Lithethefatsi tse sebetsang bakeng sa kalafo ea lefu la tsoekere la mofuta oa 2

Batho ba bangata ba tlameha ho sebelisa lipilisi tsa hypoglycemic bakeng sa lefu la tsoekere la 2, lenane la moloko o mocha le nchafatsoa selemo se seng le se seng ka liketsahalo tse ncha. Haeba matšoao a "lefu la tsoekere" le boemo ba tsoekere a ka laoloa ke ho ja le ho ikoetlisa, joale nako e bolokiloeng e bolokoa nako, 'me e ke ke ea sebetsana le bothata ka bo eona.

Ho lokela ho hlokomeloe hore ho na le mefuta e 'meli ea lefu la tsoekere - motho o itšetleha ka insulin ebile o sa itšetleha ka insulin. Tabeng ea bobeli, ka thuto e telele ea lefu la tsoekere, batho ba nang le lefu la tsoekere ba qala ho sebelisa lithethefatsi tse hatellang ho hanyetsa insulin.

Mmaraka oa meriana o hlahisa palo e kholo ea lithethefatsi tse theolelang tsoekere, empa e 'ngoe le e' ngoe ea tsona e na le mokhoa o ikhethileng oa ts'ebetso, li-contraindication le likotsi tse ka bang teng. Nahana ka mefuta ea sehlooho ea lithethefatsi tsa hypoglycemic.

Mefuta ea mantlha ea lithethefatsi tsa lefu la tsoekere la mofuta oa 2

Nts'etsopele ea lefu la tsoekere la mofuta oa 1 e amana haholo le lefu la autoimmune. Maemong ana, ts'ebetso ea manyeme e sitisoa, ka lebaka leo lisele tsa beta tsa sesebelisoa sa islet li emisa ho hlahisa li-hormone tse fokotsang tsoekere - insulin. Ho fapana le ea pele, ka lefu la tsoekere la mofuta oa 2, tlhahiso ea lihormone ha e emise. Bothata bona bo amana le kutloelo-bohloko ea li-receptor tsa sele tse amohelang insulin.

Mofuta oa bobeli oa psychology o ama 90% ea batho bohle ba lefu la tsoekere. Khafetsa bana ke batho ba kaholimo ho lilemo tse 40 ho isa ho tse 5 ba natefeloang ke botena kapa ba nang le baena ba nang le lefu la tsoekere.

Ka selemo sa 2017, meriana e mengata e fokotsang tsoekere e se e qapiloe ebile e ntlafalitsoe. Ho fihla joale, mefuta e latelang ea li-hypoglycemic agents e teng.

Ho matlafatsa kutloisiso ea insulin ea lisele:

• thiazolidinediones (Pioglar le Diaglitazone),
• biguanides (metformin).

Lithethefatsi tse ncha tse qalileng ho qaloa ka bo-2000:

1. Li-inhibitors tsa DPP-4 (Ongliza le Yanuviya),
2. alpha glucosidase inhibitors (Glucobai),
3. Li-agonists tsa GLP-1 (li-Viktoza le Baeta).

Hormone e hlohlelletsang:

• meglitinides (Starlix le Novonorm),
• derivatives tsa sulfonylurea (Maninyl, Glurenorm le Diabeteson).

Mofuta oa boraro oa lithethefatsi o ama hampe ts'ebetso ea pancreatic mme oa e theola. Ha o sebelisa meriana ena, hangata ho na le monyetla oa phetoho ea lefu la tsoekere la mofuta oa pele ho la pele.

Lithethefatsi tse boletsoeng pejana bakeng sa kalafo ea lefu la tsoekere la mofuta oa 2 li nkuoa e le motsoako o mocha oa lithethefatsi, le leseli le qaqileng ka seo se tla hlahisoa hamorao.

Likarolo tsa ho fana ka litlhare tsa lefu la tsoekere

Pele ho tsohle, ho khethoa lithethefatsi tse nang le kotsi e fokolang ea hypoglycemia: biguanides, glisitins, incretin. Haeba motho a nang le bothata ba ho ba le botenya le khatello e phahameng ea mali, li-insretin li loketse haholoanyane - li u lumella ho fokotsa boima le ho laola khatello ea maikutlo.

Sekema sa ho khethoa ha Biguanides: litekanyetso tsa pele tsa metformin ke 500 mg makhetlo a 2-3 ka letsatsi ka mor'a lijo. Keketseho e latelang ea litekanyetso e ka etsahala libeke tse peli kamora ho qala kalafo. Tekanyetso e phahameng ea letsatsi le letsatsi ea meriana ena ha ea lokela ho feta 3000 mg. Keketseho ea butle-butle e amahanngoa le litla-morao tse fokolang tse tsoang mokokotlong oa mpa.

Li-gliptins: lithethefatsi tsa lefu la tsoekere la moloko oa ho qetela, li nooa letlapeng 1 (25 mg) ka letsatsi, ho sa tsotelehe lijo tseo motho a li jang.

Tsena: lithethefatsi tsa sehlopha sena li hlahisoa ka tsela ea tharollo ea ente. Li fanoa ka makhetlo a 1 kapa a mabeli ka letsatsi, ho latela moloko.

Haeba monotherapy e fana ka litholoana tse seng ntle, ho sebelisoa litlatsetso tse latelang tsa li-hypoglycemic agents:

1. Metformin + Gliptins.
2. Incretins + metformin.
3. Litokisetso tsa Metformin + sulfonylurea.
4. Li-glinides + metformin.

Metsoako e 'meli ea pele e na le kotsi e fokolang ea hypoglycemia, boima ba eona bo lula bo tsitsitse.

Morero oa ho khetha litokisetso tsa sulfonylurea: ho latela lilemo tsa moriana. Ka tloaelo lithethefatsi li nooa nako e le 'ngoe ka letsatsi hoseng. Ka keketseho ea litekanyetso, mekhoa e ka aroloa hoseng le mantsiboea.

Sesebelisoa sa bongaka sa Clinid: Karolo ea ts'ebeliso ea lithethefatsi tsena ke hore lithethefatsi tsa sehlopha sena li tloaetse ho ja feela 'me li nkuoa kapele ka pel'a lona. Ka tloaelo matlapa a nooa makhetlo a 3 ka letsatsi.

