Diabetic Ketoacidosis ni iki? Ibimenyetso, Impamvu, n'Ubuvuzi

Diabetic ketoacidosis (DKA) ni ingorane ikomeye ibaho iyo umubiri wawe utagira insuline ihagije ifasha isukari kwinjira mu mitsi yawe kugira ngo ikubere ingufu. Ahubwo, umubiri wawe utangira gusenya ibinure kugira ngo ubone ingufu, ibi bikaba bituma habaho ibintu byangiza bita ketones, bigatuma amaraso yawe aba ashishikajwe cyane.

Iyi ndwara ikunda kwibasira abantu barwaye diyabete yo mu bwoko bwa mbere, ariko ishobora kandi kugaragara no mu barwaye diyabete yo mu bwoko bwa kabiri mu gihe runaka. Nubwo DKA ari uburwayi bukomeye busaba ubuvuzi bw’ibitaro ako kanya, gusobanukirwa icyo ari cyo n’uburyo bwo kukimenya bishobora kugufasha gufata ingamba vuba igihe bibaye ngombwa.

Ibimenyetso bya diabetic ketoacidosis ni ibihe?

Ibimenyetso bya DKA bisanzwe bigaragara vuba, akenshi mu masaha 24, kandi bishobora gutuma wumva urwaye cyane. Umubiri wawe uzaguha ibimenyetso bigaragara ko hari ikintu gikomeye kirimo kuba.

Dore ibimenyetso bisanzwe ushobora kugira:

• Umukama ukabije udashira nubwo unyoye cyane
• Gushobora kenshi, cyane cyane nijoro
• Isesemi no kuruka bituma udashobora kurya cyangwa kunywa
• Kubabara mu nda bishobora kuba bikomeye cyangwa nk’igicuri
• Intege nke cyangwa umunaniro bikabije
• Guhumeka bugufi cyangwa guhumeka vuba kandi cyane
• Impumuro y’imbuto mu kanwa isa nkaho ari ya varnish yo gukuraho ibinyege
• Uburwayi cyangwa kugorana gutekereza

Bamwe banumva uruhu rwabo n’akanwa byumaze cyane, nubwo banywa amazi. Impumuro y’imbuto mu kanwa ibaho kubera ko ketones zisohoka mu bihaha byawe, kandi iyi mpumuro y’uburyohe akenshi iba ari kimwe mu bimenyetso bya mbere abagize umuryango babona.

Mu bihe bikomeye, ushobora kugira uburwayi, kugorana kuguma uryamye, cyangwa no kubura ubwenge. Ibi ni ibimenyetso byerekana ko DKA yateye imbere kandi ikeneye ubuvuzi bwihuse.

Icyateye diabetic ketoacidosis ni iki?

DKA ibaho iyo umubiri wawe utagira insuline ihagije yo kwambura isukari mu maraso yawe ukayijyana mu mitsi yawe. Utabonye iyo ngufu, umubiri wawe uhagarika umutima utangira gusenya ibinure, ibi bikaba bituma habaho ibyo bintu byangiza bya ketones twavuze.

Ibintu byinshi bishobora gutera iyi myitwarire mibi:

• Kudakinga insuline cyangwa kudakinga imiti ihagije ya insuline
• Uburwayi cyangwa indwara, bituma umubiri wawe ukeneye insuline nyinshi uko bisanzwe
• Umuvuduko ukabije, kubagwa, cyangwa imvune zigira ingaruka ku gukurikirana isukari mu maraso
• Igufatwa ry’umutima cyangwa umwijima, bishobora guhungabanya imikorere isanzwe y’umubiri
• Imiti imwe nka steroide ishobora kuzamura urwego rw’isukari mu maraso
• Ikoreshwa ry’ibiyobyabwenge cyangwa inzoga, bishobora kubangamira imicungire ya diyabete
• Ububata, cyane cyane niba diyabete idakurikiranwa neza

Rimwe na rimwe DKA ishobora kuba ikimenyetso cya mbere cy’uko umuntu arwaye diyabete, cyane cyane diyabete yo mu bwoko bwa mbere. Ibi bibaho kubera ko umubiri wabo umaze ibyumweru cyangwa amezi uhanganye utagira insuline ihagije mbere y’igihe cy’akaga.

