Kutengera kwa chibadwa cha mtundu 1 ndi matenda ashuga 2

Chimodzi mwazinthu zomwe zimapangitsa kuti matendawa akhazikike ndi chidwi cha matenda ashuga. Kuphatikiza apo, pali zinthu zingapo zakunja zomwe zimawonjezera chiopsezo cha mawonekedwe ake.

Masiku ano, matenda a shuga ndi njira yomwe singachiritsidwe kwathunthu.

Chifukwa chake, wodwala yemwe ali ndi matenda okhazikika ayenera kutsatira malangizo onse ndi chitsogozo cha madokotala pamoyo wawo wonse, chifukwa ndizosatheka kuchiritsa matendawa kwathunthu.

Kodi matenda ndi chiyani?

Matenda a shuga ndi matenda omwe amachitika chifukwa cha zovuta za dongosolo la endocrine. Pa kukula kwake, kuphwanya njira zonse za metabolic m'thupi kumachitika.

Kuperewera kwa mphamvu kwa insulini ya mahomoni kapena kukanidwa ndi maselo amthupi kumabweretsa kuchuluka kwakukulu kwa glucose m'magazi. Kuphatikiza apo, pali zovuta pantchito yamadzi kagayidwe, kuchepa kwa madzi kumawonedwa.

Mpaka pano, pali mitundu iwiri yayikulu ya pathological process:

Mtundu woyamba wa shuga. Amayamba chifukwa chosapanga (kapena kupanga zochuluka) insulin ndi kapamba. Matendawa amtunduwu amaonedwa ngati amadalira insulin. Anthu omwe ali ndi matenda amtunduwu a shuga amadalira jakisoni wa mahomoni nthawi yonse ya moyo wawo.
Type 2 matenda a shuga ndi njira yodziyimira payokha ya insulin. Zimachitika chifukwa choti maselo amthupi amasiya kuzindikira insulini yopangidwa ndi kapamba. Chifukwa chake, pamakhala pang'onopang'ono kupezeka kwa shuga m'magazi.

Nthawi zina, madokotala amatha kudziwa mtundu wina wa matenda, omwe ndi matenda osokoneza bongo.

Kutengera mtundu wa pathology, zomwe zimayambitsa kukula kwake zimatha kukhala zosiyanasiyana. Pankhaniyi, pali zinthu zina zomwe zimafalitsa matendawa.

Khalidwe la chibadwa cha matenda ashuga komanso chibadwa chake chimagwira ntchito yofunika kwambiri.

Kukopa kwa cholowa chazinthu pakuwonekera kwa matenda

Makonzedwe a matenda ashuga angachitike ngati pali cholowa chathu. Pankhaniyi, mawonekedwe a matendawa amatengera mbali yayikulu.

Mitundu ya matenda amtundu 1 wa shuga iyenera kuchokera kwa makolo onse awiri. Kafukufuku akuwonetsa kuti kuchuluka kwa matendawo omwe amadalira insulin kuchokera kwa mayi kumawonekera pafupifupi atatu peresenti ya ana obadwa. Nthawi yomweyo, kuchokera kumbali ya abambo, cholowa chokhala ndi matenda ashuga 1 chimachulukitsidwa pang'ono ndikufika peresenti khumi. Izi zimachitika kuti makolo ndi onsewo akhoza kuyamba kudwala matenda. Pankhaniyi, mwana ali ndi chiopsezo chowonjezereka cha matenda a shuga 1, omwe amatha kufikira 70%.

Mtundu wodziyimira pawokha wa insulin umadziwika ndi gawo lalikulu la zochita za cholowa. Izi ndichifukwa choti munthu ali ndi chibadwa chokhala ndi matenda ashuga. Malinga ndi ziwerengero zamankhwala, chiwopsezo chomwe mtundu wamatenda a shuga ungawonetse mwa mwana, ngati m'modzi mwa makolo ndiwotengera matenda, ali pafupifupi 80%. Nthawi yomweyo, cholowa cha mtundu wachiwiri wa shuga chikuwonjezeka mpaka pafupifupi zana limodzi ngati matendawa akukhudza onse mayi ndi bambo.

Pamaso pa matenda a shuga m'modzi mwa makolo, mawonekedwe amtundu wa shuga amayenera kuperekedwa mwachidwi mukamakonzekera kukhala mayi.

Chifukwa chake, chithandizo cha majini chiyenera kukhala chofuna kuthetseratu ziwopsezo zambiri kwa ana omwe m'modzi mwa makolo amapezeka ndi matenda a shuga a 2. Mpaka pano, palibe njira yomwe ikanaperekera chithandizo cha chibadwa chamtsogolo.

Potere, mutha kutsatira njira zapadera ndi malingaliro azachipatala omwe angachepetse chiopsezo ngati ali ndi vuto la matenda ashuga.

Ndi zinthu zina ziti zowopsa zomwe zilipo?

Zomwe zimayambitsa zimatha kudziwitsanso chiwonetsero cha matenda ashuga.

Tiyenera kukumbukira kuti pamaso pa chinthu chobadwa nacho, chiwopsezo cha matenda ashuga chimachulukana kangapo.

Kunenepa kwambiri ndi chifukwa chachiwiri cha chitukuko cha matenda a shuga. Ndikofunikira kuyang'anitsitsa kulemera kwanu kwa magulu amtundu wa anthu omwe ali ndi mafuta ochuluka mthupi mchiuno ndi m'mimba. Pankhaniyi, ndikofunikira kuyambitsa kuwongolera kwathunthu pazakudya za tsiku ndi tsiku ndikuchepetsa pang'onopang'ono kulemera koyenera.

Zinthu zazikulu zomwe zimathandizira kuti matendawa atukuke ndi izi:

Kunenepa kwambiri komanso kunenepa kwambiri.
Kupsinjika kwambiri komanso kusokonezeka kwa malingaliro.
Kukhala ndi moyo wopanda ntchito, kusowa zochita zolimbitsa thupi.
Matenda opatsirana oyambitsidwa ndi matenda opatsirana.
Kuwonetsedwa kwa matenda oopsa, omwe atherosulinosis imadziwonetsera yokha, popeza kuti ziwiya zomwe zakhudzidwazo sizingakwanitse kupereka ziwalo zonse ndi magazi abwinobwino, kapamba, pamenepa, amavutika kwambiri, omwe amayambitsa matenda ashuga.
Kumwa magulu ena a mankhwala. Zowopsa zomwe zimapezeka m'magulu a thiazides, mitundu ina ya mahomoni ndi okodzetsa, mankhwala a antitumor. Chifukwa chake, ndikofunikira kuti musamadziyese nokha ndikumwa mankhwala aliwonse okhawo omwe mukuuzidwa ndi adokotala. Kupanda kutero, zimakhala kuti wodwalayo amachiritsa matenda amodzi, ndipo zotsatira zake amakhala ndi matenda a shuga.
Kukhalapo kwa matenda am'mimba mwa azimayi. Nthawi zambiri, matenda ashuga amatha kuchitika chifukwa cha matenda monga ma polycystic ovary, gestosis pa nthawi ya bere. Kuphatikiza apo, ngati mwana wamkazi wabereka mwana wolemera oposa kilogalamu zinayi, izi zitha kukhala pachiwopsezo cha kukula kwa matenda amisempha.

Njira yokhayo yoyenera yothandizira odwala matenda ashuga komanso kudya mokwanira sizingathandize kuchepetsa matenda. Udindo wapadera uyenera kuchitika chifukwa cholimbitsa thupi tsiku ndi tsiku, zomwe zimathandiza kugwiritsa ntchito mphamvu zochulukirapo zomwe zimalandira kuchokera ku chakudya, komanso zimathandizira pakumwa shuga.

Matenda a Autoimmune amathanso kuyambitsa matenda a shuga a mtundu woyamba, monga chithokomiro komanso kusowa kwamphamvu kwa corticosteroid.

Njira zochepetsera mwayi wokhala ndi matendawa?

Njira yabwino kwambiri yodzitetezera kukhalira kwa chinthu chobadwa nayo imatha kukhala kuchita zolimbitsa thupi. Munthu amasankha zomwe amakonda - amayenda tsiku lililonse mu mpweya wabwino, kusambira, kuthamanga kapena masewera olimbitsa thupi.

Yoga imatha kukhala othandizira abwino, omwe sangangotukula thupi, komanso amathandizanso kuti mukhale ndi thanzi labwino. Kuphatikiza apo, njira zoterezi zidzakuthandizani kuti muchotse mafuta ochulukirapo.

