Likarolo le liphapang tsa LADA-lefu la tsoekere

Lefu la tsoekere - lefu le bakoang ke ho se sebetse hantle ha tsamaiso ea endocrine, le bakang ho se sebetse hantle ha metabolism ea carbohydrate le ho eketseha ha glucose maling.

Pathology e na le mefuta e fapaneng e fapaneng le lisosa tsa eona le mekhoa ea kalafo. E 'ngoe ea mefuta ena ke lefu la tsoekere la LADA.

Tlhophiso ea mantlha ea mathata a metabolism ea carbohydrate

Ho ea ka sehlopha, lefu la tsoekere le arotsoe ka mefuta e meholo e latelang:

1. Mofuta oa 1 o itšetlehileng ka insulin. Mofuta ona oa lefu o nkuoa e le ntho e tloaelehileng ebile o fumanoa bongoaneng le bohlankaneng. Tšobotsi e ikhethang ea lefu la tsoekere la mofuta oa 1 ke tlhahiso ea insulin e sa lekanang ka lebaka la ts'enyo ea lithane tsa pancreatic. Ho boloka tsoekere e maling maling ka tekanyo e amohelehang ho etsoa ka ho pheta khafetsa monko oa lihormone ka ente.
2. Mofuta o mong o ikemetseng oa insulin oa 2. Mofuta ona oa pathology o hlaha khahlano le semelo sa ho se arabeloe ha li-cellular receptor ho ea ho hormone, mme ha ho na khaello ea insulin 'meleng. Mofuta oa 2 oa lefu la tsoekere o fumanoa ho bakuli ba lilemo li mahareng le ba tsofetseng, ba tloaeloang ho nona haholo le ho phela hamonate ntle le ho ikoetlisa. Phekolo e tšehetsang e thehiloe ho latela ho latela lijo, ho eketsa ts'ebetso ea 'mele le ho sebelisa meriana e theola tsoekere le ho ntlafatsa kutloisiso ea receptor.

Ka mefuta e fapaneng:

1. MOTHO-lefu la tsoekere ke oa sehlopha sa A 'me o hlaha ka lipilisi tsa manyeme.
2. Mokhoa oa bongaka ke oa sehlopha sa B 'me o tsoela pele ho susumetsoa ke ho sebelisa meriana.
3. C-class, e thehiloeng khahlano le semelo sa mathata a endocrine;
4. LADA, e tsejoang ka hore ke lefu la tsoekere la autoimmune. Mefuta ena e na le matšoao a mefuta ea 1 le ea 2, ha ho bapisoa le mofuta oa pele feela, matšoao a hlahella hamorao.

Matšoao a mantlha a bokuli ba carbohydrate metabolism ke:

• ho phahama khafetsa ha ho ntša metsi le ho ntšoa ha bongata ba moroto o mongata;
• maikutlo a eketsehileng a lenyora le tlala;
• boikutlo ba molomo o omileng;
• ho fokotseha ha ts'ebetso khahlano le semelo sa ho tepella kapele;
• tsoekere e eketsehang, e tsamaeang le makhopho a matla, chores, le ho tsekela.

Tsoelo-pele, pathology e matlafatsa ts'ebetso ea ho petsoha ha lisele tsa mafura, e lebisang ho bopeng 'mele oa ketone le nts'etsopele ea ketoacidosis, e bakang lipontšo tse joalo:

• lenyora le sa feleng;
• ponahalo ea polasetiki puong;
• maikutlo a monko le monko oa acetone;
• linako tsa ho hlatsa.

Ho ipapisitse le mofuta oa tlolo, matšoao a ka 'na a bua haholo kapa a fokola, a hlahella qalong ea lefu lena (le mofuta oa 1), kapa lefu lena le ka' na la bonahala le le teng ka nako e telele (mofuta oa 2).

Phapang lipakeng tsa LADA-lefu la tsoekere ho tsoa mefuteng e meng ea lefu lena

Phapano ke efe lipakeng tsa lefu la tsoekere la LADA le mefuta e meng ea lefu la tsoekere? Mofuta ona ke mofuta oa morao-rao oa lefu la tsoekere la pele, o tsoela pele ho latela boemo ba lefu la mofuta oa 2.

Ka LADA, lisele tsa pancreatic li senngoa ka botlalo ka lebaka la ho pepesetsoa li-antibodies tse hlahisoang ke sesole sa 'mele.

