I-diabetes mellitus ezinganeni yisifo se-metabolic esingamahlalakhona esibonakala ngokwakhiwa kwe-hyperglycemia kanye nokuvikelwa kwe-insulin. Lesi sifo sikhula ngokushesha, sihambisana nokuncipha kwesisindo sengane ngokuthambekela okuphezulu, ukoma okunzima nomchamo ngokweqile.
Ukuze kutholakale isifo sikashukela enganeni, kufanele kutholakale izindlela zokuxilonga elabhorethri. Izindlela eziphambili zifuna inani likashukela egazini, ukuthola izinga lokukhuthazelela ushukela nezinye izivivinyo ezithile.
Izikhombisi eziyinhloko ekwelapheni isifo sikashukela sezingane ukusetshenziswa kwezidakamizwa nokwelashwa kwe-insulin. Ukuvimbela isifo sikashukela ezinganeni kufaka ukwethulwa kokudla okungenamsoco.
Izimpawu ezejwayelekile zesifo sikashukela
Ukushoda okuphelele noma okuyingxenye kwe-insulin kuholela ekubonakalisweni okuhlukahlukene kokuphazamiseka kwe-metabolic. I-insulin inikeza ukudluliselwa nge-membrane yeseli ye-potassium, ushukela kanye nama-amino acid.
Ngokuntuleka kwe-insulin, ukuwohloka okubukhali kwe-glucose metabolism kwenzeka, ngakho-ke kuqongelela egazini kanye ne-hyperglycemia kuqala.
Ukuqina kwe-urine kukhuphuka ngenxa yokuphuma ushukela kumchamo, lokhu kuwuphawu lwesifo sikashukela sengane. I-Glucosuria icasulayo i-polyuria ngenxa yengcindezi ephezulu yomchamo.
Odokotela bachaza i-polyuria njengophawu lokubopha kwamanzi okungabekeki. Imvamisa, kwenzeka ngenxa yokuhlanganiswa kweprotheni, amanoni ne-glycogen ngaphansi kwethonya le-insulin.
Inani elikhulu likashukela ku-serum yegazi, kanye ne-polyuria, inikeza i-serum hypersmolarity kanye nokoma okungapheli - i-polydipsia. Inqubo yokuguqulwa kwama-carbohydrate abe ngamafutha nokuhlanganiswa kweprotheni kuyaphazamiseka. Ezinganeni, izimpawu zingabizwa kakhulu, ngokwesibonelo, ziqala ukunciphisa umzimba ngokushesha, ngenkathi kukhona umuzwa wokuhlala wendlala.
Kukhona ukuntuleka kwe-insulin ezinganeni, izimpawu zazo ezibonakala ngokuphulwa komzimba wamafutha. Ikakhulu, izinqubo zokwenziwa kwamafutha ziba zimbi kakhulu, ukwanda kwe-lipolysis, futhi inani elikhulu lamafutha acid lingena egazini.
Ukukhiqizwa kwe-NADP-H2, okudingekayo ekuhlanganisweni kwamafutha acid nokuqedwa ngokuphelele kwemizimba ye-ketone, nayo iyancishiswa. Ngakho-ke, ama-triglycerides ne-cholesterol aqala ukwakha ngamanani amakhulu. Umoya ophelelwa ngamandla unuka i-acetone.
Ukushoda kwe-insulin ekwelapheni isifo sikashukela ebuntwaneni kuholela ekwakhekeni ngokweqile kwe-P-lipoproteins esibindini, i-atherosulinosis nayo iyakhiwa, nayo ibangelwa i-hypercholesterolemia kanye ne-hypertriglyceridemia.
Izakhi ze-mucopolysaccharides ezikwi-serum yegazi ngesikhathi sokwelashwa kwesifo sikashukela zingawela kulwelwesi olungaphansi, isikhala se-endothelial, kanye nezakhiwo ze-pericapillary bese ziba yi-hyaline.
Ngenxa yezinqubo ze-pathological, izinguquko ziyavela ezithweni ezinjalo:
- fundus
- inhliziyo
- isibindi
- izitho zomgudu wesisu,
- izinso.
Ngokubonakaliswa kokuntuleka kwe-insulin, ukunqwabelana kwe-lactic acid kwenzeka emisipha, okuholela ku-hyperlactacidemia, ekhulisa i-acidosis.
