Ðe míenya nu tso Suklidɔ si Do ƒome kple Coma ŋu nyuiea?

Ðewohĩ àɖo ŋku ame aɖe si ŋu suklidɔ le, ɖewohĩ wò ƒometɔ alo xɔlɔ̃ aɖe dzi. Ɣeaɖewoɣi la, míese be ame siawo tɔgbi ƒe tagbɔ buna zi ɖeka, womete ŋu ƒoa nu o, eye ɣeaɖewoɣi wodzea anyi. Le nyateƒe me la, esia nye nɔnɔme si me afɔku le ŋutɔ eye wòdea ame ƒe agbe afɔku me. Esia tae, egbea míesusu be míaƒo nu tso nɔnɔme sia si ate ŋu atso suklidɔ gbɔ, alo abe alesi ɖɔktawo yɔnae ene la, `(Diabetes-Related Coma)`. Esia nyanya nyuie akpe ɖe mía ŋu míalé be na míaƒe ame veviwo.

Nukae Nye Suklidɔ Si Do Ƒome Kplii? Kpuie ko la,...

Kpuie ko la, suklidɔ ƒe alɔ̃madɔmadɔ nye nɔnɔme sesẽ aɖe si ate ŋu ade ame ƒe agbe afɔku me, si dzɔna ne míaƒe ʋumesukli ƒe agbɔsɔsɔ dzi ɖe edzi zi ɖeka (suklidɔ ƒe agbɔsɔsɔ si sɔ gbɔ akpa) alo ɖiɖi akpa (suklidɔ ƒe agbɔsɔsɔ si mede ame dzi o). "Coma" nye nɔnɔme si me ame ƒe manyamanya keŋkeŋ, abe alɔ̃dɔdɔ vevie ene, eye nuƒoƒo mete ŋu nyɔa ame o. Ke hã, wogakpɔtɔ le agbe togbɔ be woƒe susu megale dɔ wɔm o hã. Esia nye nɔnɔme si hiã be woakpɔ egbɔ kpata.

Susu vevi etɔ̃ tae afɔku le nɔnɔme sia me ɖo.

Mɔ vevi etɔ̃ li siwo dzi suklidɔ le ate ŋu ato adze alɔ̃ me. Mina míalé ŋku ɖe nusiwo wonye ŋu:

1. Suklidɔ ƒe Nɔnɔme si Me Suklidɔ Le (HHS) .

2. Ketoacidosis si Do Ƒome Kple Suklidɔ (DKA) .

3. Suklidɔ ƒe dzidziɖedzi sesẽ

Azɔ mina míaƒo nu tso esiawo dometɔ ɖesiaɖe ŋu tsitotsito vie, enyoa?

1. Nukae nye Hyperosmolar Hyperglycemic State (HHS)?

Nɔnɔme sia si woyɔna be HHS la bɔ ɖe amesiwo ŋu Suklidɔ Ƒomevi 2 le wu. Edzɔna ne wò ʋumesukli (glucose) sɔ gbɔ ŋutɔ (zi geɖe la, ewu 600 mg/dL) ɣeyiɣi didi aɖe. Esia ate ŋu ana tsi nabu le wò ŋutilã me fũ akpa, si ana tsi natsi le ŋuwò vevie, nàtɔtɔ, eye wòadze dzesi bubuwo. Ne womewɔ atike nɛ kaba o la, ate ŋu ana ame natsi alɔ̃ me.

2. Nukae Nye Ketoacidosis (DKA) si Do Ƒome Kple Suklidɔ?

Nɔnɔme aɖe si woyɔna be ``DKA'' hã nye ame ƒe agbe afɔku. Edzea amesiwo ŋu ``Suklidɔ Ƒomevi 1'' le dzi wu (ateŋu adze amesiwo ŋu wòle xoxo, kpakple amesiwo menya be ele yewo ŋu o). Gake ate ŋu adze amesiwo ŋu Suklidɔ Ƒomevi 2 le hã dzi ɣeaɖewoɣi.

