Shuga ya Steroid: kuzindikira ndi kuchiza

Matenda a shuga a sodiumid ndi mtundu woopsa wa matenda a shuga omwe amadalira insulin, omwe amayamba chifukwa cha kuchuluka kwa mahomoni a adrenal cortex m'magazi kwa nthawi yayitali kapena kuchitira mankhwala a glucocorticoid a mahomoni awa. Itha kuphatikizidwanso ndi chithandizo cha matenda ena, momwe mankhwala a glucocorticoid, mankhwala opangira pakamwa a steroid komanso okodzetsa amagwiritsidwanso ntchito kwa nthawi yayitali, monga matenda a Itsenko-Cushing, nyamakazi, bronchial mphumu, collagenosis, ndi zina zambiri.

Kukula kwa matenda a shuga a steroid kumadalira zotsatira za glucocorticoids pamatumbo ndi mapuloteni. Kukonzekera kumawonjezera kuwonongeka kwa mapuloteni ndikuchepetsa njira ya kapangidwe kawo. Chizindikiro cha kuwonongeka kwa mapuloteni mothandizidwa ndi glucocorticoids ndikuwonjezereka kwa nayitrogeni mkodzo. Zotsatira za glucocorticoids pa kagayidwe kazakudya zimafotokozedwa ndikuwonjezera ntchito ya shuga-6-phosphatase ndikuchepetsa ntchito ya minyewa ya chiwindi pakukonzekera shuga. Mphamvu yotsutsa-insulin ya ma steroid imawonetsedwa pakuchepa kwa kuchuluka kwa shuga m'thupi.

Matenda a Steroid amadziwika chifukwa cha shuga wambiri (kuchuluka kwa 11 ndi 6 mmol / L m'magazi atatha kudya komanso isanachitike) komanso kukhalapo kwa shuga mkodzo

Kuchiza kumachitika ndikuchotsa zomwe zimayambitsa hypercorticism (mahomoni owonjezera mu adrenal cortex m'magazi). Kuchotsa kwa ndulu ya adrenal gland ngati pali hyperplasia (kuchuluka kwa zigawo zikuluzikulu za matupi awo chifukwa cha kuchuluka kwambiri) kwa adrenal cortex kapena kuchotsa chotupa cha cortical chinthu cham'magazi a adrenal, komanso kusintha matenda a shuga.

Mankhwala omwe si othandizira opaleshoni amaphatikizapo mankhwala monga thiazolidinediones ndi mankhwala a hypoglycemic, insulin ikhoza kutumikiridwa, komanso mankhwala osakanikirana a pakamwa osakanikirana. Mwanjira yofatsa yamatendawa, mankhwala a gulu la sulfanylurea amagwira ntchito, koma zimayambitsa kuwonongeka kwa kagayidwe kazakudya. Kupewa kumachitika pobweretsa mtundu wa insulin yaying'ono, mankhwala a anabolic amaphatikizidwa, mapuloteni amawonjezeredwa kuzakudya za wodwalayo, ndipo zakudya zamafuta zimachepetsedwa.

Zotsatira za ma steroid pa matenda ashuga

Ma steroid ndi mahomoni azomera kapena nyama. Alipo pokonzekera glucocorticoid, corticosteroids, omwe, motsutsana ndi kugwiritsidwa ntchito pafupipafupi, angayambitse matenda a shuga, kusintha kwa impso, ndi zina. Endocrinologists, polankhula za zoyipa za odwala omwe ali ndi matenda ashuga thupi, samalani ndi chidwi chakuti:

Kusintha kwa shuga m'magazi ndikotheka ndikuwonjezera kukana kwa chiwindi ku insulin. Izi zikuwonetsedwa ndi kugwiritsa ntchito ma steroid nthawi zonse,
mahomoni amathanso kupanga chiwindi kuti chisagwire insulin, kupangitsa
ngati kusintha koteroko kukupitirirabe, ndipo chithandizo sichikuchitika, maselo sadzayankhanso ku insulin, yomwe imapangidwa ndi thupi.

Zomwe zimachitika chifukwa cha kusinthaku kwa matenda amatchedwa steroid-indeduabetes mellitus. Ndikofunikira kumvetsetsa zizindikilo zake ndikuphunzira zambiri pazomwe zimayambitsa kukula.

Zizindikiro za matendawa

Choopsa chachikulu cha matenda ndi chakuti zimakhala zovuta kudziwa nthawi yochepa.

Steroid matenda a shuga amellitus amapezeka popanda chizindikiro chilichonse, ndipo zizindikiro zomwe zilipo zitha kutchulidwa molakwika ngati matenda ena kapena mitundu ya matenda ashuga.

Mwachitsanzo, tikulankhula za kukakamiza pafupipafupi kukodza, kutopa kwambiri ndi kutopa kwambiri.

Zizindikiro zakuyamba kwa matenda a steroid amatha kuchepa thupi mwadzidzidzi, mavuto apamtima komanso zogonana (mwina kukula kwa kusabala). Oyimira akazi amatha kuwonetsa matenda osiyanasiyana amkati. Chizindikiro chinanso ndimakhala ndikumva njala nthawi zonse, ngakhale ndimakhala ndi chakudya chamagulu.

Tisaiwale kuti matenda a shuga a steroid amatha kuwonetseredwa ndi kumva kuzizira komanso kuzizira kwam'munsi komanso kumtunda, mavuto amawonedwe, chithunzi "chosachita bwino". Wodwalayo amathanso kumva ludzu, lomwe mwina silingathetse ngakhale atayamwa pafupipafupi. Chifukwa chake, ndi mtundu wa matenda omwe amaganizira kuti ali ndi matendawa, munthu sangathe kuchita popanda kufufuza kwathunthu komanso kutsimikiza kwa zomwe zimayambitsa matendawa.

Zolinga zakukula kwa matenda amisala

Zomwe zimapangitsa kuti pakhale mkhalidwewo zimagawidwa ndi ma endocrinologists kukhala amkati ndi amkati. Dziwani izi:

ndimayendedwe amkati, kuchuluka kwa mahomoni kumatha kupanga chifukwa cha matenda a endocrine system,
ndi exo native - mahomoni ochulukirapo amakula atagwiritsidwa ntchito kwa nthawi yayitali a glucocorticosteroids,
shuga ya shuga itha kuyambitsidwa ndi thiazide diuretics, mayina odana ndi kutupa, kulera. Itha kuphatikizanso mankhwala omwe amagwiritsidwa ntchito pochiza ziwengo, polyarthritis, chibayo ndi matenda ena (amagwira ku autoimmune pathologies).

Zomwe zimayambira ndizovuta mukugwira ntchito kwa pituitary gland, yomwe imadziwika kwambiri ndi matenda a Itsenko-Cushing's. Pazomwe zakuperekedwa, kuphatikiza kwambiri kwa cortisol ndi adrenal cortex ndi kakhalidwe. Choyambitsa chachikulu cha matendawa ndi pituitary microadenoma, yomwe imakulitsidwa ndikuyenda mothandizidwa ndi ma steroid.

Matenda a Graves, kapena chakumwa choopsa, chitha kupangitsa kuti matendawa akhale ngati "mankhwala". Mothandizidwa ndi matendawa, kumasulidwa kwa insulin kumachepa, kuchuluka kwa shuga m'magazi kumawonjezeka.

Ndikofunikira kulipira chidwi makamaka ndi magulu omwe ali pachiwopsezo, chifukwa shuga ya sodium samakula mwa odwala onse omwe amagwiritsa ntchito mankhwala oyenera. Kunenepa kwambiri, kumangokhala phee komanso kudya zakudya zosayenera kuyenera kuonedwa ngati zinthu zolimbikitsa. Pofuna kupatula mavuto azovuta, tikulimbikitsidwa kuti tiyambe kulandira chithandizo posachedwapa.

Mankhwala a shuga a Steroid

Mulingo woyenera kwambiri wa mankhwalawa adzaperekedwa ndi jakisoni wa insulin (amalola kuti ziwonetsere ntchito ya kapamba). Gawo lofunika kwambiri la chithandizo chamankhwala ndikukhazikitsa zakudya zomwe sizikhala ndi chakudya chambiri. Monga gawo la mankhwalawa, kugwiritsa ntchito mankhwala a hypoglycemic ndikulimbikitsidwa.

Chithandizo cha matenda a shuga a steroid ziyenera kuchitika molingana ndi algorithm:

Kulandidwa kwa mankhwalawa komwe kumayambitsa kuphwanya kagayidwe kazakudya zamagulu ndi mapuloteni m'thupi ndizofunikira
ngati izi sizingatheke pazifukwa zina (mwachitsanzo, kuwonekera kwambiri kwa mphumu kapena chifukwa cha kulowererapo kwa mankhwala kuti muikemo impso), tikulimbikitsidwa kupenda mosamalitsa mkhalidwe wa kapamba. Pambuyo pake, mankhwala amalembedwa kuti akonze ntchito zake,
m'malo ovuta kwambiri, pamene chithandizo chonse chomwe chatchulidwa kale sichikuthandizira, othandizira opaleshoni omwe cholinga chake ndi kuchotsa mbali ya gren adrenal.

Njirayi ndi yovuta kwambiri.Pomaliza, izi zimatha kubweretsa kusokonezeka kwakukulu pakugwira ntchito kwa thupi komanso kusokonezeka kwakukulu chifukwa cha kusintha kwa mahomoni, chifukwa chake ntchito imagwiritsidwa ntchito pokhapokha ngati pali zovuta kwambiri.

Udindo wazakudya

Pa gawo loyambirira la chitukuko cha matendawa, monga kuti kuthetseratu kwathunthu, zakudya zamagulu ochepa zimatha kukhala zovuta zokwanira. Izi zikutanthauza kuti chilichonse chomwe chili ndi katundu wazakudya zambiri sayenera kudyedwa. Zakudya zomwe zaperekedwa ndizabwino chifukwa zimathetsa mokwanira kuchuluka kwa shuga.

Kuphatikiza apo, zakudya zama carb ochepa zimachepetsa kufunika kwa jakisoni wa insulin, yomwe imagwiranso ntchito kwa mankhwala a hypoglycemic. Zotsatira zabwino zidzakhala kuchotsa kwa chiopsezo cha zovuta, kuchepa kwakukulu kwa cholesterol komanso kuchotsedwa kwa zizindikiro zazikuluzikulu za matenda a shuga a steroid. Zonsezi zimathandizira kwambiri momwe anthu odwala matenda ashuga amayenera.

Anthu ena amatcha mtundu wa shuga womwe amadalira insulin. Nthawi zambiri amakula chifukwa cha kupezeka kwa magazi a kuchuluka kwa corticosteroids kwa nthawi yayitali. Awa ndi mahomoni opangidwa ndi adrenal cortex. Zizindikiro zake komanso chithandizo cha matenda a shuga a steroid ziyenera kudziwika kwa aliyense amene wakumana ndi matenda amtunduwu.

Kukula kwa matenda a shuga

Mtundu wodwala wa sodium wodwala insulin nthawi zina umatchedwa sekondaleus yachiwiri kapena matenda a shuga. Chimodzi mwazinthu zomwe zimapangitsa kupezeka kwake ndikugwiritsa ntchito mankhwala a mahomoni.

Pogwiritsa ntchito mankhwala a glucocorticosteroid, mapangidwe a glycogen m'chiwindi amalimbikitsidwa kwambiri. Izi zimabweretsa kukulira glycemia. Maonekedwe a matenda osokoneza bongo ndi otheka kugwiritsa ntchito glucocorticosteroids:

Dexamethasone
Hydrocortisone
Prednisone.

Awa ndi mankhwala othana ndi kutupa omwe amadziwika kuti amathandizira pakhungu la bronchial mphumu, nyamakazi, komanso zotupa zingapo za autoimmune (lupus erythematosus, eczema, pemphigus). Amathanso kutumikiridwa chifukwa cha matenda amisempha.

Matendawa amatha kupezekanso chifukwa chogwiritsa ntchito njira zina zoletsa pakamwa komanso thiazide diuretics: Nephrix, Hypothiazide, Dichlothiazide, Navidrex.

