Ingabe siyazi kahle i-Coma ehlobene nesifo sikashukela?

Ungase ukhumbule umuntu onesifo sikashukela, mhlawumbe ilungu lomndeni noma umngane. Ngezinye izikhathi siye sezwa ngabantu abanjalo ngokuzumayo belahlekelwa ingqondo, bengakwazi ukukhuluma, futhi ngezinye izikhathi bewa phansi. Empeleni lesi yisimo esiyingozi kakhulu nesisongela ukuphila. Yingakho, namuhla sicabange ukukhuluma ngalesi simo esingabangelwa isifo sikashukela, noma njengoba odokotela besibiza kanjalo, `(Isifo Sikashukela Esihlobene Ne-Coma)`. Ukwazi lokhu kahle kuzosisiza sinakekele abathandekayo bethu.

Kuyini i-Coma ehlobene nesifo sikashukela? Kalula nje...

Kalula nje, i-diabetic coma yisimo esibi kakhulu, esisongela impilo esenzeka lapho amazinga ethu kashukela egazini eba phezulu kakhulu ngokuzumayo (i-hyperglycemia) noma ephansi kakhulu (i-hypoglycemia). I-"coma" yisimo sokungazi lutho ngokuphelele, njengokulala ubuthongo obujulile, futhi ungakwazi ukuvuswa yinkulumo. Kodwa-ke, basaphila naphezu kokulahlekelwa kwabo ulwazi. Lesi yisimo esidinga usizo oluphuthumayo lwezokwelapha.

Kunezizathu ezintathu eziyinhloko zalesi simo esiyingozi.

Kunezindlela ezintathu eziyinhloko umuntu onesifo sikashukela angawela ngazo e-coma. Ake sibheke ukuthi ziyini:

1. Isimo Sokwanda Kweglucose Ephezulu (i-HHS)

2. I-Ketoacidosis Ehlobene Nesifo Sikashukela (i-DKA)

3. I-hypoglycemia enkulu

Manje ake sixoxe ngemininingwane eminingi ngalezi zinto, kulungile?

1. Kuyini i-Hyperosmolar Hyperglycemic State (HHS)?

Lesi simo, esibizwa ngokuthi i-HHS, sivame kakhulu kubantu abanesifo sikashukela sohlobo 2. Sivela lapho amazinga kashukela egazini lakho (i-glucose) ephezulu kakhulu (ngokuvamile engaphezu kuka-600 mg/dL) isikhathi eside. Lokhu kungabangela ukuthi umzimba wakho ulahlekelwe amanzi amaningi, okuholela ekuphelelweni amanzi emzimbeni okukhulu, ukudideka, nezinye izimpawu. Uma kungelashwa ngokushesha, kungaholela ekuqulekeni.

2. Iyini i-Ketoacidosis Ehlobene Nesifo Sikashukela (i-DKA)?

Isimo esibizwa ngokuthi "i-DKA" naso sisongela impilo. Sivame ukuthinta abantu abanesifo "se-Type 1 Diabetes" (singathinta abantu asebenaso kakade, kanye nalabo abangazi ukuthi banaso). Kodwa-ke, ngezinye izikhathi singakhula nakubantu abanesifo se-Type 2 Diabetes.

I-DKA yenzeka lapho umzimba wakho ungenayo i-insulin eyanele (kungaba yemvelo noma ethathwe ngaphandle). Njengoba wazi, i-insulin ibalulekile ukuze ushukela osegazini lethu, i-glucose, ungene emaseli ethu futhi usetshenziselwe amandla. Ngakho-ke uma i-insulin ingekho noma inganele, umzimba uqala ukuphula amafutha ukuze uthole amandla. Lapho amafutha ephulwa, amakhemikhali abizwa ngokuthi ama-ketone akhishwa egazini.

