Kuzindikira matenda ashuga ndi gulu

Matenda a shuga a mellitus (DM) ndi amodzi mwa matenda omwe sapezeka m'thupi. Zotsatira zoyipa za matenda ashuga pamunthu ndizosiyanasiyana. Izi matenda amachepetsa moyo, zimawonjezera kufa ali aang'ono komanso azaka zapakati, ndipo zimatenga gawo lalikulu la magawo azaumoyo mmaiko onse padziko lapansi.

Ku Russia, kuchuluka kwa anthu ochulukirachulukira kuli kokulirapo. Pankhani ya chithandizo chachipatala chokha, pali odwala omwe ali ndi matenda a shuga a 4,5 miliyoni. Zotsatira za kafukufuku wamatenda akuwonetsa kuti chiwerengero chenicheni cha odwala ndichokwera kwambiri. Mwinanso, pafupifupi 7-10% ya anthu mdziko lathu ali ndi vuto la chakudya m'thupi m'njira zomveka bwino.

Kodi matenda ashuga ndi chiani?

Matenda a shuga ndi mitundu zingapo za ma pathologies zomwe zimalumikizidwa ndi gawo limodzi - matenda a hyperglycemia.

Mwazi wamagazi ambiri umatha kuphatikizidwa ndi:

kutsika kwa kupanga kwa insulin mthupi,
kuchepa kwa chidwi cha minofu,
kuphatikiza kwa izi.

Nthawi zambiri, shuga ndi gwero lamphamvu kwa maselo onse mthupi. Munthu amalandira chakudya, mafuta ndi mapuloteni ndi chakudya. Zonsezi zimatha kusandulika kukhala glucose. Choyamba, chakudya chamafuta chimachulukitsa shuga m'magazi.

Mwazi umapereka shuga ku ziwalo zonse. Mkati mwa maselo ambiri, chinthuchi chimalowa mkati mothandizidwa ndi wapadera wa mahomoni (insulin). Insulin imamangirira ku receptors pamwamba pa maselo ndikutsegula njira zapadera zamagulu a glucose.

Hormoni iyi ndi chinthu chokhacho chomwe chimatsitsa shuga. Ngati kapangidwe ka insulin kolekeka, ndiye kuti maselo amasiya kuyamwa. Shuga amadziunjikira m'magazi, zomwe zimapangitsa kuti pakhale zovuta zosiyanasiyana.

Kusintha komweku kumachitika chifukwa cha kusachita bwino kwa insulin receptors. Poterepa, timadzi timene timapangidwa, koma ma cell sazindikira. Zotsatira za insulin sensitivity yayitali hyperglycemia ndi vuto la metabolic.

Zotsatira za hyperglycemia:

kukomoka kwa lipid mu maselo,
kutsika kwa magazi pH
kudzikundikira kwa matupi a ketone m'mwazi,
zotupa za shuga kwamkodzo,
kutayika kwambiri kwamadzi mu mkodzo chifukwa cha osmotic diuresis,
kusowa kwamadzi
kusintha kwa magazi pamagetsi,
glycosylation (kuwonongeka) kwa mapuloteni a khoma la mtima ndi zina.

Matenda a hyperglycemia amabweretsa kuwonongeka pafupifupi ziwalo zonse ndi machitidwe. Makamaka chidwi ndi kuwonongeka kwa kagayidwe kazakudya:

zotengera impso
zombo zopangira ndalama
mandala
dongosolo lamkati lamanjenje
zotumphukira zamagetsi ndi ma neurons a mota,
mitsempha yayikulu yonse
maselo a chiwindi, etc.

Zizindikiro zamankhwala

Matenda a shuga amatha kupezeka mwai nthawi zonse mukamayesedwa kapena mukamayesedwa.

Zizindikiro zamankhwala a hyperglycemia:

Woopsa milandu, pamene wodwala alibe insulin, kuchepa kwamphamvu kwa thupi kumachitika. Wodwalayo akuchepetsa thupi ngakhale atakhala kuti alibe chidwi.

Kuyesedwa kwa magazi

Kuti mutsimikizire matenda a shuga muyenera kuzindikira hyperglycemia.

Kuti muchite izi, werengani kuchuluka kwa shuga:

pamimba yopanda kanthu
masana
Pa mayeso a kulolera m'magazi a glucose (OGTT).

