Shuga mellitus mtundu LADA

Chiwerengero cha anthu odwala matenda ashuga ku Russia lero chikufika mamiliyoni ambiri ndipo akupita patsogolo mwachangu. Zaka 12-15 zilizonse, kuchuluka kwa odwala matenda ashuga kumawonjezera.

Chifukwa chiyani matenda ashuga ndi owopsa?

Matenda a shuga ndi shuga wowonjezereka m'magazi. Kutanthauzira koteroko sikumangochitika mwangozi, chifukwa kutulutsa konse m'thupi la wodwalayo makamaka kumalumikizidwa ndi shuga wambiri. Ndipo kukhoza kwa wodwalayo kuthana ndi thanzi lawo, kukhalabe ndi shuga m'magazi pamlingo wachilengedwe, kumasinthira matendawa kukhala mtundu wapadera wamoyo, kutsatira zomwe kungatheke kupewa zovuta zazikulu zathanzi.

Matendawa amaphatikiza mitundu ingapo yomwe imalumikizidwa ndi kuperewera kwa michere mthupi la wodwalayo.

Matenda a shuga amitundu yosiyanasiyana, kuwonjezera pa hyperglycemia, amadziwonetsera ndi kuphipha shuga mu mkodzo. Ichi ndiye chiyambi cha matendawa omwe akufunsidwa. Nthawi yomweyo, ludzu la wodwala yemwe wagwiritsa ntchito limachulukirachulukira, chikhumbo chake chikukula kwambiri, lipid metabolism ya thupi imasokonekera munjira ya hyper- ndi dyslipidemia, protein kapena mineral metabolism imasokonekera, ndipo zovuta zimayamba motsutsana ndi maziko azovuta zonse zapamwambazi.

Kuchuluka kwa odwala padziko lonse lapansi kwa odwala matenda ashuga kwachititsa asayansi ochokera kumaiko osiyanasiyana kuthana mwamphamvu ndi zovuta za kuzindikira mitundu yosiyanasiyana ya matendawa kuti asiyanitse mitundu ndi inzake. Chifukwa chake, mpaka posachedwapa, amakhulupirira kuti mtundu wa 2 matenda a shuga ndi matenda omwe amadziwika makamaka kwa odwala omwe ali ndi zaka zopitilira 45. Mpaka pano, kutsimikizika kotereku kwatsimikiziridwa. Ziyenera kutsimikizidwa ndikuti chaka chilichonse pali anthu ochulukirapo omwe amadzazindikira ali aang'ono kwambiri (mpaka 35). Ndipo izi zikuyenera kupangitsa achinyamata amakono kuganiza za kulondola komwe ali m'moyo komanso kuvomerezeka kwa zomwe amachita tsiku ndi tsiku (zakudya, zochita, ndi zina).

Mitundu Yosiyanasiyana

Pali mitundu iwiri yayikulu ya matenda a shuga:

1. Mtundu I - wodwala insulin, amapangidwa mwa munthu wochepetsedwa kupanga insulin mthupi. Nthawi zambiri, amapangidwa mwa ana aang'ono, achinyamata ndi achinyamata. Ndi mtundu uwu wa matenda ashuga, munthu ayenera kuperekera insulin nthawi zonse.
2. Mtundu Wachiwiri - osadalira insulini, amatha kuchitika ngakhale ndi insulin yambiri m'magazi. Ndi mtundu uwu wa matenda a shuga, insulin sikokwanira kuchititsa shuga m'magazi. Matenda a shuga amtunduwu amakhala pafupi ndi ukalamba, nthawi zambiri atatha zaka 40. Kapangidwe kake kamalumikizidwa ndi kuchuluka kwa thupi. Mu matenda II amtundu, nthawi zina zimakhala zokwanira kusintha zakudya, kuchepetsa thupi ndi kuwonjezera kuchuluka kwa zochita zolimbitsa thupi, ndipo zizindikiro zambiri za matenda ashuga zimatha. Mtundu wachiwiri wa matenda ashuga nawonso umagawika subtype A, yomwe imapangidwa motsutsana ndi kunenepa kwambiri, komanso subtype B, yomwe imayamba mwa odwala oonda.

Mitundu yapadera ya matenda a shuga sawonjezereka, monga:

1. Matenda a shuga a LADA (dzina losatha), masiku ano shuga (mwanjira ina, autoimmune), gawo lalikulu lomwe limafanana ndi mtundu woyamba wa matenda ashuga, koma matenda a shuga a LADA amakula pang'onopang'ono, kumapeto kwake matendawa amapezeka kuti ndi matenda ashuga Mitundu iwiri.
2. MODI ndi mtundu wa matenda a shuga a subclass A, omwe ndiwowoneka bwino ndipo amapangidwa motsutsana ndi matenda a kapamba, cystic fibrosis, kapena hemochromatosis.
3. Amayambitsa matenda a shuga a shuga.
4. Matenda a shuga a Class C amakula ndi zovuta mu endocrine system.

Kodi pali kusiyanasiyana ndi matenda a shuga a LADA?

Mawu akuti LADA amapatsidwa shuga ya autoimmune yaposachedwa mwa odwala akuluakulu. Anthu akugwera m'gululi, limodzi ndi odwala omwe ali ndi mtundu woyamba, akufunikira kwambiri chithandizo cha insulin chokwanira. Nthawi yomweyo, maselo a kapamba omwe amapanga insulin amabwera m'thupi la wodwalayo, zomwe zimadziwika kuti autoimmune zimachitika.

Akatswiri ena azachipatala amatcha matenda a shuga a LADA pang'onopang'ono ndipo nthawi zina amapatsa dzinalo "1.5". Dzinali ndilosavuta kulongosola: kumwalira kwa ziwonetsero zonse za maselo obisika atakwanitsa zaka 35 kumachitika pang'onopang'ono, ndizofanana kwambiri ndi matenda a shuga a 2. Koma, mosiyana ndi iye, maselo onse a beta a kapamba amafa, motero, kupanga kwa mahomoni posachedwa kumatha, kenako nkulekana.

Nthawi zambiri, kudalira kwathunthu kwa insulin kumapangidwa pambuyo pa zaka 1 mpaka 3 kuyambira pomwe matendawa amatenga ndipo amadutsa ndi zizindikiritso mwa amuna ndi akazi. Matendawa ali ngati mtundu wachiwiri, chifukwa kwanthawi yayitali mungathe kuwongolera ndunayo pochita masewera olimbitsa thupi komanso kudya mokwanira.

