Cov Lus Qhia Txog Ntshav Qab Zib

Ntshav qab zib mellitus yog ib qho kab mob endocrine ntawm kev mob ntev uas tshwm sim tawm tsam keeb kwm ntawm tus neeg tsis paub tseeb lossis tsis txaus ntseeg ntawm qhov muaj peev xwm tsis txaus los ntawm insulin. Cov tshuaj hormones yog tsim los ntawm tus txiav, hu ua islets ntawm Langerhans.

Pathology pab txhawb kev txhim kho cov teeb meem ntawm cov zaub mov tsis txaus (muaj qhov ua tsis muaj rog, protein, carbohydrate synthesis). Cov tshuaj Insulin yog ib yam tshuaj uas tsim kho cov zom thiab cov nqus ntawm cov piam thaj sai sai, tab sis thaum nws tsis muaj peev xwm lossis ua tsis tau zoo, cov txheej txheem no cuam tshuam, uas ua rau cov piam thaj hauv cov ntshav ntxiv.

Cov teeb meem txaus ntshai tshaj plaws tuaj yeem ua rau ntshav qab zib mellitus, cov lus pom zoo soj ntsuam rau tus neeg mob yuav tsum tau pom nyob hauv hom nruj thoob plaws hauv lub neej. Peb yuav tham txog lawv nyob hauv peb chav lis haujlwm.

Ntshav qab zib mellitus yog ib qho muaj ntau yam kab mob.

Cov hom mob ntshav qab zib

Cov kab mob endocrine tau muab faib ua ob hom:

Yam I ntshav qab zib
hom II mob ntshav qab zib mellitus.

Rooj ntawv 1. Hom mob ntshav qab zib:

Hom ntshav qab zib	Kev siv tshuaj insulin ntxiv	Kev piav qhia	Cov pab pawg muaj kev pheej hmoo
Yam I ntshav qab zib	Kev siv tshuaj insulin	Ua tiav kev tuag ntawm β-hlwb ntawm islets ntawm Langerhans. Kev tsis muaj zog insulin.	Cov tub ntxhais hluas theem ntawm tib neeg hauv qab lub hnub nyoog 30 xyoo.
Mob ntshav qab zib Hom II	Tsis-insulin ywj siab	Cov txheeb ze tsis muaj cov tshuaj insulin. Kev tsim cov tshuaj hormone ib txwm kuj tseem raug sau tseg, tab sis qhov rhiab ntawm cov ntaub so ntswg rau nws cov teebmeem raug txo qis.	Cov neeg laus dua 30 xyoo, nquag kis, rog dhau.

Nws yog qhov tseem ceeb. Txawm hais tias muaj tseeb tias cov mob ntshav qab zib hom II raug kuaj pom hauv cov neeg tsuas yog tom qab 30 xyoo, kws kho mob tau sau ib qho kev paub ntxov ntawm tus kab mob hauv cov neeg mob nyhav dhau los, uas yog, nrog rau cov rog hnyav, cov kab mob no tuaj yeem txhim kho thaum muaj hnub nyoog yau.

Hauv cov tshuaj, tseem muaj ib hom pathology li mob ntshav qab zib hauv lub cev, cov lus qhia kev kho yog ua nrog cov lus pom zoo rau ntshav qab zib tseeb.

Ua ntej ntawm tag nrho cov, cov no yog:

kev noj haus kom zoo
noj qab nyob zoo neej
mus taug kev hauv huab cua ntshiab,
kev saib xyuas tas li ntawm cov concentration ntawm cov piam thaj hauv cov ntshav.

Tus kab mob yog kuaj tau pom hauv cov poj niam thaum lub caij xeeb tub. Cov piam thaj muaj ntau ntxiv tuaj yeem nce ntxiv hauv cov poj niam cev xeeb tub nyob rau lub sijhawm muaj menyuam hauv plab, thiab muaj qhov ntxim siab ntawm kev tsim hom ntshav qab zib hom II tom qab yug menyuam tas.

Kev tawm dag zog tsis tu ncua pab txo cov kev pheej hmoo ntawm kev muaj ntshav qab zib tseeb.

Saib xyuas Mob ntshav qab zib mellitus tuaj yeem nkaum autoimmune hauv xwm. Qhov pom tseeb tiag ntawm tus kab mob lossis qhov kev loj hlob qeeb ntawm pathology tau sau tseg hauv cov sib npaug sib npaug.

Soj ntsuam duab

Thaum thawj qhov ceeb toom ntawm ntshav qab zib mellitus tshwm, tus neeg mob mus cuag kws kho mob, qhov chaw uas nws tau kuaj mob kom thiaj li paub tseeb tus kab mob pathology.

Cov tsos mob hauv qab no qhia lub tswb:

nquag tso zis,
insatiable nqhis dej
qhov ncauj qhuav, mob caj pas,
kev tswj tsis hnyav hnyav los poob
kev xav tau ntau dhau rau khoom noj lossis qhov ua tiav tag nrho,
lub plawv dhia
tsis pom kev
hnov qhov khaus ntawm qhov chaw mos.

Saib xyuas Mob ntshav qab zib mellitus yog ib txoj kev mob uas yuav tsum tau saib xyuas koj kev noj qab haus huv tas li. Txhawm rau kom lub cev ua haujlwm tsis tu ncua, WHO tau tsim cov lus pom zoo rau cov ntshav qab zib mellitus, uas tso cai rau koj los tswj kev saib xyuas kev noj qab haus huv ntawm tus neeg mob thiab txo qis cov tsos mob cuam tshuam ntawm pathology.

Kev kuaj mob Algorithm

Raws li peb txhua tus paub, kev kuaj ntshav tsim nyog koj tuaj yeem paub txog pom muaj ntshav qab zib.

Thaum paub tseeb tias cov tsos mob ntawm glycemia, kev kuaj mob algorithm yog raws li nram no:

kev soj ntsuam ntshav qab zib tsawg kawg 4 zaug hauv ib hnub,
kuaj ntshav los txiav txim glycated hemoglobin yuav tsum tau nqa tawm tsawg kawg yog 1 zaug nyob rau ib hlis twg (tso cai rau koj los txiav txim siab cov ntshav qog ntshav ntshav mus ntev ntev - ntev txog 3 hlis),
txiav txim siab txog qab zib cov ntsiab lus hauv zis tsawg kawg 1 zaug hauv ib xyoos,
pub dawb cov ntshav rau biochemistry tsawg kawg 1 zaug hauv 12 lub hlis.

Cov qauv tseem ceeb rau kev kuaj ntshav qab zib yog kuaj ntshav qab zib.

Cov kev tshawb fawb los ntawm World Health Organization ua pov thawj tias cov ntshav qab zib yog qhov teeb meem thoob ntiaj teb thiab nws txoj kev daws teeb meem yog lub luag haujlwm tsis yog tsuas yog tus neeg mob nws tus kheej, tab sis lub xeev tag nrho. Yog vim li cas thiaj li WHO tsim cov lus pom zoo rau cov neeg mob ntshav qab zib mellitus, ob hom 1 thiab hom 2.

Lawv muaj cov kev tshuaj xyuas kab mob hauv lub cev, cov lus qhia rau kev tswj hwm kev saib xyuas cov piam thaj hauv cov ntshav, thiab cov hau kev los muab kev pabcuam ua ntej rau cov ntshav qab zib.

Nthuav. Hauv xyoo 2017, WHO pawg kws kho mob tau tsim thiab tshaj tawm tsab cai thib 8 ntawm "Cov Lus Pom Zoo rau kev npaj khomob tshwj xeeb rau cov neeg mob ntshav qab zib."

Ntxiv nrog rau kev kawm thiab ua raws li cov lus qhia kho mob tsim los ntawm WHO, cov neeg mob yuav tsum mloog thiab ua raws li kev pom zoo ntawm cov kws endocrinologist. Kev kho mob ntawm tus kab mob cuam tshuam nrog kev saib xyuas tus neeg mob kom tsis tu ncua, vim tias feem ntau cov kev tshawb fawb ntawm cov kab mob pathology yog cov cim ntawm cov kab mob sib kis uas xav tau kev kho mob ntxiv.

Raws li kev kuaj mob ntxiv, nws tau sau tseg:

Ultrasound ntawm plab
electrocardiogram
soj ntsuam ntshav siab
kuaj qhov muag
mus ntsib tus kws kho mob poj niam lossis urologist.

Kev cob qhia rau cov ntshav qab zib

Txhua tus neeg mob uas kuaj pom tus mob ntshav qab zib yuav tsum yauv mus ua kev cob qhia los ntawm cov chaw tshwj xeeb.

Cov chav kawm raug muab faib ua ob ncig:

Rooj ntawv 2. Lub hom phiaj ntawm cov kev qhia kev qhia rau cov mob ntshav qab zib:

Chav kawm hauv chav	Lub Hom Phiaj
Thawj	Thawj tus paub ntawm ib tug neeg nrog nws txoj kev kuaj mob. Cov kws kho mob tshwj xeeb tham txog cov kev hloov pauv uas cov neeg mob ntshav qab zib xav tau nyob rau hauv lawv lub neej yav tom ntej: khoom noj khoom haus, kev noj haus txhua hnub, tshuaj xyuas qib qab zib, noj tshuaj.
Rov Ua Dua	Rov ua dua cov cai ntawm cov chav kawm thawj zaug thiab ntxiv cov tshiab uas coj mus rau hauv tus lej pauv lub cev.

Ntawm cov neeg mob ntshav qab zib, cov pawg hauv qab no yog qhov txawv:

cov neeg mob ntshav qab zib hom I,
cov neeg mob ntshav qab zib hom II,
cov menyuam yaus
xeeb tub.

Kev cob qhia yuav pom tau tias muaj txiaj ntsig yog tias cov pab pawg ntawm cov tub ntxhais kawm raug faib tawm kom raug thiab txhua yam ntsig txog lawv txoj kev noj qab haus huv raug xav txog.

Kev qhia rau cov mob ntshav qab zib yog qhov tseem ceeb ntawm kev kho kab mob.

Cov xibfwb ntawm cov kev qhia yuav tsum muaj kev qhia paub thiab kev kho mob, thiab muab cov lus qhuab qhia kom ua raws li WHO cov qauv kev tsim qauv.

Cov teeb meem yuav tsum tau hais nyob rau hauv lub program:

hom mob ntshav qab zib
cov khoom noj
kho kev tawm dag zog
kev phom sij ntawm glycemia thiab cov hau kev los tiv thaiv nws,
cov tshuaj uas pab txo cov ntshav qab zib,
lub ntsiab lus ntawm cov tshuaj insulin thiab qhov xav tau rau nws kev siv,
cov muaj peev xwm tshwm sim ntawm ntshav qab zib
yuav tsum tau mus cuag cov kws kho mob tshwj xeeb.

Cov kev kawm yuav tsum qhia rau koj tias yuav ua li cas thiaj li txhaj tshuaj insulin thiab xyuas seb puas muaj ntshav qab zib cov ntshav. Cov txuj ci tau txais thaum lub sij hawm kev cob qhia yuav ua rau cov neeg mob ntshav qab zib kom txo cov kev pheej hmoo ntawm hypoglycemic thiab hyperglycemic tawm tsam, thiab tseem yuav muaj sia nyob nrog qhov cuam tshuam tsawg kawg ntawm tus kab mob rau kev noj qab haus huv tag nrho.

Cov lus qhia txog ntshav qab zib

Txhua tus neeg uas muaj kev kuaj mob tsis txaus siab, tus kws kho mob endocrinologist ib leeg yuav muab sijhawm rau kev kho mob ntshav qab zib kom tsim nyog, cov lus pom zoo thiab sau nqe kev cai rau lawv siv. Tag nrho cov lus qhia tshwj xeeb yog nyob ntawm hom mob, nws cov chav kawm thiab qhov muaj cov kab mob sib kis.

Ntshav qab zib noj

Ua ntej tshaj plaws, hauv cov neeg mob kuaj mob ntshav qab zib mellitus, txoj kev kho mob pib nrog kev hloov kho khoom noj khoom haus.

tsis txhob tseg mov noj
noj zaub mov me me
nquag noj mov (5-6 zaug hauv ib hnub),
kom muaj fiber ntau ntxiv,
cais tawm ntawm cov zaub mov noj txhua yam zaub mov txwv, tshwj xeeb, cov zaub mov muaj piam thaj.

Raws li cov lus pom zoo ntawm WHO, lub rooj 9 yog muab rau cov neeg mob ntshav qab zib, ib qho kev qhia zaub mov noj haus yog tsim los tswj cov dej qab zib ib txwm nyob hauv cov ntshav.

Kev noj haus kom zoo thiab sib npaug yog tus yuam sij rau kev kho ntshav qab zib kom zoo.

Nws yog qhov tseem ceeb. Cov neeg mob ntshav qab zib yuav tsum tau soj ntsuam cov calories kom tas mus li. Lawv cov ntim txhua hnub yuav tsum sib haum mus rau lub zog siv ntawm lub cev, xav txog nws txoj kev ua neej, hnyav, poj niam txiv neej thiab hnub nyoog.

Cov khoom lag luam hauv qab no yuav tsum muaj nyob rau hauv kev noj haus ntawm cov ntshav qab zib:

Kev noj zaub mov zoo txhua hnub yuav tsum tau faib raws li txoj cai hauv qab no:

protein - tsis ntau tshaj 20%,
cov rog rog - tsis tshaj 35 %%
carbohydrates - tsis ntau tshaj 60%
polyunsaturated fatty acids - tsis ntau tshaj 10%.

Ntxiv rau cov lus pom zoo saum toj no rau kev noj zaub mov zoo, cov neeg mob xav tau kom nce kev noj cov nroj tsuag uas muaj cov ntshav qab zib kom tsawg. Lawv raug pom zoo kom coj mus rau hauv daim ntawv ntawm decoctions lossis infusions, tshuaj ntsuab tshuaj ntsuab yuav yog qhov hloov chaw zoo rau kev txiav txim ntawm cov tshuaj kim.

Cov no suav nrog:

cov txiv hmab txiv ntoo thiab ntoo ntawm cov txiv ntoo,
txiv pos nphuab
blueberries
roob tshauv
xyoob ntoo
oats
npuag
taum pods
lingonberry
txiv dev.

Daim ntawv no muaj ntau heev thiab tuaj yeem txuas ntxiv rau ib lub sijhawm ntev, ntxiv rau, hauv cov khw muag tshuaj koj tuaj yeem nrhiav tshuaj tshwj xeeb sau cov tshuaj ntsuab uas ua rau kom muaj cov ntshav qabzib nyob rau hauv cov hlab ntshav. Nws tsim nyog sau cia tias cov nroj tsuag no tsis tsuas yog pab txhawb rau kev kho cov piam thaj noma, tab sis kuj tseem cuam tshuam rau kev noj qab haus huv tag nrho.

Tshuaj ntsuab yog ib yam tseem ceeb ntawm kev siv tshuaj kho mob ntshav qab zib.

Vim tias muaj tseeb tias cov ntshav qab zib hom 2 tau tsim tawm tsam keeb kwm yav dhau los ntawm kev rog, cov lus pom zoo ntawm zaub mov muaj feem cuam tshuam nrog kev suav cov zaub mov ntawm cov qhob cij (XE). Rau cov neeg mob ntshav qab zib thiab tsis tsuas yog muaj chav tsim tshwj xeeb ntawm cov chav ua mov ci, uas yooj yim heev rau kev kawm siv. Tom qab siv ntev, ntau txiav txim qhov nyiaj ntawm XE ib qhov muag.

Piv txwv li, 1 XE muaj:

ib khob mis, kefir, yogurt lossis yogurt (250 ml),
tsev cheese nrog raisins yam tsis muaj piam thaj (40 grams),
noodle kua zaub (3 tbsp),
tej lub rhaub dej qab zib (2 tbsp. ស្លាបព្រា),
mashed qos yaj ywm (2 tbsp.spoons).

Nws yog qhov tseem ceeb. Tus mob ntshav qab zib raug txwv tsis pub haus dej cawv, tab sis nyob rau qee qhov tsis tshua pom zoo nws raug tso cai rau haus cov cawv liab tsis muaj ntau tshaj 150 grams.

Insulin kho rau hom ntshav qab zib hom I

Raws li koj paub, hom ntshav qab zib hom I yog hom tshuaj insulin-cuam tshuam ntawm pathology, cov lus qhia tseem ceeb ntawm hom 1 ntshav qab zib mellitus txhawj xeeb txog kev tswj hwm kev txhaj tshuaj insulin. Qhov tseeb ntawm kev kho mob los ntawm insulin yuav tsum tsim nyog nws yog kev xav thiab txiav txim siab raws li tus kheej yam ntxwv ntawm lub cev.

Qhov kev txhaj tshuaj ntawm cov tshuaj insulin yog xam los ntawm tus kws kho mob uas tuaj koom, thaum nws coj mus rau hauv tus account yam tseem ceeb, xws li:

qhov hnyav
muaj hnub nyoog
kawm tiav ntawm pancreatic kawg,
kev xav ntawm cov piam thaj hauv cov hlab ntshav.

Kev suav txhua hnub ntawm cov tshuaj insulin tau muab faib ua ntau qhov kev txhaj tshuaj, nws yuav tsum tau yug los hauv lub siab tias ib feem ntawm kev txhaj tshuaj yuav tsum tau siv tag nrho cov ntim ntawm cov piam thaj.

