Sɛ asikre a ɛwɔ wo mogya mu no so tew a, wotaa te nka sɛ wo ho yɛ wo yaw? So ebetumi aba sɛ efi Insulinoma?

So ɛtɔ mmere bi a wote nka sɛ wo ho atɔ wo, wo ho fifiri, w’ani yɛ bruu, na w’adwene tu fra ? Eyi betumi afi asikre a ɛwɔ wo mogya mu a ɛso tew mpofirim ( hypoglycemia ). Eyi yɛ ade a ɛfata ma obi a ɔwɔ asikreyare , te sɛ sɛ ɔnom nnuru pii anaasɛ ɔpa aduan bi. Nanso sɛ eyi to obi a onni asikreyare bere nyinaa a, ebia nea ɛde ba no yɛ biribi a wunsusuw ho mpo. Ɛno yɛ tebea a ɛntaa nsi a ɛsɛ sɛ yɛn nyinaa hu, a wɔfrɛ no insulinoma .

Dɛn ankasa ne insulinoma?

Sɛ yɛbɛka no tiawa a, insulinoma yɛ akisikuru ketewaa bi a mpɛn pii no ɛnyɛ kokoram a ɛba yɛn dwensɔtwaa mu . Yɛn dwensɔtwaa no yɛ hormone bi a wɔfrɛ no insulin. Dwumadi a insulin yi yɛ ne sɛ ɛbɛhwɛ asikre (glucose) dodow a ɛwɔ mogya no mu so.

Susuw ho hwɛ, mpɛn pii no sɛ asikre dodow a ɛwɔ yɛn nipadua mu no kɔ soro a, dwensɔtwaa no yɛ insulin. Sɛ asikre dodow a ɛwɔ yɛn mu no so tew a, egyae insulin a ɛyɛ. Ɛte sɛ switch a ɛdane/dum wɔ bere a ɛfata mu.

Nanso sɛ saa akisikuru a wɔfrɛ no insulinoma yi ba a, ɛma insulin kɔ so . Ɛte sɛ nea switch no akɔhyɛ ‘on’ gyinabea. Nea ɛba ne sɛ insulin kɔ so yɛ bere mpo a asikre dodow a ɛwɔ yɛn mogya mu no sua koraa no. Eyi betumi ama asikre dodow a ɛwɔ yɛn mogya mu no so atew wɔ ɔkwan a ɛyɛ hu so. Esiane sɛ saa akisikuru yi yɛ ntini mu nkwammoaa soronko bi (neuroendocrine cells) nti, wo duruyɛfo nso betumi afrɛ no ``neuroendocrine tumor''. Saa akisikuru yi taa yɛ nketewa paa (ennu nsateakwaa biako) na ɛboro 90% nyɛ kokoram. Enti, wobetumi de oprehyɛn asa wɔn yare koraa.

Dɛn ne tebea yi ho sɛnkyerɛnne?

Esiane sɛ insulinoma no kɔ so yɛ insulin nti, asikre a ɛba mogya mu (hypoglycemia) na ɛde sɛnkyerɛnne ahorow ba. Saa sɛnkyerɛnne ahorow yi betumi ada adi mpofirim.

Dɛn na ɛde insulinoma ba? Henanom na wɔwɔ asiane kɛse mu?

Wonnya nhuu nea ɛde saa akisikuru yi ba ankasa, nanso nneɛma bi betumi ama asiane no ayɛ kɛse.

• Mmea wɔ su a ɛkorɔn kakra sen mmarima.
• Wɔtaa hu no wɔ nnipa a wɔadi fi mfe 40 kosi 60 mu .
• Nnipa a wɔwɔ awosu mu tebea horow bi nso wɔ asiane kɛse mu. Nhwɛsoɔ:
• Multiple endocrine neoplasia type 1: Tebea a ɛma akisikuru ba ntini a ɛma hormone no mu.
• Von Hippel-Lindau syndrome: Tebea a ɛma akisikuru ne nneɛma a ɛte sɛ akisikuru ( cysts ) ba nipadua no akwaa ahorow mu.
• Neurofibromatosis type 1: Nyini a ɛnyɛ kokoram wɔ ntini ne honam ani.
• Tuberous sclerosis: Akisikuru a ɛnyɛ kokoram wɔ akwaa te sɛ amemene, aniwa, koma, ne asaabo mu.

Ɔkwan bɛn so na oduruyɛfo hu eyi?

Insulinooma a wubehu no betumi ayɛ anifere kakra, efisɛ yare no ho sɛnkyerɛnne te sɛ nyarewa afoforo a ɛtaa ba, enti ebetumi agye bere kakra ansa na wo duruyɛfo ahu.

Ade titiriw ne sɛ wobɛyɛ ‘ nnɔnhwerew 72 mmuadadi’ . Wɔ eyi mu no, wɔde wo kɔ ayaresabea nnansa kosi nnansa na wɔmma wo nnidi anaa nnom biribiara gye nsu. Saa bere yi mu no, nnuruyɛfo no bɛhwɛ asikre ne insulin dodow a ɛwɔ wo mogya mu daa.

