Abasetyhini abanesifo sikashukela ngexesha lokuQala kwangaphambili kufuneka bajongisise ngononophelo impilo yabo
Zininzi iinkqubo zeburhulumenteni ezinkulu zenziwa kwi-fetus ekhulayo kwiiveki zokuqala ezisixhenxe emva kokukhulelwa. Esi sigaba - xa abanye abesifazana bengayazi ukuba bakhulelwe - kuthethwa ngokubanzi kwixesha elinzima kakhulu lophuhliso kulo lonke ixesha lobomi bomntu. Iiveki zokuqala zokukhulelwa zibaluleke kakhulu kubafazi abanesifo sikashukela.
Izilumkiso ezongezelelweyo ezichazwe apha zisebenza ikakhulu kubasetyhini abanesifo sikashukela abakhulelweyo, kunokuba abasetyhini abahlakulela isifo sikashukela ngexesha lokukhulelwa.
Ngethuba lokukhulelwa, isifo sikashukela sesifo sikashukela asinayo ingozi efanayo yoxinzelelo lomama njengohlobo 1 okanye uhlobo lwesifo sikashukela.
Ngaba Abasetyhini abanesifo sikashukela kufuneka bazilungiselele njani ukukhulelwa?
Abasetyhini abanesifo sikashukela kufuneka babe nokuhlolwa ngokusemgangathweni ngaphambi kokukhulelwa. Njengengxenye yoviwo, kufuneka banikeze oogqirha babo ngembali epheleleyo yonyango, kubandakanywa ubude kunye nohlobo lwesifo sikashukela, imichiza kunye nezongezo ezithathwayo, kunye nayiphina imbali yesifo sesifo sikashukela, njengengxaki ye-neuropathy (umonakalo weentliziyo), i-nephropathy (ukulimala kweengtso), i-retinopathy (umonakalo wamehlo) kunye neengxaki zenhliziyo.
Kwakhona kubalulekile ukuba abafazi abanesifo sikashukela bacebe phambili kwaye bagcine ukulawulwa kweeshukela egazini ngaphambi kokukhulelwa, njengoko amanqanaba aphezulu eyeshukela ebudeni be-trimester yokuqala angakhokelela ekuphumeni komzimba okanye ukungabikho komntwana, okwenza utshintsho olungavamile ngexesha lokukhula komntwana kwisisu.
Ngaphambi kokukhulelwa, abasetyhini abanesifo sikashukela nabo kufuneka bahlolwe umsebenzi wabo wengqondo.
Nangona ukukhulelwa kungabi nakweyona ntsholongwane yesifo sikashukela, abafazi abakhulelweyo abanesifo esiphambili se-kidney baxhomekeke kwixinzelelo eliphezulu legazi, ezinokuchaphazela phantse zonke iinkqubo zomzimba kwaye ekugqibeleni zibeka ingozi kumntwana.
Yiyiphi Inkathalo ekhethekileyo okanye iimvavanyo ezifunekayo kubafazi abakhulelweyo abanesifo sikashukela?
Abafazi abakhulelweyo abanesifo sikashukela kufuneka bajonge ngokunyamekela ukunyamekela kwamehlo, kubandakanya ukuhlolwa kwe-retinal epheleleyo ngaphambili, ngexesha kunye nangemva kokukhulelwa, njengokuba i-retinopathy yesifo sikashukela (umonakalo kwimithambo yegazi ye-retina) ingaba yingozi xa ukhulelwe.
Le nkxalabo ivela ngokukodwa kubasetyhini abanesifo se-glucose (i-sugar glucose).
Ngethuba lokukhulelwa, abafazi kufuneka balinganise i-blood glucose ngamanye amaxesha ngamaxesha: ngaphambi nangemva kokutya, ngexesha lokulala, nasebusuku ukuba kukho inkxalabo malunga nobusuku be-hypoglycemia (ishukela ephantsi kwegazi). Umbutho we-American Diabetes Association uncoma ukulinganisa kokutya kwe-glucose ye-80 ukuya kwi-110 mg / dL (i-milligram nge-deciliter) kunye nesilinganiselo sokutya kwe-glucose ngaphantsi kwe-155 mg / dL.