Alpha Glucosidase Inhibitors: katleho ea ho sebelisa meriana e bonoa ha feela u nka matlapa kapele pele ho lijo. Tekanyetso ea pele ea 50 mg e tahiloe makhetlo a 3 ka letsatsi. Tekanyetso e tloaelehileng ea letsatsi le letsatsi ke 300 mg. Bophahamo ke 200 mg makhetlo a 3 ka letsatsi. Haeba ho hlokahala, eketsa tekanyetso ka mor'a libeke tse 4-8.

Thiazolidinediones: lithethefatsi li nooa makhetlo a 1-2 ka letsatsi, ho latela moloko. Nako ea lijo ha e ame ho sebetsa ha bona. Haeba ho hlokahala, eketsa litekanyetso, e eketseha ka mor'a likhoeli tse 1-2.

Lethathamo la lithethefatsi tse theolelang tsoekere

Ngaka e khetha lihlopha tse itseng tsa lithethefatsi, ho nahanela litšobotsi tsa motho ka mong: mafu a kopaneng, boteng ba boima bo feteletseng, mathata a CVS, lijo, jj.

Har'a litlhare tsohle tse sehlopheng sena, methylbiguanide derivatives, metformin e ile ea tsebahala haholo. Mehato ea eona ea ts'ebetso e hlahisoa ka mokhoa oa ho fokotseha ha tlhahiso ea tsoekere ke sebete le ho fokotseha ha insulin ho hanyetsoa ke mesifa le adipose tishu.

Sesebelisoa sa mantlha se sebetsang ke metformin. Litokisetso tse thehiloeng ho eona:

• Merifatin,
• Foromo e telele
• Glyformin
• Diaspora
• Glucophage,
• Siofor
• Diaformin.

• se ke oa ama kapa oa fokotsa boima ba 'mele,
• e ka kopantsoe le mefuta e meng ea litafole ea li-hypoglycemic agents,
• ho ba le kotsi e tlase ea hypoglycemia,
• se ke oa eketsa secretion ea insulin ea hau,
• fokotsa kotsi ea mafu a pelo,
• fokotsa butle kapa ho thibela nts'etsopele ea lefu la tsoekere ho batho ba nang le metabolism ea carbohydrate e senyehileng,
• theko.

• hangata e baka litlamorao ho tsoa mpeng ea mahlaba ka mpeng, ka hona, e laetsoe pele ka tekanyetso e tlase,
• e kanna ea baka lactic acidosis.

• Ho tsamaellana le lijo tse nang le khalori e tlase (ka tlase ho 1000 kcal ka letsatsi).
• Litla-morao tsa tsamaiso efe kapa efe ea likarolo.
• Mathata a sebete, ho kenyeletsa le botahoa.
• Mefuta e matla ea ho kula le ho nyekeloa ke pelo.
• Nako ea kemaro.
• Lilemo tsa bana ho fihlela lilemo tse 10.

Sulfonylureas

Mokhoa o ka sehloohong oa ts'ebetso ke ho tsosa secretion ea insulin ea hau. Lintho tse ka sehloohong tse sebetsang le lithethefatsi bakeng sa lefu la tsoekere la mofuta oa sehlopha sena ke:

1. Gliclazide. Mabitso a Khoebo: Golda MV, Gliclad, Diabetesalong, Glidiab. Diabeteson MV, Diabefarm, Diabinax.
2. Glimepiride: Instolit, Glaim, Diamerid, Amaril, Meglimid.
3. Glycidone: Yuglin, Glurenorm.
4. GlipizideGlardenez.
5. Glibenclamide: Statiglin, Maninil, Glibeks, Glimidstad.

Lithethefatsi tse ling li fumaneha ka sebopeho sa nako e telele - se bitsoang MV (tokollo e fetotsoeng) kapa morao. Sena se etsoa molemong oa ho fokotsa palo ea lipilisi ka letsatsi. Mohlala, Glidiab MV e na le 30 mg ea ntho ena mme e nkuoa hang ka letsatsi, leha lethalamo le eketsehile, 'me Glidiab e tloaelehileng - 80 mg, kamohelo e arotsoe hoseng le mantsiboea.

Melemo ea sehlooho ea sehlopha ke:

• phello e potlakileng
• fokotsa kotsi ea mathata a methapo ea lefu la tsoekere la mofuta oa 2,
• theko.

• kotsi ea hypoglycemia,
• 'mele o li tloaela kapele - Khang ea hola,
• mohlomong le keketseho ea boima ba 'mele,
• e ka ba kotsi bakeng sa mathata a nang le pelo.

• Type 1 lefu la tsoekere
• lilemo tsa bana
• ho ima le ho nyekeloa
• allergy ho sulfonamides le sulfonylureas,
• mafu a ka mpeng
• ketoacidosis, lefu la tsoekere le komello.

Lena ke lebitso le tloaelehileng la lihormone tse hlohlelletsang tlhahiso ea insulin. Tsena li kenyelletsa glucagon-kama peptide-1 (GLP-1) le insulinotropic polypeptide (HIP) ea glucose. Li-incretin tsa "ndo "(proprietary) li hlahisoa ka har'a tšilo ea lijo ho arabela khafetsa ho ja lijo mme li sebetsa ka metsotso e fokolang feela. Bakeng sa batho ba nang le lefu la tsoekere, ho entsoe li-incretin tsa mehleng ea khale, tse nang le ts'ebetso e telele.

Mehato ea ts'ebetso ea "peptide" ea glucagon - 1 receptor agonists:

• Ho hlohlelletsa insulin.
• Secretion ea tsoekere e theohileng.
• Tlhahiso ea tsoekere e theohileng ke sebete.
• Sekhahla sa lijo se siea mpa e le ka mpeng, 'me se baka ho fokotseha ha lijo le ho theola boima ba' mele.

Lintho tse sebetsang le lithethefatsi tse etsisang litlamorao tsa GLP-1:

1. Exenatide: Byeta.
2. Liraglutide: Victoza, Saxenda.

• ba na le litlamorao tse tšoanang le tsa bona tsa GLP-1,
• Khahlano le bokapele ba kopo, ho na le phokotso ea boima ba 'mele,
• hemoglobin ea glycated e fokotseha.

• ha ho na mefuta ea litafole, lithethefatsi li kentsoe,
• Kotsi e kholo ea hypoglycemia,
• litla-morao tse tsoang khafetsa ka mpeng,
• theko.

• Type 1 lefu la tsoekere
• ho ima le ho nyekeloa
• ho se mamelle setho ka seng sa likarolo,
• lilemo tsa bana.

