Tsoka ilo, matenda ashuga amapezeka pafupipafupi: onse akulu ndi ana amavutika nayo. Matenda a shuga ndi owopsa pamavuto ake: ngati atasiyidwa, matenda oopsa amatha kukula mpaka kufa.
Nthawi zina mankhwalawa samadziwonetsa, nthawi zina zizindikiro za matenda ashuga zimatha kubisika ngati matenda ena.
Kuti muzindikire moyenera, kupezeka kwa matenda osiyanasiyana a shuga kumagwiritsidwa ntchito, omwe samangolekanitsa shuga ndi matenda ena, komanso kudziwa mtundu wake ndikupereka chithandizo chokwanira komanso chothandiza.
Njira Zodziwitsira Matendawa
World Health Organisation yakhazikitsa njira zotsatirazi zozindikirira matenda ashuga:
- kuchuluka kwa shuga m'magazi kuposa 11.1 mmol / l ndi muyeso wosasintha (ndiye kuti, muyeso umachitika nthawi iliyonse masana osaganizira chakudya chomaliza);
- kuchuluka kwa shuga m'magazi akayezedwa pamimba yopanda kanthu (kutanthauza kuti, pafupifupi maola 8 mutatha chakudya chomaliza) amaposa 7.0 mmol / l;
- kuchuluka kwa shuga m'magazi kumadutsa 11.1 mmol / l 2 patatha mlingo umodzi wa 75 g wa glucose (glucose kulolerana mayeso).
Kuphatikiza apo, zotsatirazi zimatengedwa ngati zizindikiro zapamwamba za matenda ashuga:
- polyuria - kuchuluka kwakuchulukirapo pokodza, wodwalayo samangothamangira kuchimbudzi, koma mkodzo wambiri umapangidwa;
- polydipsia - ludzu kwambiri, wodwalayo nthawi zonse amafuna kumwa (ndipo amamwa madzi ambiri);
- Kuchepetsa thupi popanda chifukwa - sawona ndi mitundu yonse yamatenda.
Kusiyanitsa mitundu yosiyanasiyana ya matenda ashuga amtundu 1 ndi matenda amitundu iwiri
Ngakhale kuti mitundu yonse ya shuga imakhala ndi zofananira, imasiyana mosiyanasiyana chifukwa chazomwe zimayambitsa komanso njira ya pathological m'thupi. Ichi ndichifukwa chake kudziwika koyenera kwa mtundu wa matenda ashuga ndikofunikira kwambiri, chifukwa kupambana kwa chithandizo mwachindunji kumatengera izi.
Pali mitundu isanu yayikulu ya matenda a shuga:
- Mtundu woyamba wa shuga - thupi silitulutsa insulin;
- Type 2 shuga - yodziwika ndi kuchepa kwa chidwi cha insulin;
- machitidwe - omwe amatchedwa "matenda apakati a shuga" - amadziwonetsa panthawi ya bere;
- steroid - Zotsatira zakuphwanya kwa mahomoni ndi ma gren adrenal;
- wopanda shuga - Zotsatira za kusokonezeka kwamafuta chifukwa cha zovuta ndi hypothalamus.
Malinga ndi ziwerengero, matenda a shuga a 2 amapezeka nthawi zambiri - amakhudza pafupifupi 90% ya odwala omwe ali ndi matenda a shuga. Matenda a shuga a Type 1 ndi ochepa kwambiri - amapezeka pafupifupi 9% ya odwala matenda ashuga. Mitundu yotsala ya matenda amatenga pafupifupi 1% ya matenda.
Mtundu woyamba wa shuga
Type 1 shuga mellitus imachitika chifukwa cha kusokonezeka komwe kapangidwe ka thupi ka insulini ya mahomoni: sikokwanira kapena ayi konse.
Chomwe chimapangitsa kuti matendawa azikhala ndi kulephera kwa autoimmune: ma antibodies omwe amayambitsa "kupha" maselo opanga insulin.
Nthawi zina, insulini imakhala yochepa kwambiri kuti igwetse glucose, ndiye kuti shuga ya magazi imakwera kwambiri.
Ichi ndichifukwa chake matenda amtundu 1 amawonekera mwadzidzidzi; Nthawi zambiri kupezeka koyambirira kumayambitsidwa ndi matenda a shuga. Kwenikweni, matendawa amapezeka mwa ana kapena akulu osakwana zaka 25, nthawi zambiri mwa anyamata.
Zizindikiro zosiyana za matenda amtundu 1 ndi:
- shuga wamkulu;
- pafupifupi kusowa kwathunthu kwa insulin;
- kukhalapo kwa ma antibodies m'magazi;
- otsika C-peptide;
- kuwonda kwa odwala.
