Mitundu ya Matenda A shuga

Mtundu woyamba wa matenda ashuga ali ndi chikhalidwe china:

• kukulira kwa autoimmune komwe kumachitika chifukwa chakugwira bwino ntchito kwa chitetezo chathupi,
• kachilombo koyambitsidwa ndi rubella, hepatitis, mamuna, nthomba,
• chibadwa.

Mtundu wachiwiri wamatenda uli ndi malo awiri:

• kunenepa kwambiri, kumamveka kwambiri, komwe kumakhala pachiwopsezo chotenga matenda a shuga,
• chikhalidwe.

Matenda a kapamba

Matenda a shuga ndi matenda osachiritsika omwe amawonongeka m'thupi. Nthawi zina, kapamba amaleka kupanga kapena satulutsa ma insulin okwanira. Mwa ena, insulini imayamba - maselo amayamba kutaya mphamvu chifukwa cha mphamvu ya mahomoni, ndipo sangathe kugwira ntchito yake.

Ngakhale pali zifukwa zingapo zomwe zimayambitsa matenda ashuga, zovuta za endocrine zimabweretsa zotsatirazi. Insulin ili ndi ntchito zambiri, koma yayikulu ndiyo kutulutsa shuga m'magazi kupita ku maselo. Ichi ndichifukwa chake onse odwala matenda ashuga adakweza shuga.

Kuchuluka kwa glucose kumakhudza mtima wamtima, makamaka, chiopsezo cha kulowerera kwamtima kumawonjezeka kwambiri. Kugonjetsedwa kwa ma capillaries ang'onoang'ono kumayambitsa ma pathologies ena, omwe ziwalo zomwe zimapangidwa ndi ma setifaya ang'onoang'ono nthawi zambiri zimavutika. Matenda a shuga amachititsa khungu (glucose imakhudza retina), kulephera kwa impso, ndi zina zambiri. Odwala amadwala mitsempha yotumphukira ndi mitsempha yamagazi, ndipo izi zimabweretsa zovuta ndi miyendo - kukulira zilonda zam'mimba, mabala osachiritsika, zilonda zam'mimba.

Popeza matendawa ndi osachiritsika, ntchito yayikulu kwa wodwala aliyense amene ali ndi matendawa ndi kuyipeza - kukhalabe ndi shuga. Ndipo pakadali pano ndikofunikira kwambiri kumvetsetsa mtundu wa matenda a shuga, chifukwa mankhwalawo adzakhala osiyana.

Mtundu woyamba wa shuga

Matenda a shuga a Type 1 amatchedwa kudalira insulin kapena unyamata (ubwana). Izi zimachitika chifukwa cha kudwalika kwamatendawa - imakula, monga lamulo, makamaka paubwana kapena unyamata ndipo zimayambitsidwa ndi matenda am'mimba, nthawi zambiri chibadwa chobadwa nawo. Chiwalo chimangoletsa kutulutsa insulini, chifukwa chake glucose yemwe amalowa m'magazi samatengera ma cell. Mukazindikira, ndikofunikira kwambiri kuyang'ana osati kuchuluka kwa shuga m'magazi, komanso mulingo wa insulin. Odwala omwe ali ndi vuto la matenda a shuga 1, mahomoni sadzakhalakonso kapena adzapezeka ochepa. Popeza tikulankhula za matenda a pancreatic, pali chithandizo chimodzi chokha cha matendawa - jakisoni wa insulin tsiku lililonse.

Odwala adzakumana ndi magulu awiri azizindikiro. Woyamba amalankhula za shuga wambiri chifukwa chake onse amadziwika ndi matenda ashuga:

• Ludzu lalikulu.
• Polyuria - kukodza pafupipafupi.
• Mabala ochiritsa olakwika.
• Khungu loyenda, pafupipafupi zotupa pakhungu.
• Kuwonongeka kwamphamvu pamapazi kapena m'manja (ndi kupitirira kwa matendawa).

Gulu lachiwiri lazizindikiro likuwonetsa kusapezeka kwa insulin. Popeza kuti glucose onse amakhalabe m'magazi ndipo samatengedwa kupita ku maselo, minofu ya thupi imasowa mphamvu. Izi zikuwonetsedwa mu kutopa, kusaikirapo mtima. Kuphatikiza apo, chakudya sichimabweretsa zotsatira zomwe zimafunidwa, kotero ana omwe ali ndi maziko azolimbitsa thupi kapena omwe amakhala ndi chidwi chambiri amachepetsa thupi kwambiri. Nthawi zina zizindikiro zotere zimayamba pakapita masiku.

Type 2 shuga ndi pakati

Matenda a shuga a Mtundu Wachiwiri ndiwo mtundu wofala kwambiri wamatendawa, omwe amatchedwanso osafunikira insulin. Matendawa amayamba ndi prediabetes - kukula kwa chitetezo chokwanira cha cell ku insulin, chifukwa chake glucose amakhalabe m'magazi. Pankhaniyi, kapamba akugwira ntchito moyenera, mahomoni amapangidwa mokwanira. Ndi kukula kwa matendawo, kaphatikizidwe kake kamatha kukula, chifukwa umu ndi momwe thupi limathandizira pakusowa kwa glucose yofunikira m'maselo.

Nthawi ya kukana insulini imatha kukhala zaka 10-15 munthu wodwala atayamba kudwala matenda a shuga a 2. Odwala ambiri omwe ali ndi vutoli ndi okalamba kuposa zaka 50, ngakhale kuti madokotala amawona kuti matendawa ndi ocheperako komanso amakhala ochulukirapo mwa anthu a 40 komanso ngakhale 30.

Matenda a 2 a matenda ashuga, komanso matenda ashuga 1, akatswiri amakhalanso ndi mwayi wokhala ndi chibadwa china. Komabe, gawo lofunikira pankhaniyi limaseweredwa ndi kadyedwe. Kuchulukirapo kwa zakudya zosavuta zamafuta (shuga, ufa, maswiti), zomwe zimachulukitsa msanga wamagazi, zimathandizira kukula kwa insulin.

