Isifo sikashukela: ukunquma kohlobo lwesifo ngokuhlaziywa

Isifo sikashukela yisifo se-metabolic esingamahlalakhona sohlelo lwe-endocrine, olususelwa ekuntuleni kwe-insulin, ngokuphelele noma isihlobo.

Ukuntuleka ngokuphelele kwe-insulin kwisifo sikashukela kubangelwa ukufa kwamangqamuzana e-beta, abangela ukukhululeka kwayo, futhi isihlobo sihlotshaniswa nesiphene ekusebenzeni kwayo nama-cell receptors (ejwayelekile ngohlobo 2 lwesifo sikashukela).

Kwi-mellitus yesifo sikashukela, incazelo ye-hyperglycemia iyisibonakaliso esingapheli kunazo zonke esithinta ukwephulwa kwe-carbohydrate metabolism emzimbeni. Lapho uthola isifo sikashukela, izimpawu ezibalulekile ziyi-glucose egazini nokubonakala kwayo emchameni. Ngokulahleka kweshukela okubalulekile, ukuphuma komchamo kuholela ekuqothulweni komzimba kanye ne-hypokalemia.

Izinhlobo zesifo sikashukela

Izizathu zokwanda okubukhali kwesibalo sabantu abanesifo sikashukela ukubonwa okungcono ngokuhlolwa ngokomzimba okusebenzayo, ukwehla kwesibalo sokushona kwezingane ezisanda kuzalwa ezivela kubazali abanesifo sikashukela, ukwanda kwesikhathi sokuphila kwesibalo kanye nokwanda kokukhuluphala.

Isifo sikashukela isifo sokudla kwesifo sikashukela yisifo esinezinto eziningi ngenxa yezizathu zokuvela kwako kanye nokubonakaliswa kwezindlela zokwelapha nezindlela zokwelashwa. Ukunquma isifo sikashukela futhi kutholakale isifo esifanele, izindlela ezimbili ezihlukaniswa ngokuyinhloko: thayipha 1 nohlobo 2 sikashukela.

Uhlobo lokuqala lwesifo sikashukela lwenzeka ngesimo sokubhujiswa kwamaseli e-beta futhi luholela ekushodweni kwe-insulin impilo yonke. Izinhlobo zayo ziyi-LADA - i-latent autoimmune sikashukela kubantu abadala nefomu le-idiopathic (non-immune). Esikhathini sikashukela se-latent, izibonakaliso nenkambo zihambelana nohlobo 2, amasosha omzimba kumaseli we-beta ayatholakala, njengohlobo 1.

Uhlobo lwesibili sikashukela luba khona ngemuva kokukhiqizwa kwe-insulin okuncishisiwe noma okwejwayelekile, kepha ngokulahlekelwa umuzwa kuyo - ukumelana ne-insulin. Olunye uhlobo lwalesi sifo sikashukela yiMODY, lapho kunesici sofuzo ekusebenzeni kwamaseli we-beta.

Ngaphezu kwalezi zinhlobo eziyisisekelo, kungahle kube:

1. Ukuhlukumezeka kwe-insulin noma ama-receptors ahlotshaniswa nokukhubazeka kofuzo.
2. Izifo ze-pancreatic - i-pancreatitis, isimila.
3. I-Endocrinopathies: i-acromegaly, isifo i-Itsenko-Cushing's, isabalalisa ubuthi obunobuthi.
4. Isifo sikashukela mellitus.
5. Isifo sikashukela esibangelwa ukutheleleka.
6. Izifo ze-Congenital ezihambisana nesifo sikashukela.
7. Isifo sikashukela sokutholwa kwesisu.

Ngemuva kokunquma uhlobo lwesifo sikashukela, kwenziwa ucwaningo lobunzima balesi sifo. Ngefomu emnene yesifo sikashukela i-mellitus, azikho izinguquko ezibalulekile kushukela wegazi, ushukela wokuzila ungaphansi kuka-8 mmol / l, akukho shukela emchameni, noma kuze kufike ku-20 g / l. Izindlela zokudla zanele ukunxephezela. Izilonda zemithambo yegazi azitholakali.

Isifo sikashukela esilinganiselwe sibonakaliswa ukwanda kokushesha kwe-glucose kuya ku-14 mmol / l, ukulahleka kwe-glucose kumchamo ngosuku - kuze kufike ku-40 g, phakathi nosuku kunokushintshashintsha kwamazinga kashukela, imizimba ye-ketone esegazini nomchamo kungavela. Ukudla ne-insulin noma amaphilisi kubekelwa ukunciphisa i-glycemia. Ama-Angioneuropathies ayatholakala.

