Lefu la tsoekere - mefuta, kalafo le thibelo

Lefu la tsoekere ke boemo ba hyperglycemia e sa foleng e bakoang ke khaello ea insulin kapa ho fokola hape hoa lintho tse khahlano le ts'ebetso ea eona. Lipontšo tsa lefu la tsoekere li kenyeletsa mathata a metabolic, carbohydrate, ketoacidosis, tšenyo e tsoelang pele ho li-capillaries tsa liphio, retina, tšenyo ea methapo ea kutlo, le atherossteosis e matla.

Ka sehloohong lipontšo tsa lefu la tsoekere - hyperglycemia, ka linako tse ling e fihla ho 25mmol / l, glycosuria e nang le glucose ka har'a moroto ho fihlela ho 555 - 666 mmol / ka letsatsi (100 - 120 g / ka letsatsi), polyuria (ho fihla ho 10 - 12 lilithara tsa moroto ka letsatsi), polyphagy le polydipsia.

Etiology. Sesosa sa lefu la tsoekere ke khaello ea insulin. Ho latela mochine oa ketsahalo, ho haella ha insulin ho ka ba teng pancreatic- e amanang le biosynthesis e senyehileng le secretion ea insulin, kapa extrapancreatic (mong ka bona) - ka secretion e tloaelehileng ea insulin ka li-isanc tsa pancreatic.

Ho haella ha insulin ho ka bakoa ke liphatsa tsa lefutso kapa lintho tse fumanoeng.

Ho ipapisitse le lisosa le tekanyo ea khaello ea insulin: ea mantlha le ea bobeli (sesupo).

Boemong ba mantlha ho bontšitsoe lefu la tsoekere insulin e itšetlehileng ka eona (Type I) le insulin e ikemetseng (Mofuta oa II).

Sekolo sa bobeli se amana le maloetse a mang: acromegaly, lefu la Itsenko-Cushing, mafu a pancreatic, ketso ea lithethefatsi, lik'hemik'hale, syndromes ea liphatsa tsa lefutso.

Lihlopheng tse arohaneng ke lefu la tsoekere le amanang le khaello ea phepo e nepahetseng, le lefu la tsoekere la basali baimana.

Lefu la tsoekere le tloaelehileng le atile. Hammoho le mabaka a liphatsa tsa lefutso, karolo e 'ngoe ea tšimoloho ea eona e bapaloa ke ts'ebetso ea boits'ireletso ba mmele le tšusumetso ea tikoloho.

Insulin e itšetlehileng ka lefu la tsoekere (IDDM) e tšoauoa ka insulinopenia, khaello ea insulin e felletseng, ka mathata a metabolic a tloaeloang ke ketoacidosis. Mofuta ona o hlaha bocheng, mofuta oa tlhaho oa liphatsa tsa lefutso o kopantsoe le li-antigen tse itseng tsa Sekhahla sa HLA. Khafetsa (HLA-B8-DR3 le B15-DR4). Ho na le ho kopants'oa le mafu a mang a autoimmune (insulinitis, thyroiditis), boteng ba antibodies ho insulin, β-cell. Ho qala ha lefu lena ho tsamaisana le ts'oaetso ea vaerase e fetileng (maselese, rubella, hepatitis, mumps). Kamano lipakeng tsa liphatsa tsa lefutso le boits'ireletso ba mmele li hlaloswa ke sebaka sa mefuta ea tsamaiso ea HLA haufi le locus e ikarabellang karabelong ea 'mele ea ho itšireletsa mafung ho 6 chromosome. Ho ba teng ha li-antigen tse ling tsa leukocyte ho bontša litšobotsi tsa boemo ba mmele ba ho itšireletsa mafung. Ntho e kantle e tlatsetsang ho phethahatseng qeto ea lefutso ho lefu la tsoekere: livaerase tse nang le tšoaetso ea beta e atileng ho batho ba nang le li-antigen tsa HLA. Likokoana-hloko li senya lisele tsa β kapa ho li senya, li etsa hore ho be le ts'ebetso ea autoimmune.

Mellitus e sa itšetleheng ka insulin (NIDDM) e tšoauoa ka litšitiso tse fokolang tsa metabolic. E ipapisitse le khaello ea insulin e amanang le ho nona haholo, botenya le ho fokotseha hoa palo ea li-insulin receptors. Li-antibodies ho lisele tsa beta le insulin ha li eo. Lefu la tsoekere le iponahatsa ka mor'a lilemo tse 40, le na le boemo bo phatlalalitsoeng ba lefutso.

Pathogeneis. Ho haella ha insulin ho lefu la tsoekere ho tsamaisana le tlolo ea mefuta eohle ea metabolism .. Carbohydrate-hyperglycemia le glycosuria.

Mokhoa oa pathogenetic oa ts'oaetso ea carbohydrate metabolism ho lefu la tsoekere ke ho fokotseha ha sekhahla sa karabelo ea hexokinase ka lebaka la ho fokotseha ha tumello ea ho kenella ha lisele le tsoekere ho lisele, le ho fokotseha hoa ts'ebetso ea hexokinase ka liseleng le ka har'a sebete tse fumanehang ka bongata ho glucose. Sena se lebisa ho fokotseng sebopeho sa glucose-6-phosphate (G-6-F), 'me joale ts'ebeliso ea metabolite ena ea "metabolism" ea glucose ka mekhoa eohle ea ho e fetola lisele - glycogen synthesis, potoloho ea phospose phomphate le glycolysis. Sebeteng, khaello ea G-6-F e koaheloa ke sebopeho sa eona nakong ea glyconeogeneis. Keketseho ea ts'ebetso ea phosphorylase le glucose-6-phosphatase ea sebete e thusa ho eketseha ha tlhahiso ea glucose le phokotseho ea ho etsoa ha glycogen ho eona.

Ts'ebetso ea glyconeogeneis ea bonoa, e hlalositsoeng ke ho etella pele ha glycocorticoids, ho kenyelletsa ho hlophisoa ha li-enzyme tse hlokahalang bakeng sa sena.

Hyperglycemia ho lefu la tsoekere e fana ka matšeliso a tlhaho, hobane ka tekanyo e phahameng ea tsoekere maling, tšebeliso ea eona ea lisele e ea ntlafala. Hyperglycemia le eona e mpe, hobane e le sesosa sa pathogenetic. lefu la tsoekere. Angiopathies e etsahala ho tsoekere ea lefu la tsoekere ka nako e telele le puseletso e sa lekanang bakeng sa khaello ea insulin. E bonts'itsoe ka mokhoa oa sclerosis, ho phatloha le maqeba a mang a methapo ea mali. Mabaka a tlhatlhobo: ho rera liphatsa tsa lefutso, ho hlahisa lihormone tse ngata tse kopaneng le liphetoho tsa metabolic, hyperglycemia le hypercholesterolemia. Hyperglycemia e tsamaisana le keketseho ea khoholeho ea li-glyco- le li-mucoprotein, tse oelang lithong tse bokellaneng, tse tlatsetsang ho hlahiseng hyaline le tšenyo leboteng la methapo.

Hyperglycemia le "phosphorylation" e holofetseng le phosphorylation e teng ka mpeng ea nephron e lebisa ho glycosuria. Keketseho ea khatello ea "osmotic" ea moroto e kenya letsoho ho polyuria, e bakang ho fokolloa ke metsi 'meleng, le lenyora la eona le eketsehang (polydipsia).

- teething e potlakileng ea meno a sa feleng ho bana, e hlalositsoeng ho banana, teething e tsamaea le gingivitis.

- Liphetoho tsa sebopeho sa litšoelesa tse qalang, tlolo ea ts'oaetso le liphetoho tsa biochemical sebopeng sa mathe, e leng se bakang xerostomia le nts'etsopele ea mathata: likhohlopo tse ngata, candidiasis, halitosis.

- Ho ata ha tšoaetso ea caries ho bana ba nang le lefu la tsoekere la mofuta oa 1, ho hlahisoa lesapo la lefu la tsoekere le lefu le tebileng, ho batho ba baholo ba nang le lefu la tsoekere la mofuta oa 2 ho na le keketseho e phahameng ea li-caries, ho bola ha meno ho bonoa, likotsi tsa carious tse lebisang nts'etsopele ea periodontitis, palo ea li-periapical foci ea ts'oaetso le ho eketseha ha endodontical. meno a phekotsoeng, monyetla oa tahlehelo ea leino o eketseha, boemo bo phahameng ba CPU ho banna bo amahanngoa le boemo bo phahameng ba hemoglobin ea Hly (HbA1) e phahameng.

- Khahlano le semelo sa systemic immunosuppression, mafu a sa foleng a mucosa ea molomo a nts'etsopele (lichen planus, narthous stomatitis, phepelo ea baktheria, vaerase le fungalitis), ts'oaetso ea monyetla, ho hlapoloha hangata nakong ea ts'ebetso ea bongaka ea nako e telele, ho pholoha nako ho hobe le ho feta. .

Mathata a amanang le khatello ea kelello (ho chesa ka hanong le lelemeng), ho khopamisa maikutlo, ho sitisoa ha bohloeki ba molomo, le ho kheloha ha tatso ho lebisa ho hyperphagia le botena, taolo ea glycemic e mpefala.

- Sebopeho sa microflora ho bakuli ba nang le lefu la tsoekere se laolehileng se ts'oana le periodontitis, lefu la tsoekere le sa laoleheng - lea fetoha: liperesente tsa likolone TM7, Aqqreqatibacter, Neisseria, Gemella, Eikenella, Selenomonas, Actinomyces, Capnocytophaga, Fusobacterium, Veillonella le Streptococcus genera tsohaPorphyromonas, Filifactor, Eubacterium, Synerqistetes, Tannerellaand Treponema genera - ea fokotseha.

