ʻO ka maʻi mellitus ka maʻi maʻamau he mea metabolic o ka endocrine system, i kau ʻia ma muli o ka hemo ʻana o ka insulin, ʻokoʻa kūkaʻe a paʻa paha.
ʻO ka make ʻole o ka insulin i ka maʻi diabetes i ka make ʻana o nā beta beta, nona ke kuleana, e pili ana ka mea pili me kahi hemahema i kona pilina me nā cell receptors (maʻamau no ka type 2 diabetes mellitus).
No ka maʻi mellitus, ʻo ka ho'ākāka o ka hyperglycemia ka hōʻailona mau loa e pili ana i ka hōʻino o ka aila o ka paʻakai i ka huina. Ke hoʻokau nei i ka maʻi diabetes, nā hōʻailona koʻikoʻi ka nui o ka nui o ka glucose i ke koko a me kona helehelena i loko o ka urine. Me nā poho nui o ke kō, hoʻonui ka hopena i ka urine e hoʻoheheʻe ʻia a me nā hypokalemia.
ʻO nā ʻano o ka maʻi maʻi
ʻO nā kumu no ka hoʻonui koʻikoʻi o ka nui o nā hihia o ka maʻi mellitus o ka maʻi maʻamau ʻoi aku ka maikaʻi o ka ʻike kino kino, ke ʻano hōʻemi o ke ʻano o nā pēpē hou mai nā mākua me ka maʻi maʻi maʻi, ka hoʻonui ʻana i ka manaʻo o ka nohona a me nā pālahalaha o ka momona.
ʻO ke maʻi mellitus he maʻi heterogeneous nā kumu ʻelua no nā hanana a me nā hōʻike haukapila a me nā lāʻau lapaʻau. I mea e hoʻoholo ai i ka maʻi diabetes a hana i ka maʻi kūpono, ʻelua mau koho kūʻokoʻa: type 1 a me ke ʻano maʻi type 2.
ʻO ke ʻano maʻi maʻi mua e loaʻa ana i loko o ke ʻano o ka luku ʻana i nā lāʻau beta a alakaʻi i ka nele o ka insulin ola. ʻO kāna ʻano like me LADA - latent autoimmune diabetes i nā pākeke a me nā ʻano idiopathic (non-immune). I ka maʻi maʻamau, e ʻike ʻia nā hōʻailona a me ke papa e like me nā ʻano 2, nā antibodies i nā beta beta, e like me ka ʻano 1.
Hoʻoulu ka lua o ke ʻano maʻi maʻi kūlohelohe i kahi ʻenehana o ka hoʻemi ʻana a i ʻole ka hana maʻamau o ka insulin, akā me ka nalowale o ka hoʻomaopopo ʻana iā ia - ke pale ʻana i ka insulin. ʻO hoʻokahi ʻano hana o kēia maʻi maʻi he MODY, a me ke ʻano o ka hemo genetic i ka hana o nā cell beta.
Ma ke ʻano o kēia mau ʻano maʻamau, aia paha:
- ʻO nā hiʻohiʻona o nā insulin a i ʻole nā mea hoʻokae e pili ana i nā kuleana genetic.
- Nā maʻi pancreatic - pancreatitis, tumors.
- Endocrinopathies: acromegaly, ʻO syndrome a Hisenko-Cush, hoʻopuʻi i ka goiter kūlohelohe.
- Naʻi maʻi mellitus.
- Ma muli o ka maʻi huakaʻi.
- Nā maʻi maʻi e pili ana i ka maʻi maʻi.
- ʻO ka maʻi maʻi gestational.
Ma hope o ka hoʻoholo ʻana i ke ʻano o ka maʻi maʻi, ua hoʻopaʻa ʻia kahi haʻawina o ka nui o ka maʻi. Me kahi ʻano maʻi mellitus o ka maʻi mellitus, ʻaʻohe nui o ka hāʻule nui o ke kō koko koko, ʻo ke kōʻai wikiwiki ma lalo o 8 mmol / l, ʻaʻohe mea i loko o ka urine, a i ʻole 20 g / l. He lawa ka meaʻai e uku ai. ʻAʻole ʻike ʻia nā leʻa vascular.
Hōʻike ʻia ka maʻi maʻamau i ka hoʻonui ʻana i ka glucose i ka wikiwiki i 14 mmol / l, ka makeʻana o ka glucose i ka urine i kēlā me kēia lā - a hiki i 40 g, i ka lā e loaʻa ai nā hilo i ke kiʻekiʻe o ke kō, nā koko ketone i loko o ke koko a me ka urine e puka mai. Ua kuhikuhi ʻia kahi meaʻai a me ka insulin a i nā lāʻau ʻaina e hōʻemi i ka glycemia. Loaʻa nā Angioneuropathies.
