ʻO ka maʻi diabetes mellitus a me kahi hapalua (he aha ka pilikia o ka maʻi maʻi gestational)

Ua hoʻonui ka ʻōpū i ka ukana ma luna o ke kino o ka makuahine, i kēia manawa ke ʻano nui nā maʻi maʻi, kū mai nā pilikia hou. Ma waena o nā maʻi metabola i ka wahine e hāpai ana i kahi keiki, ʻoi ka maʻi gestational diabetes mellitus (GDM) maʻamau. Ua hui pū ʻia kēia maʻi e pili ana i ka 4% o nā wahine hāpai, 80% o lākou e loaʻa me nā hoʻopiʻi no ka makuahine, ma 45% mau hihia e hōʻeha ai i ka maʻi maʻi gestosis.

ʻAʻole i hala aku ka maʻi maʻi gestational me kahi ʻimi ʻole o ke keiki: ma muli o ka hoʻonui o ka hiki ʻana i ka hana hana, he 20% nā keiki i loaʻa nā pilikia me ka hāliʻi cerebral, ʻo ka 19% he mau kalalā. Ma hope o ka hānau keiki ʻana, pono lākou e hoʻoponopono i ka ʻano o ke koko, hoʻopaʻa i ka hanu a mālama i ka maʻi neurological.

ʻO ka make ma nā keiki i hānau ʻia i nā makuahine me GDM i 2 mau manawa i ʻoi aku ma mua o ka nui.

ʻO ka maʻi maʻi a me nā hoʻohaʻahaʻa manaʻo e hana ia i ka wā ma mua

• Ka hana maʻamau o ke kō -95%
• Hoʻokuʻuina o ka pua thrombosis - 70%
• Hoʻopau i kahi puʻuwai ikaika -90%
• Hoʻopau i ke kiʻekiʻe o ke koko - 92%
• ʻO ka hoʻonuiʻana i ka ikehu i ka wā, hoʻomaikaʻi i ka hiamoe i ka pō -97%

ʻO ka nui o nā hoʻopiʻi i ka wahine a me ke keiki e hilinaʻi nui ana i ka manawa kūpono o ka maʻi maʻi, ka hoʻomaʻamaʻa kūpono a me ke ʻano kuleana o ka makuahine e hiki mai ana i kāna kūlana.

ʻO ka maʻi diabetes - he aha ia?

I ka wā e hānai ai i kahi keiki, nui ka pono o ka glucose, e hoʻomau ke kino iā ia ma ke koko e ʻoluʻolu i ka pono o ka fetal, no laila ua kū mai ka pale ʻana i ka physiological insulin. Inā paʻa kēia kaʻina hana, ulu ka maʻi maʻi gestational. ʻO ka manawa o ka hoʻomaka ʻana, ʻo ka hapalua kēia o ka hapai, ke ʻano nui o ke pēpē ka maʻamau mai 16 a 32 mau pule.

ʻAʻole like me mellitus maʻi maʻamau, ʻaʻole pinepine nā gestational me ka hyperglycemia koʻikoʻi. ʻO nā maʻi maʻi o nā wahine hāpai, e like me ke kāhea ʻia ʻana, ʻaʻole hiki ke hōʻike ʻia ʻaʻole wale nō ka hoʻonui ʻana i ke kō, akā ua hōʻole ʻia hoʻi i ka hoʻohaʻahaʻa glucose. ʻO ke kumu kēia, uaʻoi aku ka nui o ke kōpaʻa koko koko, akā ʻaʻole nui loa a no kēia hewa ka manaʻo e maʻi maʻi.

ʻO kekahi ʻano ʻē aʻe i ka maʻi diabetes gestational kona ʻano kūʻokoʻa. Hōʻike koke nā hōʻailona āpau o ka maʻi ma hope o ka hoʻopuka. I ka wā e hiki mai ana, ʻoi aku ka nui o nā maʻi like me nā maʻi like ʻole i ka wā o ka hāpai ʻana o ka wahine (a ʻoi aku ma mua o 60%), ua hoʻonui ʻia ka hopena o ka maʻi diabetes ʻano 2.

