Kodi matenda a shuga a autoimmune amatanthauza chiyani? Matenda a shuga "Lada": Kufotokozera ndi kutsimikiza kwa mtundu

Mtundu wodziwika bwino wa matenda ashuga ndi mitundu yosiyanasiyana ya LADA, yomwe ndi mtundu wa shuga wa autoimmune mu akulu. Pathology imapangidwa zaka zapakati pa 35 ndi 65, nthawi zambiri pakati pa 45 ndi 55. Chithunzi chachipatala cha matenda a shuga a LADA chimafanana ndi mtundu wodziyimira pawokha wa insulin, chifukwa chake nthawi zina endocrinologists amadziwitsa molakwika. Popeza izi, muyenera kudziwa chilichonse chokhudza zomwe zimayambitsa, zizindikilo ndi zina za momwe zinthu zilili.

Kodi matenda a shuga a LADA ndi ati?

Akatswiri ena amatcha matenda a shuga a LADA ngati njira yomwe ikupita patsogolo pang'onopang'ono ya endocrine pathology. Dzinalo lina ndi 1.5, ndiko kuti, mawonekedwe apakatikati pakati pa matenda amtundu 1 ndi matenda a 2. Lingaliro loperekedwa ndilosavuta kulongosola, chifukwa "kufa" kwathunthu kwazinthu zobisika pambuyo pa zaka 35 ndi njira yofulumira. Pankhani imeneyi, zizindikiro za matenda ashuga zimafanana kwambiri ndi mtundu wa insulin wopanda matenda.

Kuti mumvetsetse kuti shuga ya LADA ndiyotani, ziyenera kukumbukiridwa kuti mawonekedwe amtundu wa autoimmune amakhumudwitsa kufa kwa maselo a pancreatic beta. Pachifukwa ichi, kupanga kwake kwa mahomoni ake posachedwa kumalizidwa. Pomwe insulin ndi njira yokhayo yothetsera matenda akulu. Chisamaliro chimayenerera mitundu ya LADA, zifukwa zomwe amapangira.

Zomwe zimayambitsa matendawa

Matenda a shuga a LADA amapangidwa chifukwa cha kuwonongeka kwa autoimmune chifukwa cha kapamba. Pozindikira mwatsatanetsatane zomwe zimayambitsa matenda, dziwani kuti:

• pali kuphwanya kwa mchere wa michere m'thupi,
• Kusagwirizana kwa mafuta kagayidwe kamadziwika, hyperlipidemia. Nthawi zina, njira zotsutsana zimachitika - dyslipidemia,
• kukhalapo kwa ma antibodies ndi secretion yotsika ya C-peptide ndizowonjezera zomwe zikukhudza kuthamanga kwa chitukuko cha matenda.

Chifukwa chake, autoimmune shuga mellitus imayamba mothandizidwa ndi mitundu yonse ya zochitika zathupi. Kuti mankhwalawa akhale othandiza kwambiri mtsogolomo, muyenera kudziwa zonse zokhudzana ndi zizindikiro za matenda.

Zizindikiro za shuga ya autoimmune yaposachedwa

Ma Endocrinologists amawona mtundu womwe umaphatikizapo njira zisanu ndipo amakulolani kudziwa matenda ashuga. Mawonetseredwe oyamba ayenera kuwonedwa kuti ali ndi zaka 50. Ndikofunikanso kulabadira kuyambika kwa matendawa, monga kuchuluka kwamkodzo (oposa malita awiri patsiku), ludzu, kuchepa thupi. Zizindikiro zake zimatha kufooka komanso kuchepa mphamvu.

Pangozi ndi anthu omwe ali ndi thupi lolemera lomwe limachepera pang'ono. Kuphatikiza apo, kupezeka kwa matenda omwe kale anali autoimmune: nyamakazi, autoimmune gastritis, matenda a Crohn ndi zina zambiri ndizofunikira. Kupezeka kwa autoimmune pathologies mwa abale apamtima ndikofunikira kwambiri (awa akhoza kukhala makolo, agogo, komanso abale ndi alongo).

Poyerekeza ndi maziko azinthu zodziwikiratu, zizindikiro zotsatirazi zimawonekera: ludzu ndi chidwi cha chakudya, zovuta za matenda ena kapena ngakhale chimfine.

Nthawi zina, matenda a shuga a LADA ali asymptomatic. Monga tanena kale, izi zimachitika chifukwa chakuti matendawa amakula nthawi yayitali, ndipo chifukwa chake matendawa amachotsedwa ndikupangika nthawi yayitali. Pankhaniyi, njira yokhayo yomwe imakupatsani mwayi wodziwa matenda ayenera kuganiziridwa mwapadera pazizindikiro za onse omwe ali pachiwopsezo.Ndikulimbikitsidwa kuchita diagnostics kamodzi pachaka kuti muwone magawo a thupi.

Kuzindikira matendawa

Kuzindikira mawonekedwe omwe wodwala akuwonetsa omwe amawonetsa matenda am'mbuyomu a shuga, njira zambiri zimagwiritsidwa ntchito: kuchuluka kwa glucose m'magazi, kuchuluka kwa hemoglobin ya glycated. Mukalankhula izi, mverani:

• kusanthula ndi kugwetsa ma autoantibodies ku maselo apadera a ICA,
• kuyesa kwa ma antigen a HLA,
• kuwerenga kwa autoantibodies ku mankhwala okhala ndi mahomoni okhala ndi mbali,
• kuyesa kwa chibadwa,
• ma autoantibodies wamba kuti glutamate decarboxylase GAD.

Kuyesedwa ndi kuzindikira kwa LADA kumalumikizidwa ndi zovuta zina kapena omwe ali m'magulu omwe ali pachiwopsezo. Tikuyankhula zaka za wodwalayo mpaka zaka 35, chizindikiritso cha kudalira kwa gawo la mahomoni patapita nthawi. Chidwi chimakopeka ndi kukhalapo kwa zizindikiro za matenda amtundu 2 wokhala ndi cholozera cholondola cha thupi kapena kuonda. Kuphatikiza apo, kulipira kufooka kwa insulin kumadziwika pogwiritsa ntchito zakudya zapadera komanso masewera olimbitsa thupi.

Mgulu lomwe lingakhale pachiwopsezo cha kupangika kwa matendawa ndi azimayi omwe ali ndi mimba, momwe matenda a gestational adadziwika. Nthawi zambiri, azimayi amakumana ndi matendawa atenga kale kapena kutha kumene. Monga lamulo, mwayi wofanana ndi matendawa umapezeka mu 25% ya milandu. Matenda akapezeka, ndikofunikira kuyamba chithandizo msanga.

Chithandizo cha matenda a shuga a LADA

Kuti mankhwalawa akhale othandiza, tikulimbikitsidwa kusinthira ku chakudya chochepa chama carb, womwe ndi njira yotsogolera matenda.

Popanda kutsatira chakudya chotere, zochitika zina zonse sizingakhale zothandiza.

Gawo lotsatira ndikuphunzira mawonekedwe akugwiritsa ntchito insulin. Muyenera kuphunzira zonse zamitundu yowonjezera ya mahomoni (Lantus, Levemir ndi ena), komanso kuwerengera kwamalingaliro a kapangidwe kake musanadye. Pang'onopang'ono, insulin yotalikilapo iyenera kubayidwa, ngakhale, chifukwa cha zakudya zamafuta ochepa, shuga sofika pa 5.5-6 mmol pamimba yopanda kanthu ndikatha kudya.

Polankhula za momwe mungagwiritsire matenda a shuga a autoimmune mwa akulu, samalani ndi chidwi chakuti:

• Mlingo wa gawo la mahomoni uyenera kukhala wotsika,
• Ndikofunika kugwiritsa ntchito Levemir, chifukwa imaloledwa kuti imiritsidwe, pomwe Lantus sichoncho,
• mtundu wowonjezera wa insulin umagwiritsidwa ntchito ngakhale shuga pamimba yopanda kanthu ndikatha kudya siziwonjezera kupitirira 5.5-6 mmol,
• Ndikofunikira kuyang'anira kuchuluka kwa glucose anu kwa maola 24. Amatsimikiza m'mawa m'mimba yopanda kanthu, nthawi iliyonse asanadye chakudya, komanso maola awiri mutatha kudya komanso usiku musanagone,
• Kamodzi pa sabata ndikofunikira kuzindikiritsa chimodzimodzi pakati pausiku.

LADA ikulimbikitsidwa kuchiza matenda a shuga, kutengera chizindikiro cha shuga, kutanthauza kuti kuchulukitsa kapena kuchepetsa kuchuluka kwa insulin yayitali. Muzochitika zovuta kwambiri, zitha kukhala zofunikira kuzitsogolera kuyambira kawiri mpaka kanayi patsiku. Ngati, kusiyanasiyana ndi kugwiritsa ntchito jakisoni wa insulin yayitali, shuga atatha kudya, kuchuluka kwazakudya kumafunikira.

Palibe vuto, ndi mtundu wamtundu wa matenda ashuga, musatenge mapiritsi monga sulfonylureas ndi dongo. Mankhwalawa amalembedwera matenda a shuga a mtundu wachiwiri, chifukwa chake ali ndi mawonekedwe 1.5 amatha kuwononga zovuta. Mayina monga Siofor ndi Glucofage ndi othandiza kwa odwala onenepa kwambiri omwe ali ndi matenda ashuga. Popanda kulemera mopambanitsa, ndikulimbikitsidwa kukana zinthu zoterezi.

Kuchita masewera olimbitsa thupi ndi chida china chofunikira chothandizira odwala kunenepa kwambiri.Pamaso pa kulemera kwakanthawi, thupi limafunikira kuti kulimbikitse chitetezo chokwanira, thanzi. Chisamaliro chapadera chikuyenera kuperekedwa ku njira zodzitetezera.

Njira zopewera

Popewa mtundu wamtundu wa shuga, tikulimbikitsidwa kuti muchepetse kusokonezedwa ndi zinthu zoyipa. Chifukwa chake, akatswiri amalimbikira kuwongolera thupi komanso kuchuluka kwa shuga m'magazi. Sidzakhalanso zofunikira kutsatira chakudya, kupatula zakudya zodzaza ndi mafuta muzakudya. Ndikulimbikitsidwa kuti muthe kuchita masewera olimbitsa thupi, komanso kugwiritsa ntchito vitamini ndi mayina ena omwe angalimbikitse chitetezo.

Chofunikira china ndi kukhazikitsa kwakanthawi ma diagnostics: kuwunika shuga wamagazi, glycated hemoglobin ndi cholesterol. Zonsezi zilola, ngati sichoncho, ndiye kuti muchepetse zoopsa zomwe zingayambitse matenda a shuga a autoimmune.

Pali mitundu yoyamba komanso yachiwiri ya matenda ashuga. Ndipo zaka zochepa zapitazo, mawu awa adawonetsedwa ngati wonyoza. Komabe, pakadali pano, madotolo abwereza zomwe zidalipo kale, popeza matenda ashuga alinso ndi mitundu yapadera.

Chimodzi mwa izo ndi matenda a shuga a LADA, amatchedwanso shuga a autoentmune mwa akulu. Mkhalidwe wamtunduwu umadziwika ndi zizindikiro zomwe zimayambira mu mtundu woyamba komanso wachiwiri wa matenda a shuga.

Pathology imafunikira chithandizo chapadera cha mankhwala, ndipo ngati amathandizidwa ndi njira zamankhwala zomwe zimagwiritsidwa ntchito mtundu wachiwiri wa matenda, ndiye kuti zimatenga zaka zingapo, ndipo wodwalayo angafunikire chithandizo cha insulin ndi milingo yayikulu ya mahomoni.

Popeza mwaphunzira mwachidule kuti shuga ya LADA ndiyotani, muyenera kuganizira za mtunduwu wa matendawa mwatsatanetsatane. Dziwani zomwe zikuwonetsa kuti matendawa ndi enieni, ndipo matendawa amasiyana bwanji ndi mitundu ina ya matenda ashuga?

Matenda a shuga Lada ndi mawonekedwe ake

Monga momwe dzinalo likunenera, chizindikiro chachikulu chomwe matenda a shuga a LADA amasiyana ndi njira ya autoimmune, chifukwa chomwe chitetezo chake chomwe chimayamba kuwononga maselo a pancreatic.

Kusiyanaku kukukhalanso poti matenda a shuga a "ubwana", omwe amadalira insulin, amakula ali mwana kapena akadali aang'ono, pomwe matenda a shuga a Lada-shuga amapezeka akalamba, kuphatikiza mwa amuna ndi akazi achikulire.

Kuchuluka kwa shuga mwa mtunduwu wa shuga kumawonjezera pafupifupi. Zizindikiro ndizofanana ndi matenda amtundu wachiwiri, nthawi zambiri zimachitika kuti madokotala amayambitsa matenda olakwika.

M'malo mwake, matenda a shuga a mitundu ya LADA ndiwo mtundu woyamba wa matenda otsekemera, amangopanga mtundu wocheperako komanso digirii.

Komabe, ngati matendawa adapezeka molakwika, ndipo sanapatsidwe chithandizo choyenera, chomwe chimayambitsa matendawa, matendawa amayamba kupita patsogolo chifukwa chotsatira chimayamba kukhala chovuta kwambiri. Zotsatira zake, wodwalayo angafunike jakisoni wa insulin.

Ziwerengero zikuwonetsa kuti anthu mamiliyoni ambiri amapezeka ndi matenda a shuga a 2, koma pafupifupi 5-6% awo amadwala matenda a shuga a Lada. Popanda chithandizo chofunikira, zotsatirapo zake zimakhala zoipa.

Chithunzi cha chipatala cha matenda a shuga a Lada

Ponena za zisonyezo, zimatha kusiyanasiyana. Monga momwe zamankhwala zimasonyezera, nthawi zambiri, matenda a Lada amapitilira popanda chithunzi cha chipatala.

Popeza matendawa amapita pang'onopang'ono, munthu amatha kukhala ndi matendawa kwa zaka zambiri, osawaganizira kuti ali ndi mtundu wina wa matenda ashuga.

Komabe, ngati wodwalayo ali ndi zizindikiro za matendawa, ndiye kuti nthawi zambiri amadziwika ndi chithunzi chomwechi monga matenda a shuga a mtundu woyamba ndi wachiwiri.

Zizindikiro za matenda a shuga a Lada ndi awa:

• Kufooka pafupipafupi ndi kusachita chidwi, kutopa kwanthawi zonse.
• Chizungulire, kugwedezeka kwamiyendo.
• Khungu limakhala lofiirira.
• Kutentha kwa thupi kumakwera (kawirikawiri).
• Mwazi wamagazi ambiri.
• Kuchulukana mobwerezabwereza.
• Kuchepetsa thupi popanda chifukwa.

Ngati munthu ali ndi ketoacidosis, ndiye kuti zizindikiro zina zimawonjezeredwa pazomwe zalembedwa pamwambapa: mkamwa youma, kupuma mseru ndi kusanza, ludzu lamphamvu komanso losalekeza, lilime limazunguliridwa.

Tiyenera kukumbukira kuti zizindikiro mwa munthu zimatha kuwonetsa bwino matenda, kapena mwina palibe.

Kuzindikira matenda a shuga a LADA

Kodi mitundu ya Lada imadziwika bwanji, ndikuisiyanitsa ndi mtundu wina wa matenda ashuga, ndi ziti zomwe zilipo?

Monga momwe zamankhwala zimasonyezera, ngati wodwala ali ndi thupi labwino, samanenepa kwambiri, ndiye kuti amapezeka ndi matenda a shuga a mtundu wachiwiri. Komabe, zenizeni, imatha kukhala ndi mitundu inayake.

Pochiza matenda a shuga a 2, mankhwalawa nthawi zambiri amalimbikitsidwa kuti achepetse kuchuluka kwa shuga m'thupi. Koma ndizovulaza kwambiri kwa anthu omwe ali ndi matenda ashuga a autoimmune.

Chifukwa chake, pofuna kutsimikizira matendawa molondola, kuphatikiza pa kuyezetsa magazi a glycated hemoglobin ndi magazi a shuga, adotolo amafotokozera njira zotsatirazi:

1. Kusanthula kwa ma antibodies ku ICA.
2. Kutsimikiza kwa Antigen
3. Kafukufuku wodziwitsa za chibadwa chikuchitika.
4. Kutsimikiza kwa ma antibodies kupita ku GAD.

Kupatuka kuzinthu wamba ndizotsatira zotsatirazi. Choyamba, ngati wodwalayo ali ochepera zaka 35. Kachiwiri, kudalira insulin pambuyo kanthawi kochepa (pafupifupi zaka zingapo).

Chachitatu, chithunzi cha chipatala ndi chofanana ndi matenda amtundu wa 2, koma kulemera kwa wodwalayo kuli mkati momwe muliri, kapena wodwalayo ndi woonda kwambiri.

Ngati mukukayikira matenda a Lada, kuzindikira kuti si kovuta. Pali njira zambiri zodziwira matenda zomwe zimathandizira kuzindikira koyenera kwa odwala.

Zotsatira za kuyesedwa, zomwe zimapezeka mu labotale, zimathandizira adokotala kuti asankhe njira zabwino zowathandizira ndikuwonjezera nthawi yopanga mahomoni awo.

Gulu lomwe lingakhale pachiwopsezo cha matenda a Lada limaphatikizapo azimayi omwe adapezeka ndi matenda a shuga. Mwayi wopezeka ndi matenda amtunduwu ndi 25%.

Mankhwala

Tsoka ilo, kwa odwala matenda a shuga a Lada, kuyambitsa insulin sikungapewereke. Madokotala amapereka malingaliro omwe akuphatikizira kuyamba mankhwala a insulin nthawi yomweyo. Ndi kuzindikira koyenera kwa matenda amtunduwu, njira zamankhwala zochizira zimadalira pa mfundo iyi ya chithandizo.

Anthu omwe ali ndi matenda a Lada amafunika kudziwa matendawa asanapezeke, komanso kupezeka koyambirira kwa chithandizo choyenera, makamaka, kuyambitsa insulin.

Izi zimakhazikitsidwa chifukwa chakuti pali kuthekera kwakukulu kwa kusowa kwa kapangidwe kake kawini ka thupi m'thupi. Kuphatikiza apo, kuchepa kwa mahomoni nthawi zambiri kumalumikizidwa ndi insulin kukaniza maselo.

Palibe njira yatsopano yomwe idapangidwira kuchitira mtundu wa matenda osokoneza bongo omwe aphunzitsidwa bwino. Pankhani imeneyi, madokotala amalimbikitsa kuphatikiza mapiritsi kuti muchepetse shuga panjira ya mankhwalawo, komanso mankhwala othandizira kuti tizilimbitsa minyewa yathu ikhale yofikira.

Zolinga zazikulu za mankhwala:

• Kuchepetsa katundu pa kapamba.
• Kuletsa kwa kayendedwe ka autoimmune m'thupi.
• Matenda a shuga a magazi pamlingo wovomerezeka.

Lada akapezeka ndi matenda, dokotala amamulembera mankhwala ochepetsa mphamvu ya insulin. Ngati mungadumphe gawo ili, kapena dokotala sanazindikire matenda enaake, ndiye kuti m'kupita kwa nthawi mudzafunika mulowetse mitundu yayikulu kwambiri ya mahomoni.

Mfundo zazikuluzikulu zochizira matenda a shuga a Lada:

1. Kutsatira
2. Kukhazikitsa insulin yaying'ono Mlingo.
3. Kuwongolera shuga.
4. Zochita zolimbitsa thupi zokwanira.

Zolinga za glucose pamimba yopanda kanthu siziyenera kupitirira zovomerezeka zamitundu 5.5. Kuphatikiza apo, shuga sayenera kutsikira kuposa mayunitsi 3.8.

Ndizololedwa kuphatikiza chithandizo chamankhwala ndi njira zina, koma pokhapokha ndi chilolezo cha adokotala. thandizirani kukonza mkhalidwe wa wodwala, komanso kupewa zovuta.

Kodi mukuganiza bwanji pamenepa? Kodi munachita chiyani ndi matenda a shuga a LADA? Gawani ndemanga ndi malingaliro anu kuti mugwirizizire kuwunikaku!

Zolemba Zogwirizana

Ndi matenda a shuga, pamakhala kuchuluka kwa shuga m'thupi. Ngati wodwala aphunzira kuyang'anira bwino thanzi lawo, kusunga shuga pa nthawi yokhazikika, ndiye kuti matenda ashuga amasintha kuchoka ku matenda oopsa kukhala njira yapadera yomwe singakhale pachiwopsezo.

Pali mitundu ingapo ya matenda ashuga omwe amayenderana kwambiri ndi kusokonezeka kwa metabolic m'thupi la wodwala. Mtundu uliwonse wamatenda, kuwonjezera pa hyperglycemia, umadziwonetsa kuti umatulutsa glucose mkodzo. Pazotsatira izi, zizindikiro zotsatirazi zitha kuchitika:

1. ludzu limayamba kuchuluka kwambiri,
2. kulakalaka kukukula mwachangu
3. Pali kusakhazikika kwa mafuta kagayidwe kachakudya ka hyperlipidemia, komanso dyslipidemia,
4. wasokoneza mineral metabolism m'thupi,
5. zovuta zina zimayamba.

