Kodi Somoji Syndrome ndi chiyani?

Elena SKRIBA, endocrinologist wa Chipatala cha 2 cha Ana Chipatala ku Minsk

SOMOJI SYNDROME NDI CHIYANI?

Mu 1959, wasayansi wina waku America a Somoge anati kuwonjezereka kwa shuga m'magazi kungakhale chifukwa cha kusokonekera kwa pafupipafupi chifukwa cha mankhwala osokoneza bongo ambiri. Wasayansiyu adalongosola milandu 4 pamene odwala omwe ali ndi matenda a shuga omwe amachokera ku 56 mpaka 110 IU ya insulin patsiku adatha kukhazikika pamtunda wa matenda a shuga pochepetsa mlingo wa insulin womwe umatumizidwa 26-16 IU patsiku.

Chikhumbo chazomwe chimakhala ndi kagayidwe kazakudya, kupezeka kwa mlingo wokwanira wa insulini kumabweretsa zovuta zina, motero, ndizotheka kuchulukitsa mlingo komanso kukula kwa matenda osokoneza bongo a insulin, kapena matenda a Somoji. Mkhalidwe wa hypoglycemic ndi wovuta kwambiri pamthupi. Kuyesera kuthana nawo, amayamba kupanga ma mahomoni olimbana ndi mahomoni, kuchitidwa kumene kumakhala kotsutsana ndi insulin. Milingo yamagazi ya adrenaline, cortisol ("mahomoni opsinjika"), mahomoni okula ("kukula kwa mahomoni"), glucagon ndi mahomoni ena omwe angapangitse kuchuluka kwa shuga m'magazi.

Somoji syndrome imadziwika ndi kusapezeka kwa glucose ndi acetone mkodzo. Nthawi zambiri, ana otere amakhala ndi zovuta za matenda ashuga okhala ndi vuto la pafupipafupi.

Kuphatikiza pa kugwidwa komwe kumachitika panjala, thukuta, komanso kunjenjemera zomwe zimadziwika ndi hypoglycemia, odwala onse omwe ali ndi vuto la Somoji nthawi zambiri amadandaula chifukwa cha kufooka, kupweteka mutu, chizungulire, kusowa tulo, kumva "kutopa" ndi kugona. Kugona kumakhala kovutirapo, kosokoneza, zolakwika usiku. M'maloto, ana amalira, amafuula, ndipo podzuka, kusokonezeka kwa chikumbumtima ndi amnesia amadziwika mwa iwo. Pambuyo pausiku wotere, ana amakhalabe owopsa, otupa, osakwiya, tsiku lonse masana. Ena amataya chidwi ndi zomwe zikuchitika, amayamba kuganiza kwambiri, amakhala otsekeka komanso osayang'anira chilichonse. Ndipo ena, m'malo mwake, ndi okhudza mtima, ankhanza, odzikuza. Nthawi zina, chifukwa chokhala ndi njala, amakana kudya.

Odwala ambiri amakhala ndi zowonongeka mwadzidzidzi, zomwe zimachitika mwachangu ngati mawonekedwe a malo owala, "ntchentche", mawonekedwe a "chifunga", "chofunda" pamaso pawo kapena m'maso awiri. Izi ndi zizindikiro za hypoglycemia yam'mbuyo kapena yosadziwika kenako kuwonjezeka kwa glycemia.

Ana omwe ali ndi vuto la Somoji amatopa msanga ndi kupsinjika kwa thupi ndi luntha. Mwachitsanzo, ngati amayamba kuzizira, maphunziro awo a shuga amasintha, zomwe zimawoneka ngati zododometsa. Koma chowonadi ndichakuti matenda aliwonse omwe amalumikizana pano amakhala ngati zowonjezera zowonjezera, zomwe zimachulukitsa kuchuluka kwa mahomoni olimbana ndi mahomoni, omwe amachepetsa kwambiri insulin. Zotsatira zake, kuukira kwa latent hypoglycemia kumacheperachepera, ndipo thanzi limayenda bwino.

Kuzindikira kuchuluka kwa insulin nthawi zambiri kumakhala kovuta kwambiri. Kutsimikiza kwa kusiyanitsa kwa masamu pakati pa okwanira ndi osachepera shuga m'magazi kumathandiza kuchita izi. Ndi njira yokhazikika ya matenda ashuga, nthawi zambiri imakhala 4.4-5,5 mmol / L. Mu insulin yosatha, chiwerengerochi chimaposa 5.5 mmol / L.

Osasokoneza Somoji syndrome komanso zotsatira za "m'bandakucha" - izi sizomwezo. Zotsatira za "m'bandakucha" zimadziwika ndi kukwera kwa shuga m'magazi mbandakucha - kuyambira pafupifupi 4,00 - 6.00 m'mawa. M'mawa kwambiri, thupi limayambitsa kupanga kwa mahomoni opanga (adrenaline, glucagon, cortisol, makamaka mahomoni okula - somatotropic), kuchuluka kwa insulin m'magazi kumatsika, zomwe zimapangitsa kuti glycemia iwonjezeke. Izi ndi zochitika zathupi zathupi zomwe zimawonedwa mwa anthu onse, odwala komanso athanzi. Koma ndi matenda ashuga, matenda a m'mawa a m'mawa nthawi zambiri amabweretsa mavuto, makamaka mu achinyamata omwe akukula mwachangu (ndipo timakula, monga mukudziwa, usiku, pomwe kupanga mahomoni okula kwambiri.

Matenda a Somoji amadziwika ndi kuchuluka kwa shuga m'magazi a 2-5 a.m., ndipo ndi matenda a m'mawa otentha, kuchuluka kwa shuga m'magazi ndizachilendo masiku awa.

