I-Hypoglycaemia

Wake wazizwa unesiyezi, uqhaqhazela, noma ucasuka ngaphandle kwesizathu? Lezi kungaba izimpawu ze-hypoglycemia, isimo esingathinta noma ubani. I-Hypoglycemia, noma ushukela wegazi ophansi, kwenzeka lapho amazinga kashukela egazini ehla ngaphansi kokujwayelekile. Uma ingelashwa, le nkinga yezempilo evamile ingabangela izimpawu eziningi zikashukela ophansi, kusukela ekuphathekeni kabi kuya ezinkingeni ezinzima. Le bhulogi ihlose ukuveza izimpawu nezimbangela zoshukela ophansi wegazi. 

Iyini i-Hypoglycemia (Ushukela Wegazi Ophansi)? 

I-Hypoglycemia, evame ukubizwa ngokuthi ushukela ophansi, i-glucose ikhula lapho amazinga kashukela egazini ehla ngaphansi kokujwayelekile. Lesi simo senzeka lapho kunoshukela omncane kakhulu egazini ukuze uqhubekisele phambili imisebenzi yomzimba. Lapho uzila ukudla, uhla olujwayelekile lweglucose yegazi luphakathi kuka-60 kuya ku-99 mg/dL. Lawa mazinga angashintsha usuku lonke. 

Uma amazinga kashukela egazini engaphansi kuka-3.9 mmol/L (70 mg/dL), kuthathwa njengebanga eliphansi likashukela noma i-hypoglycemia. Lokhu kwehla kungaba nomthelela ekusebenzeni komzimba, njengoba i-glucose ingumthombo wamandla oyinhloko wawo wonke amangqamuzana emizimbeni yethu. Ubuchopho ikakhulukazi buthembele kakhulu ku-glucose ukuze busebenze ngempumelelo. 

Izinhlobo ze-Hypoglycemia 

I-Hypoglycemia inezigaba ezahlukahlukene ngokuya kwesikhathi sayo kanye nembangela. 

• Ukuhlelwa okususelwe kusikhathi: 
  • I-Fasting Hypoglycemia noma Early Morning: Lolu hlobo lwenzeka lapho ushukela wegazi wehla ngemva kokungadli isikhathi eside. 
  • I-Postprandial Hypoglycemia: Eyaziwa nangokuthi i-reactive hypoglycemia, yenzeka phakathi namahora angu-2-4 ngemva kokudla. 
  • I-Hypoglycemia ehlobene nokuzivocavoca: Lolu hlobo lwenzeka phakathi noma ngemuva kokusebenza komzimba. 
• Ukwahlukaniswa okusekelwe kusizathu: 
  • I-Hypoglycaemia ye-insulin-mediated: Lokhu kubangelwa i-insulin ngokweqile emzimbeni, kungaba yizimbangela zemvelo ezifana ne-insulinomas noma izimbangela ze-iatrogenic ezifana izidakamizwa ze-insulin. 
  • I-Hypoglycemia engeyona i-insulin: Lolu hlobo lunezimbangela ezihlukahlukene, okuhlanganisa ukuphuza utshwala, ukwehluleka kwezitho zomzimba, ukugula okubucayi, ukuntuleka kwamahomoni, kanye nemithi ethile. 
• Ukwahlukanisa okususelwe ebumnyameni: 
  • Ileveli 1 (inani lesexwayiso se-Hypoglycemia): I-glucose esegazini ≤70 mg/dL (3.9 mmol/L) 
  • Ileveli 2 (i-hypoglycemia ebaluleke kakhulu emtholampilo): Ushukela wegazi ungaphansi kuka-54 mg/dL (3.0 mmol/L) 
  • Ileveli 3 (I-Hypoglycemia Enzima): Awukho umkhawulo othize weglucose kodwa udinga usizo lwangaphandle ukuze ululame 

Izimpawu ze-Hypoglycemia 

Izimpawu ze-Hypoglycemia zingavela ngokuzumayo futhi ziyehluka kumuntu nomuntu. Izimpawu ezijwayelekile zokwehla ushukela zihlanganisa: 

