ʻO ka maʻi diabetes gestational i ka wā hāpai

ʻO ka pahuhopu o ke aʻo ʻana ʻo ia ka hoʻopaʻa ʻana i nā hoʻopiʻi a me ka hoʻopaʻa ʻana i nā hopena hopena o ka wahine i ka wahine me ka compestated gestational diabetes mellitus (GDM). Ua aʻo ʻia nā hopena a me nā hoʻopiʻi o ka wahine hāpai ma ka 50 mau wahine hāpai me ka maʻi gestational diabetes mellitus, ka manaʻo o GDM ma ka pūpū. ʻO ka hapa nui o nā wahine hāpai (33.7 ± 5.7) mau makahiki. Me ka GDM uku, ʻo ka ulu ʻana o ka gestosis a me ka piha plato pliss was 84%, polyhydramnios 36%, fetopathy fetal 48%. ʻO ka hoʻoili ʻana i ka manawa ma 96% o nā hihia, ʻo ka pinepine o nā maʻi malalolo e pili ana i nā hōʻailona ākea ākea. Ua hoʻokumu ʻia e pili ana i ka maʻi mellitus maʻi gestational i ka hoʻomohala ʻana o ka maʻi gestosis a me ka nele o ka placental, ʻoiai inā he uku no ka hoʻoneʻe ʻana i ka haʻalulu.

NĀ HOU KĀNUI MAʻU LOAʻI O NA KAHIKAI NOHO MA KOMOHE ʻO DIABETES MELLITUS

ʻO ka pahuhopu o ke aʻo ʻana ʻo ia ka hoʻopaʻa ʻana i nā hoʻopiʻi a me ka nānā ʻana i nā hopena o ka hapai i ka wahine me ka mellitus diabetes gellational. Ua aʻo mākou i nā hopena hopena a me nā hoʻopiʻi o ka hāpai ʻana i ka 50 mau wahine hāpai me ka maʻi gestational diabetes mellitus, nā hopena o ka maʻi gestational ma luna o ka pūpū. ʻO ka makahiki maʻamau o nā wahine hāpai (33.7 ± 5.7) mau makahiki. ʻO ka ulu ʻana o nā wahi ulu a me ka ʻike o ka placental no ka hoʻopiʻi ʻana i ka maʻi mestitus maʻi gestational he 84%, polyhydramnios 36%, ʻo ka fetopathy 48% o nā hihia. ʻO ka hānau ʻana i ka manawa i hala i ka 96% o nā hihia, ʻo ke alapine o nā maʻi hānai fetal e like me nā hōʻailona o ka lehulehu. Hoʻopilikia ka maʻi mellitus maʻi gestational i ka hoʻomohala ʻana o ka maʻi gestosis a me ka hoʻopiʻiʻana o ka fetoplacental, ʻoiai ka uku o ka metabolism o ka paʻakai ma hope o ke kūʻana o ka maʻi gestational diabetes mellitus.

ʻO ka ʻōlelo o ka hana ʻepekema ma ke kumuhana "Nā pilikia a me ka hopena hāpai i ka hopena mestitus maʻi gestational"

INTERDISCI PLAY KOMO HOUʻI KĀLOHE NOHO LOA I MEDICINE

NA HALO NUI A ME NA HANA I KA MANA ANA I KOLOHE DIABETES MELLITUS

Bondar I.A., Malysheva A.S.

Ke Kauka Hana Hou a Novosibirsk, Novosibirsk

ʻO ke kumu o ke aʻo ʻana ʻo ka huli ʻana i nā hoʻopiʻi a me ka hoʻopaʻa ʻana i nā hopena hopena o ka wahine i ka wahine me ka compestated gestational diabetes mellitus (GDM).

Ua aʻo ʻia nā hopena a me nā hoʻopiʻi o ka wahine hāpai ma ka 50 mau wahine hāpai me ka maʻi gestational diabetes mellitus, ka manaʻo o GDM ma ka pūpū.

ʻO ka hapa nui o nā wahine hāpai (33.7 ± 5.7) mau makahiki. Me ka GDM uku, ʻo ka ulu ʻana o ka gestosis a me ka piha plato pliss was 84%, polyhydramnios - 36%, fetopathy ailama - 48%. ʻO ka hoʻoili ʻana i ka manawa ma 96% o nā hihia, ʻo ka pinepine o nā maʻi malalolo e pili ana i nā hōʻailona ākea ākea.

Ua hoʻokumu ʻia e pili ana i ka maʻi mellitus maʻi gestational i ka hoʻomohala ʻana o ka maʻi gestosis a me ka nele o ka placental, ʻoiai inā he uku no ka hoʻoneʻe ʻana i ka haʻalulu.

KEʻU MUA: gestational diabetes mellitus, hopena hānau, gestosis, fetopathy fetal.

ka hoʻomākaukau ʻana i ka pregravid no ka hapai, ke kaohi ʻole ʻana i nā hana maʻamau o ka maʻamau kalama ma mua o ke kau ʻana o kāna papa.

Hoʻopilikia ka Diabetes mellitus (DM) i ke ʻano o ka hāpai ʻana, e hoʻoholo ana i kona hopena. ʻO ka maʻi maʻi i nā wahine hāpai e hāpai i ka holomua o nā hoʻopiʻi vascular, e alakaʻi i ka hoʻomohala pinepine ʻana o ka hypoglycemia, ketoacidosis, polyhydramnios, hypertension arterial a gestosis, recurrent genital a urinary tract infection, a me ka hoʻomaikaʻi pinepine ʻana, hoʻomāinoino, a me ka lawe ʻana i nā maʻi (kes) forceps, vacuum extraction of the fetus), premature birth 2, 3.

ʻO kahi maʻi gestational diabetes mellitus (GDM) kahi maʻi i hōʻike ʻia e ka maʻi hyperglycemia, ʻike mua ʻia i ka wā hapai, akā ʻaʻole ke hoʻokō nei i nā koina no ka "maʻi" maʻi maʻi. ʻO ka molo o GDM i ka nui o ka lehulehu ma waena o nā awelika 7%. Hoʻonui ka GDM i ka hopena o ka hopena o ka hopena hānai makemake no ka makuahine a me ka make o ka pēpē, he hopena kūpono no ka hoʻomohalaʻana i ka momona, type 2 diabetes and cardiovascular disease in the mother and seed in the future 1, 8.

Aia kahi pilina pololei ma waena o ka uku o ka maʻi pākēneka o ka maʻi a me ka hōʻeha o ka maʻi fetopathy maʻi, ka hoʻomohala ʻana o ka pilikia o ka ʻokiʻoki me ka maʻi gynecological, nā hihia o ka makeʻana o ka perinatal, a me ka hoʻomohala ʻana o nā maʻi vascular 4, 5. ʻO nā mea hoʻopiʻi e ulu ana i ka wā hāpai o ka wā ma ke ʻano o ka nele o ka hoʻolālā

ʻO ka pilikia o ka make o ke keiki ma GDM he 3-6%, a me ka ʻole o ka maʻi diabetes - 1-2%, akā ke hoʻopiʻi nei ka maʻi diabetes i ka hoʻomohala ʻana i ka make o ka maʻi fetal ma ka loaʻa ʻole o nā hoʻopiʻi hapai. Eia kekahi, me GDM, loaʻa ka mahuahua i ka hopena o nā pilikia o ka hanu - transach tachypnea, intrauterine asphyxia, ʻehaʻeha kaumaha.

