Pono ke ʻano lāʻau maʻi maʻi inā ʻike ʻia nā hōʻailona maʻamau o ka maʻi.
ʻAi mai ka hapahā o nā maʻi me kēia maʻi e kali ʻole nei i kā lākou maʻi ʻana, no laila, ʻōlelo ka World Health Organization i ka lawe ʻana i nā hoʻokolohua no ka maʻi diabetes i ka liʻiliʻi ma ʻelua mau makahiki.
ʻO ka hoʻololi kino glucose i ke kanaka olakino e loli i ka pae o 3.3-5.5 mmol / L. ʻO ka maʻi diabetes mellitus, ke ʻano he pathology autoimmune, e alakaʻi i ka pio o nā beta beta o nā moku ʻo Langerhans, ʻo ia ka hana nui o ka hana ʻana i ka insulin. ʻO kēia hormon ke kuleana no ka lawe ʻana i ka glucose mai ke koko i nā pehu e pono ai ke kumu kumu.
ʻAʻole e like me nā insulin, e hoʻohaʻahaʻa ana i ke kahe o ke kō i loko o ke koko, nui ka nui o ka hormon e kū'ē i ia. No ka hoʻohālikelike, nā glucocorticoids, norepinephrine, adrenaline, glucagon a me nā mea ʻē aʻe.
ʻO ka maʻi mellitus a me kāna mau hōʻailona
ʻO ka hana ʻana o ka hāneʻa-kaohi haʻahaʻa e hoʻohiolo ai i ka maʻi type type 1 ua pau. Aia kekahi maʻi o kēia ʻano i ka wā ʻōpio a me nā keiki. No ka mea ʻaʻole hiki i ke kino ke hoʻoulu i ka hormone, he mea nui ia i ka mea maʻi e kau pū pinepine i ka insulin.
Ma ka maʻi type 2, ʻaʻole e pau ka hana ʻana i ka hormone. Eia naʻe, paʻa ka hana o ka insulin (ka huakaʻi lawe i ka glucose) ma muli o ka hopena abnormal o nā cell target. Ua kapa ʻia kēia kaʻina hana neʻe i ka lawaiʻa insulin. Hoʻoulu ke non-insulin-diabetes i ka poʻe me ka momona nui a me ka hoʻoili ʻana mai nā makahiki 40. ʻO ka huli ʻana i ka maʻi mellitus o ka maʻi mellitus o ka ʻano like ole-insulin e pale i ka lāʻau lapaʻau. I mea e mālama pono ai i nā waiwai kaulike maʻamau, pono ʻoe e ʻai pono a me ka hoʻomaʻamaʻa.
He aha nā hoʻololi i ke kino kanaka i hiki ai ke ʻōlelo i kahi "maʻi aloha"? ʻO ke kō koko koko nui ma ka maʻi diabetes no ka manaʻo mau ʻana o ka makewai. ʻO ka hoʻohanaʻana i ka wai i ka nui nui e hoʻopili pinepine ai i ka hoʻomaha. No laila, ʻo ka makewai a me ka polyuria nā hōʻailona ʻelua o ka maʻi. Eia nō naʻe, hiki pū kekahi mau hōʻailona o ka maʻi maʻi.
- e hana mau i ka nāwaliwali a me ka maʻi lahilahi;
- hiamoe hiamoe a me nā hōʻeha pinepine;
- ʻili a me ka ʻeha;
- he ʻike hoʻopuka;
- huakai ʻole ʻole;
- lōʻihi ka ho'ōla ʻana o nā hōʻoki a me nā hōʻeha;
- i nā pinepine o nā maʻi;
- ʻĀwili a ʻike ʻole paha i ka wāwae;
- he kahe koko paʻa.
Pono kēia mau ʻōmaʻomaʻo e lilo i manawa e kipa ai i ke keʻena o ka endocrinologist, nāna e nānā i ka mea maʻi a kuhikuhi iā ia, inā pono, e hoʻomaʻemaʻe i ke koko no ka maʻi maʻi. ʻO nā mea e pono ai ke hāʻawi ʻia, e noʻonoʻo hou mākou.
Kuhi i ka hoʻāʻo koko koko maʻi
Hoʻomaʻa pinepine pinepine kekahi kanaka i ka hyperglycemia a aʻoi aku e pili ana iā ia ma ka make hewa, ke loaʻa ka hopena o kahi hōʻike koko maʻamau.
