ʻO Uacute, ka hemahema o ka hopena o ka insulin me ka hana maʻamau a i ʻole e hoʻonui ʻia i ka ʻike o ka plasma koko

Hoʻolālā o ka maʻi diabetes

Hoʻokumu ʻo DM ma muli o kahi hemahema o ka insulin (IDDM) a i ʻole ka hemahema o kāna mau hopena (NIDDM).

Nā kumu o ke Diabetes

Kakuhi i ke insulin hema loa (kū i ka nele o ka insulin).Hele mai ia ma lalo o ka mana o nā mea kūlohelohe o ke kuʻuna, ke kūlohelohe, ke ʻano kūlohelohe, a me ka pena pū ʻana o ka pancreas

Nā mea kūlohelohe

· Nā hemahema genetic mokupale b-cell Langerhans. ^ E Ha yM. Aia kahi hilinaʻi i hoʻopuka ʻia o ka hiki ʻana o hypoinsulinism i nā poʻe maʻi me IDDM ma ka hōʻike ʻana o kekahi mau HLA antigens. ʻO kēia ka poʻe glycoproteins i hoʻopili ʻia e ka alleles HLA - DR3, HLA - DR4, HLA - DQ, B1. ʻO nā hemahema genetic ke kumu o ka hoʻopili ʻana o nā hana hōʻoki kino hanu o ka maʻi (no ka mea ke ʻano o nā autoantigens malihini i ka ʻōnaehana pale) a me ka haʻahaʻa o ka synthesis o ka insulin (no ka laʻana, ke hoʻohālikelike ʻana i nā génome e hoʻopuni ai i nā insulin synthesis enima).

· Nā kumu pilikino. ^ E Ha yM. ʻO Ig, cytotoxic T-lymphocytes, a me nā cytokines i hana ʻia e lākou, hiki ke hōʻino i nā b-cells a hoʻomaka i ka hopena autoaggression.

I nā mea maʻi me ka nele o ka insulin, ʻike ʻia nā ʻano like ʻole o nā antibodies e: cytoplasmic hypertension - ISA (mai ka Pelekane. islet cell autoantibody - ka autoantibodies i nā protein cell islet), i kahi me ka protein me ka molololi mololi o 64 kD, i loaʻa i ka membace cytoplasmic o b-cell. Hōʻike pinepine ʻia kēia mau antibodies ma mua o ke ʻano ʻia o nā hōʻailona ʻē aʻe o ka maʻi maʻi. I kēia mea, aia i waena o ka mea hoʻomaka o ka hopena o ka hopena o ka anti-b-cell autoaggression, me nā molekala o ka insulin ponoʻī iho.

· Nā maʻi maʻitropic i b-mau: Coxsackie B₄, hepatitis, measles, chickenpox, mumps, rubella and others. No ka laʻana, me ka rubela intrauterine, ulu ka maʻi ma kahi o 20% o nā pēpē hou. ʻO kēia mau maʻi ka hopena i kahi hopena cytolytic pololei i nā b-cells, ka hoʻomaka ʻana o nā ʻōnaehana pale kū'ē i nā b-cell a me ka hoʻomohala ʻana i ka mumū i nā wahi o nā b-cell o nā mokupuni o Langerhans - insulitis.

· ʻO nā mea laikini endogenousʻo ka hōʻino ʻana i nā b-cell. ʻO ka mea "ikaika" ʻo lākou ka alloxan. Kūkulu ʻia ia me ka nui ma muli o kahi mau hana ʻole o ka pyrimidine metabolism a poloka i ka hoʻokumu ʻana o ka insulin. Hoʻopili ʻia ka hope loa me kahi haʻahaʻa haʻahaʻa o SH-nā hui (pono no ka hana o ka alloxan) i loko o nā b-cell.

Nā kumu lāʻau

Ua hōʻoia ʻia ʻo Alloxan Ã nā kaha kiʻekiʻe o ka ethanol, cytostatics a me nā mea'ē aʻe (no ka laʻana, ka antitumor drug streptozocin Ã ) hiki i kahi mākau kiʻekiʻe ke kumu i ka maʻi maʻi.

Nā mea pilikino

Ua ʻike ʻia ʻo ka wehe ʻana i ka radiation hou (e hoʻomaka ana i ka hoʻoulu ʻia ʻana o nā hana lipid peroxide), ke ʻano trauma o ka pancreas, a me ka hoʻoulu ʻia ʻana e kāna ʻōpala pinepine ke alakaʻi i ka maʻi maʻi me ka make o nā b-cell.

Hoʻopilikia i nā kaʻina

ʻO ka pancreatitis acute a me nā maʻi e pili ana i ka 30% o nā hihia o ka maʻi maʻi i ke kumu o ka nele o ka insulin.

ʻO ka hemahema o nā hopena insulin (pili i ka nele o ka insulin) hoʻomohala ʻia ma lalo o ka mana o nā kumu o kahi ʻano neuro- or psychogenic, contra-factor, a me ke ʻano no nā hemahema i loko o ka ʻōpū o ka insulin a me nā maʻi kiaʻi ma hope o nā maʻi i nā mea i manaʻo ʻia (Fig. 9-7).

ʻŌpō hoʻonohonoho! hookomo i ke kiʻi "laiki-9-7"

Kuhi. 9-7. ʻO nā kumu o ka hypoinsulinism pili.

ʻO nā kumu nui loa i nā ʻoi loa e pili ana i ka hypoinsulinism pili.

