Kuv haus Douglimax, sawv ntxov qab zib 8, 8, tom qab noj mov 5, 4

Nrog hom 2 mob ntshav qab zib mellitus thiab muaj cov lus hais los ntawm insulin tsis kam (txo qis rhiab rau insulin), yoo cov piam thaj ntau feem ntau dua qab zib tom qab noj mov. Cov xwm txheej no tshwm sim vim qhov tseeb tias "cov leeg" ua rau muaj cov insulin ntau dua rau cov zaub mov ", yog li cov piam thaj tom qab noj mov qis dua ua ntej noj mov.

Hauv cov xwm txheej zoo li no, nws yog ib qho tsim nyog yuav tsum ua haujlwm ntawm insulin tsis kam, uas yog, kom nce rhiab rau insulin. Metformin xav tau rau qhov no, thiab niaj hnub siv cov tshuaj qab zib-qis (i-DPP4, a-GLP1) tuaj yeem siv - lawv yuav pab txawm tias cov piam thaj nce mus txog qhov ib txwm tsis muaj kev pheej hmoo ntawm hypoglycemia (poob hauv cov ntshav qab zib), thiab txhim kho insulin rhiab heev.

Raws li rau cov tshuaj Douglimax: nws muaj cov tshuaj metformin (500 mg), ib yam tshuaj uas ua rau cov insulin rhiab heev thiab glimepiride (1 mg), ib qho tshuaj qub-txo cov tshuaj los ntawm sulfonylurea pab pawg, uas ua rau tus txiav txim siab tsim cov tshuaj insulin ntau dua thiab uas feem ntau ua rau hypoglycemia (qab zib poob) ntshav).

Yog tias koj noj cov khoom noj carbohydrates ntau dua, tom qab ntawd muaj qhov zoo uas koj yuav nce phaus, thiab cov tshuaj insulin kuj yuav nce ntxiv, cov piam thaj yuav nce ntxiv - qhov no yog lub voj voos hnyav ntawm cov ntshav qab zib. Ntawd yog, overeating carbohydrates, thiab raws li cov rog, yog twv yuav raug hu tsis tsim nyog.

Hauv koj qhov xwm txheej, Metformin xav tau, tab sis qhov zoo tshaj plaws ntawm cov metformins yog Siofor thiab Glucofage, thiab qhov nruab nrab ua hauj lwm nrog cov nquag ua haujlwm nrog kev ua haujlwm sab hauv yog 1500-2000 tauj ib hnub, 500 pom meej tsis txaus. Nws yog cov koob tshuaj no uas yuav pab txhim kho insulin rhiab heev nyob rau hauv T2DM.

Raws li glimepiride, muab koj cov suab thaj (lawv tsis siab npaum li tau muab rau nws), nws zoo dua los hloov nws nrog cov tshuaj muaj ntau dua niaj hnub, lossis yog tias koj nruj me ntsis ua raws kev noj haus thiab noj cov tshuaj metformin txaus, koj yuav tsis xav tau hom tshuaj thib ob.

Kuv qhia koj kom kuaj (tsawg kawg ntawm KLA, BiohAK, glycated hemoglobin) thiab nrhiav tus kws kho kabmob (endocrinologist) uas yuav xaiv ib txoj kev kho hypoglycemic kho dua tshiab. Thiab, ntawm chav kawm, khaws cia qab zib thiab zaub mov.

Yam ntsuas ntsuas

Txhawm rau rau cov txheej txheem ntawm cov metabolism thiab lub zog ua tiav nyob rau hauv hom kev pom zoo rau lub cev, cov piam thaj hauv cov ntshav yuav tsum nyob ntawm qee qib. Tus kws tswj lub ntsiab lus ntawm carbohydrate metabolism yog yam tshuaj insulin muab zais los ntawm tus leeg (kab mob duav).

Hauv cov tub ntxhais hluas uas muaj hnub nyoog laus dua 14 xyoos, cov poj niam laus thiab txiv neej, cov ntsiab lus qabzib nyob rau thaj tsam ntawm 3.5-5,5 mmol / L yog suav tias yog tus qauv, muab tias cov ntshav tau raug coj los soj ntsuam ntawm lub plab khoob ntawm tus ntiv tes. Hauv cov menyuam mos yug tshiab, cov menyuam hnub nyoog qis dua 14 xyoos, cov neeg laus, cov pojniam xeeb tub, cov qauv me ntsis txawv dua rau ntau dua lossis qis dua.

Yog tias ntshav noj los ntawm cov leeg ntshav, nws yuav muaj ntau cov piam thaj.

Nws yuav tsum raug sau tseg tias nyob hauv ntau qhov chaw ntsuas cov ntsuas ntawm qib qub tsis sib xws. Txawm li cas los xij, cov kev sib txawv no tsis yog qhov tseem ceeb.