Kuwonjezeka kwakukulu kwa odwala omwe ali ndi matenda a shuga amellitus kunapangitsa kuti azindikire mitundu yosiyanasiyana ya matendawa kuti amvetsetse bwino kusiyana pakati pa chinthu chimodzi ndi china.

Ngati mpaka posachedwapa, zamankhwala zimakhulupirira kuti ndi anthu omwe ali ndi zaka zopitilira 45 omwe amatha kudwala matenda amtundu II, lero malekezero amisala atafika pa 35.

Chaka chilichonse, mtundu wachiwiri wa matenda a shuga umapezeka mwa odwala achichepere, omwe amaphatikizidwa ndi kuperewera kwa zakudya komanso moyo wosayenera.

Kupatula kwakukulu kwa matendawa

Mankhwala amakono amasiyanitsa mitundu ingapo yayikulu ya matenda ashuga, omwe anthu amatha kuvutika mosaganizira zaka zawo:

• Matenda A shuga a Type I amadalira insulin. Amapangidwa m'thupi la munthu pomwe amachepetsa kuchuluka kwa timadzi timeneti. Monga lamulo, zimachitika mwa ana aang'ono, achinyamata ndi unyamata. Ndi matenda awa, ndikofunikira kuperekera insulin tsiku lililonse,
• Mtundu Wachiwiri wamatendawa suyimira insulin ndipo amatha kupezeka ndi kuchuluka kwa iwo m'magazi a munthu. Mtundu wachiwiri wa matenda ashuga amadziwika ndi anthu opitilira zaka 40 ndipo amakula motsutsana ndi zomwe zakuwonjezereka kwa thupi. Ndi mtundu uwu wa matenda ashuga, mkhalidwe waumoyo ungasinthidwe mwa kusintha zakudya, kuponya mapaundi owonjezera, komanso kumathandizira kulimbitsa thupi komanso kuchuluka kwa zochitika zolimbitsa thupi. Mankhwala otere mumankhwala nthawi zambiri amagawidwa pawiri. Subtype A imayamba motsutsana ndi kumbuyo kwa kunenepa kwambiri, ndipo subtype B imakhala yotchuka kwa odwala.

Kuphatikiza pa mitundu yayikulu ya matenda a shuga, palinso mitundu yake:

1. Matenda a shuga a LADA. Zimadziwika ndi kufanana kwina ndi matenda amtundu woyamba, komabe, kuthamanga kwake kumachepetsedwa. Ngati tizingolankhula za magawo omaliza a LADA-shuga, ndiye kuti atha kupezeka ngati matenda a shuga II. Lero dzinali latha, ndipo mawu oti autoimmuneabetes mellitus awalowetsa m'malo,
2. NTHAWI ya shuga ndi mtundu wa kalasi A matenda omwe ali ndi vuto ndipo amatha kupanga motsutsana ndi mavuto omwe amachitika chifukwa cha kapamba, hemochromatosis, komanso cystic fibrosis,
3. shuga wopangidwa ndi mankhwala osokoneza bongo (matenda a shuga a class B),
4. shuga C matenda a shuga, omwe amapezeka ndi kuphwanya kwa endocrine system.

Kusiyana pakati pa matenda a shuga a LADA ku mitundu ina ya matendawa

Matendawa akuti LADA kishuga chayesedwa mtundu wa shuga wa autoimmune mwa anthu akuluakulu.Onse omwe amagwera m'gululi, limodzi ndi odwala omwe ali ndi matenda oyamba, amafunikira chithandizo cha insulin chofunikira. Monga lamulo, limodzi ndi mavuto ndi shuga, m'thupi la odwala, maselo a kapamba omwe amapanga insulin amawonongeka. Zotsatira zake, machitidwe a autoimmune amachitika.

Muzochita zamankhwala, munthu amatha kupeza malingaliro kuti LADA-shuga ndi yaulesi, ndipo nthawi zina amatchedwanso shuga "1.5".

Mkhalidwe wofanana wa pathological umadziwika ndi kufa kwa maselo onse a ziwiya zobisika zomwe zimafikira odwala azaka 35. Njira yonseyi ndiyosakwiya komanso yofanana ndi mtundu wa matenda ashuga a 2.

Kusiyana kwakukulu ndikuti pamenepa, maselo onse a beta amafa, omwe amachititsa kuti insulin itulutsidwe mu inshuwaransi.

Monga lamulo, kudalira kwathunthu kwa insulin yowonjezereka kumapangidwa mwa nthawi 1 mpaka 3 kuyambira kumayambiriro kwa matendawa. Zimadutsa ndi zizindikiritso mwa amuna ndi akazi.

Njira ya matendawa ndi yoyenera mtundu wachiwiri, chifukwa kwanthawi yayitali ndizotheka kuwongolera njira yonse yothandizidwa ndi masewera olimbitsa thupi komanso masewera olimbitsa thupi ochepa.

Njira zabwino za matendawa zimapangitsa kuganiza kuti matenda ashuga adzachepa kapena kusamba kwake kudzasinthidwa kwamuyaya. Mfundo yofunika kwambiri pankhaniyi ndi kuwongolera glycemic.

Kuti muwonjezere kuzindikira kwa odwala, masukulu apadera a shuga akupangidwa. Cholinga chawo chachikulu ndikupereka chidziwitso chokwanira kwa wodwala aliyense kuti:

1. muyenera kuyang'anira kuchuluka kwa glycemia,
2. pali njira zowongolera kuchuluka kwa shuga,
3. khalidwe lapadera limaperekedwa chifukwa cha zovuta za matenda ashuga.

Kodi matenda a shuga a LADA amapezeka bwanji?

Kuti muzindikire zizindikiro zomwe zimawonetsa matenda a shuga a LADA wodwala, ndikofunikira kugwiritsa ntchito zotsatirazi, kuphatikiza pa mayeso onse apamwamba a glucose ndi glycated hemoglobin:

• kusanthula ndi kuthana kwa ma autoantibodies ku ma cell a ICA (ma islet cell),
• Kafukufuku wa ma antigen a HLA,
• kuwerenga kwa autoantibodies ku mankhwala okhala ndi insulin,
• kutsimikizira zolembera,
• ma autoantibodies wamba kuti glutamate decarboxylase GAD.

Kupatuka pa chizolowezi chovomerezeka pakuwonetsa mtundu wonga LADA-shuga kudzakhala magawo:

1. Zaka za wodwalayo ndizosakwana zaka 35,
2. kukhazikitsidwa kwa kudalira insulin patapita nthawi (zaka zingapo),
3. mawonetseredwe azizindikiro za mtundu wachiwiri wa shuga ndi kunenepa kwabwinobwino kapenanso kuwonda kwake,
4. kubwezeretsedwa kwa kuchepa kwa insulini kumachitika mothandizidwa ndi zakudya zapadera ndi physiotherapy.

Kwa mankhwala amakono, kuzindikira matenda a shuga sikovuta. Kuti muchite izi, pali zida zamtundu wazidziwitso zomwe zimathandizira kutsimikizira kwa odwala omwe ali ndi zaka 25 mpaka 50 pamilandu imeneyo pamene ali ndi kalasi.

Mayeso amakono a labotale amathandizira adokotala moyenera momwe angathere kusankha njira zabwino zowathandizira ndikuwonjezera nthawi yopanga mahomoni ake omwe wodwalayo amakhala nawo.

Gulu lomwe lingakhale pachiwopsezo chotenga matenda a shuga a LADA ndi amayi apakati omwe atsimikizidwa kuti ali ndi vuto la matenda ashuga. Mwambiri, azimayi awa amakhala ndi matenda ashuga atatha kubereka kapena posachedwa kwambiri. Monga lamulo, mwayi wamatenda oterewa umadziwika mu 25 peresenti ya milandu.

Njira zochizira

Monga tanenera, chithandizo chamankhwala cha insulin chimaperekedwa kwa odwala omwe apezeka ndi matenda a shuga a LADA. Madokotala amalimbikitsa kuti asachedwe jekeseni.Ngati matenda a shuga a LADA atsimikiziridwa, ndiye kuti chithandizo chamankhwala chidzakhazikitsidwa pamfundoyi.

Gululi la odwala lifunika kudziwa koyambirira kwa matendawa komanso kupatsidwa mankhwala okwanira, komanso makamaka insulin. Choyamba, izi zimachitika chifukwa cha kuthekera kwakukulu komwe kulipo kwa insulin yolimbikitsidwa. Nthawi zambiri, kuchepa kwa insulini kumatha kuphatikizidwa ndi kukana kwa maselo amthupi ku hormone iyi ngati matenda a Lada amupeza.

Zikatero, odwala atha kupatsidwa mankhwala apadera kuti muchepetse shuga mumapiritsi. Mankhwalawa sachititsa kuti ziume za pancreatic, komabe, nthawi yomweyo, zimawonjezera chidutswa chaumvekedwe wa zotumphukira kwa insulin.

Kuphatikiza apo, mankhwalawa omwe angafotokozedwe akuphatikiza ndi Biguanide derivatives (Metformin), komanso glitazones (Avandia), yathunthu ikhoza kupezeka patsamba lathu.

Zofunika kwambiri kwa odwala onse omwe ali ndi matenda a shuga a LADA. Pankhaniyi, insulini yoyambirira ingapangidwire kuti ipulumutse insulin yayitali monga momwe ingathere.

Odwala omwe ali ndi matenda a shuga a LADA ayenera kukhala ochepa pakugwiritsa ntchito secretogens. Mankhwalawa amathandizira kupanga insulini ndikupangitsa kuti pancreatic depletion ichite, kenako ndikuchepa kwa insulin kwa odwala omwe ali ndi mtundu wa Lada-shuga.

Kuphatikizanso kwakukulu kwa chithandizo chamankhwala kudzakhala.

Poyamba, mtundu 1 wa shuga umatchulidwa kuti:

• matenda ashuga a autoimmune
• shuga wa idiopathic

Maganizo a shuga a autoimmune omwe akupita mwanjira yam'mbuyomu adalandira dzina la "shuga la mtundu umodzi ndi theka". Izi ndichifukwa chakuti matendawa amayamba komanso matendawa akuwonetsa “matenda” a mtundu wachiwiri wa matenda ashuga, koma njira yayikulu yomwe matendawa akuwonetsera ndi matenda a shuga 1. Nthawi yomweyo, ma antibodies kuma cell a pancreatic B ndi ma enzymes amodzi amadziwika ndikuwoneka. Kupenda kwa akatswiri azachipatala kwawonetsa kuti m'magulu osiyanasiyana a odwala akulu omwe ali ndi matenda amtundu wa 2, mpaka theka amakhudzidwa ndi matenda a autoimmune, omwe amapezeka mwanjira yatsopano. Asayansi akunena kuti matenda amtunduwu, omwe akuwonetsedwa kale mu kafukufuku wapadera, siwoposa mtundu wamba wa matenda ashuga 1.

Zomwe zimayambitsa matenda a shuga a Autoimmune

Matenda amtunduwu, malinga ndi asayansi, amagwirizanitsidwa ndikupanga zolakwika m'thupi lanu. Njira izi zikachitika, magulu apadera amayamba kupanga - ma antibodies omwe amakhala mosayenera mu kapamba pa kubereka komanso ntchito za maselo omwe amapanga insulin. Kukula kwa matenda a shuga a autoimmune kumathandizidwanso pakufalikira kwa matenda osiyanasiyana opatsirana a mtundu wa viral, komanso momwe zimakhudzira thupi laanthu la ma carcinogens angapo, monga mankhwala ophera tizilombo ndi nitroamine.

Zizindikiro za Matenda a shuga a Autoimmune

1. Polyuria ndiye katemera wa mkodzo wambiri, kuphatikiza usiku.
2. Polydipsia ndimakonda kumwa madzi.
3. Polyphagy sikuti kuponderezedwa kumverera kwanjala.
4. Kuchepetsa thupi ndi chizindikiro chofala kwambiri cha matenda ashuga, chomwe chimayamba ngakhale malingaliro azakudya.

Zizindikiro zachiwiri ndi monga zingapo zamatenda omwe amapezeka nthawi yayitali.

Kuzindikira matenda ashuga a autoimmune

Kuzindikiritsa matenda a shuga a autoimmune kumalumikizidwa ndi chizindikiritso cha chinthu chomwe chimayambitsa vuto. Izi ndizofunikira kwambiri ku mitundu yonse ya matenda ngati awa.

"Clinic" ndi "Symbomatology" matendawa atha kufotokoza njira zochizira matendawa

Chithandizo cha Matenda a shuga a Autoimmune

Chithandizo cha matenda amtunduwu m'matenda ambiri cholinga chake ndikuchotsa zisonyezo za matendawa, chifukwaNjira yothandiza kuchiritsa matenda a autoimmune shuga sichinapezekebe mpaka pano. Ntchito zazikuluzikulu za akatswiri azachipatala zikhala:

• Carbohydrate Metabolism Kubwezeretsa
• Kupewa Kwa Matenda
• Kubweretsa kulemera kwa thupi pamagulu wamba
• Kuchita maphunziro a odwala

Amadziwika kuti kumapeto mtundu II matenda ashuga mabodza akukula insulin kukana (minofu yotsutsa insulini) ndi kulipiritsa kwakanthawi kuchuluka kwa insulin ndi kutsika kwotsatira ndi kuwonjezeka kwa shuga m'magazi. Komabe, asayansi sanamvetsetse chifukwa chake mu odwala ena omwe ali ndi matenda amtundu wa II, kuponderezana pang'onopang'ono komanso kufunikira kwa mankhwala a insulin kumachitika pokhapokha m'zaka makumi angapo , pomwe ena (kuchuluka kwawo ndikocheperako) - kale mu zaka zochepa (kuyambira miyezi isanu ndi umodzi mpaka zaka 6 ) Anayamba kumvetsetsa malamulo a shuga wachiwiri. Pofika pano, yofunikira inali yodziwika kale (ngati simunawerenge, ndikupangira kuti muiwerenge).

Akatswiri a shuga a ku Australia mu 1993 ntchito yosindikizidwa yokhala ndi zotsatira zaphunziro ma antibodies ndi mayendedwe C peptide poyankha kukondoweza glucagon zomwe zimachulukitsa shuga.

C-peptide ndi gawo laling'ono lamapuloteni lomwe limapangidwa ndi ma enzymes kuti asinthe molekyu ya proinsulin kukhala insulin. Mlingo wa C-peptide umagwirizana mwachindunji ndi msinkhu wa insulin. Mothandizidwa ndi C-peptide, munthu amatha kuyesa kubisika kwa insulin yodwala mkati mwa wodwala pa insulin.

Kufufuza kwa autoantibodies ndi kutsimikiza kwa kuchuluka kwa zomwe zidapangitsa C-peptide mwa odwala omwe ali ndi matenda amtundu II adapereka zotsatira zosayembekezereka. Zinapezeka kuti odwala kukhalapo kwa ma antibodies ndi secretion yochepa ya C-peptide alibe mtundu wachiwiri wa matenda ashuga (monga momwe amachokera ku chipatala), koma akuyenera kutero Mtundu I shuga (ndi makina a chitukuko). Pambuyo pake zidadziwika kuti amafunikira insulin yoyendetsedwa kale kuposa gulu lonselo. Maphunzirowa adatilola kusiyanitsa mtundu wina wa matenda ashuga - "lembani 1.5 shuga ", Yodziwika bwino pansi pa chidule cha Chingerezi Lada (shuga ya autoimmune mu akulu - shuga ya autoimmune mu akulu ) Chowoneka - chobisika, chosawoneka.

Kufunika Kwa Kudziwitsa LADA

Zitha kuwoneka, kodi pali kusiyana kwanji komwe asayansi abwera? Chifukwa chiyani mukuvutikira moyo wanu ndi mayeso owonjezera? Koma pali kusiyana. Wodwala akapezeka kuti ali ndi LADA (matenda a shuga a autoimmune mu akulu), amathandizidwa popanda insulini monga yachibadwa mtundu II shuga , kupangira zakudya, maphunziro olimbitsa thupi ndi mapiritsi ochepetsa shuga makamaka ochokera ku gulu la sulfonylurea (glibenclamide, glycidone, glyclazide, glimepiride, glipizide ndi ena). Mankhwalawa, mwa zina, amachititsa kuti insulin itulutsidwe ndikuwonjezera maselo a beta, ndikuwakakamiza kuti azigwira ntchito mpaka pamapeto. A kukwera kwambiri kogwira ntchito kwa maselo, ndizomwe zimawonongeka ndi kutupa kwa autoimmune. Arises bwalo loipa :

1. autoimmune beta cell kuwonongeka?
2. Kuchepetsa insulin?
3. kupereka mankhwala ochepetsa shuga?
4. kuchuluka kwa maselo a beta otsalira?
5. kuchuluka kutupa kwa autoimmune ndi kufa kwa maselo onse a beta.

Zonsezi za Zaka 0.5-6 (pafupifupi 1-2 zaka) zimatha ndi kutulutsa kwapa ndi kufunikira kwambiri insulin mankhwala (Mlingo waukulu wa insulini komanso pafupipafupi glycemic control ndi chakudya chamagulu ) Mu matenda am'mbuyomu a shuga a II, kufunikira kwa insulin kumadza pambuyo pake.

Kuti muchepetse kuzungulira kwazovuta za autoimmune, milingo yaying'ono ya insulin imayenera kuyikidwa atangopeza matenda a shuga a LADA. Chithandizo cha insulin choyambirira ali ndi zolinga zingapo:

• kupatsa kupuma maselo a beta . Mukamagwiritsa ntchito mwachinsinsi zambiri, maselo ambiri amawonongeka mu autoimmune process,
• chopinga cha autoimmune kutupa mu kapamba pochepetsa mawu (kuopsa ndi kuchuluka) kwa maantiantiants, omwe ndi "mafiyidwe ofiira" othandizira chitetezo cha mthupi ndipo amayambitsa mwachindunji kayendedwe ka autoimmune, limodzi ndi mawonekedwe a antibodies ofanana. Pazoyesa, zidawonetsedwa kuti kukhazikika kwa insulin nthawi yayitali kumachepetsa kuchuluka kwa ma autoantibodies m'magazi,
• kusamalira shuga wabwinobwino . Zakhala zikudziwika kuti kuchuluka kwa glucose okwera komanso kwa nthawi yayitali kumakhalabe, komwe kumakhala kofulumira komanso kowonjezereka.

Chithandizo cha insulin choyambirira kwa nthawi yayitali chimapulumutsa chinsinsi chake chotsalira cha pancreatic. Kupulumutsa Chinsinsi chotsalira ndikofunikira pa zifukwa zingapo:

• imathandizira kukonzanso shuga ya magazi chifukwa cha gawo la kapamba,
• amachepetsa chiopsezo cha hypoglycemia,
• zimalepheretsa kukula koyambirira kwa zovuta za matenda ashuga.

M'tsogolo, zachindunji Katemera autoimmune kutupa mu kapamba. Kwa matenda ena a autoimmune, njira zoterezi zilipo kale (onani mankhwala Infliximab ).

Momwe mungayikirere LADA?

Usiku woyambira LADA ndi kuyambira 25 mpaka 50 . Ngati pazaka izi mwakhala mukukayikira kapena kupezeka ndi matenda amtundu wa II, onetsetsani kuti mwatsimikiza za njira zina zonse za LADA. Za 2-15% ya odwala matenda a shuga a mtundu II khalani ndi shuga ya autoimmune mu akulu. Pakati pa odwala Matenda A II a shuga popanda kunenepa kwambiri LADA ili ndi 50%.

Pali "LADA Clinical Risk Scale ", Kuphatikiza zinthu zisanu:

1. Matenda a shuga amayambira msinkhu zosakwana 50 zaka .
2. Koyamba (kuchuluka mkodzo> 2 L patsiku, ludzu, kuchepa thupi, kufooka, etc., mosiyana ndi njira ya asymptomatic).
3. osakwana 25 kg / m 2 (m'mawu ena, kuchepa kwa kunenepa kwambiri komanso kunenepa kwambiri).
4. Matenda a autoimmune tsopano kapena kale (nyamakazi, systemic lupus erythematosus ndi matenda ena amitsempha , Hashimoto autoimmune chithokomiro, kuphatikiza poyizoni, autoimmune gastritis, matenda a Crohn, ulcerative colitis, autoimmune pancreatitis, autoimmune bullous dermatosis, matenda a celiac, cardiomyopathy, myasthenia gravis, vasculitis , autoimmune thrombocytopenia, paraproteinemia ndi ena).
5. Kukhalapo kwa matenda a autoimmune mu abale apamtima (makolo, agogo, ana, abale ndi alongo ).

