Hyperglycemia - ke eng, mefuta, pathogeneis le kalafo ea lefu lena

Khahlanong le metabolism ea carbohydrate, hyperglycemia e ka nts'etsapele (khatello ea tsoekere maling e ngata haholo)

5.5 mmol / L) le hypoglycemia (ka tlase ho 3.3 mmol / L).

Tekanyo ea glucose ea mali e latela mofuta oa sampole (mali kaofela, venous kapa capillary, plasma) le mochini oa sampole (ka mpeng e se nang letho - boemo ba glucose hoseng kamora bonyane lihora tse 8 tsa ho itima lijo, lihora tse 2 kamora tlhahlobo ea mamello ea glucose).

Pathogenesis ea hypoglycemia e amahanngoa le:

- ho ja tsoekere e sa lekanang maling.

- Ho tlosa tsoekere e maling kapele

-Kopeho ea lintlha tsena.

Khetholla pakeng tsa mmele le hypoglycemia ea 'mele.

Hypoglycemia ea 'mele. E fumanoa ka khatello e matla le ea nako e telele ea 'mele, khatello ea kelello ea nako e telele, ho basali nakong ea ho beleha, e ba teng ka mor'a hypentlycemia ea morao-rao ka lebaka la phumants'o ea insulin maling.

Pathological hypoglycemia (hyperinsulinism). E etsahala ho bakuli ba nang le lefu la tsoekere mellitus mabapi le ho ata ha insulin nakong ea kalafo. Lisosa: pancreatic islet cell adenoma (insuloma), Zollinger-Ellison syndrome (pancreatic adenoma kapa carcinoma, e hlahang ho tsoa liseleng tsa li-islets tsa Langerhans tse ikarabellang ho secretion ea glucagon le gastrin).

Pathological hypoglycemia (ntle le hyperinsulinism). Ho senotsoe: le pathology ea liphio e tsamaeang le ho fokotseha ha monyako oa tsoekere, e lebisang ho lahleheloa ke tsoekere ka har'a moroto, ho kenngoa ha makhopho a nang le lik'habohaedreite, mafu a sebete a tsamaeang le thibelo ea lefutso la glycogen le gluconeogenesis (hepatitis e mpe le e sa foleng), khaello ea adrenal hypaminosis.₁, galactosemia le mefuta ea hepatic ea glycogenosis, tlala kapa khaello ea phepo e nepahetseng (alimentary hypoglycemia), ho haella ha mekhoa ea taolo ea metabolism ea carbohydrate ho masea a sa tsoa hlaha.

Hyperglycemia e atile haholo. Khetholla mefuta ea hyperglycemia.

Psychological Hyperglycemia. Tsena ke maemo a fetohang ka potlako. Normalization ea mali tsoekere e etsahala ntle le liketso tsa ka ntle tsa ho lokisa. Tsena li kenyeletsa:

1. Alimentary hyperglycemia. Ka lebaka la ho ja lijo tse nang le lik'habohaedreite. Ho bokellana ha tsoekere maling ho eketseha ka lebaka la ho tsoa ha eona ka potlako ka popelong. Ts'ebetso ea secretion ea li-hormone ke li-β-cell tsa li-isanc tsa pancreatic tsa Langerhans li qala ka mokhoa o hlakileng ka mor'a hore lijo li kene kahare ea molomo mme li fihle ka bongata ha lijo li se li kene ka har'a duodenum le mala a manyane. Litlhōrō tsa insulin le likhahla tsa tsoekere ea mali li tsamaisana ka nako. Kahoo, insulin ha e netefatse feela ho fumaneha ha lik'habohaedreite tsa lijo liseleng tsa 'mele, empa hape e beha le keketseho ea phallo ea tsoekere maling maling, ho thibela tahlehelo ea eona ka har'a moroto.

2. Neurogenic hyperglycemia. E ba teng ka lebaka la khatello ea maikutlo 'me e bakiloe ke ho ntšoa ha likhomphutha tse maling, tse bopiloeng ka har'a adrenal medulla mme li hlokomela litlamorao tsa bona tsa hyperglycemic. Glucose e ntšitsoeng e kena kapele maling, e baka hyperglycemia.

Pathological hyperglycemia. Mabaka:

1) mathata a neuroendocrine - tlolo ea karolelano ea lihormone tsa hypo- le ketso ea hyperglycemic (ka mafu a pituitary gland, tumors ea cortex ea adrenal, ka tlhahiso e sa lekaneng ea insulin, glucagonoma),

2) Litho tsa tlhaho tsa tsamaiso ea methapo e kholo, kotsi ea methapo ea methapo,

3) Ho sitisoa ke ts'ebetso ea sebete "cirrhosis,"

4) maemo a sithabetsang ha ho phatloha ha mesifa ea glycogen le ho hlaha hoa lactate, ho tloha moo tsoekere e entsoe ka har'a sebete,

5) phello ea dintho tsa narcotic (morphine, ether), e thabisang tsamaiso ea methapo e nang le kutloelo-bohloko, e tlatsetsang kholisong ea hyperglycemia.

Hyperglycemia ke eng: matšoao a pathogene, matšoao, mathata a ka bang teng le maqiti a kalafo

Lingaka tse nang le hyperglycemia li bontša boemo boo ho bona tlhahlobo ea mali e bontšang boemo bo phahameng ba tsoekere. Tsoekere e nyoloha ka mabaka a fapaneng. Sena ha se bolele hore lefu la tsoekere.

Se bitsoang hyperglycemia, ke mefuta efe e etsahalang, mathata a na le eona, hore na e fumanoa joang le ho alafshoa - sengoloa se tla bua ka sena sohle.

Sena ke eng

Hyperglycemia e tšoauoa ka khatello ea tsoekere ea plasma e kaholimo ho moeli o kaholimo.

Ka lebaka la khaello ea insulin, lisele li qala ho ba le tlala, li lahleheloa ke matla a ho monya mafura acid, tsoekere e ngata le oxidize ka botlalo. Ka lebaka leo, acetone e qala ho theha le ho bokellana. Sena se halefisa ts'ebetso ea methapo ea metabolic le ho se sebetse hantle mesebetsing ea litho tse ngata le litsamaiso.

Ho na le mekhahlelo ea mofuta oa hyperglycemia:

• tekano
• e khahla
• comatose.

Likarolo tsa mantlha tsa hyperglycemia:

Hyperglycemia e atile haholo ho lefu la tsoekere. Empa e ka bonoa ka li-pathologies tse ling. Ka linako tse ling tsoekere e hlaha ho motho ea phetseng hantle.

Glucose e ngata e ama hampe ts'ebetso ea litho le litsamaiso. Ka hona, nako le nako o lokela ho fana ka mali bakeng sa tlhahlobo.

Tlhomamiso

Ho latela boholo ba matšoao, hyperglycemia e etsahala:

• lebone. Mefuta e potlakileng ea tsoekere e tloha ho 6 ho isa ho 10 mmol / L,
• tekano e lekaneng (boleng bo tsoa ho 10 ho isa ho 16 mmol / l),
• boima (mitha ea glucose ea mali e bonts'a ka holimo ho 16 mmol / l). Haeba boleng bo le boholo ho feta 16,5 mmol / L, ho na le kotsi ea ho ba le komello kapa boemo ba semmuso.

Ho bakuli ba fumanoeng ba na le lefu la tsoekere, hyperglycemia e arotsoe ka mefuta e 'meli:

• mosesane. Haeba mokuli a sa ja ka lihora tse 8, boemo ba tsoekere ea plasma bo nyolohela ho 7.2 mmol / l kapa ho feta,
• postprandial. E hlaha kamora ho ja. Tsoekere e feta 10 mmol / L.

Hyperglycemia le eona ea khetholoha:

• pathological. E etsahala le mathata a endocrine. Sebopeho sa batho ba nang le lefu la tsoekere,
• 'meleng. E ea nakoana. E tla ka lebaka la ts'ebeliso e feteletseng ea 'mele, ho nka limatlafatsi tse ngata tse tlotsang mmele habonolo, maikutlo a matla, khatello ea maikutlo,
• tsoakane.

Ho latela lisosa, hyperglycemia e khetholloa:

• sa foleng. E hlaha e susumetsoa ke lintho tse futsitsoeng. Hyperglycemia syndrome ka linako tse ling e hlaha khahlano le semelo sa mafu a pancreatic. Tloaelo ea mofuta oa 1 lefu la tsoekere,
• e sithabetsang. E iponahatsa e le karabelo ho tšisinyeho ea tlhaho ea maikutlo le kelello. Khahlano le nalane ea maemo a sithabetsang 'meleng oa motho, tšusumetso ea lihormone tse sitisang ts'ebetso ea glycogeneis e hlohlelletsoa. Hape ka nako ena, lits'ebetso tsa gluconeogeneis le glycogenolysis lia ntlafatsoa. Ho se leka-lekane hona ha maemo a lihormone ho lebisa keketseho ea tsoekere ea plasma,
• alimentary. E shebiloe kamora ho ja. Ha e tšoane le maemo a bophelo. E etsahala ha o nka lihlahisoa tse ngata tse nang le lik'habohaedreite tse ngata. Mofuta ona oa kalafo ha o hloke kalafo. Kamora nako e itseng, matšoao a ikemela a theoha ka mokhoa o ikhethileng,
• hormonal. E etsahala le ho se leka-lekane ha li-hormone khahlano le semelo sa mafu a endocrine. Catecholamines le glucocorticoids li eketsa tsoekere ea mali.

Hyperglycemia ea mantlha e hlaha ka lebaka la khaello ea phepo e ntle ea lisele tsa litsi tsa hypothalamic.

Ho potoloha ha mali ho baka ho lokolloa ha STH-RF, glyconeogeneis e eketsehileng.

Pathogenesis ea hyperglycemia ka lebaka la ts'oaetso e chefo kapa e sithabetsang ts'ebetsong ea methapo ea methapo e tšoana. Lisebelisoa tsa insulin li arabela tsoekere e phahameng ka ho lokolla palo e kholo ea lihormone.Ka atrophy ea lisebelisoa tsa kahare, tsoekere e lula e le maemong a phahameng. Ho e fokotsa, o tlameha ho hlahisa meriana e khethehileng.

Ka hyperglycemia, ho na le kotsi ea glucosuria. Hangata hona ho etsahala ha letšoao la tsoekere le fetela ka n the'ane ho tsoekere ea liphio - 170-180 mg.

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Sohle se o lokelang ho se etsa ke ho tobetsa konopo e ka tlase (FUMANA LITSELA) 'me u tlatse tlhahiso efe kapa efe e thathamisitsoeng, hamorao u tla khona ho khetha moputso oa hau (palo e fokolang!):

Hyperglycemia ke boemo boo boemo ba tsoekere bo maling bo tla ba bo phahametseng pontšo e tloaelehileng. Haeba keketseho e le bohlokoa, ho ka ba le kotsi e kholo ea komello (hyperglycemic kapa hyperosmolar) e ka lebisang ho holofala, 'me ka lefu le tebileng la lefu la pelo. Sehloohong, re tla hlahloba hore na re lokela ho etsa eng haeba ho senoloa hyperglycemia, pathogeneis, mefuta le matšoao a mantlha a pathology.

Lisosa tsa hyperglycemia ea nakoana le ea nako e telele

Mmuso oa hyperglycemic o ka phela nako e telele kapa e le ketsahalo ea nakoana.

Mabaka a keketseho ea nakoana ea glucose ea plasma a fanoa ka tlase:

• khatello ea maikutlo khafetsa
• ho ja lijo tse nang le phepo e ngata haholo,
• boimana
• bohloko bo boholo boo thyroxine le adrenaline e eketsehang maling.
• khaello ea livithamini C le B1,
• chefo ea lik'habohaedreite
• ho tsoa mali haholo
• lefu la tsoekere
• hyperplasia of the adrenal cortex,
• ho nka lihlopha tse itseng tsa lithethefatsi. Mohlala, li-antidepressants, diuretics, beta blockers, fentamidine, niacin e eketsa tsoekere,
• mafu a tšoaetsanoang
• ho ikoetlisa ho sa leka-lekanang.

Hyperglycemia ea nako e telele e bakoa ke tlolo ea metabolism ea carbohydrate le ho se sebetse hantle hoa litho tsa endocrine.

Lisosa tse atileng haholo tsa hyperglycemia li thathamisitsoe ka tlase:

• ka mofuta oa pele oa lefu la tsoekere, synthetic ea insulin e fokotseha haholo ka lebaka la tšenyo ea lisele tsa pancreatic, ts'ebetso ea ho ruruha ka hara setho. Ha 75% ea lisele tse hlahisang lihormone e felisoa, hyperglycemia e etsahala,
• ka mofuta oa bobeli oa lefu la tsoekere, maikutlo a insulin ho lisele tsa 'mele a sithabetse. Hormone ha e amoheloe esita le tlhahiso e lekaneng. Ka hona, tsoekere e maling e ea eketseha.

Ho tseba lisosa tsa hyperglycemia, ho qoba lintho tse u tsosetsang, ho na le monyetla oa ho fokotsa monyetla oa ho eketseha ha tsoekere.

