Matenda a shuga

"Chimodzi mwazomwe zimayambitsa kufa mu mtundu 1 wa shuga matenda ashuga ketoacidosis. Malinga ndi kafukufuku yemwe anachitika ngati gawo la pulogalamu yachifundo ya Alpha Endo, ana opitilira theka la ana omwe amapezeka ku Russia amapezeka ndi ketoacidosis akapezeka. Ketoacidosis ndi chiopsezo cha moyo pamene, chifukwa cha kusowa kwa insulini, osati zomwe zimakhala ndimwazi m'magazi zimakwera, komanso matupi a ketone, mwa kuyankhula kwina, acetone, "atero Anna Karpushkina, MD, wamkulu wa pulogalamu ya Alpha-charity Endo. "

• • kuchuluka kwa mkodzo kumachulukira, kumakhala kopanda mawonekedwe ngati madzi, ndipo kumamatira chifukwa cha kupezeka kwa shuga mkati mwake,
• • pali ludzu lamphamvu,
• • Ngakhale kuti amakhala ndi chidwi chambiri, kulemera kwa mwana kumachepa,
• • kutopa msanga,
• • Yachepetsa chidwi,
• • kuyabwa kapena khungu lowuma,
• • mseru ndi kusanza.

Matendawa

Matenda a shuga a Type 1 ndi matenda apadera amtundu wake. Pali matenda ambiri osachiritsika omwe amabwera chifukwa choletsa zakudya komanso mankhwala a moyo wonse. Kusiyana pakati pa matenda ashuga kumakhalapo poti munthu amapitilira malire a zomwe wodwala amayenera kuchita: kungotsatira malangizo azachipatala sikokwanira, muyenera kuphunzira momwe mungayendetsere dongosolo lanu lonse la thupi. Dotolo, ndithudi, amakhalabe wamphamvu wosasinthika komanso katswiri wamkulu, koma zochuluka za ntchitoyi ndiudindo wake zimayikidwa m'manja mwa wodwalayo. Matenda a shuga sangachiritsidwe, koma amatha kuthandizidwa.

Pofuna kuthandiza odwala, matekinoloje amagwira ntchito - njira zamakono zowunikira (pomwe deta kuchokera pa mita imaperekedwa ku foni yamakono), mapampu - zida zamagetsi zodziwikiratu, zomwe zimatha kufalikira kwa dokotala kudzera pakupanga kwa telemedicine. Malinga ndi ziwerengero, ana odwala ndi achinyamata omwe ali pachithandizo cha pampu mdziko lathu ndi anthu pafupifupi 9,000. Ku Russia, mapampu amaikiratu kwaulere, pakuwonongeratu ndalama za federal pansi pa pulogalamu yapamwamba yazamalonda ndikuchotseredwa bajeti.

Thandizo laubongo

"Akatswiri azachipatala amaphunzitsidwa kulumikizana ndi odwala omwe ali ndi matenda a shuga m'magawo a Russia. Mwachitsanzo, m'chigawo chilichonse cha Moscow m'mabungwe amzindawo amisala yama psychology komanso yachipatala pali akatswiri azamisala omwe amadziwa bwino za matenda a shuga kwa ana omwe ali okonzeka kuthandiza mabanja omwe ali okonzeka kuthandiza mabanja pakupanga matenda, kuthana ndi kukhumudwa, kusintha malingaliro ndi kudzidalira. Ndikofunika kudziwa kuti thandizo ndi laulere kwa banja, komanso chithandizo chamankhwala, "adatero Anna. arpushkina, MD Mutu wa Alfa Endo Charity Program.

Za mtsogolo

"Sindine mneneri, koma mbali ziwiri zikulonjeza - kupanga mpope wotsekeka womwe umatha kukhala chosakanizira cha kapamba, ndi maselo omwe amayamba kupangira insulin. Ndikuganiza kuti kutha kwa matenda ashuga kudzachitika zaka 10 zikubwerazi," akutero Joseph Wolfsdorf, Mutu wa Endocrinology, Boston watoto Medical Center, Pulofesa wa Pediatrics ku Harvard University.

Udindo wa kapamba

Zikondamoyo zimathandizira kugaya chakudya, chifukwa cha ma enzymes obisika, ndipo zimatulutsanso insulin kuti maselo amthupi amatha kugwiritsa ntchito moyenera gwero lawo lamphamvu - glucose.

