Mob ntshav qab zib hauv cov menyuam yaus thiab cov hluas

Hom Ntshav Qab Zib 1 mellitus yog ib hom kab mob muaj keeb hauv cov laus uas tuaj yeem tshwm sim txawm yog menyuam yaus. Qhov mob tshwm sim yog vim qhov txiav tsis tuaj yeem tsim cov tshuaj insulin.

Kev siv tshuaj insulin yog qhov tseem ceeb ntawm cov khoom noj hauv kev zom zaub mov. Nws hloov pauv hauv qabzib rau hauv lub zog xav tau rau cov cell. Raws li qhov ua tau, tsis muaj piam thaj tuaj yeem nqus tau los ntawm lub cev; nws pom muaj ntau thiab tsawg hauv cov ntshav thiab tsuas yog qee tus txhawm rau xwb.

Ntshav Qab Zib Hom 1 yog tsawg dua rau cov menyuam yaus, txog li 10% ntawm tag nrho cov mob ntawm tus kabmob. Thawj qhov tsos mob tuaj yeem pom thaum muaj hnub nyoog me me.

Cov tsos mob ntawm tus mob ntshav qab zib hom 1

Ntawm hom 1 mob ntshav qab zib mellitus, cov tsos mob pib tshwm sai sai. Hauv ob peb lub lis piam, tus me nyuam tus mob hnyav zuj zus, thiab nws xaus rau hauv tsev kho mob. Cov tsos mob ntawm tus mob ntshav qab zib hom 1 yuav tsum tau lees paub rau lub sijhawm.

Cov nqhis dej ib txwm tshwm sim vim lub cev qhuav dej, vim tias lub cev tsis zom cov piam thaj hauv cov ntshav nrog ntshav. Tus me nyuam tsis tu ncua thiab ua ntau kom tau haus dej lossis lwm yam dej haus.

Cov niam txiv pib pom tias tus menyuam yuav mus ncig hauv tsev ntau dua mus tso zis. Qhov no muaj tshwj xeeb tshaj yog thaum hmo ntuj.

Cov piam thaj ua cov khoom siv lub zog kom nkag mus rau lub hlwb ntawm tus menyuam lub cev, yog li ntawd, kev noj cov protein thiab cov nqaij rog ntau ntxiv. Vim li ntawd, ib tug neeg ce kom nce phaus, thiab feem ntau pib yuag sai sai.

Ntshav Qab Zib 1 hauv cov menyuam yaus thiab tub ntxhais hluas muaj dua lwm cov yam ntxwv tshwm sim - qaug zog. Cov niam txiv nco tias tus me nyuam tsis muaj lub zog txaus thiab tseem ceeb. Ntshai tsam tib neeg tshaib plab kuj ua loj ntxiv. Cov lus yws tsis tu ncua uas tsis muaj zaub mov raug pom.

Qhov no yog vim qhov tseeb tias cov ntaub so ntswg tsis muaj piam thaj thiab nrog zaub mov ntau. Ntxiv mus, tsis muaj ib lub lauj kaub tais diav ua rau ib tus neeg xav tias muaj kev noj qab haus huv. Thaum tus me nyuam muaj mob me zuj zus thiab ketoacidosis loj tuaj, ces cov qib ntawm lub siab xav tau poob qis dua.

Ntshav qab zib mellitus hauv cov menyuam yaus ua rau ntau yam teeb meem pom kev. Vim lub cev qhuav ntawm lub lens, ib tus neeg tau pos huab ua ntej nws lub qhov muag, thiab lwm yam kev cuam tshuam txog kev pom. Cov kws kho mob tau hais tias vim tias yog muaj ntshav qab zib, cov kab mob fungal tuaj yeem tshwm sim. Hauv cov menyuam yaus me, ntaub qhwv pob tw ua tawv tawv uas tsis yooj yim kho kom zoo. Cov menyuam ntxhais yuav muaj qhov ntsej muag.

Yog tias koj them sai sai rau cov cim ntawm tus kabmob, ces ketoacidosis tsim, uas tau hais hauv:

• nrov pa nrov
• xeev siab
• nkees
• mob plab
• hnov tsw ntawm acetone los ntawm lub qhov ncauj.

Tus minyuam yuav tsaus muag sai. Ketoacidosis kuj tseem ua rau tuag taus.

Kev mob ntshav qab zib ntshav tsawg tshwm sim thaum ntshav muaj ntshav qab zib poob qis dua qhov qub. Raws li txoj cai, cov tsos mob hauv qab no tshwm sim:

1. kev tshaib kev nqhis
2. tshee
3. palpitations
4. tsis nco qab zoo.

Kev paub txog cov tsos mob uas tau teev tseg yuav ua rau nws zam kom tsis txhob xwm txheej phom sij tuaj yeem ua rau tsis nco qab thiab tuag taus.

Cov piam thaj muaj cov ntsiav tshuaj, lozenges, kua txiv, qab zib, thiab tseem muaj cov glucagon rau kev txhaj tshuaj pab kom tshem tawm cov kev mob ntshav qab zib.

Kev pheej hmoo ntshav qab zib hauv menyuam yaus. Cov tsos mob thiab kho ntshav qab zib hauv cov menyuam yaus

Peb muaj kev ntxhov siab txhua lub sijhawm, kov yeej kev ntxhov siab, sib ntaus nrog lub cev tsis ua haujlwm, noj nrawm. Thiab dab tsi ua raws li? Tus naj npawb ntawm cov neeg mob tau nce ntxiv, piv txwv li, mob ntshav qab zib mellitus (DM), rog rog, tawg. Hmoov tsis zoo, ntau yam kab mob tsis tau tiv thaiv cov menyuam yaus thiab cov hluas.

Mob ntshav qab zib tau loj hlob thiab rov qab kho dua

Tag nrho cov naj npawb ntawm cov neeg mob ntshav qab zib (ob hom thawj thiab hom thib ob) hauv ntiaj teb muaj ntau dua 150 lab tus neeg, 2,5 lab tus neeg mob ntawm cov neeg laus tau sau npe hauv tebchaws Russia. Kwv yees li muaj pes tsawg tus tib neeg nyob rau theem ntawm ntshav qab zib. Tab sis qhov tseeb, tus naj npawb ntawm cov neeg mob yog ob txog peb zaug ntau dua li cov ntawv teev hauv lub hauv paus. Tus naj npawb ntawm cov neeg mob nce ntxiv 5-7% txhua xyoo, thiab nce siab dua txhua xyoo. Cov me nyuam cov txheeb cais tseem tu siab - mus txog rau xyoo muaj ib qho kev txhim kho hauv qhov xwm txheej tsis ntau tshaj 4%. Tom qab 2000 - txog 46% ntawm cov mob tshiab hauv ib xyoos. Hauv kaum xyoo dhau los, kev loj hlob ntawm cov ntshav qab zib los ntawm 0.7 rau 7.2 tus neeg mob ntshav qab zib hauv 100,000 cov neeg hluas.

Dab tsi thiab vim li cas

Mob ntshav qab zib mellitus, raws li WHO cov lus txhais, yog kab mob ntawm cov kab mob endocrine nyob rau hauv uas lub xeev ntawm cov kev mob ntshav qabzib (hyperglycemia) tau pom, uas tuaj yeem txhim kho qhov txiaj ntsig ntawm kev ua ntawm ntau yam caj ces, exogenous thiab lwm yam. Hyperglycemia tuaj yeem tshwm sim los ntawm qhov tsis txaus ntseeg ntawm cov tshuaj insulin - cov tshuaj hormone ntawm lub cev, lossis ntau dhau ntawm yam uas ua rau nws ua ub ua no. Tus kab mob no yog nrog los ntawm kev sib sib zog nqus ntawm carbohydrate, rog thiab protein metabolism thiab kev loj hlob tsis txaus ntawm ntau yam plab hnyuv siab raum thiab cov kab ke, tshwj xeeb tshaj yog lub qhov muag, raum, cov hlab ntsha, lub plawv thiab cov hlab ntshav.

Raws li cov tswv yim niaj hnub no, hom 1 tshuaj insulin-tiv thaiv ntshav qab zib mellitus (IDDM), uas tshwm sim hauv menyuam yaus thiab tub ntxhais hluas (feem ntau mus txog 30 xyoo), yog ib tus kabmob uas muaj kev tiv thaiv keeb kwm ntawm keeb kwm caj ces (mob ntxiv) thaum raug rau ib puag ncig. Cov laj thawj ntawm cov ntshav qab zib hom 1 yog tias cov insulin ntau lawm txo qis los yog txiav tawm kiag vim qhov kev tuag ntawm beta hlwb (Langerhans hlwb) ntawm tus txiav yog vim, piv txwv li, kis tus kab mob, muaj cov tshuaj lom hauv cov zaub mov, xws li nitrosoamine, kev ntxhov siab thiab lwm yam.

