Diabete Ya Type 1

Menya amakuru arambuye kuri diyabete yo mu bwoko bwa mbere uhereye kuri endocrinologist Yogish Kudva, M.B.B.S.

Ntabwo tuzi icyateye diyabete yo mu bwoko bwa mbere. Twemera ko ari indwara y'umubiri ubwe aho umubiri usenya utunyangingo dukora insuline mu mpyiko. Ubusanzwe, impyiko isohora insuline mu maraso. Insuline itembera, ikareka isukari kwinjira mu mitsi yawe. Iyi sukari cyangwa glucose, niyo shingiro ry'ingufu z'utunyangingo mu bwonko, utunyangingo tw'imikaya, n'utundi duto. Ariko, igihe utunyangingo twinshi dukora insuline byangiritse, impyiko ntishobora gukora insuline ihagije, bisobanura ko glucose itabasha kwinjira mu mitsi, bigatuma isukari nyinshi iba mu maraso. Ibi bishobora gutera ingaruka zikomeye zishobora kwica. Kandi iyi ndwara yitwa ketoacidosis ya diyabete. Nubwo tutaziko icyayiteye, tuzi ko hari ibintu bimwe bishobora gutera diyabete yo mu bwoko bwa mbere. Amateka y'umuryango. Umuntu wese ufite umubyeyi cyangwa umuvandimwe ufite diyabete yo mu bwoko bwa mbere afite ibyago byiyongereye gato byo kuyirwara. Ubumenyi bw'imiterere y'umubiri. Kuba hari imigeni runaka bishobora kandi kugaragaza ibyago byiyongereye. Ubutaka. Diyabete yo mu bwoko bwa mbere iba myinshi uko ugenda uva kuri Equateur. Imyaka, nubwo ishobora kubaho mu myaka yose hari ibyiciro bibiri byibonekeza. Icya mbere kiba ku bana bari hagati y'imyaka ine na karindwi kandi icya kabiri kiri hagati y'imyaka 10 na 14.

Ibimenyetso bya diyabete yo mu bwoko bwa mbere bishobora kugaragara vuba, cyane cyane ku bana. Bishobora kuba harimo inyota nyinshi, kwinnya kenshi, kunyara mu buriri ku bana batari basanzwe babyara. Inzara ikabije, kugabanuka k'uburemere bitateganijwe, umunaniro n'intege nke, kubura neza kw'amaso, kurakara, n'izindi mpinduka z'imitekerereze. Niba wowe cyangwa umwana wawe mugira bimwe muri ibi bimenyetso, mugomba kuvugana na muganga.

Uburyo bwiza bwo kumenya niba ufite diyabete yo mu bwoko bwa mbere ni igipimo cy'amaraso. Hari uburyo butandukanye nko gupima A1C, gupima isukari mu maraso, cyangwa gupima isukari mu maraso nyuma yo gusiba. Byose bifite akamaro kandi muganga wawe ashobora kugufasha kumenya icyakubereye. Niba ubonye diyabete, muganga wawe ashobora gutegeka ibindi bipimo kugira ngo arebe antikorps zisanzwe muri diyabete yo mu bwoko bwa mbere mu bipimo byitwa C-peptide, bipima umubare w'insuline ikorwa iyo bipimwe hamwe na glucose yo gusiba. Ibi bipimo bishobora gufasha gutandukanya diyabete yo mu bwoko bwa mbere na diyabete yo mu bwoko bwa kabiri iyo ubumenyi budahamye.

Niba umaze kubona diyabete yo mu bwoko bwa mbere, ushobora kwibaza uko kuvurwa kumeze. Bishobora gusobanura gufata insuline, kubara karubone, amavuta, poroteyine, no kugenzura glucose yawe kenshi, kurya ibiryo byiza, no gukora imyitozo ngororamubiri buri gihe kugira ngo ugume ufite ubuzima bwiza. Muri rusange, abafite diyabete yo mu bwoko bwa mbere bazakenera kuvurwa na insuline ubuzima bwabo bwose. Hari ubwoko butandukanye bwa insuline kandi hari izindi ziri gukorwa zifite ingufu. Kandi icyo ushobora gufata gishobora guhinduka. Nanone, muganga wawe azagufasha kumenya icyakubereye. Intambwe ikomeye mu kuvura mu myaka mike ishize ni iterambere n'ibyiza byo kugenzura glucose buri gihe no gukoresha imiti ya insuline ishobora kwihinduranya ikorana na continuous glucose monitor. Ubwo buryo bwo kuvura ni bwo buryo bwiza cyane kuri diyabete yo mu bwoko bwa mbere muri iki gihe. Iki ni igihe cyiza ku barwayi no ku baganga bashaka guteza imbere, bagatanga imiti nk'iyo. Kugira ibyago ni ikindi kintu. Kugira impyiko nziza bishobora gukuraho ibyago byo gukenera insuline yinyongera. Ariko, guhindura impyiko ntibishoboka buri gihe, ntabwo bigira icyo bikora kandi uburyo bushobora gutera ibyago bikomeye. Rimwe na rimwe bishobora kurenza ibyago bya diyabete ubwayo. Rero guhindura impyiko bikunze gukoreshwa ku barwaye indwara zigoye cyane. Kugira impyiko nziza bishobora kuzana impinduka mu buzima. Ariko, kubaga buri gihe ni ikintu gikomeye kandi bisaba ubushakashatsi buhagije n'ibyiringiro kuva kuri wowe, umuryango wawe, n'itsinda ryawe ry'abaganga.

Diyabete yo mu bwoko bwa mbere, yahoze izwi nka diyabete y'abakiri bato cyangwa diyabete isaba insuline, ni indwara iramara igihe kirekire. Muri iyi ndwara, impyiko ikora insuline nke cyangwa ntayo ikora. Insuline ni imisemburo umubiri ukoresha kugira ngo isukari (glucose) ibashe kwinjira mu mitsi kugira ngo ikore ingufu.

