Mtundu woyamba wa shuga

Pali ma cell a beta mu kapamba omwe amapanga insulin. Insulin imathandizira kutulutsa glucose kuchokera ku madzi a m'magazi kupita ku minofu yomwe ikufuna. Ziwalo zotsatirazi zimakhala ndi kuchuluka kwakukulu kwa shuga: maso, mtima, mitsempha yamagazi, impso, mantha. Chinsinsi cha matenda a shuga amtundu woyamba ndikuti ma cell a pancreatic beta amwalira mwadzidzidzi ndikusiya kupanga insulin. Pali shuga wambiri m'magazi, koma sichimafika ziwalo zomwe zimafunikira. Ziwalo ndizosakwanira mu shuga, ndipo hyperglycemia imapezeka m'magazi.

Matenda a shuga amtundu wa 1 amawonekera

Matenda a shuga 1 amayamba. Wodwala amakhala ndi ludzu lotchulidwa, pakamwa pouma, amamwa zamadzi zambiri ndi kukodza kwambiri. Odwala ena amadana ndi chakudya ndi mseru, pomwe ena, m'malo mwake, amadya kwambiri. Komabe, onse awiri amachedwa kuchepa - mpaka 20 makilogalamu m'milungu ingapo. Komanso, odwala ali ndi nkhawa chifukwa cha kufooka, chizungulire, kuchepa kwa ntchito, kugona. Popanda kulandira chithandizo kwa odwala omwe ali ndi matenda a shuga 1, ketoacidosis imayamba mwachangu, yomwe imatha kulowa mu ketoacidotic.

Mtundu woyamba wa shuga

Chithandizo cha matenda a shuga amtundu woyamba ndi pulogalamu yokhayo yoperekera mankhwala omwe amakhala ndi insulini, chifukwa muzovuta kwambiri, insulin yanu siyipangike konse.

Chifukwa chake, 2 mfundo zazikulu zochizira mtundu 1 shuga mellitus:

• Zakudya ndi kudziletsa
• Mankhwala a insulin.

Lero, kukhazikitsa insulin kuchokera kunja ndiyo njira yokhayo yochizira matenda amtundu wa 1 shuga. Ngati m'modzi mwa opanga mankhwalawa akuti akupanga mankhwala omwe angachiritse matendawa, uku ndikunamizira.

Pali mitundu iwiri ya mankhwala omwe ali ndi insulin:

• ma insulin achidule (humalog, actrapid, etc.),
• ma insulin omwe amakhala nthawi yayitali (lantus, protofan, levemir, etc.).

Malamulo apamwamba kwambiri a insulin ndi awa:

• m'mawa - insulin
• musanadye chakudya cham'mawa, chakudya chamadzulo, chakudya chamadzulo - insulin yochepa,
• usiku - - insulin.

Mlingo wa insulin nthawi zambiri amasankhidwa ndi endocrinologist. Komabe, kuchuluka kwa insulin yocheperako yomwe imayendetsedwa asanadye kumadalira kuchuluka kwake. Kusukulu ya matenda ashuga, odwala matenda ashuga amaphunzitsidwa kuwerengera magawo omwe amapezeka muzakudya ndikuyang'anira insulin yayifupi kwambiri pakufunika. Tsiku lililonse, odwala onse omwe ali ndi matenda ashuga ayenera kuyang'anira kuchuluka kwa shuga ndi magazi ake.

Matenda a shuga a Type 1 amakhala amoyo wonse. Tsoka ilo, matendawa ndi osachiritsika masiku ano.

Mtundu wa 1 shuga wodwala

Musanayambe chithandizo, kusankha njira, ndikofunikira kuganizira zomwe zimayambitsa matendawa, zizindikiro zomwe zimadziwika ndi iye, njira zodziwikira. Matenda a shuga ndi kuphwanya magwiridwe antchito a kapamba, machitidwe ena mthupi la munthu, omwe amapangidwa chifukwa chosowa insulini. Pankhani ya matenda, maselo achikondwerero omwe amapanga mahomoni sangathe kugwira bwino ntchito yawo. Zotsatira zake, zizindikiro za shuga zimachulukana, zomwe zimawononga ntchito ya ziwalo, zaumoyo.

