I-Alcoholic hypoglycemia - indlela yokuthuthukisa nokuthi ungayiqeda kanjani

Ukusetshenziswa kabi kotshwala kungenye yezimbangela ezivamile ze-hypoglycemia, ikakhulukazi uma kuphuzwa utshwala esiswini esingenalutho noma ngenani elanele lokudla lekhwalithi enganele. Umphumela ofanayo uyatholakala ngokuphuza iziphuzo eziqinile ngemuva kokuthwala imithambo esebenzayo noma ikhefu elide ekudleni. Indima enqumayo idlalwa ngokuqukethwe kotshwala obungene emzimbeni nokubukeka kwayo.

I-Hypoglycemia eshukunyiswa ngokuphuza imithi nayo ivame ukwanda ngemuva kwesizinda sokudakwa kotshwala. I-Ethanol ingehlisa imitha yakho kashukela egazini ngemiphumela emibi futhi eyingozi.

Ukuthi utshwala bukhuthaza kanjani i-hypoglycemic syndrome

Ukuziphatha kwe-ethanol egazini kwegazi kuyinqaba:

• Okokuqala, kwandisa umsebenzi wamaphilisi we-insulin namaphilisi kashukela.
• Ukulimaza isibindi, i-ethanol ivimbela ukukhiqizwa kwe-glucogen - umthombo owengeziwe weglucose.
• Indlela yokusebenza yotshwala iyafana nemisebenzi ye-lipids: ukuncibilikisa amafutha, kukhulisa ukuqina kwamaseli wamafutha. Ngokusebenzisa ama-pores anwebekile wolwelwesi, ushukela ovela egazini ungena esitokisini. Lapho okuqukethwe kwawo ohlelweni lokujikeleza kwegazi kuwele, kuvela indlala ebaluleke kakhulu.

Ngaphezu kwalokho, i-ethanol ilungisa ukusebenza kwe-hormone yokukhula futhi ihlanekezela impendulo eyanele yomzimba ekuguqukeni kashukela we-plasma. Lesi ngesinye sezimbangela ezivame kakhulu ze-hypoglycemia kubantu abasebenzisa kabi utshwala, ngoba i-hormone yokukhula ilawula i-glucometer.

Ngenxa yamakhalori "angenalutho" aqukethe i-ethanol, ivimbela ukusetshenziswa kwamafutha omzimba.

Indlela yokuthuthukiswa kwe-hypoglycemia yotshwala

Abantu abanesifo sikashukela "abanokuhlangenwe nakho" okuqinile kwesifo bayazi ngamandla okwehlisa ushukela. Izinga le-glucose likhuphuka ngezindlela ezimbili: ngokudla ama-carbohydrate ngokudla nangokukhiqizwa kwe-glycogen ngesibindi. Ukuqunjelwa koshukela okuzinzile kusekela amazinga kashukela angekho ngaphansi kuka-3.3 mmol / L. Uma utshwala buvimbela i-gluconeogeneis ngokuvimba isibindi, cabanga ukuthi kwenzekani emzimbeni lapho i-glucose ingalethwa. Amathuba okuthola i-hypoglycemia aphakeme kuma-diabetesics ancike ku-insulin, ngoba ukulungisa isilinganiso sokuthi ucabangele abadakiwe akulula.

I-Ethanol ibangela i-hypoglycemia ngenxa yokuphazamiseka kwenqubo ye-gluconeogeneis ngokushintshwa kwesilinganiso se-cytosolic se-NADH2 / NAD. Ukuqhutshwa kotshwala esibindini kufakisa i-alcohol dehydrogenase. I-cofactor ye-enzyme, i-NAD (nicotinamide adenine dinucleotide) iyisakhi esibalulekile se-glucogenesis. Ukuphuza utshwala ohlelweni lokujikeleza kwegazi kubangela ukusetshenziswa okusebenzayo kwe-NAD kanye nokuvinjwa kanyekanye kokukhiqizwa kwe-glycogen ngesibindi.

Ngokusobala, i-hypoglycemia yotshwala ikhula ngokumelene nesizinda sokwehla kwezinsizakusebenza ze-glycogen, lapho amandla wesibindi e-glucogeneis ebaluleke kakhulu ekuvumelaneni noshukela ngokwejwayelekile. Engcupheni abantu abavame ukuphuza utshwala ngokudla okuncane.

