He kanaka anei ʻoe i loaʻa i ka maʻi diabetes? No laila, ke manaʻo nei ʻoe i ka mae ʻole, ka ʻūlū, ka wela, a i ʻole ka ʻeha i kou mau lima a me kou mau wāwae? He mau hōʻailona paha kēia e hōʻino mālie ʻia ana kou mau aʻalolo e ka maʻi diabetes. Mai hopohopo, he ʻano kēia e hoʻopilikia nei i nā poʻe he nui. I kēia lā, e kamaʻilio mākou e pili ana i kēia maʻi aʻalolo i hoʻokumu ʻia e ka maʻi diabetes, i kapa ʻia ʻo `(Diabetes-Related Neuropathy)`.
I ka ʻōlelo maʻalahi, he aha ka neuropathy?
E noʻonoʻo i ka ʻōnaehana nerve i loko o ko kākou kino e like me ke kaula uila i loko o kahi hale. Lawe kēia mau aʻalolo i nā leka mai ka lolo a i kēlā me kēia kihi o ke kino, a lawe kēia mau aʻalolo i nā leka mai nā wahi ʻē aʻe o ke kino i ka lolo. Loaʻa i kēia mau aʻalolo ka meaʻai a me ka oxygen mai nā kīʻaha koko liʻiliʻi loa.
I kēia manawa, ke loaʻa iā ʻoe ka maʻi diabetes, ʻo ia hoʻi ke kiʻekiʻe o kou pae kō koko (Hyperglycemia) no ka manawa lōʻihi, hoʻomaka kēia mau kīʻaha koko palupalu e hōʻino ʻia. E like me ka wā e hele ai ka wai me ka nui o ke kō ma o nā paipu, hoʻomaka nā paipu e popo. Ke hōʻino ʻia nā kīʻaha koko ma kēia ʻano, ʻaʻole loaʻa i nā aʻalolo, e like me nā uea uila, ka meaʻai a me ka oxygen e pono ai. A laila e nāwaliwali mālie kēlā mau aʻalolo, hōʻino ʻia, a hoʻomaka e make. ʻO ia ka mea a mākou e kapa nei he Diabetes-Related Neuropathy .
Hiki i kēia ke hana i nā poʻe me ka maʻi diabetes "ʻAno 1" a me ka maʻi diabetes "ʻAno 2". Eia naʻe, ʻaʻole ia e hana i nā mea āpau me ka maʻi diabetes. Eia kekahi, hiki ke hana ʻia ka neuropathy no nā kumu ʻē aʻe. No ka laʻana, hiki ke hana ʻia e kahi ʻeha aʻalolo, kahi hemahema meaʻai, a i ʻole kahi ulia. Eia naʻe, inā ʻike ke kauka he maʻi diabetes kou a ʻaʻole hiki ke loaʻa i kahi kumu ʻē aʻe no kēia mau hōʻailona, e hōʻoia lākou he maʻi diabetes.
He aha nā ʻano maʻi aʻalolo i hoʻokumu ʻia e ka maʻi diabetes?
Hiki i kēia hōʻino aʻalolo ke hoʻopilikia i nā aʻalolo ma nā ʻāpana like ʻole o ke kino. Ua māhele ʻia i kekahi mau ʻano nui ma muli o kahi i hoʻopilikia ʻia ai. E nānā kākou i ko lākou ʻano.
| ʻAno maʻi neurological | I ka ʻōlelo maʻalahi, he aha ka mea e hana ʻia me kēia? |
|---|---|
| ʻO ka Neuropathy Peripheral | ʻO kēia ke ʻano maʻamau i ʻike ʻia i waena o ka poʻe me ka maʻi diabetes.ʻO 'Peripheral' e pili ana i nā aʻalolo e hoʻolōʻihi ana mai ke kaula spinal a i nā wēlau o ke kino. Hoʻopilikia nui kēia i nā wāwae a me nā kapuaʻi. I kekahi manawa hiki ke hoʻopilikia ʻia nā lima ʻelua. |
| ʻO ka Neuropathy Autonomic | ʻO ke ʻano o "Autonomic" e pili ana i nā aʻalolo e kāohi ana i nā kaʻina hana o ke kino i hiki ʻole iā mākou ke kāohi. No ka laʻana, nā mea e like me ka helu o ka puʻuwai, ke koko, ka hou ʻana, ka neʻe ʻana o ka ʻōpū, ka hana ʻōpū mimi, a me ka hana moekolohe. Hāʻule ka hōʻino ʻana i kēia mau aʻalolo i loko o kēia māhele. |
| ʻO ka Neuropathy Proximal | He ʻano laha ʻole kēia. Hoʻopilikia ia i nā aʻalolo ma ka ʻūhā, ka ʻūhā, a i ʻole ka puʻupuʻu. Hoʻopilikia pinepine ia i hoʻokahi ʻaoʻao o ke kino. |
E hoʻomanaʻo, ua hōʻike ʻia nā noiʻi he 50% o ka poʻe me ka maʻi diabetes e loaʻa ana i ka "Peripheral Neuropathy". ʻO ia hoʻi, hoʻokahi i loko o ʻelua mau kānaka i ka pilikia.
