Hiki iā ʻoe ke loaʻa kahi pēpē olakino ʻoiai inā he maʻi diabetes kou? (Diabetes in Pregnancy) E kamaʻilio kākou e pili ana i kēia!

Aloha! Inā ʻoe e hāpai ana i kahi pēpē i kēia mau lā, ʻoiai inā he maʻi diabetes kou, nui paha kāu mau nīnau a me nā makaʻu i loko o kou manaʻo, ʻeā? "ʻĀ, e loaʻa anei nā pilikia me ka pēpē ke loaʻa iaʻu ka maʻi diabetes?" "E mālama pono ʻia anei kēia?" Ke noʻonoʻo nei paha ʻoe i nā mea like. Mai hopohopo, ʻaʻole ʻoe hoʻokahi. He nui nā makuahine e kū nei i kēia kūlana. ʻO ka mea nui loa, me ka hoʻomaopopo pono ʻana a me ka hahai ʻana i nā ʻōlelo aʻoaʻo lapaʻau, hiki iā ʻoe ke loaʻa kahi pēpē olakino. E kamaʻilio kākou e pili ana i kēia me nā kikoʻī hou aku, ʻeā?

Pehea ka hopena o ka maʻi diabetes i ka hāpai ʻana?

I ka ʻōlelo maʻalahi, inā loaʻa iā ʻoe ka maʻi diabetes Type 1 a i ʻole Type 2 ma mua o kou hāpai ʻana, ua kapa ʻia ʻo ia he "pregestational diabetes." He ʻokoʻa kēia mai ka maʻi diabetes gestational, ka mea e ulu ana i ka wā hāpai. ʻO ka maʻamau, nalo ka maʻi diabetes gestational ma hope o ka hānau ʻana o ke pēpē.

Inā loaʻa iā ʻoe ka maʻi diabetes, hiki ke paʻakikī iki ka kaohi ʻana i kou pae kō koko i ka wā hāpai. ʻIke ʻoe i ke aha? I ka wā hāpai, loli nui kā mākou mau hormones. Me kēlā mau hoʻololi, pono paha ʻoe e hoʻololi i kāu meaʻai, ka hana hoʻoikaika kino, a me kāu mau lāʻau lapaʻau. I ka manawa pinepine, pono e hoʻololi ʻia kēia hoʻolālā hoʻokele maʻi diabetes i nā manawa he nui a hiki i ka lā e hānau ai kāu pēpē. No laila, he mea nui loa ke kamaʻilio pinepine me kāu hui lapaʻau a haʻi iā lākou e pili ana i kou kūlana. A laila hiki iā lākou ke hoʻoholo pololei i nā lāʻau lapaʻau āu e pono ai a inā pono e hoʻololi ʻia.

Akā e hoʻomanaʻo hoʻi i kēia, ʻo ka loaʻa ʻana o ka maʻi diabetes ʻaʻole ia he manaʻo ʻaʻole hiki iā ʻoe ke loaʻa kahi pēpē olakino. He mea paʻakikī iki ia, akā ʻaʻole hiki ʻole. Aia kāu hui lapaʻau ma laila e kōkua iā ʻoe.

He maʻi hāpai pilikia nui anei ka maʻi diabetes Type 1?

ʻAe, hoʻonui ka maʻi diabetes Type 1 a me ka maʻi diabetes Type 2 i ka pilikia o nā pilikia i ka wā hāpai. No laila, e nānā pono kāu kauka hānau keiki i ke olakino o kāu pēpē a me kou pae kō koko i kou wā hāpai e hōʻoia i kou mālama ʻana i kahi pae olakino. Inā noho kiʻekiʻe a haʻahaʻa paha kou pae kō koko, hiki ke lilo i mea weliweli a alakaʻi i nā pilikia.

E hana pinepine ʻoe me kahi loea lapaʻau makuahine-kōpū (MFM). Ma waho aʻe o kāu kauka hānau keiki, hiki i kāu hui lapaʻau ke komo pū me:

• Endocrinologist: He loea i nā maʻi e pili ana i ka hormone.
• ʻO ka meaʻai meaʻai i hoʻopaʻa inoa ʻia: He kanaka hiki ke kōkua i ka kaohi ʻana i ka maʻi diabetes a hāʻawi i ke alakaʻi ʻana i nā ʻano ʻai olakino i ka wā hāpai.
• Kumu aʻo maʻi diabetes: He loea me ke aʻo nui a me ka ʻike i ka mālama ʻana i ka maʻi diabetes.

