Etiology ndi pathogenesis a shuga

Phatikizani Pulofesa, Dipatimenti ya Zamankhwala Zamkati No. 2
ndi maphunziro ku KrasSMU, N. OSETROVA

Matenda a shuga ndi limodzi mwa matenda ofala kwambiri, omwe amadziwika ndi nthawi yayitali (nthawi yayitali), kukula kwa zovuta ndi kuwonongeka kwa ziwalo zosiyanasiyana ndi machitidwe, zomwe zimayambitsa kulumala koyambirira ndikuchepetsa chiyembekezo cha moyo wodwala. Kuzindikira koyambirira ndi chithandizo cha matenda a shuga mellitus makamaka kumatsimikizira mtundu wa njira yake, kupewa koyambirira komanso kwachiwiri kwa matenda osokoneza bongo a shuga ndi kusintha kwina, kumathandizira kuti ntchito isungidwe.

Matenda a shuga Ndi gulu la matenda a metabolic omwe amaphatikizidwa ndi chizindikiro chodziwika bwino - matenda oopsa a hyperglycemia, omwe ali chifukwa cha zolakwika pakubisika kwa insulin, zotsatira za insulin, kapena zonsezi.

Gulu

Kugawika kwa masoka a matenda a glycemic (WHO, 1999)

Mtundu woyamba wa matenda a shuga a mellitus (omwe amachitika chifukwa cha kuwonongeka kwa maselo a beta, nthawi zambiri amatsogolera ku kusowa kwathunthu kwa insulin): autoimmune, idiopathic.

Type 2 shuga mellitus (imatha kuyambira kuchuluka kwa insulini kukomoka ndi wachibale insulin kuchepa kwa kuchuluka kwa zolakwika mu insulin secretion ndi kapena popanda insulin kukaniza.

Matenda a shuga.

Mitundu ina yapadera:

- zolakwika zamtundu zomwe zimayambitsa kusokonekera kwa maselo a beta,

- zolakwika zamtundu zomwe zimayambitsa insulin,

- matenda a exocrine kapamba,

- yoyambitsidwa ndi othandizira azamankhwala ndi mankhwala,

- mitundu yachilendo ya matenda a shuga a immuno-Mediated,

- ma gennd syndromes ena omwe nthawi zina amaphatikizidwa ndi matenda ashuga

Zofooka zamtundu wa beta cell function:

MODY- (chromosome 12, HNF-1a),

MODY-2 (chromosome 7, glucokinase gene),

MODY-1 (chromosome 20, gene HNF-4a),

Masinthidwe amtundu wa DNA,

Zovuta za majini zomwe zimayambitsa matenda a insulin:

Lembani A Insulin Resistance

Matenda a Rabson - Mendehall,

Matenda a pancreas exocrine:

Matenda a shuga ophatikizidwa ndi mankhwala ndi mankhwala:

Mitundu ina ya ma genetic yomwe nthawi zina imalumikizidwa ndi matenda ashuga:

Lawrence-Moon-Beadle Syndrome

Prader Syndrome - Ville,

Mitundu yachilendo ya matenda ashuga olimbana ndi matenda

"Wouma khosi" - matenda (immobility syndrome),

Autoantibodies kuma insulin receptors,

Type 1 shuga, magawo

Mtundu woyamba wa shuga zimawonetsera ndondomekoyi kuwonongeka kwa foni ya beta, zomwe nthawi zonse zimabweretsa chitukuko cha matenda a shuga, momwe insulin imafunikira kuti munthu akhale ndi moyo kuti ateteze kukula kwa ketoacidosis, chikomokere ndi kufa. Mtundu woyamba umadziwika ndi kukhalapo kwa ma antibodies kupita ku GAD (glutamate decarboxylase), kwa beta cell (ICA) kapena insulin, yomwe imatsimikizira kukhalapo kwa autoimmune process.

Magawo a chitukuko cha matenda a shuga 1EisenbarthG.S, 1989)

Gawo 1 – chibadwa, omwe amadziwika kuti ndi ochepera theka la mapasa amtundu wofanana komanso 2-5% ya abale. Chofunika kwambiri ndikupezeka kwa ma antibodies a HLA, makamaka kalasi yachiwiri - DR, DR₄ ndi DQ. Nthawi yomweyo, chiopsezo chokhala ndi matenda amtundu wa 1 chikuwonjezeka nthawi zambiri. Ambiri - 40%, odwala matenda a shuga - mpaka 90%.

Muli ndi mafunso okhudza matenda ashuga?

