Kodi mwadzidzidzi mumamva kuzizira, thukuta, komanso chizungulire? Kungakhale insulinoma! Tiyeni tikambirane za izi.

Kodi mudayamba mwamvapo chizungulire mwadzidzidzi, mutu wopepuka, komanso kugunda kwa mtima, monga momwe shuga wanu m'magazi umatsikira? Nthawi zina mumaganiza kuti izi zimachitika chifukwa chakuti muli ndi njala, koma nthawi zina, pakhoza kukhala chifukwa china cha izi. Lero, tikambirana za vuto losowa koma lofunika kwambiri lomwe muyenera kulidziwa. Limenelo ndi vuto lotchedwa insulinoma.

Kodi insulinoma iyi ndi chiyani?

Mwachidule, insulinoma ndi chotupa chaching'ono, chosakhala khansa chomwe chimayamba m'chifuwa chathu. Tsopano mwina mukudabwa kuti chifuwa ichi ndi chiyani. Chifuwachi ndi chiwalo chaching'ono koma chofunikira kwambiri chomwe chili mkati mwa mimba yathu, kumbuyo kwa mimba. Chimapanga ma enzyme omwe amatithandiza kugaya chakudya chomwe timadya, komanso mahomoni otchedwa insulin, omwe amalamulira kuchuluka kwa shuga m'magazi mwathu.

Choncho, insulinoma iyi ikayamba, imapangitsa kuti insulin yambiri itulutsidwe m'magazi mwathu kuposa momwe iyenera kukhalira. Ili ngati pompo yamadzi yotsekedwa yomwe imatuluka nthawi zonse.

Ma insulinoma amenewa ndi mtundu wa chotupa cha neuroendocrine chomwe chimayamba mu kapamba chotchedwa Pancreatic Neuroendocrine Tumors (pNETs). Izi ndi zotupa zomwe sizimapezeka kawirikawiri. Chabwino kwambiri ndi chakuti 85% mpaka 90% ya ma insulinoma amenewa ndi osafalikira/osagona. Izi zikutanthauza kuti safalikira ku ziwalo zina za thupi kunja kwa kapamba. Komabe, nthawi zambiri, amatha kufalikira/kukhala ankhanza. Ngati atatero, nthawi zambiri amafalikira ku ma lymph nodes apafupi ndi chiwindi.

Kodi insulinoma imakhudza bwanji thupi?

Ndanena kale kuti insulinoma ndi chotupa chomwe chimapanga insulin yochuluka kwambiri. Ndiye, chimachitika ndi chiyani ngati pali insulin yochuluka? Ntchito yayikulu ya insulin ndikutengera shuga (timayitchanso shuga) m'magazi kupita ku maselo. Kenako maselo amapeza mphamvu. Koma ngati pali insulin yochuluka, kuchuluka kwa shuga m'magazi kumachepa mwadzidzidzi. Timatcha vutoli hypoglycemia . Mu Chisinhala, zikutanthauza kuchepa kwa shuga m'magazi.

Shuga m'magazi mwanu akatsika motere, mumayamba kuona zizindikiro.

Tangoganizirani, mwadya chakudya cham'mawa, mwapita ku ofesi, ndipo mukugwira ntchito. Mwadzidzidzi, mukumva kupweteka, thukuta, chizungulire, komanso mutu wanu ukumva ngati mwatopa komanso muli ndi njala.

Nthawi ngati izi, ngati mudya kapena kumwa mwachangu chinthu chokoma, monga madzi a apulo, kapu ya tiyi ndi shuga, kapena nthochi, mudzayamba kumva bwino pakapita nthawi.

Koma kukhala ndi shuga wotsika m'magazi ngati uyu, makamaka osadziwa chomwe chikuyambitsa komanso osadziwa nthawi yomwe zidzachitikenso, n'koopsa kwambiri. Chifukwa chake, ndi bwino nthawi zonse kusunga chakudya chaching'ono, monga toffee, pafupi. Komanso, ngati mwakumanapo ndi izi, muyenera kupita kwa dokotala mwachangu ndikuwauza za izi.

Kodi zizindikiro za izi ndi ziti?

Chizindikiro chachikulu cha insulinoma, monga tanenera kale, ndi kuchepa kwa shuga m'magazi (hypoglycemia). Izi zingayambitse zizindikiro zosiyanasiyana.

Zizindikiro zodziwika bwino:

Zizindikiro zoyamba zomwe mungazindikire ndi izi:

• Kusokonezeka kapena kuvutika kukhazikika maganizo: Ngati mutu wanu ukuzungulira, simungathe kuyang'ana kwambiri zomwe mukuchita.
• Kutuluka thukuta: Kungotuluka thukuta, mwina thukuta lozizira.
• Kugunda kwa mtima: Mukumva ngati mukumva kugunda kwa mtima wanu.
• Nkhawa kapena kukwiya: Kungokhala ndi mantha, kukwiya msanga.
• Kunjenjemera: Kumamva ngati ziwalo zanu zikugwedezeka.
• Kumva njala kwambiri.

