Matenda a shuga ndi chilichonse chokhudza izi

Mavuto a kagayidwe ka mafuta. Ndi kuchepa kwa insulin, kudya kwa glucose m'matumbo a adipose ndikupanga mafuta ochulukirapo kumachepetsa, ndipo kuyambiranso kwa triglycerides kuchokera ku mafuta acids kumachepa. Mphamvu ya lipolytic ya STH imalimbikitsidwa, yomwe imakonda kupanikizidwa ndi insulin. Nthawi yomweyo, zipatso zamafuta osaphatikizidwa kuchokera ku minofu ya adipose zimachulukitsidwa ndipo kuchuluka kwa mafuta mkati mwake kumachepetsedwa, komwe kumayambitsa emaciation ndi kuwonjezeka kwa magazi omwe amapezeka mafuta osavomerezeka. Ma acid omwe ali m'chiwindi amapangidwanso kuti akhale triglycerides, chinthu choyambirira chimapangidwira kuti mafuta azilowa m'chiwindi. Izi sizichitika ngati kupangika kwa lipocaine sikumasokonekera mu kapamba (mu ma epithelial cell a ma ducts ang'onoang'ono). Zotsirizazo zimapangitsa kuti michere ya lipotropic ikhale ndi methionine (tchizi chofufumitsa, mwanawankhosa, ndi zina zambiri). Methionine ndi wopereka gulu la methyl la choline, lomwe ndi gawo la lecithin, lomwe mafuta amachotsedwa m'chiwindi. Matenda a shuga a shuga, omwe kupanga lipocaine samasokonekera, amatchedwa islet. Kunenepa kwambiri kwa chiwindi sikuchitika. Ngati kuchepa kwa insulin kuphatikizidwa ndi kupanga osakwanira a lipocaine, shuga yonse imayambika, limodzi ndi kunenepa kwambiri kwa chiwindi. Mu mitochondria yama cell a hepatic, matupi a ketone amapangidwa mwamphamvu kuchokera ku mafuta osavomerezeka.

Matupi a Ketone. Izi zimaphatikizira acetone, acetoacetic ndi p-hydroxybutyric acid. Ndiwofanana mu kapangidwe kake ndipo amatha kupatsirana. Matupi a Ketone amapanga m'chiwindi, amalowa m'magazi ndipo kuchokera pamenepo kupita m'mapapu, minofu, impso ndi ziwalo zina ndi minofu, momwe amathandizidwa ndi tricarboxylic acid mozungulira kupita ku COz ndi madzi. Seramu yamagazi imayenera kukhala ndi 0.002-0.025 g / l ya matupi a ketone (malinga ndi acetone).

Zotsatirazi ndizofunikira pakapangidwe kachulukidwe ka matupi a ketone mu shuga mellitus:

1) kuchulukitsa kwa mafuta acids kuchokera kumagawo amafuta kupita ku chiwindi ndikuthamangitsa makutidwe awo oxidation kupita ku matupi a ketone,

2) kuchedwa kwakukonzanso kwamafuta acids chifukwa cha kuchepa kwa NADP,

3) kuphwanya makutidwe a oxidation a matupi a ketone chifukwa cha kuponderezedwa kwa kuzungulira kwa Krebs, komwe ma oxalacetic ndi a-ketoglutaric acids "amasokonekera" chifukwa cha kuchuluka kwa gluconeogeneis.

Ndi matenda a shuga, kuchuluka kwa matupi a ketone kumawonjezera nthawi zambiri (hyperketonemia) ndipo amayamba kukhala ndi poizoni. Matupi a Ketone okhala ndi poizoni wozungulira amatha kupatsa insulin, kukulitsa zotsatira za kuchepa kwa insulin. “Bwalo loyipa” likupangidwa. Hyperketonemia ndi kuwonongeka kwa kagayidwe kachakudya matenda ashuga. Kuchulukana kwambiri kwa acetone, komwe odwala ambiri kumakhala kokwirikiza katatu kuposa kuchuluka kwa acetoacetic komanso (3-hydroxybutyric acid. Acetone imawononga maselo, imasokoneza ma lipids a maselo, imalepheretsa zochitika za ma enzymes, imalepheretsa kwambiri zochitika zamagetsi apakati. ntchito pathogenesis yovuta kwambiri matenda a shuga - matenda a shuga. Amadziwika ndi kutaya chikumbumtima, kugunda pafupipafupi kwa kudzaza kofooka, kutsika kwa magazi, kupuma kwapafupipafupi (monga Kussmaul), kutha kwa Reflex, chikomokere (shuga) kumayendetsedwa ndi acidosis yayikulu (metabolic). Alkaline plasma yamagazi imatha, acidosis imakhala yopanda phindu, magazi a HH amaponyedwa kufikira mkodzo mkati mu mawonekedwe amchere wamchere wa sodium (ketonuria) .Pameneyi, kuthinana kwa osmotic kwamkodzo kumawonjezeka, komwe kumapangitsa kuti polyuria.Kuphatikiza apo, ndi kuchepa kwa insulin, sabsorption ya sodium mu rebu tubules imachepa. Chifukwa chake, kutsika kwamphamvu kwa shuga m'magazi chifukwa chakuchulukitsa kwamankhwala a insulin, kukhathamiritsa kwathunthu kwa magazi kumatha kuchepa kwambiri. Pali chiopsezo chotenga matenda a ubongo. Ndi matenda ashuga, kagayidwe ka cholesterol kamasokonekera. Acetoacetic acid yowonjezereka imapita kukapangidwa kwa cholesterol - hypercholesterolemia imayamba.

Kuphwanya mapuloteni kagayidwe. Mapuloteni a shuga mu shuga amachepetsa, monga:

1) zolimbikitsa za insulin pa michere ya enzymatic ya kaphatikizidwe kameneka imatsika kapena kwambiri.

2) amachepetsa mphamvu ya kagayidwe kamphamvu, kupereka kapangidwe ka mapuloteni m'chiwindi,

3) anaphwanya mayendedwe a amino acid kudzera mumitsempha yama cell.

Pankhani ya kuchepa kwa insulin, brake imachotsedwa mu michere yofunika ya gluconeogeneis ndipo pali * kupangika kwamphamvu kwa glucose kuchokera ku amino acid ndi mafuta. Poterepa, ma amino acid amataya ammonia, amapita ku-keto acid, omwe amapanga mapangidwe a chakudya. Ammonia yowola sakhazikika chifukwa cha kupangidwa kwa urea, komanso kumangiriza kwake ndi keto-glutaric acid ndikupanga glutamate. Kuledzera kwa a-ketoglutaric acid kumawonjezeka, ndikusowa kwa komwe kukula kwa kayendedwe ka Krebs kumachepa. Kuperewera kwa kayendedwe ka Krebs kumapangitsa kuti acetyl-CoA ikwaniritse kwambiri, motero, matupi a ketone. Chifukwa chakuchepa kwa kupuma kwa minofu mu shuga, mapangidwe a ATP amachepa. Ndikusowa kwa ATP, kuthekera kwa chiwindi kupanga mapuloteni amachepetsa.

Chifukwa chake, vuto la insulin, kuphulika kwa mapuloteni kumapambana kaphatikizidwe. Zotsatira zake, njira zamapulasitiki zimaponderezedwa, kupanga kwa antibody kumachepa, mabala ochiritsa amayamba kufooka, ndipo kukana kwa thupi kumatenda kumachepa. Mwa ana, kufalikira kumachitika. Ndi kuchepa kwa insulin, osati kuchuluka kokha, komanso kuyan'anila kwamapuloteni oyambitsa, kusintha ma paraproteins osazolowereka, mapuloteni a glycosylated amapezeka m'magazi. Amaphatikizidwa ndi kuwonongeka kwa makoma amitsempha yamagazi - angiopathy. Angiopathies amatenga gawo lofunikira kwambiri mu pathogenesis pazovuta zingapo zovuta za matenda osokoneza bongo (cholephera kuzungulira kwa coronary, retinopathy, etc.).

Tsiku Lomwe Likuwonjezeka: 2015-06-10, Views: 3699, POPANDA CHIWERUZO CHOTSA

Carbohydrate kagayidwe kachakudya matenda ashuga

Kuchepa kwa kagayidwe kazakudya mu shuga mellitus (DM) kumathandizira njira ya matendawa. Chodabwitsachi sichidathandizidwa ndi mapiritsi okha - ndikofunikira kumanganso moyo: idyani moyenera, masewera olimbitsa thupi, kugona mokwanira komanso kupewa mavuto. Kuphatikiza pa matenda ashuga, zovuta za metabolic zimayambitsa matenda ena.

Kagayidwe kazakudya - ndi chiyani?

Zakudya zomanga thupi zimapatsa mphamvu thupi. Zinthu izi ndizambiri:

• thandizani kulimbitsa chitetezo,
• kukhutitsa maselo ndi mphamvu,
• Chitani chiwindi,
• ndi gawo lofunikira popanga ma nucleic acids,
• zimathandizira homeostasis.

Carbohydrate metabolism imaperekedwa ndi magulu a njira:

• shuga oxidation njira
• njira za kutembenuka kwa glycogen kukhala glucose wochitika m'minyewa ndi chiwindi,
• kupanga mafuta ochulukirapo kuchokera ku zakudya zamafuta ochepa,
• kutembenuka kwa zovuta zamamakanidwe othandiza kukhala chakudya chochepa m'mimba.

Mwa munthu wathanzi, chakudya chopatsa mphamvu chimapatsa maselo mphamvu chifukwa cha zopatsa mphamvu zomwe zimadyedwa kapena malo osungira mafuta. Kulephera kwa kagayidwe kazakudya kumabweretsa kusintha kwa shuga m'magazi. Kuchuluka kwa shuga ndi 3.3-5,5 mmol / L. Pankhani yakusokonekera kwa metabolic, chizindikirochi chimatha kuchepa ndikukula.

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Kodi shuga imakhudza bwanji kagayidwe kazakudya?

Kugwiritsa ntchito kwambiri kwa glycoproteins kumabweretsa kukula kwa angiopathy.

Zomwe zimapangitsa kuti shuga ya 2 ikhale yopanda mphamvu ndizosakwanira kupanga insulin.Ndi kuchepa kwa kapangidwe kake kapena kuchepa kwa ntchito, kagayidwe kazakudya zam'mimba zimasokonekera. Pathophysiology ya kagayidwe:

1. Kutenga kwa glucose m'maselo kumachepa. Mwazi wamagazi umakula, njira zopangira insulin zopanda shuga zimachulukira, mwachitsanzo, polyol shunt, pamene glucose amalandila amayamba kubwezeretsanso, nkusintha kukhala sorbitol, pambuyo pake imatulutsa fructose. Tsoka ilo, njirayi imagwiritsidwa ntchito pa sorbitol dehydrogenase, enzyme yodalira insulini. The activation ya limagwirira amasonkhana sorbitol mu zimakhala, kumawonjezera mwayi kukulitsa neuropathy ndi matenda amkati.
2. Kugwiritsa ntchito kwa glycoproteins kumabweretsa kukula kwa angiopathies (atony of the vascular wall).
3. Kuchuluka kwa hemoglobin ya glycated kumakulanso.
4. Njira ya glucuronate imalimbikitsa kupangika kwa glycosaminoglycans. Zinthu izi zimathandizira kukulitsa kwa arthropathy (kusintha kwa ma trophic mu mafupa) mwa anthu omwe ali ndi matenda a shuga.

Njira zofotokozedwera za kutembenuka kwa shuga wopanda shuga sapereka ntchito yayikulu - mphamvu zowonjezera. Chochitika chododometsa chikuwoneka - pali shuga wokwanira m'magazi, ndipo maselo amafa ndi njala. Glucogeneis imayendetsedwa, komabe, chifukwa chosowa insulini, maselo sangathe kuyambitsa shuga. Hyperglycemia yosasunthika, kuperewera kwa mphamvu ndi mpweya m'maselo zimayamba. Kuchuluka kwa hemoglobin ya glycated kukukulira, zomwe zimawonjezera hypoxia.

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Zizindikiro za kuchepa kwa chakudya m'thupi

Matenda a metabolism ali ndi zosiyana pang'ono kutengera kuchuluka kwa chakudya. Ndi wopanda michere, wodwalayo akukumana ndi mawonetsedwe otsatirawa a matenda:

Kugona kungatanthauze kuyambika kwa kuphwanya kagayidwe kachakudya m'thupi.

• madera ovuta, opanda chidwi,
• kuwonda
• kugona, kufooka,
• shuga wamagazi ochepa
• ketoacidosis.

Zowonjezera chakudya:

• shuga wamagazi ambiri
• kuthamanga kwa magazi
• zochita kwambiri
• kugwedeza kwa thupi
• matenda a mtima dongosolo.

Matenda omwe amapezeka chifukwa chophwanya kagayidwe kazachilengedwe ndipo zisonyezo zawo zimafotokozedwa pagome:

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Carbohydrate kagayidwe

Kugona kwabwino kumathandizira kubwezeretsa kagayidwe kazakudya m'thupi.

Carbohydrate metabolism mu shuga imatha kuthandizidwa ngati wodwalayo asinthiratu moyo wake. Mapiritsi okha sikokwanira. Tizisinthasintha zakudya, kuchita masewera olimbitsa thupi pafupipafupi komanso kugona mokwanira. Chithandizo cha mankhwala osokoneza bongo ndikufuna kuthana ndi zomwe zimayambitsa matendawa. Wodwalayo amaphunzira zowerengera za mahomoni. Njira zomwe zimathandizira kuti kagayidwe kachakudya kagayidwe kachakudya:

• zovuta za vitamini
• mahomoni
• michere
• mangochita
• mankhwala antithrombotic
• ma amino acid
• biostimulants.

Kuti mumve zambiri za chakudya chamagulu, munthu amafunika kusintha zakudya zake m'njira yocheperako komanso kugwiritsa ntchito mphamvu zake momwe angathere.

Osamagwiritsira ntchito maswiti, kanizani chakudya chamagulu ammawa, osaluma ma cookie ndi tiyi, osalanda nkhawa. Ndikwabwino kusiya pamalo okwera m'malo mokweza masitepe. Ngati ndi kotheka, ndikulimbikitsidwa kuti mupite kuntchito kapena kuchokera ku metro station poyenda. Kuyenda mwachangu ndi masewera kumayenera kukhala gawo lofunikira m'moyo wa munthu yemwe ali ndi vuto la chakudya chamafuta.

