Ingabe unoshukela ophezulu egazini ekuseni, noma ngabe unesifo sikashukela? Ake sifunde ngalo 'mphumela weSomogyi'?

Ingabe ungumuntu othatha i-insulin yesifo sikashukela? Uma kunjalo, uke waphawula ukuthi izinga likashukela egazini lakho liye landa ngokuzumayo uma uvuka ekuseni? Ngisho noma uthatha imithi yakho ebusuku futhi uqaphele, kuyamangaza ukuthi usenayo ekuseni? Esinye isizathu salokho kungaba 'umphumela we-Somogyi'. Ake sixoxe ngalokhu ngemininingwane ethe xaxa .

Uyini umphumela weSomogyi?

Kalula nje, umphumela weSomogyi uba lapho umuntu onesifo sikashukela othatha i-insulin eba nokwehla okungazelelwe kwamazinga kashukela egazini (hypoglycemia) ebusuku, kulandelwe ukwanda okungazelelwe kwamazinga kashukela egazini (hyperglycemia) ekuseni. Lokhu kwenzeka ngenxa yesenzo samahomoni athile emizimbeni yethu. Cabanga, phakathi nobusuku, ushukela wakho wegazi wehla ngokuzumayo, bese umzimba wakho ucabanga ukuthi, "O, lo mfana uzongena enkingeni," bese ekhipha amahomoni ukuze amsindise. Yingakho amazinga kashukela egazini lakho enyuka ekuseni.

Iqanjwe ngoDkt. Michael Somogyi, udokotela owaqala ukuyithola ngawo-1930. Odokotela ngezinye izikhathi bayibiza ngokuthi 'i-rebound hyperglycemia'.

Kodwa nansi into okufanele uyazi. Umphumela we-Somogyi usengumbono phakathi kwabacwaningi, okusho ukuthi umane nje umbono. Lokho kusho ukuthi awufakazelwanga ngokuphelele, kodwa kunobufakazi besayensi obuwusekelayo. Esikhathini esidlule, odokotela babecabanga ukuthi lesi yisona sizathu esiyinhloko sokwanda koshukela ekuseni. Kodwa ucwaningo olusha, ikakhulukazi ucwaningo olusebenzisa ukuqapha okuqhubekayo kwe-glucose (CGM), luphakamise imibuzo ngalo mbono.

Kunezinye izizathu eziningana zokuthi amazinga kashukela egazini angakhuphuka ekuseni, hhayi nje umphumela weSomogyi:

• Inani lomuthi owuthathayo alanele, ngoba uphuma emzimbeni wakho ebusuku.
• Isimo esibizwa ngokuthi isenzakalo se-Dawn. (Sizoxoxa ngalokhu futhi)
• Inani lomuthi othathwe ngesikhathi sokudla kwakusihlwa alizange lilingane nenani lokudla.
• Ukuba nokumelana ne-insulin.

Uyini umehluko phakathi komphumela weSomogyi kanye nomcimbi weDawn?

Kulungile, manje ungase uzibuze, 'Kuyini lokhu okwenzeka ekuseni?' Zombili lezi zinto zibangela amazinga kashukela egazini ukuba akhuphuke ekuseni kubantu abanesifo sikashukela.

Isenzakalo sokusa siwukwanda ngokwemvelo kwamazinga kashukela egazini okubangelwa ukukhishwa kwama-hormone amaningana (njenge-cortisol kanye ne-growth hormone) ekuseni kakhulu. Lokhu kuvamile.

Kodwa emphumeleni we-Somogyi, ama-hormone nawo ayasebenza, kodwa kwenzeka ngenxa yokwehla okungazelelwe kukashukela (hypoglycemia) ebusuku. Esimweni sokusa, ushukela awukhuphuki ngenxa yokwehla okunjalo kukashukela.

Enye into ebalulekile ukuthi isenzakalo sokusa, phakathi kwezimbangela zokwanda kukashukela egazini ekuseni , sivame kakhulu kunomphumela weSomogyi.

Ziyini izimpawu zomphumela weSomogyi?

