Ruwan (wazaka 45), mainjiniya wa mapulogalamu, anabwera ku chipatala changa Lachitatu m'mawa watha. Anakhala pampando wake, akuoneka woda nkhawa kwambiri komanso wopanda thandizo.
"Dr. Priya, ndakhala ndikumva ludzu losapiririka posachedwapa. Ngakhale ndimamwa malita 5-6 a madzi patsiku, ludzu langa silimatha. Komanso, ndimayenera kupita kuchimbudzi mphindi 30-45 zilizonse. Ndiyenera kudzuka kasanu ndi kamodzi usiku kuti ndipite kuchimbudzi. Kuphatikiza apo, ngakhale nditadya mochuluka bwanji, njala yanga siitha. Ndikumva njala kwambiri. Koma ngakhale zonsezi, kulemera kwanga kwatsika ndi pafupifupi makilogalamu 4 mwezi watha," Ruwan anafotokoza kusasangalala kwake.
Ndinayang'ana lipoti la mayeso a shuga m'magazi a Ruwan ndipo ndinafotokoza kuti: "Ruwan, shuga wanu m'magazi mwasala kudya wakwera kufika pa 280 mg/dL. Zizindikiro zomwe mukufotokoza ndi zomwe sayansi ya zamankhwala imatcha 3 Ps of Diabetes . Izi ndi izi:
1. Polyuria: Kukodza pafupipafupi.
2. Kuchuluka kwa ludzu: Kumva ludzu kwambiri.
3. Kuchuluka kwa njala: Kumva njala kwambiri.
"Lero, tiyeni tikambirane chifukwa chake zizindikiro zitatuzi zimachitika chifukwa cha shuga wambiri m'thupi lanu komanso momwe mungapewere."
🚨 Zizindikiro zofiira zomwe zimafuna chithandizo chamankhwala mwachangu
Ngati pali matenda a shuga a 3P, makamaka kwa odwala matenda a shuga a Type 1, kuchuluka kwa shuga m'magazi kosalamulirika kungayambitse matenda oopsa otchedwa Diabetic Ketoacidosis (DKA) . Ngati mukukumana ndi zizindikiro zotsatirazi, muyenera kupita kuchipatala chapafupi nthawi yomweyo:
- Fungo lofanana ndi la zipatso kapena acetone pamphuno (fungo lofanana ndi la Fruity breath).
- Kupuma mofulumira komanso mozama mosalekeza (Kussmaul breathing).
- Kusanza ndi kusanza komwe kumapweteka kwambiri m'mimba.
- Kugona tulo tofa nato kwambiri, kugona tulo tofa nato, kusokonezeka maganizo, kapena kutaya chidziwitso.
- Shuga m'magazi opitirira 250 mg/dL komanso kupezeka kwa ma ketones mu mkodzo.
Mbiri ya sayansi kumbuyo kwa matenda a shuga a 3 Ps
Zizindikiro zitatu izi zimachitika chifukwa cha ntchito za thupi zogwirizana:
1. Polyuria - kukodza pafupipafupi
Pamene shuga m'magazi apitirira 180 mg/dL (Renal Threshold), impso sizingathe kuyamwa shuga wonse m'magazi. Shuga wochuluka umatulutsidwa mu mkodzo. Shuga akatulutsidwa, amakokanso madzi ambiri kuchokera m'thupi kupita kwa iwo okha chifukwa cha kuthamanga kwa osmotic. Njira imeneyi imatchedwa Osmotic Diuresis . Zotsatira zake, wodwalayo amakodza pafupipafupi komanso mochuluka.
2. Polydipsia - Ludzu lochuluka
Madzi ambiri akatuluka m'thupi chifukwa cha polyuria, maselo a thupi amauma. Pakati pa ludzu muubongo (Hypothalamus) pamayamba kukonzedwa, zomwe zimapangitsa ludzu lochuluka kuti thupi likhale ndi madzi okwanira. Kaya mumwa madzi otani, ludzu limeneli silitha mpaka shuga m'magazi mwanu atatsika.
