Cutar Somoji, ko Ciwan Injinin Inuwa na Cutar Tsaro (CFSI): alamu, ganewar asali, magani

Elena SKRIBA, endocrinologist na asibitin Clinical na yara na 2 a Minsk

MENE NE SYNDROME?

A cikin 1959, wani masanin ilimin halittu na Baitul-mali na Somoge ya kammala cewa haɓaka glucose na jini na iya zama sakamakon yawan motsa jiki na yawan jini sakamakon yawan ƙwayar insulin da ke ƙaruwa. Masanin ilimin ya bayyana kararraki 4 yayin da masu fama da cutar sankara wadanda suka karɓi daga 56 zuwa 110 IU na insulin a kowace rana sun sami nasarar tsayar da cutar sankara ta hanyar rage adadin insulin da ake sarrafawa zuwa 26-16 IU kowace rana.

Sha'awa ga alamu na yau da kullun na metabolism na metabolism, zaɓi na isasshen kashi na insulin yana gabatar da wasu matsaloli, sabili da haka, yana yiwuwa a wuce sigar da haɓakar ƙwayar cutar insulin, ko cutar Somoji. Halin hypoglycemic shine mummunan yanayin damuwa ga jiki. Tryoƙarin shawo kan shi, ya fara samar da ƙwayoyin tsohuwar ƙwayoyin cuta, aikin wanda yake akasin aikin insulin. Matakan jini na adrenaline, cortisol ("hormones damuwa"), hormone girma ("hormone girma"), glucagon da sauran kwayoyin halittar da zasu iya haɓaka haɓakar sukari na jini.

Ana nuna cutar ta Somoji yayin rashin glucose da acetone a cikin fitsari. Mafi sau da yawa, irin waɗannan yara suna da labile na ciwon sukari tare da yanayin hypoglycemic akai-akai.

Baya ga hare-hare na yau da kullun na yunwar, gumi, da rawar jiki waɗanda ke kama da cututtukan jini, duk marasa lafiya da ke fama da cututtukan Somoji suna yawan korafi game da rauni, ciwon kai, farin ciki, tashin hankalin bacci, ji na "gajiya" da rashin bacci. Barci ya zama na sama, mai rikitarwa, maimaituwa na dare suna maimaitawa. A cikin mafarki, yara sun yi kuka, kururuwa, kuma yayin farkawa, rikice rikice da amnesia an lura dasu a cikin su. Bayan irin wannan dare, yara suna zama masu kaɗaici, bakin ciki, haushi, damuwa a cikin kullun. Wasu suna rasa sha'awar abin da ke faruwa, sun fara yin zurfin tunani, suna zama rufe da kuma nuna son komai ga komai. Kuma wasu, akasin haka, suna da fa'ida, m, fitina. Wasu lokuta, akan asalin tsananin ji na yunwar, suna taurin kai sun ƙi cin abinci.

Yawancin marasa lafiya suna fuskantar rauni na gani kwatsam, da sauri-sauri a cikin nau'i mai haske, "kwari", bayyanar "hazo", "shuru" a gaban idanunsu ko hangen nesa biyu. Waɗannan sune alamun latent ko hypoglycemia hypoglycemia sannan kuma karuwar amsawa a cikin glycemia.

Yaran da ke fama da cutar Somoji da sauri sun gaji da gajiya da kwakwalwa. Kuma idan, alal misali, suna yin sanyi, tafarkin ciwon sukarinsu yana inganta, wanda yake kama da rikicewa. Amma gaskiyar ita ce duk wani cuta da ke haɗuwa a nan yana ɗauka azaman ƙarin damuwa, yana ƙaruwa da matakan maganin cututtukan cututtukan ƙwayar cuta, wanda ke rage yawan adadin insulin da aka sa a gaba. Sakamakon haka, hare-hare na latent hypoglycemia ya zama ƙasa da kullun, kuma lafiyar ta inganta.

Gano wani yawan ƙwayoyin insulin da ke faruwa sau da yawa yana da wahala sosai. Theaddarar bambance-bambancen ilimin lissafi tsakanin matsakaicin ƙaramar matakan sukari na jini a cikin rana yana taimakawa yin hakan. Tare da tsayayyen tafarkin ciwon sukari, yawanci shine 4.4-5.5 mmol / L. A cikin yawan ƙwayar insulin da ake fama dashi, wannan adadi ya wuce 5.5 mmol / L.

Kada ku rikita cutar Somoji da tasirin "sanyin safiya" - wannan ba daidai bane. Ana nuna tasirin "asubahi ta alfijir" ta hanyar hauhawar sukari jini kafin wayewar gari - daga misalin 4.00 - 6.00 na safe. A farkon sa'o'i, jiki yana kunna samar da kwayoyin halittar ciki (adrenaline, glucagon, cortisol, kuma musamman hormone girma - somatotropic), matakin insulin a cikin jini yana raguwa, wanda ke haifar da karuwa a cikin glycemia. Wannan wani sabon abu ne wanda ke faruwa a jikin mutum wanda yake lura da duka mutane, marasa lafiya da lafiya. Amma tare da ciwon sukari, cututtukan alfijir na safiya sau da yawa yana haifar da matsaloli, musamman a cikin matasa waɗanda ke girma da sauri (kuma muna girma, kamar yadda kuka sani, da dare, lokacin da ake samar da hormone girma).

Ana nuna cutar ta Somoji da ƙarancin matakan glucose na jini da karfe 2 zuwa 2 na safe, kuma tare da sanyin safiya na asuba, matakan glucose na jini al'ada ne a waɗannan lokutan.

