Ukuxilongwa kwelebhu ushukela ezinganeni nakubantu abadala

Izinga lokukhula kwezinkinga kuma-diabetics lincike ezingeni likashukela egazini labo. Okwatholakala ukuthi isifo sikashukela sitholakala kuqala, ngokushesha ukwelashwa kwalesi sifo kuzoqala, okusho ukuthi ikhwalithi nokuhlala isikhathi eside kwesiguli kuzothuthuka. Ngohlobo 2 lwesifo sikashukela, ukuqalwa kokwelashwa okufika ngesikhathi kuvumela isikhathi esijana ukulondolozwa kokusebenza kwepancreatic. Ngohlobo 1, ukutholwa kwezinkinga kusenesikhathi kwe-carbohydrate metabolism kusiza ukugwema i-ketoacidotic coma, futhi kwesinye isikhathi kusindisa impilo yesiguli sikashukela.

Zombili lezi zinhlobo zalesi sifo azinazimpawu ezihlukile, ngakho-ke ukujwayelana nomlando wesiguli akwanele ukwenza ukuxilongwa okufanele. I-endocrinologist isizwa izindlela zanamuhla zelebhu. Ngosizo lwabo, awukwazi ukukhomba kuphela ukuqala kwalesi sifo, kodwa futhi unganquma uhlobo nohlobo lwalo.

Izindlela zokuhlonza uhlobo 1 nohlobo 2 sikashukela mellitus

Ijubane lokuthuthuka kwesifo sikashukela emhlabeni liphula amarekhodi, liba yinkinga emphakathini. Bangaphezu kuka-3% abantu asebetholakele. Ngokusho kochwepheshe, njengoba abantu abaningi bengazi ukuqala kwalesi sifo, ngoba azange bazihluphe ngokuxilongwa ngesikhathi. Ngisho nezindlela zobumnene be-asymptomatic zibangela ukulimala okukhulu emzimbeni: zivusa isifo sokuqina kwemithambo yegazi, zichithe ama-capillaries, ngaleyo ndlela zinciphise izitho nemilenze yokudla, kuphazamise uhlelo lwezinzwa.

Ukuxilongwa okuncane kakhulu kwesifo sikashukela kufaka phakathi ukuhlolwa kwe-2: isivivinyo sokushukela (glucose) nokuvivinya ukubekezelela ushukela. Zingathathwa mahhala uma uvakashela njalo umtholampilo futhi uhlolwa nodokotela. Kunoma iliphi ilabhoratri yezentengiselwano, zombili lezi zindlela zokuhlaziya ngeke zibize ngaphezu kwama-ruble ayi-1000. Uma ukuxilongwa okuncane kuveze okungajwayelekile ku-carbohydrate metabolism, noma ukubalwa kwegazi kusondele emkhawulweni ophezulu wejwayelekile, kufanelekile ukuvakashela i-endocrinologist.

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%

Ngakho-ke, sidlule esivivinyweni sokukhuthazelela i-glucose kanye ne-glucose, futhi imiphumela yabo ayizange isithokozise. Yini okusamele kwenziwe?

Ukuxilongwa okuthuthukile kufaka phakathi:

1. Ukujwayelana nomlando wesiguli, ukuqoqa imininingwane ngezimpawu, indlela yokuphila kanye nemikhuba yokudla, ifa.
2. I-Glycated hemoglobin noma i-fructosamine.
3. I-Urinalysis
4. I-peptide.
5. Ukukhonjwa kwama-antibodies.
6. Iphrofayili ye-lipid yegazi.

Lolu hlu lungahluka kokubili ekuqondeni kokwehla nokwenyuka. Isibonelo, uma kuqala ukuvela kwesifo, futhi isiguli esinesifo sikashukela singaphansi kweminyaka engama-30 ubudala, ingozi yohlobo lwe-1 isifo iphezulu. Isiguli siyohlolwa okuyisibopho kwe-C-peptide nama-antibodies. Ama-lipids egazi kuleli cala, njengomthetho, ajwayelekile, ngakho-ke, lezi zifundo ngeke zenziwe. Futhi okuphambene nalokho: esigulini esidala esingenawo ushukela omningi kakhulu, ngokuqinisekile bazohlola i-cholesterol ne-triglycerides, futhi bazonikeza nokuhlolwa kwezitho ezihlushwa kakhulu yizinkinga: amehlo nezinso.

