URuwan (oneminyaka engu-45 ubudala), unjiniyela wesofthiwe, ufike emtholampilo wami ngoLwesithathu ekuseni. Uhlale esihlalweni sakhe, ebukeka ekhathazekile futhi engenakuzisiza.
"Dkt. Priya, bengilokhu ngizizwa ngomile kakhulu muva nje. Ngisho noma ngiphuza amalitha amanzi angu-5-6 ngosuku, ukoma kwami akuqedwa. Futhi, kufanele ngiye endlini yangasese njalo ngemizuzu engama-30-45. Kufanele ngivuke izikhathi ezi-5-6 ebusuku ukuze ngiye endlini yangasese. Ngaphezu kwalokho, kungakhathaliseki ukuthi ngidla malini, indlala yami ayipheli. Ngizizwa ngilambile kakhulu. Kodwa naphezu kwakho konke lokhu, isisindo sami sehle ngamakhilogremu angu-4 ngenyanga edlule," kuchaza uRuwan ngokungakhululeki kwakhe.
Ngibheke umbiko wokuhlolwa kukashukela egazini kaRuwan ngachaza: "Ruwan, ushukela wakho wegazi osheshayo ukhuphuke wafika ku-280 mg/dL. Izimpawu ozichazayo yilokho isayensi yezokwelapha ekubiza ngokuthi ama- 3 Ps eSifo Sikashukela . Lezi yizi:
1. I-Polyuria: Ukuchama njalo.
2. I-Polydipsia: Ukuzizwa womile kakhulu.
3. I-Polyphagia: Ukuzizwa ulambile kakhulu.
"Namuhla, ake sixoxe ngokuthi kungani lezi zimpawu ezintathu zenzeka ngenxa yoshukela omningi emzimbeni wakho nokuthi ungazigwema kanjani."
🚨 Amafulegi Abomvu adinga ukunakekelwa kwezokwelapha okusheshayo
Uma kukhona ama-3 P esifo sikashukela, ikakhulukazi ezigulini ezinesifo sikashukela sohlobo 1, amazinga aphezulu kashukela egazini angalawuleki angaholela esimweni esisongela ukuphila esibizwa ngokuthi i-Diabetic Ketoacidosis (DKA) . Uma uhlangabezana nezimpawu ezilandelayo, kufanele uye ngokushesha emnyangweni wezimo eziphuthumayo wesibhedlela esiseduze nawe:
- Iphunga elifana nezithelo noma i-acetone emoyeni (iphunga lokuphefumula le-Fruity).
- Ukuphefumula okusheshayo nokujulile okuqhubekayo (ukuphefumula kwe-Kussmaul).
- Ukucanuzela kwenhliziyo nokuhlanza okuhambisana nobuhlungu obukhulu esiswini.
- Ukozela okukhulu, ukozela, ukudideka, noma ukulahlekelwa ukwazi.
- Amazinga kashukela egazini angaphezu kuka-250 mg/dL kanye nokuba khona kwama-ketone emchameni.
Isizinda sesayensi ngemuva kwe-3 Ps yesifo sikashukela
Lezi zimpawu ezintathu zibangelwa imisebenzi yomzimba ehlobene:
1. I-Polyuria - ukuchama njalo
Uma izinga likashukela egazini lidlula u-180 mg/dL (Umphetho Wezinso), izinso azikwazi ukumunca yonke i-glucose emuva egazini. I-glucose eningi iyakhishwa emchameni. Uma i-glucose ikhishwa, idonsa namanzi amaningi emzimbeni iye kuwo ngenxa yokucindezela kwe-osmotic. Le nqubo ibizwa ngokuthi i-Osmotic Diuresis . Ngenxa yalokho, isiguli siyachama njalo futhi ngobuningi obukhulu.
2. I-Polydipsia - Ukoma ngokweqile
Uma kulahleka amanzi amaningi emzimbeni ngenxa ye-polyuria, amangqamuzana omzimba ayaphela amanzi emzimbeni. Isikhungo sokoma ebuchosheni (i-Hypothalamus) siyavuselelwa, okubangela ukoma ngokweqile ukuze kulondolozwe ibhalansi yamanzi emzimbeni. Kungakhathaliseki ukuthi uphuza amanzi angakanani, lokhu koma akupheli kuze kube yilapho izinga likashukela egazini lakho lehla.
3. I-Polyphagia - Indlala eningi
Emzimbeni ophilile, i-hormone i-insulin ibalulekile ukuze i-glucose ingene emaselini futhi ikhiqize amandla. Kodwa-ke, ku-diabetes, ngenxa yokuntuleka kwe-insulin noma ukumelana ne-insulin, i-glucose ayikwazi ukungena emaselini. Ngenxa yalokho, noma ngabe kunoshukela omningi egazini, amaseli ahlala elambile. Ubuchopho buhlala buthola umyalezo othi "amandla anele", ngakho-ke isiguli siyalamba kakhulu. Njengoba amaseli engawatholi amandla, umzimba uqala ukuphula amafutha nemisipha, okuholela ekunciphiseni isisindo.
Ezinye izimo zempilo ezihlobene ne-3 Ps
| Isibonakaliso | Izimbangela ezingezona ezesifo sikashukela |
|---|---|
| I-Polyuria | Isifo sikashukela i-insipidus (esinye inkinga yamahomoni lapho izinso zingakwazi ukulawula amanzi), ukusetshenziswa kwemithi yokukhipha isisu, ukusetshenziswa kwe-caffeine ngokweqile noma ukuphuza utshwala. |
| I-Polydipsia | I-Psychogenic polydipsia, ebangelwa ukucindezeleka, yisimo lapho amazinga e-calcium emzimbeni ephezulu khona. |
| I-Polphagia | I-Hyperthyroidism, ukucindezeleka, kanye nemithi ethile yama-steroid. |
Okumele Ukwenze Nokungafanele Ukwenze
| ✔️ Izinto okufanele uzenze (Okufanele Uzenze) | ❌ Okungafanele ukwenze |
|---|---|
| Uma lezi zimpawu ezintathu zikhona, thola ukuhlolwa kwegazi kwe-Fasting Blood Sugar (FBS) kanye ne-HbA1c ngokushesha. | Ungalokothi uphuze amajusi ezithelo anoshukela, iziphuzo ezibandayo, noma iziphuzo ezinoshukela ukuze uqede ukoma kwakho. Lokhu kungandisa amazinga kashukela egazini lakho futhi kubulale. |
| Phuza amanzi ahlanzekile kuphela noma nini lapho uzizwa womile. | Ungaqali ukuthatha amaphilisi esifo sikashukela (isib. i-metformin) wedwa ngaphandle kweseluleko sikadokotela. |
| Faka imifino eluhlaza ecebile nge-fiber kanye nokudla okusanhlamvu okusanhlamvu ekudleni kwakho kwansuku zonke. | Gwema ukwethuka nokuyeka ngokuphelele ukudla ngokushesha nje lapho kuvela izimpawu. Lokhu kungabangela ukuthi amazinga kashukela egazini ehle ngendlela eyingozi (hypoglycemia). |
❓ Eminye imibuzo ongase ube nayo (Imibuzo Ebuzwa Njalo)
Lezi zimpawu zihluke kanjani phakathi kwesifo sikashukela sohlobo 1 nohlobo 2 ?
Kusifo sikashukela sohlobo 1, umzimba uyeka ukukhiqiza i-insulin ngokuphelele, ngakho-ke izimpawu ze-3 Ps zingaba zimbi kakhulu phakathi namasonto ambalwa. Kodwa-ke, njengoba isifo sikashukela sohlobo 2 sikhula kancane eminyakeni eminingi, lezi zimpawu zingase zingabi sobala ezigabeni zokuqala.
Ingabe lezi zimpawu zenzeka ngesikhathi sesigaba sangaphambi kwesifo sikashukela ?
Cha, ngokuvamile, azikho izimpawu ngesikhathi sesigaba sangaphambi kwesifo sikashukela, njengoba amazinga kashukela egazini engakhuphuki aze afike ezingeni lapho kuvela khona izimpawu ze-3 Ps (ngaphezu koMgqa Wezinso). Kungatholakala kuphela ngokuhlolwa kwegazi.
Ingabe izimpawu ze-3 Ps ziyaphela uma isifo sikashukela sesilawulwa? ▼
Yebo, uma amazinga kashukela egazini egcinwa ngaphakathi kwesilinganiso esijwayelekile (ngaphansi kuka-140 mg/dL) ngokwelashwa kanye nokushintsha indlela yokuphila, izinso ziyayeka ukukhipha ushukela futhi inqubo ye-osmotic diuresis iyaphela. Ukoma, ukuchama njalo, kanye nendlala enkulu kuyaphela ngokuphelele.
Ingabe lezi zimpawu zingaba khona kumuntu onesifo sikashukela sokukhulelwa ?
Yebo, isifo sikashukela singakhula ngenxa yezinguquko zamahomoni ngesikhathi sokukhulelwa (isifo sikashukela sokukhulelwa), esingabangela nokuchama njalo kanye nokoma ngokweqile. Umama okhulelwe kufanele nakanjani enze ukuhlolwa kwe-OGTT phakathi kwamasonto angama-24-28.
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