Zojambula ndi kusiyana kwa matenda a shuga a LADA

Matenda a shuga - matenda oyambitsidwa ndi vuto la endocrine, omwe amachititsa kuti kagayidwe kazakudya kagayidwe kake ka magazi kagayidwe kake kazikhala ndi kuchuluka kwa shuga m'magazi.

Pathology ili ndi mitundu ingapo yomwe imasiyana pazomwe zimayambitsa komanso njira zamankhwala. Chimodzi mwa mitunduyi ndi matenda a shuga a LADA.

Kugawika kwakukulu kwa zovuta za kagayidwe kazakudya

Malinga ndi gulu, matenda ashuga agawidwa m'mitundu yayikulu:

1. Mtundu 1 wodalira insulin. Matenda amtunduwu nthawi zambiri amatengedwa kuti ndi obadwa ndipo amadziwika muubwana ndi unyamata. Chikhalidwe chosiyana ndi matenda amtundu wa 1 shuga ndikupanga insulin yokwanira chifukwa cha kuwonongeka kwa minofu ya kapamba. Kusunga kuchuluka kwa shuga m'magazi pamlingo wovomerezeka kumachitika ndikubwezeretsanso kuchuluka kwa timadzi timene timabadwa ndi jakisoni.
2. Mtundu wodziyimira pawokha wa insulin 2. Matenda amtunduwu amakula motsutsana ndi maziko a kusowa kuyankha kwa ma cell receptor ku ma cell, ndipo palibe kuchepa kwa insulin mthupi. Matenda a shuga a Mtundu Wachiwiri amadziwika ngati ali ndi pakati komanso okalamba, amakonda kunenepa kwambiri komanso amakhalanso ndi moyo wosachita zinthu zolimbitsa thupi. Chithandizo chothandizira chimakhazikika pakutsatira zakudya, kuwonjezera masewera olimbitsa thupi komanso kumwa mankhwala omwe amachepetsa shuga ndikuwongolera kuzindikira kwa receptor.

Mwa mitundu yosiyanasiyana:

1. Matenda Aakulu a shuga amakhala m'gulu la A ndipo amachitika ndi matenda a kapamba.
2. Mankhwala ndi a gulu la B ndipo amakula mothandizidwa ndi mankhwala.
3. C-kalasi, wopangidwa motsutsana ndi maziko a zovuta za endocrine;
4. LADA, yomwe imadziwika ndi matenda a shuga a autoimmune. Mitundu iyi imakhala ndi zizindikilo za mitundu yonse 1 ndi 2, kusiyanasiyana ndi mtundu woyamba, Zizindikiro zimawonekera pambuyo pake.

Zizindikiro zazikulu za matenda a carbohydrate metabolism ndi:

• kuchuluka kwamkodzo komanso kutulutsa mkodzo wambiri;
• kuchuluka kwa ludzu ndi njala;
• kumverera kwa kamwa yowuma;
• kuchepa kwa ntchito motsutsana ndi maziko a kutopa msanga;
• kuchuluka kwa shuga, limodzi ndi ulesi, kuzizira, komanso chizungulire.

Kupita patsogolo, matenda amapangitsa kuti magawo a mafuta agawikidwe, zomwe zimatsogolera pakupanga matupi a ketone ndikupanga ketoacidosis, yomwe imayambitsa mawonetsedwe:

• ludzu losatha;
• maonekedwe a zolembedwa m'chinenerocho;
• kumverera kwa kukoma kwa acetone ndi kununkhiza;
• kusanza.

Kutengera mtundu wakuphwanya, zizindikirazo zitha kukhala zochulukirapo kapena zochepa, zimawoneka koyambirira kwa matendawa (ndi mtundu 1), kapena matendawa amatha kukhala asymptomatic kwa nthawi yayitali (mtundu 2).

Kusiyana pakati pa LADA-matenda ashuga amitundu ina yamatendawa

Kodi pali kusiyana kotani pakati pa matenda a shuga a LADA ndi mitundu ina ya matenda ashuga? Mitundu iyi ndi mtundu wa matenda a shuga amtundu woyamba, womwe umachitika molingana ndi mtundu wa matenda 2.