DKA dzɔna ne insulin mesɔ gbɔ na wò ŋutilã o (eɖanye dzɔdzɔme tɔ alo esi woxɔ tso egodo o). Abe alesi nènyae ene la, insulin hiã vevie be sukli si le míaƒe ʋu me, si nye sukli, nate ŋu age ɖe míaƒe lãmenugbagbeviwo me eye wòazãe hena ŋusẽdodo. Eyata ne insulin bu alo mesɔ gbɔ o la, ŋutilãa dzea ami mama gɔme hena ŋusẽkpɔkpɔ. Ne ami gbã la, atike siwo woyɔna be ketones dona ɖe ʋua me.

Ne `(ketones)` ƒe agbɔsɔsɔ le suklidɔléla ƒe ŋutilã me dzi ɖe edzi la, ʋua va zua `(acidic) vivivi.` Ne womewɔ atike na esia le ɣeyiɣi nyuitɔ dzi o la, alɔ̃madɔmadɔ ateŋu adzɔ. Zi geɖe la, sukli si le amesi ŋu `(DKA)` le ƒe ʋu me sɔ gbɔ wu 250 mg/dL. Gake ɖo ŋku edzi be nu vevitɔ si gbɔ `(DKA)` tsonae nye `(insulin)` ƒe anyimanɔmanɔ kple `(ketones)` ƒe dzidziɖedzi, ke menye ʋumesukli ɖeɖeko o. Suklidɔléla aɖewo ateŋu ato `(DKA)` me ne woƒe sukli sɔ gbɔ wu 250 mg/dL gɔ̃ hã.

3. Nukae nye suklidɔ sesẽ?

Esiae nye susu etɔ̃lia. Ne sukli ƒe agbɔsɔsɔ le ʋu me ɖiɖi wu 40 mg/dL la, wobua eŋu be enye ``suklidɔ ƒe agbɔsɔsɔ si mede ame dzi o`` ƒe nɔnɔme sesẽ aɖe. Esia hã nye afɔku gã aɖe na agbe.

Mienya, ŋusẽtsoƒe vevitɔ na míaƒe ŋutilã kple vevietɔ ahɔhɔ̃ enye `(glucose)`. Eyata ne sukli ƒe agbɔsɔsɔ le ʋu me dzi ɖe kpɔtɔ la, ŋutilãa mete ŋu wɔa dɔ nyuie o. Ne sukli ƒe agbɔsɔsɔ ɖiɖi wu 40 mg/dL, abe alesi míegblɔe ene la, àte ŋu akpɔ tɔtrɔ le wò ŋutilã kple susu me, si ana màte ŋu awɔ naneke o. Ne womeda `(hypoglycemia)` nɔnɔme sesẽ sia ɣeyiɣi didi o la, àte ŋu ayi alɔ̃ me.

Suklidɔ ƒe nɔnɔme sesẽ sia bɔ ɖe amesiwo noa insulin na suklidɔ alo suklidɔtike ƒomevi aɖewo abe sulfonylureas ene ŋu wu.

Nukae nye suklidɔ ƒe alɔ̃madɔmadɔ ƒe dzesiwo? Aleke míewɔna dea dzesii?

Nɔnɔme vevi etɔ̃e le alɔ̃madɔmadɔ ŋu:

• Numakpɔmakpɔ: Ðeko wòle abe alɔ̃ dɔm vevie ŋutɔ ene. Aleke kee nèɖaƒo nu o, esesẽna ŋutɔ, manya wɔ kloe be nyɔ wò o.
• Ŋku ƒe ŋuɖoɖo ƒe anyimanɔmanɔ: Ŋkuawo gakpɔtɔ le ʋuʋu. Womeɖoa eŋu ne ame aɖe ʋu ŋku o. Gake ɣeaɖewoɣi la, ŋkuwo ƒe ŋuɖoɖo aɖewo ate ŋu anɔ nuwo abe kekeli ene ŋu.
• Dɔwɔnu ƒe dɔwɔwɔ ƒe anyimanɔmanɔ: Ʋuʋu le susu me aɖeke meli o. Gake reflex ƒe ʋuʋu aɖewo ate ŋu anɔ anyi.

