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मधुमेह र जीवनशैलीमा सुधार विकलचन्द्र्र आचार्य टाइप–२ मधुमेह भनेको वंशाणु र दीर्घरोग भन्ने भ्रमपूर्ण बुझाइले धेरै बिरामीलाई जीवनशैली बदल्न बाध्य गर्ने मात्र होइन, जीवनभर औषधिको भरमा रहनुपर्ने बाध्यता छ । पोषणविद्हरूले गएको केही दशकमा के प्रमाणित गरेका छन् भने यो जीवनशैलीसँग मात्र सम्बन्धित छ । टाइप–२ मधुमेह नियन्त्रण मात्र होइन, निराकरण नै गर्नुपर्छ भन्ने नयाँ भाष्य सुरु भएको धेरै वर्ष भयो । एकै परिवारमा उस्तै जीवनशैली अँगालेपछि बाबुआमालाई लागेको टाइप–२ मधुमेह छोराछोरीमा पनि पछि देखिन्छ । त्यो जिन (वंशाणु) को कारणले होइन । टाइप–२ मधुमेह लाग्ने कारणको उपचार औषधिले गर्दैन । यसलाई नियन्त्रण गर्न एकपछि अर्को औषधि खानुपर्ने र यसले दिने साइड इफेक्टले अरू मेडिकल झमेला खेप्न बिरामीहरू विवश हुनुपर्छ । जापानमा सन् १९८० मा ४० वर्षभन्दा माथिको करिब ३ प्रतिशत मानिसमा मधुमेह थियो । यस दशकमा नै अमेरिकी फास्टफुड रेस्टुराँहरू जापानमा खोल्न सुरु गरियो । यसले गर्दा मधुमेहको दर सन् १९९० मा नपुग्दा नै १२ प्रतिशतले बढ्यो । यस अवधिमा जापानको खानामा चिल्लोको मात्रा हरेक वर्ष बढ्न गयो । यसले के देखायो भने मधुमेह भनेको वंशाणु रोग हो भन्ने कुराको प्रमाणित गरेन । यो त खालि गलत जीवनशैलीको परिणाम हो भन्ने नै देखायो । अमेरिकाका पोषणविद् डिनअर्नेसले गरेका ३ हजार टाइप–२ मधुमेहको बिरामीको अनुसन्धानमा जीवनशैली परिवर्तन गरेको सात हप्तापछि हिमोग्लोबिन ए १सी (जसले दुई महिनाको रगतमा भएको औसत ग्लुकोजको मापन गर्छ) ७ भन्दा माथि रहेकाको ७ भन्दा कम हुनुको साथै एक वर्षपछि डाक्टरको निरीक्षणमा धेरै बिरामीको औषधि कम हुनेदेखि पूरै हटाइएको तथ्याङ्क प्रस्तुत गरेका छन् । टाइप–२ मधुमेहका धेरै बिरामीहरूले जीवनशैली परिवर्तन गर्नुअगाडि डाक्टरको परामर्श गर्नुपर्छ । रगतमा भएको उच्च ग्लुकोजको निरीक्षण गरिरहनुपर्छ । जीवनशैली परिवर्तन भनेको खानाको परिमाण कम गरेर मात्र हुँदैन, उपयुक्त खाना उपभोग गर्नुपर्छ । ठूलो परीक्षणमा गरिएको अध्ययनमा क्यालोरी कम मात्र गरेर उपयुक्त पोषणयुक्त खाना नखाईकन अवलम्बन गरिएको वजन घटाउने कार्यले कार्डियोभास्कुलर रोगको घटनालाई कम गर्न सहयोग गर्दैन । कोलेस्ट्रोल कम गर्न प्रयोग गरिएको स्टयाटिन्स औषधिले टाइप–२ मधुमेह लाग्ने जोखिम बढाउने देखिएको छ । एक