Ntshav qab zib Hom 2, uas feem ntau cuam tshuam los ntawm cov neeg laus, yog plaub npaug ntau dua li ntshav qab zib hom 1. Hauv qhov no, beta hlwb pib tsim insulin hauv ib txwm thiab txawm tias muaj ntau npaum li cas. Txawm li cas los xij, nws cov haujlwm raug txo qis (feem ntau yog vim muaj qhov tsis txaus ntseeg ntawm daim ntaub adipose, cov receptors uas muaj qhov tsis hnov ​​mob zoo rau insulin). Nyob rau hauv lub neej tom ntej, kev txo qis hauv kev tsim cov tshuaj insulin yuav tshwm sim. Cov laj thawj rau kev loj hlob ntawm hom ntshav qab zib yog kev mob caj ces, kev rog rog, feem ntau cuam tshuam nrog kev noj ntau dhau, nrog rau cov kab mob ntawm cov kab mob endocrine (pathology ntawm lub caj pas pituitary, thyroid caj pas (hypo- thiab hyperfunction), adrenal cortex). Muaj qee zaus, mob ntshav qab zib hom 2 kuj tseem tuaj yeem ua kev cuam tshuam ntawm cov kab mob khaub thuas (mob khaub thuas, kis kab mob siab, mob pob txuv, thiab lwm yam), mob cholelithiasis thiab mob ntshav siab, mob pancreatitis, hlav hlav.

Txheeb xyuas cov mob ntshav qab zib

Endocrinologist muaj kev ntseeg siab tias yuav muaj feem yuav muaj ntshav qab zib nce ntxiv yog tias muaj ib tus neeg hauv koj tsev neeg muaj lossis mob ntshav qab zib. Txawm li cas los xij, cov ntaub ntawv sib txawv muab cov lej sib txawv uas txiav txim siab qhov muaj peev xwm ntawm tus kab mob. Muaj kev soj ntsuam tias tus mob ntshav qab zib hom 1 yog tau txais qhov muaj tseeb ntawm 3-7% ntawm leej niam thiab muaj feem ntau ntawm 10% ntawm leej txiv. Yog tias ob leeg niam txiv muaj mob, qhov muaj feem yuav kis mob ntau zaus - txog li 70%. Ntshav qab zib Hom 2 yog tau txais txiaj ntsig muaj qhov tshwm sim ntawm 80% ntawm leej niam thiab leej txiv, thiab yog tias tus mob ntshav qab zib hom 2 cuam tshuam rau ob leeg niam txiv, qhov tshwm sim ntawm nws qhov kev tshwm sim hauv cov menyuam yaus ze 100%.

Yog li no, tsev neeg uas muaj cov txheeb ze ntshav muaj ntshav qab zib mellitus, yuav tsum nco ntsoov tias tus menyuam muaj qhov pheej hmoo, thiab yog li txoj kev pheej hmoo ntawm kev tsim mob loj no yuav tsum muaj tsawg (tiv thaiv kev kis kab mob, kev noj qab nyob zoo thiab kev noj haus, thiab lwm yam).

Qhov thib ob tseem ceeb tshaj plaws ua rau cov ntshav qab zib yog rog dhau los lossis rog dhau, cov tsos mob no yog qhov tseem ceeb rau hauv neeg laus thiab menyuam yaus. Ntev dhau los ntawm lawv cov kev coj ua thiab kev soj ntsuam, cov kws kho mob endocrinologist tau pom tias yuav luag 90% ntawm cov neeg mob ntshav qab zib hom 2 yog cov rog, thiab kev rog rog hnyav tuaj yeem ua rau muaj feem ntau ntawm cov ntshav qab zib hauv yuav luag 100% neeg. Txhua qhov hnyav ntxiv ntawm cov sijhawm ntxiv qhov kev pheej hmoo ntawm kev tsim muaj ntau yam kabmob: suav nrog mob plawv, xws li myocardial infarction thiab mob hlwb, sib koom tes kab mob thiab, ntawm chav kawm, mob ntshav qab zib mellitus.

Qhov laj thawj thib peb uas muaj lub luag haujlwm rau kev txhim kho cov ntshav qab zib, tshwj xeeb yog menyuam yaus, yog kis khaub thuas (kab mob qhua qhua, qhua taum, kabmob kis mob siab thiab lwm yam kabmob, suav nrog ua npaws). Cov kab mob no ua lub luag haujlwm ntawm lub tshuab uas ua rau tus txheej txheem autoimmune rau cov menyuam yaus uas muaj kev tiv thaiv kab mob (feem ntau tsis tau kuaj ua ntej). Muaj tseeb, feem ntau ntawm tib neeg, mob npaws lossis mob qhua maj yuav tsis yog ntshav qab zib pib. Tab sis yog tias tus menyuam rog dhau los ntawm tsev neeg uas leej txiv lossis leej niam muaj ntshav qab zib, ces tus mob npaws kuj yog ib qhov kev hem ua rau nws.

Lwm qhov ua rau tus mob ntshav qab zib yog kab mob pancreatic, uas ua rau beta-cell puas tsuaj, xws li pancreatitis (mob ntawm tus txiav), mob qog nqaij hlav, mob rau lub cev, thiab lom nrog tshuaj lossis tshuaj lom neeg. Cov kab mob no feem ntau muaj hnub nyoog laus dua. Cov neeg laus, kev nyuaj siab mob hlwb thiab kev ntxhov siab dhau los ua lub luag haujlwm tseem ceeb hauv kev pib mob ntshav qab zib, tshwj xeeb yog tias tus neeg rog dhau thiab mob hauv tsev neeg.

Kuv xav nco ntsoov tias nyob hauv cov neeg hluas, cov kev pheej hmoo rau kev txhim kho mob ntshav qab zib hom 2 yog:

• rog dhau
• txo qis lub cev ua si
• nra hnyav rau caj ces
• nkauj tiav nraug
• polycystic ovary syndrome hauv cov menyuam ntxhais

Tam sim no, cov kws kho mob hauv lub cev thiab cov kws kho mob endocrinologist tau muaj kev txhawj xeeb txog txoj kev loj hlob ntawm lub npe "metabolic syndrome" hauv cov hluas: kev rog dhau + insulin tsis kam (ib qho mob uas cov nqaij mos qabzib poob qis nrog kev siv tshuaj insulin li qub). Kev tsis txaus ntawm cov nqaij hauv lub cev ua rau kev ua kom lub hlwb Langerhans, kev tsim cov feem tshiab ntawm insulin thiab kev loj hlob ntawm hyperinsulinemia), ntxiv rau dyslipidemia (nce / hloov ntshav lipids), ntxiv rau cov leeg ntshav siab.

Hauv Tebchaws Meskas, kev kuaj mob metabolic tau tshwm sim hauv 4.2% ntawm cov tub ntxhais hluas ntawm tag nrho cov tub ntxhais hluas (kev tshawb fawb txog 1988 - 1994), thiab cov tub hluas ua rau muaj kev phom sij rau tus mob no ntau dua li cov ntxhais. Nws kuj tau pom tias pom cov piam thaj tsis hnov ​​qab zoo tau pom hauv 21% ntawm cov neeg hluas nrog kev rog. Hauv tebchaws Lavxias, tsis muaj kev txheeb xyuas txhua yam, tab sis xyoo 1994, Xeev Lub Chaw Tso Npe Mob Ntshav Qab Zib Mellitus tau tsim Kev Tso Npe ntawm cov neeg mob ntshav qab zib nyob hauv Moscow. Nws tau tsim muaj tias qhov tshwm sim ntawm IDDM rau cov menyuam yaus hauv xyoo 1994 yog 11.7 leej. rau 100 txhiab tus menyuam, thiab nyob rau xyoo 1995 - twb 12,1 rau 100 txhiab. Qhov no yog kev coj tsis zoo.

Paub txog lub sijhawm

Mob ntshav qab zib mellitus yog ib qho ntawm cov kab mob uas muaj ntau lub “qhov ncauj qhov ntswg”. Yog hais tias tus kab mob (ntshav qab zib hom 1) muaj kev loj hlob thaum menyuam yaus, tshwj xeeb tshaj yog thaum tseem yau, tom qab ntawd lub caij (latent) lub sijhawm luv luv - thaum niam txiv tsuas yog saib zoo rau qhov tseeb tias tus menyuam pib haus cawv thiab tso zis ntau, nrog rau thaum tsaus ntuj, enuresis yuav tshwm sim. Tus me nyuam qhov qab los noj mov yuav hloov: ib qho muaj qhov xav noj tsis tu ncua, los sis, hloov, tsis kam noj mov. Tus me nyuam poob ceeb thawj sai, dhau los ua nkees, tsis xav ua si thiab mus kev. Ob leeg niam txiv thiab kws kho mob hauv plab yuav tsis pom cov tsos mob no, vim tias tsis muaj qhov tsos mob tiag tiag ntawm tus kab mob (kub taub hau, hnoos thiab los ntswg, thiab lwm yam). Qee tus menyuam yaus thaum nyuam qhuav pib mob ntshav qab zib tuaj yeem muaj kab mob ntawm daim tawv nqaij: eczema, rwj, kab mob fungal, kab mob ncig.

Thiab yog tias kev kuaj mob tsis tau raws sijhawm, tus menyuam qhov mob hnyav dua tuaj - ketoacidosis mob ntshav qab zib: tsim muaj: nqhis dej, ua kom cov nqaij mos thiab tawv nqaij nce ntxiv, menyuam yws yws ntawm qhov tsis muaj zog, mob taub hau, tsaug zog. Xeev siab thiab ntuav tshwm sim, uas sai ua ntau zaus. Raws li ketoacidosis ua kom muaj zog, ua pa tawm ntau, ua suab nrov thiab sib sib zog nqus, tus menyuam hnov ​​tsw ntawm acetone. Kev nco qab yuav tshwm sim txog thaum nws tsis nco qab, thiab yog tias tsis muaj kev pabcuam thaum muaj xwm txheej ceev rau tus neeg mob me, nws yuav tuag.

