Abantu abanoma ibuphi ubudala bathonywa isifo sikashukela. Imvamisa, abantu abaneminyaka yobudala elivuthiwe bahlushwa yiyo.
Kunohlobo lwesifo - IMODY (Modi) - isifo sikashukela, esiboniswa kubantu abasha kuphela. Kuyini lokhu kugula, Ngabe lolu hlobo olungafani nalutho luchazwa kanjani?
Izimpawu ezingeyona eyejwayelekile nezimpawu
Isifo sohlobo lwe-MODI sibonisa indlela ehlukile yesifundo kunokugula okuvamile. I-Symbomatology yalolu hlobo lwalesi sifo ibonakala ngokungalingani futhi ihlukile kwezimpawu zesifo sikashukela sazo zombili izinhlobo 1st ne-2.
Izici zalesi sifo yilezi:
- ukuthuthukiswa kubantu abasha (ngaphansi kweminyaka engama-25);
- ubunzima bokuxilongwa;
- amaphesenti aphansi wezehlakalo;
- inkambo ye-asymptomatic;
- inkambo ende yesigaba sokuqala sesifo (kufika eminyakeni eminingana).
Isici esiyinhloko salesi sifo esingesiso esijwayelekile ukuthi sithinta abantu abasha. Imvamisa IMODYLA yenzeka ezinganeni ezincane.
Lesi sifo kunzima ukusithola. Isimpawu esisodwa kuphela esingaveziwe esingakhombisa ukubonakaliswa kwayo. Kuvezwa ngokwanda okungenangqondo ezingeni likashukela wegazi ingane lifinyelele ku-8 mmol / l.
Isimo esifanayo singenzeka kuye kaninginingi, kepha asihambisani nezinye izinkomba zesifo sikashukela esivamile. Ezimweni ezinjalo, singakhuluma ngezimpawu zokuqala ezifihliwe zokukhula kwengane uModi.
Lesi sifo sikhula emzimbeni wentsha isikhathi eside, leli gama lingafinyelela iminyaka eminingana. Ukuboniswa kuyafana ngandlela thile ukuthayipha isifo sikashukela sesi-2, esenzeka kubantu abadala, kepha lolu hlobo lesifo lukhula ngendlela emnene. Kwezinye izimo, lesi sifo senzeka ezinganeni ngaphandle kokwehla kokuzwela kwe-insulin.
Kulolu hlobo lwesifo, imvamisa ephansi yokubonakaliswa ibonakala ngokuqhathaniswa nezinye izinhlobo zesifo. IMODYULA yenzeka kubantu abasha 2-5% yamacala azo zonke izinhlobo zesifo sikashukela. Ngokwemininingwane engekho emthethweni, lesi sifo sithinta inani elikhulu kakhulu lezingane, sifinyelela ngaphezu kwe-7%.
Isici salesi sifo ukwanda kwako kwabesifazane. Emadodeni, le ndlela yalesi sifo ayivamile. Kwabesifazane, lesi sifo siqhubeka nezinkinga eziba khona njalo.
Yini isifo salolu hlobo?
Isifinyezo IMODI imele uhlobo lwesifo sikashukela esikhulile kubantu abasha.
Lesi sifo sinezimpawu:
- kutholakala kuphela kubantu abasha;
- kwehluka ngendlela yokubonisa ukubonakala ngokuqhathanisa nezinye izinhlobo zesifo sikashukela;
- kuhamba kancane emzimbeni womuntu osemusha;
- iba ngenxa yesandulela sofuzo.
Lesi sifo sofuzo ngokuphelele. Emzimbeni wengane, kuvela ukungasebenzi kahle eziqhingini zeLangerhans ezisezinhlwini zamakhasi ngenxa yokuguqulwa kofuzo ekukhuleni komzimba wengane. Ukuguqulwa kwezakhi zofuzo kungenzeka kuzo zombili ezisanda kuzalwa nasentsheni.
Lesi sifo kunzima ukusithola. Ukuqashelwa kwayo kungenzeka kuphela ngezifundo zamangqamuzana nozalo zomzimba wesiguli.
