Unogona here kushandura chirwere cheshuga?
Dzidzo yehutanoChirwere cheshuga (inozivikanwawo sekuti chirwere cheshuga mellitus) inoitika kana huwandu hweshuga yeropa rako (dzimwe nguva hunodaidzwa kuti glucose yeropa) hwanyanya. Ropa glucose ndiyo sosi yekutanga yemuviri yesimba. Inoputirwa kubva muchikafu uye inopinda mumasero nerubatsiro rwehomoni insulin, iyo inogadzirwa nerwatata.
Vanopfuura mamirioni makumi matatu nemana vekuAmerica vane chirwere cheshuga, uye nepedyo 90% -95% vavo vane Rudzi rwe 2. Inonyanya kubata vanhu vanopfuura makore makumi mana nemashanu, asi pane kuwedzera kwechiitiko muvana nevakuru vechidiki.
Zvinokwanisika here kushandura chirwere cheshuga?
Izvo zvinokwanisika kushandura zvese zviri zviviri prediabetes uye Type 2 chirwere cheshuga. Type 1 uye gestational chirwere cheshuga hazvidzoreke; vanhu vane aya mamiriro vanogona chete bata uye gadzirisa ivo.
Vanhu vazhinji vane chirwere cheshuga vane insulin yekudzivirira, zvichireva kuti miviri yavo haishandise insulin zvakanaka uye glucose vanobva vagara muropa ravo uye vasingasvike masero, zvichizopedzisira zvichikonzera matambudziko ehutano. Vamwe vanhu vane chirwere cheshuga havaiti insulini yakakwana kana kusaita zvachose. Kune akatiwandei maitiro akajairika echirwere cheshuga:
- Tora 1 chirwere cheshuga apo muviri pausingaiti insulin. Iyo immune system inorwisa uye inouraya masero mupancreas anogadzira insulin. Vanoona nezvehutano vanowanzoongorora chimiro cheshuga muvechidiki, asi chinogona kukura chero pazera. Tora 1 chirwere cheshuga varwere vanoda kutora insulin mazuva ese.
- Nyora 2 chirwere cheshuga apo muviri pausingagadzi kana kushandisa insulin zvakanaka. Ndicho chinonyanya kuzivikanwa chimiro cheshuga. Kunyangwe ichigona kuitika chero pazera, Rudzi rwechipiri chirwere cheshuga kazhinji chinokura mune vepakati-vakuru uye vakuru vakuru.
- Gestational chirwere cheshuga inokura muvakadzi vane pamuviri. Inowanzoenda mushure mekuzvarwa kwemwana asi inomutsa mukana waamai wekuve neType 2 chirwere cheshuga gare gare. Chirwere cheshuga panguva yekuzvitakura zvakare dzimwe nguva Rudzi rwechipiri chirwere cheshuga.
Vanopa hutano vanoongorora zvakare vanhu vane prediabetes . Apa ndipo apo mwero wehuga yeropa wakakwira kupfuura zvakajairwa asi kwete wakakwira zvakakwana kuti uve chirwere cheshuga. Prediabetes inomutsa njodzi yekuvandudza Type 2 chirwere cheshuga uye ine zvakawanda zvezvikonzero zvakafanana.
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Ndeipi nzira yakanakisa yekudzosera chirwere cheshuga?
Nhanho yekutanga muchirwere cheshuga kuregererwa kune avo vane prediabetes uye Type 2 chirwere cheshuga kudzora kweropa. Izvo zvinoitwa kuburikidza nemishonga kana zvichidikanwa, kudya chikafu chine hutano, uye kurasikirwa nehumwe huremu kubatsira muviri kupindura zvinobudirira kune insulin. Izvi zviito zvinogona kubatsira kudzora insulin kuramba uye kudzivirira kana kunonoka Type 2 chirwere cheshuga muvanhu vane prediabetes.
Iyo Chirwere cheshuga Kudzivirira Chirongwa (DPP), ongororo yekuenderera mberi yekutsvaga yakatanga mu1996 uye yakapihwa mari neNational Institutes of Health, inoratidza kuti vanhu vari panjodzi huru yechirwere cheshuga vakadzora mukana wavo wekuvandudza chirwere ichi nekurasikirwa ne5% -7% yehuremu hwavo hwekutanga. Kune mumwe munhu anorema mazana maviri emapaundi, ndiwo mapondo gumi kusvika gumi nemana. Vanhu vakapinda muchidzidzo vakarasa huremu nekushandura chikafu chavo uye kushandisa zvimwe.
