Hypoglycemia

Hypoglycemia yog dab tsi?

Harvard Health Publishing

Hypoglycemia yog qhov txawv txav ntawm cov piam thaj hauv ntshav qis (cov ntshav qabzib). Vim tias lub paj hlwb nyob ntawm cov ntshav qab zib ua nws lub hauv paus ntawm lub zog, hypoglycemia cuam tshuam rau lub hlwb lub peev xwm ua haujlwm zoo. Qhov no tuaj yeem ua rau kiv taub hau, mob taub hau, tsis pom kev tsis pom kev, nyuaj siab thiab lwm yam tsos mob ntawm lub paj hlwb.

Hypoglycemia kuj ua rau lub cev tso tawm cov tshuaj hormones, xws li epinephrine thiab norepinephrine. Koj lub hlwb tso siab rau cov tshuaj hormones no txhawm rau txhim kho cov ntshav qab zib. Kev tso tawm ntawm cov tshuaj hormones no ua rau muaj cov tsos mob ntxiv ntawm kev tshee, tawm hws, lub plawv dhia ceev, ntxhov siab vim thiab kev tshaib kev nqhis.



Hypoglycemia feem ntau tshwm sim hauv cov neeg mob ntshav qab zib. Rau cov neeg mob ntshav qab zib mellitus, hypoglycemia tshwm sim vim yog cov tshuaj noj ntshav qab zib ntau dhau, tshwj xeeb tshaj yoginsulin, los yog kev hloov hauv kev noj haus lossis kev tawm dag zog. Insulin thiab kev tawm dag zog ob qho tib si qis ntshav qab zib thiab zaub mov nce nws. Hypoglycemia feem ntau tshwm sim hauv cov neeg uas noj cov tshuaj insulin lossis cov tshuaj noj qhov ncauj uas txo cov ntshav qabzib, tshwj xeeb tshaj yog cov tshuaj hauv pawg sulfonylurea (Glyburidethiab lwm yam).

Qhov tseeb hypoglycemia nrog kev kuaj pom ntawm cov ntshav qab zib tsawg tsis tshua muaj tshwm sim hauv cov neeg uas tsis muaj ntshav qab zib. Thaum nws tshwm sim sab nraud ntawm ntshav qab zib, hypoglycemia tuaj yeem tshwm sim los ntawm ntau yam teeb meem kho mob. Ib daim ntawv teev npe ib nrab suav nrog:

  • Kev phais plab hnyuv, feem ntau cuam tshuam nrog kev tshem tawm qee qhov ntawm lub plab. Kev phais uas tshem tawm ib feem ntawm lub plab tuaj yeem hloov qhov kev sib raug zoo ntawm kev zom zaub mov thiab tso tawm insulin. 'Nissen' phais rau kev kho mob gastroesophageal reflux tuaj yeem ua rau lub sijhawm ntawm hypoglycemia.
  • Tus kab mob pancreatic, hu ua insulinoma, uas zais cov tshuaj insulin
  • Qhov tsis txaus ntawm kev loj hlob hormone los ntawm lub qog pituitary lossis cortisol los ntawm cov qog adrenal. Ob leeg ntawm cov tshuaj hormones no pab ua kom cov ntshav qab zib zoo li qub
  • Cawv
  • Overdose ntawmtshuaj aspirin
  • Mob siab heev
  • Kev siv tshuaj insulin los ntawm ib tus neeg uas tsis muaj ntshav qab zib
  • Mob qog noj ntshav, xws li mob qog noj ntshav ntawm lub siab
  • Tsis tshua muaj, tsis muaj enzyme. Piv txwv ntawm cov enzymes uas pab ua kom cov ntshav qab zib ib txwm yog cov piam thaj-6-phosphatase, daim siab phosphorylase, thiab pyruvate carboxylase.

Cov tsos mob

Hypoglycemia tuaj yeem ua rau:

    Cov tsos mob ntsig txog lub hlwb ' tshaib plab' rau qab zib- Mob taub hau, kiv taub hau, tsis pom kev, tsis pom kev, tsis pom kev, tsis meej pem, tsis meej pem, tsis muaj zog los yog fainting, tingling rhiab heev nyob rau hauv daim di ncauj los yog ob txhais tes, tsis meej pem, hais lus txawv txav, convulsions, tsis nco qab, coma
    Cov tsos mob ntsig txog kev tso tawm ntawm epinephrine thiab norepinephrine- hws, tshee (xav tshee), lub plawv dhia ceev, ntxhov siab vim, tshaib plab

Kev kuaj mob

Yog tias tus neeg mob ntshav qab zib muaj ntshav qab zib hom 2, nws yuav tsis tuaj yeem teb tus kws kho mob cov lus nug vim tsis meej pem lossis tsis nco qab. Hauv qhov no, ib tus neeg hauv tsev neeg lossis cov phooj ywg ze yuav tau piav qhia tus neeg mob keeb kwm kev kho mob thiab cov tshuaj insulin.

