Type 2 matenda ashuga

Mtundu wachiwiri wa matenda ashuga ndimatenda osatha (matenda) omwe mumakhala shuga wambiri m'magazi. Mtundu wa 2 wa matenda ashuga ndiwo mtundu wofala kwambiri wa matenda ashuga.

Insulini ndi timadzi tomwe timapangidwa m'matenda ndi maselo apadera, otchedwa beta maselo. Mphunoyi ili pansipa komanso kuseri kwa m'mimba. Insulini imafunika kusuntha shuga (glucose) wamagazi m'maselo. Mkati mwa maselo, shuga amasungidwa ndipo kenako amagwiritsidwa ntchito ngati mphamvu.

Mukakhala ndi matenda a shuga amtundu wachiwiri, mafuta anu, chiwindi, ndi minofu yanu siyiyankha molondola ku insulin. Izi zimatchedwa insulin kukana. Zotsatira zake, shuga wamagazi samalowa m'maselo amenewa kuti asungidwe kuti akhale ndi mphamvu.

Shuga ikalephera kulowa m'maselo, shuga wambiri amakhala m'mwazi. Izi zimatchedwa hyperglycemia. Thupi silingathe kugwiritsa ntchito glucose yamphamvu. Izi zimabweretsa zizindikilo za matenda amtundu wa 2.

Mtundu wa 2 shuga umayamba pang'onopang'ono pakapita nthawi. Anthu ambiri omwe ali ndi matendawa amakhala onenepa kwambiri kapena onenepa kwambiri akawapeza. Kuchuluka kwamafuta kumapangitsa kuti zikhale zovuta kuti thupi lanu ligwiritse ntchito insulini m'njira yoyenera.

Matenda a shuga amtundu wa 2 amathanso kukula mwa anthu omwe onenepa kwambiri kapena onenepa kwambiri. Izi ndizofala kwambiri kwa achikulire.

Mbiri ya banja komanso majini amathandizira mtundu wa 2 shuga. Mulingo wosachita bwino, kusadya bwino, komanso kunenepa kwambiri m'chiuno kumawonjezera mwayi wopeza matendawa.

Anthu omwe ali ndi matenda a shuga amtundu wa 2 nthawi zambiri samakhala ndi zizindikilo poyamba. Atha kukhala opanda zizindikilo kwazaka zambiri.

Zizindikiro zoyambirira za matenda ashuga omwe amayamba chifukwa cha kuchuluka kwa shuga m'magazi atha kukhala:

• Chikhodzodzo, impso, khungu, kapena matenda ena omwe amapezeka pafupipafupi kapena amachira pang'onopang'ono
• Kutopa
• Njala
• Kuchuluka kwa ludzu
• Kuchuluka pokodza
• Masomphenya olakwika

Pambuyo pazaka zambiri, matenda ashuga amatha kudwala, ndipo zotsatira zake, zizindikilo zina zambiri.

Wothandizira zaumoyo wanu akhoza kukayikira kuti muli ndi matenda ashuga ngati shuga yanu yamagazi ndiyokwera kuposa mamiligalamu 200 pa desilita imodzi (mg / dL) kapena 11.1 mmol / L. Kuti mutsimikizire matendawa, mayesero amodzi kapena angapo otsatirawa ayenera kuchitidwa.

• Kusala kwa shuga wamagazi - Matenda ashuga amapezeka ngati ali 126 mg / dL (7.0 mmol / L) kapena kupitilira kawiri.
• Mayeso a Hemoglobin A1c (A1C) - Matenda ashuga amapezeka ngati zotsatira zake zili 6.5% kapena kupitilira apo.
• Kuyezetsa magazi pakamwa - Matenda ashuga amapezeka ngati mulingo wa glucose uli 200 mg / dL (11.1 mmol / L) kapena kupitilira maola 2 mutamwa chakumwa chapadera cha shuga.