Kuperewera kwa insulin ndi shuga wambiri m'magazi kumayambitsa zovuta zina: kusawona bwino, kugwira ntchito kwa ubongo, mitsempha yamagazi yatha. Pakuwongolera kuchuluka kwa mahomoni, njira ya metabolic, odwala omwe amapezeka ndi mtundu wa matenda a shuga 1 amafunika kubayidwa tsiku ndi tsiku m'miyoyo yawo yonse. Chithandizo chopanda matenda a shuga a insulin 1 sichotheka, mlingo wa mahomoni umayendetsedwa payekhapayekha.

Asayansi sakudziwa zifukwa zodalirika zomwe zimayambitsa kuchepa kwa insulin. Ndi kuthekera kwakukulu komwe kuli kotheka kunena kuti chofunikira pakukula kwa matenda ashuga a 1 ndikuwonongeka kwa maselo a β-cell omwe amapezeka m'mapapo. Ndipo zoyambira vutoli zitha kukhala zosiyanasiyana:

• Kukhalapo kwa majini komwe kumatsimikizira chibadwa cha matenda ashuga.
• Zovuta za chitetezo chamthupi, njira ya autoimmune.
• Matenda opatsirana oyambitsidwa ndi mavairasi, mwachitsanzo, chikuku, mavu, chiwindi.
• Kupsinjika, kupsinjika kwa malingaliro kosatha.

Kwa matenda amtundu wa 1, zizindikiro ndi zachibadwa, monga mtundu wachiwiri. Zizindikiro zonse sizinafotokozeredwe mokwanira, motero, sizimabweretsa nkhawa kwa wodwala mpaka ketoacidosis, yomwe nthawi zina imabweretsa zovuta za matendawa. Ndikofunika kuyang'anitsitsa thanzi lanu mosamala ndipo ngati zizindikiro zingapo za matenda ashuga zapezeka, muyenera kukayezetsa magazi, kuyesa mkodzo ndikuyendera dokotala yemwe akuthandiza matendawa - endocrinologist. Zizindikiro matenda a mtundu woyamba:

• Mumva ludzu kwambiri.
• Pakamwa pakamwa.
• Kukoka pafupipafupi (usana ndi usiku).
• Kulakalaka kwamphamvu, koma wodwalayo amachepetsa thupi.
• Zowonongeka, chilichonse chimakhala chopanda tanthauzo popanda zomveka bwino.
• Kutopa, kugona.
• Kawirikawiri, kusinthasintha kwakakwiya, kusatetezeka, kusachedwa, kukwiya.
• Amayi amadziwika ndi chitukuko cha matenda opatsirana m'dera la ziwalo zamkati zomwe sizigwirizana ndi chithandizo chakanthawi.

Ngati ketoacidosis (zovuta) zayamba kale, zowonjezera zimawonedwa:

• Kutupa thupi, khungu louma.
• Kupuma kumakhala pafupipafupi, mozama.
• Fungo lochokera pamlomo wamkamwa ndilosasangalatsa - fungo la acetone.
• Kufooka kwathupi lathupi, nseru, kuchepa kwa chikumbumtima ndikotheka.

Njira yovomerezeka yothandizira mtundu wa matenda a shuga 1 ndi ma jakisoni a insulin opitilira. Koma njira zina zowonjezera zimatha kukhudzana ndi matendawa, zimachepetsa zizindikiro zake komanso kupewa kupezeka kwa zovuta. Ndikotheka kugwiritsa ntchito njira izi kapena zina mwa njira zothandizira odwala pokhapokha mutakambirana ndi adokotala ndikuthandizidwa.

Chofunikira pakuthandizira matendawa ndichakudya choyenera cha matenda a shuga 1. Zakudya zopangidwa moyenera, zosankhidwa bwino zimathandizira kuchepetsa, kupewa kuchuluka kwa shuga, motero zitheke kuchepetsa kuchuluka kwa insulin. Chakudya cha T1DM:

• Zosankha siziyenera kuthana ndi thanzi.
• Zakudya, muyenera kusankha mitundu yosiyanasiyana.
• Ndi matenda a shuga, muyenera kusankha zinthu zachilengedwe.
• Ndikulimbikitsidwa kuti mupange mndandanda wa sabata, kupenda mosamalitsa mbale ndi zida zake.
• Samalani kudya, nthawi ya jakisoni wa insulin, pewani kudya usiku.
• Chakudya chizikhala m'magawo ang'onoang'ono, ogawika osachepera 5 patsiku.
• Pewani shuga wopanda zakudya, zomwe zimakhala zowopsa kwambiri kwa odwala matenda a shuga.
• Osamadya chakudya kuchokera pamndandanda "woletsedwa".
• Ndikofunika kusiya kusuta.