Chifukwa chake, kuti mukwaniritse shuga yabwinobwino, ndimatenda a Somoji, muyenera kuchepetsa 10% mlingo wa insulin yochepa musanadye kapena nthawi yayitali - musanalowe. Pankhani ya "m'mawa kutacha", jekeseni wa insulin wa nthawi yayitali asanagone ayenera kusinthidwa nthawi yotsatira (pofika maola 22 mpaka 23) kapena kupanikizana kowonjezera kwa insulin kuyenera kupangidwa maola 4 - 6 m'mawa.

Mankhwalawa aakulu insulin bongo ndikusintha Mlingo wa insulin kutumikiridwa. Ngati mukukayikira Somoji syndrome, mlingo wa insulin wa tsiku ndi tsiku umachepetsedwa ndi 10-20% poyang'anira wodwalayo mosamala. Kuchepetsa mlingo wa insulin kumachitika pang'onopang'ono, nthawi zina mkati mwa miyezi iwiri.

Mankhwalawa, amathandizira kwambiri pakudya, masewera olimbitsa thupi, njira zamakhalidwe pazovuta zadzidzidzi komanso kudziyang'anira pawokha matenda ashuga.

ZOPHUNZITSIRA BASIC ZOPHUNZITSIRA ZA CHRONIC:

Somoji Syndrome Concept

Ndi matenda a shuga, kuwerengetsa moyenera mlingo wa insulin ndikofunikira, koma nthawi zambiri zimakhala zovuta kuchita, zomwe zimakhala ndi zovuta zambiri. Zotsatira za kuchuluka kwa mankhwalawa kwa mankhwala ndi Somoji syndrome. Mwanjira ina, ndi matenda a insulin overdose syndrome. Wasayansi waku America a Michael Somoji adaphunzira izi mu 1959 ndipo adazindikira kuti kuchuluka kwa zinthu zochuluka mthupi kumapangitsa mkwiyo wa hypoglycemia - kuchepa kwa shuga wamagazi. Izi zimabweretsa kukondoweza kwa ma contrainsulin mahomoni ndi mayankho - ricocheted hyperglycemia (kuchuluka kwa shuga wamagazi).

Likukhalira kuti nthawi iliyonse mulingo wa insulin m'magazi umaposa zomwe zikufunika, zomwe zimapangitsa kuti hypoglycemia, inayo - kuthya kwambiri. Ndipo kutulutsidwa kwa mahomoni a contrainsulin kumapangitsa kusintha kosasintha kwa magazi m'magazi, komwe kumayambitsa kusakhazikika kwa matenda a shuga, komanso kungayambitse ketonuria (acetone mu mkodzo) ndi ketoacidosis (vuto la matenda osokoneza bongo).

Chitsanzo cha Somoji Syndrome

Kuti zimveke bwino, ndidasankha kupereka chitsanzo chomveka.

Mumayetsa shuga, ndipo chizindikiricho ndikuti, 9 mmol / L. Kuti muchepetse phindu ili, mumabaya insulini ndikupita kukagwira ntchito. Pakapita kanthawi, zizindikiro za hypoglycemia zimawonekera, mwachitsanzo, kufooka. Mulibe mwayi wodya china choti muwonjezere shuga. Popita nthawi, zizindikirazo zimachoka ndipo mumabwerera kunyumba muli osangalala. Koma poyeza shuga, munaona mtengo wa 14 mmol / L. Mukangoganiza kuti mwamwa pang'ono m'mawa, mumamwa insulini ndikupereka jakisoni wamkulu.

Tsiku lotsatira zinthu zinadzibwereza zokha, koma sitife ofooka, ndipo sitingopita kwa dokotala. Mukungofunika kupaka jakisoni wambiri. 🙂

Izi zitha kupitilira milungu ingapo. Ndipo nthawi iliyonse mudzabaya mokulira. Mutu komanso kunenepa kwambiri zimawoneka moperewera. Ndi nthawi iyi pomwe azimayi nthawi zambiri amathamangira kwa dokotala. Amuna amakhala olimbikira, ndipo amatha kupulumuka zovuta zazikulu.

Zizindikiro za Somoji Syndrome

Mwachidule. Ngati mukuzindikira zomwe zalembedwa pansipa, musazengereze ndikupita kwa dokotala:

Pafupipafupi hypoglycemia
Kufika kosasangalatsa shuga
Kufunika kosalekeza kuchuluka kwa insulin
Kulemera kwakukulu (makamaka pamimba ndi kumaso)
Mutu ndi kufooka
Kugona kumakhala kopumira komanso kungokhala mopitilira muyeso
Kawirikawiri komanso kusinthasintha kwakasinthasintha
Kuona m'maso, chifunga, kapena kusala

Somoji syndrome - mawonekedwe

1. Anthu ena amasokoneza matendawa ndi matenda a m'mawa. Kuti muwonetsetse kuti muli ndi Somoji, muzipaka shuga kangapo usiku mosagwirizana ndi maola awiri ndi atatu. Ngati shuga satsika, muli ndi matenda otsegula m'mawa ndipo muyenera kuwonjezera kuchuluka kwa insulin. Ndi shuga wabwinobwino usiku, koma zizindikiro zosalembedwa zomwe zalembedwa pamwambapa, muyenera kuchepetsa kuchuluka kwa insulin, popeza muli ndi Somoji syndrome.

2. Komanso, matenda awa ndi osavuta kuwapeza mu labotale. Zitsanzo za mkodzo zimatengedwa nthawi zosiyanasiyana. Ngati zitsanzo zina zimakhala ndi acetone, koma osati zina, ndiye kuti shuga imakwezedwa chifukwa cha kupitiliza kwa hypoglycemia, ndipo ichi ndi chizindikiro chomveka cha Somoji.

