Isifo sikashukela, kukhona izinga elikhuphuka njalo likashukela emzimbeni. Uma umuntu ogulayo efunda ukuqapha kahle inhlala-kahle yabo, egcina ushukela esezingeni elijwayelekile, khona-ke isifo sikashukela siyophenduka ekuguleni okungathi sína siyindlela ekhethekile yokuphila engeke ibe yingozi.
Kunezinhlobo eziningana zesifo sikashukela ezihambisana kakhulu nokuphazamiseka kwe-metabolic emzimbeni womuntu ogulayo. Uhlobo ngalunye lwesifo, ngaphezu kwe-hyperglycemia, libonakala ngeqiniso lokuthi likhiqiza ushukela emchameni. Ngokuphikisana nalesi sizinda, izimpawu ezilandelayo zingavela:
- ukoma kuqala ukukhuphuka kakhulu;
- isifiso sokudla sikhula ngokushesha;
- kukhona ukungalingani kwama-metabolism wamafutha ngesimo se-hyperlipidemia, kanye ne-dyslipidemia;
- kwaphazamisa i-mineral metabolism emzimbeni;
- izinkinga zezinye izifo ziyaqala.
Ukwanda okukhulu kwesibalo seziguli ezinesifo sikashukela i-mellitus kudinge ukuthi kukhonjwe izinhlobo ezahlukene zalesi sifo ukuze siqonde kahle umehluko phakathi kwesimo esisodwa nesinye.
Uma kuze kube muva nje, abezokwelapha bakholelwa ukuthi abantu kuphela abangaphansi kweminyaka engama-45 ubudala abanesifo sikashukela sohlobo II, namuhla imikhawulo yobudala yalesi sifo isishintshwa ibe ngu-35.
Unyaka ngamunye, uhlobo lwesibili sikashukela lutholakala ezigulini ezincane, ezihambisana nokudla okungenampilo kanye nendlela yokuphila engalungile.
Ukuhlukaniswa okuyinhloko kwalesi sifo
Umuthi wanamuhla uhlukanisa izinhlobo ezimbalwa eziphambili zesifo sikashukela, abantu abangase bahlupheke ngazo kungakhathalekile iminyaka yabo:
- Isifo sikashukela sohlobo lwe-I sincike kwi-insulin. Kwakheka emzimbeni womuntu phakathi kokuncipha kwenani laleli hormone. Njengomthetho, kwenzeka ezinganeni ezincane, ebusheni nasebusheni. Ngalesi sifo, kubalulekile ukuphatha umthamo othile we-insulin nsuku zonke;
- Uhlobo II lwalesi sifo aluzimele nge-insulin ye-hormone futhi lungakhula ngisho nangesilinganiso salo esiningi egazini lomuntu. Uhlobo lwesibili sikashukela luphawu lwabantu abaneminyaka engaphezu kwengama-40 ubudala futhi lukhula lubhekiswe emuva ngemuva kokunyuka kwesisindo somzimba. Ngale hlobo lwesifo sikashukela, isimo sempilo singathuthukiswa ngokwenza ushintsho ekudleni, ukwehla amakhilogremu angeziwe, futhi futhi kuncike ekujuleni kokuqina kanye nokugcwala kokuzivocavoca komzimba. Umuthi onjalo kwezokwelapha uvame ukwehlukaniswa ngama-subtypes amabili. I-Subtype A ikhula ngemuva kwesizinda sokukhuluphala ngokweqile, kanti i-subtype B ijwayelekile kwiziguli ezacile.
Ngaphezu kwezinhlobo eziphambili zesifo sikashukela, kunezinhlobo zazo ezithile:
- Isifo sikashukela se-LADA. Kubonakala ngokufana okuthile nesifo sohlobo lokuqala, noma kunjalo, izinga lokuhamba kwalo liyehla. Uma sikhuluma ngezigaba zokugcina ze-LADA-sikashukela, kungatholakala ukuthi sikashukela sohlobo II. Namuhla, leli gama liphelelwe yisikhathi, futhi igama elithi autoimmune sikashukela mellitus selilithathile;
- I-MOD-sikashukela luhlobo lwesigaba A Isifo esinezimpawu ezibonakalayo futhi esingakheka ngokusemuva kwezinkinga nge-pancreas, nge-hemochromatosis, kanye ne-cystic fibrosis;
- isifo sikashukela esenziwa izidakamizwa (isifo sikashukela seklasi B);
- isigaba C sikashukela mellitus, okwenzeka lapho uhlelo lwe-endocrine lungasebenzi.
