Uma umuntu enamazinga aphezulu kashukela egazini ekuhlolweni kwegazi, udokotela ngokuqinisekile uzomazisa nge-hyperglycemia, okungaba ukuqala kwesifo sikashukela. Igama elithi hyperglycemia lihambisana nesifo sikashukela impilo yakhe yonke, ngakho-ke kubalulekile ukwazi konke ngakho.
Ngaphandle kokukhula kwamanani kashukela kushukela, i-hyperglycemia ingaphakanyiswa noma ingaba phakathi kobubanzi obujwayelekile lapho izinga le-glucose lisondele kumanani okuhlosiwe futhi asikho isidingo sokulilungisa.
Kuyisiko ukwahlukanisa izigaba eziningana zokukhula kwalesi simo se-pathological:
- ukukhanya
- isilinganiso;
- esindayo.
Udokotela ohambelayo uzosiza ekunqumeni amanani atholakalayo ngokunembile, ochaza isiguli ngasinye ukuthi kungani kubalulekile ukubheka i-glycemia njalo nokuthi isiphi uhlaka lokuyigcina.
I-Hyperglycemia isiza ukuhlola isimo sesiguli: ukuzila ukudla, ukubekezelela umzimba.
Uma i-hyperglycemia iphakeme ngokweqile, ingadala i-coma yesifo sikashukela, ebizwa nangokuthi i-ketoacidosis yesifo sikashukela. Kulesi simo, umuntu angalahlekelwa ingqondo futhi afe.
Kubalulekile njalo ukukhumbula ukuthi isifo sikashukela yisifo se-endocrine esingazivezi nganoma iyiphi indlela iminyaka eminingi.
Izimbangela ze-Hyperglycemia
Ukwanda kweglucose yegazi kungenzeka ngezizathu ezahlukahlukene, ngokuyinhloko ngenxa yokungahambelani nokudla okunqunywe udokotela. Lapho umuntu onesifo sikashukela esebenzisa kakhulu ama-carbohydrate, kungakapheli isigamu sehora ekugxiliseni kwakhe ushukela egazini ukhuphuka ngokushesha.
Naphezu kweqiniso lokuthi i-glucose ingumthombo omsulwa wamandla, ukugcwala kwayo kubangela ukulimala okuningi kunokuba kubonakala ekuqaleni.
Ngokuhamba kwesikhathi, i-hyperglycemia izothinta kabi izinqubo ze-metabolic, ezozibonakalisa:
- Ukukhuluphala ngokweqile
- ukwephulwa kohlelo lwenhliziyo;
- ukubekezelela ushukela okhubazekile;
- ukukhuphuka kwama-triglycerides.
Lapho isiguli sitholwa sinezimpawu ezi-2 noma ngaphezulu zalezi zimpawu kanye nokukhuluphala, sitholakala sine-metabolic syndrome. Ngaphandle kokwelashwa okufika ngesikhathi, thayipha 2 isifo sikashukela sikhula kancane kancane.
Ukukhuluphala ngokweqile kuphakamisa ukumelana ne-insulin, ikakhulukazi ngokukhuluphala kwesisu, lapho kufakwa amanoni okhalweni. Iningi leziguli ezinesifo sikashukela likhuluphele (BMI ngaphezulu kwama-25).
Indlela yokuthuthukiswa kwesifo sikashukela kubantu abakhuluphele ifundwe kahle. Ukweqiwa kwezicubu ze-adipose kukhuphula izinga lamafutha acid yamahhala - umthombo omkhulu wamandla. Ngokuqongelela kwamafutha acid egazini, i-hyperinsulinemia, ukumelana ne-insulin kwenzeka. Ngaphezu kwalokho, ama-asidi wamafutha wamahhala anobuthi kakhulu kumaseli we-pancreatic beta, ngoba anciphisa umsebenzi oyimfihlo wesitho.
Ngakho-ke, ekutholakaleni kokuqala kwesifo sikashukela sohlobo 2, isifundo se-plasma esezingeni le-FFA siyakhonjiswa, ngokweqile kwalezi zinto sikhuluma ngokwakhiwa kokubekezelelana kwe-glucose, i-hyperglycemia esheshayo.
Ezinye izimbangela ze-hyperglycemia: izimo ezikhathazayo njalo, ukuthatha imishanguzo ethile, izifo ezithathelwanayo noma ezingamahlalakhona, ukuntuleka kwe-insulin.
Kuyingozi kakhulu ukuntuleka kwe-insulin, i-hormone yezokuthutha ekhuthaza ukwabiwa kwamandla emzimbeni wonke. Ngokuntuleka kwayo, ama-molecule eglucose ayoqwabelana egazini, ingxenye yamandla amakhulu igcinwa esibindini, ingxenye incutshungulwa ibe ngamafutha, bese okusele kancane kukhishwe ngomchamo.
Lapho ama-pancreas engakwazi ukukhiqiza i-insulin eyanele:
- ushukela ubuthi igazi;
- iba yingozi.
