ʻAno maʻi diabetes 1He maʻi ia i hoʻopōʻino ʻia e ka autoimmune o nā pūnaewele b e hana ana i ka insulin o nā mokupuni pancreatic, e alakaʻi pinepine ana i ka hemahema o ka insulin endogenous.ʻO ka maʻi maʻi type 1 ma kahi o 5-10% o nā hihia āpau o ka maʻi diabetes.ʻOiai ke piʻi aʻe nei ka maʻi i ka wā ʻōpio a me ka wā ʻelemakule, hiki mai ka maʻi diabetes type 1 i nā makahiki āpau a ola nā poʻe me ka maʻi diabetes type 1 no nā makahiki he nui ma hope o ka hoʻomaka ʻana o ka maʻi, ʻo ia ka nui o ka maʻi diabetes type 1. ʻoi aku ka nui o nā pākeke ma mua o nā keiki, e hōʻoiaʻiʻo ana i kā mākou nānā ʻana i ka maʻi diabetes type 1 i nā pākeke (1).ʻO ka maʻi maʻi maʻi type 1 honua he 5.9 no 10,000 poʻe, ʻoiai ua piʻi wikiwiki ka maʻi i nā makahiki he 50 i hala a ua manaʻo ʻia he 15 i kēlā me kēia 100,000 mau kānaka i kēlā me kēia makahiki (2).
Ma mua o ka loaʻa ʻana o ka insulin i hoʻokahi kenekulia i hala, ua pili ka maʻi maʻi type 1 me ka lōʻihi o ke ola e like me kekahi mau mahina.E hoʻomaka ana i ka makahiki 1922, ua hoʻohana ʻia nā ʻāpana koʻikoʻi o ka insulin exogenous, i loaʻa mai nā pancreases holoholona, e mālama i ka poʻe me ka maʻi diabetes type 1.I nā makahiki e hiki mai ana, ua hoʻohālikelike ʻia ka nui o ka insulin, ua ʻoi aku ka maʻemaʻe o ka insulin, ka hopena i ka hoʻemi ʻana i ka immunogenicity, a ua hoʻohui ʻia nā mea hoʻohui, e like me ka zinc a me ka protamine, i loko o nā hopena insulin e hoʻonui i ka lōʻihi o ka hana.I ka makahiki 1980, ua hoʻomohala ʻia nā insulins kanaka semisynthetic a me recombinant, a ma ka waena o 1990s, ua loaʻa nā analogs insulin.Ua hoʻolālā ʻia nā analogs basal insulin me ka lōʻihi o ka hana a me ka hoʻohaʻahaʻa ʻana i ka pharmacodynamic variability i hoʻohālikelike ʻia me ka protaminebased (NPH) insulin kanaka, ʻoiai ua hoʻokomo ʻia nā analogs wikiwiki me ka wikiwiki a me ka pōkole ma mua o ka hana pōkole ("maʻamau") insulin kanaka, ka hopena o ka hoʻemi ʻana. mua ma hope o ka ʻaihyperglycemiaa emi iho ma hopehypoglycemiahe mau hola ma hope o ka ʻai ʻana (3).
ʻO ka loaʻa ʻana o ka insulin i hoʻololi i ke ola o nā poʻe he nui, akā ua ʻike koke ʻia ka pili ʻana o ka maʻi diabetes type 1 me ka ulu ʻana o nā pilikia lōʻihi a me ka pōkole o ke ola.I loko o nā makahiki he 100 i hala iho nei, ua hoʻololi nui ka hoʻomohala ʻana i ka insulin, kāna lawe ʻana, a me nā ʻenehana e ana i nā helu glycemic i ka mālama ʻana i ka maʻi diabetes type 1.ʻOiai ʻo kēia mau holomua, nui ka poʻe me ka maʻi maʻi type 1 ʻaʻole i hiki i nā pahuhopu glycemic e pono ai e pale a hoʻolōʻihi paha i ka piʻi ʻana o nā pilikia maʻi diabetes, e hoʻomau nei i ka hoʻokau ʻana i kahi kaumaha nui a me ke kaumaha.
ʻO ka ʻike ʻana i ka luʻi mau o ka maʻi diabetes type 1 a me ka hoʻomohala wikiwiki ʻana o nā lāʻau lapaʻau a me nā ʻenehana hou,ʻAhahui ʻEulopa no ke aʻo ʻana i ka maʻi diabetes (EASD)a me kaʻAhahui Diabetes ʻAmelika (ADA)Ua hoʻākoakoa ʻo ia i pūʻulu kākau no ka hoʻomohala ʻana i kahi hōʻike kuʻikahi e pili ana i ka mālama ʻana i ka maʻi diabetes type 1 i nā pākeke, 18 mau makahiki a ʻoi aku.Ua ʻike ka pūʻulu kākau i ke alakaʻi ʻāina a me ka honua no ka maʻi maʻi type 1 a ʻaʻole i ʻimi e hana hou i kēia, akā ua manaʻo ʻia e hōʻike i nā wahi nui o ka mālama pono e noʻonoʻo ai nā limahana mālama ola i ka wā e mālama ai i nā pākeke me ka maʻi diabetes type 1.Ua kālele nui ʻia ka hōʻike consensus i nā hoʻolālā hoʻokele glycemic o kēia manawa a me ka wā e hiki mai ana a me nā pilikia e hiki mai ana.Ua noʻonoʻo ʻia nā holomua hou o ka maʻi diabetes type 1.ʻAʻole like me nā maʻi maʻi ʻē aʻe, ʻo ka maʻi diabetes type 1 ke kau nei i kahi kaumaha kūʻokoʻa o ka mālama ʻana i ke kanaka me ke ʻano.Ma waho aʻe o nā lāʻau lapaʻau paʻakikī, pono pū kekahi hoʻololi ʻana i nā ʻano;Pono kēia mau mea a pau i ka ʻike a me ke akamai e hoʻokele ma waena o hyper- a me ka hypoglycemia.Ka mea nui oka hoʻonaʻauao a me ke kākoʻo hoʻokele ponoʻī maʻi diabetes (DSMES)a me ka mālama psychosocial i kākau pono ʻia ma ka hōʻike.ʻOiai e hoʻomaopopo ana i ke koʻikoʻi nui a me ke kumukūʻai o ka nānā ʻana, ka ʻike ʻana, a me ka mālama ʻana i nā pilikia microvascular a me macrovascular mau o ka maʻi diabetes, kahi wehewehe kikoʻī o ka mālama ʻana i kēia mau pilikia ma waho o ke kiko o kēia hōʻike.
Nā kuhikuhi
1. Miller RG, Secrest AM, Sharma RK, Songer TJ, Orchard TJ.ʻO ka hoʻomaikaʻi ʻana i ke ola o ka maʻi diabetes type 1: ʻo ka Pittsburgh Epidemiology of Diabetes Complications study cohort.Diabetes
2012;61:2987–2992
2. Mobasseri M, Shirmohammadi M, Amiri T, Vahed N, Hosseini Fard H, Ghojazadeh M. ʻO ka prevalence a me ka uluʻana o ka maʻi diabetes type 1 i ka honua: he loiloi pūnaewele a me ka meta-analysis.HealthPromotPerspect2020;10:98–115
3. Hirsch IB, Juneja R, Beals JM, Antalis CJ, Wright EE.ʻO ka ulu ʻana o ka insulin a pehea e hoʻomaopopo ai i ka lāʻau lapaʻau a me nā koho lapaʻau.Endocr Rev2020;41:733–755
Ka manawa hoʻouna: Jul-01-2022