Na maʻi hānai i nā Kaumaha

ʻO ka mālama ʻana i ka maʻi diabetes i nā wā kahiko he mea paʻakikī ia no nā poʻe heluhelu nui o kā mākou pūnaewele. No laila, ua hoʻomākaukau mākou i kahi kikoʻī kikoʻī e pili ana i kēia kumuhana, i kākau ʻia ma kahi ʻāpana. Hiki i nā mea maʻi a me nā mea lapaʻau e loaʻa i nā mea āpau a lākou e pono ai ma ke hoʻoponopono pono ʻana a me ka mālama ʻana i ka maʻi maʻi i nā pākeke.

Pehea ka hopena o ka maʻi maʻi maʻi kiʻekiʻe e hiki ai i ka mea maʻi maʻi maʻi ke hilinaʻi nui loa i ka hiki kālā a me kona mau ʻohana, a ʻoiai hoʻi, e ʻeha ana ʻo ia i ka dementia senile a ʻaʻole paha. Eia naʻe, e kōkua ana nā kumuwaiwai i kēia hana e hana i ka nui loa i ka hakakā ʻana i ka maʻi diabetes, hiki nō i ke kūlana ma kahi o ka mea ʻelemakule.

No ke aha e piʻi ai ka pilikia o ka maʻi maʻi ma ka ʻelemakule

Mai ka makahiki 50-60 mau, e hoʻēmi ʻia ana ka hoʻohaʻahaʻa glucose i ka hapa o ka poʻe. Ma ka hoʻomaʻamaʻa, ʻike kēia ma hope o 50 mau makahiki no kēlā me kēia 10 mau makahiki.

• hoonui ka paila koko wikiwiki e 0,055 mmol / l;
• ʻO ka hoʻoliʻi glucose glucose 2 mau hola ma hope o ke ala ʻana o ka pāʻina ma ka 0.5 mmol / l.

E nānā ʻoe he mau huaʻōlelo “maʻamau” wale nō kēia. I nā ʻōpiopio a pau, e loli ka hoʻoliʻiliʻi o ke koko ma ko lākou ala ponoʻī. A no laila hoʻi, ʻoi aku ka nui o ka pilikia o ka hoʻomohala ʻana i ke ʻano maʻi type 2 i kekahi mau pākeke makua ma mua o nā mea ʻē aʻe. Aia ia i ke ʻano o ke alakaʻi ʻana i kahi kanaka kahiko - no ka hapa nui, ma luna o kāna hana kino a me ka meaʻai.

ʻO ka glycemia postprandial ke koko koko ma hope o ka ʻai ʻana. Kuhi ʻia ia mau hola 2 ma hope o ka pāʻina. ʻO kēia kahi hōʻailona e ala nui i ka wā kahiko, ke alakaʻi nei i ka hoʻomohala ʻana o ke ʻano maʻi type 2. I ka manawa like, ʻaʻole e loli maoli ka wikiwiki ʻo ka maʻi glycemia.

No ke aha e hoʻohuli ai ka hoʻohaʻahaʻa glucose i ka makahiki? He loaʻa nā kumu he nui i hana ʻia ma ke kino i ka manawa like. E pili ana kēia:

• ʻO ka hala o nā makahiki i pili i ka hoʻololi ʻana i ke ʻano o ka insulin;
• Hōʻemi ʻia ka huna ʻana o ka pancreatic insulin;
• ʻO ka huna ʻia a me ka hana ʻana o nā hormones infletin i nāwaliwali o ka wā kahiko.

ʻO ka piʻi ʻana o nā makahiki i ka wā o ka naʻau me ka insulin

ʻO ka emi ʻana o ke ʻano o ka ʻili o nā umauma i ka insulin i kapa ʻia ʻo ke kū'ē o ka insulin. Hoʻoulu ia i loko o nā kuana he nui. Mea kūikawā no nā mea luhi. Inā ʻoe ʻoe e lawe i nā lāʻau lapaʻau, a laila pili loa kēia i ke ʻano o ka maʻi diabetes.

ʻO ka hoʻonui ʻana o ka hana keti he kumu nui loa i ka maʻi maʻamau i ka makahiki 2. Ke kū'ē nei nā poʻe noiʻi inā he kūlohelohe o ke kino kūlohelohe o ke ʻano he ʻano kūlohelohe. A i ʻole ma muli o ke ʻano luhi kino i ka wā ʻelemakule?

No nā kumu socio-economic, e ʻai ka poʻe kahiko, no ka hapa nui, nā kumukūʻai kiʻekiʻe. Loaʻa i kēia meaʻai ka nui o nā pōpoki ʻoihana hoʻoneʻe a me nā haʻalika, na mea e hoʻowalewale koke ʻia. I ka manawa like, e mau pinepine ia i ka protein, ka aila a me nā hāmeʻe paʻakikī, nā mea e hoʻoulu maikaʻi.

Eia kekahi, ʻo nā kānaka kahiko, e like me ke kānāwai, loaʻa nā maʻi maʻi a lawe i nā lāʻau lapaʻau no lākou. Loaʻa i kēia mau lāʻau maikaʻi i ka hopena maikaʻiʻole o ka metabolism. ʻO nā lāʻau maikaʻi loa e hoʻonui i ka hopena o ka maʻi maʻi maʻi:

• diuretics thiazide;
• nā mea ʻaihue beta (ʻaʻohe-koho ʻole);
• steroid;
• nā lāʻau lapaʻau psychotropic.

ʻO nā maʻi like ʻole e koi ai iā ʻoe e lawe i nā lāʻau lapaʻau he nui i ka hana kino o nā poʻe kahiko. Hiki ia i nā pathologies o ka puʻuwai, māmā, nā ʻōnaehana musculoskeletal a me nā pilikia ʻē aʻe. A ʻo kahi hopena, ua hoʻemi ʻia ka nui o ka musula, a ʻo ia ke kumu nui o ka hoʻonui ʻana i ka pale ʻana i ka insulin.

Ma ka hoʻomaʻamaʻa, ʻike ʻia inā e hoʻololi ʻoe i ke ola olakino, hoʻēmi ʻia ka nui o ka hoʻomohala ʻana i ke ʻano o ka maʻi maʻamau i ka makahiki ʻelima, ʻo ia hoʻi ka aneane ʻole. Pehea e hana ai - e aʻo hou ʻoe i loko o kā mākou ʻatikala.

ʻO ka hana huna no ka insulin pancreatic

Inā loaʻa ʻole kahi pōpilikia o kekahi kanaka, a laila he hapa i ka mea huna o ka insulin e ka pancreas i ke kumu nui no ka hoʻomohala ʻana i ke ʻano maʻi diabetes type 2. Hoʻomaopopo i nā poʻe me ka momona, ʻo ke kūleʻa o ka insulin ke kumu nui o ka maʻi diabetes, ʻoiai ke kīlei nei nā pancreas i ka maʻamau o ka insulin.

I ka ʻai ʻana o kekahi kanaka i ka meaʻai me nā kalaka, ke piʻi aʻe ke kiʻekiʻe o ke koko. I ka pane ʻana i kēia, hana ka pancreas i ka insulin. ʻO ka huna ʻia o ka insulin pankreatic i pane ʻana i kahi "ukana" kākena "i ʻelua mau wahi i kapa ʻia nā ʻaseslelo lua.