Malinga ndi omwe adapanga sikelo iyi, ngati mayankho abwino kuyambira 0 mpaka 1 , kuthekera kokhala ndi LADA sikupitilira 1%. Ngati pali mayankho awiri kapena ochulukirapo, kuwopsa kwa LADA kuli pafupi 90% , Pankhaniyi, kuyezetsa labotale ndikofunikira.

Chibadwa komanso chilengedwe

Kukhazikika kwa chitukuko cha matenda a matenda a shuga 1 (komanso matenda ena ambiri a autoimmune) kumalumikizidwa ndi zina za gulu la MHC lachiwiri II. Malinga ndi kafukufuku waposachedwa, mtundu wa 1 shuga mellitus mu liwiro loyera umagwirizana kwambiri ndi ma helotypes HLA-DR3, DQ2 (DQB1 * 0201) ndi HLA-DR4 (DRB1 * 0401), DQ8 (DQB1 * 0302). Mwa anthu aku Asia, mtundu wonyansa ngati uwu ndi wa DRB 1 * 0405. Mosiyana ndi izi, haplotype DR2, DQ6 (DQB 1 * 0602) akuwonetsa kuyanjana koyipa ndi matendawa. Chofunika koposa, komabe, kudziwiratu kwa mtundu wa matenda ashuga 1 kumalumikizidwa ndi kusowa kwa aspartic acid pamalo 57 (Asp 7) a amino acid omwe amatsata onse a HLA-DQP. Kafukufuku wamitundu yosiyanasiyana adawonetsa kudalira kwachidziwikire kufalikira kwa matendawa pafupipafupi pakusowa kwa Asp 57 m'matangadza a HLA-DQP mu homozygotes.

Kuphatikiza pa majini a HLA, majini omwe amafunsidwa ndi matenda amtundu woyamba 1 amaphatikizanso jini yomwe imakhala ndi kuchuluka kwa kubwereza kwa tandem (VNTR) ndi genLA-4 gene (CD152). Madera a VNTR ali pafupi ndi malangizo omwe amakhudza mawonekedwe a insulin. Kuchokera pamalingaliro okhudzana ndi chitetezo, kuyanjana kosadwala kwamatenda ndi jini la CTLA-4 ndizosangalatsa (onanikupitilira).

Udindo wa zinthu zachilengedwe (monga kachilombo ka Coxsackie B4, kachilombo ka mumps, kachilombo ka rubella, kachilomboka ka Kilham, kapena mkaka wakhanda wochokera mkaka wa ng'ombe) popanga mtundu wa matenda a shuga 1 amafunika kufufuza kwina.

Zotsatira za Autoimmune

Ma Autoantibodies mpaka (maselo 5 a kapamba amawonekera mu seramu 7 kapena kupitilira apo chiwonetsero cha matenda a matenda a shuga 1 ndipo, motero, amakhala ngati chidziwitso chodalirika cha chiwopsezo cha matendawa. Kuphatikiza apo, amatha kugwiritsidwa ntchito kuzindikira autoantigens of p-cell a B. 1990 Baekkeskov et al. Atapeza mapuloteni a 64-kDa m'maselo a islet, kapangidwe kakang'ono ka enzyme glutamate decarboxylase (GAD 65), komwe akuphatikizidwa ndi kapangidwe ka y-aminobutyric acid (GABA). 70- 80% ya munthu aliyense ndi prediabetes komanso matenda a shuga a mtundu woyamba kumene .. Gawo lachiwiri la antigen ya 64-kDa, yomwe mwina ndi tyrosine phosphatase, imatchedwa IA-2, ndipo 60-70% ya odwalawa amatenga nayo mankhwala a antibodies kupita ku GAD 65, IA - 2 kapena ma antijeni onsewa alipo opitilira 90% ya odwala omwe akupanga mtundu woyamba wa matenda ashuga, ndipo potengera ma antibodies awa, gulu laanthu omwe ali pachiwopsezo chachikulu cha matendawa amatha kuzindikirika.

Kutsimikiza kwa ma antibodies ku GAD 65 kuli ndi zovuta zovuta, koma kwawonetsedwa motsimikiza kuti mu mbewa za NOD proteni iyi ndi autoantigen yovomerezeka ndi maselo T. Kuyambitsa kulolerana kumalepheretsa matenda ku mbewa. Kuyambitsa kulekerera kwa ena omwe angakhale ndi ma autoantigen (carboxypeptidase H ndi protein protein 60) sizitulutsa zotere. Ma Autoantibodies kupita ku molekyulu ya IA-2 samapezeka mu mbewa za NOD, zomwe zimasiyanitsa mtunduwu ndi matenda aanthu (onani pansipa).

Autoantigen yachitatu yodziwika bwino ya mtundu 1 wa shuga ndi insulin. Ma antibodies kupita ku insulin amapezeka pafupifupi 50% ya ana omwe ali ndi matenda omwe angopezedwa kumene. Mwa kusamutsa maselo ena amtundu wa insulin enaake, matendawa atha kupangidwanso mu mbewa za NOD. Kuphatikiza apo, kuyambitsa kulekerera kwa insulini poyambitsa lonse, B-unyolo kapena epeptide epitope yake imateteza mbewa zotere ku matendawa. Popeza, mosiyana ndi zinyama zomwe zimalekerera GAD 65, mbewa zololera insulin kapena chingwe chake cha B-cell ndizopanda insulin (kutupa kwa ma isanc pancreatic), zimaganiziridwa kuti anti-insulin autoantibodies imawonekera pambuyo pake matenda. Mapuloteni ena amagwiritsidwa ntchito ndi ma autoantibodies amtundu wa 1 shuga mellitus mwa anthu, koma amakhala osadziwika bwino.

Ngakhale ma autoantibodies amakhala ngati zodziwika bwino za matendawa, amangochita nawo chiwonongeko chokha

Chifukwa chake, matenda a shuga a LADA ndi mtundu wobiriwira wa shuga womwe umavuta kuzindikira. Ndikofunikira kwambiri kuzindikira mtundu wa shuga wa fret munthawi yake, kenako ndikamayambitsa ngakhale mlingo wochepa wa insulin, mkhalidwe wa wodwalayo ungasinthidwe. Mwazi wamagazi uzikhala wabwinobwino, zovuta zapadera za matenda ashuga zitha kupewedwa.

Autoimmune shuga mellitus amatanthauza mtundu 1 wa shuga. Nthawi zambiri kuphatikiza ndi matenda a Addison ndipo ali ndi zizindikiro zapadera.

Autoimmune shuga mellitus (nthawi zambiri mtundu wa 1) amadziwika kuti ndi metabolism ya glucose chifukwa cha cholowa cham'tsogolo, zomwe zimapangitsa kuti insulin isowonekere m'thupi, yomwe imayendera limodzi ndi kuwonongeka kwa kapamba pama cellular.

Pakachulukidwe kakang'ono, matendawa amakhala ndi vuto losakanikirana ndi matenda ena a endocrine autoimmune, omwe amaphatikiza matenda a Addison, komanso zodwala zomwe sizikugwirizana ndi zovuta za dongosolo la endocrine, mwachitsanzo, matenda amitsempha ndi matenda a Crohn.

Zowopsa

Dziwani kuti ngakhale pali kafukufuku wambiri, zifukwa zenizeni zomwe zimapangitsa kuti pakhale zovuta monga autoimmune mtundu 1 shuga mellitus sizinadziwikebe molondola.

Komabe, pali zinthu zomwe zimayambitsa ngozi zomwe zikukonzekereratu, kutalika kwake komwe kumayambitsa kukula kwa shuga mellitus (mtundu wa autoimmune).

1. Monga taonera kale, chimodzi mwazomwe zimayambitsa matendawa chimatha chifukwa cha majini. Komabe, chiwerengero cha anthu, monga momwe zimakhalira, ndizochepa. Chifukwa chake, ngati abambo adadwala m'banjamo, ndiye kuti mwina matendawo adzadwaladwala 3%, ndipo amayi ali 2%.
2. Nthawi zina, njira imodzi yomwe ingayambitse matenda a shuga 1 ndi matenda opatsirana a mavairasi, kuphatikizapo rubella, Koksaki B, ndi mumps. Potere, ana omwe amanyamula matendawa mu utero amakhala pachiwopsezo chachikulu.
3. Kuphwanya pafupipafupi kwa thupi kumatha kudwalitsa matenda ashuga, chifukwa chake zinthu zakupha zimagwira ziwalo ndi machitidwe, zomwe zimapangitsa kuti mawonekedwe a autoimmune aperekedwe.
4. Chakudya chopatsa thanzi ndichofunika kwambiri. Mwachitsanzo, zidapezeka kuti ana atha kukhala ndi matenda amtundu woyamba wokhazikika mkaka wa ng'ombe ndi zosakaniza kutengera izi. Zoterezi zikufanana pakubweretsa chimanga.

Ponena za matenda a shuga a 2, anthu omwe ali ndi vuto lotsatirazi amakhudzidwa ndi matendawa:

• anthu azaka zopitilira 45
• shuga wamagazi kapena triglycerides, kuchepa kwa lipoproteins,
• kuperewera kwa zakudya m'thupi, kumabweretsa kunenepa kwambiri,
• kusowa zolimbitsa thupi
• ovary polycystic,
• matenda a mtima.

Anthu onse omwe ali ndi zomwe tafotokozazi ayenera kuwunika momwe thupi lawo lilili, kupimidwa pafupipafupi ndikupima mayeso a shuga. Pa gawo la prediabetesic state, matenda a shuga amatha kupewedwa, kuletsa kupititsa patsogolo kwake. Ngati pamayambiriro oyamba mtundu wachiwiri wa matenda ashuga umayamba popanda kuwononga maselo achikondwerero, ndiye matendawa amatha, njira za autoimmune zimayamba ngakhale ndi mitundu iyi ya matenda.

Gestational (panthawi yoyembekezera) matenda osokoneza bongo amatha kukhala motsutsana ndi maziko a kunenepa kwambiri, kudziwiratu zamtsogolo, kusabereka mu zochita za thupi, komanso kuchuluka kwa shuga m'magazi ndi mkodzo panthawi yapakati.

Anthu ali pachiwopsezo chapakati pazifukwa izi:

• Pakubadwa kwa mwana, wolemera kuposa makilogalamu anayi,
• Kusabereka kale
• phindu lochuluka pa kubala ana,
• Ngati mayi ali ndi zaka 30.

Kodi matendawa amakula bwanji?

Matenda a shuga a Autoimmune amawonekera pa liwiro mwachangu, pomwe chiwonetsero cha ketoacidosis chimaperekedwa kuti azitsatira pakatha masabata angapo. Mtundu wachiwiri wa matenda ashuga, womwe umachulukana kwambiri, umakonda kwambiri.

Ndipo chisonyezo chachikulu cha kuperewera kwa insulin matendawa nthawi zambiri chimafotokozedwa zaka pafupifupi zitatu, ndipo izi ngakhale kuti matendawa adapezeka ndikuwathandizira. Kwa odwala, zizindikiro monga kuchepa kwambiri kwa thupi, hyperglycemia yowonekera, ndi zizindikiro za ketonuria zimawonedwa.

Ndi matenda aliwonse a shuga a autoimmune, kuperewera kwa insulin kumawonedwa. Kusakwanira kwa chakudya chamagulu mu glucose mu adipose ndi minofu minofu, komanso kuchepa kwa mphamvu kumayambitsa kuyipitsidwa kwa zinthu zomwe zimapangidwa ndi ma contra-mahormone mahomoni, omwe amangokhala ngati othandizira gluconeogeneis.

Kuperewera kwa insulin kumayambitsa kuponderezedwa kwa hepatic liposynthetic, kuphatikizidwa ndi mafuta ochulukitsidwa acids mu ketogeneis.Ngati vuto lodana ndi madzi komanso acidosis likuyamba kuchuluka, chikomokere chimatha, chomwe, popanda chithandizo choyenera, chimayambitsa imfa.

Vuto la autoimmune la mtundu 1 limafotokoza pafupifupi 2% ya matenda onse a shuga. Mosiyana ndi matenda a mtundu 2, matenda amtundu 1 amakhala ndi nthawi yoti awonetsere asanafike zaka 40.

Ponena za matenda azachipatala, amatchulidwa, makamaka kwa ana ndi kwa anthu adakali aang'ono. Zizindikiro zake pafupifupi mitundu yonse ya matenda ashuga ndi ofanana ndipo zafotokozedwa mu:

• Khungu
• kuchuluka kwa madzi akumwa,
• kuchepa thupi kwambiri
• kufooka kwa minofu
• ambiri malaise ndi kugona.

Kumayambiriro koyambirira kwa matendawa, kulakalaka kumatha kuwonjezeka pang'ono, komwe, ndi kukula kwa ketoacidosis, kumayambitsa matenda a anorexia. Pankhaniyi, kuledzera kumayambitsa mseru, limodzi ndi kusanza, kupuma kwa acetone, kupweteka kwam'mimba komanso kuchepa thupi.

Matenda a shuga a autoimmune amtundu woyamba pakakhala matenda opatsirana kwambiri amatha kudwalitsa, komwe nthawi zambiri kumayambitsa matendawa. Odwala omwe zaka zawo zimasiyana pakati pa zaka 35 mpaka 40, matendawa nthawi zambiri amadzionetsa ngati osatchulidwa: kuchuluka kwa polydipsia ndi polyuria kumadziwika, ndipo kulemera kwa thupi kumakhalabe pamlingo womwewo. Matenda ngati amenewa nthawi zambiri amakula patatha zaka zochepa, ndipo zizindikilo zonse ndi zizindikiro zake zimayamba kuonekera pang'onopang'ono.

Kuzindikira ndi chithandizo

Popeza kuti shuga ya autoimmune imafotokozedwa momveka bwino, kuzindikira kwake sikovuta. Potsimikizira matendawa, kuyesa magazi m'kamwa kungachitike. Ngati mukukayikira, ndikofunika kugwiritsa ntchito njira zosiyanitsira mitundu.

Kubwezeretsanso kwa mankhwalawa kumatanthauza chithandizo cha hypoglycemic, insulin komanso mankhwala othandizira pakudya. Mlingo wonse wa insulin umasinthidwa poganizira zofunikira za tsiku ndi tsiku za thupi la munthu, kuchuluka kwa chakudya chotengedwa komanso kuchuluka kwa glycemia wogwiritsa ntchito glucometer, muyeso womwe umapangidwanso nthawi yomweyo jekeseni isanachitike.

Kudya matenda a shuga kumaphatikizapo kutsatira malamulo ena:

• bungwe la zakudya zabwino,
• kukhazikitsidwa kwa zakudya zama calorie ochepa,
• kuletsa zakudya zokhala ndi chakudya chamafuta, mafuta ndi mchere,
• Zakudya zopatsa mphamvu
• kupereka thupi ndi zinthu zomwe zimakhala ndi michere yokwanira, michere yaying'ono komanso zazikulu.

Cholinga cha mankhwalawa ndikulimbikitsa kudzipanga kwa insulini, kuwonjezera chiwopsezo cha insulin, ndikuchepetsa kuyamwa kwa glucose ndikuchepetsa kaphatikizidwe kake. Amayamba kuchiza matenda osokoneza bongo a mellitus (autoimmune), nthawi zambiri amakhala ndi insulin monotherapy, kenaka amawonjezera mankhwala ochepetsa shuga. Mankhwala odziwika bwino ndi awa:

• Glibenclamide,
• Mafanizo
• Dipeptidylleptidiasis zoletsa,
• Chlorpropamide
• Amapuma ndi ena angapo.

Ngati matenda a shuga apezeka, muyenera kuchitapo kanthu pa mtundu uliwonse wa matenda ashuga. Ndipo mukangoyamba chithandizo, ndibwino.

Mutha kukhala ndi chidwi.

Nthawi zambiri, kuyambira kumayambiriro kwa chiwonetsero cha matenda a shuga a LADA kupita patsogolo kwa kuperewera kwa insulin, zimatenga miyezi isanu ndi umodzi mpaka isanu ndi umodzi. Ndikofunikira kusiyanitsa mtundu wa shuga ya mellitus mtundu wa 2 ndi kufunika kwa insulin ndi matenda a shuga a LADA: mwanjira yachiwiri, kuyesedwa kwa label m'magazi a odwala kumawonetsa chidziwitso cha kuwonongeka kwa immunological kwa maselo a pancreatic ndi ma genetic omwe amafanana ndi omwe ali ndi mtundu wa 1 shuga.

Yerekezerani kukhalapo kwa LADA-shuga wodwala mwa kuzindikira zotsatirazi mawonekedwe a matenda :

• kuchuluka kwa matenda ashuga wazaka 25 - 50,
• Zizindikiro za matendawa zimakula pang'onopang'ono, zimafanana ndi chithunzi cha matenda amitundu iwiri, koma palibe onenepa kwambiri kapena kunenepa kwambiri,
• kubwezeredwa kwabwino kwa kagayidwe kazakudya koyambira kumayambiriro kwa matendawa, omwe amapezeka pogwiritsa ntchito mankhwala othandizira komanso / kapena mapiritsi ochepetsa shuga,
• chitukuko cha zizindikiro za insulin kuchepa pambuyo 0,5 - 6 zaka kuchokera chiwonetsero cha matenda.

Chifukwa chake, ngati matenda ashuga amawonekera mwa achinyamata popanda kunenepa kwambiri, zizindikiro zamatenda zomwe zili zofanana ndi mtundu wa 2 wodwala, wodwalayo ayenera kupimidwa kuti adziwe omwe ali ndi matenda amtundu wa 1 m'magazi. Zizindikiro zoterezi zimaphatikizapo ma genetic enieni (HLA alleles omwe ali pachiwopsezo chachikulu cha matenda a shuga 1 mellitus) komanso immunological (kutsitsa C-peptide mpaka 0.6 kapena kuchepera, ma antibodies kuti glutamate decarboxylase (GAD) kapena pancreatic beta-cell antijeni (ICA) Zizindikiro zomwe zimapezeka kwambiri kwa odwala omwe ali ndi matenda ashuga 1.

Kuyamba pang'onopang'ono ndi "kufutukuka" zizindikiro za matenda a shuga a LADA kumachitika chifukwa chakuti njira yowonongera maselo a beta mu ukalamba imayamba pang'onopang'ono. Kuwonjezeka pang'onopang'ono kwa zizindikiro, kusowa kwa ketoacidosis ndi kuchepa kwambiri kwa thupi poyambira matendawa kumayenderana ndi izi. Kutengera ndi chithunzi cha chipatala, odwala amapezeka ndi matenda ashuga amtundu wa 2. Pamene ntchito yamankhwala am'mimba a pancreatic beta ikutha, wodwalayo amakhala ndi vuto la insulin: kuchepa thupi, kuwonongeka kwa kagayidwe kazakudya, komanso kuchepa kwambiri kwa magazi, ngakhale atamwa mankhwala ochepetsa shuga m'mlomo.

Njira zazikulu zodziwira matenda Matenda a shuga a LADA ndi:

• otsika (oyambira komanso okondoweza) a C-peptide (0.6 -1.1 nmol / l ndi otsika),
• kupezeka kwa ma antibodies ku GAD (pafupipafupi), ICA ndi insulin,
• kuzindikira kwa majini olembera a mtundu 1 wa shuga (ma HLA oopsa).

Kuzindikiritsidwa kwa ma pancreatic beta-cell immune lesion chizindikiro mwa odwala achichepere omwe ali ndi chithunzi cha mtundu wa 2 matenda osokoneza bongo popanda kunenepa kwambiri ndizofunikira pakuzindikira, zomwe zikuwonetsa kupangika kwa kuperewera kwa insulin mtsogolo.

Odwala omwe ali ndi matenda a shuga a LADA amafunika kuwazindikira matendawa ndikugwiritsa ntchito mankhwala a insulin nthawi yayitali chifukwa chotheka kusowa kwa katemera wa insulin. Nthawi zambiri, kuchepa kwa insulin mwa odwala, makamaka koyambirira kwa matendawa, kumathandizidwa ndi insulin. Pankhaniyi, odwala amamulembera mankhwala ochepetsa shuga omwe amachepetsa kapamba, koma amachititsa chidwi cha zotumphukira za insulin. Mankhwalawa akuphatikiza glitazones (avandium) ndi zotumphukira zamagulu (metformin).

Gulu lomwe likuika pachiwopsezo cha matenda a shuga a LADA ndi azimayi omwe ali ndi vuto la matenda oyembekezera, omwe nthawi zina amakhala owonetsa mtundu woyamba wa matenda a shuga 1 komanso 2 Matenda a shuga a LADA. Pankhani ya GDM, kuyezetsa ndikulimbikitsidwa kuti mupeze ma antibodies a antigen pancreatic beta-cell antigen, i.e., ma signor a autoimmune pancreatic lesion.

