Embeera ey’amangu esinga okuba ey’akabi mu ssukaali: Omanyi HHS? (Embeera y’okulinnya kwa sukaali mu musaayi mu hyperosmolar) .

Olina obulwadde bwa sukaali? Oba maama wo, taata wo, oba omuntu omulala mu maka go alina obulwadde bwa sukaali? Olwo omulamwa guno gwe twogerako leero gujja kuba mukulu nnyo gyoli. Ssukaali mbeera esobola okuddukanyizibwa obulungi, era osobola okubeera n’obulamu obwa bulijjo. Kyokka, singa tebufugibwa bulungi, kiyinza okuvaako embeera ez’amangu ez’amaanyi eziyinza n’okuteeka obulamu bw’abantu mu matigga. Eyo y’embeera ey’amangu esinga okuba ey’akabi gye twogerako leero. Kino kiyitibwa Hyperosmolar Hyperglycemic State , kye tuyita HHS mu bufunze.

Mu ngeri ennyangu, HHS kye ki?

Okay, kino ka tukiteeke mu ngeri ennyangu ennyo. Teebereza nti ssukaali wo (blood glucose) agenda mu maaso nnyo ne kiba nti tekisoboka kumufuga. Ssukaali wo bw’asukka 180 mg/dL, ensigo zaffe zirina okufulumya ssukaali oyo ayitiridde mu musulo. Naye ssukaali ono takoma ku kuvaayo yekka, naye atwala n’amazzi g’omubiri ag’omuwendo.

Kati, kiki ekibaawo singa ssukaali wo agenda ku ddaala erya waggulu ennyo, nga 600 mg/dL, n’asigala bw’atyo okumala ennaku, mpozzi wiiki? Otandika okufulumya omusulo ekisusse, omubiri gwo ne guggwaamu amazzi amangi. Omuwendo gw’amazzi mu mubiri gwo bwe gukendeera, omusaayi gwo gugenda gugonza mpolampola. Nga bwe tukola omubisi gw’enjuki, amazzi gagonvuwa. Mu ngeri y’obusawo, kino tukiyita okugonza kw’omusaayi hyperosmolarity .

Kale, HHS mbeera ya mangu eteeka obulamu mu matigga ebaawo ng’ensonga zino essatu zikwatagana: ssukaali omungi ennyo mu musaayi (hyperglycemia) , okuggwaamu amazzi mu mubiri ennyo , ne hyperosmolarity. Embeera eno esinga kulabibwa mu bantu abalina Ssukaali ow’ekika eky’okubiri. Eno mbeera eyeetaaga okuweebwa ekitanda mu ddwaaliro mu bwangu n’okujjanjabibwa. Singa tebujjanjabwa, kiyinza n’okuviirako okufa.

HHS ne DKA: Njawulo ki eri wakati w’ebintu bino byombi?

Embeera endala ey’amangu ey’akabi eyinza okubaawo mu bantu abalina ssukaali ye DKA (Diabetic Ketoacidosis). Wadde nga HHS ne DKA zombi mbeera eziteeka obulamu mu matigga ezireetebwa ssukaali omungi mu musaayi, waliwo enjawulo entegeerekeka wakati w’ebintu bino byombi. Kikulu okumanya enjawulo eno.

• DKA (Diabetic Ketoacidosis): Kino kisinga kubeera mu bantu abalina Ssukaali ow’ekika kya 1. Ekibaawo wano nti omubiri kumpi tegulina busimu bwa insulini. Olw’obutaba na insulini, obutoffaali bw’omubiri tebusobola kukozesa ssukaali okukola amaanyi. Olwo omubiri ne gugenda mu ngeri endala okunoonya amaanyi. Kwe kugamba, nga bwokya amasavu agali mu mubiri. Amasavu bwe gaayokebwa mu ngeri eno, ekirungo ky’eddagala ekiyitibwa ketones kyongerwa mu musaayi ng’ekirungo ekiva mu musaayi. Ketoni zino zibeera asidi. Ketones bwe zeeyongera mu musaayi, omusaayi gufuuka gwa asidi. Kino kye kintu ekisinga okuba eky’obulabe ku DKA.

• HHS (Embeera y’obulwadde bwa sukaali mu musaayi):Kino kisinga kubeera mu bantu abalina ssukaali ow’ekika eky’okubiri. Wano, waliwo insulini nnyingi nnyo mu mubiri. Olw’obungi obwo obutono obwa insulini, omubiri gwokya amasavu ne guziyiza okutondebwawo kwa ketones. N’olwekyo, omusaayi tegufuuka asidi mu HHS. Naye ekizibu ekikulu wano kwe kulinnya kwa ssukaali mu ngeri etafugibwa n’okuggwaamu amazzi mu musaayi n’okugonza ennyo ekivaamu.

