Ntshav qab zib rau cov laus

Kev kho mob ntshav qab zib hauv hnub nyoog laus yog qhov teeb meem ceev rau ntau tus nyeem ntawm peb lub xaib. Yog li ntawd, peb tau npaj kom muaj ncauj lus ntxaws ntxaws ntawm cov ncauj lus no, sau ua hom lus siv tau. Cov neeg mob thiab cov kws kho mob tshwj xeeb tuaj yeem tshawb pom txhua yam lawv xav tau ntawm no txhawm rau txhawm rau tshuaj thiab kho ntshav qab zib rau cov laus.

Yuav kho cov ntshav qab zib kom siab li cas ib tus neeg laus laus tuaj yeem tau txais yog nyob ntawm nws tus kheej thiab nws cov neeg txheeb ze nyiaj txiag, thiab nws puas muaj kev nyuaj siab vim tsis muaj ntshav qab zib. Txawm li cas los xij, cov ntaub ntawv hauv tsab xov xwm no yuav pab ua kom qhov siab tshaj plaws hauv kev tiv thaiv ntshav qab zib, uas yog qhov ua tau rau hauv cov xwm txheej uas tus neeg laus laus.

Vim li cas pheej hmoo mob ntshav qab zib nce zuj zus thaum laus

Txij li lub hnub nyoog 50-60 xyoo, kev tso kua nplaum nyob hauv cov neeg feem coob tsis tuaj yeem txo qis. Hauv kev coj ua, qhov no txhais tau tias tom qab 50 xyoo rau txhua txhua 10 xyoo txuas ntxiv:

• yoo ntshav qab zib nce ntxiv los ntawm 0.055 mmol / l;
• ntshav qabzib concentration 2 teev tom qab noj mov nce txog 0.5 mmol / l.

Thov nco ntsoov tias cov no tsuas yog cov ntsuas nruab nrab xwb. Hauv txhua tus neeg laus, cov ntshav qab zib ntau yuav hloov pauv lawv tus kheej. Thiab raws li, qhov kev pheej hmoo ntawm kev tsim cov ntshav qab zib hom 2 hauv qee cov neeg laus yuav muaj ntau dua nyob hauv lwm tus. Nws nyob ntawm txoj kev ua neej uas ib tus neeg laus coj - rau feem ntau, ntawm nws lub cev ua si thiab khoom noj haus.

Postprandial glycemia yog ntshav qab zib tom qab noj mov. Nws feem ntau ntsuas 2 teev tom qab noj mov. Nws yog qhov ntsuas no uas nce nrawm rau cov laus, uas coj mus rau kev txhim kho ntshav qab zib hom 2. Tib lub sijhawm, kev yoo mov glycemia tsis hloov pauv ntau.

Vim li cas thiaj li muaj peev xwm thev qabzib thiaj cuam tshuam nrog lub hnub nyoog? Qhov tshwm sim no muaj ntau qhov laj thawj uas ua rau lub cev tib lub sijhawm. Cov no suav nrog:

• Hnub nyoog ntsig txog txo qis hauv cov ntaub so ntswg rhiab rau insulin;
• Tsawg cov zais hlaus pancreatic cov kua dej;
• Kev zais cia thiab qhov kev txiav txim ntawm cov tshuaj hormones incretin tsis muaj zog hauv lub hnub nyoog laus.

Hnub nyoog txog kev hloov hauv cov nqaij hloov pauv mus rau insulin

Qhov poob qis hauv kev nkag siab ntawm lub cev nqaij rau insulin yog hu ua insulin tsis kam. Nws tshwm sim hauv ntau tus neeg laus. Tshwj xeeb tshaj yog rau cov neeg hnyav dua qub. Yog tias koj tsis ua cov txheej txheem kho, tom qab ntawv qhov no feem ntau yuav ua rau mob ntshav qab zib hom 2.

Muaj zog insulin ntau zog yog qhov ua rau muaj mob ntshav qab zib hom 2 nyob rau lub hnub nyoog laus. Cov kws tshawb nrhiav tseem sib cav hais tias puas tseem tuaj yeem tiv thaiv cov ntaub so ntswg insulin yog cov txheej txheem ntawm kev laus. Lossis puas yog vim nws lub neej tsis zoo rau kev laus hauv lub hnub nyoog?

Txog ntawm kev noj qab haus huv, cov neeg laus noj, rau feem ntau, pheej yig, cov zaub mov muaj calorie ntau. Cov khoom noj no muaj qhov tsis zoo ntawm cov rog kev lag luam thiab cov carbohydrates, uas tau nqus sai. Tib lub sijhawm, nws feem ntau tsis muaj protein, fiber ntau thiab complex carbohydrates, uas tau yaim qeeb.

Tsis tas li ntawd, cov neeg laus dua, raws li txoj cai, muaj cov kab mob sib kis thiab noj tshuaj rau lawv. Cov tshuaj no feem ntau muaj qhov tsis zoo ntawm cov metabolism hauv kev ua noj. Cov tshuaj txaus ntshai tshaj plaws los ua kom koj muaj ntshav qab zib:

• thiazide diuretics;
• beta blockers (tsis yog xaiv);
• tshuaj steriods;
• tshuaj psychotropic.

Tib yam kab mob uas ua rau koj yuam ntau yam tshuaj txwv lub cev ua neeg laus. Nws tuaj yeem yog cov pathologies ntawm lub plawv, lub ntsws, lub cev thiab cov leeg pob txha thiab lwm yam teeb meem. Raws li qhov tshwm sim, cov leeg nqaij pob yog qhov txo qis, thiab qhov no yog qhov laj thawj tseem ceeb rau nce insulin tsis kam.

Hauv kev xyaum, nws pom tseeb tias yog koj hloov mus rau lub neej noj qab haus huv, txoj kev pheej hmoo ntawm kev tsim tus mob ntshav qab zib hom 2 hauv hnub nyoog laus yog txo kaum zaus, uas yog, yuav luag txog xoom. Yuav ua li cas ua li no - koj yuav kawm ntxiv hauv peb tsab xov xwm.

Pancreatic cov kua dej tso pa tawm

Yog tias tus neeg tsis mob rog, tom qab ntawd muaj qhov tsis xws luag ntawm qhov insulin los ntawm tus txiav yog qhov laj thawj tseem ceeb ntawm kev txhim kho ntshav qab zib hom 2. Rov qab hais tias rau cov neeg muaj rog, kev tawm tsam insulin yog qhov tseem ceeb tshaj plaws rau cov ntshav qab zib, txawm hais tias tus txiav ua kab mob siab insulin ua rau ib txwm muaj.

Thaum ib tus neeg noj zaub mov nrog cov khoom noj carbohydrates, cov ntshav qabzib nce siab. Hauv kev teb rau qhov no, txiav ua tus tsim cov tshuaj insulin. Pancreatic insulin secretion nyob rau hauv kev teb rau cov "carbohydrate" "tso" tshwm sim hauv ob ntu hu ua theem.

