Mankhwala a insulin akadali mbali zotsutsa kwambiri za chithandizo cha odwala omwe ali ndi NIDDM. Izi zikuchitika, kumbali imodzi, ku kusowa kwa lingaliro logwirizana pankhani ya etiology ndi pathogenesis ya NIDDM komanso kutsutsana komwe kumakhalapo chifukwa cha vuto lalikulu - panthawi ya insulin secretion kapena zochitika zake pamlingo wofikira, kodi ndizomveka kuthandiza odwala omwe ali onenepa kwambiri komanso opatsirana ndi insulin, Komabe, palibe njira zotsimikizika kuti mtundu wa mankhwalawa ungagwire bwino ntchito.

Pali nthawi zina pamene nkosavuta kuyankhula zakufunikira kwa kupatula insulin kwa nthawi yayitali kapena kwakanthawi.

Njira yayitali ya insulin yothandizira NIDDM ikuwonetsedwa:

• pali zotsutsana ndi kukhazikitsidwa kwa sulfonylureas ndi biguanides,
• kukana koyamba kapena kwachiwiri kwa mankhwala ochepetsa shuga a shufanilamide,
• kwambiri mochedwa zovuta za matenda ashuga (kuchuluka kwa retinopathy, kupweteka kwakukulu kwa neuropathy, makamaka mawonekedwe ake owawa, nephropathy yomwe ikupita patsogolo.

Zizindikiro za insulin yothandizira za NIDDM ndi izi:

• Opaleshoni ya opaleshoni yothandizira
• mogwirizana corticosteroid mankhwala,
• matenda oopsa a mtundu wopatsirana ndi malungo, nthenda zamtundu umodzi kapena kupsinjika, zomwe zimabweretsa kuwonjezeka kwa mahomoni otsutsana ndi kufunika kwa insulin,
• malabsorption chifukwa chogwiritsidwa ntchito nthawi yayitali pakumwa mankhwala a hypoglycemic,
• kufunikira kwa kukwaniritsa Normoglycemia ndi zizindikiro zomveka za insulin (polyuria, ludzu, kuchepa thupi) kapena zizindikiro za kuchepa kwa mitsempha.

• 110-140 mg%,
• 141-200 mg%,
• 201-240 mg%,
• oposa 240 mg%.

Ngati mukukayika za kuthekera kwa insulin mankhwala, ndikofunikira kutsimikizira kuchepa kwa insulin mobisa zochitika za maselo a B potsatira kukondoweza ndi glucagon. Kuyesaku sikungachitike poyerekeza ndi kubzala kwa matenda ashuga, chifukwa hyperglycemia ili ndi chowonjezera m'maselo a B. Izi zimatha kutsitsa zabodza poyankha mwachinsinsi kukondoweza. Kwa masiku angapo, mankhwala a insulini okonza kagayidwe ka kagayidwe kake sikakhudza kuchuluka kwa C-peptide panthawi yoyesedwa. Kuyesedwa kwa mayeso a glucagon (1 mg ya glucagon kudzera mkati mwa jekeseni ya Seramu C-peptide isanachitike ndi mphindi 6 pambuyo pa jekeseni): kusala kudya kwa C-peptide pamwamba pa 0.6 nmol / L ndi pamwamba pa 1.1 nmol / L pambuyo pa kukondoweza kumawonetsa ntchito zambiri zachinsinsi. Mlingo wa glucagon-wokondoweza wa C-peptide ya 0,6 nmol / L kapena wocheperako akuwonetsa kufunikira kopanda insulin. Komabe, kuyesa kwa glucagon sikutilola kuti tiweruze kuchuluka kwa insulin. Izi zikutanthauza kuti, ngakhale pakhale chokwanira cha mankhwala amkati a insulin, chithandizo cha mankhwala a insulin chitha kukhala chofunikira.Zotsatira za mayeso a glucagon: pheochromocytoma, matenda oopsa oopsa.

Njira ya Insulin Therapy ya NIDDM. Zochitika zamankhwala zikuwonetsa kuti pambuyo poti nthawi yayitali mankhwala “osapindulitsa” a sulfanilamide, nthawi yayitali yokwanira kulandira insulin imayenera kukonza kusokonezeka kwa metabolic, makamaka dyslipidemia. Kuphatikiza kwa insulini yoyeretsedwa kwambiri yochokera ku nyama komanso kuchita zinthu zazitali ndi ma insulin osakhalitsa a anthu kumakonda kugwiritsidwa ntchito (tebulo 5). Kuphatikiza pa vuto lomwe likufunika kuti agonekere kuchipatala kwa nthawi yayitali, odwala omwe ali ndi NIDDM popanda kunenepa kwambiri amatha kupatsidwa insulin. Nthawi zambiri, insulin imayendetsedwa musanadye chakudya cham'mawa komanso chakudya chamadzulo. Mlingo woyambirira wa insulin ya basal imatsimikizika pakuwerengedwa kwa mayunitsi a 0-0-0,5 / kg, kenako kukonza glycemia (1 unit ya insulin pa 1.1 mmol / l iliyonse, yoposa 7.7 mmol / l). Ngati ndi kotheka, jekeseni yachiwiri ya basal insulin ikhoza kuyambiranso nthawi ina pambuyo pake (22,00). Mlingo wa insulin yocheperako imatsimikiziridwa pamlingo wa 1 unit. pa 1.7 mmol / L iliyonse ya postprandial glycemia pamtunda wa 7.8 mmol / L (J.A. Galloway). Muzochitika zosavuta, kuphatikiza insulin yopanga ndi kuchuluka kwa nthawi yayitali komanso kwakanthawi kochepa kungagwiritsidwe ntchito.

Gawo 5.
Kukonzekera kwa insulin.

Komabe, machitidwe awonetsa kuti kukwaniritsa pafupi- kapena Normoglycemia ndi NIDDM nthawi zambiri zimakhala cholinga chabodza. 10%% yokha ya odwala omwe ali ndi jakisoni wambiri wa insulin omwe ali ndi shuga wamagazi omwe amavomerezedwa ndi NIDDM Policy Group. Ntchitoyi imakhala yovuta ndi nthawi yayitali ya matendawa ndikukula kwa sekondaleide. Angapo ma insulin angapo kwakanthawi kapena kwakanthawi, ndizowoneka bwino kwambiri. Ubwino wamtunduwu wa mankhwala a insulin ndi kugawa zakudya kwaulere, mwachangu komanso moyenera. Njira yamtunduwu imathandizira pazosankha zazikulu za NIDDM, kuwonjezera, kuyendetsa mwachangu kwambiri komanso kogwira mtima kwambiri kumadodometsa kuzungulira kwa "hyperglycemia - kawopsedwe wa glucose - insulin kukana - hyperglycemia".Kafukufuku wambiri akuwonetsa kuchepa kwakukulu kwa kupanga kwa shuga kozama ndi chiwindi ndikuwongolera magwiritsidwe azomwe amapezeka ndi minofu yolumikizira mafupa, onse motsutsana ndi kagwiritsidwe ntchito ka nthawi yayitali komanso kwakanthawi kokwanira kwa odwala omwe ali ndi NIDDM. Nthawi yomweyo, mankhwala osokoneza bongo aafupi a masabata atatu ali ndi tanthauzo lotsogola komanso losatha pambuyo pathetsa insulini: kuchepa kwa kupanga kwa shuga ndi chiwindi ndi 32-75%, kuwonjezeka kwa chiwonetsero cha glucose cha maola awiri ndi 6%. Cholepheretsa chachikulu pakugwiritsira ntchito mankhwalawa ndi hyperinsulinemia yosatha, yolumikizidwa ndi chiwopsezo cha atherosulinosis. Basal ndi postprandial hyperinsulinemia ndizovuta kwambiri chifukwa cha maphunziro ambiri omwe adawerengera njira zamankhwala othandizira a insulin ndi kutsimikiza kwa mulingo wa St. IRI, kapena kugwiritsa ntchito luso. Komabe, funsoli silikudziwikabe kuti hyperinsulinemia yochokera ku insulin ya exo native ndiyomwe imayambitsa chiopsezo cha atherogenesis monga kuchuluka kwa insulin kwa odwala omwe ali ndi NIDDM.

Pankhaniyi, zikuwoneka zosangalatsa kusanthula momwe insulin ingagwiritsire ntchito mankhwala a atherogenic a lipid metabolism. Malinga ndi mabukuwa, mankhwalawa obwerezedwa mobwerezabwereza a insulin amayambitsa kusintha kwa antiatherogenic mu mawonekedwe a plasma lipoprotein mwa odwala NIDDM: mulingo wa VLDL ndi triglycerides amachepetsa. Kafukufuku wokhudzana ndi kugwira ntchito kwakanthawi kochepa (masabata atatu) komanso nthawi yayitali (masabata 12) insulin kwambiri kwa odwala omwe ali ndi NIDDM omwe ali ndi "yachiwiri kulephera" kwa PSM yochitidwa mu chipatala chathu (L.P. Ivanova, 1994, V.Z. Topchiashvili, 1995), adawonetsa kuthekera kwakukonzanso bwino kwa atherogenic dyslipidemia: kutsitsa triglycerides, cholesterol yathunthu, LDL ndi VLDL cholesterol, kubwezeretsa kuchuluka kwachilengedwe kwa apoproteins a plasma.

Kuphatikiza mankhwala ndi insulin / PSM. M'zaka zoyambirira za 80s, chidwi cha kuphatikiza mankhwala othandizira ndi insulin ndi sulfonamides chinawonjezeka kwambiri ngati njira ina ya insulin monotherapy mwa odwala NIDDM omwe ali ndi "yachiwiri kulephera" kwa PSM. Malingaliro a malingaliro a mtundu uwu wa chithandizo anali awa:

• endo native insulin yolimbikitsidwa ndi sulfonamides imatengedwa mwachindunji ku chiwindi,
• Mlingo wochepa wa insulin wofunikira pa mankhwala osakanikirana samayambitsa hyperinsulinemia,
• chiwopsezo cha hypoglycemia kwa odwala amachepetsa,
• kumva kwa PSM mwa odwala pazoyambira "kulephera kwachiwiri" kumabwezeretsedwa
• Kuleza mtima kwa insulin mankhwala kumakhala bwino ndi regimen imodzi ya insulin.

Palibe mgwirizano pazabwino zogwiritsira ntchito izi kapena mtundu wa insulin wowonjezera pamodzi ndi kukonzekera kwa sulfonylurea. Olemba ena amalimbikitsa kugwiritsa ntchito insulin imodzi yayitali kwa mankhwala a 0-0-0.3 / kg ndi avareji ya PSM, pomwe phindu la jakisoni wa m'mawa kapena madzulo silinadziwike. Ngakhale kunena, kukhazikitsidwa kwa insulin musanalowe m'mimba kumakupatsani mwayi wokwanira kuphatikiza shuga wopangidwa ndi chiwindi ndikupangitsa matenda achepetsa kusala. Kuphunzira kwathu kwakanthawi kochepa kagwiritsidwe ntchito ka mitundu yosiyanasiyana ya insulini othandizira kuphatikiza ndi PSM kwawonetsa zabwino zakugwiritsira ntchito insulin yochepa pazakudya zazikulu malinga ndi kuwongolera katemera wa insulin komanso kugwiritsa ntchito shuga.

Malinga ndi H.E. Lebovitz, kuwonjezeka kwa mtengo wophatikizira ndi 30% ndi kusiyana kwakanthawi kachipatala kochizira-insulin kumalepheretsa kugwiritsa ntchito mtundu uwu wa kuchepetsa shuga kwa odwala omwe ali ndi NIDDM. Mankhwalawa ophatikizira a insulin / PSM ayenera kugwiritsidwa ntchito ngati osagwirizana ndi glycemic control ndi nthawi yayitali ya insulin pa mlingo wa 70 magawo / tsiku. kapena zoposa 1 unit / kg. 30% mwa odwala adzakwaniritsa kuyendetsa bwino glycemic. Kuphatikiza mankhwala ndi glycemia ochepera 10 mmol / l ndi kufunikira kwa tsiku ndi tsiku kwa insulin yopanda 40 mayunitsi sikolakwika.

Kuyang'anira ndi kudziyang'anira pawokha pa matenda ashuga ndi mankhwala omwe akupitilira.
SELF-CONTROL -
Maziko a chithandizo chabwino, kupewa kuwonongeka ndi zovuta za matenda ashuga.

Kudziletsa pakokha kumaphatikizapo

• kudziwa odwala omwe ali ndi mawonekedwe a mawonetsedwe azachipatala ndi chithandizo cha matenda,
• zakudya
• kuwunika glycemia, glucosuria ndi thupi
• kukonza hypoglycemic mankhwala.

Chithandizo chovuta chokha cha odwala omwe ali ndi NIDDM ogwiritsa ntchito mankhwala othandizira kudya, kuchita masewera olimbitsa thupi mokwanira, kugwiritsa ntchito mankhwala osokoneza bongo ndi njira zodziyang'anira zokha zomwe zingathandize kupewa zovuta za matenda ashuga, kusunga malo ogwira ntchito ndikuwonjezera moyo wa odwala.

Matenda ngati matenda ashuga afala kwambiri ndipo amapezeka mwa akulu ndi ana. Mellitus (NIDDM) wosadalira insulin samapezeka kawirikawiri ndipo ndi mtundu wodwala. Odwala osagwirizana ndi insulin omwe ali ndi matenda osokoneza bongo omwe ali ndi matenda osokoneza bongo ali ndi kupatuka kwa insulin ndikusokonezeka kwamtundu wa zotumphukira zamtunduwu kupita ku insulin, kupatuka kotereku kumadziwikanso kuti insulin kukana.

Mellitus wosadalira shuga yemwe amadalira odwala amafunika kuyang'aniridwa ndi kulandira chithandizo chamankhwala pafupipafupi, chifukwa zovuta kwambiri ndizotheka.