• Ukuthuthumela noma ukuthuthumela 
• Ubuthakathaka nokukhathala 
• Ukujuluka nokugodola 
• Indlala enkulu 
• Ukushaya kwenhliziyo okusheshayo 
• Isiyezi noma ikhanda elikhanyayo 
• Ukudideka noma ukugxila enkingeni 
• Coma 
• Ukukhathazeka noma ukucasuka 
• Isikhumba esiphezulu 
• Ukuba ndikindiki noma ukushoshozela ezindebeni, olimini, noma ezihlathini 
• I-Hypoglycemia enzima inezimpawu ezimbi kakhulu: + 
• Ukubona okufiphele noma okukabili 
• Inkulumo emisiwe 
• Izinkinga zokuxhumanisa 
• Ukukhathazeka 
• ukuquleka 
• Ukulahlekelwa kokwazi 

I-Nocturnal hypoglycemia, eyenzeka ngesikhathi sokulala, inesethi yayo yezimpawu eziphansi zikashukela egazini: 

• Ukulala okungaphumuli 
• Ukujuluka ngamaphijama noma amashidi 
• Ekhala ngesikhathi elele 
• Nightmares 
• Ukuzizwa ukhathele, udidekile, noma udidekile lapho uvuka 

Izinkinga ze-Hypoglycemia 

Izimbangela eziphambili ze-hypoglycemia zihlanganisa: 

• I-insulin eyengeziwe 
• Ukuthatha imithi eminingi yesifo sikashukela noma isikhathi esingalungile se-insulin nokudla ukudla 
• Ukweqa ukudla 
• Ukwandisa umsebenzi womzimba ngaphandle kokudla 
• Abesifazane abakhulelwe abanesifo sikashukela soHlobo loku-1 bangase babe noshukela wegazi ophansi ku-trimester yokuqala. 
• Okwabantu abangabodwana sikashukelaIzimbangela ze-hypoglycemia zihlanganisa: 
• I-Reactive Hypoglycemia: Ivela emahoreni angu-2-4 ngemva kokudla, mhlawumbe ngenxa yokushintshashintsha ngokushesha kukashukela egazini. 
• I-Fasting Hypoglycemia: Ivela ngokuphuza ngokweqile, izifo ezibucayi, noma ukuphazamiseka kwamahomoni. 
• Izimo Zezokwelapha: Ukuntuleka kwe-Adrenal, i-insulinomas, Isimila/umdlavuza wamanyikwe, kanye ne-non-islet cell tumor hypoglycaemia kungaholela ekwehliseni ushukela wegazi, amanyikwe, kanye ne-dictum.

Izingozi ze-Hypoglycemia 

Kunezici eziningana ezandisa amathuba okuba ne-hypoglycemia, njenge: 

• Abantu abanesifo sikashukela, ikakhulukazi labo abasebenzisa i-insulin noma imithi ethile 
• Ababhemayo abanesifo sikashukela 
• Ukuphuza ngokweqile ngaphandle kokudla kungavimbela isibindi ekukhipheni i-glucose. 
• Izimo ezithile zezokwelapha njengezifo ezinzima zesibindi, ukuphazamiseka kwezinso, isifo senhliziyo esithuthukile, kanye nendlala yesikhathi eside 

Izinkinga ze-Hypoglycemia 

I-Hypoglycemia ingaholela ezinkingeni ezinkulu uma ingelashwa, njenge: 

• Imiphumela yesikhashana ihlanganisa isiyezi, ubuthakathaka, nokuwa, okungaholela ekulimaleni. 
• Ezimweni ezimbi kakhulu, i-hypoglycemia ingabangela ukopha kobuchopho, ukuhlaselwa yinhliziyo, nokukhubazeka kokusebenza kwengqondo. 
• Izinkinga zesikhathi eside zihlanganisa ingozi eyengeziwe yesifo senhliziyo nemithambo yegazi, izinkinga zamehlo, izimo zezinso, nokulimala kwezinzwa. 
• Abantu abadala asebekhulile abaneziqephu ezivamile zoshukela wegazi ophansi banethuba elikhulu lokuthuthukisa ukuwohloka komqondo. 
• I-Hypoglycemia ingathinta nezinhlelo ezahlukahlukene zomzimba. Kungabangela i-gastroparesis, isimo esiphazamisa isimiso sokugaya ukudla, okubangela ubuhlungu besisu, isicanucanu, nokuhlanza. Izimo ezinzima zingalimaza uhlelo lwe-endocrine kanye ne-circulatory. 