Thawj theem yog cov tshuaj insulin ntau heev, uas siv sijhawm ntev li 10 feeb. Qeb thib ob yog kev ntws ntawm cov ntshav dej mus rau hauv cov ntshav, tab sis nws kav ntev dua, ntev txog 60-120 feeb. Thawj theem ntawm kev zais ntshis yog xav kom “txhawm rau” kom cov ntshav qabzib ntau ntxiv nyob hauv cov ntshav uas tshwm sim tom qab noj mov tas.

Cov kev tshawb fawb qhia tias hauv cov neeg laus tsis muaj lub cev nyhav dhau los, thawj theem ntawm cov insulin secretion txo qis dua. Feem ntau yuav ua, muaj tseeb vim tias qhov no, cov piam thaj hauv cov ntshav ntshav 2 teev tom qab cov zaub mov nce siab, xws li, los ntawm 0.5 mmol / l rau txhua txhua 10 xyoo tom qab 50 xyoo.

Cov kws tshawb fawb tau pom tias hauv cov neeg laus dua nrog lub cev hnyav li qub, qhov kev ua haujlwm ntawm cov glucosinase gene tau txo qis. Cov noob no muab tau qhov rhiab ntawm pancreatic beta hlwb rau kev ua kom lub ntsej muag ntawm cov piam thaj. Nws qhov tsis xws luag tuaj yeem piav qhia txog qhov txo qis hauv cov kua dej hauv cov lus teb rau kev nkag ntawm cov piam thaj hauv cov ntshav.

Ua li cas kev zais cia thiab qhov kev txiav txim ntawm kev hloov pauv hauv cov laus

Incretins yog cov tshuaj hormones uas tsim tawm hauv txoj hnyuv hauv kev teb rau kev noj zaub mov. Lawv ntxiv kev tsim tawm cov tshuaj insulin los ntawm cov txiav ua ntshav. Rov qab hais tias cov nyhuv loj tseem ceeb ntawm cov kua dej tso pa tawm muaj qhov nce ntxiv ntawm cov piam thaj hauv ntshav.

Qhov kev txiav txim ntawm incretins tau pib kom raug mob siab kawm tsuas yog pib thaum pib ntawm nees nkaum-caug xyoo. Nws tau muab tawm tias ib txwm, thaum noj ntawm qhov ncauj (los ntawm qhov ncauj), insulin carbohydrates yog tsim txog 2 zaug ntau dua li cov lus teb rau kev saib xyuas cov tshuaj ntawm qhov sib npaug ntawm cov piam thaj.

Cov kws tshawb fawb tau tawm tswv yim tias thaum lub sijhawm noj mov thiab tom qab noj mov, qee yam tshuaj (cov tshuaj hormones) yog tsim tawm hauv txoj hnyuv plab uas ntxiv cov tshuaj tua kom ua kom cov kua ntshav ua kom insulin. Cov tshuaj hormones no hu ua incretins. Lawv cov qauv thiab cov haujlwm ntawm kev nqis tes ua twb to taub lawm.

Cov nce ntxiv yog cov tshuaj hormones glucagon-zoo li peptide-1 (GLP-1) thiab glucose-nyob insulinotropic polypeptide (HIP). Nws tau pom tias GLP-1 muaj cov nyhuv loj dua ntawm tus txiav. Nws tsis tsuas yog tsim kho cov kua dej hauv cov zais, tab sis kuj tseem thaiv cov khoom ntawm glucagon, tus "antagonist" ntawm cov kua dej.

Cov kev tshawb fawb pom tau tias hauv cov neeg laus, cov khoom tsim los ntawm cov tshuaj hormones GLP-1 thiab GUI tseem nyob rau tib theem li hauv cov tub ntxhais hluas. Tab sis qhov rhiab heev ntawm pancreatic beta hlwb rau qhov kev txiav txim ntawm incretins txo nrog lub hnub nyoog. Qhov no yog ib qho ntawm cov txheej txheem rau kev tsim cov ntshav qab zib, tab sis tseem ceeb dua qis dua insulin tsis kam.

Kev kuaj mob ntshav qab zib hauv cov neeg laus

Cov neeg noj qab haus huv tau hais qhia tom qab 45 txhawm rau kuaj ntshav qab zib ib zaug txhua 3 xyoos. Nug saib ntshav ua ntshav qab zib cov qauv yog li cas. Thov nco ntsoov tias kev ntsuas cov ntshav qab zib sai tsis haum rau kev kuaj ntshav qab zib. Vim hais tias nyob hauv ntau cov neeg mob ntshav qab zib, kev yoo cov ntshav qab zib kom lub cev tseem nyob li qub. Yog li, peb xav kom coj mus kuaj ntshav rau glycated hemoglobin.

Txhawm rau kom nkag siab txog kev kuaj mob ntshav qab zib, ua ntej nyeem ib tsab xov xwm txog nws. Thiab ntawm no peb yuav los tham txog qee yam tshwj xeeb ntawm kev paub txog ntshav qab zib hauv cov neeg laus.

Kev kuaj mob ntshav qab zib hom 2 hauv cov neeg laus yog qhov nyuaj vim tias cov kab mob feem ntau tau nce mus yam tsis muaj tsos mob dab tsi. Cov neeg mob laus dua yuav tsis muaj kev yws yws rau qhov nqhis dej, khaus, poob phaus, lossis tso zis heev.

Nws yog qhov tshwj xeeb tshaj yog cov neeg laus cov ntshav qab zib tsis tshua yws txog nqhis dej. Qhov no yog vim qhov tseeb hais tias qhov chaw nruab nrab ntawm nqhis dej rau lub paj hlwb pib ua haujlwm zuj zus vim muaj teeb meem nrog cov hlab ntsha. Coob tus neeg laus muaj cov nqhis dej tsis muaj zog thiab, vim tias qhov no, tsis txaus hloov cov kua dej hauv lub cev. Yog li, lawv feem ntau kuaj mob ntshav qab zib thaum lawv mus rau hauv tsev kho mob thaum nyob hauv hyperosmolar tsis nco qab vim yog lub cev qhuav dej tsis txaus.

Hauv cov neeg mob laus, tsis hais meej, tab sis cov kev tsis txaus siab dav dav predominate - tsis muaj zog, nkees, kiv taub hau, teeb meem nco qab. Cov txheeb ze tuaj yeem nco ntsoov tias cov dementia senile tab tom muaj ntau zuj zus. Saib cov tsos mob no, tus kws kho mob feem ntau tsis paub txog tias tus neeg laus yuav muaj ntshav qab zib. Raws li, tus neeg mob tsis kho rau nws, thiab qhov tshwm sim muaj teeb meem.

Ntau dhau lawm, cov ntshav qab zib hauv cov neeg laus raug kuaj pom los ntawm kev ua yuam kev lossis twb dhau ntawm theem lig, thaum ib tus neeg kuaj mob vascular mob hnyav heev. Vim tias kev kuaj mob ntshav qab zib lig rau cov neeg laus, ntau dua 50% ntawm cov neeg mob nyob rau hauv pawg no yuav mob hnyav: muaj teeb meem rau lub siab, txhais ceg, qhov muag thiab raum.