ʻAʻole paha ka hili koko nui e manaʻo iā GDM, akā ʻo ka hōʻike o ka maʻi maʻamau, e mau pū me ka wahine no ke ola. Hiki iā ʻoe ke hoʻokaʻawale i waena o kēia mau pilikia i ka nānā ʻana i ka mea hoʻonohonoho o ke koko a me ka nānā ʻana i ke ʻano o ka pancreas.

Nā hōʻailona maʻi no ka maʻi gestational:

Wahi a ka helu ʻana o nā maʻi, ua hoʻopili ʻia ka maʻi mai ka maʻi mellitus maʻi gestational, ʻo ka helu ICD he 10 O24.4.

Nā kumu o GDM

Hoʻomaka mai ka wā waena o ka wā hāpai, hiki i nā loli hormonal koʻikoʻi i ka kino o ka makuahine: ka hoʻāla ʻana o ka progesterone, plact lactogen, estrogen, cortisol. ʻO nā mea āpau he insulin antagonist, ʻo ia hoʻi ko lākou hoʻonui e lilo i kumu no kona nāwaliwali. Eia kekahi, ke lactogen synthesized e ka placenta e hoʻonui i ka pae o nā momona momona i loko o ke koko, e hoʻonui ai i ka kūʻē o ka insulin o nā io. Hāʻawi i ka hoʻonui i ka glucose a me nā loli o nā maʻamau maʻamau o ke ola o kahi wahine hāpai - he hoʻonui nui hoʻi i loko o ka kalepa, kahi hōʻemi i ka hana kino a me ka hoʻonaninani, loaʻa ke kaumaha.

I ka wahine olakino, hoʻopaʻi ʻia ka pale ʻana i ke kino. Ke hoʻonui nei ke ʻano o ka insulin ma muli o ka hypertrophy o nā peka beta o ka pancreatic, e emi ana kona metabolism ma ka ate. Hoʻokumu ke ʻano maʻi maʻi gestational i nā wahine hāpai inā ʻaʻole i hana kahi ʻano o ka uku uku.

ʻO ka pinepine ka loaʻa ʻana o kēia ma nā hihia aʻe:

1. ʻO ka momona kaumaha ma ka wahine hāpai (> 20% ma mua o ka maʻamau), i loaʻa ma mua.
2. ʻO kahi kīʻaha kiʻekiʻe-calorie me nā nui kākoi.
3. Sedentary lifestyle, ma mua o ka wā hapai.
4. Laula.
5. ʻO ka maʻi diabetes mellitus a i ʻole ka pale ʻana i ka insulin i nā pili pili.
6. ʻO GDM i kahi wā hāpai.
7. ʻO ka kamaliʻi nā keiki mua he paona ma mua o 4 kg ma ka hānau ʻana.
8. Polyhydramnios.
9. ʻŌnuʻi launaima.
10. He 30 mau makahiki. Ma ka makahiki o 40, ʻo 2 ka nui o ka maʻi ʻaʻai o ka maʻi gestational.
11. Ke kuhihewa nei i ka lāhui Mongoloid me Negroid.

Nā hōʻailona a me nā hōʻailona o ke maʻi gestational

ʻO nā ʻōmaʻomaʻo o ka maʻi gestational e komo ai:

• ka waha maloʻo pinepine;
• hoʻonui nui momona;
• mahuahua o ka wai inu, lehulehu a pinepine ae urination;
• hoʻonui ka hoʻonuiʻana i ke kino i loko o ka digestive tract;
• itching, kūikawā ma ka ʻōpū a me ka perineum;
• luhi, luhi i ke kaumaha;
• kandidiasis ponoʻino maikaʻi;
• loaʻa ka momona keu.

E like me kāu e ʻike ai, aia kēia mau hōʻailona āpau i ka hemahema, hiki ke hoʻowalewale ʻia lākou a pau i nā kumu ʻē aʻe, me ka hapai ponoʻī. ʻAʻole ʻike a ʻike ʻia nā maʻi diabetes gestational, no laila ʻo kēlā me kēia wahine, ma hope o ke kākau inoa ʻana, e nānā i kahi palapala ʻokoʻa no ka ʻike ʻana i nā ʻaʻalolo glucose o ka maʻi.

