53) Hyperglycemia ndi hypoglycemia: mitundu, njira za chitukuko, kufunika kwa thupi

Kuphwanya carbohydrate metabolism, hyperglycemia imatha kukhala (kuchuluka kwa shuga m'magazi ndikochulukirapo)

5.5 mmol / L) ndi hypoglycemia (ochepera 3.3 mmol / L).

Kuchuluka kwa shuga m'magazi kumadalira mtundu wa zitsanzo (magazi athunthu, venous kapena capillary, plasma) ndi mtundu wa zitsanzo (pamimba yopanda kanthu - kuchuluka kwa shuga m'mawa mutatha kusala pang'ono maola 8, maola 2 mutatha kuyesedwa kwa glucose).

Pathogenesis ya hypoglycemia imagwirizanitsidwa ndi:

- kudya shuga wokwanira m'magazi,

- Kuchotsa shuga m'magazi

Kuphatikizana kwa zinthuzi.

Kusiyanitsa pakati pa thupi ndi pathological hypoglycemia.

Zokhudza thupi hypoglycemia. Amadziwika ndi kulimbitsa thupi kwakanthawi, kupanikizika kwa nthawi yayitali, mwa azimayi panthawi yotseka, kumayamba pambuyo pa hementary hyperglycemia chifukwa chamasulidwa a insulin m'magazi.

Pathological hypoglycemia (hyperinsulinism). Amapezeka mu odwala matenda a shuga mellitus chifukwa cha kuchuluka kwa insulin pa mankhwala. Zomwe zimayambitsa: pancreatic islet cell adenoma (insuloma), Zollinger-Ellison syndrome (pancreatic adenoma kapena carcinoma), yomwe imachokera ku α-maselo a islets a Langerhans omwe ali ndi chinsinsi cha glucagon ndi gastrin).

Pathological hypoglycemia (popanda hyperinsulinism). Zawululidwa: ndi matenda a impso limodzi ndi kuchepa kwa gawo logaya shuga, komwe kumapangitsa kutsika kwa shuga mkodzo, kuchepa kwamatumbo, matenda a chiwindi omwe amaphatikizidwa ndi kuletsa kwa kaphatikizidwe ka glycogen ndi gluconeogeneis (pachimake ndi matenda a hepatitis), adrenal insufficiency (glucocorticoiditaminosis)₁, galactosemia ndimatenda amtundu wa glycogenosis, njala kapena kusoŵa kwa zakudya m'thupi (anamentary hypoglycemia), kusakwanira kwa machitidwe a malamulo a kagayidwe kazachilengedwe kwa ana akhanda.

Hyperglycemia ndizofala. Pali mitundu ya hyperglycemia.

Psychological Hyperglycemia. Izi ndizosintha mwachangu. Matenda a shuga amachitika popanda kuwongolera kwakunja. Izi zikuphatikiza:

1. Mitsempha hyperglycemia. Chifukwa chakudya chomwe chili ndi chakudya chamafuta. Kusakanikirana kwa shuga m'magazi kumachuluka chifukwa cha kutuluka kwake msanga m'matumbo. Kutsegulira kwa katulutsidwe ka mahomoni ndi β-maselo a pancreatic mabatani a Langerhans amayamba modabwitsa pambuyo poti chakudya chalowa mkatikati mwa kamwa ndikufikira pazokwanira ngati chakudya chapita mu duodenum ndi m'matumbo aang'ono. Mitundu ya insulin ndi shuga wamagazi imagwirizana nthawi. Chifukwa chake, insulin samangopangitsanso kupezeka kwa chakudya chamagulu a m'magazi amthupi, komanso imachepetsa kuwonjezeka kwa kuchuluka kwa shuga m'magazi, kupewa kutayika kwa mkodzo.

2. Neurogenic hyperglycemia. Amayamba poyankha pamavuto am'maganizo ndipo amatuluka chifukwa chamatumbo a m'magazi, omwe amapangidwa mu adrenal medulla ndikuzindikira zotsatira zawo za hyperglycemic. Glucose wotulutsidwa amalowa m'magazi, zomwe zimayambitsa hyperglycemia.

Matenda a hyperglycemia. Zifukwa:

1) Matenda a neuroendocrine - kuphwanya kuchuluka kwa mahomoni a hypo- ndi hyperglycemic kanthu (ndi matenda am'chiberekero, zotupa za adrenal cortex, osakwanira kupanga insulin, glucagonoma),

2) zotupa za chapakati mantha dongosolo, ubongo

3) Matenda a chiwindi owonongeka m'matumbo,

4) mikhalidwe yopweteketsa thupi pamene minyewa ya glycogen imasweka ndi mapangidwe a lactate, pomwe shuga amapangidwa m'chiwindi,

5) zotsatira za mankhwala a narcotic (morphine, ether), osangalatsa a mtima wamanjenje, zomwe zimathandizira kukulitsa kwa hyperglycemia.

Kodi hyperglycemia ndi chiyani: matenda a pathogenis, zizindikiro, zovuta zotheka ndi njira zamankhwala

Madokotala omwe ali ndi hyperglycemia amawonetsa mkhalidwe womwe kuyezetsa magazi kumawonetsa kuchuluka kwa shuga. Shuga amadzuka pazifukwa zosiyanasiyana. Izi sizitanthauza shuga.

Zomwe zimapanga hyperglycemia, ndi mitundu iti yomwe imachitika, zovuta zake, momwe zimapezekera komanso kuthandizidwa - nkhaniyi ifotokoza zonsezi.

Ichi ndi chiyani

Hyperglycemia imadziwika ndi plasma shuga ndende pamwamba pamlingo wapamwamba.

Chifukwa cha kuchepa kwa insulin, maselo amayamba kumva njala, amalephera kuyamwa mafuta acid, glucose komanso oxidize wathunthu. Zotsatira zake, acetone imayamba kupanga ndi kudziunjikira. Izi zimakwiyitsa kuphwanya kwa kagayidwe kachakudya kagayidwe kachakudya ndi zovuta mu ntchito ya ziwalo zambiri ndi machitidwe.

Pali magawo otere a maphunziro a hyperglycemia:

zolimbitsa
zabwino
comatose.

Zomwe zimachitika mu hyperglycemia:

Hyperglycemia imakonda kwambiri matenda ashuga. Koma imawonedwa ndi ma pathologies ena. Nthawi zina shuga amakwera munthu wathanzi.

Kuchuluka kwa glucose kumawononga ntchito ya ziwalo ndi machitidwe. Chifukwa chake, nthawi zina mumayenera kupereka magazi kuti muwoneke.

Gulu

Kutengera ndi kuzindikira kwa zizindikirazo, hyperglycemia imachitika:

kuwala. Kuthamanga kwamisempha ya glucose kuyambira 6 mpaka 10 mmol / L,
kuopsa kozama (mtengo wake kuyambira 10 mpaka 16 mmol / l),
zolemetsa (m'magazi glucose akuwonetsa pamwamba pa 16 mmol / l). Ngati mtengo wake ndi wokulirapo kuposa 16.5 mmol / L, pamakhala chiopsezo cha kupuma kapena boma.

Odwala omwe amapezeka ndi matenda ashuga, hyperglycemia imagawika m'mitundu iwiri:

owonda. Ngati wodwala sanadye pafupifupi maola 8, kuchuluka kwa shuga m'magazi kumakwera mpaka 7.2 mmol / l kapena kupitilira,
posachedwa. Zimachitika mutatha kudya. Shuga umaposa 10 mmol / L.

Hyperglycemia imasiyananso:

zamatsenga. Zimachitika ndi zovuta za endocrine. Khalidwe la odwala matenda ashuga,
zathupi. Osakhalitsa. Zimachitika chifukwa cha kuchuluka kwa thupi, kumwa zopatsa mphamvu zambiri zamagetsi, mphamvu zamphamvu, kupsinjika,
kusakaniza.

Kutengera zomwe zimayambitsa, hyperglycemia imasiyanitsidwa:

aakulu. Chimawonekera mothandizidwa ndi cholowa. Hyperglycemia syndrome nthawi zina imachitika motsutsana ndi maziko a matenda opezeka pancreatic. Mtundu wa ashuga 1,
zopsinja. Imadziwawoneka ngati kuchitapo kogwedezeka kwa chikhalidwe chamatsenga. Poyerekeza ndi zovuta za mthupi la munthu, kuphatikiza kwama mahomoni omwe amalepheretsa glycogeneis kukondoweza. Komanso panthawiyi, njira za gluconeogeneis ndi glycogenolysis zimapangidwira. Kuperewera kwamphamvu kwa mahomoni kumabweretsa kuchuluka kwa shuga wa plasma,
anamentary. Kuyang'aniridwa mutatha kudya. Sichikhala m'mikhalidwe yamatenda. Zimachitika mukamamwa mankhwala ochulukirapo omwe amakhala ndi chakudya chamagulutsi. Njira zamtunduwu sizifuna chithandizo. Pakapita kanthawi, zizindikilozozo zimayamba kuzimiririka,
mahomoni. Zimachitika ndi kusasamala kwa mahomoni motsutsana ndi maziko a matenda a endocrine. Catecholamines ndi glucocorticoids amachulukitsa shuga wamagazi.

Hyperglycemia ya chapakati imayamba chifukwa cha kuperewera kwa maselo amalo opezeka ku hypothalamic.

Kutulutsa magazi koperewera kumayambitsa kutulutsidwa kwa STH-RF, kuchuluka kwa glyconeogeneis.

Pathogenesis ya hyperglycemia chifukwa cha kuwonongeka kwa poizoni kapena kuwonongeka kwa dongosolo lamanjenje kumakhala kofanana. Zida za insulini zimayankha shuga yayikulu ndikamasula mahomoni ambiri.Pogwiritsa ntchito zida zamagetsi zomwe zimapezeka, glucose amasungidwa kwambiri. Kuti muchepetse, muyenera kuyambitsa mankhwala apadera.

Ndi hyperglycemia, pamakhala chiwopsezo cha glucosuria. Nthawi zambiri izi zimachitika pomwe chizindikiritso cha glucose chikupita kudutsa shuga kwa impso - 170-180 mg.

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Zomwe muyenera kuchita ndikudina batani pansipa (GET REWARDS) ndikumaliza chilichonse chomwe chatchulidwa, pambuyo pake mudzatha kusankha mphotho yanu (kuchuluka kochepa!):

Hyperglycemia ndi mkhalidwe womwe kuchuluka kwa glucose womwe umapezeka m'magazi kumakhala kokwanira kuposa chizindikiro chokhazikika. Ngati chiwonjezerochi chikufunika, chiwopsezo chachikulu cha chikomokere (hyperglycemic kapena hyperosmolar) chimapangidwa, chomwe chimatha kubweretsa kulumala, komanso m'njira zovuta kwambiri za matenda, ngakhale imfa. M'nkhaniyi, tikambirana zoyenera kuchita ngati matenda a hyperglycemia, pathogenis, mitundu, ndi zizindikiro zazikulu za matenda atidziwonetsa.

Zimayambitsa hyperglycemia wosakhalitsa komanso wosakhalitsa

Mkhalidwe wa hyperglycemic ukhoza kukhala kwa nthawi yayitali kapenanso kukhala kanthawi kochepa.

Zomwe zimapangitsa kuti shuga achulukane kwakanthawi apatsidwa pansipa:

zopsinjika pafupipafupi
kudya zakudya zopatsa mphamvu kwambiri,
mimba
kupweteka kwambiri komwe thyroxine ndi adrenaline imachuluka m'magazi,
kuchepa kwa mavitamini C ndi B1,
poizoni wa calcium
magazi akulu
matenda a shuga
Hyperplasia wa adrenal kotekisi,
kumwa magulu ena a mankhwala. Mwachitsanzo, antidepressants, diuretics, beta blockers, fentamidine, niacin kuwonjezera shuga,
matenda opatsirana
zolimbitsa thupi zolimbitsa thupi.

Hyperglycemia wa nthawi yayitali amayamba chifukwa chophwanya kagayidwe kazakudya komanso kuwononga ziwalo za endocrine.