Zomwe zaletsedwa kudya:

• Zokhala ndi shuga - mitundu yonse ya maswiti (maswiti, chokoleti, makeke).
• Mowa, makamaka, umakhala wowopsa pankhani za matenda a shuga a mellitus dessert ndi zakumwa zoledzeretsa.
• Zipatso zokoma (mwachitsanzo mango, nthochi, mphesa, vwende).
• Madzi owala.
• Zakudya Zachangu.
• Nyama zosuta, zipatso, msuzi wamafuta.

Zakudya za odwala, menyu odwala:

• Chakudya chachikulu ndi chakudya cham'mawa. Ndikwabwino kusankha phala, mazira, amadyera, tiyi wopanda mafuta.
• Zakudya zokhazokha zoyambirira ndizoperewera zipatso kapena masamba.
• Chakudya chamasana - msuzi wa masamba, masamba ophika ndi owiritsa kapena wowotcha, nyama yophika kapena nsomba.
• Zakudya zokhazokha - mafuta ochepa mkaka wowawasa, saladi yamasamba kapena mkate wopanda tiyi wopanda mafuta.
• Chakudya chamadzulo - nyama yophika kapena yophika, masamba - atsopano kapena nthenga, nsomba zothimbirira, zinthu mkaka ndi mafuta ochepa.

Masewera olimbitsa thupi

Masewera ndi imodzi mwanjira zochizira matenda ashuga. Mwachilengedwe, kuchotsa matendawa sikugwira ntchito konse, koma kumathandizira kuchepetsa magazi. Nthawi zina, kupsinjika kungayambitse kuchuluka kwa shuga, kotero musanayambe makalasi, muyenera kufunsa dokotala. Mukamaphunzitsidwa pamaso pa shuga, ndikofunikira kuyeza shuga musanayambe kuchita masewera olimbitsa thupi, pakati pa maphunziro ndi kumapeto. Muyenera kuyang'anira insulini pafupipafupi ndipo kuzindikiritsa kwina ndikofunikira kusiya zolimbitsa thupi:

• 5.5 mmol / L - mlingo wotsika kumene kusewera masewera kumakhala kosavulaza. Ndikulimbikitsidwa kuti mudye chakudya chamafuta ambiri (monga mkate) musanayambe kulimbitsa thupi.
• Zizindikiro pamtunda wa 5.5-13.5 mmol / L zimapereka kuwala kobiriwira pophunzitsira.
• Zizindikiro pamwambapa 13.8 mmol / L zimawonetsa kusayenerera kwa kuchita masewera olimbitsa thupi, izi zimatha kukhala chothandizira kukulitsa ketoacidosis, ndipo pa 16.7 mmol / L - ndizoletsedwa kotheratu.
• Ngati mukumaphunzirabe shuga idatsika mpaka 3,8 mmol / L kapena kuchepera, siyani kuchita masewera olimbitsa thupi nthawi yomweyo.

Kuchita masewera olimbitsa thupi kwa odwala omwe ali ndi matenda amtundu wa 1 ali ndi mawonekedwe ake:

• Makalasi amayenera kuseweredwa ndi mpweya wabwino kuti akwaniritse kwambiri.
• Kukula kwa nthawi yokhala ndi matenda a shuga 1 ndi theka la ora, mphindi makumi anayi, kasanu sabata kapena ola limodzi ndi makalasi tsiku lililonse.
• Kupita zolimbitsa thupi, ndikofunikira kutenga chakudya chamankhwala kuti muchepetse hypoglycemia.
• Mu magawo oyamba, sankhani masewera olimbitsa thupi osavuta, pakapita nthawi, ndikuwasintha pang'onopang'ono, ndikuwonjezera katundu.
• Masewera olimbitsa thupi ndi abwino: kuthamangitsa, kutambasula, squat, thupi limatembenuka, masewera olimbitsa thupi, kulimbitsa thupi mwamphamvu.

