Ke piʻi nei kou kō koko kakahiaka inā loaʻa iā ʻoe ka maʻi diabetes? (Dawn Phenomenon a me Somogyi Effect)

Ma ke ʻano he kanaka me ka maʻi diabetes, e nānā paha ʻoe i kou pae kō koko i kou ala ʻana i ke kakahiaka. Inā ʻoe e noʻonoʻo e pili ana i ia mea, ʻoiai inā ua kāohi ʻoe i kāu ʻai a lawe i kāu lāʻau lapaʻau i ka pō, pono ʻoe e hopohopo ke ʻike ʻoe ua kiʻekiʻe kou pae kō i ke kakahiaka, ʻeā? "Ua hana pololei wau i nā mea āpau, no ke aha e piʻi wale ai kaʻu kō i ke kakahiaka?" Manaʻo paha ʻoe. ʻElua kumu nui no kēia. ʻO kekahi ka Dawn Phenomenon, a ʻo kekahi ka Somogyi Effect. ʻOiai he ʻano ʻē iki nā inoa ʻelua, mai makaʻu. E kamaʻilio maʻalahi kākou e pili ana i kēia.

ʻO ka pilina ma waena o ka Insulin, ke kō koko, a me ka hiamoe

ʻO ka mea mua, e ʻike kākou i nā mea nui o kēia moʻolelo. ʻO ke kumu nui o ka ikehu o ko kākou kino he ʻano kō i kapa ʻia ʻo glucose. Ua like ia me ka ʻaila no ke kaʻa. ʻO ka hormone e kōkua i ka lawe ʻana i kēia glucose mai ko kākou koko i loko o ko kākou mau cell a hana i ka ikehu, ʻo ia ka insulin. I ka ʻōlelo maʻalahi, ua like ka insulin me ke kī e wehe ai i nā puka o ko kākou mau cell a hoʻokuʻu i ka glucose i loko.

I ko kākou hiamoe ʻana, ʻaʻole pono ko kākou kino i ka ikaika nui. Ua like ia me ke kaʻa i hoʻomaka wale ʻia. Eia naʻe, i ka wā e ala ai i ke kakahiaka, ke hoʻomākaukau nei ko kākou kino no ka hana o ka lā. A laila hoʻouna ke kino i kahi hōʻailona i ko kākou akepaʻa, e ʻōlelo ana, "ʻAe, ʻo kēia ka manawa e hoʻomaka ai e hana, e hoʻokuʻu i kekahi glucose hou aʻe i loko o ke koko." Ma kēia ʻano, i ka wā e hōʻiliʻili ai ka glucose i loko o ke koko i ke kakahiaka, hana ke kino o ke kanaka olakino i ka insulin hou aʻe e kāohi i nā pae kō.

Eia nō naʻe, i loko o ke kino o ke kanaka me ka maʻi diabetes, ʻaʻole hana pono kēia kaʻina hana. ʻOiai ʻaʻole i hana ʻia ka nui o ka insulin e pono ai, piʻi ka pae kō koko i ke kakahiaka. Kāhea mākou i kēia he hyperglycemia. Inā hoʻomau kēia, hiki ke hoʻopilikia i ke olakino.

He aha kēia hanana wanaʻao?

I ka ʻōlelo maʻalahi, ʻo ka Dawn Phenomenon kahi hana hormonal kūlohelohe e hoʻonui ai i ke kiʻekiʻe o ke kō koko i ke kakahiaka nui, ma waena o 3 a.m. a me 8 a.m. He ʻokoʻa kēia no kēlā me kēia kanaka. Akā inā loaʻa iā ʻoe ka maʻi diabetes, ʻaʻole lawa ka insulin o kou kino e kāohi i ke kō e piʻi nei, no laila e ala ʻoe me nā pae kō koko kiʻekiʻe. He mea maʻamau kēia i ka hapalua o ka poʻe me ka maʻi diabetes Type 1 a me Type 2.

Akā hiki iā ʻoe ke kamaʻilio me kāu kauka a hana i kekahi mau mea e kaohi ai i kēia.

