Kuhlobo 1 isifo sikashukela, ukuphazamiseka ohlelweni lwe-endocrine kwenzeka. Lesi simo sibonisa ngokuntuleka kwe-insulin, engakhiqizwa ngamanyikwe ngenani elidingekayo. Ngenxa yalokhu, ushukela wegazi lesiguli uyakhuphuka, yingakho alahlekelwa isisindo ngokushesha futhi womile njalo.
Ngeshwa, lesi sifo aselapheki, ngakho-ke, lapho sithola isifo sikashukela, umuntu udinga ukuthatha imishanguzo ekhethekile yokuphila. Izidakamizwa ezinjalo zehlisa ukugcwala kweglucose egazini futhi zikuvumela ukuba ulondoloze isimo esihle sempilo.
Ngempela, noma ngabe izinga le-glucose liphakeme kancane kunokujwayelekile, lisenomphumela olimazayo ohlelweni lwe-vascular. Futhi ngenxa yokunikezwa kwegazi okungekuhle, izitho zangaphakathi eziyinhloko ngeke zithole izinto ezizidingayo ukuze zisebenze kahle.
Kepha ngokulashwa okufanele nokuhambisana nazo zonke izincomo zezokwelapha, isikhathi sokuphila sikhulu impela. Ngokwezibalo, kungaphezu kweminyaka engamashumi amathathu.
Izimbangela Nezingozi Zengozi
Isifo sikashukela esincike ku-insulin sisho izifo ze-autoimmune eziqhubeka njalo. Ukucacisa kwabo ukuthi amangqamuzana e-beta abhekene nokukhiqizwa kwe-insulin kancane kancane abhujiswa amaseli okuvikela omzimba.
Namuhla akukasungulwa ngokuphelele ukuthi yini ngempela eyenza ukungasebenzi komzimba kungasebenzi kahle. Izimbangela ezingenzeka zingama-virus angenza lesi sifo kubantu abane-genetic predisposition.
Ingozi ethile yilezi:
- amagciwane emathumbu e-coxsackie;
- i-rubella yokuzalwa;
- mumps.
Kepha imvamisa, isifo sikashukela 1 sivela ngenxa yezakhi zofuzo. Ngakho-ke, ososayensi baye bakhomba izindawo ezingama-18 zofuzo. Isibonelo, i-IDDM1 yindawo equkethe amaprotheni wokufaka izinhlobo ze-HLA eziyingxenye ye-histocompatibility tata. Izakhi zofuzo ezivela kule ndawo zithinta nokuphendula kokuzivikela komzimba.
Kodwa-ke, amathuba okuthola ifa lesifo sikashukela esincike ku-insulin, noma ngabe izihlobo zigula ngalesi sifo, sisezingeni eliphansi (cishe i-10%). Ngaphezu kwalokho, i-pathology ivame ukudluliselwa eceleni kohlangothi lobaba.
Ukucindezelwa njalo, ukukhuluphala ngokweqile, utshwala ngokweqile, ukuba khona kwe-pancreatic necrosis engapheli kanye ne-pancreatitis nakho kuholela ekuqaleni kwalesi sifo. Ngaphezu kwalokho, ukusetshenziswa kabi kwezidakamizwa ezithile nokudla okungenampilo kufaka isandla ekukhiqizeni i-insulin enganele. Ngempela, ubuningi bama-carbohydrate asheshayo, kufaka phakathi ushokoledi nokubhaka, kuphazamisa ukusebenza kwe-lipid ne-carbohydrate metabolism, okuthinta ukusebenza kwamanyikwe.
Izici zobungozi ezibangela ukuncika kwe-insulin zifaka:
- ukuzalwa sekwedlule isikhathi;
- i-anemia enobungozi;
- i-preeclampsia - ubunzima bokukhulelwa;
- i-sclerosis eminingi;
- I-Hashimoto's thyroiditis;
- Amathuna isifo.
Izithombe zemitholampilo
Isibonakaliso sokuqala sohlobo 1 sikashukela ukwehla kwesisindo ngenxa yesifiso esihle. Futhi, isiguli sikhathala ngokushesha, sizizwe sinobungozi futhi sifuna ukulala njalo, futhi sihlushwa ukoma okukhulu.
