Isifo sikashukela yisifo esidala esingapheli sohlelo lwe-endocrine. Lesi sifo sikhulu ngokwezemvelo, sinezimbangela ezahlukahlukene kanye nezici zenkambo. Kuyaqapheleka ukuthi isifo sikashukela siyimpilo yonke.
Lesi sifo siyifa, okungukuthi, isandulelo sidluliselwa ezihlotsheni. Lokhu ukuphazamiseka okunamandla komzimba, okubonakala ngokunyuka njalo koshukela wegazi.
Ngenxa ye-pathology, ukusebenza kwemithambo yegazi, uhlelo lwezinzwa, izinso, inhliziyo, amehlo nezinye izitho kuyaphazamiseka.
Izindlela zomsebenzi nokuqokwa kwama-pancreas
I-"diabetes" ihumusha ngokuthi "ushukela" noma "uju." Lokhu kuveza esinye sezimbangela eziphambili zokuqala kwalesi sifo, sikhuluma ngokudla ngokweqile, okuthi, kanye nokungasebenzi kahle komzimba, kuholele ekwakhekeni kokukhuluphala.
Isifo sikashukela i-mellitus yisifo esingelapheki futhi esithintwa yiminyaka. Ngamanye amagama, ngezikhathi ezahlukahlukene izinhlobo ezithile zesifo zingavela. Uma umsebenzi womuntu uhlotshaniswa nokucindezelwa okungapheli kokomoya nangokomqondo, lokhu futhi kuba yisici ekuqaleni kwesifo sikashukela.
Imvamisa, abantu baba nesifo sikashukela:
- lapho bobabili abazali nezihlobo ezisondelene baba nesifo sikashukela,
- abesifazane ababelethe ingane enesisindo somzimba esedlula i-4,5 kg, kanye nabesifazane abanezisu ezingaziphathi kahle kanye nezingane ezizalwe kabusha,
- ukukhuluphala, ukukhuluphala,
- ngesifo senhliziyo, isifo sokuqina kwemithambo yegazi, isigaxa somoya, unhlangothi, umfutho wegazi ophakeme,
- kanye nokuphazamiseka kwengqondo kwe-neuropsychiatric, ukucindezelwa njalo nokucindezelwa kwengqondo okuhlala isikhathi eside,
- ngokulimala, ukungenelela kokuhlinzwa, izinqubo zokuvuvukala ezenzeka ngokushisa komzimba okuphezulu,
- ubhekene nokuchayeka njalo ezintweni ezinobuthi,
- ngokwephula ukudla, umsoco wamafutha, ukusetshenziswa kabi kotshwala,
- Izingane ezondliwe ngokuzalwa.
Le pathology esabekayo ithinteka kakhulu ngabantu abahlukene emhlabeni jikelele. Ukugula kuyinkinga enkulu yezempilo yomphakathi. Kubalulekile ukuqonda ukuthi isifo sikashukela siyimpilo yonke, ngakho-ke ukuvikela nokwelashwa kwalesi sifo kuyinkinga njalo.
Amanyikwe asemuva kwesisu. Umuntu akanaso esinye isitho, esivezwa amandla aso okuthonya izinqubo ezahlukahlukene emzimbeni womuntu. Lesi sitho sisebenzisana nokugaya, njengoba sikhiqiza ujusi we-pancreatic. Ngakho-ke, umzimba unikezwa amandla adingekayo emsebenzini.
Omunye umsebenzi ohlukile we-pancreas ukukhulisa imfihlo ekhethekile, ebandakanyeka ekusebenzeni kwezinqubo eziningi emzimbeni. Kuyadingeka ekusebenzeni okuphelele komzimba.
Ijusi le-pancreatic, lisebenza njengomkhiqizo we-pancreatic. Lejusi iyi-ketshezi ecacile, engenawo umbala. Umthamo wejusi we-pancreatic, othunyelwa ngamanyikwe, okulinganiselwa ku-600-700 ml.
Izakhi zejusi le-pancreatic ngama-enzyme, okungukuthi, izinto ezisheshisa izinqubo ezihlukene zomzimba:
- i-amylase
- lipase
- trypsin nabanye.
I-enzyme ye-pancreatic juice, ephula amafutha, isebenza kanye ne-bile. Iguqula amafutha abe ngamaconsi amancane, i-lipase ifafaza lamaconsi abe yizakhi.