Ha glucose e feta ntho e tloaelehileng, motho o hlokomela ponahalo ea matšoao a latelang:

• molomo o omileng
• lenyora le matla le ke keng la hlakoloa
• pono e fifalitsoeng
• mokhathala,
• ho rota khafetsa (haholo bosiu),
• keketseho ea molumo oa moroto,
• ho fokotsa boima ba 'mele kapele
• maqeba a sa phekoleheng
• ponahalo ea mofufutso,
• khafetsa khafetsa ea ts'oaetso.

Bakeng sa ketoacidosis, e hlokometsoeng ho lefu la tsoekere, lipontšo tse latelang ke tšobotsi:

• monko oa litholoana o tsoang molomong
• bohloko bo ka mpeng,
• ho omella
• pherekano le ho lahleheloa ke kelello
• hyperventilation ea matšoafo
• ho nyekeloa
• ho otsela
• ho hlatsa

Haeba matšoao a hlalositsoeng ka holimo a hlaha, hoa hlokahala ho hlahloba mali bakeng sa tsoekere le ho nka mehato e nepahetseng.

Sehlopha sa mantlha

Haeba hyperglycemia e fumanoe, ke lokela ho etsa joang? Pele, hoa hlokahala ho theha mofuta oa "pathology" e khethiloeng e le ho thibela tlhaselo. Boloetse bo ka hlaha ka mefuta e mengata, bo fapaneng mokhoeng oa popetso le mofuta oa phello e hlahisoang ho motho. Batho ba nang le lefu la tsoekere mellitus (DM) hangata ba tobane le mofuta oa postprandial.

Tlhahlobo ea "Hypoglycemia" e etsoa motheong oa khethollo e latelang ea mefuta:

• E sa foleng E hlaha khahlanong le semelo sa li-pancreatic pathologies.
• Maikutlong E ts'oareha ka mor'a liphihlelo tsa nako e telele le maemo a sithabetsang.
• Mokhabiso. E etsahala hang kamora ho ja.
• Hormonal Ho se sebetse hantle ha semelo sa lihormone tsa 'mele hoa e halefisa.

Nahana ka lintlha ka botlalo.

Mathata

Ho bohlokoa ho tseba! Kamora nako, mathata a nang le tsoekere a tsoekere a ka lebisa ho mafu a mangata, a kang mathata a pono, letlalo le moriri, liso, bohloka ba 'mele esita le marang a nang le mofets'e! Batho ba rutile boiphihlelo bo bohloko ho fetolela maemo a bona a tsoekere ba natefeloa ...

Haeba glycogen e sa khutlisetsoe maemong a tloaelehileng, ho hlaha mathata a tebileng:

Ketoacidosis ea mofuta oa 2 lefu la tsoekere ha e fumanehe habonolo. E tsebahala ka lefu la tsoekere la mofuta oa 1. Boemong bona, acidity ea mali ea eketseha. Haeba u sa fane ka thuso ea pele ho motho, o tla oela molomong ebe oa shoa.

Ts'oaetso

Pele u phekola hyperglycemia, u hloka ho tseba hore na tsoekere e kae le hore na e bakoa ke eng. Bakeng sa morero ona, ho hlahlojoa tlhahlobo ea laboratori. Ho fumana tsoekere e ngata, ho etsoa tlhahlobo ea biochemical plasma. Sampole ea mali e nooa ka mpeng e se nang letho hoseng.

Haeba sephetho sa tlhahlobo se haufi le 126 mg / dl, sena se bontša lefu la tsoekere.

Ho hlakisa lefu lena, tsamaisa thuto ea patomorphological. E bontša hore na pherekano ea pancreatic e amana le ho ruruha.

Se ke oa hana tlhahlobo e felletseng. Ho bohlokoa ho tseba sesosa sa boemo bo seng botle. Ebe kalafo e tla sebetsa haholoanyane.

Haeba boemo ba tsoekere bo eketsehile hanyane, joale tlhahlobo ea moroalo oa carbo e phetoa hape. Ho etsa sena, ba noa khalase ea metsi a monate 'me ka mor'a lihora tse' maloa ba fana ka mali bakeng sa biochemistry.

Bakeng sa ho felisa sesosa sa khatello ea maikutlo, tlhahlobo ea bobeli ea laboratori e laetsoe kamora beke. Ho khothalletsoa hape ho fetisa tlhahlobo ea moroto o akaretsang le tlhahlobo ea hemoglobin ea glycosylated.

Hyperlycemia e bonolo ha ea hlokahala ho phekola meriana. Tekanyo ea tsoekere e tloaelehile ka ho fetola mokhoa oa bophelo, lijo.

Ho boetse ho na le thuso ea ho ikoetlisa khafetsa e lumellanang le boemo le lilemo tsa motho. Haeba lefu la tsoekere le fumanoa, joale ho tla hlokahala liente tsa insulin.

Kajeno, lingaka tsa endocrinologists li sebelisa ka matla lithethefatsi tse joalo ho phekola hyperglycemia:

• Victoza. E laola takatso ea lijo 'me e fokotsa monyetla oa ho ja ho feta tekano,
• Siofor. Fokotsa khatello ea glucose,
• Glucophage. E sebetsa joaloka Siofor,
• Se-Aktos. Eketsa kutloisiso ea lisele tsa 'mele oa motho ho insulin.

Mokhoa oa phekolo, tekanyetso ea endocrinologist e khetha motho ka mong ka mokuli. Nakong ea kalafo, ho bohlokoa ho hlokomela phepo e nepahetseng. Ho batho ba nang le lefu la tsoekere ba sebelisang li-hypoglycemic agents, hypoglycemia e ka etsahala ka lijo tse sa lokang.

Haeba sesosa sa hyperglycemia ke pancreatitis e bohloko kapa lefu le leng, ho hlokahala ho phekola lefu lena le tlas'a methapo.

Marang-rang ho na le mekhoa e mengata ea meriana ea setso e ka felisang hyperglycemia. Lioli tsa bohlokoa tse fumanehang limeleng tse ling li thusa ho fokotsa tsoekere e maling le ho tiisa boemo ba mokuli.

Thepa ena e bitsoa haholo ka juniper, eucalyptus le geranium. E na le thuso ea tee ho makhasi a birch, li-blueberries, decoction ea li-rhizomes tsa burdock, makhasi a linaoa.

Mefuta efe kapa efe ea setso e lokela ho lumellanoa le ngaka. Ho seng joalo, ho na le kotsi ea ho mpefatsa boemo.

Thibelo

Ho qoba nts'etsopele ea hyperglycemia, mehato ea thibelo e lokela ho nkuoa. Ho bohlokoa ho ikoetlisa ka mokhoa o itekanetseng letsatsi le letsatsi. Hoa hlokahala ho phekola maloetse ohle ka nako. Sena se sebetsa ho motho ea se nang lefu la tsoekere.

Ha ho na le mathata a endocrine, ho tlola ha tsoekere ho ka qojoa ka ho hlahloba maemo a tsoekere le ho etela ngaka nako le nako.

Karolo ea bohlokoa ea thibelo ke phepo e nepahetseng. Lijo li khethoa ka bomong ke ngaka bakeng sa mokuli ka mong.

Ho na le melao e akaretsang e ka fokotsang kotsi ea ho ba le hyperglycemia:

• u se ke oa nona haholo. Lijo tse ngata tse matlafatsang li beha khatello makhophong,
• ja ka nako e behiloeng,
• ja hanyane ka likarolo tse nyane,
• lekola khalori ea ho ja lijo,
• ho fokotsa palo ea lik'habohaedreite tse bonolo tse tsoang lijong,
• nka li-complexes tsa vithamine.

Haeba u latela melao e joalo, ho ka se be le mathata ka tsoekere e phahameng.

Boimana le bocheng

Nakong ea kemolo, ho ba le liphetoho tse mpe 'meleng. Ka linako tse ling lefu la tsoekere la botšehali le ea hlaha. Sena se hlalosoa ke keketseho ea boemo ba lihormone bo sebetsang e le bahanyetsi ba insulin.

Hypovitaminosis, lijo tse sa lekanang, khatello ea maikutlo, tahlehelo ea mali e bohlokoa, meriana e tsoelang pele e ka baka mathata a metabolism ea carbohydrate.

Ho bohlokoa ho qoba khatello ea maikutlo nakong ea kemolo

Sehlopha sa kotsi se kenyeletsa basali ba maemong:

• ka ho ima hangata
• ho nona haholo
• ea neng a tloaetse ho beleha bana ba boima bo fetang li-kilos tse 4,
• ba nang le li-pathologies tsa manyeme.

Hyperglycemia e ama hampe boemo ba mosali oa moimana feela, empa le bophelo ba ngoana.

Bakeng sa lesea, lenane la litlamorao le fanoa ka tlase:

Ho lesea le sa tsoa tsoaloa le nang le tsoekere e ngata e tsoetseng pele, lits'oants'o tse mpe tsa ts'ebetso, ho se sebetse hantle mesebetsing ea litho tse 'maloa le litsamaiso li ka bonoa.

Sesosa sa hyperglycemia ho masea e ka ba tšoaetso, ho nka meriana e itseng, li-pathologies tse fapaneng.

Ho thibela hyperglycemia ho mosali oa moimana le ea sa tsoa hlaha, ho bohlokoa ho lekola phepo e nepahetseng, boemo ba tsoekere, boima. Bo-'mè ba lebelletseng ba hloka ho hlahlobeloa ka nako e behiloeng ka nako.

Livideo tse amanang

Mabapi le matšoao le litlamorao tse ka hlahang tsa hyperglycemia ho video:

Ka hona, hyperglycemia e bonoa khahlano le semelo sa ho nona ho feta tekano, li-pathologies tsa manyeme le litho tse ling. Haeba litekanyetso tsa tsoekere li sa tloaeleha, ho ka hlaha mathata a tebileng. Ka hona, ha matšoao a litšobotsi a hlaha, o lokela ho ikopanya le ngaka hanghang.

O tla fana ka tlhahlobo mme a khethe mofuta o nepahetseng oa kalafo. Basali ba baimana ba lokela ho itlhokomela ka ho khetheha. Ntle le moo, hyperglycemia e ama hampe boemo ba 'm'e oa ka moso feela, empa e ama le bophelo bo botle le kholo ea ngoana.

Hyperglycemia syndrome

Hyperglycemia syndrome ke keketseho ea tsoekere ea mali. Psychology ena e ka hlaha ho batho ba nang le mafu a tsamaiso ea endocrine, hangata ho batho ba nang le lefu la tsoekere. Ramatiki ena e ka ba teng ka lilemo tse ngata le ka metsotso e seng mekae.

Mefuta e meraro ea hyperglycemia ka moetlo e khetholloa ho latela botebo ba eona: e bonolo, e leka-lekaneng ebile e tebile. Mefuta ea limela e fapana ho latela boemo ba tsoekere maling. Bakeng sa batho ba nang le lefu la tsoekere, lefu lena le na le mefuta ea bona:

• ho itima lijo hyperglycemia (ho etsahala haeba motho ea kotsing a sa ja lihora tse fetang tse robeli),
• hyperglycemia thapama (ha bongata ba tsoekere bo eketseha kamora ho ja).

Hape, psychology ena e arotsoe ka nakoana ebile e phehella. Bala ka lisosa tsa hyperglycemia e ntseng e tsoela pele ka tlase, empa lintlha tse latelang li ka baka ea nakoana:

• khatello ea nako e telele
• takatso e phahameng ea lik'habohaedreite
• tahlehelo e boima ea mali
• ho haella ha livithamini C kapa B1,
• boimana

Ho felisa hyperglycemia ea nakoana, ho lekane ho tlosa mohloli oa bona mme o buisane le setsebi mabapi le liketso tse ling hape hore boemo bo se ke ba tsoa taolong mme bo se ke ba fola.

Bakeng sa ho thibela mofuta oa nakoana oa lefu lena hore e se ke ea phehella, ho bohlokoa ho tseba ka lisosa tsa eona.

Hyperglycemia: lisosa

Lebaka la ho kheloha hona ke maemo a tlaase a insulin. Hormone ena e hlahisoa ke manyeme, 'me' mele oa e hloka hore o sebetse tsoekere. Hangata, khaello ea insulin e bonahala hantle ho bakuli ba nang le lefu la tsoekere mellitus (pele boemo ba eona boa theoha, ebe mmele o khaotsa ho amohela lisele tsa insulin, leha e le boemo ba eona bo lekaneng).

Ka hona, hyperglycemia e iponahatsa haeba motho ea nang le lefu la tsoekere a haelloa ke moriana kapa ente ea insulin, kapa a tlōla lijo tse khethehileng.

Lefu lena le boetse le hlaha ho ba tloaetseng ho ba le tšoaetso ea 'mele "- boemo boo motho a jang lijo tse fetang tseo' mele oa hae o li hlokang.Joalokaha ho boletsoe ka holimo, keketseho ea ho ja lijo tse nang le lik'habohaedreite e lebisa ho khelohileng ho nakoana ho se tloaelehileng, empa bulimia mothosa ke bokuli ba nako e telele, 'me hyperglycemia e na le nako e lekaneng ea ho ba e sa foleng.

