Ingaba uneswekile ephezulu egazini ekuseni, nokuba unesifo seswekile? Masifunde ngale 'Somogyi effect'?

Ngaba ungumntu othatha i-insulin kwisifo seswekile? Ukuba kunjalo, ngaba ukhe waphawula ukuba iswekile yakho yegazi inyuke ngequbuliso xa uvuka kusasa? Nokuba uthatha amayeza akho ebusuku kwaye ulumkile, kuyamangalisa ukuba usenawo kusasa? Esinye sezizathu zaloo nto sinokuba 'yiSomogyi effect'. Makhe sithethe ngale nto ngokweenkcukacha .

Yintoni isiphumo seSomogyi?

Ngamafutshane, isiphumo seSomogyi sifumaneka xa umntu onesifo seswekile osebenzisa i-insulin ehla ngequbuliso amanqanaba eswekile egazini (hypoglycemia) ebusuku, kulandele ukunyuka ngequbuliso kwamanqanaba eswekile egazini (hyperglycemia) kusasa. Oku kwenzeka ngenxa yesenzo seehomoni ezithile emizimbeni yethu. Khawuthelekelele, phakathi kobusuku, iswekile yakho yegazi iyehla ngequbuliso, kwaye umzimba wakho ucinge, "Owu, lo mfo uza kungena engxakini," aze akhuphe iihomoni ukuze amsindise. Yiyo loo nto amanqanaba eswekile yakho egazini enyuka kusasa.

Ithiywe ngoGqr. Michael Somogyi, ugqirha owayifumanisa okokuqala ngeminyaka yoo-1930. Oogqirha ngamanye amaxesha bayibiza ngokuba yi-'rebound hyperglycemia'.

Kodwa nantsi into omele uyazi. Isiphumo seSomogyi siseyingcamango 'eyingcamango' phakathi kwabaphandi, oko kuthetha ukuba luluvo nje. Oko kuthetha ukuba akuqinisekiswanga ngokupheleleyo, kodwa kukho ubungqina besayensi obuxhasa oko. Ngaphambili, oogqirha babecinga ukuba esi sesona sizathu siphambili sokwanda kweswekile kusasa. Kodwa uphando olutsha, ngakumbi uphando olusebenzisa ukubekwa kweliso rhoqo kweglucose (CGM), luphakamise imibuzo malunga nale ngcamango.

Kukho ezinye izizathu ezininzi zokuba amanqanaba eswekile egazini anokunyuka ekuseni, kungekuphela nje ngenxa yesiphumo sikaSomogyi:

• Ubungakanani bamayeza owaselayo awanelanga, kuba aphuma emzimbeni wakho ebusuku.
• Imeko ebizwa ngokuba yiDawn phenomenon. (Siza kuthetha ngayo nale nto)
• Ubungakanani bamayeza athathwayo ngexesha lesidlo sangokuhlwa abufani nobungakanani bokutya.
• Ukuba nokumelana ne-insulin.

Yintoni umahluko phakathi kwesiphumo seSomogyi kunye nesiganeko seDawn?

Kulungile, ngoku usenokuba uyazibuza, 'Yintoni le nto isenzeka kusasa?' Zombini ezi zinto zibangela ukuba amanqanaba eswekile egazini anyuke ekuseni kubantu abanesifo seswekile.

Isiganeko sokusa kukunyuka kwendalo kwamanqanaba eswekile egazini okubangelwa kukukhululwa kweehomoni ezininzi (ezifana ne-cortisol kunye ne-growth hormone) kusasa. Oku kuqhelekile.

Kodwa kwisiphumo seSomogyi, iihomoni nazo ziyasebenza, kodwa kwenzeka ngenxa yokwehla ngequbuliso kweswekile (hypoglycemia) ebusuku. Kwisiganeko sokusa, iswekile ayinyuki ngenxa yokwehla okunjalo kweswekile.

Enye into ebalulekileyo kukuba isiganeko sokusa, phakathi kwezizathu zokunyuka kweswekile egazini ekuseni , sixhaphake kakhulu kunesiphumo seSomogyi.

Zithini iimpawu zesiphumo seSomogyi?

