Umuthi wanamuhla uthathe izinyathelo ezinkulu ekukhuleni kwawo futhi ungaxilonga kalula izifo ezahlukahlukene, kubandakanya nesifo sikashukela. Futhi sibonga lokhu, ukukukhombisa esisezingeni lokuqala lentuthuko akunankinga ngisho nongoti abangenalwazi abasanda kuqala uhambo lwabo lokusindisa abantu. Kodwa-ke, kukhona uhlobo oluthile lwalesi sifo, okungeke kwenzeke ngaso sonke isikhathi ukuxilonga ngisho nakulabo odokotela abanokuhlangenwe nakho okukhulu ngemuva kwamahlombe abo. Futhi lolu hlobo lwalesi sifo lubizwa ngokuthi isifo sikashukela se-modi, esizokhulunywa ngalo manje.
Imininingwane ejwayelekile
Ngisho nabantu kude nemithi bayazi ukuthi isifo sikashukela sinezinhlobo ezi-2 eziphambili - esokuqala nesesibili. Indlela yokuthuthuka kwabo yehlukile, yona yona kanye indlela yokwelashwa. Isifo sikashukela sohlobo loku-1 yisifo lapho kunokungasebenzi kahle khona noma kokuphelela kwenhliziyo. Imvamisa, yisifo esizalwa naso futhi "sidluliselwa" kubantu ngamafa.
Isifo sikashukela sohlobo 2 yisifo lapho amaseli nezicubu zomzimba ziqala ukulahlekelwa umuzwa wazo we-insulin. Lokhu kungenxa yokuthi kuzo vele sekukhona umsoco owedlulele wezakhi zomzimba. Futhi lokhu kwenzeka ezimeni eziningi ngokumelene nesizinda sokukhuluphala nokungondleki.
Ukwelashwa kwesifo sikashukela sohlobo 1 kubandakanya ukusebenzisa imijovo ye-insulin, kanti nge-T2DM sekwanele ukulandela nje imithetho elula yokudla ukuze kukhiphe ushukela osheshayo wegazi.
Njengesibonelo, singanikeza amacala okuphindaphindekayo lapho, emisebenzini yezokwelapha, bekukhona ukunyuka kokugxila kwe-glucose ezinganeni ezincane ngaphandle kwesizathu esicishe sifike ku-8 mmol / l noma ngaphezulu, noma lapho ingane kutholakale ukuthi inesifo sikashukela futhi yatholakala nesifo sikashukela iminyaka eminingana. Iminyaka "ihlala" ngethamo elifanayo le-insulin, kuyilapho isimo salo singesibi.
Isifo sikashukela se-Mody sivame ukuzivela sisebancane, ngakho-ke kubalulekile kakhulu kusukela ngesikhathi sokuzalwa ukukala ushukela wegazi ezinganeni
Ngamafuphi, kwabanesifo sikashukela abasebasha, inkambo yalesi sifo ayisiqalo ngokuphelele futhi ayiwona umthwalo, njengabantu abadala abane-T2DM. Kukulezo zimo lapho kukhulunywa ngokuthuthukiswa kwesifo esifana nesifo sikashukela se-modi.
Futhi kufanele kwaziwe ukuthi le ndlela yalesi sifo itholakala kubantu abayi-5% abatholakala benesifo sikashukela. Futhi iningi labo liyizingane. Kodwa ngenxa yokuthi, ngenxa yenkambo ye-asymptomatic, isifo sikashukela kunzima kakhulu ukusithola, izibalo ezinikezwe yi-WHO zihluka kakhulu kwangempela. Ngakho-ke siyini isifo sikashukela se-modi futhi kungani sikhula?
Yini le
Igama eligcwele lalesi sifo lizwakala kanjena - iMaturity Onset Diabetes of the young. Kuhunyushwa kusuka esiNgisini, kuhumusha njengokuthi ushukela ovuthiwe kubantu abasha. Ngokokuqala ngqa, ososayensi baseMelika basho ngalesi sifo emuva ngo-1975. Bakwethule njengendlela yesifo sikashukela eqhubeka kancane ezinganeni nakwintsha enesifiso sokuthola lesi sifo.
Ngabe isifo sikashukela sitholakala kanjani?Ukuthuthukiswa kwe-pathology kwenzeka ngenxa yokuguqulwa kwezakhi zofuzo ezenzeka ngokumelene nesizinda sokungasebenzi kahle kwe-pancreatic. Ukwephulwa okunjalo kungazwakala zombili ngesikhathi sokuzalwa nakusikhathi sobusha, lapho kwenzeka ukuphazamiseka kwehomoni emzimbeni. Kodwa-ke, kungenzeka kuphela ukukhomba ubukhona bokuguqulwa kwezakhi zofuzo nokukhula kwesifo sikashukela modi ngokwenza izifundo zofuzo.