Sabili da haka, don cimma daidaituwa na sukari na jini, tare da ciwo na Somoji, ya kamata ku rage da kashi 10% na insulin gajeren aiki kafin abincin dare ko kuma tsawan lokacin aiki - kafin lokacin kwanciya. Game da cutar “sanyin safiya” asirin, allurar insulin na matsakaitan lokacin kafin lokacin kwanciya ya kamata a canzawa zuwa wani lokaci daga baya (zuwa awanni 22 zuwa 23) ko kuma za'a iya yin ƙarin jab na insulin a cikin sa'o'i 4-6 na safe.

Kula da yawan insulin na kullum shine daidaita alluran insulin. Idan kuna zargin cutar Somoji, to, ana rage yawan sinadarin insulin yau da kullum daga kashi 10-20% tare da lura da mai haƙuri. Rage kashi na insulin ana aiwatar dashi a hankali, wani lokacin cikin watanni 2-3.

A cikin jiyya, suna haɗe da mahimmancin abinci, motsa jiki, dabaru na hali a cikin yanayin gaggawa da kuma saka idanu akan ciwon sukari.

Ayyukan GASKIYA NA CIKIN KYAUTA INSULIN:

Ra'ayin Cutar Somoji

Tare da ciwon sukari, ƙididdigar daidai na kashi na insulin wajibi ne, amma sau da yawa yana iya zama da wahala a yi, wanda ke cike da rikice-rikice. Sakamakon yawan yawan magungunan ƙwayar cuta shine cutar Somoji. A takaice dai, cuta ce ta rashin lafiyar insulin da ya wuce ta jiki. Masanin kimiyyar Amurka Michael Somoji ya yi nazarin wannan sabon abu a cikin 1959 kuma ya yanke hukuncin cewa yawan shan kwayoyin a jikin mutum yana haifar da hauhawar jini - raguwar glucose din jini. Wannan yana haifar da tashin hankali na hormones contrainsulin da amsa - ricocheted hyperglycemia (ƙara yawan glucose na jini).

Ya juya cewa a kowane lokaci matakin insulin a cikin jini ya wuce abin da ake buƙata, wanda a bangare guda yana haifar da hauhawar jini, a ɗayan - don wuce gona da iri. Kuma kwantar da kwayoyin hormones na haifar da canje-canje a koyaushe a matakin glucose a cikin jini, wanda ke haifar da ingantacciyar hanya na ciwon sukari mellitus, wanda kuma zai iya haifar da ketonuria (acetone a cikin fitsari) da ketoacidosis (rikitarwa na ciwon sukari mellitus).

Misalin Somoji

Don in kara fahimta, na yanke shawarar bayar da misali.

Kun auna sukari, kuma alama ce, ka ce, 9 mmol / L. Don rage wannan darajar, ku shiga insulin kuma ku tafi aiki. Bayan wani lokaci, alamun hypoglycemia ya bayyana, alal misali, rauni. Ba ku da damar cin abinci don ƙara yawan sukari. Bayan lokaci, alamomin zasu tafi kuma kun dawo gida tare da yanayi mai kyau. Amma ta hanyar auna sukari, kun ga darajar 14 mmol / L Yanke shawarar cewa kun sha kaɗan da safe, kun ɗauki insulin kuma kuyi babban allurar.

Kashegari yanayin ya maimaita kansa, amma ba mu raunana ba, kuma ba za mu je likita ba. Kawai kana buƙatar allurar ƙarin insulin ne. 🙂

Wannan halin na iya ci gaba na tsawon makonni. Kuma duk lokacin da za ku yi ta ƙaruwa da ƙari. Ciwon kai da matsanancin nauyi zai bayyana babu matsala. A wannan lokacin ne mata yawanci suke gudu zuwa ga likita. Maza suna da haƙuri, kuma suna iya rayuwa har ma da ƙarin rikitarwa.

Alamomin Cutar Somoji

Don takaitawa. Idan kun lura da alamun cutar da aka lissafa a ƙasa, kada ku jinkirta kuma ku je wa likita:

• Akai-akai na yawan haila
• Surges mara hankali a cikin sukari
• Bukatar ƙara yawan adadin in inshin cikin insulin
• Rashin nauyi mai nauyi (musamman akan ciki da kan fuska)
• Ciwon kai da rauni
• Barci ya zama babu hutawa kuma ba na sama ba
• Akai-akai da mara ma'ana
• Visionarancin gani, hazo, ko kuzari a idanu

Somoji ciwo - fasali

1. Wasu mutane suna rikita wannan cutar tare da cututtukan alfijir. Don tabbatar da cewa kana da Somoji, auna sukari sau da yawa cikin dare tare da jinkiri na 2-3 hours. Idan glucose ba ya sauka, kuna da cutar sanyin asuba kuma kuna buƙatar ƙara yawan insulin. Tare da sukari na al'ada da dare, amma alamu na yau da kullun da aka jera a sama, kuna buƙatar rage adadin insulin, tunda kuna da cutar Somoji.

2. Hakanan, wannan ciwo yana da sauƙin ganewa a cikin dakin gwaje-gwaje. Ana ɗaukar samfurori na fitsari a lokuta daban-daban. Idan wasu samfurori suna da acetone, amma ba wasu ba, to, sukari yana sama saboda tsawan jini, kuma wannan alama ce bayyananniyar Somoji.