Hauv cov neeg laus qub, lub raum pib nce mus. Cia peb kawm saib nws yog dab tsi. Hauv cov tub ntxhais hluas, cov kua nplaum nyob hauv cov zis thaum nws cov concentration hauv cov ntshav yog li 10 mmol / L. Tom qab 65-70 xyoo, "lub raum pib" hloov mus rau 12-13 mmol / L. Qhov no txhais tau hais tias txawm tias nws tseem muaj nyiaj ntau txaus rau cov ntshav qab zib hauv ib tus neeg laus, cov piam thaj tsis nkag rau hauv cov zis, thiab nws muaj feem tsawg nws yuav kuaj mob raws sijhawm.

Kev mob ntshav siab ntshav qis hauv cov neeg laus - muaj kev pheej hmoo thiab qhov tshwm sim

Ua ntej, peb pom zoo kom nyeem kab lus "Hypoglycemia hauv ntshav qab zib." Kev mob ntshav qab zib hauv lub hnub nyoog laus yog phom sij heev. Vim tias feem ntau ua rau kom tuag, uas zoo li tuag los ntawm kev mob plawv.

Kev tshwm sim ntawm cov ntshav qog ntshav qab zib hauv cov neeg laus ntshav qab zib sib txawv ntawm cov tsos mob "qub" uas tau pom hauv cov neeg hluas. Cov yam ntxwv ntawm kev mob ntshav qab zib hauv cov neeg laus:

• Nws cov tsos mob feem ntau yog lwv thiab qhia tsis zoo. Kev mob ntshav qab zib tsawg nyob rau hauv cov neeg laus yog feem ntau "zais" raws li qhov pom ntawm lwm tus kab mob thiab, yog li ntawd, tseem tsis tau raug kuaj.
• Hauv cov neeg laus, kev tsim cov tshuaj hormones adrenaline thiab cortisol feem ntau yog neeg tsis taus. Yog li ntawd, cov tsos mob tiag tiag ntawm hypoglycemia tej zaum yuav tsis tuaj: palpitations, trembling, thiab tawm hws. Tsis muaj zog, nkees nkees, tsis meej pem, amnesia tuaj ua ntej.
• Hauv lub cev ntawm cov neeg laus, cov tswv yim rau kev kov yeej lub xeev ntawm kev mob ntshav qab zib yog qhov tsis txaus, i.e., cov txheej txheem tawm tsam ua haujlwm tsis zoo. Vim tias qhov no, hypoglycemia tuaj yeem coj qhov xwm txheej ntev.

Vim li cas cov ntshav qab zib hauv lub cev laus thiaj li muaj kev phom sij? Vim tias nws ua rau mob plawv mob rau cov neeg mob ntshav qab zib tsis ua siab ntev tshwj xeeb. Kev mob ntshav qab zib tsawg nce siab yuav ua rau muaj kev ploj tuag los ntawm lub plawv nres, mob hlab ntsha tawg, plawv nres, lossis txhaws lub nkoj loj nrog ntshav khov.

Yog tias tus neeg laus ntshav qab zib yog muaj hmoo txaus kom tsim nyog muaj txoj sia nyob tom qab lub qog ntshav qab zib, tom qab ntawv nws yuav nyob nrog tus neeg xiam oob qhab vim tsis muaj kev cuam tshuam ntawm lub hlwb. Qhov no tuaj yeem tshwm sim mob ntshav qab zib thaum muaj hnub nyoog yau, tab sis rau cov neeg laus txoj kev yuav muaj qhov tshwm sim loj yog tshwj xeeb.

Yog tias tus neeg mob ntshav qab zib mob ntshav qab zib muaj ntau yam tsis tuaj yeem thiab tsis paub txog, ces qhov no ua rau poob, uas nrog kev raug mob. Ntog nrog hypoglycemia yog ib qho kev tshwm sim ntawm pob txha lov, cuam tshuam ntawm pob qij txha, puas tsuaj rau cov nqaij mos. Kev mob ntshav qab zib ntshav siab thaum muaj hnub nyoog laus tuaj yeem ua rau muaj kev pheej hmoo ntawm cov pob txha duav.

Kev mob ntshav qab zib nyob rau hauv cov neeg laus ntshav qab zib feem ntau tshwm sim vim qhov tseeb tias tus neeg mob noj ntau yam tshuaj, thiab lawv muaj kev sib cuam tshuam. Qee cov tshuaj yuav txhim kho cov teebmeem kev mob ntshav qab zib, sulfonylurea derivatives. Lwm tus - txhawb kev zais lub cev ntawm insulin lossis nce rhiab ntawm cov hlwb rau nws qhov kev txiav txim.

Qee cov tshuaj thaiv ntawm lub cev kev xav ntawm cov tsos mob ntawm tus mob ntshav qab zib yog qhov tshwm sim, thiab tus neeg mob tsis tuaj yeem nres nws hauv lub sijhawm. Xav txog txhua txoj kev tuaj yeem cuam tshuam txog kev siv yeeb tshuaj hauv cov neeg laus neeg mob ntshav qab zib yog ib txoj haujlwm nyuaj rau tus kws kho mob.

Cov lus qhia qee qhov ua tau rau cov kev sib txuam yeeb tshuaj uas feem ntau ua rau cov ntshav qog ntshav qab zib:

Qhov zoo dua ntawm cov ntshav qab zib tswj kom nws cov ntshav qab zib kom ze rau qhov nyob ib puag ncig, qhov tsawg dua nws yuav yog qhov muaj teebmeem thiab qhov nws hnov ​​zoo dua. Tab sis qhov teeb meem yog tias cov ntshav qabzib zoo tswj tau nrog tus "mob" rau kev kho mob ntshav qab zib, feem ntau muaj ntshav qab zib ntau tshwm sim. Thiab rau cov neeg laus laus, nws muaj kev phom sij tshwj xeeb.

Nov yog qhov xwm txheej uas ob qho kev xaiv tsis zoo. Puas muaj lwm txoj hauv kev daws teeb meem ntxiv? Yog lawm, muaj ib txoj hauv kev uas koj tuaj yeem tswj ntshav qab zib kom tau zoo thiab tib lub sijhawm tswj hwm qhov muaj ntshav qab zib tsawg tsawg. Txoj hau kev no yog kom txwv tsis pub cov khoom noj carbohydrates hauv cov zaub mov uas muaj ntshav qab zib, noj cov protein thiab cov rog hauv lub plawv yog qhov tseem ceeb rau lub siab.

Noj tsawg cov carbohydrates uas koj noj, koj qhov xav tau cov tshuaj insulin lossis ntshav qab zib kom tsawg dua koj cov piam thaj. Thiab raws li, qhov tsis tshua muaj tshwm sim uas koj yuav tshwm sim hypoglycemia. Khoom noj, uas muaj protein, feem ntau yog cov rog zoo thiab fiber ntau, yuav pab ua kom cov ntshav qabzib nyob ze li qub.