Nco ntsoov tias hauv kev suav, hom tshuaj kuj tseem ceeb, raws li lub hauv paus ntsiab lus ntawm kev sib kis, nws tau muab faib ua:

ultra luv-ua yeeb yam insulin
luv luv ua yeeb yam
nruab nrab txiav txim
ntev
superlong kev txiav txim siab.

Kev ua tau zoo tshaj plaws ntawm kev them nyiaj insulin raug pom nrog kev qhia ntawm ultra-luv thiab luv luv cov tshuaj insulin. Feem ntau, cov tshuaj no tau txais kev tswj hwm yam tsis muaj kev poob siab ua ntej noj mov lossis tom qab noj mov tas. Cov tshuaj ntev ntev feem ntau siv rau thaum sawv ntxov thiab yav tsaus ntuj ua ntej yuav mus pw.

Kev txhaj tshuaj ntawm cov insulin rau hauv lub plab pab txhawb rau kev tawg sai sai ntawm cov tshuaj.

Tsis tas li ntawd, thaum suav qhov koob tshuaj, qhov ntau npaum li cas ntawm XE coj mus rau hauv tus account, uas yog, nyob rau lub sijhawm sib txawv ntawm lub hnub thiab nrog ntau ntim thiab qhov zoo ntawm cov zaub mov rau 1 XE, qee qhov nqi ntawm cov insulin yog qhov tsim nyog. Peb taw tawm ntxiv, txhua qhov kev suav ntawm kev siv ntau npaum li cas ntawm cov tshuaj tau ua ncaj qha los ntawm tus kws kho mob tuaj koom. Hloov cov koob tshuaj rau koj tus kheej yog nruj me ntsis tsis pom zoo.

Saib xyuas Kev txhaj tshuaj tau ua tiav siv cov xaum xaum tshwj xeeb, nws yooj yim heev rau kev siv ywj pheej. Kev muab cov ntshav qab zib nrog cov khoom tsim nyog rau kev txhaj tshuaj (cwj mem, insulin) tuaj txog ntawm kev siv nyiaj txiag los ntawm tsoomfwv.

Insulin kho rau hom ntshav qab zib hom II

Hom II mob ntshav qab zib mellitus, raws li peb tau sau saum toj no, tsis yog insulin-tiv thaiv ib daim ntawv ntawm tus kab mob, tab sis qee qhov xwm txheej, thaum cov txheej txheem ntawm kev ua kom pom tseeb ntawm cov duab kho mob pib, tej zaum yuav xav tau kev txhaj tshuaj.

Kev kho tshuaj Insulin rau ntshav qab zib hom II yog nyob rau kis:

kuaj ntshav rau glycated hemoglobin yog txiav txim siab los ntawm qhov ntsuas ntawm 9% lossis siab dua (nrog ua kom pom tseeb ntawm kev soj ntsuam mob ntshav qab zib hom II),
thaum lub sij hawm siv tshuaj kho nyob rau hauv tus neeg mob rau ib lub sij hawm ntev tsis muaj qhov zoo ntawm kev rov qab,
keeb kwm ntawm contraindications kev noj tshuaj hypoglycemic,
kuaj ntshav thiab zis qhia cov ntsiab lus tseem ceeb ntawm ketone lub cev thiab qab zib,
tus neeg mob pom tias yog kev phais mob.

Yog tias tus mob ntshav qab zib muaj qhov taw qhia rau kev kho tshuaj insulin, tus kws kho mob yuav tsum tham nrog nws txog kev pheej hmoo ntawm lub qog ntshav qab zib thiab muab cov lus qhia rau nws tias yuav coj li cas thaum pom thawj zaug ntawm tus mob pathological.

Nws yog qhov tseem ceeb. Muaj qee zaus, kev kho mob insulin tsis muab cov txiaj ntsig zoo, ces tus kws kho mob txiav txim siab qhov xav tau ntawm nws txoj kev ua kom muaj zog. Ntawd yog, cov koob tshuaj insulin txhua hnub rau txhua tus neeg mob nce ntxiv kom txog thaum cov khoom noj carbohydrate metabolism hauv lub cev rov qab zoo li qub.

Cov yam ntxwv ntawm kev txhaj tshuaj insulin

Raws li peb tau teev saud, insulin tau muab faib ua ob peb hom nyob ntawm cov nyhuv. Qhov hno tawm ntawm lawv txhua tus muaj lawv tus kheej cov yam ntxwv ntawm kev nqus thiab cuam tshuam ntawm kev nqis tes ua.

Daim Ntawv No. 3. Hom mob insulin thiab lawv cov teebmeem:

Hom tshuaj insulin	Cuam Tshuam Cov Nta
Ultrashort	Cov tshuaj insulins Ultrashort muaj qhov sib txawv - lawv tau txais kev tswj hwm ua ntej noj mov lossis tam sim ntawd tom qab noj mov. Ultra-luv-ua yeeb yam insulins suav nrog: Humalog, Novorapid. Txoj kev txhaj tshuaj no yooj yim txaus rau cov neeg mob ntshav qab zib, nws tsis ua rau tsis meej pem nrog kev laij lub sij hawm sib nrug ntawm kev txhaj tshuaj kawg.
Luv	Kev npaj tshuaj insulin luv luv kuj tseem tau siv ua ntej lossis tom qab noj mov, tab sis nrog lub sijhawm 30 feeb, txij li nws yog tom qab lub sijhawm no cov tshuaj pib ua kom nws ua tiav. Nco ntsoov tias luv luv hom tshuaj insulin muaj qhov tshwj xeeb uas thaum koob nce siab, cov nyhuv ntawm cov nqaij mos tau qeeb qeeb. Lub sijhawm siab kawg rau qhov pib ntawm kev ua yog 90 feeb, lub sijhawm ntawm cov nyhuv yog 4-6 teev.
Ntev ntev	Lub sij hawm ntev insulin txawv ntawm hom luv luv nyob rau hauv uas nws ua rau muaj kev cuam tshuam tas li ntawm cov tshuaj insulin. Nws raug muab 2 zaug hauv ib hnub nrog kev caij nyoog ntawm 12-14 teev. Qhov kev txhaj tshuaj thawj zaug yog thaum sawv ntxov ua ntej noj tshais, thib ob - thaum tsaus ntuj ua ntej yuav mus pw. Hom tshuaj no muaj ib qho tshuaj uas khi cov tshuaj hormones thiab cuam tshuam nws txoj kev thauj mus rau cov hlab ntshav.

Nws yuav tsum tau hais cais tias tseem muaj hom insulin ntau yam li ntau tus ncov qaum. Cov tshuaj no muaj qee qhov nyiaj ntawm ntev thiab luv insulins.

Thaum siv cov tshuaj zoo no, nws tsis tas yuav muab cov tshuaj txhaj rau thaum sawv ntxov ua ntej noj tshais thiab yav tsaus ntuj ua ntej noj hmo, vim nws tau muab rau hauv cov khoom siv ib hnub ib zaug. Tab sis tsis txhob hnov qab tias kev suav qhov ntau ntawm cov tshuaj no yog qhov nyuaj heev.

Kev xam ntawm cov koob tshuaj insulin yog nqa tawm nruj los ntawm koj tus kws kho mob.

Kev siv dag zog ntshav qab zib

Ntshav qab zib Hom 2 txawv ntawm hom ntshav qab zib hom 1 hauv qhov nws tsis xav tau kev txhaj tshuaj insulin, thiab, raws li, nrog tus kabmob no, tus neeg mob yuav tsum them nyiaj ntau dua rau kev ua neej thiab kev noj zaub mov zoo.

Yog lawm, ua tsaug rau kev tawm dag zog lub cev, ib qho tuaj yeem ua tiav cov txiaj ntsig hauv qab no:

qhib cov metabolism hauv carbohydrate,
poob phaus
normalize kev ua si ntawm cov hlab plawv system.

Kev thau khoom thiab kev tawm dag zog yog tawm los ntawm tus kws kho mob tuaj koom. Thaum xaiv, nws raug coj los ntawm cov lus hauv qab no:

tus neeg mob hnyav
muaj hnub nyoog
degree ntawm manifestation ntawm pathology,
kev noj qab haus huv
muaj nyob ntawm concomitant kab mob.

Qhov nruab nrab ntawm cov chav kawm yog los ntawm 30 feeb txog 1 teev, thiab tus naj npawb ntawm kev tawm haujlwm hauv ib lub lis piam yog 3-4 zaug.

Saib xyuas Kev qoj ib ce txhua yam raug txwv tsis pub rau cov neeg mob ntshav qab zib nrog lub cev ua tsis taus pa ntawm lub luag haujlwm thiab teeb meem vascular. Ua ntej sau ntawv tawm dag zog rau txoj kev kho mob, tus kws kho mob muab tus neeg mob xa mus rau ib qho electrocardiogram.

Kev kawm txog kab mob hauv lub cev nrog rau kev qoj ib ce muaj zog tuaj yeem ua kom muaj kev ua tau zoo ntawm kev kawm ntawm tus mob ntshav qab zib hom 1 thiab ntshav qab zib hom II, thiab tseem yuav pab txo qis kev pheej hmoo ntawm kev tsis nco qab.

Kev ua lub neej nquag tuaj yeem txhim kho qhov kev ua ntu zus ntawm cov chav kawm mob ntshav qab zib.

Yog hais tias tus neeg mob tsis qhia kev hloov pauv hauv kev txhim kho, ces tus kws kho mob hloov cov lus pom zoo hais txog qhov ntim ntawm cov nra thiab tus lej ntawm cov chav kawm hauv ib as thiv.

Tshuaj ntsuab tshuaj ntsuab

Phytotherapy rau ntshav qab zib mellitus yuav muab qhov txiaj ntsig zoo hauv kev ua ke nrog kev kho mob tseem ceeb. Nws yuav tsum raug sau tseg tias kev siv tshuaj ntawm cov tshuaj ib txwm siv yuav tsum tham nrog koj tus kws kho mob.

Cov nroj tsuag tseem ceeb tshaj plaws rau ntshav qab zib:

dandelion
sawv duav
blueberries
roob tshauv
xyoob ntoo
oats
Bay nplooj ntoos
Stinging nettle.

Herbal cov tshuaj tuaj yeem kho cov ntshav qabzib feem ntau.

Hauv pej xeem cov tshuaj, muaj ntau cov zaub mov txawv uas pab txhawb rau kev ua haujlwm ntawm cov ntshav qab zib.

Peb yuav nthuav qhia rau cov nyeem ob peb ntawm lawv:

Dandelion keeb kwm - 3 tbsp. spoons, dej npau npau - 2 tsom iav. Boil Txoj kev lis ntshav rau 6 feeb, thiab tom qab ntawd tawm mus rau brew. Noj 1 khob ntawm sab hauv sab hauv 30 feeb ua ntej noj mov.
Stinging nettle - 1 tbsp. diav, dej npau - 1 khob. Ncuav cov nroj tsuag nrog dej npau npau thiab tawm rau 30 feeb. Noj qhov ncauj rau 1 tbsp. diav 3 zaug ib hnub 20 feeb ua ntej noj mov.
Plantain - 1 tbsp. diav, dej npau - 1 khob. Ncuav nplooj qhuav ntawm plantain nrog dej npau thiab tawm rau 20 feeb. Noj ntawm qhov ncauj 1 tablespoon 3 zaug ib hnub ua ntej noj mov.

Cov lus qhia luv luv

Mob ntshav qab zib mellitus Yog ib pab pawg neeg cov kab mob metabolic (metabolic) yam ntxwv ua rau muaj tus kab mob hyperglycemia, uas yog los ntawm qhov tsis muaj zog insulin, qhov cuam tshuam ntawm insulin, lossis ob qho ntawm cov xwm txheej no.

ICD-10 code (s):

ICD-10
Cai	Npe
E 11	Tsis-insulin-mob ntshav qab zib mellitus
E 11.0	nrog coma
E 11.1	nrog ketoacidosis
E 11.2	nrog rau lub raum puas tsuaj
E 11.3	nrog qhov muag puas tsuaj
E 11.4	nrog cov leeg mob
E 11.5	nrog kev puas tsuaj rau lub peripheral ncig,
E 11.6	nrog rau lwm cov kev mob tshwm sim,
E 11.7	nrog ntau cov nyom
E 11,8	nrog rau kev piav tsis meej.

Cov txheej txheem kev txhim kho / kho dua hnub: 2014 (kho 2017).

Cov tsiaj ntawv luv siv nyob rau hauv cov txheej txheem:

Ag	–	leeg ntshav siab
HUAB TAIS	–	ntshav siab
ACE	–	angiotensin-hloov pauv enzyme
hauv / hauv	–	tso leeg ntshav
DKA	–	mob ketoacidosis
Kuv / U	–	tshuaj insulin / carbohydrates
ICD	–	luv luv ua yeeb yam insulins
HDL	–	siab ceev lipoproteins
LDL	–	tsis tshua muaj ntom lipoproteins
NPII	–	txuas ntxiv subcutaneous insulin Txoj kev lis ntshav
Jab	–	kev kuaj ntshav dav
OAM	–	urinalysis
Lifespan	–	lub neej cia siab rau
RCT	–	sim tswj kev sim
SD	–	mob ntshav qab zib mellitus
VTS	–	mob ntshav qab zib mob ko taw
SCF	–	glomerular pom npaum li cas
SMG	–	niaj hnub kuaj xyuas cov piam thaj tas li
TG	–	thyroglobulin
TV	–	thyroperoxidase
TTG	–	thyrotropic globulin
Ultrasound	–	ultrasound dopplerography
Ultrasound scan	–	kev kuaj mob ultrasound
USP	–	ultrashort cov tshuaj insulin
FA	–	kev siv lub cev
XE	–	chav ua mov ci
XC	–	roj
ECG	–	electrocardiogram
HMONG	–	electroneuromyography
Hbalc	–	glycosylated (glycated) hemoglobin
IA-2, IA-2 β	–	Cov tshuaj tiv thaiv tyrosine phosphatase
IAA	–	cov tshuaj tiv thaiv rau cov tshuaj insulin

Cov siv raws tu qauv: cov kws kho mob thaum muaj xwm ceev, cov kws kho mob feem ntau, cov tuaj kho mob, cov kws kho mob hlwb, cov sawv rov los.

Tus neeg mob qeb: neeg laus.

Qib pov thawj:

A	Kev ntsuas cov zaub mov zoo, kev soj ntsuam ib puag ncig ntawm RCTs lossis RCTs loj uas muaj qhov tshwm sim tsawg heev (++) ntawm kev ua haujlwm tsis tiav, cov txiaj ntsig ntawm uas tuaj yeem sib kis tau rau cov pej xeem.
Hauv	Kev ua tau zoo (++) kev sib koom ua ke lossis kev soj ntsuam cov ntaub ntawv lossis cov kev soj ntsuam zoo (++) pawg neeg sib koom tes lossis kev soj ntsuam cov ntaub ntawv muaj kev pheej hmoo ntawm cov kev ua haujlwm tsis zoo lossis RCTs nrog qhov tsis tshua muaj (+) kev pheej hmoo ntawm cov kab ke kev ua yuam kev, cov txiaj ntsig ntawm qhov tuaj yeem tshaj tawm rau cov neeg nyob Cov.
Nrog	Ib pab pawg los yog rooj plaub tswj kev tshawb fawb lossis kev kawm tswj xyuas uas tsis muaj kev tshawb fawb tsis muaj kev cuam tshuam nrog qhov kev pheej hmoo tsawg kawg (+). Cov txiaj ntsig ntawm qhov uas tuaj yeem muab faib rau cov pej xeem sib xws lossis RCTs nrog qhov muaj tsawg heev lossis pheej hmoo ntawm cov kev ua yuam kev (++ lossis +), cov txiaj ntsig uas tsis tuaj yeem faib ncaj qha rau cov pej xeem sib xws.
D	Cov lus piav qhia ib qho xwm txheej ntawm cov xwm txheej lossis kev tshawb nrhiav tsis tau tswj hwm lossis cov kws tshaj lij lub tswv yim.
GPP	Kev soj ntsuam zoo tshaj plaws.

Kev faib tawm

Kev faib tawm:

Rooj 1. Qhia soj ntsuam kab mob ntshav qab zib

Yam 1 ntshav qab zib	Pancreatic cell-cell puas tsuaj, feem ntau ua rau cov tsis txaus insulin
Mob ntshav qab zib Hom 2	Kev ua txhaum hnyav ntawm cov kua dej tso rau ntawm cov keeb kwm ntawm insulin tsis kam
Lwm hom mob ntshav qab zib	- kev kho mob tsis txaus siab hauv txoj haujlwm ntawm β-hlwb, - kev tsis ncaj ncees hauv caj ceg hauv kev ua ntawm insulin, - kab mob ntawm exocrine ib feem ntawm lub txiav cov qog - Raug yuam los ntawm cov tshuaj los yog tshuaj lom neeg (hauv kev kho mob HIV / AIDS lossis tom qab hloov khoom nruab nrog), - endocrinopathies, - kis tau tus mob - lwm yam kev mob caj hlav ntshav ua ke nrog ntshav qab zib
Mob ntshav qab zib Gestational	Muaj tshwm sim thaum cev xeeb tub

Kev kuaj mob

COV KEV NOJ QAB HAUS HUV, TXHEEM THIAB Cov Txheej Txheem 1,3,6,7

Kev kuaj mob:
Neeg tsis muaj zog
Malaise
· Txo kev zoo
Apathy
Cov tawv nqaij thiab chaw mos ua pob,
Polyuria
Polydipsia
Tuaj tsis pom kev tseeb
Mloog li cas kub nyob hauv taw
Cramps nyob rau hauv qis qis kawg thiab paresthesia thaum hmo ntuj,
Dystrophic hloov pauv ntawm daim tawv nqaij thiab cov rau tes.
* Kev tsis txaus siab nyob rau kis xwm txheej los ntawm kev tshawb nrhiav qhov tsis txaus ntseeg ntawm hyperglycemia tuaj yeem tsis tuaj.

