Ntshav Qab Zib Hom 1 hauv ib tug menyuam muaj hnub nyoog 6 xyoo raug tswj tsis tau siv insulin

Ntshav Qab Zib Hom 1 yog yam mob thib ob tshaj plaws (tom qab ntshav qab zib hom 2), tab sis nws tuaj yeem raug hu ua yam txaus ntshai tshaj plaws. Tus kab mob no tseem hu ua "ntshav qab zib ntshav", "ntshav qab zib nyias", thiab thaum ntxov lo lus "insulin-tiv thaiv ntshav qab zib" tau siv.

Ntshav qab zib Hom 1 feem ntau tshwm sim thaum menyuam yaus lossis thaum tiav hluas. Qee lub sij hawm qhov pib ntawm tus kab mob tshwm sim thaum muaj hnub nyoog 30-50 xyoo, thiab hauv qhov no nws yog mob me me, qhov ua ploj ntawm pancreatic ua haujlwm qeeb dua. Daim ntawv no hu ua "maj mam ua hom 1 mob ntshav qab zib" lossis LADA (Lub sijhawm pib mob ntshav qab zib feem ntau ntawm cov neeg laus).

• Tus txheej txheem ntawm kev loj hlob ntawm hom 1 mob ntshav qab zib.

Hom Ntshav Qab Zib 1 mellitus belongs rau ib pawg loj ntawm cov kab mob autoimmune. Qhov laj thawj rau txhua yam kab mob no yog tias lub cev tiv thaiv kab mob noj cov protein ntawm nws tus kheej cov ntaub so ntswg rau cov protein ntawm cov kab mob txawv teb chaws. Feem ntau ua rau pom tseeb yog qhov kev kis tus kab mob, nyob rau hauv cov protein ntawm tus kab mob zoo li lub cev tiv thaiv kab mob "zoo ib yam" rau cov protein ntawm lawv tus kheej lub cev. Xws li hom ntshav qab zib hom 1, lub cev tiv thaiv lub cev tua kabmob ua rau pancreatic beta cells (ua cov tshuaj insulin) kom txog thaum nws rhuav tshem lawv tag nrho. Cov tshuaj insulin tsis txaus, cov protein uas xav tau rau cov as-ham kom nkag mus rau hauv hlwb, tsim kho mob.

• Kho mob ntshav qab zib hom 1.

Kev kho tus kab mob yog ua raws li kev tswj hwm txuas ntxiv ntawm insulin. Txij li thaum cov tshuaj insulin raug rhuav tshem los ntawm kev noj, nws yuav tsum raug siv ua kev txhaj tshuaj. Thaum pib ntawm lub xyoo pua 21st, ntau lub tuam txhab Asmeskas tsim kev tsim cov tshuaj insulin npaj (rau kev nqus tau). Txawm li cas los xij, lawv tau tso tawm tsis ntev vim tias qhov kev thov tsis txaus. Thaj, qhov tseeb ntawm kev txhaj tshuaj nws tus kheej tsis yog qhov teeb meem tseem ceeb hauv kev kho mob.

Peb yuav sib tham txog cov teeb meem uas feem ntau tshwm sim hauv cov neeg mob uas kuaj pom tus mob ntshav qab zib hom 1 mob ntshav qab zib.

• Kho puas tau ntshav qab zib hom 1 tuaj yeem kho tau?

Niaj hnub no, cov tshuaj tsis tuaj yeem thim rov qab cov txheej txheem autoimmune uas tau rhuav tshem lub pancreatic beta hlwb. Tsis tas li ntawd, thaum cov tsos mob tshwm sim, feem ntau tsis ntau tshaj 10% ntawm kev ua haujlwm beta hlwb tseem nyob. Cov hau kev tshiab tau tsim kho kom txuag cov neeg mob los ntawm kev xav tau los tswj cov tshuaj insulin tas li ua ntej noj mov. Txog niaj hnub no, kev nce qib tseem ceeb tau ua tiav hauv cov lus qhia no.

Cov tshuaj insulin. Txij li xyoo 1990, cov kua dej insulin tau qhia rau hauv kev coj ua - cov tshuaj tiv thaiv uas hnav ntawm lub cev thiab xa cov insulin los ntawm subcutaneous catheter. Thaum xub thawj cov twj tsis siv neeg, tag nrho cov lus txib rau cov tshuaj insulin yuav tsum tau muab los ntawm tus neeg mob los ntawm nias lub khawm ntawm lub twj tso kua mis. Txij xyoo 2010, "cov tswv yim ib nrab" cov qauv twj tso kua mis tau tshwm sim rau hauv kev ua lag luam: lawv tau ua ke nrog lub ntsuas qhov ntsuas uas ntsuas cov suab thaj hauv cov nqaij mos kom tsawg thiab muaj peev xwm kho tus nqi ntawm cov tshuaj insulin raws li cov ntaub ntawv no. Tab sis tus neeg mob tseem tsis tau tag nrho qhov kev xav tau los muab cov lus txib tso kua mis. Kev cog lus qauv ntawm cov kua dej ua haujlwm tuaj yeem tswj hwm cov ntshav qab zib tsis muaj kev cuam tshuam los ntawm tib neeg. Lawv muaj feem tshwm sim hauv kev ua lag luam nyob ze yav tom ntej.

Cov duab los ntawm: shutterstock.com / Nyem thiab Yees Duab

Beta cell lossis hloov kab mob ntsws ua haujlwm. Tus neeg pub khoom siv tsuas yog tib neeg. Qhov mob tseem ceeb rau kev ua tiav hauv kev hloov pauv yog kev siv yeeb tshuaj tsis tu ncua uas tiv thaiv kev tiv thaiv kab mob thiab tiv thaiv tsis lees txais. Xyoo tsis ntev los no, cov tshuaj tau tshwm sim tias muaj kev xaiv cuam tshuam txog kev tiv thaiv kab mob - tiv thaiv kev tsis lees txais, tab sis tsis muaj kev tiv thaiv kab mob hauv feem ntau. Cov teeb meem thev naus laus zis ntawm kev cais tawm thiab khaws cia beta hlwb raug kho tau loj. Qhov no pub rau kev ua haujlwm hloov mus los kom nquag. Piv txwv, xws li kev ua haujlwm yog ua tau ib txhij nrog lub raum hloov ntshav (uas feem ntau xav tau rau tus neeg mob uas mob raum puas - lub raum tsis zoo).

