Etiology ndi pathogenesis a matenda a shuga 1

Matenda a Endocrine omwe amachitika chifukwa cha kukanika kwa kapamba komanso kuperewera kwa insulin komwe kumapangitsa kuti pakhale matenda osachiritsika - mtundu 1 wa matenda a shuga.

Pathology imafuna kulipidwa mosalekeza chifukwa cha kuchepa kwa mahomoni, apo ayi kuchuluka kwa shuga m'magazi kumakwera ndikuwopseza kupezeka kwa zovuta zazikulu.

Zoyambitsa matenda

Matenda a shuga a Type 1 ndi matenda ofala omwe amapezeka mwa achinyamata ndi ana. Matenda a shuga omwe amadalira insulin ali ndi ICD ya 10 - E 10.

Pathogenesis ya pathology imakhazikitsidwa pakuwonongeka kwa maselo a pancreatic omwe amapanga insulin. Iron amawonongedwa chifukwa cha autoimmune kulephera kwa thupi kapena chifukwa cha zinthu zina zoyipa.

Chifukwa cha kuchuluka kwa timadzi tambiri timene timapanga, ma glucose omwe amalowetsa m'maselo a ziwalo zimasokonekera, ndipo shuga amayamba kudziunjikira m'magazi.

Izi zimabweretsa vuto lamagetsi ndikugonjetsedwa kwamakina onse amkati. Kenako, potengera mtundu wa matenda ashuga amtundu woyamba, matenda ambiri amakula, omwe amakhala chifukwa cha kulumala kapena kufa kwa wodwalayo.

The etiology ya matendawa sanaphunzire kwathunthu, koma chimodzi mwazifukwa zapangidwe kamene kamakhala kachilombo ka chibadwa ndi chinthu chobadwa nacho. Jini losinthidwa limafalikira pamlingo wachibadwa ndipo limayipitsa dongosolo la autoimmune la thupi kugunda khunyu yake yomwe. Izi zikufotokozera kuti mtundu woyamba wa shuga umapezeka kawirikawiri paubwana komanso odwala omwe abale awo apamtima amadwala matenda a shuga.

Komanso pali ziwerengero malinga ndi zomwe:

• ngati bambo akudwala, ndiye kuti mwayi wa mwana wopititsa patsogolo matenda obadwa nawo umachuluka ndi 5-6%;
• ngati mayi, ndiye kuti matendawa amakula ndi 2%;
• ngati m'bale kapena mlongo, chiopsezo cha matenda a shuga chikuwonjezereka ndi 6%.

Kuphatikiza pa genetics, zifukwa zomwe zimayambitsa matenda a shuga 1 zimatha kukhala izi:

• matenda otupa a kapamba;
• kuvulala kwa gland ndi opaleshoni;
• matenda opatsirana;
• kumwa mankhwala ena (antipsychotic, glucocorticoids);
• matenda a chiwindi.

Matendawa amagawidwa m'mitundu ingapo, kutengera zomwe zimayambitsa chitukuko:

• kutupa - kumachitika motsutsana ndi maziko a zotupa zomwe zimachitika m'mapapo;
• autoimmune - imapangidwa motsogozedwa ndi autoimmune kulephera;
• idiopathic - amakula pazifukwa zosadziwika.

Magawo a mapangidwe a matendawa ali ndi magulu awo:

• prediabetes - kupatuka kopanda pake kumawonedwa pakuwunika, thanzi la wodwalayo silisintha;
• siteji yobisika - malinga ndi zotsatira za kafukufuku, Zizindikiro sizikumana ndi miyezo, palibe zizindikiro;
• gawo lodziwikiratu ndikuwonetseratu kwathunthu kwa zizindikiro za matendawa.

Kukula kwa nthendayi kumasiyanitsidwa ndi madigiri atatu:

1. Kufatsa - glucose amawerengedwa mwachizolowezi mu mkodzo ndipo amakwezedwa pang'ono m'magazi. Madandaulo a wodwala palibe.
2. Digiri yochepa - zizindikiro zazikulu za matenda a shuga zimawonekera. Shuga amakwezedwa m'madzi ndi mkodzo wonse wamagazi.
3. Madigiri owerengeka - chizindikiro cha glucose chimafika pamavuto, mawonekedwe a mkhalidwe wokongola amawonekera kwambiri.

