Kodi matenda ashuga am'mbuyomu komanso amasiyana bwanji ndi matenda ashuga
Anthu samasamala za thanzi lawo, pokhapokha ngati alibe chidwi ndi kuchuluka kwa shuga m'magazi. Chifukwa chodzimvera tokha, mwina simungazindikire zizindikiro za matenda omwe akubwera. Izi zili choncho makamaka kwa matenda monga matenda ashuga omwe amakhala nawo. Nthawi zambiri ndimazindikira mochedwa komwe kumayambitsa zotsatira zoyipa zomwe zimasiya chizindikiro choyipa mthupi la munthu.
Ndani ali pachiwopsezo cha matenda ashuga
Pa siteji ya matenda abwinobwino a shuga, njira yowonongera mitsempha yamagazi kuchokera ku glucose owonjezera imayamba. Thanzi labwino silimapatsa munthu chifukwa chokayikira thanzi lake. Koma matenda ashuga am'mawa akuwonjezera pang'onopang'ono mwayi wamatenda a mtima ndi mtima.
Madokotala azindikira zinthu zingapo zomwe zimatsogolera pakupanga shuga:
- Kusintha kokhudzana ndi ukalamba m'thupi ndizomwe zimayambitsa. Pafupifupi 85% ya anthu achikulire omwe akhala akunena kale matenda a shuga.
- Anthu ena amakhala ndi majini omwe, nthawi zina, amatsogolera matendawa. Amapatsira ana awo.
- Omwe akuvutika ndi kilogalamu yowonjezera nthawi zambiri amakhala ndi zovuta za metabolic. Chifukwa chake, aliyense wa anthu atatu kapena anayi athunthu amatha kuwona zizindikiro.
- Pa nthawi ya pakati, zovuta zomwe zimayambitsa mawonekedwe obisika ndizotheka. Chifukwa cha izi, mayi aliyense yemwe ali pamwambowu amalimbikitsidwa kukayezetsa.
- Kuwonongeka kwa maselo a pancreatic chifukwa cha matenda ena kumabweretsa kupangika kwa insulin.
- Kupanikizika kosalekeza kwa odwala matenda oopsa kumatha kuyambitsa kuwonongeka kwa maziko a shuga.
- Nthawi zina, ngakhale kusowa kwa potaziyamu kumakhudza shuga.
Zizindikiro za Matenda Atsopano
Pali zizindikiro zomwe, poyamba, sangathe kunena za matenda aliwonse. Ndiye chifukwa chake munthu amene ali ndi matenda ashuga omwe samawalabadira samawaganizira ndipo samakayikira kuti akudwala. Zizindikiro zake ndi:
- Khungu limayamba kunyezimira. Chifukwa chake microflora ya pathogenic imadziwonetsa yokha, yomwe imayendetsedwa chifukwa cha kusokonezeka kwa njira za metabolic.
- Kumva pakamwa louma komanso kufunitsitsa kosatha kuthetsa ludzu. Popeza nyengo yozizira dongosolo lotenthetsera limaphwetsa mpweya, ndipo nthawi yotentha imakhala yotentha kwambiri, munthu sangathe kufunikira mawonekedwe ake.
- Kusintha kwadzidzidzi kwa kulemera. Poyamba, wodwalayo amatha kuchepa thupi, ndipo pambuyo pake amayamba kunenepa. Nthawi yomweyo, chilakolako chake cha thupi chimakulirakulira, zomwe zimakhulupirira kuti zimachokera ku thanzi labwino.
- Kulimbikitsa nthawi zambiri kuposa kale.
- Kufooka kwachilendo kumawonekera, komwe kulibe kufotokozera.
Zizindikiro zonsezi zimatha kuchitika kangapo kamodzi, komanso chimodzi kapena ziwiri. Mwina adzafooka kwambiri mpaka wodwalayo sawazindikira.
Njira yodziwira matenda abwinobwino a shuga
Nthawi zambiri, zizindikiro zoyambirira sizimadziwika ndipo wodwalayo amafufuza thandizo kuchipatala. Koma ngakhale pakalibe malangizo owonetsa za matenda ashuga, ilipo njira yodziwira.