Mwa anthu omwe ali ndi matenda a mtundu 2, osati shuga okha komanso insulin imakwezedwa m'magazi. Ndipo kuchuluka kwa mahomoni kumayambitsa zizindikiro zake. Makamaka, popeza insulini imalimbikitsa kuyika kwa mafuta m'maselo a adipose minofu, odwala omwe ali ndi vutoli ndi onenepa kwambiri, zomwe zimakhala zovuta kwambiri kuchepetsa. Matenda a 2 a shuga nthawi zambiri amayambitsa kunenepa kwambiri. Chifukwa chake, kupanga zakudya zoyenera ndi zoperewera zamagulu ochepa, komanso moyo woyenera komanso kuchita masewera olimbitsa thupi ndikofunikira pakuthandizira matenda amtunduwu.

Nthawi zina, kuchuluka kwa shuga kumachitika pang'onopang'ono. Matenda a shuga amtunduwu amapezeka mwa azimayi awiri ndi atatu, ndipo atabadwa, matendawa nthawi zambiri amapita. Koma chenicheni cha kukula kwake chikuwonetsa kukonzekera kwamatenda amtundu wachiwiri, popeza nthawi zambiri motsutsana ndi maziko a mimba ndi insulin kukaniza - prediabetes yomwe imadziwonetsa yokha. Chifukwa chake, kuzindikira koteroko kuyenera kukhala mwayi wopeza pafupipafupi ndikuyang'anira kupewa matenda.

Kuchulukitsidwa Kwa Matenda A shuga

Masiku ano, World Health Organization yatchula mitundu isanu ya matenda ashuga:

• Type 1 shuga mellitus, momwe mitundu ya autoimmune ndi virus yomwe imayambitsa matenda (imayamba pambuyo pa matenda a virus) imasiyanitsidwa.
• Type 2 shuga. Pano, magulu a odwala omwe ali ndi kunenepa kwambiri, omwe ali ndi kulemera kwabwino komanso omwe adadwala ali aang'ono ndiosiyanitsidwa.
• Gulu la odwala matenda apakansa chifukwa cha kuperewera kwa thupi ndi kutupa kwa kapamba.
• Shuga yachiwiri kapena yodziwika, yomwe imayamba motsutsana ndi kuwonongeka kwa ziwalo zina ndi machitidwe ena, koma osati kapamba.
• Matenda a shuga.

Asayansi ku Swiss Lund University Diabetes Center, pamodzi ndi ofufuza a Institute of Molecular Medicine Finland, adasanthula zambiri kuchokera kwa odwala pafupifupi 15,000 ndipo adati njira yotsatira matendawa:

• Cluster 1 ndi nthenda ya autoimmune yomwe imatsogolera kuimitsidwa pakupanga insulin.
• Cluster 2 - matenda a shuga a insulin, omwe amafanana ndi mtundu 1. Matendawa amakula ubwana kapena unyamata mwa anthu athanzi lakale.
• Cluster 3 - kukana insulini mwa anthu omwe ali ndi kunenepa kwambiri, kuperewera kwambiri kwa metabolism. Gululi limaphatikizapo anthu ambiri omwe ali ndi matenda ashuga a 2. Vuto lalikulu la matendawa ndi kuwonongeka kwa impso.
• Cluster 4 - kukana insulini mwa anthu onenepa kwambiri.
• Cluster 5 - insulin kukana, yomwe imayamba kukalamba. Potere, matendawa ndi ofatsa kwambiri.

M'malo mwake, gawoli limapangidwa kuti lipewe chithandizo cha matenda ashuga, chifukwa m'malo mwa kupatukana kotere, njira zabwino kwambiri zamankhwala zimatha kusankhidwa.

Mitundu ya matenda a shuga

Malinga ndi gulu, ziyenera kusiyanitsidwa:

• matenda ashuga
• prediabetes
• Mokomera amayi apakati.

Kodi matenda ashuga owopsa ndi ati? Chowonadi chakuti pali kusiyana pakati pa zomwe kalasi iliyonse imayambitsa matendawa, ndipo mtundu uliwonse umayambitsa kusokonezeka kwakukulu pakugwira ntchito kwamkati mwa thupi.

Type 1 insulin yomwe amadalira matenda a shuga ndi matenda omwe amapangidwa chifukwa cha kuwonongeka kwa maselo a kapamba, zomwe zimapangitsa kuti shuga azikhala mokwanira mthupi. Izi zimayamba ndi kusowa kwa insulini kofunikira kagayidwe kazachilengedwe.

Gland yomwe ikukhudzidwa siyingathe kupirira ndikupanga mahomoni okwanira. Motere, kuyamwa kwa glucose m'maselo ndikovuta ndipo shuga wamagazi amawonjezeka. Njira yayikulu yothandizira kulipirira kusowa kwa mahomoni ndi kubayira insulin mthupi nthawi zonse.

Odwala omwe ali ndi mtundu uwu wa matenda amafunika kutsatira ndondomeko ya insulin m'miyoyo yawo yonse kuti akhalebe athanzi. Chifukwa chake, mtundu uwu umatchedwa insulin-wodalira.

Matenda amtunduwu nthawi zambiri amakhala obadwa ndipo amapezeka ubwana kapena unyamata.

Zizindikiro zazikulu za matendawa zimapezeka motere:

• kukodza kwakukulu ndi kutulutsidwa kwamikodzo yambiri,
• kulakalaka
• ludzu losatha
• kamwa yowuma
• Khungu
• Kuchepetsa thupi
• kufooka, kugona.

Malinga ndi zotsatira za kuyezetsa magazi, kuchuluka kwa shuga kumawonedwa, maselo amafuta amapezeka mkodzo.

Mtsogolomo, matenda am'mimba ophatikizidwa m'mimba amalowa ndi zomwe zimachitika, zomwe zimaphatikizana ndi vuto la mseru zimachepetsa chilimbikitso.

