LADA mtundu 1 wa shuga wofatsa

LADA - matenda a shuga a autoimmune mu akulu. Matendawa amayamba ali ndi zaka 35-65, nthawi zambiri zaka 45-55. Mwazi wamagazi umakwera pang'ono. Zizindikiro ndizofanana ndi matenda amtundu wa 2, choncho ma endocrinologists nthawi zambiri amalakwitsa kudziwa. M'malo mwake, LADA ndi mtundu 1 wa shuga wofatsa.

Matenda a shuga a LADA amafunikira chithandizo chapadera. Ngati muchita monga mtundu wachiwiri wa matenda ashuga nthawi zambiri amathandizidwa, ndiye kuti wodwalayo amayenera kupita ku insulin pambuyo pazaka 3-4. Matendawa akuwonjezereka kwambiri. Muyenera kubaya Mlingo wambiri wa insulin. Mwazi wa magazi umadumpha kwambiri. Amamva bwino nthawi zonse, zovuta za matenda ashuga zikukula mofulumira. Odwala amalemala ndi kufa.

Anthu mamiliyoni angapo omwe ali ndi matenda a shuga a 2 akukhala kumaiko olankhula ku Russia. Mwa awa, 6-12% alidi ndi LADA, koma sakudziwa. Koma matenda ashuga LADA ayenera kuthandizidwa mosiyanasiyana, apo ayi zotsatira zake zimakhala zoipa. Chifukwa chodziwidwa molakwika komanso ngati ali ndi matenda amtunduwu, anthu masauzande ambiri amamwalira chaka chilichonse. Cholinga chake ndikuti ma endocrinologists ambiri sadziwa chomwe LADA ili. Amazindikira mtundu wachiwiri wa matenda ashuga kwa odwala onse motsatana ndikupereka chithandizo chamankhwala.

Matenda a shuga a autoimmune mu akulu - tiyeni tiwone kuti ndi chiyani. Zobisika zikutanthauza zobisika. Kumayambiriro kwa matendawa, shuga amadzuka pang'ono. Zizindikiro ndizofatsa, odwala amawauza kuti asinthana ndi zaka. Chifukwa cha izi, matendawa amapezeka kuti amachedwa kwambiri. Imatha kuchitika mobisa kwa zaka zingapo. Matenda a 2 a shuga nthawi zambiri amakhala ndi njira yofananira. Autoimmune - chomwe chimayambitsa matendawa ndi kuukira kwa chitetezo cha mthupi pama cell a pancreatic beta. Izi ndizosiyana ndi matenda a shuga a mtundu wa LADA, chifukwa chake ayenera kuthandizidwa mosiyanasiyana.

Momwe mungadziwire matenda

LADA kapena matenda a shuga 2 - mungawasiyanitse bwanji? Momwe mungadziwire wodwala moyenera? Ambiri a endocrinologists safunsa mafunso awa chifukwa samakayikira kupezeka kwa matenda a shuga a LADA konse. Amadumphira mutuwu mkalasi pasukulu ya zamankhwala, kenako ndikumapitiliza maphunziro awo. Ngati munthu ali ndi shuga wambiri pakati komanso okalamba, amapezeka ndi matenda a shuga a mtundu wachiwiri.

Chifukwa chiyani ndikofunikira kuchipatala kusiyanitsa pakati pa LADA ndi matenda a shuga a 2? Chifukwa ma protocol azithandizo ayenera kukhala osiyana. Mtundu wachiwiri wa matenda ashuga, nthawi zambiri, mapiritsi ochepetsa shuga amadziwika. Awa ndi sulfonylureas ndi dongo. Odziwika kwambiri a iwo ndi maninyl, glibenclamide, glidiab, diabepharm, diabetes, gliclazide, amaryl, glimepirod, glurenorm, novonorm ndi ena.

Mankhwalawa ndi owopsa kwa odwala omwe ali ndi matenda a shuga a 2, chifukwa "amamaliza" kapamba. Werengani nkhani yokhudza mankhwala a shuga kuti mumve zambiri. Komabe, kwa odwala omwe ali ndi matenda a shuga a autoimmune LADA amakhala owopsa nthawi 3-4. Chifukwa, kumbali imodzi, chitetezo cha mthupi chimagunda kapamba wawo, ndipo, mapiritsi owopsa. Zotsatira zake, maselo a beta amatha mofulumira. Wodwala amayenera kupita ku insulin pambuyo pazaka zapakati pa 3-4, koposa, atatha zaka 5-6. Ndipo pamenepo "bokosi lakuda" lili pafupi pomwepo ... Ku boma - mosungiramo ndalama osati zolipira penshoni.