Matenda a shuga a mellitus, ndi chiyani - uwu ndi mtundu wa matenda amodzi a dzina lomweli. Ndiye kuti, mavuto omwewo okhala ndi kuchuluka kwa shuga amapezeka m'thupi. Chifukwa chake, njirayi imakhazikitsidwa ndi miyezo ya glucosuria. Choyamba, zimatsimikiziridwa pamimba yopanda kanthu, kenako woyesayo amamwa yankho la shuga (75 g). Maola atatu atadutsa, pangani muyeso watsopano. Ngati zakuphwanya zikuchitika, ndiye kuti zonse ziziwoneka kuchokera pakupenda.
Kodi mungachotse bwanji matenda ashuga am'mbuyomu?
Popanda kuchitapo kanthu, mawonekedwe omaliza m'magawo atatuwo amakhala mtundu wa shuga 2. Koma popewa, wodwalayo amatha kusintha kuchuluka kwa shuga. Kuti muchite izi, muyenera kusintha kulemera kwanu mothandizidwa ndi maphunziro akuthupi komanso zakudya. Kuchita masewera olimbitsa thupi tsiku ndi tsiku kumathandizira thupi kuthana ndi glucose owonjezera, chifukwa m'malo otere amatha nthawi yopitilira 20. Pazofunikira, simulators safunika. Kuthamanga kwa theka la ola kapena kukwera masitepe popanda kukweza kumathandiza muvutoli.
Pali mankhwala oletsa matenda ashuga omwe amakhala nawo. Awa ndi Acarbose ndi Metformin. Komabe, pazotsatira zabwino, ndalamazi ziyenera kugwiritsidwa ntchito tsiku lililonse kwa zaka zingapo motsatizana. Njira zachilengedwe zomwe tafotokozazi ndi zotsika mtengo komanso zothandiza kwambiri. Amapereka zotsatira mwachangu, ndipo chiwopsezo cha matenda a shuga chimachepetsedwa ndi 2 times.
Kuti izi zitheke, ndikofunikira kugwiritsa ntchito zitsamba. Pankhondo yolimbana ndi matenda ashuga, mbewu za fulakesi, masamba owuma nyemba za ma pod, ma bloeberries, ndi mizu ya dandelion ya mankhwala ndi burdock amagwiritsidwa ntchito. Palinso ndalama zakupanga zakapangidwe ka mankhwala, mwachitsanzo, Arfazetin. Tisaiwale za ginseng wodziwika bwino, eleutherococcus ndi muzu wagolide. Zomera izi sizimangokhala ndi shuga, komanso zimathandizira chitetezo chokwanira, kuwonjezera mphamvu. Ndikofunika kungoona kuti akupangika chifukwa cha kusowa tulo, matenda a mtima komanso matenda oopsa.
Zakudya Zolimbana ndi Matenda Obisika
Monga zakudya zilizonse, pali zakudya zabwino komanso zoletsedwa.
Ndichizolowezi kunena kuti zothandiza:
- nyama yokonda
- nsomba zam'nyanja
- masamba ndi monga: nyemba zobiriwira, udzu winawake, zukini, tomato, Yerusalemu artichoke, nkhaka,
- mabuluni.
Sizoletsedwa kugwiritsa ntchito zinthu ngati izi:
- chilichonse chomwe chili ndi mafuta ambiri,
- mafuta amkaka,
- mazira
- masoseji
- maswiti ndi koloko wokoma,
- zakudya za khofi
- mowa
Mukayamba kudya, muyenera kudziwa kuti zimatengera kuchepa kwa mafuta komanso michere yopepuka yokhala ndi mapuloteni ambiri komanso potaziyamu. Kusiya potaziyamu wocheperako kuchokera kumasamba, ndibwino kuti muzigwiritsa ntchito mwatsopano kapena zophika. Wowongolera amathandiza kusunga zinthu zonse zofunikira ndi mavitamini. Kofi, tiyi ndi zakumwa zoledzeretsa m'magawo ang'onoang'ono sizoyipa, koma zimathandiza kuchepetsa kuchuluka kwa calcium m'thupi.
Ngati mungayesetse pang'ono, mutha kulepheretsa kusintha kwa matenda ashuga am'mitundu kukhala mitundu yotseguka yomwe imakhala ndi zovuta zowopsa mthupi. Muyenera kudya kaye moyenera komanso kusamalira zosintha paumoyo wanu.
