Gulu (mitundu) ya matenda ashuga

Malinga ndi gulu, ziyenera kusiyanitsidwa:

  • matenda ashuga
  • prediabetes
  • Mokomera amayi apakati.

Malinga ndi ICD 10 (gulu lonse la matenda), gulu lamakono likuwoneka motere:

  • Mtundu 1 - wodalira insulin, Nambala ya E10 (insulin ndiyofunika)
  • Mitundu iwiri - yosagwiritsa ntchito insulin-yodziyimira payokha, code E11 (imakwiyitsa kwambiri thupi komanso kuthamanga magazi),
  • code E12 - yoyambitsidwa ndi kuperewera kwa zakudya m'thupi (imachitika motsutsana ndi maziko akumanjala kapena chiwindi ndi vuto la impso),
  • code E13 - yosakanizidwa,
  • code E14 - mtundu wosasintha wa matenda.

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

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

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

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

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

Zojambula pamakina a matenda amtundu 1

Zizindikiro zazikulu za matendawa zimawonekera motere:

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

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

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

Mothandizidwa ndi zovuta, kuwonjezereka kwa glucose ndikotheka, komwe popanda kuwongolera panthawi yake kumabweretsa hyperglycemia.

Kuyambitsa kuchuluka kwa shuga m'magazi kungathe:

  • mavuto
  • matenda opatsirana kapena otupa,
  • kuphwanya zakudya
  • mimba
  • kuvulala
  • uchidakwa komanso kusuta fodya
  • kusala kudya kapena kudya kwambiri,
  • opaleshoni kuchitapo kanthu
  • kudumpha jakisoni wa insulin kapena mlingo woyenera.

Chifukwa cha shuga wamagazi osakhazikika, mtundu 1 wa shuga ndi wowopsa chifukwa cha zovuta zake:

  • matenda ashuga nephropathy ndi kulephera kwa aimpso,
  • kuwonongeka kwa dongosolo lamanjenje (neuropathy),
  • matenda oopsa
  • matenda a mtima ndi mtima,
  • ketoacidosis - zovuta zomwe zimayambika chifukwa cha kuchepa kwa maselo amafuta amthupi, zomwe zimatsogolera pakupanga matupi a ketone,
  • hyperglycemia.

Ketoacidosis ndi hyperglycemia zimatha kuyambitsa kukomoka ndipo zimatha kufa.

Matenda a shuga a Type 1 ndi matenda osachiritsika ndipo odwala omwe ali ndi matenda amtunduwu amayenera kuyeza kuchuluka kwa shuga m'magazi awo, kutsatira zakudya zovuta komanso kutsatira dongosolo la jakisoni wa insulin.

Matendawa amayamba chifukwa chosakwanira kwa timadzi ta m'matumbo, timene timapangidwa m'matumbo, koma sitingathe kuyenderana ndi maselo.

Kodi pali kusiyana kotani pakati pa mitundu iwiri yamatenda. Kusintha kwa pathological mu chakudya cha carbohydrate mu mtundu 1 kumalumikizidwa ndi kupunduka kwa kapamba, ndipo mu 2, kutayika kwa chiwopsezo cha ma cell receptors kuti insulini.

Ndi mtundu 2 wa matenda ashuga, kubwezerera kwakelo kwa mahomoni sikofunikira, ndipo kumatchedwa osadalira insulin. Izi matenda amakula mwa anthu moyo wonse ndipo nthawi zambiri amadziwoneka lokalamba.

Zinthu zazikulu zomwe zikukhudza kupezeka kwamatenda amtunduwu ndi monga:

  • chibadwa
  • onenepa kwambiri
  • Kugwiritsa ntchito kwambiri zakudya zamafuta ambiri komanso shuga,
  • zolimbitsa thupi
  • matenda oopsa
  • mowa ndi chikonga.

Zizindikiro za matenda amtundu wa 2 sizinafotokozedwe bwino ndipo nthawi zambiri zimapezeka kuti mukudwala matenda ena. Odwala amatha kuwona kuwonongeka, kuwonjezeka kwa kudya ndi kuyabwa.

