Ngati munthu ali ndi kuchuluka kwa shuga m'magazi kuyerekeza, dokotala amamuuza za hyperglycemia, komwe kumatha kukhala kuyamba kwa matenda ashuga. Mawu oti hyperglycemia adzatsagana ndi odwala matenda ashuu kwa moyo wake wonse, chifukwa chake ndikofunikira kudziwa zonse za izi.
Ngakhale kuchuluka kwa shuga mu shuga, hyperglycemia ikhoza kukwezedwa kapena ingakhale mkati mwa mulingo wabwinobwino pamene mulingo wa glucose uli pafupi ndi zomwe mukufuna ndipo palibe chifukwa chowakonzera.
Ndichizolowezi kupatula magawo angapo chitukuko cha izi:
- kuwala
- pafupifupi;
- zolemetsa.
Dokotala wopezekapo amathandizira kudziwa zoyenera kutsata, yemwe amafotokozera wodwala aliyense chifukwa chake kuli kofunikira kuwunika glycemia komanso momwe angayikirire.
Hyperglycemia imathandizira kuwunika momwe wodwalayo alili: kusala kudya, postprandial.
Ngati hyperglycemia itakwera kwambiri, imatha kudwala matenda ashuga, omwe amatchedwanso diabetesic ketoacidosis. Munthawi imeneyi, munthu amatha kulephera kuzindikira bwino komanso kufa.
Ndikofunika nthawi zonse kukumbukira kuti shuga ndi matenda a endocrine omwe samadziwonetsa mwanjira iliyonse kwa zaka zambiri.
Zoyambitsa Hyperglycemia
Kuwonjezeka kwa shuga m'magazi kumatha kuchitika pazifukwa zosiyanasiyana, makamaka chifukwa chosagwirizana ndi zakudya zomwe adokotala amafunsa. Wodwala matenda ashuga akamadya chakudya chochuluka, mkati mwa theka la ola m'magazi ake wamagazi amapezeka mwachangu.
Ngakhale kuti glucose ndi gwero labwino la mphamvu, kuchuluka kwake kumayipa kwambiri kuposa momwe kumawonekera poyamba.
Popita nthawi, hyperglycemia imasokoneza machitidwe a metabolic, omwe amawonekera:
- Kunenepa kwambiri
- kuphwanya kwamtima dongosolo;
- kulolerana kwa shuga;
- kuchuluka triglycerides.
Wodwala akapezeka ndi 2 kapena kuposerapo mwa zizindikirozi komanso kunenepa kwambiri, amapezeka kuti ali ndi matenda a metabolic. Popanda chithandizo chakanthawi, mtundu 2 wa matenda a shuga umayamba pang'onopang'ono.
Kunenepa kwambiri kumayambitsa kukana insulini, makamaka nthawi zambiri ndi m'mimba kunenepa kwambiri, mafuta akaikidwa m'chiuno. Ambiri mwa odwala matenda ashuga ndi onenepa kwambiri (BMI yoposa 25).
Njira zopangira matenda ashuga mwa anthu onenepa aphunziridwa bwino. Kuchuluka kwa minofu ya adipose kumawonjezera kuchuluka kwamafuta acids omasuka - gwero lalikulu lamphamvu. Ndi kuchuluka kwa mafuta acids m'magazi, hyperinsulinemia, insulin kukana kumachitika. Kuphatikiza apo, mafuta achilengedwe aulere amapweteka kwambiri maselo a pancreatic beta, chifukwa amachepetsa ntchito zachinsinsi za chiwalo.
Chifukwa chake, pakuwunika koyambirira kwa matenda amitundu iwiri, matenda a plasma omwe ali pamlingo wa FFA akuwonetsedwa, mopitirira muyeso wa zinthu izi tikukamba za kukhazikika kwa kulolera kwa glucose, hyperglycemia.
Zomwe zimayambitsa hyperglycemia: pafupipafupi zinthu zovuta, kumwa mankhwala ena, matenda opatsirana kapena matenda, kuchepa kwa insulin.
Choopsa kwambiri ndichakuti kusowa kwa insulini, mahomoni oyendera omwe amalimbikitsa kugawa mphamvu mthupi lonse. Ndi kusakwanira kwake, mamolekyulu a glucose adzadziunjikira m'magazi, gawo lamphamvu zowonjezera limasungidwa mu chiwindi, gawo limapangidwa ndikukhala mafuta, ndipo chotsalacho chimachoka ndi mkodzo pang'onopang'ono.
Ngati kapamba sangathe kupanga insulin yokwanira:
- shuga amasokoneza magazi;
- imakhala poizoni.