Pambuyo kumuyika kwa impso, chithandizo cha nthawi yayitali chovomerezeka cha corticosteroid chimafunika. Kupatula apo, pambuyo pa opaleshoni yotere, ndikofunikira kumwa mankhwala omwe amapondereza chitetezo cha mthupi. Koma kugwiritsa ntchito corticosteroids sikuti nthawi zonse kumayambitsa matenda ashuga. Mwachidule, mukamagwiritsa ntchito ndalama zomwe zili pamwambazi, mwayi wokhala ndi matendawa umakulanso.

Ngati m'mbuyomu odwala sakhala ndi vuto la kagayidwe kazakudya m'thupi, ndiye kuti pali kuthekera kwakukulu kwakuti pambuyo pakuchotsedwa kwa mankhwalawa omwe adayambitsa matenda ashuga, matendawo amakhalanso amakhazikika.

Matenda owopsa

Kutengera mtundu wa shuga, matendawa amapatsidwa nambala malinga ndi ICD 10. Ngati tikulankhula za fomu yodalira insulin, ndiye kuti codeyo idzakhala E10. Ndi fomu yodziyimira payokha ya insulin, code E11 imaperekedwa.

Matenda ena, odwala amatha kuonekera. Chimodzi mwazinthu zomwe zimayambitsa kukula kwa mtundu wa steroid ndimatenda a hypothalamic-pituitary. Zolakwika mu kugwira ntchito kwa hypothalamus ndi pituitary gland ndizomwe zimayambitsa kusawoneka bwino kwa mahomoni m'thupi. Zotsatira zake, maselo samayankhanso insulin.

Matenda ofala kwambiri omwe amakhumudwitsa matenda a shuga ndi matenda a Itsenko-Cushing. Ndi matenda awa mthupi, kuchuluka kwa hydrocortisone kumawonedwa. Zomwe zimayambitsa matendawa sizinadziwikebe pano, koma zikuwuka:

mankhwalawa glucocorticosteroids,
kunenepa kwambiri
motsutsana ndi zakumwa zakumwa zoledzeretsa (zosakhalitsa),
pa mimba
motsutsana ndi maziko a matenda ena amisempha ndi amisala.

Chifukwa cha chitukuko cha matenda a Itsenko-Cushing's, maselo amasiya kuzindikira insulin. Koma palibe kutchulidwa kolakwika pakugwira ntchito kwa kapamba. Ichi ndi chimodzi mwamagawo osiyana pakati pa mtundu wa shuga wa shuga ndi ena.

Matendawa amatha kupangidwanso mwa odwala omwe ali ndi poyizoni Goiter (matenda a Graves, matenda a Bazedova). Njira yogwiritsira ntchito glucose m'misempha imasokonezeka. Ngati, motsutsana ndi zotupa za chithokomirozi, matenda a shuga atakula, ndiye kuti kufunikira kwa insulin kumawonjezeka kwambiri, ndipo minyewa yake imakhala yolimbana ndi insulin.

Mkhalidwe wamatenda

Kupita patsogolo kwa mtundu wa steroid matendawa, maselo a beta omwe amapezeka m'matumba am'mimba amayamba kuwonongeka chifukwa cha corticosteroids. Kwanthawi yayitali amatha kupanga insulini, koma kupanga kwake kumachepetsedwa. Kusokonezeka kwa metabolic. Tizilombo ta m'thupi timayambiranso insulin. Koma popita nthawi, kupanga kwake kumatha konse.

Ngati kapamba amasiya kupanga insulini, ndiye kuti matendawa ali ndi zizindikiro za matenda ashuga amtundu 1. Odwala amakhala ndi ludzu lalikulu, kuchuluka kwa kwamikodzo komanso kuwonjezeka kwamkodzo tsiku lililonse. Koma kuchepa thupi kwambiri, monga momwe amathandizira odwala matenda ashuga amtundu 1, samapezeka mwa iwo.

Mankhwala othandizira ndi corticosteroids amafunikira, kapamba amakumana ndi katundu wambiri. Mankhwala osokoneza bongo mbali imodzi imawakhudza, ndipo inayo, imapangitsa kuti insulin iwonjezeke. Kuti musunge chizolowezi chakhansa, muyenera kuchita mpaka malire.

Matenda samadziwika nthawi zonse ngakhale mwa kusanthula. Mu odwala oterowo, kuchuluka kwa shuga m'magazi ndi matupi a ketone mumkodzo nthawi zambiri.

Nthawi zina, mukamamwa mankhwala a glucocorticosteroid, shuga amachulukirachulukira, omwe m'mbuyomu sanafotokozere bwino. Pankhaniyi, kuwonongeka kwakuthwa kwa matendawa kumatheka mpaka kukomoka. Chifukwa chake, ndikofunika kuyang'ana kuchuluka kwa glucose musanayambe mankhwala a steroid. Malangizowa akulangizidwa kuti azitsatira anthu onenepa kwambiri, mavuto okhala ndi kuthamanga kwa magazi. Odwala onse a zaka zopuma pantchito ayeneranso kufufuzidwa.

Ngati pakanalibe mavuto ndi metabolism m'mbuyomu, ndipo njira ya chithandizo cha steroid sichikhala yayitali, ndiye kuti wodwalayo sangadziwe za matenda a shuga. Mukamaliza kulandira chithandizo, kagayidwe kamabwerera mwakale.

Njira zamankhwala othandizira

Kuti mumvetsetse momwe chithandizo cha matendawa chimachitikira, chidziwitso pa zamomwe zimapangidwira momwe thupi limagwiritsire ntchito. Ngati zosinthazo zidayambitsidwa ndi hyperproduction ya glucocorticosteroids, ndiye kuti chithandizo chamankhwala ndicholinga chochepetsera chiwerengero chawo. Ndikofunikira kuthetsa zomwe zimayambitsa matenda ashuwarawa komanso. Chifukwa cha izi, mankhwala omwe kale adagwiritsa ntchito corticosteroid, zodzetsa pakamwa komanso njira zakulera pakamwa zimathetsedwa.

Nthawi zina ngakhale kuchitidwa opaleshoni kumafunika. Opaleshoni amachotsa minofu yambiri ya adrenal. Kuchita uku kumakupatsani mwayi wochepetsa kuchuluka kwa glucocotricosteroids m'thupi ndi kusintha momwe odwala alili.

Endocrinologists amatha kupereka mankhwala othandizira kutsitsa shuga. Nthawi zina kukonzekera sulfonylurea ndi mankhwala. Koma poyerekeza zakumbuyo kwawo, chakudya chopatsa mphamvu cha thupi chimatha kuchuluka. Thupi siligwira ntchito popanda kukondoweza.

Ngati matenda a shuga a steroid apezeka mwanjira yosavomerezeka, njira yayikulu yothandizira ndikuchotsa mankhwalawa omwe adayambitsa matendawa, kudya komanso. Kutengera ndi malingaliro awa, mkhalidwewo ungasinthidwe posachedwa.

Zomwe zimapangitsa kuti shuga achulukane zimatha kukhala zochulukirapo kwa nthawi yayitali m'madzi. Pankhaniyi, kupezeka kwa matenda a shuga a steroid amapangidwa. Nthawi zambiri, kusowa bwino kwa mankhwalawa kumachitika chifukwa cha mankhwalawa, koma kungakhale kuphatikizanso kwa matenda omwe amachititsa kuti mahomoni azitha kutulutsa.Nthawi zambiri, kusintha kwa zamankhwala mu kagayidwe kazakudya kumatha kusintha, pambuyo pochotsa mankhwala kapena kukonza matendawo, amatha, koma nthawi zina amatha kulimbikira atalandira chithandizo.

Ndikofunikira kudziwa! Nkhani yatsopano yomwe ikulangizidwa ndi ma endocrinologists a Kuwunika Kwachisawawa Kokulu! Ndi zofunika tsiku lililonse.

Ma steroid owopsa kwambiri kwa anthu omwe ali ndi matenda ashuga a 2. Malinga ndi ziwerengero, 60% ya odwala amayenera kusintha m'malo mwa hypoglycemic.

Matenda a Steroid - ndi chiyani?

Steroidal kapena mankhwala a shuga ndi matenda omwe amabweretsa. Cholinga chake ndi zotsatira zoyipa zamahomoni a glucocorticoid, omwe amagwiritsidwa ntchito kwambiri munthambi zonse zamankhwala. Amachepetsa ntchito ya chitetezo chathupi, amakhala ndi zotsutsa-zotupa. Glucocorticosteroids akuphatikiza Hydrocortisone, Dexamethasone, Betamethasone, Prednisolone.

Posachedwa, osaposa masiku 5, chithandizo cha mankhwalawa chimaperekedwa kwa matenda:

Mahomoni ofunikira a shuga amasungunuka ndi insulin

Kwa nthawi yoyamba, insulin idalembedwa ndi Elizabeth Hughes ngati dokotala Bunting mu 1922 pochiza matenda a shuga a mtundu woyamba. Kwa pafupifupi zaka zana limodzi, insulini yakhala mankhwala othandiza kwambiri posamalira odwala. Munali mu 1922 pomwe insulin yosungunulira inapangidwa. Amabayidwa pansi pakhungu, kulowa m'mitsempha kapena m'misempha. Mbali yake yosiyanitsa ndi njira ziwiri zomalizira. Awa ndiwo mankhwala okhawo omwe angagwiritsidwe ntchito motere. Insulin ya soluble imayamba pakadutsa mphindi 15 mpaka 30, imatenga maola 6 mpaka 8.

Insulin glargine

Awa ndi mankhwala omwe atenga nthawi yayitali (akupezeka monga yankho lomveka bwino). Imayang'aniridwa pang'onopang'ono, pambuyo pake microprecipitate imapangidwa pamalo opangira jekeseni. Zochita za mankhwalawa zimachitika maola 1.5 atatha kutsata, ndipo zimatha tsiku limodzi. Dziwani kuti kuphatikiza kwake m'magazi sikusintha kwambiri, koma mawonekedwe amtunda. Ngati tifanizira kuchuluka kwa glargine, omwe ali ndi mitundu ya insulin yokhala ndi mphamvu yayitali, ndiye kuti akufanana ndi kuteteza kwa insulin.

Zosakaniza zamitundu mitundu zamankhwala

Mankhwala ena amakhala ophatikizana. Mawonekedwe awo amasulidwe: Mbale, ma cartridge - a zolembera zapadera za syringe. Ndiwo omwe amapezeka kwambiri pakumwa mankhwala osokoneza bongo. Ndiwothandiza kwambiri kwa anthu omwe ali ndi vuto lowona.

Matenda a shuga a Steroid ndi matenda oopsa, omwe ndi dzina lawo lina - matenda ashuga a shuga a mtundu woyamba. Matendawa amafunika kukhala ndi chidwi chachikulu ndi wodwalayo. Matenda a shuga amtunduwu amayamba chifukwa cha kugwiritsidwa ntchito kwa nthawi yayitali kwa mankhwala ena a mahomoni, motero amadziwika kuti matenda osokoneza bongo.

Ndani amakhudzidwa?

Matenda a shuga a sodiumid amatanthauza matenda omwe amapezeka m'chilengedwe. Ndiye kuti, sizimakhudzana ndi mavuto mu kapamba. Odwala omwe ali ndi vuto lodana ndi kagayidwe kazakudya, koma akhala akugwiritsa ntchito glucocorticoids (mahomoni opangidwa ndi ma adrenal gland) kwa nthawi yayitali, amatha kudwala matenda a shuga a steroid, omwe ndi ofatsa.

Kuwonetsedwa kwa matendawa kumatha munthu atasiya kumwa mankhwala a mahomoni. Mu 60 peresenti ya odwala omwe ali ndi matenda a shuga a 2, matendawa amabwera chifukwa chakuti odwala amasintha kupita ku insulin. Kuphatikiza apo, matenda a shuga amatha kukhala ngati vuto la matenda omwe munthu amawonjezera kupanga kwa mahomoni mu adrenal cortex, mwachitsanzo, hypercorticism.

Ndi mankhwala ati omwe angayambitse matenda ashuga?

