Diabetes

UNovemba yiNyanga yeSizwe yesifo seswekile. Eli lixesha apho uluntu kwilizwe liphela ludibanela ukuzisa ingqwalasela kwisifo seswekile.

Ngoko, kutheni ngoNovemba? Ndiyavuya ubuze.

Esona sizathu kukuba i-14 kaNovemba ngumhla wokuzalwa kukaFrederick Banting. Lo gqirha waseKhanada neqela lakhe lezazinzulu benza into emangalisayo emva phayaa ngowe-1923. Ngomsebenzi wabanye wabona ukuba izinja ezazisuswe udakada zikhawuleza zibe nesifo seswekile zaza zafa. Ke, yena nabanye babesazi ukuba kukho into eyenziwe kwi-pancreas eyanceda umzimba ukulawula iswekile (iglucose). Yena neqela lakhe bakwazi ukukhupha umchiza “kwiziqithi” zeeseli (ezibizwa ngokuba ziiLangerhans) baza bawunika izinja ezingenawo udakada, yaye zasinda. Igama lesiLatini lesiqithi yi "insula". Ivakala iqhelekile? Kufanele, le yimvelaphi yegama lehomoni esiyaziyo njenge-insulin.

UBanting kunye nesinye isazinzulu, uJames Collip, emva koko bazama isicatshulwa sabo ku-14 oneminyaka ubudala ogama linguLeonard Thompson. Emva phaya, umntwana okanye umntwana ofikisayo owayenesifo seswekile wayephila umlinganiselo wonyaka omnye. ULeonard waphila de waneminyaka engama-27 kwaye wabulawa yinyumoniya.

U-Banting ufumene ibhaso leNobel kuNyango kunye nePhysiology kwaye wabelana ngalo neqela lakhe lonke. Wayekholelwa ukuba le hormone esindisa ubomi kufuneka yenziwe ifumaneke kubo bonke abanesifo seswekile, yonke indawo.

Oku kwenzeka ngokoqobo kwiminyaka eli-100 kuphela eyadlulayo. Ngaphambi koko, isifo seswekile sasiqatshelwa ukuba mhlawumbi zintlobo ezimbini ezahlukeneyo. Kwakubonakala ngathi abanye bafa ngokukhawuleza yaye abanye babenokuthabatha iinyanga okanye iminyaka. Kwanakwiminyaka emalunga newaka eyadlulayo, oogqirha babeza kuhlola umchamo wesigulana ukuze baqonde oko kwakuqhubeka kuso. Oku kuquka ukujonga umbala, intlenga, ivumba njani, kwaye ewe, ngamanye amaxesha nokungcamla. Igama elithi "mellitus" (njengesifo seswekile) lithetha ubusi ngesiLatini. Umchamo wawuswiti kwabanesifo seswekile. Sihambe indlela ende kwinkulungwane.

Into esiyaziyo ngoku

Isifo seswekile sisifo esenzeka xa iswekile esegazini lakho, ekwabizwa ngokuba yiswekile yegazi, iphezulu kakhulu. Ichaphazela malunga ne-37 yezigidi zabantu baseMelika, kuquka abantu abadala kunye nolutsha. Isifo seswekile senzeka xa umzimba wakho ungayenzi ngokwaneleyo ihomoni ebizwa ngokuba yi-insulin, okanye ukuba umzimba wakho awuyisebenzisi i-insulin ngendlela eyiyo. Ukuba ayinyangwa, inokubangela ukungaboni, ukuhlaselwa yintliziyo, ukubetha, ukusilela kwezintso kunye nokunqunyulwa kwamalungu. Isiqingatha kuphela sabantu abanesifo sikashukela baxilongwa ngenxa yokuba kwiinqanaba zokuqala zesifo sikashukela, kukho iimpawu ezimbalwa, okanye iimpawu zingafana nezinye iimeko zempilo.

Zeziphi iimpawu zokuqala zesifo seswekile?