Njira yabwino ya matendawa imapatsa mwayi woganiza kuti ichira kapena ichedwa kwa nthawi yayitali kwambiri yopanga zovuta zonse zodziwika. Ntchito yayikulu imaperekedwa muzochitika zotere - glycemic control.

Pofuna kuwonjezera kuzindikira kwa odwala, masukulu apadera a shuga amapangidwa, cholinga chake chachikulu ndikuwunikira zida zoyenera momwe wodwalayo amayenera kuyeza zizindikiro zofunika komanso momwe akuyenera kuchitira zinthu zovuta.

Kuzindikira matendawa

Pofuna kudziwa zizindikiro za matenda a shuga a LADA wodwala yemwe amafuna thandizo la mankhwala, kuphatikiza pazowunikira zonse komanso zodziwika bwino za kuchuluka kwa shuga ndi glycated hemoglobin, machitidwe awa amagwiritsidwa ntchito:

• kusanthula ndi kusanthula kwa ma autoantibodies kuti maselo ofika ku ICA,
• kuphunzira kwa ma antigen a HLA,
• Kuzindikiritsa autoantibodies mankhwala omwe ali ndi insulin,
• kuyesa kwa chibadwa: HLA DR3, 4, DQA1, B1,
• template autoantibodies kuti glutamate decarboxylase GAD.

Ndondomeko zotsatirazi zimawerengedwa ngati chiwopsezo cha chiwonetsero cha matenda a LADA:

• zaka zodziwika zisanachitike zaka 35,
• kumachitika kwa insulin kudalira patatha zaka zingapo,
• mawonekedwe a mtundu 2 ndikuonda kapena kulemera kwabwinobwino,
• kulipira kokha pothandizidwa ndi zakudya zapadera ndi masewera olimbitsa thupi zaka 1-5.

Masiku ano, omwe ali ndi zida zamtundu wazidziwitso, sizovuta kudziwa shuga ya autoimmune, odwala onse omwe ali ndi chitsimikiziro chotsimikizika, olembetsedwa ku chipatala kuyambira azaka 25 mpaka 50, omwe ali ndi zisonyezo zoonekera za matenda ashuga a 2 omwe si onenepa kwambiri, amafunikira kulamula kwatumizidwa kuti mukafufuze zina. Kafukufuku wamakono a labotale amapatsa adokotala njira yolondola kwambiri yosankhira njira zabwino zowathandizira ndikuwonjezera nthawi yogwira ntchito ya munthu wodwala mahomoni.

Amayi oyembekezera omwe ali ndi chizindikiritso chotsimikizika cha matenda amiseche ali pachiwopsezo cha odwala omwe akuyembekezeka kuti adzakhale ndi matenda amtsogolo a LADA. Nthawi zambiri, amatha kutenga matenda osasangalatsa kumapeto kwa pakati kapena posachedwa. Akuti pafupifupi 25% ya odwala amakhudzidwa ndi matenda a shuga a LADA.

Njira ndi njira zochiritsira

Monga tanena kale, mankhwala a insulini sangalephereke kwa odwala omwe ali mgululi. Akatswiri azachipatala amalangizidwa kuti achedwetse kayendetsedwe ka insulin. Zofunika! Ndikupezeka ndi matenda a shuga a LADA, chithandizo chimakhazikitsidwa pamfundoyi.

Odwala omwe adapezeka ndi matenda a shuga a LADA amafunika kuzindikira momwe matendawa angadziwire komanso mankhwala omwe angagwiritsidwe ntchito ngati mankhwala a insulin, omwe ali makamaka chifukwa cha kuthekera kwakukulu kwa kusakhalapo kwa kukhudzidwa kwa insulin. Nthawi zambiri, kuchepa kwa insulin mwa wodwala, makamaka, koyambirira kwa matendawa, amaphatikizidwa ndi insulin kukana.

Zikatero, odwala amamulembera mankhwala ochepetsa shuga omwe amachepetsa kapamba, koma munthawi yomweyo onjezerani mphamvu ya zotumphukira za insulin. Mankhwala omwe amalembedwera mu zochitika zotere amaphatikiza ndi Biguanide derivatives (metformin) ndi glitazones (avandium).

Kupatula pokhapokha, odwala omwe ali ndi matenda a shuga a LADA ndiofunikira kwambiri kuti apatsidwe mankhwala a insulin, chifukwa chake kuvomereza koyambirira kwa insulin kumapangitsa kupulumutsa inshuwaransi yoyambira yayitali kwambiri ya insulin. Odwala omwe ali ndi zonyamula za LADA-shuga amalephera kugwiritsa ntchito secretogens, zomwe zimapangitsa kuti insulini itulutsidwe, chifukwa pambuyo pake izi zimapangitsa kuti mankhwalawa ayambe kuchepa ndipo kenako kuwonjezeka kwa insulin.

Pochiza matenda a shuga a LADA, olimbitsa thupi olimbitsa thupi, ma hirudotherapy, ndi masewera olimbitsa thupi amathandizira kuonana ndi dokotala.

Kuphatikiza apo, njira zochizira zina zimachepetsa kupitilira kwa hyperglycemia. Chachikulu ndikukumbukira kuti ndizotheka kugwiritsa ntchito njira zochiritsira zilizonse pokhapokha povomerezeka ndi adokotala. Kudzipatsa nokha mankhwala kungasokoneze thanzi lanu.

Zolemba zaukadaulo wazachipatala

Kodi matenda a shuga a LADA ndi ati? Chidule cha LADA chimayimira L: Latent (latent), A - Autoimmune (autoimmune), D - Matenda a shuga (matenda ashuga), A - mu Akuluakulu (mwa akulu).

Ndiye kuti, ndi matenda abwinobwino achikulire, chifukwa cha kuchepa kwa chitetezo chathupi. Ofufuza ena amati ndi mtundu wa shuga wa mtundu woyamba womwe umayamba pang'onopang'ono, pomwe ena amautcha kuti ndi shuga kapena pakati (wosakanizidwa, wosakanizidwa).

Mtundu wa nthendayi ndi dzina latent autoimmune shuga ya akulu ndizotsatira zaka zambiri zakufufuza komwe kunachitika ndi magulu awiri a asayansi azachipatala otsogozedwa ndi dokotala wa sayansi ya zamankhwala ku University of Helsinki (Finland), wamkulu wa Lund University Diabetes Center (Sweden) Tiinamaija Tuomi ndi ku Australia endocrinologist, pulofesa Paul Zimmet wa Baker Heart and Diabetes Institute ku Melbourne.