Kodi mtundu wa shuga wa lada (latent, latent) ndi uti?
Matenda a shuga l shuga ndi shuga mwa akulu, komwe ndi njira ya chilengedwe ya autoimmune.
Zizindikiro zake ndi maphunziro ake oyamba amafanana ndi matenda a shuga a 2, koma mu etiology amayandikira koyambirira, chifukwa thupi limapanga ma antibodies ku kanyumba ka pancreatic beta ndi glutamate decarboxylase.
Chiyambi cha autoimmune cha lada - matenda a shuga amatanthauza kulephera, zomwe zimatsogolera kumkhondo ya chitetezo chathupi ndi thupi lake, makamaka, ndi kapamba wake.
Zotsatira zake, thupi limalephera kugwira ntchito moyenera ndikuchita ntchito zake mokwanira.
Mtunduwu wa shuga umapezeka kwambiri mwa amuna ndi akazi azaka zapakati pa 35 ndi 55.
Kusiyana ndi matenda ashuga
Chifukwa chake, choyambitsa matenda a shuga ndi matenda a autoimmune, chifukwa chake, mwa njira zopangira chitukuko, chimafanana kwambiri ndi mtundu 1 shuga. Ena a endocrinologists nthawi zambiri amati matenda abwinobwino a shuga a mtundu woyamba, wodalira insulin, chifukwa chakuti matenda obisika amatchulidwa ngati 1.5.
Komabe, malinga ndi chipatalachi, mitundu 1 ndi 1.5 ndizosiyana kwambiri, mwachitsanzo, mosiyana ndi mtundu 1, wokhala ndi matenda a shuga:
- Matenda a pathological amapita pang'onopang'ono, ndikusinthana kwa nthawi yayikulu komanso yotsika insulin. Zizindikiro zake zimakhala zofatsa. Mawonekedwe owonekera oyamba amatha kuchitika pakati pazaka zapakati.
- Nthawi zambiri pamakhala palibe zizindikiro za matenda ashuga monga ludzu, kuchuluka kwa thupi, kuchepa thupi, ketoacidosis, ndi zina zambiri.
Kusiyana pakati pa matenda am'mbuyomu ndi mitundu yachiwiri ya matenda ndi awa:
- kusowa kwa kunenepa kwambiri
- kufunikira kwa mankhwala a insulin omwe amapezeka patapita nthawi (mpaka zaka 6),
- anti-GAD, IAA, ma antibodies a ICA amapezeka m'magazi, kutsimikizira mtundu wa autoimmune mwatsatanetsatane,
- kuchuluka kwa C-peptides kuli pansipa 0.6 nmol / l, komwe kukuwonetsa kuchepa kwa insulin,
- kuzindikiritsa kumawonetsa kukhalapo kwa magazi a zilembo za matenda a shuga omwe amadalira insulin 1 (HLA alleles). Kusanthula kotereku sikuchitika ndi malo onse ogwira ntchito, koma ndikofunikira pochotsa zovuta zotsutsana kuti mupeze mayesowo.
- mkhalidwewo umalipidwa pang'onopang'ono ndi mapiritsi ochepetsa shuga.
Magulu owopsa
matenda a shuga a lada amapezeka ndi pafupipafupi 2 mpaka 15% mwa odwala omwe ali ndi shuga 2 komanso onenepa kwambiri. Pa anthu odwala matenda ashuga amtunduwu ndi kulemera kwabwino, mtundu wa autoimmune umalembetsedwa pafupifupi 50% ya milandu.
Madokotala apanga njira zisanu zothandizira ngozi ya lada-matenda:
- zaka zopezeka matenda a matenda ashuga zafika zaka 50,
- pachimake koyamba nthawi yokhala ndi zizindikiro monga diuresis yopitilira malita awiri patsiku, ludzu losalekeza, kutsika kwakumvekera konse,
- kusowa kwa zizindikiro za kunenepa kwambiri,
- kukhalapo kwa vuto la autoimmune monga nyamakazi, Hashimoto thyroiditis, cardiomyopathy, vitiligo ndi zina zotero,
- kukhalapo kwa abale apamtima a matenda amtundu wotsimikiza mtima.