Ka mantsoe a mang, ts'ebetso ea ho se sebetse hantle ea metabolic e tšoana le mofuta oa lefu le itšetlehileng ka insulin. Empa tlolo ea molao e se e fumanoe ho batho ba baholo, e leng tšobotsi ea lefu la tsoekere la mofuta oa 2.

Ho felisoa ka botlalo ha tlhahiso ea tlhaho ea insulin ho etsahala ka nako e khutšoane ho tloha qalong ea kholo ea lefu lena. Kamora lilemo tse 1-3, lisele tsohle tsa beta tse ikarabellang bakeng sa tlhahiso ea lihormone lia shoa.

Ka lebaka la khaello ea lihormone, tsoekere e bokellana, e lebisang ho hyperglycemia, 'me' mele o koahela ho hloka matla ke ho phatloha ha lisele tsa mafura, ho hlahisang ketoacidosis.

Mabaka a tlatselletsang ho hlaha hoa lefu la patsi a kenyelletsa:

• bokamoso bo futsitsoeng;
• ho ikoetlisa ka tlase haholo;
• likhahla tse fapaneng tsa botenya;
• fokolisa sesole;
• tlhekefetso ea lijo tse phahameng tsa lik'habohaedreite;
• tloaelo ea ho nona;
• nalane ea li-autoimmune pathologies kapa maloetse a joalo;
• ho itlhahisa ka litlhare tse nang le li-antibacterial le li-hormone;
• nako e telele ea khatello ea methapo;
• ho lemala kapa ho buuoa;
• sesosa sa tikoloho.

Matšoao a lefu lena a ka qala ho hlaha likhoeli tse 'maloa kamora ho hloleha ha metabolic, e o lumellang hore o tsebe ho fumana kalafo le ho u fa kalafo kapele. Ka bomalimabe, maemong a mangata, bakuli ba fumanoa ka phoso ba tšoeroe ke lefu la tsoekere la mofuta oa 2 mme ba fuoa meriana e fokotsang tsoekere ka nako eo kalafo ea insulin e lokelang ho qala kapele kamoo ho ka khonehang.

Mekhoa ea ho Tseba

Tlhahlobo ea LADA e etsoa ho latela liphetho tsa bohlahlobo:

• biochemistry ea mali;
• tlhahlobo ea tsoekere ea mali;
• Tlhahlobo e akaretsang ea kliniki ea mali le urine.

Ntle le moo, lithuto tsa matšoao a latelang li laetsoe:

• li-antibodies ho lisele tsa lihlekehleke tsa Langerhans;
• li-antibodies ho insulin;
• li-antibodies tsa glutamate decarboxylase;
• mamello ea tsoekere;
• glycated hemoglobin;
• microalbumin;
• leptin;
• fructosamine;
• c-peptide;
• pancreatic peptide;
• glucagon.

Mokhoa o ka sehloohong oa tlhahlobo ea tšoaetso ke matšoao a nepahetseng a liteko tsa autoimmune boteng ba lintho tse joalo:

• matšoao a lefu la tsoekere la mofuta oa 2 ha ho na botenya ho bakuli;
• ea lilemo tse ka tlase ho lilemo tse 45;
• Khaello ea insulin e koaheloa ke ho ikoetlisa le ho ja haholo;
• ts'ehetso ea insulin e etsahetseng lilemo tse 1-3 kamora lefu le qala;
• mafu a autoimmune nalaneng kapa hara ba lelapa;
• lenyora le eketsehang, ho ntša metsi kapele, ho fokotsa ts'ebetso.

Ho ka bonoa mefuta e 'meli ea setšoantšo sa tliliniki.

LADA e nang le matšoao a lefu la tsoekere le itšetlehileng ka insulin:

• lefu le hlaha ho bakuli ba banyenyane;
• Li-genotypes tsa HLA le li-haplotypes tse hlahelang mofuta oa 1 lefu la tsoekere li teng;
• litekong tsa mali ka mpeng e se nang letho, ho bonoa boemo bo tlase ba c-peptide.

Khetho ea bobeli e khetholloa ke lipontšo tse joalo:

• matšoao a lefu la 2;
• bakuli ba tsofetseng ba nang le maemo a fapaneng a botenya;
• HLA genotypes le haplotypes ha li bonoe;
• dyslipidemia.

