Ndi matenda a shuga, pamakhala kuchuluka kwa shuga m'thupi. Ngati wodwala aphunzira kuyang'anira bwino thanzi lawo, kusunga shuga pa nthawi yokhazikika, ndiye kuti matenda ashuga amasintha kuchoka ku matenda oopsa kukhala njira yapadera yomwe singakhale pachiwopsezo.
Pali mitundu ingapo ya matenda ashuga omwe amayenderana kwambiri ndi kusokonezeka kwa metabolic m'thupi la wodwala. Mtundu uliwonse wamatenda, kuwonjezera pa hyperglycemia, umadziwonetsa kuti umatulutsa glucose mkodzo. Poyerekeza ndi izi, zizindikiro zotsatirazi zitha kuchitika:
- ludzu limayamba kuchuluka kwambiri;
- kulakalaka kukukula mofulumira;
- Pali kuperewera kwa mafuta kagayidwe kachakudya monga hyperlipidemia, komanso dyslipidemia;
- kusokoneza mineral metabolism m'thupi;
- zovuta zina zimayamba.
Kuwonjezeka kwakukulu kwa odwala omwe ali ndi matenda osokoneza bongo kumapangitsa kuti mitundu yodwalayo idziwe bwino.
Ngati mpaka posachedwapa, zamankhwala zimakhulupirira kuti ndi anthu achikulire okha azaka zopitilira 45 omwe angathe kudwala matenda amtundu II, lero malekezero amisala atafika pa 35.
Chaka chilichonse, mtundu wachiwiri wa matenda a shuga umapezeka mwa odwala achichepere, omwe amaphatikizidwa ndi kuperewera kwa zakudya komanso moyo wosayenera.
Kupatula kwakukulu kwa matendawa
Mankhwala amakono amasiyanitsa mitundu ingapo yayikulu ya matenda ashuga, omwe anthu amatha kuvutika mosaganizira zaka zawo:
- Matenda A shuga a Type I amadalira insulin. Amapangidwa m'thupi la munthu pomwe amachepetsa kuchuluka kwa timadzi timeneti. Monga lamulo, zimachitika mwa ana aang'ono, achinyamata ndi unyamata. Ndi matenda awa, ndikofunikira kuperekera insulin tsiku lililonse;
- Mtundu Wachiwiri wamatendawa suyimira insulin ndipo amatha kupezeka ndi kuchuluka kwa iwo m'magazi a munthu. Mtundu wachiwiri wa matenda ashuga amadziwika ndi anthu opitilira zaka 40 ndipo amakula motsutsana ndi zomwe zakuwonjezereka kwa thupi. Ndi mtundu uwu wa matenda ashuga, mkhalidwe waumoyo ungasinthidwe mwa kusintha zakudya, kuponya mapaundi owonjezera, komanso kumathandizira kulimbitsa thupi komanso kuchuluka kwa zochita zolimbitsa thupi. Mankhwala otere mumankhwala nthawi zambiri amagawidwa pawiri. Subtype A imayamba motsutsana ndi kumbuyo kwa kunenepa kwambiri, ndipo subtype B imakhala yotchuka kwa odwala.
Kuphatikiza pa mitundu yayikulu ya matenda a shuga, palinso mitundu yake:
- Matenda a shuga a LADA. Zimadziwika ndi kufanana kwina ndi matenda amtundu woyamba, komabe, kuthamanga kwake kumachepetsedwa. Ngati titalankhula za magawo omaliza a LADA-shuga, atha kupezeka ngati matenda a shuga II. Masiku ano, dzinali latha, ndipo mawu oti autoimmuneabetes mellitus awalowetsa m'malo;
- NTHAWI ya shuga ndi mtundu wa kalasi A matenda omwe amadziwika bwino ndipo amatha kupanga motsutsana ndi maziko amakumana ndi kapamba, ndi hemochromatosis, komanso cystic fibrosis;
- shuga yochititsidwa ndi mankhwala osokoneza bongo (matenda a shuga a class B);
- matenda a shuga a class C a mellitus, omwe amapezeka pamene dongosolo la endocrine limasokoneza.
Kusiyana pakati pa LADA-matenda ashuga amitundu ina yamatendawa
Matenda a shuga a LADA pawokha apatsidwa mtundu wina wa matenda a shuga a autoimmune mwa okalamba. Onse omwe amagwera m'gululi, limodzi ndi odwala omwe ali ndi matenda oyamba, amafunikira chithandizo cha insulin chovomerezeka. Monga lamulo, limodzi ndi mavuto ndi shuga, m'thupi la odwala, maselo a kapamba omwe amapanga insulin amawonongeka. Zotsatira zake, machitidwe a autoimmune amachitika.
Muzochita zamankhwala, munthu amatha kupeza malingaliro kuti LADA-shuga ndi yotupa, ndipo nthawi zina amatchedwanso shuga "1.5".
Mkhalidwe wofanana wa pathological umadziwika ndi kufa kwa maselo onse a ziwiya zobisika zomwe zimafikira odwala azaka 35. Njira yonseyo ndiyosakwiya komanso yofanana ndi mtundu wa matenda ashuga a 2.
Kusiyana kwakukulu ndikuti pamenepa, maselo onse a beta amafa, omwe amachititsa kuti insulin itulutsidwe mu inshuwaransi.
Monga lamulo, kudalira kwathunthu kwa insulin yowonjezereka kumapangidwa mwa nthawi 1 mpaka 3 kuyambira kumayambiriro kwa matendawa. Zimadutsa ndi zizindikiritso mu amuna ndi akazi.
