Matenda a shuga a sekondale

Zizindikiro kapena matenda ashuga owonjezera ndi matenda omwe ali chiwonetsero chachiwiri cha matenda ena. Vutoli limatha kuchitika chifukwa cha matenda kapamba kapena kusayenda bwino mu endocrine. Pafupifupi 1% ya nthenda zonse za matenda a shuga zimachitika mwanjira yachiwiri. Chachilendo cha matenda amtunduwu ndikuti pakuwonetsedwa kwamankhwala ndizofanana ndi mtundu 1 wa matenda a shuga, koma palibe chifukwa choyambitsa matendawa, i.e. Ma antibodies samapangidwa motsutsana ndi maselo omwe omwe ali ndi zilumba za Largenhans (omwe amapanga insulin).

1. Matenda a endocrine system:

- matenda kapena matenda a Itsenko-Cushing's. Ichi ndi matenda oopsa a endocrine system, yodziwika ndi kuchuluka kwa mahomoni a adrenocorticotropic. Zotsatira zake, mahomoni a adrenal cortex amapangidwa mopitirira muyeso - cortisol, cortisone, corticosterone, aldosterone ndi androgens. Zonsezi zimabweretsa chodabwitsa cha hypercorticism (kuchuluka kwa ntchito ya adrenal cortex): kunenepa kwambiri, nkhope yooneka ngati mwezi, ziphuphu, kuchuluka kwa tsitsi la thupi (hirsutism), matenda oopsa kwambiri, kusokonezeka kwa msambo. Monga mukudziwa, kuchuluka kwa cortisol kumabweretsa hyperglycemia chifukwa cha kuchuluka kwa shuga wama chiwindi ndi kuwonongeka kwa ntchito. Mu 90% ya milandu, izi zimabweretsa pituitary adenoma (ubongo pituitary chotupa chomwe chimapanga kuchuluka kwa adrenocorticotropic timadzi), ndipo mu 10% choyambitsa ndi chotupa cha adrenal chomwe chimapanga kuchuluka kwa cortisol.

- Pheochromocytoma ndi chotupa chotupa, chomwe nthawi zambiri chimapezeka m'matumbo a adrenal, nthawi zambiri kunja kwa iwo. Amadziwika ndi kutulutsidwa kosamveka kwa catecholamines (adrenaline ndi norepinephrine) m'magazi, zomwe zimapangitsa zomwe zimadziwika kuti ndi catecholamine - kugwedezeka mwadzidzidzi, kuzizira, thukuta kwambiri, tachycardia, ndi kuchuluka kwa magazi. Monga mukudziwira, ma catecholamines amatsogolera kukuwonjezeka kwa shuga wamagazi ndi zotsatira zina zonse zosasangalatsa.

- Acromegaly - matenda a anterior pituitary gland, limodzi ndi kuchuluka kwa timadzi timene timene timatulutsa - amatchedwa kukula kwa mahomoni. Mu 90% ya milandu, ndi chotupa cha pituitary chomwe chimapanga mahomoni okula. Amawoneka atapangidwa mafupa a mafupa ndipo amadziwika ndi kuwonjezeka kwa maburashi, mapazi, ndi kutsogolo kwa chigaza. Kuphatikiza apo, mahomoni okula ali ndi zotsatira za insulin komanso diabetogenic. Mphamvu yokhala ndi insulini imatha pafupifupi ola limodzi mutatha kubereka ndi mahomoni okula ndipo amadziwika ndi kuchuluka kwa insulin. Ngati kukula kwa mahomoni kumachitika kwakanthawi, ndiye kuti mapangidwe a insulin amachepetsa, kugwiritsidwa ntchito kwa glucose ndi minofu kumachepetsedwa ndipo hyperglycemia imayamba. Mwa odwala, matendawo amakula mu 10% ya milandu.

- Cohn syndrome ndi matenda a adrenal gland omwe amadziwika ndi kuchuluka kwa aldosterone, yomwe imayang'anira kuchuluka kwa calcium, sodium, potaziyamu ndi chlorine m'thupi. Mothandizidwa ndi kuchuluka kwa aldosterone, kuchuluka kwa potaziyamu m'thupi kumachepa, zomwe ndizofunikira pakugwiritsa ntchito shuga ndi maselo. Zotsatira zake, hyperglycemia imayamba.

- Hemochromatosis ndi matenda obadwa nawo omwe amadziwika ndi kupuwala kwachitsulo komanso kudzikundikira kwake. Amayamba kumilowetsa m'miyeso ikuluikulu kuposa momwe amafunikira, ndikuyamba kudziunjikira m'chiwindi, kapamba, ndi khungu. Ndi kudzikundikira kwake kwambiri mu chiwindi ndi kapamba komwe kumabweretsa kukula kwa matendawa.

- Matenda a Wilson-Konovalov ndi matenda obadwa nawo omwe amadziwika kuti ali ndi vuto la mkuwa komanso kuchuluka kwake mkati mwa ziwalo zamkati - chiwindi, ubongo, ziphuphu. Kuchuluka kwambiri kwa mkuwa m'chiwindi kumayambitsa matendawa.

2. Matenda a kapamba:

- Glucagonoma - chotupa choyipa cha alpha - maselo a masinthidwe a masapota a Langerhans a kapamba, omwe amapanga glucagon. Matendawa, limodzi ndi kuchepa kwa magazi, matendawa ndi kuchepa kwa thupi mu 80% ya odwala kumabweretsa kukula kwa matenda ashuga.

- Somatostinoma - chotupa chochokera ku selte cell ya zisumbu za Langerhans za kapamba zomwe zimatulutsa somatostatin. Hormone iyi, pamodzi ndi mahomoni ena angapo, amatsogolera pakuchepa kwa kupanga kwa insulini, ndipo kupanga kwake mopambanitsa kumabweretsa kuchepa kwa insulin.

- Khansa yapakhungu - chotupa chowopsa cha tiziwalo ta m'mapapo. Maselo a pancreatic omwe amapanga insulini amakhudzidwa ndi vuto la khansa, kugwiritsidwa ntchito kwa glucose ndi minofu kumawonongeka ndipo hyperglycemia imayamba.

- Pancreatectomy, kapena kuchotsedwa kwa kapamba - palibe kupanga insulin kwathunthu.

- Acute pancreatitis kapena pancreatic necrosis - matenda otupa kapena otupa - owononga a kapamba pomwe amayambitsa kutupa kapena kutupa ndi chiwonongeko. Izi zimachitika mu 15 mpaka 18% ya odwala. Chomwe ndikuwonongeka kwa gawo la kapamba limodzi ndi ma cell omwe ali ndi vuto lopanga insulin.

- Pancreatitis yosatha ndi kutupa kosatha kwa kapamba, komwe kumayambitsa matenda ashuga 40% ya milandu. Chifukwa cha kutupa kosatha, ntchito yamaselo azisumbu za Langerhans ya kapamba imasokonekera ndipo kupanga kwa insulin kumachepetsedwa.

- Zowopsa zowonongeka kwa kapamba.

3. Kuopsa kwa zinthu zingapo za poizoni ndi mankhwala a kapamba - zimatha kuyambitsa kukulira kwachangu (poyankha poyizoni) kapamba ndi kupindika kwa insulini, kapena kukhudza maselo a beta am'mimba ndikuchepetsa kubisalira kwa insulin insulin motero zimayambitsa hyperglycemia. Izi zikuphatikiza mankhwala ophera tizilombo, kugwiritsa ntchito nthawi yayitali glucocorticosteroids, antidepressants, diuretics, mankhwala a chemotherapy.

Zizindikiro zazikulu za matendawa komanso kupezeka kwake.

Zizindikiro zamatenda oyamba zimadza makamaka. Poyambirira, motsutsana ndi zomwe zimayambitsa matenda oyamba, munthu mwina sangadziwe za matenda ake a shuga, chifukwa sipangakhalepobe zizindikiro. Izi zimasintha pomwe milingo ya glucose imakwera m'magazi. Chizindikiro choyamba ndi ludzu lalikulu. Thupi limayamba kutaya madzi kwambiri - kusowa kwamadzi kumachitika. Izi ndichifukwa choti glucose amatunga madzi kulowa m'magazi athu ndikutuluka ndikuzichotsa mokwanira mkodzo. Chifukwa chake chizindikiro chachiwiri ndi polyuria (mapangidwe a mkodzo wowonjezera), i.e. mkodzo wambiri umayamba kumasulidwa kuposa masiku onse. Anthu amayamba kumwa madzi ambiri, koma thupi lonse limachichotsa.

