Mtundu woyamba wa matenda ashuga, kusokonezeka kwa dongosolo la endocrine kumachitika. Vutoli limadziwika ndi kusowa kwa insulini, komwe sikumapangidwa ndi kapamba pazofunikira. Zotsatira zake, shuga wa wodwalayo amakwera, chifukwa chake amachepetsa msanga komanso amakhala ndi ludzu nthawi zonse.
Tsoka ilo, matendawa ndi osachiritsika, chifukwa chake, akazindikira matenda ashuga, munthu ayenera kumwa mankhwala apadera amoyo. Mankhwalawa amachepetsa kuchuluka kwa shuga m'magazi ndipo amakulolani kukhala ndi thanzi labwino.
Zowonadi, ngakhale kuchuluka kwa glucose ndikokwera pang'ono kuposa kwabwinobwino, kumakhalabe ndi zowononga pamitsempha yamagazi. Ndipo chifukwa chakuchepa kwa magazi, ziwalo zazikulu zamkati sizipeza zinthu zomwe zimafunikira kuti zizigwira bwino ntchito.
Koma ndi chithandizo choyenera ndikutsatira malingaliro onse azachipatala, chiyembekezo chamoyo ndizambiri. Malinga ndi ziwerengero, ndizoposa zaka makumi atatu.
Zoyambitsa ndi Zoopsa
Matenda a shuga omwe amadalira insulin amatanthauza matenda a autoimmune omwe akupita patsogolo nthawi zonse. Chowonadi chake ndikuti maselo a beta omwe amachititsa kuti insulini ipangidwe amawonongeka pang'ono ndi maselo oteteza thupi.
Masiku ano sizinakhazikitsidwe bwino lomwe zomwe zimapangitsa kuti chitetezo cha mthupi chizigwira ntchito molakwika. Zomwe zimayambitsa ndi ma virus omwe angayambitse matendawa mwa anthu omwe ali ndi vuto lobadwa nalo.
Zowopsa zake ndi izi:
- mavairasi a coxsackie;
- kobadwa nako rubella;
- mumps.
Koma nthawi zambiri, shuga 1 imawoneka chifukwa cha majini. Chifukwa chake, asayansi azindikira ma genetic 18. Mwachitsanzo, IDDM1 ndi malo okhala ndi mapuloteni otulutsa ma HLA omwe ali gawo la zovuta za histocompatability. Ma genes ochokera m'derali amakhudzanso chitetezo cha mthupi.
Komabe, mwayi wolandila shuga wodalira insulin, ngakhale abale atadwala ndi matendawa, ndiwotsika (pafupifupi 10%). Kuphatikiza apo, zamatsenga nthawi zambiri zimafalikira limodzi ndi mbali ya makolo.
Kupsinjika kwapafupipafupi, kunenepa kwambiri, kuledzera, kupezeka kwa pancreatic necrosis ndi pancreatitis kumayambitsanso matenda. Kuphatikiza apo, kugwiritsa ntchito molakwika mankhwala ena osokoneza bongo komanso zakudya zopanda thanzi zimathandizira kupanga insulin yokwanira. Inde, chakudya chochulukirapo chama carbohydrate, kuphatikizapo chokoleti ndi kuphika, chimasokoneza metabolidi ndi metabolism, yomwe imakhudza kugwira ntchito kwa kapamba.
Zowopsa zomwe zimayambitsa kudalira kwa insulin zimaphatikizapo:
- kubadwa mochedwa;
- kuchepa magazi m'thupi;
- preeclampsia - complication ya mimba;
- multiple sclerosis;
- Chithokomiro cha Hashimoto;
- Manda matenda.
Chithunzi cha kuchipatala
Chizindikiro choyamba cha matenda amtundu woyamba ndicholemetsa wopanda pake chifukwa chakudya. Komanso, wodwalayo amatopa msanga, akumva kuwawa ndipo amafunafuna kugona nthawi zonse, komanso amazunzidwa ndi ludzu lalikulu.
