Sɛ wowɔ asikreyare mpo a, wubetumi awo akokoaa a ɔwɔ apɔwmuden? (Diabetes in Pregnancy) Momma yɛnka eyi ho asɛm!

Hɛlo! Sɛ worehwɛ akokoaa kwan nnansa yi, titiriw sɛ wowɔ asikreyare a, ebia nsɛmmisa ne ehu pii wɔ w’adwene mu, ɛnte saa? "Oh, so ɔhaw bɛba akokoaa no so bere a mewɔ asikreyare no?" "So wɔbɛhwɛ eyi so yiye?" Ebia woredwen nneɛma a ɛte saa ho. Mma ɛnhaw wo, ɛnyɛ wo nko ara. Ɛnanom pii hyia saa tebea yi. Nea ɛho hia paa ne sɛ, sɛ wote aduruyɛ mu afotu ase yiye na wudi akyi a, wo nso wubetumi awo akokoaa a ɔwɔ apɔwmuden. Momma yɛnka eyi ho asɛm nkɔ akyiri kakra, ɛnte saa?

Ɔkwan bɛn so na asikreyare ka nyinsɛn?

Sɛ yɛbɛka no tiawa a, sɛ wowɔ asikreyare a ɛto so 1 anaa Ɔkwan 2 ansa na woanyinsɛn a, wɔfrɛ no "asikreyare a ɛba ansa na nyinsɛn no." Eyi yɛ soronko wɔ nyinsɛn mu asikreyare a ɛba bere a wɔyem no ho. Mpɛn pii no, nyinsɛn mu asikreyare kɔ bere a woawo akokoaa no akyi.

Sɛ wowɔ asikreyare dedaw a, asikre dodow a ɛwɔ wo mogya mu a wobɛhwɛ so bere a wonyinsɛn no betumi ayɛ asɛnnennen kakra. Wunim dɛn? Wɔ nyinsɛn mu no, yɛn hormone ahorow sesa kɛse. Ɛdenam saa nsakrae no so no, ebia ɛho behia sɛ wosakra w’aduan, apɔw-mu-teɛteɛ, ne nnuru a wode di dwuma mpo. Mpɛn pii no, ɛho behia sɛ wɔsesa asikreyare ho nhyehyɛe yi mpɛn pii kosi da a wobɛwo wo ba no. Enti, ɛho hia yiye sɛ wo ne w’aduruyɛfo kuw no kasa daa na woka wo tebea no ho asɛm kyerɛ wɔn. Ɛno ansa na wobetumi asi ayaresa pɔtee a wuhia ne sɛ ebia ɛsɛ sɛ wosakra no ho gyinae.

Nanso kae eyi nso, asikreyare a wubenya no nkyerɛ sɛ wuntumi nwo akokoaa a ɔwɔ apɔwmuden. Ɛyɛ den kakra, nanso ɛnyɛ nea entumi nyɛ yiye. W’aduruyɛfo kuw no wɔ hɔ sɛ wɔbɛboa wo.

So asikreyare a ɛto so 1 yɛ nyinsɛn tebea a asiane kɛse wom?

Yiw, asikreyare a ɛto so 1 ne asikreyare a ɛto so abien ma asiane a ɛwɔ hɔ sɛ obenya nsɛnnennen wɔ nyinsɛn mu no yɛ kɛse. Enti, wo awo ho ɔyaresafo no bɛhwɛ wo ba no akwahosan ne asikre dodow a ɛwɔ wo mogya mu yiye wɔ wo nyinsɛn no nyinaa mu na ama woahwɛ ahu sɛ worekɔ so ayɛ nea ɛfata. Sɛ wo mogya mu glucose dodow kɔ so yɛ kɛse dodo anaasɛ ɛba fam dodo a, ebetumi ayɛ asiane na ɛde nsɛnnennen aba.

Mpɛn pii no wo ne ɛna ne awotwaa mu aduruyɛ ho ɔbenfo (MFM) bɛyɛ adwuma. Wɔ wo awo ho oduruyɛfo akyi no, ebia w’aduruyɛfo kuw no bi ne:

• Endocrinologist: Ɔyɛ nyarewa a ɛfa hormone ho ho ɔbenfo.
• Aduan ho ɔbenfo a wɔakyerɛw ne din: Obi a obetumi aboa ma wɔadi asikreyare so na ɔde akwankyerɛ ama wɔ adidi pa ho wɔ nyinsɛn mu.
• Asikreyare ho ɔkyerɛkyerɛfo: Oduruyɛfo titiriw a ɔwɔ ntetee ne nimdeɛ kɛse wɔ asikreyare ho dwumadie mu.