Insulin
I-insulin yi-hormone elawula imetabolism. Ngaphansi kwethonya le-insulin, okunamafutha acid akhiwa esibindini, synthesic glycogen, kanye nokwanda ukusetshenziswa kwe-amino acid kanye nemisipha glycogen nokuhlanganiswa kweprotheni.
I-hormone i-insulin ikhulisa ukusetshenziswa kwe-glucose yisibindi, kusiza ukuguqulela amandla amaminerali emzimbeni wamuntu. Ngamanye amagama, i-insulin isebenza ezinhlobonhlobo zezinhlelo nezitho zomzimba.
Kukhona ukwehla kwezinqubo zokudalelwa kwe-glycogen kanye nokwenziwa kwe-glucose kusuka kumaprotheni namafutha. I-insulin kwezicubu ze-adipose nayo yehlisa ukuqhekeka kwamafutha, nezicubu zemisipha - ukuwohloka kwamaprotheni.
Indawo yokwenza i-hormone:
- isibindi
- izicubu zomsipha
- izicubu ze-adipose.
Umuntu onempilo unezinkomba ezithile zesimo sokuqukethwe kwe-insulin. Ngakho-ke, isikhathi esamukelekayo yi-10 - 20 mcED / ml (0.4-0.8 ng / ml). Ukuma ngaphandle kwegazi, i-insulin ingena esibindini.
Kulapho uhlala khona ngesilinganiso esifika kuma-60%, futhi uyasebenza ekuphatheni umetabolism.
Izinhlobo ezimbili zikashukela
Ososayensi kwakudingeka bahlukanise isifo sikashukela ngezinhlobo ezimbili, ngoba lokhu kuzichaza ngokucacile izici zokwelashwa kwabantu, okuthi lapho kuqala isigaba zihluke kakhulu. Uma isifo sikashukela sinde futhi sinzima, ukwahlukaniswa kwaso ngezinhlobo kusebenza ngokusemthethweni. Kulezi zimo, ukwelashwa kucishe kufane, yize imvelaphi yalesi sifo kanye nefomu laso.
Isifo sikashukela sohlobo 1 yisifo sikashukela esincike ku-insulin. Njengomthetho, bahlushwa abantu beminyaka emincane kuze kube iminyaka engama-40 ngesisindo esincane somzimba. Lesi sifo sinzima impela, i-insulin isetshenziselwa ukwelashwa. Isizathu se-pathology ukuthi umzimba ukhiqiza amasosha omzimba abhubhisa amaseli we-pancreas akhiqiza i-insulin.
Isifo sikashukela sohlobo 1 asikwazi ukwelashwa ngokuphelele. Kodwa-ke, kunezimo zokubuyiselwa kwamanyikwe, kepha lokhu kungaphansi kwezimo ezithile nokudla okukhethekile ngokudla okuluhlaza. Ukugcina umzimba usesimweni sokusebenza, imijovo ye-insulin kufanele inikezwe nge-syringe.
Njengoba i-insulin igqekeza esiswini nasemathuneni, akunakwenzeka ukusebenzisa i-insulin ukube ibisezibhebheni. Kubalulekile ukunamathela ekudleni okunempilo futhi ususe ngokuphelele ama-carbohydrate ekudleni, njengalawa:
- ushukela
- ukudla okumnandi
- amajusi wezithelo
- iziphuzo ezimnandi eziyiziqholo.
Isifo sikashukela sohlobo 2 sithathwa njengokuncika kwe-insulin. Imvamisa, abantu abaneminyaka engaphezu kwengama-40 ubudala nabakhuluphele ngokweqile bahlushwa yilolu hlobo lokugula. Isizathu sokugula ukuthi ukuzwela kwamangqamuzana ukuya ku-insulin kulahlekile ngenxa yemithamo emikhulu yezakhi ezikuzo.
Ukusetshenziswa kwe-insulin ngezinjongo zokwelapha akudingekile kuwo wonke umuntu ogulayo. Udokotela oqeqeshiwe kuphela oyokwazi ukunquma imithamo nama-regimens okwelashwa. Okokuqala, abantu abanjalo badinga ukunikezwa indlela yokudla ekwelapheni.
Kubalulekile ukwenza izibopho zezempilo ngokuzibophezela. Kufanele inciphise isisindo kancane, amakhilogremu ambalwa ngenyanga. Ngemuva kokufinyelela isisindo esijwayelekile, udinga ukusigcina impilo yakho yonke.