Ho ea ka saense, li bitsoa IDPP-4 kapa mofuta 4 dipeptidyl peptidase inhibitors. Hape ke karolo ea sehlopha sa "" "" "" "" "" "" "" "" "" "" "" "" "" "" "" "" "" ""> Mochine oa ts'ebetso o khethoa ke ho potlakisa tlhahiso ea li-hormone tsa hae tsa ka mpeng, tse tsosang tšusumetso ea "insulin" makhophong ho latela bongata ba tsoekere. Li boetse li fokotsa tlhahiso ea tsoekere ka bongata 'me li fokotsa tlhahiso ea tsoekere ke sebete.

Ho na le lintho tse 'maloa le litokisetso tsa bona:

1. Sitagliptin: Januvius, Yasitara, Xelevia.
2. Vildagliptin: Galvus.
3. Saxagliptin: Onglisa.
4. Linagliptin: Trazenta.
5. Alogliptin: Vipidia.

• kotsi e tlase ea hypoglycemia,
• u se ke oa ama boima ba 'mele,
• susumetsa nchafatso ea lisele tsa manyeme, tse lumellang lefu la tsoekere ho tsoela pele butle butle,
• e fumaneha ka foromo ea letlapa.

• ha ho na data e ka tšeptjoang ea polokeho ka tšebeliso ea nako e telele,
• theko.

1. Nako ea bokhachane le pelehi.
2. Type 1 lefu la tsoekere.
3. Lefu la tsoekere la ketoacidosis.
4. Lilemo tsa bana.

Alpha Glucosidase Inhibitors

Mokhoa o ka sehloohong oa ts'ebetso ke ho liehisa ho kenngoa ha lik'habohaedreite ka mala. Lintho li feto-fetoha le maemo li thibela mosebetsi oa li-enzyme tse ikarabellang bakeng sa ho phatloha ha li-disaccharides le oligosaccharides ho glucose le fructose leseling la mala a manyane. Ho feta moo, ha li ame lisele tsa pancreatic.

Sehlopha sena se kenyelletsa motsoako oa acarbose, eo e leng karolo ea lithethefatsi Glucobay.

Mabaka a moriana:

• ha e ame ho nona haholo,
• kotsi e tlase haholo ea hypoglycemia,
• e fokotsa kotsi ea ho ba le lefu la tsoekere la mofuta oa 2 ho batho ba nang le mamello ea tsoekere e maling,
• e fokotsa kotsi ea mathata a pelo le pelo.

• litla-morao tse tsoang khafetsa ka mpeng,
• katleho e tlase ho feta li-agents tse ling tsa molomo tsa hypoglycemic,
• ho amoheloa khafetsa - makhetlo a 3 ka letsatsi.

1. Nako ea bokhachane le pelehi.
2. Lilemo tsa bana.
3. Litla-morao tsa tsamaiso efe kapa efe ea likarolo tsa moriana.
4. Boloetse ba Bowel.
5. Ho hloleha ho ho phekola ha liphoko.

Mokhoa o ka sehloohong oa ts'ebetso ke ho tsosa tlhahiso ea insulin. Ho fapana le lihlopha tse ling tsa meriana, li etsa hore ho be le keketseho ea "insulin" ka mor'a metsotso e 15 kamora ho ja, ka lebaka leo "lits'oants'o" tsa "glucose" li fokotsang khatello ea mali. Khatello ea lihormone ka boeona e khutlela ho boleng ba eona ba pele lihora tse 3-4 kamora lethal dose la ho qetela.

Lintho tse ka sehloohong le lithethefatsi ke:

1. Repaglinide. Mabitso a khoebo: Iglinid, Diclinid, NovoNorm.
2. Nateglinide: Starlix.

• lebelo la ts'ebetso qalong ea kalafo,
• monyetla oa ho sebelisoa ke batho ba nang le lijo tse sa tloaelehang,
• taolo ea postprandial hyperglycemia - ha boemo ba tsoekere ea mali bo nyoloha ka mor'a lijo tse tloaelehileng ho isa ho 10 mmol / l kapa ho feta.

• boima ba 'mele
• polokeho ea lithethefatsi ha e tiisoe ka tšebeliso ea nako e telele,
• khafetsa ea tšebeliso e lekana le palo ea lijo,
• theko.

• lilemo tsa bana le tsa senile
• nako ea kemaro le kanyeso,
• Type 1 lefu la tsoekere
• lefu la tsoekere la ketoacidosis.

Thiazolidinediones

Lebitso la bona le leng ke glitazone. Ke sehlopha sa batšehetsi ba maikutlo - ba eketsa monyetla oa hore lisele li sebetse ho insulin, ke hore, fokotsa insulin. Mokhoa oa ts'ebetso ke ho eketsa ts'ebeliso ea tsoekere ho sebete. Ho fapana le lintho tse tsoang ho sulfonylurea, lithethefatsi tsena ha li khothalletse tlhahiso ea lisele tsa pancreatic beta ka insulin.

Lintho tse ka sehloohong le litokisetso tsa bona ke:

1. Peoglitazone. Mabitso a Khoebo: Pioglar, Diab-Norm, Amalvia, Diaglitazone, Astrozone, Pioglit.
2. Rosiglitazone: Avandia.

• ho fokotsa kotsi ea mathata a maholohadi,
• kotsi e tlase ea hypoglycemia,
• Ho itšireletsa khahlanong le lisele tsa beta tsa manyeme,
• fokotsa kotsi ea ho ba le lefu la tsoekere la mofuta oa 2 ho batho ba rerileng hore,
• ho fokotseha ha triglycerides le ho eketseha ha litekanyetso tse phahameng tsa mali lipoprotein maling.

• boima ba 'mele
• Ho ruruha ha lipheletso hangata ho etsahala,
• menyetla e eketsehileng ea ho robeha ha masapo a lefuba ho basali,
• phello e tsoela pele butle
• theko.

• lefu la sebete
• Type 1 lefu la tsoekere
• lefu la tsoekere ketoacidosis,
• nako ea kemaro le kanyeso,
• lefu la pelo le matla
• lilemo tsa bana
• edema ea tšimoloho efe kapa efe.

Type 2 lefu la tsoekere

Ba leka hore ba se ke ba fana ka litokisetso tsa "insulin" - qalong ba li laola ka mokhoa oa Letlapa. Empa ka linako tse ling liente tsa insulin li hlokahala esita le qalong ea kalafo.