Anamnesis
Tus kab mob feem ntau tshwm sim thaum muaj hnub nyoog ntau dua 40 xyoo, nws yog qhov tshwm sim los ntawm qhov muaj cov khoom xyaw ntawm cov khoom noj ntawm lub cev metabolic syndrome (rog dhau, hlab ntaws ntshav, thiab lwm yam).

Kev soj ntsuam lub cev
Cov neeg mob ntshav qab zib hom 2 muaj:
Cov tsos mob ntawm IR: rog rog visceral, tawg, mob acanthosis nigrikans,
Ua rau daim siab loj,
Cov cim ntawm lub cev qhuav dej (qhuav ua qog ua paug, tawv nqaij, ua kom tawv nqaij tawv nqaij),
Cov tsos mob ntawm tus mob neuropathy (paresthesia, kev hloov pauv ntawm daim tawv nqaij thiab rau tes, ko taw mob).

Kev tshawb fawb kuaj:
Kev tsom xam ntawm cov ntshav: hyperglycemia (cov lus. 2),

Rooj ntawv 2. Kev kuaj mob ntshav qab zib rau cov ntshav qab zib 1, 3

Kev txiav txim lub sijhawm	Ciav qab zib concentration, mmol / l *
	Tag nrho cov hlab ntsha capillary	Venous ntshav ntshav
NORM
Ntawm ib plab khoob thiab 2 teev tom qab PGTT
	Mob ntshav qab zib mellitus
Kev yoo mov ** lossis 2 teev tom qab PGTT lossis random txhais cov ntsiab lus	≥ 6,1 ≥ 11,1 ≥ 11,1	≥ 7,0 ≥ 11,1 ≥ 11,1

* Kev kuaj mob yog raws li kev kuaj ntshav qab zib
** Kev kuaj mob ntshav qab zib yuav tsum tau lees paub qhov tseeb tas los ntawm kev rov qab txiav txim siab txog glycemia hauv ob peb hnub tom qab no, tsuas yog qee tus neeg mob tsis tshua muaj mob ua rau mob ntshav qab zib tsis txaus los yog muaj cov tsos mob pom tseeb.

OAM: glucosuria, ketonuria (qee zaum).
-C-peptide yog ib qho cim ntawm cov roj ntsha tsis zais pa (ib txwm 0.28-1.32 pg / ml). Kev ntsuam xyuas rau C-peptide tseg: raws li txoj cai, nrog T2DM, qib C-peptide tau nce lossis ib txwm muaj, nrog rau kev nthuav qhia nrog insulin deficiency syndrome nws txo qis.
Glycated hemoglobin (HvA1c) - ≥ 6.5%.

Kawm tshawb fawb seev (raws li kev qhia):
· ECG - txhawm rau txheeb xyuas qhov ua tau ua haujlwm cuam tshuam kev ntxhov siab, myocardial ischemia, cov cim ntawm sab laug ventricular myocardial hypertrophy, systolic ntau dhau,
· Echocardiography - txhawm rau txheeb xyuas cov cim ntawm dystrophy ntawm cov ntu ntawm myocardium, dilatation ntawm kab noj hniav, myocardial hypertrophy, thaj chaw ntawm ischemia, kev txheeb xyuas ntawm cov feem ntawm kev tshem tawm,
Ultrasound ntawm lub plab plab - cov cim ntawm concomitant pathology,
· UZDG ntawm lub nkoj ntawm qhov qis qis - txhawm rau txhawm rau ntsuas kev hloov pauv ntawm cov ntsuas kev ceev ntawm cov ntshav ntws hauv cov hlab ntsha loj thiab cov hlab ntsha ntawm ko taw,
Ter Kev saib xyuas Holter - txhawm rau txhawm rau zais nce ntshav siab, tsis tuaj yeem,
· SMG system - txheej txheem ntawm kev saib xyuas tas li ntawm glycemia txhawm rau txhawm rau xaiv thiab kho cov suab thaj kom txo qis, qhia cov neeg mob thiab koom nrog lawv hauv kev kho,
Xoo hluav taws xob ko taw - txhawm rau soj ntsuam qhov hnyav thiab tob ntawm cov ntaub so ntswg kev puas tsuaj nyob rau hauv cov leeg mob ko taw,
· Kev kuaj mob microbiological ntawm lub qhov txhab tawm nrog cov qhov txhab mob ntawm taw - txhawm rau kho kom haum,
· Electroneuromyography ntawm qis qis dua - rau kev kuaj pom tus mob ntshav qab zib ua ntej.

Cov lus qhia rau kev sib tham ntawm cov kws tshwj xeeb nqaim:
Cov lus 6. Qhov ntsuas rau kev sab laj tshwj xeeb 3, 7

Tus Kws Tshaj Lij	Cov hom phiaj ntawm kev sib tham
Kev sab laj kws kho mob	Rau kev kuaj mob thiab kho mob ntshav qab zib lub qhov muag puas - raws li kev qhia
Kws kho mob sab laj	Txog kev kuaj mob thiab kho mob ntshav qab zib muaj teeb meem - raws li kev qhia
Kws kho mob sab laj	Txog kev kuaj mob thiab kho mob ntshav qab zib muaj teeb meem - raws li kev qhia
Sab laj kev kho plawv	Txog kev kuaj mob thiab kho mob ntshav qab zib muaj teeb meem - raws li kev qhia
Kev sib tham ntawm Angiosurgeon	Txog kev kuaj mob thiab kho mob ntshav qab zib muaj teeb meem - raws li kev qhia

Kev kuaj mob sib txawv

Kev kuaj pom txawv thiab qhia qhov tseeb ntawm cov kev tshawb fawb ntxiv

Rooj 4. Cov ntsiab lus rau kev kuaj xyuas qhov sib txawv ntawm cov ntshav qab zib hom 1 thiab ntshav qab zib hom 2

Yam 1 ntshav qab zib	Mob ntshav qab zib Hom 2
Cov hnub nyoog hluas, pib mob hnyav (nqhis dej, polyuria, poob phaus, muaj acetone hauv cov zis)	Kev pham, kev kub siab, kev ua neej nyob sedentary, muaj ntshav qab zib hauv tsev neeg
Lub cev ua paug ntawm β-hlwb ntawm pancreatic islets	Kev siv tshuaj insulin ua ke nrog cov ntawv zais β-ntawm tes ua haujlwm

Cov tshuaj (cov tshuaj yeeb dej caw) tau siv hauv kev kho mob

Acarbose (Acarbose) |

Vildagliptin (Vildagliptin)

Glibenclamide (Glibenclamide)

Gliclazide (Gliclazide)

Glimepiride (Glimepiride)

Dapagliflozin (Dapagliflozin)

Dulaglutide (Dulaglutide)

Cov tshuaj insulin

Cov tshuaj insulin aspart biphasic (Insulin aspart biphasic)

Cov tshuaj insulin glargine

Khoom noj khoom haus insulin

Cov tshuaj Insulin degludec (Insulin degludec)

Cov tshuaj insulin

Cov tshuaj insulin lispro (Insulin lispro)

Lyspro insulin biphasic (Insulin lispro biphasic)

Soluble insulin (tib neeg kev sib xyaw tshuab) (Insulin soluble (tib neeg kev lom neeg lub cev))

Insulin-isophan (tib neeg kev tshawb fawb caj) (Insulin-isophan (tib neeg kev lom neeg lub cev))

Canagliflozin (Canagliflozin)

Lixisenatide (Lixisenatide)

Linagliptin (Linagliptin)

Liraglutide (Liraglutide)

Tshuaj Metformin (Metformin)

Pawg (Qeb)

Pioglitazone (Pioglitazone)

Cov Tshuaj (Repaglinide)

Saxagliptin (Saxagliptin)

Sitagliptin (Sitagliptin)

Empagliflozin (Empagliflozin)

Kev Kho Mob (Cov chaw kho mob sab nrauv)

TSHUAJ LICAS TAM SIM NO NTAWM QHOV neeg mob QIB 2,3,7,8,11:
Cov neeg mob uas muaj ntshav qab zib hom 2 uas tsis muaj kev nyuaj rau lub cev yuav tau txais kev kho mob sab nraud..

Lub hom phiaj ntawm kev kho mob:
· Kev ua tiav ntawm tus neeg lub hom phiaj qib glycemia thiab HvA1s,
Kev kho ntshav siab
Normalization ntawm lipid metabolism,
· Tiv thaiv cov mob ntshav qab zib.

Rooj ntawv 5. Lub algorithm ntawm kev xaiv tus kheej ntawm hom phiaj kho rauHbalc2,3

Cov ntsiab lus	HNUB NYOOG
Cov ntsiab lus	hluas	qhov nruab nrab	Cov neeg laus thiab / lossis lub neej tos ntev txog 5 xyoos
Tsis muaj teeb meem dab tsi thiab / lossis muaj kev pheej hmoo ntawm cov ntshav qog ntshav qab zib siab heev
Muaj cov kev mob nyhav nyhav thiab / lossis muaj kev pheej hmoo muaj ntshav qab zib tsawg

* Lub neej tos ntev - lub neej tos.

Rooj 6.Muab cov theem qibHbalccov hom phiaj hauv qab no ntawm qib ua ntej / postprandial ntshav ntshav qab zib yuav sib haum rau 2.3

Hbalc**

Ntshav piam thaj
nTxuas / ua ntej noj mov, mmol / L

Ntshav piam thaj
xyob htom qab 2 teev tom qab noj mov, mmol / l

*Cov hom phiaj no tsis siv rau cov menyuam yaus, cov hluas, thiab cov poj niam cev xeeb tub. Lub hom phiaj glycemic tswj qhov tseem ceeb rau cov pawg ntawm cov neeg mob tau sib tham hauv cov ntu.
** Qib nyob raws li cov qauv DCCT: nce txog 6%.

Rooj 7. Hom phiaj lipid metabolism hauv cov neeg mob ntshav qab zib 2,3

Qhov ntsuas	Hom Phiaj Tseem Ceeb, mmol / L *
Qhov ntsuas	txiv neej	poj niam
General roj
Cov roj khov ua tiav
HDL roj	> 1,0	>1,2
triglycerides

Pchaw muab kev pab	Tsspruce qhov tseem ceebhliHg Kos duab.
Systolic ntshav siab	> 120 * thiab ≤ 130
Diastolic ntshav siab	> 70 * thiab ≤ 80

* Tawm tsam keeb kwm ntawm antihypertensive kho
Kev ntsuas cov ntshav siab yuav tsum tau nqa tawm ntawm txhua qhov kev mus ntsib tus kws kho keeb endocrinologist. Cov neeg mob uas mob systolic ntshav siab (SBP) mm 130 hli Hg. Kos duab. lossis diastolic ntshav siab (DBP) ≥ 80 hli Hg. Art., Yuav tsum ntsuas qhov thib ob ntawm ntshav siab ntawm lwm hnub. Yog tias cov txiaj ntsig ntsig txog ntshav siab tau pom thaum ntsuas ntsuas dua, kev kuaj mob ntshav siab yog suav tias yog kev lees paub (rau kev kho mob ntawm txoj kev mob ntshav siab, saib raws li "raws li" Arterial hypertension ").

Cov tshuaj tsis raug:
Noj zaub mov naj npawb 8 - kev noj zaub mov kom tsawg. Rau cov neeg mob tau txais cov tshuaj insulin, kev noj haus ntxiv nrog kev noj haus fiber ntau,
Mode General hom,
· Qoj ib ce - coj mus rau hauv lub xeev qhov kev mob plawv,
Kawm nyob rau hauv tsev kawm ntshav qab zib
-Tswj tus kheej.

Tshuaj kho mob nkeeg

Cov npe ntawm cov tshuaj tseem ceeb (muaj 100% qhov tshwm sim ntawm kev siv):

Rooj 9. Cov ntshav qab zib tsawg siv los kho hom 2 ntshav qab zib

Pharmacological pawg	Lub npe thoob ntiaj teb nonproprietary tshuaj	Txoj kev ntawm daim ntawv thov	Theem pov thawj
SM npaj	gliclazide	Qhov ncauj	A
	gliclazide		A
	glimepiride		A
	glibenclamide		A
Glinids (meglitinides)	kwv huam	Qhov ncauj	A
Glinids (meglitinides)	* Pab pawg	Qhov ncauj	A
Kev Loj Loj	metformin	Qhov ncauj	A
TZD (glitazones)	pioglitazone	Qhov ncauj	A
Α-glucosidase inhibitors	acarbose	Qhov ncauj	A
aGPP-1	dulaglutide	Subcutaneously	A
	lisraglutide		A
	lixisenatide		A
IDPP-4	sitagliptin	Qhov ncauj	A
	vildagliptin		A
	saxagliptin		A
	linagliptin		A
INGLT-2	empagliflozin 10-12	Qhov ncauj	A
	dapagliflozin 8-9		A
	canagliflozin 13-15		A
Insulins Ultrashort (tib neeg cov tshuaj insulin)	Lyspro insulin	Subcutaneously lossis intravenously. Subcutaneously lossis intravenously.	A
	Cov tshuaj insulin		A
	Cov tshuaj insulin glulisin		A
Luv ua yeeb yam insulins	Soluble tib neeg cov chaw tsim cov tshuaj insulin	Subcutaneously, cev nqaij daim tawv	A
Nruab Nrab Sijhawm Insulins	Isofan Insulin Tib Neeg Kev Tshawb Fawb Hauv Kev Tshawb Fawb	Subcutaneously.	A
Insulins ntev ua yeeb yam (tib neeg cov tshuaj insulin)	Cov tshuaj insulin glargine 100 PIECES / ml16-20	Subcutaneously.	A
Insulins ntev ua yeeb yam (tib neeg cov tshuaj insulin)	Cov tshuaj insulin 21-23	Subcutaneously.	A
Cov Insulins Tshaj Lij Ntev (Cov Tib Neeg Ua Hluav Taws Xob Insulin)	Insulin degludec 24-28	Subcutaneously.	A
	Cov tshuaj insulin glargine 300 PIECES / ml29-35	Subcutaneously.	A
Npaj tov khoom ntawm cov tshuaj insulin luv luv thiab NPH-insulin	Cov tshuaj insipipide tib neeg kev txawj ntse engineering	Subcutaneously.	A
Npaj-sib xyaw ua ke ntawm ultra-luv ua yeeb yam insulin analogues thiab kis tau ultra luv ua yeeb yam insulin analogues	Lyspro insulin biphasic 25/75	Subcutaneously.	A
	Lyspro insulin biphasic 50/50		A
	Cov tshuaj Insulin aspart 2-theem		A
Npaj-ua ob peb ua ke cov tshuaj insulin super ntev ua thiab analogues ultra luv-ua yeeb yam insulin	Insulindegludek + Cov tshuaj Insulinaspart hauv qhov feem pua ntawm 70 / 3036-37	Subcutaneously.	A
Sib xyaw ua ke cov tshuaj ntawm ntev ntev thiab ntxiv ntev ntev insulin thiab aHPP-1	Tshuaj Insulin Glargine + Lixisenatide (1 zaug hauv ib hnub) 38-39	Subcutaneously.

Subcutaneously.
A Cov tshuaj insulin degludec + liraglutide
(1 zaug hauv ib hnub)
40-43A

Raws li kev pom zoo ntawm Cov Koom Haum Pej Xeem Kev Koom Tes "Koom Haum ntawm Endocrinologist ntawm Kazakhstan" rau kev kuaj mob thiab kho mob hom 2 ntshav qab zib mellitus, 2016, thaum xaiv pib thiab txhawb kev kho ntshav qab zib rau hom ntshav qab zib hom 2, cov txheej txheem hauv qab no yuav tsum tau ua raws:

* - tshwj tsis yog glibenclamide
Qhov kev txiav txim ntawm cov tshuaj tsis cuam tshuam qhov muaj feem thib thaum xaiv lawv

Kev phais mob: tsis muaj.

