Nguyên nhân và cơ chế sinh bệnh của bệnh tiểu đường

Nguyên nhân và cơ chế sinh bệnh của bệnh tiểu đường.

Đái tháo đường là một tình trạng rối loạn chuyển hóa đa nguyên nhân đặc trưng bởi tình trạng tăng glucose máu mạn tính với các rối loạn chuyển hóa carbohydrate, mỡ, protein do hậu quả của khiếm khuyết tiết insulin, khiếm khuyết hoạt động insulin hoặc cả hai. Tăng Glucose máu mạn tính trong bệnh tiểu đường sẽ gây tổn thương, rối loạn chức năng hay suy nhiều cơ quan, đặc biệt là mắt, thận, thần kinh, tim và mạch máu.

Nguyên nhân và cơ chế sinh bệnh của bệnh tiểu đường.
Nguyên nhân và cơ chế sinh bệnh của bệnh tiểu đường.

Nguyên nhân gây bệnh tiểu đường

– Đái tháo đường do tụy

Phẫu thuật cắt bỏ một phần hoặc toàn bộ tụy.

Sỏi tụy: Đây là biến chứng ít gặp.

Ung thư tụy nguyên phát hoặc thứ phát do ung thư nơi khác di căn đến: Ít gặp, các triệu chứng của bệnh lý ung thư lấn át bệnh đái tháo đường.

Di truyền: Đái tháo đường type 1 do di truyền thường liên quan đến hệ kháng nguyên bạch cầu người (Human Leucocyte Antigen – HLA) trong cơ thể.

Yếu tố môi trường: Các yếu tố môi trường tác động lên cơ thể làm tổn thương tuyến tụy, đặc biệt là tụy nội tiết bao gồm: Virus (quai bị, Rubella, Coxsakie B4), các chất hóa học có chứa Nitơ hay các chất độc từ củ sắn…

Yếu tố miễn dịch: Một số kháng thể tham gia vào miễn dịch dịch thể như kháng thể chống tế bào β tiểu đảo tụy, tự kháng thể kháng tế bào tiểu đảo (ICA), kháng thể kháng insuline (IAA)… được tìm thấy ở bệnh nhân đái tháo đường type 1. Ngoài ra, sự rối loạn tế bào Lympho T cũng là một trong những nguyên nhân gây bệnh đái tháo đường type 1.

– Nguyên nhân ngoài tụy

Cường thùy trước tuyến yên: Làm tăng tiết GH, gây ra đái tháo đường tuyến yên.

Cường vỏ thượng thận: Làm tăng tiết Hormone cortisol làm tăng tạo đường mới và giảm tiêu thụ Glucose tế bào, gây ra đái tháo đường do tuyến thượng thận.

Cường giáp trạng: Do Hormone tuyến giáp hầu như tác dụng lên tất cả các giai đoạn của chuyển hóa Glucid nên có thể gây rối loạn chuyển hóa đường. Tuy nhiên, trường hợp này không nặng nề.

Di truyền: Những người có tiền sử gia đình có bệnh nhân mắc đái tháo đường type 2 thì có nhiều nguy cơ mắc bệnh.

Yếu tố môi trường: Tuổi tác, béo phì, lối sống tĩnh tại, chế độ ăn quá nhiều chất béo, đường bột và ít rau quả tươi… là những nguyên nhân gây bệnh đái tháo đường type 2.

Cơ chế sinh bệnh của bệnh tiểu đường

Khi đường từ thức ăn sau khi đưa vào cơ thể sẽ được bẻ gãy để tạo thành đường đơn như Glucose. Sau khi lưu hành trong máu, Glucose được đưa vào tế bào để sử dụng tạo thành năng lượng cho cơ thể hoạt động.

Insuline là Hormone do các tế bào β của tuyến tụy nội tiết bài tiết, có tác dụng vận chuyển Glucose vào tế bào. Khi Glucose máu tăng cao, tuyến tụy sẽ bài tiết một lượng insuline vừa đủ để vận chuyển Glucose vào tế bào. Khi Glucose máu xuống thấp tụy sẽ ngừng bài tiết insuline.

– Đái tháo đường type 1

Vì những lí do trên, các tế bào β của tụy bị phá hủy, không thể bài tiết insulin phục vụ cho quá trình vận chuyển Glucose vào tế bào, làm lượng đường máu tăng cao. Hai giai đoạn phát triển đái tháo đường type 1 là: Tạo đáp ứng tự miễn hằng định với tế bào β đảo tụy, có sự xuất hiện đơn độc hay phối hợp các tự kháng thể GAD65, IAA, ICA, IA-2 và giai đoạn tiến triển từ đáp ứng tự miễn với tế bào β đảo tụy sang đái tháo đường type 1.

– Đái tháo đường type 2

Ở những bệnh nhân mắc đái tháo đường type 2, tuyến tụy bài tiết đủ insuline nhưng các tế bào trong cơ thể kháng lại tác dụng của insuline, hoặc do lượng Glucose đưa vào cơ thể quá nhiều, insuline do tụy tiết ra không đủ để đáp ứng việc vận chuyển chúng vào trong tế bào. Kết quả là đường máu tăng cao, đến một mức nào đó sẽ đào thải qua nước tiểu, gây nên tình trạng đái tháo đường.

Sự đề kháng insuline trong đái tháo đường type 2 là hậu quả của nhiều cơ chế bệnh sinh khác nhau như: Tăng Glucose máu, tăng Acid béo không – ester hoá. Những nghiên cứu gần đây thấy rằng sự đề kháng insulin ở mô cơ xảy ra rất sớm trong quá trình phát triển của bệnh.

Các Enzyme insuline receptor kinase, phosphatase liên quan tới hoạt động insuline, chất chuyển vận glucose và tổng hợp glycogene. Rối loạn chức năng tế bào β đảo tụy trong đái tháo đường type 2 bao gồm: Rối loạn tiết insuline, giảm đáp ứng của insuline đối với Glucose, rối loạn tiết insuline theo nhịp liên quan đến nồng độ Glucose, bất thường chuyển hóa Prinsuline, giảm lượng tế bào β, lắng đọng Amyloid tại đảo tụy. Vai trò của cơ chất thụ thể insulin2 2 (IRS 2: Insulin Receptor Substrate 2), NF-kB, rối loạn chức năng ti thể, stress oxy hóa.

Bị tiểu đường thì nên điều trị như thế nào?

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Thay vì để cơ thể ngày càng trở nên quá phụ thuộc, phải tiêm insulin hàng ngày, đi đâu cũng phải đặt báo thức vì đã tới giờ chích thuốc. Chỉ với bài thuốc kết hợp nhiều loại thảo dược trong đông y sẽ giúp bạn kiểm soát nhanh lượng đường – tác dụng của các loại thảo dược này đã được rất nhiều chuyên gia trong lĩnh vực sức khỏe khẳng định.

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