Uhlobo lwe-1 ngokuchasene nohlobo 2 lweswekile: Uyintoni umahluko?
Imfundo yezeMpiloUhlobo lwe-1 ngokuchasene nohlobo 2 lwesifo seswekile | Ubuninzi | Iimpawu | Uxilongo | Unyango | Imiba yomngcipheko | Uthintelo | Nini ukubona ugqirha | Ii-FAQ | Izixhobo
Phantse i-1 kubantu be-10 abanesifo seswekile, ngokwe iCDC . Kwi-2018, bekukho izigidi ezingama-34.2 zaseMelika ezifunyenwe zinesifo seswekile, eyi-10.5% yabemi. Zine iindidi zesifo seswekile: i-prediabetes, Uhlobo loku-1, Uhlobo lwe-2, kunye neswekile yokukhulelwa. Abo banesifo seswekile okanye isifo seswekile sokukhulelwa (isifo seswekile ngexesha lokukhulelwa) basemngciphekweni wokuphuhliswa kohlobo lwesibini lweswekile. Uhlobo lwe-2 lweswekile luxhaphake kakhulu kunohlobo 1, kodwa kubalulekile ukwazi umahluko ukuba usemngciphekweni omkhulu wokukhulisa naluphi na uhlobo lwesifo seswekile. Kule nqaku, siza kuthetha ngomehluko kunye nokufana phakathi kohlobo 1 ngokuchasene nohlobo 2 lweswekile.
Oonobangela
Uhlobo lwe-1 yeswekile
Umzimba womntu ufuna i-insulin, eyenziwe kwi-pancreas. I-insulin inceda iiseli zifumane iswekile yegazi kwaye ziyisebenzisele amandla. Xa kungekho insulin, iswekile yegazi ihlala egazini kunokungena kwiiseli, ekhokelela kumanqanaba eswekile ephezulu yegazi kwaye ibangele iingxaki zempilo ezinzulu kunye nomonakalo emzimbeni.
Uhlobo lwe-1 lweswekile lwenzeka xa abantu bengavelisi ngokwaneleyo i-insulin; yenzeka ngenxa yokutshatyalaliswa kwe-beta-cell cell evelisa i-insulin, icacisiwe USunitha Posina , MD, i-NYC esekwe kwibhodi eqinisekisiweyo. Uninzi lweziganeko zizenzekelayo, oko kuthetha ukuba umzimba wakho uhlasela kwaye utshabalalise iiseli zepancreatic ezivelisa i-insulin kwaye ke ngekhe wenze i-insulin eninzi.
Kutheni le nto umzimba uhlasela iiseli zawo? Abaphandi abaqinisekanga ngeli xesha. I-trigger, efana nokuvezwa kwintsholongwane, kunokubangela uhlaselo kwiiseli zomzimba, ezikhokelela kuphuhliso lohlobo 1 lweswekile.
Uhlobo lwe-2 yeswekile
I-insulin ikwangumtyholwa kwimeko yohlobo lwesibini lweswekile. Nangona kunjalo, kuhlobo lwe-2 lweswekile, iiseli aziphenduli ngokuchanekileyo kwi-insulin, ebangela ukumelana ne-insulin. Ipancreas isaza kuvelisa i-insulin, nangona kunjalo, ayizukuyenza ngokwaneleyo i-insulin okanye umzimba awuyi kuyisebenzisa ngokufanelekileyo. Ke ngoko, amanqanaba eswekile yegazi ayenyuka. Amanqanaba okuqala okuchasana ne-insulin abizwa kwisifo seswekile kwaye ekugqibeleni inokujika ibe luhlobo 2 lweswekile.
Iswekile ephezulu yegazi yingxaki enkulu. Wonakalisa umzimba kwaye unokudala eminye imiba yezempilo, kubandakanya isifo sentliziyo, isifo sezintso, okanye ukulahleka kombono.
Akucaci ukuba abanye abantu banokunganyangeki na nge-insulin, kodwa abaphandi bakholelwa ukuba izinto zemfuza, izinto ezisingqongileyo, kunye nendlela yokuphila (kubandakanya ukutyeba kakhulu kunye nokuzilolonga kancinci) kunokuba negalelo.