Kuyeza matenda ashuga kumalimbikitsa:

• Ana onenepa kwambiri omwe ali ndi ziwopsezo zina za matenda ashuga, kuyambira ali ndi zaka 10 ndikubwereza zaka ziwiri zilizonse
• Achinyamata onenepa kwambiri (BMI a 25 kapena kupitilira apo) omwe ali ndi zoopsa zina, monga kuthamanga kwa magazi, kapena kukhala ndi amayi, abambo, mlongo kapena mchimwene wake yemwe ali ndi matenda ashuga
• Amayi onenepa kwambiri omwe ali ndi zifukwa zina zowopsa, monga kuthamanga kwa magazi, omwe akukonzekera kutenga pakati
  
• Akuluakulu kuyambira zaka 45 pazaka zitatu zilizonse, kapena ali ocheperako ngati munthuyo ali ndi zoopsa

Ngati mwapezeka ndi matenda ashuga amtundu wa 2, muyenera kugwira ntchito limodzi ndi omwe amakupatsani. Onani omwe akukuthandizani nthawi zambiri monga momwe mwalangizira. Izi zitha kukhala miyezi itatu iliyonse.

Mayeso ndi mayeso otsatirawa akuthandizani inu ndi omwe akukuthandizani kuti muwone matenda anu ashuga ndikupewa mavuto.

• Chongani khungu, misempha, ndi mafupa a mapazi ndi miyendo yanu.
• Onetsetsani ngati mapazi anu akomoka (matenda ashuga amitsempha).
• Onetsetsani kuti magazi anu akuyang'aniridwa kamodzi pachaka (cholinga cha magazi chiyenera kukhala 140/80 mm Hg kapena kutsika).
• A1C yanu iyesedwe miyezi isanu ndi umodzi iliyonse ngati matenda anu ashuga ali bwino. Kayezetseni miyezi itatu iliyonse ngati matenda anu asanakuletsedwe bwino.
• Onetsetsani kuti mafuta anu a cholesterol ndi triglyceride ayang'aniridwa kamodzi pachaka.
• Pezani mayeso kamodzi pachaka kuti muwonetsetse kuti impso zanu zikuyenda bwino (microalbuminuria ndi serum creatinine).
• Pitani kwa dokotala wanu wamaso kamodzi pachaka, kapena kangapo ngati muli ndi zizindikilo za matenda amaso ashuga.
• Onani dotolo wamankhwala miyezi isanu ndi umodzi iliyonse kuti mumtsukire bwino ndikumuyeza. Onetsetsani kuti wamankhwala anu komanso waukhondo adziwa kuti muli ndi matenda ashuga.

Wopereka wanu angafune kuyang'ana mavitamini B12 a magazi anu ngati mukugwiritsa ntchito mankhwala a metformin.

Poyamba, cholinga chamankhwala ndikuchepetsa kuchuluka kwa magazi m'magazi. Zolinga zanthawi yayitali ndikuteteza zovuta. Awa ndi mavuto azaumoyo omwe amabwera chifukwa chokhala ndi matenda ashuga.

Njira yofunikira kwambiri yochizira matenda ashuga amtundu wa 2 ndiyo kukhala okangalika komanso kudya zakudya zabwino.

Aliyense amene ali ndi matenda ashuga ayenera kulandira maphunziro ndi chithandizo choyenera cha njira zabwino zothanirana ndi matendawa. Funsani omwe amakupatsirani mwayi wokawona katswiri wodziwa za matenda ashuga komanso wamaphunziro komanso wazakudya.

Phunzirani maluso amenewa

Kuphunzira maluso oyang'anira matenda ashuga kudzakuthandizani kukhala bwino ndi matenda ashuga. Maluso awa amathandiza kupewa mavuto azaumoyo komanso kufunikira kwa chithandizo chamankhwala. Maluso ndi awa:

• Momwe mungayesere ndikulemba magazi anu m'magazi
• Zomwe, nthawi, komanso kuchuluka kwake
• Momwe mungakulitsire zochita zanu mosamala ndikuwongolera kulemera kwanu
• Momwe mungamwe mankhwala, ngati kuli kofunikira
• Momwe mungazindikire ndikuchiza shuga wotsika kwambiri
• Momwe mungasamalire masiku odwala
• Komwe mungagule zinthu za shuga komanso momwe mungasungire

Zitha kutenga miyezi ingapo kuti muphunzire maluso awa. Pitilizani kuphunzira za matenda ashuga, zovuta zake, komanso momwe mungawongolere ndikukhala bwino ndi matendawa. Khalani azatsopano pakufufuza kwatsopano ndi chithandizo chamankhwala. Onetsetsani kuti mukupeza zambiri kuchokera kuzinthu zodalirika, monga omwe amakupatsirani komanso ophunzitsa za matenda a shuga.

