Chirwere cheshuga ketoacidosis

Diabetic ketoacidosis (DKA) idambudziko rinotyisidzira hupenyu rinokanganisa vanhu vane chirwere cheshuga. Izvo zvinoitika kana muviri ukatanga kupaza mafuta pachiyero chakanyanya kukurumidza. Chiropa chinogadzira mafuta kuita mafuta anonzi ketoni, izvo zvinoita kuti ropa riite acidic.

DKA inoitika kana iyo chiratidzo kubva kune insulini mumuviri yakadzika zvekuti:

1. Glucose (shuga yeropa) haigone kupinda mumasero kuti ishandiswe senzvimbo yemafuta.
2. Chiropa chinoita huwandu hwakawanda hweshuga yeropa.
3. Mafuta anovhunika pasi nekukurumidza kuti muviri uite.

Mafuta akaputsika nechiropa kuita mafuta anonzi ketoni. Ketoni inowanzo gadzirwa nechiropa kana muviri uchipaza mafuta mushure menguva yakareba kubva pakudya kwako kwekupedzisira. Aya maketoni anowanzo shandiswa nemhasuru nemoyo. Kana ketoni zvikagadzirwa nekukurumidza uye zvichivaka muropa, zvinogona kuve zvine chepfu nekuita kuti ropa riite acid. Aya mamiriro anozivikanwa se ketoacidosis.

DKA dzimwe nguva chiratidzo chekutanga cheshuga 1 chirwere cheshuga muvanhu vasati vaonekwa. Izvo zvinogona zvakare kuitika kune mumwe munhu akatoonekwa kuti ane rudzi rwekutanga chirwere cheshuga. Utachiona, kukuvara, chirwere chakakomba, kushayikwa doses ye insulin shots, kana kunetseka kwekuvhiyiwa kunogona kutungamira kuDKA kune vanhu vane chirwere cheshuga 1.

Vanhu vane rudzi rwechipiri chirwere cheshuga vanogona zvakare kugadzira DKA, asi haina kujairika uye haina kusimba. Inowanzo kukonzerwa neshuga yeropa isingadzorwe kwenguva refu, kushayikwa kwemishonga, kana chirwere chakakomba kana hutachiona.

Zviratidzo zvakajairika zveDKA zvinogona kusanganisira:

• Kuderedza kusvinura
• Kudzika, kukurumidza kufema
• Kupera mvura mumuviri
• Ganda rakaoma uye muromo
• Chiso chakatsetseka
• Kakawanda kuita weti kana nyota inogara kwezuva kana kupfuura
• Kufema kunhuwa-kunhuwa
• Kutemwa nemusoro
• Kuomesa kwemhasuru kana kurwadziwa
• Kusvotwa uye kurutsa
• Dumbu kurwadziwa

Kuedzwa kweKetone kunogona kushandiswa murudzi rwe1 chirwere cheshuga kutarisisa kwekutanga ketoacidosis. Iko ketone bvunzo inowanzoitwa uchishandisa weti sampuro kana muyenzaniso weropa.

Kuedzwa kweKetone kunowanzoitwa panofungidzirwa DKA:

• Kazhinji kazhinji, kuongorora weti kunoitwa kutanga.
• Kana weti iri yakanaka kune ketoni, kazhinji ketone inonzi beta-hydroxybutyrate inoyerwa muropa. Iyi ndiyo ketone yakajairika kuyerwa. Iyo imwe ketone huru iacetoacetate.

Mimwe bvunzo yeketoacidosis inosanganisira:

• Arterial ropa gasi
• Basic metabolic pani, (boka rekuyera ropa rinoyera yako sodium uye potasiamu mazinga, itsvo mashandiro, uye mamwe makemikari uye mashandiro, kusanganisira anion gap)
• Ropa glucose bvunzo
• Kuyera kweropa kuyera
• Osmolality yeropa bvunzo

Chinangwa chekurapa ndechekugadzirisa iyo yakakwira shuga yeropa ne insulin. Chimwe chinangwa ndechekutsiva mvura dzakarasika kuburikidza nekuita weti, kurasikirwa kwechido, uye kurutsa kana iwe uine izvi zviratidzo.

Kana iwe uine chirwere cheshuga, zvinogona kunge mupi wako wezvehutano akakuudza maitiro ekuona zviratidzo zvekunyevera zveDKA. Kana iwe uchifunga kuti une DKA, edza ketoni uchishandisa weti mitsetse. Mamwe mamirimita eglucose anogona kuyera ketoni yeropa. Kana ketoni dziripo, danaidza mupiki wako ipapo ipapo. Usanonoka. Tevera chero rairo iwe yaunopihwa.

Zvichida kuti iwe uchafanirwa kuenda kuchipatara. Ikoko, iwe uchagamuchira insulin, zvinwiwa, uye kumwe kurapwa kweDKA. Ipapo vanopa vachatsvaga uye vobata chinokonzeresa cheDKA, senge chirwere.

Vanhu vazhinji vanopindura kurapwa mukati maawa makumi maviri nemana. Dzimwe nguva, zvinotora nguva yakareba kuti uwanezve.

Kana DKA ikasarapwa, inogona kutungamira kurwara zvakanyanya kana kufa.

Matambudziko ehutano anogona kukonzerwa neDKA anosanganisira chero anotevera:

• Fluid buildup muuropi (cerebral edema)
• Mwoyo unomira kushanda (kusungwa kwemoyo)
• Itsvo kutadza

DKA inowanzo kuve yekurapa emergency. Fonera waunopa kana iwe ukaona zviratidzo zveDKA.

Enda kuimba yekukurumidzira kana kufonera iyo yemuno emergency emergency (yakadai se911) kana iwe kana nhengo yemhuri ine chirwere cheshuga uine chero chinotevera:

• Kuderera kwekuziva
• Fruity mweya
• Kusvotwa uye kurutsa
• Kunetseka kufema

Kana iwe uine chirwere cheshuga, dzidza kuziva zviratidzo nezviratidzo zveDKA. Ziva nguva yekuyedza ketoni, senge paunenge uchirwara.

Kana iwe ukashandisa insulin pombi, tarisa kazhinji kuti uone kuti insulin iri kuyerera nepakati petubhu. Ita shuwa kuti chubhu haina kuvharwa, kinked kana kubviswa papombi.

DKA; Ketoacidosis; Chirwere cheshuga - ketoacidosis

• Kudya uye insulin kusunungurwa
• Oral glucose kushivirira bvunzo
• Insulin pombi

American Chirwere cheshuga Association. 2. Kupatsanura uye kuongororwa kwechirwere cheshuga: zviyero zvekurapwa mune cheshuga - 2020. Chirwere cheshuga. 2020; 43 (Suppl 1): S14-S31. PMID: 31862745 pubmed.ncbi.nlm.nih.gov/31862745/.

Atkinson MA, Mcgill DE, Dassau E, Laffel L. Type 1 chirwere cheshuga. Mune: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Chinyorwa cheEndocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020: chitsiko 36.

Maloney GE, Glauser JM. Chirwere cheshuga mellitus uye kusagadzikana kweshuga homeostasis. Mune: Masvingo RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts uye Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: chits. 118.