Ama-antibodies kuya ku-insulin akhiqizwa ngokumelene ne-insulin yawo yangaphakathi. Ku-insulin yisiginali ekhomba kakhulu isifo sikashukela sohlobo 1. Ucwaningo kudingeka lubelwe ukuthola lesi sifo.
Uhlobo Iabetes mellitus luvela ngenxa yomonakalo we-autoimmune eziqhingini ze-Langerhans gland. I-pathology enjalo iholela ekuphepheni ngokuphelele kwe-insulin emzimbeni womuntu.
Ngakho-ke, isifo sikashukela sohlobo 1 siphikisana nesifo sikashukela sohlobo 2, lokhu kokugcina akukuhlanganisi ukubaluleka okuningi kwezifo zokugoma. Ngosizo lokuxilongwa okuhlukile kwezinhlobo zesifo sikashukela, i-prognosis ingenziwa ngokucophelela ngangokunokwenzeka futhi kungenziwa necebo elifanele lokwelashwa.
Ukunqunywa kwama-antibodies ku-insulin
Umaka wezilonda ze-autoimmune zamaseli we-pancreatic beta akhiqiza i-insulin.
Ama-Autoantibodies kuma-insulin angaphakathi ama-antibodies angatholakala ku-serum yegazi yohlobo 1 sikashukela ngaphambi kokulashwa kwe-insulin.
Izinkomba ezisetshenziswayo yilezi:
- ukuxilongwa kwesifo sikashukela
- ukulungiswa kwe-insulin therapy,
- ukutholakala kwezigaba zokuqala zesifo sikashukela,
- ukuxilongwa kwe-prediabetes.
Ukuvela kwalawa ma-antibodies ahambelana nobudala bomuntu. Ama-antibodies anjalo atholakala cishe kuwo wonke amacala uma isifo sikashukela sivela ezinganeni ezingaphansi kweminyaka emihlanu. Ezimweni ezingama-20%, ama-antibodies anjalo atholakala kubantu abanesifo sikashukela sohlobo 1.
Uma kungekho-hyperglycemia, kepha kukhona ama-antibodies, lapho-ke ukuxilongwa kwesifo sikashukela sohlobo 1 akuqinisekiswa. Ngesikhathi sokugula, izinga lama-antibodies kuya ku-insulin liyancipha, aze anyamalale ngokuphelele.
Iningi labanesifo sikashukela banezinhlobo ze-HLA-DR3 ne-HLA-DR4. Uma izihlobo zinesifo sikashukela sohlobo 1, amathuba okugula anyuka ngezikhathi eziyi-15. Ukuvela kwama-autoantibodies ku-insulin kuqoshwa isikhathi eside ngaphambi kwezimpawu zokuqala zesifo sikashukela.
Izimpawu, kuze kube ngama-85% wamaseli e-beta kufanele abhujiswe. Ukuhlaziywa kwalawa ma-antibodies kuhlola ubungozi besifo sikashukela esizayo kubantu abanokuphambuka kwengqondo.
Uma ingane ene-genetic predisposition ine-antibodies to insulin, ingozi yokuba nesifo sikashukela sohlobo 1 eminyakeni eyishumi ezayo inyuka cishe ngama-20%.
Uma kutholakala ama-antibodies amabili noma ngaphezulu acacisiwe ngohlobo lwe-1 mellitus yesifo sikashukela, amathuba okugula aya enyuka aze afike ku-90%. Uma umuntu ethola amalungiselelo e-insulin (exo native, recombinant) ohlelweni lokwelapha ushukela, lapho ngokuhamba kwesikhathi umzimba uqala ukukhiqiza amasosha omzimba kuwo.
Ukuhlaziywa kuleli cala kuzoba okuhle. Kodwa-ke, lokhu kuhlaziywa akukwenzi ukuthi uqonde ukuthi ama-antibodies kuyi-insulin yangaphakathi noma angaphandle akhiqizwanga.
Njengomphumela wokwelashwa kwe-insulin kuma-diabetes, inani lama-antibodies kuma-insulin angaphandle egazini landa, elingadala ukumelana ne-insulin futhi kuthinte ukwelashwa.
Kufanele kukhunjulwe ukuthi ukumelana ne-insulin kungavela ngesikhathi sokwelashwa ngamalungiselelo we-insulin angahlanzwa kahle.
Incazelo yohlobo lwesifo sikashukela
Ama-Autoantibodies aqondiswe ngokumelene nama-islet beta cell ayafundwa ukuthola uhlobo lwesifo sikashukela. Izinto eziphilayo zabantu abaningi ezinenkinga yesifo sikashukela sohlobo 1 zikhiqiza amasosha omzimba ezithweni zamanyikwe. Ama-autoantibodies anjalo awawona abonwa uhlobo 2 lwesifo sikashukela.
Ngohlobo 1 sikashukela, i-insulin yi-autoantigen. Kumapancreas, i-insulin yi-autoantigen ethize eqondile. I-hormone yehlukile kwamanye ama-autoantigens atholakala kulesi sifo.
Ama-Autoantibodies kuya ku-insulin atholakala egazini labantu abangaphezu kwama-50% abanesifo sikashukela. Esigulini sohlobo 1, kunamanye ama-antibodies egazini ahlobene namaseli we-beta pancreas, ngokwesibonelo, amasosha omzimba ukulwa ne-glutamate decarboxylase.
Lapho kutholakala:
- cishe i-70% yeziguli inezinhlobo ezintathu noma ngaphezulu zama-antibodies,
- ngaphansi kuka-10% banenhlobo eyodwa,
- awekho ama-autoantibodies athile ku-2-4% yabantu abagulayo.
