Ukuthini i-Diabetes Insipidus? Izimpawu, Izimbangela, Nokwelapha

I-diabetes insipidus iyisimo esingavamile esenza ukuba ukhuphe amazinga amakhulu omchamo oqhelelene, ongenalutho, futhi uzizwe unomkhulu olukhulu njalo. Ngokungafani ne-diabetes mellitus evamile (ethinta ushukela egazini), lesi simo sihilela izinkinga zendlela umzimba wakho ophatha ngayo ibhalansi yamanzi. Nakuba igama lizwakala lifana ne-diabetes ejwayelekile, lezi zizimo ezihlukile ngokuphelele ezihlanganyela nje ezinye izimpawu ezifana nokukhishwa komchamo njalo.

Iyini i-diabetes insipidus?

I-diabetes insipidus kwenzeka lapho umzimba wakho ungakwazi ukulawula kahle ukuthi ugcina kangakanani amanzi noma ukhulula. Izinso zakho ngokuvamile ziqondisa umchamo ukuze zigcine amanzi, kodwa ngalesi simo, zikhiqiza amavolumu amakhulu omchamo oqhelelene kakhulu. Cabanga ngakho njengokuthi ifaucet engavali kahle.

Lesi simo sithola igama laso ngenxa yamavolumu amakhulu omchamo “ongenaso iphunga” noma ongenalutho okuwukhiqiza. Abantu abaningi abane-diabetes insipidus bakhishwa umchamo phakathi kwama-3 kuya kuma-15 ama-litres ngosuku, uma kuqathaniswa nama-1 kuya kuma-2 ama-litres ajwayelekile. Lokhu kukhishwa komchamo okukhulu kuqalisa ukoma okukhulu njengoba umzimba wakho uzama ukubuyisela izinto eziphulukile.

Ziyini izimpawu ze-diabetes insipidus?

Izimpawu eziyinhloko ze-diabetes insipidus zigxile ekulweni komzimba wakho ukuze ugcine ibhalansi efanele yamanzi. Lezi zimpawu zingathuthuka kancane kancane noma zivele ngokuzumayo, kuye ngokuthi yini ebangela lesi simo.

Izimpawu ezivamile kakhulu zihlanganisa:

• Ukukhishwa komchamo okukhulu (polyuria) - ngokuvamile ama-3 kuya kuma-15 ama-litres ngosuku
• Ukoma okukhulu, oluqhubekayo (polydipsia) okunzima ukuhlangabezana nakho
• Ukuvuka izikhathi eziningi ebusuku ukuya ekhaya
• Ukukhetha izimpuphu ezibandayo kakhulu
• Ukukhathala nobuthakathaka obuvela ekuphazamisekeni kokulala
• Ukucasuka noma ukukhuluphala kokugxila

Ezimweni ezinzima, ungase uhlangabezane nezimpawu zokulahlekelwa amanzi ezifana nokuqhuma, ukushaya kwenhliziyo okusheshayo, noma umlomo owomile. Abantwana abanesimo esinjalo bangase baqhele ukunika, babonakale bekhuluphala ngokungavamile, noma babe nobunzima bokuzuza isisindo. Lezi zimpawu zingathinta kakhulu impilo yakho yansuku zonke nekhwalithi yokulala.

Ziyini izinhlobo ze-diabetes insipidus?

Kunezinhlobo ezine eziyinhloko ze-diabetes insipidus, ngayinye inezimbangela ezihlukile. Ukuqonda ukuthi yiluphi uhlobo olulokhu kunikeza usizo ekunqumeni indlela engcono kakhulu yokwelapha.

I-central diabetes insipidus uhlobo oluvamile kakhulu. Kwenzeka lapho ubuchopho bakho bungakhiqizi i-antidiuretic hormone (ADH) eyanele, ebizwa nangokuthi i-vasopressin. Lo hormone ngokuvamile utshela izinso zakho ukuba zigcine amanzi ngokuqondisa umchamo.

I-nephrogenic diabetes insipidus kwenzeka lapho izinso zakho zingaphenduli kahle ku-ADH, ngisho noma ubuchopho bakho bukhiqiza amazinga ajwayelekile. Izinso zakho ngokuyisisekelo azinaki isiluleko se-hormone sokuqapha amanzi.

I-gestational diabetes insipidus ithuthuka ngesikhathi sokukhulelwa lapho i-placenta ikhiqiza ama-enzyme ahlukanisa i-ADH. Lo mkhuba ngokuvamile uqeda ngemva kokubeletha kodwa udinga ukulandelelwa ngokucophelela ngesikhathi sokukhulelwa.