Zomwe zimayambitsa matenda a shuga a steroid zimatha kukhala kugwiritsidwa ntchito kwa nthawi yayitali kwa mankhwala a glucocorticoid, omwe akuphatikizapo Dexamethasone, Prednisolone, ndi Hydrocortisone. Mankhwalawa ndi mankhwala othana ndi kutupa omwe amathandizira kuchiritsa mphumu ya bronchial, nyamakazi, komanso matenda ena a autoimmune, omwe amaphatikizapo pemphigus, lupus erythematosus, ndi eczema. Komanso mankhwalawa amagwiritsidwa ntchito pochiza matenda oopsa a m'mitsempha ngati ziwongo zambiri.

Kuphatikiza apo, matenda osokoneza bongo amatha kuchitika chifukwa chogwiritsa ntchito mapiritsi oletsa kubereka a mahomoni, komanso ma thiazide diuretics, omwe ndi okodzetsa. Mankhwalawa ndi monga Dichlothiazide, Hypothiazide, Nephrix, Navidrex.

Zina zomwe zimayambitsa matendawa

Matenda a Steroid amathanso kuchitika mwa anthu atabadwa impso. Anti-kutupa chithandizo pambuyo pamafunika kugwiritsa ntchito nthawi yayitali corticosteroids mu milingo yayikulu, kotero odwala ayenera kumwa mankhwala osokoneza bongo kuti athetse chitetezo chokwanira. Komabe, matenda a shuga a steroid samapezeka mwa odwala onse omwe amachitidwa opaleshoni yamphamvu kwambiri, koma mwayiwu ndiwokwera kwambiri chifukwa chogwiritsa ntchito mahomoni kuposa momwe amathandizira matenda ena.

Ngati munthu wakhala akugwiritsa ntchito mankhwala a steroid kwa nthawi yayitali ndipo ali ndi zizindikiro za matenda ashuga, izi zikuwonetsa kuti wodwalayo ali pachiwopsezo. Popewa matenda a shuga a steroid, anthu onenepa kwambiri ayenera kuchepetsa thupi ndi kusintha moyo wawo, kuchita zolimbitsa thupi zopepuka. Ngati munthu ali ndi matenda, amakhala oletsedwa kutenga mahomoni kutengera zomwe adazilingalira.

Kutanthauzira kwake kwamatenda

Matenda osokoneza bongo amadziwika chifukwa amaphatikiza zizindikilo za mitundu yonse iwiri ya matenda ashuga. Kumayambiriro koyambirira kwa matendawa, corticosteroids ambiri amayamba kuwononga maselo a beta omwe amapezeka m'matumbo. Zizindikiro zoterezi ndizofanana ndi matenda ashuga 1. Ngakhale izi, insulin m'maselo a beta ikupitilirabe kubayidwa. Pakapita kanthawi, misempha ya insulin imayamba kutsika, ndipo minofu yake imayamba kuchepa mphamvu iyi. Zizindikirozi ndizodziwika ndi matenda amtundu wa 2. Pakapita nthawi, ma cell a beta amayamba kuwonongeka. Zotsatira zake, kupanga insulin kumayima. Matenda a shuga omwe amadalira insulin a mtundu woyamba amakhalanso chimodzimodzi.

Zizindikiro

Zizindikiro za matenda a shuga a steroid ndi ofanana ndi mitundu ina ya matenda ashuga. Munthu amadwala kwambiri komanso amakonda kukodza pafupipafupi, amavutika ndi ludzu, ndipo kumva kutopa kumawonekera mwachangu kwambiri. Zizindikiro zotere za matendawa nthawi zambiri zimakhala zofatsa kwa odwala, motero samazilabadira. Mosiyana ndi matenda amtundu wa 1 shuga, odwala sataya thupi mwadzidzidzi. Madokotala samazindikira nthawi zonse matenda a shuga ngakhale wodwala atakayezetsa magazi. Kuchuluka kwa shuga mu mkodzo ndi magazi ndizosowa kwambiri. Kuphatikiza apo, ziwerengero za acetone mu kusanthula kwa odwala zimapezekanso pazochitika zokhazokha.

Momwe mungachiritsire ngati insulin ipangidwa

Kupanga kwa insulin komwe kumayima m'thupi la munthu, matenda a shuga a steroid amafanana ndi matenda amtundu woyamba, ngakhale ali ndi mawonekedwe a wachiwiri (minofu insulin). Matendawa amathandizidwa monga momwe amachitira shuga 2. Inde, zonse zimatengera mtundu wamatenda omwe wodwala amakhala nawo. Ngati wodwala ali ndi mavuto olemera, koma insulin ikupitilizidwa, ndiye kuti ayenera kutsatira zakudya komanso kugwiritsa ntchito mankhwala ochepetsa shuga, mwachitsanzo, Thiazolidinedione kapena Glucofage.

Zikondazo zikayamba kugwira ntchito kwambiri, timalimbikitsidwa kubaya insulin, yomwe ingathandize kuchepetsa mtolo pa chiwalocho.Ngati ma cell a beta sanatheretu, ndiye pakapita nthawi, kapamba amabwerera mwakale. Pa ntchito yomweyi, madokotala amapatsa odwala zakudya zamagulu ochepa. Odwala omwe alibe mavuto onenepa kwambiri ayenera kutsatira zakudya No. 9. Kwa iwo onenepa kwambiri, madokotala amalimbikitsa kudya No. 8.

Mawonekedwe a chithandizo pamene insulin siyipangidwa

Chithandizo cha matenda a shuga a steroid zimatengera ngati pancreatic insulin imapangidwa kapena ayi. Ngati mahomoniwa asiya kupangidwa m'thupi la wodwalayo, ndiye kuti amawayika ngati jakisoni. Kuti mankhwalawa akhale othandiza, wodwala ayenera kuphunzira momwe angapangire jakisoni wa insulin. Magazi a shuga amayenera kuyang'aniridwa nthawi zonse. Chithandizo cha matenda a shuga chimapitirira monga momwe zimakhalira ndi matenda ashuga 1. Koma ma cell a beta samabwezedwanso.

Zomwe sizili muyezo

Pali milandu ina yomwe munthu amathandizidwa ndi matenda a shuga a steroid, mwachitsanzo, ngati ali ndi mphumu kwambiri kapena atachitidwa opaleshoni ya impso. Zikatero, chithandizo chamankhwala cha mahomoni ndichofunikira, ngakhale kuti wodwalayo amadwala matenda a shuga. Miyezo ya shuga imayenera kusamalidwa potengera momwe kapamba amagwirira ntchito bwino. Kuphatikiza apo, akatswiri amatenga chidwi cha minyewa ya insulin. Muzochitika izi, odwala amapatsidwa mahomoni a anabolic, omwe amawonjezera othandizira thupi, komanso amawongolera mphamvu ya glucocorticoids.

Zowopsa

Munthu amakhala ndi kuchuluka kwa mahomoni a adrenal, omwe amasiyanasiyana mosiyanasiyana mu iliyonse. Koma si anthu onse omwe amamwa glucocorticoids omwe ali pachiwopsezo cha matenda ashuga. Corticosteroids imakhudza magwiridwe antchito a kapamba, kuchepetsa mphamvu ya insulin. Pofuna kukhalabe ndi shuga mu magazi, kapamba amayenera kulimbana ndi katundu wolemera. Ngati wodwalayo ali ndi zizindikiro za matenda a shuga a steroid, izi zikutanthauza kuti minofu yake yayamba kuchepa kwambiri ndi insulin, ndipo zimavuta kuti gland igwire ntchito yake.

Chiwopsezo chokhala ndi matenda a shuga chimachulukitsa munthu akakhala ndi vuto lolemera, amamwa mankhwala a steroid mumadontho akulu kapena kwa nthawi yayitali. Popeza zizindikiro za matendawa sizimawoneka posachedwa, anthu okalamba kapena onenepa kwambiri ayenera kupimidwa kuti apezeke ngati ali ndi mtundu wina wa matenda ashuga asanayambe chithandizo cha mahomoni, popeza kumwa mankhwala ena kumatha kudzetsa matendawa.

Steroid shuga mellitus amatchedwanso sekondaleti yodalira matenda a shuga 1. Amawoneka chifukwa cha kuchuluka kwa corticosteroids (mahomoni a adrenal cortex) m'magazi kwa nthawi yayitali.

Zimachitika kuti matenda a shuga a steroid amayamba chifukwa cha zovuta za matenda momwe kuchuluka kwa mahomoni, mwachitsanzo, ndi matenda a Itsenko-Cushing.

Komabe, nthawi zambiri matendawa amapezeka pambuyo poti athandizidwe kwa nthawi yayitali ndi mankhwala ena a mahomoni, chifukwa chake, dzina limodzi la matendawa ndi matenda osokoneza bongo.

Mtundu wa shuga wa matenda a shuga, omwe adachokera, ndi wa gulu la extrapancreatic matenda, poyambirira sizigwirizana ndi zovuta zapancreatic.

Mwa anthu omwe alibe kusokonezeka kwa kagayidwe kazakudya nthawi yambiri ya glucocorticoids, amapezeka wofatsa ndipo amachoka atachotsedwa. Pafupifupi 60% ya odwala, a 2 matenda a shuga amakhumudwitsa mtundu wa matenda omwe amayimira insulin popanda wodwala.

Mankhwala a shuga a Steroid

Mankhwala a Glucocorticoid, monga dexamethasone, prednisone ndi hydrocortisone, amagwiritsidwa ntchito ngati mankhwala othana ndi kutupa a:

Mphumu ya bronchial,
Rheumatoid nyamakazi,
Matenda a Autoimmune: pemphigus, eczema, lupus erythematosus.
Multiple Sclerosis.

Matenda a shuga amatha kupezeka ndi ma diuretics:

thiazide diuretics: dichlothiazide, hypothiazide, nephrix, Navidrex,
mapiritsi olembera.

Mlingo waukulu wa corticosteroids amagwiritsidwanso ntchito ngati gawo la anti-yotupa pakumachiza opaleshoni impso.

Pambuyo Thirani, odwala ayenera ndalama kupondereza chitetezo chokwanira moyo. Anthu oterewa amakhala ndi vuto lotupa, lomwe poyambirira limawopseza chofunikira chogwiridwayo.

Matenda a shuga samapangidwa mwa odwala onse, komabe, pogwiritsa ntchito mahomoni mosalekeza, mwayi womwe umapezeka ndiwambiri kuposa momwe amathandizira matenda ena.

Zizindikiro za matenda ashuga omwe amayamba chifukwa cha ma steroid amawonetsa kuti anthu ali pachiwopsezo.

Pofuna kuti asadwale, anthu onenepa kwambiri ayenera kuchepetsa thupi, omwe ali ndi kunenepa kwambiri amafunika kuchita masewera olimbitsa thupi, ndikusintha kadyedwe kake.

Munthu akazindikira kuti ali ndi vuto la matenda ashuga, musalole kumwa mankhwala a mahomoni molingana ndi malingaliro anu.

Zolemba za matendawa ndi zizindikiro zake

Matenda a Steroid ndi apadera chifukwa amaphatikiza zizindikiro za matenda amitundu iwiri komanso matenda ashuga a 1. Matendawa amayamba pomwe chiwerengero chachikulu cha corticosteroids chimayamba kuwononga maselo a pancreatic beta.

Izi ndizogwirizana ndi zomwe zimayambitsa matenda a shuga 1. Komabe, maselo a beta akupitiliza kupanga insulini kwakanthawi.

Pambuyo pake, kuchuluka kwa insulini kumachepa, chidwi cha minofu ya timadzi timeneti timawonongeka, chomwe chimachitika ndi matenda ashuga 2.

Popita nthawi, maselo a beta kapena ena aiwo amawonongeka, zomwe zimapangitsa kuti ayambe kupanga insulin. Chifukwa chake, matendawa amayamba kuyenda chimodzimodzi ndi matenda amisomali omwe amadalira insulin 1. Kuonetsa zizindikiro zomwezo.

Zizindikiro zazikulu za matenda a shuga ndizofanana ndi mtundu uliwonse wa matenda ashuga:

Kuchulukitsa pokodza
W ludzu
Kutopa

Nthawi zambiri, zizindikiro zomwe zalembedwazo sizikuwonetsa zambiri, motero sizimalabadiridwa. Odwala sataya kulemera kwakukulu, monga mu mtundu 1 wa shuga, kuyezetsa magazi sikumapangitsa kuti azindikire.

