Matenda a shuga

Maphunziro owonjezera:

1. 2014 - "Therapy" maphunziro opitiliza maphunziro nthawi zonse pamaziko a Kuban State Medical University.
2. 2014 - "Nephrology" maphunziro opitiliza maphunziro nthawi zonse pamaziko a GBOUVPO "Stavropol State Medical University".

Zizindikiro za matenda a shuga ndi kupendekera kwanyengo makamaka kwa matenda omwe apatsidwa, zomwe zimawonetsa kwa madokotala ndi odwala kuyambika kapena kupitirira kwa njira ya pathological.

Matenda a shuga amadziwika kuti ndi amodzi mwa matenda omwe afala kwambiri padziko lonse lapansi; lero amakhudza anthu 347 miliyoni padziko lonse lapansi. Malinga ndi ziwerengero, m'zaka makumi awiri zokha, ziwerengerozi zawonjezeka kuposa nthawi 10. Pafupifupi 90% ya anthuwa ali ndi matenda ashuga a 2.

Ngati matenda atapezeka m'magawo oyamba, zovuta zambiri zitha kupewedwa. Ichi ndichifukwa chake ndikofunikira kwambiri kudziwa zomwe zimayambitsa matendawa, ndikuti pakufunika kuti munthu adzifufuze kuti athe kuyendetsa matenda a endocrinological.

Kuwonetsera kwa shuga sikudalira mtundu wake. Thupi laumunthu limatha kuzindikira pamene mphamvu yokwanira imasiya kuchokera ku glucose yofunikira pankhaniyi, mpaka zotsatira zakuphwanya kagayidwe kake, ndipo imakhala yowonjezereka m'magazi, ndikupangitsa kuvulaza kwakukulu kwa machitidwe ndi ziwalo. Njira zosokoneza za metabolic m'thupi zimaperekedwa chifukwa cha kusowa kwa insulin, yomwe imayang'anira kagayidwe ka glucose. Koma mawonekedwe a pathogenesis a shuga mellitus amitundu yoyambayo ndi yachiwiri ali ndi kusiyana kwakukulu, chifukwa chake, ndikofunikira kudziwa bwino zomwe aliyense wa iwo ali.

Zizindikiro zazikulu

Kuperewera kwa insulin m'magazi kapena kuchepa kwa chidwi cha maselo odalira insulini pakuchita insulin mthupi kumabweretsa kuchuluka kwa shuga m'magazi. Kuphatikiza pa chizindikiro ichi, chomwe chimawerengedwa kuti ndicho chachikulu pachiwopsezo cha shuga, palinso zizindikilo zina zomwe zimapezeka panthawi yomwe achipatala akuwonetsetsa. Ngati pamakhala kukayikira kocheperako kwa kukhalapo kwa matendawa, muyenera kufunsa chithandizo chachipatala, popeza matenda omwe apezeka kale ayenera kuthandizidwa, ndipo mdziko lamakono ngakhale ana azaka za sukulu ayamba kudwala matenda ashuga.

Mawonetsero oyamba

Madokotala amatchula zingapo mwatsatanetsatane monga chiwonetsero choyamba cha matenda ashuga. Mu matenda a shuga, odwala nthawi zonse amakumana ndi polyuria - kukodza mwachangu komanso koperewera chifukwa cha kukokoloka kwa glycemia ndi glucose mumkodzo. Ndi glucosuria ndicho chifukwa chomwe chimalepheretsa kuyamwa kwa madzi ndi mawonekedwe a impso. Polyuria nthawi zonse imayendera limodzi ndi ludzu, momwe munthu amatha kudya mpaka malita 10 amadzi patsiku.

Ngakhale mumamwa madzi ambiri, nthawi zonse kumakhala kumverera kukamwa kowuma. Ndi chiyambi cha matenda osokoneza bongo a mtundu wachiwiri, limodzi ndi ludzu, kumangokhala ndi njala yosatha kumawonekeranso. Izi ndichifukwa choti insulin yomwe imapangidwa ndi zikondamoyo zochuluka imazungulira m'magazi ndipo, ngati singagwiritsidwe ntchito pazolinga zake, imatumiza ziwonetsero ku ubongo zokhudzana ndi kumva njala.

Mkulu glycemia amadzetsa mavuto akulu mthupi. Kuwonongeka kwa ulusi wamitsempha kumayambitsa matenda ashuga a polyneuropathy. Chizindikiro choyambirira cha kupsinjika kotere ndi kudzimbidwa kwa zala ndi manja ndi kupezeka kowawa kwambiri m'miyendo.Mukayamba kuchita zinthu monga glucose m'magazi munthawi yake, chitukuko cha njirayi chitha kuyimitsidwa ndipo vuto la kupweteka, ngati simupumira, silitchulidwa. Komabe, ngati mukuphonya chiyambi cha kupitilira kwa zamatenda, mutha kuyembekezera zovuta zazikulu - kupweteka kwambiri, kusokonezeka kwa malo osungika, zilonda zam'mimba ndi zinthu zina.

Chifukwa cha kuwonongeka kwa glycemia wamatumbo amaso, odwala matenda ashuga amayamba. Mwachidziwikire, kumayambiriro kwa matendawa, izi zimawonekera ndikumverera kwa chifunga ndi kuchuluka kwa shuga m'magazi, ndiye kuchepa kwa kuwona kwa chidwi komanso ngakhale khungu lathunthu pakalibe chithandizo. Kupezeka kwa chilichonse mwazizindikirozi, komanso zovuta, kuyenera kukakamiza wodwalayo kuti apimidwe mwachangu kuti adziwe insulin.

Mawonetsero akunja

Pakati pazizindikiro zakunja, palinso zomwe zimawonetsa kupezeka kwa insulin kukokana komanso glycemia yayikulu. Mwachitsanzo, kupezeka kowopsa pakhungu louma, kuyamwa ndi kupendama chimatha kukhala chizindikiro. Ndikofunikira kwambiri kutchera khutu ku mawonekedwe amtundu wa khungu motsutsana ndi ludzu loyambira. Komanso, ndi matenda ashuga, kuyabwa nthawi zambiri kumachitika pakhungu la kumaliseche, chifukwa cha kukwiya kwa glucose mumkodzo. Palibe zotulutsa zomwe zimawonedwa, zomwe zimadziwika ndi matenda ashuga.

Komanso, chizindikiritso cha kuyambika kwa matenda a shuga 1 ndikuwonda kwambiri. Pankhaniyi, ndikofunikira kuyang'ana kupezeka kwa zizindikiro zina za matenda, kuti tisangofulumira kunena. Kunenepa kwambiri komanso kunenepa kwambiri sichizindikiro cha matenda amtundu wa 2, koma mwina ndi omwe amayambitsa. Mulimonsemo, ngati kulemera kwa munthu kukusintha mwachangu mbali iliyonse popanda chifukwa chomveka, muyenera kumayang'anitsitsa ndikukuyezetsa kuchipatala.

Mtundu woyamba

Matenda a shuga a Type 1 ali msanga kwambiri pakukula kwake. Ali ndi mawonekedwe ake ake, omwe amayenera kuyang'aniridwa.

Wodwala ali ndi mbiri yokula kudya, koma nthawi yomweyo amangochepetsa, watopa, ali ndi vuto la kugona. Kukakamira pafupipafupi kuchimbudzi samakulolani kuti mugone mwamtendere usiku, kukukakamizani kuti mudzuke kangapo. Kuchuluka kwa mkodzo kumawonjezeka kwambiri, monganso kumverera kwa ludzu.

Zizindikiro zotere sizingachitike popanda chidwi, chifukwa zimachitika kwambiri komanso modzidzimutsa. Amathandizirana ndi mseru, kusanza komanso kusokonekera kwambiri. Ndikofunikira kwambiri kutchera khutu ku chilimbikitso chogwiritsa ntchito chimbudzi usiku ana, ngati izi sizinawoneke kale.

Vuto lalikulu la matenda a shuga a mtundu woyamba ndi oti kuchuluka kwa shuga m'magazi kumatha kuwonjezeka kwambiri komanso kutsika kwambiri. Makhalidwe onsewa ndi owopsa ku thanzi ndipo ali ndi mawonekedwe ndi mawonekedwe awo, omwe amayenera kuyang'aniridwa mosamala.

Mtundu wachiwiri

Ambiri omwe ali ndi matenda ashuga a 2. Mawonekedwe ake ali osiyanasiyana, amawonekera pang'onopang'ono, kotero ndikovuta kuzimvetsa ndi kuzizindikira. Zizindikiro zofooka nthawi zambiri sizitengera kuti munthu, akazindikira yekha mwa iye, nthawi yomweyo amayamba kuwomba.

Mtundu wachiwiri wa shuga umadziwika ndi kupezeka pakamwa lowuma, ludzu, kukodza mopitirira muyeso, kunenepa kwambiri, kutopa, kufooka komanso kugona. Chizindikiro cha matenda amtunduwu kumayambiriro kwake ndikuwonekera kwa kugunda kwa zala ndi kutopa kwa malekezero, kuwonekera kwa hypertonic, kupezeka kwa njira zotupa mumkodzo. Momwemonso, ndi mtundu woyamba wa matenda ashuga, wodwalayo amatha kusokonezedwa ndi mseru komanso kusanza, kuuma ndi kuyabwa kwa khungu, matenda amkhungu.

Ndikofunika kukumbukira kuti kukula kwapang'onopang'ono kwa zizindikiro kumabweretsa kukula kwa matendawo omwe. Matenda a shuga kumapeto kwake amadziwika ndi kupezeka kwa hyperosmolar coma, lactic acidosis, ketoacidosis, hypoglycemia, omwe amalimbitsa thupi pakatha maola angapo ndipo amatha kupha munthu wodwala. Komanso, chifukwa cha matenda apamwamba a shuga, odwala nthawi zambiri amakhala ndi vuto lalikulu lakuwona, lomwe pambuyo pake limayambitsa khungu lathunthu, aimpso kapena mtima, komanso ma pathologies a mitsempha ndi mitsempha yamanjenje.

Pa nthawi yoyembekezera

Matenda a shuga amtundu wa m'mimba samawonetsedwa kawirikawiri ndi zizindikiro zina zakunja. Nthawi zambiri, kupezeka kwake kumawululidwa pakulemba mayeso, zomwe zimachitika kawirikawiri ndi amayi apakati. Zizindikiro zazikulu ndizochokera ku kuyesa kwa magazi ndi mkodzo.

Pamaso pa zizindikiro zakunja zamatenda amtundu, onsewa ndi ofanana ndi zizindikiro za matenda amiseche mitundu iwiri yoyamba - nseru, kusanza, kufooka, ludzu matenda ashuga.

Momwe mawonekedwe a gestational of pathology siziwopseza moyo wa mayi kapena mwana, komabe, atha kukhudza nthawi yomwe mayi amakhala woyembekezera, moyo wa mayi woyembekezera komanso wosabereka. Mafuta ochulukirapo m'magazi amatsogolera kubadwa kwa mwana wokhala ndi kulemera kwakukulu (ma kilogalamu 4), omwe mtsogolomo amakhala chinthu chofunikira kwambiri pa kunenepa kwake kapena matenda a shuga pamsana uliwonse. Komanso kuchedwa kwa mwana, hypoglycemia, jaundice m'magawo oyamba amoyo wakhanda kumawonekera pang'ono.

Matenda a shuga

Mu diabetic phazi mu mankhwala amatanthauza zovuta anatomical ndi zinchito kusintha mu zimakhala za distal m'munsi malekezero mwa odwala matenda ashuga. Ili ndiye vuto lalikulu kwambiri la matenda omwe amawerengedwa, ndipo nthawi zambiri amatsogolera ku gangore, kuduladula malekezero ndi kulumala.

Ngati muli ndi mbiri yodwala matenda ashuga, muyenera kuwunika bwino phazi lanu. Pali mitundu itatu yayikulu ya phazi la matenda ashuga: neuropathic (kuwonongeka kwenikweni kwa mitsempha), ischemic (kuwonongeka kwenikweni kwa ziwiya ndi kuchepa kwa magazi), kosakanikirana.

Pakati pa madandaulo a odwala omwe adadutsa phazi la odwala matenda ashuga, akatswiri amapeza malingaliro osasangalatsa, kuwotcha ndi kusenda m'miyendo, goosebumps, kumverera kwatsoka lamakono. Ngati zovuta izi zikusowa poyenda, izi zikuwonetsa kuyambira kwa mawonekedwe a neuropathic mawonekedwe a phazi la matenda ashuga. Ndikofunikanso kulabadira ngati chidwi chamapazi nthawi zina chimasowa. Ngati zotsekemera zimatuluka mwachindunji mukuyenda kapena usiku (mutha kukhazikika pokhapokha pamiyendo ya bedi), izi zikutanthauza kuyambira kwa mawonekedwe a ischemic phazi la matenda ashuga lotchedwa "ischemic phazi".

Mwa zina zomwe zikuwonetsa kuyambika kwa phazi la matenda ashuga, akatswiri amawunikira khungu pakamiyendo kapena mawonekedwe amisamba, kupindika ndi kuwuma kwa khungu m'derali, mawonekedwe amisala yosiyanasiyana pakhungu ndi madzi amadzimadzi, nthawi zambiri chimanga, ming'alu pakati pa zala, kusinthika kwa msomali mbale pamiyendo, kukulira kwa keratinization wa khungu la kumapazi, kuwundana kwapang'onopang'ono kwa mafupa ang'onoang'ono pamiyendo. Ngati munthu azindikira zochepa mwa izi, ayenera kufunafuna thandizo kuchipatala mwachangu.

Zizindikiro za retinopathy

Mpweya wa matenda a shuga umawonetsedwa ndi kusintha kwamitsempha yamagazi m'magazi a retina, zomwe zimayambitsa kuphwanya kwa microcirculation mmenemo. Kuphwanya kotereku kumabweretsa kupezeka kwa matenda ashuga retinopathy.Kupsinjika koteroko kumayamba pang'onopang'ono ndipo ngakhale pambuyo pake kumatha kukhala kosawoneka kwa anthu.

Zizindikiro zazikulu za matenda ashuga retinopathy ndi:

• maonekedwe a "ntchentche" pamaso,
• masomphenya osalala
• kuchepa kowoneka bwino magawo a mtsogolo,
• vitreous hemorrhages ndi retina.

Pankhaniyi, ophthalmology ya matenda ashuga amatha kudziwonetsa m'mitundu iwiri yayikulu - yosagwiritsa ntchito (maziko), kapena kupindika retinopathy kwa retina. Ndi maziko a retinopathy, choyambirira chimakhudzana ndi retina lokha. Ndi kuphwanya kwa capillary ziwiya za retina, zotupa, zotupa edema, kufotokozera wa kagayidwe kachakudya mankhwala kumachitika. Backin retinopathy ndizofala kwa odwala okalamba omwe ali ndi matenda ashuga. Zimapangitsa kutsika pang'onopang'ono kwa kupenyerera kopenyerera.

Kutengera zakumbuyo, proliferative retinopathy imayamba ngati kufooka kwa okosijeni kwa retina kukupitilizabe kukula. Poterepa, mapangidwe amitsempha yatsopano ya magazi amayamba, kutuluka kuchokera ku retina kupita ku thupi lamphamvu. Izi zimabweretsa kutupa m'matupi a thupi lamphamvu komanso kuwonjezeka kowonjezereka kwa kutsika kwa masomphenya mwa anthu ndi khungu losasinthika. Muubwana, kusintha kotereku kwakovuta kuchokera ku mawonekedwe amtundu wina kumatha kuchitika mu miyezi ingapo, kutsatiridwa ndi kuchotsedwa kwina ndi kusawona kwathunthu.

Zizindikiro za Encephalopathy

Matenda a diabetes a encephalopathy amapezeka ngati vuto la matenda ashuga, chifukwa amachititsa kuti ubongo uwonongeke. Kukula kwa encephalopathy kumadalira mtundu wa shuga, ndipo zizindikiro zake zimadalira kutalika kwa matendawa komanso kuuma kwawo. Amanena za zovuta zakumapeto ndipo akuwoneka zaka 10-15 atatha matenda ashuga.

Zomwe zimayambitsa ndikusokonekera kwa kagayidwe kachakudya komwe kumayambitsa matenda ashuga, zomwe zimapangitsa kuwonongeka kwa minyewa ya ubongo ndi mitsempha yamagazi. Njira zomwe zili pamwambapa zimayambitsa kusokonezeka kwa ubongo ntchito, kuchepa kwa ntchito zamaumbidwe. Kukula kwa encephalopathy kumayamba pang'onopang'ono, zomwe zimapangitsa kuti zikhale zovuta kudziwa zizindikiro zake koyambirira.

