Isifo sikashukela se-LADA yisifo sikashukela se-autoimmune esidala kubantu abadala. EsiNgisini, i-pathology enjalo izwakala njenge- "latent autoimmune sikashukela ebantwini abadala". Lesi sifo siba phakathi kweminyaka yobudala engama-35 nengama-65, kodwa ezimweni eziningi ezaziwayo sitholakala kubantu abaneminyaka engama-45-55 ubudala.
Kubonakala ngokuthi ukugcwala kwe-glucose emzimbeni kukhuphuka ngokulingana, isici ukuthi lesi sifo sifana nezimpawu zokuthayipha i-II sikashukela i-mellitus.
Isifo sikashukela se-LADA (leli yigama eliphelelwe yisikhathi, manje ibizwa nge- autoimmuneabetes mellitus kwezokwelapha), futhi kuyehluka ngokuthi kuyafana nohlobo lokuqala lwalesi sifo, kepha isifo sikashukela se-LADA sikhula kancane. Kungakho ezigabeni zokugcina ze-pathology kutholakala njengohlobo 2 lwesifo sikashukela.
Ezokwelapha, kunesifo sikashukela EMODI, esibhekisa kuhlobo lwesifo sikashukela se-subclass A, kubonakaliswa umlingiswa onesimpawu, okuvela njengomphumela we-pancreatic pathologies.
Ukwazi ukuthi siyini isifo sikashukela se-LADA, kufanele ucabangele ukuthi yiziphi izici eziqukethwe yilesi sifo nokuthi yiziphi izimpawu ezibonisa ukukhula kwawo? Futhi, udinga ukuthola ukuthi ungayithola kanjani i-pathology, nokuthi yikuphi ukwelashwa okunqunyelwe.
Izici ezihlukanisayo
Igama elithi LADA labelwe isifo se-autoimmune kubantu abadala. Abantu abawela kuleli qembu badinga ukwelashwa okwanele nge-hormone insulin.
Ngokuphikisana nesizinda se-pathology esigulini emzimbeni, ukubonwa kwamangqamuzana e-pancreatic, abhekele ukwenziwa kwe-insulin, kuyabonakala. Ngakho-ke, izinqubo ze-pathological zemvelo ye-autoimmune ziyabonakala emzimbeni womuntu.
Ezimweni zokwelashwa, ungezwa amagama amaningi esifo sikashukela se-LADA. Abanye odokotela bayibiza ngokuthi isifo esiqhubeka kancane kancane, abanye basibiza ngokuthi isifo sikashukela ngokuthi "1.5". Futhi amagama anjalo achazwa kalula.
Iqiniso ngukuthi ukufa kwawo wonke amaseli wemishini yokufakelwa ekufikeni eminyakeni ethile, ikakhulukazi - ineminyaka engama-35 ubudala, kuqhubeka kancane. Kungenxa yalesi sizathu ukuthi i-LADA ivame ukudidaniswa nesifo sikashukela sohlobo 2.
Kepha uma uqhathanisa nakho, khona-ke ngokuhlukile ezinhlotsheni ezi-2 zesifo, nesifo sikashukela se-LADA, ngokuphelele wonke amaseli e-pancreatic ayafa, ngenxa yalokho, i-hormone ayisakwazi ukwakhiwa isitho sangaphakathi ngesilinganiso esidingekayo. Futhi ngokuqhubeka kwesikhathi, ukukhiqizwa kuyaphela ngokuphelele.
Ezimweni ezijwayelekile zokwelashwa, ukuthembela ngokuphelele ku-insulin kwakhiwa ngemuva kweminyaka engama-1-3 kusukela kwatholakala ukuthi isifo se-mellitus sikashukela sitholakala, futhi kwenzeka sinezimpawu zokuziphatha, kwabesifazane nakwabesilisa.
Inkambo ye-pathology isondele kohlobo lwesibili, futhi isikhathi eside, kungenzeka ukulawula inkambiso yenqubo ngokuzivocavoca umzimba kanye nokudla okuthuthukisa impilo.
