Matenda a Steroid: Zizindikiro, matenda ndi njira zochizira

Kukula ndi kugwiritsa ntchito ma steroid mu 1940 kunakhala chozizwitsa chamakono m'njira zambiri. Anathandizira kuchira msanga kwa odwala ambiri omwe ali ndi matenda osiyanasiyana.

Komabe, mahomoni opanga adasanduka mankhwala oopsa, omwe nthawi zina adadzetsa mavuto akulu ndi zotsatira zina zosagwirizana ndi metabolic. Inde, chithandizo chitha kuyambitsa matenda a shuga a steroid, chifukwa zimayambitsa kukana kwa insulin pamlingo wa chiwindi, minofu yamatumbo ndi minofu ya adipose.

Ma Steroid amatsogolera ku zotsatirazi:

Kuwonongeka kwa pancreatic dysfunction ya islet insulin yopanga ma cell kwatsimikizidwanso.

Matenda a shuga a Steroid amatchulidwa kuti ndi kuchuluka kwachilendo kwa glycemia komwe kumakhudzana ndi kugwiritsa ntchito glucocorticoids mwa wodwala wokhala ndi kapena wopanda mbiri yakale ya matenda omwe amadalira insulin. Njira zoyenera kudziwa mtundu wa matenda amtunduwu ndi kutsimikiza kwa glycemia:

pamimba yopanda kanthu - ochepera 7.0 mmol / l,
patatha maola awiri ndikuyesa pakamwa - - 11.1 mmol / l,
kwa odwala omwe ali ndi zizindikiro za hyperglycemia - ochepera 6.5 mmol / L.

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:

Kuletsa zochita za insulin.
Wonjezerani shuga.
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).

Matenda a shuga a Steroid ndi mtundu wachiwiri wa matenda a shuga 1 omwe amadalira insulin. Kukula kwake kumachitika chifukwa chowonjezera corticosteroids m'magazi a odwala omwe amapangidwa ndi adrenal cortex, kapena atatha kumwa mankhwalawa. Amalandira chithandizo cha matenda angapo ndikupereka mwayi wochepetsera kupweteka kwambiri. Chiphunzitsochi sichimagwirizanitsidwa ndi kusokonezeka kwa β-cell of islets a Langerhans a kapamba.

Maziko a chitukuko cha matendawa

Matenda osokoneza bongo amayamba motsogozedwa ndi zinthu zingapo. Izi zikuphatikiza:

Mankhwala osokoneza bongo ochulukirapo a glucocorticoid, omwe amachititsa kuti azindikire shuga wambiri wodwala wa sodium omwe saulula kuphwanya kagayidwe kazakudya.
Kusintha kwa shuga wosadalira insulini kupita ku mawonekedwe ake omwe amadalira insulin.
Kusavomerezeka mu mahomoni kumbuyo chifukwa cha kuphwanya kwa ntchito kwa hypothalamus ndi gitu planditary ndikuchepetsa kukana kwa maselo ndi minofu yake ku insulin.
Dziwitsani matenda oopsa, omwe amawonetsa chithokomiro chamthupi komanso amachepetsa kukonza kwa monosaccharide ndi zimakhala mthupi la wodwalayo.
Kuzindikiritsa kusakhazikika pakati pamahomoni, chomwe chimakhala chifukwa chosagwirizana ndi zomwe thupi limapanga.
Kunenepa kwambiri kwa wodwala, komanso kuchuluka kwa hydrocortisone m'thupi - mahomoni opangidwa ndi adrenal cortex.

Njira yofatsa yamatenda, yomwe kukula kwake kumalumikizana ndi mankhwala osokoneza bongo a glucocorticoids, imatha kutha yokha itatha kumwa. Zinthu ngati izi zimapangitsa kuti pakhale tsogolo labwino la matenda a shuga a steroid, omwe amapezeka chifukwa cha kupatuka kwa mulingo wa monosaccharide m'magazi.

Kusamalira panthawi yake matendawa kumathetsa chiopsezo cha zovuta zomwe zimasokoneza thanzi komanso moyo wa wodwalayo.

Mankhwala ogwiritsa ntchito glucocorticoid wogwiritsidwa ntchito mopitirira muyeso, omwe amachititsa kuti shuga azikhala ndi matenda osokoneza bongo, amakhala ndi anti-kutupa. Amalembedwa kuti athetse mavuto a nyamakazi, mphumu ya bronchial, angapo a autoimmune pathologies. Kuphatikiza pa glucocorticoids, matenda a shuga a steroid amatha chifukwa cha kugwiritsidwa ntchito kwa ma diuretics mu mawonekedwe a Nefriks, Navidrex, Hypothiazide, Dichlothiazide ndi mitundu yina ya mapiritsi oteteza kubereka kwa mahomoni.

Kuwonetsedwa kwa matendawa

Matenda a shuga a Steroid amaphatikiza zizindikiro za matenda amtundu 1 komanso matenda ashuga 2. Izi zikuphatikiza:

Maonekedwe a ludzu ndi kuyabwa kwa zinthu pamtunda wa khungu.
Pafupipafupi kukodza.
Kuphwanya kakhalidwe, kuchepa kwamphamvu yolimbitsa thupi, kuchititsa kutopa kwambiri, kutopa kwa wodwala.
Osowerengeka milandu kupeza kwambiri shuga, acetone m'magazi ndi mkodzo.
Kuchepetsa thupi.

