Momwe mungazindikire matenda a shuga: Zizindikiro zoyambira, kuzindikira
Pali gulu lotsatila la matenda ashuga, lovomerezedwa ndi WHO mu 1999.
Kugawika kwa masoka a matenda a glycemic (WHO, 1999)
1. Type 1 shuga mellitus (kuwonongeka kwa khungu la beta, zomwe nthawi zambiri zimayambitsa kufooka kwathunthu kwa insulin):
2. Mtundu wachiwiri wa matenda a shuga a mellitus (cholimbira kwambiri insulin chifukwa cha kusintha kwa majini a insulin kapena cholakwika chachikulu chachinsinsi chifukwa chopanga insulin).
3. Mitundu ina yapadera ya matenda ashuga komanso zotsatira za insulin.
A. Zofooka zamtundu wa beta cell function.
B. Matenda a exocrine a kapamba (kapamba, zotupa, kuvulala, hemochromatosis, ndi zina).
G. Endocrinopathies - Matenda ake a Itsenko-Cushing ndi matenda, thyrotooticosis, pheochromocytoma, glucogonoma, acromegaly.
D. Matenda a shuga omwe amapangidwa ndi mankhwala kapena mankhwala - adrenergic agonists, glucocorticosteroids, diuretics, etc.
E. Matenda - rubella, mumps, etc.
4. Matenda a shuga (odwala matenda ashuga) azimayi oyembekezera.
3. Zakudya zazikuluzikulu za etiopathogenesis za matenda ashuga.
Chifukwa chachikulu cha zovuta zonse za metabolic ndi matenda owonetsa matenda a shuga ndikusowa kwa insulin kapena zochita zake, zomwe zimawonetsedwa ndi kupatsa mphamvu kwa mafuta, mafuta ndi metabolism.
Mwa munthu wathanzi, pali njira zotsatirazi zamagwiritsidwe ntchito a shuga, zolumikizidwa ndi zochita za insulin - aerobic glycolysis, pentose phosphate mzunguko, ndi kapangidwe ka glycogen m'chiwindi.
Pansi pa vuto la insulin yokwanira kapena ya insulin, kutuluka kwa glucose m'maselo a insulin amadalira minofu (minofu, adipose, hepatic) kusokonekera, njira za glucose zosayimira insulin zimayendetsedwa:
sorbitol - glucose mothandizidwa ndi enzyme aldose reductase imabwezeretsedwa ku sorbitol, yowonjezera yomwe imasonkhana mu mandala, ulusi wamitsempha, retina ndikuyambitsa kukula kwa ma neuropathies ndi ma cataracts.
glucuronate - ndi kuchuluka kwa glucose, glucuronic acid ndi glycosaminoglycans amayamba kupanga mosiyanasiyana zochuluka kuchokera pamenepo. Zotsirizika, zomwe zimayikidwa mu cartilage, tendons, zimapanga maziko a arthropathy mu shuga.
glycoprotein– kaphatikizidwe ka glycoproteins - maofesi omwe amakhala pamitsempha ya endothelium, makamaka microvasculature, imayendetsedwa. Poterepa, mikhalidwe imabuka chifukwa cha kuchuluka kwa maselo amwazi ndi kuzungulira kwa zotumphukira zimakhala, zotumphukira ndi kupitilira kwa angiopathies.
Ndi matenda a shuga, ntchito ya pentose phosphate kuzungulira kwa glucose metabolism imachepa, zomwe zimapangitsa kuphwanya kaphatikizidwe ka mapuloteni. Kuwonjezeka kwa gluconeogeneis kumabweretsa kutsegula kwa mapuloteni catabolism, kufooka kwa malo ake, kuyambira ndi amino acid. Zowonetsedwa bwino ndi minofu hypotrophy ndi kuwonda.
Protein glycosylation - ndiyofunikanso kwambiri. Mapuloteni monga hemoglobin, puloteni ya puloteni ndi mapuloteni (erythrocyte membrane protein, seramu yamagazi, makoma amitsempha, intulin ya insulin) amapezeka ndi glycosylation. Nthawi yomweyo, amasiya kutulutsa thupi, mwachitsanzo, hemoglobin ya glycosylated imamanga oxygen kwambiri ndikuipatsanso minofu yovuta, yomwe imapangitsa minofu hypoxia. Komanso, mapuloteni oterowo amakhala autoantigens, omwe amathandizira kukulitsa kusintha kwa autoimmune.
Kugwiritsa ntchito shuga kosagwiritsidwa bwino mu kayendedwe ka Krebs kumabweretsa kuyambitsa kwa lipolysis, zomwe zimapangitsa kuchuluka kwa mafuta acids ndi glycerin (mafuta a chiwindi). M'mikhalidwe yamafuta ochulukirapo, mitundu yayikulu ya matupi a ketone, omwe alibe nthawi yoyesedwa mu kayendedwe ka Krebs (ketonemia, ketonuria).
