Tarihi da cutar: irin 2 ciwon sukari, mataki decompensation subcompensation, mai tsanani Hakika, insulin, insulinopotrebny, m polyneuropathy. Outlook

Kila ba mutane da yawa karfafa su likita tarihi. Type 2 ciwon sukari da aka kayyade a cikinta na iya haifar da ma fi girma da karaya. Amma yake da daraja ba up da kuma yanke ƙauna? A mafi hatsari da cutar da kuma yadda za a magance shi - za mu gudanar da bincike.

Ciwon - abin da yake cikin hatsari?

Mutane ji sau da yawa game da ciwon sukari, amma kawai 'yan ne abin da shi ne. Ya kamata a lura da cewa Kalmar "ciwon sukari" - shi ne a gama image. Wannan kalma zai gama da dama cututtuka na endocrine tsarin. Su haddasawa suna da yawa isa ba, amma a matsayin mai mulkin, tushen cututtuka ne endocrine cuta, da kuma musamman - rashin insulin. Wani factor iya zama rashin metabolize glucose da hanta da jikin kyallen takarda. A wannan yanayin, jiki qara ta matakin, wanda, bi da bi, ya haddasa wani fanni na cuta a cikin metabolism.

Ciwon - ta daban

Modern magani bambanta iri biyu cutar. Yaye faruwa dangane da abin da irin insulin rashi - dangi, ko cikakkar - ya bayyana tarihin da cutar. Type 2 ciwon sukari ne kullum ba a hade da wani rashi na hormone insulin, wanda aka tsunduma tsara pancreas. Yawancin lokaci, dalilin da ci gaban da aka rage ji na ƙwarai gabobin da kyallen takarda ga wannan hormone. Ciwon insulin - na farko irin - An kai tsaye nasaba da insulin karanci a cikin jiki. A rashin wannan hormone take kaiwa zuwa gaskiya cewa glucose shigar da jiki, ba sarrafa, ko yana a cikin kasa yawa, kuma ta matakin a cikin jini ne kullum girma, kuma domin ya cece rayuwar wannan marasa lafiya dole sami wani ƙarin kashi na insulin.

A tarihin da cutar - irin 2 ciwon sukari mellitus

Wannan ne ma ya kira insulin-dogara da ciwon sukari. Bisa kididdigar da, marasa lafiya fama da irin wannan cuta ne sosai fiye da na farko. Tare da shekaru, hadarin da cutar zai bayyana shi, an ƙwarai karu. Sau da yawa sosai, ta ci gaba ne sumul, da haƙuri na dogon lokaci, da ba ka san game da wannan cuta, shaida ga zargin shi ba daidai da tarihin da cutar. Ciwon irin 2 da aka samu a cikin wannan harka kamar yadda "mai haɗari find" a lokacin na yau da kullum jarrabawa. Babban nuna alama cewa ba ka damar zargin gaban da wannan cuta ne mai jini gwajin, wanda inganta glucose. Bi da bi, a lokacin da hukuncin kisa tarihi na cuta, da irin 2 ciwon sukari ne zuwa kashi:

• faruwa a al'ada-nauyi marasa lafiya.
• gano a cikin marasa lafiya da kiba.

ciwon sukari Sanadin

Har yanzu a kan aiwatar da horar da matasa likitoci bayar da wani horo tarihi na cuta, da irin 2 ciwon sukari wanda za a iya lalacewa ta hanyar dalilai da dama. A mafi kowa wadanda su ne:

• ci na mai ladabi carbohydrates (sugar, cakulan, yin burodi, da dankali) a cikin manyan yawa da kuma gazawar da shuka fiber a cikin abinci.
• gadar hali - a gaban irin wannan cuta a cikin iyaye da ciwon sukari bayyanar hatsari ne mafi girma daga 40%.
• Kiba, musamman visceral irin (m adibas located da farko a cikin ciki yankin).
• hauhawar jini.
• jiki rashin aiki.