Zochita zamankhwala ziziwonetsa momwe kulungamitsidwa kudzipatula kwa mtundu wina wa matenda ashuga kuliri, koma zovuta zomwe zimakhudzana ndi matenda amtunduwu zimakambidwa pafupipafupi ndi akatswiri pankhani ya endocrinology.

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Epidemiology

Masiku ano, anthu pafupifupi 250 miliyoni apezeka ndi matenda ashuga, ndipo akuti pofika 2025 chiwerengerochi chidzakwera mpaka 400 miliyoni.

Malinga ndi kuyerekezera kosiyanasiyana, mu 4-14% ya anthu omwe ali ndi matenda a shuga a 2, ma β-cell autoantibodies amatha kupezeka. Chinese endocrinologists awona kuti ma antibodies enieni a shuga a autoimmune mwa odwala akuluakulu amapezeka pafupifupi 6% ya milandu, ndipo malinga ndi akatswiri aku Britain - mu 8-10%.

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Zomwe zimayambitsa matenda a shuga a LADA

Yambani ndi matenda a shuga amtundu woyamba, omwe amayamba chifukwa cha vuto. pancreatic endocrine ntchito, mwachindunji, maselo a β-celled in the nuclei of islets of Langerhans, kupanga mahomoni a insulini, omwe amafunikira kuyamwa kwa shuga.

Kwambiri mu etiology mtundu 2 shuga ikufunika insulin kwambiri chifukwa chokana (chitetezo chokwanira), ndiye kuti, maselo a ziwalo zojambulidwa amagwiritsa ntchito timadzi tosavutikira (zomwe zimayambitsa hyperglycemia).

Zomwe zimayambitsa matenda a shuga a LADA, monga matenda a shuga 1, zimakhalapo pakulimbana kwa chitetezo cha pancreatic β-cell, ndikuwapangitsa kuwonongeka kwakanthawi. Koma ndi matenda amtundu wa 1, zovuta zowonongeka zimachitika mofulumira, komanso mitundu yotsala ya LADA mwa akulu - monga matenda amtundu wa 2 - izi zimachitika pang'onopang'ono (makamaka muunyamata), ngakhale, monga endocrinologists amati, chiwonongeko cha β maselo amasiyana mu lonse lokwanira.

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Zowopsa

Ngakhale, monga zidakhalira, matenda a shuga a autoimmune (LADA) ndiofala kwambiri mwa akulu, koma zinthu zomwe zimayambitsa chitukuko zimadziwika mokha.

Kafukufuku pa zomwe anachitazi apangitsa kuti, monga matenda ashuga amtundu wa 2, zofunikira za matendawa zitha kukhala zaka zokhwima, kuchita masewera olimbitsa thupi ochepa, kusuta, mowa.

Koma ikugogomezera kufunika kokhala ndi mbiri yabanja ya matenda a autoimmune (nthawi zambiri amalemba mtundu wa matenda ashuga 1 kapena hyperthyroidism). Koma mapaundi owonjezera mchiuno ndi pamimba samagwira ntchito yofunika motere: Nthawi zambiri, matendawa amakula ndi thupi labwinobwino.

Malinga ndi ofufuzawo, izi zimathandizira mtundu wa hybridization mtundu wa shuga mellitus mtundu LADA.

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Njira zingapo zimakhudzidwa ndi matenda a shuga, koma pankhani ya matenda a LADA a mtundu, njira ya kagayidwe imayambitsidwa ndi chitetezo chamagulu (activation of autoreactive T cell) mwa kusokonekera kwa ma cell a ma pancreatic β maselo motsogozedwa ndi ma antibodies a cell a ma islets a Langerhans: proinsulin, an insulin. GAD65 - puloteni ya ma membrane a β-cell a L-glutamic acid decarboxylase (glutamate decarboxylase), ZnT8 kapena zinc transporter - dimeric membrane protein ya insulin secretory granules Ina, IA2 ndi IAA kapena tyrosine phosphatase - oyang'anira phosphorylation ndi maselo kuzungulira kwa cell, ICA69 - puloteni wa cytosolic wa nembanemba wa zida za Golgi za islet cell 69 kDa.

Mwina kupangidwa kwa ma antibodies kumatha kugwirizanitsidwa ndi sayansi yapadera ya β-cell, yomwe imapangidwira zomwe zimachitika mobwerezabwereza poyankha kuwonongeka kwa chakudya, lembani zolimbikitsa zina, zomwe zimapanga mwayi komanso njira zina zofunikira pakupangidwira ndi kufalitsa ma autoantibodies osiyanasiyana.

Pamene chiwonongeko cha β-cell chikupita patsogolo, kuphatikizira kwa insulini kumayamba pang'onopang'ono koma pang'onopang'ono, ndipo panthawi inayake mphamvu zawo zachinsinsi zimatsika mpaka (kapena zimatha kwathunthu), zomwe pamapeto pake zimabweretsa hyperglycemia yayikulu.

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Zizindikiro za matenda a shuga LADA

Zizindikiro za matenda a shuga a autoimmune mu akulu ndi ofanana Zizindikiro za matenda ashuga mitundu ina, zizindikiro zoyambirira zimatha kuwoneka ndi kuchepa thupi mwadzidzidzi, komanso kumva kutopa kosalekeza, kufooka ndi kugona tulo mukatha kudya komanso kumva ngati muli ndi njala mukangodya.

Matendawa akamakula, kuthekera kwa kapamba kupanga insulini kumachepa pang'onopang'ono, zomwe zingayambitse zambiri za matenda ashuga, omwe akuwonetsedwa:

• kuchuluka kwa ludzu nthawi iliyonse pachaka (polydipsia),
• kuchuluka kwachilendo pakapangidwe ka mkodzo (polyuria),
• chizungulire
• masomphenya osalala
• paresthesias (kulumikizana, dzanzi pakhungu ndi kumva kuthamanga "zotumphukira").