Ɔkwan bɛn so na obi a ɔwɔ asikreyare betumi asiesie ne ho ama nyinsɛn?

Sɛ wowɔ asikreyare na worebɔ mmɔden sɛ wobɛwo akokoaa a, ade a edi kan a ɛsɛ sɛ woyɛ ne sɛ wo ne wo duruyɛfo bɛkasa. Ɛyɛ papa sɛ wobɛka eyi ho asɛm bɛyɛ asram asia ansa na woafi ase abɔ mmɔden sɛ wobɛwo akokoaa.

Ɛho hia sɛ wohwɛ asikre dodow a ɛwɔ wo mogya mu so yiye ansa na woanyinsɛn. Botae a ɛwɔ nyinsɛn mu ne sɛ wobɛma wo mogya mu glucose dodow akɔ so ayɛ ketewaa koraa. Ebetumi ayɛ den kɛse mpo sɛ wobɛkɔ so akura eyi mu bere a woanyinsɛn akyi.

Akwankyerɛ pii kamfo kyerɛ sɛ ma wo A1C nkɔ so nyɛ 6.5% anaa nea ɛba fam ansa na woanyinsɛn . Eyi yɛ nea ɛbɛma asiane a ɛwɔ hɔ sɛ wubenya nsɛnnennen no so atew. So wunim? Akokoaa no akwaa ne ntini afoforo a ɛho hia fi ase yɛ wɔ nyinsɛn no fã a edi kan no mu. Sɛ asikre dodow a ɛwɔ wo mogya mu kɔ so yɛ kɛse wɔ saa bere no mu a, ebetumi aka akokoaa no nkɔso.

Sɛ wo ne w’aduruyɛfo kuw no hyia ansa na woabɔ mmɔden sɛ wobɛwo akokoaa a, ɛwɔ mfaso horow a edidi so yi:

• Nnuruyɛfo betumi akamfo akwan a wobɛfa so aboa ma asikre dodow a ɛwɔ wo mogya mu no ayɛ nea ɛfata.
• Aduan ho ɔbenfo betumi aboa wo ma woayɛ aduan ho nhyehyɛe a ɛfata ma nyinsɛn ne asikreyare ano aduru.
• Ebia ɛho behia sɛ wosesa asikreyare aduru bere a woanyinsɛn awie no.
• Ebia wubetumi ayɛ wo su sɛ wode asikreyare ho mfiridwuma foforo (sɛ nhwɛso no, glucose monitor a ɛkɔ so - CGM) a ebetumi aboa titiriw wɔ nyinsɛn mu bedi dwuma.
• Ebia wo duruyɛfo bɛkamfo akyerɛ wo sɛ wɔnhwɛ w’ani (asiane a ɛwɔ hɔ sɛ wubenya aniwa mu yare), w’asaabo (asiane a ɛwɔ hɔ sɛ wubenya ahurututu mu yare), ne wo koma mu ansa na woanyinsɛn, efisɛ ɛtɔ mmere bi a nyinsɛn betumi asɛe anaasɛ ɛde nsɛnnennen foforo a efi asikreyare mu aba.

Ɔkwan bɛn so na asikreyare a mede di dwuma no bɛsakra bere a manyinsɛn no?

Nneɛma atitiriw pii wɔ hɔ a ɛka sɛnea wudi asikreyare ho dwuma bere a wonyinsɛn no:

• Hia a ehia sɛ wɔma mogya mu glucose dodow kɔ so yɛ ketewaa bi na ama asiane a ɛwɔ hɔ sɛ nyinsɛn mu nsɛnnennen bɛba no so atew.
• Nsakrae a wɔbɛyɛ wɔ insulin ahiade a ɛresakra ho.
• Aduan pa a wohia wɔ nyinsɛn mu a wobedi ho dwuma denam asikre dodow a wɔbɛma ayɛ pɛ wɔ mogya mu no so.

