Qhov yuav tsum tau muaj ntawm kev ntsuas tus kheej ntawm cov piam thaj hauv hom 2 ntshav qab zib
Kuv pom tias kuv muaj ntshav qab zib los ntawm kev sib tsoo thaum kuv mus kuaj mob tom chaw haujlwm. Kuv tsis tau yws hlo li; Kuv xav tias kuv noj qab nyob zoo. Kev tsom xam cov ntshav qhia kev nce ntshav qab zib - 6.8 mmol / L. Kuv raug xa mus rau tus kws endocrinologist. Tus kws kho mob tau hais tias qhov no yog siab tshaj qhov teev tseg (cov cai yog tsawg dua 6.1 mmol / l) thiab ib qho kev soj ntsuam ntxiv yuav tsum tau ua: kev ntsuas ntsuas suab thaj. Kuv tau ntsuas ntawm lub khoob khoob suab thaj (nws tau rov qab dua qhov txiaj ntsig - 6.9 mmol / l) thiab lawv tau muab kuv cov khob ua kua dej qab zib ntau ntau - cov piam thaj. Thaum ntsuas cov ntshav qab zib tom qab 2 teev, nws tseem dhau qhov qub - 14.0 mmol / L (yuav tsum tsis pub ntau tshaj 7.8 mmol / L). Kuv kuj tau kuaj ntshav rau glycated hemoglobin (qhia tias thaj tsam li thaj tsam li “thaj” li 3 lub hlis). Nws tseem tau siab - 7% (thiab tsis ntau tshaj 6% tso cai).
Thiab tom qab ntawd kuv hnov los ntawm tus kws kho mob: "koj muaj ntshav qab zib hom 2" Rau kuv nws yog kev poob siab. Yog, Kuv tau hnov txog mob ntshav qab zib ua ntej, tab sis nws tuaj yeem nrog lwm tus, tab sis tsis nrog kuv. Lub sijhawm ntawd kuv muaj hnub nyoog 55 xyoos, Kuv tau tuav haujlwm ua tus thawj coj, ua haujlwm hnyav, tau zoo thiab tsis muaj ib qho mob hnyav hlo li. Thiab qhov tseeb, kom ncaj, kuv tsis tau mus ntsib kws kho mob. Thaum xub thawj, Kuv coj tus mob ua ib kab lus, vim hais tias cov ntshav qab zib tsis tuaj yeem kho tsis tau. Kuv nco txhua yam kuv tau hnov txog cov teeb meem nyuaj - uas muaj qee yam txaus ntshai tshwm sim rau lub raum thiab ob lub qhov muag, mob txhab rau ntawm txhais ceg thiab txhais ceg txiav tias tus neeg muaj ntshav qab zib yuav ua tsis taus. Tab sis kuv tsis tuaj yeem tso cai qhov no! Kuv muaj ib tsev neeg, cov menyuam, cov xeeb ntxwv yuav yug los sai sai! Tom qab ntawv kuv nug kuv tus kws kho mob endocrinologist tsuas yog ib lo lus nug: "Kuv yuav ua li cas?" Thiab tus kws kho mob teb kuv: "Peb yuav kawm tswj hwm tus mob. Yog tias koj tswj ntshav qab zib kom tswj tau, cov kev nyuaj yuav zam tau. ”Thiab rau ib daim ntawv kuv pleev xim rau daim duab no:
Peb pib nrog kev cob qhia: koj tsis tuaj yeem tswj hwm qhov koj tsis paub.
Kuv tau xaiv daim ntawv ntawm cov zaj lus qhia ntawm tus kheej (tseem muaj cov pab pawg hauv chav kawm - cov tsev kawm "mob ntshav qab zib"). Peb xyaum rau 5 hnub rau 1 teev. Thiab txawm tias qhov no zoo li kuv tsis txaus; ntxiv rau, hauv tsev kuv nyeem cov ntawv nyeem muab rau kuv los ntawm kws kho mob. Hauv chav kawm, Kuv tau kawm paub txog cov ntshav qab zib yog dab tsi, vim li cas nws tshwm sim, dab tsi tshwm sim hauv lub cev. Cov ntaub ntawv tau nyob rau hauv daim ntawv ntawm kev nthuav tawm, txhua yam yog tsis tshua muaj nkag thiab txawm nthuav. Tom qab ntawd, Kuv tau kawm paub ntsuas ntsuas ntshav qab zib nrog lub txiv mis (nws tsis yog qhov nyuaj, thiab nws tsis mob), khaws cia daim ntawv tswj tus kheej. Qhov tseem ceeb tshaj, Kuv tau to taub vim li cas qhov no tsim nyog, ua ntej ntawm kuv tus kheej. Tom qab tag nrho, Kuv tsis paub tias kuv cov piam thaj tau nce vim tias kuv tsis hnov dab tsi. Tus kws kho mob tau hais tias kuv muaj hmoo uas tau kuaj ntshav qab zib thaum ntxov, thaum ntshav qab zib cov ntshav tseem tsis tau nce siab. Tab sis qhov ncauj qhuav, nqhis dej, tso zis ntau zaus, poob phaus - tshwm sim thaum cov ntshav qab zib kom nws nce siab. Qhov txaus ntshai tshaj plaws yog tias ib tug neeg tsis paub txog nws tus mob, tsis tau txais kev kho mob, thiab kev puas tsuaj hauv lub cev tshwm sim thiab qhov kev pheej hmoo ntawm cov teeb meem yog siab dua, tom qab kev kuaj mob tau ua. Yog li, nws yog ib qho tseem ceeb yuav tsum tau kuaj mob tsis tu ncua: yog tias koj muaj hnub nyoog ntau dua 45 xyoos, yuav tsum kuaj ntshav qab zib txhua 3 xyoos. Tab sis txawm hais tias koj lub hnub nyoog qis dua 45 xyoos, tab sis koj rog dhau, ua lub cev qoj ib ce qis, qee tus ntawm koj cov txheeb ze muaj ntshav qab zib mellitus, koj tau muaj "ciam teb" nce rau hauv cov ntshav qab zib, tawg, ntshav siab - koj kuj yuav tsum tau noj tsis tu ncua ntshav rau qab zib.
Hauv cov chav kawm kuv tau kawm ib lub tswv yim tseem ceeb: "phiaj xwm ntshav qab zib kom sib luag" Nws txawv rau txhua tus neeg, nws nyob ntawm hnub nyoog thiab muaj lwm cov kab mob. Ntawd yog, nrog cov ntshav qab zib, nws ua rau tsis muaj txiaj ntsig kom siv zog rau qhov ib txwm ua, tab sis koj yuav tsum nyob hauv koj qhov "txwv" ntawm kev yoo mov qab zib, 2 teev tom qab noj mov thiab qhov glycated hemoglobin. Lub hom phiaj raug xaiv rau kuv: tsawg dua 7 mmol / l, tsawg dua 9 mmol / l thiab tsawg dua 7%, feem. Hauv qhov no, qhov txaus ntshai ntawm cov teeb meem yuav tsum muaj tsawg heev. Kuv raug nquahu kom ntsuas ntshav qab zib ib zaug ib hnub nyob rau txawv sijhawm thiab ib zaug ib lub lim tiam - ntau qhov ntsuas, thiab sau txhua tus ntsuas hauv phau ntawv sau cia. Kuv pub glycated hemoglobin txhua 3 lub hlis. Tag nrho cov no yog qhov tsim nyog los soj ntsuam qhov teeb meem los ntawm tus kws kho mob thiab kev hloov pauv ntawm kev kho mob yog tias tsim nyog.
Tom qab ntawd, peb muaj zaj lus qhia txog kev hloov pauv hauv lub neej, khoom noj khoom haus thiab qhov tseem ceeb ntawm kev tawm dag zog hauv kev tswj ntshav qab zib. Kuv lees paub, qhov no, ntawm chav kawm, yog qhov nyuaj tshaj plaws ntawm txhua yam. Kuv ib txwm ib txwm noj rau qhov kuv xav tau, thaum kuv xav tau thiab ntau npaum li cas kuv xav tau. Kev tawm dag zog lub cev: hauv pem teb 4 los ntawm kev nce tsheb, mus rau lub tsheb ob kauj ruam, los ntawm lub tsheb mus ua haujlwm, thaum ua haujlwm hauv lub rooj zaum ua haujlwm rau 8-10 teev, los ntawm lub tsheb hauv tsev, los ntawm lub elevator mus rau hauv pem teb 4, rooj zaum, TV, uas yog txhua yam haujlwm. Yog li ntawd, thaum muaj hnub nyoog 40, kuv tau los ua "txiv neej" muaj txiaj ntsig zoo "nrog lub" npias "plab. Thaum suav lub cev lub cev qhov ntsuas, Kuv hnov lwm qhov tsis txaus siab tshaj tawm: "rog ntawm 1 degree." Ntxiv mus, qhov chaw nyob ntawm cov roj hauv lub plab yog qhov txaus ntshai tshaj plaws. Thiab qee yam yuav tsum tau ua nrog qhov no. Hauv zaj lus qhia, Kuv tau kawm tias khoom noj tsis yog “zaub mov qab thiab zaub mov qab heev”, tab sis nws muaj cov khoom sib txuam, txhua tus nyias muaj nyias lub luag haujlwm. Cov tseem ceeb tshaj plaws rau kev tswj ntshav qab zib yog cov carbohydrates, uas ua rau cov ntshav qab zib nce siab. Nws muaj cov carbohydrates uas nce nws sai sai - sawv daws “yooj yim”: qab zib, zib ntab, kua txiv. Lawv yuav tsum tau muab tshem tawm pov tseg (es tsis txhob qab zib Kuv pib siv stevia - lub ntuj sweetener). Muaj cov carbohydrates uas maj mam nce qab zib - "nyuaj": qhob cij, cereals, qos yaj ywm. Koj tuaj yeem noj lawv, tab sis hauv feem me me. Tsis tas li, cov khoom noj muaj roj ntau (cov rog, cov rog ua rog, mayonnaise, roj, nqaij hnyuv ntxwm, ceev zaub mov) kuj tseem raug txwv. Cov piam thaj hauv cov rog tsis nce ntxiv, tab sis nce cov calories ntau ntawm cov zaub mov. Ntxiv rau, thaum qhov kev kuaj mob, Kuv tau pom tias muaj cov roj (cholesterol) ntau, uas tau ua los ntawm cov tsiaj rog. Cov roj (cholesterol) tuaj yeem muab tso rau hauv cov hlab thiab kaw lawv, uas thaum kawg ua rau lub plawv nres, hlab ntuag, thiab ua rau lub nkoj ntawm cov ceg puas tsuaj. Hauv cov ntshav qab zib mellitus, atherosclerosis muaj kev tshwj xeeb heev, yog li cov roj (cholesterol) yuav tsum yog "lub hom phiaj" (qis dua cov neeg tsis muaj ntshav qab zib!).
Koj yuav noj dab tsi?
Zoo, ntawm chav kawm, cov no yog ntau yam zaub, zaub ntsuab, nqaij ntshiv, ntses thiab khoom noj siv mis. Thiab qhov tseem ceeb tshaj plaws, nws yog qhov kev txo qis rau kev pabcuam rau ntau thiab tsawg. Tom qab tag nrho, tus txiav ua ke, uas tsim tawm cov insulin los txo cov ntshav qab zib tom qab noj mov, tsis tuaj yeem tiv nrog ntau cov carbohydrates. Yog li ntawd, nws tau pom zoo rau kuv tias muaj ntau feem me me. Kuv tau tso dej cawv, tshwj xeeb tshaj yog npias thiab txhua yam uas txuas nrog. Cawv, nws hloov tawm, muaj calories ntau, ntxiv rau qhov qab los noj mov.
