Uacute, kusakwanira kwa zotsatira za insulin ndi yachilendo kapena ngakhale kuchuluka kwa madzi am'magazi

Etiology ya matenda ashuga

DM imayamba chifukwa cha kuchepa kwa insulin (IDDM) kapena kuchepa kwa zotsatira zake (NIDDM).

Zoyambitsa matenda a shuga

Kufupika kwenikweni kwa insulini (kuperewera kwenikweni kwa insulin).Zimachitika mothandizidwa ndi zinthu zachilengedwe, mankhwala, chilengedwe, komanso kutupa kwa kapamba

Zachilengedwe

· Zofooka zamtundu b-cell zisumbu Khothi. Pali kutsimikizika kutchulidwa kwa kuchuluka kwa hypoinsulinism mwa odwala omwe ali ndi IDDM pakufotokozedwa kwa antigen ena a HLA. Izi zikuphatikiza ndi glycoprotein omwe atsekedwa ndi ma Hles - DR3, HLA - DR4, HLA - DQ, B1. Zofooka za genetic zimayambitsa kuphatikizidwa kwa chitetezo cha autoaggress pancreatic kuwonongeka kwa machitidwe (chifukwa cha mawonekedwe a autoantigens mlendo ku chitetezo cha mthupi) komanso kuchepa kwa kaphatikizidwe ka insulin (mwachitsanzo, mukamazunza majini omwe amalemba ma insulin synthesis enzymes).

· Zinthu zoyipa. Ig, cytotoxic T-lymphocyte, komanso ma cytokines opangidwa ndi iwo, amatha kuwononga maselo a b ndikuyambitsa zochitika zokhudzana ndi chitetezo cha mthupi.

Odwala omwe ali ndi vuto la insulin, mitundu ingapo ya ma antibodies ena amapezeka: cytoplasmic hypertension - ISA (kuchokera ku Chingerezi. islet cell autoantibody - autoantibodies to islet cell protein), kupuloteni yokhala ndi maselo a 64 kD, yomwe imapezeka mu nembanemba ya cytoplasmic ya ma b-cell. Ma antibodies amenewa nthawi zambiri amapezeka zizindikiro zina za matenda ashuga zisanachitike. Motere, ali m'gulu loyambitsa zomwe zimapangitsa kuti chitetezo cha anti-b-cell chikule, komanso mamolekyulu a insulin omwe.

· Ma virustropic to b-cell: Coxsackie B₄, chiwindi, chikuku, nthomba, mumps, rubella ndi ena. Mwachitsanzo, ndi intrauterine rubella, shuga amayamba pafupifupi 20% ya akhanda. Ma virus amenewa amayambitsa cytolytic mwachindunji pa ma b-cell, kukhazikitsidwa kwa chitetezo cha mthupi motsutsana ndi ma b-cell komanso kukula kwa kutupa m'malo a b-cell a Langerhans islets - insulitis.

· Zinthu zapoizonikuwononga ma cell. "Wopusa" kwambiri mwa iwo ndi alloxan. Amapangidwa mopambanitsa chifukwa chophwanya pyrimidine metabolism ndikuletsa mapangidwe a insulin. Zotsirizirazi zimagwirizanitsidwa ndi zomwe zili ndi magulu a SH-(ofunikira kutulutsa alloxan) mu ma b-cell.

Zokhudza mankhwala

Alloxan adatsimikizika Ã Mlingo waukulu wa ethanol, cytostatics ndi mankhwala ena (mwachitsanzo, mankhwala a antitumor streptozocin Ã ) kukhala ndi luso lotha kuyambitsa matenda ashuga.

Zinthu zakuthupi

Amadziwika kuti kuwonetsa ma radiation yolowa (kuyambitsa mphamvu ya lipid peroxide), kuvulala kwamakina kupita kwa kapamba, ndipo kuponderezedwa ndi chotupa chake nthawi zambiri kumayambitsa matenda a shuga chifukwa cha kufa kwa maselo a b.

Njira zotupa

Pancreatitis yovuta komanso yosatha pafupifupi 30% ya milandu ya matenda ashuga ndi omwe amachititsa kuti insulini itayike.

Kuperewera kwa insulin chifukwa (kuchepa kwa insulin) amakula mothandizidwa ndi zifukwa za neuro- kapena psychogenic, contra-factor, komanso chifukwa cha zolakwika mu insulin receptors ndi post-receptor discs mu maselo chandamale (mkuyu. 9-7).

Masanjidwe! ikani chithunzi "fig-9-7"

Mkuyu. 9-7. Zimayambitsa hypoinsulinism wachibale.