Ndetse n’ikintu gisanzwe nka grippe gishobora gutera DKA niba utarimo guhindura imicungire yawe ya diyabete uko bikwiye. Umubiri wawe ubona uburwayi nk’umuvuduko kandi usohora imisemburo irwanya insuline, bituma gukurikirana isukari mu maraso bigorana cyane.

Ni ryari ukwiye kubona muganga kubera diabetic ketoacidosis?

Ugomba gushaka ubuvuzi bw’ibitaro ako kanya niba ufite ubuhehere bw’ibimenyetso bya DKA, cyane cyane niba ufite diyabete. Iki si ikibazo ushobora kuvura mu rugo cyangwa gutegereza ngo urebe niba kiza.

Hamagara 911 cyangwa ujya mu bitaro ako kanya niba ufite:

• Urwego rw’isukari mu maraso ruri hejuru ya 250 mg/dL hamwe na ketones mu mpiswi yawe
• Kurukwa kukubuza kurya cyangwa kunywa igihe kirekire cyane
• Ketones nyinshi mu mpiswi yawe igihe ugerageza ukoresheje impapuro zigerageza ketones
• Ibimenyetso byo gucika amazi nko guhinda umutwe, akanwa kabyimbye, cyangwa kudasha mu mpiswi
• Gukomeretsa guhumeka cyangwa guhumeka vuba
• Uburwayi, uburwayi, cyangwa kugorana kuguma uryamye
• Kubabara mu nda bikomeye bidakira

Niba udafite diyabete ariko ufite ibi bimenyetso, cyane cyane impumuro y’imbuto mu kanwa n’umuma ukabije, ugomba kandi gushaka ubuvuzi bw’ibitaro ako kanya. DKA rimwe na rimwe ishobora kuba uburyo abantu bamenya ko barwaye diyabete.

Nubwo utazi neza niba ibimenyetso byawe bikomeye bihagije, bihora byiza guhitamo kwitonda cyane kuri DKA. Abaganga bo mu bitaro bakunda kukubona kubera impungenge zidafatika kuruta kuguha umwanya uhagije wo gutabara.

Ibyago byo kwibasirwa na diabetic ketoacidosis ni ibihe?

Nubwo umuntu wese ufite diyabete ashobora kwibasirwa na DKA, ibintu bimwe na bimwe bituma bamwe bahura n’iyi ngorane ikomeye. Gusobanukirwa ibyago byawe bwite bishobora kugufasha kuba maso kurushaho mu kwirinda.

Ibyago bikomeye harimo:

• Kugira diyabete yo mu bwoko bwa mbere, cyane cyane niba uherutse kuvurwa cyangwa uri muto
• Kenshi utabona insuline cyangwa ugira ibibazo byo kubona imiti ya diyabete
• Kugira ibintu byinshi bya DKA mu gihe gishize
• Guhangana n’ibibazo byo mu mutwe nka depression cyangwa indwara z’imirire
• Kuba wenyine nta bantu bagufasha gukurikirana diyabete yawe
• Kugira izindi ndwara zituma gukurikirana diyabete bigorana
• Gukoresha imashini zikoresha insuline zishobora kunanirwa cyangwa gucika

Abantu bakuru bakiri bato barwaye diyabete yo mu bwoko bwa mbere bahura n’ibyago bikomeye, akenshi kubera ibibazo byo gukurikirana diyabete wenyine ku nshuro ya mbere. Umuvuduko wo kwiga, akazi, n’ibibazo by’imibanire bishobora gutuma kwita kuri diyabete buri gihe bigorana.