· Neuro a me / ai nā manaʻo psychogenic. ^ E Ha yM. Ua ʻike kēia mau mea i kā lākou hopena ma o ka hoʻōla ʻana o nā neurons o ka nuclei o ka hypothalamus posterior, ka mea e alakaʻi ai i ka hoʻonui ʻana i ke kani o ka adrenal adathal a me ka hypothalamic-pituitary-adrenal. Ke alakaʻi nei kēia i ka hoʻonui nui a hoʻomau ʻia i ka ʻike o nā hormones contginsular hyperglycemic i loko o ke koko: adrenaline, norepinephrine (adrenal origin), glucocorticoids a, no laila, ka nele o ka pilina o ka hopena o ka insulin, a me ka hoʻomohala hou i nā hopena hoʻonaninani protracted. Hoʻokumu lākou i ka hoʻōla o nā ʻōnaehana adathal a me ka hypothalamic-pituitary-adrenal, kahi e hoʻonui ai i ke kahe o ke koko o ka "contra-hormonal" hormones catecholamines, glucocorticoids, hormones thyroid.

· Nā ʻāpana helu hoʻohālikelike. ^ E Ha yM. ʻO nā mea nui i hoʻohālikelike i nā mea e hiki mai ana.

à Hoʻohana nui loa i ka insulinase hepatocyte, ʻo kēia protease ka mea hoʻoliololi i nā mololi insulin.

à Ig i mea e hana i ka insulin.

à I ke koko o nā contrainsular hyperglycemic hormones: catecholamines, glucagon, glucocorticoids, STH, T₃, T₄, hiki ke ʻike ʻia ka momona o nā huahana e like me ke kani ʻana i nā ʻōiwi endocrine e pili ana a me ke kaumaha lōʻihi paha).

à Hoʻonui i ka plasma kukuna o nā pale e hoʻopaʻa ana i nā molekole insulin.

· ʻO nā mea i kumu no ka blockade, luku, a i ʻole ka hōʻemi ʻana i ka hoʻoweliweli ʻana o nā ʻāpana insulin.

Hāʻawi ʻia kēia hopena e:

à Ig ka hoʻohālike ʻana i ke kumu o kahi molekole insulin. Hoʻohālikelike lākou me nā ʻenekini insulin, poloka iā lākou, a laila e kāohi ana i ka loaʻa o nā molekina o ka insulin i ka mea ʻae.

à Ig, e luku ana i ka hopena o ka insulin receptors a / a i ʻole ke peri-receptor zone o nā cell target.

à Kahi mea nui o ka insulin, kahi e waiho ai i ka hyposensitization o nā hua kiko i hiki aku i ka hormone.

Ua hoʻokuʻu ʻia nā Hydrolases mai nā lysosomes a hana ʻia i loko a i waho o nā ʻehā i hōʻino ʻia a i hoʻopau ʻia paha (e like me, me ka hypoxia maʻamau, ka hanu a me ke kaʻe maʻamau).

à No nā hōʻea a me nā huahana SPOL (no ka laʻana, me ka hoʻomau ʻana i ke kaumaha mau loa, atherosclerosis, hana cardiovascular).

· ʻO nā ʻaihue e hōʻole i ka hopena o ka insulin i nā pūlima target. ^ E Ha yM. ʻO ka mea nui loa, ʻo kēia mau mea hana e hōʻino i nā membrane a me / a i ʻole nā mea hoʻonā aela no ka insulin, a me ka denature a / a luku paha i nā enzyme cellul. ʻO ka hana nui loa o nā enzymes lysosomal, ka hoʻomohala nui ʻana o ka ʻano oxygen reactive, radical free, a me nā lipid hydroperoxides hiki ke lilo i kumu hoʻohālike o nā pōʻino o ka membrane a me nā enzyme cell. ʻO kēia a me nā mea hoʻomehana pathogen'ē aʻe i ka laweʻana i ka glucose i loko o nā selela, ka hoʻokumu ʻana o cAMP, kahi hoʻoneʻe transmembrane o nā wai Ca 2+ a me Mg 2+, pono pono nā ka ʻike o ka hopena intracellular o ka insulin.

ʻO nā mea hoʻomohala maʻi huapalapala

Ua ʻike ʻia kahi nui o nā wahi pilikia o ka maʻi diabetes. ʻO kēia ka mea nui koʻikoʻi kauka:

Ú momona. Kuhi ʻia nā huakaʻi ma kahi o ka 80% o nā maʻi me NIDDM. Hoʻonui kēia i ka kūʻē o ka insulin o ka ate, adipose a me nā ʻano like ʻole o ka insulin.

Ú kū a me ka nui o ka hyperlipidemia. ʻO nā mea ʻelua e hoʻoikaika i ka hana ʻana o nā hormones contra-hormonal a me hyperglycemia. ʻO kēia, ka mea, ke hoʻoikaika nei i ka synthesis o nā insulin e nā b-cell, e alakaʻi ana i kā lākou "hōʻemi" a me ka hōʻino,

Ú arertial hypertension, alakaʻi i kahi ka hoʻokele o ka microcirculation i loko o ka pancreas,

Ú he mana hoʻoilina a i ʻole he congenital predisposition. Manaʻo nā ʻōlau he HLA e hoʻomaka ʻia i nā mea maʻi me ka maʻi maʻi immunosuppressive. I ka maʻi me NIDDM, ka predisposition i ka maʻi diabetes i ka polygenic. I mua o ka maʻi maʻi ma kahi o nā mākua, ka laha o ka lākou mau keiki maʻi i nā mea olakino hiki ke lilo i 1: 1,

Ú hopena kaumaha ka manaʻo. Hoʻohui ʻia lākou me ka ulu mau o ka nui o ke koko o nā papa contrainsular.

ʻO ka hui pū ʻana o kekahi mau hopena pilikia i haʻi ʻia ma luna nei e hoʻonui i ka hiki o ka maʻi maʻi i nā manawa 20-30.

ʻO nā pathogenesis o ka maʻi maʻi

ʻO ke kumu o ka pathogenesis o ka mellitus o ka diabetes mellitus he mea ʻole ka hemahema o ka insulin (ma ka ulu ʻana o IDDM) a i ʻole ka hemahema o nā hopena o ka insulin (e alakaʻi ana iā NIDDM).