ʻO ka hana mua ka wīkī i ka wina insulin, e lōʻihi ana i 10 mau minuke. ʻO ka lua o ka heleʻana he kahe hāneʻe o ka insulin i loko o ke koko, akā e lōʻihi ana, a hiki i 60-120 mau minuke. ʻO ka papa mua o ka hiloi pono e "hoʻopau i" ka nui o ka nui o ka glucose i loko o ke koko e hele koke ana ma hope o ka ʻai ʻana.

Hōʻike nā haʻawina i nā poʻeʻelemakule me ka nui o ke kaupaona ʻana, ke hoʻemi nui nei ka hana mua o ka hana huna o ka insulin. ʻOi aku paha, ma muli o kēia, ua hua ka ʻai glucose i ka koko koko 2 mau hola ma hope o ka manawa e piʻi ikaika ai ka pāʻina, i.e., ma ka 0.5 mmol / l no kēlā me kēia 10 mau makahiki ma hope o ke mau makahiki he 50.

Ua ʻike nā ʻepekema ʻepekema i ka poʻe kahiko me ka paona kino kino, ua hoʻemi ʻia ka hana o ke kumu glucosinase. Hāʻawi kēia gen i ke ʻano o ka mālama ʻana i nā poli pancreatic beta i ka hopena hoʻokūkū o ka glucose. ʻO kona hemahema paha e wehewehe i ka hōʻemi ʻana i ka mea huna o ka insulin i ka pane ʻana i ke komo ʻana o ka glucose i loko o ke koko.

Pehea e hoʻololi ai ka hūnā a me ka hana o nā incretins i ka pākeke

ʻO nā incretins kekahi mau hormon i hua ʻia i loko o ka wahi gastrointestinal e pane ai i ka hoʻopiʻi ʻana i ka meaʻai. Hoʻopili hou lākou i ka hana o ka insulin e ka pancreas. E hoʻomanaʻo o kahi hopena hoʻoulu koʻikoʻi i ka hilo i ka insulin e hoʻonui i ka glucose o ke koko.

Hoʻomaka i ʻike ʻia nā hana o ka incretins i ka hoʻomaka ʻana o ka makahiki iwakāluakūmākahi. Ka mea, maʻamau, i ka wa e lawe i ka waha (ma o ka waha), ua hoʻoneʻe ʻia nā mea haʻaleka a me ka 2 mau manawa e like me ka pane ʻana i ka hoʻokele intravenous ma kahi like o ka glucose.

Ua ʻōlelo mai nā kānaka ʻepekema ʻo ia a ma hope o ko ka papa ʻaina, ua hua ʻia kekahi mau mea (hormones) i loko o ka gastrointestinal tract e hoʻoikaika pū ʻia ai ka pancreas e hana i ka insulin. Ua kapa ʻia kēia mau hormones he incretins. Ke hoʻomaopopo nei i kā lākou ʻano a me ka hana ʻana o ka hana.

ʻO ka incretins ka hormon-like peptide-1 (GLP-1) a me ka glucose-e hilinaʻi i ka insulinotropic polypeptide (HIP). I ʻike ʻia he ikaika ikaika ka GLP-1 ma ka pancreas. ʻAʻole ia e hoʻonāukiuki wale ʻia i ka mea huna o ka insulin, akā ua pale aku hoʻi i ka hana o glucagon, ka "antagonist" o ka insulin.

Ua hōʻike ʻia nā haʻawina i ka poʻe ʻelemakule, ka hoʻomau ʻana o ka hoʻohālikelike i nā homela GLP-1 a me GUI ma ka pae like like i ka wā ʻōpio. Akā ka mālamalamaʻana o nā pūlei beta pancreatic i ka hana o ka incretins e hoʻemi me ka makahiki. ʻO kēia kekahi o nā hana no ka hoʻomohala ʻana i ka maʻi diabetes, akā ʻoi ka mea nui ma mua o ka pale ʻana o ka insulin.

No ka maʻi maʻi ma ka maʻi pākē

Hoʻomaopopo ʻia nā kānaka olakino ma hope o 45 e hoʻopaʻa ʻia no ka maʻi diabetes i hoʻokahi manawa i kēlā me kēia 3 mau makahiki. E ʻike i nā mea pili koko kō. E noʻonoʻo, ʻaʻole kūpono ka hoʻāʻo ʻana i ke koko koko ʻaʻa no ka hoʻāʻo ʻana i ka maʻi maʻi maʻi. No ka mea he nui nā maʻi me ka maʻi maʻi, e hoʻomau ka maʻamau o ka hoʻoliʻiliʻi o ka glucose o ke koko. No laila, manaʻo mākou e lawe i kahi hoʻāʻo koko no ka glycated hemoglobin.

I mea e hoʻomaopopo ai i ka maʻi maʻi o ka maʻi maʻi, e heluhelu mua i kahi ʻatikala e pili ana i ia mea. A eia kā mākou e kūkākūkā ai i nā hiʻohiʻona kūikawā i ka hoʻomaopopo ʻana i ka maʻi maʻi ma o nā ʻelemakule.

Maʻa ka hana ʻana i ke ʻano maʻi diabetes maha 2 i nā mea maʻi maʻi no ka mea pinepine ka maʻi me ka ʻole o nā hōʻailona. ʻAʻole paʻa kahi maʻi maʻi maʻi maʻamau no ka makewai, ka ʻuhu, ke kaumaha, a me ka urination pinepine.

Penei ke ʻano o ka heleʻana o ka maʻi maʻi ma mua o ka make wai. ʻO kēia ma muli o ka loaʻa ʻana o ka makewai o ka makewai no ka lolo ke hoʻomaka i ka hana ʻino ma muli o nā pilikia me nā moku. Nui nā poʻe ʻelemakule i ka make wai nāwaliwali a, ma muli o kēia, lawa ʻole i hoʻopiha hou i nā kaila wai i loko o ke kino. No laila, ʻike pinepine ʻia lākou i ka maʻi maʻi i ka wā e hele ai i ka haukapila i loko o kahi coma hyperosmolar ma muli o ka hoʻohemo koʻikoʻi.

I nā maʻi maʻiʻelemakule, ʻaʻole kikoʻī, akā hoʻomohala ka hoʻopiʻi maʻamau - nāwaliwali, nā luhi, ke kaumaha, nā pilikia hoʻomanaʻo. Aia paha e ʻike nā loulou ka holomua dementia. Ke nānā nei i kēlā mau ʻōuli, ʻaʻole ʻike maoli ke kauka i ka maʻi ʻōpio i loaʻa ka maʻi maʻi maʻi. Wahi a ia, ʻaʻole e mālama ʻia ka mea maʻi no ia, a me ka holomua o nā maʻi.

Hoʻohā pinepine pinepine ʻia nā maʻi maʻi i nā maʻi maʻi ma mua o ka manawa hope paha, i ka wā e nānā ʻia ai ke kanaka no nā hōʻeha vascular koʻikoʻi. Ma muli o ka hopena o ka hopena o ka maʻi maʻi i ka pākeke, ʻoi aku ma mua o 50% o nā mea maʻi i kēia mahele i loaʻa i nā hōʻeha kaumaha: nā pilikia me ka puʻuwai, nā wāwae, nā maka a me nā pu.