Kuthamanga kwa shuga ndi glycemia pambuyo pa maola 8 mpaka 14 a kudziletsa kwathunthu kuzakudya ndi zakumwa (kupatula madzi akumwa). Kuti mumve bwino kwambiri, m'mawa musanawunike muyenera kusiya kumwa mankhwala, kusuta, kutafuna chingamu, ndi zina. Nthawi zambiri, shuga othamanga amakhala kuchokera 3.3 mpaka 5.5 mM / l m'magazi a capillary mpaka 6.1 mM / l mu venous plasma.

Mkuyu. 1 - Kuyang'ana matenda a shuga a 2 komanso kusala kwamatumbo glycemia m'magazi athunthu.

Mkuyu. 2 - Kusanthula kwa matenda a shuga a mtundu wachiwiri ndi mavuto ena a kagayidwe kachakudya m'magazi a m'magazi.

Glucose masana ndi muyeso uliwonse wa shuga. Mwa munthu wathanzi, glycemia sichidutsa 11.1 mmol / L.

Mayeso a kulolerana a glucose ("shuga pamapindikira") - mayeso okhala ndi katundu. Wodwalayo amatenga magazi pamimba yopanda kanthu ndikatha kumwa madzi otsekemera (75 g a glucose wa madzi mu 250-300 ml ya madzi). Glycemia nthawi zambiri amayesedwa patangotha maola awiri atachita masewera olimbitsa thupi.

Pa kuyesedwa, simungathe kudya, kumwa, kusuntha mwachangu, kumwa mankhwala, utsi, kuda nkhawa kwambiri. Zinthu zonsezi zimatha kukhudza zotsatira za kafukufukuyu.

Osayesa mayeso a glucose:

ngati shuga akusala kuposa 61 mmol / l,
nthawi ya chimfine ndi matenda ena owopsa.
munthawi yochepa yamankhwala omwe amapezeka ndimankhwala omwe amalimbikitsa shuga.

Shuga mpaka 5.5 mM / L (magazi a capillary) musanachite masewera olimbitsa thupi mpaka maola 7.8 mM / L 2 patatha izi.

Matenda a shuga amapezeka ngati:

osachepera kawiri, chifukwa cha 6.1 kapena kupitilira pamimba yopanda kanthu,
osachepera kamodzi kwa 11.1 mM / L nthawi iliyonse masana atapezeka,
panthawi yoyesedwa, shuga yofulumira imaposa 6.1 mM / l, mutatha kuyitsitsa imaposa 11.1 mM / l.

Gome 1 - Njira zoyesera matenda a shuga ndi zovuta zina za kagayidwe kazakudya (WHO, 1999).

Mothandizidwa ndi mayeso a kulolera glucose, mayiko a prediabetes atha kupezekanso:

kusala kudya kwa hyperglycemia (shuga pamaso pa zitsanzo 5.6-6.0 mmol / l, mutatsitsa - mpaka 7.8 mmol),
kulolerana kwa shuga m'magazi (shuga yofulumira mpaka 6.1 mmol / l, mutatha - kuchokera pa 7.9 mpaka 11.0 mmol / l).

Mtundu woyamba wa matenda ashuga: mawonekedwe, mfundo za matenda

Mtundu woyamba wa shuga ndi matenda pomwe kapangidwe kake ka insulin mthupi kamakhala kuti kulibe. Chomwe chimapangitsa izi ndi chiwonongeko cha ma cell a pancreatic beta omwe amapanga mahomoni. Matenda a shuga a Type 1 ndi matenda a autoimmune. Maselo a Beta amafa chifukwa chazovuta zomwe thupi limateteza. Pazifukwa zina, chitetezo chamthupi chimatenga maselo a endocrine ngati achilendo ndikuyamba kuwawononga ndi ma antibodies.

Kuzindikira matenda omwe mukufuna:

wunika glycemia,
onani hemoglobin wa glycated,
kudziwa kuchuluka kwa C-peptide ndi insulin,
onani ma antibodies (ma cell a beta, insulin, GAD / glutamate decarboxylase).

Mtundu 1 umadziwika ndi:

aakulu hyperglycemia,
otsika C-peptide,
kuchuluka kwa insulin
kupezeka kwa antibodies.

