I chhungkuaah hian type 1 diabetes nei an awm em? A nih loh leh doctor-in natna kai theihna hlauhawm tak i nih thu a hrilh che em? Chutiang a nih chuan vawiinah hian zunthlum natna lan chhuahna kum engemaw zat tikhawtlai thei damdawi thar kan sawi dawn a ni. Hei hi mi tam tak tan beiseina nasa tak thlentu tak a ni. He damdawi hi eng nge a nih a, engtin nge a hnathawh tih i lo en ang u.
Type 1 diabetes leh Tzield-a damdawi hnathawh dan
A hmasain type 1 diabetes hi eng nge a nih tih hi i hrethiam mai ang u. A nihna takah chuan autoimmune disease a ni . A awlsam zawngin sawi ila, natna laka kan taksa venhimtu ‘sipai’ ang maia invenna (immune system) hian kan taksa cell tha tak takte chu a rawn bei sual tan a. Type 1 diabetes-ah chuan he ‘attack’ hi kan pancreas-a beta cells -ah a thleng thin.
Heng beta cells te hi factory tenau tak , insulin an tih hormone siam chhuaktu angin ngaihtuah la, chu chu kan taksa tana pawimawh tak a ni. Insulin hian kan eitur chhunga sugar (glucose) awm chu cell te chu chakna ah a chantir thei a ni. Chuvangin, immune system hian heng beta cells te hi a tihchhiat hian insulin siamchhuahna chu a tlahniam zauh zauh thin.
He chhiatna hi vawi khatah a thleng vek dawn lo. Stage thum-ah a thleng dawn a ni.
- Stage 1: Immune system chuan beta cells te chu a bei tan a, mahse insulin tling tak an la siam chhuak tho.
- Stage 2: Beta cell chhiatna a pung a, thisen sugar level chu a danglam deuh tan a, mahse pawn lam atanga lanchhuahna a la awm lo.
- Stage 3: Beta cell tam zawk chu a chhe vek a, taksain insulin a siam chhuak thei lo. Thisen sugar level a sang hle. Hei hi zunthlum natna lanchhuahna, tuihal lutuk leh zun tam lutuk te a lo lan hun a ni.
Hetah hian damdawi pakhat Tzield (teplizumab-mzwv) a lo lut a, Tzield hi biologic medicine a ni. Stage 2 type 1 diabetes vei te beta cells immune system-in a beih chakna chu a ti hniam thei a ni . Hei hian natna a zual zel tur chu stage 3-ah a tikhawtlai thei tihna a ni a, chutih hunah chuan symptoms a lo lang a, nitin insulin shot lak a ngai a ni.
Hei hi damdawi vein (intravenous infusion, or IV) hmanga pek a ni . He treatment course hi ni 14 chhung a zawnin ni khatah vawi khat pek thin a ni.
He Tzield treatment hi ka tan a tha em?
Type 1 diabetes hian kum eng pawh ni se, eng nunphung pawh neiin tu pawh a nghawng thei a ni. Tzield enkawlna hi i tan a tha thei ang, heng tehfungte hi i tlin chuan:
- Stage 2 type 1 diabetes i neih chuan .
- Nangmah hnenahType 2 diabetes i neih loh chuan .
- Kum 8 aia upa i nih chuan .
Stage hnihnaah type 1 diabetes i vei em tih finfiah nan i doctor chuan thisen test bik engemaw zat a ti ang. Chung zinga pawimawh ber chu beta cells laka autoantibodies awm leh awm loh enfiahna test leh oral sugar tolerance test te hi a ni . Tin, i thisen cell count leh liver enzyme te pawh an enfiah ang a, he damdawi hi i tan a him em tih an enfiah ang.
I chhungkuaah type 1 diabetes vei awm hi risk factor ni mahse, he natna vei tam zawk hian chhungkaw history an nei lo tih hre reng ang che.
Engtin nge Tzield damdawi hian nghawng a neih dan chu zirchian a nih?
He damdawi hi a thatna leh a hlauhawm dan zirchian nan hian special clinical study TN-10 tih a ni a. Zawhna lian ber a zawh chu, "Tzield hian mi hlauhawm tak takte zingah type 1 diabetes stage 3-a a kal zel chu a titawp thei ang em, a tikhawtlai thei ang em?"
He huna telte hi group hnih ah then an ni a. Pawl pakhat chu Tzield damdawi an pe a. Group dang chu placebo pek an ni bawk . Chu chu saline solution, damdawi ang maia lang mahse damdawi engmah awm lo tihna a ni. Damlo emaw, doctor emaw pawhin tuin nge eng nge dawng tih an hre lo.
Zirnaa tel theihna tur eligibility leh disqualification te chu a hnuaia table atang hian awlsam takin i hmu thei ang.
| Inclusion Criteria a ni | Exclusion Criteria a ni |
|---|---|
| Kum 8 leh 45 inkar a nih. | Stage 3 diabetes nei a ni. |
| Chhungkaw member hnai tak, type 1 diabetes vei neih. | Thisen cell emaw liver enzyme level pangngai lo. |
| Autoantibodies chi hrang hrang pahnih tal awm. | HIV, hepatitis B emaw C emaw ang chi hri kai tawhna history nei. |
| Sugar tolerance test atanga result pangngai lo. | Nu naupai emaw, nau hnute pe lai emaw nih. |
Zirna atanga chhuak chu eng nge ni?