Kanema kuchokera kwa Dr. Komarovsky onena za zomwe zimayambitsa matenda a shuga 1:

Zizindikiro zazikulu za matenda

Matenda a shuga a Type 1 amawonetsedwa pafupipafupi mwa odwala omwe ali ndi vuto la thupi, mosiyana ndi mtundu wa 2, omwe amadziwika ndi kupezeka kwa odwala omwe ali ndi matenda osiyanasiyana onenepa.

Anthu odwala matenda ashuga amadandaula kwambiri ndi matendawa monga:

• kutaya mphamvu ndi kusakwiya;
• kugona tulo tulo ndi kugona tulo;
• ludzu losakwanira ndi chilakolako chokwanira;
• kukodza pafupipafupi komanso kutulutsa mkodzo wambiri;
• kuyanika kwa mucous nembanemba zamkamwa ndi pakhungu;
• zotupa ndi kuyabwa;
• kuchuluka thukuta ndi masisitere;
• kuchuluka kwa matenda a chimfine ndi matenda;
• nseru, kutsegula m'mimba, ndi kupweteka kwam'mimba;
• mawonekedwe a kupuma movutikira ndi kutupa;
• kuchuluka kwa mavuto;
• kutsika kwa kusinthika kwa minofu yofewa;
• mwa akazi, kuzungulira kwa msambo kumasokonekera, ndipo mwa amuna, potency imachepa;
• dzanzi la miyendo akumva;
• pali kuchepa kapena kuwonjezeka kwa thupi.

Popanda chithandizo komanso matendawa amatengera matendawa, zizindikiro zotsatirazi zitha kuoneka:

• kutsika kwa kugunda kwa mtima ndi kukakamiza;
• malungo
• kugwedezeka kwamiyendo;
• kuwonongeka mu mawonekedwe acuity;
• mpweya wa acetone;
• kufooka kwa minofu;
• zovuta zolankhula ndi kusowa kwa mgwirizano;
• kudziwa zolakwika komanso kukomoka.

Zizindikiro izi zikuwonetsa kukulira kwa vuto lowopsa - ketoacidotic chikomokere ndipo limafunikira chisamaliro chamankhwala mwachangu kuti musafe.

Mavuto a Matenda A shuga a Type 1

A kuchuluka kuchuluka kwa shuga mu madzi am`magazi kumayambitsa kusokonezeka mu ntchito ya mtima, imasokoneza magazi ndipo kumabweretsa kuwonongeka ziwalo zamkati.

Mavuto ambiri omwe amachitika chifukwa cha matenda ashuga ndi matenda otsatirawa:

1. Retinopathy - kuwonongeka kwa ziwiya za retina. Chifukwa chosakwanira magazi, mawonekedwe a aneurysms pama capillaries a retina. Izi zimabweretsa kuchepa kwakumaso kwamaso ndi chiwopsezo chachikulu cha kukha mwazi. Popanda kulandira chithandizo pakanthawi kake, khungu la retina limachitika ndipo mwa odwala matenda ashuga, khungu lathunthu limachitika.
2. Nephropathy - mu nkhani iyi, zotupa za impso zimakhudzidwa, zomwe zimaphwanya kusefa ndi impso ntchito ya impso. Zotsatira zake, kuyamwa kwa zinthu zopindulitsa m'magazi ndikovuta, thupi limayamba kutaya mapuloteni ndi ma electrolyte ndi mkodzo. Mtsogolomo, matendawa amakula ndipo amadutsa osagonekanso monga kulephera kwa impso.
3. Mtima. Matenda oopsa komanso atherosulinosis ndi njira yodziwika bwino ya matenda ashuga. Chifukwa cha izi, magazi amapita kumtima komanso ubongo umachepa, zomwe zimayambitsa matenda a mtima ndi sitiroko.
4. Matendawa odwala matenda ashuga - ovuta kwambiri ozungulira komanso kuwonongeka kwa mitsempha kumapeto pang'ono. Miyendo imachepa pang'onopang'ono, miyendo yayitali yosachiritsa ndi zilonda zam'mimba zimakhala pakhungu, ndipo zimakhala ndi minofu yolumikizidwa ndi necrosis. Popanda chithandizo choyenera, matendawa amatuluka, omwe amafunika kudula dzanja.
5. Neuropathy - maselo amitsempha omwe amachititsa kuti mitsempha iziyenda mwamphamvu ndi ziwalo zamkati zimakhudzidwa. Zotsatira zake, makina am'mimba ndi mtima, chikhodzodzo chimasokonekera, ndipo ntchito yamagalimoto imavutika. Wodwalayo amasiya kumva kupweteka komanso kutentha kwake, amayamba kugona mosataya ndipo pali zovuta kumeza ndi kupukusa chakudya, chiopsezo cha vuto la mtima chikuwonjezeka.
6. Coma - imayamba chifukwa cha kuchuluka kapena kutsika kwa glucose m'madzi a m'magazi. Amadziwika ndi kutayika kokhala ndi matenda ashuga komanso kufera kwa mpweya m'mutu. Coma imafunikira kuti ayambirenso mwachangu, apo ayi atha kukhala ndi stroke, kugunda kwa mtima, dementia kapena kufa.