Pehea e hiki ai i kekahi me ka maʻi diabetes ke hoʻomākaukau no ka hāpai ʻana?

Inā loaʻa iā ʻoe ka maʻi diabetes a ke hoʻāʻo nei ʻoe e loaʻa kahi pēpē, ʻo ka mea mua e hana ai, ʻo ia ke kamaʻilio me kāu kauka. ʻOi aku ka maikaʻi o ke kamaʻilio ʻana e pili ana i kēia ma kahi o ʻeono mahina ma mua o kou hoʻomaka ʻana e loaʻa kahi pēpē.

He mea nui e kaohi i kou pae kō koko ma mua o kou hāpai ʻana. ʻO ka pahuhopu i ka wā hāpai, ʻo ia ka mālama ʻana i kou pae kō koko i loko o kahi pae haiki loa. Hiki ke paʻakikī loa ka mālama ʻana i kēia ma hope o kou hāpai ʻana.

Manaʻo nā alakaʻi he nui e mālama i kāu A1C ma 6.5% a i ʻole haʻahaʻa ma mua o kou hāpai ʻana . ʻO kēia ke hōʻemi i kou pilikia o nā pilikia. Ua ʻike anei ʻoe? Hoʻomaka ka hana ʻana o nā ʻōpū o ka pēpē a me nā ʻiʻo koʻikoʻi ʻē aʻe i ka wā o ka trimester mua o ka hāpai ʻana. Inā noho kiʻekiʻe kou pae kō koko i kēlā manawa, hiki iā ia ke hoʻopilikia i ka ulu ʻana o ka pēpē.

Eia nā pono o ka hālāwai ʻana me kāu hui lapaʻau ma mua o ka hoʻāʻo ʻana e loaʻa kahi pēpē:

• Hiki i nā kauka ke kuhikuhi i nā ala e kōkua ai i ka hoʻihoʻi ʻana i kāu pae kō koko i kahi pae olakino.
• Hiki i ke kauka meaʻai ke kōkua iā ʻoe e hana i nā hoʻolālā meaʻai e kūpono no ka hāpai ʻana a me ka mālama ʻana i ka maʻi diabetes.
• Pono paha ʻoe e hoʻololi i kāu lāʻau lapaʻau maʻi diabetes ma hope o kou hāpai ʻana.
• Hiki paha iā ʻoe ke hoʻomaʻamaʻa i ka hoʻohana ʻana i nā ʻenehana maʻi diabetes hou (no ka laʻana, kahi monitor glucose hoʻomau - CGM) hiki ke kōkua nui i ka wā hāpai.
• Hiki i kāu kauka ke ʻōlelo aku e nānā ʻia kou mau maka (ka pilikia o ka retinopathy), nā puʻupaʻa (ka pilikia o ka nephropathy), a me ka puʻuwai ma mua o kou hāpai ʻana, no ka mea, hiki i ka hāpai ʻana ke hoʻonui i ka ʻino a i ʻole ke kumu o nā pilikia hou mai ka maʻi diabetes.

Pehea e loli ai kaʻu mālama ʻana i ka maʻi diabetes i ka wā hāpai?

Aia kekahi mau kumu koʻikoʻi e hoʻopilikia i ke ʻano o ka mālama ʻana i ka maʻi diabetes i ka wā hāpai:

• ʻO ka pono e mālama i nā pae glucose koko i loko o kahi pae haiki e hōʻemi i ka pilikia o nā pilikia hāpai.
• Ke hoʻololi nei i nā pono o ka insulin.
• Ka mālama ʻana i nā pono meaʻai i ka wā hāpai ma ka mālama ʻana i nā pae kō koko kaulike.

