Ukubaluleka kokucindezeleka kwesifo sikashukela

Isifo sikashukela yisifo esingapheli, esiqhubekayo okumelwe siphathwe nsuku zonke. Imithi engcono, izinsizakalo ezengeziwe, imfundo ekhuphukile, namathuluzi angcono kakhulu asize abantu abanesifo sikashukela ukuba baphile isikhathi eside. Noma kunjalo, ukuphila okude isikhathi eside kungashiya isikhathi esengeziwe ukuthuthukisa izinkinga. Lokhu akusho ukuthi bonke abantu abanesifo sikashukela bahloselwe ukuba nezinkinga.

Kunalokho, abantu kumele baqhubeke nokunakekela isifo sikashukela ukuvimbela izinkinga emgwaqweni.

Indlela engcono kakhulu yokuvimbela izinkinga zesifo sikashukela ukuzama ukugcina ushukela wegazi lakho, ukucindezelwa kwegazi, nesisindo ngaphakathi kwezinga elihle. Amasu ashukela egazini angapheli angalimaza izitho eziningi zomzimba. Ukuphakama kwengcindezi yegazi nokukhuluphala kugcizelela inhliziyo bese kwenza isifo sikashukela sikwazi ukulawula.

Futhi, ukuqinisekisa ukuthi ugcina ama-aphoyintimenti nodokotela bakho-udokotela oyinhloko, udokotela we-eye, isazi se-podiatrist, i-cardiologist-nokuqaphela noma yiziphi izimpawu ezintsha kungakusiza ukuthi ubone futhi uphathe izinkinga ngokushesha. Ngaphezu kwalokho, ukugcina ushukela wakho wegazi ulawulwa futhi usebenzise izinguquko zokuphila kungavimbela noma kuphuze ukucindezeleka kwesifo sikashukela.

Ukuqonda lezi zinhlobo zezinkinga kuzothuthukisa ukuqwashisa futhi kukugqugquzele ukuthi uzizinakekele kahle.

Iyiphi Inhlobo Yezinkinga Ezikhona?

Ukucindezeleka kwesifo sikashukela kubonakala njengezinambuzane ezinkulu (izinkinga ezinkulu zemikhumbi) noma i-microvascular (izinkinga ezincane zamanzi).

Izinkinga ze-macrovascular zihlanganisa izifo zenhliziyo ezifana nokuhlaselwa kwenhliziyo, ukushaywa, nokungakwazi ukugeleza kwegazi kuya emilenzeni (isifo segazi sangasese ). Lezi zinhlobo zezinkinga zikhiqizwa yi-atherosclerosis (ukuqina kobuchopho). I-blood lipids engavamile, ukudla okunomsoco, ukugqithisa ngokweqile noma okugqamile, ukungabi nokuzivocavoca, nokucindezela kwegazi okungaba nzima ukucindezela lezi zimpawu.

Ngaphezu kokulawula ushukela egazini lakho, kufanele futhi ulungise zonke lezi zici zokufaka ingozi ukuze ukwazi ukuvimbela ukushaya nokushaya kwenhliziyo.

Izinkinga ezincane ezincane zihlanganisa ukulimala kwamehlo (retinopathy), ukulimala ezinso (nephropathy), kanye nokulimaza izinzwa (neuropathy). Lezi zinhlobo zezinkinga zinganciphisa noma zivinjelwe ngokugcina ushukela wegazi olawulwayo. Xoxa ngemigomo yakho yokushukela ngegciwane nodokotela wakho futhi uhlose ukufinyelela lezo zinhloso nsuku zonke.

Yini Okufanele Ngiyazi Ngezimpikiswano?

Isifo sezinso (i-nephropathy): Isifo sikashukela sinesisindo esikhulu sezinso zezinso. Eqinisweni, oyedwa kubantu abathathu abanesifo sikashukela uhlakulela isifo sezinso, futhi isifo sikashukela yisona esivame kakhulu ukuhluleka kwezinso. Isifo sikashukela singabangela umonakalo emkhakheni ovikela izinso kanye nengqimba engaphansi lapho inqubo yokuhlunga kwenzeka khona. Izinso zakhiwe ngemithwalo yegazi ezithintekayo ukuhlunga igazi. Lapho imithwalo yegazi ibonakalisiwe, amakhemikhali angakha egazini. Udokotela wakho kufanele ahlole umsebenzi wakho wezinso njalo lapho uthola umsebenzi wegazi. Ngaphezu kwalokho, ukuguqulwa komzimba kwenziwa ukuhlola isifo sezinso emcinini wakho.