Popeza kuopsa kwa zovuta, muyenera kufunsa dokotala pambuyo poyambirira kwa matenda. Izi zipangitsa kuti azindikire matenda a magawo kumayambiriro kwa chitukuko ndikusankha njira zoyenera zamankhwala zomwe zithandizire kupititsa shuga pazomwe zili zovomerezeka komanso kupewa kapena kuchedwetsa zotsatirapo zake.

Njira Zodziwitsira

Kuzindikira matendawa kumayamba ndi kusonkha chidziwitso cha madandaulo, moyo ndi machitidwe a wodwala, zokhudzana ndi momwe adasinthira ndikugwirizana naye. Ndikofunika kuti adotolo adziwe za matenda omwe apezeka ndi matenda ashuga m'banjali.

Mtsogolomo, maphunziro azidziwitso amtundu wa mankhwala amaperekedwa:

• kuyeserera kwa shuga;
• kuyesa kwa shuga m'magazi;
• biochemical komanso ambiri matenda magazi kuyezetsa;
• ambiri matenda a mkodzo;
• kuyesa kwa kupezeka kwa C-peptides m'magazi am'magazi ndi ketone m'mitsempha;
• mayeso a glycosylated hemoglobin;
• kuphunzira kwa mbiri ya glycemic.

Mayeso a kulolerana ndi glucose

Kuphatikiza apo, ma ultrasound ndi maginito a resonance amagwiritsidwa ntchito kuti adziwe kuchuluka kwa zowonongeka mkati mwa ziwalo zamkati.

Mankhwala a insulin komanso mankhwala atsopano

Matenda a shuga a Type 1 ndi matenda osachiritsika ndipo njira zomwe zitha kuchiritsa matenda sizinakhalepo.

Kuchita bwino kwa mankhwalawa kumatha kungokhala ndi shuga m'magazi am'magazi, kupewa zomwe zingachitike. Udindo waukulu mwa izi umaperekedwa ku mankhwala a insulin - njira yodzaza kusowa kwa insulin ya magazi.

Insulin imalowetsedwa m'thupi. Mlingo wa mahomoni ndi kuchuluka kwa jakisoni watsiku ndi tsiku amawerengedwa ndi dokotala, kenako ndi wodwalayo mwiniyo ndipo amafunikira kutsatira kwambiri.

Kuphatikiza apo, wodwalayo amayenera kuyeza kuchuluka kwa shuga m'magazi am'magazi kangapo patsiku pogwiritsa ntchito glucometer.

Nthawi zambiri, odwala matenda a shuga amabwereza jakisoni katatu kapena kanayi patsiku ndipo pokhapokha nthawi zina amaloledwa kuchepetsa kuchuluka kwa jakisoni kawiri patsiku.

Kutengera ndi kuopsa kwa maphunzirowo, insulin ya nthawi yayitali imagwiritsidwa ntchito:

• insulin yochepa - kutalika kwa mahomoni sikupita maola 4, ndipo insulini yoyendetsedwa imayamba kugwira ntchito mu kotala la ola;
• mahomoni abwinobwino - amachita kwa pafupifupi maola 6, ndipo amayamba kugwira ntchito theka la ola pambuyo pobayira;
• sing'anga-insulin - kugwira ntchito kwake kumawonedwa pambuyo pa maola 2-4 ndipo kumatenga maola 18;
• insulin yayitali - imakuthandizani kuti mukhale ndi shuga wambiri kwa maola 24 ndikuyamba kuchita pambuyo pake pambuyo pa maola 4-6.