3. Don kawar da ciwo, kuna buƙatar rage rage yawan insulin zuwa 10-20%. Idan bayan mako guda yanayin da sukarin jini bai inganta ba, dole ne ka nemi likita don ya zaɓi mafi kyawun magani a gare ka.

Yana da mahimmanci a tuna cewa sukari mai yawa na iya haifar da wasu, masu rikitarwa masu wahala. Sabili da haka, ya zama dole a magance wannan ciwo mara kyau da wuri-wuri.

Menene wannan

Ta wannan sunan ana nufin cikakkiyar bayyanannun bayyanannun abubuwa waɗanda ke faruwa yayin yawan ƙwayar insulin.

Dangane da haka, yana iya haifar da yawan amfani da kwayoyi masu dauke da sinadarin insulin, wanda ake gudanar da shi wajen maganin masu cutar siga.

In ba haka ba, wannan ilimin ana kiransa farfadowa ko hyhyglycemia na posthypoglycemic hyperglycemia.

Babban dalilin ci gaban ciwo shine maganganu na hypoglycemia, wanda ke faruwa tare da rashin amfani da magungunan da ke rage yawan glucose a cikin jini.

Babban rukuni na hadarin shine marasa lafiya waɗanda yawanci ana tilasta su yin amfani da allurar insulin. Idan ba su bincika abubuwan da ke cikin glucose ba, ba za su iya lura da cewa adadin maganin da suke bayarwa ya yi yawa ba.

Sanadin sabon abu

Increasedara yawan sukari yana da haɗari sosai, saboda yana lalata metabolism. Sabili da haka, ana amfani da wakilai na hypoglycemic don rage shi. Yana da muhimmanci sosai a zabi ainihin sigar da ta dace da wannan ko mara lafiyar.

Amma wani lokacin ba za a iya yin wannan ba, sakamakon wanda haƙuri ke karɓar insulin fiye da yadda jikinsa yake buƙata. Wannan yana haifar da raguwa mai yawa a cikin matakan glucose da haɓaka yanayin hypoglycemic.

Hypoglycemia mara kyau yana rinjayar da lafiyar haƙuri. Don magance tasirin sa, jikin ya fara samar da adadin abubuwa masu kariya - homon mai mamaye abubuwa.

Suna raunana aikin insulin, wanda ke dakatar da hanawar glucose. Bugu da ƙari, waɗannan kwayoyin suna da tasiri mai ƙarfi akan hanta.

Ayyukan samar da sukari da wannan jikin ke yi yana ƙaruwa. A ƙarƙashin rinjayar waɗannan halaye guda biyu, akwai glucose mai yawa a cikin jinin mai ciwon sukari, wanda ke haifar da hyperglycemia.

Don magance wannan sabon abu, mai haƙuri yana buƙatar sabon yanki na insulin, wanda ya wuce na baya. Wannan kuma yana haifar da hypoglycemia, sannan kuma hyperglycemia.

Sakamakon haka raguwa ne ga hankalin mutum ga insulin da kuma buƙatar karuwa koyaushe a cikin yawan ƙwayoyi. Koyaya, duk da karuwa a cikin insulin, hyperglycemia baya tafiya, tunda akwai yawan zubar da jini akai akai.

Wani abu kuma da ke haifar da karuwa a cikin glucose shine karuwa a cikin abinci wanda ya haifar da yawan insulin. Saboda wannan hormone, abubuwan da ke haifar da ciwon sukari kullum suna fama da yunwar, wanda shine dalilin da yasa ya karkata wajen cin abinci da yawa, gami da sinadarai a cikin carbohydrates. Wannan kuma yana haifar da hyperglycemia.

Wani fasalin ilimin aikin cuta shine wanda yawanci hypoglycemia baya bayyana kansa tare da alamun bayyanar cututtuka. Wannan shi ne saboda isasshen tsalle-tsalle a cikin matakan sukari, lokacin da manyan kuɗi suka juya zuwa ƙasa, sannan kuma mataimakin.

Sakamakon saurin waɗannan hanyoyin, mai haƙuri bazai lura da yanayin hypoglycemic ba. Amma wannan ba ya hana cutar daga ci gaba, tun da ma lokuta masu rauni na hypoglycemia suna haifar da tasirin Somogy.

Of Alamomin wata yawan yawan yawan ƙwayar cuta

Don ɗaukar matakan da suka dace, ya zama dole a lura da cutar ta hanyar da ta dace, kuma wannan yana yiwuwa ne kawai tare da sanin alamun ta.

Abubuwan Somoji a cikin nau'in ciwon sukari na 1 ana nuna shi ta fuskoki kamar su:

• yawan kaifi mai kaifi a cikin glucose,
• jihar hypoglycemic (ana haifar da ita ta hanyar wucewar insulin),
• nauyi riba (saboda tsananin yunwa, mai haƙuri ya fara cinye abinci),
• yunwar kullun (saboda yawan insulin, wanda ke rage matakan sukari da yawa),
• ƙarancin ci (yana haifar da karancin sukari a cikin jini),
• kasancewar jikin ketone a cikin fitsari (ana fitar dasu saboda sakin kwayoyin halittun da ke haifar da tarin fats).

A matakin farko na haɓakar wannan cuta, alamu masu zuwa na iya bayyana a cikin marasa lafiya:

• ciwon kai
• tsananin farin ciki
• rashin bacci
• rauni (musamman da safe),
• rage aiki
• yawan maimaicin dare
• nutsuwa
• yawan canza yanayi
• karancin gani
• tinnitus.