Odwala ambiri amakhala ndi vuto lanjala, limodzi ndi kuchepa kwa kuthamanga kwa magazi, khungu pakhungu, mawonekedwe a thukuta lozizira komanso tachycardia. Anthu odwala matenda ashuga nthawi zambiri amakhala ndi kufooka kwa minofu ndi kumva kumenyera.
Zizindikiro zazikulu zamatendawa azimayi ndi kuyimitsa kwina kwa ziwalo zakunja ndi perineum. Zizindikirozi zimayamba chifukwa cha kupezeka kwa glucose mkodzo. Kupatula apo, mutatha kukodza, madontho a mkodzo wokhala ndi shuga amagwera pamatumbo amtundu, ndikupangitsa kukwiya kwambiri.
Mwa amuna, chizindikiro chachikulu cha nthendayi ndi kusokonekera kwa magazi komanso kusakhazikika bwino. Kuopsa kwa matendawa ndi njira yobisika kapena wodwalayo samalabadira zowonetsa zazing'ono za matenda.
Zina zodziwika za matenda amtundu woyamba wa 1 ndi mabala osachiritsika osakhalitsa.
Nthawi yomweyo, zilonda ndi zithupsa zimapangidwa m'magulu ambiri, chitetezo chawo chimachepa, chifukwa chomwe amamva kufooka pafupipafupi ndipo nthawi zambiri amakhala ndi chimfine.
Zotsatira zoyipa za matenda ashuga: hypoglycemia ndi hyperglycemia
Anthu ambiri amafuna kudziwa momwe zovuta za mtundu woyamba wa 1 zimayambira. Ndi matendawa, glucose, yomwe ntchito yake ndikulowera m'maselo am'mimba ndi minofu ndikuyiyambitsa mphamvu, imatsalira m'magazi.
Ngati kuchuluka kwa shuga kumachulukitsidwa pafupipafupi, popanda kukwera kwamphamvu, ndiye kuti kumayamba kusiya ziwalo ndikudzaza ziwiya, kuwononga makoma awo. Zimasokonezanso kugwira ntchito kwa ziwalo zoperekedwa ndi magazi. Chifukwa chake, zovuta zimayamba ndi matenda amtundu 1, pamene thupi limasowa insulin.
Ngati kuchepa kwa mahomoni sikulipiridwa ndi insulin yochita kupanga, zotsatirapo zake zimakula mwachangu kwambiri. Ndipo izi zimachepetsa kwambiri chiyembekezo cha moyo wa munthu.
Mavuto acute amayamba chifukwa cha kuchepa kwadzidzidzi kapena kuwonjezeka kwa shuga m'magazi. Agawidwa m'mitundu iwiri:
- hypoglycemic coma (shuga wotsika);
- Hyperglycemic zinthu (shuga wambiri).
Hypoglycemia nthawi zambiri imayamba chifukwa cha kuchuluka kwa insulini kapena ngati wodwala wasowa chakudya atatha kuyamwa. Komanso, chikomokere chimawonekera chifukwa chochita zolimbitsa thupi kwambiri, kuphatikizapo kubereka ana.
Kuphatikiza apo, hypoglycemia imatha kuchitika mukamamwa mankhwala osokoneza bongo. Mkhalidwe wina wotere umayamba chifukwa chotenga mankhwala ena (ma tetracyclines, beta-blockers, fluoroquinolones, lithiamu, calcium, vitamini B 12, salicylic acid). Kuphatikiza apo, mu odwala matenda ashuga, mwayi wochepetsetsa wama glucose ukuwonjezereka ndikuchulukirachulukira kwa matenda a hepatosis kapena hepatitis, pakati, komanso matenda a impso kapena adrenal glands.