1. Ho fumanoa ha pele ho lefu la tsoekere la mofuta oa 2, ha tekanyo ea hemoglobin ea glycated> 9% le ho supa matšoao a ho bola.
2. Ho hloka matla ha ho fana ka litekanyetso tse phahameng tse lumelletsoeng tsa lithethefatsi tse theotsoeng tsoekere.
3. Ho ba teng ha li-contraindication le litla-morao tse boletsoeng ho tsoa matlapeng.
4. Ketoacidosis.
5. Phetisetso ea nakoana e ka etsahala ha opereishene e emetse motho kapa ho ata ha maloetse a mang a sa foleng a hlahileng moo ho ka khonehang ho bolaoa ha metabolism ea carbohydrate.
6. Boimana (maemong a mangata).

Lithethefatsi tse thibelang kelello

Hypertension hammoho le lefu la tsoekere li theha motsoako o phatlohang haholo - menyetla ea ho tšoaroa ke pelo, stroke, ho foufala le mathata a mang a kotsi li eketseha. Ho fokotsa menyetla ea kholo ea bona ea tsoekere, ba nang le lefu la tsoekere ba qobelloa ho lekola khatello ea bona ka hloko ho feta ba bang.

Lihlopha tsa antihypertensive:

1. Lithala tsa calcium calcium.
2. Li-inhibitors tsa ACE.
3. Diuretics.
4. Beta blockers.
5. Angiotensin-II receptor blockers.

Hangata, ka lefu la tsoekere la mofuta oa 2, ho behiloe li-inhibitors tsa ACE.Sehlopha sena se kenyeletsa:

Ke sehlopha sa lintho tse thusang ho fokotsa methapo ea methapo ea methapo le cholesterol ea mali. Ho na le meloko e mengata ea li-statins:

1. Lovastatin, Simvastatin, Pravastatin.
2. Fluvastatin
3. Atorvastatin.
4. Pitavastatin, rosuvastatin.

Lithethefatsi, ntho e sebetsang ea eona ke atorvastatin:

E thehiloe ho rosuvastatin:

Litholoana tse ntle tsa li-statins:

• Thibelo ea mali.
• Ho ntlafatsa boemo ba methapo e ka hare ea methapo ea mali.
• Kotsi ea ho ba le mathata a ischemic, infarction ea myocardial, stroke le lefu ka lebaka la bona e ea fokotsoa.

Alpha Lipoic (Thioctic) Acid

Ke moemeli oa metabolic le antioidid ea endo native. E sebelisoa ho laola metabolism ea lipid le carbohydrate, ho tsosa metabolism ea cholesterol. Ntho ena e thusa ho fokotsa khatello ea "glucose" maling, e eketsa glycogen sebete le ho hlola insulin.

Lithethefatsi tse thehiloeng ho eona li na le litlamorao tse latelang:

1. Hepatoprotective.
2. Hypolipidemic.
3. Hypocholesterolemic.
4. Hypoglycemic.
5. Trophara ea li-neuron ea ntlafala.

Lithethefatsi tse thehiloeng ho Thioctic acid lia fumaneha ka litekanyetso tse fapaneng le mefuta ea tokollo. Mabitso a mang a khoebo:

Litsebi tsa lefu la tsoekere li nka lithethefatsi tsena bakeng sa polyneuropathy - tahlehelo ea maikutlo ka lebaka la tšenyo ea methapo ea kutlo, haholo maotong.

Li-Neuroprotectors

Li-neuroprotectors ke motsoako oa lihlopha tse 'maloa tsa lintho tseo sepheo sa tsona e leng ho sireletsa li-neurons tsa boko litšenyehelong, li boetse li khona ho ama metabolism hantle, ho ntlafatsa phepelo ea matla ea lisele tsa methapo ea kutlo le ho li sireletsa maemong a bohale.

1. Nootropics.
2. Li-antioxidants.
3. Adaptogens.
4. Mabaka a semelo sa semela.

Lithethefatsi tsa lihlopha tsena li sebelisoa ke batho ba nang le lefu la tsoekere la mofuta oa 2, bao lefu la tsoekere kapa hypoglycemic encephalopathy le fumanoang ho lona. Ho kula ho hlaha ka lebaka la mathata a metabolic le vascular ka lebaka la lefu la tsoekere.

Mofuta oa 2 oa lefu la tsoekere

Mofuta oa 2 oa lefu la tsoekere ke lefu la endocrine leo ho lona tlolo ea kutloisiso ea ketso ea insulin e hlahang teng linthong tsa mmele. Tlhahiso e phahameng ea "li-pancreatic" tsa "pancreatic" tse bakoang ke lefu lena e theola lisebelisoa tsa lisele, tlhahiso ea "insulin" e qala ho fokotseha, e lebisang tlhokahalo ea ente ea eona. Hangata lefu lena le qala ka mor'a lilemo tse 40. Ho qala ha lefu lena ho bakoa ke mathata a bophelo bo botle ba kahare 'me ha hoa itšetleha ka mathata a liphatsa tsa lefutso. Bakuli ba bangata ba na le index ea boima ba 'mele.

Lefu la tsoekere le bua ka mefuta ea maloetse moo ho tsebahatsoa sesosa sa ho qala ha lefu lena ho bapala karolo ea bohlokoa. Khahlano le semelo sa kalafo ea lithethefatsi, ntho ea bohlokoa-pele ke phetiso ea bophelo ba mokuli, haholoholo mabapi le ho hana mekhoa e mebe. Tšebeliso ea lijo tse nang le index e phahameng ea glycemic (bokhoni ba ho eketsa tsoekere ea mali) e tlameha ho fokotsoa. Mokhoa o akaretsang oa kalafo ea lefu la tsoekere ho banna, basali, bana le maqheku o batla o tšoana.

Ho khothalletsoa ho fokotsa sekhahla sa mafura a liphoofolo, lik'habohaedreite tse bonolo lijong tsa hau. Lijo li lokela ho ba khafetsa ebile e le likarolo tse nyane. Hoa hlokahala ho etsa mohopolo oa litšenyehelo tsa matla nakong ea motšehare mme ho latela sena, u rala khalori ea lijo. Ka bophelo ba ho lula fatše, ha ua lokela ho ja sekotlolo sa sopho le pan ea litapole ka nama, e hlatsoitsoeng ka tee e tsoekere. Meriana ha ea lokela ho nyahlatsoa haeba e laetsoe. Ho bontša ho ikoetlisa ka tsela ea ho baleha kapa ho sesa.