Zomwe zimayambitsa kwambiri matenda oopsa a hypoinsulinism ndi izi:

· Neuro ndi / kapena psychogenic zinthu. Izi zimazindikira mphamvu zawo kudzera mwa kutseguka kwa ma neuroni a nyukiliya ya posterior hypothalamus, komwe kumabweretsa kuwonjezeka kwa kamvekedwe ka machitidwe omvera a adrenal ndi hypothalamic-pituitary-adrenal. Izi zimabweretsa kuwonjezeka kwakukulu komanso kosalekeza kwakumapeto kwa ma mahomoni ophatikizika a m'magazi: adrenaline, norepinephrine (adrenal chiyambi), glucocorticoids ndipo, chifukwa chake, kusakwanira kwa zotsatira za insulin, komanso kukonzanso kwa protracted reaction reaction. Amayambitsa kutseguka kwa ma adrenal ndi hypothalamic-pituitary-adrenal, omwe amachititsa kuti magazi azikhala ndi ma catecholamines, "glucocorticoids", ma glucocorticoids, mahomoni a chithokomiro.

· Othandizira othandizira. Othandizira othandizira ena akuphatikizira izi:

mu Kuchulukitsa kwa hepatocyte insulinase, proteinase hydrolyzes insulin.

into Ig to endo native insulin.

mu Kuchulukitsa kwa kuchuluka kwa mahomoni otsutsana a hyperglycemic: makatekolama, glucagon, glucocorticoids, STH, T₃, T₄, (Hyperproduction wa mahormone awa amatha kuwonetsedwa ndi zotupa za zotengera za endocrine zogwirizana kapena kupsinjika kwanthawi yayitali).

mu Kuchuluka kwa plasma ndende za mapuloteni omwe amamanga mamolekyulu a insulin.

· Zinthu zomwe zimayambitsa blockade, chiwonongeko, kapena kuchepa kwa chidwi cha insulin receptors.

Izi zimaperekedwa ndi:

mu Ig imalinganiza kapangidwe ka molekyulu ya insulin. Amalumikizana ndi ma insulin receptors, kuwaletsa, motero kutsekereza ma cell a insulin kupita ku receptor.

mu Ig, kuwononga insulin receptors ndi / kapena peri-receptor zone ya chandamale chandamale.

à Wowonjezera insulin, yomwe imayambitsa kukhudzika kwa maselo olimbana ndi mahomoni.

mu Hydrolases yotulutsidwa kuchokera ku lysosomes ndikuyika mkati ndi kunja kwa maselo owonongeka kapena owonongeka (mwachitsanzo, ndi hypoxia, kupuma komanso kusokonezeka kwa magazi).

mu ma radicals aulere ndi zinthu za SPOL (mwachitsanzo, ndi kupsinjika kwanthawi yayitali, atherosclerosis, kulephera kwamtima).

· Magenge omwe amasokoneza zotsatira za insulin m'maselo a chandamale. Kukula kwakukulu, awa ndi othandizira omwe amawononga ma membala ndi / kapena maselo a cell a insulini, komanso owonjezera ndi / kapena kuwononga ma enzymes a ma cell. Kuchulukitsa kwa ma enzymes a lysosomal, kupangika kwakukulu kwa mitundu ya okosijeni, ma radicals aulere, ndi lipid hydroperoxides imatha kukhala chitsanzo cha zomwe zimapangitsa kuwonongeka kwa nembanemba ndi ma enzymes am'melo. Izi ndi zina zothandizira tizilombo toyambitsa matenda zimalepheretsa kutulutsa kwa glucose m'maselo, mapangidwe a cAMP, kusamutsidwa kwa transmembrane kwa Ca 2+ ndi Mg 2+ ions, zomwe ndizofunikira kuti muzindikire zovuta za insulin.

Zowopsa za Matenda A shuga

Chiwopsezo chachikulu cha matenda ashuga chimadziwika. Izi ndizofunikira kwambiri kuchipatala:

Ú onenepa kwambiri. Kunenepa kwambiri kumapezeka mwaoposa 80% ya odwala omwe ali ndi NIDDM. Izi zimawonjezera kukana kwa insulini, adipose ndi zina zofunika za insulin,

Ú kulimbikira ndi chidwi hyperlipidemia. Zinthu zonsezi zimathandizira kupanga mahomoni olimbana ndi mahomoni am'magazi komanso hyperglycemia. Izi, zimayambitsa kapangidwe ka insulin ndi ma cell a cell, zomwe zimatsogolera "kufooka" kwawo ndikuwonongeka,

Ú matenda oopsa oopsa, zomwe zimayambitsa kuphwanya kwamphamvu kwa kapamba,

- kubadwa mwatsopano kapena kubadwa mwatsopano. Mitundu ya HLA imakhulupirira kuti imakonzedweratu kwa odwala omwe ali ndi matenda a shuga. Odwala omwe ali ndi NIDDM, chiyembekezo cha matenda a shuga ndi polygenic. Pamaso pa matenda a shuga m'modzi mwa makolo, kuchuluka kwa ana awo odwala kukhala athanzi kungakhale 1: 1,

Ú mobwerezabwereza nkhawa. Zimaphatikizidwa ndi kuwonjezereka kosalekeza kwamisempha yamagazi otsutsana.

Kuphatikizidwa kwa zinthu zingapo zoopsa zomwe zatchulidwazi pamwambapa kumawonjezera mwayi wa matenda ashuga nthawi 20-30.

