Okudingayo ukwazi ngesifo sikashukela: uhlu lokuhlola oluvela ku-endocrinologist

Intuthuko yesazi somzimba waseCanada uFrederick Bunting iguqule isifo sikashukela saba yisifo esibulalayo saba isifo esilawulekayo.

Ngo-1922, uBanting wanikela ngomjovo wakhe wokuqala we-insulin kumfana onesifo sikashukela futhi wasindisa impilo yakhe. Cishe sekudlule iminyaka eyikhulu kusukela lapho, futhi ososayensi benze inqubekela phambili ebonakalayo ekuqondeni ubunjalo balesi sifo.

Namuhla, abantu abanesifo sikashukela - futhi cishe baba yizigidi ezingama-70 emhlabeni, ngokusho kwe-WHO, - bangaphila impilo ende futhi esebenzayo, inqobo nje uma izincomo zezokwelapha zilandelwa.

Kodwa isifo sikashukela aselapheki, futhi ngaphezu kwalokho, lesi sifo besilokhu siba sincane muva nje. Ngosizo lochwepheshe, sihlanganise umhlahlandlela wesifo sikashukela wabafundi be-Healthy Food Near Me, siqoqa imininingwane ebalulekile wonke umuntu adinga ukuyazi, ngoba iningi lethu lisengozini.

Isibhedlela somtholampilo "Avicenna", eNovosibirsk

Siyini isifo sikashukela futhi siyingozi kanjani? Uyini umehluko phakathi kwezinhlobo ezimbili eziyinhloko zesifo?

I-Diabetes mellitus (DM) iyiqembu lezifo elibonakala ngokwanda njalo kukashukela (okuvame ukubizwa ngokuthi ushukela) egazini. Kungadala ukulimala nokungasebenzi kahle kwezitho ezahlukahlukene - amehlo, izinso, izinzwa, inhliziyo nemithambo yegazi. 

Uhlobo oluvame kakhulu lwe-2 yesifo sikashukela yi-90% yazo zonke izifo ezitholakele zalesi sifo.

Kuhlobo lwakudala, lolu hlobo lwesifo sikashukela lwenzeka kubantu abadala abakhuluphele kakhulu abanezifo ezihambisana nenhliziyo nemithambo yegazi. Kepha muva nje, izazi ze-endocrin emhlabeni wonke bezilokhu zibona ukuthambekela "kokuvuselela" lesi sifo.

Uhlobo lwe-1 lwesifo sikashukela lukhula ikakhulukazi ebuntwaneni noma ebusheni futhi lubonakala ngokuqala kwesifo, okuvame ukudinga ukulaliswa esibhedlela.

Umehluko omkhulu phakathi kohlobo lokuqala nolwesibili lwesifo sikashukela ukuba khona noma ukungabikho kwe-insulin yaso. I-insulin yihomoni ekhiqizwa amanyikwe ekuphenduleni ukwanda koshukela wegazi.

Ngokwesibonelo, lapho umuntu edla i-apula, ama-carbohydrate ayinkimbinkimbi ahlukaniswa emgudwini wokugaya abe ushukela olula bese emuncwa egazini. Izinga likashukela egazini liqala ukukhuphuka - lokhu kuba uphawu lokuthi amanyikwe akhiqize umthamo ofanele we-insulin, futhi ngemva kwemizuzu embalwa izinga likashukela egazini libuyela kwesijwayelekile. Kungenxa yale nqubo ukuthi kumuntu ongenaso isifo sikashukela kanye nanoma yikuphi ukuphazamiseka kwe-carbohydrate metabolism, izinga likashukela wegazi lihlala lijwayelekile, ngisho noma edla amaswidi amaningi. Ngidle kakhulu - amanyikwe akhiqiza i-insulin eyengeziwe. 

Kungani ukukhuluphala kanye nezifo ezihlobene nesifo sikashukela? Ithinta kanjani enye?

Ukukhuluphala ngokweqile nokukhuluphala ngokweqile yizici eziyingozi zokuthuthukisa uhlobo lwesifo sikashukela sohlobo 2. Ukufakwa kwezinqolobane ezinamafutha esiswini kuyingozi enkulu. Lokhu kuyinkomba yokukhuluphala ngokwe-visceral (kwangaphakathi), okubangela ukumelana ne-insulin - okuyimbangela enkulu yesifo sikashukela 2. Ngakolunye uhlangothi, ukwehlisa isisindo sikashukela kungaba nzima kakhulu, ngoba lesi sifo sidala inguquko enkulu yezinguquko zamakhemikhali emzimbeni ezihlobene kakhulu. Ngakho-ke, kubaluleke kakhulu ukuqondisa ukwelashwa hhayi kuphela ukujwayela ushukela wegazi, kodwa futhi ukunciphisa isisindo. 

