Tumanyi bulungi ku Kkoma eyeekuusa ku Ssukaali?

Oyinza okujjukira omuntu alina obulwadde bwa sukaali, oboolyawo omuntu ow’omu maka go oba mukwano gwo. Oluusi tuwulidde ng’abantu ng’abo bazirika mu bwangu, ne batasobola kwogera, ate oluusi ne bagwa wansi. Mu butuufu eno mbeera ya bulabe nnyo era eyinza okutta omuntu. Eno y’ensonga lwaki, leero twalowoozezza okwogera ku mbeera eno eyinza okuva ku ssukaali, oba ng’abasawo bwe bakiyita, `(Diabetes-Related Coma)`. Kino bwe tukimanya obulungi kijja kutuyamba okulabirira abaagalwa baffe.

Kkoma eyeekuusa ku Ssukaali kye ki? Mu ngeri ennyangu...

Mu ngeri ennyangu, okukwatibwa ssukaali mu kkoma mbeera ya maanyi, eyinza okutta obulamu bwaffe, ebaawo nga ssukaali mu musaayi gwaffe agenda mu maaso mu bwangu (hyperglycemia) oba wansi nnyo (hypoglycemia). "Koma" mbeera ya butategeera ddala, ng'okugwa mu tulo otungi, n'obutasobola kuzuukusibwa kwogera. Kyokka bakyali balamu wadde nga bazirika. Eno mbeera eyeetaaga okujjanjabibwa mu bwangu.

Waliwo ensonga ssatu enkulu eziviirako embeera eno ey’akabi.

Waliwo engeri enkulu ssatu omuntu alina ssukaali gy’ayinza okugwa mu kkoma. Ka tulabe kiki kye bali:

1. Embeera ya sukaali mu musaayi (HHS) .

2. Obulwadde bwa sukaali obukwatagana ne Ketoacidosis (DKA) .

3. Okukendeera kwa sukaali okw’amaanyi

Kati ka twogere ku buli kimu ku bino mu bujjuvu katono, okay?

1. Embeera y’obulwadde bwa sukaali obuyitibwa Hyperosmolar Hyperglycemic State (HHS) kye ki?

Embeera eno eyitibwa HHS esinga kubeera mu bantu abalina Ssukaali ow’ekika eky’okubiri. Kibaawo nga ssukaali (glucose) mu musaayi gwo ali waggulu nnyo (ebiseera ebisinga asukka 600 mg/dL) okumala ebbanga eddene. Kino kiyinza okuviirako omubiri gwo okufiirwa amazzi amangi ekivaako okuggwaamu amazzi mu mubiri, okutabulwa n’obubonero obulala. Singa tebujjanjabwa mangu, kiyinza okuvaako omuntu okugwa mu kkoma.

2. Obulwadde bwa Ssukaali obukwatagana ne Ketoacidosis (DKA) kye ki?

Embeera eyitibwa ``DKA'' nayo eri mu kabi eri obulamu. Businga kukwata bantu abalina ``Type 1 Diabetes'' (buyinza okukwata abantu ababulina edda, awamu n'abo abatamanyi nti bulina). Wabula oluusi kiyinza okukula mu bantu abalina Ssukaali ow’ekika eky’okubiri nabo.

DKA ebaawo ng’omubiri gwo tegulina insulini emala (eya butonde oba ng’agiggyiddwa ebweru). Nga bw’omanyi, insulini yeetaagibwa nnyo ssukaali ali mu musaayi gwaffe, glucose, okuyingira mu butoffaali bwaffe n’akozesebwa okukola amaanyi. Kale insulini bw’ebula oba obutamala, omubiri gutandika okumenya amasavu okusobola okufuna amaanyi. Amasavu bwe gamenyekamenyeka, eddagala eriyitibwa ketones lifuluma mu musaayi.

