Matenda a shuga: kutsimikiza kwamatenda mwa kuwunika

Matenda a shuga ndi matenda opatsirana a endocrine omwe amayamba chifukwa cha kuperewera kwa insulin, mtheradi kapena wachibale.

Kuchepa kwathunthu kwa insulin mu shuga kumachitika chifukwa cha kufa kwa maselo a beta, omwe amachititsa kuti khungu lizisungidwa, ndipo wachibaleyu amalumikizidwa ndi vuto lake mogwirizana ndi zolandirana ndi cell (monga mtundu wa 2 matenda a shuga).

Kwa matenda a shuga, kutanthauzira kwa hyperglycemia ndiye chizindikiro chokhazikika chomwe chimakhudza kuphwanya kwa kagayidwe kazachilengedwe m'thupi. Mukazindikira matenda a shuga, Zizindikiro zofunika ndizochulukirapo zamagazi m'magazi ndikuwonekera mkodzo. Ndi kutaya kwakukulu kwa shuga, kutulutsa mkodzo mowonjezereka kumabweretsa kusowa kwamadzi ndi hypokalemia.

Mitundu ya Matenda A shuga

Zomwe zikuwonjezera kwambiri chiwerengero cha anthu odwala matenda a shuga zimawonekera mosavuta ndikamayesedwa olimbitsa thupi, kuchepa kwa kufa kwa akhanda kuchokera kwa makolo omwe ali ndi matenda ashuga, kuchuluka kwa chiyembekezo cha kuchuluka kwa anthu komanso kufalikira kwa kunenepa kwambiri.

Matenda a shuga ndi matenda opatsirana chifukwa cha zomwe zimachitika komanso chifukwa cha momwe matendawo amawonekera. Kuti mudziwe matenda ashuga komanso kudziwa mtundu wa matenda omwe ali nawo, zosankha ziwiri ndizomwe zimasiyanitsa: mtundu 1 ndi mtundu 2 wa matenda ashuga.

Mtundu woyamba wa shuga umapezeka mukuwonongedwa kwa maselo a beta ndipo umabweretsa kuperewera kwa insulin kwa moyo wonse. Mitundu yake ndi LADA - mawonekedwe a shuga a autoimmune mwa akulu ndi mawonekedwe a idiopathic (osagwira chitetezo). Mu matenda ashuga am'mbuyomu, zizindikilo ndi njira zimafanana ndi mtundu wachiwiri, ma antibodies omwe amapezeka ku cell ya beta amapezeka, monga mtundu 1.

Mtundu wachiwiri wa shuga umayamba motsutsana ndi insulin yochepetsedwa kapena yabwinobwino, koma mwa kutaya chidwi chake - kukana insulini. Mtundu umodzi wa matenda ashuga awa ndi AMODI, momwe mumakhala vuto la majini mu ntchito ya maselo a beta.

Kuphatikiza pa mitundu yoyambira iyi, pakhoza kukhala:

1. Zovuta za insulin kapena zolandilira zomwe zimagwirizanitsidwa ndi zolakwika zamtundu.
2. Matenda a kapamba - kapamba, zotupa.
3. Endocrinopathies: acromegaly, tsamba la Itsenko-Cushing, limayambitsa poyizoni woipa.
4. Matenda a shuga.
5. Matenda oyambitsidwa ndi matenda.
6. Matenda obadwa nawo okhudzana ndi matenda a shuga.
7. Matenda a shuga.

Pambuyo poti adziwe mtundu wa matenda ashuga, kafukufuku amachitika mwakukula kwa matendawa. Ndi mtundu wofatsa wa shuga mellitus, palibe madontho akuluakulu mu shuga, magazi othamanga ali pansi pa 8 mmol / l, palibe shuga mumkodzo, kapena mpaka 20 g / l. zakudya ndizokwanira kulipirira. Zilonda zam'mimba sizipezeka.

