Iziphi izivivinyo onazo zesifo sikashukela?

Ukuhlolwa kwesifo sikashukela kuyadingeka lapho kuvela izimpawu ezijwayelekile zesifo.

Ingxenye yesine yeziguli ezinalesi sifo ayikasoli ngisho nokutholwa kwazo, ngakho-ke, iWorld Health Organisation incoma ukuthi kwenziwe izivivinyo zesifo sikashukela okungenani kabili ngonyaka.

Ukuqoqwa koshukela okujwayelekile kumuntu ophile kahle kufanele kuguquke ebangeni le-3.3-5.5 mmol / L. Isifo sikashukela i-mellitus, ngokuba yi-autoimmune pathology, kuholela ekunqotshweni kwamaseli we-beta weziqithi zeLangerhans, umsebenzi ophambili wawo ukukhiqizwa kwe-insulin. Le hormone inesibopho sokuhambisa ushukela osuka egazini uye ezingqamuzaneni ezidinga umthombo wamandla.

Ngokungafani ne-insulin, esehlisa ukugcwala koshukela egazini, kunama-hormone amaningi aphikisana nawo. Isibonelo, i-glucocorticoids, i-norepinephrine, i-adrenaline, i-glucagon nabanye.

Isifo sikashukela kanye nezimpawu zaso

Ukukhiqizwa kwe-hormone enciphisa ushukela ngohlobo 1 sikashukela kumisiwe ngokuphelele. Kunesifo salolu hlobo ikakhulukazi ebusheni nasebuntwaneni. Ngenxa yokuthi umzimba awukwazi ukukhiqiza ama-hormone, kubalulekile ukuthi isiguli sihlinzeke i-insulin njalo.

Ngohlobo 2 sikashukela, ukukhiqizwa kwama-hormone akuyeki. Kodwa-ke, ukusebenza kwe-insulin (ukuthutha ushukela) kukhubazeka ngenxa yokusabela okungajwayelekile kwamaseli okuqondiwe. Le nqubo ye-pathogenic ibizwa ngokuthi yi-insulin ukumelana. Isifo sikashukela esinga-insulin sincipha kubantu abanokweqile noma ifa kusuka eminyakeni engama-40. Ukuxilongwa ngesikhathi esifanele kwesifo sikashukela i-mellitus yohlobo olungena-insulin kugwema ukwelashwa kwezidakamizwa. Ukuze ulondoloze amanani ajwayelekile eglucose, kufanele udle kahle futhi uvivinye umzimba.

Yiluphi ushintsho emzimbeni womuntu olungakhuluma “ngesifo esimnandi”? Ushukela omkhulu wegazi kushukela kubangela umuzwa ongapheli wokoma. Ukuphuza utshwala ngobuningi obuningi kufaka ukuvakasha okuvame ukuya endlini encane. Ngakho-ke, ukoma ne-polyuria yizimpawu ezimbili eziyinhloko zalesi sifo. Kodwa-ke, izimpawu zesifo sikashukela nazo zingaba:

• ubuthakathaka obuphansi nesiyezi;
• ukungalali kahle futhi ikhanda elibuhlungu njalo;
• ukuqubuka kwesikhumba nokulunywa;
• umbono omfiphele;
• indlala engenangqondo;
• ukuphulukiswa isikhathi eside kwezilonda namanxeba;
• izehlakalo zokutheleleka njalo;
• ukuzindla noma ukuqina kwemilenze;
• umfutho wegazi ongazinzi.

Lezi zibonakaliso kufanele kube yisikhathi sokuvakashela ihhovisi le-endocrinologist, ezohlola isiguli bese simyalela, uma kunesidingo, ukuthi ayohlolwa igazi sikashukela. Yikuphi ukuvivinya okudingeka kudlule, sizocubungula futhi.

Ukuhlolwa kwegazi okusolisayo okusolwayo

Imvamisa umuntu akaze asole i-hyperglycemia futhi afunde ngayo ngengozi, ethola imiphumela yokuhlolwa kwegazi okujwayelekile.

Ukuthola i-diagnostic enembile, thintana nodokotela oyi-endocrinologist.

Udokotela unikeza izivivinyo eziningana ezithile ukuze acacise ukutholakala kwale nkinga.

Ukunquma izinga le-glucose, izifundo ezifundisayo kakhulu yilezi:

1. Isibalo segazi esiphelele.
2. Ukuhlolwa kwe-hemoglobin ye-glycated.
3. Ukuhlolwa kokubekezelela kwe-glucose.
4. Ceptide assay.

