Ciwon sukari - cuta na rayuwa

Cikakken rashin isasshen insulin (lahani na farko a cikin cutar sankara) yana haifar da cin zarafin kowane nau'in metabolism, kuma, sama da duka - carbohydrate:

increasedara yawan gluconeogenesis sakamakon asarar tasirin insulin akan enzymes gluconeogenesis,

haɓaka glycogenolysis a ƙarƙashin rinjayar glucagon, ƙara gluconeogenesis da glycogenolysis yana haifar da wuce haddi na glucose a cikin jini, kuma

canjawarsa ta cikin membranes a cikin kasusuwa masu dogaro da insulin saboda rashin insulin.

Saboda haka, a peculiar wani sabon abulokacin da jiki yake fuskantar matsananciyar yunwar tare da wuce haddi mai yawa na tushen kuzari a cikin jini.

Hyperglycemia - babban alamar cutar sankarau - yana ƙaruwa plasma osmolaritykuma yana kaiwa zuwabushewar sel. Da zaran bakin mutum na shiga glucose (8-10 mmol / L) ya wuce, yana fitowa a cikin fitsari, yana haifarglucosuriadapolyuria(alamun bayyanar cutar DM). Polyuria yana da alaƙa da lalacewar reabsorption na ruwa da electrolytes saboda yawan osmolarity na fitsari na fari. Polyuria da cutar sankaraƙishirwadapolydipsiakazalikanocturia(alamun bayyanar cutar DM).

Osmotic diuresis yana haifar da ciwo mai tsanani jimlar rashin ruwa a jikidamarsamaria. Sakamakon rashin ruwa shinehypovolemia, rage karfin jini, haɓakar ƙanshin ƙwaƙwalwa, ƙwalla, rage ƙurar fil,oliguria(har zuwa haɓaka ta rashin aiki mai haɓaka). Bugu da kari, saboda rashin ruwa, toshewar jini na faruwa, barkewar jini, ICE ta bunkasa, kuma rikicewar microcirculation yana haifar dahypoxiakyallen takarda.

Hyperglycemia kuma yana haifar da kunnawa sake zagayowar polyol(ta kunna aldoreductase). Yana rayuwa insulin-insulin-metabolism din tare da samuwar sorbitol da fructose. Wadannan samfuran suna tarawa a cikin kyallen da ba ta da insulin (ruwan tabarau, ƙwayar jijiya, ƙwayoyin hanta, ƙwayoyin jan jini, ganuwar jijiyoyin bugun gini, basophilic insulocytes) kuma, kasancewa osmotic, suna jawo ruwa, wanda ke haifar da lalacewar waɗannan kyallen takarda.

Hyperglycemia ta hanyar tarin sorbitol (sabili da haka, raguwa na NADPH reserve₂), kuma saboda raguwa a cikin aiki na furotin kinase C, yana haifar da raguwa a cikin kiranitric oxide (tushen nutsuwa), wanda ke haifar da vasoconstriction da ischemia na nama,

Hyperglycemia kuma yana haifar da hyalinosisda kuma thickening ganuwar jini (hyalinosis - samuwar glycoproteins, wanda, wucewa ta cikin ginshiki membrane na capillaries, sauƙin fada kuma ana hyalinized).

Hyperglycemia yana motsa tsari furotin glycosylation(glycosylation shine tsari na rashin haɗin enzymatic na glucose tare da gungun amino). Sakamakon haka, an samar da samfuran barikin glycosylation:

glycosylated haemoglobin. Kasancewa da babban kusanci ga oxygen, ba shi zuwa kyallen ba, hypoxia yana tasowa,

glycosylated apoproteins na LDL da HDL, wanda ke haifar da karuwa a cikin rabo na LDL / HDL.

glycosylation na sunadarai na coagulation da tsarin maganin anticoagulation, wanda ke haifar da haɓakar thrombosis,

glycosylation na asali sunadarai na ginshiki membrane da collagen,

glycosylation na myelin, wanda ke haifar da canji a tsarin jikin wuƙancinta,

glycosylation na ruwan tabarau na ruwan tabarau, wanda ke haifar da ci gaban cututtukan cataracts,

glycosylation na jigilar insulin, wanda ke haifar da juriya na insulin, da sauransu.

