Kev mob hypoglycemia thiab kev kho mob
Kev ntshav siab | |
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ntshav qab zib 'meter' | |
ICD-10 | E 16.0 16.0 -E 16.2 16.2 |
ICD-10-KM | E16.2 |
ICD-9 | 250.8 250.8 , 251.0 251.0 , 251.1 251.1 , 251.2 251.2 , 270.3 270.3 , 775.6 775.6 , 962.3 962.3 |
ICD-9-KM | 251.2 thiab 251.1 |
Kab mobdb | 6431 |
Medlineplus | 000386 |
eMedicine | emerg / 272 med / 1123 med / 1123 med / 1939 med / 1939 ped / 1117 ped / 1117 |
Ntxaij | D007003 |
Kev ntshav siab (los ntawm lwm cov lus Greek ὑπό - txij li hauv qab no, hauv qab + γλυκύς - qab zib + αἷμα - ntshav) - kab mob pathological ua rau muaj ntshav qabzib tsawg dua 3.5 mmol / l, ntshav nruab nrog qis dua li qub (3.3 mmol / l ), qhov chaw tsis tau teev 2771 hnub vim li ntawd, hypoglycemic syndrome tshwm sim. Raug Mob Lub Neej
Pathogenesis hloov |Thaum mus ntsib kws kho mobNrhiav tswv yim kho mob tam sim ntawd yog tias:
Nrhiav kev pab thaum muaj xwm ceev yog:
Kev mob ntshav siab yog tshwm sim thaum cov ntshav qab zib (qib qabzib) poob qis dhau. Muaj ob peb lub laj thawj vim li cas qhov no tuaj yeem tshwm sim, cov kev mob tshwm sim tsis heev ntawm cov tshuaj siv los kho ntshav qab zib. Kev tswj xyuas cov ntshav qab zibTab sis txhawm rau kom nkag siab li cas cov kev mob ntshav qab zib tsawg tshwm sim, nws yuav pab kom paub txog koj lub cev feem ntau ua cov ntshav qab zib li cas. Thaum koj noj, koj lub cev zom cov carbohydrates los ntawm cov khoom noj - xws li qhob cij, mov, nplej zom, zaub, txiv hmab txiv ntoo, thiab cov khoom noj siv mis - rau hauv ntau cov suab thaj molecules, nrog rau cov piam thaj. Cov piam thaj yog qhov tseem ceeb ntawm lub zog rau koj lub cev, tab sis nws tsis tuaj yeem nkag mus rau hauv cov hlwb ntawm feem ntau ntawm koj cov ntaub so ntswg yam tsis muaj kev pab los ntawm insulin, yam tshuaj uas ua zais los ntawm koj tus txiav. Thaum cov piam thaj hauv cov ntshav nce siab, qee cov qog hlwb (beta hlwb) hauv koj txoj kev txiav tawm cov kua dej. Qhov no tso cai rau cov piam thaj mus rau hauv lub hlwb thiab muab roj hauv koj lub hlwb yuav tsum ua haujlwm zoo. Ib qho piam thaj twg ntxiv nyob hauv nplooj siab thiab cov leeg nqaij ua glycogen. Yog tias koj tsis tau noj rau ob peb teev thiab koj cov piam thaj hauv ntshav tau tsawg zuj zus, lwm qhov los ntawm koj lub qab zib, hu ua glucagon, taw qhia koj lub siab kom zom cov glycogen thiab tso cov piam thaj rov qab rau hauv koj cov ntshav. Qhov no yuav pab kom koj cov ntshav qab zib nyob rau qhov ib txwm muaj txog thaum koj rov noj dua. Dhau li ntawm qhov tseeb tias koj lub siab ua rau glycogen nkag mus rau hauv cov piam thaj, koj lub cev kuj tseem muaj peev xwm tsim cov piam thaj. Txoj kev no feem ntau tshwm sim hauv lub siab, tab sis kuj nyob hauv