Odwala onse omwe ali ndi matenda a shuga a LADA amafunikira chithandizo cha insulin, pomwe makonzedwe oyamba a insulin samangoyang'ana osati zochuluka kwambiri kuti athe kulipirira zovuta zamatenda a carbohydrate, koma kuti asunge chinsinsi chawo cha insulini kwa nthawi yayitali kwambiri. Kuikidwa kwa secretogens (zolimbikitsa kutulutsidwa kwa insulin) kumatsutsana mu gulu la odwala matenda ashuga, chifukwa Izi zimabweretsa kufooka kwa kapamba komanso kutalika kwa insulin.

Matenda a shuga a Lada: zambiri

Ndikothekanso kuzindikira chodabwitsa cha thupi la munthu wokhala ndi dzina loti "galimoto" mwachidule kwambiri komanso mophweka - ndi gawo lapakatikati la mtundu 1 ndi mtundu 2 shuga. Amayitanidwanso chifukwa ichi "chimodzi ndi theka", kapena "1.5".

Kukula kwa mawuwa kumagwera mchaka cha 93 cha zaka zapitazi. Inali nthawi imeneyi pamene lingaliro latsopano lidawoneka ngati mankhwala - latent autoimmune shuga mwa akulu (LADA) - matenda a shuga a autoentmune akuluakulu.

Chilichonse chimachitika motere: Maselo a B amafa, koma osathamanga kwambiri ngati nthawi, koma pang'onopang'ono kwambiri, omwe ali odziwika kwambiri a mtundu 2. Motere, kupanga kwa insulini ya mahomoni pakapita nthawi kumakulirakulirakulira, pamapeto pake kuima palokha.

Momwe mungazindikirire

Matenda a shuga a Lada ndiwopanda, ndiye kuti, obisika. Kuyamba kukula, zimapatsanso mwayi munthu kuti achiritse, kapena kuti "achedwe".

Kuzindikira matendawa ndikosavuta. Choyamba ndi kuchuluka kwa shuga m'magazi. Kachiwiri, ndi kulemera kwabwinobwino kwa zizindikiro zonse za matenda osokoneza bongo omwe amadalira shuga. Ndiye kuti, ngati dokotala azindikira kuti wodwala wake ali ndi zonse zomwe akuwonetsa, koma ndi woonda, dokotalayo atha kudziwonetsa kale - LADA.

Kuti mutsimikizire, kuyesedwa kowonjezereka kwa magazi kwa wodwalayo kumachitika mu labotore ndipo kuyezetsa kwapadera zingapo kumachitika.

Chifukwa china chokayikira mtundu wa matenda amtunduwu ndi:

• M'badwo womwe matendawa adadziwonetsa - woposa zaka 35,
• Popita nthawi, matendawa amayenda mwa mtundu wodalira insulin.

Dokotala atha kunena kuti iyi ndi LADA ngati pali mbiri yamatenda monga systemic lupus erythematosus, multiple sclerosis, nyamakazi, autoimmune gastritis, bullous dermatosis ndi matenda ena a autoimmune.

Endocrinologist ayenera kufotokoza ngati wodwalayo ali ndi abale am'banja omwe ali ndi matenda a autoimmune. Yankho labwino la funsoli limawonjezera mwayi kuti matendawa ndi amtundu wa 1.5 shuga.

Zizindikiro za shuga ya Lada: imapezeka bwanji?

Kuthekera kwakukulu kopezeka ndi matendawa kumaonekera mwa amayi apakati omwe ali ndi matenda. Pa avareji, 25% ya atsikana onse otere amakhala ndi matenda omwe amapita ku 1.5. Izi zimachitika nthawi yomweyo mwana akangobadwa kumene kapena patapita nthawi.

Zimadziwikanso kuti matenda a shuga a LADA amapezeka mwa anthu azaka zapakati pa 35 ndi 65, koma nsapatoyo imagwera pa nthawi ya zaka 45-55.

Kuti mumvetse bwino za matendawa, mayeso a labotale amachitidwa kuti adziwe:

• Mitundu ya C-peptide ndi chinthu chachiwiri cha insulin biosynthesis.
• Mitundu ya Anti-GAD ndi ma antibodies kupita ku enzyme yomwe ikuphatikizidwa pakupanga GABA (gamma-aminobutyric acid).
• Mlingo wa ICA - ma antibodies kupita ku maselo a kapamba.

Kodi matenda a shuga a Lada amathandizidwa bwanji?

Popeza matendawa amatha kutchedwa kuti ulesi, chithandizo chiyenera kuyambitsidwa mwachangu pofuna kuteteza kutulutsa insulin kwathunthu ndi kapamba.

Pofuna kupewa kuchitika kwa kapamba ndi chitetezo cha mthupi, jakisoni wa insulin angakuthandizeni. Atazindikira kuti amvetsetsa matendawa, amaperekedwa kwa odwala onse, koma muyezo waukulu. Mu tsiku lonse, munthu amayenera kuwunika shuga wamagazi ndikuwonetsa.

Ndikofunikira kutsatira. Palibe chifukwa muyenera kudya shuga ndi zinthu zomwe muli nazo. Zakudya zoyenera zimatha kugwira ntchito yayikulu pano, chifukwa chifukwa cha izi, posachedwa matenda atha kutha.

Kukhala wakhama pantchito kumathandizira odwala kulimbitsa chitetezo chathupi. Kuchita masewera olimbitsa thupi ndikuyenda mlengalenga kumakhudza machitidwe onse a thupi la munthu, chifukwa chake sitinganyalanyaze.

Matenda a shuga a Lada adzadutsa ngati maloto oyipa, ngati mutsatira malangizo onse ndi upangiri wa adotolo-endocrinologist. Zakudya zapadera zimaloleza kuti insulini iperekedwe pazambiri, ndipo mankhwalawa adzapanganso kuyesa kusunga maselo a beta, makamaka, magwiridwe antchito awo. Kuchiza kuyenera kukhala kokwanira komanso kukonzekera - iyi ndi njira yokhayo yolimbana ndi matenda amishuga a 1.5.

Aliyense amadziwa za matenda amtundu wa 1 komanso a 2. Koma apa ponena kuti pali mwayi wina pakati pa mitundu iyi - Matenda a shuga a LADA ochepa akudziwa. Amatchedwa - matenda a shuga 1.5 (amodzi ndi theka).

Pali mikangano pakati pa asayansi zokhudzana ndi mtundu wanji wa matenda a shuga omwe angafotokozeredwe, chifukwa m'ziwonetsero zake zamankhwala LADA ili ngati mtundu wachiwiri, koma potengera njira ya chitukuko (autoimmune lesion) - zoyambirira.

Mawu akuti "LADA-shuga" adawoneka posachedwa - mu 1993. Nthawi iyi isanachitike, madokotala sanakayikirepo kupezeka kwake, ndipo ambiri mwa odwala adapezeka ndi matenda a shuga a 2. Ndipo kukulitsa maselo a beta, mankhwala ochokera ku gulu la zotumphukira za sulfonylurea adalembedwa, zomwe sizingachitike, kenako tikufotokozerani chifukwa chake.

Tsoka ilo, ngakhale ena a endocrinologists lero sanadziwe zokwanira kapena sanamvepo za matenda a LADA, ngakhale sizachilendo kwambiri: mu 10% ya anthu omwe amazindikira kuti ali ndi matenda ashuga a mtundu wa 2 komanso mu 15% ya omwe adazindikira mtundu wa matenda ashuga a 2, tikulankhula za matenda a shuga a LADA .

Ndipo ngati wodwala wapezeka kuti ali ndi kunenepa kwambiri, "mu 30% ya milandu pali LADA. Ndipo ndikofunikira kufotokoza bwino za nthawi yake.

Kodi matenda a shuga a LADA ndi ati?

Mawu akuti "LADA amatanthauza" matenda a shuga a autoimmune a akulu. "Matendawa amayambika pakati kapena achikulire (ofanana ndi mtundu wachiwiri), koma amasiyana ndi omwe amapanga kale.

Hyperglycemia mu mtundu 2 wa shuga imachitika chifukwa cha kupangika kwa insulin chifukwa cha kapamba, kapena chifukwa cha kufooka kwa zotumphukira zake pazomwe zimachitika.

Mtundu woyamba, zinthu ndizosiyana kotheratu: kusagwirizana kwa minofu kulibe, komanso insulin yolakwika. Komabe, mwatsoka, insulin yeniyeniyo ilinso, kapena kupanga kwake kumachepetsedwa kwambiri. Posakhalitsa, malo osungirako a beta amatha, ndiye chifukwa chake odwala otere ayenera kulandira insulin ngati jakisoni.

Mwa milandu 90%, izi zimachitika chifukwa cha chitukuko cha autoimmune mu thupi (autoimmune mtundu 1 matenda ashuga), mu 10% sizingatheke kudziwa chomwe chimayambitsa kuwonongeka kwa islet cell (idiopathic mtundu 1 shuga).

Kusiyana pakati pa LADA ndi mitundu ina ya matenda ashuga

Matenda a shuga a LADA amakumananso chifukwa cha kuwonongeka kwa autoimmune, chifukwa chake mitundu iyi imakhala ndi njira zofananira. Ndipo ena nthawi zambiri amawona kuti ali ndi vuto la shuga la mtundu umodzi wamagulu oyamba.

Komabe, malinga ndi chipatalacho, mitundu 1 ndi 1.5 zimasiyana mosiyanasiyana, mwachitsanzo, mosiyana ndi mtundu 1, wokhala ndi matenda a LADA:

• matendawa ndi aulesi ndi nthawi kuchuluka ndi kuchepa insulin amafuna. Kukula kwa zizindikiro ndi kofooka ngakhale popanda kuchiritsa komanso kugwiritsa ntchito mankhwalawa.
• matendawa amatenga matenda okalamba (zaka 25-50).
• mawonekedwe monga polyuria, polydipsia, kuchepa thupi mwadzidzidzi, kamwa yowuma, ketoacidosis, etc. nthawi zambiri kulibe kapena kufatsa.

Kusiyana kwa mtundu wa 2 matenda a shuga LADA ndikuti:

• odwala nthawi zambiri amakhala ndi thanzi labwino, samanenepa kwambiri.
• mwachangu mokwanira pakufunika mankhwala a insulin (pambuyo pa zaka 0.5 - 6).
• ma antibodies kuti glutamate decarboxylase (anti-GAD), insulin (IAA) ndi islet cell antigen (ICA) apezeka m'magazi, omwe amalankhula zowonongeka kwa autoimmune.
• (pansipa 0.6 nmol / L), kuwonetsa kuchepa kwa insulin.
• Zizindikiro za matenda amtundu 1 shuga (omwe ali ndi chiopsezo chachikulu cha HLA) amapezeka m'magazi. Masiku ano, kuzindikira kwawo ndikovuta, ndipo si ma labotore onse omwe amachita. Zimafunikira pokha pokha pakakhala nkhani zotsutsana pakufotokozera bwino za matendawa.
• matendawa samalipilitsidwa bwino ndi am'kamwa a hypoglycemic othandizira, makamaka gulu la sulfonylurea.

Kuyesa kwa matenda

Pazifukwa izi, mutha kugwiritsa ntchito:

1. Prednisolone shuga yolekerera. Uwu ndi mtundu wa mayeso ololera wa glucose pogwiritsa ntchito prednisone. Wodwalayo amapatsidwa 10 mg ya prednisone mkati maola 10 musanayesedwe, komanso maola ena awiri musanamwe shuga.Ngati glycemia wambiri mu ola limodzi pambuyo poti kukweza kwa glucose kupitirira mtengo wa 11.10 mmol / L, ndipo pawiri - 8.32 mmol / L, zotsatira zoyesedwa zimawoneka zabwino.
2. Mayeso a Staub-Traugott. Nthawi ya 8 m'mawa, mutuwu umatsimikiziridwa ndi shuga wamagazi. Poyesedwa, sayenera kudya chakudya kapena zakumwa. Kenako ayenera kumwa malita 25 a tiyi ndi dextropur osungunuka mkati. Glycemia imatsimikiziridwa mu theka la ola, ola, ola ndi theka, maola awiri, atatu, anayi ndi asanu. Pakuchita chilichonse, wodwalayo ayenera kuchotsa chikhodzodzo. Kuphatikiza apo, pa 9:30 wodwalayo amapatsidwanso yankho lomwelo. Mu LADA-shuga, pambuyo pakupatsanso shuga, kuwonjezereka kwamphamvu kwa glycemia kumachitika kuposa pambuyo poyambira mlingo woyamba. Mwa anthu athanzi, izi sizimawonedwa.

CHOKONZEDWA: lero zitsanzo zomwe sizikugwiritsidwa ntchito sizikugwiritsidwa ntchito pazolinga izi!

Zomwe zimachitika ndi matenda a shuga a LADA

Ndi kufa ndi kutha kwa pang'onopang'ono kwa magwiridwe antchito a maselo a beta, zizindikiritso za insulin yokwanira zimayamba kupita patsogolo: kuwonda, ketoacidosis, kuwonongeka kwa kagayidwe kazakudya, kuperewera kwambiri kwa hyperglycemia, ngakhale motsutsana ndi zakudya komanso mapiritsi ochepetsa shuga.

Amakhulupirira kuti matenda a shuga a LADA ndiofala kwambiri pakati pa akazi kuposa amuna. Ngati wodwalayo ali ndi anthu omwe ali ndi autoimmune pathologies pakati pa abale apamtima, kapena ngati iye ali ndi matenda aliwonse a autoimmune (matenda a Hashimoto's chithokomiro, matenda a Crohn, mtundu 1 shuga, vitiligo, nyamakazi, matenda am'mimba, etc.), chiopsezo cha kudziwika ali ndi matenda a shuga a LADA apamwamba.

Chofunikira china cha matendawa ndikuti ma antibodies omwe ali pamwambapa (anti-GAD, IAA, ICA) amayendayenda m'magazi nthawi yonse ya matenda. Mwanjira ina, gawo lawo limakhala losasinthika komanso losasinthika, zomwe sizinganenedwe za mtundu woyamba (matendawa akamapitilira, kuchuluka kwawo kumatsika pang'onopang'ono kuchokera pa 85% mpaka 15%).

Chifukwa chake, kupezeka kwa magazi a wodwala wachichepere wokhala ndi zizindikiro za mtundu wachiwiri wa matenda ashuga ndi zilembo zosatsika za kuwonongeka kwa maselo a beta ndikofunikira pakuzindikira matenda a LADA.

Odwala otere amafunika kufufuza kwatsatanetsatane, ndipo nthawi zambiri, kuikidwa kwa insulin kuchiritsa maselo.

Kufunika Kwa Kudziwitsa Matenda A shuga a LADA

Ena angaganize, chabwino, zimapanga kusiyana kotani, ndi matenda ati a shuga: choyamba, chachiwiri kapena ngakhale chapakatikati (chimodzi ndi theka)? Chinthu chachikulu ndikukwaniritsa Normoglycemia! Mwakutero, kulingalira kolondola, koma. Munthawi zonsezi, ndikofunikira kukwaniritsa kukula kwa shuga m'magazi osiyanasiyana.

Mitundu yosiyanasiyana ya mapiritsi ochepetsera shuga, ngakhale atakhala yamakono bwanji, sichithandiza mtundu woyamba. Mtundu wachiwiri sufuna insulini nthawi zonse, nthawi zambiri zinthu zimatha kukhazikika ndi zakudya komanso mapiritsi omwe ali pamwambapa. Kuti mumve zambiri za mitundu ina ya matenda ashuga patsamba lokonzanso.

Nanga bwanji matenda a shuga a LADA? Momwe muyenera kuchitira ndi zomwe mungakwaniritse? Tsoka ilo, mpaka pano sizinatheke kupanga mankhwala omwe angakhudze njira ya autoimmune mthupi. Ichi ndichifukwa chake siziri zotheka kuyimitsa kuwonongeka kwa maselo a pancreatic mu mtundu 1 wa shuga ndi LADA.

Chifukwa chakuti anthu odwala matenda ashuga omwe ali ndi LADA akusowa kutulutsa kwa insulin, ndikofunikira kupatsa kuchuluka kwa insulin kuyambira pachiyambi pomwe. Njirayi ili ndi zolinga zingapo:

1. kupatsa maselo a islet kupuma. Chifukwa chake, mutha kufooketsa pang'ono njira ya autoimmune.
2. pangani Normoglycemia m'magazi ndikuchepetsa kukula kwa zovuta.
3. khalani nthawi yayitali yotsalira ya insulin. Izi zingathandize kupewa pafupipafupi hypoglycemia mtsogolo.

Nthawi zambiri, kusowa kwa insulin mu shuga LADA kumaphatikizidwa ndi insulin.Muzochitika zotere, mutha kupatsa wodwala mankhwala ochepetsa shuga kuchokera ku gulu la Biguanide (metformin) kapena avandium (amatanthauza glitazones).

Mankhwalawa amathandizira chidwi cha minyewa kupita ku mahomoni, ndiye kuti, amachepetsa kukana kwa insulini, koma osakhudza kukondoweza kwa insulin, yomwe ndiyofunika kwambiri.

Kukonzekera kwa Sulfonylurea, komwe kumatchulidwa kuti ndi chinsinsi cha insulin (activate insulin secretion), kumapangidwira kwathunthu kwa odwala omwe ali ndi matenda a shuga a LADA, popeza izi zimangowonjezera zomwe zimapangitsa kuti ziwonongeke zisanafike pang'onopang'ono pantchito yotsalira ya maselo a beta.

Ndipo izi ndizomwe zimachitika nthawi zambiri m'moyo weniweni. Wodwalayo amapezeka ndi mtundu wachiwiri wa matenda osokoneza bongo a shuga, samawonetsa kunenepa kwambiri, zomwe zikutanthauza kuti m'modzi mwa oimira sulfonylurea zotumphukira (glycvidone, glibenclamide, glipizide, glimepiride, gliclazide, etc.) adzakhala mankhwala osankha. Ichi ndichifukwa chake kudziwika koyenera komanso chithandizo cha matenda a shuga LADA ndikofunikira kwambiri.

Kanema kuchokera kwa endocrinologist

Matenda a shuga ndi matenda oopsa omwe amakhudza thupi lonse ndipo ali ndi mawonekedwe amtundu uliwonse. Komabe, matenda a shuga a autoimmune ndi osiyana chifukwa amaphatikiza mawonekedwe amtundu uliwonse. Chifukwa chake, matendawa amatchedwa osakhalitsa kapena amodzi ndi theka, zomwe sizimapangitsa kukhala owopsa kuposa mtundu 1 ndi mtundu wa 2 pathologies. Zizindikiro zoyambirira zikawoneka, tikulimbikitsidwa kuti tisachedwe kupita kwa dokotala, chifukwa gawo lotsogola limatha kutenga chiwopsezo cha kukomoka komanso kusinthika ndi matenda ena.

Kodi matenda a shuga a autoimmune ndi ati?

Mu shuga mellitus, kagayidwe ka glucose kamasokonezeka, chifukwa chomwe kuperewera kwa insulin kumachitika m'thupi, ndipo kusowa kwa kapamba kumachitika. Nthawi zambiri kusintha matendawa kumachitika ndikaphatikizidwa ndi zovuta zina za endocrine system, komanso ma pathologies omwe sagwirizana chilichonse ndi matenda a rheumatoid ndi a Crohn's.

Zomwe zimayambitsa matendawa

Kafukufuku wambiri walephera kudziwa zifukwa zenizeni zomwe zimawonekera ngati matenda ashuga a mtundu woyamba. Zomwe zimayambitsa matenda a autoimmune ndi izi:

• Mitundu. Pali mwayi wokhala ndi matenda m'mabanja omwe mmodzi mwa abale ake anali ndi matenda ashuga. Chifukwa chake, thanzi la anthu otere, madokotala amawunika kwambiri.
• Zopatsirana. Matendawa amatha kuchitika mothandizidwa ndi rubella, mumps. Matendawa ndi owopsa kwa ana omwe adwala matenda a utero.
• Intoxication. Mothandizidwa ndi chinthu choopsa mu ziwalo ndi machitidwe, zopatuka zamtundu wa autoimmune zimatha kuyambitsa.
• Zakudya zopanda pake.

Ngati tilingalira za mtundu wachiwiri wa matenda ashuga, zinthu zotsatirazi zitha kusiyanitsidwa:

Mtundu wachiwiri wamatenda umatha kuyamba chifukwa chodya zakudya zopanda thanzi, zomwe zimapangitsa kuti kunenepa kwambiri.

• zaka zopitilira 45
• shuga wamagazi ochepa, dontho la lipoprotein.
• Zakudya zopanda pake zomwe zimayambitsa kunenepa,
• moyo wosachita bwino
• mitundu yambiri ya ma cystic pazovala zazikazi,
• matenda am`mnyewa wamtima.

Mawonekedwe akupatuka mwa amayi apakati

Matenda a shuga a Autoimmune amakula motsutsana ndi maziko a kuchuluka, kulemera kwamtsogolo, kusowa kwa kagayidwe kachakudya, kuchuluka kwa shuga m'magazi ndi mkodzo. Pafupifupi, pakakhala pakati, zifukwa zotsatirazi zimakhudza chiopsezo chotukuka:

• njira yobadwira yomwe mwana amalemera woposa 4 kg,
• kubadwa koyambirira kwa mwana wakufa
• Kulemera msanga panthawi yapakati,
• gulu la akazi azaka zopitilira 30.