Lefu la tsoekere le ipatileng le atile ka tlhahiso e eketsehileng ea li-antibodies tse bolaeang manyeme. Lisele tse setseng li qala ho hlophisa insulin haholo, e ntseng e theola tšoelesa le ho feta. Tšoaetso e 'ngoe ea ho senyeha ha tšoelesa ke boemo bo tlase ba li-c-peptide maling tse nkiloeng ka mpeng e se nang letho.

Ka mantsoe a mang, lefu lena le tiisoa ke motsoako oa li-c-peptide tse fokotsang boteng ba li-antibodies ho glutamate decarboxylase. Tlhahlobo eo ha e khetholloe haeba li-antibodies li le sieo. Ho tla hlokahala lithuto tse eketsehileng haeba li-antibodies li le teng ka maemo a amohelehang a li-c-peptides.

Mathata a mantlha a ho hlaka ke ho haella ha chelete bakeng sa litsi tsa bongaka, ka lebaka leo ho se nang lisebelisoa tse hlokahalang bakeng sa lithuto tsa autoimmune. Mabapi le sena, bakuli ba tlameha ho ea litleliniking tsa poraefete tse lefelloang bakeng sa tlhahlobo, ka hona ho ts'epahala ha liphetho tsa lithuto tse joalo hangata ho belaela.

Mekhoa ea kalafo

Bakeng sa tlhahlobo e ntle ea bakuli ba nang le LADA, tlhahlobo e nepahetseng ea bongaka le kalafo e nang le bokhoni li bohlokoa haholo. Leha ho le joalo, hangata ho etsahala hore kalafo e laetsoe e ts'oanang le kalafo ea mofuta oa 2 lefu la tsoekere, ka mohlala, ho khothalletsoa ho nka sulfonylurea le Metformin.

Ho beoa ho joalo ho lebisa ho timetso e kholo le ho feta ea lisele tsa pancreatic, tse sa amoheleheng le mofuta ona oa lefu.

Phekolo e lekaneng e bolela ho bolokoa ha nako e telele hoa tlhahiso ea tšoelesa 'me e lokela ho ikemisetsa ho rarolla mathata a joalo:

• boloka boemo ba glucose ka har'a meeli e amohelehang, ho qoba ho hlaha ha hypo- le hyperglycemia;
• lelefatsa tlhahiso ea tlhaho ea "insulin" 'meleng;
• laolla manyeme, o fokotsa tlhokeho ea tlhahiso ea lihormone, ho thibela ho theoha ha ona.

Ho fihlella lipheo ho etsoa ka likhothaletso tse latelang tsa kliniki:

1. Phekolo ea insulin. Ho sa tsotelehe boemo ba tsoekere plasma ea mali, bakuli ba fuoa ente ea litekanyetso tse nyane tsa homone e nkileng nako e telele.
2. Tlhahlobo ea likhase e lokela ho etsoa khafetsa eseng feela pele le ka mor'a lijo, empa hape le bosiu.
3. Phetoho ea lijo. Lijo tse nang le phepo e nepahetseng li lokela ho theoloa ho fokotsa phepelo ea lijo tse matlafatsang liphoofolong tse nang le phepo e potlakileng. Lintho tse ling tse tsoang kantle ho lijo ke pasta, pastry, meroho e halikiloeng, lipompong le lihlahisoa tsa phofo ea koro. Boemo ba bohlokoa ke ho boloka tekano ea metsi. Ts'ebeliso ea letsatsi le letsatsi ea lilithara tse 1.5-2 tsa metsi e thusa ho theola mali le ho thibela ho felloa ke metsi.
4. Ho eketsa boikoetliso ba 'mele. Meroalo ea lipapali ea letsatsi le letsatsi e etselitsoe ho fokotsa boima ba 'mele, ho eketsa litšenyehelo tsa matla, ho ntlafatsa phallo ea mali le ho potlakisa lits'ebetso tsa metabolic. Ntle le moo, thuto ea 'mele e tla matlafatsa mesifa ea pelo le marako a methapo, e tla ba thibelo e ntle ea nts'etsopele ea mafu a pelo le methapo.

Lintho tse fumanehang video ka lefu la LADA - tlhahlobo ea endocrinologist:

Ho lumellana le litlhahiso tsohle ho tla tsitsisa matšoao a tsoekere le ho thibela nts'etsopele ea hyperglycemic le ketoacid coma.