I waena o nā hihia āpau o ka maʻi maʻi, ʻo ka maʻi like ʻole a hiki i ka 10%. Kuhi ʻia i laila, he keiki, ʻōpio a me nā ʻōpio.
ʻO nā kumu nui o ka maʻi hilahila he predisposition hoʻoilina a me kahi ʻano na ka hopena ʻano autoimmune.
Hōʻike pinepine ʻia nā hōʻailona o ka maʻi i ka wā i pau ʻia i nā ʻāpana āpau i hoʻokumu ʻia i ka insulin i ka pancreas. No laila, he mea nui e hoʻokō i kahi maʻi maʻi ma ke kau ʻana i ka lāʻau hoʻoliʻi i ka insulin e mālama i ke olakino o ka mea maʻi.
Pehea e ulu ai ka diabetes-hilinaʻi.
I mea e hoʻokō ai i nā kaʻina no ka hana metabolic i ka mellitus type 1 type mellitus, pono ʻia ka insulin e pale ai i ka hoʻomohala ʻana o ka hoʻopiʻi koʻikoʻi o ka β-ketoacidotic coma. No laila, ʻo ka mua o ke ʻano maʻi maʻi i kapa ʻia he insulin-hilinaʻi.
Wahi a nā noiʻi hou, ʻo kahi hopena autoimmune e alakaʻi i ka make o ka insulin e hana ana i nā ʻāpana ma 95% o nā hihia. Hoʻoulu ia me nā maʻi pili congenital.
ʻO ka lua o ka koho he miopitus diabetes miopitus, kahi ma ke ʻano o ka ketoacidosis, akā ʻaʻole ke ʻano o ka pale ʻana o ka maʻi. Hoʻouka pinepine ʻia e nā poʻe o ka poʻe Afrikania a i ʻole kolo ʻAmelika.
Kūleʻa ka maʻi mellitus i loko o kāna papa, aia ma kāna papa he mau manawa a huna. Ke hāʻawi nei i nā loli i loko o ke kino, ua hoʻokaʻawale ka ʻina i hope o ka hoʻomohala ʻana o kahi ʻano like ʻole o ka maʻi maʻi.
- Predisposition genetic.
- Hāʻawi i nā mea: The virusx Coxsackie, cytomegalovirus, herpes, measles, rubella, mauʻu.
- ʻO nā kūmole Autoimmune: nā antibodies i nā mokupuni pancreatic o Langerhans, nā holomua holomua - insulin.
- ʻO ka maʻi diabetes mellitus: aia ka glucose i ka wikiwiki ma waena o nā palena maʻamau, hōʻike ka hoʻoliʻi hoʻokaʻawale i ka glucose.
- ʻO ka maʻi diabetes: ka make wai, ka nui o ka makemake, ka nui o ka urination, a me nā hōʻailona ʻē aʻe o ke ʻano o ka maʻi diabetes. I kēia manawa, ua luku ʻia ʻo 90% o nā cell beta.
- Nā hana pae: ka pono no nā nui o ka insulin, nā hōʻailona o ka angiopathy a me ke kūkulu ʻana o nā koi o ka maʻi maʻi.
Pēlā, i ka wā e hoʻokau ʻia ai kahi maʻi, kahi kūpono ka mua o ka maʻi mellitus i ka hana a kahi mea hoʻonāukiuki i ke ʻano o ke ʻano heʻano mauʻuhane. Pēlā pū kekahi o ka hoʻomohala ʻana o nā maʻi maʻi immunological a me latent (latent) diabetes mellitus.
Hōʻike ʻia ka hōʻike ʻana o ka maʻi hānai ma nā keiki i nā ʻike like ʻole, ua komo pū lākou me ka "meli" (kala) a me ke ʻano maʻi, kahi mau ola i hilinaʻi i ka insulin.
Me kahi papa lōʻihi a me ka holomua o ka maʻi, e kū mai ana ke kahua pae.
ʻO ka helehelena preclinical a me ka debut o ka maʻi diabetes i nā keiki
ʻO ke ʻano e hiki ai i ka luku ʻia o ka maʻi pancreatic, akā ʻaʻohe mau hōʻailona o ka maʻi maʻi, hiki i nā mau mahina a i ʻole mau makahiki. I ka wā e nānā pinepine ai, ʻaʻole paha ke keiki e hōʻike i nā mea maʻamau.
Hiki i ka hoʻomohala ʻana o ka maʻi mellitus preclinical i kahi wale nō i ʻike ʻia nā antibodies a i ʻole nā hōʻailona genetic o ka luku autoimmune o nā cell synthesizing insulin.
