Matenda a shuga a LADA ndi shuga ya autoimmune yaposachedwa mwa akulu. Mchizungu, matenda oterewa amamveka ngati "latent autoimmune shuga mwa akulu". Matendawa amatenga zaka zapakati pa 35 ndi 65, koma nthawi zambiri amadziwika kuti ali ndi zaka 45-55.
Zimadziwika chifukwa chakuti kuchuluka kwa glucose m'thupi kumakulirakulira, chochitika ndichakuti matendawa ndi ofanana pazizindikiro zolemba matenda a shuga a II mellitus.
Matenda a shuga a LADA (ili ndi dzina lakale, limatchedwa matenda a autoimmune mu zamankhwala), ndipo limasiyana chifukwa limafanana ndi mtundu woyamba wa matenda, koma matenda a shuga a LADA amakula pang'onopang'ono. Ichi ndichifukwa chake mu magawo omaliza a matenda amapezeka ngati mtundu wachiwiri wa matenda a shuga.
Mankhwala, pali matenda a shuga AYODI, omwe amatanthauza mtundu wa matenda osokoneza bongo a subclass A, amadziwika ndi chizindikiro, amakhala chifukwa cha pancreatic pathologies.
Podziwa chomwe matenda a shuga a LADA ali, muyenera kuganizira zomwe matendawa ali nawo ndi zomwe zikuwonetsa kutukuka kwake? Komanso, muyenera kudziwa momwe mungadziwire matenda, ndi chithandizo chamankhwala.
Zosiyanitsa
Mawu akuti LADA amapatsidwa matenda a autoimmune mwa akulu. Anthu omwe amagwera m'gululi amafunikira chithandizo chokwanira ndi insulin.
Poyerekeza ndi maziko a matenda a m'magazi m'thupi, kuwonongeka kwa maselo a pancreatic, omwe amachititsa kupanga insulin. Chifukwa chake, ma pathological a chilengedwe cha autoimmune amawonedwa m'thupi la munthu.
Muzochita zachipatala, mutha kumva mayina ambiri a matenda a shuga a LADA. Madokotala ena amachitcha kuti matenda omwe amapita pang'onopang'ono, ena amatcha matenda ashuga "1.5". Ndipo mayina otere amafotokozedwa mosavuta.
Chowonadi ndi chakuti imfa ya maselo onse a ziwiya zobisika atakwanitsa zaka zina, makamaka - ali ndi zaka 35, zimayamba pang'onopang'ono. Ndi chifukwa ichi kuti LADA nthawi zambiri imasokonezedwa ndi matenda a shuga a mtundu 2.
Koma ngati mungayerekeze, ndiye mosiyana ndi mitundu iwiri yamatendawa, yomwe ili ndi matenda a LADA, maselo onse a kapamba amwalira, chifukwa chake, mahomoni sangathenso kupangidwanso ndi gawo lamkati pazofunikira. Ndipo pakupita nthawi, kupanga sikutha konse.
Muzochitika zachipatala zokhazikika, kudalira kwathunthu insulin kumapangidwa pambuyo pa zaka 1-3 kuchokera pakuzindikiridwa kwa matenda a shuga mellitus, ndipo kumachitika ndi zodziwika, mwa amayi ndi abambo.
Njira yamatendawa ili pafupi kwambiri ndi mtundu wachiwiri, ndipo kwa nthawi yayitali, ndikotheka kuwongolera mchitidwewu mwakuchita masewera olimbitsa thupi komanso zakudya zopatsa thanzi.
Kufunika kozindikira matenda a shuga a LADA
Matenda a shuga a autoimmune mu akulu ndi matenda a autoimmune omwe "awonekera" chifukwa cha asayansi posachedwapa. M'mbuyomu, mtundu uwu wa matenda a shuga udapezeka ngati matenda amtundu wachiwiri.
Aliyense amadziwa mtundu wa matenda ashuga a mtundu woyamba komanso a 2, koma ndi ochepa omwe amvapo za matenda LADA. Zingawonekere, kodi pali kusiyana kwanji pakati pa zomwe asayansi abwera, chifukwa chiyani kudodometsa miyoyo ya odwala ndi madokotala? Ndipo kusiyana kwake ndi kwakukulu.
Wodwala akapezeka kuti ali ndi LADA, ndiye kuti amalandira chithandizo popanda chithandizo cha insulin, ndipo amamuthandizira ngati matenda abwinobwino a mtundu wachiwiri. Ndiko kuti, zakudya zaumoyo, zolimbitsa thupi zimalimbikitsidwa, nthawi zina mankhwala omwe amathandizira shuga m'magazi amapatsidwa.
Mapiritsi oterewa, pakati pa zinthu zina zoyipa, amachititsa kuti insulini ipangidwe, chifukwa maselo a beta ayamba kugwira ntchito molingana ndi mphamvu yawo. Ndipo zochulukirapo pazomwe maselo otero amakhala, zimawonongeka mwachangu pa autoimmune pathology, ndipo unyolo umapezeka.
