Izivivinyo Zomchamo Wesifo Sikashukela: Amazinga Eglucose Namaketoni

-Delile

• Ngubani okufanele ahlolwe umchamo wesifo sikashukela?
• Amazinga we-glucose
• Amaketoni
• Ukulungiselela kanjani ukuhlolwa komchamo?
• Yini ongayilindela ngesikhathi sokuhlolwa komchamo?
• Ehhovisi likadokotela
• Imichilo yokuhlola ekhaya
• Isho ukuthini imiphumela yami yokuhlolwa komchamo?
• Isho ukuthini imiphumela yami yokuhlolwa komchamo we-urine?
• Mncane ukuya kokulingene
• Maphakathi kuya kokukhulu
• Kukhulu kakhulu
• Kwenzekani ngemuva kokuhlolwa komchamo wesifo sikashukela?

Sifaka imikhiqizo esicabanga ukuthi ilusizo kubafundi bethu. Uma uthenga ngezixhumanisi ezikuleli khasi, singathola ikhomishini encane. Nansi inqubo yethu.

Yini ukuhlolwa komchamo kwesifo sikashukela?

Isifo sikashukela yisimo esivezwa amazinga aphezulu kashukela egazini. Lokhu kungabangelwa ukungakwazi komzimba ukwenza noma iyiphi noma i-insulin eyanele, ukusebenzisa i-insulin ngempumelelo, noma kokubili.

I-insulini yihomoni esiza amangqamuzana omzimba wakho ukumunca ushukela wegazi ukwenza amandla. I-insulin ikhiqizwa amanyikwe ngamanani amakhulu ngemuva kokudla ukudla.

Kunezigaba ezimbili ezinkulu zesifo sikashukela:

• thayipha isifo sikashukela esingu-1
• thayipha 2 sikashukela

Uhlobo lwesifo sikashukela sohlobo 1 lwenzeka lapho amasosha omzimba ehlasela futhi ecekela phansi amaseli akhiqiza i-insulin emanyikwe. Lolu hlobo luvame ukutholakala ebuntwaneni futhi lukhula ngokushesha.

Uhlobo lwesibili sikashukela lwenzeka lapho amaseli engasakwazi ukusebenzisa i-insulin ngempumelelo. Lo mbuso ubizwa ngokuthi ukumelana ne-insulin. Uhlobo lwesifo sikashukela sohlobo lwe-2 lukhula kancane kancane futhi luhlotshaniswa nokukhuluphala ngokweqile nokuphila ngokuhlala phansi.

Isifo sikashukela sibangela ukuba ushukela egazini, noma ushukela egazini, ukhuphuke ufinyelele emazingeni aphezulu ngokungavamile. Kuhlobo lwesifo sikashukela sohlobo 1, umzimba ungaqala nokushisa amanoni ukuze uthole amandla ngoba amaseli awatholi i-glucose ayidingayo. Uma lokhu kwenzeka, umzimba ukhiqiza amakhemikhali abizwa ngokuthi ama-ketone.

Lapho ama-ketone akha egazini, enza igazi libe ne-asidi kakhulu. Amaketoni ayinqwaba angafaka ushevu emzimbeni futhi aholele ku-coma noma nasekufeni.

Ukuhlolwa komchamo akukaze kusetshenziselwe ukuxilonga isifo sikashukela. Kodwa-ke, zingasetshenziselwa ukuqapha amazinga womuntu wamaketoni womchamo kanye ne-glucose yomchamo. Kwesinye isikhathi zisetshenziselwa ukuqinisekisa ukuthi isifo sikashukela silawulwa ngendlela efanele.

Ngubani okufanele ahlolwe umchamo wesifo sikashukela?

Ukuhlolwa komchamo kunganikezwa njengengxenye yokuhlolwa okujwayelekile. Ilebhu ingahlola umchamo wakho ngokuba khona koshukela namaketoni. Uma kukhona abakhona emchameni, kungasho ukuthi awukhiqizi i-insulin eyanele.

