Loaʻa iā ʻoe ke kō koko kiʻekiʻe i ke kakahiaka, ʻoiai inā he maʻi diabetes ʻoe? E aʻo kākou e pili ana i kēia 'hopena Somogyi'?

He kanaka anei ʻoe e lawe ana i ka insulin no ka maʻi diabetes mellitus? Inā pēlā, ua ʻike anei ʻoe ua piʻi koke kou pae kō koko i kou ala ʻana i ke kakahiaka? ʻOiai inā ʻoe e lawe i kāu lāʻau lapaʻau i ka pō a akahele, he mea kupanaha ia e loaʻa mau ana iā ʻoe i ke kakahiaka? ʻO kekahi kumu no ia mea ʻo ia ka 'hopena Somogyi'. E kamaʻilio kākou e pili ana i kēia me nā kikoʻī hou aku .

He aha ka hopena Somogyi?

I ka ʻōlelo maʻalahi, ʻo ka hopena Somogyi ka wā e ʻike ai ka mea maʻi diabetes e lawe ana i ka insulin i ka hāʻule koke ʻana o ke kō koko (hypoglycemia) i ka pō, a ukali ʻia e ka piʻi koke ʻana o ke kō koko (hyperglycemia) i ke kakahiaka. Hana ʻia kēia ma muli o ka hana a kekahi mau hormones i loko o ko kākou kino. E noʻonoʻo, i waenakonu o ka pō, hāʻule koke kou kō koko, a manaʻo kou kino, "Auē, e pilikia ana kēia kanaka," a hoʻokuʻu i nā hormones e hoʻopakele iā ia. ʻO ia ke kumu e piʻi ai kou kō koko i ke kakahiaka.

Ua kapa ʻia ʻo ia ma muli o Kauka Michael Somogyi, he kauka nāna i ʻike mua iā ia i nā makahiki 1930. I kekahi manawa kapa ʻia ia e nā kauka ʻo 'rebound hyperglycemia'.

Akā eia kekahi mea āu e ʻike ai. He 'kumumanaʻo' nō ka hopena Somogyi i waena o nā mea noiʻi, ʻo ia hoʻi he manaʻo wale nō ia. ʻO ia hoʻi, ʻaʻole i hōʻoia ʻia he 100%, akā aia nā hōʻike ʻepekema e kākoʻo iā ia. I ka wā ma mua, ua manaʻo nā kauka ʻo ia ke kumu nui o ka piʻi ʻana o ke kō kakahiaka. Akā, ua hāpai nā noiʻi hou, ʻoiai ka noiʻi e hoʻohana ana i ka nānā ʻana i ka glucose mau (CGM), i nā nīnau e pili ana i kēia manaʻo.

Aia kekahi mau kumu ʻē aʻe e piʻi ai ke kiʻekiʻe o ke kō koko i ke kakahiaka, ʻaʻole wale ka hopena Somogyi:

• ʻAʻole lawa ka nui o ka lāʻau lapaʻau āu e lawe ai, no ka mea, e haʻalele ia i kou kino i ka pō.
• He kūlana i kapa ʻia ʻo ka hanana Dawn. (E kamaʻilio pū kākou e pili ana i kēia)
• ʻAʻole i kūlike ka nui o ka lāʻau lapaʻau i lawe ʻia i ka ʻaina ahiahi me ka nui o ka meaʻai.
• Loaʻa ke kū'ē ʻana o ka insulin.

He aha ka ʻokoʻa ma waena o ka hopena Somogyi a me ka hanana Dawn?

ʻAe, ke noʻonoʻo nei paha ʻoe, 'He aha kēia hanana wanaʻao?' ʻO kēia mau mea ʻelua e hoʻonui ai i ke kiʻekiʻe o ke kō koko i ke kakahiaka i ka poʻe me ka maʻi diabetes.

ʻO ka hanana wanaʻao he piʻi kūlohelohe ia o nā pae kō koko i hoʻokumu ʻia e ka hoʻokuʻu ʻia ʻana o kekahi mau hormones (e like me ka cortisol a me ka hormone ulu) i ke kakahiaka nui. He mea maʻamau kēia.

Akā ma ka hopena Somogyi, hana pū nā hormones, akā hana ʻia ia ma muli o ka hāʻule koke ʻana o ke kō (hypoglycemia) i ka pō. I ka hanana wanaʻao, ʻaʻole piʻi ke kō ma muli o ia hāʻule ʻana o ke kō.

ʻO kekahi mea nui, ʻo ka hanana wanaʻao, kekahi o nā kumu o ke kiʻekiʻe o ke kō koko i ke kakahiaka , he mea maʻamau ia ma mua o ka hopena Somogyi.

He aha nā hōʻailona o ka hopena Somogyi?

