Ucelo-mngeni Lokunyanga Isifo Seswekile

“Akukho hlobo lwesifo seswekile lungeyongozi. Zonke iintlobo zesi sifo ziyingozi.”—UAnne Daly, weAmerican Diabetes Association.

“XA BEKUHLOLWA igazi lakho kufunyaniswe ukuba kukho into engahambi kakuhle. Kufuneka ufumane unyango ngokukhawuleza.” Loo mazwi kagqirha amothusa gqitha uDeborah yaye amshiya exakanisekile. Uthi: “Ngobo busuku, ndandicinga ukuba kukho impazamo eyenziwe elebhu. Ndandingafuni kuyamkela into yokuba ndiyagula.”

Njengabanye abantu abaninzi, uDeborah wayecinga ukuba uphilile, ngoko akazange azikhathaze ngezo mpawu zokugula wayenazo. Wayecinga ukuba unxano lwakhe olungapheliyo lubangelwa ngamayeza awayewasebenzisa. Ukuchama kwakhe rhoqo wayesithi kubangelwa kukusela kwakhe amanzi kakhulu. Kuthekani ngokudinwa—kaloku, nguwuphi umama oba sisinxada-nxada imini yonke aze angadinwa?

Kodwa iziphumo zokuhlolwa kwegazi zabonisa ukuba unesifo seswekile. Kwakunzima kuDeborah ukukwamkela oko. Uthi: “Andizange ndixelele mntu ngesigulo sam. Kwakusithi kusakulala wonk’ umntu ebusuku ndilile.” NjengoDeborah, abanye abantu bathi bakuva ukuba banesifo seswekile banxunguphale, badandatheke babe nawo nomsindo. UKaren uthi: “Kangangexesha elide ndandingayamkeli into yokuba ndiyagula.”

Iqhelekile into yokuba abantu basabele ngale ndlela xa besehlelwa zizinto ezibuhlungu. Noko ke, xa befumana inkxaso abantu abanesifo seswekile banokuqhelana nale meko. UKaren uthi: “Umongikazi owayendinyamekela wandinceda ndayamkela imeko yam. Wandiqinisekisa ukuba kuyinto efanelekileyo ukukhala. Ukukhala kwandinceda ndayamkela le meko.”

Isizathu Sokuba Esi Sifo Sibe Yingozi

Ngokufanelekileyo isifo seswekile sibizwa ngokuba “kukuphazamiseka kwenkqubo yokusebenza komzimba.” Xa umzimba ungakwazi ukusebenzisa iswekile esegazini, oko kunokuchaphazela namanye amalungu omzimba, yaye maxa wambi oku kunokubeka ubomi bomntu esichengeni. UGqr. Harvey Katzeff uthi: “Abantu ababulawa sisifo seswekile ngokuthe ngqo, kodwa babulawa zezinye izigulo ezibangelwa siso. Siyakwazi ukusithintela esi sifo, kodwa asikwazi ukusinyanga.”a

Ngaba likho ithemba ngabantu abanesifo seswekile? Ewe—ukuba bayabuqonda ubungozi baso baze bawalandele ngenyameko amacebiso okusinyanga.b

Ukutya Nokuzilolonga

Nangona i-Type 1 diabetes ingenakuthintelwa, izazinzulu zikhangela imizila yemfuza esenokubangela umntu ahlaselwe sesi sifo yaye zizama iindlela zokusithintela. (Bona ibhokisi ethi “Umsebenzi Weglucose,” kwiphepha 8.) Noko ke, incwadi ethi Diabetes—Caring for Your Emotions as Well as Your Health ithi: “Kukho ithemba elikhulu lokufumana indlela yokunyanga i-type 2 diabetes. Inkoliso yabantu abasesichengeni sokuhlaselwa sesi sifo, bayaziphepha izinto ezinokubenza bahlaselwe siso ngokutya ngendlela elungeleleneyo baze bahlale bezilolonga, yaye ngaloo ndlela bahlala besempilweni yaye baba nomzimba olingeneyo.”c

Igxininisa ukubaluleka kokuzilolonga, iJournal of the American Medical Association yanikela ingxelo ngohlolisiso olwenziwe kumabhinqa. Kolu hlolisiso kwafunyaniswa ukuba “ukusebenza okanye ukwenza umthambo ixesha nje elifutshane kuyayandisa i-insulin esegazini yaye oko kubangela ukuba [iiseli zomzimba] zikwazi ukufunxa i-glucose isithuba esingaphezu kweeyure ezingama-24.” Ngoko ke, le ngxelo iqukumbela ngelithi “ukuhamba nokuzibhokoxa emsebenzini kunokuwanciphisa amathuba okuba amabhinqa ahlaselwe yi-type 2 diabetes.” Abaphandi bancomela ukuba abantu bazilolonge imizuzu engama-30 ubuncinane phantse yonk’ imihla. Enye yeendlela zokuzilolonga kukuhamba, yaye iAmerican Diabetes Association Complete Guide to Diabetes ithi, “le yeyona ndlela yokuzilolonga isemagqabini, ikhuselekileyo nengezondleko.”

