Zoyambitsa matenda ashuga > Matenda a shuga

Matenda a shuga - matenda ophatikizidwa ndi kuchuluka kwa shuga m'magazi, omwe amayamba chifukwa cha kuperewera kwathunthu kwa insulin.
Maselo apadera a pancreatic otchedwa β-cell amapanga insulin. Mothandizidwa ndi chilichonse chamkati kapena chakunja, kugwira ntchito kwa maselo amenewa kumasokonezeka ndipo kusowa kwa insulin kumachitika, ndiye kuti, matenda a shuga.

Ma genis ndiwo olakwa

Chofunikira pakukula kwa shuga chimaseweredwa ndi majini - nthawi zambiri matendawa amatengera kwa makolo athu.

Kukula kwa matenda a shuga amtundu wa I kumadalira mtundu wakubadwa kwa njira yodutsamo. Kuphatikiza apo, nthawi zambiri njirayi imakhala autoimmune (ndiye kuti, chitetezo cha mthupi chimapangitsa β-maselo, chifukwa chomwe amalephera kutulutsa insulin). Anazindikira ma antigen amatengera matenda ashuga. Ndi kuphatikiza kwinako, chiopsezo chotenga matendawa chimakula kwambiri. Matenda a shuga amtunduwu nthawi zambiri amaphatikizidwa ndi njira zina za autoimmune (autoimmune thyroiditis, poyizoni ya poyizoni, nyamakazi ya rheumatoid).
Mtundu Wachiwiri wa matenda a shuga amakhalanso ndi cholowa chake, koma kale panjira yayikulu. Nthawi yomweyo, kupanga kwa insulin sikumayima, koma kumachepetsa kwambiri, kapena thupi limataya mphamvu kuti lizindikire.

Zomwe zimayambitsa matendawa

Ndili ndi chibadwa cha mtundu wa matenda ashuga a I, chomwe chimapangitsa chidwi ndi matenda oyamba ndi ma virus (mumps, rubella, Coxsackie, cytomegalovirus, enterovirus). Zina zomwe zimayambitsa ngozi ndi izi:

mbiri yakale yabanja (ngati pakati pa abale anu apachibale pamakhala matenda amtunduwu, ndiye kuti mwayi wokhala ndi munthu ndiwowonjezereka, komabe ndi kutali kwambiri ndi 100%),
a mu mpikisano wa ku Caucasus (chiopsezo chodwala ndi oyimira mpikisanowu ndiwokwera kwambiri kuposa anthu aku Asia, Hispanics kapena akuda),
kupezeka kwa magazi a ma antibodies kuma β cell.

Pali zinthu zambiri zomwe zikukonzekera mtundu wa shuga wa II. Komabe, kukhalapo kwa onse a iwo sikutanthauza kuti matendawa atakula. Komabe, munthu akakhala ndi zinthu zambiri, ndiye kuti amadwala.

Metabolic syndrome (insulin kukana matenda) ndi kunenepa kwambiri. Popeza minofu ya adipose ndipamene mapangidwe a chinthu chomwe chimalepheretsa kuphatikizidwa kwa insulin, matenda a shuga mwa anthu onenepa kwambiri ndiwotheka kwambiri.
Kwambiri atherosulinosis. Chiwopsezo chotenga matendawa chikuwonjezereka ngati kuchuluka kwa cholesterol "yabwino" (HDL) m'magazi a venous ndi ochepera 35 mg / dl, ndipo mlingo wa triglycerides ndi woposa 250 mg / dl.
Mbiri yokhala ndi matenda oopsa komanso matenda a mtima (stroke, kugunda kwa mtima).
Ili ndi mbiri ya matenda ashuga, omwe adachitika nthawi ya pakati, kapena kubadwa kwa mwana wolemera oposa 3.5 kg.
Mbiri yakale ya polycystic ovary syndrome.
Ukalamba.
Kupezeka kwa matenda ashuga mwa abale apamtima.
Kupsinjika kwakanthawi
Kulephera kuchita zolimbitsa thupi.
Matenda a kapamba, chiwindi, kapena impso.
Kumwa mankhwala ena (ma steroid mahomoni, thiazide diuretics).

Zoyambitsa matenda a shuga ana

Ana amadwala matenda a shuga a mtundu woyamba. Zinthu zomwe zimawonjezera mwayi wokhala mwana wokhala ndi matenda oopsa ndi izi:

chibadwa (kubadwa),
kulemera kwa wakhanda woposa makilogalamu 4.5,
pafupipafupi tizilombo matenda
kuchepa chitetezo chokwanira
matenda a metabolic (hypothyroidism, kunenepa kwambiri).