Tsoka ilo, ndizosatheka kuthetsa chibadwa chomwe chimayambitsa kuyambika kwa matenda ashuga. Ichi ndichifukwa chake ndikofunikira kusinthanitsa zifukwa zina pamwambapa:

pewani kupsinjika ndipo musakhale wamanjenje
yang'anirani zakudya zanu komanso kuchita masewera olimbitsa thupi pafupipafupi,
Sankhani mosamala mankhwala ochizira matenda ena,
Limbikitsani chitetezo chokwanira nthawi zonse kuti mupewe kuwonetsa matenda opatsirana,
munthawi yofufuza zamankhwala.

Zokhudza zakudya, ndikofunikira kupatula shuga ndi zakudya zotsekemera, kuyang'anira kuchuluka ndi zakudya zomwe zimadyedwa. Zakudya zomanga thupi zopezeka mosavuta komanso zakudya zomwe sizimagwiritsidwa ntchito nthawi yomweyo siziyenera kumenyedwa.

Kuphatikiza apo, kuti mudziwe kupezeka komanso kuthekera kwa matendawa, kuyesedwa kwakanthawi kachipatala kungachitike. Ichi ndiye, choyambirira, kuwunika kwa kukhalapo kwa maselo otsutsana a beta masamba a kapamba.

Onetsetsani kuti mukufunsa dokotala wanu momwe angakonzekerere kuyezetsa magazi kwa shuga ndi kutengera kwa chibadwa. Mu nthawi yabwinobwino ythupi, zotsatira za kafukufuku ziyenera kuwonetsa kusapezeka kwawo. Mankhwala amakono amathandizanso kudziwa ma antibodies oterewa ma labotale omwe ali ndi machitidwe apadera oyesera. Pachifukwa ichi, munthu ayenera kupereka magazi a venous.

Mu kanema munkhaniyi, adokotala akuwuzani ngati matenda ashuga atengera.

Mtundu I shuga

Matenda a Type I ndi matenda a autoimmune omwe amadziwika ndi zizindikiro zotsatirazi: kuchuluka kwambiri kwa hyperglycemia, kupezeka kwa hypoklycemia ndi ketoacidosis ndi kuwonongeka kwa matenda ashuga, kukula msanga kwa vuto la insulin (mkati mwa masabata 1-2) matenda atayamba. Kuperewera kwa insulin mu mtundu 1 wa shuga ndikubwera chifukwa cha kuwonongeka kwathunthu kwa ziphuphu zakumimba zomwe zimayambitsa kuphatikizidwa kwa insulin mthupi la munthu. Ngakhale pali maphunziro ambiri m'derali, njira yopangira matenda a shuga 1 sichidziwikebe bwinobwino. Amakhulupirira kuti zomwe zimayambitsa kukula kwa matenda ashuga amtundu wa 1 ndikuwonongeka kwa β-maselo a kapamba chifukwa cha chinthu chimodzi kapena zingapo zowononga zachilengedwe. Zinthu zotere ndi monga ma virus, zinthu zapoizoni, zakudya zosuta, nkhawa. Kuyerekezera kumeneku kumatsimikiziridwa ndi kukhalapo kwa autoantibodies kwa ma pancreatic islet antigen, omwe, malinga ndi ofufuza ambiri, ndi umboni wa zochita za autoimmune mthupi ndipo samachita nawo limodzi machitidwe amawonongeko a β cell. Kuphatikiza apo, pali kuchepa kwachilengedwe kwa chiwerengero cha ma autoantibodies pamene nthawi ikutha kuchokera ku chiyambi cha matenda a shuga a mtundu woyamba. Ngati m'miyezi yoyambirira kuyambira kumayambiriro kwa matendawa, ma antibodies apezeka mu 70-90% yoyesedwa, ndiye kuti patadutsa zaka 1-2 kuchokera kumayambiriro kwa matendawa - mu 20% yokha, pomwe ma autoantibodies amapezekanso asanachitike chiwonetsero cha matenda amtundu 1 komanso abale a odwala, nthawi zambiri abale omwe ali ndi machitidwe ofanana a HLA. Autoantibodies to pancreatic islet antigen ndi gulu G immunoglobulins. Tiyenera kudziwa kuti mtundu wa matenda a shuga a I, ma IgM kapena a IgA samapezeka ngakhale atapezeka kuti ali ndi matenda owopsa. Zotsatira za kuwonongeka kwa maselo a β-cell, ma antigen amatulutsidwa zomwe zimayambitsa ntchito ya autoimmune. Ma autoantigener angapo amafunikira gawo la activate autoreactive T-lymphocyte: preproinsulin (PPI), glutamate decarboxylase (GAD), insulini yokhudzana ndi antigen 2 (I-A2) ndi zinc transporter (ZnT8) 30, 32.

Chithunzi 1 - Njira yodzikongoletsera yopanga matenda a shuga 1, poganizira majini ndi zinthu zakunja

Pambuyo pakuwonongeka kwa β-cell, mamolekyulu a HLA 2 a HLA amayamba kuwonetsedwa pamtunda wawo, nthawi zambiri samapezeka pamaselo a chitetezo chamthupi. Chiwonetsero cha ma antigen a class 2 HLA opangidwa ndi ma cell omwe alibe chitetezo chimasandutsa maselo ena kukhala antigen omwe amawonetsa maselo ndipo amawayika pangozi kukhalapo kwawo. Cholinga chakuwonetsa kosasinthika kwa mapuloteni a MHC a kalasi 2 ndi maselo amtundu wina samveka bwino. Komabe, zidawonetsedwa kuti kukhudzana kwa nthawi yayitali kwa ma cell a β omwe ali ndi γ-interferon, mawu oterewa ndi otheka. Kugwiritsa ntchito kwa ayodini kumalo komwe kumathetsereka kumayendera limodzi ndi mafotokozedwe ofanana a MHC a kalasi 2 pa thyrocyte, zomwe zimapangitsa kuti chiwonetsero cha odwala omwe ali ndi autoimmune chithokomiro m'magawo awa. Izi zikuwonetseranso gawo la zinthu zachilengedwe mwadzidzidzi zomwe zimafotokozera mapuloteni a MHC a kalasi yachiwiri ya β-cell. Poganizira mfundo zomwe zili pamwambapa, titha kuganiza kuti mawonekedwe a polymorphism amtundu wa HLA mwa anthu ena amakhudza mphamvu ya maselo a β kufotokoza mapuloteni a MHC a kalasi 2 ndipo, motero, lingaliro lamtsogolo.

Kuphatikiza apo, posachedwapa anapeza kuti ma cell a "insulin" amapanga mapuloteni ena 1 MHC omwe amapereka ma peptides ku cytotoxic CD8 + T lymphocyte.

Udindo wa T-lymphocyte mu pathogeneis wa mtundu 1 wa matenda ashuga

Komabe, polymorphism ya gene ya HLA ndiyo imasankha masankhidwe a T-lymphocyte pakusasitsa mu thymus. Pamaso pa zovuta zina zamtundu wa HLA, mwachiwonekere, palibe kuchotsedwa kwa T-lymphocyte yomwe imanyamula zolandilira za autoantigen (s) zama pancreatic β-cell, pomwe mu thupi labwino ma T-lymphocyte amawonongeka pamasamba . Chifukwa chake, pakuwonetseratu kuti pali mtundu wa matenda ashuga 1, ma T-lymphocyte ena am'thupi amayendayenda m'magazi, omwe amayamba ndi magazi ena a autoantigen m'magazi. Nthawi yomweyo, mulingo wa maantiantigen amakwera pamtengo wamtengo wapatali mwina chifukwa chakuwonongeka mwachindunji kwa maselo a β-cell (mankhwala, ma virus) kapena kukhalapo kwa ma viral othandizira m'magazi omwe ma antigeneli amawoloka ndi ma pancreatic β-cell antigen.

