I-Diabetes mellitus ihlanganisa izindlela ezimbili ezihlukile zokuthuthuka kwalesi sifo, izibonakaliso zazo ezingukwanda okuqhubekayo kwamazinga kashukela wegazi. Esikhathini sikashukela se-mellitus sohlobo lokuqala, ukuntuleka kwe-insulin ngokuphelele kukhula ngenxa yokubhujiswa kwamangqamuzana pancreas, okudinga ukuqokwa kokwelashwa kwe-insulin kusukela ekuqaleni kwalesi sifo.
Uhlobo 2 sikashukela i-mellitus sihlotshaniswa nokukhula kwe-tishu receptor ukumelana ne-insulin. Kulokhu, ukuqala kwalesi sifo kuya ngokufihlwa okuvamile noma okuthuthukile kwe-insulin, ngakho-ke le ndlela ibizwa ngokuthi i-mellitus engavikelekile nge-insulin.
Njengoba ushukela wegazi ophakeme eqhubeka nokukhuthaza ukukhishwa kwe-insulin ngamaseli e-beta, ngokuhamba kwesikhathi, izindawo ezigcina amanyikwe ziqedwa kancane kancane bese uhlobo lwe-2 mellitus lukhula lube ngokufunwa kwe-insulin.
Izimbangela kanye nendlela yokukhula yohlobo lwesibili sikashukela
Izici zofuzo lapho kuvela isifo sikashukela sohlobo 2 zingamaqiniso angenakuphikwa, futhi zibaluleke kakhulu kunohlobo lokuqala lwesifo. Kepha kwatholakala ukuthi ukwephula ukumelana kwe-glucose kudluliselwa ngefa, okungaguquki nakancane isifo sikashukela.
Ucwaningo lwakamuva luveze ukuthi indlela eyinhloko yokwakhiwa kwalolu hlobo lwesifo sikashukela ukutholakala kwamaseli wezicubu ezingakwazi ukuthatha i-glucose kuphela lapho kukhona i-insulin, ukuthuthukiswa kokumelana ne-insulin. Ukwanda kweglucose yegazi kwenzeka kamuva, ngenxa yokwephulwa okunjalo.
Zonke ezinye izimbangela zesifo sikashukela, esinquma isiphetho sesiguli, zingaphandle futhi ziyaguquguquka, okungukuthi, zingathonywa ngendlela yokuthi zivikele ukukhula kwesifo. Izici eziphambili ezibikezela ukuvela kohlobo lwesibili zifaka lokhu:
- Uhlobo lwesisu sokukhuluphala.
- Ukuntuleka kokuzivocavoca.
- Isifo sokuqina kwemithambo yegazi
- Ukukhulelwa
- Ukusabela okucindezelayo.
- Iminyaka ngemuva kweminyaka engama-45.
Ukwehla kwesisindo ezigulini ezinokukhuluphala kuzoholela ekubuyiselweni kokugxila okujwayelekile kwe-glucose ne-insulin ngemuva kokudla. Futhi uma imikhuba yokudla ibuya, futhi isiguli siphinde sigcwala i-overeat, khona lapho kutholakala i-hyperglycemia ne-hyperinsulinemia ngokushesha, futhi ngenxa yokudla ukudla kwe-insulin kuyaphazamiseka.
Amazinga e-insulin akhuphukile ahlobene nezibonakaliso zokuqala zesifo sikashukela nokukhuluphala, lapho kusenokungabi khona ukuphazamiseka okubonakalayo kumzimba we-carbohydrate metabolism. I-Hyperinsulinemia ezimweni ezinjalo iyindlela yokuphoqelela yokumelana kwezicubu kwe-insulin. Umzimba uzama ukunqoba ukumelana ne-insulin ngokwanda kwama-hormone.
Uma ukukhuluphala kuba khona isikhathi eside kubantu abathile ngokwezakhi zofuzo zokulimaza i-carbohydrate metabolism, lapho-ke ngokuhamba kwesikhathi, ukufihla kwe-beta-cell kuyehla. Isifo sikashukela esibonakalayo esinezimpawu ezijwayelekile siyakhula.
Okusho ukuthi, ukukhiqizwa kwe-insulin eluhlobo 2 sikashukela ngeke kuhlale isikhathi eside ngokwanele futhi, lapho sikhona, ukwelashwa kwe-insulin kuyadingeka.
I-mellitus ephuza i-insulin inganxephezelwa yi-insulin kuphela, noma ichazwe kanye nezidakamizwa ezinciphisa ushukela zokwelapha okuhlanganisiwe.