Hypoglycemia ikachitika, ndikofunikira kwambiri kudya zakudya zamafuta mkati mwa mphindi 20 (tiyi ndi chokoleti ndizotsekemera). Kupatula apo, kutsika pang'ono kungapangitse kufa kwa matenda a chimbudzi. Chifukwa chake, ndikofunikira kudziwa za zizindikiro zomwe zikuwonetsa kuyambika kwa chikomokere:
- khungu pakhungu;
- kuphwanya kwakuthwa;
- dzanzi la milomo;
- chizungulire ndi matenda a shuga;
- thukuta lozizira;
- njala
- manja akunjenjemera.
Ngati dontho lamphamvu la shuga limachitika usiku, ndiye kuti munthu amayamba kulira. Popanda kudya kwambiri shuga, wodwalayo angagwe.
Pa gawo lachiwiri la hypoglycemia, zizindikiro monga kupsa mtima kapena kupha mphamvu kwambiri, kugwirira ntchito bwino, kuwona kawiri ndi kuwona koperewera, kuthamanga kwa mtima komanso kukulitsa kuchuluka kwa mtima. Kutalika kwa siteji ndikufupikirako, ndipo pamenepa shuga ndi maswiti amatha kulowa m'mpweya wopuma, chifukwa chomwe wodwalayo ayamba kukumana, motero ndi bwino kungomupatsa yankho lokoma.
Zizindikiro zomaliza za hypoglycemia zimaphatikizira mawonekedwe a kukomoka, khungu la pakhungu, lomwe limakutidwa ndi thukuta lozizira, komanso kusazindikira. Pankhaniyi, ndikofunikira kuyimba ambulansi kuti dokotala am'thandize wodwala yankho la shuga (40%). Ngati chithandizo sichingaperekedwe mu maola 2 otsatira, kukha magazi kwa ubongo kungachitike.
Kupewera kwabwino kwa chitukuko cha hypoglycemic coma ndi masewera. Koma musanayambe makalasi, muyenera kuwonjezera kuchuluka kwa chakudya chamagulu ndi 1-2 XE, muyeneranso kuchita izi mukamaliza kulimbitsa thupi.
Chakudya chamadzulo, ndikofunikira kudya zakudya zama protein. Amasintha pang'onopang'ono kukhala shuga, zomwe zimapangitsa kuti odwala matenda ashuga agone mwamtendere usiku wonse.
Amalangizidwanso kusiya mowa kwathunthu. Pazipita tsiku lililonse mowa sayenera kupitirira 75 magalamu.
Vuto linanso lalikulu la matenda a shuga omwe amadalira insulin ndi kukomoka kwa hyperglycemic, omwe amagawidwa m'mitundu itatu:
- ketoacidotic;
- lactic acidotic;
- hyperosmolar.
Zisokonezo zotere zimawoneka ndi kuchuluka kwa shuga m'magazi. Mankhwalawa amachitika m'malo osakhalitsa.
Zotsatira zambiri za matenda amtundu woyamba 1 ndi ketoacidosis. Amayamba ngati malamulo a insulini samatsatiridwa, motsutsana ndi maziko a njira zopatsirana kapena zotupa komanso kuchulukitsa kwa matenda osachiritsika. Komanso kuvulala, stroke, kugunda kwa mtima, sepsis, kugwedezeka ndi chithandizo chosafunikira cha opaleshoni zimatha kuchititsa izi.
Ketoacidosis imachitika motsutsana ndi maziko azovuta za carbohydrate metabolism, yomwe imawoneka chifukwa chosowa insulini.
Nthawi yomweyo, kuchuluka kwa matupi a ketone ndi glucose m'magazi kumakulanso. Pakapanda kupumula panthawi yake, chikomoka cha ketoacidotic chimachitika.
Vutoli limakhudza ntchito ya mtima, ubongo, mapapu, matumbo ndi m'mimba. Pali magawo anayi a ketoacidosis, limodzi ndi zizindikiro zingapo:
- Ketosis - kuyanika kwa khungu ndi mucous nembanemba, ludzu, kugona, malaise, kupweteka kwa mutu, kusowa kudya komanso kuchuluka kukodza.
- Ketoacidosis - kugona, kununkhira kwa acetone kuchokera mkamwa, palpitations, kuchepa kwa magazi, kusanza, kuchepa kwamkodzo.
