Namuhla, u-7% wabantu bomhlaba uhlangabezana nalolu hlobo lwesifo sikashukela. Abaholi ngenani labanesifo sikashukela bahlala eNdiya, China naseMelika. Kodwa-ke, iRussia ayihambanga kangako, ithatha indawo yesine (izigidi eziyi-9.6) ngemuva kwalawa mazwe.
Ukuba yisifo esikhohlisayo, isifo sikashukela ezigabeni zokuqala singadlula cishe asymptomatic. Ngokuqhubeka kwe-pathology, izimpawu zokuqala ziqala ukuvela. Kodwa-ke, ukuphendukela kudokotela kungenzeka kungabi yisikhathi, ngoba isifo sikashukela sesivele sithinte izitho eziningi zomzimba futhi kwaholela ezinkingeni.
Ukuze ugweme umphumela onjalo, udinga ukubheka ngokucophelela izimpawu zomzimba wakho. Yiziphi izimpawu nokuthi isifo sikashukela sitholakala kanjani - udaba oluthinta abantu abaningi.
Siyini isifo sikashukela?
Njengoba lesi sifo sisakazeka ngokushesha ngokwanele, futhi iziguli eziningi zibulawa yizinkinga, kubizwa ngokuthi "isifo" sekhulu lama-21. Isifo sikashukela mellitus (DM) noma "ukugula okumnandi", njengoba besho, kuyindlela ye-autoimmune pathology. Njengamanje, kunezinhlobonhlobo zesifo, njengohlobo 1 nohlobo 2, kanye nesifo sikashukela sokukhulelwa. Zonke zinento eyodwa efanayo - i-glucose ephezulu noma i-hyperglycemia.
Isifo sikashukela sohlobo loku-1 siyindlela yokuziphatha lapho ukukhiqizwa kwe-insulin kuyekayo. Njengomphumela wokuphazamiseka kwamasosha omzimba, kuqala ukuthinta kabi amangqamuzana e-beta we-islet apparatus, anomsebenzi wokukhiqiza ama-hormone anciphisa ushukela. Ngenxa yalokho, ushukela awungeni emangqamuzaneni aphathekayo futhi kancane kancane uqala ukunqwabelana egazini. Imvamisa, lesi sifo sikhula sisebancane, ngakho-ke kuthiwa yintsha. Ingxenye ebalulekile ekwelapheni lesi sifo ukwelashwa kwe-insulin.
Uhlobo lwesifo sikashukela sohlobo 2 yisimo lapho ukukhiqizwa kwe-insulin kungayeki, kepha ukushuba kwamangqamuzana okuqondisa ekuguqukeni kwe-hormone. Izizathu eziyinhloko zokuthuthukiswa kwe-T2DM zithathwa njengezikhuluphele kanye nofuzo. Uma kungenziwa lutho mayelana nokubangwa kofuzo, khona-ke amaphondo angeziwe kufanele alwe. Lesi sifo sithinta isizukulwane esidala kusuka eminyakeni engama-40 kuya kwengama-5. Kwisigaba sokuqala sokuthuthuka kwe-pathology, ungakwenza ngaphandle kwezidakamizwa ze-hypoglycemic, ukubheka ukudla nokuzivocavoca umzimba. Kepha ngokuqhubeka kwesikhathi, i-pancreas iyaphela, futhi umkhiqizo we-insulin uyancipha, odinga ukusetshenziswa kwemithi.
Isifo sikashukela sokukhulelwa senzeka kwabesifazane ngesikhathi sokukhulelwa. Isizathu sokwanda kwe-glucose ngesikhathi sokukhulelwa yi-placenta. Ikhiqiza ama-hormone aphikisana ne-insulin. Ngenxa yalokhu, ukwehla okwanele kweglucose yegazi akwenzeki. Le pathology icishe ihlale idlula ngemuva kokubeletha. Kodwa-ke, uma ungelashwa ngendlela engafanele, ingangena kusifo sikashukela sohlobo 2.
I-Hyperglycemia engapheli ku-mellitus yesifo sikashukela iholela ekuqhekekeni okwandayo kwama-lipid emangqamuzaneni, ushintsho ekwakhekeni kwama-electrolyte egazini, ukuphuma komzimba, ukwehla kwesilinganiso se-acid-base kwegazi, ukudakwa kwemizimba ye-ketone, ukukhishwa kwe-glucose nomchamo, kanye nomonakalo wamaprotheni emithambo yegazi.