Pathogenesis wa matenda ashuga

Maziko a pathogenesis a shuga mellitus mwina ali mtheradi wa insulin (momwe IDDM imayamba) kapena kusakwanira kwa insulin zotsatira (zomwe zimatsogolera ku NIDDM).

Pathogenesis wa matenda ashuga chifukwa cha kuperewera kwa insulin kwathunthu (kuperewera kwa insulin kwathunthu)

Maulalo apamwamba mu pathogenesis a insulin insulin akusowa akuwonetsedwa mu Chithunzi 9-8.

Masanjidwe! ikani chithunzi "mpunga-9-8"

Mkuyu. 9-8. Maulalo apamwamba mu pathogenesis a insulin.

Nthawi zambiri (mwina ngakhale mu zonse), pathogenesis yokhala ndi insulin yokwanira ili ndi cholumikizira chofala: immune autoaggress process(Mkuyu. 9-9). Njira yowonongera pang'onopang'ono ya zikondamoyo nthawi zambiri imatha zaka zingapo ndipo imayendera limodzi ndi kuwonongeka pang'onopang'ono kwa ma cell a b.

Zizindikiro za matenda ashuga, monga lamulo, zimawonekera pomwe pafupifupi 75-80% ya ma b-cell yawonongeka (amatha kuwunika kale pazinthu zosiyanasiyana "zopsetsa" - matenda, kuledzera, kupsinjika, kusokonezeka kwa kagayidwe kazakudya, kudya kwambiri, ndi ma endocrinopathies ena). 20-25% yotsala yamaselo nthawi zambiri imawonongedwa pazaka zitatu zotsatirazi.

Odwala omwe amwalira ndi matenda a shuga, kulemera kwa kapamba kumakhala pafupifupi 40 g (80-85 g ndikwabwinobwino). Poterepa, kuchuluka kwa ma cell (mwa anthu athanzi pafupifupi 850 mg) sikungachitike kapena sizikudziwika.

Masanjidwe! ikani chithunzi "mpunga-9-9"

Mkuyu. 9-9. Maulalo apamwamba a immune autoaggressive pathogenesis a shuga mellitus.

Maulalo otsatirawa ndi amodzi mwa omwe amalumikizana kwambiri pakupanga mtundu wa matenda ashuga othamanga: (onani mkuyu. 9-9):

Ú kuyambitsa mu thupikutengera kwa chibadwa cha anthu Alien Ag chonyamula. Nthawi zambiri awa ndi ma virus, ma tizilombo tina ochepa,

Ú mankhwala achilendo achilendo maselo othandizira antigen, kukonza chonyamulira cha antigen ndikuchiwonetsera limodzi ndi HLA matenda oopsa (chiwonetsero) othandizira T-lymphocyte,

Ú mapangidwe enieni a antibodies ndi ma activate a lymphocyte motsutsana matenda achilendo,

Ú mphamvu ya ma antibodies ndi ma activate a lymphocyte achilendo matenda oopsa(ndi chiwonongeko chake ndikuchotsedwa kwa thupi limodzi ndi ma phagocytes), komanso zida za antigenicb-mawuokhala ndi mawonekedwe ofanana ndi achilendo achilendo. Yerekezani kuti mapuloteni okhala ndi kulemera kwa 64 kD akhoza kukhala matenda amtundu wofanana ndi achilendo. Maselo okhala ndi AH oterewa amakhudzidwa ndi njira ya IHD ya thupi, yomwe imawawona kuti ndi achilendo. Vutoli limatchedwa "kuyankha kwamthupi." Pazochita izi, ma cell a b amawonongeka, ndipo mapuloteni amodzi amawonongeka ndikukhala autoantigenic,

Ú mayamwidwe, kukonza, ndi kufotokozera kwa ma lymphocyte a matenda achilendo akunja komanso kupanga ma cell a cell a cell omwe apangidwa kumene ndi monocytes / macrophages. Njira yodzitetezera kumatenda oteteza kumatenda imatha kuphatikizika ndi kaphatikizidwe ndikusunthira kupita kumaselo owonongeka a maselo oopsa a HLA I ndi II. Izi AH zimalimbikitsa othandizira T-lymphocyte ndipo, monga chotsatira, kupanga enieni Ig ndi kusiyanitsa kwa cytotoxic T-lymphocyte. Motere, kufalikira kwamphamvu pakulimbana ndi ma cell a B kukukulira. Kukula kwa zowonongeka kwa zida za islet kumakulanso.