Matenda a mtundu wa Autoimmune amakhudza anthu akulu okha, mwa ana chitukuko sichokhazikika.

Chithunzi chachipatala cha matenda

M'magawo oyamba, matenda osokoneza bongo samadziwonetsa. Komabe, matenda akupanga mofulumira ndipo amatsogolera ku mitundu yomwe imafuna insulin.Matenda a mtundu wa Autoimmune ali ndi zizindikiro zovuta, zomwe zimaphatikizapo mawonetseredwe amtundu 1 ndi 2. Izi zikuphatikiza:

• mkodzo wambiri,
• kufunikira kwamadzi nthawi zonse
• njala yosatha.

Momwe mungadziwire chitukuko cha matendawa?

Njira yodziwitsira matenda ndi yosavuta, chifukwa matenda a shuga a autoimmune ali ndi mawonekedwe. Komabe, dokotala angakupatseni mayeso ololera a glucose. Ngati mukukayika pamayeso oyamba, njira yodziwitsa wodwalayo imagwiritsidwa ntchito kwa wodwala. Kafukufuku onse athandizira kuti adziwe zoyenera, pamlingo womwe katswiri adzalembemo chithandizo choyenera.

Matenda a shuga ndi matenda opatsirana, endocrine, chinthu chachikulu chomwe ndi kusintha kwa kagayidwe kachakudya komwe kamayambitsa matenda a shuga, omwe amayamba chifukwa chophwanya chobisalira kapena magwiridwe antchito a pancreatic timadzi - insulin.

Matenda a shuga ndi matenda ofala kwambiri a endocrine: pafupifupi anthu onse 25 okhala padziko lapansi pano ali ndi vutoli. Zaka 15 zilizonse kuchuluka kwa odwala kumawirikiza. Dziwani kuti pali anthu ambiri omwe ali ndi matenda ashuga kapena ali ndi vuto lakelo! Pafupifupi theka la anthu odwala matenda ashuga ali ndi zaka 40 mpaka 60, komabe sizachilendo kuti achinyamata ayambitse matendawa.

Kuwonjezeka kwa ziwopsezo kumalumikizidwa ndi kuchuluka kwamafuta ndi zakudya za shuga, komanso kuchepa kwa ntchito zolimbitsa thupi. Anthu okhala m'mizinda amadwala nthawi zambiri kuposa okhala m'midzi.

Matenda a shuga amapezeka m'magulu awiri:

• 1. Mtundu wodalira insulini - lembani I
• 2. Mtundu wosadzimira-insulin-mtundu II

The etiology (zoyambitsa) ndi kuchuluka kwa matenda ashuga sizofanana kulikonse. Nthawi zambiri imapezeka ku USA, Southern Italy, Germany, China, Poland. Osawerengeka - pakati pa anthu okhala mdera la Alaska, ku Greenland, Zimbabwe.

Zowopsa zake ndizophatikizira:

• Kuwonongeka kwa m'maganizo, matenda apakati, Mwa anthu omwe thupi lawo limaposa 20%, matenda a shuga amadziwika ka 10 pafupipafupi kuposa anthu.
• Matenda a shuga amapezekanso chifukwa cha matenda kapamba (chifuwa chachikulu cha kapamba), kupweteka kwa kapamba). Chomwe chikuthandizira pakukula kwa matendawa amathanso kumwa kwa nthawi yayitali mankhwala omwe amakhudza kagayidwe kazakudya (diuretics, corticosteroids, njira zakulera pakamwa, ndi zina zambiri).
• Amakhulupirira kuti ma virus angathandizenso kukulitsa njira za autoimmune ndikuwonjezera chiwopsezo cha ma virus ena a pancreatotropic (matenda am'mimba ndi matumbo, cholecystitis, chiwindi ntchito, matenda opatsirana a genitourinary system angathandizenso kukulitsa matenda a shuga. Mu matenda a shuga a Type-I, njira yayikulu ya pathogenesis yamatendawa ndi kupendekera kwapang'onopang'ono kwa maselo a pancreatic a "antibodies"

SUGAR DIABETES TYPE - I

Mellitus wodwala yemwe amadalira matenda a shuga amachitika chifukwa cha kuwonongeka kwa maselo a β (maselo awa amapezeka mu minofu ya pancreatic ndikupanga insulin), yomwe imapangitsa kuti insulini itheretu.

Ndani ndipo ndani amawononga maselo amenewa?

Njira ya pathological imayambitsa zovuta mu chitetezo cha mthupi. Mwachidule, matenda oyamba amatulutsa, omwe amatsatiridwa ndikukula kwa ziphuphu zakumaso kapena zosapweteka.

Ndi vuto la autoimmune, ma antibodies (poyamba ntchito yawo ndikuteteza thupi kuzinthu zonse zachilendo ndikusungika kuti likhale lotetezeka) amayamba "kuchita misala", m'malo momangoteteza, onetsani nkhanza zolimbana ndi maselo a thupi lawo.Pankhaniyi, motsutsana ndi maselo a kapamba, ndipo chifukwa - kapamba. Pafupifupi 90% ya milandu, nkhanza za antibody sizingokhala chiwalo chimodzi, ndipo zimatha kufalikira zina zilizonse, mwachitsanzo: ku chithokomiro cha chithokomiro, zotsatira zake ndi autoimmune chithokomiro, kuyambitsa chakumwa chozizira, motero ndikotheka kuperekanso zitsanzo zina.

MALO OYAMBIRIRA A INSULIN INDEPENDENT - II

Mtundu wachiwiri wa matenda ashuga nthawi zambiri umakhala mwa anthu opitilira zaka 50.

Itha kuyendetsedwa ndi chakudya chimodzi (cha kunenepa kwambiri, kapena sulfonylurea, maninil, glucophage, siofor).

Mtundu uwu wa matenda ashuga ndi woopsa kwambiri. Mwa ambiri mwa odwalawa, ntchito ya insulini m'magazi imasiyanasiyana mosiyanasiyana, kuchokera pakuchepa kwambiri mpaka pakubwinobwino kapenanso kuwonjezereka, osamvetseka mokwanira!

Pazifukwa, kuwonjezeka kwa glucose m'magazi, alipo ambiri aiwo, koma tizitulutsa zazikulu.

Chimodzi mwa zifukwa zazikuluzikulu zomwe zimapangitsa kuti shuga asamakhale ndi insulin yodalirika ndiyosagwira ntchito pakulamulira kwa insulin katulutsidwe ka kusintha kwa shuga m'magazi. Mwambiri, magwiridwe antchito a receptor of β cell of pancreatic islets asokonezeka. Osati mu maselo amthupi, koma mu kama wamitsempha - mumakhala mpweya wambiri m'magazi, ndi pang'ono m'maselo.

Pali chiphunzitso chakuti zotsatira za kulephera kotereku zimapangidwanso modzidzimutsa komanso "zotayika".

Koma! Mu mtundu wa shuga mellitus - ma antibodies amawononga ma cell a pancreatic, ndipo mu mtundu wa shuga mellitus II, amawononga ma receptor a cell omwe amapanga insulin. Ndipo maselo amenewa asanafike, kuchuluka kwa glucose m'magazi kumadutsa bwino. Chifukwa chake, kulumpha kotero mu insulin, ndiye kwambiri, ndiye zochepa kwambiri.

Chosafunikanso kwambiri ndicho kugonjetsedwa kwa ziwiya zolandirira, osati maselo a pancreatic omwe amapanga insulin. Komanso maselo ojambulidwa, ndiye kuti. Maselo omwe amapanga glucose pogwiritsa ntchito insulin: awa amaphatikizapo minofu ya minofu, minofu ya adipose, etc.

Kugonjetsedwa kwa ma receptor zovuta maselo m'thupi kumabweretsa kuti maselo okhala ndi zovuta kwambiri amatha kulola glucose kulowa, kapena sangalole konse kulowa.

Izi zitha kufaniziridwa ndi zoterezi, mlendo amaliza belu, ndipo makamu samamutsegulira, osati chifukwa choti safuna, koma chifukwa samvera - kuyimbaku kwaduka.

Zotsatira zakusokonekera, zomwe zimadziwika kuti "siginecha ndikulandira chida", shuga amatha kudzikika m'magazi ambiri. Ndipo "ma hooligan" otere omwe amaphwanya ma receptors, ndiye kuti, zida zowonetsera, onse ndi antibodies omwe ndi "ovulala".

Kutengera ndi zomwe tafotokozazi, matenda a shuga amatha kudzetsa matenda a autoimmune.

Pothana ndi mavuto, ntchito yayikulu ndikuchepetsa "ma "ukali" ndikuwakumbutsa za udindo wawo woyambirira wa thupi. Ndipo kuchokera kuzowopsa zawo zokha ndikutupa, chiwonongeko - chotsatira.

• 1. kumwa mankhwala amkamwa hypoglycemic (mapiritsi) ...
• 2. kudya insulin kudzera m'mitsempha kapena subcutaneally.

Chithandizo chotere sichimalimbana ndi zomwe zimayambitsa matendawa, koma kuthana ndi kupsinjika kwa mavuto, ndiko kuti, chifukwa chotsatira matendawa.

Anthu amakakamizidwa kugwiritsa ntchito mankhwalawa moyo wawo wonse ngati atayamba kumwa mankhwalawo.

Ndiye kodi njuchi zitha kukhala ndi gawo lotani munjira imeneyi?

30.01.2019 Wokondedwa wam'mapiri
Uchi ndiye chinthu chapadera kwambiri chokhala ndi moyo wopanda alumali. Mpaka nthawi ya Peter Great, ku Russia, uchi unakhalabe gwero lalikulu lokoma. Koma chifukwa cha kupezeka kwa shuga, uchi wasanduka chinthu chabwino kwambiri komanso ndiwo maziko a maphikidwe achikhalidwe.

23.01.2019 Nyani uchi
Pakadali pano, alimi ali ndi uchi wambiri, womwe umasiyana pakukoma ndi zinthu zabwino, komanso kukula kwake. Nthawi zambiri mumatha kupeza uchi wokhala ndi dzina la Borovaya. Tiyeni tiwone mtunduwo wa uchi komanso zomwe amadya nawo.

16.01.2019 Uchi wakuda wa mapulo
Uchi wakuda wamapu ndi uchi wosowa. Ndi chizolowezi kutolera mu Meyi ndi Epulo. Zitsamba za mapulo a Chitata ndiye gwero lalikulu lotengera timadzi tokoma ndi mungu. Nthawi zambiri sizingatheke kukumana ndi anthu m'dera lathu .. Uchi wamtundu wakuda umadziwika kwambiri chifukwa cha mawonekedwe ake ochiritsa komanso kukoma kwake koyambirira.

10.01.2019 About zisa za uchi
Uchi wa tchizi uli ndi mitundu makumi atatu. Monga lamulo, mitunduyi siyikulira kwa nthawi yayitali, kupatula mitundu yosonkhanitsidwa kuchokera pachifuwa cha akavalo. Ya Crimea imadziwika kuti ndiwopamwamba kwambiri, womwe umakhala mumadzi kwa nthawi yayitali.

04.01.2019 Zachilendo komanso zoyera - uchi wa euphorbia
Uchi nthawi zonse wakhala umakhala wa anthu osati chowonjezera chokoma pa chakudya chokhacho, komanso chogwiritsidwa ntchito ngati mankhwala komanso zodzikongoletsera. Mwa mitundu yambiri ya uchi, pali mitundu yonse yachilendo, yofalikira, komanso yosowa. Palinso uchi wowala komanso wakuda ndimagulu ena osiyanasiyana. Lero ndikufuna kunena zambiri za uchi wopangidwa kuchokera ku mkaka wamkaka.

Kodi pali kusiyana kotani ndi matenda ashuga?

Matenda a shuga a Lada ali ndi chiyambi cha autoimmune, kukula kwake kumalumikizidwa ndi kuwonongeka kwa kapamba, koma njira za matendawa ndizofanana ndi mitundu ina ya matenda ashuga. Zaka zingapo zapitazo, asayansi sankaganiza kuti kuli LADA (mtundu 1.5), mtundu 1 wokha ndi mtundu wa 2 wodwala womwe udawonekera.

Kusiyana pakati pa matenda a autoimmune ndi mtundu 1

• Kufunika kwa insulini kumakhala kotsika, ndipo matendawa ndi otupa, ndipo amatha kutalika nthawi yambiri. Ngakhale popanda chithandizo chamanthawi zonse, zizindikiro za matenda ashuga 1.5 nthawi zambiri sizothandiza kwa anthu,
• Gulu la anthu omwe ali pachiwopsezo limaphatikizapo anthu azaka zopitilira 35, anthu azaka zilizonse amadwala ndi matenda amtundu 1,
• Zizindikiro za LADA nthawi zambiri zimasokonekera ndi zizindikiro za matenda ena, zimapangitsa kuti adziwe matenda olakwika.

Chikhalidwe komanso mawonekedwe a matenda a shuga amtundu woyamba amamveka bwino.

Kusiyana pakati pa matenda a shuga a autoimmune ndi mtundu 2:

• Odwala atha kunenepa kwambiri.
• Kufunika kwa mankhwala a insulini kumatha kupezeka kale miyezi isanu ndi umodzi kuchokera nthawi yomwe chitukuko chikuchitika,
• Magazi a wodwala amakhala ndi ma antibodies omwe amawonetsa matenda a autoimmune,
• Ndi zida zamakono, zodziwika za matenda amtundu 1 zitha kupezeka,
• Kuchepetsa hyperglycemia ndi mankhwala kulibe kanthu.

Njira zoyenera

Tsoka ilo, ambiri a endocrinologists samasanthula mwakuya akazindikira mtundu wa matenda ashuga. Pambuyo popezeka molakwika, mankhwala amachepetsa magazi a shuga. Kwa anthu omwe ali ndi LADA, mankhwalawa ndi owopsa.

Pozindikira matenda a autoimmune shuga, njira zingapo zimawerengedwa kuti ndizothandiza kwambiri.

Pa nthawi yoyamba, wodwalayo amatsatira njira zina:

• Kuyeserera kwathunthu kwa magazi
• Urinalysis

Pankhani yokayikira ya matenda obwera chifukwa cha matenda ashuga, endocrinologist amatumiza maphunziro kuti asangidwe. Mitundu yomaliza ya shuga imapezeka ndi:

• Glycated hemoglobin,
• Kuyankha kwa gluu
• Fructosamine
• Ma antibodies a IAA, IA-2A, ICA,
• Microalbumin,
• Kufotokozera.

Kuphatikiza pa mayeso a labotale, awa akufufuzidwa:

• Wodwala ndi wamkulu kuposa 35,
• Kodi insulin imapangidwa bwanji (kafukufukuyu amatenga zaka zingapo),
• Kulemera kwa wodwala ndikubwinobwino kapena kosavuta
• Kodi ndizotheka kulipira insulin ndi mankhwala ndikusintha kwa zakudya.

Pokhapokha atazindikira mozama momwemo ndi kuphunzira kwakutali m'ma labotale, kuyang'anira wodwalayo ndi momwe mthupi lake lilili, ndizotheka kuzindikira matenda a autoimmune.

Ma sampu omwe atha kugwiritsidwa ntchito ku Russia

• Kuyeserera kwa glucose pogwiritsa ntchito prednisone. Kwa maola angapo, wodwalayo amadya prednisone ndi glucose. Cholinga cha phunziroli ndikuwunika glycemia potengera momwe ndalama zimagwiritsidwira ntchito.
• Likulu la Traugott mayesero. Pamimba yopanda kanthu m'mawa mutatha kuyeza kuchuluka kwa shuga, wodwalayo amamwa tiyi wotentha wokhala ndi dextropur.Pakatha ola limodzi ndi theka, wodwala matenda a shuga amakhala ndi glycemia, mwa anthu athanzi palibe chotere.

Njira zodziwikirazi zimawerengedwa kuti sizothandiza ndipo sizigwiritsidwa ntchito kwenikweni.

Kodi chiwopsezo cha matenda olakwika ndi chiyani?

Kudziwitsa zolondola za mtundu wa matenda ashuga komanso chithandizo chotsatira chomwe sichili ndi zotsatira zoyenera zaumoyo wa wodwalayo:

• Kuwonongeka kwa autoimmune kwa maselo a beta,
• Kutsika kwamankhwala a insulin ndi kupangidwa kwake,
• Kukula kwamavuto komanso kuwonongeka kwakatundu kwa wodwalayo,
• Kugwiritsa ntchito mankhwala kwa nthawi yayitali - kufa kwa maselo a beta.

Mosiyana ndi anthu omwe ali ndi matenda a shuga a mtundu woyamba 1 kapena 2, odwala LADA muyenera kugwiritsa ntchito insulin mwachangu muyezo waung'ono popanda kugwiritsa ntchito mankhwala.

Kulemba mankhwala omwe sanayenere matenda a autoimmune kumachepetsa mwayi wowachiritsa ndi kubwezeretsa kapamba.

Odwala omwe ali ndi LADA amafunika kuwazindikira matendawa ndikugwiritsa ntchito jakisoni wa insulin.

Ndi pa kumwa kwa insulin m'malo waukulu womwe chithandizo chothandiza kwambiri chimapangidwa.

Odwala omwe adayamba mankhwala a insulin koyambirira kwa matendawa, kukhala ndi mwayi uliwonse wobwezeretsa kupanga insulin yachilengedwe pakapita nthawi.

Pamodzi ndi insulin mankhwala zotchulidwa:

• Zakudya zochepa za kaboni
• Masewera
• Kupitiliza kosamala kwa shuga wamagazi, kuphatikiza nthawi yausiku,
• Kuchotsedwa kwa mankhwalawa kwawonetsedwa kwa anthu onenepa kwambiri komanso mitundu ina ya matenda ashuga.

Ndikofunika kuchepetsa katundu pa kapamba kuti uthandizire kupanga insulin mtsogolo. Cholinga cha mankhwalawa ndikuletsa kufa kwa maselo a beta motsogozedwa ndi kusintha kwa chitetezo chathupi.

Kukonzekera kochokera ku sulfaurea kumakhudzana ndi anthu omwe ali ndi matenda osokoneza bongo a latent. Mankhwalawa amalimbitsa katemera wa pancreatic ndipo amangokulitsa kufa kwa cell ya beta.

Kanema wothandiza

Ndemanga za katswiri pankhani iyi:

Ku Russia, makamaka kumadera akutali, kupezeka ndi kuchiritsidwa kwa matenda a shuga LADA ali mwana. Vuto lalikulu lazidziwitso zolakwika lili pakuwonjezeka kwa autoimmune komanso kulandira chithandizo mosayenera.

M'mayiko otukuka, matenda ashuga am'mbuyomu amadziwika ndi kuthandizidwa bwino, njira zatsopano zamankhwala zikupangidwe zomwe posachedwapa zifika ku Russia.

Kodi matenda a shuga a LADA ndi chiyani. Ma Subtypes a Type Iabetes

Akatswiri ena amatcha matenda a shuga a LADA ngati njira yomwe ikupita patsogolo pang'onopang'ono ya endocrine pathology. Dzinalo lina ndi 1.5, ndiko kuti, mawonekedwe apakatikati pakati pa matenda amtundu 1 ndi matenda a 2.

Lingaliro loperekedwa limafotokozedwa mosavuta, chifukwa "kufa" kwathunthu kwazinthu zobisika pambuyo pa zaka 35 ndikuchita pang'onopang'ono. Pankhani imeneyi, zizindikiro za matenda ashuga zimafanana kwambiri ndi mtundu wa insulin wopanda matenda.

Kuti mumvetsetse kuti shuga ya LADA ndiyotani, ziyenera kukumbukiridwa kuti mawonekedwe amtundu wa autoimmune amakhumudwitsa kufa kwa maselo a pancreatic beta. Pachifukwa ichi, kupanga kwake kwa mahomoni ake posachedwa kumalizidwa.

Pomwe insulin ndi njira yokhayo yothetsera matenda akulu. Chisamaliro chimayenerera mitundu ya LADA, zifukwa zomwe amapangira.

Pakati pa mitundu ya matenda a shuga a mellitus omwe amadziwika kale ndi ambiri, kuwonjezera pa mitundu 1 ndi 2, pali ena angapo omwe samadziwika bwino, mwatsoka, sanaphunzire bwino, matenda a endocrine system - awa ndi matenda a shuga a LAMEDI ndi LADA.

Tikambirana za wachiwiri wawo munkhaniyi. Tikuphunzira:

• Zizindikiro zake zazikulu
• Kodi kudwala matenda ashuga kumasiyana bwanji ndi mitundu ina ya "matenda okoma"
• njira zake zowunikira
• ndi chithandizo chake

Kuzindikira koyambirira

Matenda a shuga a Lada ndiwopanda, ndiye kuti, obisika. Kuyamba kukula, zimapatsanso mwayi munthu kuti achiritse, kapena kuti "achedwe".

