Ukumelana ne-insulin kuwukwephula kokuxhumana kokungena kwe-insulin kwezicubu. Kulokhu, i-insulin ingavela ngokwemvelo kumanyikwe, futhi ngomjovo we-hormone.
I-hormone, nayo, ibandakanyeka ekusebenzeni kwe-metabolism, ukukhula nokukhiqizwa kabusha kwamaseli wezicubu, ukwakheka kwe-DNA nokuqoshwa kohlobo.
Ezikhathini zanamuhla, ukumelana ne-insulin akuhlobene nokungahambi kahle kwe-metabolic kanye nengozi eyengeziwe yohlobo 2 sikashukela. Kubandakanya ukumelana ne-insulin kuthinta kabi i-metabolism yamafutha namaprotheni, isakhi sofuzo.
Kubandakanya ukumelana ne-insulin kuzophazamisa ukusebenza kwamaseli we-endothelial, okuyingqimba engaphakathi ezindongeni zemithambo yegazi. Njengomphumela, ukwephulwa kuholela ku-vasoconstriction kanye nokuthuthukiswa kwe-atherosulinosis.
Ukuxilongwa kokumelana ne-insulin
Ukwephula umthetho kutholakala uma isiguli sinezimpawu ze-metabolic syndrome. Izimpawu zingafaka ukufaka imali okhalweni, umfutho okhuphukile, ukubalwa kwegazi okungekuhle kwe-triglycerides ne-cholesterol. Kubandakanya le nto kutholakala ukuthi ngabe ukuhlaziya kwesiguli kukhombisa iprotheni eningi emchameni.
Ukuxilongwa kwe-insulin ukumelana kwenziwa ikakhulu ngokuhlolwa okufanele kuthathwe njalo. Kodwa-ke, ngenxa yokuthi amazinga e-insulin eplasma yegazi angahluka, kunzima kakhulu ukuthola isifo esinjalo.
Uma izivivinyo zenziwa ngesisu esingenalutho, imvamisa ye-insulin epulini legazi ngu-3-28 mkU / ml. Uma i-insulin esegazini iphakeme futhi idlula indlela ebekiwe, i-hyperinsulinism iyatholakala esigulini.
Izizathu zokuthi i-insulin egazini i-overestimated kungenzeka ukuthi i-pancreas ikhiqiza okweqile kuyo ukuze inxephezele ukumelana ne-insulin kwezicubu.
Ukuhlaziywa okunjalo kungabonisa ukuthi isiguli singaba nesifo sikashukela sohlobo 2 noma isifo senhliziyo.
Ukuze ukhombe ngokunembile ukwephulwa kwe-n6, kwenziwa i-hyperinsulinemic insulin clamp. Le ndlela yaselebhu iqukethe ukuphathwa okuqhubekayo kwe-insulin ne-glucose amahora amane kuya kwayisithupha.
Ukuxilongwa okunjalo kudla isikhathi kakhulu, ngakho akuvamile ukusetshenziswa. Esikhundleni salokho, ukuhlolwa kwegazi kwenziwa esiswini esingenalutho ukuthola amazinga e-insulin.
Njengoba kwenzeka phakathi nocwaningo, lokhu kwephula umthetho kungenzeka kakhulu:
- Kumaphesenti ayishumi amacala ngaphandle kokuphazamiseka kwe-metabolic;
- Kumaphesenti angama-58 wamacala, uma kunezimpawu zomfutho wegazi ophakeme ngaphezu kwe-160/95 mm Hg. st.;
- Kumaphesenti angama-63 amacala ane-hyperuricemia, lapho amanani we-serum uric acid ephakeme kuno-416 μmol / litre emadodeni naku-387 μmol / litre kwabesifazane;
- Kumaphesenti angama-84 wamacala anokwanda kwezinga lamaseli wamafutha, lapho ama-triglycerides ephakeme ngaphezu kwe-2.85 mmol / lit;
- Kumaphesenti angama-88 amacala anamazinga aphansi e-cholesterol enhle, lapho izinkomba zayo zingaphansi kuka-0.9 mmol / ilitha emadodeni naku-1.0 mmol / ilitha kwabesifazane;
- Kumaphesenti angama-84 amacala, uma kunezimpawu zokukhula kohlobo lwesifo sikashukela sohlobo 2;
- Kumaphesenti angama-66 amacala angenayo i-glucose engabekezeleleki.
Odokotela batusa ukuthatha izivivinyo hhayi kuphela ukuthola inani eliphelele le-cholesterol egazini, kodwa futhi nokuthola i-cholesterol embi nokuhle. Ungasebenzisa ithuluzi elikhethekile lokulinganisa i-cholesterol.
Ukuthola ukuthi ngabe kukhona ukumelana ne-insulin, kusetshenziswa inkomba yokumelana ne-insulin ye-NOMA. Ngemuva kokuhlaziywa kwezinga le-insulin neglucose esiswini esingenalutho lidlulisiwe, inkomba ye-HOMA ibalwa.