Type 2 shuga
Mbali yodziwika bwino ya matenda a shuga a 2 ndiyo kukana insulini: thupi limakhala losaganizira insulin.
Zotsatira zake, shuga sawononga, ndipo zikondamoyo zimayesa kutulutsa insulin yambiri, thupi limagwiritsa ntchito mphamvu, ndipo kuchuluka kwa shuga m'magazi kumakwezedwa.
Zomwe zimayambitsa matenda amtundu wa 2 sizikudziwika, koma zidadziwika kuti pafupifupi 40% ya milandu matendawa ndi chobadwa nawo.
Komanso, nthawi zambiri amavutika ndi anthu onenepa kwambiri omwe amakhala ndi moyo wopanda thanzi. Pangozi ndi anthu okhwima azaka zopitilira 45, makamaka azimayi.
Zizindikiro zosiyana za matenda amitundu yachiwiri ndi:
- shuga wamkulu
- kuchuluka kwa insulini (kungakhale kwabwinobwino);
- okwera kapena achilendo a C-peptide;
- kuchuluka glycated hemoglobin.
Nthawi zambiri, matenda ashuga amtundu wa 2 amakhala asymptomatic, akudziwonetsa kale paziwonetsero zamavuto osiyanasiyana: Mavuto ammaso amayamba, mabala amachira, ndipo ziwalo zamkati zimatha kusokonezeka.
Mndandanda wa kusiyana pakati pa matendawa omwe amadalira insulin komanso osadalira insulin
Popeza chomwe chimayambitsa matenda a shuga 1 ndi kusowa kwa insulin, umatchedwa kuti insulin. Matenda a shuga a Mtundu Wachiwiri amatchedwa insulin-Independent, chifukwa minofu yake siyimayamwa ndi insulin.
Kusiyana kwakukulu pakati pa mitundu iwiri ya shuga kukuwonetsedwa pagome:
| Zofanizira | Mtundu woyamba wa shuga | Type 2 shuga |
| Khalidweli | sikawirikawiri | nthawi zambiri |
| Kunenepa kwambiri | Pansi pazabwino | Kunenepa kwambiri, kunenepa kwambiri pamimba |
| M'badwo wopirira | Osakwana zaka 30, nthawi zambiri amakhala ana | Zoposa zaka 40 |
| Njira ya matendawa | Anapezeka mosayembekezereka, zizindikiro zimawoneka kwambiri | Ikuwoneka pang'onopang'ono, kumakula pang'onopang'ono, zizindikirazo zimakhala zopanda tanthauzo |
| Mlingo wa insulin | Zotsika kwambiri | kukwezedwa |
| Mlingo wa C-peptides | Zotsika kwambiri | mkulu |
| Kukana insulini | ayi | ulipo |
| Urinalysis | Glucose + acetone | shuga |
| Njira ya matendawa | Ndimachulukirachulukira, makamaka nthawi yophukira-yozizira | khola |
| Chithandizo | Jekeseni wa insulin moyo wonse | Zakudya, masewera olimbitsa thupi, kuchepetsa shuga |
Kusiyana matenda a shuga ndi matenda a shuga insipidus
Ngakhale kuti mitundu ina ya shuga ndiyosowa, kuwunika kosiyanasiyana kumatilola kusiyanitsa. Ndizachilendo kwambiri (mu milandu itatu mwa 100,000) omwe amadziwika kuti ali ndi matenda a shuga - matenda a endocrine omwe, chifukwa cha kusokonezeka kwa mahomoni, njira yopangira mkodzo ndikutulutsa imasokonekera: chifukwa cha kusowa kwa mahomoni ena, thupi silimamwa madzi, ndipo limatuluka mkodzo, ndiye kuti wowala. Zizindikiro za polyuria ndi polydipsia zimawonekera.
Zomwe zimayambitsa matendawa nthawi zambiri zimakhala zotupa za hypothalamus kapena pituitary gland, komanso cholowa.
Zizindikiro zosiyana za matenda a shuga a insipidus ndi:
- kukodza kopitilira muyeso (kuchuluka kwa mkodzo kumatha kufikira malita 10-15 patsiku);
- ludzu lalikulu losagonjetseka.
Kusiyana kwakukulu pakati pa matenda ashuga ndi shuga
| Zofanizira | Matenda a shuga | Matenda a shuga |
| W ludzu | ofotokozedwa | kutchulidwa |
| Kutulutsa mkodzo | Mpaka 2-3 malita | 3 mpaka 15 malita |
| Kukonzekera usiku | ayi | zimachitika |
| Kuchulukitsa kwa magazi | inde | ayi |
| Mluza mumkodzo | inde | ayi |
| Kukhazikika ndi njira ya matendawa | pang'onopang'ono | lakuthwa |
Kodi zovuta za shuga zimasiyanitsidwa bwanji?