Masihlale imininingwane eminingi ngezifundo ezivame ukusetshenziswa ukuthola isifo sikashukela.

Umlando wezokwelapha

Imininingwane etholwa ngudokotela ngesikhathi kubuza isiguli nokuhlolwa kwayo kwangaphandle iyinto esemqoka ekutholakaleni kwesifo sikashukela hhayi nje kuphela, kodwa nezinye izifo.

Naka lezi zimpawu ezilandelayo:

• ukoma kakhulu;
• ulwelwesi olomile lwe-mucous;
• ukwanda kokudla kwamanzi kanye nokuchama;
• ubuthakathaka obukhulayo;
• ukuwohloka kokuphola inxeba, ukuthambekela kokucabanga;
• ukoma kakhulu nokulunywa kwesikhumba;
• izinhlobo zokulwa nezifo zokukhunta;
• ngesifo sohlobo 1 - ukunciphisa umzimba ngokweqile.

Izimpawu ezinkulu kakhulu isicanucanu, isiyezi, nobuhlungu besisu, ukungazi kahle. Zingakhombisa ushukela omningi ngokweqile ngokuhlanganiswa ne-ketoacidosis. Isifo sikashukela sohlobo 2 akuvamile ukuba sibe nezimpawu ekuqaleni kwalesi sifo, kuma-50% abantu abanesifo sikashukela esidala esingaphezu kweminyaka engama-65 ubudala, izimpawu zomtholampilo asikho ngokuphelele, ngokweqile.

Ingozi enkulu yesifo sikashukela ingakhonjwa nangokubona. Njengomthetho, bonke abantu abanokukhuluphala kwamathumbu besisu okungenani banezigaba zokuqala zokwephulwa kwe-carbohydrate metabolism.

Ukusho ukuthi umuntu unesifo sikashukela, kuphela izimpawu azanele, noma ngabe zinzima futhi zihlala isikhathi eside. Isifo sikashukela i-mellitus singaba nezimpawu ezifanayo, ngakho-ke, zonke iziguli kudingeka ukuba zenze uhlolo lweglucose yegazi.

Ukuzila ushukela

Lokhu kuhlaziywa kusemqoka ekuhlolweni kwesifo sikashukela. Ngokucwaninga, igazi lithathwa emthanjeni ngemuva kwesikhathi sokulamba okungamahora ayi-12. IGlucose inqunywa ku-mmol / L. Umphumela ongaphezulu kwe-7 uvame ukukhombisa isifo sikashukela, kusuka ku-6.1 kuye ku-7 - mayelana nokuphambuka kokuqala kokugayeka kokudla, ukungasebenzi kahle kwe-glycemia.

Ijubane le-glucose liqala ukukhula hhayi kusuka ekubandakanyekeni kwesifo sohlobo 2, kodwa emuva kwesikhashana. Ushukela wokuqala uqala ukwedlula ngemuva kokudla. Ngakho-ke, uma umphumela ungaphezulu kwe-5.9, kungakuhle ukuthi uvakashele udokotela futhi uthathe izivivinyo ezengeziwe, okungenani ukuhlolwa kokubekezelela kwe-glucose.

Ushukela ungaphakanyiswa okwesikhashana ngenxa ye-autoimmune, izifo ezithathelwanayo kanye nezifo ezithile ezingamahlalakhona. Ngakho-ke, lapho kungekho zimpawu, igazi liphinda linikelwe.

Izindlela zokuhlonza isifo sikashukela:

• Kabili ukweqisa kwe-glucose yokuzila;
• ukwanda okukodwa uma kuboniswa izimpawu zomlingiswa.

Ukuhlolwa kokubekezelela kwe-glucose

Lokhu kubizwa ngokuthi "isifundo ngaphansi komthwalo." Umzimba "ulayishwa" ushukela omningi (imvamisa banikeza amanzi okuphuza ngo-75 g we-glucose) futhi amahora amabili babheka ukuthi likhipha ngokushesha kangakanani igazi. Ukuhlolwa kokubekezelela kwe-glucose kuyindlela ebucayi kakhulu yokuxilongwa i-labor yesifo sikashukela; kukhombisa ukungahambi kahle lapho ushukela wokuzila usujwayelekile. Ukuxilongwa kwenziwa uma i-glucose ngemuva kwamahora ama-2 ≥ 11.1. Umphumela ngenhla kwe-7.8 ukhombisa i-prediabetes.

