Ingabe nawe unoshukela ophezulu egazini ekuseni? Lokhu kungenzeka ukuthi kungenxa ye-'Dawn Phenomenon'!

Uma unesifo sikashukela, wake waphawula ukuthi amazinga kashukela egazini lakho akhuphuka ngokuzumayo uma uvuka ekuseni? Ungase uzibuze ukuthi kungani lokhu kwenzeka yize uphuza imithi yakho ebusuku futhi ulawula ukudla kwakho. Ungakhathazeki, esinye sezizathu zalokhu kungaba 'i-Dawn Phenomenon' esikhuluma ngayo namuhla. Ake sibone ukuthi iyini, kungani yenzeka, nokuthi ungayigwema kanjani.

Iyini i-Dawn Phenomenon, lokhu kwanda koshukela egazini ekuseni kakhulu?

Kalula nje, i-'Dawn Phenomenon' iwukwenyuka ngokwemvelo kwamazinga kashukela egazini ekuseni kakhulu ngenxa yamahomoni athile akhiqizwa yimizimba yethu. Lokhu kuthinta kuphela abantu abanesifo sikashukela. Lesi yisona sizathu esiyinhloko esenza ukuthi wena onesifo sikashukela ube noshukela ophezulu egazini (i-hyperglycemia) ekuseni.

Kodwa khumbula, lesi akusona ukuphela kwesizathu esenza amazinga kashukela egazini akhuphuke ekuseni. Kungaba nezinye izizathu eziningana:

• Imithi enganele: Ngezinye izikhathi inani lemithi ethathwa ebusuku lingase linganele ekuseni, futhi umphumela wayo ungase uphele.
• Ukungalingani kwemithi nokudla: Ukungabali inani elifanele nesikhathi sokuthatha imithi ngesikhathi sokudla kwakusihlwa.
• Umphumela we-Somogyi: Lokhu kuphambene kancane. Ngezinye izikhathi, inani le -insulin elikhishwa ebusuku liyakhuphuka, okubangela ukuba ushukela egazini wehle ngokuzumayo kakhulu. Umzimba ube usukhipha i-hormone ngenxa yalokho, okubangela ukuba ushukela egazini uphinde ukhuphuke. Lokhu kubizwa ngokuthi 'umphumela we-Somogyi'.

Kuvamile kangakanani lokhu?

I-Dawn Phenomenon empeleni iyisimo esivame kakhulu kubantu abanesifo sikashukela. Ucwaningo luthole ukuthi sithinta abantu abangaphezu kuka-50% abanesifo sikashukela sohlobo 1 noma sohlobo 2. Lokhu kusho ukuthi awuwedwa.

Ziyini izimpawu zalokhu?

Isibonakaliso esiyinhloko se-'Dawn Phenomenon' ukwanda kwamazinga kashukela egazini ekuseni kakhulu. Ungakubona lokhu uma uvuka ekuseni bese uhlola i-glucometer yakho, noma uma usebenzisa idivayisi ye-CGM (Continuous Glucose Monitoring) . Ngokuvamile, i-'Dawn Phenomenon' ibangela iphethini yamazinga kashukela aphezulu egazini ekuseni izinsuku eziningana zilandelana.

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

• Ukuzizwa womile kakhulu (i-polydipsia).
• Ukuzizwa ulambile kakhulu.
• Ukuchama njalo.
• Ikhanda elibuhlungu.
• Ukucasuka, intukuthelo.
• Umbono ofiphele.

Cabanga nje, kukhona umuntu ogama lakhe linguMalani, onesifo sikashukela. Uhlola ushukela wakhe wegazi njalo ekuseni. Izinsuku ezintathu noma ezine zilandelana, ushukela wakhe wegazi ekuseni ungaphezu kuka-200mg/dL. Uphinde alawule ukudla kwakhe ebusuku futhi aphuze imithi yakhe ngesikhathi. Uzizwa ekhungathekile kakhulu. Uzizwa ekhathele kancane lapho evuka ekuseni, futhi womile kakhulu. Ingabe kukhona into efana nale ekwehlele? Khona-ke kungenzeka ukuthi 'yi-Dawn Phenomenon'.

Kungani lokhu kwenzeka?