Mavuto a lipid metabolism mu shuga mellitus: mphamvu ya insulin

Insulin imakhudzidwa ndi kayendetsedwe ka kagayidwe, kusintha kwa transmembrane kwa ayoni, amino acid. Zotsatira za insulin pa kagayidwe kazakudya zimavuta kuzidalira. Anthu omwe ali ndi matenda ashuga amawonetsanso kuchepa kwa metabolism.

Matendawa matenda a shuga apezeka pafupipafupi kwambiri. Matenda amachititsa matenda osiyanasiyana a metabolic. Matenda a shuga, matenda am'mimba omwe amatha kukhala osiyanasiyana, ali pamalo achitatu pambuyo pa matenda a oncology ndi a mtima. Pali anthu pafupifupi 100 miliyoni omwe ali ndi matenda ashuga padziko lapansi. Zaka khumi zilizonse, kuchuluka kwa odwala matenda ashuga kumapitilira 2 times.

Anthu ochokera kumaiko osatukuka ndi zinthu zodwala kumayiko otukuka ali pachiwopsezo chachikulu cha kudwala. Mavuto a metabolism a shuga mellitus amatsogolera ku ma pathologies osiyanasiyana. Matenda a shuga a Type 2 amakhala ambiri mwa anthu atatha zaka 45.

Njira ya zochita za insulin

Mu 1869, a Langerhans adapeza zilumba mu zikondamoyo zomwe adadzatcha dzina lake. Zinadziwika kuti matenda ashuga amatha kuonekera atachotsetsa England.

Insulin ndi mapuloteni, ndiye kuti, polypeptide yomwe imakhala ndi unyolo wa A ndi B. Amalumikizidwa ndi milatho iwiri yopanda tanthauzo. Tsopano ndikudziwika kuti insulin imapangidwa ndikusungidwa ndi maselo a beta. Insulin imasokonezedwa ndi ma enzymes omwe amabwezeretsa ma disulfide bond ndipo amatchedwa "insulinase." Kupitilira apo, ma enzymes a proteinolytic amakhudzidwa ndi hydrolysis ya unyolo kumitundu yochepa yamolekyulu.

Amakhulupirira kuti choletsa chachikulu cha insulin secretion ndi insulin m'magaziwo, komanso mahomoni a hyperglycemic:

TSH, catecholamines, ACTH, STH ndi glucagon m'njira zosiyanasiyana zimayambitsa adenylcyclase mu nembanemba ya selo. Wotsirizirayi amayambitsa kupangidwa kwa cyclic 3,5 adenosine monophosphate, imayambitsa chinthu china - puloteni kinase, imapatsa ma microtubules a beta, omwe amatsogolera pang'onopang'ono kumasulidwa kwa insulin.

Ma Microtubules ndimapangidwe a beta-cell omwe m'mbuyomu amapanga insulin m'mayendedwe am'mimba.

Chowonjezera champhamvu kwambiri cha mapangidwe a insulin ndi glucose wamagazi.

Limagwirira a insulin limagonekanso mu mgwirizano wotsutsana wa okhazikika okhazikika 3,5 - GMF ndi 3,5 AMP.

Limagwirira a chakudya kagayidwe

Sonyezani shuga yanu kapena sankhani jenda kuti muyimikize.

Insulin imakhudza kagayidwe kazakudya zam'mimba mu shuga. Chinsinsi cholumikizira matendawa ndi kuchepa kwa chinthu ichi. Insulin imakhudza kwambiri kagayidwe kazakudya, komanso mitundu ina ya kagayidwe, popeza katemera wa insulin amachepetsa, ntchito zake zimachepa, kapena kulandila kwa minofu yodalira insulin ndi maselo kumayipa.

Chifukwa chophwanya kagayidwe kazakudya mu shuga mellitus, ntchito ya shuga m'magazi imatsika, kuchuluka kwake m'magazi kumawonjezeka, ndipo njira zogwiritsira ntchito shuga zomwe zimayimira payekha zimapangitsa insulin.

Sorbitol shunt ndimkhalidwe womwe glucose amachepetsedwa kukhala sorbitol, kenako umatulutsa oxidin kuti achuluke. Koma makutidwe ndi okosijeni amachepetsa ndi enzyme yodalira insulini. Pamene polyol shunt imayendetsedwa, sorbitol imadzaza mu minofu, izi zimapangitsa mawonekedwe a:

Pali kupangika kwa shuga kwa protein ndi glycogen, koma mtundu uwu wa glucose sukutenga ndi maselo, popeza pali insulini. Aerobic glycolysis ndi pentose phosphate shunt imapanikizika, cell hypoxia ndi kuperewera kwa mphamvu kumawonekera. Kuchuluka kwa hemoglobin ya glycated kumawonjezeka, sikuti kumanyamula mpweya, womwe umathandizira hypoxia.

Mapuloteni a metabolism omwe ali ndi shuga amatha kuchepa:

1. hyperazotemia (kuchuluka kwa mabacteria otsalira),
2. hyperazotemia (kuchuluka kwa kuchuluka kwa nayitrogeni m'magazi).

Mulingo wanthawi zonse wa mapuloteni ndi 0,86 mmol / L, ndipo nayitrogeni yonse iyenera kukhala 0,87 mmol / L.

Zomwe zimayambitsa matenda a pathophysiology ndi:

• kuchuluka kwa mapuloteni
• kutsegula kwa kuphatikizika kwa amino acid mu chiwindi,
• asafe otsalira.

Nayitrogeni wopanda puloteni ndi nayitrogeni:

Izi zimachitika chifukwa cha kuwonjezeka kwa kuwononga mapuloteni, makamaka m'chiwindi ndi minofu.

Mu mkodzo wa shuga, kuchuluka kwa mankhwala a nayitrogeni kumawonjezeka. Azoturia ali ndi zifukwa zotsatirazi:

• kuchuluka kwazinthu zomwe zimakhala ndi nayitrogeni m'magazi, kutulutsa kwawo mkodzo,
• kagayidwe kakang'ono ka mafuta kamakhala ndi ketonemia, hyperlipidemia, ketonuria.

Mu matenda a shuga, hyperlipidemia imayamba, komwe kumawonjezera kuchuluka kwa magazi a milingo ya lipid. Chiwerengero chawo ndichoposa chachilendo, ndiye kuti, kuposa 8 g / l. Hyperlipidemia yotsatira ilipo:

1. minyewa activation lipolysis,
2. kuletsa kuwonongeka kwa lipid ndi maselo,
3. kuchuluka mafuta m'thupi,
4. kuletsa kwamtundu wama asidi ochulukirapo ku maselo,
5. kuchepa kwa ntchito ya LPLase,
6. ketonemia - kuwonjezeka kwa kuchuluka kwa matupi a ketone m'magazi.

Pagulu la matupi a ketone:

• acetone
• acetoacetic acid
• p-hydroxymalic acid.

Kuchuluka kwa matupi a ketone m'magazi kumatha kukhala okwera kuposa 30-50 mg%. Pali zifukwa izi:

1. lipolysis activation,
2. kuchuluka oxidation m'maselo amafuta ambiri
3. kuyimitsidwa kwa kapid
4. kuchepa kwa oxidation a acetyl - CoA mu hepatocytes ndi mapangidwe a matupi a ketone,

Kugawidwa kwa matupi a ketone pamodzi ndi mkodzo ndikuwonetsera kwa shuga mellitus munjira yosavomerezeka.

• matupi ambiri a ketone omwe amasefa mu impso,
• mavuto a kagayidwe wamadzi mu shuga, owonetsedwa ndi polydipsia ndi polyuria,

Polyuria ndi matenda omwe amafotokozedwa pakupanga mkodzo ndi kuchuluka kwake kwamkodzo mu voliyumu yomwe imaposa zofunikira zonse. M'mikhalidwe yokhazikika, kuyambira 1000 mpaka 1200 ml amatulutsidwa tsiku limodzi.

Ndi matenda a shuga, diuresis tsiku lililonse ndi 4000-10 000 ml. Zifukwa zake ndi izi:

1. Hyperosmia ya mkodzo, yomwe imachitika chifukwa kuchotsedwa kwa glucose owonjezera, ma ions, CT, ndi ma nitrogen ena. Chifukwa chake, kusefukira kwamadzi mu glomeruli kumapangidwira ndipo kumalepheretsanso kubwezeretsanso,
2. Kuphwanya kwa reabsorption ndi chimbudzi, zomwe zimayambitsidwa ndi matenda a shuga;
3. Polydipsia.

Insulin ndi mafuta kagayidwe

Mothandizidwa ndi insulin, chiwindi chimatha kusunga glycogen yochepa chabe. Glucose owonjezera omwe amalowa m'chiwindi amayamba phosphorylate motero amasungidwa mu cell, koma kenako amasinthidwa kukhala mafuta, osati glycogen.

Kusintha kumeneku m'mafuta ndi chifukwa chodziwikitsa mwachindunji kwa insulin, ndipo magazi omwe amapangidwira mkati mwa mafuta acids amatengedwa kupita ku minofu ya adipose. M'magazi, mafuta ndi gawo la lipoproteins, omwe amathandiza kwambiri popanga matenda a atherosulinosis. Chifukwa cha matenda awa, zitha kuyamba:

Zochita za insulin pama cell a adipose zimakhala zofanana ndi momwe zimakhudzira maselo a chiwindi, koma mapangidwe acids amafuta m'chiwindi amalimbika kwambiri, chifukwa chake amasamutsidwa kupita ku adipose minofu. Mafuta acids m'maselo amasungidwa ngati triglycerides.

Mothandizidwa ndi insulin, kuwonongeka kwa triglycerides mu adipose minofu kumachepetsedwa chifukwa chopinga lipase. Kuphatikiza apo, insulin imayambitsa kaphatikizidwe wamafuta acids m'maselo ndipo imagwira nawo ntchito yawo ndi glycerol, yomwe imafunikira pakupanga kwa triglycerides. Chifukwa chake, pakapita nthawi, mafuta amadziunjikira, kuphatikizapo physiology ya matenda a shuga a mellitus.

Zovuta za insulin pa metabolism yamafuta zitha kusinthika, ndi otsika kwambiri, triglycerides imagawidwanso m'mafuta acids ndi glycerol. Izi ndichifukwa choti insulini inhibits lipase ndi lipolysis imayatsidwa pamene kuchuluka kwake kumachepetsedwa.

Mafuta achilengedwe opanda mafuta, omwe amapangidwa nthawi ya hydrolysis ya triglycerides, nthawi yomweyo amalowa m'magazi ndipo amagwiritsidwa ntchito ngati mphamvu yopangira minofu. The oxidation a ma asidi awa amatha kukhala m'maselo onse, kupatula ma cell a nerve.

Mafuta ochulukirapo omwe amatulutsidwa pakakhala kusowa kwa insulini kuchokera m'mabotolo amafuta amadziwikanso ndi chiwindi. Maselo a chiwindi amatha kupanga triglycerides ngakhale pakhale insulin. Ndikusowa kwa chinthu ichi, mafuta acids omwe amatulutsidwa m'matumba amaphatikizidwa m'chiwindi mu mawonekedwe a triglyceride.

Pachifukwa ichi, anthu omwe ali ndi vuto la insulin, ngakhale amakonda kutsika thupi, amayamba kunenepa kwambiri m'chiwindi.

Kuchepa kwa lipid ndi kagayidwe kazakudya

Mu matenda ashuga, insulin glucagon index imatsitsidwa. Izi zimachitika chifukwa cha kuchepa kwa insulin katulutsidwe, komanso kuwonjezeka kwa kupanga kwa glucagon.

Mavuto a lipid metabolism mu shuga mellitus akuwonetsedwa mu kukondoweza kochepa kosungirako ndikuwonjezera kukondoweza kwa kukondoweza kwa malo osungirako. Mukatha kudya, mu postabsorption state ndi:

Zogulitsa ndi kugaya kwa metabolites, m'malo momasungidwa ngati mafuta ndi glycogen, zimazungulira m'magazi. Ku mulingo wina, njira za ma cyclic zimapangidwanso, mwachitsanzo, zimachitika nthawi imodzi za gluconeogeneis ndi glycolysis, komanso njira yamavuto amafuta ndi kaphatikizidwe.

Mitundu yonse ya matenda a shuga imadziwika ndi kulekerera kwa glucose, ndiye kuti, hyperglucosemia atatha kudya kapena ngakhale pamimba yopanda kanthu.

Zoyambitsa zazikulu za hyperglucoseemia ndi:

• kugwiritsa ntchito adipose minofu ndi minofu yochepa, chifukwa pakakhala insulin HLBT-4 siiwonekera poyera pa adipocytes ndi myocyte. Glucose sungasungidwe ngati glycogen,
• shuga mu chiwindi sagwiritsidwa ntchito posungira glycogen, chifukwa ndi kuchuluka kwa insulini komanso kuchuluka kwa glucagon, glycogen synthase sigwira ntchito,
• shuga wa chiwindi sagwiritsidwa ntchito popanga mafuta. Ma michere a glycolysis ndi pyruvate dehydrogenase ali mu mawonekedwe ochepa. Kusintha kwa glucose kukhala acetyl-CoA, komwe ndikofunikira pakuphatikizidwa kwamafuta acids, ndizoletsa,
• njira ya gluconeogeneis imayendetsedwa pazotsalira zambiri za insulin ndi glucagon komanso kuphatikiza kwa glucose kuchokera ku glycerol ndi amino acid.

Chowonetseranso china cha matenda ashuga ndi miyeso yambiri ya magazi ya lipoprotein, matupi a ketone ndi mafuta aulere acids. Mafuta okometsedwa samayikidwa mu minofu ya adipose chifukwa adipocyte lipase ili m'malo.

Muli nkhani zazikuluzikulu zamafuta zamafuta zamafuta m'magazi zimawonekera. Mafuta acids amatengeka ndi chiwindi, zina mwa izo zimasinthidwa kukhala ma pracylglycerols, ndipo zimalowa m'magazi ngati gawo la VLDL. Mafuta ochulukirapo amalowa mu β-oxidation mu mitochondria ya chiwindi, ndipo kupanga acetyl-CoA amagwiritsidwa ntchito pakupanga matupi a ketone.

