I-Etiology ne-pathogenesis yohlobo 1 sikashukela

Ukuphazamiseka kwe-Endocrine okuhambisana nokungasebenzi kahle kokuqina kwepancreatic nokungasebenzi kahle kwe-insulin kuholela ekwakhekeni kwesifo esingalapheki - uhlobo 1 lwesifo sikashukela.

I-Pathology idinga isinxephezelo njalo sokushoda kwe-hormone, ngaphandle kwalokho izinga likashukela wegazi liyenyuka futhi licasule ukwenzeka kwemiphumela emibi.

Izimbangela ze-pathology

Isifo sikashukela sohlobo lokuqala siyisifo esivamile esitholakala ezigulini nasezinganeni ezincane. Isifo sikashukela esincike ku-insulin sinekhodi ye-ICD engu-10 - E 10.

I-pathogenesis ye-pathology isuselwe ekubhujisweni kwamaseli we-pancreatic abhekene nokukhiqizwa kwe-insulin. I-Iron ibhujiswa ngenxa yokuhluleka kwe-autoimmune komzimba noma ngaphansi kwethonya lezinye izinto ezimbi.

Ngenxa yesilinganiso esanele se-hormone ekhiqizwayo, inqubo yokufakwa kweglucose kumaseli wezitho iyaphazamiseka, bese ushukela uqala ukunqwabelana egazini.

Lokhu kuholela enkingeni yamandla nokwehlulwa kwazo zonke izinhlelo zangaphakathi. Futhi, ngemuva kwesizinda sikashukela sohlobo 1, izifo eziningi ezingathi sína ziba, imbangela yokukhubazeka noma ukufa kwesiguli.

I-etiology yalesi sifo ayizange ifundwe ngokugcwele, kepha esinye sezizathu zokwakhiwa kwesimo se-pathological yinto eyifa. Uhlobo lofuzo olushintshiwe luhanjiswa emazingeni ezakhi zofuzo futhi lucasule uhlelo lwe-autoimmune lomzimba ukuhlasela ama-pancreas alo. Lokhu kuchaza iqiniso lokuthi uhlobo 1 sikashukela luvame ukutholakala ebuntwaneni nasezigulini ezinezihlobo zalo eziseduze ezigula ngesifo sikashukela.

Ngaphezu kwalokho, kukhona izibalo ngokulandelayo:

• uma ubaba egula, khona-ke amathuba engane okuthuthukisa i-pathology akhuphuka ngo-5-6%;
• uma umama, khona-ke amathuba okuba nesifo sikashukela akhuphuke ngo-2%;
• uma ungumfowethu noma udadewethu, ubungozi besifo sikashukela bukhuphuka ngamaphesenti angaphezu kuka-6.

Ngaphezu kofuzo, izizathu zokwakhiwa kwesifo sikashukela sohlobo 1 zingaba yizici ezinjalo:

• izifo zokuvuvukala ze-pancreatic;
• ukulimala kwe-gland nokuhlinzwa;
• izifo ezithathelwanayo;
• ukuthatha imishanguzo ethile (ama-antipsychotic, ama-glucocorticoids);
• isifo sesibindi.

Lesi sifo sihlukaniswe izinhlobo eziningi, kuye ngezimbangela zentuthuko:

• ukuvuvukala - kwenzeka ngokumelene nesizinda sezinqubo zokuvuvukala ezenzeka kumanyikwe;
• i-autoimmune - yakheka ngaphansi kwethonya lokwehluleka kwe-autoimmune;
• I-idiopathic - iba ngezizathu ezingaziwa.

Izigaba zokwakheka kwalesi sifo nazo zinokuhlukaniswa kwazo:

• i-prediabetes - ukuphambuka okungenamsebenzi kuyabonwa ekuhlaziyeni, isimo sempilo sesiguli asiguquki;
• isiteji esifihliwe - ngokwemiphumela yocwaningo, izinkomba azihlangabezani namazinga, azikho izimpawu;
• isigaba esibonakalayo ukubonakaliswa okuphelele kwezimpawu zesifo.