Lokhu kuyiqiniso elingokwesayensi kancane, kodwa ngizokubeka kalula. Ekuseni kakhulu – okungukuthi, phakathi kuka-3 no-8 ekuseni – imizimba yethu ikhipha uchungechunge lwama-hormone. Ayinhloko yi- cortisol kanye ne-growth hormone . La ma-hormone abonisa isibindi sethu ukuthi senze i-glucose eyengeziwe, okungushukela. Le glucose isiza ekusivuseni ekuseni futhi isinike amandla okuqala usuku. Lapho kukhiqizwa i-glucose eyengeziwe, amazinga ethu kashukela egazini ayakhuphuka.

Manje, uma ungenaso isifo sikashukela, i-pancreas yakho isabela kahle kulokhu futhi ikhiqiza i-insulin eyanele ukulawula ushukela wegazi lakho. Kodwa uma unesifo sikashukela, i-pancreas yakho ayikhiqizi nhlobo i-insulin, noma inani eliyenzayo alanele ukulawula ushukela wegazi ophezulu. Ngezinye izikhathi , ukumelana ne-insulin , okusho ukuthi amangqamuzana omzimba wakho awasabeli kahle ku-insulin, nakho kungaba yimbangela.

Uma sikhuluma iqiniso, lapho umzimba ulungiselela ukuvuka ekuseni, lolu 'hlelo lwe-alamu' lwemvelo emzimbeni lubangela ukuba ushukela wegazi ukhuphuke. Nakuba lokhu kulawulwa emzimbeni womuntu ongenaso isifo sikashukela, umzimba womuntu onesifo sikashukela awukwazi ukukwenza kahle.

Ukubona kanjani lokhu ngqo?

Indlela engcono kakhulu yokunquma ngokunembile ukuthi i-'Dawn Phenomenon' iyimbangela yoshukela ophezulu egazini ekuseni ukusebenzisa i-CGM (Continuous Glucose Monitoring) .

I-CGM iyithuluzi oligqokayo ukuze uqaphe amazinga kashukela egazini lakho amahora angama-24 ngosuku. Ukuze kube sobala, le divayisi ye-CGM ilinganisa amazinga kashukela egazini lakho njalo ngemizuzu embalwa bese isebenzisa leyo datha ukudala igrafu. Lokhu kukunikeza isithombe esiphelele sendlela amazinga kashukela egazini lakho ashintsha ngayo ngokuhamba kwesikhathi.

Inzuzo yokusebenzisa i-CGM, esikhundleni sokukhipha igazi emunweni wakho ngaphambi kokulala nangemva kokuvuka ekuseni bese uhlola ushukela wakho wegazi nge-glucometer, ukuthi ungakwazi ukubona kahle ukuthi ushukela wakho wegazi wehle ngokuzumayo (hypoglycemia) ebusuku. Uma kunjalo, kusho ukuthi awuzwani 'ne-Dawn Phenomenon', kodwa 'nomphumela we-Somogyi' okukhulunywe ngawo ngaphambili.

Ngisho noma ungayisebenzisi i-CGM, odokotela bangabheka iphethini yokufundwa kukashukela egazini lakho izinsuku eziningana bese besola 'i-Dawn Phenomenon.' Yingakho kubaluleke kakhulu ukugcina irekhodi lokufundwa kukashukela egazini lakho.

Iyini indlela yokwelapha lokhu?

Ukwelashwa okungcono kakhulu kwe-'Dawn Phenomenon' ukusebenzisa iphampu ye-insulin ukuletha i-insulin. Imithi yesifo sikashukela yomlomo ngokuvamile ayisizi kakhulu nge-'Dawn Phenomenon'. Futhi, imijovo ye-insulin esebenza isikhathi eside cishe ayinamphumela omkhulu kulokhu.

Udokotela wakho angakwazi ukulungisa amazinga akho e-insulin ayisisekelo bese evumela iphampu yakho ye-insulin ukuthi ilethe i-insulin eyengeziwe ngokuzenzakalelayo ekuseni. Lokhu kungasiza ekuvimbeleni amazinga kashukela egazini lakho ukuthi angakhuphuki ekuseni.

Kodwa-ke, uma ungasebenzisi iphampu ye-insulin, noma uma ungayithathi nhlobo i-insulin, wena nodokotela wakho kungadingeka nenze imizamo namaphutha ukuze nithole imithi engcono kakhulu kanye nezinguquko zendlela yokuphila ukuze nilawule ukunyuka kukashukela egazini ekuseni ngenxa 'yento yokusa.' Isibonelo, udokotela wakho angakweluleka ukuthi wandise ukuzivocavoca kwakho kusihlwa futhi wandise inani lamaprotheni esidlweni sakho sakusihlwa uma kuqhathaniswa nenani lama-carbohydrate.