Thaum xub thawj, txhua yam no zoo li tsis yooj yim rau kuv, thiab kuv tsis tuaj yeem txaus siab noj zaub mov nrog tag nrho cov kev txwv no. Txawm li cas los xij, qhov no tau hloov mus ua qhov sib txawv kiag li. Kuv tus kws kho mob tau suav sau ib qho khoom noj tshwj xeeb rau kuv, suav txog kuv txoj kev noj zaub mov (ntawm cov khoom noj uas tau tso cai, thiab) kuv tau nqa nws los tsev rau kuv tus poj niam. Tus poj niam tau teeb tsa qhov txuj ci ntawm cov zaub mov, uas nws ua tsaug ntau ntau. Tag nrho cov khoom noj uas txwv tsis pub tawm ntawm lub tsev, thiab nws tau pib noj nws tus kheej kom kuv thiaj li tsis raug ntxias kom noj tej yam tsis raug. Thiab koj paub, cov khoom noj muaj txiaj ntsig zoo tuaj yeem muaj qab thiab koj tuaj yeem txaus siab! Txhua yam phom sij tuaj yeem hloov los ntawm kev siv tau. Txawm hais tias dej cawv - es tsis txhob npias lossis ntsuj plig, tam sim no kuv xaiv cawv liab liab, 1 khob thaum noj hmo. Kuv tau txais ntau dua kev zoo siab thaum kuv tau txais ntawm nplai tom qab 6 lub hlis thiab pom tias kuv tau txo qhov hnyav hnyav los ntawm 5 kg! Tau kawg, qhov no tau ua tiav tsis tsuas yog los ntawm kev hloov khoom noj khoom haus. Peb tau yuav khoom yuav khoom ua si qoj, thiab ua ke peb pib mus kawm. Ua ntej pib qhov kev tawm dag zog, peb tau soj ntsuam nrog tus kws kho mob kis las kom suav nrog cov kabmob uas ua rau lub cev txav ntau dua tuaj yeem ua rau lub cev tsis zoo. Tus kws qhia thiab kuv tau koom rau hauv ib qho kev pabcuam ntawm tus kheej, vim tias yog tias tus neeg tsis tau txais kev paub tawm mus dhia thiab pib ua kev tawm dag zog ntawm nws tus kheej, nws tsis yog ib txwm ua tau zoo thiab tuaj yeem ua rau muaj kev phom sij rau kev noj qab haus huv. Ib qho ntxiv, raws li kws kho mob tau piav qhia rau kuv, kev ua kis las tuaj yeem ua rau lub ntsej muag ntshav qab zib, tshwj xeeb yog tias ib tug neeg noj qee yam tshuaj hypoglycemic. Peb kuj tau tham txog yuav ua li cas kom tsis txhob muaj ntshav qab zib hauv lub cev (ntau cov ntshav qab zib tsawg, qhov xwm txheej txaus ntshai heev), vim li cas nws tshwm sim, thiab yuav daws nws li cas.
Thaum xub thawj, nws nyuaj rau nrhiav sijhawm, tom qab ua haujlwm koj nkees, koj xav mus tsev thiab so kom txaus, tab sis lub hom phiaj yog lub hom phiaj. Tseeb, ntxiv rau qhov ua kom poob ceeb thawj, kev tawm dag zog tawm dag zog txo cov ntshav qab zib (Kuv kuj tau kawm txog qhov no hauv chav kawm - cov leeg nqaij ua kom qab zib rau kev ua haujlwm, thiab txav ntau, cov piam thaj zoo dua).
Thaum xub thawj peb tau tsuas yog mus ob hnub so, ib zaug ib lub lim tiam, tom qab ntawd nws tau tshwm sim taug kev ntau dua, thiab dab tsi yog qhov xav tsis thoob, muaj sijhawm. Lawv tau hais tias "yuav muaj lub siab xav tau." Thiab cov chav kawm tsim kev kub siab thiab daws kev ntxhov siab tom qab ua haujlwm zoo dua li mus so hauv tsev ua ntej lub TV. Ntxiv rau, Kuv tsis kam of the elevator ob leeg nyob hauv tsev thiab tom haujlwm, nws zoo li yog trifle, tab sis kuj ua haujlwm rau cov leeg.
Yog li, tau npaj kuv li khoom noj khoom haus thiab ntxiv kev ua kis las rau kuv lub neej, Kuv tau tswj kom txo qhov hnyav 5 kg thiab kom txog rau thaum kuv tau tswj hwm qhov ua tiav.
Tab sis li cas txog cov tshuaj rau txo cov ntshav qab zib?
Yog lawm, yuav luag muab tshuaj txhuam (tom qab tau txais cov txiaj ntsig ntawm kev ntsuam xyuas tias kuv muaj txhua yam raws li daim siab thiab lub raum) Kuv tau sau tshuaj metformin thiab kuv noj tam sim no, ob zaug ib hnub, thaum sawv ntxov thiab yav tsaus ntuj nrog pluas noj. Raws li kuv tus kws kho mob tau piav qhia rau kuv, cov tshuaj no pab lub hlwb hauv kuv lub cev zoo siab txog lawv cov insulin thiab yog li ua kom kuv cov suab thaj nyob hauv kuv lub hom phiaj xaiv. Nws puas tuaj yeem ua yam tsis muaj tshuaj? Muaj qee kis, yog, raws li kev noj zaubmov nkaus xwb thiab ua rau lub neej muaj sia. Tab sis qhov no tshwm sim tsis tshua muaj, ntau zaus, metformin yog kho tam sim tom qab kuaj mob. Peb kuj tseem muaj zaj lus qhia txog ntau yam tshuaj los txo cov ntshav qab zib. Muaj ntau ntawm lawv, thiab lawv txhua tus coj txawv. Tsuas yog koj tus kws kho mob yuav tsum txiav txim siab yam tshuaj twg uas koj yuav tsum tau muab tshuaj raws li koj cov piam thaj thiab glycated hemoglobin suav. Dab tsi pab kom koj cov neeg nyob ib ncig lossis raug hais hauv lub this vis yuav tsis zoo rau koj, thiab tuaj yeem tsim kev phom sij. Peb tau sib tham txog cov kua dej. Yog lawm, insulin yog siv rau hom 2 mob ntshav qab zib mellitus, tab sis tsuas yog nyob rau hauv rooj plaub thaum kev sib xyaw ntawm ntau cov ntsiav tshuaj ntawm qhov ntau kawg yuav tsum tsis pab, i.e. hauv qhov xwm txheej uas koj tus txiav tau nqus nws cov peev xwm thiab tsis tuaj yeem tsim insulin lawm. Txhua tus neeg muaj "tus kheej tshwj xeeb", tab sis txawm li cas los xij, txhawm rau kom tsis txhob "ua rau lub qog", nws yog qhov yuav tsum tau ua raws cov cai kev noj zaub mov hauv thawj qhov chaw, vim tias ntau cov zaub mov carbohydrates peb noj thaum tib lub sijhawm, insulin xav tau kom thauj suab thaj rau hauv hlwb, qhov kev siv zog ntau dua ntawm tus txiav yuav tsum ua haujlwm. Muaj qee kis mob uas xav tau tshuaj insulin: piv txwv li, yog qhov kev kuaj mob tau ua nrog cov piam thaj ntau dhau, thaum lub ntsiav tshuaj pab tsis tau, thiab cov tshuaj insulin nyob ib ntus. Yuav tsum tau hloov tshuaj insulin ib ntus thaum npaj ua haujlwm los ntawm kev siv tshuaj loog. Tab sis txawm hais tias nws yuav tsum tau hloov pauv mus rau insulin, txhawm rau tswj kev mob ntshav qab zib "tswj tau" Kuv npaj rau qhov no. Yog lawm, nws yuav yog qhov haujlwm tshiab, koj yuav tsum kawm ib yam tshiab, dhau los ua ib qho kev tsis txaus siab los ntawm kev txhaj tshuaj txhua hnub, suav cov nyiaj carbohydrates thiab cov koob tshuaj insulin, tab sis qhov no tsis tseem ceeb yog tias qhov no yuav pab kom zam kev mob hnyav thiab kev noj qab haus huv.
Tus kws kho mob puas tau qhia kuv txog cov teeb meem ntshav qab zib hauv peb chav kawm? Yog lawm, ntxiv, qhov tseeb thiab qhib kev, tsis yog lus tsis meej "tej yam tsis zoo rau lub raum, ob lub qhov muag, cov hlab ntshav," tab sis tshwj xeeb yog qhov tshwm sim hauv lub cev hauv ntau cov kabmob uas muaj cov ntshav qab zib kom tsis tu ncua. Tshwj xeeb insidious hauv no hwm yog lub raum - cov kabmob uas ntshav ntxuav ntawm cov co toxins. Nrog lawv cov yeej, tsis muaj qhov xav tias xav tias ib yam dab tsi tsis zoo, muaj cai mus txog rau theem thaum cov kev hloov no tsis tuaj yeem hloov thiab lub raum tsis ua haujlwm lawm. Txawv zoo li no, tib neeg xav tau kev lim ntshav nrog lub tshuab tshwj xeeb - lim ntshav hauv cov chaw tshwj xeeb ob peb zaug hauv ib lub lis piam. Yuav ua li cas koj thiaj paub tias muaj qee yam ua rau lub raum? Nws yog ib qho tsim nyog yuav tsum tau tso ntshav tsis tu ncua rau creatinine, raws li kws kho mob yuav muaj peev xwm los soj ntsuam cov hauj lwm zoo ntawm kev ntxuav cov ntshav los ntawm co toxins los ntawm lub raum. Thaum tsis muaj kev hloov pauv, qhov no yog nqa tawm txhua xyoo. Qhov siab dua ntawm cov creatinine siab dua, ua kom lub raum ua haujlwm tsis zoo. Hloov kuj tuaj yeem pom hauv urinalysis - yuav tsum tsis muaj protein ntau nyob rau hauv qhov (ib txwm) ntsuas cov zis, thiab hauv kev txheeb xyuas tshwj xeeb rau microalbumin - nws yuav tsum tsis txhob siab tshaj ib qib. Kuv xeem cov ntawv no txhua 6 lub hlis, thiab txog tam sim no txhua yam zoo li qub.
Yog li hais tias ob lub raum tsis raug kev txom nyem, nws yog ib qhov tsim nyog yuav tsum muaj ntshav siab (li 130/80 mm RT tshooj lus). Raws li nws tig mus, kuv cov ntshav siab tau nce, thiab kuv kuj tsis paub txog nws, vim kuv tsis tau ntsuas nws. Tus kws kho plawv khaws kuv cov tshuaj ntshav siab rau kuv. Txij thaum ntawd los, Kuv tau coj lawv tas li, thiab kuv cov ntshav siab yog qhov yog. Kuv tuaj cuag tus kws kho plawv tawm tswv yim ib xyoos ib zaug txhawm rau ntsuas kev ua haujlwm ntawm kev kho mob, tus ECG, thiab nqa cov ntawv txheeb xyuas tus kheej. Thaum lub sijhawm kuv tau saib xyuas, Kuv kuj tau tso lub ultrasound ntawm lub plawv, ib qho ultrasound ntawm cov hlab ntsha ntawm lub caj dab - txog thaum pom qhov hloov pauv. Lwm yam khoom hauv nruab nrog uas tuaj yeem cuam tshuam los ntawm cov ntshav qab zib yog lub qhov muag, lossis theej, cov hlab ntsha ntawm retina. Ntawm no, ib yam nkaus, nws yuav tsis muaj qhov xav, thiab koj tsis tas yuav tsom rau qhov koj pom zoo lossis tsis zoo. Cov kev hloov no tsuas pom los ntawm tus kws kho pob kws kho mob thaum kuaj cov nyiaj. Tab sis ib tug neeg tuaj yeem "hnov" ntawm nws tus kheej tsuas yog qhov ua kom tsis pom kev zoo hauv lub zeem muag, mus txog qhov tsis muaj qhov tsis meej uas tshwm sim vim yog rov ua kom zoo dua qub. Tus mob no yog kho nrog laser coagulation ntawm tus retina - "soldering" nws rau lub qhov muag. Txawm li cas los xij, nrog cov theem siab dhau los, qhov no yuav ua tsis tau, yog li nws yog qhov tseem ceeb uas tus kws kho qhov muag pom koj tsawg kawg 1 zaug hauv ib xyoos lossis ntau dua yog tias muaj kev hloov pauv txhawm rau kho tshuaj kom ncav sijhawm thiab txuag koj lub qhov muag.
Qhov phom sij txaus ntshai tshaj plaws rau kuv yog kev txiav tawm ntawm ob txhais ceg nrog kev txhim kho kev ua qog. Kuv tus kws kho mob tau piav qhia vim li cas qhov no tuaj yeem tshwm sim. Nrog cov dej qab zib kom tsis tu ncua, cov leeg ntawm ob txhais ceg maj mam tab sis muaj tseeb cuam tshuam. Thaum xub thawj, qhov tsis zoo siab, hnov lub siab kub hnyiab, "xyoob caj pas" hauv ko taw, uas tus neeg tsis mloog zoo, feem ntau yuav tshwm sim. Thaum lub sij hawm, rhiab heev txo thiab yuav ploj zoo rau nws. Ib tus neeg tuaj yeem nqis rau ntsia ntsia, sawv ntawm qhov chaw kub, txhuam pob kws thiab tsis muaj dab tsi nyob rau tib lub sijhawm, thiab taug kev nrog lub qhov txhab ntev ntev kom txog thaum nws pom nws. Thiab qhov txhab kho neeg mob hauv ntshav qab zib tau raug txo qis, thiab txawm tias lub qhov txhab me me, kev nkag siab zoo tuaj yeem nkag mus rau hauv lub qhov txhab. Txhua yam no tuaj yeem zam tau yog tias koj ua raws li txoj cai yooj yim ntawm kev saib xyuas ko taw thiab xaus rau kev tswj cov ntshav qab zib cov ntshav. Ntxiv nrog rau kev saib xyuas nws tus kheej ntawm ob txhais ceg, nws yog ib qho tsim nyog uas tus kws kho mob (endocrinologist lossis tus kws kho paj hlwb) tsawg kawg 1 zaug hauv ib xyoos ua kev soj ntsuam ntawm lub siab nrog cov cuab yeej tshwj xeeb. Txhawm rau txhawm rau txhim kho kev mob ntawm txoj hlab ntshav, cov tshuaj tiv thaiv kab mob nrog cov vitamins thiab antioxidant qee zaum sau tseg.