ʻO nā hōʻailona o ka maʻi maʻi maʻi:
- Ka hoʻopihapiha ʻana i ka glycemia ma luna o 14 mmol / L.
- ʻO nā hoʻololi nui i ke kōhi koko i loko o ke ao.
- ʻO Glucosuria ma mua o 40 g i kēlā me kēia lā.
- ʻO ka makeʻana o ka insulin e uku ai ma luna o 60 PIECES.
- ʻO ka hoʻomohala ʻana o ka angio-maʻi a me nā neuropathies.
E like me ke kiʻekiʻe o ka uku, hiki ke uku ʻia i ka maʻi maʻamau inā hiki ke hoʻokō i ka glucose maoli i loko o ke koko a me kona haʻalele ʻana i ka urine. ʻO nā haʻahaʻa subcompensation: glycemia ʻaʻole i kiʻekiʻe loa ma ka 13.95 mmol / l, nā poho glucose e 50 g a i ʻole i kēlā me kēia lā. ʻAʻohe huakaʻi pūʻai i loko o ka kāki.
Me ka decompensation, hele aku nā mea āpau ma waho o kēia mau palena, e hoʻoholo ana ka acetone i ka urine. Hiki i ke coma ke kūpaʻa ma hope o ka hyperglycemia.
Pehea e kū ai ke ʻano maʻi maʻi 1?
Hiki i ka ʻano maʻi mua o nā maʻi maʻi i nā ʻōpio āpau, akā ʻoi aku ka pili o nā keiki, ʻōpio a me nā ʻōpio ma lalo o 30 makahiki. Aia nā maʻi o ka maʻi kongenital, a me nā hōʻailona i nā kānaka mai 35 a 45 mau makahiki i ka pupule paha.
Kahi ʻano ʻano maʻi o ka maʻi maʻi i hōʻike ʻia e ka luku ʻana i nā pūpuna e hana ana i ka insulin ma muli o ke ʻano ʻano autoimmune. Hiki ke hoʻoneʻe ʻia ia lesion e nā maʻi, nā lāʻau, nā mea kanu, nā mea ʻala.
Kuhi kēia mau mea i waho i ke kaomi no ka hoʻōla ʻana i nā aʻai ma kekahi mau wahi o nā chromosomes. ʻO kēia ʻano o nā gen e hoʻoholo i ka hoʻohui ʻuhane a hoʻoilina.
I ka papa mua o ka maʻi, ua kū mai nā antibodies i nā beta beta i nā haʻahaʻa haʻahaʻa. ʻAʻohe mea lapaʻau hōʻailona o ka maʻi, ʻoiai, ʻaʻole i hoʻohālikelike ʻia nā mea e hoʻōla ʻia ai nā mea haki o ka insulin. ʻO ia, e hoʻohālikelike i ka pancreas me kahi luku.
A laila, ʻoiai ʻo ka luku ʻia ʻana o nā mokupuni o Langerhans e hoʻonui, e hoʻomohala ana kēia kaʻina hana:
- ʻO ka ʻūpī palu pancreatic he insulin autoimmune. Hoʻonui ka titio antibody, ʻānai ʻia nā mea beta, hoʻemi ʻia ka hana insulin.
- Ke komo ka glucose i ka meaʻai, ua hoʻoulu ʻia ka insulin i ka nui o ka nui. ʻAʻohe kekela, akā hiki ke ʻike ʻia nā mea hemahema o ka hoʻāʻo ʻana i ka glucose.
- Ua liʻiliʻi ʻo Insulin, kahi ulu lāʻau maʻamau. I kēia manawa, noho mau paha ma kahi o 5-10% o nā nui mau.
- ʻAʻole hua ʻia nā Insulin, pau ʻia nā cell āpau.
Ke hana ʻole i ka insulin, ka ate, nā uaua a me nā kiko adipose e hiki ʻole i ka lehelehe i ka glucose mai ke koko. Hoʻokiʻoki ka momona i ke kaaka o ka adipose, ʻo ia ke kumu no ka nui o ko lākou nānā ʻana i ke koko, a wāwahi ʻia nā protein i loko o nā ʻōpū, e hoʻonui ai i ke kiʻekiʻe o ka waikawa amino. Ka paʻakai i ka huamikiko momona a me nā waikawa amino i mau kino ketone, nāna e hoʻolilo ma ke kumu o ka ikehu.
Me ka piʻi o ka glucose i ka 10 mmol / l, hoʻomaka nā keiki i ka excrete glucose i loko o ka pūpū, a mai ka huki ʻana i ka wai iā ia iho, aia kahi ʻano hoʻoheheʻe inā kī ʻole ʻia kona kīnā me ka inu ʻona.