Kuzindikira matendawa kumachitika molingana ndi zotsatira za kafukufuku wamwazi womwe umatengedwa atatha kudya maola 8. Pathology imatsimikiziridwa ndi mitengo ya shuga yoposa yovomerezeka.

Matenda a shuga omwe amadalira insulin, ngati matenda amtundu 1, samachiritsidwa ndipo ndi matenda amoyo wonse. Chithandizo chothandizira chimakhala pakutsatira zakudya okhwima wokhala ndi zakudya zamafuta ochepa komanso zakudya zamasamba komanso kupatula mafuta, maswiti ndi wowuma kuchokera pamenyu. Njira zowonjezera zochizira ndi kugwiritsa ntchito mankhwala ochepetsa mphamvu ya shuga ndi mphamvu ya ma cellular receptors, komanso kuyambitsa zolimbitsa thupi zolimbitsa thupi.

Chofunikira kuti muchiritse bwino mankhwala ndikuchepetsa thupi komanso kusiya zizolowezi zoipa. Odwala ayenera kuyang'anira kuchuluka kwa shuga ndikuwonetsetsa kangapo patsiku.

Matenda a shuga

Kuchepa kwa hypothalamus, chifukwa chomwe zosakwanira za vasopressin zimapangidwira m'thupi, zimatchedwa shuga insipidus. Vasopressin ndi timadzi timene timayendetsa impso ndi kukodza.

Pali mitundu iwiri ya matenda:

  1. Nephrogenic - matenda osowa kwambiri omwe amayamba chifukwa cha kuchepa kwambiri kwa maselo a impso kupita ku mahomoni a hypothalamus. Pathology imatha kuchitika chifukwa cha kuwonongeka kwa impso pomwa mankhwala kapena chifukwa cha kubadwa kwa impraital.
  2. Hypothalamic Amayamba kuthana ndi maziko osakwanira opanga vasopressin ndipo amagawidwa kukhala ophatikizika - amayamba chifukwa cha kuwonongeka kwa ubongo ndi matenda, kuvulala kapena zotupa, ndi idiopathic - wopangidwa chifukwa cha chibadwa chamunthu.

Chifukwa chake, zifukwa zomwe zimathandizira kukulitsa shuga insipidus zimaphatikizapo:

  • cholowa
  • neoplasms mu ubongo,
  • kuvulala kumutu
  • kutupa kwazotupa,
  • mtima pathologies omwe amasokoneza magazi,
  • matenda a impso.

Zizindikiro zazikulu za matendawa zimawonekera mu mawonekedwe:

  • ludzu losatha
  • kuchuluka kwamkodzo (madzi amathiridwa kuposa malita 20 patsiku) (oposa 25 malita patsiku),
  • migraine ndi kusweka
  • hypotension
  • kusakhazikika mtima
  • Kuchepetsa thupi komanso kusowa chakudya,
  • kulephera kwa kuzungulira kwa mwezi,
  • kukanika kwa erectile.

Chifukwa cha kuchuluka kwa madzi omwe amalowa mthupi, m'mimba amatambasulidwa ndikuchotsedwa, matumbo ndi ndulu za bile zimakhudzidwa. Kusintha kumachitika mu kwamikodzo dongosolo, lomwe limafotokozedwa pakugawika kwa ma ureters, pelvis impso ndi chikhodzodzo.

Chithandizo cha matendawa ndi motere:

  • chakudya, komanso zakudya za mapuloteni,
  • Chithandizo cha matenda omwe amadzetsa vuto la kupanga mahomoni,
  • kubwezeretsanso kwa kuchepa kwamadzi ndi ma electrolyte mthupi mwa kulowetsedwa kwamitsempha yamchere,
  • kudzaza kusowa kwa vasopressin mwa kukhazikitsa desmopressin (cholowa m'malo mwa mahomoni) m'mphuno.

Ndi chithandizo choyenera, matenda a shuga a insipidus sasokoneza tsogolo la odwala.

