Type 1 shuga mellitusNdi vuto lomwe limayambitsidwa ndi kuwonongeka kwa autoimmune kwa ma b-cell a pancreatic islets omwe amapanga insulin, nthawi zambiri kumabweretsa kuperewera kwa insulin.Matenda a shuga amtundu woyamba amakhala pafupifupi 5-10% mwa odwala onse omwe ali ndi matenda ashuga.Ngakhale kuti chiwerengero cha anthu omwe ali ndi matenda a shuga chimachuluka kwambiri pa nthawi ya kutha msinkhu komanso ukalamba, matenda a shuga amtundu woyamba amapezeka m'magulu onse ndipo anthu omwe ali ndi matenda a shuga amtundu woyamba amakhala zaka zambiri atangoyamba kumene matendawa, kotero kuti chiwerengero chonse cha matenda a shuga a mtundu woyamba ndi 1. okwera mwa akulu kuposa ana, kulungamitsa kuyang'ana kwathu pa matenda a shuga 1 mwa akulu (1).Chiwerengero cha anthu odwala matenda ashuga amtundu woyamba padziko lonse lapansi ndi 5.9 mwa anthu 10,000, pomwe chiwerengerochi chakwera kwambiri pazaka 50 zapitazi ndipo pano akuti ndi 15 mwa anthu 100,000 pachaka (2).
Asanatulukire insulin zaka zana zapitazo, mtundu woyamba wa shuga unkalumikizidwa ndi moyo waufupi ngati miyezi ingapo.Kuyambira m'chaka cha 1922, insulin yakunja yochokera ku kapamba ya nyama idagwiritsidwa ntchito pochiza anthu omwe ali ndi matenda amtundu woyamba.Kwazaka makumi angapo zotsatira, kuchuluka kwa insulini kunasinthidwa, njira za insulin zidakhala zoyera, zomwe zimapangitsa kuti chitetezo cha mthupi chichepe, ndipo zowonjezera, monga zinc ndi protamine, zidaphatikizidwa munjira za insulin kuti ziwonjezere nthawi yogwira ntchito.M'zaka za m'ma 1980, insulini ya semisynthetic ndi recombinant yaumunthu idapangidwa, ndipo chapakati pa 1990s, ma insulin analogi adapezeka.Ma analogue a basal insulin adapangidwa kuti azikhala ndi nthawi yayitali komanso kuchepetsedwa kwa pharmacodynamic poyerekeza ndi protaminebased (NPH) insulin yaumunthu, pomwe ma analogi ochita mwachangu adayambitsidwa mwachangu komanso mofupikitsa kuposa insulin yamunthu yochepa ("yokhazikika"), zomwe zidapangitsa kuchepa. oyambirira postprandialhyperglycemiandipo pambuyo pakehypoglycemiamaola angapo mutatha kudya (3).
Kupezeka kwa insulini kunasintha miyoyo ya anthu ambiri, koma posakhalitsa zidadziwika kuti mtundu woyamba wa shuga umalumikizidwa ndi kukula kwa zovuta zanthawi yayitali komanso kufupikitsa moyo.Pazaka 100 zapitazi, chitukuko cha insulin, kaperekedwe kake, komanso matekinoloje oyeza ma index a glycemic asintha kwambiri kasamalidwe ka matenda amtundu woyamba.Ngakhale izi zapita patsogolo, anthu ambiri omwe ali ndi matenda a shuga 1 samafikira milingo ya glycemic yofunikira kuti apewe kapena kuchepetsa kukula kwa zovuta za matenda a shuga, zomwe zimapitilirabe kukhala ndi vuto lalikulu lazachipatala komanso lamalingaliro.
Pozindikira zovuta zomwe zikupitilira za matenda a shuga amtundu woyamba komanso kukula kwachangu kwamankhwala ndi matekinoloje atsopano,European Association for the Study of Diabetes (EASD)ndiAmerican Diabetes Association (ADA)adaitanitsa gulu lolemba kuti apange lipoti logwirizana pakuwongolera matenda amtundu woyamba mwa akuluakulu, azaka 18 ndi kupitilira apo.Gulu lolembali likudziwa za chitsogozo chadziko lonse komanso chapadziko lonse lapansi pamtundu wa 1 shuga ndipo silinafune kubwereza izi, koma lidafuna kuwunikira mbali zazikulu za chisamaliro zomwe akatswiri azaumoyo ayenera kuziganizira poyang'anira achikulire omwe ali ndi matenda a shuga 1.Lipoti logwirizana layang'ana kwambiri njira zaposachedwa komanso zamtsogolo zoyendetsera glycemic komanso zovuta za metabolic.Kupita patsogolo kwaposachedwa pakuzindikiritsa matenda a shuga a mtundu woyamba kuganiziridwa.Mosiyana ndi matenda ena ambiri osachiritsika, matenda a shuga a mtundu woyamba amaika chiwongola dzanja chapadera kwa munthu yemwe ali ndi vutoli.Kuwonjezera pa mankhwala ovuta a mankhwala, kusintha kwina kwa khalidwe kumafunikanso;Zonsezi zimafunikira chidziwitso ndi luso loyendetsa pakati pa hyper- ndi hypoglycemia.Kufunika kwamaphunziro a shuga odziwongolera ndi chithandizo (DSMES)ndi chisamaliro cha chikhalidwe cha anthu zalembedwa molondola mu lipoti.Ngakhale kuvomereza kufunikira kwakukulu komanso mtengo wowunika, kuzindikira, ndikuwongolera zovuta zazikulu za matenda a shuga a macrovascular ndi macrovascular, kufotokozera mwatsatanetsatane kasamalidwe kazovutazi sikuli kopitilira lipoti ili.
Maumboni
1. Miller RG, Secrest AM, Sharma RK, Songer TJ, Orchard TJ.Kusintha kwautali wa moyo wamtundu wa shuga 1: gulu la Pittsburgh Epidemiology of Diabetes Complications study cohort.Matenda a shuga
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2. Mobasseri M, Shirmohammadi M, Amiri T, Vahed N, Hosseini Fard H, Ghojazadeh M. Kukula ndi zochitika za mtundu wa shuga wa mtundu wa 1 padziko lapansi: ndondomeko yowonongeka ndi kusanthula meta.HealthPromotPerspect2020;10:98–115
3. Hirsch IB, Juneja R, Beals JM, Antalis CJ, Wright EE.Chisinthiko cha insulini komanso momwe imadziwitsira chithandizo ndi chisankho chamankhwala.Endocr Rev2020; 41:733-755
Nthawi yotumiza: Jul-01-2022