Tsawg kawg 25% ntawm cov neeg mob ntshav qab zib tsis paub txog lawv tus mob. Lawv mob siab rau kev lag luam, tsis them nyiaj rau cov tsos mob, thiab lub sijhawm no ntshav qab zib maj mam tso lawv lub cev. Tus kab mob no yog hu ua tus tua neeg uas ntsiag to. Lub sijhawm pib tsis quav ntsej mob ntshav qab zib tuaj yeem ua rau mob plawv, raum tsis ua haujlwm, tsis pom kev, lossis ceg teeb meem. Tsawg me ntsis, tus mob ntshav qab zib ntog poob rau hauv coma vim yog cov ntshav qab zib ntau, mus txog kev tu hnyav, thiab tom qab ntawd pib kho.
Ntawm nplooj ntawv no, koj yuav kawm cov ntaub ntawv tseem ceeb txog cov cim ntshav qab zib. Ntawm no yog cov tsos mob thaum ntxov uas tuaj yeem yooj yim rau kev mob khaub thuas los yog muaj hnub nyoog hloov pauv. Txawm li cas los xij, tom qab nyeem peb cov ntawv, koj yuav yog koj tus neeg zov. Ua raws sijhawm los tiv thaiv kev mob ntshav qab zib. Yog koj xav tias koj muaj ntshav qab zib, sib piv koj tus mob nrog rau cov tau piav hauv qab no. Tom qab ntawd mus rau hauv chav kuaj thiab kuaj ntshav qab zib. Qhov zoo tshaj plaws tsis yog kev tsom xam ntawm kev yoo mov qab zib, tab sis kev txheeb xyuas ntawm glycated hemoglobin.
Tshawb nrhiav koj cov piam thaj hauv ntshav kom nkag siab koj cov txiaj ntsig kev kuaj ntshav. Yog tias cov piam thaj nce ntxiv, tom qab ntawd ua cov qib los kho cov ntshav qab zib kom tsis muaj kev tshaib plab, txhaj tshuaj insulin thiab tshuaj tsis zoo. Yuav luag txhua tus neeg laus thiab poj niam tsis quav ntsej txog cov tsos mob ntshav qab zib hauv lawv tus kheej thiab lawv cov menyuam. Lawv cia siab tias "tej zaum nws yuav dhau." Hmoov tsis zoo, qhov no yog ib qho kev vam meej. Vim tias cov neeg mob zoo li no tseem mus cuag kws kho mob tom qab, tab sis nyob rau hauv kev mob nyhav dua.
Yog tias cov tsos mob ntshav qab zib tau pom ntawm tus menyuam lossis tus neeg hluas hnub nyoog qis dua 25 xyoos tsis rog, yog li feem ntau nws yog ntshav qab zib hom 1. Txhawm rau kho nws, koj yuav tsum tau txhaj tshuaj insulin. Yog tias rog dhau lossis tus txiv neej hnub nyoog tshaj 40 xyoo thiab rog hnyav tsam ntshav qab zib, ces qhov no yog yam mob ntshav qab zib hom 2. Tab sis qhov no tsuas yog qhia xwb. Tus kws kho mob - tus kws kho mob endocrinologist muaj peev xwm txiav txim siab tias hom ntshav qab zib twg yog hom. Nyeem kab lus “Kev kuaj mob ntawm hom 1 thiab hom 2 ntshav qab zib.”
Cov tsos mob ntawm Hom 1 Ntshav Qab Zib
Raws li txoj cai, cov tsos mob ntawm tus mob ntshav qab zib hom 1 tau nce ntxiv hauv ib tus neeg sai, ntawm ob peb hnub, thiab ntau heev. Feem ntau tus neeg mob dheev poob rau hauv lub ntsej muag uas tsis nco qab (tsis nco qab lawm), nws tau maj nrawm mus rau tsev kho mob thiab twb kuaj pom tias mob ntshav qab zib.
Peb sau cov tsos mob ntawm tus mob ntshav qab zib hom 1:
- nqhis dej heev: ib tug neeg haus txog 3-5 litres ntawm cov kua dej tauj ib hnub;
- hnov ntxhiab tsw ntxhiab ntawm acetone hauv pa tawm;
- tus neeg mob tau nce siab, nws noj ntau, tab sis tib lub sijhawm nws poob phaus;
- nquag thiab profuse tso zis (qhov no hu ua polyuria), tshwj xeeb tshaj yog thaum tsaus ntuj;
- qhov txhab zoo tsis zoo;
- qhov tawv nqaij khaus, feem ntau muaj fungi lossis boils.
