The pathogenesis, zizindikiro ndi chithandizo cha matenda a shuga a steroid

Ndi matenda a shuga m'thupi, pamakhala kusowa kwenikweni kwa insulin. Zotsatira zake, pali kuphwanya mu kagayidwe ka chakudya. Pali mitundu iwiri yayikulu ya matenda ashuga, amagawidwa mu I ndi II. Matenda a Steroid ndi amtundu wachiwiri. Dzina lachiwiri la matendawa ndi matenda osokoneza bongo.

Matenda a shuga amtunduwu amachokera ku mahomoni ochulukirapo omwe amapezeka mu adrenal cortex m'magazi. Nthawi zina, chomwe chimayambitsa matenda chimatha kukhala matenda omwe amapanga mahomoni awa. Chiyambireni cha matenda a shuga a steroid sichikumwa kapamba, kutanthauza kuti kapamba koyambirira amagwira ntchito bwino. Ngati zikuwoneka mwa munthu yemwe ali ndi chakudya chamagulu ochulukitsa okwana mamiliyoni ambiri a glucocorticoids, ndiye kuti akazithetsa, zonse zimakhazikika.

Kwa wodwala yemwe ali ndi mtundu wa matenda a shuga 2, kuoneka ngati sodidi kungapangitse kutembenuka kukhala fomu yodalira insulin ndi kuthekera kwa 60%. Chifukwa chake, anthu otere ayenera kudziwa za ngozi zomwe zilipo ndikuopa kusamala chifukwa cha kumwa mankhwala a corticosteroid.

Ndi mtundu wanji wa mankhwala omwe angayambitse kukula kwa matenda a shuga? Awa akhoza kukhala mankhwala a glucocorticoid:

Njira nthawi zambiri zimagwiritsidwa ntchito ngati anti-kutupa mu mphumu ndi bronchial kapena rheumatoid nyamakazi. Amalembedwanso kwa odwala omwe ali ndi sclerosis ambiri komanso matenda a autoimmune. Anthu omwe ali ndi impso yosinthika amayenera kugwiritsa ntchito mankhwalawa moyo wonse. Sikuti odwala onse adzakumana ndi matenda a shuga a steroid, koma pali mwayi.

Otsatirawa pamndandanda wa provocateurs ndi okodzetsa:

Zolemba zina ndi chizindikiro cha matendawa

Matenda a shuga a steroid amawonetsa mitundu yonse ya 1 ndi 2. Ndizofanana ndi mtundu 1 mwakuti maselo a beta amawonongeka ndi corticosteroids mu kapamba. Koma ngakhale ali munthawi imeneyi, kupanga insulin kumachitika. Popita nthawi, kuchuluka kwake kumacheperachepera komanso nthawi yomweyo, maselo amthupi amasiya kuzindikira pang'onopang'ono ma hormone awa, omwe ndi amtundu wa shuga wachiwiri. Posakhalitsa maselo onse owonongeka a beta afa. Ndipo kutengera ndi momwe adakhalira mu kapamba munyengo zambiri kapena ayi, insulini ingapangidwe mu Mlingo wocheperako, womwe sunakwanire. Wodwala amafunikira insulin, ndipo iyi ndi mtundu woyamba 1 (wodalira insulini).

Matenda a shuga a mankhwala amakhala ndi zofanana ndi mitundu yodziwika iyi:

• ludzu
• kukodza pafupipafupi
• kutopa kosafunikira.

Koma zizindikirazi ndizofatsa kwambiri kotero kuti odwala sangawamvere. Komabe, ndi mtundu uwu wamatenda palibe kuwonda kwakukulu. Nthawi zina, imatha kusokonezedwa ndi matenda a adrenal cortex.

Ketoacidosis mwa odwala otere ndi osowa, kupatula gawo lotsogola kwambiri.

Zowopsa

Kodi zimatheka bwanji kuti shuga ya mankhwala osokoneza bongo sapezeka mwa aliyense yemwe watenga corticosteroids? Pogwiritsa ntchito kapamba, mankhwalawa amachepetsa insulin. Chifukwa cha izi, kapamba amayenera kutulutsa timadzi tambiri tambiri tambiri kuti tipeze shuga. Mwa munthu wathanzi, ndi kufafaniza kwa ma glucocorticoids, zonse zimakhazikika popanda kufufuza. Koma ngati zovuta za metabolic zidalipo kale, ndiye kuti pali chiopsezo cha matenda ena.

Milandu yomwe ingachitike kuti mukhale ndi matenda a shuga a steroid:

• ma steroid amagwiritsidwa ntchito motalika kwambiri
• Mlingo wambiri wa mankhwala am'madzi
• kukhalapo kwa mapaundi owonjezera.

Ndizotheka kuti munthu wakhala ndi vuto la kuchuluka kwa shuga, koma adadutsa osazindikira. Kuyamba kugwiritsa ntchito corticosteroids, wodwalayo amayambitsa njira zobisika, zomwe zimakula bwino. Chifukwa chake, kugwiritsa ntchito mankhwala a mahomoni azimayi onenepa kapena okalamba kuyenera kuyambitsidwa poyang'ana matenda ashuga apambuyo.

Matenda a Steroid - Chithandizo

Matenda amtunduwu amapezeka ngati mfundo za shuga m'magazi zimayamba kupitirira 11.5 mmol mutatha kudya, komanso musanadye, miyeso imawonetsedwa kuti imaposa 6 mmol. Pachigawo choyamba, adotolo sayenera kupatula matenda onse omwe ali mgululi. Kuchiza kumatha kukhala kwachikhalidwe kapena koopsa. Lachiwiri ndilothandiza kwambiri, koma limafunikira luso lodziletsa kuchokera kwa wodwala ndipo limawonedwa ngati ndalama zambiri.

Chithandizo chachikhalidwe chimachitika mogwirizana ndi mfundo zofanana ndi zochitika zofananira za mtundu wa 2. Pakakhala kulephera kwathunthu kwa kapamba, mapiritsi a insulin ang'onoang'ono ndi omwe amapatsidwa. Gwiritsani ntchito othandizira a hypoglycemic ochokera ku gulu la thiazolidinedione ndi mahomoni, mwachitsanzo, Glucofage. Ndi mtundu wofatsa wamatendawa, kugwiritsa ntchito sulfonylureas kumapereka zotsatira zabwino. Koma kudya kwawo kumawonjezera mwayi wokhala ndi vuto loyambitsa matenda. Popeza kuwonongeka kwa kagayidwe kazakudya kumayambira. Pazifukwa zomwezo, matenda ashuga amatha kupita mu mawonekedwe a insulin.

Madokotala amalimbikitsa kuphatikiza mankhwala apakamwa ndi jakisoni wa insulin. Zidadziwika kuti maselo "opumula" a beta amatha kuchira ndikuyamba kupanga insulini pamitengo yapitayi. Odwala amalangizidwa kuti aziyang'anira kusintha kwa kulemera kwawo kuti mapaundi owonjezera asapeze.
Ndikofunikira kusiya mankhwalawa omwe adayambitsa matenda a shuga a steroid ndipo ngati ndi kotheka, m'malo mwake musakhale ndi mavuto ena. Izi zikuchepetsa mwayi wokhala ndi matenda ashuga enieni.

Nthawi zina kwa odwala njira yokhayo yotumikirako ndi opareshoni. M'matenda a adrenal, minofu yowonjezera imachotsedwa ngati hyperplasia ichitika. Zikatero, maphunziro a shuga amatha kusintha ndipo nthawi zina amasintha shuga. Potere, wodwalayo ayenera kutsatira zakudya zomwe zimayamwa odwala matenda ashuga omwe ali ndi matenda ofatsa kapena olimbitsa.

Zambiri:

Nkhaniyi idawonedwa maulendo 817

- Ichi ndi endocrine matenda omwe amapezeka chifukwa cha kuchuluka kwamadzi am'magazi a adrenal cortex komanso kuphwanya kagayidwe kazakudya. Amawonetsedwa ndi zizindikiro za hyperglycemia: kutopa msanga, ludzu lochulukirapo, kukodza kwambiri, kuperewera kwa thupi, chidwi chambiri. Kuzindikira mwatsatanetsatane kumatengera kuwonekera kwa labotale ya hyperglycemia, kuwunika kwa kuchuluka kwa ma steroid ndi ma metabolites awo (mkodzo, magazi). Chithandizo cha matenda a shuga a steroid chimaphatikizira kusiya kapena kuchepetsa kuchuluka kwa glucocorticoids, opaleshoni yochepetsera kupanga mahomoni a corticosteroid, komanso mankhwala antidiabetesic.

Zizindikiro za Steroid Diabetes

Chithunzi cha chipatala chikuyimiriridwa ndi matenda a matenda ashuga - polydipsia, polyuria ndi kutopa. Mwambiri, zizindikiro sizimatchulidwa kwenikweni kuposa mtundu wa 1 shuga. Odwala amawona kuwonjezeka kwa ludzu, pakamwa lowuma kosalekeza. Kuchuluka kwa madzimadzi omwe amamwa kumawonjezeka kangapo, mpaka malita 4-8 patsiku. Mkuntho sutha ngakhale usiku. Kulakalaka kumakulitsidwa, kulemera kumakhalabe chimodzimodzi kapena kumawonjezeka. Yesetsani kukodza. Malita atatu a mkodzo amachotsedwa patsiku; enursis amakula ana ndi okalamba. Odwala ambiri amadwala matenda osowa tulo, amakhala otopa masana, sangathe kulimbana ndi zochitika zawo, komanso kugona.