Lipheo tsa mantlha tsa kalafo

Phekolo e qala ka ts'ebeliso ea moriana o le mong ebe butle-butle o fetohela ho tse 'maloa, ebe, haeba ho hlokahala, oa insulin. Pheko e rarahaneng ea lefu la tsoekere la mofuta oa 2 e etselitsoe ho otla lefu lena ho tsoa maemong a 'maloa.

1. Phekolo e lokela ho ntlafatsa tlhahiso ea insulin, e lebisang pusong ea lefu la tsoekere.
2. Hoa hlokahala ho fihlela ho fokotseha ha tekanyo ea insulin ea ho hanela lisele tsa mmele.
3. Ho fokotsa ts'oarello ea tsoekere le ho monya ha eona ho tsoa pampiring ea mala ka mali.
4. Ho tlisa tloaelo e lekanang ea lipids tse maling (dyslipidemia).

Phekolo ea lefu la tsoekere la mofuta oa 2 ntle le meriana

Ho na le molemo ho lik'hamphani tsa meriana ho ts'ehetsa maikutlo a hore batho ba nang le lefu la tsoekere ba sa foleng ba lokela ho nka ente ea insulin le ho sebelisa lithethefatsi tse fetisang tsoekere bophelo bohle ba bona. Empa insulin le "chemistry" li na le litlamorao. Ka hona, pheko ntle le lithethefatsi e ntse e tsoela pele ho ba e loketseng. Mekhoa e mengata ea kalafo e se nang lithethefatsi e tsejoa:

1. Ho fetolela lijong tse theko e tlase tsa carb le ho eketsa makhetlo a lijo.
2. Lisebelisoa tsa litlama tsa litlama, tse etselitsoeng ho tlisa limela le metso ho fihlela boemo bo holimo ka ho fetisisa bo teng lijong, tse fokotsang maemo a tsoekere.
3. Thupelo E laola tlhahiso ea insulin, e ntlafatsa lipalo tsa mali.
4. Ho ikoetlisa ho thusa ho chesa tsoekere ea mali.

Pheko ea 'mele

Ts'ebeliso ea lintho tse fapaneng tsa 'mele (leseli, radiation, mocheso le tse ling) e bontšitse katleho ea bongaka. Ho sebelisoa mekhoa e latelang:

1. Electrophoresis Ka letlalo, lithethefatsi li kenngoa 'meleng tse nang le tšusumetso' meleng. Litsebi tsa tsoekere li fuoa li-electrophoresis tse nang le magnesium.
2. Magnetotherapy. Ka thuso ea lisebelisoa tse ikhethang, ho sebelisoa matla a makenete ho manyeme.
3. Ho fetoha le moea oa oksijene. Mokhoa ke ho kenya oksijene ka phapusing e khethehileng. E sebetsa hantle bakeng sa hypoxia ho lefu la tsoekere.
4. Plasmapheresis. Ke tlhoekiso ea mali. E bonts'oa batho ba nang le lefu la tsoekere ba nang le bothata ba ho phekola masapo, ho tahoa.
5. Therapy ea Ozone Nakong ea phekolo, ho eketseha ha lisele ho tsoekere ea glucose, tsoekere ea mali e ea fokotseha.

Boikoetliso ba 'mele

Phekolo ea 'mele eu lumella ho chesa tsoekere e ngata maling, e fokotsa boima ba' mele, e eketse phallo ea mali mesifa. Ho lefu la tsoekere, ngaka e ka khothaletsa boikoetliso:

1. Ho tsamaea ka maoto: ho phahamisa mangole a hau holimo, ho itsamaela ka sebaka sa metsotso e 2,5.
2. Mehato: ema u otlolohile, matsoho a hae fatše. Ebe u khutlela morao ka leoto la hau le letšehali, ha u ntse u phahamisa matsoho le ho hema ka nako e le 'ngoe. Ebe u exhale, theola matsoho, 'me u eme.
3. Ho kenyelletsa: ema u otlolohile, feto-fetoha ka ho ama menoana ea hau.

Litlhare tsa setso

Lefu la tsoekere le 'nile la tsebahala ho tloha mehleng ea khale' me meriana ea setso e hlahisitse mekhoa e mengata le mekhoa ea ho loants'a lefu lena. Litlhare bakeng sa lefu la tsoekere la mofuta oa 2:

1. Ntle: tšela makhasi a sa tsoa khethoa ka metsi a belang 'me u tsamaee lihora tse 8, u sehathatse le senoelo sa senoelo, makhetlo a mararo ka letsatsi pele ho lijo.
2. Ho reka lipere: ho bokella lithupa, tšela metsi a belang ebe u pheha metsotso e 5. Tsitlella lihora tse peli. Nka halofo ea khalase habeli ka letsatsi pele u e-ja.
3. Motsoako oa Dandelion: etsa likhaba tse peli tsa metso e omisitsoeng ka lilithara tse 0,5 tsa metsi a belang ebe u tlohela lihora tse 4. Nka halofo ea khalase pele u e-ja habeli ka letsatsi. Kalafo ea mofuta oa 2 lefu la tsoekere le kalafo ea setso e lokela ho etsoa kamora ho buisana le ngaka.

Phekolo ea mofuta oa 2 lefu la tsoekere le lithethefatsi

Ngaka e tla u thusa ho fumana litlhare tse fokotsang tsoekere ho phekola lefu la tsoekere la mofuta oa 2 ho latela boteng ba lefu lena le ho ba teng ha mathata ho mokuli. Lihlopha tse tsebahalang tsa lithethefatsi ke:

1. Litokisetso tsa Sulfonylurea - Glimepiride, Chlorpropamide. Li tsosa secretion ea li-pancreatic hormone, li fokotsa ho hanyetsoa ha lisele tsa pherekano ho insulin.
2. Biguanides - Metformin, e phahamisa maikutlo a lisele tsa mesifa le mesifa ho insulin, e lebisang ho fokotsa boima ba 'mele, metabolism e ntlafalitsoeng ea mafura.
3. Lits'oants'o tsa thiazolidatedione - Troglitazone, Rosiglitazone. Ba eketsa ts'ebetso ea li-insulin receptor, li fokotsa maemo a tsoekere.
4. Alpha-glucosidase inhibitors - Acarbose, Miglitol, e sitisa ho kenngoa ha lik'habohaedreite ka seterateng sa gastrointestinal, e fokotsa hyperglycemia.
5. Dipeptidyl peptidase inhibitors - Sitagliptin, e baka keketseho ea kutloelo-bohloko ea lisele tsa pancreatic.