Ntshav qab zib Hom 1 feem ntau pib 2-4 lub lis piam tom qab kis mob khaub thuas (khaub thuas, rubella, qhua pias, thiab lwm yam) lossis kev nyuaj siab loj.
Cov tsos mob ntawm Ntshav Qab Zib Hom 2
Hom ntshav qab zib no maj mam loj hlob dhau ob peb xyoos, feem ntau hauv cov neeg laus. Ib tug neeg mob nkees tas li, nws cov qhov txhab kho tsis zoo, nws lub zeem muag txo qis thiab nws txoj kev nco tsis zoo. Tab sis nws tsis paub tias cov no yog cov tsos mob ntshav qab zib tiag. Feem ntau, mob ntshav qab zib hom 2 yog txheeb tau los ntawm kev sib tsoo.
Ntshav Qab Zib Hom 2 yog ntaus cim los ntawm:
- cov lus tsis txaus siab thoob plaws: nkees, plooj tsis pom kev, teeb meem nco qab;
- qhov teeb meem ntawm daim tawv nqaij: khaus, nquag fungus, mob thiab txhua yam ua kom tsis zoo;
- nqhis dej - txog li 3-5 liv dej ntawm ib hnub;
- ib tug neeg nquag tau sawv los mus sau ntawv thaum hmo ntuj (!);
- mob rau ntawm txhais ceg thiab txhais taw, loog lossis tingling hauv ob txhais ceg, mob thaum taug kev;
- nyob rau hauv cov poj niam - thrush, uas yog qhov nyuaj los kho;
- hauv cov theem tom qab ntawm tus kabmob - poob ceeb thawj yam tsis tau noj zaub mov;
- ntshav qab zib tau nyaij ua tsis muaj tsos mob - hauv 50% ntawm cov neeg mob;
- kev tsis pom kev, mob raum, mob plawv nres, ntshav hlab ntsha tawg, yog thawj zaug kev mob ntshav qab zib hom 2 hauv 20-30% ntawm cov neeg mob (ntsib kws kho mob sai li sai tau, tsis txhob tos ncua!).
Yog tias koj rog dhau, nrog rau kev nkees, qhov txhab kho tsis zoo, qhov muag pom ntog, lub cim xeeb tsis zoo - tsis txhob ua tub nkeeg ntau dhau los kuaj xyuas koj cov ntshav qab zib. Yog tias nws nce siab - koj yuav tsum tau kho. Yog tias koj tsis ua qhov no, koj yuav tuag ntxov, thiab ua ntej koj yuav muaj sijhawm tiv thaiv kev mob ntshav qab zib (qhov muag tsis pom kev, raum tsis ua haujlwm, mob txhab thiab mob caj dab hauv ob txhais ceg, mob stroke, plawv nres).
Kev tswj hwm tus mob ntshav qab zib hom 2 tej zaum yuav yooj yim dua li qhov koj xav.
Cov tsos mob ntshav qab zib hauv cov menyuam yaus
Cov menyuam yaus me pib muaj ntshav qab zib, nws cov tsos mob ntau dua yuav raug pov los ntawm cov neeg pom nyob rau hauv cov laus. Nyeem cov ncauj lus ntxaws, "Cov tsos mob ntshav qab zib hauv cov menyuam yaus." Cov ntaub ntawv no muaj txiaj ntsig zoo rau txhua tus niam txiv thiab tshwj xeeb tshaj yog rau cov kws kho mob. Vim tias nyob hauv kev xyaum ntawm cov kws kho hniav mob ntshav qab zib, muaj ntshav qab zib muaj tsawg heev. Cov kws kho mob feem ntau coj cov tsos mob ntshav qab zib hauv cov menyuam yaus yog qhov tshwm sim ntawm lwm yam kab mob.
Yuav ua li cas paub qhov txawv hom 1 mob ntshav qab zib los ntawm ntshav qab zib hom 2?
