Tinonyatsoziva here nezveKukotsira Kunokonzerwa neShuga?

Ungayeuka mumwe munhu ane chirwere cheshuga, pamwe nhengo yemhuri kana shamwari. Dzimwe nguva takanzwa nezvevanhu vakadaro vanongoerekana varasikirwa nepfungwa, vasisakwanise kutaura, uye dzimwe nguva vanodonha pasi. Ichi chirwere chine njodzi uye chinotyisidzira hupenyu. Ndosaka, nhasi tafunga nezvechirwere ichi chinogona kukonzerwa nechirwere cheshuga, kana sekudanwa kwazvinoitwa navanachiremba, `(Diabetes-Related Coma)`. Kuziva izvi zvakanaka kuchatibatsira kutarisira vadikanwi vedu.

Chii chinonzi Coma Inokonzerwa neShuga? Zvichitaurwa zviri nyore...

Zvichitaurwa zviri nyore, chirwere cheshuga chinonzi diabetic coma chirwere chakakomba, chinotyisidzira hupenyu chinoitika kana huwandu hweshuga muropa redu hwakwira zvakanyanya (hyperglycemia) kana kuti hwakaderera zvakanyanya (hypoglycemia). "Coma" mamiriro ekushaya ruzivo rwakakwana, sekunge kurara hope dzakadzika, uye kusakwanisa kumutswa nekutaura. Zvisinei, vachiri vapenyu kunyangwe varasikirwa neruzivo. Ichi chirwere chinoda kurapwa nekukurumidza.

Pane zvikonzero zvikuru zvitatu zvemamiriro ezvinhu ane njodzi aya.

Pane nzira nhatu huru dzinoita kuti munhu ane chirwere cheshuga awire mukoma. Ngatitarisei kuti chii:

1. Hyperosmolar Hyperglycemic State (HHS)

2. Ketoacidosis Inokonzerwa neShuga (DKA)

3. Kuwanda kweshuga yeropa (hypoglycemia)

Zvino ngatitaurei nezve chimwe nechimwe cheizvi zvakadzama, zvakanaka here?

1. Chii chinonzi Hyperosmolar Hyperglycemic State (HHS)?

Dambudziko iri, rinonzi HHS, rinonyanya kuitika kuvanhu vane chirwere cheshuga cherudzi rwechipiri. Rinoitika kana huwandu hweshuga muropa (glucose) hwakakwira zvakanyanya (kazhinji hunopfuura 600 mg/dL) kwenguva yakareba. Izvi zvinogona kukonzera kuti muviri wako urasikirwe nemvura yakawandisa, zvichikonzera kupera mvura mumuviri zvakanyanya, kuvhiringidzika, nezvimwe zviratidzo. Kana rikasarapwa nekukasika, rinogona kukonzera coma.

2. Chii chinonzi Diabetes-Related Ketoacidosis (DKA)?

Chirwere chinonzi "DKA" chinogonawo kutyisidzira hupenyu. Chinowanzo bata vanhu vane "Type 1 Diabetes" (chinogona kubata vanhu vane chirwere ichi kare, pamwe nevaya vasingazive kuti vanacho). Zvisinei, dzimwe nguva chinogonawo kuitika kuvanhu vane Type 2 Diabetes.

DKA inoitika kana muviri wako usina insulin yakakwana (ingave yechisikigo kana kuti inotorwa kubva kunze). Sezvaunoziva, insulin inokosha kuti shuga iri muropa redu, glucose, ipinde mumasero edu uye ishandiswe sesimba. Saka kana insulin isipo kana kuti isina kukwana, muviri unotanga kuputsa mafuta kuti uwane simba. Kana mafuta apwanyika, makemikari anonzi ketones anoburitswa muropa.

Kana huwandu hwe`(ketones)` mumuviri wemunhu ane chirwere cheshuga hukawedzera, ropa rinotanga kuva`(acidic).` Kana izvi zvikasarapwa nenguva, munhu anogona kubatwa nekoma. Huwandu hweshuga muropa remunhu ane`(DKA)` hunowanzova hwakakwira kupfuura 250 mg/dL. Asi yeuka, chikonzero chikuru che`(DKA)` kushaikwa kwe`(insulin)` uye kuwedzera kwe`(ketones)`, kwete shuga yeropa chete. Vamwe vane chirwere cheshuga vanogona kupfuura ne`(DKA)` kunyangwe shuga yavo yakakwira kupfuura 250 mg/dL.

3. Chii chinonzi hypoglycemia yakanyanya?

Ichi ndicho chikonzero chechitatu. Kana huwandu hweshuga muropa hukadzikira pasi pe40 mg/dL, zvinoonekwa se "hypoglycemia" yakakura. Izvi zvine njodziwo muhupenyu.