Noko ke, abantu abanesifo seswekile bafanele benze uhlobo lomthambo olunconyelwa ziingcali zonyango. Isizathu soko kukuba isifo seswekile sinokwenza imithambo nemithambo-luvo ingasebenzi kakuhle, kuze oko kubangele ukuba igazi lingahambi kakuhle nezivamvo zingasebenzi kakuhle. Ngenxa yoko, umntu onesifo seswekile unokukrwelwa yinto elunyaweni aze angeva ukuba kukho into emkrwelileyo, kungene ukungcola, uze loo mkrwelo ube sisilonda—yaye ekugqibeleni eso silonda sinokubangela umntu anqunyulwe unyawo xa engakhange anyangwe ngokukhawuleza.d

Sekunjalo, ukuzilolonga kunokumnceda ubani ekulweni nesifo seswekile. IADA Complete Guide, ithi: “Okukhona abaphandi befunda ngokuzilolonga rhoqo, baye beseyiseka ngakumbi ngeengenelo zako.”

Ukunyangwa Nge-Insulin

Abantu abaninzi abanesifo seswekile kufuneka batye ukutya okunempilo, bazilolonge, bahlole umlinganiselo we-glucose esemzimbeni baze bazitofe nge-insulin izihlandlo eziliqela ngemini. Ngenxa yokutya ukutya okunempilo nokuzilolonga rhoqo, abanye abantu abane-Type 2 diabetes baye bayeka ukusebenzisa i-insulin kangangexesha elithile.e UKaren, one-Type 1 diabetes, ufumanise ukuba ukuzilolonga kubangela ukuba i-insulin azitofa ngayo isebenze kakuhle. Ngenxa yoko, uye wakwazi ukunciphisa umlinganiselo we-insulin azitofa ngayo ngama-20 ekhulwini.

Noko ke, akukho sizathu sokuba umntu onesifo seswekile akhathazeke xa kunconyelwa ukuba asebenzise i-insulin. UMary Ann, umongikazi onyamekela abantu abanesifo seswekile uthi: “Ukusebenzisa i-insulin akuthethi kuthi kukho into ephosakeleyo ngawe. Nokuba unaluphi na uhlobo lwesifo seswekile, ukuba uyawulawula umlinganiselo weswekile esegazini lakho, uya kuzinciphisa iingxaki ezinokuvela kamva.” Enyanisweni, uhlolisiso lwamva nje lubonisa ukuba abantu abane-Type 1 diabetes abawulawulayo umlinganiselo weswekile esegazini labo “baye bawanciphisa kakhulu amathuba okuba neengxaki zamehlo, zezintso nemithambo-luvo.” Ngokomzekelo, ukuba semngciphekweni wokuhlaselwa sisifo samehlo (i-retinopathy) kuye kwancitshiswa ngama-76 ekhulwini! Nabantu abane-Type 2 diabetes baye bazibona iingenelo zokugcina umlinganiselo weswekile esegazini ulungelelene.

Ukuze ukutofela i-insulin kube lula yaye kungabi buhlungu, kwiisirinji nakwizitofu eziqhelekileyo kuye kwafakelwa iinaliti ze-microfine. UMary Ann uthi: “Ngokuqhelekileyo, kudla ngokuba buhlungu xa umntu eqala ukusebenzisa esi sitofu. Emva koko, abantu abaninzi badla ngokuthi abeva zintlungu.” Ezinye iintlobo zezitofu ezisetyenziswayo zii-automatic injectors, ezibangela ukuba kungabikho ntlungu xa umntu etofwa, ii-jet injectors zokufaka i-insulin ngokuqhwanyaza kweliso nee-infusers ezine-catheter ehlala iintsuku ezimbini okanye ezintathu kuloo ndawo atofwe kuyo umntu. Esinye isixhobo esiye sathandwa kakhulu mvanje yi-insulin pump elingana nepager. Esi sixhobo singenisa i-insulin emzimbeni nge-catheter ngokomlinganiselo efuneka ngawo emzimbeni, yaye loo nto ibangela ukuba umzimba ufumane i-insulin eyaneleyo.