Kuzindikira matendawa ndikosavuta.Choyamba ndi kuchuluka kwa shuga m'magazi. Kachiwiri, ndi kulemera kwabwinobwino kwa zizindikiro zonse za matenda osokoneza bongo omwe amadalira shuga. Ndiye kuti, ngati dokotala azindikira kuti wodwala wake ali ndi zonse zodwala matenda a shuga a 2, koma ali wochepa thupi, dokotalayo amatha kupeza njira yoyambira - LADA.

Kuti mutsimikizire, kuyesedwa kowonjezereka kwa magazi kwa wodwalayo kumachitika mu labotore ndipo kuyezetsa kwapadera zingapo kumachitika.

Chifukwa china chokayikira mtundu wa matenda amtunduwu ndi:

• M'badwo womwe matendawa adadziwonetsa - woposa zaka 35,
• Popita nthawi, matendawa amayenda mwa mtundu wodalira insulin.

Dokotala atha kunena kuti iyi ndi LADA ngati pali mbiri yamatenda monga systemic lupus erythematosus, multiple sclerosis, nyamakazi, autoimmune gastritis, bullous dermatosis ndi matenda ena a autoimmune.

Zizindikiro

Kwenikweni, zizindikilo zomwe zikuwonetsa kukula kwa matenda osokoneza bongo a latent sizowonekeratu, koma muyenera kulabadira izi: choyamba, kulemera mwadzidzidzi, kapena, kuwonda.

Kachiwiri, khungu louma (mpaka kuyabwa), ludzu losalekeza, kukodza pafupipafupi, komanso kufooka kapena khungu limatha kukhala zizindikiro. Pazonse, titha kunena kuti zizindikiro za matenda a shuga a fret ndizofanana ndendende ndi omwe ali ndi mtundu wa 2 shuga mellitus, mwa mawonekedwe ofatsa.

Komabe, ngati matenda ashuga apambuyo apezeka munthawi yake ndikuchitapo kanthu moyenera, ndiye kuti matendawa atha kupewedwa.

Ma Endocrinologists amawona mtundu womwe umaphatikizapo njira zisanu ndipo amakulolani kudziwa matenda ashuga. Mawonetseredwe oyamba ayenera kuwonedwa kuti ali ndi zaka 50.

Ndikofunikanso kulabadira kuyambika kwa matendawa, monga kuchuluka kwamkodzo (oposa malita awiri patsiku), ludzu, kuchepa thupi. Zizindikiro zake zimatha kufooka komanso kuchepa mphamvu.

Ndizosadabwitsa kuti mtundu uwu umatchedwa wapakatikati kapena umodzi ndi theka (1.5). Kumayambiriro kwa chiwonetsero chake cha LADA, matenda a shuga amakumbukira mtundu 2, kenako amadziwika ngati matenda amtundu wa 1:

• polyuria (kukodza pafupipafupi),
• polydipsia (ludzu losatha, munthu amatha kumwa madzi mpaka malita 5 patsiku),
• kuwonda (chizindikiro chokhacho chomwe sichili chofanana ndi matenda amtundu wa 2, zomwe zikutanthauza kuti kupezeka kwake kumapangitsa kuti odwala matenda a shuga a LADA),
• kufooka, kutopa kwambiri, kuchepa kwa ntchito,
• kusowa tulo
• khungu lowuma,
• Khungu
• kubwereza pafupipafupi kwa matenda oyamba ndi fungus ndi pustular (nthawi zambiri mwa akazi - candidiasis),
• yaitali osachiritsa bala.

Matenda a shuga a mtundu wa Lada amatha kuonetsa zizindikiro kuyambira miyezi ingapo mpaka zaka zingapo. Zizindikiro zamatenda zimawonekera pang'onopang'ono. Zosintha mthupi zomwe zimayenera kuzindikira;

• polydipsia (ludzu losatha),
• polakiuria (pafupipafupi kufuna kutulutsa chikhodzodzo),
• kusokonezeka (vuto la kugona), kuchepa kwa magwiridwe antchito,
• Kuchepetsa thupi (popanda zakudya komanso katundu wochita masewera) kutengera zakumbuyo ya polyphagy (kuchuluka kwa chilakolako),
• kuchiritsidwa kwakanthawi kwa kuwonongeka kwamakina pakhungu,
• psycho-mtima kusakhazikika.

Zizindikiro zoterezi sizimapangitsa kuti odwala matenda ashuga afunefune chithandizo chamankhwala. Kupatuka kwa zisonyezo zam'magazi a plasma kumapezeka mwangozi mukamayesedwa kuchipatala kapena chifukwa cha matenda ena.

Kudziwitsa mwatsatanetsatane sikumachitika, ndipo wodwalayo amapezeka molakwika ndi matenda osagwirizana ndi insulin, pomwe thupi lake limafunikira odwala a insulin.

Zofunika! Palibe mphamvu kapena kuwonongeka chifukwa cha mapiritsi olakwika kuti muchepetse shuga, ndikofunikira kuti mupeze matenda enaake apadera.

Matenda a shuga a LADA ali ndi mawonetsedwe otsatirawa:

• polyuria, diuresis,
• kuphwanya mineral metabolism,
• chikhomo palilime, pakamwa pouma,
• kufooka, ulesi, kutopa,
• ludzu lakuya kwambiri komanso pafupipafupi
• Hyperlipidemia, hyperglycemia,
• kusanza, kusanza,
• phula, kunjenjemera, kugwedezeka,
• kudya kwambiri, polydipsia,
• Kuchulukitsa kwa matenda ena owopsa komanso owopsa,
• malungo, kuzizira,
• chizungulire, dyslipidemia,
• Fungo la acetone lochokera mkamwa,
• kuwonda popanda chifukwa,
• ketoacidosis chikomokere
• kuwonongeka kwa chakudya kagayidwe kachakudya.

Mwayi wokulirapo wa matendawa umawonedwa mwa amayi apakati omwe ali ndi matenda opatsirana a gestationalabetes. Pa avareji, 25% ya atsikana onse otere amakhala ndi matenda omwe amapita ku 1.5. Izi zimachitika nthawi yomweyo mwana akangobadwa kumene kapena patapita nthawi.

Zimadziwikanso kuti matenda a shuga a LADA amapezeka mwa anthu azaka zapakati pa 35 ndi 65, koma nsapatoyo imagwera pa nthawi ya zaka 45-55.

Kuti mumvetse bwino za matendawa, mayeso a labotale amachitidwa kuti adziwe:

• Mitundu ya C-peptide ndi chinthu chachiwiri cha insulin biosynthesis.
• Mitundu ya Anti-GAD ndi ma antibodies kupita ku enzyme yomwe ikuphatikizidwa pakupanga GABA (gamma-aminobutyric acid).
• Mlingo wa ICA - ma antibodies kupita ku maselo a kapamba.

Matenda a shuga a autoimmune akuluakulu amakhala asymptomatic kapena amawonetsa mitundu ya 2 matenda a shuga. Komabe, prediabetes imanena za mtundu woyamba wa shuga, womwe umayamba wofatsa. Zizindikiro zofanana ndi izi:

• Kutopa kwambiri
• Kukhumudwa
• Kumva njala mosalekeza.

Pamene matenda a shuga a LADA akukula, kutulutsa mphamvu kwa kapamba kumapangitsika pang'onopang'ono, zomwe zingayambitse kuwoneka kwa zizindikiro monga:

• Kutsekemera kwa mano, kumasula mano, kuwononga enamel ya mano,
• Polydipsia (ludzu kwambiri, kamwa youma),
• Kusenda ndi kusenda kwa khungu,
• Maonekedwe a zotupa pakhungu,
• Vuto lochita zogonana mwa amuna,
• Polyuria (kulimbikitsa kukodza pafupipafupi)
• Zowonongeka
• Kuwonongeka pakhungu, khungu la miyendo,
• Kuwonjezeka kwa shuga wamagazi (mpaka 5.6-6.2 mmol / l).

Ndikofunikira kuzindikira zizindikiro kumayambiriro kwa matendawa, chifukwa kupezeka ndi matenda a shuga a LADA pambuyo pake kumawonjezera mwayi wokhala ndi zovuta za matenda ashuga.

Zizindikiro za matenda am'mbuyomu ali m'njira zambiri zofanana ndi chithunzi cha chipatala chomwe chimadziwika mu mtundu 2 wa matenda ashuga. Chifukwa chake, popanga chidziwitso ndikusankha chithandizo chamankhwala, ndikofunikira kulabadira zizindikiro zomwe zimayambitsa matendawa.

1. Konda kumanga
2. Kukhalapo m'magazi a antibodies kwa cells-cell, zomwe zikuwonetsa kuti zikondamoyo zimatsutsana ndi chitetezo cha mthupi,
3. Kupita patsogolo kwa maselo
4. Chizindikiro chopanda chidwi cha kuchuluka kwa C-peptide m'magazi (ochepera 0.6 nmol / l), kuwonetsa kuchepa kwa insulin.

Mankhwala a insulin

Chithandizo chachikulu cha mankhwalawa ndikusankha Mlingo wa insulin wofanana ndi gawo la matendawa, kupezeka kwa matendawo, kulemera ndi msinkhu wa wodwalayo. Kugwiritsira ntchito koyamba kwa mankhwala a insulin kumathandizira kukhazikika kwa shuga, osadzaza ma cell a kapamba (ndi ntchito yayikulu, amawonongeka mwachangu), kusiya njira za autoimmune, ndikusunga magwiridwe antchito a insulin.

Minyewa yake ikasungidwa, zimakhala zosavuta kuti wodwalayo azikhala ndi shuga wamagulu ena ake. Kuphatikiza apo, "nkhokwe" iyi imakupatsani mwayi wochedwetsa zovuta za matenda ashuga, komanso kuchepetsa chiopsezo cha kutsika kwamphamvu kwa shuga (hypoglycemia). Kukhazikitsidwa kwa insulin koyambirira ndi njira yokhayo yolondola yothetsera matendawa.

Malinga ndi maphunziro azachipatala, chithandizo choyambirira cha insulin ndi matenda a shuga a Lada chimapatsa mpata kubwezeretsa kapamba kuti apange insulin yake, ngakhale yaying'ono. Njira zochizira, kusankha kwa mankhwala ndi kuchuluka kwake kumatsimikiziridwa ndi endocrinologist.

Kudzichitira nokha mankhwala sikovomerezeka.Mlingo wa mahomoni koyambirira kwamankhwala amachepetsedwa.

Kuphatikiza mankhwala omwe ali ndi insulin yochepa komanso yayitali.

Zakudya zamankhwala

Kuphatikiza pa mankhwala osokoneza bongo, wodwalayo ayenera kutsatira zakudya zomwe anthu odwala matenda ashuga amachita. Zakudya zaukhondo zimakhazikitsidwa ndi zakudya zamankhwala "Gawo No. 9" malinga ndi gulu la Pulofesa V.

Pevzner. Chomwe chikutsimikizidwa kwambiri menyu tsiku ndi tsiku ndi zamasamba, zipatso, chimanga ndi nyemba zokhala ndi index ya glycemic (GI) yotsika.

GI ndi gawo la kusweka kwa chakudya kulowa mthupi, kumasulidwa kwa glucose, ndi kuyamwa kwake (mayamwidwe) kuzungulira kwazinthu. Chifukwa chake, kukwera kwa GI, glucose wofulumira amalowa m'magazi ndipo kuwerenga kwa shuga kumadumpha.

Pazithunzi zazifupi zazinthu zomwe zimakhala ndi glycemic index

Ndi zoletsedwa kugwiritsa ntchito zakudya zosavuta zophatikiza ndi chakudya: zokometsera zophikira, chokoleti cha mkaka ndi maswiti, makeke ochokera puff, pastry, pastcrust past, ayisikilimu, marshmallows, kupanikizana, jamu, timadziti totsekedwa ndi tiyi. Ngati simusintha momwe mumadyera, chithandizo sichingakupatseni zotsatira zabwino.

Maphunziro akuthupi

Njira ina yofunika kwambiri yopezera matenda a shuga ndi kuchita masewera olimbitsa thupi pafupipafupi. Zochita zamasewera zimathandizira kulolerana kwa glucose, chifukwa maselo amalemeretsedwa ndi mpweya panthawi yolimbitsa thupi.

Zochita zomwe zalimbikitsidwa zimaphatikizapo masewera olimbitsa thupi, kulimbitsa thupi, kuyenda kwa Chifinishi, kusambira mu dziwe. Kuphunzitsa kuyenera kukhala koyenera kwa wodwalayo, osadzaza thupi.

Therapy imapangidwa makamaka kuti ikhale ndi kuthekera kwa maselo a pancreatic beta kuti apange insulin. Kuti muchite izi, ndikofunikira kukhala ndi moyo wathanzi, kutsatira zakudya zamafuta ochepa, komanso kuchita masewera olimbitsa thupi apadera.

Mlingo wocheperako wa insulin uyenera kumwedwa nthawi zonse. Muyenera kuwunika pafupipafupi kuchuluka kwa shuga m'thupi, ngati kuli kotheka, kusintha matendawa, osadzilimbitsa, kuwonedwa ndi endocrinologist ndikusiya zizolowezi zoyipa.

Njira izi ndizofunikira kuti zikhale bwino pakadutsa kwamatenda komanso kusungidwa kwa moyo wapamwamba komanso wathanzi mpaka ukalamba.

Popeza matendawa amatha kutchedwa kuti ulesi, chithandizo chiyenera kuyambitsidwa mwachangu pofuna kuteteza kutulutsa insulin kwathunthu ndi kapamba.

Pofuna kupewa kuchitika kwa kapamba ndi chitetezo cha mthupi, jakisoni wa insulin angakuthandizeni. Atazindikira kuti amvetsetsa matendawa, amaperekedwa kwa odwala onse, koma muyezo waukulu. Mu tsiku lonse, munthu amayenera kuwunika shuga wamagazi ndikuwonetsa.

Ndikofunikira kutsatira zakudya zamafuta ochepa. Palibe chifukwa muyenera kudya shuga ndi zinthu zomwe muli nazo. Zakudya zoyenera zimatha kugwira ntchito yayikulu pano, chifukwa chifukwa cha izi, posachedwa matenda atha kutha.

Kukhala wakhama pantchito kumathandizira odwala kulimbitsa chitetezo chathupi. Kuchita masewera olimbitsa thupi ndikuyenda mlengalenga kumakhudza machitidwe onse a thupi la munthu, chifukwa chake sitinganyalanyaze.

Matenda a shuga a Lada adzadutsa ngati maloto oyipa, ngati mutsatira malangizo onse ndi upangiri wa adotolo-endocrinologist. Zakudya zapadera zimaloleza kuti insulini iperekedwe pazambiri, ndipo mankhwalawa adzapanganso kuyesa kusunga maselo a beta, makamaka, magwiridwe antchito awo. Kuchiza kuyenera kukhala kokwanira komanso kukonzekera - iyi ndi njira yokhayo yolimbana ndi matenda amishuga a 1.5.

Matenda abwinobwino m'magawo oyambirira amachiritsidwa. Popanda chithandizo, patatha zaka zochepa matendawa amakhala ndi mawonekedwe osachiritsika, omwe amawonongetsa moyo ndi kutalika kwake.

Mwa kuukira kapamba, chitetezo chamthupi chimawononga β-cell, omwe amachititsa kuti insulini ipangidwe.Pambuyo pakuchotsa kwathunthu kwa maselo a natural-maselo, kupanga kwachilengedwe kwa insulini kutha, shuga m'magazi amadzuka ndikukhala ndi mfundo zazikulu, zomwe zimakakamiza wodwala kuti ayambe kupanga mahomoni.

Komabe, jakisoni sangathe kufananiratu kuchuluka kwa shuga m'magazi, zomwe zimayambitsa zovuta. Kuti mupewe izi, ndikofunikira kusunga insulin yopangidwa ndi ma cell a β-cell.

Chifukwa chake, pankhani ya matenda a prediabetes, ndikofunikira kuyamba jekeseni wa mahomoni ang'onoang'ono.

Chifukwa chake, njira yochizira matenda am'mbuyomu imakhazikika pa dongosolo lotsatira:

1. Mankhwala a insulin, omwe cholinga chake ndi kuletsa kukula kwa matendawa.
2. Zakudya zama carb zotsika mtengo zomwe zimafuna kuti wodwalayo asiye kwathunthu chakudya (maswiti, makeke).
3. Maphunziro azolimbitsa thupi a mphindi 30 zothandiza kuchepetsa shuga wamagazi (kusambira, kuyenda, kupalasa njinga).
4. Mankhwala osokoneza bongo - kugwiritsa ntchito mankhwala kwa nthawi yayitali (Acarbose, Metformin) kuchiritsa matendawa kwathunthu.

Chithandizo monga njira yothetsera matenda

Matenda a shuga a LADA samachedwa ndipo amatha kukhala osawoneka kwa nthawi yayitali. Chifukwa chake, chithandizo chiyenera kuyamba pomwe, monga momwe adatulukira, kuti apewe kufafaniza kwathunthu kwa insulin chifukwa cha ziwonetserozi, chifukwa chitetezo cha mthupi chimadziteteza ndikumayambitsa kufa kwa maselo a ziwalo.

Pofuna kupewa izi, jakisoni wa insulin amayikidwa nthawi yomweyo. Mukazindikira kuti vutoli likuvomerezedwa, limayikidwa muyezo waukulu, koma kwa onse odwala.

Insulin imateteza kapamba kuti asawonongeke ndi maselo ake ndi dongosolo la autoimmune. Cholinga chachikulu pakuchiritsira ndikusunga masoka a insulin mu kapamba.

Chithandizo chiyenera kukhala chokwanira. Ndikofunikira kuthana ndi kuchuluka kwa chakudya chamafuta pang'ono mthupi ndikuwerengera magawo omwe buledi wapadera amaperekedwa. Chigoba cha mkate ndimomwe amapangira chakudya. Kuchiza kumaphatikiza kudya zakudya zamafuta ochepa;

Kuphatikiza apo, chithandizo ndikuchepa kwa kutupa kwa autoimmune chifukwa chakuchepa kwa ntchito ya autoantigens. Ndipo, ndizachidziwikire, kukhala ndi shuga wabwinobwino. Pachifukwa ichi, odwala amapatsidwa mankhwala apadera omwe ali ndi shuga.

Ndikofunika kukumbukira kuti ndi matenda a shuga a LADA, sulfonylureas ndi dongo sayenera kumwedwa, Siofor ndi Glucofage amangoperekedwa kwa odwala onenepa, omwe amawoneka ndi matenda a shuga a 2, koma osati ndi matenda a shuga a LADA.

Ngati insulini yemwe wakhala akuchita kwa nthawi yayitali sangathe kuthana ndi kuchepa kwa shuga, ndiye kuti insulin yodwala mwachangu imatha "kubayidwa" musanadye.

Kuphatikiza pa chithandizo chamankhwala, amalimbikitsa kukhala ndi moyo wakhama, masewera kapena kulimbitsa thupi, hirudotherapy ndi masewera olimbitsa thupi. Njira zochiritsira zosagwiritsidwa ntchito masiku onse zimagwiranso ntchito pochiza matenda a shuga a autoimmune, koma mothandizidwa ndi adokotala.

Matenda a shuga lad ali ndi zotsatira zabwino ndi kupezeka kwake koyambirira komanso chithandizo chamanthawi. Ndikofunikira kutsatira malangizo ndi malingaliro onse a endocrinologist ndikukhala ndi moyo wakhama. Ngati musamalitsa zakudya, ndiye kuti insulini ingafunike pazofunikira zochepa. Ndipo pokhapokha mutachira kwathunthu matendawa.

Tsoka ilo, kwa odwala matenda a shuga a Lada, kuyambitsa insulin sikungapewereke. Madokotala amapereka malingaliro omwe akuphatikizira kuyamba mankhwala a insulin nthawi yomweyo. Ndi kuzindikira koyenera kwa matenda amtunduwu, njira zamankhwala zochizira zimadalira pa mfundo iyi ya chithandizo.

Anthu omwe ali ndi matenda a Lada amafunika kudziwa matendawa asanapezeke, komanso kupezeka koyambirira kwa chithandizo choyenera, makamaka, kuyambitsa insulin.

Izi zimakhazikitsidwa chifukwa chakuti pali kuthekera kwakukulu kwa kusowa kwa kapangidwe kake kawini ka thupi m'thupi. Kuphatikiza apo, kuchepa kwa mahomoni nthawi zambiri kumalumikizidwa ndi insulin kukaniza maselo.

Palibe njira yatsopano yomwe idapangidwira kuchitira mtundu wa matenda osokoneza bongo omwe aphunzitsidwa bwino.Pankhani imeneyi, madokotala amalimbikitsa kuphatikiza mapiritsi kuti muchepetse shuga panjira ya mankhwalawo, komanso mankhwala othandizira kuti tizilimbitsa minyewa yathu ikhale yofikira.

