Izindlela zokuxilongwa kwesifo sikashukela - kutholakala nini futhi liphi ushukela wegazi?

Isifo sikashukela mellitus (DM) yisifo se-multifactorial.

I-Pathology ihlotshaniswa nokungakwazi ukusetshenziswa kwe-glucose yizicubu ngenxa yokushoda kwe-insulin noma ngenxa yokwehla kokuqothuka kwamaseli we-kwelitshe isenzo se-pancreatic hormone.

Khomba isifo se-metabolic ngokwemiphumela yokuhlolwa okuningi. Imihlahlandlela yomtholampilo inikezela izinkomba ezicacile zencazelo lapho ushukela kutholakala ukuthi unesifo sikashukela.

Izindlela zokuxilonga

I-DM yenzeka ngezindlela ezimbili ezinkulu. Isithombe esibonakalayo sikhonjiswa yizimpawu ezibonakalayo eziba yisizathu sokutadisha okujulile. Kukhona nenkambo yakamuva yesifo sikashukela, ehlanganisa ukutholwa kokuqala kokuphazamiseka kwe-metabolic.

Isifo sikashukela esifihlekile kwesinye isikhathi kuvame ukutholwa ngengozi ngesikhathi sokuhlolwa noma kokuphathwa kweziguli ngokunye ukwelashwa.

Kungakhathalekile ukuthi iminyaka yobudala yokuhlolwa kwezokwelapha, iziguli ezikhuluphele kakhulu kanye nokuba khona kwalezi zinto ezilandelayo zingaphansi:

• ukuntuleka kwemisebenzi yezimoto. I-Hypodynamia iyimbangela eyinhloko yokuphazamiseka kwe-metabolic;
• umthwalo wefa. Isandulela sofuzo sokumelana ne-insulin nokwakhiwa kwezinqubo ze-autoimmune maqondana nama-antigen pancreatic sekufakazelwe;
• umlando wesifo sikashukela sokukhulelwa. Ukuvela kwesifo sikashukela kwabesifazane abane-metabolic kumonakala kwe-glucose ngesikhathi sokukhulelwa kukhuphuka kaningi;
• umfutho wegazi ophakeme. Ukucindezela kusuka ku-140/90 mm Hg Ubuciko. kubantu abane-BMI engama-25 kg / m2, kuvame ukuhambisana nokwenyuka koshukela wegazi. Ingqikithi yalezi zibonakaliso yi-metabolic syndrome;
• dyslipidemia. Ukwanda kwezingxenyana zama-protein e-atherogenic kanye nokwehla kwe-HDL engaphansi kuka-0.9 kungangena esithombeni sikashukela;
• isifo senhliziyo
• ukunciphisa ukubekezelela kwe-glucose noma i-hyperglycemia yangempela yokuzila.

Izinqubo zomzila zifaka ukuhlolwa kwe-glucose esiswini esingenalutho kanye ne-urinalysis ejwayelekile. Igazi likashukela ngokuqokwa okuhleliwe kufanele kunikelwe ngemuva kwekhefu lehora lesishiyagalombili lokudla. Ukuhlolwa kwenqatshelwe ukubhema ekuseni ngaphambi kokuthatha isivivinyo, kuvunyelwe ukuphuza amanzi ngaphandle kwegesi.

Ucwaningo olwengeziwe lwegazi lufaka ukuhlolwa kokubekezelela i-glucose (OGTT noma i-PHTT). Lolu cwaningo lwenziwa ngemiphumela emangazayo yesampula yegazi elula kashukela.

Ezinsukwini ezintathu ngaphambi kokwelashwa, isiguli silandela ukusebenza okujwayelekile komzimba nokudla kokudla. Imenyu yansuku zonke kulesi sigaba sokulungiselela kufanele ibe nama-150 g wama-carbohydrate.

Ngobusuku besifundo, isidlo sasebusuku asidlulanga i-20: 00. Ukuzila ukudla okuphelele ngaphambi kokuhlolwa okungenani amahora angama-8. Ekamelweni lokwelashwa, isiguli sinikezwa ingilazi kashukela oxutshwe (75 g wezinsalela ezomile zoshukela omsulwa). Isixazululo sonke kumele sidakwe emizuzwini emi-5. Ngemuva kwamahora amabili, kuthathwa igazi.

Ukunquma izinga lesinxephezelo se-glycemic, okuqukethwe kwe-hemoglobin ye-glycated kufundwa. I-HbA1c ikhombisa isilinganiso soshukela egazini esiye saqhubeka ezinyangeni ezintathu ezedlule. Ukuhlaziywa akudingi ukulungiswa okukhethekile nokubulawa yindlala, kunokuhluka okungatheni maqondana nokulimala nokutheleleka kwangaphambilini.

Uhlangothi olubi lokucwaninga ngamathuba aphezulu wokuphambuka ku-anemia kanye ne-hemoglobinopathy. Ukwehlukahluka kohlobo I nesifo sikashukela sohlobo II, kanye nokubikezela amathuba okuthuthukisa i-pathology, kwenziwa ngocwaningo lwe-C-peptide kanye nokunye okumaka kwe-serological.

Izimpawu zesifo

Umtholampilo wesifo sikashukela uhlobene ngqo nokuqukethwe okuphezulu kwe-glucose, ukuntuleka kokufakwa kwayo ngezicubu kanye nokwakhiwa kabusha kwe-metabolism.

