Ingaba uneswekile ephezulu egazini? Masifunde yonke into malunga ne-hyperglycemia!

Ngaba ngamanye amaxesha uziva ngathi awuziva kakuhle? Udiniwe nje, okanye uhlala unxaniwe? Ezi zinokuba ziimpawu zokuba amanqanaba eswekile yakho egazini aphezulu kancinci. Namhlanje, siza kuthetha ngale meko ibizwa ngokuba yiswekile ephezulu egazini, okanye oko oogqirha bakubiza ngokuba yi-"Hyperglycemia." Ungakhathazeki, le yinto abantu abaninzi abanayo, kwaye kubalulekile ukuba uyiqaphele.

Kuthetha ukuthini ukuba neswekile ephezulu egazini? (I-Hyperglycemia)

Ngamafutshane, `(I-Hyperglycemia)` ithetha ukuba isixa seswekile, okanye i-glucose, egazini lakho siphezulu kakhulu. Oku kwenzeka xa umzimba wethu une -insulin encinci kakhulu, okanye xa umzimba wethu ungakwazi ukusebenzisa i-insulin ngokufanelekileyo (oku kubizwa ngokuba kukunganyamezelani ne-insulin) .

I-Hyperglycemia idla ngokuthetha ukuba unesifo seswekile . Abantu abanesifo seswekile badla ngokuba namanqanaba aphezulu eswekile egazini. Ukuba eli nqanaba liphezulu leswekile egazini alinyangwa ixesha elide, lingonakalisa imithambo-luvo yakho, imithambo yegazi, izicwili kunye namalungu omzimba.

Ngamanye amaxesha, ukuba amanqanaba eswekile egazini aphezulu kakhulu, kunokukhokelela kwimeko esongela ubomi ngequbuliso ebizwa ngokuba yi-diabetes ketoacidosis (DKA) . Oku kuyingozi kakhulu kubantu abanesifo seswekile abasebenzisa i-insulin kunye nabo banesifo seswekile sohlobo 1 esingafunyaniswanga. Oku kufuna unyango olukhawulezileyo.

Ingakanani iswekile egazini ethathwa njenge 'phezulu'?

Le yinto ekufuneka icaciswe kancinci.

• Kumntu ongakhange afunyanwe enesifo seswekile, ukuba inqanaba leswekile egazini lakhe liphezulu kune-125 mg/dL (ii-milligrams nge-deciliter) emva kokuzila ukutya ubuncinane iiyure ezi-8 , oku kuthathwa njenge-"Hyperglycemia".
• Ukuba inqanaba leswekile yomntu ekuzileni ukutya liphakathi kwe-100 mg/dL kunye ne-125 mg/dL, oko kuthathwa njengesifo seswekile esingaphambi kwexesha . Oku kuthetha ukuba kukho umngcipheko omkhulu wokuba nesifo seswekile.
• Ukuba amanqanaba eswekile yokuzila ukutya ahlala ephezulu kune-125 mg/dL, isifo seswekile sidla ngokufunyaniswa - uninzi lwaso sisifo seswekile sohlobo lwesibini. Xa abantu befunyaniswa benesifo seswekile sohlobo loku-1, amanqanaba eswekile yabo yegazi adla ngokuba phezulu kakhulu (ngaphezu kwe-250 mg/dL).

Kumntu onesifo seswekile, inqanaba leswekile egazini elingaphezulu kwe-180 mg/dL kwiyure okanye ezimbini emva kokutya lithathwa njenge-"Hyperglycemia." Nangona kunjalo, la maxabiso anokwahluka ngokuxhomekeke kwiinjongo zakho zeswekile egazini. Kuya kufuneka uthethe nogqirha wakho ukuze ufumane ukuba yintoni kanye kanye injongo yakho.

Yintoni le 'swekile' (iGlucose) egazini?

Iglucose, okanye 'iswekile' nje, ngumthombo oyintloko wamandla emizimbeni yethu, ovela kwiicarbohydrates esizityayo. Lo ngumthombo oyintloko wamandla emizimbeni yethu. Le glucose ithwalwa isuka egazini lakho iye kwiseli nganye emzimbeni wakho kwaye isetyenziswa njengamandla.

