Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) ni ingaruka zikomeye ziterwa na diyabete.

Iyi ndwara ibaho iyo umubiri utashobora gukora insuline ihagije. Insuline igira uruhare rukomeye mu gufasha isukari—isoko nyamukuru y'ingufu ku mitsi n'imikaya y'umubiri—kwinjira mu mitsi y'umubiri.

Iyo insuline idahagije, umubiri utangira gusenya ibinure kugira ngo abone ingufu. Ibi bituma habaho umunyu w'amavuta mu maraso witwa ketones. Niba bitavuwe, uyu munyu ushobora gutera diabetic ketoacidosis.

Niba ufite diyabete cyangwa uri mu kaga ko kuyirwara, menya ibimenyetso by'uburwayi bwa diabetic ketoacidosis n'igihe ukwiye gushaka ubuvuzi bwihuse.

Ibimenyetso bya ketoacidose ya diabete akenshi bitangira vuba, rimwe na rimwe mu masaha 24. Kuri bamwe, ibi bimenyetso bishobora kuba ikimenyetso cya mbere cy'uko ufite diabete. Ibimenyetso bishobora kuba birimo:

• Kugira inyota cyane
• Gushobora gukora kenshi
• Kumva ukeneye kuruka no kuruka
• Kugira ububabare mu nda
• Kugira intege nke cyangwa umunaniro
• Guhumeka nabi
• Kugira umwuka ufite impumuro y'imbuto
• Kugira urujijo

Ibimenyetso bifatika bya ketoacidose ya diabete-bishobora kugaragara mu bipimo byo mu rugo by'amaraso n'impiswi-birimo:

• Urwego rwo hejuru rw'isukari mu maraso
• Urwego rwo hejuru rwa Ketone mu mpiswi

Niba wumva uburwayi cyangwa uhangayitse cyangwa uherutse kurwara cyangwa gukomereka, jya ugenzura urwego rwawe rwa sukari mu maraso kenshi. Ushobora kandi kugerageza ikizamini cyo gupima ibinure muri urine, ubone mu iduka ry'imiti.

Hamagara umuvuzi wawe vuba uko bishoboka niba:

• Urusha cyane kandi udashobora kurya cyangwa kunywa
• Urwego rwawe rwa sukari mu maraso rurengeje urwego rwawe rugeramije kandi ntiruhinduka nubwo wakoresheje uburyo bwo kuvura mu rugo
• Urwego rw'ibiture muri urine yawe ruri hagati cyangwa ruri hejuru

Shaka ubuvuzi bwihuse niba:

• Urwego rwawe rwa sukari mu maraso rurengeje imiligaramu 300 kuri desilitri (mg/dL), cyangwa milimoli 16.7 kuri litiro (mmol/L) mu bipimo birenga kimwe.
• Ufite ibinure muri urine kandi udashobora kuvugana n'umuvuzi wawe kugira ngo aguhe inama.
• Ufite ibimenyetso byinshi bya ketoacidose ya diabete. Ibi birimo inyota nyinshi, kenshi gukora imyeyo, isereri n'kuruka, ububabare mu nda, intege nke cyangwa umunaniro, guhumeka nabi, umwuka ufite impumuro y'imbuto, no gucika intege.

Wibuke ko ketoacidose ya diabete idakize ishobora gutera urupfu.

Isukari ni isoko y'ingufu nyamukuru ku mitsi igize imikaya n'imiterere y'umubiri. Insulin ifasha isukari kwinjira mu mitsi y'umubiri.

Iyo insulin idahagije, umubiri ntushobora gukoresha isukari kugira ngo ukore ingufu ukeneye. Ibi bituma hakorwa imisemburo isenya amavuta kugira ngo umubiri ayakoreshe nk'ibikomokaho. Ibi kandi bituma habaho aside izwi nka ketones. Ketones zikura mu maraso maze zikajya mu mpisho.

Diabetic ketoacidosis isanzwe iba nyuma ya:

• Indwara. Ubwandu cyangwa izindi ndwara bishobora gutuma umubiri ukora imisemburo myinshi, nka adrenaline cyangwa cortisol. Iyi misemburo irwanya ingaruka za insulin kandi rimwe na rimwe itera diabetic ketoacidosis. Pneumonia n'ubwandu bw'inzira y'umuyoboro w'inkari ni indwara zisanzwe zishobora gutera diabetic ketoacidosis.
• Ikibazo mu ikoreshwa rya insulin. Kudakinga imiti ya insulin bishobora gutuma insulin iba nke cyane mu mubiri. Kudakinga imiti ya insulin ihagije cyangwa pompe ya insulin idakora neza bishobora kandi gutuma insulin iba nke cyane mu mubiri. Icyo ari cyo cyose muri ibyo bibazo gishobora gutera diabetic ketoacidosis.