Zolinga ndi makina a chitukuko

Zomwe zimapangitsa kuti pakhale matenda osokoneza bongo omwe samadalira insulin zimaphatikizira zinthu izi:

• Makamaka. Chochititsa chake ndicho chofala kwambiri ndipo nthawi zambiri chimayambitsa matenda osokoneza bongo omwe amadzidalira.
• Zakudya zopanda pake, zoyambitsa kunenepa kwambiri. Ngati munthu akudya maswiti ambiri, chakudya chambiri, pomwe pali zakudya zochepa za fiber, ali pachiwopsezo chotenga matenda osokoneza bongo omwe amadalira insulin. Kucheperako kumawonjezeka kangapo, ngati mukudya kotere, munthu wodalira amakhala njira yamoyo.
• Akuchepetsa mphamvu ya insulin. Pathology imatha kuchitika mwanjira zitatu:
  • kupatuka kwa kapamba, momwe insulin imasokonezekera,
  • Matenda a zotumphukira zomwe zimakhala insulin, zomwe zimakwiyitsa shuga komanso ma metabolism.
  • kulakwitsa kwa chiwindi.
• Kupatuka mu kagayidwe kazakudya. Matenda a shuga a Type 2 a mellitus amayamba kugwira njira zomwe sizimadalira insulini.
• Mapuloteni osokoneza ndi mafuta kagayidwe. Pamene kaphatikizidwe amachepetsa ndipo kagayidwe kazakudya kamapulogalamu, munthu amayamba kuchepa thupi kwambiri komanso minyewa yotupa.

Mtundu wa shuga wosadalira insulini umayamba pang'onopang'ono. Choyamba, chidwi chamtundu wa insulin chimachepa, chomwe pambuyo pake chimayambitsa kuchuluka kwa lipogenis ndi kunenepa kwambiri kwapang'onopang'ono. Ndi matenda osokoneza bongo a shuga omwe amadalira insulin, matenda oopsa a ubongo nthawi zambiri amakula. Ngati wodwalayo adziyimira payekha insulin, ndiye kuti zizindikiro zake zimakhala zofatsa komanso ketoacidosis sizipezeka, mosiyana ndi wodwala yemwe amadalira jakisoni wa insulin.

Mankhwala

Kukaniza matenda ashuga kumathetsedwa mothandizidwa ndi mankhwala. Wodwala ndi amene amatengedwa pakamwa. Zogulitsa zotere ndizoyenera kwa odwala omwe ali ndi shuga wochepa kapena wodwala kwambiri. Mankhwala amatha kumatha kudya. Chosiyana ndi Glipizide, chomwe chimatengedwa theka la ola musanadye. Mankhwala a mellitus osagwirizana ndi insulin amagawidwa m'mitundu iwiri: woyamba ndi wachiwiri. Gome likuwonetsa mankhwala akuluakulu ndi mawonekedwe a phwandolo.

Mankhwalawa amaphatikizanso insulin, yomwe imafotokozedwa pa Mlingo wa munthu. Iyenera kutengedwa ndi odwala omwe nthawi zonse amakhala opsinjika. Amagwirizana ndi matenda opatsirana kapena opareshoni.

Kukonza njira

Odwala omwe ali ndi matenda osokoneza bongo omwe amadalira insulin ayenera kuyang'aniridwa ndi madokotala pafupipafupi. Izi sizikugwira ntchito kwa odwala omwe ali ndi vuto ladzidzidzi omwe ali m'chipinda chothandizira kwambiri. Odwala otere ayenera kusintha moyo wawo, kuwonjezera zochita zolimbitsa thupi. Gawo losavuta la masewera olimbitsa thupi liyenera kuchitidwa tsiku ndi tsiku, zomwe zingakulitse kulolera kwa glucose ndikuchepetsa kufunika kugwiritsa ntchito mankhwala a hypoglycemic. Odwala omwe ali ndi shuga omwe samadalira insulini ayenera kutsatira tebulo 9. Ndikofunikira kwambiri kuchepetsa kuchepa kwa thupi ngati kunenepa kwambiri. Ndikofunikira kutsatira malangizo amenewo:

• imwani michere yambiri,
• kuchepetsa kuchuluka kwa mafuta muzakudya za tsiku ndi tsiku,
• chepetsa mchere wambiri,
• kupatula mowa.

Chithunzi cha kuchipatala

Chithunzi cha chipatala cha matenda a shuga (chiwonetsero cha matenda ashuga) chimadziwika kwambiri. Madandaulo akulu a odwala ndi awa:
- kutchulidwa kufooka kwathunthu ndi minofu (chifukwa cha kuchepa kwa mphamvu, glycogen ndi protein m'misempha),
- ludzu (munthawi ya matenda a shuga a mellitus, odwala amatha kumwa ma 3-5 l ndi madzi ambiri patsiku, nthawi zambiri amamwa madzi ambiri usiku, hyperglycemia yapamwamba, ludzu lotchulidwa kwambiri),
- mkamwa youma (chifukwa cha kuchepa madzi m'thupi komanso kuchepa kwa tinthu timene timayambira)
- pafupipafupi ndi kukodza pokonzekera usana ndi usiku (ana atha kukhala ndi vuto la kugona usiku),
- kuchepa thupi (komweko kwa odwala omwe ali ndi IDDM komanso osafotokozanso kapena kusapezeka ku NIDDM, komwe nthawi zambiri kumayendetsedwa ndi kunenepa),
- chilimbikitso chowonjezereka (komabe, chifukwa cha kuwonongeka kwamatenda kwambiri, makamaka ketoacidosis, chilakolako chachepa kwambiri),
- kuyabwa kwa khungu (makamaka kumadera azimayi).

Madandaulo omwe ali pamwambawa nthawi zambiri amawonekera pang'onopang'ono, koma ndi IDDM, zizindikiro za matendawa zimatha kuoneka mwachangu. Nthawi zambiri mwa achinyamata ndi ana, kupezeka kwa IDDM kumapangidwa koyamba ndi kukhazikika kwa chikomokere.

NIDDM nthawi zambiri imapezeka mwangozi podziwitsa pazifukwa zina glycemia kapena kupenda mkodzo wa glucose (mwachitsanzo, mukamayesedwa).

Khungu ndi minofu .

Munthawi yowola, khungu louma, kuchepa kwa turgor ndi elasticity ndizodziwika. Odwala nthawi zambiri amakhala ndi zotupa pakhungu, zotulutsira mankhwalawa, hydroadenitis. Zilonda zamkhungu zam'mimba zimadziwika kwambiri, nthawi zambiri - epidermophytosis ya mapazi. Chifukwa cha hyperlipidemia, xanthomatosis ya pakhungu imayamba. Xanthomas ndi mapapu ndi mafinya a mtundu wachikasu, odzazidwa ndi ma lipids, ndipo amapezeka m'malo a matako, miyendo yotsika, bondo ndi nsapato zamanja, ndi mikono yakutsogolo. Mchigawo cha eyelids, xanthelasms nthawi zambiri amapezeka - mawanga achikasu a lipid. Pakhungu la miyendo nthawi zambiri pamakhala mapapo a bulauni, omwe amasinthidwa kukhala mawanga amitundu.

Odwala omwe ali ndi mitundu yayikulu ya matenda ashuga, makamaka okhala ndi vuto la ketoacidosis, rubeosis imakula - kukulira kwa khungu komanso ma arterioles ndi khungu hyperemia (matenda a shuga) m'malo a mafupa ndi masaya.

Odwala adazindikira lipoid necrobiosis ya khungu. Imasanjidwa makamaka pamiyendo (imodzi kapena zonse). Choyamba, timabowo tofiyira kapena timaso tating'ono timawoneka, titazunguliridwa ndi malire a ma bulugamu. Kenako khungu pamalo pang'onopang'ono limatulutsa, limayamba kusalala, kunyezimira, komanso kupindika kwambiri (kufanana ndi zikopa). Nthawi zina madera omwe amakhudzidwa ndi zilonda, amachira pang'onopang'ono, kusiya malo omwe anali ndi mitundu. Nthawi zambiri, ma vesicles amawoneka pakhungu la miyendo, akuchiritsidwa popanda zipsera pambuyo pa masabata 2-5.

Nthawi zambiri misomali imasinthidwa, imakhala yosalala, yosalala, kusweka kwawo kumawoneka, mtundu wachikasu.

Odwala ena, Darier granuloma wooneka ngati mphete amawoneka ngati malo owoneka bwino ophatikizika ndi mphete ndi m'mphepete mwa thunthu ndi malekezero. Granuloma wamtunduwu amazimiririka pakatha milungu iwiri, koma nthawi zambiri amabwereranso. Vitiligo nthawi zina amawonedwa mwa odwala omwe ali ndi IDDM, omwe amatsimikizira mtundu wa autoimmune matendawa.

Lawrence's lipoatrophic matenda a shuga, omwe amadziwika ndi kuchuluka kwa mafuta ochepetsa mphamvu, insulin kukana, hepatomegaly, matenda oopsa, hyperlipidemia, ndi kusowa kwa ketoacidosis, nthawi zina hypertrichosis, ndi mawonekedwe osowa.

IDDM imadziwika ndi kuchepa kwakukulu, kuwuka kwambiri kwa minofu, komanso kuchepa kwa mphamvu ya minofu.

Njira yogaya chakudya. Zosintha zotsatirazi ndizodziwika bwino:
- Caries zomwe zikupita patsogolo,
- matenda osakhalitsa, kumasuka ndi kuchepa kwa mano, matenda opatsirana pafupipafupi ndi chizindikiro cha kulekerera kwa chakudya chamagulu ("matenda ashuga"),
- alveolar pyorrhea, gingivitis, stomatitis (nthawi zambiri pamakhala zilonda zam'mimba, zotupa za mucosa mkamwa),
- aakulu gastritis, duodenitis ndi kukula pang'onopang'ono kwa kusintha kwa atrophic, kuchepa kwa ntchito zachinsinsi zam'mimba, zomwe zimachitika chifukwa cha kuchepa kwa insulin, chothandizira kupatsirana kwa m'mimba, kuphwanya kwamasamba a mahomoni am'mimba komanso kugwira ntchito kwa dongosolo la mantha amthupi.
- kuchepa kwa magalimoto ntchito yam'mimba, m'malo ovuta kwambiri - gastroparesis,
- Nthawi zina - zilonda zam'mimba ndi duodenum,
- kusowa kwa matumbo: kutsekula m'mimba, steatorrhea (chifukwa cha kuchepa kwa mphamvu ya pancreatic pancreatic), nthawi zina pamakhala kupangika kwa matenda a atrophic enteritis omwe ali ndi chimbudzi cha parietal komanso kulowetsedwa kwa malabsorption,
- Fatty hepatosis (diabetesic hepatopathy) amakula mu 80% ya odwala matenda ashuga. Mawonekedwe a hepatosis ya mafuta ndi: kukulitsa chiwindi ndi kupweteka kwake pang'ono, kuyesedwa kwa chiwindi, kuwonongeka kwa ntchito ya chiwindi malinga ndi radioisotope hepatography, ultrasound ya chiwindi imatsimikiza kuwonjezeka kwake komanso ma heterogeneity,
- aakulu cholecystitis, chizolowezi chopanga miyala mu ndulu,
- Nthawi zambiri amawoneka dyskinesia wa ndulu, nthawi zambiri mtundu wa hypotonic,
Muubwana, kukula kwa matenda a Moriak kungatheke, komwe kumaphatikizapo kuwonongeka kwambiri kwa chiwindi mu mawonekedwe a matenda amisempha, kukula wodabwitsa, kukula kwamthupi ndi kugonana,

Mtima wamtima. Matenda a shuga amachititsa kuti maselo ambiri a lipotrotein atherogenic apangidwe komanso kutukuka kwaposachedwa kwa matenda a mtima ndi matenda a mtima (CHD), omwe amapezeka m'matenda a shuga pafupipafupi katatu kuposa anthu. IHD mwa odwala matenda a shuga opatsirana amayambika kale, amakhala woopsa, ndipo nthawi zambiri amakumana ndi zovuta. Kukula kodziwika kwambiri kwa IHD mwa odwala NIDDM.

Zinthu za mapangidwe a myocardial infarction Myocardial infaration ndimomwe amafa mu 38-50% ya odwala omwe ali ndi matenda osokoneza bongo ndipo ali ndi zotsatirazi zachipatala:
- coronary artery thrombosis imadziwika kawiri kawiri monga momwe kulibe matenda a shuga,
- mu 23-40% ya odwala pali kuyambika kopweteka kwa myocardial infarction, izi zimachitika chifukwa chophwanya ufulu wa mtima (chidziwitso cha "mtima hypesthesia" wolemba V. M. Prikhozhan),
- njira ya kulowerera kwa myocardial imakhala yolimba kwambiri, chifukwa nthawi zambiri imakhala yovuta chifukwa cha kugunda kwa mtima, kupindika kwa m'mapapo, kumanzere kwamitsempha yama mtima,
- myocardial infaration imakonda kusinthidwa komanso kubwerezedwa,
- nthawi ya infaration yotalikirapo imakhala yotalikirapo komanso yovuta kuposa anthu opanda matenda ashuga, matenda obwera pambuyo pamtima nthawi zambiri amabweretsa kukula kwa mtima,
- kufa kwa obadwa nawo m'mnyewa wamatenda m'mwezi woyamba ndi 41% kutsutsana ndi 20% posowa shuga (Rytter, 1985), ndipo atatha zaka 5-6 - 43-65% ndi 25%, motsatana (Ulvenstam, 1985).

