I-diabetes mellitus yisimo se-pathological sohlelo lwe-endocrine yomuntu, ebonakala ngokungalingani ngokwanele kwe-insulin noma ukumelana kwamangqamuzana omzimba kwi-hormone lapho ikhiqizwa ngamanani anele. Umphumela uba inani elikhulayo le-glucose egazini, okuholela ekuphazamisweni kwezinqubo ze-metabolism, amaseli we-trophic kanye nezicubu, i-vascular and nerve pathologies.
Ukuxilongwa kwesifo sikashukela kufanele kwenzeke ekubonisweni kokuqala, ukuze ukwelashwa kwanele futhi kufike ngesikhathi. I-athikili ixoxa ngemibuzo mayelana nokuxilongwa okuhlukile kwezinhlobo zohlobo 1 kanye nezifo ezi-2 ezinganeni nakubantu abadala, mayelana nokuhlaziywa okudingekayo ukuqinisekisa ukutholwa, kanye nokucaciswa kwemiphumela.
Izinhlobo ze-pathology
Isifo sohlobo 1 (ifomu elincike kwi-insulin) livame ukwenzeka esemncane nasezinganeni, ngoba izimbangela zokubonakala kwaso isenzo sezici zangaphandle nezasendulo ngokuhlanganiswa nokwenzelwa ifa. Ama-viral agents namagciwane, izinqubo ze-autoimmune zivusa ukufa kwamangqamuzana ahlanganisa i-insulin. I-Hormone ayikhiqizwa ngenani elidingekayo. Ukwelashwa kwaleli fomu ukwelashwa kwe-insulin kuhlanganiswe nokudla okune-carb ephansi.
I-Type 2 pathology (ifomu elizimele le-insulin) libhekene nabantu asebekhulile, labo abakhuluphele, baphila impilo yokuhlala. Ama-pancreas akhiqiza ama-hormone anele, kwesinye isikhathi ngisho nangaphezu kwesidingo. Amangqamuzana nezicubu zomzimba ziba bucayi i-insulin ngaphandle kokusabela esenzweni sawo. Umtholampilo waleli fomu awubizwa ngokuthi isifo sohlobo 1. Ukwelashwa wukudla okune-carb ephansi nezidakamizwa eziphonsa ushukela.
Ukuboniswa kwesifo sikashukela
Izimpawu ongacabanga ngazo ngokuthuthukiswa kwalesi sifo yilezi ezilandelayo:
- ukulunywa kwesikhumba;
- ukwanda kokuchama;
- umuzwa ongapheli wokoma;
- ushintsho kwesisindo somzimba (ezigabeni zokuqala, ukwehla okubukhali kwesisindo, bese inzuzo eyeqile);
- iphunga le-acetone elisuka emlonyeni (enohlobo 1);
- ukuhlaselwa okukhokhisa izicubu zamathole;
- ukuqubuka kwesikhumba njenge-furunculosis.
Ukubonakaliswa okunjalo kunesimo esoshukela esincike kakhulu ku-insulin. Uhlobo lwe-2 lungaba yi-asymptomatic isikhathi eside (kufihliwe, lwenziwe ngokufana).
Ukutholwa kusenesikhathi kwezimpawu zesifo isinyathelo sokugcina izinga eliphakeme lokuphila
Ezinganeni, lesi sifo sinezimpawu ezicace ngokwengeziwe. Kuboniswa ukukhathala okusheshayo, ukozela, umthamo wokusebenza ophansi, ukuncipha kwesisindo ngemuva kokudla ngokweqile okwandayo.
Ukwehluka
Ukuxilongwa okuhlukile kwesifo sikashukela kuqukethe izivivinyo zaselebhu kanye nomlando wezokwelapha. Ngaphezu kokwenza ukuxilongwa okuyikho, kuyadingeka ukuthola isimo sayo. Umehluko Ukuxilongwa kwenziwa ngezimo ezilandelayo zokugula ezichazwe etafuleni.