Ubunzima balesi sifo buhlukaniswa ngama-degree amathathu:

1. Ukufundwa okuthambile - ushukela kuyinto evamile kumchamo futhi kuphakanyiswa kancane egazini. Izikhalazo zesiguli azikho.
2. I-degree ngokulinganisela - izimpawu eziphambili zesifo sikashukela ziyavela. Ushukela uyaphakanyiswa kuyo yonke iplasma nomchamo.
3. I-degree eqinile - Izinkomba ze-glucose zifinyelela izinombolo ezibucayi, izimpawu zesimo sesimo esihle zibonakaliswa kakhulu.

Ividiyo evela kuDkt Komarovsky mayelana nezimbangela zesifo sikashukela 1:

Izimpawu eziphambili zalesi sifo

Isifo sikashukela sohlobo loku-1 sibhekwa kaningi ezigulini ezinomzimba omncane, ngokungafani nohlobo lwe-2 pathology, ebonakala ngokuba khona kweziguli ezinamazinga ahlukahlukene okukhuluphala.

Isifo sikashukela ikakhulukazi sikhononda ngokubonakala kwesifo okufana nalokhu:

• Ukuphelelwa amandla nokungaphatheki kahle;
• ukulala isikhathi sasemini kanye nokuqwasha;
• ukomela okungagculisi nokudla okwandayo;
• ukuchama kaningi nokukhipha umthamo omkhulu womchamo;
• ukomisa ulwelwesi lwamafinyila lomlomo wesibeletho nesikhumba;
• ukuqunjaza nokulunywa;
• ukukhuphuka kokujuluka nokwenziwa yisinono;
• ukwanda kokucindezelwa umkhuhlane nezifo ezibangelwa amagciwane;
• isicanucanu, uhudo, nobuhlungu besisu;
• ukuvela kokuphefumula nokuphefumula;
• ukwanda kwengcindezi;
• ukwehla kwesilinganiso sokuvuselelwa kwezicubu ezithambile;
• kwabesifazane, umjikelezo wokuya esikhathini uphazamiseka, futhi emadodeni, i-potency iyancipha;
• ukuzwakala kwezitho zomzimba kuzwakala;
• kukhona ukwehla noma ukwanda kwesisindo somzimba.

Uma kungekho ukwelashwa kanye nokuqhubeka kwesifo, kungavela izimpawu ezilandelayo:

• ukwehla kwesilinganiso senhliziyo nokucindezela;
• umkhuhlane
• ukuzamazama kwemilenze;
• ukonakala kwe-visual acuity;
• umoya we-acetone;
• ubuthakathaka bemisipha;
• ubunzima bekhuluma kanye nokuntuleka kokuxhumana;
• ukwazi okwenziwe ngengqondo nokufiphala.

Lezi zibonakaliso zikhombisa ukuthuthukiswa kwenkinga eyingozi - i-ketoacidotic coma futhi idinga ukunakekelwa okuphuthumayo kwezokwelapha ukuvimbela ukufa.

Izinkinga zesifo sikashukela sohlobo 1

Ukuqina okunyuselwa njalo kwe-glucose kwiplasma yegazi kudala ukuphazamiseka ekusebenzeni kwesistimu ye-vascular, kuphazamisa ukuhamba kwegazi futhi kuholele ekulimaleni kwezitho zangaphakathi.