Zolinga zazikulu za mankhwala:

• Kuchepetsa katundu pa kapamba.
• Kuletsa kwa kayendedwe ka autoimmune m'thupi.
• Matenda a shuga a magazi pamlingo wovomerezeka.

Lada akapezeka ndi matenda, dokotala amamulembera mankhwala ochepetsa mphamvu ya insulin. Ngati mungadumphe gawo ili, kapena dokotala sanazindikire matenda enaake, ndiye kuti m'kupita kwa nthawi mudzafunika mulowetse mitundu yayikulu kwambiri ya mahomoni.

Mfundo zazikuluzikulu zochizira matenda a shuga a Lada:

1. Kutsatira zakudya zamafuta ochepa.
2. Kukhazikitsa insulin yaying'ono Mlingo.
3. Kuwongolera shuga.
4. Zochita zolimbitsa thupi zokwanira.

Zolinga za glucose pamimba yopanda kanthu siziyenera kupitirira zovomerezeka zamitundu 5.5. Kuphatikiza apo, shuga sayenera kutsikira kuposa mayunitsi 3.8.

Ngati wodwalayo atsatira malangizo onse a dokotala, akudya moyenera, ndiye kuti adzafunika ndi insulin yaying'ono. Zomwe zimathandizanso kuti magawo a pancreatic beta apangidwe.

Ndizololedwa kuphatikiza chithandizo chamankhwala ndi njira zina, koma pokhapokha ndi chilolezo cha adokotala. Zitsamba zomwe zimachepetsa shuga ya magazi zimathandizira kukonza wodwala, komanso kupewa zovuta.

Kodi mukuganiza bwanji pamenepa? Kodi munachita chiyani ndi matenda a shuga a LADA? Gawani ndemanga ndi malingaliro anu kuti mugwirizizire kuwunikaku!

Matenda opatsirana

Zotsatira zake komanso kutha kwa mawonekedwe awo zimatengera kutalika kwa matenda ashuga. Mavuto akulu amtundu wa LADA, monga ena, akuphatikizapo:

• matenda a mtima dongosolo (matenda a mtima, matenda a mtima, sitiroko, mtima wamatenda a mtima),
• matenda amanjenje (polyneuropathy, dzanzi, paresis, kuwuma pamayendedwe, kulephera kuyendetsa kayendedwe ka miyendo),
• matenda amaso (kusintha kwamatumbo a fundus, retinopathy, kuwonongeka kwa khungu, khungu),
• matenda a impso (diabetesic nephropathy, kuchuluka kwa mapuloteni mu mkodzo),
• diabetesic phazi (zolakwika zamatenda am'munsi, gangrene),
• zotupa zapakhungu komanso zotupa za pustular.

Kodi mungatsimikizire bwanji za matendawo?

Kwa matenda a labotale shuga ya autoimmune mu akulu amagwiritsa ntchito mayeso awiri.

1) Kutsimikiza kwa mulingo anti-gad - glutamate decarboxylase antibodies . Zotsatira zoyipa (i.e., kusowa kwa ma antibodies kuti glutamate decarboxylase m'magazi) kumathetsa LADA. Zotsatira zabwino (makamaka ndi kuchuluka kwa ma antibodies) ambiri (!) Milandu imalankhula mokomera LADA.

Kuphatikiza apo, ndikungoneneratu za kupita patsogolo kwa LADA komwe kumatsimikizika ICA - Ma antibodies kuti ma islet cell kapamba. Kupezeka kwakofanana kwa anti-GAD ndi ICA ndi mawonekedwe amitundu yayikulu kwambiri ya LADA.

2) Tanthauzo mulingo wa peptide (pamimba yopanda kanthu komanso pambuyo kukondoweza ) C-peptide ndi chinthu chopangidwa ndi insulin biosynthesis ndipo motero zonse zimagwirizana molingana ndi insulin. Mwa mtundu wa matenda ashuga a mtundu wa Type (komanso a LADA nawonso, popeza LADA ndi mtundu wocheperako wa matenda a shuga I amadziwika nawo) kuchuluka kwa C-peptide .

Poyerekeza: ndi matenda a shuga a mtundu II, oyamba anazindikira insulin kukana (minyewa ya kuketekela ku insulin) ne compensatory hyperinsulinemia (kuti achepetse kuchuluka kwa shuga, kapamba amachititsa kuti inshuwaransi ikhale yogwira kwambiri kuposa momwe zimakhalira), chifukwa chake, matenda amtundu wa II, kuchuluka kwa C-peptide sikuchepetsedwa.

Chifukwa chake, pakalibe anti-GAD, kupezeka kwa LADA kumatha. Pamaso pa anti-GAD + otsika kwambiri a C-peptide, kuwunika kwa LADA kumawerengedwa ngati kutsimikiziridwa. Ngati pali anti-GAD, koma C-peptide ndiyachilendo, kuwunikira kowonjezereka ndikofunikira.

Ndi matenda okangana, LADA imawonetsa kupezeka kwakukulu zolembera mtundu wa I matenda ashuga (), popeza mtundu uwu wa matenda a shuga sunapezeke mu mtundu II wa matenda ashuga. Nthawi zambiri, panali kulumikizana ndi antigen ya B8 HLA, ndipo sipanakhale mgwirizano uliwonse ndi antigen "yoteteza" HLA-B7.

Ichi ndi chiyani

Matenda amtunduwu amasowa ngati latent kapena latent. Dzinalo lina ndi "Matenda a shuga [1.5]. Awa si nthawi yovomerezeka, koma akuwonetsa kuti fret ndi mtundu wina wa matenda ashuga amtundu wa 2 omwe ali ndi mawonekedwe ena a shuga 2. Monga mtundu wa matenda ashuga amtundu 1, fret amatanthauzidwa ngati matenda a autoimmune momwe chitetezo chathupi chimagwirira ndikupha maselo opanga insulin. Ndipo mtundu 2 umasokonezeka chifukwa fret imayamba kwakanthawi kotalikirapo kuposa mtundu woyamba wa shuga.

Zinayamba kusiyanitsidwa kuchokera ku mtundu wachiwiri waposachedwa, asayansi adazindikira kuti shuga iyi imasiyana kwambiri ndipo iyenera kuthandizidwa mosiyanasiyana. Mpaka mtunduwu utadziwika, chithandizo chinkachitika ngati matenda amtundu wa 2, koma insulin sikuyenera kuperekedwa pano, ngakhale izi ndizofunikira kwambiri ku matenda a shuga a LADA. Mankhwalawa anaphatikizaponso mankhwala omwe ankalimbikitsa maselo a beta kuti apange insulin. Koma nthawi yamatendawa, amakhala okhumudwa kale, ndipo adakakamizidwa kugwira ntchito mpaka pamapeto. Izi zidabweretsa zotsatira zoyipa:

• maselo a beta adayamba kugwa
• kupanga kwa insulin kwachepa
• nthenda ya autoimmune yayamba
• ma cell anafa.

Kukula kwa matendawa kunatha zaka zingapo - kapamba anali atatsirizika, kunali kofunikira kuperekera insulini yayikulu muyezo ndikuyang'anira kudya mosamalitsa. Apa ndipomwe asayansi akuganiza kuti akuchiritsa matenda osokoneza bongo.

Matenda a shuga a Lada amafunika insulin yowonjezera. Ndi njira yake yaulesi, maselo a kapamba amasokonezeka, kenako nkufa.

Subtypes zamtundu I shuga

Pali mitundu iwiri yanthete yomwe ndimayikamo:

• matenda a shuga ana (ana ndi achinyamata) = subtype 1a,
• subtype 1b, izi zikugwiranso ntchito Lada (shuga ya autoimmune mu akulu). Olekanitsa chidziwitso Mtundu I shuga.

Matenda a shuga (subtype 1a) amakhala ndi 80-90% ya milandu ya matenda a shuga am'mbuyomu. Ziyenera chosalimba antiviral chitetezo chokwanira wodwala. Ndi subtype 1a, ma virus angapo (Coxsackie B, nthomba, adenoviruses ndi ena) amawononga ma virus mu ma cell a kapamba. Poyankha, ma cell a chitetezo cha mthupi amawononga ma cell omwe amakhudzidwa ndi ziphuphu za kapamba. Autoantibodies kuti islet minofu ya kapamba (ICA) ndi insulin (IAA) imayenda mu magazi nthawi iyi. Chiwerengero cha ma antibodies (titer) m'magazi pang'onopang'ono amachepetsa (amapezeka mu 85% ya odwala kumayambiriro kwa matenda ashuga komanso mwa 20% patatha chaka). Subtype iyi imachitika masabata angapo atatenga kachilombo ka ana ndi achinyamata ochepera zaka 25. Chiyambicho chimakhala chamkuntho (odwala amalowa mu chisamaliro chochepa mu masiku angapo, komwe amapezeka). Nthawi zambiri pamakhala B15 ndi DR4.

Lada (subtype 1b) amapezeka mu 10-20% ya milandu ya matenda a shuga am'mbuyomu. Izi subtype za matenda ashuga ndi chimodzi mwazinthu zowonetsera njira ya autoimmune m'thupi ndipo chifukwa chake nthawi zambiri zimaphatikizidwa ndi matenda ena a autoimmune. Zimachitika nthawi zambiri mwa akazi. Ma Autoantibodies amayendayenda m'magazi nthawi yonse ya matendawa, gawo lawo (gawo) limakhala lokhazikika. Awa ndi anti-GAD antibodies kuti glutamate decarboxylase, chifukwa IA-2 (antibodies to tyrosine phosphatase) ndi IAA (kuti insulini) ndizosowa kwambiri. Izi subtype za shuga ndi chifukwa kutsika kwa T-suppressors (mtundu wa lymphocyte womwe umachepetsa mayankho a chitetezo mthupi motsutsana ndi ma antijeni a mthupi ).

LADA-shuga pogwiritsa ntchito limagwirira limatanthauzira mtundu I shuga, koma zizindikiro zake ndizofanana ndi matenda amtundu II shuga (kuyambira pang'onopang'ono ndi koyerekeza ndi matenda ashuga). Chifukwa chake, matenda a shuga a LADA amawoneka ngati apakatikati pakati pa mtundu woyamba wa matenda a shuga ndi mtundu II. Komabe, kutsimikiza kwa kuchuluka kwa ma autoantibodies ndi C-petid sikuphatikizidwa pamndandanda wanthawi zonse wamatenda a wodwala yemwe ali ndi matenda ashuga, ndipo matenda a LADA ndi osowa kwambiri. Nthawi zambiri, kulumikizana ndi HLA antijeni B8 ndi DR3 kumadziwika.

At chidziwitso mtundu I shuga mellitus palibe kuwonongeka kwa autoimmune kwa maselo a beta, komabe pali kuchepa kwa ntchito yawo ndi kufafaniza katemera wa insulin. Ketoacidosis imayamba. Matenda a shuga a Idiopathic amapezeka makamaka ku Asia ndi ku Africa ndipo ali ndi cholowa chowonekera.Kufunika kwa mankhwala a insulini mwa odwala oterewa kumatha kuwoneka ndikutha pakapita nthawi.

Kuchokera munkhani yonseyi ndikofunikira kukumbukira mfundo zochepa.

1. Matenda a shuga a LADA sadziwika pakati pa madokotala (mawuwa adapezeka mu 1993) choncho samapezeka kawirikawiri, ngakhale amapezeka 2-15% ya anthu odwala matenda ashuga a mtundu II.
2. Chithandizo cholakwika ndi mapiritsi ochepetsera shuga amatsogolera mofulumira (pafupifupi zaka 1-2) pancreatic kufooka ndi kusamutsa mokakamiza ku insulin.
3. Chithandizo chochepa cha insulin choyambirira chimathandizira kuletsa kupitilira kwa njira ya autoimmune ndikusunga chinsinsi chotsalira cha insulin.
4. Chotsalira cha insulin chobisalira chimafewetsa njira ya matenda a shuga ndikuchinjiriza pamavuto.
5. Ngati mwapezeka kuti muli ndi matenda a shuga a mtundu II, dzifufuzeni njira zisanu za matenda a shuga a LADA.
6. Ngati njira ziwiri kapena zingapo zili zabwino, matenda a shuga a LADA ali ndi mwayi komanso C peptide ndi ma antibodies kuti glutamate decarboxylase (anti-GAD) ayesedwe.
7. Ngati anti-GAD komanso otsika a C-peptide (oyambira komanso oyambitsa) apezeka, muli ndi matenda a shuga a autoimmune akuluakulu (LADA).

Momwe mungasiyanitsire matenda a shuga a LADA?

Pali zinthu zina zomwe ziyenera kupangitsa madotolo kuganiza kuti akukumana ndi wodwala yemwe ali ndi matenda ashuga, osati ndi matenda a shuga a mtundu wa 2. Izi ndi monga:

• kusowa kwa metabolic syndrome (kunenepa kwambiri, kuthamanga kwa magazi komanso kuthamanga kwa cholesterol),
• hyperglycemia yosalamulira, ngakhale akugwiritsa ntchito pakamwa.
• kukhalapo kwa matenda ena a autoimmune (kuphatikizapo matenda a Graves 'and anemia).

Odwala ena omwe ali ndi matenda osokoneza bongo amatha kudwala matenda a metabolic, omwe angapangitse kwambiri kapena kuchedwetsa kupezeka kwa matenda amtunduwu.

Zoyambitsa ndi zizindikiro

Pali zifukwa zingapo zomwe zimapangitsa kuti munthu akhale ndi matenda ashuga:

• M'badwo. Anthu ambiri (75%) okalamba ali ndi matenda ashuga, omwe amakhudza dongosolo lofooka la endocrine.
• Kukhalapo kwa kunenepa kwambiri. Matenda a shuga amawoneka ndi zakudya zosayenera, chifukwa chomwe njira za metabolic m'thupi zimasokonekera.
• Zowonongeka kwa kapamba. Ngati panali matenda oyambitsidwa ndi omwe kuphulika kwakukulu kunayikidwa pa kapamba.
• Kutengera kwa chibadwa cha matenda ashuga. Banja lili ndi abale amwazi omwe ali ndi matenda ashuga.
• Mimba Zitha kupangitsa kuti matenda ashuga apitilize, makamaka chifukwa cha chibadwa cham'mimba, choncho mayi woyembekezera ayenera kulembetsa nthawi yomweyo ndikuyang'aniridwa ndi madokotala.

Popeza matenda ashuga ndiwosasintha, ndizobisalira, nkovuta kudziwa. Komabe pali zizindikiro zina. Izi zikuphatikiza:

• kuwonda mosayembekezereka kapena kuwonda,
• Kuuma ndi kuyabwa kwa pakhungu,
• kufooka ndi malaise
• kufuna kumwa nthawi zonse,
• pali chikhumbo chosalekeza
• nebula wa chikumbumtima
• kukodza pafupipafupi
• womvera
• shuga wamagazi ambiri
• kuzizira komanso kunjenjemera.

Matenda a shuga awa ali ndi zizindikiro zofanana ndi matenda amtundu wa 2, maonekedwe awo okha sadziwika.

Njira zoyesera

Njira zotsatirazi zoyenera kutsata ziyenera kuchitidwa kuti mupeze matenda a shuga a LADA:

1. Yesani magazi kuti mupeze shuga. Wodwala sayenera kudya osachepera maola 8 asanakudziwe. Kuchuluka kwa mitengo kumaonetsa matenda.
2. Chitani kafukufuku wa glycemic. Phunziro lisanachitike, tikulimbikitsidwa kumwa kapu yamadzi okoma. Kenako kuyezetsa magazi kumatengedwa. Chizindikiro sichikuyenera kupitilira 140 mg pa desilita iliyonse. Ngati chiwerengerochi ndi chachikulu, ndiye kuti matenda am'mbuyomu amadziwika.
3. Chitani kafukufuku wa hemoglobin wa glycated. Ngati Zizindikiro zoyambirira zikuwonetsa shuga m'magazi pakadali pano, ndiye kuti amayesedwa kwa nthawi yayitali, ndiye kuti kwa miyezi ingapo.
4. Kuyesa kwa ma antibodies.Ngati zizindikirazo zikupitilira muyeso, izi zikuwonetsanso matendawa, chifukwa zimatsimikizira kuphwanya kuchuluka kwa maselo a beta mu kapamba.

Kodi kuchitira?

Cholinga cha mankhwalawa ndikuchedwa kuchedwetsa mavuto omwe amabwera chifukwa cha chitetezo cha mthupi pama cell a pancreatic omwe amapanga insulin. Chachikulu ndikuwonetsetsa kuti wodwalayo ayambe kupanga insulin yake. Kenako wodwalayo amatha kukhala ndi moyo wautali wopanda mavuto.

Nthawi zambiri, chithandizo cha matenda a shuga a fret chimagwirizana ndi chithandizo cha matenda amtunduwu 2, motero wodwala ayenera kutsatira zakudya zoyenera komanso kuchita masewera olimbitsa thupi. Kuphatikiza apo, insulin imayikidwa muyezo waukulu.

Udindo wawukulu wa mahandawo ndikuthandizira maselo a beta kuti asawonongedwe ndi kusatetezeka kwawo, ndipo gawo lachiwiri ndikuwonetsetsa kuti shuga ali ndi vuto lililonse.

Chithandizo chagona pamalamulo otsatirawa:

1. Zakudya . Choyamba, ndikofunikira kutsatira zakudya zopanda chakudya chambiri (kupatula zoyera, zophika ndi pasitala, maswiti, chakudya chofulumira, zakumwa za kaboni, mtundu uliwonse wa mbatata kuchokera pachakudya). Werengani zambiri pa zakudya zamafuta ochepa.
2. Insulin . Gwiritsani ntchito insulin yocheperako, ngakhale shuga atakhala yachilendo. Wodwalayo ayenera kuwunika shuga. Kuti achite izi, ayenera kukhala ndi mita yake kuyeza shuga kangapo patsiku - asanadye, pambuyo pake, ngakhale usiku.
3. Mapiritsi . Ma sulfonylureas ndi mapiritsi opangidwa ndi dongo sagwiritsidwa ntchito, ndipo Siofor ndi Glucofage savomerezeka kulemera wamba.
4. Maphunziro akuthupi . Odwala omwe ali ndi thupi labwinobwino amalimbikitsidwa kuchita masewera olimbitsa thupi pakulimbikitsa kwathunthu thanzi. Ndi kunenepa kwambiri kwa thupi, muyenera kuzolowera zovuta zomwe mungachite kuti muchepetse kunenepa.

Chithandizo choyambitsidwa moyenera chithandiza kuchepetsa katundu pa kapamba, kuchepetsa ntchito za autoantigenic kuti muchepetse kutupa kwa autoimmune ndikusunga kuchuluka kwa shuga.

Makanema okambirana

Mu kanema wotsatira, katswiriyu adzalankhula za matenda a shuga a LADA - matenda a autoimmune mu akulu:

Chifukwa chake, matenda a shuga a LADA ndi mtundu wobiriwira wa shuga womwe umavuta kuzindikira. Ndikofunikira kwambiri kuzindikira mtundu wa shuga wa fret munthawi yake, kenako ndikamayambitsa ngakhale mlingo wochepa wa insulin, mkhalidwe wa wodwalayo ungasinthidwe. Mwazi wamagazi uzikhala wabwinobwino, zovuta zapadera za matenda ashuga zitha kupewedwa.

Matenda a shuga ndi amitundu iwiri: mtundu woyamba ndi wachiwiri. M'mbuyomu, milandu iyi inali chowonadi chosasinthika, koma tsopano tikuyenera kusintha zikhulupiriro. Chifukwa madokotala apeza mtundu wina wa matenda. Amatchedwa matenda a shuga a lada.

LADA - mukatsitsa mbiri, mumakhala ndi shuga ya autoimmune, yomwe imapezeka mwa akulu. Zizindikiro zina zamtunduwu, zoyambirira ndi zachiwiri za matendawa, ndizoyenera kwa iye. Matenda a shuga a LADA amawonekera kwambiri mwa odwala kuyambira azaka 35 mpaka 65.

Kukwera kwa shuga sikuphatikizidwa. Zizindikiro zake zimakhala zofanana ndi matenda a shuga a mtundu wachiwiri. Madotolo amabwera, kudzapereka chidziwitso cholakwika. Mwambiri, LADA ndi mtundu woyamba wa matenda ashuga, koma mwanjira yosavuta.

Matenda a shuga a LADA - amafunikira chithandizo chapadera. Matendawa sangathe kuthandizidwa monga momwe amachitira wachiwiri, chifukwa patatha zaka zitatu kapena zinayi mutha kukhala pa insulini. Matendawa amayambanso kukulira, munthu amamulembera mankhwala ambiri. Kuchokera pamenepa, zomwe zili shuga sizisintha. Odwala amafa msanga.

