Ukwelashwa kwe-hyperglycemia kuncike ezinhlobonhlobo zezici, kuhlanganise ubude bokuvama kanye nokuvama kwe-hyperglycemia kanye nobukhulu bayo, kanye nobudala bomuntu, impilo, kanye nokuqonda. Isibonelo, umuntu osekhulile onomlando wezempilo obunzima kanye nomsebenzi ongenamkhawulo wokucabangela kufanele aphathwe kakhulu kunomuntu omncane, ophilile ophikisana nesifo sikashukela esanda kutholakala.
I-American Diabetes Association (ADA) igcizelela ukubaluleka kwezinhlelo zokwelashwa ezizimele kubantu bonke abanesifo sikashukela. Futhi, nakuba babe ne-algorithm ezinikezelwe ekusizeni odokotela ukuba banikeze imithi yokusiza ukwelapha i-hyperglycemia, umuntu ngamunye kufanele ahlale ebeka kuqala.
Uma kwenzeka uthola i-hyperglycemia, kunezinto ongayenza ekhaya ukuze uphathe, futhi. Kodwa, ngokuya ngesilinganiso se-hyperglycemia, kungadingeka uxhumane nomhlinzeki wakho wezempilo ukuze uthole usizo ekushintsheni uhlelo lwakho lwezokwelapha. Ezimweni ezimbi kakhulu njengeziphuthumayo zesifo sikashukela i-ketoacidosis (DKA), usizo luyadingeka.
Amakhambi asekhaya kanye nendlela yokuphila
Ukuphathwa kwempilo kuyisici esibalulekile ekwelapheni i-hyperglycemia. Empeleni, yonke imithi yesifo sikashukela ihloswe ukuthi isetshenziswe ekushintsheni kokudla kanye nokuguqula indlela yokuphila. Uma umuntu engashintshi indlela yakhe yokuphila futhi athembele emithini yokwelapha yedwa, ekugcineni leyo mithi izoyeka ukusebenza futhi kuyodingeka yengeze imithi eminingi ukuze ilawulwe ushukela wegazi.
Isihluthulelo sokuguqula indlela yokuphila ukuthola ukwesekwa nokuhlala njalo. Ukusekelwa ngendlela yezemfundo, ikakhulukazi imfundo yokuziphathisa ukuphathwa kwe-diabetes (DSME), izosiza. I-ADA itusa ukuthi bonke abantu abanesifo sikashukela bathole i-DSME ekuxilongweni, ngonyaka ukuze kuhlolwe ukudla okunomsoco kanye nezidingo zomzwelo, lapho kuphakama izici ezintsha eziyinkimbinkimbi ezithonya ukuzilawula, futhi uma kuguqulwa ekunakekeleni kwenzeka.
I-DSME ingakusiza wenze izinguquko endleleni yakho yokuphila. Izinguquko ezilandelayo zokuphila zingaphatha i-hyperglycemia:
Ukudla
Ama-carbohydrate asithinta ama- sugar sukari kakhulu . Ukudla ama-carbohydrate amaningi ngokweqile, njengezinhlamvu ezimhlophe (isinkwa esimhlophe, imiqulu, ama-bagels, amakhukhi, irayisi, i-pasta, ama-crackers, amaswidi), ukudla okunoshukela, neziphuzo eziphuzozayo kungandisa ingozi yokuxoshwa komzimba. Ngakho-ke, ukudla ukudla okuphethwe nokuguqulwa okune-fiber kungasiza.
Akekho odlayo okuphelele ophethwe yisifo sikashukela. I-ADA ithi bonke abantu bathola ukwelapha okunomsoco ngokwemvelo (MNT), okungcono yi-dietitian obhalisiwe onolwazi futhi onolwazi lwe-MNT eqondene ne-diabetes. Ucwaningo luye lwabonisa ukuthi i-MNT ehlinzekwa ngumuntu odlayo ihlotshaniswa nokuncipha kwe-A1C kwamaphesenti angu-0.3 kuya ku-1 kubantu abane-type 1 yesifo sikashukela kanye no-0.5 kuya ku-2 amaphesenti kulabo abane-type 2 yesifo sikashukela.
