Izici zokuphila zohlobo 1 sikashukela

Uhlobo lwe-I I-mellitus yesifo sikashukela (encike ku-insulin) kungokwesigaba sezifo ezingamahlalakhona ezihambisana nokuphazamiseka kwe-metabolic. Lesi sifo sithinta ikakhulukazi isizukulwane esincane, yingakho ibizwa ngokuthi ulutsha.

Futhi ukuze inqubo yokuzivumelanisa nesimo esisha yenzeke ngaphandle kokudlulela okungadingekile, kuyalulekwa ukuthi uqonde: kungani izinga le-glucose egazini likhuphuka, nokuthi kungalimaza ini “ushukela ngokweqile” emzimbeni.

Ivelaphi insulin

Ama-pancreas unesibopho sokuhlinzeka umzimba nge-insulin. Noma, ingxenye yayo encane, eyenza i-1-2% yevolumu yento yonke. Lezi iziqhingi ezibizwa ngokuthi amaLangerhans, enza umsebenzi we-endocrine.

Isiqhingi ngasinye siqukethe amaseli asebenzayo ngokomzimba. Bambalwa - ama-pcs angama-80-200 kuphela. esiqeshini. Ngaphezu kwalokho, leli nani elincane lamaseli asebenzayo ngokwezigaba lihlukaniswe ngezinhlobo ezi-4:

1. U-Alfa
2. IBeta
3. Delta
4. I-PP

Amaseli we-Beta angama-85% ephelele. Yibona abakhiqiza i-insulin.

Kusebenza kanjani i-insulin glucose pair

Ngomzimba wethu, ushukela uwumthombo oyinhloko wamandla odingekayo ekusebenzeni kahle kwawo wonke izicubu nezitho zawo zomzimba. Izinga le-glucose egazini kumele lihlale likhona - lesi ngesinye sezimo ezisemqoka ekusebenzeni okujwayelekile komzimba wethu.

Kepha umuntu ophilile akacabangi ukuthi “ulethe” ushukela omningi kangakanani emzimbeni ngesikhathi sokudla. Ngabe umzimba uligcina kanjani lisejwayelekile? Yilapho-ke kusebenza khona amaseli we-beta.

Uma ushukela owedlulele ungena egazini ngokudla, kuvela ukuphuma kwe-insulin okubukhali. Ngenxa yalokho:

• Izinqubo ze-glucose synthesis emzimbeni ziyaphela;
• Ukweqa okutholwe ngaphandle kungaphandle kuthunyelwa kwezicubu ezixhomekeke kwi-insulin - i-adipose, isibindi, izicubu - ukutholwa.

Okwamanje, i-insulin idlala indima yomqhubi noma ukhiye, evula indlela eya esitokisini se-glucose.

Emizimbeni yethu kukhona nezicubu ezinganciki i-insulin ezingakhipha umsoco egazini ngqo: lokhu kuyizicubu zezinzwa. Ingqondo nayo ingeyayo - ubuchopho kanye nentambo yomgogodla. Lokhu kukuhle nokubi: ngakolunye uhlangothi, amandla "wekhompyutha" yethu ayixhomekile kokungasebenzi kahle kumanyikwe, kepha ayivikelekile emiphumeleni emibi yokusebenzisa ngokweqile noma ukuntuleka kweglucose.

Uma isidingo samandla ongezekile sesikhuphukile (uhlangabezane nengcindezi, uthathe isinqumo sokusebenza ezweni noma uyokubalekela epaki), ushukela, okukhona njengamanje osegazini, uqala ukudliwa. Lapho nje izinga lazo lehlika ngaphansi kwezinga elivumelekile, inqubo yokwenziwa kweglucose icushiwe emzimbeni:

1. Okokuqala, kuthunyelwa i-glycogen ukuze icubungulwe - izinqolobane zayo zigcinwa esibindini.
2. Uma akwanele, ama-lipids namaprotheni asetshenziswa.

