Isifo Sikashukela: Izimpawu Zaso, Izimbangela Nokuphathwa Kwazo

Yini iDiyabhethi?

IDiyabhethi noma njengoba yaziwa kabanzi njengegciwane likashukela, iyisifo esingapheli esithinta imetabolismu yomzimba futhi esanda kakhulu namuhla, sidala izinkinga eziningi ezinzima zempilo. Njengoba ivame kakhulu emhlabeni jikelele, ithathwa njengenkinga enkulu yezempilo yomphakathi. Igama eliphelele leDiyabhethi, "Diabetes Mellitus", lisuselwa olimini lwesiGreki elisho ukuthi "umchamo onoshukela"; lokhu kungenxa yokuthi abantu abanesifo bathola ushukela emchameni, okungajwayelekile. Kubantu abadala abaphilile, izinga likashukela egazini ngesikhathi sokulamba livamise ukuba phakathi kuka-70-100 mg/dL, kanti uma leli zinga liphakeme njalo, kuba uphawu lweDiyabhethi.

Indlela Yokuthuthuka KweDiyabhethi

IDiyabhethi ivela ikakhulukazi ngenxa yokuthi umzimba awukwazi ukukhiqiza i-insulin eyanele noma i-insulin ekhona ayisebenzi kahle. I-insulin iwuhomoni obalulekile okhishwa yisitho esibizwa ngephankriyasi futhi osiza ukudlulisa ushukela egazini uye ezicutshini. Kunezinhlobo eziningi zeDiyabhethi; evame kakhulu yiDiyabhethi uhlobo lwesibili (Type 2). Lolu hlobo luvame kakhulu kubantu abadala, ikakhulukazi ngemuva kweminyaka engama-40. Kuleli cala, noma iphankriyasi ikhiqiza i-insulin, amaseli omzimba akhombisa ukumelana ne-insulin futhi umzimba awukwazi ukusebenzisa ushukela ngendlela efanele. Ekugcineni, ushukela egazini uyakhuphuka futhi kudale izinkinga ezahlukene zempilo.

Yiziphi Izimpawu ZeDiyabhethi?

IDiyabhethi iyisifo esithuthuka kancane kancane, futhi abantu abaningi abaqapheli izimpawu zokuqala. Kodwa njengoba izinga likashukela egazini likhuphuka, izimpawu ezahlukene ziqala ukubonakala:

• Ukuya endlini encane kaningi

• Isifiso esikhulu sokudla ngaphandle kokwaneliseka

• Ukoma ngokweqile nokoma komlomo

• Ukwehla kwesisindo ngokuzumayo

• Ukukhathala nokungabi namandla

• Ukubona kungenzeki kahle

• Ukuluma noma ukungazizwa kahle ezinyaweni noma ezandleni

• Ukululama okude kwezilonda

• Ukomo nokuluma kwesikhumba

• Ukunuka komlomo okufana ne-asetoni

Akuzona zonke izimpawu ezibonakala kubo bonke abantu. Uma izikhalo ziqapheleka, kubalulekile ukuya esikhungweni sezempilo ukuze kuhlolwe izinga likashukela egazini.

Izimbangela Eziyisisekelo ZeDiyabhethi

Kokubili ifa kanye nezimo zokuphila kwansuku zonke zidlala indima ekuveleni kweDiyabhethi. Izinhlobo ezimbili ezivame kakhulu; i-Type 1 ne-Type 2. I-Type 1 ivamise ukuqala ebuntwaneni noma ebusheni, futhi iphankriyasi ilahlekelwa kakhulu amandla okukhiqiza i-insulin. Kuleli cala; ifa, izifo zesistimu yokuzivikela kanye namanye amagciwane angalimaza iphankriyasi.

I-Type 2 ivamise ukubonakala kubantu abadala, ngenxa yezici ezilandelayo:

• Ukukhuluphala noma inkinga yokweqisa isisindo

• Umlando womndeni oneDiyabhethi

• Ukungazivocavoci nokunganyakazi

• Ubudala obuphambili

• Imiphumela yesikhathi eside yokucindezeleka

• Ukuvela kweDiyabhethi ngesikhathi sokukhulelwa noma ukuzala ingane enesisindo esiphezulu

Izinhlobo ZeDiyabhethi Zikhona Ziphi?

