I kēlā me kēia makahiki, ʻo ka nui o nā poʻe i loaʻa i ka maʻi diabetes e hoʻomau mau ana. Hoʻoholo ʻia ka ʻatikala i nā makahiki ma hope mai, no laila, hiki ʻole ke hoʻokaʻawale loa ia. Loaʻa i ke kakahiaka, ke hoʻomohala ʻana o nā hoʻopiʻi kūpaʻa, ke kiʻekiʻe make - ʻo ia ke ʻano o kēia maʻi.
He nui nā ʻano maʻi o ke maʻi maʻi; hiki ia i nā makahiki makua, nā wahine hāpai, a me nā keiki. ʻO nā hōʻailona āpau a me nā hōʻailona o nā kūlana pathological i hui pū ʻia e ka mea hoʻokahi - hyperglycemia (hoʻonui i nā helu o ka glucose i loko o ke koko), i hōʻoia ʻia e ke kaʻina hana hana. Ma kēiaʻatikala, e noʻonoʻo mākou i ke koina o ke kō o ke koko a ʻike lākou i ka maʻi diabetes, he aha nā hōʻailona no ka hōʻoia ʻana i ka nui o ka maʻi, me nā ala āpau e hana ai i ka maʻi ʻokoʻa o ka maʻi.
He aha nā ʻano maʻi a i ke kū mai hoʻi
Hoʻomaopopo ʻia nā maʻi mellitus i kahi palakiko pila e kū mai ana mai ka nele i ka hana pono o ka nui o ka insulin a i ʻole ka hana hewa i loko o ke kino o ke kanaka. He ʻano maʻamau ka koho maʻamau no ka maʻi o ka maʻi maʻamau - hilinaʻi nui i ka insulin. No kekahi mau kumu, ʻaʻole i hiki i ka ʻenehana insulin o ka pancreas ke hana i ka synthesize i ka nui o ke ʻano o ke ʻano ikaika o hormonally e pono ai no ka hoʻolana ʻana o nā molekō o ke kō mai loko o ke kahe i loko o nā puna i ka pōkole.
I ka lua o nā ʻano (non-insulin-depend-diabetes), he hao ka nui o ka hormone, akā ua hopena kona hopena i nā pūpū a me nā ʻili. ʻAʻole "ʻike" ka periphery i ka insulin, ʻo ia ka mea ʻaʻole hiki ke haki i ke kō i loko o nā ʻāpana me kona kōkua. ʻO ka hopena ka ʻike ka nui o nā io i ka pōloli loa o ka ikehu, a pau ka glucose i ke koko i loko o ka nui.
Nā kumu kumu o ka insulin-depend-pathology o ka pathology:
- heredity - inā aia kahi hoahānau pili maʻi, ʻo ka manawa e "loaʻa" ʻo ia ka maʻi like i hoʻonui i nā manawa pinepine;
- nā maʻi o ka maʻi viral - ke kamaʻilio nei mākou e pili ana i nā puʻu, Coxsackie virus, rubella, enteroviruses;
- ka heleʻana o nā antibodies e hana i nā maʻi pancreatic i hana i ka hana o ka insulin hormone.
ʻO ka ʻano 1 o ka "maʻi ʻoluʻolu" i hoʻoili ʻia e ke ʻano ka mea i hōʻano ʻia, Type 2 - e ka mea pule
ʻO ka maʻi diabetes type 2 ka nui o nā papa inoa o nā kumu hiki. E pili ana kēia:
- hoʻoilina ʻōna;
- kaumaha nui o ke kino - ʻo ka mea nui e weliweli loa inā i hui pū ʻia me ka atherosclerosis, ke koko kiʻekiʻe;
- sedentary lifestyle;
- kuʻi ʻole o nā lula o ka ʻai maikaʻi;
- pathology o ke ʻano o ka cardiovascular ma mua;
- mau ka hopena o ke kaumaha;
- lāʻau lapaʻau lōʻihi me nā lāʻau lapaʻau.
