Isifo sikashukela i-mellitus satholakala okokuqala kubantu isikhathi eside. Ngalesi sikhathi, umuthi ukwazile ukusitadisha kahle lesi sifo, sibonga imininingwane esiyitholile, manje wonke udokotela uyakwazi ukusibona kalula.
Ngenxa ye-pathophysiology yesifo sikashukela, ongoti bayayiqonda imishini yezinkambo zayo futhi banquma ukwelashwa okufanele kakhulu.
I-Pathological physiology: kuyini?
I-Pathological physiology yisayensi enhloso yayo ukutadisha impilo yomuntu ogulayo noma yesilwane.
Inhloso eyinhloko yalesi siqondisi ukutadisha indlela yokuthuthukiswa kwezifo ezahlukahlukene kanye nenqubo yokwelapha, kanye nokuthola imithetho esemqoka futhi ejwayelekile yokusebenza kwezinhlelo ezahlukene nezitho zabagulayo.
Yiziphi izifundo ze-pathological physiology:
- ukuthuthukiswa kwezinqubo ezahlukahlukene zokugula, kanye nemiphumela yazo;
- amaphethini okuvela kwezifo;
- isimo sokukhula kwemisebenzi yomzimba ngokuya ngesimo somzimba womuntu ngama-pathologies ahlukahlukene.
I-pathophysiology yesifo sikashukela
Uhlobo olu-1
Kuyaziwa ukuthi inqubo ye-pathophysiological yokuthuthukisa uhlobo lwesifo sikashukela isuselwa esilinganisweni esincane se-insulin ekhiqizwa amaseli e-endocrine.
Isifo sikashukela ngokuvamile siyaqhubeka kulesi sigaba ku-5-10% weziguli, ngemuva kwalokho, ngaphandle kokwelashwa okudingekayo, siqala ukuthuthuka futhi sibe imbangela yokuthuthuka kwezinkinga eziningi ezinzima, kufaka phakathi:
- isifo sikashukela senhliziyo;
- ukwehluleka kwezinso;
- ketoacidosis;
- i-retinopathy yesifo sikashukela;
- isifo sohlangothi;
- isifo sikashukela sonyawo lwesifo sikashukela.
Ngenxa yokuba khona kokuntuleka kwe-insulin, izicubu ezixhomekeke kuma-hormone zilahlekelwa amandla abo okumunca ushukela, lokhu kuholela ku-hyperglycemia, okungenye yezimpawu eziphambili zohlobo lwe-1 yesifo sikashukela mellitus.
Ngenxa yokuvela kwale nqubo kwizicubu ze-adipose, ama-lipid aqhekeka, okuba yisizathu sokwanda kwezinga lawo, futhi inqubo yokuqhekeka kwamaprotheni izicubu zemisipha iyaqala, okuholela ekwandeni kokudla kwama-amino acid.
Izinhlobo ezi-2
Isifo sikashukela sohlobo II singabonakala ngokushoda kwe-insulin, okungaba nezinhlobo ezi-3 zokuphazamiseka:
- umkhuba wokumelana ne-insulin. Kukhona ukwephulwa kokusetshenziswa kwemiphumela ye-insulin, kuyilapho i-β-cell igcinwa futhi ikwazi ukukhiqiza inani elanele le-insulin;
- imfihlo yokushoda kwe-ory-cell. Lokhu kwephulwa yisici sofuzo lapho amangqamuzana β engabhubhisi khona, kepha ukugcinwa kwe-insulin kuncishiswa kakhulu;
- umphumela wezinto eziphikisanayo.
Ukuvela kokumelana ne-insulin kungenzeka emazingeni e-receptor kanye ne-postreceptor.
Izinqubo ze-receptor zifaka:
- ukucekelwa phansi kwama-receptors ngama-radicals wamahhala nama-enzyme e-lysosome;
- i-blockade of insulin receptors by antibodies eba abalingisi besakhiwo sayo;
- ushintsho ekuhlanganisweni kwama-insulin receptors ngenxa yokuvela kwesici sofuzo;
- ukwehla kokuzwela kwamaseli okuqondiswe kuye kwe-insulin ngenxa yokwanda okuqhubekayo ngokwanele kokuhlushwa kwe-insulin egazini kubantu abahlala bedla ngokweqile;
- ushintsho ekuhlanganisweni kwama-insulin receptors ngenxa yesiphene ezinhlotsheni ezisebenza ekubumbeni kwama-polypeptides abo.
Amasu we-Postreceptor afaka:
- ukwephulwa kwezinqubo ezibucayi zokuqeda ushukela;
- ukunganele kwabathuthi be-transmembrane glucose. Le nqubo ibonwa ikakhulukazi kubantu abakhuluphele.
