Matenda a shuga amatchedwa matenda a endocrine, omwe amadziwonetsera ngati kuphwanya njira zonse za metabolic mthupi. Pathology ili ndi mitundu ingapo, yosiyanasiyana chifukwa komanso magwiritsidwe ake a chitukuko. Matenda a shuga amawoneka ngati vuto lapadziko lonse lapansi, chifukwa pakadali pano kuchuluka kwa odwala kumapitilira 200 miliyoni, ndipo matendawa nawonso sangathe kuchiritsidwa.
Nkhaniyi ikufotokoza momwe mtundu wa matendawo amawonekera, mtundu wake ndi momwe ungathane nawo.
Ndalama ndi madigiri ake
Kuti musankhe njira zoyenera zowongolera odwala, endocrinologists amadziwa madigiri angapo a chiphuphu cha shuga. Iliyonse imakhala ndi mawonekedwe, zizindikiro za labotale, imafunikira kulowererapo.
Mlingo wa kubwezeretsedwa umadziwika ndi mkhalidwe wabwino kwambiri wa wodwala. Zizindikiro za shuga zikuyandikira zabwinobwino, zizindikiro za matendawa sizifotokozedwa konse. Kulipiritsa kumafunikira kutsatira malamulo a mankhwala azakudya ndi moyo wokangalika. Munthawi ya shuga operewera, endocrinologists amatha kuchepetsa kuchuluka kwa mapiritsi ochepetsa shuga, insulin kapena kusiya kugwiritsa ntchito mankhwalawo.
Kulipira shuga ndi gawo lotsatira la matendawa. Kukhala bwino kwa wodwala kumakulirakulira, chithunzi cha chipatala chimatchulidwa. Odwala ali ndi izi:
- kufunafuna zam'madzi kumwa;
- mkodzo wambiri;
- mutu
- youma mucous nembanemba;
- kuyuma ndi kuyabwa kwa khungu.
Matenda a shuga ophatikizika amaphatikizidwa ndikuphwanya njira zonse za metabolic mthupi. Amadziwika ndi zofunika kudziwa glycemia, kupezeka kwa shuga mkodzo, kukula kwa zovuta komanso zovuta zovuta. Omalizawa akupita patsogolo mwachangu.
Polydipsia ndi chimodzi mwazizindikiro zazikulu za matendawa.
Kodi ndi njira ziti zomwe zingatsimikizire kulipira?
Pali zisonyezo zingapo kutengera komwe endocrinologist imatsimikiza kuchuluka kwa chindapusa cha matendawa. Izi zikuphatikiza:
- glycosylated hemoglobin;
- Zizindikiro za glycemia chakudya chisanalowe thupi ndi maola ochepa pambuyo panjira iyi;
- kukhalapo kwa shuga mkodzo.
Zowonjezera ndi kuchuluka kwa kuthamanga kwa magazi, cholesterol ndi triglycerides m'magazi, kupezeka kwa matupi a ketone (acetone), index ya body.
Kubwezera
Digiriyo imadziwika ndi izi:
- mulingo wa glycemia musanadye siwoposa 5.9 mmol / l;
- Zizindikiro za shuga mutatha kudya zosaposa 7.9 mmol / l;
- kusowa kwa glucosuria;
- glycosylated hemoglobin osapitirira 6.5%;
- Zizindikiro za cholesterol zosakwana 5.3 mmol / l;
- kulemera kwamisempha kwamthupi kosakwana 25;
- Zizindikiro zowonjezera (systolic - mpaka 140 mm Hg. Art., diastolic - mpaka 85 mm Hg. Art.).
Kupezeka kwa shuga mu mkodzo kumayendera kunyumba pogwiritsa ntchito zingwe.
Kubwezera
Zizindikiro zotsatirazi zimalola adokotala kuti ayankhe molondola pakufunika kukonza momwe wodwalayo alili. Amatanthawuza kuti matendawa adadutsa omwe akumwalira, omwe akufunika kuwunikira mosamala.
Matenda osavomerezeka a shuga ali ndi chitsimikizo chaku labotale:
- kusala kudya glycemia pamtunda wa 7.7 mmol / l;
- glycemia 1.5-2 maola mutadya pamwamba 10 mmol / l;
- glucosuria pamwamba 0,5%;
- Zizindikiro za glycosylated hemoglobin zoposa 7.5%;
- mulingo wa cholesterol yathunthu m'magazi imaposa 6.4 mmol / l;
- index index yamthupi yoposa 27;
- kuthamanga kwa magazi kudutsa pakhomo la 160/95 mm RT. Art.
Kodi kubwezera kumayamba bwanji?
Akatswiri amati thupi la wodwala aliyense limawonedwa ngati dongosolo linalake, chifukwa chomwechi chingapangitse kuti matendawo asinthike kukhala mkhalidwe wopanda wodwala m'modzi ndipo sizingasokoneze thanzi la wina.