Ke hōʻike ʻia nei ka manaʻo e hoʻomohala i ka maʻi, mālama ʻia nā keiki a hōʻike ʻia nā haʻawina kalepona ma mua o nā pae. Ka ʻike a me ka hoʻonui aʻe ma hope o ka lālani o ia mau mea i hōʻike ʻia ka ʻike diagnostic:
- I nā pūlani islet pancreatic.
- ʻO ka glatamate decarboxylase a me ka tyrosine phosphatase.
- ʻO Autoantibodies e loaʻa i ka insulin.
Eia kekahi, ʻo ka nānā ʻana o nā mea hōʻailona genetic o ka HLA a me INS genotype, me ka hōʻuluʻulu ʻana i ka pae o ka hoʻokuʻu ʻana o ka insulin i ka pane ʻana i kahi hōʻike hoʻokaʻawale glucose intravenous.
ʻO ka hoʻomakaʻana o ke ʻano maʻi maʻi mua e loaʻa me ka nele o ka insulin. ʻO ka hopena, ʻaʻole komo ka glucose i nā pūpona, a loaʻa i kona koko ka nui o ka nui. Hoʻopau ka ʻiʻo Muscle liʻiliʻi i ka glucose, kahi e alakaʻi ai i ka luku. Hoʻomaka ʻia nā huamona amino i loko o kēia kaʻina hana mai ke koko e ka ate a hoʻohana ʻia no ka synthesis o glucose.
ʻO ka hakakā o ka momona e alakaʻi ai i ka hoʻonui i ka pae o nā momona momona i loko o ke koko a me ka hoʻokumuʻana i nā molika lipid hou a me nā kino ketone mai o lākou i ka ate. Hoʻemi ʻia ka hoʻokumu ʻana o ka glycogen, a ua hoʻonui ʻia kona wāwahi. Ke wehewehe nei kēia mau kaʻina i nā hōʻike kuikahi o nā maʻi maʻi 1.
ʻOiai ka manaʻo o ka hoʻomaka ʻana i ka maʻi diabetes i nā keiki he mau ʻoi loa, ʻōwili, ke alakaʻi ʻia e ka lā latene e mau ana i kekahi mau makahiki. I loko o kēia manawa, ma lalo o ka mana o nā maʻi maʻi viral, ka pōʻino o ke kino, ke kaumaha, ka maʻiʻa ʻana.
A laila, emi ka hana o ka insulin, akā no ka mea lōʻihi loa ma muli o kona koena synthesis synthe i mālama ʻia i loko o nā palena maʻamau.
Ma hope o ka make nui ʻana o nā pūliki islet, hele mai nā hōʻailona o ka maʻi diabetes, aʻo ka neʻe ʻana o ka C-peptide.
Nā hōʻailona o ka hoʻomaka ʻana o ka maʻi maʻi
Hiki ke ʻike ʻia nā mea hōʻike o ka maʻi diabetes i ka hoʻomaka mua ʻana, ʻike pinepine lākou i nā maʻi ʻē aʻe. I kēlā mau hanana, he lohi ka maʻi a paʻa ka mea maʻi i ke ʻano koʻikoʻi inā ʻike ʻo ia i ka maʻi maʻi.
I loko o kēlā mau ʻohana kahi maʻi nā mākua me ke ʻano type type 1, hōʻiliʻili nā genetic a me kahi "pre-emptive effect" ulu. ʻO ka hoʻomohala ʻana i ka maʻi diabetes i nā keiki ma mua ma mua o ko lākou mau mākua, a ʻoiai ke ʻano o ka maʻi. ʻO ka hoʻonui pinepine ʻia o ka nui o nā mea maʻi me ka maʻi type 1 ka pinepine i loaʻa ma muli o nā keiki mai 2 mau mahina a hiki i 5 mau makahiki.
Aia i nā mea hōʻike, hiki ke hoʻonāukiuki i ka maʻi maʻamau o nā maʻi ʻoi: ʻelua me ka huhū a ikaika. Hōʻike ka maʻi maʻi ikaika ʻole e ka hiʻohiʻona o nā hōʻailona liʻiliʻi e koi ana i ka maʻi ʻokoʻa.
Hoʻokomo kēia o nā hōʻailona i lalo aʻe:
- Enuresis, he hewa ia no ka maʻi ʻeha i ka maʻi maʻi.
- ʻO ka maʻi wili o ka kandidiasis kino.
- Puka, ka mea i manaʻo ʻia he hōʻailona o ka gastroenteritis.
- ʻAʻole kaupaona nā keiki a hoʻoluhi koʻikoʻi paha.
- Nā maʻi maʻi ʻeha.
- Hoʻēmi i ka hana haʻawina, hoʻemi a maikaʻi ʻole, irritability.