Abin da ke faruwa a kan? pathogenesis

A tarihin da cutar ciwon sukari mellitus irin 2 bayyana yadda a yawan keta a kan aiwatar da metabolism. Yana dogara ne a kan insulin juriya - da rashin iyawa na kyallen takarda kullum dauki insulin, a hannu daya, da kuma take hakkin wannan hormone samar sel da pancreas - a kan sauran. Yadda aka saba, tare da kara glucose matakin, wanda ya auku nan da nan bayan da wani abinci, da pancreas, don samar da insulin fara a hankali. Mutane da Type II ciwon sukari, wannan ba ya faruwa, da kuma kawai fara nuna insulin a lokacin da glucose yawa riga ya kai high lambobi. Duk da haka, duk da kasancewar insulin, ragewan jini sugar, a cikin wannan yanayin da ake so matakin ya auku. Constant dagagge taro na insulin take kaiwa zuwa gaskiya cewa Kwayoyin rasa su ikon amsa masa, da kuma yanzu, ko da idan hormone ba zai iya haɗawa da tsoka mai amsa sigina Kwayoyin, babu dauki. Kan bango na wadannan canje-canje a cikin hanta Kwayoyin fara rayayye haduwa glucose, kara kara da natsuwa a cikin jini. Duk wannan ba ya je ba tare da sakamakon. A ƙarshe, a karkashin mataki na wani babban taro na glucose glucose yawan guba tasowa, wanda adversely rinjayar da pancreatic Kwayoyin samar da insulin, kuma, kamar yadda wani sakamako, ta karanci tasowa. Saboda haka, da ninkawa da tarihi da cutar. Type 2 ciwon sukari ana maye gurbin insulinopotrebny siffar lokacin da insulin ba tukuna bukata. A haƙuri da yanayin tabarbarewa.Idan.

cututtuka

A classic ciwon sukari asibitin yanke shawarar ware biyu kungiyoyin na ãyõyin cuta - firamare da kuma sakandare. Babban sun hada da:

• polyuria - An ware wani yawa na fitsari (glucose, fadowa cikin shi, muhimmanci ƙara da osmotic matsa lamba).
• ƙishirwa (polidispepsiyu) - halin da akai, unquenchable bukatar sha.
• yunwa (polidisfagiyu) - saboda da rashin iyawa daga cikin sel zuwa assimilate glucose amfani da insulin, jiki yana da wani m bukatar makamashi.
• kwatsam nauyi asara - yana daukan wuri a kan backdrop na ƙãra ci.

Duk wadannan cututtuka su ne mafi halayyar da farko da irin ciwon sukari. Nau'i na biyu zai iya gudãna daga ƙarƙashinsu kullum asymptomatic ko haddasa sakandare fasali:

• itching na fata da kuma mucous membranes - sau da yawa a lokacin dubawa na haƙuri da ake zargin irin 2 ciwon sukari (tarihi), wata mace na iya yi tasbĩhi game da numfashi ba itching na al'aurar.
• janar wani rauni da ciwon kai.
• kumburi fata raunuka da suke da wuya mu bi.
• rage hangen nesa.

Matsayin mai mulkin, yawancin kawai ba biya da hankali ga irin wannan bayyanar cututtuka, da kuma cutar da za a iya saukar da shi kawai a mataki na rikitarwa.

Yara da ciwon sukari

Abin baƙin ciki, da ciwon sukari da aka gane a matsayin na biyu ya fi na kowa kullum cutar. Wannan hukuma ce don haka ilimin aikin likita na yara. Ciwon (irin 2) da tarihi na yaro ta rashin lafiya sau da yawa saka a cikin category daga cikin mafiya hatsari cututtuka. Wannan shi ne saboda da cewa shi ne daban-daban daga cutar ga mafi m ci gaba da girma da kuma sau da yawa daukan fiye da m. Duk da haka, a cikin wannan harka, duk abin da ya dogara da iyaye 'ikon daidaita ikon da yaro da kuma tabbatar da dace Drug Administration. Bugu da kari, yana da muhimmanci a gane cutar a lokacin. Idan yaro yana da wadannan cututtuka kamata nan da nan tuntubar wani endocrinologist:

• yaro yana fuskantar m ƙishirwa.
• yawa mafi kusantar su je bayan gida (a makaranta ko kindergarten tilasta sau da dama ya na nẽman izni daga makaranta).
• rage jiki nauyi.
• akwai na kullum gajiya.

bincikowa da

Ciwon yana jinya dangane da fitsari da kuma jini gwaje-gwaje. A wani m mutum a cikin fitsari glucose ba a tsare, kuma ta jini matakin bai wuce 5.5. Domin dogara da sakamakon, da jini dauka daga wani yatsa ko wata jijiya (na karshe abinci ya kamata a dauka a kalla 8 hours kafin hanya), kafin ceto ba zai iya sha dadi shayi, kofi, ko 'ya'yan itace. Ya kamata a lura da cewa ciwon sukari da aka kamu a rates sama 7. Idan rates Range daga 4 zuwa 7, da littãfi sosai glucose haƙuri.