Ukuvimbela umonakalo wezinso angakubeka emuthi wegazi, obizwa ngokuthi i-ACE inhibitor.

Kubalulekile ukuzama ukugcina ingcindezi yakho yegazi ilawulwa. Ukuphakama kwengcindezi yegazi kungafaka ukucindezeleka enhliziyweni yakho nasezinso zakho, izinto ezilukhuni ngisho nokuqhubeka. Uma ngabe umisiwe umuthi, qiniseka ukuthi uyayithatha. Uma ubhema, zama ukuyeka. Futhi uma ungumuntu osawoti, kungcono ukuzama ukugwema ukudla okuphezulu kwe-sodium, njengempahla ekheniwe, inyama enomsoco, ukudla okudlayo, nokudla okubandayo. Lezi zinhlobo zokudla ziphezulu kwi-sodium, ezingabangela ukucindezeleka kwegazi ukuphakama ngokufaka izingcindezi ezitheni zakho.

Kunezigaba ezinhlanu zesifo sezinso. Isigaba sokuqala kubhekwa njengesigaba esibucayi nesigaba sokugcina isifo sesifo sezinso sokugcina, lapho ukwelashwa kuqukethe i-dialysis noma ukufakelwa kwezinso.

Esikhathini esiningi, abantu abazizwa izimpawu zesifo sezinso baze baqhubekela phambili kuze kube sekugcineni. Ngakho-ke, kubalulekile ukuba nobuhlobo obuhle nodokotela wakho. Yiba nesiguli esisebenzayo futhi ubuze imibuzo, ukuze wazi ukuthi umsebenzi wakho wezinso uphi nokuthi kuphi.

Izindaba ezinhle ukuthi ukugcina ushukela wegazi lakho, ukucindezeleka kwegazi nokulawulwa kwesisindo kungasiza ekuvimbeleni isifo sezinso. Ngaphezu kwalokho, ukuthola izinso zakho zihlolwe njalo kuyindlela ebalulekile yokugcina ithrekhi yempilo yezinso zakho.

Umonakalo wamagciwane (neuropathy): I- neuropathy ivame kakhulu ezinyaweni nasezandleni, kodwa ingabangela nokulimala kwezinzwa kwezinye izindawo zomzimba. I-autonomic neuropathy iqala isithombeni, indlela yokugaya, kanye nezitho zokuzala . I-peripheral neuropathy ithinta izandla, izinyawo, nemilenze. Ubuhlungu bezinzwa bungalimala. Kungabangela nezimpawu ezingavamile. Isibonelo, ukulimala kwamantombazane esiswini kungabangela ukukhula okuphezulu nokushukela kwegazi. I-peripheral neuropathy ivame ukuchazwa njengokuzwa okuvuthayo noma ukuphazamiseka nokugubha. Abantu abanobuhlungu besisindo emikhawulweni yabo bangase babe nobunzima bokubona ukulimala kwenyawo, njengokungena emgqeni, noma mhlawumbe ukuxubha ngamatshe ngokumelene nezwane zakho. Ukulimala kanzima okungalahleki kungaholela ezifweni ezinzima. Njengoba ihambisana neshukela ephakeme yegazi, ukulimala kanzima kunganciphisa ukuphulukisa futhi kungaholela ekunqumeni.

Kungenzeka ukuthi uhlakulele izinzwa ze-neuropathy uma unesifo sikashukela isikhathi eside, ikakhulukazi uma ushukela wegazi wakho uphakeme kakhulu. Into engcono kakhulu ongayenza ukuvimbela i-neuropathy ukugcina ushukela wakho wegazi kahle. Uma usola ukuthi kukhona okungalungile, kufanele uxhumane nodokotela wakho.

Uma uthola ukuthi une-neuropathy yokuzimela, kungase kudingeke ulandele imithi ethile, njengokulandela ukudla okukhethekile, ukufuna ukululekwa kwengqondo, noma ukuthatha imithi ethile.