3. Kuti muchotse matendawa, muyenera kuchepetsa pang'onopang'ono mlingo wa insulin ndi 10-20%. Ngati patadutsa sabata limodzi vuto la shuga m'magazi silikuyenda bwino, muyenera kufunsa dokotala kuti akuuzeni chithandizo chabwino kwambiri.

Ndikofunika kukumbukira kuti shuga wambiri amatha kuyambitsa zovuta zina. Chifukwa chake, ndikofunikira kuthana ndi vuto losasangalatsa ili posachedwa.

Ichi ndi chiyani

Chifukwa cha dzinali, amatanthauza mitundu yambiri yosiyanasiyana yamankhwala osiyanasiyana omwe amapezeka nthawi yayitali.

Chifukwa chake, imatha kuyambitsa kugwiritsa ntchito mankhwala okhala ndi insulin, omwe amathandizidwa ndi matenda a shuga.

Kupanda kutero, matendawa amatchedwa rebound kapena posthypoglycemic hyperglycemia.

Chifukwa chachikulu chomwe chikulembedwera matendawa ndi matenda a hypoglycemia, omwe amapezeka ndi kugwiritsa ntchito mankhwala osokoneza bongo omwe amachepetsa kuchuluka kwa shuga m'magazi.

Gulu lalikulu lomwe lili pachiwopsezo ndi odwala omwe nthawi zambiri amakakamizidwa kugwiritsa ntchito jakisoni wa insulin. Ngati sangayang'ane zomwe zili ndi shuga, sangazindikire kuti mankhwalawo amathandizira kwambiri.

Zomwe zimachitika

Kuchulukitsa kwa shuga ndi kowopsa kwambiri, chifukwa kumawononga kagayidwe. Chifukwa chake, othandizira a hypoglycemic amagwiritsidwa ntchito kuti achepetse. Ndikofunika kwambiri kusankha mlingo woyenera wa uyu kapena wodwala.

Koma nthawi zina izi sizingatheke, chifukwa chomwe wodwalayo amalandira kwambiri insulin kuposa momwe thupi lake limafunira. Izi zimabweretsa kutsika kowopsa m'magulu a glucose komanso kukula kwa dziko la hypoglycemic.

Hypoglycemia imasokoneza thanzi la wodwalayo. Pofuna kuthana ndi zovuta zake, thupi limayamba kupanga zochuluka zowonjezera zoteteza - mahormoni otsutsana.

Amafooketsa zochita za insulin, zomwe zimalepheretsa kusakanikirana kwa shuga. Kuphatikiza apo, mahomoni awa amathandizira chiwindi.

Ntchito yopanga shuga ndi thupi limakula. Mothandizidwa ndi zinthu ziwiri izi, pali shuga wambiri m'magazi a odwala matenda ashuga, omwe amayambitsa hyperglycemia.

Kuti achepetse izi, wodwalayo amafunikira gawo latsopano la insulin, lomwe limaposa lakale. Izi zimayambitsanso hypoglycemia, kenako hyperglycemia.

Zotsatira zake ndikuchepa kwa chidwi cha thupi pakupanga insulini komanso kufunika kowonjezereka kwa mlingo wa mankhwalawa. Komabe, ngakhale kuchuluka kwa insulini, hyperglycemia sichitha, chifukwa pali mankhwala osokoneza bongo nthawi zonse.

Chinanso chomwe chimapangitsa kuti shuga azikula ndikuwonjezera chilimbikitso chifukwa cha kuchuluka kwa insulini. Chifukwa cha timadzi timeneti, wodwalayo amakhala ndi njala yosatha, ndichifukwa chake amakonda kudya zakudya zambiri, kuphatikizapo mafuta ambiri. Izi zimathandizanso ku hyperglycemia.

Chowoneka cha matenda ndi chakuti nthawi zambiri hypoglycemia siziwonetsa ndi chizindikiro. Izi zimachitika chifukwa chakuthwa m'mizere ya shuga, pamene mitengo yokwezeka imatsika, kenako.

Chifukwa cha kuthamanga kwa njirazi, wodwalayo mwina sangazindikire mkhalidwe wa hypoglycemic. Koma izi sizimalepheretsa matendawa kupita patsogolo, chifukwa ngakhale zochitika zaposachedwa za hypoglycemia zimabweretsa zotsatira za Somogy.

Zizindikiro za bongo wambiri

Kuti muthe kuchita zofunikira, ndikofunikira kuzindikira zamatendawa munthawi yake, ndipo izi ndizotheka pokhapokha podziwa chidziwitso chake.

Chochitika cha Somoji mu mtundu 1 wa shuga chimadziwika ndi zizindikiro monga:

kusinthasintha pafupipafupi kwa shuga,
hypoglycemic state (amayamba chifukwa cha insulin yambiri),
kunenepa kwambiri (chifukwa cha njala yosatha, wodwalayo amayamba kudya zakudya zambiri),
njala yosalekeza (chifukwa cha kuchuluka kwa insulini, komwe kumachepetsa kwambiri shuga),
kulakalaka kudya (kumayambitsa kusowa kwa shuga m'magazi),
kukhalapo kwa matupi a ketone mumkodzo (amachotsedwa chifukwa cha kutulutsidwa kwa mahomoni omwe amachititsa kuti pakhale mafuta ambiri).

Pa gawo loyambirira la vuto ili, zizindikiro zotsatirazi zitha kuoneka mwa odwala:

mutu
chizungulire
kusowa tulo
kufooka (makamaka m'mawa),
kuchepa kwa magwiridwe
zolota pafupipafupi
kugona
pafupipafupi kusintha kosinthika
kuwonongeka kwamawonekedwe
tinnitus.