Omuwendo gwa `(ketones)` mu mubiri gw'omuntu alina ssukaali bwe gweyongera, omusaayi gugenda gufuuka `(acidic).` Singa kino tekijjanjabwa mu budde, okugwa mu kkoma kuyinza okubaawo. Ssukaali mu musaayi gw’omuntu alina `(DKA)` atera okusinga 250 mg/dL. Naye jjukira, ekisinga okuvaako `(DKA)` kwe kubulwa `(insulin)` n'okweyongera kwa `(ketones)`, so si sukaali mu musaayi yekka. Abamu ku balwadde ba ssukaali basobola okuyita mu `(DKA)` ne bwe kiba nti ssukaali waabwe asukka 250 mg/dL.

3. Okukendeera kwa sukaali okw’amaanyi kye ki?

Eno y’ensonga ey’okusatu. Singa ssukaali mu musaayi akka wansi wa 40 mg/dL, kitwalibwa ng’embeera ey’amaanyi eya ``hypoglycemia``. Kino nakyo kya bulabe nnyo eri obulamu.

Omanyi ensibuko y’amaanyi enkulu eri omubiri gwaffe n’okusingira ddala obwongo ye `(glucose)`. Kale ssukaali bw’akendeera, omubiri tegusobola kukola bulungi. Singa ssukaali agwa wansi wa 40 mg/dL, nga bwe kyayogeddwa, oyinza okufuna enkyukakyuka mu mubiri n’ebirowoozo, ekikuleetera obutasobola kukola kintu kyonna. Singa embeera eno ey’amaanyi eya `(hypoglycemia)` tejjanjabibwa okumala ebbanga ddene, oyinza okugenda mu kkoma.

Embeera eno ey’amaanyi ey’okukendeeza sukaali esinga kubeera mu bantu abamira insulini ku ssukaali oba empeke ezimu eza ssukaali nga sulfonylureas.

Bubonero ki obulaga nti omuntu alina obulwadde bwa sukaali mu kkoma? Tukitegeera tutya?

Waliwo engeri ssatu enkulu eziraga nti omuntu ali mu kkoma:

• Obutamanya: Kiringa okubeera mu tulo otungi ennyo. Ne bw’oyogera otya, kizibu nnyo, kumpi tekisoboka, okukuzuukusa.
• Obutaddamu ku maaso: Amaaso gasigala nga gazibye. Tewali kuddamu ng’omuntu azibula amaaso. Naye oluusi wayinza okubaawo okuddamu okumu mu maaso ku bintu ng’ekitangaala.
• Obutaba na kuddamu kw’enkola y’omubiri: Tewali kutambula mu kutegeera. Kyokka, entambula ezimu ez’okulowooza (reflex movements) ziyinza okubaawo.

Kati ka tulabe obubonero ki obulabika nga tetunnagenda mu kkoma mu mbeera ezaayogeddwako waggulu eza `(DKA)`, `(HHS)` ne `(hypoglycemia)` ez'amaanyi. Bino bw’obitegeera nga bukyali, osobola okwewala akabenje akanene.

Obubonero obukulembera okukoma mu DKA:

• Okuziyira n’okusiiyibwa.
• Okulumwa olubuto.
• Okussa okw'amangu, okw'amaanyi (abasawo kino bakiyita ``Kussmaul breathing''). Kiyinza okuba mu nnyimba emu.
• Akawoowo k’ebibala ku mukka.
• Okuwulira nga okooye nnyo era nga munafu.
• Okuwulira ng’atabuse oba ng’asobeddwa, ng’alinga ebirowoozo by’omuntu ebitaataaganyizibwa.
• Okukendeera kw’obulindaala.

Obubonero obukulembera okukoma mu mbeera ya `(HHS)`:

• Enkyukakyuka mu birowoozo: okutabulwa, okuwuguka, okulaba ebirooto.
• Kiringa ng’ogenda okuggwaamu amaanyi.
• Akamwa akakalu n’ennyonta esukkiridde (polydipsia).
• Okufuka ennyo.
• Okulaba okuzibu oba okubulwa okulaba.
• Okuziyira, oluusi okusinga ku ludda olumu olw’omubiri.

