Type 1 shuga mellitus: zomwe zimayambitsa, zizindikiro ndi chithandizo, zovuta

Mulimonse momwe zovuta za munthu wodwala matenda ashuga zilili, pali chifukwa chake. Kwa zaka makumi angapo, madotolo akhala akukambirana pazinthu zomwe zimayambitsa zovuta, koma mpaka pano sanathe kudziwa bwinobwino zomwe zimachitika.

Nthawi yomweyo, zochitika zingapo zimadziwika kuti zimakondweretsa mawonekedwe osintha a thupi. Zodziwika kwambiri zalembedwa pansipa:

• zakudya zosayenera, zomwe zimayambitsa matenda a metabolic,
• glucose owonjezera ndi / kapena sodium,
• kuchuluka kwa magazi,
• kudzikundikira kwa lactic acid mthupi.

Zomwe zimayambitsa matenda a shuga 1 ndi mtundu wakubadwa. Ndizofunikira kudziwa kuti kupezeka kwamatenda mwa mwana kumasiyana pang'ono kutengera kuti ndi ndani m'banjamo yemwe ali ndi matenda ofananawo. Mwachitsanzo:

• ndi mayi wodwala, mwayi sawonjezeranso 2%,
• ngati matendawa apezeka mwa bambo, ndiye kuti mwayiwo ungasiyane 3 mpaka 6%,
• kupezeka kwa matenda monga matenda amtundu 1 shuga mu m'bale wanu kumawonjezera mwayi wa 6 kapena kuposa.

Amayambitsa, Zizindikiro, mankhwala ndi kuzindikira kwa hyperinsulinism mwa ana ndi akulu

Mavuto mu ana amawonetsedwa pang'ono, pokhapokha chifukwa cha "chidziwitso" chochepa. Imfa zosakwana zaka 18 zatsala pang'ono kukwana zero. Komabe, ngati mwana wapezeka ndi matenda a shuga, izi zikutanthauza kuti kubwezeretsa kwayamba kale. Madotolo amati pali zovuta zingapo zomwe zimayambitsa matenda a shuga kuubwana / unyamata:

• microalbuminuria,
• matenda ashuga nephropathy,
• angiopathy (nthawi zina),
• retinopathy.

Mavuto a matenda ashuga ali aang'ono ndi owopsa chifukwa chobisalira. Zizindikiro zomwe zimawonedwa mwa mwana nthawi zambiri zimadziwika ndi matenda ena, owonjezera komanso ofala. Kupereka nthawi yake kuchipatala moyenera, ndikotheka kukwaniritsa chindalama chokwanira cha matenda ashuga kwakanthawi ndikuonetsetsa kuti nkhawa sizichitika.

Zizindikiro sd mtundu II

Zambiri
Zizindikiro (ludzu, polyuria, kuyabwa,
kutengeka ndi matenda) ndizochepa
kapena kusowa. Nthawi zambiri kunenepa
(mu 80-90% ya odwala).

Ngakhale nthenda yake yayitali, matendawa, mothandizidwa ndi zinthu zoyipa, amakhala ndi chitukuko chofulumira komanso kusintha kwa gawo lina lakuvuta kupita kwina.

Zizindikiro zodziwika bwino za matenda a shuga 1 zimaperekedwa:

• ludzu losalekeza - izi zimapangitsa kuti munthu akhoza kumwa mpaka malita khumi amadzimadzi patsiku,
• kamwa yowuma - yowonetsedwa ngakhale kumbuyo kwa njira yambirimbiri ya zakumwa,
• kukodza kambiri komanso pafupipafupi,
• kulakalaka
• khungu louma ndi nembanemba
• kuyabwa kwachikale pakhungu ndi zotupa za pakhungu.
• zosokoneza tulo
• kufooka ndi kuchepa kwa magwiridwe
• madera a kumunsi,
• kuwonda
• kuwonongeka kwamawonekedwe
• kusanza ndi kusanza, komwe kumakhalitsa kwakanthawi,
• njala yosalekeza
• kusakhazikika
• kugona - chizindikiro ichi chimapezeka kwambiri mwa ana.

