Ngeshwa, isifo sikashukela sitholakala kaningi: abadala kanye nezingane bahlupheka ngakho. Isifo sikashukela siyingozi ezinkingeni zaso: uma sishiywa singalashwa, ama-pathologies angathi sína angakhula aze afe.
Kwesinye isikhathi i-pathology ayizivezi, kwesinye isikhathi izimpawu zesifo sikashukela zingaqanjwa njengezinye izifo.
Ukuxilonga kahle, kusetshenziselwa ukuxilongwa kwesifo sikashukela esihlukile, okuvumela hhayi ukuhlukanisa ushukela nezinye izifo, kodwa futhi nokuthola uhlobo lwaso futhi kunikeze ukwelashwa okuyikho futhi okusebenzayo.
Indlela Yokuxilonga
I-World Health Organisation isungule imigomo elandelayo yokuxilongwa kwesifo sikashukela:
- izinga likashukela wegazi lidlula i-11.1 mmol / l ngesilinganiso esingahleliwe (okungukuthi, isilinganiso senziwa nganoma yisiphi isikhathi sosuku ngaphandle kokubheka isidlo sokugcina);
- ukugcwala kwe-glucose egazini lapho kulinganiswa esiswini esingenalutho (okungukuthi, okungenani amahora angama-8 ngemuva kokudla kokugcina) kweqa ngo-7.0 mmol / l;
- ukugcwala kweglucose egazini kudlula amahora ayi-11.1 mmol / l 2 ngemuva komthamo owodwa wama-75 g we-glucose (ukuhlolwa kokubekezelela ushukela).
Ngaphezu kwalokho, okulandelayo kubhekwa njengezimpawu zakudala zesifo sikashukela:
- polyuria - ukwanda okukhulu kokuchama, isiguli hhayi nje kuphela “sigijimela” ukuya endlini encane, kodwa kwenziwa umchamo omningi kakhulu;
- polydipsia - ukoma ngokweqile, isiguli sihlala sifuna ukuphuza (futhi siphuza amanzi amaningi);
- ukunciphisa umzimba ngaphandle kwesizathu esibonakalayo - akugcinwanga zinhlobo zonke ze-pathology.
Ukuxilongwa okwehlukile kohlobo 1 sikashukela nohlobo 2 sikashukela
Ngaphandle kokuthi zonke izinhlobo zikashukela zinezimpawu ezifanayo, ziyahlukahluka kakhulu ngenxa yezimbangela nezinqubo ze-pathological emzimbeni. Kungakho ukuxilongwa ngokufanele kohlobo lwesifo sikashukela kubaluleke kakhulu, ngoba ukuphumelela kokwelashwa ngqo kuncike kulokhu.
Kunezinhlobo ezinhlanu eziphambili zesifo sikashukela:
- Thayipha isifo sikashukela sokuqala - umzimba awukhiqizi i-insulin;
- Thayipha isifo sikashukela sesi-2 - kuvezwe ngokulahleka kokuzwela kwe-insulin;
- kwezokuxhumana - okubizwa ngokuthi "ushukela okhulelwe" - kubonakala ngesikhathi sokukhulelwa;
- i-steroid - umphumela wokuphulwa kokukhiqizwa kwama-hormone yizindlala ze-adrenal;
- non-ushukela - Umphumela wokuphazamiseka kwe-hormonal ngenxa yezinkinga nge-hypothalamus.
Ngokwezibalo, isifo sikashukela sohlobo 2 sivame ukutholakala kakhulu - sithinta cishe ama-90% eziguli ezitholakele isifo sikashukela. Isifo sikashukela sohlobo 1 asivamile kakhulu - sitholakala cishe kwabangu-9% abanesifo sikashukela. Izinhlobo ezisele ze-akhawunti yesifo cishe zingu-1% wokuxilongwa.
Thayipha isifo sikashukela sokuqala
Uhlobo 1 sikashukela i-mellitus senzeka ngenxa yokuphazamiseka ekwenziweni komzimba kwe-insulin ye-hormone: kungenzeka akwanele noma akukhona nhlobo.
Isizathu salokhu kuphazamiseka kwama-hormone kulele ekwehlulekeni kwe-autoimmune: amasosha omzimba aphumelelayo “abulala” amaseli akhiqiza i-insulin.
Ngesinye isikhathi, i-insulin iba yincane kakhulu ukuba yehlise i-glucose, bese izinga likashukela wegazi likhuphuka kakhulu.
Yingakho isifo sikashukela sohlobo 1 sivele ngokuzumayo; imvamisa ukuxilongwa kokuqala kwandulelwa yikhehla likashukela. Ngokuyisisekelo, lesi sifo sitholakala ezinganeni noma kubantu abadala abangaphansi kweminyaka engama-25, kaningi kubafana.
Izimpawu ezihlukile zesifo sikashukela sohlobo 1 yilezi:
- ushukela ophakeme;
- cishe ukungabikho ngokuphelele kwe-insulin;
- ukuba khona kwama-antibodies egazini;
- izinga eliphansi le-C-peptide;
- ukwehla kwesisindo kweziguli.
