Wani labarin akan cincin koda na cututtukan siga shine ɗayan mafi mahimmanci akan rukunin yanar gizon mu. Bayanin da ka karanta a ƙasa zai yi tasiri mai kyau game da makomar cutar ciwon kuɗinta da kuma rikitarwarsa, gami da cutar cututtukan cututtukan ƙwaƙwalwa. Abincin ciwon sukari da muke ba da shawarar ku gwada shi ya bambanta sosai da shawarar gargajiya. Magunguna na jinkirta mataki na ƙarshe na gazawar ƙwayar ƙwayar cuta, dialysis da juyawa koda na shekaru da yawa. Amma wannan ba babbar riba ba ce, musamman ga marasa lafiya da ke da nau'in ciwon sukari na 1 na matasa da kuma na tsakiya. Karanta madadin da ingantaccen tsarin tsarin abinci don kula da lalacewar koda koda.
Magungunan sikari na yau da kullun suna ba da shawarar “daidaitaccen” abinci. Karanta irin gwaje-gwajen da kake buƙatar ɗauka don bincika kodan. Idan waɗannan gwaje-gwajen sun nuna maka microalbuminuria, kuma musamman furotin, to tabbas likitanku zai ba ku shawara ku ci ƙasa da furotin. Domin an yi imanin cewa samfuran furotin suna mamaye kodan kuma hakan yana hanzarta haɓakar haɓakar haɓakar koda. Likita zai faɗi kuma ya rubuta akan katin cewa yakamata a rage yawan ƙwayar zuwa kashi 0.7-1 na kilogram 1 na nauyin jiki a rana. Hakanan zakuyi ƙoƙarin cin ƙananan kitse na dabba kamar yadda zai yiwu, kuna fatan rage ƙananan ƙwayoyinku da triglycerides a cikin jini. Fats cike suke da cutarwa musamman ga cutukan jini: man shanu, qwai, man alade.
Koyaya, babban abinda ke shafar kodan a cikin ciwon suga ba shine abincin furotin na abinci ba, sai suga na hawan jini. Idan mutum yana da sukari mai narkewa a hankali, to kuwa za'a iya gano canje-canje na farko a cikin kodan sa bayan shekaru 2-3. Likitocin sun bada shawarar cewa masu ciwon sukari suna iyakance yawan abincin nasu saboda suna ba da shawarar cewa sunadaran rage cin abinci suna kara haɓakar haɓakar koda. A zahiri, sanadin ci gaban cutar sankarau shine yawan sukarin jini, kuma furotin abinci ba shi da alaƙa da shi, sai dai a lokuta mafi tsauri. Bari mu kalli yadda kodan suke aiki don tabbatar da wannan.
Yaya ake tsara kodan mutane da aiki
Kodan na tace ruwa, yawan glucose, magunguna, da sauran abubuwanda zasu iya cutar da jini daga jini, sannan kuma an fitar da sharar a cikin fitsari. Kodan sune sashin jiki wanda ke fitowa daga fitsari. A bisa ga al'ada, kowane koda ya ƙunshi kimanin tace miliyan ƙwalƙwalwa na ciki wanda jini ke wucewa a ƙarƙashin matsin lamba. Wadannan matattara ana kiransu glomeruli. Jini yana shiga cikin glomerulus ta hanyar karamin artery da ake kira afferent (mai shigowa) arteriole. Wannan arteriole yana karewa tare da tarin wasu evenan kankanan jirgin ruwa da ake kira capillaries. A cikin capillaries akwai ramuka na microscopic (pores) waɗanda ke ɗaukar cajin lantarki mara kyau.
Endarshen ƙarshen kowane abin magana yana gudana zuwa cikin arteriole efferent (mai fita), wanda girmanta yakai kusan sau 2 fiye da na mai shigowa. Saboda wannan kunkuntar, matsanancin matsa lamba yana faruwa lokacin da jini yake gudana ta cikin damƙar keɓaɓɓu. A ƙarƙashin rinjayar ƙara matsa lamba, wani ɓangare na ruwa daga jini yana gudana ta cikin pores. Ruwa wanda ya zubo yana gudana cikin capsule wanda ke kewaye da tarin kabilu, daga nan kuma zuwa tubule.
