Ọrịa shuga - ọrịa metabolic

Nnukwu insulin zuru oke ma ọ bụ ezughi oke (ntụpọ metabolic na - arịa ọrịa shuga) na - eduga n'ịmebi ụdị metabolism niile,, karịa, - carbohydrate:

ụba gluconeogenesis n'ihi ọnwụ nke insulin na enzymes gluconeogenesis,

mụbara glycogenolysis n'okpuru glucagon, ịba ụba gluconeogenesis na glycogenolysis na-emepụta oke glucose n'ime ọbara, yana

mbufe ya site na membranes na anụ ahụ na - eme insulin na - emebi emebi n'ihi enweghi insulin.

N'ihi ya, a peculiar onuma anụ ahụ na-eme ka agụụ nwee ume na oke ihe ndị na-enye ume ọrụ n'ime ọbara.

Hyperglycemia - isi ihe mgbaàmà nke ọrịa shuga - na-abawanye plasma osmolarityna-eduga nasel akpịrị. Ngwa ngwa nzipu akwara nke glucose (8-10 mmol / L), ọ na - apụta na mmamịrị, na - akpata ya.glucosurianapolyuria(ihe mgbaàmà nke decompensation DM). A na - ejikọ Polyuria na nrụpụta mmiri na electrolytes n'ihi oke osmolarity nke mmamịrị mbụ. Polyuria na hyperosmia na-akpataakpịrị ịkpọ nkụnapolydipsiakanocturia(ihe mgbaàmà nke decompensation DM).

Osmotic diuresis na-eduga n'oké mkpochapụnadyselectrolytemia. Ihe si na akpọnwụ akpọnwụ bụhypovolemia, ọbara mgbada agbada, ụbụrụ na-akawanye njọ nke ụbụrụ, akụrụ, mbelata nke mkpo ya,oliguria(na mmepe nke nnukwu gbasara akụrụ ọdịda). Na mgbakwunye, n'ihi akpịrị ịkpọ nkụ, ọbara ọgbụgba na-eme, nsị, ICE na-etolite, ọrịa microcirculation na-eduga.hypoxiaanụ ahụ.

Hyperglycemia na-eduga na ịgbalite okirikiri polyol(site na mmezi nke aldoreductase). Ọ bụ metabolism nwere nnwere onwe glucose na nguzobe sorbitol na fructose. Ngwaahịa ndị a na-agbakọ n'ime anụ ahụ na - abụghị insulin (oghere, akwara akwara, mkpụrụ ndụ imeju, sel ọbara ọbara, mgbidi vaskụla, insulocytes basophilic) na, ịbụ osmotic, na-adọta mmiri, nke na-eduga ná mbibi nke anụ ahụ.

Hyperglycemia site na nchịkọta nke sorbitol (ma, yabụ, mbelata nke NADPH mee₂), na-enwekwa n'ihi mbelata ọrụ nke protein kinase C, na-eduga n'ịbelata mkpokọtanitric oxide (ihe ntụrụndụ nke endothelial), nke na-eduga n'ịrịa vasoconstriction na ischemia anụ ahụ,

Hyperglycemia na-eduga hyalinosisna ime ka mgbidi nke arịa ọbara (hyalinosis - nguzobe nke glycoproteins, nke, na - agafe na okpuru ulo nke okpuru ulo, na-adaba ngwa ngwa ma hyalinized).

Hyperglycemia na-akpali usoro ahụ protein glycosylation(glycosylation bụ usoro njikọ nke glucose na-adịghị enzymatic na protein nke amino). N'ihi ya, a na-emepụta ngwaahịa glycosylation kwụsiri ike:

glycosylated haemoglobin. Havingnwe ezigbo mmetụta maka oxygen, adịghị enye ya anụ ahụ, hypoxia na-etolite,

glycosylated apoproteins nke LDL na HDL, nke na-eduga n'ịbawanye ụba nke LDL / HDL.

glycosylation nke protein nke coagulation na usoro anticoagulation, nke na-eduga n'ịba ụba nke thrombosis,

glycosylation nke ihe na-edozi ahụ nke akpụkpọ ahụ na okpuru ulo,

glycosylation nke myelin, nke na-eduga ngbanwe n'ụdị sistemu anụ ahụ,

glycosylation nke oghere protein, nke na-eduga na mmepe nke cataracts,

glycosylation nke protein na-ebugharị insulin, nke na-eduga na iguzogide insulin, wdg.

