Txoj hauj lwm ntawm kev tswj cov kab mob endocrinological, tswj nws, yog suav tias tsuas yog tib qho hauv kev kho mob ntshav qab zib mellitus. Kev noj haus yog ib qho ntawm cov chaw tseem ceeb ntawm kev kho mob rau tus kab mob. Yuav noj li cas nrog ntshav qab zib kom raug yog li txhawm kom glycemia qib nyob kom raws lub cev thiab lub cev tau txais ntau yam zaub mov? Txheeb xyuas zaub mov, cov kws tshawb fawb tau tsim cov ntaub ntawv qhia kev mob ntshav qab zib hom 1 qhia txog cov khob cij (XE).
Tag nrho cov subtleties ntawm kev siv lub tswv yim ntawm XE nyob rau hauv kev noj zaub mov lub cev
Mob ntshav qab zib mellitus yog ib qho kab mob uas muaj qhov sib txawv ntawm keeb kwm (keeb kwm), qhov ntev ntawm kev pabcuam thiab qhov xwm txheej ntawm qhov kev kawm. Tsis hais txog txhua yam no, tus neeg mob yuav tsum soj ntsuam lub cev kev ua noj haus kom zoo. Nrog nws, cov nqi zog yuav tsum sib haum mus rau qhov khoom noj muaj txiaj ntsig ntawm cov khoom thiab nyob ntawm qhov xwm ntawm lub neej, thauj khoom.
Cov ntsiab lus ntau ntawm cov lus qhia txog cov khoom noj carbohydrates hauv cov khoom muaj pes tsawg leeg yog nthuav tawm hauv cov ntxhuav. Nws muaj ntau ntu (khoom qab zib, hmoov nplej thiab cov nqaij ua, nqaij thiab txiv hmab txiv ntoo, zaub, khoom noj muaj mis, dej haus thiab kua txiv).
Tab sis qee qhov kev txwv thiab tsis pom qhov xwm txheej tshwm sim, vim:
- cov duab kos qhia txog cov khob cij tso rau hauv ntau cov ntawv tshaj tawm (yam tsis muaj qhia meej lub xeev ntawm cov khoom lag luam - cov nqaij nyoos lossis hau siav);
- qhov tsis muaj qhov ua tau los ntawm kev muaj peev xwm xav tau ntawm xe, yam tsis xav txog ntawm lub cev;
- kev siv cov khoom noj ua kua carbohydrate lossis cov dej haus yam tsis muaj kev qhia txog cov insulin ntxiv.
Hom 1 ntshav qab zib uas tau nyob hauv insulin, feem ntau, cov neeg hluas, menyuam yaus, kev nyuaj siab mob hlwb los ntawm qhov xav tau los txhaj tshuaj. Thaum nyob hauv zej zog (cov neeg tuaj saib, chav noj mov, chaw ua haujlwm), ntau tus tsis muab kev txhaj tshuaj rau txhua chav ua mov. Thaum zoo li no, tus neeg mob tuaj yeem siv cov khoom uas tsis tas yuav hloov mus rau XE (zaub, nqaij, nceb, txiv ntoo, noob, noob, tshuaj yej, kas fes tsis muaj kas fes).
Hauv lub sijhawm los qhia txog kev tsis haum siab ntawm lub cev yog ua tau tsuas yog kev pabcuam ntawm glucometer (khoom siv los ntsuas ntshav qab zib). Thaum tshem tawm cov ntsiab lus uas tuaj yeem ua rau tsis txaus ntseeg txog cov piam thaj hauv qabzib, tus neeg mob tau maj mam kawg. Muaj tuaj yeem them nyiaj sai rau glycemic cuam tshuam los ntawm kev raug mob, tawg, thiab ib puag ncig hloov.
Lub tswv yim ntawm "chav ua mov ci" yog siv tau yooj yim thaum hais txog kev sau nyiaj rau cov khoom noj hauv carbohydrates hauv zaub mov, tswj lub cev qhov hnyav. Ib qho qauv yooj yim ntawm kev suav cov huab hwm coj yog tias daim duab 100 yog rho tawm ntawm tus neeg mob qhov siab (hauv cm). Qhov ntsuas zoo tshaj thiab qhov tseeb tshaj yog txiav txim siab los ntawm cov rooj, uas suav txog hnub nyoog, tsab cai thiab poj niam txiv neej.