Matenda a shuga . Matenda a shuga a mtima (“diabetesic”) ndi dysmetabolic myocardial dystrophy kwa odwala matenda a shuga osakwanitsa zaka 40 popanda chizindikiro chapadera cha coronary atherossteosis. Popanga matenda ashuga a mtima, kuwonongeka kwa mphamvu, kaphatikizidwe ka protein, electrolyte metabolism, kufufuza zinthu mu myocardium, komanso zovuta zopumira m'matumbo, ndizofunikira.

Mawonetsedwe akulu azachipatala a matenda a shuga ndi awa:
- kupumira pang'ono pakulimbitsa thupi, nthawi zina kugunda kwa mtima ndi zosokoneza mdera la mtima,
Zosintha za ECG: kusalala ndi kusokonezeka kwa mano a P, R, T, kutsika kwa matalikidwe a QRS, kutsika kwa nthawi ya PQ ndi Q-T, pambuyo pazochita zolimbitsa thupi, ndipo nthawi zina ngakhale pakupuma, gawo la ST limasunthidwa kuchokera ku kudzipatula,
- mavuto osiyanasiyana a mtima mungoli ndi conduction (sinus tachycardia, bradycardia, mawonekedwe a atomy romy, extrasystole, kuchepa kwa atrioventricular ndi intraventricular conduction);
- hypodynamic syndrome, yowonetsedwa mu kuchepa kwa kuchuluka kwa magazi ndi kuwonjezeka kwa kukakamiza kwa diastolic kumapeto kwa gawo lamanzere,
- kuchepa kwa kulolerana ndi zochitika zolimbitsa thupi,
- Kuchepa kwa mphamvu ya mtima wa myocardium kupumula kwa kupumula kwa echocardiography (chizindikiro choyambirira cha matenda ashuga) ndi kuchepetsedwa kwapang'onopang'ono kwa mphamvu yam'mbuyo komanso kutsika kwa matalikidwe a mtima.

Njira yothandizira . Odwala omwe ali ndi matenda ashuga amakonzedweratu ku chifuwa cham'mapapo ndipo amavutika nayo pafupipafupi kuposa anthu omwe alibe matenda a shuga. Ndi chiphuphu chosavomerezeka cha matenda a shuga, chifuwa chachikulu cha m'mapapo chimakhala chovuta, ndimachulukirachulukira.

Matenda a shuga a shuga amadziwika chifukwa cha kuchuluka kwa mapapo a m'mapapo, omwe amapanga makulidwe a chibayo pafupipafupi. Kulowa chibayo kumayambitsa kuwonongeka kwa matenda ashuga. Kuchulukana kwake kumapitirira moseketsa, modabwitsa, ndi kutentha pang'ono kwa thupi, kutsika kwamphamvu kwa kusintha kwa magazi m'magazi. Nthawi zambiri, onse pachimake ndi kukokomeza matenda chibayo kumachitika motsutsana maziko a kuchepa chitetezo mayankho, yotupa kulowerera pang'onopang'ono, amafunika chithandizo cha nthawi yayitali.

Odwala omwe ali ndi matenda osokoneza bongo nthawi zambiri amadwala matendawa ndipo amadwala kwambiri matenda opatsirana.

Njira yamikodzo . Odwala omwe ali ndi matenda ashuga nthawi zambiri amakhala ndi matenda opatsirana komanso otupa a kwamikodzo (cystitis, pyelonephritis).

Matenda amtundu wa urinara nthawi zambiri amabweretsa kuwonongeka kwa matenda a shuga, kukulitsa kwa ketoacidosis ngakhalenso hyperketonemic coma.

Ndi kuvunda kulikonse kosavomerezeka kwa matenda a shuga, komanso kuwoneka ngati malungo a "chiyambi chosadziwika", kutupa kwamkodzo sayenera kuperekedwa, ndipo mwa amuna, kuwonjezera, prostatitis.

Tsambali lolamulira tsambali silimayesa malingaliro ndi malingaliro pazamankhwala, mankhwala ndi akatswiri. Kumbukirani kuti zokambirana zimachitika osati ndi madokotala okha, komanso ndi owerenga wamba, kotero maupangiri ena akhoza kukhala owopsa thanzi lanu. Pamaso pa chithandizo kapena mankhwala aliwonse, tikukulimbikitsani kuti mulumikizane ndi katswiri!

Matenda a shuga a Type 2 amatchedwa osadalira insulin. Izi zikutanthauza kuti shuga ya magazi imakwera osati chifukwa cha kusowa kwa insulin, koma chifukwa cha kusadziletsa kwa ma protein. Pankhaniyi, mtundu uwu wa zamatenda uli ndi mawonekedwe ake a maphunzirowa komanso chithandizo.

Mtundu wachiwiri wa matenda a shuga a mellitus, kapena osadalira insulini, ndimatenda a metabolic omwe amapanga shuga wambiri m'magazi. Izi zimachitika mwina chifukwa cha kuchepa kwa mahomoni a kapamba, kapena chifukwa cha kuchepa kwa chidwi cha maselo kwa icho. Potsirizira pake, akuti munthu amakula insulin. Ndipo izi ngakhale zili choncho kuti m'magawo oyamba a matendawo m'thupi, kuchuluka kokwanira kwa mahomoni kumapangidwa. Chifukwa chake, matenda oopsa a hyperglycemia amachititsa kuti ziwalo zonse ziwonongeke.

Mitundu yayikulu ya matenda a shuga

Shuga mellitus (DM) ndi matenda ochokera ku autoimmune, omwe amadziwika ndi kuchotsedwa kwathunthu kapena pang'ono papangidwe kamapangidwe ochepetsa shuga omwe amatchedwa insulin. Mchitidwe wama pathogenic wotere umabweretsa kuchuluka kwa shuga m'magazi, omwe amadziwika kuti ndi "mphamvu pazinthu" zama cellular ndi minofu. Kenako, minofu ndi maselo zimasowa mphamvu yofunikira ndikuyamba kuwononga mafuta ndi mapuloteni.

Insulin ndiye mahomoni okhawo m'thupi lathu omwe amatha kuwongolera shuga. Amapangidwa ndi maselo a beta, omwe amapezeka pazilumba za Langerhans za kapamba. Komabe, mthupi la munthu mumakhala kuchuluka kwama mahomoni ena omwe amachititsa kuchuluka kwa shuga. Izi, mwachitsanzo, adrenaline ndi norepinephrine, "kulamula" mahomoni, glucocorticoids ndi ena.

Kukula kwa matenda ashuga kumayendetsedwa ndi zinthu zambiri, zomwe tidzakambirana pansipa.Amakhulupirira kuti moyo wapano uli ndi mphamvu pa zamatsenga izi, chifukwa anthu amakono amakhala onenepa kwambiri ndipo samachita masewera.

Mitundu yodziwika bwino yamatenda ndi iyi:

• lembani 1 insulin yodalira matenda a shuga (IDDM),
• lembani mtundu wachiwiri wa insulin wodwala matenda a shuga (NIDDM),
• matenda ashuga.

Mtundu woyamba wa matenda ashuga omwe amadalira matenda a shuga a mellitus (IDDM) ndi njira yomwe kupanga insulin kumatha. Asayansi ndi madotolo ambiri amakhulupirira kuti chifukwa chachikulu chakukhazikitsidwa kwa mtundu wa 1 IDDM ndi chibadwa. Matendawa amafunika kuwunika nthawi zonse komanso kudekha, chifukwa masiku ano palibe mankhwala omwe angachiritse wodwalayo kwathunthu. Jakisoni wa insulin ndi gawo limodzi la mankhwalawa a matenda a shuga a insulin.

Mtundu wachiwiri wa shuga wosadalira insulini (NIDDM) umadziwika ndi kusokonekera kwa maselo omwe ukulembamo ndi timadzi timene timachepetsa shuga. Mosiyana ndi mtundu woyamba, kapamba amapitiliza kupanga insulini, koma maselo amayamba kuyankha molakwika. Matenda amtunduwu, monga lamulo, amakhudza anthu azaka zopitilira 40-45. Kuzindikira koyambirira, mankhwala othandizira kudya komanso kuchita masewera olimbitsa thupi kumathandiza kupewa mankhwalawa ndi mankhwala a insulin.

Matenda a gestational amakula nthawi yapakati. Mthupi la mayi woyembekezera, kusintha kwa ma hormone kumachitika, chifukwa chomwe zimayambitsa shuga.

Ndi njira yoyenera yothandizira mankhwalawa, matendawa amazimiririka pambuyo pobadwa kwa mwana.

Zoyambitsa matenda ashuga

Ngakhale atafufuza zochuluka motani, madokotala ndi asayansi sangathe kupereka yankho lenileni la funso lazomwe zimayambitsa matenda ashuga.

Zomwe zimavumbula chitetezo cha mthupi kugwira ntchito yolimbana ndi thupi lenilenibe chinsinsi.

Komabe, maphunziro ndi zoyesera sizinali pachabe.

Mothandizidwa ndi kafukufuku komanso zoyesa, zinali zotheka kudziwa zinthu zazikulu zomwe zimapangitsa kuti chiwopsezo cha odwala matenda a shuga azidalira komanso asanafike ndi insulin. Izi zikuphatikiza:

1. Hormonal kusalinganika muubwana wogwirizana ndi zochita za kukula kwa mahomoni.
2. Jenda ya munthu. Zatsimikiziridwa mwasayansi kuti theka labwino laumunthu limakhala ndi matenda a shuga kawiri.
3. Kunenepa kwambiri. Mapaundi owonjezera amatsogolera pakuyika pa mtima makoma a cholesterol ndikuwonjezereka kwa ndende yamagazi.
4. Mitundu Ngati mellitus wodwala kapena wodwala yemwe amadalira insulin amadwala mayi ndi bambo, ndiye kuti mwa ana awonekeranso 60-70% milandu. Ziwerengero zikuwonetsa kuti mapasa nthawi imodzi akuvutika ndi matenda amtunduwu ndi 58-65%, ndi mapasa - 16-30%.
5. Khungu la khungu la anthu limakhudzanso kukula kwa matendawa, chifukwa matenda ashuga ndi 30% ochulukirapo mu liwiro la Negroid.
6. Kuphwanya kapamba ndi chiwindi (matenda enaake, hemochromatosis, ndi zina).
7. Moyo wopanda ntchito, zizoloŵezi zoyipa ndi kudya zakudya zopanda pake.
8. Mimba, pomwe vuto la mahomoni limachitika.
9. Mankhwala osokoneza bongo ndi glucocorticoids, antipsychotic atypical, beta-blockers, thiazides ndi mankhwala ena.

Pambuyo pofufuza zomwe tafotokozazi, ndizotheka kuzindikira chinthu chomwe chili choopsa chomwe chimapangitsa gulu lina la anthu kukhala ndi matenda ashuga. Mulinso:

• anthu onenepa kwambiri
• anthu omwe ali ndi vuto lobadwa nawo
• odwala omwe ali ndi acromegaly ndi matenda ake a Itsenko-Cushing,
• odwala atherosulinosis, matenda oopsa kapena angina pectoris,
• anthu omwe ali ndi matenda amkati
• anthu amakonda ziwengo (eczema, neurodermatitis),
• odwala glucocorticoid
• anthu omwe adakumana ndi vuto la mtima, matenda opatsirana komanso matenda opha ziwalo,
• azimayi omwe ali ndi pakati osadziwika,

Gululi limaphatikizanso azimayi omwe amabereka mwana wolemera oposa 4 kg.

Momwe mungazindikirire hyperglycemia?

Kukula msanga kwa glucose ndende ndikutsata "matenda okoma". Matenda a shuga omwe amadalira insulin sangamveke kwa nthawi yayitali, akumawononga pang'onopang'ono makoma amitsempha komanso mathero a mitsempha pafupifupi ziwalo zonse zamunthu.

Komabe, ndimelitus yodalira matenda a shuga mumakhala zizindikiro zambiri. Munthu yemwe amakhala ndi chidwi ndi thanzi lake amatha kuzindikira momwe thupi limasonyezera hyperglycemia.

Ndiye, kodi ndimatenda a shuga omwe amadalira insulin? Zina mwa ziwiri zazikulu zotchedwa polyuria (kukodza mwachangu), komanso ludzu losatha. Amalumikizidwa ndi ntchito ya impso, yomwe imasefa magazi athu, ndikuchotsa thupi la zinthu zovulaza. Mowa wambiri umaphatikizanso poizoni, motero umathiridwa mkodzo. Kuchulukitsa kwa impso kumapangitsa kuti chiwalo chophatikizika kutulutsa madzimadzi osowa kuchokera ku minofu ya m'misempha, zimayambitsa zizindikiro zotere za matenda a shuga.

Chizungulire pafupipafupi, migraine, kutopa ndi kugona pang'ono ndizizindikiro zina zomwe ndizodziwika bwino za matendawa. Monga tanena kale, ndikusowa kwa glucose, maselo amayamba kuphwanya mafuta ndi mapuloteni kuti apeze madzi osungira. Zikuwonongeka chifukwa cha kuwola, zinthu zakupha zomwe zimatchedwa matupi a ketone zimatuluka. Njala yam'manja, kuwonjezera pamavuto a ma ketones, imakhudza kugwira ntchito kwa ubongo. Chifukwa chake, wodwala matenda a shuga sagona bwino usiku, sagona mokwanira, samangika, chifukwa amayamba kudandaula chizungulire komanso kupweteka.

Amadziwika kuti matenda a shuga (1 ndi 2 mawonekedwe) amakhudza mitsempha ndi makoma amitsempha. Zotsatira zake, maselo amitsempha amawonongeka ndipo makoma am'mbali amayamba kuwonda. Izi zimabweretsa zotsatira zambiri. Wodwalayo angadandaule chifukwa cha kuwonongeka kwa maonedwe, zomwe zimachitika chifukwa cha kutupa kwa khungu la diso, lomwe limakutidwa ndi ma network. Kuphatikiza apo, dzanzi kapena kumva m'miyendo ndi manja ndizizindikiro za matenda ashuga.