Ibintu bitandukanye, nko kwimenya n'ibyorezo bimwe, bishobora gutera diyabete yo mu bwoko bwa mbere. Nubwo diyabete yo mu bwoko bwa mbere isanzwe igaragara mu bwana cyangwa mu gihe cy'ubwangavu, ishobora kuza no ku bakuru.

Nubwo hakozwe ubushakashatsi bwinshi, diyabete yo mu bwoko bwa mbere nta muti ifite. Kuvura bigamije gucunga umubare w'isukari mu maraso hakoreshejwe insuline, indyo n'imibereho kugira ngo hirindwe ingaruka mbi.

Ibimenyetso bya diyabete yo mu bwoko bwa 1 bishobora kugaragara mu buryo butunguranye kandi bishobora kuba birimo: Kumva umutwe kurusha uko bisanzwe Gushobora gukora imyeyo myinshi Kuvuza imbibi mu bana batari basanzwe bavuza imbibi nijoro Kumva inzara cyane Kugabanya ibiro utihatira Kumva uburakari cyangwa guhindura imyifatire Kumva unaniwe kandi ufite intege nke Kubura ubushobozi bwo kubona neza. Vugana n'abaganga bawe niba ubona ibyo bimenyetso biri hejuru kuri wowe cyangwa umwana wawe.

Mubwire umuvuzi wawe niba ubona ibimenyetso byavuzwe haruguru kuri wowe cyangwa umwana wawe.

Intandaro nyakuri y'igisukari cyo mu bwoko bwa mbere ntiiramenyekana. Ubusanzwe, ubudahangarwa bw'umubiri ubwawo - busanzwe buhangana na bagiteri n'ibyorezo byangiza - burandura uturemangingabo dukora insuline (uturemangingabo twa islet) mu mpyiko. Izindi mpamvu zishoboka zirimo: IgenamiterereRy'umuntuKwandura virusi n'ibindi bintu byo mu kirere Iyo umubare munini w'uturemangingabo twa islet uramutse wangiritse, umubiri uzakora insuline nke cyangwa nta yo. Insuline ni hormone iva mu gice kiri inyuma kandi hepfo y'igifu (impande). Impande ishyira insuline mu maraso.Insuline itembera mu mubiri, ikaha umwanya isukari yo kwinjira mu turemangingabo.Insuline igabanya umubare w'isukari mu maraso.Iyo urwego rw'isukari mu maraso rugabanutse, impande ishyira insuline nke mu maraso. Glucose - isukari - ni isoko nyamukuru y'ingufu ku turemangingabo tugize imitsi n'utundi dusabo. Glucose iterwa n'amasoko abiri akomeye: ibiryo n'umwijima.Isukari ijyanwa mu maraso, aho yinjirira mu turemangingabo ifashijwe na insuline.Umujyi ubitse glucose mu buryo bwa glycogen.Iyo urwego rwa glucose rugeze hasi, nko mu gihe umaze igihe utariye, umwijima urasesagura glycogen yabitswe mu glucose. Ibi bituma urwego rwa glucose ruguma mu kigero gisanzwe. Mu gisukari cyo mu bwoko bwa mbere, nta nsuline ihari yo kureka glucose kwinjira mu turemangingabo. Kubera ibyo, isukari yubakira mu maraso. Ibi bishobora gutera ingaruka zangiza ubuzima.

Bimwe mu bintu bishobora kongera ibyago byo kurwara diyabete yo mu bwoko bwa 1 birimo:

• Amateka y'umuryango. Umuntu wese ufite umubyeyi cyangwa umuvandimwe warwaye diyabete yo mu bwoko bwa 1 afite ibyago byo kurwara iyo ndwara bikomeye gato.
• Igenamigambi. Kugira imwe mu mibonezamubiri byongera ibyago byo kurwara diyabete yo mu bwoko bwa 1.
• Ubuvugizi. Umubare w'abantu barwaye diyabete yo mu bwoko bwa 1 ukunze kuba mwinshi uko ugenda uva kuri Equateur.
• Imyaka. Diyabete yo mu bwoko bwa 1 ishobora kugaragara mu myaka yose, ariko ikunze kugaragara mu bihe bibiri byihariye. Igihe cya mbere kiba ku bana bari hagati y'imyaka 4 na 7. Icya kabiri kiba ku bana bari hagati y'imyaka 10 na 14.

Mu gihe gishize, ingaruka z’igicurane cya diyabete yo mu bwoko bwa mbere zishobora kugira ingaruka ku nzego z’ingenzi z’umubiri. Izo nzego zirimo umutima, imiyoboro y’amaraso, imitsi, amaso n’impyiko. Kugira urwego rw’isukari mu maraso rusanzwe bishobora kugabanya ibyago byinshi by’ingaruka.

Ingaruka za diyabete zishobora gutera ubumuga cyangwa se zikanahungabanya ubuzima bwawe.

• Kubabara kw’imitsi (neuropathy). Isukari nyinshi mu maraso ishobora gukomeretsa inkuta z’imijyana mito y’amaraso (capillaries) ihisha imitsi. Ibi ni byo cyane cyane mu maguru. Ibi bishobora gutera kuribwa, kubabara, gutwika cyangwa kubabara. Ibi bisanzwe bitangira ku ntugunda z’intoki cyangwa ibirenge bikamanuka hejuru. Isukari idakurikiranwa neza ishobora gutuma ubuze kumva mu bice by’umubiri byangiritse mu gihe gishize.

Akababaro k’imitsi kagira ingaruka ku gipimo cy’ibiryo gishobora gutera ibibazo by’umutima mubi, kuruka, impiswi cyangwa kubabara mu nda. Ku bagabo, kudakora imibonano mpuzabitsina bishobora kuba ikibazo.