Iziguli eziningi zizwa umuzwa wokulamba, ohambisana nokuncipha kwengcindezi yegazi, ukufiphala kwesikhumba, ukubonakala kwesithukuthezi esibandayo ne-tachycardia. Abantu abanesifo sikashukela bavame ukuba nobuthakathaka bemisipha nemizwa ethambile emunweni yabo.
Izimpawu eziphambili zalesi sifo kubantu besifazane ukunqunyelwa kokungabekezeleleki kwesitho sangasese sangasese kanye ne-perineum. Lezi zimpawu zidalwa ukuba khona kweglucose kumchamo. Ngemuva kwakho konke, ngemuva kokuchama, amaconsi omchamo aqukethe ushukela awela kulwelwesi lwama-mucous, obangela ukucasuka okukhulu.
Kumadoda, uphawu oluhamba phambili lwalesi sifo ukungasebenzi kahle kwe-erectile kanye ne-potency emnyama. Ubungozi besifo yinkambo efihliwe noma isiguli asinaki ukubonakaliswa okuncane kwe-pathology.
Izimpawu ezisetshenziswayo zesifo sikashukela sohlobo lokuqala zingamanxeba amade angalapheki nokukhahlela.
Ngasikhathi sinye, amathumba namathumba kuvame ukwakheka ezigulini eziningi, ukungatheleleki kwabo kuyenziwa buthaka, ngenxa yalokho bazizwa bebuthakathaka njalo futhi bavame ukuba nomkhuhlane.
Imiphumela emibi yesifo sikashukela: hypoglycemia kanye ne-hyperglycemia
Abantu abaningi bafuna ukwazi ukuthi izinkinga zohlobo 1 sikashukela ziqala kanjani. Ngalesi sifo, ushukela, umsebenzi wawo wokungena kumangqamuzana anamafutha kanye nemisipha bese uwahlawulisa ngamandla, uhlala egazini.
Uma izinga likashukela likhuphuka njalo, ngaphandle kokuphakama okunamandla, khona-ke kuqala ukushiya izicubu bese ugcwalisa izitsha, kulimaze izindonga zazo. Kuphazamisa nomthelela omubi ukusebenza kwezitho ezihlinzekwe ngegazi. Ngakho-ke, izingqinamba zivela ngesifo sikashukela sohlobo 1, lapho umzimba ungantula i-insulin.
Uma ukuntuleka kwe-hormone kungakhokhelwa nge-insulin yokufakelwa, imiphumela izokhula ngokushesha okukhulu. Futhi lokhu kuzonciphisa kakhulu isikhathi sokuphila komuntu.
Izinkinga ze-acute zivela ngenxa yokwehla okungazelelwe noma ukwanda kweglucose yegazi. Bahlukaniswe izinhlobo ezimbili:
- i-hypoglycemic coma (ushukela ophansi);
- izimo ze-hyperglycemic (glucose ephezulu).
I-Hypoglycemia ivame ukuvela ngenxa yokuqothuka kwe-insulin noma uma isiguli siphuthelwa isidlo ngemuva kokuphathwa kwehomoni. Futhi, ukukhohlisa kuvela ngenxa yokusebenza kakhulu komzimba, kufaka phakathi ukubeletha.
Ngaphezu kwalokho, i-hypoglycemia ingenzeka ngemuva kokuphuza nezidakamizwa. Esinye isimo esinjalo sivela ngenxa yokuthatha umuthi othile (i-tetracyclines, i-beta-blockers, i-fluoroquinolones, i-lithium, i-calcium, i-vithamini B 12, i-salicylic acid). Ngaphezu kwalokho, kuma-diabetes, amathuba okuncipha okubukhali kokugxila kwe-glucose akhuphuka ngokwanda kwe-hepatosis engapheli noma i-hepatitis, ukukhulelwa kanye nasendabeni yezifo zezinso noma i-adrenal glands.
Lapho kwenzeka i-hypoglycemia, kubaluleke kakhulu ukuthatha ama-carbohydrate asheshayo kungakapheli imizuzu engama-20 (itiye noshokoledi kumnandi kakhulu). Ngemuva kwakho konke, ukwehla kancane kungaholela ekufeni kwe-cortex yamakhorali. Ngakho-ke, kubalulekile ukwazi ngezimpawu ezibonisa ukuqala kwenhliziyo:
- ukucwilisa isikhumba;
- ukwephulwa okubukhali;
- ubukhulu bezindebe;
- isiyezi nesifo sikashukela;
- umjuluko obandayo;
- indlala
- izandla eziqhaqhazelayo.