Katutunuulire emmeeza eno okwongera okunnyonnyola enjawulo eno.

Bubonero ki obw’obulwadde bwa HHS? Weegendereze bino!

Ekisinga okuba eky'obulabe ku HHS kwe kuba nti obubonero tebulabika omulundi gumu . Zikula mpola, okumala ennaku oba wiiki. Kale omuntu ayinza obutakitegeera okutuusa nga kibadde kya maanyi nnyo. Eno y’ensonga lwaki kikulu okumanya obubonero buno.

• Ssukaali mu musaayi mungi nnyo: Mita ya glucose esomebwa awaka esukka nnyo 600 mg/dL (oba 33 mmol/L).
• Okutabulwa mu birowoozo: Okubulwa ebirowoozo, obutasobola kussa maanyi, okutabulwa mu kwogera, okufiirwa obudde, ekifo n’abantu abamanyi.
• Okulaba oba okuwulira ebintu ebitaliiwo (Hallucinations): Kiyinza okugambibwa nti olaba oba owulira ebintu ebitaliiwo ddala.
• Okubulwa amagezi: Mu mbeera ez’amaanyi, ayinza okubaawo mu kkoma.
• Akamwa, olulimi, n’ennyonta esukkiridde: Okuwulira ng’olina ennyonta etaggwaawo ne bw’onywa amazzi mangi.
• Okufuka ennyo: Wadde oyinza okufulumya omusulo mu kusooka, oyinza okufulumya omusulo omutono ng’amazzi gakendeera mu mubiri.
• Okulaba okuzibu oba okubulwa okulaba: Okulaba kuyinza okutambula obubi mpolampola.
• Obunafu bw’omubiri: Okuwulira obunafu mu mubiri. Oluusi oludda olumu olw’omubiri luyinza okusannyalala, ng’olinga alina obulwadde bwa ssukaali.

Lwaki embeera eno eya HHS ebaawo? Biki ebikulu ebivaako?

Omuntu alina obulwadde bwa sukaali obufugibwa obulungi, emikisa emitono nnyo egy’okukwatibwa HHS. Wabula mu muntu ssukaali gwe atafugibwa bulungi, embeera eno esobola okubaawo olw'ekintu "ekivaako." Kwe kugamba, ekintu ekibaawo kiyinza okuvaako ssukaali mu musaayi obutafugibwa, ekivaako HHS.

Ebikulu ebivaako HHS bye bino:

• Yinfekisoni: Abantu 50% ku 60% abafuna HHS balina yinfekisoni ey’ekika ekimu. Naddala ekifuba , yinfekisoni z’omusulo (UTI ), n’obulwadde bwa sepsis .) yinfekisoni ze zisinga. Teebereza, maama omukadde alina ssukaali, afuna obulwadde mu kifuba nga mulimu omusulo mungi. Situleesi eva ku bulwadde buno eyinza okuvaako ssukaali mu musaayi okulinnya okutuuka ku ddaala eritafugibwa.
• Obutamira ddagala lya sukaali nga bwe likulagiddwa: Eno nayo nsonga ya bulijjo nnyo. Abantu abamu baboola ne balekera awo okumira eddagala lyabwe, oba tebalimira mu budde. Bw’omira insulini, bw’otogimira bulungi, ssukaali mu musaayi ayinza okulinnya mu ngeri ey’akabi.
• Eddagala eddala: Eddagala erimu, gamba nga corticosteroids (ekozesebwa okujjanjaba asima n’endwadde z’enkizi), thiazide diuretics (ekozesebwa okujjanjaba puleesa), n’eddagala erimu erijjanjaba endwadde z’obwongo, nalyo liyinza okuleeta ssukaali okulinnya mu musaayi ne kireeta HHS.
• Embeera ez’amangu ez’emisuwa n’emisuwa: Mu mbeera ey’amaanyi ng’okusannyalala , okulwala omutima , oba okuzimba amawuggwe , omubiri guba ku situleesi nnyingi. Obusimu obukola ku situleesi omubiri gwe gufulumya mu kiseera kino busobola okuvaako ssukaali mu musaayi okulinnya mu bwangu.

Ani ali mu bulabe obw’amaanyi obw’okukwatibwa HHS?