Ukubaluleka kokuxilongwa kwesifo sikashukela se-LADA
Ishukela likashukela we-autoimmune kubantu abadala yisifo se-autoimmune esivele "sibonga" kososayensi muva nje. Phambilini, lolu hlobo lwesifo sikashukela lwatholakala njengesifo sohlobo lwesibili.
Wonke umuntu uyazi isifo sikashukela sohlobo 1 kanye nesifo sikashukela sohlobo 2, kodwa bambalwa abantu abazwile ngalesi sifo i-LADA. Kubukeka sengathi, yimuphi umehluko okwenziwa yilokho ososayensi abaqhamuka nakho, kungani kuguqula impilo yeziguli nodokotela? Futhi umehluko mkhulu.
Lapho isiguli singatholakali i-LADA, khona-ke ukwelashwa kunconyelwa ngaphandle kokulashwa kwe-insulin, futhi siphathwa njengesifo esijwayelekile sohlobo lwesibili. Okusho ukuthi, ukudla okuphathelene nempilo kahle, imisebenzi yomzimba iyanconywa, kwesinye isikhathi izidakamizwa ezisiza ushukela wegazi ophansi ziyabekwa.
Amathebhulethi anjalo, phakathi kokunye okuhlukile kokunye, enza kusebenze ukukhiqizwa kwe-insulin ngamanyikwe, ngenxa yalokho amaseli we-beta aqala ukusebenza ngokomkhawulo wamandla awo. Futhi lapho umsebenzi omkhulu wamaseli anjalo, akhanya ngokushesha lapho kulimala i-autoimmune pathology, futhi leli cimbi litholakala:
- Amaseli weBeta ayonakele.
- Ukukhiqizwa kwamahomoni kuyancishiswa.
- Izidakamizwa ziyabekelwa.
- Umsebenzi wamaseli agcwele asele ayakhuphuka.
- Isifo se-Autoimmune siyaqina.
- Wonke amaseli ayafa.
Ekhuluma ngokwesilinganiso, iketanga elinjalo lithatha iminyaka eminingana, futhi ukuphela ukuncipha kwamanyikwe, okuholela ekuqokweni kwezokwelapha nge-insulin. Ngaphezu kwalokho, i-insulin kufanele iphathwe ngemithamo ephezulu, kuyilapho kubaluleke kakhulu ukulandela ukudla okuqinile.
Ekholweni le-classical yohlobo 2 lwesifo sikashukela, ukubaluleka kwe-insulin ekwelashweni kubonwa ngokuhamba kwesikhathi. Ukwephula uchungechunge lwe-autoimmune pathology, ngemuva kokuxilonga isifo sikashukela se-LADA, isiguli kufanele salulekwe ukuphatha imithamo emincane ye-hormone.
Ukwelashwa kwe-insulin kwasekuqaleni kusho izinhloso eziningana eziyinhloko:
- Nikeza isikhathi sokuphumula samaseli e-beta. Ngemuva kwakho konke, lapho kusebenza kakhulu ukukhiqizwa kwe-insulin, ngokushesha amaseli aba yinto engajwayelekile ekulimaleni kwe-autoimmune.
- Vimbela isifo se-autoimmune kumanyikwe ngokuncipha kwe-autoantigens. “Zizihlahlana ezibomvu” zamasosha omzimba womuntu, futhi zifaka isandla ekusebenzeni kwezinqubo ze-autoimmune, ezihambisana nokuvela kwama-antibodies.
- Ukugcina ukugcwala kwe-glucose emzimbeni weziguli ezingeni elidingekayo. Wonke umuntu onesifo sikashukela uyazi ukuthi lapho ushukela ephezulu emzimbeni ushesha, ubunzima bazofika ngokushesha.