Ngati 1 mwa 5 mwa zizindikirozi wapezeka, ndiye kuti mwayi wodwala matenda obisika ungakhale m'dera la 1%. Pakakhala zizindikiro ziwiri kapena zingapo, kuthekera kumawonjezeka mpaka 90% ndipo madokotala amalimbikitsa kuti adziwe ngati ali ndi matendawa.
Gulu lomwe likuika pachiwopsezo chachikulu ndi azimayi omwe adadwala matenda ashuga panthawi yoyembekezera.
Matenda a shuga amawopa mankhwalawa, ngati moto!
Muyenera kungolemba ...
Matenda a shuga obisika sasiyanitsidwa ndi zizindikiro zapadera. Nthawi zambiri, amadziwonetsa yekha ndi chizindikiro chachiwiri cha matenda ashuga.
Koma powona kuti mitundu ya lada imangotanthauzira gawo loyambira, mawonetsedwe monga:
- kumangokhala wotopa
- kukhumudwa
- kupsinjika kwakanthawi,
- njala yosatha.
Komanso zichitike:
- Mavuto apakhungu - khungu ndi kuuma, kukhalapo kwa zilonda ndi zotupa,
- magazi m`kamwa ndi mano otayirira
- kuchuluka kwa shuga m'magazi kuchokera pa 5.6 mpaka 6.2 mmol / l,
- kukanika kwa erectile mwa amuna ndi kusowa kwa chilakolako chogonana mwa akazi,
- kuchepa kwa chidwi cha zala ndi madera ena khungu.
Zizindikiro zotere zimatha kukhala zopitilira zaka 5, kenako matenda a shuga obwera pambuyo pake amadwala.
Zizindikiro za matenda omwe apezeka pa nthawi yake zimawonjezera mwayi wopewa kufalikira. Kuchiza moyenera sikulola kuti mawonekedwe apangidwe akhale othandizira, komanso kuti achepetse kukula kwake.
Zizindikiro
Kuti mumvetse bwino za matenda omwe amamuganizira kuti ali ndi matenda am'mbuyomu, mitundu yotsatirayi yazogwiritsidwa ntchito,
- kuyezetsa magazi kwa ma antibodies kupita ku enzyme glutamate decarboxylase, yomwe imapangidwa ndi kapamba wa pancreas endocrine. Zotsatira zoyipa zimatanthawuza chiopsezo chochepa cha matenda a shuga anyamata,
- kusanthula kwa kuchuluka kwa C-peptides a kapamba. Ndi matenda abwinobwino a shuga, ndizochepera kuposa masiku onse.
Kuti mumvetse bwino za matendawa, gwiritsani ntchito:
- "prednisone" kuyesa, komwe kumakupatsani mwayi wololera glucose,
- kuyezetsa kwa Staub-Traugott, magazi akamamwa pamimba yopanda kanthu amayesedwa kwa maola angapo pogwiritsa ntchito kukonzanso ndi dextropur.
Chithandizo cha matenda am'mbuyomu
Chithandizo cha matenda a shuga a mellitus amatanthauza kukakamiza kwa insulin.
Kupititsa patsogolo kumvetsetsa kwa zotumphukira zopanga ndi minofu yake, mankhwala ochepetsa shuga m'mapiritsi angagwiritsidwe ntchito.
Kuphatikiza apo, glitazones ndi zotumphukira za Biguanide zimayikidwa.
Zowonjezera zofunikira pazamankhwala oyambira zidzakhala:
- kutsatira malamulo azakudya zomwe zimaphatikizapo zakudya zamagulu ochepa.
- zolimbitsa thupi mokhazikika.
Ndikofunikira kumvetsetsa kuti kwa iwo omwe ali ndi matenda a shuga a lada, ziletso zama secretojeni zimawonetsedwa zomwe zingalimbikitse kupanga kwake kwa insulin. Izi zingayambitse kufooka koyambirira kwa kapamba ndi kukula kwa kuchepa kwa insulin.
Kupewa
Kuti muchepetse chiopsezo chokhala ndi matenda ashuga, ndikofunikira kuchepetsa zomwe zimayambitsa matenda:
- kuwongolera thupi
- Nthawi ndi nthawi onani magazi anu. Izi ndizowona makamaka kwa anthu omwe ali ndi chifukwa choganiza kuti akupanga endocrine pathologies, chifukwa cha thanzi lawo kapena chibadwa chawo.