Mogya mu asikre a wɔde si wɔn ani so bere a wɔyem asikreyare no

Mpɛn pii no, asikre dodow a ɛnanom a wɔyem a wɔwɔ asikreyare de wɔn ani si so ne nea edidi so yi:

• Mmuadadi: Ennu 95 mg/dL
• Dɔnhwerew biako wɔ adidi akyi: Ennu 140 mg/dL
• Nnɔnhwerew abien wɔ adidi akyi: ennu 120 mg/dL

Ɔkwan foforo so no, wobetumi asusuw saa botae ahorow yi ho sɛ `bere a ɛwɔ akyirikyiri (TIR)`. Mpɛn pii no, `TIR` botaeɛ a ɛwɔ hɔ ma mpaninfoɔ a wɔwɔ asikreyareɛ `Type 1` wɔ nyinsɛn mu ne:

• Anyɛ yiye koraa no, 70% wɔ bere a ɛda 63 ne 140 mg/dL ntam (wɔ botae no mu) .
• Bere a ennu 5% wɔ 63 mg/dL ase
• Ennu 25% wɔ bere a ɛboro 140 mg/dL so

Akwankyerɛ dodow no ara kamfo kyerɛ bere a wɔyem noSɛ wokura `A1C` boɔ a ɛba fam 6% a, ɛbɛtumi atew asiane a ɛwɔ nsɛnnennen mu no so.

Esiane botae ahorow a emu yɛ den yi nti, ebia wo duruyɛfo bɛkamfo akyerɛ sɛ fa afiri a wɔde hwɛ glucose a ɛkɔ so (CGM) di dwuma bere a wonyinsɛn no. Sɛ́ anka wode nsateaa bedi dwuma no, CGM ma wuhu sɛnea wo glucose dodow resakra bere tenten no ho mfonini pa, na ɛma ɛyɛ mmerɛw sɛ wobɛyɛ nsakrae a ɛfata wɔ wo asikreyare ho dwumadie mu.

Sɛ wobɛkɔ so akura asikre a ɛwɔ wo mogya mu a ɛyɛ teateaa yi mu a, ebehia sɛ wudi akwan horow pii akyi:

• Fa ahwɛyiye kan carbohydrates dodow a ɛwɔ w’aduan ne nnɔkɔnnɔkɔwade mu.
• Insulin a wobɛnom simma 10-15 ansa na woadi (anaasɛ ansa na woadi mpo).
• Apɔw-mu-teɛteɛ a wɔde bedi dwuma de ahyɛ asikre dodow a ɛwɔ mogya mu no so.

Wo duruyɛfo no ne wo bɛkasa afa akwan yi ne akwan afoforo a wɔfa so yɛ adwuma no ho.

Insulin a wohia a ɛsakra bere a wɔyem no

Hwɛ kwan sɛ ɛsɛ sɛ wo insulin sesa mpɛn pii bere a wonyinsɛn no. Eyi fi hormone ahorow a ɛwɔ wo nipadua mu titiriw. Sɛnea asikreyare ka obiara wɔ ɔkwan soronko so no, saa ara na nyinsɛn nso te. Enti, ɛho hia sɛ wo ne w’aduruyɛfo kuw no yɛ adwuma yiye de yɛ nsakrae biara a ɛho hia wɔ wo asikreyare ano aduru nhyehyɛe no mu. Saa nsakrae yi bɛyɛ soronko ama wo ne w’ahiade ahorow.

Sɛ wowɔ asikreyare a ɛto so 1 a, ɛtaa ba sɛ wubehia insulin kakraa bi wɔ ɔsram abiɛsa a edi kan no mu – nanso ɛnyɛ obiara na wuhia. Bɛyɛ nyinsɛn no dapɛn a ɛto so 16 no, insulin a ehia fi ase kɔ soro. Nea enti a ɛte saa ne sɛ awotwaa no yɛ nkwaadɔm a ɛma insulin a ɛko tia no yɛ kɛse. Eyi si wɔ nyinsɛn nyinaa mu, ɛnyɛ wɔn a wɔwɔ asikreyare nkutoo mu.

Ɛda adi sɛ wubehia insulin pii kosi nyinsɛn no dapɛn a ɛto so 36 anaa 37. Saa bere no, insulin a wɔko tia no taa yɛ nea ɛyɛ den. Ebia nnipa pii behia insulin dodow a wɔnom ansa na wɔrenyinsɛn no mmɔho abien kosi abiɛsa.

Wo ne wo duruyɛfo bɛyɛ adwuma de ayɛ nsakrae biara a ɛho hia wɔ insulin mu bere a wonyinsɛn no. Ebia eyi bi ne:

• Wo `basal` anaa insulin a ɛyɛ adwuma bere tenten (akyi) (`insulin a ɛyɛ adwuma bere tenten`) .
• Insulin ne carb ntam nsonsonoe (ICR) .
• Nneɛma a ɛma insulin te nka (ISF) .

