Type 1 matenda a shuga: zimayambitsa, Zizindikiro, chithandizo

Mtundu woyamba wa matenda a shuga a mellitus (shuga wodalira insulin) ndi matenda amtundu wa endocrine, omwe amadziwika chifukwa chopanga mahomoni amtundu wa cell ndi ma cell a kapamba. Chifukwa cha izi, kuchuluka kwa shuga m'magazi kumakwera, hyperglycemia wolimbikira umachitika. Akuluakulu a shuga a Type 1 (pambuyo pa 40) samadwala. Masiku ano, ambiri amavomereza kuti mtundu 1 ndi matenda a shuga a achichepere. Tsopano tiwone chifukwa chake tili ndi matenda ashuga.

Amayambitsa ndi pathogenesis

Chimodzi mwazomwe zimayambitsa matenda ashuga ndi chibadwa cham'tsogolo. Kuthekera kwa kuyambika kwa matendawa ndizochepa, komabe kulipo. Cholinga chake sichikudziwika, pali zinthu zina zodziwika bwino (zotumizidwa za autoimmune ndi matenda opatsirana, kuphwanya chitetezo chokwanira).

Matenda a shuga amayamba chifukwa cha kusowa kwa maselo a beta a kapamba. Maselo amenewa ndi amene amapangitsa kuti insulini ipangidwe bwino. Ntchito yayikulu ya timadzi iyi ndikuwonetsetsa kuti glucose amalowa m'maselo. Ngati insulini yafupika, magazi onse amapanga m'magazi ndipo maselo amayamba kufa ndi njala. Chifukwa chosowa mphamvu, mafuta osungirako mafuta agawanika, chifukwa cha ichi munthu amalemera msanga. Ma mamolekyulu onse a glucose amakopa madzi okha. Ndi shuga wambiri m'magazi, madzi ndi shuga amatsitsidwa mkodzo. Chifukwa chake, kuchepa kwamadzi kumayamba mwa wodwalayo ndikumamverera ludzu nthawi zonse.

Chifukwa chakusweka kwamafuta mthupi, kudzikundikira kwamafuta acid (FA) kumachitika. Chiwindi sichitha "kubwezeretsa" ma FAs onse, kotero, zinthu zowola - matupi a ketone - zimadziunjikira m'magazi. Ngati sanachiritsidwe, chikomokere ndi imfa zimatha kuchitika panthawiyi.

Zizindikiro za matenda a shuga 1

Zizindikiro zimawonjezeka mofulumira: m'miyezi ingapo kapena milungu ingapo, hyperglycemia yopitilira imawoneka. Njira yayikulu yoyesera yomwe mungakayikire matenda a shuga ndi:

ludzu lalikulu (wodwalayo amamwa madzi ambiri),
kukodza pafupipafupi
njala ndi kuyabwa khungu,
kuwonda kwambiri.

Mu matenda a shuga, munthu amatha kutaya makilogalamu khumi ndi asanu pamwezi m'mwezi umodzi, pomwe pali kufooka, kugona, kutopa, komanso kuchepa kwa ntchito. Poyamba, matendawa nthawi zambiri amakhala ndi chidwi chambiri, koma matendawa akamakula, wodwalayo amakana kudya. Ichi ndi chifukwa cha kuledzera kwa thupi (ketoacidosis). Pali mseru, kusanza, kupweteka kwam'mimba, fungo lochokera mkamwa.

Kuzindikira ndi chithandizo

Kutsimikizira kuti adziwe mtundu 1 shuga, muyenera kuchita kafukufuku wotsatira:

Kuyesedwa kwa magazi kwa shuga (pamimba yopanda kanthu) - zomwe zili m'magazi a capillary zimatsimikizika.
Glycosylated hemoglobin - shuga wambiri wamiyezi itatu.
Kusanthula kwa peptide kapena proinsulin.

Mu matendawa, chithandizo chachikulu komanso chachikulu chimachotsa chithandizo (jakisoni wa insulin). Kuphatikiza apo, chakudya chokhazikika chimayikidwa. Mlingo ndi mtundu wa insulin umayikidwa payekhapayekha. Kuti muwone bwino magazi anu, ndikofunikira kuti mugule mita yamagazi. Ngati mikhalidwe yonse ikwaniritsidwa, munthu akhoza kukhala moyo wabwinobwino (inde, padzakhala zoletsa zambiri, koma palibe pothawirako).

Kodi matenda a shuga 1 amtundu wanji, bwanji?

