So wowɔ asikreyare? Anaasɛ wo maame, wo papa, anaa obi foforo a ɔwɔ w’abusua mu wɔ asikreyare? Ɛnde saa asɛmti a yɛreka ho asɛm nnɛ yi bɛyɛ nea ɛho hia wo paa. Asikreyare yɛ tebea a wobetumi adi ho dwuma yiye, na wubetumi abɔ bra sɛnea ɛsɛ. Nanso, sɛ wɔanhwɛ so yiye a, ebetumi de nneɛma a egye ntɛmpɛ a emu yɛ den a ebetumi de nkwa mpo ato asiane mu aba. Ɛno ne ntɛmpɛ a asiane wom sen biara a yɛreka ho asɛm nnɛ. Wɔfrɛ eyi Hyperosmolar Hyperglycemic State , a yɛfrɛ no HHS tiawa no.

Sɛ yɛbɛka no tiawa a, dɛn ne HHS?

Okay, momma yɛnka eyi tiawa koraa. Fa no sɛ asikre dodow a ɛwɔ wo mogya mu (mogya mu glucose) kɔ soro araa ma ɛrentumi nyɛ yiye sɛ wubedi so. Sɛ asikre dodow a ɛwɔ wo mogya mu no boro 180 mg/dL a, ɛsɛ sɛ yɛn asaabo no yi saa asikre a ɛboro so no fi nsu mu. Nanso asikre yi mfi n’ankasa mu kɛkɛ, na mmom ɛde nipadua no nsu a ɛsom bo no nso kɔ.

Afei, sɛ asikre dodow a ɛwɔ wo mogya mu no kɔ soro kɛse, te sɛ 600 mg/dL, na ɛtra hɔ saa nna pii, ebia adapɛn pii a, dɛn na ɛba? Wofi ase tow wo ho dodo, na wo nipadua mu nsu ho tew kɛse. Bere a nsu dodow a ɛwɔ wo nipadua mu no so tew no, wo mogya no mu yɛ den nkakrankakra. Te sɛ bere a yɛyɛ ɛwo no, nsu yɛ den. Wɔ aduruyɛ mu no, yɛfrɛ eyi a ɛma mogya no mu yɛ den hyperosmolarity .

Enti, HHS yɛ ntɛmpɛ a ɛde nkwa to asiane mu a ɛba bere a nneɛma abiɛsa yi bom no: asikre dodow a ɛkɔ soro yiye wɔ mogya mu (hyperglycemia) , nsu a ɛtɔ kɛse , ne hyperosmolarity. Wohu tebea yi titiriw wɔ nnipa a wɔwɔ Asikreyare a Ɛto so Abien so. Eyi yɛ tebea a ɛhwehwɛ sɛ wɔde obi kɔ ayaresabea ntɛm ara na wɔsa no yare. Sɛ wɔansa a, ebetumi ama obi awu mpo.

HHS ne DKA: Nsonsonoe bɛn na ɛwɔ abien no ntam?

Ahobammɔ foforo a ɛyɛ hu a ebetumi aba nnipa a wɔwɔ asikreyare so ne DKA (Diabetic Ketoacidosis). Bere a HHS ne DKA nyinaa yɛ tebea horow a ɛde nkwa to asiane mu a asikre a ɛkɔ soro wɔ mogya mu de ba no, nsonsonoe a ɛda adi pefee wɔ abien no ntam. Ɛho hia sɛ wuhu nsonsonoe yi.