• Ntshav qab zib tau siab, Kuv tau kuaj pom tias mob ntshav qab zib mellitus thiab kho cov tshuaj insulin. Tab sis tom qab 2 lub hlis cov piam thaj rov qab zoo li qub thiab tsis sawv, txawm tias cov tshuaj insulin tsis tswj hwm. Puas yog kuv kho tau, lossis kev kuaj mob tsis ncaj ncees lawm?

Hmoov tsis zoo, tsis yog ib tus tsis. Qhov tshwm sim no yog hu ua "kev sib deev ntawm cov ntshav qab zib." Qhov tseeb yog tias cov tsos mob ntawm tus mob ntshav qab zib hom 1 tshwm sim thaum kwv yees li 90% ntawm cov qe ntshav tuag, tab sis qee cov qe hlwb tseem muaj sia nyob rau lub sijhawm no. Nrog kev ua haujlwm ntawm cov ntshav qab zib (insulin) kom zoo li qub, lawv txoj haujlwm ua haujlwm nce ntxiv rau ib ntus, thiab cov insulin zais cia los ntawm lawv tuaj yeem ua tau kom tswj tau cov ntshav qab zib. Tus txheej txheem autoimmune (uas ua rau muaj kev txhim kho ntshav qab zib) tsis nres thaum tib lub sijhawm, yuav luag txhua cov qe ntshav tuag hauv 1 xyoos. Tom qab ntawd, nws muaj peev xwm tswj tau cov piam thaj hauv kev tsuas yog nrog kev pab ntawm cov tshuaj insulin los ntawm sab nraud. "Honeymoon" tsis tshwm sim hauv 100% ntawm cov neeg mob kuaj mob ntshav qab zib hom 1, tab sis qhov no yog qhov tshwm sim ntau. Yog tias nws raug pom, tus kws kho txoj cai endocrinologist yuav tsum txo qis cov tshuaj insulin ib ntus.

Muaj qee kis, tus neeg mob kuaj mob nrhiav kev pab los ntawm cov kws kho kom zoo thiab lwm yam kev kho mob. Yog tias txais tos ntawm "tshuaj ntsuab pej xeem" tshwm sim thaum lub sij hawm txhim kho "zib ntab muv", qhov no ua rau muaj kev xav hauv tus neeg mob (thiab tus kho mob, nws kuj yog qhov tsis zoo) tias cov tshuaj no pab tau. Tab sis, hmoov tsis, qhov no tsis yog.

• Yog tias ntshav qab zib tsis tuaj yeem siv tsis tau, thiab kuv poob qis thaum 15, kuv puas tuaj yeem nyob tsawg kawg 50?

Txog 50 thiab nce mus txog 70 - tsis muaj kev tsis ntseeg! Joslin American Foundation tau teeb tsa ntev rau cov neeg uas tau nyob 50 xyoo (thiab tom qab 75 xyoo) tom qab kuaj pom tus mob ntshav qab zib hom 1. Thoob ntiaj teb, ntau pua tus neeg tau txais cov khoom plig no, suav nrog hauv tebchaws Russia. Yuav muaj ntau tus kws ntaus kis las ntau tshaj yog tias nws tsis muaj teeb meem kev txawj ntse: tsis yog txhua tus tau khaws cov ntaub ntawv kho mob 50 xyoo dhau los, lees tias qhov tseeb ntawm kev tsim cov kev kuaj mob thaum lub sijhawm ntawd.

Tab sis yuav kom tau txais Joslin Foundation qhov khoom plig, koj yuav tsum kawm paub tswj hwm koj tus kheej cov piam thaj kom zoo. Qhov nyuaj yog tias nyob rau hauv tus neeg uas tsis muaj ntshav qab zib, qhov sib txawv ntawm cov tshuaj insulin raug tso tawm txhua hnub - nyob ntawm kev noj haus, kev tawm dag zog thiab ntau lwm yam. Tus tib neeg noj qab haus huv muaj lub ntuj "automaton" uas tswj cov qib qab zib tas li - cov no yog cov hlwb hlwb ntawm tus txiav thiab ib tug lej ntawm lwm lub hlwb thiab cov tshuaj hormones uas koom nrog txoj kev ua no. Ntawm hom 1 mob ntshav qab zib mellitus, lub tshuab no tau tawg, thiab nws yuav tsum hloov los ntawm "kev tswj hwm" - tswj ntshav qab zib ua ntej txhua pluas noj, suav txog tag nrho cov carbohydrates noj "siv cov khob cij" thiab suav qhov xav tau ntawm cov tshuaj insulin ua ntej noj mov siv ib qho tsis nyuaj. Nws yog ib qho tseem ceeb kom tsis txhob ntseeg koj txoj kev nyob zoo, uas tuaj yeem ua rau dag: lub cev tsis tas li siab xav ntau lossis qis qab zib.

Qhov ntsuas ntshav qab zib yog Ameslikas lub ntsuas ntshav cov ntshav, lub cuab yeej ua haujlwm uas ntsuas cov ntshav qab zib hauv ib qib ntshav los ntawm cov ntiv tes. Yav tom ntej, cov khoom siv tshwj xeeb raug tsim kho uas ntsuas cov qib suab thaj hauv cov kua dej intercellular (hauv cov nqaij subcutaneous). Hauv ob peb xyoos dhau los, cov cuab yeej zoo li no tau nkag mus rau hauv kev ua lag luam uas tso cai rau koj kom tau txais cov ntaub ntawv hais txog cov piam thaj tam sim no. Piv txwv yog DexCom thiab FreeStyle Libre.

