Cutar sankarar mellitus a cikin yara yana da alaƙa da raunin ƙwayar cuta saboda rashin insulin. Mafi yawanci ana gano cututtukan type 1 a cikin yaro. Dalilinsa shine amsawa daga tsarin rigakafi ga ƙwayoyin cuta, gubobi, kayan abinci a kan asalin yanayin gado.
A cikin 'yan shekarun nan, saboda sha'awar ƙurar kiba ta yara, wanda ke da alaƙa da samar da abinci mai banƙyama a cikin nau'ikan abin sha mai cike da sukari, abinci mai sauri, kayan kwalliya, endocrinologists lura da karuwa da nau'in ciwon sukari na 2 tsakanin yara da matasa.
Alamar kamuwa da cutar siga a cikin yara 'yan shekaru 7 na iya kasancewa a farkon cutar, duka zazzabin cizon sauro da kuma hoto na yau da kullun a alamu na rashin ruwa da kuma asarar nauyi. A cikin lokuta na marigayi ganewar asali, yaro zai iya shigar da shi asibiti tare da alamun ƙwayar cutar coma, inda aka fara gano ciwon sukari.
Siffofin haɓakar ciwon sukari a cikin yara
Wani abu mai sanadin gado game da ciwon suga an bayyana shi a takamaiman tsarin kwayoyin halittu waɗanda ke akwai (tare da nau'in ciwon sukari na 1) akan kwayar halittar ta shida. Ana iya gano su ta hanyar nazarin abubuwan antigenic na jini leukocytes. Kasancewar waɗannan nau'ikan halittu suna ba da babbar dama kawai ta haɓakar ciwon sukari.
Wani abin tashin hankali ana iya juyar da cututtukan hoto ko bidiyo guda biyu na cututtukan huhu, kyanda, mumps, cututtukan da ke haifar da cutar sankara, Coxsackie B. ban da ƙwayoyin cuta, wasu magunguna da magunguna, farkon sarrafa madara saniya da hatsi kuma zasu iya haifar da ciwon sukari.
Bayan nunawa ga abin da ke da lahani, ƙwayoyin beta a cikin tsibirin na pancreas an lalace. Samun kayan rigakafin yana farawa ne daga abubuwan da membrane da cytoplasm na sel a jikin mutum. A cikin farji, zazzabi (insulin) ya girma azaman kumburi mai lalacewa na jiki.
Rushewar sel yana haifar da rashin insulin a cikin jini, amma hoto na yau da kullun na asibiti ba ya bayyana nan da nan, ciwon sukari a cikin haɓakarsa ya wuce matakai da yawa:
- Lokaci na preclinical: gwaje-gwaje na jini al'ada ne, babu alamun cutar, amma ƙirƙirar ƙwayoyin rigakafi a kan ƙwayoyin ƙwayoyin ƙwayar cuta ya fara.
- Ciwon sukari na daskarewa: glycemia na azumi shine al'ada, bayan cin abinci ko lokacin gudanar da gwajin haƙuri, ana gano adadin kuzarin jini na jini.
- Matsayi na alamun bayyanar cututtukan sukari: sama da kashi 85% na sel waɗanda suke samar da insulin an lalace. Akwai alamun cututtukan sukari, hyperglycemia a cikin jini.
Rage insulin ya ragu, a cikin rashin allurar sa, akwai yuwuwar haɓaka ketoacidosis tare da ƙwayar cuta tare da matsanancin rashin ƙarfi na hyperglycemia. Tare da farkon lokacin yin insulin da kuma daidaituwa na rashin aiki, ƙwaƙwalwar ƙwayar cuta na iya sake dawowa ɗayan, wanda aka nuna ta raguwa a cikin buƙatar ilimin insulin.
Wannan yanayin ana kiransa "amaryar amarci," ko kuma kawar da ciwon sukari. Tun da halayen autoimmune ba su daina ba, ƙwayoyin beta suna ci gaba da rushewa, wanda ke haifar da maimaita alamun bayyanar cutar sankara tare da buƙatar gudanar da shirye-shiryen insulin cikin rayuwar mai haƙuri.
Abubuwan da ke haifar da nau'in ciwon sukari na biyu a cikin yara sun wuce kima, yawan motsa jiki, rikice-rikice a cikin glandar thyroid, glandon adrenal, da kuma hypothalamus da pituitary gland shine yake. Wadannan abubuwan ana nuna su a gaban rage juriya ga carbohydrates, wanda aka gada.
