Ma kāna palapala hoʻopōmaikaʻi, ʻo ka maʻi diabetes he lua mākia-insulin e pili ana i ka mellitus (DM 1), akā e hui pū ana i nā hiʻohiʻona o nā ʻano mua a me nā lua.
ʻO ke kumu o ka hele ʻana ka lōʻihi i loko o ke koko o ka nui o ka corticosteroids (nā huahana a me ka adrenal cortex) e alakaʻi ai i ka pancreas ma muli o ka hōʻino i kāna mau cell.
ʻĀmaʻomaʻo
I nā hoʻomaka mua o ka maʻi, ua keu ka nui o nā corticosteroids i nā hōʻeha o nā pona o nā pancreas endocrine, akā mau ka hana ʻana o ka insulin. ʻO kēia ka paʻakikī - ua holo mua ka maʻi, akā ke nawaliwali nei nā hōʻailona a ʻaʻole wikiwiki ka mea maʻi e ʻimi i kahi kōkua olakino.
Me kahi hoʻopau piha o ka hoʻokuʻu ʻana i ka insulin, ʻike ʻia nā hōʻailona o ka maʻi mellitus maʻamau maʻi maʻamau:
- Polyuria
- Polikiola;
- Weupuaa
- Kauʻeha;
- ʻO kahi kūlana ʻona.
ʻAʻole maʻamau ka lilo kaumaha koʻikoʻi no ka maʻi mellitus no ka maʻi maʻi, e like me ka loli wikiwiki ʻana i ka glycemia. ʻO ke kauʻana o ke kō a me ka acetone i loko o ke ʻano o ke ʻano o ke kino (ke koko a me ka urine) kokoke loa i kahi maʻamau. ʻO kēia mea paʻakikī i ka hana maʻalahi.
ʻO nā kumu no ka helehelena
Puhi ka maʻi Steroid ma muli o ka nui o ka corticosteroids i loko o ke koko o ke kanaka. ʻO nā kumu no kēia keu e hiki ke exogenous a me ka endogenous.
Me nā kumu endogenous, hiki ke loaʻa ka nui o nā hormones i ka hopena o nā maʻi o ka pūnaehana endocrine. Me ka exogenous - ka nui o nā hormones e hele ma hope o ka hoʻohana mau ʻana i nā lāʻau lapaola glucocorticosteroid.
Hoʻohālikona
Hiki i ke kumu maʻi Steroid ke kumu:
- Diuretics Thiazide (Ezidrex, Hypothiazide).
- ʻO nā lāʻau lapaʻau e hoʻohana nei i ka mālamaʻana i nā hopena kūlohelohe, polyarthritis, diphtheria, pneumonia, typhoid fever, maʻi mononukleosis a me nā maʻi ʻē aʻe he nui, ʻo ia hoʻi nā autoimmune. ʻO kēia ʻ oflelo lapaʻau e komo pū me Betaspan, Dexamethasone, Prednisolone, Dexon, Anaprilin.
- ʻO nā lāʻau anti-inflammatory i hoʻohana ʻia ma hope o nā lāʻau hoʻololi i ka lolo.
- ʻO nā pōpilikia mana hānau.
ʻO nā kumu Endogenous
ʻO ka hana maikaʻiʻole o nā kelima pituitary e hoʻopilikia i ka pale ʻana i nā kopa a me nā ʻili o ke kino i ka insulin. I waena o nā kūlana pathological nui, he pinepine ka hālāwai me Hisenko-Cush, ka mea i hōʻike ʻia e ka nui o ka neʻe ʻana o ka hormone cortisol e ka adrenal cortex.
Hōʻike pinepine ʻia nei kēlā ʻano maʻi i ka wā o ke ʻano o ka maʻi Herenko-Cush, ʻokoʻa ka ʻokoʻa mai ke ahulau i loko o kēlā hyperspunction o ka adrenal cortex i ke kekona.
ʻO ke kumu nui o ka maʻi ka pituitary microadenoma.