- Precoma - kusanza kwofiirira, kusintha kwa kupuma, kupweteka pamimba, kuwoneka ngati kutukutira m'masaya.
- Coma - kupuma kwamkamwa, kutsekeka kwa khungu, kusazindikira, kukoma kwa acetone mkamwa.
Chithandizo cha ketoacidotic chikomacho cholinga chake ndi kufewetsa insulin, kudzera pakulowetsa microdoses yake mosalekeza. Komanso, kuti abwerenso madzi, wodwalayo amapaka jekeseni wamadzi ndi ayoni.
Hyperosmolar ndi lactic acidotic coma nthawi zambiri zimayamba ndi mtundu wachiwiri wa matenda osokoneza bongo a shuga.
Machedwe mavuto
Nthawi zambiri matenda a shuga amakhudza ntchito ya impso. Ziwalo izi zimadutsa 6 l magazi kudzera mwa iwo eni tsiku lililonse, kusefa.
Kuchuluka kwa madzi akumwa kumabweretsa unyinji wa impso. Kuphatikiza apo, amadziunjikira shuga wambiri.
Ngati kuchuluka kwa shuga m'magazi ndikokwera kuposa 10 mmol / l, ziwalo zimasiya kugwira ntchito yochita kusefa ndipo shuga amalowa mkodzo. Mkodzo wotsekemera umunjikana mu chikhodzodzo, ndikukhala malo abwino kwambiri opangira tizilomboto toyambitsa matenda. Zotsatira zake, kutupa kumachitika m'm impso, zomwe zimathandizira kukulira kwa nephritis ndi nephropathy, yomwe imawonetsedwa ndi kulephera kwa impso, kuwonjezeka kwa protein mu mkodzo ndikuwonongeka m'mitsempha yamagazi.
Popewa mavuto a impso, ndikofunikira kuyang'anitsitsa shuga ndi magazi. Ndi albuminuria, mankhwala ochokera ku magulu a ARB ndi ACE amatha kutumikiridwa.
Ngati matenda a impso akupita patsogolo, zakudya zomanga thupi zochepa ziyenera kutsatiridwa. Komabe, panthawi yotsika ya kulephera kwa impso, mapuloteni ochulukirapo angafunike, chifukwa chake, zofunikira pazakudya ziyenera kuvomerezedwa ndi dokotala.
Nthawi zambiri mtundu 1 wa matenda a shuga, zomwe zimasiyanasiyana, zimakhudza ntchito yamtima. Zotsatira zoyipa kwambiri ndizo matenda a mtima, kuphatikizira mtima, angina pectoris, ndi arrhythmia. Mavuto onsewa amapezeka ndi njala ya okosijeni, ndipo ngati magazi atasweka, ziwombozo zimafa.
Kuopsa kwa vuto la mtima kwa anthu odwala matenda ashuga ndikuti mwina sikungayende ndi matenda, chifukwa kumverera kwa minofu yamtima sikunyalanyazidwa.
Mavuto ambiri amabwera chifukwa cha kuchuluka kwa mitsempha yamagazi. Chifukwa chake, kugonjetsedwa kwa chotengera chachikulu pamtima, kumenyedwa kumachitika. Ndipo matenda a "mtima wa matenda ashuga" amawonetsedwa ndi kusokonekera kwa myocardial kugwira ntchito komanso kukula kwa ziwalo.
Ndikulimbikitsidwa kuti odwala omwe ali ndi chiopsezo chokulitsa matenda a mtima amatenga Aspirin mu 65-160 mg patsiku ngati njira yodzitetezera. Komabe, mankhwalawa ali ndi zovuta zambiri, choncho chithandizo chikuyenera kuvomerezedwa ndi adokotala.
Zotsatira zinanso zomwe zimachitika chifukwa cha matenda a shuga omwe amadalira insulin ndi retinopathy.