Nthawi zambiri, insulin yayitali imaperekedwa kamodzi kapena kawiri pa tsiku. Izi zimalowa m'malo mwachilengedwe momwe timadzi tomwe timagwirira ntchito timakhala ndi thupi lathanzi tsiku lonse. Insulin yochepa imalowetsedwa musanadye chilichonse, zomwe zimakuthandizani kuti muchepetse shuga omwe amatuluka chakudya chikamalowa m'thupi. Nthawi zina mumayenera kuphatikiza mahomoni masana, ngati zolimbitsa thupi zikuwonjezeka kapena zakudya zimasokonekera.

Kanema pa njira yowerengera insulin:

Kukula kotsimikizika ndi njira yogulitsa kapamba wochita kupanga kapena gawo la maselo ake. Ntchito zoterezi zikuchitika kale m'maiko ena ndipo zikutsimikizira njira yake. Oposa theka la odwala atachitidwa opaleshoni amachotsa kufunika kwa jakisoni wa tsiku ndi tsiku wa insulin, ndipo pafupifupi 90% ya odwala matenda ashuga akuti glucose amasungidwa panthawi yovomerezeka.

Njira ina yolimbikitsa yokonzanso maselo a pancreatic ndiyo kupereka katemera wapadera wa DNA.

Chifukwa chake, odwala matenda a shuga ali ndi mwayi wowonjezereka kuti pakapita nthawi, njira zatsopano zikapezeka, azitha kuchira matenda owopsa. Pakadali pano, zimangoyang'anira shuga wamagazi ndikutsatira malangizo onse a dokotala.

Malangizo pa mankhwala

Kuphatikiza pa jakisoni wa insulin, kudya kungathandize kukhalabe ndi shuga. Zakudya ziyenera kukhala njira ya moyo wa anthu odwala matenda ashuga, chifukwa kutengera ndi zomwe amadya komanso shuga amatuluka m'magazi othamanga mosiyanasiyana.

Mitundu ina ya zinthu iyenera kupatulidwa kuchakudya:

• anagula misuzi m'matumba ndi koloko wokoma;
• nsomba zamafuta ndi nyama;
• zakudya zamzitini, zakudya zosavuta komanso nyama yofuka;
• mkaka ndi mkaka wowawasa wokhala ndi mafuta ambiri;
• makeke, mkate woyera, maswiti, makeke amchere ndi chokoleti;
• msuzi wamafuta ndi zonunkhira, zokometsera ndi zonunkhira;
• mphesa;
• zakumwa zokhala ndi mowa.

Makinawo azikhala ndi izi:

• nsomba zotsamira ndi nyama yokonda;
• nsomba zam'nyanja ndi zam'nyanja;
• skim mkaka ndi wowawasa mkaka wowonda, tchizi;
• mafuta masamba;
• rye ndi mkate wathunthu;
• mazira, nyemba, mtedza;
• nguluwe, mpunga wamafuta, barele;
• zipatso zopanda zipatso ndi zipatso;
• zitsamba zatsopano ndi masamba;
• tiyi yofooka yopanda shuga komanso zipatso.

Malonda otsatirawa amaloledwa m'miyeso yaying'ono:

• mwatsopano zipatso zatsopano;
• zipatso zouma;
• zipatso zabwino ndi zipatso.

Mitundu yamtunduwu singagwiritsidwe ntchito mopitilira kamodzi kapena kawiri pa sabata komanso osaposa kapu imodzi yamadzi kapena chipatso chimodzi.

Zakudya zomwe zimakhala ndi mafuta othamanga zimayenera kuchotsedwa kwathunthu. Shuga uyenera m'malo mwake ndi zotsekemera zachilengedwe. Muchepetse kugwiritsa ntchito mchere, komanso mbale yokazinga ndi mafuta. Ganizirani zamasamba ophika, owiritsa komanso owotcha. Pewani nthawi yayitali pakati pa zakudya ndi kudya zosachepera 5 patsiku. Tumikirani magawo ang'onoang'ono kuti musadye kwambiri. Musaiwale za madzi oyera, imwani magalasi 6 tsiku lililonse.

Vidiyo pazakudya za matenda ashuga:

Matenda a shuga amasintha momwe amakhalira moyo wa wodwalayo, kuwakakamiza kusintha zizolowezi zawo, kudzipatula pakudya zomwe amakonda, kuyeza kuchuluka kwa shuga m'magazi kangapo patsiku, ndi kubayirira insulin.

Koma pokhapokha ngati mutatha kukhala ndi thanzi labwino komanso kupewa mavuto.