Ntxiv nrog rau qhov cuam tshuam rau cov hlab ntsha, hauv kev txhim kho ko taw mob, mob atherosclerosis ntawm cov hlab ntsha (kev tso tawm ntawm cov plahaum mob plahaum) ua lub luag haujlwm tseem ceeb, ua rau txo qis ntshav ntws mus rau ceg. Qee zaum, lub lumen ntawm lub nkoj tuaj yeem kaw kom tiav, thiab qhov no yuav ua rau kev txhawm rau txhawm rau, uas qhov txiav tau dhau los ua ib txoj kev tawm xwb.Tus txheej txheem no tuaj yeem kuaj pom hauv lub sijhawm thaum lub sijhawm ultrasound ntawm cov hlab ntsha ntawm ob txhais ceg. Qee qhov xwm txheej, kev ua haujlwm tshwj xeeb yog ua rau cov nkoj - nthuav dav cov hlab nrog lub zais pa thiab txhim kho stents hauv lawv - cov nets uas tiv thaiv kev kaw ntawm lumen dua. Lub sijhawm ua haujlwm tau zoo tuaj yeem txuag koj ntawm txiav tes. Txhawm rau txo qis kev pheej hmoo ntawm kev mob atherosclerosis (thiab tib cov txheej txheem yog qhov ua rau mob stroke thiab lub plawv nres: tseem muaj kev txhaws ntawm cov hlab ntshav, tab sis tsuas yog muab lub hlwb thiab lub plawv), nws yog qhov tsim nyog los tswj cov "phiaj" ntawm qib roj thiab nws cov feem "zoo" thiab "tsis zoo". Ua qhov no, tau kawg, koj yuav tsum ua raws li kev noj zaub mov noj, tab sis kuv tsis tuaj yeem ua tiav qhov txiaj ntsig tsuas yog ntawm qhov no, thiab kws kho plawv tau xaiv kuv cov tshuaj uas tswj cov qib roj cholesterol. Kuv coj nws tsis tu ncua thiab noj lipid profile txhua rau lub hlis.
Yuav hais li cas nyob rau hauv xaus? Yog, Kuv muaj ntshav qab zib. Kuv tau nrog nws nyob tau 5 xyoos. Tab sis kuv tuav nws tswj! Kuv vam tias kuv tus yam ntxwv yuav pab tau cov neeg uas tau ntsib nrog qhov teeb meem no. Qhov tseem ceeb tshaj plaws yog tsis txhob tag kev cia siab, tsis txhob tso, tsis li nws tsis yog koj, tab sis mob ntshav qab zib uas yuav tswj hwm koj, koj lub neej, thiab txiav txim siab koj lub neej yav tom ntej yuav zoo li cas. Thiab, qhov tseeb, koj tsis tas yuav nyob ib leeg nrog tus kab mob, nrhiav kev kho mob hauv Is Taws Nem, nug cov phooj ywg ... Thov kev pab ntawm cov kws paub tshwj xeeb uas paub lawv txoj haujlwm, thiab lawv yuav pab koj, lawv yuav qhia koj kom tswj ntshav qab zib tau zoo, raws li lawv tau qhia kuv.
Saib seb leej twg, thaum twg, ntau npaum li cas thiab vim li cas cov ntshav qab zib yuav tsum tau ntsuas.
Feem ntau ntawm cov neeg muaj ntshav qab zib hom 2 ntsuas lawv cov ntshav qabzib tsuas yog thaum sawv ntxov ua ntej noj tshais - ntawm lub plab khoob.
Li ntawd xwb ib lub plab khoob qhia tsuas yog lub sijhawm me me ntawm ib hnub - 6-8 teev, uas koj pw. Thiab yuav ua li cas hauv cov seem 16-18 teev?
Yog koj tseem ntsuas koj cov ntshav qab zib ua ntej yuav mus pw thiab hnub tom qab ntawm lub plab khoob, tom qab ntawd koj tuaj yeem soj ntsuam seb cov piam thaj hauv cov ntshav yuav pauv ib hmosyog tias pauv, ces yuav ua li cas. Piv txwv li, koj noj tshuaj metformin thiab / lossis insulin thaum hmo ntuj. Yog tias yoo mov cov ntshav qab zib yog siab dua me ntsis thaum yav tsaus ntuj, tom qab ntawd cov tshuaj no lossis cov tshuaj tsis txaus. Yog tias, ntawm qhov tsis sib xws, cov ntshav ntawm cov ntshav qab zib muaj qis lossis dhau tus siab, ces qhov no yuav qhia tau tias muaj cov koob tshuaj insulin ntau dua li qhov xav tau.
Koj tseem tuaj yeem siv kev ntsuas ua ntej ua lwm yam zaub mov noj - ua ntej noj su thiab ua ntej noj hmoCov. Qhov no tseem ceeb heev yog tias koj nyuam qhuav tau txais cov tshuaj tshiab los txo koj cov ntshav qab zib lossis yog tias koj tau txais kev kho mob insulin (ob qho tib si basal thiab bolus). Yog li koj tuaj yeem soj ntsuam seb cov ntshav qabzib hauv cov ntshav hloov pauv thaum nruab hnub, ua li cas lub cev ua haujlwm lossis qhov nws qhaj cuam tshuam, noj khoom txom ncauj thaum nruab hnub thiab lwm yam.
Nws tseem ceeb heev rau kev ntsuam xyuas yuav ua li cas koj lub txiav ua haujlwm nyob rau hauv teb rau ib pluas nojCov. Ua rau nws yooj yim heev - siv glucometer ua ntej thiab 2 teev tom qab noj mov. Yog tias qhov txiaj ntsig "tom qab" muaj ntau dua qhov tshwm sim "ua ntej" - ntau dua 3 mmol / l, ces nws tsim nyog sib tham qhov no nrog koj tus kws kho mob. Tej zaum nws yuav tsim nyog txhawm rau kho cov pluas noj haus lossis hloov cov tshuaj kho.
Thaum lwm tus neeg nws yog qhov tsim nyog los ntxiv rau kev ntsuas qib cov piam thaj hauv cov ntshav:
- thaum koj xav tias tsis zoo - koj xav tias cov ntshav siab lossis qis qis ntshav qabzib,
- thaum koj mob, piv txwv li - koj muaj lub cev kub,
- ua ntej tsav tsheb,
- ua ntej, thaum thiab tom qab ua exercise. Qhov no yog qhov tshwj xeeb tshaj yog thaum koj nyuam qhuav tab tom pib koom nrog kev ua si nawv tshiab rau koj,
- ua ntej yuav mus pw, tshwj xeeb yog tom qab haus cawv (nyiam dua tom qab 2-3 teev lossis tom qab).
Yog lawm, koj yuav cam hais tias ua ntau txoj kev tshawb fawb tsis yog qab ntxiag heev. Firstly, painfully, thiab ob, kim heev. Yog lawm, thiab siv sijhawm.
Tab sis koj tsis tas yuav ua qhov ntsuas 7-10 ntsuas ib hnub. Yog tias koj ua raws li kev noj haus lossis tau txais ntsiav tshuaj, tom qab ntawd koj tuaj yeem ntsuas ntau zaug hauv ib asthiv, tab sis sijhawm txawv sijhawm. Yog tias kev noj haus, cov tshuaj noj tau hloov pauv, ces thaum xub thawj nws tsim nyog ntsuas ntau dua los ntsuas qhov ua tau zoo thiab qhov tseem ceeb ntawm kev hloov pauv.
Yog tias koj tau txais kev kho mob nrog bolus thiab basal insulin (saib ntu ntu), ces nws yog qhov yuav tsum tau soj ntsuam cov qib ntshav qab zib ua ntej txhua pluas noj thiab thaum mus pw.
Lub hom phiaj tswj ntshav qab zib yog dab tsi?
Lawv ib leeg rau ib leeg thiab ua raws lub hnub nyoog, qhov muaj thiab qhov hnyav ntawm cov mob ntshav qab zib.
Nyob rau nruab nrab, phiaj glycemic qib yog raws li nram no:
- ntawm cov npliag plab 3.9 - 7.0 mmol / l,
- 2 teev tom qab noj mov thiab thaum yuav mus pw, mus txog 9 - 10 mmol / L.
Tas li cas ntawm cov piam thaj hauv kev tswj thaum cev xeeb tub yog txawvCov. Txij li thaum nce qib hauv cov piam thaj hauv cov ntshav cuam tshuam rau txoj kev loj hlob ntawm tus me nyuam hauv plab, nws txoj kev loj hlob, thaum lub sijhawm cev xeeb tub, nws yog ib qho tseem ceeb heev kom ua nws nyob rau hauv kev tswj hwm nruj!Nws yog ib qho tsim nyog yuav tsum tau ntsuas ua ntej noj mov, ib teev tom qab nws thiab ua ntej yuav mus pw, nrog rau kev noj qab haus huv tsis zoo, cov tsos mob ntawm tus mob ntshav qab zib tsawgCov. Hom phiaj cov piam thaj hauv ntshav thaum cev xeeb tub kuj sib txawv (ntau cov ntaub ntawv ..).
Siv cov ntawv teev khaws cia tus kheej
Xws li phau ntawv sau hnub qub tuaj yeem yog phau ntawv sau tshwj xeeb uas tsim rau qhov no, lossis ib phau ntawv sau lossis cov ntawv sau uas yooj yim rau koj. Hauv phau ntawv sau hnub no, nco ntsoov lub sijhawm ntsuas (koj tuaj yeem qhia tus lej naj npawb, tab sis nws yooj yim dua tsuas yog sau ntawv “ua ntej noj mov”, “tom qab noj mov”, “ua ntej yuav mus pw”, “tom qab taug kev.” Nyob ze koj tuaj yeem cim kev noj tshuaj ntawm ib hom tshuaj, muaj pes tsawg lub tshuaj ntawm insulin. yog tias koj noj nws, koj cov zaub mov zoo li cas, yog tias nws siv sijhawm ntau dhau, ces nco ntsoov cov zaub mov uas tuaj yeem cuam tshuam rau cov ntshav qabzib, piv txwv li, koj noj chocolate, haus 2 khob cawv.
Nws kuj tseem muaj txiaj ntsig los nco txog cov naj npawb ntawm cov ntshav siab, qhov hnyav, kev siv lub cev.
Xws cov ntawv teev sijhawm yuav dhau los ua tus pab cuam tsis tseem ceeb rau koj thiab koj tus kws kho mob! Nws yuav yooj yim los soj ntsuam kev kho mob nrog nws, thiab yog tias tsim nyog, kho txoj kev kho.
Yog lawm, nws tsim nyog sib tham seb qhov twg yog qhov koj yuav tsum sau nyob hauv phau ntawv me me nrog koj tus kws kho mob.
Nco ntsoov tias ntau nyob ntawm koj! Tus kws kho mob yuav qhia koj txog kab mob, qhia tshuaj rau koj, tab sis tom qab ntawd koj twb txiav txim siab los tswj hwm koj puas yuav tsum txhawm rau noj zaub mov noj, noj tshuaj uas kws kho mob sau, thiab tseem ceeb tshaj, thaum twg thiab pes tsawg lub sij hawm los ntsuas qib siab ntawm cov piam thaj hauv cov ntshav.
Koj yuav tsum tsis txhob saib qhov no ua txoj haujlwm hnyav, tu siab ntawm lub luag haujlwm uas dheev poob ntawm koj lub xub pwg. Saib nws txawv - koj tuaj yeem txhim kho koj txoj kev noj qab haus huv, nws yog koj uas tuaj yeem cuam tshuam koj lub neej yav tom ntej, koj yog koj tus thawj coj.
Nws tau zoo heev rau pom cov ntshav qabzib zoo thiab paub tias koj tswj koj cov ntshav qab zib!