Ndi matenda a shuga a shuga omwe amadalira insulin, ndikofunikira kuyang'anira kuchuluka kwa insulin, yomwe imayikidwa kangapo patsiku. Mlingo weniweni wa mahomoni nthawi zonse umatengera chakudya cha wodwalayo, zaka zake komanso magawo ena ambiri. Ndi insulin yokwanira, hyperglycemia imayamba.
Osati gawo lomaliza pakupanga matenda a shuga a mtundu wa hyperglycemia ndi mtundu 2 omwe amapatsidwa gawo lobadwa nawo. Asayansi afotokoza mitundu yoposa zana yomwe imalumikizidwa ndi mwayi wokhudzana ndi insulin, kunenepa kwambiri, kuperewera kwa glucose komanso mafuta a metabolism.
Hyperglycemia ndi zizindikiro zake zimayambitsanso kuwonongeka kwa ma cell a pancreatic beta, omwe ndi:
- zothandiza;
- organic.
Monga taonera, zomwe zimayambitsa mavuto a shuga wamagazi zimafuna kupatsidwa mankhwala kwakanthawi: ma mahomoni a adrenal cortex (glucocorticosteroids), diuretics (thiazides), mankhwala osokoneza bongo, arrhythmias, pofuna kupewa matenda a mtima (beta-blockers), antipsychotic (antipsychotic), mankhwala a anticholesterol (ma statins).
Kafukufuku wopangidwa m'mabanja akulu ndi mapasa akutsimikizira kuti ngati m'modzi mwa makolo ali ndi matenda a shuga a 2, mwana adziwe kuti glycemia ili ndi mwayi wotani mpaka 40%.
Zizindikiro za Hyperglycemia
Odwala amati sizotheka kudziwa zizindikiro za matenda ashuga amtundu wa 2. Ndizachilendo kuti ndi glucose pamtunda kuchokera 10 mpaka 15 mmol / lita, yomwe imatenga nthawi yayitali, munthu amatha kumva bwino, osadandaula zaumoyo.
Komabe, muyenera kumvetsera thupi lanu, makamaka kuwonda mwadzidzidzi, kukodza pafupipafupi, ludzu losatha, kutopa, kuyambitsa nseru, ndi kusanza. Ndi mavuto ndi shuga, munthu amadzuka pakhosi usiku, kugona kumasokonekera.
Pamenepo pamenepa kuchuluka kwa glucose kupitilira gawo la impso, owonjezera amachoka ndi mkodzo, motero wodwalayo amakakamizidwa kupita kuchimbudzi nthawi zonse (ola lililonse kapena awiri). Zotsatira zake, thupi limayamba kutayika mwachangu, kuchepa kwamadzi kumachitika motsutsana ndi maziko a ludzu losatha.
Popeza impso sizitha kuthana ndi ntchito yawo, magazi samatsuka bwino, mkodzo, munthu amataya zinthu zomwe zili ndi thanzi:
- mapuloteni
- chloride;
- potaziyamu
- sodium
Njira ya pathological iyi imawonetsedwa ndi kuwodzera, ulesi, kuwonda.
Ngati impso zalephera kwathunthu kuyeretsa magazi, matenda a shuga a nephropathy amakula, omwe pambuyo pake amayamba kulephera kwa impso. Zikatero, pali zizindikiro za hemodialysis impso, zomwe zimaphatikizapo kuyeretsa magazi.
Kukula ndi zizindikiritso za hyperglycemia mu mtundu 2 wa matenda a shuga kumadalira makamaka pa kuchuluka kwa shuga komanso kutalika kwa mitengo yake yambiri. Pakakhala chithandizo chapanthawi yake, ketoacidosis ndi ketonuria ziyamba kukulira limodzi ndi glucosuria.
Matenda a shuga akamakula, zizindikirazo zimakulirakulira, mwinanso zoopsa. Hyperglycemia ikafika pamwambamwamba ndipo imasungidwa nthawi yayitali, zimachitika:
- kupweteka kwambiri m'miyendo;
- kukula kwa matenda yisiti;
- kuchiritsa kwapang'onopang'ono kwa mabala, mabala;
- kuchuluka kwa malekezero apamwamba komanso otsika.
Matenda a shuga a Type 2 amakhudza kwambiri minofu yamtima, mwa azimayi izi zimatchulidwa kwambiri. Odwala, chiwopsezo cha matenda a mtima chimawonjezeka nthawi ziwiri, ndipo kulephera kwamtima ndi 4.
