Kev mob ntshav siab yog thaum ntshav qab zib cov ntshav qis dua qhov qub. Cov ntshav qog ntshav qis ua rau muaj kev tsis txaus siab, uas tau piav qhia hauv qab hauv tsab xov xwm. Yog tias mob ntshav nce hlwb ntau tshwm sim, tus neeg tsis nco qab lawm, thiab qhov no tuaj yeem ua rau tuag lossis xiam oob qhab vim yog lub hlwb tsis ua haujlwm. Kev txhais cov ntsiab lus ntawm hypoglycemia yog kev txo cov ntshav qab zib kom tsawg dua 2.8 mmol / l, uas nrog cov kev mob tshwm sim thiab tuaj yeem ua rau tsis nco qab. Kuj, Kev mob ntshav qog ntshav yog qhov ua rau cov ntshav qab zib kom tsawg dua 2.2 mmol / l, txawm tias ib tug neeg tsis hnov mob.
Peb cov ntsiab lus ntawm cov ntshav qog ntshav: qhov no yog thaum tus neeg mob ntshav qab zib muaj ntshav qab zib kom tsawg dua 0.6 mmol / L qis dua nws cov hom phiaj ib qib lossis tsawg dua. Cov ntshav qog ntshav qis yog ntshav qab zib 0.6-1.1 mmol / L hauv qab qib kawm. Yog tias cov piam thaj txuas ntxiv mus, tom qab ntawd cov ntshav qab zib hauv lub cev yuav hnyav thaum cov piam thaj pib tsis txaus los pub lub hlwb. Qhov nuance yog tias txhua tus neeg mob tau muaj ntshav qab zib hom phiaj. Raws li txoj cai, koj yuav tsum sim ua kom tswj cov ntshav qab zib, zoo li hauv cov neeg noj qab haus huv tsis muaj ntshav qab zib. Tab sis nyob rau hauv cov mob hnyav heev ntawm ntshav qab zib, cov neeg mob yuav tsum tau tswj tshwj xeeb qab zib thawj zaug. Xav paub ntau ntxiv, saib kab lus “Cov hom phiaj ntawm kev saib xyuas ntshav qab zib. Yuav tswj cov ntshav qab zib li cas. "
Kev mob ntshav qab zib hauv ntshav qab zib tuaj yeem ua ob yam laj thawj:
- cov tshuaj insulin;
- noj tshuaj uas ua rau kom cov txiav ua kab mob ntau ntxiv ntawm nws cov insulin.
Tshuaj insulin rau kev kho mob ntawm hom 1 thiab ntshav qab zib hom 2 yog qhov tseem ceeb heev, thiab lawv cov txiaj ntsig zoo tshaj qhov yuav ua rau muaj ntshav qab zib tsawg. Ntxiv mus, thaum koj kawm tiav txoj kev ntawm kev thauj khoom me me thiab tuaj yeem tswj hwm nrog cov koob tshuaj insulin me me, qhov kev pheej hmoo ntawm hypoglycemia yuav tsawg heev.
Peb pom zoo kom yuav tsum tau muab cov tshuaj tshem tawm uas ua rau lub txiav ua cov kua dej ntau dua. Cov no suav tag nrho cov tshuaj mob ntshav qab zib los ntawm sulfonylurea derivatives thiab meglitinides chav kawm. Cov tshuaj no tuaj yeem ua tsis tau tsuas yog ua rau lub ntsej muag ntshav qis, tab sis tseem tuaj yeem tsim kev puas tsuaj rau lwm txoj hauv kev. Nyeem “Cov tshuaj ntshav qab zib ua rau dab tsi ntau dua li puas zoo.” Cov kws kho mob uas nyob tom qab lub sijhawm tseem txuas ntxiv tshuaj rau cov neeg mob ntshav qab zib hom 2. Lwm txoj hauv kev, uas tau piav qhia hauv txoj kev kho mob rau tus mob ntshav qab zib hom 2 tuaj yeem tswj cov ntshav qab zib kom tsis muaj kev pheej hmoo ntawm ntshav siab.
Cov tsos mob ntawm tus mob hypoglycemia
Cov tsos mob ntawm cov ntshav qog ntshav tau qhia tseeb dua, qhov sai dua qhov txo qis hauv cov ntshav qabzib tshwm sim tshwm sim.
Cov tsos mob thaum ntxov ntawm hypoglycemia (kev xav tau sai noj "ceev" carbohydrates, tshwj xeeb cov kua qabzib):
- pallor ntawm daim tawv nqaij;
- hws
- trembling, palpitations;
- kev tshaib plab heev;
- tsis muaj peev xwm mloog tau;
- xeev siab
- ntxhov siab, ntxhov siab.
Cov tsos mob ntawm tus mob hypoglycemia, thaum ntshav qab zib cov ntshav qis heev, thiab lub ntsejmuag ntshav qab zib muaj ntau twb tshwm sim:
- tsis muaj zog
- kiv taub hau, mob taub hau;
- kev ntshai ntawm kev ntshai;
- kev hais lus thiab pom kev tsis zoo rau kev coj ua;
- tsis meej pem txog txoj kev nco qab;
- kev tsis sib haum xeeb ntawm kev txav chaw;
- kev ploj kev coj hauv qhov chaw;
- tshee nog leeg, cramps.
Tsis yog tag nrho cov tsos mob glycemic tshwm tib lub sijhawm. Hauv tib qho mob ntshav qab zib, cov tsos mob ntawm kev mob ntshav qab zib tuaj yeem hloov pauv txhua zaus. Hauv ntau tus neeg mob, qhov kev hnov ntawm cov tsos mob ntawm cov qog ntshav qab zib yog "npub". Xws li cov ntshav qab zib txhua lub sijhawm cia li nco dheev vim yog qhov kev txhim kho ntawm hypoglycemic coma. Lawv muaj kev pheej hmoo siab lossis xiam oob qhab vim yog ntshav nce siab ntau. Vim li cas qhov no tshwm sim:
- lossi cov ntshav qab zib siab tas li;
- ib tug neeg tau ntev ntev mob ntshav qab zib;
- hnub nyoog siab heev;
- yog tias muaj ntshav qab zib feem ntau tshwm sim, tom qab ntawd cov tsos mob tsis hnov zoo li.
Cov neeg zoo li no yuav tsum tsis txhob tsim kev phom sij rau lwm tus thaum lub sijhawm mob ntshav qab zib sai sai. Qhov no txhais tau tias nws yog contraindicated rau lawv kom ua txoj haujlwm uas lwm tus neeg lub neej vam khom. Tshwj xeeb, cov neeg mob ntshav qab zib tsis tso cai tsav tsheb thiab thauj cov pej xeem.
Qee tus neeg mob ntshav qab zib pom tau tias lawv muaj ntshav qab zib tsawg. Lawv tswj kev nkag siab meej txaus ntawm kev xav kom tau txais cov glucometer, ntsuas lawv qab zib thiab nres nres ntawm hypoglycemia. Hmoov tsis zoo, ntau tus neeg mob ntshav qab zib nrog qhov kev paub ntawm lawv tus kheej hypoglycemia muaj teeb meem loj. Thaum lub hlwb tsis muaj cov kua nplaum ntev, tus neeg yuav pib coj tus cwj pwm yam tsis zoo. Cov neeg mob zoo li no tseem ntseeg tau tias lawv muaj ntshav qab zib ib txwm muaj, txog rau lub sijhawm mus txog thaum lawv tsis nco qab lawm. Yog tias tus mob ntshav qab zib tau ntsib ntau qhov xwm txheej tshwm sim ntawm tus mob ntshav qab zib tsawg, tom qab ntawd nws yuav muaj teeb meem nrog kev lees paub kom raws sijhawm ntawm cov kev mob tshwm sim txuas mus. Qhov no yog vim dysregulation ntawm adrenergic receptors. Tsis tas li, qee cov tshuaj cuam tshuam nrog kev paub txog tus mob ntshav qab zib lub sijhawm. Cov no yog cov beta blockers uas txo cov ntshav siab thiab lub plawv dhia.
Ntawm no yog lwm daim ntawv teev cov kev mob tshwm sim ntawm kev ua qog ntshav qab zib, uas txhim kho thaum nws qhov hnyav zuj zus:
- Cov tshuaj tiv thaiv qeeb rau ib puag ncig cov xwm txheej - piv txwv li, nyob hauv lub xeev ntawm lub qog ntshav qab zib, tus neeg tsis tuaj yeem nres lub sijhawm thaum tsav tsheb.
- Cuam tshuam, txhoj puab heev. Lub sijhawm no, tus neeg mob ntshav qab zib tau ntseeg tias nws muaj ntshav qab zib ib txwm, thiab tawm tsam qhov kev mob siab ntawm lwm tus yuam nws ntsuas ntsuas qab zib lossis noj zaub mov sai sai.