• Kwibasira kw’impyiko (nephropathy). Impyiko zifite imijyana mito y’amaraso ibihumbi n’ibihumbi irindiranya imyanda mu maraso. Diyabete ishobora kwangiza ubu buryo. Kwibasira bikabije bishobora gutera gucika kw’impyiko cyangwa indwara y’impyiko itabasha gukira. Indwara y’impyiko itabasha gukira igomba kuvurwa hakoreshejwe imashini isukura impyiko (dialysis) cyangwa gutera impyiko.
• Kwibasira amaso. Diyabete ishobora kwangiza imijyana y’amaraso muri retina (igice cy’ijisho kibona urumuri) (diabetic retinopathy). Ibi bishobora gutera ubuhumyi. Diyabete kandi yongera ibyago by’izindi ndwara zikomeye z’amaso, nka cataracte na glaucoma.
• Kwibasira ibirenge. Kubabara kw’imitsi mu birenge cyangwa amaraso make ajya mu birenge byongera ibyago by’ibibazo bimwe by’ibirenge. Niba bitavuwe, ibikomere n’ibisebe bishobora kuba indwara zikomeye. Izo ndwara zishobora kuvurwa hakurwaho intoki, ikirenge cyangwa ukuguru (amputation).
• Uburwayi bw’uruhu n’akanwa. Diyabete ishobora gutuma ugira udukoko twinshi tw’uruhu n’akanwa. Ibi birimo udukoko tuba mu ndwara ziterwa na bagiteri na fungi. Indwara y’umunwa n’umunwa wumye na byo bishobora kuba byinshi.

Nta buryo buzwi bwo gukumira diyabete yo mu bwoko bwa mbere. Ariko abashakashatsi bari gukora ubushakashatsi ku gukumira iyi ndwara cyangwa kwangiza byiyongereye ku mitobe y'ibirumwa mu bantu baherutse kuvurwa. Baza umuvuzi wawe niba ushobora kuba ukwiriye kwinjira muri kimwe muri ibyo bizamini by'ubushakashatsi. Ni ngombwa gupima neza ibyago n'inyungu by'ubuvuzi ubwo aribwo bwose buhari mu bushakashatsi.

Ibizamini byo kuvura birimo: Ikizamini cya hemoglobine isukariye (A1C). Iki kizamini cy'amaraso kigaragaza urwego rwawe rwa sukari mu maraso mu mezi 2 cyangwa 3 ashize. Kipima umubare wa sukari mu maraso ihambiriye kuri poroteyine itwara ogisijeni mu mbururu z'amaraso (hemoglobine). Uko urwego rwa sukari mu maraso rwiyongera, ni ko hemoglobine ifite isukari ihambiriyeho izaba nyinshi. Urwego rwa A1C rwa 6.5% cyangwa hejuru mu bipimo bibiri bitandukanye bivuze ko ufite diabete. Niba ikizamini cya A1C kitaboneka, cyangwa niba ufite uburwayi bumwe na bumwe bushobora gutuma ikizamini cya A1C kidahwitse — nko gutwita cyangwa ubwoko butasanzwe bwa hemoglobine (hemoglobine variant) — umuvuzi wawe ashobora gukoresha ibi bipimo: Ikizamini cya sukari mu maraso ryakozwe ku mpuzanzana. Igipimo cy'amaraso kizafatwa ku gihe icyo ari cyo cyose kandi gishobora kwemezwa n'ibindi bipimo. Ibipimo bya sukari mu maraso bitangazwa muri miligramu kuri desilitri (mg/dL) cyangwa muri milimoli kuri litiro (mmol/L). Uko waba warangije kurya igihe cyose, urwego rwa sukari mu maraso rwa 200 mg/dL (11.1 mmol/L) cyangwa hejuru bigaragaza diabete. Ikizamini cya sukari mu maraso yo mu gifu. Igipimo cy'amaraso kizafatwa nyuma yo kudakoresha (gusiba) ijoro ryose. Urwego rwa sukari mu maraso yo mu gifu rutageze kuri 100 mg/dL (5.6 mmol/L) ni rwiza. Urwego rwa sukari mu maraso yo mu gifu kuva kuri 100 kugeza kuri 125 mg/dL (5.6 kugeza kuri 6.9 mmol/L) rufatwa nk'uburwayi bwa diabete butaragaragara. Niba ari 126 mg/dL (7 mmol/L) cyangwa hejuru mu bipimo bibiri bitandukanye, ufite diabete. Niba ubonye diabete, umuvuzi wawe ashobora kandi gukora ibizamini by'amaraso. Bizapima antikorps za autoantibodies zisanzwe muri diabete yo mu bwoko bwa mbere. Ibi bipimo bifasha umuvuzi wawe guhitamo hagati ya diabete yo mu bwoko bwa mbere n'iya kabiri iyo uburwayi budahamye. Kuba hariho ketoni — ibikomoka ku isenyuka ry'amavuta — mu mpiswi byerekana kandi diabete yo mu bwoko bwa mbere, aho kuba iya kabiri. Nyuma yo kubona uburwayi Uzajya usura umuvuzi wawe buri gihe kugira ngo muganire ku kugenzura diabete yawe. Muri ibyo bisura, umuvuzi azapima urwego rwawe rwa A1C. Intego yawe ya A1C ishobora guhinduka bitewe n'imyaka yawe n'ibindi bintu bitandukanye. Ishirahamwe rya Amerika ryita ku diabete risaba muri rusange ko urwego rwa A1C rugomba kuba munsi ya 7%, cyangwa urwego rwa glucose rwa hafi 154 mg/dL (8.5 mmol/L). Gupima A1C bigaragaza neza uko gahunda yo kuvura diabete ikora kurusha gupima sukari mu maraso buri munsi. Urwego rwa A1C rwo hejuru bishobora gusobanura ko ukeneye guhindura umubare w'insuline, gahunda yo kurya cyangwa byombi. Umuvuzi wawe azatwara kandi ibipimo by'amaraso n'impiswi. Azakoresha ibyo bipimo kugira ngo apime urwego rwa kolesterol, kimwe n'imikorere y'umwijima, umwijima n'impyiko. Umuvuzi wawe azapima kandi umuvuduko w'amaraso yawe kandi azarebe ahantu upima sukari yawe mu maraso kandi utanga insuline. Amakuru y'inyongera LADA Ikizamini cya A1C Ikizamini cy'umuvuduko w'amaraso Isuzuma ry'impiswi Reba amakuru afitanye isano menshi