Ngapha koko, imvelaphi yegama lesiGrike elithi diabetes lithetha “siphon.” Ngokoqobo, ulwelo lwalukhutshelwa ngaphandle komzimba. Iimpawu ziya kubandakanya unxano olugqithisileyo, ukuchama rhoqo, ukwehla kobunzima obungachazwanga, ukubona luzizi okutshintsha imihla ngemihla, ukudinwa okungaqhelekanga, okanye ukozela, ukuntyiloza okanye ukuba ndindisholo kwezandla okanye ezinyaweni, ulusu oluthi rhoqo okanye oluphinda-phindayo, izifo zentsini okanye zesinyi.

Ukuba unayo enye yezi mpawu, fowunela ugqirha wakho wosapho ngoko nangoko.

Umonakalo usenokuba sele usenzeka emehlweni akho, izintso, kunye nenkqubo ye-cardiovascular system ngaphambi kokuba uqaphele iimpawu. Ngenxa yoku, ababoneleli bezempilo bayathanda ukujonga isifo seswekile kubantu abathathwa njengomngcipheko ophezulu. Kuquka bani oko?

• Uneminyaka engaphezu kwama-45.
• Utyebe kakhulu.
• Awuzilolongi rhoqo.
• Umzali wakho, umnakwenu okanye udade wenu unesifo seswekile.
• Ubunomntwana obunzima obungaphezu kweekhilogram ezili-9, okanye unesifo seswekile sokukhulelwa ngelixa ukhulelwe.
• UngoMnyama, umSpanish, umNtu waseMelika, ummi waseAsia okanye ummi wasePasifiki.

Uvavanyo, olukwabizwa ngokuba "luvavanyo," luhlala lwenziwa ngovavanyo lwegazi lokuzila. Uya kuvavanywa kusasa, ngoko ke akufanele utye nantoni na emva kwesidlo sangokuhlwa ngobusuku obungaphambili. Iziphumo zovavanyo lweswekile yegazi eqhelekileyo zingaphantsi kwe-110 mg ngedl nganye. Iziphumo zovavanyo eziphezulu kune-125 mg nge-dL nganye zibonisa isifo seswekile.

Abantu abaninzi banesifo seswekile malunga neminyaka emihlanu ngaphambi kokuba babonise iimpawu zesifo seswekile. Ngelo xesha, abanye abantu sele benamehlo, izintso, iintsini okanye imithambo-luvo. Akukho unyango lwesifo seswekile, kodwa kukho iindlela zokuhlala usempilweni kunye nokunciphisa umngcipheko weengxaki.

Ukuba ufumana umthambo ongaphezulu, jonga ukutya kwakho, ulawule ubunzima bakho, kwaye uthathe naliphi na iyeza elichazwe ngugqirha wakho, unokwenza umehluko omkhulu ekunciphiseni okanye ekukhuseleni umonakalo onokuthi wenziwe nesifo sikashukela. Kwangoko uyazi ukuba unesifo seswekile, ngokukhawuleza unokwenza olu tshintsho lubalulekileyo lwendlela yokuphila.

Iintlobo ezimbini (okanye ngaphezulu) zesifo seswekile?

Uhlobo loku-1 lweswekile luchazwa njengemeko yeswekile ephezulu yegazi ngenxa yokunqongophala kwe-insulin ngenxa yenkqubo yokuzikhusela komzimba. Oku kuthetha ukuba umzimba uhlasela kwaye utshabalalisa iiseli ezikwi-pancreas ezenza i-insulin. Unyango lwezondlo lwezonyango kunye neenaliti ezininzi zemihla ngemihla ze-insulin (okanye ngempompo) zingundoqo zonyango. Ukuba une-Type 1 diabetes, kufuneka uhlolwe rhoqo uxinzelelo lwegazi kunye nezinye iimeko ezinxulumene nazo.

I-Prediabetes? Uhlobo lwesi-2 seswekile?