Izimpawu zesifo sikashukela esibi:

• Ukushisa i-glycemia ngenhla kwe-14 mmol / L.
• Izinguquko ezibalulekile kushukela wegazi usuku lonke.
• I-Glucosuria engaphezu kwama-40 g ngosuku.
• Umthamo we-insulin wokunxephezela ngaphezulu kwama-60 PIERES.
• Ukuthuthukiswa kwe-angioic ne-neuropathies yesifo sikashukela.

Ngokwezinga lesinxephezelo, ushukela unganxephezelwa uma kungenzeka ukufezekisa ushukela ojwayelekile egazini kanye nokungabikho kwawo kumchamo. Isigaba sokuncephezela: i-glycemia engeqi kune-13.95 mmol / l, ukulahleka kweshukela ngo-50 g noma ngaphansi ngosuku. Akukho-acetone emchameni.

Ngokudonswa kwemali, konke ukubonakaliswa kudlula lemingcele, i-acetone inqunywa emchameni. Kungahle kube nokukhubazeka okuphikisana nesizinda se-hyperglycemia.

Luvela kanjani uhlobo lweshukela sikashukela?

Uhlobo lokuqala lwesifo sikashukela lungenzeka kunoma yisiphi isigaba seminyaka, kodwa kaningi sithinta izingane, intsha kanye nentsha engaphansi kweminyaka engama-30. Kunezimo zesifo sikashukela sokuzalwa komuntu, futhi izimpawu kubantu abaneminyaka yobudala engama-35 kuye kwengama-45 kungenzeka zibonakale.

Inkambo enjalo yesifo sikashukela ibonakala ngokubhujiswa kwamaseli akhiqiza i-insulin ngenxa yokusabela kohlobo lwe-autoimmune. Isilonda esinjalo singabangelwa amagciwane, izidakamizwa, amakhemikhali, ubuthi.

Lezi zinto zangaphandle zisebenza njengesisusa sokusebenzisa izinhlobo zofuzo ezingxenyeni ezithile zama-chromosomes. Le sethi yezakhi zofuzo inquma ukuhambisana kwezicubu futhi ifa.

Esigabeni sokuqala sesi sifo, ama-antibodies kumaseli we-beta ekugxilweni okuphansi avela. Azikho izimpawu zomtholampilo zalesi sifo, ngoba amathuba okuthola usizo kwe-insulin angakhubazeki. Lokho wukuthi, ama-pancreas abhekana nokubhujiswa okunjalo.

Lapho-ke, njengoba kubhujiswa iziqithana zeLangerhans, izinqubo ezilandelayo ziba khona:

1. Ukuvuvukala kwezicubu ze-pancreatic yi-autoimmune insulin. I-antibody titer iyanda, amaseli we-beta ayachithwa, ukukhiqizwa kwe-insulin kuyancipha.
2. Lapho i-glucose ingena ekudleni, i-insulin ikhiqizwa ngamanani anganele. Awukho umtholampilo, kepha ukutholakala kokuhlukumezeka kokuhlolwa kwe-glucose kungatholakala.
3. I-insulin incane kakhulu, umtholampilo ojwayelekile uyakhula. Ngalesi sikhathi, cishe i-5-10% yamaseli asebenzayo asele.
4. I-insulin ayakhiqizwa, wonke amaseli ayabhujiswa.

Uma kungekho insulin, isibindi, izicubu nezicubu ze-adipose azikwazi ukudonsa ushukela egazini. Ukuqhekeka kwamafutha ezicutshini ze-adipose kuyanda, okuyisizathu sokubonakala kwabo ngokwanda egazini, futhi amaprotheni ewohloka emisipha, okwandisa izinga lama-amino acid. Isibindi siguqula okunamafutha acid nama-amino acid abe yimizimba ye-ketone, esebenza njengomthombo wamandla.

Ngokwenyuka kwe-glucose kuze kufike ku-10 mmol / l, izinso ziqala ukufaka ushukela omchamo, futhi njengoba zizidonsela amanzi uqobo, kuba nokuphelelwa ngamandla okubukhali uma ukulethwa kwawo kungaphindwaphindwa ngokuphuza kakhulu.