Ndi LADA, maselo a pancreatic amawonongeka kwathunthu chifukwa chofuna kuwonetsa ma antibodies opangidwa ndi chitetezo chathupi.

Ndiye kuti, makina olephera a metabolic amafanana ndi mtundu wodwala wa insulin. Koma zakuphwanya zimapezeka kale mwa akulu, zomwe zimadziwika kwambiri ndi matenda amtundu wa 2.

Kutha kwathunthu kwachilengedwe pakupanga insulini kumachitika m'nthawi yochepa kuchokera ku matenda. Pambuyo pa zaka 1-3, maselo onse a beta omwe ali ndi vuto lopanga timuyo timafa.

Chifukwa cha kuchepa kwa timadzi tambiri, glucose amadziunjikira, komwe kumayambitsa hyperglycemia, ndipo thupi limakulipira kuchepa kwa mphamvu ndikuchepa kwa maselo amafuta, zomwe zimayambitsa ketoacidosis.

Zomwe zikuthandizira kupezeka kwa matenda a m'matumbo zimaphatikizapo:

• kubadwa mwabadwa;
• zolimbitsa thupi zochepa;
• madigiri osiyanasiyana a kunenepa;
• kufooka chitetezo chokwanira;
• kudya chakudya chamagulugulu;
• chizolowezi chodya kwambiri;
• mbiri ya concomitant autoimmune pathologies kapena matenda otere;
• mankhwala omwe mumadzipatsirana antibacterial ndi mahomoni;
• yaitali nkhawa;
• kuvulala kapena opaleshoni;
• zachilengedwe.

Zizindikiro za matendawa zimatha kuoneka miyezi ingapo pambuyo pakulephera kwa metabolic, zomwe zimakupatsani mwayi wofufuzira komanso kupereka mankhwala. Tsoka ilo, nthawi zambiri, odwala amapezeka kuti ali ndi vuto lachiwiri la matenda ashuga ndipo amapatsidwa mankhwala ochepetsa shuga panthawi yomwe chithandizo cha insulini chiyenera kuyamba mwachangu.

Njira Zodziwitsira

Kuzindikira kwa LADA kumachitika molingana ndi zotsatira za kusanthula:

• magazi zamankhwala;
• kuyesa kwa shuga m'magazi;
• ambiri matenda a magazi ndi mkodzo.

Kuphatikiza apo, kafukufuku wazomwe akutsata adalembedwa:

• ma antibodies kuma cell a islets a Langerhans;
• antibodies to insulin;
• glutamate decarboxylase antibodies;
• kulolerana kwa shuga;
• glycated hemoglobin;
• microalbumin;
• leptin;
• fructosamine;
• c-peptide;
• pancreatic peptide;
• glucagon.

Njira zazikulu zodziwitsira ndizomwe zingawonetse mayeso a autoimmune pamaso pa zinthu izi:

• Zizindikiro za matenda amtundu wa 2 posowa kunenepa kwambiri kwa odwala;
• zaka zosakwana 45;
• Kuperewera kwa insulin kumalipidwa ndi kuchuluka kwa zochitika zolimbitsa thupi ndi kudya;
• kudalira kwa insulini komwe kunachitika zaka 1-3 atachira matendawa;
• matenda a autoimmune m'mbiri kapena pakati pa abale;
• ludzu lochulukirapo, kukodza mwachangu, kuchepa kwa ntchito.

Mitundu iwiri yosiyanasiyana ya chithunzi cha chipatala imatha kuonedwa.

LADA yokhala ndi matenda a shuga omwe amadalira insulin:

• matendawa amakula odwala;
• Ma HLA genotypes ndi ma philotypes amtundu wa matenda ashuga 1 alipo;
• poyesa magazi pamimba yopanda kanthu, kuchuluka kwa c-peptide kumawonedwa.

Njira yachiwiri imadziwika ndi mawonekedwe:

• Zizindikiro za matenda 2;
• odwala okalamba omwe ali ndi minyewa yosiyanasiyana ya kunenepa;
• HLA genotypes ndi haplotypes samawonedwa;
• dyslipidemia.