Ubuvuzi bwa diyabete ya type 1 burimo:\n- Gukoresha insuline\n- Kubara karubone, amavuta na poroteyine\n- Gusuzuma isukari y'amaraso kenshi\n- Kurya ibiryo byiza\n- Gukora imyitozo ngororamubiri buri gihe no kugira ibiro byiza\nIntego ni ugutuma urwego rw'isukari y'amaraso rwegereye uko bisanzwe kugira ngo dushyire inyuma cyangwa turinde ingaruka mbi. Muri rusange, intego ni ugutuma urwego rw'isukari y'amaraso mu manywa mbere y'ifunguro ruri hagati ya 80 na 130 mg/dL (4.44 na 7.2 mmol/L). Imibare nyuma y'ifunguro ntigomba kurenza 180 mg/dL (10 mmol/L) amasaha abiri nyuma yo kurya.\nUmuntu wese ufite diyabete ya type 1 akeneye kuvurwa insuline ubuzima bwe bwose.\nHari ubwoko bwinshi bwa insuline, birimo:\n- Insuline ikora vuba. Rimwe na rimwe yitwa insuline isanzwe, ubu bwoko butangira gukora hafi iminota 30 nyuma yo guterwa. Bugera ku ngaruka nyamukuru mu minota 90 kugeza kuri 120 kandi buramara amasaha 4 kugeza kuri 6. Ingero ni Humulin R, Novolin R na Afrezza.\n- Insuline ikora vuba cyane. Ubu bwoko bwa insuline butangira gukora mu minota 15. Bugera ku ngaruka nyamukuru mu minota 60 kandi buramara amasaha 4. Ubu bwoko bukunze gukoreshwa iminota 15 kugeza kuri 20 mbere y'ifunguro. Ingero ni glulisine (Apidra), lispro (Humalog, Admelog na Lyumjev) na aspart (Novolog na FiAsp).\n- Insuline ikora buhoro. Izwi kandi nka insuline NPH, ubu bwoko bwa insuline butangira gukora mu masaha 1 kugeza kuri 3. Bugera ku ngaruka nyamukuru mu masaha 6 kugeza kuri 8 kandi buramara amasaha 12 kugeza kuri 24. Ingero ni insuline NPH (Novolin N, Humulin N).\n- Insuline ikora igihe kirekire cyane. Ubu bwoko bwa insuline bushobora gutanga ubuvuzi kugeza amasaha 14 kugeza kuri 40. Ingero ni glargine (Lantus, Toujeo Solostar, Basaglar), detemir (Levemir) na degludec (Tresiba).\nUkeneye kenshi guterwa inshuro nyinshi buri munsi zirimo guhuza insuline ikora igihe kirekire na insuline ikora vuba. Ibi byinjira mu mubiri bikora nk'uko umubiri ukoresha insuline ubusanzwe kurusha uburyo bwa kera bwo gukoresha insuline bwari busaba gusa igipimo kimwe cyangwa bibiri ku munsi. Guhuza ibipimo bitatu cyangwa birenga bya insuline ku munsi byagaragaye ko byongera urwego rw'isukari y'amaraso.\nPompe ya insuline ni igikoresho gifite ubunini bwa telefone igendanwa yambitswe hanze y'umubiri wawe. Umuyoboro uhuza ububiko bwa insuline n'umuyoboro winjizwa munsi y'uruhu rw'inda. Pompi za insuline zirashushanyirijwe gutanga umwanya runaka wa insuline byikora kandi iyo urya.\nInsuline ntishobora kunyobwa mu kanwa kugira ngo igabanye isukari kuko enzyme zo mu gifu zizamenagura insuline, bikabuza gukora. Ugomba kwisukura (gutebwa) cyangwa gukoresha pompe ya insuline.\n- Gutebwa. Urashobora gukoresha umugozi mwiza n'urushinge cyangwa ikaramu ya insuline kugira ngo uterwe insuline munsi y'uruhu. Ikaramu za insuline zisa n'ikaramu y'ubwenge kandi ziboneka mu bwoko butangwa cyangwa bushobora kongerwamo.\nNiba uhisemo gutebwa, ukeneye guhuza ubwoko bwa insuline ukoresha ku manywa no mu ijoro.\n- Pompe ya insuline. Iki ni igikoresho gito cyambitswe hanze y'umubiri wawe ushushanyirijwe gutanga umwanya runaka wa insuline ku manywa no mugihe urya. Umuyoboro uhuza ububiko bwa insuline n'umuyoboro winjizwa munsi y'uruhu rw'inda.\nHariho kandi uburyo bwa pompe idafite umuyoboro burimo kwambara igikoresho kirimo insuline ku mubiri wawe hamwe n'umuyoboro muto winjizwa munsi y'uruhu rwawe.\nGutebwa. Urashobora gukoresha umugozi mwiza n'urushinge cyangwa ikaramu ya insuline kugira ngo uterwe insuline munsi y'uruhu. Ikaramu za insuline zisa n'ikaramu y'ubwenge kandi ziboneka mu bwoko butangwa cyangwa bushobora kongerwamo.\nNiba uhisemo gutebwa, ukeneye guhuza ubwoko bwa insuline ukoresha ku manywa no mu ijoro.\nPompe ya insuline. Iki ni igikoresho gito cyambitswe hanze y'umubiri wawe ushushanyirijwe gutanga umwanya runaka wa insuline ku manywa no mugihe urya. Umuyoboro uhuza ububiko bwa insuline n'umuyoboro winjizwa munsi y'uruhu rw'inda.\nHariho kandi uburyo bwa pompe idafite umuyoboro burimo kwambara igikoresho kirimo insuline ku mubiri wawe hamwe n'umuyoboro muto winjizwa munsi y'uruhu rwawe.\nBitewe n'ubwoko bwa insuline uhisemo cyangwa ukeneye, ugomba kugenzura no kwandika urwego rw'isukari y'amaraso byibuze inshuro enye ku munsi.\nIshyirahamwe rya Amerika rishinzwe kurwanya diyabete riragira inama yo gupima urwego rw'isukari y'amaraso mbere y'ifunguro n'ibicuruzwa, mbere yo kuryama, mbere yo gukora imyitozo ngororamubiri cyangwa gutwara imodoka, kandi igihe icyo ari cyo cyose utekereza ko ufite isukari y'amaraso itagezeho. Gukurikirana neza ni bwo buryo bwonyine bwo kugenzura ko urwego rw'isukari y'amaraso rwawe ruguma mu rwego rwawe. Gukurikirana kenshi bishobora kugabanya urwego rwa A1C.