Ni 14 chhung enkawl an nih hnuah heng mite hi kum 5 vel an enkawl zui ta a ni. A rah chhuah chu a fuh tak zet a ni.
A hlawkna ber chu Tzield damdawi eitute chu damdawi ei lo (placebo) te aiin a vaiin kum hnih velin stage 3 diabetes-ah an kai chho a ni.
A awlsam zawngin sawi ila, Tzield ei thinte hian kum 4 vel an hmang a, placebo ei thinte erawh chuan kum 2 vel chhungin symptom an nei thung. A bik takin enkawl kum khatna chhung khan Tzield ei zinga tlemte chauhvin an natna a zual zel a ni. Zirna tawp lamah chuan Tzield ei zinga 57% chu an la hrisel a, zunthlum natna lanchhuahna engmah an la nei lo. Mahse placebo ei zinga 28% chauhvin an ei.
Tzield hian eng side effect nge a neih?
Damdawi dang ang bawkin Tzield hian side effect a nei thei a ni. Mahse, lungngai suh, heng zinga a tam zawk hi chu enkawl theih a ni.
Side effects awm tlangpui:
- Skin rash: Hei hi allergy chhinchhiahna a ni tlangpui. A tam zawkah chuan a serious lo va, a mah chauhin a bo mai ang. Vun chu a hnim reng la, a hrual loh nan. Tui lum hmanga sil emaw, oatmeal-a inbual emaw ang chi thilte hian a pui thei a ni. Hemi chungchang hi i doctor nen sawiho rawh. A tul chuan damdawi a pe ang. Mahse , vun rawng hi lei emaw, i rilru emaw a lo hring chhuak a nih chuan, thawk harsa i tih chuan damdawi in emergency room (ETU)-ah kal nghal rawh.
- Thisen var hniam (Lymphopenia): I thisen var zat chu enkawlna ni hmasa berah hian rei lo te chhungin a tlahniam thei. Hei hian a nghawng lo mai thei che a, mahse natna kai theihna a tipung thei a ni. Hei hi kar tlemte chhungin a pangngaiin a kir leh ang. Hei hi i doctor chuan a lo enkawl reng ang che.
- Lu na: Lu na tlem a awm thei. Amah chauhin a bo fo thin. Lu na a awm reng emaw, a nasat emaw chuan doctor hnenah hriattir rawh.
Side effect na tak tak fimkhur tur:
- Cytokine chhuah chhuahna Syndrome:A chhan chu immune system tichhe thei damdawi, Tzield ang chi hian a chang chuan immune substance tam tak cytokines an tih chu vawi khatah thisenah a chhuah tir thei a ni. Hei hi enkawl tan tirh lamah a thleng thei a ni. Khawsik, luak chhuak, taksa na, leh hah lutuk te ang chi natna lanchhuahna a awm thei. I doctor chuan hengte tihtlem nan damdawi dang (e.g. paracetamol) a pe ang che. Heng symptoms te hi i neih chuan doctor hnenah hrilh nghal rawh.
- Thisen var (white blood cell count) na tak a tlahniam: He natna hi a nasat chuan natna khirh tak tak a thlen thei a ni. Infection symptoms i neih chuan khawsik, khawsik, khuh, leh hah lutuk , i doctor hnenah hrilh nghal rawh.
Heng zawng zawng hi Tzield-a side effect awm thei zawng zawng a ni lo. I rilru tibuaitu symptom i neih chuan doctor pan ngei ngei tur a ni.
Engtin nge damdawi hian hna a thawk em tih i hriat theih ang?
Tzield hian a tum ber chu natna lan chhuah dan tihkhawtlai a ni. Chuvangin, enkawlna i ei hnuah pawh danglamna lian tham i hmu lo mai thei. Hei hi ni 14 chhunga vawi khat enkawlna a ni. Chumi hnuah chuan i doctor chuan i zunthlum hi eng ang nge a nih tih a enfiah fo ang. Doctor thurawn tel lo chuan damdawi ei kha bansan ngai suh la, schedule pawh thlak ngai suh.
Damdawi dangah harsatna a awm em?
Tzield enkawlna i tan hmain i doctor hnenah damdawi dang i ei zawng zawng (vitamin, supplement, Ayurvedic emaw herbal damdawi te pawh) i hrilh hmasak a pawimawh hle.
A bik takin Tzield i ei lai hian vaccine lak chungchangah fimkhur tur a ni. Vaccine thenkhat chu a hlawk lo zawk thei a, thenkhat chu a him lo thei bawk. Chuvangin , vaccine engmah i dawn hmain i doctor hnenah Tzield i ei tih hrilh hmasa phawt ang che.
Take-Home Thuchah a ni
- Tzield (Teplizumab) hi damdawi thar a ni a, stage 2 type 1 diabetes vei te tan chuan natna lan chhuah dan leh insulin mamawhna kum engemaw zat a tikhawtlai thei a ni.
- Hei hian taksa immune system-in pancreas-a insulin siamtu beta cells a tihchhiat rate tihziaawmna hmangin hna a thawk a ni.
- I doctor chuan thisen test bik hnuah he enkawlna hi i tan a tha em tih a hre ang.
- Side effect tenau tak tak, vun natna leh lu na te pawh a awm thei a, enkawl theih a ni. Amaherawhchu, thaw harsa emaw, khawsik emaw ang chi symptom na tak tak a awm chuan doctor lam pan nghal tur a ni.
- Damdawi dang leh vaccine i ei tur zawng zawng chu i doctor nen inbiakna neihpui ngei ang che.
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