Uhlobo lwe-2 lweswekile luxhaphake kakhulu kubantu abadala, kangangokuba kuye kwabizwa ngokuba sisifo seswekile esidala. Nangona kunjalo, ngoku Uhlobo lwesibini lweswekile lufunyaniswa kwabanye abantwana. Ikwabizwa ngokuba sisifo seswekile esingaxhomekeki kwi-insulin, esingachanekanga njengoko ezinye izigulana zisenokufuna i-insulin kwindawo ethile kulawulo lwesifo seswekile.
Uhlobo lwe-1 ngokuchasene nohlobo 2 lwesifo seswekile | |
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| Uhlobo lwe-1 yeswekile | Uhlobo lwe-2 yeswekile |
| Isifo sokuzimela komzimba apho umzimba uhlasela iiseli ze-beta kwi-pancreas, ukuyeka okanye ukunciphisa imveliso ye-insulin. | Iiseli aziphenduli ngokuchanekileyo kwi-insulin ngenxa yokuxhathisa kwe-insulin. Iipancreas ziya kuhlala zivelisa i-insulin engaphezulu, kodwa ayizukulawula iswekile yegazi ngokufanelekileyo. |
Ubuninzi
Uhlobo lwe-1 yeswekile
Ngaphandle kwezigidi ezingama-34 zabantu abadala abanesifo seswekile, kuphela 5% -10% kwaba bantu banesifo seswekile sohlobo 1, besenza ukuba singaqhelekanga kunohlobo lwe-2 yeswekile. Uqikelelo lwabantwana abakwishumi elivisayo abangama-187,000 nabakwishumi elivisayo abangaphantsi kweminyaka engama-20 ubudala abaphila nohlobo 1 lweswekile ngo-2015.
Uhlobo lwe-2 yeswekile
Olona hlobo luqhelekileyo lwesifo seswekile luhlobo 2 lweswekile, ngama-90% ukuya kuma-95% kwizigidi ezingama-34 zabantu abadala abanesifo seswekile sesi-2. Ukuxhaphaka kwesifo seswekile kuyanda ngokuhamba kweminyaka. Amadoda nabasetyhini banamazinga afanayo okuxhaphaka, kodwa izehlo ziphezulu kumaIndiya aseMelika naseMelika yaseAlaska. Abemi abaMnyama nabaseSpain banokubanokwanda okuphezulu kwesifo seswekile kunabamhlophe abangabo baseSpain.
Uhlobo lwe-1 ngokuchasene nohlobo 2 lokuxhaphaka kweswekile | |
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| Uhlobo lwe-1 yeswekile | Uhlobo lwe-2 yeswekile |
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Ezinxulumene: Izibalo zeswekile
Iimpawu
Ezinye iimpawu ziyaqhekeka phakathi kohlobo 1 kunye nohlobo 2 lweswekile. Ezi mpawu zibandakanya:
- Ukuchama rhoqo, ngakumbi ebusuku
- Ukunxanwa kakhulu okanye indlala
- Ukuphulukana nobunzima obungachazwanga
- Umbono ongenangqondo
- Ukudinwa
- Ulusu olomileyo
- Amanxeba acothayo
- Ukosuleleka rhoqo ngenxa yokwehla kwenkqubo yomzimba yokuzikhusela
Uhlobo lwe-1 yeswekile
Uhlobo lwe-1 lweempawu zeswekile zihlala zithatha iiveki okanye iinyanga ezimbalwa ukubonisa kwaye zinokuqala nangaliphi na ubudala. Uhlobo lwe-1 yeswekile ineempawu ezidweliswe apha ngasentla ukongeza kwiintlungu zesisu, isicaphucaphu, okanye ukugabha. Iimpawu zinokuba nzima nkqu kwinqanaba lokuqala. Ukuba uqaphela iimpawu, funa uncedo kwezonyango kwangoko kuba ezi ngxaki zinokubulala.