Ntau tus neeg mob uas muaj ntshav qab zib hom 2, suav nrog cov neeg laus, tom qab hloov mus rau kev noj haus uas tsis muaj cov carbohydrate ntau yuav ua rau cov tshuaj insulin thiab cov piam thaj txo qis. Tom qab qhov no, hypoglycemia tsis tuaj yeem tshwm sim txhua. Txawm hais tias koj tsis tuaj yeem dhia "dhia" los ntawm insulin, ces qhov kev xav tau nws yuav txo qis. Thiab cov tshuaj insulin tsawg dua thiab cov tshuaj koj tau txais, qis dua qhov yuav ua rau muaj kev mob ntshav qab zib tsawg.

Kev kho mob ntshav qab zib hom 2 rau cov neeg laus

Kev kho mob ntshav qab zib hom 2 hauv cov neeg laus feem ntau yog ib txoj haujlwm nyuaj tshwj xeeb rau tus kws kho mob. Vim tias nws feem ntau yog qhov nyuaj los ntawm kev muaj ntau ntawm cov kab mob sib kis hauv cov ntshav qab zib, cov xwm txheej hauv lub neej (kev nyob ib leeg, kev txom nyem, tsis paub pab), kev kawm tsis tau tus neeg mob tsis zoo, thiab txawm tias senile dementia.

Tus kws kho mob feem ntau yuav tsum tau muab tshuaj ntau rau cov neeg laus laus uas muaj ntshav qab zib. Nws tuaj yeem nyuaj rau kev txiav txim siab txhua qhov lawv tau muaj kev cuam tshuam nrog txhua lwm. Cov neeg mob ntshav qab zib feem ntau qhia cov neeg mob qis kawg rau kev kho, thiab lawv txwv tsis pub noj tshuaj thiab ntsuas kev kho lawv tus mob.

Feem coob ntawm cov neeg mob ntshav qab zib nyob rau hauv cov kev mob tshwm sim tsis zoo. Vim tias qhov no, lawv feem ntau tsim kev tsis nco qab lossis kev poob siab tob. Hauv cov neeg mob ntshav qab zib, kev nyuaj siab ua rau qhov tseeb tias lawv ua txhaum kev coj noj coj ua thiab tsis zoo tswj lawv cov ntshav qab zib.

Lub hom phiaj ntawm kev kho ntshav qab zib rau txhua tus neeg laus cov neeg mob yuav tsum teeb tsa tus kheej. Lawv vam khom:

• lub neej cia siab rau;
• kev coj mus ua ntshav nce siab ntau dua;
• puas muaj cov kab mob plawv;
• muaj ntshav qab zib mob uas twb tau tsim los lawm?
• raws li lub xeev kev mob hlwb ntawm tus neeg mob tso cai rau koj ua raws li kws kho mob cov lus pom zoo.

Nrog lub neej muaj kev cia siab (lub neej muaj kev cia siab) ntau dua 10-15 xyoo, lub hom phiaj ntawm kev kho mob ntshav qab zib hauv lub hnub nyoog laus yuav tsum ua tiav glycated hemoglobin HbA1C <7%. Nrog lub neej ua haujlwm tsawg dua 5 xyoos - HbA1C <8%. Yuav kom txo qis ntshav piam thaj nyob rau hauv cov neeg laus ntshav qab zib yuav tsum tau zoo, maj mam.

Kev tshawb fawb hauv 2000s ua pov thawj pom zoo tias siv cov kev qhia ntawm kev mob siab, tswj kev mob ntshav qab zib, qhov no nce ntau qhov tshwm sim muaj ntshav nce siab ntau thiab tuag ntawm cov neeg laus muaj mob ntshav qab zib hom 2. Yog li, nws yog ib qho tsim nyog yuav tsum ua kom cov ntshav khov ntawm cov ntshav qis maj mam dhau mus ntau lub hlis.

Thaum kho ntshav qab zib hauv cov neeg laus, nws yog ib qho tsim nyog yuav tsum tswj hwm tsis tsuas cov ntshav qab zib, tab sis kuj muaj roj cholesterol, triglycerides thiab ntshav siab. Tag nrho cov ntsuas no yuav tsum tswj hwm qhov kev txwv tsis pub tiv thaiv kev txhim kho ntawm cov teeb meem. Yog tias lawv hloov siab los ntawm tus qauv, ces tus kws kho mob tau tshaj tawm txoj kev kho mob kom tsim nyog: kev noj zaub mov, tshuaj los ntawm chav kawm ntawm statins, tshuaj rau kub siab (nyeem kuj peb lub chaw ntawm kev kho mob ntshav siab).

Tam sim no, cov kws kho mob lub tsev muag khoom muaj cov qauv hauv qab no los kho cov neeg mob ntshav qab zib hom 2, suav nrog cov neeg laus:

• tsis muaj tshuaj noj ntshav qab zib kev kho mob (kev noj haus thiab ua si lub cev);
• siv tshuaj kho ntshav qab zib (ntsiav tshuaj);
• tshuaj insulin.

Tshuaj ntshav qab zib thiab txhaj tshuaj insulin yuav tau tham hauv qab no. Lawv qhov kev txiav txim yog txhawm rau txhim kho ntau yam kev txhim kho ntawm kev txhim kho kabmob:

• nce siab ntawm cov ntaub so ntswg mus rau kev ua ntawm insulin (txo qis hauv insulin tsis kam);
• kev tsim tawm ntawm insulin secretion, tshwj xeeb tshaj yog nws theem thaum ntxov (peb tsis pom zoo kom noj cov tshuaj noj uas txhawb cov tshuaj insulin! Tsis kam lawv!);
• rov qab los ntawm cov nyhuv stimulating ntawm cov tshuaj hormones ntawm incretins ntawm lub txiav.

Cov sijhawm zoo rau kev kho mob ntshav qab zib tau nthuav dav txij li thib ib nrab ntawm 2000s, nrog kev muaj yeeb tshuaj tshiab los ntawm cov pab pawg ntxiv. Cov no yog cov tshuaj tiv thaiv ntawm dipeptidyl peptidase-4 (gliptins), nrog rau mimetics thiab analogues ntawm GLP-1. Peb qhia koj kom ua tib zoo kawm cov ntaub ntawv hais txog cov tshuaj no ntawm peb lub vev xaib.

Peb pom zoo kom cov neeg laus hloov mus rau kev noj zaub mov kom tsawg hauv cov ntshav qab zib kom muaj ntshav qab zib, ntxiv rau lwm qhov kev kho ntxiv. Kev noj haus carbohydrate-txwv kev txwv tsis pub noj yog qhov tsis ua hauj lwm zoo rau lub raum. Hauv txhua lwm yam mob, nws pab tswj cov ntshav qab zib kom nyob sib luag, zam qhov "jumps" thiab txo qhov yuav ua rau muaj ntshav qab zib tsawg.