ʻO ka pathogenesis o ka maʻi maʻi ma muli o ka kinikini ponoʻole o ka insulin (kūlohelohe insulin piha)

Hōʻike ʻia nā pilina nui i ka pathogenesis o ka nele o ka inika i ke Kīwī 9-8.

ʻŌpō hoʻonohonoho! hoʻokomo i ke kiʻi "kaʻu-9-8"

Kuhi. 9-8. ʻO nā loulou koʻikoʻi i ka pathogenesis o ka holoʻole o ka wī i ka insulin.

I ka nui o nā hihia (ʻoiai paha i loko o nā mea āpau), ʻo ka pathogenesis o ka pauʻana o ka insuline kūlike i ka pilina maʻamau ka pilina maʻamau: kaʻenehana kūlohelohe kūloko(Kin. 9-9). ʻO kēia kaʻina o ka hōʻino maikaʻi ʻana i ka ʻāpana insular o ka pancreas i mau pinepine i kekahi mau makahiki a hele pū ʻia me ka luku mau ʻana o nā b-cell.

Hōʻike ʻia nā ʻoma o ka maʻi maʻi, ma ke ʻano he kānāwai, i ka wā e luku ʻia ai nā 75 -80% o nā b-cell (e hiki ke ʻike ʻia ma mua o nā ʻano "hoʻonāukiuki" - nā maʻi, nā hoʻowalewale, nā hopohopo, nā hana hōʻemi o ka hoʻonanea kalepa, overeating, a me nā endocrinopathies). ʻO ke koena 20-25% o nā selela e luku mau ʻia i nā makahiki 2-3 e hiki mai ana.

I ka poʻe maʻi i make i ka maʻi diabetes, ke kaumaha o ke kaumaha o ka pancreas he 40 g (80-85 g ka maʻamau). I kēia hihia, ʻo ka nui o nā b-cells (ma nā poʻe olakino e pili ana i 850 mg) ka mea i hoʻowahāwahā ʻole a ʻaʻole i hoʻoholo ʻia.

ʻŌpō hoʻonohonoho! hoʻokomo i ke kiʻi "kaʻu-9-9"

Kuhi. 9-9. ʻO nā loulou nui o ka pathogenesis immaggressive o ka maʻi mellitus.

ʻO nā pilina pili i waena o nā loulou nui i ka hoʻomohala ʻana o ka maʻi autoaggressive ʻano maʻi o ka maʻi maʻi: (ʻike iʻa. 9-9):

Ú komo i loko o ke kinokanaka lahilahi predisposed kanaka ʻO ka mea lawe moku Alien Ag. ^ E Ha yM. ʻO ka maʻamau ka maʻamau o kēia mau maʻi, heʻuʻuku nā microorganisms like ʻole.

Ú uptake haole antigen-presenting cells, hana i ka mea lawe antigen a hōʻike iā ia e hui pū me ka HLA hypertension (hōʻike) kōkua kōkua T-lymphocytes,

Ú ka hoʻohuhopu o nā antibodies kikoʻī a hoʻopili i nā lymphocytes kū'ē i ke hypertension haole,

Ú ka hopena o nā antibodies a me nā lymphocytes hoʻōla i ka hypertension haole(me kona luku ʻana a me ka hoʻohemo ʻana mai ke kino me ka komo ʻana o nā phagocytes), a me nā mea hana antigenicna B-oakahe hoa like me ka haina hipertension. E manaʻo o kahi protein me ke koʻikoʻi molekine o 64 kD hiki ke lilo i kahi endogenous hypertension like me kahi mea ʻē aʻe. Hoʻokele ʻia nā ʻai i loaʻa iā ia ʻo ka ʻōnaehana ʻo IHD o ke kino, e manaʻo nei he mea ʻē ia. Hōʻike ʻia kēia ʻano hoʻohālikelike me "ka pane o ka pale-pale." I ka wā o kēia hoʻohālikelike, luku ʻia nā b-cell, a hoʻohuihui ʻia nā ʻōmaʻomaʻo pilikino a lilo i autoantigenic,

Ú ka hoʻololi ʻana, hana ʻana, a hōʻike ʻana i nā lymphocytes o nā hypertension o nā haole hou a me nā mea hou hou i hoʻoponopono ʻia e nā monocytes / macrophages. ^ E Ha yM. ʻO ke kaʻina o ka autoaggression pale kino e hoʻoiho ʻia e ka synthesis a halihali i ka papa o nā i hōʻino ʻia nā papa o nā b-cell o nā papa HLA hypertension I a me II. ʻO kēia mau AHs e hoʻowalewale i ke kōkua kōkua T-lymphocytes a, ma muli o ke ʻano, ka hana ʻana o Ig a me nāʻokoʻa ʻokoʻa o ka cytotoxic T-lymphocytes I kēia mea, ke hoʻomāhuahua nei ka palekana autoaggression i kona iho b-cell. Hoʻonui ka nui o ka hōʻino i ka ʻili o ka insularus.

Ú ka lele i nā wahi i pōʻino a hoʻopau i nā b-cell o ka pancreas o nā phagocytes. ^ E Ha yM. Ua luku aku lākou i nā b-cell me ka komo ʻana o nā enzymes lysosome, reactive oxygen species a lipid peroxides, free radical of organic fertilizers, cytokines (e.g. TNF-a, IL1),

Ú ka hoʻokuʻu ʻana i nā ʻōnaehana "alien" mai nā b-cell i hoʻopau ʻia no ka pānaʻi ʻana(ma ka maʻamau, he ulu wale lākou a ʻaʻole i komo i ke koko): huʻu wela, gangliosides cytoplasmic, proinsulin,

Ú Macrophage uptake o nā protein cytoplasmic i ʻōlelo ʻiana B-aikeke, kā lākou kaʻina a me ka hōʻike i nā lymphocytes. Hoʻopilikia kēia i nā hanana hou aʻe (a laila hana hou i ka manawa) o ka hoʻouka kaua ʻana me ka luku ʻana i kahi helu o nā b-cell. Me ka hoʻohaʻahaʻa ʻana i kā lākou papakō i 75-80% o ka maʻamau, "ākea" ʻike ʻia nā hōʻailona lapaʻau o ka maʻi maʻi.