Tisaiwale kuti maselo a T-regoda (Treg) amagwira ntchito mwachindunji pakayendetsedwe kazinthu zopanga ma T-lymphocyte, motero, amawonetsetsa kuti homeostasis ndi kupirira kwapakati pa 16, 29. Ndiye kuti, maselo a Treg amagwira ntchito yoteteza thupi ku matenda a autoimmune. Ma cell a Regulatory T (Tregs) amagwira nawo ntchito popititsa patsogolo kulekerera kwa auto, immune homeostasis, ndi chitetezo chokwanira cha antitumor. Amakhulupirira kuti atenga gawo lalikulu pakukula kwa khansa. Chiwerengero chawo chimagwirizana ndi matenda ovutitsa kwambiri ndipo amalola kuneneratu nthawi yamankhwala. Kuphatikiza apo, kuchuluka kwa ntchito kapena mafupidwe a maselo a Tregs kumatha kuyambitsa matenda osiyanasiyana a autoimmune, kuphatikiza matenda a shuga a mtundu woyamba.

Maselo a Treg ndi gawo lochulukirapo la ma T-lymphocyte akuwonetsa ma interleukin 2 receptors awo pamtunda (i.e., CD25 +). Komabe, CD25 sichizindikiro chokhacho cha maselo a Treg, chifukwa mawonekedwe ake a activor T lymphocyte amachitika pambuyo pa kutsegulidwa. Chizindikiro chachikulu cha T-regulation lymphocyte ndi intracellular transcript factor FoxP3 yomwe ikuwonetsedwa pafoniyo, yomwe imadziwikanso kuti IPEX kapena XPID 9, 14, 26. Ndizoyang'anira zazikulu kwambiri zomwe zimayambitsa kukhazikitsa ndi kugwira ntchito kwa maselo othandizira a T. Kuphatikiza apo, ex-native IL-2 ndi receptor yake zimathandizira kwambiri pakupulumuka kwapadera kwama cell a Treg.

Palinso lingaliro loti machitidwe a autoimmune samayambitsa ndi chiwonongeko cha β-cell, koma mwa kusinthika kwawo chifukwa cha chiwonongeko chotere.

Kutengera kwa chibadwa cha matenda ashuga

Chifukwa chake, gawo lalikulu la chibadwa chomwe chimapangitsa kuti mtundu wa matenda ashuga ukhale woyamba 1 limapangidwa ndi majini a dongosolo la HLA, omwe ndi ma genol encoding a class 2 a main histocompatability tata a munthu. Pakadali pano palibe zigawo za HLA zopitilira 50 zomwe zimakhudza kwambiri chiopsezo cha matenda ashuga 1. Ambiri mwa madera awa ali ndi mitundu yosangalatsa koma yosadziwika kale. Madera amtundu womwe umalumikizidwa ndi chitukuko cha matenda a matenda a shuga 1 nthawi zambiri amasonyezedwa ndi IDDM Association loci. Kuphatikiza pamtundu wa HLA system (IDDM1 locus), dera la insulin pa 11p15 (IDDM2 locus), 11q (IDDM4 locus), 6q, ndipo mwina dera lomwe lili pa chromosome 18 lili ndi mayanjano ofunikira ndi matenda amtundu wa shuga. (GAD1 ndi GAD2, yomwe imata enzyme glutamate decarboxylase, SOD2, yomwe imasokoneza superoxide dismutase, ndi Kidd magazi gulu locus) mwina amagwira ntchito yofunika.

Zoci zina zofunika zomwe zimagwirizanitsidwa ndi T1DM ndi genp 1P13 PTPN22, CTLA4 2q31, interleukin-2cy receptor (CD25 yolembedwa ndi IL2RA), 10p15 locus, IFIH1 (yomwe imadziwikanso kuti MDA5) pa 2q24 ndi CLEC16A (KIAA0350) yaposachedwa kwambiri ku 16p13, PTPN2 pa 18p11 ndi CYP27B1 pa 12q13.

Jini la PTPN22 limatulutsa puloteni ya lymphoid tyrosine phosphatase yotchedwanso LYP. PTPN22 imagwirizana mwachindunji ndi ma activation a T. LYP imachepetsa chizindikiro cha T-cell receptor (TCR). Mtunduwu ukhoza kugwiritsidwa ntchito ngati chandama chakuwongolera ntchito ya maselo a T, chifukwa imagwira ntchito zoletsa kusainira kwa TCR.

Jini la CTLA4 limayang'anira ma cell-rec-receptors pamaselo a T-lymphocyte cell. Ndiwotenganso gawo labwino pakuyambitsa chitukuko cha matenda amtundu wa 1, chifukwa zimasokoneza ma activation a T-cell.

Jini la interleukin 2α receptor gene (IL2RA) limakhala ndi ma exons asanu ndi atatu ndipo limakhazikitsa unyolo wa α wa IL-2 receptor complex (yomwe imadziwikanso kuti CD25). IL2RA ili ndi gawo lofunikira kwambiri pakukhazikitsa chitetezo chokwanira. IL2RA imawonetsedwa pamaselo oyendetsera T, omwe, monga tafotokozera pamwambapa, ndiofunikira kuti azigwira ntchito, komanso mogwirizana ndi kuponderezedwa kwa kuyankha kwa chitetezo cha mthupi cha T komanso matenda a autoimmune. Ntchito iyi ya gen2 ya IL2RA ikuwonetsa udindo wake mu pathogenesis ya T1DM, mwina ndikuchita nawo maselo othandizira a T.

Jini la CYP27B1 limasokoneza vitamini D 1cy-hydroxylase. Chifukwa chakufunika kwa Vitamini D pakuwongolera chitetezo chathupi, chimawerengedwa ngati mtundu wakusankhidwa. Elina Hipponen ndi anzawo adawona kuti mtundu wa CYP27B1 umalumikizidwa ndi matenda amtundu 1 shuga. Mtundu mwina umaphatikizapo njira yopangira cholembera. Zotsatira zamaphunziro, zidawonetsedwa kuti vitamini D imatha kupondereza zochita za autoimmune zochokera ku ma pancreatic β-cell. Umboni wa epidemiological ukusonyeza kuti kuwonjezereka kwa vitamini D kumatha kusokoneza kukula kwa matenda a shuga 1.

Jini la CLEC16A (lomwe kale linali KIAA0350), lomwe limafotokozedwa pafupifupi m'maselo a chitetezo cha mthupi ndipo limasunga mtundu wa mapuloteni amtundu wa C wa lectin. Amawonetsedwa mu ma lymphocyte ngati ma APC apadera (ma cell a antigen-presenting). Ndizosangalatsa kuti mtundu wa lectins C amadziwika kuti amagwira ntchito yofunika kwambiri pakuyamwa kwa antigen ndikupereka ma cell a β.

Kuwunika kwa majini a mtundu wa matenda a shuga omwe amadalira insulin omwe amagwirizana ndi zovuta zazikulu za histocompatibility mu mbewa kunawonetsa kuti main histocompatibility tata imathandizira kwambiri pakukweza matendawa mogwirizana ndi mitundu ina 10 ya kudziwikiratu kwa malo ena a genome.

Amakhulupirira kuti dongosolo la HLA ndilo lingaliro lamtundu lomwe limatsimikizira kutengera kwa ma pancreatic β-cell ku ma antigen virus, kapena kuwonetsa kukula kwa chitetezo chokwanira. Zinapezeka kuti ndi insulin yomwe amadalira matenda a shuga, ma antigen B8, Bwl5, B18, Dw3, Dw4, DRw3, DRw4 amapezeka kawirikawiri. Zinawonetsedwa kuti kukhalapo kwa ma antigen a B8 kapena B15 HLA mu odwala kumawonjezera chiopsezo cha matenda a shuga nthawi ziwiri mpaka zitatu, komanso kukhalapo kwa B8 ndi B15, nthawi 10. Posankha ma Dw3 / DRw3 haplotypes, chiwopsezo cha matenda ashuga chikuwonjezeka ndi katatu, Dw4 / DRw4 - ndi 4.9, ndi Dw3 / DRw4 - ndi 9.4 nthawi.