Eminye imithi yesifo sikashukela efana ne-canagliflozin (i-Invokana) ne-empagliflozin (i-Jardiance) ibangela ukwanda koshukela ukuchithekela emchameni. Kubantu abathatha le mithi, amazinga e-glucose akufanele ahlolwe ngomchamo kodwa ama-ketone wokuhlola asalungile.

Amazinga we-glucose

Esikhathini esedlule, ukuhlolwa komchamo kwe-glucose kwakusetshenziselwa ukuxilonga nokuqapha isifo sikashukela. Manje, azisasetshenziswa ngokujwayelekile.

Ukuze uhlolisise isifo sikashukela ngokunembile, udokotela uzoxhomeka ekuhlolweni kweglucose yegazi. Ukuhlolwa kwegazi kunembe kakhudlwana futhi kungalinganisa inani eliqondile likashukela egazini.

Ufuna ukuhlola okwakho ekhaya? Thenga i-glucose yomchamo wasekhaya noma ukuhlolwa kweglucose egazini ekhaya.

Amaketoni

Ukuhlolwa kwe-urine ketone kuvame ukudingeka kubantu abanesifo sikashukela sohlobo 1:

• babe namazinga kashukela egazini angaphezu kwama-milligram angama-300 nge-desilitha ngalinye (mg / dL)
• bayagula
• banezimpawu zesifo sikashukela ketoacidosis (DKA), okuyinkinga enkulu yesifo sikashukela

Amazinga we-ketone angabhekwa ngekithi yokuhlola umchamo wasekhaya. Ukuhlolwa komchamo wamaketoni kufanele kusetshenziswe uma ufanisa izincazelo ezingenhla noma unezinye zezimpawu ezilandelayo ze-DKA:

• ukuphalaza noma ukuzizwa unesicanucanu
• amazinga aphikelelayo kashukela angaphenduli ekwelashweni
• ukuzizwa ugula, njengomkhuhlane noma ukutheleleka
• ngizizwe ngikhathele noma ngikhathele ngaso sonke isikhathi
• ukoma ngokweqile noma ukuba nomlomo owomile kakhulu
• ukuchama kaningi
• umoya onuka “izithelo”
• ukudideka noma ukuzizwa sengathi “usesenkungwini”

Ungadinga futhi ukuthatha isivivinyo se-ketine yokuchama uma:

• ukhulelwe futhi unesifo sikashukela sokukhulelwa
• uhlela ukuzivocavoca futhi izinga le-glucose yegazi lakho liphezulu

Thenga isivivinyo se-ketone ekhaya.

Abantu abanesifo sikashukela, ikakhulukazi uhlobo lwesifo sikashukela sohlobo 1, kufanele bathole izincomo kudokotela wabo ngokuthi kufanele bawahlolele nini ama-ketone.Ngokuvamile, uma isifo sakho sikashukela siphethwe kahle, kungenzeka kungadingeki ukuthi uhlole njalo amazinga akho e-ketone.

Uma uqala ukuhlangabezana nanoma yiziphi izimpawu njengoba kushiwo ngenhla, amazinga akho kashukela angaphezulu kwama-250 mg / dL, noma umzimba wakho awuphenduli imijovo ye-insulin, lapho-ke kungadingeka ukuthi uqale ukuqapha amazinga akho e-ketone.

Ukulungiselela kanjani ukuhlolwa komchamo?

Ngaphambi kokuhlolwa kwakho, qiniseka ukuthi uphuza amanzi anele ukuze unikeze isampula elanele lomchamo. Qiniseka ukuthi utshela udokotela wakho nganoma imiphi imithi noma izithasiselo ozithathayo, ngoba lokhu kungathinta imiphumela.

Umchamo ungangcoliswa kalula amagciwane namaseli. Kufanele uhlanze indawo yakho yangasese ngamanzi ngaphambi kokunikeza isampula yomchamo.

Yini ongayilindela ngesikhathi sokuhlolwa komchamo?

Ungacelwa ukuthi unikeze isampula lomchamo ngenkathi usehhovisi likadokotela. Amakhithi wokuhlola umchamo nawo ayatholakala ukuze asetshenziswe ekhaya. Ukuhlolwa komchamo kulula futhi akunangozi. Akufanele uzwe ukungakhululeki phakathi nalokhu kuhlolwa.

