Musati mimba
Kana uine chirwere cheshuga, mimba inofanira kurongwa. Tanga kukurukura nemudzimai wegynecologist endocrinologist kwemwedzi mitanhatu usati waita pamuviri uye edza kuzadzikisa kugadzikana kwechirwere cheshuga.
Marudzi eeshuga uye mararamiro
Chirwere cheshuga mellitus inowedzera kusingaperi mune shuga (glucose) muropa uye murini.
- Ikoko kune marudzi anotevera eeshuga:
1. Chirwere cheshuga chekutanga chinonzi insulin-chinotarisirwa. Nokuda kwechimwe chikonzero, insulini mumuviri haisati yakagadzirwa neyoga, zvichiguma, glucose haisi kushandiswa. Nhamba yakadzika yeglucose muropa inonzi hypoglycemia, uye yakakwirira - hyperglycemia. Apo hyperglycemia inofanirwa kutarisa kuvepo kwemuviri we ketone mumuguta. Chikafu chakakodzera uye kuita basa rakanaka, kuongororwa kwehuga yehuga yepamusoro kunogona kuita hupenyu hwomurwere ane chirwere chechirwere cheshuga mellitus sechinhu chinokwanisika kuti chiite.
2. Chirwere cheshuga chechipiri hachibatanidzi ne insulini. Kazhinji inowanikwa mumakore anopfuura makumi mana emakore nemutoro wenyama.
3. Chirwere cheshuga chepancreatic. Inowedzera kune avo vane mapapanethi akabatwa, vane mutoro mumutumbi wekuvhara kwe insulini.
4. Izvozvo zvinonzi chirwere cheshuga chinokonzera vakadzi vane pamuviri, kana gestational diabetes mellitus (HSD). Iko kukanganisa kwemakrobhohydrate metabolism, inoitika kana inotanga kuzivikanwa panguva yekuzvitakura. Munenge hafu yezviitiko, GDD inopfuura mushure mokuberekwa pasina tsanangudzo, uye hafu - inova muchipiri chechirwere cheshuga.
Mamiriro ezvinhu makuru ndeyekubhadhara chirwere cheshuga uye kusavapo kwezvinetso zvakakomba (chirwere chisingaperi chisingabatsiri, chirwere chemwoyo chinonzi ischemic, kupera kwekuwedzera kwemazuva ano nehuwandu hwemhemberero kune fundus, nezvimwewo). Mukurwisana nemamiriro ekudzivirirwa kwechirwere cheshuga, zvine ngozi kutora pamuviri: shuga yakakosha yeropa inogona kudzivirira kutarirwa kwakakodzera kwemukati mhengo dzomukati, izvo zvinowanzoitika mumutambo wekutanga wekuita pamuviri. Mukuwedzera, kubuda kwepamuviri kunogona kuitika. Zvinokurudzirwa kuti zvive nekuongororwa kwakaongororwa kwehutano mberi: kufanana nemumwe mukadzi, hazvizogoneki kutarisa zvirwere zvinowanikwa zvikuru kuburikidza nekuita zvepabonde, taura neurologist, nyanzvi yehupenyu (izvi zvinotarisirwa kuti munhu ane chirwere cheshuga makore anopfuura gumi), an oculist-kuti aongorore midziyo ye fundus, pamwe nemudzidzi akachera. Ita ultrasound ye thyroid gland uye ushanyire endocrinologist. Kana zvichidikanwa, shanyirawo nephrologist uye enda kumubvunzurudzo muhofisi "Diabetes Stop". Izvi zvinotevera ma laboratory test zvinofanira kuitwa:
♦ glycated hemoglobin;
♦ microalbuminuria (UIA);
• kliniki yekuongorora ropa;
♦ biochemical blood test (creatinine, puroteni yakazara, albumin, bilirubin, cholesterol yose, triglycerides, ACT, ALT, glucose, uric acid);
♦ kuongorora kwemuti;
♦ Kuongororwa kwe glomerular filtration rate (Test Reberg);
♦ Kuongorora urongwa hweNechiporenko;
♦ Urine tsika yekutadza (kana zvichifanira);
♦ kuongorora kwehutano hwehutano (kuedzwa kweTTG pasina T4, AT ku TPO).