I ka wā kahiko, ua ala aʻe ka paepae o ka honua. E nānā pono i kahi o ia. I ka poʻe'ōpio, loaʻa ka glucose i ka urine i ka wā o kona nānā ʻana i ke koko ma kahi o 10 mmol / L. Ma hope o 65-70 mau makahiki, ua huli ka "paepae ākea" i ka 12-13 mmol / L. ʻO kēia mea, me ka uku ʻilihune maikaʻi ʻole no ka maʻi maʻi i ka pākeke ma mua, ʻaʻole i komo ke kō i ka urine, a emi iki ka manawa e loaʻa iā ia i ka manawa.

ʻO ka hypoglycemia i ka pākeke - nā hopena a me nā hopena

ʻO ka mea mua, ʻōlelo mākou no ka heluhelu ʻana i ka ʻatikala "Hypoglycemia ma ka maʻi diabetes." ʻO ka hypoglycemia i ka wā kahiko he mea koʻikoʻi nui. No ka mea e alakaʻi pinepine ana i ka make, kahi e like me ka make mai kahi maʻi cardiovascular.

Hōʻikeʻike ka hoʻohālikelike ʻana o ka hypoglycemia i nā maʻi maʻi ma waena o nā hōʻailona "ʻano maʻamau" i ʻike ʻia e nā poʻe ʻōpio. Nā hiʻohiʻona o ka hypoglycemia i nā makua:

• Hoʻopau ʻia a hāmama ʻole kona mau hōʻailona. Hōʻike pinepine ʻia ʻo Hogoglycemia i nā maʻi maʻi ma ke ʻano he maʻi like ʻole.
• I nā poʻe kahiko, ua pā pinepine ka hana o nā hormones adrenaline a me cortisol. No laila, ʻaʻole i hala nā hōʻailona kūpono o ka hypoglycemia: palpitations, haʻalulu, a me ka holoi ʻana. ʻO ka nāwaliwali, nā hiamoe, nā hūnā, ka amnesia e hele mai i mua.
• Ma ke kino o ka poʻe ʻelemakule, hoʻomehana nā hana a keu no ka hoʻonāukiuki i ka mokuʻāina o hypoglycemia, i.e., hana ʻole i nā lawelawe counter-regulat Ma muli o kēia, hiki i ka hypoglycemia ke lawe i ka ʻano protracted.

No ke aha i pilikia ai ka hypoglycemia i ka wā kahiko? No ka mea ke alakaʻi nei i nā hoʻopiʻi cardiovascular ʻaʻole hiki i ka poʻe maʻi maʻi keʻelemakule maikaʻi loa. Hoʻonui nui ka hypoglycemia i ka make o ka hōʻeha ʻana o ka puʻuwai, hōʻeha, ka puʻuwai, a i ʻole hoʻopaka ʻana i kahi moku nui me ka ʻike koko.

Inā mākia ke kelepona maʻi makua e ala i ke ola ma hope o ka hypoglycemia, a laila noho paha ʻo ia i ke kanaka maʻi kīnā ʻole ma muli o ka hōʻeha o ka lolo. Hiki i kēia ke hana me ka maʻi diabetes i ka wā ʻōpio, akā no nā poʻe kahiko ka nui o ka hopena o nā hopena koʻikoʻi.

Inā pilikia ka maʻi maʻi maʻi maʻi maʻamau a pinepine ʻole a hypoglycemia, a laila hāʻule kēia i ka hāʻule, i hele pū ʻia e nā hōʻeha. ʻO ka wai me ka hypoglycemia he kumu maʻamau o ka hana ʻana o nā iwi, hoʻohemo i nā pūnaʻi, nā mea hōʻino i nā ʻiʻo palupalu. Hoʻonui ka hypoglycemia i ka wā kahiko i ka hopena o ka pale o ka hip.

Hōʻike pinepine ʻia ka hypoglycemia i nā maʻi maʻi ma muli o ka mea i lawe ka mea maʻi i nā lāʻau like ʻole, a pili pū kekahi me kekahi. Hiki i kekahi mau lāʻau ke hoʻoikaika i nā hopena o nā pā o ka maʻi diabetes, derivatives a sulfonylurea. ʻO kekahi - hoʻoulu i ka ʻili o ka insulin a e hoʻonui paha i ka hoʻoweliweli ʻana o nā cell i kāna hana.

Hoʻopili kekahi mau lāʻau i nā hōʻino kino o nā hōʻailona o ka hypoglycemia ma ke ʻano he hopena hopena, ʻaʻole hiki i ka mea maʻi ke pani i ka manawa. Ke noʻonoʻo nei i nā hōʻiliʻili o nā lāʻau lapaʻau āpau i hiki i ka mea maʻi makua me ka maʻi hānai he hana paʻakikī no ke kauka.

Hōʻike ka papa i kekahi o nā pili o nā lāʻau lapaʻau hiki ke hoʻonāukiuki i ka hypoglycemia:

ʻOi aku ka maikaʻi o ka maʻi maʻi maʻa e mālama i kona koko koko i pili i ka maʻamau, ʻoi aku ka liʻiliʻi i ka hoʻopiʻi a ʻoi aku ka maikaʻi. Akā ʻo ka pilikia ʻoi aku ka maikaʻi o ka pae ʻai koko ma ke ʻano o ka "maʻamau" lāʻau lapaʻau no ka maʻi maʻi ʻeha, ʻoi aku ka nui o ka hypoglycemia. A no nā poʻe maʻi maʻi, ʻoi loa ia i ka pilikia.

He kūlana kēia e hewa ai nā koho ʻelua. Aia kekahi hopena kūpono hou aʻe paha? ʻAe, aia kahi ʻano e hiki ai iā ʻoe ke kāohi maikaʻi i ke kō o ke koko a ma ka manawa like me ka mālama ʻana i kahi haʻahaʻa haʻahaʻa o ka hypoglycemia. ʻO kēia ʻano ka hoʻohālikelike ʻana i nā kapalaka ʻana i ka papaʻai o ka maʻi maʻi, ʻai nui i nā protein a me nā ʻono maoli no ka puʻuwai.

ʻOi aku ka liʻiliʻi o nā momona e ʻai ai ʻoe, ʻoi ka mea e pono ai ka ʻaina o ka insulin a i ʻole ka lolo i ka pau ʻana e hoʻohaʻahaʻa i kāu gula. A ma muli iho, ʻo ka emi iki aʻe e ulu i ka hypoglycemia. ʻO ka meaʻai, ʻo ia ka mea nui o nā protein, nā ʻiʻo kūlohelohe kūlohelohe a me ka fiber, e kōkua i ka mālama ʻana i ka nui o ka glucose koko ma ka maʻamau.

Nui nā mea maʻi me ka maʻi diabetes type 2, me ka poʻeʻelemakule, ma hope o ka hoʻololi ʻana i kahi meaʻai hoʻokaʻawale haʻahaʻa e hoʻokele piha i ka insulin a me nā lāʻau hoʻomoʻa. Ma hope o kēia, ʻaʻole hiki i ka hypoglycemia i ka manawa ʻē. ʻOiai inā ʻaʻole hiki iā ʻoe ke "lele" maoli mai i ka insulin, a laila pono ke emi iho. A ʻo ka liʻiliʻi o ka insulin a me nā ʻāpana e loaʻa iā ʻoe, ʻo ka hoʻohaʻahaʻa ʻana o ka hypoglycemia.

