Ku-mellitus yesifo sikashukela, ukwephulwa kwe-metabolism yama-carbohydrate noketshezi kwenzeka emzimbeni womuntu. Njengomphumela wale nqubo ye-pathological, kunezinkinga ezinkingeni zomsebenzi wamanyikwe, futhi yiso kanye lesi sakhi esaphendula ekukhiqizweni kwe-insulin. Uma izinkinga ziqala ngokukhiqizwa kwe-hormone, umzimba womuntu ulahlekelwa yikhono lokucubungula ushukela kahle kushukela.
Ngenxa yalokhu, ushukela unqwabelana egazini, ukhululwe ngobuningi bomchamo. Ngasikhathi sinye, kukhona ukwephulwa kwe-metabolism yamanzi, izicubu ziphelelwa amandla okugcina amanzi, zichithwa yizinso. Lapho izinga likashukela wegazi lomuntu liphakeme kakhulu kunokwejwayelekile, lokhu kuzoba uphawu olukhulu lokuqalwa kwesifo sikashukela.
Lesi sifo singazalwa kabusha noma sitholakale. Ngenxa yesifo sikashukela nokuntuleka kwe-insulin, isiguli sakha izifo zezinso, inhliziyo, isimiso sezinzwa, i-vasherosososis yemithambo, izilonda zesikhumba, kanye namehlo asebusweni ziwohloka ngokushesha.
Izimpawu Zesifo Sikashukela
Ukubonakaliswa komtholampilo kwesifo sikashukela kubonakaliswa inkambo eqhubeka kancane kancane, lesi sifo siziveza ngesimo esisheshayo ngokwanda ngokushesha kwe-glycemia akuvamile kakhulu.
Ngokuqala kwesifo sikashukela, iziguli zithola lezi zinkinga zempilo ezilandelayo:
- umlomo owomile
- ukoma okungapheli;
- ukukhipha ukuphuma komchamo;
- ukwanda okusheshayo noma ukwehla kwesisindo, amafutha omzimba;
- ukomiswa nokulunywa kwesikhumba.
Imvamisa, umuntu onesifo sikashukela uba nengqondo ekhulayo yezinqubo zokwenza umzimba emzimbeni, izicubu, isikhumba, ubuthakathaka bemisipha, nokwanda kokujuluka. Inkinga enkulu yeziguli ezinesifo sikashukela ukuphulukiswa okungekuhle kwanoma imaphi amanxeba.
Izikhalazo ezishiwo ngenhla ziba yisibonakaliso sokuqala sokwephulwa kokukhiqizwa kwe-insulin, kufanele zibe yisizathu sokuhambela udokotela oholayo, ukuthatha ukuhlolwa kwegazi ngoshukela ukuthola i-hypoglycemia.
Lapho lesi sifo siqhubeka, ezinye izinkomba zingavela ezibonisa ukuqala kwezinkinga. Ezimweni ezimbi kakhulu, izinkinga ezisongela impilo, ukudakwa kakhulu, nokuhluleka kwezitho eziningi kwenzeka.
Ukubonakaliswa okuyinhloko kwenkambo eyinkimbinkimbi yesifo sikashukela sohlobo lokuqala nolwesibili kuzoba:
- Izinkinga zokubuka;
- ukuncipha kokuzwela kwemilenze, ikakhulukazi isikhumba ezinyaweni;
- izinhlungu zenhliziyo, isibindi esikhulisiwe;
- ukushuba kwemilenze;
- ukuqhubekela phambili kokukhula komfutho wegazi (kokubili i-diastolic ne-systolic).
Ngokuphazamiseka kwesifo sikashukela kumuntu ogulayo, ukudideka, ukuvuvukala kwemilenze, nobuso kuyabonakala.
Ukuvimbela ukwephulwa okunjalo, kubalulekile ukuqinisekisa ukutholwa kwesifo sikashukela kusenesikhathi.
Izindlela Zokuxilonga
Ngokusola okuncane kwesifo sikashukela, kuyadingeka ukuthi kuqinisekiswe ukutholwa okusolwayo noma ukukuphika. Ngalezi zinhloso, kunconyelwa ukwenza izindlela eziningi zelabhorethali neze-elebhu.