Mwa zina mwazidziwitso za "matenda okoma" chisamaliro chapadera chiyenera kulipidwa pazovuta za njira yolera, amuna ndi akazi. Mu theka lolimba, mavuto okhala ndi erectile ntchito amayamba, ndipo ofooka, kusamba kwa msambo kumasokonezeka.

Zocheperako ndizizindikiro monga kuchiritsa kwa bala

Zotsatira zakukula kwa shuga

Mosakayikira, matenda a shuga omwe amadalira insulin komanso osadalira insulin, omwe akupita patsogolo, amawononga pafupifupi machitidwe onse a ziwalo zamkati mwa thupi la munthu. Izi zitha kupewedwa kudzera pakuzindikira koyambirira komanso kuthandizidwa moyenera.

Chovuta chowopsa cha matenda osokoneza bongo a mtundu wa shuga wodziyimira pawokha komanso wodalira insulin ndi kuperewera kwa matenda ashuga. Vutoli limadziwika ndi zizindikiro monga chizungulire, kusanza komanso mseru, chikumbumtima chosavomerezeka, kukomoka. Pankhaniyi, kuchipatala mwachangu ndikofunikira kuti tithandizenso.

Zotsatira za matenda a shuga a insulin kapena osadalira insulini omwe amakhala ndi zovuta zingapo ndizotsatira za malingaliro osasamala pa thanzi lanu. Mawonetsedwe amachitidwe ophatikizika amakhudzana ndi kusuta fodya, kumwa mowa, kumangokhala, kudya chakudya chokwanira, kupeza matenda osafunikira komanso chithandizo chokwanira. Ndi zovuta ziti zomwe zimadziwika chifukwa cha kudwala kwamatenda?

Mavuto akuluakulu a shuga ndi monga:

1. Matenda a shuga a retinopathy ndi mkhalidwe womwe kuwonongeka kwa retinal kumachitika. Zotsatira zake, kupenyerera kwamawonedwe kumachepa, munthu sangathe kuwona chithunzi chathunthu pamaso pake chifukwa cha mawonekedwe osiyanasiyana amdima ndi zolakwika zina.
2. Matenda a Periodontal ndi matenda ogwirizana ndi matenda a chingamu chifukwa cha kupindika kwa kagayidwe kazakudya komanso magazi.
3. Matenda a shuga - gulu la matenda omwe amafotokoza matenda am'munsi am'munsi. Popeza miyendo ndiyo gawo lakutali kwambiri la thupi pakubwera kwa magazi, lembani matenda ashuga 1 a mellitus (odalira insulin) omwe amayambitsa zilonda zam'mimba. Popita nthawi, poyankha molakwika, gangrene amakula. Chithandizo chokhacho ndikuduladula miyendo.
4. Polyneuropathy ndi matenda ena okhudzana ndi kumva kwa mikono ndi miyendo. Matenda a shuga omwe amadalira odwala insulin komanso omwe samadalira insulini amatenga zovuta zambiri kwa odwala.
5. Matenda a Erectile, omwe amayamba mwa amuna zaka 15 m'mbuyomu kuposa anzawo omwe akudwala matenda a shuga. Mwayi wakukula kwa kusabala ndi 20-85%, kuphatikiza apo, pali mwayi waukulu wokhala wopanda ana pakati pa odwala matenda ashuga.

Kuphatikiza apo, odwala matenda ashuga, kuchepa kwa chitetezo chamthupi komanso kawirikawiri kuzizira kumawonedwa.

Mbali zazikuluzikulu za chithandizo

Tiyenera kudziwa kuti ngakhale mtundu wa 2 shuga umadalira insulini. Matendawa amatenga chithandizo cha nthawi yayitali komanso chosayenera. Popewa kudwala matenda a shuga a 2 omwe amadalira insulin, malamulo oyambira chithandizo chokwanira ayenera kutsatiridwa.

Ndi zigawo ziti zamankhwala zomwe zingathandize kuti glycemia iziyenda bwino komanso kupewa matenda? Ndi

Matenda a shuga ndi matenda omwe anthu akhala akuvutika nawo kwazaka zambiri. Amadziwika ndi kuchuluka kwa shuga mthupi. Matenda a shuga ndi matenda oopsa omwe samakhudzanso magazi okha, komanso ziwalo zonse. Mitundu yotsatirayi yamatenda imasiyanitsidwa: yoyamba ndi yachiwiri. Choyambirira chimadziwika chifukwa chakuti pafupifupi 90% ya maselo a pancreatic amasiya kugwira ntchito.

Pankhaniyi, kuperewera konse kwa insulini kumachitika, ndiye kuti, thupi silipanga insulin konse. Matendawa amapezeka asanafike zaka makumi awiri ndipo amatchedwa kuti insulin-basedabetes mellitus.

Mtundu wachiwiri ndi shuga wosadalira insulini. Pankhaniyi, thupi limapanga insulini yambiri, komabe, sizikwaniritsa ntchito yake. Matendawa amatengedwa ndipo amakhudza anthu patatha zaka makumi anayi, komanso omwe ali onenepa kwambiri.

Mtundu woyamba wa shuga

Amadziwika chifukwa chakuti amakula msanga ndipo amapezeka mwa ana ndi unyamata. Amadziwikanso kuti "shuga ya achichepere." Popewa, jakisoni wa insulin amagwiritsidwa ntchito, omwe amachitika pafupipafupi. Nthawi zambiri, matendawa amapezeka chifukwa cha kuvuta kwa thupi ku kapamba (maselo omwe amapanga insulin amawonongeka kudzera m chitetezo cha mthupi).

Matenda a ma virus amawonjezera chiwopsezo cha matenda a shuga 1. Ngati munthu wadwala matenda a pancreatic, ndiye kuti mu 80% ya matendawa amamuyembekezera. Ma genetics amatenga gawo lofunikira, komabe, kufalitsa motere ndi kawirikawiri.

Nthawi zambiri, lembani matenda ashuga 1 a mellitus (IDDM) mwadzidzidzi amapezeka nthawi yapakati. Pankhaniyi, jakisoni wa insulin amatumizidwa kuti thupi la mayi wapakati ndi mwana lisabadwe. Matenda amtunduwu m'mayi oyembekezera amatha kutayika atabereka. Ngakhale azimayi omwe adadwala matendawa ali pachiwopsezo.

Mtunduwu ndi wowopsa kuposa wachiwiri ndipo umayambitsidwa ndi izi:

• thupi lofooka
• kusowa tulo
• kuchepa thupi msanga
• milingo yayitali yokwezeka
• migraine
• nkhanza
• kupweteka kwa minofu.

Zochizira matenda:

• insulin
• zolimbitsa thupi
• chakudya
• thandizo la katswiri wazamisala,
• kudziletsa.

Nkhani yopezetsa kulumala imathetsedwa powunikiranso mbiri yonse yachipatala.

Type 2 shuga

Matendawa amatenga matenda oopsa kuposa oyambawo, ndipo amapezeka patatha zaka 40.Amadziwika ndi kugawa kwambiri. Amathandizidwa ndi mapiritsi omwe amasintha maselo ndikuwonjezera kuchuluka kwa shuga, matumbo, chiwindi ndi minofu.

Matendawa amawonetsedwa ndi zizindikiro zotsatirazi:

• nkhanambo
• kunenepa
• migraine
• kamwa yowuma
• zotupa pakhungu.

Kutupa kumakhala kosavuta kwambiri kuposa mtundu wodalira insulini. Zovuta za matendawa zimagwirizanitsidwa ndi kusagwira bwino ntchito kwamthupi ndi machitidwe a thupi. Ngati chithandizo sichikuchitika, mavuto otere amabwera:

• atherosulinosis
• mitsempha
• matenda amtima
• wodwala matenda ashuga.

Chithandizo chikuchitika m'njira ziwiri zogwirizana:

• kusintha kwa moyo
• mankhwala.

Zizindikiro zazikulu za matenda a shuga a mtundu woyamba ndi wachiwiri

Mitundu yonse iwiri ya matenda a shuga imakhala ndi zotsatirazi:

• kufunitsitsa kosamwa madzi am'madzi (ludzu),
• maloto oyipa
• kukodza kwambiri
• chidwi padziko lonse lapansi,
• ulesi.

Nthawi zina, wodwalayo amakhala ndi mseru kwambiri, nkusandulika kusanza, amachulukitsa acetone m'magazi ndikuwonetsa malingaliro. Ngati zizindikiro zotere zikuwoneka, munthu ayenera kulandira thandizo loyenerera nthawi yomweyo. Kupanda kutero, mwayi wodwala matenda ashuga ukuwonjezeka.

Mawonetsedwe achiwiri a matendawa ndi monga:

• kutopa kwakuthupi
• kutayika kwa mphamvu mu minofu
• kuwonda mwadzidzidzi
• kuwonongeka mwadzidzidzi
• kusintha kwa magazi pafupipafupi,
• migraine
• kulawa kwazitsulo mkamwa.

Zoyambitsa matenda a shuga

Type 1 shuga mellitus imachitika chifukwa cha matenda a chitetezo cha mthupi, momwe ma cell a pancreatic amadziwika ngati zinthu zakunja ndikuwonongeka.

Matenda a shuga (amadalira insulin) nthawi zambiri amakula ali ana ndi amayi apakati. Zifukwa zodalirika zomwe zimachitika izi, madokotala sangapeze. Koma kutsindika ndi izi:

• matenda opatsirana ndi ma virus
• autoimmune mavuto amthupi,
• mavuto a chiwindi
• chibadwa
• kuzunza kwambiri maswiti,
• kunenepa kwambiri
• mavuto amisala.

Chithandizo cha insulin

Chithandizo chimatengera insulin. Kuti matendawa azitha kudzimva kuti ndi ochepa, ayenera kuganizira kuchuluka kwa shuga omwe amalowa mthupi ndi chakudya.

Munthu amene ali ndi matenda otere ayenera kuzindikira kuti sizotheka kuthana ndi matendawa kwathunthu. Simuyenera kugwiritsa ntchito mankhwala okha, komanso zakudya zabwino. Chithandizo cha matendawa ndi gawo latsopano m'moyo wa munthu, chifukwa adzafunika kuwunika shuga nthawi zonse pofuna kupewa zovuta.

Masiku ano, mankhwala a insulin ndi njira yothandiza kwambiri yotseka matenda. Koma wodwalayo ayenera kuphunzira payekha, kupanga jakisoni (amatha kulowetsedwa ndi pampu ya insulin, popeza kuyambitsa kwa mahomoni kudzera mu catheter ndikosavuta).

Mfundo ya zakudyazi ndi kupeza kuchuluka kwa zopatsa mphamvu ndi chakudya, koma ndi mafuta ochepa. Poterepa, kusinthasintha kwa glucose level sikudzakhala lakuthwa kwambiri. Ndikofunika kukumbukira kuti muyenera kuvotera zinthu zonse zomwe zimakhala ndi zopatsa mphamvu zambiri komanso shuga. Kutengera malamulo onsewa, matenda ashuga amapita patsogolo pang'ono.

Odwala omwe ali ndi matenda a shuga amadya pafupipafupi 5-6 patsiku ndi izi:

• supu zamasamba
• nyama yokonda
• nsomba zam'nyanja

• masamba (kupatula mbatata),
• mafuta amkaka ochepa,
• zipatso zokoma ndi wowawasa ndi uchi.

Njira zoterezi ndizothandiza:

• peyala lapansi - idyani yaiwisi
• madzi a mandimu amodzi ndi dzira la nkhuku pamimba yopanda kanthu,
• tiyi wa masamba a walnut
• tirigu pansi - kumwa supuni ya ufa ndi mkaka.

Mavuto a Type 1 ndi Type 2 Diabetes Mellitus

Matenda a shuga ndi osokoneza kwambiri chitetezo cha mthupi. Chifukwa chake, munthu amamasuka mosavuta ku matenda osiyanasiyana.Amapita mu pachimake komanso matenda mawonekedwe. Mavuto akulu kwambiri ndi hypoglycemia ndi ketoacetosis. Ndi zovuta izi, m'malo mwa glucose, mafuta amawonongeka ndipo acidity ya magazi imachuluka.

Ngati zakudya sizitsatiridwa ndipo kuchuluka kwa insulin komwe kumayendetsedwa, shuga amachepetsa kwambiri ndipo glypoglycemic syndrome imayamba. Pankhani ya matenda okhudzana ndi matenda a shuga, kudalirika kumeneku sikosangalatsa konse wodwala ndi adokotala. Thupi sililandira mphamvu zokwanira ndipo limakumana ndi izi - ngati simupereka chinthu china chokoma, chikomokere chimabwera. Ngati simuchiza matenda a shuga omwe amadalira insulin, matenda opatsirana amayamba:

• sitiroko
• vuto la mtima
• matenda oopsa
• atherosulinosis
• zilonda
• mphira
• vuto la impso.

Insellitus yodalira matenda a shuga ndi matenda oopsa omwe nthawi zambiri amabweretsa imfa. Ndikofunikira kumayesedwa pafupipafupi ndikumayesedwa magazi, izi zithandiza kukhalabe ndi thanzi lathanzi kwa zaka zambiri.

Insulin yodalira matenda a shuga a mellitus (mtundu I) ndi matenda osatha a endocrine omwe amayamba chifukwa cha kuperewera kwa insulin kaphatikizidwe ndi maselo a pancreatic Langerhans, zomwe zimapangitsa kuchuluka kwa serum glucose, koma kuchepa kwake m'maselo. Mwa milandu yonse ya matenda ashuga, mtundu uwu umapezeka pafupifupi 10% ya milandu. Matendawa amapezeka pafupipafupi kwa achinyamata.

Kodi ndiyenera kupita kwa dokotala uti?

