Ngabe isifo sikashukela yisifo esiyifa noma cha?

Uma izihlobo zakho eziseduze, futhi iningi labazali bakho, zinokuphazamiseka okungapheli kokufakwa kweglue (i-DM), khona-ke kuphakama umbuzo ngokuzithoba: “Ingabe isifo sikashukela sidluliselwa ngefa?”

Ukuthola impendulo enemininingwane, kufanelekile ukubhekisisa zonke izinto ezidala lesi sifo, kubandakanya ifa.

Ngabe isifo sikashukela siyazuzwa njengefa?

Ngokwedatha eshicilelwe ku- "International Endocrinology Journal" ngonyaka we-2017, kunezimbangela eziningana zesifo sikashukela:

• ukukhuluphala
• iminyaka ngemuva kweminyaka engama-45;
• ubuzwe
• isifo sikashukela sokukhulelwa;
• ukukhuphuka kwama-triglycerides;
• umsebenzi ophansi;
• ukucindezeleka okungapheli;
• ukuntuleka kokulala;
• i-polycystic ovary syndrome;
• ukuphazamiseka kwesigqi se-circadian;
• ifa lokuzalwa.

Ngokusho kososayensi, abahola phambili be-endocrinologists, izihlobo ezisondelene zeziguli ezinesifo sikashukela zisengozini yokuba nesifo sikashukela izikhathi eziphindwe kathathu kunawo wonke umuntu. Kwenziwe ucwaningo lwakwamanye amazwe kule ndawo.

Umphumela wokucwaninga uqinisekise ukuqagelwa okulandelayo kososayensi:

1. amawele angama-monozygotic athola ifa likashukela ku-5.1% yamacala;
2. akukho luthi olulodwa olunikela kubazali okufanele lusolwe ngokuthuthukiswa kwalesi sifo, kodwa kuningana;
3. ubungozi bokuthola isifo sikashukela bukhuphuka ngendlela ethile yokuphila (ukuhlala nje, ukudla okungenampilo, imikhuba emibi);
4. imvamisa isifo sikashukela sicasulwa ukuguqulwa kwezakhi zofuzo, okungahlotshaniswa nefa;
5. isici sokuziphatha kwezifundo, ukumelana kwabo nokucindezela kwabamba iqhaza elikhulu efeni likashukela. Uma umuntu engaphansi kwesaba, uvalo, wehlisa ingozi yokugula.

Ngakho-ke, akunakwenzeka ukusho ukuthi isifo sikashukela satholakala nge-100% amathuba. Umuntu angafaka ifa lokuqagela kuphela. Okusho ukuthi, izinhlobo zofuzo zidluliselwa ezihlotsheni ezithinta ukwanda kwamaphesenti obungozi bohlobo 1 nohlobo 2 lwesifo sikashukela.

Isizungu Nengozi

Thayipha isifo sikashukela sokuqala

Uhlobo 1 sikashukela lutholakala ebuntwaneni. Lesi sifo sibonisa ngokukhathala kwamanyikwe, ukuncipha kokukhiqizwa kwe-insulin. Kuyadingeka ukwenza i-insulin ukwelashwa nsuku zonke.

Izici nezingozi ezilandelayo zinomthelela ekuqubukeni kwesifo sikashukela sohlobo 1:

• ifa. Ingozi yalesi sifo inyuka ifike kuma-30% uma izihlobo eziseduzane zitholakala ukuthi zinesifo sikashukela;
• ukukhuluphala. Amadigri okuqala okukhuluphala adala ushukela kaningi, ibanga 4 likhulisa ubungozi bohlobo 1 sikashukela ngama-30- 40%;
• i-pancreatitis. I-pancreatitis engapheli esimweni esithuthukile ithinta izicubu ze-pancreatic. Izinqubo azinakuguqulwa. Hola ukuthayipha isifo sikashukela esingu-1 ku-80-90% yamacala;
• izifo ze-endocrine. Ukukhiqizwa okuncane futhi okunganele kwe-insulin okuhambisana nezifo ze-yegilo kuphakamisa isifo sikashukela emaphesheni angama-90%;
• isifo senhliziyo. Ingozi yohlobo lwe-1 yesifo sikashukela kuma-cores iphezulu. Lokhu kungenxa yendlela yokuphila engenzi lutho, ukuntuleka kokudla;
• imvelo. Ukuntuleka komoya ohlanzekile namanzi kuthoba umzimba. Ukuzivikela komzimba obuthakathaka akumelani nenkambo yesifo, amagciwane;
• indawo yokuhlala. Izakhamizi zaseSweden, eFinland zihlushwa isifo sikashukela sohlobo 1 kaningi, bonke abanye abantu emhlabeni.
• ezinye izimbangela: ukuzalwa sekwedlule isikhathi, i-anemia, i-sclerosis eminingi, ukucindezela, ukugonywa kwengane.