ʻO nā hōʻailona o ka hoʻōla ʻana o ka ʻōnaehana nānā ʻana me ka mahalo i ka b-cell e nalowale ana ka lōʻihi o ka manawa. A make ʻo b-cell, ke emi nei ke kaohi ʻana i ke ʻano maʻi anti-agresi. No laila, ʻo ka pae o nā antibodies e hele i ke hypertension o nā b-cells ka hoʻemi nui ʻia ma hope o 1-1,5 g ma hope o kā lākou ʻike mua ʻana.

ʻO ka pathogenesis o ka maikaʻiʻole o ka insulin e kumu i nā mea kemikahōʻike ʻia ma ke kiʻi 9-10.

ʻŌpō hoʻonohonoho! hookomo i ke kiʻi "laiki-9-10"

Kuhi. 9-10. ʻO nā loulou koʻikoʻi i ka pathogenesis o ka mellitus o ka maʻi mellitus ma lalo o ka hana a nā mea hoʻomehana pancreatotropic kemika.

ʻO ka hoʻolālā o ka hoʻomohalaʻana o ka hemahema o ka insulin e kumu a nā mea kinohōʻike ʻia ma ke kiʻi 9-11.

ʻŌpō hoʻonohonoho! hoʻokomo i ke kiʻi "kaʻu-9-11"

Kuhi. 9-11. ʻO nā pilina nui i ka pathogenesis o ka mellitus o ka maʻi mellitus ma lalo o ka hana a nā mea pili kino.

ʻO ka pathogenesis o ka maʻi diabetes ma ka hopena o ka hikiʻole o nā hopena o ka insulin (ka nui o ka hema i ka insulin)

ʻO ka hoʻomohala ʻana i ka maʻi diabetes ma muli o ka lawa ʻole o ka hopena o ka insulin e hele ana i ka wā o ka maʻamau a i ʻole ka nui o ka synthes o nā b-cells a me ka hoʻonui i loko o ke koko (ʻo kēia ʻano ʻano like ʻole o ka maʻi maʻi i kapa ʻia ʻo NIDDM).

ʻO nā kumu e pili ana i ka hemahema o ka insulin e like me kēia..

· Nā mea hoʻohālikelike.

à Insulinase. ^ E Ha yM. ʻO nā kumu no ka hoʻōho nui ʻana o ka insulinase i ka nui o ka nui o ka glucocorticoids koko a me / a i ʻole STH (e nānā mau ʻia nei i nā mea maʻi me ka maʻi maʻi o ka maʻi), a me ka nele o ka zinc a me nā kaʻa keleawe, ka mea maʻamau e hōʻemi ai i ka hana insulinase. Ke noʻonoʻo nei i ka hoʻomaka ʻana o ka insulinase me ka ikaika e ke ʻia ʻana i nā maʻi hepatocytes i loko o ka wā ʻōpiopio, ʻo kēia ʻano hana kekahi o nā pilina nui i loko o ka pathogenesis o ka maʻi diabetes.

à Nā kinipōpō protein. Hiki iā lākou ke hele mai ka nui o ka mumū a me ka luku ʻana i ka insulin (no ka laʻana, me ka phlegmon, peritonitis, ke ʻano o ka ʻili o ka ʻili.

à Nā antiododies i ka insulin e like me ka protein.

à ʻO nā mea e hoʻopaʻa ana i nā molekole insulin a ma ia mea hoʻi, ke kāohi nei i kāna hoʻopili ʻana me nā mea taliaina. Hoʻopili lākou inhibitors insulin plasma kalima kino (no ka laʻana, ka hoʻopiʻi o nā pilikino o nā globulins) a ʻo nā lehelehe-lipoproteins. ^ E Ha yM. ʻAʻole hōʻike ka Insulin i ka protein plasma e hōʻike i kāna hana i nā kino āpau, ka haʻalele ʻana i ka momona momona. I ka mea hope, hana ʻia nā kūlana no ka hoʻokaʻawale ʻana o ka molekine protein a me ka ʻike ʻana o ka insulin me nā mea kūikawā hou. ʻO ke kāpili ʻana o ka b-LP i ka nui o ka nui i ʻike ʻia i nā mea maʻi me ka hyperproduction o STH. Hoʻokumu ka b-LPs i kahi pūnaehana molowa nui loa me ka insulin, i ka hoʻohālikelike ʻana o ka insulin i hiki ʻole ke launa pū me kāna mea ʻae.

· Hoʻokuʻu a hōʻemi paha i nā hopena o ka insulin i nā kiko kiko. ^ E Ha yM. ʻO ka hoʻoneʻe a hōʻemi paha i nā hopena o ka insulin i ka kiko kikoʻī e loaʻa ana ma muli o ka hopena hyperglycemic o ka nui o nā hormones - ka metabolic antagonist o ka insulin. Hoʻopili kēia ma ka catecholamines, glucagon, glucocorticoids, STH a me nā iodine e pili ana i ka thyroid. Hoʻonui ka lōʻihi a me ka hyperglycemia koʻikoʻi i ka hoʻouluʻana o ka insulin e nā b-cell. Akā, ʻaʻole lawa paha kēia no ka hana maʻamau i ka HPA, ʻoiai hoonui pinepine ia o na mokupuni pancreatic i mea e poino ai i nā b-nāna.

· Hoʻonui ka pale ʻana i ka insulin i nā cell. ^ E Ha yM. Hōʻike ka paleʻana i ka inolima e ka ʻike maopopo ʻana o nā hopena o ka insulin i ka pae o nā cell target. ʻO ka mea i hōʻike ʻia a me nā mea hana postreceptor o kēia hanana i wehewehe ʻia.

à Nā mīkini hana hoʻokipa no ka hoʻokumu ʻana o ka pale o ka insulin.

