Akulula ngaso sonke isikhathi ukunquma uhlobo lwesifo sikashukela, ngoba kunokuhlukahluka kwalesi sifo, izinkomba zaso ezingabalwa ngazo zombili izinhlobo zokuqala nezesibili. Ukwanda okungaguquki kwe-glucose esemncane, njengakuhlobo 1, olunenkambiso emfushane yohlobo 2, kwabizwa ngokuthi isifo sikashukela seModi.
I-MODI isifushaniso esithi "ukuvuthwa kokuqala kwesifo sikashukela sabancane", esingahunyushwa ngokuthi "isifo sikashukela sabadala kwabancane." Iminyaka isifo ephuca ngayo lesi sifo ayidluli iminyaka engama-25. Isifo sikashukela se-Mody sihlanganisa izindlela eziningana. Ezinye zazo zinezimpawu ezisobala zokunyuka ushukela - ukoma nokwenyuka kwevolumu yomchamo, kodwa iningi lazo zi-asymptomatic futhi zitholakala kuphela lapho kuhlolwa udokotela.
Umehluko wesifo sikashukela se-Modi kusuka kwezinye izinhlobo
Isifo sikashukela se-Mody yisifo esingajwayelekile. Ngokwezibalo ezahlukahlukene, inani leziguli lisuka 2 kuya ku-5% wabo bonke abanesifo sikashukela. Imbangela yalesi sifo ukuguqulwa kwezakhi zofuzo, ngenxa yalokho iziphithiphithi zeLangerhans ziphazamiseka. Lezi ngamaqoqo amaseli akhethekile kuma-pancreas, lapho kukhiqizwa khona i-insulin.
Isifo sikashukela nokucindezela kuzoba yinto yesikhathi esedlule
- Ukwehlela ushukela -95%
- Ukuqedwa kwe-vein thrombosis - 70%
- Ukuqedwa kokushaya kwenhliziyo okuqinile -90%
- Ukuqeda umfutho wegazi ophakeme - 92%
- Ukwanda kwamandla ngesikhathi sosuku, ngcono ukulala ebusuku -97%
Isifo sikashukela se-Mody sidluliselwa ngendlela evelelayo ye-autosomal. Uma ingane ithola okungenani uhlobo olulodwa olunenkinga kubazali bayo, ukugula kwayo kuzoqala ngamacala angama-95%. Amathuba okudluliswa kofuzo angama-50%. Isiguli ezizukulwaneni ezedlule kumele sibe nezihlobo eziqondile ezinesifo sikashukela se-Mody, ukutholakala kwaso kungahle kuzwakale njengohlobo olu-1 noma 2 sikashukela, uma ngabe isifo sofuzo asenziwanga
Isifo sikashukela se-Mody singasolwa uma i-glucose yegazi ikhuphuka ngezikhathi ezithile, lokhu kunyuka kuhlala kulelo zinga isikhathi eside, akubangeli i-hyperglycemia ne-ketoacidosis enamandla. Isici esibonakalayo ukusabela ekwelashweni kwe-insulin: i-honeymoon ngemuva kokuba iqale ayihlali izinyanga eziyi-1-3, njengoba inesifo sikashukela sohlobo 1, kodwa isikhathi eside. Ukulungiswa kwe-insulin, noma ukubalwa komthamo ofanele, kuvame ukudala i-hypoglycemia engalindeleki.
Izindlela zokuhlonza ukwehlukanisa isifo sikashukela se-Mody nezinhlobo ezivamile zesifo:
| Uhlobo olu-1 | Modyisifo sikashukela |
| Amathuba okuthola ifa aphansi, angeqi i-5%. | Isimo sobuntu, ukutholakala okukhulu kokudluliselwa. |
| I-Ketoacidosis ibonakala njengodaba lwesibungu. | Ekuqaleni kwalesi sifo, izidumbu ze-ketone azikhishwa. |
| Izifundo zaselebhu zibonisa izinga eliphansi le-C-peptide. | Inani elijwayelekile le-C-peptide, elibonisa ukucasulwa okuqhubekayo kwe-insulin. |
| Ekuqaleni, amasosha omzimba anqunywa. | Ama-antibodies awekho. |
| I-honeymoon ngemuva kokuqala ukwelashwa kwe-insulin ingaphansi kwezinyanga ezintathu. | Ushukela ojwayelekile ungahlala iminyaka eminingana. |
| Imithamo yokwanda kwe-insulin ngemuva kokuba amaseli we-beta eyeka ngokuphelele ukusebenza. | Isidingo se-insulin sincane, i-glycated hemoglobin ayiphezulu kune-8%. |
Inombolo yetafula 2
| 2 uhlobo | Isifo sikashukela se-Mody |
| Kutholakala njengomuntu omdala, imvamisa ngemuva kweminyaka engama-50. | Kuqala ebuntwaneni noma ebusheni, imvamisa kakhulu eminyakeni eyi-9-13. |
| Ezimweni eziningi, ukukhuluphala nokufisa okwandayo kwamaswidi kuyabonakala. | Iziguli zihola impilo ejwayelekile, asikho isisindo eseqile. |
Izinhlobo zesifo sikashukela se-Mody
Lesi sifo sihlukaniswa ngokusho ngofuzo oluguquliwe. Kunezinguquko eziyi-13 ezingenza ushukela wegazi, kuze kube manje, inani elifanayo lezinhlobo zesifo sikashukela se-Mody. Azimbozi zonke izimo zesifo sikashukela ngenkambo engajwayelekile, ngakho-ke, izifundo ziqhubeka njalo ukucinga izinhlobo ezintsha ezinesici. Kancane kancane, inani lezinhlobo zalesi sifo elaziwayo lizokwanda.