Matenda a shuga "amatchuka" chifukwa cha zovuta zake. Mavuto amagawidwa pachimake komanso chovuta: pachimake amatha kukhala ndi maola ochepa kapena mphindi zochepa, komanso mawonekedwe opatsika pakapita zaka komanso zaka zambiri.
Mavuto owopsa amakhala owopsa kwambiri. Kuti muwalepheretse, muyenera kuyang'anira kuchuluka kwa shuga m'magazi (mitayo idzakuthandizani) ndikutsatira malangizo a dokotala.
Hypoglycemia
Hypoglycemia ndi zovuta pachimake, zomwe zimadziwika ndi kuchepa kwambiri pamlingo wa shuga (m'munsi mwa zofunikira).
Mtundu wa matenda ashuga amtundu 1, izi zimatheka chifukwa cha kudya kwambiri insulin (mwachitsanzo, chifukwa cha jakisoni kapena mapiritsi), komanso mtundu 2 wa shuga - chifukwa chogwiritsa ntchito mankhwala ochepetsa shuga.
Insulin yochulukirapo imapangitsa kuti glucose akhazikike kwathunthu, ndipo kukhazikika kwake m'magazi kumatsikira kutsika kwambiri.
Hyperglycemia
Hyperglycemia ndimatenda a m'magazi pomwe kuchuluka kwa shuga m'magazi kumakhala kwakukulu kuposa kwazonse. Hyperglycemia imatha kukhazikika pakanapanda chithandizo choyenera, ngati vuto la insulin (mwachitsanzo, kudumpha jakisoni wa odwala omwe ali ndi matenda amtundu 1), kugwiritsa ntchito zakudya kapena mowa, komanso kupsinjika.
Matenda a shuga
Zovuta za hypo- kapena hyperglycemia zomwe sizimaletsedwa panthawi zimayambitsa zovuta zakupha: matenda a shuga.Izi zimachitika mwachangu kwambiri, zimadziwika ndi kufooka, popanda thandizo, wodwala amatha kufa.
Vuto lalikulu kwambiri la hypoglycemic coma, lomwe limadziwika ndi kuchepa kwa shuga mpaka 2-3 mmol / l, zomwe zimapangitsa kuti magazi azidwala kwambiri.
Chisoni chotere chimayamba mofulumira, kwenikweni m'maola ochepa. Zizindikiro zimawonjezeka pang'onopang'ono: kuyambira pa nseru, kufooka, kuchepa mphamvu mpaka kusokonezeka, kukhumudwa komanso kukomoka palokha.
Matenda a shuga akayamba kuchuluka, hyperglycemic coma kapena diabetesic ketoacidosis imayamba. Vutoli limadziwika ndi kuwonjezeka kwa shuga pamtunda wa 15 mmol / l ndi metabolic acidosis - zomwe zimapangitsa kusweka kwa ma acid ndi mafuta zimasonkhana m'mwazi.
Hyperglycemic coma imayamba masana ndipo imadziwika ndi zizindikiro zotchulidwa: ludzu, kukodza mopitirira muyeso, ulesi, kugona, kuyera khungu, kusokonezeka. Wodwala amafunika kuyitanitsa ambulansi mwachangu.
Matenda a shuga
Mwazi wamagazi ambiri umakhudza mitsempha yamagazi, makamaka ziwiya zamiyendo.
Chifukwa cha izi, phazi la odwala matenda ashuga limatha kukhala zovuta kwa odwala omwe ali ndi matenda ashuga - kuwonongeka m'magazi kumapangitsa kuti zilonda zosapola (odwala matenda ashuga, mabala ambiri azichiritse bwino), kuwonongeka m'mitsempha yamagazi, komanso nthawi zina mafupa.
Muzovuta kwambiri, gangrene atha kumadulidwa ndipo kumadulidwa phazi kungafunike.
Makanema okhudzana nawo
Pa kuzindikira kwa mtundu 1 ndi matenda amitundu iwiri mu kanema:
Njira zamakono zodziwitsira komanso kupatsira matenda ashuga zimathandiza kupewa zovuta zonse zowopsa, ndipo malinga ndi malamulo ena, moyo wa munthu wodwala matenda ashuga sangasiyane ndi moyo wa anthu omwe alibe matenda. Koma kuti izi zitheke, kuzindikira koyenera matendawa ndi kofunikira ndikofunikira.
