Wenza ntoni ukuba umntu onesifo seswekile ngequbuliso ulahlekelwa zingqondo aze angavuswa nokuba uthetha kangakanani naye? Oku kuyoyikisa ngokwenene. Le yi-coma, enye yezona ngxaki ziyingozi zesifo seswekile. Ukuchaneka, yimeko yokungazi nto eyenza umntu alale ubuthongo obunzulu. Oku kusongela ubomi. Kodwa ukuba unolwazi olufanelekileyo, ungayithintela le meko kwaye usindise nobomi bomntu. Ngoko masithethe ngale nto namhlanje.
Yintoni le coma yesifo seswekile?
Ngamafutshane, ukuba umntu onesifo seswekile unezinga eliphezulu leswekile egazini (i-hyperglycemia) okanye izinga eliphantsi leswekile egazini (i-hypoglycemia) , oku kunokuchaphazela ngqo ukusebenza kwengqondo kwaye kubangele umntu alahlekelwe zingqondo. Oku kubizwa ngokuba yi-diabetesic coma. Esi sisifo esinzulu esifuna unyango olungxamisekileyo.
Olu hlobo lwe-coma lunokubangelwa zizifo ezintathu eziphambili ezinxulumene nesifo seswekile.
1. I-Diabetic Ketoacidosis (DKA): Oku kwenzeka xa ii-ketones, uhlobo lwe-asidi, zisanda egazini, nto leyo ebangela ukuba igazi libe ne-asidi.
2. Imeko yeHyperosmolar Hyperglycemic (HHS): Le yimeko apho amanqanaba eswekile egazini enyuka kakhulu kwaye umzimba uphelelwa ngamanzi emzimbeni kakhulu.
3. I-hypoglycemia enzima: Oku kuxa ubungakanani beglucose enika amandla engqondweni buphantsi kakhulu, nto leyo ebangela ukuba ukusebenza kwengqondo kuyeke.
Eyona nto ibalulekileyo kukuba ukuba ubona umntu onje, kufuneka utsalele umnxeba inkonzo ye-ambulensi ka-1990 ngoko nangoko uze umse kwiYunithi yoNyango oluNgxamisekileyo (ETU) yesibhedlele .
Makhe sijonge izizathu ezintathu eziphambili ze-coma ngokweenkcukacha ezithe vetshe.
Kubaluleke kakhulu ukwazi okuncinci ngezi meko zintathu, kuba ukuzazi kwangethuba iimpawu zemeko nganye kunokubangela ukuba zingabi naso isiqabu.
1. I-ketoacidosis yesifo seswekile (i-DKA)
Le meko ixhaphake kakhulu kubantu abanesifo seswekile sohlobo loku-1 , kodwa ngamanye amaxesha inokuvela nakubantu abanesifo seswekile sohlobo lwesibini.
Kulula nje: Ihomoni i-insulin ibalulekile kwiiseli zomzimba wethu ukuze zifumane iglucose (iswekile) ukuze zifumane amandla. Kwi-DKA, umzimba awunayo i-insulin eyaneleyo. Emva koko, ngenxa yokuba iiseli azikwazi ukufumana iglucose, umzimba uqala ukutshisa amafutha awo ukuze ufumane amandla. Xa la mafutha etshisiwe , ii-ketones ziveliswa njengemveliso engasemva.Ikhemikhali ebizwa ngokuba zii-ketones iyanda egazini. Ezi ketones luhlobo lwe-asidi. Xa ziyanda egazini, igazi liba ne-asidi. Oku kubizwa ngokuba yi-DKA. Ukuba le meko ayinyangwa ngokukhawuleza, ungangena kwi-coma.
Ngokwesiqhelo, i-DKA yimeko apho inqanaba leswekile egazini liphezulu kune- 250 mg/dL . Kodwa khumbula, unobangela oyintloko we-DKA ayikokugcwala kweswekile kuphela, kodwa kukwakho nokunqongophala kwe-insulin kunye nokwanda kwee-ketones.