Cov tsos mob ntawm tus mob ntshav qab zib hom 1 yog mob neeg mob, tus kab mob pib dheev. Mob ntshav qab zib hom 2, kev mob kev nkeeg zuj zus zuj zus. Yav dhau los, tsuas muaj ntshav qab zib hom 1 tau suav hais tias yog "tus kab mob ntawm cov tub ntxhais hluas", tab sis tam sim no tus ciam teb no tau plooj li. Ntawm hom 1 ntshav qab zib, kev rog yog feem ntau tsis tuaj.
Txhawm rau paub hom ntshav qab zib hom 1 ntawm ntshav qab zib hom 2, koj yuav tsum kuaj ntshav qab zib, thiab ntxiv rau ntshav qabzib thiab C-peptide. Nyeem ntxiv hauv kab lus “Kev kuaj mob ntawm hom 1 thiab hom 2 ntshav qab zib.”
Lus piav qhia txog qee cov tsos mob ntawm tus mob ntshav qab zib
Tam sim no peb yuav piav qhia tias vim li cas, mob ntshav qab zib mellitus, cov neeg mob muaj qee cov tsos mob. Yog koj nkag siab causation, koj tuaj yeem kho thiab kho koj tus mob ntshav qab zib tau zoo dua.
Nqhis dej thiab tso zis tso zis ntau ntxiv (polyuria)
Ntawm cov ntshav qab zib, rau ib qho laj thawj lossis lwm qhov, cov piam thaj hauv cov piam thaj hauv cov ntshav nce siab. Lub cev sim muab nws tshem tawm - ua nrog zis. Tab sis yog tias qhov concentration ntawm cov piam thaj hauv cov zis ntau dhau, lub raum yuav tsis nco nws. Yog li, yuav tsum muaj zis ntau.
Txhawm rau tsim “muaj zis ntau, nws lub cev yuav tsum muaj dej txaus. Yog li muaj ib tus tsos mob ntawm kev nqhis dej heev rau ntshav qab zib. Tus neeg mob tau tso zis ntau zaus. Nws tau nce ob peb zaug ib hmos - qhov no yog tus yam ntxwv thaum ntxov mob ntshav qab zib.
Tsw ntxhiab ntawm cov acetone hauv pa tawm
Nrog rau cov ntshav qab zib, muaj ntau cov piam thaj hauv cov ntshav, tab sis cov cell tsis tuaj yeem nqus nws, vim hais tias cov insulin tsis txaus los yog nws tsis ua haujlwm zoo. Yog li no, lub hlwb ntawm lub cev (tshwj tsis yog lub hlwb) hloov mus rau khoom noj khoom haus los ntawm cov rog rog.
Thaum lub cev so tawm cov rog rog, lub npe hu ua "ketone lub cev" tshwm sim (b-hydroxybutyric acid, acetoacetic acid, acetone). Thaum cov concentration ntawm ketone lub cev hauv cov ntshav tau siab, lawv pib tso tawm thaum ua pa, thiab qhov tsis hnov tsw ntawm acetone tshwm rau saum huab cua.
Ketoacidosis - coma rau ntshav qab zib hom 1
Muaj tus ntxhiab tsw ntawm acetone hauv cov pa uas tso tawm - nws txhais tau hais tias lub cev hloov mus noj cov rog, thiab lub cev ketone nthuav tawm hauv cov ntshav. Yog tias hom ntshav qab zib hom 1 tsis raug coj mus rau lub sijhawm (insulin), tom qab ntawv ntawm cov ketone lub cev ua haujlwm dhau lawm.
Hauv qhov no, lub cev tsis muaj sijhawm los tso lawv, thiab acidity ntawm cov ntshav hloov. Cov ntshav pH yuav tsum nyob hauv qhov nqaim me me (7.35 ... 7.45). Yog tias nws txawm mus rau me ntsis dhau ntawm cov ciam teb no - muaj kab mob nkees, nkees nkees, tsis qab los noj mov, xeev siab (qee zaum ntuav), tsis mob plab. Txhua yam no yog hu ua ketoacidosis uas yog ntshav qab zib.
Yog tias tus neeg poob mus rau hauv lub cev tsis nco qab vim ketoacidosis, qhov no yog ib qho kev phom sij txaus ntshai ntawm ntshav qab zib, fraught nrog kev tsis taus lossis kev tuag (7-15% ntawm kev tuag). Nyob rau tib lub sijhawm, peb yaum kom koj tsis txhob ntshai ntawm tsis hnov tsw tsw ntawm Acetone los ntawm koj lub qhov ncauj yog tias koj yog neeg laus thiab koj tsis muaj ntshav qab zib hom 1.
