Cutar sankara (mellitus) cuta ce ta rayuwa ta wucin gadi na tsarin endocrine, wanda ya danganta da karancin insulin, cikakken ko dangi.
Rashin ƙarancin insulin a cikin ciwon sukari shine ya haifar da mutuwar ƙwayoyin beta, waɗanda ke da alhakin ɓoye shi, kuma dangi yana da alaƙa da ma'amalarsa tare da masu karɓar sel (hankula don nau'in ciwon sukari na 2).
Don ciwon sukari mellitus, ma'anar hyperglycemia shine mafi yawan alamu na yau da kullun wanda ke shafar cin zarafin ƙwayoyin carbohydrate a cikin jiki. Lokacin da ake bincika ciwon sukari, alamu masu mahimmanci shine ƙara haɓakar glucose a cikin jini da bayyanar shi a cikin fitsari. Tare da asarar sukari mai yawa, karuwar fitowar fitsari yana haifar da bushewa da hauhawar jini.
Iri ciwon sukari
Abubuwan da ke haifar da karuwa a cikin yawan lokuta na ciwon sukari mellitus shine mafi kyawun ganowa tare da bincike na zahiri, raguwar mace-macen jarirai daga iyaye masu ciwon sukari, karuwa a cikin tsawon rayuwar jama'a da yaduwar kiba.
Ciwon sukari mellitus cuta ce mai yawa duka biyu saboda dalilan faruwar hakan da kuma bayyanuwar asibiti da hanyoyin magani. Don ƙayyade ciwon sukari kuma kuyi daidaitaccen ganewar asali, zaɓuɓɓuka guda biyu ana rarrabe su da farko: nau'in 1 da nau'in ciwon sukari na 2.
Nau'in nau'in ciwon sukari na farko yana faruwa a cikin nau'i na lalata sel beta kuma yana haifar da rashi insulin tsawon rai. Abubuwansa sune LADA - latent autoimmune ciwon sukari a cikin manya da kuma nau'in idiopathic (marasa rigakafi). A cikin ciwon sukari na latent, alamun da hanya ta dace da nau'in 2, ana gano ƙwayoyin rigakafi zuwa ƙwayoyin beta, kamar a cikin nau'in 1.
Nau'in na biyu na ciwon sukari yana haɓaka da asali na raguwa ko samar da insulin na al'ada, amma tare da asarar hankalin sa - insulin juriya. Formaya daga cikin nau'i na wannan ciwon sukari shine MAGANIN, wanda akwai lahani a cikin aikin ƙwayoyin beta.
Baya ga waɗannan nau'ikan na asali, ƙila a sami:
- Rashin insulin ko masu karɓa da ke da alaƙa da lahani na ƙwayoyin cuta.
- Cutar cututtukan cututtukan cututtukan cututtukan fata - cututtukan fata, ciwace-ciwace.
- Endocrinopathies: acromegaly, Cutar ta Itenko-Cushing, ta rarraba goiter mai guba.
- Ciwon sukari mellitus.
- Cutar sankarau da kamuwa da cuta.
- Cututtukan cututtukan cututtukan da ke hade da cutar sankara.
- Ciwon ciki.
Bayan ƙayyade nau'in ciwon sukari, ana gudanar da bincike game da tsananin cutar. Tare da nau'i mai laushi na mellitus na sukari, babu manyan saukad da sukari na jini, sukari mai azumi yana ƙasa da 8 mmol / l, babu sukari a cikin fitsari, ko har zuwa 20 g / l. abincin abincin ya isa ya rama. Ba'a bincikar cutar raunukan jijiyoyin jiki ba.
Ana nuna ciwon sukari na matsakaici ta hanyar karuwar glucose mai azumi zuwa 14 mmol / l, asarar glucose a cikin fitsari a kowace rana - har zuwa 40 g, a lokacin ranar akwai sauyi a matakan sukari, jikin ketone a cikin jini da fitsari na iya bayyana. An wajabta rage cin abinci da insulin ko kwayoyin magani don rage yawan glycemia. An gano Angioneuropathies.
