Isifo sikashukela sibizwa ngokuthi i-endocrine isifo, esibonakalisa njengokwephula zonke izinqubo ze-metabolic emzimbeni. I-Pathology inezinhlobo eziningana, ezihlukile kumbangela kanye nendlela yokukhula kwayo. Isifo sikashukela sibhekwa njengenkinga yomhlaba wonke emphakathini, ngoba okwamanje inani leziguli lidlula inani lezigidi ezingama-200, futhi lesi sifo uqobo ngokwaso asikwazi ukwelashwa.
Lo mbhalo udingida ukuthi ifomu lesincibilikisiwe lalesi sifo liziveza kanjani, ukuthi uluhlobo luni lwesimo nokuthi ungasisingatha kanjani.
Isinxephezelo kanye namadigri awo
Ukuze ukhethe amaqhinga okulawulwa kweziguli afanele, ama-endocrinologists akhomba ama-degree athile wesinxephezelo sikashukela. Ngamunye unezici ezithile, izinkomba zaselebhu, zidinga ukungenelela okuthile.
Izinga lesinxephezelo libonakaliswa yisimo esihle kakhulu sesiguli. Izinkomba zeshukela zisondela ezijwayelekile, izinkomba zesifo azivezwanga. Isinxephezelo sidinga ukuhambisana nemithetho yokwelashwa kokudla nendlela yokuphila esebenzayo. Esikhathini sesifo sikashukela esikhokhelwayo, ama-endocrinologists anganciphisa umthamo wamathebulethi anciphisa ushukela, i-insulin noma akuyeke ngokuphelele ukusetshenziswa kwawo.
Ukukhokhelwa kwesifo sikashukela kuyizinga elilandelayo lesifundo. Inhlala kahle yesiguli iya iba mbi, isithombe somtholampilo siyashiwo. Iziguli zinezikhalazo ezilandelayo:
- isifiso se-pathological sokuphuza;
- inani elikhulu lomchamo likhishwe;
- ikhanda
- ulwelwesi olomile lwe-mucous;
- ukomiswa nokulunywa kwesikhumba.
Ishukela elibolile lihambisana nokuphulwa kwazo zonke izinqubo ze-metabolic emzimbeni. Kubonakala ngezinkomba ezibucayi ze-glycemia, ukuba khona koshukela emchameni, ukuthuthukiswa kwezinkinga ezinzima nezingamahlalakhona. Lezi zokugcina zithuthuka ngenkuthalo.
IPolydipsia ingenye yezimpawu eziphambili zalesi sifo.
Yiziphi izindlela zokunquma isinxephezelo?
Kunezinkomba eziningana ezisuselwa lapho i-endocrinologist inquma ukuthi isinxephezelo sesifo siyisihlobo esingakanani. Lokhu kufaka phakathi:
- izinga le-hemoglobin ye-glycosylated;
- izinkomba ze-glycemia ngaphambi kokudla kungena emzimbeni kanye namahora ambalwa emva kwale nqubo;
- ukuba khona kweshukela kumchamo.
Izindlela ezingeziwe ziyinombolo yengcindezi yegazi, i-cholesterol ne-triglycerides egazini, ukuba khona kwezidumbu ze-ketone (acetone), inkomba yomzimba.
Isinxephezelo
Izinga libonakala izinkomba ezilandelayo:
- izinga le-glycemia ngaphambi kokudla aliphezulu kune-5.9 mmol / l;
- izinkomba zikashukela ngemuva kokudla kungadluli ku-7.9 mmol / l;
- ukuntuleka kwe-glucosuria;
- i-glycosylated hemoglobin engekho ngaphezulu kuka-6.5%;
- izinkomba ze-cholesterol engaphansi kuka-5.3 mmol / l;
- inkomba yesisindo somzimba engaphansi kwama-25;
- izinkomba zokucindezela (systolic - kuze kufike ku-140 mm Hg. Art., diastolic - kuze kufike ku-85 mm Hg. Art.).