Ngokuphulwa isikhathi eside kwe-carbohydrate metabolism, izinqubo ze-pathogenic zenzeka ezithweni eziningi zomuntu, ngokwesibonelo, ezinso, isibindi, inhliziyo, iso lesimo, nokuningi.
Ngidinga ukubona nini udokotela?
Isithombe somtholampilo sikashukela sibanzi. Lapho umuntu ephazanyiswa yizimpawu ezithile ezingaba yizihibe "zokugula okumnandi", ukukhonjwa kwakhe kufanele kube ngokushesha.
Ngakho-ke, ungabona kanjani uhlobo 1 lwesifo sikashukela? Izimpawu eziphambili zesifo ukuchama kaningi nokoma okunganqamuleki. Izinqubo ezinjalo zenzeka ngenxa yokuxineka ezinso. Ngenxa yalesi sitho, umzimba ususa bonke ubuthi nezinto ezilimazayo.
Ukususa ushukela omningi, izinso zidinga uketshezi oluningi, ngakho-ke ziqala ukuluthatha ezithweni. Futhi njengoba umuntu ongazi ngalesi sifo sakhe esinezinga eliphakeme le-glycemic, ushukela kufanele ususwe njalo. Umbuthano onjalo unonya ukuvela kwalezi zimpawu ezimbili.
Kepha kunezinye izimpawu eziphikisiwe zesifo sikashukela ezidinga ukubhekiswa nazo:
- Ukucasuka, isiyezi nokukhathala. Lezi zimpawu zihlobene nokusebenza kobuchopho. Njengomphumela wokuqhekeka kweshukela, kukhipha ubuthi - imizimba ye-ketone. Lapho ukuqina kwabo kukhuphuka, baqala ukuphazamisa ukusebenza kwengqondo. Ngaphezu kwalokho, ngenxa yokuntuleka kweglucose, ebizwa ngokuthi "umthombo wamandla", amaseli ayabulawa yindlala, ngakho umuntu usheshe akhathale.
- Ukwehla kwezinsiza ezibukwayo. Njengoba ukuqina kwezindonga zemithambo kwenzeka kushukela, ukuhamba kwegazi okujwayelekile kuyaphazamiseka. I-retina inethiwekhi yayo yemisipha, futhi ngezinguquko ze-pathogenic iyavutha. Ngenxa yalokhu, isithombe esingaphambi kwamehlo siba buthuntu, kuvela iziphikiso ezahlukahlukene. Ngokuqhubeka kwenqubo, ukuthuthukiswa kwe-retinopathy yesifo sikashukela kungenzeka.
- Ukuxhaxha nobubanzi bemikhawulo engezansi. Njengoba kwenzeka esimweni sokulimazeka okubonakalayo, kuhlotshaniswa nokuhamba kwegazi. Njengoba imilenze iyindawo ekude, ihlushwa kakhulu. Ngokulashwa ngokungafanele kudokotela, izinkinga ezihlukene ziyenzeka: izicubu ze-necrosis, i-gangrene, unyawo lwesifo sikashukela nokufa.
- Ezinye izinkomba ziwumlomo owomile, umfutho wegazi okhuphukile, ukwehla kwesisindo ngokushesha, indlala engapheli, izinkinga zocansi, ukungahambi kahle kokuya esikhathini, ukuqhuma kwesikhumba nokulunywa, ukulashwa isikhathi eside kwamanxeba nezilonda.
Ngemuva kokuhlola udokotela, isiguli, okutholakale okungenani esinye sezimpawu ezisohlwini sayo, siyothunyelwa ukuxilonga isifo sikashukela.
Ukuhlolwa ushukela wegazi
Ukuxilonga ngokushesha isifo sikashukela, uchwepheshe uqondisa isiguli ekuhlolweni kwegazi kwe-capillary.
Ukuze wenze lokhu, sebenzisa idivaysi yokukala ushukela - i-glucometer noma imichilo yokuhlola.
Kumele kuqashelwe ukuthi ngisho nakubantu abaphilile, i-WHO itusa ukuthi kwenziwe ucwaningo ngokuxhunywa koshukela egazini okungenani kanye ezinyangeni eziyisithupha.
Lokhu kuyiqiniso ikakhulukazi kubantu abasengozini yokuthola isifo, okubandakanya:
- ukuba khona kwezihlobo ezinesifo esifanayo;
- ukukhuluphala;
- isigaba seminyaka engaphezu kweminyaka engama-40;
- ama-anamnesis ama-pathologies we-vascular;
- abesifazane ababeletha ingane enesisindo esingaphezu kuka-4.1 kg, nokunye.