Zizindikiro zazikulu za matenda ashuga a m'mimba ndi:

• mutu ndi chizungulire,
• kusakhazikika kwamalingaliro, kutopa kwambiri, kuvutika kugona ndi mavuto ena a neurasthenic,
• kusagadzika kwa vuto la munthu,
• kusanja kwa zinthu mukayang'ana pa iwo, kusawona bwino, kusintha kwa "ntchentche" pamaso,
• matenda amisala,
• kusokonezeka kwa chikumbumtima
• kuwonongeka kwa ntchito zamaganizidwe, kukumbukira, kuthekera kwambiri,
• mikwingwirima, kanthawi kochepa kugunda, njira zina za magazi
• kupezeka kwa kulanda.

Pa magawo oyambilira, palibe zovuta za chipatalachi, ndipo ndi chitukuko cha encephalopathy, Zizindikiro zimayamba kuwonekera bwino. Zizindikiro ndizofanana mumitundu yonse iwiri ya matenda ashuga.

Atherossteosis, matenda oopsa, komanso kunenepa kwambiri ndi abwenzi wamba a shuga. Chifukwa cha kuchepa kwa mitsempha ya minyewa kukachitika kwa atherosulinosis, chiopsezo cha kusokonezeka kwa ischemic ndi kugunda kwamtima kumawonjezeka. Ngati kusokonekera kwamphamvu m'mitsempha, kulephera kusintha kwaimpso kumachitika, komwe kumapangitsa kuti kuthetsedweratu kwamphamvu kugwira ntchito. Izi zimabweretsa kufunika kwa kuchilitsanso mankhwala aimpso kulephera ndi moyo wonse wapanga dialysis.

Matenda a shuga

Matenda a shuga amakhalapo amatanthauza kusokonezeka kwakukulu kwa thupi m'thupi la wodwala yemwe akudwala matenda ashuga. Kukomoka kumatha kuchitika onse ndi kuwonjezeka kwamphamvu, komanso kuchepa kwamphamvu kwa shuga m'magazi a munthu. Matendawa amafunika kuthandizidwa kuchipatala mwachangu, popeza pakalibe zovuta zazikulu komanso kufa.

Kukoma kumayamba m'magawo, koma mwachangu. Chizindikiro choyamba chokhala chikomokere chimatha kukhala kukomoka, kuchuluka kwa shuga m'magazi, nseru ndi kusanza, kugona, kupweteka m'mimba kwa tsiku kapena kupitilira kusanachitike mwachindunji. Chizindikiro china cha chikomokere chakudwala chikhoza kukhala kununkhira kwakuthwa kwa asetone kuchokera mkamwa mwa wodwala. Mgwinya, ludzu, komanso kumva kukomoka kumatha kuchitika.

Ndi chifuwa cha hypoglycemic, kuchuluka kwa shuga m'magazi kumachepa kwambiri. Chizindikirochi chimatha kufika pamlingo wa 2.5 mmol pa lita ndi m'munsi. Zina mwazidziwitso za kupuma, nkhawa zopanda pake, mantha a wodwalayo, kumva kufooka, kukokana, kutsika kwa magazi, kulephera kuzindikira. Makonda a hypoglycemic coma akhoza kukhala:

• general malaise
• kusowa kwa chakudya
• kudzimbidwa,
• chizungulire, kupweteka mutu, tachycardia.

Kupanda thandizo mu mkhalidwe uwu kumatha kubweretsa zotsatirapo zoopsa kwambiri. Popeza kuperewera kwa hypoglycemic kumakula mwachangu, thandizo lomwe liperekedwa liyenera kukhala lachangu.

Anthu wamba amatha kudziwa kukomoka kwa matenda ashuga ndi kuchepa kwambiri kwa magazi mwa wodwalayo, kufooka kwa mtima, kuchepa kwamaso. Dokotala wokhazikika yekha ndi amene angaukitse munthu m'moyo uno, chifukwa chake kuyimba foni ya ambulansi kuyenera kutsatiridwa posachedwa.

Zizindikiro zasayansi

Ndikudziwa mosakayikira kuti wodwalayo azindikiridwa pokhapokha ngati mayeso onse a labotale ofunika akufunika. Mayeso aliwonse a labotale a shuga amapangidwa kuti azindikire kuchuluka kwa ma glucose a magazi.

Ndikotheka kudziwa mwangozi shuga m'magazi mukamayesedwa ndi anthu ambiri asanapite kuchipatala kapena kutsimikiza kwa zisonyezo zina.

Chodziwika kwambiri ndi kuyesa kwa shuga m'magazi. Musanagonjere, simungadye chilichonse kwa maola 8-12. Komanso, simungamwe mowa komanso ola limodzi magazi asanaperekedwe simungathe kusuta. Mwanjira imeneyi, mulingo wofika mpaka 5.5 mmol pa lita imodzi uonedwa kuti ndi chizindikiro chodziwika bwino. Ngati chizindikirocho chitakhala chofanana ndi 7 mmol pa lita imodzi, wodwalayo adzatumizidwa kuti akawonjezedwe. Kufikira izi, kuyesa kwa glucose kumachitika. Pazifukwa izi, wodwalayo amapereka magazi pamimba yopanda kanthu, kenako amamwa kapu yamadzi ndi shuga (75 magalamu kwa munthu wamkulu pamililita 200 yamadzi), ndipo patatha maola awiri kuchokera pamenepo amayesanso magazi.

Ngati thupi lili bwino, ndiye kuti kuwunika koyamba kumawonetsa zotsatira zake mpaka 5.5 mmol pa lita, ndipo chachiwiri - mpaka 7.8 mmol pa lita. Ngati zizindikirozo zili m'mitundu yosiyanasiyana ya 5.5-6.7 ndi 7.8-11.1 mmol pa lita imodzi, izi zikuwuza madokotala zakukula kwa prediabetes mwa wodwalayo. Zizindikiro zopitilira ziwerengerozi zikuwonetsa matenda ashuga.

Ndizolowanso kuchita kafukufuku pa glycated hemoglobin, yomwe imawonetsa kufunikira kwapakati pa shuga m'magazi a anthu m'miyezi itatu yapitayi ya moyo. Zomwe zili pansipa 5.7%. Ngati mtengo wake uli m'magulu a 5.7-6.4%, ndiye kuti akuwonetsa kuti akhoza kukhala ndi matenda ashuga amtundu wa 2. Pankhaniyi, muyenera kukambirana ndi dokotala njira zochepetsera ngozizi. Ngati kuchuluka kwa hemoglobin ya glycated kuposa 6,5%, kupezeka kwa matenda a shuga, koma kumafunikira chitsimikiziro. Mlingo wolimbikitsidwa wa hemoglobin wa glycated mwa anthu omwe ali ndi matenda osokoneza bongo ndi ochepera 7%, ngati mulingo uwu ndiwokwera, muyenera kukambirana ndi dokotala. Tiyenera kukumbukira kuti kuchuluka kwa hemoglobin wa glycated pamwambapa 7% kuyesedwa ndi dokotala ngati mulingo woyenera.

Zizindikiro mu mwana

Matenda a shuga amatha kuwonekera pa msinkhu uliwonse, kuphatikiza paubwana. Ngakhale shuga wongobadwa kumene amapezeka. Uwu siwosowa matenda obadwa nawo matendawa. Nthawi zambiri, chiwonetsero mwa ana chimagwera zaka 6-12.Momwe metabolic amathandizira ana nthawi imeneyi imachitika mwachangu, ndipo mkhalidwe wamwazi wosasinthika ungakhudze kuchuluka kwa shuga m'magazi. Mwana akamakula mwana, ndiye kuti zovuta kwambiri za matenda a shuga ndizovuta.

Mwa zina zazikulu zomwe makolo ayenera kusamala kuti asaphonye kukula kwa matenda ashuga, madokotala amasiyanitsa pakati pa ana:

• ludzu ndi kamwa yowuma
• kusanza ndi kusanza
• kukodza pafupipafupi ndi mkodzo womata,
• Kuchepetsa thupi komanso kusilira kwambiri nthawi yomweyo,
• zithunzi zowoneka
• kutopa, kufooka ndi kukwiya.

Ngati mwana ali ndi chimodzi mwazizindikiro zomwe zili pamwambapa, uwu ndi nthawi yolankhula ndi dokotala. Ngati zizindikiro zingapo zapezeka nthawi imodzi, kulumikizana ndi dokotala kuyenera kukhala kwachangu.

Zina mwa zomwe zimachitika mwa ana, zizindikiritso za matenda ashuga zimatha kuchitika. Madokotala amati polyuria ndi zizindikiro zenizeni, zomwe makolo a makanda nthawi zambiri amasokoneza kukhudzana ndi kukodza kwamkodzo, polydipsia, polyphagia, kuyanika ndi kuyabwa Kuzindikira kwakanthawi mozindikira kumathandizira kuzindikira matendawa kumayambiriro ndikuyamba chithandizo chofunikira, chomwe sichingalole kuti pakhale zovuta.

Tanthauziro la matenda ashuga kunyumba

Njira ya shuga imatha kukhala yovuta kwambiri. Mutha kuzidziwa mwadzidzidzi mukapita kukaonana ndi dokotala kapena dokotala wina aliyense. Komabe, pali zizindikiro zambiri zomwe kupezeka kwa matenda kumatha kuwerengewera palokha. Nthawi yomweyo, kunyumba, mutha kudziwa mtundu wa matenda.

Ndi thupi lathanzi, chakudya chikatha, shuga amadzuka. Maola 2-3 zitatha izi, chizindikirocho chimayenera kubwerera kumalire ake oyambirirawo. Ngati izi sizingachitike, ndiye kuti munthu ali ndi zizindikilo zingapo zomwe sizitha kunyalanyazidwa. Izi zawonedwa kale ngati pakamwa pouma, ludzu, kusokonekera pafupipafupi komanso kukokomeza, kuchuluka kwa chidwi, kusamva bwino, kukokana, komanso kusazindikira bwino. Pang'onopang'ono, munthu amayamba kuzindikira khungu louma, lomwe m'mbuyomu silinadziwonetsere.

Komanso kunyumba, mutha kukayikira kuyambika kwa matenda ashuga chifukwa cha zomveka zosiyanasiyana zomwe munthu sanazindikirepo kale. Mtundu wachiwiri wa matenda ashuga, kutha kuchiritsa mabala ndi kukanda, kukula kwa kunenepa. Ndi mtundu woyamba wa matenda, munthu, m'malo mwake, amatha kuchepetsa thupi, ngakhale kuti chidwi chake ndi chokwanira kwambiri. Komanso, ndi mitundu yonse ya matendawa, kuyabwa kwa khungu, kukula kwa tsitsi lakumaso, kupangika kwa xanthomas (kakang'ono kakang'ono kutalika pakhungu), kusowa kwa tsitsi kumphepete ndipo ena amatha kuchitika.

Kuzindikiritsa panthawiyi zizindikiro za matenda ashuga kuyenera kukhala chifukwa chopita kwa dokotala.

Pokhapokha mutayamba chithandizo cha matenda ashuga koyambirira, mutha kuyembekezera kubwezeredwa kwa matendawa komanso moyo wabwino mtsogolo.

Zambiri zatsopano komanso zogwirizana ndiumoyo wathu pa telegalamu yathu. Kulembetsa: https://t.me/foodandhealthru

Zapadera: wazachipatala, wa nephrologist.

Kutalika konse kwa ntchito: Zaka 18 zakubadwa.

Malo antchito: Novorossiysk, malo azachipatala "Nefros".

Maphunziro: 1994-2000 Stavropol State Medical Academy.

Maphunziro owonjezera:

1. 2014 - "Therapy" maphunziro opitiliza maphunziro nthawi zonse pamaziko a Kuban State Medical University.
2. 2014 - "Nephrology" maphunziro opitiliza maphunziro nthawi zonse pamaziko a GBOUVPO "Stavropol State Medical University".

Zambiri

Pakati pa zovuta za metabolic, matenda a shuga amakhala m'malo achiwiri pambuyo kunenepa kwambiri. Pafupifupi 10% ya anthu padziko lapansi ali ndi matenda ashuga, komabe, atapatsidwa mitundu yotsala ya matendawa, chiwerengerochi chikhoza kukhala chokulirapo ka 3-4.Matenda a shuga amayamba chifukwa cha kuperewera kwa insulin ndipo amayamba ndi zovuta zamagulu am'thupi, mapuloteni komanso metabolism yamafuta. Kupanga kwa insulin kumapezeka m'mapamba ndi ma cell a ß-cell a islets a Langerhans.

Kutenga nawo kagayidwe kazakudya zam'mimba, insulin imakulitsa kuchuluka kwa glucose m'maselo, kumalimbikitsa kaphatikizidwe ndi kudzikika kwa glycogen m'chiwindi, ndikuletsa kupasuka kwa mankhwala. Mukamapanga kagayidwe kazakudya zomanga thupi, insulini imathandizira kaphatikizidwe kazinthu acid, mapuloteni ndipo amalepheretsa kusweka kwake. Mphamvu ya insulin pa mafuta kagayidwe ndikupangitsa kuyenda kwa glucose kulowa m'maselo amafuta, njira zamagetsi m'maselo, kaphatikizidwe wamafuta acid ndikuchepetsa kuchepa kwa mafuta. Pogwira nawo insulin, njira yolowera mu sodium cell imalimbikitsidwa. Mavuto a kagayidwe kachakudya kamene amayendetsedwa ndi insulini amatha kukhala osakwanira kaphatikizidwe (mtundu I wa shuga mellitus) kapena kuperewera kwa insulin (mtundu II matenda a shuga).

Zolinga ndi makina a chitukuko

Matenda a shuga a Type I amapezeka kawirikawiri kwa achinyamata ochepera zaka 30. Kuwonongeka kwa kapangidwe ka insulin kumayamba chifukwa chakuwonongeka kwa kapamba wa chibadwa cha autoimmune komanso kuwonongeka kwa maselo opanga insulin. Odwala ambiri, matenda ashuga amakula pambuyo kachilombo (ma mumps, rubella, ma hepatitis) kapena zotsatira zoyipa (nitrosamines, mankhwala ophera tizilombo, mankhwala osokoneza bongo, ndi zina zotere), kuyankha kwamthupi komwe kumayambitsa kufa kwa maselo a pancreatic. Matenda a shuga amayamba ngati maselo opanga insulin oposa 80% akhudzidwa. Pokhala matenda a autoimmune, mtundu wa matenda ashuga a shuga ndimakonda kuphatikizidwa ndi njira zina za chiyambi cha autoimmune: thyrotoxicosis, kuperekera poyizoni poyipa, etc.

Mu mtundu II shuga mellitus, insulin kukana kwa zimakhala, i.e., kusazindikira insulin. Pankhaniyi, zomwe zili mu insulin m'magazi zimatha kukhala zabwinobwino kapena zokwezeka, komabe, maselo sakhala nazo. Odwala ambiri (85%) ali ndi mtundu wachiwiri wa matenda a shuga. Ngati wodwala ndi wonenepa kwambiri, minyewa yomwe imayamba kutulutsa insulin imatsekedwa ndi minofu ya adipose. Matenda a shuga a Type II amathanso kuchitika kwa odwala okalamba omwe ali ndi kuchepa kwa kulolera kwa glucose ndi msinkhu.

Kupezeka kwa mtundu wachiwiri wa matenda a shuga kungachitike limodzi ndi zinthu zotsatirazi:

• chibadwa - chiopsezo chotenga matendawa ndi 3-9% ngati achibale kapena makolo akudwala matenda ashuga,
• kunenepa - wokhala ndi minyewa yambiri ya adipose (makamaka pamimba yam'mimba), pali kuchepa kwa chidwi cha minyewa, kuthandizira kukula kwa matenda a shuga.
• mavuto azakudya - makamaka chakudya chama carbohydrate chokhala ndi kusowa kwa CHIKWANGWANI kumawonjezera vuto la matenda a shuga,
• matenda amtima - atherosulinosis, ochepa matenda oopsa, matenda a mtima, kuchepetsa minofu insulin,
• kupsinjika kwakanthawi - atapanikizika ndi thupi, kuchuluka kwa ma catecholamines (norepinephrine, adrenaline), glucocorticoids omwe amathandizira kuti chiwopsezo cha shuga chiwonjezeke,
• diabetogenic zotsatira za mankhwala ena - glucocorticoid mahomoni opanga, ma diuretics, mankhwala ena a antihypertensive, cytostatics, etc.
• aakulu adrenal cortex osakwanira.

