Ukulahlekelwa kwesisindo esixhasayo kuyisisiseko sokukhutshwa kwesifo sikashukela
Izibonelelo zokulahlekelwa kwesisindo ekuphatheni isifo sikashukela ziye zisoloko zihamba phambili kwiinkathalo zesifo sikashukela, ngokukodwa kulabo bantu abanesifo seswekile esinesifo sikashukela. Ubunzima obuninzi bunokunyusa ukuvuvukala nokwenza iishukela zegazi zibe nzima ukulawula ngokubangela ukunyanzelwa kwe-insulin.
I-American Diabetes Association ithi, "Kukho ubungqina obuqinileyo nobungqina obuqhelekileyo bokuthi ukulahleka kokunyameka kokunciphisa umzimba kunokulibazisa ukunyuka kwe-prediabetes ukuthayipha i-diabetes yesi-2 kwaye inenzuzo ekuphatheni uhlobo lwesifo sikashukela." Kodwa, kuthekani ukuba ukulahlekelwa isisindo kunokunceda ukuguqula isifo sikashukela se-2?
Abaphandi be-Diabetes I-Remission Clinical Trial (i-DiRECT) yafumanisa ukuba emva kweenyanga ezili-12 ukungenelela, ama-46 ekhulwini abathathi-nxaxheba bakwazi ukufezekisa ukuxolelwa kohlobo lwe-2 lweswekile ngokulahlekelwa kwesisindo ngokumalunga ne-4 ekhulwini ekulawuleni. Bafumanise ukuba ukulahleka komzimba okwehliswayo kwandiswe ukuxolelwa (kuchazwe njenge -A1c engaphantsi kwama-6.5 ekhulwini ngaphandle kweyeza zesifo sikashukela) sohlobo lwe-2 lweswekile.
UMlawuli wezoNyango we-Diabetes Alliance kunye neTelediabetes ekhokelela kwiNtaba yaseSinayi iSibhedlele kunye ne-endocrinologist, uDkt. Noga Minsky uthi, "Inqaku lokuthabatha, elinika abantu abaninzi ngaphandle kwelo themba, kukuba isifo sikashukela sinokuguqulwa ngokunyuka kwesisindo. izifundo eziqhathaniswa nokutyunjwa kwezinto eziphathekayo kwiinguqu zokuziphatha okanye ukuphathwa kwezonyango, apho unyango olungaphelelanga aluzange luholele ekuxolelweni kwesifo sikashukela kuzo naziphi na izigulane eziphathwe kakubi emva kweminyaka emibili ukuya kwimithathu. " Ukongezelela, uMinsky uthi, "Kwakuthembisa ukuba i-diabetes yabuyiselwa ngokuphumelelayo nakwizigulane ezinesifo sikashukela iminyaka emithandathu, kodwa kubalulekile ukuba uqaphele ukuba izigulana ezaphathwa nge-insulin zazingabandakanywa kwisifundo."
Esi sifundo sinika abantu abaninzi abanesifo sikashukela bathemba ukuba, nangona banesifo sikashukela ixesha elithile, ukulahlekelwa isisindo kunokubanceda baphumelele ukulawulwa kweshukela egazini kwaye bayeke amayeza.
Ngoko, Ababambi-nxaxheba baye baLahla njani ubukhulu?
Ukuba ukulahlekelwa isisindo kwakulula, ngoko-ke ukulahleka kwesisindo akuyi kuthatha iibhiliyoni zeedola ngonyaka.
Ukunciphisa ukulahlekelwa nokunyuswa kwesisindo kunokuba nzima. Isinyathelo esibalulekileyo ekuphumeleleni sifumana isicwangciso onokubambelela kuso. Kwakhona kuncedo kakhulu ukuba ngabaqeqeshi bezempilo baphendule ukutya kwakho kwaye bagcine iso linyameko lokungenisa kwakho. Ukubekwa esweni akusikuncedi kuphela ukunamathela kwisicwangciso, kodwa kunceda ekupheliseni ezinye izigqibo zokuqala zokudla.