Kwenzekani ngokuntuleka kwe-insulin

Uma i-insulin engaphakathi ingakhiqizwa, asikho isihluthulelo esenza i-glucose kumaseli. Noma yisiphi isidlo siholela ekwenyukeni koshukela wegazi, kepha izicubu ezixhomekeke ku-insulin azikwazi ukukusebenzisa. Amangqamuzana ayantanta isiraphu emnandi, kepha awakwazi ukudonsa ushukela - bese athumela isinali ye-SOS ebuchosheni: "Asinawo amandla okuphila."

Isibindi sithola umyalo wokucubungula i-glycogen, futhi sithumela njalo i-glucose eyenziwe ngegazi. Lapho lokhu kunikezwa sekuqediwe, inqubo ye-gluconeogeneis iqala - amaphrotheni nama-lipid azosetshenziswa.

Umuntu uhlangabezana nendlala emzimbeni, kepha noma ngabe udla malini, isisindo sakhe siyawa, ngoba umzimba awunawo amandla. Azikho izinto zokwakheka kwamaprotheni nama-lipids.

Izinso zizama ukulungisa lesi simo: ziqala ukufaka kakhulu ushukela kumchamo. Isibalo sokuchama ngosuku siyakhula, umuntu womile, futhi aphuze amanzi ngamalitha - kuba nezimo ezivame lapho isiguli siphuza ibhakede lamanzi kuphela ebusuku.

Uma umzimba ungasizwa kulesi sigaba, izinkinga ezibucayi zizoqala ukukhula ngokushesha.

I-insulin iya kuphi?

I-mellitus encike kwisifo sikashukela ivela lapho amaseli e-pancreatic beta ebhujiswa. Ngesizathu esithile, ngenxa yokutheleleka ngegciwane (umkhuhlane, i-rubella, i-paratyphoid, njll.), Amasosha omzimba avela emasosheni omzimba, lawo izicubu zomzimba zithathwa njengezangaphandle. Benza nabo ngokungafani nabantu abangabazi - bamane bababhubhise.

Ngokungeziwe kumagciwane, uhlu lwabasolwa lufaka:

• Amanzi okuphuza ahlanjululwe kakhulu;
• Ukuntuleka kokuncelisa ibele;
• Ukuzibandakanya kwengane kusenesikhathi kakhulu ebisini lwenkomo.

Lawa ma-antibodies (ama-autoimmune markers) angatholakala ngochungechunge lokuhlolwa kwelebhu. Uma bengekho, kepha amaseli we-beta achithwa, isifo sikashukela esingu-1 siqeqeshiwe njenge-idiopathic - okungukuthi, okuvela ekubhujisweni kwamaseli we-pancreatic ngesizathu esingaziwa.

Empeleni, lapho ukwehluleka kwe-metabolic sekuvele kwenzekile, isiguli asinandaba ukuthi kungani elahlekelwe i-insulin. Unendlela eyodwa kwesokunxele: ukwethula i-insulin yokulungiselela futhi uzivumelanise nezinto ezintsha.

Izimpawu Zesifo Sikashukela

Izimpawu zesifo sikashukela zifaka:

• I-Polyuria - ukwenyuka kwenani lomchamo lansuku zonke kuze kufike kumalitha ama-3- 10 ngesilinganiso samalitha ayi-1.8-2. Lolu phawu luvame kakhulu. Mhlawumbe ngisho nokulala embhedeni;
• IPolydipsia isomiso njalo: ukuqeda kudinga inani elikhulu lamanzi - kusuka kumalitha ayi-8 kuye kwayi-10, kwesinye isikhathi nangaphezulu. Imvamisa lolu phawu luhambisana nomlomo owomile;
• I-polyphagy - ukusetshenziswa kokudla ngamanani amakhulu nomuzwa ongapheli wendlala kanye nokulahlekelwa kwesisindo somzimba;
• Ukuguqulwa kwesisindo okungenakuqhathaniswa: ukulahleka kwayo ezinyangeni ezingama-2-3 kungafinyelela ku-10 kg;
• Ukomela, ukukhathala, kwehlisile amandla omzimba nokusebenza;
• Ukuqwasha, isiyezi, ukungahambi kahle kanye nokungaphatheki kahle;
• Isikhumba nolwelwesi lwamafinyila luhlala lukhona;
• Ukufiphala kuvela ezihlathini nasezinjeni ngenxa yokwanda kwemithambo yegazi emincane;
• Ubuhlungu bomlenze, ukuqina kwemisipha.