Pakakhala kuchepa kapena kukana insulini, kuchuluka kwa glucose m'maselo kumatsika ndipo zomwe zili m'magazi zimachulukana. Thupi limayendetsa njira zina pokonzera shuga, zomwe zimabweretsa kudzikundikira kwa minyewa ya glycosaminoglycans, sorbitol, glycated hemoglobin.Kuchuluka kwa sorbitol kumabweretsa chitukuko cha matenda amkati, michereopathies (kukomoka kwa capillaries ndi arterioles), neuropathy (kusowa kwa dongosolo lamanjenje), glycosaminoglycans imapangitsa kuwonongeka kwa molumikizana. Kuti mupeze mphamvu zomwe zikusowa mthupi, momwe mapuloteni amawonongeka, amayamba kufooka kwa minofu komanso minyewa yamafupa ndi mtima. Kukula kwamafuta kumayambitsa, kudziunjikira kwa mankhwala oopsa a metabolic (matupi a ketone).

Hyperglycemia m'magazi omwe ali ndi matenda ashuga amayambitsa kukodza kwambiri kuti achotse shuga owonjezera m'thupi. Pamodzi ndi glucose, madzi ambiri amawonongeka kudzera mu impso, zomwe zimayambitsa kusowa kwamadzi (kusowa kwamadzi). Pamodzi ndi kuchepa kwa shuga, mphamvu zamagulu amthupi zimachepa, kotero odwala omwe ali ndi matenda osokoneza bongo amachepetsa thupi. Kuchuluka kwa shuga, kuchepa mphamvu kwa madzi ndi kudzikundikira kwa matupi a ketone chifukwa cha kuwonongeka kwa maselo amafuta kumapangitsa kukhala ndi vuto la matenda ashuga a ketoacidosis. Popita nthawi, chifukwa cha kuchuluka kwa shuga, kuwonongeka kwa mitsempha, mitsempha yaying'ono ya impso, maso, mtima, ndi ubongo zimayamba.

Gulu

Molumikizana ndi matenda ena, endocrinology imasiyanitsa chizindikiro (sekondale) ndi shuga yeniyeni mellitus.

Syellomatic shuga mellitus imagwirizanitsidwa ndi matenda amtundu wa endocrine: kapamba, chithokomiro, adrenal gland, gland pituitary ndipo ndi amodzi mwa mawonetsedwe a matenda oyambira.

Matenda enieni a shuga amatha kukhala amitundu iwiri:

• mtundu I wodwala insulin (ISDI Type I), ngati insulin yanu siyipangidwe m'thupi kapena yopangidwa moperewera,
• mtundu II wosadalira insulini (NIDDM mtundu II), ngati minofu yolumikizira insulin imadziwika ndi kuchuluka kwake komanso kuchuluka kwambiri m'magazi.

Pali magawo atatu a shuga mellitus: wofatsa (I), wolimbitsa thupi (II) komanso wowopsa (III), ndi mayiko atatu pobweza chifukwa cha zovuta za carbohydrate metabolism: kulipidwa, kulipidwa komanso kuwonongeka.

Matenda A shuga A Type I akukula msanga, matenda a shuga a II - m'malo mwake pang'onopang'ono. Nthawi zambiri pamakhala njira yotsika, ya asymptomatic ya matenda a shuga, ndipo kupezeka kwake kumachitika mwamwayi tikamayang'ana fundus kapena kutsimikiza kwa label m'magazi ndi mkodzo. Makamaka, Type I ndi mtundu wachiwiri wa matenda abwinobwino amadziwonetsa mosiyanasiyana, koma zizindikiro zotsatirazi ndizodziwika kwa iwo:

• ludzu ndi pakamwa pouma, limodzi ndi polydipsia (kuchuluka kwamadzi akumwa) mpaka malita 8-10 patsiku,
• polyuria (kukodza kambiri komanso pafupipafupi),
• polyphagy (kuchuluka kudya),
• khungu louma komanso zimagwira mucous, limodzi ndi kuyabwa (kuphatikizapo perineum), matenda amtundu wa pakhungu
• chisokonezo cha kugona, kufooka, kuchepa kwa magwiridwe,
• kukokana mu minofu ya ng'ombe
• kuwonongeka kwamawonekedwe.

Kuwonetsedwa kwa mtundu wa shuga ine ndimadziwika ndi ludzu lalikulu, kukhumudwa pafupipafupi, kufooka, kusanza, kutopa kwambiri, kugona mosalekeza, kunenepa kwambiri (ndimatenda abwinobwino kapena owonjezera), kusakhazikika. Chizindikiro cha matenda a shuga kwa ana ndicho mawonekedwe a bedwetting, makamaka ngati mwana sanakodzere m'mbuyomu. Mtundu wa I wa matenda a shuga, matenda a shuga (hyperglycemic (wokhala ndi shuga wambiri) komanso hypoglycemic (yotsika kwambiri shuga m'magazi) umakhazikika, womwe umafunikira njira zadzidzidzi.

Mu mtundu II matenda a shuga, kuyabwa, ludzu, kusokonezeka m'maso, kugona kwambiri ndi kutopa, matenda amkhungu, kuchiritsa pang'onopang'ono mabala, kupsinjika ndi miyendo. Odwala omwe ali ndi matenda amtundu wa II nthawi zambiri amakhala onenepa.

Njira ya matenda ashuga nthawi zambiri imayendetsedwa ndi kuchepa kwa tsitsi kummalo am'munsi ndikukula kwakukulu pamaso, mawonekedwe a xanthomas (kakulidwe kakang'ono pachikasu pakhungu), balanoposthitis mwa amuna ndi vulvovaginitis mwa akazi. Pamene matenda a shuga akupita, kusokonezeka kwa mitundu yonse ya kagayidwe kumapangitsa kuchepa kwa chitetezo chokwanira komanso kukana matenda. Phunziro lalitali la shuga limapangitsa kuti mafupa awonongeke, owonetsedwa ndi mafupa (kawirikawiri mafupa am'mafupa). Ululu m'munsi kumbuyo, mafupa, mafupa, kudzipatula ndi mafupa a mafupa ndi mafupa, mafupa ndi mapindikidwe amafupa kumayambitsa kulumala.

Mavuto

Njira ya matenda ashuga imatha kukhala yovuta chifukwa cha zovuta zingapo zamagulu:

• matenda ashuga angiopathy - kuchuluka mtima kupezeka, fragility, thrombosis, atherosclerosis, zikubweretsa kukula kwa matenda a mtima, kupatsirana claudication, matenda a shuga
• matenda ashuga polyneuropathy - kuwonongeka kwa zotumphukira mu 75% ya odwala, chifukwa chomwe pali kuphwanya kwamverera, kutupa ndi kuzizira kwa malekezero, kumverera koyaka ndi "kukwawa" kwapadera. Matenda a matenda ashuga amayamba zaka zambiri atayamba matenda a shuga, amapezeka pafupipafupi ndi mtundu wosadalira insulini,
• matenda ashuga retinopathy - kuwonongeka kwa retina, mitsempha, mitsempha ndi ma capillaries amaso, kuchepa kwa mawonekedwe, odzala ndi khungu la maso komanso khungu. Mtundu wa shuga wa I, umadziwonekera mu zaka 10-15, mu mtundu II - m'mbuyomu, wapezeka mu 80-95% ya odwala,
• matenda ashuga nephropathy - kuwonongeka kwa aimpso ziwopsezo aimpso ntchito ndi kukula kwa aimpso kulephera. Amadziwika mu 40-45% ya odwala matenda ashuga pambuyo pa zaka 15 mpaka 20 kuyambira kumayambiriro kwa matendawa,
• matenda ashuga - kuwonongeka kwamitsempha yama m'munsi, kupweteka m'matumbo a ng'ombe, zilonda zam'mimba, kuwonongeka kwa mafupa ndi mafupa a mapazi.

Zovuta, pachimake mu matenda a shuga ndi matenda ashuga (hyperglycemic) ndi kuperewera kwa hypoglycemic.

The hyperglycemic state ndi chikomokere zimayamba chifukwa chakuthwa kwambiri ndikuwonetsa kuchuluka kwa shuga m'magazi. Ma harbinger a hyperglycemia akuwonjezereka kuchepa mphamvu, kufooka, kupweteka mutu, kukhumudwa, kusowa chilakolako cha chakudya. Ndipo pali ululu wam'mimba, kupuma kwamaso kwa Kussmaul, kusanza ndi fungo la acetone kuchokera mkamwa, kusakhudzidwa kwapang'onopang'ono ndi kugona, komanso kuchepa kwa kuthamanga kwa magazi. Vutoli limayambitsidwa ndi ketoacidosis (kudzikundikira kwa matupi a ketone) m'magazi ndipo zimatha kuchititsa kuti musokonezeke - kudwala matenda ashuga komanso kufa kwa wodwala.

Chovuta china chachikulu mu matenda a shuga - kuperewera kwa hypoglycemic kumayamba ndi kutsika kwamphamvu m'magazi a glucose, nthawi zambiri chifukwa cha kuchuluka kwa insulin. Kuwonjezeka kwa hypoglycemia mwadzidzidzi, mwachangu. Pali kumva lakuthwa kwamantha, kufooka, kunjenjemera miyendo, kupuma mosasunthika, matenda oopsa, khungu la wodwalayo limazizira, kunyowa, ndipo nthawi zina kumayamba kukopeka.

Kupewa matenda a shuga ndikotheka kupitiliza kuyang'anitsitsa kuchuluka kwa shuga m'magazi.

Zizindikiro

Kukhalapo kwa shuga mellitus kumatsimikiziridwa ndi kusala kwa shuga m'magazi ochulukirapo kwa 6.5 mmol / L. Nthawi zambiri, glucose mumkodzo sakhalapo, chifukwa umasungidwa m'thupi ndi fungo la aimpso. Ndi kuchuluka kwa shuga m'magazi opitilira 8,8-9,9 mmol / L (160-180 mg%), chotchinga cha impso chimalephera ndikudutsa glucose mkodzo. Kukhalapo kwa shuga mumkodzo kumatsimikiziridwa ndi zingwe zapadera zoyeserera. Glucose wocheperapo pomwe amayamba kupezeka mumkodzo amatchedwa "cholumikizira impso."

Kuyang'ana matenda a shuga omwe akukayikira kumaphatikizapo kudziwa mulingo wa:

• kusala shuga m'magazi a capillary (kuyambira chala),
• glucose ndi matupi a ketone mumkodzo - kupezeka kwawo kumawonetsa matenda a shuga,
• glycated hemoglobin - kuchuluka kwambiri kwa matenda a shuga,
• C-peptide ndi insulin m'magazi - ndi mtundu I shuga mellitus, onsewo amachepetsa kwambiri, ndi mtundu II matenda ashuga - osasinthika,
• kuchititsa kuyesa kwa kupsinjika (kuyesa kwa glucose): kutsimikiza kusala kudya kwa glucose ndi 1 ndi maola 2 mutatha kulowetsedwa kwa 75 g shuga wosungunuka mu makapu 1.5 amadzi owiritsa. Zotsatira zoyesa (zosatsimikizira matenda a shuga mellitus) zimaganiziridwa pama sampuli: pamimba yopanda 6.6 mmol / l poyambira koyamba ndi> 11.1 mmol / l 2 patatha maola atatu kutulutsa shuga.

Kuti mupeze zovuta za matenda a shuga, kuphatikiza kowonjezera kumachitika: ma ultrasound a impso, miyendo yam'munsi yamiyendo, rheoencephalography, ndi ubongo EEG.

Kukwaniritsidwa kwa malingaliro a katswiri wa matenda ashuga, kudziyang'anira nokha komanso kuthandizira odwala matenda ashuga kumachitika moyo wonse ndipo kumachepetsa kwambiri kapena kupewa zovuta zosiyanasiyana za matendawa. Kuchiza matenda amtundu uliwonse wa shuga kumayambitsa kuchepetsa shuga wamagazi, kusintha mitundu yonse ya kagayidwe kachakudya ndi kupewa zovuta.

Maziko othandizira mitundu yonse ya matenda ashuga ndi mankhwala ochizira, poyerekeza za jenda, zaka, thupi, zochitika zolimbitsa thupi. Maphunziro amaperekedwa ku mfundo za kuwerengetsa caloric kudya, poganizira zomwe zili ndi chakudya chamafuta, mafuta, mapuloteni, mavitamini ndi zinthu zina. Pankhani ya matenda a shuga omwe amadalira shuga, kudwala kwamankhwala munthawi yomweyo kumalimbikitsidwa kuti azitha kuwongolera shuga ndi insulin. Ndi matenda a shuga a Type I, kudya zakudya zamafuta zomwe zimathandizira ketoacidosis ndizochepa. Ndi maellitus osagwirizana ndi insulin omwe amadalira shuga, mitundu yonse ya shuga imasiyidwa kunja ndipo zakudya zonse zopatsa mphamvu zimachepa.

Zakudya ziyenera kukhala zopindika (nthawi 4-5 patsiku), ndikugawa chakudya moyenera, zimapangitsa kuti shuga azikhala komanso kukhazikika kwa kagayidwe kake. Malonda apadera a matenda ashuga omwe amachokera ku zotsekemera (aspartame, saccharin, xylitol, sorbitol, fructose, etc.) amalimbikitsidwa. Kuwongolera zovuta za matenda ashuga omwe amangogwiritsa ntchito chakudya chimodzi chokha chimagwiritsidwa ntchito pang'ono matenda.

Kusankha kwa mankhwala osokoneza bongo a shuga kumatsimikiziridwa ndi mtundu wa matenda. Odwala omwe ali ndi mtundu wa matenda a shuga I amasonyezedwa matenda a insulin, mtundu II - zakudya ndi ma hypoglycemic wothandizila (insulin imayikidwa kuti isagwire bwino ntchito piritsi, kukula kwa ketoazidosis ndi boma lodziyimira, chifuwa chachikulu, chifuwa chachikulu cha m'mimba, chiwindi ndi impso.

Kukhazikitsidwa kwa insulin kumachitika pansi pa kayendetsedwe ka dongosolo la kuchuluka kwa shuga m'magazi ndi mkodzo. Kupanga ndi kutalika kwa insulin ndi mitundu itatu yayikulu: yayitali (yowonjezeredwa), yapakatikati komanso yochepa. Insulin yomwe imatenga nthawi yayitali imaperekedwa kamodzi patsiku, mosasamala kanthu za kudya. Nthawi zambiri, jakisoni wotalikilapo wa insulin amaperekedwa limodzi ndi mankhwala apakatikati komanso achidule, kuti amalipire shuga.

Kugwiritsira ntchito insulin ndi kowopsa kwa bongo, komwe kumapangitsa kutsika kwakukulu kwa shuga, kukula kwa hypoglycemia ndi chikomokere. Kusankhidwa kwa mankhwala ndi kuchuluka kwa insulin kumachitika chifukwa cha kusintha kwa zinthu zolimbitsa thupi masana, kusakhazikika kwa shuga m'magazi, kuchuluka kwa caloric, kugawikana kwa chakudya, kulolerana kwa insulini, ndi zina zambiri ndi insulin. ndi ambiri (mpaka anaphylaxis) thupi lawo siligwirizana. Komanso, mankhwala a insulin amatha kuphatikizidwa ndi lipodystrophy - "ziphuphu" mu adipose minofu pamalo a jakisoni a insulin.

Mapiritsi ochepetsa shuga amathandizidwa ndi odwala omwe samadalira shuga m'melitrate kuwonjezera pa zakudya.Magulu otsatirawa amachepetsa shuga amadziwika ndi njira yochepetsera shuga:

• kukonzekera kwa sulfonylurea (glycidone, glibenclamide, chlorpropamide, carbutamide) - - imathandizira kupanga insulini ndi β maselo a kapamba ndikulimbikitsa kulowerera kwa glucose m'misempha. Mlingo wosankhidwa bwino wa gulu la mankhwalawa umathandizira kuti shuga asadutse> 8 mmol / L. Ndi mankhwala osokoneza bongo, kukula kwa hypoglycemia ndi chikomokere ndikotheka.
• biguanides (metformin, buformin, etc.) - kuchepetsa mayamwidwe a shuga m'matumbo ndikuthandizira pakudzaza kwa zotumphukira. Biguanides amatha kuwonjezera kuchuluka kwa uric acid m'magazi ndikupangitsa kuti pakhale vuto lalikulu - lactic acidosis mwa odwala omwe ali ndi zaka zopitilira 60, komanso anthu omwe akudwala chiwindi ndi impso, matenda opatsirana. Biguanides nthawi zambiri amalembera odwala omwe amadwala matenda a shuga osadalira insulin.
• meglitinides (nateglinide, repaglinide) - zimayambitsa kuchepa kwa shuga, zomwe zimapangitsa ziphuphu kuti zitheke insulin. Zotsatira za mankhwalawa zimatengera shuga wamagazi ndipo sizimayambitsa hypoglycemia.
• alpha glucosidase inhibitors (miglitol, acarbose) - amachepetsa kuwonjezeka kwa shuga m'magazi, kutsekereza ma enzyme omwe akukhudzidwa ndi kuyamwa kwa wowuma. Zotsatira zoyipa - flatulence ndi m'mimba.
• thiazolidinediones - kuchepetsa kuchuluka kwa shuga omwe amamasulidwa ku chiwindi, kuonjezera chiwopsezo cha maselo amafuta kupita ku insulin. Otsimikizika mu kulephera kwa mtima.