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Mavuto ndi zotsatirapo zake

Zovuta zakutsogolo komanso zovuta za matenda a shuga a LADA ndi zofanana ndi matenda amtundu 1 ndi 2. Kukula komanso kuchuluka kwa zovuta monga matenda ashuga retinopathymatenda amtima matenda ashuga nephropathy ndi matenda ashuga a m'mimba (diabetesic phazi ndi chiopsezo cha zilonda zamkhungu ndi subcutaneous minofu necrosis) mwa odwala akuluakulu omwe ali ndi matenda osokoneza bongo a autoimmune chiyambi amafanana ndi mawonekedwe awo a mitundu ina ya matenda ashuga.

Matenda a shuga a ketoacidosis komanso matenda a shuga a ketoacidotic ndi zovuta komanso zowopsa za matenda osapezekawa, makamaka pambuyo pancreatic β-cell amalephera kutulutsa insulini.

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Kuzindikira matenda a shuga LADA

Akuti anthu opitilira gawo limodzi mwa anthu atatu omwe ali ndi matenda osokoneza bongo omwe amatha kunenepa kwambiri amatha kukhala ndi matenda a LADA a shuga. Popeza matendawa amakula patadutsa zaka zingapo, anthu nthawi zambiri amapezeka ndi matenda a shuga a 2, omwe amaphatikizidwa ndi insulin.

Mpaka pano, kupezeka kwa matenda a shuga a autoimmune mu akulu kumakhazikitsidwa, kuwonjezera pa kuzindikira za hyperglycemia, pazinthu zosadziwika ngati izi (monga momwe akatswiri a Illunology of Diabetes Society) amathandizira:

• zaka 30 kapena kupitirira
• gawo limodzi labwino kwambiri mwa mitundu inayi yama autoantibodies,
• wodwala sanagwiritse ntchito insulin kwa miyezi isanu ndi umodzi itatha atapezeka.

Chifukwa kuzindikira kwa matenda ashuga kuyesa magazi kwa LADA kumachitika kuti adziwe:

• shuga (pamimba loonda)
• Serum C-peptide (CPR)
• antibodies GAD65, ZnT8, IA2, ICA69,
• seramu ndende ya proinsulin,
• zomwe zili za HbA1c (glycogemoglobin).

Kuyesa kwamkodzo kwa glucose, amylase ndi acetone kumachitidwanso.

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Kusiyanitsa mitundu

Kuzindikira koyenera kwa matenda am'mbuyomu a autoimmune shuga mwa akulu ndi kusiyanasiyana kwake ndi mitundu ya matenda ashuga 1 ndi 2 ndikofunikira kusankha njira yoyenera yolandirira yomwe ingapereke ndikuwongolera glycemic control.

Mtundu wa zaka zoyambira

achinyamata kapena achikulire

Diagnostic insulin kudalira

wolemba nthawi yodziwitsa

kulibe, amakula zaka 6 mpaka 10 pambuyo pa kuzindikira

nthawi zambiri palibe kudalira

Kukana insulini

Kupita Pang'onopang'ono kwa Insulin

mpaka milungu ingapo

kuyambira miyezi yambiri mpaka zaka zingapo

kwa zaka zambiri

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Chithandizo cha matenda a shuga a LADA

Ngakhale mawonekedwe a pathophysiological a mtundu wa LADA shuga mellitus amafanana ndi matenda amtundu 1 shuga, chithandizo chake, pakafufuzidwa molakwika, chimachitika molingana ndi mtundu wa 2 mtundu wa chithandizo cha matenda ashuga, chomwe chimakhudza odwala komanso sichimawongolera mokwanira magazi a shuga.

Njira yolumikizira othandizira odwala matenda am'mimba a autoimmune mwa akulu sichinapangidwebe, koma endocrinologists ochokera kuzipatala zotsogola amakhulupirira kuti mankhwala amkamwa ngati Metformin sangakhale othandizira, ndipo zogulitsa zomwe zimakhala ndi sulfonyl ndi propylurea zimathandizanso njira ya autoimmune. Chomwe chingapangire izi ndi kuthamanga kwa oxidative nkhawa ndi apoptosis ya β-cell chifukwa chodziwikiratu kwa sulfonylurea, yomwe imasokoneza mobisa ma cell a pancreatic cell.

Zochitikazo zachipatala zimatsimikizira kuthekera kwa othandizira ena a hypoglycemic kuti asunge mphamvu yopanga insulin ndi ma cell a β, kuchepetsa kuchuluka kwa shuga m'magazi. Makamaka, awa ndi mankhwala monga:

Pioglitazone (Pioglar, Pioglit, Diaglitazone, Amalvia, Diab-standard) - 15-45 mg amatengedwa (kamodzi patsiku). Zotsatira zoyipa zomwe zingachitike zimaphatikizapo kupweteka kwa mutu komanso kupweteka kwa minofu, kutupa mu nasopharynx, kuchepa kwa chiwerengero cha maselo ofiira m'magazi,

Sitagliptin (Januvia) mapiritsi - amatenganso kamodzi pa maola 24 aliwonse pa 0,1 g). Zotsatira zoyipa monga kupweteka kwa mutu ndi chizungulire, mayankho osagwirizana, kupweteka kwa kapamba,

Albiglutide (Tandeum, Eperzan) imayendetsedwa mosavomerezeka (kamodzi pa sabata kwa 30-50 mg), Lixisenatide (Lixumia) imagwiritsidwanso ntchito.

Chizindikiro cha matenda am'mbuyomu a autoimmune mwa anthu akuluakulu ndikusowa kwa chithandizo cha insulin kwa nthawi yayitali atatha kuzindikira. Komabe kufunika kwa mankhwala a insulin Mtundu wa LADA umapezeka kale komanso nthawi zambiri kuposa momwe aliri odwala matenda ashuga a 2.

Akatswiri ambiri amati ndibwino kuti musachedwe kuyamba kugwiritsa ntchito matenda a shuga a insulin zamtunduwu, chifukwa, monga momwe kafukufuku wina wasonyezera, jakisoni wa kukonzekera kwa insulini amateteza β-cell ya kapamba kuti isawonongeke.

Kuphatikiza apo, ndi matenda amtunduwu, madokotala amalimbikitsa pafupipafupi, mosalekeza, kuwunika kuchuluka kwa shuga m'magazi, moyenera - musanadye chakudya komanso pogona.

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Zosiyanitsa

Mawu akuti LADA amapatsidwa matenda a autoimmune mwa akulu. Anthu omwe amagwera m'gululi amafunikira chithandizo chokwanira ndi insulin.