Gulu la anthu odwala matenda ashuga lidakhazikitsidwa ndikusayinidwa ndi oimira World Health Organisation mu 1985. Kutengera izi, ndichikhalidwe kupatula magawo angapo a matendawa omwe amayamba chifukwa cha kuchuluka kwa shuga m'magazi a wodwala. Gulu la anthu odwala matenda ashuga limaphatikizapo matenda a shuga, prediabetes, matenda a shuga nthawi ya pakati.

Matendawa alinso ndi mitundu ingapo, kutengera mtundu wa chitukuko cha matendawa. Gulu la anthu odwala matenda ashuga:

1. Mtundu woyamba wa shuga
2. Type 2 shuga
3. Matenda a shuga
4. Zosankha zina za shuga.

Mtundu 1 wamatenda

Amatchedwanso insulin-wodwala matenda a shuga. Matendawa akuwonetsedwa pakupanga kwa insulin ya mahomoni ndi kapamba. Izi zimabweretsa kuwonjezeka kwa shuga m'magazi komanso kulephera kwa glucose m'maselo a thupi, chifukwa ndi insulin yomwe imayang'anira ntchito yonyamula zinthuzo m'maselo.

Matenda a shuga amapezeka chifukwa cha kuwonongeka kwa kagayidwe kazakudya komanso kuwonjezeka kwa ndende yamagazi. Gulu la WHO limakhazikitsidwa, pomwe mitundu yosiyanasiyana ya matenda imasonyezedwa.

Malinga ndi ziwerengero za 2017, anthu opitilira 150 miliyoni amadziwika kuti ali ndi matenda ashuga. M'zaka zaposachedwa, milandu ya matendawa yachulukanso. Kuopsa kwakukulu kwa mapangidwe a matendawa kumachitika patatha zaka 40.

Pali mapulogalamu omwe ali ndi njira zingapo zochepetsera kuchuluka kwa matenda ashuga komanso kuchepetsa chiopsezo cha kufa. Kuchita hemoglobin wa glycosylated kumapangitsa kuti azindikire matenda a shuga ndikupatseni dongosolo la mankhwala.

Kutengera kafukufuku wasayansi, akatswiri ochokera ku WHO adapanga gulu la anthu odwala matenda ashuga. Bungweli lanena kuti ambiri odwala matenda ashuga ali ndi matenda amtundu 2, 92% yonse.

Mtundu woyamba wa shuga umakhala pafupifupi 7% ya kuchuluka konse kwa milandu. Mitundu ina ya matenda imapangitsa 1% ya milandu. Pafupifupi 3-4% ya amayi apakati amakhala ndi matenda ashuga.

Zaumoyo zamakono zimatchulanso vuto la prediabetes. Izi ndi zofunikira kwambiri pokhapokha muyezo wa glucose m'magazi ulipo kale, koma osakwaniritsa zomwe zili zenizeni zamatenda. Monga lamulo, prediabetes imatsogolera matenda odzaza.

Matendawa amapangika chifukwa cha kukanika kwa thupi, mwachitsanzo, kulephera pakukonza shuga. Izi zimawonetsedwa mwa anthu omwe ali ndi vuto komanso onenepa kwambiri.

Mtundu wina wa matenda umagawidwa ngati glucose umakonzedwa m'thupi, koma chifukwa cha zovuta, vutoli limatha kusintha ndipo ntchito yaphatikizidwe ikasokonekera.

Kuyambira 2003, matenda ashuga apezeka ndi zomwe akufuna kuchita ndi American Diabetes Association.

Type 1 shuga mellitus amawonekera chifukwa cha kuwonongeka kwa maselo, chifukwa chake kusowa kwa insulin kumachitika mthupi. Type 2 shuga mellitus amawonekera chifukwa zotsatira zachilengedwe za insulin zimasokonekera mthupi.

Mitundu ina ya matenda ashuga imawonekera chifukwa cha matenda osiyanasiyana, komanso kusagwira bwino kwa maselo a beta. Izi gulu tsopano ndi upangiri wachilengedwe.

M'magawo a WHO omwe adachitika mu 1999, pali zina zomwe zasintha pamayeso amitundu. Tsopano manambala achiarabu akugwiritsidwa ntchito, osati achi Roma.

Anthu ambiri omwe ali ndi matenda ashuga amatha kugawidwa m'magulu awiri: odwala omwe ali ndi matenda a shuga 1 a mellitus (DM 1), omwe amalumikizidwa ndi kuperewera kwa insulin, komanso odwala omwe ali ndi mtundu wa 2 shuga mellitus (DM 2), omwe amagwirizana ndi thupi kukana insulin.

Nthawi zambiri zimakhala zovuta kudziwa mtundu wa matenda ashuga, chifukwa chake magulu ena atsopano a shuga akupangidwa, omwe sanavomerezedwe ndi WHO. Pagululi pali gawo la "Matenda a shuga a mtundu wosatsimikizika".

Mitundu yambiri yosowa ya shuga imayambitsidwa, yomwe imakwiya:

• matenda
• mankhwala
• endocrinopathy
• kusowa kwa kapamba,
• zolakwika zakubadwa.

Mitundu ya matenda ashuga iyi siyokhudzana ndi zachilengedwe;

Kugawidwa kwa shuga kumeneku malinga ndi chidziwitso cha WHO kumaphatikiza mitundu inayi ya matenda ndi magulu, omwe amatchulidwa ngati kuphwanya malire a glucose homeostasis.

Type 2 shuga mellitus ali ndi gulu:

• kuyanʻanila za glucose homeostasis,
• kulolerana kwa shuga,
• glycemia wamkulu pamimba yopanda kanthu,
• matenda a shuga
• mitundu ina ya matenda.

Matenda a kapamba:

• zotupa
• kapamba
• kuvulala
• cystic fibrosis,
• fibrosing kuwerengetsa kapamba,
• hemochromatosis.