Uma ukwehla okunoshukela okunamandla kwenzeka ebusuku, khona-ke umuntu uqala ukuba namaphupho amabi. Ngaphandle kokudla okusheshayo kwe-glucose, isiguli singawela enkingeni.
Esigabeni sesibili se-hypoglycemia, izimpawu ezinjengokuhlukumezeka noma ukuqina okubabazekayo, ukuhlangana okungahambi kahle, ukubona okuphindwe kabili kanye nombono ofufiphele, ukushaya kwenhliziyo okuphezulu nokukhula kwenhliziyo kukhula. Isikhathi sesiteji sifushane kakhulu, futhi kuleli cala ushukela namaswidi angangena emphinjeni wokuphefumula, ngenxa yokuthi isiguli sizoqala ukwenaba, ngakho-ke kungcono ukumnikeza nje ikhambi elimnandi.
Izimpawu zokugcina ze-hypoglycemia zifaka ukubonakala kokuxhamazela, ukukhipha isikhumba, okumbozwe ukujuluka okubandayo, nokulahlekelwa ingqondo. Kulesi simo, kubalulekile ukubiza i-ambulensi ukuze udokotela wethule isiguli isixazululo se-glucose (40%). Uma usizo lunganikezwa emahoreni angama-2 alandelayo, kungenzeka ukuthi kuqhamuke umgogodla wobuchopho.
Ukuvimbela okuhle kwentuthuko ye-hypoglycemic coma yimidlalo. Kepha ngaphambi kokuqala amakilasi, udinga ukwandisa inani elijwayelekile lama-carbohydrate nge-1-2 XE, kufanele futhi ukwenze lokhu ngemuva kokuzivocavoca.
Ngokudla kwakusihlwa, kuyalulekwa ukudla ukudla kwamaprotheni. Iguquka kancane ibe ushukela, okuvumela oshukela ukuba alale ngokuthula ubusuku bonke.
Kuyalule futhi ukuthi ubushiye ngokuphelele utshwala. Umthamo ophelele wansuku zonke wotshwala akufanele udlule i-75 amagremu.
Enye inkinga enkulu yesifo sikashukela esincike ku-insulin yi-hyperglycemic coma, ehlukaniswe izinhlobo ezintathu:
- ketoacidotic;
- i-lactic acidotic;
- hyperosmolar.
Ukuphazamiseka okunjalo kuvela ngenqwaba kashukela egazini. Ukwelashwa kwabo kwenziwa ngezimo zokuma.
Umphumela ojwayelekile wohlobo lwesifo sikashukela sohlobo 1 yi-ketoacidosis. Kuvela uma imithetho yezokwelapha i-insulin ingalandelwa, ngokumelene nesizinda sezinqubo ezinamandla zokutheleleka noma zokuvuvukala kanye nokwanda kwezifo ezingamahlalakhona. Futhi, ukulimala, unhlangothi, ukuhlaselwa yisifo senhliziyo, i-sepsis, ukushaqeka nokungenelela kokuhlinzwa okungenakuhlelelwa kungasiza kulesi simo.
I-ketoacidosis yenzeka ngokumelene nesizinda sokuphazamiseka kwe-carbohydrate metabolism, ebonakala ngenxa yokuntuleka kwe-insulin.
Ngasikhathi sinye, izinga lemizimba ye-ketone kanye noshukela egazini liyakhuphuka. Uma kungekho impumuzo esifike ngesikhathi, kuvela ikomaacidotic coma.
Lesi simo sithinta umsebenzi wenhliziyo, ubuchopho, amaphaphu, amathumbu nesisu. Kunezigaba ezi-4 ze-ketoacidosis, ezihambisana nezimpawu ezimbalwa:
- I-Ketosis - ukomisa isikhumba nolwelwesi lwama-mucous, ukoma, ukozela, ukuqubuka komzimba, ikhanda, ukungathandi ukudla kanye nokuchama okwandayo.
- I-ketoacidosis - ukozela, iphunga le-acetone elisuka emlonyeni, palpitations, kwehle umfutho wegazi, ukuhlanza, umchamo onciphile.
