Ngaphambi kokukhulelwa
Ukuba unesifo sikashukela, kufuneka ukhulelwe. Qala ukunxibelelana nomfundi we-gynecologist endocrinologist ubuncinane kwiinyanga ezintandathu ngaphambi kokuba ukhulelwe kwaye uzama ukufumana umvuzo ozinzileyo wesifo sikashukela.
Iintlobo zesifo sikashukela kunye nendlela yokuphila
Isifo sikashukela sisigxina esingapheliyo seshukela (i-glucose) egazini kunye nomchamo.
- Zikhona iintlobo zesifo sikashukela:
1. I-diabetes yohlobo lokuqala luxhomekeke kwi-insulin. Ngesizathu esithile, i-insulin emzimbeni ayivelwanga ngokwayo, ngenxa yoko, i-glucose ayinakucutshungulwa. Iqondo eliphantsi kakhulu le-glucose egazini elibizwa ngokuba yi-hypoglycemia, eliphezulu kakhulu-hyperglycemia. Xa i-hyperglycemia iyimfuneko ukubeka iliso kubukho bemzimbeni ye-ketone kumchamo. Isondlo esifanelekileyo kunye nokusebenza ngokulinganiselayo, ukulandelwa rhoqo kwezinga leshukela legazi kunokukwenza ubomi bomguli ngesifo sikashukela se-1 sisondele ngokusemandleni.
2. I-diabetes yoluhlobo lwesibini alunxulumene ne-insulin. Ngokuqhelekileyo kubonakala kubantu abangaphezu kweminyaka engama-40 ubudala kunye nobunzima bomzimba obugqithiseleyo.
3. I-Pancreatic diabetes. Ukuphuhliswa kulabo abaneepancreas ezichaphazelekayo, ezixanduva emzimbeni ukukhutshwa kwe-insulin.
4. I-diabetes mellitus yabasetyhini abakhulelweyo, okanye isifo sikashukela sesifo sikashukela (HSD). Oku kukwaphulwa kwe-carbohydrates metabolism, eyenzekayo okanye iyaqatshelwa okokuqala ngexesha lokukhulelwa. Phantse kwisiqingatha seemeko, i-GDD idlula emva kokubeletha ngaphandle kokulandelwa, kwaye kwisiqingatha - iya kuhlobo lwesibini sikashukela.
Iimeko eziphambili ziyimbuyekezo yesifo sikashukela kunye nokungabikho kweengxaki ezinzulu (ukungaphumeleli kwintsholongwane engapheliyo, isifo senhliziyo yesichemicic, i-retinopathy esandayo kunye ne-hemorrhages kwi-fundus, njl.). Ngokuchasene nemvelaphi yokuhlengahlengiswa kwesifo sikashukela, kuyingozi ukukhulelwa: ishukela ephezulu yegazi isenokuthintela ukubekwa ngokufanelekileyo kwezitho zangaphakathi zesisu, okwenzeka ikakhulu kwi-trimester yokuqala yokukhulelwa. Ukongezelela, ukuphuphuma kwesisu kungahle kwenzeke. Kunconywa ukuba ube noviwo olupheleleyo lwezokwelapha kwangaphambili: njengawo nawuphi na umfazi, akunakukwazi ukujonga ukusuleleka kwezifo ezithathelwa ngokugqithiseleyo ngokulalana ngesondo, qhagamshelana ne-neurologist, i-cardiologist (oku kuyimfuneko yokufumana isifo sikashukela iminyaka engaphezu kwe-10), i-oculist-ukuba ihlolwe iimpahla ze-fundus, kunye nomfundi ehluthwe. Yenza i-ultrasound ye-thyroid gland uze u tyelele i-endocrinologist. Ukuba kuyimfuneko, tyelela i-nephrologist kwaye uye kwintlanganiso yokubonisana kwi-ofisi ethi "I-Stop Diabetes Stop". Ezi zilandelayo mvavanyo zelabhu kufuneka zenziwe:
♦ i-hemoglobin ene-glycated;
♦ microalbuminuria (UIA);
♦ uvavanyo lwegazi lwekliniki;
♦ Uvavanyo lwegazi lwe-biochemical (creatinine, iprotheni, i-albin, i-bilirubin, i-cholesterol epheleleyo, i-triglycerides, UMTHETHO, i-ALT, i-glucose, i-uric acid);
♦ ukuhlalutya ngokubanzi umchamo;
♦ Uvavanyo lwezinga lokuhlanjululwa kwe-glomerula (uvavanyo lukaReberg);
♦ Uhlalutyo lwe-Urine lweNechiporenko;
♦ I-urine isithethe sokunyumba (xa kuyimfuneko);
♦ Ukuhlola umsebenzi we-thyroid (iimvavanyo ze-TTG zamahhala T4, AT ukuya kwi-TPO).
