Minyaka yonke, inani labantu abatholakala benesifo sikashukela liyanda ngokuqinile. I-Pathology inqunywa kakade ezigabeni zakamuva, ngakho-ke akunakwenzeka ngokuphelele ukukuqeda. Ukukhubazeka kwasekuqaleni, ukuthuthukiswa kwezinkinga ezingamahlalakhona, ukufa okuphezulu - yilokhu isifo okugcwala ngakho.
Isifo sikashukela sinezindlela eziningi; singenzeka kubantu asebekhulile, abesifazane abakhulelwe, kanye nezingane. Zonke izinkomba nezimpawu zezimo ze-pathological zihlanganiswe yinto eyodwa - i-hyperglycemia (inani elikhulayo le-glucose egazini), eliqinisekiswa indlela yelebhu. Kulesi sihloko, sizobheka ukuthi yiliphi izinga loshukela wegazi abaluthola ushukela, yiziphi izindlela zokuqinisekisa ukuthi lesi sifo siqatha kangakanani, futhi yiziphi izindlela ezibaxilonga ngazo lesi sifo.
Hlobo luni lwesifo futhi kungani luphakama
Isifo sikashukela i-mellitus sithathwa njenge-pathology engapheli evela ekungabikho komkhiqizo owanele we-hormone insulin noma umsebenzi okhubazekile emzimbeni womuntu. Inketho yokuqala ejwayelekile yesifo sohlobo 1 - kuncike ku-insulin. Ngenxa yezizathu eziningi, izinsiza ze-insulin ze-pancreas azikwazi ukuhlanganisa inani lezinto ezisebenza ngama-hormone ezidingekayo ekusatshalisweni kwamangqamuzana kashukela asuka egazini aya emangqamuzaneni azungeze.
Kokwehluka kwesibili (okungaxhomekeki kwe-insulin sikashukela), i-iron ikhiqiza ama-hormone anele, kepha umphumela wawo kumaseli naku-izicubu akazethetheleli. I-periphery imane "ayiboni" i-insulin, okusho ukuthi ushukela awukwazi ukungena kumaseli ngosizo lwayo. Umphumela uba ukuthi izicubu zihlangabezana nendlala yamandla, futhi lonke ushukela uhlala egazini ngamanani amakhulu.
Izimbangela zendlela yokuncika kwe-insulin yilezi:
- ifa - uma kukhona isihlobo esigulayo, amathuba "okuthola" isifo esifanayo akhuphuke kaningana;
- izifo zemvelaphi yegciwane - sikhuluma ngama-mumps, igciwane leCoxsackie, i-rubella, i-enteroviruses;
- ukuba khona kwama-antibodies kumaseli we-pancreatic ahilelekile ekwenziweni kwe-insulin ye-hormone.
Uhlobo loku-1 lwalesi “sifo esimnandi” luzuzwa uhlobo lokutholwa, Type 2 - by the prime
Isifo sikashukela sohlobo 2 sinohlu olubaluleke kakhulu lwezimbangela ezingakhona. Lokhu kufaka phakathi:
- isiphetho sofuzo;
- isisindo somzimba esiphakeme - isici sibi kakhulu lapho sihlanganiswa ne-atherossteosis, umfutho wegazi ophakeme;
- impilo yokuhlala;
- ukwephulwa kwemithetho yokudla okunempilo;
- i-pathology yesistimu yenhliziyo esikhathini esidlule;
- umthelela wokucindezelwa okungapheli;
- ukwelashwa okuhlala isikhathi eside ngemithi ethile.
Ifomu lokuphaka
Ukuxilongwa kwesifo sikashukela sokukhulelwa kwenziwa kwabesifazane abakhulelwe lapho lesi sifo sivele khona ngokuqondile ngemuva kwesikhundla sabo "esithandekayo". Omama abakhulelwe babhekana ne-pathology ngemuva kwesonto lama-20 lokuzala umntwana. Indlela yokuthuthuka ifana nohlobo lwesibili lwesifo, okungukuthi, amanyikwekesi kowesifazane akhiqiza inani elanele lezinto ezisebenza ngama-hormone, kepha amangqamuzana alahlekelwa ukuzwela kuwo.
