Isifo sikashukela yisifo esenzeka ngokumelene nesizinda sokuphazamiseka ohlelweni lwe-endocrine. Kuboniswa ushukela wegazi ophakeme ongamahlalakhona. Lesi sifo sitholakala ngasiphi iminyaka, kepha ikakhulukazi sithinta abantu ngemuva kweminyaka engama-40.
Izici zesifo sikashukela asebekhulile ukuthi ngokuvamile inkambo yaso ayizinzi futhi imnene. Kepha uphawu lwesifo lwalesi sifo isisindo esengeziwe ngokweqile abantu abangaphezu kwengxenye yabantu abahola impesheni.
Njengoba kunezinkinga eziningi zempilo ekugugeni, bambalwa abantu abanaka ukukhuluphala. Kodwa-ke, naphezu kwenkambo ende yesifo futhi eyedlule, imiphumela yaso ingabulala.
Kunezinhlobo ezimbili zesifo sikashukela:
- Uhlobo lokuqala - lukhula ngokusweleka kwe-insulin. Ngokuvamile kutholakala esemncane. Lesi yisifo sikashukela esincike ku-insulin, esenzeka ngesimo esibi. Kulokhu, ukuntuleka kokwelashwa kuholela ekukholekeni kwesifo sikashukela futhi onesifo sikashukela angafa.
- Uhlobo lwesibili - luvela ngokweqile kwe-insulin egazini, kodwa futhi leli nani le-hormone alanele ukwenza amazinga e-glucose abe ngokwejwayelekile. Lolu hlobo lwalesi sifo ikakhulukazi lwenzeka ngemuva kweminyaka engama-40.
Njengoba isifo sikashukela sohlobo 2 sivela ikakhulukazi ezigulini esezikhulile, kufanelekile ukubheka izimbangela, izimpawu nokwelashwa kwalolu hlobo lwesifo ngemininingwane engaphezulu.
Izici ezinikezayo nezimbangela zentuthuko
Kusukela eminyakeni engamashumi amahlanu, abantu abaningi bakwehlisile ukubekezelelwa kwe-glucose. Ngaphezu kwalokho, lapho umuntu eguga, njalo eminyakeni eyi-10 ukugcotshwa koshukela egazini ku-sutra kuzokhula, kuthi emva kokudla kukhule. Ngakho-ke, isibonelo, udinga ukwazi ukuthi yini evamile ushukela wegazi emadodeni emva kweminyaka engama-50.
Kodwa-ke, ingozi yesifo sikashukela ayinqunywa kuphela ngezimpawu ezihlobene nobudala, kepha futhi nezinga lomsebenzi womzimba nokudla kwansuku zonke.
Kungani abantu abadala bethola i-postprandial glycemia? Lokhu kungenxa yethonya lezinto ezimbalwa:
- ukwehla okuhlobene nobudala kokuzwela kwe-insulin kwezicubu;
- buthaka kwesenzo kanye nokuqunjelwa kwama-hormone angama-incretin lapho esegugile;
- ukukhiqizwa kwe-insulin enganele.
Isifo sikashukela mellitus esekhulile naseneminyaka yobudala ngenxa yesifiso sokuthola ifa. Isici sesibili esinegalelo ekuqaliseni kwalesi sifo sithathwa njengomkhulu ngokweqile.
Futhi, i-pathology ibangelwa izinkinga kumanyikwe. Lokhu kungaba ukungasebenzi kahle ekusebenzeni kwezindlala ze-endocrine, umdlavuza noma i-pancreatitis.
Ngisho nesifo sikashukela esiyi-senile singakhula singafani nesizinda sokutheleleka ngegciwane. Izifo ezifana nalezi zifaka phakathi umkhuhlane, irubella, ihepatitis, inkukhu nezinye.