Matenda a shuga ndi matenda ofala kwambiri masiku ano. Matendawa samangosintha kwambiri moyo wa munthu, komanso amakhalanso ndi zovuta zina.

Matenda a shuga ndi zotsatira za kusayenda bwino mu dongosolo la endocrine komanso kuchuluka kwa insulin yomwe imapangidwa. Ngati kuchuluka kwa insulini sikokwanira kuti shuga awonongeke, ndiye kuti matenda amtunduwu amatchedwa matenda a shuga 1. Kuchuluka kwa insulin yomwe singathe kulumikizana ndi ma receptor ena kumawonetsa kukhalapo kwa matenda a shuga a 2.

Matenda a shuga a mtundu woyamba amakhala ambiri mwa achinyamata ndi ana. Mtundu wachiwiri wa matenda a shuga umapezeka kwambiri mwa anthu achikulire. Ndi matenda anthawi yake, kukula kwa matendawa kumatha kupewedwa ndimankhwala komanso zakudya.

Kanema wokhudza chithandizo komanso kupewa matenda ashuga

Pambuyo povomereza matendawa, odwala ambiri ali ndi chidwi ndifunsoli - kodi ndizotheka kuchiritsa matenda amtundu wa 1? Mankhwala samachiritsika kwathunthu, koma zitheka kukonza mkhalidwe wa wodwala kwazaka zambiri mothandizidwa ndi njira zochiritsira:

• m`malo insulin mankhwala - Mlingo wa chinthu chotere chimasankhidwa payekha malinga ndi kuopsa kwa maphunzirowo ndi msinkhu wa wodwalayo,
• kusunga zakudya
• makonzedwe apadera opangidwira olimbitsa thupi - ambiri, odwala amawonetsedwa kuchita masewera olimbitsa thupi mopepuka kapena olimbitsa thupi tsiku lililonse kwa ola limodzi.

Zakudya za matenda amtundu 1 amatanthauza kutsatira malamulo otsatirawa:

• kusiyanitsidwa kwathunthu kwazinthu monga shuga ndi uchi, kusunga zokhala ndi nyumba ndi zotchingira nyama zilizonse, komanso zakumwa zoziziritsa kukhosi,
• kupangitsa kuti chakudya chizikhala ndi mkate ndi tirigu, mbatata ndi zipatso zatsopano,
• kudya pafupipafupi komanso kwamitundu yambiri,
• kuletsa kudya zamafuta ochokera nyama,
• kuyang'anira kudya zakumwa ndi mkaka,
• kupatula kudya kwambiri.

Mndandanda wathunthu wazakudya zololedwa komanso zoletsedwa, komanso malingaliro ena okhudzana ndi zakudya, amaperekedwa ndi adokotala okha.

Mitundu yamavuto

Zowopsa zoyipa zomwe zimapangitsa thupi kukhala ndi matenda amtundu 1 zimatheka chifukwa cha kuchuluka kwa shuga m'magazi.

Thupi silimatha kuliphatikiza kukhala ndi mphamvu ndikuyamba kugawa mafuta, omwe, limaphwanya ma ketoni ndipo limadziphatikizanso pafupifupi ziwalo zonse komanso m'mitsempha yamagazi. Izi ndi zinthu zovulaza, monga, mwachitsanzo, acetone.

Nthawi zambiri, poyerekeza ndi zovuta za kagayidwe kameneka, wodwala yemwe ali ndi matenda a shuga 1 amayamba ketoacidosis, matenda omwe zinthu za metabolic zimadziunjikira kwambiri m'thupi, koma sizingatengeke bwino.

Ndi chitukuko cha matendawa kwa mayi woyembekezera, zovuta zake zidzakhala - kupangika padera ndi kusokonezeka kwa fetal.