- Clouding ntawm lub siab, nyuaj hais lus, tsis muaj zog, clumsiness. Cov tsos mob no tuaj yeem ua mus ntxiv tom qab cov suab thaj tau rov qab zoo li qub, txawm mus txog 45-60 feeb.
- Kev nkees nkees, qaug zog.
- Poob nco qab (muaj tsawg kawg yog tias koj tsis txhaj tshuaj insulin).
- Qhov pom tseeb.
- Kev Tuag.
Nocturnal hypoglycemia hauv npau suav
Cov cim ntawm nocturnal hypoglycemia hauv npau suav:
- tus neeg mob tau mob khaub thuas, tawm hws-ua tawv nqaij, tshwj xeeb ntawm caj dab;
- tsis meej pem ua pa;
- nyob tsis tswm pw.
Yog tias koj tus menyuam muaj ntshav qab zib hom 1, tom qab ntawd koj yuav tsum tau saib nws qee lub sijhawm thaum tsaus ntuj, kuaj nws caj dab los ntawm kov, koj kuj tuaj yeem tsa nws sawv thiab tsuas yog qee kis, ntsuas ntshav qab zib nrog ib glucometer nyob hauv nruab nrab ntawm hmo ntuj. Txhawm rau txo qis koj cov tshuaj insulin, thiab nrog nws koj qhov kev pheej hmoo ntawm ntshav qab zib, ua raws li hom 1 tshuaj kho mob ntshav qab zib. Hloov pauv tus menyuam uas mob ntshav qab zib hom 1 mus rau kev noj haus uas muaj zaub mov kom ntau thaum koj pub mis niam tiav tas.
Yog tias cov tsos mob ntawm hypoglycemia yog npub
Hauv qee cov neeg mob ntshav qab zib, cov tsos mob thaum ntxov ntawm lub qog ntshav qab zib yog npub. Nrog lub ntsej muag hypoglycemia, txhais tes tshee, pallor ntawm daim tawv nqaij, lub plawv dhia ceev ceev thiab lwm yam tshwm sim ua rau lub cev epinephrine (adrenaline). Hauv ntau cov neeg mob ntshav qab zib, nws cov khoom lag luam tsis muaj zog lossis cov kab mob tsis tshua nkag siab. Qhov teeb meem no tau dhau caij nyoog hauv cov neeg mob uas muaj ntshav qab zib tsawg lossis ntshav nce siab feem ntau los ntawm cov ntshav qab zib kom qis. Hmoov tsis zoo, cov no tau hais meej txog pawg ntawm cov neeg mob uas feem ntau ntsib kev mob ntshav qab zib thiab leej twg xav tau adrenaline rhiab heev dua li lwm tus.
Muaj 5 lub laj thawj thiab ib qho xwm txheej uas tuaj yeem ua rau lub ntsej muag ntawm cov tsos mob hypoglycemia:
- Kev mob ntshav qab zib mob ntshav siab ntshav qab zib yog cov mob ntshav qab zib uas ua rau lub hlwb tsis ua haujlwm zoo.
- Cov qog pob qij txha rau Adrenal. Nov yog kev tuag ntawm cov qog adrenal - cov qog uas tsim adrenaline. Nws muaj kev vam meej yog tias tus neeg mob muaj keeb kwm mob ntshav qab zib ntev ntev, thiab nws mob siab los yog tsis kho.
- Cov piam thaj hauv ntshav yuav nyob qis dua li qub.
- Tus mob ntshav qab zib noj tshuaj - beta-blockers - rau ntshav siab, tom qab lub plawv nres, lossis rau nws cov kev tiv thaiv.
- Ntawm cov neeg mob ntshav qab zib uas noj zaub mov kom sib luag, noj nrog cov carbohydrates, thiab yog li yuam kom txhaj tshuaj insulin ntau.
Qee tus neeg mob ntshav qab zib tsis kam noj cov piam thaj, txawm tias lawv ntsuas lawv qab zib thiab pom tias nws qis dua. Lawv hais tias lawv zoo nyob txawm tias tsis muaj tshuaj dab tsi. Cov kws kho ntshav qab zib yog qhov tseem ceeb “cov neeg siv” rau cov kws kho mob ceev, yog li lawv tuaj yeem xyaum tshem tus neeg ntawm qhov mob tsis xwm yeem. Lawv tseem muaj qhov tshwj xeeb siab tias qhov xwm txheej tshwm sim hauv lub tsheb. Thaum koj tsav, ntsuas koj cov ntshav qab zib nrog lub ntsuas ntshav qab zib txhua teev, tsis hais seb koj puas muaj ntshav siab tsis txaus lossis tsis.
Cov neeg uas muaj ntau lub sijhawm cov ntshav qog ntshav qab zib lossis ntshav qab zib qis qis tsis tu ncua, txhim kho "kev quav" rau tus mob no. Adrenaline hauv lawv cov ntshav feem ntau tshwm sim thiab ntau ntau. Qhov no ua rau qhov tseeb tias qhov rhiab heev ntawm cov receptors kom adrenaline tsis muaj zog. Tib txoj kev, ntau dhau qhov kev txiav txim siab ntawm insulin hauv cov ntshav cuam tshuam qhov rhiab ntawm insulin receptors ntawm lub ntsej muag ntawm tes.
Cov tsos mob thaum ntxov ntawm hypoglycemia - tes tshee, pallor ntawm daim tawv nqaij, lub plawv dhia ceev ceev, thiab lwm tus - yog cov cim los ntawm lub cev uas cov ntshav qab zib xav tau kev cuam tshuam sai kom cawm tau nws txoj sia. Yog tias lub teeb liab ua haujlwm tsis ua haujlwm, tom qab ntawd lub nrawm ploj mus rau hauv lub ntsej muag vim qhov kev txhim kho ntawm lub ntsej muag tsis nco qab. Xws li cov ntshav qab zib muaj kev pheej hmoo siab lossis tuag vim qhov ua rau lub qog ntshav nce siab. Tib txoj kev los daws qhov teeb meem no, yog tias nws tau tsim, nws yog ntsuas koj cov ntshav qab zib kom ntau thiab tom qab ntawd kho nws. Rov nyeem dua yog dab tsi tag nrho cov ntshav qab zib tswj thiab xyuas seb koj lub ntsuas dej puas yog.
Ua rau cov ntshav qog ntshav qab zib hauv ntshav qab zib
Kev mob ntshav qab zib yog nce hauv cov xwm txheej uas muaj cov insulin ntau heev nyob rau hauv cov ntshav, muaj feem cuam tshuam rau cov piam thaj hauv cov zaub mov thiab los ntawm cov khw hauv lub siab.
Ua rau cov ntshav qog ntshav qab zib
| A. cuam tshuam nrog kev siv tshuaj kho kom ntshav qab zib kom tsawg | |
|---|---|
| Ib qho dhau ntawm insulin, sulfonylureas lossis clayides |
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| Hloov pauv hauv pharmacokinetics (lub zog thiab tus nqi ntawm kev txiav txim siab) ntawm cov kua dej los yog txo cov ntsiav tshuaj |
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| Ua rau cov nqaij rhiab ntau ntxiv rau cov tshuaj insulin |
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B. Lwm Yam Khoom Noj | |
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Cov tshuaj tseem ceeb tau tshaj tawm tias yog tias cov neeg mob ntshav qab zib tau txais kev kho mob zoo los ntawm cov tshuaj insulin lossis cov ntshav qab zib, ces nws yuav tsum tau muaj cov tsos mob ntawm lub qog ntshav qab zib 1-2 zaug hauv ib lub lis piam, thiab tsis muaj dab tsi txhaum. Peb tshaj tawm tias yog koj tab tom siv hom kev kho mob ntshav qab zib hom 1 lossis hom kho ntshav qab zib hom 2, ntshav qabzib yuav tshwm sim ntau heev dua. Vim tias muaj ntshav qab zib hom 2, peb tsis kam siv cov tshuaj phem (sulfonylureas thiab clayides) uas tuaj yeem ua rau nws. Raws li rau cov tshuaj insulin, cov qauv ntawm kev thauj khoom me me rau hom 1 thiab ntshav qab zib hom 2 tso cai ntau zaus qis qis cov tshuaj insulin thiab yog li txo qhov kev pheej hmoo ntawm hypoglycemia.
Cov xwm txheej uas ua rau tus mob ntshav qab zib tsawg nyob rau hauv cov neeg kho tau raws li cov kev mob ntshav qab zib-Med.Com lub website:
- Lawv tsis tau tos 5 teev kom txog thaum tau txhaj koob tshuaj sai dhau los ua tiav kev ua yeeb yam, thiab tau txhaj koob tshuaj ntxiv kom txo qis qab zib hauv cov ntshav. Qhov no phom sij heev tshaj thaum hmo ntuj.
- Lawv tau txhaj cov insulin ceev ua ntej noj, thiab tom qab ntawd lawv tau noj dhau lawm. Qhov qub yog tias koj noj tshuaj ua ntej noj mov, ua rau cov txiav ua kom cov kua dej ntau ntxiv. Nws yog qhov txaus los pib noj 10-15 feeb tom qab nws yuav tsum paub tias cov tsos mob ntawm tus mob ntshav qab zib tsawg.