Ngenxa yalolu cwaningo, kungenzeka ukunquma kahle ukuthi yiluphi uhlobo lwofuzo oluguqulwe enganeni ngesikhathi sokukhula kwengane. Futhi njengoba ososayensi bethole izinhlobo ze-8 zofuzo eziguqula ukuthuthukiswa kwalolu hlobo lwe-pathology, ngokulandelana, ukuguqulwa ngakunye kunikeza isithombe esihlukile sasemtholampilo futhi kudinga indlela ehlukile yokwelashwa.
Isifo singabonakala kanjani?
Kunzima kakhulu ukusola ukuthuthukiswa kwesifo sikashukela ezinganeni nakubantu abasebasha, njengoba iqhubeka ngokuncipha futhi ingenazo izimpawu zokuphawula. Kodwa-ke, ukwenzeka kwalesi sifo kungahlala kufane nezimpawu ezenzeka ngesifo sikashukela sohlobo 1, ezihambisana nezimpawu ezilandelayo:
- ukuqala kosuku olubizwa ngokuthi yi-honeymoon yesifo sikashukela, ebonakala ngesigaba eside sokuxolelwa (okungaphezu konyaka ongu-1) kanye nokungabikho kokudonswa kwemali (ukuwohloka kokusebenza kwezitho zangaphakathi nezinhlelo ngokuwohloka okuhambisana nakho enhlalakahleni ephelele);
- ukuntuleka kwama-ketones egazini ngesikhathi sesigaba sokuqhakaza lesi sifo;
- ukukhonjwa kokusebenza okugcwele kwama-pancreas kanye nokuhlanganiswa okujwayelekile kwe-insulin, okuhlolwa ngokuthatha igazi (ngeleveli evamile ye-insulin, ukuqina kwe-C-peptide egazini nakho kuhlala kungaphansi kwemikhawulo ejwayelekile);
- ukwehla ushukela kanye nokugcinwa kwawo ngamanani ajwayelekile esikhathini eside kutholakala ngokusebenzisa imithamo emincane ye-insulin;
- lapho kudlula ukuhlolwa, ama-antibodies kuya kumaseli we-beta kanye nama-insulin awatholakali;
- akukho ukuhlangana nohlelo lwe-HLA;
- amanani we-glycated hemoglobin ahlala ejwayelekile.
Indlela yokuthuthukiswa kwesifo sikashukela modi
Ukuxilongwa kwesifo sikashukela i-modi kungenziwa ngaphandle kwemiphumela uma umuntu eba nethuba lokuthola isifo sikashukela noma umama wakhe kutholakale ukuthi unesifo sikashukela sokukhulelwa ngesikhathi sokukhulelwa. Udokotela angaphinde asole ukuthuthukiswa kwalesi sifo ngemuva kokuthola imiphumela yokuhlolwa okukhombisa ukuthi isiguli sikhubazekile ukubekezelelwa kwe-glucose yamaseli emzimbeni.
Imvamisa, udokotela ubeka ukuhlolwa okungeziwe ezimweni lapho umuntu oneminyaka engaphezulu kweminyaka engama-25 etholakala ukuthi unesifo sikashukela sohlobo 2. Ngasikhathi sinye, akanazo izimpawu zesifo futhi akanawo ukukhuluphala.
Njengoba isifo sikashukela se-Mody sivame ukuvela ngaphandle kwesithombe esicacile somtholampilo, bonke abazali, ngaphandle kokungafani, kufanele basibheke njalo isimo sengane yabo. Isizathu sokukhathazeka ukubukeka ngezikhathi ngezikhathi zeminyaka eminingana yezimpawu ezifana:
- ukuba khona kwe-hyperglycemia elambile, lapho ushukela wegazi ukhuphukela ku-8,5 mmol / l, kepha azikho izimpawu ezinjengokuchama okwengeziwe, ukuncipha kwesisindo ne-polydipsia;
- ukuhlonza ukwephulwa kokubekezelelwa kwamaseli omzimba kuma-carbohydrate (atholwe ngokuhlolwa kwegazi).
Ngakho-ke, izingane ezincane ezinesifiso sokuthola ifa likashukela kufanele zikala amazinga kashukela wazo njalo. Futhi uma izinkomba ziqale ukuguquka futhi zedlula okujwayelekile, kufanele ucele usizo kudokotela, noma ngabe kungekho ezinye izinkomba zesifo sikashukela.
Udokotela kuphela ongaxilonga ngokufanele ngemuva kokuthola imiphumela yazo zonke izivivinyo ezidingekayo.
Izinhlobo Ezihlukahlukene Zesifo Sikashukela Se-Mody
Njengoba kushiwo ngenhla, kunezinhlobo eziyisishiyagalombili ezingashintsha futhi zivuse ukuthuthuka kwesifo sikashukela modi. Kodwa-ke, lesi sifo sehlukaniswe izinhlobo ezingama-6 futhi zonke zinezimpawu zazo. Uhlobo ngalunye lwesifo sikashukela modi lubizwa ngokuthi: mody-1, mody-2, mody-3, njll.
