Thayipha i-2 sikashukela

Ukwelashwa Okungcono Kakhulu Kwesifo Sikashukela e-Hyderabad, India

Isifo sikashukela sohlobo 2 yisifo esingamahlalakhona esimisa noma esivimbela amandla omzimba okulawula nokusebenzisa ushukela (iglucose) njengophethiloli. Abantu bangaba ne-glucose eningi kakhulu egazini labo okwenza kube yisimo esingelapheki.

Amazinga aphezulu kashukela egazini angenza abantu babe isisulu sezinkinga ezihlukahlukene ezihlobene nesimiso sokujikeleza kwegazi, sezinzwa, kanye nesimiso sokuzivikela komzimba. Izinkinga eziyisisekelo ezihilelekile ohlotsheni lwesifo sikashukela sohlobo 2 ukuthi amanyikwe awakwazi ukwenza i-insulin eyanele futhi amaseli awayiphenduli i-insulin eyenziwe. Zonke lezi zici zingaba nesibopho sokungena ushukela ophansi ngaphakathi emzimbeni.

Kuphinde kubizwe ngokuthi isifo sikashukela sabadala noma isifo esiqala kubantu abadala. Kokubili uhlobo loku-1 nohlobo 2 lungaqala ezigabeni zakuqala nezakamuva, kodwa uhlobo 2 luvame kakhulu kubantu abadala. Isifo sikashukela sohlobo 2 asinalo ikhambi ngakho sithathwa njengesifo esingamahlalakhona. Nakuba ungakwazi ukubhekana nakho ngosizo lwendlela yokuphila enempilo. Ungakwazi futhi ukulawula isifo sikashukela sohlobo 2 ngosizo lwe-insulin therapy noma imithi yesifo sikashukela. Odokotela ezibhedlela ze-CARE bahlinzeka ngokwelashwa okungcono kakhulu kwesifo sikashukela kanye nezindaba ezihlobene nayo.

Izimpawu 

Izimpawu nezimpawu kungase kuthathe isikhathi ukukhula, ezinye zazo zihlanganisa;

• Khulisa ukoma

• Ukuvuthwa njalo

• Ukwandisa indlala

• Ukuncipha kwesisindo okungaziwa

• Ukukhathala

• Umbono ophundlekile

• Izilonda namanxeba okuphola kancane

• Izifo ezitholakala njalo

• Ukuba ndikindiki ezandleni noma ezinyaweni

• Ukuluma ezandleni noma ezinyaweni

• Izindawo zesikhumba esimnyama njengangaphakathi naseduze kwamakhwapha nasentanyeni

Izingozi

Ziningi izingozi ezixhumene nesifo sikashukela sohlobo 2. Uma ungayilandeli indlela yokuphila enempilo, ungase uthambekele kulesi simo. Lezi zingozi ezilandelayo ziyi-

• Izinkinga zokukhuluphala ngokweqile noma isisindo

• Ukungasebenzi noma ukuntuleka kokunyakaza- uma ungasebenzi futhi ungenzi lutho.

• Umlando womndeni ungaholela okufanayo uma omunye wabazali bakho enesifo sikashukela sohlobo 2. 

• Race

• Ubuzwe

• Amazinga e-lipid egazi

• Ubudala- kuvame kakhulu ngemva kweminyaka engama-45 ubudala.

• I-Prediabetes- lapho izinga likashukela egazini liphakeme kunokuvamile kodwa lingekho ngaphansi kwesifo sikashukela.

• Izingozi ezihlobene nokukhulelwa- uma umama enesifo sikashukela sokukhulelwa kungaholela ohlotsheni 2.

• I-Polycystic ovary syndrome- ukungaya esikhathini okungajwayelekile kungaholela ohlotsheni lwesifo sikashukela sohlobo 2.

• Izindawo zesikhumba esimnyama njengamakhwapha nasentanyeni- lezi zindawo azikwazi ukumelana ne-insulin futhi zingadala isifo sikashukela sohlobo 2.