Matenda obisala obisika amakhala ochulukirapo ndikupanga kuchuluka kwa ma antibodies omwe amawononga kapamba. Maselo otsala amayamba kupanga insulin kwambiri, yomwe imatsitsanso England. Chizindikiro china cha kuwonongeka kwa gland ndi ochepa ma c-peptides m'magazi omwe amatengedwa pamimba yopanda kanthu.

Ndiye kuti, matendawa amatsimikiziridwa ndi kuphatikiza kwa c-peptides wochepetsedwa komanso kukhalapo kwa ma antibodies kuti glutamate decarboxylase. Kuzindikira sikumachotsedwa ngati ma antibodies palibe. Maphunziro owonjezera adzafunika ngati ma antibodies apezeka pamlingo wovomerezeka wa c-peptides.

Mavuto akulu azidziwitso ndi kusowa kwa ndalama zothandizira mabungwe azachipatala, chifukwa chomwe kulibe zida zofunika pa maphunziro a autoimmune. Pankhaniyi, odwala amayenera kupita kuzipatala zachinsinsi kuti akayezetse, chifukwa chake kudalirika kwa zotsatira za kafukufukuyu nthawi zambiri kumakhala kukayikira.

Njira zochizira

Pazindikiritso zabwino za odwala omwe ali ndi LADA, kuzindikira koyenera ndi chithandizo chamankhwala ndizofunikira kwambiri. Komabe, zimachitika kawirikawiri kuti chithandizo chamankhwala chimapangidwa chofanana ndi chithandizo cha matenda a shuga a 2 mtundu, mwachitsanzo, tikulimbikitsidwa kutenga sulfonylurea ndi Metformin.

Kusankhidwa kotereku kumabweretsa chiwonongeko chachikulu cha maselo a pancreatic, osavomerezeka ndi mtundu wamtunduwu.

Chithandizo chokwanira chimatanthawuza kuteteza kwakutali kwa chithandizo ndipo ziyenera kukhala ndi cholinga chothana ndi mavuto:

• sungani kuchuluka kwa shuga m'milingo yoyenera, kupewa kupezeka kwa hypo- ndi hyperglycemia;
• kuchuluka kwa masoka a insulin mthupi;
• tulutsani ziphuphu, kuchepetsa kufunikira kwa kupanga mahomoni, kupewa kufooka.

Kukwaniritsa malonjezo kumachitika kudzera pazolingalira zotsatirazi:

1. Mankhwala a insulin. Mosasamala kanthu za kuchuluka kwa shuga m'madzi a m'magazi, odwala amapatsidwa jekeseni wa ochepa Mlingo wa mahomoni omwe amakhala atatenga nthawi yayitali.
2. Kuyang'anira ma glucose zizichitidwa pafupipafupi osati pokhapokha komanso chakudya, komanso usiku.
3. Kusintha kwa zakudya. Zakudya zopatsa thanzi ziyenera kukhazikitsidwa ndi kuchepetsa zakudya zomwe zimamwa kwambiri mu chakudya chambiri. Zosaphatikizidwa pazosankha ndizopaka, makeke, masamba otsekemera, maswiti, ndi zinthu zina za ufa wa tirigu. Chofunikira ndikusunga madzi moyenera. Kugwiritsa ntchito tsiku ndi tsiku malita 1.5-2 amadzi kumathandizira magazi ndi kupewa kuchepa kwa madzi m'thupi.
4. Kuchulukitsa zolimbitsa thupi. Katundu wa masewera a tsiku ndi tsiku amakhala ndi cholinga chochepetsera kunenepa, kuwonjezera mphamvu zamagetsi, kukonza kayendedwe ka magazi ndikuthandizira njira zama metabolic. Kuphatikiza apo, maphunziro akuthupi amalimbitsa minofu yamtima komanso makoma amitsempha, komwe kungakhale chitetezo chabwino kwambiri cha matenda a mtima.

Zambiri paz kanema za matenda a LADA - kufunsa kwa endocrinologist:

Kutsatira malingaliro onse kumakhazikitsa zikhazikitso za shuga ndikulepheretsa kukula kwa hyperglycemic ndi ketoacid coma.