Vim li cas ntsuas ntshav qab zib thiab vim li cas koj thiaj li xav tau phau ntawv sau tshuaj xyuas tus kheej?
Video (nyem mus ua si). |
Senina Anna Alexandrovna
Nrog kev hwm nws tau kawm tiav los ntawm RNIMU lawv. N.I. Pirogov (qub Lavxias Lub Xeev Kev Kho Mob University muaj npe tom qab N.I. Pirogov), qhov twg los ntawm 2005 txog 2011 kawm ntawm cov kws qhia ntawv ntawm MBF ICTM hauv Kev Tshawb Fawb Tshwj Xeeb.
Txij xyoo 2011 txog 2013 nyob hauv qhov chaw kho mob ntawm endocrinology ntawm Thawj MGMU lawv. I.M. Sechenov.
Txij xyoo 2013 Kuv tau ua haujlwm rau SOE No. 6 ceg No. 1 (yav dhau los SOE No. 21) hauv CAO.
Koj tau hais tias koj muaj ntshav qab zib. Los sis tej zaum koj tau nyob nrog tus kab mob no tau ntev thiab tsis tau nyeem cov ntshav qab zib tau zoo heev? Thaum koj tuaj ntsib kws kho mob qhov kev sab laj, nws xav kom koj khaws ib daim ntawv qhia txog tus kheej, muab qee daim ntawv me me nrog cov lej suav thiab tso lub ntiaj teb kom ua neej nrog daim ntawv no, uas koj tsis paub siv.
Nws tsis muaj qhov video thematic rau kab lus no.Video (nyem mus ua si). |
Ntxiv rau, tam sim no peb tau ntsib nrog qhov nce ntawm cov nqi ntawm cov ntawv ntsuas kev ntsuas, ib qho kev txo qis ntawm qhov uas tau tso tawm dawb hauv cov chaw kho mob hauv nroog, lossis txawm tias lawv tsis tuaj rau hauv lub khw muag tshuaj dawb. yuav ua li cas ua haujlwm nrog nws thiab tib lub sijhawm txuag cov ntawv xeem.
Raws li kev txheeb cais, cov neeg uas niaj zaus saib xyuas lawv cov ntshav qab zib kom muaj glycemia zoo dua. Qhov no feem ntau vim tias cov neeg uas muaj qib txaus ntawm kev tswj hwm tus kheej txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txha ntshav, muaj qhov sib npaug ntawm kev qhuab qhia hauv lub neej zoo tib yam, thiaj li tsis pub lawv tus kheej noj yam lawv xav tau, tab sis tsis tau. Tom qab tag nrho, lawv paub ntau npaum li cas qhov "ua tsis tau" yuav nce lawv cov ntshav qab zib cov ntshav.
Thiab lawv muaj theem txaus ntawm kev qhuab qhia tus kheej txhawm rau koom nrog kev ua haujlwm hauv lub cev, uas, raws li lawv pom los ntawm kev saib xyuas tus kheej tsis tu ncua, txo cov ntshav qab zib.
Nyob rau hauv dav dav, txheeb cais, ib yam, ntawm chav kawm, yog qhov zoo, tab sis nws tsis xav txog qee qhov nta ntawm tib neeg qhov. Cov ntshav qab zib kom zoo nyob hauv ib qho nyob ntawm seb koj noj dab tsi, koj txav mus ntau npaum li cas thiab ua tib zoo saib koj noj tshuaj muaj ntshav qab zib kom tsawg. Kev tswj glycemic tsis tu ncua tsuas yog pab koj pom ntau npaum li cas koj ua cuam tshuam rau koj cov ntshav qab zib.
Leej twg yuav tsum tswj ntshav qab zib thiab ntau npaum li cas?
Ntshav qab zib Hom 2 rau ntawm cov ntsiav tshuaj lossis ntawm cov zaub mov noj
Kev tswj tus kheej yog qhov tseem ceeb heev hauv thawj theem. Yog tias koj nyuam qhuav muaj mob ntshav qab zib lossis yog tias cov suab thaj tsis zoo heev. Kev tsis tu ncua (1 zaug hauv ib hnub lossis 1 sijhawm hauv 3 hnub) ntsuas ntsuas ntshav qab zib yuav tso cai koj taug qab cov kev hloov pauv ntawm koj lub cev rau qee yam khoom noj thiab kev tawm dag zog.
Txhua tus neeg ntawm tib cov khoom noj cov khoom qab zib yuav nce ntxiv hauv nws txoj hauv kev. Txhua yam nws yog nyob ntawm ntau npaum li cas cov hlwb pancreatic tau tshwj tseg rau kev ua haujlwm nquag, ntau npaum li cas cov leeg nqaij thiab rog pawg, qib ntawm cov roj cholesterol, thiab lwm yam. Nws yog ib qho tseem ceeb tsis yog kom ntsuas kev qab zib txhua tag kis sawv ntxov, tab sis kom ua tib zoo ua txoj kev no.
Yuav tswj cov ntshav qab zib li cas?
- Tshawb xyuas koj tus kws kho mob txog seb cov piam thaj hauv ntshav yuav tsum yog leej twg tshwj xeeb rau koj (rau lub hom phiaj ua piam thaj hauv ntshav). Lawv tau suav ib tus zuj zus, nyob ntawm lub hnub nyoog, qib thiab muaj ntau qhov teeb meem thiab cov kab mob cuam tshuam uas koj tau txais los ntawm.
- Ntsuas qab zib ib hnub ib zaug 2-3 zaug hauv ib asthiv thiab nyob rau tej lub sijhawm koj xav tias tsis xis nyob lossis hnov zoo. Qhov no yog qhov tsim nyog kom txuag tau thiab tsim nyog siv cov xeem ntsuas.
- Ntsuas qab zib ntawm lwm lub sijhawm. Tam sim no ntawm lub plab khoob, tom qab ntawd ua ntej noj su, tom qab ntawd ua ntej noj hmo, tom qab ntawd 2 teev tom qab noj mov. Sau koj cov suab thaj.
Tag nrho cov ntsuas no tseem ceeb. Lawv yuav cia koj thiab kws kho mob soj ntsuam kev hloov pauv ntawm cov piam thaj kom haum rau cov ntshav qab zib, kho kev hloov pauv ntawm cov ntshav qab zib, thiab tseem yuav tshem tawm tag nrho los yog hloov pauv nrog kev sib txawv ntawm txoj kev kho mob ntshav qab zib. Yog tias koj tsis paub yog tias ib lossis lwm yam khoom noj tuaj yeem noj, noj nws ntau npaum li koj xav tau, thiab tom qab ntawd ntsuas cov suab thaj theem 2 teev tom qab noj mov.
Yog tias glycemia tsis pub dhau lub hom phiaj qhov tseem ceeb, tom qab ntawd koj tuaj yeem noj cov zaubmov no. Yog tias koj pom cov lej ntau dua 10 mmol / l, tom qab ntawd kuv xav tias koj tus kheej yuav nkag siab txhua yam los ntawm kev tsis zoo.
Ntsuas qab zib ua ntej taug kev. Taug kev nrawm nrawm li 1 teev. Ntsuas qab zib tom qab taug kev. Kwv yees ntau npaum li cas nws tau poob. Qhov no yuav tso cai rau koj siv kev tawm dag zog yav tom ntej los ua tus tswv kom muaj txiaj ntsig zoo tshaj plaws rau cov ntshav qab zib kom tsawg. Nws tuaj yeem tsis tsuas yog taug kev, tab sis them nqi, nquag tu, mus rau tom khw thiab lwm yam.
Siv sijhawm li 1-2 lub hlis ntawm koj lub neej ntawm kev ntsuas tus kheej tsis tu ncua. Sau cov ntshav qab zib, cov kev tawm dag zog. Sau cia koj cov kev tawm tsam rau cov zaub mov ntau yam, ntxhov siab, mob, thiab lwm yam. Qhov no yuav tso cai rau koj kom paub koj lub cev zoo dua thiab, tejzaum nws, qhov chaw hloov pauv koj txoj kev ua neej lossis kev noj haus. Tab sis, tsis yog vim hais tias tus kws kho mob tau qhia koj txog qhov no, tab sis vim tias koj tus kheej tau pom li cas ib qho khoom lag luam lossis kev tawm dag zog cuam tshuam rau koj. Tsis tas li ntawd, qhov no yuav cia koj yav tom ntej ntsuas ntsuas qab zib 1 zaug hauv 7-10 hnub.
"Vim li cas kuv thiaj yuav tsum tau sau kuv qhov ntsuas yog tias kuv tsuas saib lawv lub ntsej muag?" - koj nug.
Vim tias nws yuav cia koj tsis tsuas yog sab laj nrog koj tus kws kho mob yog tias muaj qee yam tshwm sim, tab sis kuj tseem yuav pab sib piv kev ntsuas ntawm koj qhov kev ntsuas rau ob peb lub hlis, yog tias tam sim ntawd qab zib pib "hla". Nkag siab txog qhov laj thawj ntawm qhov kev hloov pauv zoo li no, nco ntsoov koj nyob li cas thiab koj tau ua dab tsi thaum cov piam thaj tau zoo thiab txheeb xyuas qhov chaw koj tau muab rau koj tus kheej kom qeeb.
“Vim li cas ntsuas qab zib yog tias kuv twb paub tag nrho kuv cov kev ntxhov siab?” - koj nug.
Qhov no yog qhov tsim nyog los tswj qhov tseeb lossis tsis raug ntawm koj kev ua thiab cwj pwm. Qhov no yuav cia thaum ntxov mus rau kev taug qab tsis paub txog kev hloov pauv hauv lub cev thiab kho kev kho lossis kev ua neej.
Yam 2 ntshav qab zib mellitus nyob rau basal insulin thiab antidiabetic tablets
Yog tias koj noj tshuaj qab zib thiab txhaj tshuaj insulin 1-2 zaug hauv ib hnub, kev tswj ntshav qab zib yuav tsum nyob ib zaug txhua 2-3 hnub tsawg kawg.
Qhov no yog dab tsi rau?
- Qee zaum cov koob tau txhaws los yog kev tsim kho tsis zoo thiab cov tshuaj insulin tsis raug txhaj, txawm tias zoo li koj tau txhaj nws. Hauv qhov no, nrog kev tswj tus kheej, koj yuav pom cov txiaj ntsig tsis muaj qab zib ntau. Thiab qhov no yuav ua lub cim ua haujlwm los kuaj koj cov hlaws tes.
- Kev ntsuas tus kheej 1 zaug hauv ib hnub yog xav tau yog tias koj yoog cov tshuaj insulin nyob ntawm kev siv dag zog (ua haujlwm hauv tebchaws lossis kev qhia ua haujlwm hnyav hauv chaw dhia ua si). Xws li cov kev tswj hwm xav tau rau kwv yees xam ntawm cov koob tshuaj insulin.
- Yog koj lub neej tsis ruaj khov, txhua txhua hnub coj tau ntau yam haujlwm tshiab, kev noj zaub mov tsis xwm yeem, hloov pauv kev noj haus, ntsuas ntshav qab zib 1, lossis tseem 2 zaug ib hnub.
Ntsuas glycemia ntawm lub sijhawm sib txawv (txawm ntawm lub plab khoob, tom qab ntawd ua ntej noj su, tom qab ua ntej noj hmo, tom qab 2 teev tom qab noj mov). Qhov no yog qhov tsim nyog txhawm rau hloov kho qog ntawm insulin. Nce nrog cov piam thaj hauv siab thiab txo qis nrog qis qis. Koj tus kws kho mob yuav qhia koj yuav ua li cas kom txaus noj ib feem ntawm koj qhov tshuaj insulin.
Yam ntshav qab zib Hom 2 ntawm kev ua yeeb yam sib xyaw
Cov tshuaj insulins sib xyaw nrog: Novomix, HumalogMiks 25 thiab 50, Humulin M3, RosinsulinMiks. Qhov no yog sib xyaw ntawm ob qho sib txawv luv luv / ultra luv luv ua yeeb yam thiab ntev ntev ua yeeb yam insulins.
Feem ntau lawv muab luv nqi 2-3 zaug ib hnub. Txhawm rau kom ntsuas qhov ua tau zoo thiab hloov kho qhov ntsuas, nws yog ib qho tsim nyog yuav tsum ntsuas ntsuas suab thaj 2 zaug ib hnub ua ntej noj tshais thiab ua ntej noj hmo. Rau qib qab zib ua ntej noj hmo - noj tshuaj insulin thaum sawv ntxov.