Mtundu wachiwiri wa matenda a shuga: kufotokozera ndi kuwazindikira

Matenda a Type 2 amakula chifukwa cha kuchepa kwa insulin. Kubisa kwa mahomoni nthawi zonse kumasungidwa. Chifukwa chake, kusintha kwa kagayidwe kake ka matendawa sikutchulidwa pang'ono (mwachitsanzo, ketosis ndi ketoacidosis pafupifupi sizikupezeka).

Type 2 matenda a shuga amachitika:

makamaka chifukwa cha kukana insulini,
makamaka chifukwa cha kubisala,
mawonekedwe osakanikirana.

Pazindikiritso, chopereka cha anamnesis, kuyezetsa kozungulira ndi kuyesa kwa labotale kumagwiritsidwa ntchito.

Pazofufuza zikuwonetsa:

shuga wamagazi ambiri
kuchuluka kwa glycated hemoglobin,
mkulu kapena wabwinobwino C-peptide,
insulin yayikulu kapena yabwinobwino
kusowa kwa ma antibodies.

Endocrinologists amagwiritsa ntchito mafayilo apadera (HOMO, CARO) kutsimikizira insulin. Amalola kuti masamu atsimikizire kuchepa kwamphamvu kwa minyewa yawo mahomoni awo.

Kusiyanitsa kosiyanasiyana kwa matenda a shuga a mtundu 1 ndi mtundu 2

Mtundu woyamba 1 ndi mtundu wa 2 shuga umakhala ndi chithunzi cha chipatala ndipo, munthawi yomweyo, kusiyana kwakukulu (onani tebulo 2).

Gome 2 - Zizindikiro zazikulu za mtundu 1 ndi mtundu 2 za matenda a shuga.

Mitundu ina ya matenda ashuga

Mitundu yapadera ya matenda ashuga ndi gulu lolemera, lomwe limaphatikizira subtypes zambiri za matendawa.

Ikani matenda ashuga chifukwa:

zolakwika zamtundu wa beta cell function (MODY-1-9, matenda a neonatal shuga, matenda osatha a neonatal shuga, mitochondrial DNA mutation),
zolakwika zamtundu wa insulin (mtundu A insulin kukana, leprechaunism, Rabson-Mendenhall syndrome, lipoatrophic shuga),
matenda a kapamba (kapamba, chotupa, zoopsa, ma cystic fibrosis, etc.),
matenda ena a endocrine (thyrotooticosis, hypercorticism, acromegaly, etc.),
mankhwala ndi mankhwala (mawonekedwe ofala kwambiri ndi steroidal),
matenda (kobadwa nako rubella, cytomegalovirus, etc.),
zochita zachilendo za autoimmune,
ma gennd syndromes ena (Turner, Wolfram, Down, Kleinfelter, Lawrence-Moon-Beadl, porphyria, Huntington's chorea, ataxia wa Friedreich, etc.),
zifukwa zina.

Kuzindikira mitundu yodwalayi yamatendawa kumafunikira:

mbiri yazachipatala
kuyesa za cholowa chamtundu,
kusanthula kwa majini
kafukufuku wa glycemia, glycated hemoglobin, insulin, C-peptide, antibodies,
Kutsimikiza kwa magawo amitundu mitundu ya magazi ndi mahomoni,
maphunziro owonjezera othandizira (ultrasound, tomography, etc.)

Mitundu yosiyanasiyana ya matenda ashuga imafuna kudziwa zambiri. Ngati vutoli ndilochepa, ndikofunikira kuzindikira sizomwe zimayambitsa matendawa komanso mtundu wake, koma kuchuluka kwa insulin. Njira zina zochizira zimadalira izi.

Kodi kupezeka kwamatenda a shuga a mtundu wachiwiri kumakhazikitsidwa bwanji?

Zizindikiro za matenda ashuga nthawi zambiri zimapezeka mu ma pathologies ena. Ichi ndichifukwa chake kudziwika kosiyanitsa mitundu 2 ya shuga kumakhala kofunikira kwambiri, komwe kungalole kuti tidziwitse matenda, komanso kuti ayambe kulandira mankhwalawa munthawi yake. Mpaka pano, kuchuluka kwa anthu odwala matenda ashuga ndiwokwera kwambiri kuposa matenda ena onse, zomwe zimatipatsa mwayi kuti titchulidwe kuti "mliri wamunthu".