Poyerekeza ndi maziko a matenda a m'magazi m'thupi, kuwonongeka kwa maselo a pancreatic, omwe amachititsa kupanga insulin. Chifukwa chake, ma pathological a chilengedwe cha autoimmune amawonedwa m'thupi la munthu.

Muzochita zachipatala, mutha kumva mayina ambiri a matenda a shuga a LADA. Madokotala ena amatcha matendawo pang'onopang'ono, ena amatcha matenda ashuga "1.5." Ndipo mayina otere amafotokozedwa mosavuta.

Chowonadi ndi chakuti imfa ya maselo onse a ziwiya zobisika atakwanitsa zaka zina, makamaka - ali ndi zaka 35, zimayamba pang'onopang'ono. Ndi chifukwa ichi kuti LADA nthawi zambiri imasokonezedwa ndi matenda a shuga a mtundu 2.

Koma ngati mungayerekeze, ndiye mosiyana ndi mitundu iwiri yamatenda, yomwe ili ndi matenda a LADA, maselo onse apachifwamba amafa, chifukwa chake, mahomoni sangathenso kupangidwanso ndi gawo lamkati pazofunikira. Ndipo pakupita nthawi, kupanga sikutha konse.

Mu milandu yazachipatala wamba, kudalira kwathunthu insulin kumapangidwa pambuyo pa zaka 1-3 kuchokera pakuzindikiridwa kwa matenda a shuga mellitus, ndipo kumachitika ndi zizindikiritso mu azimayi ndi abambo.

Njira yamatendawa ili pafupi kwambiri ndi mtundu wachiwiri, ndipo kwa nthawi yayitali, ndikotheka kuwongolera mchitidwewu mwakuchita masewera olimbitsa thupi komanso zakudya zopatsa thanzi.

Kufunika kozindikira matenda a shuga a LADA

Matenda a shuga a autoimmune mu akulu ndi matenda a autoimmune omwe "awonekera" chifukwa cha asayansi posachedwapa. M'mbuyomu, mtundu uwu wa matenda a shuga udapezeka ngati matenda amtundu wachiwiri.

Aliyense amadziwa mtundu wa matenda ashuga amtundu 1 komanso mtundu wa matenda ashuga 2, koma ndi anthu ochepa omwe amvapo za matenda LADA. Zikuwoneka kuti sizikupanga kusiyana kulikonse zomwe asayansi apeza, chifukwa chiyani zimasokoneza miyoyo ya odwala ndi madokotala? Ndipo kusiyana kwake ndi kwakukulu.

Wodwala akapezeka kuti ali ndi LADA, ndiye kuti amalandira chithandizo popanda chithandizo cha insulin, ndipo amamuthandizira ngati matenda abwinobwino a mtundu wachiwiri. Ndiko kuti, zakudya zaumoyo, zolimbitsa thupi zimalimbikitsidwa, nthawi zina mankhwala omwe amathandizira shuga m'magazi amapatsidwa.

Mapiritsi oterewa, pakati pa zinthu zina zoyipa, amachititsa kuti insulini ipangidwe, chifukwa maselo a beta ayamba kugwira ntchito mpaka kukula kwa mphamvu yawo. Ndipo zochulukirapo zomwe maselo otero amakhala, zimawonongeka mwachangu pa autoimmune pathology, ndipo unyolo umapezeka.

• Maselo a Beta awonongeka.
• Kupanga kwa mahomoni kumachepetsedwa.
• Mankhwala osokoneza bongo amalembedwa.
• Zochita za maselo athunthu zimawonjezeka.
• Matenda a Autoimmune amakula.
• Maselo onse amafa.

Poyankhula pafupifupi, tcheni chotere chimatenga zaka zingapo, ndipo kutha kwake ndi kutsekemera kwa kapamba, komwe kumabweretsa kuikidwa kwa insulin. Komanso, insulin iyenera kutumikiridwa muyezo waukulu, ngakhale ndikofunikira kwambiri kutsatira zakudya zovuta.

M'maphunziro a mtundu wachiwiri wa matenda ashuga a m'matumbo, kusungika kwofunikira kwambiri pa inshuwaransi kumawonedwa pambuyo pake. Kuphwanya unyolo wa autoimmune pathology, mutazindikira matenda a shuga a LADA, wodwala ayenera kulangizidwa kuti apereke Mlingo wochepa wa mahomoni.

Chithandizo cha insulin choyambirira chikutanthauza zolinga zingapo zazikulu:

1. Patani nthawi yopumula ya maselo a beta. Kupatula apo, tikamagwiritsa ntchito kwambiri kupanga insulini, timaselo tomwe timayamba msanga maselo a autoimmune.
2. Chepetsani matenda a autoimmune mu kapamba pochepetsa ma autoantigens. Ndiwo "ziguduli zofiira" zama chitetezo chathupi chaanthu, ndipo zimathandizira kuti magwiridwe amachitidwe a autoimmune, omwe amaphatikizidwa ndi mawonekedwe a antibodies.
3. Kusunga ndende ya glucose mthupi la odwala pamlingo wofunikira. Aliyense wodwala matenda ashuga amadziwa kuti kukwera shuga m'thupi, mavuto ake amabwera mwachangu.

Tsoka ilo, zizindikiro za autoimmune mtundu 1 shuga mellitus sizosiyana kwambiri, ndipo kudziwika kwake koyambirira sikupezeka kawirikawiri. Komabe, ngati kunali kotheka kusiyanitsa matendawa poyambira, ndiye kuti mwina mungayambitse mankhwala a insulin m'mbuyomu, omwe angathandize kuti pakhale zotsalira za mahomoni ake ndi kapamba.

Kusungidwa kwatsalira ndikotsalira ndikofunikira kwambiri, ndipo pali zifukwa zina pazifukwa izi: chifukwa cha magawo amomwe timagwiritsa ntchito mkati mwa timadzi tambiri, ndikokwanira kungoyang'anira kuchuluka kwa glucose mthupi, chiwopsezo cha hypoglycemia chimachepetsedwa, ndipo zovuta zoyambirira zamatenda zimalephereka.

Momwe mungayikirire mtundu wina wa matenda ashuga?

Tsoka ilo, chithunzi chimodzi cha matenda sichimanena kuti wodwalayo ali ndi matenda osokoneza bongo a autoimmune. Zizindikiro sizosiyana ndi mtundu wakale wa shuga matenda.

