I-ketoacidosis yesifo sikashukela

I-diabetic ketoacidosis (DKA) inkinga esongela impilo ethinta abantu abanesifo sikashukela. Kwenzeka lapho umzimba uqala ukwehla amanoni ngesilinganiso esishesha kakhulu. Isibindi sicubungula amanoni abe uphethiloli obizwa ngokuthi ama-ketone, odala ukuthi igazi libe ne-asidi.

I-DKA yenzeka lapho isignali evela ku-insulin emzimbeni iphansi kangangokuba:

1. I-glucose (ushukela wegazi) ayikwazi ukungena kumaseli ukuze asetshenziswe njengomthombo kaphethiloli.
2. Isibindi senza inani elikhulu likashukela egazini.
3. Amafutha ehlukaniswa ngokushesha okukhulu ukuze umzimba usebenze.

Amafutha adilizwa yisibindi abe uphethiloli obizwa ngama-ketone. Ama-ketone ngokuvamile akhiqizwa yisibindi lapho umzimba uhlehla amanoni ngemuva kwesikhathi eside kusukela ekudleni kwakho kokugcina. Lawa maketoni ngokuvamile asetshenziswa yimisipha nenhliziyo. Lapho ama-ketone akhiqizwa ngokushesha okukhulu futhi akha egazini, angaba nobuthi ngokwenza igazi libe ne-asidi. Lesi simo saziwa ngokuthi i-ketoacidosis.

I-DKA kwesinye isikhathi isibonakaliso sokuqala sohlobo 1 sikashukela kubantu abangakatholakali. Kungenzeka futhi kumuntu osethole ukuthi unesifo sikashukela sohlobo 1. Ukutheleleka, ukulimala, ukugula okungathi sína, imithamo ye-insulin shots, noma ukucindezela kokuhlinzwa kungaholela ku-DKA kubantu abanesifo sikashukela sohlobo 1.

Abantu abanesifo sikashukela sohlobo 2 bangabuye bahlakulele i-DKA, kepha ayijwayelekile futhi ayinzima kangako. Imvamisa kubangelwa ushukela wegazi ongalawulwa isikhathi eside, imithamo elahlekile yemithi, noma ukugula okunzima noma ukutheleleka.

Izimpawu ezijwayelekile ze-DKA zingafaka:

• Ukwehla kokuqapha
• Ukuphefumula okujulile, okusheshayo
• Ukuphela kwamanzi emzimbeni
• Isikhumba nomlomo owomile
• Ubuso obuthile
• Ukuchama kaningi noma ukoma okuhlala usuku noma ngaphezulu
• Ukuphefumula okunuka kamnandi
• Ubuhlungu bekhanda
• Ukuqina kwemisipha noma ubuhlungu
• Isicanucanu nokuhlanza
• Ubuhlungu besisu

Ukuhlolwa kwe-ketone kungasetshenziswa kuhlobo 1 lwesifo sikashukela ukuhlola i-ketoacidosis yokuqala. Ukuhlolwa kwe-ketone kuvame ukwenziwa kusetshenziswa isampula yomchamo noma isampula yegazi.

Ukuhlolwa kwe-ketone kuvame ukwenziwa lapho kusolwa i-DKA:

• Imvamisa, ukuhlolwa komchamo kwenziwa kuqala.
• Uma umchamo ulungele ama-ketone, imvamisa i-ketone ebizwa nge-beta-hydroxybutyrate ilinganiswa egazini. Leli yi-ketone ejwayelekile kakhulu elinganiswa. Enye i-ketone eyinhloko i-acetoacetate.

Ezinye izivivinyo ze-ketoacidosis zifaka:

• Igazi legazi lomzimba
• Iphaneli eyisisekelo ye-metabolic, (iqembu lokuhlolwa kwegazi elinganisa amazinga akho e-sodium ne-potassium, ukusebenza kwezinso, namanye amakhemikhali nemisebenzi, kufaka phakathi i-anion gap)
• Ukuhlolwa kweglucose yegazi
• Isilinganiso somfutho wegazi
• Ukuhlolwa kwegazi kwe-Osmolality

Inhloso yokwelashwa ukulungisa izinga eliphakeme likashukela nge-insulin. Enye inhloso ukufaka uketshezi olulahlekile ngokuchama, ukulahlekelwa isifiso sokudla, nokuhlanza uma unalezi zimpawu.