Dokotala uti kuti mulumikizane

Wodwala matenda ashuga ayenera kuyang'aniridwa ndi endocrinologist. Pazifukwa zokhudzana ndi zovuta za matenda ashuga, kufunsana ndi katswiri wa zamitsempha, matenda a mtima, ophthalmologist, ndi opaleshoni ya mtima ndikofunikira. Pofuna kumveketsa funsoli, kodi chiopsezo chotani chitha kukhala ndi matenda osabadwa kwa mwana wosabadwa, pokonzekera kutenga pakati, makolo omwe ali ndi milandu yamatendawa m'mabanja awo ayenera kukaonana ndi majini.

Makamaka

Kuchepa kwa matenda a shuga (DM) kumawonjezeka nthawi zopitilira 6 ngati banja lili ndi abale ake omwe akudwala matendawa. Asayansi apeza ma antigen komanso ma antijeni oteteza khungu omwe amapanga kudziwikiratu kumayambiriro kwa matendawa. Kuphatikiza kwina kwa ma antijeni kotereku kumatha kuwonjezera mwayi wodwala.

Tiyenera kumvetsetsa kuti matendawa eni ake sanatengerepo, koma amatanthauzira zake. Matenda a shuga a mitundu yonse iwiriyi amapatsidwira polygenically, zomwe zikutanthauza kuti popanda kukhalapo kwa zinthu zina zowopsa, matendawa sangathe kudziwonetsa.

Mphamvu yakumaso kwa matenda ashuga 1 imafalikira kudzera m'badwo, kudzera munjira yopuma. Kulemba matenda ashuga a 2, matendawo amawonjezeranso mosavuta - panjira yodziwika bwino, zizindikiro za matendawa zimatha kudziwonetsa ku m'badwo wotsatira. Chamoyo chomwe chatengera zinthu zoterezi chimaleka kuzindikira insulin, kapena chimayamba kupangidwa pang'ono. Zatsimikizidwanso kuti chiopsezo cha mwana kulandira cholowa chimawonjezeka ngati atapezeka ndi achibale awo. Zimatsimikiziridwa kuti kukula kwa matendawa m'mayimidwe amtundu wa Caucasi ndiwokwera kwambiri kuposa anthu aku Latin America, Asiya kapena akuda.

Chinthu chofala kwambiri chomwe chimayambitsa matenda a shuga ndi kunenepa kwambiri. Chifukwa chake, 1 degree ya kunenepa kwambiri imakulitsa mwayi wodwala kawiri, 2 - 5, 3 - 10. Makamaka ochenjera ayenera kukhala anthu okhala ndi cholozera cha thupi kuposa 30. Tiyenera kukumbukira kuti kunenepa kwambiri ndizofala.
chizindikiro cha matenda ashuga, ndipo sichimapezeka mwa akazi komanso mwa amuna.

Pali kulumikizana mwachindunji pakati pa chiwopsezo cha matenda ashuga ndi kukula kwake. Chifukwa chake, mwa akazi sayenera kupitirira 88 masentimita, mwa amuna - masentimita 102. Mukunenepa kwambiri, kuthekera kwa maselo kulumikizana ndi insulin pamlingo wa adipose minofu imachepa, zomwe pambuyo pake zimayambitsa kusakhala ndi gawo kapena kusakwanira kwathunthu kotheka. ngati muyamba ndewu yolimbana ndi kunenepa kwambiri ndikusiya moyo wongokhala.

Matenda osiyanasiyana

Mwayi wokhala ndi matenda a shuga umachulukitsidwa kwambiri pamaso pa matenda omwe amachititsa kuti pakhale kuperewera kwa pancreatic. Izi
Matendawa amatanthauza kuwonongeka kwa maselo a beta omwe amathandiza kupanga insulin. Zoopsa zakuthupi zingasokonezenso gland. Ma radiation wa radiyo imayambitsanso kusokonekera kwa dongosolo la endocrine; chifukwa chake, omwe kale amadzimadzi a ngozi ya Chernobyl ali pachiwopsezo cha matenda a shuga.

Kuchepetsa chidwi cha thupi ku insulini kungachitike: matenda a mtima, atherosulinosis, ochepa matenda oopsa. Zatsimikiziridwa kuti kusintha kwa sclerotic m'matumbo a pancreatic Apparatus kumathandizira kuwonongeka kwake, komwe kumayambitsa zovuta pantchito ndikupanga insulin. Matenda a Autoimmune angathandizenso kuyambika kwa matenda ashuga: matenda a adrenal cortex osakwanira komanso autoimmune thyroiditis.