\nNubwo ufata insuline kandi ukarya ku isaha, urwego rw'isukari y'amaraso rushobora guhinduka. Uziga uko urwego rw'isukari y'amaraso rwawe ruhinduka bitewe n'ibiribwa, imyitozo ngororamubiri, uburwayi, imiti, umunaniro, impinduka z'imisemburo n'inzoga.\nGukurikirana isukari y'amaraso buri gihe (CGM) bikurikirana urwego rw'isukari y'amaraso. Bishobora kuba ingirakamaro cyane mu gukumira isukari y'amaraso itagezeho. Ibi bikoresho byagaragaye ko bigabanya A1C.\nAbakurikirana isukari y'amaraso buri gihe bahuza n'umubiri bakoresheje umugozi mwiza munsi y'uruhu. Bagenzura urwego rw'isukari y'amaraso buri minota mike.\nSisitemu ifunze ni igikoresho gishyirwa mu mubiri gihuza umukurikirani wa isukari y'amaraso buri gihe na pompe ya insuline. Umugenzuzi arakora igenzura ry'urwego rw'isukari y'amaraso buri gihe. Igikoresho gitanga umwanya ukwiye wa insuline iyo umukurikirani agaragaje ko bikenewe.\nIkigo cy'Amerika gishinzwe kugenzura ibiryo n'imiti cyemereye sisitemu nyinshi zifunze zivanze kuri diyabete ya type 1. Zivugwa ko ari "zivanze" kuko izi sisitemu zisaba ibintu bimwe na bimwe bivuye ku mukoresha. Urugero, ushobora kubwira igikoresho umubare wa karubone wariye, cyangwa kwemeza urwego rw'isukari y'amaraso rimwe na rimwe.\nSisitemu ifunze idasaba ibintu byavuye ku mukoresha ntabwo iraboneka. Ariko izi sisitemu nyinshi ubu ziri mu igeragezwa rya klinik.\nImiti indi kandi ishobora kwandikwa ku bantu bafite diyabete ya type 1, nka:\n- Aspirine. Umuganga wawe ashobora kugira inama yo gufata aspirine nto cyangwa isanzwe buri munsi kugira ngo urinde umutima wawe. Umuganga wawe ashobora kumva ko ufite ibyago byiyongereye byo kugira ikibazo cy'umutima. Umuganga wawe azaganira ku byago byo kuva amaraso niba ufata aspirine.\n- Imiti igabanya cholesterol. Amabwiriza ya cholesterol akomeye ku bantu bafite diyabete kubera ibyago byiyongereye byo kurwara indwara z'umutima.\nIshyirahamwe rya Amerika rishinzwe kurwanya diyabete riragira inama yuko cholesterol ya low-density lipoprotein (LDL, cyangwa "ibihuha" bikabije) igomba kuba munsi ya 100 mg/dL (2.6 mmol/L). Cholesterol ya high-density lipoprotein (HDL, cyangwa "ibihuha" byiza) iragira inama yo kuba hejuru ya 50 mg/dL (1.3 mmol/L) mu bagore na hejuru ya 40 mg/dL (1 mmol/L) mu bagabo. Triglycerides, ubundi bwoko bw'amavuta yo mu maraso, bigomba kuba munsi ya 150 mg/dL (1.7 mmol/L).\nImiti igabanya cholesterol. Amabwiriza ya cholesterol akomeye ku bantu bafite diyabete kubera ibyago byiyongereye byo kurwara indwara z'umutima.\nIshyirahamwe rya Amerika rishinzwe kurwanya diyabete riragira inama yuko cholesterol ya low-density lipoprotein (LDL, cyangwa "ibihuha" bikabije) igomba kuba munsi ya 100 mg/dL (2.6 mmol/L). Cholesterol ya high-density lipoprotein (HDL, cyangwa "ibihuha" byiza) iragira inama yo kuba hejuru ya 50 mg/dL (1.3 mmol/L) mu bagore na hejuru ya 40 mg/dL (1 mmol/L) mu bagabo. Triglycerides, ubundi bwoko bw'amavuta yo mu maraso, bigomba kuba munsi ya 150 mg/dL (1.7 mmol/L).\nNta kintu nk'ibiryo bya diyabete. Ariko rero, ni ingenzi gushyira indyo yawe ku biribwa biryohereye, bifite amavuta make, byuzuyemo fibre nka:\n- Imbuto\n- Imboga\n- Ibinyamisogwe byuzuye\nUmuganga wawe uzagira inama yo kurya ibicuruzwa by'amatungo make na karubone yavanzwe, nka mukate wera n'ibinyobwa byinshi. Iyi gahunda yo kurya ibiryo byiza iragirwa inama ku bantu badafite diyabete.\nUgomba kumenya uburyo bwo kubara umubare wa karubone uri mu biribwa urya. Ukora ibyo, ushobora kwiha insuline ihagije. Ibi bizatuma umubiri wawe ukoresha neza ibyo karubone. Umuganga ushinzwe imirire ashobora kugufasha gukora gahunda y'ibiryo bikubereye.\nBuri wese akeneye imyitozo ngororamubiri ya aerobic buri gihe, harimo n'abantu bafite diyabete ya type 1. Ubwa mbere, menya ko umuganga wawe yemerewe gukora imyitozo ngororamubiri. Hanyuma hitamo ibikorwa ukunda, nko kugenda cyangwa koga, kandi ubikore buri munsi iyo ushoboye. Gerageza byibuze iminota 150 y'imyitozo ngororamubiri ya aerobic yo hagati mu cyumweru, nta minsi irenze ibiri utabikoze.\nWibuke ko ibikorwa by'umubiri bigabanya isukari y'amaraso. Niba utangiye igikorwa gishya, genzura urwego rw'isukari y'amaraso kenshi kurusha uko bisanzwe kugeza igihe uziko icyo gikorwa kigira ingaruka ku rwego rw'isukari y'amaraso. Ushobora kuba ukeneye guhindura gahunda yawe y'ibiryo cyangwa ibipimo bya insuline kubera ibikorwa byiyongereye.\nIbikorwa bimwe by'ubuzima bishobora kuba ikibazo ku bantu bafite diyabete ya type 1.