Isifo sikashukela ezinganeni - ukuthi ungabona kanjani izimpawu eziyingozi nokuthi yini okufanele uyenze ngokulandelayo?

I-hyperglycemia kanye nokukhubazeka kwe-insulin yinto yesibili ejwayelekile ye-endocrine pathology phakathi kwezingane nasebancane. Ngokusho kwe-World Health Organization, isifo sezingane ezine-sikashukela sikhula ngokushesha. Eminyakeni engu-5-10 elandelayo, inani leziguli lihlolwe ukwandisa ngo-70%.

Kungaba khona isifo sikashukela enganeni?

I-pathology echazwe iyatholakala ukuthi ngisho nasezinsana, izinkinga ze-endocrine zenzeka kungakhathaliseki ubudala. Abazali abaningi bayazibuza ukuthi kukhona yini isifo sikashukela ezinganeni ezingenazo izakhi zofuzo kulesi sifo. Impendulo yalo mbuzo ihle. Kunezinhlobo ezahlukene zesifo esicatshangelwayo, ezinye zazo zikhula ngenxa yezizathu zangaphandle ezingathandeki noma njengezibalo ezincane.

Izinhlobo zesifo sikashukela ezinganeni

Ngaphandle kwezinhlobo ezimbili eziyaziwayo zezifo ze-endocrine, ezihlukaniswa ngokuxhomekeka kokuxhomeka kwe-insulin, kunezinye izinhlobo zokuphazanyiswa kwe-carbohydrates. Izinhlobo eziningana zesifo sikashukela:

I-Neonatal. Lokhu okuhlukile kwesifo kutholakala ezinsana nasezinsana ezinyangeni ezingu-6. Isifo sikashukela esinjalo esibantwaneni senziwa ngesimo esingapheli nesigxili. Esikhathini sokuqala, isidingo somntwana se-insulin sishabalalisa kancane kancane isigamu sonyaka. Ukuphindaphinda kwesifo esikhathini esizayo kungenzeka kube ngu-50%. I-subtype yesibili ibonakala ngesidingo sempilo yonke ye-insulin.
UMODY. Izinhlobo ezinikezwayo zihloswe ngokuthi uhlobo oluvuthiwe lwesifo sikashukela ezincane (Ukukhula Kokukhulelwa Kwe-Diabetes Yong). I-MODY isici esingokwemvelo samaseli we-pancreatic azuzwe njenge-autosomal uhlobo oludumile (olungathintana nobulili bomntwana, olususwe kusukela esizukulwaneni kuya esizukulwaneni). Lesi sifo sikashukela sinama-subspecies angu-9, iningi lawo elibhekene nenkambo emnene, ngezinye izikhathi ukwengezwa kwe-insulin ukuphathwa akudingeki.
Secondary. Ifomu elingavamile lesi sifo esenzeka ngokumelene nesimo sezinkinga ezinkulu zofuzo. Isifo sikashukela singahamba nama-syndromes kaRogers, Wolfram, Alström, Rabson-Mendelholl, leprechaunizm, lipodystrophy nezinye izifo.

Uhlobo olulodwa lwe-diabetes mellitus

Uhlobo oluchazwe lwe-endocrine isifo (i-insulin-dependent) yiyona ejwayelekile kunazo zonke ezincane. Uhlobo lwesifo sikashukela luhlobo lwe-1 ezinganeni luhlukaniswa ngamaqembu amabili:

i-autoimmune;
idiopathic.

Ifomu lokuqala lesifo libhekene nokutholakala kwama-autoantibodies egazini, elihlasela futhi libhubhise amaseli e-beta e-island we-pancreas. Ngenxa yalokho, isitho se-endocrine senza i-insulin enganele ukuphulula i-glucose. Kunzima kakhulu ukuchaza isifo sikashukela se-idiopathic ezinganeni - izimbangela zaloluhlobo lwe-pathology aziwa. Egazini lomntwana, akukho-antibodies etholakala, kodwa lesi sifo siqhubeka ngendlela efanayo.

