Mankhwala amakono adatenga nthawi yayitali pakukula kwake ndipo amatha kudziwa mosavuta matenda osiyanasiyana, kuphatikizapo matenda ashuga. Ndipo chifukwa cha izi, kuzizindikira kumayambiriro kwa chitukuko sikubweretsa vuto ngakhale akatswiri omwe alibe nzeru omwe angoyamba kumene ulendo wawo kuti apulumutse anthu. Komabe, pali mtundu wina wamatendawa, womwe nthawi zambiri sazindikira ngati madokotala omwe ali ndi zokuchitikirani kumbuyo kwawo. Ndipo matendawa amatchedwa matenda a modi, omwe tikambirana tsopano.
Zambiri
Ngakhale anthu omwe ali kutali ndi mankhwala amadziwa kuti shuga ili ndi mitundu iwiri yayikulu - yoyamba komanso yachiwiri. Njira ya kakulidwe kake ndi kosiyana, momwemonso chithandizo. Mtundu woyamba wa shuga ndi matenda momwe mumakhala kuperewera kapena kuperewera kwa pancreatic. Nthawi zambiri, ndimatenda obadwa nako ndipo "amawerengedwa" kwa anthu ndi cholowa.
Matenda a 2 a matenda a shuga ndi matenda omwe maselo ndi minyewa yamthupi imayamba kusiya kumva za insulin. Izi ndichifukwa choti mwa iwo mumapezeka kale michere yambiri. Ndipo izi zimachitika nthawi zambiri motsutsana ndi chiyambi cha kunenepa kwambiri komanso kuperewera kwa zakudya m'thupi.
Kuchiza matenda a shuga a mtundu woyamba kumaphatikizapo kugwiritsa ntchito jakisoni wambiri wa insulin, pomwe ndi T2DM ndikokwanira kutsatira malamulo osavuta azakudya kuti munthu athetse mwadzidzidzi shuga.
Mwachitsanzo, titha kupereka milandu mobwerezabwereza pomwe, muzochitika zamankhwala, panali kuwonjezeka kwa shuga wamagazi kwa ana aang'ono popanda chifukwa chodziwika mpaka 8 mmol / l kapena kuposerapo, kapena mwana wakhanda atapezeka ndi T1DM komanso kwa angapo Zaka "zimakhala" pa mlingo womwewo wa insulin, pomwe matendawa sakulabe.
Matenda a shuga a mody nthawi zambiri amayamba kudziwoneka adakali aang'ono, chifukwa chake ndikofunikira kuyambira nthawi yayitali kuyeza kuchuluka kwa shuga kwa ana
Mwachidule, mwa achinyamata odwala matenda ashuga, njira ya matendawa imakhala yovuta kwambiri komanso osati yolemetsa, monga mwa anthu achikulire omwe ali ndi T2DM. Ndi nthawi ngati yomwe matenda a shuga monga modi amakambirana.
Ndipo ziyenera kudziwa kuti matendawa amapezeka ndi anthu 5% omwe amapezeka ndi matenda ashuga. Ndipo ambiri aiwo ndi ana. Koma chifukwa chakuti, chifukwa cha asymptomatic, matenda a shuga ndizovuta kwambiri kuzindikira, ziwerengero zoperekedwa ndi WHO zimasiyana kwambiri ndi zenizeni. Nanga matenda a shuga a modi ndi chifukwa chiyani akupanga?
Ichi ndi chiyani
Dzina lathunthu la matendawa limamveka motere - Maturity Onset Diabetes of the Young. Omasuliridwa kuchokera ku Chingerezi, amamasulira ngati shuga okhwima mwa achinyamata. Kwa nthawi yoyamba, asayansi aku America adanenanso za matendawa mu 1975. Amawonetsera ngati mtundu wa shuga wopita patsogolo mwa ana ndi achinyamata omwe ali ndi vuto lotenga matendawa.
Kodi shuga amapezeka ndi shuga uti?Kukula kwa matenda am'mimba kumachitika chifukwa cha kusintha kwa majini komwe kumachitika motsutsana ndi maziko a vuto la kapamba. Kuphwanya koteroko kumamveka pobadwa komanso muunyamata, pamene kusokonekera kwa mahomoni m'thupi kumachitika. Komabe, ndizotheka kuzindikira kupezeka kwa kusintha kwa majini komanso kukula kwa modios ya shuga pochititsa maphunziro a genetic.