Izinkomba zokwelashwa kwe-insulin ohlotsheni lwesibili sikashukela
Ukusetshenziswa okufika ngesikhathi kwamalungiselelo we-insulin yohlobo lwe-2 yesifo sikashukela kusiza ukubuyisa ukuphazamiseka okubalulekile ezintathu: ukwenza ukuntuleka kwe-insulin uqobo, ukunciphisa ukwakheka kwe-insulin esibindini nokubuyisa umuzwa wokulimala kwezicubu kuwo.
Ngokuqokwa kwe-insulin, kunezinkomba ezingapheli nezesikhashana. Ukuphatha okuqhubekayo kufanele kuqalwe ngokushesha nge-ketoacidosis, ukuncipha kwesisindo, izimpawu zokuphelelwa ngamandla emzimbeni kanye ne-glucosuria.
Inkambo enjalo yesifo sikashukela yenzeka lapho ikhula ibe nomuntu onesifo sikashukela esenzeka kancane kancane, lapho kunesidingo se-insulin khona maduze nje ngemuva kokuxilongwa kwesifo sikashukela. Kulokhu, kutholakala izimpawu zokubhujiswa kwamaseli e-pancreatic ngama-antibodies, njengakuhlobo lwesifo sokuqala. Imvamisa
Ngokuphikisana kokuqokwa kwamatafula, i-insulin ingabekwa. Lezi zizathu zibandakanya:
- Ukuntuleka kwezinso noma ukusebenza kwesibindi.
- Ukukhulelwa
- Izinga eliphakeme le-angiopathy yesifo sikashukela.
- I-Peripheral polyneuropathy enobuhlungu obukhulu.
- Unyawo lwesifo sikashukela esinokuphazamiseka kwephrophic.
- Ukuntuleka kwe-insulin ngesimo se-ketoacidosis.
Cishe ingxenye yesithathu yeziguli ayinampendulo yokuphuza amaphilisi ukwehlisa ushukela noma lokhu kusabela kuncane. Uma isinxephezelo singeke sitholwe ezinyangeni ezintathu, iziguli zidluliselwa ku-insulin. Ukuphikiswa kwezidakamizwa okuyisisekelo kwenzeka, njengomthetho, ekutholakaleni sekwephuzile kwesifo sikashukela, lapho ukucasha kwe-insulin okuncishisiwe kuncishisiwe.
Ingxenye encane yeziguli ithola ukumelana kwesibili lapho amazinga aphezulu kashukela abonwa ngokuqhathanisa nesizinda sokulashwa kokudla kanye nemithamo ephezulu yemithi. Lokhu kuphawulwa ezigulini ezine-glycemia ephezulu ngesikhathi sokuxilongwa nokuthambekela kwaso.
Imvamisa, iziguli ezinje sezigula iminyaka ecishe ibe yi-15; amanyikwe lawo awakwazi ukuphendula ekukhuthazeni ngamaphilisi. Uma i-glucose yegazi idlula i-13 mmol / l, khona-ke ayikho enye indlela yokwelashwa ngaphandle kokunquma i-insulin.
Kepha uma isiguli sinokukhuluphala, khona-ke ukuqokwa kwe-insulin akuhlali kunikeze imiphumela oyifunayo. Ngakho-ke, nge-glycemia engaphakeme kune-11 mmol / l, ungenqaba ukwelashwa kwe-insulin, ngoba ngokweqile izimpawu zokuncipha kwemali zihlala zifana nokuthatha amaphilisi.
Ukwelashwa kwe-insulin okwesikhashana kwenziwa ngenxa yezimo eziguqukayo. Lokhu kufaka phakathi:
- I-Myocardial infarction.
- Izifo ezithathelwanayo ngokushisa komzimba okuphezulu.
- Ukusabela okucindezelayo.
- Izifo ezinkulu ezifanayo.
- Ngokuqokwa kwe-corticosteroids.
- Kwezokuhlinzwa.
- Nge-ketoacidosis yesifo sikashukela kanye nokuncipha okukhulu kwesisindo.
- Ukubuyisa ukuzwela kumaphilisi futhi ngehlise ama-pancreas.
Izici zokuqokwa kwe-insulin ngohlobo lwesibili sikashukela
Uhlobo 2 sikashukela i-mellitus sisho isifo esibonakala ngokuqhubeka kwezimpawu. Futhi njengoba izifundo ziqhubeka, imithamo yangaphambi yezidakamizwa iyeka ukusebenza. Lokhu kwandisa ubungozi bezinkinga. Ngakho-ke, bonke abanesifo sikashukela bayasibona isidingo sama-regimens okwelashwa okukhulu.