Hyperglycemia e ka boela ea bakoa ke ts'oaetso e bakang tsamaiso ea endocrine ho hlahisa lihormone tse sireletsang, tseo ka nako eo li sitisang tlhahiso ea insulin.

Pathology e ka boela ea e-ba litlamorao tsa moriana o mong le o mong.

Bakeng sa ho lemoha ho kheloha hona ka nako, ho bohlokoa ho tseba hore na e iponahatsa joang, hobane keketseho e matla ea tsoekere e ka lebisa ho komeng.

• molomo o sa feleng o ommeng le lenyora le matla (ka lebaka la phallo e phahameng ea tsoekere, mokelikeli o felisoa liseleng, hangata sena se hlaha liphoofolong tsa mucous, ka hona molomo o omileng),
• ho ruruha khafetsa (ho amanang le ts'ebetso ea ho senyeha ha renal),
• bofokoli (ka lebaka la bophahamo bo boholo ba mokelikeli, metabolism ea liseleng e ea fokotseha, ka ho fapana, tlhahiso ea matla e ea fokola),
• ho fokotsa boima ba 'mele (hape, ka lebaka la tahlehelo ea mali, boima ba' mele le bona bo fokotseha),
• mokhathala le bofokoli,
• ho sitisoa ha pono
• boemo bo koatileng
• pallor

Bakeng sa batho ba khethiselitsoeng ho hyperglycemia ka mabaka a fapaneng, ho na le mehato e 'maloa ea thibelo e ka thibeloang ho fetelletsa:

• hoa hlokahala ho hlokomela lijo tse boletsoeng ke ngaka le ho etsa mojaro o nepahetseng,
• ha ho ratehe ho tlola lithethefatsi tse theolelang tsoekere le liente tsa insulin,
• maemo a tsoekere ea mali a lekoa hantle khafetsa ka nako e ts'oanang,
• hoa hlokahala ho tsebisa ngaka ka litlolo tsohle tse tsoekere ea mali,
• feela, leka ho lula u e-na le lithethefatsi tse fokotsang tsoekere

Joalokaha ho boletsoe ka holimo, hyperglycemia e iponahatsa hangata haholo ho batho ba nang le lefu la tsoekere.

Kaha, ho ea ka lipalo, ho na le karolo ea 8% ea batho ba joalo ho palo eohle ea batho, tlhahisoleseling mabapi le liketso tse potlakileng ponong ea pele ea hyperglycemia e ke ke ea e-ba ea bohlokoa ho mang kapa mang: pele ho tsohle, o lokela ho lekanya boemo ba tsoekere ho li-crochets, haeba e phahamisitsoe, etsa ente ea insulin mme o phete mehato ena lihora tse ling le tse ling tse peli ho fihlela boemo ba tsoekere bo theoha. Haeba ho se na ntlafatso, o lokela ho etela ngaka hang-hang.

Ho hlokahala hore o noe metsi a mangata ka hohle kamoo ho ka khonehang, metsi a nang le alkaline e loketseng ka ho fetisisa, haeba letlalo le sa tloaelehang le bonoa le ka hlakoloa ka thaole e mongobo.

O tlameha ho utloisisa hore le ha hyperglycemia e sa fole 'me e bakoa ke sesosa sa nako e le' ngoe, ho molemo ho buisana le ngaka le ho etsa liteko tse hlokahalang ho thibela mathata le nts'etsopele ea lefu la tsoekere.

Sengoliloeng sena se ne se shebiloe makhetlo a 340

Hyperglycemia: matšoao le kalafo

Sehlopha: Lipono tsa Endocrine Views: 28524

Hyperglycemia ke boemo ba methapo ea methapo bo ntseng bo tsoela pele ka lebaka la keketseho ea khatello ea tsoekere maling le phallo ea mafu a tsamaiso ea endocrine, ho kenyeletsa lefu la tsoekere. Tekanyo e tloaelehileng ea tsoekere ea mali e tsoa ho 3.3 ho isa ho 5.5 mmol / L. Ka glycemia, matšoao a eketseha ho fihlela ho 6-7 mmol / L. Khoutu ea ICD-10 ke R73.9.

Boemo bona bo kotsi haholo, hobane kantle le phepelo ea thuso ea pele e tlang, komisi e etsahala. Ha matšoao a pele a hlaha, a bonts'a ho kula, ho a hlokahala hore o letse sehlopha sa ambulense hanghang.

Lebaka le ka sehloohong la kholo ea hyperglycemia ke khatello e tlase ea "insulin" ea 'mele oa motho (sepheo sa mantlha sa hormone ena ke ho fokotsa sekhahla sa tsoekere maling. Ho bohlokoa ho hlokomela hore hyperglycemia e nka nako e telele ebile ea nakoana.

Lisosa tsa hyperglycemia ea nakoana:

• chefo ea 'mele ka chefo ea khase.
• tšebeliso e ngata ea lik'habohaedreite ka lijo,
• lefu la bohloko bo tebileng, le tsamaeang le secretion ea adrenaline le thyroxine,
• ho ba le ngoana,
• khatello ea maikutlo
• ho tsoa mali haholo
• lefu la tsoekere la steroid kapa hyperplasia ea adrenal,
• hypovitaminosis ea livithamini B1 le C.

Lebaka le ka sehloohong la sebopeho se telele sa lefu lena ke ho hloleha hoa molao oa neuro-endocrine ho metabolism ea carbohydrate.

Lisosa tse ka sehloohong tsa hyperglycemia

E sa foleng

Foromo ena e tsoela pele khahlano le lefu la tsoekere. Secretion e bolokiloeng ea insulin ke lona lebaka le ka sehloohong la boemo bona. Sena se tsamaisoa ke tšenyo liseleng tsa manyeme, hammoho le lintho tse futsitsoeng.

Mofuta o sa foleng ke oa mefuta e 'meli:

• postprandial hyperglycemia. Ts'oarello ea tsoekere e eketseha kamora ho ja lijo,
• mosesane. Hoa hlaha haeba motho a sa je lijo leha e le life ka lihora tse 8.

• bonolo. Mefuta ea tsoekere e tloha ho 6.7 ho isa ho 8,2 mmol / L,
• kakaretso e tsoa ho 8,3 ho isa ho 11 mmol / l,
• boima - matšoao a kaholimo ho 11.1 mmol / l.

Mokhabiso

Sebopeho sa alimentary se nkuoa e le boemo ba 'mele bo tsoelang pele kamora hore motho a je limatlafatsi tse ngata tsa mmele. Khokahano ea glucose e phahama ka mor'a hora ka mor'a ho ja. Ha ho na tlhoko ea ho lokisa hyperglycemia ea alimentary, kaha boemo ba tsoekere ka boomo bo khutlela maemong a tloaelehileng.

Matšoao a matšoao

Ho bohlokoa ho potlakela ho tšoaea keketseho e potlakileng ea tekanyo ea tsoekere maling le ho fa mokuli thuso ea pele le ho thibela ho fetela ha mathata a kotsi. Ho etsa sena, o hloka ho tseba matšoao a mantlha a hyperglycemia:

• ho teneha ho hoholo, leha ho sa susumetsoe ke eng kapa eng,
• lenyora le matla
• tsebetso ea molomo
• hlatsa haholo
• takatso e matla (sesupo sa tšobotsi),
• ho ruruha ho feteletseng
• hlooho e bohloko haholo
• fokotsa nako,
• letšoao le khethollang la bokuli ke ponahalo ea monko oa acetone o tsoang molomong oa mokuli,
• mokhathala,
• khafetsa ho ntša,
• letlalo le omeletseng.

Hyperglycemia ho bana

Hyperglycemia ho bana e bontšoa ke keketseho ea khatello ea tsoekere maling le ho 6,5 mmol / L. Ho bohlokoa ho hlokomela hore ba na le boemo bona maemong a mang ho ka hlaha ntle le letšoao le le leng.

Hyperglycemia hangata e fumanoa ho masea a sa tsoa hlaha. Ho fihlela joale, lingaka li sitoa ho bua ka bonnete ba hore na ke eng e bakang boemo bona.

Tsoekere e nyoloha khafetsa ho bana ba nang le boima bo ka tlase ho 1.5 kg, kapa ba nang le sepsis, encephalitis, meningitis le mafu a mang a kotsi.

Haeba boemo bona ba pathological bo sa fumanoe ka nako mme ngoana a sa thusoe, ts'ebetso ea lisele tsa boko e senyehile, 'me e lebise ponahalong ea ho ruruha le ho ruruha.

Hyperglycemia

Thuso haeba ho na le tlhaselo ea hyperglycemia:

• Ho bohlokoa ho khelosa acidity e eketsehileng ka mpeng. Ho fihlela sena, mokuli o fuoa ho ja meroho le litholoana tse eketsehileng, le ho noa metsi a liminerale ka sodium,
• hlakola letlalo ka thaole e mongobo. Mmele o na le metsi, 'me ka tsela ena o iketsetsa mokelikeli o lahlehileng,
• gastric lavage ka tharollo ea soda - e thusa ho tlosa acetone 'meleng.

Phekolo ea hyperglycemia e lokela ho etsoa hang-hang, joalo ka ha matšoao a pele a bontšitse. Thuso ke ho tsamaisa insulin ho theola boemo ba hau ba tsoekere.

U lokela hape ho tsamaisa kalafo ea detoxification le dehydration ka tharollo e se nang mathata. Nakong ea kalafo ea hyperglycemia, ho bohlokoa hape ho latela mokhoa oa ho ja, ho robala le ho phomola.

Thuso e tlang ka nako ha e tlo thusa feela ho ntlafatsa boemo ba mokuli, empa hape e tla qoba mathata a kotsi.

Mafu a nang le matšoao a tšoanang:

Ketoacidosis (matšoao a amanang: 6 ho a 12)

Ketoacidosis ke motsoako o kotsi oa lefu la tsoekere, leo, ntle le kalafo e lekaneng le e nakong, le ka lebisang ho letala la lefu la tsoekere kapa esita le lefu.

Boemo bo qala ho ntlafala haeba 'mele oa motho o sa khone ho sebelisa tsoekere ka botlalo e le mohloli oa matla, kaha e haelloa ke insulin.

Maemong ana, mochine oa ho qobella o sebetsa, 'me' mele o qala ho sebelisa mafura a kenang e le mohloli oa matla.

... lefu la lefu la tsoekere (matšoao a amanang: matšoao a 5 ho a 12)

Lefu la tsoekere ke lefu le bakoang ke ho haella ha vasopressin 'meleng, le hona ho hlalosoang e le hormone ea antidiuretic. Lefu la tsoekere, matšoao a lona ke tlolo ea metabolism ea metsi mme le bonahala e le lenyora le nang le nako e telele ka nako e le 'ngoe (polyuria e eketsehileng), ke lefu le sa tloaelehang.

... Premenopause (matšoao a amanang: 5 ho a 12)

Premenopause ke nako e ikhethang bophelong ba mosali, eo nako ea eona e ikhethang ho moemeli e mong le e mong oa mosali. Ona ke mofuta oa phapang pakeng tsa ho ilela khoeli le khoeli ka ho ilela khoeli le khoeli ea ho ea khoeling.

... lefu la tsoekere ho banna (matšoao a kopaneng: 5 ho tse 12)

Lefu la tsoekere ho banna ke lefu la tsamaiso ea endocrine, khahlano le nalane eo ho eona ho nang le tlolo ea phapanyetsano ea phapanyetsano ea metsi le lik'habohaedreite 'meleng oa motho. Sena se lebisa ho hlohlona ha pancreatic, e ikarabellang bakeng sa tlhahiso ea hormone ea bohlokoa - insulin, ka lebaka leo tsoekere e sa fetoheng tsoekere 'me e bokellana maling.

... Lefu la tsoekere ho bana (matšoao a amanang: 5 ho a 12)

Lefu la tsoekere ho bana ke bokuli ba metabolism, ho kenyelletsa carbohydrate, e thehiloeng ho ho hlohlona ha pancreatic. Setho sena sa kahare se ikarabella bakeng sa tlhahiso ea insulin, eo ho eona lefu la tsoekere le ka fokotsang haholo kapa la itšireletsa mafung ka botlalo. Keketseho ea bana ke ngoana a le mong ho bana ba 500, 'me har'a bana ba sa tsoa hlaha - ngoana a le mong ho isa ho likete tse 400.

Postprandial, alimentary, hyperglycemia ea 'mele

Hyperglycemia ke pontšo ea bongaka ea lefu la metabolism la carbohydrate le tsoelang pele le keketseho e kholo ea tsoekere ea mali. Sekhahla sa tsoekere ea mali se potlakileng ke 3,3 - 5, 5 mmol / L.

Pathogenesis ea hyperglycemia e bonolo - hona ke tšitiso pakeng tsa tekanyo ea tsoekere le ts'ebeliso. Ts'ebetso e sa lekanyetsoang ea ho nchafatsa e hlaha ka lebaka la ho ja lijo tse ngata kapa ho fokotsa ts'ebeliso ea tsoekere 'meleng.

E ba teng ha ho se na insulin kapa ka ho eketseha ha lihormone tse bakang lefu lena. Ka mohopolo, keketseho ea tsoekere ea mali e ka ba ea 'mele le ea tlhaho.