KUYANG'ANIRA SUKARI YAKO YA MWAZI

Kudzifufuza nokha kuchuluka kwa shuga wamagazi ndikulemba zotsatirazo kumakuwuzani momwe mukuyendetsera matenda anu ashuga. Lankhulani ndi omwe amakupatsirani komanso ophunzitsa za matenda a shuga kuti muwone kangati.

Kuti muwone kuchuluka kwa shuga wamagazi, mumagwiritsa ntchito kachipangizo kotchedwa glucose meter. Nthawi zambiri, mumaboola chala chanu ndi singano yaying'ono, yotchedwa lancet. Izi zimakupatsani kadontho kakang'ono ka magazi. Mumayika magazi pamzere woyeserera ndikuyika mzerewo mu mita. Meter imakupatsani kuwerenga komwe kumakuwuzani kuchuluka kwa shuga wamagazi.

Wopereka chithandizo kapena wophunzitsa za matendawa azakuthandizani kukhazikitsa pulogalamu yoyeserera. Wopereka chithandizo wanu akuthandizani kukhazikitsa chandamale pamanambala a shuga anu. Kumbukirani izi:

• Anthu ambiri omwe ali ndi matenda a shuga amtundu wachiwiri amafunika kuwunika shuga wawo kamodzi kapena kawiri patsiku.
• Ngati shuga yanu yamagazi ili m'manja, mungafunike kungoyang'ana kangapo pamlungu.
• Mutha kudziyesa mukadzuka, musanadye, komanso musanakagone.
• Muyenera kuyesa kangapo mukamadwala kapena mukapanikizika.
• Mungafunike kuyesa pafupipafupi ngati mukukhala ndi shuga wambiri wamagazi.

Lembani nokha ndi omwe akukuthandizani za shuga wamagazi anu. Kutengera manambala anu, mungafunikire kusintha pazakudya zanu, zochita zanu, kapena mankhwala kuti musunge msinkhu woyenera wamagazi. Nthawi zonse tengani mita yanu yamagazi m'magazi kuti mupite nawo kukalandila za data kuti muzitha kuzilandira ndikukambirana.

Omwe akukuthandizani angakulimbikitseni kuti mugwiritse ntchito poyang'anira shuga mosalekeza (CGM) kuyeza shuga wamagazi ngati:

• Mukugwiritsa ntchito jakisoni wa insulini kangapo patsiku
• Mudakhala ndi gawo la shuga wotsika kwambiri wamagazi
• Magazi anu amashuga amasiyana kwambiri

CGM ili ndi sensa yomwe imayikidwa pansi pa khungu kuti muyese glucose mumadzimadzi amtundu wanu mphindi 5 zilizonse.

Kudya MOYO WABWINO NDIPONSO KULEMERETSA NKHONDO

Gwiritsani ntchito limodzi ndi omwe amakuthandizani kuti muphunzire kuchuluka kwamafuta, mapuloteni, ndi chakudya chomwe mumafunikira pazakudya zanu. Mapulani anu azakudya ayenera kuyenderana ndi moyo wanu komanso zizolowezi zanu ndipo ayenera kuphatikiza zakudya zomwe mumakonda.

Kusamalira kulemera kwanu komanso kukhala ndi chakudya chopatsa thanzi ndikofunikira. Anthu ena omwe ali ndi matenda ashuga amtundu wachiwiri amatha kusiya kumwa mankhwala akachepetsa thupi. Izi sizitanthauza kuti matenda awo ashuga amachiritsidwa. Adakali ndi matenda ashuga.

Anthu onenepa kwambiri omwe matenda awo ashuga samayendetsedwa bwino ndi zakudya ndi mankhwala amatha kulingalira za opaleshoni yolemera (bariatric).

NTCHITO ZA NTHAWI ZONSE

Zochita zanthawi zonse ndizofunikira kwa aliyense. Ndikofunika kwambiri mukakhala ndi matenda ashuga. Kuchita masewera olimbitsa thupi ndibwino pa thanzi lanu chifukwa:

• Amachepetsa shuga wanu wamagazi popanda mankhwala
• Amawotcha mafuta owonjezera komanso mafuta othandizira kuti muchepetse kunenepa kwanu
• Bwino magazi ndi kuthamanga kwa magazi
• Kuchulukitsa mphamvu yanu
• Zimakuthandizani kuthana ndi nkhawa

Lankhulani ndi omwe akukuthandizani musanayambe pulogalamu iliyonse yochita masewera olimbitsa thupi. Anthu omwe ali ndi matenda ashuga amtundu wa 2 angafunikire kuchitapo kanthu asanayambe kuchita masewera olimbitsa thupi, nthawi, komanso atachita masewera olimbitsa thupi, kuphatikiza kusintha kwa insulin ngati kuli kofunikira.