Mtundu woyamba wa matenda ashuga, maselo a beta a kapamba omwe amatulutsa insulin amakhudzidwa. Ndipo pamapeto pake, chitsulo chimalephera kutulutsa timadzi tofunikira tambiri.

Mtundu wachiwiri wa matenda ashuga, kapamba amatha kutulutsa insulin, koma sikokwanira kuti thupi lizigwira ntchito moyenera.

Mlingo woyenera wa insulin ndikofunikira kwambiri kuti magazi azikhala ndi glucose m'malo otetezeka.

Matenda a shuga amadziwika ndi njira yayitali komanso kuphwanya mitundu yonse ya kagayidwe: chakudya, mafuta, mapuloteni, mchere komanso mchere wamchere. Pafupifupi 20% ya odwala matenda a shuga amayambitsa matenda a impso.

Zikondamoyo zopanga

Pofika mu Juni 2017, pali zida zapamwamba, mwachitsanzo, kapamba wochita kupanga (chophatikizira pampu ya insulin komanso njira yowunikira mosalekeza magazi), yomwe imathandiza kwambiri anthu omwe ali ndi matenda amtundu wa 1 kusamalira mikhalidwe yawo ndikupangitsa moyo wawo kukhala wosavuta. Kachipangizidwe kameneka kamayang'ana shuga wanu wamagazi ndikuchotsa kuchuluka kwa insulini pakafunika. Chipangizocho chimagwira ntchito molumikizana ndi foni yam'manja kapena piritsi. Masiku ano, pali mtundu umodzi wokha wa ma pancreas ochita kupanga, ndipo umatchedwa "hybrid system". Zimaphatikizanso sensa yolumikizidwa ndi thupi kuyeza glucose mphindi zisanu zilizonse, komanso pampu ya insulin yomwe imadzivulaza yokha insulin kudzera mu catheter yoikiratu.

Popeza dongosololi ndi lophatikiza, silinadziwike zokha. Izi zikutanthauza kuti wodwalayo ayenera kutsimikizira pamanja mlingo wa insulin. Chifukwa chake, mu 2017, ochita kafukufuku akuphunzira njira zothetsera insulin zowonetsetsa kuti mlingo woyenera wa mahomoniwo umayendetsedwa popanda kufunikira kwa ogwiritsa ntchito.

2019: Chuma paimfa: mtengo wa insulin ku U.S. unadutsanso

Kumapeto kwa Januware 2019, Bungwe losagwiritsa ntchito phindu la kuwunika kwa Chelete HCCI lidatulutsa lipotilo malinga ndi momwe mtengo wa insulini wochizira matenda amishuga 1 ku United States udatsala pang'ono kuwirikiza kawiri pazaka zisanu kuyambira 2012 mpaka 2016, zomwe zimalungamitsa ziwonetsero kuchokera kwa anthu zakukwera kwa mitengo yamankhwala .

Malinga ndi malipoti, mchaka cha 2012, munthu wamba yemwe ali ndi matenda a shuga 1 amawononga $ 2,864 pachaka pa chithandizo, pomwe mu 2016 ndalama za insulini pachaka zidakwera $ 5,705. Ziwerengerozi zikuyimira ndalama zonse zomwe wodwalayo adakalandira ndi inshuwaransi yake mankhwala, ndipo osawonetsa kuchotsera komwe kulipidwa pambuyo pake.

Kukwera mtengo kwa insulini kumapangitsa kuti odwala ena asokoneze thanzi lawo. Amayamba kuchepetsa kugwiritsa ntchito mankhwala ofunikira chifukwa sangakwanitse kugula insulin. Odwala ndi mamembala a mabanja awo akhala akuchita ziwonetsero kangapo pansi pa mawindo a likulu la opanga insulin.

Malinga ndi lipoti la HCCI, kudumpha pakugwiritsa ntchito kunali chifukwa chamtengo wokwera wa insulini paliponse komanso kutulutsidwa kwa mankhwala okwera mtengo ndi omwe amapanga. Anthu ambiri omwe amadwala insulin tsiku lililonse pazaka zisanu zomwezi adangokulira ndi 3% yokha, ndipo mankhwala atsopano samapereka phindu lapadera ndipo amapanga kachidutswa kakang'ono chabe ka mowa. Nthawi yomweyo, mitengo imasinthika kwa mankhwala onse atsopano ndi akale - mankhwala omwewo amatsitsa kawiri mu 2016 monga mu 2012.