Izindlela zokuxilonga zesifo kwiziguli ezingakhulelwe
Kunezinkomba eziningi kusisekelo okuqinisekiswe ngazo ukutholakala kwesifo sikashukela:
- Izinga likashukela egazini, elinqunywa ngokuthatha i-biomaterial kusuka emithanjeni ngemuva kokuzila amahora angama-8 (isb. Esiswini esingenalutho), lingaphezulu kuka-7 mmol / L. Uma sikhuluma ngegazi le-capillary (kusuka emunweni), lesi sibalo ngu-6.1 mmol / L.
- Ukuba khona kwezibonakaliso zemitholampilo nezikhalazo zesiguli kuhlangene nezibalo ze-glycemic ngenhla ne-11 mmol / l lapho kuthatha impahla nganoma yisiphi isikhathi, kungakhathalekile ukungena kokudla emzimbeni.
- Ukuba khona kwe-glycemia kungaphezu kwe-11 mmol / l ngokumelene nesizinda sokuhlolwa komthwalo woshukela (GTT), okungukuthi amahora ama-2 ngemuva kokusebenzisa isixazululo esimnandi.
I-GTT yenziwa ngokuthatha igazi le-venous ngaphambili nangamahora ama-1-2 ngemuva kokusetshenziswa kwesisombululo nge-glucose powder
Yini i-HbA1c futhi kunqunywa yiphi inhloso?
I-HbA1c ngenye yezindlela ezikuvumela ukuthi usungule ukuba khona kwesifo sikashukela. Le yi-glycated (glycosylated) hemoglobin, ekhombisa i-glycemia ephakathi kwekota edlule. I-HbA1c ibhekwa njengendlela efanelekile nenokwethenjelwa eqinisekisa ubukhona be-hyperglycemia engapheli. Ukuyisebenzisa, ungakwazi futhi ukubala ubungozi bokuthola ubunzima besifo "esimnandi" esigulini.
Ukuze kutholakale isifo sikashukela:
- Ukuxilongwa kwenziwa uma izinamba zingaphezulu kuka-6.5%. Uma kungekho zimpawu zalesi sifo, kufanele ukuthi kubuye kuhlaziywe kaningi ukuthi umphumela owedlule wawungewona yini.
- Ukuhlaziywa kwenzelwa izingane ezinobukhona bokusoleka kwe-endocrine pathology, akuqinisekiswa yisithombe somtholampilo obonakalayo namazinga e-glucose aphezulu ngokwemiphumela yokuhlolwa kwebhubhoratri.
Ukunquma iqembu leziguli ezisengozini enkulu yokuba nesifo:
Ukuxilongwa kwesifo sikashukela ezinganeni- Iziguli ezinezimpawu zokukhubazeka kwe-glucose ephazamisekile kufanele zihlolwe ngoba ukuhlolwa okujwayelekile koshukela egazini akukwazi ukukhombisa ukuqhubeka kwalesi sifo.
- Ukuhlaziywa kulungiselelwe iziguli ekuhlolweni kwazo kwangaphambilini kwe-glycosylated hemoglobin kwakusebangeni le-6.0-6.4%.
Iziguli ezingazihluphi ngezimpawu ezithile zesifo sikashukela kufanele zihlolwe kulezi zimo ezilandelayo (njengoba kunconywa ochwepheshe bamanye amazwe):
- isisindo esikhulu somzimba esihlanganiswa nokuphila kokuhlala phansi;
- ukuba khona kohlobo lwesifo esincike e-insulin ezihlotsheni eziseduze;
- abesifazane ababeletha ingane enesisindo esingaphezu kwamakhilogremu ayi-4,5 noma abasungule isifo sikashukela sokukhulelwa ngesikhathi sokukhulelwa;
- umfutho wegazi ophakeme;
- i-polycystic ovary.
Isiguli esinjalo kufanele siye kudokotela we-endocrinologist ukuze axilongwe.
Kubalulekile! Zonke iziguli ezineminyaka engaphezu kwengama-45 ngaphandle kwale mibandela engenhla kufanele zihlolwe ukuze kuhlolwe izinga le-hemoglobin ye-glycosylated.
Abesifazane abakhulelwe batholakala kanjani?
