Ukwehla kwesisindo esisindayo kuyisihluthulelo sokukhishwa kwesifo sikashukela
Izinzuzo zokulahlekelwa isisindo ekwelapheni isifo sikashukela bekulokhu zihamba phambili ekunakekeleni isifo sikashukela, ikakhulukazi kulabo bantu abane-type 2 yesifo sikashukela abangaphezu komzimba noma abakhuluphele kakhulu. Isisindo esiningi singakhuphula ukuvuvukala futhi senze kube nzima ukulawula ishukela egazini ngokudala ukungena kwe- insulin.
I-American Diabetes Association ithi, "Kukhona ubufakazi obuqinile futhi obungaguquguquki bokuthi ukuzithokozisa okunamandla okuqhubekayo kungalimaza ukuqhubekela phambili kwe-prediabetes ukuthayipha isifo sikashukela sesibili futhi kuzuzisa ukuphathwa kohlobo lwesifo sikashukela sohlobo lwesibili." Kodwa, kuthiwani uma ukulahlekelwa isisindo kungasiza ngempela ukuguqula uhlobo lwesifo sikashukela sonke?
Abacwaningi be-Diabetes Remission Clinical Trial (i-DiRECT) bathole ukuthi ngemva kwezinyanga ezingu-12 zokungenelela, amaphesenti angu-46 abahlanganyeli bakwazi ukufezekisa ukukhishwa kwesifo sikashukela ngohlobo lwe-2 ngokulahlekelwa isisindo uma kuqhathaniswa namaphesenti amane kuphela ekulawuleni. Baphinde bathola ukuthi isisindo esilahlekile sakhuphuka ukukhululwa (okuchazwe njengokufeza i-A1c engaphansi kwamaphesenti angama-6.5 ngaphandle kwemithi yesifo sikashukela) sohlobo lwesifo sikashukela 2.
UDkt. Noga Minsky uthi uMqondisi wezokwelapha we-Diabetes Alliance ne-Telediabetes eholele eNtabeni iSinayi iSibhedlela iSinayi neStrologist, uDkt. Noga Minsky uthi, "Iphuzu lokuthutha, elinikezela abantu abaningi lapha, lithemba ukuthi isifo sikashukela sinokuguqulwa kwesisindo. Ucwaningo oluqhathaniswa nokuhlinzekwa kwe-bariatric ekushintsheni kwendlela yokuphila noma ukuphathwa kwezokwelapha, lapho ukwelashwa okungelashwa okungazange kuholele ekwenzeni ukukhishwa kwesifo sikashukela kunoma iziphi iziguli eziphathwe ngaphandle kokuhlinzwa emva kweminyaka emibili kuya kwemithathu. " Ukwengeza, uMinsky uthi, "Kwakuthembisa ukuthi isifo sikashukela sabuyiselwa ngempumelelo ngisho nasezigulini ezinesifo sikashukela iminyaka eyisithupha, kodwa kubalulekile ukuthi uqaphele ukuthi iziguli ezaphathwa nge-insulin zazingekho ngaphansi kwesifundo."
Lolu cwaningo luhlinzeka abantu abaningi abanesifo sikashukela bethemba lokho, ngisho noma besesifo sikashukela isikhathi esithile, ukulahlekelwa isisindo kungabasiza ukuba bafinyelele ukulawulwa ushukela wegazi futhi baphume imithi.
Ngakho-ke, Abahlanganyeli Benza Kanjani Isisindo?
Uma ukulahlekelwa isisindo kwakulula, khona-ke imboni yokulahlekelwa kwesisindo ayengeke ithathe izigidigidi zamaRandi ngonyaka.
Ukulahlekelwa kwesisindo nokulondeka kwesisindo kungaba nzima. Isinyathelo esibalulekile ekuphumeleleni ukuthola uhlelo ongabambelela kulo. Kubuye kube usizo kakhulu ukuba nabachwepheshe bezempilo baguqule ukudla kwakho futhi bagcine iso lakho lokudla. Ukuba ne-supervision akusizi nje kuphela ukunamathela kuhlelo, kodwa kuyasiza ekuqedeni ezinye izinqumo zokuqala zokudla.