Azɔ mina míakpɔ nusiwo nye dzesi siwo dzena hafi yia kɔma me le `(DKA)`, `(HHS)` kple `(hypoglycemia)` nɔnɔme sesẽ siwo míeyɔ va yi me. Ne ède dzesi nusiawo kaba la, àte ŋu aƒo asa na afɔku gã aɖe.

Dzesi siwo doa ŋgɔ na alɔ̃madɔmadɔ le DKA me:

• Aɖuɖɔtoe kple ʋuʋudedi.
• Dɔgbo ƒe vevesese.
• Gbɔgbɔ kabakaba, si de to (ɖɔktawo yɔa esia be ``Kussmaul gbɔgbɔ''). Ate ŋu anɔ ɣeyiɣi ɖeka me.
• Atikutsetse ƒe ʋeʋẽ aɖe le gbɔgbɔa dzi.
• Sese le eɖokui me be ɖeɖi te ye ŋu ŋutɔ eye yegbɔdzɔ.
• Sese le eɖokui me be yeƒe susu tɔtɔ alo tɔtɔ, abe ɖe ame ƒe susu tɔtɔ ene.
• Ŋudzɔnɔnɔ dzi ɖe kpɔtɔ.

Dzesi siwo doa ŋgɔ na coma le `(HHS)` nɔnɔme me:

• Susu me tɔtrɔwo: tɔtɔ, tagbɔdɔ, susumenuwo kpɔkpɔ.
• Ðeko wòle abe ɖe nèle susu bu ge ene.
• Nu me ƒuƒu kple tsikɔwuame si gbɔ eme (polydipsia).
• Aɖuɖɔɖɔɖɔ enuenu.
• Nukpɔkpɔ si me kɔ o alo nukpɔkpɔ ƒe bu.
• Ʋuʋudedi, ɣeaɖewoɣi wu le ŋutilã ƒe akpa ɖeka.

Dzesi siwo doa ŋgɔ na alɔ̃madɔmadɔ le suklidɔ sesẽ me dometɔ aɖewoe nye:

• Nukpɔkpɔ si me mekɔ o alo nukpɔkpɔ eve.
• Nyawo ƒe tsakatsaka ne wole nu ƒom.
• Dadasɔ ƒe bubu kple nuwo wɔwɔ sesẽ na wò.
• Nu ƒe susu ƒe tɔtɔ.
• Alɔ̃madɔmadɔ le abe alɔ̃madɔmadɔ ene.

Ne ède dzesi dzesi siawo dometɔ aɖe la, mègaŋe aɖaba ƒu wo dzi o. Anyo wu be nàdi atikewɔlawo ƒe aɖaŋuɖoɖo enumake.

Nukae míewɔna ne ame aɖe ƒe tagbɔ gblẽ le suklidɔ ta? (Kpekpeɖeŋunana gbãtɔ) .

Tsɔe be kasia ame aɖe ƒe tagbɔ gblẽ le suklidɔ ta le miaƒe nutoa me. Nu ʋɛ aɖewo li nàte ŋu awɔ:

• Ƒo ka na 1990 enumake eye nàxɔ dɔnɔdzikpɔʋu. Ne ènya be suklidɔ le amea ŋu la, gblɔ nya ma na ƒe 1990 dɔwɔla la hã.
• Mègana naneke wo woaɖu alo ano nu o. Woate ŋu aƒo nu.
• Trɔ amea ɖe woƒe axadzi nyuie ale be aɖuɖɔ alo ʋuʋudedi nagaxe yaƒoƒomɔ̃a o.
• Vaseɖe esime dɔnɔdzikpɔʋua nava la, wɔ ɖe mɔfiame siwo ƒe 1990 dɔwɔla la na dzi.

Ne wowɔ esia nyuie la, esia ate ŋu akpe ɖe ame ma ƒe agbe ɖeɖe ŋu ŋutɔ.

Nukatae suklidɔ nana ame ƒe susu meganɔa agbe alea gbegbe ɖo? (Susuawo le bɔbɔe)

Abe alesi míedzro eme va yi ene la, nu vevi etɔ̃e na suklidɔ ƒe alɔ̃madɔmadɔ, alo? Woawoe nye:

• Hyperosmolar suklidɔ ƒe nɔnɔme `(HHS)`.
• Suklidɔ ƒe ketoacidosis (DKA) ƒe dɔléle.
• Suklidɔ ƒe ɖiɖi sesẽ (sukli si le ʋu me si bɔbɔ ŋutɔ).