Qhov sib txawv ntawm cov tsos mob ntawm tus mob ntshav qab zib hom 1 thiab ntshav qab zib hom 2 hauv cov menyuam thiab cov hluas:

Hauv cov tub ntxhais hluas, nrog kev txhim kho ntawm tus mob ntshav qab zib hom 2, daim duab soj ntsuam maj mam loj hlob tuaj. Thawj cov tsos mob ntawm tus kabmob tuaj yeem yog qhov kev nqhis dej ntau dua (polydipsia), kev nce thiab ntim ntau npaum li cas ntawm kev tso zis (polyuria), cov tsos ntawm nocturnal enuresis, khaus ntawm daim tawv thiab caj ces, qaug zog.

Nrhiav thiab neutralize ntshav qab zib

• Txoj kev yooj yim tshaj plaws los txhawm rau kuaj kab mob lossis cuam tshuam cov ntshav qabzib yog txiav txim siab koj cov ntshav piam thaj. Kev yoo ntshav cov ntshav qabzib hauv cov neeg noj qab haus huv ntau los ntawm
• Yog tias thaum kuaj cov zis thaum sawv ntxov, glucosuria (kuaj pom muaj ntshav qabzib nyob hauv cov zis), aceturia (muaj lub cev ntawm cov roj ntsha hauv lub cev), ketonuria (muaj lub cev ketone nyob hauv cov zis) lossis ib qho ntshav qabzib tau pom, nws yog qhov yuav tsum tau sab laj rau cov kws khomob tshwj xeeb thiab ua qhov kev kuaj mob tshwj xeeb - kuaj ntshav qabzib. Cov.
• Kuaj ntshav qab zib kuaj (nkhaus suab thaj).
  Ua ntej kev kuaj mob, nws yog ib qho tsim nyog yuav tsum tau sau tshuaj noj kom tsis muaj kab mob uas tsis muaj kev txwv txog carbohydrates rau tus menyuam hauv peb hnub. Qhov kev kuaj mob tau ua thaum sawv ntxov ntawm ib qho khoob khoob. Tus menyuam raug muab rau haus cov dej qab zib hauv qab zib (cov piam thaj nyob hauv tus nqi ntawm 1,75 g / kg ntawm qhov hnyav zoo, tab sis tsis ntau tshaj 75 g). Qhov kev ntsuas suab thaj yog ua rau ntawm lub plab khoob 60 thiab 120 feeb tom qab haus cov piam thaj.
  Nquag, tom qab 1 teev, cov ntshav qabzib cov ntshav yuav tsum nce tsis siab tshaj li 8.8 mmol / l, tom qab 2 teev nws yuav tsum tsis pub tshaj 7.8 mmol / l lossis rov qab coj los rau ntawm lub plab khoob.
  Yog tias cov piam thaj hauv ntshav ntawm cov ntshav txhaws lossis tag nrho cov ntshav ntawm lub plab khoob tshaj 15 mmol / L (lossis ntau zaus ntawm lub plab khoob tshaj li 7,8 mmol / L), kuaj ntshav qabzib tsis tas kuaj mob ntshav qab zib.
  Cov menyuam rog rog uas muaj lwm yam kev pheej hmoo - mob hnyav rau cov ntshav qab zib hom 2 thiab cov cim ntawm cov tshuaj tiv thaiv insulin - yuav tsum kuaj ntshav ntshav qab zib tsawg kawg txhua 2 xyoos, pib txij thaum muaj hnub nyoog 10 xyoo.
• Yuav tsum tau kev sab laj ntawm cov kws tshaj lij - endocrinologist, ophthalmologist, neurologist, nephrologist, orthopedist.
• Nws muaj peev xwm los ua cov txheej txheem tshwj xeeb ntxiv: kev txiav txim siab qhov qib ntawm glycated hemoglobin hauv cov ntshav (HbA1c), cov tshuaj proinsulin, C-peptide, glucagon, ultrasound ntawm lub hauv nruab nrog cev thiab ob lub raum, tshuaj xyuas cov nyiaj, kev txiav txim siab ntawm theem ntawm microalbuminuria, thiab lwm yam, uas tus menyuam yuav sau ntawv rau cov kws tshwj xeeb.
• Yog tias muaj dua cov neeg mob ntshav qab zib hauv tsev neeg, tshwj xeeb tshaj yog hauv niam txiv ntawm niam txiv, kev tshawb nrhiav caj ces tuaj yeem kuaj mob ua ntej los yog muaj qhov yuav ua rau nws mob.

Muaj ntau txoj hauv kev los kho ntshav qab zib. Cov hom phiaj tseem ceeb tshaj plaws hauv kev kho mob ntshav qab zib yog kev tshem tawm cov tsos mob, tswj kev noj zaub mov kom zoo, tiv thaiv cov mob hnyav thiab mob nyhav, thiab ua tiav lub neej zoo tshaj plaws rau cov neeg mob.

Lub hauv paus ntsiab lus tseem ceeb ntawm kev kho yog kev noj qab haus huv rau cov ntshav qab zib, kev ua si ntawm lub cev, kuaj xyuas tus kheej ntawm cov ntshav qabzib, thiab lwm yam. qhia hauv cov tsev kawm mob ntshav qab zib. Tam sim no muaj ntau ntau cov tsev kawm ntawv. Thoob ntiaj teb, cov menyuam yaus uas muaj ntshav qab zib thiab lawv niam lawv txiv tau muaj txoj hauv kev los paub kev paub txog lawv tus kab mob, thiab qhov no pab lawv ua cov neeg koom tes hauv zej zog.

Thawj lub tsev kawm mob ntshav qab zib tau ua haujlwm nyob rau hauv Moscow txij li ib xyoo.Tom qab kev kawm thawj zaug, yog tias tsim nyog, tom qab ib xyoos, cov neeg hluas los yog cov neeg txheeb ze ntawm cov menyuam muaj mob tuaj yeem kawm ob chav kawm thib ob los sib sau ua ke thiab hloov kho lawv cov kev paub txog ntshav qab zib.

Cov tshuaj tsis yog tshuaj kho ntshav qab zib

Kev noj haus ntshav qab zib rau cov ntshav qab zib yuav tsum ua raws li cov hauv qab no: kev cais tawm ntawm cov khoom noj zom tau yooj yim (cov piam thaj, chocolate, zib ntab, jam, thiab lwm yam) thiab kev noj zaub mov kom tsawg. Txhua cov carbohydrates yuav tsum muab 50-60% ntawm cov caloric cov ntsiab lus ntawm cov khoom noj txhua hnub, cov protein tsis ntau tshaj 15%, thiab cov roj tag nrho cov ntsiab lus yuav tsum tsis pub tshaj 30-35% ntawm qhov yuav tsum tau siv lub zog txhua hnub. Cov menyuam mos thiab menyuam yaus hnub nyoog qis dua 1 xyoos raug suav raws li kev pub khoom noj (ua kom sib xyaw, sib xyaw, ib txwm muaj). Nws yuav tsum raug sau tseg tias nws yog qhov zoo tagnrho los ua kom lub sijhawm pub niam mis ntev txog 1.5 xyoo.

Qhov yuav tsum tau ceeb thawj yog thawj kauj ruam los tiv thaiv thiab kho mob ntshav qab zib.

Qhov xav tau ntawm kev ntsuas tus kheej yuav tsum tau piav qhia rau tus menyuam mob thiab qhia tias yuav ua li cas hauv tsev nrog kev pab ntawm kev ntsuas ntsuas (kev txiav txim siab txog qib ntawm cov piam thaj hauv cov ntshav thiab zis).

Yog tias cov ntshav qab zib kav ntev dua 5 xyoos, ceev faj kev soj ntsuam ntshav siab, urinalysis rau albuminuria, kev sib tham txhua xyoo ntawm cov neeg mob hauv chav kuaj mob ntawm lub tsev kho mob qhov muag kom pom tias muaj hlwb retinopathy yog qhov tsim nyog. Ib xyoos ob zaug, tus menyuam yuav tsum tau kuaj xyuas los ntawm kws kho hniav thiab ENT kws kho mob.

Cov tub ntxhais hluas cov tub ntxhais hluas xav tau kev pabcuam kev mob hlwb thiab kev txhawb nqa rau cov neeg laus, thiab cov lus qhia ntawm ntau lub tsev kawm ntawv cov ntshav qab zib - "Ntshav qab zib yog txoj hauv kev ntawm lub neej," tsis yog qhov tsis muaj nuj nqis. Tab sis cov niam txiv yuav tsum nco ntsoov tias kev ntshai tas li rau lawv cov menyuam thiab xav tiv thaiv nws ntawm txhua yam tuaj yeem ua rau qhov tseeb tias tus menyuam tseem yuav pib pom lub ntiaj teb nyob ib puag ncig nws yog lub ntiaj teb uas coj kev txaus ntshai thiab kev hem thawj ntawm txhua qhov chaw.

Tshuaj kho mob ntshav qab zib

1. Kev kho mob ntshav qab zib hom 2 pib nrog kev teem sijhawm muaj cov piam thaj rau cov tshuaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj.
2. Kev kho tshuaj insulin.

