I-Diabetesic syndrome - into eyenzeka ekuseni kakhulu: izimbangela, izimpawu, izindlela zokuvimbela > Isifo sikashukelaI-Syndrome (i-phenomenon, umphumela) wokuntwela kokusa koku-1 ku-2 no-2 isifo sikashukelaCishe ama-50% abantu abanesifo sikashukela abanolwazi lwazo zombili izinhlobo zohlobo 1 nohlobo 2 bangazi ukuthi luyini lolu daba lokusa kokusa futhi bayakwazi ukubhekana nalesi sifo, kodwa abazali cishe bayo yonke intsha enesifo sikashukela esincike kakhulu bayasazi.I-Morning Dawn Syndrome ivame kakhulu ezinganeni ezihlaselwa yisifo sikashukela esisebusheniKuma- “novice diabetesics” wohlobo II, leli gama elihle lingaphenduka "isimanga" elingathandeki, elihlanganisa impilo ngokuphoqa, ukuphoqa ukulawula amazinga kashukela ekuseni. Kubalulekile ukuba bathole imbangela ye-hyperglycemia yasekuseni, ngoba indlela yokulungisa amazinga kashukela izoncika ngqo kuyo.Ungayithola kanjani into yokusa yokusa kushukelaIndlela eyinkimbinkimbi yokuthola ukuthi ngabe kukhona i-morning dawn syndrome ukuthatha izilinganiso zikashukela ubusuku bonke. Abanye odokotela balule ukuthi ukuqala ukukala amazinga kashukela ngo-2 a.m., bese kuthathwa izinyathelo zokulawula ngemuva kwehora.Kodwa ukuze uthole isithombe esiphelele kunazo zonke, kuyalulekwa ukusebenzisa imitha yesathelayithi, ngokwesibonelo, njalo ngehora kusuka emahoreni angama-00,00 kuze kube sekuseni - amahora angama-6-7.Ngemuva kwalokho imiphumela iqhathaniswa. Uma isibonakaliso sokugcina sihluke kakhulu kwesokuqala, uma ushukela ungakanciphile, kodwa wanda, noma kungenjalo kakhulu, kuvela isifo sokusa kokusa.Ungawuvimbela kanjani umphumelaUma lokhu kuvame ukubonakala kushukela, kufanele wazi ukuthi kufanele uziphathe kanjani kahle ukuze ugweme imiphumela engathandeki nokungathandeki.Ukushintsha komjovo we-insulin amahora amaningi. Okusho ukuthi, uma umjovo wokugcina ngaphambi kokulala uvame ukwenziwa ngo-21,00, manje kufanele wenziwe ngamahora angama-22.00-23,00. Le ndlela ezimweni eziningi isiza ukuvimbela lesi simo. Kepha kukhona okuhlukile.Ukulungiswa kwesheduli kusebenza kuphela uma kusetshenziswa i-insulin yomsuka wobuntu besikhathi esiphakathi - yiHumulin NPH, Protafan nabanye. Ngemuva kokuphathwa kwale mishanguzo kushukela, inani eliphezulu le-insulin lenzeka cishe emahoreni ayi-6-7.Uma ujova i-insulin ngokuhamba kwesikhathi, umphumela wethamo lomuthi uzoba kanye nesikhathi lapho izinga likashukela liguqukayo. Ngale ndlela, i-phenomenon izovinjelwa.Udinga ukwazi: ukushintsha uhlelo lokujova ngeke kuthinte into uma uLevemir noma uLantus belawulwa - le mishanguzo ayinalo inani lokusebenza, bagcina kuphela izinga elikhona le-insulin. Ngakho-ke, ngeke bakwazi ukuguqula izinga kashukela egazini uma lingaphezu kokujwayelekile.Ukuphathwa kwe-insulin okufakwayo ekuseni kakhulu. Ukuze ukubala kahle umthamo odingekayo futhi uvikele ukwenzeka, amazinga kashukela aqala ukukalwa phakathi nobusuku.Ngokuya ngokuthi lenyuke kangakanani, kunqunywa umthamo we-insulin.Le ndlela ayilunge neze, ngoba ngethamo elichazwe ngokungalungile, ukuhlaselwa kwe-hypoglycemia kungenzeka. Futhi ukuze uthole umthamo odingekayo ngokufanele, kuyadingeka ukukala amazinga kashukela ubusuku obuhlukahlukene ngokulandelana. Inani le-insulin elisebenzayo elizotholwa ngemuva kokudla kwasekuseni nalo liyabhekwa.Iphampu ye-insulin. Le ndlela ikuvumela ukuthi uvikele ngempumelelo into ngokubeka amashejuli ahlukene wokuphathwa kwe-insulin kuya ngesikhathi sosuku. Inzuzo enkulu ukuthi kwanele ukuqeda izilungiselelo kanye. Lapho-ke iphampu ngokwayo izokufaka inani elicacisiwe le-insulin ngesikhathi esibekiwe - ngaphandle kokubamba iqhaza kwesiguli.IPhenomenon of Morning Dawn in DiabetesicsIsifo sikashukela yisifo esidinga ukuqashwa kwezempilo. Iziguli ezincike kumjovo we-insulin ziyazi ukuthi kuyadingeka ukukala njalo ushukela egazini ngemuva kokudla ukuze uvimbe.Kodwa ngisho nangemva kokuphumula kokudla kwasebusuku, abanye abantu bathola ukuthi bagxume ushukela, yize i-hormone ingeniswe ngesikhathi.Le nto ibizwa ngeMorning Dawn Syndrome ngenxa yokukhuphuka kwamazinga kashukela emahoreni angaphambili.Ku-syndrome yokusa kokusa, ukwanda kwe-plasma glucose kwenzeka phakathi kwezine kuya kweziyisithupha ekuseni, kanti kwezinye izimo kugcina kuze kuthi kamuva.Kuzo zombili izinhlobo zesifo sikashukela ezigulini, kuyaziveza ngenxa yezici zezinqubo ezenzeka ohlelweni lwe-endocrine.Intsha eningi ithambekele kulo mphumela phakathi kwezinguquko zama-hormone, ngesikhathi sokukhula okusheshayo. Inkinga ukuthi ukweqa kwe-glucose ye-plasma kwenzeka ebusuku, lapho umuntu elele futhi angalawuli isimo.Isiguli sithambekele kulokhu, singasoli, sithande ukwandisa izinguquko zesifo sezinzwa ohlelweni lwezinzwa, izitho zombono, nezinso ezinesifo sikashukela mellitus. Le nto akuyona eyesikhathi esisodwa, ukuquleka kuzokwenzeka njalo, kwande isimo sesiguli.Ukubona ukuthi isiguli sithintekile yini yilesi sifo, kudingeka wenze isilinganiso sokulawula ngehora lesibili, bese sikhipha esinye ngehora.I-insulin ye-hormone ikhuthaza ukusetshenziswa koshukela okuvela emzimbeni, futhi okuphambene nalo, i-glucagon kuyakukhiqiza.Futhi, ezinye izinto ezithambile zezitho ezikhuthaza ukukhuphuka kwe-glucose ku-plasma. Lona indlala ye-pituitary ehlanganisa i-hormone somatotropin, izindlala ze-adrenal ezikhiqiza i-cortisol.Kusekuseni lapho ukucasulwa kwezitho zomzimba kusebenze. Lokhu akubathinti abantu abaphilile, ngoba umzimba ukhiqiza i-insulin ekuphenduleni, kepha kwabanesifo sikashukela le ndlela ayisebenzi. Ukudlondlobala ekuseni okunjalo kushukela kubangela ukuphazamiseka okuthe xaxa ezigulini, ngoba zidinga ukungenelela okuphuthumayo kwezokwelapha.Izimbangela eziphambili zalesi sifo zihlanganisa:umthamo olungiselelwe ngokungafanele we-insulin: lenyuka noma lincane,isidlo sekwedlule isikhathiizingcindezi ezivama njalo.Kungakhuphuka futhi kuholele ku-hyperglycemia, uma izinyathelo ezisheshayo zokuqinisa isimo zingathathwanga, noma zehla kakhulu ngemuva kokulawulwa okwengeziwe kwe-insulin.Ukushintshwa okunjalo