Ngaphezu kwalokho, ukuphazamiseka kwe-endocrine kuvame ukuvela ngemuva kwengcindezi yezinzwa. Ngempela, ngokwezibalo, ukuguga, kuhambisana nokuhlangenwe nakho okungokomzwelo, akukhona ukwandisa amathuba okuba nesifo sikashukela sohlobo 2 kubantu asebekhulile, kodwa futhi kwenza inkambo yaso ibe nzima.
Ngaphezu kwalokho, ezigulini ezenza umsebenzi wobungqondongqondo, izinga eliphakeme likashukela libonakala kaningi kakhulu kunalabo omsebenzi wabo uhlotshaniswa nomsebenzi womzimba.
Isimo somtholampilo kanye nezinkinga
Izimpawu ezijwayelekile zesifo sikashukela kubantu abangaphezu kweminyaka engama-40 yilezi:
- umbono ongalungile;
- ukuluma kanyeokomisa isikhumba;
- iminyakazo
- ukoma okungapheli;
- ukudumba kwemikhawulo engezansi;
- ukuchama njalo.
Kodwa-ke, zonke izibonakaliso azidingekile ukuqinisekisa isifo. Ukuvela kwezimpawu ezi-1 noma ezi-2 kwanele.
Uhlobo 2 sikashukela i-mellitus ezigulini zobudala bokuthatha umhlalaphansi luvame ukubonakaliswa ukukhubazeka okubukhali kokubonakalayo, ukoma, i-malaise nokupholisa isikhathi eside kwamanxeba.
Ukuguga kuyingozi ngokuphazamiseka okukhona njalo ohlelweni lwezinhliziyo, olwandiswa yisifundo sikashukela. Ngakho-ke, iziguli zivame ukuba ne-atherosulinosis yemithambo yegazi, ethinta imithambo yemilenze, engadala i-gangrene kushukela. Futhi lokhu kuholela ezilondeni ezinkulu zonyawo nokunqanyulwa okwengeziwe.
Izinkinga ezijwayelekile zesifo sikashukela yilezi:
- ukwakheka kwezilonda;
- ukungahambi kahle kokubuka (i-cataract, retinopathy);
- izinhlungu zenhliziyo
- ukudumba;
- izifo ezithinta umchamo.
Omunye umphumela oyingozi wesifo sikashukela ukwehluleka kwezinso. Ngaphezu kwalokho, uhlelo lwezinzwa lungathinteka, okuholela ekubukekeni kwe-neuropathy.
Lesi simo sinezimpawu ezifana nobuhlungu, ukushisa emilenzeni kanye nokulahlekelwa umuzwa.
Ukuxilongwa nokwelashwa kwezidakamizwa
Isifo sikashukela asebekhulile kunzima ukusithola. Lokhu kungenxa yokuthi ngisho noma izinga likashukela wegazi lenyuswa, ushukela ungahle ungekho emchini.
Ngakho-ke, ukuguga kuphoqa ukuthi umuntu ahlolwe minyaka yonke, ikakhulukazi uma ekhathazekile nge-atherossteosis, umfutho wegazi ophakeme, isifo senhliziyo esine-coronary, i-nephropathy kanye nezifo zesikhumba ezihlanzekile. Ukusungula ukuba khona kwe-hyperglycemia kuvumela izinkomba - 6.1-6.9 mmol / L, kanye nemiphumela ye-7.8-11.1 mmol / L ikhombisa ukwephulwa kokubekezelelwa kwe-glucose.
Kodwa-ke, izifundo zokubekezelela ushukela kungenzeka zinganembile. Lokhu kungenxa yokuthi ngobudala, ukuzwela kwamangqamuzana kuya kushukela kuyehla, futhi izinga lokuqukethwe kwalo egazini lihlala likhulu isikhathi eside.
Ngaphezu kwalokho, ukuxilongwa kwe-coma kulesi simo nakho kunzima, ngoba izimpawu zayo ziyefana nezimpawu zokulimala kwamaphaphu, ukuhluleka kwenhliziyo ne-ketoacidosis.
