I zunthlum hi thunun a harsa tak zet em? ‘Brittle Diabetes’ chungchang hi han sawi ila!

Zunthlum i nei em? A châng chuan, engtiang pawhin bei mah la, i doctor-in a hun taka a damdawi i ei a, i ei leh in thunun la, i thisen sugar level chu a sang lutuk emaw, a hniam lutuk emaw thut mai ṭhin? A nih loh leh hlauhawm takin an tlahniam nghal em? Hei hian i ni khat chhung zawng a tibuai a, damdawi ina dah a ngai fo em? Tichuan doctor-te'n "Brittle Diabetes" an tih ang chi natna bik i nei mai thei. He thu i hriat hian hlau suh. Engkim hi awlsam takin sawi ila.

A awlsam zawngin, Brittle Diabetes hi eng nge ni?

"Brittle Diabetes" hi zunthlum chi thar a ni lo. Official medical diagnosis pawh a ni lo. A awlsam zawngin, zunthlum natna harsa tak, nghet lo tak, thunun harsa tak sawina atana hman hming a ni. "Brittle" tih thumal hi "a awlsam taka chhe thei" tihna a ni. Tin, chutiang chiah chu he condition hi a ni. Thisen glucose level hi a inthlak danglam nasa hle a, rang takin a inthlak danglam thin.

Hetiang dinhmunah hian thisen sugar tlahniam (hypoglycemia) leh thisen sugar sang (hyperglycemia) te a awm fo thin. Hei hian damdawi ina awm fo a thlen thei a ni. Doctor-te chuan hei hi ``labile diabetes'' an ti \hin.

Hetiang dinhmun hi type 1 diabetes vei te zingah a tam ber a ni . Mahse, type 2 diabetes vei, insulin injection-a innghatteah pawh a awm thei bawk. Vawi tam tak chu he "brittle diabetes" natna hi zunthlum bakah hian damdawi lam harsatna dang emaw, rilru lam harsatna dang emaw avanga lo awm a ni.

Engvangin nge zunthlum hi thunun a harsat em em? A chhan engte nge ni?

Thisen sugar level control hi thil buaithlak tak a ni. Thil tam takin a nghawng a, chu chu kan ei leh in te, exercise kan tih te, stress te, leh hormone inthlak danglamna te a ni. Zunthlum vei tam zawk chuan hun kal zelah heng thilte hi enkawl dan an zir thin. Mahse "brittle diabetes"-ah chuan heng nghawngte hi a lo awm dan hi sawi lawk theih a ni lo. Chuvang chuan thisen sugar level hi a inthlak danglam nghal thei a ni.

A chhan hi chi li-ah then theih a ni a, chungte chu:

1. Taksa chhunga damdawi lam thil dang.

2. Rilru hriselna lama harsatna nei.

3. Tar leh hriatrengna hloh.

4. Insulin leh ei leh in himna chungchang.

Heng zawng zawng hi a hranin han thlir ila.

1. Taksa dinhmun awm dun

Natna thenkhat chuan taksain insulin a dawn dan (insulin resistance) a tidanglam thei a, chu chuan thisen sugar level control a ti harsa hle.

Thisen sugar a san fo thinna dinhmun:

• Hormone inthlauhna: Hormone nena inzawm natna, hyperthyroidism (thyrotoxicosis), acromegaly, leh Cushing syndrome te.
• Pianpui natna hmuh tur awm lo thenkhat (congenital lipodystrophies) .
• Taksa pum huapa natna hrik darh (systemic infection).

Thisen sugar tlahniam fo thin dinhmun:

• Gastroparesis: Hei hi pum chhunga chaw awmte chu zawi zawiin intestines-ah a thawn chhuak thin a ni. Zingah buhfai i ei ang tih han ngaihtuah teh. A hmin hian darkar hnih vel a ngai tlangpui. Mahse hetiang dinhmun avang hian i pum hian hna a thawk zawi hle. Chuvangin chaw ei hmaa insulin i inject pawhin chaw chu a digest a, darkar 4-5 hnuah thisenah sugar a dah belh leh thin. Chutih lai chuan insulin hian hna a thawk thei a, i sugar pawh a tlahniam thei hle (hypoglycemia). Chaw chu a hmin chuan sugar chu a sang hle nghal thei a ni. Thunun a harsat zia i hmu em?
• Addison natna: Enkawl loh chuan he natna hian thisen sugar level a ti tlahniam fo thei bawk.
• Celiac disease: He natna hian taksain nutrients a hip lut tha thei lo a, chu chuan thisen sugar level a ti nghet lo thei a ni.

2. Rilru hriselna dinhmun

Kan rilrua kan hriatte hian kan taksa a nghawng nghal vek a ni. Diabetes ang chi natna khirh tak nena nun hi stressor lian ber pakhat a ni.

• Stress na tak, lungkhamna, leh lungngaihna: Heng dinhmunte hian i zunthlum enkawl tura i rilru put hmang leh i theihna a ti tlem thei a ni. I damdawi ei kha a hun takah i theihnghilh thei a, i thisen sugar pawh i check thei bawk. Stress hian i taksain hormone a tihchhuah a tipung thei bawk a, chu chuan i thisen sugar level a tisang thei bawk.
• Ei leh in lama harsatna: Anorexia leh bulimia ang chi natna hian zunthlum enkawl a ti harsa thei hle. Diabulimia, type 1 diabetes vei te zingah hmuh tur a awm a, chu chu tumruh taka insulin dose skip a, taksa rihna tihtlem tumna a ni. Hei hi a hlauhawm hle mai.
• Ruihhlo leh zu hman: Cocaine leh opioid ang chi stimulant te hian thisen sugar level a tisang a. Zu hian thisen sugar level hlauhawm takin a tihhniam fo thin.