1. Kuchinja kwekudya
IAmerican Diabetes Association (ADA) uye boka revasayendisiti, vanachiremba, vadzidzisi veshuga, uye vezvekudya vakagadzirira kutsvaga nzira dzakanaka dzekudya dzinoshanda zvakanaka kune vanhu vane chirwere cheshuga. Vakaongorora zvinopfuura mazana matanhatu zvinyorwa zvekutsvaga uye vakaona kuti hapana kudya kumwe kunoshanda kune wese munhu, asi kuteedzera mashoma marongero kunogona kubatsira vanhu kubata mamiriro acho. Kazhinji, chirevo chavo chinoratidza kuti vanhu vane chirwere cheshuga vanodya yakawanda yemiriwo isiri-starchy, tsanga dzese, chikafu chisina kugadzirwa, uye shuga shoma yakawedzerwa.
Kune varwere cheshuga, iyo yekudya pachayo kana chikafu haina basa; zviri zvimwe pamusoro pechikamu kudzora uye hupenyu hurefu-kunyangwe iwe uchisarudza yakaderera-carb chikafu, ketogenic chikafu, chikafu cheMediterranean, kana kumbopota kwekutsanya. Iko hakuna mutsauko pakati pechimwe chikafu kana chimwe, anodaro Ghada Elshimy, MD, endocrinologist ane Augusta University Hutano . Chinhu chakakosha ndechekuomerera nedhayeti imwe chete. Uye isu tinotaurira varwere kuti vanofanira kudya mimwe miriwo, mapuroteni mazhinji, uye mashoma makabhohaidhiretsi.
Anokurudzira nzira yeshuga yeplate, iyo inotsigirwawo neAmerican Diabetes Association. Inopatsanura ndiro yemabiko muzvikamu zvitatu-hafu ndeyemiriwo isina starchy, chikamu chimwe muzvina mapuroteni, uye chikamu chekupedzisira macarbohydrate. Dr. Elshimy anowedzera kuti varwere vechirwere cheshuga vanofanirwa kunamira nema 60 gramu emakabohydrate pakudya (iyo yakaenzana nebhagel imwe), uye iyo isina kuomarara, iri nani.
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2. Kurambidzwa kwekalori
Zvakadiniko nekudya yakaderera-koriori chikafu? Mukati kudzidza kudiki kubva ku2011 , vaongorori vakadzora vanhu vane Type 2 chirwere cheshuga kungosvika mazana matanhatu emakori pazuva pazuva kwemavhiki masere. Vakaona izvo zviratidzo zvechirwere cheshuga-insulin kudzivisa uye pancreas basa-yakatanga kuvandudza, ichiratidza kuregererwa kweshuga. Vatsvakurudzi vakaona, zvakadaro, kuti kumwe kutsvagurudza kunodiwa mune rakakura boka revanhu.
Saizvozvo, kumwe kutsvagurudza kunoratidza iyo gastric inopfuura kana bariatric kuvhiya, iyo inoderedza kukura kwemudumbu uye inogumira macalorie, inogona kudzosera chirwere cheshuga. Mune kumwe kuongorora, vatsvagiri muDenmark vakadzidza kungopfuura vanhu chiuru nemazana zana vane chirwere cheshuga cheType 2 avo vaivhiyiwa gastric. Rimwe gore mushure mekuvhiyiwa, 74% yakange isisade mishonga yekudzikisa shuga yeropa, nepo 27% vakaona yavo shuga ichidzoka mushure memakore mashanu.
Gastric bypass isarudzo kune vanhu vane Type 2 chirwere cheshuga kana zvimwe zvakakomba zvine chekuita nehuremu senge kurara kufema, kukwirisa kweropa, kana kukora cholesterol ine body mass index (BMI) yemakumi matatu kana makumi matatu. Vaya vanovhiyiwa vachazoda kuita shanduko yakakura yehupenyu kuti varasikirwe uye vachengetedze huremu hwavo. Vamwe varwere vane matambudziko mushure mekuvhiyiwa uye vangangotadza kudzosera chirwere cheshuga.
3. Rovedza muviri
Kugara uchirovedza muviri uye kudzikisa mafuta emuviri kwakakosha mukugadzirisa Rudzi rwechipiri chirwere cheshuga uye prediabetes. Chiitwa chemuviri chinowedzera maseru emuviri insulin senzwi saka inoshanda zvakanyanya.
Nyanzvi dzinokurudzira maminetsi makumi maviri ekurovedza muviri zvine mwero pazuva-chiitiko cheeerobic senge kumhanya, kuchovha bhasikoro, kana kukwira makomo, uye kudzidzira kuramba senge kusimudza zvirema kuvaka mhasuru nyowani. Vanhu vasina kunyanyoita basa kana vane zvinonetsa pahutano vanofanirwa kubvunza kune avo vezvehutano vasati vatanga chirongwa chitsva chekurovedza muviri.
