He kanaka anei ʻoe i loaʻa i ka maʻi diabetes? Inā ʻoe e hāpai ana i kahi pēpē, nui paha kāu mau nīnau ma kou manaʻo. He mea maʻamau ke noʻonoʻo, "E hoʻopilikia anei kaʻu maʻi diabetes i kaʻu pēpē?", "He aha kaʻu e hana ai i kēia manawa?", "E hiki anei iaʻu ke hana pololei i nā mea āpau?" Akā, mai hopohopo. Inā ʻoe e hoʻokele pono, hiki iā ʻoe ke lawe mai i kahi pēpē olakino a nani i ka honua ʻoiai inā he maʻi diabetes kāu. E kamaʻilio kākou e pili ana i kēia me ka maopopo a me ka maʻalahi.
ʻO ka mea mua, e hoʻomaopopo kākou: ʻAʻole kēia he maʻi diabetes gestational!
ʻO kēia kahi e huikau ai ka poʻe he nui. Loaʻa i kekahi poʻe ka maʻi diabetes i ka wā hāpai wale nō. Kapa mākou iā ia he maʻi diabetes gestational. Nalo pinepine ke ʻano ma hope o ka hānau ʻana o ka pēpē.
Akā, ʻaʻole ia ka mea a mākou e kamaʻilio nei ma kēia ʻatikala. Ke kamaʻilio nei mākou e pili ana i ke ʻano o ka mālama ʻana i kāu hāpai ʻana inā loaʻa iā ʻoe ka maʻi diabetes mua , ʻo Type 1 a i ʻole Type 2. Ua kapa pū nā kauka i kēia he "Pregestational Diabetes." ʻAʻole pili i kou maʻa mau i ka noho ʻana me ka maʻi diabetes, he pilikia hou ka hāpai ʻana.
No ke aha he "kiʻekiʻe ka pilikia" o ka hāpai ʻana me ka maʻi diabetes?
ʻAe, ke hāpai kekahi me ka maʻi diabetes Type 1 a i ʻole Type 2, hoʻokaʻawale mākou iā ia he 'kiʻekiʻe-risk' . ʻAʻole kēia e hoʻoweliweli iā ʻoe, akā e hoʻomanaʻo iā ʻoe e pono ana ʻoe a me kāu pēpē i ka mālama kūikawā. E nānā pono kāu hui lapaʻau iā ʻoe no ka mea ʻaʻole maikaʻi nā pae kō koko kiʻekiʻe a haʻahaʻa paha iā ʻoe a i kāu pēpē paha.
I loko o kēia manawa, pono paha ʻoe i ke kōkua o nā loea ʻē aʻe ma waho aʻe o kāu kauka obstetrician a me gynecologist.
- Kauka Lapaʻau Māmā-Pēpē (MFM): He kauka i loaʻa ka ʻike kūikawā i kēia ʻano hihia kūikawā.
- Endocrinologist: He kauka i loea i nā hormones a me ka maʻi diabetes.
- He Kauka ʻAi Meaʻai i Kāinoa ʻia: E kōkua iā ʻoe e hoʻomākaukau i nā meaʻai kūpono no ka hāpai ʻana a me ka maʻi diabetes.
- Kumu Hoʻonaʻauao Maʻi Diabetes: He kanaka i aʻo kūikawā ʻia e hiki ke pane i kāu mau nīnau a hāʻawi iā ʻoe i ka ʻōlelo aʻoaʻo e pili ana i ka mālama ʻana i ka maʻi diabetes.
E hoʻomanaʻo, eia kēia poʻe e kōkua iā ʻoe. No laila, mai kānalua e kamaʻilio me lākou e pili ana i nā nīnau a hopohopo paha āu e loaʻa ai.
Pehea e hoʻomākaukau ai ma mua o ka hānau ʻana o kahi pēpē?
Inā loaʻa iā ʻoe ka maʻi diabetes, e hoʻomaka e noʻonoʻo e pili ana i ka loaʻa ʻana o kahi pēpē ma ka liʻiliʻi he 6 mau mahina ma mua o kou hāpai ʻana.ʻOi aku ka maikaʻi o ke kamaʻilio ʻana me kāu kauka. No ka mea, pono ʻoe e mālama i kou pae kō koko ma lalo o ke kaohi i kou wā hāpai, he mea nui e mākaukau no kēlā ma mua.