Tlolo ea mofuta ona e arotsoe ka mefuta e mengata ea hyperglycemia:

• Ho nts'etsapele ts'ebetso ea ts'ebetso ea manyeme e sa sebetseng, e ikarabellang bakeng sa tlhahiso ea insulin. Ena ke mokhoa o sa foleng oa "hyperglycemia": Haeba manyeme a tšoenyehile kapa a fokotsehile, ts'ebetso ea phallo ea tsoekere - glycolysis, e fokotseha haholo mme e lebisa ho bokelleng tsoekere maling. Psychology e joalo e sa foleng e hlaha ho lefu la tsoekere "mellitus" le mafu a makhopho a tšoaetsanoang: pancreatitis e bohloko (ketsahalo ea hyperglycemia feela nakong ea lefu le feteletseng), jj.
• Mefuta e meng: - alimentary hyperglycemia e amanang le ho ja lijo, - hyperglycemia ea mantlha, - maikutlong kapa khatello ea maikutlo - e nts'etsapeleng nakong ea khatello e matla ea kelello le maikutlo, - e ntse e hola nakong ea ho pepesehela li-reagents tse chefo le tse sa sebetseng tsamaisong ea methapo e bohareng. Metsoako e holofatsang lehata le bokong, marangrang a bokong le lesapo la mokokotlo, maemo a tahi, ho ruruha ha litho tsa bokantle, ho hlohlona, ​​joalo-joalo, - hormonal - hyperglycemia

Boikoetliso ba 'mele le phepo e nepahetseng

Hyperglycemia ea 'mele e kenyelletsa patlisiso ea anaemary le neurogenic. Ka mofuta oa 'mele, lits'ebetso tsa ho khutla ha li hloke mehato ea ho lokisa, hobane boemo ba tsoekere bo tloaelehileng ka mokhoa o ikemetseng.

Alimentary hyperglycemia (physiological) e ba teng nakong ea lijo e nang le lik'habohaedreite, sena ke boemo bo tloaelehileng ba 'mele.

Keketseho ea litekanyetso tsa tsoekere e ka bonoa ho elella bofelong ba hora ea pele kamora ho ja, kamora hora, litekanyetso li fokotseha le ho fihlela boleng bo tloaelehileng.

Ntho e fanang ka phokotso e potlakileng ea tsoekere e phahameng ea mali e thehiloe ts'ebelisong ea insulin, e leng hormone e hlahisoang ke lihlekehleke tsa Langerhans ea manyeme.

Ho hlahisoa ha hormone ena ho etsoa ka mokhoa o makatsang nakong ea lijo ebe ho fihla tlhoro ha lekhapetla la lijo le kena qalong ea mala. Insulin e ameha ho tsamaiseng mafolofolo a limolek'hule tsa glucose liseleng tsa 'mele.

Insulin e lekanya palo ea tsoekere maling mme, ka lebaka la tlhahiso ea eona e potlakileng, e thibela hyperglycemia le glycosuria. Sena se khetholla hyperglycemia ea 'mele le mefuta e meng, ho etsa mohlala, ho tloha ho lihormone, maikutlo, khatello ea maikutlo, ts'ebetso ea nakoana, ea nakoana le ea nakoana.

Ts'ebetso e tloaelehileng ea 'mele e ka fetoha kapele hore na u senya lijo ka liprotheine tse jang matla le lik'habohaedreite. Ho joalo, keketseho e kholo ea tsoekere ea mali e kenyelletsa mochine oa ho qobella - glycogenolysis, ka hona, hyperglycemia e etsahala.

Emotional (e sithabetsang)

Hyperglycemia ea maikutlo kapa ea khatello ea maikutlo e tšoauoa ka mochine oa pathogenetic oa neurogenic. Hangata, sesosa e ka ba karabelo e sithabetsang, ho ruruha ha neuropsychic, Causalgia, jj. Ka khatello ea maikutlo e kholo ka lebaka la ts'ebetso ea litsamaiso tsa kutloelo-bohloko le qoqotho, ho qaleha lefu la khatello ea kelello.

Ho hlahisa lihormone tse sebetsang: catecholamines, glucocorticoids, triiodo- le tetraiodoranins - ho lebisa ho emeng ha glycogeneis le keketseho ea gluconeogenesis le glycogenolysis. Ketso ea li-catecholamine maling e lebisa ts'ebetsong ea adenylate cyclase, e tsosang khatello ea cyclic adenosymmonophosphate cytoplasm ea lisele tsa mesifa ea masapo le sebete.

Cyclic AMP e sebetsa ho protheine kinase, e phethang karolo ea bohlokoa ho glycogenolysis. Protheine kinase ena e lekola hore na glycogen e putlama hakae ho hepatocytes le myocyte. Ka lebaka la tsoekere e lokolotsoeng, hyperglycemia ea maikutlo kapa e sithabetsang e fumanoa.

Ts'ebetso ena kaofela e etsahala ho ea ka melao ea 'mele bakeng sa ts'ebetso e potlakileng ea ho kenya lik'habohaedreite, tse bolokiloeng' me nakong e tlang li sebetsa e le mohloli oa matla mosebetsing oa tšebetso e matlafatsang ea 'mele kapa ea kelello.

Hormonal

Keketseho ea boemo ba li-hormone tse itseng ho mafu a mang e ama khatello ea tsoekere maling. Lihormone tse eketsang boemo ba glucose:

• glucocorticoids,
• glucagon,
• Catecholamine
• lihormone tsa qoqotho.

Matšoao a matšoao

Ho bohlokoa ho potlakela ho tšoaea keketseho e potlakileng ea tekanyo ea tsoekere maling le ho fa mokuli thuso ea pele le ho thibela ho fetela ha mathata a kotsi. Ho etsa sena, o hloka ho tseba matšoao a mantlha a hyperglycemia:

• ho teneha ho hoholo, leha ho sa susumetsoe ke eng kapa eng,
• lenyora le matla
• tsebetso ea molomo
• hlatsa haholo
• takatso e matla (sesupo sa tšobotsi),
• ho ruruha ho feteletseng
• hlooho e bohloko haholo
• fokotsa nako,
• letšoao le khethollang la bokuli ke ponahalo ea monko oa acetone o tsoang molomong oa mokuli,
• mokhathala,
• khafetsa ho ntša,
• letlalo le omeletseng.

Hyperglycemia ho bana

Hyperglycemia ho bana e bontšoa ke keketseho ea khatello ea tsoekere maling le ho 6,5 mmol / L. Ho bohlokoa ho hlokomela hore ba na le boemo bona maemong a mang ho ka hlaha ntle le letšoao le le leng.

Hyperglycemia hangata e fumanoa ho masea a sa tsoa hlaha. Ho fihlela joale, lingaka li sitoa ho bua ka bonnete ba hore na ke eng e bakang boemo bona.

Tsoekere e nyoloha khafetsa ho bana ba nang le boima bo ka tlase ho 1.5 kg, kapa ba nang le sepsis, encephalitis, meningitis le mafu a mang a kotsi.

Haeba boemo bona ba pathological bo sa fumanoe ka nako mme ngoana a sa thusoe, ts'ebetso ea lisele tsa boko e senyehile, 'me e lebise ponahalong ea ho ruruha le ho ruruha.

Hyperglycemia

Thuso haeba ho na le tlhaselo ea hyperglycemia:

• Ho bohlokoa ho khelosa acidity e eketsehileng ka mpeng. Ho fihlela sena, mokuli o fuoa ho ja meroho le litholoana tse eketsehileng, le ho noa metsi a liminerale ka sodium,
• hlakola letlalo ka thaole e mongobo. Mmele o na le metsi, 'me ka tsela ena o iketsetsa mokelikeli o lahlehileng,
• gastric lavage ka tharollo ea soda - e thusa ho tlosa acetone 'meleng.

Phekolo ea hyperglycemia e lokela ho etsoa hang-hang, joalo ka ha matšoao a pele a bontšitse. Thuso ke ho tsamaisa insulin ho theola boemo ba hau ba tsoekere.

U lokela hape ho tsamaisa kalafo ea detoxification le dehydration ka tharollo e se nang mathata. Nakong ea kalafo ea hyperglycemia, ho bohlokoa hape ho latela mokhoa oa ho ja, ho robala le ho phomola.

Thuso e tlang ka nako ha e tlo thusa feela ho ntlafatsa boemo ba mokuli, empa hape e tla qoba mathata a kotsi.

Mafu a nang le matšoao a tšoanang:

Ketoacidosis (matšoao a amanang: 6 ho a 12)

Ketoacidosis ke motsoako o kotsi oa lefu la tsoekere, leo, ntle le kalafo e lekaneng le e nakong, le ka lebisang ho letala la lefu la tsoekere kapa esita le lefu.

Boemo bo qala ho ntlafala haeba 'mele oa motho o sa khone ho sebelisa tsoekere ka botlalo e le mohloli oa matla, kaha e haelloa ke insulin.

Maemong ana, mochine oa ho qobella o sebetsa, 'me' mele o qala ho sebelisa mafura a kenang e le mohloli oa matla.

... lefu la lefu la tsoekere (matšoao a amanang: matšoao a 5 ho a 12)

Lefu la tsoekere ke lefu le bakoang ke ho haella ha vasopressin 'meleng, le hona ho hlalosoang e le hormone ea antidiuretic. Lefu la tsoekere, matšoao a lona ke tlolo ea metabolism ea metsi mme le bonahala e le lenyora le nang le nako e telele ka nako e le 'ngoe (polyuria e eketsehileng), ke lefu le sa tloaelehang.

... Premenopause (matšoao a amanang: 5 ho a 12)

Premenopause ke nako e ikhethang bophelong ba mosali, eo nako ea eona e ikhethang ho moemeli e mong le e mong oa mosali. Ona ke mofuta oa phapang pakeng tsa ho ilela khoeli le khoeli ka ho ilela khoeli le khoeli ea ho ea khoeling.

... lefu la tsoekere ho banna (matšoao a kopaneng: 5 ho tse 12)

Lefu la tsoekere ho banna ke lefu la tsamaiso ea endocrine, khahlano le nalane eo ho eona ho nang le tlolo ea phapanyetsano ea phapanyetsano ea metsi le lik'habohaedreite 'meleng oa motho. Sena se lebisa ho hlohlona ha pancreatic, e ikarabellang bakeng sa tlhahiso ea hormone ea bohlokoa - insulin, ka lebaka leo tsoekere e sa fetoheng tsoekere 'me e bokellana maling.

... Lefu la tsoekere ho bana (matšoao a amanang: 5 ho a 12)

Lefu la tsoekere ho bana ke bokuli ba metabolism, ho kenyelletsa carbohydrate, e thehiloeng ho ho hlohlona ha pancreatic. Setho sena sa kahare se ikarabella bakeng sa tlhahiso ea insulin, eo ho eona lefu la tsoekere le ka fokotsang haholo kapa la itšireletsa mafung ka botlalo. Keketseho ea bana ke ngoana a le mong ho bana ba 500, 'me har'a bana ba sa tsoa hlaha - ngoana a le mong ho isa ho likete tse 400.

Postprandial, alimentary, hyperglycemia ea 'mele

Hyperglycemia ke pontšo ea bongaka ea lefu la metabolism la carbohydrate le tsoelang pele le keketseho e kholo ea tsoekere ea mali. Sekhahla sa tsoekere ea mali se potlakileng ke 3,3 - 5, 5 mmol / L.

Pathogenesis ea hyperglycemia e bonolo - hona ke tšitiso pakeng tsa tekanyo ea tsoekere le ts'ebeliso. Ts'ebetso e sa lekanyetsoang ea ho nchafatsa e hlaha ka lebaka la ho ja lijo tse ngata kapa ho fokotsa ts'ebeliso ea tsoekere 'meleng.

E ba teng ha ho se na insulin kapa ka ho eketseha ha lihormone tse bakang lefu lena. Ka mohopolo, keketseho ea tsoekere ea mali e ka ba ea 'mele le ea tlhaho.

Tlolo ea mofuta ona e arotsoe ka mefuta e mengata ea hyperglycemia:

• Ho nts'etsapele ts'ebetso ea ts'ebetso ea manyeme e sa sebetseng, e ikarabellang bakeng sa tlhahiso ea insulin. Ena ke mokhoa o sa foleng oa "hyperglycemia": Haeba manyeme a tšoenyehile kapa a fokotsehile, ts'ebetso ea phallo ea tsoekere - glycolysis, e fokotseha haholo mme e lebisa ho bokelleng tsoekere maling. Psychology e joalo e sa foleng e hlaha ho lefu la tsoekere "mellitus" le mafu a makhopho a tšoaetsanoang: pancreatitis e bohloko (ketsahalo ea hyperglycemia feela nakong ea lefu le feteletseng), jj.
• Mefuta e meng: - alimentary hyperglycemia e amanang le ho ja lijo, - hyperglycemia ea mantlha, - maikutlong kapa khatello ea maikutlo - e nts'etsapeleng nakong ea khatello e matla ea kelello le maikutlo, - e ntse e hola nakong ea ho pepesehela li-reagents tse chefo le tse sa sebetseng tsamaisong ea methapo e bohareng. Metsoako e holofatsang lehata le bokong, marangrang a bokong le lesapo la mokokotlo, maemo a tahi, ho ruruha ha litho tsa bokantle, ho hlohlona, ​​joalo-joalo, - hormonal - hyperglycemia

Boikoetliso ba 'mele le phepo e nepahetseng

Hyperglycemia ea 'mele e kenyelletsa patlisiso ea anaemary le neurogenic. Ka mofuta oa 'mele, lits'ebetso tsa ho khutla ha li hloke mehato ea ho lokisa, hobane boemo ba tsoekere bo tloaelehileng ka mokhoa o ikemetseng.

