ʻO ka pilikia weliweli loa i ka maʻi diabetes! E makaʻala kākou i ka DKA (Diabetic Ketoacidosis)

Loaʻa iā ʻoe ka maʻi diabetes? A i ʻole he lālā o kou ʻohana a i ʻole he hoaaloha paha kou i loaʻa ka maʻi diabetes? A laila pono ʻoe e ʻike e pili ana i ka mea a mākou e kamaʻilio nei i kēia lā. Ua kapa ʻia kēia ʻo DKA (Diabetic Ketoacidosis). He pilikia weliweli loa kēia, a hiki ke hoʻoweliweli i ke ola e hiki ke hana ma muli o ka maʻi diabetes. Akā, mai hopohopo, inā ua ʻike pono ʻia mākou e pili ana i kēia, hiki iā mākou ke pale iā mākou iho mai ia mea a hana koke inā hiki koke mai.

I ka ʻōlelo maʻalahi, he aha ʻo DKA?

E noʻonoʻo i nā pūnaewele i loko o ko kākou kino e like me nā hale liʻiliʻi. Pono kēia mau hale i ka ikehu e hana. Loaʻa kēlā ikehu mai ka glucose, a i ʻole ke kō, mai ka meaʻai a kākou e ʻai ai. Akā i mea e hiki ai i kēia kō ke komo i loko o nā hale i kapa ʻia he mau pūnaewele, pono ia i kahi kī e wehe ai i ka puka. ʻO kēlā kī ka hormone insulin .

I kēia manawa, ʻo ka mea e hana ʻia ana i loko o ke kino o ke kanaka me ka maʻi diabetes, ʻaʻole lawa kēia kī i kapa ʻia ʻo ka insulin. He aha ka mea e hana ʻia a laila? ʻAʻole hiki i ke kō ke komo i loko o nā ʻāpana a ua piha i ke koko. Akā, ʻaʻohe ikehu o nā ʻāpana, "pōloli lākou".

Ke hana ʻia kēia, manaʻo ko mākou kino ua pōloli maoli mākou me ka ʻole o ka meaʻai. No laila hoʻomaka ke kino e ʻimi i ka ikehu ma kekahi ʻano ʻē aʻe. ʻO ia hoʻi, ma ka puhi ʻana i ka momona i mālama ʻia i loko o ke kino e hana i ka ikehu. Ke puhi ʻia ka momona ma kēia ʻano, hana ʻia kahi kemika i kapa ʻia ʻo ketones ma ke ʻano he huahana ʻaoʻao.

ʻAʻole pilikia ka loaʻa ʻana o kekahi mau ketones i loko o ke koko. Akā, i ka wā e puhi mau ʻia ai ka momona me ka ʻole o ka insulin, hōʻiliʻili nui kēia mau ketones i loko o ke koko. He ʻano waikawa kēia mau ketones. No laila, i ka wā e hoʻonui ai lākou i loko o ke koko, lilo mālie ko mākou koko i mea ʻakika. Ua like ia me ka hoʻohui ʻana i ka vīnega i loko o ke aniani wai. ʻO kēlā acidosis o ke koko a me ka dehydration e hele pū ana me ia ka mea a mākou e kapa nei ʻo DKA (Diabetic Ketoacidosis).

ʻO wai ka mea i pilikia nui i ka hoʻomohala ʻana i ka DKA?

ʻOiai hiki ke loaʻa ka DKA i loko o kekahi maʻi diabetes, ʻoi aku ka nui o ka pilikia o kekahi poʻe.

• Nā kānaka me ka maʻi diabetes Type 1: ʻOi aku ka nui o ka loaʻa ʻana o kēia poʻe i ka DKA no ka mea ua aneane pau loa ka hana ʻana o ko lākou kino i ka insulin.
• No ka poʻe i ʻike ʻole he maʻi diabetes ko lākou: ʻO ka mea kupanaha, ʻike wale kekahi poʻe he maʻi diabetes type 1 ko lākou ma hope o ka loaʻa ʻana o DKA a hoʻokomo ʻia i ka haukapila. ʻO kēia ka helu ma waena o 20% a me 40% o nā maʻi DKA.
• No nā kānaka me ka maʻi diabetes Type 2:ʻOiai ʻaʻole ia he mea maʻamau, hiki i kekahi poʻe me ka maʻi diabetes type 2 ke hoʻomohala i ka DKA, ʻoiai i nā kūlana e like me nā maʻi koʻikoʻi.