Nge-mellitus yesifo sikashukela esincike ku-insulin, kuyadingeka ukuqapha imithamo ye-insulin, elawulwa kaningana ngosuku. Umthamo ngqo we-hormone uhlala uncike ekunakekelweni yisiguli, iminyaka yakhe nenombolo yamanye amapharamitha. Ngokwesilinganiso esanele sokuphathwa kwe-insulin, i-hyperglycemia iyakhula.
Hhayi indima yokugcina ekwakhekeni kwe-hyperglycemia nohlobo 2 sikashukela inikezwe umbono olungiselelwe ifa. Ososayensi bachaze izinhlobo ezingaphezu kwekhulu ezihlotshaniswa nethuba lokukhula kokumelana ne-insulin, ukukhuluphala, glucose okhubazekile kanye ne-fat metabolism.
I-Hyperglycemia nezimpawu zayo nazo zibangela ukulimala kumaseli we-pancreatic beta, okungukuthi:
- ukusebenza;
- organic.
Njengoba kuphawuliwe, izimbangela zezinkinga zikashukela wegazi zidinga ukuphathwa isikhathi eside kwezidakamizwa: ama-hormone e-adrenal cortex (glucocorticosteroids), ama-diuretics (thiazides), izidakamizwa ezilwa ne-hypertension, arrhythmias, ukuvikela ukuhlaselwa yinhliziyo (i-beta-blockers), antipsychotic (antipsychotic), Imithi ye-anticholesterol (ama-statins).
Ucwaningo olwenziwe emindenini enkulu nakumawele luye lwabonisa ukuthi uma omunye wabazali enesifo sikashukela sohlobo 2, ingane iyokwazi ukuthi yini i-glycemia engaba khona ifinyelela kuma-40%.
Izimpawu ze-Hyperglycemia
Iziguli zithi akusetshenziswa njalo ukubona izimpawu ze-hyperglycemia kuhlobo 2 sikashukela. Kuyaphawuleka ukuthi nge-glucose ebangeni kusuka ku-10 kuye ku-15 mmol / ilitha, okuhlala isikhathi eside, umuntu angazizwa esejwayelekile, angakhali ngempilo.
Kodwa-ke, kufanele ulalele umzimba wakho, ikakhulukazi ngokuncipha kwesisindo ngokuzumayo, ukuchama kaningi, ukoma okungapheli, ukukhathala, ukubangela isicanucanu, nokuhlanza. Ngezinkinga noshukela, umuntu uyoma emgodleni ebusuku, ukulala kuyaphazamiseka.
Ngaleso sikhashana lapho izinga le-glucose lidlula umkhawulo wezinso, ukugcwala kwalo kukhishwa kanye nomchamo, ngakho-ke lowo onesifo sikashukela uphoqeleka njalo ukuba aye endlini yangasese (njalo ngehora noma amabili). Ngenxa yalokhu, umzimba uqala ukulahlekelwa umswakama ngenkuthalo, ukuphuma komzimba kwenzeka ngokumelene nesizinda sokoma okunganqamukiyo.
Njengoba izinso zingakwazi ukubhekana nomsebenzi wazo, igazi alihlanzi kahle, ngomchamo, umuntu ulahlekelwa yizinto ezinempilo ukuze impilo:
- amaprotheni
- ama-chloride;
- potaziyamu
- i-sodium
Le nqubo ye-pathological iboniswa ukudonsa, ukuqina, ukunciphisa umzimba.
Uma izinso zilahlekelwa ngokuphelele amandla abo okuhlanza igazi, kuba nesifo sikashukela esiqala ukwanda, esigcina ngokuba ukwehluleka kwezinso. Ezimweni ezinjalo, kunezinkomba ze-hemodialysis yezinso, ezibandakanya ukuhlanzwa kwegazi okwenziwe ngegazi.
Ukwanda nezimpawu ze-hyperglycemia kuhlobo 2 lwesifo sikashukela kuncike ngqo ekuqasheni ushukela kanye nesikhathi samanani aso aphezulu. Uma kungekho ukwelashwa okufika ngesikhathi, i-ketoacidosis ne-ketonuria izoqala ukuthuthuka ngokufana ne-glucosuria.
Njengoba sikhula isifo sikashukela, izimpawu ziba zimbi kakhulu, futhi zingaba yingozi. Lapho i-hyperglycemia ifinyelela amazinga aphezulu futhi igcinwa kubo isikhathi eside, kwenzeka:
- izinhlungu ezinzima emilenzeni;
- ukuthuthukiswa kokutheleleka kwemvubelo;
- ukuphulukiswa okuhamba kancane kokuqhekeka, ukusikeka;
- ubukhulu bendawo ephezulu nangaphansi.
Isifo sikashukela sohlobo 2 sinikeza umthelela onamandla emisipha yenhliziyo, kwabesifazane lokhu kukhulunywa kakhulu. Ezigulini, ingozi yokuhlaselwa yisifo senhliziyo ikhuphuka ngokushesha izikhathi ezi-2, kanye nokwehluleka kwenhliziyo izikhathi ezine.