Thayipha izibalo zomjaho waseCaucasus:
- I-Modi-3 - 52% yamacala;
- Modi-2 - 32%;
- Modi-1 - 10%;
- Modi-5 - 5%.
Imvamisa esondele kakhulu e-Asia:
- I-Modi-3 - 5% yamacala;
- Modi-2 - 2,5%;
- Modi-5 - 2,5%.
Yi-10% kuphela yeziguli zohlanga lwamaMongoloid esezikwazi ukuhlukanisa lolu hlobo lwesifo sikashukela, ngakho-ke, izifundo zokucinga izinhlobo ezintsha zenziwa kuleli qembu labantu.
>> Usizo: Funda Ukuthi Isifo Sikashukela Siyini - //diabetiya.ru/pomosh/nesaharnyj-diabet.html
Izici zezinhlobo ezijwayelekile kakhulu:
| Thayipha | Uhlobo oluyiphutha | Izici zokuvuza |
| Modi 1 | I-HNF4A, ilawula imisebenzi yezakhi zofuzo eziningana ezibhekele ukwelashwa kwama-carbohydrate kanye nokudluliswa kweglucose kusuka egazini iye kwezicubu. | Ukwakheka kwe-insulin kuyanda, akukho shukela emchameni, cholesterol yegazi ne-triglycerides kuvame kakhulu. Ushukela wokuzila ungahle ube ojwayelekile noma ophakeme kancane, kepha ukuhlolwa kokubekezelela ushukela kubonisa ukukhuphuka okukhulu (cishe amayunithi ama-5). Ukuqala kwalesi sifo kushubile, njengoba izinkinga zesifo sikashukela ziqala ukuthuthuka. |
| Modi 2 | I-GCK luhlobo lwe-glucokinase ekhuthaza ukuguqulwa kweglucose ngokweqile ye-glycogen, ilawula ukukhishwa kwe-insulin ukuphendula ukwanda kwe-glucose. | Mncane kunezinye izindlela, imvamisa ayidingi ukwelashwa. Ukwanda okuncane kweshukela lokuzila kungabonakala kusukela nje ngokuzalwa, kanye nobudala, amanani we-glycemic akhuphuka kancane. Izimpawu azikho; izinkinga ezinzima zivamile. I-hemoglobin ye-Glycated emkhawulweni ongenhla wokujwayelekile, ukukhuphuka koshukela ngesikhathi sokuhlolwa kokubekezelela kwe-glucose ngaphansi kwamayunithi angama-3.5. |
| Modi 3 | Ukuguqulwa kwe-HNF1A kuholela ekuphazamisweni okuqhubekayo kwamaseli e-beta. | Isifo sikashukela sivame ukuqala ngemuva kweminyaka engama-25 (ama-63% amacala), mhlawumbe ngokuhamba kwesikhathi, aze afike eminyakeni engama-55. I-hyperglycemia enkulu kakhulu kungenzeka ekuqaleni, ngakho-ke iModi-3 ivame ukudidaniswa nesifo sikashukela sohlobo 1. I-Ketoacidosis ayikho, isivivinyo sokubekezelela i-glucose sibonisa ukwanda kwe-glucose yamayunithi angaphezu kwama-5. Isithiyo sezinso siphukile, ngakho-ke ushukela emchameni ungatholakala ngisho nasezingeni elijwayelekile egazini. Ngokuhamba kwesikhathi, lesi sifo siyaqhubeka, abanesifo sikashukela badinga ukulawulwa okuqinile kwe-glycemic. Uma ingekho, izinkinga ziyaqhubeka ngokushesha. |
| Modi 5 | I-TCF2 noma i-HNF1B, ithinta ukukhula kwamaseli we-beta esikhathini se-embryonic. | Kukhona i-nephropathy ethuthukayo yemvelaphi engeyona yesifo sikashukela, i-atroph ye-pancreatic, izifo zangasese zingathuthukiswa. Ukuguqulwa okuzenzakalelayo, okungelona ifa kungenzeka. Isifo sikashukela siqala kubantu abangama-50% abanale nkinga. |
Yiziphi ezinye zezimpawu zokusolwa?