Matenda a shuga a mtundu 1 (T1DM) ndi matenda ogwirizana ndi matenda a metabolic, ndiko kuti, kuperewera kwa insulin ya mahomoni ndi kuchuluka kwa shuga m'magazi. Awa ndi matenda a autoimmune momwe chitetezo chathupi chimawonongera maselo amthupi, chifukwa chake ndizovuta kuchiza. Matendawa amakhudza onse akuluakulu ndi ana. Mwana amatha kudalira insulin pambuyo pa kachilomboka kapena matenda. Ngati tiyerekeza ziwerengero za matenda amtundu 1 komanso matenda amtundu wa 2, matenda amtundu 1 wa shuga amapezeka pafupifupi mwa anthu 10 aliwonse.

Matenda a shuga a Type 1 ndi owopsa pamavuto akulu - amawonongerapo dongosolo lonse la mtima. Mwachitsanzo, T1DM imakulitsa kwambiri chiopsezo chokhala ndi matenda amtima: anthu omwe ali ndi vuto la hyperglycemia amatha kuvutidwa ndi stroko komanso mtima. Kutalika kwa moyo kwa mayi yemwe ali ndi matenda ashuga 1 ndiwakufupikirapo kuposa zaka 15 za mnzake wathanzi. Amuna omwe ali ndi hyperglycemia amakhala pafupifupi zaka 50-60 ndipo amafa zaka 15-20 kale kuposa anzawo.

Anthu odwala matenda ashuga ayenera kutsata zakudya zawo komanso chizolowezi chawo tsiku ndi tsiku, kumwa insulini ndikuwunika shuga. Malinga ndi malingaliro onse a endocrinologist, omwe adotolo amatenga matenda amtundu wa 2 shuga, zovuta zowopsa zitha kupewedwa ndipo moyo wabwinobwino ukhoza kukhala moyo.

Zomwe zimayambitsa matenda a shuga 1 a ana ndi achinyamata

Makolo ambiri amalakwitsa poganiza kuti odwala matenda ashuga amadwala chifukwa anadya chokoleti komanso shuga. Ngati mumachepetsa mwana wanu maswiti, mutha kumuteteza ku diathesis m'malo mwa shuga. Ana amadwala matenda a shuga adakali aang'ono osati chifukwa cha kuperewera kwa zakudya m'thupi. Izi zikuwoneka ndi kutsimikiza kwa asayansi omwe akuwerenga vutoli.

Vuto lalikulu la ma virus lomwe limasungidwa ali ndi zaka 0 mpaka 3 mu 84% limabweretsa kukula kwa matenda a shuga 1, kuphatikiza apo, amapezeka pafupipafupi ngati mwana wazaka 8.
Ma ARVI mu mawonekedwe owopsa, omwe amasamutsidwa ndi makanda mpaka miyezi 3, amayambitsa matenda ashuga mu 97% ya milandu.
Mu ana omwe ali ndi cholowa champhamvu cha hyperglycemia, chiopsezo chotenga matendawa chimakulanso malinga ndi zopatsa thanzi (zakudya): chakudya chopatsa mkaka, kumwa mkaka wa ng'ombe, kubadwa kwakukulu (pamwamba pa 4.5 kg).

Pali mibadwo iwiri yapamwamba yodziwira matenda ashuga mwa ana - wazaka 5-8 ndi unyamata (zaka 13-16). Mosiyana ndi akuluakulu, matenda a shuga a ana amakula mwachangu komanso mwachangu. Matenda amadziwoneka ndi mawonekedwe owopsa a ketoacidosis (poyizoni wa matupi a ketone opangidwa m'chiwindi) kapena matenda a shuga.

Ponena za chibadwidwe, mwayi wopatsira T1DM ndi wotsika. Ngati bambo ali ndi matenda ashuga 1, chiopsezo chotengera ana ndi 10%. Ngati amayi, ndiye kuti zoopsa zimatsitsidwa mpaka 10%, ndipo pakubadwa pambuyo pake (pambuyo pa zaka 25) mpaka 1%.

M'mapasa ofanana, zovuta zomwe zimadwala zimasiyanasiyana. Ngati mwana m'modzi akudwala, ndiye kuti matenda achiwiri samaposa 30-50%.

Mavuto a Matenda A shuga a Type 1

Kuphatikiza pa matenda ashuga omwewo, zovuta zake sizokhala zowopsa. Ngakhale kupatuka pang'ono panjira yokhazikika (5.5 mmol / lita imodzi pamimba yopanda kanthu), magaziwo amadzuka ndikusintha. Zotengera zimataya kusakhazikika, ndipo zimayikika mawonekedwe ammagazi pazitsemba zawo (atherosulinosis). Kuwala kwamkati kwa mitsempha ndi mitsempha yamagazi kumachepa, ziwalo sizilandira chakudya chokwanira, ndikuchotsa poizoni m'maselo amachepetsa. Pachifukwa ichi, malo a necrosis, supplement amapezeka pa thupi la munthu. Pali zilonda zam'mimba, zotupa, zotupa, ndipo magazi ake atayandikira miyendo.