Zizindikiro zazikulu za pathology sizosiyana mu chithunzi chotchulidwa. Amatuluka chifukwa cha kuwonongeka kwa ma β-maselo a ma islets a Langerhans a kapamba ndi kuchuluka kwa corticosteroids. Mavuto a insulini m'thupi la wodwalayo amachepa, ndipo khungu lake limachepa. Zotsatira zake, chifukwa cha kuwonongeka kwa maselo a β-cell, kupanga kwa mahomoni a protein omwe amapangidwa ndi kapamba amayimitsidwa. Kukula kwa matendawa sikusiyana ndi mtundu wa matenda ashuga amtundu wa 1 ndipo kumawonetsa Zizindikiro zomwe zimayamba ndi matendawa.

Njira zothandiza kuti athetse matenda

Chithandizo chovuta kwambiri cha matenda a shuga amellitus ndi ofanana kwambiri ndi njira yothetsera vuto la matenda osagwirizana ndi insulin. Amasanjidwa payekhapayekha, mogwirizana ndi mawonekedwe a thupi la wodwalayo, zizindikiro za mulingo wa monosaccharide m'magazi ake. Matenda a Steroid amathandizidwa popanda zovuta zambiri. Kutsatira okhwima palingaliro, upangiri wa endocrinologist ndiye njira yofunikira yopezera zotsatira zabwino. Chithandizocho chimaphatikizaponso njira zina zochizira. Izi zikuphatikiza:

Kuti mupewe zovuta zomwe zingakhale zowopsa pamoyo komanso thanzi la wodwalayo, ndikofunikira kuzindikira matendawa munthawi ndikuyamba chithandizo moyang'aniridwa ndi dokotala!

Gulu la zakudya zoyenera malinga ndi zakudya zamafuta ochepa.
Kumwa mankhwala ochepetsa shuga.
Kukhazikitsa insulin mankhwala popanda kuyembekezera hypoglycemic zotsatira kumwa mapiritsi zotchulidwa kuti shuga shuga.
Kudzudzula kwambiri.
Kuthana ndi mankhwala opangidwa ndi corticosteroid omwe adayambitsa kukula kwa matenda.

Opaleshoni nthawi zina imatha kutumizidwa kuti ichotse minyewa yambiri m'magazi a adrenal ndikuchepetsa kupanga kwawo kwa corticosteroids.

Chithandizo cha matendawa chili ndi zolinga zingapo. Pambuyo kukhazikitsa, ndikotheka kusintha mulingo wa monosaccharide, ndikuchotsanso zomwe zimapangitsa kuwonjezeka kwa kuchuluka kwa mahomoni opangidwa ndi adrenal cortex. Izi zimawonjezera mwayi wobwezeretsa ntchito za β-maselo a timakhanda tachilumba cha Langerhans cha kapamba, yemwe amayang'anira kupanga insulin. Kutsatira malangizo a dokotala pazakudya zokhala ndi carb ochepa, moyo wokangalika, kusiya zizolowezi zoipa kumapereka mwayi wopeza zotsimikizika komanso kupatula kukula kwa zovuta za matenda ashuga.

Khulupirirani madokotala ndipo khalani athanzi!

Matenda a shuga amayamba kudutsa fomu yachiwiri ya steroid, pomwe wodwalayo sangachite popanda insulini. Zizindikiro zimatha kusiyanasiyana ndi matenda omwe amayambitsidwa. Kuchita mopitirira malire, kufooka, komanso thanzi labwino kumawonedwa. Timaganizira mwatsatanetsatane m'nkhaniyi.

Kodi matenda a shuga ndi ati?

Steroid matenda a shuga ndi mtundu wa matenda a shuga omwe ali ndi mawonekedwe achiwiri. Matenda amapezeka pamene ntchito ya impso imalephera, ndipo mahomoni a adrenal cortex amasungidwa kwambiri. Matenda a shuga amtunduwu amayamba chifukwa cha kugwiritsa ntchito nthawi yayitali mankhwala a mahomoni.

Mankhwala a shuga a Steroid

Mankhwala a Hormonal omwe amadziwika kuti amathandizira odwala matenda ashuga amathandizanso kuvutikira kwa metabolic, makamaka kuphatikiza mapuloteni. Mankhwala Ofunika - iyi ndi Prednisolone, Dexamethasone, yokhudzana ndi gulu la mahomoni, komanso Hypothiazide, Navidrex, Dichlothiazide - awa ndi okodzetsa.

Kugwiritsa ntchito mankhwalawa kumathandizira odwala omwe ali ndi matenda osokoneza bongo omwe amakhala mu mawonekedwe oyamba kukhalabe ndi shuga m'magazi komanso amachotsa madzi owonjezera mthupi. Nthawi yomweyo, kugwiritsa ntchito kwawo nthawi yayitali kumatha kuyambitsa mawonekedwe achiwiri - matenda a shuga. Poterepa, wodwalayo sangathe popanda insulin. Pangozi ndi anthu onenepa kwambiri, komanso othamanga omwe amagwiritsa ntchito mankhwala a steroid kuti achulukitse minofu.