Zizindikiro zazikulu:

Ngati shuga m'magazi mwanu watsika kwambiri, vutoli likhoza kukhala lalikulu kwambiri. Mutha kukhala ndi zizindikiro monga:

• Masomphenya amasintha: Masomphenya amakhala osawoneka bwino, ngati kuona zinthu ziwiri nthawi imodzi.
• Mavuto olankhula: kusalankhula bwino, kulephera kulankhula momveka bwino.
• Kulephera kulinganiza bwino kapena kugwirizana: Kugwedezeka poyenda, kugwedezeka uku ndi uku pamene ukufikira chinthu china.
• Kugwidwa ndi khunyu: Kungachitike ngati chimfine.
• Kutaya chidziwitso: Mutha kukomoka ndi kugwa.

Kawirikawiri, anthu omwe ali ndi insulinoma amakumana ndi shuga wochepa m'magazi m'mawa, kutanthauza kuti, akadzuka atatha maola angapo akusala kudya atadya chakudya chamadzulo. Izi timazitcha "hypoglycemia yosala kudya". Komabe, anthu ena amatha kukhala ndi shuga wochepa m'magazi ngakhale atangodya kumene.

Izi ndizofunikira kwambiri: Kuchuluka kwa shuga m'magazi nthawi zonse kumatha kusokoneza zochita zanu za tsiku ndi tsiku, ndipo nthawi zina kungayambitse kuwonongeka kwa ubongo, chikomokere, komanso imfa. Chifukwa chake, ngati muli ndi zizindikiro za shuga m'magazi, onetsetsani kuti mwawonana ndi dokotala.

Chifukwa chiyani insulinoma iyi imayamba?

Ndipotu, ofufuza sanapezebe chifukwa chenicheni chomwe maselo opanga insulin mu kapamba amagawikana mwadzidzidzi ndikuchulukana mosalamulirika, zomwe zimapangitsa chotupachi.

Koma chinthu chimodzi chapezeka. Ndiko kuti, vuto ili lotchedwa insulinoma nthawi zina limatchedwa Multiple Endocrine Neoplasia type 1, kapena (MEN1).Zingathenso kugwirizanitsidwa ndi vuto lobadwa nalo lotchedwa insulinoma. Izi zimachitika pamene zotupa zimapangika m'maselo angapo opanga mahomoni m'thupi lathu (monga pituitary gland, parathyroid gland, kapamba). Si ma insulinoma onse omwe amayamba chifukwa cha MEN1, koma 5% mpaka 10% ya ma insulinoma onse amayamba chifukwa cha MEN1.

Ngati achibale anu, monga amayi anu, abambo anu, kapena abale anu, auzidwa ndi madokotala kuti ali ndi vutoli (MEN1), muyenera kulankhula ndi dokotala wanu za kuyezetsa majini . Izi zingakuthandizeni kudziwa ngati muli ndi vutoli. Ngati muli ndi vutoli (MEN1), mayesowa angathandizenso kuzindikira zotupa izi zisanakule.

Kodi madokotala amazindikira bwanji izi?

Mukapita kwa dokotala, adzakufunsani za zizindikiro zanu ndikukuyesani. Pali zizindikiro zitatu zazikulu zomwe zimasonyeza kuti muli ndi insulinoma. Izi timazitcha kuti Whipple's triad .

Ali:

1. Kukhala ndi zizindikiro za shuga wotsika m'magazi (monga chizungulire ndi thukuta, monga tafotokozera kale)

2. Kuyesa komwe kumatsimikizira kuti shuga m'magazi ndi wochepa. (Nthawi zambiri, kuyesa kobayidwa chala kumasonyeza shuga m'magazi wochepera 55 mg/dL)

3. Zizindikiro zimachepa mukamadya kapena kumwa chinthu chokhala ndi shuga (chakudya).

Ngati muli ndi zizindikiro zonse zitatuzi, dokotala wanu angaganize kuti muli ndi insulinoma. Kenako adzalamula kuti muyesedwenso kuti mutsimikizire matendawa.

Mayeso ofulumira a maola 72

Iyi ndiye njira yayikulu, "yodziwika bwino" yoyezera insulinoma. Imafuna kuti musale kudya kwa maola 72. Koma musadandaule, izi zimachitika kuchipatala, moyang'aniridwa ndi dokotala kapena namwino. Simuli nokha.