Ukuba awunaso isifo seswekile, iinkqubo ezininzi zendalo emizimbeni yethu zinceda ukugcina amanqanaba eglucose egazini ekwinqanaba elifanelekileyo. Eyona nto inegalelo koku yihomoni ebizwa ngokuba yi-insulin , eyenziwa yipancreas yethu.

Iswekile ephezulu egazini idla ngokubangelwa kukungabikho kwe-insulin okanye ukuxhathisa i-insulin. Yiyo le nto ibangela isifo seswekile. Abantu abanesifo seswekile kufuneka bathathe amayeza (nokuba ngamayeza omlomo okanye i-insulin yokwenziwa) kunye/okanye benze utshintsho kwindlela abaphila ngayo ukuze balawule amanqanaba eswekile egazini.

Ixhaphake kangakanani le meko?

I-Hyperglycemia kunye nesifo seswekile zizinto eziqhelekileyo kakhulu. Umzekelo, umntu omnye kwabalishumi eMelika unesifo seswekile. Iswekile ephezulu egazini ikwaxhaphake kakhulu kubantu abanesifo seswekile. Le meko ngoku ixhaphake kakhulu kwilizwe lethu.

Zithini iimpawu zeswekile ephezulu egazini?

Xa amanqanaba eswekile egazini enyuka, usenokungaziboni iimpawu ezinkulu ngoko nangoko. Nangona kunjalo, ungaqala ukuqaphela ezi mpawu kancinci kancinci.

Iimpawu ezibonakala ngokukhawuleza:

• Unxano olugqithisileyo (i-polydipsia) kunye/okanye ukuziva ulambile.
• Ukufuna ukuchama rhoqo.
• Intloko ebuhlungu (intloko ebuhlungu).
• Umbono ofiphele kancinci.

Iimpawu ezenzeka xa amanqanaba eswekile enyuka ngokuhamba kwexesha:

• Ndiziva ndidiniwe kakhulu.
• Ukunciphisa umzimba (ngaphandle kwesizathu).
• Abafazi banamathuba amaninzi okufumana usulelo lwe-yeast kwi-vaginal .
• Usulelo lwesikhumba .
• Amanxeba athatha ixesha ukuphola.

Ukuba wena okanye umntwana wakho unezinye zezi mpawu, kubaluleke kakhulu ukubona ugqirha ukuze akunike ingcebiso.

Inqanaba leswekile abantu abanesifo seswekile abaqala ngalo ukufumana iimpawu liyahluka kumntu nomntu. Uninzi lwabantu alufumani zimpawu zinkulu de iswekile yabo yegazi ibe yi-250 mg/dL okanye ngaphezulu. Nangona kunjalo, abantu abangekafumani zimpawu zokuba banesifo seswekile banokuzifumana iimpawu kumanqanaba aphantsi.

Ukuba uthatha i-insulin okanye amanye amayeza eswekile, kubalulekile ukuba uqaphele iimpawu zokuqala zeswekile ephezulu egazini kwaye ujonge amanqanaba eswekile yakho yegazi rhoqo. Ukuba ayinyangwa, le meko (i-hyperglycemia) inokukhokelela kwi -diabetes ketoacidosis (DKA).Oku kunokukhokelela kwimeko eyingozi ebizwa ngokuba yi-ketoacidosis. Oku kwenzeka xa igazi liba ne-asidi ngenxa yokunqongophala kwe-insulin kunye nokwanda kwezinto ezibizwa ngokuba zii-ketones. Oku kunokuchaphazela nabantu abanesifo seswekile sohlobo 1 esingafunyaniswanga. Oku kungaba yingxamiseko, okukhokelela kwi-coma okanye ekufeni.

Imeko eyingozi: Iimpawu ze-diabetes ketoacidosis (DKA):

• Isicaphucaphu nokuhlanza.
• Ukuphelelwa ngamanzi emzimbeni - ukulahleka kwamanzi emzimbeni.
• Intlungu zesisu.
• Umoya onuka iziqhamo.
• Ukuphefumla okunzulu, okunzima okanye ukuphefumla ngokukhawuleza (ukuphefumla kukaKussmaul).
• Ukubetha kwentliziyo ngokukhawuleza.
• Ukudideka kunye nokudideka.
• Ukulahlekelwa yingqondo.

Ukuba wena okanye umntwana wakho unezi mpawu ze-`(DKA)`, funa uncedo lwezonyango ngokukhawuleza!