Isibonakaliso esiyinhloko somphumela we-Somogyi ukuthi amazinga kashukela egazini lakho ayanda uma uvuka ekuseni. Kungakhathaliseki ukuthi ubheka i-glucometer yakho noma uma usebenzisa idivayisi ye-CGM (Continuous Glucose Monitoring), kuzobonisa ukuthi amazinga kashukela akho aphezulu ekuseni.

Kuye ngokuthi ushukela wakho wegazi uphakeme kangakanani, ungase ube nezimpawu ezinjengalezi uma uvuka ekuseni:

• Ukoma okuvamile (i-polydipsia).
• Ukuzizwa ulambile kakhulu kunokujwayelekile.
• Ukuchama njalo.
• Ikhanda elibuhlungu.
• Ukuzizwa ucasukile futhi uthukuthele (ukucasuka).

Kungani kwenzeka umphumela weSomogyi?

Ngokusho kombono womphumela we-Somogyi, uma izinga likashukela egazini lakho lehla kakhulu (i-hypoglycemia) phakathi nobusuku ngenkathi ulele ngenxa ye-insulin oyithathayo, umzimba wakho uzozama 'ukukusindisa' kuleso simo sikashukela ophansi.

Umzimba ukhipha ama-hormone amaningana kulo msebenzi wokusindisa. Ama-hormone ayinhloko yilawa:

• I-Adrenaline
• Ama-Corticosteroids
• I-hormone yokukhula
• I-Glucagon

La ma-hormone abangela isibindi sakho ukuthi sikhiphe ushukela omningi, noma ushukela, egazini lakho kunokuvamile. Lokhu kukhishwa kwe-glucose kubangela ukuthi amazinga kashukela egazini lakho akhuphuke. Uma unesifo sikashukela, i-pancreas yakho ayikhiqizi i-insulin eyanele ukulawula leli zinga likashukela elikhuphukile, noma ayikhiqizi nhlobo. Yingakho amazinga kashukela egazini lakho ehlala ephezulu.

Kumuntu ongenaso isifo sikashukela, umzimba ulawula amazinga kashukela egazini ngokwemvelo futhi uwagcine esezingeni elithile. Yingakho umphumela weSomogyi ungabathinti abantu abangenaso isifo sikashukela.

Uthola kanjani udokotela onje?

Empeleni, umphumela we-Somogyi awuyona imbangela evamile yokwenyuka kukashukela egazini ekuseni, ngakho kungaba nzima kancane ukuwuthola. Futhi, njengoba ngishilo ngaphambili, ucwaningo lwakamuva lusikisela ukuthi kungenzeka kungabi yimbangela yokwenyuka kukashukela egazini ekuseni. Ngakho kungaba nzima, uma kungenzeki, ukuthi udokotela awuthole ngokunembile ngokuthi, 'Kulungile, nakhu.'

Uma uvame ukuba noshukela ophezulu egazini ekuseni, kungcono ukukhuluma nodokotela wakho ozokusiza ukuphatha isifo sikashukela sakho. Uzobheka ukuthi amazinga kashukela egazini lakho ayashintshashintsha kanjani bese ezama ukuthola imbangela. Indlela ephumelela kakhulu yokwenza lokhu ukusebenzisa idivayisi ye-CGM (Continuous Glucose Monitoring).

Uma ungasebenzisi i-CGM, udokotela wakho cishe uzokutshela ukuthi uhlole amazinga kashukela egazini lakho izikhathi eziningana ngosuku. Isibonelo:

• Amahora amabili ngemva kwesidlo sakusihlwa.
• Ngaphambi kokulala.
• Phakathi nobusuku (isibonelo, cishe ngo-2 noma ngo-3 ekuseni).
• Lapho evuka ekuseni.

Futhi, bakutshela ukuthi ubhale phansi imininingwane efana nokuthi yikuphi ukudla okudlayo ebusuku, ukuthi udla okungakanani, nokuthi uma uzivocavoca ebusuku, ukuthi hlobo luni lokuzivocavoca olwenzayo nokuthi luthatha isikhathi esingakanani.

Udokotela angathola imbangela yoshukela ophezulu egazini ekuseni kuphela ngokuqoqa lonke lolu lwazi.