Ngwaahịa glycosylation niile nwere usoro agbanweela, nke pụtara na ha nwere ike inweta Njirimara antigenic, n'ihi nke mmerụ ahụ nke mebiri akụkụ na anụ ahụ kwekọrọ.

Enweghị insulin na-edugakwa na mmepe lactic acidosis. Usoro:

Enweghị insulin na-eduga na igbochi pyruvate dehydrogenase, n'ihi nke PVA agbanyeghị AcCoA (isure ọkụ na c. Krebs). N'ọnọdụ a, ịpụpụ nke PVC na-agbanwe n'ime lactate,

ụkọ insulin na-akwalite catabolism protein, nke na-eduga n'ịmepụta oke nke mkpụrụ maka mmepụta pyruvate na lactate,

hypoxia anụ ahụ, yana mmụba na ọrụ nke homonụ ndị na-egbochi ihe (karịsịa adrenaline na STH) na-eduga na mmegharị nke glycolysis anaerobic, nke pụtara mmụba na nguzobe nke lactate.

Abụba metabolismya na ụdị ọrịa shuga nke 1, ha na-akpakọrịta na enweghị insulin zuru oke yana mmụba na ọrụ nke homonụ na-efe efe. Nke a na-eduga na mbelata na ojiji nke glucose site na anụ ahụ adipose ka ọ na-ebelata lipogenesis ma na-eme ka lipolysis dịkwuo elu. (ndị ọrịa nwere ụdị oria 1 dị gịrịgịrị).

N'ihi nke a, ketogenic amino acid (leucine, isoleucine, valine) na FFA na-abanye imeju, ebe ha ghọrọ mkpụrụ maka mmebi oke nke ahụ ketone (acetoacetic, b-hydroxybutyric, acetone). Na-etolitehyperketonemia.

Mmiri ọgwụ ndị dị na ketone:

gbochie njikọta insulin ma mejupụta ya,

gbazee akpụkpọ ahụ ihe na-emebi emebi,

igbochi ọrụ ọtụtụ enzymes,

inhibido ọrụ nke usoro akwara ozi,

kpatara mmepe nke ketoacidosis,

na-ebute mmepe nke hyperventilation,

mebie hemodynamics: gbochie ibulite myocardial ma belata obara mgbali elu n'ihi mmụba nke arịa dị n'akụkụ.

Ọrịa metabolismna-arịa ọrịa shuga e ji mara:

mgbochi nke protein protein (insulin na - eme ka enzymes protein) na

mmụba na mbelata ya na uru ahụ (insulin na - egbochi enzymes gluconeogenesis, na enweghi insulin, AK na - abanyekwa na glucose),

na mgbakwunye, AK na-ebugharị site na membranes cell.

N'ihi ya, a na-emepụta ụkọ protein n’ime ahụ, nke na-eduga:

nwere mmụba n'ebe ụmụaka nọ

ụkọ nke usoro plastik,

ọnya na-agwọ

belata Ati ngwaahịa

belata iguzogide ọrịa,

na mgbakwunye, mgbanwe na antigenic Njirimara nke protein ahụ nwere ike ịkpalite usoro nyocha autoimmune.

Nsogbu nke Ọrịa Shugaekewa n'ime nnukwu na-adịghị ala ala. Ọrịa siri ike nke ọrịa shuga - coma. Ala ala - angiopathies na neuropathies.

A na-ekebi angiopathies na-arịa ọrịa shuga na micro- na macroangiopathies.

Microangiopathies na-arịa ọrịa shuga - mgbanwe mgbanwe na arịa nke microvasculature.

ìgwè sorbitol na fructose n'ime arịa arịa,

glycosylation ngwaahịa nke na-edozi nke okpuru ulo,

hyalinosis nke arịa arịa,

N'ihi ya, a na-emebi usoro, metabolism na ọrụ nke mgbidi arịa ahụ, ischemia anụ ahụ na-amalite. Maindị isi nke microangiopathies: retinopathy na nephropathy.

Ọrịa mamịrị Retinopathy- microangiopathy nke arịa azụ, na ọkwa ọnụ na-eduga na mfuhụ ọhụụ zuru oke. Microaneurysms, maculopathy, hemorrhages vitreous. Otuto - ichigharị azụ, glaucoma nke abụọ.