Pali mankhwala ena omwe amathandizira kuti pakhale shuga yachiwiri: kulera, mankhwala okodzetsa, ndi mankhwala omwe amaperekedwa chifukwa cha mphumu, kuthamanga kwa magazi, ndi arthrosis.

Mukamapereka mankhwala a mahomoni, muyenera kukhala akhama pantchito kuti mupewe kuchitika kwambiri. Chithandizo chiyenera kuyang'aniridwa ndi adokotala.

Zizindikiro za Steroid Diabetes

Matenda a shuga atangolowa mu mawonekedwe a steroid, wodwalayo amayamba kumva kufooka kwambiri, kugwira ntchito mopitirira muyeso komanso osadutsa wathanzi. Zizindikiro Khalidwe lakale la shuga - ludzu losatha ndi kununkhira kwa acetone kuchokera mkamwa - ndizofooka kwambiri. Choopsa ndichakuti Zizindikiro zotere zimatha kudwala matenda aliwonse. Chifukwa chake, ngati wodwalayo saonana ndi dokotala munthawi yake, matendawa amasintha kukhala mtundu waukulu wa matenda a shuga a steroid, omwe amaphatikizidwa ndi pafupipafupi. Kufunika kwa insulin kukukulira.

Ngati matenda a shuga a steroid amapezeka pa chithandizo cha matenda monga mphumu, matenda oopsa, arthrosis ndi ena, wodwalayo amamva pakamwa pouma, kukoka pafupipafupi, kuwonda kwambiri.

Nthawi zina, abambo amayamba kukhala ndi mavuto azikhalidwe zakugonana, mwa akazi - matenda opatsirana mwa ziwalo zoberekera.

Odwala ena ali ndi vuto lodana ndi masomphenya, kumva kuwawa ndi kutalika kwa miyendo, kumverera kwachilendo kwanjala.

Ngati mukumva kufooka kosalekeza komanso kutopa msanga, ndibwino kumayeseza mkodzo ndikuwunika magazi. Monga lamulo, mulingo wa shuga mwa iwo ndi kuyambika kwa matenda ashuga yachiwiri kumawonjezeka kwambiri ndikuwonjezera zikhalidwe zovomerezeka.

Kuzindikira ndi kuchiza matenda a shuga a steroid

Chifukwa chakuti zizindikiro za matenda a shuga a steroid ndi ofanana ndi zizindikiro za matenda ena aliwonse, zimatha kupezeka ndi zotsatira za kuyesa kwamkodzo ndi magazi a shuga. Ngati shuga mkati mwawo amaposa 11 mmol, ndiye kuti iyi ndi njira yachiwiri ya matenda ashuga.

Kuphatikiza apo, endocrinologist amasankha kuyesa impso ndi adrenal glands. Chowonadi cha kumwa mankhwala a mahomoni ndi diuretic chimawerengedwa.

Kutengera zinthu izi, chithandizo chamankhwala chimayikidwa kuti chichepetse shuga komanso kusintha matenda a impso.

Mankhwala amatengera zovuta za matendawa. M'masiku oyambilira, wodwalayo amatha kudwala zakudya zoyenera komanso mankhwala. M'malo osasamalidwa, kuchitapo kanthu kwa opaleshoni kumafunika.

Njira zazikulu zochizira matenda a shuga a steroid:

Kuthana ndi mankhwala omwe amakhumudwitsa kupezeka kwa matendawa.
Chakudya cholimba. Wodwala amangodya zakudya zamagulu ochepa.
Kusintha ntchito za kapamba ndikukhazikika m'magazi a shuga, ma jakisoni a insulin ndi omwe amapatsidwa (onani komanso momwe angabayire insulin molondola).
Mankhwala ena omwe amachepetsa shuga amathandizanso.

Insulin imayikidwa pokhapokha ngati mankhwala ena sangapereke zofunika pakukhazikitsa shuga. Kumwa jakisoni kumalepheretsa zovuta za matenda a shuga a steroid.

Nthawi zina, wodwala amafunikira opaleshoni . Opaleshoniyo akhoza kukhala ndi cholinga chochotsa mu adrenal cortex kapena minofu yowonjezera, ma neoplasms osiyanasiyana. Nthawi zina ma tezi a adrenal amachotsedwa kwathunthu. Kuchita koteroko kumatha kuchepetsa matendawa, ndipo nthawi zina msuzi wa shuga umabwezeretsedwa.

Koma pali zovuta. Pambuyo pakuchita opaleshoni, njira za metabolic m'thupi zimaphwanyidwa, ntchito ya impso imabwezeretsedwa kwa nthawi yayitali. Zonsezi zimatha kuyambitsa zovuta zingapo mthupi. Motere, kulowererapo kwa opaleshoni kumagwiritsidwa ntchito kawirikawiri.