Momwe LADA imasiyanirana ndi mtundu wachiwiri wa matenda ashuga:

1. Monga lamulo, odwala alibe kulemera kwambiri, ndi ochepa thupi.
2. Mlingo wa C-peptide m'magazi umatsitsidwa, zonse pamimba yopanda kanthu komanso pambuyo poyambitsa ndi shuga.
3. Ma antibodies kuma cell a beta amapezeka m'magazi (GAD - pafupipafupi, ICA - zochepa). Ichi ndi chizindikiro kuti chitetezo cha mthupi chikuukira ziphuphu.
4. Kuyesa kwa ma genetic kumatha kuwonetsa chizolowezi chomenyera autoimmune pama cell a beta. Komabe, ichi ndichinthu chamtengo wapatali, ndipo mutha kuchita popanda icho.

Chizindikiro chachikulu ndikupezeka kapena kusapezeka kwa kunenepa kwambiri. Ngati wodwala ndi woonda (woonda), ndiye kuti alibe mtundu wachiwiri wa matenda ashuga. Komanso, kuti adziwe molimba mtima, wodwalayo amatumizidwa kukayezetsa magazi a C-peptide. Mukhozanso kusanthula ma antibodies, koma ndi okwera mtengo koma osapezeka nthawi zonse. M'malo mwake, ngati wodwala ali wochepa thupi kapena wodwala thupi, ndiye kuti kuwunika sikofunikira kwambiri.

Pakalepo, tikulimbikitsidwa kupenda ma antibodies kuma GAD beta cell odwala omwe ali ndi matenda a shuga 2 omwe ali onenepa kwambiri. Ngati ma antibodies awa apezeka m'magazi, ndiye kuti malangizowo akuti - amatsutsana kuti apatsidwe mapiritsi ochokera ku sulfonylureas ndi dongo. Mayina a mapale amenewa alembedwa pamwambapa. Komabe, mulimonsemo, simuyenera kuwalandira, ngakhale atayesedwa bwanji. M'malo mwake, sinthani matenda anu a shuga ndi zakudya zamafuta ochepa. Kuti mumve zambiri, onani njira zomwe zingathandize odwala matenda ashuga amtundu wa 2. Ma nuances othandizira matenda a shuga a LADA akufotokozedwa pansipa.

Chithandizo cha matenda a shuga a LADA

Chifukwa chake, tidaganizira za matendawa, tsopano tiyeni tiwone zovuta za mankhwalawa. Cholinga choyambirira chothandizira matenda a shuga a LADA ndikusunga kapangidwe ka insulin. Ngati cholinga ichi chitha kukwaniritsidwa, ndiye kuti wodwalayo amakhala ndi moyo wokalamba kwambiri popanda mavuto a mtima komanso mavuto osafunikira. Kupanga inshuwaransi kwabwinoko kwambiri kumasungidwa, ndiye kuti matenda ashuga alionse amapita patsogolo mosavuta.

Ngati wodwala ali ndi matenda amtunduwu, chitetezo cha mthupi chimatsutsana ndi kapamba, ndikuwonongera maselo a beta omwe amapanga insulin. Njirayi imayamba pang'onopang'ono kuposa matenda ashuga amtundu woyamba. Maselo onse a beta akamwalira, matendawa amakula. Shuga "kukulira", muyenera kubaya Mlingo waukulu wa insulin. Kudumpha kwa shuga m'magazi kumapitirirabe, jakisoni wa insulin sangathe kuwaletsa. Mavuto a shuga akupanga mwachangu, chiyembekezo cha moyo wa wodwalayo chimakhala chochepa.

Kuti muteteze maselo a beta ku zovuta za autoimmune, muyenera kuyamba kubaya insulin mwachangu momwe mungathere. Zabwino koposa zonse - atangozindikira. Jakisoni wa insulin amateteza kapamba kuti asawonongedwe ndi chitetezo cha mthupi. Zimafunikira makamaka pamlingowu, komanso pang'ono, kupanga shuga m'magazi.

