Matenda a shuga a Gestational (GDM): Zomwe Zimayambitsa, Zizindikiro, Zowopsa Ndi Chithandizo

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Mimba imafuna chisamaliro chowonjezera komanso nkhawa. Ngati ndinu mayi wapakati wokhala ndi matenda ashuga, muyenera kukhala osamala kwambiri. Matenda ashuga omwe amapezeka nthawi yapakati amatchedwa kuti gestational shuga. Izi ziziika pathupi panu pachiwopsezo chifukwa chotenga padera, kupunduka, kubadwa, kubadwa msanga komanso mwana wamkulu ^[1] . Gestational shuga imagawika m'magulu awiri, Kalasi A1 (yomwe imatha kuwongoleredwa kudzera pazakudya zokha) ndi Class A2 (imafunikira insulini kapena mankhwala am'kamwa kuti athetse vutoli).

Mzimayi akatenga pakati, thupi lake limasintha kwambiri komanso, amatha kukhala ndi zovuta zina zomwe zimakhudza amayi apakati. Mayi akadwala matenda ashuga, msinkhu wamagazi amatha kuchulukirachulukira ndipo izi zimatha kuyambitsa zovuta zina kwa mwana ndi mayi ^[ziwiri] .

Zotsatira zake, chimodzi mwazinthu zomwe zamveka kwambiri masiku ano ali ndi pakati ndizomwe zimachitika chifukwa cha matenda ashuga. Mahomoni amatha kupangitsa kuti magazi azikwera mukakhala ndi pakati, kukulitsa zovuta zakukhala ndi pakati komanso kovuta. Komabe, munthu amalangizidwa nthawi zonse kuti akhalebe ndi chiyembekezo ngakhale atapezeka kuti ali ndi matenda ashuga ^{[3] [4]} .

Gestational matenda a shuga amapezeka kokha panthawi yapakati. Zimasonyeza shuga wambiri panthawi yomwe ali ndi pakati zomwe zinali zachilendo musanabadwe. Matendawa amachira mukangobereka kumene. Nthawi zina, zimawonjezera mwayi woti mukhale ndi matenda ashuga amtundu wa 2, ngakhale ndizochepa ^[3] .

Zomwe Zimayambitsa Matenda A shuga

Zomwe zimayambitsa kukula kwa vutoli sizikudziwika. Komabe, akuti mahomoni amatenga gawo lalikulu pakukula kwa vutoli.

Pakati pa mimba, mahomoni opangidwa ndi nsengwa zimayambitsa kuchuluka kwa shuga m'magazi anu, zomwe zimapangitsa kuti mukhale ndi matenda ashuga ^[5] . Momwemo, kapamba wanu amatha kupanga insulini yokwanira kuthana ndi izi. Komabe, nthawi zina, ikapanda kutero, kuchuluka kwa magazi m'magazi kumadzetsa matenda a shuga.

Kodi zimayambitsa matenda ashuga oberekera?

Zizindikiro Za Matenda A shuga

Nthawi zambiri, vutoli silimayambitsa zizindikiro zilizonse. Zizindikiro zomwe zimayambitsa zimatha kukhala zofatsa ndipo ndi izi ^[6] .

• Masomphenya olakwika
• Kutopa
• Nthawi zina
• Ludzu lokwanira
• Kufunika kokodza kwambiri

Komabe, ziyenera kudziwika kuti zambiri mwazizindikiro zomwe zimakhudzana ndi matenda ashuga akupezeka ponseponse ndipo zimawoneka mwa amayi ambiri apakati. Izi zikuphatikiza zizindikilo monga kutopa, kuchuluka kwa ludzu, nseru ndi kusanza. Chifukwa cha kukula kwa zizindikirazo, mwina sangazindikire, zomwe zimaika mayi komanso mwana pangozi ^[7] .

Kuopsa Kwa Matenda A shuga

Mutha kukhala ndi matenda ashuga obereka ngati mukutera

• kukhala ndi mbiri ya matenda ashuga
• ndinakhala ndi matenda ashuga omwe anali ndi pakati mukakhala ndi pakati
• anali onenepa kwambiri asanakhale ndi pakati
• anali ndi shuga wambiri wamagazi
• khalani ndi kuthamanga kwa magazi
• anabala mwana wamkulu kale
• kunenepa kwambiri panthawi yoyembekezera
• ali ndi zaka zopitilira 25
• akuyembekezera ana angapo
• kupita padera kapena kubala mwana akufa
• ali ndi polycystic ovary syndrome (PCOS), acanthosis nigricans, kapena zinthu zina zomwe zimakhudzana ndi insulin kukana ^{[8] [9]}

Zovuta Za Matenda A shuga

Ngati kusowa chisamaliro ndi chisamaliro, vutoli limangokulira ndikubweretsa zovuta zomwe zingakhudze thanzi la mwanayo ndi mayi ^[9] .