E hoʻokala i kahi maʻi kūpono, e kipa me kahi endocrinologist.
Ua kau aku ke kauka i kekahi mau hoʻokolohua kūikawā e wehewehe i ka maʻi.
I mea e hoʻoholo ai i ka pae o ka glucose, ʻo nā haʻawina aʻoi loa.
- ʻO ka helu koko piha.
- Hōʻike no ka hemoglobin glycated.
- Hoʻololi hoʻokolohua Glucose.
- C peptide assay.
ʻO ka hōʻike koko ākea no ka maʻi maʻi. Hoʻoholo ʻia ia ma kahi ʻōpū ʻole i ke kakahiaka, no ka mea ma mua o ka lawe ʻana i nā mea ola olakino, ʻaʻohe hiki iā ʻoe ke ʻai i ka meaʻai no ka liʻiliʻi o 8 mau hola. 24 mau hola ma mua o ke aʻo ʻana, ʻaʻole hiki ke hoʻopau i ka nui loa a me ka inu ʻana i ka mea inu wai, no ka mea e hiki kēia ke hoʻokaʻawale i nā hopena hope loa. Eia nō hoʻi, nā hopena o ka hoʻokolohua e loaʻa i nā mea e like me ka hapai ʻana, ka momona nui, ke kaumaha, ke kaumaha, ka maʻi a me nā maʻi ʻē aʻe. Pono ka paona kōʻai i ka pae mai 3.3 a 5.5 mmol / L.
Hōʻike ka hopena o ka maʻi hemoglobin glycated i ka awelika o ka hoʻoliʻi koko. ʻO ka hoʻokolohua maʻalahi i ka maʻi hānai e mālama ʻia i kahi lōʻihi lōʻihi - mai ʻelua a ʻekolu mau malama. Loaʻa nā hopena o ka loiloi e loiloi i ke ʻano o ka maʻi, a me ka hopena o ka hoʻomaʻamaʻa iho.
Hoʻololi hoʻokolohua Glucose. Hana ʻia ia i mea e ʻike ai i ka mau hewa i ka metabolism o nā haawe. Hōʻike ʻia kēlā ʻano haʻawina no ka momona nui, ka pipi o ke akepaʻa, nā maʻi periodontal, nā ovaries polycystic, furunculosis, hypertension arterial a me ka hoʻonui ʻana i ke kō i ka wahine i ka wā hāpai. ʻO ka mua, pono ʻoe e hāʻawi i ke koko i ka ʻōpū ʻole, a laila hoʻopau i ka 75 karamu o ke kō i hoʻoheheʻe ʻia i 300 ml wai. A laila ke ʻano o ka noiʻi noiʻi no ka maʻi diabetes: ʻo kēlā me kēia hapalua hola, e ana ka glucose i ʻelua mau hola. Loaʻa ka hopena i ka 7.8 mmol / L, ʻaʻole hikiʻole ʻoe ke minamina, no ka mea he hōʻailona maʻamau kēia, e hōʻike ana i ka hala ʻole o ka maʻi. Eia naʻe, ke kuhikuhi nei nā waiwai i ka pae o 7.8–11.1 mmol / L e hōʻike ana i ka prediabetes, a me nā waiwai ma luna o 11.1 mmol / L e hōʻike ana i ka maʻi maʻi.
ʻO ka noiʻi ʻana i nā C-peptides. ʻO kahi kahi loiloi kūpono e ʻike ai i ka pili o ka pancreas. He pono e lawe ia i nā hōʻailona o ke maʻi maʻi i nā wahine hāpai, me ka neʻe ʻana o ka genetic predisposition a me nā hōʻike maʻi o ka hyperglycemia. Ma mua o ka lawe ʻana i nā hoʻokolohua no ka maʻi diabetes, ʻaʻole hiki iā ʻoe ke lawe i nā lāʻau lapaʻau e like me ka aspirin, nā hormones, ascorbic acid, a me nā contraceptives. Hoʻoholo ʻia ka hoʻonā ʻana o C-peptides me ka hoʻohana ʻana i ka ikehu koko mai kahi vein.