Ukuzivocavoca
I-ADA ithi ukuphula umsebenzi owenziwe ngokweqile nokugwema isikhathi esinqunyiwe sokuhlala kungavimbela uhlobo lwesifo sikashukela kulabo abasengozini futhi kungasiza ekulawuleni i-glycemic kulabo abanesifo sikashukela. Lokhu kungenxa yokuthi ukuvivinya umzimba kungasiza ukunciphisa i-hyperglycemia ngokushisa i-glucose . Isibonelo, ukuhamba ngemuva kokudla okukhulu kungasiza ukushisa ushukela owedlulele egazini.
Ukuvivinya umzimba njalo kubalulekile ekulawuleni isisindo, okunganciphisa i-hyperglycemia nokuthuthukisa impilo yonke.
Kunezikhathi lapho kufanele ugweme ukuzivocavoca uma ushukela wegazi lakho liphakeme. Uma ushukela wakho wegazi ungaphezu kuka 240 mg / dL futhi unezetoni, kufanele ugweme ukuzivocavoca. Ukusebenzisa ngamaketoni kungaphakamisa ushukela wegazi lakho nakakhulu.
Ngaphambi kokuqala noma yisiphi isimiso sokuzivocavoca qiniseka ukuthi ususwe udokotela.
Ukulahlekelwa kwesisindo
Ukulahlekelwa isisindo kunenzuzo ekunciphiseni ushukela wegazi ngoba kuthuthukisa ukuzwela kwe-insulini. I-ADA ithi, "kunobufakazi obuqinile futhi obuqinile bokuthi ukuzithokozisa okuqhubekayo, okungaqhubekayo kwehlisa isisindo kunganciphisa ukuqhubekela phambili kwe-prediabetes ukuthayipha isifo sikashukela sesibili futhi kuzuzisa ukuphathwa kohlobo lwesifo sikashukela." Ucwaningo oluthile lubonisa ukuthi ukulahlekelwa isisindo ngokulandela ukudla okuphansi kakhulu kwekhalori kungaba ngempela ukubeka isifo sikashukela ekuxoxweni , ngisho nalabo bantu abanesifo sikashukela iminyaka eyisithupha.
Isihluthulelo sokulahlekelwa kwesisindo kodwa sisigcina futhi sithola ukwesekwa okuqhubekayo.
Kubalulekile ukuphawula ukuthi isisindo-ukulahleka cishe kunciphise ukuxilonga kwegazi ekutholeni izigaba zesifo sikashukela noma ama-prediabetes, lapho umzimba ugcine umthamo we-insulin. Indawo enhle yokuqala ukulahlekelwa ngamaphesenti amahlanu wesisindo somzimba wakho. Ngokuvamile isisindo esiningi ulahlekelwa, ukwehlisa ishukela egazini lakho kuyoba.
Uma uthatha imithi ngenkathi ulahlekelwa isisindo futhi uqaphele ukuthi uneshukela ephansi yegazi, kuzodingeka ukuthi imishanguzo yakho ishintshe noma ishiyiwe.
Ukuyeka ukubhema
Ukubhema kungaba nendima ekukhuliseni i-hyperglycemia, ikakhulukazi ekuthuthukiseni uhlobo lwesifo sikashukela sohlobo lwesibili. Ngakho-ke, uma une-prediabetes noma engozini yesifo sikashukela, ukuyeka ukubhema kungasiza ekuvimbeleni isifo sikashukela kanye ne-hyperglycemia.
Ukuqapha kwe-Blood Sugar
Ukuqapha njalo ushukela wegazi kungasiza abantu abanesifo sikashukela ukuba bahlole impendulo yabo yokwelashwa nokuphatha ushukela ephezulu wegazi.
Kubonakala sengathi kukhona ukulungiswa phakathi kokuqapha kweshukela egazini kanye ne-A1C ephansi kweziguli ezine-type 1 yesifo sikashukela. Uma usungile iphethini yeshukela ephezulu yegazi, ungathatha isinyathelo ukuwuphatha nokuwavimbela ngokuhlola ushukela wegazi kanye namaphethini akhombayo. Ngokushesha uma uqaphela i-hyperglycemia yakho, ngokushesha ungenza izinguquko.
I-Cinnamon
Ijaji lisekhona nokuthi i- cinnamon iyakusiza kanjani ukwehlisa ushukela wegazi . Ezinye izifundo zithi amathisipuni amabili ngosuku angasiza ekunciphiseni ushukela wegazi lokuzila ukudla, kanti abanye abangekho.
Njengokukhathazeka okuningi kwesifo sikashukela, lokhu cishe kuqondene nomuntu ngamunye. Noma yikuphi, akukho lutho olulimazayo ekungenizeni i-sinle yesinamoni kukhofi yakho, i-yogurt, i-oatmeal, noma isobho sokusa.