Matenda amtundu wa insulin:

• shuga wa lipoatrophic,
• lembani kukana kwa insulini,
• leprechaunism, Donohue syndrome (mtundu wachiwiri wa matenda ashuga, kupindika kukula kwa mitsempha, dysmorphism),
• Rabson - Mendenhall syndrome (acanthosis, shuga mellitus ndi pineal hyperplasia),
• Zophwanya zina.

Mitundu yovuta yoteteza matenda ashuga:

1. "Rigid person" syndrome (mtundu 1 wa matenda a shuga, kukomoka kwa minofu, mikhalidwe yopweteka),
2. Ma antibodies kuma insulin receptors.

Mndandanda wama syndromes ophatikizidwa ndi matenda ashuga:

• Turner syndrome
• Down syndrome
• Lawrence - Mwezi - Beadle syndrome,
• Getore'sore,
• tungsten syndrome
• Klinefelter syndrome
• ataxia of Friedreich,
• porphyria
• Prader-Willi matenda,
• myotonic dystrophy.

1. cytomegalovirus kapena amkati rubella,
2. mitundu ina ya matenda.

Mtundu wina ndi shuga ya amayi apakati. Palinso mtundu wa matenda omwe amayamba ndi mankhwala kapena mankhwala.

1. Wodalira insulini (mtundu 1),

2. Osagwirizana ndi insulin (mtundu 2),

3. Matenda a shuga m'thupi,

4. Matenda a shuga omwe amaphatikizidwa ndi matenda ena (matenda a kapamba, mphamvu ya mankhwala, endocrine pathologies, matenda a insulin, matenda amtundu),

5. Kulekerera kwa shuga

6. Matenda a shuga (pakapita nthawi).

Ndi mitundu yonse yamatendawa, nthawi zambiri pamankhwala azachipatala a endocrinologist, a 1 ndi mtundu 2 amakumana.

Podziwikiratu monga matenda ashuga, mitundu yake imapezekanso mu zotupa zoyambirira za kapamba kapena motsutsana ndi chitukuko cha zochitika zina zamatenda.

Matenda a shuga

Nthawi zambiri, vuto la insulin limayamba chifukwa cha kuwonongeka mwachindunji kwa kapamba chifukwa cha matenda osachiritsika. Kukula kwakukulu kwa matenda a shuga a pancreatic kumawonetsedwa pakuwonongeka kotheratu kwa kapamba, komwe sikungapangidwe kwa insulin kokha, komanso kupangika kwa glycogen ndi chiwindi kungavute. Matendawa amatchedwa "shuga kwathunthu."

1. uchidakwa wopitilira,

2. cholelithiasis,

3. Kuwonongeka kwa poyipa kwa kapamba mukakumana ndi mankhwala kapena ziphe zina,

4. Kuchita opaleshoni pa kapamba.

Zotsatira za kupangidwa kwa kuperewera kwenikweni kwa insulin, chithunzi cha matenda a shuga a pancreatic ndi ofanana ndi mtundu woyamba wa matenda ashuga. Chifukwa chake, chithandizo chachikulu ndikugwiritsa ntchito mankhwala olimbitsa ndi kulowetsanso enzyme kuti matendawa agwiritsidwe ntchito.

Tungsten Syndrome

Tungsten syndrome ndi matenda osowa omwe amagwirizana ndi majini, ndipo zizindikiro zake ndikutukuka kwa matenda ashuga komanso matenda a shuga kuphatikiza ndi kusintha kwa atrophic mumitsempha ya optic. Pambuyo pake, ugonthi, vuto la kukodza, kugwidwa ndi khunyu ndi ataxia zimayamba.

Matendawa ndi oopsa, pakadali pano palibe njira zowonetsera zomwe zimayambitsa chitukuko, chifukwa chake mankhwalawa amakhala ndi kukonza makhwala. Matendawa ndi osauka, odwala amakhala, pafupifupi, mpaka zaka 30, ndipo amafa chifukwa cha kulephera kwa impso.

Mitundu ina ya matenda ashuga

• kusokonezeka kwa maselo opanga insulin chifukwa cha chibadwa champhamvu kapena kuphwanya masinthidwe apangidwe a insulin,

• acomegaly, Cushing's syndrome, amaika poyizoni m'matenda amenewa, kuperewera kwa insulin kumayamba chifukwa cha kuchepa kwa chidwi cha zolandilira minyewa,

• mitundu yachilendo ya autoimmune ndi ma gennd syndromes omwe amagwirizana ndi matenda a shuga.

Matenda a shuga ndi matenda a m'magazi omwe amadziwika ndi kuphwanya kagayidwe (metabolism). Izi zimachitika chifukwa chosakwanira kupanga mahomoni a insulin, monga mtundu wa matenda ashuga 1 kapena kuphwanya mayendedwe ake pama cell ndi minofu ya thupi (mtundu 2 matenda).

Nkhaniyi ikufotokozera mwatsatanetsatane mitundu yayikulu ya matenda a shuga, kusiyana kwa zomwe zimayambitsa ndi njira zotukula, komanso kufotokoza kwa machitidwe a chithandizo cha odwala.

Zokhudza insulini ndi gawo lake m'thupi la munthu

Insulin ndi mahomoni omwe kapamba amapanga. Chiwalocho chili kumbuyo kwa m'mimba, chimazunguliridwa ndi ndulu komanso chiuno cha duodenum. Kulemera kwa kapamba ndi pafupifupi 80 g.

Kuphatikiza pa mahomoni, chitsulo chimapanga madzi a pancreatic, ofunikira kuti chimbudzi cha lipids, chakudya chamagulu ndi mapuloteni. Madzi a insulin amapangidwa ndi β-cell.

Amakhala pang'onopang'ono padziko lonse la kapamba m'njira zamagulu ang'onoang'ono omwe amatchedwa islets of Langerhans-Sobolev. Zilumbazi zilinso ndi ma α-cell omwe amapanga glucagon yomwe imagwira ntchito m'thupi.