Chizindikiro chachitatu ndichokulirakulira kotopa ndi kugona. Chomwe chimapangitsa izi ndi njala yamphamvu (thupi sililandira mphamvu) kuphatikiza kusowa kwamadzi.

Potengera maziko awa, anthu atha kukhala ndi chidwi chokwanira - chizindikiro chachinayi cha matendawa, chifukwa thupi likuyesera kudzaza mphamvu. Koma nthawi yomweyo, ngakhale mutakhala ndi chidwi chofuna kudya, kuwonda kwambiri kudzadziwika. Kuphatikiza pa zonsezi, kuyabwa kwa khungu komanso kupezeka kwa mabala osachiritsika omwe sanachiritsidwe.

Fomu yachiwiri imadziwika ndi kuti kwa nthawi yayitali imatha kubisika - kuchuluka kwa glucose m'magazi musanayambe kudya kumakhala mkati mwa malire, koma mutatha kutsitsa shuga limadzuka kwambiri. Ngati sichichiritsidwenso (zakudya ndi kuphatikizika kwa kulemera kwa thupi), ndiye kuti imalowa mu mawonekedwe omveka kenako chithandizo cha insulin chofunikira. Mwanjira yodziwikiratu, glucose othamanga amakhala apamwamba kuposa 7.0 mmol / L kapena apamwamba kuposa maola 11.0 mmol / L 2 pakudya.

Kuzindikira kumakhazikitsidwa pamakhalidwe omwewo monga matenda wamba (onani. Shuga): njira zoyambira matenda).

Mfundo zofunika kwambiri zochizira matenda ashuga a sekondale.

Chithandizo choyambirira chizikhala ndi cholinga chothana ndi matenda oyambitsidwa (kuchotsedwa kwa zinthu zoopsa, mankhwalawa kapamba ndi zina). Mwakutero, chithandizo chake chimakhazikitsidwa pazizindikiro zofanana ndi chithandizo cha matenda a shuga 2 mellitus (kupatulapo vutoli atachotsa kapamba, komwe anthu amadzipatsa jakisoni wa insulin moyo wonse):

- Gulu loyamba limaphatikizapo chithandizo chamadyeretso ndi kukumbukira kwamakhalidwe olondola, zolimbitsa thupi, zomwe zimafanana ndi shuga wofatsa,

- Gawo lachiwiri - limayikidwa pakakhala kotheka kukwaniritsa kukhazikika kwa glycemia ndipo kumaphatikiza chithandizo cha masewera olimbitsa thupi, masewera olimbitsa thupi, moyo wabwino komanso kuphatikiza mankhwala ochepetsa shuga m'mapiritsi, omwe amafanana ndi zovuta,

- Gulu lachitatu - limaphatikizapo zochitika zonse za mulingo wachitatu, kuphatikiza jakisoni wa insulini amawonjezeredwa, zomwe zimagwirizana kwambiri.

Talongosola kale mwatsatanetsatane m'nkhani "Chithandizo cha matenda a matenda a shuga 1 ndi mtundu 2: Malangizo onse", "Type 2 matenda a shuga: chithandizo ndi insulin".

Matenda a shuga - matendawa pawokha ndi akulu kwambiri omwe ali ndi chiwopsezo chachikulu chotenga matendawa (kuwonongeka kwa maso, impso, ziwiya zam'munsi), komanso motsutsana ndi maziko a mainology, zakutsogolo kwa moyo wabwino kumachepa. Pitani kuchipatala munthawi yotsatira ndipo tsatirani malangizo onse a dokotala.

Yang'anirani panthawi yanu thanzi lanu

Matenda a shuga a sekondale: momwe matendawa amakulira, chithandizo cha matenda a mtima

Shuga imatha kukhala yoyambira, yogawa m'mitundu iwiri, komanso yachiwiri. Matenda oyamba a shuga ndi matenda odalirika a inshuwaransi kapena osadalira insulini. Amayamba kudziimira pawokha.

Matenda owopsa a shuga ndi chizindikiro chachiwiri cha matenda ena. Nthawi zambiri vutoli limawoneka motsutsana ndi maziko azovuta za kapamba kapena chifukwa chakugwira ntchito mwa dongosolo la endocrine.

Komabe, matenda ashuga opatsirana siofala kwambiri. Kupatula apo, ndi 1% yokha ya odwala matenda ashuga omwe ali ndi mtundu wachiwiri wa matendawa.

Chithunzi cha chipatala cha matenda amtunduwu chimachoka ndi zizindikiro za matenda amtundu 1. Komabe, panthawiyi palibe autoimmune zomwe zimapangitsa kuti matendawa atukuke.

Nthawi zambiri, mtundu wachiwiri wa matenda ashuga umapezeka mwa anthu onenepa kwambiri. Matendawa amakula pang'onopang'ono, motero zimakhala bwino.

Zomwe zimayambitsa ndikudziwikiratu

Matenda a shuga a sekondale amachitika chifukwa chonyansa mu endocrine system komanso chifukwa chosagwira bwino ntchito kwa kapamba. Poyambirira, zomwe zimayambitsa shuga wambiri m'magazi zimakhala zingapo matenda:

1. Itsenko-Cushing's syndrome, momwe mumakhala kuchuluka kwa mahomoni a adrenocorticotropic.
2. Acromegaly ndi matenda a anterior pituitary gland;
3. Pheochromocytoma ndi chotupa m'matumbo a adrenal, momwe ma catecholamine omwe amalimbikitsa kuchuluka kwa shuga amatulutsidwa m'magazi.
4. Matenda a Wilson - Konovalov - amadziwika ndi kusagwira bwino ntchito posinthana ndi mkuwa, chifukwa cha momwe amadziunjikira ziwalo zamkati.
5. Hemochromatosis ndikuphwanya kagayidwe kazitsulo, chifukwa chomwe chimasonkhanitsidwa m'matumbo a ziwalo zamkati, kuphatikizapo kapamba.
6. Cohn's syndrome ndimatenda omwe amakhudza ma grenal adrenal, momwe aldosterone imapangidwira kwambiri. Hormone iyi imachepetsa kuchuluka kwa potaziyamu omwe amagwiritsa ntchito shuga.

Komanso, mitundu yachiwiri ya matenda ashuga imawonekera motsutsana ndi mavuto omwe amakhudzidwa ndi kapamba. Izi zimaphatikizapo zotupa - khansa, somatostinoma ndi lucagonoma.

Kuchotsa kwa chiwalo kapena kapamba, pancreatic necrosis ndi kapamba zimasokonezeranso kuchuluka kwa kugaya kwa shuga. Komanso, zomwe zimayambitsa matenda a shuga zimatha kuvulaza kapamba kapena poyizoni wake nthawi zonse ndi zinthu zapoizoni.

Zomwe zimatsogolera pakupezeka kwa matenda ashuga ndi chibadwidwe. Chifukwa chake, anthu omwe ali ndi matenda ashuga m'mabanja awo amafunika kuwunika nthawi ndi nthawi.

Kukhala wonenepa kwambiri kumathandizanso kuti matendawo akule. Kupatula apo, zolakwika m'matumbo am'mimba zimayambitsa kuchuluka kwa maid ndi cholesterol m'thupi. Poterepa, wosanjikiza wamafuta amapangika pa kapamba omwe amalepheretsa kugwira ntchito kwake.

Zinthu zotsatirazi zomwe zimasokoneza kayendedwe ka shuga mthupi ndi zolephera mummimba.

Kulephera kwammimba kumapangitsanso kuti zinthu zizichitika.

Chithunzi cha kuchipatala

Malo otsogola a mtundu wachiwiri wa matenda ashuga amakhala ndi zizindikiro za matenda omwe amayambitsa mawonekedwe ake. Chifukwa chake, zizindikiro zimachitika monga kuchuluka kwa shuga m'magazi kumasintha.