Kev tawm dag zog lub cev rau cov neeg laus ntshav qab zib

Kev tawm dag zog lub cev yog qhov tseem ceeb ntawm txoj kev kho mob ntshav qab zib kom ua tiav. Rau txhua tus neeg mob, tshwj xeeb tshaj yog cov neeg laus, kev xaiv lub cev yog xaiv ntawm tus kheej, coj mus rau hauv tus account concomitant kab mob. Tab sis lawv yuav tsum muaj. Koj tuaj yeem pib nrog kev taug kev rau 30-60 feeb.

Vim li cas kev tawm dag zog yog qhov tseem ceeb rau cov ntshav qab zib:

• nws nce rhiab heev ntawm cov ntaub so ntswg rau insulin, uas yog, txo cov tshuaj insulin;
• kev tawm dag zog lub cev nres qhov kev txhim kho atherosclerosis;
• kev qoj ib ce txo qis ntshav siab.

Qhov xov xwm zoo: Cov neeg mob ntshav qab zib laus yuav ntxim nyiam lub cev ntau dua li cov hluas.

Koj tuaj yeem xaiv koj tus kheej ib hom kev tawm dag zog uas yuav ua rau koj nyiam. Peb pom zoo kom koj nyeem phau ntawv los ntawm Chris Crowley thiab Henry Lodge "yau dua txhua xyoo."

Nov yog phau ntawv zoo tshaj plaws hais txog txoj kev noj qab haus huv-kev kawm paub lub cev thiab kev ua lub neej nquag rau cov neeg laus. Thov siv nws cov lus pom zoo raws li koj lub cev mob. Tshawb cov ntsiab lus ntawm kev tiv thaiv cov qog ntshav qab zib thaum lub ce.

Kev tawm dag zog hauv ntshav qab zib yog contraindicated hauv cov xwm txheej hauv qab no:

• nrog rau cov kev them nyiaj tsis txaus rau ntshav qab zib;
• nyob rau hauv lub xeev ketoacidosis;
• nrog lub siab tsis khov;
• yog hais tias koj muaj proliferative retinopathy;
• hauv mob raum ua tsis zoo.

Ua ntej koj mob siab rau kev kawm paub lub cev, sab laj nrog kws kho mob. Nyeem peb cov ncauj lus kom ntxaws "Kev tawm dag zog ua rau ntshav qab zib."

Mob ntshav qab zib tshuaj rau cov neeg laus cov neeg mob

Hauv qab no, koj yuav kawm txog cov tshuaj kho ntshav qab zib thiab seb lawv siv los kho cov neeg laus li cas. Yog tias koj muaj ntshav qab zib hom 2, peb xav kom koj ua cov hauv qab no:

1. Txhawm rau kom koj cov ntshav qab zib kom qis thiab kom nws nyob ze rau qhov ib txwm nyob, ua ntej tshaj yog sim kom tau cov khoom noj carbohydrate-txwv kom tsawg.
2. Kuj koom nrog kev tawm dag zog uas koj tuaj yeem ua thiab coj kev zoo siab. Peb tsuas yog tham txog lo lus nug saum toj no.
3. Tsawg kawg li ntawm 70% ntawm cov neeg mob uas muaj ntshav qab zib hom 2 tau noj zaub mov txaus nrog kev txwv cov carbohydrates thiab lub cev ua rau lub cev ua kom cov ntshav qab zib muaj zog. Yog tias qhov no tsis txaus rau koj - sim kev tshuaj ntsuam kom kuaj ob lub raum thiab tham nrog koj tus kws kho mob yog tias koj tuaj yeem sau tshuaj metformin (siofor, glucophage). Tsis txhob noj Siofor yam tsis muaj kev pom zoo los ntawm kws kho mob! Yog lub raum ua haujlwm tsis zoo, cov tshuaj no tuag taus.
4. Yog tias koj pib noj cov tshuaj metformin - tsis txhob tsum qhov qis-carbohydrate cov zaub mov kom tsawg thiab ua kom tawm dag zog.
5. Nyob rau hauv txhua rooj plaub, tsis kam noj tshuaj uas txhawb cov tshuaj insulin zais cia! Cov no yog sulfonylureas thiab meglitinides (clayides). Lawv ua rau lawv tsis zoo. Ua cov tshuaj insulin yog qhov muaj txiaj ntsig zoo dua li kev noj cov tshuaj no.
6. Them nyiaj tshwj xeeb rau cov tshuaj tshiab los ntawm pawg incretin.
7. Xav tias hloov pauv mus rau insulin yog tias muaj qhov xav tau tiag tiag rau qhov no, i.e. kev noj zaub mov kom tsawg, ua kom tawm dag zog thiab noj tshuaj los pab rau koj cov ntshav qab zib tsis txaus.
8. Nyeem “hom 2 kev kho mob ntshav qab zib.”

Metformin - tshuaj kho tus mob ntshav qab zib hom 2 rau cov laus

Metformin (muag hauv qab cov npe Siofor, glucophage) yog thawj qhov tshuaj xaiv rau cov neeg laus ntshav qab zib. Nws tau sau tseg yog tias tus neeg mob tau khaws lub raum lim kev ua haujlwm (lub siab txhaws qhov siab tshaj 60 ml / min) thiab tsis muaj cov kab mob concomitant uas muaj kev pheej hmoo ntawm hypoxia.

Nyeem peb cov ntawv xov xwm metformin (siofor, glucophage). Metformin yog cov tshuaj zoo heev uas tsis tsuas txo cov ntshav qab zib, tab sis kuj muaj cov txiaj ntsig zoo rau lub cev. Nws tsis muaj (tseem tsis tau pom) cov kev mob tshwm sim, zoo li lwm yam tshuaj siv ntshav qab zib.

Metformin tsis ua rau lub cev ua kom yuag, tsis ua rau lub qog ntshav nce ntshav, thiab tsis ua kom lub cev yuag. Ntawm qhov tsis sib xws, nws txhawb nqa poob phaus. Koj tuaj yeem cia siab tias koj yuav poob li 1-3 kg lossis ntau dua los ntawm kev noj cov tshuaj metformin. Hauv ntau cov neeg mob ntshav qab zib, nws thawj zaug ua rau kev txhawm thiab kem plab, tab sis tom qab ib pliag lub cev yoog thiab cov teeb meem no ploj mus.

Thiazolidinediones (glitazones)

Thiazolidinediones (glitazones) tau pib siv los kho ntshav qab zib thaum pib ntawm 20 - 21 xyoo pua. Zoo li metformin, lawv nce qhov rhiab ntawm cov nqaij (nqaij, rog hlwb, nplooj siab) rau kev ua ntawm insulin. Cov tshuaj no tsis txhawb cov tshuaj insulin secretion, thiab yog li ntawd tsis nce qhov muaj peev xwm ua kom tus mob ntshav qab zib tsawg.