Nehropathy na-arịa ọrịa shuga- mmerụ ahụ dị kpọmkwem na microvasculature nke arịa nke akụrụ, yana ntinye nke nodular ma ọ bụ na-agbasa glomerulosclerosis na CRF na ọkwa ọnụ.

Ọrịa mamroangiopathy- mmebi nke akwara art.Usoro:

glycosylation nke ala akpụkpọ ahụ,

ìgwè sorbitol na fructose n'ime arịa arịa,

Ihe a niile na - eduga na ndagide, belata ịdị uchu nke arịa arịa, ịba ụba nke ike, mkpocha nke ndị na-anabata heparin, ịba ụba platelet, na mkpali nke ịgbatị sel ahụ dị nro, nke pụtara na mbu ma kwalitemmepeatherosclerosis. Isi usoro nke macroangiopathies mamịrị:

obi mebiri, ya mere, oria obi na akwara obi wee buru ihe ya na nsogbu.

mmebi nke arịa ụbụrụ n'ụdị ụbụrụ, ọgba aghara dị mkpirikpi nke mgbasa ụbụrụ na dementia,

ọnya ọnya nke arịa nke ala akụkụ obere akụkụ n'ụdị ngwangwa, necrosis, gangrene.

Ọrịa mamịrị na-arịa ọrịa mamịrị- mmebi nke usoro ụjọ ahụ na - arịa ọrịa shuga.

Mgbasa akwara na-emetụta ya,

nguzobe nke ogwu mgbochi ka protein gbanwetụrụ na autoaggression n'ihe metụtara antigens nke anụ ahụ akwara,

iko sorbitol na fructose na neurons na sel Schwann,

mgbada n'usoro NO na mgbidi arịa.

Ihe ndị a niile na - eduga n'ọgba aghara nke ọkọnọ ọbara, mbelata na njikọ nke myelin, na mbelata nke omume akwara. Ofdị ọrịa neuropathy mamịrị:

Mbibi CNS (encephalopathy, myelopathy),

mbibi akwara ozi (polyneuropathy, mononeuropathy): ọgba tum tum na uche,

mmebi nke akwara autonomic (autonomic neuropathy): nsogbu nke usoro ọrụ gbasara obi, ụda vaskụla, eriri afọ, eriri afọ.

Angiopathies na neuropathies nwere ike ibute ọrịa shuga dịka ụkwụ mamịrị.

Ọrịa mamịrị- Ọnọdụ pathologies ụkwụ ahụ na ọrịa shuga, nke mebiri anụ ahụ yana anụ ahụ dị nro, ọkpụkpụ na nkwonkwo ma gosipụtara n'ụdị ọnya trophic, mgbanwe nkwonkwo ọkpụkpụ na usoro purulent-necrotic (ruo gangrene).

Ọrịa siri ike nke ọrịa shuga - coma.

Ọrịa mamịrị. Isi ihe na-ebute uto nke ọrịa shuga (DC) na-arịa ọrịa shuga abụghị ọrịa shuga n'onwe ya, ebe ọ bụ na mmepe nke coma abụghị ihe mgbagwoju anya.ntụpọ.

Decompensated ọrịa shuga- ọnọdụ nke ọrịa metabolic na akwara ọrụ dị n'ọrịa ahụ wee ruo ọkwa dị oke egwu ma nwee nnukwu nsogbu nke homeostasis: hyperosmolarity na akpịrị ịkpọ nkụ, dyselectrolythemia, ketoacidosis, lactic acidosis, hypoxia siri ike, wdg offọdụ mgbanwe mgbanwe a na - enwe ike nkekpaghasị ụbụrụ, nke putara iduba na mmepe nke coma.

Dabere n'ụdị ọrịa shuga mellitus na njiri nke ihe na-akpata, ma ọ bụ ketoacidosis, ma ọ bụ hyperosmolarity, ma ọ bụ lactic acidosis nwere ike inwe otu onye ọrịa. N'akụkụ a, enwere nhọrọ atọ maka DC:

ketoacidotic hyperglycemic coma,

hyperosmolar hyperglycemic coma,

Antsdị atọ a dị iche iche nke DC nwere pathogenesis yiri nke ahụ metụtara decompensation nke ọrịa shuga, mana bụrụ otu ụdị ọrịa n'ọnọdụ nke ọ bụla.

