Ciwon hawan jini na hyperglycemic

Ciwon sukari na hyperglycemic hyperosmolar syndrome (HHS) cuta ce ta irin ciwon sukari na 2. Ya ƙunshi matakin sikarin mai yawa na glucose na jini ba tare da kasancewar ketones ba.

HHS shine yanayin:

• Matsanancin hawan jini (glucose)
• Matsanancin rashin ruwa (rashin ruwa)
• Rage faɗakarwa ko sani (a lokuta da yawa)

Hakanan za'a iya samun tarin ketones a cikin jiki (ketoacidosis). Amma baƙon abu ne kuma sau da yawa yana da sauƙi idan aka kwatanta da ketoacidosis na ciwon sukari.

HHS galibi ana ganin shi a cikin mutanen da ke da ciwon sukari na 2 waɗanda ba su da iko da ciwon sukarinsu. Hakanan yana iya faruwa ga waɗanda ba a gano su da ciwon sukari ba. Ana iya kawo yanayin ta:

• Kamuwa da cuta
• Sauran cututtuka, kamar ciwon zuciya ko bugun jini
• Magungunan da ke rage tasirin insulin a jiki
• Magunguna ko yanayin da ke ƙara zubar ruwa
• Kashewa, ko rashin shan magungunan ciwon sikari

A yadda aka saba, kodan suna ƙoƙarin yin sama da matakin glucose mai yawa a cikin jini ta barin ƙarin glucose ya bar jiki cikin fitsari. Amma wannan ma yana sa jiki rasa ruwa. Idan baka sha isasshen ruwa ba, ko kuma ka sha ruwan da ke dauke da sukari sannan ka ci gaba da cin abinci mai dauke da sinadarin ‘Carbohydrates’, to ka zama mai rashin ruwa sosai. Lokacin da wannan ya faru, kodan ba za su iya kawar da ƙarin glucose ba. A sakamakon haka, matakin glucose a cikin jininka na iya zama mai girma sosai, wani lokacin ya ninka ninkin ba ninkin sau 10.

Rashin ruwa kuma yana sa jini ya fi nutsuwa fiye da yadda yake. Wannan ana kiran sa hyperosmolarity. Yanayi ne wanda jini yake da yawan gishiri (sodium), glucose, da sauran abubuwa. Wannan yana fitar da ruwa daga sauran gabobin jiki, gami da kwakwalwa.

Hanyoyin haɗari sun haɗa da:

• Abun damuwa kamar kamuwa da cuta, bugun zuciya, bugun jini, ko tiyata kwanan nan
• Ajiyar zuciya
• Rashin ƙishirwa
• Arancin samun ruwa (musamman a mutanen da ke fama da cutar ƙwaƙwalwa ko waɗanda ba sa tafiya)
• Yawan shekaru
• Aikin koda mara kyau
• Rashin kulawa da ciwon sukari, ba bin shirin magani kamar yadda aka umurta
• Tsayawa ko ƙarancin insulin ko wasu magunguna masu rage matakin glucose

Kwayar cutar na iya haɗawa da ɗayan masu zuwa:

• Thirstara ƙishirwa da fitsari (a farkon cutar)
• Jin rauni
• Ciwan
• Rage nauyi
• Bushe bushe, bushe bushe
• Zazzaɓi
• Kamawa
• Rikicewa
• Coma

Kwayar cututtukan na iya zama mafi muni a cikin kwanaki ko makonni.

Sauran alamun da zasu iya faruwa tare da wannan cuta:

• Rashin ji ko aiki na tsokoki
• Matsaloli tare da motsi
• Lalacewar magana

Mai ba da sabis na kiwon lafiya zai bincika ku kuma ya yi tambaya game da alamunku da tarihin lafiyar ku. Jarabawar na iya nuna cewa kuna da:

• Matsanancin ruwa a jiki
• Zazzabi ya fi 100.4 ° F (38 ° C)
• Rateara yawan bugun zuciya
• Sananan hawan jini

Gwajin da za a iya yi sun hada da:

• Jinin osmolarity (maida hankali)
• BUN da matakan halitta
• Matakan sodium na jini (yana buƙatar daidaitawa don matakin glucose na jini)
• Gwajin Ketone
• Glucosewar jini

Bincike don dalilan da ke iya haifar da:

• Al'adun jini
• Kirjin x-ray
• Lantarki (ECG)
• Fitsari
• CT na kai

A farkon fara magani, makasudin shine gyara asarar ruwa. Wannan zai inganta hawan jini, fitowar fitsari, da zagayawa. Sikanin jini kuma zai ragu.

Za a bayar da ruwa da potassium ta hanyar jijiya (intravenously). Dole ne a yi wannan a hankali. Ana daukar matakin glucose mai yawa tare da insulin da aka bayar ta jijiya.

Mutanen da ke haɓaka HHS galibi ba su da lafiya. Idan ba a magance shi nan da nan ba, kamuwa, hauka, ko mutuwa na iya haifar.

Ba tare da magani ba, HHS na iya haifar da ɗayan masu zuwa:

• Shock
• Tsarin jini
• Kumburin kwakwalwa (edema)
• Levelara yawan acid acid (lactic acidosis)

Wannan yanayin gaggawa ne na gaggawa. Je zuwa ɗakin gaggawa ko kira lambar gaggawa ta gida (kamar 911) idan kun ci gaba da alamun cutar HHS.

Kula da ciwon sukari na nau'in 2 da kuma fahimtar alamun farko na rashin ruwa da kamuwa da cuta na iya taimakawa hana HHS.

HHS; Hypeglycemic hyperosmolar coma; Cikakken kwayar cutar rashin karfin jini (NKHHC); Hyperosmolar nonketotic coma (HONK); Hyperglycemic hyperosmolar ba jihar ketotic ba; Ciwon sukari - hyperosmolar

• Rubuta ciwon sukari na 2 - abin da za a tambayi likitanka

• Abinci da fitowar insulin

Crandall JP, Shamoon H. Ciwon sukari. A cikin: Goldman L, Schafer AI, eds. Magungunan Goldman-Cecil. 26th ed. Philadelphia, PA: Elsevier; 2020: babi na 216.

Lebovitz SHI. Hyperglycemia sakandare zuwa yanayin rashin ciwon sukari da hanyoyin kwantar da hankali. A cikin: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Manya da Yara. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016: babi na 42.

Sinha A. Gaggawa na ciwon sukari. A cikin: Bersten AD, Handy JM, eds. Oh's Intensive Care Manual. 8th ed. Philadelphia, PA: Elsevier; 2019: babi na 59.