Odwala omwe amadalira insulin adazindikira kuti panthawi yopanga matendawa anali ndi mawonekedwe awa:

• kamwa yowuma
• kupanda chidwi ndi malaise
• kukodza pafupipafupi
• ludzu.

Kuuma ndi kuwawa mkamwa kumapangitsa kuti munthu azikhala ndi ludzu pafupipafupi. Zizindikiro zotere zimawonekera mukakhala kuchuluka kwa glucose m'magazi, chifukwa chomwe ntchito ya impso imathandizira.

Zofooka zimachitika chifukwa chogwira ntchito molimba ziwalo, zomwe zimathandiza kuti azivala mwachangu. Komanso, wodwalayo atha kukhala ndi chidwi chambiri. Chifukwa chake thupi likuyesayesa kubwezeretsanso mphamvu zamagetsi, koma chodabwitsa cha matenda ashuga ndichakuti ngakhale atadya zakudya zopatsa thanzi kwambiri, wodwalayo amachepetsa thupi.

Zizindikiro za matenda ashuga zitha kuoneka kuti sizikuwonekera kwa nthawi yayitali kwambiri, chifukwa chake, kuchuluka kwa shuga kumakhala kwabwinobwino. Komabe, zitatha kupsinjika ndi katundu, zizindikiro zake zikukula kwambiri. Pakufunika kwakanthawi matenda ndi chithandizo chotsatira, matendawa amatenga mawonekedwe otseguka, omwe amafunika insulin.

Cholinga chachikulu cha mankhwalawa ndikuchotsa matenda omwe akuwatsogolera kapena omwe adayambitsa kukula kwa matenda ashuga. Chifukwa chake, ngati mawonekedwe ake adayambitsa kulephera kwa impso, ndiye kuti dokotalayo amapereka mankhwala a hepatoprotectors ndi mankhwala othandizira chitetezo mthupi.

Ngati zifukwa zoyambitsira matendawa ndizonenepa kwambiri, ndiye kuti chakudya ndiyofunika. Pankhaniyi, tikulimbikitsidwa kudya chakudya chomwe chimathandizira njira zama metabolic ndikuchotsa shuga mthupi. Ndi zovuta ndi thirakiti la m'mimba, muyenera kudya moyenera ndikumwa mankhwala omwe amathandizira kukonza chimbudzi.

Mwakutero, chithandizo cha matenda ashuga achiwiri ndi ofanana ndi a 2 matenda a shuga. Ndipo izi zikutanthauza kuti muyenera kutsatira kadyedwe. Pachifukwa ichi, mafuta osaposa 90 g ayenera kudya chakudya chimodzi.

Komanso, musanadye chilichonse, muyenera kuwerengera kuchuluka kwa mkate. Kuphatikiza apo, ndikofunikira kuchepetsa kugwiritsa ntchito zakumwa zakumwa za shuga (koloko, tiyi, khofi, misuzi ndi shuga).

Monga chithandizo chamankhwala, adokotala atha kufotokozera kuchokera ku gulu la sulfonylureas (Diabeteson, Amaryl, Maninil). Mankhwala opangidwa mwatsopano omwe amakonzanso chidwi cha maselo kuti apange insulin akuphatikizira Pioglitazone, Avandia, Actos, ndi ena.

Mankhwala ophatikizidwa omwe amagwiritsidwa ntchito pozindikira matenda oyamba a shuga ndi mitundu ina ya matendawa ndi Glukovans, Metaglip, Glybomet. Zomwe zimapangitsa kuti shuga azikhala m'magazi mutatha kudya amaphatikiza dongo.

Monga mankhwala omwe amachepetsa kukonza kugaya ndi kugaya chakudya m'matumbo, Acarbose, Dibicor ndi Miglitol amagwiritsidwa ntchito.Mankhwala othandizira odwala matenda ashuga, dipeptidyl peptidase inhibitors, amathanso kukonzekera. Kuphatikiza apo, physiotherapy ya matenda a shuga imagwiritsidwa ntchito.

Physiotherapy ndikofunikira kuti pakhale matenda a shuga. Chifukwa chake, anthu omwe akudwala matendawa amawonetsedwa mtundu womwewo wa katundu, monga:

1. kuyendetsa njinga
2. Kuyenda
3. kusambira
4. kuwala kuthamanga
5. aerobics.

Malowedwe ndi kuchuluka kwa katundu zimatsimikiziridwa ndi adotolo, kutengera zaka za wodwalayo, machitidwe ake a thupi komanso kupezeka kwa matenda oyanjana.

Koma pakuchotsa kapamba, njira zamankhwala zingasinthidwe. Kuphatikiza apo, ngakhale ndi mtundu wachiwiri wa matenda ashuga, jakisoni wa insulin amaperekedwa nthawi zonse kwa munthu.

Kugwiritsa ntchito bwino kwa matenda am'madzi a shuga kumakhazikitsidwa ndi kuchuluka kwa matendawa. Ndi mtundu wofatsa wamatendawa, chithandizo chimakhala ndikuwona zakudya zinazake, kukhalabe ndi moyo wabwino komanso kuchita masewera olimbitsa thupi.

Pakati pa matenda, ngati sizingatheke kutulutsa shuga, ndikofunikira kutsatira zakudya, kuchita masewera olimbitsa thupi, kusiya zizolowezi zoyipa. Koma panthawi imodzimodzi, mankhwala a antipyretic amaperekedwa kwa wodwala.

Pankhani ya matenda oopsa a shuga, mankhwalawo ndi omwewo. Komabe, insulin yokhazikika imawonjezeredwa kwa iye pamtundu wa mankhwala omwe adokotala adawauza. Kanema yemwe watchulidwa munkhaniyi akupitiliza kufotokoza za matenda oyamba a matenda ashuga.

Sonyezani shuga yanu kapena sankhani jenda kuti muyimikize.

Matenda a shuga

Kuchuluka kwa shuga m'magazi - shuga yachiwiri, kumadziwonetsera mu kuphatikiza kwa zizindikiro zomwe zimayenderana ndi matenda a kapamba kapena dongosolo la endocrine. Ndi matenda anthawi yake, chithandizo chokwanira komanso njira zopewera, matendawa amachiritsidwa.

Etiology ya chitukuko cha matenda

Matenda achiwonetsero chachiwiri amachitika chifukwa cha kuchepa kwa kupanga kwa insulini ya mahomoni, yomwe imayang'anira kutsitsa ndikuwongolera kuchuluka kwa shuga m'thupi. Glucose simalowa mu kuchuluka komwe kumafunikira m'maselo ndikuzungulira kudzera m'magazi. Thupi limayamba kubwezeretsa mphamvu ndi mafuta, kagayidwe kazinthu zonse kamasokonekera. Zomwe zimayambitsa chiwonetsero cha matenda a shuga a yachiwiri ndi matenda a kapamba kapena dongosolo la endocrine.

Zotsatira za endocrine system:

• Matenda a Itsenko-Cushing,
• Matenda a Cohn
• pheochromocytoma,
• Matenda a Wilson-Konovalov,
• acromegaly
• hemochromatosis.

Matenda a kapamba:

• khansa
• glucomanoma
• somastinoma
• aakulu kapamba kapamba,
• kapamba,
• kapamba.

Kumwa mankhwala enaake kumatha kupangitsa kuti munthu adwale matendawa.

Zinthu zoyipa zomwe zimayambitsa kuwoneka kwa matenda ashuga:

• cholowa
• kunenepa
• kulephera kwam'mimba,
• kulephera kwa aimpso
• kusokonezeka kwa mahomoni
• kumwa mankhwala: antidepressants, mahomoni, okodzetsa, mankhwala amphamvu
• moyo wolakwika.

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Zizindikiro za shuga Yachiwiri

M'magawo oyamba, shuga yachiwiri ilibe chithunzi chowonekera chachipatala komanso zizindikiro zotchulidwa. Zizindikiro za matenda oyambitsidwa zimawonekera, zomwe zimapangitsa kuwonjezeka kwa msanga komanso kusokoneza magazi a magazi. Ndikupitilizidwa kwachiwiri kwa matenda ashuga, matendawa amawonjezeka, zomwe zimapangitsa kuti pakhale kusamvana.

