Ngaba ngequbuliso uziva ubanda, ubila, kwaye unesiyezi? Isenokuba yi-insulinoma! Makhe sithethe ngale nto.

Ngaba wakha waba nesiyezi ngequbuliso, intloko ebuhlungu, kunye nokubetha kwentliziyo, kanye njengokuba iswekile yakho yegazi yehla? Ngamanye amaxesha ucinga ukuba ezi zinto zibangelwa kukuba ulambile, kodwa kunqabile, kukho esinye isizathu soku. Namhlanje, siza kuthetha ngemeko engaqhelekanga kodwa ebalulekileyo ekufuneka uyiqaphele. Leyo yimeko ebizwa ngokuba yi-insulinoma.

Yintoni le insulinoma?

Ngamafutshane, i-insulinoma sisimila esincinci, esingengomhlaza esikhula kwi-pancreas yethu. Ngoku usenokuba uzibuza ukuba yintoni le pancreas. I-pancreas sisitho esincinci kodwa esibaluleke kakhulu esikwisisu sethu, emva kwesisu. Ivelisa ii-enzymes ezisinceda ekugayeni ukutya esikutyayo, kunye nehomoni ebizwa ngokuba yi-insulin, elawula amanqanaba eswekile egazini lethu.

Ngoko ke, xa le insulinoma ikhula, ibangela ukuba kukhutshwe i-insulin eninzi egazini lethu kunokuba kufanele. Ifana nempompo yamanzi evalekileyo ehlala ivuza.

Ezi insulinomas luhlobo lwe-neuroendocrine tumor olukhula kwi-pancreas olubizwa ngokuba yi-Pancreatic Neuroendocrine Tumors (pNETs). Ezi zii-tumor ezingaqhelekanga. Eyona nto ingcono kukuba i-85% ukuya kwi-90% yezi insulinomas azina-metastatic/azinazo i-indolent. Oku kuthetha ukuba azisasazeki kwezinye iindawo zomzimba ngaphandle kwe-pancreas. Nangona kunjalo, kunqabile kakhulu, zinokusasazeka/zibe nolaka. Ukuba zenze njalo, zisenokusasazeka kwiindawo ze-lymph ezikufutshane nakwisibindi.

I-insulinoma iwuchaphazela njani umzimba?

Ndikhankanye ngaphambili ukuba i-insulinoma sisimila esivelisa i-insulin eninzi kakhulu. Ngoko ke, kwenzeka ntoni xa kukho i-insulin eninzi kakhulu? Umsebenzi ophambili we-insulin kukuthatha iswekile (siyibiza ngokuba yi-glucose) egazini siyifake kwiiseli. Emva koko iiseli zifumana amandla. Kodwa xa kukho i-insulin eninzi kakhulu, ubungakanani beswekile egazini buyancipha ngequbuliso. Le meko siyibiza ngokuba yi-hypoglycemia . NgesiSinhala, kuthetha ukwehla kweswekile egazini.

Xa iswekile yakho egazini iwela ngolu hlobo, uqala ukuba neempawu.

Khawucinge nje, utye isidlo sakusasa, uye eofisini, kwaye usebenza. Ngequbuliso, uziva uqaqambile, ubila, unesiyezi, kwaye unentloko ebuhlungu. Kufana nokuba udiniwe kwaye ulambile.

Ngamaxesha anje, ukuba utya okanye usela into emnandi ngokukhawuleza, njengejusi yeapile, ikomityi yeti eneswekile, okanye ibhanana, uza kuqala ukuziva ungcono emva kwexesha elithile.

Kodwa, ukuba neswekile ephantsi egazini ngolu hlobo, ingakumbi ngaphandle kokwazi unobangela kwaye ungazi ukuba iza kuphinda yenzeke nini, kuyoyikisa kakhulu. Ngoko ke, licebo elihle ukuhlala ugcina intwana encinci yokutya, njengetofi, kufutshane. Kwakhona, ukuba ukhe waba namava anjalo, kuya kufuneka ubone ugqirha ngokukhawuleza kwaye umxelele ngako.