Zotsatira za insulin pa metabolism zimagona poti pakukhazikitsa insulin m'misempha yosiyanasiyana ya thupi, kaphatikizidwe wamafuta ndi kuwonongeka kwa triglyceridlipids zimathandizira. Kuchepa kwa lipid kagayidwe kachakudya ndikusungidwa kwamafuta, komwe kumakwaniritsa zosowa zamagetsi pamavuto.

Maonekedwe ochulukirapo a cAMP amatsogolera kuchepa kwa kaphatikizidwe ka mapuloteni komanso kuchepa kwa HDL ndi VLDL. Chifukwa cha kuchepa kwa HDL, cholesterol excretion yochokera m'maselo a cell kulowa m'magazi amachepetsa. Cholesterol imayamba kuyikidwa m'makoma a zombo zazing'onoting'ono, zomwe zimapangitsa kuti pakhale matenda a shuga ndi atherosclerosis.

Zotsatira za kuchepa kwa VLDL - mafuta amadziunjikira m'chiwindi, nthawi zambiri amathandizidwa mu VLDL. Protein synthesis imapanikizidwa, zomwe zimapangitsa kuchepa kwa kupanga ma antibodies, kenako, kukana kosakwanira kwa odwala matenda ashuga matenda opatsirana. Amadziwika kuti anthu omwe ali ndi vuto la protein protein metabolism amadwala furunculosis.

Zovuta zotheka

Microangiopathy ndi matenda a shuga a shuga. Chifukwa cha matenda ashuga a retinopathy, anthu omwe ali ndi matenda ashuga satha kuwona mu 70-90% ya milandu. Makamaka, odwala matenda ashuga amakhala ndi matenda amkati.

Chifukwa chosowa HDL, cholesterol yowonjezera imapezeka m'matumbo am'mimba. Chifukwa chake, nthenda ya mtima kapena kuchepa kwa endarteritis imatha kuoneka. Pamodzi ndi izi, microangiopathy yokhala ndi nephritis imapangidwa.

Ndi matenda ashuga, periodontal matenda mawonekedwe a gingivitis - periodontitis - periodontal matenda. Mu odwala matenda ashuga, mawonekedwe amano amasokonezeka ndipo zimakhala zothandizira zimakhudzidwa.

Zomwe zimayambitsa matenda a microvessels mu zochitika izi, nthawi zambiri, ndikupanga kulumikizana kosagwirizana kwa glucose ndi mapuloteni a khoma lamitsempha. Poterepa, mapulateleti amabisa chinthu chomwe chimalimbikitsa kukula kwa minofu yosalala ya khoma la mtima.

Mavuto a kagayidwe ka mafuta amasonyezedwanso mfundo yoti kufalikira kwa mafuta m'thupi kumawonjezera chiwindi lipid resynthesis. Nthawi zambiri, amawapaka monga VLDL, mapangidwe ake omwe amatengera kuchuluka kwa mapuloteni. Kwa izi, opereka gulu la CHZ, ndiye kuti choline kapena methionine, amafunikira.

Kuphatikizika kwa Choline kumalimbikitsa lipocaine, yomwe imapangidwa ndi pancreatic duct epithelium. Kuchepa kwa izo kumabweretsa kunenepa kwambiri kwa chiwindi ndikupanga mitundu yonse ya shuga ndi yaing'ono.

Kuperewera kwa insulin kumabweretsa kukana kochepera matenda opatsirana. Chifukwa chake, furunculosis imapangidwa.

Kanemayo munkhaniyi ayankhula za zovuta za insulin m'thupi.

Sonyezani shuga yanu kapena sankhani jenda kuti muyimikize.

Matenda a metabolism a carbohydrate

Matenda ashuga mellitus - gulu la matenda kagayidwe kachakudya matenda a hyperglycemia, zomwe zimachitika chifukwa cha chilema pakubisala kapena zochita za insulin kapena njira zonse ziwiri,

DM ndi matenda ofala kwambiri a endocrine omwe amayambitsidwa ndi kuperewera konse kapena kwa insulin, limodzi ndi kuphwanya mitundu yonse ya kagayidwe.

Zithandizirani pakukula kwa matenda ashuga:

• zopatsa mphamvu zamafuta ndi mafuta m'zakudya,

Deficitinsulin imachitika pamene:

• kuwonongeka kwa kapamba,

• kuphwanya kusintha kwa proinsulin kupita ku insulin,

• kuphwanya maselo a insulin,

• chilema cha zolowa mu ziwalo zomwe mukufuna.

• zolimbitsa kanthu insulinase,

• yowonjezera ya contra-mahomoni mahomoni.

• Mtundu woyamba wa matenda a shuga I umadalira insulini. Zimachitika pakuwonongeka kwa maselo a ß chifukwa cha zochita za autoimmune.

Kufupika Kwambiri kwa Insulin.

• Mtundu wachiwiri wa matenda osokoneza bongo a mellitus samadalira insulin.

Zimachitika chifukwa cha kuwonongeka kwa njira yosamutsira siginecha insulini kuti ijambule ma cell kapena kuphwanya katulutsidwe ka insulin.

Zizindikiro za matenda ashuga

1. Hyperglycemia yoyambitsidwa ndi:

- kuphwanya kuchuluka kwa shuga m'matumbo,

- machitidwe a ma contra-mahomoni olimbitsa thupi.

3. Polyuria ndi polydipsia (ludzu).

4. Ketonemia ndi ketonuria.

5. Azotemia ndi azoturia.

6. Kuchepetsa chitetezo cha antioxidant.

• Kuperewera kwa insulini komanso kuwonjezeka kwakuthwa kwa mahomoni onse opikisana ndi chifukwa cha kuphatikizika kwa lipolysis ndi kukhathamiritsa kwa FFA, zomwe zimapangitsa kuti matupi a ketone agwire.

• Mafuta amagwiritsidwa ntchito ngati gwero lamphamvu, acetyl-CoA imagwiritsidwa ntchito pakupanga matupi a ketone.

• kuyezetsa magazi, misozi,

• mayeso ololera a shuga (TSH),

• kutsimikiza kwa shuga ndi acetone mu mkodzo.

Kuyeserera kwa glucose - kafukufuku wokhoza kugwiritsa ntchito glucose pochita masewera olimbitsa thupi.

1. Pamimba yopanda kanthu muyeso wamagazi.

2. Mutu umamwa kapu ya tiyi wokoma (katundu). 1 g shuga pama 1 makilogalamu amalemu.

3. Pambuyo maora awiri, kuchuluka kwa shuga kumatsimikizidwanso.

Mulingo wamba wamagazi:

• pamimba yopanda 3.3-5.5 mmol / l,

• Patatha maola awiri mutadya kochepera 7.8 mmol / l, mulibe shuga mkodzo,

• imakwera kwambiri momwe ingathere (zosaposa 80% ya zoyambirirazo) pambuyo pa mphindi 60, ndiye kuti imachepetsa ndipo pambuyo maola 3 itasintha.

Ndi matenda a shuga a latent, kulekerera kwa shuga kumachepa

• shuga wofulumira akhoza kukhala wabwinobwino (osakwana 6.7 mmol / l),

• Patatha maola awiri mutatha kudya, shuga wamagazi amaposa 7.8-11.1 mmol / l,

Ndi matenda ashuga odziwika bwino:

• kuthamanga kwa glucose kumakulitsa (kuposa 6.7 mmol / l),

• Maola awiri mutatsitsa - zopitilira 11.1 mmol / l.

2. kwambiri hyperglycemia. 3. Gawo la insulin.

Chakudya kagayidwe kachakudya matenda

Kuphwanya kwa hydrolysis ndi mayamwidwe chakudya

The mayamwidwe chakudya zimachitika mkaka chifukwa cha kusowa kwa amylolytic michere ya m'mimba thirakiti (amylase wa pancreatic madzi, ndi zina) kapena disaccharidases. Nthawi yomweyo, michere yama michere yomwe imabwera kuchokera ku chakudya samathyoledwa kukhala ma monosaccharides ndipo samamwa. Njala ya Carbohydrate imayamba.

Mafuta a chakudya omwe amapezeka ndi shuga phosphorylation amasokonezedwa khoma lamatumbo, lomwe limachitika pakatupa, mutamwa poyizoni ndi ziphe zomwe zimalepheretsa enzyme hexokinase.

Glycogenosis ndi gulu la matenda obadwa nawo obwera chifukwa cha kuchepa kwa michere yomwe imakhudzana ndi kaphatikizidwe kapena kuwonongeka kwa glycogen.

O-mtundu glycogenosis (aglykenosis) amakula ndi vuto la glycogen synthase. Amadziwika ndi kuchepa kwakukulu m'masitolo a glycogen m'chiwindi, hypoglycemic syndrome imawonedwa (mpaka kukula kwa chikomokere). Ndi kuchepa kwa glycogen synthase, odwala amamwalira ali aang'ono.

Kuperewera kwa michere yomwe imakhudzana ndi kuphwanya glycogen kumapangitsa kuti pakhale ziwalo komanso minyewa (tebulo 5).

Matenda a Carbohydrate Pakati

1. Hypoxic zinthu (zolephera kupuma kapena magazi, komanso magazi m'thupi, ndi zina). Gawo la anaerobic la kusintha kwa chakudya chamthupi limaposa aerobic. Kuchuluka kwambiri mu minofu ndi magazi a lactic ndi pyruvic acid amapezeka. Acidosis imachitika. Njira zama Enzymatic zimasokonezeka. Mapangidwe a ATP amachepetsa.

2. Matenda a chiwindi, komwe nthawi zambiri gawo lactic acid limapangidwanso mu glucose ndi glycogen. Ndi kuwonongeka kwa chiwindi, resynthesis imalephera. Hyperlactidemia ndi acidosis amakula.

3. Hypovitaminosis B1. Zosokoneza oxidation wa PVC, chifukwa Vitamini B1 ndi gawo limodzi mwa zovuta za pyruvate dehydrogenase. PVC imadziunjikira mopitirira muyeso ndipo imadutsa pang'ono kupita ku lactic acid, zomwe zimapangidwanso. PVC ndi poizoni wam'mapeto amitsempha. Ndi kuwonjezeka kwa ndende yake chifukwa cha 2-3, kusokonezeka kwa machitidwe, mitsempha, ziwalo, etc. zimachitika.

Ndi hypovitaminosis B1, njira ya pentose phosphate ya carbohydrate metabolism imasokonekera, makamaka, mapangidwe a nthiti.

Gome 5. Matenda omwe amaphatikizidwa ndi kuphwanya glycogen metabolism

3. Matenda a shuga: Njira imodzi yokha yochiritsira!

3.1. Wogulitsa nsombayo pamapeto pake amakhala ndi nsapato!

Ngati mukudwala matenda ashuga, ndiye kuti muphunzira kuchokera mu chaputalachi kuti njira zamakono zodziwira, kuchiza komanso kupewa matenda ashuga, omwe amawerengedwa, amalimbikitsidwa ndikuchitidwa ku United States (ndipo nthawi zambiri amatsutsidwa m'maiko otukuka, kuphatikiza Russia), Osangolakwitsa komanso kopanda ntchito, komanso imathandizira kwambiri njira ndikukulitsa kukula kwa matenda ashuga komanso zovuta zina.

Kuti zonena ngati izi sizikuwoneka ngati zopanda maziko, chaputalachi chimaperekedwa makamaka pakudziwitsani za "zowawa" izi. Mukamawerenga zinthu izi, musaiwale izi:

• Ngati inu kapena okondedwa anu akupezeka ndi matenda a shuga, muyenera kupitiliza kugwira ntchito ndi omwe amakuthandizani pazaumoyo, makamaka ngati mukumwa mankhwala. Dokotala wamba amadziwa za matenda ashuga zomwe amaphunzitsidwa. Tsoka ilo, monga mudzaphunzirira pambuyo pake, phunzitsani ndikupitilizabe kuphunzitsa molakwika. Mwamwayi, madokotala ambiri amakulakalirani bwino komanso mudakhala ndi thanzi labwino, mumagwira ntchito yawo mokhulupirika, koma osayang'anira moyo wanu ... Zingakhale zopanda nzeru kuti mungasiyire pomwepo udindo wamankhwala anu kwa madotolo.Ngati simukuganiza choncho, mulibe chiyembekezo ...

• Ntchito yothandiza ndikutsata njira ya "kuchiritsa" odwala matenda ashuga. Bukuli limadalira kwathunthu chidziwitso chanu chozama cha zinthu zomwe zili m'buku langa la Ntchito Nutrition 1.

• Mutuwu suli maphunziro a shuga kapena chitsogozo chamankhwala kwa madotolo. Limalongosola mfundo zakakhalidwe zomwe zimapangitsa kupewetsa onse, kupatula, "matenda obwera chifukwa chakudya," omwe pakati pawo pali shuga.

• Matenda - kuchokera ku chakudya, thanzi - komanso chakudya! Sura iyi ikulongosola za zoyenera kupewa ndi kupewa matenda ashuga omwe ali ndi magwiridwe antchito. Mfundozi ndizothandiza ngakhale kwa omwe sangathenso kugwiritsa ntchito mankhwala osokoneza bongo, koma amachepetsa kwambiri mlingo, kupewa kuwoneka osasinthika, kusintha magwiridwe antchito ndikudikirira munthawi yabwino tsiku lomwe njira yodalirika komanso yotetezedwa ibwezeretsere ntchito za pancreatic.

- Kuthetsa matenda a shuga mothandizidwa ndi zakudya zopatsa mphamvu (komanso ntchito yothandizanso paokha) sizingatheke popanda zopatsa mphamvu zapamwamba (mavitamini, mchere, kufufuza zinthu, ma enzyme, microflora yamatumbo, ndi zina zambiri). Dyera la oononga liziwononga - kufotokozera kosamveka bwino pankhaniyi. Ngati mukuwerengera inshuwaransi yomwe imalipira chithandizo chamankhwala, kapena mukuyesera kupulumutsa pamitengo yazogulitsa ndi zopatsa thanzi, mosakayikira mudzapeza zotsatira zomwe muli nazo kale. Osachepera ku USA, ngakhale "osauka kwambiri" amatha kugula $ 1.5- $ 2 madola tsiku pazinthu zabwino.