Matenda a shuga ndi monga amodzi mwa matenda ovuta. Komanso, si matenda omwewo omwe amayambitsa nkhawa, koma zovuta za matenda a shuga. Kukula kwa zovuta posachedwa kumatha ndi kulumala, nthawi yayitali komanso yovuta yomwe imayambitsa kulumala, ndikuchepetsa kosasangalatsa kwambiri m'moyo.

Zimayambitsa zovuta

Cholinga chachikulu cha zovuta zonse za matenda a shuga ndi kuchuluka kwa shuga m'thupi. Hyperglycemia yosalamulirika, kukulira kwa vuto la metabolic m'thupi kumapangitsa kukulitsa kwa matenda. Kuphatikiza apo, kuchuluka kwambiri kwa insulini m'magazi ndizowonongeka kwa zigawo zoonda zamitsempha yamagazi.

Ndi shuga ochulukirachulukira m'magazi, maselo amthupi amakhala ndi chimphepo champhamvu cha shuga, zomwe zimayambitsa zovuta za shuga.

Matenda amtunduwu amadziwika ndi zovuta zowopsa zomwe zimapita kwenikweni m'maso. Zina mwazinthu izi zimafuna chithandizo chofunikira mwachangu ndipo sizolondola popewa. Ganizirani zovuta za mtundu 1:

• Ketoacidosis ndikozindikira kwa matupi a ketone m'magazi pansi pazomwe zimapangitsa insulin kuti isaperekedwe. Ngakhale akukhalabe ndi vuto la kuchepa kwa mahomoni, wodwalayo amagwa msanga mu ketoacidotic coma.
• Zomwe zimayambitsa hyperosmolar coma ndi kuchuluka kwa shuga, ndichifukwa chake thupi limasowa madzi. Ngati wodwalayo sanalandiridwe pakadali pano, ndiye kuti chiwopsezo cha kufa chiri pamwamba.
• Hypoglycemic coma imadziwika kuti, molakwitsa, wodwala amalandira mlingo waukulu wa insulin kwambiri. Chifukwa cha izi, kuperewera kwa glucose kumapangidwa mu ubongo, komwe kumayambitsa kugwira ntchito, komwe kumapangitsa kuti musakhale ndi chikumbumtima chosakwanira, kukomoka komanso kupsa mtima.

Mavuto a shuga mellitus, chifukwa cha kuopsa kwake, ndi owopsa kwambiri kwa ana, chifukwa thupi lawo ndilofooka kwambiri kukhala ndi njira zokwanira zolipirira, ndipo malingaliro aliwonse ofotokozedwawa amatha kupha.

Kuphatikiza pazotsatira zopweteka, mtundu 1 umadziwika ndi zovuta za "mochedwa". Amakhala achikhalidwe chachilengedwe ndipo amafanana ndi mawonekedwe a 2 matenda.

Kupewa

Njira yokhayo yothanirana ndi zovuta za matenda ashuga ndikutsatira malangizo azachipatala, kuwunikira nthawi zonse misempha ya magazi ndikuwasunga bwino.

Palibe mwayi wopewa zovuta zoyambitsa matendawa motere, koma ndizotheka kuzichepetsa.

Mpaka pano, kupewa enieni a matenda ashuga a mtundu woyamba sikunayambike. Pofuna kuchepetsa mwayi wokhala ndi matenda, tikulimbikitsidwa:

• Siyani zizolowezi zoipa,
• idyani pomwe
• Imwani mankhwala okhawo omwe akuwalangizani,
• pewani kupsinjika nthawi zonse ngati zingatheke
• onenepa kwambiri
• kukonzekera mosamala mimba
• munthawi yake matenda alionse opatsirana kapena matenda,
• kuwunika pafupipafupi ndi endocrinologist.

Kuzindikira, komanso kuchuluka kwa momwe amakhalira ndi matenda amtundu wa 1, zimatengera momwe wodwalayo amatsatira mosamalitsa othandizira odwala endocrinologist. Mavuto amatha kupha.

Mtundu woyamba wa shuga - kodi matendawo ndi chiani?