Za a inganta ciyar da cutar sankara ta farko ta hanyar girman haihuwa, haɓaka haɓaka a cikin farkon rayuwa, da rashin abinci mai juna biyu yayin haihuwa: mafi yawan abinci mai narkewa da kuma rashin abinci mai furotin.
A cikin nau'in ciwon sukari na 2, ana fara samar da insulin a cikin isa, har ma ya ninka mai yawa, amma tsoka, hanta da ƙwayoyin nama na adipose ba za su iya amsa ta ba saboda ɗaukar nauyin wannan hormone ga takamaiman masu karɓa.
Wannan yanayin ana kiransa juriya ta insulin. Saboda haka, sabanin nau'in 1 na ciwon sukari, ba a ba da izinin kula da insulin don wannan hanyar ciwon sukari ba, kuma an shawarci marasa lafiya da su iyakance mai sauƙin carbohydrates a cikin abinci don kada su tayar da hanji da kuma ɗaukar kwayoyin da ke kara karɓar amsawar masu karɓar insulin.
Alamomin Clinical
Bayyanar cututtuka na ciwon sukari mellitus suna tasowa saboda gaskiyar cewa tare da rashin insulin ko ci gaban juriya da shi, glucose wanda ke shiga tare da abinci ko an kafa shi a cikin hanta ba zai iya shiga sel don samar da makamashi ba. Matsayi mai yawa na glucose a cikin tasoshin yana haifar da gudanawar kwarara daga kasusuwa zuwa jini bisa ga dokokin osmosis.
A cikin sel, rashin glucose yana haifar da samuwar ketone jikin, waɗanda sune tushen tushen ƙarfin kuzari. Babban ketones a cikin jini yana haifar da canzawa a cikin sakamako ga gefen acid da haɓaka alamun bayyanar guba, saboda suna da guba ga jiki, musamman ga kwakwalwa.
Alamun asibiti na cututtukan ƙwayar cuta a cikin yara ba koyaushe ke sa ya yiwu a bincikar lafiya ba, tunda za a iya rikitar dasu da cututtukan hanji ko na urinary, cututtukan fata na fungal. Mafi yawancin lokuta, nau'in ciwon sukari na 1 a cikin yara na tasowa ba zato ba tsammani kuma alamunta suna ƙaruwa koyaushe rashin insulin.
Abubuwan da ke nuna halayen ciwon sukari sune:
- M ƙishirwa.
- Urinaru mai saurin urination, saurin motsa jiki.
- Fata da bushe na mucous membranes.
- Rage nauyi tare da yawan ci.
- Itching na fata, musamman ma a cikin perineum.
- M cututtuka da yawa.
- Rashin ƙarfi da nutsuwa bayan cin abinci.
- Activityarancin aiki da kuma nuna son kai.
Thirstarin ƙishirwa a cikin yara na iya bayyana kansa a cikin shan ruwa na ruwa 3-4 a rana, irin waɗannan yara sukan farka da dare saboda sha'awar sha. Yawan yawan fitsari yana ƙaruwa zuwa lita 3-6, kuma yawan urination yana ƙaruwa sau 15-20 a rana. Farkon cutar enuresis na iya zama ɗaya daga cikin alamun farkon cutar sankarau a cikin yara.
Polyphagy, ko haɓaka ci, yana da alaƙa da asarar adadin kuzari da ke fitowa daga abinci saboda gaskiyar cewa ba za a iya amfani da carbohydrates don makamashi ba, wanda shine dalilin da yasa jiki yake buƙatar abinci koyaushe, musamman mai daɗi. A lokaci guda, yara zasu iya rasa kilogiram 5-6 a cikin ɗan gajeren lokaci a kan tushen abinci mai kyau.
Don ciwon sukari, alamun fata na ciwon sukari halaye ne:
- Peel na fata na hannaye da ƙafa.
- Dry seborrhea na fatar kan mutum.
- Ciwon sukari na kunci.
- Itching da dermatitis na fata na perineum.
- Rashin gashi.
- Acne da pyoderma.
- Kayan fata na fata. Nails da ciwon sukari ma suna shafar m.
Mucous membranes na bakin ciki yana bushe, lebe suna da haske mai launin shuɗi, kuma akwai fasa a sashin bakin.
Harshe a cikin yara ya bushe, cakulan duhu a launi, sau da yawa a cikin irin waɗannan marasa lafiya gingivitis, ana gano ƙwayar cutar stomatitis da thrush.
Bayyanar cututtukan cututtukan sukari
Tare da karuwa a cikin sukari na jini, wanda na iya zama sakamakon rashin tabbas game da cutar sankara, ana samar da jikkunan ketone da yawa: acetone, acetoacetic da hydroxybutyric acid.