Opanga mankhwala ali ndi zifukwa zomveka zakuti nthawi ndi nthawi amafunika kukweza mtengo wa mankhwala ku United States kuti athe kulipira kuchotsera kwakukulu komwe kumawathandiza kulowa msika wa inshuwaransi. Mu 2017-2018 opanga zazikuluzikulu zamankhwala ayamba kuthana ndi chiwonjezeko cha pachaka cha mitengo ya mankhwala opanikizika pokakamizidwa ndi akuluakulu a US Purezidenti Donald Trump ndi Congress.

Idakhazikitsa dongosolo loyamba padziko lonse lodziwitsa matenda ashuga

Mu Julayi 2018, United States idakhazikitsa njira yoyesera yodziyimira padziko lonse lapansi yodziyimira padziko lonse kuti adziwe matenda a kabetic retinopathy, vuto lalikulu la matenda osokoneza bongo omwe, popanda kuwunikira moyenera komanso kuthandizira, angayambitse kuwonongeka kwathunthu. Wopanga makina, IDx Company, adapanga algorithm yawo yodziwira matenda a retinopathy mwa anthu azaka zopitilira 22 omwe ali ndi matenda a shuga mellitus ochokera pazithunzi za fundus. Yunivesite ya Iowa inali bungwe loyamba la zamankhwala ku US kukhazikitsa tekinoloje pamachitidwe azachipatala. Zambiri apa.

2017: Anthu 45 aku Russia omwe ali pachiwopsezo chokhala ndi matenda ashuga mzaka 10 zikubwerazi

Ofufuza ku Genotek Medical Genetics Center adasanthula zotsatira za mayeso a 2500 a DNA ndipo anapeza kuti 40% ya anthu aku Russia ali ndi mtundu wankhanza wa jini la TCF7L2, lomwe limawonjezera tsogolo lawo la mtundu wa matenda ashuga 2 nthawi 1.5 - mtundu wa CT genotype. Mu 5% ina, mtundu wowopsa wamtundu womwewo udapezeka womwe umawonjezera chiwopsezo cha matendawa ndi nthawi 2.5 - mtundu wa TT. Kuphatikiza ndi mndandanda wamankhwala opitilira 25, mtundu wa CT umachulukitsa mwayi wokhala ndi matendawa pafupifupi 2,5, ndipo mtundu wa TT - osachepera kanayi. Malinga ndi ziwerengero, mwa anthu 2500 aku Russia adaphunzira, chidziwitso chowonjezeka cha thupi chimaposa 30%. Phunziroli, tidagwiritsa ntchito zoyesa za mayeso a DNA ya abambo ndi amayi azaka zapakati pa 18 ndi 60.

Malinga ndi Unduna wa Zaumoyo, chiyembekezo choti matenda a matenda ashuga a 2 achoka wafika zaka 30. World Health Organisation ilosera kuti matenda ashuga azikhala chitsogozo chachisanu ndi chiwiri cha imfa pofika 2030. Malinga ndi WHO, mu 2015, odwala 4,5 miliyoni omwe adazindikira kuti ali ndi matenda a shuga 2 adalembedwa ku Russia, ndipo chaka chilichonse chiwerengerocho chikuwonjezeka ndi 3-5%, pazaka 10 zapitazi chiwerengero cha odwala chawonjezeka ndi anthu miliyoni miliyoni. Madokotala amapeza ziwerengero zofunikira kwambiri, popeza odwala ambiri safunafuna thandizo kapena kuchedwa kwambiri. Malinga ndi kudziwikiratu kwa Institute of Diabetes of the Federal State Budgetary Institution Endocrinological Research Center, kuchuluka kwenikweni kwa matenda ashuga a 2 ku Russia ndi kokwana katatu kuposa kuchuluka kwa boma, ndiye kuti, pafupifupi anthu miliyoni 10,000.

Kuwerengera komwe kupereka kwa majini komanso zochitika m'moyo, malinga ndi akatswiri a Institute of Diabetes, ndi 90% mpaka 10%, koma lingaliro lakutsogolo kwa mtundu wachiwiri wa matenda a shuga silingatheke konse ndi njira yoyenera yopewa matendawa. Kuti mudziwe njira zodzitetezera, ndikofunikira kuwerengera kuchuluka kwa chiwopsezo cha majini komanso momwe moyo wamunthu umakhudzira. Chochita chofunikira kwambiri pankhani ya matenda a shuga ndi onenepa kwambiri, chifukwa chake ndikofunikira kuwonjezera index ya thupi (BMI) pazotsatira za kusinthidwa kwa majini kuti muwerenge zowopsa zomwe zingachitike. Kuti mudziwe mzere wamtundu wakuthupi, ndikofunikira kugawa kulemera kwamunthuyo m'makilogalamu mwake kutalika kwake, mita, mulifupi, kenako kugawa kulemera kwake ndi zotsatira zake. Matenda a shuga amawonjezeka nthawi 1.6 ndi BMI ya 25-30, yomwe mankhwalawa amadziwika kuti ndi onenepa kwambiri. Ndi BMI ya 30-35, mwayi wokhala ndi matendawa umachulukitsa katatu, ndi 35-40 - 6 nthawi, komanso BMI pamtunda wa 40 - 11 nthawi.

