Une shuga yakakwira muropa mangwanani here, kunyangwe uine chirwere cheshuga? Ngatidzidzei nezve 'Somogyi effect' iyi?

Uri munhu anotora insulin yechirwere cheDiabetes Mellitus here? Kana zvakadaro, wakaona here kuti huwandu hweshuga muropa rako hwawedzera kamwe kamwe paunomuka mangwanani? Kunyangwe ukatora mushonga wako husiku uye ukangwarira, zvinoshamisa kuti uchiri nawo mangwanani? Chimwe chikonzero cheizvozvo chingave 'Somogyi effect'. Ngatitaurei nezveizvi zvakadzama .

Chii chinonzi Somogyi effect?

Zvichitaurwa zviri nyore, mhedzisiro yeSomogyi inowanikwa kana munhu ane chirwere cheshuga achitora insulin akadzikira kamwe kamwe muhuwandu hweshuga muropa (hypoglycemia) husiku, zvichiteverwa nekukwira kamwe kamwe muhuwandu hweshuga muropa (hyperglycemia) mangwanani. Izvi zvinoitika nekuda kwekushanda kwemahormones mumiviri yedu. Fungidzira, pakati pehusiku, shuga yako muropa inodzikira kamwe kamwe, uye muviri wako unofunga kuti, "Aa, murume uyu achapinda mumatambudziko," uye unoburitsa mahormones kuti umuponese. Ndosaka huwandu hweshuga yako muropa huchikwira mangwanani.

Yakatumidzwa zita raDr. Michael Somogyi, chiremba akatanga kuiwana muma1930. Dzimwe nguva vanachiremba vanoti 'rebound hyperglycemia'.

Asi hechino chimwe chinhu chaunofanira kuziva. Mhedzisiro yeSomogyi ichiri 'dzidziso' pakati pevaongorori, zvichireva kuti ingori pfungwa. Izvi zvinoreva kuti haina kusimbiswa zvizere, asi kune humbowo hwesainzi hunoitsigira. Kare, vanachiremba vaifunga kuti ichi ndicho chikonzero chikuru chekukwira kweshuga mangwanani. Asi tsvakiridzo itsva, kunyanya tsvakiridzo inoshandisa continuous glucose monitoring (CGM), yakamutsa mibvunzo nezvepfungwa iyi.

Kune zvimwe zvikonzero zvakawanda nei huwandu hweshuga muropa huchigona kuwedzera mangwanani, kwete chete Somogyi effect:

• Huwandu hwemushonga waunotora hauna kukwana, nekuti unobuda mumuviri wako husiku.
• Chiitiko chinonzi chiitiko cheDawn. (Tichataurawo nezveizvi)
• Huwandu hwemushonga unonwiwa panguva yekudya kwemanheru hauenderane nehuwandu hwechikafu.
• Kuva ne insulin resistance.

Ndeupi musiyano uripo pakati peSomogyi effect neDawn phenomenon?

Zvakanaka, ikozvino ungave uchishamisika kuti, 'Chii ichi chinoitika mangwanani?' Zvese izvi zvinhu zvinokonzera kuti huwandu hweshuga muropa hukwire mangwanani kuvanhu vane chirwere cheshuga.

Chiitiko chemangwanani kuwedzera kweshuga muropa kunokonzerwa nekuburitswa kwemahormone akati wandei (akadai se cortisol ne hormone yekukura) mangwanani-ngwanani. Izvi zvakajairika.

Asi muSomogyi effect, mahormone anoshandawo, asi zvinoitika nekuda kwekudonha kamwe kamwe kweshuga (hypoglycemia) husiku. Muchiitiko chemambakwedza, shuga haiwedzeri nekuda kwekudonha kwakadaro kweshuga.

Chimwe chinhu chakakosha ndechekuti chiitiko chemangwanani, chimwe chezvikonzero zvinokonzera kuwedzera kweshuga muropa mangwanani , chinowanzoitika kupfuura Somogyi effect.

