ʻO ka maʻi diabetes mellitus a me nā antibodies i nā pupu beta he pilina, no laila inā he kānalua ka maʻi, hiki i ke kauka ke kuhikuhi i kēia mau noiʻi.
Ke kamaʻilio nei mākou e pili ana i nā autoantibodies a ke kino kanaka i kū'ē i ka insulin internal. ʻO nā Antibodies i ka insulin he hōʻike aʻoi a pololei hoʻi no ka maʻi type 1.
He mea nui nā hana Diagnostic no nā ʻano like ʻole o ke kō i ka hoʻomaʻamaʻa ʻana a me ka hana ʻana i kahi hoʻoponopono lapaʻau pono.
Kuhi o kahi maʻi Diabetes ka hoʻohana ʻana i nā Antibodies
I ke ʻano type pathology 1, ua hua ʻia nā antibodies i nā mea maʻi pancreatic, ʻaʻole ia he ʻano like me nā maʻi ʻano 2. Ma ke ʻano maʻi diabetes type 1, hoʻokani ka insulin i ka hana o autoantigen. Hoʻopiʻi nui ka waiwai no ka pancreas.
ʻOkoʻa ka insulin i ke koena o ka autoantigens me kēia maʻi. ʻO ka māka kūpono kūpono loa o ka malfunction i loko o ke kīpē i loko o ka maʻi diabetes type 1 he hopena maikaʻi ia i ka antibodies insulin.
I kēia maʻi āpau, aia kekahi mau kino o ke koko e pili ana i nā ʻolua beta, no ka laʻana, ʻo nā antibodies e pili ana i ka glutamate decarboxylase. Aia kekahi mau hiʻohiʻona:
- Loaʻa iā 70% o ʻekolu o nā kānaka he ʻekolu a ʻoi paha ka nui o nā antibodies.
- emi ma lalo o 10% i hoʻokahi mau ʻano,
- ʻaʻohe mau kūmole i ka 2-4% o nā maʻi.
ʻAʻole pili ʻia nā antibodies i ka hormone i ka maʻi diabetes i ke kumu o ka hoʻokumu ʻia ʻana o ka maʻi. Hōʻike wale lākou i ka luku ʻana o nā papa hana papa pancreatic. ʻO nā antiododies i ka insulin i nā keiki maʻi maʻi e ʻoi aku ka nui ma mua o ka wā pākeke.
I ka manawa pinepine i nā keiki maʻi me ka maʻi mua o ka maʻi, nā antibodies i ka insulin e ʻike mua a i loko o ka nui. ʻO kēia hiʻohiʻona hiʻohiʻona o nā keiki ma lalo o ʻekolu makahiki o kona mau makahiki. Ke hōʻike nei kahi hōʻike hoʻoliʻi e nānā i ka hōʻike maʻamau no ka hoʻoholo ʻana i nā maʻi maʻi kamaliʻi 1.
I mea e loaʻa ai ka nui o ka ʻike, pono ia e koho ʻaʻole wale i kēia haʻawina, akā e hoʻopaʻa pū ʻia i ka ʻike o nā ʻano autoantibodies ʻē aʻe o nā pathology.
Pono e hoʻopaʻa ʻia ka hōʻike inā loaʻa ke hōʻike i kahi maʻi o ka hyperglycemia:
- ka nui o ka nui o ka urine
- makewai nui
- kaumaha kaumaha wikiwiki
- ka emi ʻana o ke ʻano ʻike,
- ka hoemi ʻia o ka lehelehe wāwae.
Nā antibodulin e hoʻonāukiuki ana
Hōʻike ka hoʻāʻo ʻana i ka antibody insulin i ka hōʻino o ka beta-cell ma muli o kahi predisposition hoʻoilina. Aia nā antibodies i ka insulin waho a me loko.