Apple Cider Vinegar
Ijusi elivela ema-apula lisetshenziselwa ukwenza i-apula cider uviniga. Ucwaningo olwanyatheliswa kuyi-Journal of Functional Foods lwathola ukuthi abantu abanempilo enengozini yesifo sikashukela sohlobo lwe-2 abafaka ama-ounces angu-8 we-Braggs Organic Apple Cider Vinegar Umphuzi Sweet Stevia amasonto angu-12 wabona ukunciphisa okuphawulekayo kokuzila ushukela wegazi.
Kubalulekile ukuqaphela ukuthi laba bantu babengenayo isifo sikashukela nokuthi abacwaningi abatholanga umehluko omkhulu emashukela egazi amahora amabili emva kokudla, noma ku-hemoglobin A1C. Ngalokho kuthiwa, abalobi basikisela ukuthi ukwengeza isipuni esisodwa nje nsuku zonke kungasiza ukunciphisa ukudla okushukela egazini. Gcoba i-apula cider uviniga kwisaladi esilandelayo noma uhambise amaprotheni wakho kuwo-kancane ihamba ngendlela ende.
Imigomo
I-insulini
I-insulini i-hormone ephethe ukulawula amazinga kashukela egazini emzimbeni. Abantu abanesifo sikashukela sohlobo lwe-1 abavelisi i-insulin yabo siqu. Ngakho-ke, abantu abaningi abanesifo sikashukela sohlobo 1 kufanele baphathwe ngemijovo eminingi yansuku zonke ngesikhathi sokudla (noma i-prandial insulin) futhi basal insulin nge-injection noma ipompo ye-insulin.
Ngaphezu kwalokho, iningi labantu abanesifo sikashukela sohlobo 1 kufanele basebenzise i -insulin esebenza ngokushesha, ngokungafani nama-analog aphakathi . Abesifazane abahlolwe ukuthi banesifo sikashukela bangase badinge i-insulini ukuze banciphise ingozi ye-hyperglycemia futhi bagcine ishukela legazi lilawulwa ngokuqinile.
Ngesinye isikhathi, abantu abanesifo sikashukela esanda kutholakala abanesifo esinamandla kakhulu sokuxoshwa kwengculaza bangase baqalwe ekwelashweni kwe-insulin ngokushesha ukunciphisa ushukela wabo wegazi. Labo bantu abaye baba nesifo sikashukela sohlobo lwesibili isikhathi eside, ikakhulukazi labo abane-hyperglycemia evamile, bangadinga ukuqala ukwelapha kwe-insulin.
Akuyona into engavamile nakuba umuntu onesifo sikashukela sohlobo lwe-2 esise-insulin sinciphisa noma ashiya i-insulini uma isishukela segazi sijwayelekile, ikakhulukazi uma sesilahlekile. Icala ngalinye lihlukile futhi umgomo wokuphathwa kwe-insulin kufanele uxoxwe nomhlinzeki wezempilo ukuze ungakhathazeki noma ungahambi kahle.
Pramlintide
Le mithi ivunyiwe ukusetshenziswa kweziguli ezine-type 1 yesifo sikashukela. Ukusetshenziswa kwalo ukulibazisa isisu esiswini nokunciphisa ushukela wegazi ngokunciphisa ukufihla kweglucagon. Kungasiza abantu abanesifo sikashukela sohlobo lwe-1 ukuthi banciphise isisindo (uma bekhuluphele), futhi banciphise ushukela wegazi kanye namanani aphansi e-insulin.
Imithi Yomlomo
I-ADA ine-algorithm yokuqondisa odokotela ekumeni imithi kubantu abane-hyperglycemia. Lo mfanekiso ucabangela iminyaka, ubulili, isisindo, umlando wezempilo, ubude bokuxilongwa, izinga lokushukela egazini, indlela yokuphila, imfundo, njll yomuntu. Eqinisweni, i-ADA ithi, "indlela yokugxilisa isiguli kufanele isetshenziselwe ukuqondisa ukukhethwa kwama agent e-pharmacologic. Ukucatshangelwa kuhlanganisa ukusebenza kahle, ingozi ye-hypoglycemia, umthelela wesisindo, imiphumela emibi engaba khona, izindleko, nokuthandwa kwesiguli."