Zizindikiro zotsatirazi zimawonedwa mwa odwala: kufooka kosalekeza, kutopa kosatha, chizungulire, kugwedezeka kwamphamvu (kawirikawiri), kutentha kwa thupi (kupatula kusiyanitsa kwabwinobwino), kutuluka kwamkodzo, kuchepa thupi.

Komanso, ngati matendawa aphatikizidwa ndi ketoacidosis, ndiye kuti pali ludzu lakuya, pakamwa pouma, kupumitsa mseru komanso kusanza, zolembera pamalilime, pali fungo lodziwika bwino la acetone kuchokera pamlomo wamkamwa. Ndizofunikiranso kudziwa kuti LADA imatha kuchitika popanda zizindikilo kapena zisonyezo.

Zaka zodziwika bwino zamatenda amasiyanasiyana kuyambira zaka 35 mpaka 65. Wodwala akapezeka ndi mtundu wa matenda a shuga 2 pamsika uno, amayeneranso kufufuzidwa malinga ndi njira zina kuti asatenge matenda a LADA.

Ziwerengero zikuwonetsa kuti pafupifupi 10% ya odwala amakhala "eni" a matenda a shuga a autoentmune. Pali mtundu wina wa ngozi pamiyezo isanu:

• Choyimira choyamba ndi chokhudzana ndi zaka pamene matenda ashuga amapezeka asanakwanitse zaka 50.
• Mawonekedwe owopsa a pathology (oposa malita awiri a mkodzo patsiku, ndimakhala ndikumwa ludzu, munthu amachepetsa thupi, kufooka kwakanthawi komanso kutopa kumawonedwa).
• Mlozera wam'kati wodwala si woposa 25 mayunitsi. Mwanjira ina, alibe kulemera kwambiri.
• Pali ma autoimmune pathologies m'mbiri.
• Kupezeka kwa zovuta za autoimmune abale apafupi.

Omwe amapanga izi amati ngati pali mayankho olondola a mafunso kuchokera pa zero kupita pa imodzi, ndiye kuti mwina matendawa amatenga mtundu winawake wa matenda ashuga 1%.

Pankhaniyi ngati muli ndi mayankho oposa awiri (awiri kuphatikiza), chiwopsezo cha chitukuko chikuyandikira 90%, ndipo pankhaniyi kafukufuku wofunikira ayenera kuchitidwa.

Momwe mungazindikirire?

Kuzindikira matenda oterewa mwa akulu, pali njira zambiri zodziwira, komabe, zofunikira kwambiri ndizo kusanthula kawiri, komwe kungakhale kwanzeru.

Kusanthula kwa kuchuluka kwa anti-GAD - ma antibodies kuti glutamate decarboxylase. Ngati zotsatirapo zake zili zoipa, ndiye kuti zimachotsa mtundu wina wa shuga. Ndi zotsatira zabwino, ma antibodies amapezeka, zomwe zikuwonetsa kuti wodwala ali ndi mwayi wopanga matenda a LADA pafupi ndi 90%.

Kuphatikiza apo, kutsimikiza kwa kupititsa patsogolo kwa matenda mwa kuzindikira ma antibodies a ICA kuma cell apanc pancreatic atha kulimbikitsidwa. Ngati mayankho awiri ndi abwino, ndiye kuti akuwonetsa mtundu woopsa wa matenda ashuga LADA.

Kuwunikira kwachiwiri ndikutanthauzira kwa C-peptide. Zimatsimikiziridwa pamimba yopanda kanthu, komanso pambuyo kukondoweza. Mtundu woyamba wa matenda ashuga (ndi LADA nawonso) amadziwika ndi gawo lotsika la chinthu ichi.

Monga lamulo, madokotala nthawi zonse amatumiza odwala onse azaka 35-50 omwe ali ndi matenda a shuga mellitus ku maphunziro owonjezera kuti atsimikizire kapena kupatula matenda a LADA.

Ngati dokotala sakupatsani kafukufuku wowonjezereka, koma wodwalayo amakayikira za matendawa, mutha kulumikizana ndi kuchipatala chofufuzira ngati muli ndi vuto.

Kuchiza matenda

Cholinga chachikulu cha mankhwalawa ndikusunga kapangidwe ka maholide a pancreatic. Ngati nkotheka kumaliza ntchitoyo, wodwalayo amatha kukhala ndi moyo mpaka atakalamba, popanda mavuto ndi zovuta za matenda ake.

Mu matenda a shuga, LADA, mankhwala a insulini ayenera kuyambika nthawi yomweyo, ndipo mahomoni amatumizidwa pazing'onozing'ono. Ngati izi sizingachitike pa nthawi yake, ndiye kuti ziyenera kuperekedwa “kwathunthu”, ndipo mavuto adzayamba.

Pofuna kuteteza maselo a pancreatic beta kuukira kwa chitetezo chathupi, jakisoni wa insulin amafunikira. Popeza ndi "oteteza" a ziwalo zamkati pachiwopsezo chawo. Ndipo choyambirira, kufunikira kwawo ndikuteteza, ndipo chachiwiri - kukhalabe ndi shuga pamlingo wofunikira.

Algorithm yochizira matenda a LADA:

1. Ndikulimbikitsidwa kudya zakudya zamafuta pang'ono (zakudya zama carb ochepa).
2. Ndikofunikira kuperekera insulin (chitsanzo ndi Levemir). Kukhazikitsidwa kwa insulin ya Lantus ndikovomerezeka, koma osavomerezeka, chifukwa Levemir ikhoza kuchepetsedwa, koma mankhwala achiwiri, ayi.
3. Insulin yowonjezera imaperekedwa, ngakhale glucose sanachulukane, ndipo imasungidwa bwino.

Mu matenda a shuga, LADA, mankhwala aliwonse a dokotala amayenera kuonedwa molondola, kudzichitira nokha ndikosavomerezeka komanso kodzaza ndi zovuta zingapo.

Muyenera kuwunika bwino magazi anu, kuyeza kangapo patsiku: m'mawa, madzulo, masanawa, mukatha kudya, komanso kangapo pamlungu ndikulimbikitsidwa kuyeza miyezo ya shuga pakati pausiku.

Njira yayikulu yothanirana ndi matenda ashuga ndi chakudya chama carb ochepa, ndipo pokhapokha zolimbitsa thupi, insulini ndi mankhwala ndi omwe amapatsidwa. Mu matenda a shuga, LADA, ndikofunikira kubaya mahomoni mwanjira iliyonse, ndipo uwu ndiye kusiyana kwakukulu pakati pa matenda. Kanemayo munkhaniyi akuwuzani zoyenera kuchita ndi matenda ashuga.

