Byinshi wamenya ku ndwara ya diyabete type 2, indwara bita iy’igisukali ishegesha bikomeye imikorere y’umubiri wacu
Kuva mu myaka ya 1990, umubare w’abarwayi ba diyabete by’umwihariko abarwayi ba diyabete y’ubwoko bwa kabiri uragenda wiyongera mu buryo buteye impungenge.
Mu bitera ubwo bwiyongere harimo imibereho y’abantu ituma bahora bicaye, badashishikajwe n’imyitozo ngororamubiri, ubwiyongere bw’ikibazo cy’umubyibuho ukabije, ndetse n’ihumana ry’ibidukikije.
Kugira ngo hagabanywe ingaruka ziterwa na diyabete, bisaba guhindura imibereho, gufata imiti igabanya isukari mu maraso, ndetse no gukoresha insuline aho bikenewe. Kuri ubu, ubushakashatsi burimo gushakisha uko haboneka imiti irushijeho gukora neza, ndetse no kuvura burundu iyi ndwara binyuze mu gusana uturemangingo twa pancreas twangiritse. Ubu bushakashatsi bukaba butanga icyizere.
I.Diyabete ku Isi no mu Rwanda
Mu mwaka wa 2024, abarwayi ba diabète ku isi bari miliyoni 589 (abantu bafite imyaka 20–79), bingana na 11.1% by’abatuye isi.
Biteganyijwe ko aba bazagera kuri miliyoni 853 (13%) mu mwaka wa 2050.
Muri uwo mwaka kandi dabète yahitanye abagera kuri miliyoni 3.4, kandi bane kuri batanu bari mu bihugu bikiri mu nzira y’amajyambere.
Mu gihugu cyacu, mu bantu 100 bakuru, 3 cyangwa 4 baba barwaye diyabete nk’uko bigaragara mu makusanyirizo y’amakuru ya WHO (OMS).
II.Diyabete ni iki ?
Diyabete ni indwara iterwa n’uko isukari (glucose) yo mu maraso iba nyinshi kurusha ibisanzwe, bitewe n’uko umubiri udakora cyangwa udakoresha neza umusemburo wa insuline ufasha gukwirakwiza isukari mu turemangingo ( reba inkuru iheruka ku isukari)
Ubwoko bwa diyabete
1. Diabète y’ubwoko bwa 1
Iterwa n’uko umubiri udakora insuline na gato. Akenshi itangira mu bwana cyangwa mu buto. Uwayirwaye aba agomba gufata insuline buri munsi.
2. Diabète y’ubwoko bwa 2
Iki gihe umubiri ukora insuline ariko ntikora neza (insulin resistance). Iyi niyo ikunze kugaragara kandi niyo turi bugarukeho muri iyi nkuru.
3. Diabète Gestationnelle
Igaragara ku bagore batwite, ishobora kuzimira nyuma yo kubyara.
Iyo ititaweho, ishobora kugira ingaruka ku mwana n’umubyeyi.
III.Kwangirika kwa pancreas,imvubura (glande) itanga insuline intandaro ya diyabete y’ubwoko bwa kabiri ku muntu
Diabète Type 2 iterwa n’uko umubiri utakira insuline neza (insulin resistance), cyangwa ukayikora mu rugero ruto. Ibi bituma isukari iguma mu maraso aho kwinjira mu turemangingo, bigatera ingaruka ku mikorere y’umubiri.
Ibi byose bikaba biterwa n’ibibazo bivuka mu mikorere ya pancreas isanzwe ivubura umusemburo wa insuline.
Dore uko bigenda
Insulin resistance ni igihe uturemangingo tw’umubiri tutakira insuline neza, bityo isukari ntibe igishoboye kwinjira turemangingo uko bikwiye, igasigara mu maraso. Muri make amabwiriza insulin itanga ku turemangingo yo gukoresha isukari ntiyakirirwa na turiya turemangingo, duhitamo kwinangira ku mpamvu zinyuranye tubona hasi.
Pancreas iyo ibonye bimeze bityo, uturemangingo twinangiye ntitwakire sukari ya ngombwa, itangira gukora insuline nyinshi kugira ngo irebe ko ya sukari yabaye nyinshi yagabanuka.
Iki gihe cy’igerageza rya pancreas ngo ibe yareba ko igipimo cya sukari cyagabanuka mu maraso nicyo bita mu gifransa phase de compensation: umubiri uba ukigerageza kwirwanaho.