Ngokungafaniyo ne-Type 1 diabetes, ekufuneka inyangwe nge-insulin, i-Type 2 diabetes isenokufuna i-insulin okanye ingayifuni. I-prediabetes ayisiso isifo seswekile, okwangoku. Kodwa oogqirha kunye nabanye ababoneleli banokuxela kuvavanyo lwakho lwegazi ukuba uhamba kwicala lesifo seswekile. Ukususela kwi-2013 ukuya kwi-2016, i-34.5% yabantu abadala base-US babene-prediabetes. Umboneleli wakho uyazi ukuba usemngciphekweni kwaye unokufuna ukukuvavanya okanye ukukuhluza. Ngoba? Ngenxa yokuba kuboniswe ukuba umsebenzi womzimba kunye neendlela zokutya ezinempilo ziqhubeka zisisiseko sokuthintela isifo sikashukela. Nangona kungekho mayeza avunyiweyo yi-Food and Drug Administration (FDA) yokuthintela isifo sikashukela, ubungqina obuqinileyo buxhasa ukusetyenziswa kwe-metformin kubantu abadala abane-prediabetes. Ukulibazisa ukuqala kwesifo seswekile kukhulu kuba abantu abazizigidi ezingama-463 kwihlabathi liphela banesifo seswekile. Amashumi amahlanu ekhulwini kubo akazange afunyanwe.

Izinto ezinobungozi kwi-prediabetes okanye i-Type 2 yeswekile?

Kuba amanqanaba okuqala esifo seswekile aneempawu ezimbalwa, kukho izinto ezinobungozi ezonyusa amathuba akho okuba nesifo seswekile.

• Ukusela rhoqo iziselo ezineswekile kunye nokusela iziselo ezenziwe ngeswiti kunye nejusi yeziqhamo.
• Ebantwaneni, ukutyeba kuyingozi enkulu.
• Ukutya okunamafutha kunye neswekile eninzi.
• Ukuziphatha kokuhlala.
• Ukubonakaliswa kwesifo sikashukela somama kunye nokukhuluphala komama kwisibeleko.

Iindaba ezilungileyo? Ukuncancisa kuyakhusela. Ukongezelela, umsebenzi womzimba kunye neendlela zokutya ezinempilo zibonakaliswe njengezona ziseko zokuthintela isifo sikashukela.

Iindlela ezahlukeneyo zokutya ezinempilo ziyamkeleka kwizigulane ezine-prediabetes. Yitya imifuno engenasitatshi; ukunciphisa ukutya kwakho kweswekile eyongezelelweyo kunye neenkozo ezisulungekileyo; khetha ukutya okupheleleyo kunokutya okugayiweyo; kwaye uphelise ukungenisa iziselo ezenziwe ngokwenziwa okanye ezifakwe iswekile kunye nejusi yeziqhamo.

Kubantwana kunye nolutsha olufikisayo olunesifo seswekile, i-ADA icebisa imizuzu engama-60 ngosuku okanye ngaphezulu kwe-moderate- okanye ngamandla-intensity-intensity aerobic activity kunye nezihlunu ezinamandla kunye nemisebenzi yokomeleza amathambo ubuncinane iintsuku ezintathu ngeveki.

Ugqirha wakho unokufuna ukuba uzijonge ngokwakho i-glucose yegazi. Ikunceda ukuba uqonde ngcono ukunyuka nokuhla kweswekile yegazi lakho imini yonke, ukubona indlela amayeza akho asebenza ngayo, kunye nokuvavanya impembelelo yokutshintsha kwendlela yokuphila oyenzayo. Ugqirha wakho angathetha nawe ngeenjongo, eziquka into ebizwa ngokuba yi-A1c yakho. Oku kukunika wena kunye nogqirha wakho impendulo malunga nokuba isifo sakho seswekile siqhuba njani ekuhambeni kwexesha, njengeenyanga ezintathu. Oku kwahlukile kunokujongwa kwemihla ngemihla kweglucose yakho yegazi.

Ukuba une-Type 2 yeswekile kwaye awukwazi ukulawula ngotshintsho lwendlela yokuphila, ugqirha wakho unokukuqalisa kwiyeza elibizwa ngokuba yi-metformin. Oku kutshintshe ukhathalelo lwesifo seswekile ngokwenza iiseli zomzimba wakho zichaphazeleke ngakumbi kwi-insulin ekwinkqubo yakho. Ukuba awukafezekisi iinjongo zakho, umboneleli wakho unokongeza iyeza lesibini, okanye acebise ukuba uqale i-insulin. Ukhetho luhlala luxhomekeke kwezinye iimeko zonyango onokuba nazo.

Umgca ophantsi, isifo seswekile siyehla kuwe. Nguwe olawulayo, kwaye unokwenza oku.