Hoʻomaopopo pinepine nā kauka e mālama ʻoe i kāu A1C ma 6.5% a i ʻole haʻahaʻa ma mua o kou hāpai ʻana. ʻO kēia no ka mea ke kūkulu ʻia nei nā ʻōpū nui o ka pēpē, e like me ka lolo a me ka puʻuwai, i nā pule mua o ka hāpai ʻana. Inā ʻaʻole i kāohi ʻia kou pae kō koko i kēia manawa, hiki iā ia ke hoʻopilikia i ka ulu ʻana o kāu pēpē.
ʻO nā pono o ka hālāwai mua ʻana me ka hui lapaʻau:
- E kōkua lākou iā ʻoe e hoʻihoʻi i kāu pae kō i kahi pae olakino.
- Hiki iā ʻoe ke kamaʻilio me kekahi meaʻai meaʻai a hana i kahi papaʻai olakino e kūpono no ka hāpai ʻana.
- Pono paha ʻoe e hoʻololi i kāu lāʻau lapaʻau maʻi diabetes i ka wā hāpai. Hiki iā ʻoe ke ʻike e pili ana i kēia ma mua.
- Hiki ke ʻōlelo ʻia ʻoe e hoʻohana i kahi ʻenehana hou, e like me ka Continuous Glucose Monitor (CGM) a i ʻole ka Insulin Pump. He manawa kūpono kēia e hoʻomaʻamaʻa ai iā ia i ka wā mua.
- Hiki iā ʻoe ke nānā i ke olakino o kou mau maka, nā puʻupaʻa, a me ka puʻuwai ma mua o ka hāpai ʻana, no ka mea, hiki ke hoʻonui a ulu paha kekahi mau pilikia i hoʻokumu ʻia e ka maʻi diabetes (e like me "Retinopathy" a me "Nephropathy") i ka wā hāpai.
Pehea e loli ai ka mālama ʻana i ka maʻi diabetes i ka wā hāpai?
Aia kekahi mau hoʻololi nui i kāu mālama ʻana i ka maʻi diabetes i ka wā hāpai.
1. E mālama i nā pae kō koko ma lalo o ke kaohi: No ka hōʻemi ʻana i nā pilikia, pono ʻoe e makaʻala e pili ana i kāu mau pae kō ma mua o ka maʻamau.
2. Ke hoʻololi nei i nā pono o ka insulin: Hoʻololi pinepine ka nui o ka insulin āu e pono ai me nā loli hormonal i ke kino.
3. Ke kaulike ʻana i nā pono meaʻai: He paʻakikī ka kaohi ʻana i nā pae kō me ka loaʻa ʻana o ka meaʻai e pono ai no ka ulu ʻana o ka pēpē.
Nā pahuhopu e mālama i kou pae kō koko i ka wā hāpai
ʻO kēia nā pae i manaʻo ʻia e nā kauka. Eia nō naʻe, hiki ke ʻokoʻa iki kēia ma muli o kou kūlana. No laila , he mea nui e hahai i nā ʻōlelo a kāu kauka.
| Ka manawa nānā | Pae kō i manaʻo ʻia (mg/dL) |
|---|---|
| Ka hoʻokē ʻai ʻana (ma mua o ka ʻaina kakahiaka) | Ma lalo o 95 mg/dL |
| Hoʻokahi hola ma hope o ka ʻai nui | Ma lalo o 140 mg/dL |
| ʻElua hola ma hope o ka ʻai nui | Ma lalo o 120 mg/dL |
No ka hoʻokō ʻana i kēia mau pahuhopu, pono ʻoe e hana i kēia mau mea:
- E makaʻala i ka nui o nā kalapona i loko o nā meaʻai āu e ʻai ai.
- E hoʻokomo i ka insulin 10-15 mau minuke ma mua o ka ʻai ʻana.
- E hoʻoikaika kino e kōkua i ke kāohi ʻana i kou pae kō koko (e kamaʻilio me kāu kauka e pili ana i kēia).
Pehea e loli ai nā pono o ka insulin i ka wā hāpai
ʻO kēia ka pilikia nui loa no nā kānaka he nui. I ka wā hāpai, loli nui nā hormones o kou kino. Ma muli o kēia, loli mau ka nui o ka insulin āu e pono ai.
- ʻEkolu mahina mua (3 mahina mua): Ua emi iki ka pono o kekahi poʻe no ka insulin i kēia manawa, akā ʻaʻole kēia he mea maʻamau no nā kānaka a pau.