Ezimweni ezimbi kakhulu, i-hypoglycemia enzima isikhathi eside ingaholela ku-: 

• Ukwehluleka kwezitho eziningi 
• Ama-arrhythmias enhliziyo 
• Ukulimala kobuchopho unomphela 
• Coma 
• Ukufa 

Sifo 

Ukuxilongwa kwe-hypoglycemia kuhlanganisa inhlanganisela yokuhlolwa kwezimpawu nokuhlolwa kweglucose yegazi. Odokotela ngokuvamile baqala ngokubuyekeza umlando wezokwelapha wesiguli futhi bahlole umzimba. Kubantu abasebenzisa i-insulini noma eminye imishanguzo yesifo sikashukela, ukuzihlola imitha kashukela kubalulekile lapho bebona izimpawu zokuthi ushukela wegazi uphansi. Kubalulekile ukurekhoda le miphumela kanye nephansi izinga loshukela wegazi. 

• Ukuhlolwa kokubekezelela ukudla okuxubile (MMTT): Ukuthola i-hypoglycemia esolwayo esebenzayo. Lokhu kuhlola kuhilela ukuphuza isiphuzo esikhethekile esinamaprotheni, amafutha, noshukela, okulandelwa ukuhlolwa kweglucose egazini amahora amahlanu. 
• Amadivaysi e-Continuous glucose monitoring (CGM) angasiza ekuhlonzeni nasekuvimbeleni iziqephu zikashukela ophansi, njengoba angahlelwa ukuze axwayise abasebenzisi ngokwehla kwamazinga. 

Ukwelashwa kwe-Hypoglycemia 

Umthetho we-15-15 uyisisekelo sokwelashwa kwe-hypoglycemia. Le ndlela ihlanganisa ukudla amagremu angu-15 wamacarbohydrate asheshayo nokuhlola amazinga kashukela egazini ngemva kwemizuzu engu-15. Inqubo iyaphindwa uma ushukela wegazi uhlala ungaphansi kuka-70 mg/dL (3.9 mmol/L) kuze kube yilapho amazinga esejwayelekile. 

Ama-carbohydrate asheshayo alungele ukwelapha i-hypoglycemia afaka: 

• Ama-ounces angu-4 (amamililitha angu-120) ejusi yezithelo noma i-soda evamile 
• Isipuni esisodwa (amamililitha angu-15) kashukela, uju, noma isiraphu 
• 3-4 amaphilisi eglucose 
• 5-6 izingcezu uswidi oqinile noma jelly ubhontshisi 

Ngemuva kokuthi amazinga kashukela egazini esezinzile, kubalulekile ukuthi ube nokudla okulula noma ukudla ukuze uvimbele okunye ukwehla nokugcwalisa izitolo ze-glycogen. 

Nge-hypoglycemia enzima, lapho umuntu equlekile noma engakwazi ukugwinya ngokuphepha, iglucagon ephuthumayo iyadingeka. I-glucagon, etholakala njengomjovo noma impushana yamakhala, ibangela isibindi ukuthi sikhiphe ushukela ogciniwe. Shayela abezimo eziphuthumayo uma iglucagon 
akutholakali. 

Ngesikhathi sokubona udokotela 

Ukwelashwa ngokushesha kuyadingeka uma: 

• Othile uba nezimpawu nezimpawu zoshukela ophansi ngaphandle kokuba nesifo sikashukela ngisho ne-pt yesifo sikashukela
• Umuntu onesifo sikashukela une-hypoglycemia engaphenduli ekwelashweni (isb., ukuphuza ijusi, ukudla uswidi, noma ukuphuza amaphilisi eglucose) 
• Umuntu onesifo sikashukela noma umlando we-hypoglycemia ukhombisa izimpawu ze-hypoglycemia enzima noma alahlekelwe ukwazi  

Ukuvimbela i-Hypoglycemia 

Unganciphisa ingozi yeziqephu zeshukela eliphansi ngokulandela amasu ambalwa abalulekile, anjengokuthi: 

• Thatha yonke imishanguzo njengoba uyalelwe. 
• Ukulandela imiyalelo mayelana nokudla nokuzivocavoca kubalulekile ngokufanayo. Ukudla okuvamile okuhlukaniswe ngamahora ama-4 kuya kwangu-5 kungasiza ekuvimbeleni ukwehla kungazelelwe kushukela. 
• Gada amazinga eglucose njalo. 
• Kulabo abaphuza utshwala, ukulinganisela kubalulekile. 
• Okokugcina, ukuphatha isongo esikhomba isifo sikashukela kungasindisa ukuphila ezimeni eziphuthumayo. 