Ukulahleka kwamanzi kuhambisana nokususwa kwezinto ezilandelwayo - isodium, i-magnesium, i-potassium, i-calcium, kanye nama-chloride, phosphates ne-bicarbonate.

Izimpawu zohlobo lokuqala lwesifo sikashukela

Izimpawu zokwelapha zesifo sikashukela sohlobo 1 zingahlukaniswa zibe yizinhlobo ezimbili: izimpawu ezibonisa izinga lesinxephezelo sikashukela nezimpawu zokuphazamiseka kwenkambo yaso. Ushukela wegazi ophakeme ubangela ukukhuphuka komchamo, futhi ukoma okuhambisana nakho, umlomo owomile, kanye nesisindo.

Ngokukhula kwe-hyperglycemia, ushintsho lwesifiso sokudla, kuba buthakathaka obukhali, lapho kuvela imizimba ye-ketone, kuvela isisu esiswini, iphunga le-acetone lisuka esikhunjeni nasemoyeni okhipha amandla. Uhlobo lokuqala lwesifo sikashukela lubonakala ngokwanda okusheshayo kwezimpawu lapho kungekho ukuphathwa kwe-insulin, ngakho-ke ukubonakaliswa kokuqala kwayo kungaba yi-ketoacidotic coma.

Iqembu lesibili lezimpawu lihambisana nokukhula kwezinkinga ezinzima: ukwelashwa okungafanele, ukwehluleka kwezinso, i-cardiomyopathy, ingozi ye-cerebrovascular, i-retinopathy yesifo sikashukela, i-polyneuropathy, i-ketoacidosis, kanye nokukhubazeka kukashukela.

Izifo ezihlobene nesifo sikashukela nazo ziba khona:

• I-Furunculosis.
• ICandidiasis
• Ukutheleleka nge-genitourinary.
• Isifo sofuba
• Izifo ezahlukahlukene ezithathelanayo.

Ukwenza ukuxilongwa, kwanele ukukhomba izimpawu ezijwayelekile futhi uqinisekise i-hyperglycemia: kuma-plasma angaphezu kuka-7 mmol / l, amahora ama-2 ngemuva kokudla kwe-glucose - ngaphezu kwe-11.1 mmol / l, i-hemoglobin ye-glycated idlula i-6.5%.

Ungasibona kanjani isifo sikashukela sohlobo 2?

Ukuvela kwesifo sikashukela sohlobo 2 kuhlobene ne-genetic predisposition kanye nokutholakala kwezinkinga ngendlela yokukhuluphala, i-atherossteosis. Ukuthuthuka kungavusa izifo ezinzima ze-somatic, kufaka phakathi i-pancreatitis, i-hepatitis, ukudla ngokweqile, ikakhulukazi umsoco we-carbohydrate ephezulu kanye nokuntuleka kokuzivocavoca.

Ukuphazamiseka kwemetabolism yamafutha kanye ne-cholesterol ephakeme, isifo sokuqina kwemithambo yegazi, isifo sokuqina kwegazi kanye nesifo senhliziyo kuholela ekwehlekeni kwezinqubo ze-metabolic futhi kunciphise ukuzwela kwezicubu kwe-insulin. Ezimweni ezicindezelayo, umsebenzi wama-catecholamines nama-glucocorticoids uyanda, okwandisa okuqukethwe kwe-glucose egazini.

Ngohlobo lwesibili sikashukela, ukuxhumana phakathi kwama-receptors ne-insulin kuyaphazamiseka, ezigabeni zokuqala zesifo, ukugcinwa kwemfihlo kugcinwe, futhi kungandiswa ngisho. Isici esiyinhloko esidala ukumelana ne-insulin ukukhuphuka kwesisindo somzimba, ngakho-ke, lapho sincishisiwe, kungenzeka ukufeza amazinga ajwayelekile eglucose egazini ngokudla namathebulethi.

Ngokuhamba kwesikhathi, i-pancreas iyaphela, futhi ukukhiqizwa kwe-insulin kuyancipha, okwenza ukuthi kudingekile ukushintshela ekwelashweni kwe-insulin. Amathuba okukhula ketoacidosis ohlotsheni lwesibili sikashukela aphansi. Ngokuhamba kwesikhathi, izimpawu zokusebenza kokuphazamiseka kwezinso, isibindi, inhliziyo, nohlelo lwezinzwa zijoyina izimpawu ezijwayelekile zesifo sikashukela.

