Loaʻa iā ʻoe ke kō koko kiʻekiʻe i ke kakahiaka? Hiki paha kēia ma muli o ka 'Dawn Phenomenon'!

Inā loaʻa iā ʻoe ka maʻi diabetes, ua ʻike anei ʻoe ua piʻi koke kou pae kō koko ke ala ʻoe i ke kakahiaka? Ke noʻonoʻo nei paha ʻoe no ke aha e hana ai kēia ʻoiai ʻoe e lawe ana i kāu lāʻau lapaʻau i ka pō a kāohi i kāu ʻai. Mai hopohopo, ʻo kekahi kumu no kēia ʻo ia ka 'Dawn Phenomenon' a mākou e kamaʻilio nei i kēia lā. E nānā kākou i ke ʻano o ia mea, no ke aha e hana ai, a pehea e pale aku ai.

He aha ka Dawn Phenomenon, ʻo kēia piʻi ʻana o ke kō koko i ke kakahiaka nui?

I ka ʻōlelo maʻalahi, ʻo ka 'Dawn Phenomenon' he piʻi kūlohelohe ia o ke kō koko i ke kakahiaka nui ma muli o kekahi mau hormones i hana ʻia e ko mākou kino. Hoʻopilikia wale kēia i ka poʻe me ka maʻi diabetes. ʻO kēia ke kumu nui e ʻike ai ʻoe me ka maʻi diabetes i ke kō koko kiʻekiʻe (hyperglycemia) i ke kakahiaka.

Akā e hoʻomanaʻo, ʻaʻole kēia wale nō ke kumu e piʻi ai ke kō koko i ke kakahiaka. Hiki ke loaʻa kekahi mau kumu ʻē aʻe:

• ʻAʻole lawa ka lāʻau lapaʻau: I kekahi manawa, ʻaʻole lawa ka nui o ka lāʻau lapaʻau i lawe ʻia i ka pō i ke kakahiaka, a nalowale paha kona hopena.
• ʻAʻole kūlike ka lāʻau lapaʻau a me ka meaʻai: ʻAʻole helu i ka nui kūpono a me ka manawa e lawe ai i ka lāʻau lapaʻau me ka ʻaina ahiahi.
• ʻO ka hopena Somogyi: He ʻano ʻē kēia. I kekahi manawa, piʻi ka nui o ka insulin i hoʻokuʻu ʻia i ka pō, e hoʻemi koke ana i ke kō koko. A laila hoʻokuʻu ke kino i kahi hormone e pane ana, e hoʻonui hou ana i ke kō koko. Ua kapa ʻia kēia ʻo ka 'hopena Somogyi'.

Pehea ka maʻamau o kēia?

He mea maʻamau loa ka Dawn Phenomenon i waena o ka poʻe me ka maʻi diabetes. Ua ʻike ʻia e ka noiʻi ua hoʻopilikia ia ma mua o 50% o ka poʻe me ka maʻi diabetes Type 1 a i ʻole Type 2. ʻO ia hoʻi, ʻaʻole ʻoe hoʻokahi.

He aha nā hōʻailona o kēia?

ʻO ka hōʻailona nui o ka 'Dawn Phenomenon' ka piʻi ʻana o ke kō koko i ke kakahiaka nui. Hiki iā ʻoe ke ʻike i kēia ke ala ʻoe i ke kakahiaka a nānā i kāu glucometer, a i ʻole inā ʻoe e hoʻohana i kahi hāmeʻa CGM (Continuous Glucose Monitoring) . ʻO ka pinepine, ʻo ka 'Dawn Phenomenon' ke kumu o ke ʻano o ke kō koko kiʻekiʻe i ke kakahiaka no kekahi mau lā i ka lālani.

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:

• Manaʻo nui i ka make wai (polydipsia).
• Ke pōloli hou aku nei.
• Ka mimi pinepine ʻana.
• ʻEha poʻo.
• Ka huhū, ka huhū.
• ʻIke pōwehiwehi.