Zomwe zimayambitsa kwambiri za hyperglycemia zalembedwa pansipa:

ndi mtundu woyamba wa matenda ashuga, kuphatikiza kwa insulini kumachepetsedwa kwambiri chifukwa cha kuwonongeka kwa maselo a pancreatic, njira yotupa mu chiwalo. 75% ya maselo omwe amatulutsa timadzi timene timawonongeka, hyperglycemia imachitika,
mwanjira yachiwiri ya matenda ashuga, chidwi cha insulin m'maselo a thupi chimakhala chofooka. Homoni samayamwa ngakhale ndikupanga kokwanira. Chifukwa chake, shuga m'magazi amachuluka.

Kudziwa zomwe zimayambitsa matenda a hyperglycemia, kupewa zinthu zomwe zimayambitsa, pali mwayi wochepetsa kuchuluka kwa shuga.

Masewera a glucose akadakhala abwinobwino, munthu amawona mawonekedwe otsatirawa:

kamwa yowuma
ludzu lalikulu losagonjetseka
masomphenya osalala
kutopa,
kukodza pafupipafupi (makamaka usiku),
kuchuluka kwa mkodzo,
kuwonda msanga
mabala osachiritsa
mawonekedwe a kutupa,
pafupipafupi matenda.

Kwa ketoacidosis, yomwe imayang'aniridwa mu shuga, mawonetsedwe otsatirawa ali ndi chikhalidwe:

Fungo la zipatso kuchokera mkamwa
kupweteka pamimba,
kusowa kwamadzi
chisokonezo ndi kutayika kwa chikumbumtima
Hyperventilation yamapapo
nseru
kugona
kusanza

Ngati zizindikiro zomwe tafotokozazi zikuwoneka, ndikofunikira kuyang'ana magazi kuti apange shuga ndikuchita zoyenera.

Gulu lalikulu

Ngati Hyperglycemia wapezeka, ndiyenera kuchita chiyani? Poyamba, ndikofunikira kukhazikitsa mtundu wa matenda omwe adadziwika kuti mupewe kuukira. Matendawa amatha kuchitika m'njira zingapo zosiyanasiyana, mosiyanasiyana mu kapangidwe kake ndi mtundu womwe umakhudza munthu. Anthu omwe ali ndi matenda a shuga mellitus (DM) nthawi zambiri amakumana ndi mawonekedwe a postprandial.

Kuzindikira kwa "Hypoglycemia" kumapangidwa pamaziko a mitundu iyi:

Matenda Amayamba motsutsana ndi maziko a pancreatic pathologies.
Zamalingaliro Zimakwiya pambuyo pazochitika zazitali komanso pamavuto.
Makope. Zimachitika mukangodya.
Hormonal Zovuta zam'mbuyo za thupi zimayipitsa.

Onani lingaliro lililonse mwatsatanetsatane.

Mavuto

Ndikofunikira kudziwa! Popita nthawi, mavuto okhala ndi shuga amatha kubweretsa matenda ambiri, monga mavuto amaso, khungu ndi tsitsi, zilonda zam'mimba, zilonda zam'mimba komanso ngakhale zotupa za khansa! Anthu amaphunzitsa zomwe zinawawa kuti azisintha shuga yawo kuti asangalale ...

Ngati glycogen sabwereranso kwina, pamakhala mavuto akulu:

Ketoacidosis wa mtundu 2 wa shuga ndi osowa. Ili ndi chikhalidwe chamtundu woyamba wa matenda ashuga. Munthawi imeneyi, acidity ya magazi imachuluka. Ngati simupereka chithandizo choyamba kwa munthu, amagwa ndikumwalira.

Zizindikiro

Musanachiritse hyperglycemia, muyenera kudziwa kuchuluka kwa shuga ndi zomwe zimapangitsa kuti achulukane. Chifukwa chaichi, kuyesedwa kwa labotale ndikolembera. Kuti muzindikire kuchuluka kwa shuga, kuwunika kwa plasma kumachitika. Muyeso wamwazi umatengedwa pamimba yopanda kanthu m'mawa.

Ngati zotsatira zoyesedwa zili pafupi ndi 126 mg / dl, izi zikuwonetsa matenda ashuga.

Kuti mumvetse bwino za matendawa, phunzirani patomorphological. Zimawonetsa ngati kukanika kwa pancreatic kumalumikizidwa ndi kupweteka.

Osakana mayeso athunthu. Ndikofunikira kudziwa zomwe zimayambitsa vuto. Kenako mankhwalawa adzakhala othandiza kwambiri.

Ngati mulingo wa glucose ukuwonjezeka pang'ono, ndiye kuti kuyesedwa kwa carbohydrate kumabwerezedwa. Kuti achite izi, amamwa kapu yamadzi okoma ndipo atatha maola angapo amapereka magazi kuti apange zamankhwala am'thupi.

Pofuna kuthana ndi vuto la kupsinjika, kuwunika kwachiwiri kwa Laborator kumayikidwa pakatha sabata. Ndikulimbikitsidwanso kuyesa mayeso a mkodzo komanso kuyesa kwa glycosylated hemoglobin.

Hypoflycemia yofatsa siyofunika kuchiritsa. Mlingo wa glucose umasinthidwa ndikusintha moyo, zakudya.

Ndizofunikanso kuchita masewera olimbitsa thupi nthawi zonse omwe amafanana ndi momwe munthu alili komanso zaka zake. Ngati matenda a shuga apezeka, ndiye kuti jakisoni wa insulin adzafunika.

Masiku ano, akatswiri a endocrinologists akugwiritsa ntchito mankhwalawa kuchiza matenda a hyperglycemia:

Victoza. Imalamulira chisangalalo ndikuchepetsa mwayi wodya kwambiri,
Siofor. Imachepetsa kuchuluka kwa shuga m'magazi,
Glucophage. Zimakhala ngati Siofor,
Aktos. Kuchulukitsa chidwi cha maselo a thupi la munthu kupita ku insulin.

Malangizo, mankhwala a endocrinologist amasankha aliyense payekhapayekha kwa wodwala aliyense. Pa mankhwala, ndikofunikira kuwunika zakudya. Kwa anthu odwala matenda a shuga omwe amagwiritsa ntchito othandizira a hypoglycemic, hypoglycemia imatheka ndikudya kosayenera.

Ngati chifukwa cha hyperglycemia ndi pancreatitis yayikulu kapena matenda ena, ndikofunikira kuchiza matenda oyambira.

Pa intaneti pali njira zambiri zamankhwala azikhalidwe zomwe zitha kuthana ndi hyperglycemia. Mafuta ofunikira omwe ali muzomera zina amathandizira kuchepetsa kuchuluka kwa shuga m'magazi komanso kukhazikika kwa mkhalidwe wa wodwalayo.

Katunduyu amatchulidwa makamaka mu juniper, eucalyptus ndi geranium. Zothandiza ndi tiyi kuchokera pamasamba a birch, mabuliberiya, decoction wa ma rhizomes a burdock, masamba a nyemba.

Mitundu iriyonse yamagwiritsidwe akuyenera kuvomerezedwa ndi dokotala. Kupanda kutero, pali chiopsezo chakukulitsa vutolo.

Kupewa

Popewa kukula kwa hyperglycemia, njira zoteteza ziyenera kuchitika. Ndikofunika kuchita zolimbitsa thupi tsiku lililonse. Ndikofunikira kuchiza matenda onse munthawi. Izi zimagwira ntchito kwa munthu yemwe alibe matenda ashuga.

Pamaso pa zovuta za endocrine, kulumpha mu shuga kumatha kupewedwa ndikuwonetsetsa kuchuluka kwa glucose komanso kuyendera dokotala nthawi ndi nthawi.

Gawo lofunika kwambiri la kupewa ndi kupatsa thanzi zakudya zoyenera. Zakudyazo zimasankhidwa payekha ndi dokotala kwa wodwala aliyense.

Pali malamulo ena omwe angachepetse chiopsezo cha hyperglycemia:

osamadya kwambiri. Zakudya zambiri zopatsa thanzi zimabweretsa zovuta pa kapamba,
idyani nthawi yoyenera,
idyani pang'ono m'magawo ang'onoang'ono,
yang'anirani chakudya
chepetsa kuchuluka kwa chakudya chamafuta muzakudya,
imwani mavitamini.

Ngati mumatsatira malamulo ngati amenewa, palibe mavuto ndi shuga wambiri.

M'mimba komanso akhanda

Pa nthawi ya pakati, kusintha kwakukulu kumachitika mthupi. Matenda abwinobwino amakomanso nthawi zina. Izi zikufotokozedwa ndikuwonjezereka kwa kuchuluka kwa mahomoni omwe amakhala ngati akutsutsana ndi insulin.

Hypovitaminosis, zakudya zopanda thanzi, kupsinjika, kuchepa kwa magazi, mankhwala osalekeza angayambitse matenda a metabolism.

Ndikofunika kupewa kupsinjika nthawi yomwe muli ndi pakati

Gulu lamavuto limaphatikizapo azimayi omwe ali pamalo:

ndi mimba zingapo
onenepa kwambiri
yemwe anali ndi ana olemera kuposa ma kilogalamu 4,
omwe ali ndi pathologies a kapamba.

Hyperglycemia imasokoneza osati kokha zomwe zimachitika kwa mayi wapakati, komanso thanzi la mwana.

Kwa wakhanda, mndandanda wazotsatira zimaperekedwa pansipa:

Mu wakhanda wokhala ndi shuga wokhazikika, zotupa zachitukuko, zolakwika mu ntchito ya ziwalo zingapo ndi machitidwe zimatha kuonedwa.

Zomwe zimayambitsa hyperglycemia mu makanda zimatha kukhala matenda, kutenga mankhwala ena, osiyanasiyana a ma pathologies.

Pofuna kupewa hyperglycemia mwa mayi wapakati komanso mwana wakhanda, ndikofunikira kuwunika zakudya, shuga, kulemera. Amayi oyembekezera amafunikira kukonzekera mayeso ake munthawi yake.

Makanema okhudzana nawo

Pazisonyezo ndi zotsatira za hyperglycemia mu kanema:

Chifukwa chake, hyperglycemia imayang'aniridwa motsutsana ndi maziko a kudya kwambiri, matenda a kapamba ndi ziwalo zina. Ngati misempha ya glucose siili yodziwika bwino, mavuto amakula. Chifukwa chake, zizindikiro zamakhalidwe zikaonekera, muyenera kufunsa dokotala.

Adzaunikira mayeso ndikusankha njira yabwino yochizira. Amayi oyembekezera ayenera kusamala makamaka za iwo eni. Kupatula apo, hyperglycemia imasokoneza thanzi la mayi wamtsogolo, komanso thanzi ndi kakulidwe ka mwana.

Hyperglycemia syndrome

Hyperglycemia syndrome ndi kuchuluka kwa shuga m'magazi. Izi zitha kuchitika mwa anthu omwe ali ndi matenda a endocrine system, nthawi zambiri mwa anthu odwala matenda a shuga. Matendawa amatha kudutsa zaka zambiri komanso mphindi zochepa.

Mitundu itatu ya hyperglycemia mwamwambo imasiyanitsidwa malinga ndi kuuma kwawo: wofatsa, wofatsa komanso wowopsa. Mitundu imasiyana malinga ndi kuchuluka kwa shuga m'magazi. Kwa anthu omwe ali ndi matenda ashuga, matendawa ali ndi mitundu yake:

kusala kudya kwa hyperglycemia (kumachitika ngati munthu amene ali pachiwopsezo sanadye zoposa maola eyiti),
masana hyperglycemia (kuchuluka kwa glucose akamatha kudya).

Komanso matenda amtunduwu amagawidwa kwakanthawi komanso kosalekeza. Werengani za zomwe zimayambitsa kupitilira kwa hyperglycemia pansipa, zinthu zotsatirazi zingayambitse yochepa:

kupanikizika kwa nthawi yayitali
kudya zakudya zochuluka
kuchepa magazi
kusowa kwa mavitamini C kapena B1,
mimba

Kuthana ndi hyperglycemia kwakanthawi, ndikokwanira kuthetsa komwe kukuchokera ndikufunsira katswiri pazinthu zinanso kuti vutolo lisatuluke ndikuwonekere.

