Izimpawu ze-ketoacidosis yesifo sikashukela nokuthi kungani ziyingozi kangaka

Uma isifo sikashukela singalawulwa, kungaholela ezinkingeni eziningi ezingadala ukukhubazeka kuphela, kodwa futhi nokufa kwesiguli. Isifo sikashukela se-ketoacidosis singenye yemiphumela eyingozi yokuntuleka kwe-insulin, engaholela umuntu enkingeni ngemuva kwezinsuku.

Ezimweni ezingama-20%, imizamo yabodokotela yokuwususa ku-coma ayisebenzi. Imvamisa, i-ketoacidosis yenzeka ezigulini ezinesifo sikashukela esinokulimazeka okukhulu kokusebenza kwe-pancreatic, abanqunywe nge-insulin ngomjovo. Kodwa-ke, abanesifo sikashukela se-2 bangase bahlupheke kule nkinga uma beqala ukusebenzisa kabi amaswidi noma ngokunqunyelwe bayikhansele imishanguzo yokwehlisa ushukela ebekiwe.

Kuyini isifo sikashukela sikashukela

Igama elithi "acidosis" livela kwelesiLatin elithi "acidic" futhi lisho ukwehla kwe-pH yomzimba. Isandulelo "keto" sikhombisa ukuthi ukwanda kwe-acidity kwenzeke ngenxa yokwanda kokuxineka kwemizimba ye-ketone egazini. Ake sibheke kabanzi ukuthi kungani lokhu kwenzeka nokuthi isifo sikashukela sithinta kanjani ibhalansi ye-acid.

Kumetabolism ejwayelekile, umthombo oholayo wamandla yi-glucose, enikezwa nsuku zonke nokudla ngendlela yama-carbohydrate. Uma akwanele, kusetshenziswa imithombo yokulondolozwa ye-glycogen, egcinwa emisipheni nasezibindini futhi isebenza njengohlobo lwedepho. Lesi sitoreji sikwazi ukuvula ngokushesha futhi senzele ukuswelakala kwe-glucose okwesikhashana, kuthatha usuku olukhulu. Lapho izitolo ze-glycogen ziqediwe, kusetshenziswa imali yamafutha. Amafutha aqhekeka phansi abe ushukela, akhishwe egazini futhi anondise izicubu zawo. Lapho amaseli amanoni ephuka, kwakheka imizimba ye-ketone - acid ne-keto acid.

Isifo sikashukela nokucindezela kuzoba yinto yesikhathi esedlule

• Ukwehlela ushukela -95%
• Ukuqedwa kwe-vein thrombosis - 70%
• Ukuqedwa kokushaya kwenhliziyo okuqinile -90%
• Ukuqeda umfutho wegazi ophakeme - 92%
• Ukwanda kwamandla ngesikhathi sosuku, ngcono ukulala ebusuku -97%

Sihlangabezana nokwakheka kwe-acetone emzimbeni kaningi: ngesikhathi sokunciphisa umzimba, ukuzikhandla okukhulu ngokomzimba, ngenkathi kudla ukudla okunamafutha, okune-carb ephansi. Kumuntu ophile kahle, le nqubo iyaqashelwa, izinso zisusa ama-ketones emzimbeni emzimbeni, ukudakwa nokushintshwa kwe-pH akubonwa.

Isifo sikashukela, i-ketoacidosis yenzeka ngokushesha okukhulu futhi iba ngokushesha okukhulu. Noma ngabe kuthathwa ushukela owanele, amangqamuzana awatholakali ngokushesha. Lokhu kuchazwa ukungabikho ngokuphelele kwe-insulin noma ukusilela kwayo okunamandla, ngoba yi-insulin evula umnyango glucose ongaphakathi esitokisini. Izitolo eziqhekezayo ze-glycogen nezitolo ezinamafutha azikwazi ukwenza ngcono lesi simo, i-glucose ephumayo inyusa kuphela i-hyperglycemia egazini. Umzimba, uzama ukubhekana nokuntuleka kokudla okunempilo, uthuthukisa ukuwohloka kwamafutha, ukugcotshwa kwama-ketones kukhula ngokushesha, izinso ziyeka ukubhekana nokususwa kwazo.