Ú kusamukira kumadera owonongeka ndi ma b-cell a kapamba a phagocytes. Amawononga ma cell a b-limodzi ndi michere ya lysosome, mitundu ya okosijeni yokhala ndi okosijeni ndi lipid peroxides, ma radicals aulere a organic, cytokines (mwachitsanzo TNF-a, IL1),

Ú kumasulidwa kwa mapuloteni "achilendo" kuma cell owonongeka a chitetezo cha mthupi(nthawi zambiri amangokhala okhudzika ndipo salowa m'magazi): kutentha kutentha, cytoplasmic gangliosides, proinsulin,

Ú macrophage akuti of cytoplasmic proteinb-milingo, kukonza kwawo ndi kuwonetsa kwa ma lymphocyte. Izi zimayambitsa gawo lotsatira (komanso mobwerezabwereza) lachiwopsezo cha chitetezo cha mthupi ndikuwonongeka kwa kuchuluka kwama cell a b. Ndi kuchepa kwa kuchuluka kwawo kufika pa 75-80% yabwinobwino, zizindikiro zamatenda a "mwadzidzidzi" zimawonekera.

Zizindikiro za kukhazikitsa chitetezo chamthupi mokhudzana ndi ma b-cell zitha kutha pakapita nthawi. Momwe ma cell a b akamwalira, chidwi chomwe chimapangitsa kuti chitetezo chamthupi chidale. Chifukwa chake, mulingo wa ma antibodies mpaka matenda oopsa a b-cell amachepetsa kwambiri pambuyo pa 1-1,5 g atazindikira koyamba.

The pathogenesis ya insulin kuchepa kwathunthu chifukwa cha mankhwalachikuwonetsedwa mu Chithunzi 9-10.

Masanjidwe! ikani chithunzi "mpunga-9-10"

Mkuyu. 9-10. Maulalo apamwamba mu pathogenesis a shuga mellitus mothandizidwa ndi mankhwala pancreatotropic othandizira.

Limagwirira kukula kwa mtheradi insulin akusowa chifukwa cha zinthu zakuthupichikuwonetsedwa mu Chithunzi 9-11.

Masanjidwe! ikani chithunzi "mpunga-9-11"

Mkuyu. 9-11. Maulalo apamwamba a pathogenesis a shuga mellitus pansi pa zochita za pathogenic.

Pathogenesis ya shuga chifukwa cha kuperewera kwa zotsatira za insulin (kuchepa kwa insulin)

Kukula kwa matenda ashuga chifukwa cha kuperewera kwa zotsatira za insulin kumachitika munthawi yabwinobwino kapenanso kuwonjezeka kwa maselo a B ndikudziwikanso kwake m'magazi (zosiyanazi za shuga zimatchedwa NIDDM).

Zomwe zimayambitsa kuchepa kwa insulin wachibale ndizotsatirazi..

· Zotsatira zake.

à Insulinase. Zomwe zimapangitsa kuti insulinase ikhale yochulukirapo ikhoza kukhala kuwonjezeka kwa glucocorticoids ndi / kapena STH (yomwe imakonda kuwonetsedwa kwa odwala omwe ali ndi matenda ashuga), komanso kuchepa kwa zinc ndi ayoni amkuwa, omwe nthawi zambiri amachepetsa ntchito ya insulinase. Poganizira kuti insulinase imayamba kupangika kwambiri ndi hepatocytes mu unamwali, njira iyi ndi imodzi mwamalumikizidwe ofunika kwambiri mu matenda a matenda a shuga a ana.

à Mapuloteni a Proteolytic. Amatha kubwera kuchokera ku chinangwa chachikulu cha kutupa ndi kuwononga insulin (mwachitsanzo, ndi phlegmon, peritonitis, matenda a kutentha kwa moto).

à Ma antibodies kupita ku insulin ngati mapuloteni.

à Zinthu zomwe zimamanga ma molekyulu a insulin ndipo potero, kutseka kwake kuyanjana ndi ma receptors. Zimaphatikizapo plasma insulin zoletsa chikhalidwe cha mapuloteni (mwachitsanzo, tizigawo ta ma globulins) komanso b-lipoproteins. Insulin yolumikizidwa ndi mapuloteni a plasma sikuwonetsa ntchito zake m'matumbo onse, kupatula minofu yamafuta. Mapeto ake, zinthu zimapangidwa kuti molekyulu ya protein ikhale yolumikizika komanso yolumikizana ndi insulin. Kuphatikizika kwa b-LP mu kuchuluka kwakukulu kumawonedwa mwa odwala omwe ali ndi hyperproduction ya STH. b-LPs amapanga maselo akuluakulu ndi insulin, momwe insulin imalephera kuyanjana ndi receptor yake.

· Chotsani kapena chepetsani zovuta za insulin pazinthu zomwe mukufuna. Kuthetsa kapena kuchepetsa zotsatira za insulin pazomwe tikufuna kupezedwa zimachitika chifukwa cha kuchuluka kwa mphamvu ya mahospital - metabolism okonda insulin. Izi zimaphatikizapo catecholamines, glucagon, glucocorticoids, STH ndi mahomoni okhala ndi chithokomiro. Hyperglycemia yomwe imakhala nthawi yayitali komanso yofunikira imapangitsa kuti insulin ipangidwe kwambiri. Komabe, izi sizingakhale zokwanira kutulutsa HPA, monga yaitali hyperactivation of pancreatic islets imabweretsa kuwonongeka kwa ma b-cell.