Matenda a shuga okwanira amadziwika ndi kuwonjezeka kwa kudya kwa glucose mpaka 14 mmol / l, kuchepa kwa glucose mu mkodzo patsiku - mpaka 40 g, masana pamasinthasintha kuchuluka kwa shuga, matupi a ketone m'magazi ndi mkodzo amatha kuwonekera. Zakudya ndi insulin kapena mapiritsi amathandizira kuchepetsa glycemia. Angioneuropathies apezeka.

Zizindikiro za matenda akulu a shuga:

• Kuthamanga glycemia pamtunda 14 mmol / L.
• Kusintha kwakukulu kwa shuga m'magazi tsiku lonse.
• Glucosuria woposa 40 g patsiku.
• Mlingo wa insulin kuti ulipire 60 PISCES.
• Kukula kwa matenda ashuga angio ndi neuropathies.

Malinga ndi kuchuluka kwa chiphuphu, shuga imatha kulipidwa ngati nkotheka kukwaniritsa shuga wabwinobwino m'magazi ndikusapezekanso kwake mkodzo. Gawo lothandizidwa: glycemia osapitirira 13.95 mmol / l, kutaya kwa glucose 50 g kapena ochepera patsiku. Palibe mkodzo mumkodzo.

Ndi kuwonongeka, mawonetseredwe onse amapita kupitirira malire awa, acetone imatsimikiziridwa mu mkodzo. Pakhoza kukhala chikomokere motsutsana ndi maziko a hyperglycemia.

Kodi matenda amtundu 1 amayamba bwanji?

Mtundu woyamba wa matenda ashuga umatha kuchitika m'mibadwo iliyonse, koma nthawi zambiri umakhudza ana, achinyamata komanso achinyamata osakwana zaka 30. Pali zovuta za matenda obadwa nawo a shuga, ndipo zizindikilo mwa anthu azaka 35 mpaka 45 zimawonekera.

Njira yotereyi ya shuga imadziwika ndi kuwonongeka kwa maselo omwe amapanga insulin chifukwa cha zochita zamtundu wa autoimmune. Chotupa choterechi chitha kupangitsidwa ndi ma virus, mankhwala, mankhwala, ziphe.

Zinthu zakunja izi zimagwira monga chothandizira kuchititsa kuti majini azikhala mbali zina za ma chromosomes. Mitundu yamtunduwu imatsimikizira kufanana kwa minofu ndipo imabadwa.

Pa gawo loyamba la matendawa, ma antibodies kuma cell a beta amakhala ochepa. Palibe zizindikiro zamatenda zodwala, popeza kuthekera kobwezeretsa insulin sikumalephera. Ndiye kuti, kapamba amalimbana ndi chiwonongeko chotere.

Kenako, kuwonongedwa kwa zisumbu za Langerhans kukachuluka, njira zotsatirazi zimayamba:

1. Kutupa kwa pancreatic ndi insulin ya autoimmune. Ma antibody titer amawonjezeka, maselo a beta amawonongeka, kupanga kwa insulin kumachepa.
2. Mkulu akalowa mu chakudya, insulin imapangidwa mosakwanira. Palibe kachipatala, koma zodwala zomwe zimayesedwa pakupimidwa kwa glucose zimatha kupezeka.
3. Insulin ndi yaying'ono kwambiri, chipatala wamba chikukula. Pakadali pano, pafupifupi 5-10% yama cell yogwira idatsalira.
4. Insulin yopangidwa, maselo onse amawonongeka.

Pakakhala insulin, chiwindi, minofu ndi minyewa ya adipose sizitha kuyamwa glucose m'magazi. Kusweka kwamafuta mu minofu ya adipose kumawonjezeka, chomwe ndi chifukwa chowonekera kwawo m'magazi, ndipo mapuloteni amawonongeka m'matumbo, ndikuwonjezera kuchuluka kwa amino acid. Chiwindi chimatembenuza mafuta acid ndi ma amino acid kukhala matupi a ketone, omwe amatipatsa mphamvu.

Mokulira kwa kuchuluka kwa glucose mpaka 10 mmol / l, impso zimayamba kukhazikika m'matumbo a mkodzo, ndipo popeza zimadzipangira zokha, pamakhala kuchepa kwamphamvu ngati madzi ake samadzadzidwanso ndi kumwa kwambiri.