ʻO nā antibodies i ka waiwai waho e hōʻike i ka hopena o ka alerine i kēlā insulin a me ka nānā ʻana i ke kūlike o ka insulin. Hoʻohana ʻia ka haʻawina ʻana i ka wā e hiki ai i ke kau ʻana i ka lāʻau ketamine i ka wā ʻōpio, ʻo ia hoʻi i ka mālama ʻana i ka poʻe me ka nui o ka manawa e hoʻomohala ai i ka maʻi diabetes.
ʻAʻole pono nā kiko o kēlā mau antibodies ma mua o 10 U / ml.
ʻO nā antibody decarboxylase decutboxylase (GAD)
Hoʻohana ʻia kahi noi e pili ana i nā antibodies i GAD e ʻike ai i ka maʻi diabetes i ka wā ʻaʻole i hoʻopuka ʻia ke kiʻi ʻo ka maʻi ma ke ʻano like me ka type 2. Inā hoʻoholo ka antibodies i GAD i nā poʻe non-insulin-hilinaʻi, hōʻike kēia i ka hoʻololi o ka maʻi i kahi ʻano hana i loko o ka insulin.
Hiki ke loaʻa nā antibodies GAD i mau makahiki ma mua o ka hoʻomaka ʻana o ka maʻi. Hōʻike kēia i kahi kaʻina autoimmune e hoʻopau i nā kinipona beta o ka iʻa. Hoʻohui i nā maʻi maʻi, hiki i ke ʻano o nā antibodies ke ʻōlelo, ka mea mua, e pili ana i:
- lupus erythematosus,
- rula hulu.
Kuhi ʻia ka nui o ka 1.0 U / ml ma ke ʻano he kuhikuhi maʻamau. ʻO ka nui o nā antibodies e hiki ke hōʻike i ka maʻi diabetes type 1, a e kamaʻilio e pili ana i nā hopena e pili ana i ka hoʻomohala ʻana i nā kaʻina autoimmune.
C peptide
He mea hōʻike i ka huna o kāu iho insulin. Hōʻike ia i ka hana o nā cell beta pancreatic. Hāʻawi ke haʻawina i ka ʻikepili a me nā inikini insulin waho a me nā antibodies i loaʻa i ka insulin.
He mea koʻikoʻi loa kēia i ka aʻo ʻana o nā maʻi maʻi i ka maʻi mua. Hāʻawi kahi ʻano hoʻohālikelike i kahi manawa e loiloi ai i ka pololei o ka hoʻoponopono lāʻau i ka insulin. Inā ʻaʻole lawa ka nui o ka insulin, a laila e hoʻohaʻahaʻa ʻia ka C-peptide.
Hoike ʻia kahi haʻawina ma ia ʻano.
- inā pono ka hoʻokaʻawale i ke ʻano type type 1 a me ke ʻano type type 2.
- e loiloi i ka ulu pono ʻana o ka inika,
- inā manaʻo ʻoe i ka insulin
- e hoʻomaʻamaʻa i ka mālama ʻana i ke kūlana o ke kino me ka pathology ate.
Hiki i ka nui o C-peptide ke:
- non-insulin dependant diabetes,
- hana hanalima
- ka hoʻohana ʻana i nā hormones, e like me ka contraceptives,
- insulin
- hypertrophy o nā pūpū.
ʻO ka hoʻemi ʻana o ka C-peptide e hōʻike ana i ka maʻi diabetes-hilinaʻi, me ka:
- huahuʻi,
- kūlana paʻakikī.
ʻO ka maʻamau ka maʻamau o ka awā mai 0.5 a 2.0 μg / L. Hana ʻia ka ʻike ma luna o kahi ʻōpū ʻole. Pono he hoʻomaha o ka hola 12. ʻAe ʻia ka wai maʻemaʻe.
Holo ʻaʻai no ka insulin
ʻO kahi hōʻike koʻikoʻi kēia no ka nānā ʻana i kahi ʻano o ka maʻi maʻi.