Na Malysheva Anna Sergeevna, tel. 8-913-740-5541, e-mail: [email protected]

I loko o ka pūpū, hiki i ka hapa nui o nā maʻi fetopathy maʻi o 27 a 62%, hoʻohālikelike ʻia me 10%

i loko o kahi heluna olakino, e like me nā mea kākau ʻē aʻe, ʻo ka pinepine o ka macrosomia e ʻokoʻa ma 20% no ka maʻi maʻi i ka 35% no ka maʻi maʻi i hoʻomohala ma mua o ka wā hapai.

ʻO ke kumu o ke aʻo ʻana ʻo ia ka hoʻopaʻa ʻana i nā hoʻopiʻi a me ka hoʻopaʻa ʻana i nā hopena hopena o ka wahine i ka wahine me ka maʻi maʻi gestational compensated.

Mea ukana a me nā ʻano hana

Ua hōʻike ʻia kahi hoʻokolohua o nā wahine hāpai 50 a 20 i nā makahiki 42 (awelika makahiki (34.0 ± 5.7) mau makahiki me kahi maʻi paʻa ʻana o GDM ma nā manawa like ʻole.

ʻO nā mea i hōʻike ʻia no ka haʻalele ʻana mai ka haʻawina ʻo: ʻano type type 2 a me ke ʻano maʻi maʻi 1 i ke ʻano o ka wā hapalua, pathology concomitant pathology, thyroid dysfunction, aʻeha o nā maʻi aʻeha paha a me ka hoʻāhewa ʻana i nā maʻi maʻi mau i loko o 2 mau pule ma mua o ke komo ʻana i ka noiʻi ʻana.

ʻO kahi nānā ʻana o nā moʻolelo olakino, nā ikepili o ka obstetric a me ka gynecological history (ka wā maʻamau ka maʻi, ka hoʻokaʻawale maʻamau, ka make ʻana o ka hua wahine a i ʻole ka hoʻonui ʻana i ke ola, ka wahine hāpai nui, nā ʻano maʻi nui o ka maʻi gestosis, colpitis mau pinepine, ka maʻi maʻamau urinary infection, ka hapai ʻana, ka māmala mua, a me ka wā hapalua i kēia manawa ) Ua hōʻike ʻia ka nui o ka kaumaha o ka maʻi diabetes, GDM, glucosuria. ʻO ka ʻōlelo kikoʻī o ke kino (BMI) ma mua o ka hāpai ʻana a me ka hoʻonui ʻana i ke kaumaha o ke kino i ka wā hapai, ka pae o ka glycemia i ka wā o ka nānā ʻana, a ke hoʻomau nei ka hoʻomau i ka haʻahaʻa glucose-lowing no GDM. ʻO ka hopena o GDM ma ka maʻi wahine (ka loaʻa ʻana o ka fetopathy, ʻeha hōʻeha) i aʻo ʻia. No ka ʻike ʻana i ka maʻi gestosis, ua hoʻohana ʻia ka papa helu ICD-10, ua hoʻoholo ʻia ka ʻōpio e like me ke kākala o Goeeke ma ka hoʻololi o G.M. Olaolelei. No ka loaʻa ʻana o ka maʻi GDM, ua hōʻike ʻia nā ʻōlelo hoʻokūkū o ka Russian National Consensus "GDM: Diagnosis, Hōʻōkuhi, Hoʻomaopopo Postpartum" (2012) i noi ʻia.

Ua hoʻokō ʻia ka helu helu helu ʻana o nā hualoaʻa me ka hoʻohana ʻana i ka papahana Statistica 6.0 no ka Windows, me ka nānā ʻana i nā hana hoʻokūkū i aʻo ʻia no ka biology a me nā lāʻau lapaʻau. Kuhi ʻia nā hiʻohiʻona ʻike ʻia ma ke ʻano he M ± s, kahi o M ke kumukūʻai awelika, a me ke ʻano ka palena kūloko. Ua hoʻoholo ʻia ke hoʻoponopono ʻana me ka hoʻohana ʻana i ka hoʻāʻo ʻo Spearman r, no nā ʻano dichotomous i hoʻohana ai mākou

Ka loiloi correlation tetrachoric o ka Chuprov CN i aʻo ʻia. Ua hōʻike ʻia nā ʻokoʻa i nā statistically i p i hiki ʻole ke loaʻa kahi āu e pono ai? E hoʻāʻo i ka lawelawe palapala koho.

± 0.9) mmol / L, 13:00 - (5.4 ± 1.1) mmol / L, 17:00 - (5.4 ± 0.9) mmol / L, 21:00 - (6, 1 ± 2.6) mmol / l, ma 02:00 - (4.7 ± 1.6) mmol / l.

34 nā mea maʻi (68%) i hōʻeha ʻia ma mua o ka momona, ma mua o 8 (16%) ʻoi aku ka momona (ma waena o BMI - (28.4 ± 1.5) kg / m2), 8 (16%) - ke kaumaha kino kino, 4 ( 8%) - ke nele o ke kaupaona kino (average BMI - (17.8 ± 1.2) kg / m2). ʻO ka awelika BMI i nā maʻi me ka momona o ka wā ma mua o ka wā hapai (34.3 ± 3.9) kg / m2. Loaʻa ka nui o nā pae mua ma ka 20 (40%) nā mea maʻi, ʻo ka 2 - 10 (20%), ke kō he 3 - 4 (8%). Wahi a nā mea kākau ʻē aʻe, ʻo ka pinepine o ka momona o waena o nā wahine hāpai mai ka 12 a i 28% a ʻaʻohe kumu o ka emi ʻana o ka makahiki 13, 14. ʻO ke kaupaona ʻana no ka wahine ma ka 3 a 20 kg, ma ka awelika (11.9 ± 5.3) kg . ^ E Ha yM.

I loko o 2 (4%) nā maʻi maʻi nona ka hapalua o ka pae ma mua o ka wā hapai, ʻaʻohe mea i hoʻonui i ke kino o ke kino i ka wā hāpai ma muli o kaʻai. Loaʻa ka loaʻa ʻana o ka paona pathological i 16 mau hihia (32%): ma 10 mau hihia (20%) i nā wahine me ka momona a me ke ʻano like (2 mau hihia pākahi).

Interdisciplinary noiʻi mua ma ka lāʻau lapaʻau

i nā wahine me ka maʻamau, ka momona a me ka haʻahaʻa ma mua o ka wā hāpai. Loaʻa ka loaʻa ʻana o ka paona pathological i 16 mai 50 o nā mea maʻi a ua loaʻa (16.7 ± 1.8) kg.