Zizindikiro zazikulu za matenda:

• Ludzu lalikulu, kuuma ndi kuwawa mkamwa. Amayamba chifukwa cha kuchuluka kwa impso kuchotsa shuga wambiri.
• Kuchulukitsa pokodza. Zimachitika chifukwa chakufunika kowonjezera kwamadzi ndi kuphipha kwake mkodzo.
• Chilala chowonjezereka, njala. Kupyola mu chakudya, thupi limayesetsa kulipirira chifukwa chosowa mphamvu.
• Kuchepetsa kwambiri thupi. Thupi limagwira ntchito kwambiri, limatopa msanga.
• Kugona, kutopa. Amayamba chifukwa chakuwonjezeka kwa ntchito yathupi ndikulephera kusintha shuga mwayokha.
• Kusokonezeka kwa kugonana. Zotsatira za kutopa kosalekeza komanso kusowa mphamvu.
• Kuchepa, masomphenya opanda pake. Zizindikiro zakuyenda bwino.
• Kuyenda khungu, mabala osachiritsika. Kuphwanya chitetezo chathupi.

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Njira zodziwira matenda amisempha

Kuti mupeze matenda olondola, kufunsa ndi endocrinologist, kuyang'ana wodwalayo, ndikusonkhanitsa madandaulo ndikofunikira. Kutengera izi, njira zotsimikizira izi zikuchitika:

• kusintha kwa shuga m'magazi,
• maphunziro a magazi a venous ndi madzi a m'magazi a glucose,
• kuyeserera kwa glucose: kuyesedwa kwa magazi pambuyo pa kudya kwa glucose kusungunuka m'madzi,
• mayeso a mkodzo wamba: amawonetsa kupezeka kwa matupi a ketone ndi glucose,
• Kutsimikiza kwa glycosylated hemoglobin: kuchuluka kumawopseza kukula kwa zovuta,
• kufufuza kwa magazi pa kutsimikiza kwa c-peptide ndi insulin: kuwonetsa kuphwanya komanso kuchuluka kwa matendawa.

Kuti adziwe chomwe chimayambitsa matenda osokoneza bongo a glucose, dokotala amamuwonjezera mayeso:

• ultrasound yam'mimba, impso,
• mayeso wamba (magazi, mkodzo),
• matupi awo sagwirizana ndi matenda - amayesedwa kuti adziwe mayankho a mankhwala.

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Chithandizo cha Matenda Aakulu a shuga

Chithandizo cha matenda ashuga chachiwiri ndikuchiritsa matenda omwe amayambitsa matenda ashuga. Ngati matenda atakhala odwala, mankhwalawo amayenera kukhazikitsa mkhalidwe wathanzi ndikuchotsa mawonekedwe omwe amasokoneza ntchito yofunikira ya wodwalayo. Mankhwalawa otsatirawa amagwiritsidwa ntchito kutengera kuuma kwa zizindikirozo:

Kuchiza matenda kumatengera kusintha kwamunthu.

• Kutsatira ndi kudya mosamalitsa. Kudya zakudya zokhala ndi index yotsika ya glycemic.
• Kuchotsera zizolowezi zoipa: Kusuta fodya, mowa.
• Zochita zovomerezeka zolimbitsa thupi zimachitidwa.
• Kulephera kwamankhwala kumathandizidwa ndikugwiritsa ntchito mankhwala apadera omwe ali ndi mphamvu ya immunostimulating.
• Kusokonezeka kwa m'mimba, kunenepa kumathandizidwa ndi kusintha kwa zakudya, mankhwala osokoneza bongo.
• Kupereka mankhwala omwe angayambitse thupi lawo siligwirizana.
• Hypoglycemic mankhwala - mankhwala omwe amagwiritsidwa ntchito kuchepetsa magazi.
• Jekeseni wa Insulin. Amagwiritsidwa ntchito pothana ndi zovuta za matenda komanso zovuta zazikulu za matendawa.

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Kodi chiwopsezo cha matenda a m'matumbo ndi chiani?

Matenda obwera chifukwa cha matendawa ndi owopsa pang'onopang'ono. Ndi chithandizo chamwadzidzidzi cha matenda oyambitsidwa ndi matenda ashuga yachiwiri, pakachitika zovuta zazikulu zomwe zimawopseza moyo wathunthu. Gulu la matendawa limatengera mtundu wa maphunzirowo, kuuma kwa zizindikiro ndi kukhalapo kwa zovuta. Pali zovuta zitatu zamatenda osavuta - ofatsa, odziletsa komanso okhwima. Kufotokozera ndi mawonekedwe a madigiri a matendawa amaperekedwa pagome:

Kuchuluka kwa	Mavuto	Mawonekedwe	Zizindikiro ndi mawonekedwe
Zosavuta	Wofatsa gawo retinopathy	Kuphwanya magazi kumitseko yomwe imadyetsa retina	kuona kwakumaso kumachepa zotupa zimachitika retinal edema.
Pakatikati	Microangiopathy, arteriosulinosis yamitsempha, ketoacidosis	Kuchepa ndi kuwonongeka m'mitsempha ya thupi, kutsekeka kwa magazi, kusungunuka kwa okosijeni ku maselo ndi minyewa, kuchuluka kwa matupi a ketone okhala ndi insulin, kupha thupi	ludzu lochulukirapo kusanza ndi kusanza mpweya wa acetone kufooka.
Zovuta	Retinopathy, nephropathy, neuropathy	Kusintha kwakukulu kwa shuga m'magazi tsiku lonse	kukha magazi kwakukulu, kuyamwa kwam'mimba, kuwonongeka kwa masomphenya, kuphwanya ntchito ya kuwonekera, edema ya impso, kuwonongeka kwa minyewa yamanjenje, zolakwika m'mayendedwe a mitsempha, kupweteka, kukokana kwa miyendo, kutaya mtima.

Mavuto oyipa a matenda ashuga yachiwiri:

Mavuto a mtima ndi dongosolo la mtima nthawi zambiri zimayambitsa kuphedwa kwa odwala matenda ashuga.

• matenda a mtima dongosolo - m`mnyewa wamtima infarction, matenda a mtima,
• matenda opatsirana - amachepetsa chitetezo chokwanira, zilonda zosachiritsa, mawonetsedwe oyipa ndi fungus,
• kuwonongeka kwa mapazi ndi kutupa ndi kufa kwa khungu,
• chikomokere.

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Kupewa matenda a shuga a sekondale

Kupewera kwa matenda a m'matumbo ndi mawonekedwe a zovuta kumakhala ndikuwunikira pafupipafupi kuchipatala, kuwunika ndi endocrinologist ndikuwunika kuchuluka kwa shuga m'magazi, kukhalabe ndi moyo wathanzi. Komanso pakutsatira zakudya, zolimbitsa thupi, kuchiritsa kwakanthawi ndikuwongolera matenda omwe akutuluka. Kulandila kwa mankhwala kuyenera kugwirizanitsidwa ndi adokotala omwe akupezekapo.

Zomwe zimayambitsa matenda a shuga a Sekondale

Pali magulu atatu a zifukwa zoyambitsidwa ndi mfundo yakukula kwa mkhalidwewu:

1. Zovuta zam'mimba za kapamba.
2. Matenda a endocrine dongosolo.
3. Zotsatira za poizoni.

Zovuta za kapamba zimaphatikizapo:

• Kuphwanya kwachilengedwe m'thupi.
• Glucagonoma.
• Pancreatectomy
• Somatostinoma.
• Zowonongeka kwa kapamba chifukwa cha kuwawa.
• Matenda apakhungu / pachimake.

Matenda a endocrine dongosolo ndi monga:

• Matenda a Wilson-Konovalov.
• Itsenko-Cushing's syndrome.
• Acromegaly.
• Pheochromocytoma.
• Hemochromatosis.
• Matenda a Cohn.