Nyamara Igihe resisatnce ikomeje igihe kirekire Pancreas nayo ikomeza gukora ubutaruhuka ngo haboneke insuline ku kigero cyo hejuru. Ibi bituma uturemangingo twayo tugenda twangirika buhoro buhoro bikagabanya ubushobozi bwayo bwo gukora insulin.
Ingaruka nuko isukari iguma mu maraso kubera ko nta insulin ihagije cyangwa ntikore neza.
Muri make Insulin resistance ni intambwe ya mbere iganisha kuri Diabète Type 2. Iyo itamenyekanye hakiri kare, pancreas irananirwa, igatangira gukora insuline nke, bityo isukari ikiyongera mu maraso.
IV.Impamvu zitera insulin resistance
1. Umubyibuho ukabije (obésité abdominale)
Ibinure byinshi, cyane cyane ibiri mu nda, bituma uturemangingo twangirika,bikagabanya ubushobozi bwo kwakira insuline.
2. Imirire mibi
Kurya ibiribwa bikungahaye ku isukari nyinshi, amavuta menshi, n’ibinyamasukari byatunganyijwe (nk’imigati y’umweru, ibisuguti, ibinyobwa bisembuye).
3. Kubura imyitozo ngororamubiri
Kudakora siporo bituma glucose idakoreshwa neza, bityo igasigara mu maraso.
4. Stress ihoraho
-Stress ituma umubiri ukora imisemburo nka cortisol, ishobora kwangiza uburyo insuline ikora.
5. Imiterere y’imiryango (génétique)
Kuba hari ababyeyi cyangwa abavandimwe bayirwaye bishobora gutuma uturemangingo tw’umubiri tutakira insuline uko bikwiye.
6. Imyaka n’imihindagurikire y’umubiri
Uko umuntu agenda akura, uturemangingo tw’umubiri tugenda tunanirwa kwakira insuline.
V.Izindi mpamvu zishobora gutuma pancreas ivubura insuline nke biganisha kuri diyabete
Diabète Type 2 si ingaruka y’insulin resistance yonyine. Hari n’izindi mpamvu zituma pancreas itakaza ubushobozi bwo gukora insuline
1. Kwangirika kwa cellules bêta
Cellules bêta ni uturemangingo two muri pancreas dukora insuline.
Izi cellules zishobora kwangirika buhoro buhoro bitewe n’inflammation ihoraho, oxidative stress, cyangwa uburwayi bw’imisemburo.
Iyo zangiritse, ubushobozi bwa pancreas bwo gukora insuline buragabanuka.
2. Imiterere y’imisemburo y’umubiri
Hari igihe imisemburo nka glucagon, cortisol, cyangwa adrenaline ikora cyane, igatuma insuline idakora uko bikwiye.
Ibi bishobora guterwa na stress ihoraho, indwara z’imisemburo, cyangwa imihindagurikire y’umubiri.
3. Indwara zifata pancreas
Pancréatite chronique (kwangirika kwa pancreas) ishobora gutuma pancreas itakaza ubushobozi bwo gukora insuline.
Kanseri ya pancreas nayo ishobora kwangiza cellules bêta.
Infection cyangwa trauma (nk’impanuka) ishobora kwangiza pancreas.
4. Imyaka n’imihindagurikire y’umubiri
Abakuze bashobora kugira impinduka mu mikorere y’imisemburo, bigatuma pancreas ikora insuline nke.
Ibi biterwa n’uko uturemangingo tw’umubiri tugenda tunanirwa kwakira insuline, bityo pancreas ikarushaho kunanirwa.
5. Imiterere y’imiryango (génétique)
Hari abantu bafite ubushobozi buke bwa pancreas bwo gukora insuline kuva bavuka.
– Ibi biterwa n’imiterere y’imyandikire y’imisemburo (gènes), bigatuma bagira ibyago byinshi byo kurwara Diabète Type 2.
VI.Ibyongera ibyago byo kurwara diyabete ( facteurs du risque)
Dore bimwe mubyongera ibyago byo kuba umuntu yarwara diyabete.
1. Umubyibuho ukabije (Obésité)
Cyane cyane ibinure biri mu nda (obésité abdominale) bifitanye isano ikomeye na insulin resistance.