- Keketseho ea maloetse a tšoaetsanoang a nakoana (gingivitis, periodontitis) e ntse e eketseha.

Mokhoa oa ntlafatso (pathogeneis)

Lefu la tsoekere ke bokuli ba metabolism. Tlolo ena e ama metabolism ea lik'habohaedreite 'meleng. Ho isa tekanyong e tlase, metabolism ea mafura (lipids) le liprotheine lia ameha. Ho latela mochini oa nts'etsopele, mefuta e 'meli e meholo ea mafu a amanang le metabolism ea carbohydrate e khetholloa:

• Mofuta oa 1 (o itšetlehileng ka insulin) ke mofuta oa tlhaho oa "endocrine" o amanang le lisele tsa "manyeme" tse sebetsanang le tlhahiso ea "insulin" ea "hormone". Ke taolo ea bohlokoa ea metabolism ea glucose 'meleng. Ha insulin e sebetsa ho li-receptor tse khethehileng tsa lisele tsohle 'meleng, tsoekere ea tsoekere e ea matlafala' me e robeha ka matla a tsoang. Ka mofuta ona oa lefu la tsoekere mellitus, maemo a insulin a fokotseha, ka ho latellana, tsoekere ea tsoekere ka lisele e ea fokotseha mme boemo ba eona bo nyoloha.
• Mofuta oa 2 (o seng insulin-o ikemetseng) - o tšoauoang ke boemo bo tloaelehileng ba insulin, empa li-receptor tsa selekanyo li lahleheloa ke matla a ho e tlama, e leng hape e fokotsang ho monya ha tsoekere maling.

Ho sa tsotelehe mochine oa nts'etsopele oa motheo oa tsoelo-pele, lefu la tsoekere le ama metabolism ea lipid le protheine. Hangata hona ho bontšoa ke tloaelo ea ho nona haholo ka ho theola boima ba mmele ka morao ho moo, haholoholo ho buuoa ka lefu la tsoekere la mofuta oa 2.

Mofuta o mong o arohaneng oa tlolo ea metabolism ea carbohydrate ke lefu la tsoekere. E hlaha ho basali ba baimana mme ke pontsho ea hore kamora nako mosali a ka ba le ponahatso ea lefu lena. Ka karolelano, lefu la tsoekere ha le iponahatse, le fumanoa feela motheong oa tlhahlobo ea mali ea laboratori bakeng sa tsoekere.

Etiology (mabaka)

Lefu la tsoekere ke lefu la polyetiological. Hona ho bolela hore lintlha tse fapaneng li bapala karolo ea kholo kholisong ea eona. Kahoo tlolo ea "metabolism" ea carbohydrate ka lebaka la ho fokotseha ha insulin ho baka lintlha tse joalo:

• Heredity - ketsahalo e sebetsang ea li-pancreas tsa endocrine (lisele tsa lihlekehleke tsa Langerhans) li laoloa ke mefuta e meng. Liphetoho ho tsona (supa liphetoho) li ka fuoa ho tsoa ho batsoali ho isa ho bana. Haeba e mong oa batsoali a na le lefu la tsoekere, ngoana o na le lefu lena.
• Ts'oaetso - livaerase tse ling li ka parola liseleng tsa manyeme, tsa kenella ka genome ea tsona ka ts'ebetso e sa sebetseng hantle le boemo ba ho qala ha insulin.
• Tšenyo ea autoimmune liseleng tsa manyeme - e bakoang ke ho se sebetse hantle hoa sesole sa 'mele, moo ho hlahisoang li-antibodies ho lisele tsa litho tsa "endocrine".

Lintho tsena kaofela li lebisa ho nts'etsopele ea pathology ka ho pepeseha ka thoko kapa ho kopantsoeng. Lintho tse lebisang ho nts'etsopele ea mofuta oa bobeli oa mathata a metabolic li fapane hanyane. Tsena li kenyeletsa:

• Foreisposition ea Herederal - sensitivity of insulin receptors e khethoa ke liphatsa tse 'maloa tsa liphetoho, liphetoho ho e' ngoe ea tsona li lebisang ho fokotseha ha kutloelo-bohloko.
• Ts'ebeliso e mpe ea liswiti - ho kenella ha bongata ba tsoekere (confectionery, lihlahisoa tsa phofo, tsoekere) ho lebisa ho eketseho e sa feleng ea tlhahiso ea insulin le "ho sebelisoa" ha li-receptors ho eona.
• Ho eketsa boima ba 'mele - palo e kholo ea adipocytes (lisele tsa adipose tiske) e fokotsa khatello ea insulin.

Lintlha tsena lia fetoha - o ka fokotsa likhahla tsa tsona 'meleng ho pholletsa le bophelo bohle, tse tla thibela nts'etsopele ea lefu la tsoekere la mofuta oa 2 nakong e tlang.

Bakeng sa mathata a metabolism ea carbohydrate le keketseho ea mahloriso a tsoekere, lipontšo tse latelang ke tšobotsi:

• Ho fokotsa boima ba 'mele bakeng sa nako e khuts'oane hantle ka lijo tse sa fetoheng.
• Boikutlo bo sa feleng ba tlala, bo tlosoang nakoana feela ka ho ja.
• Lenyora le matla - motho o sebelisa lino tse fetang tse peli tsa lilithara nakong ea letsatsi.
• Ho eketseha ha diureis - mokelikeli oa ho ntša metsi o eketseha ka keketseho ea molumo oa moroto o pepesitsoeng.
• Nocturnal diuresis ke lets'oao le ikhethileng bakeng sa lefu la tsoekere. Motho o tlameha ho tsoha ka makhetlo a mangata ho sebetsana le tlhoko e nyane ea 'mele.
• Ho senyeha hoa pono ke sesupo sa nako e telele ea lefu la tsoekere, le tšoauoa ka ho koaheloa ke lense le tlolo ea phepelo ea mali ho retina.
• Phokotso ea mesifa e fokotsehileng - e bonahatsoa ke pholiso e mpe ea letlalo kamora ho poma, li-abrasions tse nyane.
• Keketso ea ts'oaetso e bakoang ke libaktheria le li-fungus ke baemeli ba microflora e nkang monyetla ke phello ea ho fokotseha hoa ts'ebetso ea boits'ireletso ba mmele ba mucous membrane le khatello e phahameng ea tsoekere ho tsona, e etsang maemo a matle bakeng sa li-microorganisms. Hangata, dysbiosis e ba teng, ho basali ho ka ba le "thrush" (candidiasis) ea botšehali.

Matšoao ana kaofela a batla a tšoana le a mefuta eohle ea pathology. Mofuta oa 2 oa lefu la tsoekere o tšoauoa ka ho ba sieo halelele ha lipontšo. Joale, ha ts'ebetso ea methapo ea methapo e ntse e putlama, matšoao a hola.

Mathata

E 'ngoe ea mathata a kotsi ho pathology ena ke keketseho e kholo ea khatello ea tsoekere, e ka lebisang ho ketoacetonemic coma. Ka nako e ts'oanang, palo e kholo ea acetone (sehlahisoa se pakeng tsa metabolism) se thehoa maling ka lebaka la mathata a metabolic 'meleng. Ho batho, kelello ha e na matla. Phefumoloho e felileng e nkha asetone. Ho eketseha ha tsoekere ka nako e telele 'meleng ho lebisa ho nts'etsopele ea mathata a maholo joalo:

• Retinal vascular angiopathy - liphetoho sebopeho sa methapo ea mali ka har'a microvasculature e nang le phallo ea mali le phepo e nepahetseng.
• Ho koaheloa ke lense ke litholoana tsa glucose e tlamang ho lintho tse etsang lense. E bonahatsoa ke bofokoli ba pono.
• Angiopathy ea lijana tsa maoto, pelo le boko - e tšoauoa ka tlolo ea phepo e nepahetseng le phepelo ea mali ea litho tsena ka matšoao a lumellanang.

Phephetso e kotsi haholo ke ts'oaetso ea "insulin" nakong ea kalafo ea lefu la tsoekere la mofuta oa 1. Ho na le insulin e ngata maling e lebisang ho fokotseheng ho hoholo hoa maemo a glucose ka phepo e sa lekaneng ea boko. Ho bonahatsoa ke tahlehelo ea kelello - hypoglycemic coma.

Ts'oaetso

Ts'oaetso e thehiloe motheong oa lipontšo tsa bongaka ba bongaka le netefatso ea laboratori. eketsa tsoekere ea mali. Hape, ho tseba nako ea pathology, hemoglobin ea glycosylated e ikemiselitse.

Phekolo ea lefu la tsoekere

Mehato ea kalafo ea lefu la tsoekere e etselitsoe haholo ho fokotsa likhahla tsa tsoekere. Sena se fihlella ka mekhoa e fapaneng, ho latela mofuta oa carbohydrate metabolism disorder. Ka lefu la tsoekere la mofuta oa 1, khaello ea insulin e phetoa hape ka litšoantšo tsa eona tsa maiketsetso, tseo motho a li hlahisang kamehla ka ente ea subcutaneous. Phekolo ea mofuta oa lefu la tsoekere la mofuta oa 2 e kenyeletsa lithethefatsi tse eketsang maikutlo a li-cell receptors ho insulin - matlapa a Siofor, Glucofage, Diaformin. Phekolo e etsoa tlasa tlhahlobo e tlamang ea nako le nako ea litekanyetso tsa tsoekere. Bakeng sa sena, ho na le li-glucometer tsa hau tse u lumellang ho lekanya tsoekere ea mali u sebelisa mohala o khethehileng oa liteko.