Hōʻike ʻia ka hoʻomaka ʻana o ka maʻi maʻi maʻamau e nā hōʻailona o ka make nui o ka maʻi, e piʻi ana i ka urination, pinepine pinepine. Me ka nui o ka momona, lilo nā keiki i ke kaumaha o ke kino ma muli o ka wai, ka adipose a me ka kiko o ka ʻiʻo.
Inā hele koke ka maʻi, a laila e lohe ʻia ke ʻala o ka acetone i ka ea lewa, maʻi rubeosis maʻi (ʻūhā o nā ʻālina) i nā ʻālina o ke keiki, lilo ka hanu a pā pinepine ʻole. Ke hoʻonui nei i ka ketoacidosis alakaʻi i ka ʻike ʻole ʻole, nā hōʻailona o ka haʻalulu i hoʻohaʻahaʻa i ka nui o ke kaomi, nui ka nui o ka naʻau, cyanosis o nā manamana.
Loaʻa i nā pēpē mua ka momona maikaʻi, akā e holomua ana kā lākou kaumaha no ka manawa pōkole, a laila ketoacidosis a me ka huihui o ka meaʻai mai loko mai o ka ʻōpū. I ka wā e hiki mai ana, pili nā kiʻi o ka lāʻau lapaʻau me ka hoʻomaka ʻana o ka maʻi, ke ʻano o kahi kohu koma a ʻokoʻa septic.
Inā hana ʻia ka lolo o ka maʻi maʻi, akā aia nō he kānalua e pili ana i kēia ʻano maʻi, a laila e ʻōlelo ʻia nā hōʻailona ma ke kākoʻo ʻana i ka insulin-hilinaʻi.
- Ketonuria
- Kau ka momona kino kino.
- Kuhiʻole i ka momona, metabolic syndrome, hypertension arterial.
He aha ka meli no ka maʻi diabetes?
I ka hoʻomakaʻana o ke ʻano maʻi mellitus type 1, he manawa pōkole loa ka manawa e nalo ai ka makemake o ka hoʻomehana ʻana o ka insulin a i ʻole ka pono no ia e hoʻemi ʻoi maoli. Ua kapa ʻia kēia manawa ʻo "Honi." I kēia manawa, aneane loaʻa nā keiki āpau e emi a nui ka insulin, a hiki i ka ʻāpana he 0.5 i ka lā.
ʻO ka hana o kēlā mau hoʻomohala ʻano noʻonoʻo ma muli o ka mea e hoʻoneʻe ka pancreas i nā mālama hope loa o nā seleka beta a ua huna ʻia ka insulin, akā ʻaʻole lawa ia e hoʻopiha piha i ka nui o ka glucose i loko o ke koko. ʻO ka loaʻa ʻana o ka maʻi diagnostic no ka hoʻohaʻahaʻa ʻana i ka maʻa o ka insulin o ke kiʻekiʻe o ka hemoglobin glycated ma lalo o 7%.
ʻO ka lōʻihi o ka pohilima ma nā lā he mau mahina paha. I ka manawa o kēia manawa, hiki i nā keiki ke haki i ka kīʻaha, ʻaʻole pono e mālama i ka pae i makemake ʻia o ka hana pilikino, akā ke mau nei ka pae o ka glycemia. ʻO kēia holomua e alakaʻi i ka hōʻole i ka insulin, me ka maikaʻi o ke keiki.
ʻO nā hopena o ka haʻalele ʻole ʻia ʻana o ka hoʻomākaukau ʻana i ka insulin e alakaʻi i ka decompensation.
Aia kekahi hiʻohiʻona: ma mua o ke ketoacidosis ma ka hoʻomaka ʻana o ka maʻi mellitus no ke ʻano type 1 ʻano, ʻaʻole paha e hele a ʻokiʻoki paha ka hana o ka hala.
Ke hilinaʻi nei ʻo insulin
Me ka kiʻi o ka maʻi maʻamau i ka maʻi maʻi, ka emi iki o ka hoʻemi ʻana i ke koena o ka insulin i ka pancreas. Hoʻonui ʻia kēia kaʻina e nā maʻi concomitant, nā maʻi, ke kaumaha, ke kīnā ʻole.
Hōʻike nā hoʻokolohua Antibody i ka emi o ka autoallergy, no ka mea, make nā cell beta. ʻO kā lākou make piha i ka 3 i ka 5 mau makahiki. Ke kū ka pae o ka protein o ka glycated i ke koko, a i ʻole ka loli i loko o nā moku, e alakaʻi ana i nā hoʻopiʻi i ka ʻano o ka neuropathy, nephropathy, retinopathy.