Kodwa zonke lezi zimpawu ezingenhla akuzona izizathu zokwelapha. Ukukuqinisekisa, kuyadingeka ukuthi kwenziwe izivivinyo zaselebhu:

• I-carbohydrate metabolism: ushukela egazini unqunywa kathathu - esiswini esingenalutho, amahora angu-1.5-2 ngemuva kokudla naphambi kokulala;
• IGlycated hemoglobin;
• Iglucose yomchamo;
• Amaphrotheni we-protein (urea, creatinine, amaprotheni);
• I-lipid metabolism (i-cholesterol nama-ketones);
• Ukushintshana kweHormonal.

Ngokuhlolwa kwe-hormonal, hhayi kuphela inani le-insulin, kodwa i-C-peptide inqunywa. Lesi sakamuva sikhiqizwa ngesilinganiso esifanayo ne-insulin. Uma isiguli sivele sisebenzisa i-insulin therapy, inani le-insulin elingaphakathi linqunywa kusetshenziswa i-C-peptide uma isakhiwa.

Ungayilungisa kanjani impilo yakho

Ngenkathi wawuphilile, akukaze kwenzeke kuwe ukuthi unake izikhathi eziningi ezibalulekile: udle okuthandayo, futhi ngangokuthanda kwakho, wagijimela ukuyozilolonga noma ukugoqa kusofa unencwadi - uwonke, ubengaqondi ukuthi ukhululekile kanjani.

Ngokuxilongwa kohlobo lwesifo sikashukela sohlobo 1, kuzodingeka uthathe indlela yakho yokuphila ngokulawulwa ngokuqinile. Kakhulu, imingcele edingekayo izoba nomthelela omncane enkululekweni yakho, kepha ngokwengqondo kunzima ukubekezelela. Kungaleso sizathu abantu abasha behlubuka, bephula umbuso, beveza isimo sabo sobucayi besifo.

Ukulwa nesifo sikashukela ngale ndlela akusizi ngalutho: ukunqoba ngokusobala ngeke kube sohlangothini lwakho. Ukulahleka kwakho kuzoholela ezinkingeni ezimbi kakhulu ezingeke ziguqulwe, ngakho-ke kuzoba ngokulungile kakhulu ukwenza "abangane" nalesi sifo. Futhi ngokushesha lapho wenza lokhu, ikhwalithi yakho yempilo ende izosala isezingeni eliphezulu.

. Ngosizo lwe-insulin therapy, izidakamizwa ze-prophylactic, amavithamini nokudla, udinga:

• Nxephezela i-carbohydrate metabolism;
• Ukuqina komzimba we-lipid;
• Gcina umfutho wegazi ojwayelekile.

Umuntu onesifo sikashukela un "amathuluzi" amaningi ukufeza umsebenzi:

• Ukwelashwa kwe-insulin;
• Ukudla
• Umsebenzi womzimba;
• Idivaysi yokuzihlola (glucometer).

Qiniseka ukuthi udlulela esikoleni sabanesifo sikashukela: abaqalayo bahlala belahleka lapho bezwa ukutholwa, ngakho-ke badinga usizo lochwepheshe.

Ukwelashwa kwe-insulin

Ukuze ulingise ukufihlwa ngokomzimba kwe-insulin, onesifo sikashukela kufanele ngesinye isikhathi alethe izidakamizwa zokwenziwa:

• I-insal insulin - izikhathi eziyi-1-2 ngosuku;
• I-Bolus - ngaphambi kokudla ngakunye.

