Ngaba ungasibuyisa umva isifo seswekile?
Imfundo yezeMpiloSeswekile (ekwabizwa ngokuba sisifo seswekile) xa amanqanaba eswekile yegazi (ngamanye amaxesha abizwa ngokuba yiglucose yegazi) aphezulu kakhulu. Iglucose yegazi ngowona mthombo uphambili wamandla omzimba. Ifunxwe ekutyeni kwaye ingena kwiiseli ngoncedo lwehomoni ye-insulin, eyenziwa yipancreas.
Ngaphezulu kwezigidi ezingama-34 zaseMelika ezinesifo seswekile, nakwindawo ezijikelezileyo 90% -95% kubo kukho Uhlobo lwe-2. Ichaphazela ikakhulu abantu abangaphezulu kweminyaka engama-45, kodwa baya besanda abantwana kunye nabantu abadala.
Ngaba kunokwenzeka ukubuyisa umva isifo seswekile?
Kuyenzeka ukuba uguqule zombini ii-prediabetes kunye nohlobo lwe-2 lweswekile. Uhlobo lwe-1 kunye neswekile yokukhulelwa ayinakubuyiselwa; Abantu abanezi meko banako kuphela phatha kwaye ulawule kubo.
Uninzi lwabantu abanesifo seswekile banokunganyangeki kwi-insulin, oko kuthetha ukuba imizimba yabo ayisebenzisi kakuhle i-insulin kunye neglucose emva koko ihlala egazini kwaye ingafikeleli kwiiseli, ekugqibeleni ibangela iingxaki zempilo. Abanye abantu abanesifo seswekile abayenzi ngokwaneleyo i-insulin okanye abayenzi kwaphela. Kukho iindlela ezimbalwa eziqhelekileyo zesifo seswekile:
- Uhlobo lwe-1 yeswekile kuxa umzimba ungenzi insulin. Amasosha omzimba ahlasela kwaye abulale iiseli kwipancreas ezenza i-insulin. Ababoneleli ngezempilo bahlala bechonga le fomu yeswekile kubantu abancinci, kodwa inokukhula nangaliphi na ixesha. Uhlobo lwe-1 lwezigulana zeswekile kufuneka zithathe i-insulin yonke imihla.
- Uhlobo lwe-2 yeswekile kuxa umzimba ungenzi okanye usebenzise i-insulin kakuhle. Yeyona ndlela iqhelekileyo yeswekile. Nangona inokwenzeka nakweyiphi na iminyaka, udidi 2 lweswekile luhlala lukhula kubantu abadala kunye nabadala.
- Isifo seswekile ikhula kwabasetyhini abakhulelweyo. Ihlala iphela emva kokuba umntwana ezelwe kodwa inyusa umngcipheko wokuba nohlobo lwesibini lweswekile kamva. Isifo seswekile ngexesha lokukhulelwa ngamanye amaxesha sikudidi 2 lweswekile.
Ababoneleli ngezempilo bafumanisa abantu abane kwisifo seswekile . Kulapho amanqanaba eswekile yegazi aphezulu kunesiqhelo kodwa engaphakamanga ngokwaneleyo ukuba angaba sisifo seswekile. I-Prediabetes iphakamisa umngcipheko wokuphuhlisa i-Type 2 diabetes kwaye inezizathu ezininzi ezifanayo.
Ezinxulumene: Ngawaphi amanqanaba esiqhelo eswekile yegazi?
Yeyiphi indlela ebalaseleyo yokuguqula isifo seswekile?
Inyathelo lokuqala kuxolelo lweswekile kwabo bane-prediabetes kunye nohlobo 2 lweswekile kukulawulwa kweglucose. Oko kwenziwa ngamayeza xa kufuneka, ukutya ukutya okusempilweni, kunye nokwehla kobunzima obongezelelweyo ukunceda umzimba uphendule ngokufanelekileyo kwi-insulin. Ezi ntshukumo zinokunceda ukubuyisela ukunganyangeki kwi-insulin kunye nokuthintela okanye ukulibazisa udidi 2 lweswekile kubantu abanesifo seswekile.