Ngenxa yokuntuleka kwe-insulin ekwelapheni isifo sikashukela, kuvela ukuphazamiseka kumaminerali wamaminerali namanzi, okuhambisana kakhulu ne-hyperglycemia, glucosuria, kanye ne-ketoacidosis.
Izimbangela zesifo sikashukela sengane
Ngaphambi kokukhula kwesifo sikashukela ezinganeni, kunesikhathi sokugcina sesimo esingahlali isikhathi eside. Kungenzeka abazali bangakunaki ukuthi ingane ivame ukuya endlini encane futhi iphuze amanzi amaningi. Ikakhulu lezi zimpawu zibonwa ebusuku.
Njengamanje, izimbangela zesifo sikashukela ezinganeni aziqondakali ngokuphelele. Lesi sifo senzeka ngenxa:
- isakhi sofuzo
- ukutheleleka ngegciwane
- ukungasebenzi kahle kwe-immunological.
Imvamisa, isifo sikashukela ezinganeni sivele ngenxa yokutheleleka ngegciwane, okunomphumela olimazayo kumaseli we-pancreatic. Yiso lesi sitho esikhiqiza i-insulin. Okubi kakhulu yilezi zifo:
- mumps - mumps,
- i-viral hepatitis,
- inkukhu
- rubella.
Uma ingane yayine-rubella, ubungozi besifo sikashukela bukhuphuka ngo-20%. Uma kungekho okubhekwe phambili kwisifo sikashukela, ukutheleleka ngegciwane ngeke kube nomphumela omubi.
Uma ingane inabazali bobabili abanesifo sikashukela, khona-ke lesi sifo kungenzeka nokuthi sitholakale nengane. Uma ukugula kutholakala ku-dadewabo noma umfowabo wengane, amathuba ayo okugula anyuka cishe ngama-25%.
Khumbula ukuthi isakhi sofuzo akusona isiqinisekiso sesifo sikashukela. Uhlobo olonakalisiwe kungenzeka lungadluliswa kusuka kumzali. Kunezimo lapho kugula kuphela elilodwa lamawele amabili.
Isifo sikashukela mellitus sinokuvela ngemuva kwezifo ezifana nalezi:
- i-autoimmune thyroiditis,
- glomerulonephritis,
- lupus,
- ihepatitis.
Isifo sikashukela sohlobo 2 singabangelwa ukuzitika ngokweqile nangokudla ukudla okuyingozi. Kwabantu abadala nezingane ezinesisindo somzimba esijwayelekile, lesi sifo sivela ezimweni ezingaphansi kweziyi-8 kwezingu-100.
Uma isisindo somzimba seqisa, khona-ke nengozi yesifo sikashukela iyanda.
Izindlela zokuxilonga
Ukubonakaliswa kwesifo sikashukela kuqinisekiswa ukuhlolwa kwegazi ngoshukela. Ushukela wegazi ojwayelekile usezingeni lika-3.3 - 5.5 mmol / L. ukukhuphuka kwezinga likashukela okufika ku-7.5 mmol / l kuvame ukubonwa kuma-mentitus wesifo sikashukela.
Ukugxila kwe-glucose egazini ngenhla kwalesi sikhombisi sibonisa ukuba khona kwesifo sikashukela ezinganeni nakubantu abadala.
Ukuhlolwa kokubekezelela ushukela okhethekile nakho kuyenziwa. Okokuqala, izinga loshukela egazini linqunywa esiswini esingenalutho. Ngemuva kwalokho izingane nabantu abadala baphuza i-75 g ushukela ngamanzi. Izingane ezingaphansi kweminyaka engu-12 ubudala zisebenzisa u-35 g we-glucose.
Ngemuva kwamahora amabili, ukuhlolwa kwegazi kwesibili kwenziwa kusuka emunweni. I-ultrasound esiswini nayo ingenziwa ukukhipha ukuvuvukala kumanyikwe.
Ukwelapha
Ukwelashwa kwezingane kwenziwa ngu-endocrinologist wezingane, kususelwa ohlotsheni lokugula. Ngesifo sohlobo 1, ukwelashwa okubuyiselwe esikhundleni kuyadingeka. Kufanele kube ne-insulin, edingwa ngumzimba ngenxa yokuntuleka kwepancreatic.
