Kurapa kwehupirglycemia kunobva kune zvakasiyana-siyana zvezvinhu, kusanganisira nguva yehuwandu hwema hyperglycemia uye kuoma kwayo, pamwe nezera remunhu, hutano, uye kugona basa. Semuenzaniso, munhu akwegura ane nhoroondo yehutano yakaoma uye kusagadzikana kwebasa rinofanirwa kupiwa zvakasiyana zvakasiyana nemunhu muduku, ane hutano anopa chirwere cheshuga chitsva.
Sangano reAmerican Diabetes Association (ADA) rinosimbisa kukosha kwezvirongwa zvehutano hwevanhu vose vane chirwere cheshuga. Uye, kunyange zvazvo vane sargorithm yakatsaurirwa kubatsira vanachiremba kupa mishonga kuti ibatsire kubata hyperglycemia, munhu mumwe nomumwe anofanira kugara achiiswa.
Muchiitiko chaunosangana ne hyperglycemia, pane zvinhu zvaunogona kuita kumba kuti uzvichengete, zvakare. Asi, zvichienderana nehuwandu hwehuwandu hwehutachiona, unogona kudikanwa kutaurirana nemupi wako wehutano wehutano kuti abatsirwe mukugadzirisa hurongwa hwako hwokurapa. Mune zviitiko zvakanyanya zvakadai sechirwere cheshuga ketoacidosis (DKA) nokukurumidza, rubatsiro runodikanwa.
Mishonga yeMusha uye Upenyu
Upenyu hwehupenyu hunokosha pakurapa hyperglycemia. Zvechokwadi, chirwere cheshuga cheshuga chinoshandiswa kushandiswa sechirevo chekudya uye mararamiro ehupenyu. Munhu haafaniri kushandura mararamiro ake uye kuvimba nemishonga chete, pakupedzisira mishonga iyi icharega kushanda uye inofanira kuwedzera mamwe mishonga kuti ropa remashuga riitwe.
Chinokosha pakugadzirisa mararamiro ehupenyu ndechokuti uwane rubatsiro uye ugare wakasimba. Kutsigirwa mumhando yezvedzidzo, kunyanya chirwere cheshuga chekuzvidzivirira (DSME), chichabatsira. IAADA inokurudzira kuti vanhu vose vane chirwere cheshuga vanogamuchira DSME pavanoongororwa, gore negore kuti vaongorore kudya kunovaka muviri uye zvinodiwa zvepfungwa, apo zvinhu zvitsva zvinonetsa zvinomuka zvinokonzera kuzvitonga, uye kana kushanduka mukuchengetwa kuchiitika.
DSME inogona kukubatsira iwe kuchinja mararamiro ako. Kuchinja mararamiro anotevera kunogona kubata hyperglycemia:
Kudya
Carbohydrates inokonzera ropa soroga . Kudya zvakanyanyisa katehydrates, zvakadai semafuta akacheneswa (mikoro mutsvuku, mavhesi, mabhasiki, makiki, rizi, pasta, crackers, sweets), shuga, uye zvinwiwa zvinotapira zvinogona kuwedzera ngozi ye hyperglycemia. Nokudaro, kudya zvokudya zvakarongedzwa uye zvakashandurwa zvakagadzirwa mu fiber zvinogona kubatsira.
Hapana mumwe munhu anodya zvakakwana chirwere cheshuga. Iyo ADA inotaura kuti vanhu vose vanowana zvakasiyana-siyana zvekurapa zvinorapwa (MNT), zvichida neavo vakanyoreswa chikafu chekudya uye vane ruzivo uye vane unyanzvi mune chirwere cheshuga-chinonzi MNT. Zvidzidzo zvakaratidza kuti MNT yakapiwa nemuchina wezvokudya inosanganiswa neA1C kuderera kwe 0.3 kusvika 1 muzana kune vanhu vane chirwere cheshuga chechirwere cheshuga uye 0.5 kusvika 2 muzana kune avo vane chirwere cheshuga chechipiri.