Uma uthola ukuthi une-neuropathy ye-peripheral noma umsolwa ukuthi ungaba nayo, kufanele ube nodokotela wakho aqhube ukuhlolwa kwezinyawo ngokugcwele ukucacisa umuzwa wakho wokuzwa nge-forge yokuhlela noma i-monofilament test. Uma usuwehlile ukuzwa, izinyawo ezingavamile, ezifana nezifo ezitholakalayo noma izipikili, ukukhubazeka, isikhumba esiqhekekile, amanxeba noma ukusikeka, cishe uzothunyelwa kudokotela wezinsizwa ukuze uqhubeke nokusebenza. Uma ungaboni isazi samaphoyisa, qiniseka ukuthi uthatha amasokisi akho nezicathulo lapho udokotela ngamunye evakashela. Uma usukhaya kubalulekile ukuhlola izinyawo zakho njalo futhi usebenzise ukuhlanzeka kwezinyawo. Qiniseka ukuthi:

Kubalulekile futhi ukuba ungahambi ngezinyawo, ungazitholi izicathulo zakho ngaphambi kokuba uzibeke, uphinde uzigqoke izicathulo ezifanele futhi zikhululekile.

I-retinopathy (umonakalo wamehlo): Ishukela ephakeme yegazi ingabangela ukulimala ezitheni ezincane ngemuva kweso, okungabangela ukuba baphuze noma baphuze amanzi. Abantu abanesifo sikashukela basengozini enkulu yokuthuthukisa izimo zamehlo, njenge-retinopathy, i-diabetes macular edema (i-DME), i-cataract ne- glaucoma . Uma kungaphathwa kahle, lezi zimo zamehlo zingaholela ekulahlekelweni kombono ngisho nasempumputhe. Abantu abanesifo sikashukela kufanele bahlolwe amehlo lapho bexilongwa ngesifo sikashukela. Ukulimala kweso kungaqala ngaphambi kokuba isifo sikashukela sitholwe. Ngakho-ke, ukuhamba kahle kubaluleke kakhulu ekuvimbeleni izinkinga. Uma unesifo sikashukela, kufanele uhlolwe amehlo akho okungenani kanye njalo eminyakeni emibili uma ungenayo ubufakazi bokuthi i-retinopathy kanye kanye ngonyaka uma unezinkinga zamehlo akhona. Ukulawula isifo sikashukela-ngokuthatha imithi njengoba kunqunyiwe, ukuhlala ngokomzimba nokugcina ukudla okunempilo-kungavimbela noma kuphuze ukulahlekelwa kombono. Ngaphezu kwalokho, ukutholakala kokuqala kanye nokunakekelwa okulandelekayo okulandelelanayo kungavimbela ukulahleka kombono.

Umfutho wegazi ophezulu nesifo senhliziyo: Abantu abanesifo sikashukela basengozini enkulu yokuthuthukisa umfutho wegazi ophezulu. Abantu abanesifo sikashukela banamathuba amaningi okuba nokuhlaselwa yinhliziyo nokushaywa kakhudlwana kunelabo abanesifo sikashukela. Kubalulekile ukucabanga ngesifo sikashukela, hhayi kuphela njengesifo sohukela lwegazi kodwa njengesifo senhliziyo. Ukwenza kanjalo kungasiza ukuvimbela noma ukubambezela ukuthuthukiswa kwesifo senhliziyo. Ngakho-ke, kubalulekile ukugcina ushukela wegazi, ukucindezeleka kwegazi, i-cholesterol, nesisindo phakathi kwezigaba ezinempilo. Ngaphezu kwalokho, uma ubhema, kufanele uzame ukuyeka. Ukuyeka ukubhema kunganciphisa ingozi yokushaywa isisu nokuncipha kokubili ushukela wegazi nomfutho wegazi.

Ngokuvamile, azikho izimpawu zomshoshaphansi wegazi ophakeme, yingakho ngokuvamile ubizwa ngokuthi "umbulali othulile." Abanye abantu bahambahamba ngokucindezela kwabo bephezulu noma bephezulu ngaphandle kokukwazi. Uma wenza izibonakaliso, ungase uhlakulele ikhanda noma uzizwe ukhanyisiwe. Ukugcina ingcindezi yegazi ejwayelekile, kufanele uqiniseke ukuthi ukucindezeleka kwegazi kuhlolwe ngaso sonke isikhathi ukuvakasha kukadokotela. Yazi izinamba zakho nokuthi yimuphi umfutho wegazi ovamile.