Kodi pali kusiyana kotani ndi matenda ashuga?

Zomwe matenda amtunduwu samadziwika bwinobwino. Zadziwika kuti matenda ashuga ndi matenda obadwa nawo. Mosiyana ndi mitundu yakale, LADA ili ndi autoimmune chiyambi. Izi ndizomwe zimasiyanitsa ndi mtundu 1 komanso matenda ashuga 2.

Mtundu wa autoimmune wamtundu wa LADA umawonetsa kuti thupi laumunthu limapanga ma antibacteries omwenso amasokoneza maselo awo athanzi, pamenepa, ma cell a pancreatic beta. Ndi zifukwa ziti zomwe zingathandizire kupanga ma antibodies sizodziwika, koma amakhulupirira kuti pali matenda a mavairasi (chikuku, rubella, cytomegalovirus, mumps, matenda a meningococcal).

Njira yakukula kwa matendawa imatha kuyambira zaka 1-2, mpaka zaka makumi. Makina amomwe matenda amachokera matenda amafanana kwenikweni ndi mtundu wa matenda a shuga a mtundu wa mellitus (mtundu 1). Ma cell a Autoimmune omwe amapanga thupi la munthu amayamba kuwononga kapamba wawo. Poyamba, pamene gawo la maselo a beta akhudzidwa laling'ono, matenda a shuga amapezeka posachedwapa (obisika) ndipo sangadziwonekere.

Ndi chiwonongeko chowonjezereka cha kapamba, matendawa amadziwoneka wofanana ndi matenda a shuga a 2. Pakadali pano, nthawi zambiri odwala amafunsa adokotala ndipo amadzazindikira molakwika.

Ndipo kumapeto kokha, zikondamoyo zikatha, ndipo ntchito yake imachepetsedwa "0", sizitulutsa insulin. Kuperewera kwenikweni kwa insulin kumapangidwa, motero, kumadziwonetsera ngati mtundu 1 wa shuga. Chithunzithunzi cha matendawa chimadzayamba kufalikira.

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.

Zochitika pamaphunzirowa

Kukula kwa matenda amtunduwu kumakhala ndi zomwe zimasiyana ndi zomwe sizigwirizana ndi chithunzi cha mitundu ya matenda ashuga. Ndikofunika kulabadira izi pazotsatira zake

• Kukula kwakanthawi kwamatenda,
• nthawi yayitali ya asymptomatic,
• kuchepa thupi kwambiri,
• Zaka zodwala zimakhala kuyambira 20 mpaka 50,
• mbiri yamatenda opatsirana.

Njira zoyenera

Ngati kuchuluka kwa shuga kwapezeka, wodwalayo ayenera kukaonana ndi endocrinologist kuti apatsenso mayeso ena, kuti adziwe ngati ali ndi matendawa. Sitikulimbikitsidwa kuyesa kupeza mtundu wa matenda mwayekha mothandizidwa ndi njira zopezekera zodziwitsa, popeza ndi katswiri yekha yemwe amadziwa njira zodziwitsa omwe angadziwe mtundu wa matenda.

LADA iyenera kusiyanitsidwa pakati pamitundu ina yamatenda. Amasiyana ndi mtundu wodwala wa insulin mu mfundo zotsatirazi:

• Matenda a shuga a LADA amadziwika ndi njira yaulesi. Nthawi za kuchepa kwa insulin nthawi zina zimawonedwa, kusinthana ndi mawonekedwe ake enieni. Chithunzi cha chipatala sichinatchulidwe. Zizindikiro zimatha kukhalapo ngakhale popanda mankhwala a insulin, mankhwala, komanso zakudya.
• Dziwa matenda akulu akulu azaka 30 mpaka 55. Matenda a shuga kwa ana si osiyana ndi LADA.
• Odwala samakonda kuwonetsedwa ndi polyuria (kukodza mwachangu), polydipsia (ludzu lalikulu) ndi ketoacidosis (metabolic acidosis) yodziwika ndi matenda a shuga 1. Kuchepetsa thupi komanso pakamwa youma kumachitikanso nthawi zambiri.

Ngati mtundu wodwala wa shuga umadalira insulin, mu 15% mwadzidzidzi adokotala amazindikira LADA.

Ndikotheka kusiyanitsa ndi nthenda yodziyimira payekha ya matendawa malinga ndi njira zotsatirazi:

• LADA makamaka siziwonetsa mwa kunenepa kwambiri, komwe kumadziwika kwambiri ndi matenda amtundu wa 2.
• Chifukwa cha kuchepa kwapang'onopang'ono kwa kupanga kwa insulin ndi ma cell a beta omwe amayambitsidwa ndi ma antibodies, wodwalayo amasamutsidwa kwa insulin mankhwala kwa zaka 5.
• Magazi a munthu yemwe akudwala matenda a shuga a LADA ali ndi ma antibodies a anti-GAD, IAA ndi ICA. Kukhalapo kwawo kumawonetsa kulephera kwamachitidwe azomwezo.
• Kuchulukitsa kwa C-peptide, ndiye kuti, mahomoni opangidwa ndi kapamba, osapitirira 0,6 nmol / L, omwe amawonetsa kupangika kwa insulin ndi kuchuluka kwake kosafunikira m'magazi.
• Pazotsatira zoyesa magazi, zodziwika za mtundu woyamba wa matenda ashuga 1 amapezeka.
• Kulipira kwa LADA ndi mankhwala okhala ndi shuga yochepetsera shuga kumakhala kofooka kapena kulibe.

Kufufuza mwatsatanetsatane kuyenera kutsimikizira kapena kutsutsa kulephera kwa autoimmune. Ku Russia, palibe mwayi wochita kafukufuku wa zasayansi m'makliniki am'deralo. Odwala amayenera kupita kuzipatala zachinsinsi, ndikubwerera kwa dokotala ndi zotsatira za mayeso.

Zizindikiro

Ndikofunikira kumvetsetsa kuti zotsatira za kuzindikiridwa kwa matendawa ziyenera kukhala zolondola momwe zingathekere, chithandizo chimatengera izi. Kuzindikira koyipa, zomwe zikutanthauza kuti kuchiritsa mosasamala kumathandizira kuti matendawo apitirire.