Ama-insalins ase-basal abizwa nangokuthi ahlala isikhathi eside noma ahlala isikhathi eside. Umsebenzi wabo ukunxenxa ushukela okhiqizwa yisibindi. I-pancreas enempilo ikhiqiza amayunithi we-insulin angama-24-26 ngosuku. Cishe inani elifanayo lizofaka umuthi oqhubeka isikhathi eside. Udokotela uzokuncoma umthamo.

Kepha ungenza ucwaningo oluzimele:

• Ungadli amahora amahlanu;
• Kala ushukela njalo ngehora;
• Uma ukugxuma kwayo kungadluli i-1.5 mmol / l - umthamo unqunywa ngokufanele;
• Ushukela uyancipha kakhulu noma ukhuphuke - kuyodingeka ukuthi wehlise ngokufanele noma wandise inani le-insulin ende.

Yenza izilinganiso zokuhlola zezinsuku ezimbalwa:

• Ngosuku lokuqala - ekuseni;
• Kwesibili - ekudleni kwasemini;
• Eyesithathu - kusihlwa.

Kuyalulekwa ukwenza ucwaningo ebusuku. Udinga nje ukuziqalela amahora ayi-6 ngemuva kwesidlo.

Ungaqinisekisa isidingo sokuhlolwa ngokulinganisa ushukela esiswini esingenalutho: uma kungaphezulu noma ngaphansi kuka-6.5 mmol / l - qala isifundo.

Kunzima ngokwengeziwe ukubala umthamo we-bolus insulin. Kuya ngezici ezimbalwa:

• Amazinga kashukela egazini ngaphambi kokudla;
• Inani le-carbohydrate osuzokudla;
• Amasu akho ngemuva kokwethulwa kwe-insulin - ingabe uzophumula nje, wenze imisebenzi yobuhlakani noma uzosebenza ngokomzimba;
• Isikhathi sosuku (lweyunithi le-1 lesinkwa - sizokhuluma ngalo ngezansi - i-insulin ethe xaxa iyadingeka ekuseni kunasemini noma kusihlwa);
• Izimo zakho zempilo (uma ulwa nohlobo oluthile lokutheleleka, kuzodingeka ukuthi unyuse umthamo we-insulin ngo-20-30%)

Ukubalwa okuyikho kwemithamo ye-insulin kungahlolwa izinkomba ezilandelayo:

• Ushukela wokuzila awudluli ku-6.5 mmol / l;
• Amahora amabili ngemuva kokudla, akufanele kukhuphuke ngaphezulu kwe-8.0 mmol / L.

Kumuntu onesifo sikashukela sokuqala, lolu lwazi olungenhla luphakamisa imibuzo eminingi: yini iyunithi lesinkwa, kuboniswa kanjani ukusebenza ngokomzimba ezingeni le-glucose, futhi kuthiwani uma ukubalwa kwehluleka?

Uma isifo sikashukela sitholwa okokuqala, leli nani lizoba ngu-0.4-0.5 U / kg. Ngokuhlangenwe nakho okungaphezulu konyaka owodwa kanye nokunxephezelwa okuhle ekubalweni, isidingo sansuku zonke sizoba ngu-0.6, kuthi esimweni sokubuyiselwa, 0,8 U / kg.

Isibonelo, isiguli esinesisindo esingu-75 kg ngonyaka wokuqala wesifo sikashukela sizodinga amayunithi angama-0.5 x 75 = 37,5 ngosuku lwe-insulin. Kunzima ukubamba uhhafu weyunithi, ngakho-ke sizungeza umphumela kuya amayunithi angama-38.