Okokuqala, udokotela uzonikeza ukuhlolwa kwegazi kokuhlushwa kwe-glucose kuyo (ukuzimisela kokuzila ukudla kwe-glycemia). Okulandelayo, udinga ukuthatha isivivinyo sokubekezelela ushukela, kubandakanya nokusungula isilinganiso sokuzila kwe-glycemia kanye namahora ama-2 ngemuva kokuthatha inani elikhulu le-glucose.
Ukuhlolwa kwegazi kwenani le-hemoglobin ye-glycated kanye nokuhlolwa kwegazi elinamakhemikhali kusiza ekuboneni izinga lokuphazamiseka ekusebenzeni kwezitho zangaphakathi ngokumelene nesizinda sikashukela i-mellitus.
Ukuhlolwa kwegazi okusheshayo kwe-glycated hemoglobin nokubekezelelwa kweglucose kubizwa ngokuthi ukubhekwa kwesifo sikashukela.
Ukuhlolwa kwephrofayili ye-glycemic kusiza ukuthola isifo sikashukela, lapho i-glycemia ihlolwa kaninginingi ilandelana amahora angama-24. Kuyadingeka futhi ukwenza lokhu ukuhlola ikhwalithi kanye nokusebenza kokwelashwa ezigulini ezinesifo sikashukela.
Ukuhlolwa okujwayelekile komchamo kuyadingeka ukukhomba:
- i-glucosuria (izinga loshukela);
- amaseli amhlophe egazi;
- proteinuria (amaprotheni).
Ukuhlolwa komchamo wokuba khona kwe-acetone kuyakhonjiswa uma kukhona izinsolo zokukhuphuka kokuxineka kwemizimba ye-ketone esegazini (sikashukela ketoacidosis).
Okulandelayo, ucwaningo lokwakheka kwe-electrolyte kwegazi, i-fundus, i-insulin yemvelo ye-insulin, nokuhlolwa kwe-Reberg kuyaphoqelelwa.
Ukuhlolwa kwesifo sikashukela, njengakwezinye izivivinyo zaselebhu, kuzokwethenjwa ngokuya ngokucacile nokuzwela kwezindlela zokucwaninga. Lezi zinkomba ekuhlaziyeni kwe-glucose yokuzila ziyahlukahluka, kodwa kubhekwa njengokucacile kwe-50%, uzwela lwe-95%. Ngasikhathi sinye, kuyabhekwa ukuthi ukuzwela kungancishiswa uma ukuxilongwa kwenziwa ngumuntu oneminyaka engaphezu kwengama-65 ubudala.
Ukuxilongwa kuqedwa nge-dopplerography ye-ultrasound, capillaroscopy, rheovasography yemikhumbi yemilenze, i-ultrasound yezinso, inhliziyo nezitho zesisu.
Isiguli ngasinye esinesifo sikashukela kumele sibonane nodokotela:
- i-endocrinologist;
- udokotela wenhliziyo;
- udokotela ohlinzayo;
- i-neuropathologist;
- ophthalmologist.
Ukuqaliswa kwayo yonke inkimbinkimbi yezindlela zokuxilonga kusiza ukuqonda ngokucacile ubukhulu besifo sikashukela, ukunquma amaqhinga wokwelashwa.
Kwesinye isikhathi kuba nezinkomba zokuqhuba lezi zifundo amahlandla amaningi ukubona amandla esifo.
Imiphumela engaba khona kanye nezinkinga
Uhlobo 1 noma isifo sikashukela 2 sodwa asikwazi ukubeka engcupheni impilo yesiguli, kepha ubunzima nemiphumela yaso iyingozi enkulu. Ku-mellitus yesifo sikashukela, isiguli sigijimisa ubungozi bokuthola ikhehla lesifo sikashukela, isibonakaliso salo esisongela siba ukudideka, ukuvimbela okwedlulele. Iziguli ezinjalo esikhathini esifushane kufanele ziyiswe esibhedlela.
I-coma ejwayelekile yesifo sikashukela yi-ketoacidotic, ebangelwa ukuqoqwa kwezinto ezinobuthi ezinomphumela omubi kumaseli wezinzwa zabantu. Isibonakaliso esiyinhloko esiqinisekisa ukutholwa okusheshayo kwesimo esisongelayo ukuhogela okuqhubekayo kwe-acetone kusuka emgodini womlomo ngesikhathi sokuphefumula. Izimpawu zisiza nokusola ukoma onesifo sikashukela:
- umzimba umbozwe umjuluko obandayo;
- ukonakala ngokushesha kwempilo.