Ka thuso ea mahlale a morao-rao a boenjiniere ba liphatsa tsa lefutso, phokotso e kholo ea theko ea insulin e fihlelitsoe. Hoo e batlang e le linaheng tsohle, moriana o fuoa batho ba nang le lefu la tsoekere mahala.

Lefu la tsoekere - phepo e nepahetseng le litlhahiso

Motheo oa kalafo ea lefu la tsoekere ke phepo e nepahetseng, sepheo sa eona ke ho fokotsa tšebeliso ea lik'habohaedreite 'meleng. Bakeng sa sena, liswiti, li-confectioneries, lihlahisoa tsa phofo le pastry ha li kenyelletsoe lijong. Ho laola tekanyo ea phepelo ea nama ea nama ea nama ea kolobe ho tsoa lijong, litsebi tsa phepo ea Jeremane li ile tsa theha setsi sa bohobe (XE) - setsi sa tloaelo se lekanang le 12 g ea lik'habohaedreite kapa 20 g ea bohobe. Sehlahisoa se seng le se seng ka tekanyo e itseng (bophahamo le boima)
e na le palo e fapaneng ea likarolo tsa bohobe. Ka thuso ea litafole tse ikhethang tseo ho bontšitsoeng lihlahisoa tsa mantlha tsa lijo le XE ea tsona e tšoanang, motho a ka laola tšebeliso ea lik'habohaedreite 'meleng. Ho khothalletsoa hape hore u latele likotlo tse ngata tsa kakaretso:

• Ts'ebetso e lekaneng ea koloi - e ntlafatsa ho monya ha tsoekere ke lisele.
• Ho robala ka ho lekaneng bonyane lihora tse 8 ka letsatsi.
• Ho hana mekhoa e mebe (ho tsuba, ho ja joala ka mokhoa o hlophisehileng).
• Tekanyetso ea khatello ea kelello le khatello ea maikutlo, e khothalletsang tlhahiso ea li-hormone tse matlafatsang tsoekere (adrenaline, glucocorticosteroids).
• Ho qoba ho tsoa likotsi tsa letlalo ho thibela mathata a sefahleho le ho phekola leqeba ka nako e telele.

Mehato ena kaofela e tla thusa ka thibelo ea lefu la tsoekere la mofuta oa 2. Maemong a mofuta oa 1 oa lefu lena la tsoekere, nts'etsopele ea lefu la tsoekere e etsahala ntle le tšusumetso ea mabaka a tikoloho.

Mefuta ea mantlha ea lefu la tsoekere 'meleng

Lefu la tsoekere ke lefu la tsoekere leo ho lona ho shebelloang tsoelo-pele ea mathata a metabolic.

Ho na le mefuta ea bohlokoa ea lefu la tsoekere:

Mofuta oa pele o itšetlehile ka insulin. Mofuta ona oa lefu la tsoekere o qala ho hlaha 'meleng haeba liphetoho tsa pathological li ama lisele tse hlahisang insulin. Lisele tsena ke lisele tsa pancreatic beta.

Type 2 lefu la tsoekere le sa itšetleheng ka insulin. Mofuta ona oa lefu o tšoauoa ka boemo bo tloaelehileng ba tlhahiso ea insulin ke lisele tsa pancreatic beta.

Motheo oa mochine oa tsoelo-pele ea lefu la tsoekere la mofuta oa 2 ke tahlehelo ea bokhoni ba lisele tsa litho tsa 'mele ho sebetsana le insulin. Sena se lebisa ho fokotseha hoa monyetla oa tsoekere ea glucose mme, ka hona, keketseho ea boemo ba tsoekere maling plasma.

Ho sa tsotelehe moelelo oa motheo oa nts'etsopele ea lefu la tsoekere, mathata a amang metabolism ea liprotheine le mafura. Liphoso tse joalo li lebisa ponahalong ea botlalo ka boima bo eketsehileng ba mmele. Boemo bona bo tloaelehile ho lefu la tsoekere la mofuta oa 2.

Khetho e arohaneng bakeng sa nts'etsopele ea lefu lena ke lefu la tsoekere. Mofuta ona oa lefu o hlaha ho basali baimana feela.

Ka tšohanyetso, ponahalo ea lefu lena ha e iponahatse 'me tlhahlobo ea lona e etsoa feela ka tsela ea laboratori, ho latela tlhahlobo ea lisampole tsa mali bakeng sa dikahare tsa tsoekere.

Lintho tse amang nts'etsopele ea lefu lena

Mehato ea tsoelo-pele ea lefu la tsoekere e ka baka lintho tse fapaneng 'meleng.

Ho senyeha ha metabolism ea tsoekere ka lebaka la ho fokotseha ha insulin e hlahisoang 'meleng ho ka baka lintlha tse latelang:

Boitšisinyo. Boemo ba tšebetso ea lisele tsa pancreatic beta bo etsoa ke mefuta e meng. Ponahalo ea liphetoho tse bang teng liphatseng tsa lefutso tsena tse ka futsitsoeng li ka qholotsa nts'etsopele ea li-pathologies mosebetsing oa tšoelesa ea ngoana.

Mafu a tšoaetsanoang - livaerase tse ling li ka baka kholo ea lefu la vaerase 'meleng le ho hlaha hoa litšitiso karolong ea endocrine ea lisele tsa pancreatic ho batho. Likokoana-hloko tse ling li khona ho ikopanya le mofuta oa lisele tsa beta le ho sitisa tšebetso ea tsona, e lebisang ho fokotseheng ha insulin.

Tšenyo ea Autoimmune ho lisele tsa pancreatic, tse bakoang ke ho se sebetse hantle ha ts'ebetso ea sesole sa 'mele. tlolo e joalo e tšoauoa ka nts'etsopele ea tsamaiso ea 'mele ea ho itšireletsa mafung ea lisele tsa litho tsa' mele ea endocrine.

Lintho tsena ke lisosa tsa kholo ea lefu la tsoekere la 1 'meleng oa motho.

Lintlha tsa ho hlaha ha lefu la tsoekere la mofuta oa 2 'meleng li fapana. Tse ka sehloohong ke tse latelang:

1. Khopolo ea lefutso ea 'mele ke hore maikutlo a lisele tse amohelang insulin a laoloa ke mefuta e' maloa ea liphatsa tsa lefutso. Liphetoho mefuteng ena ea liphatsa tsa lefutso tse ka futsitsoeng li ka baka ho fokotseha hoa kutlo ea "receptor".
2. Ts'ebeliso e mpe ea liswiti le lihlahisoa tsa phofo li lebisa ho tlhahiso e sa lekanyetsoang ea insulin ke manyeme, e lebisang tlatsong ea li-receptors ho eketseha ho hoholo ha insulin 'meleng.
3. Ho nona ho feta tekano - lisele tse mafura tse ngata 'meleng li lebisa ho fokotseha hoa khatello ea insulin' meleng oa motho.

Lintlha tsena li nkuoa li ka fetoloa, ke hore, bao liketso tsa bona li ka fokotsoang 'meleng bophelo bohle.

Tekanyetso ena e thusa ho thibela ho hlaha ha lefu la tsoekere la mofuta oa 2.

Karolo ea botenya le ho se ikoetlise 'meleng kholisong ea lefu lena

Ho ja ho feta tekano le ho boloka mokhoa oa bophelo oa ho lula o hlohlelletsa ho hlaha ha 'mele' meleng, e leng ho mpefatsang ho hanyetsa insulin. Ho fokotseha ha maikutlo a insulin ho baka mosebetsi oa liphatsa tsa lefutso tse ikarabellang bakeng sa nts'etsopele ea lefu la tsoekere la mofuta oa 2 'meleng.

Ho tsoekere ea lefu la tsoekere, mochine oa nts'etsopele oa lefu o atisang ho amahanngoa le liphoso eseng ho carbohydrate, empa le lipid metabolism. Sena se bakoa ke taba ea hore li-adcocytes tsa visceral, ho fapana le lisele tse mafura a subcutaneous, kutloisiso ea li-insulin receptors, e nang le phello ea antilipolytic, e fokotseha haholo ha e ntse e eketsa kutloisiso ea phello ea lipolytic ea catecholamines.

Ntlha ena e halefisa ho kenella maling a mali a mangata.

Ho loantšoa ha insulin ea 'mele ke' nete ea hore, ka nako ea phomolo, lisele tsa mesifa ea mesifa li sebelisa li-acid tse mafura haholo. Boemo bona bo lebisa ntlheng ea hore lisele li sitoa ho sebelisa tsoekere e tsoang maling a mali, e lebisang ho nyoloheng ha maemo a tsoekere, 'me sena se lebisa tlhahiso e eketsehileng ea insulin ke manyeme.

Likahare tse eketsehang tsa mafura a mangata 'meleng a thibela ho theoa ha litlamo lipakeng tsa li-receptor tsa lisele tsa sebete tse nang le insulin. Thibelo ea ho etsoa ha motsoako o lipakeng tsa li-receptors le insulin e thibela tšebetso ea gluconeogenesis ka har'a sebete.

Ka lebaka leo, keketseho ea boemo ba mafura a acid e ntlafatsa kholo ea insulin e amanang le insulin liseleng tsa 'mele, mme keketseho ea boits'ireletso e ntlafatsa ts'ebetso ea lipolysis le hyperinsulinomy.

Ha motho a phela bophelo bo sa sebetseng bakeng sa bakuli ba nang le lefu la tsoekere la mofuta oa 2, ho etsahala ntho e mpefatsang boemo, e kang ho ts'oaroa ha insulin le botenya.