- Mob plab zom mov - ncua kev nkees ntawm lub plab tom qab noj mov.
- Tom qab qhov kawg ntawm tus kab mob kis, kab mob tiv thaiv insulin dheev tsis muaj zog, thiab cov ntshav qab zib tsis nco qab rov qab los ntawm cov koob tshuaj insulin lossis cov piam thaj ua ke rau nws cov koob tshuaj niaj zaus.
- Tus mob ntshav qab zib tau ntev lawm nws tus kheej "tsis muaj zog" insulin los ntawm lub raj mis los yog daim cartridge, uas tau muab cov khoom tsis raug los sis dhau sijhawm lawm, thiab tom qab ntawd pib txhaj "tshiab" cov insulin yam tsis muaj qhov qis dua.
- Hloov ntawm lub twj tso kua mis insulin mus rau kev txhaj tshuaj ntawm cov insulin koob txhaj tshuaj thiab hloov pauv yog tias nws tshwm sim yam tsis tau ceev faj txog kev soj ntsuam ntshav qab zib nws tus kheej.
- Cov mob ntshav qab zib tau txhaj nws tus kheej nrog ultrashort insulin ntawm lub zog ntau zog hauv tib lub koob tshuaj uas feem ntau luv.
- Qhov kev noj tshuaj ntawm cov tshuaj insulin tsis sib haum nrog cov khoom noj uas tau noj lawm. Noj cov carbohydrates tsawg thiab / lossis muaj protein ntau dua li npaj rau noj tshais, noj su lossis noj hmo. Los yog lawv noj ntau npaum li lawv tau npaj, tab sis vim qee qhov laj thawj lawv tau txhaj cov insulin ntau dua.
- Tus mob ntshav qab zib ua rau tsis tau tsim cov kev ua haujlwm rau lub cev lossis tsis nco qab tswj ntshav qab zib txhua teev thaum ua haujlwm.
- Cawv kev haus cawv, tshwj xeeb ua ntej thiab thaum noj mov.
- Tus neeg mob ntshav qab zib uas txhaj ib pliag nruab nrab NPH-insulin protafan txhaj nws tus kheej, tsis nco qab ua kom viav vias zoo ua ntej noj cov koob tshuaj insulin rau hauv cov txhaj tshuaj.
- Intramuscularly txhaj cov tshuaj insulin hloov chaw subcutaneous.
- Lawv tau ua qhov tsim nyog txhaj tshuaj ntawm cov tshuaj insulin, tab sis nyob hauv qhov ntawd ntawm lub cev uas raug rau lub cev ua kom muaj zog.
- Kev kho mob ntev ntev nrog kev tso ntshav ntawm gamma globulin. Nws ua rau qhov tsis muaj xwm txheej thiab tsis tuaj yeem rov qab los ntawm qee qhov ntawm cov beta hlwb hauv cov neeg mob uas muaj ntshav qab zib hom 1, uas ua rau txo qis qhov xav tau ntawm insulin.
- Noj cov tshuaj nram qab no: cov tshuaj aspirin nyob rau hauv cov koob tshuaj loj, tshuaj anticoagulants, barbiturates, antihistamines thiab lwm yam. Cov tshuaj no txo cov ntshav qab zib los yog inhibit qhov ua ntawm qabzib los ntawm lub siab.
- Kev ua kom sov sov. Lub sijhawm no, ntau tus neeg mob ntshav qab zib xav tau cov tshuaj insulin tsawg dua.
Kev tshaib plab yog qhov tshwm sim tshaj plaws ntawm kev ua kom ntshav qog thaum ntxov. Yog tias koj tab tom ua ib txoj kev kho mob ntshav qab zib hom 1 los yog hom kev kho mob ntshav qab zib hom 2 thiab tswj koj tus kab mob tau zoo, ces koj yuav tsum tsis txhob ntsib kev tshaib plab loj. Ua ntej txoj kev npaj pluas noj koj yuav tsum tau tshaib plab me ntsis xwb.Ntawm qhov tod tes, kev tshaib plab feem ntau tsuas yog lub cim ntawm kev qaug zog lossis lub siab kev ntxhov siab, tab sis tsis yog hypoglycemia. Tsis tas li ntawd, thaum cov ntshav qab zib muaj ntshav ntau dhau, ntawm qhov tsis sib thooj, lub hlwb tsis muaj qabzib, thiab lawv sib zog xa cov kev tshaib plab. Xaus: yog tias koj xav tias tshaib plab - tam sim ntsuas ntsuas koj cov ntshav qab zib nrog ib glucometer.
Qhov muaj feem yuav ua rau muaj ntshav qab zib txaus:
- tus neeg mob tau mob yav dhau los ua rau muaj ntshav nce siab ntau ntau;
- tus mob ntshav qab zib tsis hnov cov tsos mob ntawm tus mob ntshav qab zib tsawg tsawg hauv lub sijhawm, thiab yog li ntawd tus mob tsis xeev tshwm sim sai;
- pancreatic insulin secretion yog kiag li tsis tuaj;
- qis qes ntawm tus neeg mob.
Yuav ua li cas to taub yog vim li cas thiaj ua kom ntshav qab zib tsawg
Koj yuav tsum rov ua kom tag nrho cov txheej xwm uas ua rau muaj kev ceeb toom thaum koj cov piam thaj hauv ntshav qis dhau. Qhov no yuav tsum tau ua txhua lub sijhawm, txawm tias tsis muaj cov tsos mob pom tias koj ua yuam kev li cas. Txhawm rau cov xwm txheej kom rov zoo, cov neeg mob ntshav qab zib insulin yuav tsum muaj kev ua neej nyob tsis tu ncua hauv kev tswj hwm ntawm cov ntshav qab zib kom tag nrho, i.e., feem ntau ntsuas nws, sau cov ntsuas ntsuas thiab cov xwm txheej cuam tshuam.
Kev mob ntshav nce siab ntau tuaj yeem ua rau qhov tseeb tshwm sim ob peb teev ua ntej nws raug tshem tawm los ntawm lub cim xeeb ntawm tus neeg mob ntshav qab zib. Yog tias nws ua tib zoo sau nws phau ceev xwm txheej ntawm kev tswj hwm tus kheej, tom qab ntawd nyob rau qhov xwm txheej zoo li no cov ntawv yuav tsis muaj txiaj ntsig. Nws tsis txaus los sau tsuas yog cov txiaj ntsig ntawm kev ntsuas ntsuas ntshav qab zib, nws tseem yuav tsum sau cov xwm txheej nrog. Yog tias koj muaj ob peb lub sijhawm kub siab ntawm lub qog ntshav qab zib, tab sis koj tsis tuaj yeem nkag siab qhov laj thawj, tom qab ntawd muab cov ntawv sau rau tus kws kho mob. Tej zaum nws yuav kom koj nug cov lus ntawv kom meej thiab xam tau.
Kev kho mob (nres) ntawm hypoglycemia
Yog tias koj muaj cov tsos mob ntawm cov ntshav qog ntshav uas peb tau teev saum toj saud - tshwj xeeb tshaj yog kev tshaib plab loj - tam sim ntsuas koj cov piam thaj hauv ntshav nrog glucometer. Yog tias nws yog 0.6 mmol / L hauv qab ntawm koj lub hom phiaj qib lossis tseem qis dua, ces ua cov qib los ua kom tsis txhob muaj ntshav qab zib. Noj cov khoom noj uas muaj carbohydrates txaus, tshwj xeeb cov ntsiav tshuaj qabzib, txhawm rau kom nce qab zib rau qib. Yog tias tsis muaj cov tsos mob tshwm sim, tab sis koj tau ntsuas cov ntshav qab zib thiab pom tias nws muaj qis, qhov qub yog tsim nyog los noj cov ntsiav tshuaj qabzib rau hauv qhov ntau thiab tsawg teev. Yog tias muaj piam thaj hauv ntshav tsawg, tab sis tsis muaj tsos mob dab tsi, ces cov zaub mov carbohydrates tseem yuav tsum tau noj. Vim tias hypoglycemia uas tsis muaj cov tsos mob yog qhov txaus ntshai tshaj li qhov uas ua rau pom tseeb.
Sai li lub ntsuas dej yog nyob ntawm koj pov tseg - ntsuas koj qab zib. Nws feem ntau yuav tsum tau tsa lossis poob qis. Coj nws rov qab ua qhov qub thiab tsis ua kev txhaum ntxiv lawm, i.e. ib txwm khaws lub ntsuas dej nrog koj.