Izinkinga ezivamile ngenxa yesifo sikashukela yilezi zifo ezilandelayo:

1. I-retinopathy - ukulimala emikhunjini ye-retina. Ngenxa yokunganele kwegazi, ifomu le-aneurysms kuma-capillaries e-retina. Lokhu kuholela ekunciphiseni okubukhali kombono kanye nengozi enkulu yokuqina kwegazi. Ngaphandle kokwelashwa okufika ngesikhathi, ukuphuma kwe-retina kwenzeka futhi kwisifo sikashukela, ubumpumputhe obugcwele buvela.
2. I-Nephropathy - kulokhu, imithambo ye-renal iyathinteka, eyephula umsebenzi wokuhlunga nowokuvelela kwezinso. Ngenxa yalokhu, ukufakwa kwezinto eziwusizo egazini kunzima, umzimba uqala ukulahlekelwa ngamaprotheni nama-electrolyte ngomchamo. Esikhathini esizayo, lesi sifo siyaqhubeka futhi sidlulela esigabeni esingenakuphikwa njengokwehluleka kwezinso.
3. Izinkinga zenhliziyo. I-Hypertension ne-atherosclerosis yimiphumela ebonakalayo yesifo sikashukela. Ngenxa yalokhu, ukuhanjiswa kwegazi enhliziyweni nasengqondweni kuya ngokuwohloka, okuholela ekuhlaselweni yinhliziyo nokushaywa unhlangothi.
4. Unyawo lwesifo sikashukela - ukuphazamiseka kokujikeleza okunamandla nokulimala kokuphela kwezinzwa emaphethelweni aphansi. Imilenze kancane kancane ilahlekelwa umuzwa wayo, amanxeba amade angapholi kanye nezilonda emzimbeni wesikhumba, kuthi kuqhume izindawo zezicubu ezivalelwa yi-necrosis. Ngaphandle kokwelashwa okufanele, i-gangrene iyakhula, edinga ukunqunywa kwelungu.
5. I-Neuropathy - amangqamuzana ezinzwa abhekene nokudluliselwa kwezihibe zezinzwa emalungwini nasezithweni zangaphakathi kuyathinteka. Ngenxa yalokhu, amasistimu wokugaya ukudla nenhliziyo, isigaxa siyaphazamiseka, kanti ukusebenza kwemoto kuyahlupheka. Isiguli siyayeka ukuzwa izinhlungu kanye namazinga okushisa, uqala ukungasebenzi kwe-urinary futhi kunobunzima bokugwinya nokugaya ukudla, ingozi yokuhlaselwa yisifo senhliziyo iyanda.
6. I-Coma - iba ngumphumela wokwanda okusheshayo noma ukuncipha kwe-glucose kwiplasma yegazi. Kubonakala ngokulahlekelwa ukwazi kwesifo sikashukela kanye nokubulawa yindlala okubalulekile komoya. IComa idinga ukuvuselelwa okuphuthumayo, ngaphandle kwalokho kungenzeka kube nokuhlaselwa yisifo sohlangothi, ukushaya kwenhliziyo, ukuwohloka komqondo noma ukufa.

Uma unikezwe ubunzima bezinkinga, kufanele uthintane nodokotela ngemuva kokuqala kwezimpawu zokuqala zalesi sifo. Lokhu kuzokwenza ukuthi sikwazi ukubona nge-pathology emazingeni okuqala entuthuko futhi ukhethe izindlela zokwelapha ezifanele ezizosiza ukugcina okuqukethwe ushukela kungakapheli imikhawulo eyamukelekayo futhi kuvimbele noma kubambezele imiphumela.

Izindlela Zokuxilonga

Ukuxilongwa kwalesi sifo kuqala ngokuqoqwa kwemininingwane mayelana nezikhalazo, indlela yokuphila kanye nemikhuba yesiguli, mayelana ne-pathologies yakhe edlulisiwe nehambisana nayo. Kubalulekile ukuthi udokotela azi ngamacala abantu abathola isifo sikashukela emndenini oseduze.

Ngokuzayo, izifundo zokuxilonga zibekiwe:

• ukuvivinya ushukela;
• ukuhlolwa kweglucose yegazi;
• ukuhlolwa kwegazi kwemitholampilo nokujwayelekile;
• ukuhlolwa okujwayelekile komtholampilo;
• ukuvivinya ubukhona be-C-peptides emthanjeni wegazi nemizimba ye-ketone emchameni;
• ukuhlolwa kwe-hemoglobin ye-glycosylated;
• isifundo sephrofayili ye-glycemic.