Nruam Cov Ntshav Qab Zib Tswj Cov Kab Mob

Cov duab los ntawm: shutterstock.com / Nata Duab

Tab sis, txawm hais tias tag nrho cov thev naus laus zis niaj hnub no, txhawm rau txhawm rau kev tswj hwm kev tswj hwm qib qab zib, koj xav tau kev cob qhia hauv cov haujlwm tshwj xeeb hu ua Tsev Kawm Ntawv Ntshav Qab Zib. Raws li txoj cai, kev cob qhia yog nqa tawm hauv ib pawg thiab siv sijhawm tsawg kawg 20 teev. Kev paub tsis yog tib qho mob rau kev tswj kom ua tiav. Ntau nyob ntawm kev muab cov kev paub no rau hauv kev coj ua: ntawm kev ntsuas ntsuas cov ntshav qab zib thiab kev tswj cov tshuaj insulin txoj cai. Yog li, nws yog ib qho tseem ceeb heev uas tus kws kho mob endocrinologist txheeb xyuas txog tus neeg mob lub cev thiab nws cov ntshav qab zib cov ntshav pauv (raws li daim ntawv sau cia tus neeg mob tus kheej), txiav txim qhov tseeb muab xam los ntawm cov tshuaj insulin thiab kho kho raws sijhawm. Hmoov tsis zoo, nyob hauv tebchaws Russia, ntau tus neeg mob ntsib nrog tus kws kho mob tsuas yog kom tau txais tshuaj insulin dawb, thiab tsuas muaj sijhawm tsis txaus rau tus kws kho mob hauv chaw kho mob ... Txhua tus neeg mob ntshav qab zib yuav tsum nrhiav tus kws kho qhov mob endocrinologist uas yuav ua qhov kev cob qhia kom yog thiab yuav txuas ntxiv nrog nws. kev saib xyuas kev ua haujlwm ntawm tus neeg mob lub cev kev noj qab haus huv thiab kev kho mob kom raws sij hawm. Xws li cov tshuaj endocrinologist tsis yog ib txwm ua haujlwm nyob rau hauv kev tiv thaiv kev tiv thaiv kev noj qab haus huv, thiab tsis tas yuav tsum muaj tib tug kws kho mob uas tau sau tshuaj insulin pub dawb.

• Kuv muaj ntshav qab zib hom 1. Yog tias kuv muaj menyuam, lawv puas yuav muaj ntshav qab zib thiab? Puas mob ntshav qab zib?

Mob ntshav qab zib hom 2 feem ntau tshwm sim thaum hnub nyoog laus dua, muaj keeb kwm caj ces rau nws txij thaum yug los. Nrog hom 1 mob ntshav qab zib mellitus, qhov mob muaj keeb yog me: nyob hauv kev muaj ntshav qab zib hom 1 hauv ib leej niam thiab txiv, qhov tshwm sim ntawm tus kab mob no hauv menyuam yaus yog li ntawm 2 txog 6% (nyob rau hauv muaj ntshav qab zib hom 1 hauv leej txiv ntawm tus menyuam, qhov tshwm sim muaj peev xwm muaj ntau dua li mob ntshav qab zib hauv leej niam). Yog tias ib tus menyuam muaj mob ntshav qab zib hom 1 hauv tsev neeg, ces qhov tshwm sim ntawm qhov mob ntawm nws cov kwv tij lossis cov muam yuav 10%.

Cov neeg muaj ntshav qab zib tau mus cuag leej niam thiab leej txiv zoo siab. Tab sis rau txoj kev nyab xeeb ntawm kev xeeb tub hauv cov poj niam uas muaj hom 1 mob ntshav qab zib mellitus, cov theem ntawm cov piam thaj kom ruaj khov ua ntej xeeb tub thiab kev saib xyuas ntawm tus kws tshuaj endocrinologist raws li qhov kev qhia tshwj xeeb thaum lub sijhawm cev xeeb tub tseem ceeb heev.

Ntshav qab zib yog ib yam kab mob insidious uas tuaj yeem "ua rau mob". Kev tshuaj xyuas tas li los ntawm cov kws kho mob muaj txiaj ntsig zoo, kev tshuaj xyuas lub chaw soj ntsuam tas li, siv cov tshuaj thiab kho mob niaj hnub no - txhua yam no pab tswj cov ntshav qab zib kom tsis txhob muaj kab mob thiab zam kom tsis txhob muaj kev phom sij.

Muaj cov lus zoo: "Mob ntshav qab zib tsis yog kab mob, tab sis yog txoj kev ua neej." Yog tias koj kawm tswj hwm koj cov ntshav qab zib, koj tuaj yeem ua lub neej ntev thiab zoo siab nrog nws.

Acetone nyob rau hauv cov zis nrog cov khoom noj uas muaj cov carbohydrate tsawg

- Thawj qhov kuv xav nug. Tam sim no koj tau kawm tias tus me nyuam muaj acetone nyob rau hauv qhov zis, thiab kuv sau rau koj tias nws yuav txuas ntxiv mus. Koj yuav ua li cas txog qhov no?
- Peb tau ntxiv dej ntau ntxiv, tus menyuam tau pib haus, tam sim no tsis muaj acetone. Hnub no peb tau sim dua, tab sis peb tseem tsis paub qhov tshwm sim.
- Rov ntsuam xyuas yog dab tsi? Ntshav lossis zis?
- Kuaj tsom rau cov qog glucosuric.
"Koj puas tau hla tib txoj kev tsom xam ntxiv?"
- muaj
- Vim li cas?
- Lub sijhawm dhau los, kev txheeb xyuas pom ob ntawm peb qhov zoo ntawm cov roj ntsha hauv acetone. Lawv thov kom rov raug muab dua, thiab peb ua qhov no kom peb tsis txhob sib cav nrog tus kws kho mob ib zaug ntxiv.
- Yog li tom qab txhua yam, acetone hauv zis yuav txuas ntxiv, kuv piav rau koj.
- Tam sim no tus me nyuam pib haus ntau yam kua, Kuv ua noj nws stewed txiv hmab txiv ntoo. Vim tias qhov no, tsis muaj cov acetone nyob hauv cov zis, tsawg kawg ntawm cov ntawv xeem tsis hnov ​​mob, txawm hais tias kuv tseem tsis paub xyov qhov kev kuaj ntawd yuav ua li cas.
- Koj puas muaj acetone ntawm daim phiaj ntsuas?
- Yog, qhov ntsuas ntsuas tsis cuam tshuam txhua. Sij hawm dhau los, nws tawm tsam tsawg kawg yog me ntsis, tsaus muag xim, tab sis tam sim no nws tsis hnov ​​mob txhua. Tab sis kuv pom tias sai li sai tau thaum tus me nyuam haus dej tsawg dua, tom qab ntawd acetone tshwm me ntsis. Nws haus dej ntau dhau - qhov ntawd yog txhua yam, muaj kiag li tsis muaj acetone.
- Thiab dab tsi ua acetone qhia? Ntawm txoj kab sim coj lossis hauv kev noj qab haus huv?
- Tsuas yog ntawm kab ntawv xeem, peb tsis txhob ceeb toom nws ntxiv lawm. Nws tsis tuaj yeem pom hauv lub siab lossis hauv lub xeev kev noj qab haus huv ntawm tus menyuam.

