Isifo sikashukela mellitus yiqembu lezifo ze-endocrine. Kunesifo sikashukela sohlobo 1 (ifomu lokuncika i-insulin), uhlobo 2 (ifomu elingathembekile le-insulin) kanye noshukela wabesifazane abakhulelwe. Ukuqonda ukuthi kungani isifo sikashukela sivela, kufanele wazi ukuthi hlobo luni lwesifo olubandakanyekayo. Kunzima ukusho ngokungathandabuzi ukuthi yini ngempela enyusa lesi sifo. Kepha odokotela bayazi ukuthi yiziphi izimbangela eziba nomthelela ekuthuthukiseni izinkinga.
Ukuhlukaniswa kwesifo sikashukela
Odokotela bahlukanisa izinhlobo ezi-2 zesifo sikashukela: ushukela kanye noshukela. Kwi-insipidus yesifo sikashukela, kutholakala ukuntuleka kwe-vasopressin (i-antidiuretic hormone), nalesi simo kukhona i-polyuria (imvamisa yokuchama) kanye ne-polydipsia (ukoma okungalawuleki).
Isifo sikashukela i-mellitus sezinhlobo eziningana. Lesi yisifo esingapheli esibonakaliswa ukwephulwa kwe-metabolism yama-carbohydrate (ushukela). Kukhona futhi ukwephulwa okuncane kwenqubo ye-protein metabolism.
Uhlobo lwesifo esincike e-insulin luhlobo losuku lwesifo sikashukela mellitus (DM). Kubonakala ngokushoda kwe-insulin emzimbeni. Ezigulini ezinjalo, i-pancreas yonakele, ayikwazi ukubekezelela umthwalo. Kwezinye iziguli, akakhiqizi i-insulin nhlobo. Kwabanye, ukukhiqizwa kwawo akubalulekile kangako kangangokuba ayikwazi ukucubungula ngisho inani elincane le-glucose, engena emzimbeni ngokudla.
Uhlobo lwesifo oluzimele lwe-insulin lubizwa ngokuthi isifo sikashukela sohlobo 2. Ikhula ikakhulu kubantu abadala. Ngalesi sifo, i-insulin iyaqhubeka nokukhiqizwa emzimbeni, kodwa izicubu ziyeka ukusibona.
Kwesinye isikhathi inkinga ivela ngesikhathi sokukhulelwa. Lokhu kungenxa yomthwalo owandayo kwizitho zangaphakathi zikamama okhulelwe.
Uhlobo 1 Sikashukela: Izimbangela
Esikhathini sikashukela esincike ku-insulin, ukukhiqizwa kwe-hormone insulin kuyancipha noma kuyeke ngokuphelele. Amaseli e-Beta atholakala kumanyikwe ayafa.
Imvamisa, lolu hlobo lwesifo lutholakala ezinganeni, intsha nentsha engaphansi kweminyaka engama-20.
Le lesion ye-autoimmune lapho amasosha omzimba eqala ukulwa namaseli ayo. Ososayensi bathole ukuthi emzimbeni wawo wonke umuntu izinhlobo eziningana zisebenza ekutholeni eyabo, imizimba yangaphandle kanye nomehluko wayo. Kepha uma kwenzeka ukungasebenzi kahle, ukungatheleleki komzimba kuqala ukuhlasela okwakhe amaseli we-beta, hhayi abahlukumezayo. Ngisho nokufakelwa kwamanyikwe akwenzi imiphumela: ukungatheleleki kubheka amaseli we-beta "njengabantu ongabazi" futhi aqala ukuwashabalalisa. Akunakwenzeka ukubabuyisela.
Ngakho-ke, isifo sikashukela esivame ukwenzeka siphikisana nesizinda sofuzo kanye nezinqubo ze-autoimmune ezithuthuka emzimbeni. Kepha kwezinye izimo, ukutheleleka ngegciwane kuvusa ukukhula kwalesi sifo.
Kusungulwe ukuthi kubazali abanempilo, izingane zingatholakala zinesifo sikashukela esincike emuva kokuhlaselwa yizifo ezingamagciwane "ezinsana".