Mitundu yayikulu ya dongosolo la HLA lomwe limagwirizanitsidwa ndi tsogolo la mtundu woyamba wa matenda ashuga ndi mitundu ya HLA-DQA1, HLA-DQA, HLA-DQB1, HLA-DQB, HLA-DRB1, HLA-DRA ndi HLA-DRB5. Chifukwa cha kafukufuku wambiri ku Russia ndi padziko lonse lapansi, zapezeka kuti kuphatikiza mitundu yosiyanasiyana ya ma HLA gene kumakhala ndi zotsatila zosiyanasiyana pachiwopsezo cha matenda a shuga 1. Chiwopsezo chachikulu chimalumikizidwa ndi haplotypes DR3 (DRB1 * 0301-DQA1 * 0501-DQB * 0201) ndi DR4 (DRB1 * 0401,02,05-DQA1 * 0301-DQB1 * 0302). Chiwopsezo chapakatikati chimaphatikizidwa ndi ma haplotypes DR1 (DRB1 * 01-DQA1 * 0101-DQB1 * 0501), DR8 (DR1 * 0801-DQA1 * 0401-DQB1 * 0402), DR9 (DRB1 * 0902-DQA1 * 0301-DQB1 * 0303) ndi DR10 (DRB2 * 0101-DQA1 * 0301-DQB1 * 0501). Kuphatikiza apo, zidapezeka kuti kuphatikiza kwina kotsutsana kumakhala ndi mphamvu yoteteza pokhudzana ndi chitukuko cha matenda ashuga. Mafuchi awa amaphatikizapo DR2 (DRB1 * 1501-DQA1 * 0102-DQB1 * 0602), DR5 (DRB1 * 1101-DQA1 * 0102-DQB1 * 0301) - chitetezo chodzitetemera kwambiri, DR4 (DRB1 * 0401-DQA1 * 0301-DQB1 * 0301), DR4 (DRB1 * 0403-DQA1 * 0301-DQB1 * 0302) ndi DR7 (DRB1 * 0701-DQA1 * 0201-DQB1 * 0201) - chitetezo chapakatikati. Dziwani kuti kudziwika bwino kwa matenda a shuga 1 kumadalira kuchuluka kwa anthu. Chifukwa chake, ena mwa anthu obisalirapo amakhala ndi mwayi woteteza (Japan), ndipo winanso amagwirizana ndi chiopsezo (maiko aku Scandinavia).

Chifukwa chofufuzira kosalekeza, majini atsopano amapezeka pafupipafupi omwe amagwirizana ndi chitukuko cha matenda a shuga 1. Chifukwa chake, pakufufuza m'mabanja aku Sweden pa 2360 SNP chikhazikitso mkati mwa malo apamwamba a histocompatability tata ndi moyandikana ndi loci m'chigawo cha centromere, zambiri zazomwe zimayambitsa matenda a shuga 1 ndi IDDM1 locus mu main main histocompatability tata, yomwe imatchulidwa kwambiri mu HLA-DQ / dera, idatsimikiziridwa DR. Komanso, zidawonetsedwa kuti mu gawo la centromeric, nsonga ya mayanjano inali mu genetic region encodeor 1, 4, 5-triphosphate receptor 3 (ITPR3). Chiwopsezo cha anthu ku ITPR3 chinali 21,6%, zomwe zikuwonetsa kufunikira kwa mtundu wa ITPR3 pakupanga mtundu wa matenda ashuga a mtundu woyamba. Kuwunikira kawiri ka locus kunatsimikizira zotsatira za kusintha kwa mtundu wa ITPR3 pakukula kwa mtundu woyamba wa shuga, pomwe gene ili losiyana ndi jini iliyonse yomwe imalemba ma molekyulu a kalasi yachiwiri ya zovuta zazikulu za histocompatibility.

Monga tanena kale, kuwonjezera pa kutengera kwa chibadwa, kukula kwa mtundu woyamba wa shuga kumakhudzidwa ndi zinthu zakunja. Monga momwe kafukufuku waposachedwa wapeza, chimodzi mwazinthu izi ndi kufalitsa ma immunoglobulin kuchokera kwa mayi wodwala wa autoimmune kupita kwa ana. Zotsatira za kufala kumeneku, 65% ya ana adayamba kudwala matenda ashuga, pomwe nthawi yomweyo, poletsa kufalitsa kwa ma immunoglobulin kwa mayi kupita kwa mbewu, 20% yokha idadwala mwa ana.

Ubwenzi wamtundu wa 1 ndi matenda ashuga

Posachedwa, zambiri zosangalatsa zapezeka pa ubale wa majini pakati pa mitundu yoyamba ndi yachiwiri ya matenda ashuga. Li et al. (2001) anawunika kuchuluka kwa mabanja omwe ali ndi mitundu iwiri ya matenda ashuga ku Finland ndipo adawerengera, odwala omwe ali ndi matenda amtundu wa II, mayanjano apakati pa mbiri ya mabanja a matenda amtundu wa 1, antibodies to glutamate decarboxylase (GADab), ndi HLA-DQB1 genotypes oyanjana ndi mtundu woyamba wa matenda ashuga . Kenako, m'mabanja osakanikirana omwe ali ndi mtundu woyamba wa 2 ndi mtundu wa matenda ashuga, adawerengera ngati kuchuluka kwa HLA m'mabanja omwe ali ndi matenda amtundu wa 2 amakhudzanso matenda a shuga. Mwa mabanja 695 momwe mudali odwala opitilira 1 omwe ali ndi matenda amtundu 2, 100 (14%) adalinso ndi abale omwe ali ndi matenda ashuga 1. Odwala omwe ali ndi mtundu wachiwiri wa matenda ashuga ochokera m'mabanja osakanikirana anali ndi mwayi wokhala ndi ma antibodies a GAD (18% motsutsana 8%) ndi DQB1 * 0302 / X genotype (25% motsutsana 12%) kuposa odwala ochokera m'mabanja omwe ali ndi mitundu iwiri yokha ya shuga, komabe, iwo panali ma frequotype ochepa a DQB1 * 02/0302 genotype poyerekeza ndi odwala achikulire omwe ali ndi matenda a shuga 1 (4% motsutsana 27%). M'mabanja osakanikirana, kuyankha kwa insulin pakutsitsa glucose kunali kwakukulu mwa odwala omwe ali ndi chiopsezo cha HLA-DR3-DQA1 * 0501-DQB1 * 02 kapena DR4 * 0401/4-DQA1 * 0301-DQB1 * 0302 haplotypes, poyerekeza ndi odwala opanda ma-hablotypes. Izi sizimadalira kukhalapo kwa antibodies a GAD. Olembawo adanenetsa kuti mitundu 1 ndi 2 ya matenda ashuga imakhala m'mabanja amodzi. Mbiri yakubadwa kwa odwala omwe ali ndi vuto la matenda ashuga amtundu wa 2 amatsimikizira mtundu wa 2 odwala matenda ashuga kukhalanso kwa autoantibodies ndipo, ngakhale atakhala kuti ali ndi antibodies, kuti achepetse insulin. Maphunziro awo amatsimikiziranso mgwirizano wamtundu pakati pa matenda amtundu wa 1 shuga ndi matenda ashuga a 2 chifukwa cha HLA locus.

Pomaliza

Pomaliza, zitha kudziwika kuti pazaka 10 zapitazi, ofufuza adapita patsogolo kwambiri pakufufuza za matenda amtundu wa 1, komabe, njira ya cholowa chamtundu wa 1 sichikudziwikiratu, ndipo palibe lingaliro labwino la momwe matenda a matenda ashuga amakhudzidwira. zambiri m'derali. Zikuwoneka kuti cholinga chachikulu pakuphunzira za matenda ashuga pakadali pano chiyenera kukhala kutsimikizira kwa matenda ashuga, poganizira zosiyana siyana za anthu osiyanasiyana komanso momwe amagwirizanirana. Pankhaniyi, chosangalatsa kwambiri kuyambira pakuwona mtundu wa matenda ashuga 1 kungakhale kupenda kwamapangidwe: 1) pewani kufa kwa T-lymphocyte yosinthika posankha mu thymus, 2) malankhulidwe osazolowereka a mainococatability complex mamolekyulu a β-cell, 3) kusagwirizana pakati paorentrate ndi malamulo T-lymphocyte, komanso kusaka kwa kulumikizana kwantchito pakati pa loci yolumikizana ndi matenda amtundu wa 1 komanso njira zachitukuko cha autoimmunity. Poganizira zotsatira za kafukufuku waposachedwa, ndizotheka ndi lingaliro lina kuganiza kuti kuwululidwa kwathunthu kwa mitundu ya njira zakukula kwa matenda ashuga komanso cholowa chake sichiri kutali kwambiri.

Kodi matenda ashuga ndi chiani?

Matenda a shuga ndi njira yomwe thupi la munthu limagwiritsa ntchito mphamvu (glucose) yolandilidwa kudzera mu chakudya pazinthu zina. M'malo mopereka minofu ndi ziwalo, imangokhala m'magazi, mpaka amafikira pazovuta kwambiri.