Prediabetes kapena kulekerera shuga

Mkhalidwe wa prediabetes umadziwika ndi kuwonjezeka pang'ono mu mafuta okhathamira wamagazi, koma panthawi imodzimodziyo kupitilira zovomerezeka. Kuopsa kwa matenda amtunduwu kuli pachiwopsezo cha matenda a mtima ndi mitsempha yamagazi, komanso matenda a shuga. Mkhalidwe wowopseza umafunika kupeza chomwe chimayambitsa kulephera kwa kagayidwe kazachilengedwe ndi chithandizo choyenera.

Zinthu zomwe zitha kupangitsa dziko lino kukhala:

  • kunenepa
  • ukalamba,
  • matenda endocrine
  • cholowa
  • matenda oopsa
  • matenda a chiwindi, impso, mtima ndi chitetezo cha m'thupi,
  • nthawi yobala mwana,
  • kuvutitsidwa kwa zakudya za shuga,
  • mankhwala othandizira,
  • mavuto
  • cholesterol yayikulu.

Pathology ili ndi zizindikiro zofatsa zomwe nthawi zambiri sizimadziwika:

  • ludzu
  • kutaya mphamvu
  • waulesi boma
  • atengeke ndi tizilombo komanso chimfine.

Kuti adziwe matendawa, kuyezetsa magazi kumachitika chifukwa cha shuga. Chizindikiro chowopsa chidzakhala mulingo woposa 6.3 mmol / L.

Amayi oyembekezera, anthu omwe ali ndi abale omwe ali ndi matenda ashuga, komanso anthu omwe amakonda shuga wambiri, amatenga mayeso ololera a glucose. Zizindikiro za kafukufuku woyamba ndizokwera 6.9 mmol / l, ndipo chachiwiri - zosaposa 11.2 mmol / l zimawonetsa chizolowezi chokhala ndi matenda.

Anthu otere ayenera kubwereza kuyezetsa magazi miyezi itatu iliyonse. Popewa, muyenera kuyezetsa miyezi isanu ndi umodzi iliyonse.

Pambuyo pozindikira matendawa, odwala amalangizidwa kuti apewe kutopa kwakuthupi komanso kwamanjenje, kuwonjezera masewera olimbitsa thupi, kutsatira zakudya zofunikira ndikusiya mowa ndi chizolowezi cha chikonga.

Kuthana ndi njira zopewera kupewa kungathandize kupewa kupita patsogolo kwa zovuta za carbohydrate metabolism ndikuletsa kukula kwa matenda ashuga.

Fomu yokhudzana ndi pakati pa mimba

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

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

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

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

Kulephera kwa kagayidwe kazakudya zambiri zimawonedwa m'gulu lino la anthu:

  • pakati ndi chibadwa cholowa
  • akazi athunthu
  • mbiri yakale yokhala ndi matenda ashuga
  • azimayi omwe ali ndi ovary ya polycystic,
  • azimayi omwe amakhala ndi shuga mumkodzo wawo
  • odwala omwe amagwiritsa ntchito zizolowezi zoyipa ndipo amakhala ndi moyo wotopa,
  • amayi apakati omwe ali ndi kuthamanga kwa magazi komanso matenda a mtima
  • azimayi omwe amakhala ndi mimbapo yambiri m'mbuyomu anali ndi ana akulu kapena mwana wosabadwayo wokhala ndi vuto lakula.

Kanema pa matenda ashuga:

Kulimbitsa thupi kuyenera kuchokera pazotsatira za dokotala, kuyang'anira shuga pafupipafupi, kuwonjezeka koyenera kwa masewera olimbitsa thupi komanso kudya. M'tsogolomu, azimayi otere amafunika kukayezetsa kuchipatala kamodzi miyezi isanu ndi umodzi kuti ateteze matenda ashuga.