Hoʻolālā no ka maʻi type 2 i ka pākeke

ʻO ka mālama ʻana i ka maʻi maʻi āpau 2 ma ka pākeke ke hana pinepine nei i ke kauka. No ka mea ʻoi ka paʻakikī o ka nui o nā maʻi concomitant i loko o kahi maʻi maʻi, a me nā mea pili i ka lehulehu (ka noho aloha ʻana, ka ilihune, ke kōkua ʻole ʻole), ke aʻo ʻana i ka maʻi hoʻomanawanui, a me ka dementia senile.

Pono ke kauka e kuhikuhi i nā lāʻau he nui i ka mea maʻi maʻi maʻi me ka maʻi maʻi. Hiki ke paʻakikī i ka noʻonoʻo pono i nā ʻoina āpau e hiki ai ke hoʻopaʻa ʻia kekahi me kekahi. Hoʻomaʻamaʻi pinepine nā poʻe maʻi pākeke i ka mālama haʻahaʻa ʻana i ka mālama ʻana, a no laila kuʻi lākou i ka lawe ʻana i ka lāʻau lapaʻau a hana i nā hana e mālama ai i ko lākou maʻi.

ʻO kahi hapa nui o nā poʻe maʻi maʻi maʻi e noho nei i nā kūlana pōʻino. Ma muli o kēia, hana pinepine lākou i ka anorexia a i ʻole ke kaumaha kaumaha. I nā poʻe maʻi me ka maʻi maʻi, hopohopo e alakaʻi i ka ʻoiaʻiʻo ua hana lākou i ka regimen o ka lāʻau lapaʻau me ka mālama ʻole ʻana i kā lākou koko koko.

Pono e hoʻonohonoho pono i nā pahuhopu o ke ʻano maʻi diabetes no kēlā me kēia maʻi maʻi. Kuhi lākou:

• ola ka manaʻo;
• piʻeha i ka hypoglycemia koʻikoʻi;
• aia kekahi mau maʻi cardiovascular;
• ua hoʻomohala ʻia nā hoʻopiʻi maʻi diabetes?
• a i ka loaʻa ʻana o nā hana noʻonoʻo noʻonoʻo o ka mea maʻi e hiki iā ʻoe ke hahai i nā ʻōlelo a ke kauka.

Me ka manaʻolana i ke ola (ʻoi ka ola) ʻoi aku ma mua o 10-15 mau makahiki, ʻo ka pahuhopu o ka mālama ʻana i ka maʻi diabetes i ka wā kahiko ua pono e hoʻokō i ka glycated hemoglobin HbA1C <7%. Me ka manaʻolana ola i liʻiliʻi ma mua o 5 mau makahiki - HbA1C <8%. E hoʻohaʻahaʻa i ka glucose koko i loko o kahi maʻi maʻi maʻi mua e pono me ka mālie, a me ka liʻiliʻi.

Ua hōʻike ʻia nā haʻawina i ka makahiki 2000 inā inā ʻoe e hoʻohana i nā hana no ka pale ʻana i ka ikaika o ka hakakā ʻana i ke kōʻai koko, nui ka hoʻonui ʻana i ka ulu ʻana o ka hypoglycemia koʻikoʻi a me ka make ma waena o nā mea maʻi me ka maʻi diabetes 2. No laila, pono e hoʻokaʻawale i ke kiʻekiʻe o ka glucose koko i nā mahina he nui.

Ke mālama nei i ka maʻi diabetes i nā maʻi maʻi ʻelemakule, pono ke kaomi ʻole i ka glucose koko wale nō, akā, ʻo ka cholesterol pū, nā triglycerides a me ke koko. Pono e mālama i kēia mau ʻōuli a pau i loko o nā palena maʻamau e pale ai ka hoʻoulu ʻia ʻana o nā haunaele. Inā hōʻole lākou iā lākou mai kahiʻano, a laila ke kauka nei ke kauka i ka mālama kūpono: nā meaʻai, nā lāʻau lapaʻau mai ka papa o nā statins, nā lāʻau lapaʻau no ka hypertension (e ʻike pū i kā mākou pūnaewele ma ka mālama ʻana o ka maʻi hypertension).

I kēia manawa, ua loaʻa i ka ʻĀina kauka ke kaukaʻi ʻana i nā hana e pili ana i ka mālama ʻana i nā mea maʻi me ka maʻi diabetes type 2, me nā mea ʻelemakule:

• lāʻau lapaʻau lāʻau-pale manuahi (meaʻai a me ka hana kino);
• ka lāʻau lapaʻau o ka maʻi diabetes (nā papa);
• ʻōpū insulin.

ʻO nā pōpoki o nā maʻi a me nā inikua insulin e kūkākūkā ma ka kikoʻī ma lalo nei. ʻO kā lākou hana, ke kuhikuhi nei i ka hoʻoponopono ʻana i nā ʻano hana like ʻole o ka hoʻomohala ʻana i ka maʻi:

• hoʻonui mahuahua o nā kiko i ka hana o ka insulin (hoʻemi i ka pale ʻana i ka insulin);
• ka hoʻoweliweli ʻana o ka huna huna o ka insulin, ka maikaʻi o kona wā mua (ʻaʻole mākou e manaʻo i ka lawe ʻana i nā lāʻau e hoʻoikaika ai i ka ʻimi ʻana i ka insulin! hōʻole iā lākou!);
• hoʻihoʻi hou ʻana i ka hopena hoʻoikaika ʻana i nā hormones o incretins ma luna o ka pancreas.

Ua hoʻonui nā wahi no ka mālama pono ʻana i ka maʻi diabetes mai ka hapa 2 o ka 2000, me ka hōʻea ʻana o nā lāʻau hou mai ka hui ʻomokē. ʻO kēia mau mea o ka meleptidyl peptidase-4 (gliptins), a me nā mimetics a me nā mea hoʻohālike o GLP-1. Manaʻo mākou iā ʻoe e aʻo pono i ka ʻike e pili ana i kēia mau lāʻau lapaʻau ma kā mākou pūnaewele.

Manaʻo mākou ua hoʻololi nā poʻe maʻi hou i kahi meaʻai haʻahaʻa haʻahaʻa no ka maʻi maʻi, i ka hoʻohui ʻia i nā mea ʻē aʻe a pau. Hoʻokomo ʻia kahi pāʻina-a-pale i kalaiwa ʻia i ka hopena o ka renal nui loa. I nā hihia āpau āpau, kōkua ia i ka mālama pono i ke kō koko koko i ka maʻamau, e pale i kāna "jump" a hōʻemi i ka hopena o ka hypoglycemia.

ʻO ka hana pilikino no ka maʻi maʻi maʻi maʻi

ʻO ka hana pilikino kahi mea pono e pono ai i ka mālama maikaʻi ʻana i ka maʻi maʻi. No kēlā me kēia kanaka maʻi, ʻoi aku ka makua, ua koho ʻia ka hana kino pilikino, me ka nānā ʻana i nā maʻi maʻi. Akā pono lākou e koi ʻia. Hiki iāʻoe ke hoʻomaka me nā hele no 30-60 mau minuke.