Zovuta zokhudzana ndi vutoli ndi izi:

• Mavuto opumira
• Kulemera kwakukulu
• Dystocia wamapazi (amachititsa kuti phewa la mwana likhazikike mumtsinje wobadwira panthawi yogwira ntchito)
• Shuga wamagazi ochepa
• Kutumiza msanga
• Zowonjezera mwayi wobereka kaisara
• Imfa ya Neonatal
• Macrosomia

Kuzindikira Kwa Matenda A shuga

Nthawi zambiri zimachitika theka lachiwiri la mimba yanu. Zizindikiro za izi zitha kukhala kufunikira kuti muzitha kuwona pafupipafupi, kumva ludzu kuposa masiku onse, kumva njala komanso kudya mopitirira muyeso. Ngakhale zizindikilozi zimatha kuphatikizidwa ndi zizindikilo za kutenga pakati pokha, nthawi zambiri matenda opatsirana pogonana amatengera mayeso omwe mumachitika mukamayesedwa ^[10] .

Nthawi zambiri, pakati pa masabata 24 mpaka 28, dokotala wanu amakupatsani mayeso kuti muwone ngati ali ndi matenda ashuga.

Kuchiza Kwa Matenda A shuga

Mukapezeka kuti muli ndi vutoli, dongosolo lamankhwala lidzadalira kuchuluka kwa shuga wamagazi tsiku lililonse.

Muyenera kuyesa shuga lanu musanadye komanso mutadya.

Nthawi zina, jakisoni wa insulini amalangizidwa kuti athandizire kuchepetsa magazi ^{[khumi ndi chimodzi]} .

Zovuta Za Shuga Wam'mimba Kwa Mwana

Mwana wanu akamalandira michere m'magazi anu, kukhala ndi matenda ashuga amakhudzanso mwanayo. Mwana amasunga shuga wowonjezera wamafuta omwe amamupangitsa kukula kukula kuposa zachilendo. Pakhoza kukhala zovuta zina zakutenga monga zotsatirazi ^[12] :

• Pakhoza kukhala kuvulala kwa khanda panthawi yobereka chifukwa chakukula kwa mwanayo.
• Mwanayo atha kubadwa ali ndi shuga wochepa magazi komanso mchere.
• Pakhoza kukhala kubadwa kusanachitike.
• Mwanayo amatha kubadwa ndi jaundice.
• Pakhoza kukhala zovuta zakanthawi zopumira.

Kupatula izi, mwanayo amathanso kukhala ndi mwayi wochulukirapo kunenepa kwambiri komanso matenda ashuga kumapeto kwa moyo wake. Ana otere ayenera kulimbikitsidwa kuti azikhala ndi moyo wathanzi kuyambira pachiyambi ^[13] .

Kusamalira Matenda a shuga

Ngati mwapezeka kuti muli ndi matenda ashuga, dokotala wanu amakhala akukuyang'anirani mosamala. Mufunsidwanso kuti mukachezere dokotala wanu kuti akakuyendereni pafupipafupi ndipo mudzafunika kuchita izi ^{[14] [khumi ndi zisanu]}

• Onetsetsani kuchuluka kwa shuga m'magazi anu kanayi patsiku. Sungani makina owunikira magazi m'magazi kunyumba.
• Pezani mayeso amkodzo pafupipafupi kuti muwone ngati pali ketoni. Izi zimachitika kuti muwone ngati matenda a shuga akuyamba.
• Kuchita masewera olimbitsa thupi nthawi zonse. Mutha kufikira ophunzitsa omwe angakutsogolereni bwino za masewera olimbitsa thupi omwe ali oyenera komanso athanzi pochita pakati.
• Funsani upangiri wa adotolo kapena adotolo anu kuti mupange tchati cha zakudya zabwino. Chakudya chanu chiyenera kukhala chotere kuti sichikuwonjezera kuchuluka kwa magazi m'magazi.