Kule sifundo esithile, abathathi-nxaxheba balandela ukutshatyalaliswa kokutya okupheleleyo (825-853 kcal / day food formula) kwiinyanga ezintathu ukuya ezintlanu), batyelela ukubuyiswa kokutya (ezimbini ukuya kwiiveki ezisibhozo), kunye nenkxaso ehleliweyo yokunakekelwa kokulahlekelwa kwexesha elide. Iinyanga ezi-ezintathu zokuqala zaziquka ukutya okuncinci kwekhalori, okunokuba kunzima ukunamathela ngaphandle kokuziva ulambile kwaye unyanzelekile. Ngaphambi kokuba wenze utshintsho olunzulu kwi-caloric intake, kukulungele ukudibana neengcali zezempilo ukwenzela ukuba ukwazi ukuba uluphi uhlobo lwesicwangciso sokutya oluza kuvelisa ngokwaneleyo kwekhalori ukwenzela ukuba unciphise umzimba kwaye ugcine ugcwele kwaye unelisekile. Ukufumana imfundo eqhubekayo kuya kukunika ithuba lokufunda indlela yokutya ngokwakho, ngoko awufumani ubunzima bokubuya.
Ubungakanani Ubunzima Okumele Bulahlekelwe Sifo Sikashukela?
Njengokuba kukho iinkalo ezininzi zesifo sikashukela, imilinganiselo yokulahlekelwa kweepesenti zokunyuka kwesisindo kuya kufuneka ukuba ibe ngabanye.
Kule sifundo esithile, abathathi-nxaxheba abalahlekelwa ubunzima bobunzima babe nezinga eliphezulu lokukhutshwa kwesifo sikashukela. Ukunciphisa ubunzima bohlukeneyo phakathi kwabathathi-nxaxheba, ukusuka kwiiyure ezili-11-33 (i-5-15 kg) kunye nesilinganiso esiphantsi kweekhilo ezili-10 (10 kg). Akucaci ukuba yeyiphi ipesenteji yesisindo somzimba esilingana nayo.
I-American Diabetes Association ibonisa ukuba ukulahleka kwepesenti ezi-5 zokuqala komzimba kuye kwaboniswa ukuba kuphuculwe ukulawulwa kwe-glycemic nokunciphisa imfuno yokunyusa imithi ye-glucose. Ukongezelela, i-percentage lossage weight is needed ukuphucula ulawulo lwe-glycemic, lipids, kunye nexinzelelo lwegazi, kunye nokulahlekelwa kwesisindo esiqhubekayo sama-7 ekhulwini.
Kuba umntu olinganisa ama-pounds angama-200, ukulahlekelwa kwesisenti se-5 kuya kuvelisa iipounds ezili-10 kunye ne-7% yexabiso lokulahlekelwa ngumzimba ngamapounds ayi-14. Ngokuqinisekileyo, inani lokulahleka kwesisindo olufunekayo ukunciphisa i-A1c ukuya kuma-6,5 ekhulwini kuya kuhluka ukusuka kumntu ukuya kumntu, kodwa ukuphuculwa kwesisindo se-5 kuya ku-7 kuyisiqalo esilungileyo.
Ukulahlekelwa kwesisindo akusilungele ukuLawula i-Blood Sugar
Siye sabona ukulungiswa phakathi kokudandatheka, ukukhuluphala, kunye nesifo sikashukela. Ukulahlekelwa isisindo nokuphucula ukulawulwa kwe-glycemic kuye kwadibaniswa nokuphucula amandla, ukulala okungcono, kunye nempilo engcono. Olu pho nonongo lubonisa ukuba ukulahleka kwesisindo kuphucula umgangatho wobomi. Umgangatho wobomi (i-QoL) yahlolwa ngokusetyenziswa kwe-EuroQol 5 Isilinganiselo se-analogue scale. Abathathi-nxaxheba be-Intervention bafumana ukuphucula okuphakathi kwamaqondo angama-7.2 kwinqanaba le-QoL xa kuthelekiswa nokuhla kwe-2.9 amanqaku okulawula (ulungelelaniso oluchaziweyo 6.4 amanqaku, ama-95 ekhulwini CI 2.5-10.3, P = 0.0012).
Ndingayenza Njani Ukuqala Ukulahlekelwa Kwisisindo sam?