Panguva yekuzvitakura
Kubata mukati mevakadzi vane SD-1 kune zvimwe zvinhu. Vanhu vane chirwere cheshuga vanoziva shuga yavo yeropa, asi havazivi nguva dzose apo panguva yekuzvitakura, chirwere cheshuga chinofanira kunge chiri pasi peizvi. Mutemo wevakadzi vane pamuviri vane chirwere cheshuga inofanira kunge iri nguva dzose yehutachiona hweropa - kanenge ka8 pazuva. Mumaawa matatu okutanga ekudzivirira, hypoglycemia inogoneka: dambudziko rekuwedzera kuwedzera kwemhepo mumamai, kukanganisa kwekuyerera kweropa mumidziyo ye placenta uye fetus, kukanganisa kwemwoyo miviri mumamai uye mumucheche, fetal hypoxia. Mukadzi anokwanisa kurasikirwa nekuziva uye kunyange kupinda mu coma. Zviratidzo zvehupirincemia: musoro, chizivi, nzara, chiratidzo chisina kunaka, kuzvidya mwoyo, nguva dzose kutapira, kutuka, kudedera, kuzvidya mwoyo, kuvhiringidzika. Kana iwe uchinge uine chero humwe huri pamusoro apa, unofanira kutarisa shuga yeropa. Kana izvi zvisingaitike, unofanirwa kumira chero chiito chemuviri, kutora-digestible carbohydrates (12 gramu 100 ml juice kana soda inotapira, kana zvidimbu zviviri zvemashuga, kana tafura imwe, spoonful uchi). Mushure meizvi, iwe unofanirwa kudya gorofuhydrates zvishoma nezvishoma (12-24 g - chimedu chechingwa, kirasi ye yogurt, apuro). Nhamba yakakwirira yehuga muropa raamai inogona kutungamirira mukukura kwehutano hwemwana, hwakadai sehutachiona hwekurwadziwa. Inogona kukurumidza kukurumidza kana kukurumidza kukura kwe fetus, polyhydramnios, kuzvimba kwezvinyama zviduku. Mwana achangoberekwa anokwanisa kutambura nekuputika uye neurologic disorders, hypoglycemia. Yakawedzerwa shuga yeropa inogona "kuvhara" mwana uye gare gare endocrine kana kukanganiswa kwepfungwa muhucheche. Kuti udzivise migumisiro yakadaro, munguva yekuzvitakura nekugadzirira uye mwedzi gumi nemana yekumirira, gara uchikurukura nachiremba. Uine shuga yakawanda yeropa, unofanirwa kubvisa chero basa rekuita uye chengetedza urineni yemitumbi yemaketone (izvi zvinogona kuitwa kuburikidza nekuedza zvipfeko zvinotengeswa pamishonga), uye zvino shandisa mazano ako gynecologist-endocrinologist kana glycemia. Chengetai diary umo iwe unonyora zviyero zvehuga, chiyero chemakhahydrates, kuumbwa kwezvokudya, muyero we insulini. Usakanganwa kutarisa kuti iwe unorema sei, uye kuyera kuwedzera kweropa. Zvakakosha kuongorora kuvepo kwemitumbi yemakone mumuguta uye nezvekuwanika kwavo pakarepo ita chiremba wako. Zvinogona kuve kudikanwa kuyera ivhu kwete kwete chete wedhakwa, asiwo wezvinyorwa zvinoshandiswa (diuresis). Kunyange nekubhadharwa nechirwere cheshuga panguva yekuzvitakura, zvakaoma kuwana hutano hwakasimba hwehuga muropa.
Kana zvichidikanwa, chiremba anogona kukutumira kune:
♦ Dopplerography - kushandisa ultrasound, kuteura ropa kunongororwa mumbilical cord, placenta uye mu fetus;
• Cardiotocography - inotaridzirwa kana fetus ine oxygen inzara nenzara (hypoxia).
Kuongororwa kwekubudirira kwehutano hwe insulin kunoitwa kuburikidza nekuongorora fructosamine (boka re albumin blood protein neropa glucose). Muchikamu chechitatu chepamuviri, chiremba achakukoka kakawanda kupfuura kare. Izvi zvinokonzerwa nekuti panguva ino iyo ngozi yezvinetso zvinokonzerwa nechirwere cheshuga zvinowedzera. Gestational diabetes mellitus yakasiyana ne gestosis yevakadzi vane pamuviri. Chikonzero chekuonekwa kwacho chakaita kuti kuderedzwa kwemasero kune insulin yavo. Maererano nevasayendisiti veEurope, kupararira kweGDD kunobva kubva kuna 1 kusvika ku14% pakati pevakadzi vane hutano. Muboka rekutengesa - vakadzi vane pamuviri vane uwandu hwepamusoro, vane nhoroondo ye obstetric anamnesis. Tora kuongororwa ropa kwehuga uye kuongorora ropa neropa glucose. Kana zvikwangwani zvikaitika, yechipiri nguva yekuedzwa kunoitwa pavhiki 24-28 yekutakura.