Mankhwala osokoneza bongo a shuga

Makapu a matenda a shuga a DiabeNot ndi mankhwala othandiza opangidwa ndi asayansi aku Germany ochokera ku Labor von Dr. Budberg ku Hamburg. DiabeNot adatenga malo oyamba ku Europe pakati pa mankhwala a shuga.

Fobrinol - amachepetsa shuga m'magazi, amakhazikika ziphuphu, amachepetsa thupi komanso amatulutsa magazi. Phwando laling'ono!

• Mwachidule kuchita insulin. Homoni imayamba mphindi khumi ndi zisanu atamwa.
• Mankhwala osokoneza bongo amawonjezeranso patatha maola awiri atakhazikitsa.
• Insulin yokhala nthawi yayitali imayamba kugwira ntchito maola anayi, atatha jakisoni.

Ndikothekanso kubaya insulin m'thupi la odwala omwe ali ndi matenda amtundu wa 1 jekeseni, pogwiritsa ntchito syringe yapadera ndi singano yopyapyala kapena pampu.

Gulu lachiwiri la mankhwalawa liphatikizapo:

• ACE (angiotensin-converting enzyme inhibitor) - mankhwala omwe amathandizira kuthamanga kwa magazi, amaletsa kapena kuchepetsa kubala kwa matenda a impso.
• Mankhwala kuthana ndi mavuto am'mimba omwe amachokera ndi matenda ashuga a mtundu woyamba. Kusankhidwa kwa mankhwalawa kumadalira pa matenda ndi mawonekedwe a vutoli. Ikhoza kukhala Erythromycin kapena Cerucal.
• Ngati pali chizolowezi chokhala ndi mtima wamatenda kapena mtima, tikulimbikitsidwa kutenga Aspirin kapena Cardiomagnyl.
• Ngati zotumphukira neuropathy, mankhwala osokoneza bongo amagwiritsidwa ntchito.
• Ngati pali zovuta ndi potency, erection, mutha kugwiritsa ntchito Viagra, Cialis.
• Simvastatin kapena Lovastatin ithandiza cholesterol yotsika.

Zithandizo za anthu

Odwala ambiri omwe ali ndi matenda ashuga a mtundu woyamba 1 amagwiritsa ntchito njira zachikhalidwe pofuna kuthana ndi matendawa. Zakudya zina, zitsamba, ndalama zitha kuchepetsa shuga m'magazi kapena ngakhale kuzichulukitsa. Zithandizo zodziwika bwino zakumwa zina, mankhwala akunyumba ndi awa:

• Nyemba (5-7 zidutswa) kutsanulira madzi 100 ml kutentha kwa chipinda usiku umodzi. Pamimba yopanda kanthu, idyani nyemba zotupa ndikumwa madzi. Chakudya cham'mawa chiyenera kuchepetsedwa kwa ola limodzi.
• Pangani kulowetsedwa komwe kumaphatikizapo malita 0,2 amadzi ndi magalamu 100 a mbewu za oat. Kugwiritsa ntchito katatu patsiku ndimamwa makapu 0,5.
• Dzazani thermos usiku ndikuphatikiza 1 chikho cha madzi (madzi otentha) ndi 1 tbsp. l chowawa. Kukhetsa m'mawa ndi kumwa chikho 1/3 aliyense kwa masiku 15.
• Pukuta ma clove ochepa ochepa a adyo mpaka gruel atapangidwa, onjezani madzi (malita 0,5) ndikuumirira kwa theka la ola pamalo otentha. Kwa odwala matenda ashuga, imwani ngati tiyi tsiku lonse.
• Kwa mphindi 7, kuphika 30 magalamu a ivy, okhathamiritsidwa ndi 0,5 l lamadzi, ndikulimbikira kwa maola angapo, kukhetsa. Malamulo olandila: Imwani musanadye kaye.
• Sungani magawo 40 a walnuts, onjezerani 0,2 L amadzi oyera ndi simmer kwa ola limodzi osamba madzi. Kukhetsa ndi kumwa tincture musanadye supuni.