Wani gwajin gano cutar da kuma zuwa ga bayyana da m darajar, a glucose haƙuri gwajin (OGTT). Yana ba ka damar samun bayanai game da matakin na azumi jini glucose, kazalika da sa'o'i biyu bayan ya ɗauki glucose bayani. Kullum bayan ta glucose maida hankali kada ta kasance sama 7.8. Wannan gwajin da aka ba da za'ayi a lokacin da glucose kafin gwajin sama 6.1 idan haƙuri yana da wani tarihi na m cututtuka ba, tiyata, tsokar zuciya infarction, rauni, da kuma lokacin da samun da kwayoyi da kara glucose. Duk wadannan data daidai da tarihin da cutar.

Rubuta 2 ciwon sukari, subindemnification

Kamar yadda da wani ciwo, ciwon sukari o ƙarin tabbatar da kara da kuma bunkasa bayyanar cututtuka. An ware a lokacin uku matakai. diyya mataki da aka sanya a cikin tsarin kula da marasa lafiya ke yi wa al'ada. Idan lokaci ba ya dauki matakan, ko ba su zo da sa ran sakamakon, cutar da ke shiga wani mataki subcompensation. A wannan hanya, da yanayin haƙuri, ba mafi kyau, amma kuma uncritical. A ranar da haƙuri hasarar fitsari ba fiye da hamsin grams na glucose, da kuma ta matakin a cikin jini ne game da 13.8, cikin acetone a cikin fitsari ba. Development of hyperglycemic coma a wannan mataki, kuma, shi ne ba zai yiwu ba. By mataki subkomensatsii hada da wani tsaka-tsaki jihar tsakanin cika da decompensated, mataki na shan babba diyya dabi'u glucose 7.5, da yawan haemoglobin glikerirovannogo 6.5% glucose da azumi - kasa da 6.1. decompensation mataki sa, idan Manuniya wuce da wadannan iyaka:

• jini glucose - fiye da 9.
• glikerirovanny haemoglobin - fiye da 9%.
• azumi glucose - mai 7.

Canje-canje a cikin wadannan awo da tasiri na wajabta magani taimaka wajen gano tarihi da cutar. Rubuta 2 ciwon sukari, mai tsanani shakka daga abin da amsa talauci to far ko jawo da wasu dalilai, da mataki ke decompensation.

Dalilai haddasa decompensation

Hakika, kowane jiki ne daban-daban, da kuma abubuwan da taimakawa ga cuta na iya zama daban-daban, amma ya fi kowa ne wadannan:

• overeating, take hakkin rage cin abinci.
• wani kuskure a zabin da wani magani, da sashi, ko ki magani.
• kai-aikace-aikace ko abin da ake ci kari a lieu kaddamarda magunguna.
• ƙi je a kan insulin far.
• kamuwa da cuta, inganta dehydration.
• stressful yanayi.

Dukkan wadannan dalilai da guda-guda ko a cikin tara ma shafi Jihar tafiyar matakai na rayuwa, da kuma a sakamakon, akwai wata karuwa da glucose matakin Manuniya cewa na kama da tarihi da cutar. Rubuta 2 ciwon sukari, decompensated wanda a cikin wannan yanayin ne da ninkawa ta bayyanar daban-daban da rikitarwa a cikin gabobin da kuma tsarin na jiki, shi ya zama ƙyacẽwa, kuma ba daidai ba magani iya lahanta haƙuri da rai. A wannan yanayin, da rikitarwa iya ci gaba kamar yadda wani shafe tsawon lokaci, kuma a zahiri a cikin sa'o'i.

decompensated

Kamar yadda taro na glucose ƙaruwa, kuma ta gyara bukatar wani karin tsanani matakan, ya dada tabarbare da tarihi da cutar. Ciwon (irin 2), decompensation wanda aka halin a babban hadarin da rikitarwa, na bukatar hankali sosai shawara. Wannan shi ne saboda da cewa shi ne da wuya sosai ga daidaita matakin glucose amfani da biyun rage cin abinci da kuma yin amfani da kwayoyi. A sakamakon, dole ne ka hankali da kullum saka idanu da yanayin da haƙuri, saboda a cikin rashi na warkewa sakamako na aikace-aikace na kwayoyi sosai da sauri akwai pathological canje-canje a cikin daban-daban gabobin. Saboda haka, wadannan marasa lafiya bukatar likita monitoring, kuma sau da yawa sosai a cikin dakin gaggawa.