Konke lokhu kuvame ukuholela eqinisweni lokuthi isifo sikashukela sitholakala kakade sekwephuzile. Ngakho-ke, abantu abaneminyaka engaphezu kwengu-45 ubudala, kuyadingeka ukuthi kwenziwe izivivinyo zokuhlushwa ushukela egazini njalo eminyakeni emibili.
Ukwelashwa kwesifo sikashukela ezigulini esezindala kungumsebenzi onzima kangako, ngoba vele sezinezinye izifo ezingamahlalakhona futhi zikhuluphele ngokweqile. Ngakho-ke, ukulungisa lesi simo, udokotela unquma izidakamizwa eziningi ezahlukahlukene kusuka emaqenjini ahlukahlukene kuya esigulini.
Ukwelashwa kwezidakamizwa kwabanesifo sikashukela esidala kubandakanya ukuthatha izinhlobo ezinjalo zezidakamizwa njenge:
- I-Metformin;
- glitazones;
- izinto ezithathwe kuma-sulfonylurea;
- zobumba;
- glyptins.
Ushukela ophakanyisiwe uvame ukwehliswa ngeMetformin (Klukofazh, Siofor). Kodwa-ke, kunqunywa kuphela ngokusebenza okuphelele kokuhlunga kwezinso futhi uma kungekho zifo ezibangela i-hypoxia. Izinzuzo zomuthi ukuthuthukisa izinqubo ze-metabolic, futhi ayiqedi i-pancreas futhi ayinikele ekubukekeni kwe-hypoglycemia.
Ama-Glitazones, njengeMetformin, angakhulisa ukuzwela kwamaseli wamafutha, izicubu nesibindi ku-insulin. Kodwa-ke, ngokudambisa i-pancreatic, ukusetshenziswa kwama-thiazolidinediones akunangqondo.
Ama-glitazones nawo ahlukaniswe nezinkinga zenhliziyo nezinso. Ngaphezu kwalokho, izidakamizwa ezivela kuleli qembu ziyingozi ngoba ziyasiza ekufakweni kwe-calcium emathanjeni. Yize izidakamizwa ezinjalo zingandisi ubungozi be-hypoglycemia.
Ama-derivatives we-sulfonylureas athinta amaseli we-beta we-pancreas, yingakho eqala ukukhiqiza i-insulin ngenkuthalo. Ukusetshenziswa kwezidakamizwa ezinjalo kungenzeka kuze kube yilapho i-pancreas isiphelile.
Kepha ukutholakala kwesulfonylurea kuholela emiphumeleni emibi eminingana:
- amathuba okukhula kwe-hypoglycemia;
- ukwehla ngokuphelele nokungaphendukiyo kwamanyikwe;
- isisindo somzimba.
Ezimweni eziningi, iziguli ziqala ukuthatha izinto ezithathwa yi-sulfonylurea, naphezu kwazo zonke izingozi, ukuze zingasebenzisi indlela yokwelapha nge-insulin. Kodwa-ke, lezo zenzo ziyingozi empilweni, ikakhulukazi uma iminyaka yesiguli ifinyelela eminyakeni engama-80.
Ama-Clinides noma ama-meglitinides, kanye nokutholakala kwe-sulfonylurea, kusebenze ukukhiqizwa kwe-insulin. Uma uphuza izidakamizwa ngaphambi kokudla, khona-ke isikhathi sokuvezwa kwabo ngemuva kokungena sisuka kumaminithi angama-30 kuye kwangama-90.
Ukuxhumanisa ukusetshenziswa kwe-meglitinides kuyafana nokutholakala kwe-sulfonylurea. Izinzuzo zezimali ezinjalo ukuthi zingakwazi ukwehlisa masinyane ukugcwala koshukela egazini ngemuva kokudla.
Ama-Gliptins, ikakhulukazi i-Glucagon-like peptide-1, ama-hormone angama-incretin. I-dipeptidyl peptidase-4 inhibitors ibangela ukuthi ama-pancreas akhiqize i-insulin, evimbela ukucasheka kwe-glucagon.