Amahora angama-24 ngaphambi kokuthatha isampula legazi, isiguli kufanele silungiselele isifundo. Akufanele azenzele umthwalo omningi ngomsebenzi omningi, kanye nokudla ngokweqile. Njengoba ukuhlaziya kuvame ukwenziwa esiswini esingenalutho, akufanele uthathe noma yikuphi ukudla noma isiphuzo (itiye, ikhofi). Ngaphezu kwalokho, isiguli kufanele sikhumbule ukuthi izici ezinjalo zithonya amazinga eglucose: ukukhathazeka, ukukhulelwa, izifo ezingamahlalakhona nezifo ezithathelanayo, ukukhathala (ngokwesibonelo, ngemuva kokuhamba ebusuku). Ngakho-ke, lapho kuvela enye yalezi zinto ezingenhla, isiguli kuyodingeka sihlehlise ukuhlolwa isikhashana.
Ngemuva kokulethwa kwezinto zokuphila esiswini esingenalutho, kwenziwa izivivinyo zelebhu. Imiphumela ingakhombisa okuqukethwe ushukela okujwayelekile uma uku-range kusuka ku-3.5 kuye ku-5.5 mmol / L, isimo sangaphambi kwesifo sikashukela sisuka ku-5.6 kuye ku-6.1 mmol / L, kanti isifo sikashukela singaphezu kuka-6.1 mmol / l Kumele kwaziwe ukuthi kwesinye isikhathi isifundo senziwa ngemuva kokudla. Lapho-ke inani le-glucose kumuntu ophilile akufanele libe ngaphezu kwe-11.2 mmol / L.
Ukuxilongwa kwesifo sikashukela sohlobo 2 kufaka isivivinyo somthwalo noma, njengoba kubizwa nangokuthi, isivivinyo sokubekezelela ushukela. Kwenziwa ngezigaba ezimbili. Okokuqala, isiguli sithatha igazi le-venous, bese bemnika ingilazi yamanzi amnandi (300 ml we-kefir ka-100 g kashukela). Ngemuva kwalokho, amahora amabili, igazi lithathwa emunweni njalo ngehora. Imiphumela yocwaningo ihluka kakhulu ngokuya ngesimo somzimba.
Imvamisa yesisu esingenalutho isukela ku-3,5 kuye ku-5.5 mmol / L, ngemuva kokuphuza uketshezi noshukela olungaphansi kuka-7.8 mmol / L.
Isifo sikashukela esiswini esingenalutho kusuka ku-5.6 kuye ku-6.1 mmol / L, ngemuva kokuphuza iziphuzo ezinoshukela ongaphansi kuka-7.8 kuya ku-11.0 mmol / L.
Isifo sikashukela i-mellitus esiswini esingenalutho kusuka ku-6.1 mmol / L, ngemuva kokuphuza iziphuzo ezinoshukela ngaphezu kuka-11.0 mmol / L.
Ezinye izindlela zokuxilonga
Ukuxilongwa kwe-capillary ne-venous yegazi kusiza ekutholeni ngokushesha isifo sikashukela, noma kunjalo, akuyona ukuphela kwendlela. Ukuhlolwa okunembe kunazo zonke ukuhlolwa kwe-hemoglobin glycosylated. Ngasikhathi sinye, ukubuyela emuva okuphambili isikhathi sokufunda - kufinyelela ezinyangeni ezintathu.
Ngokungafani nesampula yegazi ejwayelekile, lapho lesi sifo siqinisekiswa kuphela ngemuva kokuhlolwa kaningana, ukuhlolwa kwe-hemoglobin ye-glycosylated kusiza ngokunembile ukuthola isifo sikashukela.
Ngaphezu kwalokho, ukuxilongwa kwalesi sifo kufaka phakathi ukudonsa umchamo nsuku zonke. Imvamisa, ushukela emchameni awungeni noma awudluli isilinganiso se-0,02%. Umchamo ubuye uhlolwe kokuqukethwe kwawo kwe-acetone. Ukuba khona kwento enjalo kukhombisa inkambo ende yesifo sikashukela nokuba khona kwezinkinga.