Ngokukhuphuka kwezinga lokuzila i-insulin noma ushukela, inkomba ye-HOMA nayo iyanda. Isibonelo, uma ukuhlaziya kukhombisa izinga le-glycemic esiswini esingenalutho se-7.2 mmol / litre, ne-insulin 18 μU / ml, inkomba ye-HOMA ingu-5.76. Amazinga we-insulin ajwayelekile abhekwa uma inkomba ye-HOMA ingaphansi kuka-2.7.
Metabolism nge-insulin
I-insulin ikuvumela ukuthi usebenzise izinqubo ze-metabolic njengokuthuthwa kweglue kanye nokuhlanganiswa kwe-glycogen. Kubandakanya le hormone kunesibopho sokuqokwa kwe-DNA.
I-Insulin ihlinzeka:
- Ukuthathwa kwe-glucose ngamaseli emisipha, isibindi nezicubu ze-adipose;
- I-synthesis ye-glycogen esibindini;
- Ukuthathwa kwama-amino acid ngamaseli;
- Ukuhlanganiswa kwe-DNA;
- Ukwakhiwa kwamaprotheni;
- Ukwakhiwa kwamafutha acid;
- Ukuthuthwa kwe-Ion.
Ukufaka i-insulin kusiza ukuvikela izimpawu ezingafuneki njenge:
- Ukwephulwa kwezicubu ezinamafutha nokungena kwamafutha acid egazini;
- Ukuguqulwa kwe-glycogen esibindini kanye noshukela egazini;
- Ukuzikhipha kweseli.
Kubalulekile ukuqonda ukuthi i-hormone ayikuvumeli ukwehlukana kwezicubu ezinamafutha. Ngenxa yalesi sizathu, uma ukumelana kwe-insulin kubhekwa futhi amazinga e-insulin ephakanyisiwe, cishe akunakwenzeka ukunciphisa isisindo ngokweqile.
Izinga lokuzwela i-insulin yezicubu ezahlukahlukene zomzimba
Ekwelashweni kwezifo ezithile, ukuzwela kwezicubu namafutha izicubu ze-insulin kubhekwa ngokuyinhloko. Okwamanje, la mathishu ane-insulin ukumelana ngokweqile.
Ngakho-ke, ukucindezela ukwehlukana kwamafutha kwizicubu, akudingeki ngaphezulu kwe-10 mcED / ml ye-insulin egazini. Ngesikhathi esifanayo, cishe i-30 mcED / ml ye-insulin iyadingeka ukucindezela i-ingress ye-glucose esuka esibindini iye egazini. Ukwandisa ukuthathwa kwe-glucose ngezicubu zemisipha, kudingeka i-100 mcED / ml noma ngaphezulu kwe-hormone esegazini.
Amathishu alahlekelwa umuzwa we-insulin ngenxa yesimo sofuzo kanye nendlela yokuphila engenampilo.
Ngesikhathi lapho ama-pancreas eqala ukubhekana nomthwalo owandayo, isiguli sakha isifo sikashukela sohlobo 2. Uma i-insulin resistance syndrome isiqalile ukwelashwa kahle kusenesikhathi, izinkinga eziningi zingagwenywa.
Kubalulekile ukuqonda ukuthi ukumelana ne-insulin kungenzeka kubantu abangenayo i-metabolic syndrome. Ikakhulu, ukumelana kutholakala kubantu abane:
- i-polycystic ovary kwabesifazane;
- ukwehluleka okungapheli kwezinso;
- izifo ezithathelwanayo;
- i-glucocorticoid therapy.
Kubandakanya ukumelana ne-insulin kwezinye izimo kutholakala kwabesifazane ngesikhathi sokukhulelwa, kodwa ngemuva kokuzalwa kwengane lesi simo ngokuvamile siyanyamalala.
Futhi, ukumelana kungakhula ngeminyaka, ngalokho, ukuthi umuntu uhola yiphi indlela yokuphila. Kuya ngokuthi ingabe uzoba nesifo sikashukela sohlobo 2 esegugile noma abe nezinkinga ohlelweni lwenhliziyo.
Kungani kuthayipha isifo sikashukela sohlobo 2
Izizathu zokukhula kwesifo sikashukela zilele ngqo ekumeni kwe-insulin kwamaseli emisipha, izicubu ze-adipose nesibindi. Ngenxa yokuthi umzimba uba mancane ukuzwela i-insulin, ushukela omncane ungena kumaseli emisipha. Esibindi, ukuqhekeka okusebenzayo kwe-glycogen kuya glucose kuqala kanye nokukhiqizwa kwe-glucose kusuka kuma-amino acid nezinye izinto ezingavuthiwe.
Ngokumelana ne-insulin kwezicubu ze-adipose, umphumela we-antilipolytic we-insulin uyaqina. Ekuqaleni, le nqubo isuswa ukukhiqizwa kwe-insulin okuvela kumanyikwe.
Ekupheleni kwesifo, amanoni omzimba aqala ukuhlephuka abe yi-glycerin namafutha acid wamahhala.