Isilinganiso sokugcina sesinxephezelo sikashukela ukwehla kwe-glycated hemoglobin. Kungakhathaleki ukuthi ukuncishiswa okunjalo kufinyelelwa yini - nge-insulin noma ngamaphilisi, lokhu kuholela ekunciphiseni kwengozi yamathumbu, i-nephropathy, i-retinopathy, ukushaya kwenhliziyo kanye nezinye izindlela ze-vascular.
Ngakho-ke, lapho kungekho khona imiphumela evela ekwelashweni kokudla kanye nokuzivocavoca okusebenzayo komzimba, kanye nokwenziwa ngokwejwayelekile kwesisindo somzimba, kuyadingeka ukusebenzisa ukwelashwa kwezidakamizwa okuqinile ngokushesha okukhulu.
Umhlahlandlela wokukhetha indlela yawo kungaba ukwehla kwe-hemoglobin ye-glycated. Uma kuphela amaphilisi anele, khona-ke isiguli sikhethelwa ukwelashwa okungu-mono- noma inhlanganisela nezidakamizwa ezivela emaqenjini ahlukahlukene emithi yokwehlisa ushukela, noma inhlanganisela yamathebulethi ne-insulin ihlanganiswe.
Izici zokwelapha okuhlanganiswa (i-insulin namathebulethi) wohlobo 2 lwesifo sikashukela yilezi:
- Ukwelashwa, imithamo emincane emi-2 ye-insulin iyadingeka.
- Ithonya ezinkomba ezihlukile: ukwakheka kweglue ngesibindi, ukumuncwa kwe-carbohydrate, ukuvikelwa kwe-insulin nokuzwela kwezicubu kuyo.
- Izinga le-hemoglobin ye-glycated liyathuthuka.
- Izinkinga ezijwayelekile zesifo sikashukela.
- Ingozi ye-atherosulinosis iyancishiswa.
- Akukho ukuzuza kwesisindo kweziguli ezikhuluphele.
I-insulin ibekelwa isikhathi esiyi-1 ngosuku. Qala ngemithamo emincane ye-insulin yesikhathi esiphakathi. Umuthi uphathwa ngaphambi kokudla kwasekuseni noma ebusuku, into esemqoka ukugcina isikhathi esifanayo sokujova. Imvamisa esetshenziselwa ukwelashwa kwe-insulin ngenhlanganisela ye-insulin.
Uma kudingekile ukuphatha amayunithi we-insulin angaphezu kwama-40, amaphilisi akhanseliwe futhi isiguli sishintsha ngokuphelele ukwelashwa kwe-insulin. Uma i-glycemia ingaphansi kwe-10 mmol / l, futhi amayunithi angama-30 we-insulin ayadingeka, khona-ke ukwelashwa ngamaphilisi kunqunywe, bese kuthi i-insulin inqanyulwe.
Ekwelashweni kweziguli ezikhuluphele ngokweqile, kunconywa ukuthi ukuphathwa kwe-insulin kuhlanganiswe nezidakamizwa ezivela eqenjini le-Biguanide, elihlanganisa iMetformin. Okunye okungahle kube yi-acarbose (Glucobai), ephazamisa ukungena kweglucose emathunjini.
Imiphumela emihle yatholakala futhi ngokuhlanganisa i-insulin kanye ne-insulin secretion yokuvuselela, iNovoNorma. Ngale nhlanganisela, i-NovoNorm isebenza njengomlawuli wokukhuphuka kwe-glycemia ngemuva kokudla futhi ichazwe ngokudla okuyinhloko.
I-insulin esebenza isikhathi eside inconyelwe ukuphatha ngaphambi kokulala. Yehlisa ukuthathwa kwe-glucose ngesibindi futhi ilawula ushukela wegazi osheshayo ngokulingisa ukuvikela kokuqina kwe-insulin.
Akunama-insulin akhethekile wokulashwa okwenziwe esikhundleni se-mellitus yesifo sikashukela, kepha ukuthuthukiswa kwezidakamizwa ezinganciphisa i-glycemia ngemuva kokudla futhi kungabangeli i-hypoglycemia phakathi kokudla okwenziwe. Ukusetshenziswa kwama-insulin anjalo kubalulekile futhi ukuvimbela ukuzuza kwesisindo, kanye nemiphumela emibi ku-lipid metabolism. Ividiyo ekulesi sihloko izocacisa i-pathogenesis yesifo sikashukela.