ʻAno ʻano Gestational
Hana ʻia ka maʻi maʻi maʻi gestational i nā wahine hāpai i loaʻa i ka maʻi kūlohelohe i kahi o ko lākou kūlana "hoihoi". Manaʻo nā makuahine nona ka pathology ma hope o ka 20 wiki o ka hānau ʻana i kahi pēpē. Hoʻohālike ka hana hoʻomohala e like me ke ʻano o ka maʻi lua, ʻo ia hoʻi, ʻo ka pancreas a ka wahine i hana i ka nui o ka ulu ʻana o ka hormone ikaika, akā pau nā pilala i kona naʻau.
Nā hōʻailona Diagnostic no ka maʻi i nā maʻi maʻi ʻole
Nui kekahi mau hōʻailona i ka kumu e hōʻoia ʻia ai ka hopena o ka maʻi maʻi.
- ʻO ka pae kōʻai i loko o ke kahawai, kahi i hoʻoholo ʻia e ka lawe ʻana i ka biomaterial mai kahi vein ma hope o 8 mau hola o ka hoʻokē ʻai ʻana (i.e., ma kahi ʻōpū ʻole), ma luna o 7 mmol / L. Inā mākou e kamaʻilio e pili ana i ke koko capillary (mai ka manamana lima), ʻo kēia helu he 6.1 mmol / L.
- ʻO ka loaʻa ʻana o nā hōʻailona lapaʻau a me nā hoʻopiʻi o ka mea maʻi i hui pū me nā kiʻi glycemic ma luna o 11 mmol / l i ka wā e lawe ai i nā kumuwaiwai i kēlā me kēia manawa, me ka mālama ʻole o ka meaʻai i loko o ke kino.
- ʻO ka heleʻana o ka glycemia ma mua o 11 mmol / l e kū i ke kumu o kahi hōʻike hoʻokō gula (GTT), ʻo ia hoʻi 2 mau hola ma hope o ka hoʻohana ʻana i kahi hopena momona.
Hoʻopuka ʻia ʻo GTT ma o ka lawe ʻana i ke koko venous ma mua o 1-2 mau hola ma hope o ka hoʻohana pono ʻana i kahi hopena me ka pauka glucose
He aha ka HbA1c a no ke aha ua hoʻoholo ʻia?
ʻO ka HbA1c kekahi o nā kaʻina e hiki ai iā ʻoe ke hoʻokumu i ka hele ʻana o ka maʻi diabetes. ʻO kēia ka glycated (glycosylated) hemoglobin, e hōʻike ana i ka glycemia awelika ma ka hapa hope o ka makahiki. Hōʻike ʻia ka HbA1c i kahi ʻano kūpono kūpono loa e hōʻoiaʻiʻo ana i ka paʻa o ka maʻi hyperglycemia. Ke hoʻohana nei iā ia, hiki iā ʻoe ke helu i ka hopena o ka hoʻokumu ʻana i nā hoʻopiʻi o kahi "maʻi ʻoluʻolu" i ka mea maʻi.
No ka loaʻa ʻana o ka maʻi diabetes:
- Hana ʻia kahi maʻi inā inā ʻo nā helu ma luna o 6.5%. Ma ka loaʻa ʻole o nā hōʻailona o ka maʻi, pono ke hōʻike ʻana i ke ʻano o ka hopena i hala ʻole.
- Hana ʻia ka nānā ʻana no nā keiki me ka hala ʻana o ka pathology endocrine, ʻaʻole i hōʻoia ʻia e ke kiʻi ʻoliʻoli a me ke kiʻekiʻe o ka glucose kiʻekiʻe e like me nā hopena o nā diagnostics laboratorium.