Ngokusho kwe-American Heart Association, ukucindezelwa kwegazi okuvamile kungaphansi kuka-120/80 mm / Hg. Inombolo ephakeme, i-systolic blood pressure, isilinganiso sokucindezelwa emithanjeni lapho inhliziyo ishaya (noma isebenza). Futhi inombolo engezansi, ukucindezelwa kwe-diastolic, ibeka ingcindezi phakathi kwe-beats lapho inhliziyo iphumula. Uma ngabe umisiwe umuthi wegazi, qiniseka ukuthi uyayithatha. Uma unikezwe umshini we-blood pressure ukuze uqaphele ukucindezelwa kwakho ekhaya, kufanele wenze kanjalo. Yazisa udokotela wakho uma ukucindezela kwakho kuphakeme kunalokho okufanele kube khona. Okokugcina, ukushintsha ukudla kwakho kungasiza ukwehlisa ukucindezeleka kwegazi. Ukudla okune-sodium kungakhuphula umfutho wegazi. Gwema ukwengeza usawoti ekudleni kwakho bese uzama ukugwema ukudla okucutshungulwa-ukudla okusemandleni, esikhwameni, noma ebhokisini. Abantu abaningi abanomfutho wegazi ophakeme bazuza ngokulandela ukudla kwe-DASH.

Uma unomlando womndeni wesifo senhliziyo, usengozini enkulu yokuthuthukisa, ikakhulu uma unesifo sikashukela. Kodwa ungazama ukunciphisa ubungozi ngokugcina ushukela wegazi kanye ne-lipids emgomweni (i-HDL ne-LDL cholesterol kanye ne-triglycerides), inkomba yakho yomzimba wakho emkhakheni onempilo, isikhawulo sakho somzimba ngaphakathi kwemingcele evamile, nokwandisa umsebenzi wakho womzimba.

Xoxa ngemigomo yakho ethize nodokotela wakho. Iningi labantu liyazuza kulezi zinombolo:

Ukuvimbela Lezi Zinkinga

Amazinga aphezulu e-glucose enza izinguquko emithanjeni yegazi ngokwabo, kanye nasezindlini zegazi ezonakalisa ukugeleza kwegazi ezigabeni ezihlukahlukene. Ukwenza ushintsho lokuphila okunomthelela kungasiza ekunciphiseni ushukela wegazi nokuvimbela izinkinga zesifo sikashukela. Akukaze kube sekwephuzile kakhulu ukuthatha isenzo. Ngisho noma ngabe unesifo sikashukela isikhathi eside, usengenza izinguquko ukuze ube ngcono impilo yakho.

Gcina ushukela wakho wegazi kuhla lokukhomba: Qinisekisa ukuthi unokuqonda okucacile ukuthi yiziphi izinhloso zakho zomshukela wegazi. Ama-sugar suars aphezulu kakhulu (hyperglycemia) futhi aphansi kakhulu (i-hypoglycemia) ingaba yingozi. Ukugcina ushukela wakho wegazi emgomweni wakho oyifunayo kungakusiza ukuvimbela izitsha ezinkulu nezincane ukuthi zingonakali. Ungathukutheli uma uneshukela egazini egazini. Kodwa uthathe isinyathelo uma ubona iphethini lamasu ashukela ephezulu. Thintana nodokotela wakho uma wenza konke okufanayo kanye noshukela wegazi lakho phezulu-ungadinga ukulungiswa kwemithi. Ngenxa yokuthi isifo sikashukela yisifo esiqhubekayo, ngezinye izikhathi kudingeka senze izinguquko, ngisho nalapho senza konke okulungile.

