Ngo-mellitus wesifo sikashukela kuyadingeka ukuqonda ukuphulwa kokushintshaniswa kwamanzi kanye nama-carbohydrate, okwakungumphumela wezinguquko emisebenzini yamanyikwe, ukukhiqizwa kwe-insulin ye-hormone. Lesi sifo singatholakala futhi senziwe njengefa. Ngenxa yokushoda kwe-insulin noshukela wegazi ophakeme, isiguli sinenkinga yokulimala kanye nezinye izilonda zesikhumba, umfutho wegazi ophakeme, ukwehluleka kwezinso, kanye nokukhubazeka okubukwayo.
Isifo sikashukela sohlobo loku-1 kuthiwa sincike kwe-insulin, le ndlela yalesi sifo ithinta iziguli ezisencane, izingane. Lesi sifo iba lapho umzimba womuntu uqala ukukhiqiza amasosha omzimba abulala amaseli e-pancreatic. Cishe akunakwenzeka ukululama ushukela wohlobo lokuqala; impilo ejwayelekile ingagcinwa ngenxa yemijovo ye-insulin.
Uhlobo lwesibili sikashukela aluthembeli ku-insulin, lesi sifo sivame ukwenzeka kubantu abakhuluphele ngemuva kweminyaka engama-40. Izizathu kufanele zifunwe ekulahlekelweni kokuzwela kwe-insulin, okubangelwa ukweqisa komsoco. Ukwelashwa kweziguli ezinjalo kuqala ngokudla, okujwayelekile kwezinkomba zesisindo. Uma ukudla kunganele, udinga ukuqala inkambiso yezidakamizwa ezinciphisa ushukela. I-insulin iyanconywa ezimweni ezihlukile.
Izimpawu zakudala zesifo sikashukela zibonakaliswa inkambo eqhubeka kancane kancane, i-pathology yazivelela kanqabile. Isiguli siyoqala sizwe ukoma emgodleni womlomo, ubuthakathaka bemisipha, ukujuluka ngokweqile. Ezinye izinkomba zizofaka:
- umuzwa wokoma;
- ukuchama kaningi;
- ukulunywa kwesikhumba;
- ukoma
- ukuqagela izinqubo ze-pustular kwezicubu ezithambile;
- ukuphulukiswa kwenxeba okumpofu.
Njengoba lesi sifo siba sibi kakhulu, kuqale izimpawu zokuphazamiseka kwesifo sikashukela, zimboze cishe zonke izitho zangaphakathi ezibalulekile. Ezimweni ezimbi kakhulu, izimo ezisongela impilo, ukwazi ukungasebenzi kahle, ukudakwa kakhulu, ukwehluleka kwezitho eziningi kwenzeka.
Izinkinga ezinkulu zesifo sikashukela kuzoba ukungaboni kahle, ikhanda, ukuqaqamba kwemizwa, ukuzindla, izinhlungu emaphethelweni aphansi, ushintsho lwe-gait, ukwanda kwegazi, izinhlungu zenhliziyo nosayizi wesibindi.
Ukuvela kwezimpawu zokuphazamiseka kwesifo sikashukela i-mellitus, izifo zaso ezihambisana nakho kuzoba uphawu olwethusayo lokuthuthuka, ukulungiswa kwe-pathology enganele.
Izimbangela zesifo sikashukela
Yini ebangela isifo sikashukela? Izici ezibaluleke kakhulu yinzalo yefa, ukukhuluphala nezifo ze-pancreatic (umdlavuza, i-pancreatitis). Imvamisa izimfuneko ze-hyperglycemia zingukutheleleka ngegciwane, ngokwesibonelo, ubhubhane nge-hepatitis, umkhuhlane, irubella, inkukhu.
Abantu abaningi bathola isifo sikashukela ngemuva kokucindezelwa okunamandla ngokomzwelo, ukushaqeka kwemizwa. Isizathu esengeziwe siwubudala, ngoba njalo eminyakeni eyi-10 amathuba okugula aphindwe kabili.
Uhlu oluphakanyisiwe lwezimbangela aluhlanganisi lezo zifo lapho i-hyperglycemia isesekondari, kuphela uphawu. Kulokhu, ushukela ophakeme awuthathwa njengokubonakaliswa kwesifo sikashukela seqiniso.