Katswiri wodziwa bwino ayenera kutsimikizira matendawa ndikuwapatsa mankhwala othandiza. Kuchita ndi odwala matenda ashuga:

Poika koyamba, adokotala amamvetsera madandaulo a wodwalayo, zomwe akuwona ponena za kusintha kwa thupi, komanso thanzi. Ndikofunikanso kupeza chidziwitso chodalirika chokhudzana ndi kukhalapo kwa matenda ashuga m'mabanja apafupi. Komanso, adokotala:

1. amachita zowunikira zonse
2. amaphunzira mwatsatanetsatane njira zotupa, zisa pakhungu,
3. amawunika momwe zimagwira mucous,
4. Amawerengera momwe mafuta amachepera komanso kwa nthawi yayitali.

Mu mellitus wa shuga wosadalira insulin, kapangidwe ka magazi kakuyenera kuganiziridwa. Zotsatira zoyenera zimaperekedwa ndi kuyesa kwa glucose ngati chithunzi cha matenda sichinafotokozedwe bwino. Zimafunikira njira zapadera zokonzekera kuchokera kwa wodwala. Masiku atatu musanayambe phunziroli, muyenera kutsatira zakudya zabwino, kuchotsa kusowa kwa madzi, kuchita masewera olimbitsa thupi mopitirira malire. Chakudya chomaliza chiyenera kukhala maola 8 phunzirolo lisanachitike. Ndikosatheka kuchepetsa kumwa. Chiyeso chololera cha glucose ndikofunikira kudziwa prediabetes. Ngati shuga wamagazi achulukitsidwa kwambiri, ndiye kuti palibe chifukwa mu njira yodziwira matenda. Kuyesedwa kwa magazi ndi mkodzo koyenera ndi koyenera.

Etiology ndi pathogenesis

Makina a pathogenetic omwe amapanga chitukuko cha matenda ashuga amtundu wa 1 amatengera kuperewera kwa insulin yopanga ma cell a endocrine (β-cell of the pancreas) omwe amayamba chifukwa cha kuwonongeka kwawo motsogozedwa ndi zinthu zina za pathogenic (matenda a viral, nkhawa, matenda a autoimmune, ndi zina). Mtundu woyamba wa matenda a shuga umakhala ndi 10% ya matenda onse a shuga, ndipo nthawi zambiri amakula ubwana kapena unyamata. Mtunduwu wa shuga umadziwika ndi mawonekedwe azizindikiro zazikulu, zomwe zimapita patsogolo mofulumira. Njira yayikulu yochizira ndi jakisoni wa insulin, yemwe amateteza kagayidwe ka thupi la wodwalayo. Ngati sichichiritsidwenso, matenda ashuga amtundu woyamba 1 amapita patsogolo msanga ndipo zimabweretsa zovuta zazikulu, monga ketoacidosis ndi chikomokere matenda a shuga, zomwe zimapangitsa kuti wodwalayo afe.

Gulu

1. Mwa kuwopsa:
   1. maphunziro ofatsa
   2. kuopsa kozama
   3. koopsa
2. Malinga ndi kuchuluka kwa kobwezeretsa kagayidwe kazakudya:
   1. gawo la malipiro
   2. gawo logulika
   3. kubweza gawo
3. Malinga ndi zovuta:
   1. Matenda a shuga ndi macroangiopathy
   2. Matenda a shuga a polyneuropathy
   3. Matenda a shuga
   4. Matenda a shuga a ophthalmopathy, retinopathy
   5. Matenda a shuga
   6. Matenda a shuga

Pathogenesis ndi histopathology

Chifukwa cha kuchepa kwa insulini, minofu yodalira insulin (chiwindi, mafuta ndi minofu) imalephera kugwiritsa ntchito shuga m'magazi ndipo, chifukwa chake, kuchuluka kwa shuga m'magazi kumawonjezeka (hyperglycemia) - chizindikiro cha matenda a shuga. Chifukwa cha kuchepa kwa insulin, kuchepa kwamafuta kumapangidwira minofu ya adipose, komwe kumapangitsa kuti magazi azikula kwambiri, ndipo kuwonongeka kwa mapuloteni m'misempha kumalimbikitsidwa, zomwe zimayambitsa kuchuluka kwa amino acid m'magazi. Magawo a catabolism a mafuta ndi mapuloteni amasinthidwa ndi chiwindi kukhala matupi a ketone, omwe amagwiritsidwa ntchito ndi zosagwirizana ndi insulin (makamaka ubongo) kuti azisunga mphamvu moyenera motsutsana ndi kumbuyo kwa kuchepa kwa insulin.

Pali magawo 6 a chitukuko cha matenda a shuga 1. 1) Kukhazikika kwa majini ku T1DM kophatikizidwa ndi dongosolo la HLA. 2) Zoyambira zotsimikizira. Kuwonongeka kwa β - maselo osiyanasiyana okhudzana ndi matenda ashuga komanso kuyambitsa chitetezo cha mthupi. Kwa odwala, ma antibodies omwe ali pamwambawa adatsimikiziridwa kale mu gawo laling'ono, koma kutulutsidwa kwa insulin sikuvutikabe. 3) Yogwira autoimmune insulinitis. Antibody titer ndi yokwera, kuchuluka kwa β-cell kumachepetsa, insulin secretion imachepa. 4) Kuchepetsa mphamvu ya shuga yodutsa m'magazi a I. M'mikhalidwe yovuta mwa wodwala, NTG yolekerera (kulolerana kwa shuga) ndi NGPN (kusala kwamphamvu kwa glucose) kumatha kupezeka. 5) Matenda a shuga, kuphatikizira ndi gawo la “ukwati”. Katemera wa insulini amachepetsedwa kwambiri, monga 90% ya β-cell anafa. 6) Kuwonongeratu kwathunthu kwama cell a β, kufafaniza kwathunthu kwa insulini.

• hyperglycemia. Zizindikiro chifukwa cha kuchuluka kwa shuga m'magazi: polyuria, polydipsia, kuchepa thupi ndi chidwi chochepetsa, pakamwa pofooka, kufooka
• microangiopathies (diabetesic retinopathy, neuropathy, nephropathy),
• macroangiopathies (atherosulinosis of the coronary artery, aorta, GM shipping, m'munsi malesi), matenda ashuga phokoso
• concomitant matenda (furunculosis, colpitis, vaginitis, kwamikodzo thirakiti matenda)

Shuga wowerengeka - wobwezeredwa ndi chakudya, palibe zovuta (zokhazokha ndi shuga 2) shuga wofatsa - wolipiridwa ndi PSSP kapena insulin, zovuta za shuga za 1-2 zovuta. Matenda akulu a shuga ndi njira yotopetsa, yovuta yamavuto 3 ya kukhumudwa (nephropathy, retinopathy, neuropathy).

Chifukwa chiyani matendawa amachitika?

Madokotala amakhulupirira kuti matenda ashuga si matenda amtundu chabe. Chifukwa chachikulu chimatchedwa matenda opatsirana omwe amapezeka m'matumbo, pambuyo pake chitetezo chamthupi chimatsutsana ndi maselo omwe amapanga insulin. Koma kutengera kwa ma genetic sikuyenera kuchepetsedwa, chifukwa mwa anthu omwe ali ndi IDDM, ana amatha "kutola" baton molingana ndi matendawa.

Zinthu zomwe zingakhudze kuyambika kwa matendawa:

• Choyipa.
• Zachilengedwe.
• Matenda a chitetezo chamthupi.
• Kunenepa kwambiri
• Kupsinjika, nthawi yayitali ya kukhumudwa.
• Kukonda kwachidziwikire za zotsekemera.

Matenda a shuga a Type 1 a mellitus amakula mwa achinyamata, ndipo matendawa atha kukhala achangu kwambiri. Nthawi zambiri, matenda a shuga omwe amadalira insulin amapezeka mwa azimayi omwe akuyembekezera mwana. Dzina lina la matenda amtunduwu ndi matenda a shuga. Chithandizo choyenera komanso chapanthawi yake cha matenda a shuga 1 chitha kuthandizira kwambiri mayi ndi mwana. Pambuyo pobadwa, Zizindikiro zimatha kuzimiririka. Komabe, mwayi wopitilira muyeso wa matenda ena okhudzana ndi insulin ulipobe.

Malinga ndi gulu lapadziko lonse lapansi (code E-11), mtundu wachiwiri wa matenda a shuga umatchedwa osagwirizana ndi insulin, ndiye kuti, sufuna jakisoni wa mahomoni. Komabe, matenda amtunduwu amatha kumapanga gawo lina.Chifukwa chake, m'thupi la wodwalayo mulibe kuchepa m'magazi a shuga, chifukwa chake, kupanga insulin kumawonjezeka. Zikondwererozo zimayamba kulowerera nthawi zonse, ndipo maselo a beta amangowonongeka.

Momwe mungayikirere matenda anuanu

Mtundu wodalira insulin, ngati matenda osokoneza bongo omwe amadalira matenda a shuga, uli ndi mawonekedwe angapo. Zizindikiro:

• Kuchulukitsa ludzu.
• Polyuria (kukodza mwachangu).
• Kumva kutopa kosalekeza.
• Kuchepetsa thupi mwachangu ndi chakudya chokwanira.
• Zowonongeka, zowoneka pakhungu zimawonekera: kuyabwa, kuzimiririka, kukwiya.
• Kusowa tulo, kukhumudwitsa, kupanda chidwi.

Zizindikiro zina zitha kuwonekeranso: kukokana, miyendo, kununkhira kwa acetone kuchokera mkamwa.

Kuzindikira mtundu wa 2 wodwala insulin kumadalira madandaulo odwala. Monga lamulo, amapita kwa adokotala zizindikirazo zikafika, kuti zolakwa sizimayikidwa. Mayeso otsatirawa a labotale amachitidwa kuti atsimikizire kuti matenda a shuga amachokera ku insulin:

• Kuyesa kwa magazi. Kafukufuku amachitika pa kuchuluka kwa shuga m'magazi, glycosylated hemoglobin, kulolera kwa glucose.
• Urinalysis Kukhalapo kwa shuga, zizindikiro za acetone zimatsimikiza.

Ntchito ya pancreatic imasokonekera mwa wodwala yemwe ali ndi matenda osokoneza bongo ndipo akusowa kwa insulin

Mavuto Amatenda

Matenda a 2 a shuga, monga matenda ashuga 1, ndi matenda oopsa ndipo zovuta zake ndizovuta. Ndi amitundu iwiri - yayitali komanso yochepa, yodutsa mwachangu.

Vuto lenileni ndi hypoglycemia, dontho lakuthwa mu kuchuluka kwa shuga m'magazi.

Imadziwonetsanso mwa odwala omwe samadalira insulin 2 mtundu wa mellitus mukamamwa mankhwala opangidwa ndi urea. Ngati izi sizikuyimitsidwa pakapita nthawi, ndiye kuti munthu atha kuzindikira ndikugwa.
Mavuto okhalitsa amatha kuyenda ndi wodwala yemwe ali ndi matenda a shuga a 2 omwe amadalira chimodzimodzi monga akuvutika ndi matenda a shuga 1. Ngati matenda a pathologies osachiritsika samathandizidwa, ndiye kuti matenda osokoneza bongo omwe amadalira insulin, monga matenda a shuga omwe amadalira insulin, sangasiye wodwalayo mwayi wokhala ndi moyo wautali komanso wachimwemwe.

Mavuto ena opatsirana amakhala ndi matenda awa:

• Kuthamanga kwa magazi.
• Kusintha kwa mitsempha ya Atherosulinotic.
• Stroko
• Myocardial infaration.
• Zilonda zazikulu zam'maso, zamkati.
• Matenda a pakhungu, zilonda zam'mimba, zilonda zam'mimba.
• Mavuto a impso, nephropathy.

Iliyonse mwa matenda amenewa, makamaka ndi IDDM, imakhala ndi mphamvu yovulaza thupi. Chithandizo chikuyenera kuchitika mosadukiza komanso munthawi yake.

Kudya masamba, zakudya zachilengedwe, ndi zakudya zama carb ochepa kumatsitsa shuga

Momwe mungachiritsire matenda

Ndikosatheka kuchiritsa kwathunthu IDDM; ndi a gulu la odwala omwe amafunikira chithandizo pamoyo wonse wamunthu. Chithandizo chimayikidwa molingana ndi zizindikilo za matenda amtunduwu awiri omwe amapezeka.

Mankhwala samapangidwira chithandizo, koma mawonekedwe a kuchuluka kwa magazi, mkhalidwe ndi thanzi la munthu. Amapangidwa kuti azikhala ndi shuga wokwanira m'magazi (kuti asapitirire 5.6 mmol / L).

Gawo loyamba la matendawa, makamaka mtundu wa shuga womwe sodalira inshuwaransi, amawongolera potenga mapiritsi ochepetsa shuga. M'tsogolomu, kuyambitsa jakisoni wa mahomoni amafunikira, monga lamulo, chithandizo chamankhwala chimayikidwa moyo. Chofunika kwambiri ndizakudya, chakudya, kuchuluka kwa kudya ndi mtundu wake. Izi zimatsimikiza kuwerenga kwa shuga mumagazi.

Mankhwala (othandizira)

• Insulin yochepa (maola angapo). Khalid.
• Insulin yayitali (mpaka maola 36). Kuchita kwake kumayambira maola 14 jekeseni.
• Insulin yapakatikati. Protafan. Imakhala ndi maola 9 mpaka 10, "ntchito" yake imayamba pambuyo pa maola 1-2 pambuyo pa jekeseni.

Chithandizo cha mtundu wa 1 IDDM yokhala ndi mankhwala a insulin chimaphatikizira kulowetsa pancreatic. Popereka mankhwala, ndikofunikira kudziwa kuchuluka kwa shuga m'magazi ndikukhazikitsa mlingo woyenera.