Kubaqalayo, uya kufuna ukudibana neengcali, ezifana nesondlo okanye umfundisi wesifo sikashukela oqinisekisiweyo ukuba unokukunceda uyilole isicwangciso sokutya esizimeleyo esikuloo ndlela yokuphila kwaye ikunike ukutya okuthandayo.
Ukuba unqwenela ukuqaqa iqalisa ngokukhawuleza, mhlawumbi indawo efanelekileyo yokuqala ukutshintshela ukudla kwakho kokubili ukuya kwesibini ngokutya. I-American Academy yeZondlo kunye neDietetics ithi, "ukutshintshwa kokutya okuqulethwe ngamanzi awaziwayo kunye nesisombululo se-macronutrient isicwangciso esiluncedo sokuphelisa ukhetho lokutya okunengxaki kunye / okanye ukucwangciswa kokutya okunzima ngenkqubela ukuzama ukufezekisa ubunqongophala bemandla angama-500 ukuya ku-1,000." Oku kunceda ukulawula iikhalori kwaye kwongeza ukulula, okubalulekileyo ekuphumeleleni kwexesha elide. Ucwaningo luye lwabonisa ukuba abo bantu abanesifo sikashukela se-2 abalahlekelwa malunga neepesenti ezisixhenxe zesisindo somzimba wabo kunyaka owodwa, baxela ngokukhawuleza ukunciphisa amayeza xa besetyenziselwa ukutya. Kubalulekile ukuba uqaphele, nangona kunjalo, kulezi zifundo, abantu babesayisebenzisa, begcina idayari zokutya kunye nokufunda ngesondlo.
Unokuzama kwakhona inkqubo yokuhambisa ukutya ukuze uncede lula lula izinto. Namhlanje, kukho iindlela ezininzi. Kungekudala uMbutho waseSydidabeshi waseMelika uhlangene noKhef'd ukubonelela ngokukhawuleza izikiti zokufunyanwa ngabantu abanesifo sikashukela esiphefumlelwe yi-American Book Diabetes Association's award winning bookbooks.
Ukunqongophala kweMithwalo yokuPhelela kwesisindo kubalulekile
Kwabanye, ukulahlekelwa ubunzima yingxenye elula-kukugcina ubunzima obunzima kakhulu. Emva kokuba ulahlekelwe ubuninzi bexabiso, ukuphumla kwakho kwezinga lokunciphisa umzimba kunciphise kwaye udinga iikhalori ezingaphantsi ukugcina ubunzima bakho. Ngeli xesha, inkxaso inkulu. Uzakufuna zombini inkxaso ngaphakathi kwekhaya lakho, kunye nenkxaso yobugcisa-ugqirha wakho wokunakekela oyintloko, utitshala ogqityiweyo wesifo sikashukela, umqeqeshi we-dietarian, okanye umqeqeshi wezempilo. Ukuphakama kwesisindo kuya kubangela ukuba kufuneke ukuba ubuyele kwisifo sikashukela kwaye amaxesha amaninzi abantu abalahlekelwe isisindo baze babuyisele kwakhona, baya kuzuza ngaphezu kwexesha. Oku kwenza ukuba kunzima ukuphinda ukhululeke kwakhona-kwaye kudikibala kakhulu.
Kwizame zokuthintela oku kungenzeki, kubalulekile ukukhetha isicwangciso sokutya kunye nesicwangciso sokutya esilungileyo kunye nesigxina. Ukunyakaza okuqhubekayo kuya kubaluleka ekudaleni ukulahleka kwekhalori kunye nokwakhiwa kwezicubu zomzimba eziqhenqileyo ukwenzela ukwandisa i-metabolism. Ngokufanelekileyo, uya kufuna ukwenza intsebenziswano ye- cardiovascular and resistance resistance exercise. Ukunyamezela ukuxhatshazwa komzimba kunokunceda ukwandisa ukuphumla kwakho kwemetabolism (ubuninzi beekhalori ozitshisayo ngokuphila nje), okuba kubaluleke kakhulu njengoko sinobudala xa i-metabolism iyancipha.
