Matenda a shuga amakhudza thanzi la chiwindi. Thupi limatulutsa ndikusunga glucose, umakhala mtundu wamtundu wa shuga, womwe umakhala mafuta m'thupi, umasunga shuga wofunikira m'magazi.
Glucose ndi chiwindi
Chifukwa cha zosowa za thupi, kusungidwa kapena kumasulidwa kwa shuga kumanenedwa ndi glucagon ndi insulin. Mukamadya, zotsatirazi zimachitika: chiwindi chimasungidwa mu glucose mu mawonekedwe a glycogen, omwe amatha kudya pambuyo pake, pakufunika.
Kuchuluka kwa insulinkomanso kuponderezedwa madigiri a glucagon panthawi yakudya kumathandizira kuti shuga ikhale glycogen.
Thupi la munthu aliyense amatulutsa shuga, ngati kuli kotheka. Chifukwa chake, munthu akasiya kudya (usiku, nthawi yodyera chakudya cham'mawa komanso chamasana), ndiye kuti thupi lake limayamba kupanga shuga. Glycogen amakhala glucose chifukwa cha glycogenolysis.
Chifukwa chake, zakudya ndizofunikira kwambiri kwa odwala matenda ashuga, kapena anthu omwe ali ndi shuga komanso magazi ambiri.
Thupi lilinso ndi njira ina yopangira glucose kuchokera ku mafuta, amino acid, ndi zinthu zonyansa. Njirayi imatchedwa gluconeogeneis.
Zomwe zimachitika ndi vuto:
- Thupi likakhala loperewera mu glycogen, limayesetsa ndi mphamvu zake zonse kuti lisungunuke glucose mosalekeza kwa ziwalo zomwe zimafunikira malo oyamba - impso, ubongo, maselo amwazi.
- Kuphatikiza pakupereka shuga, chiwindi chimapanga njira ina yamafuta akuluakulu a ziwalo - ma ketoni ochokera ku mafuta.
- Chofunikira pakuyambika kwa ketogeneis ndichinthu chochepetsedwa cha insulin.
- Cholinga chachikulu cha ketogenosis ndikusunga masitolo a glucose a ziwalo zomwe amafunikira kwambiri.
- Kapangidwe ka ma ketones ambiri silili vuto wamba, komabe ndizowopsa, chifukwa chake, thandizo lachipatala lingafunike.
Zofunika! Nthawi zambiri, shuga wambiri m'mawa wokhala ndi matenda ashuga ndi chifukwa cha kuchuluka kwa gluconeogeneis usiku.
Anthu omwe sakudziwika ndi matenda monga matenda ashuga ayenera kudziwa kuti kuchuluka kwa mafuta m'maselo a chiwindi kumawonjezera mwayi wa matendawa.
Komanso kuchuluka kwa mafuta m'magawo ena a thupi kulibe kanthu.
Mafuta hepatosis. Pambuyo pochita maphunziro ambiri, zidapezeka kuti mafuta a hepatosis ndi owopsa kwa matenda ashuga.
Asayansi apeza kuti odwala omwe ali ndi hepatosis yamafuta ali pachiwopsezo chachikulu cha kupitirira kwa matenda ashuga a 2 kwa zaka zisanu.
Kuzindikira kwa hepatosis yamafuta kumafuna kuti munthu asamale zaumoyo wawo kuti asayambitse matenda ashuga. Izi zikutanthauza kuti zakudya zidzagwiritsidwa ntchito, komanso chithandizo chokwanira cha chiwindi pamavuto aliwonse omwe ali ndi chiwalochi.
Dziwani hepatosis yamafuta pogwiritsa ntchito ultrasound. Kafukufuku wotereyu amatha kuneneratu za matenda a shuga ngakhale atakhala kuti ali ndi insulin yambiri m'magazi.
Tcherani khutu! Ngakhale ndi zomwe zili ndi insulin yomwe ili m'magazi, anthu omwe ali ndi mafuta a hepatosis ali pachiwopsezo cha matenda a shuga kawiri kawiri kuposa omwe sakudziwika bwino ndi matendawa.
Mafuta a hepatosis adapezeka mu 1/3 mwa okhala ku US. Nthawi zina zizindikiro za matendawa sizitchulidwa, koma zimachitika kuti matendawa amatha kupangitsa kuti chiwindi chilephere komanso kuwonongeka kwa chiwindi ndikotheka.