Alamomin kamuwa da cutar sankarau:
- Azamanin glycemia sama da 14 mmol / L
- Canje-canje masu mahimmanci a cikin sukari na jini a ko'ina cikin rana.
- Glucosuria sama da 40 g kowace rana.
- Yawan insulin don rama sama da 60 NA BIYU.
- Haɓaka cutar angio-da neuropathies.
Dangane da matsayin diyya, ana iya rama cutar sankara idan ana iya cimma glucose na al'ada a cikin jini da rashinsa a cikin fitsari. Lokaci na subcompensation: glycemia ba ta wuce 13.95 mmol / l, asarar glucose na 50 g ko lessasa da kowace rana. Babu acetone a cikin fitsari.
Tare da lalata, duk bayyanannun sun wuce waɗannan iyaka, an ƙaddara acetone a cikin fitsari. Akwai yiwuwar samun daidaituwa a kan asalin cututtukan hyperglycemia.
Ta yaya ciwon sukari na 1 ya tashi?
Nau'in na farko na ciwon sukari na iya faruwa a cikin kowane nau'in shekaru, amma mafi yawan lokuta yakan shafi yara, matasa da matasa masu shekaru 30 da haihuwa. Akwai wasu cututtukan cututtukan cututtukan cututtukan da ke faruwa a cikin mutum, kuma alamun a cikin mutane daga 35 zuwa 45 shekaru suna da alama su bayyana.
Irin wannan hanyar ciwon sukari ana nuna shi ta hanyar lalacewar sel waɗanda ke haifar da insulin saboda wani nau'in amsawar autoimmune. Irin wannan cutar na iya haifar da ƙwayoyin cuta, kwayoyi, sinadarai, guba.
Wadannan abubuwan na waje suna a matsayin abu ne na kunna halittar kwayoyin halittu a wasu bangarorin chromosomes. Wannan tsarin kwayoyin halitta yana tantance daidaituwar nama kuma an gadar da shi.
A matakin farko na cutar, kwayoyin rigakafi zuwa sel na beta a cikin raguwa sun bayyana. Babu alamun alamun asibiti na cutar, tun da damar ramuwar ƙwayar insulin ba ta da matsala. Wato, aladuwar cututtukan fata suna kama da irin wannan lalata.
Bayan haka, yayin da lalata tsibirin Langerhans ke ƙaruwa, ana aiwatar da hanyoyin masu zuwa:
- Ciwon ƙwayar ƙwayar ƙwayar ƙwayar cuta shine insulin autoimmune. Titin antibody yana ƙaruwa, ƙwayoyin beta suna lalacewa, haɓakar insulin ya ragu.
- Lokacin da glucose ya shiga abinci, ana samar da insulin a cikin wadataccen abinci. Babu wani asibiti, amma ana iya gano ɓarkewar ciki a gwajin haƙuri na haƙuri.
- Insulin yayi kadan kwarai, asibitin da aka saba da girma. A wannan lokacin, kusan kashi 5-10% na sel masu aiki suka wanzu.
- Ba a samar da insulin ba, dukkanin sel sun lalace.
Idan babu insulin, hanta, tsokoki da tsotse nama ba za su iya samun glucose daga jini ba. Yawan kitse a cikin jijiya nama yana ƙaruwa, wanda shine dalilin karuwar su bayyanar da jini, kuma sunadarai sun rushe a cikin tsokoki, suna ƙara matakin amino acid. Hanta tana jujjuya kitse da amino acid zuwa jikin ketone, wadanda suke zama tushen samar da makamashi.
Tare da karuwa a cikin glucose har zuwa 10 mmol / l, kodan sun fara fitar da glucose a cikin fitsari, kuma tunda yake jawo ruwa ga kanta, to akwai kazamar ruwa idan wadataccen sa ya cika da ruwan sha.
Rashin ruwa yana haɗuwa tare da kawar da abubuwa masu ganowa - sodium, magnesium, potassium, alli, da kuma chlorides, phosphates da bicarbonate.