Ndipo, pomalizira, inenso ndili wokhudzidwa m'mbuyomu chifukwa chosadziwika bwino ndipo ndanyalanyaza mtundu wachiwiri wa matenda ashuga omwe amandibaya ndimavuto osaneneka: matenda a shuga a m'mimba, matenda a shuga, kunenepa kwambiri, kupsinjika, kusowa tulo, kuchepa kwa mafupa, matenda otupa, matenda am'mimba, kale munthawi yovuta kwambiri, yosweka ndi ntchito yabwino, ndi zina zambiri.

Wowombera wopanda nsapato? ... Lero, momwe ndingathere ndili ndi zaka 47, ndili ndi thanzi labwino. Inde, sindikhalanso ndi mano, mano, tsitsi ndi khungu, ngati mnyamata, koma pakulimbitsa thupi, luntha ndi malingaliro, ndidzagawanitsa amuna ambiri ochepera zaka 20 ...

"Wowombera" uyu, pomaliza, ali ndi nsapato, adatsimikizira pakhungu lake kuti kuchiritsa matenda ashuga ndi gawo limodzi ndikuti mutha kuchepetsa thupi pamiyendo yonse komanso kuti musakhale bwino. Gawo lotsatira ndikuzindikira mdaniyo pamaso panu ndikupambana - ndi yanu!

Gawani patsamba

Palibe ndemanga pano!

Kollokvium_obmen_uglevodov

Kupsinjika mtima kumathanso kukhala chifukwa chosadwala matenda a hyperglycemia. Ndikofunikira kuwongolera masewera olimbitsa thupi: kugwira ntchito mopitirira muyeso kapena, m'malo mwake, moyo wongokhala ungayambitse kuchuluka kwa shuga m'magazi.

Matenda opatsirana komanso osachiritsika amathanso kuyambitsa matenda a hyperglycemia. Mwa anthu omwe ali ndi matenda a shuga, hyperglycemia imatha kuchitika chifukwa cha mankhwala omwe amachepetsa shuga kapena jakisoni wa insulin.

Glucose-6-phosphatase encyme chilema (matenda a Girke)

Hepatic phosphorylase chilema - matenda a hers

Matenda operewera kwambiri

Hypoglycemia pa nthawi yapakati

Mowa ndi mankhwala

Mavuto a kagayidwe kazakudya mu shuga. Limagwirira a chitukuko cha matenda. Zizindikiro zasayansi.

Mavuto a kagayidwe kazakudya kagayidwe kachakudya matenda ashuga:

Ma cell omwe amadalira insulin amakhala ndi mphamvu yamagetsi chifukwa chosowa glucose (palibe glycolysis)

Gluconeogeneis imayikidwa m'chiwindi

M'maselo osadalira insulini, chifukwa cha kuchuluka kwa shuga, njira ya polyol imayendetsedwa

Kukhazikika kwa zovuta za matenda ashuga:

Zizindikiro zasayansi:

Madzi a m'magazi a plasma (labu. Ntchito)

Kudziletsa kwa glucose kulolera (labu. Ntchito)

Plasma glycosylated hemoglobin (HbA1-C)

Mulingo wa Plasma Fructosamine

Mafuta amkodzo

Milingo ya ketone ya urin

Njira yopangira zovuta: pali mitundu iwiri ya matenda ashuga - odalira insulini - pomwe kupanga insulin beta ndi maselo a zikondamoyo za Langerhans akuwonongeka (kutupa, zochita za autoimmune), komanso inulin-payokha - pomwe insulin imapangika nthawi zambiri, koma zotsatira zake mu khungu zimasweka. (Receptor chilema) Zizindikiro zamankhwala: Glucose kulolerana kuyesa, kutsimikiza kwa glycosylated hemoglobin, kutsimikiza kuchuluka kwa insulin ndi C-peptide mu mkodzo, ndi kuchuluka kwa albumin mu mkodzo (albuminuria), kutsimikiza kuchuluka kwa matupi a ketone.

Nonenzymatic glycation. Kuchita mu limagwirira kukula kwa mavuto a hyperglycemia. Matenda azachipatala komanso ozindikira kafukufuku wa fructosamine ndi glycosylated hemoglobin.

Glycation yopanda enzymatic - yopanda enzymatic, kuphatikiza kwa glucose kapena fructose mu membrane kapangidwe ka mapuloteni omwe ali ndi hyperglycemia. Nthawi zambiri, zimachitika mosiyanasiyana, ndi hyperglycemia, glycation imakumana ndi chilichonse komanso chilichonse. Udindo wamapangidwe akukhazikitsa zovuta za hyperglycemia: glycosylated hemoglobin imapangidwa (makamaka, izi sizothandiza kwambiri, koma hemoglobin siyikukwaniritsa ntchito yake), ma glycosylated crystallins (ma protein a mandala, omwe amachititsa kuti ma protein a ma cell a membrane, amachokera chifukwa cha angiopathies, nephropathies ndi retinopathies amakulitsa. Zotsatira zamankhwala komanso zofufuza zamaphunziro a fructosamine ndi glycosylated hemoglobin: chabwino, popeza glycosylation imawonedwa ndi hyperglycemia, ndiye kuti titha kuzindikira matenda a hyperglycemia mwa kudziwa fructose (glycosylated albumin) ndi glycosylated hemoglobin m'magazi. Kuphatikiza apo, hemoglobin imakhala masiku 90 mpaka 120. Chifukwa chake tili ndi miyezi itatu kale chifukwa sipangakhale hyperglycemia, ndipo hemoglobin ikatsala. Amakonda kufunsa funso za izi, khalani okonzeka mokwanira. Glucose amatha kumanga ma protein a magazi ndi minyewa (non-enzymatic glycation), kusokoneza kapangidwe kawo ndi ntchito yawo. Mapuloteni osinthika awa amawoneka kuti ndi achilendo ndi kuyambitsa kwa chitetezo cha mthupi chomwe chimayang'ana kuwonongeka kwawo, komwe kumayambitsa chitukuko cha matenda a metabolism. Mayeso amawagwiritsa ntchito kuzindikira matenda okoma a shuga komanso kuwunika mkhalidwe wa kagayidwe kazakudya kwa odwala omwe ali ndi matendawa. Ubwino wake pakudziwa kuchuluka kwa shuga mu seramu yamagazi ndi motere: 1. Ngati ma glucose amawonetsa glycemia panthawi yamapulogalamu, ndiye kuti kuchuluka kwa hemoglobin ya glycosylated ndi kwanthawi yayitali (masabata 3-4). 2. Kutengera ndi mawonekedwe a zakudya, zovuta zomwe zimapangitsa komanso zovuta zina, hyperglycemia imatsogolera ku overdiagnosis ya shuga okoma. Zotsatira zonsezi sizimakhudza zotsatira za kutsimikiza kwa glycosylated hemoglobin. 3. Chiyeso chofuna kukhazikitsa zomwe zili mu HbA1c ndichowonjezera kwa ashuga okoma kuposa kudziwa kuchuluka kwa shuga. Kudziwitsa za zinthu za fructosamine Mawu akuti "fructosamine" mu chemistry yachipatala amatanthauza kuchuluka kwa mapuloteni a glycosylated magazi a seramu. Fructosamine ndi chipangidwe cha zotsatira zopanda-enzymatic pakati pa monosaccharides (nthawi zambiri shuga) ndi magawo ena a mapuloteni amwazi (nthawi zambiri epsilon-amino gulu la lysine, gulu la amino la valine). Mfundo za njira. Fructosamine imatha kuchepetsa nitrosine tetrazolium mu alkaline sing'anga, kuisintha kukhala formazan ndi mayamwidwe okwanira pa 530 nm. Zomwe zimachitika pakati pa fructosamine ndi tetrazolium ya nitro-bluu zimachitika pa pH ya 10.8 (mu buffer ya carbonate) ndi kutentha kwa 37 ° C. Kujambula kumachitika pambuyo pa mphindi 15. Synthetic ketoamine (fructosoleucine) amagwiritsidwa ntchito ngati zonena. M'magazi am'magazi a anthu athanzi (abwinobwino), zomwe zimakhala mu fructosamine nthawi zambiri sizidutsa 285 μmol / L.Zachipatala komanso matenda othandiza kudziwa zomwe zili mu fructosamine Njira yayikulu yotsatsira momwe glycosylation ya mapuloteni amathandizira m'magazi ndi matenda a shuga. Kuzindikira kwa kutsimikiza kwa kutsimikiza kwa fructosamine ndiwokwera poyerekeza ndi HbA1c koyambirira kwamatenda. Ndi nthawi yayitali ya matendawa, kupezeka kwa matenda ashuga a shuga, kuchuluka kwa fructosamine kumawonjezeka mpaka pang'ono kuposa glycosylated Hb. Kukumana kwa fructosamine ndi "galasi" la glycemia masabata atatu apitawa, omwe amakupatsitsani mwayi wodziwa matenda mwachangu.

Mapangidwe a njira ya chimbudzi ndi mayamwidwe wamafuta mu hodosisi. Congenital kusowa kwa chakudya chimbudzi michere, glycogen kagayidwe, glucosaminoglycans. (kwa ophunzira a udokotala wa ana)

Munthawi yakukula, mtundu waukulu wa zakudya ndi hematotrophy, pomwe michere imalowetsa mwana wosabadwayo kudzera mwa placenta. Nembanemba ya placental imadutsa madzi, glucose, amino acid, dipeptides ndi mankhwala ena ofunikira kuti kukhazikitsidwa kwa metabolic njira mu fetus. Mapuloteni ambiri, lipids ndi ma polysaccharides mu placenta amayamba kupatsidwa enzymatic hydrolysis. Amalowa m'magazi a mwana wosabadwayo mwa mawonekedwe a monomers. Kuyambira miyezi 4-5 yakukula kwa fetal, ziwalo zam'mimba zimayamba kugwira ntchito. Amniotrophic - amniotic madzimadzi amalowa nawo hematotrophic zakudya. Amniotrophic madzimadzi amalowa m'mimba ziwalo za mwana wosabadwayo ndi kuyamwa, kumeza ndi kupuma mayendedwe. Mwezi wotsiriza wa mimba patsiku, mwana wosabadwayo amatenga madzi okwanira 1 litre. Enzymatic ntchito yamatumbo ang'onoang'ono imapangidwa kale kuposa madipatimenti ena. Mu nthawi ya chitukuko cha intrauterine, zida zamagetsi zam'mimba zimapangika pang'onopang'ono: kuchuluka kwa maselo a endocrine kumawonjezeka, zomwe zimakhala zamahomoni am'mimba zimawonjezeka. Pambuyo pobala, mtundu wa chakudya umakhala lactotrophic. Mkaka wa amayi umapereka thupi, lomwe limakula mwachangu, ndi pulasitiki komanso mphamvu zamagetsi. Mavitamini, ma enzyme, michere, madzi, mankhwala okhala ndi zinthu zina, etc. amapatsidwa mkaka. Kuyambira miyezi isanu ndi umodzi ndi itayi, zakudya zowonjezera zimayambitsidwa m'zakudya za mwana, kenako mwana zimasinthidwa pang'onopang'ono kupita kuzakudya zoyenera. Njira zomwe zimasinthira kuchokera ku mtundu wina wa zakudya kupita kwina zimatsimikiziridwa ndi magawo a mapangidwe a dongosolo la kugaya chakudya ndi njira zowongolera. Pankhani yogwiritsa ntchito zakudya zoyambirira zosakanikirana, kukula kwa dongosolo la m'mimba kumathandizira. Mu hydrolysis ya michere yopezeka mkaka wa m'mawere, ma enzyme amkaka ndi tiziwalo tating'onoting'ono ta ziwalo zathupi ta mwana zimakhudzidwa. Malovu a mwana wakhanda umagwiritsidwa ntchito kupangira kulimba pakati pa nipple ndi milomo pakuyamwa. Ntchito ya enzymatic ya malovu sichitha, koma yokwanira kupaka mkaka m'mimba. Amylase, yomwe ili pamankhwala a mwana wakhanda, pafupifupi 1/3 ya zochitika zake akuluakulu. M'zaka 1 - 2 zoyambirira, ntchito ya michere imachulukana. Reflexes kuchokera zolandirira lilime ndi mucosa mkamwa ndizofunikira kwambiri pakuwongolera kosoka. Reflex yamisala yokhazikika imapangidwa mchaka choyamba cha moyo. Mimba ya wakhanda imatha kukhala 5-10 ml. Mpaka kumapeto kwa chaka, pang'onopang'ono ukuwonjezeka mpaka 250-300 ml. Kusiyanitsa kwakukulu ndi parietal glandulocytes kumachitika ngakhale munthawi ya chitukuko cha intrauterine. Kuphatikiza apo, maselo akuluakulu amayamba kugwira ntchito kale kuposa ma parietal: pepsinogen amawoneka kale kuposa hydrochloric acid. Katulutsidwe wa hydrochloric acid zimatengera mtundu wa chakudya. Pankhani yotembenukira ku kudya kokumbidwa, acidity yamadzi imachulukitsa 2 mpaka 4. Ndi zaka, kachulukidwe ka tiziwopsezo ta mucous membrane kumakulanso.Ntchito ya enzymatic ya madziwo imatengera mtundu wa chakudya: m'miyezi yoyambirira, mapuloteni omwe amapezeka muzakudya za nyama ndi nyama samasweka. Kutalika kwamatumbo mwa ana okhudzana ndi kutalika kwa thupi kumakulirapo kuposa akulu (mwa akhanda, mwa nthawi 8.3, komanso mwa achikulire, mwa nthawi 5.4). Ntchito zachinsinsi za kapamba ndi chiwindi ndizotsika kuposa akuluakulu. Zotsatira zake, mchaka choyamba cha moyo, chimbudzi chimagwira. Adakali aang'ono, kupezeka kwa ziwalo za m'matumbo ang'onoang'ono kumakhalabe kokwanira kwambiri, kotero, kuchuluka kwazinthu zambiri zam'maselo pazakudya kumapitilirabe kuyamwa ndi kulowa m'magazi. Colon microflora colonization amapezeka mkati mwa masiku 2 - 2 amoyo. Microflora yachilendo imakhudzidwa ndi chimbudzi, mapangidwe a immunological reacaction, kuletsa kwakhazikitsidwa kwa microflora ya pathogenic, amapanga mavitamini angapo, ndipo amathandizira ena pazinthu zolimbitsa thupi. Kumayambiriro kwa chitukuko, mahomoni ndi makonzedwe amomwe amagwiritsira ntchito kayendetsedwe kazinsinsi ndi kayendedwe ka mota yamagetsi amapangidwa. Njira zamkati mwa neuro-Reflex zimalumikizidwa pambuyo pake. Kapangidwe kamakina am'mimba kumatha kutha msambo.