Unoziva, simba guru remuviri wedu uye kunyanya uropi ndi `(glucose)`. Saka kana huwandu hweshuga muropa hukadzikira, muviri haugone kushanda zvakanaka. Kana huwandu hweshuga hukadzikira pasi pe40 mg/dL, sezvambotaurwa, unogona kusangana neshanduko mumuviri wako nepfungwa, zvichiita kuti usakwanise kuita chero chinhu. Kana chirwere ichi chakakomba che`(hypoglycemia)` chikasarapwa kwenguva yakareba, unogona kupinda mukoma.

Dambudziko iri rekushaya shuga yakawanda mumuviri rinonyanya kuitika kuvanhu vanotora insulin yechirwere cheshuga kana mamwe mapiritsi echirwere cheshuga akadai sesulfonylureas.

Ndezvipi zviratidzo zvechirwere cheshuga? Tinozviziva sei?

Pane zvinhu zvitatu zvikuru zvinoita kuti munhu anzwe ari pakoma:

• Kusaziva: Zvakafanana nekurara hope dzakadzika. Hazvina mhosva kuti unotaura zvakawanda sei, zvakaoma zvikuru, zvinenge zvisingaite, kukumutsa.
• Kusaita kwemaziso: Maziso anoramba akavharwa. Hapana mhinduro kana mumwe munhu akavhura maziso ake. Zvisinei, dzimwe nguva panogona kunge paine mhinduro dzemaziso kuzvinhu zvakaita sechiedza.
• Kusashanda zvakanaka kwemuviri: Hapana kufamba-famba uchiziva. Zvisinei, mamwe mafambiro e reflex anogona kunge aripo.

Iye zvino ngationei kuti ndezvipi zviratidzo zvinoonekwa tisati tava pakoma mune zvataurwa pamusoro apa `(DKA)`, `(HHS)` uye `(hypoglycemia)` yakanyanya. Kana ukaona izvi nekukurumidza, unogona kudzivirira tsaona huru.

Zviratidzo zvinotanga ne coma muDKA:

• Kusvotwa nekurutsa.
• Marwadzo emudumbu.
• Kufema nekukurumidza, kwakadzika (vanachiremba vanodana izvi kuti "Kussmaul breathing"). Kunogona kuitwa nerhythm imwe chete.
• Kunhuhwirira kwemuchero pakufema.
• Kunzwa kuneta zvakanyanya uye kushaya simba.
• Kunzwa kuvhiringidzika kana kuvhiringidzika.
• Kudzikira kwekungwarira.

Zviratidzo zvinotangira coma mu `(HHS)` mamiriro:

• Kuchinja kwepfungwa: kuvhiringidzika, kupenga, kuona zvinhu zvisipo.
• Zvakaita sekuti wava kuda kurasikirwa nepfungwa.
• Muromo wakaoma uye nyota yakawandisa (polydipsia).
• Kuita weti kakawanda.
• Kuona kusina kujeka kana kurasikirwa nekuona.
• Kushaya simba, dzimwe nguva kune rumwe rutivi rwemuviri.

Zviratidzo zvinotanga kuitika mushure me coma mu hypoglycemia yakakura zvinosanganisira:

• Kuona kusina kujeka kana kuona kaviri.
• Kusanganisa mazwi pakutaura.
• Kurasikirwa nepfungwa dzakadzikama uye kuoma kuita zvinhu.
• Kuvhiringidzika.
• Kubatwa nepfungwa kwakafanana nekubatwa nepfungwa.

Kana ukaona chimwe chezviratidzo izvi, usazviregeredza. Zvakanaka kutsvaga rubatsiro rwechiremba nekukasika.

Toita sei kana mumwe munhu akarasikirwa nepfungwa nekuda kwechirwere cheshuga? (Rubatsiro rwekutanga)

Fungidzira mumwe munhu munharaunda yako achingoerekana arasikirwa nepfungwa nekuda kwechirwere cheshuga. Pane zvinhu zvishoma zvaunogona kuita:

• Fonera 1990 nekukasika wobva watora amburenzi. Kana uchiziva kuti munhu wacho ane chirwere cheshuga, udzawo mushandi we1990 izvozvo.
• Musavape chekudya kana chekunwa. Vanogona kudzipwa.
• Tendeudza munhu wacho nerutivi rwake nokungwarira kuitira kuti mate kana kurutsa zvisavhare nzira yekufema.
• Kusvika amburenzi yasvika, tevera mirairo yakapihwa nemushandi wepa1990.

Kana zvikaitwa nemazvo, izvi zvinogona kubatsira zvikuru mukuponesa hupenyu hwemunhu iyeye.

Sei chirwere cheshuga chichikonzera kurasikirwa nepfungwa kwakadaro? (Zvikonzero zviri nyore)

Sezvatakambokurukura, pane zvikonzero zvikuru zvitatu zvinokonzera chirwere cheshuga, handiti?