4. Mishonga
Mishonga inogona zvakare kutora chikamu mukunonoka kana kudzosera Type 2 chirwere cheshuga. Imwe tsvagiridzo inoratidza kuti vanhu vane chirwere cheshuga vanotora insulin nekukurumidza mushure mekuongororwa chirwere cheshuga vane mukana uri nani wekurarama vasina iyo mune ramangwana uye kuva nematambudziko mashoma eshuga.
Chidzidzo cheDPP chakawana kuti kutora metformin , varapi vezvehutano vanorayira kuti varape chirwere cheshuga, chinogona kudzivirira vanhu kubva mukukura kwechirwere. Uye, makirasi maviri erudzi rwechipiri chirwere cheshuga chinopihwa nevanoona nezvehutano kuti vavandudze kudzora kweshuga muropa-GLP-1 agonists uye SGLT-2 inhibitors-zvinogona zvakare kutungamira pakurasikirwa nehuremu. Kutsvagurudza kunoratidza kuti varwere veshuga vanotora mushonga weGLP-1 vanogona kurasikirwa neavhareji matatu kusvika mashanu-nehafu mapaundi. Iyo nhamba inosvetuka kusvika pamatanhatu kusvika mapfumbamwe mapaundi ane mararamiro ehupenyu kuwedzera mukuwedzera kune chirwere cheshuga.
Kune zvekare mishonga yekudzvinyirira kudya. Dr. Elshimy vanoti mushonga unonyanya kushanda pachinangwa ichi Qsymia , uye iye anongozvikurudzira kune Rudzi rwechipiri chirwere cheshuga vane BMI ye27 kana kupfuura. Avo vanotora mushonga uyu vanongofanira kuushandisa kuti vawedzere dzimwe shanduko dzemararamiro; ivo vachazofanira zvakare kuitora kwehupenyu hwavo hwese kuchengetedza mitezo yekudzikira uremu.
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Kunze kwemishonga, chikafu, uye kurovedza muviri, kune mamwe mararamire uye zvekurapa zvekuchengetedza mupfungwa kana uchishandira kuchinjika cheshuga.
5. Kurara
Kutsvakurudza kunoratidza kubatana pakati pekurara, metabolism, uye kufutisa. Kushaikwa kwekurara kunoita kuti tiwedzere nzara, kunyanya kune chikafu chakazara mumacalorie uye carbs. Masayendisiti anotenda kuti kurara kunokanganisa mahormone mumuviri anonzi ghrelin uye leptin ayo anodzora nzara. Chimwe chinhu: kushomeka kwekurara kunopedza simba redu rekuita chiitiko chemuviri.
Vazhinji vanhu vakuru vanofanirwa kutora maawa manomwe kusvika mapfumbamwe ekurara husiku uye vashande vachiita tsika dzakanaka dzekurara senge kubvisa zvigadzirwa zvemagetsi kubva mumba yekurara uye kudzivirira kudya zvinorema maawa maviri kana matatu maawa asati arara.
6. Utano hwepfungwa
Kuva nechirwere kunogona kukonzera kushushikana, kusuruvara, uye kurasikirwa nekufarira mune zvaimboita zvinonakidza zviitiko. Vanhu vane chirwere cheshuga vari vaviri kana katatu mukana wekushushikana pane avo vasina mamiriro, asi chete 25% kusvika 50% vanoonekwa uye vanorapwa. Ivo zvakare makumi maviri muzana vangangove vane kusagadzikana.
Avo vari kuyedza kudzosera chirwere chavo cheshuga vanogona zvakare kuve nemanzwiro aya kana vasingaone mhedzisiro inotarisirwa kana kuva neshamwari uye nerutsigiro rwemhuri.
7. Kusvuta
Kusvuta kunogona kuve chikonzero cheRudzi rwechipiri chirwere cheshuga, uyezve, vanoputa vane 30% -40% mukana wekukudziridza. Ivo zvakare vane dambudziko rekudzora chirwere uye vari panjodzi yakakwira yezvimwe zvinetso zvakakomba zvehutano senge chirwere chemwoyo, kutenderera kwakashata mumakumbo nemakumbo, kukuvara kwetsinga, uye chirwere chemaziso.
