Isimo esiphuthumayo esiyingozi kakhulu kusifo sikashukela! Masiqaphele i-DKA (Diabetic Ketoacidosis)

Ingabe unesifo sikashukela? Noma ingabe ilungu lomndeni noma umngane wakho unesifo sikashukela? Khona-ke ngokuqinisekile udinga ukwazi ngalokho esikhuluma ngakho namuhla. Lokhu kubizwa ngokuthi i-DKA (Diabetic Ketoacidosis). Lesi yisimo esiphuthumayo esiyingozi kakhulu, esisongela ngisho nokuphila esingase senzeke ngenxa yesifo sikashukela. Kodwa ungakhathazeki, uma sazi kahle ngalokhu, singazivikela kukho futhi sithathe isinyathelo ngokushesha uma kwenzeka ngokuzumayo.

Kalula nje, iyini i-DKA?

Cabanga ngamaseli emzimbeni wethu njengezindlu ezincane. Lezi zindlu zidinga amandla ukuze zisebenze. Lawo mandla avela ku-glucose, noma ushukela, ovela ekudleni esikudlayo. Kodwa ukuze lo shukela ungene ezindlini ezibizwa ngamaseli, udinga isihluthulelo sokuvula umnyango. Leso sihluthulelo yi-hormone insulin .

Manje, okwenzekayo emzimbeni womuntu onesifo sikashukela ukuthi akwanele lesi sihluthulelo esibizwa ngokuthi i-insulin. Kwenzekani-ke? Ushukela awukwazi ukungena emaselini futhi ugcwele igazi. Kodwa amaseli awanawo amandla, "ayalamba".

Uma lokhu kwenzeka, imizimba yethu icabanga ukuthi empeleni siyalamba ngaphandle kokudla. Ngakho umzimba uqala ukufuna amandla ngenye indlela. Okungukuthi, ngokushisa amafutha agcinwe emzimbeni ukuze akhiqize amandla. Uma amafutha eshiswa ngale ndlela, kukhiqizwa ikhemikhali ebizwa ngokuthi ama-ketone njengomkhiqizo olandelanayo.

Ukuba nama-ketone ambalwa egazini akuyona inkinga. Kodwa uma amafutha eshiswa njalo ngaphandle kwe-insulin, lawa ma-ketone aqoqana egazini ngokweqile. Lawa ma-ketone awuhlobo lwe-asidi. Ngakho-ke uma ekhula egazini, igazi lethu kancane kancane liba ne-asidi eyengeziwe. Kufana nokufaka uviniga engilazini yamanzi. Leyo acidosis yegazi kanye nokuphelelwa amanzi emzimbeni okuhambisana nayo yilokho esikubiza ngokuthi i-DKA (Diabetic Ketoacidosis).

Ubani osengozini enkulu yokuthola i-DKA?

Nakuba i-DKA ingenzeka kunoma yimuphi umuntu onesifo sikashukela, abanye abantu basengozini enkulu.

• Abantu abanesifo sikashukela sohlobo 1: Laba bantu banamathuba amaningi okuthuthukisa i-DKA ngoba umzimba wabo cishe awusakhiqizi i-insulin ngokuphelele.
• Kulabo abangazi ukuthi banesifo sikashukela: Ngokumangalisayo, abanye abantu bathola ukuthi banesifo sikashukela sohlobo 1 kuphela ngemva kokuba bethole i-DKA bese belaliswa esibhedlela. Lokhu kubalwa phakathi kuka-20% no-40% weziguli ze-DKA.
• Kubantu abanesifo sikashukela sohlobo 2:Nakuba kungavamile kangako, abanye abantu abanesifo sikashukela sohlobo lwesibili bangaba ne-DKA, ikakhulukazi ezimweni ezifana nokutheleleka okukhulu.

Yiziphi izimpawu zalesi simo esiyingozi? Sizibona kanjani?

I-DKA ayiveli ngokuzumayo. Ingaqala ngezimpawu ezincane bese iba nzima zingakapheli amahora angama-24. Uma uhlanza, lesi sikhathi singase sibe sifushane nakakhulu. Ngakho-ke kubalulekile ukuqaphela lezi zimpawu.

Uma unezinye zalezi zimpawu ezinkulu, shayela udokotela wakho ngokushesha. Noma, uma kungenzeka, iya eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze ngokushesha okukhulu.

Kungani lesi simo se-DKA senzeka? Yiziphi izimbangela eziyinhloko?