Inkqubo ye- Inkqubo yokuThintela isifo seswekile (DPP), uphononongo oluqhubekayo oluqale ngo-1996 kwaye luxhaswa ngemali ngamaZiko ezeMpilo kaZwelonke, lubonisa ukuba abantu abasemngciphekweni omkhulu wesifo seswekile banciphise amathuba okuphuhlisa isifo ngokuphulukana ne-5% -7% yobunzima bokuqala. Kumntu onobunzima obungama-200 eepawundi, ziiponti ezili-10 ukuya kwezili-14. Abantu abathathe inxaxheba kolu phando baphulukana nobunzima ngokutshintsha ukutya kwabo kunye nokuzilolonga ngakumbi.
1. Utshintsho kwizidlo
Umbutho we-American Diabetes Association (ADA) kunye neqela lezenzululwazi, oogqirha, abafundisi besifo seswekile, kunye nezidlo ezenzelwe ukufumana ukuba zeziphi iindlela zokutya ezisempilweni ezisebenza kakuhle kubantu abanesifo seswekile. Baphonononge ngaphezulu kwamanqaku ophando angama-600 kwaye bafumanisa ukuba akukho kutya kumnye okusebenzela wonke umntu, kodwa ukulandela izikhokelo ezimbalwa kunokunceda abantu ukulawula imeko. Ngokubanzi, ingxelo yabo icebisa ukuba abantu abanesifo seswekile batye imifuno emininzi engeyiyo enesitatshi, ukutya okuziinkozo okungagqitywanga, kunye neswekile encinci.
Kwizigulana ezinesifo seswekile, ukutya ngokwako okanye ukutya akunamsebenzi; kuninzi malunga nokulawulwa kwesabelo kunye nokuphila ixesha elide-nokuba ukhetha ukutya okuncinci kwe-carb, ukutya kwe-ketogenic, ukutya kweMeditera, okanye ukuzila ukutya okuphakathi. Akukho mahluko phakathi kokutya okanye okunye, utshilo uGhada Elshimy, MD, ugqirha we-endocrinologist Impilo yeYunivesithi yaseAugusta . Into ebaluleke kakhulu kukunamathela kwisidlo esinye. Kwaye sixelela abaguli ukuba batye imifuno, iiprotheyini ezininzi, kunye neecarbohydrate ezimbalwa.
Ucebisa indlela yesifo seswekile, ekwamkelweyo nguMbutho weSwekile waseMelika. Yahlula ipleyiti yesidlo sangokuhlwa ibe ngamacandelo amathathu-isiqingatha sesemifuno engekho istatshi, ikota enye yiprotein, kwaye ikota yokugqibela ziicarbohydrate. Ugqirha Elshimy wongeza ukuba abaguli abanesifo seswekile kufuneka banamathele kwiigram ezingama-60 zekhabohayidrethi kwisidlo ngasinye (ilingana nebagel enye), kwaye okuncinci xa kunzima, kungcono.
Ezinxulumene: Yintoni kanye iicarbohydrate?
2. Uthintelo lweekhalori
Kuthekani ngokutya ukutya okusezantsi kweekhalori? Kwi isifundo esincinci esivela kwi-2011 , Abaphandi bathintele abantu abanesifo seswekile sesi-2 ukuya kwii-calories ezingama-600 ngosuku kwiiveki ezisibhozo. Bafumanise ukuba iimpawu zeswekile-Ukunganyangeki kwi-insulin kunye nomsebenzi wepancreas-yaqala ukuphucula, ibonakalisa ukuxolelwa kweswekile. Nangona kunjalo, abaphandi baqaphele ukuba uphando oluthe kratya luyafuneka kwiqela elikhulu labantu.
Ngokufanayo, Olunye uphando lubonisa ukuba ukudlula esiswini okanye utyando lwe-bariatric, olucutha ubungakanani besisu kunye nokunciphisa iikhalori, lunokubuyisa isifo seswekile. Kwisifundo esinye, abaphandi baseDenmark bafunda ngaphezulu nje kwe-1,100 yabantu abane-Type 2 yeswekile ababenotyando oludlula esiswini. Kunyaka omnye emva kotyando, iipesenti ezingama-74 zazingasadingi kwamayeza okwehlisa iswekile yegazi, ngelixa iipesenti ezingama-27 zabona ukubuya kweswekile emva kweminyaka emihlanu.
Ukudlula kwesisu kukukhetha abantu abanesifo seswekile sesi-2 okanye ezinye iimeko ezinxulumene nobunzima ezinje nge-apnea yokulala, uxinzelelo lwegazi oluphezulu, okanye i-cholesterol ephezulu enesalathiso somzimba (BMI) sama-35 okanye ngaphezulu. Abo banokwenziwa utyando kuya kufuneka benze utshintsho olukhulu kwindlela yokuphila ukuze baphulukane nobunzima babo. Abanye abaguli baneengxaki emva kotyando kwaye abanakukwazi ukubuyisa isifo seswekile.