Kupewa matenda a shuga a Steroid

Pazolinga zopewera, kuti musakhale ndi matenda ashuga a steroid, muyenera kutsatira zakudya zama carb ochepa . Izi ndizowonetsa kwambiri kwa odwala matenda ashuga komanso omwe angatenge odwala.

Ngati mumagwiritsa ntchito mankhwala a mahomoni pochiza matenda ena, muyenera kuchita masewera olimbitsa thupi pafupipafupi. Kupanda kutero, pali chiopsezo cha kuchuluka kwambiri kwa thupi, zomwe zimapangitsa kuchuluka kwa shuga m'thupi. Ngati mukumva kutopa kosalekeza, kuchepa kwa ntchito, muyenera kufunafuna upangiri wa akatswiri nthawi yomweyo.

Mtundu wa insulin wa matenda a shugaidi umachiritsidwa kwathunthu muzochitika zina. Ndikofunika kumvetsetsa kuti matendawa sakuyenera kuthamanga. Kulumikizana ndi akatswiri panthawi yake kungakuthandizeni kupewa zoyipa. Kudzidziwitsa nokha sikofunika. Chithandizo chake chimatengera zisonyezo ndi machitidwe a thupi.

- 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.

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 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.

Matenda a shuga ndi matenda omwe amadziwika ndi shuga yayikulu. Chomwe chimapangitsa izi ndizosowa kukhudzana ndi mahomoni - insulin. Imasungidwa ndi kapamba, kapena, mothandizidwa ndi maselo a beta a zisumbu za Langerhans zomwe zimakhalamo.

Mahomoni ofunikira a shuga amasungunuka ndi insulin

Kwa nthawi yoyamba, insulin idalembedwa ndi Elizabeth Hughes ngati dokotala Bunting mu 1922 pochiza matenda a shuga 1. Kwa pafupifupi zaka zana limodzi, insulini yakhala mankhwala othandiza kwambiri posamalira odwala. Munali mu 1922 pomwe insulin yosungunulira inapangidwa. Amabayidwa pansi pakhungu, kulowa m'mitsempha kapena m'misempha. Mbali yake yosiyanitsa ndi njira ziwiri zomalizira. Awa ndiwo mankhwala okhawo omwe angagwiritsidwe ntchito motere. Insulin ya soluble imayamba pakadutsa mphindi 15 mpaka 30, imatenga maola 6 mpaka 8.

Insulin glargine

Awa ndi mankhwala omwe atenga nthawi yayitali (akupezeka monga yankho lomveka bwino). Imayang'aniridwa pang'onopang'ono, pambuyo pake microprecipitate imapangidwa pamalo opangira jekeseni. Zochita za mankhwalawa zimachitika maola 1.5 atatha kutsata, ndipo zimatha tsiku limodzi. Dziwani kuti kuphatikiza kwake m'magazi sikusintha kwambiri, koma mawonekedwe amtunda. Ngati tifanizira kuchuluka kwa glargine, omwe ali ndi mitundu ya insulin yokhala ndi mphamvu yayitali, ndiye kuti akufanana ndi kuteteza kwa insulin.

Zosakaniza zamitundu mitundu zamankhwala

Mankhwala ena amakhala ophatikizana. Mawonekedwe awo amasulidwe: Mbale, ma cartridge - a zolembera zapadera za syringe. Ndiwo malo ogulitsa mankhwalawa omwe amapezeka kwambiri. Ndiwothandiza kwambiri kwa anthu omwe ali ndi vuto lowona.

Anthu ena amatcha mtundu wa shuga womwe amadalira insulin. Nthawi zambiri amakula chifukwa cha kupezeka kwa magazi a kuchuluka kwa corticosteroids kwa nthawi yayitali. Awa ndi mahomoni opangidwa ndi adrenal cortex. Zizindikiro zake komanso chithandizo cha matenda a shuga a steroid ziyenera kudziwika kwa aliyense amene wakumana ndi matenda amtunduwu.

Kukula kwa matenda a shuga

Mtundu wodwala wa sodium wodwala insulin nthawi zina umatchedwa sekondaleus yachiwiri kapena matenda a shuga. Chimodzi mwazinthu zomwe zimapangitsa kupezeka kwake ndikugwiritsa ntchito mankhwala a mahomoni.

Pogwiritsa ntchito mankhwala a glucocorticosteroid, mapangidwe a glycogen m'chiwindi amalimbikitsidwa kwambiri. Izi zimabweretsa kukulira glycemia. Maonekedwe a matenda osokoneza bongo ndi otheka kugwiritsa ntchito glucocorticosteroids:

Dexamethasone
Hydrocortisone
Prednisone.

Awa ndi mankhwala othana ndi kutupa omwe amadziwika kuti amathandizira pakhungu la bronchial mphumu, nyamakazi, komanso zotupa zingapo za autoimmune (lupus erythematosus, eczema, pemphigus). Amathanso kutumikiridwa chifukwa cha matenda amisempha.

Matendawa amatha kupezekanso chifukwa chogwiritsa ntchito njira zina zoletsa pakamwa komanso thiazide diuretics: Nephrix, Hypothiazide, Dichlothiazide, Navidrex.