Isiphetho 

Ukuqonda i-hypoglycemia kunomthelela omkhulu ekulawuleni impilo yonke. Lesi simo, esibonakala ngamazinga aphansi kashukela egazini, singathinta noma ubani, nakuba sivame kakhulu kubantu abanesifo sikashukela. Ukuqaphela izimpawu ze-glucose ephansi, kusukela ekuphathekeni kabi kuya ezinkingeni ezinzima, kubalulekile ukuvimbela izingozi zempilo ezingaba khona. Ngokuqaphela izinhlobo ezahlukahlukene, izimbangela, nezici zobungozi ezihambisana ne-hypoglycemia, abantu bangathatha izinyathelo eziqinile zokuthola amazinga kashukela azinzile. 

FAQ sika 

1. Ivamise kangakanani i-glucose yegazi ephansi? 

Ukwehla kweglucose yegazi, noma i-hypoglycemia, kuvame kakhulu kubantu abanesifo sikashukela. Kulabo abanesifo sikashukela sohlobo loku-1, izimpawu zingase zenzeke kabili ngesonto. Ocwaningweni olukhulu lomhlaba wonke, amaphesenti angama-80 abantu abanesifo sikashukela sohlobo loku-1 kanye namaphesenti angaba ngu-50 alabo abanesifo sikashukela sohlobo 2 babenoshukela wegazi ophansi (hypoglycemic) okungenani kanye esikhathini esingamasonto ama-4. 

2. Ungaba ne-hypoglycemic futhi ungabi nesifo sikashukela? 

Yebo, i-hypoglycemia engeyona isifo sikashukela ingenzeka, nakuba ingajwayelekile kangako. Kungase kwenzeke ngenxa yemithi ethile, ukuphuza ngokweqile, izifo ezinzima, ukuphazamiseka kwezinso, noma indlala yesikhathi eside. 

3. Obani abangaba sengozini yokuthola ushukela wegazi ophansi? 

Abantu abanesifo sikashukela sohlobo loku-1, labo abasebenzisa i-insulin noma imishanguzo ethile yesifo sikashukela, abantu abangaphezu kweminyaka engama-65, kanye nalabo abanomlando weglucose ephansi basengozini enkulu. Ezinye izinto eziyingozi zihlanganisa izinkinga zempilo njengesifo sezinso, Isifo senhliziyo, noma ukukhubazeka kwengqondo. 

4. Yikuphi ukudla okwehlisa amazinga kashukela? 

Ukudla okuningana kungasiza ukwehlisa amazinga kashukela egazini: 

• uviniga 
• turmeric 
• Anyanisi 
• Umhlanga omunyu 
• Itiye elihlaza 

5. Yikuphi ukushoda okubangela i-hypoglycemia? 

Ukushoda kwamahomoni, ikakhulukazi ku-adrenal gland kanye namahomoni e-pituitary, kungaholela ekukhiqizweni kweglucose eyanele noma imetabolism, okuholela ku-hypoglycemia. 

6. Uwalawula kanjani amazinga kashukela ngokushesha? 

Ukuze wehlise ngokushesha ushukela wegazi, thatha i-insulin esebenza ngokushesha njengoba eyalelwe udokotela wakho. Ukuzivocavoca kungasiza futhi ukunciphisa amazinga kashukela ngokushesha. Nge-hypoglycemia, dla amagremu angu-15 wamacarbohydrate asheshayo, njengejusi yezithelo noma amaphilisi eglucose. 

7. Ingabe i-hypoglycemia ingaphenduka ibe isifo sikashukela? 

I-hypoglycemia esebenzayo, eyenzeka emahoreni ambalwa ngemuva kokudla, ingakhombisa ukwanda kwengozi yokuba nesifo sikashukela. Kodwa-ke, i-hypoglycemia ngokwayo ayibangeli ngokuqondile isifo sikashukela. 

8. Uyini umsuka we-hypoglycemia? 

Imbangela eyinhloko ye-hypoglycemia ukungalingani phakathi kwamazinga e-insulin neglucose egazini. Lokhu kungalingani kungabangelwa ukwelapha ngokweqile ngemithi yesifo sikashukela, ukungadli ngokwanele, ukuvivinya umzimba ngamandla, noma izimo zempilo ezingaphansi ezithinta ukulawulwa kwe-glucose.

UDkt. Vaibhav Agrawal

I-MBBS, MD
I-Ganga CARE Hospital Limited, eNagpur

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529

2