1dị shuga 1 (IDDM)

Ahụ mmadụ anaghị emepụta insulin. Peoplefọdụ ndị mmadụ na-ezo aka na ụdị a dịka shuga na-arịa ọrịa shuga, ọrịa shuga ma ọ bụ ọrịa shuga n'oge. A na-ebutekarị ọrịa shuga agedị nke mbụ tupu afọ 40, mgbe ọ na-etolite ntorobịa ma ọ bụ ntorobịa. Ọrịa shuga 1dị nke 1 anaghị adịkarị ka nke abụọ. Ihe dị ka 10% nke ọrịa shuga niile bụ ụdị 1. Ndị ọrịa nwere ọrịa shuga 1 kwesịrị ị inụ insulin n'oge ndụ ha niile. Ha kwesịkwara ịchọpụta ọkwa glucose ọbara dị mma site na ịme nyocha ọbara oge niile na ịgbaso nri pụrụ iche. Ọ bụ ihe nwute, ụdị shuga 1 ka na-enweghị ọgwụgwọ, na-enweghị insulin na ọrịa a, ụdị nkwarụ siri ike na-eme ngwa ngwa, ma na-akpata nsonaazụ. Ọrịa dị ogologo oge nke ụdị shuga 1 (nsonaazụ nke ọrịa shuga ụkwara ume ọkụ) nwere ike ịbụ: ìsì, nkụchi obi, ọdịda akụrụ, ụsọ ọnya, dementia, ọnya trophic (ruo na mbepụ ụkwụ).

Diabetesdị ọrịa shuga 2 (NIDDM)

Ahụ mmadụ anaghị emepụta insulin zuru oke maka ọrụ kwesịrị ya, ma ọ bụ sel ndị dị na ahụ anaghị anabata insulin (nguzogide insulin). Ihe dị ka 90% nke ọrịa shuga niile n'ụwa niile nwere ọrịa shuga 2.

Peoplefọdụ ndị na - enwe ike ịchịkwa ihe mgbaàmà ha nke ọrịa shuga 2, na - efulata, na - enwe ezigbo nri, na - emega ahụ ma na - ejikwa ọkwa glucose ọbara ha. Agbanyeghị, ụdị nke abụọ na - abụkarị ọrịa na - aga n'ihu - ọ na - akawanye njọ - onye ọrịa ahụ wee were ọgwụ belata shuga, ma ọ bụ ọbụlagodi insulin.

Ndị buru oke ibu na ndị buru oke ibu nwere ihe dị elu nke ibute ụdị nke 2 ma e jiri ya tụnyere ndị nwere ezigbo ahụ. Ndị nwere ọtụtụ abụba dị n'ime, nke a makwaara dị ka oke ibu, abụba afọ, ma ọ bụ oke ibu, nọ n'ihe ize ndụ.

Ihe ize ndụ nke ịmalite ịrịa ọrịa shuga 2 dịkwa ukwuu ka anyị na-aka nká. Ndị ọkachamara ejighị n'aka ihe kpatara ya, mana ha na-ekwu na ka anyị na-akawanye agadi, anyị na-etinye ibu ma na-esighi ike. Ndị ndị ikwu ha na-arịa ọrịa ma ọ bụ nwee ụdị nke 2 nọ n'ihe ize ndụ nke ibute ọrịa a.

Ọrịa mamịrị n'oge afọ ime (ọrịa afọ ime)

Typedị a na - emetụta ụmụ nwanyị n’oge ime. Womenfọdụ ụmụ nwanyị nwere oke glucose ọbara dị elu, ahụ ha enweghị ike imepụta insulin zuru ezu iji buru glucose niile na sel, na-eme ka ọkwa glucose na-aga n'ihu. A na-achọpụta ọrịa shuga n’afọ ime.

Imirikiti ndị ọrịa na-arịa ọrịa shuga n’oge ime nwere ike ijikwa ọrịa ha site na mmega ahụ na nri. Mana ka 10% -20% n’ime ha kwesịrị ị were ụfọdụ ọgwụ iji chịkwaa glucose ọbara. Ọrịa shuga na-achịkwaghị achịkwa ma ọ bụ nke a na-achịkwaghị achịkwa n'oge ịtụrụ ime nwere ike ịbawanye ohere nke nsogbu na ịmụ nwa. Enwere ike ịmụ nwa buru ibu.

