Ukulawula uxinzelelo lwegazi kubalulekile kwi-Diabetics
Ukulawula uxinzelelo lwegazi kuyinjongo ebalulekileyo kwizigulana zesifo sikashukela. Ingozi yexinzelelo yegazi kwi-diabetics inzima kangangokuthi ezinye iingcaphephe zicebise ukuba uxinzelelo olulawulwa kakuhle kwizigulane zesifo sikashukela lenza impembelelo enamandla ngakumbi kwixesha elide lempilo (umgangatho wobomi, ubuninzi beengxaki, ukupheliswa kwexesha elide) kunokuba igazi elinamandla ulawulo lweshukela.
Ngoxa loo nto ayithethi ukuba ufanele uyigatya iinjongo zakho zentshukela yegazi, iqinisa ingcamango yokuba ukulawula uxinzelelo lwegazi kuyinjongo ebalulekileyo.
Iinjongo Zonyango
Kwimeko yesifo sikashukela, umxhesho wegazi uphantsi kwe-130/80. Umxholo weengcinezelo zegazi ekujoliswe kuzo iqhutywe kakuhle, kwaye uphando olukhulu lwezifundo luye lwabonisa rhoqo ukuba uphuculo olubalulekileyo kwixesha elide lempilo ye-cardiovascular and kidney alibonakali kwaze kwaba yilapho ixinzelelo lwegazi linciphisa kule nqanaba. Ngenxa yalesi sizathu, oogqirha bavame ukuba nobudlova xa beceba izicwangciso zonyango kwizigulana zesifo sikashukela.
Ezinye izifundo zicebise ukuba amanye amaqela ezigulane zesifo sikashukela - njengabo abaneengxaki zeengxaki ezibangelwa yintsholongwane-bancedwa kakhulu kwiinkxwaleko zegazi ngaphantsi kwama-120/80. Idatha ibonise ukuba umngcipheko weengxaki ze-cardiovascular and further damage to the kidney isingqinisiso kwizinto ezilinganisekayo eziphantsi kweli lihlu.
Ngenxa yokuba kunzima ukunciphisa uxinzelelo lwegazi kule nqanaba, isincomo sidla ngokugcinwa kuphela kwizigulane ezithile.
Unyango Lonyango
Izikhokelo ezisemthethweni zombini we-American Heart Association kunye ne-American Diabetes Association zichaza ukuba iingcinezelo zegazi kwi-130-139 / 80-89 kufuneka zenziwe kuqala nge "non-pharmacologic" (akukho nonyango).
Ezi zikhethi ziquka:
- Ukuhla ukusinda
- Ukunciphisa ityuwa
- Utshintsho lwezondlo
- Ukuyeka ukutshaya
- Ukunciphisa utywala
Kwizigulane ezingenayo i-diabetes, ukuthobela ngokungqongqo kule mithetho kaninzi kukhokelela ekuhlahleni kwamanzi exinzelelo lwegazi, ngokwaneleyo ukwenzela ukuba unyango lweyeza lungafaneleki. Ngexesha elifanayo lingafumaneka kwizigulana zesifo sikashukela, ayinto eqhelekileyo, kwaye unyango lweziyobisi ludingeka. Olu tshintsho luyafaneleka, nangona kunjalo, ngenxa yokwandisa ukusebenza kwonyango lonyango kwaye ekugqibeleni lukhokelela ekulawuleni uxinzelelo lwegazi.
Unyango lweziyobisi
Ukusetyenziswa kweziyobisi kuyimfuneko ebalulekileyo kwiigulane ezininzi ngexesha elithile ngonyango. Amanani amaninzi ophando ayenziwe ngenzame yokufumanisa ukuba iziphi iziyobisi okanye inxube yeziyobisi "yinto ephambili" yokuphathwa kwengcinezelo yegazi kwizigulane ezineesifo sikashukela. Nangona iziphumo zokufunda zihluka kancinci, kukho ukuvumelana ngokusondeleyo-jikelele ukuba izidakamizwa ezisetyenziselwa ukusebenzisa kwisifo seswekile zi:
Ezi zonyango zijongana ngqo neengxakini ezinxulumene nexinzelelo legazi eliphezulu kwiimeko zesifo sikashukela kuquka ukunyuka kwevolumu , ukuqina kwesitya segazi kunye nokulimala kwezintso. Nangona abanye oogqirha beqala ukunyango ngokuzama i-diuretic ngokwabo, kuyaqheleke ukuba kuqale nge-ACE Inhibitor.