- Koj puas nkag siab tias cov tshuaj acetone rau ntawm cov zis ntsuas ntawm cov zis yuav txuas ntxiv rau txhua lub sijhawm? Thiab vim li cas ho tsis ntshai ntawm qhov no?
- Yog lawm, tau kawg, lub cev nws tus kheej tau hloov mus rau lwm yam kev noj haus txawv.
"Nov yog yam uas kuv sau rau koj ... Qhia rau kuv, cov kws kho mob puas pom tej kev tshwm sim no?"
- Dab tsi?
- Zis tsom rau cov acetone.
- Dab tsi ua nws dhau los ua tsawg?
- Tsis muaj, hais tias nws yog txhua.
- Ua siab ncaj, kws kho mob tsis txhawj txog qhov no, vim tias cov piam thaj tsis nyob hauv cov zis. Rau lawv, qhov no tsis qhia tias yog ntshav qab zib, vim tias tsis muaj cov piam thaj hauv. Nws hais tias, lawv tau hais, txoj kev txhim kho khoom noj khoom haus, tsis suav cov nqaij, ntses, noj porridge. Kuv xav tias - yog, twv yuav raug hu ...
"Koj puas nkag siab tias koj tsis tas yuav hloov mus ua lwm yam khaub noom?"
- Tau kawg, peb tsis yog yuav mus.

Muaj qhia txog kev noj haus cov zaub mov uas tsis muaj carbohydrate rau hom 1 thiab ntshav qab zib hom 2 muaj nyob ntawm no.

"Kuv xav paub tias lawv yuav muab cov khoom noj carbohydrates rau hauv tus menyuam hauv tsev kawm ntawv yog li ua rau acetone ploj." Nrog lawv nws yuav dhau los. Kuv ntshai tias qhov no ua tau.
- Niam Peb tsuas mus kawm ntawv thaum lub Cuaj Hli. Nyob rau lub Cuaj Hli Kuv siv sijhawm so thiab lawv yuav nyob ntawm lub luag haujlwm ntawd kom ntev ib lub hlis tsuas yog npaj nrog tus xibfwb. Kuv xav tias tus kws qhia ntawv tsis yog tus kws kho mob, lawv tau kawm ntau dua.
- Tos. Tus xibfwb tsis quav ntsej. Koj tus menyuam tsis tau txhaj tshuaj insulin, uas yog, tus kws qhia ntawv tsis muaj teebmeem. Tus me nyuam yuav noj nws cov nqaij-cheese tsis muaj carbohydrates, tus nais khu yog lub teeb ci. Tab sis hais tias muaj tus kws saib xyuas neeg nyob hauv chaw ua haujlwm. Nws pom tias tus menyuam muaj acetone hauv nws cov zis. Txawm hais tias muaj me ntsis acetone thiab tus me nyuam tsis hnov ​​dab tsi li, tus neeg saib xyuas neeg mob yuav muaj kev ywj pheej - muab suab thaj kom cov acetone tsis muaj nyob.
- Txiv Thiab nws yuav pom li cas?
- Niam, Kuv xav mus saib ntawm qhov kev tshuaj ntsuam uas peb dhau hnub no. Tej zaum peb yuav tsis qhia cov tshuaj acetone txhua lub sijhawm. Tom qab ntawd, thaum lawv thov kom tso zis rau cov glucosuric profile, tom qab ntawd peb yuav muab rau nws, tab sis hnub no peb yuav tso dej rau tus menyuam nrog kua kom txaus.
- Hauv koj txoj kev ntsuas zis rau acetone, muaj ob ntawm peb pluses. Tom qab ntawd tej zaum yuav muaj ib qho ntxiv, tab sis nws feem ntau yuav tseem muaj ...
- Nws tsis ua li cas, vim hais tias tus kws kho mob txog qhov no tsis tau qhia ib qho kev txhawj xeeb txhua. Nws hais tias kho cov khoom noj khoom haus, tab sis tshwj xeeb txog qhov no tsis thab.
- Nws tau muab cov lus qhia rau koj uas yog sau rau hauv nws cov lus qhia: yog tias muaj acetone - muab cov carbohydrates. Koj yuav tsis ua li no, thiab ua Vajtswv tsaug. Tab sis lwm tus neeg lwm qhov kev xav tau zoo tshaj plaws yuav coj koj tus menyuam mus rau tom tsev kawm ntawv thiab hais tias, hais, noj khoom qab zib, ncuav qab zib lossis lwm yam kom koj tau txais cov acetone. Nov yog ib qho txaus ntshai.
- Niam, Qhov tseeb, hais qhov tseeb, Kuv ntshai heev ntawm lub tsev kawm ntawv, vim nws yog menyuam yaus, thiab nws tsis tuaj yeem tshem tawm ...
- Zoo li cas tiag?
- Tias nws tau noj tej yam tsis ncaj qhov chaw. Peb muaj ib zaug uas peb noj peb caug, txawm tias muaj neeg nyiag los nyob hauv tsev. Tom qab ntawd peb tau pib ua kom muaj ntau yam ntawv qhia zaub mov, muab nws lub walnuts, thiab qee zaum nws calmed.
- Qhov no yog thaum twg? Thaum twg koj tau txhaj cov insulin, lossis tom qab ntawd, koj tau hloov mus rau qhov kev noj zaub mov tsis muaj zaub mov kom tsawg?
- Peb muaj cov tshuaj insulin rau tsuas yog 3 hnub. Peb tau mus rau lub tsev kho mob lub Kaum Ob Hlis 2, peb tau sau tshuaj insulin los ntawm thawj hnub, peb tau txhaj tshuaj insulin ob zaug, Kuv tau mus rau hauv tsev kho mob nrog nws thaum noj su. Tus me nyuam tam sim ntawd xav tias tsis zoo, qhov tshwm sim rau insulin yog vwm.
- Nws nyuam qhuav muaj piam thaj ntau, dab tsi cov tshuaj insulin muaj feem nrog nws ...
- Niam Yog lawm, tom qab ntawd peb tau kuaj lub plab tsis muaj ntshav kuaj ntawm chaw kho mob, qab zib yog 12.7 hauv kuv lub tswv yim, Tom qab ntawd kuv tau pub tus menyuam nyob hauv tsev nrog pilaf thiab tseem coj pilaf nrog kuv mus tom tsev kho mob. Raws li qhov tshwm sim, qab zib dhia mus txog 18.
- Txiv, Kuv nyeem thiab xav - ua li cas es? Vim li cas thiaj li muaj piam thaj 12 thiab dhau los ua 18?
- Niam Vim tias nws tau noj pilaf thiab peb twb tuaj txog hauv tsev kho mob nrog piam thaj 18.
"Yog li, dua li ntawm acetone, koj puas tseem noj cov zaub mov muaj roj tsawg?"
- Tau kawg.
- Thiab cov kws kho mob tsis tshua muaj siab tshem cov acetone no?
- Tsis yog, tus kws kho mob pom tsis muaj kev ua ub no.