Hormone iyi imasiyananso ndi insulin.

Zofunika! Munthu wathanzi labwino amakhala ndi zilumba zotere pafupifupi miliyoni zomwe zimalemera magalamu angapo.

Insulin ndi molekyulu ya protein yomwe imakhala ndi ma ma amino acid angapo. Ntchito yake ndikutenga shuga (shuga) ndi maselo amthupi. Shuga ndikofunikira kuti munthu alandire mphamvu. Popanda izi, maselo ndi minyewa sizingathe kugwira ntchito zawo.

2. Mtundu wa shuga wachiwiri (dzina lakale: insulini yodziimira payekha)

a) Achinyamata ACHINYAMATA-matenda ashuga (mitundu 3 idasiyanitsidwa ndi gulu la 1999, mitundu 6 mu 2005),

c) zolephera zina zamtundu wa function cell cell

- lembani kukana kwa insulini, - leprechaunism,

- Rabson-Mendenhall syndrome, - matenda a shuga

- mitundu inanso yamatsenga amtundu wa insulin receptors.

- aakulu kapenanso kupezekanso kwa kapamba, neoplasia, kapamba, cystic fibrosis, fibrocalculeous pancreatopathy, hemochromatosis,

Acromegaly, Cushing's syndrome, glucagonoma, pheochromocytoma, thyrotooticosis, somatostatinoma, aldosteroma, ndi zina zambiri.

Matenda a shuga ndi matenda opatsirana a hyperglycemia ndi glucosuria, omwe amayamba chifukwa cha kuperewera kwenikweni kwa insulin, zomwe zimayambitsa kusokonezeka kwa metabolic, kuwonongeka kwa mtima (mitsempha yambiri), neuropathy, komanso kusintha kwa pathological mu ziwalo zosiyanasiyana.

Matenda a shuga amapezeka mmaiko onse padziko lapansi ndipo malinga ndi WHO, pali odwala opitilira shuga mamiliyoni 150 padziko lonse lapansi.

M'mayiko otukuka a America ndi Europe, kuchuluka kwa matenda osokoneza bongo ndi 5-6% ndipo ali ndi chizolowezi chowonjezereka, makamaka m'magulu azaka zopitilira 40. Mu Russian Federation, pazaka zingapo zapitazi, 2 miliyoni adalembetsa

odwala matenda ashuga (pafupifupi anthu 300,000 odwala matenda amtundu wa I, ndi 1 miliyoni 700,000 odwala omwe ali ndi matenda amtundu II).

Kafukufuku wa Epidemiological omwe adachitika ku Moscow, St. Petersburg ndi m'mizinda ina akuwonetsa kuti chiwerengero chenicheni cha odwala matenda ashuga ku Russia chikufika kwa anthu miliyoni 6 miliyoni.

Izi zimafuna kuti pakhale njira zodziwira matendawa komanso kufalikira kwa njira zopewera matenda. Pulogalamu yomwe boma likuyang'anira "Disabetes Mellitus", yomwe idakhazikitsidwa mu Okutobala 1996, imapereka njira zothandizira mabungwe, matenda, njira zodzitetezera ndi cholinga chochepetsa kufala kwa matenda a shuga, komanso kuchepetsa kulumala ndi kufa kwa matenda ashuga.

Malinga ndi kafukufuku waposachedwa, a Katswiri wa WHO Expert on Diabetes (1985) adalimbikitsa gulu la shuga mellitus, lomwe limagwiritsidwa ntchito m'maiko onse padziko lapansi.

Gulu la anthu odwala matenda ashuga (WHO, 1985)

A. Makalasi azachipatala

I. Matenda a shuga

1. Mellitus wodwala matenda a shuga

2. Mellitus (DIA) wosadalira insulini

a) mwa anthu omwe ali ndi thupi labwinobwino

b) Anthu onenepa kwambiri

3. Matenda a shuga omwe amaphatikizidwa ndi kuperewera kwa zakudya m'thupi

a) matenda kapamba,

b) matenda a endocrine,

c) Zinthu zomwe zimayambitsidwa chifukwa cha kumwa mankhwala kapena kukhudzana ndi mankhwala,

d) zovuta za insulin kapena zolandilira,

e) ma syndromes ena amitundu,

e) mayiko osakanikirana.

II. Kulekerera kwa shuga

c) Zogwirizana ndi zochitika zina (syndr 4)

III. Matenda a shuga apakati

B. Makalasi oopsa (omwe ali ndi vuto lofanana ndi shuga koma ali ndi chiwopsezo chachikulu chotenga matenda ashuga)

a) Kuleza mtima kwa shuga m'mbuyomu

b) kulolera kusokoneza shuga.

Gulu la WHO la mellitus ya shuga lidapangidwa ndikuvomerezedwa ndi oimira World Health Organisation. Malinga ndi izi, matenda ashuga agawidwa m'mitundu iyi:

• matenda 1
• matenda 2
• mitundu ina ya matenda.

Kuphatikiza apo, malinga ndi gulu la WHO, madigiri oterewa amasiyanitsidwa ndi matenda ofatsa, olimbitsa komanso oopsa. Digili yofatsa nthawi zambiri imakhala ndi chikhalidwe chobisika, sichimayambitsa zovuta komanso zizindikiro zokulirapo. Wapakati umakhala limodzi ndi zovuta mu mawonekedwe a kuwonongeka kwa maso, impso, khungu ndi ziwalo zina. Pa gawo lotsiriza, zovuta zazikulu zimawonedwa, nthawi zambiri zimayambitsa zotsatira zakupha.

Insulin imakhala ngati mahona ofunikira kwambiri opangidwa ndi kapamba kuchokera m'maselo a mchira wake. Cholinga cha insulin ndikuwongolera kuchuluka kwa shuga m'magazi, potengera kagayidwe kogwira.