Chifukwa cha phunziroli, ndikotheka kudziwa kuti ndi mtundu wanji womwe umasinthidwa mwa mwana pakukula kwa fetal. Ndipo popeza asayansi azindikira mitundu isanu ndi itatu yomwe masinthidwe ake amatsogolera pakupanga mtundu wamtunduwu, motsutsana, kusintha kulikonse kumapereka chithunzi chosiyana kwambiri chachipatala ndipo kumafunikira njira ina yamankhwala.
Kodi matenda angadziwonekere bwanji?
Ndikovuta kwambiri kukayikira kukula kwa matenda osokoneza bongo kwa ana ndi achinyamata, chifukwa kumachitika pang'onopang'ono ndipo alibe zizindikiro. Komabe, kupezeka kwa matendawa nthawi zambiri kumatha kufanana ndi zomwe zimachitika ndi matenda amtundu wa 1, limodzi ndi zizindikiro zotsatirazi:
- kuyambika kwa chikondwerero cha shuga.
- kusowa kwa ma ketoni m'magazi pakuchulukana kwa matendawa;
- chizindikiritso cha kugwira ntchito kwathunthu kwa kapamba ndi kapangidwe kabwino ka insulin, komwe kamayesedwa ndikamayezetsa magazi (ndi mulingo wabwinobwino wa insulin, kuchuluka kwa C-peptide m'magazi kumakhalabe kosasintha);
- kutsika kwa shuga ndi kusungika kwake mwachilengedwe kwa nthawi yayitali kumatheka mwa kugwiritsa ntchito insulin yaying'ono;
- tikudutsa mayeso, ma antibodies kuma cell a beta ndi ma insulin samapezeka;
- osayanjana ndi dongosolo la HLA;
- Makhalidwe a hemoglobin a glycated amakhalabe abwinobwino.
Limagwirira a chitukuko cha matenda a shuga modi
Kuzindikiridwa kwa matenda a "modiabetes" kumatha kuchitika popanda zotsatirapo zilizonse ngati munthuyo ali ndi vuto lotenga matenda ashuga kapena mayi ake akapezeka ndi matenda ashuga panthawi ya pakati. Dotolo amathanso kukayikira kukula kwa matendawa atalandira zotsatira za mayeso omwe adawonetsa kuti wodwalayo wavutitsa kulekerera kwa glucose maselo mthupi.
Nthawi zambiri, dokotalayo amakupangira mayeso ena ngati munthu wazaka zosaposa 25 wapezeka ndi matenda a shuga a 2. Komabe, alibe zizindikiro za matendawa ndipo palibe kunenepa kwambiri.
Popeza matenda a shuga a Mody amapezeka popanda chidziwitso chachipatala chowonekera, makolo onse, kupatula, ayenera kuyang'anira mkhalidwe wa mwana wawo. Chochititsa chidandaulitsa ndi mawonekedwe amtundu wazaka zingapo za zizindikiro monga:
- kukhalapo kwa hyperglycemia yanjala, shuga m'magazi akakwera kufika ku 8.5 mmol / l, koma palibe zizindikiro monga kukodza kwambiri, kuchepa thupi komanso polydipsia;
- chizindikiritso chophwanya kulolerana kwa maselo a thupi kuma carbohydrate (opezeka mwa kuyesa magazi).
Chifukwa chake, ana aang'ono omwe ali ndi vuto lotengera matenda ashuga ayenera kuyeza kuchuluka kwa shuga m'magazi awo. Ndipo ngati zizindikirozo zinayamba kusintha ndikupita kupitirira zizolowezi, muyenera kufunsa chithandizo kuchokera kwa dokotala, ngakhale ngati palibe zizindikiro zina za matenda ashuga.
Dokotala yekha ndi amene angadziwitse moyenera atalandira zotsatira za mayeso onse ofunikira.
Mitundu Yosiyanasiyana ya Matenda a Mody
Monga tafotokozera pamwambapa, pali mitundu isanu ndi itatu yomwe imatha kusintha ndikulimbikitsa kukula kwa matenda a shuga. Komabe, matendawa amagawidwa m'mitundu 6 yokha ndipo onse ali ndi mawonekedwe awo. Mtundu uliwonse wa shuga modi umatchedwa: mody-1, mody-2, mody-3, etc.