Lesi simo sidingida i-osmotic diureis, eyenzeka noshukela wegazi ophezulu. Umchamo omningi uyagcotshwa, ukuphuma komzimba, ama-electrolyte alahlekile. Lapho umthamo wamanzi we-intercellular uwa ngenxa yokuntuleka kwamanzi, izinso zinciphisa ukwakheka komchamo, ushukela kanye ne-acetone kuhlala emzimbeni ngamanani amakhulu. Uma i-insulin ingena egazini, kuba nzima kuye ukufeza umsebenzi wakhe, njengoba ukumelana ne-insulin kukhula.

I-acid acidity imvame cishe ibe ngu-7.4, ukwehla kwe-pH esivele kuye ku-6.8 kwenza impilo yomuntu ibe nokwenzeka. I-ketoacidosis kwisifo sikashukela ingaholela ekunciphiseni okunjalo ngosuku nje. Uma ungaqali ukwelashwa ngesikhathi, isiguli esinesifo sikashukela siba nesimo sokunganakwa, ukozela, silandelwe wukuguqulelwa ekhefeni likashukela nokuqala kokufa.

I-acetone kumchamo ne-ketoacidosis - umehluko

Njengabo bonke abantu abaphilile, iziguli ezinesifo sikashukela i-mellitus ngezikhathi ezithile zithola ketoacidosis evamile, "elambile". Imvamisa, kwenzeka ezinganeni ezithambile ezisebenzayo noma lapho ulandela ukudla okunomkhawulo oqinile wama-carbohydrate. Ngomthamo owanele wamanzi kanye noshukela egazini ngaphakathi kwebanga elijwayelekile, umzimba uzimele ngokulawula ukulingana - ususa imizimba ye-ketone ngosizo lwezinso. Uma ngalesi sikhathi usebenzisa imichilo ekhethekile yokuhlola, uyakwazi ukubona ubukhona be-acetone emchameni. Kwesinye isikhathi imisipha yakhe izwakala emoyeni. I-acetone iba yingozi kuphela ngesimo sokuphelelwa ngamandla, okungenzeka ngokuphuza okunganele, ukugabha okungavikeleki, uhudo olunzima.

I-acetone kumchamo onesifo sikashukela ayisona isizathu sokuyeka ukudla okune-carb ephansi. Ngaphezu kwalokho, ngalesi sikhathi, udinga ukubheka ushukela wegazi ngokucophelela. Ukwanda kokuhlungwa kwe-glucose ngaphezulu kwe-13 mmol / L kubangela ukuthuthukiswa okusheshayo kwe-ketoacidosis yesifo sikashukela.

Umthetho ojwayelekile: ukutholwa kwe-acetone kumchamo kudinga ukwelashwa kuphela ngokuphelelwa ngamandla kanye noshukela ongafakwanga ushukela. Njalo ukusebenzisa imichilo yokuhlola akunangqondo. Ukuhambisana nokudla okunqunyiwe, irejimeni yokuphuza ejwayelekile, ukudla izidakamizwa okufika ngesikhathi nokuqapha ushukela nge-glucometer kunciphisa ubungozi be-ketoacidosis yesifo sikashukela.

Izimbangela zesifo

I-ketoacidosis iba nohlobo 1 nohlobo lwe-2 yesifo sikashukela kuphela ngokuntuleka okukhulu kwe-insulin, okuholela ekwandeni okuqinile kweshukela egazini.

Lesi simo kungenzeka kulezi zimo ezilandelayo:

1. Isifo sikashukela i-mellitus asikatholakalanga, ukwelashwa akukenziwa. Thayipha isifo sikashukela kokuthathu kokuthathu kwamacala kutholakala kuphela lapho kwenzeka i-ketoacidosis.
2. Isimo esibi sokusebenzisa izidakamizwa - ukubalwa komthamo ongalungile, ukweqa imijovo ye-insulin.
3. Ukuntuleka kolwazi esigulini esinesifo sikashukela i-mellitus ukuthi singabala kanjani kahle umthamo futhi siphathe i-insulin.
4. Ukukhulelwa nge-toxicosis enzima, okukhonjiswa ngokuhlanza okukhulu.
5. Ukudukelwa uhlobo 2 lwesifo sikashukela ukushintshela ku-insulin, lapho amanyikwe aphulukana kakhulu nokusebenza kwawo, nezidakamizwa ezinciphisa ushukela ziba nezanele.
6. Sebenzisa izindlela zokwelapha ushukela wesintu ngaphandle kokulawulwa koshukela egazini.
7. Amaphutha abalulekile ekudleni - ukusetshenziswa kwenqwaba yama-carbohydrate asheshayo, izikhawu ezinde phakathi kokudla.
8. Ukungenelela kokuhlinzwa, ukulimala okungathi sína, izifo ezibangelwa yigciwane, ukuvuvukala kwamaphaphu nohlelo lwe-urogenital, ukushaya kwenhliziyo nokushaywa unhlangothi, uma udokotela engaziswanga ngesifo sikashukela futhi engazange akhuphule umthamo wezidakamizwa ngesikhathi.
9. Ukugula kwengqondo, ukudakwa, ukuvimbela ukutholwa kokwelashwa okwanele kwesifo sikashukela.
10. Ukwehliswa kwe-insulin ngezinhloso zokuzibulala.
11. Ukusetshenziswa kwe-insulin yamanga noma ephelelwe yisikhathi, isitoreji esingafanele.
12. Ukulimala kwe-glucometer, ipeni le-insulin, iphampu.
13. Ukunquma izidakamizwa ezinciphisa ukuzwela kwe-insulin, isibonelo, ama-antipsychotic.
14. Ukuthatha izidakamizwa - ama-insulin antagonists (corticosteroids, diuretics, amahomoni).