Gawo lachiwiri - mphindi zoyambirira - matenda opatsirana ndi ma virus, kupsinjika, zakudya, mankhwala, i.e. kukhudzana ndi zinthu zomwe zimayambitsa matenda: matenda opatsirana (enteroviral, retroviral, congenital rubella, majeremusi, mabakiteriya, mafangasi), osapatsirana: Zakudya: gluten, soya, mbewu zina, mkaka wa ng'ombe, zitsulo zolemera, nitrites, nitrate, mankhwala a beta-cell , zinthu zama psychoassociation, ma radiation a UV.

3 siteji – gawo la matenda okhudzana ndi matenda - kubwezeretsa kwachizolowezi kwa insulin Zolemba zokhudzana ndi chitetezo cha matenda 1 a shuga 1 amatsimikiza - ma antibodies a beta cell antigen, insulin, GAD (GAD imatsimikizika zaka zoposa 10).

Gawo 4 – gawo la zovuta za autoimmune yodziwika ndi kuchepa kwapang'onopang'ono kwa insulin katemera chifukwa cha insulin. Mlingo wa glycemia amakhalanso wabwinobwino. Pali kuchepa kumayambiriro kwa insulin katulutsidwe.

5 siteji – gawo mawonetseredwe azachipatala amakula ndi kufa kwa 80 - 90% ya kuchuluka kwa maselo a beta. Pa nthawi yomweyo, kubisa kwatsalira kwa C-peptide kumakhalabe.

Mtundu wachiwiri wa matenda ashuga, etiology, pathogeneis

Type 2 shuga - matenda opatsirana, omwe amadziwika ndi zovuta za metabolic, zomwe zimakhazikika insulin kukana komanso kusiyanasiyana kosiyanasiyana kukanika kwa maselo a beta.

Etiologymtundu 2 shuga . Mitundu yambiri yamtundu wa 2 shuga wambiri ndi polygenic m'chilengedwe, i.e. kuphatikiza kwina kwa majini komwe kumatsimikizira kuwonekera kwa matendawa, ndipo chitukuko chake ndi chipatala zimatsimikiziridwa ndi zinthu zopanda chibadwa monga kunenepa kwambiri, kudya kwambiri, kumangokhala, kupsinjikakomanso osakwanira intrauterine zakudya ndi kupitirira chaka choyamba cha moyo.

The pathogenesis a mtundu 2 shuga. Malinga ndi malingaliro amakono, njira ziwiri zimagwira ntchito yofunika kwambiri pa matenda a matenda a shuga 2:

1. kuphwanya insulin katulutsidwe maselo a beta
2. kuchuluka kwa zopinga Kuchita kwa insulin (kuchepa kwa kuchuluka kwa shuga ndi chiwindi kapena kuchuluka kwa kupanga shuga). Nthawi zambiri, kukana insulini kumayamba m'mimba kunenepa kwambiri.

Zizindikiro za matenda amtundu 1 komanso matenda ashuga 2

Kusiyanitsa mitundu yamitundu 1 ndi 2

Zizindikiro zamankhwala Mtundu woyamba wa shuga zimachitika ndendende, nthawi zambiri mwa achinyamata (azaka zapakati pa 15 ndi 24), zomwe zimadziwika kuti zimachitika pakapita nthawi. Kuwonetsedwa kwa matenda ashuga kumanenedwa, pamakhala chizolowezi cha ketoacidosis, nthawi zambiri 25-0% amabwera ali ovuta. Ndi nthawi yayitali ya matendawa m'malo osavomerezeka, chidziwitso cha chipatala chimatsimikiziridwa ndi zovuta zakumbuyo, makamaka microangiopathies.

Type 2 shuga. Chifukwa cha kuchepa kwa insulin kwathunthu, matendawa amadziwoneka modekha. Kuzindikira kumachitika nthawi zambiri mwatsatanetsatane kutsimikiza kwa glycemia. Kunenepa kwambiri, kuwonekera patatha zaka 40, mbiri yabwino yabanja, kusapezeka kwa chizindikiro cha kuperewera kwambiri kwa insulin ndi chikhalidwe. Nthawi zambiri, panthawi yodziwitsa, zovuta za m'mbuyo zimawululidwa, choyambirira, macroangiopathy (atherosulinosis), yomwe imalongosola chithunzi cha matenda, komanso matenda aposachedwa (pyelonephritis, matenda a fungal).

