Hauv tsab xov xwm no, koj yuav kawm txhua yam yam mob ntshav qab zib muaj. Peb yuav sib tham tsis yog tsuas yog “loj” yam 1 thiab ntshav qab zib hom 2, tab sis kuj paub ntshav qab zib tsawg tsawg. Piv txwv li, ntshav qab zib vim yog qhov muaj teeb meem caj ces, nrog rau cov teeb meem ntawm lub cev zaub mov tsis txaus ntawm carbohydrates, uas tuaj yeem tshwm sim los ntawm kev noj tshuaj.
Ntshav Qab Zib mellitus yog ib pab pawg ntawm cov kab mob (cov teeb meem hauv lub cev hauv lub cev) nyob rau hauv uas tus neeg mob muaj cov ntshav nce ntshav khov nyob ntev. Qhov no yog hu ua hyperglycemia. Qhov ua rau pheej muaj hyperglycemia hauv ntshav qab zib yog qhov zais ntshis ntawm cov tshuaj insulin los ntawm tus txiav yog tsis zoo, lossis insulin tsis ua haujlwm zoo. Hauv qee hom ntshav qab zib, ob qho ntawm cov xwm txheej no tau koom ua ke hauv ib tus neeg mob.
Qhov tsis muaj kev nqis tes ua ntawm cov tshuaj insulin yog vim qhov tseeb hais tias tus txiav "ua" nws tsawg, lossis muaj kev puas tsuaj nyob rau hauv cov ntaub so ntswg teb rau insulin. Nquag ua kom cov ntshav qab zib ntau ntau ua rau tib neeg lub neej luv thiab ua teeb meem rau ntau yam plab hnyuv siab raum thiab cov kab ke hauv lub cev. Qhov no yog qhov tseeb tshwj xeeb tshaj yog rau kev kho qhov muag (mob ntshav qab zib retinopathy), mob raum (mob ntshav qab zib hauv lub raum), cov hlab ntsha (mob ntsws - mob rau cov leeg ntshav), cov hlab ntsha (ntshav qab zib neuropathy) thiab lub siab.
Tam sim no peb yuav muab cov kev faib tawm cov ntshav qab zib mellitus raws hom, uas tau pom zoo los ntawm American Diabetes Association hauv 2010. Qhov kev faib tawm ntawm cov ntshav qab zib hom no suav tias yog qhov ua tiav tshaj plaws rau hnub tim.
Yam 1 ntshav qab zib
Nrog rau tus kab mob no, pancreatic beta hlwb raug rhuav tshem, thiab qhov no ua rau cov tshuaj insulin tsis txaus hauv lub cev.
A) Tshuaj tiv thaiv kab mob ntshav qab zib hom 1 ntshav qab zib - beta hlwb tuag vim los ntawm "kev tawm tsam" ntawm lawv lub cev tsis muaj zog;
B) Idiopathic - lawv hais yog vim li cas qhov teeb meem ntshav qab zib tsis tuaj yeem txiav txim siab.
Mob ntshav qab zib Hom 2
Nws tuaj yeem tshwm sim vim kev txhim kho ntau tshaj cov ntaub so ntswg tsis kam rau insulin kev txiav txim siab - qhov no hu ua insulin tsis kam, thiab qhov no, insulin tsis txaus yog "tus txheeb ze".
Mob ntshav qab zib Hom 2 tsawg dua vim muaj qee yam ua txhaum cov tshuaj insulin zais zis los ntawm tus txiav, uas yog tseem koom nrog kev tiv thaiv insulin.
Lwm hom mob ntshav qab zib
A) Kev tsis sib deev caj ceg hauv cov haujlwm ntawm beta hlwb:
- chromosome 12, HNF-1 alpha (MODY-3);
- chromosome 7, glucokinase (MODY-2);
- chromosome 20, HNF-4 alpha (MODY-1);
- chromosome 13, IPF-1 (MODY-4);
- chromosome 17, HNF-1 beta (MODY-5);
- chromosome 2, NeuroD1 (MODY-6);
- mitochondrial DNA;
- lwm tus neeg.