3. Yenza umthambo
Ukuzilolonga rhoqo kunye nokuthoba amanqatha emzimbeni kubalulekile ekulawuleni udidi 2 lweswekile kunye ne-prediabetes. Umsebenzi womzimba wonyusa iiseli zomzimba ze-insulin uvakalelo ukuze usebenze ngokukuko.
Iingcali zincomela imizuzu engama-20 yomthambo olinganiselweyo ngosuku-Umsebenzi we-aerobic njengokubaleka, ukuhamba ngebhayisikile, okanye ukunyuka intaba, kunye noqeqesho lokumelana nokuphakamisa iintsimbi ukuze wakhe umsipha omtsha. Abantu abangasebenzi kakhulu okanye abanenkxalabo yezempilo kufuneka babonisane nabanikezeli babo bezempilo ngaphambi kokuba baqale inkqubo entsha yokuzivocavoca.
4. Amayeza
Amayeza angadlala indima ekulibaziseni okanye ekubuyiseni uhlobo lwesibini lweswekile. Olunye uphando lubonisa ukuba abantu abanesifo seswekile abathatha i-insulin ngoko nangoko emva kokuchongwa kwesifo seswekile banethuba elingcono lokuphila ngaphandle kwayo kwixesha elizayo kwaye baneengxaki ezimbalwa zeswekile.
Uphononongo lwe-DPP lufumanise ukuba ukuthatha metformin , amayeza ababoneleli ngezonyango ukumisela ukunyanga isifo seswekile, banokuthintela abantu ekuphuhliseni isifo. Kwaye, iiklasi ezimbini zohlobo lwesibini lwesifo seswekile ababoneleli bezempilo abamisela ukuphucula iswekile yegazi-I-GLP-1 agonists kunye ne-SGLT-2 inhibitors-kunokukhokelela nasekulahlekeni kobunzima. Uphando lubonisa ukuba abaguli abanesifo seswekile abathatha amayeza e-GLP-1 banokulahla umndilili weeponti ezintathu ukuya kwisiqingatha nesiqingatha. Elo nani linyuka liye kwiipawundi ezintandathu ukuya kwezisi-9 kunye notshintsho kwindlela yokuphila ukongeza kunyango lweswekile.
Kukho amayeza okuphelisa ukutya. Ugqirha Elshimy uthi elona chiza lisebenzayo kule njongo Qsymia , kwaye uyincomela kuphela kuhlobo lwe-2 lwezigulana zeswekile ezine-BMI ezingama-27 okanye ngaphezulu. Abo bathatha eli chiza kufuneka balisebenzise kuphela ukongeza ezinye iinguqulelo kwindlela yokuphila; Kuya kufuneka bayithathe ubomi babo bonke ukugcina iziphumo zokunciphisa umzimba.
| Igama leziyobisi | Iklasi yeziyobisi | Indlela yolawulo | Umthamo osemgangathweni | Imiphumela | Fumana isigqebhezana |
| IRiomet (metformin) | IBiguanide | Ngomlomo | I-500 mg kabini ngemini okanye i-850 mg kanye ngemini, emva koko yonyuswe ngama-500 mg ngokunyuswa ngeveki okanye nge-850 mg rhoqo kwiiveki ezi-2 ukuya kwidosi yokugcina i-2000 mg yonke imihla ngeedosi ezahluliweyo | Urhudo, ukudumba, isisu esibuhlungu | Fumana isigqebhezana |
| Qsymia (phentermine kunye topiramate) | Ukuxakeka | Ngomlomo | Imithamo yokubizwa: 3.75 mg (phentermine) / 23 mg (topiramate) yedosi yesondlo yemihla ngemihla: 7.5 mg / 46 mg okanye 15mg / 92 mg kanye yonke imihla | Ukuqunjelwa, ukulala, ukuphazamiseka kwemood | Fumana isigqebhezana |
| Invokana (canagliflozin) | Isithinteli se-SGLT-2 | Ngomlomo | 100 - 300 mg kanye ngemini | Ukuchama rhoqo, ukoma ngakumbi, ukuqhina, umlomo owomileyo | Fumana ikhadi le-Rx |
| Farxiga (dapagliflozin) | Isithinteli se-SGLT-2 | Ngomlomo | 5 - 10 mg kanye ngemini | Ukuchama rhoqo, ukwanda kokoma | Fumana isigqebhezana |