ʻO ka nalo ʻana o ka wai me ke kāpae ʻia o nā ʻāpana o nā wahi i loaʻa i ka waiʻaila - sodium, magnesium, potassium, calcium, a me ka chlorides, phosphates a me ka bikiniatate.
ʻO nā hōʻailona o ka maʻi maʻi mua
Hiki ke hoʻokaʻawale i nā hōʻailona lapaʻau o ke ʻano maʻi type 1 i ʻelua mau ʻano: hōʻailona e hōʻike ana i ke kiʻekiʻe o ka uku o ka maʻi maʻi a me nā hōʻailona o nā hōʻeha o kāna papa. ʻO ka hoʻāla nui o ka koko koko hoʻohaʻahaʻa i ka hoʻonui ʻana i ka urine, a me nā mea e pili ana i ka nui o ka makewai, ka maloʻo maloʻo, a me ka pohō nui.
Me ka hoʻonui nui aʻe o ka hyperglycemia, loli ka nui o ka makemake, ulu ka nāwaliwali ikaika, ke hele mai nā kino ketone, ʻeha ka ʻōpū o ka ʻōpū, ka ʻōpū o ka acetone mai ka ʻili a me ka ea o ka ea. ʻO ke ʻano o ka maʻi maʻamau i hōʻike ʻia e ka piʻi wikiwiki ʻana i nā hōʻailona me ka pau ʻole o ka hoʻomehana ʻana o ka insulin, no laila ʻo ka hōʻike mua ʻana o ia mea he ketoacidotic coma.
Hoʻopili ka hui lua o nā hōʻailona i ka hoʻomohala ʻana i nā hoʻopiʻi kino: me ka hoʻōla ʻole, hōʻeha ʻole o ka maʻi, hema ʻole, cardiomyopathy, cerebrovascular accident, retinopathy diabetic, polyneuropathy, ketoacidosis, a hoʻomohala i ka coma coma.
E hoʻomohala hou ʻia nā maʻi pili maʻi maʻi:
- Kāpukuhū.
- Candidiasis
- Nā maʻi genitourinary.
- Kūmole
- Nā maʻi maʻi ʻē aʻe.
No ka hana ʻana i kahi maʻi, ua lawa ia e hōʻike i nā hōʻailona maʻamau a hōʻoia i ka hyperglycemia: i ka plasma ma mua o 7 mmol / l, 2 mau hola ma hope o ka hoʻokomo o ka glucose - ʻoi aku ma mua o 11.1 mmol / l, hemoglobin glycated ua nui loa i ka 6.5%.
Pehea e maopopo ai i ka maʻi maʻamau 2?
ʻO ka uluʻana o nā maʻi diabetes type 2 e pili ana me kahi predisposition genetic a loaʻa i nā maʻi i ke ʻano o ka momona, atherosclerosis. Hiki i ka hoʻomohala ke hoʻonāukiuki i nā maʻi āpau koʻikoʻi, me ka papa o ka pancreatitis, hepatitis, overeating, ʻoi aku ka nui o ka ʻai o ka haʻalulu a me ka nele o ka hana ʻana.
Hōʻeha ka momona o ka metabolism, a me ka kiʻekiʻe o ka cholesterol, atherosclerosis, hypertension arterial a me ka maʻi naʻau coronary e alakaʻi i ka hana haʻahaʻa a me ka hoʻēmi ʻana i ka hoʻonaninua ʻana i ka insulin. I nā pilikia koʻikoʻi, hoʻonui ka hana o catecholamines a me nā glucocorticoids, e hoʻonui ai i ka ʻike o ka glucose i loko o ke koko.
Ma ke ʻano ʻelua o ka maʻi maʻi, he pilikia ka pilina ma waena o nā mea nānā a me ka insulin, ma nā papa mua o ka maʻi, mālama ʻia ka huna ʻana, a hiki ke hoʻonui ʻia ʻia. ʻO ka mea nui i hoʻonui ʻia i ka pale ʻana o ka insulin i hoʻonui ʻia ke kaumaha o ke kino, no laila, i ka wā i hoʻemi ʻia, hiki ke hana i nā pae o ka glucose i ke koko me ka papa ʻai a me nā papa.
I ka lōʻihi o ka manawa, ua hemo ka pancreas, a ua emi ka hana o ka insulin, kahi pono e hoʻololi ai i ka insulin therapy. ʻO ka hiki ke hoʻomohala ʻana i ka ketoacidosis ma ke ʻano lua o ka maʻi maʻi. ʻO ka lōʻihi o nā manawa, hiki i nā hōʻailona o ka hana i ʻole o ke keiki o ka pūpū, nā puʻuwai, ka puʻuwai a me nā kinipona ke hui pū me nā maʻi maʻamau o ka maʻi maʻi.