Algorithm yochizira matenda a shuga LADA:

1. Sinthani ku chakudya chochepa chamafuta. Iyi ndiyo njira yoyamba yothanirana ndi matenda ashuga. Popanda chakudya chamafuta ochepa, zinthu zina zonse sizithandiza.
2. Werengani nkhani yokhudza insulin dilution.
3. Werengani nkhani zokhudzana ndi insulin Lantus, levemir, protafan ndi kuwerengetsa kwa Mlingo wa insulin mwachangu musanadye.
4. Yambani kubayira insulin yayitali yayitali, ngakhale, chifukwa cha zakudya zamafuta ochepa, shuga samakwera pamwamba pa 5.5-6.0 mmol / L pamimba yopanda kanthu ndikatha kudya.
5. Mlingo wa insulin adzafunika wotsika. Ndikofunika kuti mupeze jekeseni Levemir, chifukwa imatha kuchepetsedwa, koma Lantus - ayi.
6. Insulin yowonjezereka iyenera kuphatikizidwa ngakhale shuga pamimba yopanda kanthu ndikatha kudya sikhala pamwamba 5.5-6.0 mmol / L. Ndipo ngakhale zowonjezereka - ngati ziwuka.
7. Yang'anirani mosamala momwe shuga yanu imakhalira masana. Muziyesa m'mawa m'mimba yopanda kanthu, nthawi iliyonse musanadye, ndiye kuti maola awiri mutatha kudya, usiku musanagone. Kamodzi pa sabata komanso muyeso pakati pausiku.
8. Pankhani ya shuga, onjezani kapena chepetsani Mlingo wa insulin yayitali. Mungafunike kumudula kawiri pa tsiku.
9. Ngati, ngakhale jakisoni wa insulin yotalikilapo, shuga amakhalabe okwera mutatha kudya, muyenera kuperekanso insulin mwachangu musanadye.
10. Palibe, musamwe mapiritsi a shuga - sulfonylureas ndi ma dongo. Mayina a odziwika kwambiri alembedwa pamwambapa. Ngati endocrinologist ikuyesani kukupatsirani mankhwala awa, muwonetseni malowa, chitani ntchito yofotokozera.
11. Mapiritsi a Siofor ndi Glucofage ndi othandiza kwa odwala matenda ashuga. Ngati mulibe kulemera kwambiri - musatenge.
12. Kuchita masewera olimbitsa thupi ndi chida chofunikira chothandizira kuchepetsa matenda a shuga kwa odwala omwe ali onenepa kwambiri. Ngati muli ndi thupi labwinobwino, ndiye zolani kuchita masewera olimbitsa thupi kuti mukhale wathanzi.
13. Simuyenera kukhala wotopetsa. Onani cholinga cha moyo, khalani ndi zolinga. Chitani zomwe mumakonda kapena zomwe mumanyadira. Cholimbikitsira chimafunikira kuti mukhale ndi moyo wautali, apo ayi palibe chifukwa choyesera kuthana ndi matenda ashuga.

Chida chachikulu chothanirana ndi matenda ashuga ndichakudya chamafuta ochepa. Maphunziro akuthupi, insulini ndi mankhwala osokoneza bongo - pambuyo pake. Kwa odwala matenda a shuga a LADA, muyenera kubaya insulini mulimonse. Uyu ndiye kusiyana kwakukulu ndi chithandizo cha matenda ashuga amtundu wa 2. Jekeseni waingʻono Mlingo wa insulin ayenera kuchitidwa, ngakhale shuga atakhala wamba.

Yambani ndi jakisoni wa insulin yowonjezera pazing'ono. Ngati wodwalayo amatsatira zakudya zamafuta ochepa, ndiye kuti mankhwala a insulin amafunikira ochepa, titha kunena, homeopathic. Komanso, odwala matenda a shuga LADA nthawi zambiri sakhala onenepa kwambiri, ndipo anthu owonda amakhala ndi insulin yokwanira. Ngati mumatsatira regimen ndi jakisoni wa insulin m'njira yoyenera, ntchito ya ma cell a pancreatic beta ikupitirirabe. Chifukwa cha izi, mudzatha kukhala ndi moyo mpaka zaka 80-90 kapena kupitilira - ndi thanzi labwino, popanda spikes mu shuga komanso zovuta zamankhwala.

