Kuphatikizika kwa shuga m'magazi ndiko chisonyezo chachikulu chomwe kufooketsa kagayidwe m'thupi kumalingaliridwa. Kwa munthu wathanzi, ndi 3.3-5.5 mmol / L.
Magawo a glycemic akhoza kukhala asanadye. Masana, imatha kusintha motsogozedwa ndi glucose kuchokera ku zakudya, masewera olimbitsa thupi, kupsinjika kwamaganizidwe ndi malingaliro, komanso kumwa mankhwala.
Kupatuka koteroko nthawi zambiri kumapitirira 30%, ndikuwonjezeka kwa glycemia, insulin yotulutsidwa ndikokwanira kuyendetsa glucose m'maselo. Mu shuga mellitus, kuperewera kwa insulini kumachitika ndipo shuga m'magazi limakhalabe lokwera.
Shuga wowerengeka komanso wopindika
Nthawi ya matenda a shuga amatha kusiyanasiyana malinga ndi kuchuluka kwa zakudya, mankhwala komanso kuchita masewera olimbitsa thupi zomwe zingagwire bwino ntchito yolipirira shuga yayikulu. Ndi matenda opatsiridwa bwino, odwala amakhalanso othandiza komanso ochezeka nthawi yayitali.
Ndi mitundu iyi ya shuga mellitus, magawo apakati a glycemia ali pafupi ndi abwinobwino, glucose mu mkodzo satsimikizika, palibe mafunde akuthwa m'magazi amwazi, kuchuluka kwa hemoglobin ya glycated sikuposa 6.5%, ndipo lipid kapangidwe ka magazi ndi kuthamanga kwa magazi ndizosiyana pang'ono ndi thupi.
Mtundu wowonjezera wa matenda a shuga umachitika glycemia ikafika ku 13.9 mmol / l, glucosuria imachitika, koma thupi limataya glucose osaposa 50 g patsiku. Matenda a shuga pankhaniyi amaphatikizidwa ndi kusinthasintha kwa shuga m'magazi, koma chikomokere sichimachitika. Chiwopsezo chowonjezeka chopeza mtima ndi mitsempha.
Matenda a shuga amawongoleredwa ngati awa:
- Kuthamanga glycemia kuposa 8,3 mmol / l, ndipo masana - kupitilira 13.9 mmol / l.
- Glucosuria tsiku ndi tsiku pamwamba 50 g.
- Glycated hemoglobin ali pamwamba 9%.
- Kuchuluka magazi cholesterol ndi otsika kachulukidwe lipids.
- Kuthamanga kwa magazi ndiwokwera kuposa 140/85 mm Hg. Art.
- Matupi a Ketone amawoneka m'magazi ndi mkodzo.
Kubwezera shuga kumawoneka ndi kukula kwa zovuta komanso zovuta. Ngati shuga m'magazi ndi 15 mmol / l, ndiye kuti izi zitha kupangitsa kuti mukhale ndi vuto la matenda ashuga, omwe amatha kupezeka ngati dziko la ketoacidotic kapena hyperosmolar state.
Mavuto osokonezeka amakula chifukwa cha kuchuluka kwa shuga kwa nthawi yayitali, nthawi zambiri pazaka zingapo.
Izi zimaphatikizapo matenda ashuga a polyneuropathy, ndikupanga matenda am'mimba a shuga, nephropathy, retinopathy, komanso systemic micro- ndi macroangiopathies.
Zifukwa zolipirira shuga
Nthawi zambiri, kufunika kwa insulini kumapangitsa kuti pakhale kuphwanya shuga komwe kumayambitsa matenda opatsirana, matenda amkati, makamaka endocrine system, panthawi yapakati, unyamata paubwana, komanso motsutsana ndi maziko a psychoemotional overstrain.
Kuwonjezeka kwambiri kwa shuga m'magazi mpaka 15 mmol / l ndikukwera kungakhale ndi kusokonezeka kwakukulu m'magazi kupita ku ubongo ndi minofu ya mtima, kuvulala, chithandizo cha opaleshoni, kuwotcha, pomwe digiri ya hyperglycemia ikhoza kukhala chizindikiritso chowunikira kukula kwa vuto la wodwalayo.