Mu shuga mellitus, ndikofunikira kuphunzitsa wodwala ndi abale ake luso lotha kuwongolera thanzi ndi momwe wodwalayo alili, njira zoyambirira zothandizira kukulitsa madera oyipa ndi oseketsa. Kupindulira kwamphamvu mu shuga kumachepetsa kwambiri thupi komanso zolimbitsa thupi zolimbitsa thupi. Chifukwa cha kuyesa kwa minofu, pali kuwonjezeka kwa makupidwe a okosijeni ndikuchepa kwa zomwe zili m'magazi. Komabe, masewera olimbitsa thupi sangayambike pamlingo wa glucose> 15 mmol / L, choyamba muyenera kudikirira kuti athe kuchepera mphamvu ya mankhwala. Ndi matenda ashuga, zolimbitsa thupi ziyenera kugawidwa wogawana m'magulu onse a minofu.

Zotsogola ndi kupewa

Odwala omwe adapezeka ndi matenda osokoneza bongo amalembetsa ndi endocrinologist. Mukakonza njira yoyenera, zakudya, chithandizo, wodwalayo amatha kumva kuti ndiwokhutira kwa zaka zambiri. Imasokoneza kuchuluka kwa matenda ashuga komanso kumachepetsa chiyembekezo chokhala ndi moyo wa odwala omwe ali ndi vuto ladzaoneni.

Kupewa kwa matenda ashuga amtundu wa I kumachepetsa kukulitsa kukana kwa thupi kumatenda ndikuchotsa zoopsa zomwe zimayambitsa ma pancreas osiyanasiyana. Njira zodzitetezera za matenda amtundu wa II zimaphatikizanso kupewa kunenepa kwambiri, kukonza zakudya, makamaka anthu omwe ali ndi mbiri yakubadwa. Kupewa kuwonongeka komanso njira yovuta ya matenda a shuga kumakhala ndi njira yake yolondola.

Kodi matenda ashuga ndi chiani?

Matenda a shuga ndi kuphwanya kagayidwe kazakudya zomanga thupi ndi madzi mthupi. Zotsatira zake ndi kuphwanya ntchito za kapamba. Ndiye kapamba yemwe amatulutsa timadzi timene timatchedwa insulin. Insulin imakhudzidwa pokonza shuga. Ndipo popanda icho, thupi silingakwanitse kusintha kwa shuga kukhala shuga. Zotsatira zake, shuga amadziunjikira m'magazi athu ndipo amatulutsidwa m'miyendo yambiri kuchokera mkodzo.

Mofananamo, kusinthana kwamadzi kumasokonezeka. Matani satha kusunga madzi okha, chifukwa chake, madzi ambiri onyentchera amatulutsidwa kudzera mu impso.

Ngati munthu ali ndi shuga m'magazi (glucose) okwera kwambiri kuposa masiku onse, ndiye ichi ndiye chizindikiro chachikulu cha matendawa - matenda ashuga. Mthupi la munthu, maselo a pancreatic (ma cell a beta) ndi omwe amachititsa kuti insulini ipangidwe.Chifukwa chake, insulin ndi timadzi tomwe timayang'anira kuti glucose amaperekedwa m'maselo moyenera. Chimachitika ndi chiani mthupi ndi matenda ashuga? Kuchuluka kwa insulin kokwanira kumapangidwa m'thupi, pomwe shuga ndi shuga zimakwezedwa, koma maselo amayamba kuvutika chifukwa cha kusowa kwa glucose.

Izi kagayidwe kachakudya akhoza kukhala cholowa kapena kutenga. Zilonda zapakhungu ndi zotupa zina zimayamba chifukwa cha kuchepa kwa insulin, mano amavutika, atherosulinosis, angina pectoris, matenda oopsa, impso, mantha am'mimba, vuto la maso.

Etiology ndi pathogenesis

Maziko pathogenetic a shuga mellitus zimatengera mtundu wamatenda. Pali mitundu yake iwiri, yomwe ili yosiyana ndi inzake. Ngakhale ma endocrinologists amakono amati kugawika kwa matenda osokoneza bongo ndizofunikira kwambiri, komabe mtundu wa matendawa ndi ofunikira kudziwa njira zamankhwala. Chifukwa chake, ndikofunikira kukhazikika pa aliyense payekhapayekha.

Mwambiri, shuga mellitus amatanthauza matenda amenewo omwe mumakhala kuphwanya njira za metabolic. Nthawi yomweyo, kagayidwe kazakudya kamene kamakhala ndi matenda kwambiri, komwe kumawonetsedwa ndikuwonjezereka komanso kusasinthasintha kwa glucose wamagazi. Chizindikiro ichi chimatchedwa hyperglycemia. Maziko oyambira kwambiri azovuta ndi kusokonekera kwa mgwirizano wa insulin ndi minofu. Ndi mahormone awa ndi omwe ali mthupi mokha omwe amathandizira kutsika kwa zomwe zili ndi shuga, pakuyendetsa m'maselo onse, monga gawo lalikulu lamphamvu lothandizira machitidwe a moyo. Ngati vuto lakhazikika pakukhudzana ndi insulin ndi minofu, ndiye kuti shuga sangaphatikizidwe mu metabolism yachilendo, yomwe imapangitsa kuti magazi azikhala ambiri. Maubwenzi apakati awa amatchedwa shuga.

Ndikofunikira kumvetsetsa kuti si onse a hyperglycemia omwe ali ndi shuga weniweni, koma okhawo omwe amayamba chifukwa chophwanya insulin!

Chifukwa chiyani pali mitundu iwiri yamatenda?

Kufunika kumeneku ndikofunikira, chifukwa kumatsimikizira chithandizo cha wodwala, chomwe m'magawo oyamba a matendawo chimasiyana mosiyanasiyana. Kutalika kwa matenda ashuga kwambiri, kumawonjezeranso mitundu ina iliyonse. Inde, muzochitika zotere, mankhwalawa amayanjana ndimtundu uliwonse ndi chiyambi cha matendawa.

Mtundu woyamba wa shuga

Mtunduwu umatchedwanso shuga wodalira insulin. Nthawi zambiri, matenda amtunduwu amakhudza achinyamata, osakwana zaka 40, oonda. Matendawa ndi oopsa, insulin ndiyofunika kuthandizira. Cholinga: Thupi limatulutsa ma antibodies omwe amawononga ma cell a pancreatic omwe amapanga insulin.

Ndizosatheka kuchira kwathunthu ku mtundu woyamba wa shuga, ngakhale pali milandu yobwezeretsa ntchito za kapamba, koma izi zimatheka pokhapokha pamtundu wapadera komanso zakudya zachilengedwe. Kuti thupi likhale lolimba, amafunika kubaya insulin kulowa mthupi ndi syringe. Popeza insulini imawonongeka m'mimba, sizotheka kumwa mapiritsi a insulin. Insulin imayendetsedwa pamodzi ndi chakudya. Ndikofunikira kwambiri kutsatira zakudya zosasamalitsa, zopatsa mphamvu zonse m'mimba (shuga, maswiti, zipatso zamasamba, mandimu omwe ali ndi shuga) samachotsedwa muzakudya.

Type 2 shuga

Mtundu uwu wa matenda ashuga sukudalira insulin. Nthawi zambiri, matenda amtundu wa 2 amakhudza anthu okalamba, onenepa pambuyo pa zaka 40. Cholinga: kutayika kwa maselo kupita ku insulin chifukwa cha kuchuluka kwa michere momwemo. Kugwiritsa ntchito mankhwala a insulin sikufunika kwa wodwala aliyense. Katswiri wodziwa ntchito yekha ndi amene angatchule mankhwala komanso mankhwala.

Poyamba, odwala oterewa amapatsidwa zakudya.Ndikofunika kutsatira mokwanira malingaliro a dokotala. Ndikulimbikitsidwa kuti muchepetse kulemera pang'onopang'ono (makilogalamu awiri pamwezi), kuti mukwaniritse kulemera koyenera, komwe kumayenera kukhalabe moyo wonse. Ngati zakudya sizili zokwanira, mapiritsi ochepetsa shuga amagwiritsidwa ntchito, ndipo pokhapokha ngati pali insulin.

Zizindikiro zake za matenda ashuga

Zizindikiro zamatenda zamatenda nthawi zambiri zimadziwika ndi njira yang'onopang'ono. Nthawi zambiri, matenda a shuga amawonekera mu mawonekedwe ochulukirapo komanso kuwuka kwa glycemic index (zomwe zili ndi glucose) mpaka kuchuluka kovuta ndikukhazikitsa mitundu yosiyanasiyana ya matenda ashuga.

Ndi isanayambike matenda odwala:

Pakamwa pokhazikika pouma

Kumva ludzu ndi kulephera kumukhutitsa. Odwala amamwa mpaka malita angapo amadzi amatsitsi tsiku lililonse,

Kuchulukitsa kwamkodzo - kuwonjezeka kwamakina ndi mkodzo wathunthu patsiku,

Kuchepetsa kapena kuchuluka kwambiri kwa thupi ndi mafuta m'thupi,

Kuchulukitsa komwe kumachitika pakhungu pakhungu ndi minofu yofewa,

Kufooka minofu ndi thukuta kwambiri,

Kuchiritsa koyipa kwa mabala aliwonse

Nthawi zambiri, madandaulo amenewa ndi kuyitanidwa koyambirira kwa matendawa. Mawonekedwe awo ayenera kukhala chifukwa chofunikira kwambiri chofufuzira magazi glycemia (zomwe zili ndi shuga).

Matendawa akamakula, zizindikiro za matenda ashuga zitha kuwoneka zomwe zimakhudza pafupifupi ziwalo zonse. Nthawi zovuta, zoopsa zingachitike chifukwa cha nkhawa, kuledzera kwambiri komanso ziwalo zambiri.

Zowonetsa zazikulu za matenda ovuta a shuga zimaphatikizapo:

Mutu ndi matenda am'mitsempha,

Kupweteka kwa mtima, chiwindi cholakulitsidwa, ngati sichinawonekere isanafike shuga,

Ululu komanso kuzizira kwa malekezero ochepa okhala ndi vuto la kuyenda,

Kuchepa kwa khungu, makamaka mapazi,

Maonekedwe a mabala omwe samachiritsa kwa nthawi yayitali,

Fungo la acetone kuchokera kwa wodwala,

Maonekedwe a chizindikiro cha matenda ashuga kapena kukula kwa zovuta zake ndi chizindikiro cha alamu chomwe chikuwonetsa kupita patsogolo kwa matendawa kapena kusakwanira kukonza mankhwala.

Zoyambitsa matenda a shuga

Zoyambitsa zazikulu za matenda ashuga ndi izi:

Khalidweli. Tikufuna zinthu zina zomwe zimakhudza chitukuko cha matenda a shuga.

Kunenepa kwambiri Menya nkhondo molimbika.

Matenda angapo omwe amathandizira kugonjetsedwa kwa maselo a beta omwe ali ndi vuto lopanga insulin. Matendawa amaphatikizapo matenda a kapamba - kapamba, khansa ya kapamba, matenda am'minyewa ya endocrine.

Matenda a ma virus (rubella, chikuku, mliri wa hepatitis ndi matenda ena, izi zimaphatikizira chimfine). Izi matenda ndi poyambira kukula kwa matenda ashuga. Makamaka kwa anthu omwe ali pachiwopsezo.

Kupsinjika kwa mantha. Anthu omwe ali pachiwopsezo ayenera kupewa nkhawa komanso nkhawa.

M'badwo. Ndi zaka, pazaka khumi zilizonse, chiopsezo chokhala ndi matenda a shuga chikuwonjezereka.

Mndandandandawo suwaphatikizira matenda omwe matenda a shuga kapena hyperglycemia amakhalanso achilengedwe, kungokhala chizindikiro chawo. Kuphatikiza apo, hyperglycemia yotere siyingaganizidwe kuti ndi shuga weniweni mpaka chitukuko cha matenda kapena matenda ashuga atakula. Matenda omwe amayambitsa hyperglycemia (shuga wowonjezereka) amaphatikizapo zotupa ndi adrenal hyperfunction, pancreatitis yachilendo, komanso kuwonjezeka kwa mahomoni olimbana ndi mahomoni.

Mwazi wamagazi mu shuga

Njira yoyamba komanso yodziwika bwino yodziwira matenda ashuga komanso kuyesa kwake kwamphamvu pa chithandizo ndi kuphunzira kuchuluka kwa shuga (shuga).Ichi ndi chizindikiro chodziwikiratu chomwe matenda ndi chithandizo chotsatira chikuyenera kukhalira.

Akatswiriwa adabwereza kangapo kangapo kawonekanso kawirikawiri. Koma lero, zikhazikitso zawo zowoneka bwino, zomwe zimawunikira zowonadi zamakhalidwe a carbohydrate metabolism m'thupi. Amayenera kuwongoleredwa osati ndi endocrinologists okha, komanso akatswiri ena komanso odwala omwe, makamaka odwala matenda ashuga omwe ali ndi mbiri yayitali ya matendawa.

Carbohydrate kagayidwe

Chizindikiro cha glucose

Mwazi wamagazi

Maola 2 mutatha chakudya

Maola 2 mutatha chakudya

Monga momwe tikuwonera patebulopo, kutsimikizira kwa matenda ashuga ndikosavuta kwambiri ndipo kumatha kuchitika m'makoma a chipatala chanthawi iliyonse kapena ngakhale kunyumba kwanu kuli ndi glucometer yamagetsi (chida chotsimikizira kuchuluka kwa shuga m'magazi). Momwemonso, njira zapangidwa kuti ziwone kukwanira kwa matenda a shuga a shuga kudzera njira imodzi. Yaikulu kwambiri ndi mulingo womwewo wa shuga (glycemia).

Malinga ndi miyezo yapadziko lonse lapansi, chizindikiritso chabwino cha mankhwalawa matenda a shuga ndi shuga wamagazi ochepera 7.0 mmol / L. Tsoka ilo, pochita izi sizingatheke nthawi zonse, ngakhale kuyesayesa kwenikweni ndi kufunitsitsa kwamphamvu kwa madokotala ndi odwala.

Kukula kwa matenda ashuga

Gawo lofunika kwambiri m'gulu la anthu odwala matenda ashuga ndi kulekanitsa kwawo pang'ono. Maziko a kusiyanaku ndi mulingo wa glycemia. Chinthu china chomwe chili ndi kupezeka koyenera kopezeka ndi matenda ashuga ndikuwonetsa njira yolipirira. Chizindikirochi chimatengera kupezeka kwa zovuta.

Koma posavuta kumvetsetsa zomwe zimachitika kwa wodwala yemwe ali ndi matenda a shuga, kuyang'ana zomwe zalembedwazi, mutha kuphatikiza zovuta ndi gawo la njirayi. Kupatula apo, mwachilengedwe kuti kuchuluka kwa shuga m'magazi, kumakhala kovuta kwambiri kuti matenda ashuga azitha komanso kuchuluka kwa zovuta.

Matenda a shuga mellitus 1 digiri

Ili ndi njira yabwino kwambiri yamatenda omwe chithandizo chilichonse chiyenera kuyesedwa. Pamlingo wotere, umalipiriridwa mokwanira, kuchuluka kwa glucose sikudutsa 6-7 mmol / l, palibe glucosuria (excretion ya glucose mu mkodzo), ndipo glycosylated hemoglobin ndi proteinuria sizipitilira muyeso wamba.

Palibe zizindikiro za zovuta za matenda ashuga mu chithunzi cha matenda: angiopathy, retinopathy, polyneuropathy, nephropathy, cardiomyopathy. Nthawi yomweyo, ndizotheka kukwaniritsa izi mothandizidwa ndi zakudya komanso kumwa mankhwala.

Matenda a shuga 2ell

Gawo ili la ntchitoyi likuwonetsa kubwezera pang'ono. Pali zizindikiro za zovuta za matenda ashuga komanso zotupa za ziwalo zodziwika bwino: maso, impso, mtima, mitsempha yamagazi, mitsempha, malekezero otsika.

Mkulu wa glucose amawonjezeka pang'ono ndipo amafika ku 8-10 mmol / L. Glucosuria sichikudziwika. Makhalidwe a hemoglobin a glycosylated ali mkati mwa malire wamba kapena ochulukirapo. Zovuta zolimbitsa thupi pakadalibe.