MANKHWALA OCHIRITSIRA MATENDA A shuga

Ngati zakudya ndi masewera olimbitsa thupi sizikuthandizani kuti magazi azikhala ndi magazi wamba kapena oyandikira, omwe amakupatsirani mankhwalawa akhoza kukupatsani mankhwala. Popeza mankhwalawa amathandiza kuchepetsa shuga m'magazi m'njira zosiyanasiyana, omwe amakupatsirani mankhwalawa atha kukupatsani mankhwala angapo.

Ena mwa mitundu yofala kwambiri ya mankhwala alembedwa pansipa. Amatengedwa pakamwa kapena jekeseni.

• Alpha-glucosidase inhibitors
• Zambiri
• Zotsatira za asidi a asidi
• Zoletsa DPP-4
• Mankhwala ojambulidwa (ma analog a GLP-1)
• Meglitinides
• SGLT2 zoletsa
• Sulfonylureas
• Anayankha

Mungafunike kumwa insulini ngati shuga m'magazi anu sangathe kuwongoleredwa ndi mankhwala ali pamwambapa. Nthawi zambiri, insulin amabayidwa pansi pa khungu pogwiritsa ntchito sirinji, cholembera cha insulini, kapena pampu. Mtundu wina wa insulini ndi mtundu wopumira. Insulini siyingatengedwe pakamwa chifukwa asidi m'mimba amawononga insulini.

KULETSA ZOVUTA

Wothandizira anu akhoza kukupatsani mankhwala kapena mankhwala ena kuti muchepetse mwayi wanu wopeza zovuta zina zofala za matenda ashuga, kuphatikiza:

• Matenda amaso
• Matenda a impso
• Matenda a mtima ndi sitiroko

KUSAMALIRA MAPAWA

Anthu omwe ali ndi matenda a shuga amakhala othekera kwambiri kuposa omwe alibe matenda ashuga kukhala ndi mavuto amiyendo. Matenda a shuga amawononga mitsempha. Izi zitha kupangitsa kuti mapazi anu asamve kupsinjika, kupweteka, kutentha, kapena kuzizira. Simungazindikire kuvulala kwa phazi mpaka mutavulaza khungu ndi minofu pansipa, kapena mutenga matenda akulu.

Matenda a shuga amathanso kuwononga mitsempha yamagazi. Zilonda zazing'ono kapena zophulika pakhungu zimatha kukhala zilonda zakuya (zilonda zam'mimba). Mwendo wokhudzidwayo ungafunike kudula ngati zilonda za pakhungu sizikupola kapena kukula, kuzama, kapena kutenga kachilomboka.

Kupewa mavuto ndi mapazi anu:

• Lekani kusuta ngati mumasuta.
• Sinthani kuwongolera shuga wanu wamagazi.
• Pezani mayeso a phazi ndi omwe amakupatsani kangapo pachaka kuti mudziwe ngati mukuwonongeka ndi mitsempha.
• Funsani omwe akukuthandizani kuti ayang'ane phazi lanu pamavuto monga ma callus, bunions kapena hammertoes. Izi zimafunika kuthandizidwa kuti zisawonongeke khungu ndi zilonda.
• Onetsetsani ndikusamalira mapazi anu tsiku lililonse. Izi ndizofunikira kwambiri mukakhala ndi vuto la mitsempha kapena mitsempha yamagazi kapena mavuto am'mapazi.
• Chitani matenda ang'onoang'ono, monga phazi la othamanga, nthawi yomweyo.
• Gwiritsani mafuta odzola pakhungu louma.
• Onetsetsani kuti mumavala nsapato zoyenera. Funsani omwe akukuthandizani kuti ndi mtundu wanji wa nsapato.