Uma unesifo sikashukela, kungenzeka umhlinzeki wakho wezokunakekelwa kwezempilo akutshele ukuthi ungazibona kanjani izimpawu eziyisixwayiso ze-DKA. Uma ucabanga ukuthi une-DKA, hlola amaketoni usebenzisa imichilo yomchamo. Amanye amamitha e-glucose nawo angalinganisa amaketoni egazi. Uma ama-ketone akhona, shayela umhlinzeki wakho khona manjalo. UNGALIBALI. Landela noma imiphi imiyalelo oyinikezwayo.

Kungenzeka ukuthi uzodinga ukuya esibhedlela. Lapho, uzothola i-insulin, uketshezi nokunye ukwelashwa kwe-DKA. Ngemuva kwalokho abahlinzeki bazobheka futhi baphathe imbangela ye-DKA, njengokutheleleka.

Iningi labantu liphendula ekwelashweni kungakapheli amahora angama-24. Kwesinye isikhathi, kuthatha isikhathi eside ukuthola kabusha.

Uma i-DKA ingelashwa, ingaholela ekuguleni okunamandla noma ekufeni.

Izinkinga zempilo ezingabangelwa yi-DKA zifaka noma yikuphi okulandelayo:

• Ukwakhela uketshezi ebuchosheni (i-cerebral edema)
• Inhliziyo iyeka ukusebenza (ukuboshwa kwenhliziyo)
• Ukuhluleka kwezinso

I-DKA imvamisa iyisimo esiphuthumayo sezokwelapha. Shayela umhlinzeki wakho uma ubona izimpawu ze-DKA.

Iya egumbini labezimo eziphuthumayo noma ushayele inombolo yendawo ephuthumayo (efana ne-911) uma wena noma ilungu lomndeni elinesifo sikashukela ninokunye kwalokhu okulandelayo:

• Ukwehla kokuqonda
• Ukuphefumula okunuka kamnandi
• Isicanucanu nokuhlanza
• Ukuphefumula kanzima

Uma unesifo sikashukela, funda ukubona izimpawu nezimpawu ze-DKA. Yazi ukuthi uwahlolela nini ama-ketone, njengalapho ugula.

Uma usebenzisa iphampu ye-insulin, hlola kaningi ukubona ukuthi i-insulin igeleza ngeshubhu. Qiniseka ukuthi ishubhu alivinjiwe, alikhonkiwe noma alixhunywanga empompini.

I-DKA; Ketoacidosis; Isifo sikashukela - ketoacidosis

• Ukukhishwa kokudla kanye ne-insulin
• Ukuhlolwa kokubekezelelana kwe-glucose ngomlomo
• Iphampu ye-insulin

I-American Diabetes Association. 2. Ukwahlukaniswa nokuxilongwa kwesifo sikashukela: izindinganiso zokunakekelwa kwezokwelapha kusifo sikashukela - 2020. Ukunakekelwa yisifo sikashukela. 2020; 43 (Suppl 1): S14-S31. I-PMID: 31862745 pubmed.ncbi.nlm.nih.gov/31862745/.

Atkinson MA, Mcgill DE, Dassau E, Laffel L. Thayipha isifo sikashukela sohlobo 1. Ku: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ, abahleli. Incwadi kaWilliams ye-Endocrinology. Umhlaka 14. IPhiladelphia, PA: Elsevier; 2020: isahluko 36.

UMaloney GE, uGlauser JM. Isifo sikashukela nokuphazamiseka kwe-glucose homeostasis. Ku: Walls RM, Hockberger RS, Gausche-Hill M, ama-eds. Imithi Ephuthumayo yaseRosen: Imiqondo kanye Nokuzijwayeza Komtholampilo. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2018: isahluko 118.