Ndezvipi zviratidzo zveSomogyi effect?

Chiratidzo chikuru cheSomogyi effect ndechekuti huwandu hweshuga muropa rako hunokwira paunomuka mangwanani. Kunyangwe ukatarisa glucometer yako kana kana uchishandisa mudziyo weCGM (Continuous Glucose Monitoring), zvicharatidza kuti huwandu hweshuga yako hwakakwira mangwanani.

Zvichienderana nekuti shuga yako yeropa yakakwira zvakadii, unogona kuona zviratidzo zvakaita seizvi paunomuka mangwanani:

• Nyota kakawanda (polydipsia).
• Kunzwa nzara kupfuura zvakajairika.
• Kuita weti kakawanda.
• Musoro.
• Kunzwa kushatirwa uye hasha (kushatirwa).

Sei chiitiko cheSomogyi chichiitika?

Zvinoenderana nedzidziso yeSomogyi effect, kana huwandu hweshuga muropa rako hukadzikira zvakanyanya (hypoglycemia) pakati pehusiku paunenge wakarara nekuda kwe insulin yauri kutora, muviri wako uchaedza 'kukuponesa' kubva pakudzikira kweshuga.

Muviri unoburitsa mahormone akati wandei e "basa rekununura" iri. Mahomoni makuru ndeaya:

• Adrenaline
• Corticosteroids
• Hormone yekukura
• Glucagon

Mahormone aya anoita kuti chiropa chako chibudise shuga yakawanda, kana kuti shuga, kupfuura zvakajairika muropa rako. Kuburitswa kweshuga uku kunoita kuti huwandu hweshuga muropa rako hukwire. Kana uine chirwere cheshuga, pancreas yako haiburitse insulin yakakwana yekudzora huwandu hweshuga uhwu hwakakwira, kana kuti haiburitse zvachose. Ndokusaka huwandu hweshuga muropa rako huchiramba hwakakwira.

Mumunhu asina chirwere cheshuga, muviri unodzora huwandu hweshuga muropa uye unohuchengeta huri mukati mehuwandu hwakati. Ndosaka Somogyi effect isingakanganisi vanhu vasina chirwere cheshuga.

Ungawana sei chiremba akadai?

Kutaura zvazviri, Somogyi effect haisiyo inonyanya kukonzera kukwira kweshuga muropa mangwanani, saka zvinogona kuoma kuona. Uye, sezvandambotaura, tsvakiridzo yazvino inoratidza kuti inogona kunge isiriyo inokonzera kukwira kweshuga muropa mangwanani. Saka zvinogona kuoma, kana zvisingaite, kuti chiremba aongorore nemazvo achiti, 'Zvakanaka, ndizvozvo.'

Kana uchiwanzova neshuga yakakwira muropa mangwanani, zvakanaka kutaura nachiremba wako anokubatsira kudzora chirwere chako cheshuga. Iye achatarisa kuti huwandu hweshuga muropa rako hunochinja sei uye oedza kutsvaga chikonzero chacho. Nzira inoshanda zvikuru yekuita izvi ndeyekushandisa mudziyo weCGM (Continuous Glucose Monitoring).

Kana usiri kushandisa CGM, chiremba wako angangokuudza kuti utarise huwandu hweshuga muropa rako kakawanda pazuva. Semuenzaniso:

• Maawa maviri mushure mekudya kwemanheru.
• Usati warara.
• Pakati pehusiku (semuenzaniso, kuma2 kana 3am).
• Pakumuka mangwanani.

Uyewo, vanokuudza kuti unyore zvese zvakaita sekuti ndezvipi zvekudya zvaunodya husiku, kuti unodya zvakadii, uye kana uchirovedza muviri husiku, kuti unoita maekisesaizi erudzii uye kwenguva yakareba sei.

Chiremba anogona kuziva chikonzero cheshuga yakakwira muropa mangwanani chete nekuunganidza ruzivo urwu.