Izi ndizofanana ndi dziko la hypoglycemic. Kupezeka kwawo pafupipafupi kumawonetsa mwayi wakukula kwa zotsatira za Somoji. Mtsogolomo, zizindikirazi zimatha kuwonekera kwakanthawi kochepa (chifukwa cha kupita patsogolo kwa matenda), chifukwa chomwe wodwalayo sangazindikire.

Popeza hypoglycemia imayamba chifukwa cha mankhwala osokoneza bongo a insulin kapena mankhwala ena a hypoglycemic, ndikofunikira kufunsa dokotala kuti musinthe mlingo kapena musankhe mankhwala ena mpaka atsogolera kupangika kwa Somoji syndrome.

Kodi muwonetsetse bwanji kuwonekera kwake?

Musanachiritse matenda aliwonse, muyenera kuzindikira. Kukhalapo kwa zizindikiro ndi chizindikiro chokhacho.

Kuphatikiza apo, ambiri mwa zizindikiro za Somoji syndrome amafanana ndi hypoglycemia kapena kugwiranso ntchito mwachizolowezi.

Ngakhale boma la hypoglycemic ndi limodzi lowopsa, limachiritsidwa mosiyana ndi matenda a Somogy's.

Ndipo pokhudzana ndi kugwira ntchito mopitilira muyeso, njira zina zimafunikira konse - nthawi zambiri, munthu amafunika kupumula komanso kupumula, osati chithandizo. Chifukwa chake, ndikofunikira kusiyanitsa mavutowa kuti mugwiritse ntchito njira yeniyeni ya chithandizo yomwe ili yoyenerera pamkhalidwewo.

Kuzindikira ngati Somoji syndrome kuyenera kutsimikiziridwa, siyovuta. Ngati mungayang'ane pa kuyezetsa magazi, mutha kuwona kuphwanyidwa mwanjira yake. Koma kuphwanya izi kungathe kuwonetsa kuchuluka kwa insulin (momwe timaganiziridwira) ndi kusowa kwake.

Muyeneranso kumuwuza za zomwe mwazindikira, kuti katswiriyo apange lingaliro lanu. Kutengera ndi izi, kuyesereranso kudzamangidwa.

Pali njira zingapo zotsimikizira kukhalapo kwa chizindikiro.

Izi zikuphatikiza:

Kudzizindikira. Pogwiritsa ntchito njirayi, shuga amayenera kuwerengedwa maola atatu aliwonse kuyambira 21:00. Nthawi ya 2 koloko m'mawa thupi limadziwika chifukwa chosowa insulini. Peak zochita zake za mankhwalawa, zomwe zimayendetsedwa usiku, zimagwera ndendende nthawi ino. Ndi Mlingo wolakwika, kuchepa kwa ndende ya glucose kumawonedwa.
Kafukufuku wa Laborator. Kuyesa kwamikodzo kumagwiritsidwa ntchito kutsimikizira kukhalapo kwa matendawa. Wodwala akuyenera kusonkhanitsa mkodzo tsiku ndi tsiku, womwe umayang'aniridwa kuti mudziwe matupi a ketone ndi shuga. Ngati hypoglycemia imayambitsidwa ndi gawo lochulukirapo la insulin yomwe imayendetsedwa usiku, ndiye kuti ziwalozi sizipezeka mu zitsanzo zonse.
Kusiyanitsa mitundu. Somoji Syndrome ili ndi zofanana ndi Morning Dawn Syndrome. Amadziwikanso ndi kuchuluka kwamamawa m'mawa. Chifukwa chake, ndikofunikira kusiyanitsa pakati pa mayiko awiriwa. Morning Dawn Syndrome amadziwika ndi kukwera pang'onopang'ono kwa shuga kuyambira madzulo.Amafika m'mawa kwambiri. Ndi mphamvu ya Somoji, mulingo wokhazikika wa shuga umawonedwa madzulo, kenako umachepa (pakati pausiku) ndikuwonjezeka m'mawa.

Kufanana pakati pa mankhwala osokoneza bongo a insulin ndi m'mawa kwambiri kumatanthauza kuti simuyenera kuwonjezera kuchuluka kwa mankhwalawa mukadzuka.

Izi zimagwira pokhapokha ngati zikufunika. Ndipo akatswiri okha ndi omwe angazindikire zomwe zimayambitsa izi, omwe muyenera kutembenukira.

Phunziro la kanema pakuwerengera kwa insulini:

Zoyenera kuchita

Zotsatira za Somoji si matenda. Izi ndimomwe thupi limapangidwira chifukwa chosagwiritsa ntchito bwino matenda ashuga. Chifukwa chake, chikapezeka, samalankhula za chithandizo, koma za kukonzekera Mlingo wa insulin.

Dokotala ayenera kuphunzira zonse zowonetsa ndikuchepetsa gawo la mankhwala omwe akubwera. Nthawi zambiri, kutsitsidwa kwa 10-20% kumachitika. Muyenera kusinthanso dongosolo la kukhazikitsidwa kwa mankhwala okhala ndi insulin, kupanga malingaliro pazakudya, kuwonjezera zolimbitsa thupi. Kutenga nawo gawo kwa wodwala motere ndikutsatira malangizo komanso kuwunika kosinthika.