ʻO 6 (12% wale nō o nā mea i aʻo ʻia ʻaʻohe hanana o ka wā hapai, 10 (20%) nā mea maʻi i loaʻa ka mōʻaukala o ka hapai, 12 (24%) - 2 mau wahine hāpai, 22 (44%) - 3 a ʻoi aku paha. ʻO ka hapa nui (52%) o nā wahine me GDM i loaʻa i kahi pālule paʻakikī-gynecological paʻakikī.

ʻO ka mea pinepine ka hoʻopiʻi pinepine ʻana i ke ʻano o kahi hapai maoli me GDM, ʻo ia ka hoʻomohala ʻana o ka maʻi gestosis - 84% o nā hihia. Loaʻa ka maʻi goutosis o nā ʻano like ʻole i ka 76% o nā wahine hāpai: edema a me proteinuria me ke ʻano hypertension ma muli o ka hapai - 4 mau hihia (8%), hypertension me ka nui o ka proteuria koʻikoʻi - 8 (16%), edema - 6 (12%), 2 ( 4%) - ke kīmaha pono hypertension i hoʻohua ʻia i ka hapai, 18 (36%) - hypertension hāpai ʻana i ka maʻi me ka proteinuria koʻikoʻi. ʻO ka 4% wale nō nā hihia i lilo i hypertension ma muli o ka hāpai ʻana me ka proteinuria koʻikoʻi a me nā maʻi edema i nānā ʻia. Ua hōʻike ʻia kahi hopena neʻe ma waena o ka hoʻomohala ʻana i ka maʻi gestosis a me ka pae o ka glycemia i ka hoʻomaka ʻana o GDM (CN = 0.29, p = 0.002) (me ka glycemia liʻiliʻi o 5.2 mmol / L ma kahi ʻōpū ʻole). Loaʻa ʻia kahi pilina kūpono ma waena o ka hoʻomohala ʻana o ka maʻi gestosis a me ka momona o nāʻokoʻa like ʻole ma mua o ka wā ʻo ka hapakā (g = 0.4, p = 0.03) i loaʻa ka momona kaumaha pathological (g = 0.4, p = 0.005) i ka wā hapai. ʻO ka hoʻolālā ʻana o ka gestosis me ka hele ʻana o ka hypertension arterial (AH) ma 26 (52%) nā wahine hāpai (g = 0.48, p = 0.0004). Ua hōʻike ʻia ka pilina ma waena o ka momona a ma mua o ka hāpai ʻana a me ka kūkulu ʻana o ka maʻi hypertension (g = 0.4, p = 0.003) i ka wā hapai. Ua nānā ʻia ka pyelonephritis maʻi i kahi mau hihia he 14 (28%). ʻO ka pae awelika o proteinuria i loko o ka hoʻomohala hōʻano maʻamau o ka urine i kēia mau mea maʻi (0,05 ± 0.04) g / l, nā proteinuria i kēlā me kēia lā (0.16 ± 0.14) g / l.

Mild a hōʻemi i ka anemia male ʻōpoki pale paʻakikī i ka wā 22 mau hihia (44%), ka nui o ka hemoglobin pae (105.6 ± 18.8) g / l. I nā 6 o 50 mau hihia, hapai ʻia me ka hematogenous thrombophilia a me thrombocytopenia.

Ua hōʻike ʻia nā loiloi o ka hopena hāpai i ka hānai ʻana i nā huaʻōlelo ma 96% o nā wahine hāpai, 2 mau wahine i hānau mua ʻia, e pili ana ia

Hōʻikeʻike Siberian Honey

Hoʻopau ia me nā kuʻuna heluna ākea ma nā wahine hāpai me kaʻole o ka metabolism metabolism (table).

Wahi a ka loiloi, ma 76% o nā hihia, ʻo ka pūpū ma ka hōʻike o ke poʻo.

Ka hopena n% Kūpono

Kāleka COP 6 12

Hoʻolālā COP 24 48 Loaʻa ma mua o ka wā hapai

Hoʻouna ma 20 40

kanawai kūlohelohe

Koi ʻia 2 4

Kaumaha o ka hana; 6 12 fetopathy fetal

r = 0.74, p = 0,02

Hoʻomaopopo KS - ʻāpana Cesarean.

I nā maʻi (42%) nā maʻi, ua mālama ʻia ka hapai me ka maʻi piha o ka placental (FPF), ka subcompensated i hōʻike pinepine ʻia - 26 (52%), i 16 (32%) - uku ʻia. ʻO ka hoʻolālāʻana o ka FPI ma 24 (48%) ka wahine i ka holo hewa ʻana o ka kahe koko ma ka ʻōpū o ka utero-placental (1st degere - 4 (8%), pae kiʻekiʻe - 14 (28%), pae kiʻekiʻe - 4 (8%), pae degere - 2 ( 4%)), ke kahe o ke hypertension arterial (r = 0.41, p = 0.003) a me ka maʻi ʻolōkole (r = 0.36, p = 0.02). Wahi a kahi scan ultrasound, 2 (4%) nā maʻi i loaʻa mua i ka plasenta i ka plasenta, 10 (20%) kahi haʻahaʻa haʻahaʻa, a ʻo ke ʻano nui o ka umbilical wale nō i loaʻa i 2 (4%). Ma nā hihia he 20 (40%), ua hāpai pū ʻia ka hapai e ka maʻi o kahi maʻi intrauterine a me ka maʻi urogenital maʻi (8%).

Ua nānā ʻia ka polyhydramnios ma nā hihia he 18 (36%), ʻaʻole i ʻike ʻia he oligohydramnios. Ua hana ʻia ʻo Amniotomy i nā wahine (4%). ʻO ka hala mua o ka wai amniotic i loaʻa i 8 (16%) nā wahine hāpai me ka GDM. ʻO ka nui o ka nui o ka wai amniotic he 660 ml, ma 6 (12%) aia kahi loli kualitatif i ka wai amniotic (kahe wai amniotic green).

ʻO ke koʻikoʻi o ke kino o nā pēpē hou mai 2,500 a 4,750 g, ka nui kino kino kino (3,862.1 ± 24.1) g, ka nui o ka nui (53.4 ± 1.6) cm. Ua kiʻi ʻia ka fetopathy fetal ma ka 24 (48 %) o nā pēpē, ʻoi paha ke kaupaona ʻana o ke kino - (4 365 ± 237) g. I nā wahine hāpai i ka GDS i ka 1st 1stester, ua loaʻa aku ka maleopopopopopopopiwa i 100% o nā hihia, aʻo ka mākaukau o ke kaumaha o nā pēpē hou aʻe ʻoi aku ma mua o nā wahine me kahi GDS debut i 2nd a me 3 trimesters ((4525.0 ± 259.8) a (3828.0 ± 429.8 g, kekona). Wahi a ke ultrasound (ultrasound), ma 8

s, 2014, volume 13, Helu 2, p. 5-9 7

nā hihia (16%) hōʻike i kahi maʻi hypoxia intrauterine o ka pēpē, i 2 mau hihia (4%) - bilateral pyeloectasia i loko o ka pūpū. Hoʻopili ʻia kā mākou ʻikepili me ke aʻo ʻana o V.F. ʻO Ordynsky, kahi i hōʻea ai ka piʻiʻana o ka fetopathy 49% (me ka ultrasound).