Ukuncipha kwesisindo: Ukulahlekelwa kwesisindo kungenye yezindlela ezinamandla kakhulu zokunciphisa ushukela wegazi. Ngaphezu kwalokho, ukwehlisa umzimba kuthatha ukucindezeleka enhliziyweni futhi kunganciphisa ingozi yesifo senhliziyo. Ukusungula isisindo esinempilo kungasiza ukunciphisa ukuvimbela i-insulin futhi uvumele umzimba wakho ukuba usebenzise i-insulin. Lokhu kuthatha ukucindezeleka kwi-pancreas futhi kungalondoloza amangqamuzana e-beta (amaseli asetshenziselwa ukwenza i-insulin). Ukulahlekelwa ngamaphesenti angu-10 wesisindo somzimba wakho kungathuthukisa kakhulu impilo yakho yonke. Uma uzama ukunciphisa isisindo isikhathi eside futhi uqhubeke nomzabalazo wakho, ungase uzuze endaweni yokudla . Ukudla okungena esikhundleni se-calorie- nokulawulwa kwe-carbohydrate. Bangakwazi ukukusiza ukuqeda ukudla okukhethwa phakathi nosuku, okungenza kube lula ngawe ukunciphisa ukudla kwakho kwekhalori. Ukuphendula ngokukhetha kwakho kokudla kungakusiza nokuba unamathele ohlelweni lokudla oluphilile. Ukwandisa ukuphendula kwakho futhi uzuze umqeqeshi ngokumisa umhlangano nomfundisi obhalisiwe noma umfundisi wesifo sikashukela oqinisekisiwe.

Landela ukudla okunempilo: Okudlayo kuthinta kakhulu ukulawulwa kwesifo sikashukela. Ama-carbohydrate yizona izakhi eziphakamisa ushukela wegazi kakhulu. Ukudla okufana nesinkwa, irayisi, i-pasta, ubhontshisi, izithelo, ubisi kanye ne-yogurt konke kuqukethe ama-carbohydrate. Abantu abanesifo sikashukela bayazuza ngokudla ukudla okulawulwa kwe-carbohydrate. Abantu abaningi bathola ukuthi ushukela wabo wegazi ulawulwa kangcono uma bedla ukudla okuphansi kwe-carbohydrate . Uma ukudla kwakho kuphezulu kuma-carbohydrates, into enhle ongayenza ukuzama ukusika.

Ukuqeda iziphuzo ezinomsoco , ukunciphisa amaswidi bese unciphisa ama-carbohydrate wakho ekudleni kwakho okungaphezulu kuka-1 indebe. Uma usuwenzile lokho, zama ukukhetha imithombo engcono ye-carbohydrate: okusanhlamvu konke, izithelo zommbila kanye nemifino yesitashi kukhona ukukhetha okungcono kwe-carbohydrate. Ngaphezu kokunciphisa ama-carbohydrates, kungcono ukunciphisa ukudla kokucutshungulwa nokuthosiwe, njengama-nyama okuphulukisiwe, inyama yokudla, namafriji aseFrance, ukubiza ezimbalwa. Lezi zinhlobo zokudla zicebile ngekhalori, zigcwele, futhi zihamba ngamafutha, futhi zingandisa ukwanda kwe-cholesterol, okuyinto ebangela ukuba i-atherosclerosis. Okokugcina, ukwandisa i-fiber yakho yokudla. Ukudla okunezifucu ezicebile, okusanhlamvu konke , izithelo, imifino , amantongomane, kanye nembewu kungakusiza uzizwe ugcwele, uzinze ushukela wegazi kanye ne-cholesterol ephansi. Kuzuzisa ukudla cishe ama-25-38g we-fibre nsuku zonke.

Hambisa okuningi: Kungase kube lula ukusho kunokukwenza, kodwa ukuvivinya umzimba kusiza kakhulu ukwehlisa ushukela wegazi ngokusebenzisa i-insulin. Ngaphezu kwalokho, ukuvivinya umzimba kungasiza ekwakheni imisipha, ukwandisa amandla, futhi kuthuthukise ukulala nokuzizwa. Ekugcineni, kufanele uhlose ukushaya cishe imizuzu engama-150 ngesonto lokusebenza okulinganiselayo (ukusakazeka okungenani kwezinsuku ezintathu). Uma kungenzeka, kufanele uhlanganise nezinsuku ezimbili ngesonto lokuzivocavoca. Uma ungakaze usebenzise ngaphambili, qiniseka ukuthola imvume yezokwelapha ngaphambi kokuqala isimiso esisha.

Thola isifo sikashukela semfundo yokuzilawula: Wonke umuntu onesifo sikashukela kufanele athole imishanguzo yokuziphathisa isifo sikashukela lapho ehlolisiswa futhi kufanele aqhubeke nokuthola imfundo kuzo zonke izigaba zesifo sikashukela. Ngisho noma ngabe unesifo sikashukela isikhathi eside, ungazuza ngokuthola inkambo yokuvuselela. Isifo sikashukela sokuziphathisa imfundo sigxile ekuziphatheni okuziphathekayo, njengokudla okunempilo, ukusebenza komzimba, ukuqapha ushukela egazini, ukuxazulula izinkinga, ukunciphisa izingozi kanye nokubhekana nokuphila okunempilo. Ungakhetha ukwenza imihlangano eyodwa noma eyodwa noma imihlangano yeqembu . Buza udokotela wakho mayelana nokuqala.