Zakudya zamankhwala. Mafuta ochepa okha omwe amafunikira kuti azichita zinthu zofunika ayenera kulowa m'thupi la wodwalayo. Ndikosatheka kugwiritsa ntchito mankhwala molakwika kwambiri.
Sinthani dongosolo la kagwiritsidwe ntchito ka mankhwala. Mafuta okhala ndi insulin amaperekedwa musanadye. Chifukwa cha izi, mutha kuwunika momwe thupi limayankhira pakudya kwawo. Kuphatikiza apo, mutatha kudya, glucose amakula, kotero zochita za insulin zidzakhala zoyenera.
Zochita zolimbitsa thupi. Ngati wodwalayo adapewa kuchita masewera olimbitsa thupi, amalimbikitsidwa kuchita masewera olimbitsa thupi. Izi zikuthandizira kuchulukitsa shuga. Odwala omwe ali ndi vuto la Somoji amayenera kuchita masewera olimbitsa thupi tsiku lililonse.

Kuphatikiza apo, katswiriyo ayenera kuunikira zomwe zikuchitika ndi mankhwala. Choyamba, mphamvu ya insulin ya usiku woyambira imayesedwa.

Chotsatira, muyenera kuwunika momwe thupi limayankhira mankhwala tsiku lililonse, komanso momwe mankhwalawa amathandizira.

Koma mfundo yayikulu ndikuchepetsa kuchuluka kwa insulin yomwe imayendetsedwa. Izi zitha kuchitika mwachangu kapena pang'onopang'ono.

Posintha mwachangu muyezo, masabata awiri amaperekedwa kuti asinthe, pomwe wodwalayo amasinthana ndi kuchuluka kwa mankhwala omwe amafunikira. Kuchepetsa pang'ono pang'onopang'ono kungatenge miyezi iwiri.

Momwe mungapangire kukonza, katswiri wasankha.

Izi zimakhudzidwa ndi zinthu zambiri, monga:

zotsatira zoyesa
kuopsa kwa vutolo
thupi
zaka, etc.

Kutsika kwa shuga m'magazi kumathandizira kubwereranso kwamalingaliro a hypoglycemic. Kutsika kwa magawo a insulin yolandilidwa kuonetsetsa kuti thupi ligwirizane ndi zomwe zimachitika.

Sizovomerezeka kuchita njira zowongolera popanda thandizo la dokotala. Kutsitsa kosavuta kwa mankhwalawa (makamaka lakuthwa) kungayambitse kwambiri hypoglycemia wodwala, komwe kumatha kupha.

Chifukwa chake, ngati mukukayikira kuti pali mankhwala osokoneza bongo osatha, muyenera kukambirana ndi dokotala. Izi zimafunika miyeso yoyenera komanso yoyenera, deta yolondola komanso kudziwa kwapadera.

Zoyambitsa ndi zotsatira zake

Glucose ndiye gwero lalikulu lamphamvu, "mafuta" omwe minofu yathu, ziwalo zamkati ndi ubongo wathu umagwiritsa ntchito. Chifukwa chake, thupi limawona kuchepa kwakukulu kwa shuga m'magazi monga chizindikiro cha ngozi, ndipo ikagwa kwambiri, imaphatikizapo njira zoteteza:

Mitsempha ya contrainsular (counterinsulinic) kapena "hyperglycemic" imatulutsidwa m'magazi: adrenaline, norepinephrine, cortisol, glucagon, mahomoni okula,
imayambitsa kusokonekera kwa glycogen polysaccharide (mwanjira imeneyi, kupezeka kwa glucose komwe kumasungidwa mu chiwindi), shuga yemwe watulutsidwa amalowa m'magazi.
chifukwa cha kukonza mafuta, matupi a ketone amapangidwa, ndipo ma acetone amawonekera mkodzo.

Nthawi zina, glucose amachepetsa msanga kwambiri kuti munthu asazindikire hypoglycemia, kapena amawoneka atypical, ndipo amatha kusokonezeka ndi kutopa, kugwira ntchito kwambiri, malaise kuchokera kuzizira. Hypoglycemia yotere imadziwika kuti latent (eni). Ngati zimakonda kubwerezedwa, wodwalayo amasiya kuzimva, zomwe zikutanthauza kuti samawalipirira pa nthawi yake.

Kubwereka kumakhalanso koopsa chifukwa thupi limazolowera kwambiri magazi (mwachitsanzo, pamimba yopanda kanthu - 10-12 mmol / l) mutatha kudya - 14-17 mmol / l). Kuperewera kwakunja kwa kuyamwa kwa shuga sikutanthauza kuti sikungayambitse zovuta za matenda ashuga! Komabe, poyesera kulipirira matenda a shuga, munthu amakumana ndi vuto loti kuchepa kwa glucose wamagazi kumachitidwe am'thupi kumamupangitsa hypoglycemia ndi rebound hyperglycemia.

Mankhwala osokoneza bongo a insulin amatha kukhala ndi mtundu uliwonse wa shuga ngati jakisoni wa insulin amagwiritsidwa ntchito pochiza. The endocrinologist akaikira Somoji matenda akachulukitsa mlingo sizikuthandizanso kuthana ndi matendawa. Mwachitsanzo, shuga adakwera kufika ku 11.9 mmol / l, wodwala yemwe ali ndi vuto la matenda ashuga, patapita kanthawi adayamba kumva kupepuka (chizindikiro cha hypoglycemia), chomwe chidapita mwachangu, koma ndi muyeso wotsatira glucometer adawonetsa 13.9 mmol / l. Atatha kulumikizana ndi insulin ndi mlingo waukulu, shugayo adakhala wambiri, munthuyo adakulitsanso mlingowo ndipo sanapezenso zotsatirazo: "ozungulira wozungulira" wa Somoji syndrome watsekeka. Anthu oterowo akuti ali ndi nkhawa:

pafupipafupi hypoglycemia, kusinthasintha kowopsa kwa shuga m'magazi (diagnostics),
Njala yosalekeza, bwanji akulemera?
kuchuluka malaise, kusokonezeka kwa chidwi ndi kukumbukira,
acetone mu mkodzo ndi magazi okhala ndi magazi ochepa.