Nā pahuhopu kō koko i ka wā hāpai me ka maʻi diabetes

ʻO ka maʻamau, ʻo nā pahuhopu kō koko no nā makuahine hāpai me ka maʻi diabetes penei:

• Hoʻokē ʻai: Ma lalo o 95 mg/dL
• Hoʻokahi hola ma hope o ka ʻai ʻana: Ma lalo o 140 mg/dL
• ʻElua hola ma hope o ka ʻai ʻana: emi ma lalo o 120 mg/dL

I nā huaʻōlelo ʻē aʻe, hiki ke manaʻo ʻia kēia mau pahuhopu he 'manawa i loko o ka laulā (TIR)'. Ma keʻano laulā, ʻo nā pahuhopu 'TIR' no nā pākeke me ka maʻi diabetes 'Type 1' i ka wā hāpai:

• Ma ka liʻiliʻi he 70% o ka manawa ma waena o 63 a me 140 mg/dL (i loko o ka pae i manaʻo ʻia)
• Ma lalo o 5% o ka manawa ma lalo o 63 mg/dL
• Ma lalo o 25% o ka manawa ma luna o 140 mg/dL

Manaʻo ka hapa nui o nā alakaʻi i ka wā hāpaiʻO ka mālama ʻana i kahi waiwai `A1C` ma lalo o 6% hiki ke hōʻemi i ka pilikia o nā pilikia.

Ma muli o kēia mau pahuhopu paʻa, hiki i kāu kauka ke ʻōlelo aku e hoʻohana i kahi mea nānā glucose hoʻomau (CGM) i ka wā hāpai. Ma kahi o ka hoʻohana ʻana i nā lāʻau manamana lima, hāʻawi ka CGM iā ʻoe i kahi kiʻi maikaʻi aʻe o ke ʻano o ka loli ʻana o kāu mau pae glucose i ka hala ʻana o ka manawa, e maʻalahi ai ka hana ʻana i nā hoʻololi kūpono i kāu hoʻokele maʻi diabetes.

No ka mālama ʻana i kēia pae kō koko haiki, pono ʻoe e hahai i kekahi mau ʻano hana:

• E helu pono i ka nui o nā kalapona i kāu mau meaʻai a me nā meaʻai māmā.
• ʻO ka lawe ʻana i ka insulin 10-15 mau minuke ma mua (a i ʻole ma mua) o ka ʻai ʻana.
• Ke hoʻohana nei i ka hana kino e kaohi i nā pae kō koko.

E kamaʻilio kāu kauka me ʻoe e pili ana i kēia mau ʻano hana a me nā hoʻolālā ʻē aʻe.

Ke hoʻololi nei i nā pono o ka insulin i ka wā hāpai

E manaʻo e loli pinepine kāu mau pono insulin i ka wā hāpai. ʻO ke kumu nui o kēia ma muli o nā hormones like ʻole i loko o kou kino. E like me ka hopena o ka maʻi diabetes i kēlā me kēia kanaka, pēlā nō ka hāpai ʻana. No laila, he mea nui e hana pū me kāu hui lapaʻau e hana i nā hoʻololi e pono ai i kāu hoʻolālā hoʻokele maʻi diabetes. E kū hoʻokahi kēia mau hoʻololi iā ʻoe a me kāu mau pono.

Inā loaʻa iā ʻoe ka maʻi diabetes Type 1, he mea maʻamau ka emi ʻana o ka insulin i ka trimester mua - akā ʻaʻole nā ​​​​mea āpau e hana pēlā. Ma kahi o ka pule 16 o ka hāpai ʻana, hoʻomaka ka piʻi ʻana o nā pono insulin. ʻO kēia no ka mea hana ka placenta i nā hormones e hoʻonui ai i ke kū'ē ʻana o ka insulin. Hana ʻia kēia i nā hāpai āpau, ʻaʻole wale ka poʻe me ka maʻi diabetes.

Pono paha ʻoe i ka insulin hou aʻe a hiki i ka pule 36 a 37 paha o ka hāpai ʻana. I kēlā manawa, paʻa mau ke kūʻē ʻana o ka insulin. Pono paha ka nui o ka poʻe i ʻelua a ʻekolu paha ka nui o ka insulin a lākou i lawe ai ma mua o ka hāpai ʻana.

E hana pū ʻoe me kāu kauka e hana i nā hoʻololi insulin e pono ai i ka wā hāpai. Hiki i kēia ke komo pū me:

• ʻO kāu insulin 'basal' a i ʻole ka insulin hana lōʻihi (background) ('insulin hana lōʻihi')
• ʻO ka lakio o ka insulin-i-carb (ICR)
• ʻO ke kumu hoʻomalu o ka insulin (ISF)

ʻO ka mea nui, ke hānau ʻia ka placenta, e emi nui ana kāu mau pono insulin. I loko o 30 mau minuke o ka hānau ʻia ʻana o ka placenta, e hoʻi hou ana kāu mau pono insulin i ko lākou pae ma mua o ka hāpai ʻana - a i ʻole haʻahaʻa. E kamaʻilio kāu kauka me ʻoe e pili ana i ke ʻano o ka hoʻoponopono ʻana i kāu regimen insulin ma hope o ka hānau ʻana. He mea nui ka loaʻa ʻana o kahi hoʻolālā no kēia.