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Txhawm rau pab kom muaj kev kho mob xwm txheej ceev, txhua tus neeg mob ntshav qab zib yuav tsum xav txog kev hnav ib lub tes tsho ceeb toom lossis caj dab. Cov hniav nyiaj hniav kub uas muaj peev xwm cawm tau txoj sia no yuav txheeb xyuas tus neeg mob tias muaj ntshav qab zib, txawm tias tus neeg mob nyob deb ntawm tsev thiab mus ncig ib leeg.

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Cov neeg hauv tsev neeg lossis cov phooj ywg ntawm tus neeg mob ntshav qab zib yuav tsum kawm yuav ua li cas coj tus neeg mob tawm ntawm qhov mob hnyav heev los ntawm kev muab cov kua txiv kab ntxwv lossis lwm cov carbohydrates, lossis los ntawm kev txhaj tshuaj.glucagon, uas tuaj yeem nce ntshav qab zib.

Yog tias tus neeg mob ntshav qab zib tuaj yeem teb cov lus nug kom tsim nyog, tus kws kho mob yuav xav paub cov npe thiab koob tshuaj ntawm txhua yam tshuaj, nrog rau kev noj zaub mov tsis ntev los no thiab lub sijhawm ua haujlwm. Yog tias tus neeg mob tau soj ntsuam cov ntshav qab zib tus kheej nrog glucometer (ib lub cuab yeej tuav tes los ntsuas cov piam thaj hauv cov ntshav los ntawm tus ntiv tes ntiv tes), tus kws kho mob yuav tshuaj xyuas cov ntsuas ntsuas tam sim no kom paub meej tias cov ntshav qab zib tsawg thiab kuaj xyuas cov ntshav qab zib. qauv ntawm hypoglycemia cuam tshuam nrog kev noj haus lossis kev tawm dag zog.

Hauv cov neeg uas tsis muaj ntshav qab zib, tus kws kho mob yuav tshuaj xyuas cov tshuaj tam sim no thiab nug txog ib qho keeb kwm ntawm kev phais plab hnyuv (tshwj xeeb tshaj yog nrog lub plab), kab mob siab thiab qhov tsis txaus enzyme. Cov neeg mob yuav tsum piav qhia lawv cov tsos mob thiab thaum cov tsos mob tshwm sim - txawm tias lawv tshwm sim ua ntej lossis tom qab noj mov, thaum pw lossis tom qab qoj ib ce.

Hauv cov neeg mob ntshav qab zib mellitus, kev kuaj mob ntawm hypoglycemia yog nyob ntawm cov tsos mob thiab kev nyeem cov ntshav qab zib. Feem ntau, tsis tas yuav tsum kuaj ntxiv.

Hauv ib tus neeg uas tsis muaj ntshav qab zib, lub sijhawm zoo tshaj plaws rau kev kuaj mob yog thaum muaj cov tsos mob tshwm sim. Thaum lub sijhawm ntawd, cov ntshav tuaj yeem rub los ntsuas qib qabzib, thiab tus neeg mob qhov kev cuam tshuam rau kev noj cov piam thaj tuaj yeem kuaj. Yog tias cov kev ntsuas no tau lees paub qhov kev kuaj mob ntawm hypoglycemia, cov ntshav tuaj yeem raug xa mus rau chav kuaj ntsuas cov tshuaj insulin.

Yog tias tus neeg mob tsis muaj tsos mob tshwm sim thaum lub sijhawm ntsuas, tus kws kho mob yuav nug nws kom ntsuas nws cov ntshav qabzib thaum muaj cov tsos mob hypoglycemic. Hauv cov neeg uas tsis muaj ntshav qab zib, cov ntshav tuaj yeem kuaj ntsuas lub siab ua haujlwm thiab qib cortisol.

Yog tias xav tias muaj cov tshuaj insulinoma, tus kws kho mob tuaj yeem txiav txim saib xyuas 48-teev nrawm. Lub sijhawm ntawd, cov ntshav qabzib thiab insulin yuav raug ntsuas thaum twg cov tsos mob tshwm sim lossis ib zaug txhua rau 6 teev, qhov twg los ua ntej. Cov ntshav qabzib tsawg dua 40 milligrams ib deciliter nrog cov tshuaj insulin siab qhia tau hais tias tus neeg muaj insulinoma lossis tau noj tshuaj insulin lossis lwm yam tshuaj ntshav qab zib tsis pub leejtwg paub.

Yog tias ib tus neeg muaj cov tsos mob ntawm hypoglycemia tsuas yog tom qab noj mov, tus kws kho mob tuaj yeem nug nws tus kheej los saib xyuas cov ntshav qab zib nrog glucometer thaum lub sijhawm cov tsos mob tshwm sim.