3. Tar leh hriatrengna hloh

Diabetes enkawl dan hi dementia ang chi natna avang hian a buaithlak hle a, kum upa lam a nih chuan a thleng thei a ni.

• I insulin dose ei kha i theihnghilh mai thei.
• Double dose pawh i ei palh thei.
• Short-acting leh long-acting insulin chi hrang hrang hi a inthlau thei hle.
• Insulin pump leh continuous glucose monitor (CGM) ang chi device te hian hna a thawk tha lo thei.

4. Insulin leh ei leh in himna chungchang

Hei hi khawtlang leh sum leh pai lam thil a ni a, kan ramah pawh mi thenkhat a nghawng a ni.

• Insulin man to tak: Insulin lei a harsat avangin mi thenkhat chuan a dose pek aia tlem an hmang thin. Hei hian thisen sugar level hlauhawm tak a thlen thei a, nunna atana hlauhawm Diabetic Ketoacidosis (DKA) ang chi natna a thlen thei bawk.
• Ei leh in mumal lohna: A hun taka ei leh in loh hian thisen sugar level a ti nghet lo thei a ni.

Hetiang natna lan chhuah dan hi engte nge ni?

Brittle diabetes vei chuan thisen sugar hniam (hypoglycemia) leh thisen sugar sang (hyperglycemia) te hi a inthlak danglam fo thin.

Hei hian eng harsatna nge a thlen theih?

Thisen sugar level inthlak danglam reng hi taksa tan a tha lo. Hei hian hun rei lote chhung leh hun rei tak chhung harsatna a thlen thei a ni.

Thisen sugar tlahniam avanga harsatna awm thei

I thisen sugar level a hniam fo chuan hun kal zelah hypoglycemia unawareness tih natna i nei thei a ni. Hei hi i taksain thisen sugar level hniam a thiam tawh a, thisen sugar tlahniam vaukhânna chhinchhiahna, nghing leh thawk hah ang chi a lantir loh lai a ni. Hei hi a hlauhawm hle a, a chhan chu rang takin hriatna i hloh thei a, vaukhânna tel lovin seizures i nei thei bawk. Enkawl loh chuan thihna hial a thlen thei a ni.

Thisen sugar sang vanga harsatna awm thei

Thisen sugar level control theih loh a nih chuan emergency diabetic ketoacidosis (DKA) an tih chu a thleng thei a ni. Hei hi nunna atana hlauhawm tak a ni. DKA natna lan chhuah dan chu:

• Nausea leh luak chhuak
• Taksa tui tlakchhamna
• Pum natna nasa tak
• Fruity thaw chhuak
• Thâwk thuk, rang tak (Kussmaul thawk) .
• Lung na tak tak
• Thil hriatna hloh leh hriat lohna

Tin, hun rei tak chhunga thisen sugar level sang hian zunthlum natna lian tham tak tak a thlen theihna a tipung bawk.

• Mit tichhe thei (Retinopathy) .
• Kal chhiatna (Nephropathy) .
• Nerve tihchhiatna (Neuropathy) 1.1.
• Lung natna
• Thai

Hei hi engtin nge enkawl a nih?

Brittle Diabetes enkawlna tum ber chu thisen sugar level nghet lo awm chhan bulpui ber ngaihtuah a ni.A chhan bulpui zawng chhuak leh enkawl. Entirnan, celiac natna vei chuan gluten-free diet a hman hian a thisen sugar level a ti nghet thei a ni. Thyroid harsatna enkawl hian zunthlum control nan a pui thei a ni.

A chhan bulpui i enkawl lai hian i doctor chuan hetiang hi a rawn rawt thei ang:

• Continuous Glucose Monitoring (CGM) device hman dan: He device hian i thisen sugar level a enfiah chhunzawm zel a, i sugar level sang leh hniam a nih chuan alert a pe thin.
• I thisen thlum zat enfiah fo ang che: I doctor chuan ni khatah vawi tam tak i kut zungtang atanga thisen tla khat la chhuakin i thisen sugar level enfiah turin a ti thei che a ni.
• Insulin pump hman dan: Hei hian taksain insulin mamawh zat chu dik zawk leh mumal zawkin a pe chhuak thin.
• Mental health professional atanga tanpuina: Psychologist ang mi hmuh a, stress leh lungkhamna ang chi thil enkawl dan tur thurawn lak hi a pawimawh hle.
• Chhungte emaw, nursing assistant emaw a\anga \anpuina: Tar emaw, hriatrengna lama harsatna nei emaw chuan a hun taka insulin pek leh an thisen sugar enfiah turin chhungte \anpuina an mamawh mai thei.
• Social worker hnen atanga tanpuina: Insulin lei thei lo emaw, ei leh in lama harsatna nei emaw te chuan solution dik tak zawng turin tanpuina an dawng thei a ni.

A nasat em em, enkawlna dangin a thunun theih lohna hmunah chuan pancreas transplant neih a tha thei.

Damdawi lam thurawn i lak nghal tur hunah

Brittle Diabetes hi khelhpui tur a ni lo. Hetiang thilah hian hmalak vat a pawimawh hle.

Hetiang dinhmun hi enkawl hi thil harsa tak a ni thei. Chuvang chuan doctor pan fo a pawimawh a, i thisen sugar level inthlak danglamna chungchang sawipui a pawimawh. Hei hi i sualna a ni lo tih hre reng ang che. Enkawlna dik tak, technology puihna leh i chhungte puihna hmangin he dinhmun hi a tam zawkah chuan thunun theih a ni.