Zizindikiro zoyambira
Kunyumba, lembani matenda ashuga amtundu woyamba ndi 2 omwe angathe kutsimikiziridwa ngati muli ndi zotsatirazi:
- kamwa yowuma, ludzu, chofunikira chakumwa madzi okwanira malita awiri patsiku,
- Kuuma ndi kusenda kwa khungu,
- njala ndi chilala.
- kukodza pafupipafupi, kuwonjezeka kwamkodzo tsiku lililonse mpaka malita 5, nthawi zina mpaka malita 10,
- kusinthasintha kwa thupi
- kukwiya, kusokoneza tulo, kusokonekera.
Zizindikiro zoyambirira zakukula kwa matendawa zimaphatikizanso kuchepa kwa mawonekedwe owoneka bwino komanso lakuthwa, kulemera m'miyendo ndi kukokana m'matumbo. Wodwala nthawi zambiri amakumana ndi vuto la vertigo, kufooka, ndipo amatopa msanga. Ndi matenda a shuga, kuyabwa kwa khungu ndi perineal mucosa kumadziwika. Matenda opatsirana amatenga chilengedwe chotupa, mabala ndi mafinya onse amachiritsidwa kwa nthawi yayitali. Pali kusatsutsika kopitilira muyeso.
Mwa anthu ena, zizindikilo zomveka zimathandiza kuzindikira matenda ashuga, mwa ena, Zizindikiro zimakhala zopanda pake. Zonse zimatengera kuchuluka kwa shuga, kutalika kwa matendawo komanso machitidwe a thupi la wodwalayo.
Matendawa akamakula, nseru komanso kusanza, kuwonongeka kwa masamba miyendo, kukula kwa tsitsi lakumaso, komanso maonekedwe a kakulidwe kakang'ono pazikhungu kumatha kuonetsa vuto.
Mwa amuna, magawo oyambirira a shuga, kuchepa kwa libido, kusowa kwa erectile, kusabereka kumadziwika. Zotsatira za kukodza pafupipafupi zimatha kukhala balanoposthitis - kutupa kwa khungu.
Amayi amamva kuchepa kwa chilakolako chogonana, amatha kukhala ndi nthawi yosakhazikika, kuuma komanso kuyabwa kwa ziwalo za m'mimba, ziwalo, kummimba.
Magulu owopsa
Matenda a shuga ndi matenda ofala kwambiri, koma sianthu onse omwe ali ndi lingaliro lakelo. Magulu omwe ali pachiwopsezo cha matenda amtundu 1 ndi 2 amasiyana.
Matenda a shuga a mtundu woyamba ndi matenda omwe achinyamata ambiri azaka zosakwana 18 amafika. Zikondamoyo sizitulutsa insulin yokwanira, ndipo wodwala amafunikira kuchokera kunja. Chiwopsezo chotenga matendawa nchokwera pamaso pa zinthu izi:
- chibadwa
- chikuku, matumbu, matenda opatsirana oyambitsidwa ndi mavava a Coxsackie, Epstein-Barr, cytomegalovirus,
- kusintha koyambirira kuchokera pakamayamwa kupita kwa makanda ochepera,
- kuchuluka kwa poizoni wama mankhwala ndi mankhwala (maantibayotiki ena, ma poizoni, ma penti ndi zida zomanga) pama cell a pancreatic,
- kukhalapo kwa abale apamtima odwala matenda a shuga.
Matenda a 2 a shuga ndi matenda osachiritsika omwe amakhala ndi anthu opitirira 45 omwe ali onenepa kwambiri ndipo amakhala moyo wongokhala. Chiwopsezo chimakhala chachikulu kwambiri pazinthu izi:
- lembani matenda ashuga 2 mwa achibale,
- kusowa kwa masewera olimbitsa thupi, kuthamanga kwa magazi pamwamba pa 140/90 mm RT. Art.
- prediabetes (kudya glycemia kapena kulolera kwa glucose),
- Matenda a shuga, kubadwa kwa mwana wolemera makilogalamu opitilira anayi, kudzipatula mwa apo ndi apo kapena kubereka mwana m'mbiri.
- mulingo wa triglycerides ndiwokwera kuposa 2.82 mmol / l, mulingo wa cholesterol wapamwamba kwambiri umakhala wotsika kuposa 0.9 mmol / l,
- polycystic ovary syndrome,
- matenda amtima.
Pamaso pa chiopsezo chimodzi kapena zingapo, ndikofunikira kuyang'anitsitsa mkhalidwe waumoyo ndikuchita mayeso pafupipafupi.
