem no, peb tsuas yog nco ntsoov tias lawv tshwm sim ntau zaus. Yog li cov kws kho mob, pom zoo siv lub neej zoo rau cov neeg mob ntshav qab zib mellitus, kuj yuav tsum piav qhia tias yuav kom zam tau cov kab mob ko taw, koj yuav tsum hnav cov khau mos, tsis txhob nyem thiab thom khwm ua los ntawm ya raws-tshem npuag rau kev ua kis las thiab ua tib zoo saib xyuas koj txhais taw.

  Cov Khoom Noj Ua Si thiab Ntshav Qab Zib hloov |