Pofuna kuteteza kuti mawonekedwe osakhalitsa amtunduwu asakhale matenda okhalitsa, ndikofunikira kudziwa zomwe zimayambitsa.

Hyperglycemia: zoyambitsa

Chomwe chimapangitsa kupatuka uku ndi kuchuluka kwa insulin. Hormone iyi imapangidwa ndi kapamba, ndipo thupi limafunikira kuti ipange shuga. Nthawi zambiri, kuperewera kwa insulin kumawonekera ndendende kwa odwala omwe ali ndi matenda osokoneza bongo (woyamba mulingo wake umatsika, kenako thupi limaleka kuzindikira maselo a insulin, ngakhale ndi mulingo wokwanira).

Chifukwa chake, hyperglycemia imadziwonekera ngati munthu wodwala matenda ashuga aphonya mankhwala kapena jakisoni wa insulin, kapena waphwanya zakudya zapadera.

Vutoli limapezekanso mwa iwo omwe amakhala ndi bulimia amanosa - mkhalidwe womwe munthu amadya kwambiri kuposa momwe thupi lake limafunikira.Monga tafotokozera pamwambapa, kuchuluka kwa kudya zakudya zamagulu m'thupi kumabweretsa kupatuka kwakanthawi, koma bulimia amanosa ndi matenda omwe amakhala nthawi yayitali, ndipo hyperglycemia ili ndi nthawi yokwanira kuti ikhale yodwala.

Hyperglycemia imayambanso chifukwa cha matenda omwe amachititsa kuti endocrine ipange mahomoni oteteza, omwe amalepheretsa kupanga insulin.

Matenda a ubongo amathanso kukhala ngati zotsatira zoyipa za mankhwala.

Kuti muzindikire kupatuka uku pakapita nthawi, ndikofunikira kudziwa momwe zimadziwonekera, chifukwa kuchuluka kwambiri kwa shuga kumatha kudzetsa mpungwepungwe.

mkamwa wowuma ndi ludzu lalikulu (chifukwa cha kuchuluka kwa shuga, timadzimadzi timachotsa minyewa, izi zimachitika kawirikawiri pakatikati kamatumbo, motero pakamwa pouma),
kukodza pafupipafupi (komwe kumakhudzana ndi vuto laimpso),
kufooka (chifukwa cha kuchuluka kwamadzimadzi, kagayidwe kam'maselo kamachepa, motero, kupanga mphamvu kumachepa),
kuwonda (kachiwiri, chifukwa cha kuchepa kwamadzi, thupi limacheperanso),
kutopa ndi kufooka,
kuwonongeka kwamawonekedwe
vuto
womvera

Kwa anthu omwe ali ndi chiyembekezo choganiza za hyperglycemia pazifukwa zingapo, pali njira zingapo zopewera kupewa:

ndikofunikira kuyang'anitsitsa zakudya zomwe adotolo adalemba ndikugwirira ntchito zoyenera,
ndikosavomerezeka kudumphitsa mankhwala omwe amachepetsa shuga ndi jakisoni wa insulin,
kuchuluka kwa shuga m'magazi kumayezedwa bwino nthawi zonse komanso nthawi yomweyo,
ndikofunikira kudziwitsa adotolo zodumpha zonse zamagulu a shuga,
mwina mungayesetse kukhala ndi mankhwalawa ochepetsa shuga

Monga tafotokozera pamwambapa, hyperglycemia imadziwoneka yokha makamaka mwa anthu omwe ali ndi matenda ashuga.

Popeza, malinga ndi ziwerengero, pali 8% ya anthu oterewa pagulu lonselo, zambiri pazomwe zimachitika nthawi yomweyo kuwonekera kwa hyperglycemia sizingakhale zabwino kwa aliyense: choyambirira, muyenera kuyeza kuchuluka kwa shuga m'makoko, ngati atakwezedwa, pangani jakisoni wa insulin ndikubwereza masitepe awa maola awiri aliwonse mpaka shuga atachepa. Ngati palibe kusintha, muyenera kufunsa dokotala.

Ndikofunika kumwa madzi ambiri momwe mungathere, mchere wamchere wamchere ndiwofunikira kwambiri, ngati khungu lowuma limawonedwa, mutha kulipukuta ndi thaulo yonyowa.

Muyenera kumvetsetsa kuti ngakhale matenda a hyperglycemia akudwala komanso chifukwa cha nthawi imodzi, ndibwino kukaonana ndi dokotala ndikupanga mayeso ofunikira kuti muchepetse zovuta komanso kukula kwa matenda ashuga.

Nkhaniyi idawonedwa nthawi 340

Hyperglycemia: Zizindikiro ndi chithandizo

Gulu: Mawonedwe a Endocrine System: 28524

Hyperglycemia ndi mkhalidwe wa m'magazi wopita patsogolo chifukwa cha kuchuluka kwa shuga m'magazi motsutsana ndi maziko a matenda a endocrine dongosolo, kuphatikizapo matenda a shuga. Miyezi yachilengedwe ya shuga yachilengedwe imachokera ku 3,3 mpaka 5.5 mmol / L. Ndi glycemia, Zizindikiro zimawonjezeka mpaka 6-7 mmol / L. Khodi ya ICD-10 ndi R73.9.

Matendawa ndi owopsa, chifukwa popanda thandizo la nthawi yake yoyamba, chikomokere chimachitika. Zizindikiro zoyambirira zikawoneka, ndikuwonetsa matenda, ndikofunikira kuyimba gulu la ambulansi nthawi yomweyo.

Chifukwa chachikulu chomwe chimapangidwira kukula kwa hyperglycemia ndikochepa kocheperako kwa insulin m'thupi la munthu (cholinga chachikulu cha timadzi iyi ndikuchepetsa shuga m'magazi). Ndizofunikira kudziwa kuti hyperglycemia ndi yotalika komanso yochepa.

Zomwe zimapangitsa hyperglycemia kwakanthawi:

Poizoni thupi
kumwa kwambiri chakudya chamagulu omwera ndi chakudya,
kwambiri ululu matenda, amene limodzi ndi kuchuluka katulutsidwe adrenaline ndi thyroxine,
wokhala ndi mwana,
kupsinjika
magazi akulu
shuga wa shuga kapena adrenal hyperplasia,
hypovitaminosis ya mavitamini B1 ndi C.

Chifukwa chachikulu cha mawonekedwe atali a matendawa ndikulephera kwa malamulo a neuro-endocrine mu kagayidwe kazachilengedwe.

Zoyambitsa zazikulu za hyperglycemia

Matenda

Fomuyi imapita patsogolo motsutsana ndi matenda a shuga. Katemera wa insulin wachepa ndiye chifukwa chachikulu chomwe chimapangitsa. Izi zimathandizidwa ndi kuwonongeka kwa maselo a kapamba, komanso zinthu za chibadwa.

Mawonekedwe osakhazikika ndi amitundu iwiri:

postprandial hyperglycemia. Kuzunzidwa kwa shuga kumawonjezeka mukatha kudya,
owonda. Zimayamba ngati munthu samadya chakudya chilichonse kwa maola 8.

zosavuta. Magazi a shuga amachokera ku 6.7 mpaka 8.2 mmol / L,
avareji ikuchokera ku 8.3 mpaka 11 mmol / l,
zolemetsa - Zizindikiro pamwamba 11.1 mmol / l

Makope

Fomu ya alimentary imawonedwa kuti ndi yaumunthu yomwe imapita patsogolo munthu atadya chakudya chochuluka. Kuphatikizika kwa shuga kumadzuka patatha ola limodzi mutatha kudya. Palibe chifukwa chokonza hyperglycemia ya alimentary, popeza kuchuluka kwa shuga ndikubwerera palokha kumakhala kosavuta.

Zizindikiro

Ndikofunikira kudziwa mwachangu kuwonjezeka kowopsa kwa mseru wamagazi m'magazi kuti apatse wodwalayo thandizo loyamba ndikuletsa kupitirira kwa zovuta zowopsa. Kuti muchite izi, muyenera kudziwa zizindikiro zazikulu za hyperglycemia:

kusakwiya kwambiri, osasunthidwa ndi chilichonse,
ludzu lalikulu
dzanzi la milomo
kuzunzidwa koopsa
kulakalaka kwambiri (chizindikiro cha khalidwe),
thukuta kwambiri
kupweteka mutu kwambiri
kuchepa kwa chidwi,
chizindikiro cha matenda ndi mawonekedwe a fungo la mkamwa kuchokera pakamwa pa wodwalayo,
kutopa,
kukodza pafupipafupi,
khungu lowuma.

Hyperglycemia mwa ana

Hyperglycemia mwa ana imadziwika ndi kuwonjezeka kwa kuchuluka kwa shuga m'magazi mpaka 6.5 mmol / L. Ndizofunikira kudziwa kuti ali ndi izi nthawi zina amatha kuchitika popanda chisonyezo chimodzi.

Hyperglycemia nthawi zambiri amapezeka mwa akhanda. Mpaka pano, asing'anga sanganene motsimikiza chomwe chimayambitsa matendawa.

Shuga amadzuka pafupipafupi mwa ana omwe amalemera zosakwana 1.5 makilogalamu, kapena akuvutika ndi sepsis, encephalitis, meningitis ndi matenda ena owopsa.

Ngati matendawa sakudziwika munthawi yake ndipo mwana sanathandizidwe, ndiye kuti maselo aubongo amasokonezeka, omwe amachititsa kuti matumbo azitupa ndi kutupa.

Hyperglycemia

Thandizo vuto la hyperglycemia:

Ndikofunikira kuti muchepetse kuchuluka kwa acidity m'mimba. Kuti izi zitheke, wodwalayo amapatsidwa mwayi kuti adye masamba ndi zipatso zambiri, komanso amwe madzi amamineral omwe ali ndi sodium,
pukuta khungu ndi thaulo yonyowa. Thupi limasowa madzi, mwanjira imeneyi amapanga madzi otayika,
gastric lavage ndi koloko solution - amathandiza kuchotsa acetone m'thupi.

Chithandizo cha hyperglycemia ziyenera kuchitika mwachangu, monga momwe ziwonetsero zoyambira zinasonyezera. Kuthandizaku ndikupereka insulin kuti muchepetse shuga.

Muyeneranso kuchitira detoxation ndi madzi osowa m'thupi ndi mayankho osabala. Pa mankhwalawa a hyperglycemia, ndikofunikira kutsatira zakudya, kugona ndi kupuma.

Kuthandizira pa nthawi yake sikuthandizira wodwalayo, komanso kupewa mavuto owopsa.

Matenda okhala ndi zofananira:

Ketoacidosis (zofananira: 6 mwa 12)

Ketoacidosis ndimavuto owopsa a matenda osokoneza bongo, omwe, popanda chithandizo chokwanira komanso chanthawi yake, amatha kudwala matenda ashuga kapena ngakhale kufa.

Vutoli limayamba kupita patsogolo ngati thupi la munthu silingagwiritse ntchito bwino glucose monga gwero lamphamvu, popeza limasowa insulin.

Poterepa, makina olumikizira adakonzedwa, ndipo thupi limayamba kugwiritsa ntchito mafuta obwera ngati mphamvu yamagetsi.

... shuga insipidus (zofananira: 5 mwa 12)

Matenda a shuga a insipidus ndimatenda omwe amayamba chifukwa chosowa vasopressin mthupi, omwe amatanthauzanso mahomoni antidiuretic. Matenda a shuga insipidus, zomwe ndi kuphwanya kagayidwe kamadzi ndikuwoneka ngati ludzu losasintha nthawi yomweyo munthawi yowonjezereka ya polyuria (pakukodza kwamkodzo), ndiye matenda osowa.

... Premenopause (zizindikiro zofananira: 5 mwa 12)

Premenopause ndi nthawi yapadera m'moyo wa mayi, nthawi yomwe aliyense amayimira wamkazi. Uku ndi mtundu wa kusiyana pakati pa kusamba kofoka komanso kotentha kwa msambo ndi msambo womaliza womwe umachitika pakusamba.

