Mayendedwe akulu a chithandizo cha matenda a shuga ndi awa:

- kugwiritsa ntchito mankhwala osokoneza bongo

- dosed zolimbitsa thupi,

- maphunziro oleza mtima komanso kudziletsa (sukulu ya shuga),

- Kupewa komanso kuchiza matenda obwera chifukwa cha matenda ashuga.

Cholinga cha chithandizo cha matenda ashuga ndikukwaniritsa kubzala kwa matenda.

Wodwala matenda ashuga ayenera kusiyiratu kugwiritsa ntchito shuga, madzi, zakudya, misuzi, makeke, mabisiketi, nthochi, mphesa, masiku, mowa ndi zinthu zina.

Chithandizo cha mankhwala amkamwa hypoglycemic.

Mankhwala ochepetsa shuga omwe amagwiritsidwa ntchito masiku onse amagawika m'magulu awiri: zotumphukira sulfonylureas ndi biguanides.

Limagwirira a zochita za mankhwala sulfonylureas zovuta komanso chifukwa cha zochita zawo zapakati komanso zoponderezana. Kukula kwawo kwapakati pa zisumbu za pancreatic kukufotokozedwa ndi kukondoweza kwa insulin secretion, kusintha kwa chidwi cha maselo a  kupita ku glycemia, yomwe pamapeto pake imabweretsa kusintha kwa insulin katulutsidwe.

Mphamvu yowonjezera-pancreatic imabweretsa kuwonjezereka kwa kugwiritsidwa ntchito kwa shuga m'chiwindi ndi minofu yowonjezereka ndikupanga kwa glycogen mwa iwo, i.e. Kutulutsa kwa shuga kwa chiwindi kumachepa ndipo mphamvu ya zochita za amkati amkati imachepa.

Biguanides onjezerani kuphatikizika kwa kugwiritsa ntchito glucose pamaso pa insulin, kuchepetsa shuga, mayamwidwe am'magazi m'mimba, komanso kuchepetsa kuchuluka kwa insulin m'magazi a odwala omwe ali ndi kunenepa kwambiri komanso mtundu wa 2 shuga. Kuphatikiza apo khwawa khalani ndi anorectic. Kugwiritsa ntchito nthawi yayitali kumakhudzanso metabolidi ya lipid (kutsitsa cholesterol, triglycerides).

Pamene osakhutira zotsatira za mankhwalawa pakamwa hypoglycemic mankhwala zotchulidwa mankhwala a insulin.

Zizindikiro zambiri odwala matenda a shuga amamulembera insulin: 1) mtundu wa 1 matenda ashuga, 2) ketoacidosis, matenda ashuga, 3) kuchepa kwambiri kwa thupi, 4) kupezeka kwa matenda apakati, 5) opaleshoni, 6) kutenga pakati ndi mkaka wa m`mawere, 7) kusowa poyambira kugwiritsa ntchito njira zina chithandizo.

Gulu la insulin

Pofika nthawi ma insulini ndi:

yochepa - kuyamba kwa mphindi 15-30, nthawi yayitali maola 5-8,

Kutalika kwapakatikati - kuyamba kwa maola 1.5-3, kutalika - maola 12 mpaka 22,

nthawi yayitali - kuyamba kwa zochita pambuyo pa maola 4-6, nthawi - kuchokera kwa maola 25 mpaka 30 (36).

bovine (insulrap, ultralong, ultlente, etc.),

nkhumba - yapafupi kwambiri ndi anthu, imasiyana mu amino acid imodzi (monoinsulin, actrapid, insprap SPP, etc.),

nkhumba ya bovine (iletin-pafupipafupi, insulin-B),

waumunthu - wopezedwa ndi genetic engineering kuchokera ku E. coli ndi yisiti wowotcha (humulin, monotard, protofan NM).

Ndi muyeso wa kuyeretsa kwa insulin (kuchokera somatostatin, pancreatic polypeptide, glucagon, etc.):

zachilengedwe (zachikhalidwe) - kuchuluka kwa zosayera kungakhale mpaka 1%, komwe kumatsimikizira kukwera kwawo kwakukulu,

monopic (semi-oyeretsedwa) - zosayera zili ndi 0,1%,

monocomponent (oyeretsedwa) - insulini zonse za anthu.

Ma insulin ndi monopomponent ndi othandiza kwambiri kuposa zokhazikika, nthawi zambiri zimayambitsa kupangika kwa antibodies, lipodystrophy, thupi lawo siligwirizana.

Malangizo a insulin

Kuwerengera kwa Mlingo wa insulin umodzi komanso wa tsiku ndi tsiku kumachitika chifukwa cha kuchuluka kwa glycemia ndi glucosuria. Zinthu zina kukhala zofanana, chisamaliro chapadera chimayenera kuthandizidwa kudziwa kuchuluka kwa insulini pakuwonongeka kwa impso, chifukwa kuchuluka kwa glucosuria sikuwonetsa bwino kuchuluka kwa glycemia. Kuphatikiza apo, impso ndi malo amisala (chiwonongeko) cha insulini ndipo ngati ntchito yawo imalephera, kufunikira kwa insulin kumachepa, komwe kumayenera kukonzedwa. Kupanda kutero, wodwalayo, zitha kuwoneka ngati ali ndi Mlingo wa insulin yabwino kwa iye, amatha kudwala matenda oopsa oopsa kwambiri.

Poyamba, wodwalayo amapatsidwa mlingo wamba wa tsiku ndi tsiku - ichi ndi mtengo womwe umawonetsera kuchuluka kwa insulin tsiku lililonse, kutengera kulemera kwa thupi la wodwalayo komanso kutalika kwa matendawo.

Mawonekedwe a shuga 1

Wapakati tsiku lililonse insulin, UNITS / kg

Pambuyo kulipira matenda a metabolic a mtundu woyamba wa matenda a shuga

Pankhani ya chiphuphu chosakwaniritsa

Chaka chachiwiri komanso nthawi yayitali ya matendawa

Ketoacidosis, kupezeka kwa matenda opatsirana ndi kutupa

Pakadali pano, amagwiritsa ntchito njira ya basal-bolus ya insulin management (i.e., yophatikiza omwe amagwira ntchito mwachidule ndi ma insulin omwe amakhala nthawi yayitali), kutsanzira kuteteza thupi kwa insulin. Pankhaniyi, insulin yomwe imakhalapo kwa nthawi yayitali imaperekedwa musanadye kadzutsa muyezo wofanana ndi 1/3 wa mlingo wa tsiku ndi tsiku, 2/3 yotsala ya tsiku ndi tsiku imayendetsedwa m'njira ya insulin yocheperako (imagawilidwa chakudya cham'mawa chisanafike, chakudya chamadzulo ndi chakudya chamadzulo moyerekeza 3: 2: 1).

Thandizo lazadzidzidzindi hyperglycemic chikoma:

Mankhwala ambiri odwala matenda ashuga amaphatikizapo:

1) Kuchotsa kuchepa kwa insulini komanso mtundu wa metabolism ya carbohydrate,

2) kuthanso kwamadzi okwanira thupi,

3) kubwezeretsa kwachilengedwe kwazowonjezera- komanso intracellular electrolyte,

4) Kubwezeretsa shuga (glycogen) m'thupi,

5) kubwezeretsa koyenera acid-base balance (COR),

6) kuzindikiritsa komanso kuchiza matenda kapena matenda omwe amachititsa kuti pakhale matenda ashuga.

7) njira zochizira zochizira ndikubwezeretsanso ntchito za ziwalo zamkati (mtima, impso, mapapu, ndi zina).

Pofuna kuthana ndi vuto la matenda ashuga, ma catecholamines ndi mankhwala ena a sympathomimetic sayenera kugwiritsidwa ntchito. Contraindication imagwirizanitsidwa osati kokha ndi kuti ma catecholamine ndi ma mahomoni opikisana ndi mahomoni, komanso chifukwa choti mwa odwala matenda ashuga mphamvu yawo yodzetsa katulutsidwe ka glucagon imakhala yamphamvu kwambiri kuposa anthu athanzi.

Wodwala akangotengedwa kupita kuchipatala, asanayambe kulandira chithandizo, amazindikira kuchuluka kwa shuga m'magazi (ngati kuthekera kwa matupi a ketone, komanso pH, malo osungirako zamchere, ma elekitirodi ndi nitrogen yotsalira), amathandizira kukhazikitsa kwa venous microcatheter. Kenako, catheterization wa chikhodzodzo ndikutsimikiza mwachangu mkodzo wambiri m'magazi a ketone ndi magazi (ngati nkotheka komanso mapuloteni komanso ma cell ofiira a magazi), kukakamizidwa kwa m'mimba ndi njira ya bicarbonate.

Ketoacidotic coma insulin mankhwala amayamba nthawi yomweyo ndi madzi am'madzi, nthawi zambiri amakhala atabadwa. Pakadali pano, m'maiko onse apadziko lonse lapansi, kuphatikiza m'dziko lathu, insulin "yaying'ono" kapena "yanyama" imagwiritsidwa ntchito pazolinga izi. Cholinga chogwiritsira ntchito Mlingo "wocheperako" wa insulin mu ketoacidosis anali maphunziro omwe akuwonetsa kuti kuchuluka kwa insulin ya 10-20 mU / ml kumalepheretsa lipolysis, gluconeogeneis ndi glycogenolysis, komanso kuchuluka kwa ma cell a 120-180 mU / ml. Kukhazikitsidwa kwa insulin pamlingo wa 5-10 U / h kumayambitsa kuyikika m'magazi, koyenera kupondereza osati lipolysis, glycogenolysis ndi glucogeneis, komanso ketogenesis.

Kwambiri mulingo woyenera kulowetsedwa ang'onoang'ono Mlingo wa insulin. Insulin yosavuta imaphatikizidwa mu njira ya 0,9% ya sodium chloride ndikuthira pamlingo wa 5-10 (kawirikawiri 10-15) U / h. Asanayambe kulowetsedwa, tikulimbikitsidwa kuti magawo 10 a insulini athandizidwe kuthandizira. Mlingo wofunika wa insulini kuti mupitirire kulowetsedwa kwa ola limodzi ndi 0.05-0.1 U / kg.

Mlingo wa kulowetsedwa, motero, mlingo wa insulin umadalira mphamvu ya zinthu zam'magazi mu seramu yamagazi a wodwala, yomwe imayang'aniridwa ola lililonse. Mulingo woyenera kwambiri wa kutsika kwa shuga m'magazi ndi 3,89-5.55 mmol / h. Mwazi wamagazi utatsika kufika 11.1-13.9 mmol / l, kuchuluka kwa kulowetsedwa kwa insulini kumachepetsedwa ndi 2-4 U / h kotero kuti chizindikirochi chikhalebe pamtunda wa 8.33-11.1 mmol / l kukonza matenda a pH, ndiye kuti insulin imayendetsedwa ndi mankhwalawa kwa maola 12 maola anayi alionse kapena magawo anayi aliwonse maola 2 aliwonse.

Glycemia, mipweya yamagetsi ndi ma electrolyte amwazi, komanso glucosuria ndi ketonuria amayang'aniridwa ola lililonse. Ngati pakutha kwa ola loyamba la kulowetsedwa mulingo sukuchepa ndi 10% kuchokera koyambirira, ndikofunikira kubwereza kayendetsedwe ka nthawi yomweyo ka 10 PESCES ya insulin ndikupitiliza kulowetsedwa kwamtundu womwewo kapena kuwonjezera kuchuluka kwa kulowetsedwa kwa insulin mpaka 12-15 PIECES / h.

Kubwezeretsa shuga m'thupi ndi gawo lomaliza pochizira matenda a shuga. Monga tafotokozera pamwambapa, ndi kuchepa kwa glycemia kufika 11.1-13.9 mmol / l, mlingo wa insulini umachepetsedwa kwambiri, pomwe kulowetsedwa kwamphamvu kwa 5% shuga yayamba. M'tsogolomu, mankhwala a insulini amachitika pokhapokha pokhazikitsa shuga, kotero kuti pamlingo wa glycemia wokwera kwambiri kuposa 10-11 mmol / l, pamlingo uliwonse wa 100 ml ya shuga, magawo 2-3 a insulin amathandizidwa, ndipo glycemia pansi pa 10 mmol / l - 1 unit pa 100 ml ya 5% yankho. Njira ya shuga ya isotonic imalowetsedwa pamlingo wa 500 ml mu maola 4-6, pomwe kuchuluka kwa shuga komwe kumayendetsedwa tsiku lililonse kuyenera kukhala 100-150 g.Ngoyang'aniridwa koyenera kwa labotale, regimen yovuta kwambiri ya "glucose insulin" imalola kukhala ndi magazi okhazikika a shuga 9 -10 mmol / l kwa nthawi yayitali.

Chisamaliro chodzidzimutsa cha hypoglycemic coma:

Potsimikizira kupezeka kwa vuto la hypoglycemic coma, mankhwalawa amakhala pakukhazikitsa 50 ml ya glucose 50% yotsekemera m'matumbo (ngati sizingatheke pakamwa wodwala) kwa mphindi 3-5, ndikutsatira kulowetsedwa kwa shuga 5 kapena 10%. Mwa odwala ena, kuchira kwa chikumbumtima kumachitika pambuyo pothandizidwa ndi shuga, mwa ena zimatenga nthawi yambiri. Kutsekeka kwa shuga kwa mkati kuyenera kupitilira nthawi yonse ya insulini kapena mankhwala ena amkati a hypoglycemic omwe adayambitsa kukomoka (mwachitsanzo, ngati chikomokere chifukwa cha kumwa chlorpropamide, shuga amayenera kuperekedwa kwa masiku angapo). Kuphatikiza apo, kukhazikitsidwa kwa 1 mg ya glucagon intramuscularly ndikulimbikitsidwa. Pambuyo pakutha kukomoka, kukonza chithandizo chochepetsa shuga, zakudya ndi machitidwe odwala amayenera kuchitika.

Kodi kudwala matenda ashuga ndi chiyani

Chimodzi mwazinthu zovuta kwambiri za matenda a shuga ndi chikomokere cha matenda ashuga chomwe chimakhudzana ndi kusintha kwa kuchuluka kwa shuga m'magazi komanso kukula kwa kusintha kwa kagayidwe kachakudya. Ngati wina sanazindikiridwe munthawi yake, ndiye kuti zosintha zake sizingasinthe ndikuti aphedwe.

Hyperglycemic

Hyperglycemic (hyperosmolar) coma mu shuga imadziwika ndi shuga wambiri wamagazi (oposa 30 mmol / l), sodium yayitali (kuposa 140 mmol / l), osmolarity wokwanira (kuchuluka kwa masenti osungunuka, anions ndi zinthu zosalowerera ndale kuposa 335 mosm / l) .

Zomwe zingayambitse:

1. Kumwa mankhwala osokoneza bongo omwe amachepetsa shuga.
2. Kuchotsa osavomerezeka kapena kulandira mankhwala a hypoglycemic, osakambirana ndi dokotala.
3. Njira yolakwika yoperekera mankhwala okhala ndi insulin.
4. Matenda obwera - zoopsa, kapamba, pakati, opaleshoni.
5. Kukula kwa chakudya zamagulu m'zakudya - kuchuluka kwa shuga kumachuluka.
6. Kugwiritsa ntchito mankhwala ena (okodzetsa kumapangitsa kusowa kwa madzi m'thupi, potero kumawonjezera osmolarity, glucocorticoids imachulukitsa shuga).
7. M ludzu, ndimadzi ochepa omwe amamwetsedwa. Zimatsogolera kumadzi.
8. Madzi am'madzi, kusanza kosaneneka - madzi amayamba.

Ndi imodzi mwa owopsa paumoyo ndi thanzi. Ndikukwera msanga kwa magazi, muyenera kufunsa thandizo kuchipatala mwachangu.

Hypoglycemic chikomokere

Malangizo othandizira odwala matenda ashuga.

Umu ndi mtundu wofala kwambiri wa matenda ashuga. Amadziwika ndi kugwa mwadzidzidzi m'magazi a shuga m'munsi mwa 3 mmol / L.

• Mlingo waukulu wa insulin
• kulephera kwamphamvu
• kulimbitsa thupi kwambiri,
• kumwa mowa waukulu,
• mankhwala ena (B-blockers, lithiamu carbonate, clofibrate, anabolics, calcium).

Nthawi zambiri zimachitika, koma zimaletsedwa mosavuta pogwiritsa ntchito mafuta othamanga (madzi ndi shuga, maswiti).

Matenda a shuga a ketoacidotic

Uwu ndi vuto lalikulu kwambiri la matenda oopsa a shuga, pomwe pH imatsika pansi pa 7.35, kuchuluka kwa glucose kumakwera mpaka 13 kapena kupitirira, ndipo kuchuluka kwa matupi a ketone kumapezeka m'magazi. Anthu omwe ali ndi matenda obadwa nawo a shuga amatha kuvutika. Cholinga chake ndikusankha kopanda mankhwalawa kwa insulin kapena kuwonjezeka kwa kufunika kwake.

1. Osakwanira kuchuluka kwa mankhwala a hypoglycemic kapena kudumpha mlingo wa insulin.
2. Kukana kwa hypoglycemic mankhwala.
3. Makonzedwe olakwika a insulin.
4. Contcomitant pathologies - kulowererapo kwa maopaleshoni, sitiroko, etc.
5. Zakudya zamatumbo akuluakulu, kudya kwambiri mwadongosolo.
6. Kugwira ntchito zolimbitsa thupi molimbika ndi kuchuluka kwa shuga m'magazi.
7. Mowa
8. Mankhwala ena (kuletsa kwa mahomoni, diuretics, morphine, kukonzekera kwa lithiamu, ma dobutamine, ma adrenal ndi mahomoni a chithokomiro).

Ketoacidotic chikomokachi nthawi zonse chimafunikira kulowererapo kwa achipatala ndi kutulutsa, ngati sichoncho munthu akafa.

Kusiyana kwa zizindikiro

Gome: Kuphatikizira kwa zizindikiro.

Ketoacidotic ndi hyperglycemic coma ya matenda osokoneza bongo amakula pang'onopang'ono, munthu amatha kulabadira mawonekedwe a fungo lakuthwa kuchokera mkamwa kapena kuchepa kwa mphamvu ya minofu. Hypoglycemic imakula kwambiri, kotero wodwalayo ayenera kumakhala ndi maswiti nthawi zonse, omwe amayenera kudyedwa pakawoneka kunjenjemera.

Thandizo loyamba la hyperglycemic chikomokere

Njira zamankhwala madokotala asanafike:

1. Ikani kumbali yake, konzani lilime.
2. Dziwani ngati panali kale matenda a shuga kapena matenda opezeka kwa nthawi yoyamba.
3. Ngati ndi kotheka, kuyeza shuga m'magazi musanayambe kukonzekera insulin ndi mphindi 20 pambuyo. Lowani magawo 5-10 a insulin modzichotsera.
4. Mukamapuma, mugwiritseni ntchito kupuma mwa pakamwa.
5. Ndi kugwedezeka kwamitsani miyendo.

Zochita za hypoglycemic chikomokere

Magawo a kuperekedwa kwa thandizo loyamba:

1. Ikani kumbali yake, konzani lilime.
2. Yesani kupereka njira yothanirana ndi shuga kuti mumwe (3 tbsp. Per 100 ml ya madzi) kapena jekeseni njira ya shuga (mankhwala opaka mankhwala).
3. Mukapumira, pitani njira zodzitsitsira - kupuma mwa pakamwa.
4. Yesani kudziwa ngati munthu ali ndi matenda ashuga kapena ngati vutolo limangobwera lokha.

Zoyenera kuchita ndi ketoacidotic chikomokere

1. Ikani wodwala pambali pake, konzani lilime.
2. Lowani 5-10 IU ya insulin.
3. Mukapuma, siyani kupumira pakamwa.
4. Onetsetsani kugunda kwa mtima, kuthamanga kwa magazi, shuga.

Kusamalidwa mwadzidzidzi ndi ketoacidotic coma kumabwera ndikuyamba kulowetsedwa (mankhwala ophatikizira amisala), motero amakhala madokotala.

Ngati mtundu wa chikomokere sichinafotokozedwe

1. Dziwani ngati wodwala ali ndi matenda ashuga.
2. Onani kuchuluka kwa shuga.
3. Onaninso munthu kuti adziwe ngati ali ndi vuto la mtundu umodzi wofanana.

Coma ndi woopsa, sizingatheke kuchitira kunyumba mankhwala enaake. Mu diabetesology, zomwe mungachite muzochitika zoterezi zimanenedwa mu ma algorithms a chisamaliro chodzidzimutsa, chifukwa cha mtundu uliwonse wamtunduwu ndi wosiyana, koma akhoza kuchitidwa ndi maphunziro azachipatala.

Thandizo Loyamba la odwala matenda ashuga Coma

Chimodzi mwa matenda amakono kwambiri ndi matenda ashuga. Ambiri sadziwa nkomwe, chifukwa cha kusowa kufotokoza kwa zizindikiro, kuti ali ndi matenda ashuga. Werengani: Zizindikiro zazikulu za matenda ashuga - muyenera kuzisamala nthawi yanji? Chifukwa chake, kuchepa kwa insulin kumatha kudzetsa mavuto akulu ndipo, pakakhala chithandizo choyenera, kumakhala koopsa. Mavuto akulu kwambiri a matenda ashuga ndi chikomokere. Ndi mitundu yanji ya matenda a shuga omwe amadziwika, ndipo ndimomwe mungapereke thandizo kwa wodwala omwe ali ndi vutoli?

Matenda a shuga - omwe amayambitsa, mitundu ya odwala matenda ashuga

Mwa zovuta zonse za matenda ashuga, kupweteka kwambiri monga kudwala matenda ashuga nthawi zambiri kumatha kusintha. Malinga ndi zomwe ambiri amakhulupirira, chikomokere cha matenda ashuga ndi mtundu wa hyperglycemia. Ndiye kuti, shuga wambiri. M'malo mwake, matenda a shuga atha kukhala osiyanasiyana:

1. Hypoglycemic
2. Hyperosmolar kapena hyperglycemic chikomokere
3. Ketoacidotic

Zomwe zimayambitsa kudwala matenda ashuga zimatha kukulira kuchuluka kwa shuga m'magazi, chithandizo chosayenera cha matenda ashuga komanso ngakhale mankhwala ambiri a insulin, momwe mulingo wa shuga umatsikira pansi.

Zizindikiro za hypoglycemic chikomokere, thandizo loyamba la hypoglycemic chikomokere

Mikhalidwe ya Hypoglycemic ndi yodziwika bwino, makamaka zamtundu 1 shuga, ngakhale amapezeka mwa odwala omwe amamwa mankhwala osokoneza bongo mapiritsi. Monga lamulo, chitukuko cha boma chimayendetsedwa ndi kuchuluka kwakukulu kwa insulin m'magazi. Kuopsa kwa hypoglycemic coma kuli mu kugonjetsedwa (kosasinthika) kwamanjenje ndi ubongo.

Choyamba thandizo la hypoglycemic chikomokere

Ndi zizindikiro zofatsa wodwala ayenera kupereka ochepa shuga, pafupifupi 100 g ma cookie kapena supuni 2-3 za kupanikizana (uchi). Ndikofunika kukumbukira kuti ndi shuga yodalira insulini nthawi zonse muyenera kukhala ndi maswiti "pachifuwa".
Ndi zizindikiro zazikulu:

• Thirani tiyi ofunda mkamwa mwa wodwala (galasi / masamba atatu a shuga) ngati angathe kumeza.
• Asanalowetse tiyi, ndikofunikira kuyika chosungira pakati pa mano - izi zithandiza kupewa kupindika kwambiri nsagwada.
• Potsatira, kuchuluka kwa kusintha, kudyetsa wodwalayo chakudya chochuluka (chakudya, mbale za ufa ndi chimanga).
• Kuti mupewe kuchitika kachiwiri, chepetsani insulini ndi ma 4-8 mamawa.
• Mukamaliza kuthana ndi vuto la hypoglycemic, pitani kuchipatala.

Ngati chikomokere chikukula Kutaya mtimandiye kutsatira:

• Yambitsani 40-80 ml ya shuga m'magazi.
• Chitanani mwachangu ambulansi.

Thandizo loyamba la hyperosmolar coma

• Yikani wodwala moyenera.
• Fotokozerani mawu oyendetsa ndikulanda lilime.
• Pangani zosintha zakakamizo.
• Lowetsani mkati mwa 10-20 ml ya glucose (40% yankho).
• Kuledzera pachimake - nthawi yomweyo imbani ambulansi.

Chisamaliro chodzidzimutsa cha ketoacidotic chikomokere, zizindikiro ndi zimayambitsa ketoacidotic chikomokere mu shuga

Zinthuomwe amalimbikitsa kufunikira kwa insulin ndikuthandizira kukulitsa ketoacidotic chikoma nthawi zambiri:

• Kuzindikira mochedwa matenda a shuga.
• Osaphunzitsidwa mankhwala mankhwala (Mlingo wa mankhwala, m'malo, zina).
• Kusazindikira malamulo a kudziletsa (mowa, mavuto azakudya ndi zizolowezi zolimbitsa thupi, ndi zina).
• Matenda owonda.
• Kuvulala mwakuthupi / kwam'mutu.
• Vuto la mtima mu pachimake mawonekedwe.
• Ntchito.
• Kubala / kutenga pakati.
• Kupsinjika.

Ketoacidotic chikomokere - Zizindikiro

Zizindikiro zoyambira kukhala:

• Kukodza pafupipafupi.
• Ludzu, nseru.
• Kugona, kufooka wamba.

Ndi kuwonongeka koonekeratu:

• Kununkhira kwa acetone kuchokera mkamwa.
• Ululu wam'mimba.
• Kusanza kwambiri.
• Phokoso, kupuma kwambiri.
• Kenako kumaletsa, kusokonezeka chikumbumtima ndikugwa.

Ketoacidotic chikomokere - thandizo loyamba

Choyamba ayenera kuyitanitsa ambulansi ndikuwunika zonse zofunikira za wodwalayo - kupuma, kupanikizika, palpitations, chikumbumtima. Ntchito yayikulu ndikuthandizira kugunda kwa mtima komanso kupumira mpaka ambulansi itafika.
Kuyesa ngati munthu akudziwa, mutha kuchita zosavuta: mufunseni funso lililonse, kugunda pang'ono pamasaya ndikupukutira m'makutu mwake. Ngati palibe zomwe angachite, munthuyo amakhala pachiwopsezo chachikulu. Chifukwa chake, kuchedwa kuyimba ambulansi ndikosatheka.

Malamulo onse othandizira odwala matenda a shuga, ngati mtundu wake sunafotokozedwe

Choyambirira chomwe achibale a wodwalayo ayenera kuchita poyambira ndipo, makamaka, zizindikiro zazikuluzikulu za kukomoka itanani ambulansi nthawi yomweyo . Odwala omwe ali ndi matenda ashuga komanso mabanja awo nthawi zambiri amadziwa bwino izi. Ngati palibe mwayi wopita kwa dokotala, ndiye kuti pa woyamba zizindikiro muyenera:

• Mu mnofu insulin - 6-12 mayunitsi. (osasankha).
• Kuchulukitsa mlingo m'mawa wotsatira - mayunitsi 4-12 / nthawi, jekeseni atatu masana.
• Zakudya zopatsa mphamvu zamagalimoto zimayenera kusinthidwa., mafuta - kupatula.
• Onjezani zipatso / masamba.
• Imwani mchere wamchere wamchere. Popeza kwawo kulibe - madzi okhala ndi supuni yosungunuka ya kumwa koloko.
• Enema ndi yankho la koloko - ndi kusokonezeka kwa chikumbumtima.

Achibale a wodwalayo ayenera kuphunzira mosamala za matendawo, chithandizo chamakono cha matenda ashuga, matenda ashuga ndi thandizo loyambira panthawi yake - pokhapokha thandizo ladzidzidzi lidzakhala lothandiza.