Chirwere cheshuga muvana - sei kuziva zviratidzo zvinokuvadza uye chii chaunotevera?

Hyperglycemia uye yakaremara kuvhara insulin ndiyo yechipiri inowanzoguma endocrine patholo pakati pevana nevechiri kuyaruka. Maererano neWorld Health Organization, chiitiko chevana vane chirwere cheshuga chirikukura nokukurumidza. Mumakore anotevera 5-10, nhamba yevarwere inotarisirwa kuwedzera ne70%.

Pane here chirwere cheshuga mumwana?

Iyo inorondedzerwa chirwere inowanikwa kunyange mumana achangoberekwa, zvinetso zve endocrine zvinoitika pasinei nezera. Vabereki vakawanda vari kushamisika kana kune vane chirwere cheshuga muvana vasina ruzivo rwechimiro chechirwere ichi. Mhinduro yemubvunzo uyu yakanaka. Kune marudzi akasiyana ehutachiwana huri kuongororwa, humwe hwahwo hunobudirira nekuda kwezvinhu zvakashata zvinokonzera kana sechirwere chechipiri.

Mhando dzechirwere cheshuga muvana

Mukuwedzera kune mazivikanwa anozivikanwa maviri e-endocrine, chirwere chakatarwa maererano nekuchengetedzwa kwe-insulin, pane mamwe maitiro ekushungurudzika kwemagetsi mumakhahydrates. Mhando dzakawanda dzechirwere cheshuga:

Neonatal. Izvi zvakasiyana-siyana zvechirwere zvinowanikwa mune zvitsva uye vaduku kusvika kumwedzi 6. Chirwere cheshuga chakadai mumwana chinowanikwa muhupenyu husingaperi uye hunogara. Muchiitiko chekutanga, mwana anoshaiwa insulin zvishoma nezvishoma anonyangarika pachako kwehafu yegore. Kudzoka kwehutano munguva yemberi kunogona kuva 50%. Chikamu chechipiri chinoratidzirwa nehupenyu hwese hwe insulini.
MODHI. Izvo zvipenyu zvakataurwa zvinotaridzika sechimiro chakakura chechirwere cheshuga muvechidiki (Kukura-Onset Diabetes yeYong). MODHI chiremera chemafuro emasero epancreatic akagara muzvinyorwa zvinotaridzika (zvisingaenderani nehupombwe hwomwana, zvinoparadzirwa kubva kune rimwe rudzi kusvika kune rimwe chizvarwa). Ichi chirwere cheshuga chine 9 subspecies, iyo yakawanda iyo inoratidzwa nenzira ine unyoro, dzimwe nguva kuwedzera insulin kutonga hakudi.
Secondary. Chimwe chimiro chechirwere chisingawanzoitiki chinowanikwa mushure mekushungurudzika kwemajini. Chirwere cheshuga chinogona kuenderera kune syndromes yaRogers, Wolfram, Alström, Rabson-Mendelholl, leprechaunizm, lipodystrophy nezvimwe zvirwere.

1 chirwere cheshuga cheshuga

Rudzi rwakarondedzerwa rwekusingaperi endocrine chirwere (insulin-inotenderera) ndiyo yakawanda pakati pevana vaduku. Chirwere cheshuga chinotaridzika 1 muvana chinosarudzwa kuva mapoka maviri:

autoimmune;
idiopathic.

Chirongwa chekutanga chechirwere chinoratidzwa nekuvapo kwe autoantibodies muropa, iyo inorwisa uye inoparadza masero echeta beta epancreas. Somugumisiro, chimiro chekupedzisira chekemikirini chinounza inshuini isina kukwana kuputsa glucose. Zvakanyanya kuoma kutsanangura idiopathic chirwere cheshuga muvana - zvinokonzera rudzi urwu hwehutano hazvizivikanwi. Muropa remwana, hapana ma antibodies anowanikwa, asi chirwere chacho chinowedzera nenzira yakafanana.