Qhov nyuaj tshaj plaws yog tias koj cov piam thaj hauv ntshav tau poob vim yog mus txhaj tshuaj insulin ntau dhau lossis noj ntau dhau ntawm cov tshuaj mob ntshav qab zib. Thaum muaj qhov xwm txheej zoo li no, cov piam thaj yuav poob dua tom qab noj cov piam thaj. Yog li no, rov ntsuas koj qab zib nrog ib glucometer 45 feeb tom qab noj ib tus kab mob hypoglycemic. Nco ntsoov tias txhua yam yuav zoo. Yog tias cov piam thaj tsawg dua, rov qab noj dua lwm cov ntsiav tshuaj, tom qab ntawd rov ua qhov ntsuas tom qab lwm 45 feeb. Thiab lwm yam, mus txog thaum txhua yam thaum kawg rov ua qhov qub.
Yuav kho tus mob hypoglycemia npaum li cas yam tsis muaj nce qib qab zib li ib txwm
Kev lig kev cai, cov neeg mob ntshav qab zib kom tsis txhob mob ntshav qab zib noj cov hmoov nplej, txiv hmab txiv ntoo thiab khoom qab zib, haus kua txiv lossis kua txiv qab zib. Txoj kev kho mob no tsis ua haujlwm zoo rau ob qho laj thawj. Ntawm ib sab, nws ua qeeb qeeb dua li tsim nyog. Vim tias cov carbohydrates uas pom muaj hauv cov zaub mov, lub cev tseem yuav tsum tau zom ua ntej lawv pib nce cov ntshav qab zib. Ntawm qhov tod tes, xws li "kev kho mob" ua rau cov piam thaj hauv ntshav ntau dhau, vim tias nws tsis tuaj yeem suav qhov tseeb ntawm cov tshuaj carbohydrates, thiab nrog kev txaus ntshai, tus neeg mob ntshav qab zib noj ntau ntawm lawv.
Kev mob ntshav qab zib ntshav siab tuaj yeem ua rau muaj ntshav qab zib txaus ntshai. Kev tawm tsam hnyav tuaj yeem ua rau tus neeg mob ntshav qab zib tuag lossis kev xiam oob qhab vim muaj kev cuam tshuam rau lub hlwb tsis ua haujlwm, thiab nws tsis yooj yim los tawm qhov twg ntawm cov txiaj ntsig no tshwm sim tsis zoo. Yog li, peb siv zog kom nce cov ntshav qab zib kom ib txwm nrawm li sai tau. Cov carbohydrates tsis yooj yim, fructose, mis qab zib, lactose - txhua tus ntawm lawv yuav tsum yauv ua cov zom zaub mov hauv lub cev ua ntej lawv pib nce ntshav qab zib. Tib yam siv rau txawm rau cov hmoov txhuv nplej siab thiab cov lus qab zib, txawm hais tias cov kev ua kom nruj tau zoo heev rau lawv.
Cov khoom peb teev saum toj no muaj kev sib xyaw ntawm cov roj sai thiab qeeb carbohydrates, uas ua nrog ncua sij hawm, thiab tom qab ntawd nce ntshav qab zib cov ntshav uas tsis paub txog. Nws ib txwm xaus nrog qhov tseeb tias tom qab nres ib qho kev tawm tsam ntawm hypoglycemia, qab zib hauv tus neeg mob ntshav qab zib "qaws". Cov kws kho mob tsis lees paub tseem ntseeg tau hais tias tom qab ib qho kev txo qis ntawm hypoglycemia nws yog ib qho tsis yooj yim sua kom tsis txhob muaj ricocheted nce rau hauv cov ntshav qab zib. Lawv txiav txim siab nws tus kheej yog tias tom qab ob peb teev cov piam thaj hauv ntshav hauv tus neeg mob ntshav qab zib yog 15-16 mmol / L. Tab sis qhov no tsis muaj tseeb yog tias koj ua tib zoo. Txoj kev kho twg yuav ua rau kom cov ntshav qab zib sai tshaj thiab kom paub tseeb tseeb? Teb: qabzib hauv nws cov ntawv dawb huv.
Glucose ntsiav tshuaj
Glucose yog cov tshuaj uas xa mus rau hauv cov ntshav thiab uas peb hu ua “cov piam thaj hauv ntshav”. Cov piam thaj hauv cov zaub mov yog nqus sai rau hauv cov ntshav thiab pib ua yeeb yam. Lub cev tsis tas yuav zom nws; nws tsis muaj kev hloov pauv hauv lub siab. Yog tias koj zom cov ntsiav tshuaj pleev hauv koj lub qhov ncauj thiab haus nws nrog dej, tom qab ntawd feem ntau nws yuav nqus mus rau hauv cov ntshav los ntawm cov qog ua kua ntawm lub qhov ncauj, txawm tias nqos tsis tsim nyog. Qee tus ntxiv yuav nkag mus rau hauv lub plab thiab cov hnyuv thiab yuav nqus tau los ntawm muaj.
Ntxiv rau qhov nrawm nrawm, qhov thib ob kom zoo dua ntawm cov ntsiav tshuaj qabzib yog kev kwv yees. Thaum lub sij hawm hypoglycemia nyob rau hauv tus neeg mob uas muaj hom 1 lossis hom 2 ntshav qab zib hnyav 64 kg, 1 gram ntawm cov piam thaj yuav nce cov ntshav qab zib kom txog 0.28 mmol / L. Thaum muaj tus mob no, nyob hauv tus neeg mob uas muaj ntshav qab zib hom 2, kev tsim cov tshuaj insulin los ntawm tus txiav yog txiav tawm, thaum tus neeg mob ntshav qab zib hom 1 tsis muaj hlo li. Yog tias cov piam thaj hauv ntshav tsis qis dua li ib txwm, ces tus neeg mob ntshav qab zib hom 2 yuav ua rau cov ntshav qabzib tsis muaj zog vim tias cov txiav "ua kom" nrog nws cov insulin. Txog rau tus neeg mob uas muaj ntshav qab zib hom 1, tseem muaj 1 ntawm cov piam thaj yuav ua rau cov ntshav qab zib nce 0.28 mmol / l, vim tias nws tsis muaj nws tus kheej insulin ntau lawm.
Tus neeg hnyav dua, cov nyhuv ntawm cov piam thaj hauv nws lub cev tsawg dua, thiab nws lub cev hnyav dua, nws muaj zog dua. Txhawm rau xam li cas 1 gram piam thaj yuav ua rau cov ntshav qab zib nyob ntawm koj qhov hnyav, koj yuav tsum ua kom muaj qhov sib npaug. Piv txwv li, rau tus neeg uas lub cev hnyav txog 80 kg, yuav muaj 0.28 mmol / L * 64 kg / 80 kg = 0.22 mmol / L, thiab rau tus menyuam uas hnyav 48 kg, 0.28 mmol / L * 64 kg / 48 yuav tau txais kg = 0.37 mmol / l.
Yog li, rau kev tso tseg cov ntshav qab zib hauv qab zib, cov ntsiav tshuaj nyob tom qab yog qhov kev xaiv zoo tshaj plaws. Lawv muag hauv feem ntau lub tsev muag tshuaj thiab yog tus nqi pheej yig heev. Tsis tas li, hauv khw muag khoom noj hauv qhov chaw txheeb xyuas, cov ntsiav tshuaj ascorbic acid (vitamin C) nrog piam thaj feem ntau muag. Lawv kuj tseem tuaj yeem siv tiv thaiv kev mob ntshav qab zib. Cov koob tshuaj ntawm vitamin C hauv lawv feem ntau qis heev. Yog tias koj tub nkeeg tag los tso cov tshuaj pleev kua qabzib - nqa cov kua qab zib nrog koj. Tsuas yog 2-3 daim, tsis ntau. Cov khoom qab zib, txiv hmab txiv ntoo, kua txiv, hmoov nplej - tsis tsim rau cov neeg mob uas ua ib txoj haujlwm kho mob ntshav qab zib hom 1 lossis hom ntshav qab zib hom 2 ...
Yog tias koj tau kov cov ntsiav tshuaj piam thaj, ntxuav koj txhais tes ua ntej ntsuas koj cov ntshav qab zib nrog ib glucometer. Yog tias tsis muaj dej, siv daim ntaub ntub dej. Ua qhov kawg, yaim tus ntiv tes uas koj nyiam ntxig, thiab tom qab ntawd so nws nrog daim ntaub huv lossis ntaub so tes. Yog hais tias qhov kab ntawm cov kua nplaum nyob twj ywm ntawm daim tawv nqaij ntawm cov ntiv tes, ces cov txiaj ntsig ntawm kev ntsuas ntshav qab zib yuav cuam tshuam. Khaws cov ntsiav tshuaj piam thaj kom deb ntawm lub 'meter' thiab sim ib daim hlab kuaj nws.