Lapho ukudla okungenamsoco kunganele, kubalulekile ukuthatha amaphilisi okwehlisa ushukela, ne-insulin, njengendlela yokugcina.
Izimbangela zesifo
Izizathu ezibaluleke kakhulu zokuthuthuka kwesifo sikashukela, odokotela babiza ukubonwa kolwelwesi kanye nesisindo ngokweqile.
Zombili lezi zici zidinga ukubhekwa njalo nokubhekwa.
Izizathu zokuthi isifo sikashukela esingamahlalakhona siqhamuka nezifo ezithinta amaseli we-beta abhekene nokukhiqizwa kwe-insulin. Ukugula okunjalo kufaka phakathi:
- umdlavuza wepancreatic
- i-pancreatitis
- ukuphazamiseka kwezinye izilonda.
Lokhu kufaka phakathi izifo ezifana nalezi:
- ihepatitis
- rubella
- inkukhu
- ezinye izifo.
Izifo ezisohlwini ziyizinto zokuqala kokuqala kwesifo sikashukela. Ikakhulu, lokhu kusebenza kubantu abasengozini. Ukushaqeka njalo kwemizwa kanye nokucindezelwa nakho kuyimbangela yesifo sikashukela. Ukungezwani okungokomzwelo nokwesaba kufanele kugwenywe.
Ososayensi bakholelwa ukuthi kuyo yonke iminyaka eyishumi, ingozi yokuba nesifo sikashukela iphindwe kabili.
Lolu hlu alufaki izifo lapho i-hyperglycemia nesifo sikashukela mellitus zisendaweni yesibili, zikhuluma uphawu. I-hyperglycemia enjalo ayithathwa njengeyiqiniso kuze kube yilapho kuvela ukubonwa kwezokwelapha noma ifomu lezinkinga.
Ukugula okubangela ukwanda koshukela (hyperglycemia) kufaka phakathi:
- i-pancreatitis engapheli,
- i-adrenal hyperfunction,
- ukukhuphuka kwezinga lama-hormone aphikisayo.
Izindlela Zokuxilonga
Kwisifo sikashukela, hhayi ukukhuluphala kuphela okubonakalisayo, kepha futhi ukushuba kwamandla, ukushuba kwesikhumba, okunzima kakhulu ukukubekezelela. Umuntu onesifo sikashukela angahlala eluma, isikhumba sakhe simbozwe amagwebu namanxeba.
Kungakuhle futhi ukugcizelela ukuthi kwizazi zesifo sikashukela kuphawulwe:
- umlomo owomile
- ukuchama njalo
- indlala enkulu nokoma
- Izinkinga zesisindo.
Abanesifo sikashukela nabo bangathola:
- ukukhathala ngokweqile
- ukufuduka okunamandla
- ukwehlukana okujwayelekile,
- kwehlise i-acuity ebonakalayo.
Uma kwenzeka lezi zigameko, kufanele uthintane nodokotela wakho ukuze ugweme ukuqaqamba kwesifo sikashukela.
Ungaqonda ukuthi kwenzekani kumuntu uma unikela ngegazi esiswini esingenalutho, noma amahora amabili ngemuva kokusebenzisa isisombululo sikashukela ukuthola izinga lokuzwela lomzimba kulo. Igazi lithathwa emunweni noma emvinini, le ndlela yokuhlaziya isetshenziswa elabhorethri.
Njengomthetho, ukuthola isifo, isiguli sinqunywe isifundo sesibili. Okuhlukile abesifazane abakhulelwe. Baqala ukuthola ukwelashwa ngokushesha, ngaphandle kokulinda imiphumela yokuhlolwa kwegazi okuphindaphindwe.
Amazinga kashukela angahlolwa ekhaya ngokwakho. Kulokhu, kusetshenziswa i-glucometer Ukuqoqwa koshukela egazini ngokujwayelekile esiswini esingenalutho akumele kube ngaphezu kuka-5.6 mmol / l (kusuka emunweni), no-6.1 mmol / l (kusuka emthanjeni). Ngemuva kokuthatha isisombululo se-glucose esisheshayo, izinga lingakhuphukela. 7.8 mmol / L.
Kwabashukela abanesifo sikashukela ngamafomu 1 no-2, amanani lawo ahlala ephakeme. Ushukela wokusheshisa ulingana noma ungaphezulu kwe-6.1 mmol / L (kusuka emunweni), nangaphezulu kuka-7.0 mmol / L (kusuka emthanjeni).