Matenda a shuga amapezeka mwa ana ndi okalamba, koma ngati matenda amtundu wa 1 amapezeka mwa achinyamata, mtundu wa 2 matenda a shuga nthawi zambiri umakhudza nzika zaka 40. Komabe, nthawi zambiri odwala amakhala ndi zifukwa zingapo zoyambitsa matenda, zomwe zazikulu kwambiri zimapangitsa kuti matendawa akhale matendawo.

Zizindikiro zamatsenga

Nthawi zambiri, matenda ashuga amtundu wa 2 amapezeka pokhapokha munthu akafuna thandizo kwa katswiri wokhudza mavuto amtima wama mtima, ziwalo zam'maso, kapena mavuto amanjenje. Popeza nthendayi ilibe zizindikiro za chipatala kapena yothira kwambiri, kupezeka kwa matenda osiyanasiyana a shuga ndikovuta. Palibe dokotala amene angadziwe zoyenera kufikira atachitika maphunziro apadera.

Zizindikiro zazikulu za matenda a m'matumbo ndi:

ludzu lalikulu
kamwa yowuma
njala yosalekeza
kuchepa kwa masomphenya
kukokana mu minofu ya ng'ombe
polyuria, yowonetsedwa pokodza mwachangu,
Kuchepetsa thupi komanso phindu lotsatira,
Zizindikiro za kutupa kwa mutu wa mbolo,
kuyabwa ndi khungu matenda.

Koma, monga akatswiri ati, odwala ochepa omwe amawona dokotala pakukula kwa thanzi amadandaula za zomwe zili pamwambapa. Matenda a shuga a Type 2 nthawi zambiri amadziwika mwangozi mukamayesa mkodzo kapena magazi a m'magazi.

Mitundu yodziwitsa matenda

Kuzindikira kosiyanitsa kumakhazikitsidwa pamene mawonekedwe a wodwala azindikiridwa.

Pankhaniyi, cholinga chodziwitsira matenda ndikuwazindikira mawonekedwe a matendawa, omwe amatha kukhala angiopathic, neurotic, kapena ophatikizidwa.

Pazidziwitso zodziwika bwino, zoyeserera zenizeni zimachitika kuti zitsimikizire kupezeka kwa matenda a shuga.

Phunziro lalikulu pankhaniyi ndi kupezeka kwa ndende yamagazi. Pozindikira, kuthira magazi kumachitika kangapo.

Kusala glucose mwa munthu wathanzi kumayambira pa 3.5 mpaka 5.5 mmol / L. Mukaphatikizidwa ndi katundu, ndiye kuti, ndi kuchuluka kwa glucose, zizindikiro zake siziyenera kupitirira 7.8 mmol / L.

Koma vuto lotchedwa kulolera shuga. Izi sizoyambitsa matenda ashuga, koma pakapita nthawi zimatha kukhala matenda. Ngati kulolera kumalephera, shuga m'magazi amatha kupitirira 6.1 ndikufika 11.1 mmol / L.

Kuphatikiza pa kuyesedwa kwa magazi, kupezeka kwa matenda a shuga kumaphatikizapo urinalysis. Mumkodzo wa munthu wathanzi, kupindika kwachilendo komanso kusowa kwa glucose kumadziwika. Ndi matenda a shuga, kachulukidwe kamadzimadzi kamawonjezeka, ndipo shuga akhoza kupezekanso pakapangidwe kake.

Pankhani yodziwikiratu wa matenda, osati chizindikiro cha shuga m'magazi am'mbuyo kapena potumphera, koma mulingo wa insulini womwe umayambitsa kusanthula kwake ndikofunikira kwambiri. Ndi kuchuluka kwa insulin, kuphatikiza ndi kuchuluka kwa shuga, titha kulankhula za kukhalapo kwa matenda ashuga. Kuzindikilanso komweku kudzapangidwanso mukamadzapeza kuchuluka kwa insulin ndi kuchuluka kwa shuga. Ngati misempha ya insulin imakwezedwa, koma kuchuluka kwa shuga kumakhalabe kwabwinobwino, hyperinsulinemia imatha kupezeka, yomwe ikapanda kuchitidwa ingayambitse matenda a shuga.

