A cikin nau'inta na asibiti, ciwon sukari na steroid shine ƙaramin insulin-dogara da ciwon sukari mellitus (DM 1), amma yana haɗar da sifofin halayen nau'ikan farko da na biyu.
Dalilin bayyanar shine kasancewar tsawan lokaci a cikin jini mai yawa na corticosteroids (kwayoyin da aka kirkiro ta adrenal cortex), wanda ke haifar da mummunan aiki na ƙwayar cuta saboda lalacewar kwayoyin jikinta.
Symptomatology
A farkon matakan cutar, wuce haddi na corticosteroids yana haifar da lalacewar sel na endocrine pancreas, amma samar da insulin har yanzu yana ci gaba. Wannan shi ne wahalar - cutar ta riga ta cika, amma alamu har yanzu suna da rauni sosai kuma mara lafiya ba ya cikin gaggawa don neman taimakon likita.
Tare da cikakken dakatarwar sakin insulin, alamomin halayen mellitus na al'ada sun bayyana:
- Polyuria
- Polydipsia;
- Rashin ƙarfi
- Gajiya;
- Gaba ɗaya yanayin talauci.
Rage nauyi ba zato ba tsammani ba ga masu ciwon suga, kamar su canje-canje kwatsam a cikin glycemia. Mayar da hankali na sukari da acetone a cikin hanyoyin da ake binciken jikin mutum (jini da fitsari) galibi yana kusa da al'ada. Wannan ya sa ya zama da wahala yin cikakken bincike.
Dalilin bayyanar
Ciwon sukari na steroid yana faruwa ne sakamakon wuce haddi na corticosteroids a cikin jinin mutum. Dalilan wannan wuce haddi na iya zama na ƙarfe da haɓaka.
Tare da haddasawar endogenous, wuce haddi na hormones na iya bayyana sakamakon cututtukan tsarin endocrine. Tare da exogenous - wuce haddi na hormones na faruwa bayan shafe tsawon lokacin amfani da magungunan glucocorticosteroid.
Yanayi
Ciwon suga na iya haifarda:
- Thiazide diuretics (Ezidrex, Hypothiazide).
- Magunguna waɗanda ake amfani da su don magance halayen halayen ƙwayar cuta, polyarthritis, diphtheria, huhu, zazzabi, zazzabin mononucleosis da sauran cututtukan da yawa, ciki har da cututtukan autoimmune. Wannan rukuni na magungunan sun hada da Betaspan, Dexamethasone, Prednisolone, Dexon, Anaprilin.
- Magungunan anti-mai kumburi ana amfani dasu bayan tiyatar da aka yiwa fitsarin.
- Kwayoyin hana haihuwa.
Sanadin rashin daidaituwa
Laifin ƙwayar ƙwayar ma'anar mara lafiyar ta shafi jigilar kyallen takarda da sel na jikin mutum zuwa insulin. Daga cikin irin waɗannan cututtukan, cutar ta Hisenko-Cushing ita ce mafi yawan lokuta ana haɗuwa da ita, wanda ke tattare da ɓoye ƙwayar hormone cortisol ta cortex adrenal.
Irin wannan ciwo yakan bayyana kansa sosai da asalin cutar ta Henenko-Cushing, wanda ya bambanta da cutar a cikin wancan hauhawar kogin adrenal yana tasowa a karo na biyu.
Babban dalilin cutar shine ƙwaƙwalwar ƙwaƙwalwar ƙwayar cuta na ƙwaƙwalwa.
Cutar 'kaburbura (mai guba mai guba), cuta ta hanji wacce ta rage yawan insulin da haɓakawar glucose jini, zai iya haifar da ci gaban ciwon sukari.
Rashin haɗari
Ba a ƙirƙirar ciwon sukari na steroid ba a cikin duk marasa lafiya da ke shan magungunan corticosteroid. Akwai wasu abubuwan da ke haifar da saurin kamuwa da wannan cuta:
kwayoyin halittar jini;
- Wuce kima;
- Hypodynamia;
- Rashin abinci mai gina jiki.
Wuce kima, wanda kuma zai iya bayyana sakamakon rashin aiki na jiki, yana haifar da hauhawar jini na insulin din insulin, lipids, cholesterol, glucose, da kuma keta hawan jini. Tare da karuwa a cikin ƙididdigar taro na jiki, wanda aka ƙididdige ta hanyar rarraba nauyi ta hanyar murabba'in girma a cikin mita, zuwa 27 kg / m2, wannan yana haifar da raguwa a cikin ƙimar jijiyoyin jikin insulin.
Mafi yawan tsarkakakke, mai sauƙin narkewa (sukari na masana'antu, zuma), carbohydrates mai sauƙi da raguwar furotin a cikin abincin yana rushe hanyoyin rayuwa a cikin jiki, wanda zai haifar da kiba.
Binciko
Hadadden ganewar cutar wannan cuta ita ce, alamomin gwajin jini da na fitsari ba su wuce yadda aka kafa tsarin. Hanyar mafi kyawun ganewar asali shine gwajin haƙuri a cikin glucose, wanda ke yanke hukunci kasancewar kamuwa da ciwon suga.