Lapho isisombululo se-glucose sisetshenziswa esiswini esingenalutho, inkomba ikhuphukela ku-11.1 mmol / L noma ngaphezulu. Uma uthatha ukuhlolwa kwegazi kusuka kumuntu onjalo nganoma yisiphi isikhathi sosuku, noma ngabe kukudla, khona-ke izinga likashukela lilingane noma lidlule i-11.1 mmol / L.
Ngaphezu kwalokhu kucubungula, ekutholakaleni kwe-pathology, kuyadingeka ukwenza ucwaningo nge-glycated hemoglobin.
Sifunda isibalo segazi, okungafanele sibe ngaphezulu kuka-6.5%.
Ukwelapha isifo sikashukela
Kubalulekile ukulandela izincomo zabanesifo sikashukela, ukubheka inqubo yokwelapha isifo sikashukela impilo yonke. Ngakho-ke, kungenzeka ukuthi wehlise ijubane noma uvimbele ubunzima obuhlukahlukene.
Ukwelashwa kwanoma yiluphi uhlobo lwesifo sikashukela kuhloswe ukunciphisa ukugcwala koshukela egazini, ukumisa ukuthuthukiswa kwezinkinga kanye nokwenza izinqubo ezijwayelekile kufakwe emzimbeni.
Zonke izinhlobo zesifo sikashukela zidinga ukwelashwa, zinikezwe:
- isisindo somzimba
- umsebenzi womzimba womuntu
- ubulili nobudala
- Ukudla okujwayelekile.
Kuyadingeka ukwenza ukuqeqeshwa emithethweni yokubala inani le-caloric yokudla, unikezwe amafutha ayo, amaprotheni, izinto zokulandela kanye nama-carbohydrate.
Ngo-ushukela othembele ku-insulin, udinga ukusebenzisa ama-carbohydrate ngasikhathi sinye ukwenza lula ukulungiswa kwamazinga kashukela. Ngohlobo lokuqala lwesifo sikashukela, udinga ukunciphisa umkhawulo wokudla okunamafutha, okunomthelela ketoacidosis. I-mellitus engavikelekile nge-insulin isusa zonke izinhlobo zoshukela futhi inciphise umthamo ophelele wekhalori.
Ukudla kufanele kube okufakayo njalo, okungenani izikhathi ezine ngosuku. Sabalalisa ngokulinganayo ama-carbohydrate, anomthelela ekubaleni ushukela okujwayelekile futhi ulondoloze imetabolism.
Udinga ukusebenzisa imikhiqizo ekhethekile yesifo sikashukela enama-sweeteners:
- i-aspartame
- saccharin
- xylitol
- i-sorbitol
- i-fructose.
Ukulungiswa kokuphazamiseka kwesifo sikashukela kusetshenziswa kuphela ukudla kungakhonjiswa ngezigaba zokuqala ze-pathology.
Ukukhetha kwemithi kungenxa yohlobo lwesifo sikashukela. Abantu abanohlobo lokuqala lwesifo badinga ukwelashwa kwe-insulin, ngohlobo lwesibili, izidakamizwa ezinciphisa ushukela nokudla kuyakhonjiswa. Kulokhu, i-insulin ibekiwe uma amaphilisi engasebenzi, futhi eba:
- isifo sofuba
- ketoacidosis
- isimo sokuthanda
- I-pyelonephritis engapheli,
- ukwehluleka kwesibindi nezinso.
I-insulin ilawulwa ngaphansi kokuqashwa njalo koshukela wegazi namazinga omchamo. Ngokwesikhathi sayo kanye nokusebenza kwayo, i-insulin yile:
- isikhathi eside
- maphakathi
- isenzo esifushane.
I-insulin esebenza isikhathi eside kufanele iphathwe kanye ngosuku. Njengomthetho, udokotela unquma imijovo yaleyo insulin ene-insulin emfushane nephakathi nendawo ukuze inxephezele isifo sikashukela.
Ukusetshenziswa kwe-insulin kugcwala i-overdose, okuholela ekuncipheni okubukhali kwamanani ezinoshukela nokwakheka kwe-coma ne-hypoglycemia. Ukukhethwa kwemithi nemithamo ye-insulin kuyenziwa, kucatshangelwa izinguquko zomsebenzi womuntu phakathi nosuku, kanye:
- ukuqina kweglucose
- ukudla ikhalori
- ukubekezelela insulin.