Lezi zinto ngemuva kokungena esibindini ziguqulwa zibe ama-lipoprotein aminyene kakhulu. Le nto enobungozi ifakwa ezindongeni zemithambo yegazi, okuholela ekwakhiweni kwe-atherosclerosis yemithambo yemikhawulo ephansi.
Kufaka egazini eliphuma esibindini, kukhuphuka izinga le-glucose, elakhiwa ngenxa ye-glycogenolysis ne-gluconeogeneis.
Ngokumelana ne-insulin esigulini, izinga elikhulayo le-insulin ye-hormone libonwa egazini iminyaka eminingi. Uma umuntu ephakamise i-insulin ngalesi sikhathi noshukela ojwayelekile, izizathu zingaholela ekutheni isiguli singaba nesifo sikashukela sohlobo 2.
Ngemuva kwesikhathi esithile, amaseli we-pancreas ayeka ukubhekana nomthwalo onjalo, izinga lawo lenyuswa kaningi. Ngenxa yalokho, umzimba uqala ukukhiqiza insulin encane, okuholela kwisifo sikashukela. Ukuvimbela lokhu kungenzeki, kufanele uqale ukuvimbela nokwelashwa kwalesi sifo ngokushesha okukhulu.
Isifo sezinhliziyo ze-Insulin Resistance
Njengoba wazi, kubantu abanesifo sikashukela, ubungozi bokufa bokuqala bukhuphuka kaningana. Ngokusho kodokotela, ukumelana ne-insulin kanye ne-hyperinsulinemia kuyizinto eziyingozi ezinkulu zokuhlaselwa yisifo sohlangothi nokushaya kwenhliziyo. Akukhathalekile ukuthi isiguli sinokugula sikashukela.
Ukungezelelwa kwe-insulin kuthinta kabi isimo semithambo yegazi, okuholela ekunciphiseni kwabo kanye nasekubukekeni kwezindawo ezibizwa nge-atherosulinotic. Ukufaka i-hormone kunomthelela ekukhuleni kwamaseli wemisipha ebushelelezi kanye nama-fibroblasts.
Ngakho-ke, i-hyperinsulinemia iba ngesinye sezimbangela eziphambili zokuthuthukiswa kwe-atherosulinosis. Izimpawu zalesi sifo zitholakala esikhathini eside ngaphambi kokukhula kwesifo sikashukela.
Ungakhomba ubudlelwano obukhulu phakathi kwe-insulin ngokweqile nokukhula kwesifo senhliziyo. Iqiniso ngukuthi ukumelana ne-insulin kunomthelela:
- ukukhuluphala kwesisu esiswini;
- ukonakala kwephrofayili ye-cholesterol yegazi, ngenxa yalokho kuvela kwama-cholesterol odongeni lwemithambo yegazi;
- khulisa amathuba okuqhekeka kwegazi emithanjeni yegazi;
- ukuqina kodonga lwe-carotid artery, okuholela ekunciphiseni ukukhanyiswa kwethambo lomthambo.
Lezi zinto zingenzeka zombili kuhlobo lwe-2 yesifo sikashukela nangaphandle kwayo. Ngalesi sizathu, lapho isiguli siqala ukwelashwa, maningi amathuba. ukuthi izinkinga ngeke zivele.
Ukwelashwa kwe-insulin
Uma kunezimpawu zokungamelana ne-insulin, ukwelashwa kwenziwa kusetshenziswa ukudla okwelaphayo okuvimba ukunqotshwa kwe-carbohydrate. Lokhu kusiza ukulawula nokubuyisela ukulinganisela ekuphazamisekeni kwe-metabolic emzimbeni. Ukudla okunjalo kwethulwa bobabili kushukela kanye nokungabikho kwayo. Ngasikhathi sinye, imenyu enjalo ekudleni kwansuku zonke kufanele ibe yinto ephambili kukho konke impilo.
Ngemuva kokulashwa kuqala ngokudla okwelapha, isiguli sizoqala ukuzizwa singcono ngemuva kwezinsuku ezintathu kuya kwezine. Ngemuva kwesonto, ama-triglycerides egazini ajwayelekile.
Amaviki ayisithupha kuya kwayisishiyagalombili kamuva, ngokudla okufanele, izivivinyo zibika ukwanda kokuhle kanye nokwehla kwe-cholesterol embi. Ngenxa yalokhu, ubungozi bokuqalwa kwe-atherosclerosis buyancipha.
Njengoba kunje, ukwelashwa kokumelana ne-insulin akakhiwa ngomuthi wanamuhla. Ngalesi sizathu, okokuqala kubalulekile ukwenqaba ukudla ama-carbohydrate akhanyisiwe. ezitholakala emikhiqizweni kashukela, enoshukela nofulawa.
Ukwelashwa kokudla kunconywa ukuthi kuhambisane nokusetshenziswa kwesidakamizwa iMetformin, esetshenziswa njengesengezo. Ngaphambi kokuthi uqale ukwelashwa, kufanele uthintane nodokotela wakho.