Abantu barwaye diyabete yo mu bwoko bwa kabiri nabo bashobora kwibasirwa na DKA, cyane cyane mu bihe by’uburwayi bukabije, umuvuduko, cyangwa niba bafata imiti imwe yitwa SGLT2 inhibitors. Nubwo bidakunze kugaragara muri diyabete yo mu bwoko bwa kabiri, biracyari ikibazo gikomeye kidakwiye kwirengagizwa.

Ingaruka zishoboka za diabetic ketoacidosis ni izihe?

DKA ishobora gutera ingaruka zikomeye niba idakuweho vuba kandi neza. Inkuru nziza ni uko, ukoresheje ubuvuzi bw’ibitaro vuba, abantu benshi barakira neza nta ngaruka ziramba.

Ariko, ingaruka zishoboka zishobora kuba zikomeye kandi zirimo:

• Gucika amazi bikabije bishobora gutera ibibazo by’impyiko cyangwa kunanirwa kwazo
• Urwego rwo hasi cyane rwa potasiyumu rugira ingaruka ku mikorere y’umutima n’imikaya
• Kubyimbagira mu bwonko (cerebral edema), bikunze kugaragara mu bana
• Ibibazo byo gukomera amaraso bishobora kongera ibyago byo kugira umwijima cyangwa ibyago byo kugira umutima
• Ibibazo by’ibihaha birimo kubyimbagira cyangwa kunanirwa
• Koma cyangwa urupfu mu bihe bikomeye, bitavuwe

Ingaruka ikomeye cyane ni cerebral edema, aho ubwonko bwibyimbagira kubera impinduka zikomeye mu maraso mu gihe cy’ubuvuzi. Niyo mpamvu abaganga bakurikirana abarwaye DKA neza kandi bagahindura ubuvuzi buhoro buhoro aho kugerageza gukosora byose icyarimwe.

Ibyiza ni uko, iyo DKA ifashwe hakiri kare kandi ivurwa mu bitaro, abantu benshi barakira neza. Ikintu nyamukuru ni ugukuramo ubufasha bw’abaganga vuba aho kugerageza gucunga ibimenyetso wenyine.

Diabetic ketoacidosis ishobora kwirindwa gute?

Inkuru nziza kuri DKA ni uko ishobora kwirindwa cyane ukoresheje imicungire myiza ya diyabete n’ubumenyi. Ibyinshi mu bintu bishobora kwirindwa binyuze mu gukurikirana neza isukari yawe mu maraso no kumenya igihe ukwiye gushaka ubufasha.

Dore ingamba zikomeye zo kwirinda:

• Fata insuline yawe uko yagenewe, nubwo wumva urwaye
• Suzuma isukari yawe mu maraso kenshi mu gihe cy’uburwayi, umuvuduko, cyangwa impinduka mu buzima busanzwe
• Suzuma ketones iyo isukari yawe mu maraso iri hejuru ya 250 mg/dL cyangwa iyo wumva urwaye
• Komeza kunywa amazi menshi, cyane cyane mu gihe cy’ubushyuhe cyangwa uburwayi
• Gufite gahunda yo kuvura mu gihe urwaye ukoranye n’itsinda ry’abaganga bawe mbere y’igihe
• Kugira ibikoresho by’insuline n’ibigeragezo by’amaraso bihagije
• Kwambara imyenda yerekana ko ufite diyabete

Kwigira gusuzuma ketones ni ingenzi cyane. Ushobora kugura impapuro zigerageza ketones muri farumasi nyinshi, kandi biroroshye kuzikoresha ukoresheje urumuri cyangwa amaraso. Gusuzuma ketones iyo urwaye cyangwa ufite isukari nyinshi mu maraso bishobora kuguha umwanya wo kumenya ko DKA ishobora kuba irimo kuba.

Gutegura gahunda yo kuvura mu gihe urwaye ukoranye n’umuganga wawe mbere y’igihe ni kimwe mu bintu by’ubwenge ushobora gukora. Iyi gahunda igomba kuba irimo igihe ukwiye guhamagara ubufasha, uburyo bwo guhindura insuline yawe, ibyo kurya, n’igihe ukwiye gusuzuma ketones.