Thaum kho cov ntshav qab zib hom 2 nrog cov zaub mov tsis muaj carbohydrate, tus neeg mob yuav pib txhim kho ketosis - kev nce qib hauv ketone lub cev hauv cov ntshav thiab cov nqaij mos. Qhov no yog qhov mob physiological zoo uas tsis muaj cov nyhuv tshuaj lom. Tus pH ntawm cov ntshav tsis poob qis tshaj 7.30. Yog li no, txawm hais tias qhov tsis hnov tsw ntawm acetone los ntawm qhov ncauj, ib tus neeg hnov zoo li qub. Nyob rau lub sijhawm no, nws tau raug tshem tawm cov rog ntau dua thiab poob phaus.
Muaj qab los ntxiv rau cov ntshav qab zib
Ntawm cov ntshav qab zib, tib neeg lub cev tsis muaj cov insulin, lossis nws tsis ua haujlwm zoo. Txawm hais tias nws muaj ntshav qabzib ntau txaus hauv cov ntshav, lub hlwb tsis tuaj yeem nqus nws vim muaj teeb meem nrog insulin thiab "tshaib plab". Lawv xa cov cim tshaib plab mus rau lub hlwb, thiab ib tus neeg lub siab xav nce.
Tus neeg mob noj tau zoo, tab sis cov carbohydrates uas nrog cov zaub mov tsis tuaj yeem nqus cov ntaub so ntswg ntawm lub cev. Cov teeb meem nce siab ntxiv txuas ntxiv mus txog thaum qhov teeb meem nrog cov tshuaj insulin raug daws los yog kom txog thaum lub hlwb pauv mus rau cov rog. Hauv rooj plaub tom kawg, hom ntshav qab zib hom 1 tuaj yeem tsim muaj ketoacidosis.
Cov tawv nqaij ua pob khaus, nquag ua fungal, tawm pob
Ntawm ntshav qab zib, piam thaj yog nce siab hauv txhua qhov dej hauv lub cev. Muaj piam thaj ntau dhau rau, nrog rau tawm hws. Cov pwm thiab cov kab mob ua tau zoo heev ntawm qhov chaw noo, sov nrog qhov nce ntawm cov piam thaj, uas lawv noj. Ua rau koj cov ntshav qabzib hauv lub cev nyob ze rau qhov qub - thiab koj cov tawv nqaij thiab qhov ntsej muag zoo yuav zoo dua.
Vim li cas cov kiav txhab thiaj tsis zoo kho tau tus mob ntshav qab zib
Thaum cov concentration ntawm cov piam thaj hauv cov ntshav tau nce, nws muaj cov nyhuv ntxim rau cov phab ntsa ntawm cov hlab ntshav thiab tag nrho cov qe ntshav uas ntxuav los ntawm cov ntshav ntws. Txhawm rau kom paub tseeb tias qhov txhab zoo, ntau cov txheej txheem muaj tshwm sim hauv lub cev. Xws li, cov tawv nqaij noj qab haus huv tau faib.
Txij li cov ntaub so ntswg raug rau cov kev phiv ntawm "piam thaj" ntau dua, tag nrho cov txheej txheem no tau ua rau qeeb. Cov kab mob ua tau rau txoj kev vam meej ntawm kis tau kuj yog tsim. Peb ntxiv tias nyob hauv cov poj niam muaj ntshav qab zib, cov tawv nqaij muaj hnub nyoog ntxov ntxov.
Ntawm qhov kawg ntawm tsab xov xwm, peb xav tau ib zaug ntxiv qhia rau koj kom sai xyuas koj cov ntshav qab zib kom tsawg thiab tham nrog tus kws kho mob endocrinologist yog tias koj pom cov tsos mob ntshav qab zib hauv koj tus kheej lossis cov neeg koj hlub. Nws yeej tseem tsis tuaj yeem kho nws tam sim no, tab sis kev tswj ntshav qab zib kom tswj tau thiab ua neej nyob yog qhov muaj tiag. Thiab nws tej zaum yuav yooj yim dua li qhov koj xav.