Kudingeka nini imijovo ye-insulin, futhi ingagwenywa nini?

Kuhlobo lwesifo sikashukela sohlobo 1, amangqamuzana asenanyini akhiqiza i-insulin ayabhujiswa. Umzimba awunayo i-insulin yawo, futhi ayikho indlela engokwemvelo yokwehlisa ushukela ophakeme wegazi. Kulokhu, ukwelashwa kwe-insulin kuyadingeka (ukwethulwa kwe-insulin kusetshenziswa amadivayisi akhethekile, izibaya zesirinji noma amaphampu e-insulin).

Cishe eminyakeni eyi-100 eyedlule, ngaphambi kokusungulwa kwe-insulin, isikhathi sokuphila seziguli ezinesifo sikashukela sohlobo 1 silinganiselwe kusuka ezinyangeni ezimbalwa kuya eminyakeni engu-2-3 ngemuva kokuqala kwalesi sifo. Kulezi zinsuku, umuthi wanamuhla awuvumeli kuphela ukwandisa iminyaka yokuphila kweziguli, kodwa futhi nokususa imikhawulo ephezulu kubo.

Ngohlobo lwesifo sikashukela sohlobo 2, izinga le-insulin yalo alincishisiwe, futhi kwesinye isikhathi liphakeme kakhulu kunokujwayelekile, kepha alikwazi ukusebenza kahle. Esikhathini esiningi lokhu kwenzeka ngenxa yokwehla kokuzwela kwamaseli omzimba kule hormone, ukumelana ne-insulin kwenzeka. Ngakho-ke, ukwelashwa kohlobo lwesifo sikashukela sohlobo lwe-2 kusekelwe ekwelashweni okungenayo i-insulin - ithebhulethi nezidakamizwa ezijojwayo, okuhloswe, phakathi kwezinye izinto, ukwenza i-insulin yakho iphumelele ngokwengeziwe.

Hlobo luni lwesifo sikashukela abesifazane kuphela abangabhekana nalo?

Olunye uhlobo oluvamile lwesifo sikashukela i- gestational diabetes mellitus. Lokhu ukwanda koshukela wegazi ngesikhathi sokukhulelwa, okungase kuhambisane nezinkinga kokubili kwe-fetus nowesifazane. Ukuthola lesi sifo, bonke abesifazane abakhulelwe bahlolelwa ukuzila ushukela wegazi ekuqaleni kokukhulelwa futhi ukuhlolwa kokubekezelela ushukela kwenziwa emavikini angama-24-26 okukhulelwa. Uma kutholakala okungajwayelekile, udokotela wezifo zabesifazane uthumela isiguli ukuthi sibonisane nodokotela we-endocrinologist ukuxazulula inkinga yokwelashwa.

Okunye ukuxilongwa kwezifo zabesifazane okuhlobene nohlobo 2 lwesifo sikashukela yi-polycystic ovary syndrome, okuthi, njengohlobo lwesifo sikashukela sohlobo 2, nayo isuselwe ekumelaneni ne-insulin. Ngakho-ke, uma owesifazane ebonwa ngalesi sifo ngudokotela wezifo zabesifazane, kubalulekile ukuthi ushiye ngaphandle isifo sikashukela kanye nama-prediabetes. 

Kukhona futhi "ezinye izinhlobo ezithile zesifo sikashukela" ezivela ngemuva kwesifo esithile, ukuthatha imishanguzo futhi njengomphumela wokukhubazeka kofuzo, kodwa ngokwezibalo akuvamile.

Ngubani osengozini? Yiziphi izici ezingaba nomthelela ekuqaleni kwesifo sikashukela?

Isifo sikashukela yisifo esinezici zofuzo, okungukuthi, ingozi yokugula iphezulu kulabo bantu izihlobo zabo eziseduze zihlushwa yilesi sifo. Isibonelo, amathuba okuba ingane ikhule ngohlobo lwesifo sikashukela esingu-1 ingu-6% uma ubaba wayo enalesi sifo, 2% - kunina, kanye no-30-35% uma bobabili abazali benesifo sikashukela sohlobo 1.

Kodwa-ke, uma umndeni ungenaso isifo sikashukela, lokhu akuqinisekisi ngokuvikelwa kulesi sifo. Azikho izindlela zokuvimbela uhlobo lwesifo sikashukela sohlobo 1.