Ekugqibeleni, inhlanganisela ye-ACE Inhibitor / ARB ngokuqhelekileyo yonyango olukhethiweyo, kunye ne-diuretic eyongeziweyo xa ifunekayo. Nangona olu luhlobo oluqhelekileyo lwonyango lweziyobisi, ezinye iziyobisi zingabandakanywa kuxhomekeke kwiziganeko ezithile zesigulane.
Ukuba ugqirha wakho ukhetha ukuqala unyango nge-diuretic, qaphela ukuba oku akukhethi okubi, kwaye kukho ubungqina bokuxhasa le sigqibo kwiintlobo ezithile zezigulane. Kuya kucaciswa ngokukhawuleza ukuba ngaba unyango lusebenza okanye cha, kwaye utshintsho luya kwenziwa xa luyimfuneko.
Inkathalo yokuLandela
Naliphi na unyango oluthile olulawulwayo, unonophelo olulandelayo lokunyamekela luyimfuneko ekulawuleni impumelelo yexesha elide lonyango lwakho.
Ekuqaleni, uya kubona ugqirha wakho nyanga zonke, okanye mhlawumbi ngeveki nganye, kude kube nesicwangciso esisebenzayo. Emva koko, oogqirha abaninzi baya kukucela ukuba ubuyele emva kweenyanga ezintathu zonyaka wokuqala. Oku kulandelelwano olufutshane kusetshenziselwa ukulandelela utshintsho kwixinzelelo lwegazi kwaye kusekwe isiseko semimiselo ethile yemvelo njengamazinga e-electrolyte (i-potassium kunye ne-sodium egazini) kunye nemisebenzi yengqondo.
Emva konyaka wokuqala, ugqirha wakho unokukhetha ukutshintshela kwiinyanga ezi-6, okanye unokufuna ukuba uqhubeke neshedyuli yeenyanga ezintathu. Ukuba ucelwa ukuba uqhubeke neshedyuli yeenyanga ezintathu, oku akusiyo imbangela ye-alarm, oko kuthetha ukuba kufuneka ixesha elide ukuqinisekisa ukuba yonke into iyacwangciswa. Inombolo ekhulayo yoogqirha icela zonke izigulane zesifo sikashukela ezinegazi eliphezulu ukuba zize emva kweenyanga ezintathu. Ukugcina ezi zikhundla kubalulekile. Unyango luyasebenza kakhulu xa udibene neshedyuli yokunakekelwa okufanelekileyo.
Imithombo:
Iziphumo eziphambili kwizigulane ezixinzeleleke kakhulu kwiingozi kwizifo ezixinzelelekileyo ezingasengozini yokuguqula i-enzyme inhibitor okanye i-calcium channel blocker vs diuretic: Ukwelashwa kwe-Antihypertensive and Lipid-Lowering to Prevent Trial Attack Trial (ALLHAT). JAMA 2002; 288: 2981.
Buse, JB, Ginsberg, HN, Bakris, GL, et al. Uthintelo oluphambili lwezifo zengqondo kwiabantu abanesifo sikashukela: inkcazelo yesayensi evela kwi-American Heart Association kunye ne-American Diabetes Association. Ukuhamba ngo-2007; 115: 114.
Gaede, P, Vedel, P, Ukusuka, HH, Pedersen, O. Ukungenelela kwamanyathelo amaninzi kwizigulane ezine-type 2 zesifo sikashukela kunye ne-microalbuminuria: Uhlobo lweSteno 2 oluqhutywe ngolu hlobo. Lancet 1999; 353: 617.
Zillich, AJ, Garg, J, Basu, S, et al. I-thiazide diuretics, i-potassium, kunye nophuhliso lwesifo sikashukela: ukuhlaziywa kwamanani. Uxinzelelo lwe-2006; 48: 219.
UDaly, CA, Fox, KM, Remme, WJ, et al. Impembelelo ye-perindopril kwi-cardiovascular disability and deathality kwizigulane ezineesifo sikashukela kwi-EUROPA yophando: iziphumo ezivela kwi-PERSUADE substudy. I-Eur Heart J 2005; 26: 1369.
Brenner, BM, Cooper, ME, de Zeeuw, D, et al. Iimpembelelo ze-losartan kwiimpembelelo kunye nemiphumo ye-cardiovascular kwizigulane ezine-type 2 zeswekile kunye nephropathy. N Engl J Med 2001; 345: 861.
Umbutho weSwekile waseMelika. Ulawulo lwe-Hypertension Management kubantu abadala abanesifo sikashukela. Usukelo lweSwekile ka-2004; 27 (iSiza 1): S65.