\n- Gutwara imodoka. Isukari y'amaraso itagezeho ishobora kubaho igihe icyo ari cyo cyose. Ni byiza kugenzura isukari y'amaraso igihe icyo ari cyo cyose uri inyuma y'umuyoboro. Niba iri munsi ya 70 mg/dL (3.9 mmol/L), fira ibiryo bifite garama 15 za karubone. Ongera upime nyuma y'iminota 15 kugira ngo ube wizeye ko yazamutse ku rwego rukwiye mbere yo gutangira gutwara imodoka.\n- Gukora. Diyabete ya type 1 ishobora gutera imbogamizi mu kazi. Urugero, niba ukora akazi gasaba gutwara imodoka cyangwa gukoresha imashini zikomeye, isukari y'amaraso itagezeho ishobora kuba ikibazo gikomeye kuri wowe n'abantu bari kumwe nawe. Ukeneye gukorana n'umuganga wawe n'umukoresha wawe kugira ngo ube wizeye ko hari impinduka zikorerwa. Ukeneye ibiruhuko byiyongereye kugira ngo upime isukari y'amaraso no kubona ibiryo n'ibinyobwa vuba. Hari amategeko ya leta zunze ubumwe za Amerika n'ay'ibihugu bigize leta zunze ubumwe za Amerika asaba abakoresha gutanga izi mpinduka ku bantu bafite diyabete.\n- Gutwita. Ibyago byo kugira ingaruka mbi mu gihe cyo gutwita biri hejuru ku bantu bafite diyabete ya type 1. Impuguke zigira inama yo kubona umuganga wawe mbere yo gutwita. Ibisubizo bya A1C bigomba kuba munsi ya 6.5% mbere yo kugerageza gutwita.\nIbyago by'indwara zibaho igihe cyo kuvuka (indwara zivuka) biri hejuru ku bantu bafite diyabete ya type 1. Ibyago biri hejuru iyo diyabete idakurikiranwa neza mu byumweru 6 kugeza kuri 8 bya mbere byo gutwita. Gukurikirana neza diyabete yawe mu gihe cyo gutwita bishobora kugabanya ibyago byo kugira ingaruka mbi.\n- Kuba mukuru cyangwa kugira ubundi burwayi. Ku bantu bafite intege nke cyangwa abarwaye cyangwa bagira ikibazo cyo gutekereza neza, gukurikirana neza isukari y'amaraso bishobora kuba bitakwiye. Bishobora kandi kongera ibyago byo kugira isukari y'amaraso itagezeho. Ku bantu benshi bafite diyabete ya type 1, intego ya A1C idakomeye cyane munsi ya 8% ishobora kuba ikwiye.\nGutwita. Ibyago byo kugira ingaruka mbi mu gihe cyo gutwita biri hejuru ku bantu bafite diyabete ya type 1. Impuguke zigira inama yo kubona umuganga wawe mbere yo gutwita. Ibisubizo bya A1C bigomba kuba munsi ya 6.5% mbere yo kugerageza gutwita.\nIbyago by'indwara zibaho igihe cyo kuvuka (indwara zivuka) biri hejuru ku bantu bafite diyabete ya type 1. Ibyago biri hejuru iyo diyabete idakurikiranwa neza mu byumweru 6 kugeza kuri 8 bya mbere byo gutwita. Gukurikirana neza diyabete yawe mu gihe cyo gutwita bishobora kugabanya ibyago byo kugira ingaruka mbi.\n- Gusimbuza pancreas. Hamwe no gusimbuza pancreas neza, ntukwiye gukenera insuline. Ariko gusimbuza pancreas ntibihora bigenda neza-kandi uburyo burimo ibyago bikomeye. Kubera ko ibyo byago bishobora kuba bibi kurusha diyabete ubwayo, gusimbuza pancreas bikunze gukoreshwa ku bantu bafite diyabete bigoye kuyigenzura. Bishobora kandi gukoreshwa ku bantu bakeneye gusimbuza impyiko.\n- Gusimbuza uturemangingo twa islet. Abashakashatsi bari kugerageza gusimbuza uturemangingo twa islet. Ibi bitanga uturemangingo tushya dukora insuline bivuye muri pancreas y'umuntu utanze. Ubu buryo bwo kugerageza bwagize ibibazo mu gihe gishize. Ariko ubuhanga bushya n'imiti myiza yo gukumira kwanga uturemangingo twa islet bishobora kunoza amahirwe yayo yo kuba ubuvuzi bwiza.\nNubwo ukora ibishoboka byose, rimwe na rimwe ibibazo bizabaho. Ingaruka mbi z'igihe gito za diyabete ya type 1, nka isukari y'amaraso itagezeho, zisaba ubuvuzi bw'ihutirwa.\nHypoglycemia ya diyabete ibaho iyo umuntu ufite diyabete atagira isukari ihagije (glucose) mu maraso. Baza umuganga wawe icyo utekereza ko ari urwego rwo hasi rw'isukari y'amaraso kuri wowe. Urwego rw'isukari y'amaraso rushobora kugabanuka kubera impamvu nyinshi, nko kudakora ifunguro, kurya karubone nke kurusha ibyo gahunda yawe y'ibiryo isaba, gukora imyitozo ngororamubiri myinshi kurusha uko bisanzwe cyangwa guterwa insuline myinshi.\nMenya ibimenyetso bya hypoglycemia. Suzuma isukari y'amaraso yawe niba utekereza ko urwego rwawe ruri hasi. Iyo uhangayitse, buri gihe suzuma isukari y'amaraso yawe. Ibimenyetso bya mbere by'isukari y'amaraso itagezeho birimo:\n- Kugaragara gikaze (pallor)\n- Kuhinda umubiri\n- Kuzenguruka cyangwa kumva utaryarya\n- Kwishima\n- Inzara cyangwa isesemi\n- Gukubita umutima udahwitse cyangwa kwihuta\n- Kugira ikibazo cyo kwibanda\n- Kumva unaniwe kandi ntufite imbaraga (umunaniro)\n- Kurakara cyangwa guhangayika\n- Kubabara umutwe\n- Kugira uburibwe cyangwa kubabara mu minwa, ururimi cyangwa itama\nHypoglycemia yo mu ijoro ishobora gutuma ukangukira ufite ipjama yose yashyizweho umwenda cyangwa kubabara umutwe. Hypoglycemia yo mu ijoro rimwe na rimwe ishobora gutuma urwego rw'isukari y'amaraso ruri hejuru cyane mu gitondo.