Kutsimikiza kwa cholakwika cha mankhwala a insulin kapena hypoglycemic kungayambitse kuchuluka kwa shuga m'magazi. Odwala amatha kusokoneza mwanjira yomweyo chithandizo kapena kuphwanya zakudya mwadongosolo.
Pakusintha kwa mankhwalawa chifukwa chokakamizidwa kuchita zinthu zolimbitsa thupi, glycemia imatha kukula pang'onopang'ono.
Zizindikiro zakuchuluka kwa hyperglycemia
Kuwonjezeka kwa shuga m'magazi kungakhale lakuthwa. Izi zimapezeka kawirikawiri ndi mtundu woyamba wa matenda a shuga 1, chifukwa insulini ilipo m'thupi, ngati siyambitsidwa ndi jakisoni, ndiye kuti odwala amagwa.
Ndi matenda a shuga mellitus motsutsana ndi maziko a mankhwalawo, Zizindikiro za hyperglycemia zimayamba kuwonjezeka pang'onopang'ono. Odwala awonjezera ludzu, khungu louma, kutulutsa kwamkodzo, kuwonda. Izi ndichifukwa choti shuga yamagazi yambiri imatsogolera pakugawikanso kwamadzimadzi, imalowa m'matumbo.
Ngati mulibe insulin yokwanira m'magazi, ndiye kuti njira za kuphwanya kwa lipid zimayamba kuphatikizika ndi minofu ya adipose, mafuta achilengedwe aulere pazochulukitsa zimawonekera m'magazi. Mwa izi, matupi a ketone amapanga mu maselo a chiwindi, amakhala gwero lamphamvu loti thupi lipere.
Matupi a Ketone ndi oopsa bongo, sangathe kugwiritsidwa ntchito pazakudya m'malo mochulukitsa ma glucose, chifukwa chake, ali ndi zambiri m'magazi, zotere zimawonekera:
- Zofooka zakuthwa, kugona.
- Kusanza, kusanza.
- Kupumira pafupipafupi komanso kwamphamvu.
- Kuwonongeka pang'onopang'ono.
Chizindikiro cha ketoacidosis mu shuga ndi fungo la acetone kuchokera mkamwa. Kuphatikiza apo, zizindikiro zam'mimba zam'mimba zimadziwika chifukwa cha kupweteka kwa mucous membrane am'mimba ndi matumbo a matupi a ketone, hemorrhages ang'onoang'ono omwe amakhala mu peritoneum, komanso kusowa kwa elekitirodi.
Mavuto a ketoacidosis amatha kukhala m'mapapo komanso m'magazi a edema, omwe nthawi zambiri amapezeka ndi chithandizo chosayenera, thromboembolism chifukwa cha kufooka kwamadzi ndi magazi, komanso kuphatikizira kwa kachilombo koyambitsa bakiteriya.
Matenda a ketoacidosis
Zizindikiro zikuluzikulu zomwe ma degree a ketoacidosis amatha kuwunika ndizochulukirapo pazomwe zili m'matumbo a ketone m'magazi: ndi chikhalidwe cha acetone, acetoacetic ndi beta-hydroxybutyric acid mpaka 0.15 mmol / l, amatha kupitilira 3mmol / l, koma amatha kuchulukitsa ndi makumi ma nthawi .
Mulingo wa shuga wam'magazi ndi 15 mmol / l, shuga m'magazi ambiri amapezeka mu mkodzo. Zomwe magazi amachitazo zimakhala zosakwana 7.35, komanso ndi ketoacidosis yaying'ono pansi 7, yomwe imawonetsa metabolic ketoacidosis.
Mlingo wa sodium ndi potaziyamu umachepa chifukwa chakuti madzi amadzimadzi am'magawo amapita m'malo amkati, ndipo osmotic diuresis imakulanso. Potaziyamu ikachoka mu cell, zomwe zimakhala m'magazi zimachulukana. Leukocytosis, kuchuluka kwa hemoglobin ndi hematocrit chifukwa cha kukula kwa magazi kumadziwikanso.
Mukangolowa kumalo osamalira odwala amayang'anira zotsatirazi:
- Glycemia - kamodzi pa ola limodzi ndi insulin ya insulin, maola atatu aliwonse osokoneza. Iyenera kutsika pang'onopang'ono.