Sifo

Ziningi izivivinyo zegazi ezenziwayo ukuze kutholakale uhlobo 2 lwesifo sikashukela. Ukuhlolwa kwe-A1C noma i-hemoglobin kukhombisa izinga likashukela egazini elimaphakathi ezinyangeni ezi-2-3 ezedlule. Okulandelayo omaka bemiphumela ye-A1C-

• Ngaphansi kuka-5.7% kuvamile.

• U-5.7% kuya ku-6.4% utholakala - i-prediabetes.

• U-6.5% noma ngaphezulu ukhombisa isifo sikashukela.

Ezimweni lapho ukuhlolwa kwe-A1C kungatholakali noma lapho izimo ezithile zezokwelapha zingathinta ukunemba kwakho, abahlinzeki bezokunakekelwa kwempilo bangasebenzisa okunye ukuhlola ukuze bathole isifo sikashukela:

• Ukuhlola ushukela wegazi okungahleliwe: Kungakhathalekile ukudla okudlayo kwakamuva, lokhu kuhlola kukala amazinga kashukela egazini. Umphumela ka-200 mg/dL (11.1 mmol/L) noma ngaphezulu uphakamisa isifo sikashukela, ikakhulukazi uma sihambisana nezimpawu zesifo sikashukela njengokuchama njalo nokoma ngokweqile.
• Ukuhlolwa kokuzila ushukela wegazi: Lokhu kuhlolwa kwenziwa ngemva kokuzila ukudla kwasebusuku, futhi imiphumela ihlukaniswa kanje:
  • Ngaphansi kuka-100 mg/dL (5.6 mmol/L) kuthathwa njengokujwayelekile.
  • Ukufundwa okuphakathi kuka-100 kuya ku-125 mg/dL (5.6 kuya ku-6.9 mmol/L) kubonisa i-prediabetes.
  • Umphumela we-126 mg/dL (7 mmol/L) noma ngaphezulu ekuhlolweni okubili okuhlukene ubonisa isifo sikashukela.
• Ukuhlolwa kokubekezelela i-glucose ngomlomo: Lokhu kuhlola akuvamile ukusetshenziswa, ngaphandle ngesikhathi sokukhulelwa. Kubandakanya ukuzila ukudla isikhathi esithile bese uphuza isixazululo esinoshukela ehhovisi lomhlinzeki wezempilo. Izinga likashukela egazini ligadwa emahoreni amabili, futhi imiphumela ihunyushwa kanje:
  • Ngaphansi kuka-140 mg/dL (7.8 mmol/L) ngemva kwamahora amabili kuthathwa njengokujwayelekile.
  • Ukufundwa okuphakathi kuka-140 kuya ku-199 mg/dL (7.8 mmol/L kuya ku-11.0 mmol/L) kubonisa i-prediabetes.
  • Umphumela we-200 mg/dL (11.1 mmol/L) noma ngaphezulu ngemva kwamahora amabili ubonisa isifo sikashukela.
• Ukuhlola: I-American Diabetes Association incoma ukuhlolwa okujwayelekile ngokuhlolwa kwesifo sikashukela sohlobo 2 emaqenjini athile athile, okuhlanganisa:
  • Abantu abadala abaneminyaka engu-35 noma ngaphezulu.
  • Abantu abangaphansi kweminyaka engama-35 abakhuluphele ngokweqile, abakhuluphele, futhi banesici esisodwa noma ngaphezulu engcupheni yesifo sikashukela.
  • Abesifazane abanomlando wesifo sikashukela sokukhulelwa.
  • Abantu abake bahlolelwa ukuthi bane-prediabetes.
  • Izingane ezikhuluphele ngokweqile noma ezikhuluphele ezinomlando womndeni wohlobo 2 lwesifo sikashukela noma ezinye izici eziyingozi.

Uvivinyo

• Ukuhlola ushukela wegazi okungahleliwe- lezi zivivinyo zibonisa ushukela ngedesilitha ngayinye futhi zivezwa ngamamiligremu. Izinga lika-200Mg/dL noma ngaphezulu lizokhombisa isifo sikashukela kungakhathaliseki ukuthi kudliwe ukudla okungakanani. Ukuchama njalo kanye nezimpawu zokoma kulandelwa yilokhu kuhlolwa ukuze kuqinisekiswe uhlobo 2 lwesifo sikashukela.