Kubereka
Vakadzi vazhinji vane pamuviri vane chirwere cheshuga vanogona kuberekera pasina, kana pasina zvikonzero zvezvikamu zvekudzivirira uye kusagadzikana kwepfungwa yekuberekwa kwepanyama. Polyhydramnios, gestosis uye urogenital zvirwere zvinogona kutungamirira kukubereka nguva isati yasvika. Kunyanya kunetseka mukubereka mwana kune varwere vane chirwere cheshuga mellitus kusununguka kusati kwapera kwe amniotic fluid.
Mushure mekusununguka
Kazhinji kazhinji, amai vanotya kuti mwana wavo achavawo nechirwere cheshuga. Kana baba vemucheche vasina chirwere ichi, ipapo mikana yekurasikirwa nechirwere cheshuga mumwana inenge 3-5%. Kana baba vane chirwere cheshuga, njodzi inofungidzirwa yakaita se 30%. Muchiitiko ichi, zvinokurudzirwa kuita maitiro ekuberekwa asati aberekwa. Vacheche vanodikanwa vanoda kunyatsotarisirwa. Kazhinji vana vacheche vakaberekwa nekuneta, asi vane mapapu asina kudzivirirwa. Mumaawa okutanga ehupenyu, kuporesa kwepumusoro, pamwe chete nehutachiona hwehutano hwekuvhiringidzika, acidosis, mazinga eropa glucose anofanira kudziviswa; kuitisa kuongorora mwoyo. Mumakaberekwa, kuwandisa muviri, kuputika kweganda, kuwedzera kwechiropa uye spleen kunogona kuonekwa. Vacheche vanobva kumadzimai ane SD-1 havakwanisi kuchinja uye saka vanowanzotambura ne jaundice yevana vachangoberekwa, cheerythma inotyisa, kurasikirwa norema shure kwekuberekwa nekudzorera zvishoma nezvishoma. Asi zvinhu zvose zvinokwanisika!
Vanyusha akaberekwa nechikamu chekudzivirira pamasvondo makumi matatu nemaviri. Amai vake Ole aiva nemakore 29 apo mwanakomana wake akaberekwa. Makore mana nehafu gare gare mukadzi akazvara mwanasikana. Hapana chakakosha? Zvichida - dai panguva yekuzvarwa kwomwana wekutanga Olya akanga asina chirwere cheshuga makore makumi mana! Dambudziko guru kune vakadzi vanoda kuva nevana vanogona kuva nechirwere cheshuga mellitus type 1 (SD-1). Vanachiremba vanotya hupenyu hwemamai nemwana uye havasi nguva dzose vakagadzirira kutora basa rekutakura dambudziko rekutakura. Saka zvakaitika kuna Olya, uyo asina kuwana rubatsiro rwekutanga kubva kuvanachiremba. Olya anoti: "Ndine rubatsiro rwakavimbika - murume wangu. Ndiye iye akaenda neni kune mazano ose, akatarisa marudzi ose ezvinyorwa, akafungisisa maitiro ose e insulini, akandiyera zvidimbu zvechingwa zve sandwiches kuti zvibate uye kazhinji zvakanyatsotevera kutevedza kwangu. Kunyaradza mazhenje angu emashepiti, akandimutsa usiku, dzimwe nguva nguva imwe neimwe kuti ndienzane nehuwandu hweglucose, yakagadzirisa ini nemusi kana zvichidikanwa nezvimwe zvakadaro. Zviuru zvezvinhu zviduku zvakadai, uye fungisisa zvose-zvakange zvakaoma kwandiri. "Nenzira iyi, munhu anogona kudzivisa migumisiro yakaipa kune amai nechecheche. Basa guru revanopedzisira vakagadziriswa nevadziviriri vanofanira kuva nekuchengetedza kugadzikana kwemakinhydrate metabolism pamatanho ose - kubvira pamuviri kusvikira kuberekwa.