2 uhlobo lwesifo sikashukela mellitus

Ifomu le-insulini-elizimele lesi sifo liye labonwa ngaphambilini ikakhulu kubantu abadala nasebekhulile. Uhlobo lwesifo sikashukela u-2 ezinganeni lwaqala ukukhula ngokushesha. Lokhu kungenxa yokushintsha endleleni yokuphila nokudla kwabafundi basesikoleni samanje. Ukungondleki kanye nokuhamba okuphansi kuphakamisa ukukhuluphala, okuholela ekuhluphekeni kwe-endocrine.

Izimbangela zesifo sikashukela mellitus

Izimbangela ezivusa i-pathology echazwe ngokuxhomeke ekujuleni kwayo. I-neonatal, eyesibili kanye ne-MODY-isifo sikashukela ivela ngenxa yokuguqulwa kwesakhi. Lezi zifo ezingavamile zihlobene nokuzalwa okubi. Izimbangela eziyinhloko zesifo sikashukela se-type 1 zingahlukaniswa ngamaqembu amabili:

i-genetic;
zangaphandle.

Ukuzikhethela okwedlulele kulokhu akukona ukuguqula noma yiziphi izakhi zofuzo ezihlukile, kodwa inhlanganisela yabo ekhethekile. Ukutholakala kwesifo sikashukela kubelethi noma kumalungu omndeni akusona isiqinisekiso sokuthuthukiswa kwesifo emntwaneni. Ukuze usebenze futhi uqale ukuphazanyiswa kwe-endocrine, kunezici zangaphandle ezengeziwe ezidingekayo:

ukudla okungalungile (ama-preservatives, nitrate, gluten);
ubuthi;
amagciwane ( rubella , parotitis, Epstein-Barr nabanye);
ukucindezeleka okunzima noma okungapheli.

Izimbangela ze-type 2 sikashukela iyindlela engafanele yokuphila yabantwana. Ukuguquka kokusebenza kwamaphancasi kanye nokukhathazeka komzimba emzimbeni kwenzeka ngokumelene nesizinda se:

ukudla ngokweqile njalo;
ukukhuluphala;
ukuhamba okuphansi;
ukusetshenziswa okuvamile "kokudla okusheshayo".

Isifo sikashukela sikhuluma ezinganeni - izimpawu nezibonakaliso

Isithombe esitholakala emtholampilo sezinsana ezisezinsaneni sibonakala ngokushesha kunabantu abadala. Izimpawu zesifo sikashukela ezinganeni zithuthuka ngokushesha ngenxa yezici ezinjalo:

ukungakhweliseki kwe-enzyme kanye nezinhlelo ze-endocrine;
isisindo samanzi esheshayo, kuhlanganise ama-carbohydrate kanye noshukela;
izibopho ze-neural ezingafundiwe.

Ngokuntula kwe-insulini, i-glucose ayinamathele, futhi amangqamuzana omzimba athola amandla elamandla. Ngenxa yokucima kwayo, amafutha aqala ukudliwa ngokubunjwa kwamagciwane we-ketone ne-acetone, okuyinto enobuthi. Le ndlela ibangela indlela yesifo sikashukela esibonakala ngayo ezinganeni. Imikhiqizo yokuhlukaniswa kwemvelo iqoqa egazini, ivuselela i-ketoacidosis kanye nezimpawu zokuqala zesifo.

Izimpawu zokuqala zesifo sikashukela ezinganeni

Uma ifomu le-MODY likhula, lesi sifo siqhubeka ngesineke ngesithombe somtholampilo esibonakaliswa ngomusa ukuthi abazali bezingane bangase bangaqapheli. Kwezinye izimo, isifo sikashukela siqhubekela phambili ngokushesha - izimpawu ezinganeni ezinkathini zokuqala zokugula zifaka:

ukuzwa njalo ukoma nokomile emlonyeni;
enuresis ;
ukuvuthwa njalo ;
ukwandisa ukudla;
isifiso sokulala ngemva kokudla;
ukukhathala.