Duk samfuran glycosylation suna da tsari mai canzawa, wanda ke nufin cewa zasu iya mallakar kaddarorin antigenic, sakamakon abin da lalacewar autoimmune yake da gabobin dake dacewa da jijiyoyin jikinsu.

Rashin insulin kuma yana haifar da ci gaba lactic acidosis. Hanyoyin:

Rashin insulin yana haifar da hanawa na dehydrogenase na pyruvate, sakamakon wanda PVA baya juya zuwa AcCoA (ƙonewa a cikin c. Krebs). A wannan yanayin, yawan PVC ya zama lactate,

karancin insulin na habaka catabolism na furotin, wanda yakan kai ga haifar da adadin abubuwan da suka dace don samar da pyruvate da lactate,

hypoxia na nama, kazalika da karuwa a cikin ayyukan ƙwayoyin haila (musamman adrenaline da STH) yana haifar da kunnawa na glycolysis anaerobic, wanda ke nufin karuwa a cikin samuwar lactate.

Fat metabolismtare da nau'in ciwon sukari na 1 na sukari, suna da alaƙa da rashin isasshen insulin da haɓaka cikin ayyukan ƙwayoyin haila. Wannan yana haifar da raguwa a cikin amfani da glucose ta hanyar tsopose nama yayin rage lipogenesis da haɓakar lipolysis. (marassa lafiya da nau'in ciwon sukari na 1 suna bakin ciki).

A sakamakon haka, ketogenic amino acid (leucine, isoleucine, valine) da FFA sun shiga hanta, inda suka zama madadin abubuwan da suka wuce kima na jikin ketone (acetoacetic, b-hydroxybutyric, acetone). Yana tasowarashin lafiya.

Mai guba da yawa daga jikin ketone:

hana ayyukan insulin da hana shi,

narke membrane tsarin lipids, wanda ke haɓaka lalacewar sel,

hana ayyukan da yawa enzymes,

hana ayyukan tsarin na tsakiya,

haifar da ci gaban ketoacidosis,

sanadiyyar haɓakar shagala,

keta hemodynamics: hana ƙwanƙwasa ƙwayar myocardial da rage hawan jini sakamakon faɗaɗa tasoshin wurare.

Rashin lafiyar metabolismtare da ciwon sukari ana rarrabe su ta:

hanawa daga cikin sunadaran gina jiki (insulin yana aiki da kwayar halittar enzymes) da

increaseara yawan lalacewarsa a cikin tsokoki (insulin yana hana enzymes gluconeogenesis, tare da rashin insulin, AK yana zuwa haɓuwar glucose),

Bugu da kari, ana lalata diskin AK ta hanyar membranes cell.

Sakamakon haka, rashi mai gina jiki a cikin jiki, wanda yake haifar da:

tsumburai girma a cikin yara

to kasawa na filastik tafiyar matakai,

rauni waraka

rage kayan Ati

rage juriya ga kamuwa da cuta,

Bugu da ƙari, canji a cikin halayen antigenic na sunadarai na jiki na iya haifar da abubuwan sarrafa kansa.

Abun Lalacewar Cutar RanaAn rarraba cikin m da na kullum. M rikice-rikice na ciwon sukari - coma. Na kullum - angiopathies da neuropathies.

An rarraba angiopathies masu ciwon sukari zuwa kananan micro- da macroangiopathies.

Microangiopathies masu ciwon sukari - canje-canje na cututtukan jini a cikin tasoshin microvasculature.

jari na sorbitol da fructose a cikin jirgin ruwa bango,

samfuran glycosylation sunadarai na membrane na kanti,

hyalinosis daga cikin jirgin ruwa bango,

A sakamakon haka, an keta tsarin, metabolism da ayyuka na bangon jirgin ruwa, ischemia nama yana tasowa. Babban nau'ikan microangiopathies: retinopathy da nephropathy.

Rashin maganin ciwon sukari- microangiopathy na jiragen ruwan kashin baya, a cikin matakin karshe wanda ke kaiwa ga cikar asarar hangen nesa. Microaneurysms, maculopathy, basur mai narkewa. Abun rikice-rikice - kashin baya, na biyu na glaucoma.

