Uchwepheshe wezokwelapha, okhetha umuthi wesifo sikashukela esigulini, kufanele aqondiswe yizici eziningi, ezibandakanya ubudala kanye nobunzima benqubo ye-pathological, ukuba khona kwezifo ezihambisanayo. Ngaphezu kwalokho, kuya ngohlobo lwe-pathology, amaqhinga wokwelapha lesi sifo angaguquka.
Kumele kuqashelwe ukuthi ukuthatha amaphilisi kuphela wesifo sikashukela awukwazi ukufeza umphumela wesikhathi eside impela, ngoba ukwelashwa kwalesi sifo kufanele kube nzima. Ukuhambisana nokudla okwelaphayo kanye nendlela yokuphila esebenzayo iba yizinto ezibalulekile.
Ngeshwa, isifo sikashukela yisifo esingelapheki ngokuphelele. Uma umuntu enikezwa lokhu kuxilonga, kusho ukuthi kufanele uyishintshe kakhulu indlela yakho yokuphila eyejwayelekile uyilandele njalo.
Ukwelashwa kwesifo sikashukela namuhla kunikeza izidakamizwa ezintsha ngokwengeziwe ezingenawo umthelela omubi kangako emzimbeni womuntu njengezidakamizwa zesizukulwane sakudala.
Yini isifo?
Ngenqubo yokuthuthukiswa kwalesi sifo, ukwephulwa okuhamba kancane kwazo zonke izinqubo ze-metabolic emzimbeni kwenzeka. Isizathu esiyinhloko salokhu kwehluleka akuyona i-pancreas ekhiqiza inani elidingekayo le-insulin ye-hormone, elawula izinga le-glucose egazini.
Ngenxa yalokhu, amangqamuzana omzimba awatholakali amandla adingekayo nezinye izinto ezibalulekile, futhi ukugcwala okungaphezulu kwezinkomba zikashukela kubangela ezinye izifo zezitho zangaphakathi ukuba zibonakale.
Namuhla, kunezinhlobo ezimbili eziyinhloko zezifo:
- Thayipha isifo sikashukela sokuqala. Isici esivelele salolu hlobo lwalesi sifo ukungakwazi kwe-pancreas ukukhiqiza i-insulin ngokwayo. Kungakho-ke, abantu abakhombe le-pathology (yohlobo lokuqala) badinga imijovo engapheli yehomoni ukugcina imisebenzi yabo ebalulekile.
- Isifo sikashukela sohlobo 2 siyindlela evamile yesifo. Ngokwezibalo zezokwelapha, abesifazane basengozini enkulu yokuba ne-pathology ukwedlula abesilisa. Ngaphezu kwalokho, asebekhulile basengozini. Isici esiyinhloko sokuqanjwa kwalolu hlobo lwenqubo ye-pathological ukungakwazi kwamanyikwe ukukhiqiza i-insulin ngenani elidingekayo lomzimba.
Ezimweni ezingavamile kakhulu, indlela ye-pathology efana nesifo sikashukela sokukhulelwa nayo ingenzeka. Izizathu eziyinhloko zokuthuthuka kwayo zingafaka lezi zinto ezilandelayo:
- isikhathi sokuzala ingane ngowesifazane;
- ukuthuthukiswa kwe-hyperglycemia.
Izimbangela zokukhula kwalesi sifo zingafaka:
- isakhi sofuzo noma isici sofuzo;
- ukukhuluphala nokukhuluphala ngokweqile;
- ukucindezela okukhulu kanye nokushaywa uvalo;
- indlela yokuphila yokuhlala nokuntuleka komzimba;
- ukungena emzimbeni wowesifazane wokutheleleka okuhlukahlukene kwamagciwane.
Ngaphezu kwalokho, izimbangela zokubonakaliswa kwalesi sifo zingafaka izinto ezinjengobudala, i-ecology, ukusebenza okujwayelekile kwamanyikwe, ubukhona bokuphumula okufanele.
Yiziphi izimpawu ezibonisa ukukhula kwe-pathology?