Matenda oopsa a matenda a shuga ndi matenda ashuga amaonedwa kuti ndi ophatikizika. Maonekedwe a matenda amodzi nthawi zambiri amakhala ndi zisonyezo zakuwoneka kwachiwiri. Matenda a mahormoni amathanso kupititsa patsogolo chitukuko cha matenda ashuga owonjezera: kuphatikiza poyizoni, matenda a Itsenko-Cushing, pheochromocytoma, acromegaly. Matenda a Itsenko-Cushing amapezeka kwambiri mwa azimayi kuposa abambo.

Matenda opatsirana ndi ma virus (mumps, chikuku, rubella, hepatitis) angayambitse matendawa. Poterepa, kachilomboka ndizomwe zimapangitsa kuti matenda a shuga ayambe. Kulowa mthupi, matendawa atha kusokoneza kapamba kapena kuwononga maselo ake. Chifukwa chake, ma virus ena, ma cell ali ngati ma cell a pancreatic. Pankhondo yolimbana ndi matenda, thupi lingayambenso kuwononga molakwika maselo a chamba. Kusuntha rubella kumawonjezera mwayi wokhala ndi 25%.

Mankhwala

Mankhwala ena amakhala ndi vuto la matenda ashuga.
Zizindikiro za matenda ashuga zimatha kuchitika mutatenga:

mankhwala antitumor
glucocorticoid mahomoni opanga,
mankhwala a antihypertensive mankhwala,
okodzetsa, makamaka thiazide okodzetsa.

Mankhwala atatenga nthawi yayitali chifukwa cha mphumu, rheumatism ndi matenda amkhungu, glomerulonephritis, coloproctitis, komanso matenda a Crohn amatha kuyambitsa matenda a shuga. Komanso, kuwoneka kwa matendawa kumatha kupangitsa kuti mugwiritse ntchito zakudya zopatsa mphamvu zokhala ndi selenium yambiri.

Mimba

Kukhala ndi mwana ndi vuto lalikulu kwa thupi la mkazi. Munthawi yovutayi kwa azimayi ambiri, matendawa amatha kuchitika. Ma mahomoni apakati omwe amapangidwa ndi placenta amathandizira kuwonjezeka kwa shuga m'magazi. Katundu pa kapamba amawonjezeka ndipo amalephera kupanga insulin yokwanira.

Zizindikiro za matenda amishuga gestational ndi ofanana ndi nthawi zonse zomwe mayi amakhala ndi pakati (mawonekedwe a ludzu, kutopa, kukodza pafupipafupi, ndi zina zambiri). Kwa azimayi ambiri, sizimawerengeka mpaka zimabweretsa zovuta. Matendawa amayambitsa kuvulaza thupi la mayi woyembekezera ndi mwana, koma, nthawi zambiri, amadutsa mwana akangobadwa kumene.

Pambuyo pa mimba, azimayi ena amakhala ndi chiopsezo chokhala ndi matenda a shuga a 2. Gulu lamavuto limaphatikizapo:

azimayi omwe ali ndi matenda ashuga
Omwe matupi awo amalemera kwambiri pobereka
azimayi omwe abereka mwana wolemera makilogalamu anayi,
amayi amene ali ndi ana okhala ndi vuto lobadwa nalo
iwo amene akhala ndi mimba yozizira kapena mwana wabadwa wamwalira.

Moyo

Zatsimikiziridwa mwasayansi kuti mwa anthu omwe amakhala pansi, zizindikiro za matenda ashuga zimawonekera katatu kuposa momwe zimakhalira ndi anthu ambiri. Kwa anthu omwe ali ndi masewera olimbitsa thupi ochepa, kugwiritsidwa ntchito kwa glucose ndi minofu kumachepa pakapita nthawi. Kukhala moyo wongokhala kumapangitsa kunenepa kwambiri, komwe kumakhudza zochita zenizeni, kumakulitsa chiwopsezo cha matenda a shuga.

Kupsinjika kwa mantha.

Kupsinjika kwanthawi yayitali kumakhudza mkhalidwe wamanjenje ndipo kumatha kukhala chinthu choyambitsa chomwe chimayambitsa chitukuko cha matenda ashuga. Zotsatira zamphamvu zakanjenjemera, mahomoni a adrenaline ndi glucocorticoid amapangidwa m'magulu ambiri, omwe amatha kuwononga osati insulin yokha, komanso maselo omwe amapanga. Zotsatira zake, kupanga kwa insulini kumachepa ndikuwonetsetsa kuti mahomoni amthupi amachepa, zomwe zimayambitsa kuyambika kwa matenda ashuga.