Thayipha isifo sikashukela sesi-2
Isici esahlukile sohlobo lwes 2 sikashukela ukumelana ne-insulin: umzimba uyangazwela i-insulin.
Ngenxa yalokhu, i-glucose ayidilizi, futhi ipancreas izama ukukhiqiza i-insulin ethe xaxa, umzimba usebenzisa amandla, kanti futhi noshukela wegazi usuphakanyisiwe.
Izimbangela zesehlakalo zhlobo lwe-2 yezifo zemvelo azaziwa, kepha sekutholakele ukuthi cishe ezimaphesenti angama-40 lesi sifo siyifa.
Futhi, bavame ukuhlupheka ngabantu abakhuluphele kakhulu abaphila impilo engenampilo. Engcupheni abantu abavuthiwe abangaphezulu kweminyaka engama-45, ikakhulukazi abesifazane.
Izimpawu ezihlukile zohlobo 2 sikashukela yilezi:
- ushukela omkhulu
- amazinga e-insulin aphezulu (angaba evamile);
- amazinga aphakeme noma ajwayelekile e-C-peptide;
- i-hemoglobin ephawuleke kahle kakhulu.
Imvamisa, isifo sikashukela sohlobo lwesibili sinesymptomatic, sivele sisezigabeni zakamuva ngokubonakala kwezinkinga ezahlukahlukene: izinkinga zokubona ziyaqala, amanxeba aphola kahle, kanti nemisebenzi yezitho zangaphakathi iyalimala.
Ithebula lokungefani phakathi kwezindlela zesifo ezincike kuma-insulin
Njengoba imbangela yesifo sikashukela sohlobo 1 ukuntuleka kwe-insulin, ibizwa ngokuthi i-insulin-kuncike. Isifo sikashukela sohlobo 2 sibizwa ngokuthi yi-insulin-Independent, njengoba izicubu zingaphenduli nje nge-insulin.
Umehluko omkhulu phakathi kwezinhlobo ezimbili zikashukela zikhonjisiwe etafuleni:
| Qhathanisa nenqubo | Thayipha isifo sikashukela sokuqala | Thayipha isifo sikashukela sesi-2 |
| Isizungu | kuyaqabukela | kaningi |
| Isisindo sesineke | Ngezansi okujwayelekile | Ukukhulupha ngokweqile, ukukhuluphala esiswini |
| Iminyaka yesineke | Ngaphansi kweminyaka engama-30, imvamisa izingane | Bangaphezu kweminyaka engama-40 ubudala |
| Inkambo yalesi sifo | Kutholwe kungazelelwe, izimpawu zivele kakhulu | Kubonakala kancane, kukhula kancane, izinkomba zifakiwe |
| Izinga le-insulin | Phansi kakhulu | iphakanyisiwe |
| Izinga lama-C-peptides | Phansi kakhulu | phezulu |
| Ukumelana ne-insulin | cha | ikhona |
| I-Urinalysis | IGlucose + acetone | ushukela |
| Inkambo yalesi sifo | Ngokukhuphuka, ikakhulukazi esikhathini sekwindla-nobusika | uzinzile |
| Ukwelashwa | Imijovo yokuphila yonke ye-insulin | Ukudla, ukuvivinya umzimba, izidakamizwa ezinciphisa ushukela |
Umehluko ukuxilongwa kwesifo sikashukela kanye nesifo sikashukela insipidus
Ngaphandle kokuthi ezinye izinhlobo zesifo sikashukela azivamile, ukuxilongwa okuhlukile kuyasivumela ukuba sibahlukanise. Kuqabukela kakhulu (ezimweni ezi-3 kwabangu-100 000) ukutholakala kwesifo sikashukela - isifo se-endocrine lapho, ngenxa yokuphazamiseka kwamahomoni, inqubo yokwakheka komchamo nokuhoxiswa iphazamiseka: ngenxa yokuntuleka kwama-hormone athile, umzimba awutholi amanzi, futhi uchazwa emchameni, okuwukuthi, uqhakazile Izimpawu ze-polyuria ne-polydipsia ziyabonakala.
Imbangela yalesi sifo kuvame ukuvuvukala i-hypothalamus noma i-pituitary gland, kanye nefa.
Izimpawu ezihlukile zesifo sikashukela yilesi:
- ukuchama okweqile (umthamo womchamo ungafinyelela kumalitha ayi-10-15 ngosuku);
- ukoma okukhulu okunganqamukiyo.
Umehluko omkhulu phakathi kwesifo sikashukela nesifo sikashukela unikezwa etafuleni:
| Qhathanisa nenqubo | Isifo sikashukela mellitus | Isifo sikashukela |
| Umile | kuveziwe | kukhulunyisiwe |
| Ukukhishwa komchamo | Kufika kumalitha angama-2-3 | kusuka kumalitha amathathu kuya kwayi-15 |
| Izikhathi zemini zasebusuku | cha | kuyenzeka |
| Kukhuphuka ushukela wegazi | yebo | cha |
| IGlucose emchameni | yebo | cha |
| Ukuqala nenkambo yalesi sifo | kancane kancane | bukhali |
Izinkinga zesifo sikashukela zihlukaniswa kanjani?