Pambuyo kumuyika kwa impso, chithandizo cha nthawi yayitali chovomerezeka cha corticosteroid chimafunika. Kupatula apo, pambuyo pa opaleshoni yotere, ndikofunikira kumwa mankhwala omwe amapondereza chitetezo cha mthupi. Koma kugwiritsa ntchito corticosteroids sikuti nthawi zonse kumayambitsa matenda ashuga. Mwachidule, mukamagwiritsa ntchito ndalama zomwe zili pamwambazi, mwayi wokhala ndi matendawa umakulanso.

Ngati m'mbuyomu odwala sakhala ndi vuto la kagayidwe kazakudya m'thupi, ndiye kuti pali kuthekera kwakukulu kwakuti pambuyo pakuchotsedwa kwa mankhwalawa omwe adayambitsa matenda ashuga, matendawo amakhalanso amakhazikika.

Matenda owopsa

Kutengera mtundu wa shuga, matendawa amapatsidwa nambala malinga ndi ICD 10. Ngati tikulankhula za fomu yodalira insulin, ndiye kuti codeyo idzakhala E10. Ndi fomu yodziyimira payokha ya insulin, code E11 imaperekedwa.

Matenda ena, odwala amatha kuonekera. Chimodzi mwazinthu zomwe zimayambitsa kukula kwa mtundu wa steroid ndimatenda a hypothalamic-pituitary. Zolakwika mu kugwira ntchito kwa hypothalamus ndi pituitary gland ndizomwe zimayambitsa kusawoneka bwino kwa mahomoni m'thupi. Zotsatira zake, maselo samayankhanso insulin.

Matenda ofala kwambiri omwe amakhumudwitsa matenda a shuga ndi matenda a Itsenko-Cushing. Ndi matenda awa mthupi, kuchuluka kwa hydrocortisone kumawonedwa. Zomwe zimayambitsa matendawa sizinadziwikebe pano, koma zikuwuka:

mankhwalawa glucocorticosteroids,
kunenepa kwambiri
motsutsana ndi zakumwa zakumwa zoledzeretsa (zosakhalitsa),
pa mimba
motsutsana ndi maziko a matenda ena amisempha ndi amisala.

Chifukwa cha chitukuko cha matenda a Itsenko-Cushing's, maselo amasiya kuzindikira insulin. Koma palibe kutchulidwa kolakwika pakugwira ntchito kwa kapamba. Ichi ndi chimodzi mwamagawo osiyana pakati pa mtundu wa shuga wa shuga ndi ena.

Matendawa amatha kupangidwanso mwa odwala omwe ali ndi poyizoni Goiter (matenda a Graves, matenda a Bazedova). Njira yogwiritsira ntchito glucose m'misempha imasokonezeka. Ngati, motsutsana ndi zotupa za chithokomirozi, matenda a shuga atakula, ndiye kuti kufunikira kwa insulin kumawonjezeka kwambiri, ndipo minyewa yake imakhala yolimbana ndi insulin.

Zizindikiro za matendawa

Ndi matenda a shuga a steroid, odwala samadandaula za kuwonekera kwa shuga. Alibiretu ludzu losalamulirika, kuwonjezeka kwa ziwopsezo. Zizindikiro zomwe odwala matenda ashuga amadandaula za ma shuga a shuga mulinso sizipezeka.

Komanso, odwala omwe ali ndi matenda a shuga a steroid, palibe zizindikiro za ketoacidosis. Nthawi zina, fungo la acetone limatha kuwoneka kuchokera mkamwa. Koma izi zimachitika, monga lamulo, muzochitikazo pamene matendawa atadutsa kale kale.

Zizindikiro za matenda a shuga a steroid zingakhale motere:

kuwonongeka kwaumoyo
mawonekedwe ofooka
kutopa.

Koma kusintha kotereku kumatha kuwonetsa matenda osiyanasiyana, kotero madokotala sangakhale onse akuganiza kuti wodwalayo amayamba matenda a shuga. Ambiri samapita konse kwa madokotala, akukhulupirira kuti ndizotheka kubwezeretsa magwiridwe antchito pomatenga mavitamini.

Mkhalidwe wamatenda

Kupita patsogolo kwa mtundu wa steroid matendawa, maselo a beta omwe amapezeka m'matumba am'mimba amayamba kuwonongeka chifukwa cha corticosteroids. Kwanthawi yayitali amatha kupanga insulini, koma kupanga kwake kumachepetsedwa. Kusokonezeka kwa metabolic. Tizilombo ta m'thupi timayambiranso insulin. Koma popita nthawi, kupanga kwake kumatha konse.

Ngati kapamba amasiya kupanga insulini, ndiye kuti matendawa ali ndi zizindikiro za matenda ashuga amtundu 1. Odwala amakhala ndi ludzu lalikulu, kuchuluka kwa kwamikodzo komanso kuwonjezeka kwamkodzo tsiku lililonse. Koma kuchepa thupi kwambiri, monga momwe amathandizira odwala matenda ashuga amtundu 1, samapezeka mwa iwo.