Kev tswj xyuas dua

Rooj ntawv 10. Sau cov kev ntsuas uas yuav tsum muaj kev saib xyuas zoo hauv cov neeg mob ntshav qab zib hom 2:

Kuajchaw muab kev pab	Daim ntawv ntsuas zaus
Kev tswj tus kheej Glycemic	Hauv kev tshwm sim ntawm tus kab mob thiab nrog decompensation - txhua hnub ob peb zaug hauv ib hnub. Ntxiv mus, nyob ntawm hom FTA: - ntawm kev siv tshuaj insulin ntau: tsawg kawg 4 zaug ntawm ib hnub, - ntawm PSST thiab / lossis GPP-1 thiab / lossis insulin basal: tsawg kawg 1 zaug hauv ib hnub ntawm txawv sijhawm ntawm hnub + 1 glycemic profile (tsawg kawg 4 zaug hauv ib hnub) toj ib lub lim tiam, - ntawm insulin-ua tiav cov sib xyaw: tsawg kawg 2 zaug hauv ib hnub nyob rau txawv sij hawm + 1 glycemic profile (tsawg kawg 4 zaug hauv ib hnub) hauv ib as thiv, - rau kev noj zaub mov noj: 1 zaug ib as thiv nyob rau txawv sij hawm ntawm ib hnub,
Hbalc	1 lub sijhawm hauv 3 lub hlis
Ntshav biochemical tsom (tag nrho cov protein, cov roj cholesterol, LDL cov roj cholesterol, roj cholesterol HDL, triglycerides, bilirubin, AST, ALT, creatinine, kev xam GFR, K, Na,)	Ib xyoos ib zaug (thaum tsis muaj hloov)
Jab	Ib zaug dhau ib zaug
OAM	Ib zaug dhau ib zaug
Kev txiav txim siab nyob rau hauv cov zis ntawm qhov feem ntawm albumin thiab creatinine	Ib zaug dhau ib zaug
Kev txiav txim siab ntawm ketone lub cev hauv cov zis thiab ntshav	Raws li kev qhia
Cov Lus Txhais ntawm IRI	Raws li kev qhia

*Thaum muaj cov tsos mob ntawm tus mob ntshav qab zib, ntxiv cov kab mob uas txuas ntxiv, qhov tshwm sim ntawm cov kev pheej hmoo ntxiv, cov lus nug ntawm qhov ntau zaus ntawm kev soj ntsuam tau txiav txim siab ntawm tus kheej.

Cov lus 11. Cov npe ntawm cov kev kuaj mob tsim nyog rau kev tswj hwm hauv cov neeg mob ntshav qab zib hom 2 * 3.7

Seev Cev Txoj Kev Seev	Daim ntawv ntsuas zaus
SMG	Raws li kev qhia
Tswj ntshav siab	Txhua lub sijhawm ntsib kws kho mob. Hauv kev muaj ntshav siab - kev soj ntsuam tus kheej ntshav siab
Kev soj ntsuam ko taw thiab ko taw ntsuas qhov ua haujlwm zoo	Txhua lub sijhawm ntsib kws kho mob
CW ntawm qhov qis qis tuaj	Ib zaug dhau ib zaug
ECG	Ib zaug dhau ib zaug
ECG (nrog rau kev ntsuam xyuas kev ntxhov siab)	Ib zaug dhau ib zaug
Kev ntsuas hluav taws xob xoo	Ib zaug dhau ib zaug
Ultrasound ntawm cov hlab ntsha ntawm qhov qis qis hauv qab thiab lub raum	Ib zaug dhau ib zaug
Ultrasound ntawm lub plab zom plab	Ib zaug dhau ib zaug

* Thaum muaj cov tsos mob ntawm tus mob ntshav qab zib, ntxiv ntawm cov kab mob sib kis, qhov tshwm sim ntawm cov kev pheej hmoo ntxiv, cov lus nug ntawm qhov ntau zaus ntawm kev soj ntsuam tau txiav txim siab ntawm tus kheej.

Qhov ntsuas ntawm kev kho mob:
Kev ua tiav ntawm ib tus neeg cov hom phiaj ntawm АвА1с thiab glycemia,
· Ua tiav ntawm cov lipid metabolism hauv lub hom phiaj,
Ua tiav ntawm lub hom phiaj ntshav siab,
Kev loj hlob ntawm kev ua lub siab rau kev tswj tus kheej.

Kev Kho Mob (Tsev Kho Mob)

TSHUAJ LUS TSHUAJ TUAJ TAWG TSEV KAWM NTAWV THEEM: Kev kho kom muaj suab thaj txaus yog raug xaiv.

Daim Ntawv Teev Tseg Neeg Mob, Kev Tuav Pov Hwm Neeg Mob

Cov tshuaj tsis raug: saib sab nrauv.

Kho tshuaj: saib sab nrauv.

Kev phais mob: tsis muaj.

Kev saib xyuas ntxiv: saib sab nrauv.

Qhov ntsuas ntawm kev kho mob: saib sab nrauv.

Tsev Kho Mob

INDICATIONS RAU COV HOSPITALIZATION NROG INDICATION NTAWM HOM TXWV YEEM

Cov lus qhia rau kev npaj pw tsev kho mob:
Lub xeev ntawm decompensation ntawm carbohydrate metabolism, tsis raug cai nyob rau sab nrauv,
Rec Ntau zaus rov qab muaj dua cov qog ntshav qab zib hauv ib hlis lossis ntau dua,
· Kev tshwm sim ntawm cov leeg mob hlwb thiab leeg ntshav (rov qab kho mob hlwb, mob nephropathy) ntawm hom 2 mob ntshav qab zib, mob ko taw mob ntshav qab zib,
Women Cov poj niam cev xeeb tub uas muaj ntshav qab zib hom 2, txheeb xyuas lub sijhawm cev xeeb tub.

Cov lus qhia rau tsev kho mob ceev:
Coma - hyperosmolar, hypoglycemic, ketoacidotic, lactic acid.

Qhov chaw thiab cov ntawv nyeem

Daim ntawv teev cov rooj sib tham ntawm Pawg Neeg Sawv Cev rau Cov Txheej Txheem Saib Xyuas Kev Kho Mob ntawm Ministry of Health of Republic of Kazakhstan, 2017
1. 1) Koom Haum Tso Ntshav Qab Zib Asmeskas. Cov qauv kev kho mob hauv ntshav qab zib - 2017.DiabetesCare, 2017, Volume 40 (Ntxiv 1). 2) Lub Koom Haum Ntiaj Teb Kev Noj Qab Haus Huv.Lus Txhais, Kev kuaj mob, thiab cais hom ntshav qab zib Mellitus thiab nws cov teeb meem: Tshaj tawm ntawm WHO kev sab laj. Ntu 1: Kev kuaj mob thiab cais hom ntshav qab zib Mellitus. Geneva, Koom Haum Noj Qab Haus Huv Ntiaj Teb, 1999 (WHO / NCD / NCS / 99.2). 3) Cov txheej txheem los kho mob tshwj xeeb rau cov neeg mob ntshav qab zib. Ed. I.I. Dedova, M.V. Shestakova, A.Yu. Mayorova, 8th tsab. Moscow, 2017.4) Koom Haum Noj Qab Haus Huv Ntiaj Teb. Siv Glycated Hemoglobin (HbAlc) hauv Kev Tshuaj Ntsuam Txog Ntshav Qab Zib Mellitus. Daim Ntawv Tshaj Tawm Lus Tshaj Tawm los ntawm WHO Kev Sab Laj. Koom Haum Noj Qab Haus Huv Ntiaj Teb, 2011 (WHO / NMH / CHP / CPM / 11.1). 5) Bazarbekova R.B., Nurbekova A.A., Danyarova L.B., Dosanova A.K. Kev pom zoo ntawm kev kuaj mob thiab kho mob ntshav qab zib. Almaty, 2016.6) Deutsche Mob Ntshav Qab Zib Gesellschaft und Deutsche Vereinte Gesellschaftfür Klinische Chemie und Labormedizin, 2016.7) Khaws J., Phil B. Insulin Kho Ntshav Qab Zib Rau Hom 1 Ntshav Qab Zib Mellitus, N Engl Med 2012, 366: 1616-24. 8) Zhang M, Zhang L, Wu B, Nkauj H, An Z, Li S. Dapagliflozin kev kho mob ntshav qab zib hom 2: kev tshuaj xyuas kom nruj thiab tshuaj xyuas kev soj ntsuam seb puas muaj ntshav qab zib Metab Res Rev. Xyoo 2014 Lub Peb Hlis, 30 (3): 204-21. 9) RaskinP.Sodium-glucose cotransporter inhibition: tshuaj kho lub peev xwm kho tau hom 2 mob ntshav qab zib mellitus. Ntshav Qab Zib Metab Res Rev. 2013 Jul, 29 (5): 347-56. 10) Grempler R, Thomas L, Eckhardt M. li al. Empagliflozin, tus tshiab xaiv cov tshuaj sodium sodium glucose cotransporter-2 (SGLT-2) inhibitor: kev ua yeeb yam thiab piv nrog lwm SGLT-2 inhibitors. Ntshav Qab Zib ObesMetab 2012, 14: 83-90. 11) Häring HU, Merker L, Seewaldt-Becker E, li al. Empagliflozin raws li ntxiv rau cov tshuaj metformin ntxiv rau sulfonylurea hauv cov neeg mob ntshav qab zib hom 2: 24-lub lis piam, randomized, ob lub qhov muag dig, tshuaj placebo. Mob Ntshav Qab Zib Kho 2013, 36: 3396-404. 12) Häring HU, Merker L, Seewaldt-Becker E, li al. Empagliflozin raws li ntxiv rau cov tshuaj metformin hauv cov neeg mob ntshav qab zib hom 2: 24-lub lis piam, randomized, ob dig muag, tshuaj placebo. Mob Ntshav Qab Zib 2014, 37: 1650-9. 13) Nisly SA, Kolanczyk DM, Walton AM. Canagliflozin, tshuaj tshiab sodium-glucose cotransporter 2 inhibitor, hauv kev kho mob ntshav qab zib.//Am J Health Syst Pharm. - 2013 .-- 70 (4). - R. 311-319. 14) Lamos EM, Younk LM, Davis SN. Canagliflozin, ib qho inhibitor ntawm sodium-glucose cotransporter 2, rau kev kho mob ntawm hom 2 ntshav qab zib mellitus. Cov Kws Muaj Txuj Ci Pom Tshuaj Yeeb Tshuaj MetabToxicol 2013.9 (6): 763-75. 15) Stenlöf K, Cefalu WT, Kim KA, li al. Kev ua tau zoo thiab kev nyab xeeb ntawm canagliflozinmonotherapy rau cov neeg uas muaj hom 2 mob ntshav qab zib mellitus tswj tsis tau zoo nrog kev noj haus thiab kev tawm dag zog.// Ntshav Qab Zib ObesMetab. - 2013 .-- 15 (4). - P. 372–382. 16) Rossetti P, Porcellati F, Fanelli CG, Perriello G, Torlone E, Bolli GB. Superiority ntawm insulin analogues piv rau tib neeg cov insulin hauv kev kho mob ntshav qab zib mellitus.ArchPhysiolBiochem. 2008 Lub Ob Hlis, 114 (1): 3-10. 17) Dawb NH, Chase HP, Arslanian S, Tamborlane WV, 4030 Kawm Pawg. Kev sib piv ntawm kev sib txawv ntawm glycemic cuam tshuam nrog insulin glargine thiab nruab nrab-ua yeeb yam insulin thaum siv los ua qhov tseem ceeb ntawm kev txhaj tshuaj txhua hnub rau cov hluas nrog hom 1 ntshav qab zib. 2009 Mar, 32 (3): 387-93. 18) Polonsky W, Traylor L, Gao L, Wei W, Ameer B, Stuhr A, Vlajnic A. Txhim kho kev mob siab rau cov neeg mob ntshav qab zib hom 1 kho nrog insulin glargine 100U / mL tiv thaiv NPH insulin: Kev tshawb nrhiav ntawm cov neeg kwv yees tseem ceeb los ntawm ob J Ntshav Qab Zib Cov Teeb Meem. 2017 Mar, 31 (3): 562-568. 19) Blevins T, Dahl D, Rosenstock J, li al. Kev ua tau zoo thiab kev nyab xeeb ntawm LY2963016 cov tshuaj insulin glargine piv nrog insulin glargine (Lantus in) rau cov neeg mob uas muaj ntshav qab zib hom 1 hauv kev sim tswj kho: cov kev kawm ELEMENT 1. Mob ntshav qab zib rog thiab Metabolism. Lub Rau Hli 23, 2015. 20) L. L. Ilag, M. A. Deeg, T. Costigan, P. Hollander, T. C. Blevins, S. V. Edelman, li al. Kev ntsuam xyuas cov tshuaj tiv thaiv kab mob ntawm LY2963016 insulin glargine piv nrog Lantus®insulinglargine hauv cov neeg mob uas muaj hom 1 lossis hom 2 mob ntshav qab zib mellitus. Mob ntshav qab zib thiab rog hauv lub cev, Lub Ib Hlis 8, 2016.21) Gilor C, Ridge TK, Attermeier KJ, Graves TK. Pharmacodynamics ntawm insulin detemir thiab insulin glargine ntsuas los ntawm ib txoj kev isoglycemic clamp hauv cov miv noj qab haus huv. J Vet Intern Med. 2010 Jul-Aug, 24 (4): 870-4. 22) Fogelfeld L, Dharmalingam M, Robling K, Jones C, Swanson D, Jacober S. Ib qho kev sib tw, kho-rau-phiaj sim kev sib piv insulin lispro tiv thaiv kev ncua thiab insulin detemir hauv cov neeg mob insulin-naive nrog Hom 2 diabetes.Diabet Med. Xyoo 2010 Lub Ob Hlis, 27 (2): 181-8. 23) Reynolds LR. Sib piv insulins detemir thiab glargine hauv ntshav qab zib hom 2: zoo sib xws dua li sib txawv.Commentary.Postgrad Med. 2010 Jan, 122 (1): 201-3. 24) Zinman B, Philis-Tsimikas A, Cariou B, li al, sawv cev ntawm NN1250-3579 (BEGIN Ib Ntus) Cov Kws Tshuaj Ntsuam Xyuas. Ntshav Qab Zib Kho Mob. 2012.35 (12): 2464-2471. 25) Heller S, Buse J, Fisher M, li al, sawv cev ntawm BEGIN Basal-Bolus Hom 1 Tus Kws Tshawb Fawb. Kev Looj Mem. 2012.379 (9825): 1489-1497. 26) Gough SCL, Bhargava A, Jain R, Mersebach H, Rasmussen S, Bergenstal RM. Ntshav Qab Zib Kho Mob. 2013.36 (9): 2536-2542. 27) Meneghini L, Atkin SL, Gough SCL, li al, sawv cev ntawm NN1250-3668 (BEGIN FLEX) Cov Neeg Tshawb Nrhiav Kev Tshawb Fawb. Ntshav Qab Zib Kho Mob. 2013.36 (4): 858-864. 28) Kev Sim Ntsuam Xyuas Qhov Ua Tau Zoo thiab Kev Nyab Xeeb ntawm Insulin Degludec hauv Cov Menyuam thiab Cov Hluas Nrog Hom 1 Ntshav Qab Zib Mellitus (BEGIN ™) ClinicalTrials.gov Cov Cim: NCT01513473. 29) Dailey G, Lavernia F. Kev txheeb xyuas cov ntaub ntawv kev nyab xeeb thiab ua tau zoo rau insulin glargine 300 units / ml, ib qho qauv tshiab ntawm insulin glargine.Diabetes ObesMetab. 2015.17: 1107-14. 30) SteinstraesserA li al. Kev tshawb nrhiav tshuaj tshiab insulin glargine 300 U / ml muaj cov metabolism tib yam li insulin glargine 100 U / ml. Ntshav Qab Zib ObesMetab. Xyoo 2014.16: 873-6. 31) BeckerRHetal. Cov tshuaj insulin glargine 300 Chav Tshiab • mL-1 qhia txog cov haujlwm muaj ntau dua thiab kev siv glycemic tswj nyob lub xeev khov kho piv nrog insulin glargine 100 Chav Nyob • mL-1. DiabetesCare. Xyoo 2015.38: 637-43. 32) Riddle MC li al. Cov Tshuaj Ntshav Tshiab Insulin Glargine 300 Chav Nyob / mL Versus Glargine 100 Chav Nyob / mL hauv Cov Neeg Muaj Mob Ntshav Qab Zib Hom 2 Siv Ntshav Qab Zib thiab Pluas Noj Sij Hawm: Kev Tshuaj Ntshav Qab Zib thiab Hypoglycemia nyob rau hauv 6-Lub hlis Qhov Kev Tshuaj Ntsuam Txog Kev Nyuaj Siab (Kho Mob 1). 2014.37: 2755-62. 33) Yki-Järvinen H li al. Tshiab tshuaj insulin glargine 300 units / mL tiv thaiv glargine 100 units / mL hauv cov neeg muaj ntshav qab zib hom 2 ntawm lub qhov ncauj thiab cov insulin basal: cov ntshav qabzib tswj thiab ntshav qab zib hauv 6-lub hlis muaj kev tswj hwm kev sim (EDITION 2). Mob Ntshav Qab Zib 2014, 37: 3235-43. 34) Bolli GB li al. Tshiab insulin glargine 300 U / ml piv nrog glargine 100 U / ml hauv insulin-naïve cov neeg mob ntshav qab zib hom 2 ntawm qhov ncauj cov ntshav qab zib: tshuaj xyuas tsis txaus (TSOOS 3). Ntshav Qab Zib ObesMetab. 2015.17: 386-94. 35) Lub Tsev PD, Bergenstal RM, Bolli GB, Ziemen M, Rojeski M, Espinasse M, Riddle MC. Cov Tshuaj Ntshav Tshiab Insulin Glargine 300 Chav Nyob / mL Versus Glargine 100 Chav Nyob / mL hauv Cov Neeg Muaj Mob Ntshav Qab Zib Hom 1: Kev Random, Phaub 3a, Qhib Kev Ntsuam Xyuas Chaw Ntsuam Xyuas (NTU 4). Ntshav Qab Zib Kho Mob. Xyoo 2015 Dec, 38 (12): 2217-25. 36) Txheej txheem cej luam ntawm Kev Ntsuam Xyuas Kuaj Mob thiab Kev Siv Tau ntawm Insulin Degludec / Insulin Aspart hauv Kev Ntshav Qab Zib Kev Tswj Ntshav Kab Mob Ganapathi Bantwal1, Subhash K Wangnoo2, M Shunmugavelu3, S Nallaperumal4, KP Harsha5, ArpandevBhattachary. 37) Kev Nyab Xeeb, Pharmacokinetics thiab Pharmacodynamics ntawm Ob IDegAsp (Ib qho Kev Tshawb Fawb) Npaj thiab Ob Qhov Insulin Degludec (Ib qho Kev Tshawb Fawb) Npaj Hauv Nyij Pooj. ClinicalTrials.gov Tus Cim: NCT01868555. 38) Aroda VR li al, LixiLan-L Cov Neeg Tshawb Fawb Kev Tshawb Fawb.Erratum. Qhov ua tau zoo thiab Kev Nyab Xeeb ntawm LixiLan, ib qho Titratable Fixed-Ratio Sib xyaw ntawm Insulin Glargine Plus Lixisenatide hauv Hom 2 Ntshav Qab Zib tsis txaus tswj ntawm Basal Insulin thiab Metformin: LixiLan-L Randomized Trial. Kev Tu Ntshav Qab Zib 2016.39: 1972-1980; Kev Tu Ntshav Qab Zib. 2017 Apr 20. 39) Rosenstock J et al, LixiLan-O Cov Neeg Tshawb Xyuas Kev Tshawb Nrhiav. Erratum. Cov txiaj ntsig ntawm LixiLan, ib qhov Titratable Fixed-Ratio Sib xyaw ua ke ntawm Insulin GlarginePlusLixisenatide, Versus Insulin Glargine thiab Lixisenatide Monocomponents hauv Hom 2 Ntshav Qab Zib tsis raug tswj los ntawm cov kab mob hauv qhov ncauj: LixiLan-O Randomized Trial. Kev Tu Ntshav Qab Zib 2016.39: 2026-2035; Kev Tu Ntshav Qab Zib. 2017 Apr 18. 40) Stephen CL, Gough, Rajeev Jain, thiab Vincent C Woo. Cov tshuaj Insulin degludec / liraglutide (IDegLira) rau kev kho mob ntshav qab zib hom 2. 41) Ua Haujlwm Ntawm Liraglutide thiab Insulin Degludec hauv Hom Ntshav Qab Zib 2: Kev Ntsuam Xyuas Sib piv cov txiaj ntsig thiab kev nyab xeeb ntawm Insulin Degludec / Liraglutide, Insulin Degludecand Liraglutide hauv Cov Ntsiab Lus Nrog Hom 2 Ntshav Qab Zib (DUAL ™ I) ClinicalTrials.gov Cov Khoom Taw Qhia: NCT01336023. 42) Qhov Chaw Ntsuam Xyuas Sib Piv Glycemic Tswj Xyuas thiab Kev Nyab Xeeb ntawm Insulin Degludec / Liraglutide (IDegLira) Versus Insulin Glargine (IGlar) raws li ntxiv-rau Kev Kho Mob rau SGLT2i hauv Cov Ntsiab Lus Nrog Hom 2 Ntshav Qab Zib Mellitus (DUALTM IX) ClinicalTrials.gov Tus Kheej: NCT02 43) Cov tshuaj Insulin degludec / liraglutide (IDegLira) Kev Kho Mob los txhim kho Glycemic Kev Tswj Xyuas hauv Cov Neeg Loj Nrog Hom 2 Ntshav Qab Zib Mellitus NDA 208583 Cov Ntawv Sau Qhia Me. 44) "Dab tsi koj yuav tsum paub txog Biosimilar Cov Khoom Siv Tshuaj Kho Mob". Kev Pom Zoo Qhov Kev Pom Zoo Ib Leeg Ntaub Ntawv.EuropeanCommision. Saib. Ares (2014) 4263293-18 / 1 // 2014. 45) "Cov lus qhia ntawm Cov Khoom Siv Tshuaj Txheeb Zoo Ib Yam Muaj Txiaj Ntsig Khoom Siv biotechnology uas yog cov tshuaj yeeb tshuaj - Tsis yog Chaw Kho Mob thiab Chaw Kho Mob". Lub Chaw Saib Xyuas Kev Noj Tshuaj Hauv Tebchaws Europe 18 Lub Kaum Ob Hlis 2014 EMEA / CHMP / BMWP / 42832/2005 Rev1 Pawg Neeg Saib Xyuas Cov Khoom Siv Tshuaj rau Cov Neeg Siv (CHMP). 46) "Kev taw qhia txog kev tsis yog chaw kho mob thiab kev txhim kho kev tshawb fawb ntawm cov khoom lag luam zoo ib yam li muaj tshuaj lom neeg muaj tshuaj lom neeg muaj insulin thiab insulin analog". Lub Chaw Haujlwm Tshuaj Noj Kho Mob European. 26 Lub Ob Hlis 2015 EMEA / CHMP / BMWP / 32775 / 2005Rev. 1 Pawg Neeg Saib Xyuas Cov Tshuaj rau Cov Khoom Siv rau Tib Neeg (CHMP).