Cov lus nug tseem ceeb tshaj plaws yog kuv yuav tsum noj pes tsawg glucose ntsiav tshuaj? Tom lawv txaus kom tsa koj cov piam thaj hauv ntshav mus rau qhov qub, tab sis tsis ntau. Cia peb xav txog qhov ua piv txwv. Cia hais tias koj lub cev hnyav 80 kg. Saum toj no, peb tau suav tias 1 gram suab thaj yuav ua rau koj cov piam thaj hauv ntshav nce 0.22 mmol / L. Tam sim no koj muaj ntshav qab zib ntawm 3.3 mmol / L, thiab lub hom phiaj qib yog 4.6 mmol / L, i.e. koj yuav tsum nce qab zib los ntawm 4.6 mmol / L - 3.3 mmol / L = 1.3 mmol / l. Txhawm rau ua qhov no, noj 1.3 mmol / L / 0.22 mmol / L = 6 grams qabzib. Yog tias koj siv cov ntsiav tshuaj piam thaj uas hnyav 1 gram txhua, nws yuav dhau los 6 ntsiav tshuaj, tsis muaj ntau thiab tsis tsawg dua.
Yuav ua li cas yog tias cov piam thaj hauv ntshav tsis txaus ua ntej noj mov
Tej zaum nws yuav tshwm sim koj pom koj tus kheej qis qab zib ua ntej koj pib noj mov. Yog tias koj ua raws li cov zaub mov tsis muaj carbohydrate kom tswj tau cov ntshav qab zib hom 1 lossis hom 2, tom qab qhov no, noj cov ntsiav tshuaj qabzib tam sim ntawd, thiab tom qab ntawd cov zaub mov "tiag". Vim tias cov zaub mov carbohydrate tsawg yuav nqus tau qeeb. Yog tias koj tsis nres qhov ntshav qab zib, tom qab no qhov no tuaj yeem ua rau ntau dhau thiab dhia hauv qab zib hauv ob peb teev, uas tom qab ntawd nws yuav nyuaj rau qhov ib txwm ua.
Yuav daws li cas nrog kev tawm tsam ntawm gluttony nrog hypoglycemia
Cov ntshav qog me me thiab “kub ntxhov hnyav” tuaj yeem ua rau txaus ntshai, thev tsis taus kev tshaib kev nqhis thiab kev ntshai. Lub siab xav noj cov zaub mov ntau dhau nrog carbohydrates tuaj yeem ua rau tsis xwm yeem. Nyob rau hauv qhov xwm txheej zoo li no, tus mob ntshav qab zib tau noj tam sim ntawd tag nrho ib phaus ntawm cov khoom noj qab zib lossis hmoov nplej cov khoom noj lossis haus ib khob kua txiv. Raws li qhov tshwm sim, cov piam thaj hauv ntshav hauv ob peb teev yuav monstrously. Hauv qab no koj yuav paub yuav ua li cas rau lub qog ntshav qab zib txhawm rau txhawm rau txo qis kev phom sij rau koj kev noj qab haus huv los ntawm kev ceeb ntshai thiab kev kub ntxhov.
Ua ntej, kev sim ua ntej thiab ua kom cov ntsiav tshuaj qabzib tuaj yeem kwv yees tau, tshwj xeeb tshaj yog rau ntshav qab zib hom 1. Koj tau noj pes tsawg grams ntawm cov piam thaj - kom koj cov ntshav qab zib yuav nce siab, tsis muaj ntxiv thiab tsis tsawg dua. Txheeb xyuas koj tus kheej, saib koj tus kheej ua ntej. Qhov no yog qhov tsim nyog thiaj li hais tias nyob rau hauv qhov xwm txheej ntawm hypoglycemia koj tsis txhob ntshai. Tom qab noj cov piam thaj hauv cov ntsiav tshuaj, koj yuav paub tseeb tias poob ntawm kev nco qab thiab tuag yog qhov twv yuav raug tsis tau.
Yog li, peb tau tswj hwm kev ntshai, vim tias peb tau npaj ua ntej rau qhov xwm txheej ntawm qhov ua rau nws muaj qog ntshav qis. Qhov no tso cai rau tus neeg mob ntshav qab zib kom nyob ntsiag to, tswj nws lub siab, thiab muaj tsawg txoj hmoo uas lub siab xav tau txhawm rau txhawm rau tsis muaj kev tswj hwm. Tab sis dab tsi yog tias, tom qab noj cov ntsiav tshuaj piam thaj, kev tshaib plab tsiaj qus tseem tsis tau tswj? Qhov no tuaj yeem vim qhov tseeb hais tias ib nrab-lub neej ntawm adrenaline nyob rau hauv cov ntshav yog ntev heev, raws li tau piav qhia nyob rau hauv tshooj yav dhau los. Hauv qhov no, zom thiab noj cov zaub mov uas tsis muaj cov carb qis hauv daim ntawv tso cai.
Ntxiv mus, nws raug nquahu kom siv cov khoom lag luam uas tsis muaj carbohydrates. Piv txwv li, nqaij txiav. Hauv qhov xwm txheej no, koj tsis tuaj yeem noj khoom txom ncauj ntawm cov txiv ntoo, vim hais tias koj tsis tuaj yeem tiv thiab noj ntau yam ntawm lawv. Cov txiv ntseej muaj qhov tseem ceeb ntawm cov carbohydrates, thiab hauv qhov ntau kuj tseem nce cov ntshav qab zib, ua rau muaj kev cuam tshuam ntawm tsev noj mov hauv Suav. Yog li, yog tias kev tshaib plab tsis muaj kev tiv thaiv, ces koj poob dej nws tawm nrog tsiaj tsiaj cov khoom noj uas tsis muaj roj ntau.
Cov piam thaj tsa kom sawv ib txwm, thiab cov tsos mob ntawm cov ntshav qog ntshav qab zib tsis ploj
Hauv qhov xwm txheej ntawm hypoglycemia, muaj kev qhia tawm sai sai ntawm hormone epinephrine (adrenaline) tshwm sim hauv cov ntshav. Nws yog nws leej twg ua rau feem ntau ntawm cov tsos mob tsis kaj siab. Thaum cov piam thaj hauv ntshav poob ntau dhau, tom qab ntawv teb rau qhov no, cov qog adrenal ua cov adrenaline thiab nce nws cov kev xav hauv cov ntshav. Qhov no tshwm sim hauv txhua tus neeg mob ntshav qab zib, tsuas yog cov neeg uas tsis nco qab txog lub qog ntshav qab zib. Zoo li glucagon, adrenaline muab lub siab ua haujlwm tias glycogen yuav tsum hloov pauv mus rau cov piam thaj. Nws kuj tseem nce cov mem tes, ua rau pallor ntawm daim tawv nqaij, sib tuav tes thiab lwm yam tsos mob.
Adrenaline muaj ib nrab-lub neej ntawm kwv yees li 30 feeb. Qhov no txhais tau hais tias txawm li ib teev tom qab kev mob ntshav qab zib tsawg los lawm, renal adrenaline tseem nyob hauv ntshav thiab tseem ua ntxiv mus. Vim li no, cov tsos mob yuav mus txuas rau qee lub sijhawm. Nws yog qhov tsim nyog kom raug kev txom nyem 1 teev tom qab siv cov ntsiav tshuaj pleev qabzib. Nyob rau lub sijhawm no, qhov tseem ceeb tshaj plaws yog los tiv thaiv kev ntxias kom noj ntau dhau. Yog tias tom qab ib teev cov tsos mob ntawm hypoglycemia tsis ploj, ntsuas koj qab zib nrog ib glucometer dua thiab ntsuas kev ntsuas ntxiv.
Kev coj tus cwj pwm mob ntshav qab zib hauv ib lub xeev ntawm cov ntshav qab zib qis
Yog tias tus neeg mob ntshav qab zib muaj ntshav qab zib tsis txaus, ces qhov no ua rau lub neej ntawm nws tsev neeg, cov phooj ywg thiab cov npoj yaig ua rau lub neej nyuaj siab. Muaj ob qho laj thawj rau qhov no:
- nyob rau hauv ib lub xeev ntawm hypoglycemia, cov ntshav qab zib feem ntau coj tus cwj pwm thiab nruj;
- tus neeg mob yuav cia li nco dheev, thiab yuav tsum tau saib xyuas sai li sai tau.
Yuav coj li cas yog tias ib tug neeg mob ntshav qab zib muaj ntshav qab zib siab heev lossis nws tsis nco qab lawm, peb yuav sib tham txog ntu txuas mus ntxiv. Tam sim no cia peb tham txog dab tsi ua rau muaj kev txhoj puab heev thiab yuav nyob nrog tus neeg mob ntshav qab zib li cas yog tsis muaj kev tsis sib haum xeeb.
Nyob rau hauv lub xeev ntawm hypoglycemia, tus mob ntshav qab zib tuaj yeem coj tus cwj pwm coj tus yam ntxwv tsis meej, ua rau mob hnyav thiab tsis txaus ntseeg rau ob qho laj thawj:
- nws poob tswj hwm nws tus kheej;
- kev sim los ntawm lwm tus los pub nws noj khoom qab zib tuaj yeem tsim kev puas tsuaj tau.