Waɗannan fasalulluka halayen halayyar ɗan adam ne. Yawancin abin da ya faru na iya kasancewa yana nuna yiwuwar farkon ci gaban tasirin Somoji. Nan gaba, waɗannan alamun zasu iya bayyana na ɗan gajeren lokaci (saboda ci gaba da yanayin cututtukan cuta), saboda wanda mara lafiya na iya lura da su.

Tunda hypoglycemia ya haifar da yawan yawan insulin ko wasu magungunan hypoglycemic, yana da kyau a nemi likita don daidaita sashi ko zaɓi wani magani har sai ya kai ga haifar da ciwo na Somoji.

Ta yaya za a tabbatar da bayyanuwar sakamako?

Kafin a magance kowace cuta, kuna buƙatar gano shi. Kasancewar bayyanar cututtuka alama ce kawai ba kai tsaye.

Bugu da kari, yawancin alamomin cutar Somoji suna kama da cutar yawan jiki ko kuma yawan aiki.

Kodayake yanayin hypoglycemic yana daya daga cikin haɗari, ana kulawa da shi daban da cutar ta Somogy.

Kuma dangane da aiki fiye da kima, ana buƙatar sauran matakan gabaɗaya - mafi yawan lokuta, mutum yana buƙatar hutawa da annashuwa, kuma ba magani ba. Sabili da haka, wajibi ne a rarrabe waɗannan matsalolin don amfani da ainihin hanyar magani wanda ya dace da yanayin.

Dole ne a tabbatar da wani ciwo kamar su cutar ta Somoji, wanda ba abu bane mai sauki. Idan kuka mayar da hankali kan gwajin jini, zaku iya lura da cin zarafi a tsarinta. Amma waɗannan cin zarafin na iya nuna duka yawan insulin na shaye-shaye (aikin da ake lura da shi) da kuma rashi.

Hakanan kuna buƙatar gaya masa game da duk alamun da aka gano, saboda kwararren ya yi ra'ayi na farko. Dangane da shi, za a gina ƙarin gwaji.

Akwai hanyoyi da yawa don tabbatar da kasancewar wata alama.

Wadannan sun hada da:

1. Cutar kansa. Amfani da wannan hanyar, ya kamata a auna glucose a cikin kowane sa'o'i 3 da fara daga 21:00. Da karfe 2 na safe da safe jikin mutum yana ɗauke da ƙananan buƙatar insulin. Babban mataki na miyagun ƙwayoyi, wanda aka gudanar da maraice, ya fadi daidai a wannan lokacin. Tare da sashi ba daidai ba, za a lura da raguwar yawan glucose.
2. Binciken dakin gwaje-gwaje. Ana amfani da gwajin fitsari don tabbatar da kasancewar irin wannan cutar. Yakamata mai haƙuri ya tattara fitsari yau da kullun, wanda aka bincika don abubuwan jikin ketone da sukari. Idan hypoglycemia yana faruwa ta hanyar wuce haddi na insulin wanda aka gudanar da maraice, to ba za'a gano waɗannan abubuwan haɗin a cikin kowane samfurin ba.
3. Bambancin ganewar asali. Somoji ciwo yana da kamanceceniya da Morning Dawn Syndrome. Hakanan ana saninsa da haɓakar matakan glucose da safe. Don haka, wajibi ne a rarrabe tsakanin waɗannan jihohin biyu. Morning Dawn Syndrome ana sanadin jinkirin ƙaruwa a cikin glucose tun yamma.Yana isa iyakar safiya. Tare da tasirin Somoji, ana lura da daidaitaccen matakin sukari da maraice, to, yana raguwa (a tsakiyar dare) kuma yana ƙaruwa da safe.

Abubuwan da ke kama da juna tsakanin yawan yawan insulin da rashin lafiyar alfijir na safe yana nufin cewa bai kamata ku ƙara adadin ba idan kun sami matakan sukari mai yawa bayan farkawa.

Wannan yana da tasiri kawai lokacin da ya cancanta. Kuma kawai ƙwararren masani ne kawai zai iya gano sanadin wannan abin mamakin, wanda lallai ne ku juya.

Koyarwar bidiyo akan lissafin sashin insulin:

Abinda yakamata ayi

Tasirin Somoji ba cuta ba ce. Wannan shi ne amsawar jiki wanda ya haifar da rashin kulawa ga masu ciwon sukari. Saboda haka, lokacin da aka gano shi, basa magana game da magani, amma game da gyaran allurai insulin.

Likita yakamata yayi nazarin dukkan alamomin sannan ya rage rabon magungunan dake shigowa. Yawanci, ana rage 10 10%. Hakanan kuna buƙatar canza jadawalin don gudanar da kwayoyi masu dauke da insulin, yin shawarwari akan abincin, ƙara yawan aiki na jiki. Kasancewa mara haƙuri a cikin wannan tsari shine bin ka'idoji da kuma sa ido akai na canje-canje.

1. Abincin far. Yawan adadin carbohydrates wanda ya zama dole don kula da mahimmancin aiki ya kamata ya shiga jikin mai haƙuri. Ba shi yiwuwa a cutar da samfuran tare da babban abun ciki na waɗannan mahadi.
2. Canza jadawalin don amfani da kwayoyi. Ana gudanar da jami'ai masu dauke da insulin kafin abinci. Godiya ga wannan, zaku iya kimanta amsawar jikin mutum game da haɗarin su. Bugu da ƙari, bayan cin abinci, abubuwan da ke cikin glucose yana ƙaruwa, don haka aikin insulin zai zama barata.
3. Aiki na Jiki. Idan mai haƙuri ya guji motsa jiki, an ba shi shawarar yin motsa jiki. Wannan zai taimaka wajen haɓaka tasirin glucose. Ya kamata masu haƙuri da cutar Somoji su yi motsa jiki kowace rana.