ʻO nā maʻi Graves (goiter toxic), kahi maʻi thyroid autoimmune i hoʻoemi ʻia nā puka ʻana a me ka piʻi ʻana o ke koko glucose, hiki nō hoʻi i ke alakaʻi o ka maʻi diabetes.
ʻO kahi hui
ʻAʻole kūkulu ʻia nā maʻi Steroid i nā maʻi āpau e lawe nei i nā lāʻau lapaʻau corticosteroid. Aia kekahi mau mea e hoʻonui ai i ke ʻano o ka hoʻomohala ʻana i kēia ʻano maʻi:
predisposition genetic;
- ʻO ke kaumaha nui;
- Hypodynamia;
- ʻAʻohe meaʻai kūpono.
ʻO ka kaupaona nui, he hiki nō hoʻi ke hopena ma muli o ka hana kūlohelohe o ke kino, e alakaʻi i ka hoʻonui o ke koko o ka immunoreactive insulin, lipids, cholesterol, glucose, a me ka hōʻino i ke koko. Me ka hoʻonui ʻana o ka ʻike mākaʻikaʻi kino kino, kahi i helu ʻia me ka hoʻokaʻawale ʻana i ke paona ma o ka square o ka ulu i loko o nā mita, a i 27 kg / m2, ke alakaʻi nei kēia i ka emi o ka noʻonoʻo o nā io i nā insulin.
ʻO ka nui o ka meli maʻalahi, maʻalahi i ka hoʻoliʻiliʻi (kaomi gula, ka meli), nā kaola māmā a me ka hoʻohaʻahaʻa ʻana i ka protein i ka meaʻai e hoʻopau i nā kaʻina metabola i loko o ke kino, kahi e hiki ai ke hoʻomoʻokeʻo.
Naʻi hoʻolika
ʻO ka paʻakikī o ka hopena o kēia maʻi, ʻo nā mākaʻikaʻi o nā hōʻike o ke koko a me nā urine i hiki ke hōʻiliʻili iki i nā mea maʻamau i hoʻokumu ʻia. ʻO ke ala maʻi ʻoi aku ka pololei ʻoi aku ka hoʻāʻo ʻana ka glucose, kahi e hoʻoholo ai i ka loaʻa o nā prediabetes.
Hiki ke hoʻomaopopo i ka maʻi ʻo ka maʻi mellitus ma ka hoʻonui ʻana i ke koko glucose mai 6 mmol / L ma kahi ʻōpū ʻole i ka 11 mmol / L ma hope o ke kuʻi ʻana me ka hopena glucose. A laila hōʻike ʻia kāna ʻano.
No ka hoʻoholoʻana i ka maʻi diabetes, hana ʻia nā hoʻokolike hou: 17-ketosteroids a me 17-hydroxycorticosteroids i ka pāʻai, ka hoʻāʻo ʻana o ke koko no ke kiʻekiʻe o nā huina i hana ʻia e ka adrenal cortex, ka mea ʻai keluitary.
Hoʻomaʻamaʻa
Hana ʻia ka maʻi maʻi Steroid e like me nā ʻōnaehana like me ka maʻi maʻi type 2 a ʻoi like nā hōʻailona no ka uku uku.
Hoʻohana maikaʻi ʻia ka maʻi diabetes maʻi penei:
- Hōʻalo ʻia o nā corticosteroids;
- Kūʻai Insulin;
- Kaweawe;
- Ka lawe ʻana i nā lāʻau antidiabetic;
- Hoʻolā hewa.
Me ke ʻano o ka exogenous i ka hoʻomohala ʻana o ka maʻi (ka hoʻohana ʻana o nā glucocorticoids), pono e hooki i kā lākou lawelawe a koho i nā analogue palekana. ʻO ka pae hou o ka papa meaʻai, he hoʻohana ʻia, nā hoʻohana ʻana o nā kuʻuna hypoglycemic a me ka hoʻomehana ʻana o dosage.
Me ka hypercorticism endogenous, ke kumu ka maʻi maʻamau o ka maʻi e ka maʻi kino o ke kino ponoʻī, ua hana pinepine ʻia nā interventions, e komo pū ana i nā palupalu nui i nā kelepa adrenal.