Yog tias koj cov zaub mov muaj kwv yees li ntawm tib cov carbohydrates rau pluas tshais, noj su thiab noj hmo txhua hnub, koj tuaj yeem tswj cov qab zib ib hnub ib zaug. Ua ntej noj tshais, ua ntej noj hmo. Yog tias koj pom tias cov suab thaj muaj peev xwm ruaj khov, thiab tsis npaj hloov pauv dab tsi tib lub sijhawm, tom qab ntawd ces tuaj yeem ntsuas cov khoom qab zib ib zaug txhua 2-3 hnub, ntxiv, nyob rau ntau lub sijhawm. Ua ntej noj tshais, ua ntej noj hmo. Nco ntsoov sau koj cov piam thaj hauv ib phau ntawv qhia txog kev tswj hwm tus kheej thiab qhia koj tus kws kho mob tsawg kawg ib hlis ib zaug 2 zaug txhawm rau txhawm rau kho qhov tshuaj tiv thaiv yog tias tsim nyog.
Yam 2 ntshav qab zib mellitus ntawm kev siv tshuaj insulin ntau zog
Cov kev siv tshuaj insulin ntau ntxiv yog 1 tswj kev noj tshuaj insulin ntev ntev lossis 2 ncua sij hawm ntev insulin txhaj PLUS 2-3 lub sijhawm luv los yog ultrashort insulin txhaj ua ntej noj mov loj. Tom qab txhua tus, ib tus neeg noj 2 zaug hauv ib hnub, uas tsis tau pom zoo, tab sis muaj txoj cai nyob ua ib ke. Raws li, luv insulin yuav tsum tau txhaj tsis yog 3 zaug, tab sis 2.
Nco ntsoov sau koj cov piam thaj hauv ib phau ntawv qhia txog kev saib xyuas tus kheej thiab qhia koj tus kws kho mob tsawg kawg ib hlis ib zaug 2 zaug txhawm rau txhawm rau kho qhov tshuaj tiv thaiv yog tias tsim nyog. Qhov ntau zaus ntawm kev ntsuas ntsuas nyob ntawm koj txoj kev ua neej.
- Koj noj ib yam nkaus txhua hnub. Yuav tsum tswj cov piam thaj ib hnub ib zaug. Lub sijhawm sib txawv. Tam sim no ntawm lub plab khoob, tom qab ntawd ua ntej noj su, tom qab ntawd ua ntej noj hmo, tom qab ntawd 2 teev tom qab noj mov.
- Koj cov zaub mov pauv hloov pauv txhua hnub.
Qab zib tswj 2-3 zaug ib hnub twg. Ua ntej cov zaub mov tseem ceeb. Tab sis qhov xwm txheej no, koj yuav tsum nug tus kws kho mob kom qhia koj tias yuav ua li cas thiaj li tso feem dhau ntawm cov tshuaj insulin ntawm luv luv lossis ultrashort kev txiav txim siab ntawm koj tus kheej, nyob ntawm seb cov ntshav qab zib.
Yog tias qhov no nyuaj thiab tsis meej rau koj, tus kws kho mob tuaj yeem sau cia yuav sau ntau npaum li cas thiab yuav tsum muaj pes tsawg qhov txo hauv qee qhov ntsuas ntawm cov ntshav qab zib.
- Koj tau nce lub sijhawm ntev lossis ntau dua ntawm kev siv dag zog.
- Tswj qab zib ua ntej lub cev tawm dag zog.
- Hauv kev ua haujlwm ntawm lub cev, muaj mob tsis zoo.
- Ua ntej noj mov tom qab ua si tawm dag zog.
Yog tias kev tawm dag zog lub cev tsis tau muab ua ntej, tom qab feem ntau nws xav tau ntau ntxiv rau hauv carbohydrates (qee lub sijhawm koj tuaj yeem txawm tias yuav tau qee yam txaus nyiam), lossis txhaj ib koob tshuaj me dua ntawm cov insulin luv luv.
Yog tias kev tawm dag zog lub cev (ntev lossis hnyav) yog tau sau tseg ua ntej, hno cov tshuaj insulin nyob ntev dua. Ntau npaum li cas tsawg dua ntaus - koj tus kws kho mob yuav qhia koj nyob ntawm koj tus yam ntxwv. Koj paub suav cov khob cij thiab koj paub tias koj xav tau cov tshuaj insulin ntawm 1 XE.
Yuav tsum tswj ntshav qab zib ua ntej txhua pluas noj rau qhov xam qhov tseeb ntawm cov koob tshuaj luv luv los yog ultrashort insulin. Nws raug nquahu kom muab tus kws kho mob sau cia nrog menyuam yaus txhua ob lub hlis, qhov twg hauv 2-3 hnub hauv qab no yuav kaw cia:
- Koj cov piam thaj ua ntej txhua pluas noj.
- 1-2 suab thaj 2 teev tom qab noj mov (xws li tom qab noj tshais lossis noj hmo, piv txwv).
- Koj noj dab tsi, thiab pes tsawg lub khob cij muaj nyob hauv qhov no, hauv koj lub tswv yim (qhov no yog qhov yuav tsum tau ntsuas qhov tseeb ntawm koj kev xam ntawm XE).
- Cov koob tshuaj insulin uas koj txhaj (ob qho tib si luv thiab ntev).
- Cov kev qoj ib ce, yog tias nws tsis yog qauv lossis tsis xav tau
Yam 1 ntshav qab zib
Ntawm no, qhov ntau tswj hwm tus kheej, zoo dua. Tshwj xeeb tshaj yog thaum ntxov. Hauv kev coj rov qab, tus qauv kuj ua haujlwm: tswj hwm tus kheej qis dua, ua kom cov ntshav qab zib ntau ntau. Qhov no yog qhov tshwj xeeb tshaj yog rau cov neeg uas coj tus cwj pwm tsis ua haujlwm, ua lub neej nquag. Kev tswj ntshav qab zib cov ntshav yuav tsum tau ua tsawg kawg ua ntej txhua pluas noj.
Qhov tseeb, ntxiv rau - nrog rau kev noj qab haus huv tsis zoo. Qee zaum - nrog cov tsos mob ntawm tus mob ntshav qab zib tsawg, txhawm rau tshem tawm "pseudohypoglycemia", uas tsis ua tib zoo sib txawv. Tsis tas li, kev tswj hwm yog xav tau rau cov kev ntxhov siab tsis xav txog thiab ua kom lub cev txav tsis tau.
Qhov ntau koj ntsuas ntsuas ntshav qab zib, qhov koj glycemia thiab koj lub neej zoo dua. Koj ua qhov no rau koj tus kheej, tsis yog rau tus kws kho mob. Nov yog qhov tseem ceeb heev rau koj.
Thiab cov hais mav, yog tias koj muaj lub tshuab nqus insulin, qhov no tsis txhais tau txhua lub suab thaj uas tsis tuaj yeem ntsuas tau. Lub twj tso kua mis yuav tsum tau ntsuas kom zoo rau kev ua haujlwm zoo. Yog li cov kev tswj hwm ntawm no yuav tsum yog tsawg kawg 4-6 zaug hauv ib hnub.
Qhov ntsuas ntshav qab zib tam sim no yuav tsum tau kho kom zoo. Tsis txhob ntsuas nws 3 zaug hauv ib hnub yog tias koj noj tshuaj Metformin nkaus xwb. “Tsis xav paub”, “rau kuv txoj kev thaj yeeb nyab xeeb ntawm lub siab” thiab “ib yam li ntawd” tam sim no kev khwv nyiaj tsis txaus. Cov uas tau txais kev kho mob insulin yuav tsum tsis txhob saib tsis xyuas qhov ntsuas ntawm qab zib. Qhov no yuav ua tau txhim kho qib glycemia.
Nco ntsoov, hom phiaj nyob rau hauv cov ntshav qab zib yog koj txoj kev noj qab nyob zoo thiab lub neej ntev yam tsis muaj teeb meem ntshav qab zib. Qhov no tseem ceeb heev rau cov uas nyuam qhuav pib taug lawv txoj kev mob ntshav qab zib.
Koj xav tias yog lawm - koj tuaj yeem khaws cov ntawv sau cia zaub mov hauv phau ntawv ib txwm siv. Hauv phau ntawv teev cov zaub mov koj qhia hnub, sijhawm thiab koj noj dab tsi (khoom + nws qhov ntau). Nws tseem yuav zoo rau koj sau cov kev tawm dag zog hauv lub chaw muag mis nyuj, ua tib hom ntawv - hauv lub sijhawm (koj tau ua li cas + lub sijhawm ua haujlwm thauj khoom).
Tshuaj yej uas tsis muaj piam thaj rau hauv phau ntawv tuaj yeem raug cais tawm, tab sis koj yuav tsum qhia meej tias koj haus dej ntau npaum li cas ib hnub.
Ua Tsaug, Nadezhda Sergeevna.
Qhia qhov ntau ntawm cov khoom noj uas tsim nyog. Koj sau dab tsi, piv txwv li, "buckwheat"? Ib tug neeg muaj kev pab ntawm buckwheat - 2 diav, lwm - tag nrho 10. Nws tuaj yeem qhia tsis yog nyob rau hauv grams, tab sis hauv cov ntxhuav, cov leeg, tsom iav, thiab lwm yam.
Hais txog “Puas yog txoj kev ua neej nyob tsis zoo rau kuv hauv qhov xwm txheej no? ”- Vim li cas koj thiaj li sab laj nrog tus kws kho mob endocrinologist? Dab tsi yog "qhov xwm txheej"? Koj tsis qhia qhov no, tsuas yog nug txog phau ntawv qhia hnub qub. Yog tias koj twb dhau qhov kev ntsuam xyuas lawm, tom qab ntawd xa lawv cov yees duab rau cov lus, yog li nws yuav yooj yim rau kuv kom nkag siab txog qhov xwm txheej.
Ua Tsaug, Nadezhda Sergeevna.
Yog tias koj tsis pom cov ntaub ntawv tseem ceeb ntawm cov lus teb rau lo lus nug no, lossis yog tias koj qhov teeb meem me ntsis txawv ntawm cov lus tau hais, sim nug tus kws kho mob nug ntxiv rau tib nplooj ntawv yog tias nws nyob ntawm lub ncauj lus nug tseem ceeb. Koj tuaj yeem nug cov lus nug tshiab, thiab tom qab ib ntus peb cov kws kho mob yuav teb nws. Nws yog pub dawb. Koj tseem tuaj yeem tshawb cov ntaub ntawv tsim nyog ntawm cov teeb meem zoo sib xws ntawm nplooj ntawv no lossis dhau ntawm tus xaib nplooj ntawv tshawb xyuas. Peb yuav zoo siab heev yog tias koj pom zoo peb rau koj cov phooj ywg hauv kev tes hauj lwm.
Medportal 03online.com muab kev sab laj kho mob hauv kev sib kis nrog cov kws kho mob hauv lub xaib. Ntawm no koj tau txais cov lus teb los ntawm cov kws qhia tiag tiag hauv koj thaj teb. Tam sim no, lub tsev kho mob muaj peev xwm muab tswv yim nyob rau hauv 45 thaj chaw: allergist, kws kho mob / kws kho mob, kws kho mob plab, hematologist, kev paub txog poj niam cev nqaij daim tawv, tus kws kho mob hlwb, homeopath, dermatologist, pediatric gynecologist, pediatric neurologist, pediatric surgeon, pediatric endocrinologist, kws qhia kev noj qab haus huv, kev tiv thaiv kab mob, tus kws kho mob, kws muaj txuj ci, kws muaj peev xwm kis mob tus kws kho mob hais lus, ENT tus kws tshaj lij, kws kho mob hlwb, kws lij choj kho mob, kws tshuaj suav phais, kws kho paj hlwb, kws kho hlwb, kws kho hlwb, oncologist, oncologist, orthopedic raug mob kws phais, kws kho pob txha, kws kho mob, kws kho mob yas, kws tshaj lij yas, psychiatrist, psychologist, pulmonologist, rheumatologist, thiab kws kho mob, kws kho hniav, urologist, kws muag tshuaj, phytotherapist, phlebologist, kws phais mob, endocrinologist.
Peb teb 95,56% ntawm cov lus nug..
XE xam cov kab ke tshwj xeeb tau tsim los pab cov neeg mob ntshav qab zib. Nws yog ib qho tseem ceeb kom paub tias tus neeg mob yog nws tus kws kho mob!
Tsis txhob quav koj ob txhais caj npab tom qab hnov mob ntshav qab zib. Qhov no tsuas yog kuaj, tsis muaj kab lus. Sim kho qhov teeb meem no lub tswv yim thiab xav tias muaj cov kev kuaj mob uas ntshai thiab tsis cia siab ntxiv. Qhov tseem ceeb tshaj plaws yog tias tam sim no koj paub txog koj tus mob, thiab yog tias koj kawm kho kom raug, lub kaw lus thiab (qhov no tseem ceeb!) Tswj tsis tu ncua qhov xwm txheej, koj lub neej zoo yuav nyob rau theem siab.