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.

Kuphwanya kumachitika chifukwa chakuchotsa kapena kupanga insulin yokwanira - mahomoni a kapamba, omwe amayang'anira kagayidwe kazakudya m'thupi. Hormone iyi imalimbikitsa kukweza kwa glucose m'maselo, kudzaza thupi ndi mphamvu komanso kumasula mitsempha yamagazi yamagazi. Matendawa amakula pamene insulini sikokwanira kuyenda kwa glucose mu ziwalo. Pali mitundu iwiri ya matenda ashuga. Kusiyana kwakukulu pakati pa matenda a shuga amtundu 1 ndi omwe amayambitsa matendawa. Kuphatikiza apo, kusiyana kuli makamaka pakukweza, njira ndi chithandizo cha matenda a zam'tsogolo. Palinso zosiyana malinga ndi jenda, zaka komanso malo omwe wodwalayo amakhala.

Makhalidwe oyerekeza onse a mitundu yonseyi

Zofanana poyerekeza za mtundu woyamba ndi wachiwiri wa matenda ashuwarawo zikuwonetsedwa pagome:

Type 1 shuga mellitus imachitika chifukwa chophwanya chitetezo cha munthu, zomwe minofu yapang'onopang'ono imawona kuti ndi yachilendo, ikuwononga. Zotsatira zake, maselo omwe amapanga insulini amawonongeka ndipo mapuloteni omwe amafunikira kuti shuga azikhala m'magazi sanapangidwe konse m'thupi. Zifukwa zake zingakhale zingapo:

Matenda a ma virus. Matendawa amatha chifukwa cha rubella kapena mumps.
Makamaka. Kukula kwa matenda amiseche kumatha ngati makolo onse ali ndi matenda.
Kudyetsa mwana ndi zosakaniza zapadera.
Nyengo ikuzizila.

Mtundu wachiwiri wa matenda ashuga amadziwika ndi anthu omwe amangokhala. Chifukwa chachikulu chomwe chimatithandizira kuti matendawa azonenepa kwambiri, chomwe chimachitika chifukwa chomwa mowa kwambiri komanso kukhala ndi moyo wopanda pake. Pang'onopang'ono, thupi limaphwanya mayendedwe achilengedwe a minofu kuti agwiritse ntchito insulin, chifukwa chomwe maselo akulephera kupanga shuga. Izi zimabweretsa kuwonjezeka kwa shuga ndi magazi kufa ndi ziwalo ndi minofu.

Zizindikiro za matenda

Zizindikiro ndizofanana. Zizindikiro zotsatirazi za shuga zimasiyanitsidwa:

kumva ludzu ndi njala nthawi zonse,
kukodza pafupipafupi
kutopa,
gag Reflex
kufooka
kusakhazikika.

Kusiyana kwakukulu pakati pa matenda ndi kulemera kwa wodwala. Ndi matenda a shuga omwe amadalira insulin, wodwalayo amachepetsa thupi, pomwe odwala osakhazikika omwe amadalira shuga amapeza mofulumira. Kuphatikiza apo, matenda a shuga a 2 amadziwika ndi dermatitis, kuyabwa, kuyanika khungu, "chophimba" pamaso pa maso, kupuma pang'onopang'ono kwa khungu pambuyo pakuwonongeka, dzanzi la miyendo.

Kusiyana kwa kuchuluka kwa glucose m'magulu 1 ndi matenda ashuga 2

Mutha kusiyanitsa munthu wathanzi ndi wodwala matenda ashuga ndi kuchuluka kwa shuga m'magazi. Mwa anthu opanda matenda a shuga pamimba yopanda kanthu, kuchuluka kwa shuga kumafika mpaka 5.9 mmol / L. Mukatha kudya chakudya, chizindikirocho sichidutsa 8 mmol / L. M'mitundu yonse iwiri ya odwala omwe ali ndi shuga pamimba yopanda kanthu, shuga ndi 4-7 mmol / l. Maola 2 mutatha kudya, chiwerengerocho chimakwera msanga: ndi matenda a shuga 1, ndi ochepera 8.5, ndipo kwa odwala matenda ashuga ochepera 2 mmol / l.

Chithandizo cha matenda

Chithandizo cha mitundu yonse ya matenda ashuga ndichosiyana. Matenda a shuga amtundu woyamba amadalira insulini chifukwa kapamba sapereka timadzi tambiri m'magazi. Kuti mukhale ndi thanzi labwino, wodwalayo amayenera kupereka jakisoni wa insulin nthawi zonse. Mtunduwu umadalira mankhwalawo, zomwe zikutanthauza kuti ndizowopsa kwa anthu, popeza kufa kumatha kupezeka jakisoni. Matenda a shuga a Type 2 amathandizidwa ndimankhwala apadera ogwiritsira ntchito mkati omwe amathandiza kuti shuga yanu ikhale ndi shuga. Kuphatikiza apo, onse mitundu ya odwala matenda ashuga amasintha kadyedwe kake, kupatula mafuta abwino, ndikumakhala ndi moyo wathanzi. Odwala ayenera kuyang'anitsitsa kuchuluka kwa glucose awo ndi kuchuluka kwa cholesterol, komanso kuthamanga kwa magazi awo.

Mtundu woyamba wa shuga

Matenda a shuga a Mtundu woyamba amadalira insulin. Amapezeka kwambiri mwa achinyamata omwe azaka zosaposa 40. Ichi ndi matenda omwe maselo amwazi amathira ndi shuga. Chomwe chimapangitsa izi ndi ma antibodies omwe amawononga insulin. Matendawa, omwe kupezeka kwake kumalumikizidwa ndi kukhalapo kwa ma antibodies ena, samachiritsidwa kwathunthu.

Kuzindikira matendawa kumaphatikizapo kuyeseza kwambiri ma laboratore. Chithunzichi sichinazindikiridwe, chifukwa chake musadalire anthu omwe akuyesera kuuza munthu za matenda ake osawona zotsatira zoyesa. Pakukayikira koyamba kwa matenda, muyenera kufunsa kuchipatala msanga.

Anthu omwe ali ndi matenda a shuga a mawonekedwe oyamba, monga lamulo, ali ndi thupi loonda. Amafunikira jakisoni wokhazikika wa insulin kuyambira pomwe matendawa awonekera mpaka kumapeto kwa moyo. Mbiri yazachipatala ya odwala ngati awa ndi yokhazikika. Matendawa ndi cholowa.

Iwo omwe ali ndi matenda ashuga m'mabanja ali ndi kutengera kwa matendawa ku matendawa. Matenda osiyanasiyana amtundu wamtunduwu amapezeka mwa iwo nthawi zina. Ma virus angapo komanso mabakiteriya amatha kuipitsa, komanso kupsinjika kwambiri kapena kupitilira nthawi yayitali. Chifukwa cha zinthu zoipa izi, ma antibodies amapangidwa omwe amatha kuwononga ma cell omwe amachititsa kuti insulini ipangidwe.

Type 2 shuga

Mtundu wodziyimira pawokha wa insulin, mtundu wachiwiri wa matenda nthawi zambiri umapezeka mwa anthu okalamba. Uku ndikusiyana kwa matendawa, omwe amadziwika ndi kusowa kwa insulini kuti ipirire ntchito yake yayikulu. Shuga sangathe kuwola pawokha ndikudziunjikira m'magazi. Pang'onopang'ono, "bongo" la insulin limapangidwa kwathunthu m'maselo a thupi. Homoni imodzimodziyo imapangidwa, palibe kuchepa kwake, koma glucose mu kapangidwe ka maselo samatha.

Chosakaniza chokha cha insulini palokha chomwe chikukula chikukula. Monga lamulo, matendawa amapezeka mwa anthu opitilira zaka makumi anayi, koma nthawi zina amapezeka ngakhale mwa ana. Kwa odwala omwe ali ndi matenda amtunduwu, kunenepa kwambiri kumadziwika. Ma cell am'magazi a anthu oterewa sathanso kuzindikira mphamvu iliyonse ya insulini.

Mawonekedwe a shuga 1

Matenda a shuga a Type 1 ndi omwe amabwera chifukwa chosakwanira katemera wa pancreatic insulin (secretion). Akatswiri amapanga zizindikiritso zomwe zimapangitsa kukayikira kukhalapo kwa matenda amunthu m'masiku oyamba.Pakati pawo: kumva ludzu kosalekeza, kuphipha kwamkodzo, kutopa, kumva kwakuthupi. Ndikofunikira kuzindikira kuchuluka kwa shuga ndi insulin m'magazi. Ngati matendawa atsimikiziridwa, chithandizo chimayikidwa nthawi yomweyo, apo ayi wodwalayo amatha kukhala ndi zilonda zam'mimba komanso zovuta zina zingapo.