kugqame ngokuvela kwe-hypoglycemia, okungeyona ingozi kangako kwisifo sikashukela kunokukhuphuka ushukela. Isifo senzeka njalo, ngaso leso sikhathi ingozi yezinkinga iyanda.Isifo sikashukela i-mellitus yiyona endocrinopathy evame kakhulu kubantu besintu emhlabeni. Umkhuba wokusa kokusa ukwanda kwe-glucose ekuseni, imvamisa kusuka ku-4 - 6, kepha kwesinye isikhathi ihlala kuze kube ngu-9 ekuseni. Isimanga sathola igama laso ngenxa yokuhlangana kwesikhathi lapho ushukela wawukhuphuka kusukela ekuntweleni kokusa.Isifo sikashukela singenye yezifo zabantu ezikhohlisayo. Ubungozi bayo bukhuliswa iqiniso lokuthi namuhla alikho ikhambi lomhlaba wonke laso. Ukuphela kwento ethuthukisa impilo yesiguli ukwanda kokuqashelwa kwe-insulin ngazo zonke izindlela ezitholakalayo.Lesi simo sibuye sidingida iqiniso lokuthi esikhathini sokuqala lesi sifo asizivezi. Kodwa-ke, ngentuthuko yayo, umuntu ubhekene nama-syndromes amaningi esifo sikashukela (lokhu kuyinhlanganisela yezimpawu ezibonisa isimo esithile somzimba). Cabanga ngama-syndromes ajwayelekile kakhulu esifo sikashukela.Isimanga sokuntwela kokusa yisimo sikashukela wegazi ophezulu obonwa ngesikhathi sokuphuma kwelanga. Isimanga sokuntwela kokusa sibonwa esikhathini sokuphumula ngehora ukusuka kwelesi-4 kuye kwelelesithupha ekuseni. Kwezinye izimo, kungenzeka ukukhuphula amazinga kashukela kuze kube ngu-9 ekuseni. Ngokuvamile kutholakala ngohlobo lwesifo sikashukela i-mellitus insulin.Umkhuba wokuvuka kokusa kwenzeka ezigulini ngenxa yezizathu ezilandelayo:izingcindezi zenzeka ngosuku olwedluleukondleka ngokweqile ebusuku,inani elanele le-insulin elilawulwa ebusuku.Kwesinye isikhathi ukubalwa okuyikho kwenani le-insulin kusiza ukuvimba ukuthuthukiswa kwento yokusa yokusa. Kodwa-ke, kufanele kukhunjulwe ukuthi ngalesi sikhathi inani lama-glucocorticoids emzimbeni liyakhuphuka. Basiza ukukhulisa amazinga kashukela.Ingozi yokwenzeka kokusa kokusa iqukethe ngokunembile ekugcinweni kwe-hyperglycemia. Ihlala emzimbeni kuze kube sekujojweni okulandelayo kwe-insulin. Futhi ngokwethulwa kwe-insulin eningi kakhulu, isiguli singathola i-hypoglycemia.Ukwelapha ukwedlula kokusa kuqukethe ukulandela izincomo ezithile.Ngohlobo lwesifo sikashukela se-mellitus-insulin (1st) - khulisa umthamo we-insulin kusihlwa.Ukuyeka ukuphathwa kwe-insulin ende ngesikhathi esizayo. Kwesinye isikhathi lokhu kuzokwenza ukuthi kuvikeleke ukubonakala kokusa kokusa kokusa.Ekuseni, ukuphathwa kwe-insulin ebamba okwesikhashana kwamukelekile ukuvikela i-hyperglycemia.Isimanga sokuntwela kokusa ekuseni sidinga indlela ngokucophelela yokwelashwa. Isifo sikashukela, kungakhathalekile ukuthi luhlobo luni, sidinga ukubhekwa njalo, ukwelashwa nokulungiswa kwendlela yokwelashwa. Umcimbi wokuntwela kokusa kufanele futhi uhlale ulawulwa.I-Nephrotic syndrome ibonakala nge-nephropathy yesifo sikashukela - ushintsho emikhunjini yezinso, okuholela ekuthuthukisweni kokwehluleka kwezinso okungamahlalakhona. Kwenzeka kungakhathalekile ukuthi hlobo luni lwesifo sikashukela.I-Nephrotic syndrome ifaka i-proteinuria (okungukuthi, ukubonakala kwamaprotheni emchameni), amaprotheni angasebenzi kahle nama-metabolism wamafutha, ne-edema. Isibonakaliso se-Nephrotic tata sidingida inkambo yesifo sezinso cishe ingxenye eyodwa kwezihlanu kweziguli.Ifomu layo eliyinhloko litholakala ku-glomerulonephritis eyingozi, i-pyelonephritis, amyloidosis namanye ama-pathologies. Ifomu lesibili litholakala kuma-pathologies amaningi.Izibalo zikashukela ziya ngokudabukisayo njalo ngonyaka! I-Russian Diabetes Association ithi umuntu oyedwa kwabayishumi ezweni lethu unesifo sikashukela. Kepha iqiniso elinesihluku ukuthi akusona lesi sifo uqobo esesabekayo, kepha ubunzima baso nendlela yokuphila eholela kuyo.Odokotela ama-endocrinologists bajwayele ukwenzeka kokusa kokusa kushukela. Ngemuva kwethemu elihle kumane kungukugxuma okubukhali kushukela wegazi, okwenzeka ngesikhathi lapho umuntu esesembhedeni ekuseni kakhulu.Ngokungangabazeki, isifo esiyinkimbinkimbi njengesifo sikashukela sidinga ukulawulwa ngokuphelele kwesimo somzimba, ngoba i-glycemia ingaba yingozi enkulu empilweni yabantu. Sizokuqonda izimbangela zesifo, kanye nezindlela zokulwa naso. Imininingwane izoba wusizo ezigulini ezinhlobo lokuqala nesibili lwesifo sikashukela.Udinga ukuthi uqonde ukuthi umphumela wokusa kokusa oshukela kuhlobo 2 lwesifo sikashukela akuyona into eyenzeka ngesikhathi esisodwa, kodwa yisimo esihlala njalo. Futhi yize kungezona zonke iziguli ezinesifo futhi ngamaphesenti le nkomba ingaphansi kunhlobo lokuqala lwesifo, kufanele wazi izimbangela zalokhu futhi akunakwa ungazinaki.Isibindi somuntu esiphilile sakha kufika ku-6 g we-glucose ngehora. Kepha ngokutholakala kwesifo sikashukela sohlobo 2, le nkomba iyanda. Ukumelana ne-insulin kwezicubu zomzimba kuholela ezingeni eliphakeme likashukela ekuphumuleni ebusuku.Ukukhiqizwa kwama-hormone e-insulin antagonist, nawo aqala ukusondela ekuseni, kuholela ekutheni ukuhlolwa kwegazi okusheshayo kukhombisa ukugcwala koshukela. Esikhathini esiningi, lesi simo siyalungiswa ngemuva kokudla.Ingozi yalesi simo ukuthi ngokumelene nesizinda saso izinkinga ezahlukahlukene zesifo sikashukela ziyaqhubeka kakhulu. Phakathi kwazo kukhona izifo eziyingozi ezinjengama-cataralog, i-nephropathy (umsebenzi wokulimala wezinso), i-polyneuropathy (ukulimala kwe-NS yodumo).Kumele kuqashelwe ukuthi i-hyperglycemia ayenzeki kuphela ngokumelene nesizinda sokwephulwa okukodwa kokudla, kepha icasulwa izinqubo ezenzeka emzimbeni njalo.Okusho ukuthi, ukuze ususe, kuyadingeka ukulungisa ukwelashwa.Abantu abanesifo sikashukela bajwayelana nomkhuba we-hyperglycemia yasekuseni, othole igama lenkondlo - ukusa kokusa. Lesi sifo sivame ukubonwa lapho kukhula isifo sikashukela sohlobo 2 nohlobo 1.Ngemuva kwegama elihle kungukusa kokusa, asikho isici esimnandi kangaka somzimba ukuze sifinyelele kushukela wegazi lapho kuphuma ilanga. I-Morning dawn syndrome ngohlobo 2 nohlobo lwe-1 yesifo sikashukela ibonwa kwezinye iziguli; izici zezinqubo