Mob ntshav qab zib mellitus yog hais txog cov kab mob ntawm cov kab mob endocrine cuam tshuam nrog kev ua txhaum ntawm kev ua haujlwm zais cia ntawm lub txiav. Raws li qhov tshwm sim, kev tsim cov tshuaj insulin raug cuam tshuam. Qhov no yog ib yam kab mob loj heev uas nyuaj kho.
Mob ntshav qab zib mellitus hauv cov menyuam yaus tuaj yeem yog hom 1 thiab 2, raws li kev kho mob uas tsim nyog raug xaiv, nrog rau kev noj haus. Nws yog ib qho tseem ceeb heev rau cov niam txiv kom paub tias dab tsi cuam tshuam rau kev loj hlob ntawm tus kab mob, nws tshwm sim thiab kuaj pom li cas.
Dab tsi yog kab mob
Mob ntshav qab zib mellitus hauv cov menyuam yaus nyob qib thib ob ntawm txhua yam kab mob. Cov laj thawj rau nws tau muab zais hauv kev ua txhaum ntawm carbohydrate metabolism. Txhawm rau nkag siab txog yam uas ua rau muaj ntshav qab zib mellitus, koj yuav tsum nkag siab tias yam twg yog tus kab mob. Qab zib nkag mus rau hauv lub cev yog tawg mus rau lub xeev ntawm cov piam thaj, uas ua raws li lub zog lub hauv paus xav tau rau lub neej ib txwm muaj ntawm ib tug neeg. Nws yuav tsum tau txhaj tshuaj insulin.
Cov tshuaj hormone no tsim tawmpancreatic cells, thiab yog vim li cas qee qhov kev ua txhaum ntawm txoj haujlwm no, cov piam thaj tseem nyob hauv nws lub xeev qub.
Type and forms
Raws li qhov ua rau mob ntshav qab zib hauv cov menyuam yaus, nws raug cais raws hom thiab daim ntawv. Ua ntej tshaj plaws, tus kab mob tau muab faib ua hom 1 thiab 2. Nws yog ib qho tseem ceeb kom nkag siab tias yog vim li cas lawv tshwm sim, dab tsi yog cov cim qhia thiab kev kho mob ntawm txhua hom.
Lub hauv paus ntawm hom 1 mob ntshav qab zib mellitus hauv cov menyuam yaus yog qhov ua haujlwm tsis zoo ntawm lub cev tiv thaiv kab mob, thaum cov hlwb ntawm cov txiav txiav pib pom tias yog kev ua phem thiab rhuav tshem los ntawm lawv tus kheej kev tiv thaiv. Daim ntawv no ntawm tus kab mob no tau kuaj pom ntau zaus thiab yog provoked los ntawm ib tug genetic predisposition, nrog rau raug rau lwm yam. Cov no suav nrog:
- kab mob sib kis;
- malnutrition;
- xov xwm ntxhov siab;
- sib sau cov tshuaj lom.
Yog tias tus menyuam yug los nrog ntshav qab zib mellitus, tom qab ntawd kev txhim kho ntawm tus kabmob thiab cuam tshuam ntawm kev tsim cov tshuaj insulin yuav tsum raug rau ib lossis ntau yam sab nraud. Hauv theem latent, cov kab mob hauv lub cev qeeb qeeb ua rau cov ntaub so ntswg tsim cov tshuaj insulin. Thaum sawv ntxov, tus menyuam cov piam thaj tseem nyob hauv qhov qub, thiab tom qab noj zaub mov, nws dhia tau pom. Nyob rau theem no, tus txiav ua haujlwm tseem tuaj yeem tiv nrog lub nra, tab sis thaum 85% ntawm cov hlwb tuag, tus kab mob nkag mus rau theem nquag.
Ntau zaus qhov no ua rau cov menyuam yaus tau mus rau hauv tsev kho mob nrog kev kuaj mob ketoacidosis lossis ketoacidosis. Cov tsos mob no yog tshwm sim los ntawm qhov tseeb tias cov piam thaj hauv cov ntshav nce siab tshaj qhov ntsuas, nws tsuas yog tsis yooj yim sua kom kho tau cov ntshav qab zib autoimmune, txawm li cas los xij, kev ua raws li tus kws kho mob cov tshuaj yuav pab kom tsis txhob muaj teeb meem thiab kev puas tsuaj ntxov ntawm vascular system. Tus menyuam muaj mob yuav tsum noj tshuaj insulin tas li nws lub neej.