Mitundu yofala kwambiri ya shuga

Mwa mitundu yonse ya matenda ashuga, lembani 1% pafupifupi 7% ya matenda onse. Chomwe chikuwonjezera shuga ndi kuwonongeka kwa maselo a beta omwe amapezeka m'matumbo. Matendawa amakula mwachangu, pamapeto pake, kupanga insulin kwa wodwalayo kumayima kwathunthu. Mwazi wamagazi umayamba kukula pamene maselo osaposa 20% atsala. Mtunduwu wa matenda ashuga amaonedwa ngati matenda a achinyamata, chifukwa umakula kwambiri mwa ana ndi achinyamata munthawi ya kukula msanga komanso kusasitsa. Chifukwa cha kuchepa kwa matendawa, cholowa chake sichimayilandira bwino. Odwala alibe zizindikiritso zakunja zomwe munthu angaganize kuti amakonda kulemba matenda ashuga 1.

Tsopano pali mayeso apadera omwe mungawone mtundu wamatenda amtunduwu wa matenda ashuga. Zimagwirizanitsidwa ndi majini ena amtundu wa HLA - anti leukocyte antigen. Tsoka ilo, mayesowa sanapeze ntchito yeniyeni, popeza ngakhale kudziwa kukhalapo kwa majini owopsa, asayansi sangalepheretse kuwonongeka kwa maselo.

Matenda a Type 1 nthawi zambiri amagawidwa m'magulu awiri a 2: autoimmune ndi idiopathic:

  1. Matenda A shuga a Autoimmune kumakwiyitsa chitetezo chaanthu. Pakubowola kwa maselo ndipo pafupifupi miyezi isanu ndi umodzi atachotsa kuphatikizika kwa insulin, ma autoantibodies amapezeka m'magazi omwe amalimbana ndi maselo a thupi lawo. Monga lamulo, chitetezo chosakwanira chimayambitsidwa ndi zinthu zakunja. Pakadali pano, ena mwa iwo adapezeka: chikuku, chikuku, gawo la enterovirus, matenda a CMV, mwa ana osakwana chaka chimodzi - mkaka wa ng'ombe.
  2. Matenda a shuga a Idiopathic ochulukirachulukira oimira amitundu ya Asia ndi Negroid. Chithunzi cha chipatala cha odwala ndi chimodzimodzi: maselo a pancreatic amawonongeka mwachangu, shuga amakula, insulini imachepa, koma ma antibodies sangapezeke.

Ambiri mwa anthu odwala matenda ashuga (malinga ndi kuyerekezera kosiyanasiyana kuchokera pa 85 mpaka 95%), omwe amapezeka ndi matenda a shuga 2. Kukula kwa matendawa kumatanthauzanso chibadwa, ndipo ndizosavuta kutsatira: odwala ambiri ali ndi abale apamtima omwe ali ndi matenda ashuga. Choipa chobadwa nacho chimaganiziridwa kuti ndichizolowezi cha minofu kuti isamvere insulin. Komabe, mitundu yeniyeni yokhala ndi vuto la matenda amtunduwu siinakhazikitsidwebe.

Zinthu zakunja ndizofunika kwambiri: zaka (zambiri zopitilira 40), kunenepa kwambiri, kusayenda bwino, zakudya zopanda thanzi. Kubweretsa shuga mumatipi ndizovuta. Maselo a pancreatic pansi pazinthu zotere amakakamizidwa kuti azisungabe kupanga kwa insulin pamlingo wokhazikika. Ngati sangapambane, glycemia imakulanso. Popita nthawi, kupanga insulin kumayamba kutsika, ndiye kuchuluka kwake kapangidwe kake kumacheperachepera.

Chiwopsezo cha maselo a beta mu mtundu 2 wa matenda ashuga ndi munthu payekha: odwala ena kale ali ndi zaka 10 akukakamizidwa kubaya insulin, pomwe ena amatulutsa insulin yawo moyo wawo wonse. Mu gulu la mtundu wachiwiri wa matenda, vuto lotere limadziwika: matenda a shuga omwe amakhala ndi insulini kapena omwe ali ndi vuto lalikulu la insulini.