IDiyabhethi ihlukaniswa ngezinhlobo ezahlukene:

• I-Type 1 Diyabhethi: Ivamise ukuqala ebusheni futhi umzimba awukwazi ukukhiqiza i-insulin. Ukugomela i-insulin kuyadingeka ekwelapheni.

• I-Type 2 Diyabhethi: Ivamise ukubonakala ebudaleni. Amaseli omzimba awasaphenduli kahle kwi-insulin.

• I-Latent Autoimmune Diabetes in Adults (LADA): Uhlobo lweDiyabhethi oluqala ebudaleni, oluhambisana nezifo zokuzivikela, futhi imvamisa kudingeka i-insulin ekwelapheni.

• I-Maturity Onset Diabetes of the Young (MODY): Uhlobo lweDiyabhethi oluqala ebusheni, oludluliselwa ngokofuzo.

• I-Gestational Diabetes: Ivela kuphela ngesikhathi sokukhulelwa futhi kwesinye isikhathi ingaguquka ibe iDiyabhethi engapheli.

Ngaphezu kwalokhu, isikhathi sePrediyabhethi (ushukela ofihlekile) sibalulekile. Kulesi sikhathi, izinga likashukela egazini liphakeme kunokuvamile kodwa alikafinyeleli ezingeni lokuthi kutholwe iDiyabhethi. I-Prediyabhethi ingalawulwa ngokudla okunempilo kanye nokushintsha indlela yokuphila ngaphambi kokuba iguquke ibe iDiyabhethi ephelele.

Kwenziwa Kanjani Ukuhlolwa KweDiyabhethi?

Izindlela ezivame ukusetshenziswa ekutholeni iDiyabhethi yilezi:

• Uma ukuhlolwa koshukela egazini ngesikhathi sokulamba kukhombisa inani elingu-126 mg/dL noma ngaphezulu, kungaba uphawu lweDiyabhethi.

• Ku-Oral Glucose Tolerance Test (OGTT), uma ushukela olinganisiwe emuva kwamahora amabili uphezulu kuka-200 mg/dL, kubonisa iDiyabhethi; uma uphakathi kuka-140-199 mg/dL, kungaba uphawu lwePrediyabhethi.

• Ukuhlolwa kwe-HbA1c kunikeza ulwazi ngezinga likashukela egazini ezinyangeni ezintathu ezedlule, futhi amanani aphezulu kuka-6,5% asekelayo ekutholeni iDiyabhethi.

Kubalulekile ukulandela imiyalelo kadokotela ukuze kutholakale imiphumela eqondile ekuhlolweni kokutholakala kwesifo.

Ukubaluleka Kokudla Okulinganiselayo Ekuphathweni KweDiyabhethi

Ukuze iDiyabhethi ilawulwe kahle, kudingeka uhlelo lokudla olulinganiselayo. Abantu abaneDiyabhethi kufanele basebenzisane nochwepheshe bokudla kanye nodokotela babo ukuze bathole uhlelo lokudla oluhambisana nezidingo zabo. Imithetho eyisisekelo yile:

• Izitshalo eziphelele, imifino emisha nezithelo kufanele kube yizona ezibalulekile

• Kufanele kukhethwe ukudla okunamafutha aphansi, okune-calorie ephansi kodwa okunothile ngezinto ezondlayo

• Kulawulwe ubukhulu bokudla kanye nezikhathi zokudla ezimisiwe

• Kugwenywe ushukela ocwengiwe kanye nokudla okucutshunguliwe ngokweqile

Ukudla okuhlelekile kusiza ukulinganisa ushukela egazini, kunciphise isisindo somzimba kanye nezingozi zezinhliziyo. Ekwehliseni isisindo, i-Type 2 Diyabhethi ingalawulwa kangcono futhi isidingo samaphilisi sincishiswe. Uma kudingeka, kungasetshenziswa izindlela ezithile zokwelapha ukukhuluphala (njengokufakwa kwe-balloon esiswini, ukuhlinzwa kwe-bariatric, njll.); kodwa isinqumo sokwenza lezi zindlela kufanele sithathwe udokotela kuphela.