2 rudzi rwechirwere cheshuga mellitus

Chimiro chekuchengetedzeka kwechirwere chechirwere chakanga chave chichiongororwa kunyanya kune vanhu vakuru uye vakwegura. Chirwere cheshuga chinyorwa 2 muvana chakatanga kukura munguva pfupi yapfuura. Izvi zvinokonzerwa nekuchinja mune mararamiro uye mararamiro emazuva ano. Kusagadzikana kwezvokudya uye kutsika kwakaderera kunokonzera kuneta, izvo zvinoita kuti zvirwere zve endocrine zvirwe.

Zvinokonzera chirwere cheshuga mellitus

Zvimwe zvinokonzera kutsanangurwa kwehutano zvinoenderana nemamiriro ayo. Neonatal, secondary and MODY-chirwere cheshuga chinokonzerwa nekuda kwekuchinja kwemajini. Izvi zvirwere zvisingawanzobatanidzwa nehuipi hutsika . Zvimwe zvinokonzera rudzi rwechirwere cheshuga mellitus zvinogona kugoverwa mumapoka maviri:

genetic;
kunze.

Kurongeka kwehupenyu huri munyaya iyi hakurevi mukushandurwa kwemarudzi ose akasiyana siyana, asi mukubatana kwavo kwakasiyana. Kuvapo kwechirwere cheshuga muvabereki kana zvimwe nhengo dzemhuri haisi chivimbo chekuvandudzwa kwehutano mumwana. Kuita kuti kuve nekuvhiringidzika kwepodocrine kunowedzera, zvimwe zvekunze zvinowanikwa:

zvokudya zvisingabatsiri (zvinodzivirira, nitrates, gluten);
toxin;
mavirusi ( rubella , parotitis, Epstein-Barr nevamwe);
acute kana kusingaperi mupfungwa.

Zvinokonzera rudzi rwechipiri chirwere cheshuga inzira isina kururama yehupenyu yevana. Kuchinja mukushanda kwepascreas uye zvinetso zvemagetsi mumuviri zvinowanzopikisana nechekubva kwe:

kugara uchidya;
kuneta;
low mobility;
kushandiswa kwe "nguva dzose".

Chirwere cheshuga chinokonzera vana - zviratidzo nezviratidzo

A pronounced clinic picture of pathology mucheche inoonekwa nekukurumidza zvikuru kupfuura yevakuru. Zviratidzo zvechirwere cheshuga muvana zviri kufambira mberi nokukurumidza nekuda kwezvinhu zvakadai:

kusakwana kwe enzyme uye endocrine systems;
kukurumidza kuwedzera metabolism, kusanganisira makhahydrates uye sukari;
unformed neural bundles.

Ne insulin inoshaya, glucose haisati yakanamirwa, uye masero emuviri anonzwa simba nenzara. Nekudzima kwayo, mafuta anotanga kupedzwa nekuumbwa kwemitumbi yemakone uye acetone, iyo inotyisa. Izvi zvinokonzera kuti chirwere cheshuga chiratidzwe muvana. Kusiyana kwezvinhu zvakagadzirwa muropa, zvichikonzera ketoacidosis uye zviratidzo zvokutanga zvechirwere.

Zviratidzo zvekutanga zvechirwere cheshuga muvana

Kana chimiro cheMODY chichikura, chirwere ichi chinowedzera zvinyoronyoro nemufananidzo wakanyatsoratidzwa wekliniki iyo vabereki vomwana vangasatombocherechedza. Mune zvimwe zviitiko, chirwere cheshuga chinowedzera nokukurumidza zvikuru - zviratidzo zvevana muzvikamu zvekutanga zvehutano zvinosanganisira:

kunzwa kunogara kwenyota nekuoma mumuromo;
enuresis ;
kugara uchicheka ;
kuwedzera kudya;
chido chekurara mushure mekudya;
kuneta.