Kumayambiriro kwa matendawa, Zizindikiro zimachuluka msanga, monga matenda amitundu 1: kukhala bwino, kupweteka mutu, kusokonekera, kutentha kwayamba. Njira yayitali ya matendawa imayendera limodzi ndi mawonekedwe a kuyabwa kwa pakhungu ndi mucous nembanemba. Nthawi zambiri pamakhala zotupa, zotupa, mabala samachiritsa kwa nthawi yayitali. Tsitsi limakhala louma, misomali imakhala yowonjezera ndikusweka. Kuwonongeka kwa magazi ndi kufalikira kwamanjenje kumawonetsedwa ndi kuphwanya kwa miyendo, miyendo, kumva thukuta, kuwotcha komanso kutentha m'miyendo, nthawi zambiri kumilingo.

Mavuto

Hyperglycemia yomwe imatenga nthawi yayitali imayambitsa matenda a shuga - kuwonongeka kwa ziwiya zazikulu ndi zazing'ono. Kusokonezeka kozungulira mu ma capillaries a retina kumawonetsedwa ndi kuchepa kwa masomphenya - matenda ashuga retinopathy. Ngati minyewa yolumikizana ndi impso ikuvutikira, ndiye kuti ntchito yake yosefaipa imakulirakulira, kutupa kumachitika, kuthamanga kwa magazi kumadzuka ndipo matenda a shuga amayamba. Zosintha m'matumbo akuluakulu zimayimiridwa ndi atherosulinosis. Zilonda zoopsa kwambiri zam'matumbo a mtima ndi m'munsi. Kusagwirizana kwa ma electrolyte komanso kusakwanira kwa magazi ku minyewa yamanjenje kumayambitsa chitukuko cha matenda ashuga. Itha kuwonetsedwa ndi kukhudzidwa, dzanzi la miyendo ndi zala m'manja, kulakwitsa kwa ziwalo zamkati, kupweteka kwamitundu yosiyanasiyana.

Zizindikiro

Omwe ali pachiwopsezo chotenga mtundu wa matenda amtundu wa sodium ndi anthu omwe ali ndi hypercorticism ya ambulera. Kafukufuku wambiri wamagulu a glucose kuti adziwe hyperglycemia amawonetsedwa kwa odwala omwe ali ndi matenda a Cushing, zotupa za adrenal, anthu omwe amamwa mankhwala a glucocorticoid, thiazide diuretics, kulera kwa mahomoni. Kuunika kwathunthu kumachitika ndi endocrinologist. Njira zofufuzira mwapadera ndizophatikiza:

• Kuthamanga mayeso a shuga . Odwala ambiri amakhala ndi glucose wabwinobwino kapena wowonjezera pang'ono wamagazi. Mfundo zomaliza nthawi zambiri zimakhala pamtunda kuchokera pa 5-5.5 mpaka 6 mmol / L, nthawi zina 6.1-6.5 mmol / L ndi kukwera.
• Mayeso a kulolera a glucose. Kuyeza glucose patatha maola awiri mutanyamula chakudya kumapereka chidziwitso chokwanira chokhudza matenda ashuga komanso kudziwa kwake. Zizindikiro kuyambira 7.8 mpaka 11.0 mmol / L zikuwonetsa kuphwanya kulekerera kwa shuga, komanso matenda ashuga - zoposa 11.1 mmol / L.
• Mayeso a 17-KS, 17-OKS . Zotsatira zake zimatithandizira kuti tizitha kuzindikira zomwe zimachitika mu cell mwa adrenal cortex. Zolemba pazolemba ndi mkodzo. Kuwonjezeka kwa mawonekedwe a 17-ketosteroids ndi 17-hydroxycorticosteroids.
• Kafukufuku wa mahomoni . Kuti mupeze zowonjezera pazantchito za pituitary ndi adrenal cortex, kuyesedwa kwa mahomoni kungachitike. Kutengera ndi matenda omwe amayambitsidwa, kuchuluka kwa cortisol, aldosterone, ACTH kutsimikiza.

Chithandizo cha Matenda a Steroid

Etiotropic chithandizo ndikuchotsa zomwe zimayambitsa hypercorticism. Nthawi yomweyo, njira zomwe zimapangidwira kubwezeretsa ndikusunga Normoglycemia, kukulitsa chidwi cha minyewa mpaka kuchitapo kanthu ka insulin, ndikulimbikitsa ntchito ya preserved-cell yomwe ikusungidwa ikuchitika. Ndi njira yophatikizidwa, chisamaliro chachipatala cha odwala chimachitika m'mbali zotsatirazi:

• Otsika milingo corticosteroid . Ndi endo native hypercorticism, chithandizo cha matenda oyambitsidwa chimakonzedwanso. Ngati kusintha kwa mankhwalawa kwa mankhwalawa sikothandiza, kufunsa kwa maopaleshoni kungathetsedwe - kuchotsedwa kwa gren adrenal gortical, gortical gawo la adrenal gasm. Masautso a mahomoni a steroid amachepa, kuchuluka kwa shuga m'magazi kumachitika. Ndi hypercorticism ya kunja, mankhwalawa omwe amachititsa kuti shuga ya shuga ipitikize kapena m'malo mwake. Ngati ndizosatheka kuletsa glucocorticoids, mwachitsanzo, mu mphumu yayikulu ya bronchial, mahomoni a anabolic amapatsidwa mphamvu kuti athe kusintha zotsatira zawo.
• Chithandizo cha madokotala cha hyperglycemia . Mankhwala amasankhidwa payekha, poganizira etiology, gawo lake, kuuma. Ngati kapamba akhudzidwa, maselo a beta amakhala pang'ono kapena atakhazikika kwathunthu, ndiye kuti mankhwala a insulin ndi omwe amakhazikitsidwa. Mwa matenda ofatsa, kuteteza minyewa ya glandular komanso kusinthika kwa maselo ku insulin, othandizira pakamwa ndi hypoglycemic, mwachitsanzo, kukonzekera kwa sulfonylurea. Nthawi zina odwala amawonetsedwa pogwiritsa ntchito mankhwala a insulin ndi hypoglycemic.
• Zakudya za antidiabetes . Odwala ambiri amawonetsedwa ngati achire othandizira kudya No. 9. Zakudyazo zimapangidwa m'njira yoti mankhwala azisamba azikhala ndi chakudya, samatsitsimutsa hyperglycemia ndipo muli zinthu zonse zofunika. Mfundo zachakudya zamafuta ochepa zimagwiritsidwa ntchito: magwero a mafuta opepuka samachotsedwa - maswiti, makeke, zakumwa zotsekemera. Mapuloteni ndi zakudya zamafuta ambiri zimakhazikika muzakudya. Mndandanda wa glycemic umatengedwa. Kudya kumachitika m'magawo ang'onoang'ono, nthawi 5-6 patsiku.

Zotsogola ndi kupewa

Matenda a Steroid, monga lamulo, amapitilira modekha ndipo ndi osavuta kuchiza kuposa matenda ashuga amtundu woyamba ndi wachiwiri. Kukula kwake kumadalira zomwe zimayambitsa kukula kwa hypercorticism, nthawi zambiri zimakhala zabwino. Kupewa kumatengera chithandizo chanthawi komanso chokwanira cha matenda a Cushing komanso matenda a adrenal chotupa, kugwiritsa ntchito moyenera glucocorticoids, thiazide diuretics komanso njira yolerera pakamwa. Anthu omwe ali pachiwopsezo ayenera kuwunika magazi a magazi pafupipafupi. Izi zimakuthandizani kuzindikira zovuta zamatenda a carbohydrate pamlingo wa prediabetes, sinthani chithandizo chachikulu, yambani kutsatira mfundo zamagulu azakudya.

Zomwe zimapangitsa kuti shuga achulukane zimatha kukhala zochulukirapo kwa nthawi yayitali m'madzi m'magazi. Pankhaniyi, kupezeka kwa matenda a shuga a steroid amapangidwa. Nthawi zambiri, kusowa bwino kumayamba chifukwa cha mankhwala omwe amakhalapo, koma amathanso kukhala vuto la matenda omwe amabweretsa kuchuluka kwa mahomoni. Nthawi zambiri, kusintha kwa zamankhwala mu kagayidwe kazakudya kumatha kusintha, pambuyo pochotsa mankhwala kapena kukonza matendawo, amatha, koma nthawi zina amatha kulimbikira atalandira chithandizo.

Ndikofunikira kudziwa! Nkhani yatsopano yomwe ikulangizidwa ndi ma endocrinologists a Kupitiliza kwa Matenda Atsopano! Ndi zofunika tsiku lililonse.

Ma steroid owopsa kwambiri kwa anthu omwe ali ndi matenda ashuga a 2. Malinga ndi ziwerengero, 60% ya odwala amayenera kusintha m'malo mwa hypoglycemic.

Matenda a Steroid - ndi chiyani?