Yini ebangela isifo sikashukela sohlobo 1? Lesi sifo sibangelwa izinqubo ze-autoimmune lapho:
- umzimba ukhiqiza amasosha omzimba emangqamuzaneni awo;
- Izinga le-insulin ye-hormone kuleli cala liyancipha kuze kuphele ukuqothuka ngokuphelele.
Odokotela banesiqiniseko sokuthi imbangela enkulu yesifo sikashukela sohlobo loku-1 yisiphetho sendlalifa. Uma omunye wabazali enesifo sikashukela, ingozi yengane yokugula inyuka kakhulu. Kepha kunezimo lapho isifo sikashukela sikhuliswa ezinganeni uma zondliwa ngobisi lwenkomo.
Isifo sikashukela esibekwe ezinhlotsheni zofuze singeze saba khona uma kungekho zici ezikhululayo: umsebenzi wokuhlala phansi, ubunzima bezinzwa, ukudla okungenampilo, ukuntuleka komthetho wokuhamba emoyeni omusha.
Indlela ebangela isifo sikashukela kuwukusebenza ngokweqile kwamaseli we-T-killer, ukwephulwa kokungavikeleki kwe-immune, cellular immune. Lapho umuntu esindwa yifa, noma iliphi igciwane lingaba ukuqala kwesifo sikashukela.
Isifo sikashukela sohlobo 2 singadala ukukhuluphala. Ngale ndlela yalesi sifo, inani le-insulin elondolozwa amaseli wamanyikwe lihlala ngaphakathi kwebanga elijwayelekile. Kodwa-ke, izicubu azivumelani nama-hormone; ukuntuleka kwama-enzymes angaphakathi kuholela ekulimazeni i-glucose metabolism.
Ngenxa yokumelana kwezicubu ezibuthakathaka ku-insulin, umuntu uhlushwa yi-insulinism, nayo ebangela:
- ukwehla kwenani lama-receptors;
- ukuthuthukiswa kwezimpawu zesifo sikashukela.
Isifo sikashukela sohlobo 2 sibangelwa ukudla ngokweqile, ukubekwa kwezicubu ze-adipose. Amafutha, ngokungafani nezicubu zomzimba, kubonakaliswa umuzwa ophansi we-insulin, ngenxa yalesi sizathu kukhona ushukela omningi egazini.
Ngokwezibalo, lapho isisindo somuntu singaphezu kokujwayelekile ngama-50%, amathuba eswekile kuye asondela ku-70% ngokushesha. Ukweqiwa kwesisindo ngo-20% kuzobangela i-hyperglycemia cishe ngamaphesenti angama-30.
Ngokombono wokubonwa kwesifo sikashukela, kuyingozi lapho inkomba yomzimba womuntu idlula ama-30 kg / sq.m, amadiphozi asesiswini ngokwemvelo, futhi ukuma komzimba kufana ne-apula. Akubalulekanga kangako ekujikelezeni okhalweni, amathuba esifo sikashukela akhuphuka ngokujikeleza okhalweni:
- kwabesifazane abangaphezu kuka-88 cm;
- emadodeni angaphezu kuka-102 cm.
Noma kunjalo, noma isisindo esijwayelekile, umuntu angagula, cishe amaphesenti ama-8 wabantu beplanethi enesisindo esijwayelekile abaphethwe yilesi sifo.
Kuyiqiniso elaziwayo ukuthi eminye imithi inomphumela wesifo sikashukela, isidakamizwa sicasula isifo sikashukela: i-antitumor, i-diuretic. Izidakamizwa ze-Glucocorticosteroid, kanye nezinye izidakamizwa eziphikisana nomfutho wegazi ophakeme, zingadala i-hyperglycemia.
Izimpawu zesifo sikashukela zingenzeka ngemuva kokusetshenziswa isikhathi eside kwezidakamizwa ezilwa nesifuba somoya, i-rheumatism, isifo sikaCrohn kanye nezinye izifo zempilo.
Izithasiselo ezisebenzayo ngokwendalo nokuqukethwe okuphezulu kwe-selenium zivame ukuba nomphumela ofanayo.