Njira zochizira

Ndi matenda a shuga a mtundu wachiwiri, chithandizo choyambirira chimagwira kwambiri. Pofuna kukhazikika pathupi ndikuyimitsa kupitilira kwa matendawa, ndikofunikira kutsatira zakudya zochepetsa shuga. Pofanana ndi izi:

• onjezerani masewera olimbitsa thupi,
• kukana mowa ndi fodya,
• kumwa mankhwala omwe amachepetsa shuga.

Mankhwala operekedwa kwa odwala amagawika m'magulu anayi. Izi ndi:

• omvera,
• sulfonylureas ndi dongo,
• utoto ndi acarbose,
• insulin pa gawo la zovuta.

Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri ayenera kuyang'anitsitsa kuchuluka kwa cholesterol ndi shuga. Ndikofunikira kuti pang'onopang'ono moyang'aniridwa ndi dokotala, muchepetse kunenepa kwambiri. Zakudya zomanga thupi ndi ulusi wazomera ziyenera kupezeka mokwanira muzakudya.

Kuchita zolimbitsa thupi mokwanira kumachepetsa kufunika kwa insulin, kumathandiza kagayidwe kachakudya. Kuphatikiza apo, iyi ndi njira yabwino kwambiri yopewera zovuta za matenda ashuga komanso kupezekanso kwa matenda ena. Ndikulimbikitsidwa kwambiri kuyang'anira ukhondo wamiyendo, kupewa kutaya kwa misomali, kapangidwe ka chimanga. Nsapato ndi masokosi osankhidwa bwino opangidwa ndi zinthu zachilengedwe ayenera kuvala. Pakuwongolera shuga tsiku ndi tsiku, muyenera kugula glucometer ndikutsatira malamulo a aseptic mukamayeza shuga.

Kodi shuga yodalira insulin ndiyotani?

Njira yayitali komanso yovuta yothandizira matenda osakhazikika ndiyofunikira. Kupanda kutero, chiwopsezo cha zovuta zakusiyana kosiyanasiyana ndichokwera. Zotsatira zoyipa zimaphatikizapo.

Kapena kuphwanya kwake kwachilengedwe.

Mtundu woyamba wa shuga - Matenda a endocrine omwe amadziwika ndi kuperewera kwa insulin chifukwa cha kuwonongeka kwa ma cell a pancreatic beta. Matenda a shuga a Type 1 amatha kukula msinkhu uliwonse, koma nthawi zambiri amakhudza anthu achinyamata (ana, achinyamata, azaka zosakwana 40. Chithunzi chachipatala chimayang'aniridwa ndi zizindikiro zapamwamba: ludzu, polyuria, kuchepa thupi, mkhalidwe wa ketoacidotic.

Kodi munthu wokhala ndi IDDM akhale moyo mpaka liti?

Kuopsa kwa matenda ashuga kumayambitsa zovuta - matenda, omwe aliwonse omwe amachepetsa kwambiri kukhala ndi moyo kapena kuchepetsa mtundu wake. Ntchito yayikulu ya wodwala aliyense ndikuyamba chithandizo cha panthawi yake. Komanso, chisamaliro chiyenera kulipidwa osati kokha m'magazi a shuga, komanso kuthandizira matenda oyanjana.

IDDM imasinthidwa ndi zakudya zoyenera. Ichi ndi chakudya chamafuta ochepera komanso chopatsa mphamvu chomwe chimakupatsani mwayi kuti muchepetse kuchuluka kwa shuga m'magazi, mudzisunge nokha osachita zambiri.

Ndi IDDM, wodwala matenda ashuga ayenera kulandira jakisoni wa tsiku ndi tsiku wa insulin kuti azilamulira shuga. Ndikofunikira kuyeza kuchuluka kwa shuga - wodwala aliyense ayenera kudziwa chimodzimodzi, komanso zizindikiro za hypoglycemia.

Zochita zolimbitsa thupi. Kuchita masewera olimbitsa thupi mokwanira kumathandizira kuchepetsa thupi, kukhalabe ndi mtima wamtima wabwino.

Matenda a shuga a Type 2 amatchedwa osadalira insulin. Izi zikutanthauza kuti shuga ya magazi imakwera osati chifukwa cha kusowa kwa insulin, koma chifukwa cha kusadziletsa kwa ma protein. Pankhaniyi, mtundu uwu wa zamatenda uli ndi mawonekedwe ake a maphunzirowa komanso chithandizo.

Mtundu wachiwiri wa matenda a shuga a mellitus, kapena osadalira insulini, ndimatenda a metabolic omwe amapanga shuga wambiri m'magazi. Izi zimachitika mwina chifukwa cha kuchepa kwa mahomoni a kapamba, kapena chifukwa cha kuchepa kwa chidwi cha maselo kwa icho. Potsirizira pake, akuti munthu amakula insulin.Ndipo izi ngakhale zili choncho kuti m'magawo oyamba a matendawo m'thupi, kuchuluka kokwanira kwa mahomoni kumapangidwa. Chifukwa chake, matenda oopsa a hyperglycemia amachititsa kuti ziwalo zonse ziwonongeke.

Mawonekedwe a shuga 1

Mtundu woyamba wa matenda a shuga ndi mtundu wa autoimmune. Izi zikutanthauza kuti maselo chitetezo chathupi chikuwonetsa kukwiya kwina kwa maselo awo aumunthu. Matenda a shuga omwe amadalira insulin amatchedwanso matenda a shuga, chifukwa amatha kuchitika mwa ana ndi achinyamata. Nthawi zambiri, matendawa amapezeka mwa anthu ochepera zaka 30. Ili ndiye gawo lake lofunikira kusiyanitsa. Type 2 matenda a shuga a mellitus (osadalira insulini) amapezeka okalamba. Zizindikiro zonse za matendawa zimagwirizanitsidwa ndi kuperewera kwathunthu m'thupi la insulin.

Tiyenera kudziwa kuti ndikakonzanso molondola kuchuluka kwa shuga m'magazi komanso kusankha mwanzeru insulin, odwala amatha kukhala ndi moyo kwazaka zambiri. Chofunikira ndikusowa kwa zovuta zina zazikulu. Kodi zimayambitsa matenda amtundu wa endocrine ndi ziti? Mpaka pano, palibe mgwirizano pa nkhaniyi. Matenda a shuga omwe amadalira insulin angachitike pazifukwa zotsatirazi: chifukwa cha zinthu zobadwa mwadzidzidzi, akapatsidwa mankhwala othandizira kapena poizoni. Zofunikanso chimodzimodzi ndi zinthu zakunja. Amaphatikizapo kuyanjana ndi malo. Pali umboni kuti anthu omwe asamukira kumalo osowa kwambiri chifukwa cha matenda ashuga amatha kudwala. Ponena za zomwe zimayambitsa matenda, izi zimaphatikizapo ma virus angapo.

Mawonetseredwe azachipatala

Matenda a shuga 1 amtundu wa shuga, onga a insulin omwe amadalira shuga, ali ndi mawonekedwe ake osiyana. Zizindikiro zimadalira osati mtundu wa shuga wokhazikika, komanso kutalika kwa nthawi yake wodwala, gawo la matendawa, komanso kupezeka kwa zovuta kuchokera kumitsempha yamagazi. Pa odwala matenda a shuga omwe amadalira insulin, zizindikiro zonse zimatha kugawidwa m'magulu awiri.

Gulu loyamba limaphatikizapo zizindikilo zomwe zikuwonetsa kuwonongeka kwa matendawa. Zikakhala zoterezi, mphamvu zoteteza komanso kusinthasintha za thupi sizitha kuthana ndi vuto la insulin. Gulu lachiwirili limayimiriridwa ndi zizindikiro zomwe zimagwirizanitsidwa ndi mapangidwe kapena zovuta zina.

Matenda a shuga a Type 1 nthawi zonse amawonetsedwa ndi chizindikiro monga hyperglycemia. Mwazi wamwazi ndi chofunikira chodziwunikira. Imapezeka pamayeso amwazi am'mwazi. Hyperglycemia, imayambanso zizindikiro zina zingapo zofunika. Izi zimaphatikizira kuphwanya kwamikodzo (kuwonjezeka kwamkodzo tsiku ndi tsiku), ludzu, kuchepa thupi, kufooka, komanso kusachita chidwi. Kuchepetsa thupi kwa wodwala kumawonedwa chifukwa chosowa gwero lamphamvu mthupi - chakudya. Matenda a shuga a Type 1 amatha kupangitsa kuti munthu azilakalaka kwambiri. Matenda a shuga a Type 1 pafupifupi nthawi zonse amatsogolera kuwonjezeka kwa shuga mumkodzo.

Akuluakulu ndi ana omwe ali ndi matendawa, mavuto akulu monga a retinal angiopathy, aimpso ntchito, ndi neuropathy amatha. Retinopathy ndimatenda a genesis osagwira. Poterepa, magazi omwe amapezeka kumbuyo kwa maso amasokonezeka. Pakakhala chithandizo choyenera, retinopathy ingayambitse kuchepa kwa kuwona kwa chidwi komanso ngakhale khungu. yoyimiriridwa ndi kuwonongeka kwa zida zosiyanasiyana za impso: tubules, glomeruli, mitsempha ndi arterioles. Pankhaniyi, mtima sclerosis, pyelonephritis, ndi aimpso papillitis nthawi zambiri kumachitika.

Kufanizanso kwofananako kumakhudza zombo zazing'ono, koma zotengera zazikulu (zamitsempha yamagazi, ziwiya zam'mimba, zonyamula miyendo) zimathanso kukhudzidwa. Nthawi zambiri muzochita zamankhwala zamtundu wa 1 zimapangidwa. Pankhaniyi, zovuta zingapo za pakhungu (zilonda, ming'alu, zotupa m'mimba) zimatha, zomwe zimakhala zovuta kuchiza.

Mavuto owopsa kwambiri a matenda ashuga

Matenda a shuga 1 amtundu wa shuga, monga shuga osadalira insulin, ndi owopsa chifukwa cha zovuta zake. Zotsirizazi zimakhala zazitali komanso zazifupi.

Potsirizira pake, ketoacidosis imatha kuchitika. Amadziwika ndi kuwonjezeka kwa acidity yamagazi chifukwa cha kuwonongeka kwa mafuta. Panthawi imeneyi, zinthu zowola zapakati - ma ketones - zimapangidwa. Poyerekeza ndi ketoacidosis wodwala yemwe samalandira chithandizo, akhoza kukhala ndi vuto la matenda ashuga. Chofunikira ndikuti zovuta zazifupi zingathetsedwe mwachangu ndi chithandizo chokwanira.

Vuto linanso lowopsa ndi hypoglycemia. Amapangidwa ndi kuchepa kwakukuru m'magazi a shuga. Ngati chithandizo cha kuchipatala sichinaperekedwe, ndiye kuti wodwala amatha kukumbukira komanso kugwa. Hypoglycemic coma nthawi zambiri imachitika mukamamwa mankhwala ambiri a insulin.

Odwala omwe ali ndi matenda ashuga, dongosolo lamanjenje limatha kukhudzidwa. Izi zimayambitsa matenda a neuropathy, ziwalo ndi paresis, omwe amakhala ndi ululu.

Palinso zovuta zina zovuta. Amakhala ovuta kwambiri kuwachotsera ndipo kupezeka kwathunthu atha kufa. Gululi limaphatikizapo kuwonongeka kwa impso, matenda a mtima (atherosulinosis, stroke, ischemia). Ndi nthawi yayitali ya matenda ashuga, kuwonongeka kolumikizana ndikukula kwa matenda a shuga ndikotheka. Nthawi zina, nyamakazi imatha kubweretsa chilema chosatha.

Njira zoyesera

Kuti apereke mankhwala okwanira, adotolo ayenera kudziwitsa ena moyenera. Mtundu woyamba wa 1 umatengera zotsatira za kafukufuku wa wodwala, mayeso a labotale, komanso chidziwitso chakunja kwa mayeso. Zodandaula za wodwala zokhudzana ndi vuto la kukodza (polyuria) ndi ludzu lalikulu ndizofunika kwambiri. Pankhaniyi, adotolo ayenera nthawi imodzi kupatula kuthekera kwa kukhalapo kwa matenda ena ofanana ndi mawonetseredwe. Kusiyanitsa kosiyanasiyana kumachitika ndi matenda monga hyperparathyroidism, kulephera kwa impso.

Kuzindikira komaliza kumapangidwa pamaziko a kuyesa kwa labotale magazi ndi mkodzo wa shuga. Ngati pali matenda ashuga, ndiye kuti kuchuluka kwa glucose kudzaposa 7 mmol / l pamimba yopanda kanthu. Tiyenera kukumbukira kuti glucose zomwe zimatsimikiziridwa mu plasma ya magazi a capillary. Nthawi zambiri, madokotala amagwiritsa ntchito mayeso ololera a glucose. Wodwala patatha masiku atatu phunzirolo lisanachitike ayenera kudya monga mwa masiku onse. Chiyeso ichochokha chimachitika m'mimba yopanda kanthu m'mawa. Wodwala sayenera kudya maola 10 mpaka 14 phunzirolo lisanachitike. Wodwala yemwe ali pamalo apamwamba komanso wopuma, shuga amawayezera, kenako wodwalayo amamwa kapu yamadzi otentha. Pambuyo pake, theka lililonse la ola, kuchuluka kwa glucose m'magazi kumawerengeredwa. Mwa munthu wathanzi, maola awiri atatha kuyesedwa, kuchuluka kwa shuga kumakhala kochepa kuposa 7 mmol / L.