Kuchuluka kwa shuga m'magazi ndi mkodzo sikumakwera kwambiri modabwitsa. Kuphatikiza apo, kupezeka kwa kuchuluka kwa ma acetone m'magazi kapena mkodzo sikumawonedwa kawirikawiri.

Matenda a shuga monga chiopsezo cha matenda a shuga

Kuchuluka kwa mahomoni a adrenal kumawonjezeka mwa anthu onse mosiyanasiyana. Komabe sianthu onse omwe amamwa glucocorticoids omwe ali ndi matenda a shuga.

Chowonadi ndi chakuti, kumbali inayo, corticosteroids amachitapo kanthu kapamba, ndipo, amachepetsa mphamvu ya insulin. Kuti magazi a shuga azikhala abwinobwino, kapamba amakakamizidwa kugwira ntchito akulemera kwambiri.

Ngati munthu ali ndi matenda ashuga, ndiye kuti minyewa ya insulin imayamba kuchepetsedwa, ndipo zodukazo sizigwira ntchito 100%. Chithandizo cha steroid chikuyenera kuchitidwa ngati chomaliza. Chiwopsezo chikuwonjezereka ndi:

kugwiritsidwa ntchito kwa ma steroid mu Mlingo wambiri,
Kugwiritsa ntchito ma steroid nthawi yayitali,
wodwala wonenepa kwambiri.

Chisamaliro chikuyenera kuchitika popanga zisankho ndi omwe nthawi zina amakhala ndi shuga wambiri pazifukwa zosadziwika.

Kugwiritsa ntchito glucocorticoids, mawonekedwe a shuga amawonjezereka, ndipo izi zimadabwitsa munthu, chifukwa sakanatha kudziwa za matenda ake a shuga.

Pankhaniyi, matenda a shuga anali ofatsa asanatenge glucocorticoids, zomwe zikutanthauza kuti mankhwala a mahomoni oterewa amatha kuchulukitsa vutoli ndipo amathanso kuyambitsa vuto longa.

Asanapange mankhwala a mahomoni, anthu achikulire ndi amayi onenepa kwambiri amafunika kukayezetsa matenda ashuga am'mbuyomu.

Chithandizo cha matenda ashuga

Ngati thupi silipanga insulin, ndiye kuti matenda osokoneza bongo, ngati matenda amtundu 1, koma ali ndi mawonekedwe a shuga 2, ndiye kuti, insulin kukana minofu. Matenda a shuga oterewa amathandizidwa ngati shuga 2.

Chithandizo chimadalira zina mwa zinthu zomwe wodwala ali nazo. Mwachitsanzo, kwa anthu onenepa kwambiri omwe amapangabe insulin, zakudya ndi zochepetsa shuga monga thiazolidinedione ndi glucophage zimasonyezedwa. Kuphatikiza:

Ngati pali ntchito ya pancreatic yotsika, ndiye kuti kuyambitsa insulini kumamupatsa mwayi wochepetsa katundu.
Pankhani yakusakwanira kwa ma cell a beta, pakapita nthawi, ntchito ya pancreatic imayamba kuchira.
Ndi cholinga chomwecho, zakudya zamafuta ochepa zimayikidwa.
Kwa anthu omwe ali ndi thupi lolemera, chakudya No. 9 chikulimbikitsidwa; anthu onenepa kwambiri ayenera kutsatira zakudya No. 8.

Ngati kapamba satulutsa insulin, ndiye kuti imayikidwa ndi jakisoni ndipo wodwalayo afunika kudziwa. Kuwongolera shuga ndi magazi kumachitidwa chimodzimodzi ndi shuga 1. Komanso, ma cell a beta sangabwezeretsedwe.

Mlandu wosiyana ndi chithandizo cha matenda osokoneza bongo omwe amayamba chifukwa cha mankhwala ndi zomwe zimachitika ngati nkotheka kukana chithandizo cha mahomoni, koma munthu amadwala matenda a shuga. Izi zitha kukhala pambuyo pakupatsirana impso kapena pakakhala mphumo waukulu.

Mlingo wa shuga umasungidwa pano, potengera chitetezo cha kapamba komanso kuchuluka kwa minyewa yomwe imakhudzidwa ndi insulin.

Monga chithandizo chowonjezereka, odwala amatha kutumizidwa mahomoni a anabolic omwe amayang'anira zotsatira za mahomoni a glucocorticoid.

Matenda a shuga amayamba kudutsa fomu yachiwiri ya steroid, pomwe wodwalayo sangachite popanda insulini. Zizindikiro zimatha kusiyanasiyana ndi matenda omwe amayambitsidwa. Kuchita mopitirira muyeso, kufooka, komanso thanzi labwino kumawonedwa. Timaganizira mwatsatanetsatane m'nkhaniyi.

Kodi matenda a shuga ndi otani?

Steroid matenda a shuga ndi mtundu wa matenda a shuga omwe ali ndi mawonekedwe achiwiri. Matenda amapezeka pamene ntchito ya impso imalephera, ndipo mahomoni a adrenal cortex amasungidwa kwambiri. Matenda a shuga amtunduwu amayamba chifukwa cha kugwiritsa ntchito nthawi yayitali mankhwala a mahomoni.

Mankhwala a shuga a Steroid

Mankhwala a Hormonal omwe amadziwika kuti amathandizira odwala matenda ashuga amathandizanso kuvutikira kwa metabolic, makamaka kuphatikiza mapuloteni. Mankhwala Ofunika - iyi ndi Prednisolone, Dexamethasone, yokhudzana ndi gulu la mahomoni, komanso Hypothiazide, Navidrex, Dichlothiazide - awa ndi okodzetsa.

Kugwiritsa ntchito mankhwalawa kumathandizira odwala omwe ali ndi matenda osokoneza bongo omwe ali mu mawonekedwe oyamba kukhalabe ndi shuga m'magazi komanso amachotsa madzi owonjezera mthupi. Nthawi yomweyo, kugwiritsa ntchito kwawo nthawi yayitali kumatha kuyambitsa mawonekedwe achiwiri - matenda a shuga. Poterepa, wodwalayo sangathe popanda insulin. Pangozi ndi anthu onenepa kwambiri, komanso othamanga omwe amagwiritsa ntchito mankhwala a steroid kuti achulukitse minofu.

Pali mankhwala ena omwe amathandizira kuti pakhale shuga yachiwiri: kulera, mankhwala okodzetsa ndi mankhwala omwe amaperekedwa chifukwa cha mphumu, kuthamanga kwa magazi ndi arthrosis.

Mukamapereka mankhwala a mahomoni, muyenera kukhala akhama pantchito kuti mupewe kuchitika kwambiri. Chithandizo chiyenera kuyang'aniridwa mosamala ndi adokotala.

Zizindikiro za Steroid Diabetes

Matenda a shuga atangolowa mu mawonekedwe a steroid, wodwalayo amayamba kumva kufooka kwambiri, kugwira ntchito mopitirira muyeso komanso osadutsa wathanzi. Zizindikiro Khalidwe lakale la shuga - ludzu losatha ndi kununkhira kwa acetone kuchokera mkamwa - ndizofooka kwambiri. Choopsa ndichakuti Zizindikiro zotere zimatha kudwala matenda aliwonse. Chifukwa chake, ngati wodwalayo sapangana ndi dokotala munthawi yake, matendawa amasintha kukhala mtundu waukulu wa matenda a shuga a steroid, omwe amaphatikizidwa ndi pafupipafupi. Kufunika kwa insulin kukukulira.

Ngati matenda a shuga a steroid amapezeka pa chithandizo cha matenda monga mphumu, matenda oopsa, arthrosis ndi ena, wodwalayo amamva pakamwa pouma, kukoka pafupipafupi, kuwonda kwambiri.

Nthawi zina, abambo amayamba kukhala ndi mavuto azikhalidwe zakugonana, mwa akazi - matenda opatsirana mwa ziwalo zoberekera.

Odwala ena ali ndi vuto lodana ndi masomphenya, kumva kuwawa ndi kutalika kwa miyendo, kumverera kwachilendo kwanjala.

Ngati mukumva kufooka kosalekeza komanso kutopa msanga, ndibwino kumayeseza mkodzo ndikuwunika magazi. Monga lamulo, mulingo wa glucose mwa iwo ndi kuyambika kwa matenda ashuga yachiwiri umachuluka kwambiri ndipo umapitilira miyambo yovomerezeka.

Kuzindikira ndi kuchiza matenda a shuga a steroid

Chifukwa chakuti zizindikiro za matenda a shuga a steroid ndi ofanana ndi zizindikiro za matenda ena aliwonse, zimatha kupezeka ndi zotsatira za kuyesa kwamkodzo ndi magazi a shuga. Ngati shuga mkati mwawo amaposa 11 mmol, ndiye kuti iyi ndi njira yachiwiri ya matenda ashuga.

Kuphatikiza apo, endocrinologist amasankha kuyesa impso ndi adrenal glands. Chowonadi cha kumwa mankhwala a mahomoni ndi diuretic chimawerengedwa.

Kutengera zinthu izi, chithandizo chamankhwala chimayikidwa kuti chichepetse shuga komanso kuchepetsa matenda a impso.

Mankhwala amatengera zovuta za matendawa. M'masiku oyambilira, wodwalayo amatha kudwala zakudya zoyenera komanso mankhwala. M'malo osasamalidwa, kuchitapo kanthu kwa opaleshoni kumafunika.

Njira zazikulu zochizira matenda a shuga a steroid:

Kuthana ndi mankhwala omwe amakhumudwitsa kupezeka kwa matendawa.
Chakudya cholimba. Wodwala amangodya zakudya zamagulu ochepa.
Kusintha ntchito za kapamba ndikukhazikika m'magazi a shuga, ma jakisoni a insulin ndi omwe amapatsidwa (onani komanso momwe angabayire insulin molondola).
Mankhwala ena omwe amachepetsa shuga amathandizidwanso.

Insulin imayikidwa pokhapokha ngati mankhwala ena sangapereke zofunika pakukhazikitsa shuga. Kumwa jakisoni kumalepheretsa zovuta za matenda a shuga a steroid.

Nthawi zina, wodwala amafunikira opaleshoni . Opaleshoniyo akhoza kukhala ndi cholinga chochotsa adrenal cortex kapena minyewa yambiri, ma neoplasms osiyanasiyana. Nthawi zina ma tezi a adrenal amachotsedwa kwathunthu. Kuchita koteroko kumatha kuchepetsa matendawa, ndipo nthawi zina msuzi wa shuga umabwezeretsedwa.

Koma pali zovuta. Pambuyo pakuchita opaleshoni, njira za metabolic m'thupi zimaphwanyidwa, ntchito ya impso imabwezeretsedwa kwa nthawi yayitali. Zonsezi zimatha kuyambitsa zovuta zingapo mthupi. Motere, kulowererapo kwa opaleshoni kumagwiritsidwa ntchito kawirikawiri.

Kupewa matenda a shuga a Steroid

Pazolinga zopewera, kuti musakhale ndi matenda ashuga a steroid, muyenera kutsatira zakudya zama carb ochepa . Izi ndizowonetsa kwambiri kwa odwala matenda ashuga komanso omwe angatenge odwala.

Ngati mumagwiritsa ntchito mankhwala a mahomoni pochiza matenda ena, muyenera kuchita masewera olimbitsa thupi pafupipafupi. Kupanda kutero, pamakhala chiopsezo cha kuchuluka kwambiri kwa thupi, zomwe zimapangitsa kuchuluka kwa shuga mthupi. Ngati mukumva kutopa kosalekeza, kuchepa kwa ntchito, muyenera kufunsira upangiri wa akatswiri.

Mtundu wa insulin wa matenda a shugaidi umachiritsidwa kwathunthu muzochitika zina. Ndikofunika kumvetsetsa kuti matendawa sakuyenera kuthamanga.Kulumikizana ndi akatswiri panthawi yake kungakuthandizeni kupewa zoyipa. Kudzidziwitsa nokha sikofunika. Chithandizo chake chimatengera zisonyezo ndi machitidwe a thupi.