Steroidal kapena mankhwala a shuga ndi matenda omwe amabweretsa. Cholinga chake ndi zotsatira zoyipa zamahomoni a glucocorticoid, omwe amagwiritsidwa ntchito kwambiri munthambi zonse zamankhwala. Amachepetsa ntchito ya chitetezo chathupi, amakhala ndi zotsutsa-zotupa. Glucocorticosteroids akuphatikiza Hydrocortisone, Dexamethasone, Betamethasone, Prednisolone.

Posachedwa, osaposa masiku 5, chithandizo cha mankhwalawa chimaperekedwa kwa matenda:

Matenda a shuga ndi kupsinjika kudzakhala chinthu chakale

Matenda a shuga ndi omwe amayambitsa pafupifupi 80% yonse yamikwingwirima ndi kuduladula. Anthu 7 mwa anthu 10 amafa chifukwa cha mitsempha ya mtima kapena ubongo. Pafupifupi nthawi zonse, chifukwa chomaliza chomaliza ndi chimodzimodzi - shuga wamwazi.

Shuga akhoza ndipo amayenera kugwetsedwa, apo ayi. Koma izi sizichiritsa matendawa, koma zimangothandiza kulimbana ndi kufufuza, osati zomwe zimayambitsa matendawa.

Mankhwala okhawo omwe amavomerezeka pamankhwala othandizira odwala matenda ashuga komanso amagwiritsidwa ntchito ndi ma endocrinologists pantchito yawo ndi awa.

Kugwiritsa ntchito bwino kwa mankhwalawa, kuwerengera malinga ndi njira yokhazikika (kuchuluka kwa odwala omwe achiwonjezere kuchuluka kwa odwala omwe ali pagulu la anthu 100 omwe adachitiridwa chithandizo):

• Matenda a shuga - 95%
• Kuthetsa kwa mitsempha thrombosis - 70%
• Kuthetsa kwa kugunda kwamtima kwamphamvu - 90%
• Kuthana ndi kuthamanga kwa magazi - 92%
• Kuwonjezeka kwa mphamvu masana, kukonza kugona usiku - 97%

Opanga si bungwe lazamalonda ndipo amalipidwa ndi chithandizo cha boma. Chifukwa chake, tsopano wokhala aliyense ali ndi mwayi.

• zotupa zoyipa
• bakiteriya meningitis
• COPD ndi matenda osatha a m'mapapo
• gout mu pachimake siteji.

Kutalika kwa nthawi yayitali, kupitirira miyezi isanu ndi umodzi, mankhwala a steroid angagwiritsidwe ntchito pneumonia yapakati, matenda a autoimmune, kutupa kwamatumbo, zovuta zamkati, komanso kufalikira kwa ziwalo. Malinga ndi ziwerengero, kuchuluka kwa anthu odwala matenda ashuga atatha kugwiritsa ntchito mankhwalawa sikupitirira 25%. Mwachitsanzo, pochiza matenda am'mapapo, hyperglycemia imawonedwa mu 13%, mavuto a khungu - 23,5% ya odwala.

Chiwopsezo cha matenda a shuga a steroid chikuwonjezeka ndi:

• cholowa m'tsogolo, achibale oyamba ndi matenda ashuga,
• pa nthawi imodzi yokha yoyembekezera,
• kunenepa kwambiri, makamaka pamimba
• ovary polycystic,
• ukalamba.

Mulingo waukulu wa mankhwala omwe amamwa, ndiwomwe umakhalapo ndi matenda a shuga a steroid:

Ngati wodwala asanalandire chithandizo cha steroid analibe vuto loyambirira la kagayidwe kazakudya, glycemia imakonda kuchitika patatha masiku atatu atachotsedwa. Kugwiritsa ntchito mankhwalawa kwa nthawi yayitali komanso kudziwikiratu matenda ashuga, hyperglycemia imatha kudwala, kufuna kudzikonzanso kwa moyo wonse.

Zizindikiro zofananazi zimawoneka kwa odwala omwe ali ndi vuto la kupanga mahomoni. Nthawi zambiri, matenda ashuga amayamba ndi matenda a Itsenko-Cushing, nthawi zambiri - ndi hyperthyroidism, pheochromocytoma, trauma kapena chotupa muubongo.

Mawonekedwe ndi zizindikiro za matenda a shuga

Odwala onse omwe amamwa ma steroid ayenera kudziwa zomwe zimayambitsa matenda ashuga:

• - kuchuluka kukodza,
• polydipsia - ludzu lamphamvu, pafupifupi osafooka mukamwa,
• nembanemba youma, makamaka pakamwa,
• khungu lakuthwa, losasamala
• wotopa nthawi zonse, kuchepa kwa ntchito,
• ndi kuchepa kwakukulu kwa insulin - kuchepa thupi kosalephera.

Ngati zizindikirozi zikuchitika, ndikofunikira kuzindikira matenda a shuga. Kuwunikira kwambiri pankhaniyi kumaganiziridwa. Nthawi zina, zimatha kuwonetsa kusintha kwa kagayidwe kazakudya pang'ono ngati maola 8 mutayamba kumwa ma steroids. Njira zoyesera ndizofanana ndi mitundu ina ya matenda ashuga: shuga kumapeto kwa kuyesedwa sikuyenera kukhala kwakukulu kuposa 7.8 mmol / l. Ndi kuchuluka kwa kuchuluka kwa magawo 11.1, titha kulankhula za kusokonezeka kwakukulu kwa metabolic, nthawi zambiri kosasinthika.

Doctor of Medical Science, Mutu wa Institute of Diabetesology - Tatyana Yakovleva

Ndakhala ndikuphunzira matenda a shuga kwa zaka zambiri. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsa odwala matenda ashuga mellitus. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 98%.

Nkhani ina yabwino: Unduna wa Zaumoyo wapanga kukhazikitsidwa komwe kumavomerezana ndi kukwera mtengo kwa mankhwalawa. Ku Russia, odwala matenda ashuga mpaka Marichi 2 nditha kuipeza - Kwa ma ruble 147 okha!

Kunyumba, shuga ya shuga imatha kupezeka pogwiritsa ntchito glucometer, mulingo wapamwamba kwambiri 11 mutatha kudya chikusonyeza kuyambika kwa matendawa. Kuthamanga shuga kumakula pambuyo pake, ngati ndizopamwamba kuposa mayunitsi 6.1, muyenera kulumikizana ndi endocrinologist kuti mupeze zowonjezereka komanso kulandira chithandizo.

Zizindikiro za matenda opha shuga a shuga sizitha kukhalapo, kotero ndichizolowezi kuwongolera shuga m'magawo awiri oyamba atatha kuperekedwa kwa glucocorticoids. Pogwiritsa ntchito mankhwala kwa nthawi yayitali, mwachitsanzo, mutabadwa, kuyesedwa kumaperekedwa sabata iliyonse mwezi woyamba, kenako pambuyo pa miyezi itatu ndi miyezi isanu ndi umodzi, mosasamala kanthu za kukhalapo kwa zizindikiro.

Momwe mungachitire ndi matenda a shuga

Matenda a shuga a Steroid amachititsa kuchuluka kwa shuga atatha kudya. Usiku ndi m'mawa musanadye, glycemia ndiyachilendo kwa nthawi yoyamba. Chifukwa chake, chithandizo chomwe chikugwiritsidwa ntchito chiyenera kuchepetsa shuga masana, koma osayambitsa hypoglycemia yausiku.

Zochizira matenda a shuga, mankhwalawa omwe amagwiritsidwa ntchito ngati mitundu ina ya matendawa: othandizira a hypoglycemic ndi insulin. Ngati glycemia ali ochepera 15 mmol / l, chithandizo chimayamba ndi mankhwala omwe amagwiritsidwa ntchito ngati mtundu 2 wa shuga. Manambala ambiri a shuga amawonetsa kuwonongeka kwakukulu pancreatic ntchito, odwala oterewa amapatsidwa jakisoni wa insulin.

Kodi ma steroid amakhudza bwanji shuga?

Ma steroids angayambitse kuchuluka kwa shuga m'magazi, ndikupangitsa chiwindi kuti chisagane ndi insulin yomwe ikupezeka m'matumbo.

Mwazi wa m'magazi ukakhala wambiri, insulin imatulutsidwa ku kapamba ndipo imaperekedwa kwa chiwindi.

Insulini ikaperekedwa kwa chiwindi, imayimira kuchepa kwa shuga omwe nthawi zambiri amaperekedwa m'maselo a mafuta. M'malo mwake, shuga amatengedwa kuchokera m'magazi kupita ku maselo. Izi zimachepetsa kuchuluka kwa shuga m'magazi.

Ma steroids amatha kupangitsa chiwindi kuti chisavutike kwambiri ndi insulin. Amatha kupangitsa kuti chiwindi chizipitilira kutulutsa shuga, ngakhale ngati kapamba atulutsa insulin, ndikuti aime.

Ngati izi zikupitirirabe, zimayambitsa kukana kwa insulini pamene maselo amasiya kuyankha insulin yopangidwa ndi thupi. Matendawa amatchedwa shuga.

