Izici kanye nokwehluka kwe-LADA-sikashukela

Isifo sikashukela mellitus - isifo esidalwa ukungasebenzi kahle kohlelo lwe-endocrine, okuholela ekungasebenzi kahle kwe-carbohydrate metabolism kanye nokwanda kokuqwabelana kwe-glucose egazini.

I-Pathology inezinhlobo eziningana ezihlukile kwizimbangela zazo nezindlela zokwelashwa. Enye yalezi zinhlobo yisifo sikashukela se-LADA.

Ukuhlukaniswa okuyinhloko kokuphazamiseka kwe-carbohydrate metabolism

Ngokusho kwesigaba, isifo sikashukela sehlukaniswe izinhlobo ezinkulu ezilandelayo:

1. Thayipha i-insulin engu-1. Lolu hlobo lwesifo luvame ukubhekwa njengolokuzalwa futhi lutholakala ebuntwaneni nasebusheni. Isici esiyingqayizivele sohlobo 1 sikashukela ukukhiqizwa kwamanani angenele we-insulin ngenxa yokubhujiswa kwezicubu ze-pancreatic. Ukugcina inani likashukela egazini elisezingeni elamukelekayo kwenziwa ngokuvuselela njalo okuqukethwe yi-hormone ngomjovo.
2. Uhlobo oluzimele lwe-non-insulin 2. Lolu hlobo lwe-pathology lukhula ngokumelene nesizinda sokuntuleka kokuphendula kwama-cell receptors kuma-hormone, futhi akukho ukushoda kwe-insulin emzimbeni. Isifo sikashukela sohlobo 2 sitholakala ezigulini ezineminyaka ephakathi nendawo futhi esegugile, sithambekele ekufutheni ngokweqile nasendleleni yokuphila engenamsebenzi nokuzivocavoca ngokomzimba. Ukwelashwa okusekelayo kusekelwe ekunamatheleni ekudleni, ekufukukeni komzimba nasekuthatheni imishanguzo esehlisa ushukela futhi kuthuthukisa ukuzwela kwe-receptor.

Ngokuhlukahluka okuhlukahlukene:

1. I-MOD-sikashukela ingeye-A-class futhi ivela ngama-pathologies we-pancreas.
2. Imithi ingeka-B-class futhi iba ngaphansi kwethonya lokuphuza imithi.
3. I-C-class, eyakhelwe ngokumelene nesizinda sokuphazamiseka kwe-endocrine;
4. I-LADA, eyaziwa ngokuthi isifo sikashukela i-autoimmune. Le nhlobonhlobo inezimpawu zazo zombili izinhlobo 1 no-2, kuphela uma kuqhathaniswa nohlobo lokuqala, izimpawu zibonakala ngokuhamba kwesikhathi.

Izimpawu eziphambili ze-carbohydrate metabolism disorder yile:

• ukwanda kokuvama kokuchama nokukhululwa kwenani elikhulu lomchamo;
• ukukhulisa imizwa yokoma nokulamba;
• umuzwa womlomo owomile;
• ukwehla kokusebenza okuphikisana nesizinda sokukhathala okusheshayo;
• ukukhuphuka kweglucose, kuhambisana nokubanga, ukubanda kanye nesiyezi.

Ukuqhubeka, i-pathology kuvuselela inqubo yokuqhekeka kwamaseli wamafutha, okuholela ekwakhekeni kwezidumbu ze-ketone kanye nokukhula kwe-ketoacidosis, okubangela ukubonakaliswa okunjalo:

• ukoma okungagculisi;
• ukubukeka kwe-plaque olimini;
• umuzwa wokunambitheka ne-acetone;
• izikhathi zokuhlanza.

Ngokuya ngohlobo lokwephulwa, izimpawu zingase zibe ngaphezulu noma ziphinyiselwe kancane, zivele ekuqaleni kwesifo (ngohlobo 1), noma lesi sifo singase sibe yi-asymptomatic isikhathi eside (uhlobo 2).

Umehluko phakathi kwe-LADA-sikashukela kusuka kwezinye izinhlobo zesifo

Uyini umehluko phakathi kwesifo sikashukela se-LADA nezinye izinhlobo zesifo sikashukela? Le nhlobonhlobo iyindlela yokugcina yesifo sikashukela sohlobo 1, eqhubeka ngokuya ngesimo sohlobo 2.

Nge-LADA, amaseli we-pancreatic abhujiswa ngokuphelele ngenxa yokuchayeka kuma-antibodies akhiqizwa amasosha omzimba.