Nea ɛho hia no, sɛ wɔde awotwaa no ma pɛ a, insulin a wuhia no so bɛtew kɛse. Wɔ bɛyɛ simma 30 akyi bere a wɔde awotwaa no awo no, wo insulin ahiade no bɛsan akɔ nea na ɛwɔ hɔ ansa na woanyinsɛn no so – anaasɛ ɛbɛba fam mpo. Wo duruyɛfo no ne wo bɛkasa afa sɛnea wobɛsakra insulin a wode ma bere a woawo awie no ho. Ɛho hia sɛ wonya nhyehyɛe ma eyi.

Asikreyare ne aduan a wohia wɔ nyinsɛn mu

Aduan pa ho hia yiye ma nyinsɛn a ahoɔden wom. Aduan a nyinsɛn mu aduannuru a wɔbɛkari pɛ na asikre dodow a ɛwɔ mogya mu no a wɔbɛkɔ so ayɛ ketewaa no betumi ayɛ anifere kakra. Sɛ wo ho yɛ wo yaw ne/anaasɛ wofe bere a woanyinsɛn a, ebetumi ayɛ den kɛse mpo.

Aduan ho ɔbenfo a wɔakyerɛw ne din a ne ho akokwaw wɔ mmea a wɔyem a wɔwɔ asikreyare ho betumi aboa wo ma woayɛ aduan ho nhyehyɛe. Wɔbɛkyerɛ wo kwan wɔ `macronutrients` (aduannuru atitiriw) dodow a ɛsɛ sɛ wudi da biara da ho. Ebia wɔn nyansahyɛ ahorow no bɛyɛ soronko wɔ nyansahyɛ ahorow a wɔde ma mmea a wɔyem a wonni asikreyare no ho. Wɔbɛkamfo nnuan ne nnuan nketenkete a ɛkari pɛ wɔ `macronutrients` mu nso aboa ma asikre dodow a ɛwɔ mogya mu no akɔ so ayɛ den.

Asikreyare a Ɛto so 1 a Wɔhwɛ So Bere a Wɔyem

Nnipa pii a wɔwɔ asikreyare a ɛto so 1 hu sɛ wɔn insulin ahiade taa sesa – mpɛn pii no dapɛn biara – wɔ nyinsɛn mu. Sɛ wohwɛ wo glucose dodow yiye na wuhu nneɛma a ɛrekɔ so a, ebetumi aboa wo ne wo duruyɛfo ma moayɛ nsakrae a ɛfata wɔ mo ayaresa nhyehyɛe no mu.

Sɛ worenom nnuru pii a wɔde twitwiw wo da biara da (MDI) a, ebia wo duruyɛfo bɛkamfo akyerɛ sɛ dan kɔ insulin pɔmpɛ so na ama woatumi ayɛ nsakrae kɛse wɔ wo insulin nhyehyɛe mu. Nanso, wubetumi akɔ so anya nyinsɛn a ahoɔden wom denam MDI so. Sɛ na worenom nnuru afoforo ansa na worenyinsɛn a, hwɛ hu sɛ mobɛbɔ ho nkɔmmɔ sɛ ebia mubetumi akɔ so de saa nnuru no adi dwuma bere a wonyinsɛn no anaa.

Sɛnea ɛte daa no, ɛho hia sɛ wodi asikre a ɛdɔɔso wɔ mogya mu ne asikre a ɛba fam wɔ mogya mu no ho dwuma ntɛm. Sɛ wotaa nya asikre a ɛwɔ wo mogya mu a ɛkɔ soro ne/anaasɛ ɛba fam a, wo ne wo duruyɛfo nkasa.

Asikreyare a Ɛto so 2 a Wobedi Ho Adi Bere a Wɔyem

Nnuru dodow no ara a wɔnom ne nea ɛnyɛ insulin a wɔde twitwiw asikreyare a ɛto so abien mu no mfata sɛ wɔde di dwuma bere a wɔyem no. Nea ɛka ho nkutoo ne metformin. Enti, ebia ebehia sɛ wode insulin di dwuma nea edi kan na ama asikre dodow a ɛwɔ wo mogya mu no ahwɛ so bere a wonyinsɛn no. Afei nso, insulin a wuhia no betumi ayɛ kɛse bere a wo nyinsɛn no kɔ so no.

W’aduruyɛ kuw no ne wo bɛyɛ adwuma abɛn de ayɛ nhyehyɛe a wɔde bedi dwuma. Sɛ womfa bi nni dwuma dedaw a, ebia wɔbɛkamfo akyerɛ sɛ fa CGM (continuous glucose monitor) di dwuma.

Dɛn na wubetumi ahwɛ kwan wɔ nyinsɛn a asikreyare wom no mu?