Umehluko phakathi kwe-LADA-sikashukela kusuka kwezinye izinhlobo zesifo
Igama elithi isifo sikashukela se-LADA uqobo linikezwe uhlobo lwashukela we-autoimmune kwiziguli ezindala. Bonke labo abawela kulesi sigaba seziguli, kanye neziguli ezinohlobo lokuqala lwesifo, badinga usizo oluphuthumayo lwe-insulin. Njengomthetho, kanye nezinkinga noshukela, emzimbeni weziguli, amaseli we-pancreatic akhiqiza i-insulin ewohloka. Njengomphumela walokhu, inqubo ye-autoimmune iyenzeka.
Emisebenzini yezokwelapha, umuntu angathola umbono wokuthi i-LADA-sikashukela iyavilapha, futhi kwesinye isikhathi ibizwa nangokuthi "ushukela" 1.5.
Isimo esifanayo se-pathological sibonakaliswa ngokufa kwawo wonke amaseli emishini esetshenziselwa ukufakwa lapho zifinyelela iziguli ezineminyaka engama-35. Yonke inqubo ihamba kancane futhi ifana nenkambo yesifo sikashukela sohlobo 2.
Umehluko omkhulu ukuthi kuleli cala, onke amangqamuzana e-beta ayafa, okubangela ukunqanyulwa kokuvikelwa kwe-insulin kumanyikwe.
Njengomthetho, ukuthembela okuphelele ekuphathweni okwengeziwe kwe-insulin kwakhiwa esikhathini kusuka eminyakeni eyi-1 kuye kwemi-3 kusukela ekuqaleni kwesifo. Kudlula nezimpawu zobuntu kwabesilisa nakowesifazane.
Inkambo yalesi sifo ilungele uhlobo lwesibili, ngoba isikhathi eside kungenzeka ukulawula inqubo yonke ye-pathological ngosizo lokuzivocavoca umzimba kanye nokudla okunempilo kwe-carb ephansi.
Inkambo yesifo esivumelana kahle yenza sikwazi ukucabanga ukuthi isifo sikashukela sizoncipha noma ukuqala kwaso kuzoshintshwa unomphela. Iphuzu elibaluleke kakhulu kuleli cala kuzoba ukulawulwa kwe-glycemic.
Ukuze kwandiswe ukuqwashiswa kweziguli, kwenziwa izikole ezikhethekile zesifo sikashukela. Umgomo wabo oyinhloko ukuhambisa imininingwane eyanele nefanele esigulini esithile esithile:
- kuyadingeka ukuqapha izinga le-glycemia;
- kunezindlela zokulawula izinga lakho ushukela;
- Ukuziphatha okukhethekile kuhlinzekelwa izinkinga zesifo sikashukela.
Sitholakala kanjani isifo sikashukela?
Ukuthola izimpawu ezibonisa isifo sikashukela se-LADA esigulini, kuyadingeka ukusebenzisa lezi zinto ezilandelayo, ngaphezu kwakho konke ukuhlolwa okujwayelekile kwe-glucose yegazi kanye ne-glycated hemoglobin:
- Ukuhlaziywa kanye nokudilizwa kwe-autoantibodies kumaseli e-ICA (islet cell);
- ucwaningo lwama-antigen we-HLA;
- ukutadisha ama-autoantibodies ezidakamizweni nge-insulin;
- ukuqinisekiswa kwezimpawu zofuzo;
- ama-autoantibodies ajwayelekile ukukhipha i-decarboxylase GAD.
Ukuphambuka kusimo esamukelwe ekubonisweni kohlobo olufana ne-LADA-sikashukela kuzoba yimingcele enjalo:
- iminyaka yesiguli ingaphansi kweminyaka engama-35;
- ukusungulwa kokuncika kwe-insulin ngemuva kwesikhathi esithile (iminyaka eminingana);
- ukubonakaliswa kwezimpawu zohlobo lwesibili sikashukela ezinesisindo esijwayelekile noma ngisho nokuncipha;
- isinxephezelo sokushoda kwe-insulin kwenzeka ngosizo lokudla okukhethekile kanye ne-physiotherapy.