Bugu da kari, gwani yakamata ya bincika fasalolin aikin kwayoyi. Da farko, ana gwada tasirin insulin basal na dare.

Na gaba, ya kamata ku kimanta martanin jikin mutum game da kwayoyi na yau da kullun, da kuma tasirin magunguna masu gajeriyar hanya.

Amma ƙa'idar aiki ita ce rage yawan insulin da ake sarrafawa. Ana iya yin wannan da sauri ko a hankali.

Tare da canji mai sauri a cikin sashi, ana ba da sati 2 don canjin, a lokacin da mara lafiya ya sauya zuwa adadin maganin da yake wajibi a yanayinsa. Rage kashi na hankali na iya ɗaukar watanni 2-3.

Yadda ake aiwatar da gyaran, kwararren ya yanke shawara.

Wannan ya rinjayi abubuwa da yawa, waɗanda suka haɗa:

• sakamakon gwaji
• tsananin tsananin yanayin
• fasalin jikin mutum
• shekaru, da sauransu.

Ragewar matakan glucose na jini yana taimakawa ga dawo da hankali ga yanayin hypoglycemic. Decreasearin raguwar sassan insulin ɗin da aka gudanar zai tabbatar da daidaituwa game da amsawar jikin ga ɓangarorin warkewa.

Ba a yarda da aiwatar da matakan gyara ba tare da taimakon likita ba. Rage sauƙin sauƙi (musamman ma kaifi) na iya haifar da matsanancin rashin ƙarfi a cikin haƙuri, wanda zai haifar da mutuwa.

Sabili da haka, idan kuna zargin cutar yawan ƙwayar cuta, kuna buƙatar magana tare da likitan ku. Wannan sabon abu yana buƙatar matakan da suka dace da dacewa, ingantaccen bayanai da ƙwarewa na musamman.

Sanadin da sakamako

Glucose shine asalin tushen ƙarfin, '' man '' wanda jijiyoyinmu, gabobin ciki da kwakwalwa suke amfani da shi. Saboda haka, jiki yana ɗaukar raguwa mai sauƙi a cikin glucose jini a matsayin alama ce ta haɗari, kuma lokacin da ya faɗi ƙasa, yana haɗa da hanyoyin kariya:

• Sakin mahaifa (counterinsulinic) ko hormones na “hyperglycemic” an saki su cikin jini: adrenaline, norepinephrine, cortisol, glucagon, hormone girma,
• yana kunna rushewar polysaccharide glycogen (a wannan nau'in, an adana isassun kayan glucose a cikin hanta), sukarin da aka saki yana shiga cikin jini,
• sakamakon kitse na sarrafa kitse, ana kirkiro jikkunan ketone, kuma acetone yana bayyana a cikin fitsari.

A wasu halaye, yawan glucose yana raguwa da sauri wanda mutum bai lura da yawan zubar jini ba, ko kuma ya bayyana a yanayin zafi, kuma ana iya rikita shi da gajiya, yawan aiki, malaise daga mura. An bayyana irin waɗannan cututtukan hypoglycemia a matsayin latent (props). Idan ana yawan maimaita su, masu ciwon sukari sai su daina jin su, wanda hakan ke nuna cewa baya rama su akan lokaci.

Har ila yau, yin rauni yana da haɗari saboda jiki yana amfani da shi zuwa matakin glucose na al'ada wanda yake al'ada (alal misali, a kan komai a ciki - 10-12 mmol / l, bayan cin abinci - 14-17 mmol / l). Rashin amsa ta waje ga sukari mai girma ba yana nufin hakan ba zai haifar da rikicewar ciwon sukari ba! Koyaya, lokacin ƙoƙarin ramawa game da ciwon sukari, mutum yana fuskantar gaskiyar cewa raguwa da glucose na jini zuwa tsarin dabi'a yana haifar dashi hypoglycemia da sake dawo da hyperglycemia.

Yawan insulin na insulin na yau da kullun yana tare da kowane nau'in ciwon sukari idan ana amfani da allurar insulin a cikin jiyyarta. Masana ilimin kimiyya na endocrinologist zasuyi zargin cutar ta Somoji idan aka kara yawan maganin ba zai taimaka wajen magance cutar ba. Misali, sukari ya tashi zuwa 11.9 mmol / l, insulin da ya kamu da ciwon suga, bayan wani dan lokaci sai yaji wani dan karamin haske (alamar rashin karfin jini), wanda yayi saurin wucewa, amma tare da sikari na gaba da glucoseeter ya nuna 13.9 mmol / l. Bayan ya yi amfani da insulin da kashi mai yawa, sukari ya kasance mai girma, mutumin ya sake karuwa kashi kuma sake bai sami sakamakon ba: “mummunan yanayin da” cutar Somoji ta rufe. Irin waɗannan mutane suna cewa sun damu:

• yawan haila, yawan zubar jini a cikin jini (gwaje-gwaje),
• yunwa kullum, me yasa suke samun nauyi,
• malaise na gaba ɗaya, rashin iya aiki da hankali da ƙwaƙwalwa,
• acetone a cikin fitsari da jini tare da ƙaramin matakin glucose na jini.