Pazindikiritso wosiyanitsa mtundu 1 ndi mtundu 2, komanso kuzindikira kwa insulin yofunikira mu mtundu 2 wa shuga, kuchuluka kwa C-peptide kumayesedwa poyesedwa ndi glucagon komanso kusangalatsa kwa chakudya. (5 XE). Kuyika kwa C-peptide kosala kuposa 0,6 nmol / L ndipo pamwamba pa 1.1 nmol / L pambuyo pazakudya kapena makonzedwe a 1 mg glucagon akuwonetsa kupanga kwa insulini ndi maselo a B. Kuchuluka kwa C-peptide yolimbikitsidwa kwa 0,6 nmol / L kapena zochepa kumawonetsa kufunikira kwa insulin yakale.

Zizindikiro

Momwe mungadziwitse matenda owonjezera a shuga (WHO, 1999)

1. Zizindikiro zamatenda a shuga mellitus (polyuria, polydipsia, kuchepera thupi) komanso kuphatikizana ndi shuga m'magazi a capillary nthawi iliyonse (mosasamala nthawi yakudya), wamkulu kuposa kapena wofanana 11.1 ml mol / L.

2. Mkulu wa glucose m'magazi othamanga a capillary (kusala kudya kwa maola osachepera 8) ndi wamkulu kapena wofanana 6.1 ml mol / L.

. Mlingo wamagazi m'magazi a capillary pambuyo 2 maola mutatha shuga (75g), wamkulu kapena wofanana 11.1 ml mol / L.

Kuti mupeze matenda osokoneza bongo a latent mellitus (kulolerana kwa shuga) mwa anthu omwe ali ndi chiopsezo chowonjezereka cha matenda a shuga, kuyesedwa kwa shuga kwa glucose kumachitika.

PakamwaTTG(Ripoti la WHO Consultation, 1999)

Kuyesedwa kwa glucose pakamwa kuyenera kuchitika m'mawa motsutsana ndi zakudya zosachepera tsiku lililonse (zopitilira 150 g zamankhwala tsiku) ndi zochitika zolimbitsa thupi. Zinthu zomwe zingakhudze zotsatira zoyeserera ziyenera kulembedwa (mwachitsanzo, mankhwala, zolimbitsa thupi, matenda). Kuyesaku kuyenera kupitilira kusala kudya kwa maola 8-14 (mutha kumwa madzi). Chakudya chamadzulo chomaliza chimayenera kukhala ndi 0-50 g yama chakudya. Pambuyo pakusala magazi, woyeserera amayenera kumwa ga 75 g wa glucose kapena 82,5 shuga wa monohydrate wosungunuka mu 250-00 ml ya madzi osaposa mphindi 5. Kwa ana, katundu ndi 1.75 g la glucose pa kg iliyonse yakulemera kwa thupi, koma osaposa 75 g. Kusuta sikuloledwa panthawi yoyesedwa. Pambuyo pa maola awiri, kuyesedwa kwachiwiri kwa magazi kumachitika. Pazifukwa zofufuzira kapena kuwunika, phindu limodzi la glucose kapena kuchuluka kwa shuga wama 2 pa TSH ndikokwanira. Pazifukwa zofufuza matenda, matenda ashuga amayenera kutsimikiziridwa ndikuwonetsanso tsiku lotsatira, kupatula milandu ya hyperglycemia yopanda pake ndi kuwonongeka kwadongosolo la metabolic kapena zodziwikiratu.

Etiology ya matenda a shuga 1

Nthawi zambiri, kuphatikiza kwa zinthu zomwe zimayambitsa matenda a shuga 1.

Shuga amachepetsedwa nthawi yomweyo! Matenda a shuga m'kupita kwa nthawi angayambitse matenda ambiri, monga mavuto amawonedwe, khungu ndi tsitsi, zilonda zam'mimba, zilonda zam'mimba komanso matenda otupa! Anthu amaphunzitsa zinzake zowawa kuti azisintha shuga. werengani.

• Mitundu ya chibadwa.
• Mavairasi: Koksaki enterovirus, chikuku, pox, cytomegalovirus.
• Mankhwala: nitrate, nitrites.
• Mankhwala: corticosteroids, maantibayotiki amphamvu.
• Matenda a kapamba.
• Zakudya zambiri zamafuta ndi mafuta a nyama.
• Kupsinjika.

The etiology ya mtundu 1 shuga siyakhazikitsidwe mwachindunji. Matenda a 1 a mtundu wa matenda a shuga amatanthauza matenda opatsirana, chifukwa madokotala sangadziwe tanthauzo lenileni pakati pa zomwe zatchulidwazi. Matenda a shuga 1 amakhudzidwa kwambiri ndi cholowa. Odwala ambiri, majini amtundu wa HLA amapezeka, kupezeka kwake kumafalikira. Ndikofunikanso kuti mtundu uwu wa matenda a shuga udziwonetseke muubwana ndipo makamaka mpaka zaka 30.