Chithandizo chatsopano

Ntchito pa kuphunzira za matenda a shuga komanso njira zake zamankhwala zakhala zikuchitika kwazaka zambiri mmaiko osiyanasiyana padziko lapansi. Pali gulu la asayansi omwe cholinga chawo chachikulu ndi kuthetsa nkhaniyi. Kafukufuku wawo amathandizidwa ndi makampani opanga mankhwala, makampani akuluakulu, mabungwe othandizira, maziko, komanso boma. Pali njira zingapo zabwino zachitukuko zokhudzana ndi matenda amtundu woyamba 1:

• Asayansi akuyesera kuti apangitse maselo amumunthu kukhala am'magazi a beta, omwe amatha kugwira ntchito yopanga mahomoni ndikuchiritsa matenda ashuga. Koma mpaka pamapeto omveka phunziroli komanso mwayi wogwiritsa ntchito chida chothandizira anthu odwala matenda ashuga, akadali kutali.
• Ofufuzawo ena akugwira ntchito ya katemera yomwe ingalepheretse kukula kwa njira ya autoimmune momwe ma cell a pancreatic beta amagundidwa, ndipo matenda a shuga amapezeka.

Anthu omwe adapezeka kuti ali ndi matenda ashuga a mtundu woyamba aphunzira kukhala nawo, kukhala ndi vuto la jakisoni wa insulin nthawi zonse, kusintha zomwe amakonda komanso zomwe amakonda. Odwala a Type 1 a shuga amakhala ndi moyo wokwanira, amasangalala komanso kuyamika mphindi iliyonse, ndi chiyembekezo cha asayansi omwe tsiku lina adzapanga "mapiritsi amatsenga" pamavuto awo. Ngati mwakumana ndi vuto la mtundu woyamba wa matenda ashuga, mukudziwa njira zina zamankhwala kapena mwakonzeka kugawana malingaliro anu - siyani ndemanga.

Zinthu zakunja

Zomwe zimachitika mwachilengedwe zimathandizanso kwambiri pakukula kwa matenda ashuga a mtundu woyamba.

Mapasa odziwika omwe ali ndi genotypes omwewo ali ndi vuto la shuga nthawi imodzi mwa 30 - 50% yokha.

Kuchulukana kwa matendawa pakati pa anthu amtundu wa Caucasan m'maiko osiyanasiyana kumasiyana kakhumi. Zadziwika kuti mwa anthu omwe amasamukira kumadera omwe ali ndi vuto lalikulu la matenda ashuga m'malo omwe ali ndi vuto lalikulu, matenda ashuga amtundu wa 1 ndiwofala kwambiri kuposa ena omwe adakhala m'dziko lawo lobadwira.

Mankhwala ndi mankhwala ena Sinthani

Streptozocin, yomwe kale idagwiritsidwa ntchito ngati mankhwala othana ndi khansa, yomwe imagwiritsidwa ntchito pano pochotsa khansa ya metastatic pancreatic, imakhala yoopsa kwambiri m'maselo a pancreatic beta kotero kuti imagwiritsidwa ntchito kuwononga maselo awa poyesa nyama.

Rat sumu Pyrinuron (Pyriminil, Vacor), wogwiritsidwa ntchito ku USA mu 1976-1979, omwe akupitilizabe kugwiritsidwa ntchito m'maiko ena, amawononga maselo a beta a kapamba.

Makina a pathogenetic omwe amapanga chitukuko cha matenda a shuga 1 amachokera pa kusakwanira kwa kupanga kwa insulin ndi maselo a endocrine (β-cell of pancreatic islets of Langerhans). Mtundu woyamba wa shuga umakhala ndi 5-10% ya matenda onse a shuga, nthawi zambiri amakula ubwana kapena unyamata. Mtunduwu wa shuga umadziwika ndi kuwonetsa koyambirira kwa zizindikiro zomwe zimapita patsogolo mofulumira pakapita nthawi.Chithandizo chokha ndicho majekeseni a insulini okhalitsa omwe amateteza kagayidwe ka wodwala. Matenda osachiritsika, a mtundu woyamba 1 amapita patsogolo kwambiri ndipo amadzetsa zovuta zazikulu monga matenda ashuga a mtima, matenda opha ziwopsezo, matenda am'mimba, matenda ammimba am'mimba, matenda a ketoacidosis ndi matenda a shuga.

