Diabetic-peripheral

I-diabetesic neuropathy yisimo esibi kakhulu sokulimala kwezinzwa esidinga ukunakwa ngokushesha. Ikhula kancane futhi ingaba yimbi ngaphandle kokwelashwa. Lesi simo sithinta cishe u-30% weziguli ezinesifo sikashukela. Izinombolo ziyaqhubeka nokukhuphuka ngokusekelwe ubude besikhathi sikashukela.

I-diabetesic neuropathy ukulimala kwezinzwa ezivela kushukela okuthinta izingxenye ezahlukene zomzimba. Abantu abanesifo sikashukela soHlobo loku-1 babhekene namathuba angama-20% okuba ne-peripheral neuropathy ngemva kweminyaka engama-20 benalesi simo. Ingozi iphezulu for Thayipha i-2 sikashukela iziguli ngemuva kweminyaka eyi-10. I-American Diabetes Association iphakamisa ukuthi kuhlolwe iziguli ezinesifo sikashukela sohlobo 2 ngemva nje kokuxilongwa. Iziguli ezinesifo sikashukela sohlobo loku-1 kufanele zihlolwe eminyakeni emihlanu ngemuva kokuxilongwa kwazo.

Izimpawu zokuqala eziyisixwayiso, izimbangela, kanye nezinketho zokwelapha izisekelo zokuqonda i-diabetesic neuropathy. Lesi sihloko sihlanganisa konke okufanele ukwazi mayelana nokunakekelwa kwesifo sikashukela - kusukela ekuzwaneni ezinyaweni zakho kuya ekwelashweni okutholakalayo okungasiza ekuqondiseni uhambo lwakho.

Iyini i-Diabetic Neuropathy?

I-diabetesic neuropathy ukulimala kwezinzwa okwenzeka ngenxa yesifo sikashukela. Lesi simo esiqhubekayo singathinta noma iyiphi inzwa emzimbeni wakho. Kunezinhlobo ezine eziyinhloko: 

• I-peripheral - evame kakhulu, ethinta imikhawulo
• I-Autonomic - ethinta izitho zangaphakathi
• I-Proximal - ethinta amathanga nezinqulu
• I-Mononeuropathy - ukulimaza inzwa eyodwa

Izimpawu ze-Diabetic Neuropathy

I-peripheral neuropathy ngokuvamile iqala ngokuthi ukungabi namandla, ukuntweza, noma ukuzwa ukushisa ezinzwaneni nasezinyaweni zakho. Lezi zimpawu ziya phezulu kulokho odokotela abakubiza ngokuthi iphethini ye-"stocking-glove". Ezinye izimpawu yilezi:

• Iziguli zivame ukuzwa izinhlungu zokudubula futhi zibe nokuzwela kakhulu lapho uzithinta. 
• Izitho ezithintekile zeziguli nazo zingase zibe buthaka.
• I-autonomic neuropathy ingadala izinkinga zokugaya ukudla, izinkinga zesinye, nokungasebenzi kahle kwezocansi. 
• Iziguli zingase zibe namaphethini okujuluka angavamile futhi zizwe nesiyezi lapho zisukuma.

Izinkinga ze-Diabetesic Neuropathy

Ushukela ophezulu wegazi ulimaza imizwa ngokuhamba kwesikhathi futhi wenze buthaka imithambo yegazi emincane (vasa nervorum) ehlinzeka komoyampilo kanye nezakhamzimba. Lokhu kusho ukuthi amaseli ezinzwa awakwazi ukusebenza kahle noma angase afe ngokuphelele. Ukulimala kwemizwa kuba kubi kakhulu ngenxa yokuphazamiseka kwe-metabolic, ukuvuvukala, kanye nengcindezi ye-oxidative.

Izingozi Zezingozi

Ingozi yakho ye-diabetesic neuropathy ikhuphuka nalokhu:

• Ukuba nesifo sikashukela isikhathi eside
• Ubudala obudala
• Ukulawula ushukela wegazi okungalungile (i-HbA1c ephezulu)
• Umfutho wegazi ophezulu
• Amafutha egazi angajwayelekile
• Ukukhuluphala
• Ukubhema
• Utshwala obuningi

Izinkinga ze-Diabetesic Neuropathy

Inselele enkulu ukuthi ukulimala kwezinzwa ngokuvamile akunakwa kuze kube yilapho umonakalo omkhulu usuvele wenzekile. Izinkinga ezinzima kakhulu zihlanganisa:

• Izilonda ezinyaweni 
• I-Gangrene
• Izinkinga zebhalansi zingabangela ukuwa. 
• Iziguli zingase futhi zibe nezinkinga zenhliziyo, izinkinga zokugaya ukudla, kanye nenkinga yokuchama. 