अध्ययनअनुसार स्टयाटिन्स औषधिले ४६ प्रतिशत टाइप–२ मधुमेह लाग्ने जोखिम देखिएको छ । मधुमेहले ल्याउने प्रमुख जोखिम मुटु रोग हो । पोषणविद् डिन अर्नेसले जीवनशैली परिवर्तनले कोलेस्ट्रोल कम गर्नुको साथै मधुमेह मुटुरोग दुवैको जोखिमलाई कम गर्न सकिन्छ भन्ने प्रमाणित गरेका छन् । मधुमेह भनेको के हो ? उमेरले ४० कटेपछि प्रायः देखिने टाइप–२ मधुमेहका कारण अहिले संसारभरि नै मोटोपन तथा कम क्रियाशील जीवनयापन गरी धेरै मानिस कलिलै उमेरमा मृत्यु सिकार भएका छन् । मधुमेह भएका मध्ये करिब ९० प्रतिशतमा टाइप–२ मधुमेह देखिएको छ, जुन अस्वस्थकर जीवनशैली तथा कम क्रियाशील जीवनसँग जोडिएको छ । टाइप–२ मधुमेह भएमा पर्याप्त मात्रामा इन्सुलिन उत्पादन हुँदैन अथवा कोषका इन्सुलिन प्रयोग गर्ने सामथ्र्य हराउँछ । हाम्रो शरीरले जब कार्बाेहाइड्रेडयुक्त खानाहरू जस्तै रोटी, भात, आलु र चिनी र अरू गुलियो खानाहरू पचाउँदछ, तब ग्लुकोज उत्पादन हुन्छ । कलेजोले पनि ग्लुकोज बनाउँछ । त्यसलाई रगतले सबै कोषहरूमा लैजान्छ । इन्सुलिन भन्ने हार्माेनले ग्लुकोजलाई कोषहरूमा पठाउन मद्दत गर्छ, जहाँ शरीरले इन्धनका रूपमा प्रयोग गर्दछ । इन्सुलिन प्याङ्क्रियाजमा बन्दछ । प्याङ्क्रियाज भनेको एउटा ठूलो डल्लो पेट पछाडि रहन्छ । दुई किसिमको मधुमेहमध्ये टाइप–१ मधुमेह प्रायः बच्चा र प्रौढहरूमा विकास हुन्छ । यो भएमा इन्सुलिन उत्पादन हुँदैन । मधुमेहका लक्षण र शरीरमा पार्ने नोक्सान टाइप–१ मधुमेहका लक्षणहरू केही हप्तामा चाँडै विकास हुन्छ तर टाइप–२ का लक्षण प्रायः विस्तारै धेरै वर्षमा विकास हुन्छ । विभिन्न मान्छेको विभिन्न किसिमका लक्षण देखापर्दछ । दुवै किसिमका मधुमेहका लक्षण प्रायः प्यास लाग्नु, खास गरी रातमा सधैँभन्दा बढी पिसाब लाग्नु, थकाइ लाग्नु, थाहै नपाई वजन घट्नु, अस्पष्ट देख्नु, गुप्ताङ धेरै चिलाउनु आदि हुन् । याद राखौं, कुनै लक्षण नभए पनि मधुमेह हुन सक्छ । बढी ग्लुकोजको लेभलले शरीरका विभिन्न भागमा नोक्सान पु¥याउन सक्छ । मधुमेहले आर्टरीहरूको रोग (जसले शरीरका विभिन्न भागहरूमा रगत पठाउँछ ) लाग्ने हुन सक्छ । त्यस्तै पैतालामा अल्सर हुने कारक हुन सक्छ । यसको कारणले स्नायुमा हुने धेरै लक्षण जस्तै खुट्टा निदाउनु, पैताला झम्झमाउनु र नपुंसक आदि हुने कारण बन्न सक्छ । मधुमेहले विभिन्न तरिकाले मुटुलाई असर गर्न सक्दछ । रगतमा उच्च ग्लुकोज लेभलले आर्टरीको