I-Hyperglycemia ngesikhathi sokukhulelwa ibangela izinkinga uma owesifazane enquma ukukhulelwa: i-toxicosis sekwephuzile, i-polyhydramnios, ukungahambi kahle kwesisu, i-pathology yepheji lomchamo.
Izimpawu ze-ketoacidosis yesifo sikashukela
Ukulandela izincomo zikadokotela ozosiza kuzosiza ukumisa izinqubo eziyingozi emzimbeni. Kunoma yikuphi, kunesidingo sokufuna usizo lukondli ozohlakulela isidlo esisezingeni eliphansi se-carb. Ngezinkinga zezinso, kunezinkomba zokunciphisa inani lokudla kwamaprotheni adliwayo, kanye nosawoti.
Nge-Type 2 sikashukela mellitus, izimpawu ze-ketoacidosis zizoba amakhanda ajwayelekile, iphunga elingelona iqiniso elivela emthanjeni womlomo, ubuthakathaka, isisu, isicanucanu, isifo sohudo, ukuphefumula ngokushesha, ukunciphisa isifiso sokudla, kufinyelela futhi kufaka phakathi ukuphambukela ekudleni. Ukuphefumula kanzima, ukugabha, kanye nenausea:
- shayela iqembu labasebenza ngama-ambulensi;
- lesi simo sihlinzekela ukwalaliswa esibhedlela ngokushesha.
Ngaphezu kwalokho, kunoma yisiphi isimo esingajwayelekile, isiguli siba sengozini enkulu. Isibonelo, ngezifo ezithathelwanayo noma ezingamagciwane, lapho izinga lokushisa lomzimba lenyuka, ingxenye ye-insulin ibhujiswa. Uma umzimba ngesikhathi lesi sifo usuthakathaka kakhulu, izinga lokushisa eliphakeme lihlala isikhathi eside, i-ketoacidosis ikhula ngokushesha okukhulu. Ngalesi sizathu, ukubonakaliswa kwe-hyperglycemia kuhlobo 2 sikashukela ngeke kunganakwa.
Ukuncoma kwesibili kuzoba ukwanda kokuzivocavoca umzimba, ikakhulukazi ezigulini:
- ukuguga;
- nokukhuluphala.
Kubalulekile ukunaka ukuhamba, i-gymnastics yezokwelapha, kepha, ungakhohlwa ukuthi ukusebenza ngokomzimba kuvinjelwe nge-hyperglycemia ngaphezulu kwe-13 mmol / l.
Kuyadingeka futhi ukuphuza isilinganiso esanele soketshezi, ikakhulukazi nge-glycemia ngaphezulu kwe-12 mmol / L. Phuza amanzi amaningi njalo ngesigamu sehora. Izidakamizwa zokunciphisa ushukela nazo ziyasiza, kepha awukwazi ukuzithatha kakhulu futhi kaningi, uma kungenjalo ukusabela okungekuhle kuyakhula.
Ezibangeni zokuqala ze-hyperglycemia ku-mellitus yesifo sikashukela kungalungiswa kuphela ngokudla okufanele nokunempilo.
Odokotela banesiqiniseko sokuthi ukwelashwa okunjalo kuzoba wukhiye empilweni ngaphandle kwesifo sikashukela ngokuzayo.
Ukuxilongwa kwe-hyperglycemia
Ukuxilongwa kwe-hyperglycemia ku-mellitus yesifo sikashukela kungenzeka ngokuhlaziya okusheshayo kwe-plasma, ukuhlolwa kokubekezelela ushukela.
Ukuhlolwa kwe-glucose ku-plasma yegazi kuyasiza nokusungula ukuba khona kwe-hypoglycemia. Bakwenza ngesisu esingenalutho ngemuva kokuzila amahora angama-10. Izinga le-glucose lizoba lejwayelekile kuzinkomba ezisuka ku-3.9 kuya ku-5.5 mmol / L, i-prediabetes ibhekwa ukusuka ku-5.6 kuye ku-6.9%, isifo sikashukela sitholakala ngokuhlaziywa sisuka ku-7 mmol / L (ukukhipha amaphutha, ukuhlaziya kuyaphindwa kaninginingi )
Ukuhlolwa kwe-glucose kubonisa izinga le-glucose amahora ama-2 ngemuva kokuphuza uketshezi olunoshukela omningi (75 amagremu kashukela ngama-300 ml wamanzi). Esikhathini sikashukela, umphumela uzoba ngu-11.1 mmol / L nangaphezulu.
Uma uthola umphumela owodwa okhuphukile kuphela, udinga ukuphinda uvivinyo kaninginingi. Kwezinye izimo, i-hyperglycemia ikhula ngokungemuva kwe:
- ukucindezelwa njalo;
- ukulimala
- izifo ezithathelwanayo.
Ukuqinisekisa noma ukungafaki ku-mellitus yesifo sikashukela, kukhonjiswa ukwenza izivivinyo eziningana ze-glucose ngezikhathi ezahlukene zosuku, ngemuva kokudla nesisu esingenalutho.
Kwividiyo ekulesi sihloko, udokotela uzochaza kabanzi ngezimpawu ze-hyperglycemia.