Nga bwe kyayogeddwako emabegako, akabi kano katono singa ssukaali afugibwa bulungi. Wabula abantu bano wammanga bali mu bulabe bwa maanyi obw’okukwatibwa HHS:

• Abantu abatafuga bulungi ssukaali.
• Abantu abakulu abasukka mu myaka 65: Bwe bakaddiwa, obusobozi bwabwe obw’okuwulira ennyonta buyinza okukendeera, n’olwekyo bayinza obutamanya nti baweddemu amazzi.
• Abo abalina endwadde endala (infection, illness) oba embeera z’omutima.

Bizibu ki ebiyinza okubaawo olw’obulwadde bwa HHS?

Singa HHS tejjanjabwa mu budde, kiyinza okuvaako ebizibu eby’amaanyi ennyo.

• Okukonziba
• Coma
• Okulemererwa kw’ebitundu by’omubiri
• Okufa

Abantu abali wakati wa 10% ne 20% abafuna HHS bafa. Ekyo kitegeeza nti omuntu omu oba babiri ku buli bantu 10 bajja kufa. Embeera eno bw’etyo bw’eri ey’amaanyi.

HHS ezuulibwa etya era n’ejjanjabibwa etya mu ddwaaliro?

Bw’oweebwa ekitanda mu kitongole ky’abalwadde ab’amangu (ETU), omusawo ajja kukukebera n’akubuuza ku bubonero bwo. Olwo, bajja kulagira okukeberebwa omusaayi emirundi egiwerako. Bino bijja kukebera ssukaali mu musaayi gwo , osmolality mu musaayi, enkola y’ekibumba, n’okumanya oba waliwo ketones mu musaayi gwo.

Singa ssukaali asinga nnyo 600 mg/dL ate nga ketone mu musaayi ntono, kizuulibwa nga HHS.

Obujjanjabi buzingiramu okukukuuma mu waadi oba mu kisenge ky’abalwadde abayi (ICU) n’okukuwa amazzi aga IV.

Waliwo ebigendererwa ebikulu bisatu eby’obujjanjabi:

1. Okuzza amazzi mu mubiri: Omunnyo guweebwa mu misuwa okumalawo okuggwaamu amazzi.

2. Okutebenkeza Electrolytes: Bw’omala okuggwaamu amazzi, eby’obugagga bingi eby’omuwendo nga potassium bibula mu mubiri. Zikyusibwa nga ziyita mu saline.

3. Okufuga ssukaali mu musaayi: Insulin aweebwa mu misuwa okusobola okukkakkanya ssukaali mu musaayi mpola mpola era mu ngeri efugibwa.

Ng’oggyeeko obujjanjabi buno, singa wabaawo yinfekisoni eyaliwo eyavaako embeera ya HHS, eyo nakyo ejjanjabwa.

Ebizibu bisobola okubaawo nga bajjanjabwa?

Yee, wadde nga tebitera kubaawo, ebizibu bisobola okuva mu bujjanjabi. Kwe kugamba, singa ssukaali mu musaayi akendeera mu bwangu era mu bwangu, obutoffaali bw’obwongo busobola okujjula amazzi mu bwangu obwongo ne buzimba (cerebral edema). Naye kino tekitera kubaawo nnyo. Abasawo bamanyi okukkakkanya ssukaali mu musaayi mu ngeri etali ya bulabe era mpola. Kale tekyetaagisa kweraliikirira ku nsonga eyo.

Oyinza otya okwekuuma okuva ku HHS?

Engeri esinga obulungi era yokka ey’okwewala embeera eno ey’akabi kwe kuddukanya obulungi ennyo obulwadde bwa sukaali. Kino okukikola, kakasa nti ebintu bino obikola.

• Kebera buli kiseera ssukaali mu musaayi gwo era fuba okumukuuma mu kigero omusawo ky’akuwadde.
• Limira eddagala (empeke oba insulini) omusawo ly’akulagidde mu kiseera ekituufu era mu ddoozi entuufu, nga tosubwa lunaku na lumu.
• Bw’oba ​​olina obuzibu okufuga obulwadde bwa sukaali, yogerako n’omusawo wo ofune amagezi ageetaagisa.
• Goberera endya ennungi ekusaanira.
• Bw’oba ​​olina obulwadde ng’omusujja oba ssennyiga, weegendereze nnyo. Nywa amazzi amangi, owummuleko nnyo, era okebere ssukaali mu musaayi emirundi mingi okusinga bulijjo. Kino kiri bwe kityo kubanga situleesi eri ku mubiri gwo ng’oli mulwadde esobola okuvaako ssukaali okulinnya.
• Beera mumanyi obubonero bwa HHS. Bw’olaba obubonero buno bwonna, kolawo mu bwangu.