Za'a iya gano cutar sankarar mellitus ta hanyar kara yawan glucose na jini daga 6 mmol / L akan komai a ciki zuwa 11 mmol / L bayan loda tare da maganin glucose. Sannan an gano nau'ikansa.
Don ƙayyade ciwon sukari na steroid, ana yin ƙarin gwaje-gwaje: 17-ketosteroids da 17-hydroxycorticosteroids a cikin fitsari, gwajin jini don matakin hormones da aka samar ta adrenal cortex, pituitary gland shine yake.
Jiyya
Ana kula da ciwon sukari na steroid gwargwadon ka'idodi iri ɗaya kamar ciwon sukari na 2 kuma sharuddan diyya iri ɗaya ne.
Inganci magani ga ciwon sukari steroid kamar haka:
- Draarye da corticosteroids;
- Gudanar da insulin;
- Abincin abinci;
- Shan magungunan kwantar da hankula;
- Shiga ciki.
Tare da yanayin yanayin ci gaban cutar (amfani da glucocorticoids), ya zama dole don dakatar da gudanarwar su kuma zaɓi analogues mafi aminci. Mataki na gaba na aikin magani shine abinci, yawan amfani da wakilai na hypoglycemic da kuma maganin insulin sashi.
Tare da hypercorticism na endogenous, lokacin da ciwon sukari steroid ke haifar da lalacewa ta jiki da kanta, ana yin ayyukan tiyata sau da yawa, wanda ya haɗa da cire ƙwayar ƙwayar cuta a cikin glandar adrenal.
Yin amfani da magungunan antidiabetic yakamata a haɗe shi da allurar insulin, in ba haka ba tasirin cutar ƙangin haihuwar zai zama kaɗan ko kuma ba ya nan. Wannan shi ne saboda gaskiyar cewa insulin yana ba da izinin ɗan lokaci don inganta ayyukan sel da kuma ba su damar dawo da ayyukan sirrin su.
Lowarancin abinci mai carbohydrate ya ƙunshi rage adadin carbohydrates da ake cinye kowace rana tare da ƙara yawan furotin da fats na kayan lambu. Sakamakon bin irin wannan abincin, rayuwar mutum gabaɗaya tana inganta, buƙatar jikin mutum ga insulin da magunguna masu rage sukari yana raguwa, kuma yaduwar matakan sukari bayan cin abinci yana raguwa.
Tsarin magunguna
Magungunan sukari na rage sukari sun shigo cikin kungiyoyi da yawa:
- Abubuwan da ke cikin Sulfonylurea;
- Thiazolidinediones;
- Alfa glucosidase inhibitors;
- Meglitinides;
- Baranzaman.
Abubuwan da keɓaɓɓe na sulfonylureas sune yawancin lokuta ana amfani dasu don maganin cututtukan type 2, da kuma ciwon sukari na steroid. Tsarin aikin su shine ta da ƙwayoyin B-sel na endocrine na ɓangaren ƙwayar cuta, a sakamakon hakan akwai haɗuwar mutane da kuma haɓaka samar da insulin.
Likitocin da ke halartar sun ba da magunguna kamar Glycvidon, Chlorpropamide, Maninil, Tolbutamide, Glipizide.
Meglitinides (Nateglinide, Repaglinide) yana haɓaka haɓakar insulin da ƙananan matakan glucose.
Biguanides (Bagomet, Metformin, Siofor, Glucofage) sune magunguna waɗanda aikinsu yayi niyya don hana samar da glucose (gluconeogenesis) da inganta tsarin amfani dashi. Idan babu allurar insulin, ba a bayyana sakamakon biguanides ba.
Thiazolidinediones ko glitazone (Pioglitazone da Rosiglitazone) suna kara yawan jijiyoyin jiki, tsotse nama da hanta zuwa insulin, ta hanyar kunna masu karbar su, da kuma inganta haɓakar lipid.
Alpha-glucosidase inhibitors (Voglibosis, Glucobay, Miglitol) yana rage jinkirin lalata saccharides, rage haɓakawa da ɗaukar glucose a cikin hanji.
Cinarin ƙwaƙwalwar ƙwayar cuta (Liraglutid, Exenatide, Sitagliptin, Saksagliptin) wani sabon rukuni ne na magungunan antidiabetic, tsarin aikin wanda ya dogara da kaddarorin incretins, kwayoyin da ke ɓoye ta wasu nau'ikan ƙananan ƙwayoyin hanji bayan cin abinci. Abun da suke ci yana inganta fitowar insulin, rage matakan glucose.
Ana amfani da ciwon sukari na steroid ta hanyar tsayayyar hanya mara kyau. Kula da irin wannan cutar ya kamata ya zama cikakke kuma ya haɗa ba kawai allurar insulin ba da amfani da magunguna masu rage sukari, har ma da abinci da salon rayuwa mai aiki.