Dzidzira
IAAA inotaura kuti kuputsa kushanda kwenguva refu uye kudzivisa nguva yakareba yekugara kunogona kudzivirira rudzi rwechipiri chirwere cheshuga kune avo vari pangozi uye kunogona kubatsirawo mune glycemic control kune avo vane chirwere cheshuga. Izvi ndezvokuti kurovedza muviri kunogona kubatsira kuderedza hyperglycemia nekupisa glucose . Somuenzaniso, kuenda kufamba mushure mekudya kukuru kunogona kubatsira kupisa shuga yakanyanya muropa.
Kushanda muviri nguva dzose kunokoshawo pakugadzirisa uremu, izvo zvinogona kuderedza hyperglycemia nekuvandudza hutano huzhinji.
Pane zviitiko apo iwe unofanirwa kudzivisa kuedza muviri kana sarukisi yeropa rako yakakwirira. Kana shuga yako yeropa iri pamusoro pe 240 mg / dL uye iwe une ketone, iwe unofanirwa kudzivisa kuedza. Kushandisa ne ketone kunogona kusimudza shuga yako yeropa kunyange yakakwirira.
Usati watanga chero chiito chekuita muviri ita nechokwadi chekuti wakanatswa nachiremba.
Kuonda
Kuora muviri kunobatsira kuderedza shuga yeropa nekuti inowedzera insulini senzwi. IAAA inoti, "kune husimbe hwakasimba uye husingagumi hwokuti kuzvidzora, kusinganisa kurashikirwa kunogona kunonoka kuenderera mberi kubva ku prediabetes kuisa 2 chirwere cheshuga uye kunobatsira kutungamira rudzi rwechipiri chirwere cheshuga." Zvimwe zvidzidzo zvinoratidza kuti kurasikirwa nokutevera kudya kwe-calorie yakanyanya kunogona kuisa cheshuga mukuregererwa , kunyange kune avo vane chirwere cheshuga kwemakore mashoma matanhatu.
Chinokosha chekurasikirwa kwemazivi asi kuchichengetedza uye kugamuchira rubatsiro ruchiripo.
Zvakakosha kuziva kuti kuora-kurasikirwa kunogona kuderedza hyperglycemia mumatanho ekutanga eeshuga kana prediabetes, apo muviri wakachengetedza insulini yakavanzika. Nzvimbo yakanaka yekutanga ndeyokurasikirwa neanenge mashanu muzana yemutumbi wako. Kazhinji uremu hunorema iwe unorasikirwa, hwezasi ropa rako rinotapira richave.
Kana iwe uri kutora mishonga panguva yekurasikirwa uye ona kuti iwe une hosha yeropa shoma, iwe unofanirwa kuve nemishonga yako yakashanduka kana kuregera.
Kusvuta Kupedza
Kusvuta kunogona kuva nehuwandu mune hyperglycemia, zvikurukuru mukurudzirwa kwechirwere cheshuga chechipiri. Nokudaro, kana iwe une prediabetes kana pane ngozi yakawanda yehuga, kusasiya kusvuta kunogona kubatsira kudzivirira chirwere cheshuga uye hyperglycemia.
Blood Sugar Monitoring
Nguva dzose kuongororwa kweshuga yeropa kunogona kubatsira vanhu vane chirwere cheshuga kuti vaongorore kupindura kwavo kunerapi uye kutarisira shuga yakakosha yeropa.
Ikoko kunoratidzika kunge kune kuwirirana pakati pekutsvaga kwega shuga uye pasi A1C kune varwere vane chirwere cheshuga chechirwere cheshuga. Kana uchinge wakagadzira chirongwa cheshuga yepamusoro yeropa, iwe unogona kutora chiito chekutora nekuchidzivirira kuburikidza nekuedza shuga yako yeropa uye maitiro ekufambisa. Nokukurumidza iwe unoziva nezvehuwandu hwenyu, nokukurumidza iwe unogona kuchinja.
Cinnamon
Nhengo dzejeri dzichiri kunze kwekuti kana cinnamon inobatsira sei kuderedza shuga yeropa . Dzimwe dzidzo dzinotaura kuti maasipuni maviri pazuva anogona kubatsira kuderedza shuga yekutsanya yeropa, asi vamwe vasingaiti.