Obubonero obukulembera mu kkoma mu kukendeera kwa sukaali okw’amaanyi mulimu:

• Okulaba okuzibu oba okulaba emirundi ebiri.
• Okufuna ebigambo okutabula ng’oyogera.
• Okubulwa bbalansi n’okukaluubirirwa okukola ebintu.
• Okutabulwa ebirowoozo.
• Okukonziba kulinga okuzimba.

Bw’olaba obubonero buno bwonna, tobubuusa maaso. Kirungi okunoonya amagezi mu bwangu eri abasawo.

Singa omuntu azirika olw’obulwadde bwa sukaali tukola ki? (Obujjanjabi obusookerwako)

Kuba akafaananyi ng’omuntu mu kitundu kyo azirika mu bwangu olw’obulwadde bwa sukaali. Waliwo ebintu ebitonotono by’osobola okukola:

• Kuba 1990 mu bwangu ofune ambyulensi. Bw’oba ​​okimanyi nti omuntu oyo alina ssukaali, ekyo nakyo kibuulire omukozi wa 1990.
• Tobawa kintu kyonna kya kulya wadde okunywa. Baali basobola okuziyira.
• Omuntu akyuse n’obwegendereza ku ludda lwe amalusu oba okusesema kuleme kuziba kkubo lya mpewo.
• Okutuusa nga ambyulensi etuuse, goberera ebiragiro ebyaweebwa omukozi wa 1990.

Singa kino kikolebwa mu butuufu, kiyinza okuyamba ennyo mu kutaasa obulamu bw’omuntu oyo.

Lwaki obulwadde bwa sukaali buleetera omuntu okubulwa amagezi? (Ensonga zino nnyangu)

Nga bwe twayogeddeko emabegako, waliwo ebintu bisatu ebikulu ebivaako omuntu okugwa mu kkoma, nedda? Bbo bali:

• Embeera ya sukaali esukkiridde mu mubiri `(HHS)`.
• Obulwadde bwa sukaali obuyitibwa ketoacidosis (DKA).
• Okukendeera kwa sukaali okw’amaanyi (ssukaali omutono ennyo mu musaayi).

HHS ne DKA zombi mbeera amazzi g’omubiri mwe gakendeera ennyo, ekivaako okuggwaamu amazzi mu mubiri ennyo. Okuggwaamu amazzi kuno kuyinza okuvaako omuntu okugwa mu kkoma.

Ate mu kukendeera kwa sukaali okw’amaanyi, obwongo tebufuna bungi bwa glucose (ssukaali) gwe bwetaaga. Ssukaali yeetaagibwa nnyo obwongo okukola obulungi. Bwe kiggwaawo, obwongo "buggalawo" n'osobola okugenda mu kkoma. Ekyo okifunye?

Ani ali mu bulabe obw’amaanyi obw’okulwala ssukaali mu kkoma?

Omuntu yenna alina ssukaali (ne abo abatalina ssukaali) ali mu bulabe bw’okulwala ssukaali mu kkoma. Wabula akabi kano kaawukana katono okusinziira ku kika kya sukaali:

• Abantu abalina Ssukaali ow’ekika kya 1 bali mu bulabe bwa maanyi obw’okugenda mu kkoma, oba okuva ku DKA oba okukendeera kwa sukaali okw’amaanyi. Kino kiri bwe kityo kubanga abantu abalina Ssukaali ow’ekika kya 1 beetaaga insulini buli kiseera era ssukaali mu musaayi gwabwe akyukakyuka nnyo okusinga abantu abalina sukaali ow’ekika eky’okubiri.
• Abantu abalina Ssukaali ow’ekika eky’okubiri batera okugenda mu kkoma olw’obulwadde bwa HHS okusinga DKA oba okukendeera kwa sukaali okw’amaanyi.

Biki ebirala ebiyinza okuleeta akabi?