Odwala amadabwitsidwa kuti shuga ndi kukhala bwino zikuchulukitsa kuchuluka kwa insulini, ndikusintha ndikachepa. Anthu ena amamva bwino pogwira chimfine cha nyengo: ndi chimfine, kufunika kwa insulini kumawonjezeka, ndipo bongo limakhala lokwanira.

Moti simukuphonya hypentent hypoglycemia?

Somoji syndrome imakwiyitsa hypoglycemia yomveka komanso yotsala, ndipo muyenera kuzindikira ndikuwongolera ma props. Ngakhale sangadzimveke bwino, amatha kuzindikiridwa ndi zizindikiro zosadziwika:

Zovuta zam'mutu komanso zowala zomwe zimachepa ngati mumadya maswiti, msuzi wokazinga.
Kusintha kwadzidzidzi: kusasinthika kopanda pake, kuukiridwa konyinyirika kapena kusasamala.
Magawo a mutu wowala, "ntchentche", osasunthika pamaso pa maso. Nthawi zina izi zimachitika asanafe, koma pamenepa, palibe amene amataya chikumbumtima.
Kusokonezeka tulo: Madzulo munthu amakhala ndi vuto kugona tulo, amakhala ndi maloto, m'mawa amavutika kudzuka, amakhala ndi tulo, ndipo masana amagona.

Makolo ochita zinthu mwachangu amazindikira mwana wosakhazikika ngati iye, akusewera mwachidwi, mwadzidzidzi akataya chidwi chake pantchito, atakhala wowopsa, ayamba kuchita masewera olimbitsa thupi, kuseka, kulira. Panjira, mwana amadandaula kuti ali ndi "miyendo yotopa", amapempha manja ake kapena akufuna kuti apumule pa benchi. Ndi nocturnal hypoglycemia, mwana amatuluka ndikutembenuka, ndikulira, kubuula m'maloto, akukana kupita ku sukulu ya chekeke, chifukwa sanagone.

Zizindikiro

Kuzindikira matenda a Somogy ndikovuta kuposa zovuta zina za matenda ashuga. Makhalidwe abwinobwino a formula yamagazi mwa anthu odwala matenda ashuga ndi ofanana onse pakalibe insulin chifukwa cha kuchuluka kwa mankhwalawa, komanso chifukwa cha kuchuluka kwa mankhwala osokoneza bongo.

Pofuna kuti musasemphane ndi zovuta, muyenera kugwirizana ndi dokotala pakukhazikitsa matenda: tengani miyezo ya shuga ya magazi molingana ndi malingaliro omwe adalimbikitsa, samalani ndi zomwe zikuwoneka zachilendo. Asanapite kuchipatala, ndikofunikira kuti aziwunika kuchuluka kwa glucose, izi zithandiza adotolo kuti adziwonetsere zoyeserera ndikupereka mayeso kuti amvetsetse.

Kudzizindikira. Kwa masiku angapo, kuyeza glucose maola atatu onse kuyambira 21:00. Nthawi zambiri hypoglycemia imadziwonekera pakati pausiku (kuyambira 2.00 mpaka 3.00): kufunikira kwa thupi kwa insulin panthawiyi kumachepa, munthawi iyi yamasamba pamakhala chiwopsezo chachikulu cha zomwe mahomoni omwe amaperekedwa madzulo. Momwe mlingo umakhala wokwera kwambiri kuposa momwe ungafunikire, hypoglycemia ndiyotheka nthawi iliyonse yamadzulo, chifukwa chake, miyezo siyiyenera kukhala yokhayo pazokhazo.
Amasanthula. Pozindikira matenda a Somoji, wodwalayo amapatsidwa mankhwala tsiku lililonse ndipo amayesedwa mkodzo matupi a shuga ndi ketone. Ndi hypoglycemia motsutsana ndi maziko osokoneza bongo a insulin, shuga ndi acetone sizipezeka mu zitsanzo zonse.
Kusiyanitsa mosiyanasiyana ndi "mawa m'mawa." Wodwala yekha amatha kukayikira matenda a Somoji ngati akuwongolera. Ngati shuga m'magazi ayamba kukwera m'mawa ndikufika pamlingo wokwanira m'mawa, tikulankhula za "m'mawa matenda." Ndi mankhwala osokoneza bongo kwambiri a insulin, chizindikiro cha glucose chimakhazikika kumayambiriro kwa usiku, chimayamba kuchepa pakati, kenako ndikuwonjezeka.

Chifukwa chake, pozindikira kuchuluka kwa shuga m'mawa, musathamangire kusintha ma insulin yamadzulo, makamaka ngati mutayesera kuwonjezera mlingo kamodzi, simunapambana. Uzani adotolo pazomwe mwawona, ndipo akupatseni mayeso kuti adziwe zomwe zasintha.

Somoji syndrome si matenda, koma chizindikiro cha mkhalidwe wochititsidwa ndi insulin yokwanira. Ngati mukukayikira kuchuluka kwa insulin, yotsimikiziridwa ndi mayeso, adokotala adzakuthandizani kuti mupeze kuchuluka kwa mahomoni tsiku ndi tsiku mpaka 10-20% ndikukupatseni malingaliro ofunikira. Nthawi yomweyo, njira yoyambira imasinthira, zakudya komanso masewera olimbitsa thupi zimasinthidwa:

kuchuluka kwa chakudya chamafuta sikuyenera kupitilira zofunikira zathupi,
jekeseni insulin musanadye chilichonse,
kwa anthu omwe sanalabadire zolimbitsa thupi, masewera olimbitsa thupi tsiku lililonse amalimbikitsidwa.