HHS kple DKA siaa nye nɔnɔme siwo me tsi ƒe agbɔsɔsɔ si le ŋutilãa me dzi ɖena kpɔtɔna ŋutɔ, si wɔnɛ be tsi vɔna le ame ŋu vevie. Tsikuɖiɖi sia ate ŋu ana ame natsi alɔ̃ me.

Le go bubu me la, le suklidɔ sesẽ me la, ahɔhɔ̃a mekpɔa sukli (sukli) agbɔsɔsɔme si wòhiã o. Sukli hiã vevie hafi ahɔhɔ̃a nate ŋu awɔ dɔ nyuie. Ne edzo la, ahɔhɔ̃a "tsia" eye àte ŋu ayi alɔ̃ me. Èse nya ma gɔmea?

Amekawoe ate ŋu axɔ suklidɔ ƒe alɔ̃madɔmadɔ?

Amesiame si ŋu suklidɔ le (amesiwo ŋu womekpɔ suklidɔ le o gɔ̃ hã) ate ŋu axɔ suklidɔ ƒe alɔ̃madɔmadɔ. Gake afɔku sia toa vovo vie le suklidɔ ƒe ƒomevi nu:

• Amesiwo ŋu Suklidɔ Ƒomevi 1 le la le afɔku gã aɖe me be woayi alɔ̃ me, eɖanye tso DKA alo suklidɔ si nu sẽ ŋutɔ gbɔ. Esia le alea elabena amesiwo ŋu Suklidɔ Ƒomevi 1 le hiã insulin ɣesiaɣi eye woƒe ʋumesukli ƒe agbɔsɔsɔ nɔa tɔtrɔm wu amesiwo ŋu Suklidɔ Ƒomevi 2 le.
• Amesiwo ŋu Suklidɔ Ƒomevi 2 le la ate ŋu ayi alɔ̃ me le HHS ta wu DKA alo suklidɔ si nu sẽ ŋutɔ.

Nukawoe nye afɔku bubu siwo ate ŋu ado tso eme?

Tsɔ kpe ɖe nu siawo ŋu la, nu bubu aɖewo ate ŋu ana suklidɔ ƒe alɔ̃madɔmadɔ ƒe afɔkua nadzi ɖe edzi:

• Dɔléle bubuwo xɔxɔ.
• Wole amekoko wɔm nɛ.
• Ŋutilã me abixɔxɔ (Trauma).
• Kuxi siwo le insulin nana ƒe ɖoɖoa ŋu (e.g., insulin pen, pɔmpi ƒe dɔmawɔmawɔ nyuie).
• Insulin ŋɔŋlɔ be, edzo, alo nono fũu akpa.
• Suklidɔ dzi kpɔkpɔ nyuie o (e.g. sukli ƒe agbɔsɔsɔ si le ʋu me me léle kpɔ gbesiagbe o, atikewo nono nyuie).
• `(Hypoglycemia unawareness)` (si fia be womenya dzesi gbãtɔ siwo fia be sukli le ʋu me o).
• Ahanono nono.
• Atike vɔ̃ɖiwo zazã.

Aleke ɖɔktawo wɔa anya suklidɔ ƒe alɔ̃madɔmadɔ nyuie?

Suklidɔ ƒe alɔ̃madɔmadɔ nye atikewɔwɔ kpata si hiã be woawɔ atike nɛ enumake. Amesiame si le alɔ̃ me la hiã be woaxɔe ɖe kɔdzi.

Zi geɖe la, ɖɔktawo ate ŋu anya suklidɔ ƒe alɔ̃madɔmadɔ kaba ne woxɔ wò atikewɔwɔ ŋutinya, lé ŋku ɖe sukli ƒe agbɔsɔsɔ si le ʋu me ŋu (ʋumesukli ƒe dodokpɔ), kple dodokpɔ bubuwo wɔwɔ be woakpɔ ketones kple wò lãmesẽ bliboa ɖa.