Imbangela eyinhloko ye-DKA ukungatholi i-insulin eyanele emzimbeni. Lezi zinto zingaba nomthelela kulokhu:

• Ukungajovi i-insulin: Uma umuntu othatha i-insulin yesifo sikashukela engayijovi eyodwa noma ezimbili, i-DKA ingenzeka.
• Izinkinga zephampu ye-insulin: Uma umuntu esebenzisa iphampu, umzimba ungase ungatholi i-insulin ngenxa yezizathu ezifana nepayipi elivalekile noma ukuxhumana okuxegayo nomzimba.
• Ukusebenzisa i-insulin ephelelwe yisikhathi noma eyonakele: I-insulini umuthi ongamelani nokushisa okukhulu noma ukubanda. Isibonelo, uma ingafakwanga efrijini noma iphelelwe yisikhathi, ingalahlekelwa ukusebenza kwayo.
• Izifo kanye nokutheleleka: Noma yikuphi ukugula, njengomkhuhlane, i-pneumonia, ukutheleleka komgudu womchamo (UTIs), kuyimbangela enkulu ye-DKA. Lokhu kungenxa yokuthi uma sigula, umzimba wethu uyacindezeleka futhi ukhiqize ama-hormone asebenza ngokumelene ne-insulin. Bese sidinga i-insulin eningi kunokujwayelekile.
• Ezinye izimbangela: Ukulimala okukhulu ngokomzimba, ukuhlukumezeka, ukuhlinzwa, ukuhlaselwa yinhliziyo, ukukhulelwa, ukuphuza utshwala ngokweqile, kanye nemithi ethile nakho kwandisa ingozi ye-DKA.

Kwenzekani uma i-DKA ingelashwa ngokushesha?

Lena yingxenye eyingozi kakhulu okudingeka sonke siyiqaphele. I-DKA ingaholela ezinkingeni ezinkulu kakhulu uma ingelashwa ngokushesha nangendlela efanele.

• Amazinga e-potassium aphansi kakhulu egazini.
• Ukuvuvukala kobuchopho.
• Ukugcwalisa amaphaphu ngamanzi.
• Ukuboshwa kwenhliziyo.
• Ukulimala kwezinso nezinye izitho zomzimba.
• I-Coma.
• Ekugcineni, ngisho nokufa kungenzeka.

Iphathwa kanjani?

Ukwelashwa kwe-DKA kufanele kwenziwe njalo esibhedlela. Uma unezimpawu ze-DKA, hamba esibhedlela ngokushesha.

Ukwelashwa okunikezwa esibhedlela

1. Uketshezi lwe-IV: Isinyathelo sokuqala ukunikeza usawoti. Lokhu kusiza ukuvimbela ukuphelelwa amanzi emzimbeni, ukukhipha ushukela omningi nama-ketone egazini, nokuhlanza umzimba.

2. I-insulini: I-insulini inikezwa ngemithambo yegazi. Lokhu kulawula amazinga kashukela egazini futhi kubangela ukuthi umzimba uqale ukusebenzisa ushukela ukuze uthole amandla futhi. Lokhu futhi kumisa ukwakheka kwama-ketone.

3. Ukunikeza Ama-Electrolyte: I-DKA ibangela ukuthi umzimba ulahlekelwe amaminerali abalulekile njenge-potassium. Lawa anikezwa ngemithambo yegazi ukuze umzimba ulinganisele.

Ukwelashwa ekhaya (kuphela ngokweseluleko sikadokotela)

Uma i-DKA itholakala kusenesikhathi, udokotela wakho angase akuncome ukwelashwa ekhaya. Kodwa-ke, lokhu kufanele kwenziwe kuphela ngaphansi kokuqondisa kukadokotela wakho.

• Ukuhlola amazinga kashukela egazini njalo (mhlawumbe kanye ngehora).
• Ukuhlola amazinga e-ketone.
• Phuza amanzi amaningi kanye noketshezi olungenashukela ukuze uvimbele ukuphelelwa amanzi emzimbeni.
• Ukugwema ukuzivocavoca.

Yini esingayenza ukuvimbela i-DKA ukuthi ingakhuli?

I-DKA yisimo esingasivimbela kaningi. Lezi zinto zingasiza.

• Hlola amazinga kashukela egazini lakho njalo: Hlola ushukela egazini lakho izikhathi eziningana ngosuku, ikakhulukazi ngaphambi nangemva kokudla, nangaphambi kokulala. Uma amazinga kashukela egazini lakho ephezulu, thatha isinyathelo ngokushesha.
• Thatha i-insulin yakho kanye nemithi ngesikhathi: Ungalokothi weqe umthamo we-insulin owunikezwe udokotela wakho.
• Hlola ama-ketone: Uma izinga likashukela egazini lakho liphakeme njalo ngaphezu kuka-250 mg/dL, noma uma unesifo esifana nomkhuhlane noma ukuhlanza, hlola umchamo wakho noma igazi lakho ukuze uthole ama-ketone.
• Yenza "uhlelo losuku lokugula": Khuluma nodokotela wakho bese wenza uhlelo kusenesikhathi mayelana nendlela yokulungisa umthamo wakho we-insulin kanye nendlela yokudla uma uba nomkhuhlane noma uhlanza.
• Qaphela: Uma wazi okwengeziwe nge-DKA, amathuba akho okusinda kuyo ayanda. Cela udokotela wakho ulwazi olwengeziwe ngalokhu.

Ngezinye izikhathi, kungakhathaliseki ukuthi siqaphile kangakanani, i-DKA ingenzeka ngezizathu ezingaphezu kwamandla ethu. Uma lokho kwenzeka, ungazizwa kabi ngakho futhi ucabange ukuthi kuyiphutha lakho. Into ebaluleke kakhulu ukuqaphela izimpawu bese ucela iseluleko sezokwelapha ngokushesha okukhulu.