Alimentary hyperglycemia (physiological) e ba teng nakong ea lijo e nang le lik'habohaedreite, sena ke boemo bo tloaelehileng ba 'mele.

Keketseho ea litekanyetso tsa tsoekere e ka bonoa ho elella bofelong ba hora ea pele kamora ho ja, kamora hora, litekanyetso li fokotseha le ho fihlela boleng bo tloaelehileng.

Ntho e fanang ka phokotso e potlakileng ea tsoekere e phahameng ea mali e thehiloe ts'ebelisong ea insulin, e leng hormone e hlahisoang ke lihlekehleke tsa Langerhans ea manyeme.

Ho hlahisoa ha hormone ena ho etsoa ka mokhoa o makatsang nakong ea lijo ebe ho fihla tlhoro ha lekhapetla la lijo le kena qalong ea mala. Insulin e ameha ho tsamaiseng mafolofolo a limolek'hule tsa glucose liseleng tsa 'mele.

Insulin e lekanya palo ea tsoekere maling mme, ka lebaka la tlhahiso ea eona e potlakileng, e thibela hyperglycemia le glycosuria. Sena se khetholla hyperglycemia ea 'mele le mefuta e meng, ho etsa mohlala, ho tloha ho lihormone, maikutlo, khatello ea maikutlo, ts'ebetso ea nakoana, ea nakoana le ea nakoana.

Ts'ebetso e tloaelehileng ea 'mele e ka fetoha kapele hore na u senya lijo ka liprotheine tse jang matla le lik'habohaedreite. Ho joalo, keketseho e kholo ea tsoekere ea mali e kenyelletsa mochine oa ho qobella - glycogenolysis, ka hona, hyperglycemia e etsahala.

Postprandial

Postprandial hyperglycemia e fumanoa haeba, ka mor'a lijo tse tloaelehileng, khatello ea tsoekere ea mali e feta 10 mmol / L. Ho kenngoa ha tsoekere ka potlako ka mpeng le ho kenella ha eona maling ho ka thibeloa ka ho sebelisa lithethefatsi - acarbose.

Leha ho le joalo, ntho ea mantlha kalafong ea keketseho ea postprandial tsoekere ea mali ke ho ja le ho fokotseha ha palo ea li-digestible poly- le oligosaccharides tse senngoeng habonolo.

Nako e khuts'oanyane, hammoho le postprandial hyperglycemia, e etsahala kapele ka mor'a ho ja lijo tse nang le lik'habohaedreite kapa hang ka mor'a khatello e matla ea kelello, ke hore, boithabiso ba tsamaiso ea methapo ea kutlo.

Ho eketseha ha mahlaseli a tsoekere ho potlakile, empa ho tloaelehile ho tsebahala ka nako e khuts'oane. Li-pathologies tsa postprandial le tsa nakoana li fapana le mefuta e meng ka mokhoa ona sekhahla sena sa ho timela.

Emotional (e sithabetsang)

Hyperglycemia ea maikutlo kapa ea khatello ea maikutlo e tšoauoa ka mochine oa pathogenetic oa neurogenic. Hangata, sesosa e ka ba karabelo e sithabetsang, ho ruruha ha neuropsychic, Causalgia, jj. Ka khatello ea maikutlo e kholo ka lebaka la ts'ebetso ea litsamaiso tsa kutloelo-bohloko le qoqotho, ho qaleha lefu la khatello ea kelello.

Ho hlahisa lihormone tse sebetsang: catecholamines, glucocorticoids, triiodo- le tetraiodoranins - ho lebisa ho emeng ha glycogeneis le keketseho ea gluconeogenesis le glycogenolysis. Ketso ea li-catecholamine maling e lebisa ts'ebetsong ea adenylate cyclase, e tsosang khatello ea cyclic adenosymmonophosphate cytoplasm ea lisele tsa mesifa ea masapo le sebete.

Cyclic AMP e sebetsa ho protheine kinase, e phethang karolo ea bohlokoa ho glycogenolysis. Protheine kinase ena e lekola hore na glycogen e putlama hakae ho hepatocytes le myocyte. Ka lebaka la tsoekere e lokolotsoeng, hyperglycemia ea maikutlo kapa e sithabetsang e fumanoa.

Ts'ebetso ena kaofela e etsahala ho ea ka melao ea 'mele bakeng sa ts'ebetso e potlakileng ea ho kenya lik'habohaedreite, tse bolokiloeng' me nakong e tlang li sebetsa e le mohloli oa matla mosebetsing oa tšebetso e matlafatsang ea 'mele kapa ea kelello.

Hormonal

Hormonal hyperglycemia e hlaha ka tlhahiso e feteletseng ea lihormone tse eketsang boemo ba tsoekere serumeng sa mali. Lihormone tse bakang ho eketseha ha tsoekere maling le melao-motheo ea phello ea tsona li latelang:

1) ka hyperplasia ea lisele tsa lihlekehleke tsa Langerhans, mofuta oa tsoekere o hlohlellelitsoe, o tsosang gluconeogeneis le glycogenolysis liseleng tsa sebete,

2) li-glucocorticoids li na le phello e ts'oanang boteng ba marang-rang,

3) pheochromocytoma ea karolo ea bokong ea lihlahala tsa adrenal e fana ka tlatsetso ea palo e eketsehang ea li-catecholamines, tseo ka tsona li hlohlelletsang glycogenolysis,

4) lihormone tsa kholo tse phahameng haholo li emisa glycolysis liseleng tse 'maloa tsa mmele,

5) Lihomone tsa qoqotho li potlakisa glycogenolysis le gluconeogeneis le ho thibela tšebetso e khutlisetsang morao. Ts'ebetso ena e hlaha ka tlhahiso e sa lekanang ea insulin kapa ho fokolisa litlamorao tsa eona, hammoho le keketseho ea tlhahiso ea lihormone tse bakang tsoekere.

Matšoao a Hyperglycemia, kalafo, litlhaloso

Hyperglycemia e bolela lets'oao la maloetse a mangata a tsamaiso ea endocrine, a hlahisoang ke tlhahiso e eketsehang kapa e feteletseng ea glucose e serum ea mali ha e bapisoa le tloaelo. Tšoaetso ea mofuta ona ke tšoaetso ea lefu la tsoekere le mafu a mang a endocrine.

Tloaelo ea litaba tsa tsoekere (tsoekere) e nkuoa e le boemo ba 3.3 - 3.5 mmol / L. Haeba letšoao lena le feta tekanyo ea 6-7 mol / l, joale ho na le matšoao a tlhahlobo ea hyperglycemia.

Mefuta e tsoekere e ngata ea 16.5 mmol / L le holimo li bontša nts'etsopele ea komello.

Mehato e meraro ea hyperglycemia e khethoa ke boemo ba tsoekere e serapeng sa mali.

1. Letšoao le bonolo le khethoa ka keketseho ea tsoekere ho isa ho 6 - 10 mmol / L.
2. Tekanyo e leka-lekane e fumanoa e le ntho e nang le "glucose" e 10 ho isa ho 16 mmol / L.
3. Pontšo e matla ea letšoao ke maemo a tsoekere ka holimo ho 16 mmol / L.

Bakeng sa bakuli ba nang le lefu la tsoekere ho na le mefuta e 'meli ea lipontšo tsa keketseho ea tsoekere ea serum.

Haeba mokuli a sa ja ka lihora tse 8 'me boemo ba hae ba tsoekere bo nyoloha ka holimo ho 7.2 mmol / l, joale ba bua ka hyperglycemia e potlakileng.

Postprandial hyperglycemia e tsejoa ha, kamora ho ja, boemo ba tsoekere bo feta 10 mmol / L.

Haeba letšoao la boemo ba tsoekere, ha ho sa fumanoe tlhahlobo ea lefu la tsoekere, le eketseha ka mor'a lijo tse ngata ho isa ho 10 mmol / l, ebe motho a ka etsa lefu la tsoekere la mofuta oa bobeli.

Kaha litlamorao tsa hyperglycemia li hlahisoa ka mathata a mangata 'meleng, bakuli ba fumanoang ba na le lefu la tsoekere ba hloka ho hlahlojoa ka linako tsohle tsoekere ea mali.

Litlamorao tsa hyperglycemia li ka bonts'oa ka tlolo ea ts'ebetso ea methapo, methapo ea mali le methapo e meng ea methapo. Tsena li kenyelletsa mathata a tebileng a kang ketoacidosis le komello.

Mokhoa oa nts'etsopele ea hyperglycemia le lisosa tsa eona

Lebaka le ka sehloohong la nts'etsopele ea matšoao ke tlhahiso e fokotsehileng ea "insulin" e fokotsang khatello ea tsoekere maling.

Mokhoa oa nts'etsopele ea hyperglycemia ke sebopeho se haellang sa e 'ngoe ea li-hormone tsa bohlokoahali ke manyeme, a amang metabolism ea carbohydrate mme o laola maemo a tsoekere ea mali.

Makhopho a kenang ka har'a sistimi ea endocrine ea motho 'me a khutlisetsa litšenyehelo tsa matla a glucose e hlokahalang bakeng sa lisele tsohle le litho tsohle.

Empa bakeng sa ho tsamaisa le ho laola tsoekere, insulin e bohlokoa, ntle le moo sethala sa tsoekere se sa laoloeng 'me ka lebaka leo, tlala ea sele le ho ata ha eona maling ho ba teng.

Ka hona, khafetsa ba bua ka likhohlano liseleng tsa cellular le mochini oa nts'etsopele ea hyperglycemia.

Arola pakeng tsa hyperglycemia e telele le ea nakoana.

Hyperglycemia ea nakoana e ka hlaha ha lijo tse nang le likhalori tse phahameng tse nang le lik'habohaedreite tse ngata li sebelisoa lijong.

Keketseho ea nakoana ea tsoekere ea mali e ka baka ho ntšoa ha adrenaline le thyroxine maling a ka lebaka la bohloko.

Khafetsa, hyperglycemia e hlaha khahlano le semelo sa maemo a sithabetsang, boimana, hyperplasia ea adrenal cortex, litekanyetso tse tlase tsa livithamini B1 le C 'meleng, li na le chefo ke li-oxide tsa carbon, ka lebaka la ho tsoa mali. Khafetsa ba tsosa hyperglycemia le meriana e meng - fentamidine,,-blockers, corticosteroids, prism ea anide le meriana e meng e mengata.

Hyperglycemia ea nako e telele e hlaha e tlola molao oa metabolism ea carbohydrate ea tlhaho ea neuro-endocrine.

Matšoenyeho Hyperglycemia

Hyperglycemia hangata e tsamaea le batho ba nang le khatello ea maikutlo e matla ka tsela ea ho phatloha ha methapo, infraction ea myocardial, kapa stroke.

Ho feta moo, hyperglycemia e joalo hangata e ba teng le ha ho se na nalane ea lefu la tsoekere.

Tlhahlobo ea bongaka e hokahanya ho eketseha ha lefu la bakuli ba nang le lefu la pelo le stroke le nts'etsopele ea khatello ea maikutlo "hyperglycemia" ka keketseho ea tsoekere ea mali.

Mochine oa ho eketsa litekanyetso tsa tsoekere nakong ea khatello ea maikutlo o ts'oaroa ke li-hormone tsa "anti" glucocorticoids, catecholamines le tse ling. Mabapi le sena, ha se kamehla ho leng bonolo ho bua ka nts'etsopele ea lefu la tsoekere ka lipontšo tsa matšoao a hyperglycemia e sithabetsang.

Lebaka la ho eketsa tsoekere ea mali ke lefe?

Pathogenesis ea hyperglycemia ke tlhahiso e sa lekaneng ea insulin ke lisele tsa manyeme.

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Ntle le insulin, tsoekere e kenngoeng ke lijo ha e kenngoe ke lisele.

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Boloetse ba metabolic bo ka hlaha eseng feela ka lebaka la ho haelloa ke insulin, empa hape le ho hanana le kutloisiso ea methapo ea kutlo ho insulin.

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Kahoo ho tla boemo ba tlala ea matla ea lisele, tse tsamaeang le tsoekere e ngata maling.

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Maemong ana, karabelo ea 'mele ho tlala ea lisele e ka hlaha: sebete se tla qala ho ts'ebetsa glycogen ka glucose ebe e e akhela maling, eo ha e le hantle e sa rarolleng bothata, empa e mpefatsa le ho feta.

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Hyperglycemia: pathogeneis

Psychology ena e khethoa ke lintlha tse 'maloa. Empa sa bohlokoahali ke mochine oa hyperglycemia ho lefu la tsoekere, hobane ke eena ea nkoang e le eena ea ka sehloohong.