No ke aha he mea kōkua nui ka hana kino ma ke maʻi maʻi.

• hoʻonui i ka maʻa pono o nā ʻili i ka insulin, ʻo ia hoʻi, e hōʻemi ana i ka pale ʻana o ka insulin;
• Hoʻomaʻamaʻa ka hoʻonaʻauao kino i ka hoʻomohala ʻana o ka atherosclerosis;
• hoʻemi ka hana kino i ke koko.

ʻO ka mea maikaʻi: ʻoi aku ka nui o nā maʻi o ka maʻi ma mua o ka lāʻau ma mua o nā makahiki ʻōpio.

Hiki iā ʻoe ke koho pono iā ʻoe iho i kahi ʻano hana pilikino e loaʻa ai iā ʻoe ka leʻaleʻa. Manaʻo mākou iā ʻoe e heluhelu i ka puke e Chris Crowley a me Henry Lodge "Pōʻalima i kēlā me kēia makahiki."

He puke nani kēia ma ke kumuhana o ka olakino hoʻomaikaʻi i ke ʻano olakino a me ke ʻano hana no nā ʻelemakule. E noi i kau mau ʻōlelo aʻoaʻo e pili ana i kou kūlana olakino. E ʻimi i ke kumumanaʻo e pale aku i ka hypoglycemia i ka wā hoʻomaʻamaʻa.

Hoʻokomo ʻia ka hoʻomaʻemaʻe ʻana i ka maʻi diabetes i nā kūlana aʻe:

• me ka uku ʻoluʻolu ʻole no ka maʻi maʻi;
• i kahi kūlana ketoacidosis;
• me ka panghina ʻole;
• inā he retinopathy proliferative;
• i nā pilikia pono ʻole a pau.

Ma mua o kou hana ikaika ʻana i ka hoʻonaʻauao kino, e nīnau aku i kahi kauka. E heluhelu i kā mākou kikoʻī kikoʻī "hoʻomaʻamaʻa Physiotherapy no ka maʻi maʻi maʻi maʻi."

Nā lāʻau lapaʻau maʻi no nā maʻi maʻi ʻole

Ma lalo nei e aʻo ʻoe e pili ana i nā lāʻau lapaʻau maʻi a pehea e hoʻohana ai iā lākou e mālama ai i nā maʻi maʻi. Inā loaʻa iā ʻoe ka maʻi diabetes 2 type, ʻāpono mākou e hana i kēia:

1. I mea e hoʻohaʻahaʻa i kāu kōkē koko a mālama i ka mea maʻamau, e hoʻāʻo mua i ka ʻai e hoʻokaʻawale ʻia o nā kākā.
2. Hoʻokomo pū i ka hana pilikino i hiki iā ʻoe ke hana a lawe mai i ka leʻaleʻa. Ua kūkā wale mākou i kēia nīnau ma luna.
3. Ma kahi o 70% o nā mea maʻi me ka maʻi diabetes type 2 ua lawa ka mea eʻai ai me ka kaohi o nā mea kāohi a me ka hana kino kino e hoʻomaʻamaʻa i ke kō koko koko. ʻAʻole lawa kēia no ʻoe - e hana i nā hoʻokolohua e nānā i nā pēpē a nīnau aku i kāu kauka inā hiki iā ʻoe ke kuhikuhi i ka metformin (siofor, glucophage). Mai lawe iā Siofor me ka ʻole o ka ʻae ʻana i ke kauka! Inā hana maikaʻi nā keiki, make ka lāʻau lapaʻau.
4. Inā hoʻomaka ʻoe e lawe i ka metformin - mai hoʻōki i kaʻai haʻahaʻa-haʻahaʻa a me ka hana.
5. I kekahi hihia, hōʻole i ka lawe ʻana i nā lāʻau lapaʻau e hōʻeuʻeu i ka huna ʻana i ka insulin! ʻO kēia nā sulfonylureas a me nā meglitinides (lepo hana). He pōʻino lākou. ʻO ka hana ʻana i nā inikini no ka olakino ʻoi aku ka olakino ma mua o ka lawe ʻana i kēia mau paila.
6. E mālama pono i nā lāʻau lapaʻau hou mai ka hui o ka puke.
7. E holo wale aku i ka hoʻololi ʻana i ka insulin inā loaʻa ka pono maoli no kēia, i.e. kahi meaʻai liʻiliʻi haʻahaʻa, hoʻōla a me nā lāʻau lapaʻau e uku ai no kāu maʻi maʻi.
8. E heluhelu i ka "papa hana lapaʻau diabetes type 2."

Metformin - kahi mea lapaʻau no ka maʻi diabetes type 2 i ka wā kahiko

ʻO Metformin (kūʻai ʻia ma lalo o nā inoa Siofor, glucophage) ka lāʻau lapaʻau mua koho mua no nā maʻi maʻi maʻi kahiko. Ua kuhikuhi ʻia inā ua mālama ʻo ka mea hoʻomalu i ka hana renal filtration (glomerular filtration rate ma luna o 60 ml / min) a ʻaʻohe mea maʻi i lawe ʻia e lawe i ka hopena o ka hypoxia.

Heluhelu i kā mākou ʻatikala metformin (siofor, glucophage). ʻO ka Metformin kahi lāʻau lapaʻau maikaʻi ʻaʻole wale e hoʻohaʻahaʻa i ke kō koko koko, akā loaʻa nō kekahi hopena maikaʻi i ke kino. ʻAʻohe mea (ʻaʻole i ʻike ʻia) hopena hopena maikaʻi, e like me ka hapa nui o nā maʻi maʻi ʻē aʻe.

ʻAʻole hōʻemi ʻo Metformin i ka pancreas, ʻaʻole i hoʻonui i ka hopena o ka hypoglycemia, a ʻaʻole ia e kau i ka waiwai kiʻekiʻe. I nā mea ʻē aʻe, hoʻoulu i nā mea luhi. Hiki iā ʻoe ke manaʻo e nalo ke kime 1-3 kg a i ʻole mai ka lawe ʻana i ka metformin. I loko o nā maʻi maʻi he nui, he mea mua ia i ka lemi a me ka indigestion, akā ma hope o ka manawa ua hoʻopili ke kino a holo aku kēia mau pilikia.

Thiazolidinediones

Ua hoʻomaka ʻo Thiazolidinediones (glitazones) e mālama i ka maʻi maʻi ma ka manawa o 20 - 21 mau kenekulia. E like me ka metformin, hoʻonui lākou i ka paʻakikī o nā palapa (nā uaua, nā momona momona, nā ate) i ka hana o ka insulin. ʻAʻole hoʻonā kēia mau lāʻau i ka neʻe ʻana i ka insulin, no laila ʻaʻole hoʻonui i ka hiki o ka hypoglycemia.

ʻO Thiazolidinediones i ka wā monotherapy e hōʻemi i ka pae o ka hemoglobin glycated HbA1C ma ka 0.5-1.4%. Akā maikaʻi wale nō lākou inā ke hoʻomau nei ka pancreas i ka insulin. No laila, ʻaʻohe pono lākou no nā poʻe maʻi e loaʻa ana i ka lolo maʻi type 2 no ka manawa lōʻihi, a hoʻopau ʻia ka pancreas.