Kuchuluka kwa shuga m'magazi kumasokoneza kugwira ntchito kwa ziwalo zonse:

Impso . Cholinga cha ziwalo zopakidwa ndi kusefa magazi kuzinthu zoyipa ndi poizoni. Pa mulingo wa shuga woposa 10 mmol / lita, impso zimasiya kugwira ntchito yawo bwino ndikudutsa shuga mumkodzo. Malo okoma amakhala maziko abwino kwambiri opititsa patsogolo microflora ya pathogenic. Chifukwa chake, matenda otupa a genitourinary system - cystitis (kutupa kwa chikhodzodzo) ndi nephritis (kutupa kwa impso) nthawi zambiri amayenda ndi hyperglycemia.
Mtima wamtima. Mapepala a Atherossteotic, omwe amapangidwa chifukwa cha kukwera kwamaso amwazi, amaika mzere wamitsempha yamagazi ndikuchepetsa kudutsa kwawo. Minofu yamtima ya myocardium imaleka kulandira thanzi labwino. Chifukwa chake pamabwera vuto la mtima - necrosis ya minofu yamtima. Ngati munthu wodwala alibe matenda ashuga, amamva kuwawa komanso kumva kuwopsa mu chifuwa chake nthawi ya vuto la mtima. Mwa odwala matenda ashuga, chidwi cha minofu yamtima chimachepa, amatha kufa mosayembekezereka. Zomwezi zimayendera mitsempha yamagazi. Amakhala osakhazikika, zomwe zimawonjezera chiopsezo chakuvutika.
Maso . Matenda a shuga amawononga ziwiya zing'onozing'ono komanso ma capillaries. Ngati magazi atseka chida chachikulu cha diso, kumwalira pang'ono pang'ono, ndipo pakatuluka khungu kapena khungu. Izi matendawa ndi osachiritsika ndipo amachititsa khungu.
Machitidwe amanjenje. Kuperewera kwa zakudya m'thupi komwe kumayenderana ndi zovuta zina za mtundu woyamba wa shuga kumabweretsa kufa kwamitsempha. Munthu amasiya kuyankha kukondoweza kwakunja, samazindikira kuzizira ndikusungunula khungu, samva kutentha ndikutentha manja ake.
Mano ndi mano. Matenda a shuga amaphatikizidwa ndi matenda amkamwa. Zilonda zam'mimba zimachepa, mano amayamba kuyenda, gingivitis (kutupa kwa chingamu) kapena periodontitis (kutukusira kwa mkati mwa m'mimba) kumayamba, zomwe zimapangitsa kuti mano asokonezeke. Mphamvu ya shuga yodalira insulin m'mano mwa ana ndi achinyamata imawonekera kwambiri - samakonda kuwona kumwetulira kokongola: ngakhale mano akutsogolo akuwonongeka.
Matumbo . Mu matenda a shuga, maselo a beta amawonongeka, ndipo limodzi ndi iwo ma PP omwe ali ndi vuto lopanga madzi a m'mimba. Odwala odwala matenda ashuga nthawi zambiri amadandaula za gastritis (kutukusira kwa mucosa wam'mimba), kutsekula m'mimba (kutsegula m'mimba chifukwa cha kugaya chakudya), mawonekedwe a ndulu.
Mafupa ndi mafupa . Kukodza pafupipafupi kumayambitsa kukoka kwa calcium, chifukwa komwe kulumikizana ndi mafupa dongosolo, ndipo chiwopsezo cha fractures chikuwonjezeka.
Chikopa . Kuchuluka kwa shuga m'magazi kumapangitsa kuti khungu lizitayika. Ma capillaries ang'onoang'ono amakhala otsekemera ndi makhiristo a shuga, ndikupangitsa kuyamwa. Kutopa kumapangitsa kuti khungu lizinyowa komanso louma kwambiri. Odwala nthawi zina amakhala ndi vitiligo - kuwonongeka kwa maselo apakhungu omwe amapanga utoto. Poterepa, thupi limakutidwa ndi mawanga oyera.
Njira yolerera yachikazi . Malo okoma amapanga dothi labwino popanga microflora yopeza mwayi. Mtundu woyamba wa matenda ashuga, omwe amapezekanso mobwerezabwereza. Mwa akazi, mafuta owonjezera kumaliseche samasungidwa bwino, omwe amachititsa kugonana. Hyperglycemia imasokoneza chitukuko cha mwana wosabadwayo m'milungu isanu ndi umodzi yoyamba ya mimba. Komanso, shuga imayambitsa kusamba kusanachitike. Kusamba kwa msambo kumachitika zaka 42-43.