Kev kho mob ntawm tus neeg mob ntshav qab zib suav nrog kev tswj lub cev qhov nyhav thiab cov nqi zog ntawm lub cev
Cov kev ntsuas paub tseeb tias, thaum ua lub teeb ua haujlwm rau lub cev, qhov nruab nrab ntawm 130 kJ lossis 30.2 kcal yog noj (rau txiv neej - 32 kcal, pojniam - 29 kcal) rau 1 kg ntawm qhov hnyav. Nrog rau lub hlwb los yog kev ua haujlwm rau lub cev, feem, 200 kJ; 46,5 kcal. Nrog lub cev ua haujlwm hnyav, cov kis las tshaj lij - txog 300 kJ; 69,8 kcal.
Kev xaiv ncaj qha ntawm lub khob cij ntawm cov koob tshuaj insulin
Tus neeg mob lub cev noj haus yog qhov qog ntawm kev ua haujlwm ntawm lub cev ib txwm los tawm tsam keeb kwm ntawm kev siv tshuaj insulin. Tus mob ntshav qab zib tau pom zoo kom khaws cov ntawv khaws cia ntawm glycemia. Thaum txheeb xyuas cov ntawv sau ntawm chaw muag mis nyuj, cov kws kho mob endocrinologists nco ntsoov feem ntau cov kev ua yuam kev thaum kev noj haus:
- ua ntej, kev siv ntau tshaj dhau ntawm cov chav ua mov ci;
- thib ob, qhov siab tshaj plaws cov khoom noj carbohydrate ntog rau yav tsaus ntuj.
Cov neeg mob piav qhia txog kev ua txhaum zaum kawg ntawm kev noj zaub mov noj nrog kev txaus ntshai ntawm nocturnal hypoglycemia (poob hauv cov ntshav qab zib). Lawv ntseeg tias nws tsim nyog yuav tsum muaj qee qhov glycemic "cia" (10-11 mmol / l) ua ntej yuav mus pw.
Cov kws tshaj lij hais tawm kom tsis txhob noj cov qhob cij thaum yav tsaus ntuj, tab sis kom kho qhov koob tshuaj ntawm cov tshuaj insulin (lub sijhawm luv thiab lub sijhawm ntev). Txhawm rau ua qhov no, ntxiv rau nqa tawm ntau qhov ntsuas thaum hmo ntuj, txhua 2-3 teev. Cov txiaj ntsig yuav tsum tsis pub dhau ib qho kev txwv thiab maj mam txo qis nyob rau hauv kev cuam tshuam ntawm lub cev ntev. Los ntawm cov lus tim khawv ntawm 7-8 mmol / l, ob teev tom qab noj mov kawg, mus txog 5-6 mmol / l - thaum lub sijhawm sawv.
Algorithm (sib lawv liag) ntawm kev ua ntawm tus mob ntshav qab zib ua ntej noj mov:
- ntsuas cov ntshav qab zib;
- ntsuas cov khoom noj carbohydrate hauv cov khob cij;
- nkag rau qhov tseeb koob tshuaj ntawm luv luv lossis ultrafast insulin (Novorapid, Apidra, Humalog);
- kuaj saib glycemia tom qab 2 teev (qhov tau nyeem yav dhau los tsis paub, vim tias qhov kev txiav txim ntawm luv insulin tseem tsis tau ua tiav).
Glucometer nyeem ntawv thaum nruab hnub yog suav tias ib txwm muaj yog tias cov ntshav qab zib yog ntshav qab zib yog 8.0-9.0 mmol / l (2 teev tom qab noj mov)
Kev txiav txim siab yog tias koj muaj cov tshuaj insulin txaus yog ib qho yooj yim. Ntxiv nrog rau kev hnyav, ib zaug ib lub lim tiam, nws yog ib qho tsim nyog yuav tsum tau nqa tawm cov npe hu ua txhua hnub "glycemic profile". Cov ntshav qab zib cov ntshav tau sau tseg ua ntej noj mov thiab 2 teev tom qab. Kev tsom xam ntawm jumps hauv cov piam thaj qhia tau hais tias lub sijhawm tau ua txhaum cai dabtsi.