Magazini ya 1999 ya World Health Organisation's Dongosolar, Diagnosis, ndi Classified of matenda a shuga ndi zovuta zake imapereka gulu ili:

Kuchepa kwa insulin m'thupi kumakula chifukwa chokwanira kwa maselo a β-cell a pancreatic islets a Langerhans.

Chifukwa cha kuchepa kwa insulin, minofu yodalira insulin (chiwindi, mafuta ndi minofu) imalephera kutulutsa shuga m'magazi ndipo, chifukwa chake, kuchuluka kwa glucose m'magazi kumatuluka (hyperglycemia) - chizindikiro chazovuta cha matenda a shuga. Chifukwa cha kuchepa kwa insulin, kuchepa kwamafuta kumapangidwira minofu ya adipose, komwe kumapangitsa kuti magazi azikula kwambiri, ndipo kuwonongeka kwa mapuloteni m'misempha kumalimbikitsidwa, zomwe zimayambitsa kuchuluka kwa amino acid m'magazi. Zigawo za catabolism zamafuta ndi mapuloteni zimasinthidwa ndi chiwindi kukhala matupi a ketone, omwe amagwiritsidwa ntchito ndi ziwalo zosadalira insulini (makamaka ubongo) kuti azisunga mphamvu moyenera motsutsana ndi kumbuyo kwa kuchepa kwa insulin.

Glucosuria ndi njira yosinthira yochotsa glucose yayikulu m'magazi pamene gawo la glucose limaposa mtengo wa impso (pafupifupi 10 mmol / l). Glucose ndi chinthu chogwira ntchito mosiyanasiyana ndipo kuwonjezereka kwa ndere yake mu mkodzo kumawonjezera chimbudzi chamadzi (polyuria), chomwe chitha kupangitsa kuti madzi atheretu ngati madzi atayika sakulipidwa ndi kuchuluka kowonjezera kwamadzi (polydipsia). Pamodzi ndi kuwonjezeka kwa madzi mkodzo, mchere wamchere umatayikidwanso - kuchepa kwa masenti a sodium, potaziyamu, calcium ndi magnesium, anions a chlorine, phosphate ndi bicarbonate.

Pali magawo 6 a chitukuko cha matenda a shuga a mtundu woyamba (wodalira insulin):

1. Kutengera kwa chibadwa cha matenda ashuga omwe amalumikizana ndi dongosolo la HLA.
2. Zoyambira kuyerekezera. Kuwonongeka kwa maselo β maselo osiyanasiyana okhudza matenda ashuga komanso kuyambitsa chitetezo cha mthupi. Odwala ali kale ndi ma antibodies opita ku ma islet cell omwe ali ndi gawo laling'ono, koma kutulutsidwa kwa insulin sikuvutikabe.
3. Yogwira autoimmune insulin. Antibody titer ndi yokwera, kuchuluka kwa β-cell kumachepetsa, insulin secretion imachepa.
4. Kuchepetsa shuga. Pamavuto, wodwalayo amatha kuwona kuloza kwapang'onopang'ono kwa glucose (NTG) ndikutsitsa shuga wa plasma glucose (NGF).
5. Mawonetseredwe azachipatala a shuga, kuphatikiza ndi gawo la "chikondwerero cha tchuthi". Katemera wa insulini amachepetsedwa kwambiri, monga 90% ya β-cell anafa.
6. Kuwonongeka kwathunthu kwa maselo a β, kuthetseratu kwathunthu kwa insulin.

Mawonetseredwe azachipatala amatenga matenda osati chifukwa cha matenda a shuga, komanso nthawi yayitali, mapangidwe ake a carbohydrate metabolism, kupezeka kwa mitsempha yamavuto ndi zovuta zina. Mokhazikika, zizindikiro zamankhwala zimagawidwa m'magulu awiri:

1. Zizindikiro zoonetsa kuwonongeka kwa matenda,
2. Zizindikiro zokhudzana ndi kukhalapo ndi kuopsa kwa matenda ashuga a shuga, ma neuropathies, ndi zina zovuta kapena zovuta zokhudzana ndi matenda.