Hom ntshav qab zib hom 1 hauv menyuam yaus tuaj yeem tswj tau yam tsis muaj kev txhaj tshuaj insulin txhua hnub, yog tias koj hloov mus rau kev noj haus uas tsis muaj cov carbohydrate los ntawm thawj hnub ntawm tus kabmob. Tam sim no cov txheej txheem yog muaj tag nrho nyob rau hauv Lavxias, pub dawb.

Khoom noj rau tus menyuam muaj mob ntshav qab zib hom 1 hauv qib pib thiab tsev kawm ntawv

- Ntawd yog, koj tsis tau mus kawm ntawv tseem muaj, tab sis tsuas yog mus, txoj cai?
- Yog, kom deb li deb peb tsuas yog mus cob qhia, thiab peb muaj txhua yam kev tswj hwm.
- Thiab rau qib K?
- Txij thaum mus kawm hauv kindergarten peb coj nws mus.
- Sai li nws tag nrho cov pib?
- Tau, peb maj mam coj nws; nws tsis mus ib hnub rau ntawm kindergarten.
- Vim li cas?
- Vim tias lawv hais tias: cov khoom noj uas tau muab hauv qib kindergarten haum rau cov menyuam muaj ntshav qab zib. Peb tsis pom zoo. Nws tsis haum txhua. Peb txawm nyob hauv tsev kho mob - 9 lub rooj - muab compote nrog qab zib.
- Qhov ntawd yog, nyob rau hauv qib pib koj yuav tsis pom zoo kom pub yam koj xav tau?
- Tsis yog, qhov tseeb, koj tab tom tham txog dab tsi ... Kuv ua tus menyuam noj txhua hnub ...
“Thiab koj yuav tsum cia nws nyob hauv tsev?”
- Yog lawm, peb khaws cia hauv tsev, yawg muaj kev cuam tshuam, thiab tus me nyuam nyob hauv tsev nrog peb, peb tau coj nws los ntawm qib menyuam yaus.

Txo cov piam thaj kom ib txwm rau peb tus kheej, thiab tom qab ntawd rau phooj ywg

- Nov yog koj li kev noj haus - nws ua haujlwm ntau heev ... Kuv tus npoj yaig tus txiv neej muaj ntshav qab zib hom 2. Nws, ntawm chav kawm, tsis mloog kuv thaum xub thawj. Nws hais tias peb tuaj yeem muaj buckwheat, thiab lwm yam. Lawv noj buckwheat - thiab qab zib tom qab nws 22. Tam sim no lawv tau noj tag nrho cov zaub mov tsis muaj carbohydrate, thiab tam sim no nws tsis tau qab zib. Thaum ntej nws hu kuv ua ntau yam. Nws tus txiv rub tawm, lawv hais, hu lawv, sab laj yog tias kuv tuaj yeem muaj cov khoom lag luam lossis cov no. Nws mloog kuv lus, thiab tam sim no lawv noj lawv yam nkaus li peb cov menyuam noj.
“Koj puas tau muab lawv lub xaib rau?”
- Lawv tsis muaj internet
- Yog, Kuv pom.
"Lawv yuav tsis yog lawm." Lawv npaj, tau kawg, tab sis cov no yog cov neeg ntawm lub hnub nyoog so haujlwm, yog li nws tsis zoo li. Tab sis tsawg kawg lawv tau mloog kuv thiab tsis ua raws li cov kws kho mob pom zoo. Tam sim no nws muaj 4-5 suab thaj, thiab qhov no nrog tus txiv neej laus.

- Ntawd yog, koj tsis dhuav lub neej, koj puas tseem qhia phooj ywg?
"Kuv sim, tab sis tib neeg tsis mloog tiag."
"Tsis txhob txhawj txog qhov no." Vim li cas koj thiaj txhawj xeeb txog lawv? Koj txhawj txog koj tus kheej ...
"Peb ua li ntawd." Peb feem ntau muaj qhov ntxeev ntawm hmoo. Peb muaj ib tus phooj ywg - hom 1 mob ntshav qab zib txij thaum menyuam yaus. Kuv tsis paub yuav mus cuag nws thiab hais li ntawd. Nws noj txhua yam hauv ib kab, thiab tsis yog noj xwb ... Nws tsis tuaj yeem piav qhia rau ib tus neeg, txawm hais tias nws pheej muaj kev mob ntshav qab zib thiab peb pom nws.
“Koj puas tau hais rau nws?”
- Tsis yog, Kuv tsis tau hais tias nws tseem; feem ntau yuav yog, nws tsis zoo.
"Tsis txhob txhawj txog lawv tag nrho." Leej twg xav tau - nws pom. Koj tau scrupulously tau tshawb. Qhia rau kuv, rau lwm tus neeg koj qhia? Hais tias koj muaj phooj ywg muaj ntshav qab zib hom 2. Nws puas yog tib tug?
- Qhov no yog ib tus neeg paub, thiab tseem muaj ib tus ntxhais uas peb tau ntsib hauv tsev kho mob. Kuv xav caw nws rau kuv lub tsev thiab qhia nws txhua. Kom deb li deb nws tsuas yog tham, thiab nws ntau dua los yog tsawg adheres rau cov zaub mov uas tsis muaj carbohydrate.
"Lawv tsis muaj Internet thiab?"
- Yog lawm, lawv tsis muaj lub computer, nws tau los hauv xov tooj. Kuv kuj tau muaj kev sib cuag nrog tsev kho mob, thaum peb nyob hauv Kiev, Kuv tau ntsib kuv niam los ntawm Lutsk. Nws kuj nug kuv txog ntaub ntawv.