Wɔrebɔ mmɔden sɛ wɔbɛfa sɔhwɛ yi so asi nneɛma abiɛsa yi so dua:

1. So worehu sɛnkyerɛnne ahorow a ɛkyerɛ sɛ asikre a ɛwɔ wo mogya mu no sua (te sɛ adwenemhaw, fifiri).

2. Sɛ saa sɛnkyerɛnne ahorow no da adi a, so asikre dodow a ɛwɔ mogya mu no sua ankasa?

3. So sɛnkyerɛnne no befi hɔ bere a wode asikre (glucose) bi ma wɔ abɔnten no?

Sɛ wowɔ insulinoma a, asikre dodow a ɛwɔ wo mogya mu wɔ mmuadadi mu no bɛba fam koraa, nanso wo insulin dodow bɛkɔ soro. Eyi ne adanse titiriw. Eyi ka ho no, mogya mu nhwehwɛmu nso bɛhwehwɛ nneɛma te sɛ `(C-peptide)` ne `(proinsulin)`.

Afei, wɔyɛ mfoninitwa nhwehwɛmu de hu baabi pɔtee a dwensɔtwaa mu akisikuru no wɔ.

• CT scan `(CT scan)`
• Ultrasound scan `(Nnyigyei a ɛboro so)`
• MRI scan `(MRI)`

Dɛn ne ayaresa ahorow a wɔde sa eyi?

Ayaresa titiriw a edi mu sen biara a wɔde sa insulinoma ne oprehyɛn a wɔyɛ de yi akisikuru no fi hɔ . Mpɛn pii no, wɔsa yare no koraa wɔ oprehyɛn akyi.

Oprehyɛn ko a wɔyɛ no gyina akisikuru no ko, ne kɛse, ne beae a ɛwɔ so.

• Akisikuru no nkutoo a wobeyi afi hɔ: Nnuruyɛfo a wɔyɛ oprehyɛn betumi de ahwɛyiye ayi akisikuru no nkutoo afi hɔ a wɔrensɛe dwensɔtwaa no.
• dwensɔtwaa no fã bi a wobeyi afi hɔ: Ɛtɔ mmere bi a, ɛsɛ sɛ woyi dwensɔtwaa no fã ketewaa bi a ɛne akisikuru no wɔ abusuabɔ nso.

Esiane nnɛyi mfiridwuma mu nimdeɛ a ɛkɔ anim nti, .Wobetumi nso de laparoscopic oprehyɛn ayi saa akisikuru yi afi hɔ. Eyi kyerɛ sɛ sɛ́ anka wobetwa oprehyɛn no kɛse biako no, wɔde mfoninitwa afiri mmoa na ɛyɛ oprehyɛn no. Mfaso a ɛwɔ eyi so ne sɛ ɛnyɛ yaw pii, nna dodow a wode bɛtra ayaresabea no yɛ tiaa, na wubetumi asan akɔ w’asetra a ɛfata mu ntɛm.

Ayaresa a wɔde sa kokoram akisikuru

Ɛntaa mma koraa (ennu 10%) saa akisikuru yi betumi abɛyɛ kokoram. Wɔ nsɛm a ɛtete saa mu no, ɛsono ayaresa. Sɛ wɔantumi anyɛ oprehyɛn nyi akisikuru no nyinaa mfi hɔ a, ebia ebehia sɛ wonom nnuru a ɛbɛma asikre a ɛwɔ wo mogya mu no ankɔ fam dodo. Ebia wubehia nnuru a wɔde sa yare nso . Wɔ kokoram ahorow bi ho no, ayaresa titiriw bi wɔ hɔ, te sɛ ``Lutetium Lu 177 dotatate``, a nea ɛka ho ne sɛ wɔde aduru a ɛma mframa bɔne fa ntini bi mu ma.

So nsɛnnennen bi wɔ oprehyɛn akyi?

Ɛwom sɛ oprehyɛn no di yiye wɔ nsɛm dodow no ara mu, sɛnea ɛte wɔ oprehyɛn biara mu de, nanso asiane wɔ hɔ sɛ nsɛnnennen nketenkete bɛba.

• Mogya a ɛretu
• Nsaneɛ
• Yeaw
• Sɛ woyi dwensɔtwaa no fã kɛse bi fi hɔ a, asiane wɔ hɔ sɛ obi benya asikreyare.
• Nsu a efi dwensɔtwaa mu (Pancreatic fistula) .
• Enzyme a ɛwɔ aduan mu a ɛso tew.

Sɛ ɛyɛ kokoram akisikuru a, nsɛnnennen te sɛ yare no a ɛtrɛw kɔ akwaa afoforo mu (metastasis) betumi aba. Wo duruyɛfo bɛkyerɛkyerɛ eyi mu akyerɛ wo kɔ akyiri.