Isifo sikashukela i-mellitus ezinganeni sihlotshaniswa nokuphazamiseka kwe-metabolic ngenxa yokuntuleka kwe-insulin. Ngokuvamile kutholakala ukuthi unesifo sikashukela sohlobo 1 kwengane. Imbangela yawo ukusabela kokuwohloka kwamasosha omzimba kuma-virus, ubuthi, imikhiqizo yokudla ngokumelene nesizinda selifa eliyindle.
Eminyakeni yamuva, ngenxa yokuthambekela kokukhuluphala kwengane, okuhambisana nokutholakala kokudla okungenamsoco ngohlobo lwesiphuzo se-carbonated noshukela, ukudla okusheshayo, i-confectionery, ama-endocrinologists aqaphela ukwanda kwesifo sikashukela sohlobo 2 ezinganeni nasentsheni.
Izimpawu zesifo sikashukela ezinganeni ezineminyaka engu-7 ubudala zingase zibe ekuqaleni kwalesi sifo, zombili lezi mbala ezijwayelekile kanye nesithombe esikwisimo sezimpawu zokuphelelwa ngamandla emzimbeni kanye nokwehla kwesisindo. Ezimweni zokwelashwa sekwephuzile, ingane ingangeniswa esibhedlela ngezimpawu zokuthamba, lapho kutholakala khona isifo sikashukela kuqala.
Izici zokuthuthukiswa kwesifo sikashukela ezinganeni
Isimo esidala sokuthola isifo sikashukela sivela kuhlobo oluthile lwezinhlobo ezitholakala (ezinesifo sikashukela sohlobo 1) ku-chromosome yesithupha. Bangatholwa ngokufunda ukwakheka kwe-antigenic kwama-leukocytes egazi. Ukuba khona kwezinhlobo ezinjalo kunikeza kuphela ithuba elikhudlwana lokuthola isifo sikashukela.
Isizathu esidabukisayo singadluliselwa ngegciwane le-rubella, isimungumungwane, umiyane, izifo ezibangelwa ama-enteroviruses, i-Coxsackie B. Ngaphandle kwamagciwane, amanye amakhemikhali nezidakamizwa angadala isifo sikashukela, ukwethulwa kobisi lwenkomo okusanhlamvu okusanhlamvu kokudla kokuqala emzimbeni.
Ngemuva kokuchayeka esicini esilimazayo, amangqamuzana e-beta esiqhingini samanyikwe ayachithwa. Ukukhiqizwa kwama-antibodies kuqala ezingxenyeni ze-membrane ne-cytoplasm yamaseli emzimbeni. Kuma-pancreas, i-reaction (insulin) iba yinqubo yokuvuvukala ye-autoimmune.
Ukubhujiswa kwamangqamuzana kuholela ekuntuleni kwe-insulin egazini, kepha isithombe esijwayelekile somtholampilo asiveli ngokushesha, isifo sikashukela ekuthuthukisweni kwaso sidlula ezigabeni eziningana:
- Isigaba preclinical: Ukuhlolwa kwegazi kuvamile, azikho izimpawu zesifo, kepha ukwakheka kwamasosha omzimba omelana namaseli e-pancreatic kuyaqala.
- I-mellitus ye-Latent yesifo sikashukela: i-glycemia esheshayo iyinto evamile, ngemuva kokudla noma lapho kwenziwa isivivinyo sokubekezelela ushukela, kutholakala okwejwayelekile kweshukela legazi.
- Isigaba sezimpawu ezisobala zesifo sikashukela: angaphezu kwamaphesenti angama-85 amaseli akhiqiza i-insulin abhujiswa. Kunezimpawu zesifo sikashukela, i-hyperglycemia egazini.