Ngeshwa, izimpawu zohlobo lwesifo sikashukela se-autoimmune 1 ngeke zehluke kakhulu, futhi ukutholwa kwaso ekuqaleni kwesigaba akuvamile ukutholakala. Noma kunjalo, uma bekunokwenzeka ukuhlukanisa lesi sifo ekuqaleni, khona-ke kungenzeka ukuqala ukwelashwa kwe-insulin ngaphambili, okuzosiza ukugcina ukukhiqizwa okuseleyo kwehomoni yakhe ngokwenziwa ngamanyikwe.
Ukulondolozwa kokuqhekeka okuyinsalela kubaluleke kakhulu, futhi kunezizathu ezithile zalokhu: ngenxa yokusebenza okuyingxenye kwehomoni yangaphakathi, kwanele ukumane ulondoloze ukugcwala kweglucose emzimbeni; ubungozi be-hypoglycemia buyancipha; izingqinamba zakuqala ze-pathology ziyavinjwa.
Ungasola kanjani uhlobo lwesifo sikashukela esingajwayelekile?
Ngeshwa, isithombe esisodwa somtholampilo salesi sifo asisho ukuthi isiguli sinesifo sikashukela i-autoimmune. Izimpawu azihlukile kunhlobo lwakudala lwesifo sikashukela.
Izimpawu ezilandelayo zibonwa ezigulini: ubuthakathaka obuphikelelayo, ukukhathala okungamahlalakhona, isiyezi, ukuzamazama komhlaba (kuyaqabukela), izinga lokushisa lomzimba (okuhlukile kunokwejwayelekile), ukuphuma komchamo, ukwehla kwesisindo somzimba.
Futhi, uma lesi sifo sihlanganiswa ne-ketoacidosis, khona-ke kukhona ukoma okuthe xaxa, umlomo owomile, ukugcwala kwenhliziyo kanye nokuhlanza, i-plaque olimini, kunephunga elivelayo le-acetone evela emgodini womlomo. Kubalulekile futhi ukuthi i-LADA ivele futhi ngaphandle kwezimpawu nezimpawu.
Iminyaka ejwayelekile yobudala be-pathology iyahluka kusuka eminyakeni engama-35 kuye kwengama-65. Lapho isiguli sitholwa sinesifo sikashukela sohlobo 2 sikashukela ngalesi sikhathi, kufanele futhi sihlolwe ngokuya kwezinye izindlela ukuze singabandakanyi isifo se-LADA.
Izibalo zikhombisa ukuthi cishe i-10% leziguli iba "ngabanikazi" besifo sikashukela se-autoentmune. Kunesilinganiso esithile sengozi yomtholampilo yezindlela ezinhlanu:
- Isilinganiselo sokuqala sihlobene nobudala lapho isifo sikashukela sitholakala ngaphambi kweminyaka yobudala engama-50.
- Ukubonakaliswa okunamandla kwe-pathology (ngaphezu kwamalitha amabili omchamo ngosuku, ngihlala ngizwa ukoma, umuntu alahlekelwa isisindo, ubuthakathaka obungapheli kanye nokukhathala kuyabonakala).
- Inkomba yesisindo somguli ayikho ngaphezu kwama-25 amayunithi. Ngamanye amagama, akanaso isisindo ngokweqile.
- Kukhona ama-autoimmune pathologies emlandweni.
- Ukuba khona kwezifo ze-autoimmune ezihlotsheni eziseduze.
Abadali balesi silinganiso baphakamisa ukuthi uma izimpendulo ezakhayo zemibuzo zivela ku-zero kuye kokunye, khona-ke amathuba okuthola uhlobo oluthile lwesifo sikashukela awwedluli i-1%.
Esimweni lapho kunezimpendulo ezingaphezu kwezimbili ezakhayo (ezimbili ezibandakanya), ubungozi bentuthuko busondela ku-90%, futhi kulokhu, isifundo se-elebhu siyadingeka.
Ungakuxilonga kanjani?
Ukuthola i-pathology enjalo kubantu abadala, kunezindlela eziningi zokuxilonga, kodwa okubaluleke kakhulu ukuhlaziya okubili, okuzobe kunquma.