Asayansi akuyerekezera kuti zaka khumi zilizonse za moyo zimachulukitsa kuwopsa kwa zizindikiro za matenda ashuga. Chiwopsezo chachikulu cha matenda a shuga chimalembedwa mwa amuna ndi akazi opitilira zaka 60. Chowonadi ndi chakuti ndi zaka, kubisala kwa ma inecretins ndi insulin kumayamba kuchepa, ndipo kuchepa kwa minofu kwa izo kumachepa.

Zabodza pazomwe zimayambitsa matenda ashuga

Makolo ambiri osamala amakhulupirira molakwa kuti ngati mungalole mwana kudya maswiti ambiri, amadwala matenda a shuga. Muyenera kumvetsetsa kuti kuchuluka kwa shuga pazakudya sikukhudza mwachindunji kuchuluka kwa shuga m'magazi. Mukamapangira mwana chakudya, ndikofunikira kuganizira ngati ali ndi vuto la matenda ashuga. Ngati pakhala matenda am'banja, ndiye kuti ndikofunikira kujambula zakudya zochokera mndandanda wazogulitsa.

Matenda a shuga sindiwo matenda opatsirana, ndipo nkosatheka 'kuchigwira' kudzera pakokha kapena pogwiritsa ntchito mbale za wodwalayo. Nthano ina ndikuti mutha kudwala matenda a shuga kudzera m'magazi a wodwala. Kudziwa zomwe zimayambitsa matenda ashuga, mutha kukhazikitsa njira zodzitetezera nokha ndikupewa kukula kwa zovuta. Kukhala ndi moyo wakhama, kudya mokwanira, komanso kulandira chithandizo cha panthawi yake kungakuthandizeni kupewa matenda ashuga, ngakhale mutakhala kuti mwakonzeka.

Mitundu ya Matenda A shuga

Zomwe zimayambitsa matendawa zimagona m'matenda a metabolic mthupi, makamaka mafuta, komanso mafuta. Mitundu iwiri yayikulu ya matenda a shuga ndi mitundu ina imadziwika, kutengera kuperewera kwa kupezeka kwa insulin kapena kuwonongeka kwa minyewa yokhudzana ndi insulin.

Insulin yodalira matenda a shuga - mtundu 1, zomwe zimayambitsa zimagwirizanitsidwa ndi kuchepa kwa insulin. Mu mtundu uwu wa shuga mellitus, kusowa kwa timadzi timeneti kumabweretsa chidziwitso chakuti sikokwanira ngakhale kungopanga shuga pang'ono yolandilidwa m'thupi. Zotsatira zake, shuga ya magazi a munthu imakwera. Popewa ketoacidosis - kuchuluka kwa matupi a ketone mumkodzo, odwala amakakamizidwa kubayira insulin m'magazi kuti akhale ndi moyo.
Mellitus wa shuga wosadalira insulin ndi mtundu 2, zomwe zimapangitsa kuti pakhale zovuta zomwe zimapangitsa kuti thupi lizimva pang'ono. Ndi mtundu uwu, onse ali ndi insulin kukaniza (kusazindikira kapena kuchepa kwa chidwi cha insulin), ndikuwonongeka kwakapakati. Chifukwa chake, mapiritsi ochepetsa shuga nthawi zambiri amaphatikizidwa ndi utsogoleri wa insulin.

Malinga ndi ziwerengero, kuchuluka kwa odwala omwe ali ndi matenda amtunduwu ndi ochulukirapo kuposa mtundu umodzi, pafupifupi kanayi, safuna jakisoni wowonjezera, ndipo chifukwa cha chithandizo chawo, mankhwala amagwiritsidwa ntchito omwe amachititsa kuti kapamba azitulutsa insulini kapena kuchepetsa minyewa yotsutsana ndi timadzi timeneti. Matenda a 2 a shuga, nawonso amagawika m'magulu:

limapezeka mwa anthu olemera
limawonekera mwa anthu onenepa kwambiri.

Gestationalabetes mellitus ndi mtundu wachilendo wa shuga womwe umapezeka mwa amayi nthawi yomwe ali ndi pakati, umayamba chifukwa cha kuchepa kwa chidwi cha minofu ya mkazi kulowa insulin mothandizidwa ndi mahomoni apakati.