Ukukhiqizwa kwe-insulin kuncishisiwe, uma kungekho umjovo wayo, kunokuthambekela kokuthuthukisa i-ketoacidosis nge-coma enesilinganiso esibi se-hyperglycemia. Ngokuqokwa kokuqala kwe-insulin kanye nokujwayelekile kokulimazeka kokudla emzimbeni, ama-pancreas angalulama ngokwengxenye, okubonakala ngokuncipha kwesidingo sokwelashwa kwe-insulin.
Lesi simo sibizwa ngokuthi "i-honeymoon," noma ukuthethelelwa kwesifo sikashukela. Njengoba ukusabela kwe-autoimmune kungayeki, amaseli we-beta aqhubeka nokuwohloka, okuholela ekubonakalweni okuphindaphindiwe kwesifo sikashukela ngesidingo sokulungiselela amalungiselelo e-insulin kuyo yonke impilo yesiguli.
Izimbangela zohlobo lwesibili sikashukela ezinganeni zikhuluphele, ukusebenza ngokomzimba okuphansi, ukuphazamiseka emgodini we-thyroid, izindlala ze-adrenal kanye ne-hypothalamus kanye ne-pituitary gland. Lezi zinto zivezwa lapho kukhona ukumelana okuncishisiwe kwama-carbohydrate, atholakala njengefa.
Ukuqala kwesifo sikashukela kungakhuthazelwa isisindo sokuzalwa esiphakeme, ukusheshiswa kokukhula empilweni yokuqala, kanye nokungondleki kwabesifazane ngesikhathi sokukhulelwa: ukubaluleka kokudla okunama-carbohydrate amaningi kanye nokuntuleka kokudla kwamaprotheni ekudleni.
Ngohlobo 2 sikashukela, i-insulin ekuqaleni yakhiqizwa ngamanani anele, noma andisiwe, kodwa amangqamuzana emisipha, isibindi kanye ne-adipose awakwazi ukuphendula kuwo ngenxa yokubopha okungafanele kwaleli hormone kuma-receptors athile.
Lesi simo sibizwa ngokuthi yi-insulin ukumelana. Ngakho-ke, ngokungafani nesifo sikashukela sohlobo 1, ukwelashwa kwe-insulin kule nkambo yesifo sikashukela akubekiwe, futhi iziguli ziyelulekwa ukuthi zibeke umngcele ngokuqinile ama-carbohydrate ekudleni ukuze zingavuseleli ama-pancreas futhi ziphuze amaphilisi akhulisa impendulo yama-insulin receptors.
Izimpawu Zesifo Sikashukela
Izimpawu zesifo sikashukela i-mellitus zivela ngenxa yokuthi ngokuntuleka kwe-insulin noma ukuthuthukiswa kokumelana nayo, i-glucose engena nokudla noma yakhiwa esibindini ayikwazi ukungena kumaseli ukukhipha amandla. Izinga eliphakeme le-glucose ngaphakathi emithanjeni liholela ekuhambeni kokuphuma kwamanzi kusuka ezicutshini ziye egazini ngokwemithetho ye-osmosis.
Emangqamuzaneni, ukungabikho kweglucose kudala ukwakheka kwezidumbu ze-ketone, okuwumthombo wesipele wamandla. Izinga eliphakeme lama-ketones egazini liholela ekushintsheni kokuphendula uhlangothi lwe-acid nokukhula kwezimpawu zobuthi, ngoba zinobuthi emzimbeni, ikakhulukazi ebuchosheni.
Izimpawu zemitholampilo zesifo sikashukela ezinganeni azihambi njalo zenza kube nokwenzeka ukuxilonga kahle, ngoba zingahlanganiswa nokutheleleka kwamathumbu noma umchamo, izifo zesikhumba fungal. Ngokuvamile, thayipha isifo sikashukela ezinganeni sikhula ngokuzumayo futhi izimpawu zaso zihlala zanda ngokungabikho kwe-insulin.
Izici zokubonisa isifo sikashukela yilezi:
- Umile njalo.
- Ukuchama okukhudlwana nokushesha, ama-envesis.