I ka helu ʻana i ka helu Apgar, ʻike ʻia ka helu mua mai 6 mau helu (1 hihia) a 8. Ua helu ka lua o ka helu mai 7 a 9 mau poʻomanaʻo.

I loko o 2 (4%) o ka wā hānau hou, ua hōʻike ʻia nā maʻi hōʻokoʻa, a ma kahi o ka hānau ʻana i hōʻike ʻia e kahi maʻi koʻikoʻi o ka pūnao a me nā hōʻailona neurological. Ua paʻakikī ka papa o ka hana ma ka hānau mua o ka poʻohiwi

2 (4%) ka paʻakikī i ka wehe ʻana i nā poʻohiwi - 2 (4%), ka hoʻolālā ʻana i kahi pelvis pōkole ʻo nā maʻi - 2 (4%).

Hoʻokuʻu ʻia ka placenta ma kāna iho i 24 mau hihia (48%), ma 20 (40%) mau wahine i ka hana, ua hoʻokaʻawale ʻia ka plasenta ma ka lima. ʻO ka nui o ka nui o ka plasenta ((760.3 ± 180.2) g. I loko o 2 mau wale nō (4%) ka edema o ka wahi o ke keiki. ʻO ka lōʻihi o ka kaula umbilical mai 30 a 96 cm, ma ka awelika - (65.5 ± 13.0) cm. Ua hōʻike ʻia he mau koholā ka māhoe ʻelua ma kahi o 12 (24%).

Hōʻike nā hopena i loaʻa i ka hopena o GDM i ka hoʻomohalaʻana o ka maʻi gestosis a me ka nele o ka placental i ka 84% o nā hihia, ʻoiai me ka loaʻa ʻana o ka manawa kūpono a me ka uku uku o GDM. I ka hoʻomakaʻana o GDM

i loko o ka 1st trimester, ua ʻike ʻia ka hoʻomohala ʻana o ka fetopathy i ka 100% o nā hihia i kū i ke kua ʻana o ka hoʻihoʻi no ka hana o ka metabolism.

Pēlā, ʻo ka hyperglycemia ma ka hoʻomakaʻana o GDM, ka momona, a me ka paona pathological i hoʻonui i ka hōʻeha o nā hoʻopiʻi a me nā hopena hoʻonāukiuki a ʻoi no ka makuahine a me ka maʻi hānau, a me ka loaʻa ʻana o ka manawa kūpono o ka GDM a me ka uku uku no ka hoʻoneʻeʻana o ka ʻaila.

1. Tiselko A.V. 7th International Symposium "Diabetes, Hypertension, Metabolic Syndrome and Pregnancy", Malaki 13-16, 2013, Florence, Italia // Diabetes. 2013. ʻAʻole 1. S. 106-107.

2. Hod M., Carrapato M. Diabetes a me nā Hoʻolālā Pōkake ʻana i nā Kahuhipa a me nā Kūlana (Mālama hana e pili ana i ka maʻi maʻi a me ka wā hāpai. Prague, 2006.

3. Ahahui Russian o Endocrinologists. Nā manaʻo loea haukapila. Endocrinology: 2nd ed. / ed. I.I. De-

Dova, G.A. Melnichenko. M .: GEOTAR-Media, 2012.S. 156-157.

4. Jovanovic L., Knopp R. H., Kim H. et al. Ka hapanui o ka male ʻana ma ka liʻiliʻi a me nā haʻahaʻa haʻahaʻa o ka glucose i ka wā ma mua o ka hānau maʻamau a me ka maʻi maʻi: mau hōʻike no ka pale ʻana i ka maʻi diabetes // Diabetes Care. 2005. V. 5. P. 11131117.

5.Demidova I.Yu., Arbatskaya N.Yu., Melnikova E.P. ʻO nā pilikia kūpono e pili ana i ka hoʻopiʻi ʻana i ka maʻi diabetes i ka wā hapai // Diabetes. 2009. ʻAʻole 4. P. 32-36.

6. Yesayan R.M., Grigoryan O.R., Pekareva E.V. ʻO ka hana o ka uku no ka hoʻoneʻeʻana o nā kalapika i nā wahine hāpai me ka maʻi type 1 i ka hoʻomohala ʻana o nā hoʻopiʻi perinatal // Diabetes. 2009. ʻAʻole 4. P. 23-27.

7. Dedov I.I., Krasnopolsky V.I., SukhikhG.T. Ma luna o ka pūʻulu hana. ʻEnslelo Lūkini Pelekikena Lūkini "Diestes Diabetes: Diagnosis, Hoʻomaʻamaʻa, Hoʻopau ʻO Postpartum" // Diabetes. 2012. ʻAʻole 4. P. 4-10.

8.Andreeva E.V., Dobrokhotova Yu.E., Yushina M.V., Heyder L.A., Boyar E.A., Filatova L.A., Shikhmirzaeva E.Sh. ʻO kekahi mau hiʻohiʻona o ka hana hana o ka gland thyroid i loko o nā pēpē mai nā makuahine me ka maʻi gestational diabetes mellitus // ʻO nā pilikia o ka hānau ʻana. 2008. ʻAʻole 5. S. 56-58.

9. Peters-Harmel E., Matur R. Diabetes mellitus maʻi a me ka maʻi / ed. unuhi N.A. Fedorova. M.: Hana Hana, 2008.S. 329-369.

10. Cherif A. et al. Hoʻonui ʻo Preeclampsia i ka hopena o ka maʻi membrane hualine i ke keiki poʻokela: kahi haʻawina hoʻihoʻi retrospective // ​​J. Gynecol. Obstet Biol. Pūnaewele. 2008. V. 37 (6). P. 597-601.

11. Gabbe S.G., Graves C. Management o ka maile mellitus e koi piha ana i ka hapai // Obstet. Gynecol. 2003. V. 102. P. 857-868.

12. Carrapato M.R., Marcelino F. ʻO ka pēpē o ka makuahine maʻi maʻi: ʻO nā puka hoʻomohala koʻikoʻi // E pili ana i ka pale ʻana. 2001. ʻAʻole 5. R. 57.

13. Bellver J., Melo M.A., Bosch E. Obesity a me ka hopena hua maikaʻi maikaʻi: ka hopena hiki i ka endometrium // Fertil Steril. 2007. V. 88.P. 446.