8. Kurapa polycystic ovary syndrome (PCOS)
PCOS chikonzero chinowanzoitika chekushaya mbereko uye chinokanganisa vakawanda semamiriyoni mashanu evakadzi vekuUS mumakore avo ekubereka. Vakadzi vane chirwere vanonetseka kushandisa insulin zvakanaka, izvo zvinomutsa njodzi yavo kune Type 2 chirwere cheshuga. Vanopfuura hafu yevakadzi vane PCOS zvakare vanogadzira Type 2 chirwere cheshuga panguva yavanosvika zera makumi mana.
Vanhu vane hutano izvi vanofanirwa kutaura nemubatsiri wavo wezvehutano kuti vabatsirwe pakurapa, izvo zvinogona zvakare kutungamira mukudzoserwa kweshuga yavo.
Zvinotora nguva yakareba sei kudzosera chirwere cheshuga?
Iko hakuna nguva yakatarwa yekuti vanhu vane Type 2 chirwere cheshuga vangangotanga kuona basa ravo rakaomarara richiripa. Kazhinji, nyanzvi dzechirwere cheshuga dzinoti nemishonga uye shanduko yemararamiro, varwere veshuga vanogona kuona mutsauko mumwedzi mitatu kusvika kumitanhatu. Zvinogona kutoramwedzi mumwe kudzikamisa shuga yeropa (uine kana usina mushonga), uyezve mwedzi yakati wandei kana kupfuura kuti shanduko yemararamiro iite.
Uine basa uye nguva yakakwana, unogona kuzviita, anodaro Stephanie Redmond, Pharm.D., CDE, BC-ADM, mubatanidzwa we shuga.com . Iyo yakareba yawave uine chirwere cheshuga uye iyo yakakwira mashuga ako anga ari enguva yakatsiga, zvakanyanya kuomera izvi. Redmond anowedzera kuti kunyangwe vachiedza nepavanogona napo, zvinogona kunge zvisingaite kuti vamwe vasabatwe nechirwere cheshuga. Iyo pancreas yako haigone kuburitsa iyo insulin yainoda. Hapana chikonzero chekuzvinetsa kana kuzvirova. Shanda nemupi wako wekuchengeta hutano pane yakanakisa chirongwa chemushonga iwe.
An A1C bvunzo zviyero zvepakati zveshuga zveropa (hemoglobin a1c) pamusoro pemwedzi miviri kusvika mitatu yapfuura. Hemoglobin A1C pazasi pe5.7% yakajairika, pakati pe5.7 uye 6.4% chiratidzo che prediabetes, uye 6.5% kana yakakwira inoratidza chirwere cheshuga. Vanhu vanogadzirisa yavo Type 2 chirwere cheshuga vanofanirwa kuwana bvunzo yeA1C kanokwana kaviri pagore uye kazhinji kana vachinja mishonga kana vaine mamwe mamiriro ehutano.
Vanhu vanoshandira kudzosera kumashure chirwere cheshuga vanogona kuona mutsauko muropa ravo reropa ipapo ipapo uye voedzwa kuti vadzokere kunzira dzavo dzekare. Usavhiringidze izvi, Redmond anodaro. Kana iwe ukarega kudya shuga uye carbs uye kurovedza muviri, unogona kunge uine yakaderera kana yakajairika shuga yeropa nekukurumidza. Asi, zvinogona kutora nguva yakareba kuti zvidzore kukuvara uko mapancreas atsungirira uye kutanga kucheka kuburikidza nemuviri we insulin kudzvinyirira uye nyika yekuzvimba.
Kuchinja chirwere cheshuga kunogona kudzoka. Vanhu vane chirwere cheshuga vanotova nemajini anoita kuti insulini isabatwe uye inogona kubatwa nechirwere ichi. Kudzorera chirwere cheshuga kunotora kuenderera mberi kwemwedzi yakawanda uye kuchengetedza shanduko kwehupenyu hwese.
Ndiani anogona kundibatsira kudzosera chirwere cheshuga?
Vanhu vane chirwere cheshuga vanofanira kutanga nevanopa rubatsiro rwekutanga kuti vatungamirirwe pakudzora mamiriro uye chirwere cheshuga. Mupiki wavo anogona kuvanongedzera kune a Chirwere cheshuga Kuzvidzora-Kudzidzisa uye Tsigiro (DSMES) sevhisi. Dare reDSMES rezvehutano rinosanganisira vadzidzisi veshuga sachiremba, vanamukoti, vanoona nezvezvokudya, vemishonga, nevamwe vanopa hutano vane hunyanzvi hwekudzidzira uye ruzivo. Chikwata chinobatsira varwere cheshuga kuti vadzidze zvakawanda nezve mamiriro uye manejimendi manejimendi.