Kulolu cwaningo oluthile, abahlanganyeli balandela ukudla okuphelele (825-853 kcal / day yokudla formula) izinyanga ezintathu kuya kwezinhlanu), bathatha ukudla kabusha kabusha (amasonto amabili kuya kwangu-8), futhi ukwesekwa okwakhiwe isikhathi eside ukulahlekelwa isondlo yesondlo. Izinyanga ezintathu zokuqala zazinokudla okuphansi kakhulu kwekhalori, okungaba nzima ukunamathela ngaphandle kokuzwa ulambile futhi kunqatshiwe. Ngaphambi kokwenza izinguquko ezinkulu kangaka ekudleni kwe-caloric, kungcono ukuhlangana nochwepheshe wezezempilo ukuze ukwazi ukuthola ukuthi yiluphi uhlelo lokudla oluzokhiqiza ngokwanele ukonakala kwekhalori ukukusiza ukuthi ulahlekelwe isisindo futhi ugcine ugcwele futhi unelisekile. Ukwamukela imfundo eqhubekayo kuzokusiza ukuba ufunde ukuthi ungadla kanjani wena, ngakho-ke awusitholi isisindo.
Ungakanani Isisindo Okumele Silahlekelwe Isifo Sikashukela?
Njengezici eziningi zesifo sikashukela, izinqubo zokulahlekelwa kwesisindo kuzodingeka zibe ngabanye.
Kulolu cwaningo oluthile, abahlanganyeli abalahlekelwa isisindo esikhulu banesilinganiso esiphakeme sokukhululwa kwesifo sikashukela. Ukulahlekelwa kwesisindo kuhluke phakathi kwababambiqhaza, kusuka ku-11-33 amakhilogremu (5-15 kg) nokulinganisa cishe amakhilogremu angu-10. Akucaci ukuthi yimaphi amaphesenti wesisindo somzimba wabo okulingana nalo.
I-American Diabetes Association iphakamisa ukuthi ukulahlekelwa kwesisindo somzimba sokuqala kwamaphesenti angu-5 kuye kwaboniswa ukuthuthukisa ukulawulwa kwe-glycemic nokunciphisa isidingo semithi ye-glucose-ukwehlisa imithi. Ukwengeza, ukulahleka kwesisindo samaphesenti angu-5 kuyadingeka ukuze kuthuthukiswe ukulawulwa kwe-glycemic, lipids, negazi, futhi ukulahlekelwa kwesisindo esiphezulu kwamaphesenti angu-7 kulungile.
Ngomuntu onesisindo esingamakhilogremu angu-200, ukulahleka kwesisindo samaphesenti angu-5 kungaletha amakhilogremu angu-10 futhi ukulahlekelwa kwesisindo samaphesenti angu-7 ngu-14 amapremu. Yiqiniso, inani lokulahlekelwa kwesisindo esidingekayo ukunciphisa i-A1c libe ngaphansi kwamaphesenti angama-6.5 kuzohlukahluka komuntu nomuntu, kepha ukuphungula kwesisindo samaphesenti angu-5 ukuya ku-7 kuyisiqalo esihle.
Ukulahlekelwa Isisindo Akukona Okuhle Ukulawula I-Blood Sugar Control
Siye sabona ukuhlangana phakathi kokucindezeleka, ukukhuluphala, nesifo sikashukela. Ukulahlekelwa isisindo nokuthuthukisa ukulawulwa kwe-glycemic kuye kwahlotshaniswa namandla ethuthukile, ukulala okungcono, nempilo engcono kakhulu. Lolu cwaningo lubonisa ukuthi ukulahlekelwa kwesisindo nakho kuthuthukisa ikhwalithi yokuphila. Ikhwalithi yokuphila (iQoL) yahlolwa ngokusetshenziswa kwe-EuroQol 5 Dimension scale analogue. Abahlanganyeli be-Intervention bazuze ukuthuthukiswa okulinganiselwe kwamaphuzu angu-7.2 emkhakheni weQoL uma kuqhathaniswa nokudonsa kwamaphesenti angama-2.9 okulawulwa (umehluko oshintshiwe 6.4 amaphuzu, amaphesenti angu-95 CI 2.5-10.3, P = 0.0012).
Ngingaqala kanjani ukuqala ukulahlekelwa kwesisindo sami?