He aha nā hōʻailona o kēia mau maʻi neurological?
ʻO nā hōʻailona āu e ʻike ai e pili ana i ke ʻano o ka neuropathy āu. E nānā kākou i nā hōʻailona e pili ana i kēlā me kēia ʻano kaʻawale.
Nā Hōʻailona o ka Neuropathy Peripheral
Ma muli o ka hopena nui o kēia i nā wāwae, hiki iā ʻoe ke ʻike i nā mea e like me:
- Ke ʻūlū nei ma nā lālā , ka manaʻo o nā ʻanuʻu e holo ana a puni, ka manaʻo e hou ʻia ana e nā nila (Paresthesia).
- ʻO ka ʻeha ʻoi, e like me ke kuni ʻana, ka hou ʻana, a i ʻole ka haʻalulu uila.
- He pane kūpono ʻole i ka hoʻopā ʻana. Eia kekahi laʻana, ke ʻeha nui nei ke hamo ka pepa moe i ka wāwae (Dysesthesia).
- Ka nāwaliwali o nā ʻiʻo.
- ʻO nā ʻeha ma nā wāwae a i ʻole nā kapuwaʻi e lōʻihi ka manawa e ho'ōla ai .
- I kekahi manawa, nalowale nā manaʻo a pau o kou mau wāwae. A laila, inā paha e hou ʻia ʻoe e ke kākalaioa a i ʻole e ʻeha ʻia e ke kāmaʻa, ʻaʻole hiki iā ʻoe ke manaʻo.
Hiki mālie kēia hōʻino ʻana o ke aʻalolo i nā makahiki he nui, no laila ʻaʻole paha ʻoe e ʻike i kekahi mau hōʻailona nui i nā pae mua.
Nā Hōʻailona o ka Neuropathy Autonomic
Ma muli o ka hoʻopili ʻana i kekahi mau ʻōnaehana i loko o ke kino, hiki ke ʻokoʻa loa nā hōʻailona.
| ʻŌnaehana i hoʻopilikia ʻia | Nā hōʻailona hiki ke loaʻa |
|---|---|
| ʻŌnaehana hoʻoheheʻe | Pehu, ʻeha puʻuwai, nausea a me ka luaʻi ʻana, kinoea , diarrhea a i ʻole constipation. I kekahi manawa, ma hope o ka ʻai ʻana, ua lohi ka haʻalele ʻana o ka meaʻai i loko o ka ʻōpū mai ka ʻōpū (Gastroparesis) . |
| ʻŌnaehana mimi | ʻO ka mimi ʻana me ka makemake ʻole, ka hiki ʻole ke hoʻokahe loa i ka mimi, nā maʻi pinepine o ke ala mimi. |
| Nā ʻōpū wahine | ʻO ka hana pono ʻole o ka moekolohe, nā pilikia ejaculation, ka maloʻo o ka vagina, ka hiki ʻole ke hoʻokō i ka orgasm. |
| Puʻuwai a me nā kīʻaha koko | Ke koko haʻahaʻa (ʻoi aku hoʻi i ke ala ʻana mai kahi noho ʻana), ka puʻuwai kūpono ʻole, ka poniuniu, a me ka maule. |
| Nā ʻōpū hou | Ka hou nui ʻana a i ʻole ka nele i ka hou ʻana. |
| Nā maka | Ka paʻakikī i ka hoʻoponopono ʻana i ka haumāna i nā loli o ka mālamalama (e laʻa, i ka wā e puka ai mai ka pouli). |
ʻO kekahi mea weliweli e hiki ke hana me kēia maʻi neurological ʻo ia ka mea ʻaʻole paha ʻoe e ʻike i nā hōʻailona hōʻailona o ka hypoglycemia, e like me ka haʻalulu, ka pōloli nui, a me ka hopohopo. Hiki i kēia ke lilo i mea weliweli.