Qog Ntshav

Kev nce ntshav qab zib yuav qhia tau tias tus neeg muaj ntshav qab zib mellitus (DM).

Muaj ob peb hom kab mob raug cais, tab sis peb ntawm lawv yog qhov tseem ceeb vim lawv muaj kabmob ntau dua.

Thawj hom (insulin-tiv thaiv kev tiv thaiv) tshwm sim nrog cov insulin deficiency los ntawm ntau yam kab mob pancreatic pathologies. Raws li txoj cai, txoj kev txhim kho kabmob pib thaum muaj hnub nyoog yau (txog 30 xyoo).
Hom ob (insulin-resistant) yog tsim thaum muaj hnub nyoog laus dua. Nrog rau qhov sib txawv ntawm tus kab mob, cov tshuaj insulin yog tsim tawm hauv tus nqi, tab sis cov ntaub so ntswg poob lawv qhov rhiab rau nws. Piv txwv li, qhov no tshwm sim nrog kev rog, txij li cov rog txheej tiv thaiv kev nkag mus ntawm insulin rau hauv cov ntaub so ntswg.
Tus yam ntxwv tau kuaj pom muaj mob hauv cov poj niam lub sijhawm thaum coj tus menyuam uas tsis muaj teeb meem suab thaj ua ntej cev xeeb tub. Feem ntau cov kws tshaj lij ntseeg tias tus kab mob no ua rau kev hloov pauv los ntawm keeb kwm hloov poj niam lub cev.

Dhau li ntawm cov piam thaj tuaj yeem raug txiav txim los ntawm cov cim hauv qab no:

kev nqhis dej tas li
hnyav haus
nquag tso zis
nce qab los noj mov
qhuav ntawm daim tawv nqaij thiab khaus,
tsis muaj zog
tsis zoo kho lub qhov txhab
rwj thiab lwm cov tawv nqaij pathologies,
plab hlaub mob leeg,
pom kev pom.

Nrog rau cov ntshav qab zib, qhov txaus ntshai ntawm cov cwj nrag thiab lub plawv nres, kev ua laib ntawm qhov kawg, lub raum tsis ua haujlwm, qhov muag tsis pom kev, thiab poob rau hauv hyperglycemic coma tsis nce ntxiv.

Kev ntshav siab

Coma tuaj yeem yog nrog cov kab mob hypoglycemic. Muaj ntau ntau yam tuaj yeem ua rau txo qis hauv cov piam thaj:

kev siv tshuaj ntau dhau ntawm cov tshuaj insulin lossis cov piam thaj hauv kev kho mob ntshav qab zib,
ua ke ntawm cov tshuaj tiv thaiv kab mob nrog qee yam tshuaj noj (Warfarin, Aspirin, thiab lwm yam),

mob hlav hlav lossis mob hlav loj
haus cawv
cov kev tawm dag zog lub cev nrog cov khoom noj tsis muaj carbohydrate tsawg,
mob caj dab ntev
mob siab pathology (mob qog ntshav, mob ntsws, rog hepatosis),
qee cov kab mob endocrine (Addison's disease, pituitary dwarfism, thiab lwm yam).

Cov tsos mob ntawm cov ntshav qog ntshav nce siab yog nyob ntawm seb cov piam thaj muaj piam thaj ntau li cas.

Nrog cov ntshav qog ntshav qab zib: ua daus no, xeev siab, tsis paub qhov tseeb, me ntsis loog ntawm cov ntsis ntiv tes, lub plawv dhia.
Hauv daim foos nruab nrab: kiv taub hau, mob taub hau, tsis pom kev, tsis meej, tsis pom zoo, ua haujlwm tsis pom kev.
Nrog rau lub caij nplooj zeeg tsis muaj zog (hauv qab 2.2): qhov txo qis hauv lub cev kub, qaug dab peg, qaug dab peg, tsis nco qab, tsis nco qab lawm.

Kuaj ntshav

Kev soj qab xyuas tsis tu ncua ntawm cov piam thaj yog qhov tsim nyog rau cov neeg uas muaj cov metabolism hauv kev ua kom yuag, ob leeg mob ntshav qab zib, kom nws sai sai yog tias nce lossis tsawg dua, thiab rau cov neeg tom qab muaj hnub nyoog 45 xyoos, uas tus kab mob ntshav qab zib pib maj mam hloov kho lawv kev noj zaub mov tshwj xeeb thiab kev ua neej nyob rau hauv kom tso cai hloov los ntawm kev mob ntshav qab zib mus rau ntshav qab zib.