Matenda a shuga ndi kupsinjika kudzakhala chinthu chakale

Matenda a shuga ndi omwe amayambitsa pafupifupi 80% yonse yamikwingwirima ndi kuduladula. Anthu 7 mwa anthu 10 amafa chifukwa cha mitsempha ya mtima kapena ubongo. Pafupifupi nthawi zonse, chifukwa chomaliza chomaliza ndi chimodzimodzi - shuga wamwazi.

Shuga akhoza ndipo amayenera kugwetsedwa, apo ayi. Koma izi sizichiritsa matendawa, koma zimangothandiza kulimbana ndi kufufuza, osati zomwe zimayambitsa matendawa.

Mankhwala okhawo omwe amalimbikitsidwa moyenera pochiza matenda ashuga komanso amagwiritsidwa ntchito ndi ma endocrinologists pantchito yawo ndi awa.

Kugwiritsa ntchito bwino kwa mankhwalawa, kuwerengera malinga ndi njira yokhazikika (kuchuluka kwa odwala omwe achiwonjezere kuchuluka kwa odwala omwe ali pagulu la anthu 100 omwe adachitiridwa chithandizo):

Matenda a shuga - 95%
Kuthetsa kwa mitsempha thrombosis - 70%
Kuthetsa kwa kugunda kwamtima kwamphamvu - 90%
Kuthana ndi kuthamanga kwa magazi - 92%
Kulimbitsa tsiku, kukonza kugona usiku - 97%

Opanga si bungwe lazamalonda ndipo amalipidwa ndi chithandizo cha boma. Chifukwa chake, tsopano wokhala aliyense ali ndi mwayi.

zotupa zoyipa
bakiteriya meningitis
COPD ndi matenda osatha a m'mapapo
gout mu pachimake siteji.

Kutalika kwa nthawi yayitali, kupitirira miyezi isanu ndi umodzi, mankhwala a steroid angagwiritsidwe ntchito pneumonia yapakati, matenda a autoimmune, kutupa kwamatumbo, zovuta zamkati, komanso kufalikira kwa ziwalo. Malinga ndi ziwerengero, kuchuluka kwa anthu odwala matenda ashuga atatha kugwiritsa ntchito mankhwalawa sikupitirira 25%. Mwachitsanzo, pochiza matenda am'mapapo, hyperglycemia imawonedwa mu 13%, mavuto a pakhungu - 23,5% ya odwala.

Chiwopsezo cha matenda a shuga a steroid chikuwonjezeka ndi:

cholowa m'tsogolo, achibale oyamba ndi matenda ashuga,
pa nthawi imodzi yokha yoyembekezera,
kunenepa kwambiri, makamaka pamimba
ovary polycystic,
ukalamba.

Mulingo waukulu wa mankhwala omwe amamwa, ndiwomwe umakhalapo ndi matenda a shuga a steroid:

Ngati wodwala musanafike ku mankhwala a steroid analibe matenda oyamba a metabolism, glycemia imakonda kuchitika patatha masiku atatu atachotsedwa. Kugwiritsa ntchito mankhwalawa kwa nthawi yayitali komanso kudziwikiratu matenda ashuga, hyperglycemia imatha kudwala, kufuna kudzikonzanso kwa moyo wonse.

Zizindikiro zofananazi zimawoneka kwa odwala omwe ali ndi vuto la kupanga mahomoni. Nthawi zambiri, matenda ashuga amayamba ndi matenda a Itsenko-Cushing, nthawi zambiri - ndi hyperthyroidism, pheochromocytoma, trauma kapena chotupa muubongo.

Mawonekedwe ndi zizindikiro za matenda a shuga

Odwala onse omwe amamwa ma steroid ayenera kudziwa zomwe zimayambitsa matenda ashuga:

- kuchuluka kukodza,
polydipsia - ludzu lamphamvu, pafupifupi osafooka mukamwa,
nembanemba youma, makamaka pakamwa,
khungu lakuthwa, losasamala
wotopa nthawi zonse, kuchepa kwa ntchito,
ndi kuchepa kwakukulu kwa insulin - kuchepa thupi kosalephera.

Ngati zizindikirozi zikuchitika, ndikofunikira kuzindikira matenda a shuga. Kuwunikira kwambiri pankhaniyi kumaganiziridwa. Nthawi zina, zimatha kuwonetsa kusintha kwa kagayidwe kazakudya mkati mwa maola 8 atatha kumwa ma steroids. Njira zoyesera ndizofanana ndi mitundu ina ya matenda ashuga: shuga kumapeto kwa kuyesedwa sikuyenera kukhala kwakukulu kuposa 7.8 mmol / l. Ndi kuchuluka kwa kuchuluka kwa magawo 11.1, titha kulankhula za kusokonezeka kwakukulu kwa metabolic, nthawi zambiri kosasinthika.

Doctor of Medical Science, Mutu wa Institute of Diabetesology - Tatyana Yakovleva

Ndakhala ndikuphunzira matenda a shuga kwa zaka zambiri. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsa odwala matenda ashuga mellitus. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 98%.

Nkhani ina yabwino: Unduna wa Zaumoyo wapanga kukhazikitsidwa komwe kumalipirira mtengo wokwera wa mankhwalawo. Ku Russia, odwala matenda ashuga mpaka Marichi 2 nditha kuipeza - Kwa ma ruble 147 okha!

Kunyumba, shuga ya shuga imatha kupezeka pogwiritsa ntchito glucometer, mulingo wapamwamba kwambiri 11 mutatha kudya chikusonyeza kuyambika kwa matendawa. Kuthamanga shuga kumakula pambuyo pake, ngati ndizopamwamba kuposa mayunitsi 6.1, muyenera kulumikizana ndi endocrinologist kuti mupeze zowonjezera ndi kulandira chithandizo.

Zizindikiro za matenda opha shuga a shuga sangakhalepo, chifukwa chake, ndichikhalidwe chake kuyendetsa shuga m'magawo awiri oyamba pambuyo pa kukhazikitsidwa kwa glucocorticoid. Pogwiritsa ntchito mankhwala kwa nthawi yayitali, mwachitsanzo, mutabadwa, kuyesedwa kumaperekedwa sabata iliyonse mwezi woyamba, kenako pambuyo pa miyezi itatu ndi miyezi isanu ndi umodzi, mosasamala kanthu za kukhalapo kwa zizindikiro.

Momwe mungachitire ndi matenda a shuga

Matenda a shuga a Steroid amachititsa kuchuluka kwa shuga atatha kudya. Usiku ndi m'mawa musanadye, glycemia ndiyachilendo kwa nthawi yoyamba. Chifukwa chake, chithandizo chomwe chikugwiritsidwa ntchito chiyenera kuchepetsa shuga masana, koma osayambitsa hypoglycemia yausiku.

Zochizira matenda a shuga, mankhwalawa omwe amagwiritsidwa ntchito ngati mitundu ina ya matendawa: othandizira a hypoglycemic ndi insulin. Ngati glycemia ali ochepera 15 mmol / l, chithandizo chimayamba ndi mankhwala omwe amagwiritsidwa ntchito ngati mtundu 2 wa shuga. Manambala ambiri a shuga amawonetsa kuwonongeka kwakukulu pancreatic ntchito, odwala oterewa amapatsidwa jakisoni wa insulin.

Mankhwala	Machitidwe
Metformin	Amasintha malingaliro a insulin, amachepetsa gluconeogeneis.
Zomwe zimachokera ku sulfanylureas - glyburide, glycoslide, repaglinide	Musatchule mankhwala a nthawi yayitali, kuwunika momwe zakudya zimafunikira.
Glitazones	Onjezerani zamphamvu za insulin.
Analogs a GLP-1 (enteroglucagon) - exenatide, liraglutide, lixisenatide	Zothandiza kwambiri kuposa ndi matenda a shuga a 2, onjezerani insulini mutatha kudya.
DPP-4 zoletsa - sitagliptin, saxagliptin, alogliptin	Chepetsani kuchuluka kwa shuga, kulimbikitsa kunenepa.
Mankhwala a insulin, kutengera mtundu wa insulini yawo yomwe, amasankha mtundu kapena mwambo	Insulin yochita pakati.

Zizindikiro za Steroid Diabetes

Monga taonera kale, matenda a shuga a sodium samadziwonetsa ngati zizindikiro zowopsa. Ludzu losagonjetseka ndi kuwonjezeka kwa mapangidwe amkodzo silingawonongeke, komanso kusinthasintha kwa glycemia. Nthawi zambiri matendawa amakhala okhazikika. Zizindikiro zomwe mtundu uwu wa shuga umawonera ndi: kufooka kwakukulu, kutopa kwambiri, komanso thanzi labwino. Koma Zizindikiro zofananira ndizodziwika bwino m'matenda ambiri. Mwachitsanzo, amatha kuwonetsa kuphwanya kwa kugwira ntchito kwa adrenal cortex.

Ndi steroid matenda a shuga, zizindikiro za ketoacidosis sikuwoneka. Nthawi zina, mumatha kununkhira acetone kuchokera mkamwa pamene matendawa atha kale. Nthawi zambiri, ma ketoni amapezeka mumkodzo. Kuphatikiza apo, nthawi zambiri pamakhala anti-insulin, chifukwa chovuta kuchita ndi chithandizo chamankhwala. Chifukwa chake, glycemia imakhazikitsidwa pogwiritsa ntchito zakudya zowonjezera komanso masewera olimbitsa thupi apadera.

Chithandizo cha matenda a shuga a steroid

Chithandizo chovuta cha matenda a shuga a steroid umalimbana ndi:

matenda a shuga
Kuchotsa kwa zomwe zidayambitsa kuchuluka kwa mahomoni mu adrenal cortex.

Nthawi zambiri pamakhala zochitika zomwe odwala sangathe kuchita popanda kuchita opaleshoni: mochuluka amachotsa minyewa yambiri m'magazi a adrenal.Kuchita koteroko kumatha kusintha matendawa pawokha, ndipo nthawi zina kumathandizanso shuga kukhala wabwinobwino. Makamaka ngati wodwalayo angatsatire chithandizo chamankhwala ndi zakudya, zomwe zimapangidwira cholesterol yambiri komanso kunenepa kwambiri.

Kulandira mankhwala kumaphatikizapo kumwa mankhwala omwe amachepetsa shuga ya magazi.

Pa gawo loyamba la mankhwalawa, sulfonylureas amalembedwa, koma amatha kuvutitsa kagayidwe kazakudya, kamene kamayambitsa matenda a shuga a sodium modell. Kuyan'anira kunenepa kwanu ndi gawo lofunikira la mankhwalawa chifukwa kunenepa kwambiri kumawonjezera matendawa ndikuwapanikiza mankhwalawo.

Choyamba, mankhwala omwe matendawa adayamba kudwala ayenera kutha. Nthawi zambiri, dokotala amasankha ma analogi osavulaza. Malinga ndi malangizo azachipatala, ndibwino kuphatikiza mapiritsi ndi jakisoni wa insulin. Chithandizo choterechi chimapatsa mwayi kubwezeretsa maselo a pancreatic omwe amachititsa kuti maselo a insulin apangidwe. Zitatha izi, matendawa amatha kuthana ndi vuto la kudya.

Steroid shuga mellitus ndimatenda omwe amayamba chifukwa chakutha kugwira bwino ntchito kwa adrenal cortex kapena kugwiritsa ntchito mankhwala osokoneza bongo kwa nthawi yayitali.

Choopsa chachikulu cha matenda a shuga a steroid ndi cha anthu omwe ali ndi chiyembekezo chokhala ndi matenda ashuga, tidzazindikira chomwe chimakhala, kaya ndi hypercorticism yolumikizidwa ndi izi, komanso zoyenera kuchita.

Matendawa amasokoneza kapamba, amawononga maselo amthupi ndikusokoneza kupanga kwachilengedwe kwa insulin. Pachifukwa ichi, shuga ya matenda a shuga imatchedwa sekondale yodalira matenda a shuga.