Ngaphezu kokudla emzimbeni wamaseli, i-ethanol ivimbela ukumunwa kwesibindi sezinto ezibandakanyekile ekwakhekeni kwe-glycogen (lactate, alanine, glycerin). Okuqukethwe yi-alanine esegazini nakho kwehla ngenxa yokuvinjwa kokudonswa kwayo okuvela emisipha.

Ukuxilongwa kwesimo se-hypoglycemic

I-Alcoholism iyisidingo esenziwa njalo ekuthuthukisweni kwe-hypoglycemia yesigaba sezisulu ngaphandle kokuxilongwa kwesifo sikashukela i-mellitus. Ekuqaleni, izibalo ezinjalo zazilungiswa ngokungcola okuqukethe iziphuzo eziqinile zekhwalithi ephansi. Kepha ngemuva kokuhlolwa nge-ethanol emsulwa, enikezwe amavolontiya anempilo ngokuphelele ayekade ebulawa yindlala izinsuku ezimbili noma ezintathu futhi abonise imiphumela efanayo, leli phuzu lokubuka kwafanelwa ukuthi lishintshwe.

I-Alcoholic hypoglycemia ivame ukutholakala phakathi kwabathandi botshwala abangahambi bodwa ngosuku noma ezimbili. Inkinga iba khona emahoreni ayi-6- 24 ngemuva kokuthi i-ethanol ingene egazini, ngakho-ke akunangqondo ukuthola ukuhlaselwa ngephunga eliphuma emlonyeni, isifundo se-elebhu siyadingeka. Kunomlando wezimpawu ngendlela yokuhlanza okuphindaphindiwe, lokhu kukhombisa ukucasuka kohlelo lwezinzwa nesisu ngotshwala, ukuntuleka kwekhalori, lapho kuphela lezo zakhi eziqukethe i-ethanol esiswini.

Ngobungozi, njengoba engatholwa kakhulu yimiphumela ye-hypoglycemic yokuphuza utshwala:

• Ama-diabetesics ancike ku-insulin;
• Iziguli ezine-pathologies yohlelo lwe-pituitary-adrenal;
• Izingane ezinethuba lokuphuza utshwala ngengozi.

Ubungozi bokuqanjwa kanye ne-coma tabia ye-hypoglycemia ikhona ezinganeni ezingaphansi kweminyaka engu-5. Umthamo obulalayo we-ethanol emsulwa wezingane ngu-3 g / kg (kubantu abadala - 5-8 g / kg).

I-hypoglycemia ebangelwa utshwala imvamisa iphelela kokhokho. Kunzima ukuhlukanisa lesi simo kusuka kubuthi obunobungozi obukhulu.

I-Alcoholic hypoglycemia ibonakala ngezimpawu ezibalulekile zomtholampilo:

• I-Hypothermia (ngenxa ye-hypoglycemia);
• Ukuphefumula komoya omncane (onayo ne-lactic acidosis);
• Ukuqoqwa kwe-ethanol egazini kungaphansi kokujwayelekile ekudakweni kwe-acute (kufika ku-1000 mg / l);
• Izinga likashukela - lifinyelela kuma-300 mg / l (ngokwethulwa kwe-glucagon, umphumela awushintshi);
• I-insulin yegazi iphansi, kunezimpawu ze-ketonoturia;
• I-ketoacidosis yotshwala ngenxa yokuqongelelwa kwe-lactic acid.

Ukuhlolwa kwe-Hepatic kukhombisa okujwayelekile, kungenzeka ukuthola isimo kuphela ngokuya ngomlando wokuphuza utshwala okuphawulwe ku-anamnesis. Ngemuva kokubuyiselwa kwezinsizakusebenza ze-glycogen, ukuvusa utshwala akubangeli i-hypoglycemia.