Marasa lafiya sun yi mamakin cewa sukari da wadatar lafiya suna ƙaruwa lokacin da suka ƙaru da adadin insulin, kuma suna haɓaka lokacin da suka ragu. Wasu mutane suna jin daɗi ta hanyar kamuwa da mura na yanayi: tare da mura, buƙatar insulin ya ƙaru, kuma yawan shan ruwa ya zama isasshe.

Yaya ba za a rasa jinin haila ba?

Somoji ciwo yana haifar da bayyananniyar rashin aiki da kuma latent na hypoglycemia, kuma kuna buƙatar samun damar ganewa da rama ayyukan props. Ko da ba su ji da kansu ba, ana iya gane su da alamu kai tsaye:

• Kai harin kai da ciwon kai wanda yake koma baya idan ka ci alewa, cokali mai yawa na zuma.
• Canje-canje yanayi ba zato ba tsammani: cutar rashin daidaituwa, rashin damuwa ko rashin damuwa.
• Abubuwa masu ƙyalƙyali, "kwari", doan dige a gaban idanun. Wasu lokuta wannan yakan faru ne kafin wucewa, amma a wannan yanayin, babu asarar hankali.
• Damuwar bacci: da yamma mutum yana da wahalar yin bacci, yana da bacci, da safe yana da wahalar farkawa, yana jin bacci, kuma a ranar ya zama mai bacci.

Iyaye masu saurin hankali sun lura da rashin karfin jiki a cikin jariri idan ya kasance, yana wasa da son rai, ba zato ba tsammani ya rasa sha'awa a cikin aikin sa, ya zama mara hankali, ya fara aiki, dariya, kuka. A kan titi, yaro ya yi gunaguni cewa '' kafafuwan da suka gaji ', ya nemi hannuwansa ko yana son shakatawa a kan benci. Tare da rashin lafiyar ɗan adam, jariri ya ɗinka ya juya, ya yi kuka, ya yi nishi a cikin mafarki, ya ƙi zuwa kindergarten, domin bai yi bacci ba.

Binciko

Binciken ciwo na Somogy yana da wahala fiye da sauran rikice-rikice na ciwon sukari. Rashin halayen tsarin jini a cikin masu ciwon sukari iri daya ne yayin rashin insulin saboda yawan lissafin da bai dace dashi ba, kuma sakamakon yawan zubar jini da yake dashi.

Don kada ku rasa matsala, ya kamata ku yi aiki tare da likita don kafa tushen ganewar asali: ɗaukar matakan sukari na jini bisa ga tsarin da ya ba da shawarar, kula da abin da bayyanar cututtuka da ba a bayyana ba. Kafin tafiya zuwa asibiti, yana da daraja 'yan kwanaki don lura da matakan glucose, wannan zai taimaka wa likita don yin gwajin farko da kuma tsara gwaje-gwaje don fayyace shi.

1. Ganin kansa. Don kwanaki da yawa, auna glucose a kowane sa'o'i uku da farawa daga 21:00. Yawancin lokaci hypoglycemia yana bayyana kanta a tsakiyar dare (daga 2.00 zuwa 3.00): buƙatun ilimin insulin na insulin a wannan lokacin yana raguwa, a wannan lokacin na rana akwai ganiya a cikin aikin homonin da aka gudanar da yamma. Lokacin da kashi yafi girma fiye da yadda ake buƙata, hypoglycemia yana yiwuwa a kowane lokaci na dare, saboda haka ma'aunin kada ta iyakance ga wannan tazara kawai.
2. Nazarin. Don gano cututtukan Somoji, ana wajabta wa mara lafiya kullun kuma anyi gwajin fitsari a jikin sukari da jikin ketone. Tare da hypoglycemia a bango na yawan zubar jinin insulin da yamma, ba'a samo sukari da acetone a duk samfuran ba.
3. Bambancin ganewar asali tare da "ciwo sanyin safiya." Mai ciwon sukari da kansa na iya zargin cutar ta Somoji idan ya kula da yanayin sa. Idan sukari na jini ya fara tashi da yamma kuma ya kai iya da safe, muna magana ne game da "cutar sanyin asuba." Tare da yawan wuce haddi na insulin, mai nuna alamar glucose yana da kwanciyar hankali a farkon dare, yana fara raguwa ta tsakiya, daga baya kuma ya ƙaru.

Sabili da haka, lura da babban matakin glucose da safe, kada ku yi sauri don daidaita allurai maraice, musamman idan kun yi ƙoƙarin ƙara yawan kashi sau ɗaya, ba ku yi nasara ba. Faɗa wa likita game da abubuwan lura, kuma zai tsara gwaje-gwaje don gano musabbabin canje-canje.

Cutar Somoji ba cuta ba ce, amma alama ce ta wani yanayi wanda rashin isasshen ilimin insulin ya haifar. Idan kuna tsammanin ƙwayar yawan ƙwayar cutar insulin, wanda aka tabbatar ta hanyar gwaje-gwaje, likita zai rage kashi na yau da kullun na kashi 10-20% kuma ya ba ku shawarwari don dubawa da kanku. A lokaci guda, canje-canje na gabatarwar, abubuwan abinci da abubuwan motsa jiki ana daidaita su:

• adadin carbohydrates kada ta wuce bukatar ilimin halittar jiki,
• allurar allura kafin kowace abinci,
• ga waɗancan mutanen da basu mai da hankali ga aikin jiki ba, ana bada shawarar motsa jiki koyaushe.