Ä "Screening" (pani) nā ʻāpana o ka insulin receptors me nā antibodies iā lākou. Hoʻomaʻamaʻa hope loa ka mea hope me nā ʻōmole o nā receptors iā lākou iho a / a i ʻole ke kahua perireceptor. I kēia hihia, hiki i nā molika ʻo Ig ke hiki ke launa pū me ka insulin a me kāna mea ʻae.

Ä ʻO ka hyposensitization o nā pū i hoʻopaʻa ʻia i ka insulin. Hoʻoulu ia e ka hoʻonui lōʻihi ma ka neʻe o ka insulin i ka koko a me ka interstitium.ʻO ka hyposensitization o nā pūpuna ka hopena o ka hoʻonui i ka helu o nā receptors insulin low i luna o ka pūlaka a me / a me kahi hōʻemi i loko o ka huina o nā receptor insulin. ʻO ka manawa pinepine, ua ʻike ʻia kēia i nā poʻe e hōʻeha nei i ka overeating, kahi e hoʻoiho ai i ka hyperproduction o ka insulin.

Ä Hoʻopau a me / a i ʻole hoʻololi i ka loli o nā mea nānā insulin Pono kēia ka hana a nā antiodeptor antibodies (ke kāpili ʻia e ka loli o ka hana o ka mea i loaʻa, no ka mea hoʻohālikelike ʻia i loko o ke ʻano o ka hapten o nā lāʻau lapaʻau a i ʻole nā mea ʻona. ka hoʻohālikelike ʻana o nā kahe maʻi manuahi a me nā huahana lipoperoxide i ka wā hypoxianā nele i nā antiioxidants - tocopherols, ascorbic acid, etc. Nā palaʻai genhoʻopili ʻana i ka synthesis o nā polypeptides receptor insulin.

à ʻO nā hana ma hope-receptor no ka hoʻokumu ʻana i ke kū'ē i ka insulin.

Ä Hāpai ka phosphorylation o nā protein kinases o nā hua ʻai, e hōʻole i nā kaʻina o ka intracellular i ka hana o ka hoʻokūkū o glucose.

Ä ʻO ka heleʻana o nā hemahema i nā mea lawe i ka glucose transembrane i loko o nā wahi e kau ai. ^ E Ha yM. ʻIke ʻia ka halihali glucose transembrane hoʻowahāwahā i nā mea maʻi me ka maʻi diabetes i hui pū ʻia me ka momona.

Hōʻikeʻike o ka maʻi maʻi

Hōʻike ka maʻi maʻi maʻi ʻokoʻa i loko o 2 mau hui o nā pilikia pili:

Ú nā maʻi hōʻea. ^ E Ha yM. He mea nui e hoʻomanaʻo e hāʻawi nā maʻi me ka maʻi maʻi i nā hōʻailona o ka makaʻu nā ʻano hana a pau loa, ʻaʻole wale ke kalaiā, e like me ka inoa o kona inoa.

Ú ke ʻano o nā kiko, huina, kā lākou ʻōnaehana. ^ E Ha yM. Hōʻike kēlā a me kekahi i kahi e haʻaleleʻole i ka hana koʻikoʻi nui o nā mea ola i kahi holoʻokoʻa.

ʻO ka maʻi ma waena o ka maʻi diabetes

Hōʻike ʻia nā pilikia o ka metabola nui i ka maʻi diabetes i ka Figure 9-12.

ʻŌpō hoʻonohonoho! hookomo i ke kiʻi "laiki-9-12"

Kuhi. 9-12. ʻO nā hōʻike nui o ka hopena metabolic i ka maʻi diabetes.

Hoʻohui i ka lā: 2016-11-24, Nānā: 685 | ʻO ka hoʻokele kope kope

He aha ke kumu o ka nele o ka hormone i ke kino?

ʻO kahi hōʻailona nui o ka nele o ka insulin i ke kino he nui ka nui o ka glucose i loko o ke koko. Hōʻike kēia iā ia iho i ke ʻano o nā hōʻailona like ʻole. ʻO nā hōʻailona nui ka hemahema o ka insulin i ke kino:

nā hoʻomaʻa pinepine ʻana
mau ka makewai mau
hiamoe a hiamoe ʻole
huhū me kahi kumu ʻole
hoʻonui ulu irritability.

Pono e hoʻomanaʻo ʻia e hana i ka insulin i nā ʻili e hiki ke loaʻa ka glucose. A he hopena, hoʻonui ʻia ka hana ʻana o ka gyscogen polysaccharide, ʻo ia ke ʻano nui o ka mālama ʻana i nā waihona glucose i loaʻa i loko.

Pono ʻoe e hoʻomaopopo e loaʻa ka nele o ka insulin ma muli o ka lawa ʻole o ka hana ʻana o kēia hormone. Aia he ʻelua ʻano nui o ia hemahema. E wehewehe ʻia kēlā me kēia pākahi mau i lalo. He mea nui ia e hoʻomaopopo i kēlā me kēia ʻano maʻi maʻi maʻamau, ua nānā ʻia kona iho hemahema. Manaʻo paha, i ka wā e koho ai i ka maʻi diabetes o ka pae mua, ua hoʻomaopopo ʻia ka iʻa o ka lawa ʻole piha. I kēia hihia, ʻaʻole hiki iā ʻoe ke hana me kahi ʻole o ka hōʻeha ʻana o kēia hikia.

Ma hope o ka hoʻomohalaʻana i ka nele o ka insulin, aneane hiki ʻole ke hoʻihoʻi i ke ʻano kūlohelohe o ka hana o ka insulin. Kuhi nā keʻena i nā inikina o kahi ʻikepili o ka hormone, a ua hoʻololi ʻo ia i ka inikini mau loa.

Me kēia hōʻeha ʻana, pono nui ka hahai ʻana i ke kīpona kūpono a alakaʻi i kahi ola olakino.