Mtundu woyamba wa shuga
Matenda a shuga a Mtundu 1 (amadalira insulin) amawonekera kwambiri mwa odwala osakwana zaka 40. Mawonekedwe ake ndiwakuthwa komanso mwadzidzidzi, omwe amathandiza kuzindikira matenda ashuga koyambirira. Nthawi zina kuwonekera kwa matendawa kumayamba kukhala ketoacidosis mwadzidzidzi, yomwe nthawi zina imabweretsa kukomoka.
Koma nthawi zambiri chithunzichi chimatsogozedwa ndi zizindikiro zakusiyanasiyana. Wodwala amafunikira chakudya chochuluka, amadya kwambiri, koma osalemera komanso amachepetsa thupi. Izi zimachitika chifukwa cha kuchepa kwa glucose. Kuonda kwambiri ndi chimodzi mwazizindikiro za matenda omwe amadalira insulin. Munthu wodwala matenda ashuga amatha kulemera mpaka 10-15 makilogalamu kulemera m'miyezi iwiri.
Nthawi yomweyo, kukodza usiku ndi kuchuluka kwa mkodzo tsiku lililonse kumachitika pafupipafupi. Vutoli limachitika chifukwa cha kuchuluka kwa magazi a mkodzo, omwe amayamba chifukwa cha kuchuluka kwa shuga mumkodzo.
Wodwala amakhala ndi ludzu pafupipafupi, kufunikira kwamadzi tsiku ndi tsiku kumatha kufika mpaka malita asanu. Mwanjira imeneyi, thupi limapanga kuchepa kwa madzi komwe kumayamba chifukwa kukodza mopitilira muyeso. Chifukwa china chowonjezera ludzu ndikukwiyitsidwa kwa osmoreceptors mu hypothalamus.
Wodwala amakhala ndi mpweya woipa, womwe umapereka ma acetone, ndipo mkodzo umanunkhira zowola. Zodabwitsazi zimachitika pamene thupi limasinthira kuchokera ku chakudya chamafuta kupita njira yamafuta yopanga mphamvu chifukwa cha kufooka kwa glucose m'maselo. Matupi a Ketone, omwe amapangidwa mwanjira iyi, amayambitsa zizindikiro za poizoni - kupweteka kwam'mimba, nseru, kusanza. Kupita patsogolo kwa ketoacidosis kumabweretsa kuperewera kwa matenda ashuga.
Matenda a metabolism amabweretsa kufooka ndi kutopa, kuchuluka kwa zopangidwa ndi poizoni. Kuphatikiza apo, mawonekedwe a wodwalayo amayamba kuwonongeka, khungu limayamba kuyakuka, khungu limayamba kutuluka, mabala osapola komanso zilonda, tsitsi limagwa kwambiri. Chizindikiro china chosakhudzana ndi matenda a shuga 1 chingapezeke ngati zaka za wodwalayo - mpaka zaka 40.
Type 2 shuga
Matenda a 2 a shuga ndi amtundu wa anthu azaka zapakati. Pafupifupi 90% ya odwala omwe adapezeka kuti ali ndi mtundu wachiwiri wa shuga ndi onenepa kwambiri, ndipo mafuta akulu am'mthupi amadziunjikira pamimba. Maselo akuluakulu osagwirizana ndi insulini amapezeka m'dera lino, pomwe adipocytes amamvera kwambiri insulin m'dera la ntchafu.
Kumayambiriro kwa matendawa, kuphatikiza kwa insulini ndi kapamba kumakulirakulira, koma matendawa akamakula, malowo amatha, kuperewera kwa insulini kumayamba. Wodwala amatha kunyalanyaza zizindikiro zakunja za vutoli, nati kufooka ndi kutopa chifukwa cha kusintha kwokhudzana ndi ukalamba. Zizindikiro za matenda amtundu wa 2 zimayenda pang'onopang'ono, zimafufutidwa, zimavuta kwambiri kuzizindikira. Chifukwa chake, kudzipangira matenda ashuga sichinthu chovuta. Monga lamulo, amapezeka mwamwayi wodwala akabwera kudzadwala matenda ena.
Matenda a shuga a Type 2 amatha kumayikiridwa kumayambiriro chifukwa cha ludzu lodziwika bwino (kufunika kwake kumafikira malita 4-5 patsiku), koma ngati munthu wamkulu akamadzimva kuti ali ndi ludzu, ndiye kuti mwa okalamba chidwi chake chimayamba kuzimiririka. Nthawi yomweyo, kukodza, makamaka usiku, kukuchulukirachulukira. Kulemera kwa thupi kukukulira pang'onopang'ono.