Ibinure byinshi bituma uturemangingo tutakira insuline uko bikwiye.
2. Imirire mibi
Kurya ibiribwa bikungahaye ku isukari nyinshi, amavuta menshi, n’ibinyamasukari byatunganyijwe (refined sugars).
Kunywa ibinyobwa birimo sucre nyinshi (sodas, jus zidasukuye).
3. Kubura imyitozo ngororamubiri
Kudakora siporo bituma umubiri utabasha gukoresha isukari uko bikwiye.
Imyitozo ifasha uturemangingo kwakira insuline no kugabanya ibinure.
4. Imiryango (génétique)
Kuba hari ababyeyi cyangwa abavandimwe bayirwaye byongera ibyago byo kuyirwara.
Imiterere y’imisemburo ishobora kuba yaranditswe mu myandikire y’umubiri (gènes).
5. Imyaka
-Abantu bafite imyaka irenge 40 bafite ibyago byinshi, ariko n’abato bashobora kuyirwara bitewe n’imibereho mibi.
6. Stress ihoraho
Stress ituma umubiri ukora imisemburo nka cortisol, ishobora gutuma insuline idakora neza.
7. Indwara z’imisemburo
Nko kwangirika kwa pancreas, hypothyroïdie, cyangwa indwara zifata uturemangingo dukora insuline.
8. Kunywa itabi n’inzoga nyinshi
Ibi bishobora kwangiza uturemangingo tw’umubiri, bikagira ingaruka ku mikorere ya pancreas.
9. Kubyara abana bafite ibiro byinshi
Ku bagore babyaye abana bafite ibiro birenze 4kg, cyangwa bagize diabète gestationnelle, bafite ibyago byinshi byo kurwara Diabète Type 2 nyuma.
VII.Ibimenyetso ku murwayi wa diyabete n’inkomoko yabyo.
1. Kunywa amazi menshi & kwihagarika kenshi
Iyo isukari iri hejuru mu maraso, umubiri ugerageza kuyikuramo binyuze mu kwihagarika.Ibi bituma umuntu agira inyota cyane, kuko umubiri utakaza amazi menshi.
2. Kugira inzara idasanzwe Nubwo isukari iba iri mu maraso, uturemangingo ntitubasha kuyikoresha kubera kubura insuline.
Umubiri utekereza ko nta ngufu zihari, bityo ukongera gutuma umuntu agira inzara.
3. Kugabanuka kw’ibiro
Umubiri utabasha gukoresha glucose, utangira gukoresha ibinure n’imikaya nk’ingufu.Ibi bituma umuntu agabanya ibiro, nubwo aba arya.
4. Kumva unaniwe cyane
Uturemangingo ntitubona glucose yo gukoresha, bityo umubiri ubura ingufu, bigatera umunaniro.
5. Kutabona neza
Isukari nyinshi mu maraso ishobora gutuma amaraso yinjira mu turemangingo tw’amaso, bigatuma umuntu ajijwa.
6. Ibisebe bidakira vuba
Isukari nyinshi ibangamira imikorere y’uturemangingo dusana ibisebe, kandi igatuma amaraso atembera nabi.
7. Kwishimagura & infections zigaruka
Isukari nyinshi ituma uruhu rwuma, kandi igatuma microbes zikura vuba, bigatera infections zigaruka.
VIII.Ibipimo by’isukari mu maraso (glycémie) y’urwaye diyabete
Umuntu urwaye diabète aba afite isukari iri hejuru y’ibisanzwe, haba utariye cyangwa nyuma yo kurya. Kugenzura ibi bipimo kenshi bifasha kumenya uko uburwayi buhagaze no gufata imiti ikwiye.
1. Glycémie à jeun (isukari mu maraso utariye)
-Umuntu utarwaye: hagati ya 70–99 mg/dL
-Prédiabète: hagati ya 100–125 mg/dL
-Diabète: 126 mg/dL cyangwa hejuru, inshuro ebyiri zikurikiranye
2. Glycémie postprandiale (isukari nyuma yo kurya, nyuma y’amasaha 2)
-Umuntu utarwaye: munsi ya 140 mg/dL
-Diabète: hejuru ya 200 mg/dL
3. HbA1c (Hemoglobine glyquée):igipimo cy’isukari mu mezi 2–3 ashize
– Umuntu utarwaye: munsi ya 5.7%
– Prédiabète: hagati ya 5.7%–6.4%
– Diabète: 6.5% cyangwa hejuru
IX.Hypoglycemie ku murwayi wa diyabete
Umurwayi wa diyabete ashobora kugira hypoglycemi.Nii ukuvuga igipimo cy’isukari mu maraso kiri hasi cyane. Ibi bishobora kuba mugihe:
1.Gufata insuline cyangwa imiti igabanya isukari: Iyo uyifashe nturye bihagije cyangwa utinze kurya, isukari mu maraso iragabanuka cyane.
