Njengomuntu onesifo sikashukela, cishe uhlola izinga likashukela egazini lakho ngokushesha nje lapho uvuka ekuseni. Uma ucabanga ngakho, noma ngabe ulawule ukudla kwakho futhi waphuza imithi yakho ebusuku, kumele futhi uzizwe ukhathazekile uma ubona ukuthi izinga likashukela lakho liphezulu ekuseni, akunjalo? "Ngenze konke kahle, kungani ushukela wami ukhuphuka ekuseni kuphela?" Ungase ucabange futhi. Kunezizathu ezimbili eziyinhloko zalokhu. Esinye yi-Dawn Phenomenon, kanti esinye yi-Somogyi Effect. Nakuba la magama amabili engavamile kancane, ungesabi. Ake sixoxe ngalokhu kalula.
Ubudlelwano Phakathi Kwe-Insulin, Ushukela Egazini, Nokulala
Okokuqala, ake sibazi abalingiswa abaphambili kule ndaba. Umthombo oyinhloko wamandla emzimbeni wethu uhlobo lukashukela olubizwa ngokuthi i-glucose. Kufana nophethiloli wemoto. I-hormone esiza ekuthatheni le glucose egazini lethu iye emaselini ethu futhi yenze amandla yi-insulin. Kalula nje, i-insulin ifana nesihluthulelo esivula iminyango yamaseli ethu futhi sivumele i-glucose ingene.
Uma silele, imizimba yethu ayidingi amandla amaningi. Kufana nemoto esanda kuqaliswa. Kodwa-ke, uma sekuyisikhathi sokuvuka ekuseni, umzimba wethu ulungiselela umsebenzi wosuku. Ngemuva kwalokho umzimba uthumela isignali esibindini sethu, uthi, "Kulungile, manje sekuyisikhathi sokuqala ukusebenza, khipha ushukela owengeziwe egazini." Ngale ndlela, lapho ushukela uqongelela egazini ekuseni, umzimba womuntu ophilile ukhiqiza i-insulin eningi ukulawula amazinga kashukela.
Kodwa-ke, emzimbeni womuntu onesifo sikashukela, le nqubo ayenzeki kahle. Njengoba inani elidingekayo le-insulin lingakhiqizwa, izinga likashukela egazini liyakhuphuka ekuseni. Lokhu sikubiza ngokuthi i-hyperglycemia. Uma lokhu kuqhubeka, kungaba yingozi empilweni.
Iyini le Nguquko Yokuntwela Kokusa?
Kalula nje, i-Dawn Phenomenon inqubo yemvelo yamahomoni ebangela ukuba amazinga kashukela egazini akhuphuke ekuseni kakhulu, ngokuvamile phakathi kuka-3 ekuseni no-8 ekuseni. Lokhu kuhlukile kuwo wonke umuntu. Kodwa uma unesifo sikashukela, umzimba wakho awunayo i-insulin eyanele yokulawula ushukela okhuphukayo, ngakho-ke uvuka unamazinga kashukela aphezulu egazini. Lokhu kuvamile cishe kubantu abanesifo sikashukela sohlobo 1 nohlobo 2.
Lokhu akusona isifo, kodwa kumane kuyimpendulo yenqubo yemvelo emzimbeni ebangelwa isifo sikashukela. Ngakho ungakhathazeki ngakho.
Kodwa ungakhuluma nodokotela wakho futhi wenze izinto ezithile ukulawula lokhu.
- Gwema ukudla ukudla okunama-carbohydrate amaningi ngaphambi kokulala.
- Ukushintsha umthamo nesikhathi sosuku uthatha umuthi wakho we-insulin noma wesifo sikashukela (isibonelo, ukuwuthatha ngaphambi kokulala esikhundleni sokuwuthatha kusihlwa).Ungalokothi wenze lezi zinguquko wedwa. Xhumana nodokotela wakho njalo.
- Uma usebenzisa iphampu ye-insulin, shintsha izilungiselelo zayo.
Ngakho-ke, iyini i-Somogyi Effect?
Umphumela we-Somogyi uyinto efanayo eyenzeka lapho amazinga kashukela egazini lakho ekhuphuka ekuseni. Kodwa imbangela ihluke ngokuphelele. Kwenzeka ngoba uthatha i-insulin eningi kakhulu ebusuku, uthatha kancane kakhulu, noma weqa ukudla ebusuku .