Hmoov tsis zoo, feem ntau muaj kev tsis sib haum xeeb nrog qhov ntsuas vim qhov tseeb tias muaj ntau ntau hom kev kuaj ntshav qab zib. Piv txwv li, yog tias muaj piam thaj 8 rau ntawm lub plab khoob - qhov no yog ib qhov xwm txheej, yog tias qab zib 8.8 tom qab noj mov twb sib txawv, thaum cov piam thaj hauv ntshav nce ntxiv mus rau 8 tom qab kuaj ntshav qab zib - qhov thib peb. Yog li ntawd, ib qho yuav tsum paub meej tias qhov muaj nuj nqis rau lawv tus kheej tej zaum yuav tsis tseem ceeb heev, nws yog qhov tseem ceeb vim qhov kev tshawb xyuas lawv tau txais dab tsi.

Kev ntsuas yoo mov

Cov nuj nqis ib txwm rau qhov kev tshuaj ntsuam no tau muab yav tas los. Nws zoo dua rau kev xeem ntawv thaum sawv ntxov. Thaum tsaus ntuj koj yuav tsum ua ib pluag hmo me me (txwv cawv tsis pub haus cawv). Thaum sawv ntxov, pluas tshais tau txais kev pom zoo. Koj tuaj yeem haus cov dej ntxhia lossis dej ntshiab. Feem ntau, cov hlab ntsha capillary yog nqus los ntawm cov ntiv tes.

Mob ntshav qab zib raug cais tawm yog qhov tshwm sim tsawg dua 5.5.
Thaum cov piam thaj nyob hauv qhov ntau ntawm 5.5 -6.1, nws txhais tau hais tias kev tso kua nplaum nyob hauv lub cev yog qhov qia.
Yog tias cov piam thaj hauv qab no siab dua 6.1, nws muaj qhov muaj feem ntau yuav muaj ntshav qab zib.

Txawm li cas los xij, qee tus kws kho mob tsis ntseeg txog qhov kev sim no. Lawv lees paub tias nws xav tau qhov zoo ntawm kev ntsuas ntsuas thaum lub sijhawm ntsuas lwm yam, tab sis lawv tsis lees paub qhov kev kuaj mob tsis raug tsuas yog nws pab. Hauv qee qhov tshwj xeeb, nws tau qhia tias kev ntxhov siab tuaj yeem nce ua qabzib. Nws raug sau tseg tias kwv yees li ib feem peb ntawm cov neeg mob ntshav qab zib tiv thaiv kab mob ntshav qab zib muaj peev xwm tsis pom tshwm sim los ntawm kev tshawb xyuas qhov no.

Kev ntsuas tom qab noj mov

Nws suav hais tias ntau dua txhim khu kev qha nyob rau hauv kev kuaj mob ntshav qab zib. Glucose yog ntsuas ob teev tom qab noj mov.

Nquag: 3.9 -6.1 mmol ib liter.
Yog tias qhov kev ntsuas pom tau hais tias 8,5, ntshav qab zib hom 2 tsis raug cais tawm, nrog rau qhov ntsuas pom ntawm 9.0 - ntshav qab zib hom 1.
Thaum cov ntaub ntawv ntsuas nyob hauv qhov ntau ntawm 6.1 -8.5, peb tuaj yeem xaus tias tus neeg muaj kev cuam tshuam txog cov zaub mov carbohydrate cuam tshuam, thiab kev ntsuas yuav tsum ua (hloov khoom noj khoom haus, poob phaus, thiab lwm yam).

Kuaj ntshav qab zib kuaj

Nws yog siv txhawm rau txheeb xyuas cov ntawv zais mob ntshav qab zib. Ua ob qhov kev ntsuam xyuas nrog lub hlis so. Thaum lub sijhawm kuaj (cov qauv sib txig), peb txoj kev kuaj ntshav (rau ntawm lub plab khoob, ib teev thiab ob teev tom qab muaj piam thaj). Qhov kev txhaj tshuaj txheem ntawm cov piam thaj yog 75 grams. Nws yog yaj hauv 250 milliliters dej.

Kev txiav txim siab txog qhov txheeb xyuas tau (tom qab 2 teev) zoo li no:

ib txwm - tsawg dua 7.8,
tsis hnov mob rhiab - ntau tshaj 7.8, tab sis tsawg dua 11.1,
ntshav qab zib - ntau dua 11.1.

Glycated hemoglobin test

Qhov kev tshawb nrhiav no yog tsim nyog los nrhiav cov kab mob latent ntawm cov kabmob lossis qhov ua tau zoo ntawm kev kho rau hauv cov neeg mob uas nyuam qhuav muaj ntshav qab zib. Yog tias lwm cov kev kuaj pom tias cov piam thaj thaum lub sijhawm ntsuas, tom qab ntawd qhov kev tsom xam no qhia tias cov piam thaj hauv nruab nrab muaj ntau tshaj li peb lub hlis. Cov cai yog nyob hauv thaj tsam ntawm 4-6.2%. Qhov ntsuas pom ntau dua, cov piam thaj ntau hauv cov ntshav dhau ib lub sijhawm.