Zovuta za kapamba wa mankhwala osokoneza bongo ndi zinthu zoopsa zimatha kuyambitsa kapamba, chifukwa cha zomwe pancreatogenic shuga mellitus imapangidwa. Pankhaniyi, kupanga insulini kumayipa, minyewa ya insulin imachepa, maselo a beta akuvutika. Zotsatira zake - hyperglycemia. Mankhwalawa amaphatikizapo magulu monga antidepressants, mankhwala ophera tizilombo, mankhwala a chemotherapy, okodzetsa.

Zizindikiro ndi matenda

Matenda a sekondale amawonekera ngati mtundu waukulu wa matendawa. Ndiye kuti, Zizindikiro zikuwoneka kuti zikukula patapita nthawi, mwachitsanzo, komanso kuwonjezeka kwa shuga m'magazi.

Matenda a shuga ndi zakudya zachilengedwe zomwe sizimafanana ndi zina zilizonse (zamankhwala) zopangidwa kuchokera ku nsomba za ku Fucus, zopangidwa ndi mabungwe asayansi aku Russia, zofunikira kwambiri pakudya komanso zakudya za odwala omwe ali ndi matenda ashuga, akulu ndi achinyamata. Zambiri.

Choyamba, ludzu losagonjetseka limawonekera, lomwe, ngakhale munthu amamwa zochuluka motani, silidutsa. Nthawi yomweyo, polyuria imakulanso - munthu amamwa kwambiri, zomwe zikutanthauza kuti amathamangira kuchimbudzi nthawi zambiri.

Kuchepa mphamvu ndi kusowa kwa mphamvu zimatsogolera ku mfundo yoti munthu amatopa msanga ndipo amafuna kugona nthawi zonse. Komanso, kusowa mphamvu kumakhudza chilakolako cha thupi. Kuti apange izo, thupi limafunikira chakudya chochuluka. Komabe, wodwalayo sakungonenepa, koma m'malo mwake amachepetsa thupi.

Njira zakuzindikira ndizofanana ndi mitundu yayikulu ya matenda ashuga. Mbali yodziwika bwino ya matenda ashuga opatsirana ndikuti chizindikiritso pakuwunika magazi chopanda pake ndichabwinobwino, koma katundu wa wodwala akangodwala, amadzuka kwambiri.

Kukhoza kwamavuto

Kukula kwamavuto sikumachotsedwa, chifukwa matenda a shuga nawonso ndi njira zovuta, ndipo palinso matenda oopsa.

Chifukwa chake, chithandizo chiyenera kuyambitsidwa mwachangu momwe mungapewere zovuta zonse.

Kodi zifukwa zazikulu kwambiri zachitukuko ndi ziti?

Kupanga kwa matendawa kumatha kukhala kosiyanasiyana motero mungathe kusiyanitsa magulu otsatirawa oyambitsa matendawa:

1. Matenda a endocrine system:

Itsenko-Cushing's matenda kapena matenda. Ichi ndi matenda oopsa a endocrine system, yodziwika ndi kuchuluka kwa mahomoni a adrenocorticotropic. Zotsatira zake, mahomoni a adrenal cortex amapangidwa mopitirira muyeso - cortisol, cortisone, corticosterone, aldosterone ndi androgens. Zonsezi zimabweretsa chodabwitsa cha hypercorticism (kuchuluka kwa ntchito ya adrenal cortex): kunenepa kwambiri, nkhope yooneka ngati mwezi, ziphuphu, kuchuluka kwa tsitsi la thupi (hirsutism), matenda oopsa kwambiri, kusokonezeka kwa msambo. Monga mukudziwa, kuchuluka kwa cortisol kumabweretsa hyperglycemia chifukwa cha kuchuluka kwa shuga wama chiwindi ndi kuwonongeka kwa ntchito. Mu 90% ya milandu, izi zimabweretsa pituitary adenoma (ubongo pituitary chotupa chomwe chimapanga kuchuluka kwa adrenocorticotropic timadzi), ndipo mu 10% choyambitsa ndi chotupa cha adrenal chomwe chimapanga kuchuluka kwa cortisol. Pheochromocytoma ndi chotupa chotupa, chomwe nthawi zambiri chimakhala m'matumbo a adrenal, nthawi zambiri kunja kwa iwo. Amadziwika ndi kutulutsidwa kosamveka kwa catecholamines (adrenaline ndi norepinephrine) m'magazi, zomwe zimapangitsa kuti ziwonetserozi zikhale za catecholamine - kugwedezeka mwadzidzidzi, kuzizira, kutuluka thukuta, tachycardia, komanso kuchuluka kwa magazi. Monga mukudziwira, ma catecholamines amatsogolera kukuwonjezeka kwa shuga wamagazi ndi zotsatira zina zonse zosasangalatsa. Acromegaly - matenda a anterior pituitary gland, limodzi ndi chiwonetsero chowonjezeka cha kukula kwa timadzi timene timatulutsidwa - amatchedwanso mahomoni okula. Mu 90% ya milandu, ndi chotupa cha pituitary chomwe chimapanga mahomoni okula. Amawoneka atapangidwa mafupa a mafupa ndipo amadziwika ndi kuwonjezeka kwa maburashi, mapazi, ndi kutsogolo kwa chigaza. Kuphatikiza apo, mahomoni okula ali ndi zotsatira za insulin komanso diabetogenic. Mphamvu yokhala ndi insulini imatha pafupifupi ola limodzi mutatha kubereka ndi mahomoni okula ndipo amadziwika ndi kuchuluka kwa insulin. Ngati kukula kwa mahomoni kumachitika kwakanthawi, ndiye kuti mapangidwe a insulin amachepetsa, kugwiritsidwa ntchito kwa glucose ndi minofu kumachepa ndipo hyperglycemia imayamba. Mwa odwala, matendawo amakula mu 10% ya milandu. Con syndrome ndi matenda a adrenal gland omwe amadziwika ndi kuchuluka kwa aldosterone, omwe amachititsa calcium, sodium, potaziyamu ndi chlorine wambiri m'thupi. Mothandizidwa ndi kuchuluka kwa aldosterone, kuchuluka kwa potaziyamu m'thupi kumachepa, zomwe ndizofunikira pakugwiritsa ntchito shuga ndi maselo. Zotsatira zake, hyperglycemia imayamba. Hemochromatosis ndi matenda obadwa nawo omwe amadziwika ndi kupuwala kwachitsulo ndikuchulukana kwake. Amayamba kumilowetsa m'miyeso ikuluikulu kuposa momwe amafunikira, ndikuyamba kudziunjikira m'chiwindi, kapamba, ndi khungu. Ndi kudzikundikira kwake kwambiri mu chiwindi ndi kapamba komwe kumabweretsa kukula kwa matendawa. Matenda a Wilson-Konovalov ndi matenda obadwa nawo omwe amadziwika kuti ali ndi vuto la mkuwa, ndipo amapezeka mkati mwa ziwalo zamkati - chiwindi, ubongo, ziphuphu. Kuchuluka kwambiri kwa mkuwa m'chiwindi kumayambitsa matendawa.

2. Matenda a kapamba:

Glucagonoma ndi chotupa choyipa cha ma cell a alpha am'mapiri a Langerhans a kapamba omwe amapanga glucagon. Matendawa, limodzi ndi kuchepa kwa magazi, matendawa ndi kuchepa kwa thupi mu 80% ya odwala kumabweretsa kukula kwa matenda ashuga. Somatostinoma ndi chotupa chochokera ku cell ya delta ya zisumbu za ma Langerhans a kapamba omwe amapanga somatostatin. Hormone iyi, pamodzi ndi mahomoni ena angapo, amatsogolera pakuchepa kwa kupanga kwa insulini, ndipo kupanga kwake mopambanitsa kumabweretsa kuchepa kwa insulin. Khansa yapachifuwa ndi chotupa choyipa cha tiziwalo tambiri ta kapamba.Maselo a pancreatic omwe amapanga insulini amakhudzidwa ndi vuto la khansa, kugwiritsidwa ntchito kwa glucose ndi minofu kumawonongeka ndipo hyperglycemia imayamba. Pancreatectomy, kapena kuchotsedwa kwa kapamba - palibe kupanga insulin kwathunthu. Acute pancreatitis kapena pancreatic necrosis ndi yotupa kapena yotupa - matenda owononga a kapamba pamene kutupa kapena kutupa kwake ndikuwonongeka kumachitika. Izi zimachitika mu 15 mpaka 18% ya odwala. Chomwe ndikuwonongeka kwa gawo la kapamba limodzi ndi ma cell omwe ali ndi vuto lopanga insulin. Pancreatitis yosatha ndi kutupa kosatha kwa kapamba, komwe kumayambitsa matenda ashuga 40% ya milandu. Chifukwa cha kutupa kosatha, ntchito yamaselo azisumbu za Langerhans ya kapamba imasokonekera ndipo kupanga kwa insulin kumachepetsedwa. Zowonongeka zowopsa m'mapamba.

3.Kuyipa kwa zinthu zingapo za poizoni ndi mankhwala - amatha kutsogolera kukula kwa yogwira (poyankha poyizoni) kapamba ndi kuphwanya kwa mankhwala a insulin, kapena angakhudze maselo a pancreatic beta ndikuchepetsa katemera wa insulin, amachepetsa chidwi cha minyewa chifukwa cha insulin ndipo motero zimayambitsa hyperglycemia. Izi zikuphatikiza mankhwala ophera tizilombo, kugwiritsa ntchito nthawi yayitali glucocorticosteroids, antidepressants, diuretics, mankhwala a chemotherapy.

Second matenda a shuga - ndizomwe zimayambitsa?

Zachidziwikire kuti ambiri a inu mwazimvapo izi - matenda ashuga. Koma, mwina, alipo ochepa omwe angapereke tanthauzo lomveka bwino la matendawa. Monga momwe dzinali likunenera, nthendayi imalumikizidwa ndi matenda achilengedwe, koma kusiyana kwake ndi kotani? Tiyesetsa kupereka yankho lenileni komanso lomveka bwino pafunso ili.

Mawonekedwe

Matenda a shuga a sekondale amapezeka chifukwa cha kuphwanya kwa pancreatic ntchito. Zimatha kuchitika ngati zolakwika za endocrine system zimawonedwa. Nthawi zambiri, kapamba amasiya kugwira ntchito mwaumoyo pambuyo pa matenda monga khansa, hemochromatosis ndi kapamba.

Chifukwa cha izi, zomwe zimapangitsa kuti matenda ashuga a shuga akhale ofanana kwathunthu ndi zomwe zimayambitsa matenda a shuga a mtundu I. Kuchokera pakuwona zamankhwala, a sekondale (kapena, monga amatchedwanso chisonyezo) shuga mellitus ndi mkhalidwe pamene shuga ya magazi imakhalabe yabwinobwino nthawi yambiri komanso isanachitike, koma amasintha kwambiri pambuyo pa kuchuluka kwamphamvu kwambiri m'thupi.

Nthawi zambiri matendawa amakumana ndi kugwiritsidwa ntchito mwadongosolo kwamitundu yambiri, koma nthawi yomweyo, thupi limakhalabe ndi mphamvu yolimbana ndi shuga wambiri. Magazi ochulukirapo amadziunjikira m'thupi, zomwe zimapangitsa kuti matendawa athe.

Pali magawo atatu a shuga yachiwiri - ofatsa, odziletsa komanso okhwima.

Ndi degree yofatsa, matendawa amatha kuchiritsidwa ndi okhwima pakudya. Mtundu wapakati wa matenda am'mimba ophatikizika amathandizirana ndi mitundu yosiyanasiyana ya chithandizo, zonse ziwiri ndi zakudya komanso mankhwala a pakamwa. Koma za kuchuluka kwakukulu, ndikofunikira kunena mawu ochepa padera - pamaso pa gawoli, wodwalayo amalumpha mosalekeza m'magawo a shuga, kuphatikiza, amafunikira insulini yayikulu.

Sekondale yokhala ndi shuga

Mtunduwu wa shuga umapezeka mu matenda a endocrine system. Izi zitha kukhala zopatuka ndi matenda:

Matenda a Itsenko-Cushing kapena chizindikiro (kapena matenda osachiritsika a cortisone), acromegaly, yomwe imadziwika ndi kukula kwambiri kwa mahomoni, pheochromocytoma, chotupa chotulutsa ma catecholamines, chizindikiro cha Cohn, hyperaldosteronism yapamwamba, imadziwika chifukwa chakuti kuchuluka kwa potaziyamu komwe kumafunikira kumachepera mchikakamizo cha aldosterone. pa kugwiritsidwa ntchito kwa shuga, glucogonoma - chotupa chochokera m'maselo a maselo a Langerhans, matendawa amadziwika chifukwa chakuti odwala atha, zilonda zam'mphepete zimakhalapo.

Matenda a shuga a pancreatic amadziwikiranso. Zimachitika mutachotsa kapamba kapena khansa ya kapamba (thupi ndi mchira wake). Ndipo kupatula apo, hemachromatosis ndi matenda akuchulukitsa kwa chitsulo, pamene mulingo wa chitsulo m'magazi (nthawi zambiri umayendetsedwa ndi kayendedwe ka mayankho) ukuwonjezeka: chitsulo chimatengedwa kuposa momwe chimakhalira, chimalowa m'chiwindi, kapamba, ndi khungu. Pankhaniyi, paliotatu: khungu laimvi lakuda, chiwindi cholimba ndi shuga.

Ndizovuta kudziwa matenda ashuga, nthawi zina matendawa amapezeka pokhapokha atakulitsa zovuta kapena pakuwunika mwachisawawa. Kwa odwala, kubwezeretsedwa kumalimbikitsidwa, komwe kumatheka makamaka ndi zakudya kapena mankhwala a pakamwa a hypoglycemic. Njira yamatendawa siyiperekezana ndi ketosis.

Pali magawo atatu azovuta za shuga, zomwe zimatengera mseru wa glycemia, chidwi ndi zochizira komanso kukhalapo kapena kusowa kwa zovuta.

Kwambiri digiri ndimilandu ya matenda momwe chiphuphu chimaphatikizidwa ndi kuphatikiza zakudya ndi mankhwala a pakamwa a hypoglycemic kapena makonzedwe a insulini osaposa 60 magawo / tsiku. Mulingo wambiri wa glucose wama 12 mmol / L umadziwika. Pali chizolowezi cha keto-acidosis, nthawi zambiri pamakhala mawonekedwe ofatsa a microangiopathy.

Shuga yayikulu imaphatikizira matenda omwe ali ndi maphunziro olembetsa, omwe amadziwika ndi kusinthasintha kwa shuga m'magazi masana, chizolowezi cha hypoglycemia, ketoacidosis. Potere, kuthamanga kwa shuga m'magazi kumapitilira 12,2 mmol / L. Kulipiritsa kumafunikira mlingo wa insulini wofanana ndi mayunitsi 60 / tsiku kapena kuposerapo. Matenda oopsa kwambiri omwe amakhala ndi matenda oopsa a shuga: retinopathy a III - IV degree, nephropathy omwe ali ndi vuto laimpso, zotumphukira neuropathy. Pokhudzana ndi zizindikiro zonsezi komanso njira yamatendawa, kuthekera kwa odwala kugwa kwambiri.

Gulu la odwala matenda a sekondale

Amayanjana ndi matenda a pancreatic, kapamba ndi pachimake komanso nthawi yayitali, matenda a fibrocalculosis, khansa ya kapamba, opaleshoni ya kapamba, hemochromatosis (pulayimale ndi sekondale). Wachiwiri kwa mahomoni ochulukirapo, matenda a Cushing's, pheochromocytoma, acromegaly, glucagon, somatostatinoma, thyrotooticosis, hyperaldosteronism. Amayanjana ndi majini syndromes: cholowa cholimbana ndi insulin, mitochondrial cytopathy, ena. Amayambitsa poizoni ndi mankhwala osokoneza bongo: poizoni ndi mankhwala osokoneza bongo a b-cell, mankhwala omwe amachepetsa katulutsidwe ka insulin, mankhwala omwe amachepetsa mphamvu ya insulin.