Matenda a shuga, komwe kumachitika komwe kumalumikizidwa ndi kusowa kwa zakudya.

Mitundu ina ya matenda ashuga, ndi yachiwiri, chifukwa imakhalapo ndi izi:

Matenda a kapamba - hemochromatosis, chifuwa chachikulu, cystic fibrosis, kapamba (iyi ndi mtundu 3 wa matenda ashuga, omwe samadziwika panthawi yake)
Zakudya zoperewera m'thupi - matenda ashuga otentha
Endocrine, vuto la mahomoni - glucagonoma, Cushing's syndrome, pheochromocytoma, acromegaly, aldosteronism yoyamba
Matenda a shuga - Amachitika ndi kugwiritsa ntchito mankhwala a mahomoni, mankhwala a psychotropic kapena antihypertensive, thiazide-diuretics (glucocorticoids, diazoxide, thiazides, mahomoni a chithokomiro, dilantin, nicotinic acid, ma adrenergic blocking agents, interferon, vaccor, pentamidine, etc.)
Abnormality of insulin receptors or genetic syndrome s - minofu dystrophy, hyperlipidemia, Huntington's chorea.

Kulekerera kwa glucose, nthawi ndi nthawi zomwe zimayendera okha. Izi zimatsimikiziridwa ndikuwunikira patatha maola 2 mutatsegula shuga, motere, shuga ya wodwalayo imachokera ku 7.8 mpaka 11.1 mmol / L. Ndi kulekerera pamimba yopanda kanthu shuga - kuyambira 6.8 mpaka 10 mmol / l, ndipo mutatha kudya zomwezo kuyambira 7.8 mpaka 11.

Malinga ndi ziwerengero, pafupifupi 6% ya anthu onse mdziko muno ali ndi matenda ashuga, izi zimangokhala malinga ndi kuchuluka kwa zinthu, koma kuchuluka kwenikweni, ndizokulirapo, popeza zimadziwika kuti mtundu wachiwiri wa matenda ashuga umatha kupezekanso pakapita zaka zambiri ndikukhala ndi zisonyezo zazing'ono kapenanso kusazindikira.

Matenda a shuga ndi matenda oopsa, chifukwa ndi oopsa chifukwa cha zovuta zomwe zimadza mtsogolo. Malinga ndi ziwerengero za matenda ashuga, oposa theka la odwala matenda ashuga amafa phazi angiopathy, kugunda kwa mtima, nephropathy. Chaka chilichonse, anthu opitilila miliyoni akusiyidwa popanda mwendo, ndipo anthu 700,000 saonanso.

Chifukwa chiyani matenda ashuga amawonekera?

Malo olowa. Ndi matenda a shuga kwa makolo onse awiri, chiopsezo chokhala ndi matendawa kwa ana moyo wawo wonse chimakhala chotsimikizika pafupifupi 60%, ngati kholo limodzi lokha lili ndi matenda a shuga, ndiye kuti mwayiwu ulinso waukulu ndipo ndi 30%. Izi ndichifukwa chakubadwa kwa hypersensitivity ku endo native enkephalin, yomwe imathandizira katulutsidwe ka insulin.

Mtundu wachiwiri wa matenda ashuga, ngakhale matenda a autoimmune, kapenanso kachilombo komwe sikamayambitsa matenda.

Kudya kwambiri pafupipafupi, kunenepa kwambiri, kunenepa kwambiri - ndizomwe zimayambitsa matenda ashuga a 2. Maselo a minofu ya Adipose, mosiyana ndi minofu ya minofu, samamva kwenikweni za insulin, kotero kuchuluka kwake kumakhudza kuchuluka kwa shuga m'magazi. Malinga ndi ziwerengero, ngati kulemera kwa thupi kupitilira muyeso ndi 50%, ndiye kuti chiwopsezo chotenga matenda ashuga chimafikira 70%, ngati owonjezera ndiye 20% yokhazikika, ndiye kuti chiwopsezo ndi 30%. Komabe, ngakhale atakhala ndi kulemera kwabwinobwino, munthu amatha kudwala matenda a shuga, ndipo pafupifupi 8% ya anthu popanda mavuto onenepa kwambiri mpaka digiri imodzi kapena ina amadwala matendawa.

Kulemera mopitirira muyeso, ngati muchepetsa thupi ngakhale 10%, munthu amachepetsa kwambiri vuto la matenda ashuga a 2. Nthawi zina kutaya thupi kwa wodwala yemwe ali ndi matenda ashuga, kusokonezeka kwa glucose metabolism mwina kumachepera kapena kutha kwathunthu.