I mea e hoʻoholo ai i ka pūʻulu o nā maʻi me ka hopena kiʻekiʻe o ka hoʻomohala ʻana i ka maʻi:
ʻO ka hoʻomohala ʻana o ka maʻi maʻi i nā keiki- ʻO nā mea maʻi e loaʻa nā hōʻailona o ka hoʻomanawanui i ka hoʻohaʻahaʻa glucose e ʻike ʻia no ka mea ʻaʻole hiki i kahi loiloi koko koko ke hiki ke hōʻike i ka hoʻomau o ka maʻi.
- Ua kuhikuhi ʻia ka huli ʻana no nā maʻi e loaʻa ana i ka loiloi mua o ka hemoglobin glycosylated ma ka pae o 6.0-6.4%.
ʻO ka poʻe maʻi ʻole i loaʻa ʻole i nā maʻi kikoʻī o ka maʻi maʻi e ʻike ʻia i nā hanana i lalo nei (e like me ka ʻōlelo ʻana e nā loea ʻike honua).
- ke kaumaha kino kiʻekiʻe i hui pūʻia me kahi ala maʻalahi;
- ka heleʻana o kahi ʻano hana like ole o ka maʻi i nā ʻohana pili;
- wahine i hānai i kahi pēpē paona ʻoi aku ma mua o 4.5 kg a i hoʻokumu paha i ka maʻi gestational i ka wā hāpai;
- ke koko kiʻekiʻe;
- pānuʻuehana polycystic.
Pono ka mea maʻi e hele i ka endocrinologist no ka maʻi maʻi.
Nui! ʻO nā maʻi āpau i ʻoi aku ma mua o 45 mau makahiki me ka ʻole o nā kūlana i luna e nānā ʻia ai e nānā i ke kiʻekiʻe o ka hemoglobin glycosylated.
Pehea e loaʻa ai nā wahine hāpai?
ʻElua hiʻohiʻona. Ma ka hihia mua, lawe ka wahine i kahi keiki a loaʻa iā ia kahi ʻano pregestational o ka maʻi, ʻo ia hoʻi, ua ala ʻia kāna ʻano kulekele ʻoi aʻe ma mua o ka hoʻomaka ʻana o ka manaʻo (ʻoiai hiki iā ia ke ʻike e pili ana i ka loaʻa ʻana o ka maʻi maʻi i ka wā hāpai). Hoʻopilikia loa kēia puka no ke kino o ka makuahine a no kāna pēpē, no ka mea ua hoʻoweliweli ʻo ia i ka hoʻomohala ʻana o ka hōʻea o ka congenital ma ke ʻāpana o ka hāpai ʻana, ʻo ka hoʻokaʻawale kūʻokoʻa o ka hāpai ʻana, a ka hānau.
Ke kū nei ka puka gestational ma lalo o ka mana o nā hormone placental, e hoʻemi ana i ka nui o ka insulin i hana a hōʻemi i ka hoʻoweliweli ʻana o nā pūpū a me nā ʻili i loko. ʻO nā wahine kūpono a pau i ka manawa 22 a 24 mau pule, e hoʻāʻo ʻia no ka hoʻohaʻahaʻa glucose.
Hoʻ lawe ʻia ia ma muli aʻe o. Lawe ka wahine i ke koko mai ka manamana lima a i ʻole vein, i ʻike ʻole ʻo ia i ʻai i kekahi mea i nā hola 10-12 hope loa. A laila inu ʻo ia i kahi hoʻonā e pili ana i ka glucose (ua kūʻai ʻia ka paukena i nā lāʻau lapaʻau a loaʻa paha i loko o nā limahana). No hoʻokahi hola, ʻo ka makuahine nona ka mana i loko o ka mālie, mai hele nui, ʻaʻole e ʻai. Ma hope o ka hala ʻana o ka manawa, lawe ʻia ka sampling koko e like me nā kānāwai like ʻole no ka manawa mua loa.