Izingane ezinezinkinga kufanele zilandele ukudla okukhethekile njalo. Ingane akufanele ilambe futhi idle kaningi izikhathi ezingama-4-5 ngosuku.
Uma ukwelashwa bekungafundile noma kungalindelekile, kungaqhamuka i-hypoglycemic coma. Yakha kungakapheli isigamu sehora futhi inezimpawu ezilandelayo:
- ubuthakathaka obukhulu
- ukwethuka kwemilenze,
- umjuluko osindayo
- indlala
- ikhanda
- kunciphe umbono
- ukuzindla kwenhliziyo,
- ukugabha kanye nenausea.
Ezinganeni nasentsheni, imizwa iguquka njalo, ingacindezelwa, noma ibe nolaka futhi ibe novalo. Uma ukwelashwa kunganikezwanga, khona-ke kunokuziphatha okunganele, ukubamba okubonakalayo nokubuka okubonakalayo, kanye nomphumela oyingozi - ukwehluleka okujulile.
Ingane kufanele njalo ibe noswidi we-chocolate naye, ongayidla ngokungenisa umthamo omkhulu we-insulin kunalokho okudingeka okwamanje. Ngakho-ke, umuntu angavimbela ukukhohlisa. Noma kunjalo, ukudla kwansuku zonke kwengane akufanele kube phezulu kuma-carbohydrate.
Ukwelashwa kwezingane kufaka ukusetshenziswa kwama-insulin amafushane, ngokuvamile i-Protofan ne-Actrapid. Izidakamizwa zilawulwa ngaphandle kokusebenzisa ipeni lesirinji. Idivayisi enjalo yenza sikwazi ukusetha ngokucacile umthamo oyifunayo. Imvamisa izingane zibhekana nokwazisa umuthi ngokwazo.
Izilinganiso ezijwayelekile zokuhlushwa ushukela wegazi zinikezwa nge-glucometer. Izinkomba zale divayisi, kanye nokudla okudliwayo, kufanele kubhalwe kudayari ekhethekile.
Kamuva, idayari ikhonjiswa kudokotela ukubala umthamo owuthandayo we-insulin. Esimweni sohlobo 1, ezimweni ezinzima, kufakwa ama-pancreas. Ukwephulwa kokudla kuvinjelwe ngokuphelele.
Ngohlobo 2 sikashukela, ukwelashwa kubandakanya ukubambelela ngokuqinile ekudleni okukhethekile. I-endocrinologist ihlola ngokuningiliziwe ukondliwa kwezingane ezinesifo sikashukela, kuya ngeminyaka yazo. Kuyadingeka ukukhipha ngokuphelele ukudla kwama-carbohydrate angagayeka kalula, ngokwesibonelo:
- ushokoledi
- ushukela
- imikhiqizo kafulawa.
Lezi zincomo kufanele zibhekwe ukuvimbela ukwanda okubukhali koshukela wegazi. Ukuxazulula le nkinga, kufanele uqaphe njalo amayunithi esinkwa. Le yunithi ikhombisa inani lomkhiqizo oqukethe ama-12 g wama-carbohydrate, akhuphula izinga likamashukela egazini ngo-2.2 mmol / L.
Njengamanje, emazweni ase-Europe, umkhiqizo ngamunye wokudla unelebuli enemininingwane emayunithi wesinkwa atholakalayo. Abantu abadala nezingane ezinesifo sikashukela bangakuthola kalula ukudla okulungile kokudla kwabo.
Uma kungenzeki ukukhetha imikhiqizo enelebuli enjalo, udinga ukusebenzisa amatafula akhethekile akhombisa amayunithi esinkwa wanoma yimuphi umkhiqizo. Uma ukusebenzisa amatafula nganoma yisiphi isizathu kungenzeki, kufanele uhlukanise inani lama-carbohydrate ku-100 g womkhiqizo ngo-12. Le nombolo ibalwa isisindo somkhiqizo umuntu ahlela ukusisebenzisa.
Kwezinye izimo, izingane zingathola ukusabela okungekuhle kwe-insulin endaweni yomjovo. Ukushintshwa kwezidakamizwa noma ushintsho kumthamo wayo kukhonjisiwe.