Me nā pathology o ka ʻano mua, hoʻohaʻahaʻa ka ʻike o ka insulin i ke koko, a me ka pathology o ka ʻano lua, hoʻonui ʻia ka nui o ka insulin a i ʻole ka maʻamau.
Hoʻohana ʻia kēia ʻano ʻike ʻana i ka insulin i loko e hopohopo i kekahi mau kūlana, ke kamaʻilio nei mākou e:
- acromegaly
- maʻi o ka hoʻokalakupua
- insulin.
ʻO ka nui o ka insulin i ka pae maʻamau ʻo 15 pmol / L - 180 pmol / L, a i ʻole 2-25 mced / L.
Hana ʻia ka nānā ʻana ma kahi ʻōpū ʻole. Hiki ia ke inu i ka wai, akā ʻo ka manawa hope loa e ʻai ai kekahi kanaka i nā hola 12 ma mua o ka hoʻopaʻa ʻana.
Hemoglobin Glycated
ʻO kēia ka māhele o kahi molekuhi glucose me ka molekine hemoglobin. ʻO ka manaʻo o ka hemoglobin glycated e hāʻawi i ka ʻikepili ma ka awelika o ke kōʻai koko ma mua o 2 mau mahina ʻekolu. ʻO ka maʻamau, kahi waiwai o glycated hemoglobin o 4 - 6.0%.
ʻO ka hoʻonui nui aʻe o ka hemoglobin glycated e hōʻike ana i kahi hana hewa i ka hoʻoliʻoliʻenehana metabolism inā ʻike mua ʻia ka maʻi maʻi. Eia kekahi, hōʻike ka nānā ʻana i ka uku kūpono ʻole a me ka hoʻolālā maikaʻi ʻole.
Kauka nā kauka i nā maʻi maʻi maʻi e hana i kēia noiʻi e pili ana i ʻehā mau makahiki i ka makahiki. Hiki ke hoʻokaʻawale ʻia nā hopena ma lalo o kekahi mau kūlana a me nā kaʻina hana, ʻo ia hoʻi:
- kahe koko
- kahe koko
- nele i nā hao.
Ma mua o ka nānā ʻana, ʻae ʻia ka meaʻai.
Fructosamine
ʻO ka protein glycated a i ʻole fructosamine ka mea i hoʻohui ʻia i kahi molika glucose me kahi molekine protein. ʻO ke ola o kēia mau pūhui ua like me ʻekolu wiki, no laila e hōʻike ana ka fructosamine i ka awelika o ke kōʻai he nui ma mua o nā hebedoma i hala aku nei.
ʻO nā kumu o ka fructosamine i loko o nā kumukūʻai maʻamau mai 160 a 280 μmol / L. No nā keiki, he haʻahaʻa loa ka heluhelu ʻana no nā pākeke. ʻO ka nui o ka fructosamine i nā keiki ka maʻa maʻamau o 140 a 150 μmol / L.
ʻO ka nānāʻana i ka urine no ka glucose
I ke kanaka ʻole ʻaʻohe pathologies, ʻaʻole i hele ka glucose i loko o ka urine. Inā ʻike ʻia, e hōʻike ana kēia i ka holo ʻana, a ʻaʻole hoʻi i lawa ka uku no ka maʻi diabetes. Me ka hoʻonui ʻana o ke kō i ke koko a me ka nele o ka insulin, ʻaʻole i maʻalahi ka hoʻopā o nā glucose i nā hana a nā keiki.
Hoʻomaopopo kēia ʻano me ka hoʻonui ʻana i ka "lōkeke aʻi", ʻo ia hoʻi o ka pae o ke kō i loko o ke koko, ma ka manawa e hoʻomaka ai ia e kū mai i ka urine. ʻO kēlā me kēia o ka "renal threshold" kū hoʻokahi, akā, ʻo ka pinepine, aia ma ka waena o 7.0 mmol - 11,0 mmol / l.