- ama-mumps;
- rubella
- isimungumungwane
- inyosi;
- i-hepatitis yegciwane.
Kwezinye, uhlobo 1 sikashukela luvela ngemuva kwesifo sezinso. Isilonda ngasinye segciwane sinomphumela ohlukile emzimbeni. Ezinye zazo zilimaza kakhulu ama-pancreas. Kwasungulwa ukuthi uma umama ehlushwa i-rubella ngesikhathi sokukhulelwa, ingane izoba nesifo sikashukela esincike ku-insulin: isiphetho sokukhula kwe-insulin siyachithwa.
Kwezinye izilonda, amagciwane akhiqiza amaprotheni afana nama-beta cell abhekene nokukhiqizwa kwe-insulin. Lapho amaprotheni angaphandle ebhujiswa, ukungasebenzi komzimba kuhlasela namaseli ayo e-beta. Ngenxa yalokho, isizukulwane se-insulin sincishiswa kakhulu. Izifo zezinso, okuyi-glomerulonephritis, nazo zingadala izinqubo ze-autoimmune.
Izingcindezi ezihleliwe zingaholela kokungasebenzi kahle kwamasosha omzimba. Ngempela, phakathi kwesimo esicindezelayo, inani elithile lama-hormone likhishwa egazini, ngokuhamba kwesikhathi, ukulethwa kwawo kuyancipha. Ukuwabuyisela, umzimba udinga i-glucose. Ngale ndlela, yingakho abantu abaningi "jam" begcizelela ngamaswidi.
Lapho inani le-glucose ngokweqile lifakwa, i-pancreas iqala ukusebenza ngemodi ethuthukisiwe. Kepha ukucindezela kuyadlula, ukudla kuyashintsha. Ama-pancreas, ngomkhuba, akhiqiza inani le-insulin ngokweqile, elingadingeki. Ngenxa yalokhu, gxumela emazingeni kashukela egazini aqala egazini: indlela yemvelo yamanyikwe iyaphazamiseka.
Kepha ukusabela okunjalo ngamagciwane nengcindezi akwenzeki kubo bonke abantu. Ngakho-ke, ukuqonda ukuthi ushukela uvela kanjani futhi kungani, umuntu kufanele aqonde ukuthi isakhi sofuzo sisadlala indima.
Izici zokuvusa ukuthuthukiswa kwesifo sikashukela 1
Ngaphezu kwezizathu eziphambili eziyimbangela yokwakhiwa kwesifo sikashukela esincike ku-insulin, ochwepheshe bakhomba izinto ezithile ezingadala ukuqala kwesifo sikashukela.
Lokhu kufaka lokhu okulandelayo.
- Ukuphazamiseka ekwakhekeni kwama-enzyme, ngenxa yalokho ukuphazamiseka kwaphazamiseka.
- Ukuba khona kwezifo ezithathelwanayo zama-pancreas noma izitho ezitholakala eduze: i-pancreatitis noma i-cholecystopancreatitis. Ukwehluleka kwenqubo yokukhiqiza ukungenelela kwe-insulin kuvimbela ukungenelela noma ukulimala.
- Ukudla okunganele kwamaprotheni, i-zinc nama-amino acid ahlukahlukene (obhekene nokudluliselwa kwe-insulin egazini), kuhlanganiswe namanani amaningi e-iron, kuholela ekuhlukaniseni inqubo yokukhiqizwa kwe-insulin. Igazi, ligcwele insimbi, lingena kumanyikwe liba imbangela yokugcwala kwalo: inqubo yokukhiqizwa kwe-insulin iyancipha.
- I-atherossteosis yemithambo yegazi ingadala ukwephula kokuhlinzekelwa kwegazi kumanyikwe. Ngenxa yalokhu, ukukhiqizwa kwe-insulin kungamisa ngokuphelele.