Kwaphela amasonto ambalwa, lezi zimpawu zesifo sikashukela ezinganeni ziyanda. Ukwengeza kwaphawula:

qinisekisa ukulahlekelwa isisindo;
ukukhubazeka okubukwayo;
ukukwazi ukukhubaza izifo;
i-neurodermatitis ;
i-mycoses;
ukushaya isikhumba;
ichthyosis.

I-coma ye-diabetes - izimpawu

Isimo esibuzwayo senzeke uma isifo sikashukela esikhungweni sezingane sithuthuka ngaphandle kokwelashwa. Lesi yisimo esiyingozi kakhulu, lapho ngisho nomphumela obulalayo kungenzeka. Ingane encane, ngokushesha kuyadingeka ukuthi uxhumane nesibhedlela ukuze uthole usizo olufanelekayo. I-coma yesifo sikashukela ebantwaneni ihambisana nokulahlekelwa ukwazi. Lesi simo sandulelwe yizimpawu ezilandelayo:

ikhanda;
ukukhathazeka, kulandelwa ukunganaki;
ukungabi nesifiso sokudla;
ukuhlanzeka nokuhlanza;
ukoma okunamandla;
ubuhlungu besisu;
ukuphazamiseka kokuchama;
ukukhanya okukhanyayo emathuneni anesikhumba esibucayi ebusweni;
ukuphefumula okujulile nomsindo;
ukwanda kwentando yenhliziyo;
ukwehla ekushiseni komzimba kanye nomfutho wegazi;
isifo sohudo ngegazi;
ukugoba kwama-eyeballs;
iphunga elimnandi lika-acetone emcimbini;
izinyembezi zemilenze.

Izinkinga zesifo sikashukela ezinganeni

Kamuva, ukutholakala kwemithi noma ukungabi nokwelapha okwanele kuholela emiphumeleni enzima ethinta cishe zonke izinhlelo zomzimba, kuhlanganise nokusebenza kobuchopho. Izinkinga zesifo sikashukela:

I-Neuropathy;
angina pectoris;
i-arteriosclerosis yemithwalo yegazi;
ukuhlasela kwenhliziyo;
i-hypertension;
ukushaywa;
i-nephropathy;
ukuhluleka kwezinso ;
ukubambezeleka ekuthuthukiseni kwengqondo nangokwenyama;
i-retinopathy;

ukulimaza esweni;
i-glaucoma;
i-cataract;
ubumpumputhe;
ukuzwela kwezinzwa zamalungu angaphansi;
ukukhwabanisa nokukhumba isikhumba;
ukutheleleka kwe-bacterial and fungal dermatological;
ukwehluleka kwamathambo;
ukuxuba.

Isifo sikashukela - ukuxilongwa

Ukuqinisekiswa kwezinsolo ekuthuthukiseni i-endocrine pathology kwenziwa ngesisekelo sezimpawu ezitholakalayo nezivivinyo zelabhoratri. Umkhuba ushukela egazini lomntwana kuncike eminyakeni yakhe:

kuze kube yizinyanga eziyi-12 - 2.8-4.4 mmol / l;
1-5 iminyaka - 3.3-5 mmol / l;
ngaphezu kweminyaka emihlanu - kufika ku-5.5 mmol / l.

Ukuze uhlolisise ngokuthekisayo isifo sikashukela ezinganeni futhi unqume uhlobo lwawo, ukuhlolwa okuningi kwegazi kwenziwa ngezinkomba ezilandelayo:

i-insulini ne-proinsulin;
I-C-peptide;
i-hemoglobin ye-glycosylated;
ukubekezelelana ne-glucose;
isimo se-asidi-base (CBS);
antibodies kuya beta-amaseli we-pancreas kanye glutamate decarboxylase;
ukushintshashintsha kwezakhi zofuzo.

Kuzodingeka futhi ukudlulisa umchamo ukucacisa ukuhlushwa:

i-glucose;
ketone imizimba;
i-acetone.