Ukwelashwa okufika ngesikhathi kwesifo sikashukela sokukhulelwa kusiza ukuvimbela ukuphazamiseka kokukhula kwengane, kwesinye isikhathi kusindise impilo yengane. Ngakho-ke, ukuhlolwa kokubekezelela i-glucose kusetshenziselwa ukuthola isifo sikashukela kwabesifazane ngesikhathi sokukhulelwa. Kufanele inikelwe kumaviki angama-24- 26.

>> Funda: Ungasithatha kanjani isivivinyo sokubekezelela ushukela

I-Glycated Hemoglobin ne-Fructosamine

Uma kukhona izinsolo zokuthi ukutholakala kwesifo sikashukela sekwephuzile, futhi isifo sohlobo 2 siqale isikhathi eside ngaphambi kokuba sitholakale, hlola inani le-glycated hemoglobin (HG) egazini - i-hemoglobin ne-glucose compounds. Ukwakheka kwe-GH ngqo kuncike kushukela emikhunjini futhi kubonisa isilinganiso saso sezinyanga ezi-3. Ingasetshenziswa ukwahlulela ubukhulu besifo futhi siphakamise ukuba khona kwezinkinga. Umphumela wokuhlaziywa kusuka ku-6% ukhombisa i-prediabetes, ngaphezu kwe-6.5% - mayelana nesifo sikashukela. Ukuhlolwa kwe-GH akusetshenziselwa kuphela ukuthola isifo sikashukela, kulawula nekhwalithi yokwelashwa kwalesi sifo.

Kwezinye izimo, ngokwesibonelo, nge-hemoglobin ephansi, ukuhlolwa kwe-GH kungenzeka kungathembeki. Ngenye indlela, kusetshenziswa i-assuct ye-fructosamine. Ibuye ikhombise ukuthi konke kuphuma ushukela, kepha isikhathi esifushane - amasonto ama-2. Ngokuvamile, i-fructosamine inqunywa ku-μmol / L, umphumela ongaphezulu kwe-285 ukhombisa isifo sikashukela.

I-Urinalysis

Abantu abaphilile akufanele babe noshukela kumchamo wabo. Ukutholwa kwayo ngenani elingaphezu kuka-2.89 mmol / L kungaba imbangela yezifo eziningana, ngakho-ke akunakwenzeka ukuthola isifo sikashukela kuphela ngokuhlaziywa komchamo. Esikhathini sikashukela, ushukela ungena kumchamo lapho umkhawulo wezinso egazini udlulwa (cishe u-9 mmol / L kubantu abadala, 11 mmol / L ezinganeni). Ezigulini ezinesifo sikashukela ezisukela eminyakeni engama-65 ubudala, ucwaningo lwe-glucose kumchamo alunakuguqulwa, ngoba umbundu wabo wezinso ungashintshwa. Yize kunganembile, kodwa lokhu kuhlaziya kusivumela ukuthi sikhombe abanesifo sikashukela abaningi abangazi ngesifo sabo. Isizathu salokhu silula - umchamo unikezwa kaningi kakhulu kunoshukela wegazi.

Ngesifo sikashukela sohlobo 1, ukutholwa kwe-acetonuria - ama-ketones kumchamo kubalulekile. Ukuvela kwakhe kukhombisa ukuqala kwe-ketoacidosis, inkinga enkulu ebisongela ngokuba nesifo sikashukela. Iziguli ezine-ketoacidosis nesifo sikashukela esisolwayo dinga ukulashwa ngokuphuthumayo esibhedlela.

Funda kabanzi:

• ingozi ye-acetone kumchamo;
• ukuhlaziywa komchamo ngokusho kweNechiporenko.

Ukuhlolwa kwelebhu kuphela okungathola isifo sikashukela.