Komanso, mothandizidwa ndi matenda osiyanasiyana, ndizotheka kusiyanitsa shuga ndi matenda ashuga, impso kapena matenda am'mimba, omwe ali ndi zofanana. Kuzindikira za mtundu uwu ndikosatheka ngati wodwala akutenga kale mankhwala omwe akukhudza kuchuluka kwa insulin mthupi.

Njira zodziwira zovuta

Kusiyanitsa mosiyanasiyana sikumapatula mayeso pazovuta zosiyanasiyana zomwe zimapezeka pakupanga matenda a shuga. Malinga ndi akatswiri, pakalibe zizindikiro, matenda ashuga amatha kupitilira zaka 5. Mavuto amatha kuchitika patatha zaka 10 chikhazikitso cha matenda.

Mavuto akulu omwe amapezeka kwambiri ndi matenda ashuga a 2 ndi awa:

Matenda a ziwalo zam'maso - matenda ammbuyo komanso retinopathy,
mtima ndi matenda amitsempha,
kulephera kwa aimpso.

Kupatula mavuto, maphunziro awa akuyenera kuchitika:

kuyesedwa ndi akatswiri a zamankhwala pofufuza za fundus ndi ziphuphu,
electrocardiogram
kusanthula mwatsatanetsatane mkodzo.

Kungoyendera nthawi yake kwa katswiri komanso njira yabwino yodziwira matendawa ndi kutipangitsa kuti tisiyanitse shuga ndi zina zomwe timayambitsa ndikuyamba kulandira chithandizo chanthawi yake. Kupanda kutero, matendawa amawopseza ndi zovuta zambiri zomwe zingawononge kwambiri moyo wa munthu.

Kusiyanitsa kosiyanitsa pakati pa matenda amtundu wa 1 ndi mtundu wa 2 wa ana

Matenda aakulu (mochedwa) a shuga

1) macroangiopathies (matenda a mtima, corbaryvascular

matenda, zotumphukira zamatumbo),

2) matenda ashuga othamanga

II.Mtundu woyamba wa matenda ashuga

a) Matendawa a retinopathy (magawo: osatulutsa, obwezeretsa)

yogwira, yolimbikitsa), b) matenda ashuga nephropathy (magawo: a) MAU, b) proteinuria

ntchito aimpso, c) kulephera kwa aimpso).

3) Mu ana - kuchedwa kukula mu thupi ndi kugonana.

4) Zilonda za ziwalo zina ndi machitidwe - mafuta a hepatosis, enteropathy, amphaka, osteoarthropathy (hyropathy), dermopathy, etc.

Mwachitsanzo:

1) Type 1 shuga mellitus, gawo la kuwonongeka ndi ketoacidosis.

2) Matenda a shuga 1, oopsa, gawo la kuwonongeka ndi ketosis. Matenda a shuga a retinopathy, osapindulitsa. Matenda a matenda ashuga nephropathy, UIA. Matenda a Moriak (anachedwetsa kukula kwa thupi ndi kugonana, mafuta

Zambiri za wodwala, poganizira matenda omwe alipo

Musanayese mayesedwe, deta yotsatirayi iyenera kuwonetsedwa pa khadi lachipatala la wodwala:

chikhalidwe cha kuwonongeka kwa kapamba, kuchuluka kwa maselo a beta omwe atha kupanga insulin,
Kuchita bwino kwa mankhwalawa, ngati kuli kotheka, chikhalidwe ndi kukula kwa kuchuluka kwa ma pancreatic enzyme obisika,
kukhalapo kwa zovuta zazikulu, kuchuluka kwake kwazovuta,
zinchito boma la impso
kufunikira kwa zovuta zina,
chiwopsezo cha matenda a mtima ndi stroko.

Izi zithandiza kudziwa kufunikira kwa mayeso owonjezera kuti adziwe matenda.

Matanthauzidwe opanga matenda ashuga

Kuphatikiza pa mayeso a labotale, mtundu 1 ndi matenda 2 amadziwika ndi zizindikiro zakunja. Wodwala amafunika kupereka magazi kuti awasanthule, fufuzani kuchuluka kwa shuga. Kuthamanga kotheka ndikumatha kudziwa komwe kumachitika, ndiye kuti zotsatirapo zake zikuwoneka bwino. Mtundu wa matenda a shuga umatsimikizira zizindikirazo.