1. [1]Sermer, M., Naylor, C. D., Gare, D. J., Kenshole, A. B., Ritchie, J. W. K., Farine, D., ... & Chen, E. (1995). Zotsatira zakuchulukirachulukira kwama carbohydrate pazotsatira za amayi ndi amayi mu 3637 azimayi omwe alibe matenda ashuga obereka: Toronto Tri-Hospital Gestational Diabetes Project. American magazine of obstetrics and gynecology, 173 (1), 146-156.
2. [ziwiri]Bungwe la American Diabetes Association. (2004). Chisamaliro cha matenda ashuga, 27 (suppl 1), s88-s90.
3. [3]Mmisili, M. W., & Coustan, D. R. (1982). Njira zowunikira poyesa matenda ashuga oyembekezera. Magazini yaku America yazachipatala ndi matenda achikazi, 144 (7), 768-773.
4. [4]Kim, C., Newton, K. M., & Knopp, R. H. (2002). Gestational shuga komanso kuchuluka kwa matenda amtundu wa 2: kuwunika mwatsatanetsatane Kusamalira matenda ashuga, 25 (10), 1862-1868.
5. [5]Pomwe, C. A., Hiller, J. E., Moss, J. R., McPhee, A. J., Jeffries, W. S., & Robinson, J. S. (2005). Zotsatira zakuchiza kwa matenda opatsirana pogonana asanafike pathupi. New England Journal of Medicine, 352 (24), 2477-2486.
6. [6]Bellamy, L., Casas, J. P., Hingorani, A. D., & Williams, D. (2009). Type 2 shuga mellitus pambuyo pobereka matenda ashuga: kuwunika mwatsatanetsatane ndikuwunika meta. Lancet, 373 (9677), 1773-1779.
7. [7]Buchanan, T. A., & Xiang, A. H. (2005). Gestational shuga mellitus. Journal of kafukufuku wamankhwala, 115 (3), 485-491.
8. [8]Boney, C. M., Verma, A., Tucker, R., & Vohr, B. R. (2005). Matenda a metabolism muubwana: kuyanjana ndi kunenepa, kubereka kunenepa kwambiri, komanso matenda ashuga obereka. Matenda, 115 (3), e290-e296.
9. [9]Zowona, G. D.F (1986). Kodi Matenda a shuga ndi chiyani?
10. [10]Koivusalo, S. B., Rönö, K., Klemetti, M. M., Roine, R. P., Lindström, J., Erkkola, M., ... & Andersson, S. (2016). Gestational diabetes mellitus itha kupewedwa ndi njira zamoyo: Chifinishi Gestational Diabetes Prevention Study (RADIEL): kuyesedwa kosasinthika. Kusamalira matenda ashuga, 39 (1), 24-30.
11. [khumi ndi chimodzi]Kamana, K. C., Shakya, S., & Zhang, H. (2015). Gestational shuga mellitus ndi macrosomia: kuwunikira zolemba. Annal of Nutrition and Metabolism, 66 (Suppl. 2), 14-20.
12. [12]Aroda, V. R., Christophi, C. A., Edelstein, S. L., Zhang, P., Herman, W. H., Barrett-Connor, E., ... & Knowler, W. C. (2015). Zotsatira zakulowererapo kwa moyo ndi metformin popewa kapena kuchedwetsa matenda ashuga pakati pa azimayi omwe ali ndi matenda ashuga osadwala: Diabetes Prevention Programme imaphunzirira kutsatira zaka 10. Journal of Clinical Endocrinology & Metabolism, 100 (4), 1646-1653.
13. [13]Kampmann, U., Madsen, L. R., Skajaa, G. O., Iversen, D. S., Moeller, N., & Ovesen, P. (2015). Gestational shuga: kusintha kwamankhwala.Udindo wapadziko lonse wa matenda ashuga, 6 (8), 1065.
14. [14]Bungwe la American Diabetes Association. (2017). 2. Gulu ndi matenda a shuga. Kusamalira matenda ashuga, 40 (Supplement 1), S11-S24.
15. [khumi ndi zisanu]Damm, P., Houshmand-Oeregaard, A., Kelstrup, L., Lauenborg, J., Mathiesen, E. R., & Clausen, T. D. (2016). Gestational shuga mellitus ndi zotulukapo zazitali kwa amayi ndi ana: malingaliro ochokera ku Denmark. Diabetologia, 59 (7), 1396-1399.

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