Alamomin nau'in ciwon suga na farko
Alamomin asibiti na nau'in ciwon sukari guda 1 za'a iya kasu kashi biyu: alamomin dake nuna matsayin raunin masu cutar siga da alamun rikice-rikice ta hanyarsa. Ciwon sukari na jini mai zurfi a jiki yana haifar da yawan fitsari, kuma alakar dake tattare da ƙishirwa, bushewar baki, da asarar nauyi.
Tare da karuwa da hauhawar hyperglycemia, canje-canje na ci, rauni mai kauri, lokacin da jikin ketone ya bayyana, zafin ciki na faruwa, ƙwanƙarin acetone daga fata kuma cikin iska mai amo. Nau'in nau'in ciwon sukari na farko ana nuna shi ta hanyar haɓaka mai sauri cikin bayyanar cututtuka a cikin rashin gudanarwar insulin, don haka bayyanuwar farko na iya zama cocin ketoacidotic.
Rukuni na biyu na alamomin suna da alaƙa da haɓaka rikice-rikice: tare da kulawa mara kyau, gazawar koda, ƙwaƙwalwar ƙwayar cuta, ƙwaƙwalwar ƙwayar cuta, retinopathy na ciwon sukari, polyneuropathy, ketoacidosis, da ciwan ciwon sukari.
Cututtukan da ke da alaƙa da ciwon sukari kuma suna haɓaka:
- Furunlera.
- Candidiasis
- Cutar cututtukan ƙwayar cuta.
- Cutar tarin fuka
- Cututtuka masu yawa.
Don yin binciken ciwo ya isa ya gano alamu na yau da kullun kuma tabbatar da hyperglycemia: a cikin plasma fiye da 7 mmol / l, sa'o'i 2 bayan ciwan glucose - fiye da 11.1 mmol / l, gemoclobin glycated ya wuce 6.5%.
Yaya za a gano nau'in ciwon sukari na 2?
Abinda ya faru da nau'in ciwon sukari na 2 yana da alaƙa da tsinkayar ƙwayoyin jini da kuma rikicewar cuta ta hanyar kiba, atherosclerosis. Haɓakawa na iya tayar da cututtukan ƙwaƙwalwar ƙwayar cuta mai haɗari, ciki har da cututtukan cututtukan cututtukan zuciya, cututtukan ƙwayar cuta, yawan motsa jiki, musamman abinci mai gina jiki da kuma rashin motsa jiki.
Rashin daidaituwa na metabolism na mai da kuma tasirin tasirin cholesterol, atherosclerosis, hauhawar jijiyoyin jini da cututtukan zuciya da jijiyoyin jini suna haifar da raguwa a cikin matakan metabolism da rage jijiyar nama zuwa insulin. A cikin yanayin damuwa, ayyukan catecholamines da glucocorticoids yana ƙaruwa, wanda ke ƙara yawan abubuwan glucose a cikin jini.
A nau'in na biyu na ciwon sukari, haɗin tsakanin masu karɓa da insulin yana da damuwa, a cikin matakan farko na cutar, an kiyaye asirin, har ma yana iya ƙaruwa. Babban abu mai haɓaka juriya na insulin shine ƙara ƙarfin jikin mutum, sabili da haka, lokacin da aka rage shi, yana yiwuwa a cimma matakan al'ada na glucose a cikin jini tare da abinci da allunan.
A cikin lokaci, ƙwayar ƙwayar cuta ta lalace, kuma haɓakar insulin ya ragu, wanda ya sa ya zama dole don canzawa zuwa ilimin insulin. Yiwuwar samun ketoacidosis a cikin nau'in na biyu na ciwon sukari yana da ƙasa. A tsawon lokaci, alamun karancin aiki na kodan, hanta, zuciya, da tsarin juyayi suna haɗuwa da alamomin kamuwa da cutar sankara.
