د. احمد مشتت
دائما ماتكون قصص اكتشاف الامراض مثيرة للاهتمام.
وقصة اكتشاف داء السكري الذي مر بمراحل تاريخية مهمة هي واحدة من هذه القصصوالتي تعتبر علامة فارقة في تاريخ البشرية.
حيث تحول داء السكري من مرض مجهول قاتل الى مرض ممكن علاجه والسيطرة عليهوحتى الوقاية منه.
فقد عرفه المصريون القدماء منذ عام ( 1500 ق – م ) ، حيث وجد على بعض الجدرانوالمخطوطات المصرية وصف لمتلازمة البول والعطش وهي من الاعراض الرئسية للمرض.
أما عند اليونان القدماء فقد ذكر داء السكري منذ عام ( 75 ق – م ) حيث أطلقوا عليه اسم ” Diabetes Mellitus ” وكلمة Mellitus باللغة اللاتينية تعني العسل ، وكلمة Diabetes تعني السائل والمقصود به البول وبذلك يكون المعنى الكامل ، البول السكري.
ويعتبر ابن سينا أول من وصف مرض السكري وصفا دقيقا في كتابه ” القانونفي الطب ” قال : هو أن يخرج الماء كما يشرب في زمن قصير أو أن صاحبه يعطشفيشرب ولا يروى. وذكر ابن سينا في كتابه عن أعراض المرض قائلا ” ومن أعراضهالعطش الشديد والضعف الجسمي والإجهاد العصبي وعدم انتظام الشهية.
واكتشف ابن سينا علاقة السكر بالضعف الجنسي والغرغرينا.
ومن المحطات المهمة في اكتشاف داء السكري هي اكتشاف العلاقة بين غدة البنكرياسالتي تفرز الانسولين الذي ينظم معدل السكر في الدم وداء السكري. حيث قام الألمانيانأوسكار منكوفسكى وجوزيف فون ميرنج في عام ١٨٨٩ بعملية استئصال البنكرياسلاحد الكلاب
، وبعد إجراء الجراحة ظهرت عليه اعراض مرض السكري حيث بدأ يشرب بكثرة ويتبولبكثرة ، الأمر الذي لفت انتباه العالِمين وذلك من خلال تجمع الذباب بكثرة على بول الكلبمما دفع بهما لإجراء تحليل للبول فوجدا بأنه يحتوي على نسبة عالية من سكرالجلوكوز وسرعان ما اكتشفا بأنهما قد تسببا بإصابة الكلب بمرض السكري .
وفي سنة 1921 نجح الباحثان ” بانتينغ ” و ” بيست ” Banting et Best ولأول مرة فياكتشاف علاج فعال لمرضى السكري بواسطة الأنسولين ومن أجل هذا الاكتشاف منحتلهم جائزة ” نوبل ” Nobel سنة 1923
ومع اكتشاف الانسولين تغيرت رحلة الانسان مع داء السكري.
وهناك ثلاثة انواع رئيسية من داء السكري
النوع الاول الذي يعتبر احد امراض المناعة الذاتية حيث يقوم الجهاز المناعي للشخصبتدمير الخلايا المنتجة للانسولين في غدة البنكرياس لاسباب مازالت غير معلومة.
يظهر هذا النوع مبكرا عند الاطفال والشباب ولكنه قد يصيب الانسان في اي مرحلةعمرية.
ويحتاج المصاب بهذا النوع الى حقن الانسولين طوال حياته.
يرتبط النوع الثاني من داء السكري عادة بالتقدم بالسن، والسمنة الزائدة حيث يعانينحو 80% من مرضى السكري من النوع الثاني من زيادة الوزن قبل الإصابة بالمرض.
يتسم المرضى الذين يعانون من مرض السكري من النوع الثاني بإنتاج البنكرياس لكميةكافية من الأنسولين، غير أن الجسم لا يكون قادرًا على استخدام الأنسولين بشكل فعال،وتعرف هذه الحالة باسم مقاومة الانسولين.
قد ينخفض إنتاج الأنسولين بعد عدة سنوات فيصبح وضع المريض شبيهًا بوضعمرضى السكري من النوع الأول.
من العوامل المهم في علاج هذا النوع هي إنقاص الوزن، وتناول الأطعمة الصحية،وممارسة التمارين الرياضية. إذا لم يكفِ اتباع النظام الغذائي الصحي وممارسةالتمارين الرياضية في السيطرة على سكر الدم، فقد يحتاج الشخص أيضًا إلى تناولأدوية السكري أو العلاج بالأنسولين.
ام النوع الثالث فهو سكري الحمل
وهذا النوع من أنواع مرض السكري يحدث عندما تصاب المرأة بالسكري خلال فترةالحمل فقط.
كما هو الحال بالنسبة للسكري من النوع الثاني فإن هذا النوع من أنواع مرض السكرييعد منتشرًا إلى حد ما وخاصة بين النساء من ذوات التاريخ العائلي الذي شهد إصاباتبمرض السكري.
معظم النساء لا تظهر عليهن أعراض الإصابة بسكري الحمل لهذا يتم فحص نسبةالغلوكوز بين الأسبوعين الرابع والعشرين والثامن والعشرين من الحمل.
داء السكري في العراق هو قاتل خفي من طراز اول. حيث يصيب المرض اكثر من ١٣.٩٪ من البالغين.
وان نسبة الإصابة بالمرض في العراق تصل الى 50% مقارنة بما ما يصاب به مواطنونمن دول أخرى في الخليج العربي، بسبب قلة الحركة والغذاء غير الصحي والسمنةوهناك بيانات تشير الى ان العنف والضغط النفسي المتزايد قد يؤدي الى تدهور خطيرفي السيطرة على مستوى السكر في الدم.
وفي وجود كوفيد ١٩ فان المصابين بداء السكري قد يتعرضون لمضاعفات خطيرة اوالوفاة ومن هنا برزت الحاجة الى اعطاء اللقاح لهم وتشديد اجراءات الوقاية العامة.
خطورة داء السكري تكمن في تطوره السريع ليضرب مناطق عدة من الجسم كتلف فيالأعصاب والأوعية الدموية في الجسم وتصلب الشرايين وأمراض الكلى وإعتلال الشبكيةوإرتفاع ضغط الدم وغيرها من الامراض التي تعتبر من نواتج مرض السكر.
وحسب منظمة الصحة العالمية سيحتل مرض السكري المرتبة السابعة في الترتيب بينأسباب الوفيات بحول العام ٢.٣٠.
قاتل خفي يتآمر مع القتلة الاخرين كالسمنة وارتفاع ضغط الدم
وعلى الانسان ان يعرف انه قادر على هزيمتهم
وسلاحه الحاسم في هذه المعركة غير المتكافئة هو الوعي.
وكما قال ابن سينا: إنّ قوة الفكر قادرة على أحداث المرض والشفاء منه.
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