Ukuhlolwa kwegazi okujwayelekile kwesifo sikashukela. Kwenziwa ngesisu esingenalutho ekuseni, ngoba ngaphambi kokuthatha izinto eziphilayo, awukwazi ukudla ukudla okungenani amahora angama-8. Emahoreni angama-24 ngaphambi kocwaningo, akufanelekile ukusebenzisa amaswidi amaningi futhi uphuze uphuzo oludakayo, ngoba lokhu kungahlanekezela imiphumela yokugcina. Futhi, imiphumela yokuhlolwa ithonywa yizici ezinjengokukhulelwa, ukukhathala okukhulu, ukucindezela, ukudangala, izifo ezithathelanayo nezinye izifo. Isimo soshukela kufanele sibe ebangeni kusuka ku-3.3 kuya ku-5.5 mmol / L.

Ukuhlolwa kwe-hemoglobin ye-glycated kukhombisa ukujula kweglue glucose. Ukuhlolwa okunjalo kwesifo sikashukela kwenziwa esikhathini eside - kusuka ezinyangeni ezimbili kuya kwezintathu. Imiphumela yokuhlaziya isiza ukuhlola isigaba sesifo, kanye nokusebenza ngempumelelo kokwelashwa uqobo.

Ukuhlolwa kokubekezelela kwe-glucose. Kwenziwa ukuze kutholwe ukwephulwa ku-metabolism of carbohydrate. Ucwaningo olunjalo luboniswa ngokweqile, ukungasebenzi kahle kwesibindi, isifo se-periodontal, ama-polycystic ovaries, i-furunculosis, umfutho wegazi ophakeme kanye nokwanda ushukela kwabesifazane ngesikhathi sokukhulelwa. Okokuqala, udinga ukunikela ngegazi esiswini esingenalutho, bese udla amagremu angama-75 kashukela ancibilikisiwe ku-300 ml wamanzi. Ngemuva kwalokho uhlelo lokucwaninga ngesifo sikashukela lumi kanje: njalo ngehora, i-glucose ilinganiswa amahora amabili. Ukuthola umphumela kuze kufike ku-7.8 mmol / L, awunakukhathazeka, ngoba lokhu kuyinkomba ejwayelekile, ekhombisa ukungatholakali kwalesi sifo. Kodwa-ke, amanani asohlwini lwe-7.8-11.1 mmol / L akhombisa i-prediabetes, futhi amanani angenhla kwe-11.1 mmol / L akhombisa isifo sikashukela.

Ucwaningo kuma-C-peptides. Lokhu kuhlaziya okulungile ukuthola ukuthi ama-pancreas athinteka kanjani. Kuzodingeka ukuthi kuthathwe izimpawu zesifo sikashukela kwabesifazane abakhulelwe, ngesifo sofuzo kanye nokubonakaliswa komtholampilo kwe-hyperglycemia. Ngaphambi kokuthatha izivivinyo zesifo sikashukela, awukwazi ukuthatha izidakamizwa ezinjenge-aspirin, amahomoni, i-ascorbic acid, nezindlela zokuvimbela inzalo. Ukuzimisela kwe-C-peptides kwenziwa ngokusebenzisa amasampula egazi avela emthanjeni.

Amanani ajwayelekile abhekwa njengasesigabeni esisuka ku-298 kuya ku-1324 pmol / L.

I-Urinalysis yesifo sikashukela

Iziphi izivivinyo onazo zesifo sikashukela ngaphezu kokuhlolwa kwegazi? Uma usola "ukugula okumnandi", udokotela unquma ukuhlaziywa komchamo. Umuntu onempilo ejwayelekile akufanele abe noshukela kumchamo, noma kunjalo, ukuba khona kwesilinganiso sikashukela esingu-0,02% kuyo akubhekwa njengokuphambuka.

Izifundo zomchamo wasekuseni nokuhlaziywa nsuku zonke zithathwa njengezisebenza kakhulu. Okokuqala, umchamo wasekuseni uhlolwa ushukela. Uma kutholakala, kumele kuhlaziywe ukuhlaziya nsuku zonke ukuze kutholakale isifo. Inquma ukukhishwa kwansuku zonke kwe-glucose ngomchamo wesintu. Isiguli sidinga ukuqoqa impahla yezinto eziphilayo usuku lonke ngaphezu komchamo wasekuseni. Ocwaningweni, u-200 ml womchamo uzokwanela, ovame ukuqoqwa kusihlwa.

Ukutholwa koshukela emchameni kuhlotshaniswa nokukhula kwengcindezi ezinso ukuze kutholakale isifo sikashukela. Lo mzimba ususa zonke izinto ezinobuthi emzimbeni, kufaka noshukela osegazini. Njengoba kudingeka uketshezi oluningi ukuze izinso zisebenze, baqala ukuthatha inani elilahlekile lamanzi kwizicubu zomsipha. Ngenxa yalokho, umuntu ufuna ukuphuza njalo futhi uye endlini yangasese "kancane". Emazingeni kashukela ajwayelekile, wonke ushukela uthunyelwa “njengamandla wezinto” zamaseli, ngakho-ke awutholi umchamo.