E noʻonoʻo, aia kekahi kanaka i kapa ʻia ʻo Malani, he maʻi diabetes. Nānā ʻo ia i kona kō koko i kēlā me kēia kakahiaka. No nā lā ʻekolu a ʻehā paha i ka lālani, ʻoi aku ka nui o kona kō koko i ke kakahiaka ma mua o 200mg/dL. Hoʻomalu pū ʻo ia i kāna ʻai ʻana i ka pō a lawe i kāna lāʻau lapaʻau i ka manawa kūpono. Manaʻo nui ʻo ia i ka huhū. Manaʻo iki ʻo ia i ka luhi ke ala ʻo ia i ke kakahiaka, a makewai nui ʻo ia. Ua hana ʻia anei kekahi mea e like me kēia iā ʻoe? A laila hiki paha ʻo ia ka 'Dawn Phenomenon'.

No ke aha lā kēia e hana nei?

He ʻano ʻepekema kēia, akā e ʻōlelo maʻalahi wau. I ke kakahiaka nui - ʻo ia hoʻi, ma waena o ka hola 3 a me 8 o ke kakahiaka - hoʻokuʻu ko mākou kino i kahi moʻo o nā hormones. ʻO nā mea nui, ʻo ia ka cortisol a me ka hormone ulu . Hōʻailona kēia mau hormones i ko mākou akepaʻa e hana i ka glucose hou aʻe, ʻo ia hoʻi ke kō. Kōkua kēia glucose e hoʻāla iā mākou i ke kakahiaka a hāʻawi iā mākou i ka ikehu e hoʻomaka i ka lā. Ke hana ʻia ka glucose hou aʻe, piʻi aʻe ko mākou pae kō koko.

I kēia manawa, inā ʻaʻohe ou maʻi diabetes, pane maikaʻi kāu pancreas i kēia a hana i ka insulin lawa e kāohi i kou kō koko. Akā inā loaʻa iā ʻoe ka maʻi diabetes, ʻaʻole hana iki kāu pancreas i kekahi insulin, a i ʻole ʻaʻole lawa ka nui o kāna hana e kāohi i ke kō koko kiʻekiʻe. I kekahi manawa , ʻo ke kūʻē ʻana o ka insulin , ʻo ia hoʻi ʻaʻole pane pono nā cell o kou kino i ka insulin, hiki ke lilo i kumu.

I ka pololei, i ka wā e hoʻomākaukau ai ke kino e ala i ke kakahiaka, ʻo kēia 'ʻōnaehana alarm' kūlohelohe i loko o ke kino ke kumu o ka piʻi ʻana o ke kō koko. ʻOiai ke kāohi ʻia nei kēia i loko o ke kino o ke kanaka me ka ʻole o ka maʻi diabetes, ʻaʻole hiki i ke kino o ke kanaka me ka maʻi diabetes ke hana pono.

Pehea ʻoe e ʻike pono ai i kēia?

ʻO ke ala maikaʻi loa e hoʻoholo pono ai inā ʻo ka 'Dawn Phenomenon' ke kumu o ke kō koko kiʻekiʻe i ke kakahiaka, ʻo ia ka hoʻohana ʻana i ka CGM (Continuous Glucose Monitoring) .

He mea hana ʻo CGM āu e ʻaʻahu ai e nānā i kou pae glucose koko i 24 mau hola o ka lā. I mea e pololei ai, ana kēia mea hana CGM i kou pae kō koko i kēlā me kēia mau minuke a hoʻohana i kēlā ʻikepili e hana i kahi pakuhi. Hāʻawi kēia iā ʻoe i kahi kiʻi piha o ke ʻano o ka loli ʻana o kou pae kō koko i ka hala ʻana o ka manawa.