Kuyaqapheleka ukuthi ama-antibodies e-hormone i-insulin ku-mellitus yesifo sikashukela awayona inkambiso yesifo. Ama-antibodies anjalo abonisa kuphela ukubhujiswa kwamaseli e-pancreatic. Ama-antibodies kuma-insulin ezinganeni ezinesifo sikashukela sohlobo 1 angabonakala ezimweni eziningi kunakwabadala.
Kubalulekile ukunaka iqiniso lokuthi, njengomthetho, ezinganeni ezinesifo sikashukela sohlobo 1, amasosha omzimba anjengalawa avela kuqala futhi asenkingeni enkulu. Lo mkhuba ubonakala kakhulu ezinganeni ezingaphansi kweminyaka emithathu.
Ukuqonda lezi zici, ukuhlaziya okunjalo namuhla kuqashelwa njengokuhlolwa kwelebhu okungcono kakhulu kokuthola isifo sikashukela ebuntwaneni.
Ukuthola ulwazi oluphelele kakhulu ekutholakalweni kwesifo sikashukela, hhayi kuphela ukuhlolwa kwe-antibody, kodwa nokuhlaziywa kobukhona be-autoantibodies.
Uma ingane ingenayo i-hyperglycemia, kepha kutholakala umaki wezilonda ze-autoimmune amangqamuzana eziqithi zeLangerhans, lokhu akusho ukuthi kunohlobo 1 lwesifo sikashukela.
Lapho isifo sikashukela sithuthuka, izinga lama-autoantibodies liyancipha futhi lingabonakali.
Lapho kuhlelwa isifundo
Ukuhlaziywa kufanele kunikezwe uma isiguli sinezimpawu zomtholampilo ze-hyperglycemia, okungukuthi:
- ukoma okukhulu
- ukukhuphuka kwenani lomchamo
- ukwehla kwesisindo okungazelelwe
- isifiso esinamandla
- ukuzwela okuphansi kwemikhawulo engezansi,
- ukwehla kwamandla okubuka,
- trophic, ulonda wezinyawo zesifo sikashukela,
- amanxeba angapholi isikhathi eside.
Ukwenza izivivinyo zama-antibodies ku-insulin, kufanele uthinte udokotela wezifo zemithi noma uthintane nodokotela wamathambo.
Ukulungiselela ukuhlolwa kwegazi
Okokuqala, udokotela uchazela isiguli isidingo sifundo esinjalo. Kufanele kukhunjulwe ngezindinganiso zezimilo zezokwelapha kanye nezimpawu zengqondo, ngoba umuntu ngamunye unezindlela azizwa ngazo.
Inketho enhle kakhulu kungaba isampula yegazi nguchwepheshe welebhu noma udokotela. Kuyadingeka ukuchaza isiguli ukuthi lokho kuhlaziya kwenziwa ukuze kutholakale isifo sikashukela. Abaningi kufanele bachaze ukuthi lesi sifo asisiyingozi, futhi uma ulandela imithetho, ungahola impilo ephelele.
Igazi kufanele linikelwe ekuseni ngesisu esingenalutho, awukwazi ngisho nokuphuza ikhofi noma itiye. Ungaphuza kuphela amanzi. Awukwazi ukudla amahora angama-8 ngaphambi kokuhlolwa. Usuku ngaphambi kokuhlaziywa luvinjelwe:
- phuza utshwala
- yidla ukudla okuthosiwe
- ukudlala imidlalo.
Isampula yegazi lokuhlaziya yenziwa ngokulandelayo:
- igazi liqoqwa kushubhu lokuhlola elilungiselelwe (lingaba ngejeli yokuhlukanisa noma ingenalutho),
- ngemuva kokuthatha igazi, indawo yokubhoboza igcwele ngotshani bekotini,
Uma i-hematoma ivela endaweni yokubhoboza, udokotela unquma ukucindezela ukufudumala.
Ithini imiphumela?
Uma ukuhlaziya kungcono, lokhu kukhombisa:
- Uhlobo 1 sikashukela
- Isifo sikaHirat
- polyendocrine autoimmune syndrome,
- ukuba khona kwama-antibodies ukuphindaphinda kanye ne-insulin engaphandle.
Umphumela wokuhlolwa ongemuhle uthathwa njengokujwayelekile.
Ukugula okuhambisana nakho
Lapho kutholwa umaki we-autoimmune beta-cell pathologies kanye nokuqinisekiswa kohlobo lwesifo sikashukela sokuqala, kuzofanela kunikezwe izifundo ezengeziwe. Ziyadingeka ukuthi zingafaki lezi zifo.
Ngohlobo oluningi lwesifo sikashukela, eyodwa noma ngaphezulu i-autoimmune pathologies iyabonakala.
Ngokuvamile, yilezi:
- i-autoimmune pathologies yegland yegilo, isibonelo, iHashimoto's thyroiditis kanye nesifo se-Graves,
- ukwehluleka okuyisisekelo kwe-adrenal (isifo sika-Addison),
- isifo se-celiac, isb. gluten Enteropathy kanye ne-anemia enobungozi.
Kubalulekile futhi ukuthi ucwaninge ngazo zombili izinhlobo zesifo sikashukela. Ngaphezu kwalokho, udinga ukwazi ukwanda kwalesi sifo kulabo abanomlando wezakhi osindayo, ikakhulukazi ezinganeni. Ividiyo ekulesi sihloko isitshela ukuthi umzimba uwabona kanjani ama-antibodies.