Izindlela Zokuxilonga
Lapho kunokusolwa kwesifo, kubalulekile ukuqinisekisa noma ukwenqabele ukutholwa kusenesikhathi ngangokunokwenzeka. Ngale njongo, kusetshenziswa izibalo eziningi zelebhu:
- amazinga okushukela;
- isivivinyo sokumelana noshukela;
- ukuhlaziywa komchamo ukuthola amaseli amhlophe egazi, amaprotheni, ushukela;
- ukuzimisela kwephrofayili ye-glycemic;
- ukuhlolwa komchamo we-acetone.
Kuboniswa futhi ukunikela ngegazi ezingeni le-hemoglobin ye-glycated, lokhu kubalulekile ukunquma izinga lokuphazamiseka okubangelwa isifo sikashukela. Ngenxa yocwaningo lwe-biochemical, udokotela unethuba lokubona ukugcwala kokusebenza kwesibindi.
Ngezindlela ezibucayi zesifo, kuhlaziywa ukwakheka kwegazi kwe-electrolyte, ngosizo lohlolo lwe-Reberg, izinga le-insulin yomzimba emzimbeni linqunywa. Ngaphezu kwalokho, kuyadingeka ukwenza ucwaningo ngesimo se-fundus, i-ultrasound ye-patity esiswini, izinso, inhliziyo, i-ECG, i-dopplerography ye-ultrasound, i-vascular rheovasography, capillaroscopy.
Wonke umuntu onesifo sikashukela kufanele abonisane nodokotela ngaphandle kokuhluleka:
- udokotela ohlinzayo
- i-endocrinologist;
- i-neuropathologist;
- udokotela wamehlo;
- isifo senhliziyo.
Ukucacisa ngokucacile ubukhulu besifo sikashukela i-mellitus, kuyadingeka ukwenza yonke inkimbinkimbi yezindlela zokuxilonga, futhi ikuvumela ukuba ukhethe amaqhinga okulashwa afanele. Kubalulekile ukuthi uphinde uxilongwe ngemuva kwesikhashana ukuze uhlaziye ukuphumelela kokwelashwa okwenziwe.
Izici zamazinga ahlukahlukene kashukela
Isifo sikashukela mellitus seveli yokuqala yobunzima sibonakaliswa yinkambo ethandeka kakhulu, noma yikuphi ukwelashwa kufanele sikuzame ngakho. Kulokhu, lesi sifo sinxephezelwe ngokuphelele, i-glycemia ayidluli i-6-7 mmol / l, i-glucose ayikhishwa kumchamo, i-proteinuria ne-glycated hemoglobin ayihambi ngalapho kwemingcele evunyelwe.
Azikho izimpawu zokuphazamiseka esithombeni somtholampilo: i-nephropathy, i-angiopathy, i-cardiomyopathy, i-retinopathy, i-polyneuropathy. Ukufinyelela lo mphumela kusiza ekudleni, kwezinye izidakamizwa.
Esikhathini sikashukela sobunzima besibili, sesikhuluma ngokunxeshezelwa okuyingxenye kwe-hyperglycemia, kunezimpawu zokulimala kwezitho zomzimba: izinso, izinzwa, imithambo yegazi, amehlo, inhliziyo, kanye nezinga eliphansi. Amanani kashukela awakhushulwa kakhulu - imvamisa yi-7-10 mmol / l, akukho mkhondo we-glucose umchamo. I-hemoglobin ye-Glycated izohlala ingaphakathi kwemikhawulo ejwayelekile noma ikhuphuke kancane, akukho ukwephulwa okukhulu kusuka ohlangothini lwezitho zangaphakathi.
Uma lesi sifo sisiya esigabeni sesithathu, lokhu kuwubufakazi bokuqhubeka kwezinkinga kanye nokusebenza okuphansi kokulawulwa kwezidakamizwa:
- ushukela wegazi ukhuphukela ku-13-14 mmol / l;
- ushukela kanye namaprotheni avela kumchamo;
- kukhona izilonda zezitho eziqondiwe.
Ama-Visic acuity ancishiswa ngentshiseko, umfutho we-arterial kunzima ukwenzeka, imizwa yezinga lezinto ezinqikayo iyancipha, zibekekile.