ʻO kekahi o nā hiʻohiʻona o ka papa o ka maʻi type kīpuna 1 i nā keiki a i ʻole nā ʻōpio, ʻo ka hoʻomohala ʻana o ka maʻi labile. ʻO kēia ma muli o ka loaʻa ʻana o nā antibodies i nā sela pancreatic i hoʻoulu ai i ka ʻenehana i nā insulin i nā umauma o nā ʻiʻo, ka adipose tissue a me ka ate.
ʻO ke kikowaena o nā antibodies a me nā mea nānā aku e alakaʻi i kahi emi o ka glucose o ke koko. Hana kēia i ka hoʻokaʻawale i ka hoʻokaʻawale ʻana o ka ʻōnaehana a me ka hyperglycemia hele ma muli o ka hana o nā hormones stress. ʻO ka overdose o ka insulin a i ʻole kaʻauʻau kai ke loaʻa nā hopena like. He pōʻino no ka hahai ʻole i nā loina o ka meaʻai no ka maʻi type o ka maʻi 1.
ʻO nā maʻi maʻi ʻōpio he mau ʻokoʻa like i ka:
- Kāne paʻa i ka ʻōnaehana hae.
- Hoʻopiʻi pinepine pinepine i ka regimen mo ka hoʻokele ʻana o ka insulin a me ka ʻaina o ka meaʻai.
- Hoʻoikaika glucose hoʻomehana.
- Papa papa ʻili me nā poloka o ka hypoglycemia a me ka ketoacidosis.
- ʻO ka noʻonoʻo noʻonoʻo a me ka noʻonoʻo noʻonoʻo.
- ʻAkahi i ka inu wai a me ka uahi.
Ma muli o ka hana hui pū ʻana o ia ʻano mea, hele mai ka hoʻokuʻu ʻana o nā hormone contrainsular: adrenaline, prolactin, androgens, catecholamines, prolactin, adrenocorticotropic hormone, chorionic gonadotropin a progesterone.
Hoʻonui ka nui o nā hormones āpau i ka pono o ka insulin ma muli o ka hoʻonui o nā pae glucose koko i ka wā e hoʻokuʻu ai lākou i ka moe vascular. E wehewehe aku nō kēia i ka hoʻonui ʻana o ka glycemia i ke kakahiaka me ka hōʻeu ʻole ʻana o ka pō e hāʻule ana i ke kō - ke "wanaʻaoʻao kakahiaka" pili i ka pō e piʻi ana i ka hormone ulu.
Nā hiʻohiʻona o ka mālamaʻana i ka maʻi diabetes i nā keiki
Hoʻohana pinepine ʻia ka nānā ʻana i ka maʻi diabetes i nā keiki me ka hoʻomākaukau ʻana o ka insulin kanaka. No ka mea ua hoʻokumu ʻia kēia insulin e ka ʻenehana genetic, he liʻiliʻi iki ia me ka hopena o nā keiki a maʻi iki ʻole ke ʻano.
Koho ʻia ka koho o ka ʻikake ma ke kaupaona ʻana, ka makahiki o ke keiki a me kahi mea e hōʻike ana i ke kiʻekiʻe o ka glucose i ke koko. ʻO ke kumuhana o ka hoʻohana ʻana i ka insulin i nā keiki e pono loa e like me ka hiki a ke ʻano o ka physiological o ka insulin intake mai ka pancreas.
No ka hana ʻana i kēia, hoʻohana i ke ʻano o ke ʻano o ke ʻano o ka insulin, ka mea i kapa ʻia ʻo ke kumu-bolus. Hoʻohana ʻia ka insulin-lōʻihi e hana i nā keiki i ke kakahiaka a me ke ahiahi e hoʻololi i ka hūnā basal maʻamau.
A laila, ma mua o kēlā me kēia pāʻina, ua hoʻokomo ʻia kahi mahele iki o nā hana pōkole o ka hana pōkole i mea e pale ai i ka piʻi ʻana o ke kōpaʻa o ke koko ma hope o ka ʻai ʻana, a me ka hoʻihoʻi ʻia mai nā ʻaina mai ka meaʻai.
Ke hoʻomalu nei i ka papa o ka maʻi maʻi a mālama i ka glycemia paʻa, ua ʻōlelo ʻia:
- ʻO ka hoʻomaka ʻana o nā kaohi i koho ʻia ai i kēlā me kēia.
- Ke hoʻokō nei me nā meaʻai.
- Hoʻomakepī i ke kōniha a me ka hoʻemi ʻana i nā mea kālai a me nā ʻaʻa holoholona.
- Hoʻohana maʻamau i ka maʻi maʻi no ka maʻi maʻamau i kēlā me kēia lā.
I ke wikiō ma kēia moʻolelo, ua kamaʻilio ʻo Elena Malysheva e pili ana i ka maʻi diabetes.
