Matenda a shuga amaphatikiza mitundu iwiri yosiyanasiyana ya chitukuko cha matendawa, mawonetsedwe ake omwe ndiwowonjezereka pamagulu a shuga m'magazi. Mu matenda a shuga a mtundu woyamba, kuperewera kwa insulin kwathunthu kumayamba chifukwa cha kuwonongeka kwa maselo a kapamba, omwe amafunikira nthawi yochizira matenda a insulin.
Type 2 shuga mellitus imagwirizanitsidwa ndi kukula kwa minyewa ya minyewa yolimbana ndi insulin. Pankhaniyi, kuyambika kwa matendawa kumachitika ndi insulin yokhazikika kapena yowonjezereka, chifukwa chake njirayi imatchedwa kuti insulin yosadalira shuga.
Popeza shuga wambiri m'magazi akupitiliza kulimbikitsa kutulutsa kwa insulin ndi maselo a beta, pakapita nthawi, zotsalira za kapamba zimatha pang'onopang'ono ndipo mtundu wa 2 shuga umayamba kukhala wovuta.
Zimayambitsa ndi mapangidwe a chitukuko cha mtundu wachiwiri wa matenda ashuga
Zomwe zimapangitsa kuti pakhale matenda ashuga a mtundu 2 ndizosatheka, ndipo ndizofunikira kwambiri kuposa mtundu woyamba wa matenda. Koma zidapezeka kuti kuphwanya mtundu wa glucose kumachitika chifukwa cha cholowa, chomwe sichimasinthika kukhala shuga.
Kafukufuku waposachedwa akuwonetsa kuti njira yoyamba yothandizira kukula kwa matenda amtunduwu ndi kupeza kwa maselo a minyewa omwe amatha kuyamwa shuga pokhapokha ngati ali ndi insulin, ndikupanga insulin. Kuwonjezeka kwa shuga m'magazi kumachitika pambuyo pake, chifukwa cha kuphwanya kotero.
Zina zonse zomwe zimayambitsa matenda ashuga, zomwe zimatsimikizira tsogolo la wodwalayo, ndi zakunja komanso zosinthika, ndiye kuti, zimatha kusokonekera m'njira yoletsa kukula kwa matendawa. Zinthu zazikuluzikulu zomwe zikuwonekerazi zimachokera ku mtundu wachiwiri:
- M'mimba mtundu wa kunenepa.
- Kulephera kuchita masewera olimbitsa thupi.
- Atherosulinosis
- Mimba
- Zotsatira zoyipa.
- Zaka ndi zaka 45.
Kuchepetsa thupi kwa odwala omwe ali ndi kunenepa kwambiri kumatsogolera kubwezeretsanso kwina kwa shuga komanso insulin mukatha kudya. Ndipo ngati machitidwe azakudya abwerera, ndipo wodwalayo amadya kwambiri, ndiye kuti hyperglycemia ndi hyperinsulinemia zimasinthidwa mobwerezabwereza, ndipo poyankha chakudya cha insulin amasokonezeka.
Miyezi yambiri ya insulin ikukhudzana ndi zisonyezo zoyambirira za matenda ashuga komanso kunenepa kwambiri, pakadakhala pasakhale zosokoneza m'thupi. Hyperinsulinemia muzochitika zotere ndi njira yothandizira pothandizira minofu kukana insulin. Thupi limayesetsa kuthana ndi insulin chifukwa chopanga mahomoni ambiri.
Ngati kunenepa kwambiri kulipo kwa nthawi yayitali mwa anthu omwe ali ndi vuto logometsa matenda a metabolism, ndiye kuti pakapita nthawi, kubisalira kwa cell ya beta kumachepa. Matenda a shuga owonekera ndi zizindikiro wamba amakula.
Ndiye kuti, kupanga insulin mu mtundu 2 wa matenda ashuga sikungakhale kwa nthawi yayitali ndipo, pakapanda kutero, chithandizo cha insulini chikufunika.
Mellitus yemwe amadya matenda a shuga amatha kulipidwa pokhapokha ndi insulin, kapena amaikidwa limodzi ndi mankhwala ochepetsa shuga a mankhwala osakaniza.