Mitsempha yamagazi ikawonongeka, maselo amafooka, chifukwa chomwe khungu, khungu ndi khungu zimapangika.
Mitsempha yamagazi ikasefukira, kukha magazi kumachitika m'maso amaso. Nthawi zambiri, odwala matenda ashuga amapanga balere, ndipo nthawi zina minofu imamwalira. Chithandizo chotsogola cha retinopathy ndi matenda a shuga a m'mimba ndi opereshoni ya laser.
Nthawi zambiri, shuga wambiri amatsogolera ku mfundo yoti mathero amitsempha amawonongeka, izi zimamvekedwa makamaka m'miyendo. Matendawa amatchedwa matenda a shuga.
Mankhwalawa, mankhwalawa amagwiritsidwa ntchito:
- anticonvulsants;
- narcotic analgesics;
- antidepressants;
- opalesa pachipala.
Neuropathy imatha kudzetsa zotsatilapo zingapo zowonongeka - kudziletsa mosasamala ndikutulutsa chikhodzodzo, kudumpha kuthamanga kwa magazi. Chifukwa chake, ndi paresis yam'mimba, Erythromycin kapena Metoclopramide ndi mankhwala.
Matenda ena a shuga omwe amadalira insulin amatha kukhala ndi vuto la mano. Kupatula apo, kusakwanira kwa magazi kumabweretsa njira zotupa mumkamwa wamkamwa. Chifukwa chake, masenti, periodontitis kapena gingivitis amawonekera. Dokotala wamano ayenera kuthana ndi izi.
Odwala ambiri omwe ali ndi matenda a shuga a mtundu woyamba ali ndi matenda a diabetes kapena phazi la Charcot, amenenso amapezeka chifukwa cha kusayenda bwino kwa magazi. Mkhalidwe uwu umadziwika ndi totupa pamiyendo (monga pachithunzichi), kufooka kwa minofu yokweza, kunachepetsa chidwi chazinthu zokhumudwitsa, chiwonongeko cha mafupa ndi mafupa a phazi.
Kusachiza kwa phazi la matenda ashuga kumatha kuduladula miyendo. Chifukwa chake, kupewa matenda a matenda a shuga 1 kumakhala kosamalitsa mosamala:
- kupenda miyendo tsiku ndi tsiku;
- kuchapa mapazi kawiri pa tsiku;
- kugwiritsa ntchito pafupipafupi moisturizer;
- kuvala nsapato zapamwamba;
- kukanidwa kwa zingwe ndi masokosi omwe amafinya phazi.
Insulin, yomwe siyipangidwe mtundu wa 1 shuga, imakhudzidwa ndikupanga madzi a m'mimba, chifukwa kuchuluka kwake kumachepetsedwa. Zotsatira zake, gastritis, kutsekula m'mimba, ndi dysbiosis zimayamba. Pankhaniyi, muyenera kulumikizana ndi gastroenterologist yemwe akupatseni mankhwala ena apadera omwe amateteza kugaya.
Ndi magazi osakwanira, kutupa kwamalumikizidwe kumatha kuchitika. Izi zimabweretsa kuwoneka ngati crunch pa nthawi yowerama miyendo, zilonda komanso kusuntha pang'ono. Nthawi zambiri, ludzu ndi kukodza pafupipafupi ndimomwe kumayambitsa kukoka kwa calcium kuchokera m'mafupa, ndikupangitsa mafupa.
Kuti muchepetse zovuta za mtundu wa matenda ashuga a 2, ndikofunikira kuti mukhale ndi moyo wathanzi, mankhwalawa ndimatenda oyambitsa matenda munthawi yake komanso kupewa nkhawa. Komanso, zakudya zomwe zimakhala ndi zosungirako komanso zowonjezera zowonjezera ziyenera kuchotsedwa muzakudya.
Mu kanema munkhaniyi, zakudya za odwala omwe amadalira matenda a shuga zimaperekedwa, zomwe zingathandize kuthana ndi shuga m'magazi motero poteteza mavuto obwera chifukwa cha matendawa.