Ukongeza, kuya kufuneka uhlale uphendula. Abathathi-nxaxheba kulolu cwaningo banikwe inkxaso ngenkxaso yesilonda eside. Inkxaso ehlelweyo inokuthi iyenze kodwa isebenze ngokusemandleni akho kunye nendlela ophila kuyo. Ingaba unokutshintshana kunye neqela lakho lononophelo lwempilo kumntu okanye usebenzisa uhlobo oluthile lwesicelo -ukukhethwa kwamhlanje kungapheliyo. I-Telemedicine yenza ukuphathwa kwezifo lula-iteknoloji inika ababoneleli ngezezempilo ukuba bakwazi ukufikelela-kwaye bancede naphi na ukuba bakuphi. Kubalulekile ukuzisebenzisela izibonelelo zakho. Buza ugqirha wakho wokukhathalela oyintloko ukuba usebenzisa nayiphi na iteknoloji yokulawula izigulane zabo okanye ukuba basebenzisana nesondlo sokutya esibhalisiweyo, utitshala wesifo sikashukela, okanye umqeqeshi wezempilo oqinisekisiweyo ukuze ukwazi ukufumana inkqubo yokuxhasa kunye nokuphumeza isicwangciso sokulahleka kwexesha elide.
Yintoni esinokuyenza Ngolu Lwazi ngekamva?
Olu pho nonongo lusinika ulwazi oluninzi malunga nokulahleka kokunyameka kwesifo sikashukela, unyango kunye nolawulo. Ngokwalaba baphandi, ukulahleka kwemilinganiselo kufuneka kube yinto ephambili ekuphatheni unyango lwesifo sikashukela, ngokulandela injongo ephambili yokukhusela izifo kwinqanaba labantu. Inkolelo kukuba, endaweni yokugxila kwisifo sikashukela ukulawula eso sifo, indlela engeyiyo ye-pharmocological ebonisa ukulahleka kwesisindo kufuneka iphinde igxininiswe. Kwaye nangona ukulahlekelwa kwesisindo akuzange kubangele ukukhishwa kweeshukela zegazi, ukuguquka kwezinto zokuphila ezifana nokutya okunempilo, okunokulinganisela kokutya kunye nemigqaliselo yokuzivocavoca kuyaqhubeka kubaluleke kakhulu ekumiseleni iishukela zegazi.
ILizwi
Abantu abanesifo sikashukela kufuneka bakhuthazwe yilo phofu. Nangona kunjalo, kubalulekile ukuba uqaphele izinto ezimbalwa apha: Ukulahleka kwesisindo akulula kwaye akukho bunzima bokulondoloza. UDkt. Minsky uthi, "Ukuqhubeka kwezi ziphumo kwiminyaka emine elandelayo yokulandelelwaniswa okucwangcisiweyo kuya kuba luncedo, ngokukodwa ukunikezelwa kwesisindo emva kokutya okuqhelekileyo." Inkxaso ibalulekile kwaye ilandelelwano oluqhubekayo linye yezitshixo zokulahlekelwa ubunzima nokuzigcina. U-Minsky uyavuma, wongezelela ukuba "izigulane ezikhuthazwa yilo phofu ukuze zilahlekelwe isisindo ukuze ziguqulwe isifo sikashukela zinconywa ukuba zenze njalo ngenkxaso yobuchule ukuqinisekisa ukutya okufanelekileyo kunye nokuncediswa ukulungiswa kwamachiza."
> Imithombo:
> Lean M, et al. Ukunyamekelwa kweprayimari kwathintela ukulawulwa kwemilinganiselo yokuxolelwa kwe-2 yesifo sikashukela (i-DiRECT): iilebula evulekileyo, ilingo le-cluster-randomized trial. "I- Lancet 2017: I-DOI: 10.1016 / S0140-6736 (17) 33102-1.
> I-American Diabetes Association. ImiGangatho yoLondolozo lwezoNyango kwiSwekile-2017. 2017 Jan; 38 (iSiza 1): S1-132.
> J Am Diet Assoc. Isikhundla se-American Dietetic Association: Ulawulo loLawulo. 2009: 109: 330-346.
> Verdi, Cassandra. Ukwenza ukutya; I-calorie ephantsi okanye izitya zingabakho inxalenye yesicwangciso sokulahlekelwa kwesisindo esiphephile. Isifo seswekile . Oktobha 2014; 62-63.