Thiab kev paub txog endocrinologist, thiab ntau cov kev tshawb fawb ua kom ntseeg tau ib yam: tus neeg mob SD tuaj yeem ua neej ntau li ib tus neeg muaj kev noj qab haus huv, thaum muaj lub neej zoo, tab sis yuav tsum soj ntsuam ntau yam tseem ceeb: tswj qib qab zib, tswj kev ua neej noj qab haus huv thiab ua raws li qee yam zaub mov noj. Uas yog hais txog lub nam kawg, peb mam li sib tham.
Nws yog qhov tsim nyog hais tias kev noj haus rau ntshav qab zib yog qhov tseem ceeb tshaj plaws ntawm kev kho mob. Ntxiv mus, qhov mob tseem ceeb no yuav tsum raug soj ntsuam rau txhua yam ntshav qab zib, tsis hais hnub nyoog, hnyav, poj niam txiv neej thiab qib kev ua si ntawm ib tug neeg. Ib qho ntxiv yog cov khoom noj rau txhua tus yuav yog tus neeg ntshiab thiab tus neeg nws tus kheej yuav tsum tswj hwm qhov xwm txheej nrog nws cov zaub mov noj, tsis yog kws kho mob lossis lwm tus. Nws yog ib qho tseem ceeb kom nco ntsoov tias ib tus neeg lub luag haujlwm rau nws txoj kev noj qab haus huv yog nyob ntawm nws tus kheej.
Nws pab tswj cov khoom noj muaj txiaj ntsig thiab, raws li nws, laij cov feem xav tau ntawm cov tshuaj insulin luv luv rau txhua qhov kev qhia, kev xam ntawm cov khob cij. XE yog ib chav tsev sib txig uas tau tsim los ntawm cov khoom noj khoom haus German thiab siv los kwv yees cov nyiaj carbohydrates hauv cov zaub mov. Nws ntseeg tias ib qho XE yog 10-12 grams ntawm carbohydrates. Yuav nqus 1 XE, 1.4 chav nyob yuav tsum. Cov tshuaj insulin-luv luv.
Feem ntau cov tib neeg ua ntej muaj ntshav siab tau nug cov lus no. Endocrinologist teb zoo li no:
“Peb yuav tsum nco qab tias txoj kev txiav txim siab ntawm tus neeg lub cev noj qab nyob zoo li cas. Tom qab txhua pluas noj, ntshav qab zib cov ntshav nce siab thiab lub cev txiav los ntawm nce insulin tso rau hauv cov ntshav. Hauv cov neeg mob uas muaj ntshav qab zib mellitus, qhov kev siv tshuab no tsis ua haujlwm - txiav tsis ua tiav nws txoj haujlwm, tsis tswj hwm qhov ntshav qab zib hauv cov ntshav. Yog li ntawd, ib tus neeg yuav tsum tau kawm ua nws tus kheej, thiab txhua yam, nrog kev pab khoom noj khoom haus. Nws yog ib qho tseem ceeb rau tus neeg mob ntshav qab zib kom nkag siab ntau npaum li cas cov carbohydrates uas pab txhawb kev nce hauv cov ntshav qab zib nws tau txais nrog txhua pluas noj. Yog li tus neeg yuav twv yuav nce ntshav qab zib. "
Cov zaub mov muaj cov rog, cov protein thiab carbohydrates, nrog rau dej, cov vitamins thiab cov zaub mov. Tsuas yog cov carbohydrates cuam tshuam rau cov ntshav qab zib hauv theem, yog li nws yog qhov tseem ceeb kom paub ntau npaum li cas lawv nyob hauv ib qho khoom lag luam. Qhov nruab nrab, ib pluas noj yuav tsum tau kwv yees li 5 XE, tab sis feem ntau, tus neeg xav tau kev sib koom tes tsim nyog txhua hnub ntawm XE nrog tus kws kho mob koom, vim tias daim duab no yog tus neeg thiab nyob ntawm lub cev qhov hnyav, kev siv lub cev, poj niam txiv neej thiab hnub nyoog.
Rough qhov teeb meem yog raws li nram no:
Pawg ntawm cov neeg mob uas muaj lub cev (lossis ze rau ib txwm) lub cev qhov hnyav.
Kev saib xyuas tus kheej cov ntshav qab zib yog qhov chaw ntawm cov ntaub ntawv tsim nyog ncaj qha rau tus neeg mob nws tus kheej, cov neeg tu nws, thiab rau kws kho mob. Nws tau ntev ua pov thawj tias nyob nrog tus kab mob no yog qhov yooj yim, txij li muaj ntshav qab zib tuaj yeem tswj tau.
Kawm paub yuav ua li cas kho kev kho kom raug, uas suav nrog kev tawm dag zog, kev noj zaub mov noj, kev siv tshuaj insulin, thiab tseem ntsuam xyuas koj tus mob kom raug - cov no yog cov haujlwm ntawm kev tswj tus kheej. Yog lawm, txoj kev coj ua hauv tus txheej txheem no tau muab rau tus kws kho mob, tab sis tus neeg mob, uas ceev faj tswj hwm nws tus kab mob, ua tiav cov txiaj ntsig zoo, ib txwm muaj qhov xwm txheej thiab muaj kev ntseeg siab dua.
Tsis qhia qhov tseeb ntawm cov ntawv uas yog tus mob ntshav qab zib lossis lub chaw muag mis nyuj ntawm kev saib xyuas tus kheej rau ntshav qab zib yuav tau qhia hauv cov tsev kawm tshwj xeeb, uas yog nyob hauv txhua lub tsev kho mob hauv nroog. Nws muaj txiaj ntsig zoo rau cov neeg mob uas muaj qee yam kabmob. Txhaws nws, nws yuav tsum nco ntsoov tias qhov no tsis yog txoj haujlwm niaj hnub uas siv sijhawm, tab sis yog ib txoj hauv kev los tiv thaiv kev mob hnyav. Tsis muaj ib qho qauv kev koom ua ke rau kev sau hauv nws, txawm li cas los xij, muaj qee qhov kev xav rau nws txij nkawm. Nws raug nquahu kom khaws phau ceev xwm txheej tam sim tom qab kuaj mob.
Nws yog ib qho tsim nyog los kho cov ntaub ntawv, tshuaj ntsuam ntawm uas yuav txo cov kev pheej hmoo ntawm kev mob tshwm sim los yog txhim kho tus neeg mob lub mob. Tseem ceeb tshaj yog cov ntsiab lus hauv qab no:
- piam thaj. Qhov ntsuas no tau tsau ua ntej thiab tom qab noj mov. Qee qhov xwm txheej, cov kws kho mob hais kom cov neeg mob kom qhia lub sijhawm tshwj xeeb,
- lub sijhawm ntawm kev tswj hwm ntawm insulin npaj,
- yog hais tias hypoglycemia tshwm sim, ces nco ntsoov
- hauv qee kis, kev kho mob nrog tshuaj tiv thaiv kab mob ua tau yog muaj mob ntshav qab zib hom 1.
Muaj ntau txoj kev xaiv los ceev cov ntaub ntawv soj ntsuam tus kheej qhov ntshav qab zib:
- phau ntawv sau lossis phau ntawv sau uas muaj cov duab piav qhia,
Ntshav qab zib tshawb xyuas tus kheej online siv
Tam sim no, muaj kev xaiv loj ntawm cov kev pab rau pawg no ntawm cov neeg mob. Lawv txawv hauv kev ua haujlwm thiab tuaj yeem them nyiaj thiab pub dawb. Cov thev naus laus zis niaj hnub ua rau nws muaj peev xwm ua kom yooj yim dua daim ntawv sau cia ntawm kev saib xyuas tus kheej rau tus mob ntshav qab zib mellitus, thiab tseem, yog tias tsim nyog, sab laj nrog kws kho mob los ntawm kev xa nws cov ntaub ntawv los ntawm phau ntawv sau ua hluav taws xob. Cov khoos kas tau teeb ntawm lub xov tooj smartphone, ntsiav tshuaj lossis lub computer ntiag tug. Cia peb xav txog qee qhov ntawm lawv.
Nws yog phau ntawv online sau txog tus kheej kev soj ntsuam zaub mov tus kheej thiab ntshav qab zib ntshav qab zib. Daim ntawv thov mobile muaj cov cwj pwm hauv qab no:
- lub cev hnyav thiab nws qhov ntsuas,
- kev siv calorie, nrog rau lawv kev xam siv lub laij lej,
- glycemic Performance index ntawm cov zaub mov
- rau ib qho khoom lag luam, zaub mov muaj txiaj ntsig yog muab tau los ntawm cov tshuaj lom neeg thiab tshuaj lom neeg yog qhia,
- lub chaw muag mis nyuj uas muab sijhawm rau koj kom pom cov protein, lipids, carbohydrates, thiab kuj suav cov calories.
Daim ntawv piv txwv txog kev ntsuas tus kheej cov ntshav qab zib tuaj yeem nrhiav tau ntawm cov khw muag khoom lub vev xaib.
Qhov khoos kas thoob plaws no muab lub sijhawm los siv rau txhua yam kabmob ntshav qab zib:
- thaum xub thawj - nws pab txhawm rau txiav txim siab qhov koob tshuaj insulin, uas yog xam raws theem ntawm glycemia thiab tus nqi ntawm carbohydrates tau txais hauv lub cev,
- hauv theem ob, txhawm rau txheeb xyuas qhov tsis sib xws ntawm theem pib.
Chaw muag mis nyuj uas muaj ntshav qab zib rau tus kheej kev soj ntsuam tus kheej
Yog tias tus poj niam cev xeeb tub tau qhia tus kab mob no, ces nws xav tau kev soj ntsuam tus kheej tas li, uas yuav pab txheeb xyuas cov ntsiab lus hauv qab no:
- Puas muaj kev tawm dag zog thiab lub cev txaus los tswj cov glycemia,
- Puas muaj qhov xav tau ntawm kev npaj tshuaj insulin nyob rau hauv thiaj li yuav tiv thaiv tus me nyuam hauv cov ntshav qabzib.
Cov lus hauv qab no yuav tsum tau sau tseg rau hauv phau ntawv ceev xwm txheej:
- tus nqi ntawm cov carbohydrates noj,
- kev noj cov tshuaj insulin
- ntshav qab zib concentration,
- lub cev hnyav
- ntshav cov lej
- ketone lub cev nyob hauv cov zis. Lawv pom nrog kev noj zaub mov carbohydrates, xaiv cov kev siv tshuaj tua kab mob insulin tsis raug, lossis nrog kev tshaib plab. Koj tuaj yeem txiav txim siab lawv siv cov khoom siv kho mob (cov ntawv ntsuas tshwj xeeb). Cov tsos ntawm ketone lub cev txo qis kev xa oxygen mus rau cov ntaub so ntswg thiab cov kabmob, uas cuam tshuam loj heev rau tus menyuam hauv plab.
Hauv ntau tus poj niam, mob ntshav qab zib hauv lub cev tsis tuaj yeem ploj tom qab kev yug menyuam. Yog tias, tom qab yug menyuam tas, xav tau cov tshuaj insulin npaj, ces feem ntau yuav muaj ntshav qab zib ntawm thawj hom tshuaj tsim thaum lub sijhawm xeeb tub. Qee tus poj niam muaj ntshav qab zib hom 2 nyob rau ob peb xyoos tom qab yug tus menyuam. Txo qhov kev pheej hmoo ntawm nws txoj kev loj hlob yuav pab ua kom lub cev ua si, noj zaub mov thiab tswj kev ua haujlwm ntawm cov piam thaj hauv cov ntshav tsawg kawg ib xyoos ib zaug.
Lub luag haujlwm tseem ceeb hauv tus kabmob no yog kev kho ntshav qabzib nyob rau hauv cov ntshav. Tus neeg mob tsis tuaj yeem hnov nws qhov hloov pauv, yog li tsuas yog ceev faj tswj tus kheej yuav cia koj taug qab qhov kev hloov pauv ntawm qhov kab mob loj no.