Pali zifukwa ziwiri zazikuluzikulu zomwe zimapangidwira shuga ya steroid:

Monga zovuta za matenda omwe amapangitsa kuchuluka kwama mahomoni a adrenal cortex, mwachitsanzo, matenda a Itsenko-Cushing,

Zotsatira zake zakukhazikika kwa mankhwala okhala ndi mahomoni.

Nthawi zambiri, chomwe chimayambitsa matenda a shuga a steroid ndi kugwiritsa ntchito mankhwala a mahomoni, chifukwa chake nthawi zina amatchedwa matenda osokoneza bongo. Matenda owopsa nthawi zambiri amakula limodzi ndi vuto lalitali ndi mankhwala a glucocorticoid monga:

Mankhwalawa nthawi zambiri amawagwiritsa ntchito kuti athane ndi matenda otupa komanso matenda othandizira odwala matenda amitsempha. Chifukwa chake, matenda a shuga a steroid nthawi zambiri amakhudza odwala omwe ali ndi matenda otsatirawa:

Mphumu ya bronchial,
Rheumatoid nyamakazi,
Matenda osiyanasiyana a autoimmune (pemphigus, eczema, lupus erythematosus),
Multiple sclerosis.

Kuphatikiza apo, kugwiritsidwa ntchito kwa ma diuretics ena kungakhudze kukula kwa matenda a shuga a steroid. Odziwika kwambiri pakati pawo ndi zida zotsatirazi:

Komanso, mtundu uwu wa shuga umapezeka kawirikawiri mwa amayi omwe agwiritsa ntchito njira zakulera za mahomoni kwa nthawi yayitali kuti ateteze pathupi osafunikira.

Kuphatikiza apo, anthu omwe anachitapo opaleshoni yopatsirana impso amakhalanso pachiwopsezo.

Kuti mudziwe momwe ma steroid ndi matenda a shuga amagwirizanirana, muyenera kumvetsetsa momwe mankhwala a mahomoni amachitikira m'thupi la munthu. Ndi kudya kwa nthawi yayitali ndalamazi, magazi a wodwalayo amasintha modabwitsa. Potere, mulingo wa corticosteroids mmenemo umachuluka kwambiri.

Ma sodiumids amakhudza maselo apachifungo, omwe amatsogolera pang'onopang'ono. Izi zimakhudza kuchuluka kwa insulini ya mahomoni m'thupi la wodwalayo, ndikuchepetsa pang'ono ndikuyambitsa kukula kwa matenda a shuga. Kuphatikiza apo, mahomoni a steroid amapangitsa kuti maselo amthupi asagwiritsidwe ntchito ndi insulin, zomwe zimasokoneza kagayidwe kazakudwala.

Chifukwa chake, zizindikiro za matenda a shuga a mitundu 1 ndi mtundu 2 amadziwika ndi matenda a shuga. Zotsatira zake, njira ya matendawa imatha kukhala yovuta kwambiri ndipo imabweretsa zovuta zazikulu.

Dziwani kuti matenda ashuga, omwe amayambitsidwa ndi ma steroid, amakula pang'onopang'ono ndipo matendawa akangoyamba matendawa sangathe kudziwonetsa. Zizindikiro zotsatirazi zikuwonetsa kupezeka kwa munthu wodwala matenda a shuga:

Ludzu lalikulu. Kuti muchepetse wodwala wake amamwa madzi ambiri,
Kutopa ndi kuchepa kwa magwiridwe antchito. Zimakhala zovuta kuti munthu achite zinthu wamba,
Kukodza pafupipafupi. Mukamayendera chimbudzi aliyense amadwala mkodzo,

Kuphatikiza apo, mosiyana ndi mtundu 1 ndi mtundu wa 2 wodwala matenda am'mimba, odwala omwe ali ndi mtundu wa matenda a steroid, kuchuluka kwa shuga m'magazi ndi mkodzo sikwaposa momwe zimakhalira. Zomwezo zimagwiranso ntchito pamlingo wa acetone, zomwe nthawi zambiri sizipitilira zovomerezeka. Izi zimasokoneza kwambiri kuzindikira matendawa.

Zomwe zimathandizira pakupanga matenda a shuga a steroid:

Njira yayitali ya chithandizo ndi corticosteroids,
Kukhazikika kwa mankhwala a mahomoni muyezo waukulu,
Kuchulukana pafupipafupi kwa shuga wamagazi pazifukwa zosadziwika,

Ndikofunika kutsindika kuti odwala ambiri omwe amamwa mankhwala a mahomoni amatha kukhala ndi matenda ashuga. Komabe, nthawi zambiri imayamba yokhala yofatsa ndipo imazimiririka ikamaliza maphunziro.

Mtundu wowopsa wa matendawa, monga ulamuliro, umawonedwa mwa anthu omwe ali ndi matenda ashuga kapena kale omwe ali ndi matenda. Anthu ambiri omwe ali ndi matenda ashuga samadziwa za matenda awo, popeza matendawa amapitilira m'njira yatsopano. Komabe, kutenga corticosteroids kumathandizira njira ya matendawa ndikuthandizira kukula.

Chinthu chinanso chomwe chikuthandizira kuti matenda a shuga a steroid ayambe kwambiri ndi onenepa, zomwe zimatsimikizira kuti zimalumikizana.

Anthu omwe ali ndi vuto la kunenepa kwambiri ayenera kumwa mankhwala a mahomoni mosamala kwambiri pokhapokha ngati dokotala akuwalimbikitsa.

Chithandizo cha matenda a shuga a steroid ziyenera kuchitika molingana ndi gawo la matendawa. Ngati chinsinsi cha insulini m'thupi chitathetsedwa, ndiye kuti kulimbana ndi matendawa kuyenera kuchitika chimodzimodzi ndi mtundu wa matenda ashuga 1.

Chithandizo cha matenda a shuga a insulin amadalira njira zotsatirazi:

Jakisoni wa insulin wa tsiku ndi tsiku
Kutsatira zakudya zochiritsika (ichi chingakhale chakudya chochepa kwambiri, koma chimalingana ndi anthu omwe ali ndi matenda a impso),
Zochita zolimbitsa thupi (kuyenda, kuthamanga, masewera olimbitsa thupi),

Kuphatikiza apo, kudya komanso kuchita masewera olimbitsa thupi ndizofunikira kwambiri kukonza mkhalidwe wa wodwalayo. Mankhwalawa amathandiza kukhala ndi shuga wabwinobwino.

Ndikofunikira kutsimikizira kuti shuga yodalira insulini ndi matenda osachiritsika, chifukwa ma cell a pancreatic b omwe anawonongedwa ndi corticosteroids sakubwezeretsedwanso.

Ngati kupanga kwa insulini sikunasokonezeke kwathunthu ndipo maselo a gland akupitiliza kupanga mahomoni, ndiye kuti wodwalayo amapanga shuga wosadalira insulini, womwe umafanana ndi matenda a shuga a 2.

Mankhwalawa amafuna:

Zakudya zamoto zochepa
Zochita zolimbitsa thupi
Kumwa mankhwala omwe amachititsa chidwi cha minyewa kupita ku insulin: Glucophage, Thiazolidinedione ndi Siofor,
Kunenepa kwambiri (ngati kuli)
Analoleza jakisoni wa insulin kuti asungitse zofunsirazo.

Ndi matenda amtunduwu a shuga, ntchito ya pancreatic imatha kuchira kwathunthu, zomwe zikutanthauza kuti shuga yosadalira insulini imachiritsidwa.

Matenda a shuga ndi matenda omwe amadziwika ndi shuga yayikulu. Cholinga cha izi ndikuchepa kwa kukhudzana ndi mahomoni - insulin.Imasungidwa ndi kapamba, kapena, mothandizidwa ndi maselo a beta a zisumbu za Langerhans zomwe zimakhalamo.

Maziko a chitukuko cha matendawa

Matenda osokoneza bongo amayamba motsogozedwa ndi zinthu zingapo. Izi zikuphatikiza:

Mankhwala osokoneza bongo ochulukirapo a glucocorticoid, omwe amachititsa kuti azindikire shuga wambiri wodwala wa sodium omwe saulula kuphwanya kagayidwe kazachilengedwe.
Kusintha kwa shuga wosadalira insulini kupita ku mawonekedwe ake omwe amadalira insulin.
Kusavomerezeka mu mahomoni kumbuyo chifukwa cha kuchepa kwa ntchito kwa hypothalamus ndi gland planditary ndikuchepetsa kukana kwa maselo ndi minofu yake ku insulin.
Dziwitsani matenda oopsa, omwe amawonetsa chithokomiro chamthupi komanso amachepetsa kukonza kwa monosaccharide ndi zimakhala mthupi la wodwalayo.
Kuzindikiritsa kusakhazikika pakati pamahomoni, chomwe chimakhala chifukwa chosagwirizana ndi zomwe thupi limapanga.
Kunenepa kwambiri kwa wodwala, komanso kuchuluka kwa hydrocortisone m'thupi - mahomoni opangidwa ndi adrenal cortex.

Njira yofatsa yamatenda, yomwe kukula kwake kumalumikizana ndi mankhwala osokoneza bongo a glucocorticoids, imatha kutha yokha itatha kumwa. Zinthu zoterezi zimapangitsa kuti pakhale tsogolo labwino la matenda a shuga a steroid, omwe amapezeka chifukwa cha kupatuka kwa mulingo wa monosaccharide m'magazi.

Kusamalira panthawi yake matendawa kumathetsa chiopsezo cha zovuta zomwe zimasokoneza thanzi komanso moyo wa wodwalayo.

Mankhwala ogwiritsa ntchito glucocorticoid wogwiritsidwa ntchito mopitirira muyeso, omwe amachititsa kuti shuga akhale ndi shuga, amakhala ndi anti-kutupa. Amalembedwa kuti athetse mavuto a nyamakazi, mphumu ya bronchial, angapo a autoimmune pathologies. Kuphatikiza pa glucocorticoids, matenda a shuga a steroid amatha chifukwa cha kugwiritsidwa ntchito kwa ma diuretics mu mawonekedwe a Nefriks, Navidrex, Hypothiazide, Dichlothiazide ndi mitundu yina ya mapiritsi oteteza kubereka kwa mahomoni.

Kuwonetsedwa kwa matendawa

Matenda a shuga a Steroid amaphatikiza zizindikiro za matenda amtundu 1 komanso matenda ashuga 2. Izi zikuphatikiza:

Maonekedwe a ludzu ndi kuyabwa kwa zinthu pamtunda wa khungu.
Pafupipafupi kukodza.
Kuphwanya kakhalidwe, kuchepa kwamphamvu yolimbitsa thupi, kuchititsa kutopa kwambiri, kutopa kwa wodwala.
Osowerengeka milandu kupeza kwambiri shuga, acetone m'magazi ndi mkodzo.
Kuchepetsa thupi.

Zizindikiro zazikulu za pathology sizosiyana mu chithunzi chotchulidwa. Amatuluka chifukwa cha kuwonongeka kwa ma β-maselo a ma islets a Langerhans amakondedwe ndi kuchuluka kwa corticosteroids. Mavuto a insulini m'thupi la wodwalayo amachepa, ndipo khungu lake limachepa. Zotsatira zake, chifukwa cha kuwonongeka kwa maselo a β-cell, kupanga kwa mahomoni a protein omwe amapangidwa ndi kapamba amayimitsidwa. Kukula kwa matendawa sikusiyana ndi mtundu wa matenda ashuga amtundu wa 1 ndipo kumawonetsa Zizindikiro zomwe zimayamba ndi matendawa.

Njira zothandiza kuti athetse matenda

Chithandizo chovuta kwambiri cha matenda a shuga amellitus ndi ofanana kwambiri ndi njira yothetsera vuto la matenda osagwirizana ndi insulin. Amasanjidwa payekhapayekha, mogwirizana ndi mawonekedwe a thupi la wodwalayo, zizindikiro za mulingo wa monosaccharide m'magazi ake. Matenda a Steroid amathandizidwa popanda zovuta zambiri. Kutsatira kwambiri malingaliro ndi upangiri wa endocrinologist ndiye njira yofunikira yopezera zotsatira zabwino. Chithandizocho chimaphatikizaponso njira zina zochizira. Izi zikuphatikiza:

Kuti mupewe zovuta zomwe zingakhale zowopsa pamoyo komanso thanzi la wodwalayo, ndikofunikira kuzindikira matendawa munthawi ndikuyamba chithandizo moyang'aniridwa ndi dokotala!

