Ndemanga zamabuku

Matenda a shuga (lat.matenda ashuga) - gulu la matenda amtundu wa endocrine wodziwika ndi kuphwanya mitundu yonse ya kagayidwe: chakudya, mafuta, mapuloteni, mchere ndi madzi amchere), momwe thupi laumunthu silingatengere shuga (glucose) moyenera. Zotsatira zake, kuchuluka kwa shuga m'magazi kumakwera kwambiri.

Glucose - Gwero lalikulu lamphamvu m'maselo athu. Kuti athe kulowa m'chipindacho, "chifungulo" chimafunikira chomwe chimapanga zinthu zina zapadera zomwe zili pafoniyo ndikulola kuti glucose alowe m'bwaloli. "Wotsogolera" wofunikira ndi insulin - mahomoni opangidwa ndi kapamba.

Pafupifupi minofu yonse ndi ziwalo (mwachitsanzo, chiwindi,> minofu, minofu ya adipose) zimatha kukonza shuga pokhapokha. Tiziwalo ndi ziwalo zimatchedwa wodwala insulin.
Tizilombo tina tating'onoting'ono, monga ubongo, safuna insulini kuti pokonza shuga, chifukwa chake amatchedwa insulin yodziyimira payokha.

Mu matenda a shuga, zinthu zotsatirazi zimawonekera: kapamba satulutsa insulini konse kapena satulutsa kokwanira. Chifukwa chake, mitundu iwiri ya matenda ashuga ndi yosiyanitsidwa:

Mtundu woyamba wa matenda ashuga 1matenda a shuga ana), omwe amakula, ngati lamulo, mwa achinyamata motsutsana ndi maziko abwinobwino a thupi.

Pankhaniyi, ma cell a pancreatic omwe amapanga insulin ali pafupi kuwonongeka kwathunthu, kuchuluka kwa insulin kopangidwa, kapena sikupangidwa konse. Zotsatira zake, maselo sangathe kuyamwa shuga wamagazi, kukhala "anjala" - osalandira mphamvu. Mwazi wamwazi ndiwambiri.

Njira yokhayo yochiritsira odwala otere ndi kudzera mu insulin ya moyo wonse yomwe imalowa m'magazi ndipo imakhala yofunikira. Odwala omwe amadalira insulin amapanga pafupifupi 10-20% ya milandu yonse.

Type 2 shugaMonga lamulo, limakula mu ukalamba ndi ukalamba motsutsana ndi maziko onenepa kwambiri.

Ndi mtundu uwu wa shuga, insulin yake yomwe imapangidwa, koma sikokwanira kuyamwa glucose onse omwe alipo.
Nthawi zina, kulephera kwa minofu ndi mafupa am'magazi kugwiritsa ntchito bwino insulin yonse yomwe imapangidwa munthawi yovomerezeka (insulin kukana) kumawululidwa.

Zizindikiro (matenda) a shuga mellitus:
- ludzu lalikulupo, mkodzo wambiri watulutsidwa,
- kufooka, kutopa,
- khungu loyenda, khungu lopezekanso,
- kuchiritsa kwamabala
- mobwerezabwereza matenda a kwamikodzo
- kutaya mtima, kunenepa kwambiri.
Monga lamulo, Zizindikiro zomwe zili pamwambapa zimawonekera bwino mu mtundu 1 wa matenda ashuga, ndipo mu mtundu 2 wa shuga satchulidwa kokwanira, ndipo anthu amakhala zaka zambiri osadziwa kuti ali ndi matendawa.

Njira zodziwira matenda ashuga:
1.Kudziwitsa kuchuluka kwa shuga m'magazi (kudya mwachangu magazi mpaka 5,5 mmol / L, mukatha kudya - mpaka 7.8 mmol / L, sikugwera pansi pa 3.5 mmol / L).
2.Kudziwitsa kuchuluka kwa shuga mu mkodzo.
3.Kudziwitsa kwa hemoglobin ya glycated, kuwonetsa mkhalidwe wa kagayidwe kazakudya kwa miyezi itatu yapitayo (ngati maluso aukadaulo alipo).

Chifukwa chiyani amayang'anira shuga yanu yamagazi?

