Mob ntshav qab zib hom 1

Mob ntshav qab zib hom 1Nws yog ib qho mob uas tshwm sim los ntawm kev puas tsuaj autoimmune ntawm insulin-tsim b-hlwb ntawm pancreatic islets, feem ntau ua rau muaj qhov tsis txaus ntawm cov tshuaj insulin.Ntshav qab zib Hom 1 suav txog kwv yees li 5-10% ntawm tag nrho cov mob ntshav qab zib.Txawm hais tias qhov tshwm sim nce siab hauv cov neeg laus thiab cov neeg laus thaum ntxov, cov kab mob ntshav qab zib hom 1 tshiab tshwm sim hauv txhua pab pawg hnub nyoog thiab cov neeg mob ntshav qab zib hom 1 nyob tau ntau xyoo tom qab pib ntawm tus kab mob, xws li tag nrho cov kab mob ntshav qab zib hom 1 yog. siab dua nyob rau hauv cov neeg laus dua li cov menyuam yaus, ua kom pom tseeb ntawm peb cov ntshav qab zib hom 1 hauv cov neeg laus (1).Lub ntiaj teb no feem ntau ntawm hom 1 mob ntshav qab zib yog 5.9 rau 10,000 tus neeg, thaum qhov tshwm sim tau nce sai heev nyob rau 50 xyoo dhau los thiab tam sim no kwv yees li 15 rau 100,000 tus neeg hauv ib xyoos (2).
Ua ntej qhov kev tshawb pom ntawm insulin ib puas xyoo dhau los, hom ntshav qab zib hom 1 tau cuam tshuam nrog lub neej expectancy luv li ob peb lub hlis.Pib xyoo 1922, cov khoom siv raw ntawm cov tshuaj insulin exogenous, muab los ntawm cov tsiaj pancreas, tau siv los kho cov neeg mob ntshav qab zib hom 1.Ntau xyoo dhau los, cov tshuaj insulin ntau ntxiv tau tsim qauv, cov kev daws teeb meem ntawm cov tshuaj insulin tau ua kom ntshiab, ua rau txo cov tshuaj tiv thaiv kab mob, thiab cov khoom ntxiv, xws li zinc thiab protamine, tau muab tso rau hauv cov tshuaj insulin kom nce lub sijhawm ua haujlwm.Hauv xyoo 1980s, semisynthetic thiab recombinant tib neeg insulins tau tsim, thiab nyob rau hauv nruab nrab xyoo 1990, insulin analogs tau muaj.Basal insulin analogs tau tsim los nrog lub sijhawm ntev ntawm kev ua haujlwm thiab txo cov tshuaj pharmacodynamic hloov pauv piv nrog cov tshuaj protaminebased (NPH) tib neeg cov tshuaj insulin, thaum cov tshuaj analogues sai tau qhia nrog qhov pib sai dua thiab luv dua li cov tshuaj insulin luv luv ("tsis tu ncua") ntawm tib neeg insulin, ua rau txo qis. thaum ntxov postprandialhyperglycemiathiab tsawg dua tom qabhypoglycemiaob peb teev tom qab noj mov (3).

Qhov kev tshawb pom ntawm insulin hloov pauv lub neej ntawm ntau tus neeg, tab sis tsis ntev nws tau pom meej tias hom 1 mob ntshav qab zib mellitus cuam tshuam nrog kev loj hlob ntawm cov teeb meem mus sij hawm ntev thiab luv luv lub neej.Hauv 100 xyoo dhau los, kev txhim kho ntawm insulin, nws cov khoom xa tuaj, thiab cov thev naus laus zis los ntsuas cov ntsuas glycemic tau hloov pauv kev tswj hwm ntawm hom 1 ntshav qab zib.Txawm hais tias qhov kev nce qib no, ntau tus neeg mob ntshav qab zib hom 1 tsis ncav cuag lub hom phiaj glycemic tsim nyog los tiv thaiv lossis ua kom qeeb ntawm cov teeb meem ntshav qab zib, uas txuas ntxiv ua rau lub nra hnyav thiab lub siab xav.
Paub txog qhov kev sib tw tsis tu ncua ntawm hom 1 ntshav qab zib thiab kev txhim kho sai ntawm kev kho mob tshiab thiab thev naus laus zis,European Association rau Kev Tshawb Fawb Kev Mob Ntshav Qab Zib (EASD)thiab covAmerican Diabetes Association (ADA)tau sau ib pab neeg sau ntawv los tsim ib daim ntawv tshaj tawm kev pom zoo ntawm kev tswj cov ntshav qab zib hom 1 hauv cov neeg laus, hnub nyoog 18 xyoo thiab tshaj saud.Pab pawg sau ntawv tau paub txog cov kev taw qhia hauv tebchaws thiab thoob ntiaj teb ntawm hom 1 mob ntshav qab zib thiab tsis nrhiav kev rov ua dua qhov no, tab sis yog tsom mus rau cov ntsiab lus tseem ceeb ntawm kev saib xyuas uas cov kws kho mob yuav tsum xav txog thaum tswj cov neeg laus uas muaj ntshav qab zib hom 1.Daim ntawv tshaj tawm pom zoo tau tsom mus rau feem ntau ntawm cov tswv yim tswj glycemic tam sim no thiab yav tom ntej thiab cov xwm txheej metabolic.Tsis ntev los no kev nce qib hauv kev kuaj mob ntshav qab zib hom 1 tau raug txiav txim siab.Tsis zoo li ntau lwm yam mob, mob ntshav qab zib hom 1 ua rau muaj lub luag haujlwm tshwj xeeb ntawm kev tswj hwm tus neeg mob.Ntxiv nrog rau kev siv tshuaj kho mob nyuaj, lwm yam kev hloov pauv tus cwj pwm kuj tseem xav tau;Tag nrho cov no yuav tsum muaj kev paub ntau thiab kev txawj ntse los taug qab ntawm hyper- thiab hypoglycemia.Qhov tseem ceeb ntawmDiabetes Self-Management Education and Support (DSMES)thiab kev saib xyuas kev puas siab puas ntsws raug sau tseg hauv daim ntawv tshaj tawm.Thaum lees paub qhov tseem ceeb thiab tus nqi ntawm kev tshuaj xyuas, kuaj mob, thiab tswj cov kab mob microvascular thiab macrovascular cov teeb meem mob ntshav qab zib, cov lus piav qhia ntxaws txog kev tswj hwm cov teeb meem no dhau ntawm qhov kev qhia no.
Cov ntaub ntawv
1. Miller RG, Secrest AM, Sharma RK, Songer TJ, Orchard TJ.Kev txhim kho hauv lub neej expectancy ntawm hom 1 mob ntshav qab zib: Pittsburgh Epidemiology of Diabetes Complications kawm cohort.Mob ntshav qab zib
2012; 61:2987–2992
2. Mobasseri M, Shirmohammadi M, Amiri T, Vahed N, Hosseini Fard H, Ghojazadeh M. Prevalence and incidence of type 1 diabetes in the world: a systematic review and meta-analysis.HealthPromotPerspect2020; 10:98–115
3. Hirsch IB, Juneja R, Beals JM, Antalis CJ, Wright EE.Kev hloov pauv ntawm insulin thiab yuav ua li cas nws qhia txog kev kho mob thiab kev xaiv kho mob.Endocr Rev 2020; 41:733–755