Vuto lachiberekero likachitika, kuchuluka kwa glucose kumayamba kukwera, zomwe zimapangitsa munthu kukhala ndi matenda ashuga. Kuti akhale wathanzi, wodwala ayenera kutsatira kadyedwe ndikuchita zoyenera.

Njirazi zimagwiritsidwa ntchito nthawi zonse ngati mankhwalawa amachokera mu njira yopangira insulin. Masiku ano, pali mitundu yambiri ya mankhwalawa. Chifukwa chake, muyenera kumvetsetsa mitundu ya insulin yomwe ilipo, momwe imasiyana ndi inzake komanso momwe amachitira.

Mitundu yayikulu ya insulin

Insulin ndi yachilengedwe komanso yopanga. Insulin yachilengedwe imapangidwa ndi maselo mu kapamba aanthu kapena nyama. Insulin yokumba imapangidwa m'malo a labotale ndi njira yolumikizira ya chinthu chachikulu ndi zowonjezera zina. Mtundu wachiwiri umapangidwira zochizira odwala omwe ali ndi matenda ashuga nthawi zambiri.

Chenjezo makamaka pofunsa mankhwala liyenera kukhala lothandiza odwala okalamba ndi ana oyambira ana kuti muchepetse zovuta zomwe zingachitike. Chifukwa chake, kudziwa mitundu ya insulini ndikofunikira kwambiri popanga dongosolo la mankhwala.

Monga chithandizo, jakisoni wa insulin tsiku lililonse amagwiritsidwa ntchito. Kuti musankhe mankhwala oyenera, muyenera kudziwa mtundu wa insulin womwe ulipo. Njirayi imapewa zotsatira zosafunikira.

Zosiyanasiyana za insulin zimagawidwa ndi magawo otsatirawa:

1. Kuthamanga kwa zochita pambuyo pa kupatsidwa mankhwala
2. Kutalika kwa mankhwalawa
3. Zomwe mankhwalawo amapangidwa
4. Kutulutsa mawonekedwe.

Gulu la zigawo

Kuphatikiza pa mitundu yayikulu, insulin imagawikidwanso mu monovoid ndikuphatikiza pamodzi. Poyamba, mankhwalawa amakhala ndi mtundu umodzi wokha wa insulin - mwachitsanzo, nkhumba kapena bovine. Kachiwiri, kuphatikiza mitundu ingapo ya insulini kumagwiritsidwa ntchito. Mitundu yonseyi imagwiritsidwa ntchito mosamala pochiza matenda ashuga.

Mlingo wa kuyeretsa kwamankhwala

Kutchulidwa kwa kukonzekera kwa insulin kumadaliranso kuchuluka kwa kuyeretsedwa kwawo ndi kufunika kwa njirayi:

1. Maonekedwe achikhalidwe amapezeka ndi liquefaction ndi asidi ethanol, kusefera, kusefukira kunja ndi mitundu yambiri. Njira yodziyeretsa siziwoneka kuti ndiyabwino chifukwa cha zodetsa zomwe sizingagwiritsidwe ntchito.
2. Peak monopic amapezeka pambuyo pa chikhalidwe chamtundu wa kuyeretsa, kenako kusefa kudzera mu gel yapadera. Zovuta pakukonzanso zimakhalabe, koma zochepa.
3. Mitundu ya monocomponent imawerengedwa kuti ndi yabwino kwambiri pochizira matendawa, chifukwa ma cell sieving ndi ion-exchange chromatography amagwiritsidwa ntchito pakuyeretsa kwake.

Fomu yokhudzana ndi pakati pa mimba

Kuchuluka kwa shuga m'magazi kumachitika mwa amayi apakati chifukwa cha kukonzanso kwakumbuyo ya mahomoni ndikuchepa kwa ntchito zolimbitsa thupi. Matenda oterewa amatha kutha pawokha mwana atabadwa kapena kutsogoloku kungayambitse kukula kwa matenda ashuga.

Kuwunika pafupipafupi shuga ya magazi ndikofunikira nthawi yonse ya bere. Momwe mawonekedwe a matendawa angakhudzire amayi, thanzi la mwana wosabadwayo komanso mayi woyembekezera.

Kuchuluka kwa shuga kumayambitsa matenda oopsa mwa mayi wapakati, zomwe zimayambitsa kuwonekera kwa edema, yomwe imathandizira kukula kwa hypoxia mu mwana wosabadwayo.

Kuchepetsa kwa matenda osagwirizana kumawonjezera kuchuluka kwa shuga m'magazi a mwana wosabadwayo, komwe amathandizira kupanga maselo amafuta. Zotsatira zake, thupi la mwanayo ndi mutu ndi mapewa ake zimakulitsidwa. Mwa amayi apakati omwe ali ndi mawonekedwe a bere, mwana wosabadwa wamkulu nthawi zambiri amabadwa, amafikira kuposa makilogalamu anayi a kulemera, komwe kumapangitsa njira ya kubala kwa mwana ndikupangitsa kuvulala kwa ngalande yobadwa.

Matenda amtunduwu, omwe amatchedwanso kuti gestational kishuga, amapezeka mwa azimayi munthawi ya bere ndipo amadziwoneka ngati chiwopsezo cha magazi. Ngati njira zonse zodzitchinjiriza zimawonedwa, matenda ashuga amisala mwana akangobadwa.

Pakadali pano, shuga wambiri amatha kuvulaza mayi woyembekezera komanso mwana wosabadwa. Nthawi zambiri mwana wotere amabadwa wamkulu kwambiri, ndikuwonjezera mavuto pakubala. Komanso, akadali m'mimba, amatha kuperewera ndi mpweya wabwino.

Amakhulupirira kuti ngati mayi adadwala matenda ashuga pakadali pano, ichi ndi chizindikiro choti wakonzekereratu. Chifukwa chake, ndikofunikira kuti mkazi aziyang'anira kulemera kwake, adye molondola komanso asayiwale za masewera olimbitsa thupi opepuka.