Wodwalayo amakhala ndi chilakolako chokwanira kwambiri chotsindika maswiti. Amaphatikizidwanso ndi kufooka, kugona, kutopa, khungu loyang'ana, kuphatikizapo perineum. Pamene matenda ashuga a m'mimba amayamba, paresthesia ndi dzanzi lakumapeto kumadziwika. Kuwonongeka kwa mtima kumabweretsa kuchepa kwa tsitsi, kupweteka ndi kutopa m'miyendo poyenda, magazi osayenda bwino m'miyendo.
Kubwezeretsa pang'onopang'ono pakhungu kumatsogolera ku candidiasis, mabala osachiritsika. Stomatitis, matenda a periodontal amatha. Mafuta ambiri a glucose amakhumudwitsa kukula kwa retinopathy ndi matenda amkati, ngakhale ndi mtundu wachiwiri wa matenda ashuga, kuwona kumatsika pambuyo pake kuposa ndi matenda a shuga 1.
Matenda a 2 a shuga amawonekanso kwa achinyamata. Ndipo kusintha kwa pamenepa pankhaniyi kumatha kuthandizira kuwonda komanso kuwonda kwambiri. Chifukwa chake, dokotala amayenera kufunsidwa kuti awone ngati pali zifukwa zokayikitsa.
Matenda a shuga mwa mwana
Chovuta pakuwona ana m'matendawa ndikuti ana sangathe kufotokoza zizindikiro zake. Makolo ayenera kukhala osamala ngati mwana amakonda kuyamwa ndikupempha chimbudzi, komanso ngati kulemera kwake kumasintha kwambiri.
Pazizindikiro zoyambirira za ketoacidosis, pitani kuchipatala mwachangu. Pa ululu wam'mimba, kusanza kapena nseru, chizungulire kapena chizindikiro cha khungu lowuma, kupuma pafupipafupi ndi fungo la asetone, ulesi, kugona, kuyitanira ambulansi.
Kuti mutsimikizire kapena kukana zokayikira za shuga kunyumba, mutha kugwiritsa ntchito glucometer kapena A1C kit. Zipangizozi zimalola akatswiri kudziwa kuchuluka kwa shuga m'magazi kwa mphindi zochepa popanda akatswiri. Muthanso kugwiritsa ntchito poyesa kuti mupeze kuchuluka kwa shuga mkodzo. Zida zonsezi zitha kugulidwa ku pharmacy popanda mankhwala. Mosasamala kanthu za zotsatira zoyeserera, musadzilimbikitse ndipo ngati mukumva kuti mulibe mtima, musazengereze kukaonana ndi dokotala.
Thupi, kukodza kochulukirapo, kufooka, khungu lowuma komanso kusinthasintha kwa thupi ndizo chizindikiro chachikulu cha mtundu 1 ndi matenda ashuga 2. Zikaonekera, muyenera kufunafuna chithandizo chamankhwala. Kuti adziwitse matenda, adotolo adzalembera mayeso okhudzana ndi glucose, kuyezetsa magazi ambiri kwa shuga, kuyezetsa magazi a hemoglobin, insulin ndi C-peptide, kuyesa kwa mkodzo kwa matupi a ketone ndi shuga, komanso maphunziro ena ofunikira, kutengera zotsatira zomwe mankhwalawo adzalembedwe.
Chofunika cha matenda
Kwa odwala matenda ashuga, matanthauzidwe a WHO ali motere - ndimatenda osachiritsika omwe amakhala ndi hyperglycemia wosalekeza wophatikizidwa ndi zinthu zingapo.
Pali zifukwa zazikulu zingapo zomwe zimayambitsa matendawa:
- ukalamba wachilengedwe - Ndi zaka, anthu ambiri amachepetsa shuga kagayidwe,
- kunenepa - lipid metabolism imakhudzanso kuchuluka kwa shuga,
- kuperewera kwa zakudya m'thupi - Kuchuluka kwa chakudya kumawononga ma insulin cell receptors.
Zinthu zomwe zimawonjezera chiopsezo cha matendawa: Matenda amtundu, kusagwira ntchito, kudya mopitirira muyeso, matenda oopsa, kugwiritsa ntchito mankhwala kwakanthawi.
Kugawidwa kwa matendawa kumaphatikizapo mitundu ingapo ya magwero osiyanasiyana:
- wodwala insulin, kapena mtundu 1,
- osagwirizana ndi insulin, kapena mtundu 2,
- gestational, kukula pa nthawi ya pakati,
- autoimmune
- zopatsirana
- mankhwala.
Kuphatikiza apo, pali magawo angapo a matendawa:
- kulipidwa, ndikukula pang'ono kwa shuga, zakudya zosinthika mosavuta komanso mankhwala osokoneza bongo,
- zoperekedwa - ndi kuchuluka kwa mphamvu zamagazi m'magazi ngakhale munthawi yamankhwala,
- zopindika - Kukula kwa zovuta pa mankhwala.