Ukuba abafazi abakhulelweyo abanesifo sikashukela banomlinganiselo we-glucose wegazi malunga ne-180 mg / dL, umchamo wakhe kufuneka uhlolwe kwietoni (acids) ukulawula i-ketoacidosis, enokubangela ukuba i-pause isifo. I-Ketoacidosis iyenzeka xa umzimba ungenayo i-insulin.
Kutheni Kulawulwa Kwegazi I-Sugar Ngokubaluleke Kakhulu Kwabesetyhini abakhulelweyo abanesifo sikashukela?
Ngophando luka-1989, abafazi abane-pre-pregnancy A1C xabiso (uvavanyo lwegazi olulinganisa amazinga e-glucose) ephakamileyo kunama-9.3% abe nomngcipheko ophezulu wamathambo kunye nokuzalwa kwiintsana ezelwe ngamanxeba okuzalwa. Ucwaningo luye lwabonisa ukuba ixabiso le-A1C elifikelela kwi-6% (kunye ne-5% ithathwa njengesiqhelo) inomngcipheko ofanayo wokukhulelwa kwesisu kunye nokukhulelwa komntwana njengomntwana ongakhulelwe.
Abasetyhini abanamaqondo aphezulu ngaphezu kwesetyhukela egazi, nokuba ngaba banesisindo somzimba, uhlobo lwe-1 okanye uhlobo lwesifo sikashukela se-2, banokuba neentsana ezinkulu.
Oku kubangela umngcipheko omkhulu wokulimala kwegxala kunye ne-brachial plexus (iimbilini ezidibanisa umgudu ngengalo kunye negxala) kusana ngexesha lokubeletha.
I-diabetes elawulwa kakubi nayo idibene ne-pre-eclampsia (uxinzelelo lwegazi oluphezulu) kunye nokuziswa kwangethuba.
Kukho ulwazi oluncinane malunga nomphumo we-hyperglycemia (ushukela ophezulu wegazi) ekuphuhlisweni kwexesha elide lomntwana.
Ngaba Unesifo Sikashukela Esimele Siphephe Ngethuba Lokukhulelwa?
Abasetyhini abanesifo sikashukela se-2 abathabatha amachiza omlomo ngenxa yokulawulwa ushukela wegazi kufuneka batshintshe ekusebenziseni i-insulin ngaphambi kokukhulelwa kunye nokukhulelwa. Nangona ezinye iipilisi zomlomo ezichasene ne-antidiabetic ziye zafunyanwa kwaye zifunyenwe zikhuselekile ekukhulelweni, i-insulin yindlela efanelekileyo kunye neyona ndlela ikhuselekileyo yokulawula iswekile yegazi ngexesha lokukhulelwa.
Uninzi lweengcinezelo zegazi lingaba yingozi kumntwana; Ngoko ke, ngokuqhelekileyo la mayeza kufuneka agqitywe ngaphambi kokukhulelwa ukuba uxinzelelo lwegazi lungagcinwa ngaphasi kwe-130/80 mmHg kunye nokutya kweetyuwa kuphela. Ukuba unyango lwegazi luyimfuneko kakhulu, abafazi kufuneka batshintshe kumachiza omtsha ngaphambi kokukhulelwa. Ngokukodwa, i-angiotensin-yokuguqula i-enzyme inhibitors kunye ne-angiotensin receptor blockers zihle kakhulu ekulawuleni uxinzelelo lwegazi kubafazi abasetyhini abanesifo sikashukela; Nangona kunjalo, ezi zikhuselekile xa zisetyenziswe ngumfazi onesifo sikashukela kwaye ukhulelwe. Ngokufanayo, imithi ye-cholesterol-yokunciphisa imishanguzo kufuneka ivalwe ngexesha lokukhulelwa.
Indlela yokutya kunye nokuSebenza okuLawulayo abafazi abakhulelweyo abanesifo sikashukela?