Gulu la zakudya zoyenera malinga ndi zakudya zamafuta ochepa.
Kumwa mankhwala ochepetsa shuga.
Kukhazikitsa insulin mankhwala popanda kuyembekezera hypoglycemic zotsatira za mapiritsi zotchulidwa kusintha matenda shuga.
Kudzudzula kwambiri.
Kuletsa kwa mankhwala malinga ndi corticosteroids omwe adayambitsa kukula kwa matenda.

Opaleshoni nthawi zina imatha kutumizidwa kuti ichotse minyewa yambiri m'magazi a adrenal ndikuchepetsa kupanga kwawo kwa corticosteroids.

Kuchiza matendawa kuli ndi zolinga zingapo. Pambuyo kukhazikitsa, ndikotheka kusintha mulingo wa monosaccharide, ndikuchotsanso zomwe zimapangitsa kuwonjezeka kwa kuchuluka kwa mahomoni opangidwa ndi adrenal cortex. Izi zimawonjezera mwayi wobwezeretsa ntchito za β-maselo a zilumba za Langerhans za kapamba, yemwe amachititsa kupanga insulin. Kutsatira malangizo a dokotala pazakudya zamafuta ochepa, moyo wokangalika, kusiya zizolowezi zoipa kumapereka mwayi wopeza zotsimikizika komanso kupatula kukula kwa zovuta za matenda ashuga.

Mavuto

Hyperglycemia yomwe imatenga nthawi yayitali imayambitsa matenda a shuga - kuwonongeka kwa ziwiya zazikulu ndi zazing'ono. Kusokonezeka kozungulira mu ma capillaries a retina kumawonetsedwa ndi kuchepa kwa masomphenya - matenda ashuga retinopathy. Ngati minyewa yolumikizana ndi impso ikuvutikira, ndiye kuti ntchito yake yosefaipa imakulirakulira, kutupa kumachitika, kuthamanga kwa magazi kumadzuka ndipo matenda a shuga amayamba. Zosintha m'matumbo akuluakulu zimayimiridwa ndi atherosulinosis. Zilonda zoopsa kwambiri zam'matumbo a mtima ndi m'munsi. Kusagwirizana kwa ma electrolyte komanso kusakwanira kwa magazi ku minyewa yamanjenje kumayambitsa chitukuko cha matenda ashuga. Itha kuwonetsedwa ndi kukhudzidwa, dzanzi la miyendo ndi zala m'manja, kulakwitsa kwa ziwalo zamkati, kupweteka kwamitundu yosiyanasiyana.

Chithandizo cha Matenda a Steroid

Etiotropic chithandizo ndikuchotsa zomwe zimayambitsa hypercorticism. Nthawi yomweyo, njira zomwe zimapangidwira kubwezeretsa ndikusunga Normoglycemia, kukulitsa chidwi cha minyewa mpaka kuchitapo kanthu ka insulin, ndikulimbikitsa ntchito ya preserved-cell yomwe ikusungidwa ikuchitika. Ndi njira yophatikizidwa, chisamaliro chachipatala cha odwala chimachitika m'mbali zotsatirazi:

Otsika milingo corticosteroid . Ndi endo native hypercorticism, chithandizo cha matenda oyambitsidwa chimakonzedwanso. Ngati kusintha kwa mankhwalawa kwa mankhwalawa sikothandiza, kufunsa kwa maopaleshoni kungathetsedwe - kuchotsedwa kwa gren adrenal gortical, gortical gawo la adrenal gasm. Masautso a mahomoni a steroid amachepa, kuchuluka kwa shuga m'magazi kumachitika. Ndi hypercorticism ya kunja, mankhwalawa omwe amachititsa kuti shuga ya shuga ipitikize kapena m'malo mwake. Ngati ndizosatheka kuletsa glucocorticoids, mwachitsanzo, mu mphumu yayikulu ya bronchial, mahomoni a anabolic amapatsidwa mphamvu kuti athe kusintha zotsatira zawo.
Mankhwala kukonza hyperglycemia . Mankhwala amasankhidwa payekha, poganizira etiology, gawo lake, kuuma. Ngati kapamba akhudzidwa, maselo a beta amakhala pang'ono kapena atakhazikika kwathunthu, ndiye kuti mankhwala a insulin ndi omwe amakhazikitsidwa. Mwa matenda ofatsa, kuteteza minyewa ya glandular komanso kusinthika kwa maselo ku insulini, othandizira pakamwa ndi hypoglycemic, mwachitsanzo, kukonzekera kwa sulfonylurea. Nthawi zina odwala amawonetsedwa pogwiritsa ntchito mankhwala a insulin ndi hypoglycemic.
Zakudya za antidiabetes . Odwala ambiri amawonetsedwa ngati achire othandizira kudya No. 9. Zakudyazo zimapangidwa m'njira yoti mankhwala azisamba azikhala ndi chakudya, samatsitsimutsa hyperglycemia ndipo muli zinthu zonse zofunika. Mfundo zachakudya zamafuta ochepa zimagwiritsidwa ntchito: magwero a mafuta opepuka samachotsedwa - maswiti, makeke, zakumwa zotsekemera.Mapuloteni ndi zakudya zamafuta ambiri zimakhazikika muzakudya. Mndandanda wa glycemic umatengedwa. Kudya kumachitika m'magawo ang'onoang'ono, nthawi 5-6 patsiku.

Zotsogola ndi kupewa

Matenda a Steroid, monga lamulo, amapitilira modekha ndipo ndi osavuta kuchiza kuposa matenda ashuga amtundu woyamba ndi wachiwiri. Kukula kwake kumadalira zomwe zimayambitsa kukula kwa hypercorticism, nthawi zambiri zimakhala zabwino. Kupewa kumatengera chithandizo chanthawi komanso chokwanira cha matenda a Cushing komanso matenda a adrenal chotupa, kugwiritsa ntchito moyenera glucocorticoids, thiazide diuretics komanso njira yolerera pakamwa. Anthu omwe ali pachiwopsezo ayenera kuwunika magazi a magazi pafupipafupi. Izi zimakuthandizani kuzindikira zovuta zamatenda a carbohydrate pamlingo wa prediabetes, sinthani chithandizo chachikulu, yambani kutsatira mfundo za zakudya.

Steroid shuga mellitus amatchedwanso sekondaleti yodalira matenda a shuga 1. Amawoneka chifukwa cha kuchuluka kwa corticosteroids (mahomoni a adrenal cortex) m'magazi kwa nthawi yayitali.

Zimachitika kuti matenda a shuga a steroid amayamba chifukwa cha zovuta za matenda momwe kuchuluka kwa mahomoni, mwachitsanzo, ndi matenda a Itsenko-Cushing.

Komabe, nthawi zambiri matendawa amapezeka pambuyo poti athandizidwe kwa nthawi yayitali ndi mankhwala ena a mahomoni, chifukwa chake, dzina limodzi la matendawa ndi matenda osokoneza bongo.

Mtundu wa shuga wa matenda a shuga, omwe adachokera, ndi wa gulu la extrapancreatic matenda, poyambirira sizigwirizana ndi zovuta zapancreatic.

Mankhwala opatsitsa matenda

Glucocorticoids. Dexamethasone, hydrocortisone pamankhwala amagwiritsidwa ntchito ngati anti-kutupa kwa nyamakazi, komanso pochiza matenda a autoimmune (eczema, lupus, ndi ena) ndi mphumu. Nthawi zambiri, mankhwalawa samaphatikizira glucocorticoids atatha kupezeka ndi matenda angapo.
Magulu a okodzetsa a thiazide diuretics (Nefrik, Dichlothiazide).
Mankhwala angapo oletsa kubereka.
Mankhwala omwe amagwiritsidwa ntchito pochiza pambuyo pakuchita opaleshoni ya impso, makamaka kupatsirana. Pambuyo pakuwonjezera, munthu amayenera kutenga ma immunomodulators moyo wake wonse, popeza amatha kutuluka mthupi. Nthawi zambiri, amaopseza thanzi la chida chija.

Zachidziwikire, kuti mankhwala a shuga a shuga samapezeka mwa wodwala aliyense amene amatenga mahomoni, komabe chithandizo choterechi chimakulitsa zovuta.

Ngati munthu wotsutsana ndi kumbuyo kwa mankhwalawa anali ndi zizindikiro za mtundu wa matendawo, ndiye kuti nthawi zambiri anali pachiwopsezo. Popewa kutukuka kwake, ndikofunikira kubweretsa kulemera kwanu moyenera, sinthani zakudya zanu ndikupita masewera.

Mawonetsero oyamba ayenera kukakamiza kusiya kugwiritsa ntchito mahomoni pafupipafupi, ngati zingatheke pankhani inayake.

Zizindikiro zazikulu komanso zina

Chomwe chimasiyanitsa ndizophatikiza zomwe zimatha mitundu iwiri ya matenda ashuga. Pa gawo loyamba la chitukuko, corticosteroids yochulukirapo imayamba kuwononga maselo a beta omwe amayang'ana kwambiri ma islets a Langerhans, omwe ali ofanana ndi matenda a shuga a steroid omwe ali ndi mawonekedwe odalira insulin. Ngakhale izi, amapanga mahomoni.

Samalani

Malinga ndi WHO, chaka chilichonse padziko lapansi anthu 2 miliyoni amafa chifukwa cha matenda ashuga komanso zovuta zake. Pokhapokha pakhale thandizo loyenerera la thupi, matenda ashuga amabweretsa mavuto osiyanasiyana, pang'onopang'ono kuwononga thupi la munthu.

Mavuto ambiri omwe amakonda ndi awa: matenda ashuga a m'mimba, nephropathy, retinopathy, zilonda zam'mimba, hypoglycemia, ketoacidosis. Matenda a shuga amathanso kuyambitsa kukula kwa zotupa za khansa. Pafupifupi nthawi zonse, wodwala matenda ashuga amwalira, akulimbana ndi matenda opweteka, kapena amasintha kukhala munthu weniweni wolumala.

Kodi anthu odwala matenda ashuga amatani? Endocrinological Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsiratu matenda ashuga.

Pulogalamu ya Federal "Health Health Nation" ikuchitika, mkati mwanjira yomwe mankhwalawa amaperekedwa kwa aliyense wokhala ku Russian Federation ndi CIS ZAULERE . Kuti mumve zambiri, onani tsamba lovomerezeka la MINZDRAVA.

Komano kuchuluka kwa zinthu zomwe zimapanga insulini kumachepa, mphamvu zama cell kwa izo zimachepa, monga mtundu wachiwiri. Popita nthawi, maselo a beta amasiya kugwira ntchito ndikufa, motero, matendawa amakhala ochulukana ndi chithunzi chodalirika cha insulin.

Zizindikiro zikufanana kwambiri ndi nthawi zonse yamatendawa:

kutopa, ntchito yochepa,
ludzu lalikulu
mkulu diuresis.

Nthawi zina, wodwalayo samazindikira mawonekedwe awo, popeza amadzionetsa ofooka. Corticosteroids samachititsa kuti thupi lizigwiritsa ntchito kwambiri kapena kupindulitsa kwake, ndipo kuyezetsa magazi kumapangitsa kuti adziwe zoyenera. Kuchuluka kwa shuga mu mkodzo ndi magazi kumatuluka kwambiri, kawirikawiri ma acetone samawonekera.

Matenda a shuga monga chifukwa cha steroid

Zokha, kuchulukitsa kwa corticosteroids kumakhudzanso chimodzimodzi. Kuphatikiza apo, sikuti aliyense amene amamwa amadwala. Ma mahormoniwa samangochita ngati kapamba wa munthu, komanso amachepetsa mphamvu ya insulini, mongosiyanitsa.