Akunandaba noma ngabe hlobo luni lwesifo olwenzeka, izimpawu zesifo sikashukela sizofana.
Esikhathini sikashukela sohlobo lwesibili, izimpawu zokuqala zingahle zivele zingabonakali esigulini. Imvamisa ukutholwa kwe-pathology kwenzeka lapho lesi sifo sithola umfutho wokukhula kwawo.
Indlela yokuphila yesimanjemanje, ukushesha okungapheli nokucindezela okuhambisana nakho kuvame ukuholela eqinisweni lokuthi umuntu umane nje akaziboni izimpawu zokuqala zesifo.
Izimpawu eziphambili zesifo sikashukela zingaba ngale ndlela elandelayo:
- Ukuphelelwa ngamandla, ukuphuka kanye nomuzwa ongapheli wokukhathala kungaba yizimpawu zokuqala ezivela nesifo sikashukela sohlobo 2. Njengomthetho, umuzwa wokuba buthakathaka awumshiyi umuntu ngisho nangemva kokuphumula okuhle nokulala.
- Ukubonakaliswa kokwehla, ukudinwa kanye nokuphelelwa amandla ngemuva kokudla, ikakhulukazi uma lesi simo siba yinto esejwayelekile futhi sizibonakalisa njalo.
- Ukoma okungaguquki, okuhambisana nokoma okunzima emgodini womlomo. Kumele kuqashelwe ukuthi, ngisho nokuphuza amanzi amaningi, umuntu akakwazi ukuqeda ukoma kwakhe. Kuwuphawu olunjalo lohlobo 2 lwesifo sikashukela esibonakala kakhulu futhi kufanele kube wuphawu lwesidingo sokubonana nodokotela.
- Isifiso esijwayelekile sokuchithwa nokukhipha uketshezi oluningi emzimbeni, kukhombisa ukuthuthuka kwalesi sifo kanye nokulimala kwemetabolism.
- Isisindo esengeziwe siphazamisa ukumuncwa okujwayelekile kwe-glucose. Kungakho ukukhuluphala kungenye yezimpawu ezinkulu zobungozi eziba nomthelela ekuthuthukiseni lesi sifo. Izimpawu zohlobo 2 sikashukela mellitus zingafaka ukukhuphuka kwamafutha omzimba esinqeni nasesiswini.
- Umfutho wegazi ojwayelekile njalo.
- Isifiso esingenakuvinjwa samaswidi kanye nesifiso sokudla. Ngasikhathi sinye, ngaphandle kokudla ukudla okuningi, umuntu angakwazi ukunciphisa umzimba.
- Ukubonakaliswa kwezinkinga ngesikhumba nokwanda kwesimo. Ngaphezu kwalokho, abesifazane bavame ukukhononda ngokulunywa kuwo wonke umzimba, ikakhulukazi endaweni ye-groin. Futhi, ama-pustule ahlukahlukene kanye nezinduna angavela esikhunjeni. Ngokuhamba kwesikhathi, isikhumba ezintendeni zezinyawo nasezinyaweni ziyashintsha - ziba zixakaxaka futhi zi-keratinized. Ukunakwa kufanele futhi kukhokhwe ekushintsheni kwamapuleti ezipikili, ukupenda kwabo nokuqina.
- Ukuphazamiseka kwekhanda okuqhubekayo, okungahle kuhambisane nomcanucanu nokuhlanza.
- Ukonakala okubukhali embonweni.
- Ukuvela kobuhlungu ematholeni nasemikhondeni.
- Lapho kudlula umchamo wokuhlaziywa, imiphumela ingakhombisa ubukhona be-acetone.
- Kunezinkinga ngomjikelezo wokuya esikhathini.
Ngaphandle kwezizathu ezenze ukuba lesi sifo sikhule, uma kuvela izimpawu ezinjalo, kufanele uthinte isikhungo sezokwelapha futhi wenze izifundo ezidingekayo.
Yikuphi ukwelashwa kwe-pathology?