Ngokuqina, uhlobo 2 sikashukela luhlukaniswe:

1. Ubumnene: isinxephezelo ngokudla kuphela noma ukuthatha ithebhulethi elilodwa lomuthi ngosuku.
2. Ukwehla okulinganiselayo: amaphilisi okwehlisa ushukela ngethamo lika-2-3 ngosuku ngokwejwayelekile enza kube lula ukubonakaliswa kwe-hyperglycemia, angiopathy ngesimo sokuphazamiseka kokusebenza.
3. Ifomu elinzima: ngaphezu kwamathebulethi, kuyadingeka i-insulin noma isiguli sidluliselwe ngokuphelele ekwelashweni kwe-insulin. Izinkinga ezinkulu zokujikeleza kwegazi.

Izici ezihlukile zohlobo 2 ukuthi izimpawu zesifo sikashukela zikhuphuka kancane kunokuba ngohlobo lwesifo sokuqala, futhi lolu hlobo luvame ukutholwa ngemuva kweminyaka engama-45. Izimpawu ezijwayelekile ezihambisana ne-hyperglycemia ziyefana nohlobo 1 sikashukela.

Iziguli zikhathazekile ngokulunywa kwesikhumba, ikakhulukazi izintende zezandla, izinyawo, i-perineum, ukoma, ukozela, ukukhathala, izifo zesikhumba, i-mycoses zivame ukujoyina. Ezigulini ezinjalo, amanxeba aphola kancane, izinwele ziyaphuma, ikakhulukazi emilenzeni, ama-xanthomas avele ezinkalweni, izinwele zobuso zikhula kakhulu.

Imilenze ihlala izizwa ikindabazekile, ikhubazekile, kukhona izinhlungu emathanjeni, amalunga, umgogodla, izicubu ezithintekayo ezibuthakathaka kuholela kuma-dislocations and sprains, fractures and deformations of bones from the background of rarefaction slowly of tis tis.

Izilonda zesikhumba zenzeka ngendlela yezilonda zama-folds we-perineum, axillary nangaphansi kwezinduna ezincelisayo. Ukulunywa, ubomvu nokuqina kuyakhathaza. Ukwakheka kwamathumba, ama-carbuncle nakho kuyisimilo. Ukutheleleka nge-fungus ngesimo se-vulvovaginitis, i-balanitis, i-colpitis, kanye nezilonda zezikhala zezikhathi ezihlukanayo, umbhede wezipikili.

Ngenkambo ende yesifo sikashukela nangokuthola isinxephezelo esibi, kuvela izinkinga:

• I-Vascular pathology (i-microangiopathy ne-macroangiopathy) - ukwanda nobuthakathaka bemithambo yegazi kuyakhuphuka, ukuqhekeka kwegazi nefomu lesigcini sendawo lapho kubhujiswa khona udonga.
• I-Diabetesic polyneuropathy: ukulimala kohlelo lwezinzwa oluyimpoqo ngendlela yokuphulwa kwazo zonke izinhlobo zokuzwela, umsebenzi wemoto ongasebenzi kahle, ukwakheka kokukhubazeka kwezilonda ezinde zesikhathi eside, izicubu ze-tishu ischemia, okuholela ekuqunjweni ngesihlakala esiswini.
• Ukulimala emalungeni - i-arthropathy yesifo sikashukela ngobuhlungu, kunciphile ukuhamba kwamalunga, ukuncipha kokukhiqizwa koketshezi lwentanjana, ukukhuphuka kwabantu nokuqina.
• Umsebenzi wokuphazamiseka wezinso: i-nephropathy yesifo sikashukela (iprotheni emchameni, i-edema, umfutho wegazi ophakeme). Ngokuqhubeka, i-glomerulossteosis kanye nokwehluleka kwezinso kukhula, kudinga i-hemodialysis.
• I-ophthalmopathy yesifo sikashukela - ukuthuthukiswa kokugcwala kwe-lens, ukubona okufiphele, ukufiphala, isihenqo namaphuzu agqamile phambi kwamehlo, i-retinopathy.
• Ukungasebenzi kohlelo oluphambili lwezinzwa ngesimo sokuqina kwesifo sikashukela: ukuncipha kwenkumbulo, amakhono obuhlakani, i-psyche eshintshiwe, ukuguquka kwemizwelo, ikhanda, isiyezi, i-asthenia, kanye nezindawo ezicindezelayo.

Futhi ividiyo ekulesi sihloko izokhombisa ngokusobala umnyombo wokuvela nokukhula kwesifo sikashukela.