Matenda a Steroid

Matenda a shuga ndi omwe amachititsa kuti shuga wa magazi a munthu akhale wolemera kwambiri. Pali mitundu iwiri yayikulu ya matenda a shuga:

• Mtundu woyamba wa shuga: momwe kapamba samatulutsa insulini.
• Mtundu wa shuga wachiwiri: momwe zikondamoyo sizipanga insulin yokwanira, kapena maselo amthupi samayankha insulin.

Matenda a shuga omwe amapangidwa ndi steroid ndi ofanana ndi matenda amtundu wa 2, chifukwa ma cell a thupi samayankha insulin. Komabe, shuga ya steroid imazimiririka chithandizo cha mankhwala a steroid chikamalizidwa. Ndipo mtundu 2 wa matenda ashuga ndi matenda amtundu woyamba 1 ndi matenda omwe ayenera kuthana nawo moyo wonse.

Zizindikiro za matenda a shuga a Steroid

Zizindikiro za matenda am'mimba a shuga omwe amachititsa kuti munthu akhale ndi shuga komanso chimodzimodzi. Mulinso:

• kamwa yowuma
• ludzu
• kutopa
• kuwonda
• kukodza pafupipafupi
• masomphenya osalala
• kusanza ndi kusanza
• Khungu lowuma
• kulumikizika kapena kutayika kwa mikono kapena miyendo

Anthu ena atha kukhala ndi shuga wambiri popanda chisonyezo. Ichi ndichifukwa chake ndikofunikira kuti anthu aziyang'anira kawirikawiri shuga m'magazi awo atatha kumwa ma steroids.

Kodi anthu odwala matenda a shuga amathandizira bwanji?

Monga mitundu yonse ya matenda ashuga, kusintha kwa moyo ndikofunikira ndi matenda ashuga chifukwa cha ma steroids kuti pakhale kusintha kwamphamvu kwa shuga m'magazi. Kusintha kumeneku kungaphatikizepo chakudya chamagulu komanso kuchita masewera olimbitsa thupi pafupipafupi.

Kuwonjezeka kwa shuga m'magazi kumachitika kawirikawiri mkati mwa masiku 1-2 atayamba ma steroids. Ngati ma steroid amatengedwa m'mawa, kuchuluka kwa shuga m'magazi nthawi zambiri kumatsika masana kapena madzulo.

Anthu omwe amamwa ma steroid amayenera kuwunika shuga wawo wamagazi pafupipafupi. Angafunike kumwa mankhwala am'kamwa kapena jakisoni wa insulini ngati shuga wawo ali wokwera.

Monga lamulo, misempha ya shuga ya magazi iyenera kubwerera pamlingo wawo wammbuyo mkati mwa masiku 1-2 mutatha kusiya kugwiritsa ntchito ma steroid. Komabe, anthu ena amatha kukhala ndi matenda a shuga a 2, ndipo wodwalayo adzafunika kuthandizidwa ndi mankhwalawa pogwiritsa ntchito mankhwala amkamwa kapena insulin.

Gulu lamavuto

Chiwopsezo chokhala ndi matenda amtundu wa 2 kuchokera ku matenda a shuga a steroid chimawonjezeka ndi Mlingo wowonjezera wa mankhwala a steroid, atapatsidwa kutalika kwa nthawi. Zina zomwe zimayambitsa matenda a shuga 2 ndi monga:

• zaka 45 kapena kupitirira
• onenepa kwambiri
• mbiri ya banja la matenda ashuga a 2
• matenda ashuga
• kulolerana kwa shuga

Woyambitsa matenda ashuga ali ndi mwayi uliwonse wosokonezeka pamankhwala olemba komanso mayeso omwe adokotala amapanga akakhazikitsa matenda oyamba a matenda ashuga.

Mukubwereza kwa lero, tidzakambirana za chithokomiro cha chithokomiro komanso kufunikira kwake ndikuwonetsa kuzindikira koyenera komanso kolondola komwe kumayenderana ndi chithokomiro cha chithokomiro. Chimodzi mwazinthu zofunikira kwambiri zomwe tikambirane kusanthula kwa mahomoni .

Zomwe zimayambitsa matenda a chithokomiro kulephera nthawi zambiri zimakhala zofanana kwambiri ndizomwe zimayambitsa matenda a shuga 1. Izi zikufotokozedwa ndikudutsa kuyezetsa magazi ndi kuyesa kwamwazi m'magazi ndipo zimawonetsedwa mwa kuchuluka kwa maselo oyera m'magawo ake.

Ngati, mutatha kuyesa magazi ambiri, zotsatira pamwambapa zimapezeka, ndiye tengani mayeso a mahomoni . Ndikofunikira kudziwa kuti kukhazikitsa kuzindikira koyenera sikokwanira thyrotropic hormone assay - dzina lina ndi thyrotropin, TSH .
Ndikofunikira kufufuza, kudutsa kusanthula kwa mahomoni T3 yaulere komanso T4 yaulere .

Ndizofunikanso kudziwa kuti kusowa kwa mahomoni a chithokomiro kungayambitse kuchuluka kwa cholesterol "yoyipa", homocysteine ​​ndi lipoprotein. Izi ndizofunikira makamaka kwa odwala matenda ashuga.

Pakachitika kuti musankhe tengani mayeso a mahomoni nokha ndipo zotsatira zake zinali zopanda pake, muyenera kulumikizana ndi endocrinologist. Nthawi zambiri, pakalandira chithandizo chamankhwala ndi dokotala, kuchuluka kwa mahomoni amabwerera mwakale. Koma izi sizitanthauza kuti tsopano mutha kumasuka ndikuyiwala za chilichonse. Ndikofunikira kutenga mayeso a mahomoni kamodzi pamwezi uliwonse wa 4, kuti mutha kudziwa momwe mankhwalawa amathandizira komanso kukhazikika kwa zotsatirazi.

M'tsogolo mayeso a mahomoni Mutha kumwa miyezi isanu ndi umodzi iliyonse.

Steroid shuga mellitus amatchedwanso sekondaleti yodalira matenda a shuga 1. Amawoneka chifukwa cha kuchuluka kwa corticosteroids (mahomoni a adrenal cortex) m'magazi kwa nthawi yayitali.

Zimachitika kuti matenda a shuga a steroid amayamba chifukwa cha zovuta za matenda momwe kuchuluka kwa mahomoni, mwachitsanzo, ndi matenda a Itsenko-Cushing.

Komabe, nthawi zambiri matendawa amapezeka pambuyo poti athandizidwe kwa nthawi yayitali ndi mankhwala ena a mahomoni, chifukwa chake, dzina limodzi la matendawa ndi matenda osokoneza bongo.

Mtundu wa shuga wa matenda a shuga, omwe adachokera, ndi wa gulu la extrapancreatic matenda, poyambirira sizigwirizana ndi zovuta zapancreatic.

Mwa anthu omwe alibe kusokonezeka kwa kagayidwe kazakudya nthawi yambiri ya glucocorticoids, amapezeka wofatsa ndipo amachoka atachotsedwa. Pafupifupi 60% ya odwala, a 2 matenda a shuga amakhumudwitsa mtundu wa matenda omwe amayimira insulin popanda wodwala.

Mankhwala a shuga a Steroid

Mankhwala a Glucocorticoid, monga dexamethasone, prednisone ndi hydrocortisone, amagwiritsidwa ntchito ngati mankhwala othana ndi kutupa a:

1. Mphumu ya bronchial,
2. Rheumatoid nyamakazi,
3. Matenda a Autoimmune: pemphigus, eczema, lupus erythematosus.
4. Multiple Sclerosis.

Matenda a shuga amatha kupezeka ndi ma diuretics:

• thiazide diuretics: dichlothiazide, hypothiazide, nephrix, Navidrex,
• mapiritsi olembera.

Mlingo waukulu wa corticosteroids amagwiritsidwanso ntchito ngati gawo la anti-yotupa pakumachiza opaleshoni impso.

Pambuyo Thirani, odwala ayenera ndalama kupondereza chitetezo chokwanira moyo. Anthu oterewa amakhala ndi vuto lotupa, lomwe poyambirira limawopseza chofunikira chogwiridwayo.

Matenda a shuga samapangidwa mwa odwala onse, komabe, pogwiritsa ntchito mahomoni mosalekeza, mwayi womwe umapezeka ndiwambiri kuposa momwe amathandizira matenda ena.

Zizindikiro za matenda ashuga omwe amayamba chifukwa cha ma steroid amawonetsa kuti anthu ali pachiwopsezo.

Pofuna kuti asadwale, anthu onenepa kwambiri ayenera kuchepa thupi;

Munthu akazindikira kuti ali ndi vuto la matenda ashuga, musalole kumwa mankhwala a mahomoni molingana ndi malingaliro anu.

Zolemba za matendawa ndi zizindikiro zake

Matenda a Steroid ndi apadera chifukwa amaphatikiza zizindikiro za matenda amitundu iwiri komanso matenda ashuga a 1. Matendawa amayamba pomwe chiwerengero chachikulu cha corticosteroids chimayamba kuwononga maselo a pancreatic beta.

Izi ndizogwirizana ndi zomwe zimayambitsa matenda a shuga 1. Komabe, maselo a beta akupitiliza kupanga insulini kwakanthawi.

Pambuyo pake, kuchuluka kwa insulini kumachepa, chidwi cha minofu ya timadzi timeneti timawonongeka, chomwe chimachitika ndi matenda ashuga 2.