Qhov ntau zaus ntawm cov kev kawm ua qabzib ncaj qha nyob ntawm lub suab thaj txo cov tshuaj kho mob rau tus neeg mob thiab theem ntawm glycemia thaum nruab hnub. Ntawm qhov muaj nuj nqis ze rau qhov ib txwm, cov piam thaj hauv ntshav tau txiav txim siab txawv sij hawm ntawm ib hnub ob peb hnub hauv ib as thiv. Yog tias koj hloov koj lub neej kev ua neej ib txwm, piv txwv li, nce kev ua haujlwm ntawm lub cev, cov xwm txheej ntxhov siab, exacerbation ntawm tus kab mob concomitant lossis qhov tshwm sim ntawm cov mob voos xwm txheej, qhov ntau zaus ntawm kev soj ntsuam ntshav qab zib nws tus kheej yog ua tiav hauv kev pom zoo nrog tus kws kho mob. Yog tias cov ntshav qab zib ua ke nrog kev rog dhau hwv, ces cov ntaub ntawv hauv qab no yuav tsum tau muab sau cia rau hauv phau ntawv ceev xwm txheej:
- qhov hnyav hloov
- lub zog nqi ntawm kev noj haus,
- ntshav siab nyeem tsawg kawg ob zaug nyob nruab hnub,
- thiab lwm yam kev txiav txim pom zoo los ntawm kws kho mob.
Cov ntaub ntawv tau teev nyob rau hauv chaw muag mis nyuj ntawm kev saib xyuas tus kheej rau ntshav qab zib mellitus yuav tso cai rau tus kws kho mob txhawm rau ntsuas qhov ua tau zoo ntawm kev kho mob thiab kho lub sijhawm kho lossis muab cov lus pom zoo tsim nyog rau kev noj haus, qhia kho lub cev kom zoo. Kev tshuaj xyuas tas li ntawm tus kab mob thiab kev kho tus mob no kom tsis tu ncua yuav pab tswj tus neeg lub cev nyob ntawm theem uas xav tau, thiab yog tias tsim nyog, yuav tau nqis tes nrawm los kho tus mob.
Vim li cas cov qhob cij tsim nyog thiab yuav ua li cas xam cov ntawv qhia noj qab zib rau cov ntshav qab zib
Cov neeg mob ntshav qab zib tsis tas yuav ua rau lawv tus kheej tsis tau txais cov khoom noj khoom noj haus uas muaj carbohydrate. Lub tswv yim ntawm khoom noj khoom haus zoo li “chav ua mov ci” yuav pab kwv yees cov khoom noj carbohydrates kom sib npaug thiab sib npaug khoom noj.
Nrog hom 1 thiab ntshav qab zib hom 2, tus neeg mob tus txiav tsis ua hauj lwm zoo li txhua tus neeg noj qab nyob zoo. Tom qab noj mov, cov ntshav qabzib feem ntau nce siab. Qhov txiav ua ntej pib tsim cov tshuaj insulin, uas pab txhawm rau ua rau cov piam thaj. Thaum cov piam thaj hauv ntshav rov qab tso tawm dua, cov tshuaj insulin yog tsim hauv qhov ntau thiab tsawg dua.
Hauv cov neeg muaj kev noj qab haus huv, cov piam thaj tsis pub dhau 7.8 mmol / L. Qhov txiav txiav txiav txim siab tso cai koob tshuaj insulin.
Ntawm cov ntshav qab zib mellitus, qhov kev siv lub tshuab tsis ua haujlwm no tsis ua haujlwm, thiab tus neeg mob yuav tsum xam cov khoom noj los ntawm cov zaub mov carbohydrates thiab cov koob tshuaj insulin ntawm nws tus kheej.
Tus mob ntshav qab zib yuav tsum nco ntsoov: tsuas yog carbohydrates kom nce qib siab. Tab sis lawv txawv.
Carbohydrates uas twb muaj nyob hauv xwm tau muab faib ua:
Lub tom kawg tseem raug faib ua ob hom:
Kev zom thiab tswj cov ntshav qab zib ib txwm, indigestible soluble carbohydrates yog qhov tseem ceeb. Cov no suav nrog cov nplooj qhwv. Cov carbohydrates hauv lawv muaj cov txiaj ntsig zoo:
- txaus siab rau kev tshaib plab thiab tsim kev xav ntawm satiety,
- tsis nce qab zib
- normalize plab hnyuv muaj nuj nqi.
Raws li tus nqi ntawm assimilation, carbohydrates tau muab faib ua:
- zom tau (butter mov ci, txiv hmab txiv ntoo qab zib, thiab lwm yam),
- qeeb-zom cov zaub mov (cov no suav nrog cov zaub mov muaj qhov glycemic tsawg, piv txwv li, buckwheat, wholemeal qhob cij).
Thaum muab tso ua ke ntawm daim ntawv qhia zaub mov, nws yog ib qho tsim nyog los xav txog tsis tsuas yog cov nyiaj ntawm cov khoom noj (carbohydrates), tab sis kuj lawv zoo. Ntawm cov ntshav qab zib, koj yuav tsum them sai sai rau cov zaub mov carbohydrate thiab tsis zom zaub mov (muaj ib lub rooj tshwj xeeb ntawm cov khoom lag luam no). Lawv saturate zoo thiab muaj tsawg XE ib 100 g ntawm cov khoom hnyav.
Yuav ua kom yooj yim dua los xam cov khoom noj carbohydrates thaum noj mov, cov khoom noj khoom haus hauv German tau los nrog lub tswvyim ntawm "chav ua mov ci" (XE). Nws yog tsuas yog siv los suav cov zaub mov ntawm hom 2 ntshav qab zib, txawm li cas los xij, nws tuaj yeem siv tau zoo rau cov ntshav qab zib hom 1.
Lub khob ua khob cij yog lub npe muaj nuj nqi vim tias nws tau ntsuas los ntawm qhov ntau ntawm cov ncuav. Hauv 1 XE 10-12 g ntawm carbohydrates. Tus nqi sib npaug muaj ib nrab ntawm daim khob cij 1 cm tuab, txiav los ntawm tus qauv loaf. Txawm li cas los xij, ua tsaug rau XE, carbohydrates hauv ib qho khoom lag luam tuaj yeem ntsuas qhov no.
Ua ntej koj yuav tsum nrhiav kom paub ntau npaum li cas cov carbohydrate ib 100 g ntawm cov khoom. Qhov no yooj yim los ua los ntawm saib cov ntim. Rau qhov yooj yim ntawm kev suav, peb coj raws li lub hauv paus 1 XE = 10 g ntawm carbohydrates. Cia li xav tias 100 g ntawm cov khoom peb xav tau muaj 50 g ntawm carbohydrates.
Peb ua piv txwv ntawm qib kawm ntawm tsev kawm: (100 x 10): 50 = 20 g
Qhov no txhais tau tias 100 g ntawm cov khoom muaj 2 XE. Nws tsuas yog yog los ntsuas qhov ntsuas cov zaub mov siav kom txiav txim siab cov khoom noj.
Thaum xub thawj, txhua hnub XE suav zoo li nyuaj, tab sis maj mam lawv dhau los ua tus qauv. Ib tus neeg noj kwv yees li ntawm cov khoom noj sib npaug. Raws li tus neeg mob ib txwm noj zaub mov, koj tuaj yeem ua cov zaub mov noj txhua hnub rau hom 1 thiab ntshav qab zib hom 2.
Muaj cov khoom lag luam, muaj pes tsawg leeg uas tsis tuaj yeem lees paub los ntawm sau ntawv rau ntawm pob. Hauv qhov nyiaj ntawm XE ib 100 g ntawm qhov hnyav, qhov rooj yuav pab. Nws muaj cov khoom noj nrov tshaj plaws thiab qhia qhov hnyav raws li 1 XE.
Txhua yam kev kuaj mob rau tus neeg mob, cov hauj lwm zoo ntawm kev kho mob yuav yog nyob ntawm kev tswj tus kheej. Tab sis nws yog ncaj qha xws li tus kab mob ntshav qab zib uas feem ntau ntawm txhua qhov yuav tsum tau saib xyuas tas li tsis yog los ntawm tus kws tshwj xeeb endocrinologist li ntawm tus neeg mob nws tus kheej.
Ua neej nyob hauv qab lub cim ntawm ntshav qab zib yog ib txwm ua haujlwm nyuaj rau txhua tus neeg mob. Tus kab mob no zoo li lub sijhawm ua haujlwm tsis tu ncua ib hnub, uas paub tias yuav tsis muaj hnub so lossis hnub so. Txawm hais tias qhov tseeb tias rau ntau tus naj npawb ntawm cov ntshav qab zib, ua raws li tus kws kho mob cov lus pom tau los ua ib txoj haujlwm nyuaj, txawm li ntawd los tus neeg mob tsuas yog yuav tsum kawm tswj hwm tsis yog nws txoj kab mob, tab sis nws lub neej tag nrho.
Txhawm rau kom lawv muaj kev noj qab haus huv ntawm theem kev tsim nyog, ib tus neeg yuav tsum tsis txhob cia siab rau kev siv tshuaj thiab qhov muag tsis pom kev los ntawm kws kho mob, nws yog qhov tsim nyog los tswj kev tswj tus kheej hauv ntshav qab zib. Tsuas yog ua ke nrog kev tswj tus kheej yuav kho tau cov txiaj ntsig zoo.
Lub ntsiab lus tseem ceeb ntawm kev tswj yus tus kheej yog nrhiav tau cov txuj ci uas yuav pab kom ntsuas tau thiab ntsuas kho kom raug (yog tias tsim nyog) kev kho mob los ntawm tus kws kho mob tshwj xeeb.
Unambiguously, tsuas yog tus kws kho mob muaj peev xwm muaj cai txiav txim siab kev kho mob kom tas, tab sis raws li kev paub ntawm ntau tus neeg mob ntshav qab zib, nws yog tus neeg mob tswj hwm tus kab mob uas tso cai rau nws mus txuas ntxiv kev kho mob nrog kev ntseeg siab tshaj plaws.
Hauv kev saib xyuas chav kawm thiab kev kho mob pathology rau cov neeg mob ntshav qab zib, phau ntawv sau tshwj xeeb yuav pab tau - qhov chaw kho mob tswj hwm tus kheej. Siv cov ntawv sau cia, tus neeg mob yuav tuaj yeem tswj hwm qhov xwm txheej, uas yuav ua rau nws koom nrog koom nrog tag nrho hauv nws txoj kev kho.
Txhawm rau txhawm rau kho cov tshuaj insulin yog tias tsim nyog, ua rau kev txiav txim siab muaj txiaj ntsig txog kev noj zaub mov noj thiab qhov kev tawm dag zog, koj yuav tsum muaj ntau cov ntaub ntawv thiab kev nkag siab txog yuav ua li cas. Cov neeg mob tau txais kev paub yooj yim los ntawm cov lus pom zoo los ntawm cov kws kho mob koom thiab hauv kev qhuab qhia hauv tsev kawm rau cov neeg mob ntshav qab zib.
Kev tiv thaiv kab mob nrog nrog kev ua haujlwm hauv qab no.
- Ua raws li cov kev cai ib hnub twg, uas suav nrog kev pw tsaug zog, kev tawm dag zog, kev noj mov thiab tshuaj noj.
- Saib xyuas ntshav qabzib (2-4 zaug ib hnub).
- Kev txiav txim siab raws txoj cai ntawm acetone thiab zis qab zib.
- Kev sau thiab nkag mus ntawm qhov tseem ceeb ntawm cov ntawv sau cia ntawm kev tswj hwm tus kheej.
- Qee lub sijhawm cov ntshav hemoglobin (glycated) ntshav.
Txhawm rau ua kom tiav qhov kev ua tiav siab tshaj tawm kev soj ntsuam tus kheej thiab sau cov ntaub ntawv tseem ceeb rau hauv phau ntawv sau cia, koj yuav xav tau cov cuab yeej xws li:
- glucometer - cov khoom siv uas tso cai rau koj los txiav txim siab txog qib ntshav qab zib,
- kev ntsuam xyuas nrawm nrawm rau txiav txim siab txog qib ntawm cov piam thaj thiab Acetone hauv cov zis,
- ntsuas ntshav siab - lub cuab yeej siv los txiav txim siab cov ntshav siab,
- phau ntawv sau cov lus cim, phau ntawv sau lossis ntawv npaj sau ua tiav uas txhua cov ntaub ntawv tseem ceeb ntawm kev mob ntshav qab zib, kev kho mob siv thiab kev noj haus thiab kev noj zaub mov kom zoo yuav nkag mus.
Nov yog phau ntawv teev keeb kwm. Nws tseem yuav tsum tau sau ntawm no txhua cov lus nug uas yuav tau nug rau tus kws kho mob thaum lub sijhawm teem mus.
Ua tsaug rau cov lus nkag uas cov ntawv teev hnub ua haujlwm, ib tus neeg tuaj yeem soj ntsuam qhov ntau ntawm cov chav kawm ntawm tus kabmob, uas txhais tau tias nws yuav tuaj yeem ywj pheej kho cov tshuaj insulin lossis koj cov zaub mov noj.