- I-Precoma - ukugabha okubomvu ngombala, ushintsho lwesigqi sokuphefumula, izinhlungu esiswini, ukuvela kwesiqubu esihlathini.
- I-Coma - ukuphefumula okunomsindo, ukumamatheka kwesikhumba, ukulahleka kwengqondo, ukunambitheka kwe-acetone emlonyeni.
Ukwelashwa kwe-ketoacidotic coma kuhloswe ngayo ukunxephezela ukuntuleka kwe-insulin, ngokungeniswa njalo kwama-microdoses ayo emithanjeni. Futhi, ukubuyisa uketshezi, isiguli sifakwa ngaphakathi emzimbeni ngama-ion.
I-Hyperosmolar kanye ne-lactic acidotic coma kuvame ukukhula ngohlobo lwesibili lwesifo sikashukela i-mellitus.
Izinkinga ezifika ngemuva kwesikhathi
Imvamisa inkambo yesifo sikashukela ithinta umsebenzi wezinso. Lezi zitho zedlulisa ama-6 l egazi ngokwazo nsuku zonke, zisefa.
Inani elikhulayo lamanzi okuphuza liholela emthwalweni osindayo wezinso. Ngaphezu kwalokho, buthelela ushukela omningi.
Uma i-glucose egazini ingaphezulu kwe-10 mmol / l, izitho ziyayeka ukwenza umsebenzi wokuhlunga bese ushukela ungena kumchamo. Umchamo omnandi unqwabelana esikhunjeni, ube yindawo efanelekile yokwakhiwa kwamagciwane we-pathogenic. Ngenxa yalokhu, inqubo yokuvuvukala yenzeka ezinso, okufaka isandla ekuthuthukiseni i-nephritis kanye nephropathy yesifo sikashukela, okubonakala ngokuhluleka kwezinso, ukuqina kokuqina kwamaprotheni kumchamo kanye nokuwohloka kokuhlunga kwegazi.
Ukuvimbela izinkinga zezinso, kubalulekile ukubheka njalo ushukela wegazi nomfutho wegazi. Nge-albhamuinuria, izidakamizwa ezivela kuma-ARB ne-ACE amaqembu zingabekwa.
Uma isifo sezinso sithuthuka, kufanele kulandelwe ukudla okuphansi kwamaprotheni. Kodwa-ke, esigabeni esibulalayo sokwehluleka kwezinso, inani elikhulu leproteyini lingadingeka, ngakho-ke, izici zokudla kufanele zivunyelwe nodokotela.
Imvamisa thayipha isifo sikashukela esi-1, ubunzima bakhona, bubonakala emsebenzini wenhliziyo. Umphumela ovame kakhulu yisifo senhliziyo esi-coronary, kufaka phakathi ukushaya kwenhliziyo, i-angina pectoris, ne-arrhythmia. Zonke lezi zinkinga ziba nendlala yomoya-mpilo, futhi uma kwenzeka ukuqhekeka kwemikhumbi, i-myocardium iyafa.
Ubungozi bokuhlaselwa yinhliziyo kwabanesifo sikashukela ukuthi kungahle kungahambisane nezimpawu zezifo, ngoba ukuzwela kwemisipha yenhliziyo akubukelwa phansi.
Izinkinga eziningi zivela ngemuva kwesizinda sokuqina kwemithambo yegazi. Ngakho-ke, ngokunqotshwa komkhumbi omkhulu enhliziyweni, kuba khona unhlangothi. Futhi i-syndrome "yenhliziyo yesifo sikashukela" ibonakaliswa ukusebenza kwe-myocardial okhubazekile kanye nosayizi okhulayo wesitho.
Kunconywa ukuthi iziguli ezinobungozi obukhulayo bokuthola izifo zenhliziyo zithathe i-Aspirin ngenani lama-65-160 mg ngosuku njengesilinganiso sokuvimbela. Kodwa-ke, le khambi linemiphumela eminingi emibi, ngakho-ke ukwelashwa kufanele kuvunyelwane nodokotela.
Omunye umphumela ojwayelekile wesifo sikashukela esincike ku-insulin yi-retinopathy.
Lapho amasistimu weso elimele onakele, umbono uyawohloka, ngenxa yokuthi kwakheka ubumpumputhe, ubumpumputhe kanye ne-cataract.