Popita nthawi, maselo a beta kapena ena aiwo amawonongeka, zomwe zimapangitsa kuti ayambe kupanga insulin. Chifukwa chake, matendawa amayamba kuyenda chimodzimodzi ndi matenda amisomali omwe amadalira insulin 1. Kuonetsa zizindikiro zomwezo.

Zizindikiro zazikulu za matenda a shuga ndizofanana ndi mtundu uliwonse wa matenda ashuga:

1. Kuchulukitsa pokodza
2. W ludzu
3. Kutopa

Nthawi zambiri, zizindikiro zomwe zalembedwazo sizikuwonetsa zambiri, motero sizimalabadiridwa. Odwala sataya thupi kwambiri, monga mtundu 1 wa shuga, kuyezetsa magazi sikumapangitsa kuti azindikire.

Kuchuluka kwa shuga m'magazi ndi mkodzo sikumakwera kwambiri modabwitsa. Kuphatikiza apo, kupezeka kwa kuchuluka kwa ma acetone m'magazi kapena mkodzo sikumawonedwa kawirikawiri.

Matenda a shuga monga chiopsezo cha matenda a shuga

Kuchuluka kwa mahomoni a adrenal kumawonjezeka mwa anthu onse mosiyanasiyana. Komabe sianthu onse omwe amamwa glucocorticoids omwe ali ndi matenda a shuga.

Chowonadi ndi chakuti kumbali inayo, corticosteroids amathandizira kapamba, ndipo, kumbali ya insulin. Kuti magazi a shuga azikhala abwinobwino, kapamba amakakamizidwa kugwira ntchito ndi katundu wolemera.

Ngati munthu ali ndi matenda ashuga, ndiye kuti minyewa ya insulin imayamba kuchepetsedwa, ndipo zodukazo sizigwira ntchito 100%. Chithandizo cha steroid ziyenera kuchitika kokha ngati njira yomaliza. Chiwopsezo chikuwonjezereka ndi:

• kugwiritsidwa ntchito kwa ma steroid mu Mlingo wambiri,
• Kugwiritsa ntchito ma steroid nthawi yayitali,
• wodwala wonenepa kwambiri.

Chisamaliro chikuyenera kuchitika popanga zisankho ndi omwe nthawi zina amakhala ndi shuga wambiri pazifukwa zosadziwika.

Kugwiritsa ntchito glucocorticoids, mawonekedwe a shuga amawonjezereka, ndipo izi zimadabwitsa munthu, chifukwa sakanatha kudziwa za matenda ake a shuga.

Pankhaniyi, matenda a shuga anali ofatsa asanatenge glucocorticoids, zomwe zikutanthauza kuti mankhwala a mahomoni oterewa amatha kuchulukitsa vutoli ndipo amathanso kuyambitsa vuto longa.

Asanapange mankhwala a mahomoni, anthu achikulire ndi amayi onenepa kwambiri amafunika kukayezetsa matenda ashuga am'mbuyomu.

Chithandizo cha matenda ashuga

Ngati thupi silipanga insulin, ndiye kuti matenda osokoneza bongo, monga matenda amtundu 1, koma ali ndi mawonekedwe a shuga 2, ndiye kuti, insulin kukana minofu. Matenda a shuga oterewa amathandizidwa ngati shuga 2.

Chithandizo chimadalira zina mwa zinthu zomwe wodwala ali nazo. Mwachitsanzo, kwa anthu onenepa kwambiri omwe amapangabe insulin, zakudya ndi zochepetsa shuga monga thiazolidinedione ndi glucophage zimasonyezedwa. Kuphatikiza:

1. Ngati pali ntchito ya pancreatic yotsika, ndiye kuti kuyambitsa insulini kumamupatsa mwayi wochepetsa katundu.
2. Pankhani yakusakwanira kwa ma cell a beta, pakapita nthawi, ntchito ya pancreatic imayamba kuchira.
3. Ndi cholinga chomwecho, zakudya zamafuta ochepa zimayikidwa.
4. Kwa anthu omwe ali ndi thupi lolemera, chakudya No. 9 chikulimbikitsidwa; anthu onenepa kwambiri ayenera kutsatira zakudya No. 8.

Ngati kapamba satulutsa insulin, ndiye kuti imayikidwa ndi jakisoni ndipo wodwalayo afunika kudziwa. Kuwongolera shuga ndi magazi kumachitidwa chimodzimodzi ndi shuga 1. Komanso, ma cell a beta sangabwezeretsedwe.

Mlandu wosiyana ndi chithandizo cha matenda osokoneza bongo omwe amayamba chifukwa cha mankhwala ndi zomwe zimachitika ngati nkotheka kukana chithandizo cha mahomoni, koma munthu amadwala matenda a shuga. Izi zitha kukhala pambuyo pakupatsirana impso kapena pakakhala mphumo waukulu.

Mlingo wa shuga umasungidwa pano, potengera chitetezo cha kapamba komanso kuchuluka kwa minyewa yomwe imakhudzidwa ndi insulin.

Monga chithandizo chowonjezereka, odwala amatha kutumizidwa mahomoni a anabolic omwe amayang'anira zotsatira za mahomoni a glucocorticoid.

Pakati pa mitundu ya matenda ashuga, pali matenda monga matenda a shuga.

Muyenera kudziwa kuti matendawo ndi chiani, ndi owopsa bwanji, ndipo ndani ali m'gulu lalikulu.

Kukula kwa matenda a shuga

Chofunikira kwambiri cha matendawa ndi kuchuluka kwa corticosteroids m'thupi kwakanthawi.

Amayamba chifukwa cha ma pathologies omwe amachititsa kuti ma gren adrenal awonjezeke, ndichifukwa chake amapanga mahomoni ochulukirapo. Koma nthawi zambiri, kugwiritsa ntchito mankhwala a mahomoni kumabweretsa mawonekedwe ake. Ichi ndichifukwa chake amatchedwanso matenda ashuga. Palinso dzina la "shuga yachiwiri ya insulin-yodalira shuga 1."

Mwa chiyambi chake, kuphwanya kumeneku ndi kwa gulu lowonjezera pancreatic, chifukwa zimachitika popanda zovuta pakugwira ntchito kwa kapamba.

Popeza kupezeka kwa mtundu wa steroid matendawa kumachitika chifukwa chogwiritsa ntchito mankhwala kwa nthawi yayitali, magulu akuluakulu a mankhwalawa omwe angapangitse kuti ayambe kutchedwa.

Izi zikuphatikiza:

• glucocorticoids (prednisone, dexamethasone, hydrocortisone),
• kulera
• diuretics a gulu la thiazide (Nephrix, Dichlothiazide, Navidrex, Hypothiazide).

Pakakhala mavuto ndi kagayidwe kazakudya m'thupi, shuga ya shuga imakhala ndi kofatsa ndipo imadzichotsa yokha pakatha kusiya mankhwala.

Matendawa samawoneka kwa wodwala aliyense amene amamwa mankhwalawo. Koma ali ndi mwayi wa kuchitika kwake.

Matenda owopsa

Matenda a Steroid amapezeka chifukwa cha ma pathologies omwe amafunikira kuperekera mankhwala kwa nthawi yayitali. Zotsatira zake, ziwalo zogwira ntchito zimadziunjikira m'thupi, zimapangitsa kusintha, komwe kumatchedwa zizindikiro za matenda osokoneza bongo.

Matendawa ndi monga:

• Mphumu ya bronchial,
• chikanga
• lupus erythematosus,
• multiple sclerosis
• nyamakazi.

Kufunika kogwiritsa ntchito mankhwalawa kwa nthawi yayitali kumachitika ndi ma opaleshoni ena (othandizira kupatsidwa ziwalo).

Ayenera kugwiritsidwa ntchito kuti athetse njira yotupa. Chifukwa chake, ntchito zakale zitha kubweretsanso matenda a shuga.

Palinso milandu yakukula kwa matendawa chifukwa cha kusokonezeka kwa thupi. Matenda a shuga a Steroid samachitika mwanjira yomwe angatengere kuchuluka kwa mankhwalawa, koma chifukwa cha zifukwa zina.

1. Matenda a pituitary ndi hypothalamic . Amayambitsa kusokonezeka kwa mahomoni, komwe kumachepetsa mayankho a maselo ku insulin. Mwa zina mwa matendawa amatchedwa matenda a Itsenko-Cushing. Ndi matenda awa, hydrocortisone imapangidwa mthupi. Zotsatira zake ndikutha kwa kuyankha kwa maselo kwa insulin yopanga. Komabe, kafukufuku samawululira zolakwika pakugwira ntchito kwa kapamba.
2. Zolemba poizoni . Ndi kupatuka uku, zovuta zimayamba ndi mayamwidwe a shuga. Kuphatikiza kwake m'magazi kumawonjezeka, motero, kufunika kwa insulini kumawonjezeka, koma chidwi chake cha zotsatira zake chimachepa. Izi zitha kupezeka m'njira zingapo, mwa zina zomwe ndizofala kwambiri ndi matenda a Bazedov komanso matenda a Graves.

Mwa zina mwa zomwe zimayambitsa matenda a shuga a steroid zimatha kuchitika chifukwa cha zovuta zomwe zimathandizira kukula kwa matenda a Itsenko-Cushing.