Ukudla Okunempilo Okungadliwa AbaneDiyabhethi

• Inhlanzi Ezinamafutha: Izinhlanzi ezifana nosalmon, usardine, iringa, uskumuru kanye no-alabaluki zinothe nge-Omega-3, ziwusizo enhliziyweni nasemithanjeni, futhi zingadliwa okungenani kabili ngesonto.

• Imifino Eluhlaza: Ispinashi, ikhala elimnyama, ulithisi kanye ne-broccoli zinothe ngamavithamini namaminerali, futhi azithinti kabi ushukela egazini.

• I-Avocado: Inothe ngamafutha anempilo angagcwali, inothile ngentambo futhi kufanele idliwe ngobuningi obulawulwayo.

• Iqanda: Landisa umuzwa wokugcwala, linothe ngephrotheni.

• Ubhanana kanye Nezinhlamvu: Njengoba zinothile ngentambo nephrotheni, zithuthukisa ukulingana koshukela egazini.

• Ubisi Oluyogathi: Lunothe ngephrotheni kanye nama-probiotic, lusekela impilo yamathumbu futhi lungathuthukisa impendulo ye-glycemic.

• Amantongomane: Ama-walnut nama-hazelnut anemafutha anempilo futhi anciphisa ingozi yezifo zenhliziyo.

• IBroccoli: Imifino enama-calorie aphansi, inothile ngentambo namaminerali.

• Uwoyela Womnqumo: Ngenxa yamafutha angagcwali, udlala indima yokuvikela enhliziyweni.

• Imbewu ye-Flax: Ngenxa ye-Omega-3 nentambo, isiza ukwehlisa i-cholesterol nokulawula izinga likashukela.

Yini Ushukela Ofihlekile (Prediyabhethi) Futhi Ungaqashelwa Kanjani?

Ushukela ofihlekile, noma i-prediyabhethi, yisikhathi lapho izinga likashukela egazini liphakeme kunokuvamile kodwa lingakafinyeleli ezingeni lokuthi kutholwe iDiyabhethi. Lesi simo siyingozi ngoba singaholela ekuthuthukeni kwe-Type 2 Diyabhethi. Imvamisa asibangeli izikhalo ezicacile, kodwa kungavela izimpawu ezincane ezifana nesifiso esikhulu sokudla okumnandi, ukukhathala ngokuzumayo noma ukulala ngemva kokudla. Kutholakala ngokuhlolwa koshukela egazini ngesikhathi sokulamba noma emva kokudla. Kulesi sigaba, izinguquko endleleni yokuphila zingavimba ukuthuthuka kwesifo.

Yiziphi Izindlela Esetshenziswa Ekulapheni iDiyabhethi?

Inqubo yokwelapha iDiyabhethi iyahlukahluka kuye ngohlobo lwesifo. Ku-Type 1 Diyabhethi, kudingeka ukwelashwa kwe-insulin impilo yonke. Ngaphezu kwalokho, kudingeka uhlelo lokudla olulungiselelwe umuntu ngokubambisana nochwepheshe bokudla, futhi kwabanye abantu, inani le-insulin lingalungiswa ngokubala ama-carbohydrate.

Ku-Type 2 Diyabhethi, izinguquko endleleni yokuphila, ukudla okunempilo kanye nokuzivocavoca kuyelulekwa esigabeni sokuqala. Uma kudingeka, kungasetshenziswa amaphilisi athuthukisa ukusabela kwamaseli kwi-insulin noma akhuthaza ukukhiqizwa kwe-insulin (ama-oral antidiabetics). Kwabanye abantu, kungadingeka ukwelashwa nge-insulin.

Esigabeni sokwelashwa, uma ushukela egazini uphakeme isikhathi eside, kungalimaza unomphelo izitho ezifana nemithambo, izinso kanye namehlo, ngakho-ke ukuhlolwa njalo nodokotela kubalulekile.

Imibuzo Evame Ukubuzwa

1. Ngingayinciphisa Kanjani Ingozi Yami YeDiyabhethi?

Ukudla okunempilo nokulinganiselayo, ukulawula isisindo, ukwenza imisebenzi yomzimba njalo, ukugwema ukubhema nokusebenzisa utshwala ngokweqile kusiza ekwehliseni ubungozi.