Pono e hoʻohana pū ʻia ka hoʻohana ʻana o nā lāʻau antidiabetic me nā inikini insulin, inā ʻaʻole ʻia ka hopena hypoglycemic o kā lākou hana. ʻO kēia ke kumu o ka inikini ua hiki i kekahi manawa e hoʻomaʻamaʻa i nā pū beta a hiki iā lākou ke hoʻihoʻi hou i kā lākou hana huna.
Hoʻokomo pū ka hoʻolioli haʻahaʻa ma ka hoʻemi ʻana i ka nui o nā karoli i kēlā me kēia lā a me ka hoʻonui ʻana i ka kaomi o ka protein a me nā ʻaila ʻai. Ma muli o ka hahai ʻana i kēlā meaʻai, hoʻomaikaʻi maikaʻi ke kanaka holoʻokoʻa, pono ke ʻano o ke kino no ka insulin a me ka hoʻokaʻa ʻana i ke kō.
Ka papa lāʻau
ʻO nā lāʻau lapaʻa kōkō hāneʻe e hele mai i kekahi mau hui:
- ʻO nā kumulapula Sulfonylurea;
- Thiazolidinediones;
- Nā mea paʻa o ka glucosidase Alpha;
- Meglitinides;
- Nā ʻōwili Incretinomimetics.
Hoʻohana pinepine ʻia nā kumulā o ka sulfonylureas no ka mālama ʻana i nā maʻi maʻi type 2, a no laila, maʻi diabetes. ʻO ka hana o kā lākou hana he mea e hoʻolalelale i nā B-sela o ka hapa endocrine o ka pancreas, ma muli o ke ʻano o ka hoʻihoʻi ʻana a hoʻonui ʻia ka hana o ka insulin.
Ua kau nā kauka hele i nā lāʻau lapaʻau e like me Glycvidon, Chlorpropamide, Maninil, Tolbutamide, Glipizide.
Hoʻonui ka Meglitinides (Nateglinide, Repaglinide) i ka hana o ka insulin a me ka pae haʻahaʻa.
ʻO Biguanides (Bagomet, Metformin, Siofor, Glucofage) he lāʻau nā lāʻau e manaʻo ana e pale i ka hoʻouluʻana o ka glucose (gluconeogenesis) a hoʻonui i ke kaʻina o kāna hana. I ka haʻalele ʻana o ka inikini no ka insulin, ʻaʻole i hōʻike ʻia ka hopena o ka biguanides.
ʻO Thiazolidinediones a i ʻole glitazone (Pioglitazone a me Rosiglitazone) e hoʻonui i ka naʻau o nā ʻili, adipose tissue a me ka ate i ka insulin, e ka hoʻihoʻi ʻana i kā lākou mau mea aʻai, a hoʻomaikaʻi pū i ka metabolid lipid.
ʻO nā inhibitors o Alpha-glucosidase (Voglibosis, Glucobay, Miglitol) e lohi i ka wā e hōʻemi ai ka peke, a hōʻemi i ka hana ʻana a me ke kao o ka glucose i loko o ka ʻōpū.
ʻO ka Increcinomimetics (Liraglutid, Exenatide, Sitagliptin, Saksagliptin) he papa hou o nā lāʻau antidiabetic, ka ʻano hana o ka hana o ka mea i kau ʻia ma luna o nā waiwai o ka incretins, nā peʻe hilo ʻia e kekahi mau ʻāpana o ka ʻōpū liʻiliʻi ma hope o ka ʻai ʻana. Hoʻonui nā intake i ka hoʻokuʻuʻana i ka insulin, e hoʻohaʻahaʻa i nā pae glucose.
Hōʻike ʻia ka maʻi Steroid e ke ʻano paʻa a me ka papa haʻahaʻa. Pono e hoʻomaʻamaʻa ʻia nā maʻi like ʻole a komo wale nō i nā inikini insulin a me ka hoʻohana ʻana i nā lāʻau hoʻohaʻahaʻa i ke kō, akā he meaʻai pū kekahi me ke ʻano hana.