Zithini iimpawu zoku?

Uphawu oluphambili lwe-insulinoma, njengoko bekutshiwo ngaphambili, kukuba neswekile ephantsi egazini (hypoglycemia). Oku kunokubangela iimpawu ezahlukeneyo.

Iimpawu eziqhelekileyo:

Ezi ziimpawu zokuqala onokuzibona:

• Ukudideka okanye ubunzima bokugxila: Ngokungathi intloko yakho iyajikeleza, awukwazi ukugxila kwinto oyenzayo.
• Ukubila: Ukubila nje, mhlawumbi ukubila okubandayo.
• Ukubetha kwentliziyo: Uziva ngathi uyayiva intliziyo yakho ibetha.
• Ixhala okanye ukucaphuka: Yimeko nje yovalo, ekhawuleza ukucaphuka.
• Ukungcangcazela: Kuvakala ngathi amalungu akho ayangcangcazela.
• Ndiziva ndilambile kakhulu.

Iimpawu ezinzulu:

Ukuba iswekile yakho egazini iyehla kakhulu, imeko inokuba mandundu ngakumbi. Ungafumana iimpawu ezifana nezi:

• Umbono uyatshintsha: Umbono uba lufifi, njengokubona izinto ezimbini ngaxeshanye.
• Ubunzima bokuthetha: ukungakwazi ukuthetha ngokucacileyo, ukungakwazi ukuthetha ngokucacileyo.
• Ukulahlekelwa kukulinganisela okanye ukulungelelana: Ukugxadazela xa uhamba, ukushukuma ubuyela umva xa ufikelela kwinto ethile.
• Ukuxhuzula: Kunokwenzeka xa umntu exhuzula.
• Ukulahlekelwa zingqondo: Usenokufa isiqaqa uze uwe.

Amaxesha amaninzi, abantu abane-insulinoma bafumana le swekile isezantsi egazini kusasa, oko kukuthi, emva kokuvuka emva kweeyure ezimbalwa zokuzila ukutya emva kwesidlo sangokuhlwa. Oku sikubiza ngokuba yi-"fasting hypoglycemia". Nangona kunjalo, abanye abantu banokuyifumana le swekile isezantsi egazini kwanasemva nje kokutya.

Oku kubaluleke kakhulu: Amanqanaba eswekile egazini aphantsi rhoqo anokuphazamisana nemisebenzi yakho yemihla ngemihla, kwaye ngamanye amaxesha anokukhokelela ekulimaleni kwengqondo, kwi-coma, kwanasekufeni. Ngoko ke, ukuba uneempawu zeswekile egazini ephantsi, qiniseka ukuba ubona ugqirha.

Kutheni le nto kuvela le insulinoma?

Enyanisweni, abaphandi abakafumani sizathu sokuba kutheni iiseli ezivelisa i-insulin kwi-pancreas zahlukana ngequbuliso kwaye zande ngokungalawulekiyo, zenze eli thumba.

Kodwa kukho into enye efunyenweyo. Oko kukuthi, le meko ibizwa ngokuba yi-insulinoma ngamanye amaxesha ibizwa ngokuba yi-Multiple Endocrine Neoplasia type 1, okanye (MEN1).Inokunxulunyaniswa nesifo esidluliselwa kwilifa esibizwa ngokuba yi-insulinoma. Oku kwenzeka xa iithumba zenzeka kwiindlala ezininzi ezivelisa iihomoni emzimbeni wethu (umzekelo, i-pituitary gland, i-parathyroid gland, i-pancreas). Ayizizo zonke ii-insulinomas ezibangelwa yi-MEN1, kodwa i-5% ukuya kwi-10% yazo zonke ii-insulinomas zibangelwa yi-MEN1.