Ntshav Qab Zib Hom 2 - yam ntxwv ntawm tus kab mob

Rau kev ua haujlwm zoo li qub, lub cev xav tau lub zog tas mus li ntawm lub zog, uas tsim tawm los ntawm cov zaub mov noj. Qhov tseem ceeb muab cov piam thaj. Rau kev nqus ntawm cov piam thaj los ntawm cov ntaub so ntswg, ib qho tshuaj hormones yuav tsum - insulin, uas tsim tawm los ntawm cov txiav.

Ntawm hom 2 Ntshav Qab Zib, hlau ua haujlwm ib txwm, tab sis lub hlwb tsim cov tshuaj tiv thaiv ua rau cov tshuaj hormones. Yog li ntawd, cov piam thaj tsis tau xa mus rau cov kab mob, tab sis tseem nyob hauv cov ntshav ntshav. Lub cev pib tsis muaj zog. Lub paj hlwb teb rau qhov xwm txheej nrog lub teeb liab kom nce insulin ntau lawm. Kev nce zuj zus ntawm cov tshuaj hormones tsis hloov pauv qhov xwm txheej.

Maj mam, kev tsim cov tshuaj insulin yog txo qis vim qhov kev coj ntawm lub cev thiab txo qis, thiab yuav nres tag nrho. Tus kab mob no nthuav dav zuj zus thiab thaum chiv thawj tsis muaj cov cim qhia tau. Nrog rau daim ntawv qib siab ntawm tus kabmob, nws tuaj yeem mus rau theem 1.

Mob ntshav qab zib Gestational

Mob ntshav qab zib mellitus yog mob pathological uas tshwm sim rau cov poj niam thaum lub sijhawm xeeb tub. Rov hais tawm tsam tom qab ntawm qhov kev ua txhaum ntawm cov carbohydrate metabolism thiab lwm yam kev hloov pauv hauv metabolism.

Hom kab mob no tau txheeb xyuas twb tau nyob rau lub sijhawm muaj menyuam hauv plab, thiab lub hauv paus tseem ceeb ntawm kev txhim kho yog qhov kev txo qis ntawm qhov rhiab ntawm cov ntaub so ntswg mus rau cov tshuaj insulin vim tias cov tshuaj tiv thaiv kab mob hauv cov pojniam xeeb menyuam. Cov teeb meem tshwm sim suav nrog qhov hnyav nce.

Muaj ntau zaus, tus kab mob no tau muab zais thiab kuaj pom twb muaj nyob hauv lub sijhawm lig. Kev mus kuaj hauv chaw kuaj ntshav thiab kev saib xyuas mob tas li yuav pab tiv thaiv tus kab mob.

Tawm tsam keeb kwm ntawm GDM, ib tug poj niam tom qab ntawv yuav muaj feem ntau txhim kho tus mob ntshav qab zib hom II.

Saib xyuas Hauv ib nrab kis ntawm GDM, cov poj niam muaj lub cev xeeb tub thib ob yog qhov muaj pheej hmoo.

Nws kuj tseem tsim nyog taw qhia tias nyob hauv cov poj niam uas tau ntsib GDM, kev pheej hmoo ntawm kev tsim muaj tus mob ntshav qab zib hom II tseeb ntxiv tuaj.

Cov Ntaub Ntawv

KEV QHIA TXUJ CI NTAWM KEV TIV THAIV

Daim ntawv uas muaj raws tu qauv:
1) Nurbekova Akmaral Asylovna - Tus Kws Kho Mob ntawm Medical Science, xibfwb ntawm Lub Tsev Haujlwm Saib Xyuas Kev Ua Haujlwm No. 2 ntawm Republican State Pedagogical University ntawm Lub Tsev Haujlwm Perm State Pedagogical University Kazakh National Medical University. Asfendiyarova. "
2) Bazarbekova Rimma Bazarbekovna - Tus Kws Kho Mob ntawm Kev Tshawb Fawb Kev Kho Mob, Xib Hwb, Lub Taub Hau ntawm Chav Haujlwm Endocrinology ntawm Kazakh Medical University of txuas ntxiv Kev Kawm JSC, Tus Thawj Tswj ntawm Cov Koom Haum Pej Xeem "Koom Haum ntawm Endocrinologist ntawm Kazakhstan".
3) Smagulova Gaziza Azhmagievna - Tus neeg sib tw ntawm Medical Science, Lub Taub Hau ntawm Lub Tsev Haujlwm Saib Xyuas Kev Noj Tshuaj thiab Chaw Kho Mob Tshuaj, Republican State Pedagogical University ntawm Western-Kazakhstan State Medical University muaj npe tom qab M. Ospanov.

Qhov ntsuas qhov tsis muaj qhov tsis sib haum xeeb: tsis muaj

Cov Neeg Tshuaj Xyuas:
Espenbetova Mayra Zhaksimanovna – Cov Kws Kho Mob ntawm Medical Science, Kws Qhia Ntawv, Lub Taub Hau ntawm Lub Chaw Haujlwm Saib Xyuas Kev Nkag Mus Rau Kev Kho Mob General, Semipalatinsk State Medical Academy.

Qhia txog cov xwm txheej rau qhov hloov kho cov txheej txheem: kev kho dua ntawm kev ua raws txoj cai 5 xyoos tom qab nws tshaj tawm thiab txij hnub nws nkag mus rau hauv lub zog lossis qhov muaj cov txheej txheem tshiab nrog theem pov thawj.

Daim Ntawv Ntxiv 1

Cov hau kev soj ntsuam rau hom 2 ntshav qab zib 2, 3
Kev soj ntsuam yog ua tiav los txheeb xyuas cov neeg mob uas yuav muaj ntshav qab zib. Kev soj ntsuam pib nrog yoo mov glycemia. Yog thaum pom tias muaj cov kabmob normoglycemia lossis kev tsis haum sai glycemia (NGN) - ntau dua 5.5 mmol / L, tab sis tsawg dua 6.1 mmol / L rau cov ntshav capillary thiab ntau dua 6.1 mmol / L, tab sis tsawg dua 7.0 mmol / L rau venous ntshav ntshav yog qhia txog kev ntsuas ntshav qab zib ntawm qhov ncauj (PHTT).
PGTT tsis ua:
Tawm tsam tus keeb kwm yav dhau los ntawm tus mob huam,
· Tawm tsam keeb kwm yav dhau los ntawm kev siv tshuaj ncua sijhawm luv uas nce qib glycemia (glucocorticoids, cov thyroid hormones, thiazides, beta-blockers, thiab lwm yam)
PGTT yuav tsum tau nqa tawm thaum sawv ntxov tawm tsam keeb kwm ntawm tsawg kawg 3-hnub tsis pub noj zaub mov noj (ntau tshaj 150 g ntawm carbohydrates ib hnub). Qhov ntsuas yuav tsum tau coj mus ua ntej thaum hmo ntuj yoo yam tsawg 8-14 teev (koj tuaj yeem haus dej). Tom qab tso ntshav kuaj ntawm lub plab khoob, qhov kev ntsuas yuav tsum haus 75 g ntawm anhydrous qab zib lossis 82.5 g ntawm cov piam thaj monohydrate yaj hauv 250-300 ml dej hauv tsis pub dhau 5 feeb. Rau cov menyuam yaus, lub nra yog 1.75 g ntawm anhydrous qabzib ib kg ntawm lub cev nyhav, tab sis tsis ntau tshaj 75 g. Tom qab 2 teev, kev kuaj ntshav ob yog tawm.

Kev ntsuas rau kev kuaj mob ntshav qab zib asymptomatic
Txhua tus neeg raug tshuaj ntsuam muaj BMI ≥25 kg / m 2 thiab cov hauv qab no yam pheej hmoo:
Lifestyle Ua neej sib hlub,
Cov txheeb ze ntawm kab thib ib ntawm cov kwv tij neej tsa kev mob ntshav qab zib,
Cov haiv neeg feem ntau muaj feem muaj ntshav qab zib,
Cov poj niam uas muaj keeb kwm kev yug menyuam uas muaj menyuam hauv plab lossis muaj tus mob ntshav qab zib rau lub ntsej muag,
Kev kub siab (≥140 / 90 mmHg lossis ntawm kev kho mob antihypertensive),
A qib HDL ntawm 0.9 mmol / l (lossis 35 mg / dl) thiab / lossis qib triglyceride ntawm 2.82 mmol / l (250 mg / dl),
Qhov kuaj pom ntawm HbAlc ≥ 5.7% ua ntej tsis tuaj yeem ua rau tsis muaj qab zib lossis cuam tshuam cov kua nplaum sai,
Keeb kwm mob plawv,
· Lwm qhov kev soj ntsuam mob uas cuam tshuam nrog kev tiv thaiv cov tshuaj insulin (suav nrog kev rog dhau heev, acanthosnigras),
Polycystic zes qe menyuam mob.
Yog tias qhov kev ntsuam xyuas ib txwm ua, nws yuav tsum tau rov ua dua txhua txhua 3 xyoo. kuaj nqa tawm txhua tus neeg uas muaj hnub nyoog tshaj 45 xyoosCov. Yog tias qhov kev ntsuas tsis zoo, koj yuav tsum rov ua nws txhua 3 xyoos.
Kev Ntsuas yuav tsum tau nqa tawm hauv cov menyuam hnub nyoog tshaj 10 xyoo thiab tub ntxhais hluas rog nrog rau 2 lossis ntau dua cov kev pheej hmoo.

Daim Ntawv Ntxiv 1

DIAGNOSTIC THIAB KHO DIABETIC KETACACIDOSIS ALGORITHM RAU LUB theem NTAWM CEEV

Mob ketoacidosis (DKA) thiab ketoacidotic coma
DKA yog ib qho mob ntshav qab zib uas ua rau lub cev tsis ua haujlwm, ua kom muaj lub ntsej muag thiab lub siab ntawm ketone lub cev nyob rau hauv cov ntshav, lawv cov tsos ntawm cov zis thiab kev loj hlob ntawm cov metabolic acidosis, nrog rau qib sib txawv ntawm lub siab tsis tuaj yeem lossis tsis muaj nws, xav tau pw hauv tsev kho mob sai.

Daim Ntawv Ntxiv 2

HAIS TXOG THIAB KHO MOB ALGORITHM RAU DIABETIC HYPOGLYCEMIC CONDITION / TUAJ SAIB LUB theem NTAWM CEEV(schemes)

♦ muab tus neeg mob tso rau ntawm nws ib sab, pub dawb qhov ncauj tawm ntawm cov zaub mov khib nyiab (tsis txhob nchuav cov kua qab zib rau hauv lub qhov ncauj ntawm qhov ncauj),
♦ iv 40-100 ml ntawm 40% dextrose tov (kom txog thaum rov qab ua tiav ntawm kev nco qab);
♦ lwm txoj - 1 mg (me nyuam yaus 0.5 mg) glucagon s / c lossis / m,
♦ Yog tias qhov tsis nco qab rov qab zoo li qub, pib tawm tsam nrog kev mob hlwb txha caj qaum: colloids, osmodiuretics, cov ntshav sib xyaw.

Daim Ntawv Ntxiv 3

HAIS RAU LUB CAIJ THIAB KHO MOB DIABETIC HYPEROSOLARY COMA ALGORITHM RAU LUB theem NTAWM CEEV

Mob ntshav qab zib mellitus hauv cov menyuam yaus

Kev soj ntsuam cov cim sau tseg ntawm kev txhim kho cov ntshav qab zib thoob plaws ntiaj teb, tuaj yeem pom tias muaj pes tsawg tus menyuam yaus kis tus kabmob muaj ntau ntxiv nyob rau txhua xyoo. Txawm hais tias muaj tseeb tias cov mob ntshav qab zib hom I yog "hluas", uas yog, nws loj hlob hauv cov neeg muaj hnub nyoog qis dua 30 xyoo, txawm tias cov mob ntshav qab zib hom II tau sau tseg hauv menyuam yaus.