Ehhovisi likadokotela

Udokotela wakho uzokunikeza imiyalo yokuthi ungasinikeza kanjani isampula nokuthi ungayishiya kuphi uma usuqedile. Ngokuvamile, yilokhu okungalindelwa ngesikhathi sokuhlolwa komchamo wehhovisi:

1. Uzonikezwa inkomishi epulasitiki ebhalwe igama lakho kanye neminye imininingwane yezokwelapha.
2. Uzothatha inkomishi uyifake endlini yangasese yangasese bese uchamela enkomishini. Sebenzisa indlela "yokubamba ehlanzekile" ukugwema ukungcoliswa ngamagciwane noma amaseli esikhunjeni sakho. Ngale ndlela, uzoqoqa umchamo wakho ophakathi nendawo kuphela. Konke ukugeleza komchamo wakho kungangena endlini yangasese.
3. Beka isivalo enkomishini bese ugeza izandla zakho.
4. Letha inkomishi noma yikuphi lapho udokotela wakho ekutshele khona ukuthi ushiye lapho usuqedile. Uma ungenasiqiniseko, buza umhlengikazi noma omunye umsebenzi.
5. Isampula sizohlaziywa lapho kutholakala khona i-glucose namaketoni. Imiphumela kufanele ilunge ngemuva nje kokunikezwa isampula.

Imichilo yokuhlola ekhaya

Ukuhlolwa kwe-ketone kuyatholakala ekhemisi ngaphandle kwemithi kadokotela, noma ku-inthanethi. Qiniseka ukuthi ufunda izinkomba ezisephakeji ngokucophelela noma uhambe ngendlela yokusebenzisa imichilo nodokotela wakho ngaphambi kokwenza isivivinyo.

Ngaphambi kokusebenzisa umucu wokuhlola, hlola ukuze uqiniseke ukuthi awuphelelwe yisikhathi noma uphelelwe yisikhathi.

Ngokuvamile, ukuhlolwa komchamo wasekhaya kubandakanya lezi zinyathelo ezilandelayo:

1. Qala ngokufunda imiyalelo yomkhiqizi.
2. Chamela esitsheni esihlanzekile.
3. Cwilisa umucu emchameni. Imichilo ifakwe amakhemikhali asabela ngamaketoni. Hlanganisa umchamo okweqile emgqeni.
4. Lindela iphedi yomugqa ukuze lishintshe umbala. Imiyalo eze nemichilo kufanele ikutshele ukuthi ulinde isikhathi esingakanani. Ungahle uthande ukuba newashi noma isibali sikhathi.
5. Qhathanisa umbala womucu eshadini lombala kwiphakethe. Lokhu kukunika ibanga lenani lamaketoni atholakala emchameni wakho.
6. Masinyane bhala phansi imiphumela yakho.

Isho ukuthini imiphumela yami yokuhlolwa komchamo?

Abantu abaphilile ngokuvamile akufanele babe noshukela emchameni wabo nhlobo. Uma ukuhlolwa kukhombisa ubukhona be-glucose emchameni wakho, kufanele uxoxe ngezimbangela ezingaba khona nodokotela wakho.

Ukuhlolwa komchamo akuhloli amazinga akho egazi kashukela manje. Kunganikeza kuphela ukuqonda ukuthi i-glucose ichitheka emchameni wakho noma cha. Iphinde iveze isimo sikashukela egazini lakho emahoreni ambalwa adlule.

Ukuhlolwa kweglucose ukuhlolwa okuyisisekelo okusetshenziselwa ukunquma amazinga wangempela kashukela.

Isho ukuthini imiphumela yami yokuhlolwa komchamo we-urine?

Ukuqapha amazinga e-ketone emchameni kubalulekile uma unesifo sikashukela sohlobo 1. Ama-ketone abonakala kakhulu emchameni wabantu abanesifo sikashukela sohlobo 1 kunabantu abanesifo sikashukela sohlobo 2.

Uma utshelwa ukuthi ubheke amaketoni akho, cela ithimba lakho lezokunakekelwa kwezempilo ukuthi likusize wakhe uhlelo lokuthi yini okufanele uyenze uma uthola amathoni emchameni wakho.