Ukwelashwa kanjani umphumela weSomogyi?

Ngemva kokuba wena nodokotela wakho senisebenzisane ukuthola ukuthi amazinga kashukela egazini lakho aziphatha kanjani ebusuku, bazokweluleka ngezinguquko ongazithatha ukusiza ekuvimbeleni ukwanda kukashukela egazini ekuseni. Khumbula, umzimba womuntu wonke uhlukile, futhi kunezici eziningi ezithinta amazinga kashukela egazini. Ngakho-ke, ongakwenza ukuvimbela ukwanda kukashukela egazini ekuseni kungahluka kuye ngomuntu nomuntu.

Udokotela wakho angase asikisele izinto ezifana nalezi:

• Ukushintsha umthamo wemithi yakho yesifo sikashukela noma i-insulin.
• Ukushintsha izinhlobo zokudla okudlayo ngesikhathi sakusihlwa. Isibonelo, kungadingeka udle ukudla okunamaprotheni amaningi, ama-carbohydrate, noma amafutha, noma kungadingeka udle okuncane kukho.
• Uma kungenzeka, ukushintshela kuphampu ye-insulin kuzokuvumela ukuthi ulawule imithamo yakho ye-insulin ngokunembe kakhudlwana.
• Ukushintsha isikhathi sokuzivocavoca ebusuku.

Yiziphi izinkinga ezingabangelwa yilokhu?

Kungakhathaliseki ukuthi umphumela weSomogyi empeleni uyimbangela yokwenyuka koshukela egazini ekuseni noma cha, lokhu kugcizelela amaphuzu amabili abalulekile. Abantu abanesifo sikashukela kufanele bazame ukugwema lezi zinkinga ezimbili:

• Amazinga kashukela egazini aphakeme njalo.
• Amazinga kashukela aphansi egazini (hypoglycemia) ayenzeka ebusuku.

Ukwanda okuqhubekayo kwamazinga kashukela egazini

Njengoba amazinga kashukela egazini lakho eqhubeka nokuba phezulu, amazinga akho e-HbA1c (A1C) azokhula, kanti ne-Time in Range yakho (TIR) ​​​​izokwehla. Ukuhlolwa kwe-HbA1c kulinganisa amazinga akho kashukela egazini ajwayelekile ezinyangeni ezintathu ezedlule. I-TIR iphesenti elimaphakathi lezinsuku amazinga akho kashukela egazini angaphakathi kwebanga eliqondiwe.

Uma amazinga akho e-A1c kanye ne-TIR eba mabi kakhulu, ikakhulukazi uma eseneminyaka eminingi ekhona, kulapho ingozi yakho yokuthola izinkinga ezibangelwa isifo sikashukela iphakama khona. Izibonelo zalezi zinkinga zifaka:

• Izinkinga zamehlo (i-Retinopathy)
• Izinkinga zezinso (i-Nephropathy)
• I-Neuropathy
• Isifo senhliziyo

Ucwaningo lukhombisile ukuthi abantu abanesifo sikashukela banganciphisa ingozi yabo yalezi zinkinga uma begcina amazinga abo e-A1c engaphansi kuka-7%.

Ushukela ophezulu egazini ekuseni kungaba yinkinga eqhubekayo, futhi uma ungelashwa, amazinga kashukela egazini lakho angahlala ephezulu amahora amaningana ngosuku. Lokhu kwandisa ingozi yakho yokuthola izinkinga zesifo sikashukela ngokuhamba kwesikhathi.

Iziqephu zikashukela wegazi ophansi ebusuku

Kubantu abaningi abanesifo sikashukela, ushukela wegazi ophansi, noma i-hypoglycemia, kwenzeka lapho ushukela wegazi wehla ngaphansi kuka-70 mg/dL (ama-milligram nge-deciliter).

Uma amazinga kashukela egazini ehla, abantu abaningi babhekana nezimpawu ezifana nalezi:

• Ukuzizwa sengathi umzimba wakho uyathuthumela.
• Ukuzizwa ulambile kakhulu (i-polyphagia).
• Ukujuluka nokuzizwa ubanda.
• Isiyezi, umuzwa wokungabi nangqondo.
• Isilinganiso senhliziyo siyanda.