Pakati pawo amatchulapo:

• kunenepa
• poyizoni wowopsa
• mavuto amisala.

Nokha, izi sizinthu zomwe zimapangitsa kuti pakhale shuga. Koma zimatha kuyambitsa mavuto mu hypothalamus kapena pituitary gland.

Makhalidwe a matenda

Mu shuga mellitus, maselo a pancreatic beta amawonongeka. Kwakanthawi, amapangira insulin, koma pang'ono.

Matendawa akamakula, kapangidwe kake kamacheperachepera. Chifukwa cha zovuta za metabolic, kuyankha kwa thupi ku insulin kumachepetsedwa.

Pancreas ikasiya kupanga insulin, matendawa amawonetsa matenda amtundu wa 1 shuga. Zodziwika kwambiri zimatha kutchedwa mawonekedwe monga ludzu losalekeza komanso kuyamwa pafupipafupi.

Koma nthawi yomweyo, kulemera kwa wodwalayo sikuchepa, ngakhale izi zimachitika nthawi zambiri.

Kugwiritsira ntchito corticosteroids panthawi ya chithandizo kumabweretsa chiwopsezo chowonjezera pa kapamba. Mwa zina, amamuthandiza, koma kuchitapo kanthu kumachepetsa chidwi chake cha insulin, chifukwa cha izi thupi liyenera kugwira ntchito molimbika, zomwe zimapangitsa kuvala kwake kofulumira.

Sizotheka kuzindikira matendawa nthawi yomweyo. Mayeso (mwachitsanzo, zamankhwala am'madzi am'magazi) nthawi zambiri amakhala abwinobwino: zonse zomwe zimakhala m'magazi komanso kuchuluka kwa matupi a ketone mumkodzo.

Nthawi zina mankhwala amatha kupititsa patsogolo shuga, yomwe inali kumayambiriro kwa chitukuko, yomwe imabweretsa vuto lalikulu. Chifukwa chake, tikulimbikitsidwa kuyezetsa magazi musanapange mankhwala a steroid. Izi zimagwira ntchito kwa odwala omwe ali ndi kunenepa kwambiri, matenda oopsa, komanso okalamba.

Pokonzekera chithandizo chanthawi yochepa kugwiritsa ntchito mankhwalawa komanso kusowa kwa vuto la metabolic, palibe ngozi iliyonse. Pambuyo pakutha kwa chithandizo, njira za metabolic zimabwelera zabwinobwino.

Makanema ochepera pa shuga:

Zizindikiro zamatsenga

Kunena za kupezeka kwa matendawa kungakhalepo, kudziwa zomwe zikuwonetsa. Koma ndi matenda a shuga a steroid, zizindikilo za matenda ashuga wamba sizimawoneka. Munthu sasintha kulemera, kukodza sikusintha pafupipafupi, ludzu lochulukirapo silimawoneka. , komanso kusowa.

Nthawi zina wodwala (komanso pafupipafupi pafupi ndi ena) amawona kupezeka kwakanthawi kwa fungo la acetone kuchokera mkamwa. Koma chizindikiro ichi chimachitika ndi matenda apamwamba a shuga.

Gawo loyambirira la matendawo limadziwika ndi zinthu monga:

• kufooka
• kuwonongeka kwa bwino,
• kugona
• kuchepa kwa magwiridwe
• kutopa,
• mphwayi
• ulesi.

Kuchokera pazawonetsero izi, ndizovuta kulingalira za momwe matendawa amafunidwira. Amadziwika ndi matenda ena ambiri, komanso ntchito yanthawi zonse.

Nthawi zambiri, matendawa amapezeka mwangozi pomwe wodwalayo amabwera kwa dokotala ndikupempha kuti amulimbikitse mavitamini kuti akweze mawu ake. Izi zikutanthauza kuti kufooka momveka bwino kwa thupi kumatha kukhala koopsa, ndipo izi siziyenera kunyalanyazidwa.

Njira zamankhwala othandizira

Njira yothandizira matendawa imatsimikiziridwa ndi dokotala, kupenda mkhalidwe wa wodwalayo, kuopsa kwa matendawa, kupezeka kapena kusapezeka kwa matenda ena, ndi zina zambiri.

Onetsetsani kuti mwazindikira chomwe chimayambitsa masinthidwe a matenda. Ngati vuto ndi kugwiritsa ntchito mankhwala, ndiye kuti liyenera kuthetsedwa. Izi zitha kusiya kudya kwachuluka kwa ma steroid ndikuletsa kukula kwa matendawa.

Nthawi zina, ndikosayenera kusiya mankhwala, chifukwa cholinga chawo ndi kuthana ndi matenda ena. Kenako muyenera kuyang'ana ndalama zothandizira m'malo omwe munagwiritsidwa ntchito kale kapena kusankha njira zina zamankhwala kuti muchepetse kugwiritsidwa ntchito kwa ma steroid.

Ngati matenda a shuga a steroid adayamba chifukwa cha vuto la mahomoni m'thupi, njira zochiritsira ziyenera kukhala ndi cholinga choti zisawasokoneze. Nthawi zina ndikofunikira kuchotsa opaleshoni minofu yowonjezera ya adrenal kuti muchepetse zomwe zili zovulaza m'thupi.

Gawo lina la mankhwalawa ndi kuchepa kwa ndende. Kwa izi, mankhwala othandizira, zowonjezera zolimbitsa thupi zimagwiritsidwa ntchito. Izi ndizofunikira ngati vuto la insulin ikupezeka. Ngati tikhudzidwa nazo timasungidwa, koma kapamba samatulutsa mokwanira, ndiye kuti jakisoni wake wasonyezedwa.

Zochita zochizira zimachitika chifukwa chophwanya thupi la wodwalayo. Popeza njira zambiri zikuyenera kugwiritsidwa ntchito kuti athetse matenda a shuga a steroid, zochita zosavomerezeka za wodwala sizovomerezeka. Amayenera kutsatira zomwe adotolo adalemba komanso kuti asaphonye mayeso okonzekera.

Matenda a Steroid ndi mtundu waukulu wa shuga womwe umadalira insulin, womwe umatha kuchitika mosasamala ndi zaka (umatha kukula ngakhale mwa ana). Vuto lalikulu ndi kupezeka kwake ndi kusapezeka kwa zizindikiro za pachimake. Zomwe zimayambitsa matendawa nthawi zambiri zimakhala zodetsa nkhawa. Nthawi zina zambiri zomwe zimapezeka mu mahomoni a adrenal m'magazi zimakhala zomwe zimayambitsa matenda. Izi zitha kuchitika chifukwa cha matenda komanso kuthana kwa nthawi yayitali ndi mankhwala a glucocorticoid.

Njira zakulera za pakamwa, diuretics, mankhwala ena amphumo, arthrosis, matenda a Itsenko-Cushing, ndi collagenosis zimayambitsidwa makamaka ndi matenda a shuga a steroid. Popita nthawi, kugwiritsa ntchito mankhwalawa pafupipafupi kumatha kuyambitsa zovuta zamapuloteni ndi zakudya, motero zimapangitsa kuchuluka kwa shuga m'magazi. Zodabwitsazi ndizowopsa kwambiri komanso zoletsa chiwindi kugwira ntchito molingana ndi kuchuluka kwa glycogen.

Zizindikiro za Steroid Diabetes

Monga taonera kale, matenda a shuga a sodium samadziwonetsa ngati zizindikiro zowopsa. Ludzu losagonjetseka ndi kuwonjezeka kwa mapangidwe amkodzo silingawonongeke, komanso kusinthasintha kwa glycemia. Nthawi zambiri matendawa amakhala okhazikika. Zizindikiro zomwe mtundu uwu wa shuga umawonera ndi: kufooka kwakukulu, kutopa kwambiri, komanso thanzi labwino. Koma Zizindikiro zofananira ndizodziwika bwino m'matenda ambiri. Mwachitsanzo, amatha kuwonetsa kuphwanya kwa kugwira ntchito kwa adrenal cortex.

Ndi steroid matenda a shuga, zizindikiro za ketoacidosis sikuwoneka. Nthawi zina, mumatha kununkhira acetone kuchokera mkamwa pamene matendawa atha kale. Nthawi zambiri, ma ketoni amapezeka mumkodzo. Kuphatikiza apo, nthawi zambiri pamakhala anti-insulin, chifukwa chovuta kuchita ndi chithandizo chamankhwala. Chifukwa chake, glycemia imakhazikitsidwa pogwiritsa ntchito zakudya zowonjezera komanso masewera olimbitsa thupi apadera.

Chithandizo cha matenda a shuga a steroid

Chithandizo chovuta cha matenda a shuga a steroid umalimbana ndi:

• matenda a shuga
• Kuchotsa kwa zomwe zidayambitsa kuchuluka kwa mahomoni mu adrenal cortex.

Nthawi zambiri pamakhala zochitika zomwe odwala sangathe kuchita popanda kuchita opaleshoni: mochuluka amachotsa minyewa yambiri m'magazi a adrenal. Kuchita koteroko kumatha kusintha matendawa pawokha, ndipo nthawi zina kumathandizanso shuga kukhala wabwinobwino. Makamaka ngati wodwalayo angatsatire chithandizo chamankhwala ndi zakudya, zomwe zimapangidwira cholesterol yambiri komanso kunenepa kwambiri.