Uma inani `(ama-ketone)` emzimbeni womuntu onesifo sikashukela landa, igazi kancane kancane liba `(i-acid).` Uma lokhu kungelashwa ngesikhathi, kungenzeka i-coma. Izinga likashukela egazini lomuntu one-`(DKA)` livame ukuba ngaphezu kuka-250 mg/dL. Kodwa khumbula, imbangela eyinhloko ye-`(DKA)` ukuntuleka kwe-`(insulin)` kanye nokwanda kwe-`(ma-ketone)`, hhayi ushukela wegazi kuphela. Abanye abanesifo sikashukela bangadlula ku-`(DKA)` noma ushukela wabo ungaphezu kuka-250 mg/dL.

3. Kuyini ukwehla okukhulu kwe-hypoglycemia?

Lesi yisizathu sesithathu. Uma izinga likashukela egazini lehla ngaphansi kuka-40 mg/dL, kubhekwa njengesimo esibi kakhulu "se-hypoglycemia". Lokhu futhi kuyingozi kakhulu empilweni.

Uyazi, umthombo oyinhloko wamandla emzimbeni wethu ikakhulukazi ubuchopho yi-`(glucose)`. Ngakho-ke lapho izinga likashukela egazini lehla, umzimba awukwazi ukusebenza kahle. Uma izinga likashukela lehla ngaphansi kuka-40 mg/dL, njengoba kushiwo, ungase ubhekane nezinguquko emzimbeni wakho nasengqondweni, okukwenza ungakwazi ukwenza lutho. Uma lesi simo esibi kakhulu (hypoglycemia)` singelashwa isikhathi eside, ungase ube yi-coma.

Lesi simo esibi se-hypoglycemia sivame kakhulu kubantu abathatha i-insulin yesifo sikashukela noma izinhlobo ezithile zamaphilisi esifo sikashukela njenge-sulfonylureas.

Ziyini izimpawu ze-diabetic coma? Sizibona kanjani?

Kunezimpawu ezintathu eziyinhloko ze-coma:

• Ukungazi: Kufana nokuba sebuthongweni obukhulu kakhulu. Kungakhathaliseki ukuthi ukhuluma kangakanani, kunzima kakhulu, cishe akunakwenzeka, ukukuvusa.
• Ukuntuleka kokuphendula kwamehlo: Amehlo ahlala evaliwe. Akukho mpendulo uma othile evula amehlo akhe. Kodwa-ke, ngezinye izikhathi kungase kube nokusabela okuthile emehlweni ezintweni ezifana nokukhanya.
• Ukuntuleka kokusabela kwemisipha: Akukho ukunyakaza okuqaphile. Kodwa-ke, kungase kube khona ukunyakaza okuthile kwe-reflex.

Manje ake sibone ukuthi yiziphi izimpawu ezibonakala ngaphambi kokuba ube yi-coma ezimweni ezishiwo ngenhla ze-`(DKA)`, `(HHS)` kanye ne-`(hypoglycemia)` embi kakhulu. Uma uzibona kusenesikhathi, ungagwema ingozi enkulu.

Izimpawu ezandulela i-coma ku-DKA:

• Isicanucanu nokuhlanza.
• Isisu esibuhlungu.
• Ukuphefumula okusheshayo nokujulile (odokotela bakubiza ngokuthi "ukuphefumula kwe-Kussmaul"). Kungaba ngesigqi esisodwa.
• Iphunga elifana nezithelo emoyeni.
• Ukuzizwa ukhathele kakhulu futhi ubuthakathaka.
• Ukuzizwa udidekile noma udidekile.
• Ukuqapha okunciphile.

Izimpawu ezandulela i-coma esimweni se-`(HHS)`:

• Izinguquko zengqondo: ukudideka, ukuphambana kwengqondo, ukubona izinto ezingekho.
• Kufana nokuthi usuzolahlekelwa ingqondo.
• Umlomo owomile kanye nokoma ngokweqile (i-polydipsia).
• Ukuchama njalo.
• Ukubona okufiphele noma ukulahlekelwa umbono.
• Ukuba ndikindiki, ngezinye izikhathi kakhulu ohlangothini olulodwa lomzimba.