- Isikhumba esomile nolwelwesi lwe-mucous.
- Ukwehla kwesisindo ngokudla okwandayo.
- Ukulunywa kwesikhumba, ikakhulukazi ku-perineum.
- Izifo ezithathelwanayo ezijwayelekile.
- Ubuthakathaka nobuthongo ngemuva kokudla.
- Umsebenzi ophansi kanye nokuthambekela kokunganaki.
Ukwanda okwandayo ezinganeni kungabonakala ngokuthatha amalitha amanzi angama-3-4 ngosuku, izingane ezinjalo zivame ukuvuka ebusuku ngenxa yesifiso sokuphuza. Umthamo womchamo ukhuphuka ufike kumalitha ama-3-6, kanti imvamisa yokuchama iyanda izikhathi eziyi-15-20 ngosuku. Ukuqala kokuhlinzwa kungaba ngenye yezimpawu zokuqala zesifo sikashukela ezinganeni zesikole.
I-polyphagy, noma ukwanda kokudla, kuhlotshaniswa nokulahleka kwama-kilojoule aqhamuka ekudleni ngenxa yokuthi ama-carbohydrate awakwazi ukusetshenziselwa amandla, yingakho umzimba uhlala udinga ukudla, ikakhulukazi okumnandi. Ngasikhathi sinye, izingane zingalahlekelwa kuze kufike ku-5-6 kg ngesikhathi esifushane ngokumelene nesizinda sokudla okunempilo.
Kwisifo sikashukela, izimpawu zesikhumba sikashukela ziyimpawu:
- Ukuzwa kwesikhumba sezandla nezinyawo.
- I-seborrhea eyomile yesikhumba.
- Ukushiswa yisifo sikashukela kwezihlathi.
- Ukulunywa kanye nesikhumba sesikhumba se-perineum.
- Ukulahlekelwa izinwele.
- Umqubuko kanye ne-pyoderma.
- Izilonda zesikhumba se-fungus. Izipikili ezinesifo sikashukela nazo zithinteka ngama-coarse.
Ulwelwesi lwe-mucous lomlomo wesibeletho lome, izindebe zibomvu ngokugqamile ngombala, futhi kukhona imifantu ekhoneni lomlomo.
Ulimi ezinganeni lome, luhlaza okomnyama ngombala, imvamisa kulezi ziguli gingivitis, stomatitis kanye ne-thrush ziyatholakala.
Izimpawu zokubola zeshukela
Ngokukhuphuka ushukela wegazi ophakeme, ongaba umphumela wokuxilongwa okungaziwa kwesifo sikashukela, imizimba ye-ketone ikhiqizwa ngokweqile: i-acetone, acetoacetic ne-hydroxybutyric acid.
Le ndlela ye-metabolic ye-metabolism iholela ekukhishweni kwe-fluid kusuka kumaseli ngenxa ye-osmolarity ephezulu yegazi, ukukhuphuka kwe-excretion komchamo sodium, potassium, magnesium ne phosphorus. Ukwehla komzimba kubangela ukuphazamiseka ekusebenzeni kwazo zonke izinhlelo emzimbeni, ikakhulukazi ubuchopho nezinso.
Ekuqaleni, ukubola kuboniswa ngokwanda kwezimpawu ezijwayelekile zesifo sikashukela: ingane ifuna ukuphuza ngaphezu kokujwayelekile, ukukhuphuka kwe-diuresis kanye nokwanda kobuthakathaka. Ngemuva kwalokho, njengoba iketoacidosis inyuka, isicanucanu, ukulahleka kwesifiso, ukuthanda ukudla, ubuhlungu besisu, okufana nomtholampilo wesisu esibuhlungu, ukwanda kwesibindi kujoyina lezi zimpawu.
Nge-ketoacidosis enzima, kuvela izimpawu ezilandelayo:
- Ukomela, ukhathala.
- Iphunga le-acetone emoyeni ophelile.