Ngokuvamile, ngaphandle kokuphikisana, abantu abaningi bayazuza ngokuqala nge-Metformin. Ngemuva kokuqalwa, i-ADA ithi, "Uma ukungenayo i-noninsulin monotherapy ekulinganisweni kwezinga elibekezelelekile akuzukufeza noma kulondoloza i-A1C target emva kwezinyanga ezintathu, engeza i-agent yomlomo wesibili, i-peptide-like peptide 1 receptor agonist, noma i-basal insulin."
I-Gestational Diabetes Mellitus
I-hyperglycemia ekukhulelwe ingabangela ukuxilongwa kwesifo sikashukela sokukhulelwa. Uhlobo lokuqala lwezokwelashwa ukwelashwa kokudla okunomsoco, umsebenzi wokuzivocavoca, nokuphathwa kwesisindo kuye ngokuthi isandulela ukukhulelwa nesishukela segazi.
Ukuguqula indlela yokuphila, ikakhulukazi ukudla nokuzivocavoca, kuyisici esibalulekile futhi bonke abesifazane kudingeka balawule ushukela wegazi. Kodwa-ke, uma ushukela wegazi lingenakulawulwa ngezinguquko zokuphila, i-insulin iyimithi ekhethwayo njengoba ingahambi i-placenta ngendlela elinganiselwe.
Eminye imithi efana ne-metformin ne-glyburide ingasetshenziswa, kodwa bobabili bawela i-placenta kuya emfusheni, nge-metformin kungenzeka ukuthi iwela ngaphezu kwe-glyburide.
Izimo Eziphuthumayo
Uma kwenzeka uye ekamelweni eliphuthumayo ngenxa yeshukela ephakeme yegazi futhi uthola ukuthi une-ketoacidosis yesifo sikashukela (i-DKA) noma i-hyperosmolar hyperglycemic state, kuzodingeka uqashwe ngokucophelela futhi kufanele uthole ukuhlolwa komtholampilo ngokucophelela.
Ukwelashwa kuzobandakanya ukuxazululwa kwe-hyperglycemia, ukulungisa ukungalingani kwe-electrolyte kanye ne-ketose, nokubuyiselwa kwevolumu yokujikeleza. Ukwengeza, kuyoba kubalulekile ukulungisa noma yikuphi imbangela ebalulekile ye-DKA, njenge-sepsis.
Kuye ngokuthi kunzima kanjani isimo, abantu abane-DKA bayokwelashwa nge-insulin engaphakathi noma engaphansi kokuphathwa kwamanzi.
Ukuhlinzwa
Ukuhlinzwa akudingekile ukuba i-hyperglycemia ngaphandle uma kunezinye izici eziphazamisayo ezifana nokukhuluphala okubi kakhulu kulabo abanesifo sikashukela sohlobo lwesibili. Ukuhlinzwa kungaba yindlela yokukhetha abantu abanesifo sikashukela sohlobo lwe-1 abanamaphilisi amaningi noma labo abane-ketoacidosis ephindaphindiwe noma i-hypoglycemia enamandla naphezu kokuphathwa okunamandla kwe-glycemic.
Ukwelashwa Kwemetabolic
Ukuhlinzeka ngamathambo, okunye okubizwa ngokuthi ukuhlinzeka nge-bariatric, kungaba yindlela yokwelashwa kwe-hyperglycemia kwiziguli ezine-type 2 yesifo sikashukela esiphelele. I-ADA iphakamisa ukuthi " ukuhlinzeka ngokwemithi kufanele kuphakanyiswe ukuphatha uhlobo lwe-diabete s ku-candidate ezifanelekile zokuhlinzeka nge-BMI 40 kg / m2 (BMI 37.5 kg / m2 kwabase-Asia baseMelika), kungakhathaliseki ukuthi izinga lokulawulwa kwe-glycemic noma ubunzima be-glucose-ukwehla ama-regimens, kanye nabantu abadala abane-BMI 35.0-39.9 kg / m2 (32.5-37.4 kg / m2
AbaseMelika baseMelika) lapho i-hyperglycemia ingalawulwa ngokungafanele naphezu kokuphila kanye nezokwelapha ezifanele
ukwelashwa. "
I-ADA iphinde ikhombise ukuthi ukuhlinzekwa komzimba okunomsoco kufanele kuthathwe ngabantu abadala abane-type 2 yesifo sikashukela kanye ne-BMI 30.0-34.9 kg / m2 (27.5-32.4 kg / m2 kwabase-Asia baseMelika) uma i-hyperglycemia ingafaneleki
elawulwayo naphezu kokulawulwa kwezokwelapha okuhle noma ngomuthi noma ngomuthi (okufaka i-insulin).