Qhubeka Ufunda

Zininzi iindlela zokunyanga isifo seswekile, kodwa azisebenzi ngokufanayo kubo bonke abantu. Xa ecinga ngendlela aza kuyisebenzisa, mntu ngamnye ufanele aqwalasele iinkalo eziliqela ukuze azenzele isigqibo. UMary Ann uthi: “Nokuba sele unyanyekelwa liqela elithile lezonyango, nguwe omele wenze isigqibo.” Eneneni, ulindixesha iDiabetes Care uthi: “Ukunyanga umntu onesifo seswekile kusenokuba yinkcitha xesha xa engafundiswa indlela yokuzinyamekela.”

Okukhona abantu abanesi sifo befunda ngaso, kokukhona bekwazi ukuzinyamekela kakuhle yaye baba nethemba lokuhlala besempilweni ixesha elide. Noko ke, ukuze bakwazi ukufunda okungakumbi, kufuneka babe nomonde. Incwadi ethi Diabetes—Caring for Your Emotions as Well as Your Health ithi: “Ukuba ufuna ukufunda yonk’ into ngexesha elinye, usenokudideka uze ungakwazi ukuyisebenzisa kakuhle loo nkcazelo. Ngaphezu koko inkcazelo eluncedo ekufuneka uyifundile akunakuyifumana ezincwadini. Kuxhomekeke . . . kuhlobo lwegazi lakho. Izinto ezininzi unokuzifumanisa ngokuhamba kwexesha nangokuqhubeka uzama amacebiso ahlukahlukeneyo.”

Ngokomzekelo, kusenokufuneka uqwalasele oko kwenzekayo xa ukhathazekile, kuba ukukhathazeka kunokuyenza inyuke ngokukhawuleza iswekile. UKen uthi “Sele ndineminyaka engama-50 ndinesifo seswekile, yaye ndiyakwazi oko kwenzekayo emzimbeni wam!” “Ngokuqwalasela” oko kwenzeka emzimbeni wakhe uKen uye wancedakala kuba usasebenza ixesha elizeleyo—nangona sele eneminyaka engaphezu kwama-70 ubudala!

Ukubaluleka Kwenkxaso Yentsapho

Enye into ebalulekileyo kukuba umntu onesifo seswekile afumane inkxaso yentsapho. Enye imbekiselo ithi “kusenokwenzeka ukuba intsebenziswano yentsapho yeyona nto ibalulekileyo” xa kunyanyekelwa abantwana nabantu abadala abanesifo seswekile.

Ibaluleke gqitha into yokuba amalungu entsapho abe nolwazi ngesifo seswekile, maxa wambi atshintshisane ngokusa umguli kwagqirha. Ukuba nolwazi kuya kuwanceda akwazi ukumxhasa umguli, azazi impawu zesi sigulo yaye ayazi nento amele ayenze. UTed, onomfazi owaqala ukuba ne-Type 1 diabetes eseneminyaka emine ubudala uthi: “Ndiyakwazi ukubona xa iswekile yehle kakhulu kuBarbara. Sithi sisancokola nje asuke athule. Usuke abile athi xhopho aze abe nomsindo ngaphandle kwesizathu. Emva koko atyhafe.”

Ngokufanayo, uCatherine, ongumfazi kaKen uthi akuphawula ukuba uKen uphatshile, ubilile yaye usabela ngendlela engaqhelekanga ambuze umbuzo othile. Uthi ke uKen akungakwazi ukuphendula uCatherine aqonde ukuba makenze icebo ukuze amncede ngokukhawuleza. Bobabini uKen noBarbara bayixabisa gqitha into yokuba namaqabane omtshato anolwazi ngesi sifo, abawathandayo nabawathemba ngokupheleleyo.f

Amalungu entsapho anothando amele azabalazele ukumxhasa, abe nobubele kunye nomonde—mpawu ezo zinokumnceda umguli ajamelane nobunzima ade achache kakuhle. Umyeni kaKaren wamqinisekisa ngendlela amthanda ngayo, nto leyo eyaba nemiphumo emihle kuye. UKaren uthi: “UNigel wathi kum, ‘Abantu kufuneka batye yaye basele amanzi ukuze baphile, ngokufanayo nawe kufuneka utye uze usele amanzi—nentwana ye-insulin.’ Loo mazwi obubele anditsho ndaziva ndihlaziyekile.”