ʻO ka hōʻailona nui o ka hopena Somogyi, ʻo ia ka piʻi ʻana o ke kō koko i kou ala ʻana i ke kakahiaka. Inā ʻoe e nānā i kāu glucometer a i ʻole ʻoe e hoʻohana i kahi hāmeʻa CGM (Continuous Glucose Monitoring), e hōʻike ana ia ua kiʻekiʻe kou kō i ke kakahiaka.

Ma muli o ke kiʻekiʻe o kou kō koko, hiki iā ʻoe ke ʻike i nā hōʻailona e like me kēia ke ala ʻoe i ke kakahiaka:

• Ka makewai pinepine (polydipsia).
• Ke pōloli nei ma mua o ka maʻamau.
• Ka mimi pinepine ʻana.
• ʻEha poʻo.
• Ka manaʻo kaumaha a me ka huhū (ka huhū).

No ke aha e hana ʻia ai ka hopena Somogyi?

Wahi a ke kumumanaʻo o ka hopena Somogyi, inā hāʻule haʻahaʻa loa kou pae kō koko (hypoglycemia) i waenakonu o ka pō i kou hiamoe ʻana ma muli o ka insulin āu e lawe nei, e hoʻāʻo kou kino e 'hoʻopakele' iā ʻoe mai kēlā kūlana kō haʻahaʻa.

Hoʻokuʻu ke kino i kekahi mau hormones no kēia 'misiona hoʻopakele'. ʻO nā mea nui:

• ʻAdrenaline
• Nā Corticosteroids
• ʻO ka hormone ulu
• ʻO Glucagon

Hoʻokuʻu kēia mau hormones i kou akepaʻa i ka glucose, a i ʻole ke kō, ma mua o ka maʻamau i loko o kou koko. ʻO kēia hoʻokuʻu ʻana o ka glucose ke kumu e piʻi ai kou pae kō koko. Inā loaʻa iā ʻoe ka maʻi diabetes, ʻaʻole lawa ka insulin o kāu pancreas e kāohi i kēia pae kō i hoʻonui ʻia, a i ʻole ʻaʻole ia e hana iki. ʻO ia ke kumu e mau ai ke kiʻekiʻe o kou pae kō koko.

I ke kanaka me ka ʻole o ka maʻi diabetes, hoʻomalu maoli ke kino i nā pae kō koko a mālama iā lākou i loko o kahi pae. ʻO ia ke kumu ʻaʻole pili ka hopena Somogyi i ka poʻe me ka ʻole o ka maʻi diabetes.

Pehea ʻoe e loaʻa ai i ke kauka e like me kēia?

ʻOiaʻiʻo, ʻaʻole ka hopena Somogyi ke kumu maʻamau o nā piʻi ʻana o ke kō koko kakahiaka, no laila hiki ke paʻakikī iki ke ʻike. A, e like me kaʻu i ʻōlelo ai ma mua, hōʻike ka noiʻi hou loa ʻaʻole paha ia ke kumu o nā piʻi ʻana o ke kō koko kakahiaka. No laila hiki ke paʻakikī, inā ʻaʻole hiki ʻole, no ke kauka ke ʻike pololei iā ia ma ka ʻōlelo ʻana, 'ʻAe, ʻo ia kēia.'

Inā loaʻa pinepine iā ʻoe ke kō koko kiʻekiʻe i ke kakahiaka, ʻoi aku ka maikaʻi o ke kamaʻilio ʻana me kāu kauka nāna e kōkua iā ʻoe e hoʻokele i kāu maʻi diabetes. E nānā ʻo ia i ke ʻano o ka loli ʻana o kou pae kō koko a hoʻāʻo e ʻimi i ke kumu. ʻO ke ala kūpono loa e hana ai i kēia, ʻo ia ka hoʻohana ʻana i kahi hāmeʻa CGM (Continuous Glucose Monitoring).

Inā ʻaʻole ʻoe e hoʻohana ana i kahi CGM, e haʻi aku paha kāu kauka iā ʻoe e nānā i kou pae kō koko i nā manawa he nui i ka lā. Eia kekahi laʻana:

• ʻElua hola ma hope o ka ʻaina ahiahi.
• Ma mua o ka moe ʻana.
• I waenakonu o ka pō (e laʻa, ma kahi o 2 a i ʻole 3 am).
• I ke ala ʻana i ke kakahiaka.

Eia kekahi, haʻi lākou iā ʻoe e hoʻopaʻa i nā kikoʻī e like me nā meaʻai āu e ʻai ai i ka pō, ka nui o kāu ʻai ʻana, a inā ʻoe e hoʻoikaika kino i ka pō, he aha ke ʻano o ka hoʻoikaika kino āu e hana ai a no ka lōʻihi.