Diabetic ketoacidosis imenyekanwa gute?

Abaganga bashobora kumenya DKA vuba ukoresheje ibigeragezo by’amaraso, ibigeragezo by’impiswi, n’isuzuma ry’umubiri. Ibi bimenyetso bisanzwe biba byoroshye kumenya kuko DKA itera impinduka zidasanzwe mu maraso yawe.

Ibizamini by’ingenzi muganga azakoresha harimo:

• Isuzuma ry’isukari mu maraso kugira ngo arebe uko isukari yawe mu maraso yazamutse
• Isuzuma rya ketones mu maraso kugira ngo apime urwego rwa ketones zangiza mu maraso yawe
• Isuzuma ry’amaraso kugira ngo arebe uko amaraso yawe yashishikajwe
• Isuzuma rusange ry’amaraso kugira ngo arebe imikorere y’impyiko zawe n’urwego rw’ibintu by’ingenzi
• Isuzuma ry’impiswi kugira ngo ashake ketones n’ibimenyetso byo gucika amazi
• Isuzuma rusange ry’amaraso kugira ngo ashake ibimenyetso by’indwara

Muganga azakora kandi isuzuma ry’umubiri, akareba ibimenyetso byo gucika amazi, uburyo bwo guhumeka, n’ubushishozi. Azakubaza ibibazo ku bimenyetso byawe, uburwayi uheruka kugira, gukurikiza imiti, n’ibintu byose bishobora kuba byarateye DKA.

Mu bihe bimwe na bimwe, bishobora kuba ngombwa gukora ibindi bizamini kugira ngo bimenye icyateye DKA, nko gufata amafoto y’amabere kugira ngo harebwe pneumonia, ibigeragezo by’amaraso kugira ngo harebwe indwara, cyangwa EKG kugira ngo harebwe imikorere y’umutima.

Ubuvuzi bwa diabetic ketoacidosis ni buhe?

Ubuvuzi bwa DKA bukorerwa mu bitaro kandi bugamije gukosora buhoro buhoro ibibazo byateye akaga. Itsinda ry’abaganga bazakorana neza kugira ngo basubize umubiri wawe mu mibanire isanzwe batateye izindi ngaruka.

Ubuvuzi busanzwe burimo ibice by’ingenzi bikurikira:

• Amazi ya IV kugira ngo asimbuze amazi n’umunyu umubiri wawe watakaje kubera gushobora kenshi
• Ubuvuzi bwa insuline butangwa binyuze muri IV kugira ngo bugabanye isukari mu maraso kandi buhagarike gukora ketones
• Gusubiza ibintu by’ingenzi, cyane cyane potasiyumu, igabanuka cyane mu gihe cy’ubuvuzi
• Gukurikirana hafi ibyavuye mu maraso hakoreshejwe ibizamini byinshi by’amaraso
• Kuvura ibibazo byose byateye DKA
• Guhindukira buhoro buhoro ku miti yawe isanzwe ya diyabete

Ubuvuzi busanzwe bumaramo amasaha 12 kugeza kuri 24, aho uzakurikiranwa hafi cyane. Itsinda ry’abaganga bazakurikirana isukari yawe mu maraso, ketones, n’ibintu by’ingenzi buri masaha make kugira ngo barebe ko byose birimo kugenda neza.

Ikintu kimwe gikomeye cyo gusobanukirwa ni uko ubuvuzi bukorwa buhoro buhoro. Abaganga ntibagerageza gukosora byose icyarimwe kuko impinduka zikomeye rimwe na rimwe zishobora gutera ingaruka, cyane cyane kubyimbagira mu bwonko mu barwayi bato.

Uko wakwitaho mu gihe cyo gukira diabetic ketoacidosis

Gukira DKA bikomeza no nyuma yo kuva mu bitaro. Umubiri wawe ukeneye umwanya wo gukira neza, kandi ugomba kwitonda cyane ku micungire yawe ya diyabete igihe runaka.