Ambiri amati hepatosis yamafuta ndimatenda a chiwindi chauchidakwa, koma matendawa amatha kukhala ndi zifukwa zina komanso zizindikiro.
Zofunika! Kunenepa kwambiri mu chiwindi kumapangitsa insulin kukana.
Ziwerengero
Pakafukufuku yemwe adafalitsidwa mu magazini yotchedwa Metabolism and Clinical Endocrinology, asayansi adachita kafukufuku wofufuza momwe mafuta a hepatosis amakhudzira chitukuko cha matenda ashuga.
Ntchitoyi idakhudza anthu 11,091 okhala ku South Korea. Kumayambiriro (2003) kwa phunziroli komanso atatha zaka zisanu mwa anthu, insulin concentration ndi chiwindi ntchito zimayeza.
- Pa gawo loyambirira la kafukufukuyu, mafuta a hepatosis adapezeka 27% ya aku Korea.
- Nthawi yomweyo, kunenepa kwambiri kunawonedwa mu 60% ya omwe adayesedwa, poyerekeza ndi 19% popanda kuwonongeka kwa chiwindi.
- Mwa 50% ya anthu omwe ali ndi chiwindi chambiri, nsonga za insulin pamimba yopanda kanthu (zolembedwa za insulin) zidalembedwa, poyerekeza ndi 17% yopanda mafuta a hepatosis.
- Zotsatira zake, ndi 1% yokha mwa anthu aku Korea omwe alibe mafuta a hepatosis omwe adapanga matenda a shuga mellitus (mtundu 2), poyerekeza ndi 4% akuvutika ndi chiwindi.
Pambuyo pakusintha chizindikiro cha kukana insulini koyambirira koyambirira kwa kafukufukuyu, mwayi wa matenda ashuga udakulabe kuposa mafuta a hepatosis.
Mwachitsanzo, pakati pa anthu omwe ali ndi kuchuluka kwambiri kwa insulini, chiopsezo cha matenda osokoneza bongo chinali okwera kawiri kumayambiriro kwa maphunziro a kunenepa kwambiri kwa chiwindi.
Kuphatikiza apo, kumayambiriro kwa phunziroli, anthu omwe ali ndi mafuta otupa a hepatosis anali atha kutengeka kwambiri ndi insulin (mkulu wa cholesterol ndi glucose) yayikulu.
Chifukwa chake, mafuta othandizira hepatosis amawonjezera mwayi wa matenda ashuga. Poona izi, anthu omwe ali ndi chiwindi chambiri onenepa amafunika kudya kwapadera, komwe kumayenera kupewa shuga, kuwongolera shuga wamagazi ndikuchepetsa kudya zakudya komanso zakudya zopatsa mphamvu zamagulu ambiri.
Tcherani khutu! Kwa iwo onenepa kwambiri, zakudya zoterezi zimapangitsa kuti zizikhala zogwirizana, ngakhale kuti zakudya zake sizimakhudzidwa kwambiri ndi kuchepetsa thupi monga momwe amathandizira komanso kupewa matenda a hepatosis.
Komanso, chakudya chapadera chimaphatikizapo kukana mowa. Izi ndizofunikira kuti chiwindi chizigwira bwino ntchito, zomwe zimagwira ntchito zoposa 500.
Cirrhosis
Poyesedwa m'magazi a glucose, anthu omwe ali ndi matenda enaake a m'magazi amakhala ndi hyperglycemia. Zomwe zimayambitsa cirrhosis sizikumveka bwinobwino.
- Monga lamulo, ndi cirrhosis, kukana kwa zotumphukira kwa insulin kumayamba ndipo chilolezo cha insulin chimachepa.
- Mlingo wa kuzindikira kwa adipocytes kwa insulin umacheperanso.
- Poyerekeza ndi gulu loyendetsa, cirrhosis imachepetsa kuyamwa kwa insulin panthawi yoyambira kudutsa chiwalo.
- Kwenikweni, kuwonjezeka kwa insulini kumakhala koyenera chifukwa cha kuchuluka kwa katulutsidwe ndi kapamba.
- Zotsatira zake, pali insulin yowonjezereka komanso kuchuluka kwa shuga m'magazi m'mawa ndi kuchepa pang'ono kwa kulolerana kwa shuga.
Nthawi zina, pambuyo poyamwa shuga wambiri, insulin katulutsidwe kamachepa. Izi zikutsimikizira kuchepa kwa C-peptide. Chifukwa cha izi, kukoka kwa glucose kumachepetsedwa kwambiri.