Kuwonongeka kwa madzi kumayendera limodzi ndi kuthetsedwa kwa zinthu - sodium, magnesium, potaziyamu, calcium, komanso chloride, phosphates ndi bicarbonate.

Zizindikiro za mtundu woyamba wa matenda ashuga

Zizindikiro zamatenda a matenda amtundu woyamba 1 zitha kugawidwa m'magulu awiri: Zizindikiro zomwe zimatsimikizira kuchuluka kwa matenda ashuga komanso zizindikiro za zovuta zake. Shuga wokweza m'magazi amachititsa kuti mkodzo uchuluke, ndipo cholumikizacho chikuwonjezeka, mkamwa wowuma, komanso kuchepa thupi.

Ndi kuwonjezeka kwa hyperglycemia, kusintha kwa njala, kufooka lakuthwa kumayamba, matupi a ketone akapezeka, kupweteka kwam'mimba kumachitika, acetone imanunkhiza kuchokera pakhungu komanso m'mlengalenga. Mtundu woyamba wa matenda a shuga umadziwika ndi kuwonjezeka kwazizindikiro posakhala ndi insulin, kotero kuwonetsa koyamba kungakhale ketoacidotic coma.

Gulu lachiwiri lazophatikizidwa limalumikizidwa ndikukula kwa zovuta zazikulu: ndi chithandizo chosayenera, kulephera kwa impso, mtima, kuchepa kwa mtima, matenda ashuga retinopathy, polyneuropathy, ketoacidosis, ndi matenda a shuga.

Matenda okhudzana ndi matenda a shuga amakhalanso ndi:

• Furunculosis.
• Candidiasis
• Matenda a genitourinary.
• Chifuwa chachikulu
• Matenda osiyanasiyana opatsirana.

Kupanga matenda ndikwanira kuzindikira zizindikiro wamba ndikutsimikizira hyperglycemia: mu plasma yoposa 7 mmol / l, maola 2 atatha shuga - oposa 11.1 mmol / l, hemoglobin wa glycated amaposa 6.5%.

Momwe mungadziwire matenda a shuga a 2?

Kupezeka kwa matenda ashuga amtundu wa 2 kumalumikizidwa ndi kubadwa kwa majini ndikupeza zovuta mu mawonekedwe a kunenepa kwambiri, atherossteosis. Kukhazikika kumatha kupangitsa matenda owopsa a pancreatitis, hepatitis, kudya kwambiri, makamaka zakudya zopatsa mphamvu komanso kusachita masewera olimbitsa thupi.

Kusokonezeka kwa mafuta kagayidwe kake komanso cholesterol yokwezeka, atherosulinosis, matenda oopsa komanso matenda a mtima kumayambitsa kutsika kwa machitidwe a metabolic ndikuchepetsa chidwi cha minofu ku insulin. Muzochitika zovutitsa, ntchito yamacatecholamines ndi glucocorticoids imawonjezera, zomwe zimapangitsa kuchuluka kwa glucose m'magazi.

Mtundu wachiwiri wa matenda ashuga, kulumikizana pakati pa ma receptor ndi insulin kumasokonekera, m'magawo oyamba a matenda, kubisala kumatetezedwa, ndipo mwina kungakulidwe. Chinthu chachikulu chomwe chikukulitsa kukonzekera kwa insulini ndikuwonjezera kulemera kwa thupi, chifukwa chake, ikafupika, ndizotheka kukwaniritsa kuchuluka kwa shuga m'magazi ndikudya ndi mapiritsi.

Popita nthawi, zikondwerero zimatha, ndipo kupanga insulin kumachepa, zomwe zimapangitsa kuti asinthane ndi insulin. Mwayi wopanga ketoacidosis mu mtundu wachiwiri wa shuga ndi wotsika. Popita nthawi, zizindikiro za matenda a impso, chiwindi, mtima, ndi mitsempha zimalumikizana ndi zomwe zimayambitsa matenda ashuga.