Jiyya yana farawa tare da likita, tare da mai haƙuri, da farko sarrafa yadda insulin basal yake aiki, sannan bincika amsawar jiki zuwa lokacin rana, sannan kuma ga insulins-gajere. Rage guda na iya zama cikin sauri da jinkirin:

• a farkon magana, ya kai kimanin sati biyu,
• a karo na biyu - watanni 2-3.

Yanke shawara game da wace hanya ce likita zai yi amfani da ita, la'akari da bayanan bincike, yanayin mai haƙuri da sauran abubuwan. Lokacin da matakan glucose na jini ya ragu, mai ciwon sukari zai sake jin ciwon jini, da alama tsallakewa zai ragu, kuma hankalin insulin zai koma al'ada.

Abubuwan tarihi

A karo na farko, anyi nasarar amfani da insulin a cikin shekarar 1922, bayanda aka fara cikakken nazarin tasirin sa akan jikin, an gudanar da gwaje-gwaje akan dabbobi da mutane. Masana kimiyya sun gano cewa yawancin magunguna a cikin dabbobi suna haifar da girgizawar jini, yawanci yakan haifar da mutuwa. An ba da shawarar cewa akwai sakamako mai guba da yawa daga cikin kwayoyin a jikin mutum. A waɗannan shekarun, an yi amfani da maganin don magance marasa lafiya na anorexia don ƙara nauyin jikinsu. Wannan ya haifar da canje-canje koyaushe a cikin matakan glucose jini, canzawa daga hypoglycemia zuwa hyperglycemia. A ƙarshen hanya, mai haƙuri ya nuna alamun ciwon sukari. Sakamakon iri ɗaya ya faru a cikin ilimin hauka, a cikin lura da marasa lafiya da schizophrenia tare da "girgizar insulin." Halin tsakanin karuwar kashi na insulin da haɓaka a cikin glycemia ya kuma bayyana a cikin lura da ciwon sukari mellitus. Wannan sabon abu ya zama sananne daga baya kamar cutar Somoji.

Tayaya zaka iya fahimtar cewa jikin yana fuskantar matsalar yawan insulin? Kwayar cutar ta Somoji tana bayyana ta bayyanar cututtuka masu zuwa:

• akwai tabarbarewa a lafiyar gaba ɗaya, rauni ya bayyana,
• ciwon kai na kwatsam, amai, wanda zai iya wucewa bayan cin abinci tare da abinci,
• barcin ya rikice, ya zama damuwa da na zahiri, mafarki mai ban tsoro ya saba mafarki,
• akwai ji na kullun gajiya, bacci,
• Zai yi wuya a farka da safe, mutum yakan ji kamar ya sha kansa,
• hargitsi na gani na iya bayyana a cikin yanayin hazo a gaban idanun, rufaffiyar fuskoki ko kuma wasu abubuwa masu haske,
• kwatsam yanayi sauya, sau da yawa a cikin wani mummunan shugabanci,
• karuwar ci, nauyi mai yawa.

Irin waɗannan bayyanar cututtuka ƙararrawa ne mai ban tsoro, amma ba zai iya zama tabbataccen dalili don yin bincike ba, saboda alamun alamun cututtuka ne da yawa. Ana iya bincika cikakkiyar hoton hanyoyin da suke gudana a jiki ta amfani da nazarin.

Bambancin ganewar asali

Lokacin da aka bincika, cutar ta Somogy ta kasance mai sauƙin rikicewa tare da alamun bayyanar “sanyin safiya”, tunda alamun a cikin waɗannan cututtukan guda biyu daidai suke. Koyaya, akwai bambance-bambance masu mahimmanci. Abin mamakin "sanyin asuba" yana faruwa ne ba kawai a cikin marasa lafiya da masu ciwon sukari ba, har ma a cikin mutane masu lafiya, yana bayyana kanta a cikin tashin hankali na asuba. Wannan ya faru ne sakamakon karancin matakan insulin na basal sakamakon lalacewarsa ta hanzari a cikin hanta ko tare da karuwar rufin asirin a cikin safiya. Ba kamar cutar Somoji ba, bayyanuwar wannan sabon abu shine wanda ke faruwa a cikin haila. Don yin daidaitaccen ganewar asali, kuna buƙatar sanin matakin glycemia daga biyu zuwa huɗu da safe, an rage shi a cikin mai haƙuri tare da ciwo na yawan ƙwayar cuta, kuma a cikin haƙuri tare da hyperglycemia na wayewar gari ba ya canzawa. Kulawa da wadannan cututtukan daidai ne akasin haka: idan a farkon batun an rage yawan insulin, to a kashi na biyu ana ƙaruwa.

Siffofin kamuwa da cutar sankarau tare da cutar Somoji

Haɗuwa da ciwon sukari mellitus tare da ƙwayar insulin overdose syndrome (ACSI) yana ba da sakamako mai lalata, cutar tana da wahala musamman. A kan tushen yawan magungunan ƙwayoyin cuta na yau da kullun, hauhawar jini yana ɗaukar wani tsari mai ɓoye. Cutar Somoji a cikin ciwon sukari tana shafan duka yanayin yanayin mai haƙuri da halayyar sa.