Izidakamizwa zokwelapha isifo sikashukela zichazwa lapho izindlela ezingezona ezokwelapha (okungukuthi, ukwelashwa kokudla kanye nomsebenzi womzimba) zingalethi umphumela ofanele.
Ngenxa yokuthi kukhona ukwephulwa kumanyikwe, izinga likashukela wegazi alikwazi ukwenziwa libe linye ngaphandle kokungenelela kwezokwelapha.
Namuhla, kunezidakamizwa eziningi ezibekwe etafuleni ezisetshenziselwa ukwenza i-glycemia ibe ngejwayelekile.
Onke ahlukaniswe ngemibandela emaqenjini athile futhi asetshenziswa ngokuya ngezici zenkambo yesifo esigulini esithile:
- Ama-Secretagogue yimithi yesifo sikashukela esiza ukukhuthaza ukukhululeka kwe-insulin ye-hormone. Leli qembu lemithi lifaka ama-subgroups amabili ayinhloko - i-sulfonylureas ne-meglitinides.
- Ama-Sensitizer yizidakamizwa zesifo sikashukela ezinomphumela onamandla wokukhulisa ukuzwela kwamaseli nezicubu zomzimba ku-insulin ekhiqizwa ama-pancreas. Amaphilisi kashukela anjalo asetshenziswa kaningi ekwakhiweni kwe-insulin ukumelana. Leli qembu lemithi lifaka ukulungiswa kwama-subgroups amabili - ama-biguanides ne-thiazolidatediones.
- Imithi yesifo sikashukela, eyi-alpha-glucosidiaz inhibitors, ebhekele ukumiswa nokufakwa okuvamile kwama-carbohydrate angenayo esiswini, kanye nokuphuma kwawo. Umuthi wesifo sikashukela, oyimeleli eyinhloko yaleli qembu, yi-Acarbose.
- Izidakamizwa ezintsha zikashukela zingama-insretins, ezifaka isandla ekukhiqizweni kwe-insulin futhi ngasikhathi sinye zivimbele ukukhiqizwa kweglucogen.
Imithi eminingi yesimanje esebenza ngempumelelo kakhulu futhi engenawo umthelela omubi emzimbeni wesiguli (ngesimo sokuhlukahluka okuhlukahlukene) inezindleko eziphakeme ngokufanele. Banikezwe iqiniso lokuthi ukusetshenziswa kwabo kufanele kwenziwe kuyo yonke impilo, iziguli eziningi zimane nje azikwazi ukukhokhela umuthi omusha wesifo sikashukela. Kungakho izidakamizwa ezisetshenziswa kakhulu kwisifo sikashukela sohlobo 2 eziseqenjini le-sulfonylurea kanye ne-Biguanide derivatives. Njengomthetho, izidakamizwa ezinje zikashukela zinezindleko eziphansi futhi zisiza ukufeza izinga elidingekayo le-glycemia.
Ngaphezu kwalokho, ukwelashwa okwelashwa kungahlanganisa ukuphathwa okuyinkimbinkimbi kwemithi eqhamuka emaqenjini ahlukahlukene (imiyalelo yesifo sikashukela yokusebenzisa) ukufeza umphumela ongcono.
Imithi eqenjini le-sulfonylurea derivatives
Izithako zeSulfonylurea kudala zisetshenziswa emithini yokwelapha ukwehlisa ushukela wegazi.
Umthelela waleli qembu lemithi emzimbeni womuntu uhlotshaniswa nenqubo yokwenza kusebenze amaseli we-pancreatic beta, axhumana nokukhuthaza nokukhulisa ukwenziwa kwe-insulin.
Ukusetshenziswa kwe-sulfonylurea derivatives kwenzeka phambi kwamaseli we-beta asebenzayo futhi aphelele emzimbeni.