Matenda a shuga 3ell

Njira imodzimodziyo ya ndondomekoyi ikuwonetsa kupitilirabe kwake komanso kusatheka kwa kayendetsedwe ka mankhwala. Nthawi yomweyo, kuchuluka kwa glucose kumasiyanasiyana 13-14 mmol / l, glucosuria wolimbikira (kutulutsa kwa shuga mumkodzo), proteinuria yayikulu (kukhalapo kwa mapuloteni mumkodzo) imayang'aniridwa, ndipo pali mawonetsedwe omveka bwino komanso osafunikira akuwonongeka kwa ziwalo za shuga.

Kuwona acuity pang'onopang'ono kumachepa, kuthamanga kwamphamvu kwamankhwala kumapitirira (kuthamanga kwa magazi), kumva kumatsika kumawoneka ndikuwonetsa kupweteka kwambiri komanso kutsekeka kwa malekezero ochepa. Mlingo wa hemoglobin wa glycosylated umasungidwa kwambiri.

Matenda a shuga mellitus 4 madigiri

Digiri iyi imadziwika ndi kubwezerera kwathunthu kwa njirayi ndikukula kwa zovuta zovuta. Nthawi yomweyo, mulingo wa glycemia umakwera mpaka ziwerengero zovuta (15-25 kapena kuposa mmol / l), ndizovuta kukonza mwanjira iliyonse.

Pang'onopang'ono mapuloteni otayika. Kukula kwa aimpso kulephera, zilonda zam'mimba ndi zilonda zam'mphepete ndizochita. Chimodzi mwazomwe zimapangitsa odwala matenda ashuga a giredi 4 kukhala ndi vuto losautsa:

Njira yayikulu yothandizira

Pofuna kuthana ndi matenda a shuga a mtundu wachiwiri, muyenera kutsatira izi:

Pitani pa chakudya chamafuta ochepa.

Pewani kumwa mapiritsi owononga a shuga.

Yambani kumwa mankhwala otsika mtengo komanso osavulaza pofuna kuchiza matenda a shuga ozikidwa pa metformin.

Yambani kusewera masewera, kuwonjezera masewera olimbitsa thupi.

Nthawi zina inulin ing'onozing'ono Mlingo angafunike kuti matenda a shuga.

Malangizo osavuta awa angakuthandizeni kuthana ndi shuga komanso kusiya kumwa mankhwala omwe amayambitsa mavuto ambiri. Muyenera kudya bwino, osati nthawi ndi nthawi, koma tsiku lililonse. Kusintha kwa moyo wathanzi ndi gawo lofunikira kwambiri kuti muchotse matenda ashuga. Njira yodalirika komanso yosavuta yochizira matenda ashuga panthawi yomwe idapangidwe idapangidwa.

Mankhwala a shuga

Ndi mtundu 2 wa shuga, mankhwala ochepetsa shuga amagwiritsidwa ntchito:

Mankhwala osokoneza bongo kuti apangitse kapamba, zomwe zimapangitsa kuti apange insulin yambiri. Izi ndi zotengera za sulfonylurea (Gliclazide, Glycidon, Glipizide), komanso meglitinides (Repaglitinid, Nateglitinide).

Mankhwala omwe amachititsa chidwi cha maselo kuti apange insulin. Awa ndi Biguanides (Siofor, Glucofage, Metformin). Biguanides sikuti amaperekedwa kwa anthu omwe ali ndi vuto la mtima ndi impso kwambiri chifukwa chosakwanira kwa ziwalozi. Komanso, mankhwala omwe amachititsa chidwi cha maselo kupita ku insulin ndi Pioglitazone ndi Avandia. Mankhwalawa ali m'gulu la thiazolidinediones.

Mankhwala osokoneza bongo omwe amagwira ntchito ya insretin: DPP-4 inhibitors (Vildagliptin ndi Sitagliptin) ndi HGP-1 receptor agonists (Liraglutid ndi Exenatide).

Mankhwala osokoneza bongo omwe amalepheretsa glucose kulowa mgonero. Awa ndi mankhwala otchedwa Acarbose kuchokera pagulu la alpha-glucosidase inhibitors.

Maganizo 6 olakwika okhudzana ndi matenda a shuga

Pali zikhulupiriro zodziwika bwino zokhudzana ndi matenda a shuga zomwe zimafunikira kuthetsedwa.

Matenda a shuga amakula mwa anthu omwe amadya maswiti ambiri. Izi sizowona konse. M'malo mwake, kudya maswiti kumatha kuyambitsa kulemera, zomwe zimawopseza kukula kwa matenda ashuga a 2. Komabe, munthu ayenera kukhala ndi tsogolo la matenda ashuga. Ndiye kuti, pamafunika mfundo ziwiri zazikulu: cholowa chambiri komanso cholemetsa.

Kumayambiriro kwa chitukuko cha shuga, insulini ikupitilizidwa kupangidwa, koma mafuta osungira samalola kuti azilowetsedwa bwino ndi maselo amthupi. Ngati izi zawonedwa kwa zaka zambiri, ndiye kuti kapamba amataya mphamvu yake yopanga insulin yokwanira.

Kugwiritsa ntchito maswiti sikukhudza kukula kwa matenda ashuga amtundu 1. Pankhaniyi, maselo a pancreatic amangofa chifukwa cha kuwukira kwa antibody. Komanso, matupi awo amawabala. Njirayi imatchedwa autoimmune reaction. Mpaka pano, sayansi sinapeze zifukwa zadongosolo lamaubongo. Amadziwika kuti matenda a shuga a mtundu woyamba sagwidwa mwakamodzikamodzi, pafupifupi 3-7% ya milandu.

Ndikadwala matenda ashuga, ndimazindikira izi nthawi yomweyo. Mutha kudziwa kuti munthu amadwala matenda a shuga nthawi yomweyo, ngati ali ndi matenda a mtundu woyamba. Izi zodziwika bwino zimadziwika ndi kuwonjezeka kwazizindikiro, zomwe sizingatheke kuzindikira.

Komanso, matenda amtundu wa 2 amakula kwa nthawi yayitali ndipo nthawi zambiri amakhala asymptomatic. Uwu ndiye chiopsezo chachikulu cha matendawa. Anthu amaphunzira za izi pang'onopang'ono pamavuto, pamene impso, mtima, ndi maselo amitsempha anavulala.

Ngakhale chithandizo chokhazikitsidwa pa nthawi yake chitha kuimitsa matendawa.

Matenda a shuga a Type 1 amakula nthawi zonse mwa ana, ndipo lembani matenda ashuga achikulire awiri. Mosasamala mtundu wa matenda ashuga, amatha kumera pazaka zilizonse. Ngakhale nthawi zambiri ana ndi achinyamata amadwala matenda amtundu woyamba. Komabe, ichi sichiri chifukwa chokhulupirira kuti matendawa sangayambe pakukalamba.

Chifukwa chachikulu chomwe chimatsogolera kukula kwa matenda ashuga a mtundu wa 2 ndi kunenepa kwambiri, koma amatha kukula pazaka zilizonse. M'zaka zaposachedwa, nkhani ya kunenepa kwambiri kwa mwana mdziko lapansi ndi yovuta kwambiri.

Komabe, matenda a shuga a 2 amapezeka kwambiri mwa anthu opitilira zaka 45. Ngakhale akatswiri akuyamba kuwomba alamu, kuwonetsa kuti matendawo ayamba kuchepa.

Ndi matenda ashuga, simungathe kudya maswiti, muyenera kudya zakudya zapadera za odwala matenda ashuga. Inde, muyenera kusintha menyu, koma simuyenera kusiya zakudya wamba. Zakudya za anthu odwala matenda ashuga zimatha kusintha maswiti wamba ndi zakudya zina zomwe amakonda, koma kuzidya, muyenera kukumbukira kuti zimapangitsa mafuta. Chifukwa chake, chiopsezo chakuchuluka kwambiri chimakhalapo. Komanso, zogulitsa odwala matenda ashuga ndizodula kwambiri. Chifukwa chake, yankho losavuta ndikusintha kukhala chakudya chamagulu. Zosinthazo ziyenera kulemezedwa ndi mapuloteni, zipatso, chakudya, mavitamini ndi masamba.

Kafukufuku waposachedwa akuwonetsa kuti njira yolumikizana ndi chithandizo cha matenda ashuga imalola kupita patsogolo kwakukulu. Chifukwa chake, simuyenera kungotenga mankhwala, komanso kutsogolera moyo wathanzi, komanso kudya moyenera. Insulin imayenera kuvulazidwa pokhapokha ngati zachitika, zimayambitsa kudalira.

Ngati munthu wodwala matenda a shuga a mtundu woyamba akukana kusiya jakisoni wa insulin, izi zimamupangitsa kuti afe. Ngati wodwala akudwala matenda amtundu wa 2, ndiye kuti kumayambiriro kwa matendawa, kapamba amatulutsa insulini. Chifukwa chake, odwala amapatsidwa mankhwala osokoneza bongo monga mapiritsi, komanso jakisoni wa mankhwala omwe amawotcha shuga. Izi zimalola kuti insulin yanu ikhale yabwino kwambiri.

Matendawa akamakula, insulin yocheperako imapangidwa. Zotsatira zake, idzafika nthawi yomwe kusiya majekeseni ake sikungapambane.

Anthu ambiri sazindikira jakisoni wa insulin, ndipo mantha amenewa sakhala achilungamo nthawi zonse. Tiyenera kumvetsetsa kuti pamene mapiritsi sangathe kupanga zomwe mukufuna, ndiye kuti chiwopsezo chokhala ndi zovuta za matendawa chimawonjezeka. Pankhaniyi, jakisoni wa insulin ndi muyeso wovomerezeka.

Ndikofunika kuwongolera kuthamanga kwa magazi ndi cholesterol, komanso kumwa mankhwala kuti muthandizire kudziwa zambiri.

Insulin imabweretsa kunenepa kwambiri. Nthawi zambiri mutha kuwona zomwe munthu yemwe akupanga mankhwala a insulin ayamba kunenepa. Mwazi wamagazi ukakhala wokwera, kulemera kumayamba kutsika, chifukwa ndi mkodzo wowonjezera umatuluka, zomwe zikutanthauza kuti zopatsa mphamvu zochulukirapo. Wodwala akayamba kulandira insulin, ma calorie omwe amakhala ndi mkodzo amasiya kuchotsedwako. Ngati kusintha kwa moyo ndi zakudya sizichitika, ndiye kuti ndizomveka kuti kulemera kumayamba kukula. Komabe, izi siziri chifukwa cha insulin.

Kuchepa kwa glucose

Mafotokozedwe oyamba a mkhalidwe wa pathological awa adawonetsa makamaka zozizwitsa zake kwambiri - kutayika kwa madzimadzi (polyuria) ndi ludzu losagonjetseka (polydipsia).Mawu akuti "matenda a shuga" (lat. Diabetes mellitus) adagwiritsidwa ntchito koyamba ndi sing'anga wachi Greek Demetrios wa Apamania (m'ma 2000 BC. E.), amachokera ku Greek wina. δδββίίω, zomwe zikutanthauza "kudutsa."

Zomwe zinali choncho panthawiyo zinali lingaliro la matenda ashuga - mkhalidwe womwe munthu umangotaya madzimadzi ndi kuumiriranso, "ngati siphon", womwe umatanthauzira chimodzi mwazizindikiro zazikulu za matenda ashuga - polyuria (kutulutsa mkodzo kwambiri). M'masiku amenewo, matenda a shuga amawoneka ngati mkhalidwe womwe thupi limatha kutaya madzi.

Glucose incinuence edit |

Chifukwa chiyani matenda ashuga amayamba, ndipo ndi chiyani?

Matenda a shuga ndi matenda osokoneza bongo omwe amachitika chifukwa cha kupangika kwa insulin (matenda a 1) kapena chifukwa chophwanya zotsatira za insulin iyi (mtundu 2). Insulin imapangidwa mu kapamba, chifukwa chake odwala omwe ali ndi matenda osokoneza bongo nthawi zambiri amakhala m'gulu la omwe ali ndi zovuta zosiyanasiyana pakugwira ntchito kwa thupilo.

Odwala omwe ali ndi matenda amtundu woyamba amatchedwa "odalira insulin" - amafunika jakisoni wambiri wa insulin, ndipo nthawi zambiri matendawa amakhala obadwa nawo. Nthawi zambiri, matenda amtundu 1 amawonekera kale muubwana kapena unyamata, ndipo matenda amtunduwu amapezeka mu milandu ya 10-15%.

Matenda a 2 a shuga amakula pang'onopang'ono ndipo amadziwika kuti ndi "matenda okalamba a shuga." Mtunduwu pafupifupi suwapezeka konse mwa ana, ndipo nthawi zambiri amakhala ndi anthu opitirira 40 omwe onenepa kwambiri. Matenda a shuga amtunduwu amapezeka mu 80-90% ya milandu, ndipo amatengera pafupifupi 90-95% ya milandu.

Zomwe zimachitika

Matenda a shuga ndi amodzi mwa zovuta kwambiri za endocrine zomwe zikuchulukirachulukira (makamaka m'maiko otukuka). Izi ndi zotsatira zamakhalidwe amakono komanso kuchuluka kwa zinthu zakunja, komwe kunenepa kwambiri.

Zomwe zimayambitsa matenda a shuga zimaphatikizapo:

1. Kudya kwambiri (kunenepa kwambiri) komwe kumayambitsa kunenepa kwambiri ndi chimodzi mwazinthu zazikulu pakupanga matenda a shuga a 2. Ngati mwa anthu omwe ali ndi thupi lozolowereka kuchuluka kwa shuga ndi 7.8%, ndiye kuti kuchulukitsa thupi ndi 20%, kuchuluka kwa matenda ashuga ndi 25%, ndipo kuchulukirapo kwa thupi ndi 50%, pafupipafupi ndi 60%.
2. Matenda a Autoimmune (kuwukira kwa chitetezo chathupi mthupi lanu) - glomerulonephritis, autoimmune chithokomiro, hepatitis, lupus, ndi zina zotere.
3. Choyipa. Monga lamulo, shuga imakhala kangapo mwa abale a odwala matenda a shuga. Ngati makolo onse akudwala matenda a shuga, chiopsezo chotenga matenda a shuga kwa ana awo ndi 100% m'miyoyo yawo yonse, ngati m'modzi mwa makolo adwala - 50%, ngati wodwala ali ndi m'bale kapena mlongo - 25%.
4. Matenda a ma virus omwe amawononga ma cell a pancreatic omwe amapanga insulin. Mwa zina mwa ma virus omwe angayambitse kukula kwa matenda ashuga ndi awa: rubella, mumps (mumps), pox nkhuku, hepatitis ya viral, ndi zina zambiri.

Munthu yemwe ali ndi vuto lotenga matenda ashuga sangakhale wodwala m'moyo wake wonse ngati atha kudziwongolera ndikukhala ndi moyo wathanzi: zakudya zoyenera, zolimbitsa thupi, kuyang'aniridwa ndi achipatala, ndi zina zambiri. Nthawi zambiri, mtundu 1 wa shuga umapezeka mwa ana ndi achinyamata.

Chifukwa cha kafukufuku, madotolo adazindikira kuti zomwe zimapangitsa kuti makolo azikhala ndi matenda osokoneza bongo azikhala 5% zimadalira mayi, 10% kwa abambo, ndipo ngati makolo onse ali ndi matenda ashuga, mwayi wofalitsa chiyembekezo chakukula kwa shuga ukuwonjezeka pafupifupi 70% .

Zizindikiro za matenda ashuga mwa akazi ndi abambo

Pali zisonyezo zingapo za matenda ashuga omwe onse amtundu 1 ndi matenda 2 amatchulidwa. Izi zikuphatikiza:

1. Kumva ludzu losatha komanso kukodza mwachangu, komwe kumabweretsa madzi,
2. Chimodzi mwazizindikiro ndi pakamwa pouma,
3. Kutopa,
4. Kukugwa, kugona.
5. Zofooka
6. Mabala ndi mabala amachiritsa pang'onopang'ono,
7. Kusanza, mwina kusanza,
8. Kupuma pafupipafupi (mwina ndi fungo la acetone)
9. Zosangalatsa pamtima
10. Kuluma kwamtundu ndi kuyabwa kwa khungu,
11. Kuchepetsa thupi
12. Kuchulukitsa pokodza
13. Zowonongeka.

Ngati muli ndi zizindikiro zomwe zili pamwambazi za matenda ashuga, mosakayikira muyenera kuyeza shuga lanu lamagazi.

Kusintha

Gawo lofunika kwambiri m'gulu la anthu odwala matenda ashuga ndi kulekanitsa kwawo pang'ono.