Lisosa tse ling tsa hyperglycemia ke:

• Lefu la tsoekere.
• Metsoako ea oncological kapa marang a mofuta oa tšoelesa ea qoqotho. Bakeng sa tlhahlobo ea mofets'e oa qoqotho, bona sengoloa.
• Phekolo ea nako e telele ka meriana e itseng.
• Keketseho e eketsehileng ea lihomone tsa qoqotho (hyperthyroidism).
• Mekhoa ea ho ruruha makhophong.
• Ho robeha ha letsoalo, liphihlelo tsa maikutlo.
• Oncology.
• Cushing's Syndrome.

Mofuteng oa 1 oa lefu la tsoekere, insulin ha e fanoe, ho setse meriana feela ea antidiabetes. Haeba mokuli a e-na le lefu la tsoekere la mofuta oa 2, ho hlokahala insulin.

Hyperglycemia ho bana ba sa tsoa hlaha

Ho tloaelehile haholo, sephetho sa tlhahlobo (mmol / l):

• Ho itima lijo - eseng ho feta 6.5.
• Kamora ho ja - 9.

Pathology hangata e shejoa ho masea a hlahileng pele ho nako a beletsoe a le boima ba ho fihlela ho 1.5 kg. Bana ba ka nkoa e le sehlopha sa kotsi haeba bo-mme ba nang le lefu la sepsis, meningitis, encephilitis nakong ea kemaro.

Kotsi e ka sehloohong ea boemo bo tsohileng le bo sa phekoloang ke ho felloa ke metsi ka potlako 'meleng, ho fokolloa ke bophelo hantle, ho lahleheloa ke boima ba' mele. Ka lebaka leo, li-pathologies tse ling tsa tsamaiso ea endocrine li hlaha.

Matšoao a Hyperglycemia

Ka lebaka la hore litlamorao tsa hyperglycemia ha li na botsoalle, ho bohlokoa ho nka mehato ea ho fokotsa tsoekere ea mali matšoao a pele a ponahatso ea eona.

Matšoao a bohlokoa le a sebopeho ke lenyora la tšohanyetso, takatso e eketsehang ea tlala le tlala e sa khathaleng, ho ntša metsi khafetsa, pono e fokotsehileng - lesira le fofa ka pel'a mahlo.

Bakuli ba nang le maemo a tsoekere a mangata ba ba le maikutlo a ho tepella, ho opeloa ke hlooho, ho sitisoa le ho teneha.

Matšoao a phatlalalitsoeng a kenyelletsa ho ruruha ho feteletseng, ho tjha maqhubu, ho tetebela molomo le letlalo le omileng.

Tekanyo e phahameng ea tsoekere e tšoauoa ka monko oa acetone e tsoang molomong.

Ka seoelo, hyperglycemia e asymptomatic.

Khalemelo ea Hyperglycemia

Kaha litekanyetso tse phahameng tsa tsoekere ea mali li atile kajeno, e le sesupo sa lefu la tsoekere le letšoao la maloetse a mang, ho hlokahala hore o arabe ka potlako le ho lokisa hyperglycemia.

Ka sekhahla se matla sa tsoekere le pontšo ea lipontšo tse kaholimo, hoa hlokahala ho fa mokuli metsi a nang le alkaline e nang le calcium kapa sodium. Metsi a hloekisitsoeng a khelloa ka thōko ka ho felletseng.

U ka noesetsa mokuli khalase ea metsi ka likhaba tse 1 tsa sopho ea soda kapa u hloekise mala ka sebopeho se tšoanang. Ho tlosa acetone, mpa e hlatsoa ka tharollo ea khatello e le 'ngoe.

Li-ruble tse letlalo li tla thusa, ho hlakola ka botlalo karolo ea matsoho, phatla, molala, ka tlas'a mangole.

Haeba ho khonahala, ho hlokahala ho tsebahatsa boemo ba glucose mme haeba e le ka holimo ho 14 mol / l, joale ka potlako o hloka ho kenya insulin. Liente tsa insulin li etsoa ho nolofatsa maemo a tsoekere.

Kamora ho lokisoa ka potlako ha hyperglycemia, ho hlokahala hore o buisane le endocrinologist bakeng sa tlhahlobo e felletseng le kalafo e eketsehileng.

Maemong a mangata, liente tsa insulin li sebelisoa kalafong ea hyperglycemia. Ntle le moo, ho kenyelletsoa mehato e hlokahalang bakeng sa kalafo ea lefu lena le lefu le tlase.

Haeba mokuli a e-na le keketseho e tsitsitseng ea tsoekere ea mali ka matsatsi a mararo, joale moralo oa kalafo o le mong le malebela a ho ntlafatsa phepo, mosebetsi le phomolo lia ntlafatsoa.

Maemo a Hyperglycemic, mefuta ea ona le mekhoa ea ntlafatso

⇐ Leqephe le fetileng la 2 la 19 E latelang

Glucose ke mohloli o ka sehloohong oa matla 'meleng. Tekanyo ea glucose e ikemiselitsoe maling a venous kapa a capillary. Tlhahlobisong ea mali a capillary, boemo bo tloaelehileng ba tsoekere ke 3,3 - 5.5 mmol / L, mali a venous 4.1 - 5.9 mmol / L.

Insulin ke eona feela hormone ketso ea antidiabetogenic, i.e. ketso ea hypoglycemic (e fokotsa tsoekere). Insulin biosynthesis e etsoa ho li-β-cell tsa li-pancreatic pancreatic islets. Glucose ke molaoli o ka sehloohong oa secretion ea insulin ke lisele tsa β.

Hyperglycemia: tsoekere e phahameng ea mali ho feta 6 mmol / l. Ka glycemia e kholo ho feta 10 mmol / l, glucosuria e hlaha.

1. Alimentary - lihora tse 1-1,5 ka mor'a ho nka bongata ba lik'habohaedreite.

2. Neurogenic - e tsosang maikutlo (e potlakileng).

a) e nang le lisebelisoa tse felletseng kapa tse sa lekanang tsa lisebelisoa tsa islet tsa manyeme:

- E felletse - ka lebaka la phokotseho ea tlhahiso ea insulin

- setho - ka lebaka la ho fokotseha hoa palo ea li-insulin tse amohelang lisele

b) bakeng sa mafu a gtucion ea senya (ho eketsa STH le ACTH)

c) hlahala ea adrenal medulla (pheochromocytoma) - potlakisang adrenaline

d) Litekanyetso tse phahameng tsa mali tsa glucagon, thyroidin, glucocorticoids, somotropin le corticotropin.

Glycocotricoids e ameha mochining oa hyperglycemia ho lefu la tsoekere le lefu la Itsenko-Cushing.

4. Motlotlehi - haeba tsoekere e feta 8mmol / l, e hlaha ka moriring:

- e sa sebetse hantle ka mokhoa oa pancreatic

-e nang le khaello ea phosphorylation le enfelos ea dephosphorylation lipelong

- ka mafu a tšoaetsanoang le a methapo.

5. Ho ts'oaroa ha mothapo o moputsoa oa "hypothalamus", "lentil" le "stelatum" ea "basal" ea boko bo boholo.

6. Bakeng sa bohloko, nakong ea lefu la sethoathoa.

Ho fokotsa sekhahla sa karabelo ea hexokinase, glyconeogeneis e eketsehileng le ts'ebetso e eketsehileng ea glucose-6-phosphatase ke lisosa tse ka sehloohong lefu la tsoekere.

- letlalo le omeletseng le li-membrane tsa mucous

Hyperglycemia ea nako e khuts'oanyane ke boleng bo sebetsang.

Nako le nako - tahlehelo ea lik'habohaedreite le phello e kotsi.

Tlolo ea ts'ebeliso ea tsoekere ea kantle ke lisele tsa lisele tse itšetlehileng ka insulin

-Khabollo ea mehloli ea tsoekere ea tsoekere ka ho eketsa palo le ts'ebetso ea lihomone tsa lefu la tsoekere: glycogenolysis ka lebaka la ketso ea glucagon le adrenaline, ts'ebetso ea gluconeogeneis ka lebaka la glucocorticoids.

Maemo a Hypoglycemic, mefuta ea ona le mekhoa ea ntlafatso.

Hypoglycemia - fokotseha ha tsoekere ea mali e ka tlase ho 3.5 mmol / l:

1. Alimentary (lihora tse 3-5 kamora ho qeta bongata ba lik'habohaedreite, insulin).

2. Ho ikoetlisa ka thata.

3. Ho basali ba anyesang.

4. Neurogenic (ka thothokiso - hyperinsulinemia).

Bakeng sa mafu:

a) e tsamaeang le keketseho ea tšebetso ea pancreatic (insuloma, adenoma, mofetše),

b) kholo ea "insulin" ea kalafo ea lefu la tsoekere,

c) Tšenyo ea sebete,

d) ho fokotseha ha kholo ea ho eketseha ha li-hormone tse khahlanong le "lisele", "glucagon"

e) Tšenyo ea pampitšana ea ka mpeng,

6. Ka marang-rang a hypothalamus, pituitary pituitary, lefu la Addison.

Hypoglycemic syndrome (glucose ea mali e ka tlase ho 3.3 mmol / l):

- ho tšoenyeha ka nakoana, ho ba mabifi

- ho ruruha, ho thothomela, makhopho

- Ho felloa ke matla a ho tseba (coma hypoglycemic, glucose ea mali e ka tlase ho 2,5 mmol / l)

- Ho phahamisa moea le pelo e matla

-bobb ea mahlo e tsitsipane

- Tsamaiso ea ho ntša metsi ka boomo le metsamao ea mmele.

- iv 60-80 di ml tse 40% tsoekere

- Tee e monate ha kelello e khutla

Ka ho fokotseha ha tsoekere ea mali ka tlase ho 2,5 mmol / L, komello ea hypoglycemic e ka hlaha.

Lefu la tsoekere: sehlopha, etiology, pathogeneis.

Lefu la tsoekere. - lefu le bakoang ke khaello ea insulin e felletseng kapa e amanang.

I. Mofuta oa 1 lefu la tsoekere kapa Lefu la tsoekereleha ho le joalo, batho ba lilemo life kapa life ba ka kula (destruction-cell senya, e lebisang ho nts'etsopele ea khaello ea insulin ea bophelo bohle)

Autoimmune, ho kenyelletsa LADA,

II. Type 2 lefu la tsoekere (sekoli ho secretion ea insulin motheong oa khanyetso ea insulin)

Lefu la tsoekere - boemo bo amanang le hyperglycemia bo etsahalang nakong ea bokhachane ho basali ba bang mme hangata bo itlhahela feela ka mor'a ho beleha.

Tsela e bonolo

Mofuta oa "Mild" (I degree) oa lefu lena o tšoauoa ka boemo bo tlase ba glycemia, e sa feteng 8 mmol / l ka mpeng e se nang letho, ha ho se na liphetoho tse kholo tsa litaba tsa tsoekere maling maling, ho tloha matsatsing a 20 ho isa ho 20 g / l. Matšeliso a lula a le kalafo ka kalafo ea lijo. Ka mofuta o bonolo oa lefu la tsoekere, angioeuropathy ea mekhahlelo ea preclinical le e sebetsang e ka fumanoa ho mokuli ea nang le lefu la tsoekere.

Tekanyo e leka-lekaneng

Ka tekanyo e kholo ea (II degree) ea lefu la tsoekere, glycemia e potlakileng e phahama, joalo ka molao, ho fihlela ho 14mmol / l, ho fokotseha ha glycemic ho pholletsa le letsatsi, glucosuria ea letsatsi le letsatsi hangata ha e fetise 40 g / l, ketosis kapa ketoacidosis ka linako tse ling e hlaha.

Mats'eliso a lefu la tsoekere a fumaneha ka lijo le tsamaiso ea li-activator tse fokotsang tsoekere kapa ka tsamaiso ea insulin (maemong a ho hanyetsa sulfamide) ka tekanyetso e sa feteng 40 OD ka letsatsi.

Ho bakuli bana, li-angioneuropathies tsa tsoekere tsa maemo a fapaneng a lehae le mehato e sebetsang li ka bonoa.

Mokhoa o matla

Mofuta o matla oa "lefu la tsoekere" la tsoekere le tšoauoa ka maemo a phahameng a 'mele oa glycemia (ka mpeng e se nang letho e fetang 14 mmol / l), ho fokotseha hoa bohlokoa hoa tsoekere ea mali letsatsi lohle, glucosuria e phahameng (e fetang 40-50 g / l). Bakuli ba hloka kalafo ea "insulin" kamehla ka lethal dose ea 60 OD kapa ho feta, ba senotse li-angioneuropathies tse fapaneng.

Ho pathogenesis ea lefu la tsoekere, ho hokahanngoa likarolo tse peli tsa sehlooho:

1. Tlhahiso e sa lekaneng ea insulin ke lisele tsa endocrine tsa manyeme,

2. Tlolo ea ho hokahana ha insulin le lisele tsa 'mele (li-insulin resistance) ka lebaka la phetoho sebopeho kapa ho fokotseha hoa palo ea li-insulin tse ikhethang bakeng sa insulin, phetoho sebopeho sa insulin ka boeona kapa tlolo ea methapo ea methapo ea phetiso ea matšoao ho tloha li-receptors ho li-cell organelles.