Ciwon mara na Nephropathy- takamaiman lalacewar microvasculature na tasoshin kodan, tare da ƙirƙirar nodular ko yaduwar glomerulosclerosis da CRF a cikin matakan ƙarewa.

Macroangiopathy mai ciwon sukari- lalacewar arteries na matsakaici.Hanyoyin:

glycosylation na ginshiki membrane sunadarai,

jari na sorbitol da fructose a cikin jirgin ruwa bango,

Duk wannan yana haifar da faduwa, rage walwala daga jikin bangon jirgin ruwa, karuwar girman jiki, bacewar masu karban heparin, karuwar farawar platelet, da kuma karfafa kwayar halitta mai narkewa, wanda ke nufin zuwa farko da ingantaci gabaatherosclerosis. Babban siffofin masu ciwon sukari macroangiopathies:

lalacewa ta hanyar zuciya, saboda haka, cututtukan zuciya da kasala na zuciya kamar yadda rikitarwa,

lalacewar jiragen ruwa na hanji kamar na shanyewar jiki, raunin jijiyoyin jiki na yaduwa da nakasa,

bayyananniyar raunuka daga cikin tasoshin ƙananan ƙananan a cikin tsinkaye mara ma'ana, necrosis, gangrene.

Ciwon mara mai cutar kansa- lalacewar tsarin juyayi a cikin cutar sankara.

na kewaye jijiya furotin glycosylation,

Samuwar ƙwayoyin rigakafi zuwa ingantattun sunadarai da autoaggression dangane da antigens na ƙwayar jijiya,

jari na sorbitol da fructose a cikin ƙwayoyin neuroron da Schwann sel,

rage NO kira a cikin jirgin ruwa bango.

Duk wannan yana haifar da rushewar jijiyar jijiyar jiki, raguwa a cikin kwayar ta myelin, da raguwa a cikin yanayin motsawar jijiyoyi. Siffofin da ciwon sukari mai ciwon sukari:

Lalacewar CNS (encephalopathy, myelopathy),

lalacewar jijiya (polyneuropathy, mononeuropathy): rikicewar motsi da azanci,

lalacewar jijiyoyin zuciya (autonomic neuropathy): rikice-rikice na ƙayyadaddun aikin zuciya, sautin jijiyoyin bugun gini, mafitsara, ƙwayar gastrointestinal.

Angiopathies da neuropathies na iya haifar da rikice-rikice na ciwon sukari kamar ƙafar masu ciwon sukari.

Kafar ciwon sukari- Yanayin da ke tattare da ƙafafun kafa a cikin ciwon sukari, wanda ke nuna lalacewar fata da kyallen takarda mai taushi, ƙasusuwa da gidajen abinci kuma an nuna su a cikin nau'ikan cututtukan trophic, canje-canje haɗin gwiwa da purulent-necrotic ሂደቶች (har zuwa gangrene).

M rikice-rikice na ciwon sukari - coma.

Cutar masu ciwon sukari. Dalilin kai tsaye ga cigaban cutar sikari (DC) a cikin masu ciwon suga ba ciwon sukari bane a jikinta, tunda ba lallai ba ne tsarinta ya rikitarwa.fitina.

Decompensated ciwon sukari- yanayin da rikice-rikice na rayuwa da ayyukan gabobin da ke cikin cutar ya kai matsayin mai mahimmanci kuma yana haɗuwa da mummunan bala'i na homeostasis: hyperosmolarity da bushewa, dyselectrolythemia, ketoacidosis, lactic acidosis, hypoxia mai tsanani, da dai sauransu Wasu daga cikin waɗannan canje-canje na ilimin halittu masu iyawarushe kwakwalwa, wanda ke nufin haifar da ci gaba.

Ya danganta da nau'in ciwon sukari na mellitus da halaye na abubuwanda ke haifar da damuwa, ko dai ketoacidosis, ko hyperosmolarity, ko lactic acidosis na iya rinjaye a cikin wani haƙuri. Game da wannan, akwai zaɓuɓɓuka guda uku don DC:

ketoacidotic hyperglycemic coma,

hyperosmolar hyperglycemic coma,

Wadannan bambance-bambancen guda 3 na DC suna da alaƙa iri ɗaya da ke da alaƙa da lalata cututtukan ƙwayar cuta, amma tare da fifikon ƙwayar cuta a cikin kowane yanayi.