Ngokulashwa kwe-insulin, kungaba nemikhuba yendawo yonke:
- izinhlungu
- ubomvu
- ukuvuvukala endaweni yomjovo.
Imiphumela evamile yokungezwani komzimba ifaka phakathi ukushaqeka kwe-anaphylactic. Ukwelashwa kwe-insulin kwesinye isikhathi kuyinkimbinkimbi nge-lipodystrophy - ama-dips in izicubu ze-adipose endaweni yokulawulwa kwe-insulin.
Udokotela ubeka izidakamizwa ze-antipyretic kumathebulethi kashukela angaxhomekeki e-insulin, njengesengezo ekudleni. Ikakhulu, kusetshenziswa amalungiselelo e-sulfonylurea:
- glycidone
- chlorpropamide
- glibenclamide,
- i-carbamide.
Zonke zivusa ukukhiqizwa kwe-insulin ngamangqamuzana e-beta of pancreas futhi anomthelela ekukhipheni i-glucose kumaseli omzimba ahlukahlukene. Umthamo walezi zidakamizwa kufanele ukhethwe kahle ukuze amazinga kashukela agcinwe angabi ngaphezu kwama-88 mmol / l. Uma kwenzeka kuba ne-overdose, i-hypoglycemia nekhoa kungaqala ukukhula.
AmaBiguanides yile:
- I-Metformin.
- IBuformin namanye ama-ejenti afanayo.
Zenzelwe ukunciphisa ukumunca ushukela emathunjini kanye nezicubu ezigcwele zephalamende nge-glucose. AmaBiguanides angakhuphula izinga le-uric acid egazini futhi abangele isimo esinzima se-lactic acidosis. Lokhu kuyiqiniso ikakhulukazi kubantu ngemuva kweminyaka engama-60 yobudala, kanye nakulabo abahlushwa ukuwohloka kwezinso nesibindi, kanye nezifo ezingamahlalakhona.
Njengomthetho, ama-biguanides anqunyelwa ushukela ongathembele kwe-insulin kubantu abasha abakhuluphele.
Meglitinides:
- I-Nateglinide.
- I-Repaglinide.
Sikhuluma ngezidakamizwa ezisehlisa ushukela wegazi futhi zivuselela ama-pancreas ukukhiqiza i-insulin. Umphumela walezi zimali uncike ezingeni likashukela egazini futhi ungavuseleli i-hypoglycemia.
I-Alpha Glucosidase Inhibitors:
- I-Miglitol,
- I-Acarbose.
Leli qembu lemithi libambezela ukwanda kwe-glucose egazini, livimba ama-enzyme ahilelekile ekungeneni kwesitashi. Kunemiphumela emibi, okungukuthi isifo sohudo kanye ne-flatulence.
Ama-Thiazolidinediones ama-ejenti anciphisa inani likashukela ekhishwa esibindini. Bakhulisa ukuthikamezeka kwe-insulin kwamaseli wamafutha. Amaqembu anjalo ezidakamizwa awanakuthathwa uma kukhona ukuhluleka kwenhliziyo.
Ku-mellitus yesifo sikashukela, kuyadingeka ukufundisa umuntu namalungu omndeni wakhe ukuthi angasilawula kanjani isimo nenhlala-kahle yabo. Kubalulekile futhi ukwazi izindlela zokuqala zosizo ekwakhekeni kwamadlozi nokhokho. Umphumela omuhle kwisifo sikashukela ukukhululwa kwamakhilogremu angeziwe omzimba nokuzivocavoca okulinganiselayo komuntu ngamunye.
Ngenxa yemizamo yemisipha, kukhuphuka i-oxidation ye-glucose kanye nokwehla kwesilinganiso sayo egazini. Kepha, ukuzivocavoca akunconywa ukuqala uma izinga kashukela wegazi lingaphezu kuka-15 mmol / l.
Ngaphambi kokuthi uqale ukubamba iqhaza kwezemidlalo, abanesifo sikashukela badinga ukwehlisa amazinga abo kashukela ngaphansi kwethonya lemithi. Esikhathini sikashukela, ukusebenza ngokomzimba kufanele kuhambisane nodokotela oholayo futhi kusatshalaliswe ngokulinganayo kuyo yonke imisipha nezitho zomuntu.Ividiyo ekulesi sihloko izobheka ezinye izidakamizwa zokwelapha isifo sikashukela.
