Koj puas muaj mob ntshav qab zib? Tej zaum, txawm koj yuav siv zog npaum li cas los xij, noj tshuaj uas koj tus kws kho mob sau rau koj raws sijhawm, thiab tswj koj cov zaub mov noj, koj cov ntshav qab zib mam li siab dhau lossis qis dhau? Los yog lawv puas cia li qis heev? Qhov no puas cuam tshuam koj tag nrho ib hnub thiab feem ntau yuav tsum tau mus pw hauv tsev kho mob? Ces koj yuav muaj ib qho mob tshwj xeeb uas cov kws kho mob hu ua "Brittle Diabetes." Tsis txhob ntshai thaum koj hnov qhov no. Cia peb tham txog txhua yam yooj yim.
Hais yooj yim xwb, Brittle Diabetes yog dab tsi?
"Brittle Diabetes" tsis yog ib hom kab mob ntshav qab zib tshiab. Nws tsis yog ib qho kev kuaj mob raug cai. Hais yooj yim xwb, nws yog ib lub npe siv los piav txog ib qho mob ntshav qab zib uas nyuaj heev, tsis ruaj khov uas nyuaj rau tswj. Lo lus "brittle" txhais tau tias "yooj yim tawg." Thiab qhov ntawd yog qhov mob no. Cov ntshav qab zib hloov pauv sai heev.
Hauv qhov mob no, feem ntau yuav muaj cov ntshav qab zib qis (hypoglycemia) thiab cov ntshav qab zib siab (hyperglycemia). Qhov no tuaj yeem ua rau koj mus pw hauv tsev kho mob ntau zaus. Cov kws kho mob qee zaum hu qhov no tias "mob ntshav qab zib tsis zoo".
Tus mob no feem ntau tshwm sim rau cov neeg uas muaj tus kab mob ntshav qab zib hom 1. Txawm li cas los xij, nws kuj tuaj yeem tshwm sim rau cov neeg uas muaj tus kab mob ntshav qab zib hom 2, uas vam khom kev txhaj tshuaj insulin. Feem ntau, tus mob "mob ntshav qab zib brittle" no yog tshwm sim los ntawm lwm yam mob lossis teeb meem kev noj qab haus huv ntawm lub hlwb ntxiv rau tus kab mob ntshav qab zib.
Vim li cas tus kab mob ntshav qab zib thiaj nyuaj rau tswj? Yog vim li cas?
Kev tswj cov ntshav qab zib yog ib qho txheej txheem nyuaj heev. Muaj ntau yam cuam tshuam rau nws, suav nrog cov khoom noj uas peb noj, kev tawm dag zog uas peb ua, kev ntxhov siab, thiab kev hloov pauv ntawm cov tshuaj hormones. Cov neeg feem coob uas muaj ntshav qab zib kawm tswj cov no raws sijhawm. Tab sis hauv "ntshav qab zib brittle," txoj kev uas cov teebmeem no tshwm sim tsis tuaj yeem kwv yees tau. Yog vim li cas cov ntshav qab zib tuaj yeem hloov pauv sai heev.
Cov laj thawj tuaj yeem muab faib ua plaub pawg tseem ceeb:
1. Lwm yam mob nkeeg hauv lub cev.
2. Teeb meem kev noj qab haus huv ntawm lub hlwb.
3. Kev laus thiab kev nco tsis zoo.
4. Cov teeb meem Insulin thiab kev nyab xeeb ntawm cov khoom noj.
Cia peb saib txhua yam no nyias muaj nyias.
1. Muaj tej yam mob uas nyob ua ke
Qee yam kab mob ua rau lub cev hloov pauv qhov kev teb rau insulin (kev tsis kam insulin), ua rau nws nyuaj rau tswj cov ntshav qab zib.
Tej yam mob uas ua rau cov ntshav qab zib nce siab ntau zaus:
- Kev tsis sib npaug ntawm cov tshuaj hormones: Cov kab mob ntsig txog cov tshuaj hormones xws li hyperthyroidism (thyrotoxicosis), acromegaly, thiab Cushing syndrome.
- Qee qhov mob tsis tshua muaj txij thaum yug los (congenital lipodystrophies)
- Cov kab mob uas kis thoob plaws lub cev (kev kis kab mob thoob plaws lub cev).