Kutheni iswekile egazini inyuka ngolu hlobo? Zithini izizathu?

Eyona nto ibangela ukuba iswekile ephezulu egazini ibe phezulu kukungabikho kwe-insulin. Oku kunokubangelwa kukunganyamezelani ne-insulin okanye iingxaki kwi-pancreas yethu, evelisa i-insulin.

Ezinye iihomoni nazo zinokuba negalelo kwiswekile ephezulu egazini. Umzekelo, ukwanda kokukhutshwa kwe-cortisol (ekwaziwa ngokuba yi-"stress hormone") okanye i-growth hormone nako kunokubangela iswekile ephezulu egazini.

Ukuxhathisa i-insulin

Eyona nto ixhaphakileyo ebangela i-hyperglycemia kukunganyangeki kwe-insulin . Oku kwenzeka xa izihlunu zakho, amafutha kunye neeseli zesibindi zingasabeli kakuhle kwi-insulin.

Xa iiseli zakho zingasabeli kakuhle kwi-insulin, umzimba wakho udinga i-insulin engaphezulu ukulawula iswekile yakho yegazi. Ukuba umzimba wakho awukwazi ukwenza i-insulin eyaneleyo (okanye ukuba awuthathi i-insulin eyaneleyo), amanqanaba eswekile yakho yegazi ayanyuka.

Ukunganyangeki kwe-insulin yeyona nto iphambili ebangela isifo seswekile sohlobo lwesibini. Nangona kunjalo, sinokuvela nakubantu abangenaso isifo seswekile nakubantu abanezinye iintlobo zesifo seswekile. Kunokuba yinto yexeshana okanye ixesha elide.

Ezinye zezizathu eziqhelekileyo zokuxhathisa i-insulin:

• Ukutyeba kakhulu: Izazinzulu zikholelwa ukuba ukutyeba kakhulu, ingakumbi amafutha amaninzi esiswini nakwizitho zomzimba (esiwabiza ngokuba yi -'visceral fat' ), yeyona nto ibangela ukuxhathisa i-insulin.
• Ukungawunyamezeli umzimba.
• Ukutya okune-carbohydrate eninzi, ukutya okucutshungulwe kakhulu kunye namafutha agcweleyo.
• Amanye amayeza: Umzekelo , ii-corticosteroids, amanye amayeza oxinzelelo lwegazi, amanye amayeza e-HIV, kunye namanye amayeza engqondo. Ezi zinokubangela ukunganyangeki kwe-insulin, nokuba okwethutyana okanye ixesha elide, kuxhomekeke ekubeni uzithatha ixesha elingakanani.

Ezinye iimeko zehomoni zinokubangela ukunganyangeki kwe-insulin:

• I-Cushing's syndrome (ukwanda kwe-cortisol).
• I-Acromegaly (i-hormone yokukhula eyonyukileyo).
• Ukukhulelwa: Ngexesha lokukhulelwa, iihomoni ezikhutshwa yi-placenta zinokubangela ukunganyangeki kwe-insulin. Oku kunokubangela isifo seswekile sokukhulelwa kwabanye abantu.

Ezinye iimeko zemfuza ezizuzwe njengelifa zikwanxulunyaniswa nokuxhathisa i-insulin:

• `Isifo sikaRabson-Mendenhall`
• `Isifo sikaDonohue`
• `I-Myotonic dystrophy`
• `Isifo se-Alström`
• `Isifo sikaWerner`

Iingxaki zePancreas

Ukonakala kwepancreas yakho kunokubangela ukwehla kwemveliso ye-insulin, okukhokelela kwi-hyperglycemia. Ezinye zezifo zepancreas ezinokubangela i-hyperglycemia kunye nesifo seswekile ziquka:

• Isifo sokuzilolonga: Kwisifo seswekile sohlobo loku-1, inkqubo yakho yomzimba yokuzikhusela ihlasela iiseli ezivelisa i-insulin kwi-pancreas yakho ngesizathu esingaziwayo. Oku kuthetha ukuba i-pancreas yakho ayisakwazi ukuvelisa i-insulin, nto leyo ebangela i-hyperglycemia. Imeko ebizwa ngokuba yi -Latent Autoimmune Diabetes in Adults (LADA) nayo ibangelwa kukusabela kwe-autoimmune, kodwa ikhula kancinci kunesifo seswekile sohlobo loku-1.
• I-pancreatitis engapheliyo: Le meko ibangela ukudumba kwexesha elide kwepancreas, okunokonakalisa iiseli ezenza i-insulin. Oku kunokukhokelela ekuswelekeni kwe-insulin (i-hyperglycemia). I-Pancreatitis yimbangela eyaziwayo yesifo seswekile sohlobo lwe-3c .
• Umhlaza wePancreatic: Umhlaza wePancreatic unokonakalisa iiseli ezenza i-insulin, nto leyo ebangela ukungabikho kwe-insulin (i-hyperglycemia). Malunga nama-25% abantu abanomhlaza wePancreatic bafunyanwa benesifo seswekile kwiinyanga ezi-6 ukuya kwezingama-36 ngaphambi kokuba umhlaza ufunyanwe.
• I-Cystic fibrosis: Abantu abane-cystic fibrosis banokufumana amanxeba kwi-pancreas yabo ngenxa yokuveliswa kwe-mucus eninzi. Oku kunciphisa ubungakanani be-insulin eveliswa yi-pancreas yabo, nto leyo ekhokelela kwi-hyperglycemia kunye nesifo seswekile esinxulumene ne-cystic fibrosis (CFRD) .

Izizathu zokunyuka kweswekile okwethutyana

Kwezinye iimeko, abantu abanesifo seswekile nabangenaso banokufumana ukunyuka okwethutyana kwamanqanaba eswekile egazini (i-hyperglycemia).

• Uxinzelelo lomzimba, olufana nokugula, utyando, okanye ukwenzakalaOku kunokunyusa iswekile yegazi okwethutyana.
• Uxinzelelo olukhulu lweemvakalelo , olufana nesiganeko esibuhlungu okanye uxinzelelo olunxulumene nomsebenzi, lunokubangela ukuba amanqanaba eswekile egazini anyuke. Oku kungenxa yokukhululwa kweehomoni ezibizwa ngokuba yi-cortisol kunye/okanye i-epinephrine (adrenaline) .

Izizathu ezikhethekileyo ezibangela iswekile ephezulu egazini kubantu abanesifo seswekile

Kukho izizathu ezahlukeneyo zokuba abantu abanesifo seswekile babe namanqanaba aphezulu eswekile egazini. Oku kunokwenzeka ukuba izinto ezifana nokutya kunye namayeza eswekile azilingani.

Iimeko eziqhelekileyo ezinokubangela "i-Hyperglycemia" kubantu abanesifo seswekile:

• Ukungayithathi ngokwaneleyo i-insulin, ukuthatha uhlobo olungafanelekanga lwe-insulin, ukuthatha i-insulin ephelelwe lixesha, okanye ingxaki kwindawo yokufaka i-insulin (umz., ingxaki kwindawo yokufaka i-insulin kumntu osebenzisa ipompo ye-insulin).
• Ixesha elingachanekanga lokuthathwa kwe-insulin kunye neecarbohydrate.
• Ubungakanani beekhabhohayidreyithi ozityayo busenokungalingani nobungakanani be-insulin eveliswa ngumzimba wakho okanye ubungakanani be-insulin oyijovayo.
• Awusebenzisi ngokwaneleyo amayeza akho eswekile aselwayo.
• Ukungasebenzi kakhulu kunesiqhelo.
• Isiganeko sokusa: Ukunyuka kweswekile egazini ekuseni kakhulu.

Ziziphi iingxaki ezenzekayo xa iswekile egazini iqhubeka nokunyuka?

Ukuba unezinga eliphezulu leswekile egazini (i-hyperglycemia engapheliyo) iminyaka emininzi, inokonakalisa imithambo yegazi kunye nezicubu zakho. Oku kunokukhokelela kwiingxaki ezahlukeneyo. Ezinye zazo zezi:

• I-retinopathy, echaphazela amehlo .
• I-Nephropathy, echaphazela izintso .
• I-neuropathy, echaphazela imithambo-luvo .
• I-Gastroparesis, ebangela ukuba isisu singaphumi kakuhle .
• Isifo sentliziyo .
• Istroke .

Into ebalulekileyo ekufuneka uyikhumbule kukuba ezinye izinto, ezifana nefuthe lemfuza kunye nokuba unexesha elingakanani unesifo seswekile, zinokuchaphazela ukukhula kweengxaki zeswekile.