Lub hauv paus tseem ceeb ntawm tus kab mob yog nyob rau hauv qhov kev ua txhaum ntawm kev coj ua ke ntawm cov tshuaj hormone insulin, vim qhov kev hloov cov khoom noj hauv lub cev tau cuam tshuam thiab cov concentration ntawm cov piam thaj hauv cov ntshav nce ntxiv.

Cov hauv paus los ntawm hom mob ntshav qab zib hom I hauv menyuam yaus, ib yam li cov neeg laus, tseem tab tom tshawb fawb, tab sis txawm li cas los qhov pib ntawm tus kabmob yog:

noob neej
kev ntxhov siab heev
haujlwm
kev cuam tshuam ib puag ncig ib puag ncig.

Nyob rau hauv xyoo tas los no, muaj ntau yam kev txhim kho mob ntshav qab zib hauv menyuam yaus.

Yog tias peb tham txog kev txhim kho mob ntshav qab zib hom II hauv menyuam yaus, ces peb tuaj yeem hais tias muaj ntau yam tshwm sim yog:

thawj
kev ua neej nyob sedentary
kev tshuaj ntsuam genetic predisposition.

Yog tias mob ntshav qab zib hauv cov menyuam yaus tau txheeb xyuas, cov lus pom zoo yuav ua raws li WHO lees paub. Ua ntej tshaj plaws, lawv yuav cuam tshuam nrog kev noj haus kom raug, kev noj zaub mov zoo, kev ua neej nyob zoo thiab ua raws li cov kev teem caij ntsib kws kho mob.

Txheej txheem dav dav ntawm kev ua kom zoo

Cov neeg mob ntshav qab zib yuav tsum noj 5-6 zaug nyob rau ib hnub hauv qhov me. Khoom noj yuav tsum muaj cov ntsiab lus tsis muaj calorie thiab cov zaub mov glycemic tsawg lossis nruab nrab kom ib tug neeg tsis nce nrawm thiab tsis txom nyem los ntawm kev hloov pauv hauv cov ntshav qab zib cov ntshav sai. Tsis tas li ntawd, qhov me me ntawm cov zaub mov, nws yooj yim dua mus zom thiab assimilate, thiab lub nra hnyav rau lub plab hnyuv tws hauv lub plab zom mov hauv ntshav qab zib yog qhov tsis zoo.

Thaum muab tso ua ke ntawm cov ntawv qhia zaub mov zoo, tus kws kho keeb, nrog rau tus neeg mob, yuav tsum coj mus rau hauv tus yam ntxwv ntawm nws cov metabolism, saj nyiam, qhov hnyav, hnub nyoog thiab muaj lwm cov kab mob. Kev noj zaub mov uas tsis muaj cov carb qis yog qhov zoo rau qee tus neeg, rau lwm tus, cov zaub mov muaj roj tsawg, thiab qhov peb, cov khoom noj muaj txiaj ntsig nrog cov zaub mov tsis muaj calorie tsawg. Tus tib neeg mus kom ze thiab qhov zoo tshaj plaws ntawm cov khoom noj qab haus huv zoo tshaj plaws hauv kev noj zaub mov yog tus yuam sij rau kev ua tiav ntawm kev kho mob thiab kev ua raws lub neej ntev mus rau kev noj haus tsis muaj swb.

Muaj cov ntsiab cai ntawm lub koom haum ua zaub mov, uas nws yog ntshaw kom ua raws li txhua tus, tsis hais hom kabmob twg:

noj tshais yuav tsum muaj tais diav nrog zaub mov qeeb kom txaus rau lub cev nrog lub zog rau ib hnub,
kev so ntawm cov zaub mov yuav tsum tsis txhob ntau dua 3 teev,
nrog kev xav txog kev tshaib plab, nws yog ib qho tsim nyog yuav tau ntsuas cov ntshav qab zib thiab noj zaub mov zoo (txiv apples, txiv ntoo), thiab nrog hypoglycemia, noj zaub mov nrog cov carbohydrates ceev,
nws zoo dua rau kev sib xyaw nqaij tsis nrog zaub mov, tab sis nrog cov zaub mov sab zaub, vim nws zoo nqus thiab yooj yim kom zom,
koj tsis tuaj yeem mus pw nrog kev zoo siab rau kev tshaib kev nqhis, ua ntej mus pw koj tuaj yeem haus tau ib khob uas muaj roj tsawg dua kefir lossis kua mis nyeem qaub uas tsis muaj cov tshuaj ntxiv.

Plums, beets thiab mis nyuj ua khoom pab txhawm rau txhim kho kev zom zaub mov thiab nce plab hnyuv kom muaj zog. Rau tib lub hom phiaj, koj tuaj yeem haus dej ib khob dej ntawm lub plab tas li 15 feeb ua ntej noj tshais. Qhov no ua kom lub plab zom mov thiab txhim kho kev zom zaub mov.

Hais txog hom mob ntshav qab zib, nws yog qhov tseem ceeb rau tus neeg mob ua raws kev noj haus. Muaj tseeb, muaj ib hom tshuaj insulin-tiv thaiv kab mob, nws tuaj yeem yog qhov hnyav me ntsis, vim tias tus neeg mob ua ntu zus los ntawm kev txhaj tshuaj thiab tuaj yeem suav qhov tsim nyog ntawm cov tshuaj nyob ntawm seb nws npaj noj dab tsi. Tab sis muaj qee kis, txhua tus neeg mob ntshav qab zib yuav tsum tsis txhob noj zaub mov nrog cov khoom noj hauv lub siab, vim nws ua rau muaj kev hloov pauv hauv cov ntshav qab zib thiab ua rau muaj kev txhim kho ntawm cov teeb meem yav tom ntej.

Lub hauv paus ntawm cov khoom noj yuav tsum yog zaub. Lawv muaj cov glycemic tsis tshua muaj siab thiab muaj cov ntsiab lus fiber ntau, uas yog tsim nyog rau kev nquag plob tsis so tswj. Nrog rau cov ntshav qab zib, cov metabolism hauv lub cev poob qis, thiab tus neeg mob yuav cuam tshuam los ntawm cem quav, uas yog fraught nrog intoxication ntawm lub cev. Txhawm rau zam qhov no, nws raug nquahu kom noj zaub 3-4 zaug ib hnub. Lawv muaj cov vitamins thiab pob zeb hauv av uas tsim nyog rau kev ua haujlwm ntawm txhua qhov nruab nrog cev thiab kab ke. Cov txiv hmab txiv ntoo tseem muaj txiaj ntsig zoo rau cov neeg mob ntshav qab zib, tab sis xaiv lawv, koj yuav tsum tau them sai sai rau qhov glycemic index - nws yuav tsum muaj qis lossis nruab nrab.

Qhov tshwj xeeb tshaj yog pab tau rau tus mob ntshav qab zib yog cov khoom noj:

txiv lws suav
pob zaub paj
taub dag
ib cov kua
pear
txiv qaub
pomegranate
txaij
hneev
qij
kua txob.

Ntawm cov ntses thiab nqaij, koj yuav tsum xaiv cov hom ntshiv. Nws yog qhov zoo tshaj plaws los ua noj lawv steamed los yog hauv qhov cub yam tsis ntxiv roj ntau. Nqaij yuav tsum muaj nyob rau hauv cov zaub mov noj txhua hnub, ntses - txog 2 zaug hauv ib as thiv. Tus kws kho mob ntshav qab zib yog pab tau zoo tshaj plaws nrog cov nqaij qaib xyaw nqaij siav los yog ci nqaij qaib. Pollock, hake thiab tilapia yog qhov kev xaiv zoo tshaj plaws rau cov ntses, vim tias cov no yog cov khoom siv roj tsawg nrog kev nplua nuj thiab muaj tshuaj lom neeg. Nws yog qhov tsis tsim nyog rau cov neeg mob noj cov nqaij npuas, rog nqaij nyuj, nqaij ntses, tus hma thiab rog ntses, vim cov khoom no thauj cov txiav thiab nce roj hauv cov ntshav siab.

Cov txiaj ntsig zoo tshaj plaws yog cov nplej porridge, buckwheat, millet thiab pea porridge. Lawv cov glycemic Performance index yog nruab nrab, thiab lawv cov muaj pes tsawg leeg muaj ntau cov vitamins, hlau, calcium thiab lwm yam kab kawm. Thaum tsim cov ntawv qhia zaub mov, cov kab mob ntshav qab zib yuav tsum tau tshem semolina thiab polished nplej los ntawm nws, vim tias tsis muaj ib yam dab tsi pab tau rau lawv nrog cov ntsiab lus muaj calorie siab.

Vim li cas rau kev loj hlob

Qhov thib ob ntawm cov ntshav qab zib feem ntau loj hlob tuaj vim yog kev coj thiab tsim kua muag ntawm lub cev, yog li pathology tshwm sim ntau dua rau cov neeg laus dua 40 xyoo.

Tab sis muaj lwm yam laj thawj thiab ua rau pom kev txhim kho kabmob:

kev kis tus mob. Yog tias muaj cov txheeb ze muaj ntshav qab zib (ntawm txhua yam), tom qab ntawv txoj kev loj hlob ntawm lub pathology nce 50%,
kev rog dhau los yog cov neeg muaj kev cuam tshuam rau kev loj hlob ntawm tus kab mob, txij li cov rog rog txo qhov rhiab ntawm cov hlwb, li no txo cov kev ua haujlwm ntawm cov kabmob,
noj tsis yog. Nquag siv cov piam thaj, rog thiab cov khoom noj ceev nrawm
kev siv hluav taws xob tsawg tsawg, tshwm sim nrog qee yam tsawg ntawm kev ua haujlwm hauv lub cev,
pathological hloov ntawm lub txiav,
nquag muaj cov kab mob cuam tshuam rau kev ua haujlwm ntawm lub plab zom mov,
kev nkees nkees nkees thiab lub cev, nrog rau kev ntxhov siab thiab kev ntxhov siab ntau zaus,
nquag nce hauv siab
noj tshuaj tsis zoo nrog kev txhim kho cov kev mob tshwm sim uas cuam tshuam rau kev ua haujlwm ntawm lub qog.

Pathology kev txhim kho thaum muaj 2 lossis 3 lub laj thawj ntawm ib zaug. Qee zaum kuaj tus kab mob no hauv tus poj niam cev xeeb tub. Hauv qhov no, nws qhov tshwm sim tau cuam tshuam nrog kev hloov hauv hormonal hauv lub cev. Tus kabmob (feem ntau) ploj mus nws tus kheej tom qab xa khoom.

Cov hau kev tiv thaiv ntshav qab zib

Hmoov tsis zoo, muaj kev nce ntxiv ntawm cov neeg mob ntshav qab zib hauv ntiaj teb. Qee zaum, txhawm rau txo cov kev pheej hmoo ntawm pathology, nws tsis tuaj yeem ua rau cuam tshuam txog kev ua txhaum, piv txwv li kev mob siab lossis ib puag ncig ntawm ib puag ncig, tab sis qee qhov nws tseem muaj peev xwm txo qhov muaj feem ntawm pathology.

Txhawm rau tiv thaiv kev txhim kho tus kabmob yuav cia:

hnyav tswj
kev noj haus kom zoo
tshem tawm ntawm kev coj ua tsis zoo,
ntshav qab zib tswj.

Daim Ntawv No. 4. Kev ntsuas tiv thaiv los tiv thaiv tus mob ntshav qab zib:

Kev tiv thaiv ua	Txheej xwm
Kev txheeb xyuas cov neeg muaj kev pheej hmoo.	Qhov feem ntau ua rau mob ntshav qab zib yog rog dhau. Hauv cov txiv neej, txoj kab ncig ntawm lub duav yog siab tshaj li 94 cm, thiab hauv cov poj niam - ntau dua 80 cm, nws yog lub sijhawm los qw lub tswb nrov. Cov neeg zoo li no yuav tsum tau ua tib zoo soj ntsuam thiab kuaj.
Kev soj ntsuam kev pheej hmoo.	Thaum thawj qhov kev ntxhov siab hu rau tus kabmob tshwm, nws yog ib qhov tsim nyog yuav tsum tau kuaj ntshav cov ntshav qab zib. Nws ua rau ntawm lub plab khoob. Xws li kev kuaj mob los ntawm tus kws kho mob endocrinologist, nrog rau lwm tus kws tshaj lij, yog qhov yuav tsum tau kuaj tus kab mob pathologies. Piv txwv, muaj cov kev tsis sib haum xeeb hauv cov hlab plawv cov ntshav yuav ua rau muaj ntshav qab zib ntau dua.
Kev tshem tawm qhov tsis zoo tshwm sim ntawm pathological yam.	Thawj qhov tseem ceeb uas cuam tshuam cov kev hloov pauv hauv lub cev yog qhov hnyav dhau. Yog li ntawd, cov ntsiab lus ntawm cov neeg xav tau: tshem ntawm lub cev nyhav dhau heev lawm, txwv kev noj haus ntawm cov carbohydrates hauv lub cev, nce kev tawm dag zog ntawm lub cev (kev caij tsheb kauj vab, luam dej, seev cev, thiab lwm yam), poob phaus nrog cov ntsiav tshuaj, tsam koj tsis tuaj yeem tiv thaiv ua tsaug rau kev noj haus.

Hauv kev xaus, peb nco ntsoov tias raws li kev tshawb nrhiav haujlwm, nws tau hais tias poob ceeb thawj thiab kev tawm dag zog lub cev ib txwm muaj:

tiv thaiv mob ntshav qab zib
yog tias tam sim no, txo qhov kev loj hlob ntawm cov teeb meem,
kom tau txais qhov zoo ntawm qhov pathology.

Tom qab paub tseeb tias qhov kev ntsuas tsis txaus siab, nws yog ib qho tseem ceeb heev uas hloov pauv koj txoj kev ua neej, pib los ntawm kev noj zaub mov zoo thiab xaus nrog kev noj tshuaj.

Qhov muaj feem thib tau txais cov lus qhia ntawm:

txo ntsev noj,
ua kom tiav kev tshem tawm cov rog thiab cov dej cawv uas muaj cawv,
txo cov roj kom tsawg
kev nce ntxiv ntawm cov vitamins thiab cov as-ham.

Kev tshuaj xyuas cov ntshav qabzib thiab ntshav siab feem ntau yuav tiv thaiv kom tsis txhob muaj ntshav qabzib thiab hyperglycemia, nrog rau kev txhim kho ntawm cov kev mob tshwm sim, uas tuaj yeem yog tus kabmob ntshav qab zib ntau heev.

Kev tswj ntshav qab zib

Kev tshuaj xyuas cov piam thaj tsis tu ncua yog lub hauv paus rau kev kho mob ntshav qab zib txhua yam thiab tiv thaiv cov teeb meem. Yog hais tias tus neeg mob tsis tu ncua siv lub ntsuas ntsuas, nws tuaj yeem paub qhov pib ntawm kev ua ntshav lossis ua ntshav qab zib hauv lub sijhawm. Thaum kuaj pom qhov ua txhaum sai npaum li cas, nws yooj yim los muab kev pab thiab tswj hwm tus neeg mob noj qab haus huv. Ib qho ntxiv, ua tsaug rau kev saib xyuas glycemia ntau zaus, koj tuaj yeem saib xyuas lub cev ntawm cov lus teb rau cov zaub mov tshiab thiab nkag siab tias lawv yuav tsum tau qhia rau hauv cov khoom noj no.

Txhawm rau kom ntsuas rau lub ntsuas ntsuas kom raug qhov tseeb, nws yuav tsum tau ntsuas thiab ntsuas xyuas txhua lub sijhawm siv cov kua nplaum tswj kev ua kua. Kev sim tshuaj ntsuas tsis tuaj yeem siv tom qab hnub tas sij hawm, vim tias cov txiaj ntsig tuaj yeem cuam tshuam loj heev.Nws yog ib qho tseem ceeb kom hloov lub sijhawm hloov lub roj teeb uas ntsia tau rau hauv lub cuab yeej, vim nws tseem cuam tshuam qhov veracity ntawm cov txiaj ntsig tau.

Txhawm rau tswj kev nyob zoo hauv cov neeg mob ntshav qab zib hom 1, yuav tsum muaj kev txhaj tshuaj insulin. Nrog hom mob no, nws tsis tuaj yeem ua yam tsis muaj kev txhaj tshuaj, vim tias lub cev tsis tuaj yeem tsim cov tshuaj insulin nyob rau hauv tus nqi. Tsis muaj kev noj haus yuav cia koj ua kom muaj kev noj qab haus huv ntev ntev yog tias tus neeg mob tsis saib xyuas cov tshuaj hormone los yog ua rau lawv xaiv ib qho. Nws yog ib qho tseem ceeb uas ib tus neeg muaj peev xwm cais nws tus kheej kev tsim nyog tshuaj ntawm kev siv tshuaj, nyob ntawm nws yuav noj dab tsi, thiab nkag siab qhov sib txawv ntawm lub sijhawm ua haujlwm ntawm cov tshuaj insulin luv thiab ntev.