Sɛ wowɔ asikreyare a, wubetumi ahwɛ kwan sɛ wobɛkɔ akɔsra wo ansa na woawo na wɔayɛ nhwehwɛmu pii asen sɛnea anka wobɛyɛ wɔ nyinsɛn a ɛfata mu. Eyi te saa sɛnea ɛbɛyɛ a nea ɔhwɛ wo ba ansa na wɔawo no betumi ahwɛ sɛnea wo ba no nyin ne w’akwahosan nyinaa yiye. Wɔ nhwehwɛmu a wɔtaa yɛ ansa na wɔawo (te sɛ mogya mu nhwehwɛmu ne nipadua mu nipadua mu nhwehwɛmu) akyi no, wubetumi nso ahwɛ nhwehwɛmu "a ɛboro so" yi kwan:

• Fetal echocardiogram: Ebia wo duruyɛfo bɛkamfo nhwehwɛmu yi akyerɛ sɛ wɔmfa nhwɛ sɛnea wo ba no koma te, efisɛ asikreyare a obi nya no ma asiane a ɛwɔ hɔ sɛ obenya komayare a efi awo mu no yɛ kɛse.
• Onyin ho mfonini (ultrasounds): Ebia wo duruyɛfo bɛkamfo akyerɛ sɛ wɔnyɛ mfonini adapɛn kakraa biara de hwɛ sɛnea wo ba no nyin. Eyi ho hia titiriw efisɛ asiane kɛse wɔ hɔ sɛ wo ba no bɛyɛ kɛse asen sɛnea ɛte daa. Nanso kae sɛ saa ultrasound ahorow yi yɛ akontaabu ara kwa. Ebia wo ba no bɛyɛ kɛse anaa ketewaa sen sɛnea scan no kyerɛ no.
• Nhwehwɛmu a ɛnyɛ adwennwen (NST): Wɔ nyinsɛn no fã a ɛto so abiɛsa mu no, ebia wo duruyɛfo bɛkamfo NST a wɔyɛ no dapɛn biara akyerɛ wo. Saa nhwehwɛmu ahorow yi hwɛ sɛnea akokoaa no koma bɔ ne sɛnea ɔkeka ne ho.
• Biophysical profiles (BPPs): Ebia wo duruyɛfo nso bɛkamfo akyerɛ sɛ wɔmfa BPP mma dapɛn biara. Eyinom yɛ ultrasound ahorow a ɛhwɛ sɛnea akokoaa no home, sɛnea ne ntini te, ne sɛnea ɔkeka ne ho. Wɔsan nso susuw nsu dodow a ɛwɔ awotwaa mu.

Ɛho behia nso sɛ wo ne wo endocrinologist anaa asikreyare ho ɔkyerɛkyerɛfo kasa daa. Wɔbɛkyerɛ akwan ne nsakrae ahorow a ɛbɛboa ma wo glucose dodow abɛn wo botae no sɛnea wubetumi biara.

Asiane ne nsɛnnennen bɛn na ɛwɔ asikreyare a ɛto so 1 anaa 2 a obi benya bere a ɔyem no mu?

Ɛho hia sɛ wotu anammɔn de di asikreyare ho dwuma bere a wonyinsɛn no. Sɛ asikre dodow a ɛwɔ wo mogya mu kɔ so yɛ kɛse dodo a, asiane kɛse wom sɛ wubenya nsɛnnennen bi. Asikre dodow a ɛkɔ fam wɔ mogya mu mpɛn pii anaasɛ ɛyɛ kɛse nso betumi ayɛ nea asiane wom.

Saa nkurɔfo yi wɔ asiane kɛse mu sɛ wobenya nsɛnnennen esiane asikreyare a wonya ansa na wɔanyinsɛn nti:

• Nkwaboaa ne nyinsɛn
• Wo ba no wɔ awo akyi
• Wo

Nsɛnnennen a ɛba ansa na wɔawo ne awo akyi

Asikreyare a obi nya bere a ɔyem no betumi ama asiane a ɛwɔ hɔ sɛ akokoaa no benya nsɛnnennen te sɛ:

• Awo mu dɛmdi (awo mu tebea horow): Awo mu dɛmdi ba wɔ nyinsɛn a na wɔwɔ asikreyare a edi kan wɔ nyinsɛn mu no mu 6% kosi 12% mu. Koma mu dɛmdi a wofi awo mu na ɛtaa ba, nanso ntini mu dɛmdi ne nneɛma afoforo a ɛnteɛ nso betumi aba.
• Fetal macrosomia: Eyi ne bere a akokoaa a wɔawo no foforo mu duru boro nkaribo 9 ne ɔuns 15. Sɛ wowo akokoaa kɛse a, ɛma asiane a ɛwɔ hɔ sɛ wo ne wo ba no nyinaa bepira bere a wɔrewo no yɛ kɛse.
• Polyhydramnios: Eyi yɛ nsu a ɛwɔ awotwaa no mu a ɛkɔ soro wɔ awotwaa kotoku no mu. Eyi betumi ama wawo awo ntɛm na wɔawo awuwu.
• Awo a wɔawo no ansa na bere aso:Sɛ nsɛnnennen sɔre a, asiane kɛse wom sɛ wobɛwo awo ntɛm, efisɛ ebia wo duruyɛfo besi gyinae sɛ awo ne ɔkwan a ahobammɔ wom sen biara sɛ wunnya nnuu bere a edi mũ mpo a.
• Awo a wawu: Sɛ obi anya asikreyare wɔ nyinsɛn mu pɛn a, ebetumi ama asiane a ɛwɔ hɔ sɛ obi bɛwo a wawu no ayɛ kɛse.

Wɔ awo akyi no, wo ba no nso wɔ asiane kɛse mu sɛ obenya akwahosan ho tebea horow bi. Ɛwom sɛ nnipa a wɔwɔ asikreyare dodow no ara wo nkokoaa a wɔwɔ apɔwmuden de, nanso asiane wɔ hɔ sɛ nneɛma yi bɛba:

• Asikre dodow a ɛba fam wɔ mogya mu wɔ awo akyi
• Ɔhome a ɛyɛ den
• Jaundice a ɛyɛ mmerɛw

Sɛ wo ba no wɔ saa nsɛnnennen yi bi a, ebia ɛho behia sɛ wɔsa no yare wɔ NICU ( neonatal intensive care unit).

Nkokoaa a nnipa a wɔwɔ asikreyare wo nso betumi ayɛ kɛse mmoroso akyiri yi wɔ wɔn nkwa nna mu.

Nsɛnnennen a ebetumi aka wo

Asikreyare a wubenya bere a wonyinsɛn no betumi ama asiane a ɛwɔ hɔ sɛ:

• Preeclampsia: Preeclampsia yɛ tebea a mogya mmoroso ne protein a ɛwɔ nsu mu na ɛda adi. Asikreyare yɛ asiane titiriw a ɛma obi nya preeclampsia. Nea ɛbɛyɛ na asiane a ɛwɔ hɔ sɛ obi benya preeclampsia so atew no, ebia wo duruyɛfo bɛkamfo akyerɛ sɛ fa aspirin a ano nyɛ den pii bere a woanyinsɛn no adapɛn 12 akyi.
• Hia a ɛho hia sɛ wɔyɛ oprehyɛn (`C-section`): Ade titiriw nti a eyi ba ne asiane a ɛwɔ hɔ sɛ akokoaa no bɛyɛ kɛse dodo wɔ awo mu.
• Asikre a ɛwɔ wo mogya mu a ɛba fam: Esiane sɛ worebɔ mmɔden sɛ wobɛma asikre dodow a ɛwɔ wo mogya mu no ayɛ ketewaa nti, asiane kɛse wom sɛ asikre dodow a ɛba wo mogya mu bɛtaa ne/anaasɛ kɛse.
• Asikreyare a ɛne ketoacidosis (DKA): Wowɔ asiane kɛse mu sɛ wubenya DKA bere a woanyinsɛn esiane insulin a ɛko tia no kɛse nti. Ɔfe esiane anɔpa yare nti nso betumi ama DKA aba.
• Nsɛnnennen a ɛfa asikreyare ho: Nyinsɛn betumi asɛe anaasɛ ɛde asikreyare ho nsɛnnennen foforo aba (te sɛ retinopathy, nephropathy, ne neuropathy).

Ɔkwan bɛn so na asikreyare ka awo ne awo?

Mpɛn pii no, nnuruyɛfo kamfo kyerɛ sɛ wɔnyɛ nhyehyɛe a wɔde hyɛ mu (`scheduled induction`) mma mmea a wɔyem a wɔwɔ asikreyare. Bere a wɔkamfo kyerɛ sɛ wɔmfa induction no gyina nneɛma pii so, nanso ɛtaa ba wɔ nyinsɛn no adapɛn 39 mu anaasɛ ansa na ɛno adu. Ɛsono obiara ne nyinsɛn biara. Wo ne wo duruyɛfo no bɛbom asi nea eye ma wo ho gyinae.