Okusho ukuthi, indlela yokuhluleka kwe-metabolic ifana nohlobo lwesifo oludinga i-insulin. Kepha ukwephulwa kwamacala sekutholakele kubantu abadala, okuyisici esengeziwe kwisifo sikashukela sohlobo 2.

Ukuqedwa ngokuphelele komkhiqizo wemvelo we-insulin kwenzeka esikhathini esifushane kusukela ekuqaleni kokukhula kwesifo. Ngemuva kweminyaka eyi-1-3, wonke amaseli we-beta abhekene nokukhiqizwa kwe-hormone ayafa.

Ngenxa yokuntuleka kwe-hormone, ushukela uqongelela, okuholela ku-hyperglycemia, futhi umzimba unxephezela ngokuntuleka kwamandla ngokwehlukana kwamaseli wamafutha, okuholela ketoacidosis.

Izizathu ezibangela ukuba khona kwe-pathology zifaka:

• isiphetho sofuzo;
• umsebenzi ophansi womzimba;
• amazinga ahlukahlukene okukhuluphala;
• ukungasebenzi komzimba okungenamandla;
• ukuhlukunyezwa kokudla okune-carbohydrate okuningi;
• ukuthambekela kokudla ngokweqile;
• umlando we-conquitant autoimmune pathologies noma izifo ezinjalo;
• umuthi wokuzelapha ngemithi ye-antibacterial ne-hormonal;
• ubunzima besikhathi eside bezinzwa;
• ukulimala noma ukuhlinzwa;
• isici semvelo.

Izimpawu zesifo zingaqala ukuvela izinyanga ezimbalwa ngemuva kokwehluleka kwe-metabolic, okukuvumela ukuthi uxilonge ngokushesha futhi unikeze ukwelashwa. Ngeshwa, ezimweni eziningi, iziguli zitholakala ngephutha uhlobo lwe-2 mellitus yesifo sikashukela futhi zinikezwa izidakamizwa ezinciphisa ushukela ngesikhathi lapho kufanele kuqalwe khona ukwelashwa nge-insulin ngokushesha okukhulu.

Izindlela Zokuxilonga

Ukuxilongwa kwe-LADA kwenziwa ngokwemiphumela yokuhlaziya:

• i-biochemistry yegazi;
• ukuhlolwa kweglucose yegazi;
• Ukuhlaziywa okujwayelekile komtholampilo kwegazi nomchamo.

Ngaphezu kwalokho, izifundo zezinkomba ezilandelayo zinqunyelwe:

• ama-antibodies kumaseli ezinqola zaseLangerhans;
• ama-antibodies kuma-insulin;
• glutamate decarboxylase antibodies;
• ukubekezelela ushukela;
• i-glycated hemoglobin;
• i-microalbumin;
• i-leptin;
• i-fructosamine;
• i-c-peptide;
• i-pancreatic peptide;
• glucagon.

Izindlela eziphambili zokuxilonga ziyizinkomba ezinhle zokuhlolwa kwe-autoimmune phambi kwalezi zinto:

• izimpawu zohlobo 2 lwesifo sikashukela lapho kungekho khona ukukhuluphala kweziguli;
• iminyaka engaphansi kweminyaka engama-45;
• Ukushoda kwe-insulin kunxephezelwa ukukhuphuka komzimba nokudla;
• ukuthembela kwe-insulin okwenzeka eminyakeni eyi-1-3 emva kokuqalwa kwesifo;
• izifo ze-autoimmune emlandweni noma phakathi kwezihlobo;
• ukoma okwandayo, ukuchama okusheshayo, ukwehla kokusebenza.

Izinhlobo ezimbili zesithombe somtholampilo ziyabonakala.

I-LADA enezimpawu zesifo sikashukela esincike ku-insulin:

• lesi sifo sihlakulela iziguli ezisencane;
• Izinhlobo ze-HLA genotypes nama-haplotypes abonakala ngohlobo lwe-1 mellitus yesifo sikashukela;
• ekuhlolweni kwegazi esiswini esingenalutho, kubhekwa izinga eliphansi le-c-peptide.

Inketho yesibili iboniswa ukubonakaliswa okunjalo:

• izimpawu zesifo sohlobo 2;
• iziguli esezikhulile ezinama-degree ahlukahlukene okukhuluphala;
• Ama-genotypes we-HLA nama-haplotypes awabonwa;
• dyslipidemia.