Powayoyin dake cikin capillaries suna da matuƙar diamita waɗanda ƙananan ƙwayoyi, kamar urea da glucose mai yawa, waɗanda suke haɗuwa da fitsari, suna fitowa daga jini zuwa cikin ruwa tare da ruwa. A halin da ake ciki na al'ada, manyan ƙwayoyin diamita (sunadarai) ba zasu iya wuce ta pores ba. Yawancin sunadaran jini suna dauke da cajin wutan lantarki. An jingina su daga hanun illaan mulkin mallaka, saboda su ma suna da mummunan laifi. Sakamakon wannan, koda ƙananan sunadarai ba su rub da ciki da kodan kuma ba a keɓance su a cikin fitsari ba, amma ana mayar da su zuwa ga jini.
Matsakaici na tacewa (GFR) alama ce ta yawan aikin zubar jini da kodan ke aiwatarwa a cikin wani lokaci lokaci. Ana iya yin lissafi ta hanyar wucewa gwajin jini don creatinine (yadda ake yin wannan, daki daki). Yayin da gazawar haɓaka ke ci gaba, ƙarar ƙimar ƙasa ta raguwa. Amma a cikin masu ciwon sukari da ke da hauhawar sukari na jini na lokaci-lokaci, yayin da kodan har yanzu suna aiki yadda yakamata, da farko adadin ƙirar gurɓatar ƙasa yana ƙaruwa. A irin waɗannan yanayi, ya zama sama da na al'ada. Wannan saboda wuce haddi a cikin jini yana jawo ruwa daga kyallen da ke kewaye. Don haka, yawan jini yana ƙaruwa, hawan jini da kuma yawan hauhawar jini ta cikin kodan yana ƙaruwa. A cikin marasa lafiya da ciwon sukari, a farkon cutar, kafin lalacewar koda na kullum, ƙirar fillo na duniya tana iya zama sau 1.5-2 sama da na al'ada. A lokacin rana, irin waɗannan mutanen da suke fitar da fitsari a yawancin dubun gram na glucose.
Me yasa babban barazanar da kodan shine sukari mai yawa
Yawan wucewar glucose a cikin jini yana da sakamako mai guba a jikin tsarin daban-daban na jikin mutum, saboda kwayoyin glucose suna hade da sunadarai kuma suna tarwatsa aikin su. Wannan ana kiran shi amsawar glycosylation. Kafin masana kimiyya suyi nazarin wannan amsa a hankali, sun ɗauka cewa hauhawar jini, i.e., haɓaka ƙira a cikin ƙasa da haɓakar ƙwaƙwalwar koda, shine sanadin cututtukan cututtukan cututtukan zuciya. Bayan karanta sashin da ya gabata na labarin, yanzu kun san cewa haɓakar ɗaukar ƙasidar ba matsala ba ce, amma sakamakon hakan. Dalilin gaske na haɓakar ƙarancin ƙwaƙwalwar koda shine sakamako mai guba wanda karuwar sukari jini keyi akan sel.
A cikin aiwatar da amfani da sunadaran abinci a cikin jiki, ana samar da samfuran sharar gida - urea da ammonia, waɗanda ke ɗauke da nitrogen. Komawa a cikin karni na 20 na karni, masana kimiyya sun ba da shawarar cewa yawan kuzarin dunƙulewa a cikin ƙodan yana ƙaruwa saboda buƙatar tsarkake jini daga urea da ammoniya. Sabili da haka, an ba da shawarar marasa lafiya da ciwon sukari kuma har yanzu suna ba da shawarar cin ƙarancin furotin don rage nauyi a kan kodan. Amma wani binciken da masanan kimiyyar Isra'ila suka nuna cewa a cikin mutane masu lafiya ba tare da ciwon sukari ba, yawan fillo a cikin kodan ya kasance iri ɗaya ne a kan abinci mai wadataccen furotin da kuma abincin masu cin ganyayyaki. Shekaru da yawa, an gano cewa kasancewar ƙarancin koda tsakanin masu cin ganyayyaki da masu cin nama ba ta ƙididdiga ba. Hakanan an tabbatar da cewa ƙaruwar ƙaruwar matattara mai ɗorewa ba lallai ba ne ko isasshen yanayin ci gaban cututtukan cututtukan ƙwaƙwalwar mahaifa.