Tau ntev lawm, ntshav qab zib hom 2 tau suav hais tias yog kab mob ntawm cov neeg laus, tab sis cov tub ntxhais hluas muaj kev txom nyem ntau dua. Lub ntsiab lus ntawm tus kab mob yog nyob rau hauv qhov tseeb tias pancreas tsim cov tshuaj insulin txaus, tab sis tsis yog txhua yam ntawm lub cev tau pom. Feem ntau, nws tshwm sim thaum lub sij hawm puberty, txij li thaum lub sij hawm no cov tshuaj hormones pib inhibit cov ntaub so ntswg mus rau insulin. Ntawm cov laj thawj tseem ceeb ntawm tus kab mob tuaj yeem txheeb xyuas xws li:
- rog dhau thiab rog;
- kev ua neej nyob;
- noj tshuaj hormonal;
- kab mob ntawm endocrine system.
Qhov kev pheej hmoo ntawm kev mob ntshav qab zib yog tshwj xeeb yog nce ntxiv nrog cov kab mob tshwm sim. Cov chav kawm ntawm hom kab mob no feem ntau yog asymptomatic thiab tsis muaj kev hloov pauv tshwj xeeb hauv kev tshuaj ntsuam xyuas. Kev kho mob ntshav qab zib mellitus hauv cov menyuam yaus yog raws li kev noj zaub mov thiab kev siv tshuaj uas txo cov ntshav qab zib, nrog rau tswj cov kab mob sib kis.
MODY ntshav qab zib feem ntau pom muaj nyob hauv cov menyuam yaus hnub nyoog qis dua 10 xyoo. Qhov laj thawj tseem ceeb rau nws qhov tshwm sim yog kev puas tsuaj rau cov hlwb ntawm qib caj ces. Feem ntauTus kab mob no muaj kev kawm tsis yooj yim, thawj zaug tus menyuam tsis muaj kev tswj hwm insulin ntxiv.
Neonatal diabetes feem ntau tshwm sim rau cov menyuam yaus hnub nyoog qis dua 6 hli, tsis tshua muaj thiab yog los ntawm caj ces.
Kev tshwm sim
Mob ntshav qab zib yog ib kab mob ntev uas kho tau nyuaj heev. Muaj ntau ntau qhov laj thawj rau nws txoj kev loj hlob, ntawm qhov uas nws yuav tsum tau nthuav tawm:
- genetic predisposition;
- mob khaub thuas;
- overeating;
- hnyav dhau;
- kev ua neej nyob.
Qhov tshwm sim ntawm ntshav qab zib mellitus hauv cov menyuam yaus tuaj yeem tso rau ntawm qib caj ces, txij li cov niam txiv uas muaj tus kabmob no twb muaj tus menyuam mob. Hauv qhov no, tus kab mob tuaj yeem tshwm sim tam sim ntawd lossis tom qab ob peb xyoos. Kev nce ntshav qabzib hauv cov poj niam thaum cev xeeb tub yog qhov txaus ntshai heev. Nws yog ib qho tsim nyog sau cia tias nws dhau los ntawm cov placenta zoo heev thiab nkag mus rau hauv tus menyuam cov hlab ntsha, thiab vim tias qhov kev xav tau ntawm tus menyuam hauv lub sijhawm no tsawg heev, nws cov rog ntau dhau los ntawm cov rog subcutaneous. Hauv qhov no, cov menyuam yug los hnyav heev.
Kev noj ntau ntawm cov carbohydrates yooj yim zom tau ua rau hnyav hnyav rau tus menyuam lub hlwb tsim cov tshuaj insulin. Raws li qhov tshwm sim, lawv deplete lawv cov reserves sai heev thiab tsis ua haujlwm zoo, uas ua rau muaj kev txo qis hauv cov tshuaj insulin hauv cov ntshav.