Kunezimo ezimbili. Esimweni sokuqala, owesifazane uphatha ingane futhi abe nesimo sokuxilongwa kwalesi sifo, okusho ukuthi, i-pathology yakhe yavela ngisho nangaphambi kokuqala kokukhulelwa (okungenani angathola ngokuba khona kwesifo sikashukela ngesikhathi sokukhulelwa). Leli fomu liyingozi kakhulu emzimbeni kamama nasenganeni yakhe, ngoba lisongela ukukhula kwezimpawu zokuzala ngokuzalwa kwengane, ukunqanyulwa okuzimele kokukhulelwa, ukuzala umntwana.
Indlela yokuthambisa yenzeka ngaphansi kwethonya lamahhala e-placental, anciphisa inani le-insulin ekhiqizwa futhi anciphise ukuzwela kwamangqamuzana nezicubu kuwo. Bonke abesifazane abakhulelwe ngesikhathi esingamaviki angama-22 kuye kwangama-24 bahlolwe ukuthi babekezelelwa i-glucose.
Kwenziwa njengokulandelayo. Owesifazane uthatha igazi emunweni noma emthanjeni, inqobo nje uma engadlanga lutho emahoreni angama-10-12 edlule. Ngemuva kwalokho uphuza isixazululo esuselwa ku-glucose (impuphu ithengwa emakhemisi noma etholakala elebhu). Ihora, umama okhulelwe kufanele abe sesimweni esizolile, angahambi kakhulu, angadli lutho. Ngemuva kokuba isikhathi sesidlulile, igazi lidonswa ngokuya ngemithetho efanayo neyokuqala.
Ngemuva kwalokho, kwelinye ihora, umhloli akadli, ugwema ukucindezela, ukukhuphuka izitebhisi neminye imithwalo, abuye futhi athathe i-biomaterial. Umphumela wokuhlaziywa ungatholakala ngakusasa udokotela wakho.
Uhlobo lwesifo lokutholwa lusungulwa ngesigaba sezigaba ezimbili zokuseshwa kwezifo. Isigaba I senziwa lapho kuqala ukukhalazwa kowesifazane kudokotela we-gynecologist ukuze abhaliswe. Udokotela unquma lezi zivivinyo ezilandelayo:
- ukuzila ushukela wegazi opholile;
- ukuzimisela okungahleliwe kwe-glycemia;
- glycosylated hemoglobin level.
Kutholakala nesifo sikashukela sokukhulelwa ngemiphumela elandelayo:
- ushukela wegazi ovela emthanjeni - 5.1-7.0 mmol / l;
- i-glycosylated hemoglobin - ngaphezu kuka-6.5%
- glycemia okungahleliwe - ngaphezulu kwe-11 mmol / l.
Isigaba II senziwa ngemuva kwamasonto angama-22 sokukhulelwa, siqukethe ukuqokwa kokuhlolwa ngomthwalo ushukela (GTT). Yiziphi izinkomba eziqinisekisa ukutholakala kwefomu lomzimba:
- i-glycemia esiswini esingenalutho - ngenhla kuka-5.1 mmol / l;
- kwisampula yegazi lesibili (ngehora) - ngenhla kwe-10 mmol / l;
- kocingo lwesithathu (elinye ihora kamuva) - ngenhla kuka-8.4 mmol / l.
Uma udokotela enqume ukuba khona kwesimo se-pathological, kukhethwe irejimeni yokwelashwa komuntu ngamunye. Njengomthetho, abesifazane abakhulelwe banqunyelwe ukwelashwa kwe-insulin.
Ukuxilongwa kwesifo sikashukela sohlobo 2 ezinganeni
Ochwepheshe batusa ukuthi kuhlolwe ingane ukuthi ikhona uhlobo 2 lwesifo “esimnandi” uma inesisindo esingajwayelekile, ehlanganiswa nanoma yimaphi amaphuzu amabili ngezansi:
- ukuba khona kohlobo oluzimele lwe-insulin lwe-pathology kusihlobo esisodwa noma ngaphezulu;
- umjaho osengozini enkulu yokuba nesifo;
- ukuba khona komfutho wegazi ophakeme, i-cholesterol ephezulu egazini;
- isifo sikashukela somama esikhathini esidlule.