Matenda a shuga, ngati sanatsatire njira zoyenera, angadzetse mavuto:

Zilonda zam'maso. Zowonongeka za retinal - matenda ashuga retinopathy: zovuta zamagazi mumatumbo ang'onoang'ono a fundus.

Kuwonongeka kwa impso - diabetesic nephropathy, momwe mumasinthira magawo ang'onoang'ono. Mapuloteni amawonekera mkodzo, kuthamanga kwa magazi kumatha kuchuluka.

Kugonjetsedwa kwa mtima wamtima: matenda oopsa oopsa, matenda a mtima, ndi zina zambiri.

Zilonda za kumapazi - diabetesic neuropathy, momwe mumakhala kugonjetsedwa kwa mitsempha, ziwiya zazikulu. Mawonekedwe: ululu wamitundu yosiyanasiyana, kumva kuyaka, "tsekwe", kugwedezeka, dzanzi. Kutsika kwamitundu yonse yamatenda (mwachitsanzo, kupweteka, kutentha) ndi khalidwe.

Malamulo A Zaumoyo Paziphuphu

1. Kuyendera dokotala pafupipafupi.
2. Kudziletsa thanzi komanso shuga yamagazi.
3. Zochita zolimbitsa thupi zabwino zathanzi, thanzi lathunthu, zimathandizira kuchepetsa thupi ndi shuga m'magazi. Simungathe kuthana ndi thanzi labwino, shuga wambiri. Amatha kutsitsa shuga pang'onopang'ono ngati mankhwala ochepetsa shuga amagwiritsidwa ntchito nthawi yomweyo.
4.Power Mode – Chithandizo chofunikira kwambiri cha matenda a shuga. Shuga, madzi, mizimu, makeke, makeke, mphesa ndi masiku ake siziyenera kuperekedwa kuchakudya. Zinthu zotsimikizidwa zokhala ndi zotsekemera zosiyanasiyana (saccharin, xylitol, sorbitol, fructose, etc.). Kasanu patsiku - ndondomeko yakudya ya shuga: yopuma yoyamba ndi yachiwiri, chakudya chamadzulo, chakudya chamadzulo ndi chakudya chamadzulo. Pansipa tikunena izi mwatsatanetsatane.
5. Kugwiritsa ntchito mankhwala apadera pafupipafupi kutsitsa shuga wamagazi ndikusintha kukhathamiritsa kwa glucose.

Zakudya zamankhwala - maziko mankhwalawa odwala matenda a shuga, ngakhale atakhala kuti ali ndi matenda.

Wodwala aliyense, poganizira kulemera kwake, msinkhu wake, jenda, zolimbitsa thupi, ayenera kuwerengera zowonjezera zam'thupi zopezeka m'zakudyazo, zakudya zake, mapuloteni ndi mafuta, kufufuza zinthu ndi mavitamini.

Bwerezani: kasanu patsiku - ndondomeko yakudya ya shuga: yopuma yoyamba ndi yachiwiri, nkhomaliro, tiyi wamadzulo ndi chakudya chamadzulo.

Zakudya Iyenera kukhazikitsidwa makamaka pamasamba ndi mkaka, chifukwa kugwiritsa ntchito masamba osaphika ndi zipatso kumapangitsa kuti kapamba azitulutsa insulini. Muyenera kuphatikiza mtedza wambiri, mbewu monga momwe zingathere m'zakudya zanu, komanso kudya tchizi, lingonberry, nyemba, anyezi, adyo, nkhaka ndi radish (imakhala ndi insulin yambiri, motero imatsitsa shuga).

Lingaliro lalikulu pakupanga zakudya zoyenera mu shuga mkate..

Izi ndi chiyani?

Zakudya zimakhala ndi mitundu itatu ya michere: mapuloteni, mafuta ndi chakudya (gwero lalikulu la shuga). Chifukwa chake, michere ndi michere yomwe imafunikira insulin.

Pali mitundu iwiri ya chakudya.: m'mimba komanso osagaya chakudya.

Zakudya zamafuta osagaya chakudya (fiber) kuchuluka kwa shuga m'magazi sikuchuluka. Amagwira gawo lofunikira pakugaya: amatupa pakulowa m'mimba, ndikupanga kumva kuti mukukomoka, ndikuthandizira matumbo kukhala ofanana, omwe ndi ofunikira kwambiri kudzimbidwa.