Ukwehla kwesine sikashukela kubonakaliswa ukubola ngokuphelele kwalesi sifo, okucasulayo ukuthuthukiswa kwezinkinga ezinzima, ezisongela impilo. I-glucose inyukela emazingeni abucayi, lesi simo asikwazi ukuzilungisa kahle. Isiguli sinenkinga yokuqunjelwa yiziqongo, ukwehluleka kwezinso, nezilonda zesifo sikashukela.
Enye inkomba yesifo sikashukela sobunzima bwesine kuzoba yisihlungo se-comas yesifo sikashukela esivamile: ketoacidosis, hyperglycemic, hyperosmolar.
Izinkinga ezingaba khona, imiphumela yesifo sikashukela
Isifo sikashukela uqobo asisongozi ngqo empilweni yomuntu, imiphumela kanye nezinkinga ziyingozi enkulu. Ezinye zazo zingakhula ngaso leso sikhathi, ngokwesibonelo, ukukhohlisa. Izimpawu zezexwayiso kufanele kube yizithiyo zomuntu kanye nokujikisa ukwazi kwakhe. Isiguli kufanele silethwe esibhedlela ngokushesha ngangokunokwenzeka.
I-coma yesifo sikashukela okungenzeka kakhulu i-ketoacidotic, ngenxa yokuqongelela kwemikhiqizo ye-metabolic. Le nqubo ye-pathological ingasolwa ngephunga lesimo se-acetone elisuka emgodini womlomo. Isiguli sifunga kakhulu, inkomba yeglucose esibucayi iyabangelwa, icasulwe yi-insulin ephezulu kakhulu.
Enye inkinga ingaba banzi noma i-edema yendawo, ihambisana nokuhluleka kwenhliziyo. Lolu phawu lubhekwa njengophawu lobunzima bokungasebenzi kahle kwezinso, kulapho i-nephropathy iba nzima ngokwedlulele. Lapho i-puffiness is asymmetric, imboza kuphela unyawo, umlenze ophansi, udokotela uzosola i-microangiopathy yesifo sikashukela ngokumelene nesizinda se-neuropathy.
Enye inkinga yesifo sikashukela izinkinga zomfutho wegazi:
- ngomfutho wegazi ophakeme, i-nephropathy yesifo sikashukela iyaqhubeka;
- ngomfutho wegazi ophansi, kuphawulwa i-angiopathy yesifo sikashukela.
Esikhathini sikashukela, isiguli sinobuhlungu obukhulu emaphethelweni aphansi. Ubuhlungu bobusuku bukhombisa i-neuropathy yesifo sikashukela, ukungakhululeki ngesikhathi sokuvivinya umzimba, ukuhamba kuwuphawu lwe-microangiopathy.
Isifo sikashukela siyinto ecasulayo ukuthuthukiswa kwezilonda ezikhulu kanye ne-gangrene. Izilonda ze-peptic ulcer yisigaba esilandelayo se-neuro- ne-angiopathy. Udokotela kumele ahlaziye ngokuphelele zonke izinkomba, ngoba amandla okusindisa umlenze onesifo kuncike kulokhu. Kuyadingeka ukukhombisa ukuthandwa okuhlobene kwezilonda ze-neuropathic, okubangelwa ukuncipha kokuzwela komlenze.
Lapho ukwelashwa kunganikeli umphumela noma kungabikho ngokuphelele, kuthinteka iziqu ezinkulu kanye nezincane, bese kuthi isifo sikashukela siqale ubuthi. Imvamisa inqubo ye-pathological iqala kusukela ezinzwaneni zonyawo, ukugeleza kwegazi kuya onyaweni kuyema, kuqala ukulimala, kuphenduka kube bomvu. Emazingeni akamuva, isikhumba siba:
- i-cyanotic;
- kubanda
- ukuvuvukala.
Ngokushesha, isikhumba simbozwa ngamabhulayo anamabala amnyama nokuqukethwe kwamafu. Lezi zinguquko aziguquki, ayikho indlela yokusindisa umlenze othintekile, okuwukuphela kwendlela yokusindisa impilo yesiguli ukunqamula umlenze.
Kuyelulekwa ukuqhuba kube phansi ngangokunokwenzeka, noma kunjalo, ukusebenza onyaweni ngokuvamile akulethi imiphumela, ngakho-ke, ukunqunywa ku-shin kulungile.