Izimpawu ze-ketoacidosis kushukela

I-ketoacidosis imvamisa ukukhula ezinsukwini ezingama-2-3, ngenkambo engajwayelekile - ngosuku. Izimpawu ze-ketoacidosis yesifo sikashukela ziyanda ngokwanda kwe-hyperglycemia kanye nokuthuthukiswa kokuphazamiseka kwengqondo kwe-metabolic.

Izindlela zokuxilonga ze-DC

Ukuxilongwa kwanoma yisiphi isifo kuqala ngomlando wezokwelapha - ukucaciswa kwezimo zokuphila zesiguli kanye nezifo ebezihlonziwe phambilini. Isifo sikashukela se-ketoacidosis asifani. Ukuba khona kwesifo sikashukela, uhlobo lwaso, isikhathi salesi sifo, izidakamizwa ezinqunyelwe kanye nesikhathi sokuphathwa kwazo kuyacaciswa. Ukuba khona kwezifo ezihlangana futhi ezingabhebhethekisa ukukhula kwe-ketoacidosis nakho kuyabonakala.

Isigaba esilandelayo sokuxilongwa ukuxilongwa kwesiguli. Izimpawu zokutholwa zokuqala komzimba, iphunga le-acetone, izinhlungu lapho ucindezela udonga olungaphambili lwesisu ziyisizathu sokusola ukuthuthukiswa kwesifo sikashukela sikashukela. Izici ezingezinhle futhi zifaka ukushaya ngamandla kanye nomfutho wegazi ophansi, izimpendulo zesiguli ezinganele emibuzweni kadokotela.

Imininingwane eyisisekelo ephathelene nezinguquko emzimbeni ngesikhathi se-ketoacidosis inikezwa izindlela zaselebhu zokuhlola umchamo negazi lakho. Ekuhambeni kokuhlaziywa kunqunywa:

1. Iglucose egazini. Uma inkomba ikhulu kune-13.88 mmol / L, i-ketoacidosis iqala, lapho kufinyelelwa okungu-44, kuvela isimo esivumayo - ukuhlolwa kwegazi ngoshukela.
2. Izidumbu zeKetone emchameni. Ukuhlaziywa kwenziwa kusetshenziswa umucu wokuvivinya. Uma ukukhipha amanzi emzimbeni sekuvele futhi umchamo ungekho, i-serum yegazi isetshenziselwa umucu ukuze ihlaziywe.
3. Iglucose emchameni. Kunqunywa ngesikhathi sokuhlaziywa okujwayelekile komchamo. Ukudlula ezingeni le-0,8 mmol / L kusho ukuthi ushukela wegazi mkhulu kune-10, kanti kungenzeka ukuthi isifo sikashukela sibe nesifo sikashukela.
4. Igazi le-Urea. Ukukhuphuka kubonisa ukungasebenzi emzimbeni kanye nokukhubazeka kwezintso.
5. Amylase emchameni. Lesi yisimo esidala ukubandakanyeka ekuwohlokeni kwama-carbohydrate, kuvikela amanyikwe alo. Uma umsebenzi we-amylase ungaphezulu kwe-17 u / h, ubungozi be-ketoacidosis buphakeme.
6. I-osmolarity yegazi. Ifaka okuqukethwe egazini lezakhi ezahlukahlukene. Ngamazinga akhulayo we-glucose nama-ketones, i-osmolarity nayo iyanda.
7. Ama-electrolyte ku-serum yegazi. Ukwehla kwamazinga e-sodium ngaphansi kwe-136 mmol / l kubonisa ukuphuma kwezicubu, ukukhuphuka kwe-diuresis ngaphansi kwethonya le-hyperglycemia. I-Potassium ngenhla kwe-5.1 ibonwa esigabeni sokuqala se-ketoacidosis, lapho i-potassium ions iphuma kumaseli. Ngokukhuphuka komzimba, izinga le-potassium liwela ngaphansi kwamanani ajwayelekile.
8. I-cholesterol yegazi. Izinga eliphakeme lingumphumela wehluleka kwe-metabolic.
9. Ama-bicarbonate wegazi. Yizinto ze-alkaline ezisebenza njenge-buffer emzimbeni - zibuyisele i-pH ejwayelekile yegazi lapho ivuselelwa ngemizimba ye-ketone. Ku-ketoacidosis yesifo sikashukela, ama-bicarbonate aphelile, futhi ukuzivikela kuyayeka ukusebenza. Ukwehla kwezinga lama-bicarbonates kuya kuma-22 mmol / l kubonisa ukuqala kwe-ketoacidosis, izinga elingaphansi kwe-10 likhombisa isigaba salo esinzima.
10. Isikhawu se-anionic. Kubalwa njengomehluko phakathi kwezimpawu (ngokuvamile i-sodium ibalwa) ne-anions (chlorine ne-bicarbonates). Imvamisa, lokhu kuhlangana kusondele ku-zero, nge-ketoacidosis iyanda ngenxa yokuqongelelwa kwe-keto acid.
11. Amagesi wegazi. Ukwehlisa izinga lekhabhoni diokde egazini le-arterial kwenzeka ukunxephezela i-acidity yegazi, njengoba umzimba uzama ukuhambisa i-pH ohlangothini lwe-alkaline. Ukuntuleka kwekhabhoni dayokisi kuthinta kabi ukunikezwa kwegazi kwingqondo, okuholela enesiyezi nasekulahlekelweni ukwazi.

Kwenziwa nezifundo ezikhethekile - i-cardiogram ukuthola ukungahambi kahle emsebenzini wenhliziyo, futhi ikakhulukazi izimo zangaphambi kokulimala, kanye ne-x-ray yezitho zesifuba ukuthola izifo ezingatheni zamaphaphu.

Ubunzima balokhu kuhlaziya nezifundo zinikeza isithombe esiphelele sezinguquko ezenzeka esigulini futhi zikuvumela ukuthi unikeze umuthi wokwelashwa obanele ekuqineni kwesi sifo. Ngosizo lokuhlaziya, ukwahlukanisa kwe-ketoacidosis yesifo sikashukela nezinye izimo ezifanayo nakho kuyenziwa.

Ukwelashwa okufanele

Ukuthuthukiswa kwe-ketoacidosis kuyinkomba yokuthi kunikezwe usizo oluphuthumayo esibhedlela. Ukwelashwa kuqalwa ekhaya ngomjovo we-intramuscular we-insulin osebenza kancane. Lapho ihanjiswa nge-ambulensi, kubekwa i-dropper ukwenza ukulahleka kwe-sodium. Ukwelashwa kwe-ketoacidosis emuncu yesifo sikashukela kwenzeka emnyangweni wezokwelapha, izwe elithandekayo lidinga ukubekwa lapho kunakekelwa kakhulu. Esibhedlela, zonke izivivinyo ezidingekayo zenziwa ngokushesha, bese kuthi ushukela, i-potassium nesodium kuhlolwe njalo ngehora. Uma kukhona ukuhlaziywa kwegesi emnyangweni, njalo ngehora kusetshenziselwa ukuthola imininingwane nge-glucose, i-urea, ama-electrolyte, kanye ne-carbon dioxide egazini.

Ukufakwa esikhundleni kwe-Insulin

I-insulin yokwelashwa kwe-ketoacidosis isetshenziswa kunoma yikuphi, kungakhathalekile ukuthi ngabe wake wanikezwa isiguli isifo sikashukela sohlobo 2 noma ukuthi wayenemithi eyanele yokunciphisa ushukela ukunciphisa ushukela. Ukufakwa kwe-insulin kuphela ngaphandle okungasusa imbangela ye-ketoacidosis yesifo sikashukela ngomsebenzi we-pancreatic, ukumisa ushintsho lwe-metabolic: ukumisa ukuqhekeka kwamafutha nokwakhiwa kwama-ketones, ukuvuselela ukwakheka kwe-glycogen esibindini.