- Ma hope o 16 mau pule: I loko o kēia manawa, hoʻonui nā hormones i hoʻopuka ʻia e ka placenta i ke kū'ē ʻana o ke kino i ka insulin. Hiki kēia i nā poʻe me ka ʻole o ka maʻi diabetes. ʻO ka hopena, piʻi mālie ka nui o ka insulin āu e pono ai.
- Ma nā pule 36-37: I kēia manawa, pono paha ʻoe i ka pālua a i ʻole ka pākolu o ka nui o ka insulin āu e pono ai ma mua o ka hāpai ʻana.
- Ma hope o ka hānau ʻana: ʻO ka mea kupanaha, ma hope o ka hānau ʻana o ke pēpē a me ka hānau ʻana o ka placenta, e emi nui ana kāu mau pono insulin. Pono paha ʻoe i ka nui like me ma mua o ka hāpai ʻana a emi mai paha. He mea nui e kūkākūkā i kēia me kāu kauka ma mua a hana i kahi hoʻolālā.
He aha nā hoʻokolohua hou aʻu e manaʻo ai i ka wā hāpai?
No ka mea he maʻi diabetes kou, pono ʻoe e loaʻa i nā hoʻokolohua lapaʻau a me nā scan hou aʻe ma mua o kahi makuahine hāpai maʻamau. Hana ʻia kēia mau mea e hōʻoia i ka ulu ʻana o kāu pēpē a olakino ʻoe.
| Hoʻāʻo | No ke aha e hana ai? |
|---|---|
| ʻEchocardiogram o ka pēpē | Ma muli o ka hoʻonui ʻana o ka maʻi diabetes i ka pilikia o ka pēpē i ka maʻi puʻuwai hānau, e nānā i ke ʻano o ka puʻuwai o ka pēpē. |
| Nā Scans Ulu | Nānā ʻia ka ulu ʻana o ka pēpē i kēlā me kēia mau pule. ʻO nā pēpē i hānau ʻia e nā makuahine me ka maʻi diabetes, aia lākou i ka pilikia o ka nui aʻe ma mua o ka maʻamau (Fetal Macrosomia). |
| Hoʻāʻo ʻole-koʻikoʻi (NST) | Hana ʻia ia ma kahi o hoʻokahi manawa i ka pule i ka hapalua hope o ka hāpai ʻana. Nānā ʻia ka puʻuwai o ka pēpē a me kāna mau neʻe ʻana. |
| ʻIkepili Biophysical (BPP) | He scan nō hoʻi kēia. Ana ia i nā neʻe ʻana o ka hanu o ke pēpē, ke kani o nā ʻiʻo, ka neʻe ʻana, a me ka nui o ka wai amniotic i loko o ka ʻōpū. |
He aha nā pilikia a me nā pilikia e hiki mai ana?
He mea nui e mālama i kou pae kō koko ma lalo o ke kaohi e hōʻemi i kēia mau pilikia. He mea nui e makaʻala i kēia mau mea, akā, mai makaʻu ʻoe e hiki mai ana kēia mau mea a pau iā ʻoe.
Nā pilikia hiki ke loaʻa i ka pēpē
- Nā kīnā hānau: Ua piʻi iki ka pilikia o ka loaʻa ʻana o nā kīnā hānau, ʻoiai nā kīnā puʻuwai.
- He pēpē i ʻoi aku ka nui ma mua o ka maʻamau (Fetal Macrosomia): Hiki i ke kaumaha o ka pēpē ke ʻoi aku ma mua o 4 kg. Hiki i kēia ke hoʻopilikia i ka makuahine a me ke pēpē i ka wā hānau.
- Ka hānau mua ʻana: Inā kū mai kekahi pilikia, pono paha e hānau ʻia ke pēpē ma mua o ka lā palena.
- Ma hope o ka hānau ʻana: Ma hope o ka hānau ʻana o ka pēpē, hiki ke loaʻa nā kūlana e like me ke kō koko haʻahaʻa, ka paʻakikī o ka hanu ʻana, a me ka jaundice. I kēlā mau manawa, pono paha e mālama ʻia ka pēpē i loko o ka ʻāpana mālama koʻikoʻi neonatal (NICU).
Nā pilikia iā ʻoe (ka makuahine)
- Preeclampsia: Ke koko kiʻekiʻe a me ka protein i loko o ka mimi i ka wā hāpai. ʻO ka maʻi diabetes kahi kumu nui o ka pilikia no kēia.