I-Hypoglycemia enezimpande zotshwala incike kwimithi: lapho isisulu sithathe khona, i-glucogenesis ende iyacindezelwa. Ingozi ethile yindlela ebambezelekile ye-hypoglycemia. Uma kusihlwa athathe umthamo oqinile wotshwala, kungaba nenkinga ebusuku. Ngenxa yokuhlushwa okuncane kwe-glycogen esibindini, lesi simo sinzima ukwelapha. Ukudakwa kotshwala kunomthelela ekungazinaki izimpawu zezimbangi ze-hypoglycemia, ngakho-ke izinyathelo ezithatha isikhathi zokuziqeda azithathwa.

Ungakuqeda kanjani i-hypoglycemia yohlobo lotshwala

Ngaphandle kokuxilongwa okufika ngesikhathi kanye nokwelashwa okwanele okuphuthumayo, ukushona okukulesi simo kubonwa ku-25% wezingane kanye ne-10% yezisulu zabantu abadala.

Ngokwazisa kwe-glucagon, inkinga ebangelwa ukudakwa kotshwala ayikwazi ukuxazululwa, ngoba azisekho izinqolobane zama-glycogen, kanye nokuphendula komzimba kule hormone. Imijovo ye-glucose iyasebenza ukunciphisa amazinga e-lactate futhi ibuyise ibhalansi ye-acid-base. Ngokungafani nefomu lomthamo we-hypoglycemia, isiguli asidingi ukumiliselwa kweglucose okuqhubekayo. Ezinganeni ezinezimpawu ezinjengalezi, ziqala nge-glucose, bese kuthi i-dropper ene-glucose-electrolyte solution igcwalise lona.

Njengosizo lokuqala (uma ohlukunyeziwe) uvunyelwe ukusebenzisa ama-carbohydrate asheshayo - amaswidi, ujusi omnandi. Ukuphindelela kwe-hypoglycemia kuvinjelwa ngamanani alinganiselayo ama-carbohydrate. Amacwecwe we-glucose aqukethe inani elijwayelekile lama-carbohydrate.

Indlela enhle yokuqeda i-hypoglycemic coma ukuvimbela:

1. Isifo sikashukela kudingeka sinciphise ukuphuza utshwala.
2. I-Alcohol ayisebenzi njengendlela yokunciphisa i-glycemia.
3. Ngesibindi esinempilo, kuvunyelwe ukudla i-50 g ye-vodka ne-cognac noma i-150 mg ye wayini eyomile (umbandela oyinhloko wesiphuzo ukungabikho koshukela kanye namakhalori amancane).
4. Kwesinye isikhathi ungaphuza ubhiya - kuze kufike ku-300 g (ukulimala okuvela kuma-carbohydrate kunxephezelwa yinzuzo yomvubelo we -werwer).
5. Zonke iziphuzo ezinoshukela ezinqatshelwe - i-dessert newayini elivikelwe, utshwala, i-liqueurs, njll. Kwabesifazane abakhulelwe, akukho ukukhetha: utshwala obunqatshelwe ngokomthetho.
6. Khumbula ukuthi utshwala busika izibonakaliso ze-hypoglycemia ezayo, kufaka phakathi ukubambezeleka. Xwayisa ngezinkinga zakho kulabo abakulesi sikhathi.
7. Ukudla kotshwala kufanele kudliwe kuphela ngemuva kokudla.
8. Ngaphambi kokulala, qiniseka ukuthi ucubungula ushukela futhi udle okuthile nama-carbohydrate.
9. Lapho ubala amakhalori wokudla kwakho, cabanga ngokuqukethwe kwekalori yotshwala: 1 g amaprotheni noma ama-carbohydrate - 4 kcal, 1 g wamafutha - 9 kcal, 1 g we-ethanol - 7 kcal.
10. Yilungele iqiniso lokuthi utshwala buzokhulisa ukugcwala kwama-triglycerides, bukeke ukubonakaliswa kwezimpawu ze-neurological ku-nephropathy yesifo sikashukela.

Kwiziphuzo ezinamandla (i-40% yotshwala), umthamo wobungozi be-hypoglycemia ngu-50-75 g ngesidlakela ngendlela yamazambane namanye ama-carbohydrate. Kumawayini anezinga eliphansi le-ethanol kanye nenqwaba yama-carbohydrate (iwayini elomile, i-brut), umthamo wobungozi ngu-50-20 ml. Funda imininingwane ekulebula bese ungathatheli indawo kadokotela wakho “ngemithi” yotshwala.