I-primary polydipsia, ebizwa nangokuthi i-dipsogenic diabetes insipidus, kwenzeka lapho uphuza amanzi amaningi ngenxa yengxaki yendlela yokomela kwakho. Lokhu kudlula amandla ezinso zakho okuqondisa umchamo, kudala izimpawu ezifana ne-diabetes insipidus yangempela.

Ziyini izimbangela ze-diabetes insipidus?

Izimbangela ze-diabetes insipidus zihluka kuye ngohlobo olulokhu. Izimo eziningi zithuthuka ngenxa yomonakalo noma izinkinga ezisezingxenyeni ezithile zomzimba wakho ezilawula ibhalansi yamanzi.

I-central diabetes insipidus ngokuvamile ivela ku:

• Ukulimala kwekhanda noma ukuhlinzwa kobuchopho okubangela umonakalo e-hypothalamus noma e-pituitary gland
• Ukuqhuma kobuchopho, ikakhulukazi lokho okuthinta indawo ye-pituitary
• Ukutheleleka njenge-meningitis noma i-encephalitis
• Ukuguqulwa kwe-genetic okudluliselwa emindenini
• Izimo ze-autoimmune lapho isimiso sakho sokuvikela umzimba sihlasele amaseli akhiqiza ama-hormone

I-nephrogenic diabetes insipidus ingathuthuka ku:

• Ukuguqulwa kwe-genetic okuthinta umsebenzi wezinso
• I-chronic kidney disease noma umonakalo wezinso
• Imithi ethile, ikakhulukazi i-lithium esetshenziswa ekwelapheni i-bipolar disorder
• Amazinga aphezulu e-calcium egazini
• Amazinga aphansi e-potassium

Ezimweni ezithile, ikakhulukazi nge-central diabetes insipidus, odokotela abakwazi ukubona imbangela ethile. Lezi zimo zibizwa ngokuthi i-idiopathic, okusho ukuthi isimo sithuthuka ngaphandle kokuphazamiseka okucacile. Nakuba lokhu kungase kuzwakale kukhungathekisa, ukwelashwa okuphumelelayo kusatholakala kungakhathaliseki imbangela.

Nini kufanele ubheke udokotela nge-diabetes insipidus?

Kufanele uxhumane nodokotela wakho uma ukhipha umchamo ongama-3 ama-litres ngosuku noma uzizwa unomkhulu olukhulu naphezu kokupha amanzi amaningi. Lezi zimpawu, ikakhulukazi uma ziqhubeka izinsuku eziningi, zidinga ukuhlolwa kwezokwelapha.

Funani usizo lwezokwelapha ngokushesha uma uhlangabezana nezimpawu zokulahlekelwa amanzi okukhulu. Lokhu kuhlanganisa ukuqhuma uma umi, ukushaya kwenhliziyo okusheshayo, ukudideka, noma ukungakwazi ukugcina amanzi. Ukushona kwamanzi kungaba yingozi ngokushesha nge-diabetes insipidus.

Kubantwana, qaphela ukunika okukhulu embhedeni kumntwana owayeselokhu eqeqeshwe e-toilet, ukukhathazeka okungavamile, noma ukwehluleka ukuchuma. Izingane ezincane zingase zibonise izimpawu ezifana ne-diapers ezomile naphezu kokondla okujwayelekile, ukondla okubi, noma ukukhala okukhulu. Ukuxilongwa kwangaphambi kwesikhathi nokuphathwa kungavimbela izinkinga futhi kuthuthukise ikhwalithi yempilo kakhulu.

Ziyini izici ezingaba yingozi ze-diabetes insipidus?

Izici eziningana zingandisa amathuba akho okukhula kwe-diabetes insipidus. Ukuqonda lezi zici ezingaba yingozi kukusiza uhlale ulungile ezimpawu zokuqala futhi ufuna ukunakekelwa okufanele.

Izici eziyinhloko ezingaba yingozi zihlanganisa:

• Umlando womndeni we-diabetes insipidus, ikakhulukazi ngezinhlobo ze-genetic
• Ukuhlinzwa kobuchopho noma ukulimala kwekhanda okuthinta indawo ye-pituitary
• Ukuthatha imithi ye-lithium isikhathi eside
• Ukuba nezimo ze-autoimmune ezingase zithinte ukukhiqizwa kwama-hormone
• Ukukhulelwa, okungase kubangele i-gestational diabetes insipidus
• I-chronic kidney disease noma ezinye izifo zezinso

Ubudala bungase futhi bube nomthelela, nge-central diabetes insipidus ngezinye izikhathi ivela ebuntwaneni ngenxa yezici ze-genetic. Kodwa-ke, lesi simo singathuthuka kunoma yiliphi iminyaka, ikakhulukazi ngemva kokulimalala kobuchopho noma ukutheleleka. Ukuba nesici esisodwa esingaba yingozi akusho ukuthi uzokhula ngalesi simo, kodwa kufanele ukuxoxe nodokotela wakho uma uqaphela izimpawu ezifanele.

