Matenda a shuga a Lada

Posachedwa, odwala matenda ashuga adagawidwa woyamba ndi wachiwiri, koma, chifukwa cha kafukufuku wopitilira, mitundu yatsopano idapezeka, imodzi mwa iyo inali matenda a shuga a Lada (LADA kishuga). Za momwe zimasiyanirana ndi mitundu ina, momwe kupezeka kwake ndi chithandizo chake zimachitikira - mwatsatanetsatane munkhaniyi.

Ichi ndi chiyani

Matenda a shuga a Lada ndi mtundu wa shuga omwe apezedwa ndi akatswiri azakudya ku Austria kumapeto kwa zaka za m'ma 1900. Adazindikira kuti odwala omwe ali ndi antibodies komanso secretion yotsika ya C-peptide (zotsalira za mapuloteni) siziri za mtundu wachiwiri, ngakhale chithunzi chachipatala chikulozera. Kenako zinafika kuti sizili mtundu woyamba, chifukwa kuyambitsa insulini kumafunikira kale kwambiri. Chifukwa chake, mawonekedwe apakatikati a matendawa adadziwika, omwe pambuyo pake amatchedwa Lada matenda a shuga (latent autoimmune shuga mu akulu).

Mawonekedwe

Matenda a shuga a mtundu wobiriwira ndi omwe amapangitsa kuti maselo a pancreatic beta awole. Ofufuzawo ambiri amatcha matenda amtunduwu "1.5", chifukwa amafanana kwambiri ndi mtundu wachiwiri pang'onopang'ono, komanso woyamba mumakina. Ndikosavuta kudziwikitsa popanda kufufuza kowonjezera. Ngati izi sizichitika ndipo matendawa amathandizidwa chimodzimodzi monga matenda amtundu wa 2 (kumwa mapiritsi ochepetsa shuga), ndiye kuti kapamba amagwira ntchito mpaka kumapeto, ndipo kufa kwa maselo a beta kumangothamanga. Pakapita kanthawi kochepa - kuyambira miyezi isanu ndi umodzi mpaka zaka zitatu - munthu adzafunika kukhala ndi insulin yokwanira, ngakhale kuti ndi mtundu wachiwiri wa matenda ashuga 2 amadziwikiratu pambuyo pake.

Odwala omwe ali ndi matenda am'mbuyomu nthawi zambiri amakhala ndi kulumala

Kusiyanitsa kwakukulu pakati pa mtundu wa latent ndi mtundu 2 wa matenda ashuga ndi awa:

• kuchepa kwambiri kwa thupi (milandu yamtundu wa odwala omwe ali ndi kunenepa kwambiri ndizosowa kwambiri);
• Amachepetsa magawo a C-peptides m'magazi pamimba yopanda kanthu ndikatha kutenga shuga;
• kukhalapo kwa magazi a ma antibodies kuma cell a pancreatic - chitetezo chathupi cha matenda ashuga chikuwatsutsa;
• kusanthula kwa majini kukuwonetsa chizolowezi chomenya maselo a beta.

Zizindikiro

"Lada matenda a shuga a chiopsezo cha matenda owopsa pangozi" opangidwa ndi madokotala akuphatikizira izi:

• kumayambiriro kwa matendawa ndi zaka 25-50. Ngati munthawi imeneyi munthu wapezeka ndi matenda a shuga a 2, ndiye kuti ndikofunikira kukafufuza ku Lada, popeza pakati pa odwala omwe ali ndi mtundu wachiwiri, kuchokera 2 mpaka 15% ali ndi mawonekedwe a latent, ndipo iwo omwe alibe vuto la kunenepa amalandila matenda apakati theka;
• chiwonetsero chachikulu cha kuyambika kwa matendawa: pafupifupi kuchuluka kwamkodzo tsiku lililonse kumawonjezera (malita 2), ludzu lamphamvu nthawi zonse limawonekera, wodwala amachepetsa thupi ndipo akumva kufooka. Komabe, njira ya matenda a shuga a Lada ndi asymptomatic;
• index mass body osakwana 25 kg / m2, ndiye kuti, monga lamulo, palibe kunenepa kwambiri kapena kunenepa kwambiri mwa iwo omwe ali pachiwopsezo;
• kukhalapo kwa matenda a autoimmune m'mbuyomu kapena pakadali pano;
• matenda a autoimmune mwa abale apamtima.

Kunenepa kwambiri ndi chizindikiro chofala cha mtundu wina wamatenda.

Ngati wodwala apereka kuchokera ku 0 mpaka 1 mayankho abwino pazinthu zomwe zaperekedwa pamlingo wopatsidwa, ndiye kuti mwayi wokhala ndi mtundu wa autoimmune ndi wotsika kuposa 1%, ngati pali mayankho awiri kapena angapo, chiopsezo chokhala ndi matenda a shuga a Lada chikuwonjezeka mpaka 90%. M'malo omaliza, munthu ayenera kuchita mayeso owonjezera.

Zizindikiro

Zipangizo zamakono zamakono zodziwikiratu zimazindikira mosavuta mtundu wamtundu wamatendawa. Chinthu chachikulu, ngati mumakayikira mtundu uwu, ndikupanga kafukufuku wowonjezera posachedwa.