Lub chaw muag mis nyuj tuaj yeem yog ib daim ntawv twg, qhov tseem ceeb tshaj plaws yog cov ntaub ntawv tshaj plaws tiav. Cov lus sau uas yuav ua rau lub ntsej muag yog nyob ntawm hom mob ntshav qab zib thiab hom kev kho mob. Tab sis nws yog qhov zoo tshaj plaws los mus yuav ib phau ntawv npaj tsim muaj uas muaj txhua kab thiab kab ntawv tsim nyog los sau. Ntawm no yog nws qhov piv txwv rau hom mob ntshav qab zib zaum ob.
Tab sis ib tus neeg niaj hnub tsis xav thab nrog phau ntawv sau thiab cov ntawv sau, nws yooj yim dua rau nws tuav cov khoom siv, yog li koj tuaj yeem khaws cov ntawv sau txog koj lub smartphone. Ntawm no yog cov piv txwv ntawm cov chaw muag mis nyuj.
Ib tug neeg mob uas tau txais kev kho mob insulin ntau yuav tsum sau cov hauv qab no rau hauv phau ntawv sau npe ua si:
- muab pes tsawg thiab lub sijhawm ntawm cov tshuaj insulin,
- ntshav qabzib tshuaj soj ntsuam,
- lub sijhawm paub tseeb thaum kuaj ntshav qabzib,
- tus nqi ntawm XE noj (faib thiab ib hnub),
- cov txiaj ntsig ntawm kev ntsuas tus kheej ntawm cov zis acetone thiab cov piam thaj,
- ntaub ntawv hais txog kev noj qab haus huv.
Cov neeg mob uas muaj ntshav qab zib hom 1, tau muab tias lawv tau txais kev kho mob insulin ib txwm thiab ua raws nraim li lub sijhawm tau teev tseg, tej zaum yuav tsis sau cov tshuaj insulin txhua hnub thiab lub sijhawm ntawm nws cov thawj coj hauv phau ntawv sau cia. Cov kws kho mob ntshav qab zib nrog rau tus kws kho mob zoo yuav tau sau cov ntaub ntawv piav qhia saum toj no 3 zaug hauv ib lub lis piam. Nws raug nquahu kom ntsuas ntshav qab zib ntawm lub plab lossis 3 teev tom qab noj mov. Nws yog ib qho tseem ceeb kom nco ntsoov tias cov ntawv sau hais txog kev nyab xeeb zoo yuav tsum muaj cov ncauj lus thiab ib txwm muaj.
Tus mob ntshav qab zib nrog hom mob thib ob, uas suav nrog kev kub siab thiab kev rog dhau, yuav tsum tau ntxiv rau phau ntawv sau cia:
- nws qhov hnyav nrog qhov nws kho kom zoo,
- kwv yees cov ncauj lus hais txog caloric kom tsawg (tsawg kawg ib zaug txhua ob hnub),
- cov ntaub ntawv muaj tseeb txog ntshav siab (ob zaug ib hnub),
- yog tias kev kho ua ke nrog kev siv cov tshuaj uas txo cov suab thaj kom tsawg, tom qab ntawd lub sijhawm thiab kev noj tshuaj yuav tsum tau qhia nyob rau hauv phau ntawv ceev xwm txheej,
- cov txiaj ntsig ntawm kev ntsuas tus kheej ntawm cov piam thaj.
Tsis tas li, yog qhov xav tau, koj tuaj yeem sau cov txiaj ntsig ntawm lipid metabolism hauv kev tshuaj xyuas. Qhov no yuav pab ua kom pom ntau qhov tseeb ntawm cov duab saib mob.
Ib tug neeg mob ntshav qab zib mellitus yuav tsum paub tias yuav tsum khaws phau ntawv ceev xwm tsis yog kws kho mob, nws yog qhov xav tau hnyav uas tuaj yeem ua rau kev kho mob kom zoo dua qub, thiab muaj kev noj qab nyob zoo.
Lub chaw muag mis nyuj yuav pab khaws tag nrho cov ntaub ntawv tseem ceeb hais txog chav kawm ntawm tus kab mob, hais txog kev ua haujlwm ntawm kev kho mob, sau cia cov lus nug rau tus kws tshwj xeeb. Thiab nws tsis muaj teeb meem txawm tias nws yog phau ntawv sau los yog ib qho program hauv lub xov tooj. Thaum xub thawj, qhov yuav tsum tau sau tag nrho koj cov kev ua hauv phau ntawv sau cia yuav zoo li yog ib txoj haujlwm nyuaj, tab sis sijhawm dhau los nws yuav pab tau yooj yim rau tus neeg mob lub neej, ua kom muaj kev ntseeg siab rau nws hauv kev ua tiav ntawm tus kab mob.
"Cov tshuaj thiab lawv siv", phau ntawv hais txog. Moscow, Avenir-Tsim LLP, 1997, 760 nplooj ntawv, ncig 100,000 daim luam.
Bulynko, S.G. Kev noj zaub mov zoo thiab ua kom muaj txiaj ntsig zoo rau kev rog rog thiab ntshav qab zib / S.G. Bulynko. - Moscow: SINTEG, 2004 .-- 256 p.
C. Kilo, J. Williamson “Mob ntshav qab zib yog dab tsi? Cov lus tseeb thiab cov lus pom zoo. ” M, Mir, 1993
Cia kuv qhia kuv tus kheej. Kuv lub npe yog Elena. Kuv tau ua haujlwm li endocrinologist rau ntau tshaj 10 xyoo. Kuv ntseeg hais tias tam sim no kuv yog tus kws tshaj lij hauv kuv daim teb thiab kuv xav pab txhua tus neeg tuaj saib lub vev xaib kom daws qhov nyuaj thiab tsis yog li cov haujlwm. Txhua cov ntaub ntawv rau lub xaib tau sau thiab ua tib zoo ua kom tiav thiaj li xa ntau li ntau tau cov ntaub ntawv tsim nyog. Ua ntej thov cov ntaub ntawv uas tau piav qhia hauv lub vev xaib, kev sab laj yuav tsum nrog tus kws tshaj lij yog ib txwm tsim nyog.
Vim li cas kuv thiaj xav tau lub chaw muag mis nyuj muaj piam thaj?
Feem ntau, cov neeg mob ntshav qab zib tsis muaj qhov chaw mos ua qab zib. Rau cov lus nug: "Vim li cas koj thiaj tsis sau cov piam thaj?", Ib tug neeg teb: "Kuv twb nco txhua yam," thiab ib tug neeg: "Yog lawm, vim li cas sau cia, Kuv tsis tshua paub ntsuas lawv, thiab feem ntau lawv zoo." Ntxiv mus, "feem ntau cov suab thaj zoo" rau cov neeg mob yog ob qho tib si 5–6 thiab 11ol12 mmol / l suab thaj - "Zoo, Kuv tsoo nws, uas nws tsis tshwm sim." Alas, ntau tus tsis to taub tias kev noj zaub mov tsis xwm yeem thiab qab zib nce siab tshaj 10 mmol / l ua rau cov phab ntsa ntawm cov hlab ntsha thiab cov leeg ntshav thiab ua rau muaj ntshav qab zib tsis txaus.
Txhawm rau kom ntev li ntev tau ntawm kev saib xyuas cov hlab ntsha thiab cov leeg ntshav qab zib hauv ntshav qab zib, TXHUA cov suab thaj yuav tsum zoo li qub - ua ntej noj mov thiab tom qab - TXHUA HNUB. Cov piam thaj zoo tshaj yog los ntawm 5 txog 8-9 mmol / l. Cov piam thaj zoo - txij li 5 txog 10 mmol / l (Cov no yog cov lej peb qhia raws li lub hom phiaj ntawm cov ntshav qab zib rau feem ntau cov neeg mob ntshav qab zib).
Thaum peb xav txog glycated hemoglobin, koj yuav tsum nkag siab tias yog, nws tiag tiag yuav qhia peb qab zib hauv 3 lub hlis. Tab sis dab tsi tseem ceeb yuav tsum nco ntsoov?
Glycated hemoglobin muab cov ntaub ntawv hais txog theem nrab Cov suab thaj hauv 3 lub hlis dhau los, tsis tas muab cov ntaub ntawv hais txog cov kev hloov pauv ntawm cov suab thaj. Ntawd yog, glycated hemoglobin yuav yog 6.5% hauv ob tus neeg mob uas muaj suab thaj 5-6-7-8-9 mmol / l (them rau mob ntshav qab zib) thiab tus neeg mob uas muaj suab thaj 3-5-15-2-18-5 mmol / l (decompensated ntshav qab zib) .Yog li cas, tus neeg muaj suab thaj dhia ntawm ob sab - tom qab ntawv ntshav siab, ces cov ntshav qab zib siab, kuj tseem tuaj yeem muaj glycated hemoglobin zoo, txij thaum lub nruab nrab txhais tau tias suab thaj rau 3 lub hlis yog qhov zoo.
Yog li, ntxiv rau kev soj ntsuam ib txwm, cov neeg mob ntshav qab zib yuav tsum khaws cov zaub mov qab zib txhua hnub. Nws yog tom qab ntawm qhov txais tos uas peb tuaj yeem soj ntsuam qhov tseeb ntawm daim duab ntawm cov khoom noj metabolism thiab kho cov kev kho kom haum.
Yog tias peb tham txog cov neeg mob uas tau txiav txim, ces cov neeg mob zoo li no khaws cia cov ntawv qab zib rau lub neej, thiab thaum lub sijhawm kho kho lawv kuj tseem khaws cov ntawv qhia noj haus kom zoo (xav txog ntau npaum li cas cov zaub mov ntawm lub sijhawm hnub lawv noj, xav txog XE), thiab thaum txais tos peb txheeb xyuas ob qho khoom noj thiab cov suab thaj , thiab khoom noj khoom haus.
Cov neeg mob muaj lub luag haujlwm nrawm dua li lwm tus los them rau cov ntshav qab zib, thiab nws yog nrog cov neeg mob ntawd nws yog ua tau kom ua tiav cov suab thaj zoo.
Cov neeg mob khaws cia qhov chaw muag mis nyuj ntawm cov piam thaj txhua hnub, thiab qhov no yooj yim rau lawv tus kheej - kev qhuab qhia, thiab peb tsis siv sijhawm los noj suab thaj.
Yuav ua li cas kom muaj suab thaj chaw mos?
Cov ntsuas uas peb xav txog nyob rau hauv cov xov xwm qab zib:
- Hnub uas tau tshuaj ntsuas glycemia. (Peb ntsuas ntshav qab zib txhua txhua hnub, yog li ntawd hauv cov ntawv cov kab yog feem ntau muaj 31 kab kis, rau 31 hnub, ntawd yog, rau ib hlis).
- Lub sijhawm ntsuas ntsuas cov ntshav qab zib yog ua ntej lossis tom qab noj mov.
- Tshuaj Ntshav Qab Zib (Feem ntau muaj ib qho chaw hauv cov lus teev cia rau kev sau cia. Hauv qee daim ntawv sau cia, peb sau kev kho mob rau sab saum toj lossis hauv qab ntawm nplooj ntawv, hauv qee qhov nyob rau sab laug ntawm kev kis - qab zib, ntawm sab xis - kev kho mob).
Koj ntsuas ntsuas qab zib npaum li cas?
Nrog ntshav qab zib hom 1 peb ntsuas ntshav qab zib tsawg kawg 4 zaug nyob rau ib hnub - ua ntej noj mov tseem ceeb (noj tshais, noj su, noj hmo) thiab ua ntej yuav mus pw.
Nrog ntshav qab zib hom 2 ntsuas ntshav qab zib tsawg kawg 1 zaug hauv ib hnub txhua hnub (txawv sij hawm ntawm ib hnub), thiab tsawg kawg 1 zaug hauv ib lub lis piam, peb npaj cov ntaub ntawv glycemic - ntsuas qab zib 6 - 8 zaug hauv ib hnub (ua ntej thiab 2 teev tom qab noj mov tseem ceeb), ua ntej mus pw thiab thaum tsaus ntuj.
Thaum cev xeeb tub Cov lus qhia tau ntsuas ua ntej, ib teev thiab 2 teev tom qab noj mov.
Nrog rau kev kho kho peb ntsuas cov piam thaj ntau: ua ntej thiab 2 teev tom qab noj mov tseem ceeb, ua ntej yuav mus pw thiab ntau zaus thaum tsaus ntuj.
Thaum kho kho kev kho mob, ntxiv rau phau ntawv sau cov piam thaj, koj yuav tsum khaws cov ntawv qhia zaub mov noj (sau yam peb noj, thaum twg, ntau npaum li cas thiab suav cov XE).
Yog li leej twg tsis muaj chaw sau cia - pib sau! Yuav tsum rhais ib kauj ruam rau kev noj qab haus huv!