Mabaka a ka sehloohong a nts'etsopele ea ho hanyetsa insulin

Ho hanyetsa insulin ke lefu leo ​​ho lona ho nang le karabelo e sa lekaneng ea lisele tse itšetlehileng ka insulin ho "insulin" ea hormone haeba palo e tloaelehileng ea insulin e hlahisoa. Boemo bo hlaha khahlano le semelo sa ts'ebetso e tloaelehileng ea insulin.

Sephetho se ka sehloohong sa nts'etsopele ea ho hanyetsa insulin ke ho theha boemo ba hyperinsulinemia, hyperglycemia le dyslipoproteinemia. Hyperglycemia ho tsoekere e tsoelang 'meleng e bapala karolo e kholo ho hlaha ho haella ha insulin ho mokuli ea nang le lefu la tsoekere la mofuta oa 2.

Ho batho ba nang le lefu la tsoekere la mofuta oa 2, matla a lisele tsa pancreatic beta ho koahela bofokoli ba insulin 'meleng a lekanyelitsoe ka lebaka la ho sitoa ke sebopeho sa glucokinase le GLUT-2. Litholoana tsena tsa lik'hemik'hale 'meleng li na le boikarabello ba ts'ebetso ea tlhahiso ea insulin tlasa ts'usumetso ea khatello e ngata ea tsoekere.

Bakuli ba nang le lefu la tsoekere la mofuta oa 2 hangata ba ba le mathata a ho etsa insulin ka lisele tsa beta.

Mathata ana a bonahala ho tse latelang:

• Ho na le ho theoha butle-butle mohato oa pele oa karabo ea lekunutu molemong oa mojaro 'meleng ka tsoekere, ha e tsamaisoa ka matla,
• ho na le ho fokotseha le ho lieha ha karabo ea lekunutu ea ts'ebeliso ea lijo tse tsoakiloeng ke 'mele,
• e senotse boemo bo eketsehileng 'meleng oa proinsulin le lihlahisoa tse entsoeng nakong ea ts'ebetso ea eona,
• mathata a morethetho oa ho feto-fetoha ha maemo ka insulin secretion a bonoa.

Sesosa se ka sehloohong sa ho se sebetse hantle ha motsoako oa insulin ke ponahalo ea bofokoli ba liphatsa tsa lefutso liseleng tsa beta, hammoho le mathata a bakoang ke ho hlaha ha chefo ea lipo- le glucose.

Tšoaetso ea methati ea pele ea insulin secretion mafu

Liphetoho mokhoeng oa ho boloka li-insulin sethaleng sa prediabetes li ka hlaha ka lebaka la keketseho ea litaba tsa mafura a mahala. Keketseho ea khatello ea khatello ea mantlha e lebisa ho thibelo ea pyruvate dehydrogenase, 'me, ka lebaka leo, ho fokotseha ha lits'ebetso tsa glycolysis. Thibelo ea ts'ebetso ea glycolysis liseleng tsa pancreatic tse ikarabellang bakeng sa ho hlophisoa ha insulin, e leng ho tsosang ho fokotseha ha motsoako oa ATP. Khaello ea ATP liseleng tsa pancreatic e baka ho fokotseha ha secretion ea insulin.

Ho ba le chefo ea glucose ke lintho tse rarahaneng tseo ho tsona tsoekere e fetelletseng e tsosang tlolo ea secretion ea insulin le ho fokotseha ha kutloisiso ea lisele tse thehiloeng ho insulin ho insulin.

Nts'etsopele ea hyperglycemia 'meleng oa mokuli ke e' ngoe ea lisosa tsa tsoelo-pele ea lefu la tsoekere la mofuta oa 2 bathong ka lebaka la ts'ebetso ea tsoekere ea glucose.

Nts'etsopele ea chefo ea tsoekere e lebisa ho fokotseheng ha maikutlo a lisele tsa "insulin" tse ts'epahalang ho insulin. Ho tsoa ho tsohle tse ka holimo, ho ka fihlela qeto ea hore ho fihlella ha matšoao a tloaelehileng a 'mele a amanang le tsoekere ho plasma ea mali le ho boloka matšoao ana ka mokhoa o ts'oanang ho thusa ho khutlisetsa kutloisiso ea lisele tsa "cell insulin" tse amanang le insulin.

Hyperglycemia hase eona feela letšoao le ka sehloohong la ho khetholla lefu la tsoekere 'meleng, empa hape le sehokela sa bohlokoa ho pathogeneis ea lefu la tsoekere. Hyperglycemia e halefisa ho hlaha hoa lits'oaetso nakong ea tlhahiso ea insulin ke lisele tsa beta tsa manyeme le ho kenngoa ha glucose ke lisele tse itšetlehileng ka insulin. Sena se halefisa ho hlaha hoa litlolo tsa ts'ebetso ea metabolism ea carbohydrate.

Letšoao la pele-pele la nts'etsopele ea lefu la tsoekere ke tsoekere e eketsehang ea mmele 'meleng oa mokuli, ka lebaka la keketseho ea tlhahiso ea tsoekere ke lisele tsa lithane tsa sebete. Video e sehloohong sena e tsoela pele ka sehlooho sa lefu la tsoekere.

Mokhoa oa nts'etsopele ea lefu lena

Ho molemo ho utloisisa etiology le pathogenesis ea lefu la tsoekere ha o nahana ka litšobotsi tsa metabolism ea carbohydrate 'meleng.

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Haholo-holo mathata a joalo a ama metabolism ea lik'habohaedreite, mme metabolism ea liprotheine le mafura ha e amehe.

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Mefuta ea lefu la tsoekere ea khetholoha, 'me e' ngoe le e 'ngoe ea eona e na le mokhoa oa eona oa ntlafatso:

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1. Mofuta oa 1 (mothehi oa insulin). Mofuta oa 1 oa lefu la tsoekere ke lefu le bitsoang endocrine leo ho lona ho amehang lisele tsa glandular tsa manyeme.

Ke Hormone ena e laolang metabolism ea tsoekere 'meleng oa motho. Ha insulin e sebetsa ho li-receptor tsa lisele tsohle, ts'ebetso ea tsoekere ea tsoekere le ho phatloha ha eona ka mor'a moo ka ho tsoa ha matla ho potlakisa.

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Mofuta oa 1 oa lefu lena, morero oa pathogeneis ke hore tlhahiso ea "insulin" e fokotsehile haholo, mme ka lebaka leo, tsoekere ea tsoekere ka lisele e ea fokotsoa.

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Ditlamorao tsa etiopathogenesis ena ke ho theoha butle ho tlositsoeng ha tsoekere maling le ho bokellana ha eona ka bongata.

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Ho sa tsotelehe moelelo oa motheo oa nts'etsopele ea lefu la tsoekere mellitus, mathata a hlaha ka metabolism ea lipids le liprotheine. Sena se bonahala ka taba ea hore motho o qala ho nona ka potlako kapa ho theola boima ba 'mele.

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Mofuta o mong o fapaneng oa tlolo ea metabolism ea carbohydrate 'meleng o nkoa e le GDM (gestationalabetes mellitus).

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Polelo ena e sebelisoa haholo ho basali nakong ea kemaro mme lefu le fumanoa motheong oa liteko tsa mali tsa laboratori bakeng sa tsoekere.

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Har'a mefuta eohle ea mafu a sa foleng, ho ikamahanya le maemo ho ka fetoha ho mpefatsang lefu la methapo ea methapo.

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Le ha ho le joalo, tšoaetso e matla e ka thatafatsang nako ea lefu la tsoekere le eona e nahaneloa.

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Mohlala, mokuli o tšoeroe ke lefu la bronchial asthma mme o kula le SARS, mme ke lefu la morao le tla fetoha kahare.

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Ha e le molao, ka bobeli, lefu le tšoaetsanoang hangata le hlaha le lefu la tsoekere.

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Ho ikopanya le lefu la tsoekere la mafu a tšoaetsanoang a mafu a tšoaetsanoang ho mpefatsa le ho feta lefu la motheo.

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Boemong bo joalo, kalafo e hlokoang ea mafu a kopaneng a hlokehang e le karolo ea bokuli, esita le keketseho ea tekanyetso ea insulin ea letsatsi le letsatsi.

Ka nts'etsopele ea mathata a bokuli bo sa foleng le ho eketsoa ha li-pathologies tse arohaneng, ho bohlokoa ho lekola ka hloko boemo ba mokuli ea nang le lefu la tsoekere, kaha ho na le menyetla e phahameng ea ho senyeha ha metabolism le ponahalo ea acidosis.

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Phello ea lefutso

Bokapele ba lefu lena bo ka ba teng ho batho ha ho e-na le mofuta oa liphatsa tsa lefutso. Ha se sebaka sa ho qetela ka ponahalo ea lefu la tsoekere ke mofuta oa eona.

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Tlwaelo ea bongaka e bontša hore ke palo e fokolang feela ea bana ba tsoaloang ba nang le tšekamelo ea mofuta o mong o tsoang ho insulin o tsoang ho mme.

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Ka nako e ts'oanang, lehlakoreng la ntate, menyetla ea ho tsoella lefu la tsoekere la 1 e eketseha mme e ka ba 10%.

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Ka linako tse ling lefu la tsoekere le ka fetisoa ke batho ba baholo ka bobeli. Maemong ana, menyetla ea ngoana ea ho ba le lefu la tsoekere e eketseha makhetlo a 'maloa mme a ka fihla 70%.

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Tšenyo ea lihlekehleke tsa Langerhans

Lisele tsa Beta, tse fumanehang libakeng tsa manyeme lihlekehlekeng tsa Langerhans, li hlahisa insulin ho batho.

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Sesosa sa lefu la tsoekere e ka ba tšenyeho ea boholo ba lisele tsa beta ke sesole sa mmele.