Cabanga ngalokhu. Uthathe i-insulini eningi kakhulu ebusuku. Bese kuthi phakathi nobusuku, izinga likashukela egazini lakho lehle kakhulu. Lokhu sikubiza ngokuthi i-hypoglycemia. Umzimba usabela kulokhu kwehla ngokwesaba. Uma ucabanga ukuthi, "O, ushukela wami uyehla, ngidinga ukukhulisa izinga likashukela wami ngokushesha," umzimba ukhipha ama-hormone amaningi asebenza ngokumelene ne-insulini (isb., i-cortisol, i-hormone yokukhula). Ngenxa yalokho, izinga likashukela eliphansi liyenyuka ngokuzumayo. Okusho ukuthi, izinga likashukela liyehla kakhulu, bese liphinde lenyuke kakhulu. Lokhu kubizwa ngokuthi 'i-Rebound Hyperglycemia'. Lesi simo sivame kakhulu kubantu abanesifo sikashukela sohlobo 1.
Kodwa ucwaningo olusha, ikakhulukazi izifundo ezisebenzisa ama-Continuous Glucose Monitors (CGMs) , luthole ukuthi i-Somogyi Effect ayivamile njengoba kwakucatshangwa ngaphambili. Abanye ochwepheshe manje bakholelwa ukuthi i-Dawn Phenomenon, noma ukungazinzi komthamo we-insulin, kungaba yimbangela yokwanda okuningi kwasekuseni kune-Somogyi Effect.
Wazi kanjani umehluko phakathi kwalezi ezimbili?
Zombili lezi zimo zibangela ushukela ophezulu egazini ekuseni, kodwa izindlela zokwelapha zihlukile ngoba izimbangela zihlukile. Ngakho udokotela wakho kuzodingeka anqume ukuthi iyiphi kulezi ezimbili onazo. Ukuze akusize ngalokho, udokotela wakho angakucela ukuthi uhlole amazinga kashukela egazini lakho phakathi nobusuku (cishe ngo-2-3 ekuseni) izinsuku ezimbalwa. Uma usebenzisa i-CGM, izoyithola ngokuzenzakalelayo le datha.
Ithebula elingezansi lichaza kabanzi umehluko omkhulu phakathi kwalokhu okubili.
| Isici | Isenzakalo Sokusa | Umphumela we-Somogyi |
|---|---|---|
| Isizathu esiyinhloko | Inqubo yemvelo yama-hormone emzimbeni. | Amazinga kashukela ehla phakathi nobusuku, kulandele ukubuya kwamazinga kashukela. |
| Amazinga kashukela egazini phakathi nobusuku (2-3 ekuseni) | Okuvamile noma okuphezulu. | Ushukela wegazi ophansi. |
| Indlela yokwelapha | Ukungaphuzi ama-carbohydrate ngaphambi kokulala, ukushintsha imithi/isikhathi se-insulin noma umthamo. | Ukunciphisa umthamo we-insulin, ukudla okulula ngaphambi kokulala. |
Ziyini izimpawu zalezi zimo zombili?
Uphawu oluyinhloko amazinga kashukela egazini aphezulu uma uvuka ekuseni. Ngaphezu kwalokho, kuye ngokuthi amazinga kashukela egazini lakho aphezulu kangakanani, ungase ube nezimpawu ezifana nalezi:
- Ukuzizwa womile kakhulu kunokujwayelekile
- Ukuzizwa ulambile kakhulu kunokujwayelekile
- Isidingo sokuphuza njalo
- Ikhanda elibuhlungu
- Ukuzizwa ungakhululekile futhi uthukuthele
Kungakhathaliseki ukuthi yiziphi lezi zimpawu, kungcono ukugcina irekhodi lamazinga kashukela wakho bese ubona udokotela wakho.
Umlayezo Wokuya Nawe Ekhaya
- Isizathu sokwenyuka kwamazinga kashukela ekuseni kungaba yi-Dawn Phenomenon, inqubo yemvelo emzimbeni, noma i-Somogyi Effect, ebangelwa ukwehla kwamazinga kashukela phakathi nobusuku.
- Indlela engcono kakhulu yokwazi kahle ukuthi iyiphi kulezi ezimbili onayo ukuhlola amazinga kashukela egazini lakho phakathi nobusuku (2-3 ekuseni) izinsuku ezimbalwa, njengoba kuceliwe udokotela wakho.
- Ungalokothi ushintshe imithamo yakho ye-insulin noma yesifo sikashukela ngokwakho ngaphandle kwemvume kadokotela wakho. Ukwenza kanjalo kungaba yingozi.
- Uma amazinga kashukela wakho ekuseni ehlala ephezulu, khuluma nodokotela wakho ngakho. Uzokunikeza ikhambi elifanele kakhulu.
- Ukubhala phansi amazinga kashukela egazini lakho, ukudla okudlayo, kanye nemithi kuzosiza udokotela wakho ukuthi enze izinqumo ezifanele.
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