Thiazolidinediones thaum lub sij hawm monotherapy txo qis theem ntawm glycated hemoglobin HbA1C los ntawm 0.5-1.4%. Tab sis lawv tsuas cuam tshuam yog tias tus txiav ua ntej tsim cov tshuaj insulin. Yog li, lawv tsis muaj txiaj ntsig rau cov neeg mob uas muaj ntshav qab zib hom 2 ntev heev, thiab lub cev ntaj ntsug yuav ploj mus.

Cov tshuaj tiv thaiv ntshav qab zib Glitazone ua zoo ib yam li metformin, tab sis, ntawm kev tsis sib haum, muaj cov kev mob tshwm sim loj heev. Cov npe ntawm cov tsis zoo no suav nrog:

• kev saib xyuas dej hauv lub cev;
• hnyav;
• leeb kev loj hlob ntawm lub plawv nres.

Thiazolidinediones (glitazones) yog qhov ua rau pom kev mob ntshav lossis lub plawv tsis ua haujlwm ntawm ib chav kawm ua haujlwm. Hauv cov neeg laus mob ntshav qab zib, kev siv cov tshuaj no nyuaj rau cov hauv qab no:

• Cov neeg mob ntshav qab zib feem ntau mob lub plawv tsis ua hauj lwm sib txawv, vim yav dhau los lub plawv mob (plawv nres).
• Thiazolidinediones (glitazones) pab txhawb kev txhim kho txha, i.e., leaching ntawm calcium los ntawm cov pob txha. Lawv nce feem ntau ntawm cov pob txha lov rau cov neeg mob laus 2 npaug zog dua li lwm cov tshuaj noj ntshav qab zib. Qhov kev pheej hmoo no tseem muaj ntau dua rau cov poj niam tom qab lawm.

Qhov zoo ntawm kev siv thiazolidinediones rau ntshav qab zib yog tias lawv tsis nce ntxiv ntawm kev mob ntshav qab zib. Txawm hais tias qhov txiaj ntsig tseem ceeb no, glitazones tsis yog thawj kab kev xaiv rau kev kho mob ntshav qab zib hauv cov laus.

Sulfonylureas

Cov tshuaj rau cov ntshav qab zib hauv pab pawg no tau siv txij li 50 ntawm xyoo pua nees nkaum. Lawv “nplawm” lub qe ntshav qab zib uas ua rau lawv mob kom lawv thiaj li muaj cov insulin ntau dua. Siv tau kom txog rau thaum lub cev muaj peev xwm los tsim nws cov insulin yog ua kom tiav.

Vim li cas peb pom zoo kom txhua tus neeg mob ntshav qab zib nres tsis noj cov tshuaj no:

• Lawv ntxias kev tsis pom kev. Lwm txoj hauv kev los txo cov ntshav qab zib tsis muaj qhov phem tshaj li sulfonylurea derivatives, thiab tsis nce qhov kev pheej hmoo ntawm hypoglycemia.
• Cov tshuaj no thaum kawg "tiav tawm" qhov ua tiav. Txawm hais tias nws yuav siv tau zoo rau tus neeg mob kom nws muaj peev xwm los tsim tsawg kawg ntawm nws cov insulin
• Lawv ua rau qhov hnyav hauv lub cev. Cov kev xaiv ntshav qab zib lwm txoj hauv qab yuav txo cov ntshav qab zib kom tsis muaj kab mob phem dua, thiab tib lub sijhawm tsis nce rog.

Koj yuav muaj peev xwm nco tau qhov ua kom koj cov ntshav qabzib hauv qib siab, tsis muaj tshuaj ntawm pab pawg no thiab tsis muaj kev phiv tshuaj. Feem ntau, cov neeg mob ntshav qab zib sim noj sulfonylurea derivatives ua qhov chaw kawg, yog li kom tsis txhob tso cov tshuaj insulin. Cov “kev kho mob” no ua rau muaj mob rau lawv lub cev. Xav tias yuav pib kho cov tshuaj insulin, yog tias muaj kev qhia rau nws. Nyeem “hom 2 kev kho mob ntshav qab zib.”

Meglitinides (Clinids)

Zoo li sulfonylurea derivatives, cov tshuaj no txhawb cov beta hlwb ua kom cov insulin ua hauj lwm ntau dua. Meglitinides (glinids) pib ua sai sai, tab sis lawv cov txiaj ntsig tsis ntev, ntev txog 30-90 feeb. Cov tshuaj no yog sau ua ntej noj mov.

Meglitinides (glinides) yuav tsum tsis txhob siv rau tib qho laj thawj li sulfonylureas. Lawv pab kom "ua rau kom tsis txhob muaj ntshav qabzib ntau ntxiv" tom qab noj mov tas. Yog tias koj tsum tsis noj cov khoom noj carbohydrates uas nqus sai, ces koj yuav tsis muaj qhov nce no txhua.

Dipeptidyl Peptidase-4 Tus Inhibitors (Gliptins)

Rov qab nco qab tias glucagon zoo li peptide-1 (GLP-1) yog ib ntawm cov tshuaj hormones ntawm incretins. Lawv txhawb cov txiav ua ntej kom tsim cov tshuaj insulin thiab tib lub sijhawm txwv kev tsim cov glucagon, tus “thaiv” tawm ntawm cov kua dej. Tab sis GLP-1 ua tsuas yog tsuav cov ntshav qab zib cov qib tseem nyob siab.

Dipeptidyl peptidase-4 yog ib qho enzyme uas ib txwm rhuav tshem GLP-1, thiab nws qhov kev txiav txim siab raug tso tseg. Cov tshuaj noj los ntawm cov pab pawg ntawm dipeptidyl peptidase-4 inhibitors tiv thaiv qhov enzyme no los ntawm kev ua kom pom nws cov haujlwm. Daim ntawv teev cov kev npaj glyptin suav nrog:

• vildagliptin (galvus);
• sitagliptin (Januvia);
• saxagliptin (onglise).

Lawv thaiv (inhibit) kev ua ub no ntawm ib qho enzyme uas rhuav tshem hormone GLP-1. Yog li, cov ntsiab lus ntawm GLP-1 nyob rau hauv cov ntshav nyob rau hauv kev cuam tshuam ntawm cov tshuaj muaj peev xwm nce ntxiv mus rau ib theem li 1.5-2 npaug siab dua qib physiological. Raws li, nws yuav muaj zog ntxiv ua rau lub txiav ua kom tso cov kua dej mus rau hauv cov ntshav.

Nws yog ib qho tseem ceeb tias cov tshuaj los ntawm cov pab pawg ntawm dipeptidyl peptidase-4 cov tshuaj tiv thaiv ua rau lawv cov nyhuv tsuas yog thaum cov piam thaj hauv ntshav nce siab. Thaum nws poob rau qhov ib txwm ua (4.5 mmol / L), cov tshuaj no yuav luag tsis taus los tsim cov tshuaj insulin thiab thaiv kev tsim cov glucagon.