Mankhwala othandizira ndi corticosteroids amafunikira, kapamba amakumana ndi katundu wambiri. Mankhwala osokoneza bongo mbali imodzi imawakhudza, ndipo inayo, imapangitsa kuti insulin iwonjezeke. Kuti musunge chizolowezi chakhansa, muyenera kuchita mpaka malire.

Matenda samadziwika nthawi zonse ngakhale mwa kusanthula. Mu odwala oterowo, kuchuluka kwa shuga m'magazi ndi matupi a ketone mumkodzo nthawi zambiri.

Nthawi zina, mukamamwa mankhwala a glucocorticosteroid, shuga amawonjezereka, omwe kale sanafotokozedwe bwino. Pankhaniyi, kuwonongeka kwakuthwa kwa matendawa kumatheka mpaka kukomoka. Chifukwa chake, ndikofunika kuyang'ana kuchuluka kwa glucose musanayambe mankhwala a steroid. Malangizowa akulangizidwa kuti azitsatira anthu onenepa kwambiri, mavuto okhala ndi kuthamanga kwa magazi. Odwala onse a zaka zopuma pantchito ayeneranso kufufuzidwa.

Ngati pakanalibe mavuto ndi metabolism m'mbuyomu, ndipo njira ya chithandizo cha steroid sichikhala yayitali, ndiye kuti wodwalayo sangadziwe za matenda a shuga. Mukamaliza kulandira chithandizo, kagayidwe kamabwerera mwakale.

Njira zamankhwala othandizira

Kuti mumvetsetse momwe chithandizo cha matendawa chimachitikira, chidziwitso pa zamomwe zimapangidwira momwe thupi limagwiritsire ntchito. Ngati zosinthazo zidayambitsidwa ndi hyperproduction ya glucocorticosteroids, ndiye kuti chithandizo chamankhwala ndicholinga chochepetsera chiwerengero chawo. Ndikofunikira kuthetsa zomwe zimayambitsa matenda ashuwarawa komanso. Chifukwa cha izi, mankhwala omwe kale adalemba corticosteroid, zododometsa ndi njira zakulera za pakamwa zimathetsedwa.

Nthawi zina ngakhale kuchitidwa opaleshoni kumafunika. Opaleshoni amachotsa minofu yambiri ya adrenal. Kuchita uku kumakupatsani mwayi wochepetsa kuchuluka kwa glucocotricosteroids m'thupi ndi kusintha momwe odwala alili.

Endocrinologists amatha kupereka mankhwala othandizira kutsitsa shuga. Nthawi zina kukonzekera sulfonylurea ndi mankhwala. Koma poyerekeza zakumbuyo kwawo, chakudya chamafuta amatha kuchepa. Thupi silidzagwira ntchito popanda kukondoweza.

Ngati matenda a shuga a steroid apezeka mwanjira yosavomerezeka, njira yayikulu yothandizira ndikuchotsa mankhwalawa omwe adayambitsa matendawa, kudya komanso. Kutengera ndi malingaliro awa, mkhalidwewo ungasinthidwe posachedwa.

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:

Mphumu ya bronchial,
Rheumatoid nyamakazi,
Matenda a Autoimmune: pemphigus, eczema, lupus erythematosus.
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:

Kuchulukitsa pokodza
W ludzu
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.

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 kawirikawiri ndi mtundu woyamba wa matenda ashuga.

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.

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. Zizindikiro zomwe zimawonedwa ndi kuchuluka kwa shuga mulinso.

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.

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:

Ngati pali ntchito ya pancreatic yotsika, ndiye kuti kuyambitsa insulini kumamupatsa mwayi wochepetsa katundu.
Pankhani yakusakwanira kwa ma cell a beta, pakapita nthawi, ntchito ya pancreatic imayamba kuchira.
Ndi cholinga chomwecho, zakudya zamafuta ochepa zimayikidwa.
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.

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.

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.

Matenda a Steroid (a sekondale omwe amadalira insulin) amawonekera chifukwa chazindikira kuchuluka kwa ma corticosteroids m'magazi, omwe amakhalapobe kwanthawi yayitali.

Nthawi zambiri, imayamba chifukwa cha kuoneka kwa zovuta zazikulu za matenda omwe amapangitsa kuti mahomoni apangidwe mofulumira.

Komabe, komabe, nthawi zambiri zimawonekera pambuyo povomerezeka kwa nthawi yayitali ndimankhwala a mahomoni. Ndiye chifukwa chake kudwala kumeneku kumatchedwanso mtundu wa shuga.

Matenda a shuga a Steroid kuchokera komwe adachokera sakhala m'gulu la matenda achamba. Ndikofunikira kudziwa kuti poyamba sizimagwirizanitsidwa ndi mitundu yayikulu yamatenda a kapamba.

Anthu omwe alibe vuto la metabolism wamafuta, vuto la kuchuluka kwa mahomoni a steroid, amatha kupeza matenda ofatsa, omwe amachoka pomwe atatha. Chofunikira ndichakuti pafupifupi theka la odwala onse omwe akudwala matendawa amalandila fomu yodziyimira payokha kupita ku matenda omwe amadalira insulin.