· Kuchulukana kwa insulin. Kukana kwa insulini kumadziwika ndi kusokonezeka kwamavuto a insulin pamlingo wama cell omwe akufuna. Njira zolandirira ndi postreceptor pazinthuzi zimalongosoledwa.

à Receptor njira zopangira kuchuluka kwa insulin.

Ä "Kujambula" (kutseka) kwa insulin zolandila ndi ma antibodies kwa iwo. Zotsirizirazo zimachita makamaka ndi mapuloteni a ma receptor okha ndi / kapena perireceptor zone. Mwanjira imeneyi, ma mamolekyulu a Ig amapangitsa kuti asamayanjane ndi insulin ndi receptor yake.

Ä Hyposensitization ya maselo chandamale insulin. Amayamba chifukwa cha kuchuluka kwa nthawi yayitali m'magazi a insulin m'magazi komanso mu interstitium.Hyposensitization ya maselo ndi chifukwa cha kuchuluka kwa insulin receptors otsika kumtunda kwa cell ndi / kapena kuchepa kwa chiwerengero chonse cha insulin receptors. Nthawi zambiri, zimawonedwa mwa anthu omwe akudwala kwambiri, zomwe zimayambitsa matenda a insulin.

Ä Chiwonongeko ndi / kapena kusintha kwa mapangidwe a receptors insulin Izi zikuchitika machitidwe a antieceptor antibodies (wopangidwa ndi kusintha kwamapangidwe a receptor, mwachitsanzo, chifukwa chodziphatika nacho mwanjira ya mankhwala kapena poizoni, Kupangidwa kowonjezera kwaulemu wama radicals ndi lipoperoxide mankhwala pa hypoxiakusowa kwa antioxidants - tocopherols, ascorbic acid, etc., zolakwika zamtunduencoding synthesis wa insulin receptor polypeptides.

à Njira zopangira pambuyo polandirira mapangidwe a kuchuluka kwa insulin.

Ä Phosphorylation wa kuphwanya kwa mapuloteni a kinase ya maselo, yomwe imasokoneza ma intracellular process of glucose metabolism.

Ä Kukhalapo kwa zolakwika m'mayendedwe a transmembrane glucose mu maselo aku chandamale. Matenda a shuga a transmembrane amakhudzika amapezeka mwa odwala omwe ali ndi shuga limodzi ndi kunenepa kwambiri.

Mawonekedwe a shuga

Matenda a shuga amawonekera m'magulu awiri a zovuta zokhudzana:

Ú kagayidwe kachakudya matenda. Ndikofunika kukumbukira kuti odwala matenda ashuga amawonetsa kukhumudwa mitundu yonse ya kagayidwe, osati chakudya chokha, monga dzina lake likunenera,

Ú matenda a zimakhala, ziwalo, machitidwe awo. Zonsezi ndi zina zimabweretsa chisokonezo cha ntchito yofunika yonse.

Mavuto amtundu wa shuga

Zovuta zazikulu za metabolic mu shuga zimawonetsedwa pa Chithunzi 9-12.

Masanjidwe! ikani chithunzi "mpunga-9-12"

Mkuyu. 9-12. Kuwonetsera kwakukulu kwa zovuta zama metabolic mu shuga.

Tsiku Lomwe Likuwonjezeka: 2016-11-24, Views: 685 | Kuphwanya lamulo laumwini

Kodi chimayambitsa kusowa kwa mahomoni m'thupi ndi chiyani?

Chizindikiro chachikulu cha kuchepa kwa insulin m'thupi ndi kuchuluka kwa shuga m'magazi. Zimadziwonetsera yokha mwa mawonekedwe osiyanasiyana. Zizindikiro zazikulu za kuchepa kwa insulin m'thupi ndi:

kukodza pafupipafupi
ludzu losalekeza
kugona kusokonezedwa
kusakwiya popanda chifukwa
kuchuluka kukwiya.

Dziwani kuti insulini imapangitsa kuti maselo azikhala ndi glucose ambiri. Zotsatira zake, kupanga kwa glycogen polysaccharide kumawonjezereka, ndiyo njira yayikulu yosungiramo zinthu zonse zomwe zimapezeka m'magulu a glucose.

Muyenera kumvetsetsa kuti kuchepa kwa insulin kumachitika chifukwa chosakwanira kupanga mahomoni awa. Pali mitundu iwiri yayikulu ya kusakwanira. Iliyonse yaiwo idzafotokozeredwe mwatsatanetsatane pansipa. Ndikofunikira kumvetsetsa kuti mtundu uliwonse wa matenda ashuga, kuperewera kwa mahomoni ake amadziwika. Tiyerekeze, pozindikira matenda a shuga oyambira digiri yoyamba, kupezeka kwa kuperewera kwathunthu kumadziwika. Pankhaniyi, simungachite popanda jakisoni wa timadzi timeneti.