Kulumikizana koyambira mu mapulani a pathogenesis a shuga mellitus ndikusowa kwa insulin - kuchepa kwa 80-90% ya mtundu 1 chifukwa cha kulephera kwa maselo a beta a pancreatic kukwaniritsa ntchito zawo. Izi zimabweretsa kuphwanya mitundu yonse ya kagayidwe. Koma koposa zonse, kulowa kwa glucose m'misempha yodalira insulin ndikugwiritsa ntchito kumachepetsedwa. Glucose ndiye gawo lalikulu lamphamvu ndipo kuchepa kwake kumatsogolera ku kufa kwa maselo. Mafuta osaphatikizika amadzaza m'magazi, omwe amawonetsedwa pakupanga hyperglycemia. Kulephera kwa impso kusefa shuga kumawonekera mwa kuwonekera kwa glucose mkodzo. Glycemia imatha kukhala ndi osmotic diuretic, yomwe imadziwoneka mu mawonekedwe a zizindikiro monga polyuria (pathological pafupipafupi pokodza), polydipsia (ludzu lamphamvu kwambiri), hypotension (kuthamanga kwa magazi).

Kuperewera kwa insulin kumakhumudwitsa malire pakati pa lipolysis ndi lipogenesis ndi mphamvu yakale. Zotsatira zake ndikuwunjikana kwamafuta ambiri m'chiwindi, zomwe zimapangitsa kuti mafuta ake asinthe. The oxidation a acid awa amatsatiridwa ndi kaphatikizidwe ka matupi a ketone, omwe amayambitsa zizindikiro monga fungo la acetone kuchokera mkamwa, kusanza, anorexia. Kapangidwe ka zinthu zonsezi kumakhudza moyenera mphamvu yamagetsi yamagetsi, yomwe imawonetsedwa ndikuphwanya mtima, kutsika kwa magazi komanso kuthekera kugwa.

Zifukwa za matenda ashuga a mtundu wachiwiri

Zotsatira zathu za mtundu wa 2 matenda a shuga ndi ofanana ndi omwe ali ndi matenda ashuga 1. Koma choyambirira, kuperewera kwa zakudya m'thupi kumabwera patsogolo, monga kuchuluka kwa mafuta ndi mafuta ambiri, omwe amadzaza pancreas ndikuyambitsa kutayika kwa minofu kumapangitsa insulini. Matenda a 2 a shuga amakhudzidwa makamaka ndi anthu onenepa. Kukhala moyo wongokhala, ntchito yogona, matenda ashuga m'mabanja apafupi, vuto la kusowa kwa zakudya m'thupi kapena matenda a shuga pakapita nthawi yayitali - etiology ya mtundu wachiwiri wa matenda ashuga. The pathogenesis of shuga mellitus 2 imachokera pakusokonekera kwa maselo a kapamba komanso kukana kwakukhudzidwa ndi kuzindikira kwa insulin, komwe kumatha kukhala kwa hepatic komanso kotumphukira. Zina zomwe zimapangitsa kuti wodwalayo akhale wonenepa kwambiri, kuthamanga kwa magazi komanso kusachedwa kwa shuga.

Maphunziro a shuga 1 ndi 2 matenda ashuga

Mtundu 1 ndi mphezi mwachangu. M'masiku ochepa chabe, mkhalidwe wa munthu umakulirakulira: ludzu lalikulu, kuyabwa khungu, pakamwa lowuma, chimbudzi cha malita oposa 5 a mkodzo patsiku. Nthawi zambiri, mtundu 1 umamvekera bwino ndi matenda a shuga. Chifukwa chake, chithandizo chokhacho chomwe chimagwiritsidwa ntchito pochiza - jakisoni wa insulin, popeza 10% ya mahomoni a kuchuluka koyenera satha kuchita ntchito zonse zofunika.

Maphunziro a shuga 1 ndi 2 ndi osiyana. Ngati mtundu wa 1 umayamba pa liwiro la mphezi ndipo umadziwika ndi zizindikiro zazikulu, ndiye kuti ndi mtundu wachiwiri, odwala nthawi yayitali samakayikira kupezeka kwa kuphwanya.

Matenda a 2 a shuga amayambira pang'onopang'ono komanso mosawonekera kwa anthu. Poyerekeza ndi kunenepa kwambiri, kufooka kwa minofu, dermatitis pafupipafupi, njira zowonjezera, kuyabwa kwa khungu, kupweteka kwa mwendo, ludzu pang'ono. Ngati mutembenukira kwa endocrinologist pakapita nthawi, chindapusa chitha kupezeka kokha mothandizidwa ndi zakudya komanso zolimbitsa thupi. Koma nthawi zambiri, odwala amayesetsa kuti asazindikire vuto lomwe likukula ndipo matendawo akupita patsogolo. Anthu onenepa kwambiri ayenera kudzimvetsera ndi kufunsa dokotala kuti asinthe kwambiri.