- Matupi a Ketone, ma electrolyte m'mwazi ndi pH mpaka makulidwe okhazikika.
- Mafuta kutsimikiza kwa diuresis musanathetse madzi amthupi.
- Kuwunika kwa ECG.
- Kuyeza kutentha kwa thupi, kuthamanga kwa magazi maola awiri aliwonse.
- Kuunika kwa X-ray pachifuwa.
- Kuyesa kwa magazi ndi mkodzo ndizodziwika kamodzi pakapita masiku awiri.
Kuchiza ndikuwonetsetsa kwa odwala kumachitika kokha m'magulu othandizira kwambiri kapena mu wodi (mu chisamaliro chachikulu). Chifukwa chake, ngati shuga yamagazi ndi 15 ndiye zoyenera kuchita ndi zotsatirapo zake zomwe zimawopseza wodwalayo zitha kungoyesedwa ndi dokotala malinga ndi mayeso okhazikika a labotale.
Sizoletsedwa kuyesa kuchepetsa shuga nokha.
Matenda a shuga a ketoacidosis
Kukula kwa matenda ashuga a ketoacidotic amatsimikiza ndi kuyenera kwa mankhwalawa. Matenda a shuga komanso matenda ashuga ketoacidosis onse amachititsa kufa kwa 5-10%, komanso kwa azaka zopitilira 60 ndi kupitilira.
Njira zazikulu zamankhwala ndizoyang'anira insulin kupondereza kupangika kwa matupi a ketone ndi kuwonongeka kwa mafuta, kubwezeretsa kuchuluka kwa madzimadzi ndi ma electrolyte oyambira m'thupi, acidosis ndikuchotsa zomwe zimayambitsa izi.
Kuti muchepetse kuchepa kwamadzi, mchere wamankhwala umalowetsedwa pa 1 lita imodzi, koma ngati pali vuto la mtima kapena impso, umatha kuchepa. Kutsimikiza kwa nthawi yayitali komanso kuchuluka kwa yovulazidwayo imatsimikiziridwa munthawi iliyonse.
Mothandizidwa kwambiri ndi insulin, mankhwala a insulin ndi omwe amapangidwira ukapangidwe kabwinobwino kapangidwe kake kapangidwe kake malinga ndi njira zotsatirazi:
- Mothandizirana, pang'onopang'ono, PISCES 10, kenako 5 PIERES / ola limodzi, 20% ya albin imawonjezeredwa kuti muchepetse matope pamakoma a otsikira. Pambuyo kutsitsa shuga mpaka 13 mmol / l, kuchuluka kwa makonzedwe kumachepetsedwa ndi 2 times.
- Mu dontho lokhazikika muyezo wa 0.1 PIECES kwa ola limodzi, kenako kutsikira pambuyo pakukhazikika kwa glycemic.
- Insulin imayendetsedwa ndi intramuscularly kokha ndi kigawo kotsika ketoacidosis ka magawo 10-20.
- Ndi kuchepa kwa shuga mpaka 11 mmol / l, amasinthana ndi jakisoni wa insulin: magawo a 4-6 maola atatu aliwonse,
Pofuna kupatsanso madzi m'thupi, njira ya sodium chloride imapitilizidwanso, kenako 5% shuga imatha kutumikiridwa limodzi ndi insulin. Kubwezeretsa zomwe zinali mwazinthu za kufufuza zinthu pogwiritsa ntchito mayankho okhala ndi potaziyamu, magnesium, phosphates. Akatswiri nthawi zambiri amakana kuyambitsa sodium bicarbonate.
Kuchiza kumawerengedwa ngati kupambana ngati chiwonetsero cha matenda ashuga ketoacidosis chikuchotsedwa, kuchuluka kwa shuga kuli pafupi ndi cholinga, matupi a ketone samakwezedwa, mawonekedwe a magazi ndi asidi omwe amakhala pafupi ndi thupi. Odwala, mosasamala mtundu wa shuga, amawonetsedwa kuchipatala kuchipatala.
Kanemayo munkhaniyi akupereka malingaliro ochepetsa shuga m'magazi.