Nazarin Harvard ya nuna waɗannan. Groupungiyar rukunin berayen sun riƙe sukarin jini a matakin kimanin 14 mmol / L. Cutar mai fama da ciwon sukari ta ci gaba cikin sauri cikin ɗayan waɗannan berayen. Idan an kara samun furotin a cikin abincin su, to sai aka bunkasa ci gaban kasa koda. A cikin gungun makwabta na berayen, sukarin jini shine 5.5 mmol / L. Dukkansu sun yi rayuwa ta al'ada. Babu wanin su da ke fama da cutar sankara, duk da yawan furotin da suka cinye. Hakanan yana da ban sha'awa cewa aikin koda ya farfado a cikin 'yan watanni bayan da sukarin jininsu ya ragu zuwa al'ada.
Yadda cutar siga ke lalata kodan: ka'idar zamani
Ka'idar zamani game da ci gaban cututtukan cututtukan ƙwaƙwalwar ƙwayar cuta shine cewa a lokaci guda abubuwa da yawa suna shafar maganin capillaries a cikin ƙwayar kodan. Wannan glycation na sunadarai saboda yawan jini mai yawa, har ila yau, rigakafi zuwa glycated sunadarai, mai wuce haddi na platelet a cikin jini da kuma katange kananan ƙananan jijiyoyin jini. A wani matakin farko na lalacewar koda, ƙarfin mummunan wutan lantarki a cikin ƙwayoyin capillaries yana raguwa. Sakamakon wannan, sunadaran da ake zargi marassa nauyi a mafi kankanin diamita, musamman, albumin, ya fara zubowa daga jini cikin fitsari. Idan urinalysis ya nuna yana dauke da albumin, to wannan ana kiran shi microalbuminuria kuma yana nufin haɓakar haɗarin rashin lafiyar koda, bugun zuciya, da bugun jini.
Sunadarai masu alaƙa da glucose na zubowa ta cikin filayen ƙwayar ƙwayar jikin dan adam yafi sauki fiye da yadda suke. Pressureara yawan hawan jini, gami da haɗuwa da insulin a cikin jini, haɓaka ƙonewa a cikin ƙodan, kuma don haka ƙarin sunadarai suna ratsa ta cikin matatun. Wasu daga cikin waɗannan sunadarai, waɗanda ke da alaƙa da glucose, suna manne da mesangium - wannan ita ce ƙwaya tsakanin ƙwayoyin. Ana samun mahimmancin tarin sunadarai masu guba da ƙwayoyin cuta a cikinsu ana samunsu ne a cikin ƙoshin yara na mutanen da ke fama da ciwon sukari, kan bangon capillaries da kuma cikin mesangium. Wadannan gungu a hankali suna girma, mesangium yayi kauri kuma ya fara matsi da kayan. A sakamakon haka, diamita na pores a cikin capillaries yana ƙaruwa, kuma sunadarai na ƙara yawan diamita sun sami damar rarrabe jini daga cikin su.
Tsarin halakar da kodan yana hanzarta, saboda ƙari sunadarai masu glycated sun tsaya a cikin mesangium, kuma yana ci gaba da ƙaruwa. A ƙarshe, mesangium da capillaries ana maye gurbinsu da tabo, saboda abin da renal glomerulus ya daina aiki. Tsananin mesangium ana ganin shi a cikin marassa lafiyar da ke da mummunar sarrafa ciwon sukari, tun kafin albumin da sauran sunadarai su fara bayyana a cikin fitsari.
Yawancin binciken da aka yi a cikin mutane sun nuna cewa idan an inganta iko da sukari na jini, to a farkon matakan cutar sankarar jini, ƙanƙara mai narkewa a cikin ƙasa ya ragu zuwa al'ada, kuma tattarawar furotin a cikin fitsari shima yana raguwa. Idan sukari ya kasance yana zama mai ɗaukar nauyi har abada, to lalacewar koda yana ci gaba. Yin nazarin berayen masu ciwon sukari, masu ilimin kimiyya sun lura cewa idan suka rage sukarin jininsu zuwa al'ada kuma su rike ta al'ada, to sabbin glomeruli suna fitowa a cikin kodon maimakon waɗanda suka lalace.