Kuchiza kumayambira ndi dokotala, limodzi ndi wodwalayo, kuyamba kuwongolera momwe insulin ya usiku imagwirira ntchito, kenako ndikuyang'ana momwe thupi limayankhira masana, kenako ndikuchita insulin. Kuchepetsa Mlingo kumatha kukhala mwachangu komanso pang'onopang'ono:

koyamba, kumakhala pafupifupi milungu iwiri,
wachiwiri - miyezi 2-3.

Lingaliro la njira yomwe adzagwiritse ntchito ndi dokotala, poganizira momwe amawunikira, mkhalidwe wa wodwalayo ndi zinthu zina. Mwazi wamagazi ukachepa, odwala matenda ashuga adzayambanso kumva kuti hypoglycemia, mwayi wodumphadumpha umachepa, komanso kumva kwa insulin kudzabwezeretsa mwakale.

Zambiri zakale

Kwa nthawi yoyamba, insulin idagwiritsidwa ntchito bwino mu 1922, pambuyo pake kafukufuku wambiri wazokhudza thupi adayamba, zoyeserera zidachitika pa nyama ndi anthu. Asayansi apeza kuti Mlingo waukulu wa mankhwalawa umayambitsa matenda a hypoglycemic, ndipo nthawi zambiri umabweretsa imfa. Ndipo akuti pali vuto lakuchuluka kwa mahomoni ambiri m'thupi. M'zaka zakale izi, mankhwalawa amagwiritsidwa ntchito pochiza odwala anorexia kuti awonjezere thupi. Izi zinapangitsa kuti magazi asinthe kwambiri, magazi amasintha kuchokera ku hypoglycemia kupita ku hyperglycemia. Kumapeto kwa maphunzirowo, wodwalayo adawonetsa zizindikiro za matenda ashuga. Zofanana zomwezi zachitika mu psychiatry, mankhwalawa odwala omwe ali ndi matenda a schizophrenia omwe ali ndi "insulin mantha." Kuphatikiza kwa kuchuluka kwa insulin ndi kuchuluka kwa glycemia kunawonekeranso pa matenda a shuga. Vutoli lidayamba kudziwika kuti Somoji syndrome.

Kodi mungamvetse bwanji kuti thupi limadziwitsidwa ndi insulin yambiri? Somoji syndrome imawonetsedwa ndi izi:

pali kuwonongeka kwathanzi lonse, kufooka kumawonekera,
kupweteketsa mutu mwadzidzidzi, chizungulire, chomwe chingadutse mwadzidzidzi mutadya chakudya ndi chakudya,
tulo timasokonekera, timakhala ndi nkhawa komanso ndimaganizira, zoyipa nthawi zambiri zimalota,
kumakhala kutopa kosalekeza, kugona,
zimakhala zovuta kudzuka m'mawa, munthu amamva kutopa,
zosokoneza zowoneka zitha kuwoneka ngati nkhungu patsogolo pa maso, makatani kapena kuthwanima kwa mfundo zowala,
kusintha kwamwadzidzidzi, komwe nthawi zambiri kumakhala koyipa,
kulakalaka kwambiri, kuwonda.

Zizindikiro zotere ndi belu loopsa, koma sizingakhale chifukwa chomveka chodziwitsira matenda, popeza ndi umboni wa matenda ambiri. Chithunzi chokwanira cha zomwe zimachitika mthupi chitha kutsatiridwa pogwiritsa ntchito kusanthula.

Kusiyanitsa mitundu

Mukazindikira, matenda a Somogy amasokonezeka mosavuta ndi mawonekedwe a "mbandakucha", chifukwa zizindikiritso izi ndi zofanana. Komabe, pali zosiyana zazikulu. Chozizwitsa cha "m'mawa kutacha" sichimangopezeka mwa odwala matenda a shuga, komanso mwa anthu athanzi, zimadziwonetseranso m'bandakucha. Izi zimachitika chifukwa chosowa ma insulin insulin chifukwa cha kuwonongeka kwake mwachangu m'chiwindi kapena chifukwa chokwanira cha mahomoni olimbitsa thupi m'mawa. Mosiyana ndi Somoji syndrome, chiwonetsero cha izi sichimayambitsidwa ndi hypoglycemia. Kuti mupeze matenda oyenera, muyenera kudziwa kuchuluka kwa glycemia kuyambira awiri mpaka anayi m'mawa, amachepetsedwa mwa wodwala wokhala ndi matenda osokoneza bongo osaneneka, ndipo mwa wodwala yemwe ali ndi matenda a m'mawa hyperglycemia sasintha. Mankhwalawa matendawa ndi chimodzimodzi: ngati poyambira mlingo wa insulin utachepa, ndiye kuti wachiwiri umakulitsidwa.

Zomwe zimachitika ndi matenda ashuga omwe ali ndi matenda a Somoji

Kuphatikizidwa kwa matenda osokoneza bongo a shuga ndi matenda a insulin overdose syndrome (ACSI) kumabweretsa zovulaza, matendawa ndi ovuta kwambiri. Poyerekeza ndi kukula kwa Mlingo wa mankhwala, hypoglycemia imayamba kubisika. Somoji syndrome mu shuga imakhudza zonse zomwe wodwalayo ali nazo ndi zomwe amachita.