Pambuyo pa kuperewera kwa insulin kwathunthu, ndizosatheka kubwezeretsa zachilengedwe pakupanga insulin. Odwala amapereka jakisoni wa analogue ya mahomoni, ndipo amasinthana ndi jakisoni wokhazikika.

Pozindikira, ndikofunikira kutsatira kadyedwe koyenera ndikuyamba kukhala ndi moyo wathanzi.

Mitundu ya Insulin Defence

Monga tafotokozera pamwambapa, pali mitundu ingapo ya kulephera:

kapamba
osati kapamba.

Poyambirira, imayamba chifukwa cha kusintha kwina komwe kumachitika mu kapamba, m'maselo ake. Pachiwonetsero chachiwiri, kusayenda bwino kwa kapamba sikungatengedwe ngati komwe kumayambitsa matendawa.

Mwachizolowezi, mtundu wachiwiri wa kusowa mphamvu umawonedwa mwa odwala omwe ali ndi matenda a shuga a 2. Mu shuga mellitus wamtundu wachiwiri, sikofunikira kukhazikitsa mtundu wowonjezera wa insulin mthupi, kapamba amapanga kuchuluka kokwanira. Ndi mtundu wopanda inshuwaransi wakusowa kwa insulin, mikhalidwe imachitika nthawi zambiri pamene insulin ya mahomoni imasungidwa kwambiri, koma maselo ndi minyewa sizizindikira bwino.

Kuperewera kwa kapamba kumachitika chifukwa cha kusintha kwina kwa ma cell a beta a gland, zomwe zimapangitsa kuti ma cell amenewa amalepheretse kuphatikiza kwa mahomoni kapena amachepetsa kwambiri. Kusintha kwachilengedwe mu maselo a ma cell a beta ndizomwe zimayambitsa kukula kwa mtundu wa 1 shuga mellitus mwa anthu, omwe amadalira insulin.

Kuperewera kwenikweni kwa insulin kumapezeka mu mtundu woyamba wa shuga, ndipo kuchepa kwa insulin komwe kumachitika nthawi zambiri kumapezeka mwa odwala omwe ali ndi matenda a shuga a mtundu wachiwiri.

Kodi zazikulu zomwe zimayambitsa matendawa ndi ziti?

Zikuwonekeratu kuti kusintha kotereku sikumachitika. Izi zimatsogozedwa ndi kusintha komwe kumachitika mthupi la munthu aliyense. Kutengera izi, chifukwa cha chitukuko cha insulin iliyonse chimawerengedwa kuti ndi:

Khalidwe loipa, makamaka ngati panali achibale m'banjamo omwe ali ndi matenda a shuga.
Njira iliyonse yotupa mu kapamba kapena chikhodzodzo.
Mitundu yonse yovulala kwapancreatic, mwachitsanzo, ntchito iliyonse pa chiwalo ichi.
Kusintha kwa ziwisi m'matayala, kumayambitsa kuphwanya kwa magazi ndipo kungayambitse vuto mu chiwalocho.
Zoterezi zimatha kuchitika chifukwa cha kapangidwe kosayenera ka michere.
Vuto linanso lalikulu lomwe lingakhale matenda aliwonse, lomwe limapangitsa kufooka kwamphamvu kwa chitetezo chathupi.
Tisaiwale kuti kupsinjika konse kapena kusokonezeka kwamanjenje kungapangitse kukula kwa insulin m'thupi.
Kuchita zolimbitsa thupi kwambiri,, kapena, kusintha kwakuthwa pa moyo wokhalitsa.
Kupanikizika kulikonse mu kapamba kumapangitsanso kukula kwa chizindikiro.

Ndikofunika kumvetsetsa kuti ngati zinc ndi mapuloteni sakwanira mthupi, koma chitsulo, m'malo mwake, ndicochulukirapo, ndiye kuti zimachitika ngati kulibe insulin yokwanira. Izi zikufotokozedwa mophweka, mfundo yonse ndiyakuti zinc, komanso zinthu zina zingapo, zimathandizira kuti insulini igwere m'magazi, komanso kayendedwe koyenera kupita ku magazi. Ngati ndi ochepa kwambiri m'thupi, ndiye kuti zikuonekeratu kuti pali kuchepa kwa insulini kapena sikulowa m'magazi ndipo sikukwaniritsa ntchito zake.

Ngati timalankhula za chitsulo, ndiye kuti zochuluka kwambiri mthupi sizabwino kwambiri pakubadwa ndi thanzi. Chowonadi ndichakuti ili ndi mtolo wowonjezera pa thupi. Zotsatira zake, pali kuchepa kwa kapangidwe ka insulin.

Thupi, mwachidziwikire, silileka kudzipatula kwathunthu, koma sikokwanira kuonetsetsa kuti njira zonse zimachitika pamlingo woyenera.