Isondlo kubaluleke kakhulu kubasetyhini abakhulelweyo abanolu hlobo 1 kunye nohlobo lwesibini lweswekile. Ngokuqhelekileyo, abafazi abakhulelweyo nabancinci abanesifo sikashukela kufuneka bancede ama-calorie angama-15 ukuya kwezi-17 ngeekhilogari nganye kwimizimba yesisindo somzimba imihla ngemihla, nangona le nto ingahluka ukusuka kumntu ukuya kumntu kwaye kufuneka ixoxwe ngeqela lokunyamekela isifo sikashukela ngaphambi, ngexesha, nangemva kokukhulelwa kunye noongikazi.
Iinkxalabo ezibalulekileyo zesondlo kwi-type 1 isifo sikashukela ziquka ukutya kunye nokusetyenziswa kwexesha lokulala ngexesha lokulala, nokuguqula i-insulin ngokwemisebenzi kunye nokutya okukhuselekileyo ukukhusela amanqanaba aphezulu ashukela okanye aphantsi ekunyangeni ngokucophelela i-hyperglycemia kunye ne-hypoglycemia, ngokulandelanayo.
Isondlo yindlela ebaluleke kakhulu yokulawula i-glucose yegazi kwi-type 2 yeswekile.
Abafazi abakhulelweyo abanesifo sikashukela se-2 kufuneka bathethe nabanikezeli benonophelo yesifo sikashukela, kunye ne-diabetes isondlo sezondlo, ukugqiba iinjongo zabo ngeekhalori zansuku zonke, i-carbohydrate, ukulinganisela kokutya kunye nokutya ngexesha lonke.
Ukuzivocavoca kunenzuzo kubasetyhini abakhulelweyo abane-type 2 yeswekile, njengoko kunceda ukuphucula impendulo yomzimba kwi-insulin. Abafazi abanesifo sikashukela se-1 abasebenzisa ngaphambi kokukhulelwa banokuqhubeka beqhuba xa bekhulelwe. Nangona kunjalo, abafazi abanesifo sikashukela se-1 abangaqhelekanga ukuba basebenzisane baxhomekeke kwi-hypoglycemia kunye nokusetyenziswa ngexesha lokukhulelwa; Ngenxa yesi sizathu, aba bafazi abacebisi ukuba baqalise i-regimen xa bekhulelwe.
Imithombo:
UDelahanty, uLinda M. noDavid K. McCulloch. Ingqwalasela yeZondlo ngohlobo lwe-1 lwesifo sikashukela seMellitus. UpToDate.com 2007. UpToDate. 18 Sept. 2007 (ubhaliso)
UDelahanty, uLinda M. noDavid K. McCulloch. Ingqwalasela yeZondlo ngohlobo lwe-2 lwesifo sikashukela seMellitus. UpToDate.com 2007. UpToDate. 18 Sept. 2007 (ubhaliso)
Greene, MF, JW Hare, JP Cloherty, BR Benacerraf, kunye noJS Soeldner. "I-Hemoglobin yokuqala ye-Trimestri A1 kunye neengozi yoLungiso oluMkhulu kunye noKukhupha isisu kwi-Diabetes pregnancy." I-Teratology 39 (1989): 225-31.
Jovanovic, uLois. Ulawulo lwe-Glycemic Women in Type 1 kunye no-Type 2 lwesifo sikashukela seMellitus ngexesha lokukhulelwa. UpToDate.com 2007. UpToDate. 18 Sept. 2007 (ubhaliso)
Jovanovic, uLois. "Ukulungiswa koMcebisi kunye nokuVavanywa kwabasetyhini abaneSifo seSifo seSwekile iMellitus." UpToDate.com 2007. UpToDate. 16 Septemba 2007 (ukubhalisa)
"Ukunakekelwa kwangaphambili kwabesetyhini abanesifo sikashukela." Uncedo lweSwekile 27 (iSondlo 1) (2004): 76 ngo-18 Septemba 2007