A laila, no kahi hola aʻe, ʻaʻole iʻai ka mea nānā, pale i ke hopohopo, piʻi i ke ala a me nā ukana ʻē aʻe, a lawe hou i ka biomaterial. Hiki ke loaʻa ka hopena o ka loiloi i ka lā aʻe mai kou kauka.
Ua hoʻokumu ʻia ke ʻano o ka maʻi e kū nei ma ke kumu o ʻelua mau manawa o ka huli ʻimi. Hoʻopili ʻia kaʻu Phase i ka hoʻopiʻi mua ʻana o ka wahine i kahi gynecologist no ke kau inoa. Koho ke kauka i nā hoʻokolohua aʻe:
- ka hookeai ʻaina koko gula;
- ka hoʻoholo kūhelu ʻana i ka glycemia;
- pae kiʻekiʻe glycosylated hemoglobin.
Kūkā ʻia me ka maʻi gestational me nā hopena aʻe:
- kahe koko mai loko o kahi vein - 5.1-7.0 mmol / l;
- hemoglobin glycosylated - ʻoi aku ma mua o 6,5%
- glycemia tupono - ma luna o 11 mmol / l.
Hoʻopili ʻia ka Phase II ma hope o 22 mau pule o ka hapai, i koho ʻia i kahi hoʻāʻo me ka ukana holi (GTT). I nā ʻōkuhi ua hōʻoia i ka maʻi maʻi o ka maʻi gestational:
- glycemia ma kahi ʻōpū ʻole - ma luna o 5.1 mmol / l;
- ma ka welau koko ʻelua (i hoʻokahi hola) - ma luna o 10 mmol / l;
- ma ka pā ʻekolu (ʻehā hola aʻe) - ma luna o 8.4 mmol / l.
Inā hoʻoholo ka kauka i ka hele ʻana o kahi kūlana pathological, ua koho ʻia kekahi ʻano lāʻau lapaʻau ponoʻī. Ma ke ʻano he kānāwai, ua hoʻohālikelike ʻia nā wahine hāpai i ka insulin.
ʻO ka hoʻomohala ʻana o ke ʻano maʻi maʻi maʻamau i nā keiki
Kūleʻa nā mea hōʻike i ke nānā ʻana i kahi keiki no ka loaʻa ʻana o kahi ʻano "maʻi ʻala" 2 inā loaʻa kekahi koʻikoʻi maʻamau, ka mea i hui pū ʻia me nā mea ʻelua ʻelua ma lalo nei:
- ka heleʻana o kahi ʻano hana kūʻokoʻa o ka ʻimi kūwili ʻana i kekahi o nā hoahānau pili ʻole paha;
- lāhui i ka hopena kiʻekiʻe o ka hoʻomohala ʻana i ka maʻi;
- ka heleʻana o ke kahe koko kiʻekiʻe, ke kiʻekiʻe o ka cholesterol ma ke koko;
- ka maʻi hānai ma ka wā ma mua.
ʻO ke kaumaha nui o ke keiki i ka wā hānau, ʻo kekahi kumu ʻē aʻe no ka maʻi ʻana i ka maʻi i ka wā o ka wā ʻōpiopio
Pono e hoʻomaka ka maʻi maʻi i nā makahiki he 10 a kau hou i kēlā me kēia 3 mau makahiki. Manaʻo nā Endocrinologists e nānā i ka helu i ka helu ʻai wikiwiki.
ʻO nā mākaʻikaʻi no ka hoʻoholo ʻana i ka ʻeha o ka maʻi
Inā hana ka hoʻokau maʻi o ka papa maʻi maʻa, pono ke kau a ke kauka i ka hōʻeha. He mea koʻikoʻi kēia no ka mālamaʻana i ka noho o ka mea maʻi o ka dinamics a no ke koho pono ʻana i nā regimens o ka mālama ʻana. Ua hōʻoia ʻia kahi maʻi maʻi maʻi i ka wā e hele ʻole ʻole nā mea holi i ka paepae o 8 mmol / L, a i loko o ka iomi ua pau ʻole ia. Ke hoʻokō nei ka uku o ke kūlana ma ka hoʻoponopono ʻana i ka ʻai pilikino a me ke ʻano hana. Hoʻololi ʻole ka hoʻopiʻi ʻana o ka maʻi a i ʻole ka hoʻomaka ʻana o ka hana mua o ka maʻi vascular.