Gulu la Russia

Kuyambira 1999, ku Russia, akhala akugwiritsa ntchito matenda padziko lonse lapansi. Zizindikiro kuchokera pagawoli zimasungidwa muzolemba zamankhwala, tchuthi chodwala, chogwiritsidwa ntchito zolemba zamakalata, kupereka lipoti. Tsopano mtundu wachikhumi wa gulu lagwira - ICD-10. Muli mitundu 6 ya matenda ashuga:

  1. E10 imaperekedwa kwa odwala omwe ali ndi shuga omwe amadalira insulin, ndiye kuti, iwo omwe, pazifukwa zaumoyo, ayenera kubaya insulin.Pochita, gululi limaphatikizapo matenda a shuga 1.
  2. E11 ndiye nambala ya matenda osokoneza bongo omwe amadalira insulin, ndiye kuti, mitundu iwiri. Ngakhale wodwalayo atadwala kwa nthawi yayitali, kaphatikizidwe ka insulin ndi kocheperako, ndipo amalandira insulin ndi jakisoni, kachidindo ka matenda sikusinthidwa.
  3. E12 - gawoli liyenera kuperekedwa kwa odwala omwe matenda a shuga amayamba chifukwa cha zakudya zomwe zimatha. Kugwirizana pakati pa vuto la kuperewera kwa zakudya m'thupi ndi matenda a shuga pakadali pano ndikukaika, chifukwa chake manambala awa sagwira ntchito.
  4. E13 - mitundu ina ya matenda ashuga, mitundu ya Mody yachilendo imatumizidwa ku code.
  5. E14 - matenda ashuga, mtundu wa omwe sanatchulidwe. Khodiyi imagwiritsidwa ntchito pamene mtundu wa matenda udakali kukayikira, ndipo chithandizo chiyenera kuyambika nthawi yomweyo.
  6. O24 ndi matenda omwe amapezeka pa nthawi yoyembekezera (matenda a shuga). Ndi gawo limodzi, popeza pambuyo pobadwa shuga amamera.

Mavuto ochepa a metabolic omwe sangatchulidwe chifukwa cha matenda osokoneza bongo ali ndi R73.

Gulu la anthu odwala matenda ashuga lidayamba kugwiritsidwa ntchito mdziko la 1994. Mpaka pano, nthawi yayitali. Matendawa adawulula mitundu yatsopano, njira zambiri zamakono zodziwonera zatulukira. Tsopano WHO ikugwira ntchito yatsopano ya ICD-11, kusintha kwa iyo kukuyembekezeka mu 2022. Mwachiwonekere, kapangidwe kazomwe zimakhazikitsidwa ndi matenda ashuga zidzasinthidwa. Mawu oti "kudalira insulin" ndi "kudziyimira pawokha insulin" nawonso sadzaphatikizidwa.

Gulu la WHO

Kugawidwa kofunikira kwambiri tsopano malinga ndi WHO 2017. Idapangidwa mu 1999, pambuyo pake idasinthidwanso mobwerezabwereza.

MtunduSubtypes
1Autoimmune (kapena immuno-mediated).
Idiopathic.
2Ndi mkulu insulin kukana.
Ndi predominance wa kuphwanya insulin kaphatikizidwe.
Mitundu ina yapadera imatchulidwa chifukwa cha matenda ashuga.Zofooka m'mitundu yomwe imatsogolera kaphatikizidwe ka insulin. Izi zikuphatikiza subtypes a Mody 1-6.
Zovuta za Gene zomwe zimatsogolera ku kusokonezeka kwa insulin: disendocrinism, Rabson-Mendenhall, Seip-Lawrence syndromes, A-Type insulini kukana, ndi zina zambiri.
Matenda a kapamba: kutupa, neoplasms, zoopsa, cystic fibrosis, etc.
Matenda a Endocrine.
Zinthu zamankhwala, makamaka mahomoni.
Kuperewera: cytomegalovirus, rubella wakhanda.
Zovuta zamitundu yomwe nthawi zambiri zimaphatikizidwa ndi matenda ashuga: Down and Turner syndromes, porphyria, etc.
Matenda a shugaGawani ma subtypes sanaperekedwe.