lub raum. Cov Muaj Peev Xwm Ua Ntshav Qab ZibCov neeg mob ntshav qab zib tej zaum yuav tsis muaj cov insulin ntau txaus (hom ntshav qab zib 1) lossis tej zaum yuav ntxim rau nws (hom ntshav qab zib 2). Vim li ntawd, cov piam thaj nws thiaj li ua rau cov ntshav nce ntxiv thiab tuaj yeem ncav cuag cov qib txaus ntshai. Txhawm rau txhim kho cov teeb meem no, ib tus neeg muaj ntshav qab zib tuaj yeem siv tshuaj insulin lossis lwm yam tshuaj los txo lawv cov ntshav qab zib. Tab sis ntau dhau cov insulin lossis lwm yam tshuaj kho ntshav qab zib tuaj yeem txo koj cov ntshav qab zib, ua rau cov ntshav qabzib. Mob Hypoglycemia tuaj yeem tshwm sim yog tias koj tsis noj zaub mov ntau raws li koj ib txwm ua tom qab noj koj cov tshuaj ntshav qab zib, lossis yog tias koj ua exercise ntau dua li ib txwm muaj. Muaj peev xwm ua rau tsis muaj ntshav qab zibKev mob ntshav qab zib kom tsawg hauv cov neeg uas tsis muaj ntshav qab zib yog qhov tsawg dua. Cov laj thawj yuav suav nrog cov hauv qab no:
Lwm yam nyuajYog tias koj tsis quav ntsej cov tsos mob ntawm kev mob ntshav qab zib ntev ntev, koj yuav tsis nco qab. Qhov no yog vim tias koj lub hlwb xav tau cov piam thaj kom ua haujlwm kom raug. Nws tseem ntxov paub txog qhov tshwm sim thiab tsos mob ntawm tus mob qog ntshav qab zib vim tias tsis kho tus mob hypoglycemia tuaj yeem ua rau: Kev txo ntshav qabzib tej zaum kuj yuav ua rau: Kev muaj ntshav qab zib tsawgSij hawm dhau mus, kev rov ua ntu zus dua ntawm cov ntshav qog tuaj yeem ua rau kom tsis muaj peev xwm ceev faj txog tus mob ntshav qab zib tsawg. Lub cev thiab lub hlwb tsis tsim cov cim thiab cov tsos mob uas ceeb toom cov ntshav qab zib hauv qis, xws li tshee lossis lub plawv dhia tsis xwm yeem. Thaum qhov no tshwm sim, qhov kev pheej hmoo ntawm mob ntshav qab zib tsawg dua, ua rau lub neej muaj ntshav siab ntau. Tsis muaj ntshav qab zib txausYog tias koj muaj ntshav qab zib, ntu ntawm cov ntshav qab zib qis yuav tsis xis nyob thiab tuaj yeem hem. Rov ua dua ntawm cov ntshav qog ntshav qis tuaj yeem ua rau cov insulin tsawg dua kom cov ntshav qab zib cov ntshav tsis poob. Tab sis cov piam thaj hauv ntshav mus ntev tuaj yeem ua rau txaus ntshai, uas tuaj yeem ua rau puas tsuaj rau txoj hlab ntshav, ntshav hlab, thiab ntau yam kabmob. Nruam cov kua nplaum saib xyuas
Yog tias koj cov piam thaj hauv ntshav qis dhau, qee tus qauv CGM yuav ceeb toom koj kom muaj kev ntxhov siab. Qee cov tshuaj insulin tam sim no ua ke nrog CGM thiab tuaj yeem cuam tshuam cov insulin xa tawm thaum ntshav qab zib cov ntshav poob sai dhau los tiv thaiv kev mob ntshav qab zib. Nco ntsoov tias koj ib txwm muaj cov carbohydrates ceev zoo li kua txiv los yog qabzib koj tuaj yeem kho cov ntshav qab zib ua ntej nws poob qis txaus ntshai.
Ib qho ntxiv, koj tus kws kho mob yuav yog qhov kev kuaj mob lub cev thiab tshuaj xyuas koj li keeb kwm kev kho mob. Kev kho tus mob hypoglycemia suav nrog:
Kev kho mob sai saiKev pib kho yog nyob ntawm koj qhov tsos mob. Cov tsos mob thaum ntxov feem ntau tuaj yeem kho tau los ntawm kev noj 15 mus rau 20 gram ntawm kev ua kom yuag. Cov khoom noj uas muaj cov carbohydrates muaj txiaj ntsig yog cov zaub mov uas yooj yim tig mus ua suab thaj hauv lub cev, xws li cov ntsiav tshuaj qabzib lossis kua txiv, kua txiv ua kua, tsis tu ncua, thiab tsis noj zaub mov - dej haus thiab cov qab zib muaj suab thaj xws li licorice. Cov zaub mov muaj roj lossis protein tsis yog ib txoj kev kho zoo rau kev mob ntshav qab zib, vim lawv cuam tshuam rau kev nqus cov suab thaj hauv lub cev. Kev kuaj xyuas koj cov ntshav qab zib 15 feeb tom qab kho tas. Yog tias koj cov piam thaj hauv ntshav tseem qis dua 70 mg / dl (3.9 mmol / L), kho lwm 15-20 g ntawm kev yoo mov uas ua rau yuag yuag thiab tshawb xyuas koj cov ntshav qab zib ib zaug ntxiv hauv 15 feeb. Rov ua cov kauj ruam no kom txog thaum cov ntshav qab zib kom siab dua 70 mg / dl (3.9 mmol / L). Thaum cov ntshav qab zib kom rov zoo li qub, nws yog ib qho tseem ceeb kom muaj khoom noj txom ncauj lossis zaub mov kom pab tswj koj cov piam thaj hauv ntshav kom nyob taus. Nws kuj tseem ua rau lub cev hloov cov glycogen khw muag khoom, uas tej zaum yuav tau ploj thaum lub sij hawm hypoglycemia. Yog tias koj cov tsos mob hnyav dua, uas ua rau koj tsis muaj peev xwm noj qab zib nyob hauv koj lub qhov ncauj, koj yuav tau txhaj tshuaj glucagon los yog tso ntshav qab zib rau. Tsis txhob muab khoom noj lossis dej haus rau ib tus neeg tsis nco qab lawm, vim nws muaj peev xwm nqus cov tshuaj no mus rau hauv lub ntsws. Yog tias koj nquag ua rau lub sijhawm muaj ntshav qab zib tsawg, nug koj tus kws kho mob yog tias koj lub tsev glucagon tuaj yeem tsim nyog rau koj. Feem ntau, cov neeg mob ntshav qab zib uas raug kho nrog insulin yuav tsum muaj cov khoom siv glucagon rau qhov xwm txheej ceev uas muaj ntshav qab zib tsawg. Tsev neeg thiab cov phooj ywg yuav tsum paub yuav nrhiav cov khoom siv qhov twg, thiab nws yuav tsum tau muaj kev kawm paub siv nws ua ntej muaj xwm txheej ceev. Kev kho mob ntawm qhov mob hauv qabTiv thaiv kev txo cov ntshav qab zib kom tsis txhob mob ua kom koj tus kws kho mob txiav txim siab qhov mob thiab kho mob. Nyob ntawm qhov pib vim li cas, kev kho mob yuav suav nrog:
Npaj tuaj teem sijhawmKev mob ntshav qab zib ntshav siab yog hom mob ntshav qab zib hom 1, uas tshwm sim thaum lub cev tsis muaj ntshav qab zib tsawg ob zaug nyob rau ib as thiv. Tab sis yog tias koj pom tias koj muaj ntshav qab zib ntau dua, lossis yog tias koj cov piam thaj hauv ntshav qis qis dua, tham nrog koj tus kws kho mob kom paub seb koj yuav xav hloov koj txoj kev tswj ntshav qab zib li cas. Yog tias koj tsis kuaj pom tias mob ntshav qab zib, teem sijhawm nrog koj tus kws khomob xub thawj. Nov yog qee cov xov xwm los pab koj npaj rau koj lub sijhawm teem thiab tshawb nrhiav qhov xav kom tau dab tsi los ntawm koj tus kws kho mob. Koj tuaj yeem ua dab tsi
Cov lus nug nug koj tus kws kho mob yog tias koj muaj ntshav qab zib:
Cov lus yuav nug yog koj tsis tau ntsuas pom tias muaj ntshav qab zib muaj xws li:
Dab tsi xav kom los ntawm koj tus kws kho mobTus kws kho mob uas pom koj rau cov tsos mob ntawm lub qog ntshav qab zib yuav nug koj ib cov lus nug ntau ntxiv. Tus kws kho mob yuav nug:
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