Izifundo zeHormonal nezokugoma

Ezinye iziguli zinesifo sikashukela, yiziphi izivivinyo esizenzayo ngaphandle kwegazi nomchamo?

Kubukeka sengathi uhlu oluphelele lwazo zonke izinhlobo zezifundo lwethulwa ngenhla, kepha kunokunye okuningi.

Lapho udokotela engabaza ukuthi uzokuxilonga noma cha, noma efuna ukusicwaninga kabanzi lesi sifo, unikeza izivivinyo ezithile.

Ukuhlaziya okunje:

1. Ukuhlaziywa kokuba khona kwama-antibodies kumaseli we-beta. Lolu cwaningo lwenziwa ezigabeni zokuqala zalesi sifo futhi lunquma ukuthi isiguli sinamathuba okuthayipha isifo sikashukela sokuqala.
2. Ukuhlaziywa kokuhlushwa kwe-insulin. Imiphumela yocwaningo kumuntu ophilile kufanele isuke kumamilimitha ayi-15 kuye kwangama-180 ilitha ngalinye. Lapho okuqukethwe yi-insulin kungaphansi kokujwayelekile okukhonjisiwe, lolu uhlobo lwesifo sikashukela 1, lapho eliphakeme luhlobo 2 sikashukela.
3. Ucwaningo kuma-antibodies kuma-insulin. Ukuhlolwa okunjalo kuyadingeka ukuthola i-prediabetes futhi uthayiphe ushukela ongu-1.
4. Ukunqunywa kwama-antibodies ku-GAD. Ngisho iminyaka emi-5 ngaphambi kokuqala kwesifo sikashukela, ama-antibodies kumaprotheni athile e-GAD kungenzeka akhona.

Ukuze uqaphele isifo sikashukela ngesikhathi, ukuhlaziya kusiza ukukhomba izisu emzimbeni womuntu.

Uma nje ukuhlolwa kusenziwa, ukwelashwa kuzoba ngcono kakhulu.

Ukuhlolwa kwezinkinga

Isifo sikashukela sohlobo lokuqala nesesibili, esithuthukayo, sithinta cishe zonke izitho zangaphakathi zomuntu.

Njengomthetho, ukulimala kokuphela kwezinzwa nemithambo yegazi kwenzeka.

Ngaphezu kwalokho, kukhona ukwephulwa emsebenzini wezitho eziningi zomzimba.

Imiphumela evame kakhulu yokuthi "ukugula okumnandi" yizifo ezinjalo:

• i-retinopathy yesifo sikashukela - ukulimala kwinethiwekhi yemithambo yezinto ezibonakalayo;
• isifo sikashukela - isifo sezinso lapho umsebenzi wemithambo, ama-arterioles, i-glomeruli kanye ne-tubules yezinso kancane kancane ulahleka khona;
• unyawo lwesifo sikashukela - ukuhlangana okuhlanganisa ukulimala kwemithambo yegazi nemithambo yezinzwa yemikhawulo ephansi;
• i-polyneuropathy - i-pathology ehambisana nohlelo lwezinzwa, lapho isiguli silahlekelwa khona ukuzwela ukushisa nobuhlungu, zombili emaphethelweni aphezulu nangaphansi;
• i-ketoacidosis yisimo esiyingozi esisuka ekuqongeleleni kwama-ketones, imikhiqizo yokuqhekeka kwamafutha.

Okulandelayo uhlu lokuthi yiziphi izivivinyo zesifo sikashukela okufanele zithathwe ukubheka ukuthi kukhona noma ukungabikho kwezinkinga:

1. Ukuhlolwa kwegazi kwe-biochemical kusiza ukukhomba izifo ezahlukahlukene ezigabeni zokuqala zokukhula. Odokotela batusa ukuthatha lezi zivivinyo zesifo sikashukela okungenani kabili ngonyaka. Imiphumela yocwaningo ikhombisa amanani we-cholesterol, amaprotheni, i-urea, i-creatinine, ingxenyana yamaprotheni kanye ne-lipids. I-biochemistry yegazi yenziwa ngokuthatha kusuka kumthambo iye esiswini esingenalutho, mhlawumbe ekuseni.
2. Ukuhlolwa kwesikhwama kuyadingeka kwisifo sikashukela sohlobo 2 kanye nezikhalazo zesiguli sokulimazeka okubukwayo. Kuyiqiniso elaziwayo ukuthi kuma-diabetesics ohlobo oluzimele lwe-insulin, amathuba okulimala kwe-retinal akhuphuka ngezikhathi ezingama-25 kunakwabanye abantu. Ngakho-ke, aphoyintimenti nodokotela wamehlo kufanele kwenziwe okungenani kanye ezinyangeni eziyisithupha.
3. I-Microalbinium kumchamo - ukuthola iprotheni ethile. Umphumela omuhle ukhombisa ukuthuthukiswa kwe-nephropathy yesifo sikashukela. Ukhipha i-hypothesis ye-nephropathy, thatha nsuku zonke izinyanga eziyisithupha uphile ngokuthula.
4. I-ultrasound yezinso ibekelwe iziguli ezinomphumela omuhle we-microalbium kumchamo.
5. I-electrocardiogram isiza ukukhomba izinkinga ngohlelo lwethambo nenhliziyo.
6. Ukuhlolwa kwe-Fructosamine - ucwaningo olusiza ekuboneni inani eliphakeme le-glucose emasontweni amabili edlule. Okujwayelekile kusuka ku-2.0 kuye ku-2.8 wamamilimitha ngelitha.