Ukwelashwa kwesifo sikashukela ezinganeni

Kubalulekile ukuthi abazali baqaphele ukuthi ukutholakala okuqinisekisiwe okuqinisekisiwe kuyisikhathi eside. Kuze kube yilapho kusungulwa izindlela zokuvuselela okuphelele kwemisebenzi ye-pancreatic kanye nokujwayelekile kwe-carbohydrate metabolism, ukwelashwa kwesifo sikashukela kubantwana kuyobe sekuphila isikhathi eside. Ukwelashwa kufanele kube okuphelele futhi okuhlala njalo, kubalulekile ukulandela izincomo zesidakamizwa, ukuhambisana nokudla nokunikeza isikhathi sokusebenza ngokomzimba.

Into yokuqala eqala ukwelashwa ukuqapha njalo amazinga kashukela egazi. Ukuze wenze lokhu, thenga i-glucometer kanye nemigqa yokuhlola. Ukuze kulawulwe ngempumelelo inkinga yesifo, odokotela bayelulekwa ukuba babe nedayari ekhethekile, engabhalwanga kuphela ukufundwa kwedivayisi, kodwa futhi nezimo zesisebenzi:

ukutholakala kokucindezeleka noma ukutheleleka;
ukudla okudliwayo neziphuzo;
umsebenzi womzimba;
isimo jikelele sempilo nesimo sengqondo.

Ukunakekelwa kohlobo lwesifo sikashukela se-Type 1 ku-Children

Leli fomu le-pathology libhekene nokuntuleka okukhulu kwe-insulin emzimbeni wengane. Ukugcina impilo evamile, kubalulekile ukukhokhela ukungabi khona kwehomoni kusuka ngaphandle. Ukulawula isifo sikashukela se-type 1 ezinganeni, ukujova nsuku zonke kwe-insulini kuyadingeka. Ukulinganisa kanye nokuvama kwamagciwane kukhethwe yi-endocrinologist ngamunye ngokuhambisana nemingcele eminingana:

ubudala kanye nesisindo somntwana;
i-hyperglycemia;
ukulinganisa kwengane;
izinga lomsebenzi womzimba

Isifo sikashukela esisekelwe ku-insulini esikhungweni sezingane asikwazi ukuphathwa ngaphandle kwe-insulin injection. Noma yiziphi ezinye izindlela zokwelashwa ziyi-charlatanism futhi ziyingozi kumntwana. Uhlelo olulodwa olulawulwayo lokulawula lolu hlobo lwesifo lubandakanya:

ukujova nsuku zonke;
ukuhambisana nokudla;
umsebenzi ovamile ngokomzimba.

Ukwelashwa kohlobo lwe-2 lwesifo sikashukela Mellitus ezinganeni

Indlela echazwe ngayo ye-pathology ayifani kakhulu, cishe ngamacala angu-10-20%. Isifo sikashukela esithathelwana nge-insulin ezinganeni kuphakamisa ukwelashwa okuyinkimbinkimbi, okubandakanya imisebenzi enjalo:

ukujwayelekile kwesisindo somzimba (phambi kokukhuluphala);
umsebenzi womzimba;
ukugcinwa njalo kokudla;
ukuthatha imithi ye-hypoglycemic.

Imisebenzi yemvelo ephakanyisiwe ihlanganisa okungenani ama-3 amakilasi asebenzayo ngesonto amahora angu-1-1.5. Ngaphezu kwalokho, ingane idinga ukuhamba nsuku zonke (3-4 km), intsha iyanconywa ukuba iya ku-5-7 km. Ngokuhambisana ngokuhambisana nezeluleko ze-endocrinologist ngokudla, lokhu kwanele ukugcina ukuhlushwa kweshukela nenhlalakahle ngendlela evamile.

Uma isifo sikashukela ebantwaneni sibonakalisa i-ketoacidosis esicacile futhi esicasulayo, kuyodingeka ukuthi kube khona ukuphuthuma okuphuthumayo kokuntula kwe-insulin. Ngemva kokuqinisa izinga le-glucose nokunciphisa ukukhiqizwa kwemizimba ye-ketone, ungayeka ukujova i-hormone. Ukuze ulawule inkinga yesifo, izidakamizwa ze-hypoglycemic zibekiwe kumathebulethi. Imithi kuphela yileli qembu, evunyelwe ukuba isetshenziswe kumazinzi - i-Metformin.