Esia tae wòle vevie be suklidɔlélawo nado asigɛ alo kɔgɛ si naa atikewɔwɔ ŋuti nuxlɔ̃ame. Ne nu kpata aɖe dzɔ la, ɖɔktawo ate ŋu akpɔe ahawɔ nyametsotsowo kaba. Ele vevie hã be nàna wò ƒometɔwo, xɔlɔ̃wo, kple dɔwɔhatiwo nanya be suklidɔ le ŋuwò. To mɔ sia dzi la, wonya nusi woawɔ ne nɔnɔme kpata aɖe dzɔ.

Aleke nèdaa suklidɔ ƒe alɔ̃madɔmadɔe?

Suklidɔ ƒe alɔ̃madɔmadɔ ƒe atikewɔwɔ toa vovo le nusi gbɔ wòtso nu , gake kɔdziyiyi hiã ɣesiaɣi.

Atikewɔwɔ na alɔ̃madɔmadɔ si `(DKA)` alo `(HHS) hena vɛ:

• IV-tsi: Wotsɔa esiawo naa tsikuɖiɖi kple elektrikŋusẽ ƒe masɔmasɔwo.
• Insulin: Atikewɔlawo ƒe ƒuƒoƒoa ate ŋu ana insulin wò to ʋumenugbagbeviɣidɔ me alo abe atike si wodona ɖe ŋutigbalẽ te ene.
• Dɔdamɔnu bubuwo: Woate ŋu awɔ atike bubuwo be wòakpe ɖe ŋuwò nàhaya. Esiawo ate ŋu anye atikewɔwɔ alo dɔlékui ɖesiaɖe si ate ŋu ana sukli nasɔ gbɔ ɖe wò ʋu me la dada.

Atikewɔwɔ na alɔ̃madɔmadɔ si suklidɔ sesẽ hena vɛ:

• Glucagon si wozãna kpata:Esia nye lãmetsi si nye glucagon ƒe ƒomevi aɖe si wowɔ. Ame vevi aɖe alo ɖɔkta ate ŋu anae abe atike si wodona ɖe lãme na ame ene alo abe atike si woatsɔ aƒu gbe ɖe ŋɔti me ene (le eƒe ƒomevi nu). Glucagon si wowɔ la wɔa dɔ to sukli si wodzra ɖo ɖe aklã me la ɖeɖeɖa me, si wɔnɛ be sukli ƒe agbɔsɔsɔ le ʋu me dzina ɖe edzi.

Vevietɔ wu: Ne ame aɖe si te ɖe ŋuwò na `(glucagon)` wò hã la, èhiã kɔdziyiyi godoo. Ele be woana `(glucagon)` wò eye nàƒo ka na 1990 enumake.

Ne kuxi bubuwo do mo ɖa, abe ŋutinuwo ƒe dɔmawɔmawɔ nyuie ene la, woate ŋu ahiã atikewɔwɔ bubuwo hã.

Nukae míate ŋu awɔ atsɔ axe mɔ ɖe suklidɔ ƒe alɔ̃madɔmadɔ nu?

Be nàxe mɔ ɖe suklidɔ ƒe alɔ̃madɔmadɔ nu la, ele vevie be nànya nuxlɔ̃amedzesi siwo fia kaba be suklidɔ ƒe dzidziɖedzi (DKA), suklidɔ ƒe ɖiɖi (HHS), kple suklidɔ ƒe ɖiɖi. Ðo dze kple wò ɖɔkta tso afɔ siwo nàte ŋu aɖe atsɔ ada nɔnɔme siawo hafi woava sesẽ ŋu.

Kpɔ ɖɔkta enumake ne:

• Ne sukli ƒe agbɔsɔsɔ le ʋu me nye 300 mg/dL alo esi wu nenema zi eve tsiã ɖe enu le susu aɖeke manɔmee.
• Ne sukli ƒe agbɔsɔsɔ si le ʋu me dzi ɖe kpɔtɔ (si mede 70 mg/dL o) eye megatrɔ va nɔ nɔnɔme nyuitɔ me le atikewɔwɔ ƒe agbagbadzedze zi etɔ̃ megbe o (e.g., sukli ƒe atikekuiwo, suklinono siwo me sukli le) la, ƒo ka na wò ɖɔkta alo 911 enumake.