Noma kunjalo, i-GLP-1 isebenza kuphela lapho ushukela empeleni uphakanyisiwe. Ngokwakhiwa kwama-gliptins kukhona iSaxagliptin, iSitagliptin neVildagliptin.
Lezi zimali zenza into ethile ibe nomthelela omubi ku-GLP-1. Ngemuva kokuphuza izidakamizwa ezinjalo, izinga le-hormone egazini landa cishe izikhathi ezi-2. Ngenxa yalokhu, i-pancreas iyavuseleleka, eqala ukukhiqiza i-insulin ngenkuthalo.
Ukwelashwa kokudla nezindlela zokuthibela
Isifo sikashukela asebekhulile sidinga ukudla okuthile. Injongo eyinhloko yokudla ukunciphisa umzimba. Ukunciphisa ukungena kwamafutha emzimbeni, umuntu udinga ukushintshela ekudleni okunekhalori ephansi.
Ngakho-ke, isiguli kufanele sicebise ekudleni ngemifino emisha, izithelo, izinhlobo ezinamafutha aphansi enyama nenhlanzi, imikhiqizo yobisi, okusanhlamvu nezinhlamvu. Futhi kusuka kumaswidi, amakhekhe, ibhotela, umhluzi ocebile, ama-chip, ukhukhamba, inyama ebhemayo, utshwala neziphuzo ezimnandi zekhabhoni kufanele kushiywe.
Futhi, ukudla ushukela kubandakanya ukudla izingxenye ezincane okungenani izikhathi ezinhlanu ngosuku. Futhi isidlo sakusihlwa kufanele sibe amahora ama-2 ngaphambi kokulala.
Ukuzivocavoca umzimba kuyindlela enhle yokuvimbela ukukhula kweshukela kubantu asebathatha umhlalaphansi. Ngokuzivocavoca njalo, ungafinyelela imiphumela elandelayo:
- umfutho wegazi ophansi;
- vimbela ukubonakala kwe-atherosulinosis;
- thuthukisa ukuzwela kwezicubu zomzimba ku-insulin.
Kodwa-ke, umthwalo kufanele ukhethwe ngokuya ngenhlala kahle yesiguli kanye nezimpawu zayo. Inketho enhle kungaba ukuhamba imizuzu engama-30-60 emoyeni omusha, ukubhukuda nokuhamba ngamabhayisekili. Ungenza futhi izivivinyo zasekuseni noma wenze izivivinyo ezikhethekile.
Kepha ezigulini esezikhulile, kunezindlela eziningi zokwephulwa komzimba. Lokhu kufaka ukwehluleka okukhulu kwe-renal, isinxephezelo sikashukela esingesihle, i-proliferative retinopathy, i-angina engazinzile kanye ne-ketoacidosis.
Uma isifo sikashukela sitholwa sineminyaka engama-70-80 ubudala, khona-ke ukuxilongwa okunjalo kuyingozi kakhulu esigulini. Ngakho-ke, angadinga ukunakekelwa okukhethekile endlini yokugibela, ezothuthukisa inhlala-kahle yesiguli futhi yelula impilo yayo ngangokunokwenzeka.
Enye into ebalulekile ebambezela ukuthuthukiswa kokuxhomekeka kwe-insulin ukulondolozwa kokulinganisela ngokomzwelo. Ngemuva kwakho konke, ukucindezela kufaka isandla ekunyuseni kwengcindezi, okubangela ukungasebenzi kahle kwe-carbohydrate metabolism. Ngakho-ke, kubalulekile ukuhlala uzolile, futhi uma kunesidingo, thatha ama-sedative asuselwa ku-mint, valerian nakwezinye izinto zemvelo. Ividiyo ekulesi sihloko isitshela ngezici zesifo sikashukela ekugugeni.