... Matenda a shuga mwa amuna (Zizindikiro zophatikiza: 5 mwa 12)

Matenda a shuga m'magulu a amuna ndi matenda a endocrine system, kumbuyo komwe kumakhala kuphwanya kusintha kwa madzi ndi michere m'thupi la munthu. Izi zimabweretsa kukanika kwa pancreatic, yomwe imayang'anira kupanga mahomoni ofunikira - insulin, chifukwa chomwe shuga sichisintha kukhala glucose ndikudziunjikira m'magazi.

... Matenda a shuga mu ana (zizindikiro zofananira: 5 mwa 12)

Matenda a shuga m'magazi a ana ndi vuto la metabolic, kuphatikizapo chakudya chamafuta, chifukwa cha kukanika kwa pancreatic. Chiwalo chamkati chimagwira ntchito yopanga insulin, yomwe mu shuga imakhala yochepa kwambiri kapena chitetezo chathunthu chimatha kuwonedwa. Ziwerengerozi ndi mwana m'modzi mwa ana 500, ndipo pakati pa akhanda - wakhanda m'modzi mpaka 400 zikwi.

Postprandial, alimentary, zokhudza thupi hyperglycemia

Hyperglycemia ndi chiwonetsero chazachipatala cha matenda a carbohydrate metabolism omwe amayamba ndi kuwonjezeka kwakukulu kwa shuga wamagazi. Kuthamanga kwa shuga kwa magazi ndi 3,3 - 5, 5 mmol / L.

Pathogenesis ya hyperglycemia ndiyosavuta - ichi ndi cholakwika pakati pa kuchuluka kwa glucose ndikugwiritsa ntchito. Njira yosakwanira yobwezeretsanso zinthu imayamba chifukwa cha kuchuluka kwa shuga kapena kuchepa kwa shuga m'thupi.

Amayamba posakhala ndi insulin kapena kuchuluka kwa mahomoni omwe amayambitsa matenda awa. Mwachidziwitso, kuchuluka kwa shuga m'magazi kungakhale kwamoyo komanso kwatsamba.

Kuphwanya kwamtunduwu kumagawidwa m'magulu angapo a hyperglycemia:

Kukhazikika munkati mwa kuphwanya magwiridwe antchito a kapamba, yemwe amachititsa kuti pakhale insulin. Umu ndi m'mene matenda a hyperglycemia amakhudzidwira. Matendawa amatenga matenda a shuga, komanso nthawi ya kutupa kwamatumbo: chimbudzi cha pancreatitis (chodabwitsa cha hyperglycemia pokhapokha pakukula kwa matenda).
Mitundu ina: - anamentary hyperglycemia yokhudzana ndi kudya, - hyperglycemia yapakati, - kutengeka mtima kapena kupsinjika - kukulira munthawi yamavuto amakhudzidwe amisala, - - amakula munthawi yodziwika ndi kawopsedwe komanso makina osokoneza bongo pakhungu lamanjenje. Makina kuvulala kwa chigaza ndi ubongo, zotupa za ubongo ndi msana, vuto la kuledzera, kutupa kwa ziwalo za muubongo, opaleshoni, ndi zina zotere - mahomoni - hyperglycemia, etiology yomwe ndi kusalinganika kwa mahomoni - hepatic hyperglycemia.

Zachilengedwe komanso maleentary

Hyperglycemia yachilengedwe imaphatikizapo anamentary ndi neurogenic pathogenesis. Ndi mtundu wakuthupi, njira zobwerera sizifunikira kulowererapo, popeza kuchuluka kwa gluu payekha kumasintha.

Alimentary hyperglycemia (zokhudza thupi) zimayamba nthawi ya chakudya chambiri chamagulu chamagulu, izi ndizovuta kwachilengedwe.

Kuwonjezeka kwa glucose kumatha kuwonedwa ndikutha kwa ola loyamba mutatha kudya, pambuyo pa ola limodzi zomwe zimatsika ndikufika pazofunikira.

Chomwe chimapangitsa kuchepa msanga m'magazi okwera kumadalira pakugwiritsa ntchito insulin, timadzi tating'onoting'ono tomwe timapangidwa ndi zisumbu za ma Langerhans a kapamba.

Kupanga kwa timadzi timeneti kumachitika mozizwitsanso pachakudya ndikufika pachimake pomwe chidutswa cha chakudya chikalowa kumayambiriro kwamatumbo ang'onoang'ono, komwe kumayamwa mwachangu. Insulin imathandizira kuti ma cell a glucose azigwira nawo ntchito m'maselo a thupi.

Insulin imayesa kuchuluka kwa shuga m'magazi ndipo, chifukwa chopanga mwachangu, imalepheretsa hyperglycemia ndi glycosuria. Izi zimasiyanitsa hyperglycemia yakuthupi ndi mitundu ina, mwachitsanzo, kuchokera ku mahomoni, m'maganizo, pamavuto, postprandial, osakhalitsa, aakulu komanso osakanikirana.

Kuchita kwakuthupi kwachilengedwe kumatha kusintha kukhala kwachilengedwe ngati mugwiritsa ntchito moyenera zakudya zama protein ndi chakudya chamagulu. Inde, kuwonjezeka kwa shuga m'magazi kumaphatikiza njira yothandizira - glycogenolysis, motero, hyperglycemia imachitika.

Zodandaula (zodetsa nkhawa)

Hyperglycemia yotupa kapena yopsinjika imadziwika ndi makina a neurogenic pathogenetic. Nthawi zambiri, zomwe zimayambitsa mavutowa zimatha kukhala nkhawa zosiyanasiyana, kukhumudwa kwa neuropsychic, causalgia, etc. Ndi nkhawa yayikulu chifukwa cha kutseguka kwa machitidwe achifundo komanso chithokomiro, matenda a kupanikizika amayambitsidwa.

Kupanga kwamphamvu kwa mahomoni: catecholamines, glucocorticoids, triiodo- ndi tetraiodoranins - kumabweretsa kuyimitsidwa kwa glycogeneis komanso kuwonjezeka kwa gluconeogeneis ndi glycogenolysis. Kuchita kwa ma catecholamine m'magazi kumabweretsa kutseguka kwa adenylate cyclase, yomwe imapangitsa chidwi cha cyclic adenosymmonophosphate mu cytoplasm ya mafupa am'mimba minofu ndi chiwindi.

Cyclic AMP imagwira mapuloteni kinase, omwe amathandiza kwambiri glycogenolysis. Protein kinase ndi amene amawona kuchuluka kwa glycogen komwe kumachitika mu hepatocytes ndi myocyte. Chifukwa cha glucose womasulidwa, nkhawa kapena kupsinjika kwa mtima kumapezeka.

Ndondomeko yonseyi imachitika molingana ndi malamulo a kuthupi kwa kuthamanga kwa chakudya, zomwe zimasungidwa ndipo mtsogolomo zimatipatsa mphamvu pakuchita zinthu zolimbitsa thupi kapena zamaganizidwe.

Hormonal

Kuwonjezeka kwa mahomoni ena m'matenda ena kumakhudza kuchuluka kwa shuga m'magazi. Ma mahomoni omwe amachulukitsa shuga:

glucocorticoids,
glucagon,
katekisimaamu
mahomoni a chithokomiro.

Zizindikiro

kusakwiya kwambiri, osasunthidwa ndi chilichonse,
ludzu lalikulu
dzanzi la milomo
kuzunzidwa koopsa
kulakalaka kwambiri (chizindikiro cha khalidwe),
thukuta kwambiri
kupweteka mutu kwambiri
kuchepa kwa chidwi,
chizindikiro cha matenda ndi mawonekedwe a fungo la mkamwa kuchokera pakamwa pa wodwalayo,
kutopa,
kukodza pafupipafupi,
khungu lowuma.

Hyperglycemia mwa ana

Hyperglycemia mwa ana imadziwika ndi kuwonjezeka kwa kuchuluka kwa shuga m'magazi mpaka 6.5 mmol / L. Ndizofunikira kudziwa kuti ali ndi izi nthawi zina amatha kuchitika popanda chisonyezo chimodzi.

Hyperglycemia nthawi zambiri amapezeka mwa akhanda. Mpaka pano, asing'anga sanganene motsimikiza chomwe chimayambitsa matendawa.

Shuga amadzuka pafupipafupi mwa ana omwe amalemera zosakwana 1.5 makilogalamu, kapena akuvutika ndi sepsis, encephalitis, meningitis ndi matenda ena owopsa.

Ngati matendawa sakudziwika munthawi yake ndipo mwana sanathandizidwe, ndiye kuti maselo aubongo amasokonezeka, omwe amachititsa kuti matumbo azitupa ndi kutupa.

Hyperglycemia

Thandizo vuto la hyperglycemia:

Ndikofunikira kuti muchepetse kuchuluka kwa acidity m'mimba. Kuti izi zitheke, wodwalayo amapatsidwa mwayi kuti adye masamba ndi zipatso zambiri, komanso amwe madzi amamineral omwe ali ndi sodium,
pukuta khungu ndi thaulo yonyowa. Thupi limasowa madzi, mwanjira imeneyi amapanga madzi otayika,
gastric lavage ndi koloko solution - amathandiza kuchotsa acetone m'thupi.

Chithandizo cha hyperglycemia ziyenera kuchitika mwachangu, monga momwe ziwonetsero zoyambira zinasonyezera. Kuthandizaku ndikupereka insulin kuti muchepetse shuga.

Muyeneranso kuchitira detoxation ndi madzi osowa m'thupi ndi mayankho osabala. Pa mankhwalawa a hyperglycemia, ndikofunikira kutsatira zakudya, kugona ndi kupuma.

Kuthandizira pa nthawi yake sikuthandizira wodwalayo, komanso kupewa mavuto owopsa.

Matenda okhala ndi zofananira:

Ketoacidosis (zofananira: 6 mwa 12)

Ketoacidosis ndimavuto owopsa a matenda osokoneza bongo, omwe, popanda chithandizo chokwanira komanso chanthawi yake, amatha kudwala matenda ashuga kapena ngakhale kufa.

Vutoli limayamba kupita patsogolo ngati thupi la munthu silingagwiritse ntchito bwino glucose monga gwero lamphamvu, popeza limasowa insulin.

Poterepa, makina olumikizira adakonzedwa, ndipo thupi limayamba kugwiritsa ntchito mafuta obwera ngati mphamvu yamagetsi.

... shuga insipidus (zofananira: 5 mwa 12)

Matenda a shuga a insipidus ndimatenda omwe amayamba chifukwa chosowa vasopressin mthupi, omwe amatanthauzanso mahomoni antidiuretic. Matenda a shuga insipidus, zomwe ndi kuphwanya kagayidwe kamadzi ndikuwoneka ngati ludzu losasintha nthawi yomweyo munthawi yowonjezereka ya polyuria (pakukodza kwamkodzo), ndiye matenda osowa.

... Premenopause (zizindikiro zofananira: 5 mwa 12)

... Matenda a shuga mwa amuna (Zizindikiro zophatikiza: 5 mwa 12)

... Matenda a shuga mu ana (zizindikiro zofananira: 5 mwa 12)

Postprandial, alimentary, zokhudza thupi hyperglycemia

Amayamba posakhala ndi insulin kapena kuchuluka kwa mahomoni omwe amayambitsa matenda awa. Mwachidziwitso, kuchuluka kwa shuga m'magazi kungakhale kwamoyo komanso kwatsamba.