zomzimba zangaphakathi ze-endocrine ziholela ekubukekeni kwayo.Akuncike ohlotsheni lwesifo sikashukela, kepha kuvame ukubonwa kwintsha enesifo sikashukela i-mellitus, ngenxa yokukhiqizwa okuningana kwe-hormone yokukhula, ebizwa ngokuthi ngesinye sezici ekubonakaleni kwesifo. Ngokwamazinga wesikhashana, lo mphumela ubonwa kusukela ngo-4 kuye ku-8 ekuseni, ezimweni ezingandile, kuze kufike ku-9.Into yokusa yokusa ibonakala ngokugxuma okubukhali emazingeni kashukela ekuseni. Ukwanda okukhulu kwesibalo se-glucose kwenzeka lapho umuntu elele futhi engakwazi ukuthatha izinyathelo zokunciphisa. Kuholela ekwakhiweni kwe-pathologies yezitho zombono, izinso noma uhlelo lwezinzwa oluyingozi, lapho abantu abanesifo sikashukela bethambekele khona.Lokhu kuyingozi yesifo. Kuqinisekiswe ngomuthi ukuthi lesi simo ngeke sibe yisikhathi esisodwa, lapho kusungulwa inkambiso ye-hyperglycemia yasekuseni, amacala azophindwa, avuse ama-pathologies angafanele.Ifana neyehlakalo zokusa okusa kuthiwa yi-Somoji syndrome ku-mellitus yesifo sikashukela. Yize lezi zifundazwe ezi-2 zinamandla afanayo entuthuko, ahlukile ngezizathu ezibangela wona. I-Somoji syndrome yenzeka ngokumelene nesizinda sokwehla ngokweqile komthamo odingekayo we-insulin.Izimpawu Zokuphakama Kwegazi Ushukela EkuseniKungakhathalekile ukuthi ziyini izimbangela ze-hyperglycemia yasekuseni, ingaqashelwa ukubonakaliswa okulandelayo:ukulala kabi, kuvame ukuhambisana nobusuku,umuzwa wokuthi wephukile ngemuva nje kokuvuka,ukozela kuze kube yisikhathi sokudla kwasemini,ukukhuphuka kokukhathazekaukuhlaselwa kobutha obungashukunyiswa,ushintsho olubi lomzwelo,inzondo yezwe elingaphandle.Kubalulekile! Izimpawu ezikleliswe ngenhla entathakweni yokusa kokusa zingavela ngamazinga ahlukahlukene obukhulu kanye nokuhlanganiswa okuhlukahlukene, kepha kungahle kungabikho ngokuphelele. Isibonakaliso esibaluleke kakhulu, sangempela futhi esivame ukwenzeka salesi sifo sekhanda ekuseni.Izimbangela zokwanda kukashukela wegazi ekuseniI-Dawn hyperglycemia noma ukwanda koshukela egazini ekuseni yinto eyenzeka kubantu abaphilile. Kungani ushukela wegazi uvuka lapho ulele?Lokhu kungenzeka ngenxa yezizathu ezilandelayo:isidlo esimnyama nesimnandi “nesinganambitheki kahle” se-hormone ye-insulin egazini, ebhujiswa kakhulu yisibindi ekuseni kakhulu,secretion yemvelo ekhushulwayo yama-hormone aphikisayo.Kuzona zozimbili lezi zinhlobo, i-pancreas enempilo iphendula ngokushesha nangendlela efanayo - imane ikhiphe inani elingeziwe le-hormone ye-insulin ebhekene nokusetshenziswa ushukela. Ngakho-ke, imiphumela yesifo sokusa kokusa ekuseni iningi labantu abaphilile ladlula ngaphandle kwezimpawu nokubonakaliswa, futhi labo abambalwa abanokugula okuncane ekuseni, basusa ukudla kwabo ekuseni, futhi bazizwa bejabule futhi begcwele amandla.Ezigulini ezinesifo sikashukela, ukwanda ushukela ekuseni kungabangelwa izizathu ezahlukahlukene. Kuzo kuphuma amagama wezimo ze-pathological.I-insulin engapheli i-Insulin Excess Syndrome - i-rebound phenomenon, i-Samoji syndromeNgohlobo I diabetes, isimo hyperglycemia yasekuseni kungenzeka kube ukuqhubeka ebusuku.I-Samoji syndrome ingumphumela womthamo omude wemithamo ye-insulin engalawulwa kahle, okuthi ivuse i-chain ye-pathological elandelayo:ukukhushulwa okunyusa kwamahomoni e-contrainsulin,kudlulela kushukela kushukela wegazi.Ezigulini ezinesifo sikashukela sohlobo 2 esingayifaki i-insulin, i-Samoji syndrome asiyona into ehlukile. Kodwa-ke, kwezinye izikhathi, ezigulini eziphatha kabi futhi ngokuqhubekayo ukwephula indlela yokuziphatha ekudleni kusihlwa futhi zingalungisi ushukela wazo wegazi ngaphambi kokulala nemithi ye-hypoglycemic, isithombe esifanayo kakhulu singabonakala.Ukunaka! Izinga eliphakeme likashukela ekuseni lingabangelwa hhayi kuphela ngokweqile, kepha futhi nemithamo yakusihlwa enganele ye-hormone esebenza nge-insulin ephakathi nendawo.Izimbangela zesifo sokusa kokusa yizinto ezinjalo:ukudla ngokweqile ngaphambi kokuphumula kobusuku,umthamo we-insulin onganele ngaphambi kokulalaukucindezela okwedlule noma imizwa yengqondo,inqubo yokutheleleka nokuvuvukala,umkhuhlane.Sizokuqonda izimbangela zesifo, kanye nezindlela zokulwa naso. Imininingwane izoba wusizo ezigulini ezinhlobo lokuqala nesibili lwesifo sikashukela.Emzimbeni womuntu, yonke into iyaxhuma, futhi isenzo ngasinye sinokuphikisana naso. Isibonelo, i-insulin ye-hormone iphikiswa yi-glucagon antagonist yayo. Futhi uma ushukela wokuqala osegazini ulusebenzisa, khona-ke okuphambene nalo kuyawukhiqiza.Ngaphezu kwe-glucogon, umzimba nawo ukhiqiza ezinye izinto, ubukhona bawo buvusa ukwanda kwe-glucose. Le yi-hormone yokukhula somatotropin ekhiqizwa i-pituitary gland, i-cortisol eyenziwe ngezindlala ze-adrenal, kanye ne-hormone egqugquzela i-thyroid (nayo ikhiqizwa yi-anterior pituitary gland).Inani eliphakeme lemfihlo yabo livele nje liqale ekuseni, noma kunalokho, esikhathini sokuphuma kwesine kuya kwesishiyagalombili. Umsebenzi wawo wonke amasistimu ngaphambi kokuvuka ungokwemvelo. Umzimba, ngenxa yalokhu, uyaveva ngaphambi kosuku olusha, uvuke usebenze.Isikhathi sokusebenza kwezindlala ze-adrenal kanye ne-pituitary gland kuyinto yomuntu ngamunye, ngezindlela eziningi kuncike eminyakeni yobudala.Kumzimba ophile kahle, inqubo yokuncephezela, okuwukuthi, ukukhiqizwa kwe-insulin, kuvulwa kanyekanye, kodwa lokhu akwenzeki lapho kutholakala khona isifo sikashukela.I-Morning dawn syndrome iyimpawu yabasakhula nezingane, ngoba icasulwa ikakhulukazi yi-hormone yokukhula (somatotropin), eyenziwe ngesikhumba sendlala. Njengoba izingane zikhula ngemijikelezo, ushukela we-glucose ekuseni ngeke ube unomphela nawo. Kuyo yonke le minyaka, izinga le-hormone lokukhula liyancipha, umuntu ojwayelekile ukhula aze afike eminyakeni engama-25.Kwabashukela abancike e-insulin, ukukhuphuka kushukela kubangela ukuphazamiseka okuningi. Ngokubona ukuthi lesi simo siphindwa kaninginingi, kufanele kuthathwe izinyathelo zokusithuthukisa. Phakathi kwezimbangela zalo mkhuba, ama-endocrinologists ahlukanisa