Uhlobo 2 sikashukela mellitus: izimbangela
Uma uhlobo lwesifo oludinga i-insulin luthinta ikakhulukazi abantu abasha, bese uthayipha isifo sikashukela sesibili isifo esidala. Emizimbeni yabo, inqubo yokukhiqiza i-insulin iyaqhubeka, kepha le hormone iyayeka ukubhekana nemisebenzi yayo. Amathishu alahlekelwa ukuzwela kuwo.
Lesi sifo asihlotshaniswa nezici zamasosha omzimba noma nokutheleleka ngegciwane. Simply, ukungavikeleki kwe-insulin ekhiqizayo kungavela. Amangqamuzana awasebenzisi i-glucose, ngakho-ke, isibonakaliso mayelana nokugcwala komzimba ngoshukela akuveli. Noma kungekho ukungasebenzi kahle kwamanyikwe, i-insulin iqala ukukhiqizwa kamuva.
Izimbangela ngqo zikashukela kubantu abadala kunzima ukuzazisa. Ngemuva kwakho konke, kulokhu kufanele uqonde ukuthi kungani izicubu zingasaphenduli ukungena kweglucose emzimbeni. Kepha odokotela sebekhombile ubungozi obukhona lapho kungenzeka khona ukuthi isifo sikashukela sohlobo 2 siphezulu kakhulu.
- Isakhi sofuzo. Uma omunye wabazali enesifo sikashukela sohlobo 2, khona-ke amathuba okukhula kwengane afinyelela kuma-39%, uma bobabili abazali begula, - ke - 70%.
- Ukukhuluphala ngokweqile Ukuba khona kwesisindo ngokweqile kubantu abadala kuyisici esinqunyiwe: iningi leziguli ezine-endocrinologists ezinesifo sikashukela sohlobo 2 zinenkinga yokukhuluphala, i-BMI yazo idlula ngo-25. Ngokweqile kwezicubu ze-adipose emzimbeni, inani le-FFA (fat free acids) liyenyuka: zinciphisa umsebenzi oyimfihlo wamanyikwe. Ama-FFA nawo anobuthi kumaseli we-beta.
- Isifo se-Metabolic. Lesi simo sibonakaliswa ukwanda kwenani lama-visceral fat, metabolite imetrate ye-purines, ama-carbohydrate kanye ne-lipids, ukubonakala komfutho wegazi ophakeme. Inkinga iba yisizinda sokuphazamiseka kwe-hormonal, umfutho wegazi ophakeme, ama-polycystic ovari, isifo senhliziyo, ukuqaqamba kokuya esikhathini.
- Ukuthatha umuthi. Lapho uthatha imishanguzo ethile, kunengozi yokuba nesifo sikashukela. Lokhu kufaka phakathi i-glucocorticoids (ama-hormone akhiqizwa emzimbeni yi-adrenal cortex), ama-antipsychotic atypical, ama-statins nama-beta-blockers.
Ezinye zezimbangela zesifo sikashukela sohlobo 2 yilezi:
- ukuntuleka kokunyakaza;
- ukungondleki okungafanele, lapho inani elincane le-fiber nenani lokudla elicwengekileyo lingena emzimbeni;
- i-pancreatitis ngesimo esingamahlalakhona noma esibuhlungu;
- isifo sokuqina kwemithambo yegazi kwemithambo yegazi.
Lapho uthola lolu hlobo lwesifo, kufanele uqonde ukuthi kungani lwavela. Mhlawumbe kuzokwanela ukulungisa ukudla, ukunciphisa ukubonakaliswa kwesifo esingaphansi, ukuze ususe izimpawu zesifo sikashukela. Ngeke kusebenze ukuqeda lesi sifo se-endocrine, kepha iziguli zinethuba lokugcina amazinga ashukela wazo elawulwa.