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Hoa tsebahala hore mefuta e meng ea tšoaetso ea tlhaho ea vaerase, lefutso le futsanehileng le ho kenella lebese la khomo sejo sa ngoana li khona ho tsosa karabelo e joalo.

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Maemo a leholimo a fapaneng

Ntho e sa rateheng joalo ka tšilafalo ea tikoloho e ka tsosa mofere-fere.

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Lingaka tse ling li bolela hore tikoloho e mpe e ka senya lisele tsa beta feela ho bakuli ba nang le lefu la tsoekere la tsoekere.

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Litsebi tse ling li pheha khang ea hore thuto ea tikoloho le lihloliloeng tse mpe li phetha karolo e itseng khafetsa ho thuto ea tlhaho.

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Matla a tšoaetso ea vaerase

Nts'etsopele ea pathology e hlokomeleha haholo mariha, ha tšoaetso ea vaerase e atile haholo.

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Likokoana-hloko tse ka bakang lefu la tsoekere li ka thoko:

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• rubella
• li-mumps
• cytomegalovirus,
• adenovirus.

Bo-rasaense ba tseba litsela tse 'maloa tseo ka tsona livaerase, ha li pepesetsoa' mele, li ka lematsang kapa tsa senya lisele tsa beta, hammoho le ho baka karabelo ea autoimmune bathong ba kotsing.

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Ho fepa masea

Boithuto bo bontšitse hore lijo tse itseng e ka ba sesosa sa lefu la tsoekere la mofuta oa 1.

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Ho masea a noang li-supplement tsa vithamine D, menyetla ea ho ba le lefu la tsoekere la 1 e fokotsehile haholo.

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Leha ho le joalo, kotsi ea pathology e joalo e eketseha haeba lebese la khomo le liprotheine tsa lijo-thollo li kenngoa pele lijong tsa ngoana e monyane.

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Likotsi tsa manyeme le maloetse

Li-pathologies tsa pancreatic tse kang oncology, pancreatitis le likotsi tse fapaneng li ka senya lisele tsa pancreatic tsa beta kapa tsa liehisa tlhahiso ea insulin.

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Ha pancreas e senyehileng e tlosoa, mofuta oa lefu la tsoekere la 1 o ka hlaha ka lebaka la tahlehelo ea lisele tsa beta tse hlahisang insulin.

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Lithethefatsi tse entsoeng ka maiketsetso

Maemong a mang, lefu la 1 le hlaha ka meriana e itseng.

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Pentamidine ke lithethefatsi tse ka eketsang kotsi ea ho tšoaroa ke pancreatitis le lefu la tsoekere ka lebaka la tšenyo ea lisele tsa beta.

Glucocorticoids e nkoa e le lihormone tsa steroid tse ka mpefatsang litlamorao tsa insulin, 'me ka hona tsa baka lefu lena.

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Kotsi ea boemo ba pathological ho tsoekere ea mellitus le eona e eketseha ka tšebeliso ea lik'hemik'hale tse ngata tse nang le naetrojene.

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Boholo

U hloka ho utloisisa hore ha se bokuli ka boyona joalo ka lefu la tsoekere le fetisitsoeng, empa ke sepheo sa nts'etsopele ea mofuta o mong oa pathology.

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Mofuta oa 2 oa lefu la tsoekere ke pathology ea polygenic, 'me nts'etsopele ea eona e ikemiselitsoe ke ho ba teng hoa lintlha tse' maloa.

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Boloetse bo joalo bo fumanoa hangata ho bakuli 'me sena se amana le ho hanyetsa kahare ho lisele tsa mmele ho insulin.

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Mofuta oa 2 oa lefu la tsoekere o tšoauoa ka tekanyo e phahameng ea monyetla oa lefa, haholo-holo haeba batsoali ka bobeli ba na le eona.

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Ho tseba pele lefu la tsoekere le lefutso ho lokela ho nahanoa ha ho raloa lelapa le ho khetha mosebetsi.

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Khaello ea phepo e nepahetseng

Mofuteng oa 2 oa lefu la tsoekere, maikutlo a lisele tsa 'mele ho ea insulin a fokotseha.

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Boithuto bo bontšitse hore ke botenya le lijo tse se nang phepo tse nkoang e le lisosa tse ka sehloohong tsa lefu lena.

Sesosa sa lefu la tsoekere la mofuta oa 2 e ka ba tšebeliso ea lijo tse ntlafalitsoeng ebile li na le lik'habohaedreite tse ngata.

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Ho nona haholo

Lisosa tse ka sehloohong tsa lefu la tsoekere ho nkoa e le botenya haholo, haholoholo, hammoho le bophelo ba lefutso, ho phela bophelo bo sa feleng le khatello ea methapo ea mali.

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Bohlokoa ba bohlokoa bo bapaloa eseng feela ka taba ea boteng ba botenya, empa hape le mofuta oa kabo ea oona.

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Ka botenya ba visceral, lithane tsa adipose ka bongata li bokellana ho potoloha litho tsa kahare mme ho tlosoa lintho tse ngata tse sebetsang ka biolojene tse kang adipokines.

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Ketso ea bona e baka tlolo ea ts'ebetso ea metabolic, mme ho ba le lefu la tsoekere hoa hlaha.

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Ho batho, kutloisiso ea "tisulin" ea insulin e fokotseha, khatello ea matla le ts'oaetso ea methapo ea methapo ea methapo.

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Kamora nako, liphetoho tsohle tsa pathological li lebisa ho nts'etsopele ea methapo ea pelo, oncology le lefu la tsoekere.

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Ho lahla lipapali

Lefu la tsoekere le fumanehang ke lefu le hlokang ho hlahlojoa bophelo ba hau.

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Mokuli o hloka ho hlophisa letsatsi la hae ka tsela e tla thibela ho ata ha lefu lena le nts'etsopele ea mathata.

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Melao-motheo ea bohlokoa eo motho a lokelang ho e latela ke phepo e nepahetseng, phomolo e nepahetseng le lipapali.

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Ka ho ikoetlisa khafetsa, mesifa e monya tsoekere e ntle, 'me butle-butle tsoekere ea mali e fokotsehe.

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Ho ikoetlisa ho tsoelang pele ho thusa ba lefu la tsoekere ho fokotsa tlhoko ea insulin le litlhare tse ling tse fokotsang tsoekere.

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Tlas'a khatello ea maikutlo, 'mele o sebetsa hantle' me o hlokomoloha lintlha tsa bobeli. Ka mantsoe a mang, 'mele o tsepamisa mohopolo nthong ea mantlha, ke hore, maemong a sithabetsang.

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Boemong bo sithabetsang, ho lokolloa ha insulin le mosebetsi oa mokokotlo oa mpa, hammoho le boitšoaro ba thobalano le phepo e nepahetseng.

Khatello ea kelello e lebisa 'neteng ea hore ho na le tšitiso ea Reflex ea basal secretion ea insulin mme ka nako e ts'oanang, ho lokolloa ha tsoekere ho depo ho potlakile.

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Litlamorao tsa boemo bona ba pathological ke boemo ba hyperglycemic le bofokoli ba insulin.

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Likarolo tsa lilemo

Ho batho ba bangata, mamello ea tsoekere e fokotseha ka lilemo, 'me hangata, ho joalo, liphetoho tse joalo ha li fetohe.

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Kotsi ea ho ba le lefu la patsi kamora lilemo tse 50-60 e eketseha haholo, empa sena ha se bolele hore matšoao a lefu lena a tla hlaha.

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Motho e mong le e mong o fetola phallo ea tsoekere maling maling ka mekhoa e fapaneng mme ts'ebetso ena e latela bophelo, phepo e nepahetseng, mafu a sa foleng le ho ikoetlisa.

Ho batho ba baholo, matšoao a hypoglycemia hangata ha a boleloe joalo mme lefu la kelello le ka fumanoa ka phoso ka phoso.

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Matšoao a lefu lena a ka hlaha, empa mokuli hangata ha a ba ele hloko.

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Maemong ana, hypoglycemia e lula e pepesehetse 'me ho na le kotsi ea lefu la tsoekere le pelo, likotsi tsa mali le nephropathie.

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Lisosa tsa mathata a lefu la tsoekere

Sesosa se ka sehloohong sa mathata a lefu la tsoekere ke keketseho e sa feleng ea tsoekere e maling.

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Sena se baka tšenyo ea methapo le ho fokotseha ha tsoekere ka nako e telele. Pele, ts'ebetso ea methapo e kholo ea mmele, ke hore, ho phalla ha mali ka har'a lijana tse nyane ho a sitisa.

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Li-pathologies tse latelang li fetisoa ho mathata a tebileng:

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Maemong a sa foleng, liphio, methapo ea mali, letlalo le tsamaiso ea methapo ea methapo lia senyeha.

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Mathata a morao-rao a lefu la tsoekere a ka kenyelletsa maloetse a kang retinopathy, angiopathy, polyneuropathy, le lefu la tsoekere.

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Lefu la tsoekere

Lefu la tsoekere kapa lefu la tsoekere le nkoa e le mokhoa o sa tloaelehang oa ho iphelisa, o hlahang ha ho sebetsa hantle ha pituitary kapa hypothalamus.

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Ponahatso ea mantlha ea lefu lena ke lenyora le matla le ho ruruha ho eketsehileng. Lisosa tsa lefu la lefu la tsoekere e ka ba:

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• hlahala ea tlhaho le a hypothalamic,
• likotsi tse mpe tsa kelello
• lebaka la liphatsa tsa lefutso
• mathata a potoloha sebakeng sa methapo e matlafatsang mafapha a boko,
• lefu la liphio.

Botebo ba matšoao bo khethoa ke tekanyo ea ho haella ha li-hormone tsa antidiuretic.