- Idyani pafupipafupi komanso moyenera, kupewa zakudya zambiri zamoto kwambiri,
- khalani ndi moyo wokangalika,
- khazikitsani chitetezo chamthupi pamulingo woyenera, osayiwala kutenga mavitamini olimbitsa chitetezo chokwanira.
Matenda abwinobwino a shuga ndivuto lalikulu kuposa momwe matimu a mtundu 1 ndi 2 amodzi amakhalira. Kungosamala thanzi lanu pokha ndi kumene kungathandize kuzizindikira m'nthawi yake komanso kuchita zonse zofunika kuti mukhale ndi moyo wautali komanso wachangu.
Kodi LADA imasiyana bwanji ndi matenda amitundu iwiri?
Ndi matenda aposachedwa a shuga, pakhoza kukhala zizindikilo zomwe nthawi zambiri zimakhalapo mu matenda a shuga a 2. Kuzindikira kwa munthu sikugwirizana ndi msinkhu, kunenepa kwambiri, nthawi zina kuyendetsa shuga m'magazi sikukupezeka pogwiritsa ntchito mankhwala wamba antidiabetes. Chowonetsera chachikulu ndi hyperglycemia, yomwe kwa miyezi ingapo kapena zaka zimathandiza kuthana bwino ndi chakudya chokhala ndi matenda obisika komanso mankhwala osokoneza bongo. Pokhudzana ndi maphunzirowa, LADA imadziwonetsa ngati mtundu 1 wa matenda a shuga, i.e. pakufunika jakisoni wa insulin. Chowonetsera china ndicho chizolowezi chokhala ndi ketoacidosis. Chifukwa chake, zizindikiro za mitundu yonse iwiri yamatenda zimawonekera.
Kodi ndimagulu ati omwe odwala matenda am'mbuyomu amachokera?
- Zaka zopitilira 35.
- Hyperglycemia yomwe ikubwera, ngakhale mutamwa mankhwala.
- Kukhalapo kwa matenda ena a autoimmune.
Chithandizo ndi chofanana ndi matenda a shuga 1. Maziko ndikukhazikika kwa kulemera kwa thupi, njira zopewera zakudya, kugwiritsa ntchito insulin.
Momwe mungakhalire mukulimbana ndi matenda a shuga LADA?
Vuto lina lathanzi la matendawa ndi ketoacidosis, yomwe imatha kupezeka mwa anthu omwe akhala akudwala kwa nthawi yayitali ndipo amadalira insulin. Kuopseza matenda a mtima ndi chimodzimodzi ndi matenda a mtundu 2.
Monga tafotokozera pamwambapa, chithandizo chimachitika ngati matenda amtundu 1: kukhazikika kwa thupi, zakudya, kugwiritsa ntchito insulin, matenda a hyperglycemia. Mwa anthu omwe ali ndi LADA, ndikofunikira kuwonetsetsa kuti maselo a beta amagwira ntchito kwanthawi yayitali.
LADA kuchokera kwa akatswiri
LADA mtundu wa shuga mellitus imatchulidwa ngati matenda a autoimmune, pathogenesis yomwe imatsindika makamaka kuchepa kwa insulin, kutengera kuwonongeka kwa maselo a beta a islets a Langerhans. Akuti kupita patsogolo kwa matenda a autoimmune kumakhudzidwanso ndi insulin. Itha kuganiziridwa kuti mwa anthu omwe sazindikira kwenikweni za mahomoni ofunikawa, kuchepa kwa kuchuluka kwa timadzi timeneti kumathandizira kuwonongeka kwa metabolic, komanso kumakhudza zaka zomwe matenda amayambika komanso kuchuluka kwa mawonekedwe.
M'mabuku apadera mulibe malipoti a ntchito yayikulu ya chipatala makamaka yokhudzana ndi ubale wa insulin komanso mtundu 1 wa matenda ashuga. Posachedwa, umboni wapezeka kuti anthu ena omwe ali ndi ma antibodies abwino motsutsana ndi ma cell a B (GADA, ICA) nawonso ali ndi kukana kwakukulu kwa insulin, malinga ndi index ya HOMA, yofanana ndi matenda a shuga a 2.Pofufuza anthu ambiri omwe amawawona m'mayesero akulu azachipatala (monga UKPDS), ndizotheka kuyesa kukhalapo kwa zinthu zomwe zimakhudzana ndi insulin. Zimavomerezedwa kuti kupezeka kwa autoantibodies yokhala ndi islet autoimmunity (GADA, ICA, IAA) kumalumikizana ndi zaka zazing'ono panthawi yodziwitsa, index yotsika ya thupi komanso kuchepa kwa ntchito ya B-cell.