Muaj ntau haiv neeg, txhais tau tias cov khoom noj muaj ntshav qab zib kom tsim nyog
Ib qho khoom noj sib txawv rau cov neeg mob uas muaj ntshav qab zib - qhov no txhais tau tias muaj peev xwm hloov qee lub tais diav nrog lwm tus. Hauv qhov no, qhov keeb kwm glycemic yuav tsum tsis txhob yauv pauv hloov tseem ceeb. Nws yog hom kev hloov pauv uas yooj yim ua tiav siv chav ua mov ci.
Rau tus qauv (ib qho txiaj ntsig ntawm tus kwv tij sib piv) coj tus nqi ntawm cov khoom uas muaj nyob hauv 25 g ntawm qhob cij. Cov khoom lag luam carbohydrate yuav tsis tsuas yog ua cov khoom bakery. Nws yog ib qho tseem ceeb kom paub txog qhov loj ntawm qhov hloov chaw. Piv txwv li, 1 XE tso nyiaj rau ib qho kua txiv kab ntxwv hauv nruab nrab los sis lub iav (200 ml) ntawm mis. Ua porridge hauv 2 tbsp. l los ntawm cov khaub noom txawv yuav muaj kwv yees li ntawm ntau qhov ntawm chav ua mov ci.
Qhov yooj yim ntawm kev siv lub rooj XE yog vim muaj qhov tseeb tias tus neeg siv tsis xav tau hnyav khoom txhua lub sijhawm. Lawv tus lej yog kwv yees tsis pom. Rau qhov no, cov khoom siv tau paub tau siv (iav, thooj, thooj, rooj thiab diav me me, nrog lossis tsis xaub). Qhov zoo tshaj plaws ntawm lub rooj pom tau lees paub yog qhov ua tiav rau qhov xwm txheej ntawm cov khoom lag luam tseem qhia (qhuav nplej qhuav, cutlet sib xyaw nrog qaws, qhov sib npaug ntawm cov txiv ntsej muag lossis cov dib liab nrog tev).
Noj cov kib french, haus npias yog qhov tsis zoo rau cov mob ntshav qab zib, txawm tias cov khoom lag luam no tuaj yeem suav hauv chav ua mov ci thiab txhaj tshuaj nrog qhov hormone. Tab sis tus neeg mob nrog kev noj zaub mov noj rau hom 1 ntshav qab zib mellitus tsis tuaj yeem txwv nws tus kheej kom noj zaub, bran whole-grain bread, ntses tsis muaj roj, nqaij, thiab tshij. Rog txwv tsis pub cov insulin los nthuav tawm nws cov nyhuv hypoglycemic.
Cov lus qhia yooj yim yuav pab cov neeg mob ntshav qab zib noj kom yog:
- hla zaub mov yog txaus ntshai;
- tus nqi ntawm cov zaub mov noj txhua hnub yuav tsum yog kwv yees li qub;
- kev siv dej cawv haus, tsis muaj qhov txuas ntawm cov zaub mov, txo qis glycemia, tab sis cuam tshuam kev cuam tshuam ntawm daim siab;
- Thaum tsis pom qhov kev tawm dag zog lub cev, yuav tsum xav tau cov nyiaj carbohydrates ntau ntxiv.
Piv txwv li, ntxiv rau 1 XE (lub khob ntawm cov kua txiv hmab txiv ntoo tsis muaj qab zib) kom them rov qab rau ib teev ntawm kev mus ncig, tsis muaj khoom thauj. Nrog kev ua kis las rau kev ua kis las thiab cov xwm txheej ceev, cov tshuaj insulin raug suav, cov keeb kwm glycemic tseem tshuaj xyuas tas li.