Ngexesha lokukhulelwa
Ukukhulelwa kwabasetyhini abane-SD-1 kunempawu ezininzi. Abantu abanesifo sikashukela bayazi iqondo legazi laso, kodwa abahlala besazi ukuba ngexesha lokukhulelwa, izinga leswekile kufanele libe ngaphantsi kwesi siqhelo. Umgaqo wabasetyhini abakhulelweyo abanesifo sikashukela kufuneka babe ngumlinganiselo oqhelekileyo wezinga legazi le-glucose - ubuncinane ama-8 ngosuku. Kwi-trimester yokuqala yokukhulelwa, u-hypoglycemia inokwenzeka: umngcipheko wokunyuka kwengcinezelo yomama kumama, ukuphulwa kwegazi ukuhamba kwiinqanawa ze-placenta kunye ne-fetus, ukuphulwa kwentliziyo kwisigqithiso kumama kunye naseswini, i-hypoxia yesisu. Ibhinqa likwazi ukulahlekelwa ingqondo ize iwele kwi-coma. Iimpawu ze-hypoglycemia: intloko, intlanzi, indlala, umbono ongaphumeleli, ukuxhalaba, ukukhawuleza, ukuthuthumela, ukuthuthumela, ukuxhalabisa, ukudideka. Ukuba unamava angentla, kufuneka ukhangele iswekile yegazi. Ukuba oku akunakwenzeka, kufuneka umeke nayiphi na into eyenziwa ngumzimba, uthathe i-carbohydrate enokukhawuleza ngokukhawuleza (12 grams ngu-100 ml yejusi okanye i-soda e-sweet, okanye i-2 ishukela, okanye itafile e-1, i-spoonful honey). Emva koko, kufuneka udle i-carbohydrate engancinci (12-24 g - isonka sesonka, iglasi ye yogurt, i-apula). Inqanaba eliphezulu leswekile egazini likaMama lingakhokelela ekuphuhlisweni kwentsholongwane yomntwana, njengobungane besifo sikashukela. Iyakwazi ukukhawuleza ngokukhawuleza okanye ukukhula kancinci kwe-fetus, polyhydramnios, ukuvuvukala kwezicubu ezithambileyo. Usana olusandul 'ukuzalwa lunokugula ngenxa yokuphazamiseka kwentsholongwane kunye neurologic, i-hypoglycemia. Isetyhu ephakamileyo yegazi inokuthi "i-hiccup" umntwana kwaye kamva i-endocrine okanye ingxaki yeengxaki zentsholongwane. Ukuze ugweme imiphumo enjalo, ngexesha lokucwangcisa ukukhulelwa kunye nazo zonke iinyanga ezili-9 zokulinda, mahlale uqhagamshelana nodokotela. Ngokunyuka kweshukela legazi, kufuneka ukhansele nantoni na eyenziwa ngumzimba kwaye ukhangele umchamo kumzimba we-ketone (oku kungenziwa ngokusebenzisa amaqhinga okuvavanywa athengiswa kwi-pharmacy), kwaye usebenzise iziphakamiso ze-gynecologist-endocrinologist kwimeko ye-glycemia. Gcina idayari apho urekhoda imilinganiselo yeswekile, ubungakanani be-carbohydrate, ukuveliswa kokutya, umthamo we-insulin. Ungakulibali ukujonga indlela ulinganisa ngayo, kwaye ulinganise uxinzelelo lwegazi. Kubalulekile ukubeka iliso kubukho bamaziko e-ketone kumchamo kunye nokufumaneka kwazo ngokukhawuleza uzazise ugqirha wakho. Kungadingeka ukuba ulinganise umthamo ongeyomnxila kuphela, kodwa kunye ne-fluide exreded (diuresis). Nangona isifo sikashukela esikhatywayo ngexesha lokukhulelwa, kunzima ukuphumeza inqanaba elinqabileyo leswekile egazini.
Ukuba kuyimfuneko, ugqirha unokukuthumela apha:
♦ Ukutshatyalaliswa kwemifanekiso - usebenzisa i-ultrasound, ukuhamba kwegazi kuhlolwe kwintambo yomlomo, i-placenta kunye ne-fetus;
♦ I-cardiotocography - ihlolwe ukuba umntwana lowo unesondlo se-oksijini (i-hypoxia).