• Funda kangangoko unako malunga nesifo sakho kwaye uthethe nomboneleli wakho malunga nendlela onokufumana ngayo inkxaso oyifunayo ukuhlangabezana neenjongo zakho.
• Lawula isifo seswekile kwangoko.
• Yenza isicwangciso sokhathalelo lweswekile. Ukwenza ngokukhawuleza emva kokufunyaniswa kunokunceda ukukhusela isifo seswekile-iingxaki ezifana nesifo sezintso, ukulahlekelwa ngumbono, isifo senhliziyo, kunye nesifo sohlangothi. Ukuba umntwana wakho unesifo seswekile, mxhase kwaye ube nesimo sengqondo esihle. Sebenza nomboneleli womntwana wakho ukuba abeke iinjongo ezithile zokuphucula impilo yakhe yonke kunye nokuphila kakuhle.
• Yakha iqela lakho lokhathalelo lwesifo seswekile. Oku kunokubandakanya ingcali yezondlo okanye utitshala oqinisekisiweyo ngesifo seswekile.
• Lungiselela utyelelo kunye nababoneleli bakho. Bhala phantsi umbuzo wakho, uphonononge isicwangciso sakho, urekhode iziphumo zakho zeswekile yegazi.
• Thatha amanqaku kwidinga lakho, cela isishwankathelo sotyelelo lwakho, okanye ujonge i-portal yesigulana sakho kwi-intanethi.
• Hlola uxinzelelo lwegazi, ukujonga unyawo, kunye nokujonga ubunzima. Thetha neqela lakho malunga namayeza kunye neendlela ezintsha zonyango, kunye nezitofu zokugonya ekufuneka uzifumene ukunciphisa umngcipheko wokugula.
• Qala ngeenguqu ezincinci ukudala imikhwa enempilo.
• Yenza umsebenzi womzimba kunye nokutya okunempilo kube yinxalenye yendlela yakho yemihla ngemihla
• Zibekele usukelo kwaye uzame ukusebenza ngeentsuku ezininzi zeveki
• Landela isicwangciso sokutya seswekile. Khetha iziqhamo kunye nemifuno, ukutya okuziinkozo, inyama ebhityileyo, itofu, iimbotyi, imbewu, kunye nobisi olunganamafutha okanye obungamafutha aphantsi kunye netshizi.
• Cinga ngokujoyina iqela lenkxaso elifundisa iindlela zokulawula uxinzelelo kwaye ucele uncedo ukuba uziva uphantsi, ulusizi, okanye uxinezelekile.
• Ukulala iiyure ezisixhenxe ukuya kwezisibhozo ubusuku ngabunye kunokunceda ukuphucula umoya wakho kunye nenqanaba lamandla.

Awungomntu unesifo seswekile. Usenokuba ungumntu onesifo seswekile, kunye nezinye iimpawu ezininzi. Kukho abanye abakulungeleyo ukuza kunye nawe ekufezekiseni iinjongo zakho. Ungakwenza oku.

 

niddk.nih.gov/health-information/community-health-outreach/national-diabetes-month#:~:text=November%20is%20National%20Diabetes%20Month,blood%20sugar%2C%20is%20too%20high.

U-Kolb H, uMartin S. Imiba yokusingqongileyo / yokuphila kwi-pathogenesis kunye nokuthintela uhlobo lwe-2 yeswekile. BMC Med. 2017;15(1):131

i-American Diabetes Association; Imigangatho yokhathalelo lwezonyango kwi-diabetes-2020 efinyeziweyo kubaboneleli abaphambili. UClin isifo seswekile. 2020;38(1):10-38

i-American Diabetes Association; Abantwana kunye nabakwishumi elivisayo: imigangatho yokhathalelo lwezonyango kwisifo seswekile-2020. Ukhathalelo lwesifo seswekile. 2020;43(Suppl 1):S163-S182

aafp.org/pubs/afp/issues/2000/1101/p2137.html

i-American Diabetes Association; Ukuxilongwa kunye nokuhlelwa kwesifo sikashukela. Ukhathalelo lwesifo seswekile. 2014;37(Suppl 1):S81-S90