Matenda a shuga amatha kuchitika popanda zovuta. Pali mawonekedwe monga matenda am'mbuyomu a shuga - pomwe palibe chizindikiro china, kuwonjezeka kwa shuga kokha komwe kumalembedwa.
Chithunzi cha kuchipatala
Mitundu yosiyanasiyana ya matendawa imakhala ndi zosiyana pang'ono. Type 1 kapena 2 matenda ashuga - momwe mungadziwire ndi zizindikiro?
Kwa mitundu iyi ya matenda ashuga, pali zizindikiro wamba:
- ludzu losatha ndi njala,
- kukodza pafupipafupi,
- kuyabwa ndi khungu louma
- kutopa,
- kusanza, kusanza,
- dzanzi ndi kumva kuwawa m'miyendo,
- kuchiritsa pang'onopang'ono mabala, mikwingwirima,
- kusakhazikika.
Koma palinso zosiyana za zizindikiro.
Gome. Kusiyana kwazachipatala za mtundu 1 ndi matenda ashuga 2:
Zizindikiro | Mtundu woyamba wa shuga | Type 2 shuga |
Matenda oyamba | Zonunkhira. Ketoocytosis nthawi zambiri imawonedwa. | Pang'onopang'ono. Zizindikiro zake palibe kapena zofatsa. |
Zolimbitsa thupi, thupi | Mtundu wabwinobwino kapena wowonda | Kunenepa kwambiri kapena kunenepa kwambiri |
Matenda a kapamba | Chiwerengero cha maselo omwe amapanga insulin amachepetsa. | Chabwino. |
Tanthauzo la shuga limaphatikizapo zovuta zomwe zingachitike. Ndiwofanana pamitundu iwiriyi: matenda oopsa, hypoglycemia, neuropathy, matenda a impso, kugunda kwa mtima ndi stroko, phazi la matenda ashuga, kudula miyendo, kupweteka kwa matenda ashuga.
Zizindikiro
Momwe mungadziwire mtundu wa shuga? Kuti muchite izi, muyenera kuchititsa maphunziro owunikira.Choyamba, dokotala amayang'anira m'badwo ndi thupi la wodwalayo, kuti adziwe zomwe zilipo.
Kenako wodwalayo amatumizidwa kukayesedwa kwa labotale:
- Kuyesedwa kwa magazi kwa shuga. Wokhala pamimba yopanda kanthu. Magazi amachokera mu chala kapena mtsempha.
- Mayeso a kulolera a glucose. Magazi amatengedwa pamimba yopanda kanthu. Pakatha ola limodzi, wodwalayo amapatsidwa njira yotsekemera yomwa ndipo magazi amatengedwanso. Gawo lotsatira la magazi limatengedwa pambuyo pa maola awiri ndipo zotsatira zake zimayerekezedwa.
- Zisonyezero za hemoglobin ya glycated. Kuyesa kopindulitsa kwambiri komwe kumakupatsani mwayi wofufuza kuchuluka kwa shuga kwa miyezi itatu.
- Kupima mkodzo wa shuga ndi matupi a ketone. Kupezeka kwa ketone mu mkodzo kumatsimikizira kuti glucose simalowa m'maselo amthupi ndipo samadyetsa.
Kuyesedwa kwa kudziwa shuga kunyumba kulibe. Kugwiritsa ntchito mita ya shuga m'magazi, mutha kudziwa kuchuluka kwa shuga m'magazi, koma izi sizokwanira kupanga matenda.
Kungoyesa kwa labotale ndi komwe kumatha kudziwa kukhalapo kwa matenda ashuga komanso kudziwa mtundu wa matenda
Type 2 shuga mellitus - kudziwa kukhalapo kwa matenda siovuta. Kuzindikira kwakanthawi kumathandizira chithandizo ndikupewa kukula kwa zovuta.
Mafunso kwa adotolo
Ndikufuna kudziwa momwe ndingadziwire matenda ashuga popanda mayeso? Ndipo ndizotheka kuzichita nokha?
Oleg N. 43 zaka, mzinda wa Yelets
Ngati mungazindikire zodabwitsa zilizonse - kuwonda msanga kapena mosemphanitsa, kunenepa kwambiri, ludzu, pakamwa kowuma, kusokonekera, mavuto amkhungu ndi masomphenya, ndiye pamaziko a zizindikirazi mutha kungokayikira matenda. Zizindikirozi ndizofanana ndi mitundu iwiri ya matenda ashuga. Kuti mumvetse bwino za matendawa, muyenera kupita kwa dokotala kuti akamupatse mayeso ofunika.