14. Chen A., Feresu S.A., Fernandez C. Materesal obesity a me ka hopena o ka make o ke keiki ma ka United States. Epidemiology 2009, 20:74. Dashe J.S., McIntire D.D., Twickler D.M. ʻO ka hopena o ka momona o ka hānauʻana ma ka nānā ʻana i ka ultrasound o nā infinsous anomal // Obstet Gynecol. 2009.V. 113.P. 1001.

15. Ordynsky V.F. Nā hiʻohiʻona o nā loli i ka hana o ka plasenta i nā wahine hāpai me ka maʻi maʻi maʻi e like me nā hopena o kahi noi ultrasound // Ultrasound a me nā hana hoʻokolohua. 2005. Helu 5. P. 21-22.

Loaʻa i ka lā 24 Dekemaba 2013; Apono ʻia no ka paʻi i ka lā 20 Malaki 2014

Bondar Irina Arkadevna - Kauka med. ʻenekele, luna ʻōlelo aʻoaʻo, ke poʻo. Ke Keʻena o Endocrinology, Novosibirsk State Medical University (Novosibirsk). 8 Bulletin of Siberian Medicine, 2014, Volume 13, No. 2, p. 5-9

Interdisciplinary noiʻi noiʻi ma ka lāʻau Malysheva Anna Sergeevna (I) - haumāna haumāna pukaʻike mua o ke Keʻena ʻo Endocrinology, Novosibirsk State Medical University (Novosibirsk). Na Malysheva Anna Sergeevna, tel. 8-913-740-5541, e-mail: [email protected]

NĀ HOU KĀNUI MAʻU LOAʻI O NA KAHIKAI NOHO MA KOMOHE ʻO DIABETES MELLITUS

Bondar I.A., Malysheva A.S.

ʻO Ke Kauka Mokuʻau Novosibirsk State, Novosibirsk, Russian Federation ABSTRACT

ʻO ka pahuhopu o ke aʻo ʻana ʻo ia ka hoʻopaʻa ʻana i nā hoʻopiʻi a me ka nānā ʻana i nā hopena o ka hapai i ka wahine me ka mellitus diabetes gellational.

Ua aʻo mākou i nā hopena hopena a me nā hoʻopiʻi o ka hāpai ʻana i ka 50 mau wahine hāpai me ka maʻi gestational diabetes mellitus, nā hopena o ka maʻi gestational ma luna o ka pūpū.

ʻO ka makahiki maʻamau o nā wahine hāpai (33.7 ± 5.7) mau makahiki. ʻO ka ulu ʻana o nā maʻi gestoses a i ka plol i ka placental o ka hoʻopiʻi ʻana i ka maʻi diabetes gellational he 84%, polyhydramnios - 36%, ka maʻi fetopathy - 48% o nā hihia. ʻO ka hānau ʻana i ka manawa i hala i ka 96% o nā hihia, ʻo ke alapine o nā maʻi hānai fetal e like me nā hōʻailona o ka lehulehu.

Hoʻopilikia ka maʻi mellitus maʻi gestational i ka hoʻomohala ʻana o ka maʻi gestosis a me ka hoʻopiʻiʻana o ka fetoplacental, ʻoiai ka uku o ka metabolism o ka paʻakai ma hope o ke kūʻana o ka maʻi gestational diabetes mellitus.

NĀ KOHO ʻ :lelo: gestational diabetes mellitus, hopena hopena o ka hapai, ka maʻi ʻana, ka maʻi hakakā.

Kūpono o ka Siberian Medicine, 2014, vol. 13, ʻaʻole. 2, pp. 5-9

1. Tisel'ko A.V. ʻO ka maʻi diabetes mellitus, 2013, no. 1, pp. 106-107 (ma ka Lūkini).

2. Hod M., Carrapato M. Diabetes a me nā Hoʻolālā Pōkake ʻana i nā Kahuhipa a me nā Kūlana (Mālama hana e pili ana i ka maʻi maʻi a me ka wā hāpai. Prague, 2006.

3. Dedov I.I., Mel'nichenko G.A. Russian Lūkini o endo-crinologist. Nā manaʻo loea haukapila. Endocrinology. 2nd ed. Moscow, Geotar-Media Publ., 2012.335 p.

4. Jovanovic L., Knopp R. H., Kim H. et al. Ke piʻi ʻana o ka hapai male i ka kiʻekiʻe a me ka haʻahaʻa o ka glucose i ka wā ma mua o ke ʻano maʻamau a me ka maʻi diabetes: mau hōʻike no ka pale ʻana i ka maʻi maʻi. ʻO ka mālama maʻi hānai, 2005, vol. 5, pp. 11131117.

5. Demidova I.Yu., Arbatskaya N.Yu., Mel'nikova E.P. ʻO ka maʻi diabetes mellitus, 2009, no. 4, pp. 32-36 (i ka Lūkini).

6. Esayan R.M., Grigorian O.R., Pekareva Ye.V. ʻO ka maʻi diabetes mellitus, 2009, no. 4, pp. 23-27 (i Lūkini).

7. Dedov I.I., Krasnopol'skiy V.I., Sukhikh G.T. Ma luna o ka hui noiʻi. Diabetes mellitus, 2012, no. 4, pp. 4-10 (ma ka Lūkia).

8. Andreyeva Ye.V., Dobrokhotova Yu.Ye., Yushina M.V., Kheyder L.A., Boyar Ye.A., Filatova L.A., Shikhmirzae-

va Ye.Sh. Russian Journal of Human Reproduction, 2008, ʻaʻole. 5, pp. 56-58 (ma ka Lūkia).

9. Piters-Kharmel E., Matur R. Diabetes mellitus: maʻi ʻaʻaʻi a me ka mālama ʻana. Moscow, Kau Kuhi ʻia., 2008. 500 p.

10. Cherif A. et al. Hoʻonui ka Preeclampsia i ka nui o ka maʻi o ka membrane hualine i ka pēpē keiki mua: kahi haʻawina hoʻihoʻi retrospective. J. Gynecol. Obstet Biol. Reprod., 2008, vol. 37 (6), pp. 597-601.

11. Gabbe S.G., Graves C. Kapena o ka maʻi mellitus e koi piha ana i ka hapai. Obstet Gynecol., 2003, vol. 102, pp. 857-868.

12. Carrapato M.R., Marcelino F. ʻO ke keiki o ka makuahine maʻi maʻi: ʻO nā puka hoʻomohala koʻikoʻi. ʻO ke ʻihi ʻOihana, 2001, ʻaʻole. 5, pp. 57.

13. Bellver J., Melo M.A., Bosch E. Obesity a me ka hopena hua maikaʻi maikaʻi: ka hopena kūpono o ka endometrium. Fertil Steril., 2007, vol. 88, pp. 446.

14. Chen A., Feresu S.A., Fernandez C. Materesal obesity a me ka hopena o ka make o ke keiki ma ka United States. Epidemiology, 2009, 20:74. Dashe J.S., McIntire D.D., Twickler D.M. Hoʻopilikia i ka hopena o ka momona o ka māmā ma ka nānā ʻana i ka ultrasound o nā fetuses anomalous. Obstet Gynecol., 2009, vol. 113, pp. 1001.