ʻO ka pōmaikaʻi o ka hoʻohana ʻana i ka CGM, ma mua o ka lawe ʻana i ke koko mai kou manamana lima ma mua o kou hiamoe ʻana a ma hope o kou ala ʻana i ke kakahiaka a nānā i kāu kō koko me ka glucometer, ʻo ia ka hiki iā ʻoe ke ʻike pololei inā ua hāʻule koke kāu kō koko (hypoglycemia) i ka pō. Inā pēlā, ʻo ia hoʻi, ʻaʻole ʻoe e ʻike nei i ka 'Dawn Phenomenon', akā ʻo ka 'Somogyi effect' i ʻōlelo ʻia ma mua.

ʻOiai inā ʻaʻole ʻoe e hoʻohana i ka CGM, hiki i nā kauka ke nānā i ke ʻano o kāu heluhelu kō koko i loko o kekahi mau lā a kānalua i ka 'Dawn Phenomenon.' ʻO ia ke kumu he mea nui loa ka mālama ʻana i kahi moʻolelo o kāu heluhelu kō koko.

He aha ka lāʻau lapaʻau no kēia?

ʻO ka lāʻau lapaʻau maikaʻi loa no ka 'Dawn Phenomenon' ʻo ia ka hoʻohana ʻana i ka pamu insulin e hāʻawi i ka insulin. ʻAʻole kōkua nui nā lāʻau lapaʻau maʻi diabetes waha me ka 'Dawn Phenomenon'. Eia kekahi, ʻaʻole paha e loaʻa ka hopena nui o nā inikini insulin hana lōʻihi ma kēia.

Hiki i kāu kauka ke hoʻoponopono i kāu mau helu insulin basal a loaʻa i kāu pamu insulin ka insulin hou aʻe i ke kakahiaka. Hiki i kēia ke kōkua i ka pale ʻana i ka piʻi ʻana o kou pae kō koko i ke kakahiaka.

Eia nō naʻe, inā ʻaʻole ʻoe e hoʻohana i ka pamu insulin, a inā ʻaʻole ʻoe e lawe iki i ka insulin, pono paha ʻoe a me kāu kauka e hana i kekahi mau hoʻāʻo a me ka hewa e ʻike ai i nā lāʻau lapaʻau maikaʻi loa a me nā hoʻololi ʻana i ke ʻano o ka nohona e kāohi ai i kāu mau piʻi koko koko kakahiaka ma muli o ka 'wā wanaʻao'. No ka laʻana, hiki i kāu kauka ke aʻo iā ʻoe e hoʻonui i kāu hoʻoikaika kino i ke ahiahi a hoʻonui i ka nui o ka protein i kāu ʻaina ahiahi i hoʻohālikelike ʻia me ka nui o nā carbohydrates.

ʻAʻole anei hiki ke pale ʻia kēia?

ʻOiai ʻo ka 'Dawn Phenomenon' ka hopena o ke kaʻina hana kūlohelohe e kū nei i loko o ke kino, ʻaʻohe mea hiki iā ʻoe ke hana e pale loa aku ai.

Eia nō naʻe, inā ʻoe e hoʻohana i ka pamu insulin, hiki iā ʻoe ke hoʻoponopono i kāu mau helu insulin basal e like me nā kuhikuhi a kāu kauka a kaohi i nā piʻi koko koko i ke kakahiaka e hiki mai ana ma muli o ka 'wānana wanaʻao' i kekahi ʻano.

He aha nā hopena ʻaoʻao e hiki mai ana o kēia?

ʻO ka hopena nui o ke kō koko kiʻekiʻe i ke kakahiaka i mālama ʻole ʻia ma muli o ka 'dawn phenomenon' ʻo ia ka piʻi ʻana o kāu A1C. Hōʻike kahi hoʻāʻo A1C i kāu awelika o ka glucose koko (sugar) i nā mahina ʻekolu i hala.