Type 1 Ciwon sukari (IDDM)

Jiki ba ya samar da insulin. Wasu mutane suna ambatar wannan nau'in kamar ciwon sukari-wanda ke dogara da sukari, ciwon sukari na yara ko ciwon sukari-farko. Yawancin nau'in ciwon sukari na 1 ana yinsa sau da yawa kafin shekaru 40, yawancin lokaci a farkon girma ko lokacin samartaka. Nau'in nau'in 1 ba shi da yawa kamar na biyu. Kimanin 10% na duk cututtukan cututtukan cututtukan ƙwayar cuta sune nau'in 1. Marasa lafiya da ke da nau'in ciwon sukari na 1 ya kamata allurar insulin har tsawon rayuwarsu. Hakanan ya kamata su tabbatar da matakan glucose na jini ta hanyar yin gwaje-gwajen jini na yau da kullun da kuma bin abinci na musamman. Abin takaici, ciwon sukari na nau'in 1 har yanzu ba shi da magani, ba tare da insulin a cikin wannan cuta ba, mummunan nau'in raunin jiki yana faruwa da sauri, bayan haka mummunan sakamako. Rikice-rikice na dogon lokaci na nau'in 1 na ciwon sukari (sakamakon kamuwa da cutar malaria) na iya zama: makanta, ciwon zuciya, gazawar koda, rashi haƙori, ƙarancin ciki, raunin trophic (har zuwa yanki da ƙafar ƙafa).

Type 2 ciwon sukari (NIDDM)

Jiki ba ya samar da isasshen insulin don aiki daidai, ko ƙwayoyin da ke jikin ba su amsa insulin (jure insulin). Kusan 90% na duk cututtukan sukari a duk duniya suna da ciwon sukari na 2.

Wasu mutane suna iya sarrafa alamun su na kamuwa da ciwon sukari na 2, rasa nauyi, kiyaye ingantaccen abinci, motsa jiki da sarrafa matakan glucose na jini. Koyaya, nau'in 2 yawanci cuta ce mai ci gaba - sannu a hankali yana ƙaruwa - kuma mara lafiya dole ne a ƙarshe ya ɗauki magungunan rage sukari, ko ma injections.

Yawan masu kiba da masu kiba suna da babban haɗari na haɓaka nau'in 2 idan aka kwatanta da mutane masu ƙoshin lafiyar jiki. Mutane masu yawan kitse ciki, wanda kuma aka sani da kiba na tsakiya, mai mai ciki, ko kiba mai ciki, suna cikin haɗari.

Kuma hadarin kamuwa da ciwon sukari na 2 shima ya fi girma yayin da muke tsufa. Masana ba su da tabbas game da abin da ya sa, amma sun ce yayin da muke tsufa, muna ɗaukar nauyin nauyi kuma mu zama ba ma ɗan motsa jiki. Mutanen da dangi na kusa basu da lafiya ko suna da nau'in 2 suna cikin haɗarin kamuwa da cutar.

Ciwon sukari yayin daukar ciki (cutar sankarar mahaifa)

Wannan nau'in yana shafar mata yayin daukar ciki. Wasu mata suna da matakan glucose na jini sosai, jikinsu ya kasa samar da isasshen insulin don jigilar dukkan glucose zuwa sel, wanda hakan ke haifar da haɓakar glucose a hankali. Ana gano ciwon sukari a lokacin daukar ciki.

Yawancin marasa lafiya da ciwon sukari a lokacin daukar ciki na iya sarrafa rashin lafiyar su ta hanyar motsa jiki da abinci. Amma har yanzu 10% -20% daga cikinsu ya kamata su ɗauki wasu magunguna don sarrafa glucose jini. Ciwon mara ko rashin kula da cutar siga yayin haihuwa yana iya kara hadarin matsaloli yayin haihuwa. Ana iya haihuwar jariri mafi girma.