Zizindikiro za Insulin Defence

Pali chizindikiro chimodzi chofunikira kwambiri chomwe chikusonyeza kuti wodwala ali ndi vuto la insulin. Izi, zachidziwikire, ndi mseru wokwezeka wa glucose. Mwanjira ina, matendawa amatchedwa hyperglycemia. Choyipa chachikulu ndikuti chizindikiro ichi chimadziwonekera ngakhale gawo la matenda a shuga lili pamlingo womwe jakisoni wa insulin sangathe kuchita.

Ngakhale pali zizindikiro zina zomwe zimanenanso kuti munthu alibe insulini mwachidziwikire. Zizindikiro zake ndi:

Kukoka pafupipafupi kwambiri, ngakhale usiku kukakamira sikumatha.
Kumva ludzu pafupipafupi, tsiku lomwe wodwalayo amatha kumwa mpaka malita atatu amadzi.
Kuwonongeka kwa khungu.
Kusankha pang'ono.
Zowonongeka.
Kutupa kwa malekezero.
Kuchiritsa mabala koopsa m'thupi.

Ndikofunika kumvetsetsa kuti ngati simutayamba kulandira chithandizo munthawi yake, ndiye kuti pakhoza kukhala chiwopsezo cha matenda a shuga. Amadziwika ndi odwala omwe ali ndi matenda a shuga 1 ndipo samatenga jakisoni wa anulin.

Kuti mupewe izi, ndikokwanira kupimidwa ku endocrinologist wam'deralo, komanso kuyeza kuchuluka kwa shuga m'magazi.

Ngati akuyamba kupita pamlingo, ndiko kuti, ali pa mulingo wa mamililita 10 kapena kuposerapo, ndiye kuti akuyenera kuyambanso ntchito.

Chifukwa chiyani kusowa kwa insulin kumachitika?

Chifukwa choyamba chomwe kuperewera kwa insulin kumawonedwa ndikuphwanya njira za metabolic m'thupi. Odwala ambiri amakhala ndi chibadwa chokhala ndi cholakwika choterocho, ndipo, amakhalanso ndi moyo wosayenera. Zotsatira zake, matenda a shuga amakula.

Zifukwa zazikulu zomwe kusowa kwa insulin kumayambira kupanga ndi izi:

Chakudya chochuluka chomwe chimadzaza ndi chakudya.
Pomwe dotolo adapereka mankhwala omwe amachepetsa shuga, ndipo wodwalayo atayiwala kumwa, hyperglycemia imatha kuchitika.
Kupsinjika
Kuzunza.
Njira zotupa zotumphukira ndi matenda ena.

Ndikofunika kudziwa zomwe zingachitike ngati simutayamba kulandira chithandizo munthawi yake. Chimodzi mwazotsatira zazikulu zimawonedwa kuti ndikomanso. Koma palinso zinthu zina zoyipa zomwe zingachitike, mwachitsanzo, ketoacidosis. Poterepa, acetone yochulukirapo mu mkodzo imakhazikika.

Tiyeneranso kudziwa kuti zofananazo zimatha kupezekanso mwa ana. Ndi ana okha omwe amakumana ndi zovuta izi. Izi ndichifukwa choti, mosiyana ndi achikulire, sangathe kudzilamulira pawokha mthupi lawo, samvetsetsa zomwe zimachitika, chifukwa chake atha kuphonya zina zodziwika bwino za matenda ashuga a mtundu wa 2.

Nthawi zonse muzikumbukira kuti ngozi zitha kuchitika nthawi iliyonse ngati mwana ali ndi shuga 6.6 mmol / l musanadye kapena 8.9 mutadya.

Makamaka ayenera kuyang'aniridwa thanzi la ana omwe adwala matenda osiyanasiyana opatsirana kapena ngati kulemera kwa mwana pobadwa sikunaposa kilogalamu imodzi ndi theka.

Ngati vutoli likufika povuta kwambiri, ndiye kuti zotupa mu ubongo kapena zovuta za edema zitha kujambulidwa. Ichi ndichifukwa chake kholo limayenera kuphunzitsa mwana kuwunika zakudya zawo komanso kum'pangira masewera olimbitsa thupi, komanso zakudya zoyenera.

Zomwe muyenera kudziwa mukazindikira hyperglycemia?

Monga tafotokozera pamwambapa, kuchepa kwa insulin m'thupi kumabweretsa kuti shuga wamagazi amawonjezeka kangapo. Potengera izi, hyperglycemia imatha kuchitika. Ndipo iye, monga mukudziwa, amayamba kugonja.

Koma, mwa zinthu zina, hyperglycemia imathandizanso kuti madzi owonjezera omwe amapezeka m'thupi amalowa m'mitsempha mwachindunji kuchokera ku zimakhala.

Zotsatira zake, minofuyo imasiyidwa popanda chinyezi, motero munthu amayamba kumva ludzu kwambiri. Kuphatikiza apo, khungu limayamba kupukuta ndikusupuka, tsitsi ndi misomali zimawonongeka.

Ndi hyperglycemia, urinalysis iwonetsere kupezeka kwa shuga.