- Maselo a Beta awonongeka.
- Kupanga kwa mahomoni kumachepetsedwa.
- Mankhwala amapatsidwa mankhwala.
- Zochita za maselo athunthu zimawonjezeka.
- Matenda a Autoimmune amakula.
- Maselo onse amafa.
Poyankhula pafupifupi, tcheni chotere chimatenga zaka zingapo, ndipo kutha kwake ndi kutsekemera kwa kapamba, komwe kumabweretsa kuikidwa kwa insulin. Komanso, insulin iyenera kutumikiridwa muyezo waukulu, ngakhale ndikofunikira kwambiri kutsatira zakudya zovuta.
M'maphunziro a mtundu wachiwiri wa matenda ashuga a m'matumbo, kuchuluka kwa insulin komwe kumachitika mtsogolo kumachitika pambuyo pake. Kuphwanya unyolo wa autoimmune pathology, mutazindikira matenda a shuga a LADA, wodwalayo ayenera kulangizidwa kuti apereke Mlingo wochepa wa mahomoni.
Chithandizo cha insulin choyambirira chikutanthauza zolinga zingapo zazikulu:
- Patulani nthawi yopumula ya maselo a beta. Kupatula apo, tikamagwiritsa ntchito kwambiri kupanga insulini, timaselo tomwe timayamba msanga maselo a autoimmune.
- Thibwetsani matenda a autoimmune mu kapamba pochepetsa ma autoantigens. Ndiwo "nsanza zofiira" zama chitetezo chathupi chaanthu, ndipo amathandizira kuti magwiridwe amachitidwe a autoimmune, omwe amaphatikizidwa ndi mawonekedwe a antibodies.
- Kusunga ndende ya glucose mthupi la odwala pamlingo wofunikira. Aliyense wodwala matenda ashuga amadziwa kuti kukwera shuga m'thupi, mavuto ake amabwera mwachangu.
Tsoka ilo, zizindikiro za matenda a mtundu wa autoimmune 1 sizosiyana kwambiri, ndipo kudziwika kwake koyambirira sikupezeka kawirikawiri. Komabe, ngati kunali kotheka kusiyanitsa matendawa poyambira, ndiye kuti mwina mungayambitse mankhwala a insulin m'mbuyomu, omwe angathandize kusunga zatsalira za mahomoni ake ndi kapamba.
Kusungidwa kwazinthu zatsalira ndikofunikira kwambiri, ndipo pali zifukwa zina pazifukwa izi: chifukwa cha magawo amomwe timagwiritsa ntchito mkati mwa timadzi tambiri, ndikokwanira kungosunga kuchuluka kwa shuga mthupi; chiopsezo cha hypoglycemia chimachepa; zovuta zamatenda a matenda zimapewedwa.
Momwe mungayikirire mtundu wina wa matenda ashuga?
Tsoka ilo, chithunzi chimodzi cha matenda sichimanena kuti wodwalayo ali ndi matenda osokoneza bongo a autoimmune. Zizindikiro sizosiyana ndi mtundu wa shuga wodwala.
Zizindikiro zotsatirazi zimawonedwa mwa odwala: kufooka kosalekeza, kutopa kosatha, chizungulire, kugwedezeka kwamphamvu (kawirikawiri), kutentha kwamphamvu kwa thupi (kupatula kusiyapo kwabwinobwino), kutuluka kwamkodzo, kuchepa thupi.
Komanso, ngati matendawa aphatikizidwa ndi ketoacidosis, ndiye kuti pali ludzu lakuya, pakamwa pouma, kupuma ndi mseru, chilinganizo palilime, pali fungo lodziwika bwino la acetone kuchokera pamlomo wamkamwa. Ndizofunikanso kudziwa kuti LADA imatha kuchitika popanda zizindikilo kapena zisonyezo.
Zaka zodziwika bwino zamatenda amasiyanasiyana kuyambira zaka 35 mpaka 65. Wodwala akapezeka ndi mtundu wachiwiri wa matenda ashuga pakadali pano, amafunikanso kuwunika malinga ndi njira zina kuti asatenge matenda a LADA.
Kafukufuku akuwonetsa kuti pafupifupi 10% ya odwala amakhala "eni" a matenda a shuga a autoentmune. Pali mtundu wina wa ngozi pamiyezo isanu:
- Choyimira choyamba ndi chokhudzana ndi zaka pamene matenda ashuga amapezeka asanakwanitse zaka 50.
- Mawonekedwe owopsa a pathology (oposa malita awiri a mkodzo patsiku, ndimakhala ndikumwa ludzu, munthu amachepetsa thupi, kufooka kwakanthawi komanso kutopa kumawonedwa).
- Mkulu wodwala sakhala ndi mayeso opitilira 25. Mwanjira ina, alibe kulemera kwambiri.
- Pali ma autoimmune pathologies m'mbiri.