Izimpawu ezingaphambi kwe-coma ku-hypoglycemia enzima zifaka:

• Umbono ofiphele noma umbono ophindwe kabili.
• Ukuxuba amagama lapho ukhuluma.
• Ukulahlekelwa ibhalansi nokuba nobunzima bokwenza izinto.
• Ukudideka.
• Ukuquleka kufana nokukhubazeka.

Uma ubona noma yiziphi zalezi zimpawu, ungazinaki. Kungcono ukufuna iseluleko sezokwelapha ngokushesha.

Senzani uma umuntu elahlekelwa ukuqonda ngenxa yesifo sikashukela? (Usizo lokuqala)

Cabanga ngomuntu endaweni yakini olahlekelwa ingqondo ngokuzumayo ngenxa yesifo sikashukela. Kunezinto ezimbalwa ongazenza:

• Shayela u-1990 ngokushesha bese uthola i-ambulensi. Uma wazi ukuthi lo muntu unesifo sikashukela, tshela nomqhubi ka-1990 lokho.
• Ungaziniki lutho lokudla noma lokuphuza. Zingaminyaniswa.
• Mphendule ngokucophelela umuntu ngohlangothi ukuze amathe noma ukuhlanza kungavimbi indlela yokuphefumula.
• Kuze kufike i-ambulensi, landela imiyalelo enikezwe umqhubi we-1990.

Uma kwenziwa kahle, lokhu kungaba usizo olukhulu ekusindiseni impilo yalowo muntu.

Kungani isifo sikashukela sibangela ukulahlekelwa kangaka kwengqondo? (Izizathu zilula)

Njengoba sesixoxile ngaphambili, kunezimbangela ezintathu eziyinhloko ze-diabetic coma, akunjalo? Lezi yilezi:

• Isimo se-hyperosmolar hyperglycemic `(HHS)`.
• I-ketoacidosis yesifo sikashukela (i-DKA).
• I-hypoglycemia enkulu (ushukela wegazi ophansi kakhulu).

Kokubili i-HHS kanye ne-DKA yizimo lapho amazinga amanzi emzimbeni ehla khona kakhulu, okuholela ekuphelelweni kwamanzi emzimbeni okukhulu. Lokhu kuphelelwa amanzi emzimbeni kungaholela ekuqulekeni.

Ngakolunye uhlangothi, uma kwenzeka i-hypoglycemia enkulu, ubuchopho abutholi inani le-glucose eliyidingayo. Ushukela ubalulekile ukuze ubuchopho busebenze kahle. Uma usuphelile, ubuchopho "buyavala" bese ungaba yi-coma. Uyaqonda lokho?

Ubani osengozini enkulu yokuba nesifo sikashukela?

Noma ubani onesifo sikashukela (ngisho nalabo abanesifo sikashukela esingakatholakali) usengozini yokuba nesifo sikashukela. Kodwa-ke, le ngozi iyahlukahluka kancane kuye ngohlobo lwesifo sikashukela:

• Abantu abanesifo sikashukela sohlobo 1 basengozini enkulu yokuba sekhomeni, kungaba ngenxa ye-DKA noma i-hypoglycemia enzima. Lokhu kungenxa yokuthi abantu abanesifo sikashukela sohlobo 1 badinga i-insulin ngaso sonke isikhathi futhi amazinga abo kashukela egazini ayashintshashintsha kakhulu kunabantu abanesifo sikashukela sohlobo 2.
• Abantu abanesifo sikashukela sohlobo lwesibili banamathuba amaningi okuba ne-coma ngenxa ye-HHS kune-DKA noma i-hypoglycemia enzima.

Yiziphi ezinye izinto eziyingozi?