Ukutadisha kokuhlaselwa kwe-anti-GAD - ama-antibodies ukuze glutamate decarboxylase. Uma umphumela ungathandeki, khona-ke lokhu kuqeda uhlobo olunqabile lwesifo sikashukela. Ngemiphumela emihle, ama-antibodies ayatholakala, okusikisela ukuthi isiguli sinamathuba okuthuthukisa i-LADA pathology eduze kwe-90%.
Ngaphezu kwalokho, ukunquma kokuqhubeka kwezifo ngokuthola amasosha omzimba e-ICA kumaseli we-pancreatic islet anganconywa. Uma izimpendulo ezimbili zinhle, khona-ke lokhu kukhombisa uhlobo olunzima lwesifo sikashukela i-LADA.
Ukuhlaziywa kwesibili yincazelo ye-C-peptide. Kunqunywa esiswini esingenalutho, kanye nangemva kokugqugquzelwa. Uhlobo lokuqala lwesifo sikashukela (kanye ne-LADA futhi) lubonakala ngezinga eliphansi lale nto.
Njengomthetho, odokotela bahlala bethumela zonke iziguli ezineminyaka engama-35-50 ubudala nokuxilongwa kwesifo sikashukela ezifundweni ezingeziwe zokuhlola noma zokukhipha isifo se-LADA.
Uma udokotela engakuniki ucwaningo olwengeziwe, kepha isiguli singabaza ukutholwa, ungaxhumana nesikhungo sokuxilonga esikhokhelwayo ngenkinga yakho.
Ukwelashwa kwezifo
Umgomo oyinhloko wokwelapha ukugcina umkhiqizo we-pancreatic hormone uqobo. Lapho kungenzeka ukuqeda umsebenzi, isiguli singaphila isikhathi eside kakhulu, ngaphandle kwezinkinga nezifo zesifo sakhe.
Esikhathini sikashukela, i-LADA, ukwelashwa kwe-insulin kumele kuqalwe ngokushesha, bese i-hormone iphathwa ngemithamo emincane. Uma lokhu kungenziwa ngesikhathi, khona-ke kufanele kwethulwe "ngokugcwele", futhi izinkinga zizoba khona.
Ukuze uvikele amaseli we-pancreatic beta ekuhlaselweni amasosha omzimba, kudingeka imijovo ye-insulin. Njengoba 'bengabavikeli' besitho sangaphakathi kusuka ekugomeni kwabo. Futhi okokuqala, isidingo sabo ukuvikela, futhi kwesesibili kuphela - ukulondolozela ushukela ezingeni elidingekayo.
I-algorithm yokwelashwa kwezifo ze-LADA:
- Kunconywa ukusebenzisa ama-carbohydrate amancane (ukudla okuphansi kwe-carb).
- Kuyadingeka ukuphatha i-insulin (isibonelo nguLevemir). Ukwethulwa kwe-Lantus insulin kwamukelekile, kepha akunconywa, ngoba iLevemir ingahlanjululwa, kepha umuthi wesibili, cha.
- I-insulin enwetshiwe iyabhalwa, noma ngabe i-glucose ayikhuphukanga, futhi igcinwa ngokwejwayelekile.
Esikhathini sikashukela, i-LADA, noma yimuphi umuthi kadokotela kufanele ubonwe ngokunemba, ukuzelapha akwemukeleki futhi kugcwele izinkinga eziningi.
Udinga ukubheka ushukela wakho ngokucophelela, ukukala kaningi ngosuku: ekuseni, kusihlwa, ntambama, ngemuva kokudla, futhi kaningana ngesonto kunconywa ukukala amanani eglucose phakathi nobusuku.
Indlela enkulu yokulawula ushukela wukudla okuphansi kwe-carb, futhi kuphela lapho umsebenzi womzimba, i-insulin nemithi ibekiwe. Esikhathini sikashukela, i-LADA, kuyadingeka ukujova i-hormone nganoma yisiphi isimo, futhi lo mehluko omkhulu phakathi kwe-pathology. Ividiyo ekulesi sihloko izokutshela ukuthi wenzeni ngesifo sikashukela.