Manaʻo ʻia nā waiwai maʻamau i ka pae mai 298 a 1324 pmol / L.
Urinalysis no ka maʻi maʻi
He aha nā hōʻike āu e hōʻoia ai no ka maʻi diabetes ma ke ʻano o nā hoʻāʻo koko? Inā kānalua ʻoe "ka maʻi ʻoluʻolu", ke kauka nei ke kauka i kahi kaohi o ka urine. ʻAʻole pono ka hona o ke kanaka e loaʻa ka hilo i loko o ka urine, akā naʻe, ʻaʻole i ʻike ʻia ka kūwea a hiki i kahi 0,02% glucose i loko.
ʻO nā hōʻike i ka ʻihi ʻana i ke kakahiaka a me ka nānā ʻana i kēlā me kēia lā i manaʻo ʻia ka mea e ʻoi aku ka maikaʻi. ʻO ka mea mua, e hoʻomaʻamaʻa ʻia ka urine kakahiaka i ka kō. Inā i loaʻa, e noi ʻia kahi hōʻike o kēlā me kēia lā e hōʻoia i ka maʻi ʻana. E hoʻoholo i ka lā hoʻokuʻu o ka glucose me nā urine kanaka. Pono ka mea maʻi e hōʻiliʻili i nā ʻili olakino ma loko o ke ao holoʻokoʻa i ka ʻāpana kakahiaka. No ka noiʻi ʻana, lawa ka 200 ml o ka urine, ka mea e hōʻiliʻili ʻia i ke ahiahi.
ʻO ka ʻike kino ʻana i ke kō i loko o ka urine e pili pū me ka hoʻonui ʻana i ka luhi ma luna o nā keiki no ka loaʻa ʻana o ka maʻi maʻi. Hoʻopau kēia kino i nā mea make āpau mai ke kino, me ka momona nui i loko o ke koko. No ka nui o ka wai o ka nui e pono no ka hana ʻana o nā keiki, hoʻomaka lākou e lawe i ka nui o ka wai ma ke kikoo. ʻO ka hopena, makemake ke kanaka i ka inu mau a hele i ka lolo "i ka liʻiliʻi". I nā pae gula maʻa maʻamau, hoʻouna ʻia nā honu āpau e "ʻ energylelo ikaika" no nā ʻili, no laila ʻaʻole i loaʻa i loko o ka wai.
ʻO nā noiʻi hormonal a me ka immunological
Ke makemake nei kekahi mau maʻi i ka maʻi maʻi, he aha nā hōʻike e hana ai mākou ma waho o ke koko a me ka paʻakai?
He mea ʻia he papa inoa o nā ʻano hana like ʻole i hōʻike ʻia ma luna, akā he nui aku.
Ke kānalua nei ke kauka inā paha e hana i kahi maʻi a i ʻole ka makemake, a makemake paha e noi i nā maʻi ma nā kikoʻī hou aku, ua ʻōlelo ʻo ia i nā hoʻokolohua kūikawā.
Nā mea hoʻohālikelike penei:
- ʻO ka hoʻopaʻa ʻia no ka hele ʻana o nā antibodies i nā beta beta. Hoʻopili ʻia kēia haʻawina ma nā hoʻomaka mua o ka maʻi a hoʻoholo inā he predisposition ka mea maʻi ma ke ʻano type 1 ʻano maʻi.
- ʻO ka hoʻonaninani no ka ʻike ʻana i ka insulin. ʻO nā hualoaʻa o kahi noiʻi ma ke kanaka olakino paha mai 15 a 180 mm mau kekona. Ke liʻiliʻi ka haʻahaʻa o ka insulin ma mua o ka maʻamau i hōʻike ʻia, ʻo kēia ke ʻano maʻi maʻi 1, i ke ʻano kiʻekiʻe o ka maʻi diabetes.
- He haʻawina no ka antibodies i ka insulin. Pono ʻia kēlā hoʻokolohua e hoʻohālikelike ai i ka prediabetes a me nā maʻi diabetes 1 ʻano.
- Hoʻolālā o nā antibodies i GAD. ʻOi aku 5 mau makahiki ma mua o ka hoʻomaka ʻana o ka maʻi diabetes, hiki ke noho ʻia nā antibodies i kahi protein GAD kikoʻī.