Nā hana hoʻohālikelike

I ka kipa mua ʻana i ke kauka, ua kau ʻia nā wāhine hāpai a pau i nā hoʻāʻo koko koko. Me ka wikiwiki o ka glucose ma luna o 7 mmol / L a me ka gogemobin glycated eʻoi aku ma mua o ke kiʻekiʻe o ka 6,5%, nui ka hopena o ka maʻi diabetes. Inā hui pū ʻia nā helu ʻai maikaʻi ʻole me nā hōʻailona o ka hyperglycemia, ʻike ʻia ka maʻi maʻi. Inā ʻaʻohe ʻike ʻike ʻia o ka nui o ke kō, ua hana ʻia kahi hoʻāʻo ʻana e pale aku i nā hewa. Kuhi ʻia kahi mea maʻi me kahi debut o ka maʻi ma ke ʻano he endocrinologist e hana i nā haʻawina hou, hoʻoholo i ke ʻano a me ke ʻano o ka maʻi, a kuhikuhi i ka mālama ʻana. I ka wā hāpai i ka wahine, he mau kumu no ke kumu o ka piʻi ʻana o ka maʻi mellitus o ka maʻi mellitus, ʻo ia mau hoʻokolohua i hoʻohuli ʻia i hoʻokahi mau pule ma hope aʻe.

ʻO ka manawa maikaʻi loa e ʻike i ka maʻi gestational ka manawa mai 24 a 26 mau pule o ka hāpai ʻana. ^ E Ha yM. Wahi a nā loiloi lapaʻau o ke Kuhina o ke Ola, e hoʻomaʻamaʻa ʻia kahi hōʻike hoʻoliʻi glucose. Inā loaʻa i ka wahine ke hoʻonui i ke kō o ka maʻi maʻi, kahi hapahō nui, nā hōʻailona o ka fetopathy, hiki ke hana ʻia ka nānā ʻana ma hope mai. ʻO ka make he 32 mau pule, ma hope ka pilikia e hiki ai i ka pilikia ma muli o ka piʻi ikaika o ke kō koko koko.

ʻO ka hiʻona o ka hōʻike hoʻokolohua o ke ana ʻana i ka hoʻonaninani o ke koko venous ma kahi ʻōpū ʻole, a ma hope o 60 a me 120 mau minuke ma hope o ka "kaila" o nā palahalaha wikiwiki. ʻO nā kapohalowa he 75 g o ka glucose anhydrite o glucose a he 82.5 g o ka glucose monohala. Hoʻopili ʻia lākou i ke aniani o ka wai mahana a hāʻawi ʻia i kahi wahine hānai e inu. Hōʻike pololei ka hōʻike ʻana i ka glucose i ka huina o ke kao o ka glucose mai ke koko, no laila hoʻokahi hopena maikaʻi i lawa e hōʻike iā GDM.

I mea e pili pono ai i ka pololei o ka hoʻokolohua, he mea kūpono ʻole ka mālama ʻana i ka hoʻomākaukau no ka hāʻawi koko: i kakahiaka ma mua o ke ʻano ʻoi ʻana, hiki nō iā ʻoe ke inu i ka wai wale. Inā ʻai ʻole, ʻaʻohe lāʻau lapaʻau. No 3 mau lā, ʻaʻole kūpono ia e hoʻololi i kekahi mea ma ke ʻano a i ʻole ka hānai ʻana.

ʻO nā kumu ke kau i ka hoʻāʻo:

• huʻipiʻi;
• palena paʻa, hoʻomaha hoʻomaha;
• mākau a hoʻonā ʻia paha;
• nā maʻi ʻeha o ka gastrointestinal, kahi mea i hoʻopuka ʻia ai ka glucose.

Pehea e mālama ai i ka maʻi maʻi i nā wahine hāpai

Hoʻopilikia i ka maʻi diabetes i ka wā hapai ʻaʻole kumu i panic. Inā hoʻomaka ʻoe i ka mālama ʻana i ka manawa, e kipa i ke kauka ma ke ʻano aʻo a me ka hahai i kāna mau papa kauoha a pau, hiki iā ʻoe ke hoʻopau i nā hopena maikaʻi ʻole no ke keiki, pale aku i nā hōʻeha i ka makuahine, a e kaohi aku i ka maʻi maʻi i ka wā e hiki mai ana.