Uhlobo lwe-2 yeswekile
Iimpawu zohlobo lwesibini lweswekile zibandakanya zonke ezi zidweliswe apha ngasentla kunye nokutswina okanye ukuba ndindisholo ezandleni okanye iinyawo . Ezi mpawu zikhula ngokuhamba kwexesha, kungathatha ixesha elide ukuziqaphela. Ngamanye amaxesha, iimpawu zinokungabonakali. Ngenxa yoku, kubalulekile ukuba kuvavanywe iswekile egazini lakho rhoqo ukuba unayo nayiphi na imeko yomngcipheko: ukutyeba kakhulu, amalungu osapho ane-Type 2 yeswekile, amadala kuneminyaka eyi-45, okanye ukungasebenzi.
Uhlobo lwe-1 ngokuchasene nohlobo 2 lweempawu zeswekile | |
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| Uhlobo lwe-1 yeswekile | Uhlobo lwe-2 yeswekile |
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Uxilongo
Uhlobo lwe-1 yeswekile
Kukho iimvavanyo ezahlukeneyo eziza kwenziwa ngababoneleli bezempilo ukuba ngaba kukho uhlobo lweswekile olukrokrelwayo. Omnye uya kuvavanya ii-autoantibodies, ezibonisa ukuba umzimba uzihlasela ngokwawo. Ezi autoantibodies zikhona kuhlobo 1 lweswekile kodwa hayi uhlobo 2. Iiketoni nasemchameni wakho kuya kuvavanywa.
Uhlobo lwe-2 yeswekile
Kukho iimvavanyo ezine ezinokwenzeka ukuba ugqirha wakho angazenza ukujonga amanqanaba eswekile yegazi. Babandakanya oku kulandelayo:
- Uvavanyo lwe-A1C : Olu vavanyo luthatha umndilili weswekile yegazi lakho kwezi nyanga zimbini ukuya kwezintathu ezidlulileyo. Uvavanyo olungaphantsi kwe-5.7% luqhelekile, i-5.7% -6.4% sisalathiso sesifo seswekile, kwaye i-6.5% okanye ngaphezulu ibonisa isifo seswekile.
- Ukuzila ukutya kweswekile yovavanyo: Kolu vavanyo lwegazi, uya kuzila ukutya (ungatyi) ukuqala kubusuku obungaphambili. Kwabo bangenaso isifo seswekile, a inqanaba leswekile yegazi eliqhelekileyo iya kuba yi-99 mg / dL okanye iphantsi. Uluhlu lwe-100 ukuya kwi-125 mg / dL lusemgangathweni kwabo bane-prediabetes, kunye namanqanaba aphezulu eswekile yegazi ayi-126 mg / dL okanye nangaphezulu abonisa isifo seswekile.
- Uvavanyo lokunyamezelwa kweglucose : Uvavanyo lokunyamezelwa kweswekile, nawe uyakhawuleza ngokungatyi ukutya kubusuku obungaphambili. Uya kuthi emva koko utsale igazi lakho ukuze ubone inqanaba leswekile yegazi lakho elikhawulezayo. Okulandelayo, uya kusela iswekile eglucose engamanzi, kwaye amanqanaba eswekile yegazi lakho aya kujongwa iyure nganye ukuya kwiiyure ezintathu. Kwiiyure ezimbini, iswekile yegazi eliqhelekileyo yi-140 mg / dL okanye ngaphantsi, i-140 ukuya kwi-199 mg / dL ibonisa i-prediabetes, kwaye inqanaba eliphezulu liya kubonisa isifo seswekile.
- Uvavanyo lweswekile lwegazi: Uvavanyo lweswekile egazini olungafunekiyo lunokuthathwa nangaliphi na ixesha kwaye alufuni kuzila. Ukuba amanqanaba eswekile yegazi akho angaphezulu kwama-200 mg / dL, oku kubonisa isifo seswekile.
Sihlala sisebenzisa i I-A1C kwezi ntsuku okanye ukuzila ukutya kovavanyo lweswekile ukufumanisa isifo seswekile, utshilo uGqirha Posina.