• Ukuhlolwa kokuzila ushukela wegazi- lawa masampuli athathwa ngemva kokuzila ukudla kwasebusuku bonke futhi imiphumela ihunyushwa ngokuthi 100mg/dL njengokujwayelekile, 100-125 mg/dal njenge-prediabetes, nangaphezulu kuka-126mg/dL njengesifo sikashukela.

• Ukuhlolwa kokubekezelela i-glucose ngomlomo - ziwukuxilongwa okuvame kakhulu okwenzeka ngemva kokuzila ukudla kwasebusuku. Kudingeka ukuthi uphuze isiphuzo esinoshukela futhi ukuhlolwa kwenziwa ngezikhathi ezithile emahoreni amabili alandelayo. Abesifazane abakhulelwe abavunyelwe ukuthatha lezi zivivinyo. Imiphumela ingabalwa ngokuthi- 140mg/dL njengokujwayelekile, 140-199mg/dL njenge-prediabetes, futhi ngaphezu kuka-200mg/dL njengesifo sikashukela. 

• Ukuhlola- abantu abadala abangaphezu kweminyaka engama-45 kufanele bahlolwe ngemuva kokuxilongwa kwesifo sikashukela sohlobo 2 kumaqembu alandelayo:

• abangaphansi kweminyaka engama-45 abakhuluphele basengozini enkulu 

• Abesifazane abanesifo sikashukela sokukhulelwa 

• Itholakala nge-prediabetes 

• Izingane ezikhuluphele ngokweqile noma ezinomlando womndeni wohlobo 2.

Ukwelashwa 

Ukwelashwa kwesifo sikashukela sohlobo 2 kuyaphathwa, futhi lokho kubandakanya okulandelayo:

• Ukudla okunempilo

• Ukuvivinya njalo

• Ukwehla kwesisindo

• Imithi yesifo sikashukela

•  ukwelashwa kwe-insulin

• Ukuqapha ushukela wegazi

Lokhu kwelashwa kungalawula futhi kuvimbele ezinye izinkinga zesifo sikashukela.

• Ukudla okunempilo- Akukho ukudla okunqunyiwe kwesifo sikashukela kodwa kufanele wenze lokhu okulandelayo-

• Hlela ukudla nokudla okulula okunempilo

• Osayizi bezingxenye ezincane

• Okunye ukudla okunothe kakhulu nge-fiber njengezithelo, imifino engenasitashi, kanye nezinhlamvu

• Izinhlamvu ezicolisisiwe kancane, imifino enesitashi, namaswidi

• Ukunikezwa okuncane kobisi olunamafutha aphansi

• Inyama nenhlanzi enamafutha amancane

• Amafutha anempilo afana nomnqumo noma i-canola okupheka

• Amakhalori ambalwa

• Umsebenzi womzimba- Kubaluleke kakhulu ukuhlala unempilo futhi ugcine isisindo ngokwe-BMI. Ungazama okulandelayo-

1. Ukuzivocavoca kwe-aerobic - Ukuzivocavoca kwe-aerobic kuhlanganisa ukuhamba, ukuhamba ngebhayisikili, noma ukugijima. Umuntu kufanele atshale okungenani imizuzu engama-30 kulezi zivivinyo ze-aerobic ukuze alondoloze isisindo.

2. Ukuzivocavoca kokumelana- ukuthuthukisa amandla, ibhalansi kanye nekhono lokwenza- izibonelo i-yoga kanye nokuphakamisa izinsimbi.

3. Khawulela ukungasebenzi- hamba uhambe ukuze ukhawulele ukungasebenzi.

• Ukuncipha kwesisindo- lawula amazinga akho kashukela egazini, i-cholesterol, i-triglycerides nomfutho wegazi.