• Hyperglycemia imayambitsa mawonekedwe a glucosuria. Zizindikiro za shuga wambiri wamagazi (hyperglycemia): polyuria, polydipsia, kuchepa thupi ndi chidwi chambiri, mkamwa wowuma, kufooka
• microangiopathies (diabetesic retinopathy, neuropathy, nephropathy),
• macroangiopathies (atherosulinosis yam'mitsempha yama coronary, aorta, GM chotengera, malo otsika), matenda am'mimba a shuga
• concomitant matenda: furunculosis, colpitis, vaginitis, kwamikodzo thirakiti matenda ndi zina zotero.

Muzochita zamankhwala, njira zokwanira zodziwira matenda a shuga ndi kukhalapo kwa zizindikiro zodziwika bwino za hyperglycemia (polyuria ndi polydipsia) ndi hypotlycemia yoyeserera - glucose mu plasma ya capillary magazi ≥ 7.0 mmol / l (126 mg / dl) pamimba yopanda kanthu komanso / kapena .1 11.1 mmol / l (200 mg / dl) Maola 2 mutatha kuyesedwa kwa glucose. Mulingo wa HbA1c> 6.5 %.Dziwani kuti matenda atakhazikitsidwa, adokotala amachita malinga ndi algorithm yotsatira.

1. Matenda okhawo omwe amawonetsedwa ndi zizindikiro zofanana (ludzu, polyuria, kuchepa thupi): shuga insipidus, psychogenic polydipsia, hyperparathyroidism, kulephera kupweteka kwa aimpso, ndi zina. Gawo lino likutha ndi mawu a labotale a hyperglycemia syndrome.
2. Mtundu wa nosological wa matenda a shuga umafotokozedwa. Choyamba, matenda omwe amaphatikizidwa ndi gulu la "Mitundu ina ya matenda ashuga" samachotsedwa. Ndipo pokhapokha vuto la matenda a shuga 1 kapena mtundu wa matenda ashuga 2 amathetsa. Kutsimikiza kwa mulingo wa C-peptide pamimba yopanda kanthu ndikatha kuchita masewera olimbitsa thupi kumachitika. Kugwiritsa ntchito njira zomwezo, kuchuluka kwa kuchuluka kwa ma antibodies a GAD m'magazi akuti.

• Ketoacidosis, hyperosmolar chikomokere
• Hypoglycemic coma (vuto la bongo la insulin)
• Matenda ashuga micro- ndi macroangiopathy - kuphwanya mtima kupezeka, kuchuluka kufalikira, kuchuluka kwa thrombosis, kukula kwa mtima atherosclerosis,

• Dongosolo la matenda ashuga polyneuropathy - zotumphukira mitsempha polyneuritis, kupweteka pamodzi ndi mitengo ikuluikulu ya mitsempha, paresis ndi ziwalo,

• Matenda a shuga - matenda ophatikizika, "kupindika", kuchepa kwa madzi, kuchepa kwa kuchuluka kwa madzimadzi okhathamiritsa ndi kukweza mamasukidwe ake,

• Dongosolo la matenda ashuga ophthalmopathy - kukulira koyambirira kwa matenda amtundu wa khungu (mawonekedwe a mandala), retinopathy (zotupa zam'mimba),

• Matenda a shuga - nephropathy - kuwonongeka kwa impso ndi mawonekedwe a mapuloteni ndi magazi mumkodzo, komanso ovuta kwambiri ndi glomerulonephritis ndi kulephera kwa aimpso.

• Matenda ashuga encephalopathy - kusintha mu psyche ndi maganizo, kutengeka mtima kapena kukhumudwa, Zizindikiro za chapakati mantha dongosolo.

Mfundo zazikuluzikulu Sinthani

Zolinga zazikulu za chithandizo:

• Kutha kwa matenda onse am'matenda a shuga
• Kukwaniritsa kagayidwe koyenera ka nthawi.
• Kupewa kwambiri komanso zovuta za matenda ashuga
• Kuwonetsetsa kuti ali ndi moyo wabwino kwambiri kwa odwala.