Kodi chifukwa nthenda yoyamba ya shuga imayamba bwanji? Sukulu yachipatala yakale imapereka yankho lomveka bwino ku funso ili. Choyambitsa chachikulu cha matendawa ndi kusokonezeka kwa kapamba, momwe mapangidwe a insulin amayimira kapena amachepetsa kwambiri. Ndizofunikanso kudziwa kuti amayi oyembekezera ali ndi matenda otchedwa gestationalabetes, omwe amayanjana ndi chiwopsezo chokhala ndi matenda omwe amadalira insulin.

Musaiwale kukambirana mitu komanso zizindikiro zapadera. Nthawi zambiri, matenda amtundu wa 1 amakhala limodzi ndi kapangidwe ka fungo lamkati m'kamwa. Awa ndi mabelu oyamba amthupi omwe amayenera kuchenjeza ndikupangitsa munthu kufunsa katswiri. Wodwalayo amatha kupita kwa dokotala motere, ndipamenenso matendawa amatha kuonekera koyambirira. Komabe, nthawi zambiri anthu, makamaka amuna, amanyalanyaza kukaonana ndi katswiri ndikukhala chaka chimodzi kapena zaka zingapo, osadziwa kuti ali ndi vuto liti, mpaka atalephera.

Zizindikiro zosavomerezeka za matenda amtundu 1 zimaphatikizapo:

Mavuto pochiza matenda opatsirana,
Kuchiritsa kwamabala kochepa,
Kulemera m'miyendo
Ululu m'matumbo a ng'ombe

Ndikofunikanso kukumbukira kuti anthu omwe akudwala matendawa ayenera kuwunika magazi awo nthawi zonse ndikukhalanso momwemo masiku ano lilili ndi mankhwala amakono. Mankhwala enieni amayenera kuperekedwa ndi katswiri, potengera momwe wodwalayo awonera komanso zomwe akuchita.

Momwe mungadziwe mtundu wa shuga 1?

World Health Organisation (WHO) yalongosola njira zomwe anthu amafunika kutsatira akakaikira matendawa. Mndandanda wawo ukuphatikizapo:

Kuyesa kwa shuga m'magazi,
Kuphunzira kulekerera kwa khungu
Kuzindikira kwamkodzo
Kuwerengera kuchuluka kwa hemoglobin ya glycosylated,
Kuzindikira kwa insulin ndi C-peptide m'magazi.

Muyenera kudziwa kuti magazi amaperekedwa kuti awunike pamimba yopanda kanthu. Zotsatira za phunziroli zimayerekezedwa ndi shuga omwe amapezeka pagome lapadera. Ngati mulingo:

Sichimafika 6.1 mmol / l - palibe hyperglycemia, matendawa amasiyidwa,
Muli mulingo kuyambira 6,1 mpaka 7.0 mmol / l - glycemia ili pafupi kwambiri ndi zovomerezeka,
Kupitilira 7.0 mmol / L - kukhalapo kwa matendawa ndikothekera kwambiri, koma kuwunika koyenera kumafuna kutsimikiziridwa kowonjezereka.

Mkhalidwe wa munthu wodwala matenda ashuga umawonetsedwa ndi kulolerana kwa glucose, kuchuluka kwa glycemia, komwe, sikunapitirire malire ovomerezeka. Wodwala yemwe wapeza zotere amafunikanso kuwunika ndi kupewa.

Kodi matenda amtundu wa 1 amathandizidwa bwanji?

Chithandizo chotsatira cha matendawa chilipo: zakudya zapadera, masewera olimbitsa thupi, mankhwala.

Njira yosankhidwa bwino yazakudya imathandiza kuthetsa zizindikiritso zazikulu za matenda ashuga. Cholinga chachikulu cha zakudya ndizoletsa kuchuluka kwa shuga m'thupi.

Kodi kuchitira matenda? Muzochitika ndi mtundu woyamba wa matenda, nthawi zambiri, simungathe kuchita popanda jakisoni wokhazikika wa insulin. Akatswiri kudziwa tsiku lililonse mulingo wambiri wa munthu aliyense payekhapayekha.

Kukonzekera komwe kumakhala ndi insulini kumayamwa m'magazi othamanga mosiyanasiyana ndikukhala ndi nthawi yosiyana. Ndikofunikira kusankha malo oyenera jakisoni. Pali mitundu ingapo ya mahomoni awa:

Insulin yofulumira: mphamvu yake imatha kuwoneka nthawi yomweyo. Kuti mupeze mahomoni amtunduwu, mankhwalawa Actrapid amagwiritsidwa ntchito, pafupifupi maola 2-4,
Insulin yapakati imaperekedwa kwa thupi kudzera mu mankhwala a Protafan, omwe amakhala ndi zinthu zomwe zimachepetsa kuyamwa kwa mahomoni. Mankhwalawa amagwira ntchito pafupifupi maola 10,
Wochedwa insulin. Zimaperekedwa ku thupi kudzera pokonzekera mwapadera zingapo. Pafupifupi maola 14 ayenera kudutsa kuti akwaniritse bwino. Horomus imachitika kwa tsiku limodzi ndi theka.

Monga lamulo, odwala amadzipatsa okha mankhwala, podzipukusa ndi jekeseni motsogozedwa ndi katswiri.

Dokotala mwanjira yapadera amapangira njira yothandizira odwala malinga ndi momwe wodwalayo akumuperekera, zomwe zikuwonetsa monga:

Ngati wodwala yemwe ali ndi matenda ashuga ali ndi kulemera kwambiri, ndiye kuti kuchepa kwa kuchuluka kwa zakudya zopatsa mphamvu kwambiri menyu kumakhala kovomerezeka kwa mankhwala komanso kupewa. Zili zovulaza kugwiritsa ntchito zakudya zam'chitini, nyama yamafuta, zakudya zosuta, kirimu wowawasa, mayonesi, mtedza, ndi zipatso zambiri. Musaiwale za maswiti. Izi ndizovuta kwambiri ngati matendawa apezeka mwa ana kapena azimayi omwe amakonda kupendekera okha.

Muyenera kuyang'ana njira zochepetsera kuchuluka kwa zakudya zopatsa mphamvu kwambiri. Kusowa kwa mphamvu kumachitika, ndipo thupi limatulutsa minofu ya adipose. Komabe, ziyenera kukumbukiridwa kuti munthu sangadzitopetse.

Kuchita masewera olimbitsa thupi kumathandizira kuchepetsa kuchepa kwa shuga m'magazi. Kuchita masewera olimbitsa thupi kofunikira. Kuchita zolimbitsa thupi kuchitike pafupipafupi, dosed. Palibenso chifukwa chodzikanira nokha ndi zolemera. Masewera okwanira olimbitsa thupi.

Mapampu omwe amatchedwa insulin amatha kusintha kwambiri moyo wa odwala. Izi ndi zida zochokera kudziko lamagetsi zomwe zimatsimikiza kuchuluka kwa shuga m'magazi, ndipo, pamaziko a umboni womwe wapezeka, kudzipereka mwa jakisoni wa insulin. Amapangitsa chithandizo kukhala chothandiza komanso kuchepetsa chiopsezo cha zovuta.

Momwe mungasungire mankhwala ndi insulin?

Mbale zotseguka zimatha kusungidwa kutentha kosakwana masabata asanu ndi limodzi. Iyenera kusungidwa m'malo omwe kuwala kwa dzuwa kapena kuwala kwanyengo sikulowa. Musasunge zinthu zokhala ndi insulini pafupi kwambiri ndi kutentha.

Kusagwiritsidwa ntchito kwa mankhwalawa kumasonyezedwa ndikupanga kwa kanema kapena mawonekedwe akuwoneka ofanana ndi ma flakes mkati mwa botolo. Chizindikiro ichi chimagwira ntchito yofunika kwambiri. Kugwiritsira ntchito mankhwala omwe atha ntchito kumatha kuwonjezera zovuta za matendawa komanso kungayambitse zotsatira zoyipa.