Mapiritsi a shuga, omwe ali m'magulu a sulfonylureas ndi dongo, ndi owopsa kwa odwala. Chifukwa amataya kapamba, ndichifukwa chake ma cell a beta amafa mwachangu. Kwa odwala omwe ali ndi matenda a shuga a LADA, ndi owopsa nthawi 3-5 kuposa odwala omwe ali ndi matenda a shuga a mtundu wachiwiri. Chifukwa mwa anthu omwe ali ndi LADA, chitetezo chawo chomwe chimawononga ma cell a beta, ndipo mapiritsi owopsa amawonjezera kuukiridwa kwake. Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri, kulandira chithandizo mosayenera "amapha" kapamba pazaka 10-15, komanso kwa odwala omwe ali ndi LADA - nthawi zambiri amakhala zaka 3-4. Kaya muli ndi matenda ashuga otani - perekani mapiritsi owononga, tsatirani zakudya zamafuta ochepa.

Chitsanzo cha moyo

Mkazi, wazaka 66, kutalika 162 masentimita, kulemera kwa makilogalamu 54-56. Shuga zaka 13, autoimmune chithokomiro - zaka 6. Shuga wamagazi nthawi zina amafika 11 mmol / L. Komabe, mpaka nditadziwana ndi tsamba la Diabetes-Med.Com, sindinatsatire momwe limasinthira masana. Madandaulo a mitsempha ya matenda ashuga - miyendo ikuyaka, ndiye kukuzizira. Heredity ndiyabwino - bambo anga anali ndi matenda ashuga ndi mwendo. Asanayambe chithandizo chatsopano, wodwalayo amatenga Siofor 1000 kawiri patsiku, komanso Tiogamm. Insulin sanabale.

Autoimmune chithokomiro ndimafooketsa a chithokomiro chifukwa chakuwopsezedwa ndi chitetezo cha mthupi. Kuti athetse vutoli, endocrinologists adasankhira L-thyroxine. Wodwala amatenga, chifukwa momwe mahomoni a chithokomiro m'magazi amakhala achilendo. Ngati autoimmune chithokomiro chimaphatikizidwa ndi matenda ashuga, ndiye kuti mwina ndi mtundu woyamba wa shuga. Ndizodziwikanso kuti wodwala samanenepa kwambiri. Komabe, akatswiri angapo a endocrinologists adziyimira okha matenda amtundu wa 2. Anatumizidwa kuti atenge Siofor ndikutsatira zakudya zama calorie otsika. M'modzi mwa madotolo osautsa adati zingathandize kupewa mavuto ndi chithokomiro cha chithokomiro ngati muthana ndi kompyuta mnyumba.

Kuchokera kwa wolemba malowa Diabetes-Med.Com, wodwalayo adazindikira kuti alidi ndi matenda a shuga a LADA 1 mu mawonekedwe ofatsa, ndipo akuyenera kusintha mankhwalawo. Kumbali ina, zinali zoipa kuti adachitiridwa zinthu molakwika kwa zaka 13, chifukwa chake matenda amitsempha ya matenda ashuga amakula. Komabe, anali ndi mwayi wodabwitsa kuti sanapereke mankhwala omwe amalimbikitsa kupanga insulin ndi kapamba. Kupanda kutero, lero sakadangochokera. Mapiritsi olakwika "amaliza" kapamba wazaka 3-4, pambuyo pake matenda a shuga amawawa kwambiri.

Zotsatira zakusintha kwa chakudya chamafuta ochepa, shuga wodwalayo adachepa. M'mawa pamimba yopanda kanthu, komanso mutadya kadzutsa ndi nkhomaliro, idakhala 4.7-5.2 mmol / l. Mukatha kudya chakudya mochedwa, pafupifupi 9 p.m. - 7-9 mmol / l. Patsamba, wodwalayo adawerenga kuti amayenera kudya chakudya cham'mawa kwambiri, maola 5 asanagone, ndikuyika chakudya chamadzulo kwa maola 18-19. Chifukwa cha izi, shuga madzulo atatha kudya komanso asanagone adagona pa 6.0-6.5 mmol / L. Malinga ndi wodwalayo, kutsatira kwambiri zakudya zamafuta ochepa sikophweka kuposa kufa ndi chakudya chamagulu ochepa omwe madokotala adamupatsa.

Kulandila kwa Siofor kunathetsedwa chifukwa palibe nzeru kwa odwala ochepa kapena owonda kuchokera kwa iye. Wodwalayo anali atatsala pang'ono kuyamba kubaya insulin, koma sanadziwe momwe angapangire molondola. Malinga ndi zotsatira za kuyang'anira shuga mosamala, zidapezeka kuti masana zimakhazikika, ndipo zimadzuka madzulo, pambuyo pa 17.00. Izi sizachilendo, chifukwa odwala matenda ashuga ambiri amakhala ndi mavuto akuluakulu a shuga m'mimba yopanda kanthu.