Tej yam mob uas ua rau cov ntshav qab zib poob qis tas li:
- Gastroparesis: Qhov no yog ib qho mob uas cov khoom noj hauv plab raug xa mus rau cov hnyuv qeeb heev. Xav txog tias koj noj mov thaum sawv ntxov. Feem ntau nws siv sijhawm li ob teev los zom. Tab sis vim yog qhov mob no, koj lub plab ua haujlwm qeeb heev. Yog li txawm tias koj txhaj tshuaj insulin ua ntej noj mov, cov khoom noj zom thiab qab zib ntxiv rau hauv cov ntshav tom qab 4-5 teev. Lub sijhawm no, cov insulin tuaj yeem ua haujlwm thiab koj cov qab zib tuaj yeem qis heev (hypoglycemia). Thaum cov khoom noj zom, cov qab zib tuaj yeem nce siab heev. Koj puas pom tias nws nyuaj npaum li cas los tswj?
- Kab mob Addison: Yog tias tsis kho, tus mob no kuj tseem tuaj yeem ua rau cov ntshav qab zib poob qis ntau zaus.
- Kab mob Celiac: Kab mob no ua rau lub cev tsis nqus tau cov as-ham kom zoo, uas ua rau cov ntshav qab zib tsis ruaj khov.
Qee cov tshuaj, piv txwv li corticosteroids, kuj tuaj yeem ua rau "mob ntshav qab zib brittle" thaum siv ntev.
2. Cov mob hlwb
Tej yam uas peb xav hauv peb lub siab cuam tshuam ncaj qha rau peb lub cev. Kev nyob nrog tus kab mob ntev xws li ntshav qab zib yog ib qho ntawm cov kev ntxhov siab loj tshaj plaws.
- Kev ntxhov siab heev, kev ntxhov siab, thiab kev nyuaj siab: Cov mob no tuaj yeem txo koj lub siab xav thiab lub peev xwm los tswj koj tus kab mob ntshav qab zib. Tej zaum koj yuav hnov qab noj koj cov tshuaj raws sijhawm thiab kuaj xyuas koj cov ntshav qab zib. Kev ntxhov siab kuj tseem tuaj yeem ua rau cov tshuaj hormones uas koj lub cev tso tawm ntau ntxiv, uas tuaj yeem ua rau koj cov ntshav qab zib ntau ntxiv.
- Kev Noj Tsis Zoo: Cov mob xws li anorexia thiab bulimia tuaj yeem ua rau nws nyuaj rau tswj tus kab mob ntshav qab zib. Diabulimia, ib qho mob uas pom muaj rau cov neeg uas muaj tus kab mob ntshav qab zib hom 1, cuam tshuam nrog kev txhob txwm hla cov tshuaj insulin kom poob phaus. Qhov no txaus ntshai heev.
- Kev siv tshuaj yeeb thiab cawv: Cov tshuaj ua kom lub siab xav ua haujlwm xws li cocaine thiab opioids ua rau cov ntshav qab zib nce ntxiv. Cawv feem ntau tuaj yeem ua rau cov ntshav qab zib poob qis heev.
3. Kev laus thiab kev nco tsis zoo
Kev tswj tus kab mob ntshav qab zib muaj teeb meem ntau yam xws li kev puas hlwb, uas tuaj yeem tshwm sim thaum muaj hnub nyoog ntau zuj zus.
- Tej zaum koj yuav tsis nco qab noj koj cov tshuaj insulin.
- Koj tuaj yeem noj ob zaug tshuaj yog tias koj ua yuam kev.
- Cov hom insulin ua haujlwm luv thiab ntev tuaj yeem tsis meej pem.
- Cov khoom siv xws li cov twj insulin thiab cov ntsuas ntshav qab zib tas mus li (CGMs) tej zaum yuav tsis ua haujlwm zoo.
4. Insulin thiab teeb meem kev nyab xeeb ntawm zaub mov
Qhov no yog teeb meem kev sib raug zoo thiab kev lag luam uas cuam tshuam rau qee tus neeg hauv peb lub tebchaws thiab.
- Tus nqi ntawm cov tshuaj insulin siab: Vim yog qhov nyuaj rau kev yuav cov tshuaj insulin, qee tus neeg siv tsawg dua li qhov tau teev tseg. Qhov no tuaj yeem ua rau muaj cov ntshav qab zib siab heev thiab cov mob uas txaus ntshai rau lub neej xws li Diabetic Ketoacidosis (DKA) .