Kodwa-ke, uma ushukela wakho wegazi wehla ngenkathi ulele, kungathatha isikhathi ukuthi uvuke futhi uqaphele izimpawu. Lokhu kungaba yingozi, futhi i-hypoglycemia enkulu ingaba yingozi empilweni. Izimpawu zoshukela wegazi ophansi ebusuku zingase zihluke kancane, okuhlanganisa:

• Ukungalali, ukuzizwa ungakhululekile ngokulala.
• Ukuzizwa ukhathele futhi ungagxilile lapho uvuka ekuseni.
• Ukuba namaphupho amabi.
• Izingubo noma imibhede oyigqokile iba manzi ngenxa yokujuluka.

Kungakhathaliseki ukuthi unaziphi izimpawu ezikwenza ucabange ukuthi unoshukela wegazi ophansi, kubalulekile ukuhlola izinga likashukela egazini lakho ukuze ubone ukuthi liphansi kangakanani. Lokhu kuzokusiza ukuthi unqume ukuthi uzoliphatha kanjani. Ukuze welaphe i-hypoglycemia, kufanele udle ama-carbohydrate asebenza ngokushesha, okungushukela (njengobhanana noma ijusi le-apula).

Uma uvame ukuba noshukela wegazi ophansi ebusuku, qiniseka ukuthi ukhuluma nodokotela wakho ngakho. Ngokubambisana, ningalungisa uhlelo lwenu lokuphatha isifo sikashukela ukuze nisivimbele ukuthi singaphinde senzeke.

Kufanele ngimbone nini udokotela?

Uma uhlala ubhekene namazinga aphezulu kashukela egazini ekuseni, kubalulekile ukukhuluma nodokotela wakho okusiza ukuphatha isifo sakho sikashukela. Angahlola amazinga kashukela egazini lakho, anqume ukuthi umphumela weSomogyi uyimbangela, noma kukhona okunye okwenzekayo, futhi ancome uhlelo lokwelashwa olufanele wena.

Ukuba noshukela ophezulu egazini ekuseni kungaba yinto ecasulayo futhi engakhululekile. Asikho ikhambi elilodwa elifanelana nakho konke kulokhu. Ngakho-ke kungathatha isikhathi ukuthola ikhambi elifanele wena. Udokotela wakho angakusiza ukuthi unqume ukuthi iyiphi indlela engcono kakhulu yokwenza. Ungesabi ukucela usizo lwabo. Ukuthatha isinyathelo manje kungakusiza ugweme izinkinga zesikhathi esifushane nezesikhathi eside.

Okokugcina, into ebaluleke kakhulu (Umyalezo Wokuya Ekhaya)

Kulungile, manje usuqonda kangcono umphumela we-Somogyi esikhulume ngawo. Khumbula, lesi akusona ukuphela kwesizathu sokwanda koshukela ekuseni. Kodwa, kubalulekile ukukuqaphela.

• Into eyinhloko ukuthi, uma uhlala unoshukela ophezulu egazini ekuseni, ungakushayi indiva. Khuluma nodokotela wakho nakanjani.
• Uma usebenzisa i-CGM (Continuous Glucose Monitoring), cela usizo kudokotela wakho ukuze ahlaziye kahle idatha.
• Ushukela ophansi egazini (i-hypoglycemia) ebusuku kuyingozi kakhulu. Uma unezinye zalezi zimpawu, tshela udokotela wakho ngazo.
• Xoxa nodokotela wakho ngokudla kwakho, ukuzivocavoca, kanye nomthamo wemithi bese uyilungisa ukuze ivumelane nalokho okusebenzela kahle kakhulu.

Ukuphila nesifo sikashukela kuyinselele, kodwa ngokuphathwa kahle, ungaphila impilo enempilo. Ungesabi, kulungile?

Umphumela we- Somogyi, isifo sikashukela, ukwanda koshukela ekuseni, i-hypoglycemia, i-hyperglycemia, i-insulin