Kodi zikuwonekabe zosatheka kuchiritsa matenda ashuga?

Poona kuti mukuwerenga izi tsopano, kupambana polimbana ndi shuga wambiri sikuli kumbali yanu.

Ndipo mudaganizapo kale za chithandizo kuchipatala? Ndizomveka, chifukwa matenda ashuga ndi matenda oopsa, omwe, ngati sanapatsidwe, amatha kufa. Udzu wokhazikika, kukodza mwachangu, masomphenya osalala. Zizindikiro zonsezi mumazidziwa nokha.

Koma kodi ndizotheka kuchitira zomwe zimayambitsa m'malo mothandizira? Timalimbikitsa kuwerenga nkhani yokhudza matenda a shuga omwe alipo masiku ano. Werengani nkhani >>

Mitundu ya Matenda A shuga

The etiology ya shuga imamvetsetsa bwino ndipo, mwanjira zambiri, itha kufotokozedwa motere. Mavuto a pathological atabuka ndi endocrine system, chifukwa chomwe kapamba amaleka kupanga insulin, yomwe imayambitsa kugwiritsidwa ntchito kwa zakudya zamagulu, kapena, m'malo mwake, minofuyo siyikuyankha "thandizo" kuchokera ku ziwalo zake, madokotala amafotokoza kuyambika kwa matenda oyambawa.

Chifukwa cha kusinthaku, shuga amayamba kudziunjikira m'magazi, ndikuwonjezera "shuga" wake. Mwadzidzidzi popanda kunyentchera, chinthu china choyipa chimasinthidwa - kusowa kwamadzi. Zingwe sizimagwira madzi m'maselo ndipo impso zimapukusa msuzi wa shuga mthupi. Pepani, chifukwa cha kumasulira kwaulere kwa njirayi - izi ndi kungomvetsetsa kwabwinoko.

Mwa njira, zinali pamaziko awa ku China yakale kuti matendawa adapezeka ndikulola nyerere kupita mkodzo.

Wowerenga osazindikira atha kukhala ndi funso lachilengedwe: chifukwa chiyani nthenda ya shuga imakhala yoopsa, amatero, magazi adayamba kukoma, nanga bwanji izi?

Choyamba, matenda ashuga ndi owopsa chifukwa cha zovuta zomwe zimabweretsa. Pali kuwonongeka kwa maso, impso, mafupa ndi mafupa, ubongo, kufa kwa minofu ya m'munsi komanso m'munsi.

Mwanjira - uyu ndiye mdani woyipitsitsa osati wa munthu, koma waanthu, tikadzabweranso ku ziwerengero.

Mankhwala amagawa shuga m'mitundu iwiri (mitundu):

1. Kudalira insulini - mtundu 1. Zovuta zake zimagona pysreatic dysfunction, yomwe, chifukwa cha matenda ake, sangathe kupanga insulini yokwanira ya thupi.
2. Mtundu wodziyimira pawokha wa insulin-2. Apa njira yosinthira imadziwika - mahomoni (insulin) amapangidwa mokwanira, komabe, chifukwa cha zochitika zina za m'magazi, minofu imalephera kuyankha mokwanira.

Tiyenera kudziwa kuti mtundu wachiwiri umawoneka mu 75% ya odwala. Amakonda kukhudzidwa ndi okalamba komanso achikulire. Mtundu woyamba, mmalo mwake, umasunga ana ndi unyamata.

Zomwe zimayambitsa matenda A shuga 1

Mtunduwu wa matenda ashuga, womwe umatchedwanso kuti shuga mwana, ndiye mdani woipitsitsa wa achichepere, chifukwa nthawi zambiri umadziwonetsa usanakwane zaka 30. Etiology ndi pathogenesis ya mtundu 1 wa shuga akuphunzirabe mosalekeza. Asayansi ena azachipatala amakonda kukhulupirira kuti chomwe chimayambitsa matendawa ndi ma virus omwe amapangitsa kuti pakhale miluza, rubella, chikuku, mumps, hepatitis komanso matenda am'mimba a Coxsackie.

Chimachitika ndi chiani mthupi izi?

Zilonda zapamwambazi zimatha kukhudza kapamba ndi zigawo zake - --cell. Iwo omaliza amasiya kutulutsa insulin mu kuchuluka kofunikira pakupanga ma metabolic.