Ukuphononongwa kwempembelelo yonyango ye-insulin kuqhutyelwa ngokusebenzisa isifundo se-fructosamine (i-protein ye-albumin yeprotein yegazi kunye neglucose yegazi). Kwi-trimester yesithathu yokukhulelwa, ugqirha uya kukumema kaninzi kunaphambili. Oku kubangelwa kukuba kungoku ngeli xesha ukuba ingozi yeengxaki ezinxulumene nesifo sikashukela iyanda. I-gestational diabetes mellitus ihluke kwi-gestosis yabasetyhini abakhulelweyo. Isizathu sokubonakala kwayo sinciphise ubunzulu beeseli kwi-insulin yabo. Ngokwezinzululwazi zaseYurophu, ukusabalalisa kwe-GDD kuvela kwi-1 ukuya ku-14% phakathi kwabasetyhini abasempilweni. Kwinqanaba elijongene nobungozi - abafazi abakhulelweyo abanomzimba ogqithiseleyo, benembali ye-obstetric anamnesis. Thatha uvavanyo lwegazi ngentshukela kunye nokuhlolwa kwegazi ngomthwalo we-glucose. Ukuba ii-indices ziqhelekileyo, okwesibini uvavanyo luqhutyelwa kwiveki yama-24 ukuya kwe-28 yokukhulelwa.
Ukuzala
Abaninzi abafazi abakhulelweyo abanesifo sikashukela bangakwazi ukuzala ngokuzimela, ukuba akukho zizathu ezongezelelweyo zesigaba se-quarantine kunye nokuchasene okungeyona nto yokukhulelwa komzimba. I-Polyhydramnios, i-gestosis kunye nosulelo lwe-urogenital lungakhokelela ekuzalweni kwangaphambi kokuzalwa. Inkxalabo eqhelekileyo ekuzalweni kwezigulane ezinesifo sikashukela i-disinatal discharge of amniotic fluid.
Emva kokubeletha
Ngokuqhelekileyo, umama uyayika ukuba umntwana wakhe uya kuba nesifo sikashukela. Ukuba ubaba womntwana akanalo esi sifo, ngoko ukuhlaselwa kwesifo sikashukela kumntwana malunga ne-3-5%. Ukuba ubaba unesifo sikashukela, umngcipheko uqikelelwa malunga ne-30%. Kule meko, kucetyiswa ukuba wenze iimvavanyo zofuzo ngaphambi kokukhulelwa. Iintsana zidinga ukunakekelwa okhethekileyo. Iintsana kaninzi zizalelwa ngokukhuluphala, kodwa zinemiphunga engaphantsi. Kwiiyure zokuqala zokuphila, izifo zokuphefumula, kunye nomonakalo omkhulu womnyoba, i-acidosis, amazinga e-glucose egazi kufuneka agwenywe; ukuqhuba ukuhlolwa kwentliziyo. Kwiintsana, ukunyuka komzimba okweqile, ukuvuvukala kwesikhumba, ukwandiswa kwesibindi kunye nesantya kuya kuqatshelwa. Iintsana ezisuka kumama kunye ne-SD-1 azihambelani kakuhle kwaye ngenxa yoko zihlala zihlushwa i-jaundice zintsana, i-erythema enetyhefu, ilahlekelwa ubunzima emva kokuzalwa kwaye ibuyise ngokuthe ngcembe. Kodwa yonke into iphakanyisiwe!
U-Vanyusha wazalwa ngeqendu le-37 kwiiveki. Unina u-Ole wayeneminyaka engama-29 ubudala xa unyana wakhe wazalwa. Kwiminyaka emine nesiqingatha kamva umfazi wazala intombi. Akukho nto ekhethekileyo? Mhlawumbi - ukuba kuphela ngexesha lokuzalwa komntwana wokuqala u-Olya wayengenasova nesifo sikashukela iminyaka engama-19! Ingxaki ebalulekileyo yabasetyhini abafuna ukuba nabantwana banesifo sikashukela se-type 1 (SD-1). Oogqirha bayesaba ubomi bomama nomntwana kwaye abahlala bekulungele ukuthatha uxanduva lokuqhuba ingxaki yokukhulelwa. Ngoko kwenzeka ntoni no-Olya, ongazange afumane inkxaso yokuqala yoogqirha. U-Olya uthi: "Ndinenkxaso ethembekileyo - indoda yam. Nguye owahamba kunye nami kuzo zonke iingxoxo, wayejonga zonke iindidi zamanqaku, wayeqwalasela onke amanani e-insulini, wandilinganisa isonka sezonkwa zesiqhelo ukusebenza kwaye ngokubanzi ndilandele ngokutya kwam. Ukucima ukukhanya kwam amaqhinga, ndivusa ebusuku, ngezinye iiyure nganye ireyithi ukulinganisa umgangatho we-glucose, wandilungisa ngamanzi xa kunyanzelekile njalo njalo. Izigidi zezinto ezinje ezincinci, kwaye ziqwalasele zonke izinto-eyona nto yayinzima kum. "Ngale ndlela, umntu unokuphepha iimiphumo emibi kumama nosana.Umsebenzi oyintloko we-endocrinologists kunye nababelethisi kufuneka ukuba kuqinisekiswe ukuhlaziywa okusemgangathweni kwe-carbohydrates metabolism kuzo zonke izigaba - ukusuka ekukhulelwe ukuya kuzalwa.