Mbido oria shuga

Okwesiri iburu n’uche na ibu iwe gi (opekata mpe 5 ruo 10 n’ime aro ị bido) nwere ike gbochie ma ọ bụ gbuo oge ịrịa ọrịa shuga ma ọ bụdị gwọọ ọrịa shuga. Lee: Probiotics megide oke ibu

Ihe ka ọtụtụ n'ime ndị ọrịa nwere ụdị nke mbụ butere ọrịa shuga nke mbụ. Imirikiti ndị mmadụ nwere ọrịa shuga na-arịa ọrịa enweghị akara ọ bụla. Dọkịta gị nwere ike ịchọpụta ọbara gị ka ọ mara ma ọ̀ nwere ọ̀tụ̀tụ̀ glucose ọ̀tụ̀tụ̀ ọbara gị dị elu karịa nke nkịtị. Na tupu ịrịa ọrịa shuga, ọkwa glucose ọbara dị elu karịa nke nkịtị, mana ezughi oke maka ịchọpụta ọrịa shuga. Mkpụrụ ndụ nke anụ ahụ na - eguzogide ọgwụ insulin. Nnyocha e mere egosiwo na ọbụlagodi tupu ịrịa ọrịa shuga, ụfọdụ mebiri sistemụ akwara ụbụrụ na obi.

* Maka iji ihe bara uru nke probiotic microorganisms na ihe okike nke ọgwụ ogwu maka ọgwụgwọ na mgbochi nke dyslipidemia na ọrịa shuga, lee nkọwa maka probiotic "Bifikardio":

OGO, INSULIN NA CARBOHYDRATES

MA Ọ B 12 STzọ 12 na-aga n'okporo ụzọ

Ebe ọ bụ na oke ibu bụ otu n'ime ihe na-ekpebi mmepe nke ọrịa shuga, ọ ga-aba uru ịghọta etu usoro a si eme ahụ na ihe na-akpasu ya iwe.

Ibu oke algorithm enwere ike ịnọchite anya ya: 1. ị na-eche banyere nri, 2. ịmalite ịhapụ insulin, 3. insulin na-enye ahụ ahụ ihe nchekwa iji chekwaa abụba ma ghara iwe ha ọkụ, na-ewepụta ike, 4. agụụ na-agụ gị, 5. Ọbara shuga bilitere, 6. carbohydrates dị mfe na-abanye n’ọbara gị n’ụdị glucose; 7. start malite izochi insulin ọzọ obia mara gi oke karia 12. I gha abuba

Abụba mgbe niile na-abịa site na sel nke ahụ. Anyị na-agbake site na abụba ndị ahụ nke dị n'ahụ. A na-edobe abụba n'ime sel abụba n'ụdị triglycerides. A na - eme Triglycerides site na abụba atọ nke otu glycerol na - ejikọta n'ime sel abụba. Ha dị oke nke ukwuu iji pụọ na membranes nke sel sel, n'adịghị ka ọdụdụ ọdụdụ, nke na-apụ apụ ngwa ngwa. I.e. ka triglycerides chịkọbara, ka mkpụrụ ndụ ahụ bukwuo ibu, ka anyị buru ibu.

Carbohydrates enwere mfe (ngwa ngwa) na mgbagwoju anya. Carbohydrates dị ngwa ma ọ bụ dị mfe bụ ngwakọta nwere otu monosaccharide mole ma ọ bụ abụọ, ma ha bụ ihe kachasị emerụ n’ihe gbasara ịkpata oke ibu.

A na-eke carbohydrates dị mfe ụzọ abụọ:

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

Kaadị dị nro na-enweta gị ozugbo site na itinye glucose n'ime ọbara. N'aka nke ya, nke a na-eso akpata mmepụta nke insulin.

Insulin - Nke a bụ isi nchịkwa nke metabolism. Ọ dabere n'ọkwa ya ma aga-eme ka mkpụrụ ndụ abụba ma-ọbụ kewaa. Mgbe ọkwa insulin na-ebili, enzyme lipoprotein lipase - (LPL) na-arụ ọrụ, nke a na-ahụ maka ịba abụba n'ime sel. I.e. ọzọ insulin anyị na-emepụta, ka LPL dị ike karị na-adọba mkpụrụ ndụ abụba.

Yabụ, ịmịpụta isulin bụ nke carbohydrates kpatara. Ogo na ogo nke carbohydrates riri ga-ekpebi ego ole edobere.

Nke ahụ pụtakwara

carbohydrates na - abawanye insulin -

- insulin na - akwalite itinye abụba

N'isiokwu, hụkwa:

Nwee ahụike!

NSOGBU NIILEN ’EGO NA-EGO EGO