Thaum muaj ntau cov piam thaj nkag mus rau hauv lub cev, nws cov ntau dhau tsis tau tawm, tab sis tsonyob rau hauv daim ntawv ntawm rog. Cov roj molecules, cov receptors lub luag haujlwm rau kev ua cov piam thaj, ua rau lub cev tsis muaj zog. Yog li ntawd, txawm tias muaj cov tshuaj insulin txaus, cov piam thaj hauv cov ntshav tsis txo qis.
Kev ua neej tsis muaj zog ua rau hnyav nce, uas tuaj yeem ua rau mob ntshav qab zib. Nrog rau mob khaub thuas tsis tu ncua, lub cev tiv thaiv kab mob tas li tsim cov tshuaj tiv thaiv kab mob txhawm rau tiv thaiv kab mob thiab kab mob. Yog li ntawd, nws tuaj yeem pib tawm tsam lub cev ntawm tus kheej cov hlwb, tshwj xeeb yog cov uas tsim cov tshuaj insulin. Qhov no ua rau kev puas tsuaj rau txiav txiav thiab txo qis hauv nws qhov ntau.
Cov tsos mob tseem ceeb
Yeej, ntshav qab zib mellitus hauv cov menyuam yaus loj hlob hauv preschool lossis thaum hluas, thaum tus menyuam qhov kev loj hlob ntawm lub cev tshwm sim. Txij li thaum lub cev xav tau ntau lub zog, cov tsos mob tshwm sim nyob rau theem no. Ntawm cov cim tseem ceeb ntawm ntshav qab zib hauv cov menyuam yaus yog:
- poob ceeb thawj;
- nqhis dej tas li;
- tso zis ntau zaus;
- nquag tshaib plab;
- tawv nqaij qhuav, pob khaus thiab pustules;
- tawm hws, txheej liab ntawm tus nplaig;
- mob taub hau, tsis nco qab.
Tus me nyuam pib haus dej ntau, txawm tias thaum lub caij txias, thiab tib lub sijhawm txawm sawv ntxov los ua kom nqhis dej. Thaum noj cov kua ntau ntau, cov zis ntau pib tso tawm, vim tias cov piam thaj ntau dhau tau tawm nrog nws. Tsis tas li ntawd, bedwetting yog ib qho.
Ntawm cov cim tseem ceeb ntawm ntshav qab zib hauv cov menyuam yaus yog qhov hnyav ntawm lub cev, vim tias cov piam thaj ua lub zog tseem ceeb. Nrog rau cov txheej txheem ntawm tus kab mob, cov piam thaj nkag mus rau hauv cov hlwb txo qis, uas txhais tau hais tias lawv cov khoom noj khoom haus tsis zoo. Txij li thaum tus menyuam lub zog txo qis, nws ua rau qaug zog, qaug zog thiab nkees sai.
Diagnostics
Yog xav tias muaj tus kab mob no, nws yog ib qho tsim nyog yuav tsum tau kuaj xyuas cov ntshav qab zib mellitus hauv cov menyuam yaus, uas suav nrog:
- kev tshuaj xyuas los ntawm kws kho mob;
- kuaj ntshav thiab zis rau qab zib;
- glucose tolerance test;
- biochemical tswj ntshav.
Koj yuav tsum tau kuaj los ntawm kws kho mob dermatologist, kws kho mob menyuam yaus, kws kho mob plab, kws kho qhov muag, kws kho mob endocrinologist. Kev tshuaj xyuas thiab kev ntsuam xyuas pab txiav txim siab qib ntawm cov piam thaj hauv cov ntshav thiab txheeb xyuas cov kev mob tshwm sim. Ib qho ultrasound ntawm cov kabmob sab hauv yuav xav tau.
Kev kuaj mob nyuaj yuav tso cai rau koj ua qhov kev kuaj mob kom raug thiab sau cov kev kho mob raws sij hawm, uas suav nrog kev noj zaub mov tshwj xeeb, kev tawm dag zog, thiab, yog tias tsim nyog, kev kho tshuaj insulin raug sau. Kev kuaj mob raws sij hawm yuav pab kom tsis txhob muaj coma thiab tuag ntawm tus menyuam.