Asayansi azindikira zinthu zofunika kwambiri zokhudzana ndi matenda ashuga mwa ana:

• Kutalika kosautsa kwamthupi: kupsinjika ndi hypothermia,
• kudya mapuloteni ochulukirapo,
• chibadwire.

Wopha shuga samawonetsera "zoipa" zake nthawi yomweyo, koma ambiri atamwalira - 80% ya maselo omwe amapanga insulin.

Dongosolo la pathogenesis la matenda osokoneza bongo a shuga kapena chochitika (algorithm) pakukula kwa matendawa ndi amodzi mwa odwala ambiri ndipo amakhudza maubale omwe amayambitsa zotsatira:

1. Zoyambitsa zamtundu wakukula kwa matendawa.
2. Kuvulala kwamaganizidwe. Kuphatikiza apo, anthu omwe ali ndi chiwopsezo chambiri amatha kudwala matendawa chifukwa cha zovuta m'maganizo.
3. Insulin ndi njira yotupa ya zigawo za pancreatic ndi kusintha kwa maselo a β-cell.
4. Kukula kwa ma cytotoxic (wakupha) ma antibodies omwe amalepheretsa kenako kutseka kuyankha kwachilengedwe kwa thupi, kusokoneza machitidwe a metabolic ambiri.
5. Necrosis (imfa) ya ma cell a and komanso mawonetsedwe azizindikiro zoonekeratu za matenda ashuga.

Kanema kochokera kwa Dr. Komarovsky:

Zowopsa Zamatenda a 2 A shuga

Zomwe zimapangidwira matenda a shuga a 2, mosiyana ndi oyamba aja, ndi kuchepa kapena kusowa kwa malingaliro ndi tiziwalo ta kapamba tomwe timapangidwa ndi insulin.

Mwachidule: pakuwonjezeka kwa shuga m'magazi, maselo a "β-cell" amapanga kuchuluka kokwanira kwa hormone iyi, ziwalo zomwe zimakhudzana ndi metabolic, pazifukwa zosiyanasiyana, sizikuwona komanso sizimva.

Vutoli limatchedwa insulin kukana kapena kuchepa kwa minyewa.

Mankhwala amatenga zinthu zotsatirazi kuti zitha kukhala zoopsa:

1. Mitundu. Kafukufuku "akutsimikiza" kuti 10% ya anthu omwe ali ndi matenda ashuga amtundu wa 2 amatha kupezanso odwala.
2. Kunenepa kwambiri. Ichi mwina ndicholinga chanzeru chomwe chimathandizira kuti matendawa azitha mofulumira. Kodi pali chiyani chotsimikizira? Chilichonse ndichopepuka - chifukwa cha mafuta ambiri, minofu imasiya kuyamwa, motero, 'sawona'!
3. Kuphwanya zakudya. Izi "chingwe cholumikizira" chimalumikizidwa ndi chakale. Zhor zosasunthika, zokometsedwa ndi ufa wabwino, zotsekemera, zokometsera komanso zotsekemera, sizimangoyambitsa kulemera, komanso zimapweteketsa mwankhanza.
4. Matenda a mtima. Matenda monga atherosulinosis, ochepa matenda oopsa, matenda a mtima amathandizira kuzindikira kwa insulin pamaselo a ma cell.
5. Kupsinjika ndi kulimbikira kwa mitsempha yokhazikika. Munthawi imeneyi, kumatulutsa kwamphamvu ma catecholamines mu mawonekedwe a adrenaline ndi norepinephrine, omwe, nawonso amawonjezera shuga.
6. Hypocorticism. Uku ndikulakwitsa kwa adrenal cortex.

The pathogenesis ya mtundu 2 matenda a shuga titha kufotokozeredwa ngati mndandanda wamatenda amtundu wa heterogenible (heterogenible) wowonetseredwa pakuchitika kwa metabolic (metabolic) m'thupi. Maziko, monga momwe adatsimikizirira kale, ndiko kukana insulini, ndiko kuti, osazindikira za minofu ya insulin, yomwe cholinga chake ndikugwiritsa ntchito shuga.

Zotsatira zake, kusowa bwino kwamphamvu kumawonedwa pakati pobisalira (kupanga) kwa insulini ndi kuzindikira kwake (kutengeka) ndi minofu.

Pogwiritsa ntchito chitsanzo chosavuta, pogwiritsa ntchito mawu omwe siasayansi, zomwe zikuchitika zitha kufotokozedwa motere. Mwanjira yathanzi, kapamba, "powona" kuti pali kuchuluka kwa shuga m'magazi, amatulutsa insulini limodzi ndi ma cell a β ndikuponyera m'magazi. Izi zimachitika munthawi yomwe akuti yoyamba (yachangu).