भित्तामा असर गर्दछ, जसले चिल्लो जम्ने क्रमको विकास गर्न सक्छ । मुटु रोगका जोखिमका तत्त्वहरू धूमपान, उच्च रक्तचाप र रगतमा उच्च कोलेस्ट्रोलबाट हुने नोक्सानलाई मधुमेहले अरू बढाउँछ । टाइप–२ मधुमेह भएको मान्छेको प्रायः ट्राइग्लिसराइड बढी र एचडीएल कोलेस्ट्रोल कम हुन्छ । ट्राइग्लिसराइड हामीले खाएको खानाबाट आउँछ । हामीले खाएको खानामा बनेको क्यालोरी बासोको रूपमा ट्राइग्लिसराइडमा परिणत हुन्छ र बोसो भएर स्टोर गर्छ । मधुमेह भएको मान्छेलाई रक्तचाप हुने बढी सम्भावना हुन्छ । मधुमेहले मुटुको मांशपेशीलाई असर गर्न सक्छ र रगत पम्प गर्ने क्षमतामा ह्रास आउन सक्छ । मधुमेहले मुटुको स्नायुलाई असर पार्न सक्छ । त्यसैले एन्जाइनाका लक्षणहरूमा फरक पर्न सक्छ । मधुमेहले आँखा र मिर्गौलाको जोखिम बढाउनको साथै खुट्टामा रगतको सञ्चारलाई नोक्सान पार्न पनि सक्छ । मधुमेहले दिमागलाई पनि आक्रमण गर्छ । जापानमा सन् २०११ मा गरिएको अनुसन्धानमा मधुमेह हुने व्यक्तिलाई अल्जाइमर रोग लाग्न सक्ने जोखिम मधुमेह नभएकोलाई भन्दा दोब्बर देखिएको छ । त्यस्तै अमेरिकाको सिकागो हेल्थ एन्ड एजिङ प्रोजेक्टले गरेको परीक्षणमा स्याचुरेटेड फ्याट बढी र कम खानेबीच तुलना गरिएको थियो, जसले स्याचुरेटेड फ्याट २५ ग्रामभन्दा बढी स्याचुरेटेड फ्याट उपभोग गरेको छ । ती व्यक्तिहरूमा अल्जाइमर रोगको जोखिम कम स्याचुरेटेड फ्याट खानेभन्दा दोब्बर देखिएको थियो । स्याचुरेटेड फ्याट सबैभन्दा बढी पाइने दूध तथा दूधका परिकार हुन् भने दोस्रोमा मासु हो । ट्रान्स फ्याट व्यापारिक हिसाबले तेलमा तारेर बनाइएको स्न्याक खानेहरूमा पनि जोखिम स्याचुरेटेड फ्याट खानेको जस्तै देखिएको छ । शरीरमा खराब चिल्लोले जति कोलेस्ट्रोल बढाउँछ, उति नै अल्जाइमर रोगको जोखिम बढ्छ । तसर्थ मुटुका लागि जुन कुरा हानिकारक छ, त्यो दिमागका लागि पनि हुन्छ । दक्षिण एसियामा मधुमेह करिब ५० प्रतिशत दक्षिण एसियाका मानिसहरू शाकाहारी छन् । मासु खानेहरू पनि पश्चिमी देशका मानिसको तुलनामा कम खान्छन् । तर पनि मुटुरोग तथा मधुमेह दक्षिण एसिया किन बढी छ ? पहिलो– शरीरलाई चाहिने फाइबर, मिनरल तथा भिटामिन, एन्टिअक्सिडेन्ट, फाइटोकेमिकल, ओमेगा–३, बी १२ जस्ताको कमीको कारणले पनि हुन सक्छ । फाइबर बिनाको कार्बाेहाइड्रेट जस्तो बेसन, मैदा, सेतो भात आदि सबै प्रशोधित खानाको उपभोगको कारण हुन पुग्छ । यी सबैमा खास कुनै पोषणका तत्त्व