Indlela yokusebenza yaleli qembu lezidakamizwa ukubonakaliswa kwemiphumela elandelayo:
- ukugqugquzelwa kwamaseli we-pancreatic beta kanye nokwanda kokuzwela kwabo ezingeni lamaselulaꓼ
- isenzo esandayo se-insulin nokucindezela kwe-hormone esiyaphula (insulinase) ꓼ
- yenza buthaka ubudlelwano be-insulin namaprotheni, banciphise izinga le-insulin elibophayo kuma-antibodiesꓼ
- neqhaza ekwandeni kokuzwela kwezicubu zemisipha ne-lipid izicubu ze-insulinꓼ
- khuphula inani lama-insulin receptors kuma-membranesꓼ wezicubu
- neqhaza ekusetshenzisweni kangcono kwe-glucose esibindini nasemisiphani
- yenza amandla inqubo ye-gluconeogeneis kusibindiꓼ
- kwezicubu ze-lipid zicindezela i-lipolysis futhi futhi kukhuphula izinga lokufakwa kanye ne-oxidation ye-glucose.
Kuze kube manje, kunezinhlobo eziningi zemithi ethathwe kuma-sulfonylureas.
Izidakamizwa zesigaba sokuqala, ezingasasetshenziswa emithini yesimanje, iTolazamide, Carbutamide. Baphenduka abamele i-sulfonylurea ekuqaleni kwekhulu lamashumi amabili, kepha ngenxa yenani elikhulu lemiphumela emibi ekusebenzeni kwamanye amalungu nezinhlelo zabantu, abasasetshenziswa ngomuthi wanamuhla.
Isigaba sesibili, i-Glibenclamide, Gliclazide neGlipizide ngabamele. Imithi enjalo ivame ukubelwa iziguli ukwehlisa ushukela wegazi labo. Sebenzisa izidakamizwa ezinjalo, kuyadingeka ukuqapha ngokucophelela isimo se-glycemia, ngoba umthamo okhethwe ngokungalungile ungadala ukukhula kwe-hypoglycemia. I-Glimepiride ingey isigaba sesithathu.
Imithi eqenjini le-Biguanide
Izidakamizwa zesifo sikashukela azinakucatshangwa ngaphandle kokusebenzisa ama-biguanides, aqala ukusetshenziswa kwezokwelapha esikhathini esingaphezu kwengxenye yekhulu edlule. Abanye babamele leli qembu baphelelwe yithemba.
Kulokhu, isakhi esiyinhloko sawo wonke ama-biguanides anamuhla yi-metformin hydrochloride esebenzayo. Ngokwesisekelo sayo, imithi eminingi ehlukene yokuhweba iyatholakala, engaba nemithamo ehlukile.
Umuthi onjalo wesifo sikashukela awugcini nje nomphumela we-hypoglycemic, kodwa futhi usiza ukwehlisa isisindo, okubalulekile kubantu abaningi abanesifo sikashukela ngefomu lokuzimela le-insulin. Enye yezinzuzo ze-metformin hydrochloride ukuthi yehlisa ushukela wegazi ngaphandle kokubangela i-hypoglycemia.
Imiphumela ehlukahlukene yezidakamizwa ze-Biguanide ihloselwe:
- Ngokubambisana ne-insulin, kusiza ukunciphisa ukukhiqizwa koshukela ngesibindi, ngenkathi ikhulisa izinga lokuzwela kwe-hepatocides. Ngaphezu kwalokho, le nhlanganisela iholela ekwandeni kwe-glycogen synthesis kanye nokwehla kwe-glycogenolysis.
- Ukunyusa kukhuphula ukubonakaliswa kwe-insulin.
- Umphumela onenzuzo ekususeni ngokushesha ushukela emzimbeni.
- Iphazamisa ukumuncwa kwe-glucose emathunjini.
- Kuthuthukisa inqubo yokusebenzisa ushukela emzimbeni.
Umuthi okhethwe kahle sikashukela osuselwa ku-metformin hydrochloride hhayi ukuthi wehlisa ushukela wegazi kuphela, kepha futhi uvimbela ukwanda kwawo ngokuzayo. Ngaphezu kwalokho, ama-biguanides abekezelelwa kalula yiziguli eziningi futhi awanalo inani elikhulu le-contraindication kanye nemiphumela emibi.