Kwevhiki dzinoverengeka, zviratidzo izvi zvechirwere cheshuga muvana zviri kuwedzera. Yakawedzerwa ichiti:

kusakosha kuora kurasikirwa;
kuonekwa kusakanganisika;
kukanganisa kuganda zvirwere;
neurodermatitis ;
mycoses;
kunhuwa kweganda;
ichthyosis.

Chirwere cheshuga - zviratidzo

Mamiriro ezvinhu ari mubvunzo anoitika kana chirwere cheshuga chevana chirwere chevana chirwere chinopfuurira pasina kurapwa. Iyi ndiyo mamiriro ezvinhu anonyanya kuipa, umo kunyange mhedzisiro inouraya inogona. Muduku mwana wacho, anokurumidza zvakakosha kusangana nechipatara kuti abatsirwe rubatsiro. Chirwere cheshuga chinosangana nevana chinoperekedzwa nekurasika kwekuziva. Izvi zvinotangira zviratidzo zvinotevera:

headache;
kushushikana, kuteverwa nekusava nehanya;
kusava nenzara;
kushungurudza uye kurutsa;
nyota yakasimba;
kurwadziwa kwepamuviri;
kushungurudzika kwekuzora;
bhiza rakajeka pamatama ane ganda rechiso;
kudzika nekudzika kufema;
kuwedzera kwenhamba yemwoyo;
kuderera kwekushisa kwemuviri uye kuwedzerwa kweropa;
kurarisa neropa;
kunyura kwemaziso ebiso;
kunhuhwirira kunopisa kweAcetone kubva mumuti;
makumbo emakumbo.

Zvinetso zvechirwere cheshuga muvana

Gare gare, kuonekwa kwehutachiona kana kusakwanisa kurapwa kwakakwana kunokurudzira migumisiro yakaipisisa inenge inenge yose yezvirongwa zvenyama, kusanganisira kushanda kweuropi. Zvinetso zvechirwere cheshuga:

Neuropathy;
angina pectoris;
arteriosclerosis yemidziyo yeropa;
heart attack;
hypertension;
kurohwa;
nephropathy;
kidney failure ;
kunonoka pakukura kwepfungwa uye kwemuviri;
retinopathy;

kuora ropa muziso;
glaucoma;
cataract;
bofu;
nerve senitivity yezvikamu zviduku;
ganda rinoputika uye rakasviba;
bhakitiriya uye fungal dermatological zvirwere;
kuputsika kwemapfupa;
kunetseka.

Diabetes mellitus - kuongororwa

Chiratidzo chekufungidzirwa pamusana pekugadziriswa kwepodocrine pathology inoitwa pamusana pezviratidzo zviripo uye kuongororwa kwe laboratori. Chimiro cheshuga muropa romwana chinoenderana nezera rake:

kusvika kumwedzi gumi nemaviri - 2.8-4.4 mmol / l;
1-5 makore - 3.3-5 mmol / l;
kupfuura makore mashanu - kusvika ku5,5 mmol / l.

Kuti uwane hutachiona hunokonzera chirwere cheshuga muvana uye uchitarisa rudzi rwahwo, zvakawanda zvekuwedzerwa ropa zvinowanikwa pane zvinotevera zviratidzo:

insulini uye proinsulin;
C-peptide;
glycosylated hemoglobin;
kushivirira kuglucose;
acid-base state (CBS);
ma antibodies kune beta-masero e pancreas uye glutamate decarboxylase;
genetic mutations.

Izvo zvichavawo zvakafanira kupfuudza urini kuti uone hutambudziro:

glucose;
ketone miviri;
acetone.