Kulephera kwa kagayidwe kachakudya matenda a shuga

Popeza kapamba amatenga gawo lalikulu mu kayendetsedwe ka kagayidwe kazakudya ndi kuchuluka kwa shuga mthupi, ndiye ndikusokonezeka pang'ono pakugwira kwake ntchito kwa ziwalo zonse ndi machitidwe ake amavutika.

Ngati sichitulutsa insulin yokwanira, ndiye kuti zomwe zimadziwika kuti pathological glucosuria zimachitika.

Ndi cholinga chopewa zovuta zomwe zingabuke kumbuyo komwe kumayambira matendawa, ndikofunikira kutsatira malamulo apadera ndi zofunika, zonse zokhudzana ndi zakudya komanso kukhalabe ndi moyo wathanzi. Ngati izi sizichitika, ndiye kuti matendawa amatha kukhala ndi vuto lalikulu la matenda a shuga.

Kusagwira bwino ntchito kwa ziwalo ndi machitidwe

Popeza pamaso pa matendawa munthu amakhala ndi kusowa kwa mahomoni a pancreatic omwe amatchedwa insulin, ndiye kuti glucosuria ya pathological imachitika.

Mavuto akulu a chiwonetsero cha glycogen kupanga chiwindi ndi kusokoneza ntchito kwa glucose ndi zotumphukira zimakhala zofunikira kwambiri pakuwonekera kwake.

Monga mukudziwira, m'chiwindi cha munthu aliyense pali njira zingapo zovuta zowonjezera zomwe zimapangitsa kuti pakhale kuwonongeka ndikupangidwanso kwa lipids, mapuloteni, ndipo, zowonjezera, zopezeka m'magazi, zomwe zimabwera palimodzi ndi madzi am'magazi omwe amayenda mwachindunji kuchokera mu dongosolo la chimbudzi.

Ambiri a endocrine tiziwalo timene timatulutsa timatenda tambiri timakhudzana ndi ntchito ya kapamba ndi chiwindi. Popeza zakudya zopatsa mphamvu ndizothandiza kwambiri kwa munthu, kusinthana kwa zinthuzi ndikofunikira m'thupi lake.

Kuphatikiza pa insulini, mahomoni osiyana kwambiri omwe kapamba amatulutsa amakhudzanso kagayidwe kazachilengedwe. Amatchedwa glucagon ndipo ali ndi zotsatira zotsutsana kwathunthu.

Komanso mahomoni okula, omwe amapangidwa ndi pituitary gland, cortisol ndi mahomoni ena a chithokomiro, amakhudza kagayidwe kazachilengedwe.

Zinthu zonsezi zimatha kuchititsa kuti glycogen iwonongeke, zomwe zimapangitsa kuti shuga azichulukirachulukira. Ichi ndichifukwa chake adrenaline, mahomoni okula, glucagon ndi mahomoni a chithokomiro amangotchulidwa kuti ndi a insulin antagonists.

Atangotuluka kwa insulin yakuthwa komanso ya pachimake, njira zonse za mayamwidwe amthupi zimasokonezeka nthawi yomweyo. Choyamba, glycogen ya chiwindi imasweka ndikuyamba kulowa m'magazi a magazi m'magazi a shuga.

Kupitilira apo, thupi limayamba kuphwanya kwa glycogen kopanda insulin yokwanira. Pambuyo pake, izi zimapangitsa kuti mafuta azikhala m'maselo a m'mimba a m'mimba.Ndikofunika kudziwa kuti kusokonezeka kwa metabolic m'thupi kumabweretsa mtsogolo kusintha kwakukulu komanso koopsa m'madzi kagayidwe ndi mchere.

Pofuna kukhazikika thupi ndi matenda ashuga, muyenera kuphunzira momwe mungawongolere mawonekedwe ake. Ichi ndichifukwa chake muyenera kuphunzira kumvetsetsa malangizo azachipatala ndi nthawi yake.

Kulephera kupangira glycosaminoglycans (GAG)

Glycosaminoglycans ndiye gawo lama chakudya a proteinoglycans, omwe amaphatikizapo amino shuga-hexosamines. Zinthu izi ndizogwirizana kwambiri ndi kachigawo kakang'ono ka mapuloteni.

Glycosaminoglycans, mtundu wa maselo

Zinthu zofunika zomwe zili mu proteinoglycans zimagwirizana ndi zinthu zomwe zimapangidwira minyewa yolumikizana. Chifukwa chake, amapezeka m'mafupa, matupi akhungu ndi ziphuphu za diso. Kuphatikiza ndi ulusi wa collagen ndi elastin, amatembenukira ku matrix.

Zinthu zoterezi zimakhudza gawo lonse la maselo, kuwonjezera, zimagwira gawo lalikulu pakusinthana kwa ion, ntchito zoteteza thupi, komanso kusiyanasiyana kwa minofu. Ngati munthu ali ndi kuphwanya kwakukulu kwa kapangidwe ka GAG mu shuga, ndiye kuti izi zitha kubweretsa matenda akulu akulu.

Kuti muthe kukhazikika pakulimbana ndi matenda a shuga, muyenera kumayesedwa pafupipafupi ndi dokotala wodziwa bwino, kumwa mankhwala oyenera, kuwunika zakudya, ndikutsatira malangizo onse a akatswiri.

Lipid kagayidwe kagayidwe kachakudya matenda a shuga: biochemistry

Monga mukudziwa, insulin imakhudzanso kwambiri mapid metabolism mu minofu ya adipose.

Imatha kulimbikitsa kaphatikizidwe wamafuta ena acids kuchokera ku glucose. Ntchito inanso yofunika kwambiri ndi kulepheretsa kusweka kwa lipid komanso kuwonongeka kwa mapuloteni m'misempha minofu.

Ichi ndichifukwa chake kusowa kwakukulu kwa mahomoni a pancreatic kumatha kubweretsa kusokonezeka kwa metabolic, komwe nthawi zambiri kumawonedwa kwa odwala matenda a shuga.

Carbohydrate kagayidwe

Matendawa amatha kuthana ndi zochita zonse za metabolic zomwe zimachitika mthupi.

Monga mukudziwa, ndi matenda ashuga, kagayidwe kazakudya kameneka kamasokonezedwa makamaka, komwe kamadziwika ndi zina:

1. kwambiri amachepetsa kaphatikizidwe ka glucokinase, kamene kamatsala pang'ono kutayika m'chiwindi. Zotsatira zake, thupi limakhala ndi kuperewera kwa glucose-6-phosphate. Zotsatira zake ndikuchepa kwa kapangidwe ka glycogen,
2. kuchuluka kwa shuga-6-phosphatase ayamba kuchuluka, motero glucose-6-phosphate ndi dephosphorylated ndipo amalowa m'magazi a magazi m'magazi a glucose.
3. kusokonezeka kwakukulu kwa metabolic kumachitika - kusintha kwa glucose kukhala mafuta kumachepetsa,
4. kulephera kwa glucose kudutsa mumitsempha ya cell kumadziwika,
5. Kupanga kwa glucose kuchokera ku zinthu zina zopanda mafuta owonjezera mphamvu kumachitika mofulumira.

Mavuto a kagayidwe kakang'ono ka kagayidwe kachakudya m'mimba yokhala ndi matenda a shuga amakhala ndi mapangidwe osakwanira komanso kugwiritsidwa ntchito kosakwanira kwa glucose ndi minofu yambiri ya thupi, chifukwa cha hyperglycemia.

Monga mukudziwa, ndi matenda ashuga, kuchuluka kwa shuga kumatha kufikira magawo ovuta, motero ndikofunikira kuti muziwongolera pogwiritsa ntchito chipangizo chapadera kapena muofesi ya katswiri.

Matenda a protein a shuga

Si chinsinsi kuti vuto la metabolic mu shuga limakhudza osati chakudya chokha komanso lipid, komanso metabolism ya protein.

Monga mukudziwa, kufooka kwambiri kwa thupi la mahomoni a kapamba ndi kugwiritsa ntchito shuga m'magazi kungayambitse kuchepa kwa kaphatikizidwe ka mapuloteni.

Njira zosasangalatsazi zimayenderana ndi kutayika kwa nayitrogeni ndi thupi komanso kumasulidwa kwa potaziyamu, kutsatiridwa ndi kupukusa kwa ayoni okhala ndi zinthu zonyansa.

Kuchuluka kwa mahomoni a pancreatic kumakhudza magwiridwe antchito a maselo, osati chifukwa chophwanya mapuloteni, komanso chifukwa cha zovuta zina ndi zovuta zina. Mwa zina, kusowa kwamadzi kumabweretsa zomwe zimatchedwa kuperewera kwamadzi mkati mwa maselo a thupi.

Ndikofunika kwambiri kukumbukira kuti kuchepa kwamadzi m'matupi a shuga, kuperewera kwa mkodzo kumawonjezera mwayi wotaya potaziyamu ambiri. Pankhaniyi, muyenera kufunsa kuchipatala mwachangu kuti muthandizidwe mwadzidzidzi.

Chifukwa chiyani kulephera kuli koopsa?

Ngati atazindikira wodwala yemwe ali ndi matenda a shuga, akupitilizabe kukhala ndi chizolowezi chomadya, kumwa kwambiri "mowa, kumwa mowa mwauchidakwa, kusuta" chiopsezo cha hypoglycemic chikomokere.

Ichi ndi chikhalidwe chowopsa kwambiri, chomwe chimadziwonetsa ndi kuchepa kwamphamvu kwa magetsi mu glucose. Ngati kagayidwe kabwinobwino ka munthu kali ndi shuga, ndiye kuti mwayi wokhala ndi matendawa ndi wochepa.

Koma, komabe, kuti muchepetse mitundu yonse ya zovuta za metabolic mu shuga mellitus, ndikofunikira kutsatira malangizo onse a akatswiri omwe amagwirizana ndi onse omwe amamwa mankhwala oyenera komanso zakudya za tsiku ndi tsiku.

Ponena za kadyedwe, omwe amatchedwa tebulo nambala 9 ndi oyenera kwa odwala matenda ashuga.

Komabe, si mphindi zonse zakudya zomwe zili zoyenera kwa wodwala wina, amenenso ndiyenera kuyang'ana kwa adokotala omwe akupezekapo. Ayenera kusintha kuti wodwala aliyense apewe zovuta.

Chofunikira chachikulu pakupanga chakudya cha wodwala wina ndikuwonetsetsa pa kuchuluka kwa zosowa za kalori tsiku ndi tsiku. Ndikofunikira kuti muchepetse zakudya zomwe mumadya kwambiri.

Izi ndizowona makamaka pazinthu zopukusa mosavuta. Izi zimaphatikizapo shuga, mkate, confectionery, chokoleti, ndi timadziti. Ndikofunikanso kupatula zakudya zokazinga komanso zokhala ndi mafuta owopsa muzakudya.

Ndi anthu ochepa omwe amadziwa kuti ndi matenda ashuga mungathe kudya zakudya monga masamba, nyama yoyera, nsomba zamafuta ochepa komanso zinthu zamkaka.

Makanema okhudzana nawo

Kuphunzitsa kwa woyembekezera wa sayansi ya zamankhwala pa matenda a metabolic odwala matenda ashuga:

Ngati muli ndi matendawa omwe akufunsidwa, muyenera kuyang'anitsitsa momwe thanzi lanu limakhalira ndi moyo wanu, zomwe zimatha kutsogolera matendawa.

Kuti mupewe zovuta zilizonse zowopsa, muyenera kuwona dokotala wanu nthawi zonse kuti muwone momwe matendawo akupiririra ndikuthandizira kuyimitsa kapena kupewa.

Kuyesedwa kwa nthawi ndi nthawi, kuyezetsa, kukonza zakudya, kuyendera katswiri, komanso kukhalabe ndi moyo wathanzi kudzathandizira kuimitsa matendawa.

Ndi njira yabwino, mutha kukhala ndi moyo wabwinobwino popanda zoletsa, zomwe sizisiyana ndi moyo wamunthu wathanzi kwathunthu. Ngati wodwala ali ndi mtundu wachiwiri wa matenda a shuga, ndiye kuti simungathe kuchita popanda mankhwala apadera omwe amachepetsa kuchuluka kwa shuga, insulin ndi mankhwala ena ochepetsa lipid.

Matenda a shuga |

Popeza kapamba amatenga gawo lalikulu mu kayendetsedwe ka kagayidwe kazakudya ndi kuchuluka kwa shuga mthupi, ndiye ndikusokonezeka pang'ono pakugwira kwake ntchito kwa ziwalo zonse ndi machitidwe ake amavutika.

Ngati sichitulutsa insulin yokwanira, ndiye kuti zomwe zimadziwika kuti pathological glucosuria zimachitika.

Ndi cholinga chopewa zovuta zomwe zingabuke kumbuyo komwe kumayambira matendawa, ndikofunikira kutsatira malamulo apadera ndi zofunika, zonse zokhudzana ndi zakudya komanso kukhalabe ndi moyo wathanzi.Ngati izi sizichitika, ndiye kuti matendawa amatha kukhala ndi vuto lalikulu la matenda a shuga.

Kusagwira bwino ntchito kwa ziwalo ndi machitidwe

Popeza pamaso pa matendawa munthu amakhala ndi kusowa kwa mahomoni a pancreatic omwe amatchedwa insulin, ndiye kuti glucosuria ya pathological imachitika.

Mavuto akulu a chiwonetsero cha glycogen kupanga chiwindi ndi kusokoneza ntchito kwa glucose ndi zotumphukira zimakhala zofunikira kwambiri pakuwonekera kwake.