Lub sijhawm xav tau

Qhov tshwm sim ntawm hypoglycemia tshwm sim los ntawm kev tawm dag zog lossis los ntawm kev ua haujlwm luv luv ntawm insulin feem ntau tuaj yeem nres tsis pub dhau feeb los ntawm kev noj lossis haus cov zaub mov lossis dej haus uas muaj suab thaj (cov ntsiav tshuaj qab zib, khoom qab zib, kua txiv kab ntxwv, dej qab zib tsis noj). Hypoglycemia tshwm sim los ntawm sulfonylurea lossis insulin ua haujlwm ntev tuaj yeem siv sijhawm ib mus rau ob hnub kom ploj mus.

Cov neeg mob ntshav qab zib tseem muaj kev pheej hmoo rau lub sijhawm hypoglycemia thoob plaws lub neej vim lawv xav tau cov tshuaj uas txo cov ntshav qab zib. Lub sijhawm hypoglycemic thaum hmo ntuj yog qhov txaus ntshai tshwj xeeb vim tias tus neeg feem ntau pw tsaug zog los ntawm ib feem ntawm lub sijhawm uas lawv cov ntshav qab zib tsawg, kho cov suab thaj tsawg dua sai. Nyob rau tib lub sijhawm, kev rov ua dua tuaj yeem ua rau lub hlwb ua haujlwm tsis zoo.

Kwv yees li 85% ntawm cov neeg mob uas muaj cov tshuaj insulinoma yuav kho tau ntawm hypoglycemia thaum cov qog nqaij hlav insulin-secreting raug tshem tawm.

Ntau tus neeg tsis muaj ntshav qab zib uas muaj cov tsos mob zoo li cov tsos mob ntawm cov ntshav qab zib tsawg tsis tshua muaj suab thaj. Hloov chaw, cov tsos mob tshwm sim los ntawm lwm yam uas tsis yog cov ntshav qabzib tsawg.

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Kev tiv thaiv

Hauv cov tib neeg noj cov tshuaj insulin lossis lwm yam tshuaj ntshav qab zib, haus cawv tuaj yeem ua rau muaj qhov tshwm sim ntawm hypoglycemia. Cov neeg mob ntshav qab zib yuav tsum sib tham nrog lawv tus kws kho mob tias haus cawv ntau npaum li cas, yog tias muaj, lawv tuaj yeem haus dej nyab xeeb. Cawv tuaj yeem ua rau muaj qhov mob hnyav ntawm hypoglycemia txawm tias insulin tau noj ntau teev ua ntej. Cov neeg mob ntshav qab zib yuav tsum paub txog qhov teeb meem no yog tias lawv haus.

Cov neeg mob ntshav qab zib yuav tsum tau npaj nkag mus rau cov khoom siv thaum muaj xwm txheej ceev los kho cov xwm txheej tsis txaus ntseeg ntawm hypoglycemia. Cov khoom siv no yuav suav nrog cov khoom qab zib, cov ntsiav tshuaj qab zib, qab zib muab tshuaj rau hauv lub raj thiab / lossis cov khoom siv tshuaj glucagon. Kev txhaj tshuaj glucagon tuaj yeem muab los ntawm cov neeg hauv tsev neeg lossis phooj ywg paub yog tias tus neeg mob hypoglycemic tsis nco qab thiab tsis tuaj yeem noj qab zib los ntawm qhov ncauj. Rau cov menyuam yaus uas muaj ntshav qab zib, cov khoom siv xwm txheej ceev tuaj yeem khaws cia hauv tsev kawm tus kws saib xyuas neeg mob lub chaw haujlwm.

Txhua tus neeg uas muaj kev pheej hmoo ntawm hypoglycemic ntu tuaj yeem pab kom tsis txhob ncua sijhawm kho kev tawm tsam los ntawm kev kawm txog nws tus mob thiab qhia cov kev paub no rau cov phooj ywg thiab tsev neeg. Qhov kev pheej hmoo rau hypoglycemia yog qis dua yog tias koj noj cov sijhawm tsis tu ncua thaum nruab hnub, tsis txhob hla cov zaub mov thiab tswj kom muaj kev tawm dag zog zoo ib yam.

Zoo li cov neeg mob ntshav qab zib, cov neeg tsis muaj ntshav qab zib mellitus yuav tsum muaj kev nkag mus rau cov piam thaj ib txwm. Qee qhov xwm txheej tsis tshua muaj, tus kws kho mob tuaj yeem sau cov khoom siv kho mob ceev glucagon rau cov neeg tsis muaj ntshav qab zib uas muaj keeb kwm ua tsis zoo lossis tsis nco qab los ntawm hypoglycemia.