Izinkinga zesifo sikashukela
Izinkinga zesifo sikashukela ezinganeni zivezwa ngokulinyazwa kwemithambo yegazi enemiphumela engeguquki. Isibonelo, ukuguqulwa kwemikhumbi ye-retina yeso kungaholela ekungaboni ngokuphelele, ukwehluleka kwezinso kwenzeka ngenxa yokulimala kwemithambo ye-renal.
Ngenxa yomonakalo emithanjeni yobuchopho, i-encephalopathy iba.
Kuhle ukwazi ukuthi i-ketoacidosis yesifo sikashukela iyisigaxa sezinkinga eziyingozi ezinganeni, sikhuluma nge-ketoacidotic coma. Ukuvela kwe-ketoacidosis kufaka izimpawu eziphimisiwe:
- isicanucanu
- ukuhlanza
- ukuphefumula kanzima
- umoya omubi
- ukwehla kwesifiso sokudla
- ukozela nobuthakathaka.
Uma zingekho izindlela zokwelapha ezilungile, khona-ke i-ketoacidosis ngokoqobo ezinsukwini ezimbalwa iba ikoma kidacidotic. Lesi simo singabonakala ngokuphefumula okungalingani, ukushaya ngamandla okungajwayelekile, i-anuria. Ungakhuluma nge-ketoacidotic coma enenkomba engaphezu kuka-20 mmol / l.
Kwezinye izimo, ngenkambiso yesifo sikashukela esingeyona eyakudala noma eyithuthukile ezinganeni, i-hyperosmolar noma i-lactic acid coma ingavela.
Uma isifo sikashukela sitholakala ebuntwaneni, khona-ke ungahlangabezana:
- i-neuropathy
- nephropathy
- i-retinopathy
- ikati
- isifo sokuqina kwemizwa
- Isifo senhliziyo se-Ischemic,
- CRF,
- isifo sikashukela sikashukela.
Isifo sikashukela ezinganeni, izingqinamba zazo ezingathinta noma yisiphi isitho nohlelo lomzimba, zidinga ukudla okuqhubekayo nokulawula ukugcwala kweglucose egazini.
Yonke imiyalo nezincomo ze-endocrinologist kufanele zibhekwe ngokuqinile.
Ukuvimbela
Ukuvimbela isifo sikashukela ezinganeni kufanele kwenziwe kusukela ezinyangeni zokuqala zempilo yengane. Enye yezindlela ezibalulekile zokuvimbela ukuncelisa ingane ibele kusukela izalwa iye enyakeni wokuphila. Lokhu kubaluleke kakhulu ezinganeni ezinezimfanelo zokuthola ifa.
Izingxube zokwenziwa zingathinta kabi ukusebenza kwamanyikwe. Kuyadingeka nokuthi kugonywe ingane ngesikhathi ukuze igweme izifo ezikhuthaza ukukhula kwesifo sikashukela.
Kusukela esemncane, ingane idinga ukujwayela imithetho eyisisekelo yendlela yokuphila enempilo:
- ukuvivinya umzimba njalo
- ubheka irekhodi losuku ulala ngokugcwele,
- ukungafakwa kunoma yimiphi imikhuba emibi,
- ukuqina komzimba
- umsoco ofanele.
Uma kungenzeka ukuthi isifo sikashukela sivele ezinganeni, ukuvimbela kufaka futhi:
- ukufakwa ushukela ngokuya ngeminyaka,
- Ukuqedwa kwezengezo eziyingozi kanye nodayi,
- Imikhawulo yokusetshenziswa kokudla okusemathinini.
Ngaphandle kokuhluleka, izithelo nemifino kufanele kufakwe ekudleni. Futhi, inombolo yokudla 5 yezingane ingasebenza njengesisekelo semenyu enempilo. Izimo ezicindezelayo kufanele zingafakwa eceleni futhi kunikezwe isizinda esihle sokonga ingqondo. Kuyadingeka ukwenza izivivinyo zezokwelapha futhi minyaka yonke kulinganiswe izinga likashukela wegazi ezinganeni ezinezici zofuzo. Ngaphezu kwalokho, kufanele ubheke njalo ukukhuluphala kwesisindo.
Kwividiyo ekulesi sihloko, udokotela uzoqhubeka nokuveza isihloko sokuvimbela isifo sikashukela.
