Type 1 chirwere cheshugachirwere chinokonzerwa ne autoimmune kukuvara kwe insulin-inogadzira b-masero epancreatic islets, kazhinji inotungamira kune yakanyanya endogenous insulin kushomeka.Type 1 chirwere cheshuga chinotora 5-10% yezviitiko zvese zvechirwere cheshuga.Kunyange zvazvo chiitiko chacho chichikwira mukuyaruka uye kutanga kwevakuru-hood, kutsva-kutanga kwechirwere cheshuga 1 kunowanikwa muzera rose-mapoka uye vanhu vane chirwere cheshuga 1 vanorarama kwemakumi emakore akawanda mushure mekutanga kwechirwere, zvakadai kuti kupararira kwechirwere cheshuga 1 ndiko. yakakwirira muvakuru kupfuura muvana, tichiruramisa tarisiro yedu parudzi rwe 1 chirwere cheshuga muvakuru (1).Huwandu hwepasi rose hwechirwere cheshuga cherudzi rwekutanga ndeye 5.9 pa10,000 vanhu, nepo chiitiko ichi chakakwira nekukurumidza mumakore makumi mashanu apfuura uye parizvino inofungidzirwa kuva gumi nevashanu pa100,000 vanhu pagore (2).
insulini isati yawanikwa makore zana apfuura, chirwere cheshuga cherudzi rwekutanga chaienderana nezera rehupenyu hupfupi semwedzi mishoma.Kutanga muna 1922, zvinyorwa zvisina kuchena zve insulin yekunze, zvakatorwa kubva pancreas yemhuka, zvakashandiswa kurapa vanhu vane Type 1 chirwere cheshuga.Kwemakumi emakore akatevera, insulini yakagadziriswa yakagadziriswa, insulin mhinduro dzakava dzakachena, zvichiita kuti immunogenicity yakaderedzwa, uye zvinowedzera, zvakadai se zinc uye protamine, zvakabatanidzwa mune insulin mhinduro kuti iwedzere nguva yekuita.Muma1980, semisynthetic uye recombinant insulins yemunhu yakagadzirwa, uye pakati pema1990, insulin analogues yakatanga kuwanikwa.Basal insulin analogues yakagadzirwa nehurefu hwekuita uye yakaderedzwa pharmacodynamic variability kana ichienzaniswa neprotaminebased (NPH) insulin yemunhu, nepo kukurumidza-kuita analogis akaunzwa nekukurumidza uye kupfupika pane kupfupi-kuita ("nguva dzose") yemunhu insulin, zvichikonzera kuderedzwa. kutanga postprandialhyperglycemiauye zvishoma gare garehypoglycemiamaawa akawanda tapedza kudya (3).
Kuwanikwa kwe insulin kwakashandura hupenyu hwevanhu vazhinji, asi zvakabva zvava pachena kuti Type 1 chirwere cheshuga chakabatana nekukura kwezvinetso zvenguva refu uye kupfupika kwehupenyu hwehupenyu.Kwemakore zana apfuura, kusimukira kwe insulin, kuendesa kwayo, uye matekinoroji ekuyera glycemic indices zvakachinja zvakanyanya manejimendi emhando yekutanga chirwere cheshuga.Pasinei nekufambira mberi uku, vanhu vakawanda vane chirwere cheshuga 1 havasviki kune zvinangwa zveglycemic zvakakosha kudzivirira kana kunonoka kufambira mberi kwezvinetso zveshuga, izvo zvinoramba zvichiita mutoro mukuru wekliniki uye wepfungwa.
Kuziva dambudziko ririkuenderera mberi rerudzi rwe 1 chirwere cheshuga uye kukurumidza kukura kwekurapa kutsva uye matekinoroji,European Association for the Study of Diabetes (EASD)uyeAmerican Diabetes Association (ADA)akaunganidza boka rekunyora kuti rigadzire gwaro rekubvumirana pamusoro pekutarisirwa kwechirwere cheshuga chevanhu vakuru, vane makore gumi nemasere zvichikwira.Boka rekunyora raiziva nezvekutungamira kwenyika uye kune dzimwe nyika nezvechirwere cheshuga 1 uye harina kutsvaga kudzokorora izvi, asi rakanangana nekusimbisa nzvimbo huru dzekutarisira dzinofanirwa kutariswa nevashandi vehutano pakubata vanhu vakuru vane Type 1 chirwere cheshuga.Chirevo chekubvumirana chakatarisa zvakanyanya pane zvazvino uye zveramangwana glycemic manejimendi maitiro uye metabolic emergency.Kufambira mberi kuchangobva kuitika mukuongororwa kwechirwere cheshuga 1 kwakatariswa.Kusiyana nezvimwe zvakawanda zvisingaperi zvirwere, Type 1 chirwere cheshuga chinoisa mutoro wakasiyana wekutarisira kune munhu ane mamiriro acho.Mukuwedzera kumishonga yakaoma yemishonga, kumwe kuchinjwa kwemaitiro kunodiwawo;zvese izvi zvinoda ruzivo rwakakura uye hunyanzvi hwekufamba pakati pe hyper- uye hypoglycemia.Kukosha kwechirwere cheshuga chega-management dzidzo uye tsigiro (DSMES)uye psychosocial care yakanyorwa nenzira kwayo mumushumo.Ndichiri kubvuma kukosha kukuru uye mari yekuongorora, kuongorora, uye kugadzirisa zvisingagumi microvascular uye macrovascular complications yechirwere cheshuga, tsanangudzo yakadzama yehutungamiri hwematambudziko aya inodarika chiyero chemushumo uyu.
References
1. Miller RG, Secrest AM, Sharma RK, Songer TJ, Orchard TJ.Kuvandudzwa kwehupenyu hunotarisirwa hwemhando 1 chirwere cheshuga: iyo Pittsburgh Epidemiology yeDiabetes Matambudziko yekudzidza cohort.Chirwere cheshuga
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2. Mobasseri M, Shirmohammadi M, Amiri T, Vahed N, Hosseini Fard H, Ghojazadeh M. Kuwanda uye kuitika kwechirwere cheshuga 1 munyika: kuongorora kwakarongeka uye meta-analysis.HealthPromotPerspect2020;10:98–115
3. Hirsch IB, Juneja R, Beals JM, Antalis CJ, Wright EE.Iko kushanduka kwe insulin uye kuti inozivisa sei kurapwa uye kurapwa sarudzo.Endocr Rev2020;41:733–755
Nguva yekutumira: Jul-01-2022