15. Ordynskiy V.F. Nā mea uila a me nā diagnostics hana, 2005, ʻaʻole. 5, pp. 21-22 (i ka Lūkini).

Bondar Irina A., ʻOihana Kauʻāina ʻo Novosibirsk State, Novosibirsk, Russian Federation. Malysheva Anna S. (H), Ke Kauka Hana Hou ma Novosibirsk, Novosibirsk, Russian Federation.

Nā kumu kumu a me nā hopena paʻakikī

ʻO ka etiopathogenesis o ke maʻi gestational i ka wā hāpai a maopopo ʻaʻole i maopopo loa. Ua kuhi ʻia kona ulu ʻana ma muli o ka pani ʻana o ka hana ʻana i kahi nui o ka insulin e nā hormones e kuleana ana i ka ulu kūpono a me ka hoʻomohala ʻana o ka maʻi hānau. I ka wā hapai, ka hopena o ka loli o ka hormonal-koi i loko o ke kino o ka wahine i pili me ka hoʻokumu ʻana i ka plasenta, ka mea huna i ka chorionic gonadotropin, corticosteroids, estrogens, progesterone, a me ka lactogen plenta i loko o ka kahe koko o ka makuahine. Hoʻopili kēia mau hormones i ka nānāʻana o nā ʻiʻo peripheral i ka insulin endogenous. Hōʻike ka hoʻonāʻana i ka metabola i ka insulin endogenous e hoʻonui i ka lipolysis, ʻoiai ka hoʻohana ʻana o ka glucose i nā kinipona kinipōpōnē e hoʻēmi ana i ka insulin, ʻoiai inā aia kekahi mau hopena, hiki ke hoʻopilikia i ka maʻi diabetes.

Hāʻawi ka maʻi Autoimmune i ka hoʻomohala ʻana o ka maʻi gestational, kahi i luku ʻia ai ka pancreas a ma ia mea, ke hōʻemi nei ka hopena o ka hana ʻana i ka insulin. I nā wahine he mau ʻohana pili i nā maʻi maʻi, ua pālua ka hopena o ka ulu ʻana o ka maʻi gestational i ka wā hāpai.

ʻO nā kumu ʻē aʻe e pili ana:

• predisposition genetic
• maʻi maʻamau maʻi virus
• kanalima candidiasis
• polycystic ovary syndrome,
• kaila maikaʻi loa, hānau ʻia o kahi fetus nui, mōʻaukala polyhydramnios, gestational diabetes mellitus i nā wā hāpai mua,
• koko koko kiʻekiʻe
• momona momona
• mau ʻano maikaʻi
• ke kino kino a ʻuhane paha
• nā pāʻālua keʻokeʻo (kūwili, ka hoʻohana ʻana o ka nui o nā mea i kā lākou hoʻokaʻawae wikiwiki).

I mea e pale ai i ka hoʻomohala ʻana o ka maʻi mellitus maʻi gestational, ua ʻōlelo ʻia: kahiʻai kaulike, hōʻole i nā hana ʻino, lawa ka hana kino.

Nā ʻano o ka maʻi

Ua hoʻokaʻawale ʻia nā maʻi diabetes mellitus i nā wahine hāpai i mua o ka maʻi diabetes gestational, kahi i pili ai nā maʻi o ka pakanā kalepa i loko o kahi wahine ma mua o ka wā e hapai ai, a me ke ʻano maoli kekahi maʻi, kahi i hōʻike mua ʻia ai ka maʻi iā ia i ka wā hāpai.

Ua hoʻokaʻawale ʻia ka maʻi diabetes mellitus i ka uku ʻia e ka lāʻauʻai a me ka uku ʻia ʻana e ka lāʻau insulin i hui pū ʻia me ka meaʻai. Hoʻohālikelike ʻia a me ka decompensated gestational diabetes mellitus ma muli o ke ʻano o ka uku o ka pathology.

Nā hōʻailona o ka maʻi gestational

Hoʻololi ka maʻi maʻi gestational, pili kona mau hōʻailona, ​​inter alia, i ka lōʻihi o ka wā hāpai. I kekahi mau hihia, ʻaʻole i ʻike ʻia ka maʻi like ʻole a ʻike ʻia i ka wā hana o ka diagnostics laboratorium, ka mea i mālama ʻia ma ke ʻano o ka nānā ʻana o ka wā hāpai.

ʻO ka hōʻailona nui o ka maʻi maʻi gestational i ka wā o ka hapai, he hoʻonui i ka neʻe o ka glucose i ke koko o kahi wahine hāpai (maʻa mau ke maʻi ma hope o ka wiki 20,) i ka haʻalele ʻole o nā hōʻailona o ka maʻi maʻi ma ka wahine ma mua o ka wā hapai. ʻO nā hōʻike ʻē aʻe o ka maʻi gestational ka nui o ka loaʻa ʻana o ka paona nui, pākuʻi pinepine a me ka hoʻopiʻi ʻana, ka hōʻeha ʻana o ka ʻili, ʻo ka hōʻeha ʻana i ka ʻōpū o ka ʻano o ka ʻāina o ka pūnāwai, ka waha maloʻo, ka makewai mau, ka hoʻohaʻahaʻa ʻana i ka momona, nāwaliwali a me ka luhi.

Naʻi hoʻolika

Ma kahi ʻāpana o ka maʻi maʻi i ka wahine hāpai, hōʻiliʻili lākou i nā hoʻopiʻi a me ka anamnesis, e nānā pono ana i ka neʻe ʻana o ka maʻi maʻi ma ka mōʻaukala ʻohana.

ʻO nā ala nui e hōʻike i ke koko no ka glucose a me ka gogemia glycosylated, a me ka hōʻike pāina maʻamau me ka hoʻoholo ʻana i nā kino glucose a me ka ketone. Hōʻike ka hōʻike ʻana i ka glucose i hiki ke ʻike iā ʻoe i nā pilikia o ka mea i kālai ʻia o ka hoʻoliʻiliʻi o ka hana hoʻomohala mua i ka hoʻomohala ʻana. ʻO ka maʻamau, hana ʻia ka hōʻike hoʻoliʻi maʻamau glucose ma ka lawe ʻana i ka 75-100 g o ka glucose i ka waha a laila e ana i ka glucose o ke koko. Inā loaʻa ka maʻi maʻi hyperglycemia, contraindicated ʻo ka hōʻike.

ʻO ka etiopathogenesis o ke maʻi gestational i ka wā hāpai a maopopo ʻaʻole i maopopo loa.

ʻO ka mālama ʻana no ka maʻi maʻi gestational i ka wā hapai ka hana ma ka mea maʻi. Pono kēlā lā i kēia lā e kāohi i ka kiʻekiʻe o ka glucose i ke koko. ʻO ka ʻike ʻana o kēia hōkuhi e lawe mua ʻia ma kahi ʻōpū ʻole, a i hoʻokahi hola ma hope o kēlā me kēia pāʻina.