ʻO ka maʻi diabetes a me nā pono meaʻai i ka wā hāpai

He mea nui loa ka meaʻai kūpono no ka hāpai olakino. ʻO ke kaulike ʻana i nā pono meaʻai o ka hāpai ʻana a me ka mālama ʻana i kahi pae kō koko haiki hiki ke lilo i mea paʻakikī iki. Inā loaʻa iā ʻoe ka nausea a/a i ʻole ka luaʻi ʻana i ka wā hāpai, hiki ke ʻoi aku ka paʻakikī.

Hiki i kahi meaʻai loea i kākau inoa ʻia i loea i nā wahine hāpai me ka maʻi diabetes ke kōkua iā ʻoe e hana i kahi papaʻaina. E alakaʻi lākou iā ʻoe i ka nui o nā `macronutrients` (nā meaʻai nui) - ʻo ia hoʻi, `carbohydrates` (carbohydrates), `protein` (protein) a me `dietary fat` (dietary fat) - pono ʻoe e ʻai i kēlā me kēia lā. Hiki ke ʻokoʻa kā lākou mau ʻōlelo aʻoaʻo mai nā ʻōlelo aʻoaʻo maʻamau no nā wahine hāpai me ka ʻole o ka maʻi diabetes. E paipai pū lākou i nā meaʻai a me nā meaʻai māmā i kaulike ʻia i nā `macronutrients` e kōkua i ka mālama ʻana i nā pae kō koko i paʻa.

Ka Hoʻokele ʻana i ka Maʻi Diabetes Type 1 i ka wā hāpai

He nui ka poʻe me ka maʻi diabetes type 1 e ʻike ana ua loli pinepine kā lākou mau pono insulin - maʻamau mai kēlā pule a kēia pule - i ka wā hāpai. ʻO ka nānā pono ʻana i kāu mau pae glucose a me ka ʻike ʻana i nā ʻano e hiki ke kōkua iā ʻoe a me kāu kauka e hana i nā hoʻololi kūpono i kāu hoʻolālā lapaʻau.

Inā ʻoe e lawe ana i nā inikini he nui i kēlā me kēia lā (MDIs), hiki i kāu kauka ke ʻōlelo aku e hoʻololi i kahi pamu insulin e hāʻawi iā ʻoe i ka maʻalahi i ka hoʻoponopono ʻana i kāu mau hoʻonohonoho insulin. Eia nō naʻe, hiki nō iā ʻoe ke loaʻa kahi hāpai olakino me kahi MDI. Inā ʻoe e lawe ana i nā lāʻau lapaʻau ʻē aʻe ma mua o kou hāpai ʻana, e kūkākūkā pono inā hiki iā ʻoe ke hoʻomau i ka hoʻohana ʻana i kēlā mau lāʻau lapaʻau i ka wā hāpai.

E like me nā manawa a pau, he mea nui e hoʻokele koke i ke kō koko kiʻekiʻe a me nā pae kō koko haʻahaʻa. Inā ʻike pinepine ʻoe i ke kō koko kiʻekiʻe a/a haʻahaʻa paha, e kamaʻilio me kāu kauka.

Ka Hoʻokele ʻana i ka Diabetes Type 2 i ka wā hāpai

ʻAʻole kūpono ka hapa nui o nā lāʻau lapaʻau waha a me nā injectables non-insulin no ka maʻi diabetes type 2 no ka hoʻohana ʻana i ka wā hāpai. ʻO ka metformin wale nō ka ʻokoʻa. No laila, pono paha ʻoe e hoʻohana i ka insulin no ka manawa mua e hoʻokele i kou pae kō koko i ka wā hāpai. Eia kekahi, hiki ke hoʻonui ʻia kāu mau pono insulin i ka holomua ʻana o kou hāpai ʻana.

E hana pū ana kāu hui lapaʻau me ʻoe e hoʻomohala i kahi hoʻolālā hoʻokele. Inā ʻaʻole ʻoe e hoʻohana nei i hoʻokahi, e paipai paha lākou i ka hoʻohana ʻana i kahi CGM (continuous glucose monitor).