Njira zochizira

Matenda a shuga a Type 1 amathandizidwa kuti athetse zizindikiro zazikulu za matendawa, kupewa zovuta, komanso kukonza moyo wa anthu odwala. Chithandizo chiyenera kukhala chokwanira. Zosafunika kwenikweni pa matenda a shuga ndi zakudya. Chofunikira kwambiri pazakudya ndikuti muyenera kuchepetsa kuchuluka kwa chakudya chamafuta. Ayenera kuwerengera 50-60% ya zakudya zopatsa mphamvu. Ndikofunikira kuchepetsa kugwiritsa ntchito maswiti. Confectionery imatha kudyedwa kokha ndi hypoglycemia. Pamaso pa kunenepa kwambiri kwa thupi, zimafunikanso kuchepetsa kuchuluka kwa mafuta omwe mumamwa.

Kuchiza matenda a shuga a mtundu woyamba kumaphatikizapo kupereka insulin kwa odwala.

Pakadali pano, pali kusankha kwakukulu kwa mankhwala ozikidwa ndi insulin. Zitha kukhala zazifupi, zazitali, zazitali komanso zazifupi. Mlingo wa insulin ndi mankhwala omwe amupeza. Mankhwalawa amaperekedwa mosavuta pogwiritsa ntchito syringes yapadera.Chifukwa chake, mtundu 1 wa matenda ashuga, monga shuga wosadalira insulin, ndi matenda oopsa ndipo amatha kupweteketsa ziwalo zina zambiri ndi machitidwe.

Zikomo chifukwa cha ndemanga yanu.

Ndemanga

Megan92 () masabata 2 apitawo

Kodi pali amene wakwanitsa kuchiza matenda ashuga? Amati ndizosatheka kuchiritsa kwathunthu.

Daria () masabata 2 apitawo

Ndinaonanso kuti sizingatheke, koma nditawerenga nkhaniyi, ndidayiwaliratu za matenda "osachiritsika" awa.

Megan92 () masiku 13 apitawa

Daria () masiku 12 apitawo

Megan92, kotero ndidalemba mu ndemanga yanga yoyamba) Chitani izi molingana ndi - ulalo wa nkhani.

Sonya masiku 10 apitawo

Koma kodi uku si kusudzulana? Chifukwa chiyani akugulitsa pa intaneti?

Yulek26 (Tver) masiku 10 apitawo

Sonya, mukukhala m'dziko liti? Amagulitsa pa intaneti, chifukwa masitolo ndi mafakitala amaika chizindikiro chawo. Kuphatikiza apo, kulipira kokha atalandira, ndiko kuti, ankayang'ana koyamba, kufufuzidwa kenako ndi kulipira. Inde, ndipo tsopano amagulitsa chilichonse pa intaneti - kuchokera ku zovala kupita pa televizioni ndi mipando.

Kuyankha Kwa mkonzi masiku 10 apitawa

Sonya, moni. Mankhwalawa othandizira matenda osokoneza bongo a shuga samagulitsika kudzera pa intaneti ya mankhwala kuti asawonongeke kwambiri. Mpaka pano, mutha kuyitanitsa pa tsamba lovomerezeka. Khalani athanzi!

Sonya masiku 10 apitawo

Pepani, poyamba sindinazindikire zambiri zandalama. Kenako chilichonse ndichabwino, ngati mwalandira mukalandira.

Zolemba za mtundu wa 2 wodwala matenda a shuga

Mosiyana ndi mitundu ina ya matendawa, ludzu silizunza. Nthawi zambiri zimachitika chifukwa cha ukalamba. Chifukwa chake, ngakhale kuchepetsa thupi kumalandiridwa ngati zotsatira zabwino za zakudya. Endocrinologists amati chithandizo cha matenda ashuga a 2 amayamba ndi zakudya. Wochiritsira kapena gastroenterologist amapanga mndandanda wazinthu zololedwa, dongosolo lazakudya. Kwa nthawi yoyamba, pali kufunsana pakupanga menyu tsiku lililonse. (Onaninso: Mellitus wodwala matenda a shuga - chidziwitso chothandiza pa matendawa)

Ndi mtundu 2 matenda a shuga, mumachepa thupi nthawi zonse. Nthawi yomweyo kuchotsa mafuta madipoziti. Izi zimabweretsa kuwonjezeka kwa insulin sensitivity. Insulin yotulutsidwa ndi kapamba imayamba kupanga shuga. Mapeto ake amathamangira ku maselo. Zotsatira zake, pali kuchepa kwa sucrose yamagazi.

Sizotheka nthawi zonse ndi matenda ashuga a 2 kuti azilamulira kuchuluka kwa shuga m'zakudya. Chifukwa chake, pakukambirana, endocrinologist amakupatsani mankhwala. Itha kukhala mapiritsi, jakisoni.

Mankhwala a insulin 2 a shuga amasonyezedwa mwa omwe ali onenepa kwambiri. Ngakhale nditakhala ndi zakudya zochepa, sikuti nthawi zonse kuchepetsa thupi. Izi zili choncho chifukwa kuchuluka kwa shuga sikunachitike, ndipo insulini yopanga sikokwanira kutsika shuga. Zikatero, ndikofunikira kuchepetsa kuchuluka kwa magazi ndipo kubayidwa jakisoni wa insulin.

Kukula, matenda ashuga amafunikira jakisoni wa mankhwala omwe amachepetsa magazi. Pankhaniyi, endocrinologist akuyenera kuwonetsa pa kachipangizidwe ka khadi - "Mtundu wachiwiri wa matenda osokoneza bongo a mellitus insulin-". Chowonjezera pakati pa odwala matenda ashuga amtunduwu kuchokera koyamba ndi mulingo wa jakisoni. Izi sizotsutsa. Kupatula apo, zikondamoyo zimapitilizabe insulin.

Kodi mungasankhe bwanji dokotala?

Kutalika kwa moyo wodwala matenda a shuga oopsa kumakhala kovuta kudziwa. Pali zoterezi pamene wodwala matenda ashuga amasiya kudalira endocrinologist. Amakhulupirira kuti chithandizo cha insulin chimapangidwira molakwika ndipo amayamba kuthamangira mozungulira zipatala.

Mwanjira ina, mumasankha kugwiritsa ntchito ndalama popeza zotsatira za kafukufuku ndi ntchito zothandizidwa. Ndipo njira zamankhwala zingasiyane. Pa mpikisano uwu, kuti insulin yothandizira mtundu wa 2 matenda ashuga amafunika kupanga chisankho nthawi yomweyo.Kupatula apo, ngati tili ndi matenda osalamulirika, kuvulaza kumachitika msanga komanso mosagwirizana. Chifukwa chake, musanaponye ku maofesi a endocrinologists, muyenera kusankha zoyenera dokotala.

Matenda a shuga amtunduwu amapezeka zaka zapakati pa 40 ndi akulu. Nthawi zina, kukula kwa mankhwala a insulini sikofunikira, chifukwa kapamba amabisa kuchuluka kwa insulini. Zinthu ngati izi sizimayambitsa matenda a diabetes ketoocytosis. Komabe, pafupifupi aliyense wodwala matenda ashuga ali ndi mdani wachiwiri, kuphatikiza pa matendawa - kunenepa kwambiri.

Kutengera kwam'tsogolo matendawa

Ndi matenda a shuga omwe amadalira insulin, kuchuluka kwa moyo kumakhala ndi gawo lalikulu. Mwayi winawake umaperekedwa ndi majini
chikhalidwe cha matenda ashuga. Zowonadi, ngati banja lili ndi chiopsezo chotenga matenda osadziletsa a insulin, ndiye kuti mwa ana mwayi wokhala wathanzi umachepetsedwa ndi 50% (ndi matenda a abambo) ndi 35% yokha yokhala ndi matenda a amayi. Mwachilengedwe, izi zimachepetsa nthawi yamoyo.

Endocrinologists amati mitundu yama-sellassus yomwe imadalira shuga imatha kupezeka. Ndipo nthawi yomweyo kudziwa zoyambitsa matenda kagayidwe kachakudya. Mwanjira ina, mu zamankhwala, pali mitundu iwiri ya zilema.

• kukana insulini ndi dzina lachiwiri, lochulukirapo, - kunenepa kwambiri.
• kuchepa kwapachitetezo cha ma cell a beta / kusazindikira kwawo.

Matenda a shuga osagwirizana ndi insulin

Matenda a shuga a 2 osadalira insulin amakula motsatizana, nthawi zambiri pazaka zingapo. Wodwala sangathe kuwona zomwe akuwonetsa konse. Zizindikiro zowopsa kwambiri zikuphatikiza:

M ludzu umatha kutchulidwa kapena kuwonekera pang'ono. Zomwezo zimagwiranso pokodza mwachangu. Tsoka ilo, matenda a shuga a 2 amapezeka mwangozi. Komabe, ndimatenda otere, kuzindikira koyambirira ndikofunikira kwambiri. Kuti muchite izi, muyenera kupimidwa magazi pafupipafupi kuti mupeze shuga.

Matenda a shuga omwe amadalira insulin amawonetsedwa ndimavuto a pakhungu ndi mucous nembanemba. Izi nthawi zambiri:

Ndi ludzu lotchulidwa, wodwalayo amatha kumwa mpaka malita 3-5 patsiku. Nthawi zambiri usiku kupita kuchimbudzi.

Ndikupita patsogolo kwa matenda ashuga, dzanzi ndi kumva kuwawa kumapeto zimawonekera, miyendo imapweteka poyenda. Mwa akazi, candidiasis yosasinthika imawonedwa. Pambuyo pake magawo azikhala:

Zizindikiro zoopsa zomwe zili pamwambapa mu 20-30% ya odwala ndiye zizindikiro zoyambirira za matenda ashuga. Chifukwa chake, ndikofunikira kwambiri kuyesa mayeso chaka chilichonse kuti mupewe izi.