Zakudya zomanga thupi zopatsa mphamvu onjezani shuga wamagazi ndipo amagawika m'magulu awiri: kupukusa mosavuta (yowonongeka m'matumbo, zakudya zotsekemera zimadzaza nawo) zovuta kupukusazimawonongeka pang'onopang'ono m'matumbo.

Ndikofunika kuti wodwala wodwala matenda ashuga adziwe kuchuluka kwa chakudya chamagulu omwe amaphatikizidwa ndi chakudya kuti awerenge molondola kuchuluka kwa insulin (kapena mankhwala ochepetsa shuga).

Kuwerengera mankhwala osokoneza bongo ndikuyambitsa lingaliro "Chakudya chama mkate" - XE.
Amakhulupirira kuti 12 g yamafuta (kapena 25-30 g ya buledi) amawerengedwa ngati XE imodzi. Kudziwa kuchuluka kwa XE, mutha kudziwa kuchuluka kwa shuga m'magazi mutatha kudya, ndikuwerengera moyenera mankhwalawo.

Pa chakudya chimodzi (kadzutsa, nkhomaliro, chakudya chamadzulo), tikulimbikitsidwa kuti tisadye mopitilira 7 XE pa jekeseni wa insulin. Pakati pa zakudya ziwiri, mutha kudya 1 XE osanunkha insulin (bola kuti shuga ya magazi ikhale yabwinobwino komanso yoyang'aniridwa mosalekeza). 1 XE chifukwa cha kukhathamiritsa kumafunikira insulin pafupifupi 1.5-4. Kufunikira kumeneku ndikumodzi payekha, komwe kumatsimikiziridwa ndi kuwongolera misempha ya magazi.

Zamgululi:
1XE = 1 chidutswa chilichonse cha mkate, 1 tbsp. spoonful ufa kapena wowuma,
2 XE = 3 tbsp. mafuta a pasitala.
Mphesa ndi phala: 1 XE = 2 tbsp. supuni ya nyama iliyonse yophika.
Ziphuphu (nandolo, nyemba, mphodza):
1 XE = 7 tbsp. spoons
Mkaka:
1 XE = 1 galasi
Zokoma:
Phala la shuga - 1 XE = 1 tbsp. supuni, shuga woyengetsa 1 XE = 2,5 zidutswa
Nyama ndi nsomba mulibe chakudya chamafuta ndipo simuyenera kuwerengeredwa.
Zomera:
1 XE = tuber imodzi yayikulu-mbatata, kaloti atatu akuluakulu, kachilomboka chimodzi chachikulu.
Zipatso ndi zipatso:
1 XE = 3-4 mphesa, hafu ya mphesa, nthochi, chimanga, apulosi, pichesi, lalanje, Persimmon, kagawo ka vwende kapena chivwende, marashi atatu apakatikati, ma apricots kapena plums, sitiroberi ya tiyi wosasa, yamatcheri, yamatcheri rasipiberi, sitiroberi, mabulosi abulu, currants, lingonberries, mabulosi akutchire.
Zakumwa: 1 XE = 1/3 chikho cha mphesa, 1 / chikho cha apulosi madzi, 1 ston kvass kapena mowa.

Zoyambitsa matenda a shuga sichinafotokozedwe bwino. Pali malingaliro angapo:

Khalidweli. Zadziwika kuti ngati wina mwa abale anu ali ndi matenda a shuga, mwayi wopeza "cholowa" chosangalatsa ndi 37% (poyerekeza ndi omwe analibe matenda ashuga).
Kupsinjika Malinga ndi chiphunzitso chopsinjika, matenda omwe amapezeka pafupipafupi komanso kupsinjika kumayambitsa kuperewera kwa kapamba, zomwe zikutanthauza kuti kupanga insulini kumayipa, ndipo chifukwa cha matenda a shuga.
Chitetezo chokwanira. Pakachitika vuto la chitetezo mthupi, thupi silikudziwa komwe kuli "athu", komwe "mlendo", ndikuyamba kuwononga tinthu tating'onoting'ono take. Njira yotupa imayamba mkatimo.
Chiphunzitso cha insulin chovomerezeka ndi maselo kutengera ndi kuchuluka kwa maselo amafuta m'thupi kapena kuperewera kwa okosijeni (mwachitsanzo, chifukwa cha matenda amtima), timadzi tating'onoting'ono timene timapangidwa, lomwe limatchinga "kuzindikira" kwa insulini ndi maselo. Pali insulin m'thupi, koma "singatsegule" maselo, ndipo glucose samalowa.
Chiphunzitso cha mankhwala osokoneza bongo. Kugwiritsa ntchito kwakanthawi mankhwala ena (hypothiazide, anaprilin, prednisone, ndi mapiritsi ena othandizira kubereka) kumatha kukhudza kagayidwe kazakudya, ngakhale kuti matenda a shuga pamenepa sikuti amayamba.

Lingaliro, kufunikira ndi gulu la matendawa

Matenda a shuga ndi njira yoyambirira pakati pa mavuto omwe asayansi akukumana nawo azamankhwala omwe akukumana nawo. Malinga ndi tanthauzo la WHO, kuchuluka kwa anthu odwala matenda ashuga kuli ngati vuto lomwe likukulirakulira ndipo layamba kufala kwambiri kotero kuti World Community yakhazikitsa malamulo angapo (St. Vincent Declaration 1989, Weimar Initiative 1997) omwe cholinga chake ndi kuthana ndi matenda ovuta kwambiri mwachilengedwe, yodziwika ndi zotsatira zoyipa, kulumala koyambirira komanso kufa kwa odwala.

Malinga ndi mkulu wa Endocrinology Research Center Ivan Dedov (2007), "Matenda a shuga ndi tsamba lodabwitsa kwambiri pamankhwala amakono, chifukwa matendawa amadziwika ndi kuchuluka, kulumala kwambiri komanso kufa kwa anthu ambiri."

Kuchulukana kwa matenda ashuga kudakambidwa pa Msonkhano Waukulu Wa 61 wa United Nations mu Disembala 2006, pomwe adapangana chigamulo chopempha mayiko ndi maboma a mamembala a UN ndi mabungwe aboma kuti achitepo kanthu poyesetsa kuthana ndi matendawa .

Matenda a shuga (Latin :abetes mellotus) ndi gulu la matenda amtundu wa endocrine omwe amayamba chifukwa chamtheradi kapena wachibale (kusokonezeka kwa mgwirizano ndi maselo ojambulidwa) kuchepa kwa insulin, chifukwa cha hyperglycemia, kuchuluka kwa glucose kosalekeza. Matendawa amadziwika ndi zovuta komanso kuphwanya mitundu yonse ya kagayidwe: chakudya, mafuta, mapuloteni, mchere komanso mchere wamchere.

Kufunika kwa matenda ashuga kumatsimikiziridwa kokha ndikuwonjezereka kwaposachedwa kwa zochitika. Malinga ndi WHO mdziko lapansi:

* Wodwala matenda ashuga 1 amafa masekondi 10 aliwonse,

* pachaka - pafupifupi 4 miliyoni odwala amafa - izi ndizofanana ndi kachilombo ka HIV ndi hepatitis ya mavairasi,

* chaka chilichonse padziko lapansi amatulutsa zopanga zoposa 1 miliyoni zakumunsi.

* Oposa 600,000 amalephera kuwona,

* Pafupifupi odwala 500,000, impso zimasiya kugwira ntchito, zomwe zimafunikira chithandizo cha hemodialysis chamtengo wapatali komanso kupatsirana kwa impso kosalephera.

Pofika pa Januware 1, 2008, Russia idalembetsa odwala 2,834 miliyoni omwe ali ndi matenda a shuga (mtundu 1 wa matenda ashuga mellitus 282,501, okhala ndi matenda a shuga 2,551,115).