| I-Jardiance (empagliflozin) | Isithinteli se-SGLT-2 | Ngomlomo | 10 - 25 mg kanye ngemini | Ukuchama rhoqo, ukwanda kokoma | Fumana isigqebhezana |
| Itrulicity (dulaglutide) | I-GLP-1 i-agonist | Inaliti | 0.75 - 4.5 mg itofelwe phantsi kolusu kanye ngeveki | Isicaphucaphu, ukugabha, urhudo | Fumana isigqebhezana |
| I-ozempic (semaglutide) | I-GLP-1 i-agonist | Inaliti | I-0.25 mg itofelwe phantsi kolusu kanye ngeveki iiveki ezi-4, emva koko inyuke iye kwi-0.5 mg kanye ngeveki iiveki ezi-4, emva koko inyuke iye kwi-1 mg yolondolozo lweveki | Isicaphucaphu, ukugabha, urhudo | Fumana isigqebhezana |
| UVictoza (iliraglutide) | I-GLP-1 i-agonist | Inaliti | Tofa i-0.6 mg yonke imihla kangangeentsuku ezisi-7, emva koko unyuke uye kwi-1.2 mg phantsi kolusu kube kanye yonke imihla; idosi enkulu: 1.8 mg yonke imihla | Isicaphucaphu, ukugabha, urhudo | Fumana isigqebhezana |
Ngaphandle kwamayeza, ukutya, kunye nokuzilolonga, kukho ezinye iindlela zokuphila kunye nezinto zonyango ekufuneka uzigcine engqondweni xa usebenza kwisifo seswekile.
5. Lala
Uphando lubonisa unxibelelwano phakathi kokulala, imetabolism kunye nokutyeba kakhulu. Ukungabikho kokulala kusenza silambe ngakumbi, ngakumbi kukutya okuphezulu kwiikhalori kunye neecarbs. Izazinzulu zikholelwa ekubeni ukulala kuchaphazela iihomoni emzimbeni obizwa ngokuba yi-ghrelin kunye neleptin elawula indlala. Enye into: ukungabikho kokulala kuphelisa amandla ethu kwimithambo yomzimba.
Uninzi lwabantu abadala kufuneka balale iiyure ezisixhenxe ukuya kwezisi-9 zokulala ngobusuku kwaye basebenze kwimikhwa elungileyo yokulala njengokukhupha izixhobo zombane kwigumbi lokulala kunye nokuphepha ukutya okunzima iiyure ezimbini ukuya kwezintathu ngaphambi kwexesha lokulala.
6. Impilo yengqondo
Ukuba nesigulo kunokubangela uxinzelelo, usizi, kunye nokuphulukana nomdla kwizinto ezazikonwabisa ngaphambili. Abantu abanesifo seswekile banamatyeli amabini ukuya kwamathathu amathuba okuba babe noxinzelelo kunabo bengenayo le meko, kodwa ngama-25% ukuya kuma-50% kuphela afunyaniswa enyangwa. Bakwangama-20% amathuba okuba babe nexhala.
Abo bazama ukuguqula isifo seswekile banokuba nazo ezi mvakalelo ukuba ababoni ziphumo zilindelweyo okanye banabahlobo kunye nenkxaso yosapho.
7. Ukutshaya
Ukutshaya kungangunobangela wohlobo lweswekile yesi-2, kwaye ke, abantu abatshayayo banamathuba angama-30% -40% ekuphuhliseni. Banengxaki yokulawula esi sifo kwaye basemngciphekweni omkhulu wokufumana ezinye iingxaki zempilo ezinje ngesifo sentliziyo, ukujikeleza okungalunganga kwemilenze neenyawo, ukonakala kwemithambo-luvo kunye nesifo samehlo.
8. Ukunyanga isifo se-ovary syndrome (i-PCOS)
I-PCOS sisizathu esiqhelekileyo sokuzala kunye nokuchaphazela uninzi lwezigidi ezi-5 zabasetyhini baseMelika kwiminyaka yabo yokuzala. Abasetyhini abanesi sifo banengxaki yokusebenzisa i-insulin kakuhle, ephakamisa umngcipheko kuhlobo lwe-2 lweswekile. Ngaphezulu kwesiqingatha sabasetyhini abane-PCOS bakwaphuhlisa uhlobo lweswekile sesi-2 ngexesha abafikelela kwiminyaka engama-40.