Ukuhlolwa kokubekezelela kwe-glucose

Ngaphezu kwalokho, ukucabanga kwe-ultrasound kanye ne-magnetic resonance kwenziwa ukuthola ubukhulu bomonakalo wezitho zangaphakathi.

Ukwelashwa kwe-insulin nezindlela ezintsha zokwelapha

Isifo sikashukela sohlobo loku-1 yisifo esingalapheki futhi izindlela zokwelapha ngokuphelele i-pathology azikabikho.

Ukwelashwa okunekhono kungagcina kuphela izinga ephephile likashukela kwiplasma yegazi, kuvikele ukukhula kwemiphumela. Indima enkulu yalokhu inikezwa ekwelashweni kwe-insulin - indlela yokugcwalisa ukuntuleka kwe-insulin ye-hormone yegazi.

I-insulin ifakwa emzimbeni. Umthamo we-hormone kanye nenani lemijovo yansuku zonke ibalwa kuqala ngudokotela, bese kubalelwa isiguli uqobo futhi kudinga ukubambelela ngokuqinile.

Ngaphezu kwalokho, isiguli sidinga ukukala ukugcwala koshukela endaweni ye-plasma yegazi kaningana ngosuku kusetshenziswa i-glucometer.

Imvamisa, iziguli ezinesifo sikashukela ziphindaphinda amahlandla ama-3 noma ama-4 ngosuku futhi kwezinye izimo zivunyelwe ukunciphisa inani lemijovo liye kabili kathathu ngosuku.

Ngokuya kobunzima benkambo, kusetshenziswa i-insulin yobude besikhathi sokusebenza:

• i-insulin emfushane - isikhathi se-hormone asidluli amahora ama-4, kanti i-insulin elawulwayo iqala ukusebenza ikota yehora;
• i-hormone ejwayelekile - isebenza cishe amahora ayi-6, futhi iqala ukusebenza isigamu sehora ngemuva komjovo;
• i-insulin esezingeni eliphakathi nendawo - ukusebenza ngempumelelo kwalomphumela kuyabonakala ngemuva kwamahora we-2-4 futhi kuthatha amahora angama-18;
• i-insulin ende - ikuvumela ukuba ulondoloze amazinga e-glucose ayemukelekayo amahora angama-24 futhi uqala ukusebenza amahora angama-4-6 ngemuva kokuphathwa.

Ngokuvamile, i-insulin ende iphathwa kanye noma kabili ngosuku. Lokhu kuthatha indawo yezinga lemvelo le-hormone ekhona emzimbeni womuntu ophilile usuku lonke. I-insulin emfushane ifakwa ngaphambi kokudla ngakunye, okukuvumela ukuthi wehlise izinga likashukela elikhuphuka ngemuva kokuba ukudla kungene emzimbeni. Kwesinye isikhathi kufanele ufake i-hormone phakathi nosuku, uma ukusebenza komzimba kunyuka noma ukudla kuyaphazamiseka.

Ividiyo mayelana nendlela yokubala i-insulin:

Ukuthuthuka okuthembisayo yindlela yokufakelwa kwamanyikwe noma okwenziwe ngamaseli awo. Ukusebenza okunjalo sekuqalile ukwenziwa kwamanye amazwe futhi kuqinisekisa ukusebenza kwendlela. Iziguli ezingaphezu kwesigamu ngemuva kokuhlinzwa ziqeda isidingo somjovo we-insulin nsuku zonke, futhi cishe ama-90% esifo sikashukela abika ukuthi i-glucose igcinwa inganqunyelwe.

Enye indlela ethembisayo yokulungisa amaseli e-pancreatic owonakalile ukuphatha umuthi okhethekile wokugomela iDNA.