Ukuba amalungu osapho lwakho, njengomama wakho, utata, okanye abantakwenu, baxelelwe ngoogqirha ukuba banale meko (MEN1), kufuneka uthethe nogqirha wakho malunga novavanyo lwemfuza . Oku kunokukunceda ufumanise ukuba unayo na le meko. Ukuba unayo (MEN1), olu vavanyo lunokunceda ekuchongeni la mathumba ngaphambi kokuba akhule.

Oogqirha bayibona njani le nto?

Xa usiya kugqirha, baza kukubuza ngeempawu zakho baze bakuhlole. Kukho iimpawu ezintathu eziphambili ezibonisa ukuba une-insulinoma. Ezi sizibiza ngokuba yi-Whipple's triad .

Bazi:

1. Ukuba neempawu zeswekile ephantsi egazini (ezifana nesiyezi kunye nokubila, njengoko bekutshiwo ngaphambili)

2. Uvavanyo oluqinisekisa ukuba inqanaba leswekile egazini liphantsi. (Ngokwesiqhelo, uvavanyo lokuhlaba ngomnwe lubonisa inqanaba leswekile egazini elingaphantsi kwama-55 mg/dL)

3. Iimpawu ziyaphucuka xa usitya okanye usela into equlethe iswekile (iicarbohydrate).

Ukuba unazo zonke ezi mpawu zintathu, ugqirha wakho unokurhanela ukuba une-insulinoma. Emva koko uya kuyalela ukuba kwenziwe ezinye iimvavanyo ukuqinisekisa ukuba unesifo.

Uvavanyo olukhawulezayo lweeyure ezingama-72

Olu lolona vavanyo luphambili, "olusemgangathweni ogqwesileyo" lwe-insulinoma. Lufuna ukuba uzile ukutya ukuya kuthi ga kwiiyure ezingama-72. Kodwa ungakhathazeki, oku kwenziwa esibhedlele, phantsi kweliso likagqirha okanye umongikazi. Awuwedwa.

Xa uzila ukutya ngolu hlobo, amanqanaba eswekile egazini lakho ayehla kwaye uqala ukuba neempawu, oogqirha baza kuthatha isampuli yegazi kuwe baze bavavanye oku kulandelayo:

• Inqanaba leswekile egazini
• Inqanaba le-insulin
• Inqanaba le-proinsulin
• Inqanaba le-C-peptide
• Inqanaba le-Beta-hydroxybutyrate
• Inqanaba le-sulfonylurea (eli lisetyenziselwa ukujonga ukuba kukho amayeza athile asetyenziselwa ukunyanga isifo seswekile egazini)

Emva kokuthatha igazi, oogqirha baya kunyanga iswekile yakho ephantsi egazini. Iziphumo zezi mvavanyo zinokunceda ekuqinisekiseni ukuba iswekile yakho ephantsi egazini ibangelwa yi-insulin eninzi (esiyibiza ngokuba yi-hyperinsulinemia).

Zeziphi ezinye iimvavanyo ezenziwayo? (Uvavanyo lomfanekiso)

Ukuba uvavanyo lokuzila ukutya oluthatha iiyure ezingama-72 lubonisa ukuba une-insulinoma, inyathelo elilandelayo kukufumanisa ukuba ithumba likwi-pancreas kwaye likhulu kangakanani. Oku kunokubandakanya enye okanye ezingaphezulu kwezi skeni zilandelayo:

• Iskeni ye-CT
• Iskeni ye-MRI
• Iskeni ye-ultrasound yesisu
• I-Endoscopic ultrasound (EUS): Oku kuquka ukufaka ityhubhu enekhamera encinci ngomlomo uze ujonge kwi-pancreas.

Ukuba ezi scan azikwazi ukubona indawo echanekileyo enesi sifo, ugqirha wakho unokuyalela olunye uvavanyo olukhethekileyo olubizwa ngokuba luvavanyo lokukhuthaza i-calcium yemithambo yegazi. Olu luvavanyo olunzima ngakumbi.