• Mamiriro e hyperosmolar hyperglycemic `(HHS)`.
• Chirwere cheshuga chinonzi ketoacidosis (DKA).
• Hypoglycemia yakanyanya (shuga shoma muropa).

HHS neDKA zvirwere apo huwandu hwemvura mumuviri hunodzikira zvakanyanya, zvichikonzera kushaya mvura yakakwana mumuviri. Kushaya mvura mumuviri uku kunogona kukonzera coma.

Kune rumwe rutivi, kana munhu aine hypoglycemia yakanyanya, uropi hahuwani huwandu hweglucose (shuga) yahunoda. Shuga inokosha kuti uropi hushande zvakanaka. Kana yapera, uropi "hunodzima" uye unogona kupinda mukoma. Wanzwisisa izvozvo?

Ndiani ari panjodzi huru yekubatwa nechirwere cheshuga (diabetic coma)?

Munhu wese ane chirwere cheshuga (kunyangwe avo vane chirwere cheshuga chisati chaonekwa) ari panjodzi yekubatwa nechirwere cheshuga. Zvisinei, njodzi iyi inosiyana zvishoma zvichienderana nerudzi rwechirwere cheshuga:

• Vanhu vane chirwere cheshuga cherudzi rwekutanga (Type 1 Diabetes) vari panjodzi huru yekubatwa nechirwere checoma, kungave nekuda kweDKA kana hypoglycemia yakanyanya. Izvi zvinodaro nekuti vanhu vane chirwere cheshuga cherudzi rwekutanga vanoda insulin nguva dzese uye huwandu hweshuga muropa ravo hunochinja-chinja kupfuura vanhu vane chirwere cheshuga cherudzi rwechipiri.
• Vanhu vane chirwere cheshuga cherudzi rwechipiri vane mukana mukuru wekupinda mukoma nekuda kweHHS kupfuura DKA kana hypoglycemia yakanyanya.

Ndezvipi zvimwe zvinhu zvinokonzera njodzi?

Kuwedzera kune izvi, zvimwe zvinhu zvinogona kuwedzera njodzi yekuva nechirwere cheshuga:

• Kukura kwezvimwe zvirwere.
• Ndiri kuvhiyiwa.
• Kukuvara mumuviri (Kukuvara).
• Matambudziko nehurongwa hwe insulin (semuenzaniso, insulin pen, kusashanda zvakanaka kwepombi).
• Kukanganwa, kusvetuka, kana kutora insulin yakawandisa.
• Kusakwanisa kudzora chirwere cheshuga nemazvo (semuenzaniso kusaongorora huwandu hweshuga muropa zuva nezuva, kusatora mishonga nemazvo).
• `(Hypoglycemia kusaziva)` (kureva kusaziva zviratidzo zvekutanga zveshuga yakaderera muropa).
• Kunwa doro.
• Kushandisa zvinodhaka.

Vanachiremba vanoongorora sei chirwere cheshuga (diabetes coma) nemazvo?

Kurwara nechirwere cheshuga idambudziko rehutano rinoda kurapwa nekukasika. Munhu wese ari mukoma anoda kugara muchipatara.

Vanachiremba vanowanzo kwanisa kuona chirwere cheshuga nekukurumidza nekutora nhoroondo yako yehutano, kutarisa huwandu hweshuga muropa (kuongororwa kweglucose muropa), uye kuita mimwe miedzo yekutarisa ketones uye hutano hwako hwese.

Ndosaka zvichikosha kuti vanhu vane chirwere cheshuga vapfeke bracelet yekuzivisa nezvechirwere kana mutsipa. Kana pakaitika emergency, vanachiremba vanogona kuzviona voita sarudzo nekukurumidza. Zvakakoshawo kuzivisa mhuri yako, shamwari, nevaunoshanda navo kuti une chirwere cheshuga. Nenzira iyi, vanoziva zvekuita kana pakaitika emergency.

Unorapa sei munhu ane chirwere cheshuga (diabetes coma)?

Kurapwa kwechirwere cheshuga (diabetic coma) kunosiyana zvichienderana nechikonzero chacho , asi kugara muchipatara kunodiwa nguva dzose.

Kurapwa kwekoma inokonzerwa ne `(DKA)` kana `(HHS):

• Mvura yemutsinga: Izvi zvinopihwa kugadzirisa kushaya mvura mumuviri uye kusawirirana kwema electrolyte mumuviri.
• Insulin: Chikwata chekurapa chinogona kukupa insulin kuburikidza neIV kana sejekiseni repasi peganda.
• Mamwe marapirwo: Mamwe marapirwo anogona kupiwa kuti akubatsire kupora. Izvi zvinogona kusanganisira kurapa chero matambudziko ehutano kana hutachiona hunogona kunge huri kukonzera huwandu hweshuga muropa rako.