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Matšoao a ho felloa ke metsi 'meleng a bitsoa, ​​ka mantsoe a mang, ho na le bofokoli, pelo le phallo ea pelo.

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Hobaneng u nyoriloe joalo?

Lebaka le ka sehloohong la lenyora le sa feleng la lefu la tsoekere le nkoa e le ho eketseha ha ho ruruha, ho lebisang ho feliseng metsi haholo.

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Bakuli ba nang le lefu la tsoekere ba tletleba ka ho oma le ho omella ha mucous membrous le letlalo.

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Sesosa sa lenyora le sa feleng e ka ba tsoekere e phahameng ea mali, 'me' mele o leka ka hohle kamoo o ka khonang ho itokolla ho tsoekere e ngata. Ho etsa sena, o leka ka matla ho e ntša ka moroto, e lebisang ponahalong ea lenyora.

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Keketseho e tsoekere ea tsoekere maling e ka hohela metsi feela, ho e ntša liseleng. Ha tsoekere e nang le moroto e tlosoa 'meleng, motho o lahleheloa ke metsi a mangata.

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Lebaka le leng la lenyora la tsoekere le sa feleng ke taba ea hore tsoekere e phahameng e baka ts'abo ea methapo ea kutlo.

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Sena se lebisa ts'ebetsong e sa sebetseng ea litho tse fapaneng tsa kahare mme haholoholo ea senya.

Ho etsahalang ka lefu la tsoekere?

Ka tlhahiso e sa lekaneng ea insulin, tsoekere e maling e phahame ho feta boemo bo tloaelehileng, empa lisele tsa 'mele tse boemong bona li ikutloa li haelloa ke glucose.

Lefu la tsoekere le etsahala:

• Mofuta oa lefutso o ikhethileng
• Mofuta oa lefu la tsoekere.

Ho tsoa ho khaello ea glucose ho li-tishu, li-pathologies tse joalo li theha:

• Letlalo la letlalo la mofuta oa abscess,
• Membrane ea mucous e robehile
• Enamel ea menoana e senyehile
• Lefu la Atherosmithosis le hlaha,
• Lenane la khatello ea mali le phahama - khatello ea mali,
• Pathology e hlaha lipelong,
• Pono ea oa
• Ho na le lefu la angina pectoris,
• Mathata a teng methating ea tsamaiso ea methapo.

Khoutu ea ICD-10

Ho ea ka karohano ea machaba ea maloetse a ntlafatso ea leshome ea ICD-10 - ts'ebetso ena ke ea sehlopha sa "Lefu la tsoekere" mme e na le khoutu:

• E10 - mofuta oa 1 lefu la tsoekere,
• E11 - mofuta oa 2 lefu la tsoekere,
• E12 - lefu la tsoekere le khaello ea phepo e nepahetseng,
• E13 - mefuta e meng e boletsoeng lefu la tsoekere mellitus,
• E14 - mellitus e sa hlalosoang ea lefu la tsoekere.

Sistimi ea nts'etsopele

Glucose ke e 'ngoe ea matla a mantlha a phepo e nepahetseng ea lisele tsa litho tsohle. Ha ho kheloha tlhahiso ea "insulin" ka lebaka la ho se sebetse hantle mokhoeng, joale ho ts'oenyeha hoa metabolism ea 'mele ho qala.

Glucose ha e kene liseleng tsa lisele, empa e bokellana maling.

Ka lebaka la khaello ea lisele tsa tsoekere, li-pathologies tse lumellanang le lefu la tsoekere li qala ho ba teng - mathata a ts'ebetsong ea potoloho ea mali, maloetse a pelo, methapo ea letlalo, mathata a ts'ebetsong ea methapo ea methapo, hammoho le ho kheloha ha ts'ebetso ea litho tsa ka hare.

Hyperglycemia e mpefatsa sebopeho sa mali, e leng se lebisang ho tsitsipaneng tsamaisong ea hematopoiesis le tsamaisong ea heestatic.

Ts'ebetso ena ea tsoekere e ngata maling e bitsoa lefu la tsoekere.

Lefu la tsoekere le kotsi bakeng sa 'mele?

Lenane la tsoekere le phahameng la mali le baka ho se sebetse hantle ha lisele tsohle tsa litho tsa setho. Ha theko ea tsoekere e phahame ka ho fetisisa, ho boleloa haholoanyane ka litlamorao tsa eona tse mpe 'meleng.

Pathologies e hlahang ho lefu la tsoekere:

• Ho nona haholo - botenya
• Organ glycosylation
• Ho kenella ka har'a lisele tsa methapo ea methapo, ho lebisang tšenyehong ea sistimi,
• Tšusumetso e mpe marakong a methapo ea mali ea tsamaiso ea mali ea 'mele,
• Nts'etsopele ea maloetse a amang pelo, bokong, le setho sa liphio le sebete.
• Sisteme eohle ea tšilo ea lijo e senyehile,
• Ho na le tšenyo ea lisele tsa mesifa ea mesifa, hammoho le lenane la letlalo,
• Ho faola hoa etsahala
• Hyperglycemic coma, eo hangata e bolaeang.

Mefuta ea lefu la tsoekere

Haeba ho na le tlhahiso ea insulin e sa lekaneng 'meleng' me ho na le moo e haelloang teng, lenane la tsoekere le ke ke la lula ho li-unit tse sa ts'oaneng ho 3.30 mmol / litha mme ha li kaholimo ho 5.50 mmol / litha.

Boemo bona 'meleng bo bitsoa lefu la tsoekere - lefu la tsoekere.

Ho na le mefuta ea lefu la tsoekere:

• Makhopho a makhopho ha a hlahise insulin ho hang (ho ba sieo ha eona ka botlalo). Ka tlolo e joalo ea setho sa "endocrine", "mellitus" e thehiloeng holima lefu la tsoekere ea mofuta oa pele (IDDM) e thehiloe,
• Bophahamo ba insulin bo haellang bo hlahisoang ke setho sa endocrine (khaello ea insulin). Boemo bona bo nang le ho haella ha insulin bo senya metabolism ea carbohydrate le mofuta oa bobeli oa insulin o ikemetseng oa lefu la tsoekere oa mellitus (NIDDM) oa hlaha.

Nts'etsopele ea lefu la tsoekere e hlaha ka mekhahlelo mme ha ho ba le keketseho e kholo ea tsoekere ea mali ea serum, joale ho hlaha matšoao a lefu la tsoekere le matšoao a boletsoeng. Ho tlatlapuoa ho etsahala ka botlalo ho metabolism ea 'mele, ts'ebetso ea litho tsa mpa e ferekanngoa ke sena.

Ts'ebetso ea methapo ea methapo e ama mesebetsi eohle ea 'mele oa motho ea lefu la tsoekere. Lefu la tsoekere le tsoekere ebile le ama lisele tsohle.

Tekanyo ea tsoelo-pele ea lefu la tsoekere e amanang le mmuso oa tsamaiso ea endocrine le palo ea insulin ea pancreatic e hlahisitsoeng.

Maikutlo a bobeli

Psychology ena e qala ka ho ruruha hoa setho sa endocrine (pancreatitis), hammoho le lefu le hlahang la li-pathologies tse joalo:

• Litla-morao tse kotsi ka har'a tšoelesa,
• Le Psychology ea cirrhosis, ho baka ka mokhoa o thata le o matla,
• Lefu la Acromegaly - tlhahiso e eketsehang ea bahanyetsi ba hormone ea insulin ea setho ke litho tsa endocrine,
• Lefu la Cushing,
• Pathology of the onthology of pheochromocytoma,
• Pathologies le mafu a tšoelesa ea qoqotho.

Hape, mofuta oa bobeli oa lefu la tsoekere o ka hlaha ka lebaka la tšebeliso ea meriana nako e telele:

• Ho nka diuretics
• Li-antihypertensive lithethefatsi,
• Lithibela-mafu tsa molomo tsa molomo.

Pono ea boits'oaro

E qala nakong ea bokhachane ho basali. Lebaka la ponahalo ea mofuta ona ke hore makhopho a pancreas a ho etsa lesea utero o qala ho hlahisa insulin ea hae, e sitisang ts'ebetso ea insulin ea 'mele.

Ka lebaka lena, ho ba teng ha mofuta oa gestational mofuta oa lefu la tsoekere le hlahang.

Kamora ts'ebetso ea tlhaho ea tsoalo, karolo ea pele ea lefu la tsoekere e etsahala ho basali, empa hoo e batlang e le 40.0% nakong ea lilemo tse 7 ho isa ho tse 8 e na le tsoelo-pele ea lefu la tsoekere la mofuta oa bobeli o sa ts'epeng insulin.

Mefuta ea lefu la tsoekere

Matšoao a lefu la kelello

Ka seoelo, ho ba teng ha tsoekere ka tšohanyetso ho hlaha, e leng se potlakisang lenane la tsoekere ea mali le phahameng haholo, mme le ka tšosetsang hyperglycemic coma.

Khafetsa, kholo ea kholo ea methapo ena e etsahala butle mme ka mekhahlelo, ka hona matšoao a lefu la tsoekere le a hlahella ka methati.

Mehato ea pele ea lefu lena e hlahisoa ke matšoao a latelang:

• Molomo o omileng, oo lefu la tsoekere le lulang le o utloa,
• Lenyora le sa khaotseng, leo ho leng thata haholo ho le tima. Ka lefu la tsoekere, bakuli ba nwa ho fihlela lilithara tse 5 tsa mokelikeli,
• Ho eketsa urination ho tsoa 'meleng. Boholo ba mochine oa letsatsi le letsatsi bo eketseha haholo,
• Ho fokotsa boima ba 'mele ka phepo e tloaelehileng,
• Phello e potlakileng ea boima ba 'mele ka bongata ba lijo tse feliloeng,
• Letlalo le ommeng, leo tsoelo-pele ea lefu la tsoekere le eketsang,
• Li-ulc li hlahella letlalong,
• 'Mele oa fufuleloa,
• Bofokoli ba mesifa
• Maqeba a tlhaho efe kapa efe a fola haholo.