Farkon cutar sankara

Ya kamata a lura cewa rasa nauyi (aƙalla 5 zuwa 10 bisa dari na nauyinku na farawa) na iya hana ko jinkirta ciwon sukari ko ma warkar da ciwon suga gaba ɗaya. Duba: Kwayoyin rigakafin cutar Kiba

Mafi yawan masu haƙuri da ke da nau'in 2 da farko suna da ciwon sukari na farko. Yawancin mutanen da ke da ciwon sukari masu tasowa ba su da alamun cutar. Likita na iya duba jininka don ganin ko matakan glucose na jininka sun yi yawa sama da na al'ada. A cikin pre-ciwon sukari, matakan glucose na jini suna sama da al'ada, amma basu isa sosai don kamuwa da cutar sankarau ba. Kwayoyin jikin sun zama suna tsayayya da insulin. Nazarin ya nuna cewa har ma a cikin farkon-ciwon sukari, wasu lalacewar tsarin zuciya da jijiyoyin jini sun riga sun faru.

* Don amfani da ƙimar amfani da ƙwayoyin halittar ƙwayoyin cuta a cikin ƙirƙirar ƙwayoyin cuta don magancewa da rigakafin cutar dyslipidemia da ciwon sukari, duba bayanin probiotic "Bifikardio":

OBESITY, INSULIN DA CARBOHYDRATES

KO 12 matakai akan hanyar zuwa canji

Tunda yawan kiba yana ɗayan abubuwan ƙayyade abubuwan ci gaba na ciwon sukari, zai zama da amfani a fahimci yadda wannan tsari yake faruwa a cikin jiki da abin da yake tsokanar shi.

Algorithm mai kiba ana iya wakilta kamar haka: 1. kuna tunani game da abinci, 2. kun fara sakin insulin, 3. insulin yana bawa jiki siginar don adana kitse mai ƙonawa ba ƙone su ba, yana fitar da kuzari, 4. kuna jin yunwa, 5. Ciwon jini ya hauhawa, 6. carbohydrates mai sauqiqin yana shiga cikin jininka a cikin hanyar glucose; 7. ka fara tono insulin sosai; 8. ka fara cin abinci, 9. zaka toshe insulin sosai, 10. Ana sanya kitse a jikin kitse kamar triglycerides; 11. Kwayoyin mai Yakan yi kiba 12 sosai

Fats koyaushe kuzo ku tafi daga sel. Kuma muna murmurewa daga wadancan kitsen da ya rage a jikin su. An adana mai a cikin ƙwayar mai a cikin nau'in triglycerides. An samar da Triglycerides daga abubuwa masu kitse guda uku da ke hade da kwayoyin glycerol guda daya cikin kwayar mai. Sun yi girma da yawa don fita zuwa cikin membranes na sel mai, sabanin acid mai, wanda yakan fita da sauƙi. I.e. yayin da ake tara abubuwan triglycerides, mafi girma sel sun zama, mafi girma mu zama.

Carbohydrates akwai sauki (mai sauri) da hadaddun abubuwa. Carbohydrates mai sauri ko mai sauƙi sune mahadi wanda ya ƙunshi kwayoyin monosaccharide ɗaya ko biyu, kuma sune mafi cutarwa dangane da haifar da kiba.

Ana rarraba ƙananan carbohydrates zuwa rukuni biyu:

• Monosaccharides (glucose, fructose, galactose),
• Disaccharides (sucrose, lactose, maltose)

Kayan carbohydrates masu sauki ana sha nan take ta hanyar shigar da glucose a cikin jini. Wannan kuma yana ba da gudummawa ga samar da insulin.

Insulin - Wannan shine babban mai sarrafa metabolism. Ya dogara da matakinsa ko za a samar da ƙwayoyin mai ko rarraba. Lokacin da matakan insulin suka tashi, enzyme lipoprotein lipase - (LPL) yana aiki, wanda ke da alhakin haɓakar mai a cikin sel. I.e. yayin da ake samarda insulin din, mafi yawan aiki LPL shine yake yin tukin sel tare da mai.

Don haka, samar da isulin shine ya haifar da carbohydrates. Yawan da ingancin carbohydrates ɗin da aka cinye zai ƙayyade adadin mai da aka adana.

Kuma hakan yana nufin

carbohydrates kara insulin -

- insulin na inganta adon mai

A kan batun, gani kuma:

Kasance cikin koshin lafiya!

SANARWAGAME DA YAWAN MAGANGANU