Na bayar da muhimmanci a nan shi ne da yiwuwar m iko da hãlãyensu. Abin farin, ta zamani, magani yana da isasshen kudi don wannan zabi. Daban-daban gwaje-gwaje da kuma kida da cewa sanin da matakin na glucose, damar marasa lafiya da ciwon sukari a kai-gane asali hãlãyensu kuma, dangane da sakamakon, don gudanar da gyaran.

Insulin a ciwon sukari far

Kamar yadda cutar progresses, da kuma tasowa cikin sha na pancreatic Kwayoyin wanda tsunduma a samar da insulin. Wannan tsari na bukatar nan da nan hormone far. Kamar yadda aka nuna ta hanyar kwanan nan karatu, wani lokacin shi kawai ba ka damar kula da glucose a dama matakin. Duk da haka, ya kamata ka ba ɗauka cewa da nada insulin - yana da rai. Sau da yawa, irin 2 ciwon sukari, insulin, likita tarihi, wanda alama da za a qaddara kama wani rayuwa na insulin ci, tare da wasu kokarin a kan wani ɓangare na haƙuri iya shiga cikin wannan rukuni, ba ya bukatar yau da kullum gwamnati na wannan hormone. Ciwon a wannan batun yana nufin wadanda pathologies a cikin abin da za a cimma a warkewa sakamako ne da muhimmanci sosai, da kuma kula da kokarin a kan wani ɓangare na haƙuri. Saboda haka, shi ne, daga horo game da abinci, kai-monitoring na matakin na sukari da kuma dace magani zai dogara ne a kan mataki na ramuwa da cutar. Duk da haka, a wasu lokuta, da nada insulin - wajibi gwargwado. Wannan na faruwa:

• a lokacin daukar ciki.
• a cikin hali na zuciya harin ko shanyewar jiki.
• a lokacin tiyata.
• cututtuka pyoseptic hali.
• a dagagge rates na awon bincikowa.

Wani muhimmin dalilin da m nada insulin iya zama jinsin rashin wannan hormone, wanda aka tabbatar da tarihi da cutar. Type 2 ciwon sukari, wanda mataki decompensation ne halin mai tsanani m nauyi asara da kuma kara ketoacidosis, shi ne Firayim misali.

Ya kamata a lura da cewa a yau magani ƙwarai kumbura da ikon yinsa, daga amfani da insulin, kuma a hukumance ya tabbatar da cewa inganci na monotherapy da baka magani ake adana kasa da shekaru 6. Sa'an nan dole mu yi rubũta mafi kwayoyi. A cewar da dabarun zamani da magani na ciwon sukari, insulin amfani a irin haka ne, dauke su more m.

m rikitarwa

M rikitarwa na decompensated - shi ne wani yanayin a cikin abin da akwai real barazana ga haƙuri ta rayuwa. Suna kullum lalacewa ta hanyar wani gagarumin karuwa a matakin na glucose da alaka da cuta da metabolism. Bayan da ya faru na wannan yanayin yana da muhimmanci da kuma dace taimako, kamar yadda sanin bayyanar cututtuka daga cikin wadannan yanayi ya kamata ba kawai likitoci, amma kuma masu aikin jinya, da reno tarihi da cutar da irin 2 ciwon sukari da kuma ta rikitarwa da aka bayyana kamar haka.