- Tsis muaj kev ruaj ntseg zaub mov: Tsis noj thiab haus raws sijhawm tuaj yeem ua rau cov ntshav qab zib tsis ruaj khov.
Cov tsos mob ntawm tus mob no yog dab tsi?
Ib tug neeg uas muaj tus kab mob ntshav qab zib brittle feem ntau muaj cov tsos mob sib txawv ntawm cov ntshav qab zib qis (hypoglycemia) thiab ntshav qab zib siab (hyperglycemia).
| Hom tsos mob | Tej yam yuav tau saib |
|---|---|
| Cov tsos mob ntawm cov ntshav qab zib qis (Hypoglycemia) | |
| Cov yam ntxwv me me |
|
| Cov tsos mob hnyav (yuav tsum tau kho tam sim ntawd) |
|
| Cov tsos mob ntawm cov ntshav qab zib siab (Hyperglycemia) | |
| Cov tsos mob thaum ntxov |
|
| Cov yam ntxwv ntev |
|
Qhov no ua rau muaj teeb meem dab tsi?
Cov ntshav qab zib uas hloov pauv tas li tsis zoo rau lub cev. Qhov no tuaj yeem ua rau muaj teeb meem luv luv thiab ntev.
Cov teeb meem vim yog cov ntshav qab zib tsawg
Yog tias koj cov ntshav qab zib qis tas li, koj yuav muaj tus mob hu ua hypoglycemia unawareness . Qhov no yog thaum koj lub cev tau siv rau cov ntshav qab zib qis thiab tsis qhia cov cim ceeb toom ntawm cov ntshav qab zib qis, xws li tshee hnyo thiab tawm hws. Qhov no txaus ntshai heev vim tias koj tuaj yeem poob siab thiab muaj qaug dab peg yam tsis tau ceeb toom. Yog tias tsis kho, nws tuaj yeem ua rau tuag taus.
Cov teeb meem vim muaj ntshav qab zib ntau
Yog tias cov ntshav qab zib tsis tswj tau, qhov xwm txheej ceev hu ua diabetic ketoacidosis (DKA) tuaj yeem tshwm sim. Qhov no ua rau muaj kev phom sij rau lub neej. Cov tsos mob ntawm DKA muaj xws li:
- Xeev siab thiab ntuav
- Kev qhuav dej ntawm lub cev
- Mob plab heev
- Ua pa tsw qab zoo
- Ua pa tob tob thiab sai (ua pa Kussmaul)
- Lub plawv dhia ceev
- Kev poob siab thiab kev tsis nco qab
DKA yog ib qho xwm txheej ceev hauv kev kho mob. Yog tias koj muaj cov tsos mob no, koj yuav tsum mus rau Chav Kho Mob Ceev (ETU) ze tshaj plaws ntawm tsev kho mob tam sim ntawd.
Tsis tas li ntawd xwb, cov ntshav qab zib ntau dhau lub sijhawm ntev ua rau muaj kev pheej hmoo ntawm kev mob ntshav qab zib loj.
- Kev puas tsuaj rau qhov muag (Retinopathy)
- Kev puas tsuaj rau lub raum (Nephropathy)
- Kev puas tsuaj rau cov hlab ntsha (Neuropathy)
- Kab mob plawv
- Mob stroke
Qhov no kho li cas?
Lub hom phiaj tseem ceeb ntawm kev kho mob Brittle Diabetes yog daws qhov ua rau cov ntshav qab zib tsis ruaj khov.Nrhiav thiab kho qhov ua rau mob ntshav qab zib. Piv txwv li, ib tug neeg uas muaj kab mob celiac yuav tswj tau lawv cov ntshav qab zib kom ruaj khov thaum lawv noj zaub mov tsis muaj gluten. Kev kho mob teeb meem thyroid tuaj yeem pab tswj tau tus kab mob ntshav qab zib.
Thaum kho qhov ua rau mob, koj tus kws kho mob yuav qhia tej yam xws li:
- Siv lub cuab yeej saib xyuas ntshav qab zib tas mus li (CGM): Lub cuab yeej no saib xyuas koj cov ntshav qab zib tas mus li thiab ceeb toom rau koj yog tias koj cov ntshav qab zib siab lossis qis.