\nNiba hypoglycemia ya diyabete itabonye ubuvuzi, ibimenyetso bya hypoglycemia birushaho kuba bibi kandi bishobora kuba birimo:\n- Kwitiranya, imyitwarire idasanzwe cyangwa byombi, nko kudakora imirimo isanzwe\n- Kubura ubushobozi bwo guhuza\n- Kugira ikibazo cyo kuvuga cyangwa kuvuga nabi\n- Kubura ubushobozi bwo kubona neza cyangwa kubona ibintu bike\n- Kudashaka kurya cyangwa kunywa\n- Kugira intege nke z'imitsi\n- Ubunebwe\nHypoglycemia ikomeye ishobora gutera:\n- Kugwa cyangwa gufata\n- Kubura ubwenge\n- Urupfu, gake\nUrashobora kongera isukari y'amaraso yawe vuba ukoresheje kurya cyangwa kunywa isoko y'isukari yoroshye, nka glucose tablets, amagambo akomeye cyangwa umutobe w'imbuto. Bwira umuryango wawe n'inshuti zawe ibimenyetso byo kureba n'icyo gukora niba utashoboye kuvura uwo muntu ubwawe.\nNiba metero y'isukari y'amaraso idahari, uvure isukari y'amaraso itagezeho niba ufite ibimenyetso bya hypoglycemia, hanyuma upime vuba bishoboka.\nMenyesha abantu wizeye kuri hypoglycemia. Niba abandi bazi ibimenyetso byo kureba, bashobora kukumenyesha ibimenyetso bya mbere. Ni ngombwa ko abagize umuryango n'inshuti za hafi bazi aho ubitse glucagon n'uburyo bwo kuyitanga kugira ngo ikibazo gishobora kuba gikomeye cyoroshye gucungwa neza. Glucagon ni hormone ishishikariza isukari kwinjira mu maraso.\nDore amakuru y'ubufasha bw'ihutirwa ugomba gutanga ku bandi. Niba uri kumwe n'umuntu utasubiza (abura ubwenge) cyangwa adashobora kugira ibiryo kubera isukari y'amaraso itagezeho:\n- Ntugomba guterwa insuline, kuko bizatuma urwego rw'isukari y'amaraso rugabanuka cyane\n- Ntugomba gutanga amazi cyangwa ibiryo, kuko bishobora gutera guhumeka\n- Tanga glucagon uterwa cyangwa ukoresheje imiti yo mu mazuru\n- Hamagara 911 cyangwa serivisi z'ubufasha bw'ihutirwa mu karere kawe kugira ngo ubone ubuvuzi bw'ihutirwa niba glucagon idahari, utazi uko uyikoresha cyangwa uwo muntu atarimo gusubiza\nBamwe bashobora kubura ubushobozi bwo kumva ko urwego rw'isukari y'amaraso rwabo rugenda rugabanuka. Ibi bita hypoglycemia unawareness. Umubiri ntukigira ibimenyetso by'isukari y'amaraso itagezeho nka kuzenguruka cyangwa kubabara umutwe. Uko uhuye n'isukari y'amaraso itagezeho kenshi, ni ko ushobora kurwara hypoglycemia unawareness.\nNiba ushobora kwirinda kugira ikibazo cya hypoglycemic ibyumweru byinshi, ushobora gutangira kumenya neza ibyo kugwa. Rimwe na rimwe kongera intego y'isukari y'amaraso (urugero, kuva kuri 80 kugeza kuri 120 mg/DL kugeza kuri 100 kugeza kuri 140 mg/DL) byibuze igihe gito bishobora kandi gufasha kunoza ubumenyi bw'isukari y'amaraso itagezeho.\nIsakari y'amaraso ishobora kuzamuka kubera impamvu nyinshi. Urugero, ishobora kuzamuka kubera kurya cyane, kurya ibiryo bibi, kudafata insuline ihagije cyangwa kurwanya uburwayi.\nKora izi ngingo:\n- Gusukura kenshi\n- Kwishima cyane\n- Kubura ubushobozi bwo kubona neza\n- Umunaniro\n- Kubabara umutwe\n- Kurakara\nNiba utekereza ko ufite hyperglycemia, suzuma isukari y'amaraso yawe. Niba iri hejuru y'urwego rwawe, ukeneye gutanga "amakosa". Amakosa ni umwanya w'inyongera wa insuline uhabwa kugira ngo usubize isukari y'amaraso yawe mu buryo busanzwe. Urwego rw'isukari y'amaraso ruri hejuru ntiruza vuba nk'uko ruzamuka. Baza umuganga wawe igihe cyo gutegereza mbere yo kongera kugenzura. Niba ukoresha pompe ya insuline, ibisubizo by'isukari y'amaraso biri hejuru bishobora gusobanura ko ukeneye guhindura aho ushyira pompe ku mubiri wawe.\nNiba ufite urwego rw'isukari y'amaraso rurenze 240 mg/dL (13.3 mmol/L), suzuma ketones ukoresheje igiti cyo gupima imyeyo. Ntukore imyitozo ngororamubiri niba urwego rw'isukari y'amaraso rwawe rurenze 240 mg/dL cyangwa niba ketones zihari. Niba hari ibimenyetso bike cyangwa bike bya ketones, nywa amazi yiyongereye adafite calorie kugira ngo ukureho ketones.\nNiba isukari y'amaraso yawe ihora iri hejuru ya 300 mg/dL (16.7 mmol/L), cyangwa niba ketones yawe mu myeyo igumye iri hejuru nubwo ufata ibipimo byo kuvura bya insuline, hamagara umuganga wawe cyangwa shaka ubuvuzi bw'ihutirwa.\nNiba uturemangingo twawe twicwa n'inzara y'ingufu, umubiri ushobora gutangira gusenya amavuta. Ibi bituma habaho aside z'ubumara zizwi nka ketones. Ketoacidosis ya diyabete ni uburwayi bukomeye bw'ihutirwa.\nIbimenyetso by'ubwo burwayi bukomeye birimo:\n- Isesemi\n- Kuruka\n- Kubabara mu nda\n- Impumuro y'imbuto nziza mu miheto yawe\n- Guhumeka bugufi\n- Akanwa kari kabyimbye\n- Intege nke\n- Kwitiranya\n- Koma\nNiba ukekako ufite ketoacidosis, suzuma imyeyo yawe kugira ngo urebe niba hari ketones nyinshi ukoresheje igiti cyo gupima ketones cyo kugura. Niba ufite ketones nyinshi mu myeyo, hamagara umuganga wawe vuba cyangwa shaka ubuvuzi bw'ihutirwa. Nanone, hamagara umuganga wawe niba warukaye inshuro zirenze imwe kandi ufite ketones mu myeyo.