Zizindikiro za matenda amtundu woyamba:

wodwala amakhala ndi ludzu nthawi zonse, thupi limataya madzi okwanira malita 5 patsiku,
mpweya wa acetone
njala, yofulumira yamakalori oyaka,
kuwonda msanga
kuchiritsa koyipa kwa zowonongeka, zipsera ndi kudula pakhungu.
Ndimafuna kugwiritsa ntchito chimbudzi nthawi zonse, chikhodzodzo chimakhala chikudzazidwa, chinyontho ndikusiya thupi,
zotupa za pakhungu, zilonda, mafangasi.

Zizindikiro zimathamanga, zinthu zam'mbuyo sizipezeka.

Zizindikiro za matenda a shuga a 2:

pali mavuto amawonedwe
munthu amatopa msanga
waludzu
kukodza sikulamulidwa usiku,
Zilonda zam'miyendo chifukwa chotayika komanso magazi ake osagwirizana ndi miyendo,
paresthesia
mafupa amapweteka poyenda.
Matenda a azimayi odwala matenda ashuga sayenda bwino,
Zizindikiro zimasiyana ma mawonekedwe
Nthawi zambiri pamakhala mavuto a mtima, kugunda kwa mtima, sitiroko.

Choyamba, kusanthula kumachitika pa glycated hemoglobin, yomwe imatha kuwonetsa chidziwitso:

shuga wabwinobwino
shuga umapangidwa popanda mavuto
gawo la matenda a shuga limayamba,
kusintha kwa glucose kumasintha
shuga wamagazi amatuluka
wapezeka ndi mtundu 1 ndi matenda ashuga 2.

Pathology ya mtundu 1 imadziwika ndi chitukuko chachikulu, kusokonezeka kwakukulu kwa metabolic kumachitika. Nthawi zambiri chizindikiro choyamba chimakhala ndi matenda ashuga kapena mtundu wovuta wa acidosis. Zizindikiro zimachitika mwadzidzidzi kapena masabata awiri atatha kukula kwa matenda opatsirana.

Wodwalayo amawona ludzu lamphamvu, akufuna kumwa madzi ambiri, thupi limataya malita atatu mpaka 5 amadzimadzi patsiku, ndipo chilakolako chake chikukula. Kukodza kumachitika pafupipafupi, osapitirira 10-20% ya odwala amathandizira odwala matenda ashuga 1, ena onse akumenyana ndi matenda amtundu wachiwiri.

Matenda a Type 1 amadziwika ndi kukula kwamphamvu kwa zizindikiro, pomwe mavuto onenepa kwambiri samachitika. Anthu odwala matenda amtundu wa 2 amakhala ndi thupi lolimba, nthawi zambiri amakhala atayamba kale kukalamba, zizindikiro sizili kwambiri.

Mtundu 2 wa matenda ashuga, ketoacidosis ndi chikomokere cha matenda ashuga zimachitika kawirikawiri. Anthu ambiri amalabadira mankhwala mosavuta kuposa matenda omwe ali m'gulu loyambalo. Matenda a shuga a Type 2 amapezeka kwambiri mwa achinyamata, achinyamata.

Kusiyanitsa mitundu

Kuyesedwa kwa magazi kumachitika m'mawa pamimba yopanda kanthu. Chisamaliro chachikulu chimalipidwa kuzisonyezo za katundu wa chakudya. Kuongolera kuchuluka kwa shuga kumachitika pogwiritsa ntchito glucometer kapena mu labotale. Nthawi zambiri endocrinologists amawerengera mkodzo, kudziwa kuchuluka kwa shuga. Anthu athanzi sayenera kukhala ndi glucose mkodzo. Pakuwunika mwatsatanetsatane, kuyesa kwa acetone kumachitika. Kuwonjezeka kwa ziwerengero za metabolites amtunduwu m'magazi achilengedwe kumawonetsa mawonekedwe amtunduwu wa matendawa.

Fungo la acetone mu mkodzo mwa munthu wamkulu

Mkodzo wa munthu ndi chinthu chopanga thupi. Pambuyo pokonzedwa ndi impso, okhawo omwe ndi achabechabe amakhalamo ...

