Isifo sikashukela sohlobo loku-1yisimo esibangelwa ukulimala kwe-autoimmune kwama-b-cell eziqhingi ze-pancreas akhiqiza i-insulin, ngokuvamile okuholela ekuntulekeni okukhulu kwe-insulin okungapheli.Isifo sikashukela sohlobo loku-1 sibalelwa cishe ku-5-10% wazo zonke izimo zesifo sikashukela.Yize lesi sifo sikhuphuka kakhulu ekuthombeni nasekukhuleni kwabadala, uhlobo lwesifo sikashukela sohlobo 1 olusha lwenzeka kuwo wonke amaqembu eminyaka futhi abantu abanesifo sikashukela sohlobo loku-1 baphila amashumi amaningi eminyaka ngemuva kokuqala kwalesi sifo, kangangokuthi ukwanda okuphelele kwesifo sikashukela sohlobo loku-1 kungukuthi. ephakeme kubantu abadala kunasezinganeni, okuthethelela ukugxila kwethu ohlotsheni 1 lwesifo sikashukela kubantu abadala (1).Ukusabalala komhlaba wonke kwesifo sikashukela sohlobo loku-1 kungama-5.9 kubantu abayi-10,000, kanti izigameko zikhuphuke ngokushesha eminyakeni engama-50 edlule futhi njengamanje kulinganiselwa ukuthi ziyi-15 kubantu abayi-100,000 ngonyaka (2).
Ngaphambi kokutholwa kwe-insulin eminyakeni eyikhulu edlule, uhlobo lwesifo sikashukela sohlobo loku-1 lwaluhlotshaniswa neminyaka yokuphila okufushane njengezinyanga ezimbalwa.Kusukela ngo-1922, izingcaphuno ezingahluziwe ze-insulin yangaphandle, eziphuma kumanyikwe ezilwane, zazisetshenziselwa ukwelapha abantu abanesifo sikashukela sohlobo loku-1.Emashumini eminyaka alandelayo, ukugxila kwe-insulin kwenziwa ngendlela efanayo, izixazululo ze-insulin zaba msulwa kakhulu, okuholele ekunciphiseni ukuzivikela komzimba, futhi izithasiselo, njenge-zinc ne-protamine, zafakwa ezixazululweni ze-insulin ukwandisa ubude besikhathi sokusebenza.Ngeminyaka yawo-1980, kwasungulwa ama-insulin enziwa abantu abancane kanye ne-recombinant, kwathi maphakathi nawo-1990, kwatholakala ama-insulin analogue.Ama-analogues e-Basal insulin aklanywe anesikhathi eside esebenza futhi anciphisa ukuhlukahluka kwe-pharmacodynamic uma kuqhathaniswa ne-protaminebased (NPH) insulin yomuntu, kuyilapho ama-analogue asebenza ngokushesha aqala ukuqala ngokushesha nokuba mfushane kune-insulin yomuntu esebenza isikhathi esifushane (“evamile”), okuholele ekunciphiseni. i-postprandial yokuqalai-hyperglycemiafuthi kancane kamuvai-hypoglycemiaamahora ambalwa ngemva kokudla (3).
Ukutholakala kwe-insulin kwaguqula izimpilo zabantu abaningi, kodwa kwasheshe kwacaca ukuthi uhlobo lwesifo sikashukela sohlobo loku-1 luhlotshaniswa nokuthuthukiswa kwezinkinga zesikhathi eside kanye nesikhathi sokuphila esifushane.Eminyakeni eyi-100 edlule, ukuthuthuka kwe-insulin, ukulethwa kwayo, kanye nobuchwepheshe bokulinganisa izinkomba ze-glycemic kuye kwashintsha ngokuphawulekayo ukuphathwa kwesifo sikashukela sohlobo loku-1.Naphezu kwalokhu kuthuthuka, abantu abaningi abanesifo sikashukela sohlobo loku-1 abafinyeleli ezihlokweni ze-glycemic ezidingekayo ukuze bavimbele noma babambezele ukuqhubeka kwezinkinga zesifo sikashukela, eziqhubeka nokuba nomthwalo ophakeme womtholampilo nongokomzwelo.
Ngokubona inselele eqhubekayo yesifo sikashukela sohlobo loku-1 kanye nokuthuthuka okusheshayo kwezindlela zokwelapha ezintsha nobuchwepheshe,I-European Association for the Study of Diabetes (EASD)kanye neI-American Diabetes Association (ADA)ubize iqembu lokubhala ukuze enze umbiko wokuvumelana ngokuphathwa kwesifo sikashukela sohlobo 1 kubantu abadala, abaneminyaka engu-18 nangaphezulu.Iqembu elibhalayo lalazi kokubili isiqondiso sikazwelonke nesamazwe ngamazwe mayelana nohlobo 1 lwesifo sikashukela futhi alizange lifune ukukuphindaphinda lokhu, kodwa lalihlose ukugqamisa izindawo ezinkulu zokunakekela ochwepheshe bezokunakekelwa kwempilo okufanele bazicabangele lapho belawula abantu abadala abanesifo sikashukela sohlobo loku-1.Umbiko wokuvumelana ugxile kakhulu kumasu okuphatha i-glycemic amanje nawesikhathi esizayo kanye nezimo eziphuthumayo ze-metabolic.Intuthuko yakamuva ekuxilongweni kwesifo sikashukela sohlobo loku-1 iye yacatshangelwa.Ngokungafani nezinye izifo eziningi ezingamahlalakhona, uhlobo lwesifo sikashukela sohlobo loku-1 lubeka umthwalo oyingqayizivele wokuphatha kumuntu onalesi simo.Ngaphezu kwemithi eyinkimbinkimbi yemithi, okunye ukuguqulwa kokuziphatha kuyadingeka;konke lokhu kudinga ulwazi oluningi nekhono lokuzulazula phakathi kwe-hyper- kanye ne-hypoglycemia.Ukubaluleka kweImfundo yokuzilawula nokwesekwa kwesifo sikashukela (DSMES)kanye nokunakekelwa ngokwengqondo kubhalwe ngokufanelekile embikweni.Nakuba sivuma ukubaluleka okukhulu kanye nezindleko zokuhlolwa, ukuxilonga, nokulawula izinkinga ezingapheli ze-microvascular kanye ne-macrovascular yesifo sikashukela, incazelo enemininingwane yokulawulwa kwalezi zinkinga ingaphezu kobubanzi balo mbiko.
Izikhombo
1. Miller RG, Secrest AM, Sharma RK, Songer TJ, Orchard TJ.Ukuthuthukiswa kwesikhathi sokuphila sohlobo loku-1 lwesifo sikashukela: iqoqo locwaningo lwe-Pittsburgh Epidemiology of Diabetes Complications.Isifo sikashukela
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2. U-Mobasseri M, u-Shirmohammadi M, u-Amiri T, u-Vahed N, u-Hosseini Fard H, u-Ghojazadeh M. Ukusabalala kanye nezigameko zesifo sikashukela sohlobo loku-1 emhlabeni: ukubuyekezwa okuhlelekile nokuhlaziywa kwemeta.I-HealthPromotPerspect2020;10:98–115
3. Hirsch IB, Juneja R, Beals JM, Antalis CJ, Wright EE.Ukuvela kwe-insulin nokuthi ikwazisa kanjani ukwelashwa kanye nokukhetha kokwelashwa.I-Endocr Rev2020;41:733–755
Isikhathi sokuthumela: Jul-01-2022