Dore ibyo ushobora kwitega mu gihe cyo gukira:

• Kumva unaniwe cyangwa ufite intege nke iminsi myinshi uko umubiri wawe ukomeza gukira
• Kunywa amazi menshi kugira ngo imyeyo yawe ikire
• Kugira ibizamini byinshi byo gukurikirana n’itsinda ry’abaganga bawe
• Bishobora kuba ngombwa guhindura inzira yo gukoresha insuline yawe by’agateganyo
• Gukurikirana isukari yawe mu maraso kenshi uko bisanzwe
• Gusubira buhoro buhoro ku mirire yawe isanzwe n’imirimo

Birasanzwe kumva uhangayitse nyuma y’igihe cya DKA. Abantu benshi bumva batinya, bababazwa, cyangwa barushye kubera ibyabaye. Ibyo byiyumvo ni byiza, kandi kuvugana n’itsinda ry’abaganga bawe, umuryango, cyangwa umujyanama bishobora kugufasha cyane.

Iki kandi ni igihe cyiza cyo kureba icyateye DKA kandi ukore n’itsinda ry’abaganga bawe kugira ngo wirinde ko byongera kubaho. Abantu benshi bahuye na DKA rimwe ntibabona ko byongera kubaho kuko baba maso cyane ku micungire ya diyabete yabo. Ufite ubufasha n’ubumenyi bikwiye, ushobora gucunga diyabete yawe neza kandi ukabaho ubuzima buzira umuze.

Uko wakwitegura gusura muganga

Uko waba ubonana n’umuganga wawe kugira ngo ukore ibizamini nyuma ya DKA cyangwa kuko uhangayikishijwe n’ibimenyetso, kwitegura neza bishobora kugufasha kubona ibyiza byinshi mu ruzinduko rwawe. Kwitegura neza biragufasha kutazibagirwa amakuru y’ingenzi igihe wumva uhangayitse cyangwa urwaye.

Mbere y’uruzinduko rwawe, kora ibi bintu by’ingenzi:

• Ibipimo bya vuba by’isukari mu maraso n’ibintu byose wabonye
• Urutonde rwuzuye rw’imiti yose, harimo n’ingano n’igihe cyo kuyifata
• Amakuru yerekeye uburwayi uheruka kugira, umuvuduko, cyangwa impinduka mu buzima bwawe busanzwe
• Ibimenyetso wabonye n’igihe byatangiye
• Ibisubizo byo gusuzuma ketones niba wari ubisuzumye mu rugo
• Ibibazo byo kwirinda ko byongera kubaho

Andika ibibazo byawe mbere y’igihe kugira ngo utabyibagirwa mu gihe cy’uruzinduko. Ibibazo bisanzwe harimo kubaza ku guhindura insuline mu gihe cy’uburwayi, igihe cyo gusuzuma ketones, n’ibimenyetso byo kwitondera.

Niba uherutse kugira DKA, vugana n’umuganga wawe ku bibazo byose uhura na byo mu gukurikirana diyabete. Uko waba ufite ibibazo byo kubona imiti, kugorana kwibuka ingano, cyangwa ibibazo byo kurya no gukora imyitozo ngororamubiri, itsinda ry’abaganga bawe rishobora kugufasha gusa niba bazi icyo kibazo.

Icyo ukwiye kumenya cyane kuri diabetic ketoacidosis

Ikintu cy’ingenzi cyo kwibuka kuri DKA ni uko ari ingorane ikomeye ariko ishobora kwirindwa ya diyabete. Ukoresheje imicungire myiza y’isukari mu maraso, kumenya ibimenyetso byo kwitondera, no gushaka ubuvuzi bw’ibitaro vuba igihe bibaye ngombwa, abantu benshi barwaye diyabete ntibazigera bahura na DKA.

Niba ufite ibimenyetso bya DKA, gushaka ubuvuzi bw’ibitaro vuba bishobora kwirinda ingaruka zikomeye kandi bikagufasha gukira neza. Ntugerageze kubihanganira cyangwa gucunga ibimenyetso wenyine – DKA isaba ubuvuzi bw’abaganga mu bitaro.