Ziyini izinkinga ezingase zivele ze-diabetes insipidus?

Uma ilawulwa kahle, i-diabetes insipidus ngokuvamile ayibangeli izinkinga ezinkulu zempilo yesikhathi eside. Kodwa-ke, i-diabetes insipidus engaphathwa noma engalawulwa kahle ingabangela izinkinga eziningana ezithinta inhlalakahle yakho jikelele.

Ukukhathazeka okukhulu kakhulu kuhlanganisa:

• Ukushona kwamanzi, okungaba nzima uma ukungenisa amanzi kungalingani nokukhipha
• Ukungahambisani kwama-electrolyte, ikakhulukazi amazinga aphansi e-sodium (hyponatremia)
• Ukuphazamiseka kokulala okuvela ekukhishweni komchamo ebusuku njalo
• Izinkinga zezinso ezivela ekushoneni kwamanzi isikhathi eside
• Ukulibaziseka kokukhula kubantwana ngenxa yokulala okubi nokondla okubi

Izinkinga ezingavamile kodwa ezinzima zingase zenzeke uma uthola ukungena kwamanzi okukhulu ngokupha amanzi amaningi ngokushesha. Lokhu kungabangela amazinga aphansi e-sodium, okuholela ekukhuleni kobuchopho, ukuhlinzwa, noma i-coma. Imiphumela yempilo yengqondo efana nokukhathazeka noma ukucindezeleka ingase futhi ivele ngenxa yesimo esiqhubekayo sezimo zabo kanye nomthelela wabo emisebenzini yansuku zonke.

Ngokwelashwa okufanele nokubuka, lezi zinkinga zivimbeka kakhulu. Abantu abaningi abane-diabetes insipidus bangagcina impilo evamile, esebenzayo uma isimo sabo silawulwa kahle.

I-diabetes insipidus ixilongwa kanjani?

Ukuxilongwa kwe-diabetes insipidus kuhilela ukuhlolwa okuhlukene ukuqinisekisa ukukhishwa komchamo okukhulu nokunquma imbangela.

Ukuhlolwa kokuqala ngokuvamile kuhlanganisa ukuhlolwa komchamo ukuhlola ukugxila nokubutha komchamo kwamahora angu-24 ukuze kuqale ukukhipha okujwayelekile. Ukuhlolwa kwegazi kusiza ukuhlola amazinga e-electrolyte, umsebenzi wezinso, namazinga e-hormone. Lokhu kuhlolwa okuyisisekelo kusiza ukwahlukanisa i-diabetes insipidus kwezinye izimo ezifana ne-diabetes mellitus.

Udokotela wakho angase enze i-water deprivation test, ethathelwa ingqondo njengendlela ebaluleke kakhulu yokuxilonga. Ngesikhathi salo mviwo oqondiswa, uzoyeka ukupha amanzi amahora amaningana ngenkathi odokotela belandela ukukhipha komchamo nokugxila kwakho. Lokhu kusiza ekuqondeni ukuthi izinso zakho zingagxila kahle umchamo uma kudingeka.

Ukuhlolwa okuqhubekayo kungase kuhlanganise ukubuka ubuchopho nge-MRI ukuhlola ukuqhuma noma umonakalo endaweni ye-pituitary. Ukuhlolwa kwe-genetic kungase kunconywe uma kukhona umlando womndeni wesimo. Inqubo yokuxilonga ingathatha isikhathi, kodwa ukuthola ukuxilongwa okufanele kuqinisekisa ukuthi uthola ukwelashwa okuphumelelayo.

Iyini ukwelashwa kwe-diabetes insipidus?

Ukwelashwa kwe-diabetes insipidus kugxile ekuqedeni ama-hormone ashiyiwe noma ekusizeni izinso zakho ukuba zisebenze kahle. Indlela ethile ixhomeke kuhlobo olulokhu nokuthi yini elibangela.

Nge-central diabetes insipidus, ukwelashwa okuyinhloko yi-desmopressin (DDAVP), inguqulo ye-synthetic ye-hormone eyi-ADH. Le mithi ifika njengesiphundu sesifuba, amathebulethi omhlathi, noma ukugcoba. Iyanciphisa ukukhipha komchamo nokoma kubantu abaningi abalolu hlobo.