Intsapho nabahlobo kufuneka baqonde ukuba njengoko umlinganiselo weswekile osegazini utshintsha-tshintsha, umntu onesifo seswekile unokusuke aqumbe ngaphandle kwesizathu. Elinye ibhinqa lithi: “Xa ndisiva ukuba ndihlaselwa sisifo seswekile, ndisuka ndithule, ndibe ntshingintshingi, ndibe nomsindo yaye ndixakaniseke. Emva koko ndiba buhlungu gqitha ngenxa yokwenza izinto ngathi ndingumntwana. Kodwa ndiyavuya xa ndisazi ukuba abanye bayasiqonda isizathu soko—yaye ndiyazama ukulwa nalo mkhwa.”

Abantu abanesifo seswekile banako ukuhlangabezana ngokuphumelelayo naso, ngakumbi ukuba umntu onaso ufumana inkxaso kubahlobo nakumalungu entsapho. Enye into enokubanceda yimigaqo yeBhayibhile. Njani?

[Imibhalo esemazantsi]

[Ibhokisi/Umfanekiso okwiphepha 6]

Ngaba Esi Sifo Siyabahlasela Nabaselula?

UGqr. Arthur Rubenstein oyi-endocrinologist nomphathi kwiNew York’s Mount Sinai School of Medicine uthi, “baya besiba baninzi abantu abaselula abahlaselwa sisifo seswekile.” Ngoku abantu baqala beselula kakhulu ukuhlaselwa sisifo seswekile. Ithetha nge-Type 2 diabetes, ingcali ngesi sifo uGqr. Robin S. Goland uthi: “Kwiminyaka elishumi edluleyo, sasixelela abafundi bezonyango ukuba esi sifo asibahlaseli abantu abaneminyaka engaphantsi kwama-40 ubudala. Ngoku sele sihlasela nabantwana abaneminyaka engaphantsi kwe-10 ubudala.”

Kutheni besanda kangaka nje abantu abaselula abanesi sifo? Maxa wambi sibangelwa yimfuza. Kodwa ezinye izinto ezinokuba negalelo kukutyeba nendawo umntu ahlala kuyo. Kula mashumi amabini eminyaka edluleyo liye landa ngokuphindwe kabini inani labantwana abatyebe ngokugqithiseleyo. Yintoni ebangela oku? UGqr. William Dietz weU.S. Centers for Disease Control and Prevention uthi, “Kule minyaka ingama-20 idluleyo, abantu baye bayitshintsha indlela abatya nabasebenza ngayo. Ngoku abantu bakuthanda kakhulu ukutya kwiivenkile zokutyela; baninzi abantu abangasityiyo isidlo sakusasa; baya besiba baninzi nabantu abathanda ukusela iziselo ezihlwahlwazayo nokuthenga ukutya okusele kuphekiwe; yaye ayisaxhaphakanga kangako nento [yokufundiswa kwabantwana ukuzilolonga] esikolweni; yaye lapheliswa nexesha lekhefu ezikolweni.”

Isifo seswekile asinyangeki. Ngoko ke, kuya kuba bubulumko ukusebenzisa icebiso elivela komnye okwishumi elivisayo onesi sifo, uthi: “Musa ukutya ukutya okungekho mpilweni, hlala uzilolonga ngalo lonke ixesha.”

[Ibhokisi/Umfanekiso okwiphepha 8, 9]

Umsebenzi We-glucose

Izigidi zezigidi zeeseli zomzimba zifumana amandla kwi-glucose. Noko ke, ukuze ikwazi ukungena kwiiseli kufuneka “isitshixo” sokuvula—i-insulin, umchiza oveliswa ngudakada. Imizimba yabantu abane-Type 1 diabetes ayikwazi kuvelisa i-insulin. Yona imizimba yabantu abane-Type 2 diabetes iyayivelisa i-insulin kodwa iba ncinane kakhulu.g Ngapha koko, iiseli zabo azikwazi kungenisa i-insulin—yaye loo nto kuthiwa yi-insulin resistance. Zombini ezi ntlobo zesifo seswekile, ziba nemiphumo efanayo: iiseli aziyifumani ngokwaneleyo i-glucose yaye umlinganiselo weswekile esegazini unyuka kakhulu okanye uhle kakhulu.

Inkqubo yokuzikhusela yomzimba womntu one-Type 1 diabetes, ihlasela ii-beta cells ezikudakada ezivelisa i-insulin. Ngoko ke, i-Type 1 diabetes yi-autoimmune disease yaye maxa wambi ibizwa ngokuba yi-immune-mediated diabetes. Ezinye izinto ezinokubangela le meko ziintsholongwane, imichiza enetyhefu neziyobisi ezithile. Nemfuza inokuba negalelo, kuba i-Type 1 diabetes idla ngokutyhutyha entsatsheni, yaye ixhaphake kakhulu kwabaMhlophe.