Ezinye izinhlobo zekoma ziyaqabukela kakhulu.
Ezinye izinkinga zesifo sikashukela kufanele zibonise i-edema, zingaba sendawo noma zibe nemvelo ebanzi. Ubukhulu bokuvuvukala buqonde ngqo ebukhoneni bokuwohloka kwenhliziyo nokwehluleka kwezinso. Eqinisweni, lolu phawu luwuphawu lwe-nephropathy yesifo sikashukela, lapho sikhulunywa khona, kulapho ukugcwala okuqina khona.
Lapho i-edema i-asymmetrical, imboza umlenze owodwa kuphela, udokotela ukhuluma nge-Microangiopathy yesifo sikashukela semikhawulo ephansi, esekelwa yi-neuropathy.
Ukutholwa ngesikhathi sikashukela kubalulekile futhi ukuvimbela ukwanda noma ukwehla ngokushesha komfutho wegazi. Izinkomba zokucindezela kwe-systolic ne-diastolic nazo ziba yisikhombisi sokubona ubucayi bokuntuleka kwe-insulin. Nge-nephropathy yesifo sikashukela eqhubekayo, lapho izinso zithinteka, kuzokhula ukwenyuka kwengcindezi ye-systolic.
Uma kunokwehla kwengcindezi yegazi emithanjeni yemilenze, okuqinisekiswa inqubo ye-Dopplerography, isiguli sitholakala sine-angiopathy yemikhawulo engezansi. Ubuhlungu bomlenze bungakhombisa nesifo sikashukela ne-neuropathy. Kwi-microangiopathy, Ubuhlungu bubonakala nge:
- ehamba
- noma yimuphi umsebenzi womzimba.
Ukuzwa okungaphatheki kahle kubangela onesifo sikashukela ukuba ame kaningi, aphumule ukuze anciphise ukuqina kwawo. Kepha izinhlungu emilenzeni, ezenzeka kuphela ebusuku, zizoba uphawu lwe-nephropathy yesifo sikashukela. Imvamisa, izimpawu ziba yisigaxa, kanye nokwehla kokuzwela kwesikhumba. Ezinye iziguli zinomuzwa ovuthayo wendawo endaweni eyodwa yonyawo, umlenze ophansi.
Uma kungekho ukwelashwa kwesifo sikashukela, i-angiopathy iyaqhubeka, kunengozi enkulu yokuqala kokulimala kuwo womabili amancanyana amakhulu amakhulu emithi. Njengomthetho, le nqubo ye-pathological iqala kuphela kuzwane eyodwa. Ngenxa yokuntuleka kokugeleza kwegazi, isifo sikashukela sizwa izinhlungu ezinzima, ubomvu nokuvutha. Njengoba ukugula kwesibalo kukhula:
- ukubanda, i-cyanotic, ukuvuvukala;
- amabublue avela nokuqukethwe yi-turbid, amabala amnyama (necrosis).
Izinguquko ezinjalo azinakuphikwa, kungenzeka ukuthi ugcine umlenze othintekile kuphela ngokunqanyulwa. Kuyinto efiselekayo kakhulu ukuyenza iphansi ngangokunokwenzeka, ngoba ukuhlinzwa onyaweni ngeke kulethe umphumela omningi, odokotela batusa ukunqunywa ezingeni lasemlenzeni ophansi. Ngemuva kokuhlinzwa, kunethuba lokubuyisela ukubonga kokuhamba emazinyweni aphezulu osebenzayo.
Ukuvimbela isifo sikashukela kungukutholwa kwangempela kwesifo, ukwelashwa okufika ngesikhathi nangendlela efanele. Impumelelo yokwelapha incike ekuqalisweni okuqinile kwemiyalelo kadokotela, ukudla okukhethekile. Ngokwehlukana, kufanele ucacise ukunakekelwa kwesikhumba okuphathelene nemilenze nsuku zonke, lokhu kuzosiza ukuqeda ukulimala, futhi uma kwenzeka, funa usizo lodokotela ngokushesha. Ividiyo ekulesi sihloko izokusiza ekuboneni isifo sikashukela.