2. Imeko ye-hyperosmolar hyperglycemic (HHS)
Oku kuxhaphake kakhulu kubantu abanesifo seswekile sohlobo lwesibini . Oku kuxa amanqanaba eswekile egazini ephakama ngendlela engalawulekiyo (ngokuqhelekileyo ngaphezulu kwe -600 mg/dL ). Xa oku kusenzeka, umzimba uzama ukukhupha iswekile engaphezulu kumchamo. Kwangaxeshanye, amanzi amaninzi alahleka emzimbeni, nto leyo ebangela ukuphelelwa ngamanzi emzimbeni . Oku kunokuchaphazela ingqondo, kubangele ukulahlekelwa zingqondo, kwaye ukuba akunyangwa, kunokukhokelela kwi-coma.
3. I-hypoglycemia enzima
Kulapho amanqanaba eswekile egazini ehla aye kumanqanaba aphantsi kakhulu, adla ngokuba ngaphantsi kwe -40 mg/dL . Oku kukwayingozi kakhulu ebomini.
Iglucose yeyona nto iphambili enika amandla emizimbeni yethu, ingakumbi ingqondo. Xa kungekho glucose egazini, ingqondo ilahlekelwa ngamandla ayo okusebenza. Kanye njengokuba injini yemoto ima xa iphelelwa yipetroli, ingqondo isenoku "vala" ize ifikelele kwi-coma. Le meko ixhaphake kakhulu kubantu abathatha i-insulin injections okanye iintlobo ezithile zamayeza eswekile (umz., i-sulfonylureas).
Iimpawu zesilumkiso ngaphambi kokuba uqalise i-coma
Umntu akangeni kwi-coma ngequbuliso. Ngaphambi koko, umzimba ubonisa iimpawu ezininzi ezilumkisayo. Eyona nto ibalulekileyo kukubona ezi mpawu kwangethuba. Makhe sijonge iimpawu ezinxulumene nezi meko zintathu ngokwahlukeneyo.
| I-DKA (isifo seswekile) | I-HHS (i-Hyperglycemia kunye nokuphelelwa ngamanzi emzimbeni) | I-Hypoglycemia Eqatha |
|---|---|---|
| Isicaphucaphu nokuhlanza | Ukuphelelwa ngamanzi emzimbeni kakhulu (umlomo owomileyo, ulwimi) | Umbono ofipheleyo |
| Isisu esibuhlungu | Ukoma okugqithisileyo (i-polydipsia) | Ubunzima bokuthetha (ukuthintitha) |
| Ukwanda kwesantya sokuphefumla (ukuphefumla kukaKussmaul) | Ukuchama rhoqo | Ukulahlekelwa yibhalansi, ukulahleka kolungelelwaniso |
| Ivumba elimnandi leziqhamo emlonyeni | Ukulahlekelwa zingqondo, ukubona izinto ezingekhoyo | Ukungcangcazela kunye nokuxhuzula |
| Ukudinwa kakhulu kunye nobuthathaka | Ukulahlekelwa yingqondo kwelinye icala lomzimba | Indalo ephelelwe lithemba |
Emva kwezi mpawu, ukuba umntu ungena kwi-coma, uya kubonisa iimpawu ezintathu eziphambili:
- Ukulahlekelwa ngokupheleleyo zingqondo: Njengokulala ubuthongo obunzulu. Akunakuvuswa nangayiphi na indlela.
- Amehlo angaphenduliyo: Amehlo ahlala evaliwe. Akukho mpendulo xa amehlo evuliwe.
- Ukungakwazi ukuhamba komzimba: Akukho ntshukumo yeengalo okanye imilenze engqondweni. Nangona kunjalo, ezinye iindlela zokusabela zisenokuba zikhona.
Izinto esifanele sizenze ngoko nangoko ukuba umntu uphelelwa ziingqondo (uncedo lokuqala)
Khawucinge nje ukuba umntu onesifo seswekile kwindawo okuyo ebenokuquleka ngolu hlobo. Zimbalwa izinto onokuzenza. Oku kunokusindisa nobomi.
1. Fowunela u-1990 ngoko nangoko: Into yokuqala omawuyenze kukufowunela i-ambulensi. Xa ufowuna, yithi, "Umntu onesifo seswekile akakho zingqondweni."
2. Musa ukumnika into yokutya okanye yokusela: Ukuba unika umntu ongazi nto ukutya okanye isiselo, sinokungena kwindawo yomoya kwaye sibe yingozi ngakumbi.
3. Jika umntu aye ecaleni: Endaweni yokuba alale ngecala, mjike umntu aye kwelinye icala (ngecala) ukuze angahlanzi okanye akrwitshwe.
4. Linda i-ambulensi ifike: Landela imiyalelo enikwe ngumsebenzisi we-1990.
Kutheni oku kusenzeka? Zithini izinto ezibangela umngcipheko?
Njengoko bekutshiwo ngaphambili, ukuphelelwa ngamanzi emzimbeni kakhulu, okwenzeka kwi-DKA nakwi-HHS, kuchaphazela ingqondo kwaye kukhokelela kwi-coma. Ngokufanayo, ngexesha le-hypoglycemia, ingqondo ayifumani amandla (i-glucose) eyifunayo, nto leyo ebangela ukuba ukusebenza kwengqondo kume kwaye ikhokelele kwi-coma.
Nabani na onesifo seswekile usemngciphekweni, kodwa kukho izinto ezithile ezinokunyusa lo mngcipheko.
- Uhlobo lwesifo seswekile: Abantu abanesifo seswekile sohlobo loku-1 banamathuba amaninzi okuba ne-coma ngenxa ye-DKA kunye ne-hypoglycemia enzima. Abantu abanesifo seswekile sohlobo lwesibini banamathuba amaninzi okuba ne-coma ngenxa ye-HHS.
- Ezinye izifo: Ngexesha lezifo ezifana nomkhuhlane kunye nosulelo, kunzima ukulawula amanqanaba eswekile emzimbeni.
- Utyando okanye iingozi: Uxinzelelo olubekwa zezi zinto emzimbeni lunokubangela ukuba amanqanaba eswekile egazini anyuke.
- Iingxaki zokusebenzisa i-insulin: Le meko inokubangelwa kukungafakwa kakuhle kwe-insulin, ukuthatha idosi engalunganga, okanye ukungasebenzi kakuhle kwepompo ye-insulin.
- Ukungalawuli kakuhle isifo seswekile: ukungawasebenzisi kakuhle amayeza, ukungajongi amanqanaba eswekile egazini rhoqo.
- Ukusela utywala: Utywala bunokubangela ukuba amanqanaba eswekile egazini ehle ngendlela eyingozi.
- Ukungazi ngeHypoglycemia: Abanye abantu abaziboni iimpawu zokuqala zeswekile ephantsi egazini, njengokungcangcazela nokubila. Basenokulahlekelwa zingqondo ngequbuliso.
Benza ntoni esibhedlele? (Ukuxilongwa nonyango)
Ngenxa yokuba le yingxamiseko yezonyango, lonke unyango lwenzeka esibhedlele. Oogqirha banokufumanisa imeko ngokukhawuleza ngokujonga iinkcukacha zesigulana kunye namanqanaba eswekile egazini. Bakwajonga igazi ukuba alinazo na ii-ketones.
Yingakho kubalulekile ukuba abantu abanesifo seswekile banxibe isongo okanye umgexo obonisa ukuba bagula ngengqondo . Oku kunokuba luncedo kakhulu kwabo babanyangayo xa kukho imeko engxamisekileyo.
Unyango luxhomekeke kwisizathu se-coma.
- Ukuba kungenxa ye-DKA okanye i-HHS:
- Ulwelo lwe-IV (ityuwa): Ityuwa inikwa ngemithambo ukuze kuthintelwe ukuphelelwa ngamanzi emzimbeni kwaye kulinganiswe ityuwa yomzimba.