Ngaphezu kwalokho, kwenziwa i-ultrasound yemithambo yemithambo nemithambo, edingekayo ukuze kutholakale ngokushesha i-venous thrombosis. Uchwepheshe kufanele aqaphe ubunikazi begazi kanye nesivinini sokugeleza kwegazi.

Izici zokuphasa izivivinyo

Kunezici ezithile zokuhlaziywa ngokuya ngohlobo lwesifo sikashukela kanye nobudala isiguli. Isivivinyo ngasinye sine-algorithm ethile necebo lokuhlola.

Ukuthola isifo sikashukela sohlobo 1, bavame ukuthatha ukuhlolwa kwe-glycohemoglobin, i-glucose engahleliwe ye-plasma, ukuhlolwa kwegazi nokuhlolwa kofuzo.

Ukunquma isifo sikashukela sohlobo 2, thatha isivivinyo sikashukela wegazi, ukuhlangana koshukela egazini okungahleliwe, ukuhlolwa kwe-hemoglobin ye-glycated, kanye nokuhlolwa kokubekezelela ushukela.

Ukuhlola okungenhla kufanelekile kubantu abadala. Kodwa-ke, ukutholakala kwesifo sikashukela ezinganeni nakwabesifazane abakhulelwe kuhluke kancane. Ngakho-ke, ezinganeni, isifundo esifanele kunazo zonke ukuhlaziya okuhlushwa ushukela okusheshayo. Izinkomba zokuhlolwa okunjalo kungaba:

• ukufinyelela ingane eneminyaka eyi-10;
• ukuba khona kwesisindo ngokweqile enganeni;
• ukuba khona kwezimpawu "zokugula okumnandi".

Njengoba wazi, isifo sikashukela sokukhulelwa singakhula ngesikhathi sokukhulelwa - isifo esenzeka ngenxa yokungalingani kwe-hormonal. Ngokulashwa okufanele, i-pathology inyamalala ngokushesha ngemuva kokuzalwa kwengane. Ngakho-ke, esikhathini se-trimester yesithathu kanye nezinyanga eziyi-1.5 ngemuva kokuzalwa, abesifazane kudingeka bahlolwe isivivinyo sikashukela. Izinyathelo ezinjalo zingavimbela ukukhula kwe-prediabetes kanye nohlobo 2 sikashukela.

Kubalulekile futhi ukuthi ulondoloze impilo enempilo ukuze ugweme ukuthuthukiswa kwesifo “esimnandi”. Ngakho-ke, kunemithetho ethile, ukuhambisana okuvimbela i-hyperglycemia:

1. Ukudla okufanele, ngaphandle kokudla okunamafutha, ukudla okugayeka kalula.
2. Indlela yokuphila esebenzayo, kufaka noma yiluphi uhlobo lwezemidlalo nokuhamba ngezinyawo.
3. Hlola njalo ukugxila koshukela bese uqinisekisa ukuthi zonke izinto zokuhlola ushukela ziyathathwa.

Yikuphi ukuhlaziya okufanele ukukukhetha? Kungcono ukuhlala ocwaningweni olushesha kakhulu olunikeza imiphumela efanele. Udokotela unikeza ukuhlaziywa okuthile, kucatshangelwa isimo sempilo sesiguli, ukuqinisekisa ukutholwa. Isilinganiso sokuphoqelelwa kwesifo sikashukela isifundo esenziwa njalo kokuqukethwe ushukela kanye nezinkinga ze-pathology. Isifo sikashukela singalawulwa ngokwazi ukuthi kwenziwa nini futhi kanjani ukuhlolwa kwegazi nomchamo.

Yiziphi izivivinyo okudingeka ukuthi uzenze ukuthatha isifo sikashukela ezizotshela uchwepheshe kuvidiyo ekulesi sihloko.