main main:umthamo omncane kakhulu we-insulinisimo sokucindezelaiphutha ekubaleni umthamo we-insulin ngokumelene nesizinda seSomoji syndrome.Ukwelashwa kwenziwa emikhondweni emibili, kepha ngokuqinisekile kufaka phakathi ukulungisa isilinganiso se-insulin, okwathi ngasizathu simbe kwakunganele ngaphambi kokudla kwasekuseni.Kwezinye izimo, ukudluliselwa komjovo esikhathini esizayo sekwanele. Leli qhinga elilula lisebenza lapho kusetshenziswa okubizwa ngokuthi "ukufakwa kobude besikhathi esiphakathi", njenge- "Protofan" noma "Basal".Zinezinsimbi eziphakemeyo, ezingashintshwa ukuze isenzo somuthi senzeke ngenkathi kukhiqizwa ama-insulin antagonist hormone. Ngakho-ke, bayasusa ngempumelelo omunye komunye.Ama-analogue "angenasisekelo" awanayo impahla enjalo, futhi ukudluliswa kwesikhathi sokufakwa kwawo akusizi ukunxephezela ukukhwehlela kokusa kokusa. Kulokhu, ukuphathwa okwengeziwe kwesidakamizwa kuzodingeka, isikhathi sokujova kufanele sibe kuleli cala ngesikhathi sika-4-5 ekuseni.Umthamo wesidakamizwa ubalwa ngokuya ngomehluko phakathi kwesilinganiso se-glucose esisunguliwe, esaziwa njengezinga elijwayelekile kanye nomkhawulo omkhulu wokunyuka. Ukuze ungaqali inqubo ye-hypoglycemia, umthamo okhethiwe ulungiswa ngokuya ngenhlala kahle. I-insulin efushane ngaphambi kokudla kwasekuseni nayo iyabhekelwa kucatshangelwa into esevele isebenza.Indlela yesithathu yokwehlula ukuvela kokusa kokusa ekuseni ene-Type 1 sikashukela ibiza kakhulu, usebenzisa iphampu ye-insulin. Uzoqeda isidingo sokuvuka ukuze athole umjovo. Ngokuhlela uhlelo okwesikhathi esithile, ungafaka umuthi we-hormone ngokuzenzakalelayo.Kepha ngesifo sikashukela, i-ekuseni dawn syndrome idala ukungaphatheki kahle futhi ilimaza isiguli kakhulu. Imvamisa, le nto ibonwa yintsha. Ngasikhathi sinye, azikho izizathu ezisobala zokuxhuma ushukela: i-insulin yajova ngesikhathi, ukuhlaselwa kwe-hypoglycemia akuzange kwandule ushintsho emazingeni kashukela.Imininingwane ebalulekile: i-ekuseni dawn syndrome ene-Type 2 sikashukela mellitus yinto ejwayelekile, hhayi eyodwa. Ngemuva kwalokho ukungawunaki umphumela kuyingozi enkulu kakhulu futhi akunangqondo.Odokotela abakwazi ukubona ukuthi kungani le nto yenzeka. Kukholelwa ukuthi isizathu sisezimpawu zomuntu ngamunye zomzimba wesiguli. Ezimweni eziningi, onesifo sikashukela uzizwa ejwayelekile ngokuphelele ngaphambi kokulala. Kodwa-ke, ekuseni, ngenxa yezizathu ezingachazwanga, ukukhishwa kwama-hormone we-insulin antagonist kwenzeka.I-Glucagon, i-cortisol namanye ama-hormone enziwa ngokushesha okukhulu, futhi yilesi sici esivusa ukugxuma okubukhali kushukela wegazi ngesikhathi esithile sosuku - i-ekuseni kokusa kokusa.I-Morning dawn syndrome kungenzeka i-imperceptibly kumuntu onesifo sikashukela uqobo, kodwa kuphela uma izinguquko zeglucose zingasho lutho. Kwenzeka into eqala ngo-3 a.m. iphele ngo-9 a.m., imvamisa kakhulu ngesikhathi sokulala okuzwakalayo.Esikhathini sobusha, le nto ivame ukutholwa kakhulu, kepha asikho isizathu samazinga kashukela ngokweqile, i.e. i-insulin yenziwa ngesikhathi. Ochwepheshe abakwazi ukubona imbangela yesifo, kodwa ngokuvamile kukholelwa ukuthi lokhu kuhambisana nesici somzimba womuntu.Ngokuyisisekelo, abanesifo sikashukela bazizwa bejwayelekile ngaphambi kokuphumula kobusuku, kodwa ngaphambi kokuvuka, kukhululwa i-hormone emzimbeni wokucindezela i-insulin. Kubantu abanesifo sikashukela sohlobo 2, i-ekuseni dawn syndrome yenzeka njalo, kepha ukungazinaki lezi zifo kuthathwa njengeyingozi.Endabeni yesifo sikashukela esincike ku-insulin, i-ekuseni yokuvuka yesifo esibangelwa i-insulin engalawulwa engalungisiwe inomthelela ekwakhiweni kwezinkinga ezinkulu, ezinjengokuthi:iso lenyama (ukumnyama kwelensi)ukukhubazeka kwe-flaccid kwemilenze (ukubonakaliswa kwe-polyneuropathic),isifo sikashukela nephropathy (ukwehluleka kwezinso).Ezinye iziguli zidida isifo sasekuseni se-Somoji syndrome (i-insulin overdose), kodwa-ke, le nto ivela ngenxa yokusabela okuvamisile kwe-hypoglycemic futhi ngemuva kwesizinda sokuntuleka kwe-insulin yemvelo.Izimpawu zalo mkhubaIzimpawu zesifo yizimpawu ezilandelayo:ukulahleka kokuqondisaukomela okukhuluukwehla kwamandla okubuka,kukhanya okukhulu emehlweni.Ukuqinisekisa ngokuphelele uma unesifo sokusa sokusa, kufanele ulinganise ukubalwa kwakho ushukela ebusuku. Odokotela batusa ukusebenzisa idivaysi ekhethekile yokulinganisa - i-glucometer.Ukulinganisa kokuqala kufanele kwenziwe kusuka ngo-2 ekuseni, kwesibili - ngemuva kwehora. Ukuqedela isithombe, izindlela zingathathwa kusukela ngo-23: 00, wonke alandelayo - njalo ngehora kuze kube ngu-7 ekuseni.Ngemuva kwalokho, izinkomba ziqhathaniswa. Kubhekelwa kakhulu imiphumela ebikalwa kusukela ngo-5 ekuseni. Uma izinga likashukela lenyuke, noma kancane, khona-ke unayo le ndlela yokuxilonga umzimba.Umkhuba wokusa kokusaLesi sifo singenzeka kwabanesifo sikashukela sanoma yiluphi uhlobo lwesifo sikashukela, kufaka phakathi isifo sikashukela kwabesifazane abakhulelwe. Egameni lalesi sifo, igama elithi "phenomenon" alivelanga ngengozi.Iqiniso ngukuthi uma ulinganisa ushukela wegazi phakathi kobusuku, kuze kube ngu-4-00, khona-ke kuzoba ngaphansi kwemikhawulo ejwayelekile, kepha kusuka ku-5,00 kuye ku-70000, futhi ngezinye izikhathi kuze kube ngu-9 a.m, ushukela wegazi uqala ukukhula.Namuhla le nto ichazwa yizizathu ezilandelayo:kusuka ku-4 :00 kuye ku-6 :00, izindlala ze-endocrine zikhiqiza ngamandla ama-hormone we-contrainsulin - glucagon, cortisol, adrenaline, kepha ikakhulukazi somatotropin (i-hormone yokukhula),ngalesi sikhathi, isibindi sisusa ngokunamandla i-insulin egazini ukuze singaphazamisi umsebenzi wamahomoni angenhla, futhi ngosizo lwaso siguqula izitolo zalo ze-glycogen zibe glucose, okudingeka “umsebenzi” ophumelelayo we-hormonal.Lezi zinqubo zanele zabanesifo sikashukela ukuphazamisa isilinganiso se-glucose ne-insulin egazini:ezigulini ezinesifo sikashukela sohlobo lokuqala, amaseli we-beta athintekile amakhoba awakwazi nje ukukhiqiza inani elifanele le-insulin hormone "ekubuyiseleni" ushukela okhiqizwe isibindi,ku-diabetesics yohlobo lwesibili, isibindi siba i-insulin immune futhi sifake ushukela omningi kunokuba kunesidingo, okuthi, kanye nokukhiqizwa kweglucose okungenakugwenywa ekuphendukeni kwamahomoni, kunikeza ukugxuma okuyingozi kushukela.Ngemininingwane. Ososayensi bakholelwa ukuthi imbangela eyinhloko yesifo sokusa kokusa kungukukhulula kwe-hormone yokukhula. Kunoma ikuphi, lokhu kungachaza ukuthi lokhu kubonakaliswa kukhulunywa kakhulu kubantu abaneshukela sikashukela ngesikhathi sokukhula ngokushesha futhi akuvamile kakhulu kubantu asebekhulile abanesifo sikashukela sohlobo 2.Ungasihlukanisa kanjani i-Samoji syndrome entweni yokusa yokusaUkwehlukahluka kwe-insulin ye-insulin engaphezulu kwe-overdose syndrome ngokwayo inqubo ethatha isikhathi esizodinga imizamo ehlangene ye-endocrinologist bese uthayipha isifo sikashukela esingu-1, nabazali bakhe besebasha.Ukuqinisekisa ubukhona bomsuka wokusa wasekuseni, kunconywa ukuthi iziguli ezinoma yiluphi uhlobo lwesifo sikashukela ezikhathazekile ngokuzwa zingathandeki futhi zinekhanda lasekuseni kufanele zithathe isilinganiso se-glucose ku-plasma yegazi izinsuku eziningana zilandelana.Okokuqala, ngaphambi kokulala, bese kuthi njalo ngehora kuze kube ngu-9 ekuseni, ukuqala ngo-3 a.m. Lapho kukhona into yokusa yokusa, ukugxila kwe-glucose kuzoba okungenani yi-1.5-2 mmol / l ephakeme kunezinkomba zakusihlwa nasebusuku.Izindlela zeMorning Dawn SyndromeNjengoba ushukela wegazi "weqa" esigulini ngasinye ngezindlela ezihlukile, kufaka phakathi ekuseni, izindlela zokulawula azifani. Wonke umuntu kuzofanele azikhethele indlela yakhe.Njengamanje, izincomo ezilandelayo zikhona:Qinisekisa ukuthi isidlo sakusihlwa asilibali isikhathi eside kuno-19-00.Umkhawulo obanzi wokudla kwe-fiber kusihlwa.Hambisa umthamo wansuku zonke we-insulin hormone ukuze umjovo owodwa we-insulin esebenza-isikhathi eside wenziwe phakathi kuka-1-00 no-3-00. Qiniseka ukuthi ubheka ushukela wakho ngaphambi kokujova.Imijovo "eyengeziwe" ye-insulin emfushane ngo-3-00, ku-4,00 noma ku-5,00 iyasebenza, kepha idinga ukubalwa nokuhambisana nomthamo ngqo (kusuka kumayunithi angama-0,5 kuye kwayi-2) nokucaciswa kwesikhathi esithile somjovo.Ngohlobo 2 sikashukela, thatha i-Glucofage-Long ngesikhathi sokulala. Kulokhu, ngokushesha ngemuva kokuvuka, kuyadingeka ukwenza isilinganiso sokulawula nge-glucometer. Uma ithebhulethi eyodwa ka-500 mg inganele, khona-ke umthamo kufanele ukhethwe, kancane kancane uwukhulisa. Umthamo omkhulu ebusuku ngamaphilisi ama-4. Kulokhu, ngokushesha ngemuva kokuvuka, kuyadingeka ukwenza isilinganiso sokulawula nge-glucometer.Uma izindlela ezingenhla zingalethi umphumela ofanele, kunendlela eyodwa kuphela yokulawula ushukela wegazi - ukwelashwa kwepampu yewashi ejikelezayo.Kubalulekile! Uma phakathi nobusuku bokukalwa kwezinga likashukela wegazi, ukugxila kwalo kwavela kwaba ngaphansi kwama-3.5 mmol / l, qaphela! Ungazifaki ngengozi nge-insulin insomnia futhi ungakhohlwa ukuthatha iphilisi likashukela.Ngobunzima bokusa kokusa kwabesifazane abakhulelwe abanesifo sikashukela sokukhulelwa, kwenziwa ngenye yezindlela ezingenhla. Kunconywa ukuthi omama abakhulelwe abanesifo sikashukela ngaphambi kokukhulelwa basebenzise ipompo le-insulin ngokushesha, kodwa baqaphele kakhulu futhi balawule i-glycemia yabo, baqiniseke ukuthi isivunguvungu ketoacidosis asikhuli.Sengiphetha, sifuna ukukukhumbuza ukuthi isifo sikashukela sisho ama-pathologies aqeda ukusongela empilweni. Ngakho-ke, ngaphambi kwanoma isiphi isenzo esingathinta isilinganiso sokuhlushwa kashukela egazini, kokubili phezulu naphansi, kufanele uthole ukuvunyelwa udokotela wakho.Uma unenkinga yesifo sokusa sokusa nesifo sikashukela, kufanele ulalele izincomo ezilandelayo ukuvimbela ukuthuthukiswa kwalesi simo:Njengoba izinga likashukela livuka ekuseni, kufanele wenze umjovo owedlulele we-insulin ngaphambi nje kokulala, ushintshwe ngesikhathi ngamahora amaningana. Okusho ukuthi, uma i-insulin ijovwe ngo-22,00, lapho-ke idilizwa kufanele iphathwe ngamahora angama-23: 00-00: 00. Ezimweni eziningi, lezi zinguquko ziyasiza.Ukubhekisisa ikakhulukazi kufanele kukhokhwe kumalungiselelo we-insulin osebenza phakathi nendawo. Kungaba izindlela ezinjengokuthi "Humulin NPH", "Protafan", njll. Isikhathi sokusebenza kwezidakamizwa siyehluka cishe amahora angama-7. Ngakho-ke, izinga eliphakeme kakhulu lokuhlushwa kwe-insulin lizoba nje ngo-6-7 ekuseni.Ukugcina i-insulin ijwayele ukuthatha i- "Lantus" noma "Levemir", kepha le mishanguzo ene-glucose enamandla ayithinti izinkomba eziphambili.Kukhona okunye ongakwenza: ukuphatha i-insulin esebenza isikhathi esifushane kakhulu ekuqaleni kwesikhathi - kusukela ngo-4 kuye ku-5 ekuseni. Kepha khumbula ukuthi kuleli cala kubalulekile ukubala ngokunembile umthamo we-hormone. Ngaphandle kwalokho, i-hypoglycemia kungenzeka. Kulokhu, umuntu onesifo sikashukela kuzodingeka alinganise ushukela ngobusuku obuhlukahlukene. Ngobusuku obubodwa, kuthathwa izilinganiso eziningana. Ngokulandelayo, izinga lokuhlushwa ushukela libalwa, umthamo wehomoni ophethwe ngemuva kokudla kwasekuseni uyabhekwa.Ungavimbela i-ekuseni dawn syndrome ngosizo lwensiza entsha - Iphampu ye-insulin ye-Omnipod. Idivayisi ikuvumela ukuthi usethe ngokuphelele noma isiphi isheduli sokwethulwa kokulungiswa kwe-insulin ngokubheka isikhathi.Iphampu ye-insulin iyithuluzi lezokwelapha elinamapharamitha amancane. Ngenxa yalolu cingo, i-insulin ifakwa ngokuqhubekayo ngaphansi kwesikhumba. Noma ngabe ukhohliwe ngesikhathi ihhashi likhishwe ngalo, iphampu izokwenzela wena.Uhlelo lolu lufakelwe amashubhu acashile futhi aguquguqukayo axhumanisa indawo yokugcina insulin kanye nezendlalelo ezingaphansi kwezicubu ze-adipose. Inzuzo enkulu ukuthi ipompo ayidingi ukuhlanganiswa nsuku zonke, sekwanele ukusetha isikhathi nenani lamahomoni ajovwe kanye. Okubi izindleko eziphakeme zedivayisi.Ushukela ophakeme ekuseni onesifo sikashukela sohlobo lokuqala kuyinto evame ukuvela. Ngokunquma ukuthi kungani