He aha nā mea e hoʻonui ai i ka pilikia o kēia maʻi?
Inā loaʻa iā ʻoe ka maʻi diabetes, aia kekahi mau kumu e hoʻonui ai i kou pilikia o ka hoʻomohala ʻana i kēia neuropathy:
- Ka lōʻihi o ka maʻi diabetes: ʻO ka lōʻihi o kou loaʻa ʻana i ka maʻi diabetes, ʻo ka nui aʻe o ka pilikia o ka hōʻino ʻia ʻana o nā aʻalolo.
- Makahiki: Hoʻonui pū kēia pilikia me ka makahiki.
- Ka kaohi maikaʻi ʻole o ke kō koko: Inā kiʻekiʻe mau kou pae kō koko, ʻo ia ke kumu nui o ka pilikia. ʻO ka loaʻa ʻana o kahi A1C ma luna o 7% no nā makahiki ʻekolu a ʻoi aku ka nui o ka hoʻonui ʻana i kou pilikia.
- Ke koko kiʻekiʻe (Hypertension): Inā kiʻekiʻe ke koko, hiki iā ia ke hōʻino i nā kīʻaha koko palupalu.
- ʻO ke kolesterol kiʻekiʻe: ʻAʻole maikaʻi ka piʻi ʻana o ka nui o ka cholesterol i loko o ke koko no nā kīʻaha koko.
- Ke kaumaha o ke kino (BMI kiʻekiʻe): Pili pū ka momona i kēia.
- Maʻi puʻupaʻa: Inā ua hōʻino ʻia nā puʻupaʻa ma muli o ka maʻi diabetes, ʻoi aku ka kiʻekiʻe o ka pilikia o ka neuropathy.
- Puhi paka a me ka inu ʻona: ʻO kēia mau ʻano ʻelua e hōʻino pololei i nā kīʻaha koko a me nā aʻalolo.
Pehea e ʻike ai ke kauka i kēia?
Inā loaʻa iā ʻoe kēia mau hōʻailona, ʻo ka mea mua āu e hana ai, ʻo ia ke ʻike i kāu kauka. E nīnau ʻo ia iā ʻoe e pili ana i kāu mau hōʻailona a pehea ʻoe e mālama ai i kāu maʻi diabetes. A laila, e hana lākou i kahi hoʻokolokolo kino. Aia kekahi mau hoʻokolohua e hiki ke hana ʻia e hōʻoia i ka hōʻailona.
- Hoʻokolokolo wāwae maʻi diabetes: Maanei, e nānā pono ke kauka i kou mau wāwae no kekahi mau ʻeha, ʻoki, a i ʻole nā ʻōpū. A laila, me ka hoʻohana ʻana i kahi mea hana liʻiliʻi (e like me ka monofilament), e hoʻopā lākou i nā wahi like ʻole o kou mau wāwae a ʻike inā hiki iā ʻoe ke hoʻopā iā lākou. E kōkua kēia i ka hoʻoholo ʻana i ka nui o ka ʻike i nalowale i kou mau wāwae.
- Nā Haʻawina Hoʻoili Aʻalolo (NCS): Ke ana kēia i ka wikiwiki o ka hele ʻana o nā hōʻailona uila ma kou mau aʻalolo. Inā ua hōʻino ʻia nā aʻalolo, e hoʻemi ʻia kēia wikiwiki.
- Electromyography (EMG): Nānā kēia hoʻokolohua i ke olakino o kou mau ʻiʻo a me nā aʻalolo e kaohi ana iā lākou.
ʻOkoʻa nā hoʻāʻo e ʻike ai i ka neuropathy autonomic ma muli o ka ʻōnaehana i hoʻopilikia ʻia. No ka laʻana, inā he pilikia me ka ʻōpū mimi, hiki ke hana ʻia kahi scan ultrasound.
He aha nā lāʻau lapaʻau no kēia?
ʻO ka hana mua a koʻikoʻi loa i ka mālama ʻana, ʻo ia ke kāohi pono i kou pae kō koko . ʻO kēia ka mea hiki ke hoʻōki a hōʻemi paha i ka hōʻino hou ʻana i nā aʻalolo.