Kev kho mob

Kev kho mob

Yog tias tus neeg tsis nco qab muaj cov tsos mob ntawm hypoglycemia, cov tsos mob feem ntau ploj mus yog tias tus neeg noj lossis haus cov khoom qab zib (cov ntsiav tshuaj qab zib, khoom qab zib, kua txiv hmab txiv ntoo, dej qab zib tsis noj). Tus neeg mob tsis nco qab tuaj yeem kho nrog kev txhaj tshuaj tam sim ntawm glucagon lossis nrog kev tso ntshav qabzib hauv cov ntshav hauv tsev kho mob.

Cov neeg mob ntshav qab zib mellitus uas muaj lub sijhawm hypoglycemic yuav tsum tau kho lawv cov tshuaj, tshwj xeeb tshaj yog cov koob tshuaj insulin, hloov lawv cov zaub mov lossis lawv cov kev coj ua.

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Yog tias koj pom tias koj cov tsos mob tshwm sim los ntawm hypoglycemia, koj yuav tsum kho koj tus kheej los yog nrhiav kev kho mob, thiab tsis txhob sim ua kom 'tawv tawm.' Cov neeg uas muaj ntshav qab zib ntev ntev yuav tsum tsis txhob muaj cov tsos mob ceeb toom ntxov ntawm hypoglycemia. Qhov no yog hu ua hypoglycemic unawareness. Nws tuaj yeem hnyav heev vim tus neeg yuav tsis paub nrhiav kev kho mob.

Yog tias koj thiab koj tus kws kho mob pom tias koj tsis paub txog thaum koj muaj ntshav qab zib tsawg, koj cov tshuaj insulin lossis lwm yam tshuaj ntshav qab zib yuav tsum tau txo. Koj yuav tau kuaj koj cov ntshav qab zib ntau zaus. Koj cov koob tshuaj insulin yuav xav tau kev hloov kho ntau zaus los tswj cov ntshav qab zib kom tsim nyog (tab sis tsis yog 'zoo meej' cov suab thaj) uas tsis tshua muaj kev pheej hmoo ntawm hypoglycemia.

Ib qho insulinoma yog kho nrog kev phais kom tshem tawm cov qog. Hypoglycemia tshwm sim los ntawm cov teeb meem ntawm cov qog adrenal lossis pituitary yog kho los ntawm kev hloov cov tshuaj hormones uas ploj lawm nrog tshuaj.

Cov neeg tsis muaj ntshav qab zib muaj cov tsos mob hypoglycemic tom qab noj mov yog kho los ntawm kev hloov kho lawv cov khoom noj. Lawv feem ntau yuav tsum tau noj ntau zaus, me me thiab tsis txhob yoo mov.

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Thaum Hu Rau Tus Kws Tshaj Lij

Hu rau kev pab kho mob xwm txheej ceev thaum twg leej twg tsis nco qab los yog pom tseeb tsis txaus ntseeg. Cov tshuaj insulin hnyav tuaj yeem ua rau tuag taus, yog li nws tseem ceeb heev kom nrhiav kev kho tam sim.

Cov neeg mob ntshav qab zib yuav tsum hu rau lawv tus kws kho mob sai yog tias lawv tau ntsib ntau zaus ntawm hypoglycemia. Tej zaum lawv yuav tau kho lawv cov tshuaj noj txhua hnub, npaj pluas noj thiab/lossis kev pab cuam qoj ib ce.

Cov neeg tsis muaj ntshav qab zib uas muaj cov tsos mob ntawm hypoglycemia yuav tsum hu rau lawv tus kws kho mob kom ntsuas qhov teeb meem.

Kev kwv yees

Hu rau kev pab kho mob xwm txheej ceev thaum twg leej twg tsis nco qab los yog pom tseeb tsis txaus ntseeg. Cov tshuaj insulin hnyav tuaj yeem ua rau tuag taus, yog li nws tseem ceeb heev kom nrhiav kev kho tam sim.

Cov neeg mob ntshav qab zib yuav tsum hu rau lawv tus kws kho mob sai yog tias lawv tau ntsib ntau zaus ntawm hypoglycemia. Tej zaum lawv yuav tau kho lawv cov tshuaj noj txhua hnub, npaj pluas noj thiab/lossis kev pab cuam qoj ib ce.

Cov neeg tsis muaj ntshav qab zib uas muaj cov tsos mob ntawm hypoglycemia yuav tsum hu rau lawv tus kws kho mob kom ntsuas qhov teeb meem.

Cov peev txheej sab nraud

National Institute of Diabetes & Digestive & Kidney Disorders
http://www.niddk.nih.gov/

American Diabetes Association
http://www.diabetes.org/

Cov ntaub ntawv ntxiv

Nco ntsoov sab laj nrog koj tus kws kho mob kom paub meej tias cov ntaub ntawv uas tshwm sim hauv nplooj ntawv no siv tau rau koj tus kheej.