• DKA (Diabetic Ketoacidosis): Eyi ba nnipa a wɔwɔ Asikreyare a Ɛto so 1 so titiriw. Nea ɛkɔ so wɔ ha ne sɛ ɛkame ayɛ sɛ nipadua no nni insulin hormone biara. Esiane sɛ insulin nni nipadua no mu nti, nipadua no mu nkwammoaa ntumi mfa asikre nyɛ ahoɔden. Afei nipadua no kɔ ɔkwan foforo so kɔhwehwɛ ahoɔden. Ɛne sɛ, denam srade a ɛwɔ nipadua no mu a wɔhyew so. Sɛ wɔhyew srade wɔ saa kwan yi so a, wɔde nnuru bi a wɔfrɛ no ketones ka mogya no ho sɛ ade a ɛka ho. Saa ketones yi yɛ acid. Sɛ ketones dɔɔso wɔ mogya no mu a, mogya no yɛ acidic. Eyi ne ade a asiane wom sen biara wɔ DKA ho.

• HHS (Hyperosmolar Asikre a Ɛkɔ So Tebea):Eyi ba nnipa a wɔwɔ asikreyare a ɛto so abien so titiriw. Ɛha yi, insulin kakraa bi na ɛwɔ nipadua no mu. Esiane saa insulin kakraa bi no nti, nipadua no hyew srade na esiw ketones ano. Enti, mogya no nnyɛ acid wɔ HHS mu. Nanso ɔhaw titiriw a ɛwɔ ha ne asikre dodow a ɛkɔ soro a wontumi nni so ne mogya no mu nsu a ɛtɔ kɛse na ɛyɛ den a efi mu ba no.

Momma yɛnhwɛ saa pon yi na yɛama nsonsonoe yi mu ada hɔ bio.

Dɛn ne HHS ho sɛnkyerɛnne ahorow? Hwɛ yiye wɔ eyinom ho!

Ade a ɛyɛ hu sen biara wɔ HHS ho ne sɛ yare no ho sɛnkyerɛnne no nna adi prɛko pɛ . Wonyin nkakrankakra, nna anaa adapɛn pii mu. Enti ebia obi renhu kosi sɛ ɛbɛyɛ aniberesɛm kɛse. Ɛno nti na ɛho hia sɛ wohu saa sɛnkyerɛnne ahorow yi.

• Asikre dodow a ɛkɔ soro kɛse wɔ mogya mu: Ofie glucose mita akenkan a ɛboro 600 mg/dL (anaasɛ 33 mmol/L) koraa.
• Adwene mu basaayɛ: Nhumu a ɛyera, ontumi mfa n’adwene nsi biribi so, kasa mu adwene a ɛyɛ basaa, bere, beae, ne nnipa a wonim no a wɔhwere.
• Nneɛma a enni hɔ a wuhu anaa wote (Hallucinations): Yebetumi aka sɛ wuhu anaa wote nneɛma a enni hɔ ankasa.
• Nhumu a ɛyera: Wɔ tebea horow a emu yɛ den mu no, coma betumi aba.
• Ano, tɛkrɛma a ɛyow, ne sukɔm a ɛtra so: Nkate a ɛkyerɛ sɛ sukɔm de wo a ɛmfa ho sɛ wobɛnom nsu dodow biara.
• Nsu a wotaa tow: Ɛwom sɛ ebia mfiase no wobɛtow wo ho dodo de, nanso ebia woretow nsu pii bere a nsu a ɛho ayɛ wo hyew no mu yɛ den no.
• Anisoadehu a ɛyɛ kusuu anaa aniwa a ɛyera: Etumi hu ade nkakrankakra.
• Nipadua mu mmerɛwyɛ: Ɛyɛ mmerɛwyɛ ho nkate wɔ nipadua no mu. Ɛtɔ mmere bi a, nipadua no fã biako betumi abubu, te sɛ nea akisikuru.

Dɛn nti na HHS tebea yi ba? Dɛn ne nneɛma atitiriw a ɛde ba?

Obi a ɔwɔ asikreyare a wotumi di so yiye no ntaa nnya HHS. Nanso, wɔ obi a wontumi nni ne asikreyare so yiye fam no, tebea yi betumi aba esiane "ade bi a ɛkanyan" nti. Ɛne sɛ, adeyɛ bi betumi ama asikre dodow a ɛwɔ mogya mu no akɔ soro dodo sɛ wobetumi adi so, na ɛde HHS aba.