Kuphwanya kwamtunduwu kumagawidwa m'magulu angapo a hyperglycemia:

Kukhazikika munkati mwa kuphwanya magwiridwe antchito a kapamba, yemwe amachititsa kuti pakhale insulin. Umu ndi m'mene matenda a hyperglycemia amakhudzidwira. Matendawa amatenga matenda a shuga, komanso nthawi ya kutupa kwamatumbo: chimbudzi cha pancreatitis (chodabwitsa cha hyperglycemia pokhapokha pakukula kwa matenda).
Mitundu ina: - anamentary hyperglycemia yokhudzana ndi kudya, - hyperglycemia yapakati, - kutengeka mtima kapena kupsinjika - kukulira munthawi yamavuto amakhudzidwe amisala, - - amakula munthawi yodziwika ndi kawopsedwe komanso makina osokoneza bongo pakhungu lamanjenje. Makina kuvulala kwa chigaza ndi ubongo, zotupa za ubongo ndi msana, vuto la kuledzera, kutupa kwa ziwalo za muubongo, opaleshoni, ndi zina zotere - mahomoni - hyperglycemia, etiology yomwe ndi kusalinganika kwa mahomoni - hepatic hyperglycemia.

Zachilengedwe komanso maleentary

Hyperglycemia yachilengedwe imaphatikizapo anamentary ndi neurogenic pathogenesis. Ndi mtundu wakuthupi, njira zobwerera sizifunikira kulowererapo, popeza kuchuluka kwa gluu payekha kumasintha.

Alimentary hyperglycemia (zokhudza thupi) zimayamba nthawi ya chakudya chambiri chamagulu chamagulu, izi ndizovuta kwachilengedwe.

Kuwonjezeka kwa glucose kumatha kuwonedwa ndikutha kwa ola loyamba mutatha kudya, pambuyo pa ola limodzi zomwe zimatsika ndikufika pazofunikira.

Chomwe chimapangitsa kuchepa msanga m'magazi okwera kumadalira pakugwiritsa ntchito insulin, timadzi tating'onoting'ono tomwe timapangidwa ndi zisumbu za ma Langerhans a kapamba.

Zosasintha

Postprandial hyperglycemia imadziwika ngati, mutatha kudya, magazi omwe amapezeka m'magazi amapitilira 10 mmol / L. Kuyamwa mwachangu kwa glucose m'matumbo ndi kulowa kwake m'magazi kungathe kupewedwa pomwa mankhwalawa - acarbose.

Komabe, chinthu chachikulu pa mankhwalawa kuwonjezereka kwa shuga m'magazi ndikudya ndi kuchepa kwa kuchuluka kwakamagwiritsidwe ntchito ka digestible poly- ndi oligosaccharides amadya.

Wosakhalitsa, komanso postprandial hyperglycemia, umachitika msanga mukatha kudya chakudya chamafuta kapena mutangomva kupsinjika kwamphamvu kwamaganizidwe, ndiye kuti, kudzikondweretsa kwa dongosolo la mantha a ziwonetserozo.

Kukwera kwa ndende ya shuga ndikwachangu, koma kufalikira kumadziwika munthawi yochepa. Ma postprandial komanso ma pang'onopang'ono ma pathologies amasiyana mitundu ina mwanjira imeneyi.

Zodandaula (zodetsa nkhawa)

Hormonal

Hormonal hyperglycemia imayamba ndikupanga mahomoni ambiri omwe amalimbikitsa shuga mu seramu yamagazi. Mahomoni omwe amachititsa kuchuluka kwa glucose m'magazi ndi mfundo zazotsatira zake ndi motere:

1) ndi hyperplasia yama cell a islets a Langerhans, kaphatikizidwe ka glucagon kamakhudzidwa, kamene kamalimbikitsa gluconeogenesis ndi glycogenolysis m'maselo a chiwindi,

2) glucocorticoids ali ndi zofanana pamaso pa zotupa,

3) pheochromocytoma ya ubongo gawo la ma adrenal glands imapereka kaphatikizidwe kakang'ono ka macatcholamines, omwe amachititsa glycogenolysis,

4) kukula kwamafuta mumitsempha yambiri kumayimitsa glycolysis mu minofu ingapo yamthupi,

5) mahomoni a chithokomiro amathandizira glycogenolysis ndi gluconeogeneis ndikuletsa kusintha kosinthika. Mchitidwewo umayamba pamene kupanga insulini sikokwanira kapena zotsatira zake zitafooka, komanso kuwonjezereka kwa kapangidwe ka mahomoni kamene kamayambitsa kuchuluka kwa shuga.

Zizindikiro za Hyperglycemia, chithandizo, kufotokoza

Hyperglycemia amatanthauza chizindikiro cha matenda angapo amtundu wa endocrine, womwe umawonetsedwa ndi kuchuluka kwa shuga mu seramu yamagazi poyerekeza ndi chizolowezi. Zizindikiro zamtunduwu ndizofanana ndi matenda a shuga komanso matenda ena a endocrine.

Zomwe zimachitika mu shuga (glucose) zimawerengedwa kuti ndi mulingo wa 3,3 - 3.5 mmol / L. Ngati chizindikiro ichi chikuposa kuchuluka kwa 6-7 mol / l, ndiye kuti pali zisonyezo zakuzindikiritsa kwa hyperglycemia.

Mafuta ochulukirapo a 16.5 mmol / L ndipo pamwambapa akuwonetsa kukula kwa chikomokere.

Magawo atatu a hyperglycemia amatsimikiza ndi kuchuluka kwa shuga m'magazi a magazi.

Chizindikiro chofatsa chimatsimikiziridwa ndi kuwonjezeka kwa shuga mpaka 6 - 10 mmol / L.
Kuzindikira kwamphamvu kumapezeka ndi glucose wokhala 10 mpaka 16 mmol / L.
Chizindikiro chachikulu cha chizindikiro ndi misempha ya shuga pamwamba pa 16 mmol / L.

Kwa odwala matenda a shuga pali mitundu iwiri yowonetsera kuchuluka kwa shuga wa seramu.

Ngati wodwala sanadye pafupifupi maola 8 ndipo kuchuluka kwake kwa glucose kumakwera pamwamba pa 7.2 mmol / l, ndiye kuti amalankhula za hyperglycemia yofulumira.

Postprandial hyperglycemia imatsimikiziridwa kuti, mutatha kudya, shuga yodutsa 10 mmol / L.

Ngati chizindikiro cha glucose, posazindikira matenda a shuga, chikukula pambuyo chakudya chochuluka mpaka 10 mmol / l, ndiye kuti munthu akhoza kupanga matenda ashuga amtundu wachiwiri.

Popeza zotsatira za hyperglycemia zimawonetsedwa ndi zovuta zingapo mthupi, odwala omwe amapezeka ndi matenda osokoneza bongo amafunika kuwunika pafupipafupi kuchuluka kwa shuga m'magazi.

Zotsatira za hyperglycemia zitha kuwonetsedwa ndi kuphwanya kwamanjenje, mitsempha yamagazi ndi ma pathologies ena. Izi zimaphatikizapo zovuta zazikulu monga ketoacidosis ndi chikomokere.

Limagwirira a chitukuko cha hyperglycemia ndi zomwe zimayambitsa

Chomwe chimapangitsa kukula kwa chizindikirocho ndi kuchepa kwa mahomoni a insulin, omwe amachepetsa kuchuluka kwa shuga m'magazi.

Kapangidwe ka kakulidwe ka hyperglycemia ndikochepa kosakwanira kwa mahomoni ofunikira kwambiri ndi kapamba, omwe amakhudza kagayidwe kazakudya ndikuwongolera kuchuluka kwa shuga m'magazi.

Zikondwererozo zimalowa m'magulu a anthu endocrine ndikubwezeretsanso mphamvu ya kuchuluka kwa glucose ofunikira minofu ndi ziwalo zonse.

Koma pofuna kuyendetsa ndikuwongolera shuga, ma insulin ya mahomoni ndiyofunikira, popanda zomwe shuga siziwongolera ndipo, chifukwa chake, njala yam'mimba komanso kuchuluka kwake m'magazi kumachitika.

Chifukwa chake, nthawi zambiri amalankhula za mikangano pa ma cellular ndi makina a chitukuko cha hyperglycemia.

Kusiyanitsa pakati pa hyperglycemia yayitali komanso yongoyembekezera.

Hyperglycemia yochepa imatha kuchitika pamene zakudya zopatsa mphamvu zopatsa mphamvu kwambiri zimagwiritsidwa ntchito muzakudya.

Kuchulukitsidwa kwakanthawi kwa shuga m'magazi kungayambitse kutulutsa kwa adrenaline ndi thyroxine m'magazi chifukwa cha ululu.

Nthawi zambiri, hyperglycemia imachitika motsutsana ndi maziko azinthu zopsinja, pakati, hyperplasia ya adrenal cortex, mavitamini B1 ochepa C ndi C mthupi, poyizoni ndi kaboni oxides, chifukwa chotuluka magazi. Nthawi zambiri zimayambitsa hyperglycemia komanso mankhwala ena - fentamidine, β-blockers, corticosteroids, prism yothandizira ndi mankhwala ena angapo.

Kukhalitsa kwa hyperglycemia kumayamba kuphwanya malamulo a carbohydrate metabolism a neuro-endocrine chikhalidwe.

Kupsinjika Hyperglycemia

Hyperglycemia nthawi zambiri imatsagana ndi anthu omwe adakumana ndi kupsinjika kwamphamvu pakusokonezeka kwamanjenje, myocardial infarction, kapena stroke.

Kuphatikiza apo, hyperglycemia nthawi zambiri imayamba ngakhale kuti kulibe matenda ashuga.

Kuwona kwa zamankhwala kumagwirizanitsa kuwonjezeka kwa odwala omwe ali ndi vuto la mtima komanso sitiroko ndi chitukuko cha kupsinjika kwa hyperglycemia, i.e. ndi kuchuluka kwa shuga m'magazi.

Amayendedwe owonjezera kuchuluka kwa glucose panthawi yamavuto amayamba chifukwa cha mahomoni a antiinsulin amkati - glucocorticoids, catecholamines ndi ena. Pankhaniyi, sizotheka nthawi zonse kuyankhula za kukhazikika kwa matenda ashuga ndikuwonetsa zizindikiro za kupsinjika kwa hyperglycemia.

Kodi chifukwa chachikulu chowonjezera shuga?

Pathogenesis ya hyperglycemia ndikochepa kokwanira kwa insulin ndi maselo a kapamba.

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Popanda insulini, shuga, yemwe amangidwe ndi chakudya, samakamizidwa ndi maselo.

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Vuto la metabolic limatha kuchitika osati kokha chifukwa cha kusowa kwa insulin, komanso kuphwanya mphamvu zama cellular insulin.

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Chifukwa chake pamabwera mphamvu yakufa kwa maselo, omwe amaphatikizidwa ndi kuchuluka kwa shuga m'magazi.

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Pankhaniyi, kuyankhidwa kwa thupi kumatha kukhala ndi njala ya m'magazi: chiwindi chimayambira kupanga glycogen mu glucose ndikuponyera m'magazi, omwe kwenikweni sangathetse vutoli, koma amangokulitsa.

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Hyperglycemia: pathogenesis

Izi matenda amatsimikiza ndi zingapo. Koma chofunikira kwambiri ndi makina a hyperglycemia mu shuga mellitus, chifukwa ndi amene amamuyesa wamkulu.

Zowonjezera za hyperglycemia ndi:

Matenda a shuga.
Ziphunzitso za oncological kapena zotupa mu chithokomiro cha chithokomiro. Kuti mupeze matenda a khansa ya chithokomiro, onani nkhaniyo.
Chithandizo cha nthawi yayitali ndi mankhwala ena.
Kuchulukitsa kwa mahomoni a chithokomiro (hyperthyroidism).
Njira zotupa mu kapamba.
Kusweka kwamasamba, zokumana nazo.
Oncology.
Cushing's Syndrome.

Mtundu woyamba wa matenda ashuga, insulini siliperekedwa, mankhwala okhawo amene amatsalira ndi omwe amatsala. Ngati wodwala ali ndi matenda a shuga a 2, insulin ndiyofunikira.

Hyperglycemia mwa akhanda

Ndizofala kwambiri, chifukwa cha kusanthula (mmol / l):

Kusala - osapitirira 6.5.
Mutatha kudya - 9.

Pathology nthawi zambiri imawonedwa m'makanda obadwa asanakwane kulemera kwa 1.5 makilogalamu. Ana amatha kuonedwa ngati gulu lowopsa ngati amayi ali ndi vuto la sepsis, meningitis, encephilitis nthawi ya bere.