Ng’oggyeeko ebintu bino, waliwo ebintu ebirala ebiyinza okwongera ku bulabe bw’okubeera mu kkoma eya ssukaali:

• Okukulaakulanya endwadde endala.
• Okulongoosebwa.
• Obuvune mu mubiri (Trauma).
• Ebizibu ku nkola y’okugaba insulini (e.g., ekkalaamu ya insulini, ppampu obutakola bulungi).
• Okwerabira, okubuuka oba okumira insulini ennyo.
• Obutaddukanya bulungi ssukaali (e.g. obutakebera ssukaali mu musaayi buli lunaku, obutamira ddagala bulungi).
• `(Hypoglycemia unawareness)` (kwe kugamba, obutamanya bubonero busooka obwa ssukaali omutono mu musaayi).
• Okunywa omwenge.
• Okukozesa ebiragalalagala.

Abasawo bazuula batya mu butuufu omuntu alina obulwadde bwa sukaali mu kkoma?

Obulwadde bwa sukaali mu kkoma mbeera ya mangu ey’obujjanjabi era nga yeetaaga okujjanjabibwa mu bwangu. Omuntu yenna ali mu kkoma yeetaaga okuweebwa ekitanda mu ddwaaliro.

Ebiseera ebisinga abasawo basobola okuzuula amangu obulwadde bwa sukaali mu kkoma nga batwala ebyafaayo byo eby’obujjanjabi, ne bakebera ssukaali mu musaayi gwo (okukebera glucose mu musaayi), n’okukola ebigezo ebirala okukebera ketones n’obulamu bwo okutwalira awamu.

Y’ensonga lwaki kikulu abantu abalina ssukaali okwambala akakomo oba omukuufu ogulaga obusawo. Singa wabaawo embeera ey’amangu, abasawo basobola okugiraba ne basalawo amangu. Era kikulu okutegeeza ab’omu maka go, mikwano gyo ne bakozi banno nti olina obulwadde bwa sukaali. Mu ngeri eyo, bamanyi eky’okukola mu mbeera ey’amangu.

Ojjanjaba otya omuntu alina obulwadde bwa sukaali mu kkoma?

Obujjanjabi bw’omuntu alina ssukaali mu kkoma bwawukana okusinziira ku kivaako , naye bulijjo kyetaagisa okuweebwa ekitanda mu ddwaaliro.

Obujjanjabi bwa kkoma obuva ku `(DKA)` oba `(HHS):

• Amazzi aga IV: Gano gaweebwa okutereeza okuggwaamu amazzi n’obutakwatagana mu masanyalaze.
• Insulin: Ttiimu y’abasawo eyinza okukuwa insulini ng’eyita mu IV oba ng’ekuba essasi eriri wansi w’olususu.
• Obujjanjabi obulala: Obujjanjabi obulala buyinza okuweebwa okukuyamba okudda engulu. Mu bino biyinza okuli okujjanjaba embeera yonna ey’obujjanjabi oba yinfekisoni eziyinza okuba nga zikuleetera ssukaali okubeera omungi mu musaayi.

Obujjanjabi bw’okugwa mu kkoma obuva ku kukendeera kwa sukaali okw’amaanyi:

• Glucagon ey’amangu:Eno ngeri ya busimu ya glucagon ekoleddwa mu ngeri ey’ekikugu. Kiyinza okuweebwa omwagalwa wo oba omusawo ng’empiso oba ng’ekifuuyira mu nnyindo (okusinziira ku kika). Glucagon ow’obutonde akola nga afulumya glucose eterekeddwa mu kibumba, n’eyongera ku sukaali mu musaayi.

Ekisinga obukulu: Ne bwe kiba nti omuntu akuli ku lusegere akuwadde `(glucagon)`, mazima ddala weetaaga obujjanjabi mu ddwaaliro. Balina okukuwa `(glucagon)` n'okuba 1990 mu bwangu.

Singa wabaawo ebizibu ebirala, gamba ng’okulemererwa kw’ebitundu by’omubiri, era biyinza okwetaagisa obujjanjabi obulala.

Kiki kye tuyinza okukola okuziyiza okugwa mu kkoma eya ssukaali?