Ngaphambi kokucubungula ukuhlinzwa, abantu abane-type 2 yesifo sikashukela kufanele bathole ukuhlolwa okuphelele kwezokwelapha futhi bathole imvume yezokwelapha kusuka odokotela abaningi, njengodokotela wabo oyinhloko nodokotela wezinhliziyo. Ukwengeza, kumele bahlangane ne-dietitian ebhalisiwe izikhathi eziningana ngaphambi nangemva kokuhlinzwa ukuze baqiniseke ukuthi bahambisana neziqondiso zokudla.
Ukwesekwa kwenkathi yesikhathi eside yokuphila kanye nokuqapha okujwayelekile kwesimo semvelo kanye nesimo somsoco kufanele kunikezwe iziguli ngemuva kokuhlinzwa. Ukuhlola ukuhlola isidingo sezinsizakalo zempilo yengqondo eqhubekayo ukusiza ukulungisa izinguquko zezokwelapha nezengqondo emva kokuhlinzwa okufanele kwenziwe.
I-Pancreas ne-Islet Transplantation Cell
Ukuhlinzwa ukutshala izidakamizwa kudinga ukukhulelwa komzimba okuqhubekayo okungaqeda uketshezi wegazi, okubangelwa i-hyperglycemia. Ngenxa yemiphumela emibi, akuyona into eyenziwa ngabantu abanesifo sikashukela sohlobo 1.
Esikhundleni salokho, i-ADA iphakamisa ukuthi "ukufakelwa kwe-pancreas kufanele kugcinwe iziguli ezine-type 1 yesifo sikashukela esithinta ukuguqulwa kwesimiso esisodwa ngesikhathi esifanayo, ngemuva kokufakelwa kabusha kwe-renal, noma kulabo abane-ketoacidosis ephindaphindiwe noma i-hypoglycemia enamandla naphezu kokuphathwa okukhulu kwe-glycemic."
Ukufakelwa kwe-Islet kuqhubeka uphenyo. Ukufakelwa kwezitshalo ngokuzenzakalelayo kungacatshangelwa iziguli ezidinga ukuphathwa kwe-pancreatectomy ephelele yokuphefumula okungapheli komzimba okuphazamisayo. Uma ucabanga ukuthi ungumfundi, funda kabanzi mayelana nenqubo bese ukhuluma nodokotela wakho ngakho.
Imithi Ephelele (CAM)
Uma i-hyperglycemia ingenxa yokungakwazi ukuzinakekela ngenxa yezinkinga ezingokwengqondo noma zenhlalo, i-psychotherapy ingasetshenziswa ukuphatha inkinga engaphansi, engasiza ekuphatheni nasekunciphiseni i-hyperglycemia.
Uma umuntu ezwa ukucindezeleka kwesifo sikashukela (DD), echazwa ngokuthi "ukusabela okuphawulekayo kwengqondo okuhlobene nokucindezeleka ngokomzwelo okuqondene nomuntu ngamunye ekulawuleni isifo esinesifo sikashukela esinzima, esiyinkimbinkimbi nesicindezelayo," ukuthola usizo kuyoba okubalulekile ekulawuleni i-hyperglycemia nokucindezeleka.
Yazi ukuthi usizo luyatholakala futhi ayikho inhlamba ehambisana nayo. Kungakusiza ukuthi uzinakekele kangcono futhi ubheke futhi uzizwe ungcono, ngakho unganqikazi ukuphuma uma kudingeka.
> Imithombo:
> I-American Diabetes Association. Amazinga Wokunakekelwa Kwezokwelapha Esifo Sikashukela - 2017. Ukunakekelwa Kweshukela . 2017 Jan; 38 (I-Suppl 1): S1-132.
> I-American Diabetes Association. I-Hyperglycemia (i-High Blood Glucose).
> Lean M, et al. Ukuphathwa kokunakekelwa kokunakekelwa okuyisisekelo ukukhishwa kwesishukela se-type 2 yesifo sikashukela (DiRECT): i > ilebuli evulekile >, isilingo esenziwe ngezikhathi ezithile. " Lancet . 2017: DOI: 10.1016 / S0140-6736 (17) 33102-1