1. Ili ndi njira yabwino kwambiri yamatenda omwe chithandizo chilichonse chiyenera kuyesedwa. Pamlingo wotere, umalipiriridwa mokwanira, kuchuluka kwa glucose sikudutsa 6-7 mmol / l, palibe glucosuria (excretion ya glucose mu mkodzo), ndipo glycosylated hemoglobin ndi proteinuria sizipitilira muyeso wamba.
2. Gawo ili la ntchitoyi likuwonetsa kubwezera pang'ono. Pali zizindikiro za zovuta za matenda ashuga komanso zotupa za ziwalo zodziwika bwino: maso, impso, mtima, mitsempha yamagazi, mitsempha, malekezero otsika. Mkulu wa glucose amawonjezeka pang'ono ndipo amafika ku 8-10 mmol / L.
3. Njira imodzimodziyo ya ndondomekoyi ikuwonetsa kupitilirabe kwake komanso kusatheka kwa kayendetsedwe ka mankhwala. Nthawi yomweyo, kuchuluka kwa glucose kumasiyanasiyana 13-14 mmol / l, glucosuria wolimbikira (kutulutsa kwa shuga mumkodzo), proteinuria yayikulu (kukhalapo kwa mapuloteni mumkodzo) imayang'aniridwa, ndipo pali mawonetsedwe omveka bwino komanso osafunikira akuwonongeka kwa ziwalo za shuga. Kuwona acuity pang'onopang'ono kumachepa, mphamvu yamitsempha yamagazi imapitilira, kumva kumachepetsa ndikuwoneka ngati kupweteka kwambiri komanso dzanzi lakuthwa m'munsi.
4. Digiri iyi imadziwika ndi kubwezerera kwathunthu kwa njirayi ndikukula kwa zovuta zovuta. Nthawi yomweyo, mulingo wa glycemia umakwera mpaka ziwerengero zovuta (15-25 kapena kuposa mmol / l), ndizovuta kukonza mwanjira iliyonse. Kukula kwa aimpso kulephera, zilonda zam'mimba ndi zilonda zam'mphepete ndizochita. Chimodzi mwazomwe zimapangitsa odwala matenda ashuga a giredi 4 kuti azikhala ndi matenda ashuga pafupipafupi.

Mayiko atatu omwe amalipira ndalama za matenda a carbohydrate metabolism nawonso amasiyanitsidwa: kulipidwa, kulipidwa, komanso kuwalipitsidwa.

Zotsatira ndi zovuta za matenda ashuga

Mavuto owopsa ndi zochitika zomwe zimayamba pakapita masiku kapena ngakhale maola ochepa kukhalapo kwa matenda ashuga.

1. Matenda a shuga a ketoacidosis ndi vuto lalikulu lomwe limayamba chifukwa chodzikundikira magazi a zinthu zamagulu a metabolism apakatikati (matupi a ketone).
2. Hypoglycemia - kuchepa kwa shuga m'magazi m'munsi mwazofunikira (nthawi zambiri pamakhala 3.3 mmol / L), kumachitika chifukwa cha kuchuluka kwa mankhwala omwe amachepetsa shuga, matenda opatsirana, kuchita masewera olimbitsa thupi osazolowereka kapenanso kudya mokwanira, komanso kumwa kwambiri mowa.
3. Hyperosmolar chikomokere. Imapezeka makamaka mwa odwala okalamba omwe ali ndi matenda amtundu wa 2 omwe ali ndi mbiri kapena alibe mbiri yake ndipo nthawi zonse amakhudzana ndi kuchepa thupi kwambiri.
4. Lactacidic coma kwa odwala omwe ali ndi matenda osokoneza bongo amayamba chifukwa cha kudzikundikira kwa lactic acid m'magazi ndipo nthawi zambiri amapezeka mwa odwala omwe ali ndi zaka zoposa 50 motsutsana ndi maziko a mtima, chiwindi ndi kulephera kwa aimpso, kuchepa kwa kupezeka kwa oksijeni mu minofu ndipo, chifukwa chake, kudzikundikira kwa lactic acid mu minofu.

Zotsatira zomaliza zimakhala gulu lamavuto, kukula komwe kumatenga miyezi yambiri, komanso nthawi zambiri zaka za matendawo.

1. Matenda a shuga a retinopathy - kuwonongeka kwa retina mu mawonekedwe a ma micaneurysms, kutsina ndi ma hemorrhages, ma exudates olimba, edema, mapangidwe a ziwiya zatsopano. Zimatha ndi zotupa pa fundus, zimatha kuyambitsa kuyamwa kwina.
2. Matenda a shuga a micro- ndi macroangiopathy ndikuphwanya kwachulukidwe kwamitsempha, kuwonjezereka kwa kusokonekera kwawo, chizolowezi cha thrombosis ndi chitukuko cha atherosulinosis (zimachitika koyambirira, makamaka ziwiya zazing'ono zimakhudzidwa).
3. Diabetesic polyneuropathy - nthawi zambiri mu mawonekedwe a kuphatikizana kwamitsempha yama neropathy ya mtundu wa magolovesi ndi masheya, kuyambira kumapeto kwa miyendo.
4. Matenda a shuga - nephropathy - kuwonongeka kwa impso, koyamba mwa mawonekedwe a microalbuminuria (kuchotsedwa kwa mapuloteni a albumin mkodzo), ndiye proteinuria. Zimabweretsa kukula kwa matenda aimpso.
5. Matenda a shuga - matenda opatsirana, "kupindika", kusunthika pang'ono, kuchepa kwamadzi amadzimadzi komanso kukweza kwamaso.
6. Matenda a shuga a ophthalmopathy, kuphatikiza pa retinopathy, akuphatikizanso kukula koyambitsidwa ndi matenda amtundu wa khungu (mawonekedwe a mandala).
7. Matenda a shuga - matenda a shuga
8. Matendawa odwala matenda ashuga - kuwonongeka kwa mapazi a wodwala yemwe ali ndi matenda osokoneza bongo mwa njira zoperekera-necrotic, zilonda zam'mimba ndi zotupa zomwe zimachitika motsutsana ndi maziko amasinthidwe amitsempha yamagazi, mitsempha yamagazi, khungu ndi minofu yofewa. Ndiye chifukwa chachikulu cha kudula kwa odwala matenda ashuga.

Komanso, matenda ashuga ali ndi chiwopsezo chokulirapo kwa matenda amisala - kukhumudwa, mavuto a nkhawa, komanso mavuto akudya.

Momwe mungachiritsire matenda ashuga

Pakadali pano, chithandizo cha matenda ashuga m'milandu yambiri ndizachidziwitso ndipo cholinga chake ndikuwachotsa zomwe zilipo popanda kuthetsa zomwe zimayambitsa matendawa, chifukwa chithandizo chokwanira cha matenda ashuga sichinayambike.

Ntchito zazikulu zomwe dokotala amathandizira pa matenda ashuga ndi:

1. Kubwezera kwa kagayidwe kazakudya.
2. Kupewa komanso kuchiza zovuta.
3. Matenda a kunenepa kwambiri.
4. Kuphunzitsa wodekha.

Kutengera mtundu wa shuga, odwala amapatsidwa mankhwala a insulin kapena pakamwa. Odwala azitsatira zakudya, zomwe zili zovomerezeka komanso zochulukirapo zomwe zimatanthauzanso mtundu wa matenda ashuga.

• Ndi matenda a shuga a mtundu 2, zakudya ndi mankhwala omwe amachepetsa kuchuluka kwa shuga m'magazi amalembedwa: glibenclamide, glurenorm, glyclazide, glibutide, metformin. Iwo amatengedwa pakamwa pambuyo pa kusankha kwa mankhwala enaake ndi mlingo wake ndi dokotala.
• Mtundu woyamba wa matenda ashuga, mankhwala a insulin komanso zakudya ndiwo omwe amapatsidwa. Mlingo ndi mtundu wa insulin (yocheperako, yapakati kapena yayitali) amasankhidwa payekha kuchipatala, moyang'aniridwa ndi shuga ndi mkodzo.

Matenda a shuga ayenera kudwala popanda kutero, apo ayi amakhala ndi zovuta zowopsa, zomwe zidatchulidwa pamwambapa. Munthu akapezeka ndi matenda ashuga posachedwa, pamakhala zovuta zambiri kuti zovuta zoyipa zitha kupewedwa ndipo moyo wabwinobwino umakhala ndi moyo.

Zakudya za anthu odwala matenda ashuga ndi gawo lofunikira la chithandizo, komanso kugwiritsa ntchito mankhwala ochepetsa shuga kapena insulin. Popanda kudya, kulipiritsa kagayidwe kazakudya sikungatheke. Dziwani kuti nthawi zina matenda a shuga a 2, zakudya zokha ndizokwanira kulipirira kagayidwe kazakudya, makamaka koyambirira kwa matendawa. Ndi matenda amtundu wa 1 shuga, kudya ndikofunikira kwa wodwalayo, kuphwanya zakudya kungayambitse matenda a hypo- kapena hyperglycemic, ndipo nthawi zina mpaka kufa kwa wodwalayo.

Cholinga chamankhwala othandizira odwala matenda ashuga ndikuwonetsetsa kuti mayendedwe azinthu zofunikira m'thupi la wodwala.Zakudya ziyenera kukhala zamagulu a mapuloteni, mafuta ndi zopatsa mphamvu. Zakudya zopatsa mphamvu mosavuta ziyenera kusiyidwa kwathunthu ndi zakudya, kupatula milandu ya hypoglycemia. Ndi matenda 2 a shuga, nthawi zambiri pamafunika kukonza thupi.

Lingaliro lalikulu mu chithandizo chamankhwala a shuga ndi gawo la mkate. Chipinda cha mkate ndi muyezo wofanana ndi 10-12 g wa chakudya chamafuta kapena 20-25 g wa mkate. Pali magome omwe akuwonetsa kuchuluka kwa magawo a mkate mu zakudya zosiyanasiyana. Masana, kuchuluka kwa mkate womwe amadya wodwala kumayenera kukhalabe kosatha, pafupifupi 12-25 mkate amadyedwa patsiku, kutengera kulemera kwa thupi ndi zolimbitsa thupi. Pa chakudya chimodzi chomwe sichikulimbikitsidwa kudya magawo opitilira mkate 7, ndikofunika kukonza chakudya kuti kuchuluka kwa zigawo zosiyanasiyana za chakudya ndizofanana. Tiyeneranso kudziwa kuti kumwa mowa kumatha kudzetsa hypoglycemia, kuphatikizapo hypoglycemic coma.

Chofunikira pakukula kwa chithandizo cha zakudya ndikusunga diary yodwala kwa odwala, zakudya zonse zomwe zimadyedwa masana zimawonjezeredwa kwa iyo, ndipo kuchuluka kwa magawo omwe amadyedwa pakudya chilichonse komanso ambiri patsiku amawerengedwa. Kusunga diary ya chakudya chotere kumapangitsa kuti nthawi zambiri muzindikire zomwe zimayambitsa matenda a hypo- ndi hyperglycemia, zimathandizira kuphunzitsa wodwalayo, zimathandiza dokotala kusankha mlingo woyenera wa mankhwala ochepetsa shuga kapena insulin.

Kudziletsa

Kudziyang'anira wekha wa glycemia ndi imodzi mwazinthu zazikulu zomwe zingakwaniritse kubwezeretsa kwadwala kwa nthawi yayitali. Chifukwa chakuti ndizosatheka pamlingo wamakono momwe mungayerekezere bwino ntchito zachinsinsi za kapamba, kusinthasintha m'magazi a shuga kumachitika masana. Izi zimakhudzidwa ndi zinthu zambiri, zazikuluzikulu zimaphatikizanso kupsinjika kwakuthupi ndi m'maganizo, kuchuluka kwa chakudya chamafuta, matenda oyanjana ndi zina.

Popeza ndizosatheka kumuyika wodwalayo kuchipatala nthawi zonse, kuwunika momwe alili komanso kusintha kwamalingaliro ochepa a insulin. Kudziletsa kwa glycemia kutha kuchitika m'njira ziwiri. Choyambirira chikuyerekeza mothandizidwa ndi mizere yoyeserera, yomwe imazindikira kuchuluka kwa shuga mumkodzo pogwiritsa ntchito mayankho oyenera, pamaso pa glucose mkodzo, mkodzo uyenera kuyang'ana pazinthu za acetone. Acetonuria - chisonyezo chakuchipatala kuchipatala komanso umboni wa ketoacidosis. Njira iyi yowunikira glycemia ndiyowona pafupifupi ndipo salola kuwunikira kwathunthu momwe matenda a carbohydrate umakhalira.

Njira yamakono kwambiri komanso yokwanira yoyesera momwe vutoli likugwiritsira ntchito ma glucometer. Gluceter ndi chipangizo choyezera kuchuluka kwa glucose m'madzimadzi a organic (magazi, madzimadzi a cerebrospinal, etc.). Pali njira zingapo zoyezera. Posachedwa, ma glucose omwe amatha kunyamula magazi pazinthu zapakhomo afalikira. Ndikokwanira kuyika dontho la magazi pachifuwa chowoneka bwino cholumikizidwa ndi zida za glucose oxidase biosensor, ndipo patapita masekondi angapo gawo la glucose m'magazi (glycemia) limadziwika.

Tiyenera kudziwa kuti kuwerengera kwama glucometer awiri amakampani osiyanasiyana akhoza kusiyanasiyana, ndipo mulingo wa glycemia wowonetsedwa ndi glucometer nthawi zambiri umakhala magawo 1-2 kuposa omwewo. Chifukwa chake, ndikofunikira kuyerekeza kuwerengera kwa mita ndi zomwe zimapezeka pakuyesedwa ku chipatala kapena kuchipatala.

Mankhwala a insulin

Chithandizo cha insulini ndicholinga chokwanira kubwezera chakudya cha metabolism, kupewa hypo- ndi hyperglycemia, motero kupewa mavuto a shuga.Kuchiza kwa insulin ndikofunikira kwa anthu odwala matenda amtundu wa 1 ndipo angagwiritsidwe ntchito pazinthu zina kwa anthu omwe ali ndi matenda a shuga a 2.

Zisonyezo poika insulin mankhwala:

1. Mtundu woyamba wa shuga
2. Ketoacidosis, matenda ashuga hyperosmolar, hyperlacticemic chikomokere.
3. Mimba komanso kubereka ndi matenda ashuga.
4. Kubwezera kwakukulu kwa matenda ashuga a 2.
5. Kuperewera kwa chithandizo ndi njira zina zamtundu wa 2 shuga.
6. Kuchepetsa kwambiri shuga.
7. Matenda a shuga.

Pakadali pano, pali zokonzekera zambiri za insulini zomwe zimasiyana nthawi yayitali (ultrashort, yochepa, yapakatikati, yayitali), pankhani ya kudziyeretsa (monopic, monocomponent), mitundu ya mitundu (umunthu, nkhumba, bovine, genetically engineering, etc.)

Popeza kunenepa kwambiri ndi kupsinjika kwamalingaliro, insulin imayikidwa pa 0,5-1 unit pa kilogalamu imodzi ya thupi patsiku. Kukhazikitsidwa kwa insulin kumapangidwira kutsata chinsinsi cha thupi pokhudzana ndi izi, zofunika zotsatirazi zimayikidwa patsogolo:

1. Mlingo wa insulin uyenera kukhala wokwanira kugwiritsa ntchito shuga kulowa m'thupi.
2. Insulin yovulazidwa iyenera kutsanzira kupansi kwa kapamba.
3. Jakisoni wovulazidwa amayenera kutsata nsonga za postprandial za insulin secretion.

Pankhani imeneyi, pali otchedwa insulin Therapy. Mlingo wa tsiku ndi tsiku wa insulin umagawika pakati potalika pang'ono kapena mwachidule. Ma inshuwiti owonjezera nthawi zambiri amathandizidwa m'mawa ndi madzulo ndipo amayeseza kubisala kwapansi kwa kapamba. Ma insulin omwe amagwira ntchito mwachangu amathandizidwa pakudya kulikonse komwe kumakhala chakudya, muyezo umatha kusiyanasiyana ndi mgawo womwe umaperekedwa pa chakudya chomwe wapatsidwa.

Insulin imalowetsedwa mosamala pogwiritsa ntchito insulin, cholembera kapena pampu yapadera. Pakadali pano, ku Russia, njira yodziwika kwambiri yothandizira kupangira insulin pogwiritsa ntchito zolembera. Izi zimachitika chifukwa cha kuthekera kwambiri, kusapeza bwino komanso kusamasuka kwa makasitomala poyerekeza ndi ma syringes wamba. Cholembera cha syringe chimakupatsani mwayi kuti mulowe mwachangu komanso mosapweteka.