Ma ka uluʻana, ua hoʻokaʻawale ke ʻano type type 2:
- Kahi wale: uku hoʻolaʻa wale ʻia a ʻai ʻana paha i kahi papa o ka lāʻau lapaʻau i kēlā me kēia lā.
- Ma kahi o ka hoʻokūkū haʻahaʻa: nā hoʻahaʻa ʻana o ke kōpaʻa ma ke ʻano o nā lā 2-3 o kēlā me kēia lā e hoʻāla i nā hōʻailona o ka hyperglycemia, angiopathy ma ke ʻano o ka hana kūpono.
- Ke ʻano ikaika: ma kahi o nā papa, koi ʻia ka insulin a e hoʻoneʻe maoli ʻia ka mea maʻi i ka ʻomoʻana o ka insulin. ʻO nā maʻi helehelena koʻikoʻi.
ʻO nā hiʻohiʻona hiʻohiʻona o ka ʻano 2 ka mea e hoʻonui lohi ana nā maʻi o ka maʻi ma mua o ka maʻi o ka maʻi like, a ʻike ʻia kēia ʻano ma hope o 45 mau makahiki. ʻO nā hōʻailona maʻamau e pili ana i ka hyperglycemia like me ke ʻano maʻi type 1.
Hoʻokomo ka poʻe maʻi i ka ʻeha o ka ʻili, ka ʻula nui, nā wāwae, nā perineum, ka makewai, ka hiamoe, ke ana ʻole, ka maʻi ʻehaʻeha, nā maʻi Mycoses. I nā mea maʻi āpau, hoʻōla lohi nā lūlū, hāʻule ka lauoho, ʻoi aku hoʻi ma nā wāwae, ua ʻike ʻia nā xanthomas ma nā lau, e ulu nui ka lauoho o ka lauoho.
Hōʻā nā wāwae i nā huki, nā ʻōpū, loaʻa nā puʻupuʻu i nā iwi, nā kuʻuna, nā māiwi, nā iwi pono ʻole lohi e hele i nā hōʻalolo a me nā puʻu, nā pōkole a me ka hana ʻana o nā iwi i ka wā o ka lohi ʻana o ka holomua o ka iwi.
ʻO ka hōʻeha ʻili ma loko o ke ʻano o nā leʻaleʻa o nā lipine o ka perineum, axillary a ma lalo o nā keli mammary. Itching, ʻulaʻula a me ka suppuration o nā hopohopo. He ʻano hiʻohiʻona ka hana o nā ʻōpū, carbuncles. ʻO nā maʻi hupa ma ke ʻano o ka vulvovaginitis, balanitis, colpitis, me nā leʻaleʻa o ka waenakonu interdigital, kahi moena kuku.
Me kahi papa lōʻihi o ka maʻi maʻi a me ka uku ʻole ʻia ʻole, loaʻa nā ʻōpiopio.
- ʻO nā pathology vascular (microangiopathy a me macroangiopathy) - ke ulu ākea a me ka nahā o nā moku koko ke piʻi, nā kīwaha koko a me nā pā pleke atherosclerotic ma ke kahua o ka luku.
- Polyneuropathy Diabetic: poino i ka ʻōnaehana o peripheral i ke ʻano o ka hōʻole ʻana i nā ʻano o ka ʻano o ka ʻano he ʻano, ka hana o ka hemo, ke ʻano o ka hana ʻana o ka maʻi ulcerative lōʻihi, ischemia kiko, e alakaʻi ana i ka gangrene a me ka amputation o ka wāwae.
- Nā hana hōʻino - ka maʻi diabetic arthropathy me ka ʻeha, hoʻemi i ka holo lima i loko o nā ʻōpū, hoʻemi i ka hana o ka wai o ka synovial, hoʻonui i ka mānoanoa a me ka hiʻona.
- Hāpaiʻia ka hana renalally: nephropathy diabetes (protein i ka urine, edema, ke koko kiʻekiʻe). Me ka holomua, hoʻomohala ka glomerulosclerosis a me ka maikaʻi ʻole o ka pūlū, e koi ana i ka hemodialysis.
- ʻO ka ophthalmopathy Diabetic - ke hoʻomohala ʻana o ke ao panilima, ʻike maka, blurred, pale a me nā poʻomanaʻo i mua o nā maka, retinopathy.
- ʻO ka hapa o ka pīhoihoi o ke kikowaena i ke ʻano o ka encephalopathy maʻi: ka hoʻomanaʻo ʻana, ka ʻike naʻauao ʻana, ka psyche hoʻololi, ke ʻano o nā luhi, ke poʻo, ka dizziness, asthenia, a me nā kūlana kaumaha.
A ke hōʻike nei ka wikiō ma kēia ʻatikala i keʻano o ka ulu ʻana a me ka hoʻomohala ʻana i ka maʻi diabetes.