Lapho imithambo yegazi ichichima, ukuphuma kwesibindi kuhlamvu lwesohlo. Ngokuvamile, abanesifo sikashukela bakha ibhali, futhi kwesinye isikhathi izicubu ziyafa. Ukwelashwa okuholayo kwe-retinopathy kanye ne-diabetesic ophthalmopathy ukuhlinzwa kwe-laser.
Imvamisa, okuqukethwe ushukela okuphezulu kuholela eqinisweni lokuthi iziphetho zezinzwa zilahlekelwa umuzwa wazo, lokhu kuzwakala ikakhulukazi emilenzeni. Lesi simo sibizwa ngokuthi yi-neuropathy yesifo sikashukela.
Ekwelapheni le nkinga, kusetshenziswa izidakamizwa eziningi:
- ama-anticonvulsants;
- ama-analcics we-narcotic;
- antidepressants;
- abadwebi bendawo.
I-Neuropathy ingaholela emiphumeleni emibi eminingana - ukungahlonzwa okungalawulwa nokungasasebenzi kahle isigaxa, gxuma ekucindezelweni kwegazi. Ngakho-ke, ngama-paresis wesisu, i-Erythromycin noma iMetoclopramide inqunyelwe.
Abanye abantu abanesifo sikashukela esincike ku-insulin bangaba nezinkinga zamazinyo. Ngemuva kwakho konke, ukufakwa kwegazi okunganele kuholela ezinqubweni zokuvuvukala emgodini womlomo. Ngakho-ke, ama-caries, i-periodontitis noma i-gingivitis avela. Udokotela wamazinyo kufanele abhekane nemiphumela enjalo.
Iningi leziguli ezinesifo sikashukela sohlobo 1 liba nesifo sikashukela sonyawo noma i-Charcot's foot syndrome, nayo eye yenzeka ngenxa yokujikeleza kwegazi okungekuhle. Lesi simo sibonisa ngokuhlaselwa imilente emilenzeni (njengasesithombeni), buthaka izicubu zokuphakamisa, kwehle ukuzwela ezintweni ezicasulayo, ukubhujiswa kwamalunga namathambo onyawo.
Ukungaphathwa kahle konyawo lwesifo sikashukela kungahle kuphumele ekunqunyweni komlenze. Ngakho-ke, ukuvimbela kwezinkinga zohlobo lwe-1 yesifo sikashukela kuqukethe ukunakekelwa kwezinyawo ngokucophelela:
- ukuhlolwa nsuku zonke kwemilenze;
- ukugeza izinyawo izikhathi 2 ngosuku;
- ukusetshenziswa njalo kwama-moisturizer;
- ukugqoka izicathulo ezintofontofo;
- ukwenqatshwa kwamathayi namasokisi okucindezela unyawo.
I-insulin, engakhiqizwa ngohlobo 1 sikashukela, iyabandakanyeka ekwakhiweni kwejusi lesisu, ngenxa yokuthi inani layo liyancishiswa. Ngenxa yalokho, i-gastritis, isifo sohudo, kanye ne-dysbiosis ingakhula. Kulokhu, udinga ukuxhumana nodokotela we-gastroenterologist ozokunikeza izidakamizwa ezikhethekile eziguqula ukugayeka okujwayelekile.
Ngokuhlinzekelwa kwegazi okunganele, ukuqubuka kwamalunga kungavela. Lokhu kuholela ekubukekeni kwesikhumba ngesikhathi sokugoba imilenze, ukuqina kanye nokuhamba okulinganiselwe. Imvamisa, ukoma nokuchama kaningi kube yimbangela yokuxhuma kwe-calcium kusuka emathanjeni amathambo, kubangele i-osteoporosis.
Ukwehlisa amathuba okuba nezinkinga kusuka kuhlobo lwesifo sikashukela sohlobo 2, kuyadingeka ukuhola indlela yokuphila enempilo nenempilo, welapha izifo ezibangelwa amagciwane nangesikhathi futhi ugweme ukucindezeleka. Futhi, ukudla okuqukethe izithako zokugada nezithasiselo zokwenziwa kufanele kususwe ekudleni.
Kwividiyo ekulesi sihloko, kuphakanyiswa indlela yokudla kwabanesifo sikashukela esincike ku-insulin, esizosiza ukulawula amazinga kashukela wegazi futhi ngaleyo ndlela sigweme izinkinga ezingezinhle zesifo.
