Mwazi wamagazi 35, zimatanthawuza chiyani, odwala ali ndi chidwi? Kuchuluka kwa shuga m'thupi la munthu wodwala matenda ashuga kumawonetsa shuga, chifukwa chomwe magwiridwe antchito onse amkati ndi machitidwe amalephereka.
Potengera zomwe zalembedwako, shuga amatha kukula mosakhalitsa mpaka 40, zomwe zikutanthauza kuti atha kukhala ndi zovuta kwambiri pang'onopang'ono. Kuphatikiza apo, chiwopsezo cha kupita patsogolo kwa zotsatira zoyipa chimawonjezeka.
Matenda a shuga ndi matenda osachiritsika, "obisirika" omwe ali chitukuko cha zovuta zingapo - mawonekedwe opuwala amaso mpaka khungu, kulephera kwa impso, vuto lambiri m'munsi.
Ndikofunikira kulingalira zomwe zimatanthawuza ngati shuga atakula kuposa 46, ndipo ndi zovuta ziti zomwe zingayambike?
Pachimake mavuto a shuga
Mawu akuti hyperglycemic state amatanthauza kuwonjezeka kwa shuga m'thupi la munthu kuposa malire ovomerezeka. Kuzunzidwa kwa shuga kuyambira mayunitsi 3.3 mpaka 5.5 kumawerengedwa kuti ndiwowonetsa zizindikiro.
Ngati shuga m'thupi la munthu pamimba yopanda kanthu ndi wokulirapo kuposa ma 6.0, koma ochepera 7.0 mmol / l, ndiye kuti amalankhula za dziko lomwe limakhalapo. Ndiye kuti, matenda awa sikuti ali ndi matenda ashuga, koma ngati njira zoyenera sizitengedwa, mwayi wakukula kwake ndiwokwera kwambiri.
Ndi zipatso za shuga pamtunda wama 7.0 pamimba yopanda kanthu, matenda a shuga akuti. Ndipo kutsimikizira matendawa, zowonjezera zimachitika - kuyesa kwa glucose sensitivity, glycated hemoglobin (kuwunika kumawonetsa shuga m'masiku 90).
Ngati shuga atakwera pamwamba pa magawo 30-35, boma la hyperglycemic limawopseza ndi zovuta zowopsa zomwe zimatha kupangika m'masiku ochepa kapena maola angapo.
Mavuto ambiri a matenda oopsa a shuga:
- Ketoacidosis amadziwika ndi kudziunjikira m'thupi la zinthu za metabolic - matupi a ketone. Monga lamulo, lomwe limayang'aniridwa mwa odwala omwe ali ndi matenda amtundu wa 1, amatha kubweretsa kusokonezeka kosagwirizana ndi ziwalo zamkati.
- Khoma lachi hyperosmolar limayamba shuga atakwera mthupi mpaka milingo yambiri, ndikukhala ndi sodium wambiri. Zimachitika motsutsana ndi maziko am'madzi. Amapezeka kawirikawiri mtundu wa 2 odwala matenda ashuga omwe ali ndi zaka zopitilira 55.
- Lactacidic chikomokere chimachitika chifukwa cha kudzikundikira kwa lactic acid mthupi, imadziwika ndi kusokonezeka kwa chikumbumtima, kupuma, kuchepa kwakukulu kwa magazi kumapezeka.
M'mazithunzi ambiri azachipatala, mavutowa amakula mwachanguchangu, maola ochepa. Komabe, kukomoka kwa Hyperosmolar kumatha kuwonetsa kukula kwake masiku angapo kapena milungu isanayambike.
Chilichonse mwazinthu izi ndi nthawi yopempha thandizo la mankhwala;
Kunyalanyaza vutoli kwa maola angapo kungatayitse moyo wodwala.
Ketoacidosis wodwala matenda ashuga
Matenda a shuga a ketoacidosis ndi matenda oopsa kwambiri omwe amatha kudzetsa matenda ambiri amkati, chikomokere, komanso imfa.
Vutoli limayamba pamene kuchuluka kwakukulu kwa shuga kumadzaza m'thupi la wodwalayo, koma thupi silingathe kuyamwa, popeza pali insulini yochepa kapena ayi.
Komabe, thupi limafunikira kukhala ndi mphamvu kuti ligwire ntchito, chifukwa cha momwe thupi "limatenga" zinthu zamagetsi kuchokera kumayikidwe a mafuta, panthawi yakuphwanya komwe matupi a ketone amasulidwa, zomwe ndi zinthu zakumwa.
Vutoli limayamba chifukwa cha kusowa kwambiri kwa thupi chifukwa cha kuchuluka kwa insulin. Ndipo zomwe zimayambitsa zingakhale izi:
- Viral kapena matenda opatsirana (matenda opumira kwambiri pachimake, fuluwenza ndi ena).
- Kuphwanya chilengedwe cha endocrine.
- Kupsinjika (makamaka mwa ana).
- Mikwingwirima, vuto la mtima.
- Pambuyo pa opaleshoni.
- Nthawi yamimba (shuga ya amayi apakati).
Poyerekeza ndi tsogolo la shuga wopitilira 35 mayunitsi, wodwalayo nthawi zonse amafuna kumwa madzimadzi, motero, pali kuwonjezeka kwamphamvu kwamikodzo patsiku. Kuuma kwa mucous nembanemba ndi khungu, khungu lonse limapezeka.
Ngati vutolo lanyalanyazidwa, ndiye kuti chithunzi cha chipatala chimathandizidwa ndi mseru, kusanza, fungo linalake kuchokera mkatikati mwa kamwa, ndipo kupuma kumakhala kwakuya komanso kwamkokomo.