Sezvo nehutano hwehutano hwehuga, izvi zvichida zvakananga kune mumwe munhu. Chero nzira, hapana chakaipa mukuwedzera kusasa kwekinamoni kune ikhofi yako, yogurt, oatmeal, kana mbiriso yemangwanani.
Apple Cider Vinegar
Muto kubva maapuro unoshandiswa kuita apple cider vhiniga. Chidzidzo chakabudiswa mu Journal of Functional Foods chakawana kuti vanhu vane utano hwakakonzerwa nechirwere cheshuga chechirwere chechipiri vakadya maawa 8 eBraggs Organic Apple Cider Vinegar Drink Drink Sweet Stevia kwemavhiki gumi nemaviri vakaona kuderedza kukuru mukutsanya shuga yeropa.
Zvakakosha kucherechedza kuti vanhu ava havana chirwere cheshuga uye kuti vatsvakurudzi havana kuwana kusiyana kwakakosha muropa shuga maawa maviri mushure mekudya, kana mu hemoglobin A1C. Nezvo zvataurwa, vanyori vanoratidza kuti kuwedzera kwepuni imwechete kamwechete zuva rega rega kunogona kuderedza kuderedza kudya kweropa. Tora imwe aple cider vhiniga muwaini yako inotevera kana kuti marinate mapuroteni ako mairi-zvishoma zvinotora nzira yakareba.
Zvinyorwa
Insulin
Insulin ndiyo hormone inotarisira kumira mashuga eropa muviri. Vanhu vane chirwere chirwere cheshuga chechirwere havanetsi kubereka insulin yavo. Nokudaro, vanhu vakawanda vane chirwere cheshuga chechirwere chemazuva 1 vanofanira kupirwedzwa nemajojo akawanda ezuva nezuva ezvokudya (kana kuti prandial insulin) uye basal insalin kuburikidza nemajisi kana insulin pump.
Uyezve, vanhu vazhinji vane chirwere cheshuga chekuita 1 vanofanira kushandisa kushandiswa kwekukurumidza-insulin, kusiyana neanamatoo akafanana . Vakadzi vanowanikwa vane gestational diabetes vangadawo insulini kuderedza dambudziko re hyperglycemia uye kuchengetedza serosi yeropa zvakasimba.
Dzimwe nguva, vanhu vane chirwere cheshuga changobva kuongororwa vane hyperglycemia yakasimba vanogona kutanga pamusana we insulin therapy panguva pfupi kuderedza ropa ravo. Vanhu ivavo vane chirwere cheshuga chechipiri kwenguva refu, kunyanya avo vane kazhinji hyperglycemia, vangave vachida kutanga insulin therapy pamwe chete.
Hazvishamisi kunyange zvazvo munhu ane chirwere cheshuga chine chirwere cheshuga chinoderedza kana kusasiya insulin yavo kana ropa ravo rega rinowedzera, kunyanya kana vakaremerwa. Chiitiko chimwe nechimwe chakasiyana uye chinangwa chekuchengetedza insulin chinofanira kukurukurwa pamwe nemupi wehutano wehutano kuitira kuti iwe urege kuvhiringidzika kana kusakanganiswa.
Pramlintide
Iyi mishonga inobvumirwa kuti ishandiswe kune varwere vane chirwere cheshuga chechirwere cheshuga. Kushandiswa kwaro ndiko kunonoka gastric kubvisa uye kuderedza ropa shuga nekudzikisa kuchengetedzwa kweglucagon. Inogona kubatsira vanhu vane chirwere cheshuga chechirwere cheshuga (kana vari kunyanya kuwandisa), uyewo kuderedza shuga yeropa uye kuderedza insulin doses.
Oral Mishonga
IAA ine gadziriro yekurongedza vanachiremba mukuronga mishonga kuvanhu vane hyperglycemia. Uyu muenzaniso unofunga nezvezera, hutano, uremu, nhoroondo yehutano, urefu hwekuongororwa, shuga yeropa, mararamiro, mararamiro, nezvimwe zvevanhu. Kutaura zvazviri, ADA inoti, "nzira yevarwere-inonyanya kushandiswa inofanira kushandiswa kutungamira kusarudzwa kwemashambadziro emagetsi.Kufungidzira kunosanganisira kushanda, ngozi ye hypoglycemia, kukanganisa kuyerwa, zvingava nemigumisiro, zvinodhura, uye zvinoda kurapa."
