Izici zenkambo yalezi zifo, kanye nezindlela zokutholwa, ukwelashwa nezindlela zokuvikela kuzoxoxwa kabanzi.
Siyini isifo sikashukela se-lada (i-latent, i-latent)?
Isifo sikashukela i-lada sinoshukela kubantu abadala, okuyi-pathology yemvelo ye-autoimmune.Izimpawu zayo kanye nenkambo yokuqala kufana nesifo sikashukela sohlobo 2, kepha ku-etiology kusondele kweyokuqala, njengoba umzimba ukhiqiza amasosha omzimba ezinhlakeni ze-beta zamanyikwe kanye ne-glutamate decarboxylase.
Umsuka we-autoimmune we-lada - isifo sikashukela sisho ukwehluleka, okuholela emzabalazweni wamasosha omzimba ngomzimba wakhe, ikakhulukazi, namanyikwe.
Ngenxa yalokhu, umzimba uphelelwa amandla okusebenza ngokujwayelekile futhi wenze imisebenzi yawo ngokugcwele.
Umehluko kwisifo sikashukela
Ngakho-ke, imbangela yesifo sikashukela isifo sikashukela ukuphazamiseka kwe-autoimmune, ngakho-ke, ngezinqubo zokuthuthuka, kufana nokufana okuningi ngohlobo lwe-1 ushukela wezifo. Ezinye izazi ze-endocrinologists zivame ukuthi isifo sikashukela sokugcina sibe yi-subtype yefomu lokuqala, elithembele ku-insulin, ngoba i-pathology ye-latent ihlukaniswa njenge-1.5.
Kodwa-ke, ngokusho komtholampilo, izinhlobo 1 no-1.5 ziyehluka kakhulu, ngokwesibonelo, ngokuqhathaniswa nohlobo 1, onesifo sikashukela:
- Isimo se-pathologicals siqhubeka kancane, kube nezikhathi zokushintshana zokufunwa okukhulu kwe-insulin. Izimpawu zimnene. Ukubonakaliswa kokuqala okuphawulelayo kungenzeka kuminyaka ephakathi.
- Imvamisa azikho izimpawu ezinjengalezi zesifo sikashukela zokoma, ukukhuphuka kwesisindo somzimba, ukuncipha kwesisindo, i-ketoacidosis, nokunye.
Umehluko phakathi kwesifo sikashukela esenzeka kanye ne-pathology 2 amafomu yile:
- ukuntuleka kokukhuluphala;
- isidingo sokuphathwa kwe-insulin okwenzeka ngemuva kwesikhathi esithile (kuze kube iminyaka eyi-6);
- ama-antibodies anti-GAD, IAA, ICA akhona egazini, aqinisekisa isimo se-autoimmune yenqubo;
- ukuqoqwa kwe-C-peptides kungaphansi kwe-0,6 nmol / l, okubonisa ukushoda kwe-insulin;
- ukuxilongwa kukhombisa ubukhona egazini lamamaki ohlobo lwe-insulin exhomeke kwisifo sikashukela (ama-HLA alleles). Ukuhlaziywa okunjalo akwenziwa yizo zonke izindawo zokucwaninga izingane, kepha kuyadingeka lapho ukususwa kwezinkinga eziphikisanayo kudingekile ukuze kutholwe isifo.
- isimo sinxephezelwa kancane ngamathebhulethi anciphisa ushukela.
Amaqembu anobungozi
I-lada-kishukela itholakala nemvamisa ephakathi kuka-2 kuye ku-15% ezigulini ezinama-2 noshukela we-2 noshukela omningi. Esikhathini sikashukela salolu hlobo ngesisindo esijwayelekile, izinhlobo ze-autoimmune zibhaliswe cishe emaphesenti angama-50.
Odokotela bakhiqize izindlela ezi-5 zengozi yomtholampilo yokuphazamiseka kwe-lada:
- iminyaka yokutholwa kwe-pathology yesifo sikashukela ifinyelela eminyakeni engama-50;
- inkathi yokuqala ebukhali enezimpawu ezinjenge-diuresis yamalitha angaphezu kwama-2 ngosuku, ukoma okungapheli, ukuncipha okujwayelekile;
- ukuntuleka kwezimpawu zokukhuluphala;
- ukuba khona kwezifo ze-autoimmune ezifana ne-rheumatoid arthritis, iHashimoto thyroiditis, i-cardiomyopathy, vitiligo nokunye;
- ukuba khona kwezihlobo eziseduze zezinkinga zempilo ezinqunywe ngofuzo.