Chithandizo cha ketoacidosis chimaphatikizapo mfundo zazikulu zisanu. Mankhwala a insulin amachitika, madzi mu thupi amakonzedwanso, kuperewera kwa potaziyamu, sodium ndi zinthu zina zomanga thupi, acidosis imachotsedwa, ma concomitant pathologies amathandizidwa.
Chitsimikizo chakuchira bwino chimawerengedwa ngati kuchepa kwa shuga kupita kumagawo 11 ndipo pansi pa manambala.
Hyperosmolar coma: Zizindikiro ndi zotsatira zake
Hyperosmolar coma nthawi zambiri imapezeka mwa anthu odwala matenda ashuga, omwe ali m'gulu la anthu azaka zopitilira 50. Imfa chifukwa cha matenda amtunduwu imafika 40-60% mwa zithunzi zonse zamankhwala.
Izi matenda amapanga motsutsana maziko a shuga osawerengeka kagayidwe kachakudya, ndipo amapezeka ndi kuchuluka kwambiri kwa shuga mthupi, magawo opitilira 50, osakanikirana ndi plasma hyperosmolarity, pakalibe zovuta za ketoacidotic.
Zomwe zimapangidwira sizimveka bwino. Madotolo amati izi zimachitika motsutsana ndi maziko a matenda a hyperglycemic, pomwe pakadali kolepheretsa kupezeka kwa shuga kudzera mu impso.
Hyperosmolar coma imatha kupezeka pakangotha masiku angapo kapena milungu ingapo. Choyamba, wodwalayo amawonetsa kuti ali ndi chidwi chofuna kumwa, kukonzekera mwachangu komanso moperewera, kufooka.
Kuphatikiza apo, zizindikiro za kuchepa thupi zimadziwika:
- Kutsitsa turgor pakhungu.
- Matani amaso amachepa.
- Kuthamanga kwa magazi kumachepa.
- Kutentha kwa thupi kumachepa.
Woopsa mawonekedwe a matenda, wodwalayo amakula. Mavuto omwe amakonda kwambiri ndi kuvulala kwamitsempha yayikulu, komanso kuwonongeka kwa impso mu matenda a shuga komanso kapamba, khunyu.
Zomwe amathandizira pa vutoli ndikuti ndizoletsedwa kwambiri kuchepetsa shuga. Njira yabwino ndiyakuti muchepetse shuga m'magulu asanu pa ola limodzi. Nawonso, osmolarity wamagazi sayenera kuchepa mwachangu kuposa magawo 10 m'mphindi 60.
Ngati simutsatira ndondomeko ya zamankhwala, ndiye kuti chiopsezo chotupa cham'mapapu ndi ubongo chakwera kwambiri.
Lactacidotic chikomokere
Lactacidic chikomokere ndimavuto osowa a anthu odwala matenda ashuga, koma amaphatikizidwa ndi kuphedwa kwakukulu, ndipo mwayi wa kufa ndi 80%.
Monga lamulo, izi zokhudzana ndi matenda a m'mimba zimawonedwa mwa anthu odwala matenda ashuga omwe ali ndi mbiri yokhudzana ndi matenda a mtima, chiwindi ndi impso.
Pathogenesis ya chikomokere imakhazikitsidwa ndi kuchuluka kwambiri kwa glucose komwe kumachitika mthupi la munthu motsutsana ndi maziko a kusowa kwa timadzi m'magazi. Chithunzi chachipatala cha matendawa chimakula mwachangu, chimasiyana pakadutsa.
Zizindikiro zotsatirazi zimawonedwa mwa odwala:
- Ululu pamimba.
- Zovuta za mseru mpaka kusanza.
- Zofooka zambiri.
- Kupweteka kwa minofu ikusuntha.
- Kupanda chidwi, ulesi ndi kufooka.
- Kugona kapena kugona.
- Zopusitsa, kuyerekezera zinthu m'maganizo (kawirikawiri).
Ngati sanachitepo kanthu kuti aletse wodwalayo, ndiye kuti agwa. Pafupipafupi, zizindikiro za kuchepa madzi m'thupi zimapezeka, kupuma kwa wodwalayo kumakhala kaphokoso komanso kwakuya, kuthamanga kwa magazi kumachepa, ndipo kugunda kwa mtima kumapitilizidwa.
Lactacidic coma imatha kuchitika mothandizidwa ndi zinthu zambiri:
- Poyerekeza ndi kumbuyo kwa chikomokere kwa hyperosmolar, chosadziwika ndi ketosis.
- Pamene matenda ashuga ketoacidosis amapezeka, lactic acidosis imawonedwa pafupifupi 8-11% ya milandu;
- Chifukwa chosayenda bwino m'magazi.
- Pa nthawi yomwe mukumana ndi matenda osokoneza bongo, kapena shuga ya amayi apakati.
- Kulephera mwadzidzidzi kwa kagayidwe kachakudya mthupi.
Chithandizo cha pathological chikhalidwe chimakhala ndikuwongolera acid ndi alkaline bwino m'thupi, kubwezeretsa madzi ndi electrolyte metabolism, ndi dalili. Komanso matenda a masanjidwe am'mimba kudzera mu njira ya shuga ndi kuchuluka kwa insulin.
Chifukwa chake, titha kunena kuti kuchuluka kwambiri kwa shuga ndi njira yayitali yopezera zovuta zambiri zomwe zingawononge moyo wa wodwalayo.
Kanema yemwe ali munkhaniyi akuwonetsa kuti azidya shuga wambiri.