C) Cov kab mob caj ces hauv txoj haujlwm ntawm insulin:
- hom A cov tshuaj insulin;
- leprechaunism;
- rabson-mendenhall syndrome;
- lipoatrophic dibet;
- lwm tus neeg.
C) Cov kab mob ntawm exocrine pancreatic apparatus:
- pancreatitis
- kev poob plig, kev mob caj dab;
- cov txheej txheem neoplastic;
- cystic fibrosis;
- hemochromatosis;
- fibrocalculeous pancreatopathy;
- lwm tus neeg.
D) Endocrinopathy:
- acromegaly;
- Itsenko-Cushing's syndrome;
- glucagonoma;
- pheochromocytoma;
- hyperthyroidism;
- somatostatinoma;
- aldosteroma;
- lwm tus neeg.
E) Ntshav Qab Zib Vim Raug Tsim los ntawm Cov Tshuaj Yeeb Tshuaj los Siv Tshuaj
- txhaj tshuaj tiv thaiv kab mob (mob rau cov nas);
- pentamidine;
- nicotinic acid;
- glucocorticoids;
- cov thyroid hormones;
- diazoxide;
- alpha adrenergic kev thaiv kev;
- beta-adrenergic antagonists;
- beta-blockers;
- thiazides (thiazide diuretics);
- dilantin;
- alpha interferon;
- protease inhibitors (HIV);
- cov tshuaj tiv thaiv kab mob (Tacrolimus);
- opiates;
- atypical tshuaj tiv thaiv kev ntxhov siab;
- lwm tus neeg.
F) Kab mob
- qoob rub los ntshav;
- cytomegalovirus;
- lwm tus neeg.
G) Txawv cov ntshav qab zib uas tsis muaj zog tiv thaiv:
- txhav kab mob tib neeg mob (txhav-txiv neej -syndrom);
- cov tshuaj tiv thaiv rau cov tshuaj insulin;
- lwm tus neeg.
Lwm yam kev mob raws caj ces qee zaum cuam tshuam nrog ntshav qab zib:
- Down mob ntsws;
- Klinefelter syndrome;
- Turner syndrome;
- tungsten syndrome;
- Fredericks ataxia;
- Huntington's chorea;
- Lawrence-Moon-Beadle syndrome;
- myotonic dystrophy;
- porphyria;
- Prader-Willi syndrome;
- lwm tus neeg.
Lus khaws xav Ib tug neeg mob uas muaj ntshav qab zib tej zaum yuav xav tau kev pab tshuaj insulin rau txhua ntu ntawm tus kab mob. Txawm hais tias tus neeg mob tau txais insulin lossis tsis tau, qhov no tsis tuaj yeem yog qhov pib los cais nws cov ntshav qab zib mus rau hauv ib lossis lwm chav kawm.
Mob ntshav qab zib Gestational
Lub American Diabetes Association qhia txog tus mob ntshav qab zib hauv lub ntsej muag (uas tau tshwm sim rau tus poj niam lub sijhawm muaj menyuam hauv plab) ua lwm hom. Nws tsis siv rau hauv kev txiav txim siab txawm tias tus poj niam raug kho nrog insulin lossis tsuas yog noj zaub mov noj, thiab tseem yuav paub txog kev noj haus carbohydrate tsis zoo tom qab yug menyuam.
6 lub lis piam tom qab kawg ntawm cev xeeb tub (lossis tom qab), tus poj niam yuav tsum rov kuaj dua thiab muab rau ib ntawm cov hauv qab no:
- mob ntshav qab zib
- tsis hnov lus ceev ceev glycemia;
- tsis hnov lus qab zib kom tsis taus;
- ntshav qab zib li qub yog normoglycemia.