Cov txiaj ntsig ntawm kev kho mob ntshav qab zib hom 2 nrog cov tshuaj los ntawm cov pab pawg ntawm dipeptidyl peptidase-4 inhibitors (gliptins):

• lawv tsis nce tiv thaiv kev phom sij ntawm hypoglycemia;
• tsis ua rau lub cev hnyav;
• lawv cov kev mob tshwm sim - tshwm sim tsis ntau dua li thaum noj cov placebo.

Hauv cov neeg mob ntshav qab zib muaj hnub nyoog 65 xyoos, kho nrog DPP-4 inhibitors thaum tsis muaj lwm yam tshuaj ua rau muaj qhov txo qis ntawm glycated hemoglobin HbA1C los ntawm 0.7 txog 1.2%. Txoj kev pheej hmoo ntawm kev ua qog ntshav ntshav tsawg tsawg, ntawm 0 txog 6%. Hauv pawg tswj cov neeg mob ntshav qab zib uas tau noj cov placebo, qhov pheej hmoo ntawm cov ntshav qog ntshav nce siab li 0 txog 10%. Cov ntaub ntawv no tau txais tom qab kev tshawb fawb ntev, los ntawm 24 txog 52 lub lis piam.

Cov tshuaj noj los ntawm cov pab pawg ntawm dipeptidyl peptidase-4 inhibitors (gliptins) tuaj yeem ua ke nrog lwm cov tshuaj mob ntshav qab zib, tsis muaj kev pheej hmoo ntawm kev phiv. Ntawm qhov kev txaus siab tshwj xeeb yog lub sijhawm los muab tshuaj rau lawv nrog metformin.

Kev tshawb fawb 2009 tau sib piv cov kev ua tau zoo thiab kev nyab xeeb los kho cov ntshav qab zib hauv cov neeg mob laus dua 65 xyoo siv cov tshuaj sib txuas hauv qab no:

• metformin + sulfonylurea (glimepiride <6 mg ib hnub twg);
• metformin + vildagliptin (galvus) ntawm kev noj tshuaj ntawm 100 mg rau ib hnub.

Kev txo qis hauv qib ntawm glycated hemoglobin HbA1C hauv cov neeg mob ntshav qab zib hauv ob pawg neeg tau kwv yees li qub. Tab sis hauv cov neeg mob ntawm thawj pab pawg, 16.4% ntawm cov qog ntshav qab zib tau sau tseg, thiab tsuas yog 1,7% hauv kev siv tshuaj metformin nrog galvus. Nws hloov tawm tias hloov cov tshuaj sulfonylurea derivatives nrog DPP-4 inhibitors txo cov zaus ntawm hypoglycemia los ntawm 10 zaug, thaum tswj kev cuam tshuam ntawm txo cov ntshav qabzib.

Mimetics thiab cov qauv sib piv ntawm GLP-1

Cov tshuaj hauv qab no suav nrog pawg tshuaj ntshav qab zib tshiab no:

• exenatide (bayeta);
• liraglutin (tsim txom).

Lub tshuab ntawm kev txiav txim ntawm cov tshuaj no zoo ib yam li yuav ua li cas dipeptidyl peptidase-4 inhibitors (glyptins) ua. Tab sis cov tshuaj no tsis nyob hauv cov ntsiav tshuaj, tab sis raug txhaj tshuaj subcutaneously.

Nws tau raug pov thawj tias mimetics thiab analogues ntawm GLP-1 pab rau kom poob phaus thiab muaj qhov pheej hmoo tsawg kawg ntawm kev txhim kho hypoglycemia. Lawv tuaj yeem siv rau hauv cov neeg laus cov neeg mob ntshav qab zib uas muaj kev rog rog (mob hauv lub cev qhov hnyav> 30 kg / m2), yog tias tus neeg mob tau npaj muab tshuaj.

Nws yog cov tshuaj mimetics thiab analogues ntawm GLP-1 uas ua rau kev txiav txim siab los siv ua "kawg kev" yog tias tus neeg mob xav ncua sijhawm pib kho ntshav qab zib nrog insulin. Thiab tsis sulfonylureas, raws li yog feem ntau ua.

Acarbose (glucobai) - ib yam tshuaj uas txwv tsis pub muaj suab thaj

Cov tshuaj ntshav qab zib no yog alpha glucosidase inhibitor. Acarboro (glucobai) inhibits kev zom ntawm cov carbohydrates ntau, poly- thiab oligosaccharides hauv cov hnyuv. Hauv qab qaug tshuaj ntawm cov tshuaj no, cov piam thaj tsawg tsawg yuav nqus mus rau hauv cov ntshav. Tab sis nws siv feem ntau ua rau tsam plab, pom kev, raws plab, thiab lwm yam.

Txhawm rau kom txo qhov hnyav ntawm cov kev mob tshwm sim, nws raug nquahu kom txwv tsis pub muaj cov carbohydrates ntau hauv kev noj zaub mov thaum noj acarbose (glucobaya). Tab sis yog tias koj siv cov khoom noj muaj protein tsawg, raws li peb pom zoo, kom cov ntshav qab zib cov ntshav qab zib, tom qab ntawd yuav tsis muaj lub laj thawj noj cov tshuaj no txhua lub sijhawm.

Kev kho mob ntshav qab zib hauv cov neeg laus nrog insulin

Insulin rau hom ntshav qab zib hom 2 yog raug kho yog tias kev kho mob nrog kev noj zaub mov zoo, ua kom tawm dag zog thiab tshuaj noj ntshav qab zib tsis txaus kom txo cov ntshav qab zib. Ntshav qab zib Hom 2 yog kho tau cov tshuaj insulin hauv kev sib xyaw nrog lossis tsis muaj ntsiav tshuaj. Yog tias muaj lub cev nyhav dhau los, tom qab ntawd cov tshuaj insulin tuaj yeem ua ke nrog kev siv cov metformin (siofor, glucophage) lossis DPP-4 inhibitor vildagliptin. Qhov no thiaj li xav tau cov tshuaj insulin thiab, raws li, txo qis kev pheej hmoo ntawm kev mob ntshav qab zib.

Cov neeg laus uas mob ntshav qab zib ib txwm muaj cov hlwb tawm tsam nyuaj thaum kws kho mob sau ntawv mus txhaj tshuaj insulin.Txawm li cas los xij, yog tias qhov ntsuas pom rau qhov no muaj pov thawj, tus kws kho mob yuav tsum maj mam hais tias tus neeg mob "mus ib pliag" sim tshuaj insulin, tsawg kawg yog 2-3 lub hlis. Xav tias pib kho mob ntshav qab zib thaum muaj hnub nyoog laus nrog insulin, yog tias muaj pov thawj rau qhov no. Nyeem “Hom 2 Ntshav Qab Zib Tau Zoo

Feem ntau nws hloov tawm hais tias cov neeg laus mob ntshav qab zib tau pib ua kom zoo dua nyob rau hauv 2-3 hnub tom qab pib siv tshuaj insulin. Nws xav tias qhov no tshwm sim los tsis yog los ntawm kev txo qis hauv cov ntshav qab zib, tab sis kuj los ntawm cov nyhuv anabolic ntawm insulin thiab nws cov lwm yam cuam tshuam. Yog li, lo lus nug ntawm rov qab rau kev kho mob ntshav qab zib nrog kev pab ntawm cov ntsiav tshuaj ploj mus ntawm nws tus kheej.