Mtundu woyamba wa matenda a shuga a mellitus (kapena a shuga omwe amadalira insulin) ndi matenda amtundu wa endocrine wodziwika chifukwa chosakwanira kupanga mahomoni a insulin ndi kapamba. Zotsatira zake, munthu amakhala ndi shuga wambiri m'madzi a m'magazi komanso zizindikiro zazikulu zotsatana - ludzu losatha, kuchepa thupi popanda chifukwa.

Matendawa ndi osachiritsika, chifukwa, pozindikira matenda ashuga, odwala ayenera kumwa mankhwala omwe amachepetsa shuga m'magazi amoyo ndikuwonetsetsa momwe aliri.

Chiyembekezo chamoyo mu mtundu woyamba wa matenda ashuga, ndi chithandizo choyenera komanso kukhazikitsidwa kwa malingaliro a dokotala, ndizokwera kwambiri - kuposa zaka 30-30.

Zomwe zimayambitsa matenda A shuga 1

Zomwe zimayambitsa matendawa sizinakhazikitsidwe. Amakhulupirira kuti chinthu chomwe chimapangitsa kwambiri kuti shuga asadalire insulin adziwike chibadwa.

Kuphatikiza pa kubadwa mwatsopano, zinthu zina zimatha kuyambitsa matendawa:

• Kunenepa kwambiri kapena kunenepa kwambiri,
• Mavuto a kudya - kugwiritsa ntchito muffin, chokoleti, michere yosavuta, chifukwa zimapangitsa kuti chakudya chamafuta ndi mafuta asokonezedwe m'thupi la munthu, zomwe zimapangitsa kuti matumba azisokonekera.
• Matenda a kapamba kapena pancreatic necrosis,
• Kupsinjika
• Mowa
• Kugwiritsa ntchito mankhwala omwe amasokoneza ma cell a pancreatic omwe amachititsa kuti pakhale insulin ya mahomoni (omwe amatchedwa islets of Langerhans),
• Matenda opatsirana am'mbuyomu komanso kutupika kwa chithokomiro.

Zizindikiro za matenda a shuga 1

Zizindikiro za matenda amtundu 1 shuga, chithunzi 1

Zizindikiro zoyambirira za matenda amtundu 1 ndi:

• Kuchepetsa thupi mwachangu
• Kuchulukitsa ludzu
• Kuchulukitsa chilakolako
• Kuchulukitsa pokodza (polyuria),
• Lethargy, kutopa, kugona,
• Njala, yomwe imatsatana ndi khungu la khungu, tachycardia, mawonekedwe a thukuta lozizira, kutsika kwa kuthamanga kwa magazi,
• Kuwona kumverera kwa chala ndi kufooka kwa minofu.

Mwa akazi, chimodzi mwazizindikiro zoyambirira za matenda ashuga ndizowuma kwambiri kwa ziwalo zam'mimba komanso ziwalo zakunja, zomwe zimayambitsidwa ndi kupezeka kwa makhristali a mkodzo.

Atapita kuchimbudzi, madontho a mkodzo amakhazikika pakhungu ndi mucous nembanemba, nkumapangitsa kuyamwa kwambiri komanso kuyamwa kosaletseka, komwe kumakakamiza azimayi kukaonana ndi dokotala.

Mwa abambo, chiwonetsero choyamba cha matenda a shuga a mtundu woyamba ndi vuto logonana (erectile dysfunction) ndi kusowa kwa chilakolako chogonana.

Matendawa amatha kuchitika kwakanthawi kochepa chabe kapena wodwalayo samangoganizira kufunika kwa chithunzi chokulirapo.

Chenjerani ndikukhala chifukwa chakuchezera kwadotolo msanga kuyenera kukhala mabala osachiritsika ndi mabala ang'onoang'ono pakhungu, mapangidwe a zithupsa, ndi zotupa, komanso kuwonongeka kowopsa pakusatetezeka, chimfine pafupipafupi komanso malaise wamba.