Kuchepetsa shuga yamadzulo, tinayamba ndi jakisoni wa 1 IU wa insulin yowonjezera pa 11 a.m. Ndizotheka kujambula muyeso wa 1 PIECE mu syringe pokhapokha pokhapokha ± 0,5 PIECES mbali imodzi kapena ina. Mu syringe padzakhala ZINSINSI za 0,5-1,5 za insulin. Kuti mupeze mlingo molondola, muyenera kuchepetsa insulin. Levemir adasankhidwa chifukwa Lantus saloledwa kuchepetsedwa. Wodwalayo amawonjezera insulin maulendo 10. M'mbale zoyera, amathira ma PISCES a 90 a saline yanyama kapena madzi a jekeseni ndi ma PIECES 10 a Levemir. Kuti mupeze mlingo wa inshuwaransi 1 ya insulin, muyenera kubaya ma PISCES 10 a izi. Mutha kuyisunga mufiriji kwa masiku atatu, kotero yankho lake limakhala kutayika.

Pambuyo pa masiku 5 a regimen iyi, wodwalayo adanena kuti shuga yamadzulo idayenda bwino, koma atatha kudya, idakwera mpaka 6.2 mmol / L. Panalibe zigawo za hypoglycemia. Zochitika ndi miyendo zikuwoneka kuti zikuyenda bwino, koma akufuna kuti athane ndi matenda ashuga a mtima. Kuti muchite izi, ndikofunikira kusunga shuga pambuyo chakudya chilichonse osaposa 5.2-5.5 mmol / L. Tidaganiza zowonjezera kuchuluka kwa insulin mpaka 1.5 PIERES ndikuyimitsa nthawi ya jakisoni kuyambira maola 11 mpaka maola 13. Pa nthawi yolemba izi, wodwala ali munjira iyi. Malipoti omwe shuga atatha kudya samasungirako kuposa 5.7 mmol / L.

Cholinga china ndikuyesa kusintha insulin. Choyamba yesani gawo limodzi la Levemire, kenako 2 mayunitsi. Chifukwa mlingo wa 1.5 E sugwira ntchito mu syringe. Ngati insulini yosaoneka bwino imagwira ntchito mwachizolowezi, ndikofunika kukhalabe. Munjira iyi, ndizotheka kugwiritsa ntchito insulin popanda zinyalala komanso chifukwa chosafunikira. Mutha kupita ku Lantus, zomwe ndizosavuta kupeza. Kuti mugule Levemir, wodwalayo amayenera kupita ku republic yoyandikana nawo ... Komabe, ngati misempha ya shuga ikulirakika ndi insulini wosafupika, ndiye kuti muyenera kubwereranso ku shuga wofinya.

Kuzindikira ndi kuchiza matenda a shuga LADA - mawu:

1. Chaka chilichonse, odwala masauzande ambiri a LADA amafa chifukwa amapezeka kuti ali ndi matenda osokoneza bongo a 2 ndipo amamuthandiza molakwika.
2. Ngati munthu alibe kulemera kwambiri, ndiye kuti alibe mtundu wa matenda ashuga 2!
3. Odwala omwe ali ndi matenda a shuga a 2, kuchuluka kwa C-peptide m'magazi ndikwabwinobwino kapena kukwezeka, ndipo mwa odwala LADA, ndiye kuti amatsika.
4. Kuyesedwa kwa magazi kwa ma antibodies kuma cell a beta ndi njira yowonjezerapo yodziwira mtundu wa matenda ashuga. Muyenera kuchita izi ngati wodwalayo wanenepa kwambiri.
5. Diabetes, manninil, glibenclamide, glidiab, diabepharm, glyclazide, amaryl, glimepirod, glurenorm, novonorm - mapiritsi owopsa a matenda a shuga a 2. Osawatenga!
6. Kwa odwala matenda a shuga, mapiritsi a LADA, omwe alembedwa pamwambapa, ndi owopsa kwambiri.
7. Chakudya chopatsa thanzi ndi njira yeniyeni yothetsera matenda alionse a shuga.
8. Mlingo wofunikira wa insulin ndiwofunikira kuti muwongolere matenda a shuga a 1 LADA.
9. Ngakhale mulingo wocheperako, mankhwalawa amafunika kuti azilangizidwa m'njira yoyenera, kuti musabayidwe jakisoni.