Hauv hom ntshav qab zib hom 2, txiav txiav feem ntau tsim cov insulin txaus (lossis nws txoj haujlwm ua kom tsawg me ntsis). Hauv qhov no, tus neeg mob yuav tsis xav tau kev txhaj tshuaj los ntawm lub cev, thiab txhawm rau kom tswj tau cov ntshav qab zib cov ntshav lub hom phiaj, nws yuav txaus ua raws li kev noj haus thiab kev tawm dag zog. Tab sis yog tias cov tshuaj insulin tiv thaiv ntawm cov ntaub so ntswg muaj ntau heev, thiab cov txheej txheem kev kho mob no tsis muaj txiaj ntsig, raws li cov lus pom zoo thiab cov chaw ua haujlwm, tus neeg mob yuav muab cov tshuaj rau txo cov suab thaj. Tsuas yog tus kws endocrinologist yuav tsum xaiv lawv, txij li kev sim ntawm kev siv tshuaj rau tus kheej tuaj yeem ua rau muaj kev tsis txaus ntseeg hauv qhov mob thiab qhov tshwm sim ntawm tus kab mob.

Ua li cas rau cov ntshav qab zib?

Hom 2 mob ntshav qab zib mellitus (kev noj haus thiab tshuaj sib cuam tshuam: yog tias tsis pom kev noj zaub mov noj, noj tshuaj yuav tsis muaj txiaj ntsig) cuam tshuam kev ua haujlwm ntawm tag nrho cov kab mob. Thaum pib ntawm kev loj hlob ntawm tus kab mob, cov nqaij hloov pauv mus rau insulin tsawg dua. Lub txiav thiab lwm yam kabmob ua haujlwm li qub.

Yog tias tsis muaj kev kho kom zoo, kev saib xyuas cov piam thaj hauv cov ntshav nce ntxiv, uas ua rau "cov suab thaj" ntawm cov protein nyob hauv cov ntshav. Txoj kev hloov pauv no ua txhaum txoj haujlwm ntawm cov kabmob. Lub cev muaj kev paub txog qhov ua kom lub zog ua rau lub cev muaj zog, uas ua rau lub cev tsis ua haujlwm ntawm txhua lub.

Qhov tsis muaj lub zog pib tau nyiaj los ntawm kev tawg ntawm cov roj ntsha. Qhov txheej txheem yog nrog los ntawm tso tawm cov co toxins, uas lom lub cev tag nrho thiab cuam tshuam rau kev ua haujlwm ntawm lub hlwb hlwb.

Muaj piam thaj ntau dhau lawm ua rau lub cev qhuav dej, cov vitamins thiab cov zaub mov muaj txiaj ntsig yog ntxuav nrog dej. Cov xwm txheej ntawm cov hlab ntsha tsis zoo, uas ua rau muaj kev cuam tshuam ntawm lub siab. Tsis tas li, kev pheej hmoo ntawm clogging ntawm cov hlab ntshav nce. Raws li qhov no, lub zeem muag, kev ua haujlwm ntawm lub siab thiab lub raum yog cuam tshuam, vim tias cov kabmob no muaj ntau cov hlab ntsha me. Ntshav cov ntshav ncig hauv cov nqua.

Cev xeeb tub thiab ntshav qab zib

Yog tias kev xeeb tub tshwm sim tiv thaiv keeb kwm ntawm cov ntshav qab zib hom 1 tam sim no, tus pojniam yuav tau yoog cov tshuaj insulin. Hauv kev txiav plaub hau sib txawv, qhov xav tau ntawm cov tshuaj no nws txawv, thiab nws yog qhov cuam tshuam tau tias hauv qee lub sijhawm cev xeeb tub lub cev muaj peev xwm tuaj yeem ua ib ntus yam tsis muaj kev txhaj tshuaj. Tus kws kuaj mob endocrinologist, uas, ua ke nrog kws kho mob yug menyuam yaus yuav saib xyuas tus neeg mob thaum lub sijhawm xeeb tub, yuav tsum tau koom nrog kev xaiv cov koob tshuaj tshiab thiab hom tshuaj.

Muaj ib hom mob uas tshwm sim rau cov poj niam lub sijhawm muaj menyuam hauv plab - nws yog tus mob ntshav qab zib hauv lub cev. Hauv qhov no, tus neeg mob yog yuav luag tsis tau sau cov tshuaj insulin, thiab cov ntshav qab zib cov ntshav yuav rov qab zoo li qub, ua tsaug rau cov zaub mov noj. Tag nrho cov khoom noj qab zib thiab txiv hmab txiv ntoo uas muaj cov khoom noj muaj carbohydrate siab, qab zib, ncuav thiab ncuav qab zib tsis suav rau hauv cov zaub mov. Tus poj niam cev xeeb tub yuav tsum tau txais cov carbohydrates los ntawm cereals, nplej zom los ntawm durum nplej thiab zaub.Kev noj zaub mov ntawm cov neeg mob uas muaj mob ntshav qab zib muaj mob mellitus yog qhov tsim nyog los txo cov kev pheej hmoo ntawm kev loj hlob ntawm kev xeeb menyuam hauv plab thiab teeb meem kev yug menyuam, thiab nws tseem pab tiv thaiv kev hloov mus ntxiv rau tus kabmob ntshav qab zib kom "puv" ntshav qab zib. Ua raws li cov lus pom zoo ntawm tus kws kho mob tuaj koom, raws li txoj cai, tom qab yug tus me nyuam, teeb meem ntawm cov khoom noj carbohydrate metabolism ploj, thiab cov ntshav qab zib cov ntshav yuav rov ua haujlwm li qub.

Kev Tiv Thaiv Kab Mob Ntshav Qab Zib

Mob taw rau tus mob ko taw yog ib qho mob hnyav ntxiv ntawm ntshav qab zib mellitus, uas yog tus cwj pwm los ntawm cov kev hloov pauv pathological hauv cov nqaij mos ntawm qhov qis qis. Thawj cov tsos mob tej zaum yuav loog thiab tingling ntawm daim tawv nqaij, qhov hloov pauv ntawm nws cov xim thiab ib feem ploj ntawm qhov kev paub tab thiab qhov mob rhiab. Nyob rau hauv lub neej yav tom ntej, mob rwj yog tsim rau hauv ko taw, tshwm sim los ntawm kev tsis txaus ntawm cov ntaub so ntswg hauv zos, uas kho tsis zoo thiab ntev ntev. Yog hais tias tus mob koom nrog cov qhov txhab ntub, qhov kev pheej hmoo ntawm kev loj hlob mob qog txhawm rau nce ntxiv, uas tuaj yeem ua rau txiav tes taw thiab tuag taus.

Txhawm rau tiv thaiv qhov txaus ntshai txaus ntshai ntawm tus kab mob, koj yuav tsum:

ua raws li kev nyiam huv ntawm tus kheej thiab ua kom koj txhais ko taw huv si
tsis tu ncua tshuaj xyuas cov tawv nqaij ntawm ob txhais ceg rau kev raug mob me, abrasions thiab kab nrib pleb,
niaj hnub tus kheej zaws ntawm tus taw txhawm rau txhim kho ntshav ncig thiab sab hauv,
tom qab cov txheej txheem dej, muab cov phuam so tawv nqaij kom huv si,
xaiv khau zoo rau kev niaj hnub hnav tsis muaj siab heels,
moisturize daim tawv nqaij tsis tu ncua nrog qab zib los yog lotion kom nws tsis txhob qhuav tawm.

Thaum lub sijhawm teem sijhawm sab laj ntawm tus endocrinologist, nws yog ib qho tsim nyog rau tus kws kho mob kuaj xyuas tus neeg mob ob txhais ceg thiab, yog tias tsim nyog, sau ntawv rau cov chav kawm ntawm cov tshuaj txhawm rau txhim kho ntshav microcirculation. Ntawm polyclinics, raws li txoj cai, chav ntawm cov mob ko taw ua haujlwm, qhov chaw uas tus neeg mob tuaj yeem ntsuas qhov rhiab ntawm daim tawv nqaij ntawm ob txhais ceg thiab ntsuas lawv qhov mob.

Tiv thaiv teeb meem raum thiab qhov muag

Ntshav qab zib nephropathy yog lwm qhov kev cuam tshuam ntawm tus kab mob uas hloov zuj zus sai nrog cov ntshav qab zib. Vim tias qhov tseeb tias cov ntshav siab ntau hauv cov piam thaj ua rau cov ntshav khov dua, nws yuav dhau los ua nyuaj rau lub raum yuav lim nws. Yog hais tias tus neeg mob txhim kho kev mob ntshav siab hauv kev sib txig, cov teeb meem no tuaj yeem ua rau lub raum tsis ua haujlwm thiab xav tau kev lim ntshav tas mus li (siv "raum cuav" lub tshuab).

Txhawm rau txo txoj kev pheej hmoo ntawm kev tsim muaj mob nephropathy, koj yuav tsum:

tsis tu ncua ntsuas ntshav qab zib thiab tswj nws ntawm cov phiaj,
txwv txiav cov ntsev kom tsawg nyob hauv kev noj zaub mov kom tsis txhob ua rau o nra thiab siab,
yog tias pom muaj protein hauv cov zis, yuav tsum noj zaub mov kom muaj protein tsawg
tshuaj xyuas cov cim qhia ntawm cov rog metabolism thiab tiv thaiv kev muaj zog hauv cov roj cholesterol.

Ib qho tseem ceeb ntxiv uas raug kev mob ntshav qab zib yog qhov muag. Mob ntshav qab zib retinopathy (kev hloov pauv pathological ntawm tus Retina) tuaj yeem ua rau txo qis qhov pom thiab tseem dig muag. Txog kev tiv thaiv, nws yog qhov yuav tsum tau mus ntsib tus kws kho qhov muag txhua txhua rau lub hlis thiab kuaj xyuas cov nyiaj. Kev tshuaj xyuas cov ntshav qabzib kom tsis tu ncua yog qhov zoo tshaj plaws los txhawm rau tiv thaiv teeb meem kev mob hlwb txha hnyav. Nws yog vim tias cov ntshav qab zib ntau hauv cov ntshav uas muaj kev hloov pauv hauv cov ntshav me thiab ua rau tsis pom kev. Hmoov tsis zoo, kev rov qab zoo siab yuav luag tsis yooj yim uas yuav zam rau, tab sis nws txoj kev txhim kho tuaj yeem nres thiab qeeb.

Mob ntshav qab zib mellitus tsis yog kab mob uas ntshav qab zib nce siab dua li ib txwm. Qhov kev mob nkeeg no yog qhov cim tseg rau txhua qhov ntawm tus neeg lub neej, yuam nws ua tib zoo mloog xaiv cov khoom noj thiab npaj cov kev ua noj ua haus txhua hnub. Tab sis ua raws li cov lus pom zoo ntawm cov kws kho mob thiab mloog koj tus kheej txoj kev noj qab haus huv, koj tuaj yeem kawm ua neej nyob nrog tus kab mob no yam tsis tau xav txog nws tas li.Nrog rau cov ntshav qab zib kom tau txais txiaj ntsig, qhov kev pheej hmoo ntawm cov kev tsis sib haum yog qhov tsawg, thiab tus neeg mob lub neej zoo heev.

Cov tsos mob ntawm Ntshav Qab Zib Hom 2

Nyob rau theem pib, tus kab mob no tau ua tiav yam tsis pom muaj tsos mob. Yog tias tsis pom tus kab mob lossis kev kho tsis tau txais, tus kab mob tseem ntxiv nrog nrog cov yam ntxwv ntawm tus yam ntxwv:

ib qho kev xav ntawm dryness nyob rau hauv lub qhov ncauj kab noj hniav, nrog los ntawm kev nqhis dej uas tsis xav tau. Qhov tsos mob no tshwm sim vim yog qhov tseeb tias cov kua ntshav ntau yuav tsum tshem cov piam thaj ntau ntawm cov ntshav. Lub cev siv ntawm qhov no tag nrho cov kua dej thiab dej los ntawm cov ntaub so ntswg,
kev tsim cov zis muaj ntau npaum li cas, raws li ib tug tshwm sim, ib tug neeg nquag mus tso quav,
nce tawm hws, uas nce ntxiv thaum pw tsaug zog,
nce dryness ntawm daim tawv nqaij thiab mucous daim nyias nyias, nrog los ntawm khaus,
tsis muaj dej noo thiab tsis zoo ntawm lub paj optic ua rau tsis pom kev,
cov microcracks thiab cov qhov txhab zoo mob kom qeeb qeeb,
kev sib tw ntswg dhau ntawm cov leeg nqaij cov nqaij tshwm sim vim yog qhov ua haujlwm tsis zoo ntawm lub cev tsis txaus siab,
o ntawm cov kawg nrog mob thiab loog,
vim tias tsis muaj lub zog, muaj lub zog ua kom tsis muaj zog, ua kom qab los noj mov ntau thiab qeeb,
qhov muaj zog txo hauv kev tiv thaiv kab mob, hauv kev txuas nrog qhov no muaj feem ntau ntawm khaub thuas.

Hauv thawj theem, muaj qhov nce siab ntawm kev qab los noj mov, nkees thiab kev xav tau rau lub cev ntau dhau. Txhawm rau tshem tawm / paub meej txog ntshav qab zib, nws yog qhov yuav tsum tau sab laj nrog kws kho mob / kws kho menyuam yaus kom kuaj ntshav qab zib. Thaum pib ntawm tus kab mob, nws txaus los kho kev noj haus rau kev kho mob.

Nyob ntawm seb mob hnyav npaum li cas, cov kho mob thiab cov teeb meem uas tshwm sim los ntawm tus kab mob, cov ntshav qab zib tau muab faib ua 4 qib qhov mob hnyav.

Cov qib ntawm pathology	Tus yam ntxwv tseem ceeb	Cov yam ntxwv sib txawv
Yooj Yim	Tus kab mob no tshwm sim nrog cov ntshav qab zib me ntsis, uas ua rau nqhis dej ntau ntxiv, ua kom muaj zog thiab cov leeg tsis muaj zog. Tsis pom muaj kev hloov pauv hauv lub cev. Raws li kev kho, kev kho qhov tseeb hauv kev noj haus yog siv. Kev siv tshuaj tau tawm hauv qee kis tsawg.	Nyob rau theem no, mob ntshav qab zib raug kuaj pom muaj tsawg zaus, feem ntau ntawm kev kuaj mob thaum kuaj ntshav. Cov nkauj muaj zis tsis hloov pauv. Cov piam thaj nyob hauv thaj tsam 6-7 mmol / L.
Qhov nruab nrab	Cov tsos mob ntawm tus kab mob nce ntxiv. Muaj kev tsis zoo hauv kev ua haujlwm ntawm cov plab hnyuv siab raum ntawm lub zeem muag, cov hlab ntsha, cov ntshav tsis txaus rau cov ceg. Yuav tsis pom qhov ua tiag tiag hauv lub cev. Txoj kev kho yog nrog noj thiab noj tshuaj.	Cov piam thaj hauv qab zib yog ib txwm, nyob ntawm cov ntshav yog 7-10 mmol / L.
Hnyav	Cov tsos mob muaj lus tshaj tawm. Muaj qhov ua tsis zoo ntawm lub cev ua haujlwm (tsis pom kev, ua kom lub cev tsis muaj ntshav siab, mob ib ce thiab tshee ntawm cov leeg). Thaum kho, cov zaub mov nruj thiab tswj hwm kev siv tshuaj insulin yog siv (tshuaj tsis muab txiaj ntsig).	Zis thiab ntshav muaj ntshav qab zib ntau. Hauv cov ntshav, qhov siab yuav txawv nyob ntawm thaj tsam ntawm 11-14 mmol / L.
Nce qhov loj	Kev ua txhaum ntawm kev ua haujlwm ntawm cov plab hnyuv siab raum yog qhov tseeb yuav tsis ua kom rov zoo. Tus kab mob yuav kho tsis tau; kev saib xyuas cov piam thaj tas li thiab nws txoj cai los ntawm txhaj tshuaj insulin.	Cov kua nplaum nyob hauv thaj tsam li 15-25 mmol / L. Tus neeg mob feem ntau poob rau hauv cov ntshav qab zib tsis xeev.

Me ntsis mus rau mob ntshav qab zib kom yooj yim kho thiab tswj ntshav qab zib. Hauv cov theem no, tsis muaj lub cev ua haujlwm tsis zoo hauv lub cev. Kev noj zaub mov zoo, poob phaus thiab noj tshuaj qee zaum ua rau nws ua tiav qhov ua kom tiav tag nrho.

Kev txo cov tshuaj muaj piam thaj

Ntshav qab zib Hom 2 yog pib tshem tawm los ntawm kev noj haus. Thaum kev kho mob tsis pom tshwm sim, tus kws kho mob tshwj xeeb tshaj tawm txog kev noj tshuaj uas txo cov piam thaj hauv ntshav. Thaum pib kho, 1 hom tshuaj kho yog raug xaj.Txog rau qhov ua haujlwm ntawm kev kho mob, tus naj npawb ntawm cov tshuaj tau nce zuj zus.