3. Polyphagia - Njala yochuluka
Mu thupi lathanzi, hormone ya insulin ndi yofunika kwambiri kuti shuga ilowe m'maselo ndikupanga mphamvu. Komabe, mu matenda a shuga, chifukwa cha kusowa kwa insulin kapena kukana insulin, shuga sangalowe m'maselo. Zotsatira zake, ngakhale kuti shuga ali wochuluka m'magazi, maselo amakhalabe ndi njala. Ubongo nthawi zonse umalandira uthenga wakuti "mphamvu siikwanira", kotero wodwalayo amakhala ndi njala yambiri. Popeza maselo salandira mphamvu, thupi limayamba kuswa mafuta ndi minofu, zomwe zimapangitsa kuti thupi lichepe.
Matenda ena okhudzana ndi 3 Ps
| Chizindikiro | Zifukwa zina kupatula matenda a shuga |
|---|---|
| Polyuria | Matenda a shuga a Insipidus (vuto lina la mahomoni lomwe impso sizingathe kulamulira madzi), kugwiritsa ntchito mankhwala ochepetsa mphamvu ya madzi m'thupi, kumwa khofi wambiri kapena kumwa mowa. |
| Kuchuluka kwa shuga m'magazi (polydipsia) | Matenda a psychogenic polydipsia, omwe amayamba chifukwa cha kupsinjika maganizo, ndi vuto lomwe calcium m'thupi imakhala yambiri. |
| Polyphagia | Hyperthyroidism, kuvutika maganizo, ndi mankhwala ena a steroid. |
Zoyenera kuchita ndi zosayenera kuchita
| ✔️ Zinthu zoti muchite (kuchita) | ❌ Zosayenera kuchita |
|---|---|
| Ngati zizindikiro zitatuzi zikupezeka, pitani kukayezetsa magazi nthawi yomweyo kuti mupeze shuga m'magazi (FBS) ndi HbA1c. | Musamamwe madzi a zipatso, zakumwa zoziziritsa kukhosi, kapena zakumwa zotsekemera kuti muchepetse ludzu lanu. Izi zitha kuonjezera shuga m'magazi mwanu ndikukuphani. |
| Imwani madzi oyera okha nthawi iliyonse mukamva ludzu. | Musayambe kumwa mapiritsi a shuga (monga metformin) nokha popanda upangiri wa dokotala. |
| Onjezerani ndiwo zamasamba zobiriwira zokhala ndi ulusi wambiri ndi chimanga cha chimanga muzakudya zanu za tsiku ndi tsiku. | Pewani kuchita mantha ndi kusiya kudya nthawi yomweyo zizindikiro zikayamba kuonekera. Izi zingayambitse kuchepa kwa shuga m'magazi (hypoglycemia). |
❓ Mafunso ena omwe mungakhale nawo (FAQ)
Kodi zizindikirozi zimasiyana bwanji pakati pa matenda a shuga a mtundu woyamba ndi mtundu wachiwiri ?
Mu matenda a shuga amtundu woyamba, thupi limasiya kutulutsa insulin kotheratu, kotero zizindikiro za 3Ps zimatha kukhala zazikulu kwambiri mkati mwa milungu ingapo. Komabe, popeza matenda a shuga amtundu wachiwiri amakula pang'onopang'ono kwa zaka zambiri, zizindikirozi sizingawonekere pachiyambi.
Kodi zizindikirozi zimachitika panthawi ya prediabetes ?
Ayi, nthawi zambiri, palibe zizindikiro zomwe zimawonekera panthawi ya prediabetes, chifukwa shuga m'magazi sakwera kufika poti zizindikiro za 3 Ps zimachitika (pamwamba pa Renal Threshold). Itha kupezeka kokha poyesa magazi.
Kodi zizindikiro za matenda a shuga a 3P zimatha munthu akangoyamba kudwala matenda a shuga ?
Inde, pamene shuga m'magazi akukhalabe mkati mwa mulingo wabwinobwino (wosakwana 140 mg/dL) kudzera mu chithandizo ndi kusintha kwa moyo, impso zimasiya kutulutsa shuga ndipo njira ya osmotic diuresis imasiya. Ludzu, kukodza pafupipafupi, ndi njala yambiri zimachiritsidwa kwathunthu.
Kodi zizindikiro izi zingachitike mu matenda a shuga a mimba? ▼
Inde, matenda a shuga amatha kuchitika chifukwa cha kusintha kwa mahomoni panthawi ya mimba (matenda a shuga a mimba), omwe angayambitsenso kukodza pafupipafupi komanso ludzu lochuluka. Mayi woyembekezera ayenera kuyesedwa OGTT pakati pa milungu 24-28.
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