Malinga ndi akatswiri, kuchuluka kwa odwala padziko lathu lapansi mu 2000 kunali 175.4 miliyoni, ndipo mu 2010 adakwera kufika 240 miliyoni. Zikuwonekeratu kuti zakukula kwa akatswiri kuti kuchuluka kwa odwala omwe ali ndi matenda ashuga pazaka zilizonse 12-15 kudzakhala kolungamitsidwa. Pakadali pano, zambiri zolondola kuchokera ku zowunikira ndi kafukufuku wamatenda omwe amachitika ndi ogwira ntchito ku Endocrinological Research Center m'madera osiyanasiyana ku Russia pazaka 5 zapitazi zawonetsa kuti chiwerengero chenicheni cha odwala matenda ashuga mdziko lathu ndi okwera katatu kuposa omwe adalembetsedwa ndipo ndi anthu pafupifupi mamiliyoni 8. (5.5% ya anthu onse ku Russia).

Ndikofunika kulingalira za kagayidwe kachakudya m'thupi la munthu, monga chinthu chofunikira pophunzira matendawa ndikusankhidwa kwa chithandizo choyenera.

Zakudya zimakhala ndi mitundu yosiyanasiyana yamafuta. Zina mwa izo, monga glucose, zimakhala ndi mphete imodzi ya heterocyclic imodzi ya sikisi ndipo zimamizidwa m'matumbo osasinthika. Zina, monga sucrose (disaccharide) kapena wowuma (polysaccharide), zimakhala ndi zolumikizana ziwiri kapena zingapo zolumikizika ndi heterocycle zisanu kapena zisanu ndi chimodzi. Zinthu izi zimapukutidwa ndi ma michere osiyanasiyana am'matumbo kuti amolekyu a glucose ndi shuga ena osavuta, ndipo, pomaliza, amadziwikanso m'magazi. Kuphatikiza pa shuga, mamolekyulu osavuta monga fructose, omwe m'chiwindi chimasandulika shuga, amalowanso m'magazi. Chifukwa chake, shuga ndiye chakudya chachikulu m'magazi ndi thupi lonse. Ali ndi gawo limodzi lofunikira mu kagayidwe kamunthu: ndiye gwero lenileni komanso lamphamvu kwa chilengedwe chonse. Ziwalo zambiri ndi minyewa (mwachitsanzo, ubongo) zimatha kugwiritsira ntchito glucose ngati gwero lamphamvu.

Udindo waukulu mu kayendedwe ka chakudya kagayidwe kamthupi umaseweredwa ndi mahomoni a kapamba - insulin. Ndi puloteni wopangidwa mu maselo a Langerhans islet (kuchuluka kwa maselo amtundu wa endocrine m'matumba a pancreatic) ndipo adapangidwa kuti apangitse kukonzanso kwa glucose ndi maselo. Pafupifupi minofu yonse ndi ziwalo (mwachitsanzo, chiwindi, minofu, minofu ya adipose) zimatha kukonza shuga pokhapokha. Tiziwalo ndi ziwalo zimatchedwa insulin- kudalira. Tizilombo tina tating'onoting'ono, monga ubongo, safuna insulini kuti pokonza shuga, chifukwa chake amatchedwa insulin-Independent. Glucose wosasunthika amayikidwa (kusungidwa) m'chiwindi ndi minofu mu mawonekedwe a glycogen polysaccharide, yomwe imatha kusinthidwa kukhala glucose. Koma pofuna kusintha glucose kukhala glycogen, insulin imafunikiranso.

Nthawi zambiri, kuchuluka kwa glucose m'magazi kumasiyana mosiyanasiyana: kuchokera 70 mpaka 110 mg / dl (milligram pa decilita) (3.3-5.5 mmol / l) m'mawa atagona komanso kuyambira 120 mpaka 140 mg / dl atatha kudya. Izi ndichifukwa choti kapamba amatulutsa insulin yochulukirapo, kuchuluka kwambiri kwa shuga m'magazi.

Pakakhala vuto la insulin (mtundu 1 wa matenda ashuga mellitus) kapena kuphwanya kwa njira yogwirira ntchito ya insulin ndi maselo amthupi (mtundu 2 shuga mellitus), glucose imadziunjikira m'magazi ambiri (hyperglycemia), ndi maselo amthupi (kupatula ziwalo zosagwirizana ndi insulin) mphamvu.

Pali magawo angapo a shuga m'magulu osiyanasiyana. Pamodzi, zimaphatikizidwa ndikuwunika kwake komanso kumalongosola molondola momwe wodwalayo aliri.