Diabete ishobora kugira ingaruka ku mimerere y'umuntu, haba mu buryo butaziguye no mu buryo buziguye. Iyo isukari mu maraso idagenzurwa neza, ishobora kugira ingaruka ku mimerere y'umuntu mu buryo buziguye, itera impinduka mu myitwarire, nko guhora urakaye. Hari igihe ushobora kwanga diabete yawe. Abantu bafite diabete bafite ibyago byinshi byo kurwara ihungabana ndetse n'ibibazo bifitanye isano na diabete. Abaganga benshi b'inzobere mu kuvura diabete bakunda gushyira umukozi wo mu muryango w'abafasha cyangwa umuhanga mu by'imitekerereze mu itsinda ryabo ryita ku barwayi ba diabete. Ushobora kubona ko ari byiza kuvugana n'abandi bantu barwaye diabete yo mu bwoko bwa mbere. Hariho amatsinda y'abantu bahuriye hamwe yo gufashanya, haba kuri interineti no mu bantu. Abagize amatsinda akenshi baba bazi uburyo bushya bwo kuvura. Bashobora kandi gusangira uburambe bwabo cyangwa amakuru afatika. Urugero, bashobora gusangira aho ushobora kubona umubare wa karubone mu biryo byawe ukunda kurya hanze. Niba ushaka kujya mu itsinda ry'abantu bahuriye hamwe, umuganga wawe ashobora kugusaba rimwe mu karere kawe. Cyangwa ushobora gusura imbuga za interineti za American Diabetes Association (ADA) cyangwa Juvenile Diabetes Research Foundation (JDRF). Izi mbuga zishobora kugaragaza amakuru y'amatsiko y'abantu bahuriye hamwe n'ibikorwa byo mu gace abantu barwaye diabete yo mu bwoko bwa mbere. Ushobora kandi kuvugana na ADA kuri 800-DIABETES (800-342-2383) cyangwa JDRF kuri 800-533-CURE (800-533-2873).