2.Imyitozo ngororamubiri ikabije: Imyitozo ikoresha ingufu nyinshi ishobora gutuma isukari ikoreshwa vuba, igashyira vuba mu mubiri.
3.Kurya gake cyangwa gusiba ifunguro: Iyo umurwayi asiba ifunguro cyangwa arya bike, ntihaboneka isukari ihagije yo kwinjira mu maraso.
4.Kunywa inzoga: Inzoga ishobora kubangamira uburyo umubiri ubika isukari, bigatuma igipimo cyayo kigabanuka.
Ibimenyetso bya hypoglycemie
– Kugira isereri cyangwa gucika intege
– Kubira ibyuya byinshi
– Gutitira cyangwa kugira ubwoba butunguranye
– Kunanirwa gutekereza neza
– Kugwa igihumure (mu gihe bikabije)
Icyo wakora
– Kurya ibintu birimo isukari vuba (nka jus y’imbuto, isukari y’amazi, cyangwa bombo)
– Guhita ushaka ubufasha bwa muganga niba bikomeje.
X.Ibice by’umubiri diyabete yibasira
1.Impyiko (Reins): Diyabete ishobora kwangiza impyiko ikabyara insuffisance rénale.
2. Amaso: Ishobora gutera retinopathie diabétique igatuma umuntu ahuma.
3.Imyakura (nerfs): Diyabete yangiza imyakura , bikaba intandaro y’uburibwe, kudakora kw’ibice by’umubiri, cyangwa neuropathie.
4.Umutima n’imitsi y’amaraso: Diyabete izamura ibyago byo kurwara umutima, stroke, n’indi ndwara y’imitsi.
5. Ibirenge: Kubura amaraso n’imitsi bikora neza bishobora gutuma ibirenge bibora, bikaba byanakurwaho.
XI.Kuremba k’umurwayi wa diyabete (complication)
Umurwayi warembye wa diyabete ashobora kugira:
1 Coma ya diyabete:
Diabetic ketoacidosis (DKA): Iyo umubiri ubura insulin, ugakoresha ibinure bikabyara aside nyinshi mu maraso, bikaba byaviramo uyurwaye kujya muri coma.
2.Hyperosmolar hyperglycemic state (HHS): Isukari nyinshi cyane mu maraso ituma umubiri utakaza amazi menshi, bikaviramo gutakaza ubwenge.
3.Hypoglycemia: Iyo isukari igabanutse cyane, umuntu ashobora kugwa mu koma.
XII.Uko bita ku murwayi wa Diabète Type 2 (Prise en charge)
Kwitaho umurwayi wa diabète bisaba uburyo bwuzuye bwo guhindura uburyo bw’imibereho (hygiene de vie)
1.Kurya indyo iboneye: imboga, imbuto, ibinyamisogwe, fibre nyinshi.
2.Kugabanya isukari, amavuta menshi, n’ibiribwa byatunganyijwe cyane (byo mu nganda) .
3.Gukora imyitozo ngororamubiri buri munsi.
4.Kwirinda stress, itabi, n’inzoga nyinshi.
5.Gufata imiti igabanya isukari (antidiabétiques oraux)
Harimo imiti ifasha insuline gukora neza cyangwa igabanya isukari mu maraso.Iyi miti genwa n’umuganga hakurikijwe uko uburwayi buhagaze.
6. Gukoresha insuline (aho bikenewe)
Iyo pancreas itagikora insuline ihagije, umurwayi ashobora guhabwa insuline yo hanze.
7.Gukurikirana uburwayi (suivi médical)
-Gupima isukari mu maraso kenshi (glycémie).
-Gupima HbA1c buri mezi 3 kugira ngo hamenyekane uko isukari ihagaze mu gihe kirekire.
– Kugenzura ibindi bice by’umubiri bishobora kwangirika: amaso, ibirenge, impyiko.