Nā ʻōpū o Insulin

E like me ka mea i ʻōlelo ʻia ma luna nei, hiki i nā ʻano hemahema ʻole:

pancreatic
ʻaʻole pancreatic.

I ka hihia mua, he ala ia ma muli o kekahi mau loli e kū ana i ka pancreas, ma loko o kāna mau puna. I ka lua o nā hihia, ʻaʻole hiki ke manaʻo ʻia kahi mea maʻi ma ka pancreas i ke kumu o ka maʻi.

ʻO ka maʻamau, ʻike ʻia ke ʻano lua o ka paʻa ʻole i nā maʻi e loaʻa nei i ka maʻi diabetes type 2. I ka maʻi mellitus o ka lua, ʻaʻole pono e hoʻopuka i kahi hoʻohui o ka insulin i loko o ke kino, hana ka pancreas i ka nui o ka nui. Me kahi ʻano ole o ka pancreatic i ʻole i hemahema o ka insulin, e hele pinepine nā kūlana i ka wā i hūnā ʻia ai ka nui o ka hormon a nui i kahi nui loa, akā ʻaʻole maopopo nā mea a me nā kiko.

ʻO ka maʻi pancreatic e hoʻoulu ʻia e kekahi mau loli pathological i nā beta beta o ka palahalaha, ke alakaʻi nei i ka manaʻo o kēia mau kelepona ke kāpae i ka synthesis o ka hormone a hōʻemi nui paha ia. ʻO nā hoʻololi ʻana i nā hana kūwaho o nā hale beta o ke kumu ke kumu o ka hoʻomohala ʻana i ka maʻi mellitus type 1 i ka poʻe, ʻo ia ka insulin.

ʻO ka hemahema o ka insulin e kū ana i nā maʻi maʻi type 1, a me nā hemahema o ka insulin i loaʻa pinepine i nā poʻe maʻi e loaʻa nei i ka maʻi type 2.

He aha nā kumu nui o ka hoʻomohala ʻana i ka maʻi?

Maopopo loa ia aole kela mea i na loli. ʻO ke kūlana kēia i kau ʻia e kekahi mau loli e kū i ke kino o kēlā me kēia kanaka. E pili ana i ke kumu, ke kumu o ka hoʻolālā ʻana i kekahi hemahema o ka insulin e pono ai:

Hoʻolaha ka'āina, ʻoiai inā he mau ʻohana ma ko ka ʻohana i loaʻa i ka maʻi maʻi.
ʻO kekahi kaʻeha hoʻonā i loko o ka pancreas a iʻa paha i ka lolo.
ʻO nā ʻano hōʻeha pale āpau, no ka laʻana, kekahi hana ma kēia ʻaha.
ʻO nā loli Sclerotic i loko o nā moku, hoʻonā lākou i ka hōʻino ʻana i ke kaʻina holo o ke kaʻe a hiki i ka hana hōʻino ma ke kino iho.
Hiki mai kekahi kūlana like ma muli o ka hoʻopili hewa ʻana o nā huina.
Hiki i kekahi kumu pilikia ke kūwaha i kekahi maʻi mau, kahi, ke alakaʻi nei i kahi nāwaliwali loa o ka ʻōnaehana o ke kino.
ʻAʻole hiki iā mākou ke poina i kahi kaumaha a i ʻole ka ʻeha hoʻowalī i kumu e ulu ai ka nele o ka insulin i ke kino.
Ka hana pilikino kino a i ʻole, i ka hoʻololi ʻana, ka loli koʻikoʻi i ka hana maʻamau no kahi hana maʻalahi.
Hiki i kahi neoplasm ke pancreas ke hoʻoulu i ka hoʻomohala ʻana o ia ʻano ʻano.

He mea nui ia e hoʻomaopopo inā ʻaʻole i lawa ka zinc a me nā protein i loko o ke kino, akā ke hao aku, ma ke ʻano ʻē, ua nui loa, a laila hele mai kahi kūlana inā ʻaʻole lawa ka insulin. Ua wehewehe maʻalahi ʻia kēia kūlana, ke kiko āpau i kēlā Zinc, me ke ʻano o nā mea ʻē aʻe, e hāʻawi i ka hōʻiliʻili o ka insulin i loko o ke koko, a me kāna kaʻikaʻi kūpono i ke koko. ʻLelo, inā heʻuʻuku loa i ke kino, a laila e akaka no ka nele o ka insulin a ʻaʻole ia e komo i ke kahe a ʻaʻole e hoʻokō nei i kāna mau hana koke.

Inā mākou e kamaʻilio e pili ana i ka hao, a laila nui loa ka maikaʻi i ke olakino. ʻO ka mea he uku hou ia ma ke kino. I ka hopena, loaʻa ka emi ʻana o ka synthesis o ka insulin.

ʻO ke kino, ʻoiai, ʻaʻole i pau ka hoʻokaʻawale ʻana, akā ʻaʻole lawa ia e hoʻokō ʻo nā hana āpau i ka pae kūpono.

Hoʻomaopopo o ka Insulin Deficiency

Aia kekahi hōʻailona koʻikoʻi e hōʻike i ka nele o kēia maʻi i ka insulin. ʻO kēia, ʻoiaʻiʻo, he pae kiʻekiʻe o ka glucose. I nā huaʻōlelo aʻe, kapa ʻia kēia kūlana i kapa ʻia ʻo hyperglycemia. ʻO ka mea ʻino loa ka mea o kēia maʻi e hōʻike nei iā ia iho inā hiki i ka pae o ka maʻi maʻi i ka pae ma kahi o nā inikini insulin hiki ʻole ke hana.

ʻOiai aia kekahi mau hōʻailona e hōʻike pū ana e loaʻa ke ʻano maopopo o kahi kanaka i ka insulin. He hōʻailona kēia mau:

Hoʻomaʻemau pinepine pinepine ʻia, ʻoiai hoʻi i ka pō ʻaʻole i pau ka makemake.
ʻO ka make ʻole mau ka makewai, i ka lā e hiki ai i ka mea maʻi ke inu i ka ʻekolu o nā wai o ka wai.
Ke hoʻoholo nei i ke ʻano o ka ʻili.
ʻO ka maʻa ʻāpana ke hiki.
Ka maʻi manu
Ka ʻuʻake o nā ʻoi loa.
ʻO nā hōʻeha maikaʻi i ke kino.