Kulandira mankhwala kumaphatikizapo kumwa mankhwala omwe amachepetsa shuga ya magazi.

Pa gawo loyamba la mankhwalawa, sulfonylureas amalembedwa, koma amatha kuvutitsa kagayidwe kazakudya, kamene kamayambitsa matenda a shuga a sodium modell. Kuyang'anira kuwonda kwanu ndi gawo lofunika la mankhwalawa chifukwa kunenepa kwambiri kumakulitsa matendawa ndikuwapatsirana mankhwala.

Choyamba, mankhwala omwe matendawa adayamba kudwala ayenera kutha. Nthawi zambiri, dokotala amasankha ma analogi osavulaza. Malinga ndi malangizo azachipatala, ndibwino kuphatikiza mapiritsi ndi jakisoni wa insulin. Chithandizo choterechi chimapatsa mwayi kubwezeretsa maselo a pancreatic omwe amachititsa kuti maselo a insulin atulutsidwe. Pambuyo pa izi, njira ya matendawa imatha kulamulidwa mosavuta mothandizidwa ndi zakudya.

Kupewa

Kupewa komanso kupezeka kwa nthawi yayitali ndi mankhwala a shuga a steroid ndi gawo lofunika la chithandizo ndi glucocorticoids, makamaka ngati kugwiritsa ntchito kwawo kwakanthawi kuyembekezeredwa. Njira zomwezo zomwe zimagwiritsidwa ntchito pa matenda a shuga a 2 komanso kuwonjezeka kwa zochitika zolimbitsa thupi zimayambitsa kuchepa kwa chiopsezo chophwanya kagayidwe kazachilengedwe.

Tsoka ilo, prophylaxis iyi ndiyovuta kukwaniritsa, popeza ma steroid amalimbitsa chilimbikitso, ndipo matenda ambiri omwe amawagwiritsa ntchito amawachotsa kapena kuchepetsa malire pamasewera. Chifukwa chake, popewa matenda a shuga a steroid, gawo lalikulu ndi la kuzindikira kwa zovuta ndi kukonza kwawo pamlingo woyambirira mothandizidwa ndi mankhwala ochepetsa shuga.

Onetsetsani kuti mwaphunzira! Kodi mukuganiza kuti kuyamwa kwa mapiritsi ndi insulini kwa nthawi yonse yokhayo ndi njira yokhayo yothanirana ndi shuga? Sichowona! Mutha kutsimikizira izi nokha ndikuyamba kuzigwiritsa ntchito.

Njira yodalira insulini imayamba chifukwa cha kuperewera kwa zakudya m'thupi kapena kunenepa kwambiri. Monga lamulo, chifukwa chachikulu ndicho kugwiritsidwa ntchito kwa nthawi yayitali kwa mankhwala a mahomoni. Ichi ndichifukwa chake mawonekedwe amatchedwa matenda ashuga.

Steroid shuga mellitus mu mankhwala amatchedwa mitundu yopanda pancreatic yamatendawa. Chifukwa chake, pamlingo wachitukuko, sizigwirizana ndi kupunduka kwa kapamba ndipo, makamaka zisumbu za Langerhans.

Ngati munthu alibe zosokoneza mu kagayidwe kazakudya zama cellelo, ndipo kuchuluka kwa glucocorticoids kumachitika, ndiye kuti matenda a shuga a cellid amakhala ndi mawonekedwe ofatsa. Kumapeto kwa maphunziridwe a mankhwala a mahomoni, matendawa amatha.

Matenda a shuga a Type II, omwe amadziwika ndi kuchuluka kwamahomoni omwe amapangidwa, odwala oposa theka amapita mu fomu yodalira insulin.

Zomwe madotolo amati pa matenda ashuga

Doctor of Medical Science, Pulofesa Aronova S. M.

Kwa zaka zambiri ndakhala ndikuphunzira za zovuta za DIABETES. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsa odwala matenda ashuga mellitus. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 100%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipilira mtengo wonse wa mankhwalawo. Ku Russia ndi mayiko a CIS odwala matenda ashuga kale atha kupeza mankhwala ZAULERE .

Mankhwala opatsitsa matenda

• Glucocorticoids. Dexamethasone, hydrocortisone pamankhwala amagwiritsidwa ntchito ngati anti-kutupa kwa nyamakazi, komanso pochiza matenda a autoimmune (eczema, lupus, ndi ena) ndi mphumu. Nthawi zambiri, mankhwalawa samaphatikizira glucocorticoids atatha kupezeka ndi matenda angapo.
• Magulu a diuretic a thiazide diuretics (Nefrik, Dichlothiazide).
• Mankhwala angapo oletsa kubereka.
• Mankhwala omwe amagwiritsidwa ntchito pochiza pambuyo pochita opaleshoni ya impso, makamaka kupatsirana. Pambuyo pakuwonjezereka, munthu amayenera kutenga ma immunomodulators moyo wake wonse, popeza amatha kutuluka mthupi. Nthawi zambiri, amaopseza thanzi la chida chija.

Zachidziwikire, kuti mankhwala a shuga a shuga samapezeka mwa wodwala aliyense amene amatenga mahomoni, komabe chithandizo choterechi chimakulitsa zoopsa zake.

Ngati munthu wotsutsana ndi kumbuyo kwa mankhwalawa anali ndi zizindikiro za mtundu wa matendawo, ndiye kuti nthawi zambiri anali pachiwopsezo. Kuti mupewe kutukuka, ndikofunikira kuti mupeze kulemera kwanu moyenera, sinthani zakudya zanu ndikupita masewera.

Mawonetsero oyamba ayenera kukakamiza kusiya kugwiritsa ntchito mahomoni pafupipafupi, ngati zingatheke pankhani inayake.

Zizindikiro zazikulu komanso zina

Chomwe chimasiyanitsa ndizophatikiza zomwe zimatha mitundu iwiri ya matenda ashuga. Pa gawo loyamba la chitukuko, corticosteroids yochulukirapo imayamba kuwononga maselo a beta omwe amayang'ana kwambiri ma islets a Langerhans, omwe ali ofanana ndi matenda a shuga a steroid omwe ali ndi mawonekedwe odalira insulin. Ngakhale izi, amapanga mahomoni.

Samalani

Malinga ndi WHO, chaka chilichonse padziko lapansi anthu 2 miliyoni amafa chifukwa cha matenda ashuga komanso zovuta zake. Pokhapokha pakhale thandizo loyenerera la thupi, matenda ashuga amabweretsa mavuto osiyanasiyana, pang'onopang'ono kuwononga thupi la munthu.

Mavuto ambiri omwe amakonda ndi awa: matenda ashuga a m'mimba, nephropathy, retinopathy, zilonda zam'mimba, hypoglycemia, ketoacidosis. Matenda a shuga amathanso kupititsa patsogolo chotupa cha khansa. Pafupifupi nthawi zonse, wodwala matenda ashuga amwalira, akulimbana ndi matenda opweteka, kapena amasintha kukhala munthu weniweni wolumala.

Kodi anthu odwala matenda ashuga amatani? Endocrinological Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsiratu matenda ashuga.

Pulogalamu ya Federal "Health Health Nation" ikuchitika, mkati mwa momwe mankhwalawa amaperekedwa kwa aliyense wokhala ku Russian Federation ndi CIS ZAULERE . Kuti mumve zambiri, onani tsamba lovomerezeka la MINZDRAVA.

Komano kuchuluka kwa zinthu zomwe zimapanga insulini kumachepa, mphamvu zama cell kwa izo zimachepa, monga mtundu wachiwiri. Popita nthawi, maselo a beta amasiya kugwira ntchito ndikufa, motero, matendawa amakhala ochulukana ndi chithunzi chodalirika cha insulin.

Zizindikiro zikufanana kwambiri ndi nthawi zonse yamatendawa:

• kutopa, ntchito yochepa,
• ludzu lalikulu
• mkulu diuresis.

Nthawi zina, wodwalayo samazindikira mawonekedwe awo, popeza amadzionetsa ofooka. Corticosteroids samachititsa kuti thupi lizigwiritsa ntchito kwambiri kapena kupindulitsa kwake, ndipo kuyezetsa magazi kumapangitsa kuti adziwe zoyenera. Kuchuluka kwa shuga mu mkodzo ndi magazi kumatuluka kwambiri, kawirikawiri ma acetone samawonekera.

Owerenga athu amalemba

Mutu: Matenda a shuga apambana

Ku: my-diabet.ru Administration

Ndili ndi zaka 47, ndinapezeka kuti ndili ndi matenda ashuga a 2. M'masabata angapo ndinapeza pafupifupi 15 kg. Kutopa nthawi zonse, kugona, kumva kufooka, kuwona kunayamba kukhala pansi. Nditakwanitsa zaka 66, ndinali ndikumenya insulin yanga, zonse zinali zoipa kwambiri.

Nayi nkhani yanga

Matendawa adapitilirabe, kukomoka kwakanthawi kunayamba, ambulansi imandibwezera kuchokera kudziko lina. Nthawi zonse ndimaganiza kuti nthawi ino ikhala yomaliza.