Ukuxilongwa kwe-Diabetic Neuropathy

Iziguli zinemiphumela yokwelashwa engcono ngokuxilongwa kusenesikhathi. Ngesikhathi sokuhlolwa komzimba, odokotela bahlola amandla emisipha, ukukhalipha, nokuzwela kokuthinta. Ukuhlola kungase kuhlanganise:

• Ukuhlolwa kwefilament ukuhlola ukuzwela kokuthinta
• Ukuhlolwa kwezinzwa kwezimpendulo zokudlidliza
• Izifundo zokuqhuba izinzwa
• I-Electromyography ukukala umsebenzi kagesi wemisipha

Ukwelashwa kwe-Diabetic Neuropathy

Ukwelashwa kwe-diabetesic neuropathy kuhlanganisa inhlanganisela yezindlela zokwelashwa ezahlukahlukene zoku:

• Ukulawula amazinga kashukela egazini ukuvimbela ukulimala kwemizwa eyengeziwe
• Ukuphathwa kobuhlungu
• Ukwelapha ama-comorbidities
• Ukwenza ngcono ukusebenza kwesitho esithintekile 

Ukuze bathole le migomo, odokotela ngokuvamile basikisela:

• Imithi: Odokotela bangalungisa umthamo wezidakamizwa zakho ezilawula ushukela noma bashintshele emthini ohlukile ukusiza ukugcina amazinga kashukela egazini phakathi kwezigaba ezinempilo. Odokotela bavame ukunikeza le mithi ukukhulula ubuhlungu:
  • Imithi elwa nokuquleka 
  • antidepressant 
  • Ukwelashwa kwezihloko okuhlanganisa ukhilimu we-capsaicin noma ama-patches e-lidocaine
• Ukwelashwa kwezinkinga ezihlobene ne-diabetes neuropathy:
  • Ukwelashwa komfutho wegazi kuyashintsha ngokushintsha indlela yokuphila elula noma, uma kunesidingo, imithi.
  • Uhlelo olukhethekile lokwelapha uma izitho zangaphakathi ezifana nenhliziyo, izinso, noma uhlelo lokugaya ukudla kuhileleka
  • Ukwelashwa kwezinguquko zocansi

Kufanele Ngimbone Nini Udokotela

Xhumana nodokotela wakho ngokushesha uma ubona:

• Isilonda sonyawo esingapholi
• Ukushiswa noma ukushoshozela ezandleni noma ezinyaweni okuthinta ukulala kwakho
• Izinguquko ekugayeni ukudla, ukuchama, noma ukusebenza kocansi
• Akuchaziwe isiyezi noma ukuquleka

Prevention

Ukulawula ushukela wegazi phakathi kwebanga eliqondiwe kuyisu elibalulekile lokuvimbela i-neuropathy. Lezi zinqubo ezinempilo zingasiza:

• Kufanele uhlole izinyawo zakho njalo ukuze ubambe izinkinga kusenesikhathi. 
• Ukugqoka izicathulo ezivikelayo kusiza ukuvikela ukulimala okungenzeka ungakuzwa. 
• Ukuzivocavoca njalo kuthuthukisa ukujikeleza kwegazi.
• Ukuqapha umfutho wegazi lakho & amazinga e-cholesterol futhi ukuzigcina ngaphakathi kwezigaba ezinempilo kusiza ukuvikela izinzwa zakho.
• Kungcono ukuyeka ukubhema futhi wehlise ophuzweni oludakayo ngoba le mikhuba ingabhebhethekisa i-neuropathy.

Izindlela Zemvelo Zokwelapha I-Neuropathy

Nazi izindlela ezingokwemvelo zokuphatha izimpawu:

• Ukugeza okufudumele kungakhuphula ukujikeleza komzimba emzimbeni.
• Ukuzigcina umatasa ngokuvivinya umzimba njalo kusiza ukugeleza kwegazi futhi kudambise ukungakhululeki.
• Ukusebenzisa amasu okuzindla kungasiza abantu ukuphatha ubuhlungu.
• I-massage enamafutha abalulekile eyaziwa ngemiphumela yawo yokulwa nokuvuvukala inganikeza ukukhululeka.

Isiphetho

I-diabetesic neuropathy ithinta umuntu ngamunye ngendlela ehlukile. Abanye abantu bazizwa beluma ezinyaweni zabo, kuyilapho abanye bengabhekani kahle nezinkinga zokugaya ukudla. Izimpawu zomzimba wakho zibaluleka uma unesifo sikashukela.