Mukasala kudya motere, shuga m'magazi mwanu amatsika ndipo mumayamba kuona zizindikiro, madokotala adzakuyesani magazi ndikuyesa zotsatirazi:

• Mulingo wa shuga m'magazi
• Mulingo wa insulin
• Mulingo wa proinsulin
• Mulingo wa C-peptide
• Mulingo wa Beta-hydroxybutyrate
• Mulingo wa sulfonylurea (izi zimagwiritsidwa ntchito poyesa kupezeka kwa mankhwala enaake omwe amagwiritsidwa ntchito pochiza matenda a shuga m'magazi)

Pambuyo potenga magazi, madokotala adzakuchizani shuga wochepa m'magazi. Zotsatira za mayesowa zingathandize kudziwa ngati shuga wochepa m'magazi mwanu ndi chifukwa cha insulin yochuluka (imeneyi timaitcha hyperinsulinemia).

Ndi mayeso ena ati omwe amachitidwa? (Mayeso ojambula zithunzi)

Ngati mayeso osala kudya kwa maola 72 akusonyeza kuti munthu ali ndi insulinoma, sitepe yotsatira ndikupeza komwe chotupacho chili mu kapamba komanso kukula kwake. Izi zitha kuphatikizapo chimodzi kapena zingapo mwa izi:

• Kujambula kwa CT
• Kujambula kwa MRI
• Kujambula kwa ultrasound m'mimba
• Endoscopic ultrasound (EUS): Izi zimaphatikizapo kulowetsa chubu chokhala ndi kamera kakang'ono kudzera pakamwa ndikuyang'ana kapamba.

Ngati ma scan awa sakutha kuzindikira komwe kuli chotupacho, dokotala wanu angakupatseni mayeso ena apadera otchedwa selective arterial calcium stimulation test. Iyi ndi mayeso ovuta kwambiri.

Kodi chithandizo cha izi ndi chiyani?

Nkhani yabwino ndi yakuti ma insulinoma ambiri amatha kuchiritsidwa kwathunthu ndi opaleshoni, makamaka ngati chotupacho sichinafalikire kumadera ena (osafalikira).

Chinthu chachikulu ndi opaleshoni.

Pali mitundu ingapo ya opaleshoni. Dokotala wanu adzasankha opaleshoni yoyenera kwa inu kutengera mtundu, malo, ndi kukula kwa chotupa chanu.

• Kuchotsa dzira: Izi zimaphatikizapo kuchotsa chotupa chokha popanda kuwononga kwambiri kapamba, monga momwe kuchotsa mosamala yolk yokha kuchokera mu dzira lophika.
• Kuchotsa kapamba pang'ono: Monga momwe dzinalo likusonyezera, izi zimaphatikizapo kudula ndikuchotsa gawo la kapamba komwe kuli chotupa.
• Opaleshoni ya Whipple: Iyi ndi opaleshoni yaikulu. Imachitika pamene chotupa chafalikira (metastatic). Imafuna kuchotsa gawo la kapamba ndi minofu ina yapafupi.

Opaleshoni iliyonse ili ndi zoopsa zina. Dokotala wanu adzakufotokozerani zonsezo.

Kodi mungachepetse bwanji shuga m'magazi musanachite opaleshoni komanso ngati opaleshoniyo sizingatheke?

Mpaka opaleshoni, kapena ngati opaleshoniyo singatheke pazifukwa zina, ndikofunikira kwambiri kuchepetsa shuga m'magazi mwanu.

• Yang'anani shuga m'magazi mwanu nthawi zonse: Dokotala wanu angakulangizeni kuti mugwiritse ntchito njira yowunikira shuga m'magazi mosalekeza (CGM) . Izi zingakuthandizeni kuyang'anira shuga m'magazi mwanu nthawi zonse. Izi zingakuthandizeni kuzindikira shuga m'magazi anu msanga, makamaka usiku.

Koma kumbukirani, '(CGM)' iyi siigwiritsidwa ntchito kuzindikira matenda monga insulinoma, koma kuyang'anira matendawa akangotsimikizika.

• Kusintha zakudya: Kudya zakudya nthawi zonse, makamaka chakudya chopatsa mphamvu (monga buledi wa tirigu wonse, mpunga wofiirira, ndiwo zamasamba), kungathandize kupewa kutsika kwadzidzidzi kwa shuga m'magazi. Kudya chakudya chochepa musanagone kungathandizenso anthu ena.
• Glucose wolowetsedwa m'mitsempha (IV glucose): Ngati muli ndi shuga wochepa kwambiri m'magazi, mungapatsidwe shuga kudzera mu saline kuchipatala.
• Mitundu ya mankhwala:
• Diazoxide: Mankhwalawa amatha kuletsa kutulutsidwa kwa insulin kuchokera ku kapamba. Angathenso kuwonjezera kutulutsidwa kwa glucagon (yomwe imawonjezera shuga m'magazi) kuchokera ku chiwindi.
• Octreotide ndi Lanreotide: Mankhwalawa amathandizanso kuchepetsa kutulutsa kwa insulin kuchokera ku insulinomas zina.