Txoj kev kho mob
Kev kho mob ntshav qab zib rau cov menyuam yaus feem ntau nyob ntawm nws hom. Kev kho mob txaus yog muab los ntawm tus kws kho mob endocrinologist. Kev Kho Mob Ntshav Qab Zib txhais tau tias ua raws li cov hauv paus ntsiab lus xws li:
- ua raws li kev nyiam huv ntawm cov mucous daim nyias nyias thiab daim tawv nqaij;
- sports;
- kev noj haus;
- kev txhawb siab.
Kev hloov pauv feem ntau yog siv los kho mob ntshav qab zib hom 1 hauv cov menyuam yaus. Txij li cov hlwb ntawm cov txiav ua cov tshuaj insulin tsis txaus, nws yog ib qho tsim nyog yuav tsum tau ntxiv nws cov nyiaj hauv cov ntshav. Nyob rau tib lub sijhawm, nws yuav tsum tau coj mus rau hauv tus account qhov peculiarity ntawm cov piam thaj ntau lawm raws li kev noj zaub mov, vim yog tias lub cev siv tag nrho cov qab zib reserves, qhov no yuav ua rau lub zog tshaib plab.
Yog vim li ntawd, ntxiv rau kev siv tshuaj, nws yog ib qho tsim nyog los npaj cov khoom noj kom zoo ntawm tus menyuam, vim kev tshaib plab yog qhov tsis txaus ntseeg. Cov khoom noj txom ncauj kuj yuav tsum tau noj ntawm cov zaub mov tseem ceeb.
Kev saib xyuas cov ntshav qabzib txhua hnub nrog kev pab ntawm glucometers tshwj xeeb yog qhov yuav tsum tau ua. Koj yuav tsum khaws ib daim ntawv teev npe tshwj xeeb, uas qhia txog cov zaub mov noj ib hnub, cov xwm txheej ntxhov siab, vim lawv ua rau muaj cov piam thaj ntau ntxiv. Qhov no yuav cia tus kws kho mob xaiv txoj kev kho mob.
Lwm hom kev kho mob ntshav qab zib hom 1 yog kev hloov pauv pancreas, vim qhov no yuav ua rau muaj kev noj qab haus huv zoo thiab tshem tawm qhov xav tau ntawm insulin mus ntev.
Nrog hom 2 mob ntshav qab zib, nws yog qhov tsim nyog los kho tus kab mob hauv qab. Qhov no yuav tshem tawm cov tsos mob tseem ceeb ntawm tus kab mob. Cov menyuam yaus uas muaj ntshav qab zib hom 2 yuav tsum ua raws li kev noj haus. Hauv qhov no, tus menyuam hauv lub cev muajTxawm li cas los xij, koj yuav tsum ua kom paub tseeb tias tsis muaj qhov dhia nrawm hauv qabzib.
Nws yog ib qho tseem ceeb kom tshem tawm tau yooj yim digestible carbohydrates los ntawm kev noj haus thiab txwv kev noj ntawm tag nrho lwm yam ntawm lawv. Tsis tas li ntawd, kev siv cov tshuaj hypoglycemic yog xav tau, tshwj xeeb, xws li Amaryl, Maninil, Diabeton. Cov tshuaj txhawb lub siab xav tau, xws li Essentiale Forte N, thiab cov roj flaxseed, uas yog ib qho ntawm cov fatty acids.
Kom normalize ntshav microcirculation, kev siv tshuaj xws li Trental thiab Vazinit yog qhia. Vitamin complexes kuj yuav tsum tau. Taurine yog tshuaj los txhawb lub qhov muag. Cov amino acid no muaj cov nyhuv hypoglycemic thiab tseem pab txhawb cov retina. Cov menyuam yaus uas muaj ntshav qab zib tsis tuaj yeem tso lawv txoj kev ua neej nyob ib puag ncig, yog li cov niam txiv yuav tsum txhawb nqa lawv los ntawm lawv tus kheej tus yam ntxwv.