ʻO ka mea mua, ua hāʻawi ʻia ka mea maʻi e nānā i nā meaʻai. Eia kekahi, ʻo ka hana o ke kino hana maʻalahi e pale aku i ka nui o ka kaupaona ʻana a mālama i ke kino i ke ʻano maikaʻi. Eia kekahi, i ka wā hoʻoulu, hōʻeha nā ʻōpū o ka non-insulin-glucose e hoʻoliʻoli i ka glucose, e kōkua ana e hōʻemi i ka glycemia. Hiki i ka hana kino ke hoʻomaʻamaʻa no nā wahine hāpai, ka ʻauʻau, ka hele. I kēia hihia, ʻo ka hoʻoneʻe wikiwiki, me nā hoʻomaʻamaʻa e kuhikuhi ana i ka hana ʻana i nā mākia o ka paia o ka ʻōpū kuʻuna, pono e pale ʻia. Koho ʻia ka luhi e ka kauka ke alakaʻi i ka hapai, a i ʻole i mea loea i ka lāʻau lapaʻau ʻano.

ʻO ka mālama gestational, inā pono, hiki ke kau pū me ka lāʻau lapaʻau lāʻau (flaxseed, pakano burdock, lau blueberry, etc.), hepatopoietic a me nā angioprotective lāʻau.

I ka ʻike ʻole ʻana o ka hopena maikaʻi o ka meaʻai, me ka hui ʻana me kahi pūʻulu o nā hana o ka hana physiotherapy, ua hōʻike ʻia nā inikini insulin. ʻO nā lāʻau lapaʻau hypoglycemic ʻē aʻe no ka maʻi gestational e contraindicated ma muli o nā hopena teratogenic hiki.

Hoʻokumu ʻia ka huaʻōlelo o ka lawe ʻana i ke ʻano o ka nui o ka maʻi, ke ʻano o ke kuʻi ʻana a me ka loaʻa ʻana o nā maʻi paʻakikī. ʻO ka manawa kūpono ʻo ia ka 38 mau hebedoma hāpai ʻana, ʻoiai ua hala nā limu a ka mea maʻi aʻaʻohe pilikia i ka hoʻomōhala ʻana i nā pilikia o ka hanu.

Ma ka maʻi maʻi gestational koʻikoʻi a me / a i ʻole ka ulu ʻana o nā hoʻopiʻi ʻana, ʻōlelo ʻia ka lawe ʻana, ʻo ka manawa kūpono loa ʻo ia ka la 37 o ka wiki o ka hāpai ʻana.

Me ka nui o ka pelvis o ka wahine, ka liʻiliʻi o ka liʻiliʻi loa a me ke hōʻike poʻo, ke hāʻawi ʻia nei ka hāʻawi ʻana i ka waʻa o ka hānau hānau. ʻO ka hoʻouna ʻana i kahi ʻāpana caesarean e lawe pinepine ʻia i ka hihia, me ka nui o nā pūpū.

Hoʻomaʻamaʻa ka maʻi no ka pūpū e hoʻomohala i ka hyperinsulinemia, nā mea ma ke ʻano, hiki ke alakaʻi i ka hana ʻana o nā mea hanu.

Meaʻai no ka maʻi gestational i ka wā hāpai

Kuhi no ka maʻi maʻi gestational i ka wā hapai ke kuhikuhi mua i ka hoʻohaʻahaʻa i ka nui o ka glucose koko. ʻAi ʻia kahi papa ʻai 40-45% a e 20-25% ka momona. Kuhi ʻia ka nui o ka ʻai o ka protein e like me ke kahe like ʻana o 2 g o ka protein i ka 1 kg o ka paona. ʻO nā meaʻai ʻaiʻai, confectionery, momona a me nā meaʻai ʻai, nā aiʻa, ka meli, nā huaʻai, nā meaʻai koke, nā mayonnaise a me nā ʻano hana ʻē aʻe i haʻalele ʻia i ka meaʻai. Pono nā hua a me nā hua ʻai i ka hoʻonaninani, makemake ʻia i ka momona ʻole (currants, gooseberries, apple apana, cherries, cranberry). Hoʻohana ʻia ia e hoʻokomo i ka ʻai momona haʻahaʻa, nā iʻa a me ka tiʻa, nā ʻeke, nā pasta o nā lāʻau paʻakikī, ka ʻalahala, nā ʻūhā, ka zucchini, nā pepeke pepa, nā kuʻi, nā greens i ka meaʻai. ʻO nā mea maʻi me ka maʻi mellitus maʻi gestational i ka wā hāpai a pono e mālama i ka hoʻokomo o kahi nui o nā waiora a me nā minela e pono ai no ka hoʻomohala ʻana o ka pūpū.

Pono ka haʻahaʻa (nā meaʻai a 6-8 i ka lā i nā lā liʻiliʻi). Pono e hāʻawi ʻia o ka makemake i nā pā kuke, kāpaʻa a me ka ʻalī, a me nā ʻala lau hou. Eia kekahi, e pono e hoʻohana i ka liʻiliʻi o 1.5 lita o ka wai i kēlā me kēia lā.

Hoʻomaopopo ʻia kahi mea maʻi me ka maʻi maʻi gestational ma hope o ke hāpai ʻana e hahai i kahi ʻai no kekahi manawa a nānā i nā pae glucose koko e hōʻemi i ka hopena o ka maʻi maʻi type 2. Hōʻike nā hōʻike o ka metabolism, e like me ke kānāwai, ka maʻamau i ka malama mua ma hope o ka hānau keiki.

Hiki i nā hoʻopiʻi a me nā hopena

Hoʻonui ka mellitus maʻi mellitus i ka hōʻeha o ka hoʻopiʻi a me kahi hopena maikaʻi loa no ka wahine hāpai a me ka maʻi wahine. Hoʻomaʻamaʻa ka maʻi no ka pūpū e hoʻomohala i ka hyperinsulinemia, nā mea ma ke ʻano, hiki ke alakaʻi i ka hana ʻana o nā mea hanu. Eia kekahi, hiki i ke kaʻina pathological ke kumu o ka maʻi fetopathy maʻi, i hōʻike ʻia e macrosomia, i mea e pono ai kahi māhele cesarean. Eia kekahi, hoʻonui ka maʻi gestational diabetes mellitus i ka hopena o ka maluhia a i ʻole ka make o ka pēpē i ka wā neonatal ma mua.

I ka poʻe maʻi me ka maʻi maʻi gestational i ka wā hāpai, nā maʻi lēpa o ka urogenital tract, preeclampsia, eclampsia, ka hana mua o ka wai amniotic, hānau mua, postpartum hemorrhage a me nā hoʻopiʻi hapai nā mea maʻamau.

Me ka hoʻomaka ʻana o ka maʻi kūpono a me ka lawa pono o ka maʻi maʻamau, ua makemake ʻia ka prognosis no ka maʻi maʻi gestational no ka wahine hāpai a me kahi pēpē hānau.