Ukuba khona ushukela kumchamo kungahlolwa ekhaya kusetshenziswa imichilo eqondile.
Ukubuyiselwa
Izinkomba ezilandelayo zivumela udokotela ohambelayo ukuba aphendule ngokunembile isidingo sokulungisa isimo sesiguli. Basho ukuthi lesi sifo sesidlulile esigabeni esibulalayo, esidinga ukwenzeka ngokuqapha kanye nokuqashwa njalo.
Isifo sikashukela esingakhokhwanga sinokuqinisekiswa kwelabhoratri elilandelayo:
- ukushesha kwe-glycemia ngenhla kwe-7.7 mmol / l;
- glycemia 1.5-2 amahora ngemuva kokudla ngaphezulu kwe-10 mmol / l;
- i-glucosuria ngaphezulu kwe-0.5%;
- izinkomba ze-glycosylated hemoglobin ezingaphezu kuka-7.5%;
- Izinga le-cholesterol esegazini lingaphezulu kwe-6.4 mmol / l;
- inkomba yesisindo somzimba idlula i-27;
- umfutho wegazi weqa umkhawulo we-160/95 mm RT. Ubuciko.
Kungani ukubola kunciphisa?
Ochwepheshe bathi umzimba wesiguli ngasinye ubhekwa njengohlelo oluhlukile, ngakho-ke isizathu esifanayo singenza lesi sifo singene esimweni esingakhokhelwa esigulini esisodwa futhi singathinti isimo sempilo sesinye nganoma iyiphi indlela.
I-Endocrinologist uchwepheshe ofanelekayo osiza isiguli ukulwa nesifo sikashukela
Izinto ezinokwenzeka-provocateurs zithathwa njengokusetshenziswa ngokweqile kokudla kwe-carbohydrate, ukunqamuka kwemithi, ukwethulwa komthamo ongalungile wezidakamizwa isikhathi esithile. Lolu hlu lubandakanya ukusetshenziswa kwezithasiselo ezisebenzayo ngokwemvelo kanye nemithi yesintu esikhundleni sokwelashwa kwendabuko, umthelela wezimo ezicindezelayo, izifo zesifo esingelapheki.
Izimbangela zokudlondlobala kwalesi sifo kungaba ukulimala kambi, ukusetshenziswa kophuzo oludakayo, i-myocardial infarction, nemithi eyingqayizivele.
Ukuncipha kwesifo sikashukela kuboniswa isithombe esicacile somtholampilo we-pathology, ukuthuthukiswa kanye nokuqhubeka kwezinkinga:
Isifo Sikashukela Esiyinkimbinkimbi- i-retinopathy;
- i-encephalopathy;
- i-nephropathy;
- isifo senhliziyo;
- i-polyneuropathy;
- ukulimala kwesikhumba nolwelwesi lwama-mucous.
Kungahle kube nezinkinga ezinzima kakhulu zesifo “esimnandi” ngesimo se-ketoacidosis (uhlobo 1) isimo se-hyperosmolar kanye ne-lactic acidosis (enohlobo 2).
Izinkinga Eziyingozi Zokuncipha
I-Ketoacidosis kanye ne-hyperosmolar state kubhekwa njengezinkinga ezimbili eziyingozi kakhulu. I-American Diabetes Association ikuqinisekisile ukuthi imiphumela ebulalayo ehlotshaniswa ne-ketoacidosis ifinyelela ku-5%, kanti i-hyperosmolar coma idlula ngo-15%.
Isiguli esibhekene nethambo kufanele sithole usizo ngokushesha, ngaphandle kwalokho umphumela uyoba obulalayo
Indlela yokuthuthuka kwalezi zimo zombili isuselwe ekushoneni kwe-insulin (ngokuphelele noma isihlobo), futhi ukukhiqizwa kwama-hormone okulwa nabaphikisi kuyanda ngokufana, okubuye kuvimbele isenzo nokuhlanganiswa kwe-insulin. Umphumela ukwanda ukukhiqizwa ushukela ngamaseli wesibindi kanye nokwephulwa kokusetshenziswa kwawo ngamaseli nezicubu onqenqemeni.