I-nephrogenic diabetes insipidus kunzima ukuyiphatha ngoba ukufakwa kwe-hormone akusebenzi. Izindlela zokwelapha zihlanganisa:

• I-thiazide diuretics, ebangela ukuba izinso ziqondisa umchamo
• Imithi yokulwa nokuvuvukala njenge-indomethacin
• Ukudla okune-sodium ephansi, okune-protein ephansi ukuze kuncishiswe umsebenzi wezinso
• Ukuyeka imithi engase ibe yimbangela yengxaki, uma kungenzeka

Nge-gestational diabetes insipidus, i-desmopressin iphephile ngesikhathi sokukhulelwa futhi ngokuvamile iyalungisa izimpawu. I-primary polydipsia idinga ukwelashwa kwimbangela yokuphuza amanzi okukhulu, okungase kuhilele imithi ye-psychiatric noma ukungenelela kokuziphatha.

Ukubuka njalo kusiza ekuqinisekiseni ukuthi ukwelashwa kuqhubeka kuphuma futhi kuvumela ukulungiswa kwemithamo uma kudingeka. Abantu abaningi bathola impumuzo enkulu ngokwelashwa okufanele.

Indlela yokuphatha i-diabetes insipidus ekhaya?

Ukuphatha i-diabetes insipidus ekhaya kuhilela ukunakekelwa ngokucophelela ibhalansi yamanzi namahora okwelashwa. Ngeqhinga elifanele, ungagcina ukulawulwa okuhle kwezimpawu futhi uvikele izinkinga.

Ukuthatha imithi njalo kubalulekile ekulawuleni izimpawu. Beka izikhumbuzo zemithamo ye-desmopressin futhi ungayeki, njengoba lokhu kungabangela ukubuyela ngokushesha kwezimpawu. Gcina imithi eyengeziwe itholakala uma uhamba noma ngesikhathi sezimo eziphuthumayo.

Hlola ukungenisa amanzi nokukhipha ukuze ubone izibonelo noma izinkinga. Gcina i-log elula yalokho okuphuzayo nokuphumayo, ikakhulukazi uma ulungisa ukwelashwa. Qaphela izimpawu zokulahlekelwa amanzi ezifana nokuqhuma, ukushaya kwenhliziyo okusheshayo, noma umchamo omnyama.

Ukuphathwa kwansuku zonke okuwusizo kuhlanganisa:

• Ukuhlala uthwala amabhodlela amanzi nokukwazi ukuthi ama-restrooms aphi
• Ukugqoka ubucwebe be-medical alert obuveza isimo sakho
• Ukuhlela imisebenzi ngokuhambisana namahora okwelashwa nokufinyeleleka kwama-bathroom
• Ukugcina izimpuphu zokubuyisela ama-electrolyte zitholakala ngesikhathi sesifo noma isimo sezulu esishisayo
• Ukuthola ukulala okwanele ngokulinganisa imithi yokuhlwa ngokufanele

Ngesikhathi sesifo, ikakhulukazi ngomkhuhlane noma ukugabha, xhumana nodokotela wakho ngokushesha. Lezi zimo zingabangela ukushona kwamanzi okubi ngokushesha kubantu abane-diabetes insipidus.

Kufanele ulungiselele kanjani i-appointment yakho nodokotela?

Ukulungiselela kahle i-appointment yakho nodokotela kusiza ekuqinisekiseni ukuthi uthola ukuxilongwa okuchane kakhulu nesiqondiso sokwelapha esiphumelelayo. Ukulungiselela okuhle kungasindisa isikhathi futhi kuholele emiphumeleni engcono yokunakekelwa.

Ngaphambi kwe-appointment yakho, landela izimpawu zakho okungenani isonto elilodwa. Bhala phansi ukuthi uphuza kangakanani nokukhipha umchamo, lapho izimpawu zibi kakhulu, nokuthi yini ebonakala ikusiza noma eyenza zibi. Qaphela noma iyiphi imithi oyithathayo, kuhlanganise imithi yokuthengwa ngaphandle komthetho kanye nezinye izinto.

Butha amarekhodi ezokwelapha afanele, ikakhulukazi uma uke waba nokulimala kwekhanda, ukuhlinzwa kobuchopho, noma izinkinga zezinso. Letha uhlu oluphelele lwazo zonke imithi yakho ngemithamo nangesikhathi. Uma unemlando womndeni we-diabetes insipidus noma izimo ezinhlobene, bhala phansi lokho okukwazi.