I mea e hoʻomaopopo ai i ka maʻi maʻi i ka manawa, ua kōkua ke kaanalike e ʻike i nā mea pono ʻole o ke kino kanaka.
Ma kahi wikiwiki koke ʻia ka hoʻokolokolo, ʻoi aku ka nui o ka hoʻomaʻamaʻa ʻana.
Ke nānā nei no nā hoʻopiʻi
ʻO ka maʻi hoʻomohala o nā ʻano mua a me ka lua, e holomua ana, pili i kēlā me nā hui āpau i loko o ke kanaka.
Ma ke ʻano he kānāwai, e hōʻino ʻia ka hopena me ka pili o ke nerve.
Eia kekahi, aia nā hewaʻole i ka hana o ka hapa nui o nā kino.
ʻO nā hopena maʻamau loa o ka "maʻi maʻi" ʻo ia nā maʻi:
- retinopathy maʻi maʻi - hōʻino i ka ʻoihana vascular o ka mea ʻike maka;
- maʻi nephropathy maʻi '- kahi maʻi maʻi ma kahi o ka hana o nā kīʻaha, nā arterioles, glomeruli a me nā puna o nā pēpē e lemu kaila;
- maʻi maʻi wāwae - kahi maʻi maʻi e hoʻohui pū i ka hōʻeha o nā pili koko a me nā pehu o ke aʻalolo o nā lalo haʻahaʻa;
- polyneuropathy - kahi ala e pili ana i ka wahī nīpona, ma muli ka mea i hōʻemi ʻia e ka mea maʻi i ka wela a me ka ʻeha, ma nā ʻaoʻao o luna a me nā lalo;
- ʻO ke ketoacidosis kahi kūlana paʻakikī i ka hōʻiliʻili o nā ketones, nā huahana o ka uhaʻi o nā loina.
Eia ka papa inoa o nā mea e hoʻohālikelike ai i nā maʻi maʻi maʻi e nānā no ka hele a i ʻole nā hemahema.
- Kōkua kahi huina koko biochemical e ʻike i nā maʻi like ʻole i ka hoʻomaka mua ʻana o ka hoʻomohala ʻana. Kauka ʻia nā kauka i kēia mau hoʻokolohua no ka maʻi diabetes i ka liʻiliʻi ma ʻelua mau makahiki. Hōʻike nā hualoaʻa o nā hōʻike i nā waiwai o ke kolamu, ka protein, ka urea, ka mea hana a me ka lipids. Lawe ʻia nā biochemistry koko ma o ka lawe ʻana mai i kahi vein i kahi ʻōpū ʻole, maikaʻi i ke kakahiaka.
- Pono pono kahi hoʻokolohua o ka waihona kālā no ka maʻi type o ka maʻi 2 a no nā hoʻopiʻi hoʻomanawanui o ka ʻike maka ʻana. Ua ʻike ʻia aia ma ka maʻi maʻi o ke ʻano kūʻokoʻa i kahi insulin, ʻo ka hopena o ka hōʻino ʻana o ka ʻoki ʻana i ka nui o ka 25 mau manawa ma mua o nā poʻe ʻē aʻe. No laila, ʻo kahi hana me ka ophthalmologist e hana ʻia ma kahi o kēlā me kēia ʻeono mahina.
- ʻO ka Microalbinium i ka paʻakai - e loaʻa ana i kahi protein kikoʻī. ʻO kahi hopena maikaʻi e hōʻike i ka hoʻomohala ʻana o ka nephropathy maʻi. No ka hoʻoholo ʻana i ka hypothesis o nephropathy, e lawe i ka urinalysis i kēlā me kēia lā i kēlā me kēia mau mahina 6 a e noho maluhia hoʻi.
- Ua hōʻike ʻia kahi ultrasound o ka pūpū i nā maʻi i loaʻa i kahi hopena maikaʻi no ka microalbium i ka urine.
- Kōkua kahi electrocardiogram e ʻike i nā pilikia me ka ʻōnaehana cardiovascular.
- Hōʻike ʻo Fructosamine - kahi haʻawina e kōkua i ka hoʻoholo ʻana i ka waiwai o ka glucose ma hope o nā hebedoma 2 i hala. Hoʻomau ka maʻamau mai ka 2.0 a i ka 2.8 milimelika ma ka lita.