Mwa amayi apakati, kuchuluka kwa shuga m'magazi kumatha kuwonjezeka chifukwa cha kusintha kwa mahomoni m'thupi. Nthawi yomweyo, zikondamoyo zimalemedwa kwambiri ndipo nthawi zambiri sizimalimbana ndi ntchito yomwe mukufuna. Izi zimabweretsa zovuta za metabolic mwa amayi ndi kwa mwana wosabadwayo.

Mwanayo amapanganso insulini kawiri, chifukwa chake shuga amapezeka mafuta, zomwe zimakhudza kulemera kwa mwana wosabadwayo. Pankhaniyi, mwana wosabadwayo amafunikira kuchuluka kwa oksijeni, komwe sangathe kubwezeretsanso, komwe kumapangitsa kuti njala ibwere.

Zizindikiro za matenda a shuga

Pamaso pa chimodzi mwazizindikiro zomwe zalembedwa, ndipo makamaka ngati pali ziwiri kapena zingapo, kuyankhulana ndi endocrinologist ndikofunikira. Chifukwa chake:

1. Kukhalapo kwa ludzu losalekeza, lomwe limavuta kuletsa.
2. Kukodza pafupipafupi.
3. Madontho a mkodzo wouma ndi zoyera, zokhala ndi madontho, ofanana ndi wowuma.
4. Kugona pafupipafupi komanso kufooka.
5. Kuuma kwambiri pakhungu.
6. Ngakhale mabala ang'onoang'ono amachiritsa kwa nthawi yayitali.
7. Kukhalapo kwa khungu kuyabwa.
8. Kumva njala mosalekeza.
9. Kukhalapo kwa pustular formations pakhungu.

Zizindikiro zodziwika bwino za matenda a shuga zimaphatikizaponso chilakolako chofuna kumwa, kumva kukamwa kowuma, kukodza mwachangu, kuyabwa, ndi kuwonongeka kwa mawonekedwe. Nthawi zambiri, zizindikiro zimayamba kuonekera pomwe matendawa atakula kale.

Pokhudzana ndi izi, ndikofunikira kuti nthawi zonse mumayesedwe ndikuwonetsetsa kuchuluka kwa shuga m'magazi. Izi zikuyenera kuchitika kamodzi pachaka.

Kuti muwonetsetse kuti palibe matenda, ndikofunikira kuyesedwa magazi ndi mkodzo. Mwa milandu inayi, monga lamulo, atatu saganiza ngakhale pang'ono kuti ali ndi matendawo.

Matenda a prediabetes

Vutoli limadziwika ndi kusokonezeka kwa glucose kuzindikira kwa thupi. Zizindikiro zoterezi zidzakhala - 5.6-6.9 mmol, mutatha kudya pambuyo pa maola 2 azichulukitsa mpaka 7.8-11 mmol. Mkhalidwe wodwalayo ungayambitse matenda a mtima ndi matenda a mtima. Mu zoterezi, hemoglobin ya glycosylated imawunikidwa ndipo kuchuluka kwa shuga kumatsimikizika kwakanthawi.

Nthawi zina, matenda a prediabetes amatha kumatha popanda zizindikiro. Zizindikiro zomwe munthu angaganize kuti ali ndi matenda ashuga.

Nthawi zina, matenda a prediabetes amatha kumatha popanda zizindikiro. Zizindikiro zomwe munthu angaganize kuti ali ndi matenda ashuga.

Njira zakuzindikira zimatengera kupezeka kwa hyperglycemia pansi pazinthu zina. Mitundu ya matenda ashuga imawonetsa zizindikiro zosiyanasiyana. Ndiosagwirizana, kotero, kusapezeka kwa matendawa sikukuthandizira kuzindikira.

WHO Worldwide Diagnostic Standard imalongosola zodwala zam'mphepete mwa glucose homeostasis yochokera shuga m'magazi pogwiritsa ntchito njira zina.

• shuga wa m'magazi pamimba yopanda kanthu (pafupifupi maola eyiti atatha kudya),
• shuga wamagazi (nthawi iliyonse masana, kupatula zakudya),
• glycemia pa mphindi 120 za kuyamwa kwa glucose pakamwa ndi 75 g shuga.

Matenda a shuga angapezeke m'njira zitatu:

1. kukhalapo kwa tingachipeze powonetsa zizindikiro za matendawa, glycemia wosaposa 11.1 mmol / l,
2. glycemia pamimba yopanda 7.0 mmol / l,
3. glycemia pa mphindi ya 120 ya PTTG yoposa 11.1 mmol / l.

Kwa glycemia wowonjezera, kuchuluka kwina kwa glucose m'madzi amadzi am'mimba yopanda kanthu, ndi 5.6 - 6.9 mmol / L.

Kulekerera kwa shuga wambiri kumadziwika ndi kuchuluka kwa glucose wa 7.8 - 11.0 mmol / L pa mphindi 120 za PTTG.

Matenda a shuga amapezeka mosavuta, izi zimachitika chifukwa chakuti, monga lamulo, wodwalayo amapita kwa dokotala mochedwa kwambiri, matendawa atayamba kale ndipo zizindikiro zake zikuwonekera bwino.

Njira yofunikira kwambiri yodziwira pakakhala shuga ndi kuphunzira magazi a shuga. Kuyesedwa kumawonetsa kuchuluka kwa shuga, kuperewera kwa glucose metabolism, ngati kulipo.

Mtundu wa matenda umatsimikiziridwa ndi mulingo wa shuga m'magazi. Monga lamulo, ngakhale kuyezetsa magazi kokha kungaweruze kukhalapo kapena kusowa kwa matenda a shuga.

Nthawi zina, kuwunika kowonjezera kungafunike - kuyesa kwa glucose, kutsimikiza kwamatenda a shuga ndi glucose, ma ultrasound a impso ndi ziwalo zam'mimba, komanso electrocardiogram.

Chithandizo cha matenda ashuga

Chithandizo cha matenda a shuga chimachitika molingana ndi ziwembu zosiyanasiyana. Zimatengera mtundu wamatendawa komanso mtundu wake.