Nneɛma atitiriw a ɛkanyan HHS ne:

• Nyarewa: Nnipa a wonya HHS no mu 50% kosi 60% wɔ ɔyare mmoawa bi. Ne titiriw no, ahurututu mu yare , nsu mu yare (UTI ), ne sepsis .) ɔyare mmoawa ne nea ɛwɔ hɔ titiriw. Fa no sɛ ɛna bi a ne mfe akɔ anim wɔ asikreyare, onya koko mu yare a nsu pii wom. Adwennwen a ɔyare mmoawa yi de ba no betumi ama asikre dodow a ɛwɔ mogya mu akɔ soro akodu baabi a wontumi nni so.
• Asikreyare aduru a worennom sɛnea wɔakyerɛw ama wo no: Eyi nso yɛ ade a ɛtaa ba. Nnipa binom mfono wɔn na wogyae wɔn nnuru nom, anaasɛ wɔnnom no bere ano. Sɛ wofa insulin a, sɛ woannom no yiye a, asikre dodow a ɛwɔ wo mogya mu no betumi akɔ soro wɔ ɔkwan a ɛyɛ hu so.
• Nnuru afoforo: Nnuru bi te sɛ corticosteroids (a wɔde sa ayamtu ne ntini mu yare), thiazide diuretics (a wɔde sa mogya mmoroso), ne nnuru bi a wɔde sa adwenemyare nso betumi ama asikre a ɛwɔ mogya mu akɔ soro na ɛde HHS aba.
• Koma ne ntini mu nsɛm a egye ntɛmpɛ: Wɔ asɛm a anibere wom te sɛ ɔyare a ɛma obi hwe ase , komayare , anaa ahurututu mu ntini a ɛma mogya tu mu no, nipadua no wɔ adwennwen kɛse mu. Adwennwen hormone ahorow a nipadua no yi fi adi saa bere yi betumi ama asikre dodow a ɛwɔ mogya mu no akɔ soro mpofirim.

Hena na ɔwɔ asiane kɛse mu sɛ obenya HHS?

Sɛnea yɛadi kan aka no, sɛ wodi asikreyare so yiye a, asiane yi sua. Nanso, nnipa a wodi so yi wɔ asiane kɛse mu sɛ wobenya HHS:

• Nnipa a wontumi nni asikreyare so yiye.
• Mpanyimfo a wɔadi boro mfe 65: Bere a wɔrenyin no, tumi a wotumi te sukɔm nka no so betumi atew, enti ebia wɔrenhu sɛ nsu atɔ wɔn.
• Wɔn a wɔwɔ nyarewa afoforo (yare mmoawa, yare) anaa komayare.

Nsɛnnennen bɛn na ebetumi aba esiane HHS nti?

Sɛ wɔansa HHS wɔ bere ano a, ebetumi de nsɛnnennen a emu yɛ den yiye aba.

• Akisikuru a ɛma obi ho kyere no
• Coma
• Akwaa a entumi nyɛ adwuma yiye
• Owuo

Nnipa a wonya HHS no mu 10% kosi 20% wuwu. Ɛno kyerɛ sɛ nnipa 10 biara mu biako anaa baanu bewuwu. Saa na tebea yi yɛ aniberesɛm.

Ɔkwan bɛn so na wohu HHS na wɔsa wɔ ayaresabea?

Sɛ wɔde wo kɔ Emergency Department (ETU) a, oduruyɛfo bi bɛhwɛ wo na wabisa wo sɛnkyerɛnne ahorow ho asɛm. Afei, wɔbɛhyɛ sɛ wɔnyɛ mogya mu nhwehwɛmu mpɛn pii. Eyinom bɛhwɛ asikre dodow a ɛwɔ wo mogya mu , mogya mu osmolality, asaabo dwumadi, ne sɛ ebia ketones wɔ wo mogya mu anaa.