Mlingo wa shuga pamimba yopanda kanthu umakhalabe wabwinobwino. Ndi hypoecretion wodziwika bwino wa insulini, shuga kuchokera ku chiwindi amalowa m'magazi chifukwa chosowa mphamvu ya insulini pakapangidwe ka shuga.
Zotsatira za kusinthika kotero ndi hyperglycemia pamimba yopanda kanthu komanso vuto lalikulu la hyperglycemia atatha kudya shuga. Umu ndi momwe matenda a shuga amakhalira, ndipo mankhwalawa ayenera kuganiziridwanso.
Kutsika kwa kulekerera kwa glucose mu cirrhosis kumatha kusiyanitsidwa ndi shuga weniweni, chifukwa kuchuluka kwa shuga mwa munthu amene samadya chakudya, makamaka kumakhala koyenera. Pankhaniyi, zizindikiro zamatenda a shuga sizinafotokozedwe.
Ndikosavuta kuzindikira matenda amisempha m'matenda a shuga. Kupatula apo, ndi kuperewera kwa insulin, zizindikiro monga:
- ascites;
- mitsempha ya kangaude;
- hepatosplenomegaly;
- jaundice.
Ngati ndi kotheka, mutha kudziwa matenda amisempha pogwiritsa ntchito chiwindi.
Chithandizo cha matenda a cirrhosis chimaphatikizapo kugwiritsa ntchito mankhwala ochulukitsa, ndipo pano chakudya chimabwera koyamba. M'malo mwake, wodwalayo adayikidwa zakudya zapadera, makamaka, ndizofunikira kwa encephalopathy, chithandizo pano chikugwirizana kwambiri ndi zakudya.
Zizindikiro za chiwindi
Ndi chifuwa chachikulu cha matenda a shuga, kusintha kulikonse kwa ziwindi za chiwindi sikumawonedwa. Ndipo ngakhale atapezeka, zizindikiro zawo ndi zomwe sizikugwirizana ndi matenda ashuga.
Ndi kuphwanya kwa kagayidwe kazakudya, mawonekedwe a hyperglobulinemia ndi zizindikiro zosonyeza kuchuluka kwa bilirubin mu seramu kumatha kuchitika.
Kwa odwala matenda ashuga, zizindikiro zoterezi sizikhalidwe. Mu 80% ya odwala matenda ashuga, kuwonongeka kwa chiwindi chifukwa cha kunenepa kwake kumawonedwa. Chifukwa chake, kusintha kwina mu seramu kumawonekera: GGTP, transaminases ndi alkaline phosphatase.
Kuwonjezeka kwa chiwindi chifukwa cha glycogen wokwanira mu mtundu 1 wa shuga kapena kusintha kwamafuta ngati matendawo ndi amtundu wachiwiri sagwirizana ndi kuwunika kwa chiwindi.
Chithandizo chophweka chothandizira pano chithandizira kupewa, pomwe chithandizo chovuta chikuvomereza kupezeka kwa chithandizo chamankhwala.
Kugwirizana kwa matenda am'mimba komanso chiwindi ndi shuga
Mu matenda ashuga, matenda enaake amayamba pang'ono. Monga lamulo, cirrhosis imayamba kupezeka ndipo pambuyo pake ikupezeka ndi kuperewera kwa insulin, ndipo mankhwala akupangidwa.
Matenda a shuga amathanso kukhala chizindikiro cha chibadwa cha hemochromatosis. Amaphatikizidwanso ndi matenda oopsa a autoimmune hepatitis komanso ma antigen of the main histocompatability tata DR3, HLA-D8.
Ngakhale ndi shuga wodziimira payekha, ma gallstones amatha kupanga. Mwambiri, izi sizikugwirizana ndi matenda ashuga, koma kusintha kwa kapangidwe ka bile chifukwa cha kunenepa kwambiri. Zakudya zochiritsira, monga chithandizo, pankhaniyi zimatha kupewa mapangidwe amiyala yatsopano.
Kungatchulidwenso ndi zizindikiro zakuchepa kwa ntchito yolerera mu ndulu.
Kuchita opaleshoni ya gallbladder mwa anthu odwala matenda ashuga sikuti kwangozi, koma opaleshoni yamitsempha yantchito nthawi zambiri imadzetsa matenda opweteka komanso kufa.
Mankhwalawa sulfonylurea angayambitse zilonda zamkati kapena za cholestatic.