• 1. Ndikofunikira kufotokozera kuchuluka komwe kusala kudya kwa magazi ndikatha kudya ndikuyesera kuzisamalira. Magawo awa amakonzedwa mosiyanasiyana. a. Kwa odwala omwe akudziwa kuyambika kwa hypoglycemia ndipo mwa iye amadzisankhira okha kapena atatha kudya shuga, kuthamanga kwa glucose komwe kumayandikira kwambiri kwa anthu athanzi (3.9-7.2 mmol / L) kungasonyezedwe. Gululi limaphatikizapo odwala achikulire omwe amakhala ndi nthawi yochepa ya insulin wodalira matenda a shuga komanso achinyamata. b. Amayi oyembekezera ayenera kukhala ndi chidwi chotsika glucose wocheperako. c. Miyezi yokhazikika ya glucose iyenera kukhala yapamwamba mwa odwala omwe samva kuti njira ya hypoglycemia, komanso muzochitika zomwe hypoglycemia imafunikira chithandizo chamankhwala kapena chowopsa (mwachitsanzo, odwala omwe ali ndi matenda amitsempha yamagazi). g. Mu odwala omwe amalangidwa, omwe nthawi zambiri amayesa kuchuluka kwa shuga m'magazi ndikusintha Mlingo wa insulin, ndizotheka kukhalabe ndi kuchuluka kwa glucose kwa 70-80% ya nthawi ya tsiku.
• 2. Ndikofunikira kutsanzira kusinthasintha kwazinthu zamagulu a insulin monga momwe kungathekere. Mwa anthu athanzi, maselo a beta amapitilira insulin yaying'ono ndipo motero amapereka basal yake. Pambuyo kudya, insulin katulutsidwe kumatheka. Kuti apange insulin yofunikira kwambiri m'magazi a wodwalayo ndikusintha kusinthasintha kwakuthupi kwakuthengo kwa insulin, imodzi mwalamulo yotsatirayi ya insulin imasankhidwa: a. Insulin yomwe imagwira ntchito mwachidule imayendetsedwa musanadye chilichonse, ndipo insulini yokhazikika imayendetsedwa kamodzi patsiku (nthawi yogona) kapena kawiri pa tsiku (musanadye kadzutsa komanso asanagone) kuti apange gawo loyambira la mahomoni. b. Insulin yomwe imagwira ntchito mwachidule imaperekedwa musanadye chilichonse, ndipo insulini yokhala ndi nthawi yayitali imaperekedwa 1 kapena 2 kawiri patsiku kuti ipange gawo loyambira la mahomoni. c. Kawiri pa tsiku, insulin yocheperako komanso sing'anga kapena kuphatikiza insulini kukonzedwa kumayendetsedwa nthawi yomweyo. d. Asanadye chakudya cham'mawa, insulin yochepa komanso sing'anga wothandizidwa ndi insulin kapena kaphatikizidwe kenakake kamene kamaperekedwa nthawi yomweyo. Asanadye chakudya chamadzulo, insulin yovala pang'ono, ndipo isanagone, insulin ya nthawi yayitali imabayidwa. e. Wodwala yemwe amatha kunyamula insulin amafunika kuwonjezera kuchuluka kwa mahanderi asanadye. Mitundu yamakono yopatsirana yam'magazi a glucose metres samangokhala ndi insulin, komanso imangokulitsa kuchuluka kwa timadzi timatenda ta m'magazi tikatha kudya.
• 3. Muzisamala pakati pa Mlingo wa insulin, zakudya, komanso masewera olimbitsa thupi. Ma tebulo omwe amadyedwa ndi American Diabetes Association amaperekedwa kwa odwala kapena abale awo. Ma tebulo awa amawonetsa chakudya chamagulu amitundu mitundu ya zakudya, mphamvu zawo ndi kusinthana. Dokotala, limodzi ndi wodwala, amapanga dongosolo la munthu wazakudya. Kuphatikiza apo, adotolo amafotokozera momwe zochitika zolimbitsa thupi zimakhudzira kuchuluka kwa shuga m'magazi.
• 4. Kudziona wekha wamagazi a. Tsiku lililonse, 4-5 pa tsiku (musanadye chakudya chilichonse komanso musanakagone), wodwalayo amayesa kuchuluka kwa shuga m'magazi a chitseko chogwiritsa ntchito zingwe zoyeserera kapena glucometer. b. Kamodzi pakatha masabata awiri, komanso nthawi zonse pamene gawo la insulin limayendetsedwa musanayambe kugona, wodwalayo amayeza kuchuluka kwa shuga pakati pa 2:00 ndi 4:00. Mlingo wa glucose mukatha kudya umatsimikiziridwa pafupipafupi. c. Nthawi zonse yeretsani kuchuluka kwa shuga ndikuwonekera kwa zotsogola za hypoglycemia. d. Zotsatira za miyeso yonse, Mlingo wa insulini ndi zomverera zina (mwachitsanzo, zizindikiro za hypoglycemia) zalembedwa mu diary.
• 5. Kudzikonza nokha kwa dongosolo la insulin mankhwala ndi zakudya, kutengera kuchuluka kwa shuga wamagazi ndi moyo. Dokotala ayenera kupatsa wodwalayo dongosolo mwatsatanetsatane wa momwe angachitire, kupereka zambiri momwe angathere, momwe angafunikire kusintha njira ya insulin ndi zakudya. a. Kuwongolera kwa insulin mankhwala regimen kumaphatikizapo kusintha kwa insulin Mlingo, kusintha kwa chiŵerengero cha mankhwala osiyanasiyana nthawi, komanso kusintha kwa jakisoni. Zifukwa zosinthira kuchuluka kwa insulin ndi mitundu ya insulin
• 1) Kusintha kwamwazi wamagazi panthawi inayake masana, kuzindikiridwa ndi zolemba. Mwachitsanzo, ngati shuga wamagazi pambuyo pa chakudya cham'mawa ayamba kuchuluka, mutha kuwonjezera kuchuluka kwa insulin yochepa yomwe mumapereka musanadye chakudya cham'mawa. Komanso, ngati kuchuluka kwa shuga pakati pa chakudya cham'mawa komanso chamasana kwatsika, ndipo makamaka ngati zizindikiro za hypoglycemia zikuwoneka panthawiyi, mlingo wam'mawa wa insulin yochepa kapena pakati pa insulin mlingo uyenera kuchepetsedwa.
• 2) Kuchulukitsa kapena kuchepa kwa kuchuluka kwa shuga m'magazi a tsiku ndi tsiku (mogwirizana, mutha kuwonjezera kapena kuchepetsa kuchuluka kwa insulin tsiku lililonse).
• 3) Chakudya chowonjezera chomwe chikubwera (mwachitsanzo, ngati wodwalayo akuyendera).
• 4) Zochita zolimbitsa thupi zikubwera. 5) Ulendo wautali, kumverera kolimba (kupita kusukulu, makolo osudzulana, ndi zina).
• 6) Matenda onga.
• 6. Maphunziro a odwala. Dokotala ayenera kuphunzitsa wodwalayo kuti azichita zinthu modziyimira payekha m'malo alionse. Nkhani zazikulu zomwe adotolo ayenera kukambirana ndi wodwala: a. Kudziyang'anira wekha wamagazi. b . Malangizo a insulin mankhwala regimen. c. Kukonzekera Zopatsa Thanzi. g. Zochita zolimbitsa thupi zovomerezeka. d. Kuzindikira, kupewa komanso kuchiza matenda a hypoglycemia. e. Kuwongolera chithandizo cha matenda oyanjana.
• 7. Kuyanjana ndi wodwala ndi dokotala kapena gulu la anthu odwala matenda ashuga. Choyamba, adokotala amafunikira nthawi zambiri za momwe wodwalayo alili. Kachiwiri, wodwalayo ayenera kuonana ndi dokotala kapena anamwino nthawi ina iliyonse masana ndi kulandira upangiri pa vuto lililonse lokhudza vuto lakelo.
• 8. Kulimbikitsa wodwala. Kupambana kwa chithandizo cha insulin kwambiri kumadalira kulanga kwa wodwalayo komanso kufunitsitsa kwake kuti athane ndi matendawa. Kukhalabe ndi chilimbikitso kumafuna kuyesayesa kwakukulu kwa abale ndi abwenzi a wodwala ndi ogwira ntchito kuchipatala. Nthawi zambiri ntchito imeneyi imakhala yovuta kwambiri.
• 9. Kuthandizira pa zamaganizidwe. Odwala omwe adayamba kudwala matenda osokoneza bongo omwe amadalira insulin ndipo abale awo amafunikira thandizo lamalingaliro. Wodwala ndi abale ake ayenera kuzolowera lingaliro la matendawa ndikuzindikira kulephera kwake ndipo ayenera kulimbana nayo. Ku United States, magulu apadera odzithandiza amapanga dongosolo ili.

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      Matenda a shuga osagwirizana ndi insulin

      Mellitus (NIDDM) yosadalira insulini Pakadali pano amatengedwa ngati matenda opatsirana, okhala ndi vuto la insulin komanso kuwonongeka kwa minofu.
      

      Zomwe zingayike pachitukuko cha NIDDM ndi:
      - kubadwa kwa makolo, maziko a chibadwa cha NIDDM amachitika pafupifupi 100% ya milandu. Chiwopsezo chotenga NIDDM chimachulukitsa kuchulukitsa kawiri mpaka kasanu ndi kamodzi pamaso pa odwala ashuga kapena abale,
      - Kunenepa kwambiri ndi chiopsezo chachikulu pakukula kwa NIDDM. Chiwopsezo chotenga NIDDM pamaso pa kunenepa kwambiri I tbsp. ukuwonjezeka nthawi 2, ndi II tbsp. - Nthawi 5, ndi zaluso - nthawi zopitilira 10. Kukula kwa NIDDM kumalumikizana kwambiri ndi mawonekedwe am'mimba kuposa kufalikira kwamafuta m'matumbo a thupi.

      Mtundu. Zomwe zimayambitsa chibadwa cha NIDDM pakadali pano ndizopatsidwa chofunikira kwambiri. Mtundu wa chibadwa cha NIDDM umatsimikiziridwa ndikuti m'mapasa onse ofanana amapanga 95-100%. Komabe, vuto lomaliza la chibadwa lomwe limayambitsa kukula kwa NIDDM silinapangidwe. Zosankha ziwiri zikukambidwa pano:
      - kukhalapo kwa majini awiri osalongosoka, pomwe amodzi mwa iwo (pa chromosome 11) ndi omwe ali ndi vuto la insulin yotupa, yachiwiri - yopanga insulini (mwina chilema mu genoma la chromosome 12 lomwe limayambitsa kuphatikizidwa kwa insulin receptors),
      - kukhalapo kwa vuto la chibadwa chodziwika mu kachitidwe kodziwika ndi shuga ndi ma cell a B, kapena ma cell ofunikira, komwe kumayambitsa kuchepa kwa glucose kutengedwa m'maselo kapena kuchepa kwa insulin yotulutsidwa ndi ma B-cell poyankha glucose. Amayesedwa kuti NIDDM imafalikira kwambiri.

      Kunenepa kwambiri komanso kunenepa kwambiri . Diabetogenic ndichakudya chomwe chimadziwika ndi ntchito zama calorie ambiri omwe amakhala ndi zakudya zamafuta ambiri, maswiti, mowa, komanso kuchepa kwa fiber. Udindo wa zakudyazi umachulukirachulukira ndi kumangokhala. Chikhalidwe chomwe chikuwonetsedwa cha zakudya komanso kunenepa kwambiri zimayanjana kwambiri ndipo zimathandizira kubisala kwa insulin komanso kukula kwa insulin.

      Akuchepetsa mphamvu ya insulin . Njira yophwanya glucose homeostasis, chifukwa chake, pathogenesis ya NIDDM, imayambitsidwa ndi zovuta m'magawo atatu:
      - mu kapamba - insulin katulutsidwe,
      - mu zotumphukira (makamaka mu minofu), zomwe zimayamba kugonjetsedwa ndi insulin, zomwe, kumene, zimayambitsa kuphwanya mayendedwe ndi kagayidwe ka shuga,
      - mu chiwindi - kupanga shuga kumachuluka.
      

      Kusokonezeka kwa katemera wa insulin ndiye vuto lalikulu mu NIDDM ndipo amadziwika kwambiri koyambirira kwamatendawa. Kuphwanya kwa insulin katulutsidwe kumawonetsedwa pakusintha kwofunikira, kinetic ndi kuchuluka.

      Carbohydrate kagayidwe . Mu shuga mellitus, kutuluka kwa glucose mu cell ya insulin yomwe imadalira insulin kumayipa, ntchito ya ma enzymes ofunikira aerobic glycolysis ndi kayendedwe ka Krebs amachepetsa, kupanga mphamvu kumayipa, kuperewera kwa mphamvu, cell hypoxia imayamba, glycogenolysis ndi gluconeogenesis imachulukanso, komanso glucone-glucose-glucose-glucose-glucose-glucose-glucose-glucoseo gluconeoisuis watsopano. Zonsezi zimabweretsa kuchuluka kwa shuga m'magazi, omwe samatengedwa ndi maselo chifukwa cha kuchepa kwa insulin.

      Mavuto amtunduwu wa carbohydrate metabolism amatsogolera ku hyperglycemia, glucosuria (glucose reabsorption mu renal tubules amachepetsa chifukwa chosowa mphamvu komanso chifukwa cha kuchuluka kwa glucose komwe kumasefedwa ndi impso), motero, polyuria imayamba (chifukwa cha osmolarity yayikulu ya mkodzo), ludzu, kusowa kwamadzi. Maonekedwe a ludzu amalimbikitsidwanso ndikuwonjezereka kwa plasma osmolarity pokhudzana ndi hyperglycemia.

      Kusowa kwa insulin kwa nthawi yayitali kumabweretsa kuwonjezeka kopita patsogolo kwa kusefedwa kwa shuga ndi urea, komwe kumachepetsa kubwezeretsanso mu renal tubules yamadzi ndi ma elekitiroma. Zotsatira zake, kuchepa kwa ma electrolyte (sodium, potaziyamu, magnesium, phosphorous) ndi kuchepa kwa madzi m'thupi.

      Kuwonongeka kwa potaziyamu komanso kuperewera kwa glycogen kuchokera ku glucose kumabweretsa kufooka kwathunthu ndi minofu. Potengera kuchepa kwa mphamvu, polyphagy imawoneka.

      Odwala omwe ali ndi matenda a shuga, njira za glucose metabolism zomwe sizimayimira insulin zimayambitsa: polyol (sorbitol), glucuronate ndi glycoprotein. Glucose mothandizidwa ndi aldose reductase enzyme imasinthidwa kukhala sorbitol. Omaliza, mothandizidwa ndi sorbitol dehydrogenase, nthawi zambiri amasintha kukhala fructose, yomwe imapukutidwa m'njira ya glycolysis. Sorbitol dehydrogenase ndi enzyme yodalira insulini. Mu shuga mellitus pansi pazovuta za insulin, kutembenuka kwa sorbitol kukhala fructose kumangika, kuchuluka kwa sorbitol kumapangidwa, komwe kumasonkhana mu mandala, mafupa am'mitsempha, ndi retina, ndikuthandizira kugonjetsedwa kwawo. Sorbitol ndi mankhwala osmotic kwambiri omwe amakopa madzi kwambiri, omwe ndi amodzi mwa machitidwe a neuropathy ndi chitukuko cha cataract.

      Nthawi zambiri, shuga amasinthidwa kukhala glucuronic acid kudzera mu uridine diphosphate glucose, komanso amagwiritsidwa ntchito pakupanga glycogen. Chifukwa chakuti kugwiritsidwa ntchito kwa gulcohate wa uridine chifukwa cha kapangidwe ka glycogen kumachepetsedwa, kaphatikizidwe ka glucuronic acid ndi glycosaminoglycans kumawonjezeka kwambiri, komwe ndikofunikira pakapangidwe ka angiopathies.

      Kuphatikiza apo, palinso kuphatikiza kwama glycoproteins, komwe kumathandizanso kukula kwa angiopathies.

      Mavuto a kagayidwe ka protein . Mu shuga mellitus, ntchito ya pentose kuzungulira kwa glucose metabolism imachepa, zomwe zimapangitsa kuphwanya kaphatikizidwe ka mapuloteni. Kuwonjezeka kwa gluconeogeneis kumayendetsedwa ndi kuchuluka kwa mapuloteni, kuwononga mphamvu zake, chifukwa gluconeogeneis amawerengedwa kuchokera ku amino acid. Kuchepa kwa kaphatikizidwe ndi kuwonjezereka kwa mapuloteni othandizira kumapangitsa kuti thupi lizichepa kwambiri komanso minofu hypotrophy. Chofunika kwambiri ndi kutsika kwa mapuloteni, makamaka hemoglobin.

      Mafuta kagayidwe . Kuperewera kwa insulin ndi kuletsa kwa pentose kuzungulira kwa glucose metabolism kusokoneza kaphatikizidwe ka mafuta ndikulimbikitsa lipolysis, zomwe zimapangitsa kuchuluka kwa mafuta acid ndi glycerol. Mafuta ochulukirapo amalowa m'chiwindi, pomwe amasandulika mafuta osagwirizana ndikupangitsa mafuta kulowa m'chiwindi. Mafuta ochulukirapo amathandizanso kuti mapangidwe a matupi ambiri a ketone omwe alibe nthawi yoti awotche mu mkombero wa Krebs, ketonemia, ketonuria. Pokonza matupi a ketone m'thupi, mapapu amatenga nawo gawo, fungo la acetone mkamwa limawonekera. Ketonuria (kwamikodzo am'mimbamo a matupi a ketone: β-hydroxybutyric ndi acetoacetic acids) imachulukitsa hyponatremia ndi hypokalemia, chifukwa ma ro-hydroxybutyric ndi acetoacetic acids amamangiriridwa ku odium ndi potaziyamu.

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