- Isikhumba somile nge-turgor encishisiwe.
- Amehlo abolile.
- Umoya unemisindo futhi ujulile.
- Ukuqina kwenhliziyo, i-arrhythmia.
Esikhathini esizayo, ukwazi ukungasebenzi kahle kuyaqhubeka, futhi ingane ingakhubazeka, idinga ukuvuselelwa ngokushesha ngokufakwa kwe-insulin nokunxephezela ukomisa.
I-ketoacidosis ezinganeni iholela kumthamo wokubala ngokungalungile we-insulin noma ukuqashwa kwayo kungafanele, ukuxilongwa sekwephuzile, ukuphazamiseka kokudla okwedlulele, isidingo esandayo se-insulin ngokumelene nesizinda sezifo ezihlangeneyo, izifo, ukulimala, izimo ezicindezelayo nokungenelela kokuhlinzwa, ukucindezelwa ngokomzimba.
Izibonakaliso zaselebhu zesifo sikashukela ezinganeni
Ukuxilonga isifo sikashukela, akwanele ukumane sikhombe izimpawu, noma ngabe zivamile kulesi sifo. Qinisekisa ukuba khona kokuntuleka kwe-insulin usebenzisa ukuhlolwa kwegazi kwe-glucose, kanye nezifundo ezengeziwe uma ungabaza ekutholeni uhlobo lwesifo sikashukela nezinkinga zalo.
Ukuhlolwa kwegazi kwe-glucose kwenziwa okungenani kabili ukukhipha imiphumela yamanga, igazi lengane lithathwa esiswini esingenalutho ngemuva kwamahora angama-8 ekudleni kokugcina. Isibonakaliso sikashukela yi-glycemia ngaphezulu kuka-6.1 mmol / L.
Izimo eziphakathi nendawo ezijwayelekile nesifo sikashukela ziyizinkomba ebangeni ukusuka ku-5.5 kuye ku-6.1 mmol / L. Imiphumela enjalo ingabhekwa njenge-prediabetes. Iziguli ezinjalo zingabekwa ukuhlolwa kwengcindezi. Isifo sikashukela i-mellitus sibhekwa njengesiqinisekisiwe uma, ngemuva kwamahora ama-2 kusuka ekuthatheni ushukela, noma ngokuhlolwa kwegazi okungahleliwe, ushukela ungaphezulu kwe-11.1 mmol / L.
Ukuze kucaciswe ukutholakala kwalesi sifo, izifundo ezinjalo ziyenziwa:
- IGlucose ne-acetone kumchamo (ngokujwayelekile akufanele kube).
- Ukuchazwa kwe-C-peptide: ngohlobo lwesifo sikashukela sokuqala kuyathululwa, ngohlobo 2 sikashukela okujwayelekile noma okuphakeme. Ibonisa ukufihlwa kwe-insulin.
- I-insulin engasebenzi: incishiswe ngohlobo 1, onesifo sikashukela sohlobo 2 - okwejwayelekile noma okwandisiwe.
- Ukuhlolwa kwe-Fundus ukunquma i-retinopathy.
- Ukutadisha komsebenzi wezinso: ukuzimisela kwesilinganiso sokuhlunga kwe-glomerular, i-urography ye-excretory.
Ukuzimisela kwe-hemoglobin ye-glycated nakho kuyenziwa, okukhombisa izinguquko ku-glucose ezinsukwini ezingama-90 ezedlule. Ngokuvamile lesi sikhombisi sisetshenziselwa ukuqapha ukunemba kokwelashwa nokunxephezela isifo sikashukela. Imvamisa, iphesenti le-hemoglobin ye-glycated ayidluli ku-5.9%, kepha ngesifo sikashukela ingaphezu kuka-6.5%.
Imininingwane yezimpawu nezimpawu zenkathi yesifo sikashukela ezinganeni ivezwe kule vidiyo kulesi sihloko.