Lokhu akunakuvinjelwa?

Njengoba 'i-Dawn Phenomenon' ingumphumela wenqubo yemvelo eyenzeka emzimbeni, akukho lutho ongakwenza ukuyivimbela ngokuphelele.

Kodwa-ke, uma usebenzisa iphampu ye-insulin, ungalungisa amazinga akho e-insulin ayisisekelo ngokwemiyalelo kadokotela wakho futhi ulawule ukunyuka kukashukela egazini ekuseni ngenxa 'yento eyenzeka ekuseni' ngezinga elithile.

Yimiphi imiphumela engemihle engaba khona ngenxa yalokhu?

Umphumela oyinhloko woshukela wegazi ophezulu ekuseni ongalashwanga ngenxa 'yento eyenzeka ekuseni' ukwanda kwe-A1C yakho. Ukuhlolwa kwe-A1C kukhombisa amazinga akho ajwayelekile kashukela egazini (ushukela) ezinyangeni ezintathu ezedlule.

Uma izinga lakho le-A1C liphezulu, kulapho ingozi yakho yokuthola izinkinga ezihlobene nesifo sikashukela iphakama khona. Le ngozi iphakeme kakhulu uma izinga lakho le-A1C lihlala liphezulu iminyaka eminingi. Izinkinga zesifo sikashukela zingafaka:

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

Ucwaningo lukhombisile ukuthi uma abantu abanesifo sikashukela bengagcina amazinga abo e-A1C ngaphansi kuka-7% , banganciphisa ingozi yabo yezinkinga ezihlobene nesifo sikashukela.

'I-Dawn Phenomenon' ivame ukuba yinkinga eqhubekayo, okusho ukuthi uma ingelashwa, amazinga kashukela egazini angahlala ephezulu amahora amaningana nsuku zonke. Lokhu kwandisa ingozi yokuthola izinkinga zesifo sikashukela ngokuhamba kwesikhathi.

Kufanele ngimbone nini udokotela?

Uma uhlala unamazinga aphezulu kashukela egazini ekuseni, kubalulekile ukukhuluma nodokotela wakho okusiza ukuphatha isifo sakho sikashukela. Angahlola amazinga kashukela egazini lakho, anqume ukuthi lokhu kungenxa ye-Dawn Phenomenon, futhi ancome izindlela ezifanele zokwelapha.

Ukubhekana 'nesenzakalo sokusa', ukwanda kwamazinga kashukela egazini ekuseni, kungaba yinto ekhungathekisayo futhi ecasulayo ngempela. Kodwa khumbula, akulona iphutha lakho. Ayikho indlela eyodwa efanelana nakho konke yokuphatha ukwanda kwakho kwashukela ekuseni. Ngakho-ke kungathatha isikhathi ukuthola ukwelashwa okufanele. Udokotela wakho angakusiza ukuthi uthole uhlelo olungcono kakhulu. Ngakho-ke ungangabazi ukucela usizo. Ukuthatha isinyathelo manje kungakusiza ugweme imiphumela emibi yesikhathi eside.

Into ebaluleke kakhulu okufanele uyikhumbule

Kulungile, ngakho-ke ngithemba ukuthi usuyaqonda kangcono 'i-Dawn Phenomenon' esikhulume ngayo. Khumbula, uma unesifo sikashukela, qaphela ukwanda koshukela egazini ekuseni.

Akulona iphutha lakho leli, futhi kunezixazululo zalokhu.

• Khuluma nodokotela wakho ngalokhu ngokukhululekile.
• Gcina amarekhodi anembile amazinga kashukela egazini lakho, ukudla, kanye nemithi.
• Uma ungasebenzisa i-CGM, idatha enikezayo ibaluleke kakhulu.
• Khuluma nodokotela wakho ngephampu ye-insulin, kungaba yisisombululo esihle salokhu.
• Ungesabi noma uphelelwe yithemba, sebenzisana nodokotela wakho ukuze uthole ikhambi elifanele wena.

Khumbula, ungaphila impilo enempilo nejabulisayo unesifo sikashukela. Kudinga nje ukuqaphela, ukunakekela, nokulandela iseluleko sikadokotela wakho. Ube nosuku oluhle!

Isenzakalo Esimangalisayo Sokufiphala, isifo sikashukela, ukwanda koshukela egazini ekuseni, i-hyperglycemia, umphumela we-Somogyi, iphampu ye-insulin, i-A1C