हँुदैन । केवल चिनी जस्तै क्यालोरीको भण्डार मात्र हो । दोस्रो– तरकारीमा तेलको धेरै उपभोग हुन आउँछ । यी सबै तेलमा ओमेगा–६ पाइन्छ । यसले आन्तरिक सुनिने (इन्फ्लेमेसन) बनाउँछ । हाम्रो शरीरलाई एकदम थोरै ओमेगा–६ र ओमेगा–९ को जरूरी पर्छ । तर शरीरको आवश्यकभन्दा धेरै नै बढी उपभोग भइरहेको छ । आजभन्दा सय वर्ष अगाडि यस्तो तेलको खपत हुँदैन थियो । किनभने भेजिटेबलसिड तेल निकाल्ने प्रविधि नै थिएन । धेरै तेलको उपभोग हुनुको प्रमुख कारण सबै प्रशोधित खानामा तेल हालिएको हुन्छ । तेलले सुक्खा बनाउनुको साथै खानाको आयु बढाउँछ । खाना प्राकृतिक रूपमा छैन र यसलाई बदलिएर अर्काे परिकार बनाइएको छ भने नखानु नै उत्तम हुन्छ । तेस्रो– नुनको अत्यधिक सेवन हुन सक्छ । संसारमा चाहिनेभन्दा करिब दस गुणा बढी सोडियमको उपभोग हुन्छ । नुनले स्वाद बढाउन पनि मद्दत गर्छ । प्रशोधित खानामा लुकाइएको नुन पनि हुन्छ । सही जीवनशैली अपनाए शरीरलाई चाहिने सोडियम खानाबाट नै आउँछ । अतिरिक्त नुनको आवश्यकता पर्दैन । नुनको उच्च उपभोग ह्यामरिजिक स्ट्रोकको कारण पनि बन्न सक्छ । पर्याप्त मात्रामा सागसब्जी तथा तरकारीको धेरै उपभोग गर्नु नै माथि भनिएका पोषणका तत्त्वहरू पाउन सकिन्छ । त्यसैले विभिन्न किसिमका सलाद मुख्य खानाको रूपमा खाने संस्कारको विकास गर्नुपर्छ । बढी मात्रामा रासायनिक मल, किटनाशक औषधि, प्रदूषित वातावरण आदिले पनि मधुमेह तथा अरू स्वास्थ्यमा ठूलो असर परिरहेको हुन्छ । चौथो– अर्गानिक मल प्रयोग गरेर आफैँ उब्जाएर खाने परम्परा रहेको दक्षिण एसियामा केही दशक यता निकै ह्रास आएको छ । यसले पोषणलगायत क्रियाशीलतामा पनि असर गरेकोले मधुमेह लाग्नुको अर्काे कारक पनि हो । धूमपान, मदिरापान तथा चिन्ताको सही व्यवस्थापन गर्न नसक्नु जस्ता धेरै कारणले पनि स्वास्थ्यमा असर परिरहेको छ । स्वास्थ्यकर तथा अस्वास्थ्यकर दुवै खाना खाएपछि शरीरले उच्चतम पोषण पाउँदैन । उत्तम खाना खाएर धूमपान गरेको जस्तो हुन आउँछ । जीवनशैली परिवर्तनले टाइप–२ मधुमेह या प्रि–धुमेहको रोकथाम गर्ने औषधिभन्दा बढी प्रभावकारी छ । धूमपान कहिल्यै नगरेका, मोटोपन नभएका, हप्तामा घटीमा साढे ३ घण्टा व्यायाम गरेका, सागसब्जी, फलफूल तथा होलग्रेन अन्नलाई प्रमुख आहारा बनाएका, मासु उपभोग कम गरेका २३ हजार युरोपियन महिला तथा पुरुषमा गरिएको अध्ययनले ९३ प्रतिशत टाइप–२ मधुमेह आउँदो आठ वर्षमा विकास हुने