Kulaba, ama-50% azokwabelwa isabelo se-insulin enwetshiwe (eyi-10 yayo - ekuseni, 9 - ebusuku), bese kuthi amanye ayi-19 asatshalaliswe ngale ndlela elandelayo:

• Amayunithi ayi-8 ngaphambi kokudla kwasekuseni;
• Amayunithi ama-6 - ngaphambi kwasemini;
• Amayunithi ama-5 - ngaphambi kokudla kwakusihlwa.

Manje kusalokhu kudonsa imenyu ukuze iqukethe amayunithi wesinkwa anele ukubuyisa umthamo olungiselelwe we-insulin. Okokuqala, ake sibheke ukuthi i-XE iyini - amayunithi wesinkwa, nokuthi ungakuveza kanjani okudlayo kukho.

Yini iyunithi lesinkwa (XE)

Iyunithi lesinkwa yinani elinemibandela elihambelana nama-gramu ayi-10 wama-carbohydrate (ngaphandle kokudla kokudla komoya).

Cishe wonke umkhiqizo uqukethe ama-carbohydrate. Kwezinye, inani labo lincane kangangokuba lapho bebala umthamo we-insulin banganakwa. Imithombo esemqoka yama-carbohydrate ushukela, ufulawa, okusanhlamvu, izithelo, amazambane kanye namaswidi - iziphuzo eziqukethe ushukela, amaswidi, ushokoledi.

Kepha kukhona i-caveat eyodwa: abathuthukisi balo mbhalo obalulekile baveze ukuthi umkhiqizo othile uwela kangakanani kwi-XE eyodwa ngendlela yayo eluhlaza. Isibonelo, iyunithi elilodwa lesinkwa lihambelana nama-gramu ayi-15 we-buckwheat.

Kuhlala ukuthola ukuthi ungaxhuma kanjani konke lokhu ngephalishi eliphelile? Ngemuva kwakho konke, ingafakwa i-welded friable noma i-viscous. Futhi ngamehlo awukwazi ukubona ukuthi mangaki ama-carbohydrate eza ne-plate yokudla emzimbeni wakho.

Ekuqaleni, wena (noma abathandekayo bakho) kuzofanele usebenze kanzima wenze lo msebenzi olandelayo:

1. Thenga izikali zasekhishini;
2. Sika ngokucophelela okusanhlamvu, bese uguqula isisindo saso sibe amayunithi esinkwa;
3. Ukubhala phansi ukuthi uthatha ini namanzi nokusanhlamvu?
4. Linganisa ipani lapho iphalishi elizopheka khona;
5. Yilinganise ngesitsha esilungiselelwe bese ususa isisindo sepaneli engenalutho kusukela kusibalo esiphumela;
6. Hlukanisa umphumela ngenombolo yamayunithi esinkwa (bheka isigaba 2).

Ake sithi upheka iphalishi ngesilinganiso esingu-1: 4, futhi isisindo sengxenye eyodwa yesinkwa somkhiqizo ophelile wawungamalitha angama-60. Manje faka ipuleti esikalini bese uyigcwalisa ngokudla: beka i-120 g - yidla i-2 XE, wandise ingxenye ibe ngu-180 g - thola i-3 XE.

Uma ulungisa zonke izinto ozenzayo ephepheni, futhi ungaguquki inani, ezikhathini ezilandelwayo udinga ukukala inani likakolweni okusanhlamvu okumi ngomumo.

Ngokwalolu hlelo, ungabala ngokunembile isisindo se-XE eyodwa yanoma yisiphi isidlo. Ezinye izazi zesifo sikashukela zizama ukuthola leli nani ngeso, okuholela kumphumela odabukisa kakhulu: kungaba yi-hypoglycemia noma i-hyperglycemia.

Ukuhlelwa kwemithwalo

Qaphela ukuthi ukusebenza komzimba kuguqula ukuzwela kwezicubu ezixhomekeke ku-insulin. Umzimba ophilile ngalezi zikhathi ngokuzenzakalelayo unciphisa ukugcinwa kwe-insulin ngesigamu.