• E pale i ka ʻai ʻana i nā meaʻai kiʻekiʻe i nā carbohydrates ma mua o ka hiamoe ʻana.
• Ke hoʻololi nei i ka nui a me ka manawa o kāu insulin a i ʻole ka lāʻau maʻi diabetes (no ka laʻana, e lawe ana ma mua o ka hiamoe ma kahi o ke ahiahi).Mai hana i kēia mau hoʻololi iā ʻoe iho. E kūkākūkā mau me kāu kauka.
• Inā ʻoe e hoʻohana i ka pamu insulin, e hoʻololi i kāna mau hoʻonohonoho.

No laila, he aha ka hopena Somogyi?

ʻO ka hopena Somogyi ka mea like e hana ʻia ke piʻi aʻe kou pae kō koko i ke kakahiaka. Akā ʻokoʻa loa ke kumu. Hana ʻia ia no ka mea lawe nui ʻoe i ka insulin i ka pō, lawe liʻiliʻi, a hōʻole paha i ka ʻai i ka pō .

E noʻonoʻo i kēia. Ua lawe ʻoe i ka nui o ka insulin i ka pō. A laila i waenakonu o ka pō, hāʻule loa kou pae kō koko. Kāhea mākou i kēia hypoglycemia. Pane ke kino i kēia hāʻule ʻana ma ka hopohopo. Me ka noʻonoʻo ʻana, "Auē, ua emi koʻu kō, pono wau e hoʻokiʻekiʻe koke i koʻu pae kō," hoʻokuʻu koke ke kino i ka nui o nā hormones e hana kūʻē i ka insulin (e.g., cortisol, hormone ulu). ʻO ka hopena, piʻi koke ka pae kō haʻahaʻa. ʻO ia hoʻi, hāʻule loa ka pae kō, a laila piʻi hou i luna. Ua kapa ʻia kēia ʻo 'Rebound Hyperglycemia'. ʻOi aku ka maʻamau o kēia ʻano i ka poʻe me ka maʻi diabetes Type 1.

Akā, ua ʻike ʻia ma o nā noiʻi hou, ʻoiai hoʻi nā haʻawina e hoʻohana ana i nā Continuous Glucose Monitors (CGMs) , ʻaʻole i maʻamau ka Somogyi Effect e like me ka mea i manaʻo ʻia ma mua. Manaʻo kekahi poʻe loea i kēia manawa ʻo ka Dawn Phenomenon, a i ʻole ka paʻa ʻole o ka nui o ka insulin, ke kumu o nā piʻi kakahiaka he nui ma mua o ka Somogyi Effect.

Pehea ʻoe e ʻike pono ai i ka ʻokoʻa ma waena o kēia mau mea ʻelua?

ʻO kēia mau kūlana ʻelua ke kumu o ke kō koko kiʻekiʻe i ke kakahiaka, akā ʻokoʻa nā lāʻau lapaʻau no ka mea ʻokoʻa nā kumu. No laila, pono kāu kauka e hoʻoholo i ka mea o nā mea ʻelua āu i loaʻa ai. No ke kōkua ʻana i kēlā, e noi paha kāu kauka iā ʻoe e nānā i kou pae kō koko i waenakonu o ka pō (ma kahi o 2-3 a.m.) no kekahi mau lā. Inā ʻoe e hoʻohana i kahi CGM, e loaʻa koke iā ia kēia ʻikepili.

Hōʻike hou aku ka papa ma lalo nei i nā ʻokoʻa nui ma waena o nā mea ʻelua.

He aha nā hōʻailona o kēia mau kūlana ʻelua?

ʻO ka hōʻailona nui, ʻo ia ke kiʻekiʻe o ke kō koko ke ala ʻoe i ke kakahiaka. Eia kekahi, ma muli o ke kiʻekiʻe o kou kō koko, hiki iā ʻoe ke ʻike i nā hōʻailona e like me:

• Manaʻo nui aku i ka make wai ma mua o ka maʻamau
• Manaʻo pōloli ma mua o ka maʻamau
• Pono pinepine e mimi
• ʻEha poʻo
• Manaʻo ʻoluʻolu ʻole a huhū

Me ka nānā ʻole i kekahi o kēia mau hōʻailona, ​​​​ʻoi aku ka maikaʻi o ka mālama ʻana i kahi moʻolelo o kāu pae kō a ʻike i kāu kauka.