Mu gulu lino, matenda ashuga satengedwa ngati matenda osiyana, koma ngati matenda. Mchere wapamwamba umawerengedwa kuti ndi imodzi mwazowonetsa za matenda aliwonse mthupi, zomwe zimayambitsa kusokonezeka pakupanga kapena kwa insulin. Zifukwa zake zimaphatikizapo njira ya autoimmune, kukana insulini, matenda a kapamba, zolakwika zamtundu.

Asayansi akukhulupirira kuti gulu lamakono lisintha kangapo. Mwachiwonekere, njira yodwala matenda ashuga 2 ikusintha. Chisamaliro chochulukirapo chidzaperekedwa pazomwe zimapangitsa kunenepa kwambiri ndi moyo wawo. Kugawidwa kwa matenda a shuga a mtundu 1 kudzasinthanso. Mwanjira yomweyo momwe majini omwe amayambitsa mitundu ya Mody 1-6 amawerengedwa, zolakwika zonse zamtundu zomwe zimayambitsa mtundu wa 1 matenda zimapezeka. Zotsatira zake, idiopathic subtype ya shuga idzatha.

Gulu lina

Matenda a shuga a Mtundu Wachiwiri amagawidwanso m'magawo malinga ndi kuopsa kwa matendawa:

Kuchuluka kwaKutsika kwamakhalidweKufotokozera
IneZosavutaKuthamanga shuga sikumapitilira 8, masana kusinthasintha kwake kuli kochepa, mkodzo mulibe shuga kapena mulipo wocheperako. Kuchepetsa matenda a glycemia, chakudya ndi chokwanira. Mavuto amapezeka mu mawonekedwe ofatsa mukamayesedwa.
IIGiredi yapakatikatiKusala shuga mndandanda wa 8-14, mutatha kudya glycemia amakula mwamphamvu. Mu mkodzo, shuga amapezeka, ketoacidosis ndiyotheka. Mavuto akukula mwachangu. Kuteteza matenda a shuga, mapiritsi a hypoglycemic kapena insulin muyezo wa magawo 40 amafunikira. patsiku.
IIIZovutaKuthamanga magazi kuposa 14, mkodzo - woposa 40 g / l. Mankhwala amkamwa ndi osakwanira, zopitilira 60 ndizofunikira. insulin patsiku.

Kugawidwa ndi gawo la chiphuphu cha shuga kumagwiritsidwa ntchito kuwunika kupambana kwa chithandizo. Njira yabwino kwambiri yochitira izi ndikugwiritsa ntchito mayeso a glycated hemoglobin (HG), omwe amakupatsani mwayi kuwona kusintha kulikonse kwa shuga kupitirira miyezi itatu.

Kuchulukitsa kwamalipiroMlingo wa GGKufotokozera
kubwezerazosakwana 6.5Wodwalayo akumva bwino, amatha kutsogolera moyo waumoyo.
kulipira6,5-7,5Pakupsinjika kwa shuga, thanzi la munthu limakulirakulira, thupi limatha kutenga matenda, koma palibe ketoacidosis.
kubwezerazopitilira 7.5Kufooka pafupipafupi, chiopsezo chachikulu cha ketoacidosis, kusinthasintha kwadzidzidzi mu shuga, chikomokere cha matenda a shuga ndichotheka.

Pokhapokha ndikotheka kuti matenda ashuga azikhala nawo m'malo ochezera, zimakhala zovuta kuti apange zovuta zina ndi kupitilira kwa zomwe zilipo. Mwachitsanzo, ndi mtundu woyamba wa 1, chiopsezo cha retinopathy chimatsitsidwa ndi 65%, neuropathy ndi 60%. Ubale wolunjika pakati pamalipiro ndi zovuta unapezeka 75% ya odwala matenda ashuga. Pafupifupi 20% ya omwe ali ndi mwayi nthawi zambiri samakumana ndi vuto lililonse la glycemia; madokotala amati izi zimachitika chifukwa cha majini. Mu 5% ya odwala, zovuta zimayambika ngakhale ndi shuga wofupikiratu.