Hōʻike ʻia ka hōʻaha iki o ka maʻi maʻalahi e nā kiʻi glucose i 14 mmol / L; ʻo kahi liʻiliʻi liʻiliʻi o ke kō i ʻike ʻia ma ka urine. Ke hele mai nei nā kūlana Ketoacidotic. ʻAʻole hiki ke mālama i ke kiʻekiʻe o ka glycemia me kahi lāʻauʻai i hoʻokahi. Ua kauka nā kauka i nā lāʻau lapaʻau i ʻole e lawe ai i nā papa o nā lāʻau lapaʻau haʻahaʻa.
E kū'ē i ke kua o kahi hopena koʻikoʻi, hōʻike ka hyperglycemia i nā helu ma luna o 14 mmol / l, ʻike nui ka nui o ka glucose i ka urine. Hoʻopiʻi ka poʻe maʻi me ka piʻi pinepine o kā lākou kōpuka, a ma waena a i lalo, kū ʻia ka ketoacidosis.
ʻOkoʻa ka maʻi ʻokoʻa
Ma muli o nā noi hana noiʻi a me nā mea kōkua, he mea nui e hana i kahi hoʻokaʻawale. ʻaʻole wale ke maʻi ma waena o ka maʻi maʻi a me nā maʻi ʻē aʻe, akā nā ʻano o ka "maʻi ʻoliʻoli" ponoʻī. Hana ʻia kahi ʻano maʻi ʻokoʻa ma hope o ke hoʻohālikelike ʻana me nā ala ʻē aʻe e pili ana i nā syndromes nui.
E like me ka heleʻana o nā hōʻailona lapaʻau (make wai pathological a me ka hopena o ka urine nui), pono e hoʻokaʻawale i ka maʻi:
- diabetes insipidus;
- pyelonephritis palole a i ʻole hoʻopōmaikaʻi o kaʻeha;
- hyperaldosteronism kumu mua;
- kahaa-hana o nā kūmole poli o ka parathyroid;
- ka neurogen polydipsia a me ka polyuria.
Ma ke kau koko koko kiʻekiʻe:
- mai ka maʻi lolo;
- ʻ'Slelo ʻia Heenko-Cush;
- acromegaly;
- nā ʻaʻe adrenal;
- Nā neurogenic a me ka hyperglycemia meaʻai.
ʻO Pheochromocytoma kekahi o nā kūlana i pono e hana i ka maʻi ʻokoʻa
Ma ka loaʻaʻana o ka glucose i ka urine:
- mai ka ulana wai;
- nā ala o nā keiki;
- nā glucosuria o nā wahine hāpai;
- meaʻai glucosuria;
- i nā mea ʻē aʻe kahi e hele ai ka hyperglycemia.
ʻAʻole he lāʻau lapaʻau wale nō, akāʻo kahi maʻi maʻi hānai. ʻOkoʻa nā mea e kau ʻia e nā poʻe loea i loko ʻole ia me ka inoa o ka maʻi, akā nā pilikia nui o ka mea maʻi. Wahi a ka maʻi maʻi hānai, hāʻawi nā kahu hānai i ka mālama pono maʻi.
Ma kahi hoʻokolohua kūpono i hiki iā ʻoe ke koho i kahi hoʻoponopono lapaʻau kūpono e hiki ai iā ʻoe ke hōʻea koke i kahi kamaʻāina a pale i ka hoʻoulu ʻana o nā hoʻopiʻi o nā maʻi.