Umuthi wanamuhla ukhomba ufuzo olungu-8 olubhekele ukuvela kwezinguquko ezinjalo. Ukuguqulwa okuvelayo kwezakhi zofuzo ezahlukahlukene kuhlukaniswa ngokuhluka kwazo nezici. Ngokuya kwesilonda sohlobo oluthile, ochwepheshe bakhetha iqhinga elithile lokwelapha isiguli.
Ukuxilongwa okubhalwe ukuthi “I-MODI-sikashukela” kungenzeka kuphela ngokuqinisekiswa okuphoqelekile kokuguqulwa kwezakhi ezithile zohlobo oluthile. Uchwepheshe usebenzisa imiphumela yocwaningo lwama-molecule wesiguli esisencane ekuxilongeni.
Kungaziphi izimo lapho isifo singasolwa khona?
Ukugqama kwalesi sifo kubonakaliswa ngokufana kwaso nezimpawu zesifo sikashukela sohlobo lwe-1 nolwesi-2.
Izimpawu ezengeziwe ezilandelayo zingasolwa ngokuthuthukisa ingane EMODY:
- I-C-peptide inezibalo ezijwayelekile zegazi, futhi amangqamuzana akhiqiza i-insulin ngokuya ngemisebenzi yawo;
- umzimba awunantuthuko yokwenza ama-antibodies kuma-insulin kanye namaseli we-beta;
- ukuxolelwa okude kwesifo (i-attenuation) yesifo, okufinyelela unyaka;
- akukho ukuhlangana nohlelo lokuhambisana kwezicubu emzimbeni;
- lapho inani elincane le-insulin lingeniswa egazini, ingane inxephezela ngokushesha;
- isifo sikashukela asibonisi isimilo se-ketoacidosis yaso;
- Izinga le-hemoglobin ye-glycated alikho ngaphezu kwama-8%.
Ukuba khona kweModi kumuntu kuboniswa yisifo sikashukela esiqinisekisiwe esisemthethweni, kepha ungaphansi kweminyaka engama-25 ubudala, futhi akakhulupheli.
Ukuthuthuka kwalesi sifo kuboniswa ukwehla kokusabela komzimba kokudla i-carbohydrate. Lolu phawu lungenzeka kumuntu osemusha iminyaka eminingana.
I-hyperglycemia ebizwa ngokuthi yindlala ingakhombisa IMODY, lapho ingane inokukhuphuka ngezikhathi ezithile kokuhlushwa kashukela egazini kuya ku-8.5 mmol / l, kepha ayihlushwa ukwehla kwesisindo ne-polyuria (ukuphuma komchamo omningi).
Ngalezi zinsolo, kudluliselwa ngokushesha isiguli ukuze siyohlolwa kuyadingeka, noma ngabe asinazo izikhalazo ngokuphila kahle. Uma lingelashwa, lolu hlobo lwesifo sikashukela luba sesigabeni esibunjiweyo okunzima ukulelapha.
Ngokuqondile, singakhuluma ngokuthuthukiswa kwe-MODY kumuntu, uma oyedwa noma izihlobo zakhe zinesifo sikashukela:
- ngezibonakaliso zohlobo lwe- hyperglycemia elambile;
- ithuthukiswe ngesikhathi sokukhulelwa;
- ngezimpawu zokuhluleka kokubekezelela ushukela.
Ukutadisha isiguli esifike ngesikhathi kuzovumela ukwelashwa okufika ngesikhathi ukuze kuncishiswe ukugcwala kweglucose egazini lakhe.
Izinhlobo Ezinhlobonhlobo Zesifo Sikashukela
Izinhlobo zesifo ziyahlukahluka kuye ngokuthi ziphi izinhlobo zofuzo eziguqukile. Lokhu kukuvumela ukuthi unqume ukuxilongwa kofuzo.
Kunezinhlobo ezi-6 zeMODY - 1, 2, 3, 4, 5 no-6
Uhlobo lokuqala lwesifo luyivelakancane. Izehlakalo ze-pathology yi-1% yawo wonke amacala. I-MOD-1 ibonakala ngenkambo enzima enezinkinga eziningi.