Maiko apakati

Pali ena apakati pakatikati pa carbohydrate metabolism ndi mtundu 2 shuga, womwe nthawi zambiri umatchedwa prediabetes. Matenda a shuga ndi matenda osachiritsika omwe sangachiritsidwe kamodzi. Matenda a shuga ndi omwe amatha kusintha. Ngati muyamba mankhwala panthawiyi, pazochitika zambiri, matenda a shuga amatha kupewedwa. Mayiko apakati a WHO akuphatikizapo:

  1. Kulekerera kwa shuga. NTG imapezeka ngati shuga amalephera pang'onopang'ono ndi wodwala kuposa munthu wathanzi. Kuwunikira koyang'anira pamkhalidwewu ndi kuyesa kwa glucose.
  2. Kuthamanga glycemia. Ndi NGN, shuga m'mawa adzakhala pamwamba pamakhalidwe abwino, koma pansi pamalire omwe amakupatsani mwayi wofufuza matenda ashuga. NTG imatha kuwoneka pogwiritsa ntchito mayeso amtundu wa glucose othamanga.

Zovuta izi sizikhala ndi zisonyezo, matendawa amapangidwa kokha chifukwa cha zotsatira za mayeso a shuga. Kuyesedwa kumayesedwa kwa anthu omwe ali pachiwopsezo chachikulu cha mtundu wachiwiri. Zovuta zomwe zimayambitsa ngozi zimaphatikizapo kunenepa kwambiri, cholowa chosakwanira, kukalamba, matenda oopsa, kuchita masewera olimbitsa thupi, kudya kosasamala komanso kudya zamafuta ambiri komanso mafuta ambiri.

Mikhalidwe yodziwira matenda ashuga

WHO idalimbikitsa njira zodziwira matenda ashuga:

Doctor of Medical Science, Mutu wa Institute of Diabetesology - Tatyana Yakovleva

Ndakhala ndikuphunzira matenda a shuga kwa zaka zambiri. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsiratu matenda ashuga. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 98%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipira mtengo wa mankhwalawo. Ku Russia, odwala matenda ashuga mpaka Meyi 18 (kuphatikiza) nditha kuipeza - Kwa ma ruble 147 okha!

  1. Zizindikiro zodziwika bwino: kukodza pafupipafupi, ludzu, matenda opatsirana pafupipafupi, kuyesa ketoacidosis kamodzi kokha pamayeso a shuga. Malire omwe adavomerezedwa pakadali pano: pamimba yopanda kanthu m'mimba muli shuga 7, mutadya pamwamba 11.1 mmol / l.
  2. Zizindikiro sizikupezeka, koma pali deta kuchokera pamayeso awiri pamwambapa, yotengedwa nthawi zosiyanasiyana.

Chizindikiro kwa munthu wathanzi ndizotsatira za kusanthula kwa 6.1 pamimba yopanda kanthu, mpaka 7.8 mutatha kudya. Ngati zomwe zapezedwa ndizapamwamba, koma m'malire mwa matenda a shuga, wodwalayo amapezeka ndi prediabetes. Ngati shuga adayamba kukula kuchokera pa 2nd trimester ya mimba ndipo ali pakati pa 6.1 mpaka 7 pamimba yopanda kanthu, pamwamba pa 10 atatha kudya, matenda a shuga a gestational amadziwika.

Pakusiyanitsa mitundu 1 ndi 2, njira zowonjezera zimayambitsidwa:

ChikhazikitsoMtundu
12
Insulin ndi c-peptidePansi pa chizolowezi, pamakhala chizolowezi chowonjezereka.Zabwinobwino kapenanso zabwinobwino.
AutoantibodiesPali m'magazi a 80-90% ya odwala.Sapezeka.
Kuchita pakamwa hypoglycemic mankhwalaZosagwira.Amachepetsa shuga bwino, bola ngati palibe ketoacidosis.

Nthawi zina, njirazi sizokwanira, ndipo madotolo amafunika kukhwimitsa ubongo wawo asanapange chidziwitso choyenera ndikupereka mankhwala oyenera. Matenda a shuga amadziwika ndi kuchuluka komwe kumachitika nthawi zambiri. Izi zawonekera kwambiri m'zaka 20 zapitazi. Kuphatikiza apo, gulu la anthu amtundu wa shuga likukulira.