Shin kwalagen kwayoyi suna shafar kodan?
Increasedara yawan ƙwayoyin cuta da “mummunan” cholesterol da triglycerides (fats) a cikin jini yana haɓaka garkuwar tasoshin jini ta hanyar filayen atherosclerotic. Kowa ya san cewa wannan yana haifar da haɗarin cututtukan zuciya. Sai dai itace tasoshin da suke bayarda jini ga kodan suci gaba da cutar atherosclerosis kamar dai yadda ake yin jijiya mafi girma. Idan tasoshin da ke ciyar da kodan suna hana su ta hanyar barin jiki, to kuwa matsanancin ƙwayoyin ƙwayoyin cuta na haɓaka. Wannan ana kiran shi stenosis (kunkuntar) na artal din koda kuma yana nufin cewa gazawar koda a cikin ciwon sukari yana haɓaka da sauri. Akwai wasu hanyoyin da “mummunan” cholesterol da yawaitar triglycerides a cikin jini suna lalata kodan.
Conclusionarshen shine cewa kuna buƙatar saka idanu game da cholesterol da abubuwan triglycerides a cikin jini, shine, a kai a kai gwaje-gwaje don ciwon sukari. Don kiyaye su tsakanin iyakoki na al'ada, likitoci suna ta tsara magunguna daga ɗimbin mutun-mutumi shekaru da yawa. Wadannan kwayoyi suna da tsada kuma suna da sakamako masu illa: haɓaka gajiya kuma yana iya lalata hanta. Labari mai dadi: rage cin abinci a cikin karasba yana ba da sukari jini kawai ba, har ma da cholesterol da triglycerides. Statauki gumaka kawai idan gwajin da aka maimaita shi bayan makonni 6 ya nuna cewa rage cin abinci mai ƙura da ƙwayoyi ba ya taimaka. Wannan ba zai yiwu ba idan aka hore ka bin tsarin abinci kuma ka ƙaurace ma haramcin abinci.
Zabi tsakanin karamin carb da karancin abinci mai gina jiki
Idan kunyi nazarin wani nau'in magani na ciwon sukari na nau'in 1 ko shirin kula da masu ciwon sukari na 2 kuma kun yi ƙoƙari ku bi shawarar, kun san cewa rage cin abinci mai narkewa yana ba ku damar rage sukari na jini zuwa al'ada kuma ku tsayar da shi al'ada, kamar yadda yake cikin mutane masu ƙoshin lafiya ba tare da ciwon sukari ba. Karanta cikakkun bayanai menene hanyar ƙananan ɗimbin yawa. Kun riga kun gani da kanku cewa "daidaitaccen" abincin, kazalika da furotin mai ƙima da mai-mai mai ƙoshin gaske, baya ƙyale sukari ya daidaita. An cika su da carbohydrates, don haka sukari jini a cikin haƙuri tare da ciwon sukari tsalle-rikice-rikice da rikice-rikice sun haɓaka da sauri.
Koyaya, likitoci sun ci gaba da bayar da shawarar rage cin abinci mai karancin furotin ga masu ciwon sukari don rage haɓakar ciwan koda da jinkirta farawa game da ciwon sukari. A kan wannan abincin, an maye gurbin mafi yawan furotin na abin da ake amfani da shi tare da carbohydrates. An yi imanin cewa wannan hanyar abinci mai gina jiki yana rage nauyin a kan kodan, duk da cewa ba ta barin ciwon sukari ya kula da sukarin jini na al'ada. Yadda za a zabi abincin da ya fi dacewa da ƙodan? Wanne abincin ya fi dacewa - low furotin ko low carbohydrate? Amsa: ya dogara da matsayin matakan da ke fama da cutar sankara ta jiki.