He aha kāu e manaʻo ai i ka wā hāpai me ka maʻi diabetes?

Inā loaʻa iā ʻoe ka maʻi diabetes, hiki iā ʻoe ke manaʻo e loaʻa nā kipa a me nā hoʻokolohua prenatal hou aʻe ma mua o ka wā hāpai maʻamau. ʻO kēia i hiki i kāu mea mālama maʻi prenatal ke nānā pono i ka ulu ʻana o kāu pēpē a me kou olakino holoʻokoʻa. Ma waho aʻe o nā hoʻokolohua prenatal maʻamau (e like me nā hoʻokolohua koko a me kahi scan anatomy), hiki iā ʻoe ke manaʻo i kēia mau hoʻokolohua "keu":

• ʻO ka echocardiogram fetal: Hiki i kāu kauka ke ʻōlelo i kēia hoʻāʻo e nānā i ke ʻano o ka puʻuwai o kāu pēpē, ʻoiai ʻo ka loaʻa ʻana o ka maʻi diabetes e hoʻonui i ka pilikia o ka hoʻomohala ʻana i nā maʻi puʻuwai congenital.
• Nā scan ulu (ultrasounds): Manaʻo paha kāu kauka i nā scan i kēlā me kēia mau pule e nānā i ka ulu ʻana o kāu pēpē. He mea nui loa kēia no ka mea he nui ka pilikia o kāu pēpē e ʻoi aku ka nui ma mua o ka maʻamau. Akā e hoʻomanaʻo, he mau kuhi wale nō kēia mau ultrasounds. Hiki i kāu pēpē ke ʻoi aku ka nui a i ʻole ka liʻiliʻi ma mua o ka hōʻike ʻana o ke scan.
• Nā hoʻāʻo ʻole kaumaha (NST): I ke kolu o ka trimester o ka hāpai ʻana, hiki i kāu kauka ke ʻōlelo aku i nā NST hebedoma. Nānā kēia mau hoʻāʻo i ka helu o ka puʻuwai a me nā neʻe ʻana o ka pēpē.
• Nā ʻikepili Biophysical (BPP): Hiki i kāu kauka ke ʻōlelo aku i nā BPP hebedoma. He mau ultrasound kēia e nānā i nā ʻano hanu o ka pēpē, ke kani o nā ʻiʻo, a me ka neʻe ʻana. Ana pū lākou i ka nui o ka wai amniotic.

Pono nō hoʻi ʻoe e kamaʻilio pinepine me kāu endocrinologist a i ʻole kumu aʻo maʻi diabetes. E hāʻawi lākou i nā ala a me nā hoʻololi e kōkua ai e mālama i kāu mau pae glucose kokoke i kāu pae pahuhopu e like me ka hiki.

He aha nā pilikia a me nā pilikia o ka loaʻa ʻana o ka maʻi diabetes Type 1 a i ʻole Type 2 i ka wā hāpai?

He mea nui e hana i nā hana e mālama ai i ka maʻi diabetes i ka wā hāpai. Inā kiʻekiʻe loa kou pae kō koko, aia ʻoe i kahi pilikia nui o ka loaʻa ʻana o kekahi mau pilikia. Hiki i nā pae kō koko haʻahaʻa pinepine a koʻikoʻi paha ke lilo i mea weliweli.

ʻOi aku ka nui o ka pilikia o kēia poʻe i nā pilikia ma muli o ka loaʻa ʻana o ka maʻi diabetes pregestational:

• ʻO ka Embryo a me ka hāpai ʻana
• ʻO kāu pēpē ma hope o ka hānau ʻana
• ʻO ʻoe

Nā pilikia ma mua o ka hānau ʻana a me ka postpartum

ʻO ka loaʻa ʻana o ka maʻi diabetes i ka wā hāpai e hoʻonui i ka pilikia o nā pilikia no ka fetus, e like me:

• Nā kīnā hānau (nā kūlana hānau): Loaʻa nā kīnā hānau ma 6% a 12% o nā hāpai ʻana me ka maʻi diabetes gestational ma mua. ʻO nā kīnā puʻuwai hānau ka mea maʻamau, akā hiki nō hoʻi ke loaʻa nā kīnā neural tube a me nā ʻano ʻē aʻe.
• ʻO ka macrosomia fetal: ʻO kēia ka wā e kaupaona ai kahi pēpē hānau hou ma mua o 9 paona a me 15 auneke. ʻO ka loaʻa ʻana o kahi pēpē nui e hoʻonui i ka pilikia o ka ʻeha i ka wā hānau no ʻoe a me kāu pēpē.
• Polyhydramnios: He hoʻonui kēia o ka nui o ka wai amniotic i loko o ka ʻeke amniotic. Hiki i kēia ke alakaʻi i ka hānau mua ʻana a me ka hānau make.
• Ka hānau mua ʻana:Inā kū mai nā pilikia, ʻoi aku ka nui o ka pilikia o ka hānau ʻana ma mua o ka manawa, no ka mea, e hoʻoholo paha kāu kauka ʻo ka hānau ʻana ka koho palekana loa inā ʻaʻole ʻoe i hiki i ka manawa piha.
• Hānau make: ʻO ka loaʻa ʻana o ka maʻi diabetes gestational ma mua e hoʻonui ai i ka pilikia o ka hānau make.

Ma hope o ka hānau ʻana, ʻoi aku ka nui o ka pilikia o kāu pēpē i ka loaʻa ʻana o kekahi mau maʻi olakino. ʻOiai ʻo ka hapa nui o ka poʻe me ka maʻi diabetes e hānau i nā pēpē olakino, aia kahi pilikia kiʻekiʻe iki o kēia mau mea:

• Nā pae kō koko haʻahaʻa ma hope o ka hānau ʻana
• Nā pilikia hanu
• ʻĀʻī

Inā loaʻa i kāu pēpē kekahi o kēia mau pilikia, pono paha lākou e mālama ʻia ma ka NICU ( neonatal intensive care unit).

ʻO nā pēpē i hānau ʻia i ka poʻe me ka maʻi diabetes, ʻoi aku ka nui o ka lilo ʻana i ka momona ma hope o ke ola.

Nā pilikia e hoʻopilikia paha iā ʻoe

ʻO ka loaʻa ʻana o ka maʻi diabetes i ka wā hāpai e hoʻonui i kou pilikia o:

• Preeclampsia: ʻO ka Preeclampsia kahi kūlana i hōʻike ʻia e ke koko kiʻekiʻe a me ka protein i loko o ka mimi. ʻO ka maʻi diabetes kahi kumu nui o ka pilikia no ka preeclampsia. No ka hōʻemi ʻana i ka pilikia o ka preeclampsia, hiki i kāu kauka ke ʻōlelo aku e lawe i ka aspirin haʻahaʻa ma hope o 12 mau pule o ka hāpai ʻana.
• ʻO ka pono no ka ʻoki ʻoki cesarean (`C-section`): ʻO ke kumu nui o kēia, ʻo ia ka pilikia o ka nui loa o ka pēpē i ka wā hānau.
• Haʻahaʻa ke kō koko: No ka mea ke hoʻāʻo nei ʻoe e mālama i kou pae kō koko i kahi pae haiki, ua nui kou pilikia o ka haʻahaʻa pinepine a/a i ʻole ka haʻahaʻa nui o ke kō koko.
• ʻO ke ketoacidosis pili i ka maʻi diabetes (DKA): ʻOi aku kou pilikia o ka hoʻomohala ʻana i ka DKA i ka wā hāpai ma muli o ka hoʻonui ʻia o ke kūʻē ʻana o ka insulin. Hiki i ka luaʻi ʻana ma muli o ka maʻi kakahiaka ke kōkua pū i ka DKA.
• Nā pilikia e pili ana i ka maʻi diabetes: Hiki i ka hāpai ʻana ke hoʻonui aʻe a i ʻole ke kumu o nā pilikia hou o ka maʻi diabetes (e like me ka retinopathy, nephropathy, a me ka neuropathy).

Pehea ka hopena o ka maʻi diabetes i ka hānau ʻana a me ka hānau ʻana?

I ka hapanui o nā hihia, ʻōlelo nā kauka i kahi hoʻokomo i hoʻolālā ʻia ('induction i hoʻonohonoho ʻia') no nā wahine hāpai me ka maʻi diabetes. ʻO ka manawa a lākou e ʻōlelo ai i kahi hoʻokomo e pili ana i kekahi mau kumu, akā hana pinepine ia ma mua o 39 mau pule o ka hāpai ʻana. He ʻokoʻa kēlā me kēia hāpai ʻana. E hoʻoholo pū ʻoe a me kāu kauka i ka mea maikaʻi loa iā ʻoe.