Gawoli silikupezeka mu matenda, chifukwa chitsulo "sichikuwona" kufunika kwa insulini, iwo akuti chifukwa chake, ilipo kale. Koma vuto lili poti kusinthaku sikubwera, kuchuluka kwa shuga sikumachepa, popeza minyewa yakeyo siyimalumikizana.

Kuchepa kapena gawo lachiwiri la katulutsidwe limachitika kale monga momwe hyperglycemia imachitikira. Mumachitidwe a tonic (pafupipafupi), kupanga insulini kumachitika, komabe, ngakhale kuchulukana kwa mahomoni, kuchepa kwa shuga sikumachitika pazifukwa zodziwika. Bwerezabwereza.

Kanema kochokera kwa Dr. Malysheva:

Mavuto osinthana

Kuganizira za etiopathogenesis ya mtundu 1 ndi mtundu 2 wa matenda a shuga, njira zomwe zimayambitsa zotsatira zake, zidzatsogolera ku kusanthula kwa zinthu monga kusokonezeka kwa metabolic komwe kumapangitsa njira yamatendawa.

Ndikofunika kudziwa nthawi yomweyo kuti zosemphazo zokha sizichitika ndi mapiritsi okha. Afunika kusintha m'moyo wonse: thanzi, nkhawa komanso kulimbitsa thupi.

Mafuta kagayidwe

Mosiyana ndi malingaliro omwe amatchuka pakuopsa kwa mafuta, ndikofunikira kudziwa kuti mafuta ndiye gwero lamphamvu kwa minofu yolimba, impso ndi chiwindi.

Polankhula za chiyanjano ndikulalikira axiom - chilichonse chiyenera kukhala choperewera, ziyenera kutsimikiziridwa kuti kupatuka panjira yachilendo ya kuchuluka kwamafuta, mbali iliyonse kapena kwina, kumavulazanso thupi.

Zovuta zamisempha wamafuta kagayidwe:

1. Kunenepa kwambiri. Muyezo wamafuta ochulukirapo mu minofu: kwa amuna - 20%, kwa akazi - mpaka 30%. Zomwe zimapamwamba kwambiri ndi matenda. Kunenepa kwambiri ndi chipata chotseguka pakupanga matenda a mtima, matenda oopsa, matenda ashuga, matenda a matenda a m'mimba.
2. Cachexia (kutopa). Umu ndi momwe zimakhalira kuti mafuta ochuluka omwe amapezeka mthupi ali pabwino. Zomwe zimayambitsa kutopa zimatha kukhala zosiyana: kuchokera pakudya kwa nthawi yayitali zama calorie, kupita ku mahomoni a m'magazi, monga kuchepa kwa glucocorticoids, insulin, somatostatin.
3. Dyslipoproteinemia. Matendawa amayamba chifukwa cha kusalinganika kwakuthupi pakati pamafuta osiyanasiyana omwe amapezeka m'madzi a m'magazi. Dyslipoproteinemia ndi gawo limodzi la matenda monga matenda a mtima, kutupa kwa kapamba, atherosclerosis.

Basic ndi mphamvu kagayidwe

Mapuloteni, mafuta, chakudya chamafuta - uwu ndi mtundu wamafuta wamphamvu zamphamvu zonse. Thupi likamaledzera ndi zinthu zowola chifukwa cha mitundu yosiyanasiyana ya matenda, kuphatikiza matenda am'mimba a adrenal, kapamba ndi chithokomiro, kuphwanya mphamvu ya kagayidwe kachakudya thupi kumachitika mthupi.

Momwe mungadziwire komanso momwe mungafotokozere kuchuluka kwamphamvu zamagetsi zofunika pothandizira moyo wa munthu?

Asayansi atulutsa zinthu monga metabolism yofunikira, poyambira kutanthauza kuchuluka kwa mphamvu zomwe zimafunikira pakugwira bwino ntchito kwa thupi ndi ma metabolic ochepa.

M'mawu osavuta komanso osavuta, izi zitha kufotokozeredwa motere: sayansi imati munthu wathanzi wokhala ndi mawonekedwe abwinobwino wolemera makilogalamu 70 pamimba yopanda kanthu, pamalo opumira, wokhala ndi mpumulo wamphumphu komanso kutentha kwa chipinda kwa 18 ° C, amafunika 1700 kcal / tsiku kuti agwire ntchito zonse zofunika .

Ngati kusinthana kwakukulu kumachitika ndikupatuka kwa ± 15%, ndiye kuti izi zimawerengedwa pamitundu yokhazikika, apo ayi kufufuza kwina kwapezeka.