Hyperglycemia pa nthawi yapakati imayambitsa zovuta ngati mkazi wasankha kuti akhale ndi pakati: toxicosis yoleketsa, polyhydramnios, kusokonezeka kwapakati, matenda amitsempha.
Zizindikiro za matenda a shuga a ketoacidosis
Kutsatira malingaliro a dokotala omwe akupezekapo kungathandize kuyimitsa njira zovulaza mthupi. Mulimonse momwe zingakhalire, pakufunika kufunafuna thandizo la dotolo yemwe angapangitse kadyedwe kakang'ono ka munthu. Kwa zovuta za impso, pali zizindikiro zochepetsera kuchuluka kwa zakudya zama protein, zomwe zimaperekedwa, komanso mchere.
Ndi mtundu wachiwiri wa matenda a shuga a mellitus, zizindikiro za ketoacidosis zimayamba kupweteka pafupipafupi, fungo losasangalatsa kuchokera pamlomo wamkamwa, kufooka, m'mimba, nseru, kutsegula m'mimba, kupumira mwachangu, kufalikira, mpaka kuphatikizira kudana ndi chakudya. Kupuma kwambiri, kusanza, ndi nseru:
- itanani ambulansi;
- Izi zimapereka kuchipatala mwachangu.
Kuphatikiza apo, mulimonse lachilendo, wodwalayo amakhala pachiwopsezo chachikulu. Mwachitsanzo, ndi matenda opatsirana kapena mavairasi, kutentha kwa thupi kukakwera, gawo la insulin limawonongeka. Ngati thupi pakadwala limafooka kwambiri, kutentha kwambiri kumatenga nthawi yayitali, ketoacidosis imakula msanga. Pachifukwa ichi, kuwonetsa kwa hyperglycemia mu mtundu 2 wa shuga sikunganyalanyazidwe.
Kuyambiranso kwachiwiri kudzakhala kuchuluka kwa zochitika zolimbitsa thupi, makamaka kwa odwala:
- ukalamba;
- ndi kunenepa kwambiri.
Ndikofunika kulabadira kuyenda, masewera olimbitsa thupi, koma osayiwala kuti zolimbitsa thupi ndizoletsedwa ndi hyperglycemia pamtunda wa 13 mmol / l.
Timafunikiranso kumwa madzi okwanira, makamaka ndi glycemia pamtunda wa 12 mmol / L. Imwani madzi ambiri theka lililonse la ola. Mankhwala ochepetsa mphamvu ya glucose amathandizanso, koma simungathe kumwa nawo mopitilira ndipo nthawi zambiri zimachitika zovuta.
Mu magawo oyamba a hyperglycemia mu shuga mellitus amatha kuwongoleredwa kokha ndi chakudya choyenera komanso chopatsa thanzi.
Madokotala akutsimikiza kuti chithandizo choterocho chidzakhala chofunikira pamoyo popanda matenda a shuga mtsogolo.
Matenda a hyperglycemia
Kuzindikira kwa hyperglycemia mu matenda a shuga kumatheka kudzera mu kusanthula kwa plasma, kuyesa kwa glucose.
Kupenda shuga m'magazi amwazi kumathandizanso kukhazikitsa kukhalapo kwa hypoglycemia. Amachita izi pamimba yopanda kanthu pambuyo maola 10 akusala kudya. Mkulu wa glucose azikhala wabwinobwino kuzizindikiro kuchokera ku 3.9 mpaka 5.5 mmol / l, prediabetes imayesedwa kuti ndiyambira pa 5.6 mpaka 6.9%, odwala matenda a shuga amapezeka ndi kusanthula kwa 7 mmol / l (kupatula zolakwika, kusanthula kumabwerezedwa kangapo )
Kuyesedwa kwa shuga kumawonetsa shuga m'magawo 2 mutatha kumwa shuga wamadzimadzi ambiri (75 magalamu a shuga pa 300 ml yamadzi). Mu matenda ashuga, zotsatira zake zidzakhala 11.1 mmol / L ndikukwera pamwamba.
Ngati mungapeze zotsatira zochepa zokhazo, muyenera kubwereza kuyesako kangapo. Nthawi zina, hyperglycemia imayamba motsutsana ndi maziko a:
- kupsinjika pafupipafupi;
- kuvulala
- matenda opatsirana.
Kutsimikizira kapena kupatula matenda a shuga, amasonyezedwa kuyesa shuga zingapo nthawi zosiyanasiyana patsiku, akatha kudya komanso pamimba yopanda kanthu.
Mu kanema munkhaniyi, adokotala amafotokoza mwatsatanetsatane Zizindikiro za hyperglycemia.