- I-Insulin: I-Insulin inikwa ngemithambo okanye njengenaliti ukulawula amanqanaba eswekile egazini.
- Ezinye iindlela zonyango: Ukuba kukho usulelo olufihlakeleyo olubangela le meko, nalo luya kunyangwa.
- I-Hypoglycemia ephezulu (iswekile ephantsi egazini) ibangelwa zezi zinto zilandelayo:
- Inaliti yeGlucagon: IGlucagon yihormone enceda isibindi sethu sikhuphe iglucose ngokukhawuleza egazini. Inganikwa njengenaliti okanye njengespray yempumlo (umgubo wempumlo). Nokuba unika umntu ekhaya oku,Ngokuqinisekileyo kufuneka usiwe esibhedlele.
Ngaba kunokwenzeka ukuba uphile ngokupheleleyo kule meko?
Ewe. Ukuba inyangwa ngokukhawuleza nangendlela efanelekileyo, i-diabetes coma inokunyangeka ngokupheleleyo. Nangona kunjalo, ngamanye amaxesha, ukuba unyango lulibaziseka, lunokubangela umonakalo ongunaphakade engqondweni, kwaye kwezinye iimeko, nokufa.
Ukuba umntu uhlala ixesha elingakanani ekwi-coma kuxhomekeke ekubeni ufumana unyango ngokukhawuleza kangakanani. Ngaphandle konyango, umntu akanakuvuka eyedwa kule meko. Kungoko ke, kubalulekile ukuba umfikise esibhedlele ngokukhawuleza.
Ingaphetshwa njani le meko iyingozi?
Le coma idla ngokuthintelwa . Eyona nto ibalulekileyo ekufuneka uyenze kukwazi iimpawu zokuqala ze-DKA, HHS, kunye ne-Hypoglycemia kwaye uthathe amanyathelo ngokukhawuleza nje ukuba zivele.
Thetha nogqirha wakho malunga nesicwangciso sakho sokulawula isifo seswekile. Funa uncedo lwezonyango ngokukhawuleza ukuba ufumana nayiphi na kwezi zilandelayo:
- Ukuba inqanaba leswekile egazini lakho liphezulu kune- 300 mg/dL kabini ngokulandelelana ngaphandle kwesizathu.
- Ukuba inqanaba leswekile yakho egazini lingaphantsi kwe- 70 mg/dL kwaye uzame ukutya into emnandi kathathu kwaye ayinyukanga.
Kuqhelekile ukuba noloyiko xa usiva ngeengxaki zesifo seswekile. Kodwa ukuba nolwazi olufanelekileyo nokulungiselela yeyona ndlela ilungileyo yokuthintela ezi ngxaki. Ungaze ungathandabuzi ukubuza ugqirha wakho nayiphi na imibuzo onayo malunga nokulawula isifo sakho seswekile.
Umyalezo Wokuya Ekhaya
- I-diabetic coma yimeko engxamisekileyo yezonyango esongela ubomi ebangelwa ngamanqanaba aphezulu kakhulu eswekile egazini (i-DKA, i-HHS) okanye aphantsi kakhulu (i-hypoglycemia enzima).
- Hlala uqaphela iimpawu ezilumkisayo kwangethuba ezifana nokucaphuka, ukuqaqamba kwesisu, ivumba lomphefumlo elifana neziqhamo (kwi-DKA), ukoma kakhulu, ukudideka (kwi-HHS), kunye nokungcangcazela, ukungakwazi ukuthetha (kwi-hypoglycemia).
- Ukuba umntu onesifo seswekile uphelelwa zingqondo, fowunela u-911 ngoko nangoko umse esibhedlele. Ungaze umnike into yokutya okanye yokusela.
- Le meko iyingozi inokuthintelwa kakhulu ngokulawula ngokufanelekileyo isifo seswekile, ukujonga amanqanaba eswekile egazini rhoqo, nokufuna ingcebiso kugqirha wakho malunga nento omawuyenze ngeentsuku zokugula.
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