Ukuvakasha kodokotela kusiza ukubona ukulimala kwezinzwa ngaphambi kokuba izimpawu zibe zimbi kakhulu. Imikhuba elula yansuku zonke njengokunakekelwa okufanele kwezinyawo, ukuvivinya umzimba, nokugwema ugwayi kwakha isivikelo esiqinile ekwandeni kwe-neuropathy. Abantu abagcina amazinga eglucose ehlolwa bavame ukubona ukukhula kancane kanye nezinkinga ezimbalwa.

Izinketho zokwelashwa zikhulile eminyakeni embalwa edlule. Lokhu kunikeza iziguli izindlela eziningi zokusingatha ubuhlungu nokungakhululeki. Abantu abaningi bagcina izinga lempilo yabo ngokuhlanganisa imithi nezinye izindlela ezifana nokugeza okufudumele noma ukuzindla.

Ukukhuthala ngokunakekelwa kwezempilo kanye nezinguquko zendlela yokuphila kukusiza ukuthi uhlale uphezu kwalesi simo. Izinyathelo ezincane ozithathayo namuhla zivikela izinzwa nempilo yakho iminyaka ezayo.

Imibuzo Evame Ukubuzwa

1. Yiziphi izimpawu zokuqala ze-neuropathy ezinyaweni zakho?

Abantu abaningi baqale babone ukuba ndikindiki okuncane noma ukushoshozela ezinzwaneni zabo okuzwakala njengezikhonkwane nezinaliti. Le mizwa ivame ukuba yimbi kakhulu ebusuku futhi ingenza kube nzima ukulala. 

Ungase futhi uzwe ubuhlungu obushisayo futhi uzwele lapho uthintwa - ngisho namashidi ombhede angase abe buhlungu lapho ethinta isikhumba sakho. Abanye abantu bayaphuthelwa yilezi zimpawu eziyisixwayiso zakuqala ngenxa yokuthi zingaba nobuqili, okubambezela ukutholakala kwazo.

2. Yiziphi izigaba zokugcina ze-diabetesic neuropathy?

Abantu abane-neuropathy ethuthukisiwe yesifo sikashukela balahlekelwa yiwo wonke umuzwa ezinyaweni nasemilenzeni. Bazabalaza ngokulinganisela futhi bakuthola kunzima kakhulu ukuhamba ngoba abazizwa kahle izinyawo zabo. Abaningi badinga izihlalo ezinamasondo ukuhambahamba kulesi sigaba. Izinkinga ezingathi sína zingavela njengezilonda ezinyaweni, izifo, kanye nokunqunywa kwesitho. Isimo esibizwa nge-Charcot foot singase senzeke, esicekela phansi amathambo futhi sibangele ukukhubazeka kwezinyawo.

3. Ngingakwazi ukululama ku-diabetesic neuropathy?

Umzimba wakho awukwazi ukulungisa ngokwemvelo izicubu zemizwa ezilimele, ngakho awukwazi ukuhlehlisa i-diabetesic neuropathy. Kodwa ungakunqanda ukuthi kungabi kubi ngokugcina amazinga kashukela egazini elawulwa. Ukwelashwa okufanele kunganciphisa kakhulu izimpawu ezibuhlungu, okungenza kubonakale sengathi i-neuropathy yakho isithuthukile, nakuba ukulimala kwemizwa kusasele.

4. Ungamisa kanjani i-neuropathy ukuthi ingasakazeki?

Ukulawula ushukela egazini ukuzivikela kwakho okuyinhloko. Kumele:

• Unyawo luhlola izinkinga
• Gqoka izicathulo ezifanele
• Ukulawulwa kwengcindezi yegazi
• Ukuvivinya umzimba njalo

5. Indlela yokuhlola i-neuropathy yesifo sikashukela ezinyaweni?

Odokotela basebenzisa izivivinyo ezimbalwa ezisheshayo phakathi nokuhlolwa kwakho. Baxubha umucu othambile wenayiloni (ukuhlolwa kwe-monofilament) onyaweni lwakho ukuze bahlole ukuthi ungezwa yini ukuthintwa okuncane. Babeka imfoloko yokulungisa onyaweni lwakho ukuze bahlole inzwa yokudlidliza. Ukuhlolwa kwe-pinprick kuhlola ukuthi ungakwazi yini ukuzwa ubuhlungu ngokujwayelekile. Baphinde bahlole amandla akho e-ankle ukuze babone ukuthi izinzwa zakho zisebenza kahle kangakanani. Ukuhlolwa ngakunye kuthatha cishe iminithi ukuqeda.

CARE Medical Team