UMOYO WOKHUDZA MTIMA

Kukhala ndi matenda ashuga kumatha kukhala kopanikiza. Mutha kukhala ndi nkhawa ndi chilichonse chomwe muyenera kuchita kuti muchepetse matenda anu ashuga. Koma kusamalira thanzi lanu ndikofunikira mofanana ndi thanzi lanu.

Njira zothetsera nkhawa ndi izi:

• Kumvetsera nyimbo zotsitsimula
• Kusinkhasinkha kuchotsa malingaliro anu
• Kupuma kwambiri kuti muchepetse mavuto amthupi
• Kuchita yoga, taichi, kapena kupumula kopita patsogolo

Kukhumudwa kapena kukhumudwa (kukhumudwa) kapena kuda nkhawa nthawi zina kumakhala kwachilendo. Koma ngati mumakhala ndi malingaliro awa nthawi zambiri ndipo akukulepheretsani kuthana ndi matenda anu ashuga, lankhulani ndi gulu lanu lazachipatala. Amatha kupeza njira zokuthandizani kuti muzimva bwino.

Anthu omwe ali ndi matenda ashuga akuyenera kuwonetsetsa kuti ali ndi nthawi yoyenera katemera.

Pali zambiri zothandizira matenda ashuga zomwe zingakuthandizeni kumvetsetsa zamtundu wa 2 matenda ashuga. Muthanso kuphunzira njira zothanirana ndi matenda anu kuti muzitha kukhala bwino ndi matenda ashuga.

Matenda a shuga ndi matenda a moyo wonse ndipo palibe mankhwala.

Anthu ena omwe ali ndi matenda ashuga amtundu wa 2 safunikiranso mankhwala akachepetsa thupi ndikukhala achangu. Akafika pa kulemera kwawo koyenera, insulin yamthupi lawo komanso zakudya zopatsa thanzi zimatha kuwongolera shuga wawo wamagazi.

Pambuyo pazaka zambiri, matenda ashuga amatha kuyambitsa mavuto akulu azaumoyo:

• Mutha kukhala ndi mavuto amaso, kuphatikiza kuwona (makamaka usiku), komanso kuzindikira kwa kuwala. Iwe ukhoza kukhala wakhungu.
• Mapazi ndi khungu lanu zimatha kukhala ndi zilonda komanso matenda. Ngati mabala ake sakupola bwino, phazi kapena mwendo wanu ungafunike kudulidwa. Matenda amathanso kubweretsa ululu komanso kuyabwa pakhungu.
• Matenda ashuga angapangitse kuti zikhale zovuta kuchepetsa kuthamanga kwa magazi ndi cholesterol. Izi zingayambitse matenda a mtima, kupwetekedwa, ndi mavuto ena. Zimatha kukhala zovuta kuti magazi azithamangira mpaka miyendo ndi mapazi anu.
• Mitsempha m'thupi lanu imatha kuwonongeka, kuyambitsa kupweteka, kulira, komanso kufooka.
• Chifukwa cha kuwonongeka kwa mitsempha, mutha kukhala ndi zovuta kugaya chakudya chomwe mumadya. Mutha kumva kufooka kapena kukhala ndi vuto kupita kuchimbudzi. Kuwonongeka kwa mitsempha kumatha kupangitsa kuti zikhale zovuta kuti amuna akhale ndi erection.
• Kuchuluka kwa shuga m'magazi komanso mavuto ena kumatha kubweretsa kuwonongeka kwa impso. Impso zanu sizigwira ntchito kale. Angaleke kugwira ntchito kotero kuti mufunikira dialysis kapena kumuika impso.
• Shuga wamagazi ambiri amatha kufooketsa chitetezo chamthupi. Izi zitha kukupangitsani kuti mukhale ndi matenda, kuphatikiza khungu lowopsa komanso matenda opatsirana.
  

Imbani 911 kapena nambala yachangu yakomweko ngati muli:

• Kupweteka pachifuwa kapena kupanikizika
• Kukomoka, kusokonezeka kapena kukomoka
• Kulanda
• Kupuma pang'ono
• Khungu lofiira, lopweteka lomwe likufalikira mofulumira

Zizindikirozi zimatha kukulirakulira ndikukhala zochitika zadzidzidzi (monga kugwidwa, kukomoka kwa hypoglycemic kapena kukomoka kwa hyperglycemic).