Uphawu oluphambili lwesiphumo seSomogyi kukuba amanqanaba eswekile egazini lakho ayanda xa uvuka kusasa. Nokuba ujonga i-glucometer yakho okanye ukuba usebenzisa isixhobo se-CGM (Continuous Glucose Monitoring), kuya kubonisa ukuba amanqanaba eswekile yakho aphezulu kusasa.

Ngokuxhomekeke ekubeni iswekile yakho egazini iphezulu kangakanani, unokufumana iimpawu ezifana nezi xa uvuka kusasa:

• Ukoma rhoqo (i-polydipsia).
• Ukuziva ulambile ngaphezu kwesiqhelo.
• Ukuchama rhoqo.
• Intloko ebuhlungu.
• Ukuziva ucaphukile kwaye unomsindo (ukucaphuka).

Kutheni kukho isiphumo seSomogyi?

Ngokwethiyori yesiphumo seSomogyi, ukuba inqanaba leswekile egazini lakho liyehla kakhulu (i-hypoglycemia) ezinzulwini zobusuku ngelixa ulele ngenxa ye-insulin oyithathayo, umzimba wakho uya kuzama 'ukukusindisa' kuloo meko yeswekile iphantsi.

Umzimba ukhupha iihomoni ezininzi kulo msebenzi 'wokuhlangula'. Ezona ziphambili zezi:

• I-Adrenaline
• Ii-Corticosteroids
• Ihomoni yokukhula
• I-Glucagon

Ezi hormone zibangela ukuba isibindi sakho sikhuphe iglucose engaphezulu, okanye iswekile, kunesiqhelo egazini lakho. Oku kukhululwa kweglucose kubangela ukuba amanqanaba eswekile egazini lakho anyuke. Ukuba unesifo seswekile, ipancreas yakho ayivelisi i-insulin eyaneleyo ukulawula eli nqanaba leswekile linyukileyo, okanye ayivelisi kwaphela. Yiyo loo nto amanqanaba eswekile egazini lakho ehlala ephezulu.

Kumntu ongenaso isifo seswekile, umzimba ngokwendalo ulawula amanqanaba eswekile egazini kwaye uwagcine kumanqanaba athile. Yiyo loo nto isiphumo seSomogyi singabachaphazeli abantu abangenaso isifo seswekile.

Ufumana njani ugqirha onje?

Enyanisweni, isiphumo seSomogyi asiyonto ixhaphakileyo yokunyuka kweswekile egazini ekuseni, ngoko ke kunokuba nzima kancinci ukusifumanisa. Kwaye, njengoko benditshilo ngaphambili, uphando lwamva nje lubonisa ukuba kusenokwenzeka ukuba asiyonto ebangela ukunyuka kweswekile egazini ekuseni. Ngoko ke kunokuba nzima, ukuba akunakwenzeka, ukuba ugqirha ayixilonge ngokuchanekileyo ngokuthi, 'Kulungile, yiyo le.'

Ukuba uhlala uneswekile ephezulu egazini kusasa, kungcono ukuthetha nogqirha wakho okuncedayo ukulawula isifo sakho seswekile. Uza kujonga indlela amanqanaba eswekile egazini lakho atshintsha ngayo aze azame ukufumana unobangela. Eyona ndlela isebenzayo yokwenza oku kukusebenzisa isixhobo se-CGM (Continuous Glucose Monitoring).

Ukuba awusebenzisi i-CGM, ugqirha wakho uya kukuxelela ukuba ujonge amanqanaba eswekile egazini lakho izihlandlo ezininzi ngemini. Umzekelo:

• Iiyure ezimbini emva kwesidlo sangokuhlwa.
• Ngaphambi kokulala.
• Ezinzulwini zobusuku (umzekelo, malunga nentsimbi yesi-2 okanye yesi-3 kusasa).
• Ekuvukeni kusasa.

Kwakhona, bakuxelela ukuba ubhale phantsi iinkcukacha ezifana nokutya okutyayo ebusuku, ukuba utya kangakanani, kwaye ukuba uzilolonga ebusuku, uhlobo lomthambo owenzayo kunye nexesha elingakanani.