Amakhulupilira kuti odwala omwe ali ndi matenda ashuga a m'matenda a shuga sanakhale ndi microangiopathy, koma zakhala zikuwonetsa kuti zovuta zitha kukhalabe ndi vuto la hyperglycemia

Matenda a Pancreatic

Njira iliyonse ya pathological yophatikizira kapamba imatha kuyambitsa matenda ashuga: kutupa ndi opaleshoni ya kapamba. Glucose tsankho limapezeka mu 9-70% ya odwala omwe ali ndi pancreatitis yayikulu, njira zambiri zogawa pafupipafupi zamankhwala zimagwirizanitsidwa ndi njira zosiyanasiyana za kusalolera kwa shuga ndi zina zake. Pafupifupi 15-18% ya odwala amakhala ndi “matenda ashuga” pambuyo povutitsidwa ndi chifuwa chachikulu cha khansa, pakatha miyezi 6, hyperglycemia ndi glucosuria amatha kuthetsedwa zokha.

Matenda a shuga mu pancreatitis yachilengedwe amadziwika ndi hypoinsulinemia ndi hyperglucagonemia, yomwe imatha kukhala chifukwa cha ketoacidosis. Mu chifuwa chachikulu, mapiritsi a insulin ndi glucagon amalumikizana ndi kuchuluka kwa maselo a islet: kumayambiriro kwa matendawa, kuchuluka kwa insulini kumakhala kwabwinobwino kapena kokwezeka pang'ono, kuchuluka kwa glucagon ndikwabwinobwino, ndipo ndi kupita patsogolo kwa matendawa, hypoinsulinemia ndi hypoglucagonemia zimayamba.

Kuwona kwa mahomoni kumeneku chifukwa cha kuchepa kwa enzyme komanso kuledzera kumapangitsa kuti glycemia ikhale ndi pafupipafupi komanso mikwingwirima yayikulu ya hypoglycemia.

Mowa Pancreatitis (AP) ndi mtundu wofala kwambiri wamatenda a kapamba. Matendawa amakhudza anthu, makamaka azaka zapakati, pomwe ma endocrine ndi ma exocrine omwe amapulumutsa. Pozindikira AP, kuthana ndi vuto la uchidakwa, cirrhosis ndi matenda oopsa a portal ndizofunikira.

Mu magawo oyamba a shuga amatha kuthana ndi zakudya komanso mankhwala amkamwa a hypoglycemic, ovuta kwambiri, chithandizo cha insulin ndi chofunikira. Kuletsa zakudya ndi kuchiza ndi ma pancreatic enzyme kumapangitsa kuti matendawa athe.

Malinga ndi gulu la WHO, matenda ashuga otentha amagawika kukhala ndi vuto la shuga la kapamba (PDPD) ndi matenda a chifrocalculeous pancreatic (FCPD) - Jamaican ndi Indonesia, motsatana (molingana ndi madera omwe mitundu iyi ya shuga idafotokozedwa koyamba). Pambuyo pake, mawu akuti "shuga mellitus modified shuga" amafunsidwa pagululi.

Njira zoyesera za PDA

Glycemia ndiwokwera kuposa 11 mmol / l, - kuyambika kwa matendawa pambuyo pa zaka 30, - thupi misa index (BMI) yochepera 19 kg / m2, - kusowa kwa ketosis, - otsika pazachuma komanso chikhalidwe, - kufunika kwa insulin zoposa 60 mayunitsi / tsiku.

Zowonjezera za FKPD zimaphatikizapo: - zambiri zowonetsera kupweteka pamimba zaka zapitazo, - umboni wa radiographic kapena wa ultrasound wa pancreatic Calculator kupatula uchidakwa, cholelithiasis, hyperparathyroidism.

Kusowa kwa ketosis kumasiyanitsa nthawi zambiri za matenda ashuga otentha ku IDDM. Amayesa kufotokoza kukana uku kwa ketosis ndi chotsalira cha insulin, kuchepa kwa ntchito ya-cell yokhala ndi kufooka kwa glucagon pamagetsi a glucose, komanso kusowa kwa kunenepa kwambiri komanso kuchepa komwe kumayenderana ndi kupezeka kwa magawo a NEFA - ketogene.

PDPD imadziwika ndi fibrosis pamlingo wocheperako kuposa fibrocalculous. Zilonda za maselo a islet ndizowonjezera, koma palibe umboni wazowonongeka zam autoimmune wapezeka. Nthawi zina, chiwindi chimakhudzidwa ndi zochitika zina (cirrhosis, mafuta achilengedwe).

PDAP idaganiziridwa kuti ndi chifukwa cha kusowa kwa mapuloteni muzakudya. Zinakatsimikizidwanso kuti kuchepa kwa mapuloteni kunachitika nthawi zina matendawa m'maiko momwe mtundu uwu wa matenda a shuga sufalikira, ndipo odwala ena omwe ali ndi matendawa alibe zizindikiro za kuperewera kwa zakudya. Zikuwoneka kuti zina kupatula kuperewera kwa mapuloteni kungatenge nawo gawo la PDAP (Chiwembu 1).

Zakudya zinazake zomwe zimakhala ndi mtundu wa chinangwa - zimatha kuyambitsa vuto la kufinya.

Cassava imakhala ndi linamarine, yomwe imapangidwa ndi hydrocyanide acid. Nthawi zambiri, imapangidwa ndi magulu a sulfhydryl a amino acid: methioninine, cystine, cysteine ​​mu thiocyanate. Ngati vuto la kuchepa kwa mapuloteni (i.e. amino acid), hydrocyanide acid imadziunjikira, zomwe zimabweretsa kuwonongeka kwa kapamba (Scheme 2).

Chiphunzitsochi sichitha kufotokoza kufalikira kwa matenda ashuga otentha komwe kumatha kudya zakudya izi, chifukwa chake palibe “mliri” wa matenda ashuga otentha m'malo omwe anthu amadya chinangwa. Mwinanso, nkhaniyi ili m'njira zofunikira kukonza zinthu.

Mtundu wina wamatendawa umaphatikizidwa ndi mowa, womwe umasungidwa mumzotengera wapadera wokhala ndi cyanide. Amuna azaka zopitilira 30 amadwala matendawa ku Kenya, Uganda ndi South Africa.

FKPD ndi yachiwiri pokhudzana ndi pancreatitis yotentha kwambiri ndipo sikhala konseko. Kusintha kwachilengedwe ndi FKPD kumangotchulidwa kuposa PDPD. Kuwunika kwa duct yokulitsidwa ndi kapamba wam'mimba kumayambitsa kukokoloka ndikuchepetsa ntchito ya b-cell.

Mu kafukufuku wina, kuchepa kwa kuchuluka kwa C-peptide m'madzi am'magazi kunatsimikizika mwa 75% ya odwala, komanso immunoreactive trypsin (chizindikiro cha kusokonekera kwa procrine) mu 66% ya odwala omwe ali ndi FKPD. Izi zikusonyeza chitukuko chachiwiri cha mtundu uwu wa shuga pokhudzana ndi chifuwa chachikulu.

Kuperewera kwa procrine pancreatic kungakhale mtundu wapadera wa matenda a shuga, mosiyana ndi kuperewera kwa zakudya m'thupi. Izi zikuwonetsa lingaliro lina la kagwiritsidwe ka zinthu zomwe zapangidwira - kuchepa kwa thupi ndi chifukwa cha matenda osakhazikika a shuga, i.e. Matenda operewera chifukwa cha matenda ashuga ndiwofunika kwambiri kuposa kuperewera kwa vuto la shuga.

Kuphatikiza kwakukulu kwa mabanja kwa FCPD kunapezeka ku South India, komwe kuchuluka kwa mabanja omwe amagwirizana kwambiri kuli kwachikhalidwe, 10% ya odwala anali ndi abale am'banja omwe anali ndi pancreatitis kapena procrine pancreatic pathology komanso kulolera shuga.

Kafukufuku wama genetic a anthuwa adawonetsa kuyanjana kwa FCD ndi HLA chikhomo DQB, komanso kuyanjana ndi 3 allele ya dera lochepa la insulin, yomwe imalumikizidwanso ndi NIDDM. Ku North India, mitundu ya mabanja ya FKPD siyachilendo; zochitika zachilengedwe zimagwira ntchito yayikulu pano.