Yuav cob qhia koj tus menyuam li kev noj zaub mov zoo

- Tus txiv pom koj tam sim ntawd, ntawm thawj hnub. Peb tau mus pw tsev kho mob rau hnub Monday, thiab txog rau hnub kawg ntawm lub asthiv peb twb tau pib tsis kam yuav cov tshuaj insulin. Thawj lub sijhawm lawv tsis kam, vim tias qhov twg yuav txhaj tshuaj insulin yog tias tus menyuam muaj suab thaj 3.9?
- Papa Fed nws nrog borsch nrog zaub qhwv, tom qab ntawd lawv tau txhaj tshuaj insulin, raws li xav pom los ntawm cov qauv kev kho mob, thiab tus me nyuam pib mob ntshav qab zib tsawg. Txog qhov peb muaj suab thaj ntawm 2.8 nyob rau hauv cov nqe lus ntawm glucometer, uas yog me ntsis overpriced.
- Niam. Tus me nyuam nyob rau lub xeev txaus ntshai, kuv ntshai heev.
"Kuv xav nug: koj tuaj yeem nrhiav tau kuv li cas?" Rau cov lus nug twg, koj puas tsis nco qab?
- Dad Kuv tsis nco qab, Kuv tau nrhiav txhua yam ua ke, Kuv tau tshawb tawm Is Taws Nem taw qhia rau hauv kuv lub qhov muag. Nws zaum rau peb hnub, nyeem txhua yam.
- Niam, Ua li cas peb pom koj, tam sim no koj tsis nco qab, vim tias thaum ntawd peb tsis tau xav txog, tab sis tsuas yog quaj.

- Koj twb muaj hmoo, vim tias lub xaib tseem tsis muaj zog, nws yog qhov nyuaj nrhiav. Koj tus menyuam yuav coj li cas tom tsev kawm ntawv? Nyob ntawd nws yuav muaj kev ywj pheej ntau dua tam sim no, thiab kev sim siab yuav tshwm sim. Ntawm ib sab tes, ib tus neeg laus yuav sim pub nws kom nws tsis muaj acetone. Ntawm qhov tod tes, tus menyuam yuav sim ua qee yam nws tus kheej. Koj xav tias nws yuav coj li cas?
- Peb yeej vam rau nws, vim nws hnyav thiab ywj siab. Thaum xub thawj, txhua tus neeg qhuas nws ua siab ntev. Lwm cov menyuam yaus hauv chav tsev kho mob tau noj txiv tsawb, txiv tsawb, khoom qab zib, tab sis nws tsuas zaum ntawm qhov ntawd, mus txog nws txoj kev lag luam thiab nws tsis hnov ​​mob. Txawm hais tias cov zaub mov hauv tsev kho mob mob heev dua li nyob hauv tsev).
“Puas yog nws yeem tsis kam ua tag nrho cov khoom zoo no, los yog koj yuam nws?”
- Lub luag haujlwm tau ua los ntawm qhov tseeb tias nws mob hnyav los ntawm cov tshuaj insulin. Nws nco ntsoov tus mob no tau ntev thiab pom zoo rau txhua yam, yog tias tsuas yog nws yuav tsis tau txhaj tshuaj insulin. Txawm tam sim no, nws nce hauv qab rooj, hnov ​​lo lus "insulin." Yuav kom ua tau zoo yam tsis muaj insulin, koj yuav tsum tswj koj tus kheej. Nws paub tias nws xav tau nws. Cov khoom noj kom tsim nyog - qhov no yog rau nws, thiab tsis yog rau kuv thiab txiv, nrog rau kev tawm dag zog.
- Nws yuav nthuav kom saib xyuas koj thaum lub caij nplooj zeeg, yuav ua li cas txhua yam mus ntxiv, thaum nws yuav muaj kev ywj pheej hauv tsev kawm ntawv hais txog khoom noj khoom haus.
"Peb yuav saib koj tus kheej thiab muab sijhawm rau koj saib peb."

Cov niam txiv muaj me nyuam mob ntshav qab zib li cas thiaj sib haum nrog kws kho mob?

"Koj puas tau hais rau tus kws kho mob txog qee yam hauv chav ua noj?"
"Lawv tsis xav mloog." Hauv Kiev, Kuv hais me ntsis, tab sis pom sai sai tias nws tsis tuaj yeem hais qhov no txhua. Lawv tau hais qhia rau kuv qhov no: yog tias ib yam khoom ntxiv qab zib rau menyuam, ces koj yuav tsum tsis txhob lees qhov khoom no ib qho twg. Txoj kev txhaj tshuaj zoo dua, tab sis pub mis rau tus menyuam noj.
- Vim li cas?
- Niam, kuv tsis nkag siab.
- Papa. Kuv tus muam yog tus kws kho mob yug nws tus kheej, kws kho mob, thiab ntawm no peb xub tau txais kev foom tsis zoo. Nws tau hais tias tsis ntev tom qab no peb yuav hloov mus rau hauv insulin. Nws tshoov peb lub tswv yim tias koj muaj tus me nyuam mob ntshav qab zib thiab koj muaj ib txoj hauv kev - kom insulin.
"Txoj kev, nws yog lawm, nws yuav tshwm sim lub sijhawm, tab sis peb yuav cia siab rau qhov zoo tshaj plaws." Ib qho lus nug tseem ceeb: nws puas yuav pub koj cov menyuam ua txhaum cai ntawm nws tus kheej? Koj yuav tsum tsis txhob txhawj txog dab tsi nws tshoov koj lub siab, tab sis hais txog qhov xwm txheej thaum nws yuav pub mis rau nws tus kheej.
- Qhov no yuav tsis tshwm sim, vim lawv nyob rau lwm lub xeev.