1) Kutengeka kwachilengedwe

I. Mtundu woyamba wa matenda ashuga ochititsa chachikulu Choyambitsa matenda a shuga a ana (kuwonongedwa kwa maselo a b kumapangitsa kuti insulin isakhale ndi vuto lililonse):

II. Type 2 shuga mellitus (zimatsogolera pakuchepa kwa insulin):

1. Mwa anthu omwe ali ndi thupi labwinobwino

2. Mwa anthu onenepa kwambiri

III. Mitundu ina ya shuga ndi:

1. Kulephera kwamtundu wamtundu wa b-cell,

2. zolakwika zamtundu wa insulin,

3. matenda a pancreas exocrine,

5. shuga wopangidwa ndi mankhwala osokoneza bongo,

6. matenda ashuga oyambitsidwa ndi matenda,

7. mitundu yachilendo ya matenda osokoneza bongo opatsirana,

8. ma gennd syndromes ophatikizidwa ndi shuga.

IV. Matenda a shuga

2) Kusankhidwa ndi kuopsa kwa matendawa

1. Njira yopepuka

Matenda ofatsa (I degree) amadziwika ndi glycemia wocheperako, osapitirira 8 mmol / l pamimba yopanda kanthu, pomwe palibe kusinthika kwakukulu pazomwe zili ndi shuga m'magazi tsiku lonse, glucosuria yaying'ono tsiku ndi tsiku (kuyambira tsiku mpaka 20 g / l). Malipiro amasamalidwa kudzera mu chakudya. Ndi mtundu wofatsa wa shuga, angioeuropathy a preclinical ndi magawo othandiza amatha kupezeka mwa wodwala yemwe ali ndi matenda osokoneza bongo.

2. Kusakhazikika

Ndi kukula kwamagulu (II digiri) matenda osokoneza bongo a shuga, kuthamanga kwa glycemia kumadzuka, monga lamulo, mpaka 14 mmol / l, kusinthasintha kwa glycemic tsiku lonse, glucosuria tsiku ndi tsiku nthawi zambiri simapitilira 40 g / l, ketosis kapena ketoacidosis imayamba. Kulipira shuga kumachitika ndi kadyedwe komanso kayendetsedwe ka mankhwala ochepetsa mphamvu ya pakamwa kapena mwa kuphatikiza insulin (munthawi ya sekondaleide yotsutsa) muyezo womwe sukula magawo 40 patsiku. Mu odwalawa, odwala matenda ashuga angioneuropathies osiyanasiyana kutanthauzira ndi magawo magwiridwe antchito amatha kupezeka.

3. Njira zingapo

Matenda akulu a shuga (III digiri) amadziwika ndi kuchuluka kwa glycemia (pamimba yopanda 14 mmol / l), kusinthika kwakukulu mu shuga m'magazi tsiku lonse, glucosuria yayikulu (kupitilira 40-50 g / l). Odwala amafunikira chithandizo cha insulin nthawi zonse pa 60 PIECES kapena kupitilira apo, ali ndi mitundu ingapo ya shuga.

The etiology ya matenda ashuga a shuga sichikumvetsetsa kwathunthu ndipo ingathe kutsutsidwa, komabe, zinthu zazikulu zomwe zimatha kupereka kapena zimayambitsa chitukuko cha matenda osokoneza bongo amadziwika.

1. Etiology ya matenda ashuga a mtundu woyamba

Chifukwa chake, mtundu 1 wa matenda ashuga ndi chifukwa cha masinthidwe, omwe, komabe, amawunika matchulidwe a matendawo, osati kutukuka kwake, popeza kuti kuzindikira kwa majini mu phenotype kumadalira momwe zinthu zilili (chilengedwe). Potere, pakukwaniritsidwa kwa kusintha kwa majini komanso kukula kwa mtundu woyamba wa matenda ashuga, chidwi cha zinthu zoyambitsa ndikofunikira, monga ma virus omwe amapezeka ku ma cell a beta a isanger a Langerhans a kapamba (Coxsackie, chikuku, mumps, chikuku, rubella), komanso kuledzera kwa ma genesis osiyanasiyana, kuphatikiza pakumwa mankhwala (thiazide diuretics, ma antitumor othandizira, ndi mahomoni a steroid amakhalanso ndi mphamvu ya cytotoxic pamaselo a beta).