Ngozi yayikulu yakuwuka komanso kusasinthika ndiko kuchepa thupi kwakuthupi, kusowa bwino kwa thupi, kuchepa thupi. Zotsatira zake, ma pathologies ena a endocrine system amawuka.

Zizindikiro za Hyperglycemia

Chifukwa chakuti zotsatira za hyperglycemia sizabwino, ndikofunikira kuchitapo kanthu kuti muchepetse shuga m'magazi pazizindikiro zoyambirira za mawonekedwe ake.

Zizindikiro zofunikira komanso zofunikira ndizodwala mwadzidzidzi, chilimbikitso chowonjezereka ndi njala yosatopa, kukodza pafupipafupi, kuchepa kwa masomphenya - chophimba ndikuwuluka pamaso pa maso.

Odwala omwe ali ndi shuga ochulukirapo amakhala ndi kutopa kosalekeza, kupweteka mutu, kusokonezedwa, komanso kukwiya.

Zizindikiro zonenedwazo zimaphatikizapo thukuta kwambiri, kuzizira, milomo, komanso khungu louma.

Mitundu yambiri ya shuga imadziwika ndi fungo la acetone lochokera mkamwa.

Osowa kwambiri, hyperglycemia ndi asymptomatic.

Hyperglycemia Correction

Popeza kuchuluka kwa shuga m'magazi kuli ponseponse masiku ano, chizindikiro cha matenda ashuga komanso chizindikiro cha matenda ena, ndikofunikira kuyankha mwachangu ndi kukonza hyperglycemia.

Ndi kuwonjezeka kowopsa kwa msinkhu wa shuga ndikuwonetsedwa kwa zizindikiro zomwe zili pamwambapa, ndikofunikira kuti mupatse odwala mchere wamchere wamchere ndi calcium kapena sodium. Madzi okometsedwa samasiyanitsidwa konse.

Mutha kumwa wodwala kapu yamadzi ndi supuni ziwiri za supuni kapena kutsuka matumbo ndi mawonekedwe omwewo. Kuti muchotse acetone, m'mimba mumatsukidwa ndi yankho la ndende yomweyo.

Malo opaka khungu amathandiza, kupukuta kwambiri dera lamanja, pamphumi, khosi, pansi pa mawondo.

Ngati ndi kotheka, ndikofunikira kuzindikira kuchuluka kwa glucose ndipo ngati ali pamwamba 14 mol / l, ndiye kuti muyenera kulowa insulin mwachangu. Jakisoni wa insulini amachitika kuti matendawa asakhale shuga.

Pambuyo pakuwongolera mwachangu kwa hyperglycemia, ndikofunikira kukaonana ndi endocrinologist kuti mumve zambiri ndikupeza chithandizo.

Nthawi zambiri, jakisoni wa insulin amagwiritsidwa ntchito pochiza hyperglycemia. Kuphatikiza apo, njira zoyenera zochizira matenda oyambitsidwa zimaphatikizidwa, kudzipatula ndi kufanana kwa acid-base balance kumachitika.

Ngati wodwala akuchulukirachulukira m'magazi atatu kwa masiku atatu, ndiye kuti njira yolandirira munthu payekha ndi malangizo othandizira zakudya, ntchito ndi kupuma zimapangidwa.

Mitundu ya Hyperglycemic, mitundu yawo ndi njira zopititsira patsogolo

⇐ Tsamba 2 la 19 Kenako ⇒

Glucose ndiye gwero lalikulu lamphamvu mthupi .Magulu a shuga amatsimikizika m'magazi a venous kapena capillary. Pakuwunika kwa magazi a capillary, kuchuluka kwa shuga ndi 3.3 - 5.5 mmol / L, magazi a venous 4.1 - 5.9 mmol / L.

Insulin ndiye mahomoni okha antidiabetogenic kanthu, i.e. hypoglycemic action (amachepetsa shuga). Insulin biosynthesis imachitika mu β-maselo a pancreatic pancreatic islets. Glucose ndiye woyang'anira wamkulu wa insulin katemera wa by-cell.

Hyperglycemia: shuga wambiri kuposa 6 mmol / l. Ndi glycemia wamkulu kuposa 10 mmol / l, glucosuria amawoneka.

1. Alimentary - 1-1.5 mawola mutatha kudya chakudya chamafuta ambiri.

2. Neurogenic - wokondoweza mtima (wodutsa mwachangu).

a) Chosakwanira kapena chosakwanira cha kanyumba kovomerezeka:

- mtheradi - chifukwa cha kuchepa kwa kupanga kwa insulin

- wachibale - chifukwa cha kuchepa kwa chiwerengero cha insulin zolandila pama cell

b) matenda a pituitary gland (kuchuluka STH ndi ACTH)

c) chotupa cha adrenal medulla (pheochromocytoma) - adrenaline mothamanga

d) Mwazi wambiri wa glucagon, chithokomiro, glucocorticoids, somotropin ndi corticotropin.

Glycocotricoids amatenga nawo mbali pa chipangizo cha hyperglycemia mu shuga ndi matenda a Itsenko-Cushing.

4. Wotsimikizira - ngati shuga ndi woposa 8 mmol / l, amawoneka mkodzo:

- ndi osakwanira pancreatic ntchito

- ndi akusowa kwa phosphorylation ndi dephosphorylation michere

- ndi matenda opatsirana komanso amanjenje.

5. Kukwiya kwa imvi tuber ya hypothalamus, lentus nucleus ndi striatum ya basal nuclei ya bongo wamkulu.

6. Kwa ululu, matenda a khunyu.

Kuchepetsa kuchepa kwa mayankho a hexokinase, kuchuluka kwa glyconeogeneis ndi kuchuluka kwa glucose-6-phosphatase ndizomwe zimayambitsa matenda ashuga hyperglycemia.

- khungu louma komanso mucous nembanemba

Hyperglycemia yochepa ndi phindu losinthika.

Chokhazikika - kuwonongeka kwa chakudya chamafuta ndi zotsatira zoyipa.

Kuphwanya kugwiritsa ntchito glucose wakunja mwa maselo otengera insulin

- Kupanga kwa amkati magwero a shuga pakukweza kuchuluka ndi zochitika zamagulu a shuga: kuchuluka kwa glycogenolysis chifukwa cha glucagon ndi adrenaline, kuyambitsa kwa gluconeogeneis chifukwa cha glucocorticoids.

Mikhalidwe ya Hypoglycemic, mitundu yawo ndi njira zopititsira patsogolo.

Hypoglycemia - kuchepa kwa shuga m'magazi ochepera 3.5 mmol / l:

1. Mafuta (maola 3-5 atatha kudya chakudya chambiri, insulin).

2. Kugwira ntchito molimbika.

3. Mu amayi oyamwitsa.

4. Neurogenic (ndi zokopa - hyperinsulinemia).

5. Matenda:

a) limodzi ndi kuwonjezeka kwa ntchito ya pancreatic (insuloma, adenoma, khansa),

b) bongo wa insulin pakuchizira matenda a shuga,

c) kuwonongeka kwa chiwindi,

d) kuchepa kwa kukhathamira kwa mahomoni opikisana - glucagon, cortisone, adrenaline, mahomoni okula (hypofunction ya adrenal cortex, pituitary peteroti, chithokomiro cha chithokomiro),

e) kuwonongeka kwa m'mimba thirakiti,

6. Ndi zotupa za hypothalamus, pituitary pituitary, matenda a Addison.

Hypoglycemic syndrome (shuga wamagazi ochepera 3.3 mmol / l):

- kuda nkhawa kwakanthawi, kukwiya

- thukuta, kunjenjemera, kukokana

- Kutha kwa chikumbumtima (chikomokere hypoglycemic, shuga wamagazi ochepera 2.5 mmol / l)

- kuchuluka kwa kupuma komanso kugunda kwa mtima

- mawonekedwe amaso ndiwovuta

- kukonzekera kwamphamvu ndi matumbo.

- iv 60-80 ml ya glucose 40%

- tiyi wokoma chikumbumtima chikadzabweranso

Ndi kuchepa kwa shuga m'magazi m'munsimu 2,5 mmol / L, kukomoka kwa hypoglycemic kunga.

Matenda a shuga: gulu, etiology, pathogeneis.

Matenda a shuga. - matenda oyambitsidwa ndi kuperewera kwathunthu kapena wachibale.

I. Mtundu woyamba wa matenda ashuga kapena Matenda a shugakomabe, anthu azaka zilizonse amatha kudwala (chiwonongeko cha β-cell chotsogolera pakukula kwa insulin ya moyo wonse)

Autoimmune, kuphatikiza LADA,

II. Type 2 shuga (chilema pakubisidwa kwa insulini pamsana pa kukana insulin)

Matenda a shuga - pathological yodziwika ndi hyperglycemia yomwe imachitika mwa amayi ena ndipo nthawi zambiri amangozilala atangobereka.

Zochita bwino

Matenda ofatsa (I degree) amadziwika ndi glycemia wocheperako, osapitirira 8 mmol / l pamimba yopanda kanthu, pomwe palibe kusinthika kwakukulu mu shuga mumagazi tsiku lonse, osafunikira tsiku lililonse glucosuria (kuyambira zovuta mpaka 20 g / l). Malipiro amasamalidwa kudzera mu chakudya. Ndi mawonekedwe ochepera a shuga, angioeuropathy a preclinical ndi magawo othandiza amatha kupezeka mwa wodwala yemwe ali ndi matenda osokoneza bongo.

Kuopsa kwambiri

Ndi kukula kwamagulu (II digiri) matenda osokoneza bongo a shuga, kuthamanga kwa glycemia kumadzuka, monga lamulo, mpaka 14 mmol / l, kusinthasintha kwa glycemic tsiku lonse, glucosuria tsiku ndi tsiku nthawi zambiri simapitilira 40 g / l, ketosis kapena ketoacidosis imayamba.

Kulipira shuga kumachitika ndi kadyedwe komanso kayendetsedwe ka mankhwala ochepetsa mphamvu ya pakamwa kapena mwa kuphatikiza insulin (pankhani ya kukana kwachiwiri kwa sulfamide) pa mlingo womwe umapitilira 40 OD patsiku.

Mu odwalawa, odwala matenda ashuga angioneuropathies osiyanasiyana kutanthauzira ndi magawo magwiridwe antchito amatha kupezeka.

Njira zingapo

Matenda akulu a shuga (III digiri) amadziwika ndi kuchuluka kwa glycemia (pamimba yopanda 14 mmol / l), kusinthika kwakukulu mu shuga m'magazi tsiku lonse, glucosuria yayikulu (kupitilira 40-50 g / l). Odwala amafunikira chithandizo cha insulin nthawi zonse pa 60 OD kapena kuposerapo, ali ndi mitundu ingapo ya shuga.

Mu pathogenesis ya matenda a shuga, pali maulalo awiri omwe adadziwika:

1. Kupanga kwa insulin kokwanira kwa maselo a endocrine a kapamba,

2. Kuphwanya kulumikizana kwa insulin ndi maselo a minofu ya thupi (insulin kukana) chifukwa chosintha kapangidwe kake kapena kuchepa kwa chiwerengero cha zolandirira insulini, kusintha kapangidwe ka insuliniyake kapena kuphwanya njira zamkati mwa njira yotumizira ma cell kuchokera kuma receptors kupita ku cell organelles.

Pali cholowa chamtundu wa matenda ashuga. Ngati m'modzi mwa makolo adwala, ndiye kuti kuthekera kwa kulandira matenda ashuga 1 ndi 10%, ndipo mtundu 2 wa matenda ashuga ndi 80%.

The pathogenesis yachipatala komanso mawonetsedwe a labotale a insulin omwe amadalira matenda a shuga (IDD).

Matenda a shuga omwe amadalira insulin (mtundu 1) . EdI kutengera njira ya chitukuko ikhoza kugawidwa mu: autoimmune, kachilombo koyambitsa matenda komanso kosayenda pang'onopang'ono.