Kuti musiyanitse matenda ashuga ndi ma pathologies ena, kuyezetsa magazi kwa C-peptide kumachitika. Mwa kukhalapo kwake, mulingo wa kubwezeretsedwa watsimikizika, zotsatira zoyesedwa zikuwonetsa kuchuluka kwa insulini mu mawonekedwe a shuga a insulin. Enemme yolumikizidwa ndi immunosorbent assay imakupatsani mwayi wodziwa kuthekera kwa endocrine system.

Mapazi amwazi

Mayeso omwe amachitika pa nthawi yake komanso nthawi zonse amakupatsani mwayi wodziwitsa mavuto azaumoyo musanayambike, pitani mwachangu mankhwala.

Kuti adziwe matenda a shuga poyesa magazi, wodwalayo ayenera kudutsa izi:

mtundu wamtundu: HLA DR3, DR4 ndi DQ,
mtundu wa immunological: kukhalapo kwa ma antibodies kuchokera ku decarboxylase, kupanga zinthu m'madipatimenti a Langerhans, kuchuluka kwa insulini, kupezeka kwa asidi a glutamic.
mtundu wa metabolic: glycohemoglobin, yafupika kupanga insulin pambuyo pakupenda kwa glucose mu kusanthula kwa intravenous makonzedwe a reagents.

Maphunzirowa amathandizira kuti adziwike moyenera.

Kuyesedwa kwa magazi

Pathology mwanjira imeneyi imatsimikiziridwa mwachangu. Iyi ndi imodzi mwazothandiza kwambiri njira zodziwitsira matenda. Mulingo wabwinobwino mwa anthu athanzi musanadye kuchokera pa 3.3 mpaka 5.5 mmol / L. Kuchuluka kwa shuga kumawonetsa zovuta za metabolic.

Malamulo oyang'anira shuga:

kuyeserera kumachitika katatu pamlungu,
Odwala amapereka m'mawa m'mimba yopanda kanthu,
akatswiri amatsimikizira maumboni angapo ndikuphunzira mwatsatanetsatane,
pa kulondola kwazidziwitso, kuyesedwa kumachitika modekha, pamene munthu ali womasuka.

Zomwe zimachitika pazinthu zakunja ndizosayenera, popeza kuchuluka kwa shuga kungasinthe, izi zimakhudza kulondola kwa zotsatira zoyesa.

Madzi a insulin

Enzyme imapangidwa mu ma cell a beta a kapamba munthawi wamba. Zimathandizira kuyang'anira kuchuluka kwa shuga m'thupi, zimapereka shuga ku maselo a ziwalo zamkati. Popanda insulini, glucose amakhalabe m'magazi, timadzimadzi timadzakhala tothinana, magazi amawoneka m'matumbo. Proinsulin amadziwika kuti ndiye maziko opanga mahomoni opanga. Kuchuluka kwa zinthu izi kumatha kuwonjezeka ndi matenda amtundu wa 2 komanso matenda a shuga.

Ma cholembera a syringe amagwiritsidwa ntchito kuperekera mlingo wowonjezera wa mahomoni opanga. Mankhwalawa amalowetsedwa pansi pakhungu, jakisoni wamkati komanso wamkati samaloledwa. Insulin yothandizira imathandizira ma enzymes achilengedwe a pancreatic, omwe samasungidwa chifukwa cha zovuta ndi dongosolo la endocrine.

Mayeso a kulolera a glucose

Njirayi imapangitsa kuti adziwe mtundu wa matenda ashuga, kudziwa zovuta zomwe zimabisika. Kuzindikira kumachitika mutadzuka pamimba yopanda kanthu. Osamadya chakudya maola 10 mayeso asanachitike.

simungathe kuvulaza thupi kwambiri pakuchita zolimbitsa thupi,
mowa ndi ndudu ndizoletsedwa
Osamadya zakudya zomwe zimachulukitsa shuga.

Kulekerera kwa shuga

Kupatuka kulikonse muumoyo sikuyenera kunyalanyazidwa. Mkulu shuga - osati ...

Chifukwa chake, mankhwalawa sakuphatikizidwa:

adrenaline
khofi
kulera kwamlomo
glucocorticosteroids.