Ngaphezu kwalezi zinto, ezinye izinto zingandisa ingozi yokuba nesifo sikashukela:

• Ukuthuthukisa ezinye izifo.
• Ukuhlinzwa.
• Ukulimala ngokomzimba (Ukuhlukumezeka).
• Izinkinga ngohlelo lokulethwa kwe-insulin (isb., ipeni le-insulin, ukungasebenzi kahle kwephampu).
• Ukukhohlwa, ukweqa, noma ukuthatha i-insulin eningi kakhulu.
• Ukungalaphi kahle isifo sikashukela (isib. ukungahloli amazinga kashukela egazini nsuku zonke, ukungaphuzi imithi ngendlela efanele).
• `(Ukungazi kwe-Hypoglycemia)` (okungukuthi, ukungazi izimpawu zokuqala zoshukela wegazi ophansi).
• Ukuphuza utshwala.
• Ukusetshenziswa kwezidakamizwa.

Odokotela bakuthola kanjani ngokunembile ukuthi umuntu unesifo sikashukela?

I-coma yesifo sikashukela iyisimo esiphuthumayo sezokwelapha esidinga ukwelashwa ngokushesha. Noma ubani okwi-coma udinga ukulaliswa esibhedlela.

Odokotela bavame ukuxilonga ngokushesha i-diabetic coma ngokuthatha umlando wakho wezokwelapha, ukuhlola amazinga kashukela egazini lakho (ukuhlolwa kwe-glucose egazini), nokwenza ezinye izivivinyo ukuhlola ama-ketone kanye nempilo yakho iyonke.

Yingakho kubalulekile ukuthi abantu abanesifo sikashukela bagqoke isongo noma umgexo wezokwelapha. Uma kwenzeka isimo esiphuthumayo, odokotela bangasibona futhi benze izinqumo ngokushesha. Kubalulekile futhi ukwazisa umndeni wakho, abangani, kanye nosebenza nabo ukuthi unesifo sikashukela. Ngaleyo ndlela, bazi ukuthi benzeni esimweni esiphuthumayo.

Umelapha kanjani i-coma yesifo sikashukela?

Ukwelashwa kwe-diabetic coma kuyahlukahluka kuye ngembangela , kodwa ukulaliswa esibhedlela kuyadingeka njalo.

Ukwelashwa kwe-coma ebangelwa yi-`(DKA)` noma `(HHS):

• Uketshezi lwe-IV: Lokhu kunikezwa ukulungisa ukuntuleka kwamanzi emzimbeni kanye nokungalingani kwama-electrolyte.
• I-insulini: Ithimba lezokwelapha lingakunikeza i-insulini nge-IV noma njengomjovo ongaphansi kwesikhumba.
• Ezinye izindlela zokwelapha: Ezinye izindlela zokwelapha zinganikezwa ukuze zikusize ululame. Lokhu kungafaka phakathi ukwelapha noma yiziphi izimo zezokwelapha eziyisisekelo noma izifo ezingase zibangele amazinga akho aphezulu kashukela egazini.

Ukwelashwa kwe-coma ebangelwa yi-hypoglycemia enzima:

• I-glucagon ephuthumayo:Lolu uhlobo lokwenziwa lwe-hormone i-glucagon. Lunganikezwa ngumuntu omthandayo noma udokotela njengomjovo noma njengesifutho samakhala (kuye ngohlobo). I-glucagon yokwenziwa isebenza ngokukhipha ushukela ogcinwe esibindini, okwandisa amazinga kashukela egazini.

Okubaluleke kakhulu: Ngisho noma umuntu oseduze nawe ekunika i-`(glucagon)`, ngokuqinisekile uyakudinga ukwelashwa esibhedlela. Kufanele bakunike i-`(glucagon)` bese beshayela u-1990 ngokushesha.

Uma kuvela ezinye izinkinga, njengokwehluleka kwezitho zomzimba, zingadinga nokwelashwa okwengeziwe.

Yini esingayenza ukuze sivimbele i-diabetic coma?