Pathology yomwe imapangitsa kuti metabolism iwonjezeke:

• Hyperthyroidism, matenda osachiritsika a chithokomiro,
• kuchuluka kwa mitsempha yachifundo,
• kuchuluka kwa norepinephrine ndi adrenaline,
• kuchuluka kwa gonads.

Kutsika kwa basal metabolic rate kumatha kuchitika chifukwa chokhala ndi njala nthawi yayitali, komwe kumapangitsa kuperewera kwa chithokomiro komanso kapamba.

Kusintha kwamadzi

Madzi ndi gawo lofunikira la chamoyo. Udindo wake ndi kufunikira kwake ngati "galimoto" yoyenera yachilengedwe komanso yopanga zinthu, komanso yoyenera kusungunuka pang'ono komanso kosiyanasiyana mu zochita za metabolic sizingafanane.

Koma pano, polankhula za kuyanjana komanso mgwirizano, ndikofunikira kutsindika kuti zonse zowonjezera ndi kuchepa kwake ndizovulaza thupi.

Ndi matenda a shuga, kusokonezeka kwa kayendedwe ka madzi kagayidwe kotheka kumatheka mbali imodzi ndi imodzi:

1. Kuchepa kwa madzi kumachitika chifukwa cha kusala kudya kwanthawi yayitali komanso kuchepa kwamadzi chifukwa cha ntchito ya impso mu shuga.
2. Nthawi inanso, pamene impso sizigwirizana ndi ntchito yomwe apatsidwa, pamakhala kuchuluka kwa madzi m'malo ophatikizika komanso m'matumbo a thupi. Matendawa amatchedwa hyperosmolar hyperhydration.

Kubwezeretsa acid-base bwino, kulimbikitsa kagayidwe kachakudya ndikubwezeretsa malo oyenera amadzi, madokotala amalimbikitsa kumwa madzi amchere.

Madzi abwino kwambiri ochokera kumagwero achilengedwe:

• Borjomi
• Essentuki
• Mirgorod,
• Pyatigorsk
• Istis,
• Madzi okhala ndi mchere wa Berezovsky.

Carbohydrate kagayidwe

Mitundu yofala kwambiri yamatenda a metabolic ndi hypoglycemia ndi hyperglycemia.

Mayina odziwika ali ndi kusiyana kwakukulu:

1. Hypoglycemia. Umu ndi momwe ma glucose achilengedwe amatsika kwambiri kuposa abwinobwino. Zomwe zimayambitsa hypoglycemia zimatha kugaya chakudya, chifukwa cha kuphwanya mu njira ya kusweka ndi mayamwidwe a chakudya. Koma osati chifukwa chokhacho chomwe chingakhale. Matenda a chiwindi, impso, chithokomiro, zotupa, ma adrenal gland, komanso zakudya zochepa zomwe zimapangidwa m'magazi zingapangitse kutsika kwa shuga kukhala kovuta kwambiri.
2. Hyperglycemia. Izi ndi zosiyana kwambiri ndi zomwe zili pamwambapa, pomwe msinkhu wa shuga umakhala wokwera kwambiri kuposa wabwinobwino. Etiology ya hyperglycemia: zakudya, kupsinjika, zotupa za adrenal cortex, chotupa cha adrenal medulla (pheochromocytoma), pathological kukulitsa kwa chithokomiro cha chithokomiro (hyperthyroidism), kulephera kwa chiwindi.

Zizindikiro za kusokonezeka kwa njira za chakudya zamagulu mu shuga

Zakudya zamafuta ochepa:

• mphwayi, kukhumudwa,
• kuwonda osapatsa thanzi
• kufooka, chizungulire, kugona,
• ketoacidosis, momwe maselo amafunikira shuga koma osachipeza pazifukwa zina.

Kuchuluka kwa chakudya:

• kuthamanga
• Hyperacaction
• mavuto ndi mtima
• kunjenjemera kwa thupi - kuthamanga, kugwedezeka kwamphamvu kwa thupi komwe kumalumikizana ndi kusalinganika kwamanjenje.

Matenda oyambitsidwa ndi kuphwanya kagayidwe kazakudya:

Chithandizo chamankhwala chimati mtundu wa 2 komanso matenda amitundu iwiri sangathe kuchiritsidwa kwathunthu. Koma chifukwa cha kuwunikira kosalekeza mkhalidwe wake wathanzi, komanso kugwiritsa ntchito mankhwala osokoneza bongo, matendawa pakukula kwake amachepetsa kwambiri kotero amalola wodwalayo kuti asamve kuperewera kwinakwake kosangalatsa kwatsiku ndi tsiku ndikukhala moyo wathunthu.