Cia peb pom tias ua li cas hauv lub hlwb ntawm tus neeg mob ntshav qab zib thaum lub sij hawm nres ntawm hypoglycemia. Lub paj hlwb tsis muaj cov ntshav qabzib txaus rau kev ua haujlwm zoo, thiab vim qhov no, tus neeg coj zoo li nws qaug cawv. Kev xav tshwm sim yog xav. Qhov no tuaj yeem ua kom pom los ntawm ntau cov tsos mob - nkees, lossis lwm tus npau taws, ntau dhau kev ua siab zoo lossis rov ua phem rau nws. Txawm li cas los xij, cov tsos mob ntawm kev mob hypoglycemia zoo li cawv rau cawv. Tus uas mob ntshav qab zib yog ntseeg tau tias nws tam sim no nws muaj ntshav qab zib ib txwm muaj, ib yam li tus txiv neej qaug cawv yeej paub meej tias nws muaj kev qaug dab tsi lawm tiag. Cawv ua rau qaug cawv thiab ua rau lub ntsej muag tsis cuam tshuam qhov kev ua haujlwm ntawm tib lub chaw haujlwm ntawm cov kev ua haujlwm siab dua hauv lub hlwb.
Tus neeg mob ntshav qab zib tau kawm paub tias cov piam thaj hauv ntshav yog txaus ntshai, ua kom muaj kev noj qab haus huv, thiab yog li ntawd yuav tsum zam. Txawm hais tias nyob rau hauv lub xeev ntawm hypoglycemia, nws khov kho nco txog qhov no. Thiab tam sim no, nws paub tseeb tias nws muaj ntshav qab zib ib txwm thiab, feem ntau, nws lub hauv caug nyob hauv hiav txwv. Thiab tom qab ntawd ib tug neeg tau sim noj nws nrog cov khoom noj uas tsis zoo rau lub cev ... Pom tseeb, hauv cov xwm txheej zoo li no, tus neeg mob ntshav qab zib yuav xav tias nws yog tus neeg koom thib ob hauv qhov xwm txheej uas coj tus cwj pwm tsis zoo thiab sim ua phem rau nws. Qhov no yuav muaj feem ntau yog tias tus txij nkawm, niam txiv lossis cov neeg ua haujlwm nrog yav dhau los tau sim ua zoo ib yam, thiab tom qab ntawd nws tau hloov tawm tias cov neeg mob ntshav qab zib yeej muaj suab thaj ib txwm.
Qhov loj tshaj uas yuav ua rau muaj kev ntxhov siab los ntawm ib tus neeg mob ntshav qab zib yog tias koj sim tsuj khoom qab zib hauv nws lub qhov ncauj. Txawm hais tias, raws li txoj cai, kev hais lus nrog kev txaus ntseeg yog qhov txaus rau qhov no. Lub hlwb, ua rau tsis txaus siab vim tsis muaj qabzib, qhia nws tus tswv kev paub qhov tseeb tias tus txij nkawm, niam txiv lossis tus npoj yaig xav nws ua kom nws raug mob thiab tseem sim tua nws, ntxias nws nrog cov zaub mov qab zib. Thaum muaj cov xwm txheej zoo li no, tsuas yog cov neeg dawb huv tuaj yeem tawm tsam qhov kev tawm tsam ... Cov neeg nyob ib puag ncig peb ib txwm npau taws thiab xav tsis thoob txog qhov tsis zoo ntawm tus neeg mob ntshav qab zib thaum lawv sim pab nws.
Tus txij nkawm lossis niam txiv ntawm tus neeg mob ntshav qab zib tuaj yeem tsim qhov ntshai tsam muaj teeb meem ntshav qab zib tsawg, tshwj xeeb yog tias tus mob ntshav qab zib yav tas los tsis nco qab zoo li ntawd.Feem ntau khoom qab zib yog khaws cia rau ntau qhov chaw hauv tsev kom lawv nyob ntawm tes thiab cov ntshav qab zib tau noj lawv sai thaum xav tau. Qhov teeb meem yog hais tias hauv ib nrab ntawm cov neeg mob, tib neeg ib puag ncig nws xav tias hypoglycemia nyob rau hauv cov neeg mob ntshav qab zib thaum nws cov piam thaj tsis txaus. Qhov no feem ntau tshwm sim thaum tsev neeg scandals vim yog lwm qhov laj thawj. Cov neeg tawm tsam xav tias peb tus neeg mob ntshav qab zib yog li ntawv dag vim tias nws muaj ntshav qab zib tsawg tam sim no. Hauv txoj kev no lawv sim zam kom paub qhov tseeb, ntau qhov teeb meem ntawm kev txaj muag. Tab sis nyob rau lub sijhawm thib ob ntawm cov xwm txheej ntawm kev coj tus cwj pwm tsis zoo, kev mob ntshav qab zib muaj tiag, thiab yog tias tus neeg mob ntshav qab zib paub tseeb tias nws muaj ntshav qab zib ib txwm, tom qab ntawd nws yog qhov tsis zoo ua rau nws tus kheej muaj kev pheej hmoo.
Yog li, hauv ib nrab kis thaum cov neeg nyob ib puag ncig sim pub zaub mov noj ntshav qab zib rau cov neeg mob qab zib, lawv tau ua txhaum, vim tias nws tiag tiag tsis muaj ntshav qab zib. Noj cov khoom noj carbohydrates ua rau dhia hauv ntshav qab zib, thiab qhov no tsis zoo rau kev mob ntshav qab zib. Tab sis nyob hauv ob nrab ntawm cov xwm txheej thaum muaj ntshav qab zib tsawg, thiab tus neeg tsis lees paub nws, nws tsim cov teeb meem tsis tsim nyog rau lwm tus, muab nws tus kheej muaj qhov txaus ntshai. Yuav coj tus cwj pwm zoo li cas rau txhua tus neeg koom? Yog tias tus neeg mob ntshav qab zib coj tsis zoo, koj yuav tsum yaum nws kom nws tsis txhob noj khoom qab zib, tab sis kom ntsuas nws cov ntshav qab zib. Tom qab ntawd, hauv ib nrab kis nws hloov tawm tias tsis muaj ntshav qab zib. Thiab yog tias nws yog, tom qab ntawd cov tshuaj pleev cov piam thaj tam sim ntawd tau tuaj rau txoj kev cawm, uas peb twb tau npaj thiab tau kawm kom paub ntsuas lawv cov koob tshuaj kom raug. Tsis tas li, nco ntsoov tias cov ntsuas tau ntsuas (yog li cas ua qhov no). Yog tias nws hloov tawm tias koj lub ntsuas dej yog dag, tom qab ntawd hloov nws nrog qhov raug.
Cov kev mus tshuaj ib txwm muaj, thaum uas cov mob ntshav qab zib tau yaum kom noj khoom qab zib, yam tsawg kawg yog kev puas tsuaj ntau dua li zoo. Lwm txoj kev xaiv uas peb tau hais tseg hauv kem yav dhau los yuav tsum coj kev thaj yeeb nyab xeeb rau tsev neeg thiab ua kom lub neej zoo rau txhua tus neeg txhawj xeeb. Tau kawg, yog tias koj tsis txuag ntawm cov ntawv xeem rau cov ntsuas thiab cov lancets. Ua neej nyob nrog tus neeg mob ntshav qab zib muaj yuav luag ntau yam teeb meem ib yam li cov ntshav qab zib nws tus kheej muaj. Ntsuas koj cov piam thaj tam sim ntawd ntawm kev thov ntawm tsev neeg lossis cov npoj yaig yog lub luag haujlwm ncaj qha rau cov ntshav qab zib. Tom qab ntawd nws yuav twb tau pom seb lub qog ntshav qab zib yuav tsum tau nres los ntawm kev noj cov piam thaj hauv cov ntsiav tshuaj. Yog tias tam sim ntawd tsis muaj glucometer ntawm tes los yog cov ntawv ntsuas cov ntshav tau tawm, tom qab ntawd noj cov ntsiav tshuaj qabzib kom txaus rau koj cov ntshav qab zib yog 2.2 mmol / L. Qhov no tau lees tias tiv thaiv tiv thaiv tus mob ntshav qab zib tsawg kawg. Thiab koj yuav paub nrog cov qab zib ntau ntau thaum nkag mus rau cov ntsuas muaj.
Yuav ua li cas yog tias mob ntshav qab zib twb dhau ntawm lub siab nco qab lawm
Yog hais tias tus mob ntshav qab zib twb dhau ntawm lub siab qhia ntawm kev nco qab, ces qhov no yog qhov mob ntshav qab zib tsawg, tig mus ua mob hnyav. Hauv cov mob no, cov neeg mob ntshav qab zib ua rau zoo li nkees heev, inhibited. Nws tsis teb rau kev thov rov hais dua, vim nws tsis muaj peev xwm teb tau cov lus nug. Tus neeg mob tseem nco qab, tab sis nws tsis muaj peev xwm pab tau nws tus kheej. Tam sim no nws txhua tus nyob ntawm cov neeg ib puag ncig koj - lawv puas paub yuav pab tau cov ntshav qog zoo li cas? Ntxiv mus, yog tias hypoglycemia tsis yooj yim, tab sis hnyav.
Thaum zoo li no, nws lig dhau lawm los sim ntsuas qab zib nrog glucometer, koj yuav tsuas ploj lub sijhawm muaj nuj nqis. Yog tias koj muab cov tshuaj qab zib rau cov ntshav qab zib lossis cov khoom qab zib, ces nws tsis zoo li yuav zom lawv. Feem ntau cov yuav, nws yuav nti cov zaub mov tawv lossis daig ntxiv. Nyob rau theem ntawm cov ntshav qog ntshav qab zib, nws yog qhov tseeb rau dej rau tus neeg mob ntshav qab zib nrog kua dej kua nyeem. Yog tias tsis yog, tom qab tsawg kawg ib qho kev daws ntawm qab zib. Cov lus qhia txog mob ntshav qab zib Asmeskas pom zoo rau cov xwm txheej no yog kev siv cov kua nplaum (glucose glucose), uas ua rau cov pos hniav lossis lub puab tsaig sab hauv tuaj sab hauv, vim tias nws tsis tshua muaj kev pheej hmoo tias tus neeg mob ntshav qab zib yuav nqus tau kua thiab txhawm chim. Hauv cov tebchaws hais lus Lavxias, peb tsuas muaj cov khw muag tshuaj muaj kua qabzib lossis tshuaj ua kom qab zib sai tom tsev.
Cov kua nplaum hauv qab zib yog muag hauv khw muag tshuaj, thiab cov neeg mob ntshav qab zib feem ntau muaj nws nyob hauv tsev. Nws tso tawm kom ua rau 2-teev qhov ncauj kuaj ntshav qab zib nyob hauv tsev kho mob. Thaum koj haus cov ntshav qab zib nrog cov piam thaj hauv dej qab zib, nws yog qhov tseem ceeb heev kom ntseeg tau tias tus neeg mob tsis txhawm chim, tab sis ua tau kom nqos cov kua. Yog tias koj tswj hwm ua qhov no, ces cov tsos mob ntawm kev mob ntshav qab zib siab sai sai yuav dhau mus. Tom qab 5 feeb, tus mob ntshav qab zib twb yuav teb tau cov lus nug. Tom qab ntawd, nws yuav tsum ntsuas nws qab zib nrog glucometer thiab, nrog kev pab los ntawm kev txhaj tshuaj ntawm cov tshuaj insulin, qis dua nws mus rau qhov qub.
Kev khomob kub ntxhov yog tias tus neeg mob ntshav qab zib kis tawm
Koj yuav tsum paub tias tus neeg mob ntshav qab zib yuav plam tsis nco qab tsuas yog vim mob ntshav qab zib tsawg. Qhov ua rau kuj tseem tuaj yeem yog lub plawv nres, mob hlab ntsha tawg, ntshav nce siab tam sim ntawd. Qee zaum tus neeg mob ntshav qab zib poob poob qab yog tias lawv muaj ntshav qab zib ntau ntau (22 mmol / L lossis siab dua) rau ob peb hnub ua ke, thiab qhov no yog nrog lub cev qhuav dej. Qhov no yog hu ua hyperglycemic coma, nws tshwm sim rau cov neeg laus laus cov neeg mob ntshav qab zib. Yog tias koj raug qhuab qhia nrog hom 1 kho mob ntshav qab zib hom ntshav qab zib los yog hom kev kho mob ntshav qab zib hom 2, nws tsis zoo li koj lub suab thaj yuav nce siab.
Raws li txoj cai, yog tias koj pom tias tus neeg mob ntshav qab zib tau ploj mus rau hauv lub siab, tom qab ntawd tsis muaj sijhawm los tshawb nrhiav cov laj thawj ntawm qhov no, tab sis kev kho yuav tsum tau pib tam sim ntawd. Yog tias tus mob ntshav qab zib ua rau lub cev ntaj ntsug, tom qab ntawd nws yuav tsum xub txhaj ib yam tshuaj glucagon, thiab tom qab ntawd nws yuav tsum nkag siab qhov laj thawj. Glucagon yog yam tshuaj uas ua rau cov ntshav qab zib sai sai, ua rau lub siab thiab cov nqaij mus rau lawv cov khw muag glycogen rau hauv qabzib thiab txaus ntshav nrog lub ntsej muag no. Cov neeg uas nyob ib ncig ntawm tus mob ntshav qab zib yuav tsum paub:
- qhov twg pob khoom thaum muaj xwm ceev nrog glucagon khaws cia;
- yuav ua li cas thiaj txhaj tshuaj.
Cov khoom siv xwm ceev rau kev txhaj tshuaj glucagon yog muag hauv khw muag tshuaj. Qhov no yog rooj plaub uas cov koob txhaj tshuaj nrog kua yog khaws cia, ntxiv rau hauv lub raj mis nrog cov hmoov dawb. Kuj tseem muaj lus qhia meej hauv cov duab kos duab kev txhaj tshuaj. Nws yog ib qho tsim nyog yuav tsum tau txhaj cov kua ntawm lub koob txhaj tshuaj mus rau hauv lub vial los ntawm lub hau, tom qab ntawd tshem tawm rab koob ntawm lub hau, co lub vial kom zoo kom cov tshuaj sib tov, muab rov qab rau hauv cov phwj. Tus neeg laus yuav tsum txhawm rau txhaj tag nrho cov ntim ntawm cov ncauj lus ntawm koob txhaj tshuaj, subcutaneously lossis intramuscularly. Qhov hno tuaj yeem ua rau txhua qhov chaw uas cov tshuaj insulin feem ntau tau txhaj. Yog tias tus neeg mob ntshav qab zib tau txhaj tshuaj insulin, tom qab ntawd cov neeg hauv tsev neeg tuaj yeem xyaum ua ntej los ntawm kev txhaj tshuaj rau nws kom lawv tuaj yeem tiv taus tom qab yog tias lawv yuav tsum tau txhaj nrog glucagon.
Yog tias tsis muaj khoom siv xwm txheej ceev nrog glucagon ntawm tes, koj yuav tsum hu rau lub tsheb tos neeg mob lossis xa tus neeg mob ntshav qab zib kom tsis muaj mob mus rau hauv tsev kho mob. Yog hais tias ib tus neeg tau xiam lub siab, tom qab ntawd tsis muaj ib qho dab tsi yuav tsum koj sim nkag mus rau ib yam dab tsi los ntawm nws lub qhov ncauj. Tsis txhob muab cov piam thaj hauv cov ntshav lossis cov zaub mov tawv tso rau hauv nws lub qhov ncauj, lossis sim ncuav rau hauv ib qho dej. Txhua yam no tuaj yeem nkag mus rau hauv lub pa ua pa, thiab ib tug neeg ua tsis taus pa. Thaum tsis nco qab lawm, tus mob ntshav qab zib tuaj yeem hnoos lossis nqos tsis tau, yog li koj pab tsis tau nws txoj hauv kev no.
Yog tias tus neeg mob ntshav qab zib tsis txaus siab vim yog mob ntshav qab zib, ces nws yuav muaj kev chua leeg. Nyob rau hauv cov ntaub ntawv no, cov qaub ncaug yog tso tawm ntau, thiab cov hniav sib xyaw thiab sib zog. Koj tuaj yeem sim muab ib daim ntoo tso rau hauv cov hniav ntawm tus neeg mob tsis nco qab lawm kom nws tsis tuaj yeem tom nws tus nplaig. Nws yog ib qho tseem ceeb ntawm kev tiv thaiv nws los ntawm kev tom koj cov ntiv tes. Muab nws tso rau ntawm nws sab kom cov qaub ncaug ntws tawm ntawm lub qhov ncauj, thiab nws tsis daig ntawm nws.
Glucagon qee zaum ua rau xeev siab thiab ntuav hauv ntshav qab zib. Yog li, tus neeg mob yuav tsum pw ntawm nws ib sab kom ntuav tsis txhob nkag mus rau hauv txoj pa pa. Tom qab kev txhaj tshuaj ntawm glucagon, tus neeg mob ntshav qab zib yuav tsum tuaj rau hauv ntau lawm hauv 5 feeb. Tsis pub dhau 20 feeb, nws yuav tsum twb muaj peev xwm los teb cov lus nug. Yog tias nyob hauv 10 feeb tsis muaj cov cim qhia txog kev txhim kho kom meej meej, tus neeg mob ntshav qab zib tsis nco qab lawm xav tau kev kho mob sai sai. Tus kws kho mob tos neeg mob yuav muab cov kua nplaum pleev cov ntshav pleev rau nws.
Kev txhaj tshuaj ib zaug ntawm glucagon tuaj yeem nce ntshav qab zib mus rau 22 mmol / L, nyob ntawm ntau npaum li cas glycogen tau khaws cia hauv lub siab. Thaum nco qab tau rov qab zoo, tus neeg mob ntshav qab zib yuav tsum ntsuas nws cov ntshav qab zib nrog ib qho glucometer. Yog tias 5 teev lossis ntau dua tau dhau mus txij li kev txhaj tshuaj kawg ntawm cov tshuaj insulin, tom qab ntawd koj yuav tsum txhaj ib qho tshuaj insulin los nqa suab thaj kom rov zoo li qub. Qhov no tseem ceeb ua vim tias tib txoj kev ua rau daim siab pib kho nws cov khw muag khoom glycogen. Lawv yuav rov qab los nyob hauv 24 teev. Yog tias tus neeg mob ntshav qab zib ua rau nws tsis nco qab 2 zaug hauv kev sib txuas rau ntau xuab moos, tom qab ntawv txhaj koob thib ob ntawm glucagon yuav tsis tuaj yeem pab, vim tias lub siab tseem tsis tau rov qab nws lub khw glycogen.
Tom qab tus neeg mob ntshav qab zib tau rov qab ua dua nrog kev txhaj tshuaj glucagon, nyob rau hnub tom qab nws yuav tsum ntsuas nws cov piam thaj nrog ib qho glucometer txhua 2,5 teev, suav nrog thaum tsaus ntuj. Nco ntsoov tias hypoglycemia tsis tshwm sim ntxiv. Yog tias cov piam thaj hauv ntshav qis, tam sim ntawd siv cov ntsiav tshuaj qab zib ntxiv rau nws kom ib txwm. Kev tshuaj xyuas zoo yog qhov tseem ceeb heev, vim tias yog tias tus neeg mob ntshav qab zib rov qab ua txhaum dua, tom qab ntawv txhaj koob thib ob ntawm glucagon yuav tsis pab nws rov qab los. Vim li cas - peb tau piav qhia saum toj saud. Tib lub sijhawm, kev nce siab ntshav qab zib yuav tsum tau kho kom tsawg dua. Qhov thib ob txhaj ntawm cov tshuaj insulin tuaj yeem ua tiav tsis pub dhau 5 teev tom qab qhov kev ua ntej dhau los.
Yog hais tias hypoglycemia yog heev li uas koj poob nco qab, koj yuav tsum ua tib zoo saib xyuas koj cov txheej txheem kho ntshav qab zib kom nkag siab qhov twg koj ua yuam kev. Rov nyeem cov npe ntawm cov teeb meem tshwm sim ntawm cov ntshav qab zib, uas tau muab rau saum toj no hauv tsab xov xwm.
Npaj cov tshuaj qog ntshav ua ntej
Cov khoom lag luam rau cov ntshav qog ntshav qab zib yog cov ntsiav tshuaj qabzib, cov khoom siv xwm txheej ceev nrog glucagon, thiab cov kua dej qab zib ua kua tseem yog qhov tsim nyog. Kev yuav txhua yam ntawm no hauv cov tshuaj yuav yooj yim, tsis kim, thiab nws tuaj yeem cawm lub neej ntawm cov neeg mob ntshav qab zib. Nyob rau tib lub sijhawm, cov khoom siv rau cov ntshav qab zib yuav tsis pab yog tias cov neeg nyob ib puag ncig koj tsis paub qhov chaw lawv khaws cia, lossis tsis paub yuav ua li cas muab kev pabcuam thaum muaj xwm txheej ceev.
Khaws cov khoom ntshav qab zib nyob rau tib lub sijhawm nyob rau ntau qhov chaw yooj yim hauv tsev thiab tom haujlwm, thiab qhia rau tsev neeg thiab cov npoj yaig paub qhov twg lawv cia. Khaws cov piam thaj hauv koj lub tsheb, hauv koj lub hnab nyiaj, hauv koj cov hnab ris thiab hauv koj lub hnab nqa. Thaum taug kev los ntawm dav hlau, khaws koj cov khoom siv hypoglycemic tso rau hauv koj lub thawv, nrog rau cov khoom qub hauv lub nra uas koj tau khij hauv. Qhov no yog qhov tsim nyog yog tias txhua lub hnab ntim khoom yuav ploj lossis nyiag ntawm koj.
Hloov cov khoom siv kub ntxhov nrog glucagon thaum hnub tim tas sij hawm tas sij hawm. Tab sis nyob rau hauv qhov xwm txheej ntawm hypoglycemia, koj tuaj yeem tsim kev nyab xeeb txhaj tshuaj, txawm tias nws yuav tas sijhawm. Glucagon yog hmoov nyob hauv lub vial. Txij li nws tau qhuav, nws tseem siv tau rau ntau xyoo tom qab hnub tas sij hawm. Ntawm chav kawm, qhov no tsuas yog yog tias nws tsis raug rau qhov kub thiab txias heev, zoo li tshwm sim rau lub caij ntuj sov hauv lub tsheb kaw hauv lub hnub. Nws raug nquahu kom muab cov khoom siv xwm txheej ceev nrog glucagon hauv lub tub yees ntawm qhov kub ntawm + 2-8 degrees Celsius. Npaj cov tshuaj glucagon daws teeb meem tsuas siv tau hauv 24 teev.
Yog tias koj siv qee yam los ntawm koj cov khoom seem, ces rov ntim rau lawv sai li sai tau. Muab cov ntsiav tshuaj qabzib ntau tshaj thiab cov ntsuas cov kua ntsuas nyob ntev. Nyob rau tib lub sijhawm, cov kab mob paub zoo txog cov piam thaj. Yog tias koj tsis siv cov ntsiav tshuaj pleev nyob rau 6-12 lub hlis, tom qab ntawd lawv yuav dhau los ua cov pob dub. Qhov no txhais tau hais tias cov kab mob pawg kab mob tau tsim rau lawv. Nws yog qhov zoo dua los hloov tam sim ntawd cov ntsiav tshuaj nrog cov tshiab.
Hlua Tes Taw Cov Ntshav Qab Zib
Hauv cov teb chaws hais lus Askiv, ID txhaws caj dab, cov hlua khi thiab cov kab mob rau cov neeg mob ntshav qab zib yog nrov. Lawv yuav pab tau zoo heev yog tias cov kab mob ntshav qab zib tsis txaus vim tias lawv muab cov ntaub ntawv tseem ceeb rau cov kws saib xyuas mob nkeeg. Tus neeg mob ntshav qab zib-hais lus neeg mob ntshav qab zib tsis yog tsim nyog yuav tau xaj yam khoom ntawd los ntawm neeg txawv teb chaws. Vim tias nws tsis zoo li tus kws kho mob tsheb thauj neeg mob yuav nkag siab dab tsi sau ua lus Askiv.
Koj tuaj yeem ua koj tus kheej txoj kev paub saws tes los ntawm kev txiav txim ib tus neeg engraving. Ib txoj hlua tes yog qhov zoo dua li lub rooj zaum siab vim tias feem ntau cov kws kho mob yuav pom nws.
Hypoglycemia ntshav qab zib: cov lus xaus
Tej zaum koj tau hnov ntau cov dab neeg txaus ntshai uas nyob rau hauv cov neeg mob ntshav qab zib hom 1, ntshav qab zib ntshav qab zib feem ntau tshwm sim thiab mob hnyav heev. Qhov xov xwm zoo yog tias qhov teeb meem no tsuas cuam tshuam rau cov neeg mob ntshav qab zib uas ua raws "kev noj zaub mov kom zoo", noj zaub mov ntau ntau thiab yog li yuav tsum tau txhaj tshuaj insulin ntau. Yog tias koj tab tom ua raws li peb qhov kev pabcuam kho mob ntshav qab zib hom 1, qhov kev pheej hmoo ntawm cov ntshav qog ntshav qab zib siab muaj tsawg heev. Kev txo ntau hauv cov ntshav qog ntshav qab zib yog qhov tseem ceeb, tab sis tsis tseem ceeb rau qhov hloov mus rau peb hom 1 ntshav qab zib tswj kev tswj hwm.
Yog tias koj mus noj cov zaub mov tsis muaj carbohydrate, koj qhov kev xav insulin yuav poob qis dua. Tsis tas li, peb cov neeg mob tsis noj cov tshuaj mob ntshav qab zib uas tsim kev puas ntshav qab zib. Tom qab qhov no, hypoglycemia tuaj yeem tshwm sim hauv ib ntawm ob kis xwb: koj tau txhaj tshuaj tiv thaiv koj tus kheej ntxiv insulin ntau dua li qhov tsim nyog, lossis txhaj ib koob tshuaj insulin ceev ceev yam tsis tau tos 5 teev kom txog rau thaum cov koob tshuaj tas los tsum. Ua siab dawb thov nug koj tsev neeg thiab cov npoj yaig ua haujlwm los kawm cov lus no. Txawm hais tias txoj kev pheej hmoo yuav raug txo qis, koj tseem tuaj yeem nyob rau qhov xwm txheej uas muaj ntshav qab zib tsawg, thaum koj tsis tuaj yeem pab koj tus kheej, thiab tsuas yog cov neeg nyob ib puag ncig koj thiaj li cawm koj kom tsis nco qab, tuag lossis xiam oob khab xwb.