Miyezi isanu yapitayo, ndinabereka mwana wamwamuna. Pa miyezi isanu ndi umodzi ndili ndi pakati, ndinapezeka kuti ndili ndi matenda osokoneza bongo. Ndimada nkhawa ndi thanzi la mwana wanga. Momwe mungadziwire matenda a shuga kwa mwana?
Catherine V., wazaka 34, Penza.
M'miyezi yoyambirira ya moyo, matendawa samakula, zizindikiro zimayamba pafupifupi miyezi 9. Mwa ana ena, matendawa amawonekera kwambiri, ndi kuledzera kwambiri - kusanza, kusowa kwamadzi.
Mwa ena, Zizindikiro zimayamba kuwonjezeka, pang'onopang'ono. Mwana yemwe amakhala ndi chilakolako chabwino samakhala wolemera, ngati zotupa za m'mimba zimawoneka, ndiye kuti samachira kwa nthawi yayitali. Samalani zochita za mwana. Mwana wodwala amachita zinthu mosavutikira, amakhala pansi atamwa.
Mkodzo ukatha kupukuta, wopukusira amawoneka kuti alibe nyenyezi. Mitsempha ya mkodzo ikagwera pamalo osalala, osalala. Mulimonsemo, ngati pali zokayikitsa zokhudzana ndi thanzi la mwana, ndikofunikira kukaonana ndi mwana wakhanda.
Mwazi wa magazi - wabwinobwino, kupatuka
Ngati mukukayikira matenda a shuga, funsani kwa endocrinologist yemwe adzayambitsa maphunziro angapo. Kuyesedwa kwa magazi kumathandizira kudziwa kuchuluka kwa shuga, chifukwa ichi ndi chofunikira kwambiri chidziwitso cha thanzi la odwala matenda ashuga. Odwala amapereka magazi kuti afufuze, kuti adokotala awonetsetse momwe kagayidwe kazinthu kameneka kamakhalira.
Kuti mupeze zotsatira zodalirika, choyamba pezani kuchuluka kwa shuga, kenako khalani ndi magazi ndi shuga (mayeso a shuga).
Zotsatira za kuwunikiridwa zikuwonetsedwa patebulo:
Nthawi yosanthula | Magazi a capillary | Magazi magazi |
Ntchito wamba | ||
Pamimba yopanda kanthu | pafupifupi 5.5 | mpaka 6.1 |
Mukatha kudya kapena kumwa shuga | pafupifupi 7.8 | mpaka 7.8 |
Matenda a shuga | ||
Pamimba yopanda kanthu | za 6.1 | mpaka 7 |
Mukatha kudya chakudya kapena mafuta osungunuka | za 11.1 | mpaka 11.1 |
Matenda a shuga | ||
Pamimba yopanda kanthu | kuyambira 6.1 ndi zina | kuyambira 7 |
Mukatha kudya kapena shuga | zopitilira 11.1 | kuyambira 11.1 |
Pambuyo pamaphunziro omwe atchulidwa pamwambapa, pali kufunika kuzindikira zizindikiro zotsatirazi:
- Mulingo wokwanira wa Baudouin ndiwo kuchuluka kwa glucose mphindi 60 pambuyo pa kuyeserera kwa glucose kufikira kuchuluka kwa shuga m'magazi pamimba yopanda kanthu. Mulingo wabwinoko ndi 1.7.
- Rafalsky mgawo - kuchuluka kwa glucose (120 maminiti pambuyo shuga katundu) kuti shuga ndende. Nthawi zambiri, kufunika kwake sikoposa 1.3.
Kudziwa mfundo ziwiri izi kudzakuthandizani kuzindikira koyenera.
Zizindikiro za matenda a shuga 1
Matenda a Type 1 amadalira insulin, amakhala ndi zovuta komanso amakhala ndi vuto lalikulu la metabolic. Vuto lotchedwa autoimmune kapena viral pancreatic lesion limapangitsa kuchepa kwamphamvu kwa insulin m'magazi. Chifukwa cha izi, nthawi zina, chikomokere cha matenda ashuga kapena acidosis chimachitika, momwe mulingo wa asidi-wosokoneza umasokonekera.
Izi zatsimikiziridwa ndi zizindikiro izi:
- xerostomia (kuyanika kuchokera mucosa wamlomo),
- ludzu, munthu amatha kumwa mpaka malita 5 amadzi mu maola 24,
- kulakalaka
- kukodza pafupipafupi (kuphatikiza usiku),
- kunenepa
- kufooka wamba
- kuyabwa kwa khungu.
Kusavomerezeka kwa mwana kapena wamkulu kumafooka, wodwalayo amakhala pachiwopsezo cha matenda opatsirana. Kuphatikiza apo, zithunzi zowoneka zimachepetsedwa, mwa akulu, chilakolako chogonana chimachepetsedwa.