Insulin tswj ntshav qab zib cov ntshav, ua rau kev hloov pauv ntawm cov piam thaj ntau tshaj rau hauv lub cev mus rau hauv glycogen. Insulin receptors ua raws li "hom xauv", thiab insulin tuaj yeem sib piv nrog tus yuam sij uas qhib kev qhib lub ntsej muag thiab tso cai rau cov kua nplaum nkag mus hauv lub cell, yog li nrog IDDM, kev kho pib nrog kev kho mob insulin.

Hauv cov neeg mob cov neeg laus uas muaj tus kab mob ntev ntev, kev quav yeeb tshuaj rau cov ntshav qab zib kom tsawg nyob rau hauv hom tshuaj ntsiav feem ntau muaj kev txhim kho, thiab tom qab xyoo dhau los ntawm qhov pib ntawm tus kab mob, nyob rau nruab nrab 10-15% ntawm cov neeg mob ntshav qab zib hom 2 mus kho tshuaj insulin.

Hauv cov kab mob ntshav qab zib, cov tshuaj insulin yog yam ua rau hauv lub cev. Txhawm rau txhawm rau txhaj tshuaj siv cov txhaj tshuaj ib nrab tsis siv neeg - xaum xaum qhwv.

Sij hawm dhau mus, kev xav tau cov tshuaj insulin nce, qhov qab los noj mov yuav hloov, hauv cov menyuam nws feem ntau poob qis. Yog li, cov ntshav piam thaj, nrog rau cov ntshav qabzib thiab acetone, yuav tsum ua tib zoo saib.

Nta ntawm chav kawm ntawm tus kab mob

Feem ntau ntawm cov menyuam yaus uas muaj IDDM, kev rov qab los ntawm tus kabmob pib txij li ob peb lub lis piam los ntawm lub sijhawm ntawm kev kuaj mob thiab kev kho mob kom raug, txawm tias kev kho mob ib ntus yog ua tau thaum xav tau cov tshuaj insulin. Cov theem no tuaj yeem ntev txog ob peb lub hlis. Hmoov tsis zoo, qhov xav tau rau insulin nce dua thiab ncav cuag lub cev qhov hnyav hauv lub xyoo txij li hnub pib ntawm tus mob. Thaum tiav nkauj tiav nraug, thaum muaj qhov loj hlob thiab muaj qhov hnyav hauv lub cev, qhov ua rau mob ntshav qab zib yog yam ntxwv ua haujlwm thiab yuav tsum tau ua tib zoo saib xyuas. Tom qab qhov kawg ntawm lub sijhawm tseem hluas, ntshav qab zib tau rov qab ruaj khov.

Feem ntau, ntshav qab zib yog thawj qhov kev tawm ntawm pathology ntawm tag nrho cov kab mob endocrine. Tom qab, cov menyuam yaus tuaj yeem pib ua kabmob autoimmune ntawm lwm cov qog endocrine, feem ntau yog cov thyroid caj pas. Kev them nyiaj tsis zoo ntawm cov ntshav qab zib ua rau kev ua txhaum ntawm txhua hom metabolism thiab tshwj xeeb tshaj yog cov protein, uas nyob rau hauv lem yog nrog los ntawm kev poob qis hauv kev tiv thaiv tsis muaj kev tiv thaiv thiab tiv thaiv kab mob. Yog li ntawd, qhov ntau zaus ntawm kev txhim kho qhov mob txuas rau ntawm daim tawv nqaij thiab cov qog ua kua rau hauv daim ntawv ntawm cov pyoderma thiab cov kab mob fungal, txoj kev kho kom zoo yog qhov nyuaj.

Qhov mob hnyav ntawm ntshav qab zib mellitus hauv menyuam yaus suav nrog: ketoacitosis, ketoacidotic coma, hypoklemic mob thiab hypoklemic coma, hyperosmolar coma.

Lwm yam teeb meem hauv cov menyuam yaus pib qeeb. Lawv tau ua raws cov teeb meem vascular - microangiopathies, kev txhim kho ntawm uas nyob ntawm caj ces ntawm cov me nyuam thiab cov nyiaj them rov qab los ntawm cov metabolism hauv kev noj haus. Feem ntau, microangiopathies tsim xyoo tom qab pib ntawm tus kab mob. Teeb meem tshwm sim tuaj yeem tshwm sim hauv daim ntawv ntawm:

• raum puas (mob ntshav qab zib nephropathy),
• kev puas tsuaj rau cov hlab ntsha hlwb (ntshav qab zib neuropathy, encephalopathy),
• mob qhov muag (mob ntshav qab zib retinopathy),

Cov kab mob sib kis tau pom muaj ntau hauv cov neeg mob, suav nrog tuberculosis.

Kev mob nkeeg ntawm cov menyuam yaus uas muaj ntshav qab zib yog qhov kev ntxhov siab rau tag nrho tsev neeg. Tab sis nrog txoj kev sib koom tes ruaj khov ntawm tsev neeg thiab tus kws kho mob, peb yuav muaj peev xwm los muab kev saib xyuas lub cev thiab kev loj hlob kom raug, nrog rau kev sib raug zoo ntawm kev sib raug zoo. Cov menyuam uas raug kev txom nyem no tuaj yeem koom tes hauv lub neej ntawm tsev kawm, muaj kev npaj tau txhij, lawv tuaj yeem taug kev nrog lawv niam lawv txiv, mus kev taug kev, caij tsheb, thiab lwm yam. Tau ua tus neeg paub tab, lawv yuav tau txais cov tsev neeg puv npo. Qhov tseeb thiab ua raws li kev kho mob ntshav qab zib yuav ua kom ntseeg tau tias cov teeb meem txhim kho tau sai li sai tau.

Thaum mus ntsib kws kho mob

Yog tias koj pom muaj cov cim lossis tsos mob ntawm tus mob ntshav qab zib hom 1, sab laj nrog koj tus menyuam tus kws kho mob.

Qhov tseeb ua kom mob ntshav qab zib hom 1 tsis paub txog. Tab sis feem coob ntawm cov neeg muaj ntshav qab zib hom 1, lub cev tiv thaiv kab mob, uas feem ntau tua cov kab mob thiab kab mob uas tsis zoo, ua rau cov ntshav insulin tsim (islet) hauv cov txiav ua kab mob rau kom txiav ntshav. Lub luag haujlwm hauv cov txheej txheem no tau ua si los ntawm cov noob caj noob ces thiab ib puag ncig.

Cov tshuaj insulin ua haujlwm tseem ceeb ntawm kev hloov cov piam thaj (ntshav qab zib) los ntawm cov ntshav mus rau lub cev lub cev. Qab zib nkag mus rau hauv cov ntshav thaum cov zaub mov raug zom.

Sai li sai tau rau tus kab mob pancreatic islet cell raug rhuav tshem, koj tus me nyuam tsim insulin tsawg los tsis muaj. Vim li ntawd, cov piam thaj nyob hauv koj tus menyuam cov ntshav, uas nws tuaj yeem tsim kev phom sij txog lub neej.

Yam pheej hmoo

Kev phom sij los tsim tus mob ntshav qab zib hom 1 hauv cov menyuam yaus muaj xws li:

• Keeb kwm tsev neeg. Cov neeg uas muaj niam txiv lossis cov kwv tij uas muaj tus mob ntshav qab zib hom 1 muaj qhov pheej hmoo me me ntawm kev txhim kho tus mob no.
• Caj ces raug taus. Muaj qee cov noob qhia tias muaj kev pheej hmoo ntawm kev tsim muaj ntshav qab zib hom 1.
• Kwv Txhiaj. Hauv Tebchaws Meskas, hom mob ntshav qab zib hom 1 yog tshwm sim rau cov neeg tawv dawb uas tsis yog neeg Hispanic dua li lwm haiv neeg.

Kev pheej hmoo ib puag ncig tej zaum yuav muaj:

• Ib co kab mob. Raug rau cov kab mob ntau yam tuaj yeem tsim kev phom sij autoimmune ntawm islet hlwb.
• Kev noj haus Nws tau qhia tias muaj qee yam kev noj zaub mov zoo lossis khoom noj muaj txiaj ntsig thaum me nyuam yaus tsis yog lub luag haujlwm ntawm kev tsim cov ntshav qab zib hom 1. Txawm li cas los xij, kev noj mis nyuj thaum ntxov yog cuam tshuam nrog kev pheej hmoo ntawm tus mob ntshav qab zib hom 1, thaum pub mis niam tuaj yeem txo qhov kev pheej hmoo. Kev noj cov zaub mov noj raws sij hawm rau menyuam yaus kev noj zaub mov noj tuaj yeem cuam tshuam txog kev pheej hmoo ntawm kev muaj ntshav qab zib hom 1 hauv menyuam yaus.

Lwm yam nyuaj

Teeb meem ntawm tus mob ntshav qab zib hom 1 pib maj mam tshwm sim. Yog tias cov ntshav qab zib cov ntshav tswj tsis tau lub sijhawm ntev ntev, cov ntshav qab zib muaj teeb meem thaum kawg yuav raug txiav tawm lossis tseem muaj sia nyob.