- Lawv kom koj kuaj sim thiab qhia rau tus kws kho mob nrog qee zaus, txoj cai?
- Ib hlis ib zaug, mus ntsib kws kho mob thiab noj glycated hemoglobin txhua 3 lub hlis.
- Koj puas mus cuag kws kho mob tsis muaj kev ntsuam xyuas? Cia li mus thiab txhua tus?
“Yog lawm, taug kev xwb.”
“Thiab muaj xwm dab tsi tshwm sim rau qhov ntawd?”
- Dab tsi yog zom - mloog, ntsia, nug. Koj noj dabtsi? Koj xav li cas Koj puas khiav mus rau chav dej thaum hmo ntuj? Koj puas xav tau ib co dej? Puas yog koj tsis zoo siab? Tus me nyuam zaum thiab tsis paub yuav hais txog dab tsi txog dej, vim tias ntawm qhov tsis sib thooj Kuv yuam nws haus. Khoom noj muaj protein ntau txhais tau tias koj xav tau kua dej ntau dua. Thiab tam sim no nws tsis paub hais tias yuav hais li cas. Txhawm rau hais tias kuv tsis haus dej lossis xav hais tias kuv haus ntau qhov twg yog qhov tseeb? Kuv qhia nws - tus tub, hais kom nws li nws. Thiab hais txog yuav ua li cas kuv pub nws ... Lawv nug dab tsi koj pub nws? Kuv teb - Kuv pub txhua tus: kua zaub, borscht, zaub ...
- Ua tau zoo. Ntawd yog, nws yog qhov zoo dua tsis mus nyas txog tag nrho chav ua noj no, puas yog?
- Tsis yog, lawv tsis xav mloog dab tsi. Kuv tus txiv, rau thawj hnub, mus kiag li vwm. Tom qab txhua tus, tus kws kho mob yuav tsum muaj kev xav hloov pauv, tab sis tsis muaj dab tsi. Kuv tsis tuaj yeem ntseeg kuv tus kheej tus muam. Tab sis lub ntsiab tshwm sim rau peb. Thaum Lub Kaum Ob Hlis xyoo tas los, tus me nyuam glycated hemoglobin yog 9.8%, thiab tom qab ntawd dhau rau lub Peb Hlis - nws hloov mus rau 5.5%.

Kuaj thiab xiam oob khab rau hom ntshav qab zib hom 1

"Koj tsis mus tsev kho mob rau tsev kho mob lawm, txoj cai?"
- Tsis yog.
- Nws yog qhov tseeb tias koj tsis tas yuav. Lo lus nug yog, cov kws kho mob yuam koj mus rau tsev kho mob ib ntus los yog tsis?
- Lawv tsuas yuam tau cov neeg xiam oob khab xwb. Lawv tsis muab rau peb xiam oob khab, yog li lawv yuam tsis tau peb mus rau hauv tsev kho mob. Dab tsi?
- Cov kev tsis taus tsuas yog muab rau cov uas muaj txim. Tsis yog mob ntshav qab zib hom 1 xwb, tab sis muaj teeb meem.
- Tsis yog, lawv muab tam sim ntawd rau txhua tus neeg uas txhaj tshuaj insulin.
“Nquag heev…”
- Txij li thaum Kiev tsis sau ntawv cov tshuaj insulin rau peb, peb tsis muaj kev tsis taus. Kiev hais tias: xws li tus menyuam hais tias nws yog qhov tsim nyog txhawm rau sau tshuaj insulin rau nws. Lawv saib xyuas peb tau ib lim tiam. Peb tau insulin-tsis pub rau ntawm kev noj zaub mov tsis zoo carbohydrate. Tab sis tseem, tus kws kho mob hais tias nws tsis tuaj yeem pom nyob rau lub sijhawm twg ntawm hnub txhawm rau txhaj tshuaj insulin me me.
- Kev xiam oob qhab feem ntau yog qhov khoom loj, nws yuav tsis mob yog tias nws.
- Yog, peb kuj xav txog nws.
"Yog li koj tham nrog lawv nyob ntawd."
- Nrog peb tus kws kho mob mus koom?
- Zoo, yog. Tsis muaj leej twg hais tias ib tug menyuam yuav tsum npaj cov dej qab zib kom muaj tshuaj insulin, thiab lwm yam. Tab sis kom pom zoo - nws yuav zoo heev rau koj, vim tias nws muab txiaj ntsig tsim nyog. Kuv xav tias qhov tsis taus tsuas yog muab rau cov neeg uas muaj yam kabmob ntshav qab zib. Thiab yog tias koj hais tias lawv muab txhua tus los ua ke ...
- Tau, lawv muab nws tam sim ntawd, thiab lawv kuj tau mus rau peb. Yog tias peb tsis tau mus rau hauv Kiev, peb yuav tau muab qhov ua tsis taus. Tam sim no kuv yuav tsis mus Kiev, paub dab tsi uas kuv twb paub lawm. Peb tau mob siab rau lub limtiam vim kev ua haujlwm tsis zoo rau hauv tsev khomob.

Yuav kom tswj cov ntshav qab zib hom 1 rau menyuam yaus tsis tas txhaj tshuaj insulin txhua hnub yog qhov muaj tiag. Tab sis koj yuav tsum nruj me ntsis ua raws tsoomfwv. Hmoov tsis zoo, lub neej nyob hauv nroog tsis pab ua qhov no.

Kev tawm dag zog rau hom ntshav qab zib hom 1 hauv cov menyuam yaus

- Peb tau dhau mus hauv Kiev ib qho kev soj ntsuam ntawm cov tshuaj tiv thaiv GAD yog lub cim ntawm autoimmune kev puas tsuaj ntawm pancreatic beta hlwb, yog tam sim no nyob rau hauv feem ntau cov neeg mob uas muaj ntshav qab zib hom 1. Thiab hauv ib xyoos peb npaj kom dhau txoj kev tsom xam no ntxiv.
- Vim li cas?
- Ua ntej, peb yuav tuav C-peptide. Yog tias nws hloov tawm kom siab dua tam sim no, tom qab ntawd nws yuav raug txiav txim siab los kuaj xyuas cov tshuaj tiv thaiv kab mob ib zaug ntxiv - muaj ntau dua, muaj tsawg dua lossis tus lej qub.
"Koj to taub, tsis muaj dab tsi yuav ua tau tam sim no mus cuam tshuam lawv." Peb tsis paub yog vim li cas lawv tshwm sim. Nws tuaj yeem yog qee hom vais lav lossis gluten nkag rau. Koj puas paub gluten yog dab tsi?
- Yog lawm.
- Gluten yog ib co protein nyob hauv cov nplej thiab lwm cov taum pauv. Muaj cov lus qhia hais tias cov neeg mob ntshav qab zib tsis ua siab ntev rau nws, thiab qhov no ua rau muaj kev tawm tsam ntawm lub cev tiv thaiv kab mob rau ntawm lub cev.
- Kuv muaj lwm yam ntaub ntawv. Uas yog, tias qhov tshuaj tiv thaiv tsis tshwm sim ntawm gluten, tab sis ntawm casein - nyuj lub mis protein.
- Yog, thiab kua mis muaj protein kuj tseem muaj, qhov no yog tus lej 2 lub npe tom qab gluten. Ntawd yog, raws li txoj kev xav, koj tuaj yeem sib xyaw ua zaub mov noj zaub mov kom tsawg nrog zaub mov gluten thiab tsis pub casein dawb hauv menyuam yaus. Tab sis tag nrho cov kwv yees no tseem sau nrog ib rab hmuv.
“Tab sis koj tuaj yeem sim nws.”
"Yog lawm, tab sis muaj ntau cov hemorrhoids." Yog tias koj tseem tsis kam chees, ces kev noj zaub mov yuav nyuaj dua rau kev ua raws.
- Peb tsis txhob twv thiav. Peb ua ce aerobic. Tus sau Zakharov sau hais tias yog tias qhov nruab nrab ntawm cov ntshav qab zib txhua hnub tsawg dua 8.0, tom qab ntawd koj tuaj yeem ua haujlwm nrog ib tus neeg. Txhawb kev tiv thaiv autoimmune tawm tsam nrog kev tawm dag zog aerobic - thiab cov qe hlwb pib rov pib dua. Tam sim no kuv tau suav kev ua pa ua pa ntawm Strelnikova. Lawv muab cov tshuaj tiv thaiv ua kom puas tsuaj.
- Txhua yam no tau sau nrog cov hmuv nyob hauv dej. Yog tias ib tug neeg pom ib txoj hauv kev los kho hom ntshav qab zib hom 1, nws yuav tau txais qhov khoom plig Nobel tam sim ntawd. Peb paub tseeb tias kev noj haus cov zaub mov carbohydrate muaj suab thaj tsawg dua. Tab sis qhov twg hom 1 ntshav qab zib los ntawm - peb tsis paub txog. Tsuas yog ib txhia twv tau ua. Koj tabtom xyaum ua nrog kev qoj ib ce, tab sis tsis muaj kev cia siab rau qhov no.