Mu kafukufuku wa UKPDS, kuchuluka kwa kuchuluka kwa ma autoantibodies ICA, GADA mwa odwala omwe angopezeka kumene, ofotokozedwa ngati nambala yocheperako, amatsika ndi msinkhu, koma kuchuluka kwathunthu kwa odwala omwe ali ndi matenda a shuga omwe ali ndi gawo la zaka 25 25 ndi 55- Zaka 65 ndizofanana. Iyenera kukumbukiridwa kuti kuchepa kwa insulin kumachepa ndi zaka, komanso kutengera zamtundu komanso zinthu zakunja zomwe zimayambitsa kukana kwa mahomoni ndizofala kwambiri m'chilengedwe chathu. Zogwirizana ndi mawuwa ndikuti kufananiza kwa BMI mwa odwala matenda ashuga monga LADA ndi anthu omwe alibe matenda ashuga sikuwonetsa kusiyana kwakukulu. Kuchokera pazomwe tafotokozazi, titha kunena kuti odwala matenda ashuga monga LADA atha kufotokoza kwambiri insulin, yomwe imagwira ntchito yayikulu pakukula kwa matendawa.
Kutalika ndi kuopsa kwa chikhululukiro cha matenda kwa odwala omwe ali ndi vuto la matenda a shuga 1 amachitika chifukwa chotsalira cha insulin ndikudziwonetsa kukana kwake. Cholinga cha chithandizo cha matendawa ndicho kuchuluka kwa nthawi yayitali yosungidwa kwa insulin, yomwe ndiyofunikira pakulamulira kwa kagayidwe kachakudya ndikuchedwetsa zovuta za matendawa. Ubale pakati pa kayendedwe ka metabolic ndi zochita za autoimmune mumalo ampata a Langerhans akuti. M'malo momwe maselo a B amakhudzidwa kwambiri, mwachitsanzo, ndi hyperglycemia, amawonetsa ma antigen ambiri pamtundu wawo motero, chiwonongeko cha autoimmune chimachitika kwambiri. M'malo mwake, chitetezo cha insulin mwa odwala matenda ashuga omwe ali ndi zotsimikizira antibodies (GADA, ICA) akuwonetsedwa. Vutoli limafotokozedwa osati pongowongolera zochitika za kagayidwe kake (kukonza Hyperglycemia ndi ketoacidosis), komanso mphamvu ya insulin, komanso kuchuluka kwa insulin. Pokhudzana ndi kukana kwa insulin, odwala matenda ashuga omwe ali ndi antibodies abwino, makamaka anthu onenepa kwambiri, angaganize kuphatikizapo zinthu zomwe zimasintha insulin (Glitazones, Metformin) ndi algorithm yokhudza matenda a shuga a mtundu wa LADA.
Pomaliza
M'mabuku apadera, shuga imaperekedwa ngati matenda a metabolic omwe amadziwika ndi hyperglycemia, yomwe imayamba chifukwa chakuchepa kwa kupanga kwa insulin, mphamvu zake zosakwanira m'thupi, kapena kuphatikiza kwa magawo onse awiri.
Kutsutsa kwa insulini komanso kuchepa kwa chinsinsi chake kungachititse wina ndi mnzake, komanso kumathandizira kukula kwa autoimmune insulin.
Chimodzi mwa zolinga za diabetesology zamakono ndizokhazikika pa mayeso osavuta kuchipatala ndi ma labotale omwe cholinga chake chizindikiritse anthu omwe ali ndi matenda a shuga a LADA, makamaka omwe ali ndi insulin. Pofuna kupewa (kuchedwetsa kukula kwa zovuta za matendawa) mwa anthuwa kuchokera nthawi yomwe amadziwika, chithandizo cha insulin chimasonyezedwa, chowonjezera ndi mankhwala omwe amakhudza insulin.