Zizindikiro za matenda a shuga a Type 2
Matenda a shuga omwe amadziimira pawokha amadziwika ndi insulin yosakwanira komanso kuchepa kwa zochitika za ß cell zomwe zimatulutsa timadzi timeneti. Matendawa amapezeka chifukwa cha majini osafunikira a insulin.
Matendawa nthawi zambiri amapezeka mwa anthu opitilira zaka 40 akulemera mopitirira muyeso, matendawa amawonekera pang'onopang'ono. Kuzindikira kwadzidzidzi kumawopseza zovuta za mtima.
Zizindikiro zotsatirazi ziyenera kuganiziridwa kuti zitha kudziwa mtundu wachiwiri wa matenda ashuga:
- ulesi
- kuvutika kwakumbuyo kwakanthawi
- ludzu, wodwalayo amamwa mpaka malita asanu a madzi,
- kukodza mwachangu usiku,
- Mabala samachiritsa kwa nthawi yayitali,
- Khungu
- matenda oyamba ndi mafangasi,
- kutopa.
Odwala otsatirawa ali pachiwopsezo:
- Matenda opangidwa ndi matenda ashuga,
- Kunenepa kwambiri
- Amayi omwe abereka ana olemera makilogalamu anayi ndi kupitilira apo ndi glucose panthawi yapakati.
Kukhalapo kwa zovuta zotere kumawonetsa kuti muyenera kuyang'anira shuga nthawi zonse.
Mitundu ina ya matenda ashuga
Madokotala amasiyanitsa mitundu yamatendawa:
- Gestational ndi mtundu wa matenda ashuga omwe amakula nthawi yomwe mayi ali ndi pakati. Chifukwa chosowa insulini, kuchuluka kwa shuga kumawonjezeka. Pathology imadutsa palokha pambuyo pobereka.
- Latent (Lada) ndi mtundu wapakatikati wa matendawa, omwe nthawi zambiri amadziwika ngati mtundu wake wa 2. Ichi ndi matenda a autoimmune omwe amadziwika ndi kuwonongeka kwa maselo a beta chifukwa chodziteteza kwawo. Odwala amatha kupita popanda insulin kwa nthawi yayitali. Mankhwala, mankhwalawa amtundu wa 2 odwala matenda ashuga amagwiritsidwa ntchito.
- Mtundu wodwala kapena wamtulo wamatenda umadziwika ndi shuga wamagazi. Kulekerera kwa glucose kumavulala. Pambuyo potulutsa shuga, kuchuluka kwa shuga kumachepa. Matenda a shuga amatha kuchitika zaka 10. Chithandizo chapadera sichofunikira, koma adokotala ayenera kuyang'anitsitsa momwe wodwalayo alili.
- Mu shuga yolembedwa, hyperglycemia (kuchuluka kwa shuga) imasinthidwa ndi hypoglycemia (kuchepa kwa glucose) tsiku lonse. Matenda amtunduwu nthawi zambiri amakhala ovuta chifukwa cha ketoacidosis (metabolic acidosis), yomwe imasandulika kukhala chikomokere cha matenda ashuga.
- Idalipira. Matendawa amadziwika ndi shuga wambiri, kupezeka kwa glucose ndi acetone mkodzo.
- Zolipidwa. Kuchulukitsa kwa shuga kumachulukitsidwa, acetone kulibe mkodzo, gawo lina la glucose limatuluka kudzera mumtsempha wa kwamkodzo.
- Matenda a shuga. Kwa matenda amtunduwu, kuperewera kwa vasopressin (mahomoni antidiuretic). Mtundu wa matendawa umadziwika ndi kutulutsa kwamkodzo mosadukiza komanso kambiri (kuyambira malita 6 mpaka 15), ludzu usiku. Odwala, chilimbikitso chimachepa, kunenepa kumachepa, kufooka, kusakwiya, ndi zina zambiri.
Zowonjezera
Ngati pali zizindikiro zotchulidwa, kuyezetsa magazi kumachitika, ngati chikuwonetsa kuchuluka kwa glucose, ndiye kuti dokotalayo amazindikira matenda a shuga ndikupereka chithandizo. Kudziwitsa sikungapangidwe popanda zikhalidwe. Izi ndichifukwa chakuti hyperglycemia imatha kuchitika chifukwa cha matenda opatsirana, zoopsa kapena kupsinjika. Potere, mulingo wa shuga umasinthidwa mosadalira popanda chithandizo.
Izi ndiye zizindikiro zazikulu zowonjezera pakufufuza.
PGTT ndi mayeso ololera a glucose. Kuti muchite izi, yang'anani magazi a wodwala omwe akutenga pamimba yopanda kanthu. Ndipo pomwepo wodwalayo amamwa madzi amchere a shuga. Pakatha mphindi 120, magazi amatengedwanso kukayezetsa.