- Yog tias peb pheej noj tej zaub mov uas tsis muaj roj (carbohydrate) tsawg, ces peb thiaj noj txoj hauv kev no mus tas peb lub neej.
- Yog lawm, nws yuav tsum nyob li ntawd, rau txhua yam uas tau ua tiav. Koj tsuas yog yuav tsum tau piav qhia rau tus menyuam tias vim li cas nws tsis tsim nyog rau noj zaub mov tsis raug cai. Sai li uas koj noj ib co bun - ib qho roj ntsha insulin nyob ib sab ntawm peb.
- Yog lawm, txhua yam nyob hauv peb lub tub yees.
- Zoo, zoo heev. Ua tsaug rau qhov kuv xav paub los ntawm koj tam sim no, Kuv pom tawm. Kuv tsis cia siab tias koj cov neeg mob ntshav qab zib tau muaj qhov tsis zoo hauv Is Taws Nem hauv Kirovograd.
- Yog lawm, peb cov phooj ywg tsis muaj nws, nws tau tshwm sim.
"... Yog li nws nyuaj rau kuv tau txais." Ua tsaug rau kev xam phaj, nws yuav muaj txiaj ntsig ntau rau lub xaib. Peb tseem yuav txuas lus thiab sib nug, tsis muaj ib tus poob.
- Thiab ua tsaug.
- Thov tsis txhob nqa mus nrog cov txiv hmab txiv ntoo compotes, lawv kuj muaj carbohydrates, zoo dua muab tshuaj ntsuab teas.
- Peb txhua qhov sim, qab zib tsis nce ntxiv.
- Los ntawm cov txiv hmab txiv ntoo thiab berries, carbohydrates yog zom thiab yaj hauv dej. Nws tseem yuav ntim lub txiav, txawm hais tias nws tseem ua.
- Zoo, tsaug.
- Ua tsaug, tej zaum peb niaj hnub xam phaj hnub no - nws yuav yog ib qho xov xwm sib foob.

Yog li, tus menyuam thiab nws cov txheeb ze nyob lub sijhawm zoo nkauj honeymoon, muaj lub suab thaj zoo kawg nkaus thiab tsis muaj tshuaj insulin txhua lub sijhawm. Cov niam txiv hais tias tsis muaj ib tug menyuam twg uas muaj ntshav qab zib hom 1 uas tau dag nrog lawv tus menyuam pw hauv tsev kho mob tsis muaj dab tsi zoo li no. Txhua tus tub ntxhais hluas mob ntshav qab zib tau noj yam tsis tu ncua, thiab tsis muaj ib tug muaj peev xwm nres txhaj tshuaj insulin, txawm hais tias cov ntaub ntawv qhia tias qhov no feem ntau tshwm sim thaum lub sijhawm honeymoon.

Cov tsev neeg tau rho tawm lub xeem lub npe ntawm qhov kev thov ntawm neeg txiv plig tus thawj coj, txaus siab rau qhov tshwm sim uas cov zaub mov tsis muaj roj ntau. Txawm hais tias muaj kev ntshai ntawm acetone hauv cov zis, lawv yuav tsis hloov pauv kev kho mob.
Dr. Bernstein qhia tias kev siv cov khoom noj muaj suab thaj ua rau muaj peev xwm ncua sijhawm lub sijhawm zib ntab ua rau tsis muaj kev txhaj tshuaj insulin rau cov ntshav qab zib hom 1 rau ntau caum xyoo, lossis ib sim neej. Cia siab tias qhov no tshwm sim. Peb tseem soj qab xyuas qhov xwm txheej.

Lub taub hau ntawm tsev neeg tabtom sim sim nrog kev kho mob hom ntshav qab zib 1 nrog kev tawm dag zog. Kuv tsis ntseeg txog qhov no. Tseem tsis muaj leej twg muaj peev xwm ua pov thawj tias ib qho kev tawm dag zog ua rau lub zog tawm ntawm lub cev ua rau lub cev ua mob rau cov leeg. Yog tias muaj qee leej ua tiav - Kuv xav tias qhov khoom plig Nobel muab rau cov neeg zoo li ntawd. Nyob rau hauv txhua rooj plaub, qhov tseem ceeb tshaj plaws yog tias tus me nyuam tsis tau tawm ntawm lub pluas noj cov zaub mov uas tsis muaj cov pluas mov, uas peb twb paub tseeb tias nws pab tau. Hauv qhov kev txiav txim siab no, kev pib kawm ntawv yog qhov txaus ntshai heev. Lub caij nplooj zeeg, Kuv yuav sim hu rau kuv tsev neeg dua kom paub seb lawv yuav sib haum li cas. Yog tias koj xav sau npe yuav cov ntawv xov xwm hauv e-mail, sau ib qho lus pom rau ntawm no lossis lwm tsab xov xwm, thiab kuv yuav ntxiv koj qhov chaw nyob rau hauv daim npav xa ntawv.