Type 2 shuga

Kapamba wa iwo omwe ali ndi matenda ashuga a 2, amadzipangira okha insulin yokwanira, koma thupi silingathe kuyamwa timadzi tomweti chifukwa chakuchita bwino kwa ma cell receptors. Glucose samapangidwira bwino, chifukwa, mitsempha yamagazi ndi ziwalo zamkati zimawonongeka. Izi zitha kukhala zowopsa nthawi yapakati. Komabe, mawonekedwe odziyimira pawokha amadziwika ndi okalamba.

Matenda a shuga amtundu wachiwiri amapangidwa pazifukwa zina, zazikulu zomwe zimawerengedwa kuti ndizonenepa komanso kutengera kwa chibadwa cha matendawa. Malinga ndi ziwerengero, pafupifupi 80% ya odwala omwe ali ndi matenda ashuga 2 ali onenepa kwambiri. Kodi ndizotheka kuchira kwathunthu pochepetsa thupi lanu? Yankho pano likhala loipa, komabe, monga njira yoletsera, muyezo uwu ungakhale wothandiza kwambiri. Malinga ndi lingaliro lamasayansi lomwe limavomerezeka, kuchuluka kwamafuta amthupi kumalepheretsa kugwiritsa ntchito insulin.

Zizindikiro ndi zovuta za matenda amitundu iwiri

Zizindikiro za mtundu woyamba ndi wachiwiri wamatenda omwe ali ndi vuto lofanana kwambiri: ludzu lamphamvu limayendera limodzi ndi kukodza mopitirira muyeso, munthu amakhala akumadzimva kutaya - kufooka ndi kutopa, kupuma pang'ono, nthawi zina mseru komanso kusanza.

Kuyang'aniridwa kwakukulu kuyenera kulipidwa pazovuta zomwe zingachitike. Malinga ndi lipangidwe laposachedwa la International Classization of Diseases (MBC 10), mndandanda wawo ndiwokulirapo ndipo umapatsa odwala zovuta zambiri. Ngati magazi ali ndi shuga, ndiye kuti zosintha zamkati zilizonse zamkati sizitha. M'magawo apamwamba a matendawo, odwala amapatsanso kulemala.

Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri, chiopsezo cha kulowerera m'mitsempha ndi matenda a sitiroko, mitundu yonse yamatenda a impso, komanso kuwonongeka kwa mawonekedwe kumawonjezeka. Ngakhale mabala ang'onoang'ono samachiritsa kwa nthawi yayitali. Nthawi zina matendawa amatha kutsogolera gangore, komwe kungafunikire kudulidwa kwa dzanja lowonongeka. Mndandanda wazovuta za abambo umakwaniritsa kusabala. Mndandanda wowopsa kwambiri wa zinthu zoyipa umapangitsa akatswiri kupitiriza kupeza njira zochizira kwambiri masiku ano.

Kodi mukuganiza kuti muyenera kuchita chiyani mutazindikira zizindikiro za matendawa?

Ngati mumakayikira koyamba matenda a shuga a fomu yachiwiri, muyenera kukayezetsa kuchipatala mwachangu. Anthu omwe amadziwa kutengera kwa chibadwa chawo pamatendawa ayenera kuwunika magazi ndi mkodzo wawo pafupipafupi. Izi ndizowona makamaka kwa anthu azaka 50 kapena kupitirira, komanso kwa onse omwe onenepa kwambiri.

Ngati matendawa adakhazikitsidwa kale, wodwalayo ayenera kuyang'aniridwa ndi achipatala ndipo nthawi ndi nthawi azikakumana ndi katswiri.

Kwa anthu omwe ali ndi matenda a shuga a 2, madokotala amalembera:

Onaninso shuga ndi cholesterol, komanso kulemera kwa thupi,
Sinthani zakudya zanu ndikuwonjezera zakudya zopatsa mphamvu zopezeka ku menyu, zomwe zimayenera kukhala ndi shuga pang'ono. Muyenera kudya michere yambiri komanso zakudya zopangidwa ndi ulusi wazomera,
Chitani masewera olimbitsa thupi pafupipafupi.

Odwala ayenera kuphunzira kudziimira pawokha kuchuluka kwa shuga m'magazi. Masiku ano, pali zida zapadera zomwe zimapangitsa kukhala kosavuta kuchita izi kunyumba. Amatchedwa glucometer.

Ndikofunikira nthawi zonse kutsata kudziletsa kwambiri. Kuchiza kumalumikizidwa ndi chithandizo chamankhwala komanso masewera olimbitsa thupi. Izi zimathandizira bwino mankhwalawa potengera kugwiritsa ntchito mankhwala ochepetsa shuga otchedwa incretomimetics mankhwala. Nthawi zambiri awa amakhala mapiritsi, osati jakisoni, monga momwe zimakhalira ndi mankhwala okhala ndi insulin.

Mankhwala enieni amayenera kuperekedwa ndi dokotala, kutengera zonse zomwe wodwala angapeze. Amakakamizidwa aliyense payekha kudziwa kuchuluka kwa maulendo omwe amabwera kudzacheza. Pali ziyeso zambiri zomwe ziyenera kuchitidwa, kuti mudziwe momwe wodwalayo alili, kaya pali ngozi yotenga zovuta, kupewa komwe kungafunike chithandizo chowonjezera.

Pogwiritsa ntchito zotsatira za maphunziro angapo asayansi, akatswiri adatha kudziwa kuti, limodzi ndi kuchepa thupi, matendawo amatenga mawonekedwe ofooka. Zotsatira zake, zizindikiro zake sizizunza odwala pang'ono, ndipo moyo wawo umakhala bwino.

Posachedwa, njira yatsopano yothetsera yakhala ikuwonetsedwa kwambiri pazofalitsa - Chinese chigamba cha shuga. Opanga ake amalonjeza pafupifupi zozizwitsa, akulimbikitsa kuti asasunge ndalama ndi kugula zinthu zawo. Komabe, akatswiri pazamankhwala azikhalidwe amakayikira njira iyi yothandizira. Ngati muwerenga ndemanga pa intaneti pa izi, ndiye kuti zikutsutsana kwambiri. Ena amalemba kuti amayenera kuti adawathandiza. Ena akhumudwitsidwa kwathu pano.

Njira zopewera

Monga tafotokozera pamwambapa, muyenera kuchita masewera olimbitsa thupi ndikuwunika zakudya zanu. Pali zakudya zopangidwa mwapadera zomwe zimapindulitsa thanzi la odwala. Ngati mumatsatira malangizo a dokotala, mutha kusintha kwambiri moyo wanu, ndikuchotsa zofunikira zomwe zimayenderana ndi matendawa.

Muyenera kupatula zinthu zina pamenyu. Nthawi zambiri, akatswiri amasankha chakudya chotchedwa 9. Cholinga chake ndikuchepetsa kugwiritsa ntchito zinthu zomwe zimakhala ndi chakudya chambiri m'magulu awo. Zatsimikiziridwa kuti mwa odwala omwe amagwiritsa ntchito izi, ntchito ya pancreatic imayenda bwino.

Ndi zakudya ziti zomwe zimaloledwa? Mndandanda wawo umaphatikizapo: Mitundu yochepa yamafuta a nyama ndi nsomba, kabichi, nkhaka, biringanya, tomato ndi zukini, buckwheat, barele la pearl, mapira ndi oatmeal. Maapulo ndi sitiroberi amaloledwa, koma pang'ono. Zopangira mkaka zimatha kudyedwa ndi mafuta ochepa. Pambuyo pa chakudya chotere, kuchuluka kwa shuga kwa magazi sikungakhale kovomerezeka.

Pazosankha zamankhwala pazachipatala, kapangidwe kake ka chakudya kamayeneranso kuganiziridwa. Zakudya ziyenera kuphatikizapo:

55% ya gulu la mapuloteni a nyama (magalamu 80-90).
30% yamafuta az masamba (70-80 magalamu).
300-350 magalamu a chakudya.
12 magalamu amchere
Limodzi ndi theka malita amadzi.

Tsiku lomwe simungadye zoposa 2200-2400 kcal. Muyenera kudya 5-6 tsiku lililonse, monganso "kufalitsa" kugwiritsa ntchito chakudya nthawi. Shuga ayenera kulamulidwa. Zakudya zotsekemera zimaphikidwa kakang'ono, ndipo ndizophatikiza ndi shuga zokha monga stevia, sorbitol, kapena xylitol.