Odwala ambiri ali ndi chidwi ndi funso lazotsatira zomwe zingachitike pamayesedwe awa komanso momwe angawerengere. Zotsatira za PGTT ndi msempha wamagazi pambuyo pa mphindi 120:
- 7.8 mmol / l - kulolera kwa glucose ndikwabwinobwino,
- 11.1 mmol / l - kulekerera kumakhala kovuta.
Palibe zizindikiro, kafukufukuyu amachitika nthawi zina ziwiri.
Zizindikiro za matenda amtundu 1 komanso matenda ashuga 2
Malinga ndi ziwerengero, pafupifupi 20% ya odwala amadwala matenda amtundu 1, mitundu yonse ya 2 odwala matenda ashuga. Poyamba, zizindikiro zotchulidwa zikuwoneka, matendawo amayamba modzidzimutsa, kunenepa kwambiri kulibe, chachiwiri - zizindikiro siziri zowopsa, odwala ndi anthu onenepa kwambiri kuyambira zaka 40 ndi akulu.
Mtundu wina wa matenda ashuga ukhoza kupezeka pamayeso otsatirawa:
- mayeso a c-peptide azindikira ngati maselo ß atulutsa insulin,
- autoimmune antibody test,
- kusanthula pamakulidwe a matupi a ketone,
- kufufuza kwa majini.
Kuti adziwe mtundu wa wodwala yemwe ali ndi matenda ashuga, madokotala amalabadira mfundo izi:
Mtundu 1 | Mtundu 2 |
M'badwo wopirira | |
zosakwana zaka 30 | kuyambira zaka 40 ndi kupitilira |
Kunenepa kwambiri | |
wonenepa | onenepa kwambiri mu 80% ya milandu |
Matenda oyamba | |
lakuthwa | yosalala |
Nyengo ya matenda | |
kugwa nthawi yozizira | chilichonse |
Njira ya matendawa | |
pali nthawi zina zowonjezera | khola |
Kukonzekereratu kwa ketoacidosis | |
mkulu | zolimbitsa, chiwopsezo chikuwonjezereka ndi kuvulala, opaleshoni, etc. |
Kuyesa kwa magazi | |
kuchuluka kwa glucose ndikokwera, matupi a ketone alipo | shuga wamkulu, zomwe zili ndi ketone wapakati |
Kafukufuku wa urine | |
shuga ndi acetone | shuga |
C-peptide m'madzi a m'magazi | |
otsika kwambiri | kuchuluka kwapakati, koma nthawi zambiri kumachulukitsa, ndikudwala kwanthawi yayitali kumachepa |
Ma Antibodies kwa? - Mak | |
wapezeka mu 80% ya odwala m'masiku 7 oyambirira a matenda | palibe |
Matenda a 2 a matenda ashuga amakhala osowa kwambiri chifukwa cha matenda ashuga komanso ketoacidosis. Mankhwala, makonzedwe apiritsi amagwiritsidwa ntchito, mosiyana ndi matenda amtundu wa 1.
Matenda a shuga
Matendawa amakhudza thupi lonse, chitetezo chofooka chimafooka, chimfine, chibayo chimayamba kupezeka. Matenda a ziwalo zopumira amakhala ndi vuto losatha. Ndi matenda a shuga, mwayi wokhala ndi chifuwa chachikulu ukuwonjezeka, matendawa amachulukana.
Kubisala kwa michere ya m'mimba yomwe kapamba amatulutsa imachepetsedwa, ndipo m'mimba mumasokonekera. Izi ndichifukwa choti shuga imawonongera mitsempha yamagazi yomwe imadzaza ndi michere ndi mitsempha yomwe imayang'anira gawo logaya chakudya.
Anthu odwala matenda ashuga amawonjezera mwayi wamatenda am kwamikodzo dongosolo (impso, ureters, chikhodzodzo, etc.). Izi ndichifukwa chakuti odwala omwe ali ndi chitetezo chofooka amakhala ndi matenda a shuga. Kuphatikiza apo, tizilombo toyambitsa matenda timayamba chifukwa cha kuchuluka kwa shuga m'thupi.
Odwala omwe ali pachiwopsezo ayenera kuyang'anitsitsa thanzi ndipo ngati mawonekedwe awonekera apezeka, funsani kwa endocrinologist. Njira zamankhwala pochizira matenda amtundu wa 2 ndi mtundu wa 2 ndizosiyana. Dokotala amathandizira kukhazikitsa dokotala komanso kupereka mankhwala oyenera. Popewa zovuta, wodwalayo ayenera kutsatira upangiri wa chipatala mosamalitsa.