Zizindikiro za matenda a shuga 1

Zizindikiro zakunja zimathandiza kudziwa matenda a shuga, chifukwa matendawa amakhudza kugwira ntchito kwa thupi lonse. Mwa achinyamata ochepera zaka 18, matenda ashuga amakula msanga kwambiri komanso mwachangu. Nthawi zambiri zimachitika kuti miyezi iwiri itatha pambuyo pa chochitika chovuta (SARS, kusamukira kudziko lina), chikomokere cha matenda a shuga chimachitika. Kwa akuluakulu, zizindikirazo zimatha kukhala zofowoka, pang'onopang'ono zikukula.

Zizindikiro zotsatirazi ndizomwe zimadetsa nkhawa:

Kukoka pafupipafupi, munthu amapita kuchimbudzi kangapo usiku.
Kuchepetsa thupi (chakudya komanso chidwi chofuna kuchepetsa thupi muunyamata zimadzaza ndi chitukuko champhamvu cha hyperglycemia).
Maonekedwe a makwinya sakhala ndi zaka, khungu louma.
Kuchulukitsa njala ndi kuchepa.
Lethargy, chidwi, wachinyamata amatopa msanga, malingaliro opweteka amawonekera mwa iye.
Kukomoka, kupweteka mutu, mavuto amawonedwe.
Udzu wokhazikika, kamwa yowuma.
Fungo la acetone lochokera mkamwa, komanso lodetsa thupi.
Thukuta lausiku.

Ngati zizindikiro zochepa zaonedwa, wodwala ayenera kutumizidwa kwa endocrinologist.

Aang'ono thupi, amakula msanga.

Kuzindikira matenda ashuga

The endocrinologist mwachidziwikire ikupereka mayeso otsatirawa a matenda ashuga:

Kuyesa kwa shuga m'magazi . Magazi amatengedwa pamimba yopanda kanthu, chakudya chomaliza sichikhala chisanafike maola 8 kale. Chizindikiro chimatengedwa ngati chizindikiro pansipa 5.5 mmol / lita. Chizindikiro cha mpaka 7 mmol / lita chimawonetsa kukonzekera kwapamwamba, 10 mmol / lita ndipo okwera kukuwonetsa hyperglycemia.
Mayeso a kulolerana a glucose . Kusanthula uku kumachitika kwa iwo omwe ali pachiwopsezo cha kukhala ndi matenda ashuga. Pamimba yopanda kanthu, wodwalayo amatenga shuga. Ndipo pakatha maola awiri amamwa magazi a shuga. Nthawi zambiri, chisonyezo chiyenera kukhala pansi pa 140 mg / dl. Kuchuluka kwa shuga m'magazi kuposa 200 mg / dl kumatsimikizira matenda a shuga.
Glycosylated hemoglobin A1C assay . Mafuta ochulukirapo amakumana ndi hemoglobin, kotero kuyezetsa kwa A1C kumawonetsa kutalika kwa momwe shuga ya magazi m'thupi imakhalira yochepa. Kuwunikira kumachitika miyezi itatu iliyonse, mulingo wa glycosylated hemoglobin suyenera kupitirira 7%.
Kuyesedwa kwa magazi kwa ma antibodies . Matenda a shuga a Type 1 amadziwika ndi ma antibodies ambiri kuma cell a zilumba za Langerhans. Amawononga maselo amthupi, motero amatchedwa autoimmune. Pozindikiritsa maselo amenewa, kukhalapo ndi mtundu wa matenda ashuga kumatsimikizika.
Urinalysis - microalbuminuria . Imazindikira mapuloteni mumkodzo. Zikuwoneka osati ndi mavuto a impso, komanso zowonongeka m'mitsempha yamagazi. Mapulogalamu apamwamba kwambiri a proteinin a albin amatsogolera kugunda kwa mtima kapena stroko.
Kujambula kwa retinopathy . Kuthamanga kwa shuga kumapangitsa blockage ya ziwiya zazing'ono ndi capillaries. Diso lakumaso sililandiridwanso, limachulukana nthawi yambiri ndikupangitsa khungu. Zipangizo zamakono zapadera zimakuthandizani kuti muthe kujambula zithunzi zam'mbuyo ndikuwona zowonongeka.
Mayeso a mahomoni a chithokomiro. Kuchulukitsa kwa chithokomiro kumatsogolera ku hyperthyroidism - kupanga kwambiri mahomoni. Hyperthyroidism ndiyowopsa chifukwa kupezeka kwa zinthu za mahomoni a chithokomiro kumachulukitsa kuchuluka kwa shuga m'magazi, shuga imayendetsedwa ndi acidosis (acetone yayikulu mumkodzo), osteoporosis (leaching of calcium kuchokera m'mafupa), arrhythmia (kulephera kwa mtima).

