Ngaba siyazi kakuhle i-Coma enxulumene nesifo seswekile?

Usenokukhumbula umntu onesifo seswekile, mhlawumbi ilungu losapho okanye umhlobo. Ngamanye amaxesha siye seva ngabantu abanjalo ngequbuliso belahlekelwa ziingqondo, bengakwazi ukuthetha, kwaye ngamanye amaxesha bewa phantsi. Esi sisifo esiyingozi kakhulu nesisongela ubomi. Yiyo loo nto, namhlanje sicinge ngokuthetha ngesi sifo esinokubangelwa sisifo seswekile, okanye njengoko oogqirha besibiza, `(i-Diabetes-Related Coma)`. Ukukwazi oku ngokufanelekileyo kuya kusinceda sikhathalele abantu esibathandayo.

Yintoni i-Coma enxulumene nesifo seswekile? Ngamafutshane...

Ngamafutshane, i-diabetesic coma yimeko enzima, esongela ubomi eyenzeka xa amanqanaba eswekile egazini lethu enyuka kakhulu ngequbuliso (i-hyperglycemia) okanye esezantsi kakhulu (i-hypoglycemia). I-"coma" yimeko yokungazi nto ngokupheleleyo, njengokulala ubuthongo obunzulu, kwaye ungakwazi ukuvuswa yintetho. Nangona kunjalo, basaphila nangona belahlekelwe zingqondo. Le yimeko efuna unyango olungxamisekileyo.

Kukho izizathu ezintathu eziphambili zale meko iyingozi.

Kukho iindlela ezintathu eziphambili umntu onesifo seswekile anokuwa ngazo kwi-coma. Makhe sijonge ukuba ziintoni:

1. Imeko yeHyperosmolar Hyperglycemic (HHS)

2. I-Ketoacidosis Enxulumene Neswekile (DKA)

3. I-hypoglycemia enzima

Ngoku masithethe ngeenkcukacha ezithe vetshe ngayo nganye kwezi, kulungile?

1. Yintoni iHyperosmolar Hyperglycemic State (HHS)?

Le meko, ebizwa ngokuba yi-HHS, ixhaphake kakhulu kubantu abanesifo seswekile sohlobo lwesibini. Iyenzeka xa amanqanaba eswekile egazini lakho (iglucose) ephezulu kakhulu (ngesiqhelo ingaphezulu kwe-600 mg/dL) ixesha elide. Oku kunokubangela ukuba umzimba wakho ulahlekelwe ngamanzi amaninzi, nto leyo ekhokelela ekuphelelweni ngamanzi emzimbeni kakhulu, ukudideka, kunye nezinye iimpawu. Ukuba ayinyangwa ngokukhawuleza, inokukhokelela kwi-coma.

2. Yintoni i-Diabetes-Related Ketoacidosis (DKA)?

Imeko ebizwa ngokuba yi-"DKA" nayo ibeka ubomi esichengeni. Ixhaphake kakhulu kubantu abanesifo seswekile sohlobo 1 (inokuchaphazela abantu abasele benaso, kunye nabo bangaziyo ukuba banaso). Nangona kunjalo, ngamanye amaxesha inokuvela nakubantu abanesifo seswekile sohlobo 2.

I-DKA yenzeka xa umzimba wakho ungenayo i-insulin eyaneleyo (nokuba yeyendalo okanye ithathwe ngaphandle). Njengoko usazi, i-insulin ibalulekile ukuze iswekile egazini lethu, i-glucose, ingene kwiiseli zethu kwaye isetyenziswe njenge-energy. Ngoko ke xa i-insulin ingekho okanye inganelanga, umzimba uqala ukuqhekeza amafutha ukuze ufumane amandla. Xa amafutha eqhekekile, iikhemikhali ezibizwa ngokuba zii-ketones zikhutshwa egazini.

Xa ubungakanani be-`(ketones)` emzimbeni womntu onesifo seswekile busanda, igazi liba `(acidic).` Ukuba oku akunyangelwanga ngexesha, i-coma inokwenzeka. Inqanaba leswekile egazini lomntu one-`(DKA)` lidla ngokuba ngaphezulu kwe-250 mg/dL. Kodwa khumbula, imbangela ephambili ye-`(DKA)` kukungabikho kwe-`(insulin)` kunye nokwanda kwe-`(ketones)`, kungekuphela nje kweswekile yegazi. Abanye abantu abanesifo seswekile banokudlula kwi-`(DKA)` nokuba iswekile yabo ingaphezulu kwe-250 mg/dL.

3. Yintoni i-hypoglycemia enzima?

Esi sesona sizathu sesithathu. Ukuba inqanaba leswekile egazini lehla ngaphantsi kwe-40 mg/dL, oko kuthathwa njengemeko "ye-hypoglycemia" embi kakhulu. Oku kukwayingozi kakhulu ebomini.

Uyazi, umthombo oyintloko wamandla emzimbeni wethu ingakumbi engqondweni yi-`(glucose)`. Ngoko ke xa inqanaba leswekile egazini lehla, umzimba awukwazi ukusebenza kakuhle. Ukuba inqanaba leswekile lehla ngaphantsi kwe-40 mg/dL, njengoko kukhankanyiwe, unokufumana utshintsho emzimbeni wakho nasengqondweni, nto leyo ekwenza ungakwazi ukwenza nantoni na. Ukuba le meko imbi kakhulu ye-`(hypoglycemia)` ayinyangwa ixesha elide, ungangena kwi-coma.

Le meko imbi ye-hypoglycemia ixhaphake kakhulu kubantu abasebenzisa i-insulin xa benesifo seswekile okanye kwiintlobo ezithile zeepilisi zeswekile ezifana ne-sulfonylureas.

Zithini iimpawu ze-diabetes coma? Siyibona njani loo nto?

Kukho iimpawu ezintathu eziphambili ze-coma:

• Ukungazi nto: Kufana nokuba sebuthongweni obunzulu. Nokuba uthetha kangakanani na, kunzima kakhulu, phantse akunakwenzeka, ukukuvusa.
• Ukungabikho kwempendulo yamehlo: Amehlo ahlala evaliwe. Akukho mpendulo xa umntu evula amehlo akhe. Nangona kunjalo, ngamanye amaxesha kunokubakho iimpendulo ezithile emehlweni kwizinto ezinjengokukhanya.
• Ukungabikho kwentshukumo yomzimba: Akukho ntshukumo engqondweni. Nangona kunjalo, ezinye iintshukumo ze-reflex zinokubakho.

Ngoku makhe sibone ukuba zeziphi iimpawu ezibonakala ngaphambi kokuba umntu abe yi-coma kwezi meko zikhankanyiweyo apha `(DKA)`, `(HHS)` kunye ne-`(hypoglycemia)` enzima. Ukuba uyazibona kwangethuba, ungaphepha ingozi enkulu.

Iimpawu ezingaphambi kokuba umntu afumane i-coma kwi-DKA:

• Isicaphucaphu nokuhlanza.
• Isisu esibuhlungu.
• Ukuphefumla okukhawulezayo nokunzulu (oogqirha bakubiza oku ngokuthi "ukuphefumla kukaKussmaul"). Kungaba ngesingqi esinye.
• Ivumba leziqhamo emlonyeni.
• Ndiziva ndidiniwe kakhulu kwaye ndibuthathaka.
• Ukuziva udidekile okanye udidekile.
• Ukuncipha kokuphaphama.

Iimpawu ezandulela i-coma kwimeko ye-`(HHS)`:

• Utshintsho lwengqondo: ukudideka, ukuphazamiseka kwengqondo, ukubona izinto ezingekhoyo.
• Kufana nokuba sele uza kulahlekelwa zingqondo.
• Umlomo owomileyo kunye nokunxanwa okugqithisileyo (i-polydipsia).
• Ukuchama rhoqo.
• Umbono ofipheleyo okanye ukulahleka kombono.
• Ukuba ndindisholo, ngamanye amaxesha ngakumbi kwelinye icala lomzimba.

Iimpawu ezibonisa ukuba umntu unesifo se-hypoglycemia enzima ngaphambi kokuba aqalise i-coma ziquka:

• Umbono ofipheleyo okanye umbono ophindwe kabini.
• Ukudideka kwamagama xa uthetha.
• Ukulahlekelwa yibhalansi nokuba nobunzima bokwenza izinto.
• Ukuphazamiseka kwengqondo.
• Ukuxhuzula kufana nokubetha.

Ukuba ubona naziphi na ezi mpawu, musa ukuzityeshela. Kungcono ukufuna ingcebiso kagqirha ngokukhawuleza.

Senza ntoni ukuba umntu ulahlekelwa zingqondo ngenxa yesifo seswekile? (Uncedo lokuqala)

Khawuthelekelele umntu okwindawo okuyo ngequbuliso elahlekelwa zingqondo ngenxa yesifo seswekile. Zimbalwa izinto onokuzenza:

• Fowunela u-1990 ngoko nangoko uze ufumane i-ambulensi. Ukuba uyazi ukuba umntu unesifo seswekile, xelela nomqhubi ka-1990 loo nto.
• Musa ukubanika into yokutya okanye yokusela. Banokukrwitshwa.
• Mjike umntu ngecala ngononophelo ukuze amathe okanye ukuhlanza kungavimbi indlela yomoya.
• Ide ifike i-ambulensi, landela imiyalelo enikwe ngumsebenzi we-1990.

Ukuba kwenziwe ngokuchanekileyo, oku kunokuba luncedo olukhulu ekusindiseni ubomi baloo mntu.

Kutheni isifo seswekile sibangela ukulahlekelwa zingqondo kangaka? (Izizathu zilula)

Njengoko besikhe sathetha ngaphambili, kukho izizathu ezintathu eziphambili zokuba umntu abe ne-diabetic coma, akunjalo?

• Imeko ye-hyperosmolar hyperglycemic `(HHS)`.
• I-ketoacidosis yeswekile (i-DKA).
• I-hypoglycemia enzima (iswekile ephantsi kakhulu egazini).

Zombini i-HHS kunye ne-DKA ziimeko apho amanqanaba amanzi emzimbeni ehla kakhulu, nto leyo ekhokelela ekuphelelweni ngamanzi emzimbeni kakhulu. Oku kuphelelwa ngamanzi emzimbeni kunokukhokelela kwi-coma.

Kwelinye icala, kwi-hypoglycemia enzima, ingqondo ayifumani umlinganiselo weglucose (iswekile) eyidingayo. Iswekile ibalulekile ukuze ingqondo isebenze kakuhle. Xa iphelile, ingqondo "iyavala" kwaye ungangena kwi-coma. Uyayazi loo nto?

Ngubani osengozini enkulu yokuba ne-diabetic coma?

Nabani na onesifo seswekile (kwanabo banesifo seswekile esingafunyaniswanga) usemngciphekweni wokuba ne-diabetic coma. Nangona kunjalo, le ngozi iyahluka kancinci ngokuxhomekeke kuhlobo lwesifo seswekile:

• Abantu abanesifo seswekile sohlobo loku-1 basengozini enkulu yokuba ne-coma, nokuba yi-DKA okanye i-hypoglycemia enzima. Oku kungenxa yokuba abantu abanesifo seswekile sohlobo loku-1 bafuna i-insulin ngalo lonke ixesha kwaye amanqanaba eswekile egazini labo ayatshintshatshintsha ngaphezu kwabantu abanesifo seswekile sohlobo lwesibini.
• Abantu abanesifo seswekile sohlobo lwesibini banamathuba amaninzi okuba ne-coma ngenxa ye-HHS kunabo bane-DKA okanye i-hypoglycemia enzima.

Ziziphi ezinye izinto ezibangela umngcipheko?

Ukongeza kwezi zinto, kukho nezinye izinto ezinokunyusa umngcipheko wokuba ne-diabetes coma:

• Ukuphuhlisa ezinye izifo.
• Utyando.
• Ukulimala emzimbeni (Ukwenzakala).
• Iingxaki kwinkqubo yokuhambisa i-insulin (umz., ipeni ye-insulin, ukungasebenzi kakuhle kwepompo).
• Ukulibala, ukutsiba, okanye ukuthatha i-insulin eninzi kakhulu.
• Ukungalawuli kakuhle isifo seswekile (umz. ukungajongi amanqanaba eswekile egazini imihla ngemihla, ukungasebenzisi amayeza ngokufanelekileyo).
• `(Ukungazi ngeHypoglycemia)` (oko kukuthi, ukungazazi iimpawu zokuqala zeswekile ephantsi egazini).
• Ukusela utywala.
• Ukusetyenziswa kweziyobisi.

Oogqirha bayixilonga njani ngokuchanekileyo i-diabetes coma?

I-diabetic coma yingxamiseko yezonyango efuna unyango olukhawulezileyo. Nabani na okwi-coma kufuneka alaliswe esibhedlele.

Oogqirha banokufumanisa ngokukhawuleza ukuba une-diabetes coma ngokuthatha imbali yakho yezonyango, ukujonga amanqanaba eswekile egazini lakho (uvavanyo lweswekile egazini), nokwenza ezinye iimvavanyo ukujonga ii-ketones kunye nempilo yakho iyonke.

Yingakho kubalulekile ukuba abantu abanesifo seswekile banxibe isongo okanye umgexo wesilumkiso sezonyango. Kwimeko yengxakeko, oogqirha banokuyibona baze benze izigqibo ngokukhawuleza. Kubalulekile nokwazisa usapho lwakho, abahlobo, kunye nabantu osebenza nabo ukuba unesifo seswekile. Ngaleyo ndlela, bayazi into abamele bayenze xa kukho ingxakeko.

Unyanga njani umntu onesifo seswekile?

Unyango lwe-diabetes coma luyahluka ngokuxhomekeke kwisizathu , kodwa ukulaliswa esibhedlele kusoloko kuyimfuneko.

Unyango lwe-coma ebangelwa yi-`(DKA)` okanye `(HHS):

• Ulwelo lwe-IV: Olu lunikwa ukulungisa ukungabikho kwamanzi emzimbeni kunye nokungalingani kwe-electrolyte.
• I-insulin: Iqela lezonyango linokukunika i-insulin nge-IV okanye njenge-subcutaneous shot.
• Ezinye iindlela zonyango: Ezinye iindlela zonyango zinganikwa ukunceda uphile. Ezi zinokubandakanya ukunyanga naziphi na iimeko zempilo ezingabonakaliyo okanye usulelo olunokubangela amanqanaba aphezulu eswekile egazini.

Unyango lwe-coma ebangelwa yi-hypoglycemia enzima:

• I-glucagon engxamisekileyo:Olu luhlobo lwe-hormone ye-glucagon eyenziweyo. Inganikwa ngumntu omthandayo okanye ugqirha njengenaliti okanye njenge-spray yempumlo (kuxhomekeke kuhlobo lwayo). I-glucagon eyenziweyo isebenza ngokukhupha i-glucose egcinwe esibindini, inyusa amanqanaba eswekile egazini.

Okubaluleke kakhulu: Nokuba umntu osondeleyo kuwe ukunika i-`(glucagon)`, ngokuqinisekileyo uyaludinga unyango lwasesibhedlele. Bafanele bakunike i-`(glucagon)` baze batsalele umnxeba ku-1990 ngoko nangoko.

Ukuba kuvela ezinye iingxaki, ezinje ngokungasebenzi kakuhle kwezitho zomzimba, zisenokufuna unyango olongezelelweyo.

Yintoni esinokuyenza ukuthintela i-diabetic coma?

Ukuze uthintele i-diabetesic coma, kubalulekile ukuba uqaphele iimpawu zokuqala ze-hypoglycemia (DKA), i-hypoglycemia (HHS), kunye ne-hypoglycemia. Thetha nogqirha wakho malunga namanyathelo onokuwathatha ukunyanga ezi meko ngaphambi kokuba zibe yingozi.

Bona ugqirha ngoko nangoko ukuba:

• Ukuba inqanaba leswekile egazini lakho liyi-300 mg/dL okanye ngaphezulu izihlandlo ezibini ezilandelelanayo ngaphandle kwesizathu esicacileyo.
• Ukuba unesiganeko seswekile ephantsi egazini (ngaphantsi kwe-70 mg/dL) kwaye ayibuyeli kwisiqhelo emva kwemizamo emithathu yonyango (umz., iipilisi zeswekile, iziselo ezineswekile), tsalela umnxeba ugqirha wakho okanye ku-911 ngoko nangoko.

Ngaba umntu angasinda kwi-coma yesifo seswekile? Ngaba kukho naziphi na iziphumo ezihlala ixesha elide?

Ewe, i-diabetic coma inokuthintelwa ukuba unobangela wayo unyangwa ngokukhawuleza. Nangona kunjalo, abanye abantu banokulimala kwengqondo ngokusisigxina. Ukuba abanyangwa ngokukhawuleza nangendlela efanelekileyo, banokufa.

Izinga lokufa kwabantu abane-DKA liphakathi kwe-0.2% kunye ne-2.5%. Abo bakwi-coma, abane-hypothermia, kwaye banomchamo ophantsi (i-oliguria) baneziphumo ezimbi kakhulu.

Malunga nama-20% abantu abane-HHS bayafa ngenxa yesi sifo. Abo bafumana i-coma kunye/okanye uxinzelelo lwegazi oluphantsi abanalo ithemba lokuba baza kusweleka.

Ungahlala ixesha elingakanani kwi-coma enesifo seswekile?

Ubude bexesha olichitha kwi-diabetic coma buxhomekeke kakhulu ekubeni ufumana unyango olufanelekileyo ngokukhawuleza kangakanani. Eyona ndlela yokuphelisa i-coma efana nale kukubuyisela amanqanaba eglucose egazini lakho kunye ne-insulin kumanqanaba aphilileyo. Oku kungenziwa kuphela ngoncedo lweengcali zonyango. Umntu kwi-diabetic coma akayi kubuyela engqondweni eyedwa.

Ukuba umntu okwi-coma efana nale akafumani unyango ngexesha, kusenokwenzeka ukuba afe. ​​"Ekuhambeni kwexesha" kuyahluka ngokwemeko yomntu nomntu. Yiyo loo nto kubaluleke kakhulu ukufumana uncedo ngokukhawuleza.

Ngamafutshane, nazi izinto ekufuneka sizikhumbule (Umyalezo Wokubuyela Ekhaya):

Nangona i-diabetes coma iyingozi kakhulu, idla ngokuthintelwa.

• Eyona nto iphambili kukuba,Qaphela iimpawu ezilumkisayo ze-`(DKA)`, `(HHS)` kunye neswekile ephantsi egazini kwaye uthathe inyathelo ngokukhawuleza xa uzibona.
• Ukuba uneempawu zale meko, fowunela ugqirha wakho ngokukhawuleza.
• Iingxaki zesifo seswekile ziyoyikisa ngokwenene, kodwa ukuqaphela nokuzilungiselela yeyona ndlela ilungileyo yokuzithintela.
• Ungaze ungathandabuzi ukubuza ugqirha wakho nayiphi na imibuzo onayo malunga nokulawula isifo sakho seswekile okanye ezi ngxaki. Impilo yakho ibalulekile kuwe.

Isifo seswekile, i-Coma, i-DKA, i-HHS, i-Hypoglycemia, iswekile egazini, i-insulin, uncedo lokuqala, iingxaki zeswekile, ukulahleka kwenkumbulo