He aha nā hōʻailona o kēia ʻano weliweli? Pehea mākou e ʻike ai?

ʻAʻole ulu koke ka DKA. Hiki iā ia ke hoʻomaka me nā hōʻailona liʻiliʻi a laila lilo i mea koʻikoʻi i loko o 24 mau hola. Inā ʻoe e luaʻi ana, hiki ke pōkole kēia manawa. No laila he mea nui e makaʻala i kēia mau hōʻailona.

Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona koʻikoʻi, e kāhea koke aku i kāu kauka. A i ʻole, inā hiki, e hele i ka ʻOihana Pilikia (ETU) o ka haukapila kokoke loa i ka hikiwawe loa.

No ke aha e kū mai ai kēia maʻi DKA? He aha nā kumu nui?

ʻO ke kumu nui o DKA ʻaʻole lawa ka insulin i ke kino. Hiki i kēia mau mea ke kōkua i ia mea:

• Nā inikini insulin i hala: Inā hala kekahi kanaka e lawe ana i ka insulin no ka maʻi diabetes i hoʻokahi a ʻelua paha inikini, hiki ke hana ʻia ʻo DKA.
• Nā pilikia o ka pamu insulin: Inā hoʻohana kekahi i ka pamu, ʻaʻole paha e loaʻa i ke kino ka insulin ma muli o nā kumu e like me ka paipu i paʻa ʻia a i ʻole kahi pilina palupalu i ke kino.
• Ke hoʻohana ʻana i ka insulin i pau ka lāʻau a i ʻole ka insulin i hōʻino ʻia: ʻO ka insulin kahi lāʻau lapaʻau i kū ʻole i ka wela nui a i ʻole ke anu. No ka laʻana, inā ʻaʻole ia e hoʻokomo ʻia i loko o ka pahu hau a i ʻole ua pau ka lāʻau, hiki ke nalowale kona pono.
• Nā maʻi a me nā maʻi ahulau: ʻO kēlā me kēia maʻi, e like me ke kuni, ka maʻi pneumonia, nā maʻi urinary tract (UTI), he kumu nui ia o DKA. ʻO kēia no ka mea ke maʻi mākou, lilo ko mākou kino i ke kaumaha a hana i nā hormones e hana kūʻē i ka insulin. A laila pono mākou i ka insulin hou aʻe ma mua o ka maʻamau.
• Nā kumu ʻē aʻe: ʻO ka ʻeha kino koʻikoʻi, ka trauma, ke ʻoki kino, ka hōʻeha puʻuwai, ka hāpai ʻana, ka inu nui ʻana i ka waiʻona, a me kekahi mau lāʻau lapaʻau e hoʻonui pū i ka pilikia o DKA.

He aha ka mea e hana inā ʻaʻole mālama koke ʻia ʻo DKA?

ʻO kēia ka ʻāpana weliweli loa e pono ai kākou a pau e makaʻala. Hiki i ka DKA ke alakaʻi i nā pilikia koʻikoʻi loa inā ʻaʻole e mālama koke ʻia a kūpono hoʻi.

• Haʻahaʻa loa nā pae potassium i loko o ke koko.
• Pehu ʻana o ka lolo.
• Ke hoʻopiha nei i nā māmā me ka wai.
• Paʻa ka puʻuwai.
• Ka hōʻino ʻana i nā puʻupaʻa a me nā ʻōpū ʻē aʻe.
• Koma.
• I ka hopena, hiki nō hoʻi ke make.

Pehea e mālama ʻia ai?