Kāohi

I mea e pale ai i ka hoʻomohala ʻana o ka maʻi mellitus maʻi gestational, ua ʻōlelo ʻia:

• ka malama ana i ke ano o ka wahine i ka wā hapai,
• hoʻoponopono kūloko,
• ʻai maikaʻi
• hāʻawi i nā hana maikaʻi,
• lawa ka hoʻoikaika kino.

ʻO nā hōʻailona nui ka maʻi hānai

ʻO ka hōʻailona nui o ka HD koko kiʻekiʻe. ^ E Ha yM. ʻO kēia maʻi iho he papa unexpressed ʻole.

Hiki i ka wahine ke make wai, wikiwiki a luhi. E holomua ka momona, akā i ka manawa like ia e lilo ai ke kaumaha.

ʻAʻole hiki i ka wahine ke mālama i kēlā mau hōʻailona, ​​me ka manaʻoʻiʻo o ka hopena kēia o ka hapai. A makehewa ole. ʻO kahi mea e ʻike ai ka ʻoluʻolu ʻole e kiaʻala i ka makuahine e manaʻo ai a ʻike ʻo ia i ke kauka e pili ana iā lākou.

Nā hōʻailona o ka latent o ka maʻi

Inā hele ka maʻi, hiki i kēia mau hōʻailona:

• ka waha maloʻo maloʻo (ʻoiai ʻo ka nui o nā wai inu),
• hookeau pinepine,
• ake a makemake hou e hoʻomaha mālie
• ulu ka ʻike
• ulu ka momona, a me nā paona o ia paona.

I ka makewai a me ka makemake maikaʻi, paʻakikī ke hoʻomaopopo i nā hōʻailona o ka maʻi lolo, no ka mea, i kahi wahine olakino, ke kali nei no kahi keiki, hoʻonui nā hana nei. No laila, e wehewehe i ka hoʻomālamalama ʻana, kuhikuhi ʻo ke kauka i ka makuahine ʻāpono i kahi noiʻi hou.

Hoʻohana ʻia i ka wā maʻi

I ka nui o nā hihia (he 70%), hoʻololi ʻia ka maʻi e ka meaʻai. Pono kekahi wahine hāpai i hiki ke mālama kūʻokoʻa i ka glycemia.

Hoʻokumu ʻia ka lāʻau mālamaola no HD i nā ʻōkuhi i lalo:

• ua hoʻolālā ʻia ka meaʻai i kēlā me kēia lā inā loaʻa iā 40% ka protein, 40% momona a me 20% mau hāamao,
• e aʻo i ka ʻai liʻiliʻi: 5-7 mau lā i ka lā me ke anuanu o 3 mau hola,
• me ka nui o ke kaumaha, pono nō hoʻi ke kauā o ka calorie: ʻaʻole iʻoi aku ma mua o 25 kcal no ka paona o ke paona. Inā ʻaʻohe wahine ʻē aʻe i ka wahine - 35 kcal i ka kilokilo. E ho'ēmi i ka ʻoluʻolu o ka meaʻai o ka meaʻai e makaʻala a mālie, me ke ʻano ʻole.
• ʻO nā ʻōmaʻomaʻo, a me nā nati a me nā huaʻai, ʻaʻole i haʻalele ʻia mai ka meaʻai. A inā makemake paha ʻoe i ka ʻaiʻai, e sui me nā hua,
• Maiʻai i nā meaʻai maloʻo (malala, palaoa, palaoa kālai ʻia).
• hāʻawi i ke kīʻaha ʻana i ka pā kuke a me ka ʻaihue,
• inu hou - 7-8 mau aniani o ka wai i kēlā lā i kēia lā,
• lawe i nā ʻōlima paʻakikī me kāu kauka, me kēia mau lāʻau ka glucose,
• e hoʻāʻo e hōʻemi i ka nui o ka momona i ka meaʻai, a e hōʻemi i ka protein i 1,5 g no ka kg. Hoʻonui i kāu meaʻai me nā meaʻai.

E hoʻomanaʻo ʻaʻole hiki iā ʻoe ke ʻai i ka makuahine e kali mai nei, no ka mea e ulu ana ke kō mai ka nele i ka ʻai.

Inā hāʻawi ʻole ka meaʻai i ka hopena i manaʻo ʻia, a mālama ʻia ke kiʻekiʻe o ka glucose, a i ʻole ka mea maʻi i ka hoʻāʻo ʻia i ka urine me ka kō maʻamau, ua ʻōlelo ʻia ka therapy insulin.

ʻO ka hala a me ke hoʻoponopono ʻia e hoʻoholo ʻia e nā kauka wale nō ma o ke kaumaha o ka wahine hāpai a me nā makahiki gestational.

Hiki ke hoʻokō ʻia nā ʻōlelo hoʻohālikelike, hōʻike ʻia e kekahi endocrinologist. ʻO ka maʻamau, ua mahele ʻia ke kauā i ʻelua mau wai: i ke kakahiaka (ma mua o ke kakahiaka) a i ke ahiahi (a hiki i ka pāʻina hope).

Insulin therapy ma ke ala ʻaʻole hiki i ka mea pale ke kaʻai, ke hoʻomau i ka holo ʻana o ke ao holoʻokoʻa.

Hoʻomaopopo postpartum

ʻO ka maʻi diabetes gestational kekahi hiʻohiʻona: ʻaʻole nalo ke neʻe ma hope o ka lawe ʻana.

Inā loaʻa he wahine hāpai i ka HD, a laila ʻoi aku ka hopena o ka ʻohi ʻana i ka maʻi maʻamau no kāna mau piʻi aʻe ma o 5 mau manawa.

He hanana koʻikoʻi nui kēia. No laila, nānā mau ka wahine i hope o ka hānau ʻana. No laila, ma hope o 1.5 mau mahina, pono ʻo ia e nānā i ka hoʻoliatohā o ka ʻaina kalapona.

Inā maikaʻi ka hopena, e mālama ʻia ka nānā ʻana i kēlā me kēia mau makahiki ʻekolu. Akā inā ʻike ʻia kahi kipi o ka pale ʻana i ka glucose, hoʻomohala ʻia kahi meaʻai kūikawā, a hoʻonui ka ʻike i 1 manawa i kēlā me kēia makahiki.

E pono ke hoʻolālā ʻia nā hāpai ʻia a pau ma hope mai o kēia hihia, no ka mea, ʻo ka maʻi diabetes (maʻamau 2 mau ʻano ʻano) hiki ke hoʻomohala i kahi mau makahiki ma hope o ka hānau ʻana. E hoʻonui ʻia ka hoʻoikaika kino.

Hoʻonohonoho pinepine ʻia nā pēpē i loko o nā māmā me HD i ka hui ʻoihana no ka make ʻana o nā pēpē a ma lalo o ka mākaʻi loiloi mau.