He mea nui ia e hoʻomaopopo inā ʻaʻole ʻoe e hoʻomaka i ka mālama ʻana i ka manawa, a laila pilikia paha kahi maʻi maʻi koma maʻi. ʻO ia kahi hiʻohiʻona o ka poʻe maʻi e loaʻa nei i ka maʻi type type 1 a ʻaʻole lawe i ka inikini insulin injections.

Ke pale i kēlā mau hopena, ua lawa ia no ka hoʻomaʻamaʻa pinepine ʻana i ka endocrinologist kūloko, a me ke ana ʻana i ka pae o ka glucose i loko o ke koko.

Inā hoʻomaka ia e hele i ka pae ʻona, ʻo ia hoʻi, ma ka pae ma ka mole he mmol / l a i ʻole, a laila makemake koke ʻoe e hoʻomaka i ka lapaʻau.

No ke aha i hana ai ka hemahema i ka insulin?

ʻO ke kumu mua e loaʻa ai ka hemahema o ka insulin e manaʻo ʻia he mea kue i nā kaʻina metabola i loko o ke kino. ʻO ka hapa nui o nā maʻi he maʻi hoʻohemo i kēlā mau hōʻino a, ʻoi aku, alakaʻi i kahi ʻano kūpono. ʻO ke hopena, e hoʻomohala ka maʻi diabetes.

ʻO nā kumu nui e hoʻomaka ai ka hemahema o ka insulin e ulu:

ʻOi loa nā meaʻai a i hoʻokahe ʻia me nā mea kākā.
I kahi hihia ke kau nei ke kauka i ka lāʻau lapaʻau e hoʻokaʻawale i ke kō, a poina ke kanaka maʻi e lawe, ua hiki mai ʻo hyperglycemia.
ʻĀkau
Naawai.
ʻO nā kaʻina hana a me nā maʻi ʻē aʻe.

He mea nui ia e ʻike i nā hopena paha inā ʻaʻole ʻoe e hoʻomaka i ka mālama ʻana i ka manawa. ʻO kekahi o nā hopena koʻikoʻi e manaʻo ʻia he coma. Akā aia kekahi mau wahi maikaʻiʻole e hiki ke hele mai, no ka laʻana, ketoacidosis. I kēia hihia, paʻa ka nui o ka acetone i loko o ka urine.

Pono e hoʻomanaʻo ʻia he hiki i nā ʻōhua like i hiki i nā keiki. ʻOi wale ka paʻakikī o nā keiki i kēia mau manawa. ʻO kēia no ka mea, ʻaʻole like me nā pākeke, ʻaʻole hiki iā lākou ke ʻokoʻa kūʻokoʻa i ka pae o ke kō i loko o ko lākou kino, ʻaʻole lākou ʻike i nā ʻōpona, no laila e hala paha i kekahi mau ʻōmaʻomaʻo o ka hyperglycemia ma ke ʻano maʻi type 2.

Pono ʻoe e hoʻomanaʻo e hiki i ka pōʻino ke hiki mai i kēlā me kēia manawa inā loaʻa ka pēpē i ke kōʻai gula 6.5 mmol / l ma mua o kaʻai ʻana a i ʻole 8.9 ma hope o ka ʻai.

Pono ka nānā pono ʻana e nānā pono i ke olakino o nā keiki i loaʻa i nā maʻi maʻi like ʻole a inā ʻaʻole i nui ka hapa a me ka hapa kilokilo ke kaumaha o ke keiki i ka wā hānau.

Inā lilo koʻikoʻi ke kūlana, a laila hiki ke hoʻopaʻa ʻia i nā hemorrhages i loko o ka lolo a i ʻole edema koʻikoʻi o ke kino. ʻO ia ke kumu e aʻo ai ka makua i ka pēpē e nānā i kā lākou ponoʻai a hoʻonohonoho pono iā ia i nā mea e pono ai a pau o ke kino, me ka meaʻai kūpono.

He aha kāu e ʻike pono ai i ka wā e ʻike ai i ka hyperglycemia?

E like me ka mea i ʻōlelo ʻia ma luna nei, ʻo ka hemahema o ka insulin i loko o ke kino e alakaʻi ai i ka nui o ke kō o ke koko e hoʻonui i kekahi mau manawa. E kū aku i kēia kuʻina, hiki i ka hyperglycemia. A ʻo ia, e like me kāu e ʻike nei, e alakaʻi i ka coma.

Akā, ma waena o nā mea āpau, e kōkua pū ka hyperglycemia i ka nui o ka nui o ka wai i loaʻa i loko o ke kino e komo koke i ke kahe koko mai nā kiko.

ʻO ka hopena, ke waiho ʻia nei nā ʻāpana ʻole me ka wai ʻole o ka mea kanu, no laila ua hoʻomaka kahi kanaka me ka ʻoliʻoli loa. Eia kekahi, hoʻomaka ka ʻupena e pala a palalulu, lauoho a nā kui.

Me ka hyperglycemia, kahi urinalysis e hōʻike i ka mua o ke kō.

ʻOiaʻiʻo, hiki ke pale i kēia mau hopena āpau. Akā inā wale ʻoe e hoʻomaka e mālama i kēia hōʻailona ma ka manawa. ʻO ka ʻōnaehana hoʻoili ʻia penei:

ʻO ke ʻano holoʻokoʻa o ka maʻi.
Ke hoʻokumu nei i ka pae o ka maʻi, ʻo ia ka ʻano o ka maʻi maʻi.
Kuhi i nā maʻi hoʻomohala hou a me nā hopena pili paha,
Ke kuhikuhi ʻana i nā lāʻau lapaʻau no ka mālama ʻana.