Mankhwala ochepetsa shuga

Mapiritsi ochepetsa shuga amathandizidwa ndi odwala omwe samadalira shuga m'melitrate kuwonjezera pa zakudya. Magulu otsatirawa amachepetsa shuga amadziwika ndi njira yochepetsera shuga:

1. Biguanides (metformin, buformin, ndi ena otero) - amachepetsa kuyamwa kwa matumbo m'mimba ndikupangitsanso kuchuluka kwa zotumphukira. Biguanides amatha kuwonjezera kuchuluka kwa uric acid m'magazi ndikupangitsa kuti pakhale vuto lalikulu - lactic acidosis mwa odwala omwe ali ndi zaka zopitilira 60, komanso anthu omwe akudwala chiwindi ndi impso, matenda opatsirana. Biguanides nthawi zambiri amalembera odwala omwe amadwala matenda a shuga osadalira insulin.
2. Kukonzekera kwa Sulfonylurea (glycidone, glibenclamide, chlorpropamide, carbamide) - kumathandizira kupanga insulini ndi ma pancreatic β-cell ndikulimbikitsa kulowerera kwa glucose m'misempha. Mlingo wosankhidwa bwino wa gulu la mankhwalawa umathandizira kuti shuga asadutse> 8 mmol / L. Ndi mankhwala osokoneza bongo, kukula kwa hypoglycemia ndi chikomokere ndikotheka.
3. Alpha-glucosidase inhibitors (miglitol, acarbose) - amachepetsa kuwonjezeka kwa shuga m'magazi, kutsekereza ma enzyme omwe akukhudzidwa ndi kuyamwa kwa wowuma. Zotsatira zoyipa - flatulence ndi m'mimba.
4. Meglitinides (nateglinide, repaglinide) - imayambitsa kutsika kwa shuga, ndikupangitsa kapamba kuti azisunga insulin. Zotsatira za mankhwalawa zimatengera shuga wamagazi ndipo sizimayambitsa hypoglycemia.
5. Thiazolidinediones - kuchepetsa kuchuluka kwa shuga omwe amamasulidwa ku chiwindi, kuonjezera mphamvu ya maselo amafuta kupita ku insulin.Otsimikizika mu kulephera kwa mtima.

Komanso, chithandizo chothandiza cha matenda a shuga chimachepa kwambiri komanso zimachita zolimbitsa thupi zolimbitsa thupi. Chifukwa cha kuyesa kwa minofu, pali kuwonjezeka kwa makupidwe a okosijeni ndikuchepa kwa zomwe zili m'magazi.

Pakadali pano, matendawa a mitundu yonse ya matenda a shuga amakhala abwino, ndipo chithandizo chokwanira ndikutsatira zakudya, kulumala kumakhalabe. Kukula kwa zovuta kumachepetsedwa kwambiri kapena kuyimitsidwa kwathunthu. Komabe, ziyenera kudziwidwa kuti nthawi zambiri, chifukwa cha chithandizo, zomwe zimayambitsa matendawa sizichotsedwa, ndipo kuchiritsa kumangokhala chizindikiro.

Matenda amafalikira

Pali lingaliro lakuti matenda ashuga ndi matenda amakono, vuto la chitukuko chathu komanso kuwerengera moyo wabwino, zomwe zimapangitsa kuti zakudya zizikhala ndi chakudya chambiri. Komabe, izi siziri choncho, chifukwa chomwe shuga ali, amadziwika kwambiri mdziko lakale, ku Greece ndi Roma wakale. Mawu oti "shuga" amachokera ku Greek. Omasuliridwa kuchokera ku Chigriki, amatanthauza "kudutsa." Kutanthauzira kumeneku kukuwonetsa zizindikiro zazikulu za matenda ashuga - ludzu losasinthika komanso kukodza kwakukulu. Chifukwa chake, zinkawoneka kuti timadzi tambiri timene munthu amapereka kudzera m'thupi lake.

Madokotala akale adatha kudziwa mtundu wa matenda omwe wodwalayo anali nawo, ndipo mtundu woyamba wa matenda amawoneka ngati wosapweteka ndipo umayambitsa kufa koyambirira, ndipo wachiwiri adathandizidwa ndi zakudya komanso masewera olimbitsa thupi. Komabe, ubale wa matenda ashuga mwa anthu ndi kapamba ndi insulin wakukhazikitsidwa kokha m'zaka za zana la 20. Kenako anakwanitsa kupeza insulin kuchokera kapamba wamafuta. Izi zapangitsa kuti insulin idwale.

Matenda a shuga masiku ano ndi amodzi mwa matenda ofala kwambiri. Padziko lonse lapansi, pali odwala pafupifupi 250 miliyoni omwe ali ndi matenda ashuga (makamaka amtundu wachiwiri), ndipo kuchuluka kwa omwe ali nako kumakhala kukukulirakulira. Izi zimapangitsa kuti matenda ashuga asakhale othandizira, komanso ovuta. Ku Russia, matendawa amawonedwa ndi 6% ya anthu, ndipo m'maiko ena amalembedwa mwa khumi aliyense. Ngakhale madotolo amakhulupirira kuti ziwerengerozi zitha kuchepetsedwa kwambiri. Zowonadi, mwa iwo omwe akudwala ndi mtundu wachiwiri wa matenda, zizindikiro za matenda zimafotokozedwa ofooka kwambiri m'mayambiriro. Chiwerengero chonse cha odwala matenda ashuga, poganizira izi, akuti akuti alipo mamiliyoni 400. Nthawi zambiri, matenda ashuga amapezeka mwa akulu, koma pafupifupi 0% ya ana nawonso amadwala matendawa. Kuneneratu za kufalikira kwa matenda ashuga mtsogolomo ndikhumudwitsa - zikuyembekezeka kuti mu 2030 kuchuluka kwa odwala kuchulukanso.

Pali kusiyana kwamitundu mu mtundu wa matenda ashuga 2. Matenda a shuga ndi omwe amatha kukhudza oimira amtundu wa Mongoloid ndi Negroid kuposa a Caucasians.

Kuchuluka kwa matenda a carbohydrate metabolism padziko lapansi

Matendawa ndi a m'gulu la endocrine. Ndipo izi zikutanthauza kuti matenda a shuga amabwera chifukwa cha zovuta za matenda zomwe zimachitika chifukwa chogwira ntchito m'magazi a endocrine. Pankhani ya matenda ashuga, tikulankhula zakuchepa kwa zotsatira za thupi la munthu wapadera - insulin. Mu shuga mellitus, zimakhala zimamva kusowa - kaya mtheradi kapena wachibale.

Ntchito ya insulin

Chifukwa chake, kuyambika kwa shuga kumayenderana kwambiri ndi insulin. Koma sikuti aliyense amadziwa mtundu wa chinthu, komwe amachokera ndi zomwe amagwira. Insulin ndi mapuloteni apadera. Kuphatikizika kwake kumachitika m'njira yapadera yamkati yamkati yomwe ili pansi pamimba ya munthu - kapamba.Kunena zowona, sikuti minofu yonse yapancreatic yomwe imakhudzidwa ndikupanga insulin, koma gawo limodzi lokha. Ma cell a gland omwe amapanga insulini amatchedwa maselo a beta ndipo amapezeka m'malo apadera a Langerhans omwe amapezeka pakati pa tinthu timene timatulutsidwa. Mawu akuti "insulin" pawokha amachokera ku liu loti insula, lomwe mu Latin limatanthawuza "islet."

Ntchito za insulin zimagwirizana kwambiri ndi kagayidwe kazinthu zofunika monga chakudya. Munthu amatha kudya chakudya chamagulu okha ndi chakudya. Popeza chakudya chopatsa mphamvu ndimphamvu zambiri, zochitika zambiri zathupi zomwe zimachitika m'maselo ndizosatheka popanda chakudya. Zowona, sikuti mafuta onse omwe amamwe thupi. M'malo mwake, shuga ndi chakudya chachikulu m'thupi. Popanda glucose, maselo amthupi sangathe kupeza mphamvu zochuluka. Insulin samangophatikizidwa ndi kutenga shuga. Makamaka, ntchito yake ndikupanga mafuta acids.

Glucose ndi m'gulu la zopatsa mphamvu zosavuta. Fructose (shuga ya zipatso), yomwe imapezeka mu zipatso zambiri ndi zipatso, ilinso m'gulu lino. Mthupi, fructose imapangidwa mu chiwindi mpaka glucose. Kuphatikiza apo, shuga wosavuta (disaccharides) ndi sucrose, yomwe ndi gawo la zinthu monga shuga wokhazikika, ndi lactose, yomwe ndi gawo la zinthu zamkaka. Mitundu yamafuta awa imasungidwanso mpaka glucose. Izi zimachitika m'matumbo.

Kuphatikiza apo, pali ma polysaccharides angapo (ma carbohydrate) okhala ndi unyolo wamtali wautali. Zina mwa izo, monga wowuma, sizingatengeke bwino ndi thupi, pomwe mafuta ena, monga pectin, hemicellulose ndi cellulose, samaphwanya konse m'matumbo. Komabe, ma carbohydrate amenewa amagwira ntchito yofunika kwambiri pakugaya chakudya, kupititsa patsogolo mayamwidwe ena a michere ina ndikusunganso kuchuluka kwa microflora yamatumbo.

Ngakhale kuti glucose ndiye gwero lalikulu lamphamvu yama cell, minofu yambiri imalephera kuzitenga mwachindunji. Chifukwa chaichi, maselo amafunikira insulini. Organs omwe sangakhalepo popanda insulini amadalira insulin. Ndi ochepa ochepa okha omwe amatha kulandira glucose popanda insulin (monga, mwachitsanzo, ma cell a ubongo). Minofu yotereyi imatchedwa insulin-Independent. Kwa ziwalo zina, shuga ndiye gwero lokha lamphamvu (mwachitsanzo, ku ubongo womwewo).

Zotsatira zake zimakhala chiyani, pazifukwa zina, maselo akusowa insulini? Izi zimawonekera mu njira ziwiri zoyipa zoyipa. Choyamba, maselo sangathe kulandira glucose ndipo adzafa ndi njala. Chifukwa chake, ziwalo zambiri komanso minyewa sizitha kugwira ntchito moyenera. Komabe, glucose wosagwiritsidwa ntchito amadzunjikira m'thupi, makamaka m'magazi. Matendawa amatchedwa hyperglycemia. Zowona, shuga wambiri nthawi zambiri amasungidwa m'chiwindi ngati glycogen (kuchokera komwe kungathe, ngati kuli kotheka, kubwerera m'magazi), koma insulini imafunikanso kuti isinthe glucose kukhala glycogen.

Magazi a glucose abwinobwino amachokera ku 3,3 mpaka 5.5 mmol / L. Kutsimikiza kwa mtengowu kumachitika ngati magazi atengedwa pamimba yopanda kanthu, chifukwa kudya nthawi zonse kumayambitsa kuchuluka kwa shuga kwakanthawi kochepa. Shuga owonjezera amadziunjikira m'magazi, zomwe zimapangitsa kusintha kwakukulu mu malo ake, mawonekedwe a shuga pamakoma amitsempha yamagazi. Izi zimabweretsa kukula kwa ma pathologies osiyanasiyana am'magazi ndipo, pamapeto pake, kumagwira ntchito matumbo ambiri. Njirayi, kuphatikiza shuga ochulukitsitsa m'magazi, imatchedwa shuga mellitus.

Zoyambitsa matenda ashuga ndi mitundu yake

Makina a pathogenesis a matendawa amatsitsidwa kukhala mitundu iwiri yayikulu.Poyamba, shuga wambiri amachititsa kuchepa kwa kapangidwe ka insulin. Zodabwitsazi zimatha kuonekera chifukwa cha njira zosiyanasiyana za matenda, mwachitsanzo, chifukwa cha kutupa kwa kapamba - kapamba.

Mtundu wina wa shuga umawonedwa ngati kupanga kwa insulin sikunachepe, koma kumakhala koyenera (kapena mwina pamwamba pake). Njira yotsogola yopangira matenda a shuga pankhaniyi ndiyosiyana - kutayika kwa minofu kumapangitsa insulini.

Mtundu woyamba wa shuga umatchedwa - shuga yamtundu woyamba, ndi mtundu wachiwiri wa matenda - matenda ashuga amtundu wachiwiri. Nthawi zina matenda amtundu wa 1 shuga amatchedwanso insulin, ndipo matenda a shuga a 2 amatchedwa osadalira insulin.

Palinso mitundu ina ya matenda ashuga - gestational, AMODZI-matenda ashuga, matenda a shuga a autoentmune, ndi ena ambiri. Komabe, ndizochepa kwambiri poyerekeza ndi mitundu iwiri yayikuluyo.

Kuphatikiza apo, shuga insipidus iyenera kuganiziridwa padera ndi matenda ashuga. Awa ndi dzina la mtundu wa matenda omwe amakwaniritsa kukodza (polyuria), koma samayambitsidwa ndi hyperglycemia, koma ndi zifukwa zina, monga matenda a impso kapena a pituitary.

Ngakhale kuti shuga mellitus ali ndi machitidwe omwe amawagwirizanitsa, zizindikiritso ndi chithandizo cha matenda ashuga onse amitundu yayikulu ndizosiyana kwambiri.

Mitundu iwiri ya matenda ashuga - osiyana nawo

Insulin-wodwala matenda a shuga

Matendawa amapezeka mwa khumi alionse odwala kuchokera kuchuluka kwa odwala omwe ali ndi matendawa. Komabe, mwa mitundu iwiri ya matenda ashuga, mtundu woyamba wa shuga umawerengedwa kuti ndiwowopsa kwambiri ndipo nthawi zambiri umatha kubweretsa mavuto.

Mtundu woyamba wa matenda ashuga, monga lamulo, ndi matenda omwe amapezeka. Amayamba chifukwa chovuta kugwira ntchito kapamba. Kutheka kwa gland kumatsatiridwa ndikuchepa kwa kuchuluka kwa insulin yomwe imapangidwa, yomwe imayambitsa matenda a shuga. Kodi chitsulo chimaleka kugwira ntchito chifukwa chiyani? Vutoli limatha kuwonekera chifukwa cha zifukwa zambiri, koma nthawi zambiri zimachitika chifukwa cha kutukusira kwa England. Nthawi zambiri, imayamba chifukwa cha zovuta zapakhungu zomwe zimayambitsa matenda a autoimmune, pomwe chitetezo cha mthupi chimayamba kugunda maselo a pancreatic. Komanso, mtundu woyamba wa matenda ashuga nthawi zambiri umachitika chifukwa cha khansa. Chofunikira kwambiri pakukula kwa matendawa ndi cholowa cham'tsogolo. Kuphatikiza apo, mikhalidwe ina imathandizira kupezeka kwa mtundu woyamba wa matenda ashuga:

• mavuto omwe munthu wakumana nawo
• kapamba cell hypoxia,
• Zakudya zosayenera (zamafuta ochulukirapo komanso zakudya zochepa zama protein).

Nthawi zambiri, kukula kwa wodalira insulin kumachitika ali aang'ono (mpaka zaka 30). Komabe, ngakhale anthu okalamba sakhala ndi matendawa.

Kodi matenda ashuga 1 amawonekera bwanji?

Matendawa amadziwika ndi gawo loyambilira, kotero nthawi zambiri zovuta za matenda a shuga sizovuta kuzizindikira.Zizindikiro zazikulu za matenda ashuga ndi ludzu lalikulu, kumwa madzi ambiri. Momwemo, kuchuluka kwa mkodzo wamafuta (polyuria) kumakulanso. Mkodzo wa wodwala nthawi zambiri umakhala ndi kukoma kokoma, komwe kumafotokozedwa ndi kuchuluka kwa shuga mkati mwake. Chizindikiro ichi ndikuwonjezereka kwa kuchuluka kwa shuga mumkodzo, wotchedwa glucosuria. Kukula kwa glucosuria kumawonedwa pamene kuchuluka kwa shuga m'magazi kudutsa 10 mmol / L. Mwanjira iyi, zosefera za impso zimayamba kuthana ndi kuchotsedwa kwa glucose ndipo zimayamba kulowa mkodzo. Komabe, ndi njira zina za aimpso, shuga mumkodzo amawonedwa pafupipafupi m'magazi a shuga, kotero gawo ili - kuchuluka kwa glucose mkodzo, sichizindikiro cha matenda a shuga.

Komanso, shuga mellitus amawonetsedwa ndi kuwonjezeka kwa pathological mu chilakolako (polyphagy). Vutoli limangofotokozedwa, chifukwa chifukwa chakuti glucose salowa m'maselo, thupi limakumana ndi kuperewera kwa mphamvu komanso minyewa yanjala imayimira izi ku ubongo. Ndi kudya kosalekeza, komabe, wodwalayo samachuma, koma amachepetsa. Zizindikiro zina zamatendawa ndi kutopa kwambiri ndi kufooka, khungu lotupa, kupweteka pamutu, kuthamanga kwa magazi, komanso kuchepa kwa mawonekedwe. Mkodzo ukasanthulidwa, ma acetone amapezeka mmenemo, zomwe zimachitika ndikugwiritsa ntchito masitolo amafuta ndimaselo. Komabe, acetone nthawi zambiri imathiridwa limodzi ndi mkodzo m'matenda ena ambiri, monga kutupa. Makamaka, acetone mu mkodzo amawonekera mwa ana. Chifukwa chake, izi siziyenera kuonedwa ngati chizindikiro chodwala.