Luluphi unyango lwale nto?

Iindaba ezimnandi zezokuba uninzi lwee-insulinomas zinokunyangwa ngokupheleleyo ngotyando, ingakumbi ukuba ithumba alikasasazeka kwezinye iindawo (ezingenazo ii-metastatic).

Eyona nto iphambili lutyando.

Kukho iintlobo ezahlukeneyo zotyando. Ugqirha wakho uya kugqiba ukuba loluphi utyando olufanelekileyo kuwe ngokusekwe kuhlobo, indawo, kunye nobukhulu bethumba lakho.

• Ukususwa kwe-enucleation: Oku kuquka ukususa ithumba kuphela ngaphandle kokubangela umonakalo omkhulu kwi-pancreas, njengokususa ngononophelo i-yolk kuphela kwiqanda elibilisiweyo.
• Ukususwa kwepancreatectomy engaphelelanga: Njengoko igama lisitsho, oku kuquka ukusika nokususa inxalenye yepancreas apho kukho khona ithumba.
• Utyando lweWhipple: Olu lutyando olukhulu. Lwenziwa xa ithumba lisasazekile (lisasazeka). Lubandakanya ukususa inxalenye yepancreas kunye nezinye izicwili ezikufutshane.

Lonke utyando lunemingcipheko ethile. Ugqirha wakho uza kukuchazela yonke loo mingcipheko.

Ungayilawula njani iswekile ephantsi egazini ngaphambi kotyando kwaye ukuba utyando alunakwenzeka?

Kude kube lutyando, okanye ukuba utyando alunakwenzeka ngesizathu esithile, kubaluleke kakhulu ukulawula iswekile yakho yegazi ephantsi.

• Jonga amanqanaba eswekile egazini lakho rhoqo: Ugqirha wakho unokucebisa ukuba usebenzise inkqubo yokujonga iswekile rhoqo (i-CGM) . Oku kunokukunceda ukuba ujonge amanqanaba eswekile egazini lakho rhoqo. Oku kunokukunceda ukuba ubone amanqanaba eswekile egazini aphantsi kwangethuba, ingakumbi ebusuku.

Kodwa khumbula, le `(CGM)` ayisetyenziselwa ukubona iimeko ezifana ne-insulinoma, kodwa isetyenziselwa ukujonga isifo xa sele siqinisekisiwe.

• Utshintsho kwindlela yokutya: Ukutya ukutya ngamaxesha aqhelekileyo, ingakumbi iicarbohydrate ezintsonkothileyo (umz., isonka esipheleleyo, irayisi emdaka, imifuno), kunokunceda ekuthinteleni ukwehla ngequbuliso kweswekile egazini. Ukutya isidlo esincinci ngaphambi kokulala kunokunceda abanye abantu.
• Iglucose efakwa emthanjeni (iglucose ye-IV): Ukuba uneswekile ephantsi kakhulu egazini, unokunikwa iswekile ngetyuwa esibhedlele.
• Iintlobo zamayeza:
• I-Diazoxide: Eli yeza linokulawula ukukhululwa kwe-insulin kwi-pancreas. Linokunyusa nokukhululwa kwe-glucagon (enyusa amanqanaba eswekile egazini) kwisibindi.
• I-Octreotide kunye neLanreotide: La mayeza anceda ekunciphiseni ukukhululwa kwe-insulin kwezinye ii-insulinomas.

Kubaluleke kakhulu ukuba uhlale uphethe ikhadi lokuzazisa elichaza ukuba uneswekile ephantsi egazini. Ngale ndlela, ukuba ngequbuliso unengxaki, umntu anokukunceda ngokukhawuleza. Kwakhona, yazisa usapho lwakho nabahlobo bakho ngale nto kunye nendlela abanokukunceda ngayo.