A cikin tsananin, nau'in ciwon sukari 2 ya kasu kashi biyu:
- Matsakaici: rama kawai rage cin abinci ko shan kwamfutar hannu guda na miyagun ƙwayoyi kowace rana.
- Verarancin matsakaici: Allunan mai rage sukari a kashi biyu na 2-3 a rana ɗaya yana daidaita alamun bayyanar cututtukan hyperglycemia, angiopathy a cikin yanayin rikicewar aiki.
- Tsarin mara kyau: ban da Allunan, ana buƙatar insulin ko kuma an tura mai haƙuri gaba ɗaya zuwa ilimin insulin. Cututtuka wurare dabam dabam na rayuwa.
Abubuwan rarrabe na nau'in 2 shine alamomin ciwon sukari suna haɓaka a hankali fiye da nau'in cutar ta farko, kuma ana gano wannan nau'in mafi yawan lokuta bayan shekaru 45. Gabaɗayan alamun cututtukan da ke hade da hyperglycemia suna kama da ciwon sukari na 1.
Marasa lafiya suna damuwa da itching da fata, musamman dabino, ƙafa, perineum, ƙishirwa, amai, gajiya, cututtukan fata, mycoses sau da yawa suna haɗuwa. A cikin irin waɗannan marasa lafiya, raunuka suna warkar da hankali, gashi yana fitowa, musamman a kan kafafu, xanthomas sun bayyana a kan ƙoshin idanu, gashin fuska yana girma sosai.
Kafafu sun zama lambobi, rarrabuwa, akwai rauni a cikin kasusuwa, gidajen abinci, kashin baya, kasala mai rauni yana haifar da rarrabuwa da jijiyoyi, kasala da nakasa kasusuwa a bango na rashin ci gaban kasusuwa na kasusuwa.
Raunukan fata na faruwa ne ta hanyar raunuka na sassan jikin na perineum, axillary kuma a ƙarƙashin gamin mammary. Itching, redness da fitarwa suna da matukar damuwa. Samuwar kwaya, carbuncles shima halayyar mutum ce. Cutar fitsari a cikin nau'in vulvovaginitis, balanitis, colpitis, da kuma raunuka na wurare na interdigital, gado ƙusa.
Tare da dogon lokaci na ciwon sukari kuma tare da rashi mara kyau, rikice-rikice sun taso:
- Cututtukan jijiyoyin bugun gini (microangiopathy da macroangiopathy) - ɓarna da ɓarna na tasoshin jini yana ƙaruwa, ƙwanƙwasa jini da filayen atherosclerotic a cikin rukunin lalata bango.
- Polyneuropathy na ciwon sukari: lalacewar tsarin jijiyoyin mahaifa a cikin nau'i na keta duk nau'ikan ji na jijiyoyi, aiki mai rauni, samuwar lahani na lokaci mai tsawo, lahani na nama, haifar da gangrene da yanke ƙafa.
- Haɗar haɗin gwiwa - cututtukan cututtukan ciwon sukari tare da jin zafi, rage motsi a cikin gidajen abinci, rage samar da ruwa mai narkewa, ƙarancin girma da danko.
- Imarancin yara na nakasa: nephropathy mai ciwon sukari (furotin a cikin fitsari, edema, hawan jini). Tare da ci gaba, glomerulosclerosis da gazawar koda, haɓaka, suna buƙatar haɓakar hemodialysis.
- Ophthalmopathy na masu ciwon sukari - haɓakar ƙwaƙƙwaran ruwan tabarau, hangen nesa, mai duhu, mayafi da maki mai motsawa a gaban idanun, retinopathy.
- Dysfunction na tsakiya juyayi tsarin a cikin nau'i na ciwon sukari encephalopathy: rage ƙwaƙwalwar ajiya, damar hankali, canza yanayin psyche, yanayin motsin rai, ciwon kai, farin ciki, asthenia, da jihohi masu juyayi.
Kuma bidiyon da ke cikin wannan labarin zai nuna ainihin bayyanar asali da haɓakar ciwon sukari.