`Kuyesedwa kwa DNA ndikofunikira kudziwa momwe vuto limakukhudzirani. Kukhalapo kwa zolembera zomwe zimawonjezera mwayi wokhala ndi matenda ashuga ndi nthawi 1.5 komanso kupezeka kwa zolemba zomwe zimachulukitsa nthawi za 2.5 ndizosiyana ndi chiopsezo ndi kupewa njira zomwe ndizosiyana poyeserera. Ndipo ngati chiwonetsero chambiri cha thupi chikuwonjezeredwa kwa izi, ndiye kuti kuchulukitsa kumawonjezeka pafupifupi nthawi 1.6. Zikhala zokwanira kwa wina kudzikana yekha chakudya chamadzulo kapena chakudya, ndipo kwa wina, kupewa ndi njira yayikulu yomwe ingasinthe moyo wanu. Kafukufukuyu akuyenera kuwunikira zovuta za matenda ashuga ku Russia komanso chitukuko cha njira zodzitetezera payekha potengera mikhalidwe ya genome`, atero a geneticist, director wamkulu wa Genotek Genetek Medical and Genetic Center Valery Ilyinsky.

`DNA yaumunthu siyimasintha pakapita nthawi, koma machitidwe omwe moyo wathu umadalira. Ndi kuchuluka kwa chakudya chofulumira komanso zakudya zambiri za shuga, ndi vuto lomwe likukula la zinthu zolimbitsa thupi, matenda ashuga ngati matenda ayamba kuchepa. Pakalipano, madokotala akuti m'mbuyomu adapezeka mwa anthu achikulire opitilira 60, koma tsopano akupezeka ndi odwala omwe ali ndi zaka 30- 35. Cholinga chake ndikubadwa kwamunthu komwe kumakulirakulira ndi moyo wopanda thanzi, 'atero a Marina Stepkovskaya, MD, Ph.D., dokotala wamkulu ku genotek Medical Genetics Center.

Kodi matenda ashuga ndi chiani?

Matenda a shuga a mellitus (DM) ndi matenda osachiritsika omwe amayamba ngati kapamba satulutsa insulin yokwanira, kapena ngati thupi silingagwiritse ntchito bwino insulini.

Insulin ndi timadzi timene timayendetsa shuga m'magazi. Zotsatira zonse za shuga wosalamulirika ndi hyperglycemia, kapena kuchuluka kwa shuga (m'magazi) m'magazi, omwe pakapita nthawi amabweretsa zowonongeka zambiri m'magulu amthupi ambiri.

Matenda a shuga amayambitsa kuwonongeka kwa mtima, mitsempha yamagazi, maso, impso ndi mitsempha. Amadziwika kuti kukula kwa matenda ashuga a mtundu 2, monga lamulo, kumayendetsedwa ndi kusintha kwa thupi, mu mankhwala omwe amatchedwa prediabetes.

Zizindikiro za matenda ashuga

ZOONA

Matenda a shuga ndi matenda osachiritsika omwe amapezeka pamene kapamba satulutsa timadzi tokwanira ta insulin, kapena ngati thupi silingagwiritse ntchito bwino insulin yomwe ikupanga pazosowa zake.

Ndi insulin yomwe imasunganso shuga m'magazi. Chifukwa cha kuchepa kwa insulin, kuchuluka kwa shuga m'magazi, hyperglycemia imayamba. Ngati kuchuluka kwa glucose okwera sikukonzedwa kwa nthawi yayitali mothandizidwa ndi mankhwala, zovuta zingapo zimabuka, kuphatikizapo khungu kapena kulephera kwa impso. Wachiwiri aliyense wodwala matenda ashuga amakhala ndi myocardial infarction kapena ischemic stroke pakapita nthawi.

Ndi thanzi labwino, simungathe kuyeza kuchuluka kwa shuga m'magazi.