Glucocorticosteroids (Dexamethasone, Prednisolone, Hydrocortisone) amagwiritsidwa ntchito ngati mankhwala othandiza komanso odana ndi kutupa pazovuta zotere:

Mphumu ya bronchial,
nyamakazi
kuphwanya magwiridwe antchito a chitetezo cha thupi,
multiple sclerosis.

Steroid shuga mellitus imatha kuchitika chifukwa chogwiritsa ntchito mankhwala kwa nthawi yayitali monga kulera pakamwa ndi thiazide diuretics.

Mlingo wamphamvu kwambiri wa corticosteroids ungagwiritsidwe ntchito pochiza, womwe umalimbana ndikuchotsa kutupa pambuyo pa opaleshoni, pomwe unamuyika impso.

Pambuyo pakuchita opaleshoni yayikuluyi, odwala ayenera kumwa mankhwala oyenera pamoyo wawo wonse kuti apondereze chitetezo cha thupi. Amakhala ndi chizolowezi chotupa chomwe chimatha kukhudza ziwalo zopatsirana moyenera.

Zizindikiro za matenda omwe adayamba chifukwa cha chithandizo cha mankhwala chomwe chimatenga nthawi yayitali amadziwitsa kuti odwala amadziwika kuti ndi anthu osatetezeka kwambiri.

Kuti athetse koyamba matenda ashuga, anthu onenepa kwambiri ayenera kudzisamalira ndikuyamba kutaya mapaundi owonjezera.

Koma omwe ali ndi kulemera kwabwino, muyenera kuyamba kusewera masewera ndikusintha pang'ono zakudya zawo za tsiku ndi tsiku, kuwonjezera kuwonjezera zitsamba, masamba ndi zipatso zina.

Ngati munthu akudziwa zam'tsogolo za matendawa, sayenera kuyamba kumwa mankhwala a mahomoni.

Matendawa ndi osiyana chifukwa amakhala ndi zizindikiro za matenda ashuga amtundu woyamba komanso wachiwiri.

Matendawa amayamba chifukwa chakuti kuchuluka kwa corticosteroids kumayamba kuwononga maselo a beta a kapamba.

Amapitilizabe kupanga ma pancreatic mahomoni omwe amayendetsa kagayidwe kazakudya kwa nthawi yayitali.

Pakapita kanthawi, kuchuluka kwa mahomoni omwe amapangidwa amachepetsa kwambiri ndipo khungu lake limasokonekera. Izi ndi mtundu wa matenda ashuga a 2. Pambuyo pake, maselo angapo a beta amawonongeka kwathunthu, zomwe zimapangitsa kuti ayime pakupanga insulin. Poterepa, matendawo amayamba kupitilirabe ngati matenda a shuga a mtundu woyamba.

Zizindikiro za matenda a shuga a Steroid ali ndi izi:

kuchuluka kukodza
ludzu lalikulu
kutopa.

Monga lamulo, chizindikiro cha matenda a shuga a steroid ndi chofatsa, kotero odwala samapereka chidwi chokwanira kwa iwo.

Amayamba kuchepa thupi msanga, ngati matenda amtundu 1. Kuyesedwa kwa magazi sikamathandiza kuzindikira matendawa nthawi yake.

Komabe, kawirikawiri kuchuluka kwa glucose kumatha kukhala okwera kwambiri. Kuphatikiza apo, kuchuluka kwa propanone mu mkodzo kumakhalabe kosangalatsa.

Mtundu wa shuga ungawonekere kwa odwala onse. Koma ngati munthu akumwa mankhwala a mahomoni nthawi zonse, ndiye kuti chiopsezo chotenga matenda ndi iye chikukula kwambiri.

The pathogenesis yokhala ndi matenda a shuga

Njira yolimbikitsira shuga-6-phosphatase m'chiwindi ndi mahomoni amtunduwu amathandizira kutulutsa kwa glucose kuchokera ku chiwalochi. Mwa zina, glucocorticoids amachepetsa kwambiri ntchito ya hexokinase, yomwe imachepetsa kuyamwa kwa glucose.

Polankhula za matenda a shuga a steroid, kuphatikiza kwa matendawa ndikuti kutseguka kwa mapuloteni kungayambitse kukula kwake, chifukwa chomwe mafuta ochulukirapo m'magazi amapangidwa. Chifukwa cha izi, kuchuluka kwa shuga m'magazi kumawonjezeka.

Mwanjira ina, matenda a shuga a steroid ndi mtundu wa matenda omwe amatenga matendawa, omwe amayamba chifukwa cha kuchuluka kwa mahomoni a adrenal m'magazi. Izi zimagwiranso ntchito pa mankhwalawa omwe ali ndi zinthu zomwe zimapangidwa.

Zingachitike kuti insulini italeka kupangidwa mthupi, matendawa amapitilira chimodzimodzi monga matenda ashuga amtundu woyamba. Koma ndi zonsezi, ili ndi zizindikiro za matenda ashuga a 2.

Kuchiza mwachindunji kumatengera mtundu wanji wakuphwanya wodwalayo. Kwa anthu omwe ali onenepa kwambiri, koma amapanga insulin, zakudya zapadera ndi mankhwala omwe shuga yotsika ndiyabwino. Izi zikuphatikiza Glucofage ndi Thiazolidinedione. Mlingo wocheperako wa insulin nthawi zina amalamula.