I-peptide

Kwezinye izimo, uhlobo lwesifo sikashukela alunqunywa kuphela ngesisekelo somlando nokuhlolwa ushukela. Ukuxilongwa okuhlukile, okuqukethwe kwe-C-peptide emikhunjini kuyahlolwa. Ngohlobo 1 sikashukela, amaseli we-pancreatic abhujiswa futhi angabe esakwazi ukuhlanganisa i-insulin. Ama-antibodies kuma-hormone ahlala ekhona egazini, ngakho-ke ukuhlolwa kwe-insulin kuzobe kungasebenzi. I-C-peptide yakhiwa ngasikhathi sinye ne-insulin, akukho-antibodies kuyo, ngakho-ke, ngobuningi bayo umuntu angahlulela isimo se-pancreas.

Izimpawu ze-Autoimmune

Uhlobo 1 sikashukela lubonakala ngomonakalo we-autoimmune kumaseli we-beta akhiqiza insulin. Ukuxilongwa kwanamuhla kungathola amasosha omzimba egazini ngisho nangaphambi kokuba umphumela wawo owonakalisayo uqalise. Ngeshwa, azikho izindlela eziphumelelayo zokuvimbela, ngakho-ke ukuhlolwa kwe-antibody kusetshenziswa kuphela ukunquma uhlobo lwesifo sikashukela.

90% wamacala ezigulini ezinohlobo 1 angatholakala:

Ukuhlaziywa kophawu lwe-Autoimmune kuyithuluzi elibalulekile ekuhloleni isifo sikashukela ngokungafani. Imiphumela emihle enoshukela ophakeme ikhombisa ukubhujiswa kwamaseli e-beta kanye nesidingo sokwelashwa kwe-insulin.

Izindebe zegazi

Kuhlobo 2 sikashukela, ukuphazamiseka kwe-carbohydrate kanye ne-lipid metabolism ezimweni eziningi kukhula ngasikhathi sinye, kwakha okubizwa ngokuthi yi-metabolic syndrome. Iziguli zesifo sikashukela zibonakala ngezinkinga ezinengcindezi, ukukhuluphala ngokweqile, ukuphazamiseka kwe-hormonal, isifo sokuqina kwemizwa nesifo senhliziyo, ukungabi namandla kwabesilisa, ama-ovishini ama-polycystic kwabesifazane.

Uma izinhlobo ezi-2 zesifo sikashukela zikhonjwa njengomphumela wokuxilongwa, iziguli ziyelulekwa ukuthatha ukuhlolwa kwe-lipid kwegazi. Lokhu kufaka i-cholesterol ne-triglycerides, ngokuhlolwa okweluliwe, i-lipoprotein ne-VLDL cholesterol nakho kuyanqunywa.

Iphrofayili ephansi yeLipid ifaka:

Ungaxhumana nini nochwepheshe

Izinguquko eziyisisekelo, ezibizwa nge-prediabetes, zingelashwa ngokuphelele. Isigaba esilandelayo sokuphazamiseka kwesifo sikashukela. Okwamanje, lesi sifo sithathwa njengesihlala isikhathi eside, singelapheki, iziguli ezinesifo sikashukela ziphoqelelwa ukuba zishintshe kakhulu izimpilo zazo, zilondoloze ukubalwa kwegazi okujwayelekile ngosizo lwamathebulethi kanye ne-insulin therapy. Ngokuhamba kwesikhathi, isifo sikashukela sitholakala emayunithi eziguli. Ngesifo sohlobo 1, ingxenye enkulu yeziguli ingeniswa esibhedlela esimweni se-ketoacidotic precoma noma ukoma, futhi ngohlobo 2, isifo sesiqalile futhi izinkinga seziqalile.

Ukutholwa kwesifo sikashukela kusenesikhathi kuyindlela yokwelashwa kwayo ephumelelayo. Ukuthola lesi sifo ekuqaleni, kubalulekile:

1. Yenza isivivinyo sokubekezelela ushukela njalo. Kuze kube yiminyaka engama-40 - kanye njalo eminyakeni emi-5, isuka eminyakeni engama-40 - njalo eminyakeni emi-3, uma kuba nomqondo wokudla okulungiselelwe, ukukhuluphala nokudla okungenampilo - njalo ngonyaka.
2. Yenza ukuhlolwa okubonakalayo kokudla ushukela endaweni yokucwaninga noma ngemitha kashukela egazini uma unezimpawu ezithile eziqondene noshukela.
3. Uma umphumela ungaphezulu kokujwayelekile noma usondele emkhawulweni wawo ophakeme, vakashela i-endocrinologist ukuthola ukuxilongwa okwengeziwe.