Letšoao lena le hlaha qalong ea lefu la tsoekere mme e sebetsa e le sesupo sa ho etela endocrinologist le ho qala kalafo ea lefu lena ka nako.

Phekolo ea nako ka nako e tla emisa tsoelo-pele ea lefu la tsoekere, e tlang ka sebopeho se rarahaneng mme e ama bophelo bohle ba litho tse tšehetsang.

Ka mofuta o rarahaneng oa lefu la tsoekere, ho tahoa hoa 'mele ho etsahala, ho ka lebisang ho komeng ea glycemic.

Matšoao a lefu la tsoekere

Matšoao a mofuta o rarahaneng oa lefu la tsoekere

• Ts'ebetso ea setho se bonoang e senyehile - ho na le tšitiso ea boleng ba pono, 'me e ka lebisa bofofu bo felletseng,
• Ho opeloa ke hlooho, ka linako tse ling ho bonahatsoa ka matla, 'me ha ho na mokhoa o ikhethang oa bohloko,
• Mathata a amanang le methapo a hlaha ka lebaka la khaello ea phepo e ntle ea methapo ea kutlo,
• Pathologies ho setho sa pelo e nts'etsapele, lisele tsa myocardial ha li fumane glucose,
• Keketseho ea setho sa hepatic ea hlaha 'me lefu la cirrhosis le hlaha liseleng tsa eona,
• Ho opeloa ke mesifa ea mesifa e tlase, e sitisang mesebetsi ea makoloi.
• Ho ba le lipalo tse phahameng ho etsahala ka lebaka la ts'ebetso e sa lokelang ea sistimi ea phepelo ea mali,
• Mabota a methapo ea mali ea sistimi ea phallo ea mali a senyeha, ho kheloha ts'ebetsong ea sistimi ena hoa etsahala le boleng ba mali a fanang ka 'ona boa fokotseha. Haholo-holo sebaka sa pherekano se tšoeroe ke sena - likepe tsa mokokotlo le li-capillaries tsa libaka tse tlase,
• Boikutlo ba letlalo bo fokotsehile, bo bonahala haholo maotong a maoto le matsoho.
• Lenane la khatello ea mali le nyoloha 'me khatello ea mali e tsoela pele ka potlako. Ho na le khatello ea khatello ea hore index e phahameng maling a tsoekere e ama hantle likarolo tsa litho tsa mpa mme e li pepesetsa sclerosis. Ka hona, likepe li lahleheloa ke matla a tsona le bokhoni ba ho hola ka nako e loketseng.
• Ho ruruha ha maoto le sefahleho. Ka lebaka la hore ba nang le lefu la tsoekere ba sebelisa metsi a mangata ka letsatsi le ka lebaka la ho se sebetse hantle ha setho sa liphio, mokelikeli kaofela ha o theohe ka moroto 'me ho ruruha hoa pele lintlheng tse tlase, ebe sefahlehong.
• Monko oa acetone o tsoa ho batho ba nang le lefu la tsoekere,
• Ho lahleheloa ke kelello
• Hyperglycemic diabetesic coma,
• Sephetho se bolaeang.

Matšoao a mellitus a rarahaneng a lefu la tsoekere a hlaha kalafong e sa lokang ka meriana, kapa ho tsoa ho e seng kalafo ho hang, ha tsoelo-pele ea lefu la tsoekere e etsahala ka potlako.

Lisosa tsa lefu la tsoekere

Lisosa tse tloaelehileng tsa lefu la tsoekere:

• Le leng la mabaka a sehlooho a lebisang ho lefu la tsoekere ke lefutso la lefutso. Ka lebaka la lefutso, lisosa tse setseng ha li bohlokoa ka nts'etsopele ea lefu lena la methapo ea mafu,
• Sesosa sa ho nona haholo ke botenya. Ka ntoa e nakong ka nako e telele khahlanong le boima bo feteletseng, o ka qoba tlolo ea molao tsamaisong ea endocrine, le ho thibela ho qala ha lefu la tsoekere,
• Likokoana-hloko tse bolaeang lisele ka har'a manyeme a hlahisang insulin. E ka ba ts'ebetso ea ho ruruha tšoelesa, hammoho le kholo ea mofets'e e timetsang lisele tsena.
• Boloetse ba litho tse ling tsa tsamaiso ea endocrine - litšoelesa tsa adrenal hammoho le tšoelesa ea qoqotho.
• Maloetse a vaerase - likhoho, le ntaramane. Likokoana-hloko li ka baka tlolo ea molao tsamaisong ea endocrine le ho qala kholo ea lefu la tsoekere,
• E boetse e tsosa ho ruruha ho manyeme le mafu a tšoaetsanoang - mofuta oa lefu la hepatitis, rubella e tšoaetsanoang.

Litekanyetso tsa ketsahalo e tla etsahala

• Khatello ea kelello. Ka khatello ea maikutlo ea kamehla, ho se sebetse hantle ha lihormone ho etsahala 'meleng, kaha litšoelesa tsa endocrine li khaotsa ho hlahisa lihormone ka tekanyo e nepahetseng. Ka lebaka la khaello ea insulin ea lihomone, methapo ea methapo ea kutlo e utloa bohloko, 'me sena se mpefatsa boemo ba lefu la tsoekere.
• Tloaelo e tloaelehileng ea lino tse tahang, e bakang ho ruruha makhophong,
• Bokhoba ba Nikotine. Ka nako e telele ea ho tsuba ho mokuli, eseng feela ts'ebetso ea methapo ea mali, empa le tsamaiso ea endocrine, e lebisang ho lefu la tsoekere, ea tsoela pele.
• Nako ea botsofali ea 'mele. Ha motho a ntse a tsofala, menyetla ea lefu la tsoekere 'meleng ea eketseha. Ha motho a ntse a tsofala, o ba le monyetla o moholo oa ho ba le lefu la tsoekere.

Lenane ha le kenyeletse mabaka ao nts'etsopele e amanang le maloetse a mang, mme lefu la tsoekere le nkoa e le lefu la bobeli.

Lefu la tsoekere la bobeli ha se 'nete,' me phekolo ea lona e reretsoe ho phekola sesosa sa lefu la tsoekere ho theola matšoao a lefu la tsoekere.

Hangata mofuta oa bobeli oa lefu la tsoekere o hlaha 'meleng, e le lefu le ikemetseng, le tsoela pele ka potlako haholo.

Patlisiso

Ha matšoao a lefu la tsoekere a bonahala 'me ho e-na le litabatabelo tsa lona, ​​ho bohlokoa ho etsa tlhahlobo le litsebi tse joalo:

• Endocrinologist,
• Cardiologist
• Neurologist
• Ophthalmologist,
• Ngaka e buoang masapo
• Ngaka ea mafu a tšoaetsanoang
• Oncologist
• Ngaka ea bana e hlahloba bana.

Empa ketelo ea pele e lokela ho ba ho endocrinologist, eo, ho latela liphetho tsa tlhahlobo, a behang likeletso tse eketsehileng tsa litsebi tse ikhethang. Kamora tlhahlobo ea pono, ngaka e bokella anamnesis, ho theha etiology ea litekanyetso tsa tsoekere pele.

Taba ea mantlha ke hore nakong ea tumellano ea pele ho hlokahala ho fumana hore na ho na le batho ba lefu la tsoekere har'a beng ba lefutso.

Bakeng sa ho netefatsa ho fumanoa ha lefu la tsoekere, ho entsoe lithuto tse ngata tsa lipalo le tlhahlobo ea laboratori ea motsoako oa mali bakeng sa boemo ba eona ba tsoekere.

Teko ea Lab

• Ho hlahlojoa hore na mali a entsoe joang ka mpeng e se nang letho,
• Ho etsa tlhahlobo ea mali bakeng sa mamello ea glucose - mali a nkeloa ka mpeng e se nang letho, ebe mokuli o fuoa seno sa tharollo ea tsoekere. Kamora ho qeta lihora tse peli, mali a huloa hape 'me lenane la tsoekere le sebetsoa,
• Teko ea boemo ba profinse ea Glycemic - index ea glucose e lekanyetsoa makhetlo a 'maloa ka letsatsi. Teko ena e ntse e etsoa ho lekola boleng ba kalafo ea kalafo ea lefu la tsoekere mellitus,
• Tlhahlobo ea laboratori ea moroto oa ho bona tsoekere ea moroto le leseli la lisele tse tšoeu tsa mali le protheine ho tsona,
• Ka ketoacidosis ho lefu la tsoekere mellitus, index ea 'mele oa ketone le acetone e khethiloe moroto,
• Tlhahlobo ea biochemical ea motsoako oa mali bakeng sa ho fumanoa ha hemoglobin ea glycated. Ha hemoglobin e phahame haholo, e na le mellitus e rarahaneng ea lefu la tsoekere.
• Biochemistry ea mali bakeng sa liteko tsa meno, hammoho le biochemistry ea sampole ea sebete,
• Boithuto ba electrolyte ba sebopeho sa mali le mofuta o tsoetseng pele oa lefu la tsoekere,
• Teko ea Robert - e senola tšenyo ho setho sa liphio,
• Boikemisetso ba index ea mofuta oa "insulin" o tsoang maling.