Hoʻololi nā lāʻau lapaʻau maʻi Glitazone like me ka metformin, akā, he ʻokoʻa ka hopena ʻona koʻikoʻi. ʻO ka papa inoa o kēia mau mea i loko ʻole e loaʻa ai:

• ka mālama kaʻa ʻana i ke kino;
• ʻo ka waiwai kaumaha;
• hoʻopili ʻana i ka hoʻomohala ʻana o ka hana ʻole o ka naʻau.

Thiazolidinediones (glitazones) ua contraindicated ma ka edema a i ʻole ka huhū ʻana o kekahi papa hana. I nā poʻe maʻi me nā maʻi maʻi maʻi, he paʻakikī ka hoʻohana ʻana i kēia mau lāʻau i nā kumu:

• Hoʻomaʻamaʻa pinepine ka poʻe maʻi ma mua o ka naʻau me ka hiki ʻole o ka ʻano paʻakikī, ma muli o nā hanana cardiovascular ma mua (hōʻeha ka naʻau).
• ʻO Thiazolidinediones (glitazones) e hoʻopili i ka hoʻomohala ʻana o ka osteoporosis, i.e., ke kolo ʻia ʻana o ka calcium mai nā iwi. Hoʻonui lākou i ka hōʻeha o nā mea hōʻeha i nā mea maʻi maʻi mau manawa 2 ma mua o nā lāʻau maʻi diabetes. ʻOi aku ka nui o kēia pilikia no nā wahine ma hope o ka menopause.

ʻO ka pōmaikaʻi o ka hoʻohanaʻana i thiazolidinediones no ka maʻi diabetes, ʻaʻole lākou e hoʻonui i ka maʻa o ka hypoglycemia. ʻOiai ʻo kēia pōmaikaʻi koʻikoʻi, ʻaʻole nā ​​glitazones ka laina mua e koho pono ai no ka mālama ʻana i ka maʻi maʻi i ka wā ʻelemakule.

Sulfonylureas

Ua hoʻohana ʻia nā lāʻau lapaʻau no ka maʻi maʻi i kēia hui mai nā makahiki 50 o ka makahiki iwakālua. Ua "kī ʻia" lākou i nā ʻōleka pancreatic no laila ke hana hou i ka insulin. Hoʻohana a hiki i ke ʻano o ke kino e hana i kāna iho i ka insulin.

No ke aha mākou e koi ai i nā maʻi maʻi āpau e pau i ka lawe ʻana i kēia mau lāʻau lapaʻau.

• Hōʻeu lākou i ka hypoglycemia. ʻO nā ala ʻē aʻe e hoʻohaʻahaʻa i ke kōkela koko ʻaʻole iʻoi aku ka maikaʻi ma mua o nā derivatives o sulfonylurea, ʻaʻole e hoʻonui i ka hopena o ka hypoglycemia.
• ʻO kēia mau lāʻau kūʻokoʻa i hōʻea "i hoʻopau i ka pancreas. ʻOiai he mea maikaʻi ka hoʻomanawanui e mālama i ka hiki ke hoʻopuka i ka liʻiliʻi o kekahi o kāna insulin
• Hoʻokumu lākou i ka hoʻonui ʻana i ke kaupaona kino. ʻO nā koho mālama maʻi maʻi ʻano haʻahaʻa e hoʻohaʻahaʻa iho i ke kō o ke koko, a i ka manawa like ʻaʻole e hoʻonui i ka momona.

Hiki iā ʻoe ke hoʻomaikaʻi i kou ʻano glucose i kāu koko, me ka ʻole o nā lāʻau lapaʻau o kēia pūʻulu a me ka ʻole o ko lākou hopena. Hoʻomaʻamaʻa pinepine, nā mea maʻi me ka maʻi diabetes e lawe i nā derivatives o sulfonylurea ma ke ʻano he hopena hope loa, no laila, ʻaʻole i hiki ke hele i nā inikini insulin. ʻO kēlā "ʻano lapaʻau" pili nui i ko lākou olakino. Eʻoluʻolu e hoʻomaka i ka hoʻomehana ʻana i ka insulin, inā aia nā hōʻailona no ia. E heluhelu i ka "papa hana lapaʻau diabetes type 2."

Nā Meglitinides (Nā Hana Kūʻai)

E like me nā derony e like me ka olonylurea, ua hoʻoikaika kēia mau lāʻau i nā lāʻau beta e hana i ka insulin. Hoʻomaka ʻo Meglitinides (glinids) i ka holo wikiwiki, akā ʻaʻole e mau ka hopena, a hiki i ka 30-90 mau minuke. Ua kuhikuhi ʻia kēia mau lāʻau ma mua o kēlā me kēia meaʻai.

ʻAʻole pono e hoʻohana ʻia ʻo Meglitinides (glinides) no nā kumu like e like me ka sulfonylureas. Kōkua lākou i "hoʻolauleʻa" i ka ulu kiʻekiʻe o ka glucose koko ma hope koke o ka ʻai ʻana. Inā kū ʻoe i ka ʻai ʻana i nā kalapona e pili koke iā ʻoe, a laila ʻaʻole ʻoe e loaʻa hou i kēia hoʻonui.

Hoʻopiʻi ʻOepeptidyl Peptidase-4 (Gliptins)

Hoʻomaopopo i ka hana like me ka ponaide-like peptide-1 (GLP-1) kekahi o nā hormones o ka huaʻala. Hoʻokomo lākou i ka pancreas e hana i ka insulin a ma ka manawa like i hoʻopaʻa ʻia ai ka hana ʻana o ka glucagon, ka "antagonist" o nā insulin. Akā hana wale nō ʻo GLP-1 inā lōʻihi ka lōʻihi o ke kō o ke kō.

ʻO Dipeptidyl peptidase-4 kahi enzyme e hoʻopau pono ana i ka GLP-1, a ua pau ka hana ʻana. ʻO nā lāʻau lapaʻau mai ka pūʻulu o dipeptidyl peptidase-4 inhibitors e pale i kēia enzyme mai ka hōʻike ʻana i kāna hana. ʻO ka papa inoa o ka hoʻomākaukau ʻana no ka glyptin:

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

Hoʻopili lākou i ka hana ʻana i kahi hana a ka mea i hoʻopau i ka GLP-1. No laila, ʻo ka ʻike o ka GLP-1 i ke koko ma lalo o ka mana o ka lāʻau lapaʻau hiki ke hoʻonui i ke kiʻekiʻe o 1.5-2 mau manawa ma mua o ka pae physiological. Wahi a ia, e hoʻoikaika nui ʻia ka pancreas e hoʻokuʻu i ka insulin i loko o ke koko.

He mea koʻikoʻi nā lāʻau lapaʻau mai ka pūʻulu o dipeptidyl peptidase-4 e hoʻomau i ko lākou hopena wale nō i ka hāpai ʻana o ke kō koko. Ke waiho nei i ka maʻamau (4.5 mmol / L), ua pau kēia mau lāʻau e hoʻōla i ka hana o ka insulin a hoʻopaʻa i ka hana o ka glucagon.