Endocrinologist ndi katswiri woyenera amene amathandiza wodwala kulimbana ndi matenda ashuga
Zomwe zimayambitsa-provocateurs amaonedwa kuti ndi kudya zakudya zamagulu ochulukirapo, kusiya kumwa mankhwala, kukhazikitsa njira yolakwika ya mankhwala kwakanthawi. Mndandandawu umaphatikizanso kugwiritsa ntchito njira zowonjezera zowonjezera zachilengedwe komanso wowerengeka m'malo mochiritsira, chikhalidwe, zovuta, matenda opatsirana.
Zomwe zimayambitsa matendawa kuchepa kwambiri zimatha kuvulala koopsa, kugwiritsa ntchito zakumwa zoledzeretsa, infarction ya myocardial, komanso mankhwala osokoneza bongo.
Kubwezeredwa kwa shuga kumawonetsedwa ndi chithunzi chowoneka bwino cha matenda, kukula ndi kupitilira kwa zovuta:
Kulimbana ndi Matenda A shuga- retinopathy;
- encephalopathy;
- nephropathy;
- mtima;
- polyneuropathy;
- kuwonongeka kwa khungu ndi mucous nembanemba.
Pakhoza kukhalanso zovuta za "matenda okoma" mu mawonekedwe a ketoacidosis (ndi mtundu 1) hyperosmolar state ndi lactic acidosis (yokhala ndi mtundu 2).
Mavuto Ovuta a Kubweza
Ketoacidosis ndi boma la hyperosmolar zimadziwika kuti ndizovuta ziwiri. American Diabetes Association yatsimikiza kuti zotsatira zakupha zomwe zimagwirizanitsidwa ndi ketoacidosis zimafika 5%, pomwe hyperosmolar coma ikupitilira 15%.
Wodwala akakhala chikomokere ayenera kulandira thandizo nthawi yomweyo, apo ayi zotsatira zake zingakhale zakupha
Kupanga kwazinthu zonse ziwiri kumakhazikitsidwa ndi kuperewera kwa insulini (mtheradi kapena wachibale), ndipo kupanga mahomoni opatsirana kumawonjezeranso limodzi, komwe kumapangitsa kuti zochita ndi mapangidwe a insulini azikhala. Zotsatira zake ndikuwonjezereka kwa shuga kwa maselo a chiwindi ndi kuphwanya kwawo kumwa kwa maselo ndi minofu yake kufupi.
Ketoacidotic state imachitika chifukwa chodzikundikira kwambiri m'magazi ndi mkodzo wa matupi a acetone (ketone), omwe amasintha acidity ya magazi kupita ku acidosis. Kachiwiri, kuchuluka kwa mahomoni kumapangitsa kuti thupi lipangike, komabe, kufooka kwamphamvu kwa thupi kumayamba, komwe kumafunika chisamaliro chamankhwala.
Kuzindikira matenda owopsa
Hyperosmolar state imayamba kupitilira milungu ingapo, ndipo ketoacidosis imatha kupanga maola angapo. Mawonetsero akulu muzochitika zonsezi ndi:
- mkodzo wambiri;
- ludzu
- kuwonda kwambiri;
- Zizindikiro zakutha kwamadzi;
- kulakalaka;
- kufooka
- mutu.
Kuthamanga kwa magazi kumachepa, zimachitika kuti zimachitika pafupipafupi komanso ngati ulusi. Mpweya ukulu, ukumveka patali. Kotala mwa odwala ketoacidosis amakhala ndi mseru komanso kusanza. Ma diagnostics a Laborator amatengera kutsimikiza kwa glycemia, ma ketoni mumkodzo ndi magazi, shuga wa mkodzo, creatinine, urea, komanso usawa wa electrolyte.
Thandizo
Chithandizo cha zovuta pachimake zimatengera mfundo izi:
- kuperekanso madzi m'thupi (kubwezeretsa kuchuluka kwa madzimadzi m'thupi) - gwiritsani ntchito njira ya isotonic sodium chloride, 10% shuga;
- mankhwala a insulin - timadzi timadzi timene timalowa m'thupi la wodwalayo mumilingo yaying'ono, yomwe imakuthandizani kuti muchepetse shuga pang'onopang'ono m'magazi ndikuletsa kuti asafe;
- kukonzekera kwa electrolyte bwino - kulowetsedwa kwa potaziyamu mankhwala enaake a calcium amachitika limodzi ndi mahomoni achifundo;
- Chithandizo cha matenda ophatikizika - mankhwala othandizira, kuperewera kwa mankhwala.
Kulowetsedwa chithandizo kuyenera kuchitika kuchipatala.
Mavuto Akulimbana Kwambiri
Matenda a shuga a nthawi yayitali, omwe adalowa gawo la kuwonongeka, akuwoneka ndi zowopsa zomwe zimachitika mwa kuwonongeka kwa khungu ndi mucous nembanemba, minofu ndi mafupa, impso, maso, mitsempha, mtima ndi mtsempha wamagazi.