Isifo sikashukela kufanele sihlele ngokucophelela noma yisiphi isenzo saso. Uma ehlose ukudalula umzimba wakhe ekusebenzeni isikhathi eside komzimba, kuzofanela aqale athole izinga le-glucose egazini ngesikhathi sokuqala kokusebenza. Uma eqamba:

• I-4.5 mmol / l, udinga ukudla i-1-4 XE ngaphambi kokuzivocavoca;
• I-5-9 XE - vele ungeze i-1-2 XE ekuqaleni, kepha njalo ngehora udinga ukudla iyunithi eyodwa yesinkwa;
• I-10-14 mmol / l - akukho okudliwayo.

Izinkinga zesifo sikashukela sohlobo 1

Izinkinga zesifo sikashukela zingahlukaniswa ngamaqembu amathathu:

• Bukhali;
• Kamuva;
• Okungapheli

I-acute ifaka nezinkinga ezingaholela ekufeni komuntu. Akhula ngokushesha okukhulu, futhi usizo olufika ngesikhathi kuphela olungasindisa impilo yesifo sikashukela. Lokhu kufaka phakathi:

• I-Ketoacidosis: yenzeka njengomphumela wokuqongelela komzimba wemizimba ye-ketone (acetone);
• I-Hypoglycemia: Ukwehla ngokushesha kweglucose yegazi. Isizathu sokuwa okunjalo kungaba yidosi elibalwe ngokungalungile nge-insulin, utshwala obunamandla, ukubhebhetheka, ukuzikhandla okukhulu ngokomzimba, hhayi okunxeshezelwe ngokudla okwengeziwe kwama-carbohydrate;
• I-Hyperglycemia: ushukela wegazi ophakeme. Kungenzeka kwisisu esingenalutho - ngokungagodli isikhathi eside ekudleni, noma ngemuva kokudla, uma umthamo olungiselelwe we-insulin ungahambisani nenani lamayunithi esinkwa esidliwayo.

Izinkinga zasemuva kwesikhathi zifaka:

• I-retinopathy, lapho kuthinteka khona i-retina, ukuphuma kwesibindi ku-fundus, futhi, ngenxa yalokho, ukulahleka kombono;
• I-Angiopathy - lokho okubizwa ngokuthi ukwephulwa kokuqina kwemithambo yegazi;
• I-Polyneuropathy - ekhonjiswa ekulahlekelweni kokuzwela kwezingalo ukushisa, ukubanda nobuhlungu. Okokuqala, kunomuzwa ovuthayo emilenzeni: uzwakala kahle ikakhulukazi ebusuku - lokhu kuwuphawu lokuqala lwe-polyneuropathy;
• Unyawo lwesifo sikashukela - inkinga, ehambisana nokuvela kwama-purulent abscesses, izilonda ezivulekile nezindawo ezinobuthi emilenzeni yesifo sikashukela. Izinyawo zidinga ukunikezwa ukunakwa okukhethekile: inhlanzeko, ukukhethwa kwezicathulo ezifanele, okugqoka amasokisi angenazo izintambo ezihlanganayo, njll.

Izinkinga ezingalapheki ezingemnandi zihlanganisa ukulimala kwemithambo yegazi, isikhumba nezinso. Izilonda ezinamahlwili, ukuhlaselwa yisifo senhliziyo, imivimbo, isifo senhliziyo kanye ne-nephropathy yizihlobo ezivamile zabanesifo sikashukela.

Kepha abanesifo sikashukela kudingeka baqonde into eyodwa ebaluleke kakhulu: ngamandla akhe ukusondeza noma ukubambezela isikhathi sokubonakaliswa kwalezi zinkinga ezinkulu. Uma ethatha isifo sakhe ngokungathi sína, siyothamba. Kepha kufanele uvele usonge isandla sakho ku-regimen and control - futhi uzothola isethi ephelele yezinkinga ezifika sekwephuze iminyaka embalwa ngemuva kokuqala kwesifo sikashukela.