M'mbuyomu, anthu ankakhulupirira kuti achinyamata amatha kukhala ndi mtundu umodzi wokha wa matenda, komanso achikulire atatha 40 - 2 mtundu. Tsopano kapangidwe kazomwe zidachitikazo zasintha kwambiri. Odwala ambiri omwe ali ndi shuga wamkulu wazaka 20 mpaka 40 ali ndi zizindikiro zamtundu 2. Mwachitsanzo, ku United States pazaka 8 zapitazi mu zaka zakubadwa izi adayamba kuzindikira mtundu wachiwiri pa 21% pafupipafupi. Pali milandu yodziwitsa ana izi. Chikhalidwe chofananachi chadziwika mmaiko onse otukuka, ndiye kuti, pali kuphatikizanso kwatsopano kwa matenda ashuga.

Ana ndi unyamata amadziwika ndi chitukuko chachikulu cha matenda ashuga. Akuluakulu, pafupifupi zaka 10 zimadutsa pakati pa kutha kwa NTG ndi kuyambika kwa matenda ashuga, mwa achinyamata pafupifupi 2.5. Komanso, 20% momveka bwino ali ndi mtundu wosakanizika wa matenda ashuga, popeza matenda awo amakula pang'onopang'ono, koma ndizotheka kudziwa autoantibodies yomwe ili mu mtundu 1 m'magazi.

Mtundu woyamba wa shuga "wopanda shuga", m'malo mwake, ndiwachikulire. M'mbuyomu, zidawululidwa mpaka zaka 35-40. Tsopano pali milandu ya matenda mpaka zaka 50. Chizindikiro chodziwika ngati kunenepa kwambiri sichimathandizira kutsimikiza mtima kwa mtunduwo. M'mbuyomu, mwa kukhalapo kwake kapena kusakhalapo, zinali zotheka kudziwa mtundu wa shuga molondola kwambiri. Tsopano onenepa kwambiri mwa anthu ndiwofala kwambiri, chifukwa chake madokotala amangoganizira za kunenepa kwambiri: ngati kulemera kuli koyenera, matenda a shuga a 2 amakayikiridwa.

Zovuta zambiri

Choyambitsa chachikulu ndimavuto a glycation omwe amapezeka mu minofu polumikizana ndi shuga wamagazi ambiri. Mapuloteni amamangidwa molekyulu ya glucose, chifukwa, maselo sangathe kugwira ntchito zawo. Makoma amitsempha yamagazi omwe amalumikizana mwachindunji ndi shuga amatha kugwidwa ndi glycation. Potere, wodwala matenda ashuga amakula angiopathies a magawo osiyanasiyana.

Kusokonezeka m'matumbo akuluakulu omwe ali ndi matenda a shuga kumawopseza ndi matenda amtima. Ma Microangiopathies amatsogolera kuphwanyidwa kwa magazi kwa ziwalo zakutali ndi mtima, nthawi zambiri mapazi a wodwala amavutika. Zimakhudzanso impso, zomwe zimasefa shuga m'magazi miniti iliyonse ndipo zimakonda kuzichotsa mkodzo.

Chifukwa cha glycation wa hemoglobin, kuperekera kwa oksijeni ku minofu kumasokonekera. Woopsa milandu, mpaka 20% ya hemoglobin amasiya kugwira ntchito. Mafuta ochulukirapo mwa mtundu wa sorbitol amawaika m'maselo, chifukwa cha momwe zosmotic zimasinthira mwa iwo, zimakhala. Zowonjezera za sorbitol mu minyewa ya mitsempha, retina ndi mandala ndizowopsa.

Onetsetsani kuti mwaphunzira! Kodi mukuganiza kuti kuyamwa kwa mapiritsi ndi insulini kwa nthawi yonse yokhayo ndi njira yokhayo yosungira shuga m'manja? Sichowona! Mutha kutsimikizira izi nokha ndikuyamba kuzigwiritsa ntchito. werengani zambiri >>

Kusiya Ndemanga Yanu