Lungisa imibuzo okumele uyibuze udokotela wakho:

• Yiluphi uhlobo lwe-diabetes insipidus enami?
• Yini ebangela isimo sami?
• Ziyini izindlela zokwelapha ezitholakalayo?
• Sizoyilandela kanjani intuthuko yami?
• Ziyini izimo eziphuthumayo okumele ngizibheke?
• Lokhu kuyothinta kanjani imisebenzi yami yansuku zonke?

Cabanga ngokuletha ilungu lomndeni noma umngani ozosiza ukukhumbula ulwazi olubalulekile. Bangase futhi banikeze ukubuka okuqhubekayo ngezimpawu zakho ongaqapheli.

Iyini into ebaluleke kakhulu nge-diabetes insipidus?

I-diabetes insipidus iyisimo esilawuleka esingathinta impilo yakho. Ngokuxilongwa nokuphathwa okufanele, abantu abaningi bathola ukuthuthuka okukhulu ezimpawu zabo futhi bangagcina impilo evamile, esebenzayo.

Into ebaluleke kakhulu okumele uyikhumbule ukuthi ukwelashwa okuphumelelayo kutholakala kuzo zonke izinhlobo ze-diabetes insipidus. Kungakhathaliseki ukuthi udinga ukufakwa kwe-hormone, ukushintsha kokudla, noma ezinye imithi, ukusebenzisana eduze neqembu lakho lezokunakekelwa kwempilo kuholela emiphumeleni engcono kakhulu.

Ukuxilongwa kwangaphambi kwesikhathi nokuphathwa kuvimbela izinkinga futhi kuthuthukise ikhwalithi yempilo kakhulu. Unganqikazi ukufuna usizo lwezokwelapha uma uhlangabezana nokoma nokukhipha umchamo okukhulu, njengoba ukuxilongwa kwangaphambi kwesikhathi nokuphathwa kungenza umehluko omkhulu endleleni ozizwa ngayo usuku nosuku.

Imibuzo evamile ebuzwa nge-diabetes insipidus

Ingabe i-diabetes insipidus ifana ne-diabetes ejwayelekile?

Cha, i-diabetes insipidus ihlukile ngokuphelele kwi-diabetes mellitus (i-diabetes ejwayelekile). Nakuba zombili zibangela ukukhipha umchamo njalo, i-diabetes mellitus ihilela izinkinga zokusheshisa igazi, kuyilapho i-diabetes insipidus ihilela izinkinga zebhalansi yamanzi. Ukwelashwa nezinkinga zihlukile ngokuphelele, nakuba amagama afana ngokumangazayo.

Ingabe i-diabetes insipidus ingaphiliswa ngokuphelele?

Ezinye izinhlobo zingaphiliswa uma imbangela iyaphatheka, njengokukhipha ukuqhuma kobuchopho noma ukuyeka imithi ebangela ingxaki. Kodwa-ke, izimo eziningi zidinga ukwelashwa okuqhubekayo ukuze zilawule izimpawu ngokuphumelelayo. Izindaba ezinhle ukuthi ngokwelashwa okufanele, abantu abaningi baphila impilo evamile, enempilo.

Amanzi amaningi kangakanani okumele ngiwaphe nge-diabetes insipidus?

Kufanele uphuze amanzi anele ukuze uhlangabezane nokoma lwakho futhi ugcine ukondla okuhle, okungavamile okungaphezulu kunokujwayelekile. Unganciphisi amanzi ngaphandle kokunconywa udokotela wakho, njengoba lokhu kungabangela ukushona kwamanzi okubi. Iqembu lakho lezokunakekelwa kwempilo lizokusiza uthole ibhalansi efanele ngokuhambisana nesimo sakho.

Ingabe abantwana abane-diabetes insipidus bangaphila impilo evamile?

Yebo, abantwana abane-diabetes insipidus bangaphila impilo evamile, esebenzayo ngokwelashwa nokusekelwa okufanele. Izikole zingakwazi ukuhlangabezana nezidingo ze-bathroom namahora okwelashwa. Abantwana abaningi abane-diabetes insipidus elawulwa kahle bahlanganyela ngokugcwele ezemidlalo, emisebenzini, nasemicimbini yomphakathi ngaphandle kokulinganiselwa okukhulu.

Ingabe ngizodinga ukuthatha imithi ye-diabetes insipidus phakade?

Lokhu kuya ngokuthi yini ebangela i-diabetes insipidus yakho. Abanye abantu badinga ukwelashwa okuphakade, kuyilapho abanye bengase baphile uma imbangela iphela. Udokotela wakho uzohlola njalo ukuthi usadinga imithi futhi angase alungise noma ayeke ukwelashwa ngokuhambisana nendlela obuyela ngayo nesimo sakho.