Mankhwala a insulin nthawi zambiri safunika. Komabe, mankhwalawa opaleshoni yotupa (yonse pancreatectomy kapena proximal subtotal pancreatectomy ndi duodenectomy, imabweretsa chitukuko cha matenda a shuga, monga pancreatitis yayitali.

Boma losowa kwambiri lomwe limatulutsira pancreatectomy yokhazikika ya hyperinsulinemic hypoglycemia syndrome mu makanda, nthawi zambiri amakhala ndi matenda ashuga pambuyo opaleshoni.

Mu hemochromatosis (pulayimale kapena yachiwiri mpaka yayikulu thalassemia), kukana insulini kumadziwika, komwe kumapangitsa chidwi chazitsulo, zomwe zimapangitsa chidwi cha insulini. Hemochromatosis nthawi zambiri imagwirizanitsidwa ndi matenda a shuga, ndichifukwa chake nthawi zina amatchedwa "matenda a shuga."

Maziko a matenda a shuga mu hemochromatosis ndi kuphatikizika kwa cholowa, chiwindi cha chiwindi ndipo, mwina, kuwonongeka kwazitsulo komwe kumayikapo zitsulo zamkati. Odwala a gululi, kuchepetsedwa kwazowonetsa za matenda a carbohydrate metabolism atachepa.

Matenda a shuga obwera chifukwa cha kuchuluka kwa mahomoni

Ma syndromes angapo a endocrine amadziwika ndi hypersecretion yama antiinsulin mahomoni omwe amatsogolera pakupanga shuga. Cushing's syndrome - cortisol secretion imawonetsedwa ndi chithunzi chamankhwala ambiri: nkhope yooneka ngati mwezi, kunenepa kwambiri, buffalo hump, ziphuphu, hirsutism, matenda oopsa, kusamba kwa msambo.

Malinga ndi mabukuwa, 50-94% ya odwala omwe ali ndi vuto la Cushing adathetsa shuga, 13% ali ndi matenda a shuga. Pambuyo kukonza kwa hypercortisolemia, 10% ya odwala amapezeka ndi matenda a shuga. Popeza kufalikira kwa NIDDM pagulu lambiri ndi 5-10%, ndizotheka kuti odwala awa ali ndi NIDDM yoyambitsa hypercortisolemia.

Pheochromocytoma imadziwika ndi kutulutsidwa kosavomerezeka kwa adrenaline ndi norepinephrine ndipo kumabweretsa dziko la hyperadrenergic: matenda oopsa, tachycardia, thukuta, ndi zina zambiri.
Kukula kwenikweni kwa matenda ashuga okhala ndi pheochromocytoma sikudziwika.

Acromegaly amadziwika kuti amadziwika ndi mitundu yokwezeka ya mahomoni okula. Zoposa 90% zamilandu zimachokera ku STH-secreting pituitary chotupa, kupumulako kumabisalira ectopic ya STH kapena somatoliberin ndi zotupa zingapo. STH ili ndi insulin-komanso diabetogenic. Zotsatira za insulin, pambuyo poti katundu wambiri “wa STH,” amatha pafupifupi ola limodzi.

Kuchita bwino kwa mankhwala a acomegaly nthawi zambiri sikuchiritsa matenda ashuga; munthu sayenera kuyiwala za lingaliro la NIDDM ponseponse.

Glucagon - chotupa chosowa kwambiri cha ma cell a Isanger a Langerhans. Kuwonjezeka kwa milingo ya glucagon kumapangitsa kuti pakhale matenda apadera, omwe amadziwika ndi necrolytic kusuntha erythema, kuwonda, glossitis, angular chileitis ndi zochitika za thromboembolic.

Glucagon imatha kudwala matenda ashuga, kukulitsa gluconeogenesis ndi lipolysis mu minofu ya adipose. Pakuwunika kwaposachedwa kwamilandu yonse ya glucagonoma, odwala oposa 80% anali ndi matenda a shuga. Milandu yambiri ya NIDDM imayendetsedwa ndi zakudya kapena mankhwala amkamwa a hypoglycemic.

Somatostatinoma ndi chotupa chochokera ku ma-cell a ma isanger a Langerhans, zomwe zimatsogolera ku matenda ashuga. Hypersecretion ya somatostatin ndi chotupa chimayambitsa kutsegula m'mimba, steatorrhea, cholelithiasis, ndi shuga. Matenda a shuga nthawi zambiri amapitilira bwino, mwina chifukwa cha kuchepa kwapang'onopang'ono kwa insulin katulutsidwe.

Thyrotooticosis ndi hyperaldosteronism nthawi zambiri zimagwirizanitsidwa ndi NTG. Zowawa za matenda ashuga pansi pamikhalidwe imeneyi mwina siziposa izi pa anthu onse.
Mitundu yosiyanasiyana ya cholowa cholowa imalumikizidwa ndi NTG komanso matenda a shuga.

Wodwala weniweni ndi mayi wachichepere (wazaka 8-30) wonenepa kwambiri kapena wolimbitsa thupi, acanthosis nigricans, hyperandrogenism (mtundu wa A insulin kukana). Mtundu wa kukana kwa B-insulin uli ndi chilengedwe cha autoimmune chokhudzana ndi ma antibodies kuma insulin receptors.

Mawonekedwe a maselo a insulin receptors nthawi zambiri awonetsa masinthidwe awo, omwe angakhudze ntchito zake zosiyanasiyana: kayendedwe kupita ku membrane wa cell, insulin binding, autophosphorylation. Zofooka izi zimabweretsa insulin kukana, NTG.

M'zaka zaposachedwa, kuwonjezeka kwa matenda omwe amalumikizana ndi vuto la majini mu mitochondrial DNA kwatsimikiziridwa. Zisokonezo izi zimaphatikizapo ntchito zosiyanasiyana za mitsempha ndi kulolerana kwa glucose.

Chitsanzo ndi Tungsten syndrome kapena DIDMOAD. Mwa odwala, shuga amayamba msanga ndipo amadalira insulin. Kuyesedwa kwa odwala kunawonetsa maumboni aumboni zam'mbuyomu komanso zamankhwala osokoneza bongo. Choyambitsa matenda a shuga sichidziwika. Komabe, DNA ya mitochondrial imapanga ma enzyme omwe amachitika mu aerobic glycolysis, yomwe mwina imachepetsa ntchito ya ma cell a b.

Poizoni ndi mankhwala owopsa a b-cell Mankhwala a Rodent (PNU, RH 787), omwe amatengedwa mwangozi pakamwa, amayambitsa matenda ashuga chifukwa cha kuwonongeka kwa ma cell a B. Pafupifupi milandu 300 yanenedwapo. Pali zizindikiro zina, kuphatikizapo kuwonongeka kwam'maganizo, kupuma kwa kupsinjika kwa mtima, mtima arrhythmias, hypotension, ndi neuropathy.

Nthawi zambiri, ketoacidosis imayamba masiku 2-7 pambuyo kuledzera ndikufunika kwa insulin. Mankhwala ofala - DDT, dieldrin, malaton - alinso ndi matenda ashuga. Nkhani ya matenda ashuga yomwe imayamba chifukwa cha mphamvu ya ma organic sol sol (toluene, methylene chloride) akuti.

Mankhwala osokoneza bongo omwe amakhudza katulutsidwe ka insulin. Mankhwala omwe amalepheretsa Ca-channels (verapamil, nifedipine), amathandizira hypokalemia (diuretics), mankhwala a adrenergic (epinephrine, norepinephrine), b-blockers ndi mankhwala osiyanasiyana a psychotropic (phenothiazines, tridclic antidepressants, kukonzekera kwa lithiamu) kungayambitse kuchepa kwa kulolerana kuti shuga poletsa insulin katulutsidwe.

Zachidziwikire, ngakhale "yachiwiri" matenda a shuga amakula mwa anthu omwe akuyembekezeka kukhala "woyamba" matenda ashuga, ndikuzindikira njira zake zomalizirazi zimapangitsa kuti athe kunena kuti gawo lalikulu la milandu ndi gulu la "sekondale".