Mhedzisiro yeSomogyi inorapwa sei?

Mushure mekunge iwe nachiremba wako mashanda pamwe chete kuti muone kuti huwandu hweshuga muropa rako hunoita sei husiku, vachakupa mazano ekuchinja kwaunogona kuita kudzivirira kukwira kweshuga muropa mangwanani. Yeuka, muviri wemunhu wese wakasiyana, uye pane zvinhu zvakawanda zvinokanganisa huwandu hweshuga muropa. Saka, zvaunogona kuita kudzivirira kukwira kweshuga muropa mangwanani zvinogona kusiyana kubva pamunhu nemunhu.

Chiremba wako anogona kukupa mazano ekuti:

• Kuchinja mushonga wechirwere cheshuga kana insulin.
• Kuchinja marudzi ezvekudya zvaunodya panguva yekudya kwemanheru. Semuenzaniso, ungangoda kudya zvekudya zvine mapuroteni akawanda, makabhohaidhiretsi, kana mafuta, kana kuti ungangoda kudya zvishoma.
• Kana zvichibvira, kushandisa pombi ye insulin kunokubatsira kudzora madhigirii ako e insulin nemazvo.
• Kuchinja nguva yekurovedza muviri husiku.

Ndezvipi zvinetso zvinogona kukonzera izvi?

Kunyangwe Somogyi effect iriyo inokonzera kukwira kweshuga muropa mangwanani kana kwete, izvi zvinoratidza zvinhu zviviri zvakakosha. Vanhu vane chirwere cheshuga vanofanira kuedza kudzivirira matambudziko maviri aya:

• Kugara kwakakwira kweshuga muropa.
• Kuderera kweshuga muropa (hypoglycemia) kunoitika husiku.

Kuwedzera kweshuga muropa kuri kuramba kuchienderera mberi

Sezvo huwandu hweshuga muropa rako huchiramba hwakakwira, huwandu hweHbA1c (A1C) yako huchawedzera, uye Time in Range (TIR) ​​yako ichaderera. Kuongororwa kweHbA1c kunoyera huwandu hweshuga muropa rako mumwedzi mitatu yapfuura. TIR ndiyo avhareji yemazuva ayo huwandu hweshuga muropa rako huri mukati mehuwandu hwakatarwa.

Kana huwandu hweA1c neTIR hwako hwakanyanya kuipa, kunyanya kana hwagara huripo kwemakore, njodzi yako yekuve nematambudziko anokonzerwa nechirwere cheshuga inowedzera. Mienzaniso yematambudziko aya inosanganisira:

• Matambudziko emaziso (Retinopathy)
• Matambudziko eitsvo (Nephropathy)
• Kurwara netsinga
• Chirwere chemwoyo

Ongororo yakaratidza kuti vanhu vane chirwere cheshuga vanogona kuderedza njodzi yezvinetso izvi kana vakaramba vaine A1c levels pasi pe7%.

Kuwanda kweshuga muropa mangwanani kunogona kuva dambudziko rinogara riripo, uye kana rikasarapwa, huwandu hweshuga muropa rako hunogona kuramba hwakakwira kwemaawa akati wandei pazuva. Izvi zvinowedzera njodzi yako yekuve nematambudziko echirwere cheshuga nekufamba kwenguva.

Kurara kweshuga shoma muropa husiku hwese

Kune vanhu vazhinji vane chirwere cheshuga, shuga shoma muropa, kana kuti hypoglycemia, ndipo apo shuga muropa inodonha pasi pe70 mg/dL (milligrams pa deciliter).

Kana huwandu hweshuga muropa hukadzikira, vanhu vazhinji vanowana zviratidzo zvakaita seizvi:

• Kunzwa muviri wako uchidedera.
• Kunzwa nzara yakanyanya (polyphagia).
• Kudikitira uye kunzwa kutonhorwa.
• Dzungu, kunzwa kusuruvara.
• Kurova kwemoyo kunowedzera.