Hiki ke ʻike i ka Sugar i loko o hoʻokahi helu o ka urine a i ʻole i loko o kēlā me kēia lā. Ma ka lua o kēia, ua hana ʻia kēia: ʻo ka nui o ka urine e ninini ʻia i loko o kahi pahu i ka lā, a laila e ana ʻia ka lōla ʻana, hui ʻia a hui pū ʻia i loko o kahi pahu kūikawā.
ʻAʻole pono ʻoi i ka Sugar ma mua o 2.8 mmol i nā lā i ka lā.
Hoʻololi hoʻokolohua Glucose
Inā ʻike ʻia kahi nui o ka glucose i ke koko, ua hōʻike ʻia kahi hōʻike hoʻoliʻi glucose. Pono e ana ke kaona i ka ʻōpū hoka ʻole, a laila e lawe ka mea maʻi i 75 g o ka glucose i hoʻoheheʻe ʻia, a ʻo ka lua o ka manawa i hana ʻia ai ka noiʻi (ma hope o hoʻokahi hola a ʻelua mau hola ma hope).
Ma hope o hoʻokahi hola, pono ʻole ke hopena e ʻoi aku ka kiʻekiʻe ma mua o 8.0 mol / L. ʻO ka hoʻonui ʻana i nā glucose i 11 mmol / L a i ʻole he mea e hōʻike ana i kahi hiki ke hoʻomohala hou i ka maʻi diabetes a me ka pono no ka noiʻi hou.
Inā he wai ma waena o 8.0 a 11.0 mmol / L, hōʻike kēia i ka hoʻomanawanui i ka makemake o ka glucose. ʻO ke kūlana kahi harbinger o ka maʻi maʻi.
ʻAʻohe ʻike hope
Hōʻikeʻike ka maʻi diabetes type 1 i nā pane kūʻē e kū ana i ka pehu sela pancreatic. ʻO ka hana o nā kaʻina autoimmune e pili pono ana i ka neʻe ʻana a me ka nui o nā antibodies kikoʻī. Kahi ʻia kēia mau antibodies ma mua o ka puka ʻana o nā hōʻailona mua o ka maʻi diabetes type 1.
Ma ke nānā ʻana i nā antibodies, hiki ke hoʻokaʻawale i waena o ke ʻano type type 1 a me ka type 2, a ke nānā pū me ka maʻi LADA ma ke ʻano manawa. Hiki iā ʻoe ke hana i kahi maʻi kūpono ma kahi wīwī a hoʻolauna i ka therapy insulin pono.
I nā keiki a me nā pākeke, ua ʻike ʻia nā ʻano like ʻole o ka antibodies. No kahi loiloi kūpono loa o ka hopena o ka maʻi o ka maʻi maʻi, pono e hoʻoholo i nā ʻano lāʻau āpau.
ʻO kēia manawa hou, ua ʻike ka poʻe ʻepekema i kahi autoantigen kūikawā kahi e hana ʻia ai nā antibodies i ka maʻi diabetes type 1. He lānani kaʻa zinc ma lalo o ke acronym ZnT8. Hāʻawi ia i nā atom zinc i nā ʻāpana pancreatic, kahi lākou e komo ai i ka mālama o kahi ʻano like ʻole o ka insulin.
ʻO Antibodies a ZnT8, ma ke ʻano he kānāwai, ua hui pū ʻia me nā ʻano ʻē aʻe o nā antibodies. Me ka hui ʻano maʻi mellitus 1 mua i ʻike ʻia, aia nā antibodies i ZnT8 e loaʻa i ka 65-80% o nā hihia. Ma kahi o 30% o ka poʻe me ka maʻi type kīpē 1 a me ka nele o nā ʻano ʻē aʻe autoantibody ʻehā i loaʻa iā ZnT8.
ʻO ko lākou neʻeʻana he hōʻailona o ka hoʻomaka o ka maʻi type i ka mua a me ka loaʻa ʻole o ka insulin i loko.
ʻO ka wikiō i kēia ʻatikala e haʻi no ka pili o ke ʻano o ka hana a ka insulin i ke kino.