Ma ka hōʻiliʻili ʻana i kēia ʻike āpau e hiki ai i ke kauka ke hoʻoholo i ke kumu o ke kō koko kiʻekiʻe i ke kakahiaka.

Pehea e mālama ʻia ai ka hopena Somogyi?

Ma hope o kou hana pū ʻana me kāu kauka e ʻike i ke ʻano o ke ʻano o kou pae kō koko i ka pō, e aʻo aku lākou iā ʻoe i nā hoʻololi hiki iā ʻoe ke hana e kōkua i ka pale ʻana i nā piʻi ʻana o ke kō koko i ke kakahiaka. E hoʻomanaʻo, he ʻokoʻa ke kino o kēlā me kēia kanaka, a he nui nā mea e hoʻopilikia ai i nā pae kō koko. No laila, ʻokoʻa paha nā mea hiki iā ʻoe ke hana e pale aku ai i nā piʻi ʻana o ke kō koko i ke kakahiaka mai kēlā kanaka a kēia kanaka.

Hiki i kāu kauka ke kuhikuhi i nā mea e like me:

• Ke hoʻololi nei i ka nui o kāu lāʻau lapaʻau maʻi diabetes a i ʻole insulin.
• Ke hoʻololi nei i nā ʻano meaʻai āu e ʻai ai no ka ʻaina ahiahi. Eia kekahi laʻana, pono paha ʻoe e ʻai i nā meaʻai i ʻoi aku ka nui o ka protein, nā carbohydrates, a i ʻole ka momona, a i ʻole pono paha ʻoe e ʻai iki i ia mau mea.
• Inā hiki, ʻo ka hoʻololi ʻana i kahi pamu insulin e ʻae iā ʻoe e kaohi pono i kāu mau dosis insulin.
• Ke hoʻololi nei i ka manawa o ka hoʻoikaika kino pō.

He aha nā pilikia e hiki ai i kēia ke hana?

Inā paha ʻo ka hopena Somogyi ke kumu o ke piʻi ʻana o ke kō koko i ke kakahiaka, hōʻike ia i ʻelua mau mea nui. Pono ka poʻe me ka maʻi diabetes e hoʻāʻo e pale i kēia mau pilikia ʻelua:

• Ke kiʻekiʻe mau nei ke kō koko.
• ʻIke ʻia nā pae kō koko haʻahaʻa (hypoglycemia) i ka pō.

Hoʻomau ka piʻi ʻana o nā pae kō koko

Ke hoʻomau nei ke kiʻekiʻe o kou pae kō koko, e piʻi aʻe kou pae HbA1c (A1C), a e emi iho kou Time in Range (TIR). Ana ka hoʻāʻo HbA1c i kou pae kō koko awelika i nā mahina ʻekolu i hala. ʻO TIR ka pakeneka awelika o nā lā i loko o ka pae i manaʻo ʻia kou pae kō koko.

ʻO ka ʻino o kāu mau pae A1c a me TIR, ʻoiai inā ua mau lākou ma laila no nā makahiki, ʻo ka ʻoi aku ka nui o kou pilikia o ka loaʻa ʻana o nā pilikia mai ka maʻi diabetes. ʻO nā hiʻohiʻona o kēia mau pilikia:

• Nā maʻi maka (Retinopathy)
• Nā pilikia puʻupaʻa (Nephropathy)
• ʻO ka neuropathy
• Maʻi puʻuwai

Ua hōʻike ʻia e ka noiʻi hiki i ka poʻe me ka maʻi diabetes ke hōʻemi i ko lākou pilikia o kēia mau pilikia inā mālama lākou i kā lākou pae A1c ma lalo o 7%.

Hiki i ke kō koko kiʻekiʻe i ke kakahiaka ke lilo i pilikia mau, a inā ʻaʻole mālama ʻia, hiki i kou pae kō koko ke noho kiʻekiʻe no kekahi mau hola i ka lā. Hoʻonui kēia i kou pilikia o ka loaʻa ʻana o nā pilikia maʻi diabetes i ka hala ʻana o ka manawa.

Nā hanana kō koko haʻahaʻa i ka pō

No nā kānaka he nui me ka maʻi diabetes, ʻo ke kō koko haʻahaʻa, a i ʻole hypoglycemia, ʻo ia ka wā e hāʻule ai ke kō koko ma lalo o 70 mg/dL (milligrams no ka deciliter).

Ke hāʻule ka nui o ke kō koko, ʻike ka poʻe he nui i nā hōʻailona e like me kēia:

• Manaʻo e haʻalulu ana kou kino.
• Manaʻo nui i ka pōloli (polyphagia).
• Ke hou nei a ke anu nei.
• ʻĀʻī, he manaʻo o ke poʻo māmā.
• Piʻi ka helu o ka puʻuwai.