Zvisinei, kana shuga yako yeropa ikadonha paunenge wakarara, zvinogona kutora nguva kuti umuke woona zviratidzo. Izvi zvinogona kuva nengozi, uye hypoglycemia yakanyanya inogona kutyisidzira hupenyu. Zviratidzo zveshuga yakaderera yeropa husiku zvinogona kunge zvakasiyana zvishoma, zvinosanganisira:

• Kushaya hope, kunzwa kusagadzikana nehope.
• Kunzwa kuneta uye kusanyatsofunga paunomuka mangwanani.
• Kurota hope dzakaipa.
• Mbatya kana magumbeze awakapfeka anonyorova nekuda kwedikita.

Hazvinei kuti zviratidzo zvako zvinoita kuti ufunge kuti une shuga shoma muropa, zvakakosha kuti utarise huwandu hweshuga muropa rako kuti uone kuti hwakaderera sei. Izvi zvichakubatsira kusarudza kuti ungahurapa sei. Kuti urape hypoglycemia, unofanira kudya makabhohaidhiretsi anokurumidza kushanda, ayo ari shuga (senge bhanana kana muto weapuro).

Kana uchiwanzova neshuga shoma muropa husiku, iva nechokwadi chekutaura nachiremba wako nezvazvo. Pamwe chete, munogona kugadzirisa hurongwa hwenyu hwekutarisira chirwere cheshuga kuti chisaitike zvakare.

Ndinofanira kuona chiremba rini?

Kana uchigara uchisangana neshuga yakakwira muropa mangwanani, zvakakosha kutaura nachiremba wako ari kukubatsira kudzora chirwere chako cheshuga. Iye anogona kuyedza huwandu hweshuga muropa rako, kuona kana Somogyi effect iriyo chikonzero, kana kana paine chimwe chinhu chiri kuitika, uye kukurudzira chirongwa chekurapa chakakunakira.

Kuva neshuga yakakwira muropa mangwanani kunogona kunetsa uye kusingafadzi. Hapana mhinduro imwe chete yeizvi. Saka zvinogona kutora nguva kuti uwane mhinduro yakakunakira. Chiremba wako anogona kukubatsira kusarudza nzira yakanakisisa yekuita. Usatya kukumbira rubatsiro rwavo. Kutora matanho izvozvi kunogona kukubatsira kudzivirira matambudziko enguva pfupi uye enguva refu.

Chekupedzisira, chinhu chinonyanya kukosha (Mharidzo Yekuenda Kumba)

Zvakanaka, saka ikozvino wava kunzwisisa zviri nani nezveSomogyi effect yatakataura nezvayo. Yeuka, ichi hachisi chikonzero chega chekuwedzera kweshuga mangwanani. Asi, zvakakosha kuziva nezvazvo.

• Chinhu chikuru ndechekuti, kana uchigara uine shuga yakakwira muropa mangwanani, usazviregeredza. Iva nechokwadi chekutaura nachiremba wako.
• Kana uri kushandisa CGM (Continuous Glucose Monitoring), tsvaga rubatsiro kuna chiremba wako kuti aongorore ruzivo rwacho nemazvo.
• Kuderera kweshuga muropa (hypoglycemia) husiku kune njodzi huru. Kana uine chimwe chezviratidzo izvi, udza chiremba wako nezvazvo zvakare.
• Kurukurai nachiremba wenyu nezvekudya kwenyu, maekisesaizi, uye mwero wemishonga yenyu mozvigadzirisa zvichienderana nezvakakunakirai.

Kurarama nechirwere cheshuga idambudziko, asi kana ukabatwa zvakanaka, unogona kurarama hupenyu hune hutano. Usatya, zvakanaka here?

` Mhedzisiro yeSomogyi, chirwere cheshuga, kuwedzera kweshuga mangwanani, hypoglycemia, hyperglycemia, insulin