Izici zamafa zesifo sikashukela sohlobo 1 zihlanganisa ukudluliselwa kusuka esizukulwaneni esidala kuya kuma-antibodies amancane (ama-autoantibodies) alwa namaseli wezinto ezihlangene. Lokhu kufaka phakathi:

1. ama-antibodies amaseli we-beta aslet;
2. IAA - anti-insulin antibodies;
3. I-GAD - ama-antibodies ukuze glutamate decarboxylase.

Uhlobo lokugcina lubamba iqhaza elibaluleke kakhulu ekwakhiweni kwesifo sikashukela sohlobo 1 ezinganeni. Ukuba khona kweqembu le-antibodies emzimbeni wosana olusanda kuzalwa akusho ukuthi lesi sifo sizokhula. Kuyafaneleka ukubheka izici ezingeziwe zempilo, ukukhula kwengane.

Izinhlobo ezi-2 zesifo sikashukela

Uhlobo 2 sikashukela asidingi i-insulin eyengeziwe. I-hormone ikhiqizwa, inani layo lijwayelekile, kepha amaseli omzimba awakuboni ngokuphelele, alahlekelwa umuzwa wawo.

Ukwelashwa, kusetshenziswa imishanguzo enciphisa ukungatheleleki kwezicubu ku-insulin. Izici zobungozi zokuvela kwesifo sikashukela sohlobo 2 zingahlukaniswa ngezinhlobo ezi-2: ezingashintshashintshwa futhi ezingenakuvinjwa.

Iyashintshwa (iyasebenziseka ekuphatheni komuntu):

• ukukhuluphala;
• ukuphuza okunganele;
• ukuntuleka kokuzivocavoca umzimba;
• ukungondleki;
• isifo sikashukela sokukhulelwa;
• umfutho wegazi ophakeme
• ukubhema
• isifo senhliziyo
• izifo
• ukukhuluphala ngokweqile kwesisindo kwabesifazane abakhulelwe;
• i-autoimmune pathologies;
• ukungasebenzi kahle kwe-yegilo yegilo.

Ayikwazi ukuguquguquka (ayikwazi ukushintshwa):

• ifa. Ingane ithatha isisekelo sokukhula kwesifo kubazali;
• umjaho
• ubulili
• iminyaka

Ngokwezibalo, abazali abangenaso isifo sikashukela bangaba nengane egulayo enesifo sikashukela sohlobo lokuqala. Umuntu osanda kuzalwa udla ifa lalesi sifo ezihlotsheni ezizukulwaneni ezi-2.

Emgqeni wesilisa, isifo sikashukela sidluliselwa kaningi, kowesifazane - singama-25% ngaphansi. Indoda nomkayo, bobabili abanesifo sikashukela, bayozala ingane egulayo enamathuba angama-21%. Esimweni lapho umzali 1 egula - kungenzeka i-1%.

Uhlobo 2 sikashukela mellitus yisifo esinamandla. Kubonakala ngokubandakanyeka kwezakhi zofuzo eziningi ku-pathogenesis (MODY nabanye). Ukwehla komsebenzi we-β-cell kuholela ekulimazeni i-carbohydrate metabolism, ukuthuthukiswa kwesifo sikashukela sohlobo 2.

Ukuguqulwa kwesakhi sofuzo se-insulin kuyimbangela evamile yesifo sikashukela kubantu asebekhulile. Izinguquko ezenzeka ku-receptor zithinta ukwehla kwezinga le-insulin biosynthesis, ukuhanjiswa kwe-intracellular, kuholele ekulimazekeni kokubopha kwe-insulin, ukucekelwa phansi kwe-receptor ekhiqiza le hormone.

Isigameko ezinganeni

Ezinganeni, isifo sikashukela sohlobo 1 sivame ukutholakala kakhulu. Ibizwa ngokuthi yi-insulin-kuncike. Ingane idinga imijovo ye-insulin nsuku zonke. Umzimba wakhe awukwazi ukukhiqiza inani elifanele le-hormone ukucubungula ushukela, onikeza umzimba amandla.