1. Hyperglycemic coma (hyperosmolar da ketoatsidoticheskaya) - su bayãnin hukuncin alama ne cigaba. Dalilai da haddasa su zama kasa sashi ko rasa liyafar da insulin, rage cin abinci cuta (wuce kima amfani da carbohydrates), motsa jiki a kan wani bango na hyperglycemia, gazawar wajen saka idanu da matakin na glucose, barasa ko wasu magunguna. Asibiti, da ta bayyana girma ga dama, kwanaki ƙishirwa da kuma polyuria (ƙãra fitsari), mai tsanani dehydration. Jini da aka rage, da kuma tachycardia. Lokacin da tabarbarewar yiwu convulsions da ciki na sani. Fata bushe yiwu scratches, acetone wari a lokacin exhalation. A wannan yanayin, wanda aka azabtar yana bukatar nan da nan arin da kuma magunguna.
2. Hypoglycemic coma - ne ya sa mai kaifi karu a jini glucose (kasa da 3 mmol / l), inda ya isa cikin kwakwalwa shigarsu kaifi rashin gina jiki. Wannan yanayin na iya tsokane wani yawan abin sama da insulin, skipping daya daga abinci ko kuskure zaba rage cin abinci, barasa ko kwayoyi. Asibiti hari tasowa cikin sauri. Halin da wani sanyi gumi a goshin, wani rauni, hannunka tremors, ciwon kai, numbness na lebe. A haƙuri ne m, talauci hadewa da ƙungiyoyi, akwai wani bugun zuciya, biyu hangen nesa, rikice. A baya, saukarwa akwai wani asarar sani, seizures. Prehospital irin marasa lafiya za a iya ba da wani zaki da abin sha, ko ya ci wani abu, dumama da kuma hawa zuwa wani likita da makaman ga follow-up kula.

marigayi rikitarwa

Irin wannan rikitarwa faruwa a decompensated ciwon sukari, bayan shekaru da dama na rashin lafiya. Hadari su ne da cewa su ne hankali da kuma imperceptibly worsen haƙuri da yanayin. Bugu da kari, sau da yawa ilimi ciwon sukari far iya ba da tabbacin cewa jima ko daga baya, za su bayyana ba.

1. Retinopathy ne halin da raunuka na akan tantanin ido. Abin baƙin ciki, duk da dukan da ci gaba a zamani magani, da ya faru na retinopathy a marasa lafiya tare da Type II ciwon sukari, wanda yana for fiye da shekaru 20, ta halarci 100%. Wannan Pathology sa hemorrhages a fundus, da kuma ƙarshe manyan don kammala asarar hangen nesa.
2. Angiopathy - ne a take hakkin jijiyoyin bugun gini permeability, wanda ya zama cikin hanyar thrombosis da kuma atherosclerosis. Zai iya ci gaba a cikin wani gajeren lokaci (game da mai shekara), da bambanci ga sauran dogon lokacin da matsalolin da sukan nauyin tarihi.
3. Type 2 ciwon sukari mellitus, m polyneuropathy, inda ma wani na kowa wahala, rijistar shi a 90% na lokuta. Asibiti, wannan fassara kayar da jijiyoyi da cewa sarrafa tsokoki da kuma kayan ciki. Polyneuropathy iya bayyana hypersensitivity, kwatsam m (janye) zafi, kona. Har ila yau manifestations neuropathy iya zama numbness, rage ji na ƙwarai, sakamakon raunin da ya faru da yawa. A ciki gabobin iya zama zawo, urinary incontinence, ciwon kai, dizziness, interruptions a cikin aikin na zuciya.
4. M kafar - ne halin da bayyanar da kafafu da kuma, musamman, a kan ƙafãfu da m venous ulcers, abscesses, necrotic yankunan. Wannan shi ne dalilin da ya sa marasa lafiya fama da wannan cuta, shi ne shawarar biya kulawa ta musamman wajen selection na takalma.

Outlook

Yana da bakin ciki, amma a karshe cinye ciwon sukari zamani magani iya ba. Duk da haka, shi zai iya da kyau yi dace sabawa munanan cewa sa wani ƙara taro na glucose a cikin jikin mutum, wato, irin 2 ciwon sukari mellitus. A tarihin da cutar, da hangen nesa da wannan cuta a cikin mutane da yawa, idan ba duk, zai dogara ne a kan hali ga shi na haƙuri. Tare da hankali iko da shi zuwa ga matakin na sukari da sauran Manuniya, da zama dole sashi gyara, dieting da kuma shawarwari daga likitoci, za ka iya kauce wa matsalolin da shekaru da yawa.