Kukholelwa ukuthi uhlobo lwesifo esithambile kunazo zonke yi-mody-2. Ngokukhula kwayo, i-hyperglycemia esheshayo yenzeka kakhulu kakhulu, futhi ukukhula kwesimo esinjengokuthi i-ketoocytosis kucishe kungalungiswa. Kodwa-ke, ezinye izinkomba zesifo sikashukela nazo azikho. Njengoba izibalo zomhlaba zibonisa, inani elikhulu kakhulu labantu abatholakala benesifo sikashukela se-mody-2 bahlala eFrance naseSpain. Siyini isizathu, ososayensi namanje abakakwazi ukukhomba.
Njengoba isifo sikashukela se-Mody sicishe sibe njenge-asymptomatic, isidingo semijovo ye-insulin siyivelakancane kakhulu.
Ngokuthuthuka kwalolu hlobo lwesifo, umthamo omncane we-insulin uvumela ukufeza isimo esinxephezelayo. Njengoba lesi sifo singabangeli usizi olukhulu esigulini futhi singathinti ikhwalithi yempilo yakhe, isidingo sokwandisa umthamo we-insulin cishe asikaze siqhamuke.
I-Mody-3 ivame ukutholakala ezakhamuzini zamazwe ase-Europe, okuyiNetherlands neJalimane. Njengomthetho, lesi sifo siqala ukukhula ezinganeni ezineminyaka engaphezu kwe-10 ubudala futhi sivame ukuholela ezinkingeni ezinkulu.
Kodwa i-mody-1 iyindlela eyivelakancane kakhulu ye-pathology futhi itholakala kuphela 1% yabantu abanesifo sikashukela. Lesi sifo siqhubeka ngesimo esibi kakhulu futhi kwesinye isikhathi siholela ekufeni. Kepha i-mody-4 ivame ukutholakala kwabasakhulayo abaneminyaka yobudala eyi-15-17. Kuneziphakamiso ukuthi umfutho oyinhloko wokukhula kwayo ukuphazamiseka kwama-hormone emzimbeni, kepha lokhu akukaze kufakazelwe ngomuthi osemthethweni.
I-Mody-5 esesithombeni sayo somtholampilo iyafana nokukhula kwe-mody-2, kepha ngokungafani nalolu hlobo lwesifo, ivame ukuholela ekwakhiweni kwezinkinga ezifana nesifo sikashukela nesifo sikashukela.
Ngabe welashwa kanjani?
Ngenxa yokuthi ukungasebenzi kahle kwe-pancreatic akubonwa ngokuthuthukiswa kwesifo sikashukela, ukwelashwa kusetshenziswa ikakhulu okufanayo ne-T2DM. Okusho ukuthi, ekuqaleni kwentuthuko yesifo, isiguli sabelwa ukudla okune-carb okuphansi kanye nokuzivocavoca okulinganiselayo. Lokhu kukuvumela ukuthi wenze ushukela wegazi ube ngokwejwayelekile futhi uvikele ukuvela kwe-hyperglycemia.
Ngaphezu kwalokho, ezinye izindlela zokwelapha zingasetshenziswa njengezokwelapha zokwelapha. Isibonelo, iziguli eziningi ezitholakale zinesifo sikashukela se-modi zingathola isinxephezelo unomphela ngokuzivocavoca ngokuphefumula kanye ne-yoga. Zenziwa kuphela ngaphansi kokuqashwa okuqinile kongcweti.
Ukuzivocavoca okusesilinganisweni ku-mellitus yesifo sikashukela kungafinyelela isinxephezelo esimeme
Umuthi ohlukile unikeza imiphumela emibi efanayo. Kodwa-ke, odokotela abazikhuthazi ukusebenzisa amakhambi abantu njengekhambi eliyinhloko, ngoba umzimba womuntu ngamunye ungabantu futhi kwesinye isikhathi abaniki umphumela olindelekile, futhi ukuqhubeka kwesifo kuyaqhubeka.
Kungenxa yalesi sizathu ukuthi udokotela kuphela okufanele abhekane ne-modi yesifo sikashukela. Noma isiguli sikhetha omunye umuthi njengezokwelapha, ngokuqinisekile kudingeka sikuxhumanise lokhu nodokotela onguchwepheshe.
Kufanele kuqondwe ukuthi uma uphuthelwa isikhathi lapho ungafinyelela khona isinxephezelo esizinzile, kuzokuba nesidingo sokusetshenziswa kwezidakamizwa njalo okwehlisa ushukela kanye nemijovo ye-insulin. Futhi lokhu akubizi kuphela, kodwa futhi kuyinkimbinkimbi.