Mtundu woyamba wa shuga

Matenda a shuga amtundu wa 1 samachiritsidwa chifukwa ma cell a beta sangabwezeretsedwe. Njira yokhayo yosungira shuga wambiri m'magazi kwa munthu wodwala ndiyo kumwa insulin, timadzi tating'onoting'ono tomwe timapangidwa ndi maselo a beta a zisumbu za Langerhans.

Malinga ndi kuthamanga ndi kutalikirana kwake, mankhwala omwe ali ndi insulin amagawidwa m'magulu:

Mwachidule (Insuman Rapid, Actrapid) . Amayamba kuchita mphindi 30 atamwa, choncho ayenera kumwedwa theka la ola asanadye. Mothandizidwa ndi mankhwalawa kudzera m'mitsempha, imayambitsidwa pakapita mphindi. Kutalika kwa izi ndi maola 6-7.
Ultrashort kanthu (Lizpro, Aspart). Yambani kugwira ntchito mphindi 15 mutabayidwa. Kuchitikaku kumatha maola 4 okha, ndiye kuti mankhwalawa amagwiritsidwa ntchito popangira pompopompo.
Kutalika kwapakatikati (Insuman Bazal, Protafan). Zotsatira zimachitika ola limodzi pambuyo pa kukhazikitsa ndipo zimatha maola 8-12.
Kuwonetsedwa kwanthawi yayitali (Tresiba). Mankhwalawa amaperekedwa kamodzi patsiku, alibe chochita.

Mankhwala amasankhidwa kwa wodwala payekhapayekha kuphatikiza ndi mankhwala ena omwe amaletsa zoyipa zomwe zimachitika chifukwa cha kuchuluka kwa shuga m'magazi.

Chithandizo chatsopano cha matenda a shuga 1

Tsopano asayansi akuwonetsa njira zatsopano zochizira matenda a shuga ogwirizana ndi insulin. Mwachitsanzo, njira yonyamula maselo a beta kapena kulowetsa pancreas yonse ndizosangalatsa. Ma genetic tiba, stem cell tiba nawonso ayesedwa kapena akupangidwa. M'tsogolomu, njirazi zidzalowetsa jakisoni wa insulin tsiku ndi tsiku.

Kuchita masewera olimbitsa thupi a shuga

Kuchita masewera olimbitsa thupi a matenda amtundu wa 1 ndikofunikira kwenikweni, ngakhale kuli ndi zoletsa pamasewera. Kuchita masewera olimbitsa thupi kumachepetsa kuthamanga kwa magazi, kukhala bwino, kuthanso kulemera. Koma nthawi zina, zolimbitsa thupi zimapangitsa kudumpha kwamagazi a shuga.

Ndi matenda a shuga a mtundu woyamba, simungathe kudzinyamula nokha, chifukwa chake maphunziro sayenera kupitirira mphindi 40 patsiku. Masewera otsatirawa amaloledwa:

kuyenda, kupalasa njinga,
kusambira, aerobics, yoga,
tebulo la tennis
makalasi ochita masewera olimbitsa thupi.

Katundu aliyense ali wovomerezeka ngati ma ketoni apezeka mu mkodzo - zinthu zosokonekera zama protein, komanso kuchuluka kwa magazi kapena mavuto amitsempha yamagazi.

Pomwe mtundu wa 1 matenda a shuga umapezeka komanso kuthandizidwa ku St. Petersburg, mitengo

Ngati mukukayikira shuga, onetsetsani kuti mukuyesa, mutha kuchita izi ku chipatala cha Diana ku St. Apa mutha kulandira upangiri kuchokera kwa katswiri wazophunzira za endocrinologist, yemwe adutsa pancreatic ultrasound ndi mitundu inanso yazidziwitso. Mtengo wa ultrasound ndi ma ruble a 1000, mtengo wolandira endocrinologist ndi ma ruble 1000.

Ngati mwapeza cholakwika, chonde sankhani gawo ndikusindikiza Ctrl + Lowani