Uma kungu-1 kwezi-5 zalezi zimpawu ezitholakalayo, khona-ke amathuba okuba nesifo sikashukela esisezingeni eliphezulu azoba sesigabeni se-1%. Lapho kunalezi zibonakaliso ezi-2 noma ngaphezulu, amathuba okuthi akhuphuke afike ku-90% futhi odokotela batusa ukuxilongwa
Izimpawu
I-pathology kashukela esezingeni eliphezulu ayihlukaniswa yizimpawu ezikhethekile. Esikhathini esiningi, uzazisa ngezimpawu zobuntu besifo sikashukela sesibili.
Kepha uma unikezwe ukuthi izinhlobonhlobo ze-lada zisabhekisa kwi-subtype yokuqala, ukubonakaliswa okunjengokuthi:
- umuzwa ongapheli wokukhathala;
- Ukudana
- imizwa yokudangala ngokuhamba kwesikhathi;
- indlala engapheli.
Futhi kwenzeke:
- Izinkinga zesikhumba - ukoma nokukhonkotha, ukuba khona kwamathumba nemiphunga,
- ukopha kwezinsini namazinyo okuphuma;
- ukukhuphuka koshukela wegazi kusuka ku-5.6 kuye ku-6.2 mmol / l;
- ukungasebenzi kahle kwe-erectile emadodeni kanye nokuntuleka kwesifiso sobulili kwabesifazane;
- ukuncipha kokuzwela kweminwe nezindawo ezithile zesikhumba.
Izimpawu ezinjalo zingakhula ngaphezulu kweminyaka emi-5, kuthi emva kwalokho isifo sikashukela esidlule singalapheki.
Izimpawu ze-pathology ezitholakele ngesikhathi zikhulisa amathuba okuvimbela ukubhebhetheka. Ukwelashwa okufanele ngeke kuvume ukuthi ifomu le-latent lisebenze, futhi yehlise kakhulu ukukhula kwalo.
Ukuxilonga
Ukucacisa ukutholakala kwesifo sikashukela esisolwa ngokusobala, kusetshenziswa lezi zinhlobo ezilandelayo zokuxilonga;
- ukuhlolwa kwegazi kuma-antibodies kuma-enzyme glutamate decarboxylase, okuhlanganiswa yilungu le-pancreas endocrine. Umphumela ongemuhle usho ubungozi obuncane besifo sikashukela sabafana;
- Ukuhlaziywa kwezinga le-C-peptides lamanyikwe. Njengoba unesifo sikashukela esisetshenzisiwe, kungaphansi kokujwayelekile.
Ukucacisa lokhu kutholakala,
- ukuhlolwa kwe- "prednisone", okukuvumela ukuthi unqume ukubekezelelwa kwe-glucose;
- ukuhlolwa kwe-Staub-Traugott, lapho igazi elithathwa esiswini esingenalutho lihlolwa amahora amaningi kusetshenziswa ukulungiswa nge-dextropur.
Ukwelashwa kwesifo sikashukela esisebusweni
Ukwelashwa kwesifo sikashukela se-latent sikisela ukuphathwa okuphoqelekile kwe-insulin.
Ukuze uthuthukise ukuzwela kwezakhiwo nezibopho kukho, izidakamizwa ezisehlisa ushukela ezisezibhebheni zingasetshenziswa.
Ngaphezu kwalokho, i-glitazones kanye ne-Biguanide derivatives inqunyelwe.
Izengezo ezibalulekile zokwelapha okuyisisekelo zizoba:
- ukunamathela emithethweni yokudla okunempilo, okuphakamisa ukuthi kudliwe i-carb ephansi;
- ukuzivocavoca umzimba okwenziwa njalo.
Ukuvimbela
Ukunciphisa ingozi yokuthola isifo sikashukela esisebusweni, kubalulekile ukunciphisa umthelela wezinto ezibangelwa yi-pathology:
- ukulawula isisindo somzimba;
- ngezikhathi ezithile hlola ushukela wakho wegazi. Lokhu kuyiqiniso ikakhulukazi kubantu abanesizathu sokucabanga ukuthuthukiswa kwe-endocrine pathologies, ngenxa yesimo sabo sempilo noma ukubekeka phambili kofuzo;
- udle njalo futhi ulinganise, ugwema inani elikhulu lokudla okune-carb ephezulu;
- phila impilo esebenzayo;
- gcina izivikela zomzimba zisezingeni elifanele, ungakhohlwa ukuthatha amavithamini ukuqinisa ukungatheleleki komzimba.
Isifo sikashukela esibuhlungu asiyona inkinga enkulu kangako kune-pathologies efanayo yohlobo 1 no-2. Isimo sengqondo sokunakekela impilo yomuntu uqobo kuphela esizosiza ukuyikhomba ngesikhathi futhi sithathe zonke izindlela ezidingekayo zokuqhubeka nempilo ende futhi esebenzayo.