Kazhinji, kunze kwekupikisa, vanhu vazhinji vanobatsirwa nekutanga neMetformin. Mushure mokutanga, ADA inoti, "Kana kusina musinoni monotherapy pamusana unoregererwa muzinga hakuiti kana kuchengeta chinangwa cheA1C mushure memwedzi mitatu, wedzera wechipiri muromo, glucagon-peptide-peptide 1 receptor agonist, kana kuti insulin."
Gestational Diabetes Mellitus
Hyperglycemia in pregnancy inogona kukonzera kuongororwa kwegestational chirwere cheshuga. Rudzi rwekutanga rwekurapa nderokurapa kunyanzvi hwekurapa, chiito chemuviri, uye kutarisirwa kwekutema zvichienderana nekutanga kutakura pamuviri uye kuongorora shuga yeropa.
Upenyu huri kuchinja, kunyanya kudya uye kuita muviri, chinhu chinokosha uye vakadzi vose vanoda kutarisa shuga yeropa. Zvisinei, kana shuga yeropa isingagoni kudzorwa nemararamiro emararamiro, insulini ndiyo inoshandiswa mishonga sezvo isingayambuki pasi pencenta kusvika pachiyero chinotaridzika.
Mimwe mishonga yakadai semetformin uye glyburide inogona kushandiswa, asi zvose zvinodarika muparcenta kusvika kumucheche, uye metformin inogona kuenderera kune imwe yakawanda kupfuura glyburide.
Emergency Situations
Muchiitiko chekuti wakaenda kune imwe nzvimbo yekukurumidzira nekuda kweshuga yepamusoro yeropa uye iwe wakarwara une chirwere cheshuga ketoacidosis (DKA) kana hyperosmolar hyperglycemic state, iwe uchafanira kuongororwa zvakanyanya uye unofanira kugamuchira kliniki yakanyatsoongorora.
Mushonga unosanganisira kusarudzwa kwehupirglycemia, kugadziriswa kwekusawirirana kwe electrolyte uye ketosis, nekudzorerwa kwemhepo yakawanda. Uyezve, zvichave zvakakosha kugadzirisa chero chinokonzera chikonzero cheDKA, sepispis.
Zvichienderana nemamiriro ezvinhu akaoma sei, vanhu vane DKA vachabatwa neine intravenous kana subcutaneous insulin uye kuronga kwemvura.
Surgeries
Kuvhiya hakubvumirwi nehupirglycemia kunze kwekunge kune zvimwe zvinokonzera kukanganisa zvakadai sehutano hwakanyanya kune avo vane chirwere cheshuga chechipiri. Kuvhiya kunogona kuve sarudzo yevanhu vane chirwere cheshuga chirwere cheshuga chinenge chichiwedzera kana kuti kune avo vane ketoacidosis yakawandisa kana kuti hypoglycemia yakakomba zvisinei nehutachiona hwekuita glycemic management.
Metabolic Surgery
Kuvhiyiwa kwemagetsi, zvichida kuzivikanwa sekushandiswa kwebhinzi, kunogona kuva sarudzo yekurapa hyperglycemia kune varwere vane chirwere chechirwere cheshuga chinenge chakaoma. IAAA inoratidza kuti " kuvhiyiwa kwemagetsi kunofanira kukurudzirwa kubata chirwere chechirwere che diabete s muvakakodzera vakagadziriswa vane BMI 40 kg / m2 (BMI 37.5 kg / m2 muAsia America), pasinei nehuwandu hwekuita glycemic kana kuoma kweglucose-kuderedza regimens, uye kuvakuru vane BMI 35.0-39.9 kg / m2 (32.5-37.4 kg / m2 mu
Vanhu vokuAsia America) apo hyperglycemia isingatenderwi kudzora pasinei nemararamiro uye hutano hwakanaka
therapy. "
Iyo ADA inoratidza zvakare kuti kuvhiyiwa kwemagetsi kunofanirwa kune vanhu vakuru vane chirwere cheshuga chechirwere cheshuga ne BMI 30.0-34.9 kg / m2 (27.5-32.4 kg / m2 muAsia America) kana hyperglycemia isingakoshi
inodzorwa pasinei nekurapa kwekurapa kwechirwere nemuromo kana kuti injectable mishonga (kusanganisira insulini).