Kuzindikira matenda ashuga amtundu 1

Kuzindikira matenda a shuga omwe amadalira insulin nthawi zambiri kumakhala kovuta, ngati mukukayikira matenda, wodwala amayenera kukayezetsa magazi kuti adziwe kuchuluka kwa shuga.

Kuti zotsatira za kafukufuku zikhale zodalirika, magazi amayenera kumwedwa pamimba yopanda kanthu, ndipo maola 8 isanachitike, wodwalayo sayenera kudya maswiti, kudya chakudya, kumwa khofi, kusuta fodya kapena kumwa mankhwala.

Chizindikiro choyenera cha shuga m'magazi ndi 3-3,5 mmol / l, mwa amayi apakati Zizindikiro izi zimatha kufika 4-5 mmol / l, yomwe si njira yoyambira. Mu matenda a shuga, kuchuluka kwa shuga m'magazi pamimba yopanda kanthu kudzakhala kofanana ndi 7.0-7.8 mmol / L.

Kuti muwonetsetse kuti matendawa ndi olondola, wodwalayo amapeza mayeso ololera a glucose: choyamba, magazi amatengedwa pamimba yopanda kanthu, kenako wodwalayo amapatsidwa njira yotseka shuga ndipo ndikulimbikitsidwa kuti ayambirenso pambuyo pa maola awiri. Ngati zotsatira pambuyo pa maola awiri ndizoposa 9.0-11.0 mmol / l, ndiye izi zikuwonetsa matenda amtundu 1 shuga.

Njira yothandiza kwambiri yodziwira matendawa ndi kuyesa kwa glycated hemoglobin A1C, yomwe imakupatsani mwayi wofufuza molondola ndipo sikutanthauza kukonzekera kwa nthawi yayitali.

Mtundu woyamba wa shuga

Potsimikizira matenda a shuga omwe amadalira insulin, dokotala amamulembera wodwalayo chithandizo chamankhwala - izi ndi mankhwala omwe amachepetsa kuchuluka kwa shuga m'magazi, omwe wodwalayo amayenera kutenga moyo wonse.

Mlingo wa mankhwalawa ungasinthidwe molingana ndi mawonekedwe a thupi la wodwalayo, matendawa, momwe angagwiritsidwire ntchito mankhwala ena, kupezeka kwa zovuta.

Pa gawo loyambirira la chithandizo, wodwalayo adapangidwira kukonzekera kwa insulin mu mawonekedwe a piritsi, komabe, ngati vutoli silikwanira kapena lofooka, ndipo matenda a shuga akupita patsogolo, ndiye kuti amayamba jakisoni wa insulin.

Mlingo wa mahomoni amawerengedwa mosiyana payekhapayekha, uyenera kuperekedwa kwa wodwala mosadukiza (m'dera la phewa, ntchafu yakunja, khoma lakunja kwam'mimba).

Malowo a jakisoni amayenera kusinthidwa pafupipafupi, popeza pamene jekeseni wa insulin m'malo amodzi, wodwala amapanga lipodystrophy mwachangu.

Kutengera ndi kuthekera ndi kuchuluka kwa kupangira insulini ndi zisumbu za Langerhans, wodwalayo amamulembera mankhwala am'mbuyo (muyenera kulowa kangapo patsiku) kapena kuchitapo kanthu kwa nthawi yayitali (1 jakisoni kamodzi patsiku ndikokwanira).

Wodwala aliyense yemwe ali ndi vuto la mtundu woyamba wa shuga ayenera kukhala ndi glucometer yapadera ndi iye - chipangizo cha m'thumba chomwe chiziyeza msanga magazi.

Pampu ya insulin

Chithunzi cha Insulin Pump 3

Kwa odwala omwe kapamba wawo sagwira ntchito ndipo samapanga insulin, amapaka insulin.