| Lesi sifo | Incazelo | Ukubonakaliswa kwemitholampilo |
| Isifo sikashukela | I-Pathology yesistimu ye-hypothalamic-pituitary, ebonakala ngokushoda kwe-vasopressin ye-hormone | Ukuchama okuningi, ukoma, isicanucanu, ukugabha, isikhumba esomile, ukomisa |
| Isifo sikashukela seSteroid | Lesi sifo senzeka ngenxa ye-adrenal gland pathology noma ngemuva kokusetshenziswa isikhathi eside kwezidakamizwa ze-hormonal | Ukuchama okuningi, ukomela ngokulingana, ubuthakathaka, ukukhathala. Izimpawu ziyavilapha |
| I-glucosuria yangempela | Ukuba khona kwe-glucose kumchamo ngamazinga ayo ajwayelekile egazini. Kwenzeka ngokumelene nesizinda sesifo sezinso esingamahlalakhona | Ubuthakathaka, ukukhathala okungaguquki, isikhumba siyoma, sithola umbala ophuzi. Ukulunywa okuqhubekayo kwesikhumba |
| I-Alimentary Glucosuria | Ukuba khona kweshukela emchameni ngemuva kokudla okubalulekile kwama-carbohydrate ekudleni naseziphuzweni | Ukuchama kaningi, ukoma, ubuthakathaka, ukusebenza okunciphile, ukozela |
Izindlela zokucwaninga
Kungenzeka ukuthola isifo sikashukela ngemuva kokuhlolwa kwegazi lomchamo, i-venous ne-capillary. Thola izinga likashukela, izinkomba eziningi ze-insulin, izinga le-hemoglobin ye-glycosylated, i-fructosamine, ihlole inani elithile lezinto zokuxilonga ezithombeni ezixhunywe kwi-enzyme ezixhumene ne-enzyme.
I-Urinalysis
Enye yezindlela eziphambili zokuxilonga, esetshenziswa njengengxenye yokuhlolwa komzimba. Umuntu ophilile akufanele abe noshukela umchamo; kwezinye izimo, ukuba khona kwe-0.8 mmol / L kuvunyelwe. Uma kunezinkomba ezingenhla, igama elithi "glucosuria" liyasetshenziswa.
Ukuze uqoqe izinto zokucwaninga, udinga ukulungisa isitsha esomile esomile nenqubo yokuhlanzeka. Ingxenye yokuqala yomchamo ayisetshenziswa, maphakathi iqoqwe esitsheni, kuthi okokugcina kudedelwe endlini yangasese. Kufanele ihanjiswe elabhorethri ngokushesha okukhulu ukuze imiphumela ilungile.
Umchamo uketshezi lokuzalwa olunezinkomba ezibalulekile zokuxilonga.
Izidumbu zeKetone
Ukuvela kwe-acetone kumchamo kuwubufakazi bokuthi ukuphazamiseka kwe-metabolic kwenzeka ezingeni le-lipid ne-carbohydrate metabolism. Ukunquma imizimba ye-ketone, izivivinyo ezithile ziyadingeka. Ngaphezu kokuxilongwa elabhorethri, i-acetone yomchamo ezinganeni nakubantu abadala "ingabonakala" ngosizo lwemivimbo yokuhlolwa, etholakala emakhemisi.
Ukuzimisela kwamaprotheni omchamo
Lokhu kuhlaziywa kukuvumela ukuthi unqume ukuba khona kwezinkinga zesifo sikashukela ngendlela ye-nephropathy. Izigaba zokuqala ze-pathology zihambisana nokuvela kwenani elincane le-albhamuin, ngokuwohloka kombuso, izinga lamaprotheni liba ngaphezulu.
Isibalo segazi esiphelele
Ungalinikela kanjani ngegazi ushukela ngomthwaloIgazi lingamanzi wegciwane, izinkomba eziphambili zazo ezishintsha ngokwephulwa kwezitho nezinhlelo zomzimba. Izindlela zokuhlola ezihlolwe ngesikhathi sokuhlaziywa:
- izinkomba zokulinganisa zezinto ezakhiwe;
- izinga le-hemoglobin;
- izinkomba zokubumbana;
- i-hematocrit;
- isilinganiso se-erythrocyte sedimentation.
Ukuhlolwa kwe-glucose
Sebenzisa igazi le-capillary noma le-venous. Ukulungiselela ukuqoqwa kokuqukethwe kungokulandelayo:
- ekuseni ngaphambi kokuhlaziywa, ungadli lutho, ungaphuza amanzi;
- ngezikhathi ezingama-24 zokugcina ungabuphuzi utshwala;
- Musa ukuxubha amazinyo akho ekuseni, ulahle itshungama, ngoba ushukela uyingxenye yawo.
Ukuhlaziywa kwamakhemikhali
Ukuxilongwa kokwahlukahluka kwesifo sikashukela kuqinisekiswa ekuzimiseleni kwezinkomba ezilandelayo:
- cholesterol - onesifo sikashukela, izinga laso liphakeme kunokujwayelekile;
- I-C-peptide - enesifo sohlobo 1, izinga liyancipha, ngesifo sohlobo 2 - okwejwayelekile noma ngaphezulu;
- ama-fructosamine - izinkomba zanda kakhulu;
- izinga le-insulin - ngohlobo 1, izinkomba ziyancishiswa, ngefomu elizimele le-insulin, elijwayelekile noma elanda kancane;
- lipids - izinga liphakeme.