Ke hoʻomalu nei i kēia mau kuhikuhi, mālama nā wāhine hāpai i kahi diary ma kahi lākou i helu ai ia lā: he koko koko - ma kahi he 8 mau ana i kēlā me kēia lā, ʻo ka mua o nā ketones i loko o ka kakahiaka i ka kakahiaka ma mua o ka ʻai, ka paona, ke kaumaha, ka hana fetal, ka papa ʻaina a me nā haʻalulu momona i loko.

Hana ʻia ke nānā ʻana i ka wā hāpai e kahi gynecologist a me kahi endocrinologist. Pono e kipa ʻia nā kauka i nā manawa 2 a i ka mahina a hiki i ka 29th pule a me ka pule i kekahi lā ma hope aʻe. Ma ke ʻano he kānāwai, lawa ka mākaukau a me ka hana maʻalahi e hoʻoliu i ka glucose. I nā pilikia pinepine, hoʻonoho ʻia nā lāʻau insulin.

ʻO ka hoʻohana ʻana i nā lāʻau lapaʻau

ʻO ka hoʻoliʻu haʻahaʻa i hoʻolaʻa ʻia, ka mea i kuhikuhi ʻia no ka maʻi type 2, ua pāpā ʻia i ka wā o ka hapai ʻana, no ka mea ke alakaʻi ʻia nei i ka nele o nā hua fetus. No laila, ʻo ke ala wale nō i kēia manawa ke mālama i ka glycemia i ka lāʻau lapaʻau - insulin i loko o ke ʻano o injections.

ʻ islelo ʻia ka Insulin i ʻelua mau hihia. ʻO ka mea mua, inā ʻaʻohe ikaika o ka meaʻai a me nā hana o ke kino, ʻaʻole hiki i nā pae koko ke koko i ka 2 mau pule mai ka hoʻomaka ʻana o ka ʻoihana. ʻO ka lua, inā hōʻike nā ʻike ultrasound i nā hōʻailona o ka hopena ma ka ʻōpū o nā kiʻekiʻe kiʻekiʻe o ka glucose: kiʻekiʻe ke kau, nui ka nui o ke momona subcutaneous, ʻonanui, huina, polyhydramnios.

Koho ʻia ka regimen haukapila i ke ʻano e ke kauka e like me ka lālani o ke kāohi ponoʻī. ʻAʻole e hana ʻia ka lōʻihi o ka insulin i ka wā o ka hapai ʻana, ma ke ʻano he kānāwai, no ka nele i kona ʻimi ponoʻī. No laila, ʻo ka insulin pōkole a iʻole kāna analogash ultrashort e pono ai e hōʻeha. Hoʻokomo ʻia ka insulin i ka ʻōpū a i ʻole ʻōpū e hoʻohana ana i ka syringe insulin a i ʻole pen - ʻike pehea e hoʻopili pololei ai ka insulin.

Hoʻokomo ʻia ka lāʻau lapaʻau ma mua o kēlā me kēiaʻai ma ke ʻano he mau palaka, ua helu ʻia ka nui ma muli o ka nui o nā pūʻulu ʻai i ka meaʻai. Ke kipa aku nei i kahi kauka, e hoʻoponopono ʻia ka makeke i kēlā me kēia manawa e pili ana i ka ʻike glycemia no ka pule hope loa. Inā nui ka nui o ka insulin i ka lā e pono ai no ke kō o ke koko maʻamau ma mua o nā ʻāpana 100, hiki ke kau ʻia kahi paila insulin ma luna o ka mea maʻi, me ke kōkua o ia lāʻau e hoʻomau ka hoʻomau ʻia ma ka wikiwiki haʻahaʻa.

ʻO kaʻai kūpono a me nā meaʻai

Kōkua maikaʻi: Diet no ka maʻi gestational ma nā wahine hāpai

ʻO ka nānā ʻana i ka papa hana no ka lōʻihi o ke kōmole kekahi o nā kumu nui no ka hoʻokō ʻana i ka maʻi maʻi gestational. ʻO ka hapa nui o nā wahine hāpai me kēia maʻi he nui loa, no laila pono ʻoe e kaupalena i ka calake intake.