Zakudya zamchere ziyeneranso kukhala zochepa. Njira yophikira ndiyofunikira. Zakudya zowiritsa ndi zophika ziyenera kupezeka muzakudya. Zakudya zophika komanso zopatsa mphamvu zimaloledwa kudya zochepa. Pali maphikidwe opangidwa makamaka kwa odwala matenda ashuga. Kutsatira, mutha kuphika zakudya zokoma zomwe sizikuvulaza thanzi lanu.

Patsiku muyenera kumamatira ku menyu winawake. Chifukwa chake, zakudya nambala 9 zitha kuyimiridwa:

M'mawa: tiyi, phala la bwwheat, tchizi wopanda mafuta ambiri, mkaka,
Chakudya chachiwiri: tirigu wa tirigu (wowiritsa),
Chakudya chamasana: kabichi wa borsch ndi mafuta a mpendadzuwa (masamba), zakudya odzola, nyama yophika ndi msuzi wamkaka,
Zosadya: ochepa maapulo,
Chakudya chamadzulo: nsomba yophika, msuzi wowotchera, komanso mbale za kabichi.

Lolemba

Chakudya cham'mawa: tchizi cha chicory, tchizi chamafuta ochepa ndi mkaka, phala (buckwheat).

Chakudya chamadzulo: 200 ml ya mkaka.

Chakudya chamadzulo: msuzi wa kabichi m'njira yamasamba, chifuwa cha mbalame yoyera, zakudya zonona.

Chakudya chamadzulo: nsomba yophika, tiyi, mbale za kabichi.

Musanagone: kapu ya kefir wopanda mafuta.

Chakudya choyamba: barele, dzira la nkhuku, chicory, kabichi yabwino.

Chakudya chamadzulo: kapu yamkaka (mafuta ochepa okha ndi oyenera).

Chakudya chamasana: mbatata yosenda, chiwindi chophika, msuzi wa brine, zipatso zowuma zambiri.

Zosakhazikika: zipatso zonona.

Chakudya chamadzulo: nkhuku yophika, kabichi yoyamwa.

Musanagone: kefir-mafuta ochepa.

Chakudya choyamba: tchizi chopanda mafuta ndi mkaka, chicory, oatmeal.

Chakudya chamadzulo: mgonero wa zakudya.

Chakudya chamasana: borsch, nyama yophika, phala la buckwheat, tiyi.

Zokhwasula: mapeyala awiri kapena awiri.

Chakudya chamadzulo: saladi kapena vinaigrette, dzira, tiyi.

Musanagone: kapu yamafuta osapika.

Chakudya choyamba: phala la buckwheat, chicory, tchizi chaching'ono cha mafuta ochepa.

Chakudya cham'mawa chachiwiri: kefir.

Chakudya chamadzulo: borsch, zipatso zouma zophika, nyama yophika.

Zosakhazikika: Peyala yopanda masamba.

Zakudya zamadzulo: kabichi schnitzel, nsomba yophika, mitundu ya tiyi wopanda mafuta.

Musanagone: kapu ya kefir yopanda mafuta.

Chakudya choyamba: dzira, batala pang'ono, vinaigrette wopanda mbatata ndi kuwonjezera kwa mafuta a mpendadzuwa, chicory.

Chakudya chamadzulo: sauerkraut, mphodza kapena nyama yophika, msuzi ndi nandolo.

Zosadya: zipatso zatsopano zingapo.

Chakudya chamadzulo: kudula masamba ndi masamba, nkhuku yophika, tiyi.

Asanagone: kapu ya yogati.

Chakudya choyamba: mapira mapira, chicory, soseji yaying'ono ya dotolo.

Chakudya chamadzulo: tirigu wa tirigu

Chakudya chamadzulo: nyama yophika, mbatata yosenda, msuzi wanyanja.

Zakudya zoziziritsa kukhosi: kapu ya kefir yamafuta ochepa.

Chakudya chamadzulo: tchizi tchizi chokhala ndi mafuta ochepa, tiyi, oatmeal.

Lamlungu

Chakudya choyamba: dzira la nkhuku, chicory, phala la buckwheat.

Chakudya chamasana: maapulo awiri kapena awiri.

Chakudya chamadzulo: nyama yodulidwa, msuzi wopepuka wa masamba, phala la barele.

Zosadya: mkaka skim.

Chakudya chamadzulo: saladi wa masamba, nsomba yophika, mbatata yosenda.

Musanagone: kefir-mafuta ochepa.

Njira zina zochizira

Mankhwala wowerengeka, pali maphikidwe ambiri omwe, okhala ndi magawo osiyanasiyana ogwira ntchito, amathandizira kulimbana ndi shuga chamafuta. Madokotala olembetsedwa nthawi zambiri amakayikira njira zotere, koma samaletsa odwala kuti azigwiritsa ntchito limodzi ndi chithandizo choyambira. "Njira yophatikiza" chotereyi nthawi zambiri imakhala ndi zotsatirapo zabwino, zolola odwala kuti athe kuchepetsa mawonetsedwe opweteka.

Maphikidwe othandiza kwambiri a mankhwala achilengedwe:

Popewa, dzira ndi kuwonjezera kwa mandimu lingakuthandizeni. Gwedezani zomwe zili dzira laiwisi, onjezani msuzi wa ndimu imodzi. Landirani mphindi 50-60 musanadye, masiku atatu m'mawa. Patatha masiku khumi, maphunzirowo atha kubwerezedwa.
M'mawa, gwiritsani anyezi wophika kwa mwezi umodzi.
Njira yabwino yochepetsera glucose yanu imakhala ndi mpiru pang'ono kapena mafilakisi tsiku lililonse, komanso tiyi wamtundu wakuda.
Kugwiritsa ntchito msuzi wa mbatata watsopano kumene kumathandiza kuchepetsa shuga. Zomwe zimagwiritsidwanso ntchito ndi raspberries, kabichi yoyera.
Tincture wa oyera mabulosi (2 tbsp / l) amakonzedwa ndikuthira madzi otentha (2 tbsp), nthawi ya kulowetsedwa ndi maola 2-3, kutenga katatu pa tsiku.
Musaiwale za wowerengeka mankhwala monga decoction wa oats. Thirani supuni ya oat mbewu ndi madzi (imodzi ndi theka magalasi), ndiye kuti wiritsani kwa mphindi 15, chifukwa - 3 r / d mphindi 15-20 musanadye.
Cinnamon amathandiza - theka la supuni patsiku. Imwani ndi tiyi.
Pogaya mitengo ya oak mpaka ufa utapezeka. Maphunzirowa ndi 1 tsp pamimba yopanda kanthu m'mawa, komanso asanagone masiku asanu ndi awiri.
Magawo a mtedza (40 g) kuthira madzi otentha (500 ml) ndikuyatsa moto. Wiritsani kwa mphindi khumi. Kuumirira mpaka wachifundo, kumwa 1 tbsp / l theka la ola musanadye.
Thirani madzi otentha (theka la lita) ndi makungwa a aspen (2 matebulo / mabokosi), ikani chilichonse pamoto ndikuphika pafupifupi mphindi 10. Popeza mudalimbikira, imwani theka kapu musanadye.
Kulowetsa kogwira kumakonzedwa kuchokera ku kapu yamadzi otentha, omwe amathiridwa ndi ma cloves (20 ma PC). Kuumirira usiku, kumwa katatu patsiku ndendende gawo lachitatu lagalasi. Osachotsa ma cloves omwe agwiritsidwa ntchito, onjezerani kutsina kwa iwo madzulo, kutsanulira madzi otentha kachiwiri, etc. Njira ya chithandizo ndi miyezi isanu ndi umodzi.
Bolani theka la lita imodzi ya madzi otentha ndi supuni ziwiri za nettle osakaniza ndi zipatso za mzere muyezo wa atatu mpaka asanu ndi awiri. Limbikani pa dongosolo la maola atatu kapena anayi. Tengani kawiri patsiku kwa theka lagalasi.
Thirani mizu ya burdock (20 g) ndi madzi otentha (galasi), wiritsani ndi madzi osamba, pafupifupi mphindi 10. Maphunziro - katatu pa tsiku patebulo / bokosi musanadye.

Zonse zomwe zimawerengedwa kwa owerenga nkhaniyi zimangokhala ntchito yowunikira. Musanagwiritse ntchito zomwe mwapeza pochita, onetsetsani kuti mwakumana ndi zovuta zomwe zingachitike ndi katswiri waluso!