Uma i-insulin ingalimalanga ngesikhathi sokwelashwa okuphuthumayo, lapho isiguli singena esibhedlela, ukwelashwa kwe-ketoacidosis kuqala ngokuphathwa kwe-insulin kwethamo elikhulu le-insulin - ukuya kuma-unit ayi-14. Ngemuva komthwalo onjalo, i-glucose ihlolwa njalo ukuvikela ukukhula kwe-hypoglycemia. Ushukela wegazi akufanele wehle ngaphezu kwama-5 mmol / l ngehora, ukuze ungaphazamisi ukulingana phakathi kwengcindezi engaphakathi kwamangqamuzana nasendaweni yokuhlangana. Lokhu kuyingozi ngokuvela kwe-edema eminingi, kufaka phakathi izinhlaka zobuchopho, ezigcwele i-coma esheshayo ye-hypoglycemic.

Esikhathini esizayo, i-insulin kufanele ifakwe emithanjeni emincane kuze kwehle ukutholakala kwe-glucose kuye ku-13 mmol / l, lokhu kwanele emahoreni angama-24 okuqala ukwelashwa. Uma isiguli singadli sisodwa, kufakwa i-glucose ku-insulin ngemuva kokuthola lokhu kugxila. Kuyadingeka ukuqinisekisa izidingo zamandla zezicubu ezibulawa yindlala. Kuyinto engathandeki ukuphatha ushukela ngokwezifiso isikhathi eside, ngokushesha lapho isifo sikashukela sidluliselwa ekudleni okujwayelekile ngokubakhona okuphoqelekile kwama-carbohydrate amade ekudleni.

Ekunakekelweni okukhulu, i-insulin ingena egazini lesiguli ngokungena kancane kancane (amayunithi ama-4 kuye kwayi-8 ngehora) ngomjovo.Lokhu kwenziwa kusetshenziswa idivaysi ekhethekile - i-perfuser, okuluhlobo lwepompo elikuvumela ukuthi ufake izidakamizwa ngokunemba okuphezulu. Uma igumbi lingafakwanga ngamafutha okugcoba, i-insulin ifakwa kancane kancane isirinji ifakwe kwishubhu le-dropper. Akunakwenzeka ukuyithululela ebhodleleni, ngoba lokhu kwandisa ingozi yemithamo engalungile nokubekwa kwesidakamizwa ezindongeni zangaphakathi zohlelo lokungenisa.

Lapho isimo sesiguli sithuthuka, waqala ukudla eyedwa, futhi ushukela wegazi wazinza, ukuphathwa okubucayi kwe-insulin ebambele esikhundleni kwathathelwa indawo ngokunganaki, izikhathi eziyisithupha ngosuku. Umthamo ukhethiwe ngamunye, ngokuya nge-glycemia. Bese ufaka i-insulin "ende", esebenza isikhathi eside. Ngemuva kokuzinza, i-acetone ikhishwa cishe izinsuku ezintathu, ukwelashwa okuhlukile akudingeki.

Ukulungiswa kwamanzi emzimbeni

Ukwehla kuqedwa ukwethulwa kukasawoti ongu-0.9%. Ehoreni lokuqala, umthamo wayo akufanele udlule ilitha elilodwa nengxenye, emahoreni alandelayo, ukuphatha kwehlisa ukubheka ukwakheka komchamo. Kukholelwa ukuthi i-saline ejojile akufanele ibe ngaphezu kwesigamu selitha edlula umthamo womchamo okhishwa yizinso. Kufika ku-malitha angama-6-8 koketshezi athululelwa ngosuku.

Uma umfutho wegazi ophakeme wehliswe ngokuqinile futhi ungeqi i-80 mmHg, kwenziwa igazi.

Ukubuyiselwa kokusweleka kwe-electrolyte

Ukulahleka kwe-sodium kuyakhokhelwa ngesikhathi sokulungiswa kokuphelelwa ngamandla, ngoba usawoti yi-chloride yayo. Uma ukushoda kwe-potassium kutholakala ngokuhlaziywa, kuqedwa ngokwahlukana. Ukwethulwa kwe-potassium kungaqala ngokushesha ngemuva kokuvuselelwa komchamo. Kulokhu, kusetshenziswa i-potassium chloride. Ehoreni lokuqala lokwelashwa, akufanele kudliwe ngaphezulu kwe-3 g chloride, khona-ke isilinganiso siyancipha kancane kancane. Umgomo ukufeza ukuqoqwa kwegazi okungenani kwe-6 mmol / L.