Ukunyuka ngequbuliso nangokuqatha kweswekile egazini (i-hyperglycemia ebukhali) kunokukhokelela kwimeko esongela ubomi ebizwa ngokuba yi -diabetesic ketoacidosis (DKA) .

Uyixilonga njani le nto?

Oogqirha bayalela uvavanyo lwegazi ukuze kuhlolwe i-hyperglycemia kunye nokufumanisa isifo seswekile. Olu vavanyo lungabandakanya:

• Uvavanyo lweglucose yokuzila ukutya.
• Uvavanyo lokunyamezela i-glucose.
• Uvavanyo lwe-A1c.

Abantu abanesifo seswekile bavavanya iswekile yabo egazini ekhaya (besebenzisa i-glucose meter). Oku kubavumela ukuba bajonge amanqanaba eswekile yabo egazini baze bajonge i-hyperglycemia. Ukuba usebenzisa inkqubo yokujonga iswekile rhoqo (i-CGM) , inokukwazisa xa iswekile yakho yegazi iphezulu. Nangona kunjalo, le teknoloji ngamanye amaxesha inokuba ayichanekanga, ngoko ke ukuba ukufundwa kwe-CGM akuhambelani nendlela oziva ngayo, kubalulekile ukujonga iswekile yakho yegazi nge-glucose meter.

Ungayilawula njani iswekile ephezulu egazini? (Unyango)

Ukuba uthatha i-insulin ukulawula isifo sakho seswekile, eyona ndlela iphambili yokunyanga iswekile ephezulu egazini kukufaka i-insulin. Wonke umntu udinga isixa esahlukileyo se-insulin. Wena nogqirha wakho niza kugqiba kunye ukuba yeyiphi idosi efanelekileyo yokunyanga nokuthintela iswekile ephezulu egazini kuwe. Utshintsho kwindlela yokutya kunye nesicwangciso sokuzilolonga kunokunceda ukulawula iswekile yakho yegazi kunye nokuthintela i-hyperglycemia.

Abantu abanesifo seswekile sohlobo lwesibini abangadingi kusela i-insulin banokulawula i-hyperglycemia yabo ngokutshintsha indlela abaphila ngayo (njengokutya kunye nokuzilolonga) kunye namayeza eswekile aselwayo. Wena nogqirha wakho niya kugqiba ukuba loluphi ucwangciso olulungele wena.

Luhlobo luni lwethemba onokuba nalo xa uphila nale meko?

Isiganeko esilindelekileyo kubantu abane-hyperglycemia sixhomekeke ekubeni balawula kakuhle kangakanani isifo sabo seswekile ngokubanzi.

Zininzi izinto ezichaphazela indlela umntu anokuyilawula ngayo isifo sakhe seswekile:

• Ukufikelela kwiinkonzo zempilo.
• Ukufikelela kwimfundo ngesifo seswekile.
• Ukufikelela kubuchwepheshe bokulawula isifo seswekile kunye namayeza.
• Ukwazi ukufikelela kwizixhobo zokutya okunempilo kunye nokuzilolonga.
• Inkxaso evela kubantu obathandayo.
• Iimeko zempilo yengqondo (umz. ukudakumba, ixhala).
• Ezinye iimeko zempilo yomzimba.

I-hyperglycemia yexesha elide inokukhokelela kwiingxaki ezinkulu, kwaye ezi ngxaki zihlala zingalungiseki. Izifundo ezininzi zibonise ukuba i-hyperglycemia yexesha elide enganyangwanga inciphisa ixesha lokuphila kwaye iyenza mandundu umgangatho wobomi.

Eyona nto ibalulekileyo kukwazi ukuba ungaphila ubomi obusempilweni xa unesifo seswekile. Ezi zinto zibaluleke kakhulu ukuze ube nembono entle:

• Utshintsho kwindlela yokuphila.
• Ukuzilolonga rhoqo.
• Utshintsho kwindlela yokutya.
• Ukujonga iswekile yegazi rhoqo (ingakumbi kwabo basebenzisa i-insulin).

Izifundo zibonise ukuba abantu abanesifo seswekileUkugcina inqanaba le-A1C lingaphantsi kwe-7% kunokunciphisa umngcipheko weengxaki.