Kuti muzindikire matendawa, muyenera kudutsa mayeso otsatirawa:

• Kuyesedwa kwa magazi konse.
• Kuyesa kwamwazi wamagazi.
• Mayeso a kulolerana ndi shuga m'magazi (yesani ndi 75 g ya shuga wosungunuka mu 250 ml ya madzi).
• Urinalysis
• Kuyesedwa kwa magazi kwa glycated hemoglobin (HbA1C).
• Kuyesedwa kwa magazi kwa C-peptide (kumawonetsa kuchuluka kwa insulini yomwe amadziwika ndi kapamba. Chizindikiro chachikulu pakupezeka kwa matenda amtunduwu).
• Kusanthula kwa ma antibodies kuma cell a pancreatic beta (ICA, GAD). Kukhalapo kwawo m'mwazi kumawonetsa kuti akuwongolera kuti aukire ziphuphu.

Izi zikusonyeza kuti kapamba amabisa insulin yaying'ono, mosiyana ndi mtundu wachiwiri wa matenda ashuga, pomwe C-peptide ikhoza kukhala yabwinobwino komanso ngakhale ikukulira pang'ono, ndipo kutsutsana kwa insulin kumatha kuchitika.

Nthawi zambiri, matendawa samadziwika, koma amatengedwa ngati mtundu wachiwiri wa shuga ndi chinsinsi cha mankhwala osokoneza bongo - mankhwala omwe amalimbikitsa katulutsidwe ka insulin ndi kapamba. Ndi mankhwalawa, matendawa adzakula msanga. Popeza kuchulukana kwamatenda a insulin kudzathetsa msanga zosungirako kapamba ndipo mofulumira boma lidzakhala ndi insulin yokwanira. Kuzindikira koyenera ndiko chinsinsi chakuwongolera kopambana matenda.

Malangizo a algorithm a matenda a shuga a LADA amatanthauza izi:

• Zakudya zochepa za carb Izi ndizofunikira kwambiri pochiza matenda amtundu uliwonse wa shuga, kuphatikiza mtundu wa LADA. Popanda kudya zakudya, gawo la zochitika zina ndilachabe.
• Zolimbitsa thupi zolimbitsa thupi. Ngakhale palibe kunenepa kwambiri, zolimbitsa thupi zimathandizira kugwiritsa ntchito shuga ochulukirapo m'thupi, chifukwa chake, ndikofunikira kupereka katundu ku thupi lanu.
• Mankhwala a insulin. Ndiye chithandizo chachikulu cha matenda a shuga a LADA. Njira yoyamba ya bolus imagwiritsidwa ntchito. Zikutanthauza kuti muyenera kubaya insulin "yayitali" (1 kapena 2 kawiri patsiku, kutengera mankhwala), yomwe imapereka insulin. Komanso musanadye chakudya chilichonse, jekeseni insulin "yayifupi", yomwe imakhala ndi shuga m'magazi mutatha kudya.

Tsoka ilo, ndizosatheka kupewa insulin chithandizo ndi matenda a shuga a LADA. Kukonzekera kwa mapiritsi sikothandiza pano, monga matenda a shuga a 2.

Mankhwala a insulin

Kodi ndi insulini iti yomwe musankhe komanso muyezo womwe dokotala adzakulemberani. Otsatirawa ndi ma insulin amakono omwe amagwiritsidwa ntchito pochiza matenda a shuga a LADA.

Matendawa

Mawuwa amagwira ntchito kokha ku matenda a shuga a LADA. Kukondwererana kwa matendawa ndi kanthawi kochepa (mwezi umodzi kapena iwiri) atazindikira, wodwala akapatsidwa insulin.

Thupi limayankha bwino mahomoni omwe amapangidwa kuchokera kunja ndipo mkhalidwe wa kuyerekezera kumachitika. Magazi a shuga m'magazi abwerera mwachangu. Palibe paliponse palokha malire a shuga. Palibe chosowa chachikulu pakuwongolera insulin ndipo zimawoneka kwa munthu kuti kuchira kwabwera ndipo nthawi zambiri insulin imathetsedwa palokha.

Chikhululukiro choterechi sichimatenga nthawi yayitali. Ndipo kwenikweni mwezi umodzi kapena iwiri, kuchuluka kwamphamvu kwa glucose kumachitika, zomwe zimakhala zovuta kudziwa.

Kutalika kwa kuchotsedwa kumeneku kumatengera zinthu izi:

• zaka odwala (okalamba wodwalayo, pomwepo kuchotsedwa kwake)
• jenda la wodwala (mwa amuna ndiwotalikirapo kuposa azimayi),
• kuopsa kwa nthendayo (pang'ono ndi pang'ono, kuchotsedwa kwa nthawi yayitali),
• mulingo wa C-peptide (pamlingo wake wokwera, kuchotsera kumatenga nthawi yayitali kuposa momwe kumatsalira zotsalira),
• mankhwala a insulini adayamba pa nthawi yake
• kuchuluka kwa ma antibodies (akapanda kuchepa, kuchotsedwa kwawo kwanthawi yayitali).

Kupezeka kwa vutoli kumachitika chifukwa chakuti pa nthawi yomwe akukonza insulin kukonzekera, pali magwiridwe antchito a pancreatic. Pa chithandizo cha insulin, maselo a beta amachira, amakhala ndi nthawi "yopuma" kenako, atatha insulin, kwakanthawi amatha kugwirabe ntchito mwaokha, kupanga mahomoni awoawo. Nthawiyi ndi "chithandiziro" cha odwala matenda ashuga.

Komabe, odwala sayenera kuyiwala kuti kupezeka kwa mawonekedwe abwino awa sikumapatula njira ina yopangira autoimmune. Ma antibodies, m'mene adapitilirabe kuwononga kanyumba, pitilizani. Ndipo patapita kanthawi, maselo amenewa, omwe tsopano amapereka moyo wopanda insulini, adzawonongedwa. Zotsatira zake, gawo la insulin Therapy ndilofunikira.

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.

Pomaliza

Mtundu wa LADA siwofala monga momwe amawerengera, koma kuwunika koyambirira komanso kolondola kumachotsa chithandizo chosayenera ndi zotsatirapo zoyipa za matendawa. Chifukwa chake, ngati pali zizindikiro zilizonse zomwe zikuwonetsa kuti mukudwala matenda ashuga, muyenera kupita ku endocrinologist kapena dokotala wamkulu kuti muwone zifukwa zomverera.