Zachidziwikire, zovuta zonsezi zitha kupewedwa. Koma pokhapokha mutayamba kuthandizira chizindikirocho pa nthawi. Njira yakuchiritsira ili motere:

Kuzindikira kwathunthu matendawa.
Kukhazikitsa kuchuluka kwa matendawa, omwe ndi mtundu wa matenda ashuga.
Kuzindikira kowonjezera matenda ndi zovuta zina zilizonse,
Kupereka mankhwala othandizira.

Ngati zonse zili zomveka ndi mfundo zitatu zoyambirira, ndiye kuti zomalizirazi ziyenera kuchitika mwatsatanetsatane. Ngati kuchuluka kwa matendawa sikufuna kuikidwa kwa ma insulin analogues, omwe adalowetsedwa m'thupi, ndiye kuti mutha kusiya mapiritsi okonzekera. Zachidziwikire, tsopano sizikupanga tanthauzo kutchula mankhwala aliwonse, chifukwa adokotala okha ndi omwe amawauza, ndipo simuyenera kuyamba kumamwa popanda mankhwala.

Njira zina zochizira

Inde, kuphatikiza pa mankhwala, njira zingapo zothandizanso zimathandizanso pochiza matendawa. Koma, zowona, amatha kuphatikizidwa ndi chithandizo chachikulu, simuyenera kudalira kuti atha kubwezeretsanso chithandizo cha mankhwala.

Mwachitsanzo, sizopweteka kuchita maphunziro olimbitsa thupi. Kuchita masewera olimbitsa thupi moyenera kumathandizira kubwezeretsa njira yopanga insulin. Kuchita masewera olimbitsa thupi kotereku kumathandizanso kuchepetsa kunenepa. Mu gawo lachiwiri la matenda ashuga, odwala nthawi zambiri amakhala ndi chizindikiro chosalimbikitsa monga kunenepa kwambiri.

Payokha, muyenera kuganizira zakudya. Mwakutero, chakudya chamagulu. Ndikwabwino kudya pafupifupi kasanu patsiku, magawo ochepa.

Ndikofunikira kugawa chakudya chamagulu omwe amapezeka mu chakudya ndi zinthu zolimbitsa thupi.

Madokotala amalimbikitsa kutsatira zakudya ngati izi:

Pewani chakudya chotsekemera (ndibwino kudya zakudya zopanda shuga, koma sorbitol kapena xylitol ndi zina).
Muyenera kudzipatsa zakudya zochepa.
Zakudya zophika ndizovuta.
Zomwezi zimapangidwanso ngati msuzi wa nyama yolimba.

Zinthu zonse zomwe zimakhala ndi mavitamini A, B, C, komanso zomwe zili ndi mapuloteni ambiri ndizothandiza. Musaiwale kuti chakudyacho chikuphatikiza:

Ngati tikulankhula za mankhwala azikhalidwe, ndiye kuti msuzi wochokera kuzomera monga barberry, cranberries, chimanga, sorelo ndi mpesa waku China wa magnolia ndizoyenera.

Ngati matenda ashuga ali m'mayambiriro a chitukuko, ndiye kuti kutsatira zakudya zoyenera ndikukhalanso ndi moyo wathanzi kumabwezeretsa zachilengedwe pakupanga insulin. Ndipo potero kuchepetsa mwayi wokhala ndi gawo latsopano la matendawa.

Momwe mungazindikire msanga vuto lakukula?

Hyperglycemia ndi chimodzi mwazovuta kwambiri za kusowa kwa insulin. Ndipo posachedwa ndikuzindikira kuwonongeka uku, mwachangu ndizotheka kukonza vutoli ndikupulumutsa moyo wa wodwalayo.

Zizindikiro zazikulu zachilengedwe zimaganiziridwa:

chizungulire chachikulu,
khungu
thukuta lalikulu
wodwala amatopa kwambiri
kunjenjemera kumayamba
Masomphenya amachepa kwambiri,
kukokana kumatha kuyamba
Pali kumva kwamphamvu kwamantha,
palpitations.

Chizindikiro choyipitsitsa ndi chikomokere. Pankhaniyi, kuthandizira odwala kuchipatala mwachangu ndi kukhazikitsidwa kwa njira zoperekera chithandizo champhamvu kwambiri kumafunikira.

Chovuta kwambiri ndikuthana ndi zoterezi kwa anthu osakwatira. Ngati sakudziwa kuti akuvutika ndi insulin, ndiye kuti kuwonongeka kotereku kumatha kuchitika nthawi iliyonse. Ndikofunika kuti pamenepa pali wina wapafupi yemwe angawathandize ndikuyimba ambulansi. Ngati munthu ali yekha, ndiye kuti muyenera kuyesa pa sign yoyamba, itanani dokotala.

Koma, zowona, kuti tipewe izi, ndibwino kumayesedwa pafupipafupi ndikuzindikira kupatuka kulikonse muumoyo wanu. Ndi chifukwa ichi kuti zovuta kwambiri zitha kupewedwa. Kanemayo munkhaniyi akuwuzani zonse zokhudza insulin.