Wannan tafarki na rayuwa wanda ya haifar da kwantar da hankula a cikin sel sakamakon girman osmolarity na jini, karuwar fitowar fitsari fitsari, potassium, magnesium da phosphorus. Fasawa a jiki yana haifar da rudani a cikin aikin dukkan tsarin jiki, musamman kwakwalwa da kodan.
Da farko, bayyanar cuta yana bayyana ne ta hanyar haɓaka alamu na kamuwa da cutar siga: yaro yana son sha fiye da yadda ya saba, diuresis ya tashi kuma rauni yana ƙaruwa. Sannan, tare da karuwa a cikin ketoacidosis, tashin zuciya, raguwar ci, tashin hankali ga abinci, zafin ciki wanda yayi kama da asibitin wani babban ciki, haɓaka hanta suna haɗuwa da waɗannan alamun.
Tare da ketoacidosis mai tsanani, alamun bayyanar cututtuka suna haɓaka:
- Damuwa, bakin ciki.
- Kamshin acetone a cikin iska mai nutsuwa.
- Fata ya bushe tare da rage turgor.
- Idanun ta sunkuya.
- Numfashi mai hayaniya ne mai zurfi.
- Kayan bugun zuciya, arrhythmia.
Nan gaba, ƙwaƙwalwar lalaci na ci gaba, kuma ƙila yaro ya faɗi cikin matsalar rashin lafiya, yana buƙatar sake tayar da hanzari tare da gabatarwar insulin da diyya don rashin ruwa.
Ketoacidosis a cikin yara yana haifar da ƙididdigar insulin ba daidai ba ko alƙawarin da ba a san shi ba, lokacin bacci, matsanancin rashi na abinci, ƙara buƙata ta insulin a kan tushen cututtukan haɗuwa, cututtuka, raunin da ya faru, yanayin damuwa da aikin tiyata, aikin motsa jiki.
Alamun dakin gwaje-gwajen cututtukan sukari a cikin yara
Don gano ciwon sukari, bai isa kawai a gano alamun cutar ba, koda kuwa suna kamuwa da wannan cutar. Tabbatar da kasancewar ƙarancin insulin ta amfani da gwajin jini don glucose, kazalika da ƙarin nazarin idan akwai shakku cikin ƙayyade nau'in ciwon sukari da rikitarwarsa.
Ana yin gwajin jini don glucose aƙalla sau biyu don ware sakamakon ƙarya, ana ɗaukar jinin yaron a cikin komai a ciki bayan sa'o'i 8 daga abincin ƙarshe. Alamar ciwon sukari shine glycemia sama da 6.1 mmol / L.
Matsakaicin matsakaici tsakanin al'ada da ciwon sukari alamu ne a cikin kewayon daga 5.5 zuwa 6.1 mmol / L. Irin waɗannan sakamakon ana iya ɗaukarsu azaman ciwon suga. Ana iya tsara irin waɗannan marasa lafiya gwajin damuwa. Ana la'akari da tabbatar da ciwon sukari mellitus idan, bayan 2 hours daga shan glucose, ko tare da gwajin jini bazuwar, sukari ya wuce 11.1 mmol / L
Don fayyace ganewar cutar, ana gudanar da irin waɗannan karatun:
- Glucose da acetone a cikin fitsari (yawanci bai kamata su kasance ba).
- Ma'anar C-peptide: don nau'in 1 na ciwon sukari an saukar da shi, don nau'in ciwon sukari na 2 al'ada ne ko kuma yana da girma. Yana nuna ma'anar insulin.
- Insulin Immunoreactive: rage tare da nau'in 1, tare da nau'in ciwon sukari na 2 - na al'ada ko ƙaru.
- Gwajin kudade domin yanke hukunci daga kwayar cuta.
- Nazarin aikin renal: ƙuduri na ƙirar fillanci guda ɗaya, urography na ciki.
Har ila yau an aiwatar da ƙuduri na haemoglobin, wanda ke nuna canje-canje a cikin glucose na kwanakin 90 da suka gabata. Mafi sau da yawa ana amfani da wannan manuniya don saka idanu daidai da magani da diyya ga masu ciwon sukari. A al'ada, kashi na haemoglobin na glycated bai wuce 5.9% ba, kuma tare da ciwon sukari ya fi 6.5%.
Bayanai game da alamu da halayen hanyar kamuwa da cutar siga a cikin yara an gabatar dasu a cikin bidiyo a wannan labarin.