Isisindo esikhulu somntwana lapho ezalwa singesinye isizathu sokuthola lesi sifo ngesikhathi sokuthomba
Ukuxilongwa kufanele kuqalwe eneminyaka eyi-10 bese kuphindwa njalo eminyakeni emi-3. I-Endocrinologists incoma ukuthi ihlole izinombolo ze-glycemic zokuzila ukudla.
Izindlela zokunquma ubunzima besifo
Uma kwenziwa isifo sokuxilongwa kwesifo sikashukela, udokotela kufanele acacise ubulukhuni baso. Lokhu kubalulekile ukuqapha isimo sesiguli samandla amakhulu kanye nokukhethwa okufanele kwama-regimens okwelashwa. Isifo sikashukela esibuhlungu siyaqinisekiswa lapho izibalo zikashukela zinganqamuki umkhawulo we-8 mmol / L, futhi lapho umchamo ungekho ngokuphelele. Isinxephezelo sesimo sitholakala ngokulungisa indlela umuntu adla ngayo nendlela aphila ngayo. Izinkinga zesifo azikho noma isigaba sokuqala sokulimala kwemithambo siyabonakala.
Ukwehla okulinganiselwe kubonakaliswa izibalo ze-glucose ezifika ku-14 mmol / L; inani elincane likashukela liyabonakala nakuwo umchamo. Izimo ze-Ketoacidotic kungenzeka zivele zivele. Akunakwenzeka ukuba ulondoloze izinga le-glycemia ngelashwa okukodwa kokudla. Odokotela banquma ukwelashwa kwe-insulin noma ukuthatha amaphilisi emithi enciphisa ushukela.
Ngokuphikisana nesizinda sethanga elinzima, i-hyperglycemia itholakala ngezinombolo ezingaphezu kuka-14 mmol / l, kutholakala inani elikhulu le-glucose emchameni. Iziguli zikhononda ukuthi ushukela wazo uvama ukugxuma, futhi bobabili naphezulu, i-ketoacidosis ivela.
Ukuxilongwa okuhlukile
Ngokusekelwe kwizifundo zaselaborathri kanye nezinsizakalo, kubalulekile ukwenza okuhlukile. ukuxilongwa hhayi phakathi kwesifo sikashukela nezinye izifo, kodwa futhi nezindlela "zesifo esimnandi" uqobo. Ukuxilongwa okuhlukile kwenziwa ngemuva kokuqhathaniswa namanye ama-pathologies asuselwa kuma-syndromes ayinhloko.
Ngokusho kokuba khona kwezimpawu zomtholampilo (ukoma kwe-pathological kanye nokuphuma komchamo ngokweqile), kuyadingeka ukuhlukanisa lesi sifo:
- isifo sikashukela insipidus;
- i-pyelonephritis engapheli noma ukwehluleka kwezinso;
- i-hyperaldosteronism eyinhloko;
- ukusebenzelana kwegazi kwezindlala ze-parathyroid;
- neurogenic polydipsia ne-polyuria.
Ngamazinga kashukela aphezulu kakhulu:
- kusuka kushukela onesifo sikashukela;
- I-Itsenko-Cushing's syndrome;
- i-acomegaly;
- isimila se-adrenal;
- i-neurogenic kanye ne-hyperglycemia yokudla.
I-Pheochromocytoma ingesinye sezimo lapho kudingekile ukwenza ukuxilongwa okuhlukile
Ukuba khona kwe-glucose kumchamo:
- ekudakwiseni;
- i-pathologies yezinso;
- i-glucosuria yabesifazane abakhulelwe;
- i-glucosuria yokudla;
- ezinye izifo lapho i-hyperglycemia ikhona.
Kukhona hhayi kuphela yezokwelapha, kodwa futhi ukuxilongwa kwabahlengikazi. Kuhlukile kulokho okubekwe ochwepheshe ngoba akubandakanyi igama lesifo, kodwa izinkinga eziphambili zesiguli. Ngokusekelwa ekuxilongweni kwabahlengikazi, abahlengikazi bahlinzeka ngokunakekelwa kweziguli okufanele.
Ukuxilongwa okufika ngesikhathi kukuvumela ukuthi ukhethe irejimeni yokwelashwa eyanele ezokuvumela ukuthi ufinyelele ngokushesha esimweni esinxephezelayo futhi uvikele ukuthuthukiswa kwezinkinga zesifo.