Monga mukudziwira, m'chiwindi cha munthu aliyense pali njira zingapo zovuta zowonjezera zomwe zimapangitsa kuti pakhale kuwonongeka ndikupangidwanso kwa lipids, mapuloteni, ndipo, zowonjezera, zopezeka m'magazi, zomwe zimabwera palimodzi ndi madzi am'magazi omwe amayenda mwachindunji kuchokera mu dongosolo la chimbudzi.

Ambiri a endocrine tiziwalo timene timatulutsa timatenda tambiri timakhudzana ndi ntchito ya kapamba ndi chiwindi. Popeza zakudya zopatsa mphamvu ndizothandiza kwambiri kwa munthu, kusinthana kwa zinthuzi ndikofunikira m'thupi lake.

Kuphatikiza pa insulini, mahomoni osiyana kwambiri omwe kapamba amatulutsa amakhudzanso kagayidwe kazachilengedwe. Amatchedwa glucagon ndipo ali ndi zotsatira zotsutsana kwathunthu.

Komanso mahomoni okula, omwe amapangidwa ndi pituitary gland, cortisol ndi mahomoni ena a chithokomiro, amakhudza kagayidwe kazachilengedwe.

Zinthu zonsezi zimatha kuchititsa kuti glycogen iwonongeke, zomwe zimapangitsa kuti shuga azichulukirachulukira. Ichi ndichifukwa chake adrenaline, mahomoni okula, glucagon ndi mahomoni a chithokomiro amangotchulidwa kuti ndi a insulin antagonists.

Atangotuluka kwa insulin yakuthwa komanso ya pachimake, njira zonse za mayamwidwe amthupi zimasokonezeka nthawi yomweyo. Choyamba, glycogen ya chiwindi imasweka ndikuyamba kulowa m'magazi a magazi m'magazi a shuga.

Kupitilira apo, thupi limayamba kuphwanya kwa glycogen kopanda insulin yokwanira. Pambuyo pake, izi zimapangitsa kuti mafuta azikhala m'maselo a m'mimba a m'mimba. Ndikofunika kudziwa kuti kusokonezeka kwa metabolic m'thupi kumabweretsa mtsogolo kusintha kwakukulu komanso koopsa m'madzi kagayidwe ndi mchere.

Pofuna kukhazikika thupi ndi matenda ashuga, muyenera kuphunzira momwe mungawongolere mawonekedwe ake. Ichi ndichifukwa chake muyenera kuphunzira kumvetsetsa malangizo azachipatala ndi nthawi yake.

Kulephera kupangira glycosaminoglycans (GAG)

Glycosaminoglycans ndiye gawo lama chakudya a proteinoglycans, omwe amaphatikizapo amino shuga-hexosamines. Zinthu izi ndizogwirizana kwambiri ndi kachigawo kakang'ono ka mapuloteni.

Glycosaminoglycans, mtundu wa maselo

Zinthu zofunika zomwe zili mu proteinoglycans zimagwirizana ndi zinthu zomwe zimapangidwira minyewa yolumikizana. Chifukwa chake, amapezeka m'mafupa, matupi akhungu ndi ziphuphu za diso. Kuphatikiza ndi ulusi wa collagen ndi elastin, amatembenukira ku matrix.

Zinthu zoterezi zimakhudza gawo lonse la maselo, kuwonjezera, zimagwira gawo lalikulu pakusinthana kwa ion, ntchito zoteteza thupi, komanso kusiyanasiyana kwa minofu. Ngati munthu ali ndi kuphwanya kwakukulu kwa kapangidwe ka GAG mu shuga, ndiye kuti izi zitha kubweretsa matenda akulu akulu.

Kuti muthe kukhazikika pakulimbana ndi matenda a shuga, muyenera kumayesedwa pafupipafupi ndi dokotala wodziwa bwino, kumwa mankhwala oyenera, kuwunika zakudya, ndikutsatira malangizo onse a akatswiri.

Lipid kagayidwe kagayidwe kachakudya matenda a shuga: biochemistry

Monga mukudziwa, insulin imakhudzanso kwambiri mapid metabolism mu minofu ya adipose.

Imatha kulimbikitsa kaphatikizidwe wamafuta ena acids kuchokera ku glucose.Ntchito inanso yofunika kwambiri ndi kulepheretsa kusweka kwa lipid komanso kuwonongeka kwa mapuloteni m'misempha minofu.

Ichi ndichifukwa chake kusowa kwakukulu kwa mahomoni a pancreatic kumatha kubweretsa kusokonezeka kwa metabolic, komwe nthawi zambiri kumawonedwa kwa odwala matenda a shuga.

Carbohydrate kagayidwe

Matendawa amatha kuthana ndi zochita zonse za metabolic zomwe zimachitika mthupi.

Monga mukudziwa, ndi matenda ashuga, kagayidwe kazakudya kameneka kamasokonezedwa makamaka, komwe kamadziwika ndi zina:

1. kwambiri amachepetsa kaphatikizidwe ka glucokinase, kamene kamatsala pang'ono kutayika m'chiwindi. Zotsatira zake, thupi limakhala ndi kuperewera kwa glucose-6-phosphate. Zotsatira zake ndikuchepa kwa kapangidwe ka glycogen,
2. kuchuluka kwa shuga-6-phosphatase ayamba kuchuluka, motero glucose-6-phosphate ndi dephosphorylated ndipo amalowa m'magazi a magazi m'magazi a glucose.
3. kusokonezeka kwakukulu kwa metabolic kumachitika - kusintha kwa glucose kukhala mafuta kumachepetsa,
4. kulephera kwa glucose kudutsa mumitsempha ya cell kumadziwika,
5. Kupanga kwa glucose kuchokera ku zinthu zina zopanda mafuta owonjezera mphamvu kumachitika mofulumira.

Mavuto a kagayidwe kakang'ono ka kagayidwe kachakudya m'mimba yokhala ndi matenda a shuga amakhala ndi mapangidwe osakwanira komanso kugwiritsidwa ntchito kosakwanira kwa glucose ndi minofu yambiri ya thupi, chifukwa cha hyperglycemia.

Monga mukudziwa, ndi matenda ashuga, kuchuluka kwa shuga kumatha kufikira magawo ovuta, motero ndikofunikira kuti muziwongolera pogwiritsa ntchito chipangizo chapadera kapena muofesi ya katswiri.

Matenda a protein a shuga

Si chinsinsi kuti vuto la metabolic mu shuga limakhudza osati chakudya chokha komanso lipid, komanso metabolism ya protein.

Monga mukudziwa, kufooka kwambiri kwa thupi la mahomoni a kapamba ndi kugwiritsa ntchito shuga m'magazi kungayambitse kuchepa kwa kaphatikizidwe ka mapuloteni.

Njira zosasangalatsazi zimayenderana ndi kutayika kwa nayitrogeni ndi thupi komanso kumasulidwa kwa potaziyamu, kutsatiridwa ndi kupukusa kwa ayoni okhala ndi zinthu zonyansa.

Kuchuluka kwa mahomoni a pancreatic kumakhudza magwiridwe antchito a maselo, osati chifukwa chophwanya mapuloteni, komanso chifukwa cha zovuta zina ndi zovuta zina. Mwa zina, kusowa kwamadzi kumabweretsa zomwe zimatchedwa kuperewera kwamadzi mkati mwa maselo a thupi.

Ndikofunika kwambiri kukumbukira kuti kuchepa kwamadzi m'matupi a shuga, kuperewera kwa mkodzo kumawonjezera mwayi wotaya potaziyamu ambiri. Pankhaniyi, muyenera kufunsa kuchipatala mwachangu kuti muthandizidwe mwadzidzidzi.

Chifukwa chiyani kulephera kuli koopsa?

Ngati atazindikira wodwala yemwe ali ndi matenda a shuga, akupitilizabe kukhala ndi chizolowezi chomadya, kumwa kwambiri "mowa, kumwa mowa mwauchidakwa, kusuta" chiopsezo cha hypoglycemic chikomokere.

Ichi ndi chikhalidwe chowopsa kwambiri, chomwe chimadziwonetsa ndi kuchepa kwamphamvu kwa magetsi mu glucose. Ngati kagayidwe kabwinobwino ka munthu kali ndi shuga, ndiye kuti mwayi wokhala ndi matendawa ndi wochepa.

Koma, komabe, kuti muchepetse mitundu yonse ya zovuta za metabolic mu shuga mellitus, ndikofunikira kutsatira malangizo onse a akatswiri omwe amagwirizana ndi onse omwe amamwa mankhwala oyenera komanso zakudya za tsiku ndi tsiku.

Ponena za kadyedwe, omwe amatchedwa tebulo nambala 9 ndi oyenera kwa odwala matenda ashuga.

Komabe, si mphindi zonse zakudya zomwe zili zoyenera kwa wodwala wina, amenenso ndiyenera kuyang'ana kwa adokotala omwe akupezekapo. Ayenera kusintha kuti wodwala aliyense apewe zovuta.

Chofunikira chachikulu pakupanga chakudya cha wodwala wina ndikuwonetsetsa pa kuchuluka kwa zosowa za kalori tsiku ndi tsiku. Ndikofunikira kuti muchepetse zakudya zomwe mumadya kwambiri.

Izi ndizowona makamaka pazinthu zopukusa mosavuta. Izi zimaphatikizapo shuga, mkate, confectionery, chokoleti, ndi timadziti. Ndikofunikanso kupatula zakudya zokazinga komanso zokhala ndi mafuta owopsa muzakudya.

Ndi anthu ochepa omwe amadziwa kuti ndi matenda ashuga mungathe kudya zakudya monga masamba, nyama yoyera, nsomba zamafuta ochepa komanso zinthu zamkaka.

Makanema okhudzana nawo

Kuphunzitsa kwa woyembekezera wa sayansi ya zamankhwala pa matenda a metabolic odwala matenda ashuga:

Ngati muli ndi matendawa omwe akufunsidwa, muyenera kuyang'anitsitsa momwe thanzi lanu limakhalira ndi moyo wanu, zomwe zimatha kutsogolera matendawa.

Kuti mupewe zovuta zilizonse zowopsa, muyenera kuwona dokotala wanu nthawi zonse kuti muwone momwe matendawo akupiririra ndikuthandizira kuyimitsa kapena kupewa.

Kuyesedwa kwa nthawi ndi nthawi, kuyezetsa, kukonza zakudya, kuyendera katswiri, komanso kukhalabe ndi moyo wathanzi kudzathandizira kuimitsa matendawa.

Ndi njira yabwino, mutha kukhala ndi moyo wabwinobwino popanda zoletsa, zomwe sizisiyana ndi moyo wamunthu wathanzi kwathunthu. Ngati wodwala ali ndi mtundu wachiwiri wa matenda a shuga, ndiye kuti simungathe kuchita popanda mankhwala apadera omwe amachepetsa kuchuluka kwa shuga, insulin ndi mankhwala ena ochepetsa lipid.

Matenda a shuga |

Matenda a shuga ndi matenda ovuta a chamoyo chonse, chodziwika ndimatenda a metabolic, makamaka chakudya chamafuta, komanso mapuloteni, mafuta, madzi ndi mchere.

Matenda a shuga amayamba pafupipafupi chifukwa cha kuperewera kwa insulin (pancreatic and extrapancreatic) ndipo nthawi zambiri amawonetsedwa mu hyperglycemia ndi glucosuria, nthawi zambiri polydipsia, polyuria, ndipo nthawi zina hyperketonemia ndi ketonuria.

Nthawi zambiri, matenda ashuga amakakamizidwa ndi mawonetsedwe osiyanasiyana amatsenga, mtima ndi ziwalo zina.

KUSINTHA KWA FAT NDIPONSO ZOTSATIRA

Hyperlipemia, hypercholesterolemia, hyperketonemia ndi ketonuria, hyperazotemia ndi hyperazoturia. Acidosis
Kutsika kwa kuchuluka kwa glycogen m'chiwindi mu shuga kumayendetsedwa ndi kukhudzidwa kwakukulu kwamafuta ochokera kumafamu amafuta, komanso kusintha kwa chiwindi. Pamodzi ndi mafuta, cholesterol imapangidwanso. Kusintha kwamafuta ndi lipoids kuchokera ku depot yawo kupita ku chiwindi kumachitika kudzera m'magazi ndipo kumayambitsa hyperlipidemia (m'malo mwa 1%, 5-10-20% amapezeka nthawi zambiri). Kulowa kwamafuta chiwindi kumawonedwa. Pokhudzana ndi izo komanso kufooka kwa chiwindi ndi glycogen, hyperketonemia (ketosis) imadziwika. M'mitundu yoopsa ya shuga m'magazi, m'malo mwa kuchuluka kwa matupi a ketone (10 mg%), kuchuluka kwawo (acetoacetic ndi beta-hydroxybutyric acid ndi acetone) amapezeka, mpaka 2040 mg% kapena kuposa. Hyperketonemia iyi ikufotokozedwa ndikuwonjezereka kwa kusintha kwa matupi a ketone kuchokera ku chiwindi kupita kumagazi, zomwe zimachitika mwachindunji ndikulowerera kwa mafuta a chiwindi ndi kutsika kwake kwa glycogen.

Amadziwika kuti matupi a ketone ndi chinthu chapakatikati pakuwotcha kwamafuta, amatha kupangika panthawi yopanda mapuloteni ena.

Kuti makutidwe awo okhatikiza ndi mpweya wabwino ndi madzi, kutenga michere ndi mpweya wambiri ndikofunikira.

Gawo lililonse lamafuta acid limapereka gawo limodzi la asidi acetoacetic (kuchokera pomwe ma acetone ndi beta-hydroxybutyric acid amapangidwira kale).

Akatswiri ena a endocrinologists amagawa shuga kuti akhale "islet" ndi "kwathunthu", chifukwa cha kuwonongeka kwa kapamba wonse. Mu matenda a shuga a islet, kumangokhala kusowa kwa insulini, ndipo hyperglycemia ndi glucosuria sizovuta za kunenepa kwambiri kwa chiwindi ndi ketosis.

Pa matenda ashuga athunthu, pamene, kuwonjezera pa kuchepa kwa insulin, chinthu china chogwira pancreatic, lipocaine (yomwe imapangidwa ndi maselo a epithelial a ma ducts ochepa a gland) sichimatulutsidwa, kulowa m'mafuta kumayamba m'chiwindi, chifukwa lipocaine imalepheretsa kuchuluka kwa mafuta m'chiwindi ndikuwonjezera njira zake zowonjezera.