जोखिम कम गरेको छ । अमेरिकाको हार्डवर्र्ड स्कुल अफ पब्लिक हेल्थले २ लाख महिला तथा पुरुषमा बीस वर्षसम्म गरेको अध्ययनले वनस्पतिप्रधान होलग्रेन खानाले टाइप–२ मधुमेहको जोखिम निकै कम भएको देखाएको छ । फिनल्यान्डमा फिनिस डाइबेटिज प्रिभेन्सन प्रोग्रामले प्रि–डाइबेटिज हुने व्यक्तिहरूले वजन घटाई चिल्लो खानेमा कम गरे र क्रियाशील भए मधुमेह हुने जोखिम ५८ प्रतिशतले कमी आएको देखाएको छ । यसले मधुमेहको विकास हुन जीवनशैलीको अहम् भूमिका रहन्छ भन्ने देखाएको छ । ब्रिटिस मेडिकल जर्नलमा प्रकाशित ३३ वटा विभिन्न परीक्षणमा ३५ हजार मधुमेहका बिरामीलाई ग्लुकोज कम गर्ने उपचार गरिएको औषधिले कार्डियो भास्कुलरको सबै कारणको मृत्यदर तथा मृत्यु कम गर्न थोरै फाइदा मात्र देखाएको छ । यस्तै अमेरिकाको मेयो क्लिनिकले निकालेको समीक्षा आर्टिकलमा औषधिद्वारा कडा नियन्त्रित गरिएको बिरामी माथि जटिल उपचारको भारी हुने, हाइपोग्लेसिमिया (रगतमा ग्लुकोज कम हुने) हुने, वजन बढ्ने, लागत बढी लाग्ने भई बदलामा अनिश्चित फाइदा हुने भनेको छ । यसले डाक्टरले बिरामीको स्वास्थ्यकर जीवनशैली परिवर्तन गर्न प्राथमिकतामा राख्नुपर्ने, रोकथामको विचार साथै कार्डियो भास्कुलर रोगको जोखिम कम गर्न उपाय अवलम्बन गर्नुपर्ने सल्लाह दिएको छ । सही जीवनशैलीले धेरै बिरामीहरूको रगतमा रहेको ग्लुकोज औषधिले भन्दा राम्रोसँग कम गरी टाइप–२ मधुमेहलाई अरू बढ्न नदिने मात्र नभई निराकरण गर्न पनि सक्छ । अमेरिकी डाइबेटिज एसोसिएसनले हिमोग्लोबिन ए १ सी (जसले दुई महिनाको रगतमा भएको औसत ग्लुकोजको मापन गर्छ) खाना तथा जीवनशैलीले ७ भन्दा कम गर्नाले मधुमेहले ल्याउने जटिलता जस्तै अङ्ग काट्नु पर्ने, नपुंसक हुने, मिर्गौलामा खराबी हुने, अन्धो हुने, वजन बढ्ने आदि कम गर्न सहयोग गर्छ भन्ने तथ्याङ्क दिएको छ । उपयुक्त पोषण, क्रियाशील जीवनयापन, २३ भन्दा कम बीएआई भएको पातलो तन्दुरुस्त शरीर, धूमपान तथा मदिरापन त्यागी घटीमा वर्षको एकपल्ट रगतमा भएको ग्लुकोज जाँच गरी सही कदम चालेर टाइप–२ मधुमेहबाट टाढा रहन सकिन्छ । कमेन्ट कमेन्ट गर्नुहोस् तपाईको ईमेल गोप्य राखिनेछ यो पनि पढौँ रातोपाटीको अंग्रेजी, हिन्दी र ग्लोबल संस्करणका साथै अनलाइन टिभी पनि सञ्चालित छ । एप्सबाट सिधै समाचार पढ्न एन्ड्रोइडका लागि यहाँ र आइफोनका लागि यहाँ क्लिक गर्नुहोस् । फेसबुक र ट्वीटरमार्फत पनि हामीसँग जोडिन सकिनेछ ।