Esiane nsakrae a ɛba wɔ hormone ne nipadua mu wɔ awo mu nti, asikre dodow a ɛwɔ wo mogya mu no betumi akɔ soro anaasɛ akɔ fam – ɛyɛ den sɛ wobɛka no yiye. Ɛdenam wo duruyɛfo ne ayaresabea nhyehyɛe so no, ebia wubetumi de insulin pɔmpɛ anaa nnuru a wɔde twitwiw wo ho adi wo ho ho dwuma bere a worewo ne awo no, anaasɛ ebia wubehia sɛ wɔde insulin a wɔde fa IV gu mu.

Sɛ woyi awotwaa no wie a, insulin a wuhia no so bɛtew kɛse – mpɛn pii no ɛbɛkɔ akodu sɛnea na ɛte ansa na worenyinsɛn no anaasɛ ɛbɛba fam mpo. Wo ne wo duruyɛfo nkasa mfa nhyehyɛe a wobɛyɛ de asan ayɛ nsakrae wɔ wo asikreyare ano aduru nhyehyɛe mu bere a woawo awie no ho.

Mɛyɛ dɛn agyina nsakrae a asikreyare ne nyinsɛn ba no ano?

Asikreyare ne nyinsɛn betumi de nsɛnnennen foforo aba. Ebia wo nyinsɛn no bɛyɛ soronko wɔ nea na wohwɛ kwan no ho, na ebia wubenya nsɛmmisa bi afa wo asikreyare ano aduru ho nhyehyɛe no ho. Bere a ɛsono obiara akwantu no, obiara a ɔwɔ asikreyare betumi adi afotu yi akyi na ama ne suahu no ayɛ nea ahoɔden wom sɛnea obetumi bere a wanyinsɛn no:

• Hwɛ asikre dodow a ɛwɔ wo mogya mu daa (sɛnea wo duruyɛfo kyerɛ no).
• Ma asikre dodow a ɛwɔ wo mogya mu no nkɔ so ntra baabi a wopɛ sɛ woyɛ no.
• Di wo duruyɛfo akwankyerɛ a ɛfa insulin, nnuru, ne ayaresa afoforo ho akyi.
• Kɔ wo ayaresabea a wɔhwɛ ansa na wɔawo no ne nhwehwɛmu a wɔyɛ.
• Kɔ so yɛ apɔw-mu-teɛteɛ. Wo ne wo duruyɛfo nkasa mfa wo dwumadi dodow ne sɛ ebia ɛsɛ sɛ wosakra no ho.
• Di nnuan a ahoɔden wom a ɛkari pɛ ne nnuan nketenkete.
• Kwati anonne a nsa ne tawa mu nneɛma wom.
• Hwɛ w’adwene mu akwahosan so. Ɛyɛ ade a ɛfata sɛ wobɛte adwennwen nka wɔ saa bere yi mu. Nsuro sɛ wobɛka ho asɛm na woabisa mmoa.

Bere bɛn na ɛsɛ sɛ mekɔ me duruyɛfo nkyɛn?

Sɛ wowɔ asikreyare na wuhu nneɛma yi mu biara a, wo ne nea ɔhwɛ wo ansa na woawo no nkasa:

• Sɛ wuntumi mma asikre dodow a ɛwɔ wo mogya mu no nkɔ baabi a wopɛ sɛ wobɔ no ɛmfa ho mmɔden biara a woabɔ no a. (Sɛ ɛba fam dodo anaasɛ ɛkorɔn dodo a.)
• Sɛ asikre dodow a ɛwɔ wo mogya mu no kɔ soro mpofirim anaasɛ ɛsakra esiane nneɛma bi a wonte ase nti a.
• Sɛ wote nka sɛ akokoaa no ntumi nkɔ baabiara a.
• Sɛ wowɔ nsu anaa mogya bi a efi wo awotwaa mu reba a.
• Sɛ w’ani nhu ade yiye anaasɛ sukɔm de wo dodo a.
• Sɛ worefe a, ɛnyɛ hwee, sɛ wuntumi mma aduan ne anonne nkɔ fam a, ɛnyɛ hwee.

Kae sɛ, ɛyɛ papa bere nyinaa sɛ wubenya ahobammɔ sen sɛ wobɛpa wo kyɛw na woabisa nsɛm. Wɔ nyinsɛn ho dadwen akyi no, asikreyare a wobedi ho dwuma ho dadwen betumi ayɛ adwennwen. Mma nsusuw wo nkate ho nea ɛto so abien anaasɛ mmu w’ani ngu so – wo ne wo duruyɛfo nkasa hwehwɛ akwankyerɛ.