Ma muli o nā loli hormonal a me ke kino i ka wā hānau, hiki ke piʻi a iho paha kou pae kō koko - he paʻakikī ke ʻōlelo maopopo. Ma muli o kāu kauka a me nā kulekele o ka haukapila, hiki paha iā ʻoe ke hoʻokele ponoʻī me kahi pamu insulin a i ʻole nā ​​​​​​inikini i ka wā hānau, a i ʻole pono ʻoe i kahi drip insulin IV.

Ma hope o ka wehe ʻia ʻana o ka placenta, e emi nui ana kāu mau pono insulin - maʻamau i ka pae like me ma mua o ka hāpai ʻana a i ʻole ka emi ʻana. E kamaʻilio me kāu kauka e pili ana i ka hana ʻana i kahi hoʻolālā e hoʻoponopono hou i kāu hoʻolālā hoʻokele maʻi diabetes ma hope o ka hānau ʻana.

Pehea e hiki ai iaʻu ke hoʻoponopono i nā loli e hele mai me ka maʻi diabetes a me ka hāpai ʻana?

Hiki i ka maʻi diabetes a me ka hāpai ʻana ke lawe mai i nā pilikia hou. ʻOkoʻa paha kou hāpai ʻana ma mua o kou manaʻo, a he mau nīnau paha kāu e pili ana i kāu hoʻolālā hoʻokele maʻi diabetes. ʻOiai he ʻokoʻa ka huakaʻi a kēlā me kēia kanaka, hiki i kekahi me ka maʻi diabetes ke hahai i kēia mau ʻōlelo aʻoaʻo e hoʻolilo i ko lākou ʻike i olakino e like me ka hiki ke hāpai lākou:

• E nānā pinepine i kou pae kō koko (e like me ke kuhikuhi a kāu kauka).
• E mālama i kou pae kō koko i loko o ka pae i manaʻo ʻia.
• E hahai i nā ʻōlelo a kāu kauka e pili ana i ka insulin, nā lāʻau lapaʻau, a me nā lāʻau lapaʻau ʻē aʻe.
• E hele i kāu mau manawa hoʻonohonoho a me nā nānā ʻana i ke keʻena hāpai.
• E noho ikaika kino. E kamaʻilio me kāu kauka e pili ana i kāu pae hana a inā pono ʻoe e hoʻololi.
• E ʻai i nā meaʻai olakino a kaulike a me nā meaʻai māmā.
• E hōʻalo i nā mea inu i loaʻa ka waiʻona a me nā huahana paka.
• E mālama i kou olakino noʻonoʻo. He mea maʻamau ka manaʻo kaumaha i kēia manawa. Mai makaʻu e kamaʻilio e pili ana i ia mea a noi i ke kōkua.

Āhea wau e ʻike ai i kaʻu kauka?

Inā loaʻa iā ʻoe ka maʻi diabetes a ʻike ʻoe i kekahi o kēia mau mea, e kamaʻilio me kāu mea mālama maʻi prenatal:

• Inā ʻaʻole hiki iā ʻoe ke mālama i kou pae kō koko i loko o ka pae i makemake ʻia me ka nānā ʻole i kāu mau hana maikaʻi loa. (Inā haʻahaʻa loa a kiʻekiʻe loa paha.)
• Inā piʻi koke a loli paha kou pae kō koko no nā kumu āu i maopopo ʻole ai.
• Inā manaʻo ʻoe e neʻe iki ana ke keiki i loko o ka ʻōpū.
• Inā he wai a koko paha e puka mai ana mai loko mai o kou ʻōpū.
• Inā he ʻike pōwehiwehi kou a i ʻole ka make wai nui.
• ʻAʻole pilikia inā ʻoe e luaʻi ana, ʻaʻole pilikia inā ʻaʻole hiki iā ʻoe ke hoʻomau i ka ʻai a me ka inu ʻana.

E hoʻomanaʻo, ʻoi aku ka maikaʻi o ka palekana ma mua o ke kaumaha a nīnau i nā nīnau. Ma waho aʻe o ka hopohopo e pili ana i ka hāpai ʻana, hiki i ka hopohopo e pili ana i ka mālama ʻana i ka maʻi diabetes ke lilo i mea kaumaha. Mai kānalua i kou mau manaʻo a hoʻowahāwahā paha iā lākou - e kamaʻilio me kāu kauka no ke alakaʻi.