Akwai batun rashin dawowa. Idan ka ƙetare shi, glomeruli sun lalace wanda ya zama al'ada na sukari a cikin jini ba zai baka damar dawo da aiki ko haɓakar aikin koda ba. Dr. Bernstein ya ba da shawarar cewa wannan matakin na dawowa shine adadi mai narkewa na kodan na kusan 40 ml / min. Idan adadin filtular duniya ya ragu, sannan rage cin abinci mai dauke da carbohydrate mai dauke da sunadarai ba zai sake taimakawa ba, kawai yana hanzarta farawa da matakin karshe na lalacewa ta kasa. Idan adadin filtular duniya shine 40-60 ml / min, to, daidaituwa na sukari na jini tare da abinci mai ƙayyadaddun carbohydrate zai taimaka matuka wajen tsawan aikin koda. A ƙarshe, idan ƙirar tacewa ta ƙasa ta wuce 60 ml / min, to, a ƙarƙashin rinjayar abincin maras ƙwayar ƙwayar ƙwaƙwalwa, an mayar da kodan gabaɗaya kuma suna aiki, kamar yadda suke cikin mutane masu lafiya. Gano yadda za a kirga adadin filter ɗinku na duniya anan.
Ka tuna cewa rashin abinci mai karancin carbohydrate baya maganin kodan kai tsaye. Babu shakka, yana taimakawa wajen kula da sukarin jini na al'ada cikin masu ciwon suga. Ana tsammanin saboda wannan, ana dawo da aikin koda idan har yanzu batun dawowar ba a riga an wuce shi ba. Don kula da daidaitaccen sukari na yau da kullun, koda akan rage cin abinci na carbohydrate, dole ne a bi tsarin dokar sosai. Dole ne ku zama mai haƙuri game da abinci mara kyau kamar yadda musulmai masu aminci ke haƙuri da naman alade da ruhohi. Auna sukari tare da glucometer a kalla sau 5 a rana, a rayuwa a cikin tsarin sarrafa kansa gaba daya na sukari na jini. Theoƙarin da kuke buƙatar yinwa zai biya kuɗi sau da yawa idan kun tabbatar sukari ya tabbata. Bayan 'yan watanni, gwaje-gwaje zai nuna cewa aikin koda yana kwantar da hankali ko haɓakawa. Sauran rikice-rikice na ciwon sukari kuma zasu koma baya.
Abun kula da ƙwayar cutar koda na Ciwon koda
Marasa lafiya masu ciwon sukari waɗanda ke haifar da gazawar ƙwayar cuta a cikin matakin ƙarshe yana tallafawa rayuwarsu ta hanyoyin dialysis. Yayin waɗannan hanyoyin, ana cire sharar da ke ɗauke da nitrogen daga jini. Dialysis hanya ce mai tsada da mara dadi, tare da babban haɗarin kamuwa da cuta. Don rage tasirin sa, ana roƙon marasa lafiya da su iyakance yawan abincinsu da ƙwayar su. A wannan matakin lalacewar koda, karancin carbohydrate, abinci mai-furotin wanda bai dace ba. A mafi yawancin lokuta, ana maye gurbin furotin na abinci don carbohydrates. Wasu cibiyoyin binciken cututtukan fata na Yamma a yanzu suna ba da shawarar cewa masu ciwon sukari su cinye zaitun maimakon carbohydrates. Tana da ƙoshin abinci mai kyau.
Karshe
Yawan amfani da furotin a cikin abinci ba shine dalilin ci gaban gazawar kasa ba, ciki har da masu fama da cutar sankara. Kawai idan ma'anar komowar baya ta riga an wuce kuma kodan sunyi lalata ba tare da matsala ba, kawai a wannan yanayin, sunadaran abinci na iya haɓaka ci gaban lalacewa na koda.Ciwon sukari ba ya haɓaka idan mai haƙuri ya aiwatar da shirin kula da masu ciwon sukari na nau'in 1 ko shirin kula da masu ciwon sukari na 2, yana horar da tsarinsa kuma yana kula da sukarinsa daidai. Amintaccen abinci a cikin abinci bashi da wani tasirin gaske a ƙimin ƙirar ƙodan. Ciwon sukari na jini mai zurfi da gaske yana rushe kodan idan cutar siga ba ta da kyau.