Kurapa kwekoma kunokonzerwa nehypoglycemia yakanyanya:

• Glucagon yekukurumidza:Iyi imhando yehormone inonzi glucagon yakagadzirwa. Inogona kupihwa nemunhu waunoda kana chiremba sejekiseni kana semushonga wekupfapfaidza mhino (zvichienderana nerudzi rwayo). Glucagon yakagadzirwa inoshanda nekuburitsa shuga yakachengetwa muchiropa, ichiwedzera huwandu hweshuga muropa.

Chinonyanya kukosha: Kunyangwe kana mumwe munhu wepedyo newe akakupa `(glucagon)`, zvechokwadi unoda kurapwa kuchipatara. Vanofanira kukupa `(glucagon)` uye fonera 1990 nekukasika.

Kana paine mamwe matambudziko, akadai sekutadza kushanda kwenhengo dzemuviri, anogonawo kuda kurapwa kwakawedzerwa.

Chii chatingaita kudzivirira chirwere cheshuga (diabetic coma)?

Kuti udzivise chirwere cheshuga chekoma, zvakakosha kuziva zviratidzo zvekutanga zvehypoglycemia (DKA), hypoglycemia (HHS), uye hypoglycemia. Taura nachiremba wako nezvematanho aungatora kurapa zvirwere izvi zvisati zvanyanya kuipa.

Enda kuna chiremba nekukasika kana:

• Kana huwandu hweshuga muropa rako huri 300 mg/dL kana kupfuura kaviri kakatevedzana pasina chikonzero chakajeka.
• Kana shuga yako yeropa yakaderera (iri pasi pe70 mg/dL) uye ikasadzoka payakajairika mushure mekuedza katatu kurapwa (semuenzaniso, mapiritsi eglucose, zvinwiwa zvine shuga), fonera chiremba wako kana 911 nekukasika.

Munhu anogona kurarama nechirwere cheshuga here kana kuti ari pakoma? Pane migumisiro yenguva refu here?

Ehe, chirwere cheshuga chinogona kudzivirirwa kana chikonzero chacho chikarapwa nekukurumidza. Zvisinei, vamwe vanhu vanogonawo kukuvara uropi zvachose. Kana chikarapwa nekukurumidza uye nemazvo, rufu runogona kutoitika.

Huwandu hwevakafa neDKA huri pakati pe0.2% ne2.5%. Avo vanopinda mukoma, vane hypothermia, uye vane weti shoma (oliguria) vanowana mhedzisiro yakaipa zvikuru.

Vanhu vanosvika 20% vane HHS vanofa nekuda kwechirwere ichi. Avo vanova nekoma kana BP yakaderera vane fungidziro yakaipa yekuti vacharwara.

Ungagara kwenguva yakareba sei uri mukoma une chirwere cheshuga?

Nguva yaunopedza uri mu diabetic coma inoenderana nekuti unokurumidza sei kuwana kurapwa kwakakodzera. Nzira chete yekugumisa coma yakadai ndeyekudzosera huwandu hweglucose muropa rako ne insulin padanho rakanaka. Izvi zvinongogona kuitwa chete nerubatsiro rwenyanzvi dzezvekurapa. Munhu ari mu diabetic coma haazodzokeri mupfungwa dzake ega.

Kana munhu ari mukoma akadai akasawana kurapwa nenguva, anogona kufa. "Nekufamba kwenguva" zvinosiyana zvichienderana nemamiriro ezvinhu uye munhu nemunhu. Ndosaka zvichikosha kuwana rubatsiro nekukurumidza.

Muchidimbu, hezvino zvinhu zvatinofanira kurangarira (Mharidzo Yekuenda Kumba):

Kunyangwe chirwere cheshuga chiri chinhu chine njodzi zvikuru, chinowanzo dzivirirwa.

• Chinhu chikuru ndechekuti,Ziva zviratidzo zvinonyevera zve `(DKA)`, `(HHS)` uye shuga shoma muropa uye ita chimwe chinhu nekukurumidza kana uchizviona.
• Kana uine zviratidzo zvechirwere ichi, fonera chiremba wako nekukasika.
• Matambudziko echirwere cheshuga anotyisa zvechokwadi, asi kuziva uye kugadzirira ndiyo nzira yakanakisisa yekudzivirira.
• Usambozeza kubvunza chiremba wako chero mibvunzo yaunayo nezvekurapa chirwere cheshuga chako kana matambudziko aya. Hutano hwako hunokosha kwauri.

Chirwere cheshuga, Coma, DKA, HHS, Hypoglycemia, Shuga muRopa, Insulin, Rubatsiro rwekutanga, Matambudziko eChirwere cheShuga, Kurasikirwa neMemori