Kev npaj tshwj xeeb rau kev tsom xam tsis tas yuav tsum muaj.

Kev kho hyperglycemia

Thaum cov piam thaj nce ntxiv hauv cov ntshav, tab sis tus kab mob tsis pom tseeb, kev kho tshuaj tsis tas yuav tsum tau ua. Koj tuaj yeem xa cov suab thaj rov qab rau hauv ib txwm muaj nrog kev noj haus, haus luam yeeb tsis pub haus cawv thiab haus cawv, ua haujlwm lub cev, poob ceeb thawj, thiab siv cov tshuaj ib txwm muaj tom qab sab laj nrog kws kho mob.

Muaj ob qho khoom noj tseem ceeb rau cov piam thaj hauv siab.

Muab kev txwv qhov tseem ceeb ntawm cov calories ntau. Koj yuav tsum noj plaub mus rau tsib zaug nyob rau ib hnub. Cov carbohydrates yooj yim (ua kom zoo qab zib, zib ntab, thiab lwm yam), thiab cov zaub mov ua noj uas muaj lawv, tsis suav nrog cov zaub mov. Nyob rau tib lub sijhawm, cov txiv hmab txiv ntoo thiab cov txiv ntoo tau raug tso cai qab zib thiab qaub, tab sis qab zib (figs, txiv quav, pomegranates, thiab lwm yam) tau raug txwv tsis pub.

Hloov ntawm monosaccharides, nws raug nquahu kom siv cov piam thaj hloov (sorbitol, stevia, aspartame, thiab lwm yam).

Cov khoom noj los ntawm cov nqaij rog thiab ntses, cheese, butter, nqaij nqaij, thiab lwm yam yog txwv tsis pub.

Muaj roj ntses ntau hom nqaij tsawg, nqaij, khoom noj siv mis, cov khoom noj tsis tau rau hauv, cov zaub mov, legumes, cov zaub feem ntau suav nrog cov khoom noj.

Tsawg cov zaub mov carb

Hauv hom kev noj haus no, cov khoom noj carbohydrates yog suav tias yog kev phom sij, vim txhua yam ntawm lawv (qee qhov nrawm dua, lwm tus qeeb qeeb) nce qab zib. Txhua yam txiv ntoo thiab txiv ntoo ua txwv tsis pub noj, zaub tuaj yeem yog, tab sis tsis qab zib. Cov khoom qab zib tawm mus.

Ntawm qhov tod tes, kev noj haus tsis txwv kev ua kom muaj protein thiab cov rog. Nws ntseeg tau hais tias yog tsis muaj carbohydrates lawv tsis ua rau kev rog. Nws tau tawm tsam tias kev noj zaub mov zoo li no muaj txiaj ntsig zoo rau lub paj hlwb, vim tias tus tib neeg tsis muaj kev nyuaj siab rau kev tshaib plab, zoo li cov zaub mov tsis muaj calorie ntau.

Kev siv tshuaj kho ntshav qab zib

Txoj kev kho mob yog txhawm rau tshem tawm qhov ua rau cov piam thaj txo.

Nws tuaj yeem yog phais mob (qee ntu rov ua dua ntawm tus txiav nrog ib tus neoplasm, thiab lwm yam).
Nws yog ib qho ua tau los siv kev kho mob rau malignant neoplasms.
Kev saib xyuas cov kab mob pathology uas ua rau kom txo qis ntshav qabzib yog ua.

Kev noj zaub mov kom zoo sib xws nrog cov ntsiab lus pes tsawg carbohydrate. Nrog rau kev txhim kho ntawm kev tawm tsam hypoglycemic, koj yuav tsum noj zaub mov nrog cov khoom noj sai sai (khoom qab zib, ib qho qab zib, jam, thiab lwm yam).

Kev tsis sib haum xeeb ntawm cov piam thaj ntawm qhov tsis zoo thiab qhov sib txawv ntawm cov ntshav yog qhov txaus ntshai tsis yog rau kev noj qab haus huv tab sis kuj rau lub neej. Yog li, yog tias muaj cov cim qhia tias cov piam thaj tau ntau dua lossis hloov dua lwm qhov qis, koj yuav tsum sab laj tus kws kho mob tam sim ntawd txhawm rau pib nws qhov kev ib txwm ua tiav raws sijhawm.

Koj tuaj yeem kawm paub ntau ntxiv txog hyperglycemia los ntawm cov yeeb yaj kiab:

Cov lus qhia ntxiv txog hypoglycemia tuaj yeem tau los ntawm cov khoom siv video: