Cov piam thaj hauv ntshav tsawg

Cov piam thaj hauv ntshav qis yog ib yam mob uas tshwm sim thaum lub cev cov ntshav qab zib cov ntshav qabzib (ntshav qabzib) tsawg thiab tsawg dhau.

Cov piam thaj hauv ntshav qis dua 70 mg / dL (3.9 mmol / L) yog pom tias nws qes. Cov ntshav qab zib kom qis lossis qis dua qib no yuav muaj kev phom sij.

Lub npe tshuaj kho mob uas muaj ntshav qab zib tsawg yog ntshav qab zib tsawg.

Cov tshuaj insulin yog yam tshuaj tsim los ntawm cov txiav ntshav. Yuav tsum muaj cov insulin txav cov piam thaj mus rau hauv cov cell uas nws cia los sis siv rau lub zog. Yog tias tsis muaj cov insulin txaus, cov piam thaj nyob hauv cov ntshav es tsis txhob nkag mus rau hauv cov ntshav. Qhov no ua rau cov tsos mob ntshav qab zib.

Muaj piam thaj hauv ntshav tsawg tshwm sim vim ib qho hauv qab no:

• Koj lub cev cov piam thaj (qabzib) tau siv sai dhau
• Glucose ntau lawm los ntawm lub cev tau qis heev lossis nws tso tawm rau hauv cov ntshav qeeb dhau
• Ntau cov insulin nyob rau hauv cov hlab ntshav

Cov piam thaj hauv ntshav qis yog muaj rau cov neeg muaj ntshav qab zib uas tseem noj tshuaj insulin lossis lwm yam tshuaj los tswj lawv cov ntshav qab zib. Txawm li cas los xij, ntau lwm cov tshuaj ntshav qab zib tsis ua rau cov ntshav qab zib qis.

Kev tawm dag zog tuaj yeem ua rau cov piam thaj hauv ntshav tsawg hauv cov neeg siv tshuaj insulin los kho lawv cov ntshav qab zib.

Cov menyuam mos liab uas yug los ntawm leej niam uas muaj ntshav qab zib yuav poob rau hauv cov ntshav qab zib tom qab yug tas.

Rau cov neeg uas tsis muaj ntshav qab zib, cov ntshav qab zib hauv lub siab yuav tshwm sim los ntawm:

• Haus cawv
• Insulinoma, uas yog ib qho mob qog hauv cov ntshav me me uas tsim cov tshuaj insulin ntau dhau
• Tsis muaj cov tshuaj hormones, xws li cortisol, kev loj hlob hormone, lossis thyroid hormone
• Mob lub plawv heev, raum, lossis mob siab
• Kev kis mob uas cuam tshuam rau tag nrho lub cev (sepsis)
• Qee hom kev phais hnyav-poob (feem ntau 5 lossis ntau xyoo tom qab phais mob)
• Cov tshuaj tsis siv rau kev kho mob ntshav qab zib (qee yam tshuaj tua kab mob lossis tshuaj mob plawv)

Koj yuav muaj cov tsos mob thaum koj cov piam thaj hauv ntshav qis heev suav nrog:

• Ob lub zeem muag lossis plooj plooj
• Lub plawv dhia ceev lossis dhia ceev
• Mloog zoo li cranky lossis ua yeeb yam txhoj puab heev
• Ntshai plhu
• Mob taub hau
• Kev tshaib plab
• Qaug dab peg
• Tua los yog tshee
• Tawm hws
• Tingling lossis loog ntawm daim tawv nqaij
• Nkees lossis tsis muaj zog
• Teeb meem pw
• Tsis paub kev xav

Hauv ntau tus neeg muaj ntshav qab zib, cov ntshav qab zib qis ua rau cov tsos mob ze li txhua zaus nws tshwm sim. Tsis yog txhua tus neeg xav tias cov ntshav qab zib qis yuav zoo ib yam nkaus.

Qee qhov tsos mob, zoo li kev tshaib plab lossis tawm hws, tshwm sim thaum cov ntshav qab zib tsuas yog qis me ntsis. Cov tsos mob hnyav dua, xws li kev xav tsis meej lossis qaug dab peg, tshwm sim thaum cov piam thaj hauv ntshav qis dua (tsawg dua 40 mg / dL lossis 2.2 mmol / L).

Txawm hais tias koj tsis muaj tsos mob tshwm sim, koj cov piam thaj hauv ntshav tseem tseem tsawg dhau (hu ua hypoglycemic unawareness). Koj yuav tsis txawm paub tias koj muaj ntshav qab zib kom txog thaum koj tsaus muag, qaug dab peg, lossis nkag mus rau hauv coma. Yog tias koj muaj ntshav qab zib, nug koj tus kws saib xyuas kev noj qab haus huv yog tias kev saib xyuas cov piam thaj txuas ntxiv tuaj yeem pab koj tshawb pom thaum koj cov piam thaj hauv ntshav qis dhau los pab tiv thaiv kev kub ntxhov. Qee cov ntshav qabzib nyob hauv ib qho tuaj yeem ceeb toom koj thiab lwm tus neeg uas koj xaiv thaum koj cov piam thaj hauv ntshav qis dua qhov teeb tsa.

Yog tias koj muaj ntshav qab zib, tswj koj cov ntshav qab zib kom zoo yuav pab tiv thaiv kom tsis txhob muaj piam thaj hauv ntshav. Tham nrog koj tus kws kho mob yog tias koj tsis paub meej txog cov laj thawj thiab cov tsos mob uas muaj ntshav qab zib tsawg.

Thaum koj cov ntshav qab zib kom tsawg, nyeem ntawv yuav qis dua 70 mg / dL (3.9 mmol / L) ntawm koj cov piam thaj.

Koj tus kws khomob yuav hais kom koj hnav ib lub ntsuas me me uas ntsuas koj cov piam thaj hauv ntshav txhua 5 feeb (ntsuas cov piam thaj nyob tas mus li). Cov cuab yeej siv tas li hnav rau 3 lossis 7 hnub. Cov ntaub ntawv no tau rub tawm los tshawb xyuas saib koj puas muaj lub sijhawm ua cov piam thaj hauv ntshav tsawg uas tsis muaj qhov cim tseg.

Yog tias koj mus pw hauv tsev kho mob, koj yuav muaj qhov ntsuas ntshav ntawm koj txoj hlab ntsha mus rau:

• Ntsuas koj cov ntshav qab zib theem
• Kev txheeb xyuas qhov ua rau koj cov piam thaj hauv ntshav qis (qhov kev ntsuam xyuas no yuav tsum ua tib zoo siv sijhawm ntsig txog cov piam thaj hauv ntshav kom paub qhov tseeb)

Lub hom phiaj ntawm kev kho mob yog kho koj cov ntshav qab zib kom qis. Nws yog ib qho tseem ceeb yuav tau sim thiab txheeb xyuas qhov laj thawj uas vim li cas cov piam thaj hauv ntshav kom tsawg thiaj li tiv thaiv tau lwm cov ntshav qab zib cov ntshav kom tsis txhob muaj tshwm sim.

Yog tias koj muaj ntshav qab zib, nws yog qhov tseem ceeb uas koj tus kws kho mob qhia koj yuav ua li cas kho koj tus kheej rau cov ntshav qab zib kom tsawg. Kev kho mob yuav suav nrog:

• Haus kua txiv
• Noj zaub mov
• Noj cov kua nplaum hauv cov ntsiav tshuaj

Lossis tej zaum koj yuav raug hais kom koj txhaj tshuaj glucagon. Cov tshuaj no yog cov tshuaj uas ua rau cov ntshav qab zib.

Yog tias cov piam thaj hauv ntshav tsawg tshwm sim los ntawm insulinoma, kev phais mob kom tshem tawm cov qog yuav pom zoo.

Mob ntshav qab zib hnyav heev yog ib qho mob xwm txheej ceev. Nws tuaj yeem ua rau qaug dab peg thiab puas hlwb. Mob ntshav qab zib qis heev uas ua rau koj tsis nco qab lawm yog hu ua hypoglycemic lossis insulin poob siab.

Txawm ib ntu ntawm cov ntshav qab zib qis heev yuav ua rau nws tsawg dua uas koj muaj cov tsos mob uas ua rau koj paub txog lwm qhov ntawm cov ntshav qab zib qis. Kev tshwm sim ntawm cov ntshav qab zib qis heev tuaj yeem ua rau tib neeg ntshai noj cov tshuaj insulin raws li cov kws kho mob pom zoo.

Yog tias cov cim ntawm cov ntshav qab zib qis tsis zoo tom qab koj noj khoom txom ncauj uas muaj suab thaj:

• Tau txais kev pab thauj mus rau chav xwm txheej ceev. TSIS TXHOB tsav koj tus kheej.
• Hu rau tus xov tooj xwm ceev hauv zos (xws li 911)

Mus nrhiav kev pab kho mob sai rau tus neeg muaj ntshav qab zib lossis ntshav qab zib uas yog:

• Tau txais kev ceeb toom qis dua
• Yuav tsis woken li

Kev Hypoglycemia; Insulin poob siab; Cov tshuaj tiv thaiv insulin; Ntshav Qab Zib - hypoglycemia

• Khoom noj khoom haus thiab insulin tso
• 15/15 txoj cai
• Cov tsos mob uas muaj ntshav qab zib tsawg

Koom Haum Asmeskas Mob Ntshav Qab Zib. 6. Glycemic lub hom phiaj: cov qauv kev kho mob hauv ntshav qab zib-2020. Ntshav Qab Zib Kho MobCov. 2020; 43 (Cov Khoom Siv 1): S66-S76. PMID: 31862749 pubmed.ncbi.nlm.nih.gov/31862749/.

Cryer PE, Arbeláez AM. Kev ntshav siab. Hauv: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Phau Ntawv ntawm EndocrinologyCov. Xab 14th. Philadelphia, PA: Elsevier; 2020: cha 38.