Sɛ asikre dodow a ɛwɔ mogya mu no boro 600 mg/dL koraa na mogya mu ketone dodow sua a, wohu sɛ ɛyɛ HHS.

Ayaresa no hwehwɛ sɛ wɔde wo bɛto ayaresabea anaa baabi a wɔhwɛ wɔn a wɔyare denneennen (ICU) na wɔama wo nsu a wɔde fa IV mu.

Botae atitiriw abiɛsa na ɛwɔ ayaresa mu:

1. Nsu a wɔsan de ma: Wɔde nkyene fa ntini mu na ama nsu a ɛho ayɛ fĩ no afi hɔ.

2. Electrolytes a Ɛkari pɛ: Sɛ nsu fi nipadua no mu a, nneɛma a ɛsom bo pii te sɛ potassium yera fi nipadua no mu. Wɔnam nkyene so na ɛsesa wɔn.

3. Asikre dodow a ɛwɔ mogya mu a wɔbɛhwɛ so: Wɔde insulin fa ntini mu na ama asikre dodow a ɛwɔ mogya mu no so atew nkakrankakra na wɔahyɛ so.

Wɔ saa ayaresa ahorow yi akyi no, sɛ ɔyare mmoawa bi a ɛda adi a ɛde HHS tebea no bae wɔ hɔ a, wɔsa ɛno nso.

So nsɛnnennen betumi aba bere a wɔreyɛ ayaresa no?

Yiw, ɛwom sɛ ɛntaa nsi koraa de, nanso nsɛnnennen betumi afi ayaresa mu aba. Ɛne sɛ, sɛ asikre dodow a ɛwɔ mogya mu no so tew mpofirim na ɛyɛ ntɛmntɛm a, nsu betumi ahyɛ amemene mu nkwammoaa ma mpofirim na amemene no ahonhon (amemene mu akisikuru). Nanso eyi ho yɛ na koraa. Nnuruyɛfo nim sɛnea wɔtew asikre dodow a ɛwɔ mogya mu no so dwoodwoo na wɔde nkakrankakra. Enti ɛho nhia sɛ wohaw wo ho wɔ ho.

Ɔkwan bɛn so na wobɛbɔ wo ho ban afi HHS ho?

Ɔkwan a eye sen biara ne ɔkwan biako pɛ a wobɛfa so akwati tebea a asiane wom yi ne sɛ wubedi wo asikreyare no ho dwuma yiye. Sɛ wobɛyɛ eyi a, hwɛ hu sɛ wobɛyɛ saa nneɛma yi.

• Hwɛ asikre dodow a ɛwɔ wo mogya mu daa na bɔ mmɔden sɛ wobɛma akɔ so ayɛ nea wo duruyɛfo de ama wo no.
• Nom nnuru (aduru anaa insulin) a wo duruyɛfo akyerɛw ama wo no wɔ bere a ɛfata mu ne dodow a ɛfata mu, a wompa da koro mpo.
• Sɛ ɛyɛ den ma wo sɛ wubedi wo asikreyare so a, wo ne wo duruyɛfo nka ho asɛm na nya afotu a ɛho hia.
• Di aduan pa a ɛfata wo akyi.
• Sɛ wowɔ yare bi te sɛ atiridii anaa atiridii a, hwɛ yiye kɛse. Nom nsu pii, gye w’ahome pii, na hwɛ asikre a ɛwɔ wo mogya mu mpɛn pii sen sɛnea wotaa yɛ no. Eyi te saa efisɛ adwennwen a ɛba wo nipadua so bere a woyare no betumi ama asikre a ɛwɔ wo mogya mu no akɔ soro.
• Hu HHS ho sɛnkyerɛnne ahorow no yiye. Sɛ wuhu saa sɛnkyerɛnne ahorow yi bi a, yɛ ho biribi ntɛm ara.