Kuphatikiza apo, lipocaine imathandiziranso lipotropic zotsatira (i.e., ikuchedwa kuchulukitsa mafuta m'chiwindi) cha zakudya zina (kanyumba tchizi, oatmeal ndi zinthu zina zomwe zili ndi casein, choline, methionine, ndi zina).

Chifukwa chake, pakalibe lipocaine, mafuta amayamba kulowa m'chiwindi.

Pambuyo pake, kunenepa kwambiri kwa chiwindi, kumachepetsa ntchito zake zokonza glycogen, zomwe zimapangitsa kuti mafuta azikhala ndi chiwindi chambiri ndi chiwindi chambiri.

Chifukwa chake, ketosis ndi kuchepa kwa glycogen mu shuga mellitus sikugwirizana mwachindunji pathogenetically ndi insulin. Amakhala nthawi yachiwiri ndi kuwonongeka kwa chiwindi, komwe kumatha kuchitika ndikusowa kwa lipocaque chinthu cha kapamba, monga zovuta zina zingapo.

M'mikhalidwe yokhazikika, palibe matupi a ketone mu mkodzo. Matupi amenewa amapezeka m'magazi ndi hyperketonemia, chifukwa kukwera kwamkodzo kwamkodzo kwamkodzo, samasungidwanso kwathunthu m'matubu.

Mu matenda osakhazikika a shuga, hyperazotemia imapezekanso nthawi zambiri, zomwe zimachitika chifukwa cha kuchuluka kwa zinthu zomwe zimapangidwa nthawi yayitali ya mapuloteni, chifukwa mu shuga, mapuloteni omwe amapezeka m'matumbo amaphatikizira m'chiwindi ndikupanga kusintha kwakukulu kwa ma carbohydrate. Mukapanga mapangidwe a michere kuchokera m'mapuloteni, ammonia, urea, amino acid amapangidwa ndipo amayambitsa hyperazotemia, yomwe imabweretsa hyperazoturia, i.e., kuwonjezeka kwa kuperewera kwa zinthu za nayitrogeni mkodzo. Kuchepa kwa kukana kwa thupi kumatenda komanso kuchepa kwa chitetezo cha mthupi mu matenda a shuga kumafotokozeredwa ndikuti njira za metabolic mu ziwalo zonse ndi minofu zimasokonezeka m'thupi la wodwalayo.

Kuphatikiza apo, matupi a ketone amalepheretsanso kugwira ntchito kwa reticuloendothelial system, potero amachepetsa chitetezo cha thupi.

Pomaliza, ndikufuna ndikuuzeni kuti: ngati mukukumana ndi matenda okhumudwitsa ngati "matenda ashuga", musataye mtima, chifukwa masiku ano mankhwala achikhalidwe akula kwambiri poyerekeza ndi zaka za zana la 20, pomwe matenda ashuga anali amodzi mwa matenda oopsa.

Ndipo ngakhale zili choncho kuti ngakhale lero, asayansi sanathe kupeza mankhwala omwe amathandizanso wodwala matenda ashuga pakukwaniritsa malingaliro oyenerera a akatswiri odziwa bwino Mutha kukhala ndi matenda ashuga kwa nthawi yayitali komanso zosangalatsa. Chinthu chachikulu ndikudziwa malamulo ochepa (komanso ofunikira!) Olimbana ndi matenda a shuga.

Kuti mudziwe zambiri za njira zopewera matenda ashuga komanso momwe mungaphunzitsire matendawa moyenera, chonde lowani ku sukulu yathu ya matenda ashuga. Sukulu iyi ya matenda a shuga ndi yaulere ndipo imapangidwira makamaka anthu omwe ali ndi matenda a shuga omwe amafunikira zoposa kufunsa endocrinologist walusokomanso chithandizo chamalingaliro.

Ndikhulupirireni, izi ndizofunikira kwambiri! Ingolowetsani mafomu pansi pa nkhaniyi kuti mulembetse ku sukulu ya matenda ashuga. Ndikukufunirani thanzi labwino!

Siyani ndemanga ndikupeza MPHATSO!

Gawani ndi abwenzi:

Werengani zambiri pamutuwu:

ZOSANGALATSA MALANGIZO NDI LIPID METABOLISM MU ZIWANDA

Mu shuga mellitus, index insulin-glucagon yafupika. Izi zimachitika osati kuchepa kwa insulin katulutsidwe, komanso kuwonjezeka kwa secretion wa glucagon (insulin inhibits secretion wa glucagon).

Zotsatira zake, kusunthika kwa njira zotsitsimutsa kumafooka ndipo kusinthika kwa kusungirako kosungirako kumalimbitsidwa, kotero kuti chiwindi, minofu, minyewa ya adipose, ngakhale itatha kudya, imagwira ntchito mu boma la postabsorption (onani mkuyu. 2).

Pankhaniyi, zinthu zofunika kugaya, komanso ma metabolites, m'malo momasungidwa mwa glycogen ndi mafuta, zimazungulira m'magazi. Mwinanso, pamlingo wina, njira zotsika mtengo za ma cyclic, monga glycolysis ndi gluconeogeneis kapena kaphatikizidwe ndi kuwonongeka kwa mafuta, etc., zimachitika.

Mitundu yonse ya matenda a shuga imadziwika ndi kulolerana kwa shuga, i.e. hyperglucemia atatha kudya kapenanso pamimba yopanda kanthu.

Zomwe zimayambitsa hyperglucoseemia:

- kudya kwa glucose minofu ndi adipose minofu ndi ochepa, chifukwa pakakhala insulin GLUT-4 silikuwonekera padziko myocyte ndi adipocytes.

Chifukwa chake, shuga sagwiritsidwa ntchito posungira monga glycogen mu minofu ndi mawonekedwe a mafuta mu minofu ya adipose,

- mu chiwindi, glucose sagwiritsidwa ntchito posungira glycogen, chifukwa m'magazi ambiri a insulin komanso glucagon glycogen synthase ali mu mawonekedwe a phosphorylated

- shuga sagwiritsidwa ntchito m'chiwindi kuphatikiza kwamafuta: glycolysis ndi michere ya pyruvate dehydrogenase siyothandiza, chifukwa chake, kutembenuka kwa glucose kukhala acetyl CoA, komwe ndikofunikira pakapangidwira mafuta acids,

- njira ya gluconeogeneis imayendetsedwa pamsika wambiri wa insulin ndi glucagon wambiri komanso kuphatikiza kwa glucose kuchokera ku amino acid ndi glycerol ndikotheka.

Chizindikiro china cha matenda ashuga ndizowonjezereka m'magazi a lipoprotein (makamaka VLDL), mafuta achilengedwe aulere, koposa zonse, matupi a ketone. Izi ndichifukwa choti zakudya zamafuta sizimayikidwa mu minofu ya adipose, chifukwa cAMP-amadipocyte lipase wodalirika wa cAMP ali mu fomu ya phosphorylated (yogwira).

Chifukwa chake zochuluka zowonjezera zamafuta am'magazi. Mafuta acids amalowetsedwa ndi chiwindi, ena mwa iwo amasinthika kukhala adipocytes kukhala ma triacylglycerols, omwe amatsekeredwa m'magazi ngati gawo la VLDL.

Gawo lina lamafuta acids limalowa mu njira ya β-oxidation mu mitochondria ya chiwindi, ndipo chifukwa cha acetyl-CoA chimagwiritsidwa ntchito pakupanga matupi a ketone.

MALANGIZO OGWIRITSIRA (ACUTE COMPLICATIONS) MU DIYABETES NGATI CHINSINSI CHA ZINSINSI ZA KUTHENGA KWA ULELELELE NDI FAT

Mu matenda a shuga, mitundu itatu ikuluikulu ya kupuma ndiyotheka: ketoacidotic coma yokhala ndi kuperewera kwenikweni kwa insulin, hyperosmolar coma yokhala ndi kuchepa kwa insulin, lactic acidosis kukomoka kwambiri ndi hypoxia, sepsis, ndi mtima. Kuphatikiza apo, ndi mankhwala a insulin, pamakhalanso vuto lotchedwa hypoglycemic coma lomwe limakhudzana ndi bongo wa insulin. Zinthu zitatu zoyambirira zimatha kukhazikika osati ndi matenda ashuga okha, komanso mchikakamizo cha zina zambiri (poizoni, matenda, etc.).

Mitundu itatu yayikulu ya chikomokoma pafupifupi siyimachitika padera. Nthawi zambiri mawonetseredwe amtundu wina (nthawi zambiri hyperosmolar) amakhala ambiri, omwe amapereka chifukwa chogogomezera mafomu akuluakulu.

Choyambitsa chachikulu cha ketoacidosis ndikusowa kwa insulin: nthawi ya chikomokere, C-peptide ndi immunoreactive insulin (IRI) m'magazi sizikupezeka. Hyperglycemia imawonedwa nthawi zonse (20-30 mmol / l, nthawi zina zowonjezera).

Acidosis mu matenda ashuga ndi zotsatira za kuchuluka kwa ma organic acid: matupi a ketone, komanso lactate ndi pyruvate.

Kukumana kwa matupi a ketone kumafikira 2 mmol / ml (nthawi 200 kupitirira kuposa momwe zimakhalira), kumangowonjezereka osati chifukwa cha kaphatikizidwe m'chiwindi, komanso chifukwa choti kutuluka kwa matupi a ketone kumachepa chifukwa cha oliguria ndi anuria, zomwe zimachitika kawirikawiri ndi chikomokere. Kutsika kwa magazi pH mpaka 7 ndi kutsika (chizolowezi 7.4) kumawonedwa nthawi zonse.

Kuperewera kwa madzi kumayamba: kuchepa kwa madzi kumatha kukhala 10% ya thupi lonse.Kuchuluka kwa madzi ozungulira kumachepa ndi 25-30%, zomwe zimapangitsa kuchepa kwa magazi.

Mpweya wabwino wa okosijeni ndi mphamvu ya myocardium, kuchepa kwa magazi kumayambitsa kulephera kwa mtima. Kutheka kwa magazi, kuchuluka kwa mtima, kuchepa kwamitsempha, mtima, kugunda, zotumphukira.

Matenda a matenda ashuga amakula pang'onopang'ono masiku angapo, nthawi zina amatha kuchitika m'maola ochepa.

Pali mseru, kusanza, nkhope ndizakuthwa, maso akuwongoka, kusayang'anira chilengedwe kukukulira, ulesi, womwe umasandulika chikomokere (kutembenuka kwathunthu chikumbumtima, kusowa kwa chidwi, kupuma kwa minofu, ndi zina). Mchipinda chomwe wodwalayo ali, fungo la acetone limamveka.

Kuthamanga kwa magazi kumachepetsedwa, oliguria kapena anuria pafupifupi imawonedwa.

Kukomoka kwa matenda ashuga kumafuna zotsatirazi kuti zichitidwe mwachangu: 1) kuthetseratu kuchepa kwa insulin poika ma insulin mu Mlingo womwe umatsimikizira kuchepa pang'onopang'ono kwa kuchuluka kwa shuga m'magazi mpaka kufika pafupi, chamoyo pobweretsa njira zoyenera zamchere; 4) kubwezeretsanso glycogen nkhokwe mthupi.

Mawonekedwe a chikomokere nthawi zambiri amachotsedwa mkati mwa masiku awiri ndi chithandizo mosalekeza, ndipo chithandizo mu maola oyamba ndikofunikira kwa wodwalayo.

Asanayambike mankhwala othandizira odwala matenda a shuga, odwala anamwalira patangotha ​​matendawa atangomaliza kumene. Komabe, pakadali pano, chikomokere chimawonedwa nthawi zambiri.

Makamaka, chiwonetsero choyamba cha matendawa mu 15-30% ya milandu imayendetsedwa ndi ketoacidosis ndi chikomokere. Imfa ya anthu odwala matenda ashuga amakhalabe okwera - kuyambira 1 mpaka 30%.

Choyambitsa chachikulu cha odwala omwe ali ndi matenda ashuga ndi zovuta zomwe zimachedwa.

PROTEIN GLYCOSYLATION NDI CHimodzi mwazinthu Zofunikira Kwambiri ZOSAVUTA KWA ZINSINSI ZABWINO

Mavuto obwera chifukwa cha matenda ashuga makamaka amaphatikizidwa ndi kuwonongeka kwa mitsempha yamagazi (diabetes angiopathies). Njira yayikulu yawonongera minofu - glycation (glycosylation) ya mapuloteni - siyomwe imapanga michere yama glucose yopanda ma amino aulere a molekyulu wa protein (Lys, Arg, N-terminal amino acid):

Poyamba, mitundu yosakhazikika ya aldimine moeches, yomwe imatha kukhala mitundu ingapo, yokhazikika (("glycosylation product"). Ndikumveka kuti ntchito za protein zimatha kukhala zopanda pake chifukwa cha kusintha kwa molekyulu ya protein, mawonekedwe ake, kapena kutsekereza kwa malo othandizira.

Glycosylation sachitapo kanthu pang'onopang'ono; mapuloteni ochepa chabe a glycosylated amapezeka mu minofu ya anthu athanzi. Ndi hyperglycemia, zomwe zimachitika zimathandizira kwambiri. Mwachitsanzo, mwa odwala omwe ali ndi matenda osokoneza bongo omwe ali ndi vuto la hyperglycemia, zomwe zili m'magulu amodzi a glycosylated hemoglobins - HbAlc - zimawonjezeka katatu pakadutsa masabata 2-3.

Mlingo wa glycosylation wa mapuloteni osiyanasiyana mulibe, zimatengera kuchuluka kwa mapuloteni awa. M'mapuloteni osinthika pang'onopang'ono, magulu ambiri amino amasonkhana.

Kuphatikiza apo, kusintha kwatsalira kwa zotsalira za chakudya. mapuloteni, kuphatikiza kuphatikiza kwa kulumikizana pakati pa mamolekyulu a mapuloteni. Mapuloteni osinthika pang'onopang'ono amaphatikiza mapuloteni ambiri opanga minofu yolumikizana, matellx a interellular, membranes apansi.Kuphatikiza apo, mapuloteni amtunduwu amalumikizana mwachindunji ndi madzi ophatikizika ndi ma cell (cellellular fluid), momwe kuchuluka kwa glucose kuli chimodzimodzi m'magazi (m'maselo nthawi zambiri kumakhala kotsika kwambiri chifukwa chogwiritsa ntchito glucose pochita metabolic). M'magawo amenewa, BCPs imadziunjikira ndi zaka, ndipo kudziunjikira kumathandizira kwambiri mu shuga.