I-Type 2 diabetes, ibakho kakhulu kwimizila yemfuza kodwa ixhaphake kakhulu kwiintlanga ezingekho Mhlophe. Abanye abantu abathand’ ukuhlaselwa lolu hlobo lwesifo seswekile ziinzalelwane zaseOstreliya nezaseMerika, yaye amaMerika omthonyama ngawona ahlaselwa kakhulu yi-Type 2 diabetes ehlabathini lonke. Abaphandi basakhangela isizathu sokuba i-insulin ingakwazi ukungena kwiiseli zabantu abatyebe ngokugqithiseleyo nabasesichengeni sokuphathwa sesi sifo.h Ngokwahlukileyo kwi-Type 1 diabetes, i-Type 2 diabetes idla ngokuhlasela abantu abaneminyaka engaphezu kwama-40 ubudala.

[Imibhalo esemazantsi]

[Umfanekiso]

Imolekyuli ye-glucose

[Inkcazelo]

Courtesy: Pacific Northwest National Laboratory

[Ibhokisi ekwiphepha 9]

Umsebenzi Kadakada

Udakada uphantse alingane nebhanana ngobukhulu, yaye usemva kwesisu. Ngokutsho kwencwadi ethi The Unofficial Guide to Living With Diabetes, “udakada womntu ophilileyo uvelisa i-insulin eyaneleyo ukuze i-glucose esegazini ihlale ikumlinganiselo ofanelekileyo.” I-insulin iveliswa zii-beta cells ezikudakada.

Xa ii-beta cells zingakwazi ukuvelisa i-insulin eyaneleyo, i-glucose iba ninzi egazini, aze umntu abe ne-hyperglycemia. Xa incinane iswekile esegazini kuthiwa umntu une-hypoglycemia. Ukuze sincedise udakada, isibindi sigcina iswekile esegazini ikumlinganiselo ofanelekileyo ngokuguqula i-glucose eseleyo ibe yi-glycogen size siyigcine. Xa ifuneka kwakhona isibindi siphinda siyiguqule ibe yi-glucose.

[Ibhokisi/Umfanekiso okwiphepha 9]

Umsebenzi Weswekile

Abantu abaninzi bacinga ukuba ukutya iswekile eninzi kwenza abantu babe nesifo seswekile. Uphando lwezonyango lubonisa ukuba ukutyeba—kungakhathaliseki ukuba uyitya kangakanani na iswekile—kuyawandisa amathuba okuba nesi sifo kubantu abasesichengeni sokuhlaselwa sesi sifo. Yinyaniso yona into yokuba ukutya iswekile eninzi akukho sempilweni, ekubeni ingenazo izondlo ezininzi yaye inokwenza umntu atyebe ngokugqithiseleyo.

Kwakhona abantu badla ngokucinga ukuba abantu abanesifo seswekile bayithanda gqitha iswekile. Inyaniso kukuba, izinto ezineswekile bazithanda ngokufanayo nabanye abantu. Xa engazinyamekeli kakuhle umntu onesifo seswekile unokulamba—kodwa angalambeli kutya izinto ezineswekile. Abantu abanesifo seswekile banokuzitya iilekese, kodwa kufuneka babe ngcathu kwizinto ezineswekile.

Uphando olwenziwe kutshanje lubonisa ukuba ukutya okuneswekile eninzi—iswekile yeziqhamo nemifuno—kunokubangela i-insulin ingakwazi ukungena kwiiseli inokubangela isifo seswekile nakwizilwanyana, kungakhathaliseki ukuba zinomzimba ongakanani.

[Imizobo/Imifanekiso ekwiphepha 8, 9]

Indlela Elula Yokuchaza Isifo Seswekile

UDAKADA

↓ ↓ ↓

Umntu Ophilileyo I-Type 1 Diabetes I-Type 2 Diabetes

↓ ↓ ↓

↓ ↓ ↓

[Umzobo]

(Ukuba ufuna inkcazelo ehlahlelwe kakuhle, yiya kwimpapasho)

Iseli

I-receptor

I-portal

I-insulin

I-nucleus

I-glucose

[Umzobo]

(Ukuba ufuna inkcazelo ehlahlelwe kakuhle, yiya kwimpapasho)

UMTHAMBO WEGAZI

Iiseli ezibomvu zegazi

I-glucose

[Inkcazelo]

Man: The Complete Encyclopedia of Illustration/J. G. Heck

[Umfanekiso okwiphepha 7]

Kubalulekile ukuba abantu abanesifo seswekile batye ngendlela efanelekileyo

[Imifanekiso ekwiphepha 10]

Abantu abanesifo seswekile banako ukwenza imisebenzi eqhelekileyo