Hlanganisa iqembu labodokotela: Indlela enhle yokunciphisa ingozi kanye nezinkinga ukudala ubuhlobo obuhle nodokotela wakho wokunakekela oyinhloko. Ngokujwayelekile, uzokudlulisela kwabanye odokotela: udokotela wezilanga, udokotela onyawo, isazi se-cardiologist, i-endocrinologist, njll Ukuthola ukuhlolwa okunempilo kungasiza ukuthatha isinyathelo sokuvimbela ukunciphisa izinkinga zesifo sikashukela. Ukuba nokuhlola okuyisisekelo kungakusiza ukuthi ubone izinguquko. Ukusheshisa okubonakalayo kushintsha ithuba elingcono onalo lokuphatha ngokushesha futhi ukuvimbela izinkinga ezengeziwe.

Thatha isifo sakho sikashukela ngokujulile: Ngokuvamile, abantu abanesifo sikashukela babika ukuthi abazizwa sengathi ama-sugar sukari abo aphezulu. Ngenxa yalokho, banquma ukungelapheki isifo sikashukela. Lokhu kuyingozi kakhulu. Isifo sikashukela esisele singaphathwa singabangela ushukela ophezulu wegazi, ongabangela izinkinga ezingenakuguqulwa. Kubalulekile ukuthatha isifo sikashukela ngokuyinhloko kusukela ekuqaleni . Ngezinye izikhathi ukuguquka kokuphila okunonya, ukulahlekelwa isisindo, ukudla, nokuzivocavoca kungasiza ekunciphiseni ushukela wegazi kakhulu kangangokuthi asisekho ebangeni lesifo sikashukela . Kungenzeka ukwenza lokhu uma ulungisa ukuziphatha kwakho ngokushesha nje uma wazi ngesifo sikashukela sakho. Thatha isenzo namuhla-ungayenza.

Izwi elivela

Isifo sikashukela yisifo esingabangela izinhlobo eziningi zezinkinga. Kodwa, izindaba ezinhle ukuthi uma wenza izinguquko zokuphila ezinonya unganciphisa noma uzibazise ingozi yokuthuthukisa lezi zinkinga. Indlela engcono kakhulu yokunciphisa ingozi yakho ukugcina ushukela wegazi lakho, ukucindezeleka kwegazi, isisindo, kanye ne-cholesterol eseduze nokuvamile njengoba unakho. Ungalindi. Qinisekisa ukuthi uhlangana nezinhlobo ezifanele zodokotela nokuthi usebenza kahle ekunakekeleni isifo sikashukela. Ungaphila impilo enempilo, isikhathi eside nesifo sikashukela, kodwa kufanele usebenze kuso.

> Imithombo:

> I-American Diabetes Association. Amazinga Wokunakekelwa Kwezokwelapha 2016.http: //care.diabetesjournals.org/content/39/Supplement_1

> American Heart Association. Ukuqonda Ukufundwa Kokucindezelwa Kwegazi.http: //www.heart.org/HEARTORG/Conditions/HighBloodPressure/AboutHighBloodPressure/Understanding-Blood-Pressure-Readings_UCM_301764_Article.jsp#.V-xqU_ArK00

> I-National Eye Institute. Amaqiniso Ngezifo Zesifo Sikashukela.https: //nei.nih.gov/health/diabetic/retinopathy

> I-National Kidney Foundation. Isifo sikashukela.https: //www.kidney.org/atoz/atozTopic_Diabetes

> Amandla, futhi. al. Isifo sikashukela sokuziphathisa ukuphathwa kanye nokusekelwa ngohlobo lwesifo sikashukela 2: isitatimende esivumelanisiwe sehlangano yaseMelika, isifo sikashukela, nesifunda sezokudla kanye ne-dietetics. Ukunakekelwa yisifo sikashukela. http://care.diabetesjournals.org/content/early/2015/06/02/dc15-0730.full.pdf+html?sid=edddb5d0-7234-4c1c-ba68-a00342c0bb7b