- Ka pono o ka ʻoki ʻoki cesarean (C-section): He paʻakikī paha ka hānau maʻamau ma muli o ka nui o ka pēpē.
- Haʻahaʻa ke kō koko (Hypoglycemia):Ke hoʻāʻo nei e kaohi i kou pae kō koko, i kekahi manawa hiki ke haʻahaʻa loa kou pae kō koko.
- Diabetic Ketoacidosis (DKA): ʻOi aku ka nui o ka hiki ʻana mai o kēia maʻi i ka wā hāpai ma muli o ka hoʻonui ʻia ʻana o ke kūʻē ʻana o ka insulin. Hiki i ka maʻi kakahiaka ke kumu.
- Nā pilikia ʻē aʻe e pili ana i ka maʻi diabetes: Hiki ke hoʻonui ʻia nā hopena o ka maʻi diabetes i nā ʻōpū e like me nā maka a me nā puʻupaʻa i ka wā hāpai.
Pehea ʻoe e kū ai i kēia pilikia? Āhea ʻoe e ʻike ai i ke kauka?
Hiki i ka noho ʻana me ka maʻi diabetes i ka wā hāpai ke luhi i ka noʻonoʻo a me ke kino, akā inā ʻoe e hahai pololei i kēia mau ʻanuʻu, hiki iā ʻoe ke hoʻomau i kēia huakaʻi me ka holomua.
- E nānā mau i kou pae kō koko e like me ke kuhikuhi a kāu kauka.
- E hoʻāʻo i kāu mea maikaʻi loa e mālama i kou pae kō koko i loko o ka pae i makemake ʻia.
- E hoʻohana i ka insulin a me nā lāʻau ʻē aʻe e like me ke kuhikuhi a kāu kauka.
- Mai hōʻalo i kekahi keʻena lapaʻau a i ʻole hoʻokolohua.
- E ʻai i ka meaʻai olakino a kaulike.
- E ho'ōki loa i ka inu ʻona a me ka puhipaka.
- E noʻonoʻo hoʻi i kou olakino noʻonoʻo. Inā ʻoe e hopohopo nei, e kamaʻilio me kahi hoaaloha a kauka paha.
Inā loaʻa iā ʻoe kēia mau hōʻailona, e kāhea koke aku i kāu kauka.
| Hōʻailona | Wehewehena |
|---|---|
| Inā ʻaʻole hiki iā ʻoe ke kaohi i kāu mau pae kō | ʻOiai ke ʻano o kou hoʻāʻo ʻana, aia mau nō kou pae kō ma luna a ma lalo paha o ka pahuhopu. |
| Inā haʻahaʻa nā neʻe ʻana o ka pēpē | Inā manaʻo ʻoe e neʻe iki ana kāu pēpē ma mua o ka maʻamau. |
| Ka hoʻokuʻu ʻana o ka vaginal a i ʻole ke kahe koko | Inā he kahe wai a i ʻole ke koko e puka mai ana. |
| Nā hiʻohiʻona ʻē aʻe | Inā pōwehiwehi kou ʻike, makewai nui ʻoe, a i ʻole e luaʻi mau ʻoe. |
E hoʻomanaʻo, inā he hopohopo kou e pili ana i kekahi mea, mai makaʻu e kamaʻilio me kāu kauka. He mea nui loa ia no kou palekana a me kāu pēpē.
Leka Lawe-Home
- ʻOiai inā loaʻa iā ʻoe ka maʻi diabetes, me ka hoʻolālā a me ka mālama pono ʻana, hiki iā ʻoe ke hānau i kahi pēpē olakino.
- Ma mua o kou noʻonoʻo ʻana e pili ana i ka loaʻa ʻana o kahi pēpē, e kamaʻilio me kāu kauka i kekahi mau mahina ma mua e kaohi i kou pae kō koko.
- Ua like ka hāpai ʻana me kahi 'haʻuki hui.' Pono ʻoe, kou ʻohana, a me kāu hui lapaʻau e hele pū ma kēia huakaʻi.
- E loli pinepine ana kāu mau pono insulin i kou wā hāpai, no laila e hana i nā hoʻololi e pono ai e like me ke kuhikuhi a kāu kauka.
- Inā he mau hopohopo a nīnau paha kāu, e kamaʻilio ākea me kāu hui lapaʻau. Aia lākou ma laila e kōkua iā ʻoe.
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