Kev siv tshuaj insulin
Kev kho mob ntshav qab zib mellitus feem ntau nyob ntawm theem uas nws tau kuaj pom. Yog hais tias tus me nyuam nyob rau hauv lub xeev ntawm coma los yog ketoacidosis, txoj kev kho yog nqa tawm nyob rau hauv lub tsev kho mob, qhov chaw uas nws tau muab cov tshuaj droppers uas pab tshem tawm toxins los ntawm lub cev, kho cov tshuaj muaj pes tsawg leeg ntawm cov ntshav, thiab kuj xaiv qhov yuav tsum tau. koob tshuaj insulin. Txhawm rau kom rov zoo, kev siv cov tshuaj yaj yeeb nrog cov piam thaj thiab insulin raug qhia.
Nws yog qhov yuav tsum tau ua raws li kev noj zaub mov nrog ntshav qab zib mellitus hauv cov menyuam yaus hom 1, vim tias qhov ntau npaum li cas ntawm cov tshuaj insulin nyob ntawm cov khoom noj. Tus kws endocrinologist kos ib daim ntawv qhia tshwj xeeb, suav nrog hnub nyoog, qhov hnyav, qhov hnyav ntawm chav kawmkab mob.
Txij li thaum kev kho mob tau ua nrog kev pab ntawm insulin, nws tsim nyog xav tias nws tuaj yeem yog 2 hom, xws li bolus lossis basal. Cov tshuaj insulin luv luv tuaj yeem raug ntaus nqi xws li "Humulin Regulator" lossis "Humalog". Tsis tas li ntawd, koj tuaj yeem siv cov khoom lag luam hauv Lavxias. Bolus insulin pib ua haujlwm yuav luag tam sim ntawd, thiab lub sijhawm ua haujlwm siab tshaj plaws yog kwv yees li 4-8 teev.
Cov tshuaj insulin ntev ua haujlwm 30 feeb tom qab txhaj tshuaj thiab kav ntev li 20-30 teev. Cov peev nyiaj tseem ceeb suav nrog Ultratard-NM, Humulin-NPKh, Insuman Basal, VO-S.
Tus menyuam yuav tsum tau qhia txog kev siv thiab khaws cov tshuaj insulin kom zoo. Nws yog ib qho tseem ceeb uas nws paub txog txhua lub luag haujlwm rau nws txoj kev noj qab haus huv thiab nkag siab txog qhov yuav tsum tau txhaj tshuaj, vim tib neeg lub neej nyob ntawm nws.
Yog tias qhov ntsuas ntawm cov tshuaj insulin tsis raug, lub xeev ntawm hypoglycemia tuaj yeem tshwm sim. Qhov txo qis hauv qab zib tsis yog tsuas yog vim suav cov tshuaj tsis raug. Noj cov zaub mov uas tsis muaj carbohydrate thiab kev tawm dag zog ntau dhau tuaj yeem ua rau qhov no.
Calculation of bread units
Nco ntsoov ua raws qee cov lus pom zoo rau cov menyuam yaus mob ntshav qab zib, vim qhov no yuav ua rau lub neej ntev thiab txhim kho nws qhov zoo. Hauv Tebchaws Europe, cov ntsiab lus ntawm cov khob cij tau qhia rau yuav luag txhua yam khoom. Qhov no pab cov neeg mob ntshav qab zib kom yooj yim nrhiav lawv cov zaub mov.
Koj tuaj yeem suav tus kheej ntawm cov khob cij. Tag nrho cov khoom noj muaj cov suav carb. Cov nyiaj no yuav tsum muab faib los ntawm 12 thiab muab faib los ntawm qhov hnyav uas tau teev tseg rau ntawm pob. Kev noj zaub mov rau ntshav qab zib hauv cov menyuam yaus txhais tau hais tias muaj kev txwv tsis pub noj carbohydrate, vim tias txhua yam tsis raug tuaj yeem ua rau muaj kev noj qab haus huv tsis zoo.
Kev tswj ntshav qabzib
Ib tug menyuam mob ntshav qab zib xav tau kev saib xyuas cov ntshav qab zib tas li. Txhawm rau ua qhov no, koj tuaj yeem siv cov cuab yeej tshwj xeeb - glucometer. Tam sim no muaj ntau ntau txoj kev xaiv rau cov khoom zoo li no, yog li koj tuaj yeem xaiv nws raws li koj xav tau. Txij li cov cuab yeej no siv ntau zaus, nws yuav tsum yog cov khoom zoo thiab txhim khu kev qha.