Mwakuya, matenda a shuga a 2 agawidwa kukhala:

1. Kufatsa: kubwezera kokha zakudya kapena kumwa piritsi limodzi la mankhwala patsiku.
2. Kuchepa kwamphamvu: mapiritsi ochepetsa shuga pamlingo wa 2-3 patsiku amasintha mawonetseredwe a hyperglycemia, angiopathy mu mawonekedwe a magwiridwe antchito.
3. Fomu yolimba: kuwonjezera pa mapiritsi, insulin ndiyofunikira kapena wodwalayo asamutsidwa kwathunthu ku insulin. Mavuto akulu azungu.

Zosiyanitsa za mtundu wachiwiri ndikuti zizindikiro za matenda ashuga zimawonjezeka pang'onopang'ono kuposa mtundu woyamba wa matenda, ndipo mtundu uwu umadziwika kawirikawiri pambuyo pa zaka 45. Zizindikiro zambiri zokhudzana ndi hyperglycemia ndizofanana ndi matenda a shuga 1.

Odwala amakhudzidwa ndi kuyabwa kwa khungu, makamaka ma kanjedza, miyendo, perineum, ludzu, kugona, kutopa, matenda apakhungu, mycoses nthawi zambiri amalowa. Mwa odwala, mabala amachiritsa pang'onopang'ono, tsitsi limagwa, makamaka pamiyendo, xanthomas imawonekera pazowoneka, tsitsi la nkhope limakula kwambiri.

Miyendo nthawi zambiri imamva dzanzi, dzanzi, pali ululu m'mafupa, mafupa, msana, minofu yolumikizika yofooka imatsogolera ku ma dislocation ndi sprains, fractures ndi kupunduka kwa mafupa motsutsana ndi maziko osowa pang'onopang'ono.

Zilonda zamkhungu zimachitika mu mawonekedwe a zotupa za m'mphepete mwa perineum, axillary komanso pansi pa tiziwalo ta mammary. Kuyamba, redness ndi supplement ndizokhudza nkhawa. Mapangidwe a zithupsa, ma carbuncle amakhalanso ndi chikhalidwe. Matenda oyamba ndi mafangasi amtundu wa vulvovaginitis, balanitis, colpitis, komanso zotupa za malo ophatikizirana, beti la misomali.

Ndi nthawi yayitali ya matenda ashuga komanso osalipidwa bwino, mavuto amabwera:

• Vascular pathology (microangiopathy ndi macroangiopathy) - kuchuluka ndi kutsekeka kwa mitsempha yamagazi kumawonjezeka, kuwundana kwa magazi ndi mawonekedwe a atherosulinotic malo pamalo owonongera khoma.
• Diabetesic polyneuropathy: kuwonongeka kwa zotumphukira zamitsempha m'njira yophwanya mitundu yonse ya kukhudzika, kuwonongeka kwa magalimoto, mapangidwe azachilala zazitali zolakwika, ischemia yamatumbo, zomwe zimayambitsa kudwala kwam'mimba komanso kuphwanya kwamiyendo.
• Kuwonongeka kwa mafupa - matenda a shuga a m'mitsempha, amachepetsa kuyenda m'malo olumikizirana mafupa, kuchepa kwa mapangidwe amadzimadzi am'mimba, kuchuluka kachulukidwe ndi mamasukidwe amaso.
• Matenda a impso: matenda a shuga a nephropathy (mapuloteni mu mkodzo, edema, kuthamanga kwa magazi). Pang'onopang'ono, glomerulossteosis ndi impso zimayamba, zomwe zimafuna hemodialysis.
• Dongosolo la matenda ashuga ophthalmopathy - kukula kwa maonedwe a mandala, kupenya kwamaso, mawonekedwe osalala, chophimba ndi malo owonekera pamaso, maso a retinopathy.
• Kuchepa kwa chapakati mantha dongosolo mu mawonekedwe a matenda a shuga: kuchepa kukumbukira, luntha, kusinthika psyche, kusinthasintha, kupweteka kwa mutu, chizungulire, asthenia, ndi mayiko okhumudwitsa.

Ndipo kanema yemwe ali munkhaniyi akuwonetsa momveka bwino tanthauzo la kutuluka kwa shuga.