Nā Kauka Hana ʻia:

I mea e loaʻa i ke kino nā momona e pono ai me ka hōʻemi o ka calorie i hōʻemi ʻia, pono pono i ka papa inoa i nā greens, nā mea ʻai, ka ʻai a me ka iʻa, nā hua.

He aha nā huaʻai a me nā mea kanu ʻai ʻia: nā ʻōpala āpau, nā kukama, nā aniani, nā greens āpau, ʻōpala, zucchini, hua manu, kāloti raw, avocados, lemona, nā ʻoma, nā cherries, nā huaʻala, nā hua ʻai.

Lāʻai: nā ʻuala, kāobala kālai ʻia, ka lā, nā melona, ​​nā maiʻa, ka ʻawaʻawa, ʻoi loa ka hohi kohi.

Diet no ka maʻi maʻi gestational e pono e hoʻokō i kēia mau koi:

1. Ka Hoʻohui momona. I ke 6 mau manawa ma nā wahi liʻiliʻi e like me nā kaulike like.
2. ʻOi mau ka hana. Mai hoʻokiolo ʻole a hoʻolohi i ka manawa pāʻina i manawa lōʻihi.
3. ʻO ka weheʻana i nā kaola wikiwiki. Hoʻopiha piha loa i ka kō, nā mea ʻala me kāna ʻike, ka palaoa, kaʻai koke - e pili ana i ka wikiwiki a me ka haʻalulu pailua //diabetiya.ru/produkty/bystrye-i-medlennye-uglevody.html.
4. E hoʻonui i ka nui o ke kao i ka papa hana. ʻOi aku ka nui o nā lau ʻai i ka mea kanu ʻia i ka wela - nā meaʻai momona.
5. Hoʻohui i nā momona momona i 10%. Hoʻololi i nā iʻa ʻai, ka ʻai me ka aila ʻaila ma mua o nā momona holoholona.
6. ʻO ka hoʻonā wai kūpono. I ka wā hāpai, pono ʻoe e inu i ka liʻiliʻi o 1,5 lita i kēlā me kēia lā.
7. Ka nui o ka kō ana o nā huaora.

ʻO ke ʻano o nā mea kanu (BJU) no ka maʻi maʻi gestational e pono e nānā e like me: nā protein = 20-25%, nā mea momona <30%, mea kalaiwa = 38-45%.

ʻO Gymnastics a me ka hoʻonaʻauao kino no ka maʻi maʻi gestational

Mālama ka hana hoʻoikaika kino i ka hoʻohaʻahaʻa ʻana i ka pale ʻana i ka insulin a pale i ka nui ʻana o ke kaupaona ʻana, no laila ʻaʻole pono e haʻalele ʻia ka hoʻomaʻamaʻa inā he maʻi gestational. Hoʻālikelike ʻia ka papahana aʻoaʻo no kēlā me kēia wahine i kēlā me kēia, e pili ana i kona olakino a me kona mau kino. ʻO nā haʻahaʻa haʻahaʻa haʻahaʻa-hele - hele, ʻauʻau a wai wai aerobics. ʻAʻole hiki iā ʻoe ke hana i ke kau ʻana ma luna o kou kua a i ʻole ʻōpū paha, e hoʻoneʻe ana i ka ʻoki a me nā wāwae. ʻAʻole kūpono nā haʻuki i hoʻopōʻino ʻia: nā lio, nā keke, nā lewa a me nā mea pana.

Nā ʻano hana hou e mālama ai i ka GDM

ʻO ka hāpai ʻana kahi manawa e hoʻonui ʻia ai ka nāwaliwali o ka māmā a me ka pēpē. Ma muli o ka makemake e pale i ka lāʻau lapaʻau, nui nā wahine i kēia manawa ke hoʻololi i ka lāʻau lapaʻau. Eia kekahi, ʻo ka hoʻāʻo e mālama i ka maʻi maʻi gestational, me ka ʻike ʻole, e like me nā ʻona mai ka Pūnaewele ua hiki i ka hopena me ka maikaʻi.