Asanazindikire, njira yothetsera shuga weniweni imagwiritsidwa ntchito. Kuyeserera mobwerezabwereza kumachitika pambuyo maola ochepa. Mtengo wabwinobwino umafanana ndi 7.8 mmol pa lita 2 mutatha kutenga yankho. Gawo la prediabetes limatsimikiziridwa ndikuwonjezera kuchuluka kwa glucose mpaka 11 mmol / L. Izi zikuwonetsa kuphwanya kulolerana kwa ma enzyme.

Matenda a shuga amapezeka pamene kuchuluka kwa shuga kumadutsa 11 mmol pa lita imodzi, wodwalayo amapezeka patatha maola awiri atayesedwa.

Urinalysis

Odwala athanzi sayenera kukhala ndi glucose mu mkodzo. Mwa odwala matenda ashuga, kuchuluka kwa shuga mumkodzo kumawonjezeka. Izi zikutanthauza kuti glucose amadutsa mu chotchinga cha impso, chiwalo chophatikizacho sichichita bwino. Kuzindikiritsa kuchuluka kwa shuga pamkhalidwewu kumatengedwa monga chitsimikizo chowonjezera cha chizindikirocho.

Pamene urinalysis ikuchitika, zinthu monga:

mtundu wa chopondapo
matope
kuchuluka kwa acidity komanso kuwonekera,
mankhwala
kuchuluka kwa shuga
kuchuluka kwa acetone
kuchuluka kwa mapuloteni.

Mphamvu yapadera yokhazikitsa ntchito ya impso komanso kutulutsa mkodzo. Kusanthula kumakupatsani mwayi kuti muwone kuchuluka kwa microalbumin mkodzo.

Pa phunziroli, mkodzo umagwiritsidwa ntchito, umatulutsidwa pafupifupi 12:00 a.m., amadzimadzi amaikamo chidebe chosalimba. Pasanathe maola 24, mutha kuyeserera. Mwa odwala, mitundu ya microalbumin yochulukirapo imapezeka. Mavuto azaumoyo amatsimikiziridwa ngati muyeso wa thunthu limaposa 4 mg. Pakuwunika kwa ultrasound, kukula kwa impso, kusinthika kwazinthu kumazindikiridwa, zomwe zimayambitsa kusokonekera nthawi zambiri zimawonetsedwa pamasamba 3-4 a matendawa.

Acetonuria

Njira yowonjezera yodziwira matenda. Matenda a shuga amayambitsa zovuta za metabolic, kuchuluka kwama asidi ochulukirapo nthawi zambiri kumadziunjikira m'magazi. Izi ndi zinthu zapakatikati zamafuta zomwe zimatchedwa matupi a ketone. Ngati mkodzo wa anthu muli matupi ambiri otere, ayenera kuchitapo kanthu kuti muchepetse kukula kwa ketoacidosis.

Ichi ndi chimodzi mwazovuta za matenda ashuga. Kuti mudziwe chomwe chimayambitsa chitukuko cha matenda amtundu wachiwiri, palibe chifukwa chofufuzira zigawo za insulin ndi zinthu zamafuta kagayidwe. Izi zimachitika pokhapokha pofotokoza mwatsatanetsatane chipatala mu mtundu 1 wa shuga.

Kutsimikizika kwa matenda

Posankha matenda ndikusankha njira yothandizira, njira zina ziyenera kuonedwa. Wodwala ayenera kufunsa dokotala pazizindikiro zoyambirira.

Zinthu zotsatirazi zimakumbukiridwa:

njala yosalekeza
kukodza pafupipafupi
ludzu
zotupa ndi zotupa pakhungu,
mavuto onenepa kwambiri.

An endocrinologist amachita mayeso, kuyezetsa kofunikira. Kuphatikiza mankhwala kumatengera kuwunika kwa chithunzithunzi chonse cha matendawa, kuphunzira zotsatira za labotale. Wodwala sangathe kudzipenda yekha komanso kuthandizidwa popanda dokotala.

Mankhwala achikhalidwe sagwiritsidwa ntchito popanda kutsatira akatswiri. Pambuyo pozindikira matenda a shuga, ndikofunikira kuyamba chithandizo, kuti mudziwe mankhwala omwe wodwala akufuna.