- Tshawb xyuas koj cov ntshav qab zib tsis tu ncua: Koj tus kws kho mob yuav qhia koj kom tshawb xyuas koj cov ntshav qab zib los ntawm kev haus ib tee ntshav ntawm koj tus ntiv tes ntau zaus hauv ib hnub.
- Siv lub twj tso kua insulin: Qhov no xa cov insulin uas lub cev xav tau kom raug thiab sib xws dua.
- Kev txhawb nqa los ntawm tus kws tshaj lij kev noj qab haus huv ntawm lub hlwb: Nws yog ib qho tseem ceeb heev uas yuav tsum mus ntsib ib tus neeg zoo li tus kws kho mob hlwb thiab tau txais cov lus qhia txog kev tswj hwm tej yam xws li kev ntxhov siab thiab kev ntxhov siab.
- Kev pab los ntawm tsev neeg lossis tus pab saib xyuas neeg mob: Cov neeg laus lossis cov neeg uas muaj teeb meem nco qab yuav xav tau kev pab los ntawm ib tug neeg hauv tsev neeg kom muab insulin raws sijhawm thiab kuaj xyuas lawv cov ntshav qab zib.
- Kev txhawb nqa los ntawm tus neeg ua haujlwm pabcuam zej zog: Cov neeg uas tsis muaj peev xwm them taus insulin lossis tsis muaj zaub mov txaus noj tuaj yeem tau txais kev pab nrhiav cov kev daws teeb meem tsim nyog.
Hauv cov xwm txheej hnyav heev, qhov twg tsis muaj lwm txoj kev kho mob tuaj yeem tswj tau qhov mob, kev hloov pauv pancreas yuav raug pom zoo.
Thaum twg koj yuav tsum nrhiav kev pab kho mob tam sim ntawd
Kab mob ntshav qab zib tsis yog ib yam dab tsi uas yuav ua si nrog. Hauv cov xwm txheej zoo li no, nws yog ib qho tseem ceeb heev uas yuav tsum ua tam sim ntawd.
Yog tias koj muaj cov tsos mob ntawm DKA (diabetic ketoacidosis) (mob plab hnyav, ntuav, ua pa tsw qab txiv hmab txiv ntoo, tsis meej pem), mus rau lub tsev kho mob ze tshaj plaws Chav Kho Mob Thaum Muaj Xwm Ceev (ETU) tam sim ntawd.
Yog tias koj muaj cov tsos mob ntawm hypoglycemia hnyav (tsaim muag, qaug dab peg), hu rau lub tsheb thauj neeg mob tam sim ntawd lossis coj koj tus kheej mus rau tsev kho mob ETU sai li sai tau.
Kev tswj tus mob no yuav nyuaj heev. Yog vim li ntawd nws thiaj li tseem ceeb uas yuav tsum mus ntsib koj tus kws kho mob tsis tu ncua thiab tham txog kev hloov pauv ntawm koj cov ntshav qab zib. Nco ntsoov tias qhov no tsis yog koj qhov txhaum. Yog tias muaj kev kho mob zoo, kev pab los ntawm thev naus laus zis, thiab kev txhawb nqa los ntawm koj tsev neeg, tus mob no feem ntau tuaj yeem tswj tau.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- 'Brittle Diabetes' yog ib yam mob uas tus kab mob ntshav qab zib nyuaj heev rau tswj, nrog rau cov ntshav qab zib feem ntau nce thiab nqis yam tsis tau xav txog.
- Qhov no tsis yog koj qhov txhaum. Feem ntau nws yog los ntawm lwm yam teeb meem kev noj qab haus huv ntawm lub cev lossis lub hlwb.
- Yog tias koj muaj teeb meem tswj koj tus kab mob ntshav qab zib, tham nrog koj tus kws kho mob txog qhov no thiab sim nrhiav qhov ua rau muaj teeb meem no.
- Tsis txhob tsis quav ntsej cov cim qhia tias muaj ntshav qab zib qis heev lossis DKA. Nrhiav kev kho mob tam sim ntawd.
- Koj tsis yog tib tug neeg nyob hauv txoj kev no. Tsis txhob yig nrhiav kev txhawb nqa los ntawm tsev neeg, phooj ywg, thiab cov kws kho mob.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus