Hypoglycemic coma: zoyambitsa ndi chisamaliro chodzidzimutsa

Hypoglycemia ndi matenda omwe amadziwika kuti "shuga wotsika" kapena "shuga m'magazi". Zimabweretsa zizindikiro zosiyanasiyana, kuphatikizapo chizungulire, chisokonezo, kusazindikira, kukokana, komanso m'malo ovuta kwambiri, ngakhale imfa.

Zizindikiro zazikulu za hypoglycemia ndi: njala, thukuta, kunjenjemera ndi kufooka. Ndi miyeso yoyenera, zizindikiro zimachoka mwachangu.

Kuchokera pamalingaliro azachipatala, hypoglycemia imadziwika ndi kuchepa kwa kuchuluka kwa glucose m'magazi komwe kumatha kuyambitsa zizindikiro monga chisokonezo komanso / kapena kukondoweza kwa dongosolo lamanjenje lachifundo. Zinthu zotere zimayamba chifukwa cha kupatuka kwa njira ya glucose homeostasis.

Zoyambitsa Hypoglycemia

Choyambitsa chachikulu cha hypoglycemia mwa odwala omwe ali ndi matenda osokoneza bongo ndi kugwiritsa ntchito jekeseni wa insulin komanso kuphwanya ndondomeko ya zakudya (kulumpha zakudya), komanso kuchuluka kwambiri kwa insulin.

Pakadwala, chomwe chimayambitsa hypoglycemia imatha kukhala mankhwala omwe amagwiritsidwa ntchito pochiza matenda ashuga. Izi zikuwonetsedwa kale insulin, sulfonylurea ndi kukonzekera zomwe zili m'gulu la biguanides.

Kuopsa kwa hypoglycemia kumachulukitsidwa mwa odwala matenda a shuga omwe amadya zochepa kuposa zomwe amafunikira, komanso mwa omwe amamwa mowa kwambiri.

Zowonjezera za hypoglycemia:

• kulephera kwa aimpso
• hypothyroidism
• Njala yayitali,
• matenda kagayidwe
• matenda oopsa.

Ana amathanso kukhala ndi hypoglycemia wongochitika ngati sanadye kwa maola angapo.

Mlingo wa glucose womwe umatsimikizira kupezeka kwa hypoglycemia ukhoza kukhala wosiyana. Mu odwala matenda ashuga, imagwera pansi 3.9 mmol / L (70 mg / dl). Mwa makanda, ili ndi mulingo wokhala pansi pa 2.2 mmol / L (40 mg / dL) kapena wochepera 3.3 mmol L (60 mg / dL).

Kuyesedwa komwe kumazindikira kuchuluka kwa hypoglycemia: kusintha kwa mulingo wa C-peptide m'mwazi ndi kuyesedwa kwa insulin.

Kusamalira mwadzidzidzi

Zizindikiro za kukomoka kwa hypoglycemic zikawoneka, muyenera kuyimbira ambulansi. Madokotala asanafike, wodwalayo amaphatikizidwa ndi 40% yankho la glucose kudzera m'mitsempha ndi glucagon intramuscularly. Ngati palibe zabwino, zosintha zonse zimabwerezedwa pambuyo pa mphindi 15.

Musanapereke chithandizo choyambirira, ndikofunikira kuti mudziwe zoyenera. Zizindikiro za insulin zikawoneka, muyenera kuwunika kuchuluka kwa shuga m'magazi pogwiritsa ntchito glucometer. Mchere wotsika ndiye kusiyana kwakukulu kuchokera ku chikomokere cha hyperglycemic, pomwe zizindikiro zina zingadutse.

Ndikofunika kupatsa wodwala chisamaliro chadzidzidzi m'boma la precoma, osalola kutaya kwa chikumbumtima. Pachifukwa ichi, wodwalayo akulimbikitsidwa kuti apatse tiyi wokoma, chidutswa cha shuga woyengetsa, maswiti kapena chinthu china chachikulu chapa carb. Izi zikuthandizira kukwera kwamphamvu kwa glucose wamagazi ndikusintha. Chocolate kapena ayisikilimu sioyenera kulimbana ndi glycemia. Zakudya izi zimakhala ndi mafuta ambiri, zomwe zimalepheretsa kuyamwa kwa shuga.

Pambuyo pakuthandizidwa koyamba, wodwalayo ayenera kugona, kumamupatsa mtendere weniweni wamthupi komanso wamalingaliro. Ndi zoletsedwa kusiya munthu osakhudzidwa. Ndikofunikira kumamupatsa chisamaliro choyenera komanso kuthandizira. Matenda a mtundu wa psychoemotional amatithandizanso kuchepetsa chiopsezo chokhala ndi vuto la hypoglycemic.

Mpumulo wa kuukira ukhoza kukhala kwakanthawi, chifukwa cha kufupika kwa chakudya cham'thupi chambiri. Chifukwa chake, ngakhale atatha kusintha mkhalidwe wa odwala matenda ashuga, munthu ayenera kuchipatala kuchipatala kuti alandire chisamaliro choyenera ndikupewa kuyambiranso.

Zomwe zimayambitsa zosiyanasiyana zimatha kutsitsa kwambiri shuga wamagazi ndi kukula kwa chikumbumtima cha hypoglycemic. Nthawi zambiri, iyi ndi insulin yochulukirapo, yomwe imayang'anira kutulutsa shuga kwa adipose ndi minofu minofu. Masewera azambiri okhathamiritsa, zomwe zimakhala ndimwazi zimatsika, zomwe zimapangitsa kukula kwa hypoglycemia.

Zifukwa zazikulu zowonjezera kuchuluka kwa insulin.

• Kusokonezeka kwa kapamba kapena kukula kwa chotupa - insulinoma, yomwe imalimbikitsa kupangika kwa mahomoni.
• Kuchulukitsa kuchuluka kwa mahomoni oyenera ndikulipira mtundu wa matenda ashuga 1.
• Jakisoni wosalondola (intramuscularly, not subcutaneally), zomwe zimapangitsa kuti chinthucho chibwere mofulumira m'magazi.
• Kulephera kutsatira zakudya pambuyo pa jakisoni.
• Kukhazikitsidwa kwa insulin yochepa kwambiri yocheperako popanda kudya zakudya zamagulu owonjezera.
• Kumwa mowa musanayambe jakisoni wa insulin kapena pambuyo pake. Ethanol amasokoneza ntchito ya chiwindi pakusintha glycogen ndikupereka shuga ku ubongo. Kubwezeretsa kuchuluka kwa shuga kumbali yakumwa kale mowa kumatha.

Hypoglycemic coma imachitika ndikusakwanira kwa shuga m'thupi. Izi zimachitika chifukwa cha kuchepa kwa chakudya chamagulu m'zakudya, kudya mwamphamvu kapena kusala kudya kwanthawi yayitali.

Zomwe zimayambitsa zimatha kukhala kulephera kwa impso, matenda a chiwindi (kuphatikiza mafuta ochulukitsa m'thupi) kapena kuchuluka kwa zochitika zolimbitsa thupi popanda kuwonjezera kuchuluka kwa chakudya chamafuta.

Mwa anthu athanzi, chikomokere cha hypoglycemic nthawi zina chimachitika pang'onopang'ono chifukwa cha kupsinjika kwakukulu, zokumana nazo, zolimbitsa thupi kwambiri, kapenanso kudya kwambiri.

Coma imayamba ndi kuchepa kwa kuchuluka kwa shuga m'magazi m'munsimu 2,5 mmol / L. Izi zimathandiza kwambiri kuti thupi lizigwira ntchito bwino. Shuga imachulukitsa mphamvu, imalimbikitsa ubongo, zamaganiza ndi zochita zolimbitsa thupi. Kutsika kwa shuga m'munsi mwa zovomerezeka kumayambitsa machitidwe angapo omwe amakhudza thanzi la munthu komanso thanzi lake. Muzochitika zovuta kwambiri, vuto la hypoglycemic limatha kupha.

Pathogenesis ya pathological mkhalidwe: kusowa kwa glucose kumabweretsa chakudya komanso kuperewera kwa mpweya m'thupi. Mitsempha yamkati imakhudzidwa makamaka. Maselo aubongo akumwalira pang'onopang'ono. Njira ya pathological imayamba ndi ma dipatimenti yosiyanitsidwa, yomwe imakhudza mawonekedwe a mutu, kuwonjezeka kukwiya, kapena kusachita chidwi kwathunthu. Popanda thandizo la panthawi yake, matendawa amapita patsogolo, akukhudza mbali zakumaso ndi kumtunda kwa chingwe cha msana. Wodwalayo amayamba kusokonezedwa ndi kukokana, kusunthira kosafunikira m'magulu osiyanasiyana a minofu, kusokonezeka kwa chidwi komanso kusintha kwa kukula kwa ana (amasintha). Maonekedwe a zomwe tafotokozazi zikuwonetsa kusintha kwa ubongo.

Mwapadera, pathogenesis ya hypoglycemic chikomayi imachitika chifukwa cha zizindikiro za atypical. Izi zitha kukhala bradycardia, kusanza, dziko la euphoria. Chithunzi chachipatala chosazolowereka chimatha kusokeretsa dokotala ndikupangitsa zovuta pakudziwitsani moyenera. Pankhaniyi, zotsatira zake zidzakhala zowopsa: edema yam'mimba ndi imfa.

Hypoglycemic coma ndi njira yoopsa yomwe imafunikira chithandizo chamankhwala chofunikira. Kudzilanga tokha komanso kugwiritsa ntchito njira zachikhalidwe zamankhwala pamenepa zimangokulitsa vutolo komanso zimabweretsa zovuta. Njira zoterezi ndizoletsedwa.

Wodwala wodwala matenda opweteka amagonekedwa m'chipatala. Kuti khazikitse boma, 20-60 ml ya 40% dextrose solution imabayidwa kudzera m'mitsetse. Wodwalayo akapezekanso mkati mwa mphindi 20, amapatsidwa njira ya 5%% dextrose, mpaka amamva bwino.

Muzochitika zovuta kwambiri, njira zobwezeretsa ntchito zimagwiritsidwa ntchito. Pofuna kupewa matenda a ubongo, Prenisolone mu gawo la 30-60 mg kapena Dexamethasone (4-8 mg), komanso diuretics (Furosemide, Mannitol kapena Mannitol) akuwonetsedwa. Ngati wodwalayo sakungokhala kwa nthawi yayitali, wodwalayo amamuthandizira kuti apume mokwanira, ndipo amamuwuza kuti alandire chithandizo choopsa.

Wodwala akachotsedwa mu vuto la chikomokere, amamuthamangitsira kuchipatala. Kuyang'anira zachipatala pafupipafupi kumathandizira kuti muzindikire, kuchotsera kapena kupewa matenda amanjenje. Kuphatikiza apo, chomwe chimayambitsa hypoglycemia chimakhazikitsidwa, zakudya zimasinthidwa ndipo mulingo woyenera kwambiri wa insulin umasankhidwa.

Ndi chithandizo chanthawi komanso chothandiza cha hypoglycemic coma, wodwalayo amabwereranso kuzindikira, glucose amakhala okhazikika ndipo zizindikiro zonse zoipa zimatha. Komabe, nthawi zina chikomokere sichitha popanda kufufuza. Mwa ana, zimayambitsa mavuto akulu kuchokera ku chapakati mantha dongosolo, kulephera kupuma komanso kulephera kwa mtima. Mu okalamba, imayambitsa kukula kwa myocardial infarction kapena sitiroko, chifukwa chake, atayimitsa kuwukira kofunikira, ndikofunikira kupanga electrocardiogram.

Kupewa

Ndikofunikira kwambiri kwa odwala matenda a shuga kuti azisamala popewa kuperewera kwa vuto la hypoglycemic. Choyamba, ndikofunikira kuyang'anira kuchuluka kwa shuga m'magazi ndikudya mafuta okwanira ndikuyambitsa kuchuluka kwa insulin. Ndikofunikira kupewa kuchuluka kwa mahomoni ambiri, kayendetsedwe kake kosayenera kapena jekeseni ndikulumpha chakudya.

Kupatsa thanzi kwa odwala matenda ashuga ndi gawo lofunikira lomwe lingathandize kukhala ndi thanzi labwino komanso kupangitsa thupi kukhala lolimbitsa thupi. Odwala ayenera kudya chakudya kangapo patsiku zisanu ndi chimodzi, patsiku laling'ono, mosamala kwambiri za zomwe zili ndi mavitamini komanso kuchuluka kwa mapuloteni, mafuta ndi chakudya. Ndikofunikira kuyerekezera kuchuluka kwa magawo omwe buledi amawotcha ndi mlingo wa insulin.

Ndi matenda a shuga, muyenera kusamala ndi zochitika zolimbitsa thupi. Amachepetsa shuga komanso amatha kukhala ndi insulin. Anthu odwala matenda ashuga amalangizidwa kuti apewe kupsinjika ndi zokumana nazo zina zomwe zimatsogolera ku kuchuluka kwa shuga.

Hypoglycemic coma ndi mkhalidwe wowopsa womwe umawopseza kukulitsa zovuta zazikulu kapena kufa. Ndikofunikira kuzindikira panthawi yake kukula kwa hypoglycemia, kupereka chithandizo choyamba ndikupereka wodwala kuchipatala. Pofuna kupewa kukomoka, tikulimbikitsidwa kutsatira zakudya komanso kupatsa insulin yoyenera mulingo woyenera.

Zizindikiro za hypoglycemic coma

Kutanthauzira kwa matenda azachipatala omwe ali ndi hypoglycemia ndikofunikira kwambiri kwa wodwala, ndipo chofunikira kwambiri ndichakuti anthu omwe ali pafupi ndi wovutikayo akachitapo kanthu angayankhe bwanji. Ubwino wazidziwike za zizindikiro za hypoglycemia ndikuti kusowa kwawo kungasokoneze molakwika kuperekera thandizo ndikukulitsa vuto la wodwalayo, kuphatikiza ubongo wa edema, ndipo izi, zimayambitsa kupangika kwa zilonda zosasinthika mkati mwa dongosolo lamanjenje.

Hypoglycemia ndi chikhalidwe chovuta kwambiri mu dongosolo la munthu la endocrine, chifukwa cha kuchepa kwambiri kwa shuga m'magazi.

Zizindikiro zoyambirira za kuchepa kwa magazi za m'magazi zimawoneka pamene kuchuluka kwa shuga m'magazi kumatsika pang'ono. Zizindikiro zoyambirira za hypoglycemia zimawonedwa pamene kuchuluka kwa shuga m'magazi kuli pansi pa 2.6 - 2.8 mmol / L. Mkulu wa glucose wa 1.3 -1.7 mmol / l, wodwalayo amasiya kuzindikira.

Magawo mwa odwala omwe ali ndi matenda ashuga

Hypa ya hypoglycemic imagawidwa m'magawo awiri: pachimake komanso kuyambika kwa chikomicho. Nawonso, amagawika m'magawo osiyanasiyana omwe amasiyana ndi mawonekedwe azachipatala.

Gawo loyamba - poyamba, chifukwa cha kuchepa kwa glucose m'magazi, cortex yamatumbo imavutika, chifukwa cha zomwe zimapangitsa kuti pakhale zizindikiro zingapo za ubongo. Chizungulire, kupweteka mutu, wodwalayo atha kukhala ndi nkhawa, kusintha kwa mtima, wodwalayo amawoneka wokhumudwa kwambiri kapena wosangalala kwambiri. Kumbali ya machitidwe ena, tachycardia imawonedwa, kumverera kwakukulira kwanjala, khungu limakhala lonyowa.

Hypoglycemia Zizindikiro Zoyipa

Panthawi imeneyi, moyo wa anthu uli pachiwopsezo chachikulu, ndipo popanda kulandira chithandizo chokwanira komanso chapanthawi yake, kuwonongeka kungachitike mpaka kufa.
Choyambitsa chachikulu cha kufa kwa glycemic coma ndi matenda otupa. Kuchedwa kuyankhidwa pakukula kwa hypoglycemia, kulakwitsa kwa insulin, komanso kukhazikitsidwa kwa glucose ochulukirapo kumayambitsa kukula kwa mkhalidwewu. Zizindikiro zamatenda a edema yam'mimba imawonekera pamaso pa zizindikiro za meningeal (hypertonicity of the occipital minerals), kulephera kupuma, kusanza, kusintha kwa kutentha kwa mtima, komanso kuwonjezeka kwa kutentha kwa thupi.

Dziwani kuti kuwukira kwa pafupipafupi kwa hypoglycemia, komanso pafupipafupi chikhalidwe cha hypoglycemic coma, odwala akuluakulu amayang'anizana ndi kusintha kwa umunthu, pomwe ana ali ndi kuchepa kwa luntha. M'njira zonsezi, mwayi wa imfa sunasiyidwe.

Kusiyanitsa mitundu

Popeza zomwe wodwalayo angakhale atakomoka nazo zimapangitsa kuti azitha kupeza zovuta komanso kuthandizanso, muyenera kukumbukira zizindikiro ndi zizindikiro zingapo zomwe zimasiyanitsa hypoglycemia ku coma ina, kuphatikizapo hyperglycemic coma.

• mwachangu (nthawi zina zimayamba kukhazikika)
• thukuta, thukuta lozizira ("wodwala chonyowa")
• nkhawa, njala, kuchepa mphamvu kwambiri
• polyuria (mapangidwe a mkodzo), kupweteka kwam'mimba, tachycardia
• kuyerekezera zinthu zina, kunyengerera, kusokonezeka kwa chikumbumtima, kukhudzika
• palibe fungo la acetone kuchokera mkamwa
• shuga m'magazi ochepera 3.5 mmol / l (muyenera kuyeza glucose wamagazi ndi glucometer)
• Nthawi zambiri pambuyo pa kukhwima kwa 40% glucose mu 40-80 ml, wodwalayo amatha

Ndikofunika kukumbukira kuti anthu odwala omwe ali ndi matenda a shuga a nthawi yayitali omwe ali ndi matenda oopsa ochedwa hyperglycemia, precoma ndi chikomokere amatha kuonedwa ngakhale ndimikhalidwe yokhazikika (3.3 - 6.5 mmol / L). Mwachizolowezi, mikhalidwe yotere imachitika ndi kutsika kwakuthwa kwa shuga kuchokera ku kuchuluka kwambiri (17-19 mmol / L) kufika pamlingo wokwanira 6-8 mmol / L.

Zoyambitsa ndi Zoopsa

Zomwe zimayambitsa hypoglycemia:

• mankhwala osokoneza bongo ochepetsa shuga kapena insulin,
• osakwanira chakudya pambuyo pakukhazikika kwa mankhwala a insulin,
• Hypersensitivity insulin,
• utachepa-insulin yothandiza ntchito,
• hyperinsulinism
• kuledzera.

Nthawi zambiri, chikhalidwe cha hypoglycemia chimayamba chifukwa:

• mankhwala osokoneza bongo a beta-blockers ndi aspirin,
• aakulu aimpso kulephera
• hepatocellular carcinoma,
• kusowa kwa pituitary.

Kudziwikitsa chilichonse mwazinthu izi kumapangitsa kuchepa kwa shuga m'magazi.

Kudziwikitsa chilichonse mwazinthu izi kumapangitsa kuchepa kwa magazi m'thupi. Nthawi zambiri zochitika za hypoglycemic zimatha kubweretsa kulowerera m'magazi, kugwidwa, khunyu.

Kusakwanira kwa glucose kumayambitsa mphamvu ya kufa kwa maselo muubongo, njira yofowoka ya redox mwa iwo, yomwe ili yofanana ndi kusintha komwe kumawonedwa mu ubongo hypoxia.Izi zimapangitsa kuti ntchito ziziyenda bwino, kenako kusintha kwachilengedwe m'mitsempha, ndi chidwi cha hypoglycemia - mpaka kufa kwawo.

Mitsempha yamkati ya chithokomiro imakonda kwambiri hypoglycemia, ndipo mawonekedwe a medulla oblongata samva kwenikweni. Ichi ndi chifukwa chake ndi hypoglycemic chikomokere, odwala amasunga mtima nthawi yayitali, mtima wamatumbo ndi kupuma, ngakhale zitasinthika.

Magawo a matenda

Pokonza chikomero cha hypoglycemic, magawo angapo amadziwika:

1. Cortical. Amalumikizidwa ndi kukula kwa hypoxia ya maselo am'mimba.
2. Subcortical-diencephalic. Kuchulukitsa kwa hypoglycemia kumabweretsa kuwonongeka kwa gawo la subcortical-diencephalic la ubongo.
3. Precoma. Amayamba chifukwa chophwanya njira za kagayidwe kachakudya komwe kamapangidwa ndi maubongo.
4. Kwenikweni kukomoka. Ntchito zamagawo akumtunda a medulla oblongata ndizoperewera.
5. Kukoma kwambiri. Magawo am'munsi a medulla oblongata amakhudzidwa ndi pathological process, ntchito za vasomotor ndi malo opumira zimachepa.

Hypoglycemic coma imayamba m'magawo. Poyamba, zizindikiro zakutsogolo zimawonekera, zikuwonetsa kuchepa kwa ndende yamagazi. Izi zikuphatikiza:

• nkhawa, mantha,
• njala,
• thukuta lotupa (hyperhidrosis),
• chizungulire ndi mutu
• nseru
• khungu lakuthwa,
• kugwedezeka kwa dzanja
• tachycardia
• kuchuluka kwa kuthamanga kwa magazi.

Ngati thandizo siliperekedwa pakadali pano, ndiye kuti pakuwonekeranso kuchepa kwamphamvu kwa shuga m'magazi, kukhumudwa kwa psychomotor kudzawonekera, kuwunika komaso kuwonera. Odwala omwe ali ndi vuto lalikulu la hypoglycemia nthawi zambiri amadandaula za kuphwanya kwamphamvu kwa khungu (paresthesia) ndi diplopia (kuwona kawiri).

Nthawi zina, nthawi yazoyambira imakhala yochepa kwambiri kotero kuti ngakhale wodwalayo kapena ena omwe ali pafupi naye alibe nthawi yoyenda komanso kuchitapo kanthu - Zizindikiro zimawonjezeka mofulumira, kwenikweni mkati mwa mphindi 1-2.

Odwala omwe ali ndi matenda a shuga komanso okondedwa awo ayenera kudziwa zizindikiro za vuto la hypoglycemic. Izi zikawoneka, wodwala amafunikira kumwa tiyi wokoma wofunda, kudya shuga, maswiti kapena chidutswa cha mkate woyera.

Ndi kukula kwa hypoglycemia ndi kutsika kwa mitsempha yoteteza neuroendocrine, mkhalidwe wa odwala umakulirakulira. Kusangalatsa kumalowedwa m'malo ndi zoletsa, kenako kutaya kwathunthu chikumbumtima. Pali zopweteka tonic, yokhazikika minyewa zizindikiro. Kupuma kumakhala kopambanitsa, kuthamanga kwa magazi kumachepa. Anawo amasiya kuyankha kukuwala, corneal Reflex imazirala.

Zizindikiro

Diagnosis ya hypoglycemic coma imachitika pamaziko a mbiri yakale ndi chithunzi cha matendawa. Kuzindikira kumatsimikiziridwa ndi kuyesa kwamwazi wamagazi. Mkhalidwe wa hypoglycemic umawonetsedwa ndi kuchepa kwa ndende ya glucose kufikira osachepera 3.5 mmol / L. Zizindikiro za chikomokere zimawonekera pamene kuchuluka kwa shuga kumachepera 2.77 mmol / L. Pa kuchuluka kwa shuga m'magazi a 1.38-11.65 mmol / l, wodwalayo amataya chikumbumtima.

Therapy ya hypoglycemic coma imayamba ndi mtsempha wa magazi a hypertonic glucose solution. Mukakomoka kwambiri, glucagon kapena hydrocortisone amathandizidwanso mwachindunji. Kusintha kagayidwe ka shuga, kugwiritsa ntchito ascorbic acid ndi cocarboxylase kumasonyezedwa.

Ngati wodwala ali ndi vuto la matenda osokoneza bongo motsutsana ndi maziko a chikomokere, ndiye kuti amamuika osmotic diuretics.

Kuwongolera kusokonezeka kwa asidi-base, kusokonezeka kwa madzi-electrolyte kumachitikanso. Malinga ndi zikuwonetsa, chithandizo cha okosijeni chimachitika, mtima ndi omwe amathandizidwa ndi mtima.

Mavuto omwe angakhalepo komanso zotsatirapo zake

Hypoglycemic coma nthawi zambiri imayendera limodzi ndikupanga zovuta - zamakono komanso zakutali. Zovuta zomwe zilipo pakalipano zimachitika limodzi ndi mtundu wa hypoglycemic, muperekezeni. Awa akhoza kukhala myocardial infarction, stroke, aphasia.

Matenda obanika kwa nthawi yayitali a hypoglycemic coma amawoneka masiku angapo kapena ngakhale masabata atadwala kwambiri. Mavuto omwe amakonda kwambiri ndi encephalopathy, parkinsonism, khunyu.

Mothandizidwa ndi panthawi yake, chikomokere cha hypoglycemic chimasiya msanga ndipo sichikhala ndi zotsatirapo zoyipa za thupi. Pankhaniyi, kuneneraku ndikabwino. Komabe, nthawi zambiri zomwe zimachitika m'magazi a hypoglycemic zimabweretsa nthawi yayitali kukulitsa zovuta zazikulu za matenda a chithokomiro.

Mkhalidwe wa hypoglycemic umawonetsedwa ndi kuchepa kwa ndende ya glucose kufikira osachepera 3.5 mmol / L. Coma amakula ndi glucose wochepera 2.77 mmol / L.

Odwala omwe ali ndi matenda a mtima.