Zisonyezo za mankhwala a insulin mu mtundu wachiwiri wa matenda ashuga
Kugwiritsa ntchito kwakanthawi insulin kukonzekera mtundu wachiwiri wa matenda a shuga kumathandizira kubwezeretsa zovuta zitatu: kupanga kuchepa kwa insulin, kuchepetsa mapangidwe a insulin m'chiwindi ndikuwabwezeretsanso kuchepa kwa minyewa.
Poika insulin, pali zizindikiritso zosakhalitsa komanso zosakhalitsa. Kupitiliza kosalekeza kuyenera kuyambika nthawi yomweyo ndi ketoacidosis, kuchepa thupi, chizindikiro cha kuchepa mphamvu kwa magazi ndi glucosuria.
Njira yotereyi imawonekera mukamakula ndi matenda a shuga a autoimmune omwe amapita pang'onopang'ono, pomwe pakufunika insulin posakhalitsa atazindikira kuti ali ndi matenda ashuga. Pankhaniyi, zizindikiro zakuwonongeka kwa maselo a pancreatic ndi ma antibodies apezeka, monga mtundu woyamba wa matenda. Nthawi zambiri
Ndi contraindication poika mapiritsi, insulin akhoza zotchulidwa. Izi ndi monga:
- Kuperewera kwa impso kapena chiwindi.
- Mimba
- Angapoopathy odwala matenda ashuga.
- Peripheral polyneuropathy yokhala ndi ululu waukulu.
- Matenda a shuga ndi matenda otupa.
- Kuperewera kwa insulin mwanjira ya ketoacidosis.
Pafupifupi gawo limodzi mwa magawo atatu aliwonse odwala sakhala ndi vuto lililonse akamamwa mapiritsi kuti achepetse shuga kapena izi sizochepa. Ngati chiphuphu sichingatheke m'miyezi itatu, ndiye kuti odwala amapatsirana ndi insulin. Kukana kwa mankhwala oyamba kumachitika, monga lamulo, pakuzindikira matenda a shuga, pamene chinsinsi cha insulin chachepetsedwa.
Gawo laling'ono la odwala limalandira kukana kwachiwiri pamene milingo yokwezeka ya shuga ikuwonetsedwa motsutsana ndi maziko a mankhwala othandizira komanso kuchuluka kwa mankhwala. Izi zimadziwika mwa odwala omwe ali ndi glycemia yayikulu panthawi yodziwitsa komanso mtima wake.
Nthawi zambiri, odwala otere akhala akudwala pafupifupi zaka 15; kapamba wawo sangathe kuyamwa ndi mapiritsi. Ngati glucose wamagazi aposa 13 mmol / l, ndiye kuti palibe njira inanso yothandizira kuposa kupatsa insulin.
Koma ngati wodwalayo ali ndi kunenepa kwambiri, ndiye kuti nthawi zonse kupatsidwa insulin sikumapereka zotsatira zoyenera. Chifukwa chake, ndi glycemia osapitirira 11 mmol / l, mutha kukana mankhwala a insulini, chifukwa ndi mafuta onenepa kwambiri omwe chizindikiro chobwezeretsanso chimakhala chofanana ndikumwa mapiritsi.
Chithandizo cha insulin kwakanthawi chimachitidwa pazinthu zomwe zimatha kusintha. Izi zikuphatikiza:
- Myocardial infaration.
- Matenda opatsirana omwe ali ndi kutentha kwambiri kwa thupi.
- Zotsatira zoyipa.
- Matenda owopsa.
- Ndi poika corticosteroids.
- Opaleshoni.
- Ndi matenda ashuga ketoacidosis komanso kuwonda kwambiri.
- Kubwezeretsa zomverera m'mapiritsi ndikutsitsa ziphuphu.
Zomwe zimayikidwa poika insulin mu mtundu wachiwiri wa matenda ashuga
Type 2 shuga mellitus amatanthauza matenda omwe amadziwika ndi kupitilira kwa zizindikiro. Ndipo maphunzirowa akupita patsogolo, mankhwalawa am'mbuyomu a mankhwala amasiya kugwira ntchito. Izi zimawonjezera chiopsezo cha zovuta. Chifukwa chake, onse odwala matenda ashuga azindikira kufunika kwa ma regimens othandizira.