Chilichonse chinasintha mwana wanga wamkazi atandilola kuti ndiwerenge nkhani imodzi pa intaneti. Simungayerekeze m'mene ndimamuyamikirira. Nkhaniyi inandithandiza kuthana ndi matenda ashuga, omwe amati ndi osachiritsika. Zaka 2 zapitazi ndidayamba kusuntha kwambiri, nthawi yamasika ndi chilimwe ndimapita kumayiko tsiku lililonse, ndikumalima tomato ndikugulitsa pamsika. Azakhali anga amadabwa ndimomwe ndimapangira chilichonse, komwe ndimapeza mphamvu zambiri, sakhulupirira kuti ndili ndi zaka 66.

Ndani akufuna kukhala ndi moyo wautali, wamphamvu komanso kuiwalako za matenda oyipawa kwamuyaya, tengani mphindi 5 ndikuwerenga nkhaniyi.

Pitani pa nkhaniyi >>>

Maselo a Beta amagwira ntchito mwamphamvu kwambiri kuti akhalebe ndi shuga. Ngati kapamba ali wathanzi, ndiye kuti posachedwa azolowera katundu wolemera. Ndi kuchepa kwa mulingo kapena kusiya mankhwala kwathunthu, njira zonse za metabolic zimabwezeretseka.

Koma ngati munthu amene amatenga mahomoni ali ndi matenda ashuga, chithunzicho ndi chosiyana kotheratu. Maselo ataya kale chidwi ndi insulini, motero, kapamba sichita ntchito yake bwino. Pazifukwa izi, ndikofunikira kuti odwala matenda ashuga azigwiritsa ntchito corticosteroids pokhapokha pokhapokha.

Mlandu wosiyana kotheratu ndi pamene sizingatheke kukana mahomoni, mwachitsanzo, ngati mphumu yayikulu ya bronchial. Apa, wodwalayo amayenera kuyang'anira kuchuluka kwa shuga, komanso zakumwa za anabolics zomwe zimasiyanitsa pang'ono zotsatira zoyipa za glucocorticoids.

Fotokozani

Ngati muwerenga izi, mutha kuzindikira kuti inu kapena okondedwa anu mukudwala matenda ashuga.

Tinachita kafukufuku, tinaphunzira zambiri za zida ndipo koposa zonse tinayang'ana njira ndi mankhwala ambiri a shuga. Chigamulochi ndi motere:

Ngati mankhwalawa onse akaperekedwa, zinali zotsatira zosakhalitsa, atangomaliza kudya, matendawa amakula kwambiri.

Chithandizo chokhacho chomwe chinapereka zotsatira zazikulu ndi Dialife.

Pakadali pano, awa ndiye mankhwala okhawo omwe amachiritsiratu matenda ashuga. Dialife adawonetsa chidwi chachikulu magawo a shuga.

Tidafunsa Unduna wa Zaumoyo:

Ndipo kwa owerenga tsamba lathu lino mwayi
pezani dialife ZAULERE!

Yang'anani! Milandu yogulitsa mankhwala abodza a Dialife tsopano yachulukira.
Mukayika lamulo pogwiritsa ntchito maulalo pamwambapa, mumatsimikiziridwa kuti mudzalandira malonda kuchokera kwa wopanga wamkulu. Kuphatikiza apo, mukamayitanitsa pa tsamba lovomerezeka, mumalandira chitsimikizo cha kubweza (kuphatikizapo ndalama zoyendera) ngati mankhwalawo alibe.

Steroid shuga mellitus amatchedwanso sekondaleti yodalira matenda a shuga 1. Amawoneka chifukwa cha kuchuluka kwa corticosteroids (mahomoni a adrenal cortex) m'magazi kwa nthawi yayitali.

Zimachitika kuti matenda a shuga a steroid amayamba chifukwa cha zovuta za matenda momwe kuchuluka kwa mahomoni, mwachitsanzo, ndi matenda a Itsenko-Cushing.

Komabe, nthawi zambiri matendawa amapezeka pambuyo poti athandizidwe kwa nthawi yayitali ndi mankhwala ena a mahomoni, chifukwa chake, dzina limodzi la matendawa ndi matenda osokoneza bongo.

Mtundu wa shuga wa matenda a shuga, omwe adachokera, ndi wa gulu la extrapancreatic matenda, poyambirira sizigwirizana ndi zovuta zapancreatic.

Mwa anthu omwe alibe kusokonezeka kwa kagayidwe kazakudya nthawi yambiri ya glucocorticoids, amapezeka wofatsa ndipo amachoka atachotsedwa. Pafupifupi 60% ya odwala, a 2 matenda a shuga amakhumudwitsa mtundu wa matenda omwe amayimira insulin popanda wodwala.

Zomwe zimayambitsa matenda a shuga a Steroid

Amithenga am'magazi a Hormonal amapangidwa mwachilengedwe ndi ziwalo za adrenal ndi ziwalo zoberekera. Amasokoneza chitetezo chathupi ndipo amagwiritsidwa ntchito pochiza matenda otsatirawa a autoimmune,

Kuti akwaniritse cholinga chawo, corticosteroids amatengera zotsatira za cortisol, timadzi timene timatulutsa impso, mwakutero timatsogolera pamavuto chifukwa cha kuthamanga kwa magazi ndi shuga.

Komabe, palimodzi ndi phindu, zinthu zopangidwa zogwira ntchito zimakhala ndi zotsatira zoyipa, mwachitsanzo, kunenepa kwambiri ndi kuwonda kwa mafupa mukamatengedwa nthawi yayitali. Odwala a Corticosteroid atengeka mosavuta ndi chitukuko cha dziko lotengera.

Pakukhudzidwa kwambiri kwa m'magazi, maselo opanga insulin amatulutsa timadzi tambiri kuti timatseke shuga. Chifukwa chake, umasiyanitsa shuga mkati mwa yokhazikika kuti thupi lonse lizigwira ntchito.

Mu pathological mkhalidwe wa mitundu iwiri, ma steroid amapanga shuga. Amachulukitsa glycemia m'njira zitatu:

1. Kuletsa zochita za insulin.
2. Wonjezerani shuga.
3. Kupanga kwamphamvu kwa chiwindi.

Zinthu zophatikizika zomwe zimagwiritsidwa ntchito pochiza mphumu sizimakhudza shuga. Komabe, mulingo wake umakwera m'masiku ochepa ndipo udzasiyanasiyana kutengera nthawi, mlingo ndi mtundu wa mahomoni:

• Zotsatira zamankhwala akumamwa zimathera patatha maola 48 mutachotsedwa,
• Zotsatira za jakisoni zimatha masiku atatu mpaka 10.

Atayimitsa kugwiritsa ntchito ma steroid, glycemia imayamba kuchepa, komabe, anthu ena amatha kudwala matenda amtundu wa 2, omwe amayenera kuthandizidwa pa moyo wonse. Matendawa amtundu wamtunduwu amakula ndikugwiritsa ntchito mankhwala osokoneza bongo kwa nthawi yayitali (oposa miyezi 3).

Ma Steroid amagwiritsidwa ntchito pochiza matenda osiyanasiyana, kuchokera ku zovuta za autoimmune mpaka mavuto omwe amabwera chifukwa cha kutupa, monga nyamakazi.

Amagwira ntchito pochepetsa kuchepa kwa chitetezo chathupi komanso kuchepetsa kutupa, chifukwa chake ndiwothandiza popewa kuwonongeka kwa minofu.

Komabe, ma steroids amathanso kukopa momwe thupi limachitikira ndi insulin, mahomoni omwe amawongolera shuga.

Zizindikiro ndi zomwe zimachitika pa maphunziro a shuga

Ngakhale kuti matenda a shuga amakhudzidwa ndi shuga, koma amaphatikiza zomwe zimachitika ndi matenda ashuga, woyamba ndi wachiwiri. Ndi matenda ashuga, ntchito ya ziwalo zamkati imasintha, katundu wawo amasintha.

Kumayambiriro kwa matendawa, corticosteroids ambiri amayamba kuwononga maselo a beta a kapamba, omwe akupitiliza kupanga insulin. Pakapita kanthawi, insulin imayamba kupangidwa kale pang'ono, kenako ikasiya kupangidwa.

Nthawi zambiri odwala samalabadira izi. Zonse ndi zabwinobwino, kulemera kumakhala chimodzimodzi. Chifukwa cha izi, ndizovuta kwambiri kuti adziwe matenda a shuga a shuga.

Ndi mawonekedwe apamwamba a shuga, fungo la acetone kuchokera mkamwa limayamba kutuluka. Matupi a Ketone nawonso samapezeka mkodzo nthawi zonse. Mphamvu yotsutsa-insulin nthawi zambiri imadzipangitsa kumva, choncho nkovuta kuzindikira mozama ndikumachita chithandizo chofunikira. Kuti akhazikitse glycemia (shuga m'magazi), wodwalayo amapatsidwa zakudya zofunikira komanso zolimbitsa thupi.

Matenda a shuga monga chifukwa cha steroid

Zokha, kuchulukitsa kwa corticosteroids kumakhudzanso chimodzimodzi. Kuphatikiza apo, sikuti aliyense amene amamwa amadwala. Ma mahormoniwa samangochita ngati kapamba wa munthu, komanso amachepetsa mphamvu ya insulin, kungosokoneza.