Muva nje, isifo sikashukela sahlukaniswa kwabokuqala nesesibili, kepha, sibonga imiphumela yokucwaninga okuqhubekayo, izinhlobo ezintsha zatholakala, esinye sazo kwakuyisifo sikashukela se-Lada (i-LADA sikashukela). Mayelana nokuthi ihluke kanjani kwezinye izinhlobo, ukuthi ukuxilongwa kwayo nokwelashwa kwenziwa kanjani - ngokuningiliziwe kulokhu okuqukethwe.
Yini le
Isifo sikashukela sohlobo lwe-Lada siwuhlobo lwesifo sikashukela esatholwa izazi zezempilo zase-Austrian ngasekupheleni kwekhulu lama-20. Babone ukuthi iziguli ezinama-antibodies kanye nokugcinwa okuphezulu kwe-C-peptide (insalela yamaprotheni) azikho neze zohlobo lwesibili, yize isithombe sasemtholampilo sikukhombisa. Ngemuva kwalokho kwavela ukuthi lolu akulona uhlobo lokuqala, ngoba ukwethulwa kwe-insulin kudingeka kakhulu ekuqaleni. Ngakho-ke, kwatholakala indlela yesifo esezingeni eliphakathi, kamuva eyabizwa ngokuthi yi-Ladaabetes (isifo sikashukela se-autoimmune kubantu abadala).
Izici
Isifo sikashukela esisezingeni eliphakeme siyindlela yokugcina lapho amaseli we-pancreatic beta abola khona. Abaphenyi abaningi babiza lolu hlobo lwesifo ngokuthi "1.5", ngoba lufana kakhulu nohlobo lwesibili ekuhambeni kancane, nolokuqala kumakhenikha. Kunzima ukuthola ukuxilongwa okulungile ngaphandle kocwaningo olwengeziwe. Uma lokhu kungenziwa futhi lesi sifo selashwa ngendlela efanayo nesifo sikashukela sohlobo 2 (ukuthatha amaphilisi anciphisa ushukela), khona-ke ama-pancreas azosebenza kuze kube sekupheleni, futhi ukufa kwamaseli we-beta kuzoshesha kuphela. Ngemuva kwesikhashana esifushane - kusuka ezinyangeni eziyisithupha kuya eminyakeni emi-3 - umuntu uzodinga ukwelashwa okukhulu kwe-insulin, yize ngohlobo lwe-2 yesifo sikashukela esinqunyelwe kamuva.
Iziguli ezinesifo sikashukela se-latent zivame ukukhubazeka
Umehluko omkhulu phakathi kwefomu lokugcina nohlobo 2 sikashukela yile:
- ukuntuleka kwesisindo ngokweqile (amacala ohlobo lwe-latent ezigulini ezinokukhuluphala akuvamile);
- ukunciphisa amazinga we-C-peptides egazini esiswini esingenalutho nangemva kokuthatha isixazululo se-glucose;
- ukuba khona kwegazi lama-antibodies kuya kumaseli we-pancreatic - amasosha omzimba wesifo sikashukela asihlasela;
- Ukuhlaziywa ngofuzo kubonisa ukuthambekela kokuhlasela amaseli we-beta.
Izimpawu
I- “Lada Diabetes Clinical Risk Clinical Risk Scale” eyakhiwa odokotela ifaka lezi zindlela ezilandelayo:
- ukuqala kwalesi sifo yiminyaka engama-25-50. Uma kule nkathi yokufika komuntu kutholakale ukuthi unesifo sikashukela sohlobo 2, lapho-ke kuyadingeka ukuthi ahlole i-Lada, ngoba phakathi kweziguli ezinohlobo lwesibili, kusuka ku-2 kuya ku-15% banefomu le-latent, futhi nalabo abangahlushwa ukukhuluphala bathola lokhu kutholakala kwengxenye yamacala;
- ukubonakaliswa okunamandla kokuqala kwesi sifo: isilinganiso sansuku zonke somchamo siyakhuphuka (ngaphezu kwamalitha ama-2), kuvela ukoma okuqinile njalo, isiguli sincipha futhi sizizwa sibuthakathaka. Kodwa-ke, inkambo yesifo sikashukela se-Lada is asymptomatic;
- inkomba yesisindo somzimba engaphansi kwama-25 kg / m2, okungukuthi, njengomthetho, akukho ukukhuluphala noma isisindo ngokweqile phakathi kwalabo abasengozini;
- ukuba khona kwezifo ze-autoimmune esikhathini esidlule noma okwamanje;
- izifo ze-autoimmune ezihlotsheni eziseduze.
I-Underweight wuphawu olujwayelekile lwefomu lokugcina lalesi sifo.
Uma isiguli sinika kusuka ku-0 kuye ku-1 izimpendulo ezakhayo ngamaphuzu avela kusilinganiso esinikeziwe, khona-ke amathuba okuba nohlobo lwe-autoimmune angaphansi kuka-1%, uma kunezimpendulo ezi-2 noma ngaphezulu, ubungozi bokuba nesifo sikashukela se-Lada bukhuphukela kuma-90%. Esimweni sokugcina, umuntu kufanele ahlolwe ezinye izivivinyo.
Ukuxilonga
Amadivaysi ahlukahlukene okuxilonga anamuhla aqaphela kalula uhlobo lwamuva lwalesi sifo. Into esemqoka, uma usola lolu hlobo, ukwenza ucwaningo olwengeziwe ngokushesha okukhulu.
Kunoma yiluphi uhlobo lwesifo sikashukela, ukuxilongwa kusenesikhathi kubalulekile.