Amazinga ajwayelekile noma wokulandela umkhondo wamaketoni emchameni angaphansi kwamamilimitha ayi-0.6 ilitha ngalinye (mmol / L), ngokweNational Health Service (NHS).

Umphumela ongajwayelekile usho ukuthi unamaketoni emchameni wakho. Ukufundwa kuvame ukuhlukaniswa njengokuncane, okulingene, noma okukhulu.

Mncane ukuya kokulingene

Izinga le-ketone elingu-0.6 kuye ku-1.5 mmol / L (10 kuye ku-30 ​​mg / dL) lithathwa njengelincane ukulinganisela. Lo mphumela ungasho ukuthi ukwakhiwa kwe-ketone kuyaqala. Kufanele uphinde uhlole emahoreni ambalwa.

Okwamanje, phuza amanzi amaningi ngaphambi kokuhlolwa. Ungazivocavoci umzimba uma amazinga eglucose egazi nawo ephezulu. Indlala nayo ingadala inani elincane lama-ketone emchameni, ngakho-ke gwema ukweqa ukudla.

Maphakathi kuya kokukhulu

Izinga le-ketone elingu-1.6 kuye ku-3.0 mmol / L (30 kuye ku-50 mg / dL) lithathwa njengelingene ukuya kwelikhulu. Lo mphumela ungakhombisa ukuthi isifo sikashukela asiphethwe kahle.

Okwamanje, kufanele ushayele udokotela wakho noma ufune usizo lwezokwelapha.

Kukhulu kakhulu

Izinga le-ketone elingaphezu kuka-3.0 mmol / L (50 mg / dL) lingakhombisa ukuthi une-DKA. Lesi yisimo esisongela impilo futhi sidinga ukwelashwa ngokushesha. Iya ngqo egumbini lezimo eziphuthumayo uma amazinga akho emakhulu kangaka.

Ngaphandle kwamazinga amakhulu we-ketone emchameni, izimpawu ze-ketoacidosis zifaka:

• ukuhlanza
• isicanucanu
• ukudideka
• iphunga lokuphefumula elichazwa ngokuthi “isithelo”

I-Ketoacidosis ingadala ukuvuvukala kobuchopho, i-coma, nokufa uma ishiywe ingalashwa.

Kwenzekani ngemuva kokuhlolwa komchamo wesifo sikashukela?

Uma i-glucose noma amaketoni atholakala emchameni ngesikhathi sokuhlolwa okujwayelekile, udokotela wakho uzokwenza ukuhlolwa okwengeziwe ukuthola ukuthi kungani lokhu kwenzeka. Lokhu kungafaka ukuhlolwa kweglucose egazini.

Udokotela wakho uzobheka uhlelo lwakho lokwelashwa uma unesifo sikashukela. Ungaphatha amazinga kashukela egazini lakho ngosizo lwe:

• ukuphathwa kokudla
• ukuzivocavoca umzimba
• imithi
• ukuhlolwa kwashukela egazini ekhaya

Uma unesifo sikashukela sohlobo 1, kungadingeka ukuthi ubheke njalo amazinga we-ketone emcimbini wakho usebenzisa umugqa wokuhlola ekhaya. Uma amazinga e-ketone eba makhulu kakhulu, ungathuthukisa i-DKA.

Uma ukuhlolwa kukhombisa ukuthi unamaketoni amancane noma alinganiselayo, landela uhlelo olumisile nethimba lakho lokunakekelwa kwezempilo. Uma unamazinga amakhulu wamaketoni emchameni wakho, thintana nomhlinzeki wakho wezempilo ngokushesha noma uye egumbini labezimo eziphuthumayo.

I-DKA izolashwa ngamanzi afakwa emthanjeni (IV) ne-insulin.

Khuluma nodokotela wakho ngalokho okungenziwa ukuvimbela iziqephu ezizayo. Ukugcina ithrekhi yemiphumela yakho kanye nezimo ezibangele isiqephu samaketoni amakhulu kungakusiza wena nodokotela wakho ukulungisa uhlelo lwakho lokwelashwa kwesifo sikashukela.