Pono e mālama ʻia ka lāʻau no DKA ma ka haukapila. Inā loaʻa iā ʻoe nā hōʻailona o DKA, e hele koke i ka haukapila.

Ka lāʻau i hāʻawi ʻia ma ka haukapila

1. Nā wai IV: ʻO ka hana mua, ʻo ia ka hāʻawi ʻana i ka saline. Kōkua kēia i ka pale ʻana i ka maloʻo ʻana o ka wai, hoʻokahe i ke kō keu a me nā ketones i loko o ke koko, a hoʻomaʻemaʻe i ke kino.

2. ʻInsulina: Hāʻawi ʻia ka ʻinsulina ma o ka intravenous. Hoʻomalu kēia i nā pae kō koko a hoʻomaka hou ke kino e hoʻohana i ke kō no ka ikehu. Hoʻōki pū kēia i ka hoʻokumu ʻia ʻana o nā ketones.

3. Ka Hāʻawi ʻana i nā Electrolytes: Hoʻolilo ka DKA i ke kino i ka nalowale o nā minelala koʻikoʻi e like me ka potassium. Hāʻawi ʻia kēia mau mea ma ke ʻano intravenous e hoʻihoʻi i ke kaulike i ke kino.

Ka mālama ʻana ma ka home (ma ke aʻo a ke kauka wale nō)

Inā ʻike mua ʻia ʻo DKA, hiki i kāu kauka ke ʻōlelo aku i ka mālama ʻana ma ka home. Eia nō naʻe, pono e hana ʻia kēia mau mea ma lalo o ka nānā ʻana a kāu kauka.

• E nānā pinepine i nā pae kō koko (malia paha i hoʻokahi manawa i ka hola).
• Ke nānā ʻana i nā pae ketone.
• E inu i ka wai nui a me nā wai me ke kō ʻole e pale ai i ka maloʻo ʻana.
• Ke pale nei i ka hoʻoikaika kino.

He aha kā mākou e hana ai e pale aku ai i ka ulu ʻana o DKA?

He maʻi ʻo DKA hiki iā mākou ke pale pinepine. Hiki i kēia mau mea ke kōkua.

• E nānā pinepine i kou pae kō koko: E nānā i kou kō koko i nā manawa he nui i ka lā, ʻoi aku hoʻi ma mua a ma hope o ka ʻai ʻana, a ma mua o ka hiamoe ʻana. Inā kiʻekiʻe kou pae kō koko, e hana koke.
• E lawe i kāu insulin a me nā lāʻau lapaʻau i ka manawa kūpono: Mai hōʻole i kahi mahele o ka insulin i kauoha ʻia e kāu kauka.
• E nānā i nā ketones: Inā ʻoi aku ke kiʻekiʻe o kou pae kō koko ma mua o 250 mg/dL, a inā he maʻi kou e like me ke kuni a i ʻole ka luaʻi ʻana, e nānā i kāu mimi a i ʻole ke koko no nā ketones.
• E hana i kahi "hoʻolālā lā maʻi": E kamaʻilio me kāu kauka a e hana i kahi hoʻolālā ma mua e pili ana i ka hoʻoponopono ʻana i kāu nui o ka insulin a pehea e ʻai ai inā loaʻa iā ʻoe ke kuni a luaʻi paha.
• E makaʻala: ʻO ka nui o kou ʻike e pili ana iā DKA, ʻoi aku ka maikaʻi o kou manawa e ola ai. E noi i kāu kauka no ka ʻike hou aku e pili ana i kēia.

I kekahi manawa, ʻoiai ke akahele o kākou, hiki ke loaʻa ka DKA no nā kumu i ʻole e hiki mai ana ma ko kākou mana. Inā hana ʻia kēlā, mai manaʻo ʻino no ia mea a manaʻo ʻoe he hewa kou. ʻO ka mea nui loa, ʻo ia ka ʻike ʻana i nā hōʻailona a me ka ʻimi ʻana i ke kōkua lapaʻau i ka wā hikiwawe loa.