Yintoni omawuyenze ukuba ithumba lisasazekile (lisasazeka kwi-metastatic)?

Kunqabile kakhulu, ukuba i-insulinoma isasazeke kwamanye amalungu omzimba (i-metastatic), oogqirha banokudibanisa utyando nezinye iindlela zonyango. Okanye, ukuba utyando alunakwenzeka, olu nyango lungasetyenziswa.

• Unyango lweRadionuclide yePeptide Receptor (PRRT)
• Unyango olujoliswe kulo
• Unyango ngamakhemikhali

Ezi ziindlela zonyango ezintsonkothileyo, aza kukuchazela ugqirha wakho.

Ngaba oku kunganyangeka?

Ewe! I-Insulinoma idla ngokunyangwa ngokupheleleyo ngotyando. Olunye uphando lubonise ukuba ama-87% abantu abatyandwa i-insulinoma engeyiyo i-metastatic babesaphila emva kweminyaka eli-10 bexilongiwe. Elo lizinga elihle kakhulu.

Nangona kunjalo, ukuba ithumba lisasazekile (lisasazeka), izinga lokusinda kweminyaka eli-10 kuthiwa limalunga ne-33%. Kodwa khumbula, ezi ziingqikelelo nje eziqhelekileyo. Ngokuxhomekeke kwimeko yakho, iqela lakho lezonyango lingakunika ulwazi oluchanekileyo ngakumbi.

Liyinyaniso elokuba igama elithi "ithumba" linokusoyikisa. Ingakumbi xa liyimeko engaqhelekanga efana ne-insulinoma. Kodwa eyona nto ilungileyo kukuba uninzi lwale meko lunokunyangeka ngotyando. Nangona kunjalo, akulula ukufumanisa ukuba unesifo esingaqhelekanga esifuna utyando. Kodwa awuwedwa. Iqela lakho lezonyango liya kuhlala likho xa likunceda, liphendula imibuzo yakho, kwaye likuxhase. Ukuba uziva uxinezelekile ngokweemvakalelo, thetha nogqirha wakho ngaloo nto kwaye ufumane ulwazi ngeenkonzo onokufumana uncedo kuzo.

Izinto ezibaluleke kakhulu ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, ngoko ke, ngokwezinto esithethe ngazo namhlanje, ezi zezona zinto zibalulekileyo ekufuneka uzikhumbule:

• I-insulinoma yithumba elingelona libi (kakhulu elingelona libi) elikhula kwi-pancreas. Livelisa i-insulin eninzi kakhulu.
• Oku kunokubangela ukwehla ngequbuliso kweswekile egazini (hypoglycemia). Oku kunokubangela iimpawu ezifana nesiyezi, ukubila, kunye nokubetha kwentliziyo.
• Ukuba ufumana ezi mpawu rhoqo, qiniseka ukuba ubona ugqirha.
• Oku kunokubonwa ngovavanyo olukhethekileyo (uvavanyo lokuzila ukutya lweeyure ezingama-72, iiskeni).
• Unyango oluphambili lutyando. Kwiimeko ezininzi, oku kuphumela ekuphilisweni ngokupheleleyo.
• Ngaphambi kotyando, okanye ukuba utyando alunakwenzeka, unokulawula amanqanaba aphantsi eswekile egazini ngokutya ukutya okunempilo kunye namayeza.
• Nangona esi sisifo esingaqhelekanga, iziphumo ezilungileyo zinokufumaneka ukuba ziqatshelwe kwangethuba kwaye zinyangwe ngokufanelekileyo.

Ungakhathazeki, njengayo nayiphi na enye isifo, kukho unyango lwaso. Eyona nto ibalulekileyo kukunika ingqalelo kwiimpawu kwaye ufune iingcebiso zonyango ngokukhawuleza.

I- Insulinoma, i-pancreas, i-insulin, iswekile ephantsi yegazi, i-hypoglycemia, ithumba, i-hormone, umhlaza we-pancreas