Amakhulupirira kuti mtundu wofatsa kwambiri wamatendawa ndi mody-2. Ndi chitukuko chake, kusala kudya kwa hyperglycemia kumachitika kawirikawiri, ndipo kukhazikika kwa chikhalidwe chamtunduwu monga ketoocytosis kuli konse konse. Komabe, zizindikiro zina za matenda ashuga sizipezekanso. Monga ziwerengero zapadziko lonse lapansi zikuwonetsa, chiwerengero chachikulu cha anthu omwe amapezeka ndi matenda a shuga a mody-2 amakhala ku France ndi Spain. Kodi nchifukwa chiyani, asayansi sanadziwebe?
Popeza matenda a shuga a Mody ali ngati asymptomatic, kufunika kwa jakisoni wa insulin ndikosowa kwambiri.
Ndi chitukuko cha matenda amtunduwu, kuchuluka kwa insulini kumapangitsa kuti dziko likhale lopweteketsa. Popeza matendawa sadzetsa vuto lalikulu kwa wodwalayo ndipo samakhudza moyo wake, kufunika kochulukitsa kuchuluka kwa insulin sikunakhalepo.
Mody-3 amapezeka kawirikawiri mmaiko a ku Europe, omwe ndi Netherlands ndi Germany. Monga lamulo, matendawa amayamba kukhazikika mwa ana opitirira zaka 10 ndipo nthawi zambiri amabweretsa zovuta zazikulu.
Koma mody-1 ndiye mtundu wovuta kwambiri wamaphunziro ndipo amapezeka mwa 1% yokha ya anthu omwe ali ndi matenda a shuga. Matendawa amatuluka kwambiri ndipo nthawi zambiri amafa. Koma mody-4 amapezeka nthawi zambiri achinyamata. Pali malingaliro oti cholimbikitsira chachikulu pakukula kwake ndikusokonezeka kwa mahomoni m'thupi, koma izi sizinatsimikizidwebe ndi mankhwala ovomerezeka.
Mody-5 m'chifaniziro chake chachipatala ndi chofanana ndi chitukuko cha mody-2, koma mosiyana ndi mtundu uwu wa matendawa, nthawi zambiri zimayambitsa kukula kwa zovuta monga matenda ashuga nephropathy.
Kodi matenda amatithandizira bwanji?
Chifukwa chakuti kusowa kwa kapamba sikuwoneka ndi chitukuko cha matenda ashuga, mankhwalawa amagwiritsidwa ntchito chimodzimodzi monga a T2DM. Ndiko kuti, kumayambiriro kwa matendawo, wodwalayo amapatsidwa zakudya zamagulu ochepa komanso kuchita masewera olimbitsa thupi. Izi zimakuthandizani kuti muchepetse shuga m'magazi komanso kupewa zotumphukira za hyperglycemia.
Kuphatikiza apo, njira zina zochiritsira zitha kugwiritsidwa ntchito ngati achire. Mwachitsanzo, odwala ambiri omwe adapezeka kuti ali ndi matenda a shuga a modi amatha kulandira chindapusa chokhazikika kudzera mukuchita masewera olimbitsa thupi komanso yoga. Amachitidwa pang'onopang'ono moyang'aniridwa ndi katswiri.
Kuchita masewera olimbitsa thupi mokulitsa mu shuga kumatha kubwezeretsedweratu
Njira zina zamankhwala zimathandizanso. Komabe, madokotala salimbikitsa kugwiritsa ntchito wowerengeka azitsamba monga chithandizo chachikulu, popeza thupi la munthu aliyense ndiwokhazikika ndipo nthawi zina samapereka zotsatira zomwe zikuyembekezeka, ndipo kupita patsogolo kwa matendawa kumapitirirabe.
Ndi chifukwa ichi kuti ndi dokotala yekha yemwe ayenera kuthana ndi modi wa matenda ashuga. Ngakhale wodwalayo atasankha njira ina monga chithandiziro, ayenera kuchita izi ndi katswiri.
Tiyenera kumvetsetsa kuti ngati muphonya mphindi yomwe mungathe kupeza chiphuphu chokhazikika, padzafunika kugwiritsidwa ntchito kosalekeza kwa mankhwala omwe amachepetsa shuga ndi jakisoni wa insulin. Ndipo izi sizokwera mtengo chabe, komanso zosasangalatsa.