Sesebelisoa sa hypoglycemic sa molomo ke vipidia, se ntlafatsang taolo ea metabolism ea plasma ea glycemia. Moriana o ka sebelisoa ho monotherapy kapa ka mekhoa e meng, ho kenyeletsa insulin. Contraindication bakeng sa ts'ebeliso ea Vipidia ke ho ba teng ha hypersensitivity ho alogliptin, ketoacidosis, mathata a sebete le a liphio, boimana le bophelo bo botle. Phekolo ea kalafo ea moriana ke 25 mg hang ka letsatsi, ho sa tsotelehe menyetla ea lijo.

Liphetoho tsa bioloji (BAA) tse sebelisitsoeng kalafo ea lefu la tsoekere la mofuta oa 2 li kenyeletsa pheko ea tlhaho ea Diapil. E laetsoe ho fokotsa tsoekere ea mali, ho etsa hore metabolism ea "carbohydrate e fetole" le ho thibela nts'etsopele ea mathata a lefu la tsoekere. Sebopeho sa tlatsetso ea lijo se kenyelletsa tlhahiso ea setlama le herrographis, e nang le matla a ho hanyetsa le ho fokola. Ho latela lipatlisiso tsa bakuli ba nkang Diapil, lithethefatsi li fokotsa tlhokahalo ea insulin.

Mokhoa o atlehang ka ho fetisisa oa phekolo ea lefu la tsoekere

Phekolo ea lefu la tsoekere la mofuta oa 2 e kenyelletsa litlhare tse latelang tse sebetsang tse mabapi le metformin:

1. The drug Glucophage - moriana oa mantlha oa ketso ea nako e telele, o nooe bosiu, o sebetsa ka mor'a lihora tse 10. Kameho ea ho kenella ke glucose e tlase ka mpeng e se nang letho hoseng.
2. Siofor - analog ea theko e tlase ea Glucofage, e ka sebelisoa ho thibela nts'etsopele ea lefu la tsoekere la mofuta oa 2. Nka litafole tsa metformin 1-2 habeli ka letsatsi. Setlhare se sebetsa hantle halofo ea hora. Ho eketsa lethal dose ho etsoa butle butle hore acidosis e se ke ea hlaha.

Ncha ho Mofuta oa 2 lefu la tsoekere

Ho fihla joale, bo-rasaense le lingaka ba se ba qapile kapa ba ntse ba etsa lipatlisiso ho fumana mekhoa e mecha ea ho phekola lefu la tsoekere la mofuta oa 2:

1. Lijo tse nang le phepo e tlase ea carb hammoho le ho ikoetlisa hangata li sebetsa hantle ho feta lipilisi.
2. Lihlopha tsa lithethefatsi tse ntšang tsoekere e ngata ho feta liphio.
3. Ente ke lisele tsa stem tse fumanoeng mohala oa makhubu a masea a sa tsoa tsoaloa.

Ho laola tsoekere ea mali, o hloka ho latela lijo tse itseng. E ipapisitse le lipalo tsa index ea glycemic (GI). Lijo tse nang le lik'habohaedreite tse tlase li lumelloa ka har'a lijo tse nang le lithibelo tse ngata, tse nang le phahameng - li thibetsoe ka thata. Lethathamo la mehlala ea lijo tse lumelloang le tse thibetsoeng:

Garlic, eiee, tamati, mefuta eohle ea hop, likomkomere, linaoa tse tala, li-turnips

Poone e monate e khabisitsoeng, li-beet, litapole, mokopu

Liapole, litholoana tsa morara, plums, liapole,

Melon, libanana, liphaenapole

Harese, lierekisi, lensisi, poone, bulgur, oatmeal, buckwheat

Semolina, granola, lijo-thollo tse tsoang hang-hang

Fructose, chokolete e lefifi,

Lirosa, chokolete ea lebese, li-bar, tsoekere, oaffle

Li-uyoe, raese ea raese, bohobe, spaghetti ea tlhaho

Banana, biscuit, bijoux, likuku, bohobe bo sootho, phofo ea koro, phofo ea sopho, lisose, linoko

Cheese, lebese la skim, mafura a liphoofolo

Nama e khubelu e mafura, soseji, tlhapi e mafura e letsoai, e tsubang nama

Lino tse monate tsa khabone, biri, veine, kvass

Melemo ea Fiber bakeng sa batho ba lefu la tsoekere

Ha lijo tse nang le lik'habohaedreite tse bonolo li kena 'meleng, hang-hang li fetoha tsoekere. Ka lefu la tsoekere, tsoekere e hlahisoa, e sa anngoeng hantle, e lebisang ho momahaneng ea manyeme. Haeba ho sebelisoa lik'habohaedreite tse rarahaneng (fiber, starch, pectins), joale ho kenngoa ka lebelo ho ea butle, ha ho na karohano ho glucose, motho o lula a le telele.

Lijo tse nang le phepo e ntle li bohlokoa lijong tsa mokuli ea lefu la tsoekere hobane li fokotsa tsoekere ea mali. Ha o ja, o lokela ho latela molao oa 25-25 g ea fiber letsatsi le leng le le leng, ho kenella ka bongata ho lokela ho lieha hore mmele o tsebe ho sebetsa lijo ka botlalo mme o se ke oa fetelletsa mala. Soluble fiber e theola cholesterol, e fokotsa tšilo ea tsoekere, 'me e sebetsa e le prophylaxis ea methapo ea methapo. Mofuta o sa keneleng letho o na le litaba tsa khalori ea zero, e fokotsa khatello ea mali le litaba tsa Homocysteine.

Lik'habohaedreite ea lefu la tsoekere la mofuta oa 2

Lijo tsa mokuli ea nang le lefu la tsoekere la mofuta oa 2 li lokela ho kenyelletsa lik'habohaedreite, hobane 'mele o fumana matla ho tsona, empa ho bohlokoa ho hopola hore li fapane. Molemo ka ho fetisisa bakeng sa lefu la tsoekere o nkoa o le thata - fiber, fiber ea ho ja le ho ba kotsi - e bonolo, eo hang-hang e bakang "tlola" tsoekere. Bakuli ba nang le lefu la tsoekere ba lokela ho latela lijo tse nang le lik'habohaedreite tse tlase, tse sa eketseng tsoekere, ho fokotsa kotsi ea hypoglycemia e matla.

Thibelo

Ho thibela mofuta oa bobeli oa lefu la tsoekere ho fetoha lefu la tsoekere le itšetlehileng ka insulin, kapa ho thibela nts'etsopele ea lefu lena, ho sebelisoa mehato e latelang ea thibelo.