Rau cov neeg mob laus, koj tuaj yeem siv ntau yam qauv ntawm kev siv tshuaj insulin:

• Ib koob txhaj tshuaj insulin ua ntej mus pw - yog tias piam thaj feem ntau yog nce siab ntawm lub plab khoob. Siv insulin txhua hnub los yog qhov nruab nrab tsis txaus siab yog siv.
• Kev hno cov tshuaj insulin ntawm qhov nruab nrab lub sijhawm ua haujlwm 2 zaug hauv ib hnub - ua ntej noj tshais thiab ua ntej yuav mus pw.
• Txhaj tshuaj ntawm cov tshuaj insulin 2 zaug ib hnub. Cov tshuaj sib tov tas ntawm "luv" thiab "nruab nrab" insulin yog siv, hauv kev sib piv ntawm 30:70 lossis 50:50.
• Lub hauv paus bolus regimen rau cov ntshav qab zib insulin. Cov no yog cov kev txhaj tshuaj luv luv (ultrashort) insulin ua ntej noj mov, nrog rau cov insulin ntawm ncua sijhawm ntev lossis "txuas ntxiv" thaum mus pw.

Lub sijhawm kawg ntawm cov cai teev los ntawm kev siv tshuaj insulin tsuas yog siv tau yog tias tus neeg mob tuaj yeem kawm thiab ua kev soj ntsuam tus kheej ntawm cov ntshav qab zib thiab txhua lub sijhawm xaiv cov tshuaj noj ntawm cov tshuaj insulin. Qhov no xav kom tus neeg laus uas mob ntshav qab zib muaj peev xwm tswj hwm ib txwm muaj peev xwm mloog thiab kawm tau.

Ntshav qab zib rau cov laus: Tshawb pom

Cov neeg laus dua, muaj ntau dua qhov kev pheej hmoo ntawm kev tsim tus mob ntshav qab zib hom 2. Qhov no yog vim lub ntuj laus ntawm lub cev, tab sis rau feem ntau tau vim qhov tsis zoo lub neej ntawm cov neeg laus. Thaum muaj hnub nyoog 45 xyoos thiab laus dua - tau kuaj ntshav qab zib txhua 3 xyoos. Nws yog qhov zoo tshaj los kuaj ntshav tsis yog rau yoo mov qab zib, tab sis rau glycated hemoglobin.

Cov cuab yeej siv tau txiaj ntsig zoo tshaj plaws rau kev tiv thaiv thiab kho mob ntshav qab zib hom 2, suav nrog cov neeg laus, yog cov zaub mov tsis muaj ntsev ntau. Sim ib tug hearty thiab qab qes-carb cov ntshav qab zib kom noj ntshav! Txhua cov ntaub ntawv tsim nyog muaj nyob hauv peb lub vev xaib, suav nrog cov npe khoom lag luam rau cov neeg mob ntshav qab zib - tso cai thiab txwv tsis pub. Raws li qhov tshwm sim, koj cov piam thaj hauv ntshav yuav pib poob rau qhov qub tom qab ob peb hnub. Yog lawm, koj yuav tsum muaj cov tshuaj tua kab mob ntshav hauv tsev thiab siv nws niaj hnub.

Kev kho lub cev kuj tseem siv tau. Nrhiav kev xaiv lub cev ua si uas coj koj zoo siab. Qhov no yuav pab Chris Crowley phau ntawv "yau dua txhua xyoo."

Yog tias kev noj zaub mov tsis zoo rau lub cev thiab kev tawm dag zog tsis pab txo qis cov piam thaj hauv ntshav mus rau qhov qub, tom qab ntawv ntsuam xyuas thiab tham nrog koj tus kws kho mob yog tias koj yuav tsum noj tshuaj metformin (siofor, glucophage). Tsis txhob khiav mus rau lub tsev muag tshuaj rau siofor, thawj zaug coj mus kuaj thiab tham nrog kws kho mob! Thaum koj pib siv cov metformin, qhov no tsis txhais tau tias tam sim no koj tuaj yeem tso tseg kev noj haus thiab kev tawm dag zog.

Yog tias kev noj zaub mov zoo, tawm dag zog thiab tshuaj noj tsis pab zoo, tom qab ntawv koj tau txhaj tshuaj insulin. Tsuag tsuag thiab pib tsim lawv, tsis txhob ntshai. Vim tias thaum koj nyob tsis muaj cov tshuaj insulin nrog cov ntshav qab zib kom ntau ntxiv - koj tab tom muaj kab mob ntshav qab zib sai sai. Qhov no tuaj yeem ua rau txiav tes taw, qhov muag tsis pom kev, lossis zam dhau kev tuag los ntawm lub raum tsis ua haujlwm.

Kev mob ntshav qab zib hauv lub hnub nyoog laus yog phom sij heev. Tab sis tus mob ntshav qab zib tuaj yeem txo nws qhov yuav tshwm sim rau yuav luag xoom siv 3 txoj kev hauv qab no:

• Tsis txhob noj tshuaj mob ntshav qab zib uas ua rau lub plawv tsis tuaj yeem. Cov no yog sulfonylureas thiab meglitinides (clayides). Koj tuaj yeem ua tau zoo rau koj qab zib tsis muaj lawv.
• Noj cov khoom noj uas muaj carbohydrates me ntsis li uas ntau tau. Tej cov carbohydrates, tsis yog cov uas tau nqus nrawm. Vim tias cov zaub mov carbohydrates tsawg hauv koj cov zaub mov noj, koj yuav tsum tau txhaj tshuaj insulin tsawg dua. Thiab cov tshuaj insulin tsawg dua - qhov qis dua qhov tseem ceeb ntawm kev txhim kho hypoglycemia.
• Yog tias tus kws kho mob tseem pheej hais kom koj noj tshuaj uas yog los ntawm sulfonylureas lossis meglitinides (glinides), hu rau lwm tus kws kho mob tshwj xeeb. Tib yam yog tias nws ua pov thawj tias koj yuav tsum tau noj "kom muaj txiaj ntsig". Tsis muaj kev sib cav, tsuas hloov kws kho mob.

Peb yuav zoo siab yog tias koj sau txog koj qhov ua tiav thiab teeb meem ntawm kev kho mob ntshav qab zib hauv cov laus hauv cov lus rau cov tshooj no.

Nyeem kuj cov lus:

• Mob ceg hauv ntshav qab zib - yuav ua li cas;
• Mob ntshav qab zib thiab raum mob lwm yam;
• Qhov ntsuas twg los xaiv qhov tseeb tshaj.