Mapuloteni a BCP amatha kukhala hydrolyzed ndi macrophages (mwa kutenga nawo mbali kwa BCP receptors) kapena ma processellular proteinolytic machitidwe omwe amapangidwa ndi BCP peptides, nthawi zambiri pafupifupi zotsalira 30 amino acid kutalika. Mapuloteni a PPG, makamaka omwe amachokera chifukwa cha hydrolysis, PPG peptides, amalowa m'magazi.

The kuchuluka kwa PPG peptides m'magazi limakwera kwambiri ndi aimpso kulephera zosiyanasiyana, kuphatikizapo matenda ashuga nephropathy.

Izi ndichifukwa choti kuchotsa kwa PPG peptides kumachitika ndi kutenga impso: PPG peptides imasefedwa mu glomeruli, kubwezeretsedwanso ndi ma cell a tubule proximal, ndikuwayika m'matumba a maselo amenewa.

Poyeserera makoswe, zidawonetsedwa kuti kukhazikitsa mapuloteni a PPG m'magazi kumapangitsa kuti mapuloteniwo agwirizane ndi mapuloteni amtundu wa cell matupi ambiri komanso kuwoneka kwa zovuta komanso zogwira ntchito zofanana ndi zomwe zimapezeka m'matenda a shuga.

BCPs ikuwonetsa zochita zamitundu yosiyanasiyana: zimakulitsa kuchuluka kwa maselo a endothelial, kumangiriza ku ma receptors a macrophages, maselo endothelial ndi mesangial, kuyambitsa macrophages kuti secrete cytokines (receptor njira), kuletsa mapangidwe a NO ndikuletsa kukweza kwa minyewa, ndikukulitsa makulidwe a oxidation a LDL. M'magazi a odwala matenda a shuga, ma antibodies opita ku BCP peptides amapezeka.

Amayambitsa ndi limagwirira a lipid kagayidwe kachakudya

Matenda a shuga mellitus (DM) ndi matenda pamene kapamba amalephera kuyamwa, kukonza ndikugwiritsa ntchito shuga m'thupi, ndiye kuti, insulini yoyendetsedwa ndi maselo a cell imasokonekera. Chifukwa cha matendawa, anthu omwe ali ndi matenda ashuga amakumana ndi zovuta zingapo za metabolic, zomwe, zimayambitsa matenda osiyanasiyana komanso chiopsezo chakufa. Chimodzi mwazovuta zazikulu ndizosayenera metabolite (dyslipidemia), omwe, malinga ndi ziwerengero, amapezeka mwa 50-90% ya anthu odwala matenda a shuga.

Lipids ndi mafuta omwe amapangidwa m'chiwindi komanso amalowa m'thupi ndi chakudya. Popeza ma lipids ndi ochokera ku mafuta, izi zikutanthauza kuti samasungunuka bwino m'madzi ndipo, motero, m'magazi.

Mwa munthu wathanzi, maselo a chiwindi amatenga shuga popanda kusokonezedwa. Kuphwanya kapangidwe ka insulin kumayambitsa kuchepa kwa kupanga kwa hexokinase (ma enzyme a oxidation a shuga), omwe amalepheretsa mayamwidwe a shuga. Kuperewera kwa insulin, komwe kumayambitsidwa ndi biosynthesis yosayenera ya michere, kumasokoneza kagayidwe kazakudya, kamene kamayambitsa kusokonezeka pakuchitika kwa kuchepa kwamafuta (kuthamanga kwa mafuta).

Komanso, ndi kuchepa kwa kuchuluka kwa mafuta acids ndi ma triacylglycerols, kuchuluka kwa matupi a ketone kumawonjezeka. Odwala odwala matenda ashuga Mtundu woyamba (amadalira insulin - kapamba samatulutsa kapena kuphatikiza insulin yokwanira), dyslipidemia sichachilendo komanso sichikulankhulidwa kuposa odwala omwe ali ndi insulin matenda ashugaMtundu wachiwiri (zosagwirizana ndi insulin - insulini imapangidwa m'njira zokwanira kapena zochulukirapo, koma matupi amthupi amakhalabe opanda chidwi ndi mahomoni).

Kodi lipids ndi lipid metabolism, zomwe zafotokozedwa muvidiyoyi:

Kodi pali vuto lotani la matenda a lipid mu shuga?

Zosokoneza polid lipid mu shuga amachititsa zotsatirazi matenda:

• ketosis ndi mafuta a chiwindi,
• kuchuluka kwa ndulu,
• kuchuluka kwa mafuta m'thupi,
• matenda a ndulu
• kunenepa
• kuwonongeka kwaimpso,
• kuthamanga kwa magazi
• kupezeka kwa zotupa pakhungu ndi diso
• Kusagwirizana ndi matenda opatsirana,
• furunculosis,
• atherosulinosis
• kusintha kwa mitsempha ya maso,
• kukhudzana ndi m'badwo

Mitundu yamatenda a lipid metabolism

Mitundu yotsatirayi ya zovuta za lipid metabolism imasiyanitsidwa:

• woyamba (wobadwa naye) - vuto la kubadwa lomwe lachitika chifukwa cha kusinthika kapena kufala kwa makolo kuchokera kwa kholo limodzi,
• sekondale - zimachitika chifukwa cha matenda ena,
• anamentary -amachitika ndi moyo wosayenera (mavuto okhala ndi kunenepa kwambiri, kudya mafuta ambiri, kusowa chakudya choyenera, kumwa mowa mwauchidakwa, kusuta fodya, moyo wopanda ntchito).

Zizindikiro

Popeza dyslipidemia imadziwika ndi triglycerides ndi cholesterol m'magazi, endocrinologist imayesa mayeso apadera a labotale omwe akuwonetsa chithunzi cha kunyowa ndi kuphatikizika kwa mafuta.

Chimodzi mwazomwe amafunika kuyesa mayeso ndi lipid mbiri, yomwe imakhala ndi zikhazikitso zinayi zikuluzikulu zomwe madokotala amadalira kuti apitirize kulandira chithandizo (cholesterol (OXC)) "chabwino" cholesterol (HDL), "yoyipa" cholesterol (LDL), triglycerides).

Kuwonongeka kwa lipids m'magulu akuluakulu odwala matenda ashuga kumachitika kamodzi pachaka. Kupatula kukhazikitsa kwa pathologies a mtima dongosolo, tikulimbikitsidwa kuti mukafunse katswiri wamtima ndipo ngati pakufunika kutero, mufunsidwanso.

Kumbukirani kuti kulingalira kwa lipid kumakhala koyenera kuwunikira nthawi zonse.

Chithandizo ndi kupewa

Kuti muchepetse vuto la lipid metabolism mu matenda a shuga, ndikofunikira kutsatira malangizo onse a endocrinologist. Izi ndi njira zabwino zopewera matenda a lipid a shuga.

Ndi matenda, lipid metabolism imayenera kuwongoleredwa nthawi yomweyo. Zotsatira zake zimakhudzidwa:

• kusintha moyo wa wodwala
• zakudya mankhwala
• kumwa mankhwala.

Moyo ndi Zopatsa Thanzi

Kusintha kwakhalidwe kumaphatikizapo:

• Zakudya zomwe zimayenera kuphatikiza chakudya chomwe chimayikidwira mosavuta (endocrinologists amalangize kusunga diary ya chakudya komwe wodwala amalemba kuchuluka kwa chakudya chomwe chidyedwa ndi kuledzera patsiku),
• kusiya mowa ndi kusuta,
• kuchepetsa wodwala,
• Chitani masewera olimbitsa thupi
• matenda a psychoemotional boma.

Zakudya ndi gawo loyamba komanso lofunikira kwambiri pochiza matenda amtundu uliwonse.

Choyambirira, mafuta am'mimba okha ndi 50-60% yazakudya zonse zopatsa mphamvu. Zogulitsa zomwe zimakhala ndi zida zamagetsi zamagetsi zimachotsedwa muzakudya. Amasinthidwa ndi masamba, chimanga, mkate wakuda, mbatata ndi zina, kuchuluka kwake komwe kumatsimikiziridwa ndi adokotala.

Ndizosavomerezeka kusiyanitsa mafuta kuchokera pachakudyacho, koma sayenera kupitilira 25% yazakudya zonse zopatsa mphamvu. Muyenera kusankha zinthu zomwe zikuphatikiza mafuta osakhala ndi mafuta: nthomba ndi mpendadzuwa, sesame, nyemba, mtedza, avocados, nsomba, nsomba, shrimp. Pakachulukitsa matenda, tikulimbikitsidwa kusiya batala kwathunthu.

Mapuloteni amatulutsa pafupifupi 20% ya zakudya zopatsa mphamvu. Munthawi zonsezi, ganizirani za momwe matendawo aliri, kuchuluka kwa thupi la wodwalayo, kukhalapo kapena kusowa kwa kunenepa kwambiri, mawonekedwe a ntchitoyo (mtengo wamagetsi).

Vitamini wokwanira wazakudya amafunika, makamaka mavitamini B ndi vitamini C. Chakudya chamagulu 25: 25% ya zopatsa za tsiku ndi tsiku zam'mawa, 10% za nkhomaliro, 35% pa nkhomaliro, 10% pa nkhomaliro, ndi 20% pa chakudya chamadzulo. Kwa odwala matenda a shuga mellitus, makampani ogulitsa zakudya amapanga zinthu zapadera zomwe sizikhala ndi chakudya chamafuta ochepa: mashuga a shuga, mkate, makeke, masoseji, ndi zina zambiri.

Pakuvomerezedwa ndi dokotala, ndikofunikira kuchitira kuchipatala, komanso masewera olimbitsa thupi, kuphatikizapo masewera olimbitsa thupi, kuyenda, kuchita masewera olimbitsa thupi, yoga, kusambira, komanso kuwonjezeka pang'onopang'ono kwa kupsinjika.

Nthawi yabwino kwambiri yophunzirira thupi ndi maola 1-2 mutatha kudya, pomwe kuchuluka kwa glucose m'magazi kumakwera.

Kuti mukwaniritse zochizira, zolimbitsa thupi ziyenera kukhala za tsiku ndi tsiku, osatopetsa ndipo ziyenera kukonzedwa maola ena.

Ndi kuperewera kwa mankhwala othandizira pakudya ndi kukonza moyo, mankhwala othandizira alumikizidwa. Dokotala wofunsayo amatipatsa mankhwala ofunikira kuti muchepetse cholesterol m'thupi. Chithandizo choyambirira chitha kuphatikizidwa ndi zina zowonjezera taurine, zomwe zimakhudza kusintha kwa matenda a lipid ndi carbohydrate komanso chithandizo cha matenda osokoneza bongo ambiri.

Dziwani kuti kugwiritsa ntchito mankhwala ochepetsa mphamvu ya lipid sikukutanthauza kuti kusiyidwa kwa mankhwala osagwiritsa ntchito mankhwala. M'malo mwake, chithandizo chilichonse chimagwiritsidwa ntchito ngati chikutsatiridwa. Popeza akatswiri amati matenda ashuga, makamaka a 2, ndi matenda amoyo.

Masiku ano, pali magulu angapo apamwamba a mankhwala: satin (Atorvastatin, Pravastatin, Rosuvastatin, etc.), antioxidants, nicotinic acid ndi zotumphukira zake, zotsatizana, ma fibrate. Amasiyana mu njira zogwirira ntchito, zoyenera, zoyipa, zosakanikirana zamitundu mitundu ya dyslipidemia.

Magulu akuluakulu a mankhwala omwe amagwiritsidwa ntchito pochiza matenda a lipid metabolism:

Chithandizo cha anthu

Kuphatikiza apo, chithandizo chamankhwala wowerengeka chimaloledwa, koma pokhapokha ngati mungakambirane ndi adokotala.

Kukonzekera kwazitsamba kumatha kuwamwa kwa nthawi yayitali. Kusuta kwa iwo sikuchitika. Komabe, njira ya chithandizo siyenera kupitilira masiku 20-25, ndiye kuti muyenera kupuma. Komanso kuphatikiza mankhwala azitsamba osiyanasiyana. Kuchiza kuyenera kuyamba ndi yaying'ono.

Chimodzi mwazida zabwino kwambiri ndi zotchuka ndi izi:

Stevia - wokoma wachilengedwe wachilengedwe wopanda mafuta. Mulinso ma glycosides, vitamini A, C, E, magulu a B, antioxidants, mchere (phosphorous, potaziyamu, magnesium, zinc, mkuwa, chromium, selenium, ndi zina zambiri). . Pachifukwa ichi, ndiwothandiza pazochitika za metabolic odwala omwe ali ndi matenda osokoneza bongo. Ngakhale pakugwiritsidwa ntchito kwa nthawi yayitali, stevia ndiwotchi yopweteketsa. Kafukufuku waposachedwa akuwonetsa kuti pakuyamba kutenga stevia, kuchepa kwa kuchuluka kwa shuga m'magazi, makoma azotengera amalimbitsa.

Ku China, ku World Symposium, yomwe idafotokoza za zovuta zokhala ndi moyo wautali komanso matenda a shuga, zidalengezedwa kuti Stevia amadziwika kuti ndi imodzi mwazofunikira kwambiri zamankhwala.

Samalani - chomera ichi ndi chakupha.Kuti mugwiritse ntchito mkati, amatengedwa ngati gawo la mankhwala azisamba, kapena mapiritsi.

Zitsanzo zina za ndalama zomwe zimagwiritsidwa ntchito pochiza matenda a lipid metabolism mu matenda a shuga:

Kukhazikika kwa mankhwala a lipid metabolism mu diabetes kumachitika pokhapokha ngati mankhwala othandizira pakudya ndi kusintha kwa moyo sanabweretse zotsatira zoyenera. Komabe, imathandizidwa ndi zowonjezera zama biology zomwe zimakhala ndi mawonekedwe apamwamba a taurine, omwe amakhudza bwino mphamvu ya chithandizo cha matenda osokoneza bongo.