Ungayithintela njani iswekile ephezulu egazini rhoqo?

Ngelishwa, kunzima ukuthintela ngokupheleleyo iswekile ephezulu egazini xa unesifo seswekile. Nangona kunjalo, ungenza utshintsho kwisicwangciso sakho sokulawula isifo seswekile ukuze uzame ukunciphisa ukuphindaphindeka kweswekile ephezulu egazini.

Oku kulula ukukwenza xa wena nogqirha wakho niqonda ukuba yintoni ebangela iswekile ephezulu egazini. Nika ugqirha wakho iinkcukacha ezininzi kangangoko unako malunga nexesha ngalinye iswekile yakho yegazi iphezulu. Ngamanye amaxesha isisombululo sengxaki sinokuba lula njengokutshintsha amaxesha othatha amayeza akho, ukutya, okanye ukuzilolonga.

La manyathelo anokunceda ukuthintela iswekile ephezulu egazini:

• Thatha onke amayeza akho njengoko uyalelwe.
• Landela icebiso likagqirha wakho malunga nokutya kunye nokuzilolonga.
• Jonga iswekile yakho yegazi rhoqo.

Ufanele uye nini kugqirha malunga neswekile ephezulu egazini?

Ukuba unesifo seswekile kwaye uneziqendu ezihlala ziphezulu zeswekile egazini, bonana nogqirha wakho onokukunceda ulawule isifo sakho seswekile. Angakunceda ulungise isicwangciso sakho sokulawula. Oku kungabandakanya utshintsho kwindlela yakho yamayeza, isicwangciso sokutya, okanye umthambo.

Ufanele uye nini kwiYunithi yoNyango oluNgxamisekileyo (i-ETU) ?

Ukuba uneempawu ze-`(DKA)` (umz. ukuhlanza kunye nokunxanwa okugqithisileyo okubangelwa yiswekile ephezulu yegazi), yiya kwigumbi likaxakeka ngoko nangoko. `(DKA)` ifuna unyango olukhawulezileyo.

Yintoni umahluko phakathi kweswekile ephezulu egazini (i-Hyperglycemia) kunye neswekile ephantsi egazini (i-Hypoglycemia)?

• I-Hyperglycemia kukunyuka kweswekile egazini. Igama elithi "hyper-" lithetha "ukuphakama" okanye "ukugqitha."
• I-Hypoglycemia yiswekile ephantsi egazini. Igama elithi "Hypo-" lithetha "isezantsi."

I-Hyperglycemia ixhaphake kakhulu kubantu abanesifo seswekile. Ukujonga iswekile yakho rhoqo kunye nokubona ugqirha wakho weswekile kunokukunceda ulawule isifo seswekile kunye ne-hyperglycemia. Khumbula, iswekile ephezulu egazini ayisiyonto ekufuneka uyenze rhoqo. Yazi ukuba kukho izinto onokuzenza ukuyithintela. Ukuba uziva uxinezelekile kukulawula isifo sakho seswekile, thetha nogqirha wakho. Kunye, ninokwenza isicwangciso sokufikelela kwiinjongo zenu zolawulo.

Umyalezo Wokuya Ekhaya

Ngoko ke, ngokwezinto esizithethileyo, kufuneka uqonde ukuba yintoni iswekile ephezulu egazini, okanye "i-Hyperglycemia", izizathu zayo, iimpawu zayo, kunye nendlela yokuyilawula.

Eyona nto ibalulekileyo kukubona ugqirha ukuba unale mpawu. Ukuba zifunyenwe kwangethuba kwaye zilawulwa kakuhle, ungaphila ubomi obusempilweni nobonwabisayo.

• Qaphela amanqanaba eswekile egazini lakho.
• Sebenzisa amayeza amiselweyo ngokuchanekileyo.
• Yitya ukutya okunempilo .
• Zilolonge rhoqo.
• Zama ukunciphisa uxinzelelo .

Ukuba uzenza kakuhle ezi zinto, uya kuncedwa kakhulu kukuzikhusela kwi-"Hyperglycemia" kunye neengxaki ezinokubangelwa sisifo seswekile. Awuwedwa, kwaye baninzi abantu abanokukunceda kolu hambo.

I- Hyperglycemia, isifo seswekile, iswekile yegazi, i-insulin, iimpawu, i-DKA, ukuxhathisa i-insulin