Ukuhlolwa kwegazi kwe-biochemical - amandla okuhlola izindlela ezibalulekile ezingaphezu kwe-10 zokuhlukanisa ushukela
Ukuhlolwa kokubekezelela kwe-glucose
Ukuhlaziywa kunikezwa ekuseni ngesisu esingenalutho. Igazi lokuxilongwa lithathwa emunweni noma emvinini. Umsizi weLabhoratri unikeza isiguli ukuphuza ikhambi le-glucose elinokuhlushwa okuthile. Ngemuva kwamahora ama-2, impahla iqoqwa ngendlela efanayo nakwimeko yokuqala. Njengoba kuboniswe yi-endocrinologist, amasampula egazi aphakathi angahle adingekile.
Ukuhunyushwa kwemiphumela (ku-mmol / l):
- Akunashukela: esiswini esingenalutho - kuze kufike ku-5.55, ngemuva kwamahora ama-2 - aze afike ku-7.8.
- I-Prediabetes: esiswini esingenalutho - kufinyelela ku-7.8, ngemuva kwamahora ama-2 - aze afike kwayi-11.
- Isifo sikashukela: esiswini esingenalutho - ngaphezulu kwe-7.8, ngemuva kwamahora ama-2 - ngaphezulu kwe-11.
IGlycosylated hemoglobin
Ukuhlolwa okuphoqelekile kokuxilongwa okuhlukile kwesifo sikashukela. Ukuqaliswa kwaso kukuvumela ukuthi ucacisele izinkomba eziningi ze-glucose esegazini ezinyangeni ezi-3 ezedlule. Nikeza kusukela ekuseni kuze kube sekudleni. Ukuqonda imiphumela:
- okujwayelekile ngu-4.5-6.5%;
- uhlobo 1 sikashukela - 6.5-7%;
- Uhlobo 2 sikashukela - 7% noma ngaphezulu.
Ukuqoqwa kwezinto kanye nokulungiswa kwesiguli kuyo yonke imisebenzi engenhla kuyingxenye yokunakekelwa kwezihlengikazi kweziguli ezilungiselweni eziphuma ngaphandle nasezinkulumweni.
Ukuxilongwa kwezinkinga zesifo
Kwezinye izimo, ukuxilongwa kwe- "matenda amnandi" kusethelwa ngemuva kwesizinda sezinkinga. Uma lokhu kwenzekile phambilini, isiguli kufanele sihlolwe kaningi uchungechunge ukukhomba inkinga ezigabeni zokuqala. Emadolobheni nasezikhungweni zezifunda, uhlelo lokuhlolwa lwenziwa ngababekhona kuma-endocrinologists, futhi emadolobhaneni le ndima ingeyabezimo eziphuthumayo.
Udokotela umsizi ongapheli ekulweni nalesi sifo
Uhlelo lokuhlola isampula:
- Ukubonisana nokuhlolwa ngudokotela wezifo zamehlo. Kubandakanya i-ophthalmoscopy, i-gonioscopy, ukuhlolwa kwe-fundus, i-optical tomography (ukukhipha i-retinopathy yesifo sikashukela).
- Ukubonisana nodokotela wezinhliziyo, wenza i-ECG, i-echocardiography, i-coriary angiography (ukuthola ukuthi kukhona isifo senhliziyo (isifo senhliziyo), isifo senhliziyo.
- Ukuhlolwa kwe-angiosurgeon, i-Doppler ne-arteriography yemikhawulo engezansi (ukuhlola ubunikazi bemikhumbi yemilenze, ukuvimbela ukukhula kwe-atherossteosis).
- Ukubonisana kwe-Nephrologist, i-renal ultrasound, renovasography, dopplerography ye-renal vascular (ukukhipha i-nephropathy yesifo sikashukela).
- Ukuhlolwa ngudokotela wezinzwa, ukuzwela kokuzwela, umsebenzi we-reflex, imaging kazibuthe wobuchopho (ukunqunywa kwesifo sikashukela se-neuropathy, i-encephalopathy).
Izindlela zokuxilonga ngesikhathi zikuvumela ukuthi uqale ukwelashwa kusenesikhathi, uvikele ukukhula kwezinkinga ezinzima futhi ulondoloze impilo ephezulu yeziguli.