ʻO ke kiʻekiʻe o kou pae A1C, ʻo ke kiʻekiʻe o kou pilikia o ka loaʻa ʻana o nā pilikia e pili ana i ka maʻi diabetes. He kiʻekiʻe loa kēia pilikia inā mau ke kiʻekiʻe o kou pae A1C no nā makahiki he nui. Hiki i nā pilikia maʻi diabetes ke komo pū me:

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

Ua hōʻike ʻia nā noiʻi inā hiki i ka poʻe me ka maʻi diabetes ke mālama mau i ko lākou pae A1C ma lalo o 7% , hiki iā lākou ke hōʻemi i ko lākou pilikia o nā pilikia e pili ana i ka maʻi diabetes.

ʻO ka 'Dawn Phenomenon' he pilikia mau ia, ʻo ia hoʻi, inā ʻaʻole mālama ʻia, hiki i nā pae kō koko ke noho kiʻekiʻe no kekahi mau hola i kēlā me kēia lā. Hoʻonui kēia i ka pilikia o ka loaʻa ʻana o nā pilikia maʻi diabetes i ka hala ʻana o ka manawa.

Āhea wau e ʻike ai i ke kauka?

Inā loaʻa mau iā ʻoe 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 nānā i kou pae kō koko, e hoʻoholo inā ma muli kēia o ka Dawn Phenomenon, a hāʻawi i nā koho lapaʻau kūpono nou.

ʻO ka ʻike ʻana i ka 'wā kakahiaka', kahi piʻi ʻana o ke kō koko i ke kakahiaka, hiki ke hoʻonāukiuki a hoʻonāukiuki maoli. Akā e hoʻomanaʻo, ʻaʻole na ʻoe ia hewa. ʻAʻohe ala hoʻokahi e kūpono i nā mea āpau no ka mālama ʻana i kāu piʻi ʻana o ke kō kakahiaka. No laila hiki ke lōʻihi ka manawa e ʻimi ai i ka lāʻau kūpono nāu. Hiki i kāu kauka ke kōkua iā ʻoe e hana i ka hoʻolālā maikaʻi loa. No laila, mai kānalua e noi i ke kōkua. ʻO ka hana ʻana i kēia manawa hiki ke kōkua iā ʻoe e pale i nā hopena ʻaoʻao lōʻihi.

ʻO ka mea nui e hoʻomanaʻo

ʻAe, ke lana nei koʻu manaʻo ua ʻoi aku kou maopopo i ka 'Dawn Phenomenon' a mākou i kamaʻilio ai. E hoʻomanaʻo, inā ʻoe e noho nei me ka maʻi diabetes, e makaʻala i ka piʻi ʻana o ke kō koko i ke kakahiaka.

ʻAʻole kēia kou hewa, a aia nā hopena no kēia.

• E kamaʻilio ākea me kāu kauka e pili ana i kēia.
• E mālama i nā moʻolelo pololei o kou pae kō koko, ka meaʻai, a me nā lāʻau lapaʻau.
• Inā hiki iā ʻoe ke hoʻohana i kahi CGM, he waiwai nui ka ʻikepili āna e hāʻawi ai.
• E kamaʻilio me kāu kauka e pili ana i ka pamu insulin, he hopena maikaʻi paha ia no kēia.
• Mai hopohopo a hoʻonāwaliwali paha, e hana pū me kāu kauka e ʻimi i ka hopena maikaʻi loa nāu.

E hoʻomanaʻo, hiki iā ʻoe ke ola i kahi ola olakino a hauʻoli me ka maʻi diabetes. Pono wale nō ka ʻike, ka mālama, a me ka hahai ʻana i nā ʻōlelo aʻoaʻo a kāu kauka. I lā maikaʻi!

ʻO ke ʻano wanaʻao, ka maʻi diabetes, ka piʻi ʻana o ke kō koko kakahiaka, hyperglycemia, ka hopena Somogyi, ka pamu insulin, A1C