Loaʻa nā pōmaikaʻi o ka mālama ʻana i ka maʻi type 2 me nā lāʻau lapaʻau mai ka pūʻulu o nā peptidase-4 inhibitors (gliptins):

• ʻaʻole lākou e hoʻonui i ka hopena o ka hypoglycemia;
• mai hāʻawi i ka waiwai kaumaha;
• ʻaʻole ka hopena o ka ʻaoʻao i ka wā e lawe ai i kahi placebo.

I nā mea maʻi me ka maʻi diabetes ma mua o ka makahiki 65, ʻo ka hopena me ka DPP-4 inhibitors i ka ʻole o nā lāʻau'ē aʻe e alakaʻi i ka emi ʻana o ka pae o ka gogemobob HbA1C glycated mai 0.7 a 1.2%. He liʻiliʻi ka hopena o ka hypoglycemia, mai 0 a 6%. I ka hui hoʻomalu o ka poʻe maʻi āpau i lawe i ka placebo, i hoʻopā ʻia ka hopena o ka hypoglycemia mai 0 a 10%. Loaʻa ʻia kēia mau ʻike ma hope o nā haʻawina lōʻihi, mai 24 a 52 mau pule.

Hiki ke hoʻohui pū ʻia nā lāʻau lapaʻau mai ka pūʻulu o nā peptidase peptidase-4 (gliptins) me nā lāʻau lapaʻau ʻē aʻe, me ka ʻole o ka hoʻonui ʻana i nā hopena ʻaoʻao. ʻO ka hoihoi kūikawā ʻo ia ka manawa kūpono e kuhikuhi ai iā lākou me ka metformin.

Hoʻohālikelike kahi noiʻi 2009 i ka hopena a me ka palekana o ka mālama ʻana i ka maʻi maʻi i nā maʻi maʻi ʻelemakule ma mua o 65 me ka hoʻohana ʻana i nā hui pūnoa e like nei:

• metformin + sulfonylurea (glimepiride <6 mg i kēlā me kēia lā);
• metformin + vildagliptin (galvus) i ka nui o 100 mg pākahi.

ʻO ka emi ʻana o ke kaila o ka hemoglobin HbA1C i ka maʻi maʻi i nā maʻi maʻi ʻelua i nā mea like like. Akā i loko o nā mea maʻi o ka hui mua, ua paʻi ʻia ka 16,4% o ka hypoglycemia, a he 1,7% wale nō i ka metformin therapy me galvus. Ka mea i hoʻololi ʻia i nā derivatives o sulfonylurea me nā DPP-4 inhibitors e hōʻemi i ka pinepine o ka hypoglycemia e 10 mau manawa, ke mālama nei i ka hopena o ka hoʻohaʻahaʻa i ka glucose koko.

Nā Mimetics a me nā hoʻohui o GLP-1

Hoʻokomo ʻia kēia mau lāʻau i loko o kēia pūʻulu o nā lāʻau lapaʻau hou:

• exenatide (bayeta);
• liraglutin (pāpaʻa).

Hoʻohālikelike ka hana o kēia mau lāʻau i ke ʻano o ka hana dipeptidyl peptidase-4 (glyptins). ʻAʻole like kēia mau lāʻau lapaʻau i loko o nā papa, akā ke kau ʻia e subcutaneously.

Ua hōʻike ʻia ua hoʻohālikelike ʻia a me nā mea hoʻohālike o GLP-1 i ka hāʻawi ʻana i ka mea hoʻolilo kaumaha a he haʻahaʻa haʻahaʻa haʻahaʻa loa i ka ulu ʻana i ka hypoglycemia. Hiki iā lākou ke hoʻohana i nā maʻi maʻi me nā maʻi maʻi pākela i loaʻa ka maʻi koʻikoʻi (kahi hui kino kino> 30 kg / m2), inā ua mākaukau ka mea maʻi e hāʻawi i nā inikini.

ʻO ia nā lāʻau lapa mimetics a me nā mea o GLP-1 i manaʻo nui i ka hoʻohana ʻana i "ka hopena hope" inā makemake ka mea maʻi e hoʻolohi i ka hoʻomaka ʻana i ka maʻi diabetes me ka insulin. A ʻaʻole wauʻo sulfonylureas, e like me ka mea maʻamau.

Acarbose (glucobai) - kahi lāʻau lapaʻau e pale ai i ka heʻe ʻana o ka glucose

ʻO kēia lāʻau lapaʻau maʻi he mea hoʻomehana alpha glucosidase. Hoʻopili ka Acarboro (glucobai) i ka hoʻowalewale ʻana o nā haʻalulu pōkole, poly- a me nā oligosaccharides i loko o nā ʻāpana. Ma lalo o ka hopena o kēia lāʻau lapaʻau, emi ka glucose i loko o ke koko. Akā ʻo kona hoʻohana maʻamau e alakaʻi i ka puhipuhi, lemela, ʻōpala, etc.

No ka hōʻemi ʻana i ka paʻakikī o nā hopena ʻaoʻao, ʻoi aku ia e hoʻoponopono i nā haʻalulu paʻakikī i ka mea ʻai a ke lawe nei i ka acarbose (glucobaya). Akā inā ʻoe e hoʻohana i kaʻai haʻahaʻa-haʻahaʻa, e like me kā mākou manaʻo ʻana, e hoʻomaʻamaʻa i ke kō koko koko, a laila ʻaʻohe kumu no ka lawe ʻana i kēia lāʻau lapaʻau.

Hoʻopilikia i ka maʻi maʻi i ka pākeke me ka insulin

Ua hoʻākāka ʻia ka insulin no ka maʻi type 2 inā loaʻa ke ʻano me ka ʻai, ka hoʻomaʻamaʻa a me nā lāʻau maʻi i ka ʻokoʻa ʻaʻole hoʻemi i ke kōhi koko. Hana ʻia ka maʻi diabetes type 2 me ka hui pū ʻole a i ʻole nā ​​papa. Inā he nui ke kaumaha o ke kino, a laila hiki ke hoʻohui pū ʻia nā inikini me ka hoʻohana ʻana o ka metformin (siofor, glucophage) a i ʻole v Ddag-4 inhibitor vildagliptin. Hoʻemi kēia i ka pono o ka insulin a, ma muli, e hoʻohaʻahaʻa i ka nui o ka hypoglycemia.

ʻO ka poʻe ʻōpio me nā maʻi hilahila e hōʻike ikaika loa i ka wā e ho'āʻo ai ke kauka e kuhikuhi i nā ʻōlelo inikua.Eia nō naʻe, inā i hōʻoia ʻia nā mea ʻike ʻia no kēia, pono ke hoʻomau nei ke kauka e hoʻāʻo ʻo ka mea maʻi e hoʻāʻo i ka insulin, ma ka liʻiliʻi no 2-3 mau mahina. Eʻoluʻolu e hoʻomaka i ka mālama ʻana i ka maʻi diabetes i ka wā kahiko me ka insulin, inā he hōʻike no kēia. Heluhelu i ka "Type 2 Diabetes Effective Strategy"

Hōʻike pinepine ia e hoʻomaka nā maʻi maʻi maʻi kahiko i nā lā 2-3 ma hope o ka hoʻomaka ʻana o nā inikini insulin. Ua manaʻo ʻia ua kumu ʻia kēia ʻaʻole wale e ka emi ʻana o ke kō i ke koko, akā, nā hopena o ka anabolic o ka insulin a me nā hopena ʻē aʻe. No laila, ke nīnau nei i ka hoʻi i ka hana o ka maʻi maʻi me ke kōkua o nā papa i nalo i ka pono iā ia iho.