2. Kungenzeka yini ukuvimbela ukudlulela kweprediyabhethi kube yidiyabhethi?

Yebo, ukwehlisa isisindo, ukudla okunempilo nokwenza umzimba kungavimbela noma kubambezele ukuguquka kweprediyabhethi kube yidiyabhethi.

3. Yiziphi izivivinyo ezisetshenziswa ekutholeni isifo sikashukela?

Izivivinyo zegazi ezinjengoshukela wegazi ngesikhathi sokuzila, ukuhlolwa kokubekezelela ushukela (OGTT), kanye ne-HbA1c zisetshenziswa ekutholeni lesi sifo.

4. Ingabe kunokwelashwa okungapheli kwesifo sikashukela?

Isifo sikashukela yisifo esingapheli. Nakuba kungelula ukusisusa ngokuphelele, ukwelashwa okusebenzayo kungalawula ushukela wegazi futhi kuvimbele izinkinga.

5. Yiziphi izindlela eziyinhloko ezihlukanisa uhlobo 1 nohlobo 2 lwesifo sikashukela?

Uhlobo 1 lwesifo sikashukela luvame ukuqala ebuntwaneni futhi umzimba awukwazi ukukhiqiza i-insulin nhlobo. Uhlobo 2 luvame ukubonakala ebudaleni futhi amaseli omzimba akhombisa ukumelana ne-insulin.

6. Ingabe izindlela ezingezona ezemithi ziyasebenza ekwelashweni kwesifo sikashukela?

Ukudla, ukuzivocavoca kanye nokushintsha indlela yokuphila kuyasebenza kakhulu ikakhulukazi ekuqaleni kohlelo 2 lwesifo sikashukela, kwezinye izimo kungadingeka imithi.

7. Ingabe abesifazane abakhulelwe bangathola isifo sikashukela?

Yebo, kukhona isifo sikashukela esivela ngesikhathi sokukhulelwa (gestational diabetes) futhi sidinga ukuqashwa nokwelashwa ukuze kuvikelwe impilo kamama nengane.

8. Yiziphi izimpawu zokuqala zezingqinamba zesifo sikashukela?

Ukungazizwa kahle ezinyaweni, ukulahlekelwa ukubona, ukuphazamiseka kwemisebenzi yamaphaphu kanye nezifo zenhliziyo nezitho zegazi kungaba izimpawu zezingqinamba.

9. Yiziphi izithako okufanele zigwenywe abantu abanesifo sikashukela?

Kuyelulekwa ukunciphisa ushukela ocwengiwe, ukudla okwenziwe ngofulawa omhlophe, ukudla okuthosiwe nokunamafutha amaningi, iziphuzo ezidakayo kanye nosawoti.

10. Umdlalo womzimba udlala kanjani indima ekwelashweni kwesifo sikashukela?

Ukuzivocavoca njalo kwandisa ukuzwela kwe-insulin, kwehlisa ushukela wegazi futhi kusiza ekulawuleni isisindo.

11. Singayithuthukisa kanjani ikhwalithi yokuphila kwabantu abanesifo sikashukela?

Ukuqashwa njalo kwezempilo, ukudla okunempilo, ukuphathwa kokucindezeleka kanye nomsebenzi womzimba ofanele kungathuthukisa ikhwalithi yokuphila.

12. Kubalulekile kangakanani ukuvakashela udokotela njalo ngesifo sikashukela?

Kuncike esimweni somuntu ngamunye, kodwa ngokuvamile kunconywa ukuhlolwa njalo phakathi kwezinyanga ezi-3 kuya kwezi-6. Uma ubungozi bezinkinga buphezulu, ukuqashwa kungadingeka kube njalo kakhulu.

Imithombo

• Inhlangano Yezempilo Yomhlaba (World Health Organization - WHO), Diabetes Mellitus Guidelines

• Inhlangano Yomhlaba Yezifo Sikashukela (International Diabetes Federation - IDF), Diabetes Atlas

• Inhlangano YaseMelika Yezifo Sikashukela (American Diabetes Association - ADA), Standards of Medical Care in Diabetes

• Centers for Disease Control and Prevention (CDC), Diabetes Publications

• New England Journal of Medicine, Diabetes-Related Research

• European Association for the Study of Diabetes (EASD) Guidelines