Isifo sikashukela esifihlekile sivame ngokwengeziwe ngokukhiqizwa okwandayo kwama-antibodies abulala ama-pancreas. Amangqamuzana asele aqala ukuhlanganisa ngokuqinile i-insulin, edonsa futhi indlala. Enye inkomba yomonakalo we-gland yizinga eliphansi lama-c-peptides egazini athathwe esiswini esingenalutho.

Okusho ukuthi, lesi sifo siqinisekiswa ngokuhlanganiswa kwama-c-peptides ancishisiwe ngokuba khona kwama-antibodies ukuze glutamate decarboxylase. Ukuxilongwa kukhishwe ngaphandle uma amasosha omzimba engekho. Izifundo ezengeziwe zizodingeka uma ama-antibodies ekhona emazingeni amukelekile we-c-peptides.

Ubunzima obukhulu bokuxilonga ukungabikhona kwemali yokuthola usizo ezikhungweni zezokwelapha, ngenxa yokuthi akukho zisetshenziswa ezidingekayo zezifundo ze-autoimmune. Kulokhu, iziguli kufanele ziye emitholampilo yangasese ekhokhelwa ukuhlolwa, ngakho-ke ukuthembeka kwemiphumela yezifundo ezinjalo kuvame ukungabaza.

Izindlela zokwelapha

Ukuze uthole i-prognosis enhle yeziguli ezine-LADA, ukuxilongwa ngokufanele nokwelashwa okunekhono kubaluleke kakhulu. Kodwa-ke, kwenzeka kaningi ukuthi ukwelashwa kubekiwe kufana nokwelashwa kohlobo lwesifo sikashukela sohlobo 2, ngokwesibonelo, kunconyelwa ukuthatha i-sulfonylurea neMetformin.

Ukuqokwa okunjalo kuholela ekubhujisweni okukhulu kakhulu kwamaseli e-pancreatic, angamukeleki ngalolu hlobo lwesifo.

Ukwelashwa okwanele kusho ukulondolozwa kwesikhathi eside kokukhiqizwa kwendlala futhi kufanele kuhloswe ukuxazulula izinkinga ezinjalo:

• gcina amazinga we-glucose emikhawulweni eyamukelekayo, uvikela ukuvela kwe-hypo- ne-hyperglycemia;
• kwandise ukukhiqizwa kwemvelo kwe-insulin emzimbeni;
• thulula ama-pancreas, unciphisa isidingo sokukhiqizwa kwama-hormone, ukuvimbela ukuncipha kwawo.

Ukufezekiswa kwezinhloso kwenziwa ngokusebenzisa izincomo ezilandelayo zomtholampilo:

1. Ukwelashwa kwe-insulin. Kungakhathaleki ukuthi ushukela uphezulu kangakanani egazini, iziguli zinqunywe imijovo yemithamo emincane ye-hormone esebenza isikhathi eside.
2. Ukuqapha kwe-glucose kufanele kwenziwe njalo hhayi ngaphambi nangemva kokudla kuphela, kodwa futhi nasebusuku.
3. Ukushintshwa kokudla. Ukudla okunempilo kufanele kube kuncike ekunciphiseni ukungena kokudla okuphezulu kumakhakhamzimba amunca ngokushesha. Kukhishwe kwimenyu kukhona i-pasta, i-khekhe, imifino enesitashi, amaswidi nemikhiqizo kafulawa kakolweni. Isimo esibalulekile ukugcina ibhalansi yamanzi. Ukusetshenziswa nsuku zonke kwamalitha amanzi ayi-1.5-2 kusiza ekunciphiseni igazi futhi kuvikele ukuphuma komzimba.
4. Ukwanda kokuzivocavoca komzimba. Imithwalo yemidlalo yansuku zonke ihlose ukunciphisa isisindo, ukukhulisa izindleko zamandla, ukwenza ngcono ukuhamba kwegazi nokusheshisa izinqubo ze-metabolic. Ngaphezu kwalokho, imfundo yomzimba izohamba iqinisa izicubu zenhliziyo nezindonga ze-vascular, okuzoba ukuvimba okungcono kakhulu kokuthuthukiswa kwezifo zenhliziyo.

Izinto zevidiyo eziphathelene nesifo se-LADA - ukubonisana nge-endocrinologist:

Ukuhambisana nazo zonke izincomo kuzoqinisa izinkomba ze-glucose futhi kuvikele ukukhula kwe-hyperglycemic ne-ketoacid coma.