isiguli sinoshukela omningi ekuseni ngaphambi kokudla, ukwelashwa kungalungiswa.Izimbangela ezivame kakhulu zokunyuka kokushukela kwe-glucose:inani elincane lomuthi ophathwe ngaphambi kokulala,I-hypoglycemia ngesikhathi sokuphumula kobusuku,I-Syndrome (i-phenomenon) yokuntwela kokusa kuhlobo lwesifo sikashukela mellitus 1 no-2.Futhi, ukwanda kwe-glucose kungabangelwa ukungondleki kahle ngaphambi kokulala noma ukwephulwa kwemithetho yokwelashwa kwe-insulin.Umthamo ongalungile we-insulin ende yesikhathi sohlobo 1 sikashukela ubangela ushukela osheshayo wokuzila. Lokhu kungenxa yokuthi imijovo ayanele ukugcina isimo se-glucose ejwayelekile ubusuku bonke.Ngomthamo omkhulu we-insulin, ushukela uyancipha ebusuku, kepha ekuseni kukhona ukugxuma okubukhali.Ungasusa kanjani lesi sifo?Uma kutholakala izimpawu zalesi sifo, isiguli singathatha lezi zindlela ezilandelayo:ukuphathwa kwe-insulin ngokuzayo. Kulokhu, ama-hormone wesikhathi esiphakathi angasetshenziswa: I-Protafan, Bazal. Umphumela omkhulu wezidakamizwa uzoza ekuseni, lapho ama-hormone we-insulin antagonist esetshenzisiwe,umjovo owengeziwe. Umjovo wenziwa cishe ngehora lesine. Inani libalwa kucatshangelwa umehluko phakathi komthamo ojwayelekile nalowo odingekayo ukuze uzinzise isimo,ukusetshenziswa kwephampu ye-insulin. Uhlelo lwedivayisi lungasethwa ukuze i-insulin ihanjiswe ngesikhathi esifanele, kanti isiguli silele.Ngokuya ngohlobo lwesifo (i-mellitus esekela i-insulin noma i-insulin), izimpawu zayo ziyehluka. Ngakho-ke, ngohlobo lwesifo sikashukela (1st) sikashukela, umuntu ubhekene nezimpawu ezinjalo:ukukhathala, kanye nokungabi nandaba nakho konke okwenzekayo,ukwehla kwesisindo, yize iqiniso lokuthi umsoco uhlala unjalo.Izimpawu zohlobo lwesifo sikashukela esizimele (2nd) zihlukile kancane:ukukhathala, ubuvuvu, ukunganaki,ukuphazamiseka kokulala (ukozela phakathi nosuku, ukuqwasha),ingozi yokutheleleka kwesikhumbaumlomo owomile, ukoma,ukonakala kwezinqubo zokwenziwa kabusha kwesikhumba,ukwephula ukuzwela kobuhlungu bezitho,ubuthakathaka bemisipha nokuncipha kwethoni yemisipha eyejwayelekile.Wonke umuntu udinga ukunaka lezi zimpawu, ngoba ukwelashwa kwesifo sikashukela okuholela esikhathini esizayo kubangela izinkinga eziyingozi.Ukusetshenziswa kwephampu ye-insulinUkuthola ukuthi kungani ushukela wegazi lesiguli uvuka ebusuku noma kungani ukugxuma kwakhe okubukhali kuqashelwa ekuseni ngokuhlolwa okulula. Ukuze wenze lokhu, udinga ukwenza izilinganiso eziningana zamazinga kashukela: ngaphambi kokulala, ngehora lesibili, ngehora lesine nangelesithupha ekuseni.Ngokubona inani eliphakeme kakhulu neliphezulu le-glucose, ungaguqula umthamo we-insulin ngaphambi kokulala. Ezigulini ezinesifo sikashukela sohlobo 2, lokhu kukuvumela ukuthi uthathe isinqumo sokuthi kungenzeka yini ukuthi uphuze izidakamizwa ezinciphisa ushukela ngaphambi kokulala.Ukwanda koshukela egazini ekuseni kungenzeka kungenxa yokuntuleka komjovo noma amaphilisi anciphisa ushukela ngesikhathi sokulala.Ukulungisa ushukela wokuzila kakhulu ekuseni ngohlobo lwesifo sikashukela 1 kuzosiza ukukhulisa ukuphathwa kwe-insulin. Kwesinye isikhathi kwanele ukuhlehlisa umjovo ngo-23:00 ukuze kugwemeke ukwanda koshukela egazini.Ushukela ophakeme ekuseni kakhulu ngemuva kokulala nohlobo 2 sikashukela kulungiswa ngokudluliswa kwezidakamizwa ezinciphisa ushukela ngaphambi kokulala noma ukwanda kwenani labo. Thola imininingwane efanele ngale ndaba kudokotela wakho.I-Hypoglycemia ebusukuEnye imbangela yokuthi ushukela wegazi esigulini uvamile kusihlwa, kuthi ekuseni iphakanyiswe kakhulu, kungaba yi-hypoglycemia ebusuku. Lesi simo sibonisa ukuncipha kweglucose yegazi ngesikhathi sokulala, bese kuthi ukugxuma okubukhali emahoreni okusa.I-Hypoglycemia ingabangelwa amazinga aphezulu e-insulin alawulwa ngesikhathi sokulala. Kulokhu, kuyadingeka ukulawula ushukela wegazi ngaphambi kokulala. Ngokufanelekile, inani layo kufanele libe ngu-10. Bese kukhishwa umjovo ukuze kuthi phakathi kokuphumula kobusuku, izinga likashukela lihle liye ku-4,5, bese likhuphuka liye kumayunithi ayi-6.Amanani anjalo atholakala ngokulungiswa okude futhi okuphikelelayo kwithamo le-hormone elawulwa noma ngokuthatha amaphilisi okwehlisa ushukela. Ukuvimbela i-hypoglycemia ebusuku, kufanele kuhlolwe igazi phakathi kwehora lesibili ekuseni. Ngokufanelekile, inani kufanele okungenani libe ngu-6 mmol / L.Ngaphansi kwezimo zokuhlola, ukuhlolwa ngokufakwa kwe-insulin kungasetshenziselwa lokhu, kepha ngokwenza le nqubo kungenzeka ukuthi kungenzeka. Ngalesi sivivinyo, ukubonakala kwezimpawu ze-neuroglycopenic noma ukubambezeleka kokubuyiselwa kwezinga le-glucose lokuqala ngemuva kokuncipha kwalo okubangelwa ukufakwa kwenani le-insulin ejwayelekile lisebenza njengesinkomba sokwephulwa kohlelo lwe-anti-law.Umbuzo uwukuthi ngabe izimpawu ze-hypoglycemia zingavela ngaphandle kwe-hypoglycemia se, ngokwesibonelo, ekuphenduleni kwehle ngokushesha okukhulu kwe-plasma glucose. Yize kungenakwenzeka ukuphendula lo mbuzo ngqo, kukhona ubufakazi bokuthi ijubane noma izinga lokuncipha okunjalo kusebenza njengezimpawu zokukhishwa kwamahomoni alawulayo, isibonakaliso kuphela esisezingeni eliphansi le-glucose ku-plasma.Amanani wokuncipha aleli zinga ahlukile kubantu abahlukile, kepha ngokugxila okujwayelekile noma okuphezulu kwe-glucose, ukucashelwa kwamahomoni alawulayo akhuphuki. Izimpawu ze-adrenergic ezibonwe ngemuva kwesizinda se-hyperglycemia kungenzeka kakhulu ngenxa yendlela yokuphazamiseka noma kwenhliziyo.I-Hypoglycemia ezigulini ezinesifo sikashukela nazo zingabangelwa ezinye izinto. Isibonelo, ukulimala kwezinso kusifo sikashukela kuvame ukuhambisana nokwehla kwesidingo se-insulin futhi, uma umthamo wayo ungashintshiwe, i-hypoglycemia esobala ingaqhamuka. Indlela yokunciphisa ukufunwa kwe-insulin ezimweni ezinjalo ayicacile.Noma ngesifo sikashukela i-nephropathy impilo ye-plasma uhhafu we-insulin uyanda, indima yezinye izinto nayo ayinakuphikwa. I-Hypoglycemia ingaba ngumphumela wokungapheleli kwe-adrenal kwesimo se-autoimmune - okunye ukubonakaliswa kweSchmidt syndrome, okuvame kakhulu ezigulini ezinesifo sikashukela kunesibalo sabantu bonke.Kwezinye iziguli, ukukhula kwe-hypoglycemia kuhlotshaniswa ne-titer ephezulu yama-antibodies ukufaka i-insulin egazini. Ezimweni ezinjalo, indlela ngqo ye-hypoglycemia ayaziwa. Kwesinye isikhathi iziguli ezinesifo sikashukela zingakhula i-insulinoma. Kuyaqabukela, kunokuxolelwa njalo kwesifo sikashukela sangaphandle.Izizathu zalokhu azicacile, kodwa izimpawu ze-hypoglycemia ezigulini ezinikezwe kahle ngaphambili zingaba uphawu lokuqala. Kufanele kugcizelelwe ukuthi ukuhlaselwa kwe-hypoglycemia kuyingozi futhi, uma kuphindaphindwa kaningi, kuveza izingqinamba ezinkulu noma kufe nokufa.I-hypoglycemia esebenzayo eyenzeka ngemuva kokuhlaselwa kwe-hypoglycemia ngenxa yokudedelwa kwama-hormone alawula ukubizwa ibizwa ngokuthi yi-Somogy phenomenon. Kufanele kucatshangwe njalo lapho kutholwa izinguquko ezibukhali emazingeni kashukela we-plasma ngesikhathi esifushane, noma ngabe isiguli singakhonondi.Ukushintshashintsha okusheshayo okunjalo kuhluka ngokuhlukahluka okubonwe ngesikhathi sokususwa kwe-insulin ezigulini ezinxeshezelwe kahle ngaphambili; esimeni sokugcina, i-hyperglycemia ne-ketosis kukhula kancane kancane futhi ngokulinganayo emahoreni ayi-12-24.Ukudla ngokweqile kanye nokwanda kwesisindo somzimba ngokumelene nesizinda se-hyperglycemia ekhulayo kungakhombisa umthamo owedlulele we-insulin, ngoba ukwehla kwesisindo somzimba (imvamisa kubangelwa ukwehla kwe-osmotic kanye nokulahleka kweglucose) kuvame uphawu lwesinxephezelo esibi.Uma usola into yakwaSomoji, kufanele uzame ukwehlisa umthamo we-insulin noma kungekho zimpawu ezithile zokuthi uthola i-insulinization ngokweqile. Ezigulini ezisebenzisa amaphampu we-insulin, imvelo yeSomoji ibonakala ingajwayelekile kunakulabo abathola imishanguzo ejwayelekile noma imijovo eyodwa ye-insulin.Isimo sokuntwela kokusa sibizwa ngokuthi ukwanda kwe-plasma glucose ekuseni kakhulu, okudinga inani elikhulu le-insulin ukuze kugcinwe i-euglycemia. Noma, njengoba kuphawuliwe ngenhla, i-hyperglycemia yasekuseni ingahle ihlotshaniswe ne-nocturnal hypoglycemia, izehlakalo zokusa kokusa njengoba kunjalo zithathwa njengezimele enkambweni yento ye-Somoji.Ukubaluleka okuyinhloko kunikezwa ukukhululwa ebusuku kwe-hormone yokukhula. Esikhathini sasekuseni kakhulu, kusheshe futhi ukuqashelwa kwe-insulin clearance, kepha lokhu kungenzeka kungadali indima eholayo. Umuntu angahlukanisa into eyenzeka ekuseni kakhulu kusuka ku-posthypoglycemic hyperglycemia, njengomthetho, ngokuthola izinga le-glucose egazini ngo-3 ekuseni.Lokhu kubalulekile, njengoba isici Somoji singasuswa ngokunciphisa umthamo we-insulin isikhathi esithile, futhi into yokusa yokusa, ngokuphambene nalokho, idinga ukwanda komthamo we-insulin ukuze kulondolozwe amazinga evamile eglucose. Izindlela zomlomo.Ukwelashwa kweziguli ezinesifo sikashukela esingancikileli i-insulin, esingenakunxeshezelwa ngokudla kokudla, amalungiselelo e-sulfonyl-urea asetshenziswa kaningi. Akunzima ukusebenzisa lezi zinto, futhi ngokusobala azinabungozi.Ukukhathazeka okuvezwe emibikweni ye-University Diabetesological Group (UDG) mayelana nokwanda kokushona kwabantu ngenxa yesifo senhliziyo ngenxa yokusetshenziswa kwalezi zimali kwaqedwa ngenxa yokungabaza kohlelo lokufunda.Ngakolunye uhlangothi, ukusetshenziswa okubanzi kwama-ejenti omlomo kuvinjelwa umbono wokuthi ukunxephezelwa okungcono kwesifo sikashukela kunganciphisa ukuthuthuka kwezinkinga zawo zakamuva. Yize kwezinye iziguli zinenkinga yesifo sikashukela esilinganiselwe, amazinga e-plasma glucose ajwayelekile ngaphansi kwethonya lama-ejenti omlomo, kepha ezigulini ezine-hyperglycemia ephezulu, uma yehla, akuyona into evamile.Ngakho-ke, njengamanje, iphesenti elikhulu leziguli ezinesifo sikashukela esingancikile i-insulin zithola i-insulin. Ukulungiswa kwe-Sulfonylurea kusebenza kakhulu njengezithuthukisi zokufihlwa kwe-insulin ngama-p-cell.Kodwa-ke, ukuthuthuka okumangazayo kwe-glucose metabolism lapho kungekho ukwanda okuqhubekayo kwamazinga e-insulin kwachazwa lapho kukhonjiswa ukuthi ngokwanda kweshukela kufinyelela ezingeni elibonwe ngaphambi kokwelashwa, ukuqina kwe-insulin insulin kulezi ziguli kukhuphukela emazingeni aphakeme kunangaphambi kokwelashwa.Ngakho-ke, lezi zinto ziqala ukukhulisa ukuvikelwa kwe-insulin bese ngokwenza kanjalo zinciphisa ushukela we-plasma. Njengoba ukucindezelwa kweglucose kunciphisa, amazinga e-insulin nawo ancipha, ngoba i-plasma glucose iyisikhuthazo esiyinhloko sokugcinwa kwe-insulin.Ngaphansi kwezimo ezinjalo, umphumela we-insulinogenic wezidakamizwa ungabonakala ngokwandisa okuqukethwe kwe-glucose ezingeni lokuqala eliphakeme. Iqiniso lokuthi amalungiselelo e-sulfonylurea alisebenzi ku-IDDM, lapho ubuningi bamaseli e-p-seli buyehliswa, iqinisekisa umqondo wendima ehola phambili yesenzo sokukhishwa kwalezi zidakamizwa, yize ngokungangabazeki izindlela ezibalulekile nezenzo zazo zibalulekile.Izithako ezifana ne-glipizide ne-glibenclamide ziyasebenza ngemithamo emincane, kepha kwezinye izinto azihlukile kakhulu kuma-ejenti amade anjenge chlorpropamide ne-butamide. Iziguli ezinomonakalo obalulekile wezinso kufanele zichazwe nge-butamide noma i-tolazamide (Tolazamide), ngoba zitholwa futhi zisetshenziswe kuphela kuI-Chlorpropamide iyakwazi ukuzwela ama-rebu tubules kwisenzo se-antidiuretic hormone. Ngakho-ke, kusiza ezinye iziguli ezinesifo sikashukela esilinganayo, kepha ngesifo sikashukela kungadala ukugcinwa kwamanzi emzimbeni.Lapho usebenzisa ama-ejenti omlomo, i-hypoglycemia ayivamisile ukwedlula lapho usebenzisa i-insulin, kepha uma kwenzeka, ivame ukuziveza inamandla futhi ihlala isikhathi eside. Ezinye iziguli zidinga ama-infusions amakhulu we-glucose ezinsukwini eziningana ngemuva kokuthatha umthamo wokugcina we-sulfonylurea.Ngakho-ke, esimweni se-hypoglycemia ezigulini ezithola izidakamizwa ezinjalo, ukulaliswa esibhedlela kuyadingeka. Ezinye izidakamizwa zomlomo ezisebenza kahle kushukela labadala