Ngemuva kokunquma i-hyperglycemia, udokotela kufanele athole uhlobo lwe-pathology. Ukuxilongwa kwesifo sikashukela uhlobo 1 no-2 kwenziwa ngenxa yocwaningo kuma-C-peptides. Amanani ajwayelekile azimele ngokobulili noma ngeminyaka futhi aqala ku-0.9 kuya ku-7.1 ng / ml. Ngaphezu kwalokho, ucwaningo olunge-C-peptides lusiza uhlobo lwe-1 sikashukela ukubala umthamo ofanele wokulimala kwe-insulin.
Izindlela zokuxilonga zinikeza isiqiniseko esinembile sesifo sikashukela kanye nobunzima baso.
Ukuxilongwa kwesifo sikashukela sabantwana
Ngokuyisisekelo, isifo sikashukela ezinganeni sitholakala sineminyaka emihlanu kuya kwengu-12. Izikhalazo zengane zihambisana ngokuphelele nezimpawu zabantu abadala.
Ezimweni ezingavamile, isifo sikashukela senzeka ezinganeni ezisanda kuzalwa. Ukuxilongwa kwesifo sikashukela sohlobo 1 ezinganeni ezinjalo ekuqaleni kufaka ukubabheka. Ukuqunjelwa kwe-diaper kwenzeka ezinsaneni, kuqhuma ukuvela kwesitofu, umchamo ube unamathele, ukuvuvukala kuvela esikhunjeni.
Ngakho-ke izimbangela zesifo sikashukela ezinganeni akuyona nje ukudla okungalinganiseli kanye nokunatha utshwala bokuqala, kodwa futhi nezici ezingokwengqondo nezomzimba.
Lezi zinto yilezi:
- Khulisa imizwa.
- Ukucindezela umthwalo.
- Izinguquko zeHormonal.
Ngokuyisisekelo, ukutholakala kwesifo sikashukela ezinganeni empeleni akufani nokutholwa kubantu abadala. Imvamisa, uchwepheshe onesifo esithi "ukugula okumnandi" okusolwayo unquma ingane ukuthi idluliselwe kohlolwa kwegazi. Amazinga kashukela ahlukile kubantu abadala. Ngakho-ke, ezinganeni ezingaphansi kweminyaka emi-2 ubudala, okujwayelekile kusuka ku-2.8 kuya ku-4,4 mmol / L, eminyakeni kusuka eminyakeni emi-2 kuye kwengama-6 - kusuka ku-3.3 kuye ku-5.0 mmol / L, ekukhuleni, izinkomba zihambelana nabantu abadala - kusuka ku-3 , 3 kuye ku-5.5 mmol / L.
Ngokwanda kwezinkomba, isifo sikashukela sitholakala ezinganeni. Uma imiphumela yocwaningo ibanga kusuka ku-5.6 kuye ku-6.0 mmol / l, udokotela unezela ngokuhlolwa kokuhlolwa kwe-glucose. Ngemuva kwamahora amabili wokuthatha amanzi amnandi, inkomba efinyelela ku-7 mmol / L ibhekwa njengejwayelekile. Lapho amanani asukela ku-7.0 kuya ku-11.0 mmol / L, lesi yisifo sikashukela; ngaphezu kwe-11.0 mmol / L, isifo sikashukela ezinganeni.
Ngemuva kokudlula ochungechungeni lwezifundo, uchwepheshe angaqinisekisa noma aphikise ukutholwa okusolwayo. Ukuthola lesi sifo, hlobo luni ezinganeni, njengakwejwayelekile, kwenziwa ukuhlaziya kwe-C-peptides.
Ukuxilongwa nokwelashwa kwesifo sikashukela ezinganeni nakubantu abadala kufaka phakathi ukuthatha imishanguzo noma ukwelashwa kwe-insulin, ukugcina ukudla okulinganiselayo, ukuqapha njalo i-glycemia kanye nemidlalo.
Ukuze kutholakale isifo sikashukela kusenesikhathi, abazali, ikakhulukazi umama, kudingeka babheke ingane ngokucophelela.
Uma izimpawu ezinkulu zesifo sikashukela zibonakala, kuzodingeka ukuthi ubonane nodokotela ngokushesha futhi ukhumbule ukuthi awukwazi ukwenza ngaphandle kokuhlaziya nganoma iyiphi indlela. Ukwazi ukuthi usithola kanjani isifo sikashukela, ungazivikela wena nabathandekayo bakho ezinkingeni eziningi.
Kwividiyo ekulesi sihloko, isihloko sezindlela zokuxilonga isifo sikashukela siyaqhubeka.