Abantu abanale nkxalabo yezempilo kufuneka bathethe nomboneleli wabo wezoncedo ngoncedo ekubanyangeni, okunokuthi kukhokelele ekutshintsheni isifo seswekile.
Kuthatha ixesha elingakanani ukuguqula isifo seswekile?
Akukho xesha libekiweyo xa abantu abanesifo seswekile sohlobo lwesibini banokuqala ukubona ukusebenza nzima kwabo kuhlawula. Ngokubanzi, iingcali zeswekile zithi ngamayeza kunye notshintsho kwindlela ophila ngayo, abaguli abanesifo seswekile bangawubona umohluko kwiinyanga ezintathu ukuya kwezintandathu. Ingathathainyanga enye yokuzinzisa iswekile yegazi (kunye okanye ngaphandle kwamayeza), kwaye emva kweenyanga ezimbalwa okanye nangaphezulu ukuze utshintsho lwendlela yokuphila luqale ukusebenza.
Ngomsebenzi nexesha elaneleyo, ungayenza, Utsho uStephanie Redmond, uFarm.D., i-CDE, i-BC-ADM, umseki-mbumba Iswekile.com . Okukhona usenesifo seswekile kwaye iswekile yakho ibisoloko ilixesha elizinzileyo, koku kunokuba nzima. URedmond wongeza ukuba ngaphandle kwemizamo yabo emihle, kunokwenzeka ukuba abanye bangabinasifo seswekile. Iipancreas zakho azinakho ukuvelisa i-insulin eyifunayo. Akukho ndawo yoxinzelelo okanye ukuzibetha. Sebenza nomboneleli wakho wezempilo kwisicwangciso sonyango esona silungileyo kuwe.
An Uvavanyo lwe-A1C imilinganiselo yamanqanaba eswekile yegazi (hemoglobin a1c) kwiinyanga ezimbini ukuya kwezintathu ezidlulileyo. Ihemoglobin A1C engaphantsi kwe-5.7% iqhelekile, phakathi ko-5.7 no-6.4% luphawu lwe-prediabetes, kwaye i-6.5% okanye ngaphezulu ibonisa isifo seswekile. Abantu abalawula uhlobo lwabo lwesifo seswekile kufuneka bafumane uvavanyo lwe-A1C ubuncinci amaxesha amabini ngonyaka kwaye kaninzi ngakumbi ukuba batshintsha amayeza okanye banezinye iimeko zempilo.
Abantu abasebenza ukuguqula isifo seswekile banokubona umahluko kwiswekile yegazi ngoko nangoko kwaye bahendeke ukuba babuyele kwiindlela zabo zakudala. Musa ukudida oku, utshilo uRedmond. Ukuba uyeka ukutya iswekile kunye nee-carbs kunye nokuzilolonga, unokuba neswekile yegazi esezantsi okanye eqhelekileyo phantse kwangoko. Kodwa, kunokuthatha ixesha elide ukubuyisela umva inyikima ekunyamezeleyo kwaye iqale ukusika ngokuchasene ne-insulin yomzimba kunye nelizwe lokudumba.
Isifo seswekile esibuyiselweyo sinokubuyela. Abantu abanesifo seswekile sele benofuzo olwenza ukuba banganyangeki kwi-insulin kwaye banesifo. Ukuguqula isifo seswekile kuthatha umzamo oqhubekayo kwiinyanga ezininzi kunye nokugcina utshintsho ebomini.
Ngubani onokundinceda ndibuyise isifo seswekile?
Abantu abanesifo seswekile kufuneka baqale ngomboneleli wabo wokuqala wokufumana isikhokelo ekubuyiseni imeko kunye nokunyamekela isifo seswekile. Umboneleli wabo unokubhekisa kubo a Isifo seswekile Imfundo yokuZilawula kunye neNkxaso (DSMES) inkonzo. Iqela le-DSMES lokhathalelo lwempilo libandakanya abafundisi beswekile abanjengoogqirha, abongikazi, abagqirha bezonyango, oosokhemesti, kunye nabanye ababoneleli ngezempilo abanoluqeqesho olukhethekileyo kunye namava. Iqela linceda abaguli beswekile ukuba bafunde ngakumbi malunga nemeko kunye nolawulo lweswekile.