Kuti mukwaniritse izi:

• chakudya
• dosed zolimbitsa thupi (DIF)
• kuphunzitsa odwala kudziletsa komanso njira zosavuta zochiritsira (kuyang'anira matenda awo)
• kudziletsa kosalekeza

Kusintha kwa Insulin Therapy

Chithandizo cha insulini ndicholinga chokwanira kuti athe kulipira matenda osokoneza bongo, kupewa hyperglycemia komanso kupewa zovuta za matenda ashuga. Kukhazikitsa insulini ndikofunikira kwa anthu odwala matenda ashuga amtundu wa 1 ndipo angagwiritsidwe ntchito m'malo ena kwa anthu odwala matenda a shuga a 2. Njira imodzi yochitira insulin kwa anthu omwe ali ndi matenda amtundu wa 1 ndi mtundu wa 2 kudzera pampu ya insulin.

Sinthani Pilot

Gawo loyamba la mayesero azachipatala a katemera wa BHT-3021 adalandiridwa ndi odwala 80 azaka zopitilira 18 omwe adapezeka ndi matenda amtundu wa 1 m'zaka 5 zapitazi. Hafu ya iwo adalandira jakisoni wa intramuscular wa BHT-3021 sabata iliyonse kwa milungu 12, ndipo theka lachiwiri adalandira placebo. Pambuyo pa nthawi imeneyi, gulu lomwe limalandira katemerayu likuwonetsa kuchuluka kwa C-peptides m'magazi - cholembera chosonyeza kubwezeretsedwa kwa ntchito ya beta-cell.

Kugwiritsa ntchito ketogenic zakudya kumakuthandizani kuti muzitha kuyendetsa bwino glucose, kuchepetsa zoopsa za zovuta.

Ndalama zomwe zimathandizira ntchito ya michere ya kapamba. Sinthani

Pokhudzana ndi kuwonongeka kwa pancreatic: nkhondo yolimbana ndi hypoxia (hyperbaric oxygenation, cytochrome, actovegin) aprotinin, creon, festal, mankhwala a immunomodulatory (pamaso pa chinthu chopatsirana, kachilombo) cha matenda ashuga, komanso chifukwa cha zovuta zina: echinococcal cyst, opisthorchiasis, candidiasis, cryptosporodiosis) kutsegula kwake kwa nthawi yake.

Pazosintha za poizoni ndi zosokoneza

Extracorporeal detoxization (hemodialysis). Kuzindikira kwakanthawi ndikuchotsa / kukonza kwa zomwe zimayambitsa (d-penicylamine for SLE, desferal for hemochromatosis), kuthetseratu kwa corticosteroids, thiazides, ndi zina zambiri, zomwe zimathandiza popangitsa matenda kuwonekera, kuchotsedwa kwawo pogwiritsa ntchito mankhwalawa.

Sinthani Njira Zatsopano

Ofufuza ku Yunivesite ya California, San Francisco, anali oyamba kusintha maselo a stem ya anthu kukhala maselo okhwima a insulin (maselo a beta), zomwe zinali zopambana kwambiri pakupanga chithandizo chamankhwala amtundu wa matenda ashuga a mtundu woyamba (T1).

Kusintha maselo amenewa, omwe amawonongeka kwa odwala omwe ali ndi matenda a shuga a T1, lakhala loto lam'tsogolo mwatsopano. Asayansi samatha kudziwa momwe angakulitsire ma cell a beta m'malo azachipatala kuti azigwira ntchito chimodzimodzi ndi anthu athanzi.

Chinsinsi chopezera maselo opanga ma beta anali momwe amapangidwira mu zisumbu za Langerhans mwa munthu wathanzi.

Asayansi adatha kubereka izi mu labotale. Adasankha mwadala ma cell apadera a pancreatic stem ndikuwasintha kukhala magulu amisipu. Kenako kukula kwa maselo kwathandizira. Maselo a Beta adayamba kuyankha mwamphamvu kwambiri m'magazi kuposa ma cell omwe amapanga insulin. Komanso "kufupi" kwa chisumbucho, kuphatikiza maselo osaphunzira a alpha ndi delta, adayamba kupanga chifukwa sizinathekepo ngati anali ochitika.