Ho na le monyetla oa lefutso la lefu la tsoekere. Haeba e mong oa batsoali o kula, monyetla oa ho amohela lefu la tsoekere la 1 ke 10%, mme mofuta oa 2 lefu la tsoekere ke 80%.

Pathogenesis ea lipontšo tsa kliniki le tsa laboratori tsa lefu la tsoekere tse tsamaeang le insulin (IDD).

Mellitus ea lefu la tsoekere e itšetlehileng ka insulin (mofuta oa 1) . EdI ho latela mochine oa ntlafatso e ka aroloa ho: autoimmune, vaerase e susumetsoang le e tsoelang pele butle.

Etiology ea EDI: Ha ho na khakanyo ea tlhaho ea lefu la EDI, hobane monyetla oa ho fetisetsa mofuta o senyehileng ho tsoa ho batsoali ho ngoana o nyane haholo (ka tlase ho 4%).

Ho khothalletsoa hore EDI ke lefu la autoimmune le amanang le li-antigen tse ling tsa HLA histocompatibility tse fumanehang letsohong le khuts'oane la chromosome ea 6.

Lisosa tsa kantle tsa etiological tse hohelang IDD ke tšoaetso ea vaerase: livaerase tsa Coxsackie, rubella, cytomegalovirus, chefo ea ka ntle, liprotheine tsa lebese.

Mokhoa oa pathogenetic oa nts'etsopele ea lefu la tsoekere la mofuta oa 1 o ipapisitse le ho haella ha tlhahiso ea insulin ke lisele tsa endocrine (lisele tsa β-lihlekehleke tsa li-pancreatic Langerhans).

Mofuta oa 1 oa lefu la tsoekere o etsa 5% ea liphesente tsohle tsa lefu la tsoekere, hangata le hlaha bongoaneng kapa bohlankeng. Mofuta ona oa lefu la tsoekere o tšoauoa ka ponahatso ea matšoao a pele, a tsoelang pele kapele ka nako.

Pheko feela ke liente tsa insulin

· Hyperglycemia e baka ponahalo ea glucosuria. Matšoao a tsoekere e phahameng ea mali (hyperglycemia): polyuria, polydipsia, boima ba 'mele ka takatso e matla ea ho ja, molomo o ommeng, bofokoli

· Microangiopathies (lefu la tsoekere le hlahang, neuropathy, nephropathy),

· Macroangiopathies (atherosulinosis ea methapo ea methapo ea mokokotlo, aorta, likepe tsa GM, litheko tse tlase), lefu la tsoekere la lefu la tsoekere

Progitant pathology: furunculosis, colpitis, vaginitis, ts'oaetso ea pampitšana ea urinary joalo-joalo.

EDI (mocha) - matšoao a hlaha pele a e-ba lilemo li 30, tlhaselo ea tlhoro ke lilemo tse 5-11, e tšoauoa ka insulinopenia le tloaelo ea ketonemia. Ho latela lits'ebetso tsa nts'etsopele ea eona, mefuta e 'meli e khethollotsoe - autoimmune le ts'oaetso ea vaerase.

1.Lefu la tsoekere la Autoimmune e tšoauoa ka ho ba teng ha matšoao a ho senyeha ha mmele makhophong. Ho 90% ea bakuli ba nang le lefu la tsoekere, boteng ba li-antibodies tsa autoimmune khahlano le li-antigen tsa membrane ea cytoplasmic ea lihlekehleke li fumanoe.

Li-antibodies li ikemiselitse esita le pele ho nts'etsopele ea lipontšo tsa lefu la tsoekere mme li bolokoa maemong a phahameng ka lilemo tse ngata kamora ho qaleha ha lefu la tsoekere; ho ka ba le li-antibodies ho lisele tsa litho tse ling tsa endocrine.

Ka lebaka la ho kenella ka hare ho lymphocytic le ho hlaseloa ha sele ka lisele tsa autoimmune cytotoxic of T-lymphocyte (CD8 +) le lisele tsa T-assist (CD4 +), cytolysis ea li-islets tsa Langerhans e etsahala.

Mokhoa o mong oa ts'ebetso ea ho senyeha ha litonki tsa pancreatic ho DM ke β-cell apoptosis e kenyellelitsoeng ke nitric oxide, e thehiloeng ka liseleng tsa β-cell le tsona ha li sa sireletseha 'meleng le li-macrophages tse etsang islet apparatus (hoo e ka bang li-macrophages tse 10 ka iseke). Matšoao a lefu la tsoekere a hlaha ha 75-85% ea lisele tsa islet e senngoa.

2. Lefu la Ts'oaetso ea vaerase . Ha se tšoaetso eohle ea vaerase e khonang ho susumetsa nts'etsopele ea lefu la tsoekere, hobane sena se ka baka tšoaetso ea vaerase ka ho toba.

Likokoana-hloko tse joalo li kenyelletsa vaerase ea rubella, vaerase ea Coxsackie, khoho, cytomegalovirus, vaerase ea ntaramane, mumps, hepatitis. Maemong a morao, li-antibodies tseo 'mele o li “lihelang” ho timetsa livaerase ha li emelle pakong ebe li qala ho hlasela lisele tsa tsona.

Bakeng sa lefu la tsoekere le hlahisitsoeng ke vaerase sebopeho sa nakoana feela sa li-antibodies ho li-pancreatic islet antigen ke tšobotsi, eo, joalo ka molao, e nyamelang pele ho fela selemo.

Mofuta ona oa lefu la tsoekere ha o kopantsoe le methapo ea autoimmune ea litho tse ling tsa endocrine; e hlaha e sa le pele ho mofuta oa autoimmune. Tšobotsi e ikhethang ea bakuli bana ke mokhoa o eketsehileng oa ho theha li-antibodies ho tsoa ho insulin ea ka ntle.

Pathogenesis ea lipontšo tsa kliniki le tsa laboratori ea nisulin-e ikemetseng ea lefu la tsoekere la mellitus (NIDDM).

Mellitus (IND) e sa itšetleheng ka insulin

Mabaka a kotsi:

— lilemo pontsho ya lefu la tsoekere hangata ho motho ka mong e moholo ho lilemo tse 30-50

- semelo sa lefutso. IND e tloaelehile hangata ho baena ba bakuli ba nang le lefu la tsoekere. Haeba batsoali ka bobeli ba kula le lefu la tsoekere, monyetla oa ho ba le bana ba bana ka lefu la tsoekere ke 100%, haeba e mong oa batsoali a kula - 50%, moo lefu la tsoekere ho mora kapa khaitseli - 25%.

- botenya, (ho fihlela ho 85-90%) bakuli ba batenya

- ho se sebetse hantle mmeleng

Pathogenesis ea IND (mofuta oa 2).

Boemong ba pele ba NIDDM, boemo ba insulin maling bo tloaetse ho ba bo tloaelehileng kapa bo phahameng, bo bonts'a boemo bona khanyetso ea insulin.

Mofuta oa 2 lefu la tsoekere, "phello ea" tsoekere e holofetse mabapi le ho ts'oara secretion ea "insulin", "" "" insulin secretion ha e na ts'oaetso. Ho na le tlhoko ea tlhoko ea "insulin" ea pele ho lijo ho bakuli ba nang le IND e eketseha butle, ho fihlela boleng bo phahameng ka mor'a metsotso e 30-45. (Bona feiga 5). Kaha bakuli ba na le karabelo ea nakoana ea pele ho secretion ea insulin ho tsoekere, empa karabelo ea lintho tse ling hape e khothalletsang tlhahiso ea insulin, joalo ka arginine, ha e anngoe, sena se bolela tlolo ea li-receptor tse itseng tsa tsoekere ho li--cell kapa tlolo ea ba tsamaisang glucose ea gluutse 2.

Ka bofokoli bo nang le liphatsa tsa lefutso ho secretion ea "insulin" ka lisele tsa "pancreatic islet" le "cell insulin" tse matla, "li-insulin" li matla le ho feta. lisele.

Boemong ba lisele tsa tharollo:

mongolo:

synthesis ea insulin e sa tloaelehang

ketsahalo e phahameng ea insulinase

-Kotlo ea phetoho ea proinsulin ho insulin

receptor:

phetoho ea mofuta oa "insulin receptor" (bofokoli ba β-subunit ea receptor)

- ho fokotsa palo ea li-receptor ho lisele tse itšetlehileng ka insulin, mohlala ho nona

- Tlhahiso ea kamano ea receptor (kutloisiso)

—hyperglycemia ea nako e telele e lebisa ho nyahameng ho lisele tsa β, tse bonahatsoang ke ho fifala mosebetsing oa bona oa lekunutu.

postreceptor:

Tlolo ea phetisetso ea matšoao le phosphorylation

- phetisetso ea lets'oao le sa senyehang ka lebaka la bofokoli kapa khaello ea ba tsamaisang glucose (GLUT 4, 6)

Boemong ba manyeme:

—Tsamaiso ea tsoekere e sa sebetseng hantle ka lebaka la ho fokotseha ha palo kapa bofokoli ba limolek'hule tsa GLUT 2, e leng eona feela phepelo ea glucose ho lisele tsa β.

Pontšo ea bongaka le ea laboratori ea lefu la tsoekere:

Hyperglycemia - khatello ea "glucose" maling e feta 6 mmol / l, mme IND, boemo ba glucose maling bo ka fihlela lipalo tsa linaleli tsa 55,5 mmol / l.

Hyperglycemia ke litholoana tsa:

Tlolo ea ts'ebeliso ea tsoekere ea kantle ke lisele tsa lisele tse itšetlehileng ka insulin

-Khabollo ea mehloli ea tsoekere ea tsoekere ka ho eketsa palo le ts'ebetso ea lihomone tsa lefu la tsoekere: glycogenolysis ka lebaka la ketso ea glucagon le adrenaline, ts'ebetso ea gluconeogeneis ka lebaka la glucocorticoids.

Ka keketseho ea tsoekere ea mali e fetang 10 mmol / l (renal barriers bakeng sa glucose) e hlaha glucosuria.

Polydipsia kesephetho sa hyperglycemia. Glucose ke ntho e sebetsang e etsang hore mmele o fete le ho omella hoa sele.

Polyuria(ho fihlela lilithara tse 10 tsa moroto ka letsatsi) ke litholoana tsa keketseho ea bongata ba glucose bo sebetsang le polydipsia (tlhoko e eketsehileng ea ho noa). Polyuria e lebisa ho tahlehelo ea li-electrolyte (dle electrolytemia)Na, Ca, Cl, K, Mg, eketsa ponahalo ea mali, mathata a hemodynamic.

Polyphagy - takatso ea lijo e eketsehang ka lebaka la lits'ebetso tsa "catabolic" (phenomena of proteinolysis and lipolysis).

Ho fokotsa boima ba 'mele (e tloaelehileng bakeng sa IDDM) - e hlaha ka lebaka la proteinolysis le lipolysis.

Hyperazotemia - nakong ea ho phatloha ha li-amino acid, ammonia, urea le lihlahisoa tse ling tsa nitrogenous metabolic li thehoa.

Ketonemia(boteng ba 'mele oa ketone maling)le ketonuria(boteng ba 'mele oa ketone moroto)–hangata ho ba le ponahatso ea ED. Litopo tsa Ketone: acetone, acetoacetic acid, β-hydroxybutyric acid. Sesosa se ka sehloohong sa ketosis ke ho eketseha ha mafura, ho eketseha ha acetyl CoA, le oxidation e sa lekanang mokolokong oa Krebs.

Tlolo ea CBS -metabolic acidosis ka lebaka la ho bokellana ha lihlahisoa tsa acidic ('mele oa ketone, FFA, lactic acid, H +) e ka baka ho ruruha ha komello.

Glycosylationhemoglobin, liprotheine tsa membrane ea lisele le li-cellels tsa sele li lebisa ho felloeng ke tšebetso ea tsona. Ho bakuli ba nang le lefu la tsoekere ba maemong a hyperglycemia, litaba tsa hemoglobin ea glycosylated - HbAlc - li eketseha ka makhetlo a 2-3 nakong ea libeke tse 2-3. Ka lebaka la glycosylation ea hemoglobin, ho etsoa mofuta oa hemiclob ea hypoxia.

Glycosylated hemoglobin e bonts'a ts'ebetso ea mefuta-futa ea likokoana-hloko: e eketsa sekhahla sa lisele tsa endothelial, e hokahana le li-receptors tsa macrophages, lisele tsa endothelial le mesangial, e kenya ts'ebetso ea li-macrophages ho secrete cytokines, e thibela sebopeho sa NO mme e thibela vasodilation, e ntlafatsa oxidation ea LDL.

Matšoao a mantlha a hyperglycemia

Ka bongaka, ho na le matšoao a mararo a mantlha a kliniki ea hyperglycemia:

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• khafetsa ho ntša,
• lenyora, esita le ka mor'a ho noa metsi a lekaneng,
• ho theola boima ba 'mele ntle le lebaka le hlakileng.