Ukuze uvimbele i-diabetic coma, kubalulekile ukuqaphela izimpawu zokuqala ze-hypoglycemia (DKA), i-hypoglycemia (HHS), kanye ne-hypoglycemia. Zifundise futhi ukhulume nodokotela wakho ngezinyathelo ongazithatha ukwelapha lezi zimo ngaphambi kokuba zibe zimbi kakhulu.

Bheka udokotela ngokushesha uma:

• Uma izinga likashukela egazini lakho lingu-300 mg/dL noma ngaphezulu izikhathi ezimbili zilandelana ngaphandle kwesizathu esibonakalayo.
• Uma kwenzeka ushukela wegazi ophansi (ngaphansi kuka-70 mg/dL) futhi ungabuyeli esimweni esijwayelekile ngemva kwemizamo emithathu yokwelashwa (isib. amaphilisi e-glucose, iziphuzo ezinoshukela), shayela udokotela wakho noma ku-911 ngokushesha.

Ingabe umuntu angasinda e-coma ngenxa yesifo sikashukela? Ingabe ikhona imiphumela yesikhathi eside?

Yebo, i-diabetic coma ingagwenywa uma imbangela eyinhloko yelashwa ngokushesha. Kodwa-ke, abanye abantu bangase balimale ubuchopho unomphela. Uma kungelashwa ngokushesha nangendlela efanele, ukufa kungavela.

Izinga lokufa kwe-DKA liphakathi kuka-0.2% no-2.5%. Labo abaya kwi-coma, abane-hypothermia, kanye nokukhishwa komchamo okunciphile (i-oliguria) banemiphumela emibi kakhulu.

Cishe abantu abangu-20% abane-HHS bayafa ngenxa yalesi simo. Labo abathola i-coma kanye/noma umfutho wegazi ophansi banesifo esibi.

Ungahlala isikhathi esingakanani ku-coma onesifo sikashukela?

Ubude besikhathi osichitha ku-diabetic coma buxhomeke kakhulu ekutheni uthola ukwelashwa okufanele ngokushesha kangakanani. Okuwukuphela kwendlela yokuqeda i-coma efana nale ukubuyisela amazinga akho kashukela egazini kanye ne-insulin emazingeni anempilo. Lokhu kungenziwa kuphela ngosizo lochwepheshe bezokwelapha. Umuntu okwi-diabetic coma ngeke aphinde aqonde yedwa.

Uma umuntu okwi-coma efana nalena engatholi ukwelashwa ngesikhathi, cishe uzofa. "Ngokuhamba kwesikhathi" kuyahlukahluka kuye ngesimo nomuntu nomuntu. Yingakho kubaluleke kakhulu ukuthola usizo ngokushesha okukhulu.

Ngamafuphi, nazi izinto okudingeka sizikhumbule (Umyalezo Wokuya Ekhaya):

Nakuba i-diabetic coma iyingozi kakhulu, ivame ukuvinjelwa.

• Into eyinhloko ukuthi,Qaphela izimpawu eziyisixwayiso ze-`(DKA)`, `(HHS)` kanye noshukela ophansi egazini bese uthatha isinyathelo ngokushesha uma uzibona.
• Uma unezimpawu zalesi simo, shayela udokotela wakho ngokushesha.
• Izinkinga zesifo sikashukela ziyesabeka ngempela, kodwa ukuqaphela nokuzilungiselela kuyindlela engcono kakhulu yokuzivimbela.
• Ungalokothi unqikaze ukubuza udokotela wakho noma yimiphi imibuzo onayo mayelana nokuphatha isifo sikashukela sakho noma lezi zinkinga. Impilo yakho ibalulekile kuwe.

Isifo Sikashukela, I-Coma, i-DKA, i-HHS, i-Hypoglycemia, Ushukela Egazini, i-Insulin, Usizo Lokuqala, Izinkinga Zesifo Sikashukela, Ukulahlekelwa Yinkumbulo