Ekuqaleni kokwelashwa, amazinga e-potassium angaconsa, naphezu kokuphinda kubuye ukulahlekelwe. Lokhu kungenxa yokuthi ubuyela kumaseli ashiye ekuqaleni kokukhula kwesifo sikashukela sikashukela. Ngaphezu kwalokho, ngokungeniswa kukasawoti ngamanani amakhulu, ama-diuresis akhula ngokungenakuvinjezelwa, okusho ukuthi ukulahleka okungokwemvelo kwama-electrolyte kumchamo. Lapho nje kuba ne-potassium eyanele ezicutshini, izinga layo esegazini lizoqala ukwanda.

Ukuhlelwa ngokwejwayelekile kwe-acidity yegazi

Ezimweni eziningi, i-acidity ephezulu yegazi iyaqedwa lapho ilwa ne-hyperglycemia kanye nokuphelelwa ngamandla komzimba: i-insulin ivimba ukukhiqizwa kwama-ketones, futhi inani elikhulayo lamanzi likuvumela ukuba uwasuse ngokushesha emzimbeni ngomchamo.

Igazi le-alkalizing alinconywa ngenxa yezizathu ezilandelayo:

• ukuntuleka kwe-potassium ne-calcium;
• i-insulin yehlisa ijubane, ama-ketones aqhubeka ukwakha;
• umfutho wegazi uyancipha;
• ukukhuphuka kwendlala komoya ophuma izicubu;
• ukwanda okungenzeka kwezinga le-acetone ku-cerebrospinal fluid.

Ngenxa yezizathu ezifanayo, iziphuzo ze-alkaline ngesimo samaminerali noma isixazululo se-baking soda azisabekelwa iziguli ezine-ketoacidosis. Futhi kuphela uma kuthiwa i-ketoacidosis yesifo sikashukela ikhulunyiwe, i-acidity acid ingaphansi kwe-7, futhi ama-bicarbonates egazi anciphile aze afinyelela ku-5 mmol / l, ukuphathwa kwe-intravenous kwe-soda ngendlela yesisombululo esikhethekile se-sodium bicarbonate yama-droppers asetshenziswayo.

Imiphumela yesifo

Imiphumela ye-ketoacidosis yesifo sikashukela iwukulimala kuzo zonke izinhlelo zomzimba, kusukela ezinsobeni kuya emithanjeni yegazi. Ukuzibuyisela, uzodinga isikhathi eside, lapho udinga ukugcina ushukela ujwayelekile.

Izinkinga ezivame kakhulu:

• isizungu,
• ukuphazamiseka kokujikeleza ezingalweni nasezitho zomzimba,
• ukwehluleka kwezinso
• ukwehla okunamandla kwengcindezi,
• ukulimala kwemisipha yenhliziyo,
• ukuthuthukiswa kwezifo ezinzima.

Umphumela omubi kakhulu yi-coma enzima, okuholela ku-edema yamakhemikhali, ukuboshwa kokuphefumula kanye nokushaya kwenhliziyo. Ngaphambi kokuqalwa kwe-insulin, i-ketoacidosis kushukela sikashukela njalo yayisho ukufa okuseduze. Manje izinga lokufa elivela ekubonakalisweni kwe-ketoacidosis lifinyelela ku-10%, ezinganeni ezinesifo sikashukela lesi yisona sizathu esivamile sokudlula emhlabeni. Futhi ukuphuma egunjini ngenxa yemizamo yodokotela akusho ngaso sonke isikhathi imiphumela ephumelelayo. Ngenxa ye-edema yamakhemikhali, eminye yemisebenzi yomzimba ilahleka ngokungenakulungiswa, kuze kube yilapho isiguli siguqukela esimweni sesitshalo.

Lesi sifo asisihlobo oluhlangene nesifo sikashukela ngisho nokuqedwa ngokuphelele kokukhiqizwa kwe-insulin. Ukusetshenziswa okunekhono kwezidakamizwa zesimanje kunganciphisa ubungozi be-ketoacidosis ku-zero futhi kunciphise ezinye izinkinga eziningi zesifo sikashukela.