Uhlobo lwe-1 ngokuchasene nohlobo lwe-2 lwesifo seswekile | |
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| Uhlobo lwe-1 yeswekile | Uhlobo lwe-2 yeswekile |
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Unyango
Uhlobo lwe-1 yeswekile
Abo bane-Type 1 yeswekile abayivelisi i-insulin, ngenxa yoko bafuna inaliti ye-insulin okanye impompo ye-insulin elawula iswekile egazini mihla le. Umboneleli wezempilo uyakukukhokela ukumisela amanqanaba afanelekileyo e-insulin oyifunayo. Unyango lwe-insulin linceda ukugcina inqanaba leswekile yegazi eliqhelekileyo malunga ne-80-130 mg / dL ngaphandle kokuba ubusitya, kwaye amanqanaba aqhelekileyo angaya kuthi ga kwi-180 mg / dL ukuya kuthi ga kwiiyure ezimbini emva.
Ukongeza ekusebenziseni i-insulin ukulawula iswekile esegazini, abo bane-Type 1 yeswekile kuya kufuneka batye ukutya okusempilweni kwaye babeke iliso kwi-carbohydrate, enamafutha, nakwiiprotein. Ukugcina ubunzima obusempilweni kunye nokuzilolonga nako kuya kunceda ukuphucula iziphumo zabo bane-Type 1 yeswekile.
Isixhobo esithembisayo kwabo balawula udidi 1 lweswekile yile iipancreas ezingezizo . Lwamkelwa yi-Food and Drug Administration (i-FDA) ngo-Septemba ka-2016, esi sixhobo sihlola amanqanaba eswekile yegazi ngokuzenzekelayo kwaye sihambise i-insulin njengoko kufuneka.
Uhlobo lwe-2 yeswekile
Elona candelo libalulekileyo kunyango lweswekile 2 lonyango lwenza utshintsho olusempilweni. Utshintsho lubandakanya ukwehla kobunzima, ukutya ukutya okusempilweni, kunye nokwenza umthambo rhoqo. Ukwehla kobunzima be-5% ukuya kwi-10% yomzimba womntu kunokunciphisa amanqanaba eswekile yegazi. Ukutya okusempilweni okunemifuno eninzi, iziqhamo, kunye nefayibha enokutya okumbalwa okuphezulu kwii-carbs kunye namafutha agcweleyo anokunceda ekulawuleni amanqanaba eswekile yegazi. Ukuzilolonga rhoqo kuya kubaluleka njengoko kunciphisa iswekile yegazi. Olunye utshintsho kwindlela yokuphila lunokubandakanya ukulawula uxinzelelo kunye nokulala ngokwaneleyo.
Ukubeka esweni iswekile yegazi kunye namayeza ezinye izinto ezibalulekileyo kuhlobo lwesibini lwesifo seswekile. Ukuhamba rhoqo kokujonga iswekile yegazi kuyahluka ngokwabantu kwaye kuxhomekeke kwisicwangciso sabo sonyango. Ukuba umntu onesifo seswekile sohlobo lwe-2 uxhomekeke kwi-insulin, kuyakufuneka ajonge iswekile yegazi kaninzi ngemini. Ngelixa abanye abantu bekwazi ukulawula isifo seswekile ngokutya kunye nokuzilolonga kuphela, abanye banokufuna amayeza kunye nonyango lwe-insulin.
Amachiza anokubandakanya:
- Umbutho weSwekile waseMelika ucebisa metformin njengonyango olukhethwayo kunyango lwe-2 yeswekile. IMetformin sisiyobisi esenziwe ngendlela engaqhelekanga kunye nokutya kunye nokuzilolonga ukuphucula iswekile yegazi kubantu abadala abane-Type 2 diabetes mellitus. Ihamba ngamagama e-brand Glucophage, IRiomet , Uqhulo , kunye Fortamet . Isebenza ngokunciphisa ukuveliswa kweglucose kwisibindi kunye nokuphucula amandla omzimba wokusebenzisa i-insulin.
- I-DPP-4 inhibitors , kubandakanya i-Tradjenta (linagliptin) okanye Januwari (sitagliptin), sebenza ngokunciphisa amanqanaba eswekile yegazi.