• Gada amazinga kashukela egazini- lokhu kungenziwa ngosizo lwe-blood glucose meter ezokala inani likashukela elikhona egazini. Umuntu angaphinde akhethe ukuqapha kwe-glucose okuqhubekayo- uhlelo lwe-elekthronikhi lokurekhoda amazinga e-glucose. Ungakwazi ukuxhuma lawa madivayisi kumafoni akho bese usetha i-alamu ukukwazisa ngamaleveli kashukela aphezulu noma aphansi.

• Imithi yesifo sikashukela- lena imithi yokwelapha futhi inikezwa uma umuntu engakwazi ukubhekana nalezi zindlela zokwelapha ezingenhla.

Imithi yesifo sikashukela

Imithi yesifo sikashukela inqunywa lapho ukudla nokuzivocavoca kukodwa kungakwazi ukulondoloza amazinga kashukela egazini. I-Metformin imvamisa iwukwelashwa kokuqala kwesifo sikashukela sohlobo 2, esebenza ngokunciphisa ukukhiqizwa kweglucose esibindini futhi ithuthukise ukuzwela kwe-insulin.

• I-Metformin: Imvamisa umuthi wokuqala wesifo sikashukela sohlobo 2, wehlisa ukukhiqizwa kwe-glucose esibindini futhi uthuthukise ukuzwela kwe-insulin.
  • Okuqhamuka uma udla imishanguzo: Imiphumela engemihle engaba khona ihlanganisa isicanucanu, ubuhlungu besisu, ukuqunjelwa, kanye nesifo sohudo.
• I-Sulfonylureas: Thuthukisa ukukhiqizwa kwe-insulin. Izibonelo yi-glyburide, i-glipizide, ne-glimepiride.
  • Okuqhamuka uma udla imishanguzo: Kungase kuholele kushukela wegazi ophansi kanye nesisindo somzimba.
• I-Glinides: Khuthaza ama-pancreas ukuthi akhiphe i-insulin ngokushesha kakhulu kune-sulfonylureas kodwa ngomphumela omfushane. Izibonelo zifaka i-repaglinide ne-nateglinide.
  • Okuqhamuka uma udla imishanguzo: Ngokufana ne-sulfonylureas, okubangela ushukela wegazi ophansi kanye nesisindo somzimba.
• I-Thiazolidinediones: Thuthukisa ukuzwela kwezicubu ku-insulin. I-Pioglitazone iyisibonelo.
  • Okuqhamuka uma udla imishanguzo: Ingase ibe nezingozi, njengokuhluleka kwenhliziyo ukucinana, umdlavuza wesinye, ukuphuka kwamathambo, nokukhuluphala.
• I-DPP-4 inhibitors: Amazinga kashukela egazi aphansi ngesizotha. Izibonelo i-sitagliptin, i-saxagliptin, ne-linagliptin.
  • Okuqhamuka uma udla imishanguzo: Lokhu kungaholela ku-pancreatitis nobuhlungu bamalunga.
• I-GLP-1 receptor agonists: Imijovo enciphisa ukugaya ukudla, enciphisa ushukela osegazini, ekhuthaza ukwehla kwesisindo, futhi ingase yehlise ukuhlaselwa yinhliziyo kanye nezingozi zohlangothi. Izibonelo yi-exenatide, i-liraglutide, ne-semaglutide.
  • Okuqhamuka uma udla imishanguzo: Izingozi ezingaba khona ze-pancreatitis, isicanucanu, ukuhlanza, kanye nesifo sohudo.

Isifo sikashukela sohlobo 2 singesinye sezifo ezingelapheki ezihamba phambili emhlabeni wonke, ezibhedlela ze-CARE sihlose ukuhlinzeka ngamasu okulawula afanele ngokumelene nesifo sikashukela sohlobo 2. Ngendlela yethu ebanzi nephelele enhlalakahleni nempilo yabantu, sihlinzeka ngokuxilongwa okufanele ngokumelene nesifo sikashukela sohlobo 2. Ubuchwepheshe bethu obusezingeni lomhlaba bungakusiza futhi bukunike impilo entsha.