Kwa mtundu uliwonse wa matenda ashuga, kuzindikira koyambirira ndikofunika.

Pambuyo poyezetsa koyamba shuga ndi glycated hemoglobin, wodwalayo amapereka magazi chifukwa cha mayeso otsatirawa:

Matenda a shuga osagwirizana ndi insulin

• kutsimikiza kwa milingo yama autoantibodies kuti glutamate decarboxylase GAD. Zotsatira zabwino, makamaka ngati mphamvu ya antibody ndi yokwera, nthawi zambiri imawonetsa kukhalapo kwa matenda ashuga mwa munthu;
• tanthauzo ndi kusanthula kwa ICA - autoantibodies to islet maselo a kapamba. Kafukufukuyu akuphatikiza pa woyamba yekha woneneratu za kudwala kwamatenda a matenda obisika. Ngati anti-GAD ndi ICA zilipo m'magazi, izi zikuwonetsa mtundu wovuta kwambiri wa matenda a autoimmune;
• kutsimikiza kwa mulingo wa C-peptide, chomwe ndi chopangidwa ndi biosyntase ya insulin. Kuchuluka kwake kuli kolingana mwachindunji ndi mulingo wa insulin yake yomwe. Ngati kuwunika kukuwonetsa anti-GAD ndi C-peptides otsika, wodwalayo amapezeka ndi matenda a shuga a Lada. Ngati anti-GAD ilipo koma mulingo wa C-peptide ndi wabwinobwino, maphunziro ena akusankhidwa;
• kuphunzira kwa kukula kwakukulu kwa ma HLA, ma genetic chizindikiro a mtundu 1 wa shuga (ubalewu palibe ndi mtundu wa 2 matenda). Kuphatikiza apo, ma DQA1 ndi zilembo za B1 amayendera;
• kuzindikira kwa ma antibodies ku mankhwala okhala ndi insulin.

Chithandizo

Ndi njira yolakwika, matenda a shuga a Lada ayandikira kwambiri, ndipo wodwala amayenera kupereka insulin yayikulu. Munthu amakhala ndi vuto nthawi zambiri, zovuta zambiri zimawonekera. Ngati simusintha njira zamankhwala, awa ndi moni wa kulumala kapena kufa.

Mankhwala a insulin ndi pomwe muyenera kuyamba

Kuchita bwino kwamankhwala otupa a autoimmune kumayamba ndi kuyambitsa milingo yaying'ono ya insulin.

Chithandizo cha insulin choyambirira ndikofunikira:

• ndalama zatsalira zapa pancreatic secretion. Kuchepetsa kwa ntchito ya beta-cell ndikofunikira kuti magazi azikhala ndi shuga wokwanira, kuchepetsa chiopsezo cha hypoglycemia komanso kupewa kukula kwa zovuta;
• Kuchotsa kwa autoimmune kutupa kwa kapamba pochepetsa kuchuluka kwa ma autoantigenas komwe chitetezo cha mthupi chimakumana kwambiri ndikuyamba kupanga antibody. Kuyesa kwa Laborator kunawonetsa kuti kuyambitsa milingo yaying'ono ya insulin nthawi yayitali kumapangitsa kuchepa kwa chiwerengero cha ma autoantijeni m'magazi;
• kukhalabe ndi shuga wamagulu ena kuti muchepetse zovuta zomwe zingachitike nthawi yomweyo.

Mankhwala othandizira odwala matenda opatsirana omwe amapangidwa kale kuti athandizidwe ku matenda ena a autoimmune. Posakhalitsa, asayansi amalosera za kubwera kwa njira zotere kuchizira kwa autoimmune kutupa kwa kapamba.

Zakudya zopatsa thanzi komanso kudya mavitamini ndi gawo limodzi la mankhwala

Chithandizo cha matenda a shuga a Lada, kuphatikiza pa insulin, chimaphatikizaponso:

• kumwa mankhwala omwe amathandizira kuti azindikire za zotumphukira za minofu;
• choletsa kutenga zothandizira kupanga insulin (yodzaza ndi kutopa kwa kapamba ndi kuchepa kwa insulin);
• kuwongolera kwamuyaya shuga;
• kusintha kwa zakudya zamafuta ochepa (pomwe odwala amatha kudya chokoleti chamdima pang'ono);
• zolimbitsa thupi zolimbitsa thupi (pokhapokha ngati pali kuchepa kwakukulu kwa thupi);
• hirudotherapy (njira yochiritsira pogwiritsa ntchito mankhwala apadera).

Osapeputsa mbiri yakale.

Pambuyo pakugwirizana ndi dokotala yemwe amapezekanso, ndizotheka kugwiritsa ntchito mankhwala azikhalidwe. Monga lamulo, chithandizo chothandizira chimakhala ndi kutenga mankhwala osakanikirana ndi mankhwala a mankhwala, omwe amachepetsa mphamvu ya shuga m'magazi.

Matenda a shuga a Lada, monga mitundu ina, popanda kuchitapo kanthu panthawi yake komanso kulandira chithandizo moyenera kumayambitsa zovuta zambiri. Chifukwa chake, pakuzindikira matenda ashuga, ndikofunikira kuti mupange maphunziro owonjezera kuti musatenge chithandizo chamankhwala cholakwika, zomwe zimapangitsa kukhala ndi kulumala ndi kufa.