Eia kekahi, ua hana ʻia kahi ultrasound o ka lāʻau a me nā veins, kahi e pono ai no ka ʻike wikiwiki ʻana i ka thrombosis venous. Pono ka loea e nānā i ka palest a me ka wikiwiki o ka kahe koko.
Nā hiʻohiʻona o ka hōʻike hōʻike ʻana
Aia kekahi mau hiʻohiʻona o ka loiloi e pili ana i ke ʻano o ke ʻano maʻi maʻi a me ka makahiki o ka mea maʻi. Hōʻike kēlā me kēia hōʻike i kahi algorithm kikoʻī a me ka hoʻolālā papahana.
No ka ʻike ʻana i ka maʻi lolo 1, ʻike pinepine lākou i ka hōʻike no ka glycohemoglobin, ke aila plasma glucose, nā ʻike koko, a me ka hōʻike ʻano genetic.
No ka hoʻoholo ʻana i ka maʻi diabetes 2 type, e lawe i kahi kaila koko koko, kahi kūlohelohe kōhi koko koko mai kahi vein, kahi maʻi ʻānō he gogine (a).
He kūpono nā loiloi i luna aʻe no nā pākeke. Eia naʻe, ʻo ka weheʻana i ka maʻi maʻi i nā keiki a me nā wahine hāpai wahine he meaʻokoʻa. No laila, no nā keiki, ʻo ka aʻo pono kūpono ka nānā ʻana o ka hoʻolienehana ʻana i ka kōʻai wikiwiki. Hiki i nā ʻōkuhi no nā hoʻokolohua ʻē aʻe:
- hiki ana i kahi keiki o 10 mau makahiki;
- ka heleʻana o ke kaumaha nui ma ke keiki;
- ka heleʻana o nā hōʻailona o ka "maʻi ʻoluʻolu".
E like me kāu e ʻike ai, hiki i ka maʻi maʻi gestational ke hoʻomohala i ka wā o ka hapai - kahi maʻi e kū mai ana ma muli o ka nānāʻole ʻana o ka hormonal. Me ka hoʻomaʻamaʻa kūpono, nalowale koke ka palola ma hope o ka hānau ʻana o ke pēpē. No laila, i ka manawa o ke kolu o ka mākolu a me 1.5 mau mahina ma hope o ka hānau ʻana, pono nā wahine e hoʻomaʻamaʻa i kahi hōʻike hoʻomanawanui glucose. ʻO ia mau ʻano e pale aku ai i ka hoʻomohala ʻana o ka prediabetes a me nā maʻi diabetes type 2.
He mea nui hoʻi ia e mālama i kahi nohona olakino e pale aku i ka hoʻomohala ʻana o kahi "maʻi ʻoluʻolu". No laila, aia kekahi mau rula, pili pono e pale i ka hyperglycemia:
- ʻO ka pono o ka meaʻai kūpono, me ka hoʻokaʻawale ʻana i nā mea momona a nā meaʻai ponoʻī.
- ʻO ke ʻano ola, ʻo ia kekahi ʻano hana a me ka piʻi.
- E nānā pinepine i nā kukuna o ke kō a ʻike e lawe ʻia nā lāʻau hoʻāʻo ʻana i ka maʻi diabetes.
ʻO ke ʻano loiloi e koho ʻia? ʻOi aku ka maikaʻi e noho ma nā loiloi wikiwiki loa e hoʻolako i nā hopena kūpono. Kūkulu ke kauka i kahi loiloi kikoʻī, me ka noʻonoʻo ʻana i ke ʻano o ke olakino o ka mea maʻi, e hōʻoia i ka maʻi maʻi. ʻO kahi kapu ʻokoʻa no ka pale ʻana i ka maʻi hika ma ka aʻo maʻamau no ka hoʻāʻo ʻana i ka honi a me nā hoʻopiʻi ʻana o ka pathology. Hiki ke hoʻomalu ʻia ka maʻi maʻi ma ka ʻike ʻana a me pehea e lawe ai i nā hoʻāʻo koko a me ka urine.
ʻO nā mea e pono ai ʻoe e lawe i ka maʻi maʻi maʻi e haʻi i ka loea i ka wikiō ma kēia ʻatikala.