Isimo se-Ketoacidotic senzeka ngenxa yokuqongelela okukhulu egazini nomchamo wezidumbu ze-acetone (ketone), ezishintsha i-acidity yegazi ngokuqondiswa kwe-acidosis. Esimweni sesibili, inani le-hormone lanele ukucindezela ukwakheka kwemizimba ye-ketone, noma kunjalo, ukuphuma komzimba okubalulekile kuyakhula, okudinga ukunakekelwa ngokushesha kwezokwelapha.
Ukuxilongwa kwezinkinga ezinzima
Isimo se-hyperosmolar sikhula ngaphezulu kwamasonto ambalwa, futhi i-ketoacidosis inokwakheka emahoreni ambalwa. Ukuvezwa okuyinhloko kuzo zombili lezi zimo yilezi:
- inani elikhulu lomchamo likhishwe;
- ukoma
- ukunciphisa isisindo;
- izimpawu zokuphelelwa ngamanzi emzimbeni;
- ukwanda kwesifiso sokudla;
- ubuthakathaka
- ikhanda.
Umfutho wegazi uyancipha, ishayela liba kaningi futhi lifane nentambo. Umoya uphefumula, uzwakala ukude. Ikota yeziguli ezinesifo se-ketoacidosis ziqala ukuba nomfutho nokuhlanza. Ukuxilongwa kwelabhoratri kususelwa ekunqumeni kwe-glycemia, ama-ketones kumchamo nasegazini, ushukela womchamo, i-creatinine, urea, nokulinganisela kwe-electrolyte.
Usizo
Ukwelashwa kwezinkinga ezinzima kususelwa kula maphuzu alandelayo:
- ukuphindisela emzimbeni (ukubuyisa inani lamanzi emzimbeni) - sebenzisa isisombululo sokotshini we-isotonic sodium chloride, isisombululo se-10% kashukela;
- ukwelashwa kwe-insulin - i-hormone iyafakwa emzimbeni wesiguli ngemithamo emincane, ekuvumela ukuthi unciphise kancane kancane amazinga kashukela egazini futhi uvikele umphumela obulalayo;
- ukulungiswa kwe-electrolyte ibhalansi - ukufakwa kwesisombululo se-potassium chloride kwenziwa ngokuhambisana nokwelashwa kwe-hormonal;
- Ukwelashwa kwezifo ezihambisanayo - nikeza ukwelashwa ngama-antibiotic, ukuqedwa kwemithi yezimpawu.
Ukwelashwa kwe-infusion kufanele kwenzeke esimweni sesibhedlela.
Izinkinga Ezingamahlalakhona Zokubuyiselwa kwemali
Isifo sikashukela sesikhathi eside, esangena esigabeni sokubuyiselwa kwemali, sivezwa yimiphumela emibi eyenzeka esimweni sokulimala kwesikhumba nolwelwesi lwama-mucous, uhlelo lwe-musculoskeletal, izinso, amehlo, uhlelo lwezinzwa, inhliziyo nemithambo yegazi.
Isikhumba nolwelwesi lwe-mucous
Izimo zesimo sokwehla kwesifo ezenzeka ngokumelene nesizinda se- "matenda amnandi" zichazwe etafuleni.