Ngohlobo lwesifo sikashukela sohlobo 2, ochwepheshe bakhomba izinto ezibeka engcupheni njalo esingasakwazi ukuzithonya. Lokhu kufaka: iminyaka engaphezu kwengu-45, ukuba khona kwezihlobo ezinesifo sikashukela sohlobo 2, isifo sikashukela sokukhulelwa esikhathini esedlule (noma ukuzalwa kwezingane ezinesisindo esingaphezu kuka-4 kg).

Futhi izinto ezinobungozi ezingaguquguquka zibandakanya ukukhuluphala ngokweqile noma ukukhuluphala ngokweqile, ukuvivinya umzimba ngokweqile, umfutho wegazi ophakeme namazinga aphezulu e-cholesterol. Ngokwenza lokhu, lokhu kusho ukuthi ukunciphisa isisindo somzimba kanye nokujwayela ukucindezela kwegazi kunganciphisa ubungozi bokuthola uhlobo lwesifo sikashukela sohlobo lwesibili. 

Yiziphi izivivinyo okudingeka uzenze uma usola isifo sikashukela?

Ukuze uqinisekise ukuxilongwa, udinga ukuthatha ukuhlolwa kweglucose egazini okuzila ukudla. Inkomba ejwayelekile kuzoba ileveli yeglucose engaphansi kuka-6,1 mmol / L uma unikela ngegazi elivela emthanjeni nangaphansi kuka-5,6 mmol / L uma unikela ngegazi ngomunwe.

Futhi unganquma izinga le-hemoglobin eglycosylated egazini, elizokhombisa isilinganiso seglucose egazini ezinyangeni ezi-3 ezedlule. Uma unamaphutha kulezi zimingcele, thintana nodokotela we-endocrinologist, uzokwenza uhlolo olwengeziwe futhi anikeze ukwelashwa okudingekayo. 

Kuthiwani uma uchwepheshe ekuqinisekisile ukuxilongwa?

Uma usuvele utholakale unesifo sikashukela, akufanele wesabe, kodwa nakanjani udinga ukukucabangisisa kahle lokhu, futhi into yokuqala okufanele ukwenze ukuthola i-endocrinologist ozobhekwa naye njalo. Ekuqaleni kwesifo, udokotela uzonquma uhlobo lwesifo sikashukela, izinga le-insulin secretion, ukuba khona kwezinkinga noma izifo ezihambisana nesifo sikashukela futhi uzonikeza ukwelashwa okufanele.

Ngokungeziwe ekwelashweni kwezidakamizwa, izingqinamba zokudla okunomsoco nokusebenza komzimba kuxoxwa ngazo nodokotela we-endocrinologist, osiza ekwelapheni isifo sikashukela. Ekhaya, ukuzihlola kwe-glucose yegazi kwenziwa ngedivayisi ekhethekile - i-glucometer, ukuze kuhlolwe ukusebenza kwemigomo. Udinga ukuvakashela i-endocrinologist kanye ezinyangeni ezi-1-3, kuya ngesimo sesifo, ngenkathi ugcina ushukela wegazi ngamanani ajwayelekile, kudingeka ukuvakashelwa okumbalwa kudokotela. 

Ingabe zikhona izindlela ezintsha zokwelapha isifo sikashukela?

Ngisho neminyaka eyi-10 eyedlule, uhlobo lwesifo sikashukela sohlobo lwe-2 lwaluthathwa njengesifo esiqhubekayo, okungukuthi, ngokuwohloka kancane kancane, ukuthuthukiswa kwezinkinga; imvamisa kwaholela ekukhubazekeni. Manje sekunamaqembu amasha emithi ejwayeza ngempumelelo i-glucose yegazi futhi anciphise ubungozi bezinkinga.

Ukuhlinzwa ngamakhemikhali wuhlobo lokuhlinzwa esiswini nasemathunjini amancane, okuholela ekuguqukeni kokumunca ukudla nasekukhiqizeni ama-hormone athile nama-enzyme, okukuvumela ukuthi wehlise isisindo futhi ujwayeze ushukela wegazi.

Ukuthethelelwa kohlobo lwesibili sikashukela kwenzeka ngo-2-50%, kuya ngohlobo lokuhlinzwa okwenziwe. Njengamanje, ukwelashwa okuhlinzwa kuyindlela ephumelela kunazo zonke yokwelapha isifo sikashukela. Inkomba yokuhlinzwa kwemetabolism yohlobo lwesibili sikashukela iyinkomba yomzimba (BMI) engaphezu kuka-80 kg / m2 noma ukungakwazi ukulungisa isifo sikashukela ngemithi nange-BMI ka-35-2 kg / m30.

shiya impendulo