Emithini yesimanje, ukutholakala kwesifo sikashukela akunzima. Ukuze wenze lokhu, kunemishini ehlukahlukene yokuxilonga esiza ukuthola ukutholakala kweziguli ezineminyaka engama-25 kuye kwengama-50 kulezo zimo lapho zinezimpawu zakudala zesifo sikashukela.
Ukuhlolwa kwelebhu yanamuhla kusiza udokotela ngokunemba ngangokunokwenzeka ukukhetha izindlela zokwelapha eziphumelelayo futhi kwandise isikhathi sokukhiqizwa kwamahhala eguli uqobo.
Iqembu elingaba sengozini yokuthola uhlobo lwesifo sikashukela se-LADA abesifazane abakhulelwe abaqinisekisiwe ngesifo sikashukela sokukhulelwa. Ezimweni eziningi, laba besifazane bathambekele ekushukela ngemuva kokuphela kokukhulelwa kwabo noma esikhathini esizayo esingekude kakhulu. Njengomthetho, amathuba wenkambo enjalo yalesi sifo aqapheleka ngamaphesenti angama-25 amacala.
Izindlela zokwelapha
Njengoba kuphawuliwe, ukwelashwa kwe-insulin okuphoqelelayo kunqunyelwe kwiziguli ezitholakala ukuthi zinesifo sikashukela se-LADA. Odokotela batusa ukuthi ungalibali imijovo. Uma i-LADA-sikashukela iqinisekisiwe, ukwelashwa kuzobe kususelwa kule nqubomgomo.
Lesi sigaba seziguli sidinga ukutholwa kokuqala kwesifo kanye nemithi eyanele yezidakamizwa, kanye ne-insulin ikakhulukazi. Okokuqala, lokhu kungenxa yamathuba aphezulu okuvela kokungabikho kokukhiqizwa kwe-insulin. Kaningi, ukushoda kwe-insulin kungahlanganiswa nokumelana kwamaseli womzimba kuleli hormone uma kutholakala ukuthi isifo sikashukela sitholakala.
Ezimweni ezinjalo, iziguli zingabekwa ngemithi ekhethekile yokunciphisa ushukela ngefomethi ye-tablet. Izidakamizwa ezinjalo azibangeli ukoma kwe-pancreatic, noma kunjalo, ngasikhathi sinye, zandisa umkhawulo wokuzwela wezinto zokuphathelene ne-insulin ze-hormone.
Ngaphezu kwalokho, imishanguzo engabekwa ifaka phakathi i-Biguanide derivatives (Metformin), kanye nama-glitazones (Avandia), uhlu oluphelele lwezidakamizwa zabanesifo sikashukela lungatholakala kuwebhusayithi yethu.
Kubaluleke impela kuzo zonke iziguli ezinesifo sikashukela se-LADA. Kulokhu, ukuphathwa kwe-insulin okuqala kakhulu kuzohlose ukonga umkhiqizo oyisisekelo we-insulin isikhathi eside ngangokunokwenzeka.
Lezo ziguli ezithwala i-LADA-sikashukela kufanele zilinganiselwe ekusebenziseni ama-secretogens. Le mishanguzo ingavuselela ukukhiqizwa kwe-insulin futhi iholele ekunciphiseni kwe-pancreatic ngokushesha, futhi iqhubeke nokuntuleka kwe-insulin ezigulini ezinohlobo lwe-Lada-sikashukela.
Ukwengeza okukhulu kwezokwelapha kuzoba:
- ukuqina
- i-hirudotherapy;
- ukuzivocavoca komzimba.
Ngaphezu kwalokho, ngemvume kadokotela, izifundo zokwelashwa zingenziwa kusetshenziswa umuthi wendabuko. Kukhona inani elikhulu kakhulu lezitshalo zokwelapha elehlisa kufanele ushukela wegazi kwiziguli ezinesifo sikashukela se-LADA.