- I-GLP-1 i-receptor agonists zisetyenziselwa izigulana ezingakwaziyo ukunyamezela okanye ukusebenzisa i-metformin. Ngamayeza atofwayo anceda ukunciphisa amanqanaba eswekile yegazi. I-GLP-1 receptor agonists ibandakanya UVictoza (liraglutide) kunye Ozempic (semaglutide).
- Meglitinides ukunciphisa inani leeswekile ezilula (iswekile) egazini ngokwandisa imveliso ye-insulin ngepancreas. Amanye amayeza aqhelekileyo kolu luhlu abandakanya ipharamikhi kwaye Inkwenkwezi ( yeza ).
- SGLT2 inhibitors yehlisa iswekile yegazi ngokusebenzisa izintso ukususa iswekile emzimbeni ngomchamo. I-inhibitors ezimbini eziqhelekileyo ze-SGLT2 zibandakanya Ulonwabo (dapagliflozin) kunye Intlanganisela (empagliflozin).
- Isulfonylureas Ngaba udidi lweziyobisi ezibangela ukuba umzimba wakho ukhuphe i-insulin engakumbi. Imizekelo ibandakanya Glynase ( glyburide ) kunye Iswekile yeglucotrol ( glipizide ).
- Tiazolidinediones (TZD) kunciphisa nokumelana komzimba kwi-insulin. Amayeza aqhelekileyo aquka I-Avandia (rosiglitazone) kunye KwiZenzo ( mzantsiweb ).
- Unyango lwegazi kuqhelekile ekunyangeni isifo seswekile, njengoko abantu aba-2 kwabathathu abanesifo seswekile nabo banexinzelelo lwegazi.
Uhlobo lwe-1 vs. 2 yonyango lweswekile | |
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| Uhlobo lwe-1 yeswekile | Uhlobo lwe-2 yeswekile |
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Ezinxulumene: Amayeza eswekile kunye nonyango
Imiba yomngcipheko
Uhlobo lwe-1 yeswekile
Imiba yomngcipheko ayicaciswanga ngokucacileyo kuhlobo 1 lweswekile. Nangona kunjalo, zimbalwa izinto eziyaziwayo zomngcipheko.
- Imbali yosapho: Kukho umngcipheko ophakame kancinci wokuphuhliswa kohlobo lweswekile 1 ukuba udadewenu, umntakwenu, okanye abazali bane-Type 1 diabetes.
- Ubudala: Uhlobo lwe-1 yeswekile lunokwenzeka nakweyiphi na iminyaka, kodwa luxhaphake kakhulu ebantwaneni nakubantu abadala abancinci. Ngenxa yoku, kuye kwabizwa ngaphambili isifo seswekile solutsha okanye isifo seswekile.
- Ugqatso: Abantu abamhlophe banesifo seswekile sohlobo 1 ngokuxhaphakileyo kunabantu abaMnyama baseMelika kunye namaLatin aseMelika.
Uhlobo lwe-2 yeswekile
Abantu abanomngcipheko ophezulu kuhlobo 2 lweswekile kubandakanya:
- Isifo seswekile: Abo bafunyaniswe benesifo seswekile banamathuba aphezulu okuba nesifo seswekile.
- Ubunzima : Abo batyebe ngokugqithiseleyo banomngcipheko ophezulu kunabo bane-BMI esempilweni.
- Ubudala : Abantu ngabanye abaneminyaka engama-45 nangaphezulu bafumanisa ukuba bane-Type 2 yeswekile.
- Imbali yosapho: Kukho umngcipheko ophezulu wokufumana uhlobo lwesibini lweswekile ukuba udadewenu, umntakwenu, okanye abazali bakho banesifo seswekile sesi-2.
- Ukungasebenzi: Ukuzilolonga ngaphantsi kwamaxesha amathathu ngeveki yinto eyaziwayo.
- Isifo seswekile : Kukho umngcipheko ophezulu wokukhula kohlobo lwesibini lweswekile ukuba owasetyhini unesifo seswekile okanye unesana elinobunzima obuziikhilogram ezilithoba nangaphezulu xa kuzalwa.