Ukuze uqale, uzofuna ukuhlangana nomuntu onguchwepheshe, njengomfundisi wesifo sikashukela noma oqinisekisiwe ozoqinisekisa ukuklama uhlelo lokudla oluzimele oluhambisana nendlela yakho yokuphila futhi linikeza ukudla okuthandayo.
Uma ungathanda ukungena uqale ngokushesha, mhlawumbe indawo enhle ukuqala ukushintshanisa ukudla kwakho kokubili kuya kokudla esikhundleni . I-American Academy of Nutrition and Dietetics ithi, "ukuguqulwa kokudla okuqukethe amandla awaziwayo kanye nokwenyuka kwamanzi kuyisisetshenziswa esiwusizo sokuqeda ukukhethwa kwezinkinga ezibucayi kanye / noma ukuhlelwa kokudla okuyinkimbinkimbi ngenkathi uzama ukufezekisa ukulahlekelwa amandla kwamandla angu-500 kuya ku-1,000." Lokhu kusiza ukulawula amakholori bese kwenezela lula, okuyisihluthulelo sempumelelo yesikhathi eside. Ucwaningo luye lwabonisa nokuthi labo bantu abanesifo sikashukela sohlobo lwesibili abalahlekelwa cishe ngamaphesenti ayisikhombisa esisindo somzimba wabo ngonyaka owodwa, babika njalo ukunciphisa imithi umabenzisa ukushintshwa kokudla. Kubalulekile ukuthi uqaphele ukuthi kulezi zifundo, abantu babesazivocavoca, begcina idayari yokudla kanye nokufunda ngomsoco.
Ungazama futhi uhlelo lokulethwa kokudla ukuze usize lula izinto kuwe. Namuhla, kunezinketho eziningi kakhulu. Muva nje i-American Diabetes Association ihlangene noChef'd ukuhlinzeka ngamakethi okuthola kalula okulungiselelwa abantu abanesifo sikashukela abaphefumulelwe yizincwadi zokupheka zakwa-American Diabetes Association.
Ukwehla kwesisindo esimisiwe kuyisihluthulelo
Kwabanye, ukulahlekelwa isisindo yingxenye elula-kugcina isisindo esihlala sinselele kakhulu. Uma usulahlekelwe isisindo esikhulu, isisindo sakho sokuphumula sinciphile futhi udinga amakholori angaphansi ukugcina isisindo sakho. Ngalesi sikhathi, ukusekela kubalulekile. Uzodinga kokubili ukusekelwa ngaphakathi kwekhaya lakho, kanye nokwesekwa kochwepheshe-udokotela wakho oyinhloko wokunakekelwa, uthisha oqinisekisiwe wesifo sikashukela, umqeqeshi obhalisiwe, noma umqeqeshi wezempilo. Ukuphakama kwesisindo kuzokwenza kube nesidingo sokubuyela emuva emithini yesifo sikashukela futhi ngezikhathi ezithile abantu abaye balahlekelwa isisindo futhi babuyisela futhi, bayothola okungaphezu kwalokho ngaphambili. Lokhu kwenza uma kunzima ukulahlekelwa isisindo futhi-futhi kudangalisa kakhulu.
Emizamweni yokuvimbela lokhu ukuthi kungenzeki, kubalulekile ukukhetha uhlelo lokudla kanye nesu lokudla okusebenzayo nokusimeme. Ukunyakaza okuqhubekayo kuyoba okubalulekile ekudaleni ukwehluleka kwekhalori nokwakhiwa kwezicubu zomzimba ezinomzimba ukwandisa umzimba. Okungcono, uzofuna ukwenza inhlanganisela yokuzivocavoca kwenhliziyo nesisindo. Ukuzivocavoca umzimba kuzokusiza ukwandisa ukuphumula komzimba wakho (inani lamakholori oshisa nje ukuphila), okubaluleke nakakhulu njengoba sisebudala lapho i-metabolism iyancipha.