Khungu komanso mucous nembanemba
Mavuto azovuta omwe amachitika motsutsana ndi maziko a "matenda okoma" akufotokozedwa pagome.
| Zovuta | Kodi ndi chiyani ndipo zifukwa zake ndi ziti | Zimawoneka bwanji |
| Lipodystrophy | Kuchepetsa kwa kuchuluka kwa mafuta ochulukirapo m'malo ena a thupi motsutsana ndi kuyambitsa insulin nthawi yomweyo | "Maenje" amawoneka pamimba, m'chiuno, matako, omwe ali ndi mawonekedwe amakumbukidwe osiyanasiyana amakulu |
| Dermopathy | Matenda a pakhungu amachitika chifukwa cha kuchepa kwa madzi m'thupi ndi kusokonezeka kwa magazi | Pali matenda otupa, malo okhala ndi mitundu, zilonda zam'mimba za trophic |
| Xanthomatosis | Kukhazikika chifukwa cha kusintha kwa kayendedwe ka mafuta kagayidwe | Pamadera akumtunda ndi otsika, mdera la matako, timabowo ta pinki timawoneka |
| Kunenepa kwambiri | Pathologic kuchuluka kwamphamvu kwa thupi komwe kumachitika chifukwa cha chidwi | Mpira wa subcutaneous mafuta wosanjikiza umachuluka m'malo okhala, kuchuluka kwa mafuta kuzungulira ziwalo zamkati kumakulanso |
| Lipoid necrobiosis | Amayamba chifukwa cha mtima wamitsempha yamagazi. | Papules amawoneka pakhungu, lomwe pambuyo pake limakhala penti yofiyira, kenako amasintha zilonda |
Musculoskeletal system
Matenda a shuga osakwanira amawonetsedwa ndi kuwonekera kwa mawonekedwe a nkhope, mafupa kumapazi. Kuwonetsera pafupipafupi ndi phazi la matenda ashuga. Njirayi imayendetsedwa ndi kusintha kwakukula komanso kutupa, kapangidwe ka zilonda zam'mimba komanso ngakhale zironda.
Matumbo
Ngati matendawa sanaperekedwe nthawi, odwala adzapita kwa adokotala ndi madandaulo otsatirawa:
- kupumirana mseru ndi kusanza;
- kupweteka pamimba;
- kumverera kolemetsa mu hypochondria;
- yotupa njira m`kamwa;
- makina amano;
- jaundice pakhungu ndi mucous nembanemba (mu odwala matenda ashuga nthawi zambiri amapezeka motsutsana maziko a mafuta hepatosis);
- kutsegula m'mimba
Masomphenya
Chimodzi mwazovuta zazikulu za "matenda okoma" ndi retinopathy. Ichi ndi chotupa chakumaso, chomwe chimawonetsedwa ndikupanga ma aneurysms ang'ono, zotupa, komanso kuchepa kwa ma visual acuity. Kusintha kowopsa kwa shuga m'magazi kumapangitsa kuti pakhale mkokedwe wa khungu. Zotsatira zake ndi matsoka.
Mkhalidwe wa retina ndi kupita patsogolo kwamatenda pang'onopang'ono
Nthawi zambiri, masomphenyawa sangathe kubwezeretsedwanso chifukwa cha kuchuluka kwa momwe matendawo akupezekera. Ndikofunikira kuti odwala matenda ashuga azitha kuyesetsa kukwaniritsa chiphuphu cha matenda ashuga. Izi zitha kupewa kukula kwa zovuta za matendawa.
Impso
Pali kugonja kwa glomeruli la impso, komwe kulephera kwa impso kumayamba. Kuchuluka kwa mapuloteni omwe amathandizidwa mumkodzo akuwonjezeka pang'onopang'ono. Vutoli limawonedwa ngati losasinthika, m'malo ovuta kwambiri, kufalikira kwa thupi kumafunika.
Kuti mupewe kukula kwa matenda a diabetesic nephropathy, ndikofunikira kuti glycosylated hemoglobin isefike mpaka 6.5%. Ngati vuto lakuka kale, odwala akulangizidwa kuti azitsatira zakudya zokhwima, azigwiritsa ntchito nephroprotectors, ndikuyesetsa kuchepetsa glycemia.
Kubwezera ndiko ntchito yayikulu ya munthu aliyense wodwala matenda ashuga, amene amakwaniritsidwa mwa kukonza zakudya zamagulu olimbitsa thupi, kuchita masewera olimbitsa thupi, kugwiritsa ntchito mankhwala osokoneza bongo. Kutsatira kwakukulu pazomwezo kumakupatsani mwayi wowonjezera moyo wa wodwala ndikuwongolera mawonekedwe ake.