Wibuke ko kugira DKA rimwe ntibivuze ko uzongera kuyibona. Abantu benshi bakoresha ibyabaye nk’ishimikiro ryo kunoza imicungire ya diyabete yabo kandi ntibongera guhura n’iyi ngorane. Ufite ubufasha n’ubumenyi bikwiye, ushobora gucunga diyabete yawe neza kandi ukabaho ubuzima buzira umuze.

Ibibazo byakunda kubaho kuri diabetic ketoacidosis

Urashobora kugira DKA ufite urwego rusanzwe rw’isukari mu maraso?

Yego, iyi ndwara yitwa euglycemic DKA, kandi ishobora kubaho iyo urwego rw’isukari mu maraso ruri hejuru gato cyangwa ruri rusanzwe. Ikunda kugaragara mu bantu bafata imiti imwe ya diyabete yitwa SGLT2 inhibitors, mu gihe cy’ububata, cyangwa iyo umuntu atarya ibiryo bihagije. Ketones n’ubushishika bw’amaraso bishobora kubaho nubwo isukari mu maraso idakabije, niyo mpamvu gusuzuma ketones ari ingenzi cyane iyo wumva urwaye.

Igihe kingana iki kugira ngo ukire diabetic ketoacidosis?

Abantu benshi batangira kumva bameze neza mu masaha 12 kugeza kuri 24 batangiye kuvurwa mu bitaro, ariko gukira neza bisanzwe bimamara iminsi myinshi kugeza ku cyumweru. Ibintu by’ingenzi mu maraso yawe bisanzwe bisubira mu buryo mu munsi umwe cyangwa ibiri, ariko ushobora kumva unaniwe cyangwa ufite intege nke iminsi myinshi uko umubiri wawe ukomeza gukira. Igihe nyacyo kigendera ku buryo DKA yari ikomeye n’uburyo wahawe ubuvuzi vuba.

Umuvuduko wenyine ushobora gutera diabetic ketoacidosis?

Nubwo umuvuduko wo mu mutwe cyangwa umubiri udashobora gutera DKA, ushobora kuba intandaro ikomeye yo kuzamura isukari yawe mu maraso no kongera ibyo umubiri wawe ukeneye bya insuline. Umuvuduko usohora imisemburo nka cortisol ituma insuline idakora neza, bishobora gutera DKA niba utarimo guhindura imicungire yawe ya diyabete uko bikwiye. Niyo mpamvu kugira gahunda yo gucunga diyabete mu bihe by’umuvuduko ari ingenzi cyane.

Diabetic ketoacidosis ni kimwe na ketosis yo muri za diets?

Oya, ibi ni ibintu bitandukanye rwose. Ketosis yo muri za diets zidafite isukari nyinshi ituma habaho ketones nke, zidahagaritse amaraso yawe. DKA ikubiyemo gukora ketones nyinshi bituma habaho ubushishika bw’amaraso. Abantu badafite diyabete bakurikiza za diets za ketogenic ntibabona DKA kuko imibiri yabo iracyashobora gukora insuline ihagije kugira ngo ihagarike urwego rwa ketones.

Urashobora kwirinda DKA niba wumva irimo gutangira?

Niba ufashe ibimenyetso byo kwitondera hakiri kare kandi ukora vuba, ushobora kwirinda DKA yuzuye binyuze mu gusuzuma isukari yawe mu maraso na ketones, gufata insuline nyongeza nk’uko umuganga wawe yabigutegetse, kuguma unywa amazi, no gushaka ubuvuzi bw’ibitaro vuba. Ariko, iyo ibimenyetso bya DKA byamaze kugaragara, ukeneye ubuvuzi bw’ibitaro. Niyo mpamvu gukurikirana isukari mu maraso buri gihe no kugira gahunda yo kuvura mu gihe urwaye ari ingenzi cyane mu gutabara hakiri kare.