Ndikofunikira kwambiri kunyamula khadi lodziwitsa dokotala lomwe limasonyeza kuti muli ndi shuga wochepa m'magazi. Mwanjira imeneyi, ngati mwadzidzidzi mwakumana ndi vuto, wina angakuthandizeni mwachangu. Komanso, dziwitsani achibale anu ndi anzanu za izi komanso momwe angathandizire.

Kodi mungachite chiyani ngati chotupacho chafalikira (chosakhazikika)?

Kawirikawiri, ngati insulinoma yafalikira ku ziwalo zina za thupi (yomwe yafalikira), madokotala amatha kuphatikiza opaleshoni ndi njira zina zochiritsira. Kapena, ngati opaleshoni siingatheke, chithandizochi chingagwiritsidwe ntchito.

• Mankhwala a Peptide Receptor Radionuclide (PRRT)
• Chithandizo cholunjika
• Mankhwala a Chemotherapy

Izi ndi njira zovuta kuzitsatira, zomwe dokotala wanu adzakufotokozerani.

Kodi izi zitha kuchiritsidwa?

Inde! Insulinoma nthawi zambiri imatha kuchiritsidwa kwathunthu ndi opaleshoni. Kafukufuku wina adawonetsa kuti 87% ya anthu omwe adachitidwa opaleshoni ya insulinoma yopanda khansa anali akadali ndi moyo zaka 10 atapezeka ndi matendawa. Chiŵerengero chimenecho ndi chabwino kwambiri.

Komabe, ngati chotupacho chafalikira (chofalikira), chiŵerengero cha moyo wa zaka 10 chimanenedwa kuti ndi pafupifupi 33%. Koma kumbukirani, izi ndi ziwerengero wamba. Kutengera ndi momwe zinthu zilili, gulu lanu lachipatala lingakupatseni zambiri zolondola.

N’zoona kuti mawu oti “chotupa” angatiopseze. Makamaka ngati ndi vuto losowa kwambiri monga insulinoma. Koma chabwino kwambiri n’chakuti ambiri mwa matenda amenewa amatha kuchiritsidwa ndi opaleshoni. Ngakhale zili choncho, sikophweka kudziwa kuti muli ndi vuto losowa kwambiri lomwe limafuna opaleshoni. Koma simuli nokha. Gulu lanu lachipatala lidzakhalapo nthawi zonse, kuyankha mafunso anu, ndikukuthandizani. Ngati mukumva kutopa kwambiri, lankhulani ndi dokotala wanu za zimenezo ndikupezanso chithandizo chomwe mungapeze.

Zinthu zofunika kwambiri zomwe muyenera kukumbukira (Uthenga Wopita Nawo Kunyumba)

Chabwino, kuchokera pa zomwe takambirana lero, izi ndi zinthu zofunika kwambiri zomwe muyenera kukumbukira:

• Insulinoma ndi chotupa chosaopsa (chomwe nthawi zambiri chimakhala chosaopsa) chomwe chimayamba m'chifuwa. Chimapanga insulin yambiri.
• Izi zingayambitse kutsika kwadzidzidzi kwa shuga m'magazi (hypoglycemia). Izi zingayambitse zizindikiro monga chizungulire, thukuta, komanso kugunda kwa mtima.
• Ngati mukumva zizindikiro izi pafupipafupi, onetsetsani kuti mwawonana ndi dokotala.
• Izi zitha kuzindikirika kudzera mu mayeso apadera (mayeso osala kudya kwa maola 72, ma scan).
• Chithandizo chachikulu ndi opaleshoni. Nthawi zambiri, izi zimapangitsa kuti munthu achire bwino.
• Musanayambe opaleshoni, kapena ngati opaleshoniyo sizingatheke, mutha kuchepetsa kuchuluka kwa shuga m'magazi kudzera mu zakudya ndi mankhwala.
• Ngakhale kuti vutoli ndi losowa, zotsatira zabwino zitha kupezeka ngati zadziwika msanga ndikuchiritsidwa bwino.

Musadandaule, monga matenda ena aliwonse, pali mankhwala a izi. Chofunika kwambiri ndikuyang'anira zizindikiro ndikupempha upangiri wa dokotala mwachangu momwe mungathere.

Insulinoma , kapamba, insulin, shuga wochepa m'magazi, hypoglycemia, chotupa, mahomoni, khansa ya kapamba