M'dziko lathu, muli anthu mamiliyoni angapo omwe ali ndi matenda ashuga a 2. Koma ena mwaiwo ndi onyamula matenda a shuga a LADA, ndipo iwonso sakudziwa za izi. Ndipo izi zimawopseza munthu mavuto oyipa. Chimodzi mwazifukwa zosadziwika bwino ndikuti madokotala ambiri sazindikira mtundu uwu wa matenda ashuga.

Zobisika zimabisika. Kumayambiriro kwa matendawa, Zizindikiro sizowonekera nthawi yomweyo, ndiye kuti mayeso amachedwa. Mtundu wachiwiri wa matenda ashuga, ulinso ndi njira yomwe imadziwonetsa yokha.

Kuzindikira koyenera

Matenda a shuga a LADA kapena matenda a shuga 2 - kusiyana kwawo ndi kuwazindikira. Ma endocrinologists ena saganiza zambiri za matenda awo, chifukwa sakudziwa za kukhalapo kwa matenda oyamba. Munthu akapanda kunenepa kwambiri, ndipo shuga amadzuka, ndiye kuti ichi ndi matenda a shuga a LADA, osati chachiwiri. Chifukwa chake, akatswiri azachipatala ayenera kuyang'ana nkhaniyi mozama. Popeza chithandizo pankhaniyi ndi chosiyana.

Mukakhala ndi matenda a shuga a 2, mumalandira mapiritsi omwe amakhala ndi shuga. Koma mankhwalawa ndi owopsa kwa odwala matenda ashuga a II, chifukwa akabzala kapamba. Ndipo kwa odwala amtundu wina, amachita zinthu zoipa kwambiri. Popeza chitetezo cha mthupi lawo chimavulaza England, komanso mapiritsi. Ichi ndichifukwa chake ma cell a beta atha. Ndipo patatha zaka zitatu, odwala matenda ashuga amayamba kutenga jekeseni wamkulu wa insulin. Ndipo palibe chabwino.

Kusiyana pakati pa matenda a shuga a LADA ndi mtundu wachiwiri:

• Anthu odwala matenda ashuga alibe zovuta zokhala onenepa kwambiri, onse ali ndi chithunzi chabwino.
• Peptide-C, yomwe ili m'magazi m'munsi kwambiri kuposa masiku onse.
• Ma antibodies kuma cell a beta amawoneka. Izi zikutsimikizira kuti kapamba sakhudzidwa bwino.
• Mutha kuyeserera ma genetic omwe akuwonetsa kuukira. Koma ndiokwera mtengo kwambiri. Chifukwa chake, mutha kugwiritsa ntchito njira zina.

Koma chizindikiro chachikulu cha matendawa ndi kunenepa. Wodwala akakhala ndi shuga wamagazi ambiri, komanso kuti ndiine wosakwanira, wowonda ndiye kuti izi sizabwino. Koma kuti mutsimikizire izi, pitani peptide-C yowunika. Mutha kuyesanso ma antibodies, koma ndi okwera mtengo.

Anthu onenepa nawonso ali ndi matenda a shuga a LADA. Pankhaniyi, amafunikiranso kuyesedwa. Odwala onse odwala matenda ashuga a 2 omwe ali onenepa kwambiri ayenera kuwunika. Ma antibodies akapezeka mwadzidzidzi, kumwa mapiritsi kumaletsedwa. M'malo mwake, ayenera kudya zakudya zamagulu ochepa.

Kuchiza matenda a shuga a LADA

Tsopano muyenera kumvetsetsa zovuta zochizira matenda amtunduwu. Cholinga chake ndi chitetezo cha insulin yopangidwa ndi kapamba. Ngati zitheka, ndiye kuti munthuyo akhala ndi nthawi yayitali ndipo amakhala ndi mavuto ochepa azaumoyo.

Ndi mtundu uwu wa matenda ashuga, jakisoni wa chipangidwacho mumagwiritsidwa ntchito pang'ono. Pofuna kuti zisatenge nthawi yayikulu. Insulin imateteza kapamba ku zotsatira za chitetezo chamthupi.

Malangizo a matenda a shuga a LADA:

Zakudya zomwe zimakhala ndi mafuta ochepa zimapangitsa kuti matendawa akhale pamzere. Ndipo kenako masewera olimbitsa thupi, insulin ndi mankhwala osokoneza bongo. Matenda a shuga a LADA ndi matenda omwe amafunikira insulin. Ngakhale mutakhala ndi kuchuluka kwa shuga m'magazi, simuyenera kusiya kubaya. Zowona, yaying'ono Mlingo.

Ndi matenda a shuga amtunduwu, shuga wamagazi amakhala ndi 4,6 mpaka 6 mmol / L pamimba yopanda kanthu ndikatha kudya. Koma siyenera kugwera pansi pa 3.5 mmol / l.

Chithandizo cha matenda a shuga a LADA chimayamba ndi jakisoni wowonjezera wa insulin. Ngati wodwalayo akhazikika, ndipo ali ndi chakudya chochepa m'thupi, ndiye kuti kuwombera pafupifupi kumapezeka. Komanso, odwala matenda amtundu wa 3 si onenepa kwambiri. Munthu wochepa thupi amakhala ndi insulin yaying'ono. Ngati mukufuna kukhalabe ndi zochitika zapadera za pancreatic, simuyenera kuphonya jakisoni wa insulin. Potere, munthu amatha kukhala ndi moyo mpaka kukalamba kwambiri, popanda mavuto a mtima, shuga imatsika.

Zotsatira zoyipa zamankhwala

Mankhwala osokoneza bongo okhudzana ndi dongo komanso sulfonylureas amavulaza thanzi la wodwalayo. Amapangitsa kuti zikondamoyo zanu zikhale zochepa. Maselo a Beta amayamba kufa mwachangu.

Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri, osalandira chithandizo choyenera, kapamba amawonongeka zaka khumi ndi zisanu. Ndipo ngati wodwala akudwala matenda a shuga a LADA - wazaka zinayi.

Chinthu chachikulu, ngakhale muli ndi matenda ashuga, musameza mapiritsi owononga. Bwino kudya zakudya zowonjezera zomwe zimakhala ndi chakudya chambiri.

Zomwe tinganene:

Matenda a autoimmune Izi ndi matenda omwe maselo omwe amateteza thupi (omwe amatetezedwa kuteteza thupi) amasokonezeka posankha mdani ndikuyamba kuwononga osati ma virus ochepa, koma maselo a thupi lawo.

Chitetezo cha mthupi chimateteza ku mabakiteriya, ma virus, poizoni, maselo osavulaza m'thupi. Imazindikira ma antigen (zinthu zakunja) ndikupanga ma antibodies motsutsana nawo (mapuloteni apadera). Zimachitika kuti chilema chikuwoneka m'thupi lanu, chimayamba kuwona maselo ena a thupi lake ngati ma antigen (zinthu zakunja) ndikuziwononga. Pankhani ya matenda a shuga a mtundu woyamba, ma cell a beta-cell a kapamba (ma cell omwe amapanga insulin) amagwidwa.

Chifukwa chiyani chitetezo chamthupi chikuyamba kugwira ntchito?

Sizikudziwika kwenikweni. Pali malingaliro ambiri, ndizotheka kuti mabakiteriya, ma virus, mankhwala, mankhwala amatha kuyambitsa chisokonezo mu ntchito yake.

Kodi zolimbana ndi chitetezo chamthupi zitha kukhala ndi chiyani?

Kuukira kungaphatikizeponso:

Maselo ofiira

Matenda ofala kwambiri a autoimmune.

Matenda a Addison - ma antibodies amawongolera motsutsana ndi gren adrenal, mahomoni awo amasokonezeka.

Matenda a Celiac - thupi silitenga chinthu chapadera, gluten. Gluten ikalowa m'matumbo ang'onoang'ono, imayambitsa kuyankha kwa mthupi ndi kutupa m'matumbo. Zotsatira zake, kuyamwa kwa zinthu zina kumavulala.

Matenda A Manda - ntchito ya chithokomiro chithokomiro imapangidwa ndi ma antibodies apadera, kutulutsidwa kwa mahomoni a chithokomiro kumawonjezeka.

Autoimmune chithokomiro (AIT) kapena chithokomiro cha Hashimoto's - chithokomiro cha chithokomiro chimawonongedwa ndipo, monga lamulo, chikhalidwe chotchedwa hypothyroidism (kuchepa kwa glandular function) chimachitika, ndiko kuti, mahomoni a chithokomiro ndi ochepa kapena sapezeka m'thupi.

Multiple sclerosis - Kuukira kwamthupi kumayendetsedwa ku ma sheels a myelin omwe amateteza ulusi wamitsempha.

Matenda a mafupa - chitetezo cha mthupi chimasokeretsedwa, ndikuganiza kuti matenda omwe adalowapo kale (nyamakazi) akadalipo ndikuwononga zimakhala zathupi zathupi.

Rheumatoid nyamakazi - chitetezo chitetezo mthupi.

Pankhani ya matendawa, momwe zinthu ziliri mosiyana, ntchito ya gland ikhoza kuchepa. Maselo a chitetezo chamthupi amawononga chithokomiro ndipo amatha kulephera kupanga ma mahomoni, omwe amatha kudziwonetsa ndi zizindikiro zotsatirazi:

Kuzindikira kuzizira

Kusintha Kwa Umunthu (Kukhumudwa)

Goiter (chotupa chachikulu cha chithokomiro)

Pankhani ya hypothyroidism, ndikofunikira kutenga mahomoni a chithokomiro mwanjira ya mapiritsi. Koma palibe mavuto kuchokera kwa oyang'anira (ngati mlingo wa mankhwalawo umasankhidwa molondola). Kamodzi miyezi isanu ndi umodzi, zidzakhala zofunikira kuwunika mtengo wa mahomoni a TSH.

Zotsatira za matenda a chithokomiro pa matenda ashuga.

Matendawa amatha kuthana ndi chidwi chanu komanso kagayidwe kake, kamene kamayambitsa matenda a shuga m'magazi anu. Chifukwa chake, ndikofunikira kuzindikira matendawo mwachangu.

Kusowa kwa adrenal kuchepa (matenda a Addison).

Tizilombo ta adrenal ndi ziwalo zophatikizika zomwe zimakhala pamwamba pa impso. Amapanga mahomoni ambiri omwe amayang'anira ntchito zambiri m'thupi lathu.

Matenda a Addison ndi matenda a autoimmune, omwe amatengera kugonjetsedwa kwa adrenal cortex ndi maselo chitetezo. Kupanga kwa mahomoni kumasokonezeka ndipo zizindikiro zotsatirazi zikuwonekera:

Mawonekedwe am'mimba (nseru, kusanza, kusowa kwa chakudya, kupweteka pamimba)

Kuchepetsa thupi

Kuthamanga kwa magazi

- "Tan" (Hyperpigmentation) wa pakhungu ndi mucous nembanemba

Chizungulire posintha mawonekedwe a thupi

Mkulu potaziyamu

Cortisol yotsika, aldosterone

Kuchuluka kwa ACTH

Nthawi zambiri pamakhala kuperewera kwa chilengedwe kwa adrenal, komwe kumadziwonetsera pakakhala zovuta kwa thupi. Pali mayeso ena omwe angadziwitse inu pasadakhale.

Muyenera kutenga mankhwalawa m'malo mwake, mahomoni amasankhidwa mu mlingo wa munthu, pamavuto, chimfine, maopaleshoni, kuchuluka kwa mahomoni kumawonjezeka.

Matenda a shuga ndi matenda a Addison.

Pafupipafupi pamikhalidwe ya hypoglycemic imachulukanso, kufunika kwa insulin kumachepa. Ngati muzindikira kuti zoterezi zili kunyumba, muyenera kudziwitsa dokotala za nkhaniyi munthawi yake.

Malo oyera amatuluka m'malo osankhidwa khungu. Mtundu wa melatonin, womwe umasokoneza khungu, umasowa. Vitiligo sikhala ndi choopsa chilichonse (kupatula kuti madera akhunguwo amawotcha dzuwa), chilema chokha. Koma pamaso pa vitiligo, chiopsezo cha matenda aliwonse a autoimmune chikukula.

Ichi ndi matenda omwe nembanemba ya mucous yaing'onoting'ono imawonongeka ndi gluten (kwa chitetezo cha m'thupi, chinthuchi chimakhala mdani). Gluten ndi mapuloteni omwe amapezeka mumbewu: rye, tirigu, barele. Popeza matumbo a m'mimba amawonongeka, chakudya sichigaya bwino.

Zizindikiro zake ndi ziti?

Kupweteka kwam'mimba, kusasangalala

Koma zizindikilo zimatha kukhala zofatsa zokwanira. Mu ana, matenda a celiac amayamba kuonekera pamene chimanga chimalowetsedwa mu zakudya.

Kodi zomwe zimayambitsa matendawa ndi ziti?

Gluten ili ndi zigawo ziwiri: gliadin ndi glutenin. Kufika m'matumbo aang'ono, kumayambitsa chitetezo cha mthupi. Chitetezo cha mthupi chimalimbana ndi villi ya m'matumbo aang'ono (momwe kuphatikizira kwa michere kumachitika), kutupa kumayamba mwa iwo ndikufa. Nthawi yomweyo, michere ina singathenso kumezedwa bwino ndi matumbo a villi, omwe amabweretsa mavuto ena.

Matenda a celiac atha kubadwa (ngati banja lili ndi munthu yemwe ali ndi matendawa, ndiye kuti matenda a celiac mwa inu amawonjezeka ndi 10%).

Kodi njira zowunikira ndi ziti?

Muyenera kuyezedwa ndi dokotala wa gastroenterologist. M'pofunika kudziwa mulingo wa antigliadin antibodies, malinga ndi zikuwonetsa - kuchita biopsy yamatumbo mucosa.

Chibale cha mtundu 1 wa matenda ashuga komanso matenda a celiac.

Pamaso pa matenda a shuga 1, ndikofunikira kuyesedwa kwa matenda a celiac, matendawa amapezeka limodzi palimodzi. Ndikofunikanso kukumbukira kuti ndi matenda a celiac, kuyamwa kwa mafuta osokoneza bongo kumasokonekera, komwe kungayambitse hypoglycemia.

Kodi ndiyenera kudya chiyani ngati ndili ndi matenda osokoneza bongo komanso matenda a shuga 1?

Lamulo lopanda zakudya za gluten liyenera kutsatiridwa. Ndikofunikira kupatula magwero ambiri a chakudya: mkate, pasitala, chimanga, makeke ndi makeke.

Zovuta zazikulu posankha chakudya?

Gluten akhoza kubisidwa muzinthu zomwe zimawoneka ngati "zotetezeka".

Ndikofunikira kuphika pasadakhale

Mtengo wazopanda zinthu zamafuta (nthawi zambiri zimakhala zokwera mtengo)

Ndi matendawa, muyenera kuwunika mosamala zakudya zanu.

Anthu omwe ali ndi matenda amtundu woyamba ali pachiwopsezo cha matendawa. Ndi nyamakazi, chitetezo cha mthupi chimawononga cartilage, minofu yozungulira mafupa, kayendedwe kazinthu zolumikizana.

Anthu omwe ali ndi majini ena amatha kukhala ndi matenda ashuga komanso nyamakazi. Mitundu iyi ndi:

Zizindikiro za nyamakazi.

Mawonetsero ofunikira kwambiri ndikutukuka kwa zotupa mkati, zomwe zimakhala zowawa komanso zowuma. Minyewa yolimba m'mawa, yomwe imakhala yopitilira mphindi 30, imatha kuwonetsa kukhalapo kwa nyamakazi.

Nthawi zambiri, kulumikizana kwa zala ndi zala kumakhudzidwa koyamba, ndipo kufanana kwake kulinso ndi chikhalidwe.

Pakhoza kukhala zizindikiro zina za matendawa:

Thupi (kutentha pamwamba pa 37.5 C)

Kodi amadziwika bwanji?

Ngati mukumva izi, onani dokotala. Pali mitundu yambiri ya nyamakazi ndipo muyenera kupimidwa kuti muwonetsetse kuti muli ndi nyamakazi.

Ngati banja lanu lili ndi munthu wina wokhala ndi nyamakazi kapena mtundu 1 shuga, matenda a celiac, kapena matenda ena aliwonse a autoimmune, dziwitsani dokotala.

Mlingo wa Erythrocyte sedimentation rate (ESR)

C-protein yogwira (CRP)

Ma X-ray, ultrasound ndi MRI angagwiritsidwe ntchito kuwunika zizindikiro zowonongeka ndi kutupa kwa cartilage yolowa.

Zoyambitsa Rheumatoid Arthritis

Sizikudziwika zomwe zimapangitsa chitetezo cha mthupi kuwononga mafupa, koma zinthu zimadziwika zomwe zimapangitsa kuti matendawa athe:

Matenda amtundu (kupezeka kwa abale omwe ali ndi nyamakazi)

Pali mankhwala ambiri omwe amagwiritsidwa ntchito pochiza matendawa limodzi, cholinga cha zomwe akuchita ndikuchepetsa kupitiliza kwa matendawa, kuchepetsa kutupa, kuchepetsa ululu. Mahomoni apadera - glucocorticoids - amafunikira kuti athetse kutupa.

Kugwiritsa ntchito glucocorticoids kumapangitsa kuchuluka kwa shuga m'magazi, chifukwa chake, pakakhala shuga, ndikofunikira kusintha mlingo wa insulin.

Sikoyenera kuti pamaso pa matenda amtundu wa 1 mukhale ndi matenda aliwonse omwe ali pamwambawa. Koma, ngati mungazindikire mwadzidzidzi kusintha kwina kosamveka muumoyo wanu, zikwangwani zamagazi - kumbukirani, muyenera kulumikizana ndi dokotala kuti mupeze kufunika kwowunikiranso komanso kusankha njira zamankhwala.

Ndi matenda a shuga, pamakhala kuchuluka kwa shuga m'thupi. Ngati wodwala aphunzira kuyang'anira bwino thanzi lawo, kusunga shuga pa nthawi yokhazikika, ndiye kuti matenda ashuga amasintha kuchoka ku matenda oopsa kukhala njira yapadera yomwe singakhale pachiwopsezo.

Pali mitundu ingapo ya matenda ashuga omwe amayenderana kwambiri ndi kusokonezeka kwa metabolic m'thupi la wodwala. Mtundu uliwonse wamatenda, kuwonjezera pa hyperglycemia, umadziwonetsa kuti umatulutsa glucose mkodzo. Pazotsatira izi, zizindikiro zotsatirazi zitha kuchitika:

1. ludzu limayamba kuchuluka kwambiri,
2. kulakalaka kukukula mwachangu
3. Pali kusakhazikika kwa mafuta kagayidwe kachakudya ka hyperlipidemia, komanso dyslipidemia,
4. wasokoneza mineral metabolism m'thupi,
5. zovuta zina zimayamba.

Kuwonjezeka kwakukulu kwa odwala omwe ali ndi matenda a shuga amellitus kunapangitsa kuti azindikire mitundu yosiyanasiyana ya matendawa kuti amvetsetse bwino kusiyana pakati pa chinthu chimodzi ndi china.

Ngati mpaka posachedwapa, zamankhwala zimakhulupirira kuti ndi anthu omwe ali ndi zaka zopitilira 45 omwe amatha kudwala matenda amtundu II, lero malekezero amisala atafika pa 35.

Chaka chilichonse, mtundu wachiwiri wa matenda a shuga umapezeka mwa odwala achichepere, omwe amaphatikizidwa ndi kuperewera kwa zakudya komanso moyo wosayenera.

Kuwonetsedwa ngati chowonadi cha matenda

Pali malingaliro oti matenda a shuga a fret ndi njira yopepuka yowonetsera matenda ashuga 1. Mapangidwe ake a matendawa amapezeka monga amtundu 1 - B maselo amafa, koma pang'onopang'ono kwambiri. Chifukwa chake, insulini imatulutsidwa kwambiri m'magazi ndipo imaleka kupanga nthawi yonse. Kusiyana kokhako kuchokera ku mitundu iwiri ya shuga ndi kulephera kwa autoimmune m'thupi.

Zizindikiro zovuta za shuga lada ndizofanana ndi chizolowezi chapamwamba cha matendawa. Ndi kuwonjezeka kwa shuga wamagazi ndi kuchepa kwakamodzi kwa insulin, ketoacidosis imachitika.

Zizindikiro zodziwika bwino ndi izi:

• Mumva ludzu kwambiri.
• Pakamwa pakamwa.
• Zofooka.
• Kusanza, kusanza.

Woopsa milandu, matenda a m'matumbo angayambitse kudwala.

Kuphatikiza apo, pali zizindikiro zapadera za matendawa. Izi zikuphatikiza:

• Chizungulire
• Kunjenjemera, kunjenjemera ndi kuzizira kwa thupi.
• Khungu loyera ndi mucous nembanemba.
• Hyperglycemia.
• Kuchepetsa thupi, pafupipafupi diuresis.

Ndizofunikira kudziwa kuti matenda a shuga a fret amatha kuchitika kwa nthawi yayitali popanda chizindikiro.