Etiology ya EDI: Palibe cholowa chabadwa kwa EDI, popeza kuthekera koperekera mtundu wosalidwa kuchokera kwa makolo kupita kwa mwana ndikochepa kwambiri (kochepera 4%).

Akuti EDI ndi vuto la autoimmune lomwe limalumikizana ndi ma antigen ena a HLA histocompatibility omwe ali kumanja kwapfupi kwa 6 chromosome.

Zomwe zimatulutsa zakunja zomwe zimayambitsa IDD ndizovuta zam'mimba: Ma virus a Coxsackie, rubella, cytomegalovirus, poizoni wakunja, mapuloteni amkaka.

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 the pancreatic Langerhans Islands).

Mtundu woyamba wa shuga umakhala ndi 5-10% yamatenda onse a shuga, omwe amakhala aubwana kapena unyamata. Mtunduwu wa shuga umadziwika ndi kuwonetsa koyambirira kwa zizindikiro zomwe zimapita patsogolo mofulumira pakapita nthawi.

Chithandizo chokha ndi jakisoni wa insulin

· Hyperglycemia imayambitsa mawonekedwe a glucosuria. Zizindikiro za shuga wambiri wamagazi (hyperglycemia): polyuria, polydipsia, kuchepa thupi ndi chidwi chambiri, mkamwa wowuma, kufooka

· Microangiopathies (matenda ashuga retinopathy, neuropathy, nephropathy),

· Macroangiopathies (atherosulinosis of the coronary artery, aorta, GM chotengera, m'munsi malekezero), matenda ashuga phokoso

Njira zodutsa: furunculosis, colpitis, vaginitis, matenda amkodzo thirakiti ndi zina zotero.

EDI (mwana) - Zizindikiro zimachitika asanakwanitse zaka 30, chiwerengerochi chimakhala zaka 5-11, chodziwika ndi insulinopenia komanso chizolowezi cha ketonemia. Malinga ndi njira za kakulidwe kake, mitundu iwiri imasiyanitsidwa - autoimmune komanso kachilombo koyambitsa ma virus.

1.Matenda a shuga a Autoimmune yodziwika ndi kukhalapo kwa zizindikiro za kuwonongeka kwa chitetezo cha m'mimba kapamba. Mu 90% ya odwala matenda a shuga, kupezeka kwa ma antiimodune antibodies motsutsana ndi ma antigen a cytoplasmic membrane a islets amapezeka.

Ma antibodies amatsimikizika ngakhale asanayambike zizindikiro za matenda ashuga ndipo amasungidwa kwambiri kwa zaka zingapo atatha matenda ashuga; pakhoza kukhala ma antibodies a cell a ziwalo zina za endocrine.

Chifukwa cha kulowa kwa lymphocytic ndi kuwukira kwa maselo ndi autoimmune cytotoxic clones of T-lymphocyte (CD8 +) and T-assist cell (CD4 +), cytolysis of β-cell of islets of Langerhans limachitika.

Njira ina yowonjezera pancreatic minofu yowonongeka mu DM ndi β-cell apoptosis yoyambitsidwa ndi nitric oxide, yomwe imapangidwa mu β-maselo okha pamene atayika mphamvu zowonongeka ndi ma macrophages omwe amapanga zida zamtundu wa islet (pafupifupi ma macrophages 10 pa islet). Zizindikiro zamatenda a shuga zimawoneka pomwe 75-85% ya maselo a islet awonongeka.

2. Matenda Atiyambitsa Matendawa . Si ma virus onse omwe amatha kuyambitsa chitukuko cha matenda a shuga, chifukwa izi zimapangitsa kuti ma virus apatsidwe mwachindunji.

Mavairasi oterewa akuphatikizapo ma virus a rubella, kachilombo ka Coxsackie, chikuku, cytomegalovirus, kachilombo ka chimfine, mumps, hepatitis. M'mawu omaliza, ma antibodies, omwe thupi limakonda "kuponya" kuti awononge ma virus, osayima pam cholinga ndikuyamba kuwukira maselo awo.

Chifukwa kachilombo koyambitsa matenda a shuga kapangidwe kanthawi kochepa chabe ka ma antibodies kwa ma antigen of the pancreatic islets ndi khalidwe, lomwe, monga lamulo, limasowa patatha chaka chimodzi.

Matenda amtunduwu a shuga samaphatikizidwa ndi zotumphukira za autoimmune ziwalo zina za endocrine; zimakula m'mbuyomu kuposa mtundu wa autoimmune. Chikhalidwe cha odwala awa ndi chizolowezi chowonjezereka chopanga ma antibodies a exo native insulin.

Pathogenesis ya mawonetseredwe azachipatala ndi a labotale ya nikulin-Independent shuga mellitus (NIDDM).

Matenda a shuga a insell -us osadalira insulin

Zowopsa:

— zaka chiwonetsero cha matenda a shuga nthawi zambiri mwa anthu wamkulu kuposa zaka 30-50

- cholowa. IND imachulukana kangapo mwa abale a odwala matenda ashuga. Ngati makolo onse akudwala matenda ashuga, chiopsezo chotenga matenda a shuga kwa ana awo m'miyoyo yawo yonse ndi 100%, ngati m'modzi mwa makolo adwala - 50%, pankhani ya matenda a shuga kwa m'bale kapena mlongo - 25%.

- kunenepa kwambiri, (mpaka 85-90%) odwala ndi onenepa kwambiri

- kusachita masewera olimbitsa thupi

Pathogenesis wa IND (mtundu 2).

Pa gawo loyamba la NIDDM, mulingo wa insulin m'magazi nthawi zambiri umakhala wabwinobwino kapena wokwera, womwe umawonetsa chodabwitsa insulin kukana.

Mtundu wachiwiri wa matenda ashuga a shuga, mphamvu ya shuga imalephera kuthana ndi katemera wa insulin, kukoka kwa katulutsidwe ka insulini kumayipa, pali kusowa kwa kuchuluka kwa insulin secretion (prandial). (onani mkuyu. 5). Popeza odwala amakhala ndi yankho lochepetsedwa poyambira kwa insulini ku glucose, koma kuyankha kwa zinthu zina zomwe zimapangitsanso kupanga kwa insulin, monga arginine, sikuwonongeka, izi zikutanthauza kuti kuphwanya kwa enieni a glucose receptors pa -cell kapena kuphwanya kwaomwe amatengera glucose GLUT-2.

Ndi vuto la chibadwa chotsimikizika mu insulin katulutsidwe ka ma cell a cell pancreatic ndi cell ya insulin, insulin yolimba, mitundu yozungulira yoyipa: kulimba kwambiri kwa insulini, insulin yochulukirapo imapangidwa ndi maselo a islet kuti igonjetse, ndipo kukwera kwa insulin m'magazi, kumachepetsa chidwi chake zimakhala.

Pa mulingo wa zotumphukira:

cholembera:

kaphatikizidwe ka insulin yachilendo

mkulu insulinase ntchito

- kuphwanya kutembenuka kwa proinsulin kukhala insulin

cholandirira:

kusintha kwa mtundu wa insulin receptor (chilema cha β-subunit ya receptor)

- Kuchepetsa kuchuluka kwa zolandilira pama cell omwe amadalira insulin, mwachitsanzo, kunenepa kwambiri

- Kupanga mgwirizano wa receptor (zomverera)

—hyperglycemia yomwe imatenga nthawi yayitali imabweretsa kukhumudwa kwa ma cell a β, omwe amawonetsedwa ndi kuwonongeka mu ntchito zawo zachinsinsi.

postreceptor:

Kuphwanya kwa kufalikira kwa chizindikiro ndi phosphorylation

Kuphwanya kwa kufalikira kwa chizindikiro chifukwa cha chilema kapena kuchepa kwa omwe amayendetsa glucose (GLUT 4, 6)

Mulingo wa kapamba:

—mayendedwe a shuga chifukwa cha kuchepa kwa chiwerengero kapena chilema cha ma molekyulu a GLUT 2, omwe ndi gawo lokhalo la glucose transporter mu β-cell.

Zowonekera zamankhwala ndi zasayansi za matenda a shuga:

Hyperglycemia - kuchuluka kwa shuga m'magazi kumaposa 6 mmol / l, ndi IND, kuchuluka kwa glucose m'magazi kumatha kufika pakuyerekeza kwa nyenyezi za 55,5 mmol / l.

Hyperglycemia ndi zotsatira za:

Kuphwanya kugwiritsa ntchito glucose wakunja mwa maselo otengera insulin

Ndi kuwonjezeka kwa shuga wamagazi opitirira 10 mmol / l (chotchinga cha impso kwa glucose) glucosuria.

Polydipsia ndiyeZotsatira za hyperglycemia. Glucose ndi chinthu chogwira ntchito chomwe chimayambitsa kuperewera kwa madzi m'thupi ndi ludzu.

Polyuria(mpaka malita 10 a mkodzo patsiku) ndizotsatira zakuchulukitsidwa kwa shuga m'magazi ndi polydipsia (kufunika koti amwe). Polyuria imabweretsa kuchepa kwa ma elekitirodiya (dndi electrolytemia)Na, Ca, Cl, K, Mg, kuchuluka magazi kukhuthala, hemodynamic matenda.

Polyphagy - chilakolako chowonjezereka chifukwa cha njira za catabolic (zochitika za proteinolysis ndi lipolysis).

Kuchepetsa thupi (kwenikweni kwa IDDM) - amakula chifukwa cha proteinolysis ndi lipolysis.

Hyperazotemia - pakuwonongeka kwa amino acid, ammonia, urea ndi zinthu zina za nayitrogeni zimapangidwa.

Ketonemia(kupezeka kwa matupi a ketone m'magazi)ndi ketonuria(kupezeka kwa matupi a ketone mu mkodzo)–nthawi zambiri pamakhala chiwonetsero cha ED. Matupi a Ketone: acetone, acetoacetic acid, β-hydroxybutyric acid. Choyambitsa chachikulu cha ketosis ndikuwonjezereka kwa mafuta, kuwonjezereka kwa acetyl CoA, komanso makutidwe a oxidation osakwanira mumjikelezo wa Krebs.

Kuphwanya malamulo a CBS -metabolic acidosis chifukwa cha kuchuluka kwa zinthu zophatikiza acidic (matupi a ketone, FFA, lactic acid, H +) zitha kuchititsa kuti pakhale chikomokere.

Glycosylationhemoglobin, mapuloteni am'mimba am'mimba ndi ma cell cell am'mimba amatsogolera ntchito yawo. Odwala omwe ali ndi matenda osokoneza bongo omwe ali ndi vuto la hyperglycemia, zomwe zimakhala za glycosylated hemoglobin - HbAlc - zimawonjezeka katatu pakadutsa masabata awiri. Chifukwa cha glycosylation wa hemoglobin, mawonekedwe a hemiclob amapangidwa.

Glycosylated hemoglobin imawonetsa zochitika zosiyanasiyana zachilengedwe: imachulukitsa kuchuluka kwa maselo a endothelial, kumangiriza kwa ma cell a macrophages, maselo endothelial ndi mesangial, activates macrophages kuti secrete cytokines, inhibits mapangidwe a NO ndikuletsa vasodilation, amalimbikitsa kukhathamiritsa kwa LDL.

Zizindikiro zazikulu za hyperglycemia

Mankhwala, pali zizindikiro zazikulu zitatu zaku chipatala cha hyperglycemia:

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kukodza pafupipafupi,
ludzu, ngakhale mutamwa madzi okwanira,
Kuchepetsa thupi popanda chifukwa.

Kuphatikiza pa zizindikiro zazikulu za matendawa, zina zingapo zitha kusiyanitsidwa:

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kuchiritsa pang'onopang'ono kudula pakhungu,
khungu lowuma, kuyabwa,
kutopa popanda chifukwa
kuona patali kapena kuona pang'ono kumene kumayamba
candidiasis wosavomerezeka kapena kutupa kwamkhutu,
kupumula kwamphamvu kwamphamvu, arrhythmia.