Cov hom tshuaj ntshav hypoglycemic thiab lawv cov nyhuv:

Hom tshuaj	Lawv lub hom phiaj	Lub npe tshuaj
Glinides thiab sulfonylureas	Muab tso rau kev nce qib ntawm kev tsim cov tshuaj insulin los ntawm lub cev ntawm nws tus kheej.	Repaglinide, glibenclamide, chlorpropamide.
Biguanides thiab Glitazones	Txo cov khoom tsim tawm ntawm cov piam thaj hauv daim siab thiab ua rau cov neeg mob ntawm cov nqaij mos ua kom qab zib. Ua rau kom qhov txo qis qis tsis qab.	Metformin, pioglitazone.
Alpha Glucosidase Inhibitors	Txo qhov feem pua ntawm cov piam thaj tau los ntawm cov ntaub so ntswg.	Miglitol, tus tuav pov hwm, acarbose.
Glyptins thiab glucagon-zoo li peptide receptor agonists	Ua kom cov insulin ntau ntxiv thiab tib lub sijhawm ua kom cov suab thaj txo qis.	Exenatide, saxagliptin, lixisenatide.
Cov tshuaj insulin	Txhawb nqa qhov nqus ntawm cov piam thaj los ntawm cov ntaub so ntswg lub cev.	Cov tshuaj insulin
Thiazolidone derivatives	Txhim kho qhov kev cuam tshuam ntawm cov cell receptors rau insulin.	Troglitazone, rosiglitazone.

Feem ntau, 2 lossis 3 cov tshuaj sib txuam nrog cov tshuaj tau sau tseg. Kev siv nyiaj ib txhij los txhawm rau tsim cov tshuaj insulin ntau dua, nrog cov tshuaj uas cuam tshuam rau kev nkag siab ntawm lub hlwb mus rau lub cev, yuav ua tiav kev txo qis hauv cov ntshav qab zib.

Nws yog qhov txaus ntshai rau ywj siab xaiv cov tshuaj siv. Qhov ua rau cov suab thaj txo ntau ntxiv ua rau muaj kev cuam tshuam rau lub cev ua haujlwm. Yog tias cov tshuaj ua rau muaj kev phiv, nws yog hloov los ntawm tus kws kho mob. Nrog qhov tsis muaj txiaj ntsig ntawm kev noj tshuaj, tus neeg mob pauv mus rau tshuaj insulin.

Noj cov ntshav qab zib hom 2. Cov ntsiab cai ntawm khoom noj khoom haus

Thaum kho ntshav qab zib, koj yuav tsum tau yoog tas mus li rau kev noj haus uas yog nyob ntawm qhov mob hnyav, muaj ntau qhov hnyav thiab ua si lub cev. Cov ntawv qhia zaub mov yuav tsum pom zoo nrog tus kws tshaj lij uas tuaj koom. Nrog rau kev hloov pauv hauv cov piam thaj (nce ntxiv los sis txo qis), tus kws kho hloov pauv kev noj zaub mov.

Thaum ua raws kev noj haus, yuav tsum ua raws qhov tseem ceeb:

kev noj zaub mov yuav tsum tshwm sim ntawm qee lub sijhawm tsawg kawg 6 zaug hauv ib hnub,
cov khoom noj yuav tsum tsis txhob muaj cov khoom noj muaj roj thiab hauv plab yooj yim,
nyob rau hauv qhov muaj qhov hnyav dua, nws yog ib qhov tsim nyog los txo cov calories ntau ntawm cov tais diav,
tus nqi ntawm cov ntsev noj yuav tsum yog tsawg kawg,
cawv thiab cov khoom noj txom ncauj yoo mov tsis suav nrog,
cov txiv hmab txiv ntoo muaj txiaj ntsig zoo thiab tau txais txiaj ntsig ntawm cov tshuaj vitamin npaj kom muaj zog tiv thaiv.

Kev noj zaub mov zoo thiab kev kho mob ntshav qab zib hom 2 yog ob qhov kev sib txuam nrog lwm yam. Qee zaum koj tsis tas yuav thov tshuaj yog koj kho cov zaub mov kom zoo

Nws raug nquahu kom ua zaub mov noj yam tsis siv roj lossis muaj qhov tsawg kawg ntawm nws (koj tuaj yeem rhaub, ci). Nws yog qhov tsim nyog yuav tau nce cov dej huv siv ib hnub. Thaum sau cov ntawv qhia zaub mov, nws yog ib qho tsim nyog yuav tsum coj mus rau hauv tus account qhov muaj lwm cov kab mob pathologies (kab mob ntawm lub plab zom mov, plawv, raum).

Cov Khoom Txwv Txwv

Hom 2 mob ntshav qab zib mellitus (kev noj haus thiab kev kho yuav ua rau muaj txiaj ntsig zoo, nrog kev noj zaub mov kom zoo) hauv ib daim ntawv me me tuaj yeem tshem tawm los ntawm kev tshem tawm cov zaub mov tsis zoo thiab cov zaub mov ntawm cov zaub mov noj.

Cov Khoom Muaj Zog Txwv	Muaj Mob Tsis Raug Cov Khoom Noj
Lauj kaub tais diav thiab zaub mov muaj cov carbohydrates zom.	Qos qos, hau xwb. Carrots thiab beets.
Cov khoom lag luam nrog cov ntsiab lus zoo ntawm cov piam thaj (qab zib, txiv hmab txiv ntoo qhuav).	Cereals, tshwj tsis yog semolina.
Lauj kaub tais diav thiab khoom los ntawm cov hmoov nplej	Cov khoom siv los ntawm wholemeal thiab rye hmoov.
Cov tais diav nrog cov ntsiab lus ntawm ntsev, kua txob, roj.	Legumes thiab taum cov qoob loo.
Cov khoom siv mis ua kom muaj roj ntau.	Lub taub
Lub cev rog thiab roj ua kom rog.
Nqaij thiab ntses nrog lub siab ua cov roj, cov kaus poom, haus luam yeeb.
Cov txuj lom, cov txuj ci, cov qab rog.

Tus nqi ntawm kev siv cov khoom lag luam raug txwv yuav tsum pom zoo nrog tus kws tshaj lij. Lawv nce qib ntawm cov piam thaj, tab sis maj mam. Nyob rau tib lub sijhawm, haus 2 lossis ntau hom khoom muaj npe los ntawm daim ntawv teev npe uas raug cai txwv tsis pub siv.

Yuav soj ntsuam cov ntshav qabzib ntshav qab zib li cas?

Ntawm ntshav qab zib, yuav tsum tau saib xyuas qib qab zib kom tsis tu ncua. Ib qhov glucometer yog siv los ntsuas nws hauv tsev. Qhov tsim nyog yog ntsuas ntsuas txhua hnub, ua ntej noj zaub mov. Yog tias ua tau, ces ntsuas thaum nruab hnub (tom qab noj mov tag, muab lub cev ua haujlwm loj).

Txhua cov ntaub ntawv yuav tsum tau sau rau hauv phau ntawv sau tshwj xeeb, uas yuav tsum qhia tus kws kho mob thaum kuaj xyuas tom ntej. Lub zog ntawm cov piam thaj hloov yuav raug kho cov kev kho (tshuaj noj, noj zaub mov). Ib qho ntxiv, koj yuav tsum tau soj ntsuam hauv qhov chaw kuaj ntshav txhua 3-6 hlis (teem los ntawm koj tus kws kho mob).

Sau cov Khoom Uas Tau Tso Cai nrog GI Kev Pom Zoo

Ntawm cov ntshav qab zib, cov khoom lag luam hauv qab no raug tso cai rau kev noj nyob rau hauv ib qho kev txiav txim siab, tab sis coj mus rau hauv tus account lawv cov calorie cov ntsiab lus thiab GI.

Cov Khoom Qhia	GI (glycemic Performance index)
Hau qe	48
Hau nceb noj	15
Hiav txwv kale	22
Hau pob kws tus ntses	5
Kefir	35
Kua mis	30
Tsev cheese	45
Tofu cheese	15
Tsawg rog mis	30
Zaub paj zaub	10
Dib lauj	10
Txiv lws suav	20
Txaij	20
Tau cov txiv ntseej	15
Radish	10
Cov txiv apples	30
Cwj	34
Plum	22
Txiv duaj	22
Rye qhob cij	45
Dill	15
Zaub xam lav	10
Hlaws barley rau ntawm cov dej	22
Cov nplej zom ntxas tag nrho	38
Oatmeal	40
Khob cij yob	45
Marmalade	30

Daim ntawv no tuaj yeem nthuav dav los ntawm tus kws kho mob, coj mus rau hauv kev ua si lub cev thiab ua mob hnyav.

Cov tshuaj kho neeg mob

Hom 2 mob ntshav qab zib mellitus (kev noj haus thiab kev kho mob - qhov xwm txheej tsim nyog los tiv thaiv kev txhim kho ntawm cov kev mob tshwm sim thiab ntxiv cov kab mob ntxiv) tuaj yeem txuas ntxiv los ntawm kev kho mob ntawm pej xeem. Lawv siv yog pom zoo kom tham nrog koj tus kws kho mob.

Cov zaub mov txawv uas ua rau cov txheej txheem hauv lub cev hauv lub cev ua kom zoo thiab pab txhawb rau kom yuag:

Hauv 0.4 l ntawm cov dej npau, do 70 ml ntawm zib ntab thiab 40 g ntawm cinnamon qhuav (hmoov). Yaum ib hnub nyob rau hauv qhov txias. Cov dej haus tau muab faib ua 2 txoj haujlwm. Txhawm rau siv thaum sawv ntxov thiab yav tsaus ntuj. Lub sijhawm kho yog txog 14 hnub.
Zog nyob rau hauv 0.5 l dej 10-12 pcs. Bay nplooj. Haus 30 ml 3 zaug. Lub chav kawm yog 10 hnub. Nws yog ib qho tsim nyog yuav tau ua 3 chav kawm nrog so ntawm 10 hnub.
Hloov cov tshuaj yej nplooj, muab cov paj linden paim. Haus li 2 khob tshuaj rau ib hnub.
Finely chop 350 g ntawm qej thiab parsley thiab 100 g ntawm txiv qaub zest. Do thiab hais kom txog li 14 hnub thaum mob khaub thuas. Haus 10-12 mg ib hnub twg.
Boil 20 g ntawm taum nyob rau hauv 1 liter dej (4 teev). Kev haus ntau txog 300 ml ib hnub (tuaj yeem faib ua ntu). Lub sijhawm tiv thaiv yog 31 hnub.
Cov dej qab zib uas tau npaj tseg siv tshuaj yej (haus dej haus 400 ml ib hnub) los ntawm:

John lub wort, chamomile, blueberry,
aspen xyoob ntoo,
taum nplooj
tag nrho cov cinnamon.

Nyob rau hauv muaj ntawm intolerance los yog kev fab tshuaj tsis haum, dej qab zib yog cais tawm ntawm kev noj haus.

Lub cev qoj ib ce

Lub xub ntiag ntawm kev tawm dag zog lub cev yuav tsum ua, txawm tias tsis muaj teeb meem qhov hnyav. Cov kev tawm dag zog tuaj yeem ua haujlwm li qub ntawm lub plawv, cov hlab ntsha thiab cov hlab ntsws ua pa, thiab ua kom lub cev ntawm lub cev kom ruaj khov.

Thaum cov chav kawm, nws yog ib qho tseem ceeb uas yuav tsum coj lub nra mus rau hauv qhov tseeb, txij li qhov muaj calorie ntau ntxiv ua rau kev tshaib kev nqhis, thiab zaub mov, tom qab kev tawm dag zog, tuaj yeem nqus nrog kev tso ntshav qab zib mus rau hauv cov ntshav.

Cov kev ua si pom zoo rau cov ntshav qab zib:

dumbbell ce muaj zog
taug kev hauv lub tiaj ua si lossis khiav teeb,
kev caij tsheb kauj vab
ua luam dej
yoga
ua las voos zoo nkauj.

Nws raug nquahu kom tham txog hom haujlwm nrog tus kws tshwj xeeb uas tuaj koom. Raws li tau siv lub sijhawm tsim nyog ntawm cov txheej txheem.

Cov kab mob muaj teeb meem

Thaum kuaj pom tus kab mob thaum theem qeeb, tsis kho txaus lossis tus neeg mob tsis ua raws li cov lus pom ntawm tus kws tshaj lij, cov teeb meem phom sij tuaj yeem tsim:

O o. Edema tuaj yeem tsim tsis tsuas yog sab nraud (caj npab, ceg, ntsej muag), tab sis kuj tuaj yeem sab hauv lub cev. Nyob ntawm seb qhov kev pabcuam twg yog kev txhim kho ntawm cov tsos mob. Nws tuaj yeem yog kev txhim kho lub plawv lossis lub raum tsis ua haujlwm, uas kuj tuaj yeem txhim kho uas yog cov mob ntshav qab zib.
Mob mob hauv ceg. Cov tsos mob pib tshwm sim nrog lub cev ua kom lub zog zoo. Nrog txoj kev loj hlob ntawm tus kab mob, mob yog cuam tshuam thaum tsaus ntuj. Ib qho ntxiv, khaus ntawm qhov kawg thiab poob ib ntus ntawm lub qhov muag pom tshwm. Tej zaum ib tug hlawv lom zem.
Cov tsos ntawm cov rwj. Vim tias cov piam thaj hauv siab, cov mob ua kom zoo tsis zoo thiab rau lub sijhawm ntev, uas ua rau txoj hauv kev txhim kho ntawm qhov txhab qhib. Tus kws kho mob pom zoo tias txawm tias kev txiav me me yuav tsum ua tib zoo kho kom txog thaum lub qhov txhab raug kho kom zoo.
Kev ua laibCov. Muaj ntshav qab zib, lub xeev cov hlab ntsha cuam tshuam, uas tuaj yeem ua rau lawv txhaws. Feem ntau, cov xwm txheej no tau sau tseg rau ntawm cov nqua. Raws li qhov tshwm sim ntawm kev tsim ntawm cov ntshav txhaws, ntshav tshiab nrog cov pa oxygen thiab cov as-ham tsis nkag rau hauv lub dab teg / ko taw. Ntaub nqaij tuag. Liab pib tshwm sim, nrog mob thiab o. Yog tias tsis muaj kev kho mob, tom qab ntawd ntxiv tig xiav. Cov nqua tau txiav npluav.
Nce / txo siab. Ib qho pauv ntawm qhov loj ntawm lub ntsuas qhov ntsuas feem ntau tshwm sim vim qhov ua haujlwm ntawm lub raum.
Coma Tus mob no tuaj yeem tshwm sim nrog kev nce ntxiv hauv cov piam thaj hauv qab lossis txo qis (vim tias muaj ntau dhau ntawm cov tshuaj insulin). Los yog vim qhov kev lom hnyav ntawm lub cev los ntawm co toxins, uas tsim tawm thaum tsim lub zog los ntawm cov rog rog. Hauv qhov no, tus neeg mob dhau los ua khaub thuas nrog txias thiab nplaum hws, hais lus yuav tsis txaus ntseeg thiab tsis nco qab. Nrog rau kev nce ntxiv hauv cov piam thaj, ib qho ntxhiab tsw ntawm cov kab mob acetone tshwm. Tom qab ntawd muaj qhov ploj ntawm kev nco qab. Yog tsis muaj kev pab, kev tuag sai heev yog qhov ua tau.
Pom kev tsis pom kevCov. Vim yog khoom noj tsis zoo ntawm cov ntaub so ntswg ntawm lub qhov muag thiab cov leeg. Thaum pib, dots, veil tshwm sim, maj mam ua tiav qhov muag tsis pom kev tuaj yeem tsim.
Lub raum tsis zoo. Vim yog qhov hnyav ntawm lub plab hnyuv siab raum, lub raum tsis ua haujlwm.

Hauv kev kho mob ntshav qab zib, kev txhim kho ntawm lub txim yuav tuaj yeem zam. Kev txiav txim siab kom raws sij hawm ntawm qhov pib ntawm kev txhim kho ntawm cov teeb meem yuav tshem tawm lawv cov kev nce ntxiv.

Cov lus qhia soj ntsuam rau tus mob ntshav qab zib hom 2

Yog tias kuaj tau ntshav qab zib, yuav tsum muaj kev thov sai rau tus kws kho mob thiab kuaj ntshav qab zib. Thaum paub tseeb tias tus kabmob, koj yuav tsum tau kuaj mob tag nrho. Tom ntej no, koj yuav tsum tau ua raws txhua qhov kev teem sijhawm ntawm tus kws kho mob tshwj xeeb (noj zaub mov, noj tshuaj, tawm dag zog). Nco ntsoov txheeb xyuas rau qhov concentration ntawm cov piam thaj hauv cov ntshav. Yog tias tus mob hloov, tus kws kho mob koom yuav tsum kho qhov kev kho mob.

Mob ntshav qab zib mellitus tuaj yeem tsim maj mam thiab kuaj pom twb muaj nyob rau theem nrab. Nrog hom 2, lub hauv paus ntawm kev kho mob yog kev noj haus. Nrog daim foos siab, kev siv tshuaj kho mob lossis txhaj tshuaj insulin yog qhov tsim nyog.

Tshooj qauv: Mila Friedan