Komanso itanani omwe akukuthandizani ngati muli ndi:

• Dzanzi, kumva kulasalasa, kapena kupweteka kumapazi kapena miyendo yanu
• Mavuto ndi maso anu
• Zilonda kapena matenda pamapazi anu
• Zizindikiro za shuga wambiri wamagazi (ludzu lokwanira, kusawona bwino, khungu louma, kufooka kapena kutopa, kufunika kokodza kwambiri)
• Zizindikiro za shuga wotsika magazi (kufooka kapena kutopa, kunjenjemera, kutuluka thukuta, kukwiya, kuvuta kuganiza bwino, kugunda kwamtima, kuwonera kawiri kapena kusawona bwino, kumva kusasangalala)
• Kumangokhalira kukhumudwa kapena kuda nkhawa

Mutha kuthandiza kupewa matenda ashuga amtundu wa 2 pakukhala onenepa. Mutha kufika polemera bwino mwa kudya zakudya zopatsa thanzi, kuwongolera magawo anu, ndikukhala moyo wokangalika. Mankhwala ena amathanso kuchedwetsa kapena kupewa mtundu wa 2 wa shuga kwa anthu omwe ali pachiwopsezo chotenga matendawa.

Matenda a shuga osadalira insulin; Matenda a shuga - mtundu wachiwiri; Matenda akuluakulu a shuga; Ashuga - mtundu wachiwiri wa shuga; Pakamwa hypoglycemic - mtundu wa 2 shuga; Shuga wamagazi amtundu wa 2

• Zoletsa za ACE
• Pambuyo pa opaleshoni yochepetsa thupi - zomwe mungafunse dokotala wanu
• Musanachite opaleshoni yochepetsa thupi - zomwe mungafunse dokotala wanu
• Matenda a shuga ndi masewera olimbitsa thupi
• Kusamalira maso a shuga
• Matenda a shuga - zilonda za kumapazi
• Matenda a shuga - kugwira ntchito
• Matenda ashuga - kupewa matenda amtima komanso kupwetekedwa mtima
• Matenda a shuga - kusamalira mapazi anu
• Kuyesedwa kwa matenda ashuga ndikuwunika
• Matenda a shuga - mukamadwala
• Kudulidwa kwamapazi - kutulutsa
• Opaleshoni yolambalala m'mimba - kutulutsa
• Laparoscopic chapamimba banding - kumaliseche
• Kudulidwa mwendo - kutulutsa
• Kudulidwa mwendo kapena phazi - kusintha kosintha
• Shuga wamagazi ochepa - kudzisamalira
• Kusamalira shuga wanu wamagazi
• Lembani 2 matenda ashuga - zomwe mungafunse dokotala wanu

• Matenda a shuga ndi masewera olimbitsa thupi
• Katundu wazadzidzidzi wa ashuga
• 15/15 lamulo
• Zakudya zowuma
• Zizindikiro za shuga m'magazi ochepa
• Glucose m'magazi
• Alpha-glucosidase inhibitors
• Zambiri
• Mankhwala a Sulfonylureas
• Anayankha
• Chakudya ndi insulin kumasulidwa
• Kuwunika shuga wamagazi - Mndandanda

Bungwe la American Diabetes Association. 2. Gulu ndi matenda a shuga: miyezo ya chithandizo chamankhwala ashuga - 2020. Chisamaliro cha shuga. 2020; 43 (Suppl 1): S14-S31. PMID: 31862745 adasankhidwa.ncbi.nlm.nih.gov/31862745/.

Bungwe la American Diabetes Association. 11. Mavuto a Microvascular ndi chisamaliro cha phazi: miyezo ya chithandizo chamankhwala ashuga - 2020. Chisamaliro cha shuga. 2020; 43 (Suppl 1): S135-S151. PMID: 31862754 pubed.ncbi.nlm.nih.gov/31862754/.

Bungwe la American Diabetes Association. 8. Kuwongolera kunenepa kwambiri pochiza matenda amtundu wa 2: miyezo yamankhwala azachipatala - 2020. Chisamaliro cha shuga. 2020; 43 (Suppl 1): S89-S97. PMID: 31862751 pubed.ncbi.nlm.nih.gov/31862751/.

Chinsinsi MC, Ahmann AJ. Njira zamankhwala zamtundu wa 2 shuga. Mu: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ, olemba. Buku la Williams la Endocrinology. Wolemba 14th. Philadelphia, PA: Elsevier; 2020: chap 35.