Pankhani yamavuto apachiwopsezo, kuyambitsa kwa insulin kumapangitsa kuti ichite ntchito ndi katundu wochepa. Izi ndizotheka ngati maselo a beta akupitilizabe ntchito yawo. Zakudya zapadera zimatha kuthandiza mankhwalawo, kuthetseratu kugwiritsa ntchito mankhwala okhala ndi chakudya.

Kwa anthu omwe ali ndi chakudya chamagulu okwanira, chakudya No. 9 chitha kugwiritsidwa ntchito, ndipo kwa odwala okulirapo, zakudya No. 8 zingagwiritsidwe ntchito.

Ngati munthu akuvutika ndi matenda a shuga a steroid, kapamba sathanso kudzipangira payekha payokha, ndiye kuti amamulembera momwe amapangira jakisoni wovomerezeka.

Pankhaniyi, munthu sayenera kuyiwala za kuwunika kosalekeza kwamisempha yamagazi. Njira yakuchiritsira ikuyenera kuchitika momwemo ndi mtundu 1 wa matenda ashuga. Kuphatikiza apo, ndi mtundu uwu wa matendawa pomwe ndikosatheka kubwezeretsa maselo a beta omwe adafa kale.

Matenda amtunduwu amapezeka kuti kuchuluka kwa shuga m'magazi kumayamba kupitirira chizindikiro cha 11.5 mmol mutatha kudya, ndipo kutsogolo kwake kuli zoposa 6 mmol. Pambuyo pozindikira zowopsa, ndikofunikira kulumikizana ndi dokotala kuti akuthandizeni.

Poyamba, katswiri ayenera kupatula kwathunthu matenda onse omwe ali mgululi. Njira yochizira matendawa imatha kukhala yamwambo komanso kukhala ndi mayendedwe ofunikira. Zotsirizirazi ndizothandiza kwambiri, koma zimafunanso maluso ena odziletsa kwa wodwalayo.

Njira zachikhalidwe zachikhalidwe zimachokera pamfundo yomwe ili yofanana ndi miyeso yofananira yachiwiri.

Ngati kapamba amavulala, ndiye kuti mlingo wa insulin ndi womwe umapangidwa. Mankhwala, hypoglycemic ndi mahomoni othandizira amagwiritsidwa ntchito, mwachitsanzo, Glucofage.

Ngati wodwalayo ali ndi mtundu wocheperako wa matenda, ndiye kuti sulfonylureas angagwiritsidwe ntchito, zomwe zingathandize kuthana ndi vutoli. Koma njirayi ili ndi zotsatira zoyipa, zowopsa kwambiri komanso zosayembekezeka zomwe zimachitika ndikubadwa kwa myocardial infarction.

Izi ndichifukwa choti chakudya cha carbohydrate chimachepa kwambiri, chifukwa chomwe pamakhala kuphwanya kowopsa pakuchita kwa ziwalo ndi machitidwe. Ndi chifukwa ichi kuti matendawa amatha kusintha pang'onopang'ono kukhala mawonekedwe otchedwa insulin.

Mwazinthu zina zapadera, yankho lolondola kwambiri ndikuchita opareshoni. Matani osafunikira amachotsedwa ku adrenal gland ngati hyperplasia yapezeka.

Pambuyo pakuchita opaleshoni, mkhalidwe wa wodwalayo umayamba bwino, ndipo akuchira. Komabe, ndikofunikira kutsatira malangizo a adotolo kuti matendawo azikhala okhazikika.

Pangozi ndi anthu omwe ali ndi mafuta ochulukirapo. Kuti mupewe kupatula matendawa omwe mungakhale nawo, muyenera kuyang'anitsitsa zakudya zanu.

Makanema okhudzana nawo

Kodi shuga ya steroid ndi chiyani? Mayankho mu kanema:

Chithandizo cha matenda a shuga a steroid chitha kuyenda bwino pokhapokha ngati wodwalayo asanyalanyaza malangizo omwe katswiri amamuwona. Ndikofunikira ngati zoyamba zizindikirika munthawi yolumikizana ndi achipatala kuti mukayezetse ndikupeza kuti mwazindikira. Pambuyo pake, adotolo adzalembera chithandizo choyenera, chomwe chingathandize pokhapokha ngati zonse zikutsatiridwa mosamalitsa.

Musaiwale kuti shuga ya steroid imachitika chifukwa chogwiritsa ntchito nthawi yayitali kulera kwa mahomoni ndi mankhwala ena ofanana. Komanso omwe ali pachiwopsezo ndi anthu onenepa kwambiri. Chifukwa chake, kuti mupewe matendawa, muyenera kusiyiratu kumwa mankhwala a mahomoni (ngati sanalengedwe ndi dokotala) ndikuyamba kuyang'anira kudya kwanu. Ndikofunikira kupangira chakudya chanu ndi zinthu zofunikira, makamaka, masamba, zipatso, zitsamba, nyemba, komanso kuchotsa shuga wovulaza, yemwe samabweretsa phindu lililonse.