| Izinkinga | Kuyini futhi yiziphi izizathu | Kubonakala kanjani |
| I-Lipodystrophy | Yehla enanini lamafutha angaphansi kwezinye izindawo zomzimba ngokumelene nesizinda sokuphathwa njalo kwe-insulin endaweni efanayo | "Amaphayiphu" avela esiswini, okhalweni, emaqhingeni, anendlela yokuphinda osayizi abahlukahlukene |
| Isikhumba | I-pathology yesikhumba yenzeka ngenxa yokuphelelwa ngumzimba isikhathi eside nokuphazamiseka kokujikeleza kwegazi | Kukhona umqubuko we-pathological, izindawo ezine-pigment, ulceration of a trophic nature |
| I-Xanthomatosis | Kuthuthukiswe ngenxa yezinguquko ezinqubweni ze-metabolism yamafutha | Emaphethelweni aphezulu nangaphansi, endaweni yamabhuza, kuvela amaqhubu apinki |
| Ukukhuluphala ngokweqile | Isisindo somzimba esonyuka ngokweqile sivela ngemuva kwesifiso sokudla esikhulu | Ibhola lengqimba lama-subcutaneous fat likhuphuka ezindaweni ezinobuntu, inani lamafutha elizungeze izitho zangaphakathi libuye landa |
| I-Lipoid necrobiosis | Kuvela ngenxa yama-pathologies emithambo yegazi. | Ama-papapules avela esikhunjeni, okuthi kamuva sithole i-tint ebomvu, bese siphenduka izilonda |
Uhlelo lwe-musculoskeletal
Ishukela elinxephezelwe ngokungafanele libonakaliswa ukuvela kobuso obufushane, amathambo ezinyawo. Ukubonakaliswa okujwayelekile unyawo lwesifo sikashukela. Le nqubo ihambisana nezinguquko zokutheleleka nokuvuvukala, ukwakheka kwezilonda zezimpawu zomzimba ngisho ne-gangrene.
Amapheshana wesisu
Uma lesi sifo singasinxephezwanga ngesikhathi, iziguli zizoza kudokotela ngezikhalazo ezilandelayo:
- ukuphefumula kwenhliziyo kanye nokuhlanza;
- Ubuhlungu esiswini;
- umuzwa wobunzima e-hypochondria;
- izinqubo zokuvuvukala zomgogodla womlomo;
- amakhokho wamazinyo;
- i-jaundice yesikhumba nolwelwesi lwe-mucous (ku-diabetesics kuvame ukwenzeka ngokumelene nesizinda se-hepatosis esinamafutha);
- isifo sohudo
Umbono
Enye yezinkinga ezinkulu ze "sifo esimnandi" yi-retinopathy. Le lesion ye-retinal, eboniswa ngokwakhiwa kwama-aneurysms amancane, ama-hemorrhages, kanye nokwehla kwe-acuity ebonakalayo. Izinguquko ezibucayi kushukela wegazi phezulu naphansi zivusa ukusinda kwe-crystalline. Umphumela uba ukwanda kwamehlo.
Isimo se-retina ngokuqhubeka kancane kancane kwalesi sifo
Ezimweni eziningi, umbono awukwazi ukubuyiselwa ngenxa yezinga eliphakeme lokuqhubeka kwesimo se-pathological. Kubalulekile ukuthi abanesifo sikashukela balwele ekuqaleni ukufeza isinxephezelo sikashukela. Lokhu kuzovikela ukukhula kwezinkinga zesifo.
Izinso
Kukhona ukwehlulwa kobukhazikhazi bezinso, lapho ukwehluleka kwezinso kuvela khona. Inani lamaprotheni afakelwa emchini liyakhula kancane. Isimo sithathwa njengengaguquki, ezimweni ezinzima, ukuthunyelwa kwesitho kuyadingeka.
Ukuze ugweme ukuthuthukiswa kwe-nephropathy yesifo sikashukela, kubalulekile ukugcina i-glycated hemoglobin isebangeni lefika ku-6.5%. Uma kuvela inkinga, iziguli ziyelulekwa ukuthi zilandele ukudla okuqinile, zisebenzise i-nephroprotectors, futhi zifune ukunciphisa i-glycemia.
Isinxephezelo kuwumsebenzi oyinhloko wawo wonke umuntu onesifo sikashukela, otholakala ngokulungisa izondlamzimba nendlela yokuphila, ukwelashwa kokuzivocavoca, ukwelashwa ngezidakamizwa. Ukuhambisana kakhulu nezincomo kukuvumela ukwelula impilo yesiguli futhi uthuthukise ikhwalithi yayo.