Njira ya matendawa ndi yoyenera mtundu wachiwiri, chifukwa kwanthawi yayitali ndizotheka kuwongolera njira yonse yothandizidwa ndi masewera olimbitsa thupi komanso masewera olimbitsa thupi ochepa.
Njira zabwino za matendawa zimapangitsa kuganiza kuti matenda ashuga amachepa kapena kusamba kwake kudzasinthidwa kwamuyaya. Mfundo yofunika kwambiri pankhaniyi ndi kuwongolera glycemic.
Kuti muwonjezere kuzindikira kwa odwala, masukulu apadera a shuga akupangidwa. Cholinga chawo chachikulu ndikupereka chidziwitso chokwanira kwa wodwala aliyense kuti:
- ndikofunikira kuyang'anira kuchuluka kwa glycemia;
- pali njira zowongolera shuga;
- khalidwe lapadera limaperekedwa chifukwa cha zovuta za matenda ashuga.
Kodi matenda a shuga a LADA amapezeka bwanji?
Kuti muzindikire zizindikiro zomwe zimawonetsa matenda a shuga a LADA wodwala, ndikofunikira kugwiritsa ntchito zotsatirazi, kuphatikiza pa mayeso onse a glucose ndi glycated hemoglobin:
- kusanthula ndi kuthana kwa ma autoantibodies ku maselo a ICA (maselo a islet);
- kufufuza kwa ma antigen a HLA;
- kuphunzira kwa autoantibodies ku mankhwala okhala ndi insulin;
- kutsimikizira zolembera;
- ma autoantibodies wamba kuti glutamate decarboxylase GAD.
Kupatuka pa chizolowezi chovomerezeka pakuwonetsa mtundu wonga LADA-shuga kudzakhala magawo:
- zaka wodwalayo zochepera 35;
- kukhazikitsidwa kwa kudalira insulin pambuyo kanthawi (zaka zingapo);
- mawonetseredwe azizindikiro za mtundu wachiwiri wa shuga ndi kunenepa kwabwinobwino kapenanso kuwonda kwake;
- kubwezeretsedwa kwa kuchepa kwa insulini kumachitika mothandizidwa ndi zakudya zapadera ndi physiotherapy.
Kwa mankhwala amakono, kuzindikira matenda a shuga sikovuta. Kuti muchite izi, pali zida zosiyanasiyana zodziwonera zomwe zimathandizira kutsimikizika kwa odwala omwe ali ndi zaka 25 mpaka 50 muzochitikazo pamene ali ndi zizindikiro zapamwamba za matenda ashuga.
Mayeso amakono a labotale amathandiza dokotala moyenera momwe angathere kusankha njira zabwino zowathandizira ndikuwonjezera nthawi yopanga mahomoni ake omwe wodwalayo amakhala nawo.
Gulu lomwe lingakhale pachiwopsezo chokhala ndi matenda a shuga a LADA ndi amayi apakati omwe atsimikizidwa kuti ali ndi vuto la matenda ashuga. Mwambiri, azimayi awa amakhala ndi matenda ashuga atatha kubereka kapena posachedwa kwambiri. Monga lamulo, kuthekera kwa maphunziro ngati amenewo kumatchulidwa 25 peresenti ya milandu.
Njira zochizira
Monga taonera, insulin yovomerezeka imaperekedwa kwa odwala omwe apezeka ndi matenda a shuga a LADA. Madokotala amalimbikitsa kuti asachedwe jekeseni. Ngati matenda a shuga a LADA atsimikiziridwa, ndiye kuti chithandizo chamankhwala chidzakhazikitsidwa pamfundoyi.
Gululi la odwala lifunika kudziwa koyambirira kwamatendawa komanso kupatsidwa mankhwala okwanira, komanso insulin. Choyamba, izi zimachitika chifukwa cha kuthekera kwakukulu komwe kulipo kwa insulin yolimbikitsidwa. Nthawi zambiri, kuchepa kwa insulini kumatha kuphatikizidwa ndi kukana kwa maselo amthupi ku hormone iyi ngati matenda a Lada amupeza.
Zikatero, odwala amatha kupatsidwa mankhwala apadera kuti muchepetse shuga mumapiritsi. Mankhwalawa sachititsa kuti ziume za pancreatic, komabe, panthawi imodzimodzi, zimawonjezera gawo laumvekedwe wazinthu zophatikizira kwa insulin.
Kuphatikiza apo, mankhwalawa omwe angafotokozedwe akuphatikiza ndi Biguanide derivatives (Metformin), komanso glitazones (Avandia), mndandanda wathunthu wa mankhwala a odwala matenda ashuga amatha kupezeka patsamba lathu.
Zofunika kwambiri kwa odwala onse omwe ali ndi matenda a shuga a LADA. Pankhaniyi, insulini yoyambirira ingapangidwire kuti ipulumutse insulin yayitali kwa nthawi yayitali.
Odwala omwe ali ndi matenda a shuga a LADA ayenera kukhala ochepa pakugwiritsa ntchito secretogens. Mankhwalawa amathandizira kupanga insulini ndikupangitsa kuti mofulumira kufooka, komanso kupitirira kuchepa kwa insulin kwa odwala omwe ali ndi mtundu wa Lada-shuga.
Chowonjezera chachikulu pa zamankhwala chidzakhala:
- kulimba
- hirudotherapy;
- olimbitsa thupi.
Kuphatikiza apo, mwachilolezo cha dokotala, maphunziro othandizira amatha kuchitika pogwiritsa ntchito mankhwala achikhalidwe. Pali mitundu yambiri yamankhwala omwe amachepetsa shuga m'magazi odwala LADA.