1 XE yuav nce cov ntshav qab zib kom tsawg li 1.8 hliol / L. Qhov yuav tshuaj rau yuav tsum tau them nws compensation txog 2 chav nyob. Tus nqi ntawm cov tshuaj insulin uas yuav tsum tau muaj nyob rau hauv cov hluas ntshav qab zib yog nyob ntawm lub sijhawm nruab hnub. Hauv thawj ib nrab ntawm ib hnub, vim muaj cov haujlwm ntawm cov txheej txheem hauv metabolism - qhov siab tshaj plaws, hauv ob - tsawg kawg.
Tag nrho cov naj npawb ntawm cov txiv hmab txiv ntoo hauv ib hnub tau muab faib ua 2 koob tshuaj (1 XE txhua)
Qhov piv txwv ntawm kev xam cov zaub mov noj su
Ib nrab ntawm qhov yuav tsum tau siv lub zog txhua hnub hauv cov neeg tsis cuam tshuam txog kev siv zog lub zog yog nrhiav los ntawm cov khoom lag luam carbohydrate - 15-17 XE. Cov no suav nrog: qhob cij, cereals, zaub. 2 XE - txiv hmab txiv ntoo.
Kwv yees nyob hauv kev sib txig sib luag ntawm cov calories seem yog cov protein thiab cov rog. Lawv tsis suav rau hauv chav ua mov ci. Qhov kev faib tawm tshwj xeeb ntawm cov carbohydrates raws li cov pluas noj thaum nruab hnub nyob ntawm hom kev siv tshuaj insulin siv los ntawm cov neeg mob ntawm hom 1. Ib zaug noj mov yuav tsum tsis txhob muaj ntau tshaj 7 XE. Rau kev noj tshais thiab noj hmo, 3-4 XE, 3 khoom noj txom ncauj thaum noj mov - 6 XE.
Hauv tag nrho, thov noj su mus rau 5.2 XE:
- zaub xam lav ntawm cov zaub tshiab (kua txob qab zib, txiv lws suav) - ½ XE;
- qhov thib ib yog kua zaub (qos, cereal lossis vermicelli) - 0.6 XE;
- qhov thib ob - ntses stewed nrog zaub (carrots) - 0.9 XE;
- cheesecake (hmoov nplej) - 0.6 XE;
- tsis muaj rog-rog kefir - 0.6 XE;
- 50 g rye qhob cij lossis 2 slices - 2 XE.
Hauv cov ntawv ci yog cov khoom siv hauv lub tais uas muaj cov khob cij. Ua ntej yuav noj mov rau yav tav su no, yuav tsum muaj 8 seem ntawm cov tshuaj insulin luv luv. Noj su tau noj kom muaj protein, rog thiab carbohydrates. Cov pluas noj muaj cov nplua nuj nyob hauv fiber, vitamins thiab minerals.
Cov zaub xam lav yog cov khoom noj nrog roj zaub, qhov thib ob yog ntxiv - qab zib. Cov neeg uas xav ua kom noj hmo kom tsawg dua, nws pom zoo kom nphoo cov zaub tshiab nrog kua txiv qaub, noj nqaij ntses yam tsis muaj roj ntxiv.
Nws yooj yim dua rau cov neeg uas noj tom tsev uas ua zaub mov noj lawv tus kheej los laij cov khob cij. Tsis tsuas yog muaj ntshav qab zib, tab sis kuj muaj ntau lwm cov kab mob pathologies ntawm lub cev, qee cov tais diav thiab lawv cov khoom siv tuaj yeem tshem tawm ntawm kev noj haus lossis hloov nrog lwm tus.
Lub tuam txhab ua zaub mov noj lub luag haujlwm tseem ceeb ntawm cov ntim khoom muaj pes tsawg leeg, muaj pes tsawg calories thiab khob cij. Kev txaus siab tshwj xeeb rau tus mob ntshav qab zib yog qhov sau ntxig rau hauv lub rooj, rov qab rau cov khoom nyiam - "tsis xav tau XE cov nyiaj."