Ntle le matšoao a lefu lena, ho ka khetholla tse ling tse ngata:

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• pholiso e liehang ea ho khaola letlalong,
• letlalo le omeletseng, ho hlohlona,
• ho teneha ntle le lebaka
• ho bona lintho kapele kapa ho se bone lintho ka mahlo a kelello tse liehang ho hlaha
• candidiasis e sa phekoleheng kapa ts'oaetso ea tsebe e sa foleng,
• Phefumoloho e tebileng e lerata, arrhythmia.

Letšoao la bohlokoa la bokuli le ho rarahana ha lona ke ketonuria, eo ka nako eo acetone kapa ketoacidosis e fumanoang ka har'a moroto, e lebisang bothateng ba lefu la tsoekere le komello.

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Mokhoa oa mathata ana o tjena:

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1. Kaha tsoekere ha e kene liseleng, tekanyo ea eona maling e ea eketseha.
2. Sebete se qala ho nyenyefatsa glycogen ho tsoekere e le hore e e fepe ka lisele, empa hape ha e kene liseleng tsa litho tsa 'mele.
3. Ka nako e ts'oanang, lisele tsa tlhahiso ea matla li qala ho senya mafura, ao, ha a bola, a hlahisa 'mele ea ketone, ke hore, acetone.
4. Acetone e ngata haholo e feta lipelong mme e sitisa mosebetsi oa eona.

Ho na le boemo ba ho se sebetse hantle ha lipholiso, ka mefuta e thata eo ho eona ho ka bang le tlhoko ea hemodialysis.

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Lisosa tsa Hyperglycemia

Lintlha tse lebisang kotsing ea ho ba le hyperglycemia li ka aroloa ka lihlopha tse 'maloa:

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• insulin e itšetlehileng ka eona
• 'meleng
• e seng lefu la tsoekere
• hormonal.

Boemo ba tsoekere e ngata maling bo ka hlahisoa eseng feela ke kholo ea tsoekere, empa hape le ka tahlehelo ea manyeme a mesebetsi ea ona ho fa 'mele palo e nepahetseng ea lihormone, le mabaka a mang.

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Lisosa tsa lefu la tsoekere

Hyperglycemia e sa foleng e hlaha ho lefu la tsoekere la mefuta ea pele le la bobeli.

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Kaha matšoao a tsoekere e phahameng ea mali ho lefu la tsoekere a sa feleng, hyperglycemia e bitsoa e sa foleng.

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Pathology e hlaha ka lebaka la tlhahiso e sa lekanyetsoang ea insulin ka lisele tse bopang li-pancreas.

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Ka hona, tsoekere e bokellana maling maling ntle le ho kena liseleng tsa masapo le lisistimi tse ling tsa 'mele. Matšoao ntlheng ena a lula a phehella ebile a telele.

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Ramatiki e sa foleng ea hyperglycemia ho lefu la tsoekere

Ramatiki e sa foleng ea hyperglycemia ha e bakoe feela ke khaello ea insulin. E boetse e kenyelletsa li-nephropathie le angiopathies.

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Pontšo ea motsoako oa matšoao ke maloetse a latelang:

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• mofetše wa pancreatic
• pancreatitis ea boima bo fapaneng,
• mafu a bakoang ke li-virus tsa mafu a tšoaetsanoang
• mathata a liphatsa tsa lefutso le li-syndromes tse fapaneng.

Hyperglycemia syndrome e ka boela ea kenyelletsa mafu a fapaneng a 'mele a ho itšireletsa mafung. Ka lebaka la khaello ea insulin e ka nako e telele, lefu la masapo a mokokotlo le ka hlaha ka lebaka la ts'ebetso ea sebete e sa sebetseng.

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Psychological Hyperglycemia

Physical hyperglycemia ponts'ong ea eona e arotsoe ka mefuta e meraro:

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1. Postprandial hyperglycemia, eo ka nako eo ho nang le keketseho ea nakoana ea tsoekere ea mali ka lebaka la ho ja ho feta tekano le tšebeliso ea nako e le 'ngoe ea likhalori tse ngata.
2. Hyperglycemia ea nakoana e khetholloa ke pokello ea mali e sa lokang nakong ea ho hlahlojoa.

Taba e ka tlola melao ea ho tlisoa ha serum bakeng sa tsoekere ka ho ja ho hong pele ho tlhahlobo kapa ho tšoha.

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Tabeng ena, sephetho se tla bonts'a tekanyo e fetelletseng ea tekanyo ea ho itima lijo ea tsoekere, eo mokuli a se nang eona hantle.

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1. Khatello ea maikutlo e sithabetsang kapa khatello ea maikutlo e etsahala kamora boiphihlelo bo matla kapa ka lebaka la khatello ea kelello e telele.

Khokahano ea glucose e fihla tlhorong ea eona ka ho fokotseha ho latelang.

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Sena se etsahala ka lebaka la tokollo ea lihormone tsa khatello ea maikutlo: cortisol le adrenaline, tse amang phetoho ea glycogen ho glucose. Kahoo, palo ea tsoekere maling e nyoloha haholo.

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1. Acute hyperglycemia e ka bakoa ke ho ikoetlisa ho feta tekano, hobane ts'ebetso ea mesifa e ka baka tlala e matla ea lisele, tse tla baka ts'abo ea glucose maling le mabenkeleng a glycogen a sebete.

Hangata ho ba le hyperglycemia ea etiology e sa boleloang, ha lisosa tsa keketseho ea tsoekere ea mali li ke ke tsa tsejoa.

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Lintho tse senang lefu la tsoekere

Mokhoa oa ho eketsa tsoekere ea mali o ka baka ts'ebetso ea ts'oaetso kapa ts'oaetso.

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Lisosa tse latelang tse se nang lefu la tsoekere tsa hyperglycemia lia khetholoha:

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• myocardial infarction kapa stroke,
• lits'oants'o tse fapaneng tsa tsamaiso ea genitourinary e amang tahlehelo ea tsoekere maling ka moriring,
• ketsahalo ea ho chesa,
• adrenal haelloang
• oncology ea pancreatic, pancreatitis e matla le e sa foleng
• khaello ea metabolic ho masea a sa tsoa hlaha,
• hyperthyroidism, ligomegaly, le mafu a mang a endocrine,
• Maloetse a sebete, moo ho nang le phokotseho ea tlhahiso ea glycogen le gluconeogeneis, khaello ea vithamine B1, hepatitis e sa foleng le lefu la ho fokola ha sebete,
• tloaelo ea lefutso.

Ho feta tekano ea khatello ea tsoekere ea mali e bang teng ka mor'a ho tsoa likotsi tse fapaneng, stroke, ho nyekeloa ke pelo ho bitsoa "hyperglycemia" e tsoaloang, ho latela lipalo, ho bonts'ang kotsi e kholo ea lefu ho batho ba pholohileng tlhaselo ena.

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Hyperglycemia Syndrome Treatment

Kaha hyperglycemia syndrome e na le lisosa tse ngata, kalafo ea eona e tla ipapisa le tlhahlobo e nepahetseng le ho felisoa ha litla-morao eseng feela, empa le mabaka a bakoang ke sena.

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Pele ho tsohle, lingaka li ela hloko haholo ho felisa ts'oaetso le ts'oaetso ea ts'oaetso, hape li fana ka phepelo e khethehileng ea lijo tse nang le lik'habohaedreite tse ngata.

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Bakeng sa batho ba nang le lefu la tsoekere, kalafo ea phetisetso ea insulin e laetsoe hang-hang.

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Ka keketseho e sa feleng ea tsoekere ea mali, tsamaiso ea batsamaisi ba molomo ba prandial, repaglinide le nateglinide, e ipakile e le ntle.

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Lintho tse sebetsang tse tsoang ho amino acid li kenya letsoho ho khutlisetsong ha karabo ea insulin ho ja lijo.

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Ho feto-fetoha le maemo ha tšebeliso ea lithethefatsi, e amanang ka kotloloho le lijo tse jeoang, ha ho senye boleng ba bophelo ba batho ba nang le hyperglycemia.

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Hyperglycemia ea nako e telele e lokela ho lula e beiloe leihlo eseng feela ke endocrinologist, empa hape le litsebi tse ling:

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• cardiologist
• ngaka ea methapo
• ophthalmologist
• urologist.

Kahoo, menyetla ea mathata a ho litho tse ling e lula e le tlasa taolo ea litsebi. Bakeng sa sena, ho khothalletsoa ho etsa tlhahlobo ea setsebi hang hang ka likhoeli tse ling le tse ling tse tšeletseng, kapa kamoo ho hlokahalang.

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Thuso ea pele

Haeba ho na le bothata bo hlobaetsang ba "hyperglycemia" kapa "hyperglycemic", motho ea hlokofalitsoeng a ka hloka thuso ea pele ka potlako.

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1. Ho qala, haeba ho khonahala, o hloka ho lekanya tsoekere ea mali ka glucometer, e sa nkeng nako e ngata. Haeba ho belaelloa ho belaela ka matla ka tsoekere e matla, ho lokela ho nkuoa mehato e latelang:
2. Letsetsa ambulense, hobane feela ho kenella ho tsa bongaka ke setsebi ho ka thusa ho qoba litlamorao tse mpe.
3. Fana ka seno se noang haholo ho tlosa lintho tse kotsi 'meleng. Ka halofo ea pele, ena e lokela ho ba bonyane litara e le 'ngoe ea metsi a hloekileng, ebe o fa halofo ea litha e le nngwe tsa metsi hora e ngoe le e ngoe.
4. Haeba mokuli a akhehile, o lokela ho mo beha ka lehlakoreng la hae hore a se ke a bua ka leleme la hae.

Haeba motho a tseba hore o na le lefu la tsoekere mme o sebelisa meriana e hlokahalang, haholo insulin, o lokela ho fuoa ente, empa feela haeba tekanyo ea tsoekere e feta 15 mmol / l, hobane tšebeliso e sa lebelloang ea insulin e ka baka lerotholi le leholo la tsoekere, eo hape e leng kotsi ho motho. .

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Lijo tsa hyperglycemia

Ka ts'oaetso ea hyperglycemia, mokuli o fuoa lijo tse khethehileng, tseo a lokelang ho li latela kamehla.

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Ha e lumelloe ho ja lijo tse nang le lik'habohaedreite tse bonolo le tse rarahaneng. Pele ho tsohle, ke lihlahisoa tse latelang:

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• liswiti, likuku,
• ho baka
• bijoux
• litholoana tse monate
• litapole
• feiga.

Hyperglycemia e ama mekhoa e itseng ea ho ja ea motho ea tšoeroeng ke lefu lena.

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Ho latela melao e latelang, o ka boloka tekanyo ea tsoekere ea mali:

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• fokotsa nako lipakeng tsa lijo, hangata ka likarolo tse nyane,
• fokotsa lijo tse halikiloeng le lijo tse nokiloeng ka linoko tse ngata.
• kenyelletsa palo e kholo ea meroho e ncha le litholoana tse sa lomosoang lijong
• ja liprotheine tse ngata - nama e tšoeu, mahe,
• kenyelletsa lihlahisoa tsa lebese tse halikiloeng lijong,
• ka liswiti, o ka sebelisa litholoana tse omisitsoeng feela kapa liswiti tse khethehileng,
• nwa metsi a mangata.

Melao ena e bonolo e tla etsa hore o ikutloe o le betere hape e tla fokotsa monyetla oa mathata.

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Phekolo ka litlhare tsa setso

Mokhoa o mong oa ho boloka tsoekere ea mali ke moriana oa litlama. Limela li khethoa ho li-alkaloids tse 'maloa:

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• dandelion
• elecampane
• makhasi a poli.

Li-alkaloids li na le bokhoni ba ho thusa tsoekere ho kena liphoofolong tsa sele, ka tsela eo, ka ho etsa joalo, ba leka ho sebelisa metabolism.

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Mokhoa o motle oa ho phekola linaoa: nka linaoa tse mashome a mahlano ka lilithara tse peli tsa metsi a belang. Pheha linaoa ka nako e ka etsang lihora tse tharo ka bateng. Fokotsa moro mme o noe ena pheko makhetlo a 4 ka letsatsi pele ho lijo ka halofo ea khalase. Nako ea kamohelo ha e ka tlase ho kotara e le 'ngoe ea selemo.

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E 'ngoe ea mekhoa e sebetsang ea setso ke ts'ebeliso ea artecoke ea Jerusalema e le moriana. Ho etsa sena, e belise halofo ea hora ebe u nka moro o phehiloeng pele ho lijo halofo ea hora.

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Li-decoctions le infusions tse sa sebetseng letho li tsoang lijong tse latelang:

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• makhasi a blueberry
• lilac inflorescences,
• lekhasi la bay
• makhasi le metso ea limela,
• oats
• ginseng e khubelu.

Ntle le ts'ebetso ea "insulin", e boetse e na le bokhoni ba ho matlafatsa boits'ireletso ba mmele le ho thusa sebete ho sebetsana le ts'ebetso ea lintho tse kotsi.

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Makhasi a Blueberry le 'ona a na le diuretic effect mme a thibela mathata a liphio.

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Lekhasi la Bay le thusa ho thibela ho lutla ha lintho tse nang le molemo 'meleng, hape e sebetsa e le tšireletso e ntle haholo ea ho tsoa ka mpeng.

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