Ciwon Lada

Kwanan nan, an rarraba cutar sukari zuwa na farko da na biyu, amma, godiya ga sakamakon binciken da ake ci gaba, an gano sababbin nau'ikan, ɗayansu shine cutar Lada (cututtukan LADA). Game da yadda ta bambanta da sauran nau'ikan, yadda ake gudanar da bincikenta da magani - daki-daki a cikin wannan kayan.

Menene wannan

Cutar sankarar Lada wani nau'in ciwon suga ne da masana masana abinci na Austriya suka gano a ƙarshen karni na 20. Sun lura cewa marasa lafiyar da ke cikin ƙwayoyin cuta da ƙarancin ɓoyewar sinadarin na C-peptide (ragowar furotin) ba su da nau'in na biyu, kodayake hoton asibiti yana nuna hakan. Sannan ya juya ga cewa wannan ba shine nau'in farko ba, tunda gabatarwar insulin ana buƙatar shi a matakan da suka gabata. Don haka, an gano wani nau'in tsakiyar cuta na cutar, daga baya aka kira shi da ciwon sukari na Lada (latent autoimmune diabetes a latti).

Siffofin

Ciwon sukari na latent shine nau'in latent wanda acikin kwayoyin sel cututtukan fata ke lalacewa. Yawancin masu bincike suna kiran wannan nau'in cutar "1.5", saboda tana da alaƙa da nau'in na biyu a cikin jinkirin, kuma na farko a cikin injiniyoyi. Yana da wuya a yi ingantaccen ganewar asali ba tare da ƙarin bincike ba. Idan ba a yi wannan ba kuma ana bi da cutar ta hanyar guda biyu kamar ciwon sukari na 2 (ɗaukar allunan da ke cikin sukari), to kuwa kumburin zai yi aiki har iyaka, kuma mutuwar ƙwayoyin beta za su ƙara haɓaka. Bayan ɗan gajeren lokaci - daga watanni shida zuwa shekaru 3 - mutum zai buƙaci maganin insulin mai zurfi, kodayake tare da nau'in gargajiya na 2 na ciwon sukari mellitus an tsara shi daga baya.

Marasa lafiya da ke fama da ciwon sukari na nesa suna yawan samun nakasa

Babban bambance-bambancen tsakanin nau'in latent da nau'in ciwon sukari na 2 sune:

• rashin wuce kima (yanayin nau'ikan latent a cikin marasa lafiya da kiba masu wuya ne);
• rage matakan C-peptides a cikin jini akan komai a ciki kuma bayan shan maganin glucose;
• kasancewar cikin jini na rigakafi zuwa sel na cututtukan cututtukan cututtukan zuciya - tsarin garkuwar jiki na masu ciwon sukari suna kai shi;
• Binciken kwayoyin halitta yana nuna halayyar kai farmaki sel sel.

Kwayar cutar

“Lada Clinical Clinical Risk Clinical Risk Clinical Risk Scile” wanda likitoci suka kirkira ya hada da wadannan sharudda:

• farkon cutar shine shekaru 25-50. Idan a cikin wannan tsaka-tsakin wannan mutum an gano shi da nau'in ciwon sukari na 2, to ya zama dole a bincika Lada, tunda a tsakanin marasa lafiya da nau'in na biyu, daga 2 zuwa 15% suna da nau'in latent, kuma waɗanda ba sa fama da kiba suna karɓar wannan maganin a cikin rabin shari'o'in;
• m bayyanar cututtuka na farko da cutar: matsakaita yau da kullum ƙara yawan fitsari ƙaruwa (fiye da 2 lita), akai mai ƙarfi ƙishirwa ya bayyana, haƙuri rasa nauyi da ji rauni. Koyaya, hanyar cutar Lada tana asymptomatic;
• bayanin jikin mutum kasa da 25 kg / m2, wato, a matsayin mai mulkin, babu wani kiba ko wuce kima a tsakanin wadanda ke cikin hadarin;
• kasancewar cututtukan autoimmune a baya ko a halin yanzu;
• cututtukan autoimmune a cikin dangi na kusa.

Rashin nauyi wata alama ce ta kowa sanadiyyar cutar latti.

Idan mai haƙuri ya ba da amsoshi masu kyau daga 0 zuwa 1 akan maki daga sikelin da aka bayar, to yuwuwar samun nau'in autoimmune ya ƙasa da 1%, idan akwai amsoshi 2 ko sama da haka, haɗarin kamuwa da cutar Lada yana ƙaruwa zuwa 90%. A ƙarshen batun, mutum yana buƙatar samun ƙarin gwaje-gwaje.

Binciko

Na'urorin bincike na zamani daban-daban na iya gane saurin cutar. Babban abu, idan kuna zargin wannan nau'in, shine a nemi ƙarin bincike da wuri-wuri.

Ga kowane nau'in ciwon sukari, gano wuri farkon yana da mahimmanci.