Kuphela kukuqokelela lonke olu lwazi apho ugqirha anokuthi afumanise unobangela weswekile ephezulu egazini kusasa.

Iphathwa njani isiphumo seSomogyi?

Emva kokuba wena nogqirha wakho nisebenzisane ukufumanisa indlela amanqanaba eswekile egazini lakho aziphatha ngayo ebusuku, baya kukucebisa ngotshintsho onokulwenza ukunceda ukuthintela ukunyuka kweswekile egazini ekuseni. Khumbula, umzimba womntu wonke wahlukile, kwaye kukho izinto ezininzi ezichaphazela amanqanaba eswekile egazini. Ngoko ke, into onokuyenza ukuthintela ukunyuka kweswekile egazini kusasa inokwahluka kumntu nomntu.

Ugqirha wakho unokucebisa izinto ezifana nezi:

• Ukutshintsha umthamo weyeza lakho leswekile okanye i-insulin.
• Ukutshintsha iintlobo zokutya okutyayo ngexesha lesidlo sangokuhlwa. Umzekelo, kusenokufuneka utye ukutya okuneeproteni ezininzi, iicarbohydrate, okanye amafutha, okanye kusenokufuneka utye kancinci.
• Ukuba kunokwenzeka, ukutshintshela kwipompo ye-insulin kuya kukuvumela ukuba ulawule iidosi zakho ze-insulin ngokuchanekileyo.
• Ukutshintsha ixesha lokuzilolonga ebusuku.

Zeziphi iingxaki ezinokubangela oku?

Nokuba isiphumo seSomogyi singunobangela wokunyuka kweswekile egazini ekuseni okanye akunjalo, oko kugxininisa amanqaku amabini abalulekileyo. Abantu abanesifo seswekile kufuneka bazame ukuphepha ezi ngxaki zimbini:

• Amanqanaba eswekile egazini ahlala ephezulu.
• Amanqanaba aphantsi eswekile egazini (hypoglycemia) ayenzeka ebusuku.

Ukwanda okuqhubekayo kwamanqanaba eswekile egazini

Njengoko amanqanaba eswekile egazini lakho eqhubeka ephezulu, amanqanaba akho e-HbA1c (A1C) aya kwanda, kwaye i-Time in Range yakho (TIR) ​​​​iya kwehla. Uvavanyo lwe-HbA1c lulinganisa amanqanaba akho eswekile egazini kwiinyanga ezintathu ezidlulileyo. I-TIR yipesenti ephakathi yeentsuku amanqanaba akho eswekile egazini akuluhlu olujoliswe kulo.

Okukhona amanqanaba akho e-A1c kunye ne-TIR emabi, ingakumbi ukuba sele ekho iminyaka emininzi, kokukhona umngcipheko wakho wokuba neengxaki zesifo seswekile uphezulu. Imizekelo yezi ngxaki ibandakanya:

• Izifo zamehlo (i-Retinopathy)
• Iingxaki zezintso (i-Nephropathy)
• I-Neuropathy
• Isifo sentliziyo

Uphando lubonise ukuba abantu abanesifo seswekile banokunciphisa umngcipheko wabo wezi ngxaki ukuba bagcina amanqanaba abo e-A1c engaphantsi kwe-7%.

Iswekile ephezulu egazini ekuseni inokuba yingxaki engapheliyo, kwaye ukuba ayinyangwa, amanqanaba eswekile egazini lakho anokuhlala ephezulu iiyure ezininzi ngemini. Oku kwandisa umngcipheko wokuba neengxaki zeswekile ngokuhamba kwexesha.

Iziqendu zeswekile ephantsi egazini ebusuku

Kwabaninzi abantu abanesifo seswekile, iswekile ephantsi egazini, okanye i-hypoglycemia, kuxa iswekile yegazi iwela ngaphantsi kwe-70 mg/dL (ii-milligrams nge-deciliter nganye).

Xa amanqanaba eswekile egazini ehla, abantu abaninzi bafumana iimpawu ezifana nezi:

• Ukuziva ngathi umzimba wakho uyangcangcazela.
• Ukuziva ulambile kakhulu (i-polyphagia).
• Ukubila nokuziva ubanda.
• Ukudinwa, ukuziva ungenangqondo.
• Isantya sentliziyo siyanda.