Ngaphezu kwalokho, kuzodingeka uhlale uziphendulela. Abahlanganyeli kulolu cwaningo banikezwe ukwesekwa okuhlelekile ukulungiswa kwesisindo eside. Ukwesekwa okwakhiwe kungenziwa kodwa isebenza kahle kakhulu ngendlela yakho yokuphila. Kungakhathaliseki ukuthi unezingxoxo ngeqembu lakho lokunakekelwa kwezempilo ngomuntu noma usebenzisa uhlobo oluthile lwesicelo -izinketho namuhla azipheli. I-Telemedicine yenza ukwelashwa kwezifo kalula-ubuchwepheshe buhlinzeka abahlinzeki bakho bezempilo ukuthi bakwazi ukufinyelela-futhi bakusize noma ngabe ukuphi. Kubalulekile ukusebenzisa ngokunenzuzo imithombo yakho. Buza udokotela wakho wokunakekelwa okuyinhloko uma usebenzisa noma yibuphi ubuchwepheshe ukuphatha iziguli zabo noma uma besebenza nomlobi orejistiwe obhalisiwe, uthisha wesifo sikashukela, noma umqeqeshi wempilo eqinisekisiwe ukuze ukwazi ukuthola uhlelo lokusekela futhi usebenzise isu lokulahlekelwa isisindo eside.
Yini Engayenza Ngalo Lwazi Ngekusasa?
Lolu cwaningo lusinikeza ulwazi oluthe xaxa mayelana nokuthi ukulahlekelwa kwesisindo kubaluleke kangakanani ekuvimbeleni isifo sikashukela, ukwelashwa kanye nokuphathwa. Ngokusho kwalaba cwaningi, ukulahlekelwa isisindo kufanele kube yiyona nto ebaluleke kakhulu ekunakekeleni uhlobo lwesifo sikashukela ngohlobo lwesibili, okulandela umgomo oyinhloko wokuvimbela izifo ezingeni labantu. Inkolelo yukuthi, esikhundleni sokugxila kwimithi yesifo sikashukela ukuphatha lesi sifo, indlela engeyona ye-pharmacy eveza ukulahlekelwa kwesisindo kufanele igcizelelwe kabusha. Futhi noma ngabe ukulahlekelwa kwesisindo akuzange kubangele ukusimama kwe-ushukela wegazi, indlela yokuphila eguquka njengokudla okunomsoco, okunomsoco nokuzivocavoca umzimba kuhlale ibucayi ekusimeni okushukela kwegazi.
Izwi elivela
Abantu abanesifo sikashukela kufanele bakhuthazwe yilolu cwaningo. Kodwa-ke, kubalulekile ukuqaphela izinto ezimbalwa lapha: Ukulahlekelwa kwesisindo akulula futhi akulona isondlo sokulondeka. UDkt. Minsky uthi, "Ukuqhubeka kwemiphumela kule minyaka emine yokulandelwa okuhleliwe kuyoba yindalo, ikakhulukazi uma kunikezwa ukuthi isisindo sokubuyela emuva ngemva kokudliwayo sivame kakhulu." Ukusekela kubalulekile futhi kulandelelwe njalo kukhona ezinye izihluthulelo zokulahlekelwa isisindo nokuzigcina. U-Minsky uyavuma, wanezela ukuthi "iziguli ezikhuthazwa yilolu cwaningo ukuze zilahlekelwe isisindo ukuze ziguqulwe isifo sikashukela ziyanconywa ukuba zenze kanjalo ngokusekelwa kochwepheshe ukuqinisekisa ukudla okunempilo kanye nokusizwa ngokulungiswa kwemithi."
> Imithombo:
> Lean M, et al. Ukuphathwa kokunakekelwa kokunakekelwa okuyisisekelo ukukhishwa kwesifo sikashukela sohlobo lwe-2 (DiRECT): ilebuli evulekile, isilingo esenziwe ngokungahleliwe. "I- Lancet 2017: DOI: 10.1016 / S0140-6736 (17) 33102-1.
> I-American Diabetes Association. Amazinga Wokunakekelwa Kwezokwelapha Esifo Sikashukela - 2017. Ukunakekelwa Kweshukela . 2017 Jan; 38 (I-Suppl 1): S1-132.
> J Am Diet Assoc. Isikhundla se-American Dietetic Association: Weight Management. 2009; 109: 330-346.
> Verdi, uCassandra. Ukwenza ukudla; i-calorie ephansi-shakes noma imigoqo ingaba yingxenye yecebo elihle lokulahlekelwa kwesisindo. Isifo sikashukela sokubikezelwa . Okthoba 2014; 62-63.