E kōkua kāu kauka iā ʻoe e mālama i nā pae kō koko olakino a mālama i kekahi mau hōʻailona āu e loaʻa ai, ʻoiai ka ʻeha.
- Nā lāʻau lapaʻau e hōʻoluʻolu ai i ka ʻeha: Hoʻohana pinepine ʻia nā lāʻau lapaʻau e like me 'Pregabalin' a me 'Gabapentin' no ka ʻeha o ke aʻalolo. I kekahi manawa, hoʻohana ʻia nā ʻāpana '(Capsaicin)' i hoʻopili ʻia i ka wahi ʻeha a i ʻole kekahi mau lāʻau lapaʻau no ke kaumaha '(Antidepressants)' no kēia ʻeha.
- Hoʻōla Kino: Kōkua kēia i ka hoʻoikaika ʻana i nā ʻiʻo, pale i nā pilikia hele wāwae, a mālama i ke kaulike.
- Hoʻōla Hana: Hāʻawi i nā ʻōlelo aʻoaʻo a me nā mea kōkua e maʻalahi ai nā hana o kēlā me kēia lā.
- Nā lāʻau lapaʻau ʻē aʻe: Hiki i kekahi poʻe ke loaʻa ka hōʻoluʻolu o ka ʻeha ma o nā mea e like me ka acupuncture. He mea nui hoʻi e ʻike i kahi meaʻai meaʻai e aʻo e pili ana i ka ʻai olakino.
Hiki ke hoʻohuli ʻia kēia pōʻino aʻalolo?
He nīnau kēia a ka poʻe he nui e nīnau ai. Inā mālama pono ʻia ke kiʻekiʻe o ke kō koko, hiki i nā hōʻailona mua e like me ke kani ʻana ke emi a nalo paha i loko o hoʻokahi makahiki a i ʻole. Eia nō naʻe, inā koʻikoʻi ka hōʻino ʻana i nā aʻalolo , he paʻakikī ke hoʻohuli loa iā ia. No laila he mea nui e ʻike koke i nā hōʻailona a hoʻomaka e kaohi i kāu kō.
He aha kā kākou e hana ai e pale aku ai?
ʻO ka mea maikaʻi loa e hana ai, ʻo ia ke pale aku i kēia. Aia kekahi mau mea hiki iā ʻoe ke hana e hana ai i kēlā:
- E mālama i kāu A1C ma lalo o 7%. ʻO kēia ka mea nui loa.
- E mālama i ke kaomi koko ma lalo o 140/90 mmHg a i ʻole ma ka pae i manaʻo ʻia e kāu kauka.
- E hahai i kahi papaʻai olakino a me ka hoʻolālā hoʻoikaika kino.
- E mālama i ke kaumaha o ke kino olakino.
- Inā ʻoe e puhipaka ana, e hoʻōki koke.
- E hōʻemi a hoʻōki loa paha i ka inu ʻana i ka waiʻona .
- E ʻike i kāu kauka ma ka liʻiliʻi hoʻokahi manawa i ka makahiki no kahi nānā piha, ʻoiai ka hoʻokolokolo wāwae .
- E nānā i kou mau wāwae i kēlā me kēia lā no nā pehu, nā ʻoki, nā ʻeha, nā māwae ʻili, a me ka ʻulaʻula. No ka mea, ʻaʻole ʻoe i ʻike nui, hiki iā ʻoe ke hōʻeha iā ʻoe iho me ka ʻike ʻole.
Leka Lawe-Home
- ʻO ka neuropathy i hoʻokumu ʻia e ka maʻi diabetes he pilikia maʻamau, akā hiki ke pale ʻia.
- ʻO ka lāʻau lapaʻau maikaʻi loa a me ka pale no kēia, ʻo ia ke kaohi pono i kou pae kō koko .
- Inā he ʻeha kou, he ʻūlū, he ʻeha, a he nalowale paha o ka ʻike ma kou mau lālā, mai hoʻowahāwahā. E kamaʻilio koke me kāu kauka.
- E nānā pono i kou mau wāwae i kēlā me kēia lā. ʻOiai kahi ʻeha liʻiliʻi hiki ke lilo i pilikia nui. Inā ʻike ʻoe i kahi ʻeha, e ʻimi koke i ka lāʻau lapaʻau.
- Me ke kaohi ʻana i ke kō, he mea nui hoʻi e kaohi i ke koko, ka cholesterol, a pale i ka puhipaka.
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