Izinkinga Zesifo Sikashukela
Isifo sikashukela kufanele siqaphe isimo sabo, ukunaka izincomo zikadokotela kungaholela ekwakhiweni kwezinkinga ezahlukahlukene:
- ubunzima bezinkinga. Lokhu kufaka phakathi i-ketoacidosis (ukunqwabelana kwemizimba ye-ketone eyingozi emzimbeni), i-hyperosmolar (ushukela omningi nesodium ku-plasma) ne-lacticidotic (ukugcwala kwe-lactic acid egazini) ikhesa, i-hypoglycemia (ukwehla okunzima kweshukela egazini);
- ubunzima obungamahlalakhonamina. Ukubonakaliswa, njengomthetho, ngemuva kweminyaka eyi-10-15 yokuba khona kwalesi sifo. Kungakhathalekile ukuthi unjani umbono wokwelashwa, isifo sikashukela siwuthinta kabi umzimba, okuholela ezinkingeni ezingapheli, izitho ezinjalo ziyahlupheka: izinso (ukungasebenzi kahle kanye nokungasebenzi kahle), imithambo yegazi (ukuvunyelwa okungalungile, okuphazamisa ukuthathwa kwezinto eziwusizo nomoya-mpilo), isikhumba (ukunikezwa kwegazi elincane, izilonda ezinde kakhulu) ), uhlelo lwezinzwa (ukulahleka kwemizwa, ubuthakathaka obungapheli nobuhlungu);
- Izinkinga ezifika sekwephuzile. Imiphumela enjalo ivame ukukhula kancane, kepha lokhu kuyingozi kwabanesifo sikashukela. Phakathi kwazo: i-angiopathy (fragility yemithambo yegazi), unyawo lwesifo sikashukela (izilonda kanye nezilonda ezifanayo zamaphethelo aphansi), i-retinopathy (ukukhipha i-retina), i-polyneuropathy (ukuntuleka kokuzwela kwezandla nezinyawo ukushisa nobuhlungu).
Izindlela ze-pathophysiological ekwelapheni isifo sikashukela
Lapho belapha noma yiluphi uhlobo lwesifo sikashukela, odokotela basebenzisa izimiso ezintathu eziyinhloko:
- ukwelashwa kwe-hypoglycemic;
- imfundo yeziguli;
- ukudla.
Ngakho-ke, ngohlobo lokuqala, kusetshenziswa i-insulin therapy, ngoba lezi ziguli zithola ukuntula kwayo ngokuphelele, futhi zidinga obambele esikhundleni. Umgomo wayo oyinhloko ukukhulisa ukulingisa kwama-hormone wemvelo.
Umthamo kufanele unqunywe kuphela ngudokotela oholayo esigulini ngasinye ngamunye. Endabeni yesifo sikashukela sohlobo 2, kusetshenziswa izidakamizwa ezinciphisa ushukela wegazi ngokushukumisa ama-pancreas.
Umthetho obalulekile wokwelashwa kokuxilongwa yisimo esifanele sesiguli kuye. Odokotela bachitha isikhathi esiningi befunda indlela efanele yokuphila nesifo sikashukela.
Ukudla kuvuselelwa kakhulu, imikhuba emibi nokucindezela kuyasuswa, ukuvivinya umzimba okulinganiselayo kuyangezelelwa, futhi isiguli sizodinga futhi njalo ukuqaphela inkomba yeglucose yegazi (glucometer ikhona lokhu).
Mhlawumbe, iziguli zikujwayela ukudla okukhethekile (ithebula No. 9) isikhathi eside kakhulu.
Kudinga ukukhishwa kwemikhiqizo eminingi, noma okunye esikhundleni sayo. Isibonelo, inyama enamafutha, inhlanzi kanye nomhluzi, ama-khekhe noswidi, ushizi we-canta, ukhilimu, ushizi onosawoti, ibhotela, i-pasta, i-semolina, ilayisi elimhlophe, izithelo ezimnandi, ukudla okubhakiwe ushukela omkhulu.
Ukudla okunye kungadliwa, kepha kufanele ubheke inani lama-kilojoule adliwayo ngosuku, kanye nenani lama-carbohydrate - akufanele kube khona okuningi kwawo.
Amavidiyo ahlobene
Mayelana ne-pathophysiology yesifo sikashukela kuvidiyo:
I-pathological physiology yesifo sikashukela ikuvumela ukuthi uthole imininingwane mayelana nezici zenkambo nokwelashwa kwalesi sifo. Ngohlobo lokuqala nolwesibili, kuhlukile.