8. Guhabwa ubujyanama n’ubumenyi ku ndwara
– Kwigishwa uko diabète ikura, uko wayirinda, n’uko wayitaho mu buzima bwa buri munsi.
– Guhabwa inama ku mirire, siporo, n’imyitwarire ikwiye.
XIII.Imivurure ya Diabète mu gihe kizaza
Muri iki gihe ubushakashatsi burimo gutanga icyizere cyinshi ku buryo bwo gufasha abarwayi kurushaho kubaho neza, ndetse no kushaka uko indwara yavurwa burundu. Dore aho ibintu bigana:
1. Guteza imbere imiti ikora neza kurushaho
-Harimo antidiabétiques oraux bashyiramo imisemburo ifasha uturemangingo kwakira insuline neza.
-Hari imiti mishya ifasha pancreas gukora insuline mu buryo bwihuse kandi butavuna.
2. Gukoresha insuline yihindura ku buryo bw’umubiri
– Harimo insuline intelligente: ikora bitewe n’uko isukari iri mu maraso ihagaze.
– Iyi insulin izajya ikora gusa iyo ikenewe, ikagabanya ibyago byo kugabanuka kw’isukari (hypoglycémie).
3. Regénération ( gusana) ya cellules bêta
– Abashakashatsi barimo kugerageza gusana uturemangingo twa pancreas twangiritse, kugira ngo tubashe kongera gukora insuline.
4. Imiti y’uturemangingo tw’ubwenge (nanotechnologie)
– Hari ibikoresho bito cyane bishobora gupima isukari mu maraso no gutanga insuline mu buryo bwikora.
– Ibi bizafasha abarwayi kudakenera kwipima kenshi cyangwa kwitera insuline buri gihe.
5. Imiti ivura diabète burundu (curative therapies)
– Ubushakashatsi burimo kwiga uko guhindura imisemburo y’umubiri cyangwa guhindura ADN byavura diabète burundu.
– Nubwo bikiri mu igeragezwa, ibyavuye mu bushakashatsi biratanga icyizere.
Mu gihe kizaza,birashoboka ko umurwayi wa diabète ashobora kuzabaho atagomba kwitera insuline buri munsi, cyangwa akavurwa burundu binyuze mu gusana pancreas. Ibi bizahindura ubuzima bw’abarwayi ku isi hose.
XIV.Inama ku barwayi n’abarwaza ba diyabete
Diyabete si indwara y’umuntu ku giti cye gusa, ahubwo isaba ubufatanye hagati y’umurwayi, umuryango, n’abaganga. Inama nziza ni inkingi yo kubaho neza n’ubuzima burambye.
Inama ku barwayi
– Kurya indyo iboneye: imboga, imbuto, ibinyamisogwe, ibiribwa bifite fibre nyinshi; kwirinda isukari nyinshi n’amavuta menshi.
– Gukora siporo buri munsi: nko kugenda n’amaguru, kwiruka buhoro, koga, cyangwa kwikorera imirimo yo mu rugo.
– Kwipimisha isukari kenshi: kumenya uko ihagaze, cyane cyane mbere na nyuma yo kurya.
– Gufata imiti uko yagenwe: ntukayihagarike cyangwa ngo uyihindure utabibwiwe n’umuganga.
– Kwita ku birenge: kwirinda ibisebe, kwambara inkweto nziza, no gusukura neza.
– Kwirinda stress: kuko ishobora gutuma isukari izamuka.
Inama ku barwaza (abafasha umurwayi)
– Kumuba hafi mu buzima bwa buri munsi: kumufasha kwibuka gufata imiti, kumuherekeza kwipimisha.
– Kumushyigikira mu guhindura imibereho: kumufasha gutegura indyo iboneye, kumushishikariza siporo.
– Kumwumva no kumutega amatwi: kuko diyabete ishobora gutera impungenge n’umubabaro w’amarangamutima.
– Kumenya ibimenyetso by’isukari iri hejuru cyangwa iri hasi: kugira ngo bafate ingamba vuba.
– Kujya kumwe mu biganiro by’ubujyanama: kugira ngo bamenye uko bafasha umurwayi mu buryo bw’umwuga.
Twifashishije: www.idf.org na www.ameli.fr
Inkuru bifitanye isano:
Umwanditsi: Musengimana Emmanuel