Izimbangela zesifo sikashukela sokukhulelwa
Ukuphazamiseka kwesifo seglucose komama abakhulelwe kudinga ukulawulwa okukhethekile. Ukuthola izimbangela zesifo sikashukela sokukhulelwa kungaba nzima. Ngenhlanhla, lesi sifo asenzeki kaningi. Izizathu ezinkulu ezingavusa ukwephulwa:
- isakhi sofuzo: phambi kwezihlobo ezinesifo sikashukela, amathuba okuthuthuka kwayo ayanda;
- izifo ezidlulisiwe ezibangelwa amagciwane: ezinye zazo zingadala ukungasebenzi kahle kwamanyikwe;
- ukuba khona kwezilonda ze-autoimmune lapho amaseli wokuzivikela emzimbeni eqala ukubhubhisa amaseli we-beta;
- ukondleka okunamakhalori aphezulu kuhlanganiswe nokuhamba okuphansi: abesifazane abane-BMI ngaphambi kokukhulelwa ngaphezulu kwama-25 basengozini;
- iminyaka yokukhulelwa: kuyalulekwa ukuthi uhlole zonke iziguli ezingaphezulu kweminyaka engama-35;
- ukuzalwa kwezingane zangaphambilini ezinesisindo esingaphezu kwama-4.5 kg noma ukuzalwa kwezingane ezifile ngezizathu ezingaziwa.
Kutholakale ukuthi abantu base-Asia kanye nabase-Afrika basengozini enkulu yokuba nalesi sifo.
Izimpawu zomuntu
Akwanele ukuqonda ukuthi isifo sikashukela sakhiwa kanjani, yiziphi izifo nezinto ezibangela isifo, kufanele wazi ukuthi sibonisa kanjani. Uma unaka izimpawu ezibonakala ezigabeni zokuqala zokukhula kwalesi sifo, ukuqhubekela phambili kohlobo 2 lwesifo sikashukela kungavinjelwa.
Ngoshukela wohlobo loku-1, izimpawu ziyabizwa, futhi iziguli zithuthukisa i-ketoacidosis ngokushesha. Lesi simo sibonisa ngokuqongelela kwemikhiqizo yokubola kwe-metabolic kanye nemizimba ye-ketone. Ngenxa yalokhu, uhlelo lwezinzwa luyathinteka, isiguli singawela enkingeni yesifo sikashukela.
Izimpawu eziphambili zokwanda ushukela wegazi yilezi:
- ukoma okungenakuphikiswa;
- ukozela
- ubuqili;
- umuzwa owomile emgodini womlomo;
- ukuchama njalo;
- ukunciphisa umzimba.
Inani loketshezi oludakayo lingadlula amalitha ama-5 ngosuku. Kulokhu, umzimba uqongelela ushukela emzimbeni, ngenxa yokuntuleka kwe-insulin, awuphuli.
Nge-Type 2 sikashukela, izimpawu azishiwongo, zibonakala sekwephuzile. Ngakho-ke, abantu abanokukhuluphala, izinkinga ezinomfutho wegazi kanye nesifo sofuzo belulekwa ukuba bahlole njalo amazinga abo kashukela egazini. Izimpawu zesifo sikashukela sohlobo 2 zihlanganisa:
- umlomo owomile
- ukulunywa kwesikhumba;
- ukukhuluphala
- ukwanda kokuchama;
- ukoma okuphikelelayo;
- ubuthakathaka bemisipha;
- ukungaboni kahle
Ebudodeni, ukwehla kwesifiso sobulili kungabonakala. Ngokuthuthukiswa kwalezi zimpawu, kufanele uthintane ngokushesha nodokotela oyi-endocrinologist. Uyonquma ukuhlolwa okudingekayo. Uma ukuxilongwa kuqinisekisiwe, udokotela uzozama ukuthola ukuthi lesi sifo sivelaphi. Uma kungenakwenzeka ukuthola izizathu noma i-endocrine disorder ivele ngenxa yengozi eyenzeka kusengaphambili, udokotela uzozama ukukhetha indlela efanelekile yokwelapha.
Izincomo zikadokotela kumele zibhekwe ngokuqinile. Le ukuphela kwendlela yokugcina lesi sifo silawulwa. I-Endocrinologist izodinga ukukhonjiswa njalo. Uma isimo siba sibi kakhulu, khona-ke uyakwazi ukulungisa lapho uya khona.