- Uhlanga : Iintlanga ezithile zisemngciphekweni omkhulu, kubandakanya abaMnyama baseMelika, amaSpanishi / amaLatino aseMelika, amaIndiya aseMelika, kunye nabemi baseAlaska
Uhlobo lwe-1 ngokuchasene nohlobo 2 lwesifo seswekile | |
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| Uhlobo lwe-1 yeswekile | Uhlobo lwe-2 yeswekile |
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Uthintelo
Uhlobo lwe-1 yeswekile
Ngelishwa, akukho sithintelo saziwayo kuhlobo 1 lweswekile ngeli xesha.
Uhlobo lwe-2 yeswekile
Ukwenza utshintsho kwindlela yokuphila esempilweni kunokulibazisa ukuqala kohlobo lwesibini lweswekile, ukuyikhusela, okanye ukuyibuyisela umva kwezinye iimeko. Uthintelo lubandakanya ukwehla kobunzima ukuba utyebe kakhulu, uzilolonga rhoqo, kwaye ufumana indlela efanelekileyo yokutya.
Ungaluthintela njani udidi 1 ngokuchasene nohlobo 2 lweswekile | |
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| Uhlobo lwe-1 yeswekile | Uhlobo lwe-2 yeswekile |
| Akukho nanye |
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Uza kubona nini ugqirha kuhlobo 1 okanye uhlobo 2 lweswekile
Ukuba unayo nayiphi na impawu yesifo seswekile, kuya kufuneka undwendwele umboneleli wezempilo kwangoko njengoko iimpawu zinokuba nzima kwaye zisongele ubomi. Kuya kufuneka uhlolwe rhoqo kunye nomboneleli wakho wezempilo ukubeka esweni inkqubela yokhathalelo lwakho lweswekile.
Imibuzo ebuzwa rhoqo malunga nesifo seswekile
Yintoni eyona imbi kakhulu: Chwetheza 1 okanye udidi 2 lweswekile?
Uhlobo lwe-1 kunye nohlobo lwe-2 lweswekile lunokuba neziphumo ezibi zempilo ukuba alulawulwa ngokufanelekileyo. Umntu ngamnye wahlukile kwaye wahlukile, ke akunakwenzeka ukuba uchaze ukuba yeyiphi eyona imbi ngakumbi.
Ezinxulumene: Uvavanyo lwesifo seswekile lubonisa iimpawu ezisezantsi zobomi kwizigulana ezi-1 kwezi-5
Ngaba udidi 2 lweswekile lube luhlobo 1?
Hayi, Uhlobo 1 kunye nohlobo 2 lweswekile banezizathu ezahlukeneyo. Nangona kunjalo, ngenxa yokuba babelana ngeempawu ezifanayo, ukufumanisa isifo gwenxa kunokwenzeka.
Ngaba uhlobo 1 okanye uhlobo 2 lweswekile ludinga i-insulin?
Abantu abanesifo seswekile sohlobo 1 bathathelwa ingqalelo ukuba baneswekile exhomekeke kwi-insulin njengoko baya kuhlala befuna i-insulin ukulawula amanqanaba eswekile yegazi. Abanye abantu abanesifo seswekile sesi-2 baxhomekeke kwi-insulin, kodwa abanye bayayilawula ngokulandela indlela yokuphila esempilweni kunye nokusebenzisa amayeza ngaphandle kwe-insulin.
Ngaba uhlobo 1 lweswekile lunokubuyiselwa?
Kuba abo bane-Type 1 yeswekile abanako ukuvelisa i-insulin, okwangoku akukho ndlela yokuyijika.
Kukuphi ukutya okungalunganga kubantu abanesifo seswekile?
Iswekile kunye nee-carbohydrate, ezithi zehle ziye kwiswekile, kufuneka zithintelwe kwaye zityiwe ngokumodareyitha njengoko kunokubangela iipikisi kwiswekile yegazi. Ezi spikes zinokukhokelela kubunzima bempilo.
Izixhobo
- Ingxelo yesizwe yeswekile , I-CDC
- Iipancreas ezingezizo ezenziweyo ziphucula uhlobo lwesifo seswekile , Amaziko ezeMpilo kaZwelonke