Canje-canje kwatsam cikin yanayi ba tare da wani takamaiman dalili ba - yawan faruwa tare da irin wannan cutar. Tare da sha'awar kowane kasuwanci ko wasa, bayan wani lokaci mutum ba zato ba tsammani mutum ya rasa sha'awar duk abin da ya faru, ya zama mai kishin ƙasa da rashin kulawa, ba da son kai ga yanayin waje. Wani lokaci ana iya lura da fushi ko rashin jituwa. Sau da yawa akwai yawan ci a cikin haƙuri, amma, duk da wannan, wani lokacin akwai mummunan halin rashin abinci ga mutum, mutum ya ƙi abinci. Irin waɗannan bayyanar cututtuka suna faruwa a cikin 35% na marasa lafiya. Complaintsarin ƙarin gunaguni na yau da kullun sun haɗa da rashin ƙarfi, amai, ciwon kai, da tashin hankali na bacci. Wasu suna lura da rauni na gani kwatsam da gajeriyar magana (a cikin wata mayafar a gaban idanunsa ko "kwari").

Jiyya don cutar Somoji ta ƙunshi ƙididdigar lissafin daidai na kashi na insulin. Don wannan, dole ne a daidaita adadin maganin da aka sarrafa, ana rage shi da 10-20% tare da tsayayyen saka idanu akan yanayin haƙuri. Yaya tsawon lokacin da Somoji ciwo yake bi? Ya danganta da alamomin mutum daban-daban, ana amfani da hanyoyi daban-daban na gyara - sauri da sauri. Na farko ana aiwatar da makonni biyu, na biyu yana ɗaukar watanni 2-3.

A duban farko, zaku yi tunanin cewa rage yawan sinadarin insulin zai haifar da bacewar cutar, amma wannan ba haka bane. Kawai raguwar adadin magungunan da ake sarrafawa ba ya inganta hanyar ciwon sukari; hadadden magani ya zama dole. Yana shafar abincin (ƙayyadadden adadin carbohydrates da aka cinye tare da abinci), aikin jiki. Ana gudanar da insulin kafin kowane abinci. Hanyar da aka haɗa kawai zai iya ba da sakamako mai kyau a cikin yaƙi da cutar ta Somoji.

An gano cewa yanayin yawan insulin da yake fama dashi na lokaci yana da tsinkaya mai kyau.Yana da mahimmanci kula da kanku, alamun sutturar jiki, kowane canje-canje a cikin yanayin ku, kuma idan kun ji mummunan rauni, nan da nan ku nemi likita, misali, Cibiyar Endocrinology a Akademicheskaya (Moscow). A cikin kyakkyawan sakamako na jiyya, babban aikin yana aiki ne ta hanyar ƙwarewa da ƙwarewar likita. Tare da ciwo wanda ba a bincika shi ba, ƙaddarawar ba ta da matsala: ci gaba da yaduwar insulin zai ƙara dagula yanayin haƙuri, yanayin ciwon sukari ya ƙaru.

Yin rigakafin

Babban mahimmancin rigakafin CAPI sun haɗa da jerin matakan.

• Tare da ciwon sukari, abincin da aka zaɓa daidai ga mai haƙuri da kuma ba da tabbacin ramawa ga ƙwayar ƙwayar carbohydrate dole ne a bi shi sosai. Ya kamata mutum ya tsara abincinsa, ya iya ƙididdige darajar carbohydrate na abincin da aka ƙone, kuma idan ya cancanta, yi cikakken canjin samfurin.
• Ana aiwatar da ilimin insulin a cikin allurai da suka dace don wani mai haƙuri. Aikin likita shine yin gyare-gyare idan ya cancanta, kuma mai haƙuri ya kamata ya lura da alamun jikinsa.
• Yin aiki na yau da kullun yana da mahimmanci ga masu ciwon sukari, musamman idan mai haƙuri ya jagoranci salon rayuwa mai rauni ko kuma yana da aikin kwance.
• Kullum sanya idanu game da cutar, tattaunawa na endocrinologist akan tsarin mutum kuma kamar yadda ya cancanta.
• Ingantaccen kimantawa game da yanayin jikin mutum, kyautatawa, gano saurin alamun alamun rashin tabbas.
• Creatirƙirar yanayi don gudanar da kamun kai a rayuwar yau da kullun, nazarin ƙa'idodin sarrafa kai ga marasa lafiya da membobin iyali.

Cutar Somoji a cikin yara

Yaran da ke fama da ciwon sukari ba koyaushe suna sa ido kan canje-canje a yanayin jikinsu ba, galibi wannan yana ganin ba zai yiwu ba, saboda haka sarrafa yanayin cutar shine damuwar iyaye. Ya kamata a kula don lura da jaririn da yake bacci, tunda aikin insulin yana faruwa ne da daddare, kuma halin yaron zai iya faɗi sosai. Lokacin da ciwo ya bayyana, barcinsa ya zama ba shi da hutawa kuma na sama, tare da numfashi mai amo. Yaro na iya kururuwa ko ya yi kuka a cikin mafarki saboda fargaba. Farfaɗo da wahala, nan da nan bayan an rikice.

Duk waɗannan bayyanannun alamu alama ce ta yanayin rashin haila. Duk ranar da yaron ya kasance mai rauni, yana da hankali, ya fusata, bai nuna sha'awar wasanni ko karatu ba. Tashin hankali na iya faruwa ba zato ba tsammani, ba gaira ba dalili, kan aiwatar da kowane aiki. Abubuwan fashewa marasa ƙarfi da tashin hankali suna da yawa, canjin yanayi ya zama wanda ba'a iya faɗi ba. Sau da yawa yara masu fama da cutar suna fama da baƙin ciki. Ana gudanar da jiyya a kan ka'idar kamar yadda ake amfani da shi a cikin manya. Cibiyar Endocrinology a Ilimi, alal misali, tana taimaka wa yara su jimre da cutar ta Somoji.