Ukuthuthukiswa kwalesi sifo ezinganeni kucasulwa yilezi zinto ezilandelayo:

• ukuqagela. Ifakwa ezihlotsheni eziseduze, ngisho nangemva kwezizukulwane eziningana. Lapho kutholwa isifo sikashukela ezinganeni, isibalo sazo zonke izihlobo ezigulayo, ngisho hhayi ezisondele kakhulu, siyabhekelelwa;
• ukukhuphuka koshukela kwabesifazane ngesikhathi sokukhulelwa. Kulokhu, ushukela udlula kwi-placenta ngokukhululeka. Ingane ihlushwa ukweqiwa kwakhe. Ukuzalwa ngesifo noma ingozi enkulu yokukhula kwayo ezinyangeni ezizayo;
• yokuphila kokuhlala phansi. Ushukela wegazi ngaphandle kokunyakaza komzimba wehla;
• amaswidi ngokweqile. Amakhandlela, ushokoledi ngamanani amakhulu avusa ukungasebenzi kahle kwe-pancreatic. Ukukhiqizwa kwe-insulin ye-hormone kuyancishiswa;
• ezinye izizathu: ukutheleleka njalo kwegciwane, ukusetshenziswa ngokweqile kwezidakamizwa zokugoma, ukungezwani komzimba.

Izindlela zokuthuthukisa lesi sifo

I-pathogenesis yesifo sikashukela incike kuhlobo nobudala isiguli.

Uhlobo 1 sikashukela lukhula ngokuya ngesimo esilandelayo:

1. ukuba khona kwezakhi zofuzo eziguqukayo kubantu. Zingavusa isifo;
2. umfutho wokuthuthukiswa kwesifo sikashukela (ukutheleleka, ukucindezela, njll);
3. ukwehla kancane kancane kwenani le-insulin emzimbeni. Ukuntuleka kwezimpawu zeminyaka engu-1-3;
4. ukuthuthukiswa kwesifo sikashukela esibekezelayo;
5. ukubonakala kwezimpawu zokuqala zalesi sifo: ukukhathala, i-malaise, umlomo owomile;
6. ukuthuthukiswa okusheshayo kwesifo. Ukwehla kwesisindo, ukuchama kaningi, ukulahleka kwengqondo, lapho ungekho khona ukwelashwa - ukukhohlisa isifo sikashukela;
7. ukuqeda ukukhiqizwa kwe-insulin;
8. ukulungiswa kwamazinga we-insulin ngokufakwa kwe-insulin.

I-pathogenesis yohlobo 2 sikashukela:

1. ukuthuthuka kancane kwesifo ngokumelene nesizinda sezinto ezicasulayo;
2. ukubonakala kwezimpawu zokuqala (ukoma, ukukhuphuka kwamazinga kashukela, ukuncipha kwesisindo);
3. ukulungiswa kwamazinga kashukela ngenxa yezondlamzimba nemithi yokunciphisa ushukela.

Izindlela zokuvimbela

Ukuvimbela isifo sikashukela sohlobo 1 nohlobo 2 kufaka izindlela ezimbalwa okuhloswe ngazo ukwenza ngcono impilo yabantu.

Bazali bezingane ezimiselwe ukuthayipha isifo sikashukela sokuqala kudingeka ukuthi zivikelwe kushukela kusukela ekuzalweni. Nazi izincomo ezimbalwa:

1. ukuncelisa ibele kuze kube unyaka owodwa noma ngaphezulu;
2. ukunamathela ekhalendeni lokugoma;
3. indlela yokuphila enempilo;
4. ukuhlinzeka ngokudla okufanele;
5. ukuqedwa kwengcindezi;
6. ukulawula isisindo somzimba;
7. ukuhlolwa okujwayelekile kwezokwelapha, ukuqapha ushukela.

Ukuvimbela ukuzalwa kwengane enesifo sikashukela sohlobo 1 kufanele kwenziwe ngowesifazane okhulelwe. Ukweqile, ukucindezela kufanele kugwenywe. Ukuzalwa kwengane eyeqile ngokweqile kufanele kubhekwe njengophawu lokuthi kungenzeka ukuthi kukhula isifo sikashukela sohlobo 1.

Izinyathelo eziphambili zokuvimbela isifo sikashukela sohlobo 2 zihlanganisa:

1. i-normalization yokudla okunempilo;
2. ukwehla kwenani loshukela ekudleni, emafutheni;
3. ukuphuza uketshezi oluningi;
4. ukusebenza komzimba;
5. ukunciphisa umzimba;
6. ukuvama ukulala;
7. ukuntuleka kwengcindezi;
8. ukwelashwa kwe-hypertension;
9. ukwenqaba ugwayi;
10. ukuhlolwa okufika ngesikhathi, ukuhlolwa kwegazi kwezinga loshukela.

Amavidiyo ahlobene

Mayelana nelifa likashukela kuvidiyo:

Isifo sikashukela isifo sikashukela yisifo esingazuzwanga njengelungelo lokuthola i-100%. Izakhi zofuzo zinegalelo ekwakheni lesi sifo ngokuhlanganiswa kwezinto eziningana. Isenzo esisodwa sofuzo, ukuguqulwa kwezakhi zofuzo akubalulekile. Ukuba khona kwabo kukhombisa kuphela ubungozi.