• etsa khalemelo e nepahetseng
• khomarela lijo tse nang le lik'habohaedreite tse ngata, noa livithamini,
• ho ba mafolofolo mmeleng
• e hlahlojoa selemo le selemo ka ho tseba hore na lefu le tla hlaha neng,
• tlohela ho tsuba, ho nwa joala,
• boloka boima bo tloaelehileng, thibela botenya.

Lithethefatsi tse eketsang insulin kotsing

Li-Thiazolidinediones li qalile ho sebelisoa e le li-agents tse fokotsang hyperglycemia, haufinyane haholo. Lithethefatsi tsena tsa lefu la tsoekere ha li ame lisele tsa beta; ho fapana le moo, li ntlafatsa kutloisiso ea lisele tsa pherekano ho insulin. Ka lebaka leo, thiazolidatediones e fokotsa tsoekere hape e na le phello e molemo ho khatello ea kelello ea lipid.

Ka kakaretso, lithethefatsi tsa sehlopha sena li khona ho fokotsa khatello ea tsoekere ka 0.5-2%, ka hona, hangata li nooa hammoho le metformin, liente tsa insulin kapa li-sulfonylurea. Mehlala ea lithethefatsi matlapeng ao e leng karolo ea sehlopha sa thiazolidinediones ke Pioglar, Actos le Diaglitazone. Karolo e ntle ea ts'ebeliso ea bona ke monyetla o tlase oa ho fokotseha ka potlako ha maemo a tsoekere. Meriana e joalo ea lefu la tsoekere e nkoa e le eona e tšepisang ka ho fetisisa ho felisa ho loants'oa ha insulin.

Li-Biguanides li emeloa ke moemeli a le mong - metformin, eo e leng karolo ea lithethefatsi tsa sehlopha sena. Mokhoa oa bongaka o ile oa qala ho sebelisa ntho ena ka mor'a 1994. Ka selemo sa 2017, e ne e le "biguanides" e ileng ea tsebahala haholo kalafong ea lefu la tsoekere la mofuta oa 2. Metformin e thibela ts'ebetso ea tlhahiso ea tsoekere ke sebete le ho kena ha eona maling. Ntle le moo, e ntlafatsa kutloelo-bohloko ea lisele tsa pherekano ho insulin. Mmaraka oa meriana oa Russia o fana ka palo e kholo ea matlapa a lefu la tsoekere la 2 a nang le motsoako o sebetsang - metformin hydrochloride. Li-analogues tse tummeng ke Metformin, Siofor, Glucofage le tse ling.

Ho lokela ho hopoloa hore har'a likarolo tse ntle tsa ts'ebeliso ea lithethefatsi tsena, ho na le kotsi e tlase ea boemo ba hypoglycemic, thibelo ea atherosulinosis, ho theola boima ba 'mele le bokhoni ba ho nka hammoho le kalafo ea insulin le litlhare tse ling tse theolelang tsoekere.

Har'a likarolo tse mpe tsa ts'ebeliso ea metformin, lintlha tse tharo li ka khetholoha.

1. Mathata a amanang le ho ja ka nako eo qalong ea kalafo e amanang le ho lemalla hoa setho sa mmele. Matšoao a tloaelehileng ke ho nyekeloa le pelo le ho hlatsa, lets'ollo, ho hloka takatso ea lijo, bohlasoa.
2. Monyetla oa lactic acidosis.
3. Pheko ea nako e telele e fokotsa khatello ea vithamine B 12 'meleng.

Ho ke ke ha khoneha ho sebelisa matlapa a metformin bakeng sa pathologies ea sebete, tšubuhlellano ea matšoafo, a renal kapa a pelo.

Lithethefatsi tsa morao-rao

Ho tloha 2006, ts'ebetsong ea bongaka, ba ile ba qala ho sebelisa lithethefatsi tse ncha tse bitsoang "DPP-4 inhibitors." Ha li amanang le tlhahiso ea "insulin" ka lisele tsa beta.Ketso ea bona e etselitsoe ho sireletsa polypeptide e kang mofuta oa "glP-1", tlhahiso ea e etsahalang ka mpeng, ho tsoa ts'ebetsong e senya ea enzyme DPP-4. Lebitso la lithethefatsi sehlopheng sena le tsoa lebitsong la enzyme.

GLP-1 e ntlafatsa manyeme, ka lebaka leo insulin e qalang ho hlahisoa ka tekanyo e kholo. GLP-1 e boetse e sebetsana le nts'etsopele ea tsoekere e amang hampe tsoekere e fokotsang tsoekere.

Melemo ea ho sebelisa li-inhibitors tsa DPP-4 ke:

• Ho se khonehe ha hypoglycemia ha moriana o phethela ketso ea ona kamora ho nolofatsa maemo a tsoekere.
• Monyetla oa ho eketsa boima ba 'mele ka lebaka la ho sebelisa lipilisi ha oa kenyelletsoa.
• Li ka sebelisoa mohahong o nang le mekhoa e mengata, ho tlatselletsa ho enta li-agonists tsa li-receptor tsa GLP-1 le insulin.

Har'a tse mpe tse mpe, o ka tsepamisa maikutlo ho ts'oenyehang ho lijo, tse atisang ho bontšoa ke bohloko ba ka mpeng le ho nyekeloa ke pelo. Lipilisi tse joalo tsa lefu la tsoekere ha li khothalletsoe hore li sebelisoe khahlanong le sebete kapa liphio. Sehlopha sena sa lithethefatsi se arotsoe ka: saxagliptin (Onglisa), vildagliptin (Galvus), sitagliptin (Onglisa).

Li-agonists tsa GLP-1 ke lihormone tse hlohlelletsang tlhahiso ea insulin ea pancreatic le ho lokisa lisele tse senyehileng tsa islet. Ntle le moo, mofuta ona oa lithethefatsi o fokotsa boima ba 'mele ho bakuli ba batenya haholo. Lithethefatsi tsena ha li etsoe ka tsela ea litafole, li ka rekoa feela ka tsela ea li-ampoules tsa ente. Moemeli oa sehlopha ke moriana o mocha oa Viktoza, hammoho le Baeta.