He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?

Inā loaʻa iā ʻoe ka maʻi diabetes a hāpai ʻoe, makemake paha ʻoe e nīnau i kāu kauka e pili ana i kēia mau mea:

• ʻEhia pinepine e pono ai iaʻu ke nānā i koʻu pae kō koko?
• He aha kaʻu laulā pahuhopu?
• He aha nā pilikia e hiki mai ana inā ʻaʻole mālama ʻia koʻu pae kō koko i loko o ka pae i makemake ʻia?
• Pono anei iaʻu e hoʻololi i kaʻu dosis insulin?
• Pono anei wau e hoʻōki a hoʻomaka paha i nā lāʻau lapaʻau ʻē aʻe?
• Ke paipai nei ʻoe i nā hoʻololi nohona?
• ʻEhia pinepine e pono ai iaʻu e hele mai no ka nānā ʻana?
• Pono anei iaʻu e hana i ka hoʻokomo mua ʻana?

Hiki i nā kānaka me ka maʻi diabetes Type 1 ke hānau i nā pēpē olakino?

ʻAe, he nui ka poʻe me ka maʻi diabetes Type 1 (a me ka maʻi diabetes Type 2) he mau pēpē olakino. ʻO ka mālama ʻana i kou pae kō koko a me ka mālama ʻana i ke kamaʻilio pili me kāu hui lapaʻau nā kī i ka hāpai kino olakino.

Hiki ke paʻakikī loa ka mālama ʻana i ka maʻi diabetes i ka wā hāpai, ʻoiai no ka poʻe i noho me ka maʻi diabetes no nā makahiki he ʻumi. ʻO ka mālama ʻana i kou pae kō koko i kahi pae olakino i kou wā hāpai hiki ke koi nui i ka noʻonoʻo a me ke kino. Akā me ka ʻōnaehana kākoʻo kūpono a me kahi hoʻolālā hoʻokele maʻi diabetes, hiki iā ʻoe ke lanakila i nā pilikia a ka maʻi diabetes e lawe mai ai i ka hāpai ʻana.

E hoʻomau i ke kamaʻilio pū ʻana me kāu hui lapaʻau. E haʻi iā lākou i ka wā e kaumaha ana ʻoe. Ma o nā mea āpau, e kālele i ke kukui ma ka hopena o ke ana - ka hālāwai ʻana me kāu pēpē.

He leka hope loa e lawe ʻia i ka home

ʻAe, no laila mai kā mākou i kamaʻilio ai, pono ʻoe e maopopo e pili ana i ka hāpai ʻana me ka maʻi diabetes. ʻAʻohe kumu e makaʻu ai, akā pono ʻoe e makaʻala.

• E hoʻolālā i mua: Inā ʻoe e noʻonoʻo ana e loaʻa kahi pēpē, e ʻimi i ke aʻo lapaʻau i kekahi mau mahina ma mua.
• Kaohi ʻana i ke kō koko: E hoʻāʻo i kāu mea maikaʻi loa e mālama i kou pae kō koko i loko o nā pahuhopu a kāu kauka i hoʻonohonoho ai nou i kou wā hāpai. Hiki i nā mea e like me ka 'CGM' ke kōkua i kēia.
• E hana pū me ka hui lapaʻau: e kamaʻilio pinepine me lākou, e nīnau i nā nīnau, a e kaʻana like i kou mau manaʻo.
• He nohona olakino: He mea nui loa ka ʻai pono ʻana, ka hoʻoikaika kino inā pono (e like me ke kuhikuhi a ke kauka), a me ke olakino noʻonoʻo.

E hoʻomanaʻo, ʻoiai inā loaʻa iā ʻoe ka maʻi diabetes, me ka mālama pono ʻana a me ka nānā ʻana o ke kauka, hiki iā ʻoe ke lawe mai i kahi pēpē olakino a hauʻoli hoʻi i kēia ao. E loaʻa iā ʻoe ka ikaika a me ke koa e pono ai ʻoe e hana pēlā!

ʻO ka maʻi diabetes, ka hāpai ʻana, ke kō koko, ka insulin, ka hānau keiki ʻana, nā pilikia, ka pēpē olakino