Kusintha kwadzidzidzi kwakanthawi popanda chifukwa - kumachitika pafupipafupi ndi matenda omwewo. Ndi chidwi chachikulu ndi bizinesi kapena masewera, pakapita nthawi munthu ataya mwadzidzidzi zonse zomwe zimachitika, amakhala wowopsa komanso wopanda chidwi, wopanda chidwi ndi zochitika zakunja. Nthawi zina mkwiyo wosakwiya kapena ukali utha kuonedwa. Nthawi zambiri pamakhala chikhumbo chowonjezereka mwa wodwala, koma, ngakhale izi, nthawi zina pamakhala malingaliro olakwika pa chakudya, munthu amakana chakudya. Zizindikiro zotere zimapezeka mwa 35% ya odwala. Zodandaula zambiri zofala zimaphatikizapo kufooka, chizungulire, kupweteka mutu, komanso kusowa tulo. Ena amazindikira kuwonongeka kwakanthawi komanso kwakanthawi (mwa mawonekedwe a chophimba pamaso pa maso kapena "ntchentche" yowala).

Chithandizo cha matenda a Somoji chimaphatikizapo kuwerengera kolondola ya insulin. Kuti izi zitheke, kuchuluka kwa mankhwala omwe amathandizidwa ayenera kusinthidwa, amachepetsedwa ndi 10-20% poyang'anira mwamphamvu momwe wodwalayo alili. Kodi Somoji syndrome imachiritsidwa nthawi yayitali bwanji? Kutengera ndi zomwe zikuwonetsedwa, njira zosiyanasiyana zakukonzanso zimagwiritsidwa ntchito - mwachangu komanso pang'onopang'ono. Yoyamba imachitika kwa masabata awiri, yachiwiri imatenga miyezi iwiri.

Koyamba, mutha kuganiza kuti kuchepetsa kuchuluka kwa insulin kudzapangitsa kuti matendawa athe, koma sichoncho. Kuchepa chabe kwa kuchuluka kwa mankhwala omwe amaperekedwa sikuti kumapititsa patsogolo shuga; Zimakhudza chakudya (kuchuluka kwa chakudya chamagulu omwe amakhala ndi chakudya), zolimbitsa thupi. Insulin imayendetsedwa musanadye chilichonse. Njira yokhayo yophatikizidwa yomwe ingapereke zotsatira zabwino polimbana ndi matenda a Somoji.

Odziwika bwino omwe ali ndi vuto la insulin bongo amakhala ndi malonjezo olimbikitsa.Ndikofunikira kudzisamalira nokha, zizindikilo za thupi, kusintha kulikonse pamatenda anu, ndipo ngati mukumva kuwawa, funsani kwa dokotala mwachitsanzo, ku Endocrinology Center ku Akademicheskaya (Moscow). Mu zotsatira zabwino zamankhwala, gawo lalikulu limaseweredwa ndi ukatswiri ndi luso la dokotala. Ndi matenda osadziwika, matendawa ndi osathandiza: kuchuluka kwa insulin kopitilira muyeso kumangokulitsa mkhalidwe wa wodwalayo, njira ya matenda a shuga ikulirakulira.

Kupewa

Njira zazikulu zothandizira kupewa CAPI zimaphatikizapo njira zingapo.

Ndi matenda a shuga, zakudya zomwe zimasankhidwa molondola kwa wodwala ndikuwatsimikizira kuti zimapatsanso kagayidwe kake ka carbohydrate ziyenera kutsatiridwa. Munthu ayenera kukonza zakudya zake, azitha kuwerengera kuchuluka kwa chakudya chamagwiritsidwe, ndipo ngati kuli kotheka, sinthani zina moyenera.
Mankhwala a insulin amachitika mu Mlingo wofunikira wodwala wina. Ntchito ya adotolo ndikupanga kukonza ngati kuli kofunikira, ndipo wodwalayo ayenera kuwunika mawonekedwe a thupi lake.
Kuchita masewera olimbitsa thupi pafupipafupi ndikofunikira kwa odwala matenda ashuga, makamaka ngati wodwala amakhala pansi kapena ali pantchito.
Kuyang'anira matenda pafupipafupi, kuonana ndi endocrinologist pa ndandanda payekha ndipo pakufunika.
Kuwunika kokwanira komwe kumakhala mkhalidwe wamthupi, kukhala bwino, kuzindikiridwa mwachangu kwa zizindikiro zokayikitsa.
Kupanga mikhalidwe yoyendetsera kudziletsa m'moyo watsiku ndi tsiku, kuphunzira mfundo za kudziletsa kwa odwala komanso achibale.

Somoji syndrome mwa ana

Ana omwe ali ndi matenda a shuga sangayang'anire kusintha kwa matupi awo, nthawi zambiri zimawoneka ngati zosatheka, chifukwa chake kuwongolera matendawa ndi nkhawa ya makolo. Chisamaliro chimayenera kutengedwa kuti ayang'anire mwana wagona, popeza zochita za insulin zimachitika kwambiri usiku, ndipo zochita za mwana zimatha kunena zambiri. Matendawa amawonekera, tulo take timayamba kupumula komanso mopepuka, timapuma limodzi ndi phokoso. Mwana akhoza kufuula kapena kulira m'maloto chifukwa cha zolakwika. Kudzuka ndikovuta, nthawi yomweyo chisokonezo chikachitika.

Mawonetsedwe onse awa ndi chizindikiro cha dziko la hypoglycemic. Tsiku lonse mwana amakhalabe waulesi, amakhala wopanda nkhawa, wokwiyitsidwa, samawonetsa chidwi ndi masewera kapena kuphunzira. Kukonda chidwi kumatha kuchitika mosayembekezereka, popanda chifukwa, pakuchitika kwina kulikonse. Kukula kosadziwika mosadukiza kumachitika pafupipafupi, kusintha kwa malingaliro kumakhala kosayembekezereka. Nthawi zambiri ana omwe ali ndi matendawa amakhala ndi nkhawa. Chithandizo chimachitidwa pa mfundo yomweyo monga akulu. The Endocrinology Center ku Academic, mwachitsanzo, amathandiza ana kuthana ndi Somoji syndrome.