Chizindikiro chofunikira cha matenda komanso kupsinjika kwake ndi ketonuria, pomwe apetone kapena ketoacidosis amapezeka mumkodzo, zomwe zimayambitsa vuto la matenda ashuga komanso chikomokere.

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Makina a zovuta izi ndi awa:

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Popeza glucose simalowa m'maselo, kuchuluka kwake m'magazi kumawonjezeka.
Chiwindi chimayamba kuphwanya glycogen mu glucose kuti chizilimbitsa icho ndi maselo, komanso sichilowa m'maselo a ziwalo zathupi.
Nthawi yomweyo, maselo opanga mphamvu amayamba kuthyola mafuta, omwe, akaola, amatulutsa matupi a ketone, i.e. acetone.
Acetone yambiri imadutsa impso ndikusokoneza ntchito yawo.

Pali mkhalidwe wa kulephera kwa impso, mwa mitundu ikuluikulu yomwe pangafunike vuto la hemodialysis.

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Zoyambitsa Hyperglycemia

Zomwe zimayambitsa chiopsezo cha hyperglycemia zitha kugawidwa m'magulu angapo:

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wodwala insulin
zathupi
osakhala ndi matenda ashuga
mahomoni.

Mkhalidwe wamafuta ochulukirapo m'magazi ungayambitsidwe osati kokha ndi chitukuko cha shuga, komanso kutayika kwa kapamba azomwe amagwira ntchito kuti apatse thupi kuchuluka koyenera kwamahomoni, komanso zifukwa zina.

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Amayambitsa matenda ashuga

Matenda a hyperglycemia amakula m'matenda a shuga a mitundu yoyamba komanso yachiwiri.

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Popeza zizindikiro za shuga zapamwamba m'magazi a shuga zimakhala zosatha, hyperglycemia imatchedwa aakulu.

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Pathology imayamba chifukwa chosakwanira kupanga insulin mwa kupanga ma cell a kapamba.

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Chifukwa chake, glucose amadziunjikira m'magazi osalowa m'maselo a skeleton ndi ma system ena a thupi. Zizindikiro pamenepa ndizolimba komanso zimapitilira.

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Matenda a hyperglycemia a shuga

Matenda a hyperglycemia aakulu amayamba chifukwa cha kuchepa kwa insulin kokha. Mulinso ma nephropathies ndi angiopathies.

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Matendawa ndiwonetsero wa zovuta zake:

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khansa ya kapamba
kapamba osiyanasiyana zovuta,
matenda oyambitsidwa ndi othandizira opatsirana
zovuta zamtundu komanso ma syndromes osiyanasiyana.

Hyperglycemia syndrome ikuphatikizanso matenda osiyanasiyana okhudzana ndi chitetezo chamthupi, kuphatikizapo chifuwa. Mukusowa kwambiri kwa insulini, matenda a arteriosulinosis amatha kuchitika chifukwa cha kuwonongeka kwa chiwindi.

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Psychological Hyperglycemia

Physiological hyperglycemia mu mawonekedwe ake imagawidwa m'mitundu itatu:

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Postprandial hyperglycemia, pomwe pali kuwonjezeka kwakanthawi kwa shuga m'magazi chifukwa chodya kwambiri komanso nthawi yomweyo kumwa kuchuluka kwa zopatsa mphamvu.
Hyperglycemia yochepa imatsimikiziridwa ndi kusakanikirana kosayenera kwa magazi pakuwunika.

Mutuwo ungaphwanye malamulo operekera seramu ya shuga mwa kudya kena kake musanapendeke kapena kukhala ndi mantha.

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Potere, zotsatirazi zikuwonetsa kuchuluka kwa shuga omwe amasala kudya, omwe wodwala alibe.

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Kupsinjika kwakukulu kwa hyperglycemia kapena kupsinjika kwamaganizidwe kumachitika pambuyo pokumana kwambiri kapena chifukwa cha kupsinjika kwanthawi yayitali.

Kuchulukitsa kwa glucose kumafika pachimake ndikuchepera.

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Izi zimachitika chifukwa cha kutulutsidwa kwa mahomoni opsinjika: cortisol ndi adrenaline, zomwe zimakhudza kusintha kwa glycogen kukhala glucose. Chifukwa chake, kuchuluka kwa shuga m'magazi kumakwera kwambiri.

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Acute hyperglycemia imatha kuchitika chifukwa chochita zolimbitsa thupi kwambiri, chifukwa ntchito ya minofu imatha kupangitsa kuti maselo azitha kufa, zomwe zimapangitsa kuti shuga atuluke m'magazi a glycogen m'chiwindi.

Nthawi zambiri pamakhala hyperglycemia ya etiology yosadziwika, zomwe zimayambitsa kuchuluka kwa shuga m'magazi sizingadziwike.

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Zinthu zopanda matenda ashuga

Njira yogwiritsira ntchito shuga wamagazi imayamba chifukwa cha chotupa kapena matenda.

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Zotsatira zopanda shuga zomwe zimayambitsa matenda a hyperglycemia zimasiyanitsidwa:

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myocardial infarction kapena stroke,
zosiyanasiyana za genitourinary dongosolo zomwe zimakhudza kuchepa kwa shuga mumkodzo,
kupsa kwamoto,
kuperewera kwa adrenal,
Cancreatic oncology, pancreatitis yayikulu komanso yovuta,
kagayidwe kachakudya ka akhanda,
hyperthyroidism, acromegaly, ndi matenda ena a endocrine,
matenda a chiwindi, momwe kuchepa kwa kupanga kwa glycogen ndi gluconeogeneis, kuchepa kwa vitamini B1, hepatitis yayitali ndi chiwindi cirrhosis,
majini obadwa nawo.

Kupitilira muyeso wamagazi wowonjezera wamagazi omwe amachitika pambuyo povulala, mikwingwirima, matenda amtima amatchedwa "yogwira hyperglycemia", akuti, malinga ndi ziwerengero, akuwonetsa chiopsezo chakufa mwa anthu omwe apulumuka kuwukiraku.

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Hyperglycemia Syndrome Treatment

Popeza hyperglycemia syndrome imakhala ndi zifukwa zambiri, chithandizo chake chimadalira kuzindikira koyenera komanso kuthetseratu osati zotsatira zake, komanso zifukwa zina.

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Choyamba, madokotala amalabadira kwambiri kuti athetse matenda ndi njira zochizira, komanso amapereka zakudya zapadera zokhala ndi zakudya zamagulu ochepa.

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Kwa anthu omwe ali ndi matenda ashuga, mankhwala a insulini obwezeretsedwa amakhazikitsidwa mwachangu.

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Ndi kuwonjezeka kwa shuga m'magazi, makonzedwe a owongolera pakamwa, repaglinide ndi nateglinide, atsimikizira kuti ali ndi chiyembekezo.

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Zinthu zogwira ntchito zochokera ku ma amino acid zimathandizira kubwezeretsa yankho la insulin pakudya.

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Kusinthasintha kwa kumwa mankhwalawa, komwe kumakhudzana mwachindunji ndi kuchuluka kwa zakudya zomwe zimadyedwa, sikukuphwanya mtundu wa moyo wa anthu omwe ali ndi hyperglycemia.

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Hyperglycemia ya nthawi yayitali iyenera kuyang'aniridwa osati ndi endocrinologist, komanso akatswiri ena:

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mtima
wamisala
ophthalmologist
urologist.

Chifukwa chake, kuthekera kwamavuto ku ziwalo zina kumayang'aniridwa ndi akatswiri. Kuti muchite izi, ndikulimbikitsidwa kukayezetsa kamodzi kamodzi miyezi isanu ndi umodzi, kapena ngati pakufunika.

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Thandizo loyamba

Ngati vuto la pachimake hyperglycemia kapena vuto la hyperglycemic, wovutikayo angafunikire thandizo loyambirira mwachangu:

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Poyamba, ngati kuli kotheka, muyenera kuyeza shuga wamagazi ndi glucometer, yomwe simatenga nthawi yambiri. Ngati kukayikakayika kwa kudumphadumpha kwa shuga kwatsimikiziridwa, zotsatirazi ziyenera kuchitidwa:
Itanani ambulansi, chifukwa ngati kulowererapo kwa zamankhwala kokha ndi katswiri komwe kungathandize kupewa zovuta.
Patsani chakumwa chochuluka kwa womenyedwayo, kuti muchotse zinthu zovulaza m'thupi. Mu theka la ora loyamba, ayenera kukhala osachepera 1 lita imodzi ya madzi oyera, ndikupatsanso theka la lita imodzi ya madzi ola lililonse.
Wodwala akasiya kuzindikira, muyenera kumuyika kumbali yake kuti asamadziziridwe ndi lilime lake.

Ngati munthu akudziwa kuti ali ndi matenda ashuga ndikugwiritsa ntchito mankhwala ofunikira, makamaka a insulin, ndiye kuti ayenera kupatsidwa jakisoni, koma pokhapokha kuchuluka kwa glucose kupitirira 15 mmol / l, chifukwa kugwiritsa ntchito mosakonzekera insulin kumapangitsa kutsika kwambiri kwa shuga, komwe kumakhalanso koopsa kwa anthu .

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Zakudya za hyperglycemia

Ndi matenda a hyperglycemia, wodwalayo amapatsidwa zakudya zapadera, zomwe ayenera kutsatira.

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Saloledwa kudya zakudya zokhala ndi zovuta komanso zovuta zamafuta. Izi ndiye, zoyambirira, ndi izi:

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maswiti, makeke,
kuphika
pasitala
zipatso zokoma
mbatata
mkuyu.

Hyperglycemia imakhudza mayendedwe ena a munthu yemwe akudwala matendawa.

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Kutengera malamulo awa, mutha kukhalabe ndi shuga m'magazi:

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chepetsani nthawi pakati pa chakudya, nthawi zambiri m'magawo ang'onoang'ono,
chepetsa zakudya zokazinga komanso zakudya zonunkhira,
phatikizani masamba ambiri atsopano ndi zipatso zopanda zipatso.
Idyani mapuloteni ambiri - nyama yoyera, mazira,
phatikizani mkaka wokazinga mkaka
Maswiti, mutha kugwiritsa ntchito zipatso zouma kapena maswiti apadera,
imwani madzi ambiri.

Malamulo osavuta awa amakupangitsani kumva bwino komanso kuti muchepetse zovuta.

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Kuchiza ndi wowerengeka azitsamba

Njira ina yosungirako shuga wamagazi ndi mankhwala azitsamba. Zomera zimasankhidwa kuchokera ku ma alkaloids angapo:

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dandelion
elecampane
masamba ambuzi.

Ma alkaloids amatha, monga insulini, kuthandiza glucose kudutsa ma membrane a maselo, potero amakhala ndi metabolism.

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Chinsinsi chabwino cha mankhwalawa nyemba: tengani nyemba zachinyamata makumi asanu mumalita awiri a madzi otentha. Kuphika nyemba kwa pafupifupi maola atatu mukusambira. Tsanulira msuzi ndi kumwa mankhwalawa kanayi pa tsiku musanadye pakati kapu. Njira yovomerezeka siosakwana gawo limodzi pachaka.

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Njira imodzi yothandiza ndi kugwiritsa ntchito Yerusalemu artichoke ngati mankhwala. Kuti muchite izi, wiritsani kwa kotala la ola limodzi ndi kutenga msuzi utakhazikika musanadye kwa theka la ola.

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Zosagwiritsanso ntchito kwambiri ndi ma decoctions ndi ma infusions a mbewu zotsatirazi:

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masamba a mabulosi
lilac khalidal,
tsamba
masamba ndi mizu,
mafuta owonda
ginseng ofiira.

Kuphatikiza pa ntchito ya insulin, amakhalanso ndi mphamvu yolimbitsa chitetezo cha mthupi komanso kuthandizira chiwindi kuthana ndi kukonza zinthu zovulaza.

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Masamba a Blueberry amakhalanso okodzetsa komanso amateteza zovuta za impso.

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Tsamba la Bay limathandiza kupewa kukoka kwa zinthu zopindulitsa m'thupi, komanso limathandiza kupewa kuteteza matenda a m'mimba.

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