zifaka ama-biguanides kuphela.Lezi zihlanganisi zivame ukusetshenziswa kuphela ngokuhlanganiswa namalungiselelo we-sulfonylurea, lapho isinxephezelo esanele singeke satholakala ngosizo lwakamuva kuphela. Njengoba ukushicilelwa okuningi kuxhumanise ukusetshenziswa kwe-phenformin kanye nokwenziwa kwe-lactic acidosis, i-Food and Drug Administration ikuvimbile ukusetshenziswa kwemitholampilo kwaleli ciko e-United States, ngaphandle kwezinye izimo uma kuqhubeka ukusetshenziselwa izinjongo zocwaningo.Kwamanye amazwe, i-phenformin namanye ama-Biguanides asasetshenziswa. Akufanele zinikezwe iziguli ezine-renal pathology futhi kufanele zikhanseliwe uma kunenhliziyo, ukuhlanza, isifo sohudo, noma yisiphi isifo esenzeka ngasese.Lezo ziguli ezivame ukunquma ukugcwala kweglucose egazini lazo ukuze zikhethe umthamo we-insulin zingasungula kalula inani eliphakathi noshukela. Njengamanje, iningi labanesifo sikashukela basebenzisa ukuzimisela kwenqanaba le-hemoglobin A1c ukuhlola izinga lesinxephezelo isikhathi eside ukuze kubhekwe ukunemba kokuzithiba.Ukungondleki kanye nokujovaEsinye isizathu okungenzeka ukuthi ushukela wegazi lesiguli ekuseni ukhulu ukwedlula kusihlwa kungenxa yokungondleki kahle.Uma ukudla kokugcina ngaphambi kokulala kuqukethe inani elikhulu lamafutha kanye nama-carbohydrate, izinga likashukela ekuseni lizoba liphezulu kakhulu. Ukulungiswa kokudla okunomsoco kuzosiza bobabili ukunciphisa ushukela wasekuseni (ukuzila ukudla) kanye nokugwema ukulungisa i-insulin nokwandisa umthamo wezidakamizwa ezokwehlisa ushukela.Ezigulini ezinesifo sikashukela i-mellitus, ifomu elincike ku-insulin lingadala ukwanda koshukela ngenxa yomjovo ongafanele. Kubalulekile ukukhumbula le mithetho elandelayo futhi ungayinaki.Ukufakwa kwe-insulin ende kubekwe ethangeni noma emabhulokeni. Ukufakwa kwalesi sidakamizwa esiswini kuholela ekunciphiseni kwesikhathi somuthi futhi kunciphise ukusebenza kwawo.Indawo yomjovo kufanele iguqulwe njalo. Lokhu kuzosiza ukuvikela ukwakheka kwezimpawu ezinzima, eziphazamisa ukungena kwejwayelekile kwehomoni.Uma ujovwa, kufanele kwakheke i-crease esikhumbeni. Lokhu kuzovikela i-hormone ukuthi ingangeni emsipheni, okunganciphisa kakhulu ukusebenza kwawo.Abantu abaningi bayazibuza ukuthi kungani ushukela wegazi esigulini kusihlwa uphakeme ukwedlula ngokushesha kokulala ekuseni. Eqinisweni, lesi yisimo esejwayelekile, ngesikhathi sokuphumula ebusuku, ushukela kufanele unciphe kancane ngaphansi kwethonya le-insulin noma i-metformin, uma uqhathanisa nezinkomba zakusihlwa.Ungawagwema kanjani amaphutha?Imvamisa kufanele ulungise ukwelashwa ngokwakho, ngaphandle kokubonana nodokotela. Ukuze uvikele amaphutha, kufanele ugcine njalo idayari lapho uqopha izinkomba ze-glucose, inani lomuthi olawulwa nemenyu.Lokhu kuzokuvumela ukulandelela amandla okukhula noma ukuncipha kwe-glucose egazini, kuya ngenani lezidakamizwa nesikhathi sokuphathwa kwazo.Noma kunjalo, uma kungenzeki ukwehlisa i-glucose yasekuseni ngokwakho, kubalulekile ukuxhumana nodokotela we-endocrinologist. Ukubonisana nochwepheshe kuzosiza ekugwemeni amaphutha angakhona ekwelashweni futhi kuxwayiswe ngokuthuthukiswa kwezinkinga.Uma amandla wezezimali evumela, iziguli ziyalulekwa ukuthi zithenge iphampu ye-insulin, ukusetshenziswa kwayo kusiza kakhulu isingeniso nokulungiswa.Imininingwane ekulesi siza ihlinzekelwe kuphela izinjongo ezithandwayo zemfundo, ayisho isithenjwa nokunemba kwezokwelapha, akuyona umhlahlandlela wesenzo. Ungazindli.Kungani lokhu kuyabonakalaUma sikhuluma ngokulawulwa komzimba kwama-hormone ngokomzimba, khona-ke ukwanda kwe-monosaccharide egazini ekuseni kuyinto evamile. Lokhu kungenxa yokukhishwa kwansuku zonke kwe-glucocorticoids, ukukhishwa okuphezulu kakhulu okwenziwa ekuseni.Kumuntu ophile kahle, ukukhishwa kwe-glucose kunxephezelwa yi-insulin, ekhishwa yi-pancreas ngenani elifanele. Ku-mellitus yesifo sikashukela, kuye ngohlobo, i-insulin ayikhiqizwa ngenani elidingeka ngumzimba, noma ama-receptors asezicubu ayamelana nalo. Umphumela uba yi-hyperglycemia.Kubaluleke kakhulu ukunquma izinga likashukela kaningana phakathi nosuku ukuze kutholakale into yokuqala yokusa ngesikhathi.Yini ubungozi be-ekuseni dawn syndrome nokuthi ungayithola kanjani le nkinga?Futhi, ukuthuthukiswa kwezimo ezixakile ngenxa yokushintshashintsha okubukhali kushukela wegazi akunakwa. Izimo ezinjalo zifaka i-coma: hypoglycemic, hyperglycemic, ne-hyperosmolar. Lezi zingqinamba zanda ngejubane lombani - ukusuka emaminithini ambalwa kuya emahoreni ambalwa. Akunakwenzeka ukubikezela ukuqala kwabo ngokumelene nesizinda sezimpawu ezikhona manje.Ithebula "Izinkinga ezinzima zesifo sikashukela"Lesi simo siyingozi i-hyperglycemia eyingozi, engami kuze kube ngumzuzu wokuphathwa kwe-insulin. Futhi njengoba wazi, ukuguquguquka okunamandla ekuqoqweni koshukela egazini okujwayelekile kwawo kusuka ku-3.5 kuye ku-5.5 mmol / l, kunomthelela ekuthuthukiseni okusheshayo kwezinkinga.Futhi, i-syndrome yokusa kokusa iyingozi ngoba ivela kaningi, kodwa yenzeka esigulini nsuku zonke ngokumelene nesizinda sokukhiqizwa ngokweqile kwama-hormone we-contra-hormonal ekuseni. Ngenxa yalezi zizathu, i-carbohydrate metabolism iyaphazamiseka, okwandisa kakhulu ingozi yokuba nezinkinga zesifo sikashukela.Kuyaqapheleka ukuthi kubalulekile ukukwazi ukuhlukanisa umphumela wokuvela kokusa entweni yakwaSomoji. Ngakho-ke, into yokugcina ibonakaliswa ngokweqile kwe-insulin, okwenzeka ngokumelene nesizinda se-hypoglycemia nokuphendula kwe-posthypoglycemic ngokushesha, nangenxa yokuntuleka kwe-insulin ye-basal.Ukuthola i-hyperglycemia yasekuseni, kufanele ulinganise ukugcwala kwe-glucose egazini ubusuku nobusuku. Kepha ngokuvamile, isenzo esinjalo sinconywa ukuba senziwe kusukela ngo-2 kuye ku-3 ebusuku.Uma phakathi nalesi sikhathi sesikhathi bekungekho ukwehla okuphawulekayo ekuqoqweni kwe-glucose egazini ngokuqhathaniswa nobusuku, kepha, ngokuphambene nalokho, kukhona ukwanda okufanayo kwezinkomba, khona-ke singakhuluma ngokuthuthukiswa komphumela wokusa kokusa.