Kunzima kakhulu ukuqaphela i-Mody-sikashukela ekuqaleni kwalesi sifo, ngoba imvamisa ukuphazamiseka kuqala kancane kancane, futhi nezimpawu ezicacile azikho ngokuphelele. Kwezibonakaliso ezingejwayelekile, izinkinga zokubuka zingabonakala (umgubuzelo wesikhashana phambi kwamehlo, ubunzima obugxile endabeni). Ingozi yezifo zokukhunta inyuka, abesifazane babonakala ngokubuyela njalo kwe-thrush.
Lapho ushukela wegazi ukhuphuka, kuqala izimpawu ezijwayelekile zesifo sikashukela:
- ukoma
- ukuchama njalo;
- ukwanda kwesifiso sokudla;
- ukungasebenzi komzimba okungenamandla;
- izilonda zesikhumba ezingahambi kahle;
- Izinguquko zesisindo, kuya ngesimo se-Mody-sikashukela, isiguli singancipha futhi sibe ngcono.
Kufanelekile ukuthi uhlole i-Modi-sikashukela uma ingane noma umuntu osemncane ethole i-glycemia kaningi ephakeme kune-5.6 mmol / l, kepha azikho izimpawu zesifo sikashukela. Isibonakaliso sexwayiso sikhulu ushukela kuno-7.8 mmol / L ekugcineni kokuhlolwa kweshukela. Ezinganeni, ukungabikho kokuncipha kwesisindo ekuqaleni kwalesi sifo kanye noshukela ngemuva kokudla okungekho amayunithi angaphezu kwayishumi futhi kukhombisa isifo sikashukela se-Mody.
Ukuqinisekiswa kwelabhoratri yesifo sikashukela se-Mody
Naphezu kobunzima bokuqinisekiswa kwelebhu yelesi sifo sikashukela, izifundo zofuzo zibaluleke kakhulu, ngoba zikuvumela ukuthi unqume amaqhinga wokuphatha afanele hhayi esigulini kuphela, kodwa nasezihlotsheni zakhe ezindala.
Ukuhlolwa okugcwele kufaka phakathi:
- ushukela wegazi
- ushukela namaprotheni emchameni;
- I-peptide;
- ukuvivinya ushukela;
- ama-antibodies ama-autoimmune kuya ku-insulin;
- i-glycated hemoglobin;
- i-lipids yegazi;
- I-Ultrasound yamanyikwe;
- i-amylase yegazi nomchamo;
- fecal trypsin;
- ucwaningo lwezakhi zofuzo.
Ukuhlolwa kokuqala okuyi-10 kungathathwa lapho uhlala khona. Ucwaningo lwakamuva lukuvumela ukuthi unqume uhlobo lwesifo sikashukela se-Mody, kwenziwa. eMosos naseNovosibirsk kuphela. Ukuxilongwa kusekelwe ezikhungweni zocwaningo ze-endocrinological. Ocwaningweni, kuthathwa igazi, kuthathwe i-DNA esitokisini, ihlukaniswe izigaba futhi kuhlanganiswa izingcezwana, amaphutha okukhona kuwo kakhulu.
Ukwelashwa
Imithi kadokotela incike ohlotsheni Modyisifo sikashukela:
| Thayipha | Ukwelashwa |
| Modi 1 | Ama-Derivatives we-sulfanylureas - Glucobene, Glidanil, amalungiselelo weGlidiab anikeza umphumela omuhle. Bandisa ukwakheka kwe-insulin futhi kukuvumela ukuthi ugcine ushukela evamile isikhathi eside. Amalungiselelo we-insulin asetshenziswa ezimweni ezihlukile. |
| Modi 2 | Ukwelashwa okujwayelekile akunakusebenza, ngakhoke, ukwenza ushukela ube ngokwejwayelekile, udinga ukulandela indlela yokudla enamanani ancishisiwe wama-carbohydrate futhi uthola njalo ukusebenza komzimba. Ukuvimbela i-macrosomia ye-fetus (usayizi omkhulu) ngesikhathi sokukhulelwa, owesifazane unqunywe imijovo ye-insulin. |
| Modi 3 | Lapho uhlobo lwe-3 yesifo sikashukela se-Type 3 sikashukela, okuphuma ku-sulfa urea izidakamizwa zokuzikhethela, futhi nokudla okuphansi kwe-carb nakho kuyasebenza. Njengoba ukuqhubekela phambili kwenziwa, ukwelashwa okunjalo kuthathelwa indawo ukwelashwa kwe-insulin. |
| Modi 5 | I-insulin inqunywa ngokushesha ngemuva kokutholwa kwalesi sifo. |
Ukwelashwa kusebenza ngempumelelo kakhulu uma kungekho isisindo ngokweqile. Ngakho-ke, iziguli ezinokukhuluphala zinqunyelwe ukudla okungeziwe kokuqukethwe okukhawulelwe kwekhalori.
Imibhalo ewusizo:
Lapha sikhulume ngesifo sikashukela esise-latent