Bayan daidaitattun gwaje-gwaje na sukari da glycated haemoglobin, mai haƙuri ya ba da jini don gwaje-gwajen gwaje-gwaje masu zuwa:

Mellitus na rashin insulin-da ke fama da cutar sankara

• tabbatar da matakin autoantibodies zuwa glutamate decarboxylase GAD. Sakamako mai kyau, musamman idan matakin antibody yana da girma, a mafi yawan lokuta yana nuna kasancewar ciwon sukari a cikin mutum;
• ma'anar da kuma bincike na ICA - autoantibodies zuwa islet sel na pancreas. Wannan binciken ya kasance ban da na farkon kawai don yin hasashen ci gaban nau'in cutar latent. Idan anti-GAD da ICA suna nan a cikin jini, wannan yana nuna wani mummunan yanayin cutar sankara ta autoimmune;
• determinationuduri na matakin C-peptide, wanda samfuri ne na biosynthesis na insulin hormone. Yawanta daidai ne gwargwado zuwa matakin insulin nasa. Idan bincike ya nuna anti-GAD da ƙananan C-peptides, ana gano mai haƙuri da cutar Lada. Idan anti-GAD ya kasance amma matakin C-peptide al'ada ne, ana tsara sauran karatun;
• nazarin HLA girma, alamomin tsararraki na alamomin 1 na ciwon sukari (wannan dangantakar ba ta tare da cutar ta 2). Bugu da kari, DQA1 da B1 alamomin ana duba su;
• gano ƙwayoyin rigakafi zuwa ƙwayoyin insulin-dauke da kwayoyi.

Jiyya

Tare da tsarin da ba daidai ba, cutar sankaran Lada za ta zama mai rauni ba da daɗewa ba, kuma mai haƙuri dole ne ya gudanar da manyan allurai na insulin. Mutum zai ji dadi koyaushe, mummunan rikice-rikice zai bayyana. Idan baku canza hanyar magani ba, wannan hello ne ga nakasassu ko mutuwa.

Harkokin insulin shine inda kuke buƙatar farawa

Therapywarewar ƙwayar cuta daga cututtukan autoimmune yana farawa da gabatarwar ƙananan allurai na insulin.

Farko insulin farji ya zama dole don:

• tanadi daga sauran cututtukan da ke gudana. Ragewa a cikin ayyukan kwayar beta ya zama dole don kula da mafi kyawun matakan glucose na jini, rage haɗarin cutar hypoglycemia da hana haɓakar rikicewar cutar;
• cire cututtukan cututtukan fata daga cututtukan fata ta hanyar rage yawan autoantigens wanda tsarin rigakafi ke rikitarwa sosai kuma yana fara aiwatar da maganin rigakafi. Gwaje-gwaje na dakin gwaje-gwaje sun nuna cewa ƙaddamar da ƙananan allurai na insulin a cikin dogon lokaci yana haifar da raguwar adadin autoantigens a cikin jini;
• Tsayar da daidaitaccen glucose na yau da kullun don guje wa rikice-rikice nan da nan da yawa.

An riga an haɓaka magungunan rigakafi don magance wasu cututtukan cututtukan cututtukan cututtukan kansa. Ba da daɗewa ba, masana kimiyya sunyi hasashen bayyanuwar irin waɗannan hanyoyin don magance cututtukan cututtukan fata daga cututtukan fata.

Cikakken abinci mai gina jiki da kuma shan bitamin sashi ne mai mahimmanci na aikin jiyya

Kulawar cututtukan Lada, ban da maganin insulin, shima ya haɗa da:

• shan magunguna waɗanda ke haɓaka ƙarshen ji na jijiyoyin ƙwalƙwalwa zuwa insulin;
• Ban hana shan abubuwan motsa jiki don samar da insulin (cike da gajiyawar hanji da kuma hauhawar karancin insulin);
• iko na dindindin na sukari na jini;
• canji zuwa abinci mai ƙarancin carb (yayin da marasa lafiya zasu iya cin ɗan cakulan duhu);
• motsa jiki na jiki (sai dai a lokuta da babban rashi na nauyin jiki);
• aiwatarudotherapy (hanyar magani ta amfani da leeches na musamman).

Karka manta da labarin baki.

Bayan daidaituwa tare da likitan halartar, zai yuwu a iya amfani da maganin gargajiya. A matsayinka na mai mulkin, magani na taimako ya ƙunshi ɗaukar kayan kwalliya da tinctures na tsire-tsire masu magani, wanda ya cancanta rage matakan glucose a cikin jini.

Cutar sankarar Lada, kamar sauran nau'ikan, ba tare da dacewa ba tare da dacewa da magani ba wanda zai iya haifar da rikice-rikice da yawa. Sabili da haka, a cikin ganewar asali na ciwon sukari, yana da mahimmanci a gudanar da ƙarin nazarin don ware yiwuwar rashin lahani, sakamakon wanda zai iya zama nakasa da mutuwa.