Vasati vaongorora kuvhiyiwa, vanhu vane chirwere cheshuga cheshuga vanofanira kuwana chirongwa chakazara chezvehutano uye vanogamuchira rubatsiro rwechiremba kubva kune vanachiremba vakawanda, saivo chiremba wavo mukuru uye chiremba. Uyezve, vanofanira kusangana nevanyoreji vekudya zvakanyoreswa kanoverengeka kaviri uye mushure mekuvhiyiwa kuti vaone kuti vari kunamatira kune zvido zvekudya.
Kurarama kwenguva yakareba mararamiro emararamiro uye kuongororwa kwemuitiro we micronutrient uye chikafu chekudya kunofanira kupiwa kuvarwere mushure mekuvhiyiwa. Chirongwa chekuongorora kukosha kwekuenderera mberi kwehutano hwehutano hwepfungwa kubatsira rubatsiro rwekurapa uye rwekuchinja kwepfungwa mushure mekuvhiyiwa kunofanira kuitwa.
Pancreas uye Islet Cell Transplantation
Kuvhiyiwa kwekushandura kunoda kuti muviri wose usapinde mumuviri unogona kukonzera kushuga kweropa, zvichikonzera hyperglycemia. Nemhaka yemigumisiro yakaipa, haisi chinhu chinowanzoitwa kuvanhu vane chirwere cheshuga chechirwere cheshuga.
Pane kudaro, ADA inoratidza kuti "pancreas transplantation inofanira kuchengetwa kune varwere vane chirwere cheshuga chechirwere chechirwere chechirwere chechirwere chechirwere chechirwere chechirwere chechirwere chechirwere chechirwere chechirwere chechirwere chechirwere chechirwere chechirwere chechirwere chechirwere chechirwere chechirwere.
Islet transplantation inoramba ichiongorora. Autoislet transplantation inogona kuonekwa kune varwere vanoda chirwere chepancreatectomy zvachose chekurapa kwechirwere chisingaperi chine pancreatitis. Kana iwe uchifunga kuti iwe uri mubatidziro, dzidza zvakawanda pamusoro pehutano uye taura nachiremba wako nezvazvo.
Complementary Medicine (CAM)
Kana hyperglycemia inokonzerwa nokushaya kukwanisa kuzvitarisira iwe pachako nekuda kwezvinetso zvepfungwa kana zvepakati, psychotherapy inogona kushandiswa kugadzirisa dambudziko riripo, iro rinogona kubatsira kurapa uye kuderedza hyperglycemia.
Kana munhu ane chirwere chinorwara cheshuga (DD), chinotsanangurwa se "kuipa kwakanyanya kwepfungwa kunofanirana nemitoro yemanzwiro uye kunetseka zvakananga kune zvakaitika kune mumwe munhu pakugadzirisa chirwere chakakomba, chakaoma, uye chinoda kudai sechirwere cheshuga," kugamuchira rubatsiro kuchave kunoshora mukutarisa hyperglycemia uye kuora mwoyo.
Ziva kuti rubatsiro runowanika uye hapana rusarura runosangana naro. Iyo inogona kukubatsira iwe kutora zviri nani iwe pachako uye kutarisa uye kunzwa zviri nani iwe, saka usanonoka kusvika kunze kana zvichidiwa.
> Sources:
> American Diabetes Association. Maitiro ekurapa muShuga - 2017. Chirwere cheshuga . 2017 Jan; 38 (Suppl 1): S1-132.
> American Diabetes Association. Hyperglycemia (High Blood Glucose).
> Lean M, et al. Kutarisirwa kwepamusoro kutungamirirwa-kuyerwa kwekutakura kwe > kuregererwa > kwechikwata chechirwere cheshuga (DiRECT): an > open label >, cluster-randomized trial. " Lancet 2017: DOI: 10.1016 / S0140-6736 (17) 33102-1