Isifo sikashukela "saziwa" ngenxa yezinkinga zaso. Izinkinga zihlukaniswe zibe zimbi futhi zingamahlalakhona: i-acute ingakhula emahoreni ambalwa noma imizuzu, ifomu elingapheli eminyakeni futhi amashumishumi eminyaka.
Izinkinga ezinkulu kakhulu ziyingozi. Ukuze ubavimbele, kufanele ubheke njalo ushukela wegazi (imitha izosiza) futhi ulandele izincomo zikadokotela.
I-Hypoglycemia
I-Hypoglycemia iyinkimbinkimbi kakhulu, ebonakala ngokuncipha okukhulu kwezinga loshukela (ngaphansi kwamanani ajwayelekile).
Ngohlobo 1 sikashukela, isimo esinjalo kungenzeka uma kwenzeka kudliwa ngokweqile i-insulin emzimbeni (ngokwesibonelo, ngenxa yemijovo noma amaphilisi), ngohlobo 2 sikashukela - ngenxa yokusebenzisa izidakamizwa ezwehlisa ushukela.
I-insulin engaphezulu iholela eqinisweni lokuthi ushukela udonswa ngokuphelele, futhi ukugxila kwalo egazini kwehle ngamanani aphansi kakhulu.
I-Hyperglycemia
I-Hyperglycemia yisimo se-pathological lapho izinga kashukela wegazi liphakeme kakhulu kunokwejwayelekile. I-Hyperglycemia ingakhula ngaphandle kokuthola ukwelashwa okufanelekile, uma kwenzeka kungenayo i-insulin (ngokwesibonelo, ukweqa umjovo weziguli ezinesifo sikashukela sohlobo 1), ukusetshenziswa kokudla okuthile noma utshwala, kanye nengcindezi.
Isifo sikashukela sikashukela
Ukuhlaselwa kwe-hypo- noma i-hyperglycemia engamiswa ngesikhathi kuholela ezinkingeni ezibulalayo: isifo sikashukela.Lezi zimo zanda ngokushesha okukhulu, zibonakaliswa ukulahlekelwa ukwazi, uma kungekho usizo, isiguli singafa.
I-coma ejwayelekile kakhulu ye-hypoglycemic, ebonakala ngokuncipha kwamazinga kashukela ukuya ku-2-3 mmol / l, okuholele ekutheni kubulawe ubuchopho obukhulu.
Isikungu esinjalo sikhula ngokushesha okukhulu, ngokoqobo emahoreni ambalwa. Izimpawu zanda kancane kancane: kusuka ku-nausea, ebuthakathakeni, ekulahlekelweni kwamandla ukudideka, ukukhishwa inyumbazane kanye nokuphefumula uqobo.
Lapho amazinga kashukela enyuka emazingeni abucayi, i-hyperglycemic coma noma i-ketoacidosis yesifo sikashukela ingahle ikhule. Le nkinga ibonakala ngokwanda koshukela ngaphezulu kwe-15 mmol / l ne-metabolic acidosis - imikhiqizo yokuqhekeka kwama-asidi namafutha aqongelela egazini.
I-Hyperglycemic coma iba phakathi nosuku futhi ibonakala ngezimpawu eziphawuliwe: ukoma, ukuchama ngokweqile, ukubulala, ukudonsa, izimpunga zesikhumba, ukudideka. Isiguli kudingeka sibize ngokushesha i-ambulensi.
Isifo sikashukela
Ushukela ophezulu wegazi uthinta imithambo yegazi kabi, ikakhulukazi izitsha zemilenze.
Ngenxa yalokhu, unyawo lwesifo sikashukela lungakhulisa inkinga ezigulini ezinesifo sikashukela - ukuwohloka kokugeleza kwegazi kuholela ekubonakaleni kwezilonda ezingapholiyo (ezinesifo sikashukela, amanxeba ngokuvamile aphulukisa kabi), ukulimala kwemithambo yegazi, futhi kwesinye isikhathi amathambo.
Ezimweni ezimbi kakhulu, i-gangrene ingahle ikhule futhi ukunqunywa konyawo kungadingeka.
Amavidiyo ahlobene
Ekuhlolweni okuhlukile kohlobo 1 nesifo sikashukela 2 kuvidiyo:
Izindlela zanamuhla zokuxilonga nokwelapha isifo sikashukela zisiza ukugwema zonke izingqinamba ezimbi kakhulu, futhi ngokuya ngemithetho ethile, impilo yesifo sikashukela ayinokwahluka empilweni yabantu abangahlushwa yilesi sifo. Kepha ukufeza lokhu, kutholakala isifo esifanelekile futhi esifike ngesikhathi.