Ngemuva kokuhlolwa okujwayelekile koshukela ne-hemoglobin ye-glycated, isiguli sinikela ngegazi lezi zivivinyo ezilandelayo zelebhu:
I-mellitus engavikelekile nge-insulin- ukuzimisela kwezinga lama-autoantibodies ku-glutamate decarboxylase GAD. Umphumela omuhle, ikakhulukazi uma izinga le-antibody liphezulu, ezimeni eziningi libonisa ukuba khona kwesifo sikashukela kumuntu;
- Ukuchazwa nokuhlaziywa kwe-ICA - ama-autoantibodies kuma-islet cell wamanyikwe. Lolu cwaningo lungeziwe kokuqala kuphela ukubikezela ukuqhubekela phambili kohlobo lwakamuva lwesifo. Uma i-anti-GAD ne-ICA ikhona egazini, lokhu kubonisa uhlobo olunzima kakhulu lwesifo sikashukela se-autoimmune;
- ukunqunywa kwezinga le-C-peptide, okuwumkhiqizo we-biosynthesis ye-insulin ye-hormone. Inani layo lilingana ngqo nezinga le-insulin uqobo. Uma ukuhlaziya kukhombisa i-anti-GAD ne-C-peptides ephansi, isiguli sitholakala sinesifo sikashukela se-Lada. Uma i-anti-GAD ikhona kepha izinga le-C-peptide livamile, ezinye izifundo ziyaqalwa;
- ukucwaninga kokukhula okuphezulu kwe-HLA izinsolo, okumaka izakhi zofuzo zohlobo 1 sikashukela (lobu budlelwano abukho ngesifo sohlobo 2). Ngaphezu kwalokho, abamaki be-DQA1 ne-B1 bayahlolwa;
- ukutholwa kwama-antibodies ezidakamizweni eziqukethe i-insulin.
Ukwelashwa
Ngendlela engalungile, isifo sikashukela se-Lada maduze sizoba kakhulu, futhi isiguli kuzodingeka sisebenzise imithamo emikhulu ye-insulin. Umuntu uzohlala ezizwa kabi, kuzovela izinkinga eziningi. Uma ungaguquki enkambweni yokwelashwa, lokhu kuyisihlonipho sokukhubazeka noma ukufa.
Ukwelashwa kwe-insulin kulapho udinga ukuqala khona
Ukwelashwa okunekhono kokuvuvukala kwe-autoimmune kuqala ngokufakwa komthamo omncane we-insulin.
Ukwelashwa kwe-insulin kokuqala kuyadingeka:
- ukonga kokusala kokugcotshwa kwe-pancreatic. Ukwehla komsebenzi we-beta-cell kuyadingeka ukuze kulondolozwe amazinga aphezulu kashukela egazini, ukunciphisa ingozi ye-hypoglycemia futhi kuvikele ukukhula kwezinkinga zesifo;
- ukususwa kokuvuvukala kwe-autoimmune kwamanyikwe ngokunciphisa inani lama-autoantigens lapho amasosha omzimba abhekana ngqo futhi aqale inqubo yokukhiqiza ama-antibody. Ukuhlolwa kwelebhu kwakhombisa ukuthi ukwethulwa kwemithamo emincane ye-insulin isikhathi eside kuholela ekwehleleni kwenani lama-autoantigens egazini;
- nokugcina izinga le-glucose ejwayelekile ukuze ugweme izinkinga ezisheshayo neziningi.
Ukwelashwa kwe-immunological sekuvele kwenziwa ukwelashwa kwezifo ezithile ze-autoimmune. Ngokushesha, ososayensi babikezela ukuvela kwalezi zindlela zokwelapha ukuvuvukala kwe-autoimmune kwamanyikwe.
Ukudla okunempilo kanye nokudla i-Vitamin kuyingxenye ebalulekile yokwelashwa
Ukwelashwa kwesifo sikashukela seLada, ngaphezu kokwelashwa kwe-insulin, kufaka phakathi:
- ukuthatha imishanguzo ekhulisa umkhawulo wokuzwela kwezicubu ze-peripheral to insulin;
- ukuvinjelwa kokuthatha izithasiselo zokukhiqizwa kwe-insulin (ukugcwala ukukhathala kwama-pancreas kanye nokwanda kokuntuleka kwe-insulin);
- ukulawulwa okungapheli koshukela wegazi;
- ukuguqulwa kokudla okuphansi kwe-carb (ngenkathi iziguli zingadla ushokoledi omncane omnyama);
- ukuvivinya umzimba ngokuzivocavoca (ngaphandle kwezimo ezinesisindo esikhulu sokusinda komzimba);
- i-hirudotherapy (indlela yokwelapha isebenzisa izinkulumo ezikhethekile zezokwelapha).
Ungabukeli phansi inganekwane.
Ngemuva kokuxhumana nodokotela oya khona, kungenzeka futhi ukuthi usebenzise umuthi wendabuko. Njengomthetho, ukwelashwa okusizayo kuqukethe ekuthatheni ama-decoctions kanye nama-tinctures wezitshalo zokwelapha, ezinciphisa izinga le-glucose egazini ngokufanele.
Isifo sikashukela se-Lada, njengezinye izinhlobo, ngaphandle kokungenelela okufika ngesikhathi kanye nokwelashwa okufanele kungaholela ezinkingeni eziningi. Ngakho-ke, ekutholakaleni kwesifo sikashukela, kubalulekile ukwenza izifundo ezengeziwe ukukhipha amathuba wokulashwa okungalungile, imiphumela yako ingaba ukukhubazeka nokufa.