Ezimweni eziningi, iziguli zibuyisela ukuhamba ngezindlela ezisezingeni eliphakeme ezisebenzayo.
Ukuvimbela Ushukela
Akuwona wonke amacala angavimbela ukuqala kwesifo sikashukela, ikakhulukazi uhlobo lokuqala lwesifo, ngoba izimbangela zepatholezi zihambisana nesifo sofuzo, amagciwane amancane. Kuyinto ephawuleka ukuthi isifo sikashukela, ngisho nokuba nefa elibi, asikhuli kubo bonke abantu.
Naphezu kweqiniso lokuthi isifo sikashukela sivame kancane ezinganeni ezinceliswa amabele nakubantu abadala abaphatha izifo zokuphefumula ngama-antiviral agents, lezi zindlela ngeke zibizwe ngokuthi ukuvimbela i-hyperglycemia. Ngakho-ke, izindlela ezisebenza ngempela zokuvimbela isifo sikashukela sohlobo 1 azikho njengamanje.
Kodwa-ke, umuntu angathembela ekuvinjelweni kwesifo sohlobo lwesibili, ngoba lesi sifo singumphumela wendlela engafanele. Yini engaba yizindlela ezinhle zokuvimbela i-hyperglycemia kulokhu?
Ukuvikela okugcwele ngokuphelele kuzoba:
- ukulungiswa kwesisindo;
- ukulawulwa kwengcindezi yegazi, i-metabolism yamafutha;
- ukudla okuqinile;
- ukusebenza ngokomzimba okulinganiselayo
Inani elanele lokudla kwamaprotheni, imifino emisha nezithelo kufanele kufakwe ekudleni. Ngaphezu kwalokho, kukhonjiswa ukuthatha i-Vitamin kanye ne-mineral complexes. Ukuvimbela, ungasebenzisa izidakamizwa ezifaka i-lipoic acid.
Kuboniswa futhi ukwenqaba ukufaka esikhundleni sikashukela kanye nemikhiqizo efanayo, ukubheja kuma-sweeteners wemvelo: i-stevia, i-artichoke yaseJerusalema. Awumnandi njengoshukela omhlophe ojwayelekile, kepha awunawo umthelela omubi emzimbeni womuntu.
Ukuvimbela izinkinga ngokuxilongwa okuqinisekisiwe kufaka ukwelashwa kokuqala nokwanele. Udokotela uyadingeka ukuthi abe nolwazi olucacile lwawo wonke ama-nuances wokwelapha lesi sifo, futhi isiguli kufanele silandele ngokuqinile izincomo zezokwelapha nezokudla.
Kubalulekile ukuqapha njalo isimo samaphethelo aphansi, uwanakekele ukuvimbela ukulimala kwesikhumba. Uma kwenzeka kutholwa izinkinga ngemilenze, kukhonjiswa ukuthi ngokushesha ufuna usizo lukadokotela.
Ngabe isifo sikashukela singalapheka? Kunzima kakhulu ukuphendula umbuzo obuziwe, ngoba amangqamuzana e-beta pancreas ayafa, futhi akunakwenzeka ukuwabuyisela. Okuhlukile kuzoba yilezo zindlela zikashukela ezingalungiswa ngokudla okujwayelekile kanye nokwenza umsebenzi womzimba.
Kubalulekile ukulawula izinkomba ze-glycemia, lokhu kuzonquma ukusebenza kahle kokwelashwa. Ukwelapha okunqunyiwe kuhlala kuthatha isikhathi eside, kuphela:
- shintsha izinhlobo zezidakamizwa;
- imithamo yabo.
Abanye abantu bathi bakwazile ukuqeda i-pathology ngenxa yokuzila ukudla okwelashwa.
Kufanele kukhunjulwe ukuthi amathuba okuphindeka kwesifo ahlala ephezulu kakhulu.Umuthi osemthethweni ugcizelela ukuthi isifo sikashukela sohlobo lokuqala nesesibili ngeke selapheka, kodwa ngokulawulwa ngokuhlelekile, umuntu angakwazi ukunciphisa ukuqubuka kwesifo futhi ayeke ukuthuthukiswa kwezinkinga. Ividiyo ekulesi sihloko izachaza ukuthi yini ebangela isifo sikashukela.