Muyeso womaliza wa chiphuphu cha shuga ndi kuchepa kwa hemoglobin ya glycated. Osatengera kuti kuchepetsedwa kotereku kumatheka - ndi insulin kapena mapiritsi, izi zimayambitsa kuchepa kwa chiwopsezo cha matenda amanjenje, nephropathy, retinopathy, kugunda kwa mtima ndi zina zotupa zamitsempha.
Chifukwa chake, pakalibe zotsatira za zakudya kuchokera pakudya ndikuchita zolimbitsa thupi, komanso kuchepa kwa thupi, ndikofunikira kugwiritsa ntchito kwambiri mankhwala posachedwa.
Chitsogozo posankha njira yake ikhoza kukhala kuchepa kwa hemoglobin ya glycated. Ngati mapiritsi okha ndi okwanira, ndiye kuti wodwalayo amasankhidwa kuti alandire mankhwala a mono- kapena osakanikirana ndi mankhwala ochokera m'magulu osiyanasiyana amitundu yochepetsera shuga, kapena kuphatikiza mapiritsi ndi insulin kuphatikizidwa.
Zomwe zimaphatikizidwa monga mankhwala a insulin ndi mapiritsi a mtundu 2 a shuga ndi:
- Mankhwala, kawiri Mlingo wa insulin wofunikira umafunikira.
- Kukopa mbali zosiyanasiyana: kaphatikizidwe kagayidwe ndi chiwindi, chakudya mayamwidwe, insulin katulutsidwe ndi kudziwa minyewa kwa izo.
- Mlingo wa hemoglobin wa glycated umayenda bwino.
- Mavuto ochepa a shuga.
- Chiwopsezo cha atherosulinosis chimachepetsedwa.
- Palibe kulemera kwa odwala onenepa kwambiri.
Insulin imayikidwa makamaka 1 nthawi patsiku. Yambani ndi ochepa Mlingo wa insulin wa nthawi yayitali. Mankhwalawa amatumizidwa musanadye chakudya cham'mawa kapena usiku, chinthu chachikulu ndikusunga nthawi yomweyo ya jekeseni. Nthawi zambiri mumagwiritsidwa ntchito mankhwala a insulin.
Ngati kuli kofunikira kuphatikiza inshuwaransi yoposa 40, mapiritsiwo amathetsedwa ndipo wodwalayo amasinthiratu insulin. Ngati glycemia ndi ochepera 10 mmol / l, ndipo pafupifupi magawo 30 a insulin amafunikira, ndiye kuti chithandizo cha mapiritsi chimayikidwa, ndipo insulin imatha.
Mankhwala a odwala onenepa kwambiri, tikulimbikitsidwa kuti makulidwe a insulin aphatikizidwe ndi mankhwala ochokera ku gulu la Biguanide, lomwe limaphatikizapo Metformin. Njira ina ikhoza kukhala acarbose (Glucobai), yomwe imasokoneza kuyamwa kwa glucose m'matumbo.
Zotsatira zabwino zidapezekanso ndikuphatikiza insulini ndi chosintha chochepa cha insulin secretion, NovoNorma. Ndi kuphatikiza uku, NovoNorm imagwira ntchito ngati chiwongolero cha kukwera kwa glycemia mutatha kudya ndipo imayikidwa ndi zakudya zazikulu.
Kuchita insulin kwa nthawi yayitali kumalimbikitsidwa pakukhazikitsa musanalowe. Amachepetsa kukhathamiritsa kwa shuga ndi chiwindi ndikuwongolera kudya kwa magazi mwa kutsitsa maselo a insulin secretion.
Palibe ma insulin apadera omwe angachotsere matenda a shuga. Kugwiritsa ntchito ma insulin otere ndikofunikira kuti muchepetse kulemera, komanso mavuto obwera chifukwa cha metabolidi ya lipid. Kanemayo m'nkhaniyi afotokoza za matenda a shuga.