Ibindi bintu bishobora gutera diabetic ketoacidosis birimo:

• Imvune z'umubiri cyangwa zo mu mutwe
• Igitero cy'umutima cyangwa stroke
• Pancreatitis
• Gutwita
• Gukoresha inzoga cyangwa ibiyobyabwenge, cyane cyane cocaine
• Imiti imwe, nka corticosteroids na diuretics zimwe

Ibiro byo kwibasira ketoacidose ya diyabete biri hejuru cyane niba:

• ufite diyabete yo mu bwoko bwa mbere
• Usiba kenshi inshinge za insulin

Rimwe na rimwe, ketoacidose ya diyabete ishobora kubaho hamwe na diyabete yo mu bwoko bwa kabiri. Mu mubare w'imimerere, ketoacidose ya diyabete ishobora kuba ikimenyetso cya mbere cyo kuba ufite diyabete.

Diabetic ketoacidosis irarwanywa hakoreshejwe amazi, électrolytes — nka sodium, potasium na chloride — na insuline. Birashoboka ko bitangaje, ingaruka mbi zisanzwe cyane za diabetic ketoacidosis zifitanye isano n'ubu buryo bwo kuvura burokora ubuzima.

Hariho uburyo bwinshi bwo gukumira ketoacidose ya diyabete n'izindi komplikasi za diyabete.

• Genzura diyabete yawe. Komeza kurya indyo nzima kandi ukore imyitozo ngororamubiri buri munsi. Fata imiti ya diyabete cyangwa insuline nkuko wabwiwe.
• Genzura urwego rwa glucose mu maraso yawe. Ushobora kuba ukeneye kugenzura no kwandika urwego rwa glucose mu maraso yawe byibuze inshuro 3-4 ku munsi, cyangwa kenshi kurushaho iyo urwaye cyangwa uri mu kaga. Gukurikirana neza ni bwo buryo bwonyine bwo kugenzura ko urwego rwa glucose mu maraso yawe rukomeza kuba mu rwego rwawe.
• Hindura umwanya wawe wa insuline uko bikenewe. Ganira n'abaganga bawe cyangwa umwarimu wa diyabete ku buryo bwo gukora umwanya wawe wa insuline. Tegereza ibintu nk'urwego rwa glucose mu maraso yawe, ibyo urya, uko ukora, niba urwaye. Niba urwego rwa glucose mu maraso yawe rutangira kuzamuka, kurikiza gahunda yawe yo kuvura diyabete kugira ngo urwego rwa glucose mu maraso yawe rusubire mu rwego rwawe.
• Suzuma urwego rwa Ketone. Iyo urwaye cyangwa uri mu kaga, suzuma imyanda yawe kugira ngo urebe niba hari ketones nyinshi ukoresheje ikiti cyo gupima ketones mu myanda. Urashobora kugura ibikoresho byo gupima muri farumasi. Niba urwego rwa ketone rwawe ari rwo hagati cyangwa ruri hejuru, hamagara umuganga wawe vuba cyangwa shaka ubuvuzi bwihuse. Niba ufite urwego rwo hasi rwa ketones, ushobora kuba ukeneye gufata insuline nyinshi.
• Tegura kwerekana vuba. Niba utekereza ko ufite ketoacidose ya diyabete kuko glucose yawe iri hejuru kandi ufite ketones nyinshi mu myanda yawe, shaka ubuvuzi bwihuse. Komplikasi za diyabete ziterwa ubwoba. Ariko ntukareke ubwoba bugutere kubura kwita ku buzima bwawe. Kurikiza gahunda yawe yo kuvura diyabete neza. Saba ubufasha itsinda ryawe ryita ku diyabete iyo ubukeneye.

Isuzuma ry'umubiri n'ibipimo by'amaraso bishobora gufasha mu gusobanura indwara ya diabetic ketoacidosis. Mu mubare w'ibindi bihe, ibindi bipimo bishobora kuba bikenewe kugira ngo bigufashe kumenya icyateye diabetic ketoacidosis.

Ibisubizo by'amaraso bikoresha mu gusobanura diabetic ketoacidosis bizapima:

Ibisubizo bishobora gufasha mu gushaka ibibazo by'ubuzima bishobora kuba byarateye diabetic ketoacidosis no kugenzura ingaruka zishobora kuba zirimo:

• Igipimo cy'isukari mu maraso. Niba nta insuline ihagije mu mubiri kugira ngo isukari ijye mu mitsi, igipimo cy'isukari mu maraso kizagenda kizamuka. Ibi bizwi nka hyperglycemia. Uko umubiri usenya ibinure na poroteyine kugira ngo ubone imbaraga, igipimo cy'isukari mu maraso kizakomeza kuzamuka.

• Igipimo cya Ketone. Iyo umubiri usenya ibinure na poroteyine kugira ngo ubone imbaraga, aside izwi nka ketones ijya mu maraso.

• Uburyo bw'amavuta mu maraso. Igipimo cya Ketone kiri hejuru cyane kizatera amaraso kuba aside. Ibi bishobora guhindura uko imyanya y'umubiri ikora.

• Ibizamini by'amaraso bya electrolyte

• Urinalysis

• Chest X-ray

• Igitabo cy'umurimo w'amashanyarazi w'umutima, kizwi kandi nka electrocardiogram