I-Modi-2 ingenye yezinhlobo ezejwayelekile, ayibonakaliswa ukubonakaliswa okunamandla kakhulu.
Nge-Modi-2 ezigulini eziphawuliwe:
- ukungabikho kwe-ketoacidosis ejwayelekile kwisifo sikashukela;
- I-hyperglycemia igcinwa emazingeni njalo angekho ngaphezulu kuka-8 mmol / l.
IModi-2 ivame kakhulu kubahlali baseSpain nabaseFrance. Lesi sifo asinazo izimpawu zesifo sikashukela esijwayelekile futhi selashwa ngokuphatha i-insulin encane ezigulini. Ngenxa yalokho, iziguli zigcina izinga likashukela wegazi elijwayelekile futhi, ezimeni eziningi, azidingi ukwandisa umthamo wehomoni ekhishwe.
Ifomu lesibili elivame kakhulu yiModi-3. Leli fomu livame ukutholakala ezakhamuzini zaseJalimane naseNgilandi. Ine-peculiarity: ikhula ngokushesha ezinganeni ngemuva kweminyaka eyi-10 futhi ivame ukuhambisana nezinkinga.
I-Pathology Modi-4 ithinta intsha eyeqe umugqa ineminyaka engu-17 ubudala.
I-Modi-5 ekubonakalisweni nasezintweni ifana nefomu leModi-2. Ukugxila kulele ekukhuleni okuvame kwentsha yesifo esijwayelekile - isifo sikashukela.
Kuzo zonke izinhlobo ze-pathology, yi-Modi-2 kuphela engenawo umthelela omubi ezithweni zangaphakathi zengane.
Zonke ezinye izindlela zesifo zithinta kabi impilo:
- izinso
- izitho zombono;
- inhliziyo
- uhlelo lwezinzwa.
Ukugwema ubunzima, kubalulekile ukubheka ukugcwala kweglucose egazini losemusha nsuku zonke.
Izindlela zokwelapha
I-pathology ekhonjisiwe iphathwa ngezindlela ezifanayo njengohlobo 2 sikashukela mellitus.
Ukwelashwa kwesinye isikhathi akubandakanyi ukuthatha izidakamizwa ezinhlobonhlobo futhi kukhawulelwe ku:
- ukudla okuqinile okukhethekile;
- izivivinyo zomzimba ezidingekayo.
Ukuzivocavoca kudlala indima enkulu ekwelashweni kwe-pathology.
Ngaphezu kwalokho, intsha eyehlushwa isifo sikashukela EMODI inqunyelwe:
- ukudla okwehlisa ushukela;
- izivivinyo zokuphefumula;
- Amaseshini we-Yoga
- umuthi ohlukile wendabuko.
Izingane ngaphambi kokufika esikhathini sokuthomba ekwelashweni kwe-pathology, kwanele ukulandela ukudla okhethekile, ukusetshenziswa kokudla okwehlisa ushukela nokuzivocavoca ngokwelashwa.
Ehlelweni lokukhula, ukuhlelwa kabusha kwama-hormone komzimba wengane kwenzeka, phakathi lapho kukhona ukwehluleka ezinqubweni ze-metabolic. Ngesikhathi sokuthomba, ukwelashwa ngokudla nangezinye izindlela akusenele ezinganeni. Ngalesi sikhathi, badinga ukuthatha imithamo emincane ye-insulin futhi badle ukudla okwehlisa ushukela wegazi.
Izinto zevidiyo ezivela kuDkt Komarovsky ngesifo sikashukela ezinganeni:
Amasu okuphulukisa ngokuqondile ancike ohlotsheni lwe-pathology osemusha. NgoModi-2, imvamisa akadingi ukwelashwa kwe-insulin. Lesi sifo siqhubeka ngaphandle kwezinkinga ezinkulu.
I-Modi-3 ifaka ukwelashwa kwe-insulin ngezikhathi ezithile. Ngale ndlela yokugula, izingane zivame ukubekwa izidakamizwa ezisuselwa ku-sulfonylurea.
I-Modi-1, njengefomu lesifo esinzima kakhulu, ifaka ukwelashwa kwe-insulin nokuthatha imali yengane equkethe i-sulfonylureas.