Alpha glucosidase inhibitors e thibela phetoho ea tsoekere ho lik'habohaedreite. Lithethefatsi tsa sehlopha sena li sebelisoa ha mokuli a e-na le khatello e eketsehileng ea tsoekere ka mor'a ho ja. Lichelete tsena li ka kopanngoa le lithethefatsi leha e le life tse theolelang tsoekere. Minus feela ea alpha-glucosidase inhibitors ke hore ts'ebeliso ea bona e thibetsoe ho pathologies ea mala.

Litla-morao tse sa thabiseng ka mor'a ho sebelisa litlhare ke mathata a tshilo - ho eketseha ha khase ka mpeng le lets'ollo. Ka metformin, sethethefatsi sena se molemo ho se sebelise, hobane se ama le ts'ebetso ea tšilo ea lijo ea motho. Baemeli ba sehlopha sena ke Diastabol le Glucobay.

Hormone e hlohlelletsang

Moloko oa batho o tsebile ka mefuta e meng ea sulfonylurea nako e telele, empa o e sebelisitse feela kalafong ea mafu a tšoaetsanoang. Phello ea bona ea hypoglycemic e ile ea sibolloa ka boomo nakong ea Ntoa ea II ea Lefatše.

Moriana ona oa lefu la tsoekere o ama ho sebetsa ha lisele tsa beta tse fumanoang makhophong, a kopanyang lihormone. Lintho tse tsoang ho Sulfonylurea li qala tlhahiso ea insulin hape li matlafatsa kutloisiso ea lisele tse amohelang insulin.

Leha ho le joalo, lichelete tsena li baka litlamorao tse sa batleheng tse kang:

• hypoglycemia boemo
• beta cell depletion,
• boima ba 'mele.

Ho lula ho feteletseng hoa manyeme ho lebisa 'neteng ea hore mofuta oa bobeli oa "psychology" o fetela ho oa pele. Sena se bolela hore molemong oa ho boloka boleng ba tsoekere ka har'a meeli e tloaelehileng, mokuli o tla tlameha ho kenella li-hormone khafetsa. Liphetho tsa sulfonylureas li arotsoe ka lihlopha tse 'maloa:

1. Glyclazide - Diabeteson MV le Glidiab MV.
2. Glimepiride - Glemaz le Amaril.
3. Glycvidon - Glurenorm.
4. Glibenclamide (Maninyl).

Lithethefatsi tsa sehlopha sa meglitinide le tsona li khothalletsa tlhahiso ea hormone e fokotsang tsoekere. Ho khothalletsoa ba nang le lefu la tsoekere leo ho pepesetsoa tsoekere ea mali ka mor'a ho ja. Sehlopha sena se kenyelletsa lihlopha tse peli tsa lithethefatsi - nateglinide (Starlix) le repaglinide (Novonorm).

Melemo ea ho sebelisa lithethefatsi tsena e ka nkoa e le hore ha e ame boima ba 'mele oa mokuli' me ha e le hantle ha e lebise ho boemo ba hypoglycemia.

Le ha ho le joalo, lithethefatsi sehlopheng sena li baka karabelo e mpe e amanang le tšilo ea lijo le tsamaiso ea methapo.

Phoso ea lithethefatsi ke litheko tse phahameng haholo, ha li sebetse hantle haholo hypoglycemic ebile e sebelisoa khafetsa motšehare.

Pheko le litlamorao tsa ho hana ha eona

Matšoao a mantlha a lefu la tsoekere ke ho ea khafetsa ka kamoreng ea ho hlapela le lenyora le sa feleng. Matšoao ana a mabeli a mantlha a ka supa tlolo ea boemo ba glycemia. Haeba motho a hlokomela matšoao a joalo ka boeena, o lokela ho bona setsebi sa bophelo nakong e tlang e haufi.

Lebaka la lefu le phahameng la bakuli ba nang le lefu la tsoekere le amahanngoa hantle le kalafo e sa reroang le e sa sebetseng. Ha a kopana le ngaka e fanang ka kalafo, mokuli o lokela ho bua ka botlalo ka matšoao ohle a mo tšoenyang. Kamora moqoqo, ngaka e fana ka tlhahlobo ea lefu la tsoekere.

Ho na le liteko tse 'maloa tse ka sebelisoang ho bona hore na tsoekere e kae, empa ho bonolo le ho potlakileng ke ho hlahloba mali ho tsoa monwana kapa ho tsoa mothapong. Haeba sephetho se phahame ho feta 5.5 mmol / L (madi a capillary) le 6.1 mmol / L (madi a venous), sena se ka supa lefu la tsoekere kapa lefu la tsoekere. Ho tseba mofuta oa lefu lena, tlhahlobo e etsoa bakeng sa li-C-peptides le litaba tsa li-antibodies tsa GAD.

Haeba ngaka e fumane mofuta oa lefu la tsoekere la mofuta oa 2, o ntse a etsa mofuta o khethehileng oa kalafo o nang le likarolo tse 'nè tse ka sehloohong.

• taolo ea glycemic khafetsa,
• phepo e khethehileng
• bophelo bo tsamayang
• ho sebelisa meriana.

Ho boloka melao ena kaofela ho ka u laola palo ea tsoekere maling le ho thibela nts'etsopele ea litlamorao tse mpe tsa lefu la tsoekere. Boikutlo bo hlokang tlhokomelo ho bophelo bo botle ba hau bo ka lebisa nts'etsopele ea:

1. Ho hloleha ho ho phekola ha liphoko.
2. Lefu la tsoekere le lefu la tsoekere - ho senyeha hoa pono ho bakoang ke ho ruruha hoa mmele.
3. Lefu la tsoekere ke lefu la tsamaiso ea methapo.
4. Gangrene ea libaka tse tlase. Maemong ana, ho ka khaoloa leoto bakeng sa lefu la tsoekere.
5. Glycemic coma.
6. Myocardial infarction kapa stroke.

U hloka ho phekola lefu la tsoekere ka nako. Lefu lena ha se polelo, lekholo la ho qetela, ka lebaka la theknoloji ea morao-rao, batho ba phela le lona ka botlalo.

Selo sa mantlha ga se go ineela. Phekolo ea sejoale-joale ha e eme: letsatsi le letsatsi, bo-rasaense ba theha moriana o mocha o nang le li-contraindication tse fokolang mme o nang le phello e ntle ea kalafo.

Ho lokela ho hopoloa hore ha o sebelisa moriana, o tlameha ho latela litlhare le litlhahiso tse nepahetseng tsa ngaka. Ka tsela ena, maemo a tsoekere a ka lula maemong a tloaelehileng. Video e sehloohong sena e bua ka kalafo ea lefu la tsoekere la mofuta oa 2.