Okuziyiza ssukaali okugwa mu kkoma, kikulu okumanya obubonero obulabula nga bukyali obw’okukendeera kwa sukaali mu musaayi (DKA), okukendeera kwa sukaali mu musaayi (HHS), n’okukendeera kwa sukaali mu musaayi. Yogerako n’omusawo wo ku mitendera gy’oyinza okuyitamu okujjanjaba embeera zino nga tezinnaba kufuuka za maanyi.

Laba omusawo mu bwangu singa:

• Singa ssukaali wo abeera 300 mg/dL oba okusingawo emirundi ebiri egy’omuddiring’anwa awatali nsonga.
• Bw’oba ​​olina ekizibu kya ssukaali omutono mu musaayi (wansi wa 70 mg/dL) era nga tekidda mu mbeera ya bulijjo oluvannyuma lw’okugezaako emirundi esatu okujjanjaba (e.g., empeke za glucose, ebyokunywa ebirimu ssukaali), kuba omusawo wo oba 911 mu bwangu.

Omuntu asobola okuwonawo mu kkoma eya ssukaali? Waliwo ebiyinza okuvaamu okumala ebbanga eddene?

Yee, okugwa mu kkoma eya ssukaali osobola okwewalibwa singa ekizibu ekivaako ssukaali kijjanjabwa mangu. Kyokka n’abantu abamu basobola okukosebwa obwongo obw’olubeerera. Singa tebajjanjabwa mangu era mu ngeri entuufu, okufa kuyinza n’okubaawo.

Omuwendo gw’abafa olw’obulwadde bwa DKA guli wakati wa 0.2% ne 2.5%. Abo abagenda mu kkoma, abalina ebbugumu eringi, era nga bakendeeza ku musulo (oliguria) be basinga okuvaamu obubi.

Abantu nga 20% abalina HHS bafa olw’embeera eno. Abo abafuna okugwa mu kkoma ne/oba puleesa entono baba n’okuteebereza okubi.

Osobola okumala bbanga ki ng’oli mu kkoma ya ssukaali?

Ebbanga ly’omala ng’oli mu kkoma ya ssukaali kisinziira nnyo ku ngeri gy’ofunamu amangu obujjanjabi obutuufu. Engeri yokka ey’okumalawo kkoma nga eno kwe kuzzaawo glucose ne insulin mu musaayi gwo ku mutindo omulamu. Kino kisobola okukolebwa nga tuyambibwako abakugu mu by’obujjanjabi. Omuntu ali mu kkoma ya sukaali tajja kuddamu kutegeera ku lulwe.

Omuntu ali mu kkoma nga eno bw’atafuna bujjanjabi mu budde, ayolekedde okufa. "Mu kiseera" kyawukana okusinziira ku musango n'omuntu ku muntu. Eno y’ensonga lwaki kikulu nnyo okufuna obuyambi mu bwangu.

Mu bufunze, bino bye bintu bye twetaaga okujjukira (Take-Home Message):

Wadde nga ssukaali mu kkoma kintu kya bulabe nnyo, emirundi mingi kisobola okuziyizibwa.

• Ekikulu kiri nti,Weegendereze obubonero obulabula obwa `(DKA)`, `(HHS)` ne sukaali omutono mu musaayi era okole mangu ng'obirabye.
• Bw’oba ​​olina obubonero bw’embeera eno, kuba essimu y’omusawo mu bwangu.
• Ebizibu bya sukaali ddala bitiisa, naye okubeera nga omanyi era nga weetegese y’engeri esinga obulungi ey’okubiziyiza.
• Tolonzalonza kubuuza musawo wo bibuuzo byonna by’olina ku ngeri y’okuddukanyaamu obulwadde bwa sukaali oba ebizibu bino. Obulamu bwo bwa mugaso gy’oli.

` Ssukaali, Coma, DKA, HHS, Hypoglycemia, Ssukaali mu musaayi, Insulin, Obuyambi obusookerwako, Ebizibu bya sukaali, Okufiirwa okujjukira