Teeb meem yuav suav nrog:

• Kab mob hauv lub plawv thiab ntshav. Ntshav qab zib ua rau koj tus menyuam muaj feem ua mob loj xws li mob hlab ntsha hauv hlab ntshav nrog mob hauv siab (angina pectoris), mob plawv nres, hlab ntsha tawg, leeg ntshav hlab ntshav (atherosclerosis), thiab ntshav siab ntau ntxiv hauv lub neej tom ntej.
• Kev puas ntsoog. Muaj piam thaj ntau dhau yuav ua kev puas tsuaj rau cov hlab ntshav me me uas pub koj tus menyuam cov hlab ntshav, tshwj xeeb yog ceg. Qhov no tuaj yeem ua rau tingling, loog, hlawv, lossis mob. Kev raug mob hauv lub cev feem ntau tshwm sim maj mam ntev mus ntev.
• Kev puas tsuaj rau lub raum. Ntshav qab zib tuaj yeem ua kev puas tsuaj ntau pawg ntawm cov hlab ntshav uas lim koj tus menyuam cov ntshav cov ntshav. Kev puas tsuaj loj tuaj yeem ua rau lub raum tsis ua haujlwm lossis tsis tuaj yeem hloov raum thaum kawg ntawm theem, yuav tsum tau lim ntshav lossis hloov raum.
• Qhov muag puas tsuaj. Mob ntshav qab zib tuaj yeem ua kev puas tsuaj rau cov hlab ntshav ntawm retina, uas tuaj yeem ua rau tsis pom kev tsis zoo thiab txawm tias qhov muag tsis pom. Mob ntshav qab zib kuj tseem tuaj yeem ua rau mob cataracts thiab muaj feem ntau ntawm kev mob txha caj dab.
• Cov kab mob ntawm daim tawv nqaij. Ntshav qab zib yuav ua rau koj tus menyuam muaj feem cuam tshuam rau ntawm daim tawv nqaij ntau dua, suav nrog kev kis kab mob, kab mob fungal, thiab khaus.
• Kab mob hauv Ntshav qab zib tuaj yeem ua rau txo qis ntawm cov pob txha ntxhia hauv lub cev, uas ua rau muaj kev pheej hmoo ntawm pob txha pob hauv koj tus menyuam nce mus zuj zus.

Kev tiv thaiv

Tam sim no tseem tsis tau muaj txoj hauv kev los tiv thaiv ntshav qab zib hom 1.

Cov menyuam yaus uas muaj qhov pheej hmoo loj rau kev tsim muaj ntshav qab zib hom 1 tuaj yeem kuaj rau cov tshuaj tiv thaiv ua rau cuam tshuam nrog kev cuam tshuam. Tab sis, cov neeg muaj cov khoom tiv thaiv kab mob no tsis ua kom mob ntshav qab zib ua kom dhau. Thiab tam sim no tseem tsis tau muaj txoj hauv kev los tiv thaiv kev mob ntshav qab zib hom 1 yog kuaj pom cov tshuaj tiv thaiv.

Cov kws tshawb nrhiav tau ua haujlwm los tiv thaiv kev mob ntshav qab zib hom 1 hauv cov neeg uas muaj kev pheej hmoo siab los ua tus kab mob. Lwm cov kev tshawb fawb yog tsom rau kev tiv thaiv ntxiv kev puas tsuaj ntawm islet cell hauv cov neeg uas nyuam qhuav raug mob tshiab.

Txawm hais tias koj tsis tuaj yeem ua ib yam dab tsi los tiv thaiv koj tus menyuam li ntshav qab zib hom 1, koj tuaj yeem pab koj tus menyuam tiv thaiv nws cov teeb meem:

• Pab koj tus menyuam kom tswj tau cov ntshav qab zib kom ntau li ntau tau
• Qhia koj tus menyuam txog qhov tseem ceeb ntawm kev noj zaub mov zoo thiab mus koom kev tawm dag zog
• Teem sijhawm mus ntsib koj tus menyuam tus kws kho mob ntshav qab zib thiab kuaj qhov muag txhua xyoo pib tsis pub dhau tsib xyoos tom qab kuaj pom thawj zaug.
• Muaj ntau txoj kev kuaj ntshav rau tus kabmob ntshav qab zib hom 1 hauv cov menyuam yaus:
  • Kev kuaj cov ntshav qab zib kom qis. Nov yog thawj kev soj ntsuam kuaj ntshav qab zib hom 1. Yuav kuaj cov ntshav thaum twg los tau. Tsis hais txog lub sijhawm kawg uas koj tus menyuam tau noj, muaj ntshav qab zib ntau ntawm 200 milligrams ib deciliter (mg / dl) lossis 11,1 millimoles ib liter (mmol / l) lossis siab dua qhia tias mob ntshav qab zib.
  • Glycidal hemoglobin (A1C). Qhov ntsuam xyuas no qhia pom koj tus menyuam cov piam thaj hauv ntshav ntev li ob rau peb hlis. Tshwj xeeb, kev ntsuas ntsuas ntsuas cov feem pua ​​ntawm cov piam thaj hauv ntshav txuas rau ib cov protein muaj oxygen hauv cov ntshav liab (hemoglobin). Qib A1C ntawm 6.5 feem pua ​​lossis siab dua hauv ob qho kev ntsuas cais qhia tau tias mob ntshav qab zib.
  • Kev yoo mov ua ntshav rau cov ntshav qab zib. Yuav tau tso ib cov ntshav tom qab koj tus me nyuam zoo sai. Kev yoo mov cov ntshav qab zib ntawm 126 mg / dl (7.0 mmol / L) lossis siab dua qhia tias hom ntshav qab zib hom 1.

  Cov kev ntsuam xyuas ntxiv

  Koj tus kws kho mob yuav pom zoo kom mus kuaj ntxiv kom paub meej cov hom mob ntshav qab zib uas koj tus menyuam muaj. Nws yog ib qho tseem ceeb kom paub qhov txawv ntawm cov ntshav qab zib hom 1 thiab ntshav qab zib hom 2, vim cov tswv yim kho tau txawv.

  Cov kev xeem ntxiv no suav nrog:

  • Kev kuaj ntshav los ntsuas cov tshuaj tiv thaiv tshwj xeeb rau hom ntshav qab zib hom 1
  • Txoj kev tso ntshav kuaj mus kuaj ketones, uas tseem qhia tau tias mob ntshav qab zib hom 1, tsis yog hom 2

  Tom qab kuaj paub

  Koj tus menyuam yuav tsum ntsib kev sib ntsib tas li txhawm rau txhawm rau tswj ntshav qab zib kom tau zoo thiab kuaj xyuas nws qib A1C. Lub koom haum American Diabetes Association pom zoo A1C 7.5 lossis qis dua rau txhua tus menyuam.

  Koj tus kws kho mob tseem yuav siv cov kev kuaj ntshav thiab tso zis kuaj koj tus menyuam:

  • Cov theem roj ntau
  • Lub qog ua haujlwm
  • Raum muaj nuj nqi

  Ib qho ntxiv, koj tus kws kho mob yuav ua ntu zus:

  • Ntsuas koj tus menyuam cov ntshav siab thiab qhov siab
  • Kuaj xyuas thaj chaw uas koj tus me nyuam kuaj xyuas cov piam thaj hauv ntshav thiab muab cov tshuaj insulin

  Koj tus menyuam yuav tsum tau kuaj qhov muag tsis tu ncua. Koj tus menyuam tej zaum yuav raug kuaj mob celiac thaum kuaj mob ntshav qab zib thiab nyob rau ntu tsis tu ncua, nyob ntawm koj tus menyuam lub hnub nyoog thiab cov tsos mob.

  Lub neej kho mob ntshav qab zib hom 1 suav nrog kev saib ntshav qab zib, kev kho tshuaj insulin, kev noj zaub mov zoo, thiab kev tawm dag zog ib txwm - txawm tias cov menyuam yaus. Thaum koj tus menyuam loj hlob thiab hloov pauv, tseem yuav muaj phiaj xwm kho mob ntshav qab zib.

  Yog tswj hwm koj tus menyuam cov ntshav qab zib zoo li nyhav dhau lawm, noj nws ib hnub zuj zus. Qee hnub, koj tuaj yeem ua tau zoo nrog koj tus menyuam cov piam thaj thiab lwm hnub, nws zoo li tsis muaj dab tsi ua haujlwm. Tsis txhob hnov ​​qab tias tsis yog koj ib leeg.

  Koj yuav ua haujlwm nrog pab pawg neeg mob ntshav qab zib - kws kho mob, kws qhia ntshav qab zib thiab kws qhia zaub mov noj kom koj tus menyuam cov ntshav qab zib nyob ze npaum li qhov ua tau.

  Kev tswj ntshav qab zib

  Koj yuav tsum tau kuaj xyuas thiab sau koj cov menyuam cov piam thaj hauv ntshav tsawg kawg yog plaub zaug hauv ib hnub, tab sis tej zaum yuav luag ntau. Qhov no yuav tsum tau nquag nrog. Qee qhov ntsuas ntshav qab zib pub tso cai kuaj xyuas ntawm lwm qhov chaw dhau ntawm lub taub ntiv tes.

  Kev sim ntau zaus yog tib txoj kev los xyuas kom koj tus me nyuam cov ntshav qab zib nyob hauv nws qhov hom phiaj, uas yuav hloov pauv thaum koj tus menyuam loj hlob thiab hloov. Koj tus menyuam tus kws kho mob yuav qhia koj seb koj cov ntshav qab zib cov ntshav yog hom dabtsi rau koj tus menyuam.

  Kev Ntsuam Xyuas Cov Qib Qib (CGM)

  Kev Tshuaj Ntsuam Qhov Ua Kab Zuj Zus (CGM) yog txoj kev kawg los tswj koj cov ntshav qab zib. Qhov no yuav muaj txiaj ntsig zoo tshaj rau cov neeg uas tsis tau ua rau cov kev mob tshwm sim li cas ntawm kev mob ntshav qab zib tsawg.

  CGM siv ib rab koob nyias ntxig ncaj qha rau hauv qab daim tawv nqaij, uas kuaj xyuas cov ntshav cov ntshav qab zib txhua ob peb feeb. CGM tseem tsis pom tias muaj tseeb raws li kev tswj ntshav qab zib cov ntshav. Qhov no yuav yog ib qho cuab yeej ntxiv, tab sis feem ntau tsis hloov pauv kev soj ntsuam cov ntshav qab zib kom tsis tu ncua.

  Cov tshuaj insulin thiab lwm yam tshuaj

  Txhua tus neeg muaj ntshav qab zib hom 1 xav tau kev kho mob insulin kom ciaj sia. Muaj ntau hom insulin muaj, suav nrog:

  • Ceev ua yeeb yam insulin. Kev siv tshuaj insulin xws li lispro (Humalog), aspart (NovoLog) thiab glulisin (Apidra) pib ua haujlwm tsis dhau 15 feeb, ncov tom qab li ib teev thiab plaub teev tas los.
  • Luv luv ua yeeb yam insulin. Cov kev kho mob, xws li cov tshuaj insulin rau tib neeg (Humulin R), yuav tsum tau siv 20-30 feeb ua ntej noj mov, nce siab tshaj li 1.5 txog 2 teev thiab txij plaub mus rau 6 teev.
  • Nruab nrab ua yeeb yam insulin. Cov kev kho mob, xws li insulin NPH (Humulin N), pib ua haujlwm tom qab li ib teev, ncov tom qab li rau teev thiab kawg 12-24 teev.
  • Ntev insulin. Cov kev kho mob, xws li insulin glargine (Lantus) thiab insulin detemir (Levemir), tsis muaj lub ncov siab thiab tuaj yeem muab kev pab them nqi li 20-26 teev.

  Ua raws li koj tus menyuam lub hnub nyoog thiab cov kev xav tau, koj tus kws kho mob yuav sau ntawv tawm ntau hom tshuaj insulin rau nruab hnub thiab hmo ntuj.

  Kev xaiv cov tshuaj insulin

  Muaj ntau txoj hauv kev rau tus menyuam cov insulin, suav nrog:

  • Nyias rab koob thiab koob txhaj tshuaj. Qhov zoo ntawm rab koob thiab koob txhaj tshuaj yog tias qee hom sib txawv ntawm cov kua dej tuaj yeem sib tov hauv ib qho kev txhaj tshuaj, txo cov koob tshuaj.
  • Cov tshuaj insulin. Cov cuab yeej no zoo nkaus li tus cwj mem kua mem, tsuas yog tias daim cartridge tau sau nrog insulin. Cov tshuaj insulin sib xyaw muaj cov khoom, tab sis cov khoom sib xyaw no feem ntau tsis yog rau menyuam yaus.
  • Insulin twj tso kua mis. Cov cuab yeej no yog qhov loj me ntawm lub xov tooj ntawm tes uas hnav nyob sab nraum lub cev. Ib txoj yas txuas nrog cov pas dej insulin mus rau txoj raj raj tso rau hauv qab daim tawv nqaij ntawm lub plab. Lub twj tso kua mis tuaj yeem siv nrog CGM.

  Noj qab nyob zoo

  Koj tus menyuam yuav tsis txwv nws txoj kev noj haus qab zib thiab tawv mos mus tag lub neej. Hloov chaw, koj tus menyuam yuav tsum muaj txiv hmab txiv ntoo, zaub, thiab nplej ntau ntau - cov khoom noj muaj zaub mov ntau thiab muaj rog thiab calories ntau. Qhov tsim nyog, koj tus me nyuam kev noj haus carbohydrates yuav tsum muaj xwm yeem.

  Koj tus menyuam cov khoom noj khoom haus zoo yuav xav tias koj tus menyuam - thiab tsev neeg - noj zaub mov thiab khoom qab zib tsawg. Cov phiaj xwm noj mov no yog qhov zoo tshaj plaws rau tsev neeg. Cov khoom noj qab zib zoo yog nyob ntawm kev txiav txim, los ntawm lub sijhawm, ntev li ntev tau lawv suav nrog hauv koj tus menyuam txoj kev npaj khoom noj khoom haus.

  To taub dab tsi thiab ntau npaum li cas pub mis rau koj tus menyuam tuaj yeem yog teeb meem. Tus kws qhia noj zaub mov zoo tuaj yeem pab koj tsim hom phiaj xwm khoom noj khoom haus uas ua tau raws koj tus menyuam cov hom phiaj kev noj qab haus huv, kev nyiam noj haus thiab kev ua neej.

  Qee yam khoom noj, xws li cov piam thaj lossis rog, tej zaum yuav nyuaj rau hauv koj tus menyuam txoj kev noj zaub mov zoo dua li xaiv cov khoom noj rau lub cev. Piv txwv li, cov zaub mov muaj roj ntau tuaj yeem ua rau dhia ntshav qab zib ob peb teev tom qab koj tus menyuam noj vim cov rog ua rau lub plab zom mov.

  Hmoov tsis zoo, tsis muaj qauv tsim qauv qhia koj txog koj tus menyuam lub cev yuav ua cov khoom noj sib txawv li cas. Tab sis, tom qab sijhawm, koj yuav kawm paub ntau ntxiv txog qhov koj tus hlub cuam tshuam nws li ntshav qab zib, thiab tom qab ntawv koj tuaj yeem kawm txhawm rau them rau lawv.

  Lub cev qoj ib ce

  Txhua leej txhua tus xav tau kev tawm dag zog aerobic tsis tu ncua, thiab cov menyuam muaj ntshav qab zib hom 1 tsis txawv. Txhawb koj tus menyuam kom dhia ua si kom ib ce muaj zog thiab, txawm tias nws zoo dua, tawm hwv nrog koj tus menyuam. Muab lub cev ua ub no ua ib feem ntawm koj tus menyuam lub neej txhua hnub.

  Tab sis nco ntsoov tias kev tawm dag zog feem ntau ua rau cov ntshav qab zib qis thiab tuaj yeem cuam tshuam cov piam thaj hauv ntshav txog 12 teev tom qab ua exercise. Yog tias koj tus menyuam pib ua yam tshiab, xyuas koj tus menyuam cov ntshav qab zib kom ntau dua li ib txwm txog thaum koj paub tias nws lub cev ua li cas rau qhov kev ua no. Tej zaum koj yuav tau hloov kho koj tus menyuam txoj kev npaj lossis tshuaj noj insulin kom them nyiaj rau cov kev ua ub no ntau ntxiv.

  Txawm hais tias koj tus menyuam siv tshuaj insulin thiab noj mov ntawm lub sijhawm nruj me ntsis, cov piam thaj hauv nws cov ntshav tuaj yeem hloov pauv tsis tau. Nrog pab neeg tu tus mob ntshav qab zib koj tus menyuam, koj yuav kawm paub txog koj tus menyuam cov ntshav qab zib cov ntshav pauv li cas rau cov lus teb rau:

  • Cov khoom noj khoom haus. Khoom noj yuav yog qhov teeb meem tshwj xeeb rau cov menyuam yaus muaj tus mob ntshav qab zib hom 1, vim tias lawv feem ntau ua tiav tsis tiav dab tsi ntawm lawv cov phaj. Nov yog teeb meem yog tias koj muab cov tshuaj txhaj insulin rau koj tus menyuam kom npog cov khoom noj ntau dua li nws muaj. Qhia rau koj tus kws kho mob yog tias qhov no yog qhov teeb meem rau koj tus menyuam, yog li koj thiab koj tus kws kho mob tuaj yeem tsim lub koob tshuaj insulin uas ua haujlwm rau koj tsev neeg.
  • Lub cev qoj ib ce. Koj tus menyuam nquag siv npaum li cas, lawv cov piam thaj hauv ntshav yuav qis dua. Txhawm rau them, koj yuav tsum tau txo qis koj tus menyuam cov tshuaj insulin rau qhov kev ua si hauv lub cev. Lossis koj tus menyuam yuav xav tau khoom txom ncauj ua ntej ua exercise.
  • Tus kab mob. Tus kab mob no muaj qhov txawv txav ntawm koj tus menyuam qhov xav tau tshuaj insulin. Cov tshuaj hormones ua haujlwm thaum lub sijhawm muaj mob ntxiv ntshav qab zib, tab sis qhov txo qis ntawm cov zaub mov carbohydrate vim tsis qab los noj mov lossis ntuav txo qhov xav tau cov tshuaj insulin. Nug koj tus kws kho mob txog hom phiaj xwm kho mob hnub.
  • Kev loj hlob sprinkles thiab puberty. Tsuas yog, thaum koj tau ua tiav cov kev xav tau ntawm tus menyuam yaus insulin, nws yuav hlav, nws yuav zoo li, thaum hmo ntuj thiab tam sim ntawd tsis tau txais insulin txaus. Cov tshuaj hormones kuj tseem tuaj yeem cuam tshuam rau cov kev xav tau insulin, tshwj xeeb tshaj yog rau cov menyuam ntxhais hluas thaum lawv pib coj khaub ncaws.
  • Mus pw. Txhawm rau zam kom tsis txhob muaj teeb meem cov ntshav qab zib kom tsawg nyob rau yav hmo ntuj, koj yuav tau kho koj tus menyuam txoj kev siv insulin. Nug koj tus kws kho mob txog ntshav qab zib zoo ua ntej mus pw.

  Cov cim ntawm teeb meem

  Txawm hais tias tag nrho koj cov kev siv zog, qee zaum teeb meem tshwm sim. Qee qhov mob ncua luv ntawm hom ntshav qab zib hom 1, xws li cov ntshav qab zib qis, ntshav qab zib hauv ntshav ntau, thiab ketoacidosis, feem ntau yog kuaj pom los ntawm ketones nyob rau hauv cov zis - xav tau kev saib xyuas sai. Yog tias tsis kho, cov mob no tuaj yeem ua rau qaug dab peg thiab tsis nco qab (tsis nco qab lawm).

  Ntshav qog

  Ntshav Qab Zib - Cov ntshav qab zib nyob qis dua koj cov menyuam qhov phiaj xwm. Ntshav qab zib cov ntshav tuaj yeem txo qis rau ntau qhov laj thawj, suav nrog kev noj mov hla kev, ua kom lub cev qoj ib ce ntau dua li ib txwm muaj, lossis txhaj cov insulin ntau dhau.

  Qhia koj tus menyuam qhov tsos mob ntshav qab zib tsawg. Thaum tsis paub tseeb, nws yuav tsum kuaj ntshav qab zib tas li. Cov cim thaum ntxov thiab cov tsos mob ntawm cov ntshav qab zib qis muaj xws li:

  • Tawv dawb nplooj
  • hws
  • xoob
  • kev tshaib plab
  • Vauv
  • Tsaus muag lossis ntxhov siab
  • Mob taub Hau

  Tom qab ntawd, cov cim thiab tsos mob ntawm cov ntshav qab zib qis, uas qee zaum yuam kev haus cawv rau cov hluas thiab cov neeg laus, suav nrog:

  • nkees
  • Tsis meej pem lossis ntxhov siab
  • Kev nkees nkees
  • Cov hais lus tsis meej
  • Plam kev sib koom tes
  • Cov cwj pwm khib
  • Tsis nco qab

  Yog koj tus menyuam muaj piam thaj hauv ntshav qis:

  • Muab kua txiv rau koj tus menyuam haus kua txiv, kua qabzib, caramel, dej qab zib (lossis tsis qab ntsev), lossis lwm yam qab zib
  • Ntsuam xyuas koj cov piam thaj hauv ntshav li ntawm 15 feeb kom paub tseeb tias nws nyob hauv qhov qub.
  • Yog tias koj cov piam thaj hauv ntshav tseem tsawg, rov ua qhov kev kho mob uas muaj suab thaj ntau, thiab tom qab ntawv rov qab ua qhov ntsuas tom qab lwm 15 feeb

  Yog koj tsis kho, cov piam thaj hauv ntshav yuav ua rau koj tus menyuam tsis nco qab lawm. Yog tias qhov no tshwm sim, tus menyuam yuav xav tau kev txhaj tshuaj sai sai uas ua rau nws tso ntshav qab zib mus rau hauv cov ntshav (glucagon). Nco ntsoov tias koj cov menyuam ib txwm nqa cov khoom qab zib.

  Hyperglycemia

  Hyperglycemia - Koj cov piam thaj hauv ntshav siab tshaj qhov koj tus me nyuam lub hom phiaj. Cov ntshav qab zib cov ntshav muaj peev xwm nce mus rau ntau qhov laj thawj, nrog rau kev mob nkeeg, noj ntau dhau, noj zaub mov tsis yog, thiab tsis muaj insulin txaus.

  Cov cim thiab tsos mob ntawm ntshav qab zib suav nrog:

  • Nquag tso zis ntau zaus
  • Muaj nqhis dej ntau dua los yog qhov ncauj qhuav
  • Qhov muag plooj
  • Nkees
  • Xeev siab

  Yog tias koj xav tias hyperglycemia:

  • Kuaj xyuas koj tus menyuam cov ntshav qab zib
  • Tej zaum koj yuav tau txhaj ntxiv cov insulin yog tias koj cov piam thaj hauv ntshav siab dua qhov koj tus me nyuam lub hom phiaj xav tau.
  • Tos 15 feeb thiab tom qab ntawv xyuas koj cov ntshav cov ntshav qab zib dua ob zaug
  • Kho koj cov pluas noj lossis hom phiaj noj tshuaj kom tsis txhob muaj ntshav qab zib yav tom ntej

  Yog tias koj tus menyuam muaj ntshav qab zib cov ntshav siab tshaj li 240 mg / dl (13.3 mmol / L), koj tus menyuam yuav tsum siv cov ntsuas zis coj mus kuaj cov ketones. Tsis txhob cia koj tus menyuam qoj ib ce yog tias koj cov piam thaj hauv ntshav siab lossis ketones tam sim no.

  Ntshav qab zib ketoacidosis

  Kev qaug zog hauv insulin ntau ua rau koj tus menyuam lub cev ua cov ketones. Cov ketones ntau dhau nyob hauv koj tus menyuam cov ntshav thiab cov ntshav tawm hauv cov zis, ib yam mob hu ua ntshav qab zib ketoacidosis (DKA). Kev tsis paub teb rau DKA tuaj yeem tsim kev phom sij tau.

  Cov cim thiab tsos mob ntawm DKA suav nrog:

  • Nqhis dej los yog qhov ncauj qhuav
  • Nce tso zis
  • kev qaug zog
  • Qhuav lossis ntxuav cov tawv nqaij
  • Xeev siab, ntuav, lossis mob plab
  • Qab zib, tsw qab ntxiag ntawm koj tus menyuam cov pa
  • tsis meej pem

  Yog tias koj xav tias DKA, kuaj koj tus menyuam cov zis rau ntawm cov ketones ntau dhau nrog cov khoom siv ketone uas yuav tom kiab khw. Yog tias lub ketone nyob rau theem siab, sab laj nrog koj tus menyuam tus kws kho mob lossis nrhiav kev kho mob kub ntxhov.

  Txoj kev ua neej & Kev nyob hauv tsev

  Ntshav Qab Zib Hom 1 yog ib qho mob hnyav heev. Pab koj tus menyuam kom ua raws li nws qhov hom phiaj npaj kho ntshav qab zib yuav siv sijhawm 24 teev thiab yuav tsum tau hloov qee yam tseem ceeb ntawm kev ua neej nyob.

  Tab sis koj cov dag zog yuav tsum tau saib xyuas. Txoj kev kho mob hnyav rau hom ntshav qab zib hom 1 tuaj yeem txo koj tus menyuam txoj kev pheej hmoo mob hnyav, txawm tias nws muaj kev phom sij txog lub neej.

  Raws li koj tus menyuam hlob dhau los:

  • Hais kom nws ua lub luag haujlwm nce siab rau kev tswj ntshav qab zib
  • Tshaj tawm txog kev saib xyuas ntshav qab zib lub neej ntev ntev
  • Qhia koj tus menyuam kom ntsuas nws cov ntshav qab zib thiab txhaj tshuaj insulin
  • Pab koj tus menyuam xaiv cov khoom noj muaj txiaj ntsig zoo
  • Txhawb koj tus menyuam kom siv dag zog ib ce
  • Txhawb txoj kev sib raug zoo ntawm koj tus menyuam thiab nws pab pawg saib xyuas ntshav qab zib
  • Nco ntsoov tias koj tus menyuam hnav daim ntawv qhia txog tus mob.

  Qhov tseem ceeb tshaj, nyob qhov zoo. Cov cwj pwm uas koj qhia koj tus menyuam niaj hnub no yuav pab nws kom nws lub neej nquag thiab noj qab haus huv nrog muaj ntshav qab zib hom 1.

  Tsev kawm ntawv thiab ntshav qab zib

  Koj yuav tsum tau ua haujlwm nrog tus kws saib xyuas mob hauv tsev kawm thiab koj tus menyuam cov kws qhia ntawv txhawm rau paub tseeb tias lawv paub cov tsos mob siab thiab muaj ntshav qab zib tsawg. Koj tus kws saib mob hauv tsev kawm yuav xav tau txhaj tshuaj insulin lossis kuaj koj tus menyuam cov piam thaj hauv ntshav. Tsoomfwv txoj cai lij choj tiv thaiv cov menyuam muaj ntshav qab zib, thiab cov tsev kawm ntawv yuav tsum ua cov txheej txheem tsim nyog los xyuas kom meej tias txhua tus menyuam tau txais txoj kev kawm zoo.

  Koj cov menyuam txoj kev xav

  Ntshav qab zib tuaj yeem cuam tshuam koj tus menyuam qhov kev xav, txawm yog ncaj qha lossis tsis ncaj. Kev tswj cov ntshav qab zib tsis zoo tuaj yeem ua rau hloov kev coj tus cwj pwm, xws li txob taus. Yog tias qhov no tshwm sim ntawm hnub yug lub hnub yug vim tias koj tus menyuam tsis nco qab noj tshuaj insulin ua ntej ib qho khoom qab zib, nws tuaj yeem tuav nrog phooj ywg.

  Mob ntshav qab zib kuj tseem tuaj yeem ua rau koj tus menyuam txawv ntawm lwm tus menyuam. Muaj peev xwm kos duab ntshav thiab txhaj tshuaj rau lawv tus kheej, cov menyuam muaj ntshav qab zib dhau ntawm lawv cov phooj ywg. Kev coj koj tus menyuam nrog lwm cov menyuam uas muaj ntshav qab zib tuaj yeem pab ua rau koj tus menyuam tsawg ib leeg.

  Kev Mob Hlwb thiab Kev Ua Phem

  Cov neeg muaj ntshav qab zib muaj feem ntau yuav muaj kev nyuaj siab thiab ntxhov siab, vim li no ntau tus kws kho mob ntshav qab zib tsis tu ncua suav nrog tus kws lis haujlwm pab neeg lossis kws kho mob hlwb hauv pab pawg ntshav qab zib.

  Tshwj xeeb, cov hluas yog qhov tshwj xeeb nyuaj rau cov ntshav qab zib. Ib tug menyuam yaus uas ua raws li nws kev kho mob ntshav qab zib tau zoo tuaj yeem nce siab hauv nws cov hluas, tsis quav ntsej txog nws cov ntshav qab zib kho mob.

  Nws tseem yuav nyuaj rau cov hluas qhia lawv cov phooj ywg tias lawv muaj ntshav qab zib vim lawv xav kom haum rau. Lawv tseem tuaj yeem sim tshuaj, haus dej cawv thiab haus luam yeeb, tus cwj pwm uas tuaj yeem tsim kev phom sij ntau rau cov neeg muaj ntshav qab zib. Kev noj zaub mov tsis zoo thiab tsis kam insulin rau qhov poob phaus yog lwm yam teeb meem uas tuaj yeem tshwm sim ntau dua nyob rau cov neeg hluas.

  Tham nrog koj tus hluas lossis nug koj tus hluas kws kho mob tham nrog koj tus hluas hais txog kev cuam tshuam nrog tshuaj, dej cawv thiab haus luam yeeb rau ib tug neeg muaj ntshav qab zib.

  Yog tias koj pom tias koj tus menyuam lossis tus hluas yuav tu siab lossis chim siab tas li los yog muaj kev hloov pauv ntawm lawv txoj kev pw tsaug zog, cov phooj ywg, lossis kev kawm hauv tsev kawm ntawv, hais kom koj tus menyuam soj ntsuam kev nyuaj siab. Kuj qhia koj tus menyuam tus kws kho mob yog tias koj pom tias koj tus tub lossis tus ntxhais tab tom poob phaus lossis zoo li nws tsis zoo rau noj.

  Pawg sib txhawb

  Tham nrog tus kws pab tswv yim lossis kws kho mob tuaj yeem pab koj tus menyuam lossis koj tuaj yeem daws nrog txoj kev hloov pauv ntawm kev ua neej uas tuaj nrog kev txheeb xyuas tus mob ntshav qab zib hom 1. Koj tus menyuam tuaj yeem nrhiav tau kev txhawb nqa thiab nkag siab hauv pawg 1 pab txhawb rau ntshav qab zib hom ntshav rau cov menyuam. Pawg sib txhawb pab niam txiv kuj tseem muaj.

  Txawm hais tias kev txhawb pab pawg tsis yog rau txhua tus neeg, lawv tuaj yeem ua cov ntaub ntawv zoo. Cov pab pawg neeg feem ntau paub txog cov qauv kho tshiab kawg nkaus thiab nyiam qhia lawv qhov kev paub dhau los lossis cov ntaub ntawv muaj txiaj ntsig, piv txwv, qhov twg yuav nrhiav cov khoom noj carbohydrates rau koj cov menyuam nyiam haus hauv tsev noj mov. Yog tias koj xav tau, koj tus kws kho mob yuav pom zoo kom pab pawg hauv koj qhov chaw.

  Txhawb cov vev xaib suav nrog:

  • American Diabetes Association (ADA). ADA tseem muaj cov phiaj xwm ntshav qab zib uas muab kev kawm thiab txhawb rau cov menyuam yaus thiab cov hluas muaj ntshav qab zib.
  • JDRF.
  • Cov menyuam muaj ntshav qab zib.

  Cov ntawv tshaj tawm hauv cov ntsiab lus

  Teeb meem los ntawm cov ntshav qab zib uas tswj tsis tau zoo yuav yog ib qho kev hem. Nws yog ib qho tseem ceeb kom nco ntsoov tias ntau txoj kev tshawb nrhiav - thiab yog li ntawd ntau cov ntawv nyeem uas koj tuaj yeem nyeem - tau ua tiav ua ntej ntau qhov kev vam meej hauv kev kho tus mob ntshav qab zib tau tshwm sim. Yog tias koj thiab koj tus menyuam ua haujlwm nrog koj tus menyuam tus kws kho mob thiab ua txhua yam koj ua tau los tswj koj cov piam thaj hauv ntshav, koj tus menyuam yuav nyob lub neej ntev thiab zoo li qub.

  Npaj tuaj teem sijhawm

  Koj tus menyuam tus thawj kws kho mob yog thawj tus yuav kuaj pom tus mob ntshav qab zib hom 1. Yuav tsum tau pw hauv tsev kho mob los tswj koj tus menyuam cov ntshav qab zib kom nyob ruaj.

  Koj tus menyuam qhov kev saib xyuas ntshav qab zib mus ntev yuav tshwm sim los ntawm tus kws kho mob uas paub tshwj xeeb txog kev mob plab zom mov hauv menyuam yaus (kws kho mob endocrinologist). Koj tus menyuam lub chaw noj qab haus huv feem ntau yuav muaj ib tus kws qhia noj zaub mov, muaj qhia paub txog ntshav qab zib, thiab tus kws tshaj lij saib xyuas qhov muag (kws kho qhov muag).

  Nov yog qee cov xov xwm los pab koj kom npaj tau lub rooj sib tham.

  Koj tuaj yeem ua dab tsi

  Ua ntej yuav teem caij, ua cov hauv qab no:

  • Sau tag nrho cov kev txhawj xeeb txog koj tus menyuam kev noj qab nyob zoo.
  • Hais kom ib tus hauv tsev neeg lossis cov phooj ywg koom nrog koj. Txhawm rau tswj ntshav qab zib, koj yuav tsum nco ntsoov ntau cov ntaub ntawv. Qee tus neeg nrog ua ke koj yuav nco qab yam koj plam lossis tsis nco qab lawm.
  • Sau cov lus nug uas koj yuav tau nug koj tus kws kho mob. Koj lub sijhawm nrog koj tus kws kho mob tsawg, yog li nws yuav pab tau los npaj cov lus nug ntsig txog koj tus menyuam. Hais kom koj tus kws kho mob hu rau koj tus kws qhia noj zaub mov kev noj haus lossis kws qhia kev mob ntshav qab zib yog tias koj muaj teeb meem tuaj yeem daws tau.

  Cov ntsiab lus koj tuaj yeem sab laj nrog koj tus kws kho mob, khoom noj khoom haus, lossis kws qhia kev mob ntshav qab zib suav nrog:

  • Zaus thiab lub sijhawm kuaj ntshav qabzib
  • Kev siv tshuaj insulin - hom tshuaj insulin uas siv, siv sijhawm thiab noj ntau npaum li cas
  • Insulin Administration - Txhaj Tshuaj Tiv Thaiv Twj
  • Cov piam thaj hauv ntshav qis (muaj ntshav qab zib tsawg) - yuav ua li cas paub thiab kho mob
  • Mob ntshav qab zib (hyperglycemia) - yuav ua li cas paub thiab kho mob
  • Ketones - kuaj thiab kho
  • Khoom noj khoom haus - hom zaub mov thiab lawv cov nyhuv ntshav qab zib
  • Luag suav roj
  • Kev tawm dag zog - Kev tswj hwm insulin thiab kev noj zaub mov kom tsawg rau kev ua si
  • Ua haujlwm nrog ntshav qab zib nyob hauv tsev kawm lossis tsev pw tshav ntuj thiab rau qee lub sijhawm tshwj xeeb xws li pw ib hmos
  • Kev tswj hwm kev kho mob - kho mob npaum li cas koj tuaj yeem ntsib kws kho mob thiab lwm cov kws paub txog ntshav qab zib

  Dab tsi xav kom los ntawm koj tus kws kho mob

  Koj tus kws kho mob yuav nug koj ib co lus nug, xws li:

  • Koj yuav nyob nyab xeeb los tswj koj tus menyuam cov ntshav qab zib li cas?
  • Koj tus menyuam puas tau mob ntshav qab zib?
  • Kev noj haus niaj hnub niaj hnub yog dab tsi?
  • Puas yog koj tus menyuam qoj ib ce? Yog tias muaj, ntau npaum li cas?
  • Hauv nruab nrab, koj siv insulin ntau npaum li cas txhua hnub?

  Hu rau koj tus menyuam tus kws kho mob lossis tus kws qhia mob ntshav qab zib ntawm kev sib tham yog tias koj tus menyuam cov piam thaj hauv ntshav tsis tau tswj, lossis yog koj tsis paub meej tias yuav ua dab tsi hauv qee kis.