Inā maopopo nā mea a pau me nā helu ʻekolu mua, a laila e nānā pono ka mea i hope. Inā ʻaʻole e koi ʻia ka pae o ka maʻi i ka koho ʻana i nā inikini insulin, kahi i hoʻonoho ʻia i loko o ke kino, a laila hiki iā ʻoe ke pani i ka hoʻomākaukau o ka papa. ʻO kaʻoiaʻiʻo, i kēia manawa ʻaʻole kumu no ka inoa inoa i nā lāʻau lapaʻau, ʻoiai ke kaukaʻi wale ke kauka iā lākou, a pono ʻoe e hoʻomaka e lawe me ka ʻole o kāna kauoha.

Nā ʻano hana lapaʻau e pili ana

ʻO kaʻoiaʻiʻo, ʻo ka hoʻohui ʻana i nā lāʻau lapaʻau, kōkua nā ʻano hana like ʻole i ka mālama ʻana o kēia maʻi. Akā, ʻo kaʻoiaʻiʻo, hiki iā lākou ke hoʻohui wale ʻia me ka hoʻolālā koʻikoʻi, ʻaʻole pono ʻoe e hilinaʻi i ka mea hiki ke hiki ke hoʻololi hou i ka lāʻau lapaʻau.

ʻO ka hoʻohālike, ʻaʻole ia e hōʻeha i ka hoʻonaʻauao kino. Hiki i ke hoʻomaʻamaʻa kūpono ke kōkua i ka hoʻihoʻi ʻana i ke kaʻina o ka hana no ka insulin. Hāʻawi pū kekahi ʻano hana pilikino i ka pohō kaumaha. I ka lua o ke ʻano o ka maʻi maʻi, ʻike pinepine nā mea maʻi i kahi ʻano maikaʻi ʻole e like me ka pohō.

ʻO kahi kaʻawale, pono ʻoe e noʻonoʻo pono i nā mea e pono ai ke olakino. ʻO ka momona, ka momona hāleu. ʻOi aku ka ʻai ma kahi o elima manawa i ka lā, me nā māhele liʻiliʻi.

He mea nui ia e kaʻana like i ka nui o nā haʻalulu i hoʻopau ʻia i ka meaʻai a me ke ʻano kino.

Hoʻomaopopo nā kauka i ke ʻano o kahi meaʻai like:

E hoʻopau pono i nā meaʻai momona (ʻoi aku ka maikaʻi o ka ʻai ʻana i nā meaʻai ʻaʻole i loaʻa ka kō, akā, ʻo sorbitol a i ʻole xylitol a me nā mea ʻē aʻe).
Pono ʻoe e hoʻokaʻawale iā ʻoe iho i nā meaʻai starchy.
ʻO nā meaʻai keu ka maikaʻi.
Hele no ka like me ka mau moena momona ikaika.

E pono nā huahana a pau e loaʻa i nā huaora A, B, C, a me nā mea momona i nā protein. Maikaʻi, mai poina e hiki ke kau i nā meaʻai ke:

Inā mākou e kamaʻilio e pili ana i ka lāʻau lapaʻau kuʻuna, a laila nā pōkā mai nā mea kanu e like me ka barberry, cranberry, cornel, sorrel a me ka nui o ka nui o ka nui o ka nui o nā Hawaiʻi magnolia.

Inā hoʻomaka ka lolo i ka hoʻomaka ʻana o ka hoʻomohala, a laila ma muli o kaʻai kūpono a mālama i ke ʻano olakino maikaʻi e hoʻihoʻi i ke ʻano kūlohelohe o ka hana o ka insulin. A laila e hōʻemi i ka hiki ke hoʻomohala hou i kahi maʻi hou.

Pehea e ʻike koke ai i kahi kūlana weliweli?

ʻO ka Hyperglycemia kekahi o nā hopena paʻakikī loa o ka hemahema o ka insulin. A ʻo ka hiki koke ke ʻike i ka popo i kēia, ʻo ka wikiwiki hoʻi ke hiki ke hoʻoponopono i ke kūlana a mālama i ke ola o ka mea maʻi.

Kuhi nā hōʻailona kiko kikoʻī:

maʻi kaumaha,
a me ka ili o ka ʻili,
kaumaha kaumaha
ua maʻeha loa ka mea maʻi
hoʻomaka ka hoʻomaka ʻana
Hoʻopili hewa loa ka ʻike,
hoʻomaka nā poʻo kāhiki
aia kekahi manaʻo ikaika o ka pōloli,
palpitations.

ʻO ka hōʻailona ʻino loa he coma. I kēia hihia, pono ka hoʻokipa i ka maʻi maʻi a me ka hoʻohana ʻana i nā hana mālama ulu koke.

ʻO ka mea paʻakikī ka mea e hoʻokō ai i kahi kūlana no ke kanaka hoʻokahi. Inā ʻaʻole lākou i ʻike he pilikia lākou i ka nele o ka insulin, a laila hiki ke ʻano ʻia kēlā ʻano ʻino i kēlā me kēia manawa. He mea nui ia i kēia hihia aia kekahi ma kahi e hiki ke kōkua iā lākou a kāhea i kahi ambulance. Inā aia kekahi kanaka ma kāna iho, laila pono ʻoe e hoʻāʻo ma ka hōʻailona mua, e kāhea i ke kauka.

Akā ʻo ia, ʻo ia hoʻi, i mea e pale aku ai i kēlā kūlana, ʻoi aku ka maikaʻi o ka hoʻomaʻamaʻa pinepine ʻana e kekahi loea me ka ʻike ʻana i ke ʻano o nā kihi ʻē aʻe i kou olakino. Aia ma kēia hihia e hiki ke pale aku i nā hoʻopiʻi koʻikoʻi. ʻO ka wikiō ma kēia ʻatikala e haʻi aku iā ʻoe e pili ana i ka insulin.