- Kupezeka kwa zovuta za autoimmune abale apafupi.
Omwe amapanga izi akuti ngati mayankho olondola a mafunso amachokera ku zero kupita ku chimodzi, ndiye kuti kuthekera kopanga mtundu wina wa matenda ashuga sikuposa 1%.
Muzochitika pamene pali mayankho oposa awiri (awiri ophatikizika), chiwopsezo cha chitukuko chikuyandikira 90%, ndipo pankhaniyi, kuphunzira kwa labotali ndikofunikira.
Momwe mungazindikirire?
Kuzindikira matenda oterewa mwa akulu, pali njira zambiri zodziwira, koma zofunikira kwambiri ndizo kusanthula kawiri, komwe kungakhale koyankha bwino.
Kusanthula kwa kuchuluka kwa anti-GAD - ma antibodies kuti glutamate decarboxylase. Ngati zotsatirapo zake zili zoipa, ndiye kuti zimachotsa mtundu wina wa shuga. Ndi zotsatira zabwino, ma antibodies amapezeka, zomwe zikusonyeza kuti wodwalayo ali ndi mwayi wopanga matenda a LADA pafupi ndi 90%.
Kuphatikiza apo, kutsimikiza kwa kupititsa patsogolo kwa matenda mwa kuzindikira ma antibodies a ICA ku maselo a pancreatic islet angalimbikitsidwe. Ngati mayankho awiri ndi abwino, ndiye kuti akuwonetsa mtundu woopsa wa matenda ashuga LADA.
Kuwunikira kwachiwiri ndikutanthauzira kwa C-peptide. Amatsimikiza pamimba yopanda kanthu, komanso pambuyo kukondoweza. Mtundu woyamba wa matenda ashuga (ndi LADA nawonso) amadziwika ndi gawo lotsika la chinthu ichi.
Monga lamulo, madokotala nthawi zonse amatumiza odwala onse omwe ali ndi zaka 35-50 azindikira kuti ali ndi matenda osokoneza bongo ku maphunziro owonjezera kuti atsimikizire kapena kupatula matenda a LADA.
Ngati dokotala sakupatsani kafukufuku wowonjezereka, koma wodwalayo amakayikira za matendawa, mutha kulumikizana ndi kuchipatala chofufuzira ngati muli ndi vuto.
Kuchiza matenda
Cholinga chachikulu cha mankhwalawa ndikusunga kapangidwe ka maholide a pancreatic. Ngati nkotheka kumaliza ntchitoyo, wodwalayo amatha kukhala ndi moyo mpaka atakalamba, popanda mavuto ndi zovuta za matenda ake.
Mu matenda a shuga, LADA, mankhwala a insulini ayenera kuyambika nthawi yomweyo, ndipo mahomoni amatumizidwa pazing'onozing'ono. Ngati izi sizingachitike pa nthawi yake, ndiye kuti ziyenera kuyambitsidwa “kwathunthu”, ndipo mavuto adzayamba.
Pofuna kuteteza maselo a beta a pancreatic kuukira kwa chitetezo cha mthupi, jakisoni wa insulin amafunikira. Popeza ndi "oteteza" a ziwalo zamkati pachiwopsezo chawo. Ndipo choyambirira, kufunikira kwawo ndikuteteza, ndipo chachiwiri - kukhalabe ndi shuga pamlingo wofunikira.
Algorithm yochizira matenda a LADA:
- Ndikulimbikitsidwa kudya zakudya zamafuta pang'ono (zakudya zama carb ochepa).
- Ndikofunikira kuperekera insulin (mwachitsanzo ndi Levemir). Kukhazikitsidwa kwa insulin ya Lantus ndikovomerezeka, koma osavomerezeka, chifukwa Levemir ikhoza kuchepetsedwa, koma mankhwala achiwiri, ayi.
- Insulin yowonjezera imaperekedwa, ngakhale glucose sanachulukane, ndipo imasungidwa bwino.
Mu matenda a shuga, LADA, mankhwala aliwonse a dokotala amayenera kuonedwa molondola, chithandizo chodziyimira pawokha sichili chovomerezeka komanso chokwanira ndi zovuta zambiri.
Muyenera kuwunika bwino magazi anu, kuyeza kangapo patsiku: m'mawa, madzulo, masanawa, mukatha kudya, komanso kangapo pamlungu ndikulimbikitsidwa kuyeza miyezo ya shuga pakati pausiku.
Njira yayikulu yothanirana ndi matenda ashuga ndichakudya chamagulu ochepa, ndipo pokhapokha zolimbitsa thupi, insulini ndi mankhwala zimayikidwa. Mu matenda a shuga, LADA, ndikofunikira kubaya mahomoni mwanjira iliyonse, ndipo uwu ndiye kusiyana kwakukulu pakati pa matenda. Kanemayo munkhaniyi akuwuzani zoyenera kuchita ndi matenda ashuga.