Ma ka hapa nui me nā mea kanu, ua helu pū ʻia ka wahine hāpai ma ka papa inoa o nā contraindications. No laila, pono ʻoe e hana i kahi kānāwai: ʻo kēlā me kēia lapaʻau hou e pono aponoia e ke kauka komo ana.

Pau ka mea e hoʻoneʻe ai i ka maʻi maʻi gestational i ka hakakā ʻana ʻo ka maʻi rosehip. E hoʻopau aku ia i ka nele o ka vitamin C, e hōʻemi i ka nui o nā radical manuahi, a e hōʻoluʻolu i ka huehue. He maʻalahi kēia ʻōwele: ʻo kahi manamana o nā h rose ma kahi i kau ʻia ma kahi thermos ma mua o ka hele ʻana o ka moena, e ninini i kahi lita o ka wai kaila. I ke kakahiaka, ua mākaukau ka mea ʻala ʻala. E inu i ka hapalua o ke aniani ma mua o ka papaʻaina.

ʻO ka hopena o ka maʻi diabetes ma ka wā hāpai

ʻO ke kiʻekiʻe o ke kō koko koko i loko o kahi wahine hāpai, ʻoi aku ka nui o ka weliweli no kahi keiki. Inā ʻaʻole e nānā pono i ka mālama ʻana, kūkulu ka fetopathy fetal: hānau nui ke keiki i ke ʻano nui, me kahi pancreas i hoʻonui ʻia, ʻoi loa ka momona. E loaʻa iā ia nā pilikia hanu, hypoglycemia, pākīpī o ka lipid lipid. I ka wā e hiki mai ana, ʻoi aku ka nui o kēia mau pēpē i ka momona o ka momona a me ka maʻi diabetes.

ʻO ka hānau ʻia me ka maʻi maʻi gestational e kuhikuhi pinepine ʻia ma 38 mau hebedoma. Inā nui ke kaumaha o ke keiki, ua ʻoki ʻia kahi ʻāpana cesarean. ʻAʻole e like me nā keiki maʻamau, ʻo ka makuahine me ka maʻi maʻi e pono ai i nā meaʻai mai nā minuke mua o ke ola, e like me kā lākou pancreas, hana i ka hopena o ke kō o ke koko, e hoʻomau i ka nui o ka insulin i kekahi manawa. Inā hiki ʻole ke kīnā ʻole pono e hoʻomaikaʻi pono i ka glycemia, ua paʻi ʻia ka pēpē me ka glucose intravenously.

He aha ka maʻi maʻi maʻi gestational no ka makuahine: i ka wā hapai - edema, kiʻekiʻe ke koko kiʻekiʻe, ʻohiʻawa i ka maʻi maʻi. I ka wā hānau ʻana - ua hoʻonui ʻia ka nui o nā rupture ma muli o kahi maʻi fetus. Ma hope o lākou aia kahi pilikia nui o ka maʻi gestational i ka wā o ka wā hāpai a me ka maʻi diabetes type 2.

Pono e nānā ʻia ma hope o ka hānau ʻana

ʻO ka nānā ʻana o nā maʻi a me nā loiloi o nā makuahine e hōʻike ana he nui loa ka maʻi diabetes gestational i ka wā i hānau ai ka pēpē. Ma hope koke o ka haʻalele ʻana o ka plasenta, ʻo ia ka mea nui ka nui o ka nui o ka hāneau nui ma ka wā hāpai, hoʻoilo ʻia ke koko koko. A hiki i hoʻokuʻu ʻia ka wahine, hoʻomau lākou e nānā i kona pae kūlohelohe.Ma hope o 2 mau mahina, pono ʻoe e lawe hou i ka hoʻoneʻe o ka glucose i ʻike e ʻike ai inā he mau kākena metabolism i koe iho a inā ʻoe e alo ana i ka maʻi ma ka wā e hiki mai ana.

No ka hōʻemi ʻana i ka pilikia, pono nā wahine i loaʻa iā GDM e hōʻemi i ka paona, e pale i nā pale kākī wikiwiki, a hoʻonui i kā lākou kino kino. I ka hoʻomākaukau no ka hāpai ʻana aʻe, e ʻike ʻike ʻia e ka endocrinologist.