Kurapa kwechirwere cheshuga kuvana

Zvakakosha kuti vabereki vazive kuti avo vakagamuchirwa vanozivikanwa kuti vanoona zvirwere ndezvekusingaperi. Kusvikira nzira dzekudzorera kwakakwana kwepascreatic mabasa uye nekugadziriswa kwemakinhydrate metabolism yakagadzirwa, kurapwa kwechirwere cheshuga muvana kuchadaro hupenyu hurefu. Therapy inofanira kuva yakazara uye yakagadzikana, zvinokosha kuti uite zvakakwana mazano echiremba, kubatana pane kudya uye kupa nguva yekuita basa.

Chinhu chokutanga chinotanga kurapwa inogara ichiongororwa nezvehuga hwehuga. Kuti uite izvi, tenga glucometer uye test strips. Kuti kuve nekugadzirisa kutonga kwechirwere chechirwere, vanachiremba vanorayirwa kuti vave nedhidhiyo inokosha, iyo inonyora kwete chete kuverengwa kwechigadziro, asiwo mamiriro emushandi:

kuvapo kwekushungurudzika kana utachiona;
zvokudya zvinopedzwa uye zvinwiwa;
kuita basa;
hurumende yehutano nemafungiro.

Kurapwa kwechirwere cheshuga 1 Mellitus muvana

Ichi chimiro chekurwara chinoratidzwa nehutachiona hwekushaya muviri mumuviri wemwana. Kuti urambe uine hupenyu hwakanaka, zvinokosha kubhadhara kushayikwa kwehomoni kubva kunze. Kuti uchengetedze chirwere cheshuga chevana chirwere cheshuga mukati mevana, zvirwere zvezuva nezuva zve insulini zvinodiwa. Nhamba uye nguva yakawanda yejojeni inosarudzwa ne-endocrinologist mumwe nomumwe maererano nemitemo yakawanda:

zera uye kurema kwechecheche;
chiyero che hyperglycemia;
ration of the child;
chiitiko chekuita basa

Insulin-inokonzerwa nechirwere cheshuga mellitus muvana haigone kurapwa pasina injirin injections. Chero dzimwe nzira dzokurapa dzakasiyana ndeyechirlatanism uye dzine ngozi kumwana. Iyo chete inoshanda yekugadzirisa chirongwa chechirwere ichi chinosanganisira:

zvirwere zvezuva nezuva;
kudya kwekudya;
chiito chepanyama.

Kurapa Kwechipiri 2 Chirwere Cheshuga Mellitus muvana

Iyo inorondedzerwa maitiro ehutachiwana haawanzozivikanwi, inenge mu10-20% yemhosva. Shuga yehutachiwana-inotarirwa nechirwere cheshuga muvana inoratidzira chirwere chakaoma, chinosanganisira mabasa akadaro:

kuenzanisa kwehutano hwemuviri (muhupo hwekuwedzera kuneta);
kuita basa;
kugara uchichengetedza kudya;
kutora hypoglycemic mishonga.

Mabasa anokurudzirwa mumuviri anosanganisira zvidzidzo zvitatu zvematambo anoshingaira pavhiki kwemaawa 1-1.5. Mukuwedzera, mwana wacho anofanirwa kuita mazuva ose (3-4 km), vechidiki vanokurudzirwa kuenda kune 5-7 km. Nekutevedzana kwakafanana nemapurogiramu epodocrinologist pamusoro pezvokudya, izvi zvakakwana kuti urambe uine shuga uye hupenyu hwakanaka mumutambo.

Kana chirwere cheshuga muvana chichiratidzira zvakajeka uye chichigumbura ketoacidosis, kuchinjwa kwekutsvaga kwekushayikwa kwe insulin kuchadiwa. Mushure mekusimbisa huwandu hwehuga uye kuderedza kugadzirwa kwemitumbi yeketone, unogona kumira kujoka hormone. Kuti udzidzise nzira yechirwere ichi, unyengeri hwemishonga hunorayirwa muhwendefa. Iyo chete mishonga yeboka iri, yakabvumirwa kushandiswa mukurapa - Metformin.