No nā poʻe maʻi maʻi, hiki iā ʻoe ke hoʻohana i nā ʻano lāʻau like ʻole o ka insulin insulin:

• Hoʻokahi kahi injection o ka insulin ma mua o ka moe - inā he hana ʻoi loa ka nui o ka hilo ma luna o kahi ʻōpū ʻole. Hoʻohana ʻia kēlā me kēia lā a ʻoi ole kahi kiʻekiʻe insulin a i ʻole “medium”.
• Nā hoʻonāʻana o ka insulin o ka lōʻihi o ka hana mau manawa 2 i ka lā - ma mua o ka ʻaina kakahiaka a ma mua o ka wā hiamoe.
• Nā manawa hoʻohālikelike i nā insulin like ʻole 2 i ka lā. Hoʻohana ʻia nā ʻano kaulike o "insulin" a me "medium" i nā ratios no 30:70 a 50:50.
• Hoʻokomo ʻia ka palena bolus pae waiwai no ka maʻi diabetes. ʻO kēia nā kaha inika pōkole (ultrashort) ma mua o ka papa ʻai, a me ke ʻano o ka insulin o ka lōʻihi o ka hana a "i hoʻonui ʻia" i ka wā hiamoe.

Hiki ke hoʻohana ʻia ka mea hope loa o ka papa inoa o ka insulin i ka ʻenemi inā hiki i ka mea maʻi ke aʻo a hoʻokau ponoʻī i ka nānā ʻana i ke kō o ke koko a me kēlā me kēia manawa e koho pololei i ke ʻano o ka insulin. Pono kēia i ka mea ʻelemakule e hoʻomau i ka hiki ke hoʻoikaika a aʻo.

Maʻa maʻi hānai i nā ʻōpio: Loaʻa

ʻO ke kanaka ʻoi aku ka mea kiʻekiʻe, ka ʻoi o ka hopena o ka ulu ʻana o ka maʻi diabetes type 2. ʻO kēia no ka maʻi kūlohelohe o ke kino, akā no ka hapa nui ma o ke ʻano o ke ola o ka poʻe kahiko. I nā makahiki he 45 a ʻoi aku - e hoʻomaʻamaʻa ʻia no ka maʻi diabetes i kēlā me kēia 3 mau makahiki. ʻOi aku ka maikaʻi o ka lawe ʻana i ke koko hoʻāʻo no ka ʻaina wikiwiki, akā no ka hemoglobin glycated.

ʻO ka mea e pono ai ka hopena a me ka pono o ka pale ʻana a me ka mālama ʻana i ka maʻi type 2, kahi a me nā poʻe maʻi maʻa ʻole, he meaʻai haʻahaʻa. E hoʻāʻo i kahi puʻuwai haʻahaʻa haʻahaʻa a me ka momona! Aia nā ʻike āpau e pono ai ma kā mākou pūnaewele, me nā papa inoa o nā huahana no nā maʻi maʻi - ʻae ʻia a pāpā ʻia. ʻO ka hopena, e hoʻomaka ka hoʻokahe o kou koko i ka maʻamau ma hope o kekahi mau lā. ʻO kaʻoiaʻiʻo, pono ʻoe e loaʻa i kahi mika koko koko home a hoʻohana iā ia i kēlā me kēia lā.

E pono no ka hoʻonaʻauao kino. E ʻimi i nā koho hoʻoikaika kino e hāʻawi iā ʻoe i ka leʻaleʻa. E kōkua kēia i ka puke ʻo Chris Crowley "ʻōpio i kēlā me kēia makahiki."

Inā ʻaʻole kōkua ka lāʻau hōʻemi i ka hāmeʻe haʻahaʻa a hoʻoneʻe i ke kiʻekiʻe o ke kōpaʻa koko, a laila e hana i nā hōʻike a nīnau aku i kāu kauka inā ʻoe e lawe i ka metformin (siofor, glucophage). ʻAʻole ʻoe e holo i ka lāʻau lapaʻau no siofor, e hana mua i nā hoʻokolohua a nīnau aku i kahi kauka! I ka hoʻomaka ʻana o ka hoʻohana ʻana i ka metformin, ʻaʻole kēia ke manaʻo e hiki iā ʻoe ke hōʻea i kēia manawa a me ka hoʻonaʻauao kino.

Inā ʻaʻole kōkua maikaʻi kaʻai ʻana, hoʻomaʻamaʻa a me nā paila, a laila ke hōʻike ʻia nei ʻoe i ka injectations o ka insulin. E wikiwiki ae hoʻomaka i ka hana ʻana iā lākou, mai makaʻu. No ka mea, ʻoiai e noho ana ʻoe me ka ʻole o ka hoʻonā ʻana i ka insulin me ka kō koko o ke koko - ke ulu wikiwiki nei ʻoe i nā hoʻopiʻi o ka maʻi diabetes Hiki i kēia ke alakaʻi i ka make o ka wāwae, makapō, a i ʻole e make ai ka make mai ka renal maikaʻi ʻole.

ʻO ka hypoglycemia i ka wā kahiko he mea koʻikoʻi nui. Akā hiki i kahi maʻi maʻi maʻi maʻi e hōʻemi i kona hiki ke aneane me ka ʻole o ka hoʻohana ʻana i nā hana 3:

• Mai lawe i nā papa maʻi diabetes e kumu ai i ka hypoglycemia. ʻO kēia nā sulfonylureas a me nā meglitinides (lepo hana). Hiki iā ʻoe ke hoʻomaʻamaʻa maikaʻi i kāu gula me ka ʻole.
• ʻAi e like me nā liʻiliʻi liʻiliʻi. ʻO nā kalana, ʻaʻole ia wale nā ​​mea e pehi koke ʻia. No ka mea ʻaʻole i emi iho ka nui o ka mauʻu i kāu papaʻai, ʻo ka liʻiliʻi e pono ai e hoʻoiho i ka insulin. A me ka emi o ka insulin - e hoʻohaʻahaʻa ka haʻahaʻa i ka ulu ʻana o ka hypoglycemia.
• Inā mau ka kauka e hoʻomau i ka lawe ʻana i nā pōpoki i loaʻa mai ka sulfonylureas a i nā meglitinides (glinides), e kipa aku i kekahi kanaka hou aku. ʻO ka mea like inā hōʻike ʻo ia i pono e ʻai i ka "kaulike". Mai paio, e hoʻololi wale i ke kauka.

E hauʻoli mākou inā ʻoe e kākau e pili ana i kāu mau pōmaikaʻi a me nā pilikia o ka mālama ʻana i ka maʻi diabetes i ka wā kahiko i nā ʻōlelo i kēia ʻatikala.

E heluhelu pū i nā ʻatikala:

• ʻO ka ʻehaʻeha o kaʻeha i ka maʻi maʻi - he aha e hana ai;
• ʻO nā maʻi huehue a me nā hoʻopiʻi maʻi;
• Kekahi mita e koho ai i ka pololei loa.