Pompo ndi chida chaching'ono chomwe wodwalayo amapatsidwa mosalekeza ndi insulini mu njira yokonzedweratu kudzera mu chubu chapadera ndi singano.Singano imayilidwa kukhoma kwamkati ndipo imasinthidwa masiku angapo aliwonse.

Ubwino wa njira yothandizira mankhwalawa ndikuchotsa kufunika kwa kubwereka insulini mosalekeza komanso kuwongolera bwino matendawa, koma zomwe zimabweza pampu ndi mtengo wake wokwera, chifukwa, onse odwala matenda ashuga sangathe kuyikapo.

Mavuto a Matenda A shuga a Type 1

Insellus yodalira matenda a shuga imakhala yothandiza chifukwa matendawa amapita patsogolo kwambiri ndipo mkhalidwe wa wodwalayo umatha kuwonongeka msanga.

Ndi zovuta zam'mbuyomu zomwe zimapezeka m'magazi a seramu, wodwalayo amatha kuyamba zovuta:

1. Matenda ashuga angiopathy - mitsempha yamagazi, miyendo, mtima, impso ndi ziwalo zina zofunika zimakhudzidwa, chifukwa cha zomwe ntchito yawo yasokonekera,
2. Kuperewera kwa magazi ndi chakudya cham'mimba, kugunda kwamtima,
3. Gangrene - amakula chifukwa chowonekera pakhungu la zilonda zazing'ono ndi zilonda zosachiritsa ndipo zimatha kupindika nthawi zonse,
4. Matenda a shuga - kusintha mawonekedwe a phazi, kuchepetsa kuchepa kwa khungu, zotupa za mafangasi ndi mapangidwe a ming'alu ya microscopic,
5. Hepatitis
6. Matendawa
7. Mafuta chiwindi.

Vuto lalikulu la matenda ashuga a mtundu woyamba 1 ndi:

• Hypoglycemic - chifukwa cha kuchuluka kwa insulin,
• Ketoacidotic - yoyambitsidwa ndi shuga wamagazi ambiri komanso kuchuluka kwa matupi a ketone.

Zinthu zonsezi zimawopseza moyo wa wodwalayo, ndipo ngati kulibe chithandizo choyenera panthawi yake kumabweretsa imfa.

Ndi anthu angati omwe ali ndi matenda amtundu wa 1 omwe amadwala matendawa ndipo amadalira kwambiri chithunzithunzi cha matendawa ndi kutha kuwongolera kuchuluka kwa glucose.

Mukamakwaniritsa malangizo onse azachipatala, kutsatira zakudya komanso kukhala ndi moyo wathanzi, odwala amakhala ndi ukalamba popanda zovuta.

Zakudya Zabwino Kwambiri Matenda A shuga

Kuphatikiza pa chithandizo chamankhwala, wodwalayo amayenera kutsatira zakudya zonse zoletsedwa ndi mafuta (mbatata, mafuta a nyama, maswiti, chokoleti, khofi, nyemba, makeke ndi makeke, mafuta tchizi, mafuta okuya, pasitala, mkate watsopano).

Zomwe zimakhazikitsidwa ndi zakudya ndi chimanga, chinangwa, zipatso ndi ndiwo zamasamba, nyama yamafuta ochepa, zakudya zamkaka.

Mtundu woyamba wa matenda ashuga mellitus ICD 10

Mu gulu lapadziko lonse la matenda a mtundu 1 matenda a shuga ndi:

Class IV - Matenda a endocrine system, mavuto azakudya ndi zovuta zama metabolic (E00 - E90)

Matenda a shuga (E10-E14)

• E10 wodwala matenda a shuga a insulin.

Otsatirawa saphatikizidwa m'ndime iyi: shuga mellitus wophatikizidwa ndi kuperewera kwa zakudya m'thupi (E12.-), akhanda (P70.2), pa nthawi yobereka, nthawi yobereka komanso nthawi yapambuyo pake (O24.-), glycosuria: NOS (R81), renal (E74.8), kuphwanya lamulo kulolerana kwa shuga (R73.0), postoperative hypoinsulinemia (E89.1)