Kunezimpawu ezintathu "ezinkulu" zesifo sikashukela:

• polydipsia. Umuntu uzwa ukomela kakhulu. Ukwanelisa isidingo sokuphuza, isiguli siphoqelelwa ukusebenzisa amalitha afinyelela ku-3-5 uketshezi ngosuku;
• polyuria. I-Hyperglycemia iholela ekwandeni kokuphuma komchamo yizinso. I-glucose njengemvelo esetshenziswayo ngokwangempela idonsa amanzi ngayo. Isiguli esinesifo sikashukela siphawula ukuchama kaningi. Isimo sihambisana nesidingo sokuhamba ebusuku ukuya endlini encane (i-nocturia);
• polyphagy. Njengoba ukuthathwa komkhiqizo wamandla oyinhloko kungenasisekelo, umuntu uhlala elambile. Abantu abanesifo sikashukela bakhulisa hamu. Iziguli ezinesifo sikashukela sohlobo II zibukeka zondlekile kahle. Abantu abaphethwe yisimo esincike emgomeni we-insulin basheshe banciphise umzimba ekuqaleni kwesifo.

Izimpawu ezisele zesifo sikashukela zibonakala ezimfanelweni ezahlukahlukene. Ukuqhekeka kwamaprotheni kunomthelela ekunciphiseni kwesisindo semisipha kanye nokuvela kwezinguquko ezibhubhisayo emathanjeni. Ingozi yokuqalwa kwamathambo nokuqhekeka "uphume kolwandle oluhlaza okwesibhakabhaka."

Ukwanda kwama-lipoprotein e-atherogenic, kanye nomphumela olimazayo we-hyperglycemia, kucasula ama-micro- kanye nama-macroangiopathies. Isilonda semithambo yesikhumba sabazali kubonakaliswa ukubomvu kwezihlathi, isilevu, ibunzi.

Ukubona kuyawohloka. Isisekelo se-morphological se-retinopathy ukuhlukaniswa kwama-arterioles kanye nama-capillaries, ama-hemorrhages kanye nokwakhiwa kwemikhumbi engabonakali yemvelo.

Iziguli eziningi zibika ukwehla kwenkumbulo nokusebenza kwengqondo. Ubuthakathaka, ukukhathala, ikhanda, isiyezi yizimpawu zokungondleki. Isifo sikashukela i-mellitus siba yisizinda sokuthuthukiswa kwemivimbo kanye nokuhlaselwa yisifo senhliziyo. Ukwehlulwa kwemithambo ye-coronary kuvusa ukuhlaselwa kobuhlungu besifuba.

Izinkinga zezinhlaka zezinzwa zibonakaliswa ngendlela yama-polyneuropathies. Izinguquko ekuthinteni, ukuzwa kobuhlungu kubangela ukulimala ezinyaweni naseminweni. Ukuwohloka kwezicubu trophism kuholela ekwakhekeni kobunzima bokupholisa amanxeba. Kukhona ukuthambekela kokuthuthukisa i-panaritium ne-paronychia.

Isifo se-hyperglycemia esingamahlalakhona sithinta kabi ukungasebenzi komzimba komzimba.

Iziguli ezinesifo sikashukela zivame ukutheleleka njalo ezifweni ezithile zasekhaya. Iziguli zivame ukuhlukunyezwa yi-gingivitis, caries, isifo se-periodontal. I-Staphilo- ne-streptoderma inamathele kalula.

I-thrush evamile, isikhumba esomile nolwelwesi lwama-mucous, ukulunywa ku-perineum kuyizibonakaliso ze-pathognomonic ze-hyperglycemia.

Izinkomba Zesifo

Amanani angaphezu kwe-6.1 mmol / L lapho uthatha i-biomaterial kusuka emunweni noma esithendeni kanye no-7.0 mmol / L kusuka kumthambo kukhombisa isifo sikashukela i-mellitus.

Ukuxilongwa kuqinisekiswa ukuhlolwa kokubekezelela i-glucose: amahora ama-2 ngemuva kwe-PHTT, inkomba ifinyelela ku-11.1 mmol / L.

Ukuqinisekisa ukuphazamiseka kwe-metabolic, i-glycosylated hemoglobin iyalinganiswa. I-HbA1c enkulu kune-6.5% ikhombisa ukuba khona kwe-hyperglycemia isikhathi eside. Inani lesikhombi ebangeni lisuka ku-5.7 liye ku-6.4% libonakala ngokubhekisele ezingcupheni zokuthola ushukela esikhathini esizayo esiseduze.

Kungenzeka ukubona ezinye iziphazamiso ze-glucose metabolism:

I-biochemistry yegazi ibonisa ukwephulwa kwamaprotheni kanye ne-lipid-carbohydrate metabolism. I-Urea, cholesterol, LDL, VLDL iyakhuphuka.

Amavidiyo ahlobene

Mayelana nenqubo yokuxilongwa kuvidiyo:

Ngokusho kokuhlolwa kwelebhu kanye nesithombe somtholampilo, ukuxilongwa kungasungulwa ngokuthembekile. Ucwaningo olwengeziwe lwe-C-peptide, ama-autoantibodies kuma-protein abo, kanye nokuxilonga izakhi zofuzo kusiza ekuboneni ubunjalo kanye nendlela yesifo esigulini esithile. Ukuhlola okuhleliwe kwezinkomba ku-Dynamics kukuvumela ukuthi ulawule ukunemba kokwelashwa, uma kunesidingo, wenze ukulungiswa kwezokwelapha.