Nangona kunjalo, ukuba iswekile yakho yegazi iyehla ngelixa ulele, kungathatha ixesha ukuba uvuke uze uqaphele iimpawu. Oku kunokuba yingozi, kwaye i-hypoglycemia enzima inokuba yingozi ebomini. Iimpawu zeswekile ephantsi egazini ebusuku zinokwahluka kancinci, kuquka:

• Ukungalali, ukuziva ungakhululekanga xa ulele.
• Ukuziva udiniwe kwaye ungacingisisi kakuhle xa uvuka kusasa.
• Ukuba namaphupha amabi.
• Iimpahla okanye izinto zokulala ozinxibileyo ziyamanzi ngenxa yokubila.

Nokuba zeziphi iimpawu onazo ezikwenza ucinge ukuba uneswekile ephantsi egazini, kubalulekile ukujonga inqanaba leswekile yakho egazini ukuze ubone ukuba iphantsi kangakanani. Oku kuya kukunceda ukuba uthathe isigqibo sokuba ungayinyanga njani. Ukuze unyange i-hypoglycemia, kufuneka utye iicarbohydrates ezisebenza ngokukhawuleza, eziziiswekile (ezifana nebhanana okanye ijusi yeapile).

Ukuba uhlala uneswekile ephantsi egazini ebusuku, qiniseka ukuba uthetha nogqirha wakho ngayo. Nonke, ningayilungisa isicwangciso senu sokulawula isifo seswekile ukuze nithintele ukuba singaphindi senzeke.

Ndifanele ndimbone nini ugqirha?

Ukuba uhlala ufumana amanqanaba aphezulu eswekile egazini kusasa, kubalulekile ukuthetha nogqirha wakho okuncedayo ukulawula isifo sakho seswekile. Angavavanya amanqanaba eswekile egazini lakho, afumanise ukuba isiphumo seSomogyi singunobangela, okanye ukuba kukho enye into eyenzekayo, aze acebise isicwangciso sonyango esifanelekileyo kuwe.

Ukuba neswekile ephezulu egazini ekuseni kunokuba yinto ecaphukisayo nengathandekiyo. Akukho sisombululo sinye esifanelekileyo koku. Ngoko ke kungathatha ixesha ukufumana isisombululo esifanelekileyo kuwe. Ugqirha wakho angakunceda ukhethe eyona ndlela ilungileyo yokwenza izinto. Ungoyiki ukucela uncedo lwabo. Ukuthatha inyathelo ngoku kunokukunceda uphephe iingxaki zexesha elifutshane nezexesha elide.

Okokugqibela, eyona nto ibalulekileyo (Umyalezo Wokuya Ekhaya)

Kulungile, ngoku uyiqonda ngcono impembelelo yeSomogyi esithethe ngayo. Khumbula, esi asisosizathu sokwenyuka kweswekile kusasa. Kodwa, kubalulekile ukuyiqonda loo nto.

• Eyona nto iphambili kukuba, ukuba uhlala uneswekile ephezulu egazini kusasa, musa ukuyityeshela loo nto. Qiniseka ukuba uthetha nogqirha wakho.
• Ukuba usebenzisa i-CGM (Continuous Glucose Monitoring), funa uncedo kugqirha wakho ukuze ahlalutye idatha ngokuchanekileyo.
• Iswekile ephantsi egazini (hypoglycemia) ebusuku iyingozi kakhulu. Ukuba unayo nayiphi na kwezi mpawu, xelela ugqirha wakho ngazo.
• Xoxa nogqirha wakho ngokutya kwakho, umthambo, kunye nomlinganiselo wamayeza uze uwalungise ukuze ahambelane noko kukulungeleyo.

Ukuphila nesifo seswekile ngumceli mngeni, kodwa ngolawulo olufanelekileyo, ungaphila ubomi obusempilweni. Musa ukoyika, kulungile?

Isiphumo seSomogyi , isifo seswekile, ukunyuka kweswekile ekuseni, i-hypoglycemia, i-hyperglycemia, i-insulin