Ðe ame aɖe ate ŋu atsi agbe le suklidɔ ƒe alɔ̃madɔmadɔ mea? Ðe nusiwo wògblẽna le ame ŋu ɣeyiɣi didi aɖe lia?

Ẽ, woate ŋu aƒo asa na suklidɔ ƒe alɔ̃madɔmadɔ ne woda nusi gbɔ wòtsona kaba. Ke hã, ame aɖewo hã ate ŋu agblẽ nu le woƒe ahɔhɔ̃ ŋu tegbee. Ne womewɔ atike nɛ kaba hewɔe nyuie o la, ku ate ŋu adzɔ gɔ̃ hã.

DKA ƒe ku ƒe agbɔsɔsɔme le 0.2% va ɖo 2.5% dome. Amesiwo yia alɔ̃madɔmadɔ me, woƒe ŋutilã ƒe dzoxɔxɔ medea to o (hypothermia), eye woƒe aɖuɖɔ mebɔ o (oliguria) ye nu gblẽna le wo ŋu wu.

Ame siwo ŋu HHS le la dometɔ siwo ade 20% kuna le dɔlélea ta. Amesiwo ƒe alɔ̃madɔmadɔ kple/alo ʋu ƒe sisi ɖiɖi la ƒe ŋgɔdonya menyo o.

Ɣeyiɣi didi kae nàte ŋu anɔ suklidɔ ƒe alɔ̃madɔmadɔ me?

Ɣeyiɣi didi si nàzã le suklidɔ ƒe alɔ̃madɔmadɔ me nɔ te ɖe alesi nèxɔ atike nyuitɔ kabae dzi koŋ. Mɔ ɖeka kolia si dzi nàto adzudzɔ alɔ̃madɔmadɔ aleae nye be nàna wò ʋumesukli kple insulin ƒe agbɔsɔsɔ nagaɖo afisi wòle be wòanɔ le lãmesẽ me. Atikewɔlawo ƒe kpekpeɖeŋu koe woate ŋu awɔ esia. Ame si le suklidɔ ƒe alɔ̃madɔmadɔ me la magate ŋu ƒe susu ake le eɖokui si o.

Ne ame aɖe si le alɔ̃madɔmadɔ me alea mekpɔ atike nɛ le ɣeyiɣi nyuitɔ dzi o la, anɔ eme be aku. "Le ɣeyiɣi aɖe megbe" toa vovo tso nya ɖeka gbɔ yi bubu gbɔ kple ame ɖeka gbɔ yi bubu gbɔ. Esia tae wòle vevie ŋutɔ be nàxɔ kpekpeɖeŋu kaba ale si nàte ŋui.

Kpuie ko la, nusiwo dzi wòle be míaɖo ŋkui (Take-Home Message):

Togbɔ be suklidɔ ƒe alɔ̃madɔmadɔ nye nusi me afɔku le ŋutɔ hã la, zi geɖe la, woate ŋu axe mɔ ɖe enu.

• Nu vevitɔe nye be, .Nya nu tso nuxlɔ̃amedzesi siwo nye `(DKA)`, `(HHS)` kple sukli si bɔbɔ ɖe ʋu me ŋu eye nàwɔ nu kaba ne èkpɔ wo.
• Ne nɔnɔme sia ƒe dzesiwo le ŋuwò la, yɔ wò ɖɔkta enumake.
• Suklidɔ ƒe kuxiwo dzi ŋɔ vavã, gake be woanya nu tso eŋu ahadzra ɖoe nye mɔ nyuitɔ si dzi woato axe mɔ ɖe wo nu.
• Mègahe ɖe megbe gbeɖe le nya ɖesiaɖe si le asiwò ku ɖe wò suklidɔ alo kuxi siawo dzi kpɔkpɔ ŋu biabia wò ɖɔkta o. Wò lãmesẽ xɔ asi na wò.

` Suklidɔ, Coma, DKA, HHS, Suklidɔ, Ʋumesukli, Insulin, Kpekpeɖeŋu Gbãtɔ, Suklidɔ ƒe Kuxiwo, Ŋkuɖodzi ƒe Bubu