Matenda a shuga amtundu wa 1 amathandizidwa ndi insulin yowonjezera. Chithandizo choterechi ndichofunikira kwa wodwala moyo wake wonse.

Mankhwala amakono apanga zomwe amatchedwa cholembera, mothandizidwa ndi zomwe wodwalayo amatha kupanga payekha jakisoni. Chopangitsa china ndi pampu ya insulin, ina mwa iyo imapangidwa mwanjira yoti amasintha okha mankhwalawo, atazindikira kale kuchuluka kwa shuga.

Ndikotheka kugwiritsa ntchito mankhwala omwe amachititsa kuti insulin ipange.

Popeza matenda ashuga amtundu wachiwiri amakhala ndi mawonekedwe a chitetezo chokwanira ku insulin, chithandizo chachikulu ndikuchepetsa shuga m'magazi, komanso mankhwala omwe cholinga chake ndikuchotsa matenda osokoneza bongo. Dongosolo la chithandizo pankhaniyi ndi motere:

• kukonza insulin
• kutsika kwa insulin kukana, ndiko kuti, chitetezo chamthupi,
• kuletsa kulowetsa shuga m'magazi,
• kuchotsa kuphwanya dyslipidemia.

Pofuna kuperekera chithandizo cholondola, kufufuza koyenera kumachitika, pomwe kuchuluka kwa kapamba kumakhazikitsidwa.

Zovuta zotheka

Matenda a shuga angayambitse kuwonongeka m'moyo wonse. Izi zimachitika mosasamala mtundu wa shuga. Zizindikiro ziziwoneka pang'onopang'ono ndipo kupenda kwathunthu ndikofunikira kuti mudziwe ngati muli ndi matenda. Kukula kwa zovuta kumakhudza thanzi lathunthu.

Retinopathy imatha kuyamba - izi ndizowonongeka kwa retina kapena kufinya, komwe kukha magazi pakhungu kumatha kuchitika. Popanga matendawa, wodwalayo amatha kukhala wakhungu kwathunthu. Pali chitukuko cha zotupa m'matumbo, mapangidwe magazi, kupindika.

Polyneuropathy ndiye kuchepa kwa ululu komanso kumva kutentha. Nthawi yomweyo zilonda zam'manja ndi miyendo zimayamba kukulira. Manja ndi miyendo nthawi zambiri zimavutika. Zomverera zonse zizilimbitsa usiku. Mabala samachiritsa kwa nthawi yayitali ndipo pali mwayi woti ungayambe gangore. Nephropathy ndimatenda a impso omwe amaphatikizapo kutulutsidwa kwa mapuloteni kudzera mkodzo. Kulephera kwamankhwala kumatha.

Matenda a shuga ndi omwe amayambitsa kukalamba kwa thupi. Ndipo sizosadabwitsa kuti kupezeka kwakeko, ndikuphwanya kwathunthu njira zonse za metabolic mthupi:

• chakudya kagayidwe kachakudya
• mafuta,
• mapuloteni kagayidwe
• mchere
• mchere wamchere.

Kuphatikiza apo, matendawa amabweretsa zovuta zingapo, zomwe:

1. Kuphwanya kwa magwiridwe antchito a ziwalo zogonana. Amuna amatha kukhala opanda mphamvu, pomwe azimayi amatha kusokonezeka mu msambo.
2. Kukula kwa matenda awa:
3. Matenda amaso: kuchokera ku conjunctivitis kupita ku khungu la retinal lomwe limatsogolera ku khungu.
4. Kutupa kwachilendo pakatikati pamlomo.
5. Pustular mawonekedwe phazi, kufewetsa zimakhala ndi mafupa a phazi. Izi zitha kubweretsanso mapazi.
6. Matendawa
7. Matenda a mtima ndi mtima: arrhythmia, matenda a mtima ndi zina zambiri.
8. Kulephera kwina
9. Kuphwanya kwachilengedwe kugwira ntchito kwamanjenje.

Kupewa matenda a shuga

Popewa kukula kwa matenda a shuga, omwe ndi amtundu wachiwiri, ndikofunikira kuyang'anira kulemera, osapeza mapaundi owonjezera. Zakudya siziyenera kukhala ndi zopatsa mphamvu zambiri. Kudya moyenera komanso kuwongolera kunenepa ndi njira yodalirika yopewera matendawa. Ngakhale ndi matenda a prediabetes, njira zoterezi zimachepetsa kwambiri chiwopsezo cha matenda.

Zakudya zopatsa thanzi zimaphatikizapo kuchepetsa kudya shuga komanso zakudya zopatsa shuga. Zakudya zotere zimawonjezera mwayi wokhala ndi matenda ashuga. Muyeneranso kuchepetsa kumwa ma muffin, zakudya zokhuthala, nyama ndi mkaka. Menyuyi muyenera kukhala ndi nyemba, chimanga, zitsamba, phwetekere, zipatso za malalanje.

Udindo wofunikira umachitika ndi zolimbitsa thupi. Amawerengedwa kuti ndi njira imodzi yothanirana ndi matendawa, makamaka pamaso pa kudwala kwachiwiri. Ndikofunikira kuchita masewera olimbitsa thupi komanso masewera olimbitsa thupi osachepera mphindi khumi ndi zisanu patsiku. Zochita zolimbitsa thupi zimagawidwa tsiku lonse: maulendo awiri kapena atatu, iliyonse imatenga mphindi 10.

Njira ina yothandiza ndi kukana kupsinjika. Kugwiritsa ntchito mankhwalawa ndikothandiza kupewa matenda aliwonse. Kupatula apo, misempha yofooka, kupsinjika kwapafupipafupi ndi nthaka yabwino pakupanga matenda osiyanasiyana. Kupanikizika kumayanjana mwachindunji ndi msambo woponderezedwa, kumawonjezera kwambiri. Kuthamanga kwa magazi kumayambitsa mavuto a metabolic.