Matenda a shuga ketoacidosis

Diabetic ketoacidosis (DKA) ndimavuto owopsa omwe amakhudza anthu omwe ali ndi matenda ashuga. Zimachitika thupi likayamba kuthyola mafuta pamlingo wothamanga kwambiri. Chiwindi chimapanga mafuta kukhala mafuta otchedwa ketoni, omwe amachititsa magazi kukhala acidic.

DKA imachitika pamene chizindikiro chochokera ku insulin mthupi chimakhala chotsika kwambiri kuti:

1. Glucose (shuga wamagazi) sangathe kulowa m'maselo kuti agwiritsidwe ntchito ngati mafuta.
2. Chiwindi chimapanga shuga wambiri wamagazi.
3. Mafuta amathyoledwa mofulumira kwambiri kuti thupi liziwongolera.

Mafuta amathyoledwa ndi chiwindi kukhala mafuta otchedwa ketoni. Ma ketoni nthawi zambiri amapangidwa ndi chiwindi thupi likamawononga mafuta pambuyo poti mwakhala mukudya kale. Ma ketoni awa amagwiritsidwa ntchito ndi minofu ndi mtima. Ma ketoni akamapangidwa mwachangu kwambiri ndikumanga m'mwazi, amatha kukhala poizoni ndikupangitsa magazi kukhala acidic. Matendawa amadziwika kuti ketoacidosis.

DKA nthawi zina chimakhala chizindikiro choyamba cha mtundu wa 1 shuga kwa anthu omwe sanapezekebe. Zitha kukhalanso mwa munthu yemwe wapezeka kale ndi matenda amtundu wa 1. Kutenga, kuvulala, matenda akulu, kuchepa kwa insulin, kapena kupsinjika kwa opaleshoni kumatha kubweretsa DKA mwa anthu omwe ali ndi matenda ashuga amtundu woyamba.

Anthu omwe ali ndi matenda ashuga amtundu wa 2 amathanso kukhala ndi DKA, koma siichulukanso kwenikweni. Nthawi zambiri zimayambitsidwa ndi shuga wamagazi wosalamulirika wautali, kusowa kwa mankhwala, kapena matenda akulu kapena matenda.

Zizindikiro zodziwika za DKA zitha kuphatikiza:

• Kuchepetsa kuchepa
• Kupuma kozama, mwachangu
• Kutaya madzi m'thupi
• Khungu louma ndi pakamwa
• Nkhope
• Kukodza pafupipafupi kapena ludzu lomwe limatenga tsiku limodzi kapena kupitilira apo
• Mpweya wonunkhira
• Mutu
• Kuuma kwa minofu kapena kupweteka
• Nseru ndi kusanza
• Kupweteka m'mimba

Kuyesedwa kwa ketone kungagwiritsidwe ntchito mu mtundu wa 1 shuga kuti muwonetse ketoacidosis yoyambirira. Mayeso a ketone nthawi zambiri amachitika pogwiritsa ntchito mkodzo kapena magazi.

Kuyesedwa kwa ketone kumachitika nthawi zambiri DKA ikayikiridwa:

• Nthawi zambiri, kuyesa mkodzo kumachitika koyamba.
• Ngati mkodzo uli ndi ma ketoni, ketone yotchedwa beta-hydroxybutyrate imayesedwa m'magazi. Ichi ndi ketone chofala kwambiri. Ketone ina yayikulu ndi acetoacetate.

Mayeso ena a ketoacidosis ndi awa:

• Magazi amitsempha yamagazi
• Gawo loyambira la kagayidwe kachakudya, (gulu la mayeso amwazi omwe amayesa kuchuluka kwanu kwa sodium ndi potaziyamu, ntchito ya impso, ndi mankhwala ena ndi ntchito, kuphatikiza kusiyana kwa anion)
• Mayeso a magazi m'magazi
• Kuyeza kwa magazi
• Kuyesa magazi kwa Osmolality

Cholinga cha chithandizo ndikuwongolera kuchuluka kwa shuga wamagazi ndi insulin. Cholinga china ndikubwezeretsa madzi omwe adatayika pokodza, kusowa kwa njala, ndi kusanza ngati muli ndi izi.

Ngati muli ndi matenda ashuga, zikuwoneka kuti wothandizira zaumoyo wanu wakuwuzani momwe mungazindikire zizindikiro za DKA. Ngati mukuganiza kuti muli ndi DKA, yesani ma ketoni ogwiritsa ntchito mkodzo. Mamita ena a glucose amathanso kuyeza ma ketoni amwazi. Ngati ma ketoni alipo, itanani omwe akukuthandizani nthawi yomweyo. Musachedwe. Tsatirani malangizo aliwonse amene mwapatsidwa.

Zikuwoneka kuti mufunika kupita kuchipatala. Kumeneko, mudzalandira insulini, madzi, ndi chithandizo china cha DKA. Kenako othandizira adzafufuzanso ndikuchiza zomwe zimayambitsa DKA, monga matenda.

Anthu ambiri amalabadira chithandizo mkati mwa maola 24. Nthawi zina, zimatenga nthawi kuti uchira.

Ngati DKA sichithandizidwa, imatha kubweretsa matenda kapena imfa.

Mavuto azaumoyo omwe angabwere kuchokera ku DKA ndi awa:

• Kumanga kwamadzimadzi muubongo (edema wamaubongo)
• Mtima umasiya kugwira ntchito (kumangidwa kwamtima)
• Impso kulephera

DKA nthawi zambiri imakhala yachipatala. Itanani omwe akukuthandizani mukawona zizindikiro za DKA.

Pitani kuchipinda chodzidzimutsa kapena itanani nambala yadzidzidzi yakomweko (monga 911) ngati inu kapena wachibale wanu yemwe ali ndi matenda a shuga muli ndi izi:

• Kuchepetsa chidziwitso
• Mpweya wachipatso
• Nseru ndi kusanza
• Kuvuta kupuma

Ngati muli ndi matenda ashuga, phunzirani kuzindikira zizindikilo za DKA. Dziwani nthawi yoyesera ma ketoni, monga nthawi yomwe mukudwala.

Ngati mumagwiritsa ntchito pampu ya insulini, yang'anani pafupipafupi kuti muwone ngati insulini ikuyenda kudzera mumachubu. Onetsetsani kuti chubu sichimatsekedwa, kinked kapena kuchotsedwa pampu.

DKA; Ketoacidosis; Matenda a shuga - ketoacidosis

• Chakudya ndi insulin kumasulidwa
• Mayeso olekerera pakamwa
• Pampu ya insulini

Bungwe la American Diabetes Association. 2. Gulu ndi matenda a shuga: miyezo ya chithandizo chamankhwala ashuga - 2020. Chisamaliro cha shuga. 2020; 43 (Suppl 1): S14-S31. PMID: 31862745 adasankhidwa.ncbi.nlm.nih.gov/31862745/.

Atkinson MA, Mcgill DE, Dassau E, Laffel L. Type 1 matenda ashuga. Mu: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ, olemba. Buku la Williams la Endocrinology. Wolemba 14th. Philadelphia, PA: Elsevier; 2020: chap 36.

Maloney GE, Glauser JM. Matenda a shuga ndi matenda a glucose homeostasis. Mu: Makoma RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: mutu 118.