Thaum menyuam yaus me, cov niam txiv siv cov glucometer los ntsuas cov piam thaj, thiab thaum nws loj hlob tuaj, nws tuaj yeem siv nws tus kheej, yog li tus qauv tsim yuav tsum yooj yim li sai tau. Cov cuab yeej nrog cov ntawv xeem tshwj xeeb yog yooj yim heev. Txawm li cas los xij, lawv hnub tas sij hawm yuav tsum tau saib xyuas. Cov strips tas mus li yuav ua rau muaj qhov tsis zoo uas tuaj yeem ua rau muaj kev phom sij rau tus menyuam mob ntshav qab zib.
Muaj Teeb Meem
Mob ntshav qab zib tuaj yeem mob thiab lig. Kev mob hnyav tuaj yeem tshwm sim txhua lub sijhawm thaum muaj mob thiab xav tau kev saib xyuas tam sim. Ntawm lawv yog:
- hyperglycemic coma;
- hypoglycemic coma;
- effect on internal organs.
raws lihyperglycemic coma yog qhov tsis muaj insulin. Nws loj hlob maj mam thiab nyob rau tib lub sijhawm, tsaug zog, tsis muaj zog, nqhis dej ntau ntxiv thiab tso zis. Tsis tas li ntawd, tej zaum yuav muaj mob plab, xeev siab thiab ntuav. Hauv qhov no, koj yuav tsum hu lub tsheb thauj neeg mob tam sim.
Hypoglycemic coma tshwm sim nrog kev siv tshuaj insulin ntau dhau. Nws tshwm sim sai heev, raws li daim tawv nqaij tam sim ntawd moist, tus me nyuam yog overexcited, nws cov me nyuam dilate, thiab nws qab los noj mov. Nyob rau hauv cov ntaub ntawv no, koj yuav tsum tau pub nws los yog txhaj cov kua qab zib intravenously. Feem ntau, cov menyuam yaus uas muaj ntshav qab zib yog neeg xiam oob qhab, vim lawv muaj kev ua haujlwm tsis zoo ntawm ntau lub cev. Ntawm cov teeb meem lig ntawm tus kab mob, nws yog ib qho tsim nyog los qhia txog:
- ophthalmopathy;
- nephropathy;
- -arthropathy;
- Neuropathy;
- ncephalopathy.
Thaum ntshav qab zib tau pom cov kab mob ua rau lub cev tsis pom kev. Qhov no manifests nws tus kheej nyob rau hauv daim ntawv ntawm kev puas tsuaj rau cov hlab ntsha ntawm optic los yog ib tug txo nyob rau hauv kev pom acuity. Kev puas tsuaj los ntawm kev sib koom ua ke kuj tshwm sim, uas yog tus yam ntxwv los ntawm qhov mob hnyav thiab txwv tsis pub lawv txav mus los.
Encephalopathy ua rau muaj kev hloov pauv ntawm lub siab lub ntsws thiab lub siab lub ntsws ntawm tus menyuam, uas qhia txog kev hloov pauv sai ntawm lub siab, tsis txaus ntseeg thiab kev nyuaj siab. Tsis tas li ntawd, kev puas tsuaj rau lub raum thiab lub paj hlwb tuaj yeem pom. Cov teeb meem yog qhov txaus ntshai heev, uas yog vim li cas koj yuav tsum tau kho, noj zaub mov, thiab tswj cov ntshav qab zib.
tiv thaiv kab mob
Tam sim notsis muaj kev tiv thaiv kab mob ntshav qab zib mellitus hauv cov menyuam yaus, txawm li cas los xij, txhawm rau tiv thaiv qhov tshwm sim ntawm tus kab mob hauv cov menyuam yaus uas muaj cov caj ces predisposition, koj yuav tsum ua raws li kev noj zaub mov tsawg-carbohydrate. Tsis tas li ntawd, koj yuav tsum zam kev ntxhov siab, tawv, siv cov vitamin complexes.
Nws yog ib qho tseem ceeb uas yuav tsum tau soj ntsuam kev tiv thaiv raws sijhawm kom pom tau tias muaj kev ua txhaum cai raws sijhawm.