Kuphatikiza apo, matenda a shuga amatha kukhala ndi mitundu yambiri yamatenda a kapamba, momwe gawo lake la endocrine, zilumba za Langerhans, limakhudzidwa ndi matenda a pathological. Matendawa ndi monga kapamba, fibrosis, hemochromatosis, komanso zotupa za kapamba.

2. Zochitika m'maselo a 2 shuga

Type 2 shuga mellitus amadziwika kwambiri osati zomwe zimayambitsa chitukuko chifukwa cha zinthu zomwe zingayambitse chitukuko. Type 2 shuga mellitus ali ndi vuto lobadwa nalo, ziwopsezo zomwe zimayambitsa kukula kwake ndi matenda oopsa ochokera kunthano iliyonse, kunenepa kwambiri, kukomoka, kupsinjika, kusuta, kudya kwambiri, komanso kumangokhala.

Mu pathogenesis ya matenda a shuga, pali maulalo awiri omwe adadziwika:

- kupanga insulin yokwanira ndi ma cell a endocrine a kapamba,

- kusokonezeka kwa mgwirizano wa insulin ndi maselo a minofu ya thupi (insulin kukana) chifukwa cha kusintha kwa kapangidwe kake kapena kuchepa kwa chiwerengero cha zolandirira insulin, kusintha kwa kapangidwe ka insulin kapena kuswa kwa ma intracellular sign transmitms from receptors to cell organelles.

Pali cholowa chamtundu wa matenda ashuga. Ngati m'modzi mwa makolo adwala, ndiye kuti kuthekera kwa kulandira matenda ashuga 1 ndi 10%, ndipo mtundu 2 wa matenda ashuga ndi 80%.

4. Cholestatic syndrome, mitundu, zomwe zimayambitsa ndi njira zopititsira patsogolo.

Cholestatic syndromeNdiye kuchepa kwa kuperekera kwa biliary duodenum chifukwa chophwanya mapangidwe ake, chimbudzi kapena chimbudzi chifukwa cha njira za m'magazi zomwe zitha kupezeka m'dera lirilonse kuchokera kuzizimba za hepatocytes za dofater (duodenal) nipple. Milandu yambiri ya cholestasis, makina oyendetsedwera a biliary system opita ku jaundice yama makina kulibe.

Cholestatic syndrome imagawidwa intrahepatic komanso owonjezera.

1. IntrahepaticLachiwiri limalumikizidwa ndi kusokonekera kaphatikizidwe ka zigawo za ndulu ndikulowa kwawo kwa bile capillaries.

Zomwe zimayambitsa: intrauterine matenda, sepsis, matenda a endocrine (hypothyroidism), vuto la chromosomal (trisomy 13.17 / 18), mankhwala othandizira, zovuta za metabolic (galactosemia, cystic fibrosis, alpha1-antitrypsin akusowa), mabanja a syndromes (Alagille syndrome, ndi zina).

Zinthu zazikuluzikulu za pathogenesis za intrahepatic cholestasis pamlingo wa hepatocytes ndi:

a) kutsika kwa kupezeka kwa nembanemba, makamaka, ndi kuchuluka kwa cholesterol / phospholipids mwa iwo ndi kutsika

Mulingo wa metabolic

b) kuponderezana kwa ntchito ya michere yolimba

(ATP-basics ndi ena omwe akuchita nawo kayendedwe ka mayendedwe kudzera pa umuna),

c) Kugawiranso kapena kuchepetsa mphamvu zamagetsi ndi kuchepa kwa mphamvu yamagetsi

g) kuchepa kwa kagayidwe ka bile acid ndi cholesterol.

2. Zowonjezera mogwirizana ndi vuto la kupindika kudzera biliary dongosolo chifukwa cha kuphwanya dongosolo ndi ntchito ya biliary dongosolo: atresia of biliary thirakiti, cyst ya wamba bile duct, zina zotsutsana ndi biliary thirakiti, choledocholithiasis, kutsutsana kwa ma ducts, biliary thickening syndrome, biliary dyskinesia.