Eia nō naʻe, inā hāʻule kou kō koko i kou wā hiamoe, hiki ke lōʻihi ka manawa e ala ai ʻoe a ʻike i nā hōʻailona. Hiki ke lilo kēia i mea weliweli, a hiki i ka hypoglycemia koʻikoʻi ke hoʻoweliweli i ke ola. Hiki ke ʻokoʻa iki nā hōʻailona o ke kō koko haʻahaʻa i ka pō, me:

• ʻAʻole hiki ke hiamoe, me ka manaʻo ʻoluʻolu ʻole me ka hiamoe.
• Manaʻo luhi a me ka noʻonoʻo ʻole ke ala ʻoe i ke kakahiaka.
• Loaʻa nā moeʻuhane maikaʻi ʻole.
• Ua pulu nā lole a i ʻole nā ​​​​​​mea moe āu e ʻaʻahu nei i ka hou.

ʻOiai nā hōʻailona āu e loaʻa ai e manaʻo ai ʻoe he haʻahaʻa kou kō koko, he mea nui e nānā i kou pae kō koko e ʻike i kona haʻahaʻa. E kōkua kēia iā ʻoe e hoʻoholo pehea e mālama ai. No ka mālama ʻana i ka hypoglycemia, pono ʻoe e ʻai i nā kalapona hana wikiwiki, ʻo ia hoʻi nā kō (e like me ka maiʻa a i ʻole ka wai ʻāpala).

Inā pinepine ʻoe i ka haʻahaʻa o ke kō koko i ka pō, e kamaʻilio me kāu kauka e pili ana i ia mea. Hiki iā ʻoe ke hoʻoponopono pū i kāu hoʻolālā hoʻokele maʻi diabetes e pale aku ai i ka hana hou ʻana.

Āhea wau e ʻike ai i ke kauka?

Inā ʻoe e ʻike mau nei i nā pae kō koko kiʻekiʻe i ke kakahiaka, he mea nui e kamaʻilio me kāu kauka nāna e kōkua iā ʻoe e hoʻokele i kāu maʻi diabetes. Hiki iā ia ke hoʻāʻo i kou mau pae kō koko, e hoʻoholo inā ʻo ka hopena Somogyi ke kumu, a inā he mea ʻē aʻe e hana nei, a e paipai i kahi hoʻolālā lapaʻau kūpono iā ʻoe.

Hiki i ke kō koko kiʻekiʻe i ke kakahiaka ke hoʻonāukiuki a ʻoluʻolu ʻole. ʻAʻohe hopena hoʻokahi e kūpono i nā mea āpau. No laila, e lōʻihi paha ka manawa e loaʻa ai ka hopena kūpono nāu. Hiki i kāu kauka ke kōkua iā ʻoe e hoʻoholo i ke ala hana maikaʻi loa. Mai makaʻu e noi i kā lākou kōkua. ʻO ka hana ʻana i kēia manawa hiki ke kōkua iā ʻoe e pale i nā pilikia pōkole a me ka wā lōʻihi.

ʻO ka mea hope loa, ʻo ka mea nui loa (Leka Lawe-Home)

ʻAe, i kēia manawa ua ʻoi aku kou maopopo i ka hopena Somogyi a mākou i kamaʻilio ai. E hoʻomanaʻo, ʻaʻole kēia wale nō ke kumu o ka piʻi ʻana o ke kō i ke kakahiaka. Akā, he mea nui e makaʻala i ia mea.

• ʻO ka mea nui, inā loaʻa mau iā ʻoe ke kō koko kiʻekiʻe i ke kakahiaka, mai hoʻowahāwahā iā ia. E kamaʻilio me kāu kauka.
• Inā ʻoe e hoʻohana ana i ka CGM (Continuous Glucose Monitoring), e ʻimi i ke kōkua o kāu kauka e kālailai pono i ka ʻikepili.
• He mea weliweli loa ke kō koko haʻahaʻa (hypoglycemia) i ka pō. Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, ​​e haʻi pū i kāu kauka e pili ana iā lākou.
• E kūkākūkā i kāu meaʻai, hoʻoikaika kino, a me ka nui o ka lāʻau lapaʻau me kāu kauka a hoʻololi iā lākou i ka mea e kūpono loa iā ʻoe.

He paʻakikī ke ola me ka maʻi diabetes, akā me ka mālama pono ʻana, hiki iā ʻoe ke ola i kahi ola olakino. Mai makaʻu, ʻeā?

ʻO ka hopena Somogyi, ka maʻi diabetes, ka piʻi ʻana o ke kō kakahiaka, hypoglycemia, hyperglycemia, insulin