Ngakho-ke, iziguli ezinesifo sikashukela zinethuba elandayo lokuthi ngokuhamba kwesikhathi, lapho izindlela ezintsha sezitholakala kalula, zizokwazi ukululama ngokuphelele isifo esiyingozi. Okwamanje, kusala kuphela ukubhekisisa ushukela wegazi futhi ulandele zonke izincomo zikadokotela.

Iziphakamiso ngesikhathi sokwelashwa

Ngaphezu kwemijovo ye-insulin, ukudla kungasiza ekugcineni amazinga e-glucose ajwayelekile. Ukudla kufanele kube yindlela yokuphila yomuntu onesifo sikashukela, ngoba kuye ngokuthi yikuphi ukudla okudliwayo kanye noshukela kuphakama egazini ngejubane elihlukile.

Ezinye izinhlobo zemikhiqizo kuzodingeka zikhishwe ngokuphelele ekudleni:

• uthenge iziphuzo ezikhwameni nakushukela omnandi;
• izinhlanzi ezinamafutha nemikhiqizo yenyama;
• ukudla okusemathinini, ukudla okulula kanye nenyama ebhemayo;
• imikhiqizo yobisi nobisi omuncu enamaphesenti amaningi okuqukethwe kwamafutha;
• namakhekhe, isinkwa esimhlophe, amaswidi, amakhekhe kirimu noshokoledi;
• amasoseji enamafutha nezinongo, ukosa nezinongo;
• amagilebhisi;
• iziphuzo eziqukethe utshwala.

Imenyu kufanele ibe nezithako ezilandelayo:

• izinhlanzi ezinamafutha nenyama enamafutha;
• ukudla kwasolwandle nokusolwandle;
• imikhiqizo yobisi ekhephu kanye nemikhiqizo yobisi olunoshukela, ushizi;
• amafutha emifino;
• i-rye nesinkwa esiphelele sokusanhlamvu;
• amaqanda, ubhontshisi, amantongomane;
• i-buckwheat, irayisi elinsundu, ibhali;
• izithelo ezingafakiwe kanye nezithelo zomawolintshi;
• amakhambi amasha nemifino;
• itiye elibuthakathaka ngaphandle koshukela kanye nama-decoctions wezithelo.

Imikhiqizo elandelayo ivunyelwe ngobungako obuncane:

• izithelo ezintsha ezisikiwe;
• izithelo ezomisiwe;
• amajikijolo amnandi nezithelo.

Lezi zinhlobo zemikhiqizo azikwazi ukudliwayo zingadluli kanye kanye noma kabili ngeviki futhi akukho ngaphezu kwengilazi eyodwa kasawoti noma izithelo eyodwa.

Izitsha ezinama-carbohydrate asheshayo kufanele ziqedwe ngokuphelele. Ushukela kufanele ungene esikhundleni soshukela bemvelo. Khawulela ukusetshenziswa kosawoti, kanye nezitsha ezithosiwe kawoyela. Nikeza imifino eluhlaza, izitsha ezibilisiwe nezinesitshulu. Susa izikhawu ezinde phakathi kokudla futhi udle okungenani izikhathi ezinhlanu ngosuku. Khonza izingxenye ezincane ukugwema ukudla kakhulu. Ungakhohlwa ngamanzi ahlanzekile; phuza okungenani izingilazi ezi-6 nsuku zonke.

Izinto zevidiyo ezikondlayo zesifo sikashukela:

Isifo sikashukela siguqula indlela yokuphila ejwayelekile yesiguli, ibaphoqelele ukuthi bashintshe imikhuba yabo, bazilinganisele ekudleni abakudlayo, bakala amazinga kashukela egazini kaningana ngosuku, futhi bajobe i-insulin.

Kepha ngaphansi kwezimo ezinjalo kuphela lapho ungagcina impilo enhle futhi ugweme izinkinga.