Lipatlisiso tsa liletsa

Sesebelisoa sa tlhahlobo ea methapo e etselitsoe ho fumana hore na hobaneng lefu la tsoekere le etsahala le hore na mathata a lona a phahama hakae kahare:

• Ho ithuta boemo ba fundus,
• ECG (electrocardiography),
• ECHO cardiography
• Ultrasound ea setho sa pelo,
• Ultrasound ea liphio
• Ultrasound ea sebete,
• Ultrasound ea litho tsa 'mele ea endocrine,
• MRI (imagonance imaging) ea methapo ea mali le lisele tsa boko,
• Rheovasography ea li-capillaries tsa maoto,
• Limb capillaroscopy,
• Dopplerography ea likepe le li-capillaries.

Boithuto bona bo felletseng ba ho tseba hore na lefu la tsoekere ha le na ho theha feela lefu la tsoekere, empa hape bo tla khetholla mofuta oa lefu la tsoekere le hore na le holile hakae.

Ha ho fumanoa, ho ka etsahala ho tsebahatsa ka botlalo lipontšo tsa lefu la tsoekere ho litho tsa ka hare.

Ho bohlokoa haholo ho etsa tlhahlobo ea mafu khafetsa ho tseba hore na lefu lena le tsoela pele hakae le ho lokisa kalafo ea lefu lena ka nako.

Index ea Serum Glucose

Tšoaetso ea pele ea lefu la tsoekere ke index ea sebopeho sa tsoekere ea mali. Ho na le matšoao a tloaelehileng a "glucose" ho latela lilemo tsa motho.

Ho masea a sa tsoa tsoaloa, tsoekere ea mali ha e lekanyetsoe, hobane likarolo tsa bona ha lia tsitsa ebile li tla lula li fapana. Matšoao a laolang tsoekere maling a ikemiselitsoe ho tloha ho lilemo tse 3.

Lethathamo la likarolo tsa tlhaho tsa tsoekere e tloaelehileng ka mekhahlelo ea lilemo:

Ho basali ba ho ilela khoeli, matšoao a ka fapana ka litekanyetso, ka lebaka la liphetoho tsa lihormone 'meleng le phokotso ea tlhahiso ea lihormone.

Hape nakong ea bokhachane, index ea glucose ha ea lokela ho ba tlase ho 3.30 mmol / litha e le ngoe ea mali mme e seng tse fetang 660 mmol ka litha e le nngwe tsa serum ea mali.

Lethathamo la likarolo tsa tlhaho tsa tsoekere ea mali ka mpeng e se nang letho, le kamora 'mojaro oa lik'habohaedreite:

Tekanyo ea lefu la tsoekere

Ha o khetholla methapo ea methapo ea litho tsa "endocrine", "mellitus" ea tsoekere, ho bohlokoa haholo ho e arola ho latela tekanyo ea pathology. Ha ho aroloa ka likhato, ha ho nkuoe feela index ea glucose, empa hape le puseletso ea lefu la tsoekere, hammoho le litlamorao tsa bohato ba lona 'meleng.

Ha lenane la tsoekere la serum le le phahamisa, le thatafala le ho thatafala le ho feta, mme le monyetla o moholo oa ho ba le bothata ba lefu la tsoekere.

Mofuta oa pele oa kalafo o nang le insulin

Mofuta oa 1 oa lefu la tsoekere o phekoloa feela ka insulin.

Kajeno, insulin e nang le monocompetent e teng bakeng sa kalafo, e arotsoe ka lihlopha tse joalo tsa pharmacological:

• Insulin ea lithethefatsi tsa monocompetent tse nang le foromo ea tlhaho ea li-pharmacological e lumellanang le ntho ea "insulin" 'meleng oa motho. Mokhoa ona oa "insulin" o na le melemo ea bohlokoa ho feta insulin ea tlhaho ea liphoofolo (tšibollo ea nama ea kolobe). Ha ho na li-contraindication ho sehlopha sena sa insulin, hammoho le litlamorao tsa eona,
• Ho hlophisetsoa ka matla insulin, e fumanoang ho tsoa ho makhopho a tsoang liphoofolong tse tsoang liphoofolong. Haeba u sebelisa sehlopha sena sa "insulin" kalafong, joale u lokela ho eketsa litekanyetso ka 15,0%.

Mofuta oa 2 Pheko

Phekolo ea mofuta oa bobeli oa lefu la tsoekere, hangata e ba le lijo tse mo thibelang, hammoho le litokisetso tsa letlapa ho fokotsa index ea glucose maling serum.

Lijo tsa mofuta ona oa lefu la tsoekere ke mokhoa o ka sehloohong, haholo ha index ea glucose e le sethaleng sa pele sa kholo ea lefu lena.

Haeba o lekanya phepo e nepahetseng mohatong oa pele oa lefu la tsoekere, o ka fokotsa matšoao a tsoekere e haufi le li-unit tse tloaelehileng, kapa o ea sethaleng sa mofuta oa lefu la tsoekere.

Lijo le tlhaiso ea kamehla ea maemo a tsoekere le phetoho e nepahetseng ea meriana ea eona e tla etsa hore lefu la tsoekere le phele bophelo bo felletseng.

Mekhoa ea kalafo bakeng sa kalafo ea lefu la tsoekere la mofuta oa 2

Bakeng sa kalafo ea lefu la tsoekere la mofuta oa 2 le lefu la tsoekere, ho sebelisoa lihlopha tse latelang tsa meriana tse ka fokotsang index ea tsoekere maling serum:

Lijo le lijo tsa lefu la tsoekere

Ha o phekola lefu la tsoekere, ho bohlokoa ho latela mokhoa oa ho ja, hammoho le phepo e nepahetseng.

Sejo sa phepo ea lefu la tsoekere:

• Lijo tse nang le ts'oaetso ea lefu lena li leka-lekane hore ho se lahleheloe ke boleng ba lijana tse felileng,
• Palo ea likhalori tse sebelisitsoeng e lokela ho tsamaisana le tšebeliso ea matla. Sena se tla thusa ho theola boima ba 'mele.
• Mokhoa oa ho ja o lokela ho bonoa - o je ka nako e le 'ngoe,
• U hloka ho ja makhetlo a 6 ka letsatsi,
• Palo ea lijo ka nako e nyane,
• E-ja meroho le merogo e ncha lijong tsohle. Li na le fiber e ngata, 'me li fokotsa tsoekere ea monko,
• Se ke oa sebelisa lik'habohaedreite habonolo,
• Li-carbohydrate tse rarahaneng ho ja tse fokolang
• Se ke oa ja mafura a liphoofolo
• Fokotsa tekanyo ea letsoai
• Tlohela joala
• Ts'ebeliso ea metsi ka letsatsi - ha ho na li-milliliters tse fetang 1500.

Lihlahisoa tse ka sebelisoang ebile ha lia lokela ho jelloa

Mehato ea thibelo

Bakeng sa ho qoba lefu la tsoekere, ho bohlokoa ho boloka mehato e meng ea thibelo:

• Lekola boima ba 'mele ka thata, thibela boima ba' mele, 'me haeba ho hlokahala, fetola liponto tse eketsehileng,
• Tsamaea haholo 'me u kenelle lipapaling tse mafolofolo - palama baesekele, e-ea letamong,
• Boloka tloaelo ea lijo - u se ke ua ja lijo tse ka eketsang index ea hau ea tsoekere ea mali,
• Fokotsa tšebeliso ea letsoai,
• Tsamaea ka mokhoa o nepahetseng ka li-mineral complexes,
• E ja meroho e mecha, litlama le litholoana,
• Laola tekanyo ea metsi 'meleng,
• Shebella boemo ba cholesterol 'meleng, thibela keketseho ea pontšo ea k'holeseterole e mpe maling.
• Sheba khatello ea mali 'me u etele ngaka ea lefu la pelo ka tatellano.
• Lekola maloetse 'meleng ka nako le ho phekola li-pathologies ka botlalo.
• Khaotsa ho lemalla joala ba nikotine,
• Se ke oa noa joala
• Qoba maemo a sithabetsang le khatello ea kelello,
• Kamehla phomola moeeng o mocha,
• Ela leihlo lenane la tsoekere maling maling ka mokhoa o hlophisehileng.

Tlhatlhobo ea bophelo le lefu la tsoekere

Kameho ea bophelo le lefu la tsamaiso ea endocrine - lefu la tsoekere le ipapisitse le lintlha tse joalo:

• Ho tsoa mofuteng oa lefu la tsoekere
• Ho tloha sethaleng sa nts'etsopele ea pathology,
• Ho tsoa tseleng ea bophelo
• Ho tsoa ho kalafo e nepahetseng le ts'ebetsong ea likhetho tsohle tsa ngaka.

Lefu la tsoekere le bua ka maloetse a ke keng a phekoleha ka botlalo, empa ka kalafo e nepahetseng, hoa khoneha ho thibela phetoho ea hae hore e be mofuta o rarahaneng.

Ho tsoekere ea lefu la tsoekere la mofuta oa bobeli qalong ea lefu lena ka thuso ea lijo tse khethiloeng hantle, o ka theola index ea glucose ho matšoao a tloaelehileng. Ka lijo tsena, pheko ea bophelo e ea rateha.

Ho tsoekere ea lefu la tsoekere la mofuta oa pele, hangata e tsoela pele ho fihlela litekanyetso tse matla tsa ho teba ha methapo ea mafu a lefu lena.

Ho ramatiki e rarahaneng ea lefu la tsoekere, ha litho tsohle tsa bohlokoa li amehile 'me kalafo ea lithethefatsi e sa tlise litholoana tse ntle, monyetla o moholo oa ho ba le lefu la tsoekere, eo maemong a mangata o lebisang lefung, ke phepo e ntle.