Owerenga athu amalemba

Mutu: Matenda a shuga apambana

Ku: my-diabet.ru Administration

Ndili ndi zaka 47, ndinapezeka kuti ndili ndi matenda ashuga a 2. M'masabata angapo ndinapeza pafupifupi 15 kg. Kutopa nthawi zonse, kugona, kumva kufooka, kuwona kunayamba kukhala pansi. Nditakwanitsa zaka 66, ndinali ndikumenya insulin yanga, zonse zinali zoipa kwambiri.

Nayi nkhani yanga

Matendawa adapitilirabe, kukomoka kwakanthawi kunayamba, ambulansi imandibwezera kuchokera kudziko lina. Nthawi zonse ndimaganiza kuti nthawi ino ikhala yomaliza.

Chilichonse chinasintha mwana wanga wamkazi atandilola kuti ndiwerenge nkhani imodzi pa intaneti. Simungayerekeze m'mene ndimamuyamikirira. Nkhaniyi inandithandiza kuthana ndi matenda ashuga, omwe amati ndi osachiritsika. Zaka 2 zapitazi ndidayamba kusuntha zowonjezereka, nthawi yamasika ndi chilimwe ndimapita kumayiko tsiku lililonse, ndikumalima tomato ndikugulitsa pamsika. Azakhali anga amadabwa ndimomwe ndimapangira chilichonse, komwe ndimapeza mphamvu zambiri, sakhulupirira kuti ndili ndi zaka 66.

Ndani akufuna kukhala ndi moyo wautali, wamphamvu komanso kuiwalako za matenda oyipawa kwamuyaya, tengani mphindi 5 ndikuwerenga nkhaniyi.

Pitani pa nkhaniyi >>>

Maselo a Beta amagwira ntchito mwamphamvu kwambiri kuti akhalebe ndi shuga. Ngati kapamba ali wathanzi, ndiye kuti posachedwa azolowera katundu wolemera. Ndi kuchepa kwa mulingo kapena kusiya mankhwala kwathunthu, njira zonse za metabolic zimabwezeretseka.

Koma ngati munthu amene amatenga mahomoni ali ndi matenda ashuga, chithunzicho ndi chosiyana kotheratu. Maselo ataya kale chidwi ndi insulini, motero, kapamba sichita ntchito yake bwino. Pazifukwa izi, ndikofunikira kuti odwala matenda ashuga azigwiritsa ntchito corticosteroids pokhapokha pokhapokha.

Mlandu wosiyana kwambiri ndi pomwe ndizosatheka kukana mahomoni, mwachitsanzo, ndi mphumo waukulu wa mphumu ya bronchial. Apa, wodwalayo amayenera kuyang'anira kuchuluka kwa shuga, komanso zakumwa za anabolics zomwe zimasiyanitsa pang'ono zotsatira zoyipa za glucocorticoids.

Fotokozani

Ngati muwerenga izi, mutha kuzindikira kuti inu kapena okondedwa anu mukudwala matenda ashuga.

Tinachita kafukufuku, tinaphunzira zambiri zamagulu ndipo makamaka ndinayang'ana njira ndi mankhwala ambiri a shuga. Chigamulochi ndi motere:

Ngati mankhwalawa onse akaperekedwa, zinali zotsatira zosakhalitsa, atangomaliza kudya, matendawa amakula kwambiri.

Chithandizo chokhacho chomwe chinapereka zotsatira zazikulu ndi Dialife.

Pakadali pano, awa ndiye mankhwala okhawo omwe amachiritsiratu matenda ashuga. Dialife adawonetsa chidwi chachikulu magawo a shuga.

Tidafunsa Unduna wa Zaumoyo:

Ndipo kwa owerenga tsamba lathu lino mwayi
pezani dialife ZAULERE!

Yang'anani! Milandu yogulitsa mankhwala abodza a Dialife tsopano yachulukira.
Mukayika lamulo pogwiritsa ntchito maulalo pamwambapa, mumatsimikiziridwa kuti mukulandila zabwino kuchokera kwa wopanga ovomerezeka. Kuphatikiza apo, mukafuna kuyitanitsa pa tsamba lovomerezeka, mumalandira chitsimikizo cha kubweza (kuphatikizapo ndalama zoyendera) ngati mankhwalawo alibe.

Second matenda a shuga - matenda opezeka chifukwa cha matenda enaake kapena mankhwala. Matenda a shuga a steroid amakula mwa anthu omwe magazi awo a mahomoni a steroid amawonjezeka.

Matenda a shuga a Steroid amakhalanso odalira insulin. Amayamba mwa anthu chifukwa chambiri cha kuchuluka kwa corticoids m'magazi - ma adrenal mahomoni. Matenda a Steroid amakula modutsa zovuta za adrenal gland pathologies. Komabe, nthawi zambiri matendawa amakumananso ndi vuto atatha kumwa mankhwala a mahomoni. Chodabwitsa cha matenda awa ndikuti zimachitika mwapang'onopang'ono. Zizindikiro zapadera za matendawa sizitchulidwa.

Zomwe zimayambitsa matenda a shuga a Steroid

Cholinga chofunikira kwambiri cha kupezeka kwa matenda a shuga a steroid ndi hypothalamic-pituitary syndromes, komanso matenda a Itsenko-Cushing. Kuphwanya kwa hypothalamus ndi pituitary gland kumayambitsa kusalinganika kwa mahomoni ena m'thupi ndipo, chifukwa chake, amasintha pakukaniza kwa maselo ndi minyewa kupita ku insulin. Mwa zina mwa matenda otere, matenda a Itsenko-Cushing ndi ofala kwambiri.

Matendawa amadziwika ndi kupanga kwambiri hydrocortisone, mahomoni a adrenal. Cholinga chophwanya lamulo sichinadziwikebe bwinobwino. Amadziwika kuti mwa amayi pali ubale pakati pa zomwe zimachitika ndi matendawa komanso pakati. Kusagwirizana pakati pamahomoni m'thupi kumabweretsa chakuti ma cell amthupi samayankha insulin.

Ndi matenda a Itsenko-Cushing, palibe zovuta kutchulidwa pakugwira ntchito kwa kapamba. Izi zimasiyanitsa kwambiri shuga ya steroid kuchokera ku mitundu yake ina.

Chimodzi mwazinthu zomwe zimapangitsa kukula kwa matenda osokoneza bongo ndi kugwiritsa ntchito glucocorticosteroids. Amathandizira kukulitsa mapangidwe a glycogen mu chiwindi. Chifukwa chake wodwalayo ali ndi glycemia.

Matenda a Steroid amakumananso ndi odwala omwe ali ndi poizoni woopsa (matenda a Bazedova, matenda a Graves). Nthawi yomweyo, kukonzanso kwa glucose ndi minofu kumawipira. Pankhani ya kuphatikizika kwa ntchito ya chithokomiro chamtunduwu ndi matenda a shuga, kufunikira kwa insulin kumawonjezeka kwambiri ndipo kukana insulini kumayamba.

Mahomoni a Corticosteroid amachita m'njira ziwiri pa thupi. Amasokoneza kapamba ndipo amathandizira insulin. Ichi ndichifukwa chake gawo lofunikalo limagwira, makamaka, pamphepete mwa zotheka. Pambuyo pakuchiritsa kwambiri kwa mahomoni, zovuta za metabolic nthawi zambiri zimatha.

Zotsatira za ma steroid pa matenda ashuga

Ochita masewera ambiri amatenga anabolic steroids kuti minofu ikule msanga.Ali pachiwopsezo, monga kafukufuku wambiri akusonyeza kuti othamanga otere amatha kukhala ndi shuga osadalira insulin. Ubale wotere umakhalapo chifukwa mahomoni amakula kwambiri kuchuluka kwa mahomoni amtundu wa glucocorticoid. Ma ricochet amachititsa insulin kukana.

Mukamamwa mahomoni a steroid, shuga m'masewera othamanga amatha kukula m'njira ziwiri. Poyambirira, kusokonezeka kwa kapamba kumachitika, ndipo kumatulutsa insulin yochepa kwambiri. Matenda a shuga 1 amayamba.

Nthawi ina, kapamba amatulutsa kuchuluka kwa insulini, koma maselo ndi minyewa yathupi lake zimamvekera pang'ono. Ili ndiye mtundu wa shuga wodziimira payekha.

Mankhwala a mahomoni ndi matenda ashuga

Mankhwala ena a mahomoni omwe amayi amatenga ngati njira zakulera amathandizira kwambiri kutenga matenda ashuga a 2. Izi zimachitika, makamaka, chifukwa chakuti mahomoni omwe amagwiritsidwa ntchito ngati mankhwalawa amasintha kuchuluka kwa mahomoni.

Nthawi zina, zimathandizira kukulitsa matenda a shuga ndi prednisolone, anaprilin ndi mankhwala ena. Komabe, kuphwanya thupi komwe kumapangitsa chidwi cha insulin muzochitika zotere ndizosowa kwambiri: kusokonezeka kwa metabolic sikumatchulidwa kotero kuti kumapangitsa kuti shuga ikule.

Matenda a shuga a Steroid amathanso chifukwa cha thiazide diuretics - Dichlothiazide, Hypothiazide, Nephrix, Navidrex ndi ena.

Glucocorticoids omwe amagwiritsidwa ntchito pochiza mphumu, nyamakazi yodutsa matenda am'mimba, systemic lupus erythematosus, pemphigus ndi eczema zingayambenso kusokonezeka kwa metabolic komanso kuyambitsa matenda osokoneza bongo. Nthawi zina mankhwalawa amatha kupatsira ma cell a pancreatic beta. Poterepa, amalankhula za chitukuko.

Mfundo zachikhalidwe zamankhwala

Njira zochizira matenda amtunduwu ndizofanana ndi matenda ashuga. Zimatanthauzanso zomwe wodwala ali nazo. Chithandizo choyenera cha wodwala aliyense chimatha kusankhidwa ndi dokotala wodziwa zambiri.

Chithandizo chothandiza pa matenda ngati awa:

Kukhazikitsidwa kwa insulini kusintha matendawa. Jekeseni ndikofunikira makamaka pakukonza pancreatic ntchito.
Odwala amapatsidwa.
Phwando limasankhidwa.
Nthawi zina, chithandizo cha opaleshoni chimasonyezedwa ndikuchotsa minyewa yambiri m'magazi a adrenal ndikupanga kuchepetsa ma hormone.
Kuletsa kwakanthawi kwa mankhwalawa omwe amayambitsa kusokonezeka kwa metabolic m'thupi. Komabe, zimachitika kawirikawiri kuti sizingatheke kusiya mankhwala ena - makamaka, pambuyo pothana ndi impso kapena pochiza mphumu. Zikatero, kuyang'anira kwachipatala kumachitika.

Jakisoni wa insulini amaperekedwa ngati makonzedwe a mankhwala omwe amachepetsa shuga sapereka zotsatira zoyenera za hypoglycemic. Wodwala ayenera kukumbukira kuti chithandizo cha insulin ndi chimodzi mwazinthu zomwe zingapangitse matenda a shuga. Cholinga chofunikira kwambiri chomwe chimatsatiridwa ndi chithandizo cha matenda osokoneza bongo ndichakuti tikwaniritse chipepeso ndi kuchedwetsa zovuta za matendawo.

Kuchotsa kwa gawo limodzi la gren ya adrenal kumachitika kwambiri, chifukwa chithandizo chotere chimawopseza odwala omwe ali ndi zovuta zambiri.

Udindo wa chakudya chamafuta ochepa

Njira zabwino zothanirana ndi glucose wamagazi mumtundu 1 kapena shuga ya 2 ndikuyamba. Nthawi yomweyo, zakudya zimachepetsa chakudya chamafuta - mpaka 20-30 magalamu patsiku. Izi zimawonjezera kuchuluka kwa mapuloteni, komanso mafuta azamasamba.

Ubwino wakudya yamtengo wotsika pang'ono:

amachepetsa kufunika kwa thupi kwa insulin ndi mankhwala ochepetsa shuga,
amakulolani kuti muzikhala ndi shuga nthawi zonse, ngakhale mutatha kudya,
Kukhala bwino kwamunthu kumachita bwino ndipo zizindikiro zonse za matenda ashuga zimatha,
mwayi wopanga zovuta umachepetsedwa,
amachepetsa mafuta m'thupi.