Kusintha kwamphamvu m'magazi a glucose m'magazi nthawi zambiri kumayambitsa kukwera kwake kwakukulu kapena kotsika, ndipo chotsatira - kwa hypoglycemic kapena hyperglycemic comas. Izi nthawi zambiri zimatha pakufa kwa wodwala.

A wamba matenda a shuga ndi a Raynaud's syndrome, kuphatikizapo:

• scleroderma
• atherosulinosis
• matenda am'mimba
• thromboangiitis obliterans,
• kuziziritsa ndi dzanzi miyendo,
• kupweteka m'manja.

Mtundu woyamba wa matenda a shuga sikuti sangachiritsike, komanso matenda oopsa. Wodwala akapanda kulandira chithandizo, matenda ake obwera chifukwa cha insulin amasintha kukhala zovuta monga ketoacidosis kapena matenda a diabetes, omwe amayamba kufa. Kutengera ndi kuchuluka kwa shuga m'magazi, gawo la matenda ashuga limawerengedwa kuti ndi lofatsa, lamphamvu kapena lozama.

Magawo a shuga omwe amadalira insulin

Maphunziro a odwala monga gawo la zamankhwala

Chofunikira chamankhwala othandizira odwala matenda ashuga ndi maphunziro a odwala. Wodwala ayenera kudziwa zomwe ayenera kuchita ngati pali vuto la hypoglycemia kapena hyperglycemia, momwe angayang'anire kuchuluka kwa shuga m'magazi, momwe angasinthire zakudya. Zomwezi ziyenera kupezeka kwa abale a wodwalayo.

Matenda a shuga ndi matenda a metabolic. Chifukwa chake, zakudya zomwe zimakhazikitsidwa ndi mfundo yoletsa kuchepetsa kuchuluka kwa chakudya mu chakudya ndi njira yofunika kwambiri yothandizira. Popanda kudya, wodwalayo amathanso kufa chifukwa chakukula kwa matenda oopsa (hyper- hypoglycemia).

Zakudya zamatenda omwe amadwala matenda a shuga obwera chifukwa cha insulin ziyenera kukhazikitsidwa potsatira miyambo yonse ya chakudya cholowa mthupi la wodwalayo. Kuti mupewe kuwerengera zamafuta, gawo lapadera la muyeso, mkate mkate (XE), lidayambitsidwa machitidwe othandizira odwala matenda ashuga. XE imodzi ili ndi 10 g yamafuta osavuta, kapena 20 g ya mkate. Kuchuluka kwa XE komwe amamwa patsiku kumasankhidwa ndi dokotala payekhapayekha, poganizira zolimbitsa thupi, kulemera kwa odwala komanso kuopsa kwa matendawa.Pankhani ya matenda a shuga a shuga omwe amadalira insulin, kumwa mowa kumaletsedwa kotheratu.

Matenda a shuga osagwirizana ndi insulin

Mtundu uwu wa matenda ashuga ndiwofala kwambiri. Malinga ndi ziwerengero, amapezeka pafupifupi 85% ya anthu odwala matenda ashuga. Matenda a shuga a Mtundu Wachiwiri samachitika ali aang'ono. Amadziwika kwambiri ndi achikulire a zaka zapakati komanso okalamba.

Matenda a Mtundu Wachiwiri amayamba chifukwa cha kuperewera kwa insulin, koma kuphwanya mgwirizano pakati pa insulin. Maselo amasiya kuyamwa insulin ndipo glucose amayamba kudziunjikira m'magazi. Zomwe zimayambitsa izi sizinafotokozedwe bwino, koma, monga asayansi akukhulupirira, gawo lalikulu mu pathogenesis ya shuga imaseweredwa ndi:

• kusintha kwa mayamwidwe a shuga m'matumbo,
• mathamangitsidwe akuwonongeka kwa insulin,
• kutsika kwa kuchuluka kwa zolandilira m'madzi m'maselo.

Makamaka, mu ma pathologies ena, chitetezo cha mthupi chimatha kuwona ma insulin receptors ngati ma antigen ndikuwawononga.

Chochitika chachikulu chomwe chimakhudza mwayi wokhala ndi matenda a shuga ndi kunenepa kwambiri. Izi zikuwonetsedwa ndi ziwerengero, chifukwa 80% ya odwala omwe samadalira insulin amadwala kwambiri.

Mwa zina zomwe zikuthandizira pakukula kwa matendawa, munthu amatha kusiyanitsanso:

• kumangokhala
• kusuta
• uchidakwa
• matenda oopsa
• kusowa zolimbitsa thupi,
• kudya kolakwika
• kupsinjika
• kumwa mankhwala ena, monga glucocorticosteroids.

Udindo wofunikira umachitidwanso ndi chibadwa komanso chibadwa. Ngati m'modzi mwa makolo ali ndi matenda osokoneza bongo omwe amadalira insulin, ndiye kuti mwayi wokula kuti mwana atakula adzadwala matendawa ndi 80%.

Pali malingaliro olakwika akuti matenda ashuga angayambitse kumwa kwambiri maswiti, ngakhale kamodzi. M'malo mwake, sizili choncho, munthu wathanzi amatha kudya maswiti ambiri nthawi, ndipo izi sizingawononge thanzi lake. China chake ndichakuti kudya mosasinthidwa kwa maswiti nthawi zambiri kumabweretsa kunenepa kwambiri, koma kunenepa kwambiri kumatha kuyambitsa njira zomwe zimayambitsa matenda a shuga.

Zizindikiro za Matenda A shuga

Matenda a shuga osadalira insulin amakula pang'onopang'ono zaka zambiri. Chifukwa chake, odwala nthawi zambiri samalabadira zoyamba za matenda ashuga, chifukwa cha zomwe zimachitika chifukwa cha ukalamba, kugwira ntchito mopitirira muyeso. Poyambirira, zizindikiro za matenda ashuga nthawi zambiri zimakhala sizipezeka. Chifukwa chake, zizindikiro zoyambirira za shuga zimawonekera pokhapokha kuwonjezeka kwakukulu kwa shuga m'magazi.

Pali mitundu ya matenda omwe amatsata omwe amadalira shuga. Wodwalayo amayamba kusokonezedwa ndi ludzu lalikulu, kukodza pafupipafupi, kugona tulo usiku, kutopa, kufooka komanso kugona tulo masana.

Komanso, zizindikiro zoyambirira za matenda ashuga zimaphatikizapo izi:

• kupoleka pang'onopang'ono
• kuwonongeka kwamawonekedwe
• chizungulire chamatsenga kapena cholimbikira,
• dzanzi kapena kubinya kwa miyendo,
• dermatitis.

Komabe, zochitika zofananira zimakonda kukhala ndi ma pathologies ena, chifukwa chake, kuzindikiritsa, komanso kutsimikiza kwa mtundu wa matenda ashuga kuyenera kuchitika ndi adokotala, osati wodwala iye mwini.

Ngati sanapatsidwe, zovuta zamtundu zimayamba - neuropathy, nephropathy, retinopathy, angiopathy.

Zizindikiro zobisika zakusintha kwa kagayidwe kazakudya zimachepa pakupanga mapuloteni komanso mafuta acids. Ndi kukula kwa matendawa, zizindikiro za matenda zimayamba kukhala zowonekera kwambiri. Pamapeto pake, kuchuluka kwa glucose m'magazi kumayamba kugwira ntchito kwa kapamba, njira za insulin zimasokonekera. Ketoacidosis imayamba, ndipo kuchepa kwa madzi ndi maelekitiroma mu mkodzo kumawonjezeka.

Zochokera ku sulfonylureas

Gulu lina lodziwika bwino la mankhwalawa ndi mankhwala omwe amachokera mu mankhwala omwe amachokera ku sulfanilurea derivatives (tolbutamide, glibenclamide, glimepiride). Amagwiritsidwa ntchito pa shuga wambiri, pamene metformin sichithandiza wodwala kapena kugwiritsa ntchito kwake nkosatheka pazifukwa zina. Mfundo ya zochita za sulfanilurea zotumphukira zimakhazikitsidwa ndi kukondoweza kwa maselo a pancreatic, chifukwa chomwe amayamba kupanga insulin yambiri. Njira zamkati zimagwirizanitsidwa ndi kuponderezana kwa kaphatikizidwe ka glucagon komanso kumasulidwa kwa glucose ku chiwindi. Choyipa cha ndalamazi ndizotheka kwambiri kwa hypoglycemia wokhala ndi Mlingo wosalondola.

Zakudya ndi zina mwazinthu zofunikira kwambiri pochiza matenda osokoneza bongo omwe amadalira insulin nthawi iliyonse yamatendawa. Mfundo yayikulu yazakudya ndi kuchepetsa kuchuluka kwa chakudya chamafuta omwe amaperekedwa. Choyamba, izi zimagwira ntchito kwa shuga woyengedwa, yemwe thupi ndi losavuta kugaya. Ndikulimbikitsidwa kuti mukulitse kugwiritsa ntchito ma fungo ochepetsa mphamvu, popeza amalepheretsa kuyamwa kwa mafuta osavuta, amakhala olimba m'mimba, amasintha kapangidwe ka microflora yamatumbo.

Mankhwala osokoneza bongo omwe amadalira insulin, mowa uyenera kusiyidwa. Izi ndichifukwa choti mowa umasokoneza njira zachilengedwe za kagayidwe kachakudya, kuphatikiza njira zopangira insulin komanso kuyamwa kwa glucose ndimisempha.

Matenda a shuga

Matenda a shuga oyembekezera (gestational) ndi matenda omwe amapezeka mwa akazi okha pakubala kwa mwana wosabadwayo. Maphunzirowa ndi zizindikiritso za matenda amiseche ofanana ndi omwe samadalira shuga. Matendawa amapezeka 2-5% ya amayi oyembekezera. Kafukufuku wodziwika bwino wa matenda a zam'mimba ndi kutha kwadzidzidzi kwake ndikatha kubereka. Komabe, izi sizimachitika nthawi zonse. Zinapezekanso kuti shuga ya gestational imawonjezera chiopsezo cha odwala omwe samadalira insulini omwe amadalira amayi. Kuphatikiza apo, matenda osokoneza bongo amatha kusokoneza mayiyo mtsogolo, kuyambitsa zovuta zina pakukonzekera kwa mwana wosabadwayo, ndikuwonjezera kuchuluka kwa khanda lobadwa kumene. Matenda a shuga ochitika mthupi amayenera kusiyanitsidwa ndi mitundu yokhazikika ya shuga yokhala ndi mitundu yoyamba komanso yachiwiri yomwe idawonekera asanakhale ndi pakati.

SD ModY-mitundu

Ili pafupi kwambiri ndi matenda a shuga omwe amadalira insulin, koma ilinso ndi zina za matenda osokoneza bongo omwe amadalira insulin. Ichi ndi autoimmune pathology limodzi ndi kuchepa kwa kupanga kwa insulin. Amakhulupirira kuti mwa odwala onse omwe ali ndi matenda ashuga, pafupifupi 5% ali ndi matenda amtunduwu. Pathology nthawi zambiri imawonekera kuyambira paubwana. Poyerekeza ndi shuga yemwe amadalira insulin nthawi zambiri, ndi mtundu wa shuga wambiri wa AMODZI, kufunikira kwa insulini sikokwanira kwambiri.

Matenda a shuga ndi njira yomwe nthawi zambiri imayamba pang'onopang'ono. Pali magawo atatu a shuga. Phata lalikulu chifukwa choti magawo awa amatha kusiyanitsidwa ndi kuchuluka kwa shuga m'magazi am'magazi.

Magawo a shuga ndi shuga wamagazi

Chitsutso china chamgulu ndi kukana kwa thupi ku matenda. Poganizira izi, munthu amatha kusiyanitsa magawo omwe adalipidwa, ophatikizidwa, komanso osinthika. Chimodzi mwa gawo lomwe lawola ndi kupezeka kwa acetone mu mkodzo ndi kuchuluka kwa glucose m'magazi, omwe samayankha bwino pakumwa mankhwala.

Matenda a shuga

Mkhalidwe wofananawo, womwe nthawi zambiri umatchedwa kulekerera kwa glucose, umadziwika ndi malire amagazi a m'magazi. Sichiri matenda ophunzitsidwa bwino kapena gawo limodzi, koma zimatha kuyambitsa matenda ashuga pakapita nthawi.Ndiye kuti, kupezekanso kwakanthawi koyamba kwa matenda a prediabetes ndimatenda a shuga omwe amapezeka kale.

Kuzindikira kwa matenda ashuga

Kukula kwake kumadalira gawo la matenda ndi mawonekedwe a matenda ashuga. Mkuluyu amatithandizanso kudziwa za matenda a shuga. Njira zamakono zamankhwala zimatha kusintha mtundu wa shuga m'magazi, kapena, ngati izi sizingatheke, kukulitsa moyo wa wodwalayo. China chomwe chimakhudza matendawo ndi kupezeka kwa zovuta zina.

Ketoacidosis

Ketoacidosis ndi vuto lomwe mafuta omwe amapanga metabolism - matupi a ketone - amadziunjikira m'thupi. Ketoacidosis nthawi zambiri imapezeka mu diabetes komanso concomitant pathologies, kuvulala, kuperewera kwa zakudya m'thupi. Ketoacidosis imalowetsa kuphwanya zinthu zambiri zofunika m'thupi ndipo ndi chisonyezo chakuchipatala.

Hypoglycemia

Hypoglycemia ndi vuto lomwe shuga wambiri amapezeka m'magazi. Popeza glucose ndiye gwero lofunikira kwambiri lamaselo, izi zimawopseza kuchepa kwa ziwalo zambiri, makamaka ubongo. Mwachizolowezi, cholowa pansi chomwe hypoglycemia imakhazikitsidwa ndi 3.3 mmol / L.

Mavuto a Hypoglycemic nthawi zambiri amayenda ndi matenda a shuga. Amatha kuyambitsidwa ndi kupsinjika, mowa kapena mankhwala ochepetsa shuga. Njira yayikulu yothanirana ndi hypoglycemia ndichangu kwambiri cha zinthu zomwe zili ndi shuga (shuga, uchi). Ngati wodwalayo ataya chikumbumtima, ndiye kuti ndikofunikira kuti mumupatse vitamini B1 modekha kenaka kudzera m'mitsempha 40% ya shuga. Kapena kukonzekera kwa glucagon kumachitika ndi intramuscularly.

Hyperosmolar chikomokere

Vutoli limachitika nthawi zambiri ndi anthu okalamba omwe amakhala ndi matenda osokoneza bongo omwe amadalira shuga, ndipo amalumikizidwa ndi kuchepa thupi kwambiri. Coma nthawi zambiri imayambitsidwa ndi polyuria yotalikirapo. Matendawo nthawi zambiri amawonekera mwa anthu okalamba chifukwa chakuti ndi ukalamba kumamva ludzu nthawi zambiri, ndipo wodwala sadzipangitsa kuti madzi ake athere chifukwa chakumwa. Hyperosmolar chikomaso ndichizindikiro chofunikira kuchipatala.

Retinopathies

Ma retinopathies ndi omwe amapezeka kwambiri pazovuta za shuga. Choyambitsa matendawa ndikuwonongeka m'magazi kwa retina. Izi nthawi zambiri zimakhudza madera ena amaso. Nthawi zambiri amawona kukula kwa ng'ala. Odwala omwe ali ndi matenda ashuga, chaka chilichonse matendawa amawonjezera mwayi wokhala retinopathy ndi 8%. Pambuyo pa zaka 20 mukudwala, pafupifupi aliyense wodwala matenda ashuga ali ndi vuto lofananalo. Kuopsa kwa retinopathy ndiko kukula kwa khungu, kuthekera kwa kutulutsa kwa magazi, komanso kuchepa kwa khungu.

Polyneuropathy

Polyneuropathy nthawi zambiri imayambitsa kutayika kwa khungu (kupweteka ndi kutentha), makamaka m'miyendo. Kenako, izi zimapangitsa kuti pakhale zilonda zovuta kuchiritsa. Zizindikiro za polyneuropathy ndi kutopa kwa miyendo, kapena kutentha kwa iwo. Izi nthawi zambiri zimakwezedwa usiku.

Kupewa

Kukhala ndi moyo wopanda tanthauzo, kudya mosayenera, komanso masewera olimbitsa thupi osakwanira nthawi zambiri kumayambitsa matenda a shuga. Chifukwa chake, anthu okalamba, makamaka omwe angakayikire kuti ali ndi matenda a shuga, ayenera kuwunika momwe amakhalira ndi thanzi lawo, kumayesedwa pafupipafupi ndi kukaonana ndi akatswiri.