Kumele kuqashelwe ukuthi izidakamizwa ezintsha zesifo sikashukela ziyavela, ezikhipha kancane kancane ukusetshenziswa kwama-Biguanides.
Ngasikhathi sinye, amaphilisi eMetformin asiza ukunciphisa inkambo yesifo emelana noshukela futhi yizo izidakamizwa ezingabizi kakhulu ezigabeni eziningi zeziguli.
Kungenzeka yini ukugwema ukuthuthukiswa kwalesi sifo?
Kunamaqembu athile anobungozi kubantu angaba yizinto ezinomthelela ekuthuthukisweni kwesifo sikashukela.
Lokhu kufaka, okokuqala, abesifazane nabesilisa abanesifiso sokuthola ukuthuthukiswa kwalesi sifo, abantu abakhuluphele kakhulu, abantu abane-vashericherosisosis noma i-hypertension, abesifazane, uma ngesikhathi sokukhulelwa bekunokubonakaliswa kwesifo sikashukela sokukhulelwa noma ukubekezelela okungahambi kahle ushukela, abesifazane abake baba nokuphuphuma kwesisu phambilini.
Izincomo eziphambili ezizosiza ukugwema ukuthuthukiswa kwalesi sifo yilezi ezilandelayo:
- Yenza amasheke avamile wamazinga kashukela.
- Bukeza ngokuphelele ukudla kwakho, gwema ukudla ngokweqile nokuzila ukudla. Ukudla kufanele kube nokwenqatshwa okuphelele kokudla okumnandi noshukela, imikhiqizo yokubhaka, ukudla okunamafutha nokuthosiwe. Imikhiqizo efakazelwe kahle efana neklabishi, isilimo esidliwayo esinamagatsha anamanzi, isipinashi, okusanhlamvu (ngaphandle kwerayisi ne-semolina), i-legumes. Imenyu yokudla ushukela ophezulu kufanele ithuthukiswe uchwepheshe onakekela zonke izici eziqondene nesiguli.
- Yenqaba imikhuba emibi, ungasebenzisi kabi utshwala nokubhema;
- Hola indlela yokuphila esebenzayo, dlala ezemidlalo. Ukuzivocavoca kuyadingeka nokulawula ushukela wegazi. Kwesinye isikhathi kwanele ukumane ungene ekuhambeni kwansuku amabanga ahlukahlukene nasezikhondweni ezahlukahlukene ngendlela yakho yokuphila. Indawo ekahle "yemidlalo" enjalo ingaba ihlathi noma ipaki. Ungase futhi wenze iqoqo lokuzivocavoca ekhaya noma ejimini. Kulokhu, kubalulekile ukucabanga ngamakhono nezimpawu zomzimba wakho futhi ungazisebenzisi ngokweqile.
- Gwema izimo ezicindezelayo, unikeze ukuphumula okuhle futhi wamukele noma ibuphi ubunzima.
Uma kwenzeka kuba nezimpawu eziphazamisayo, kufanele uthintane nodokotela ngokushesha bese uhlola ushukela wakho wegazi. Ukuxilongwa kwalesi sifo kufaka izivivinyo ezimbili eziyinhloko - igazi nomchamo.
Ukubona izinga le-glucose, igazi kumele liphuzwe ekuseni esiswini esingenalutho. Kulokhu, isidlo sokugcina kufanele okungenani sibe ngamahora ayishumi ngaphambi kokubeletha.Ukulungiselela okulungile kuphela okuzosiza ekutholeni ulwazi oluthembekile. Uma imiphumela yokuhlolwa ikhombisa ukuthi kungenzeka isifo, isiguli singathunyelwa ukuze siyohlolwa ama-pancreas. Ukuxilongwa nokwelashwa kwe-pathology kwenziwa yi-endocrinologist.
Ividiyo ekule ndatshana inemininingwane yokuthi yimiphi imishanguzo yesifo sikashukela esebenza ngempumelelo kakhulu.