Nsɛm bɛn na ɛsɛ sɛ mibisa me duruyɛfo?

Sɛ wowɔ asikreyare na wunyinsɛn a, ebia wobɛpɛ sɛ wubisa wo duruyɛfo no nneɛma yi ho asɛm:

• Mpɛn ahe na ɛsɛ sɛ mehwɛ asikre dodow a ɛwɔ me mogya mu?
• Dɛn na ɛsɛ sɛ me botae range yɛ?
• Sɛ wɔamma asikre dodow a ɛwɔ me mogya mu no ankɔ nea wɔahyɛ da ayɛ no mu a, nsɛnnennen bɛn na ebetumi aba?
• So ɛho behia sɛ mesesa insulin dodow a mede ma no?
• So ɛsɛ sɛ migyae nnuru afoforo anaasɛ mifi ase?
• So wokamfo kyerɛ sɛ wɔnyɛ nsakrae wɔ asetra mu?
• Mpɛn ahe na ɛsɛ sɛ meba bɛdi akyi?
• So ɛsɛ sɛ meyɛ induction ntɛm?

So nnipa a wɔwɔ asikreyare a ɛto so 1 betumi awo nkokoaa a wɔwɔ apɔwmuden?

Yiw, nnipa pii a wɔwɔ asikreyare a ɛto so 1 (ne asikreyare a ɛto so abien) no wɔ nkokoaa a wɔwɔ apɔwmuden. Asikre dodow a ɛwɔ wo mogya mu a wobɛhwɛ so ne nkitahodi a emu yɛ den a wo ne w’aduruyɛfo kuw no bɛkɔ so adi no ne nneɛma atitiriw a ɛbɛma woanyinsɛn a ahoɔden wom.

Asikreyare a wobedi ho dwuma bere a wɔyem no betumi ayɛ den titiriw, ama wɔn a wɔde asikreyare atra ase mfe du du pii mpo. Asikre dodow a ɛwɔ wo mogya mu a wobɛma ayɛ nea ɛfata bere a woanyinsɛn no betumi ayɛ nea ɛyɛ den wɔ adwene ne nipadua mu. Nanso sɛ wowɔ mmoa nhyehyɛe a ɛfata ne asikreyare ano aduru ho nhyehyɛe a, wubetumi adi nsɛnnennen a asikreyare de ba nyinsɛn mu no so.

Kɔ so ne w’aduruyɛfo kuw no nni nkitaho yiye. Ka kyerɛ wɔn bere a w’abam abu no. Wɔ ne nyinaa mu no, fa w’adwene si hann a ɛwɔ ɔkwan no awiei no so – hyia wo ba no.

Nkrasɛm a etwa to a wɔde kɔ fie

Okay, enti sɛnea yɛaka ho asɛm no, ɛsɛ sɛ woda adi pefee wɔ asikreyare a wubenyinsɛn no ho. Biribiara nni hɔ a enti ɛsɛ sɛ wusuro, nanso ɛsɛ sɛ wohwɛ yiye.

• Di kan yɛ nhyehyɛe: Sɛ woresusuw ho sɛ wobɛwo akokoaa a, hwehwɛ aduruyɛ mu afotu asram pii ansa na woanya.
• Mogya mu asikre a wobɛhwɛ so: Bɔ mmɔden biara sɛ wobɛma asikre dodow a ɛwɔ wo mogya mu no akɔ so ayɛ nea wo duruyɛfo de asi w’ani so wɔ wo nyinsɛn no nyinaa mu. Nneɛma te sɛ `CGM` betumi aboa wɔ eyi mu.
• Wo ne nnuruyɛfo kuw no bom nyɛ adwuma: wo ne wɔn nkasa daa, bisa nsɛm, na ka wo nkate ho asɛm.
• Asetra a ahoɔden wom: Aduan pa, apɔw-mu-teɛteɛ sɛ ɛho hia a (sɛnea oduruyɛfo kyerɛ no), ne adwene mu yiyedi ho hia yiye.

Kae sɛ, sɛ wowɔ asikreyare mpo a, sɛ wohwɛ wo so yiye na ayarehwɛfo hwɛ wo so a, wo nso wubetumi de akokoaa a ɔwɔ apɔwmuden na ɔwɔ anigye aba wiase yi mu. Ɛmmra sɛ wubenya ahoɔden ne akokoduru a wuhia na wode ayɛ saa!

` Asikreyare, nyinsɛn, asikre a ɛwɔ mogya mu, insulin, awo, nsɛnnennen, akokoaa a ɔwɔ apɔwmuden