Ke haʻalulu koke nei ʻoe? Ke hou nei, ke poniuniu nei, a me ka pōloli loa? He mau hōʻailona paha kēia ua haʻahaʻa kou pae kō koko ma mua o ke olakino. Ma nā ʻōlelo lapaʻau, kapa mākou i kēia ʻano he hypoglycemia . He mea maʻamau kēia i waena o ka poʻe me ka maʻi diabetes. Akā i kekahi manawa hiki ke hana i ka poʻe me ka ʻole o ka maʻi diabetes. No laila, mai hopohopo. E kamaʻilio kākou e pili ana i kēia me ka maʻalahi a me ka maopopo.
I ka ʻōlelo maʻalahi, he aha ka hypoglycemia?
ʻO ka hypoglycemia ka wā e hāʻule ai ka nui o ka glucose, a i ʻole ke kō e like me kā mākou e kapa nei, i loko o kou koko ma lalo o ka pae olakino e pono ai ke kino.
- No ka hapa nui o nā kānaka me ka maʻi diabetes, ua manaʻo ʻia he hypoglycemia ka pae kō koko ma lalo o 70 mg/dL (milligrams no ka deciliter) a i ʻole 3.9 mmol/L (millimoles no ka lita).
- No kekahi kanaka me ka ʻole o ka maʻi diabetes, ʻo ka hypoglycemia ka mea maʻamau i wehewehe ʻia he pae ma lalo o 55 mg/dL (3.1 mmol/L).
Ke kū mai kēia ʻano, pono e mālama koke ʻia ma ka ʻai ʻana a i ʻole ka inu ʻana i kahi mea i loaʻa ke kō a i ʻole nā kalapona. I kekahi manawa hiki i kēia ke alakaʻi i kahi ʻano koʻikoʻi (hypoglycemia koʻikoʻi). Inā hana ʻia kēia, hiki ke hoʻoweliweli i ke ola a pono e mālama koke ʻia e ke kauka.
No ke aha he mea nui ka glucose i ko mākou kino?
Loaʻa i ko kākou kino ka glucose (kōpaʻa) mai nā kalapona a kākou e ʻai ai. ʻO kēia ke kumu nui o ka ikehu o ko kākou kino. Ua like ia me ka ʻaila no ke kaʻa. ʻOi aku ka nui, he mea nui ka glucose no ka hana ʻana o ko kākou lolo. Pono ka lolo i ka lako mau o ka glucose.
Inā ʻaʻohe ou maʻi diabetes, mālama ko mākou kino i nā pae kō koko i loko o kahi pae kūikawā ma o kekahi mau kaʻina hana kūlohelohe. ʻO ka hormone nui e kōkua ana i kēia, ʻo ia ka insulin, i hana ʻia e ka pancreas. He mea nui nō hoʻi ka hormone i kapa ʻia ʻo glucagon no kēia.
Eia nō naʻe, i ka poʻe me ka maʻi diabetes, ʻaʻole holo pono kēia kaʻina hana. No laila, pono lākou e kāohi i ko lākou pae kō koko ma o ka lāʻau lapaʻau (no ka laʻana, nā inikini insulin) a me nā hoʻololi ʻana i ke ʻano o ka nohona. ʻO ke kumu nui o ke kō koko haʻahaʻa ʻo ia ka piʻi ʻana o nā pae insulin i loko o ke kino.
He aha nā hōʻailona o ke kō koko haʻahaʻa?
Hiki ke hoʻomaka koke nā hōʻailona o ka hypoglycemia. A hiki ke ʻokoʻa mai kēlā kanaka a kēia kanaka. ʻOiai hiki ke hoʻoluhi iki kēia mau hōʻailona, he ʻōlelo aʻo maikaʻi lākou e haʻi mai ana iā mākou, "Ua haʻahaʻa kāu kō, e hana koke i kahi mea."
| Nā Hiʻohiʻona Kumu/Laulā | Nā hōʻailona koʻikoʻi (pono koke ke kōkua lapaʻau) |
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He mea hoʻoweliweli ke ola i nā hōʻailona koʻikoʻi. He mea nui ka mālama koke ʻana i ke kauka i ia mau hihia. Inā ʻaʻole mālama ʻia, hiki ke make a make paha.
Ke emi nei ke kō koko i ka wā e hiamoe ana (Nocturnal Hypoglycemia)
I kekahi manawa, hiki ke hāʻule nā pae kō koko i ka wā e hiamoe ana mākou. Eia kekahi o nā hōʻailona:
- Ke hakakā nei me ka hiamoe
- Ke hou nui nei a pulu nā moena
- Ke uē nei i kou hiamoe ʻana
- Nā moeʻuhane ʻino
- Manaʻo nui i ka luhi a me ka huikau i ke ala ʻana i ke kakahiaka
Hiki ke hāʻule ke kō koko me ka ʻole o ka hōʻike ʻana i nā hōʻailona? (Hypoglycemia Unawareness)
ʻAe, he kūlana weliweli iki kēia. No kekahi poʻe, ʻoi aku hoʻi ka poʻe maʻi diabetes i loaʻa pinepine nā kō koko haʻahaʻa, i ka hala ʻana o ka manawa, hiki i ko lākou pae kō koko ke hāʻule me ka ʻole o ka hōʻike ʻana i nā hōʻailona. Hoʻomaʻamaʻa ke kino i nā pae kō koko haʻahaʻa a hoʻōki i ka hāʻawi ʻana i nā hōʻailona hōʻike. Ua kapa ʻia kēia he hypoglycemia unawareness .
ʻOi aku ka nui o ka poʻe me kēia maʻi e maʻi koke. Inā hiki kēia iā ʻoe, he mea nui loa ia e haʻi aku i kou ʻohana a me nā hoaaloha e pili ana i kēia. I hiki iā lākou ke kōkua iā ʻoe i kahi pilikia. Eia kekahi,
- ʻO ka hoʻohana ʻana i kahi hāmeʻa e ana mau ana i nā pae glucose (Continuous Glucose Monitoring - CGM) hiki ke kōkua iā ʻoe e ʻike i ka wā e haʻahaʻa ai kāu kō koko.
- He mea maikaʻi nō hoʻi e nānā i kou kō koko i nā manawa he nui i ka lā me kahi glucometer maʻamau.
He aha nā kumu o ke kō koko haʻahaʻa?
Hiki ke hoʻokaʻawale ʻia nā kumu i ʻelua mau pūʻulu: ka poʻe me ka maʻi diabetes a me ka poʻe ʻaʻole me ka maʻi diabetes.
Nā kumu e haʻahaʻa ai ke kō koko o ke kanaka me ka maʻi diabetes
Hana ʻia kēia ke kūlike ʻole ma waena o ka ʻai, ka hoʻoikaika kino, a me nā lāʻau lapaʻau no ka maʻi diabetes.
- Ka nui o ka insulin: Ke hoʻokomo ʻana i ka insulin ma mua o ka mea e pono ai.
- Nā hewa o ka lāʻau lapaʻau a me ka manawa ʻai: Ke lawe nei i ka insulin a ʻaʻole ʻai no ka manawa lōʻihi.
- ʻO ka lawe ʻana i nā pila maʻi diabetes kūpono ʻole: ʻO ka lawe nui ʻana i kekahi mau pila maʻi diabetes (e like me ka sulfonylureas) hiki ke hoʻohaʻahaʻa i ke kō koko.
- Hoʻoikaika kino ʻoi aku ma mua o ka maʻamau: Hoʻoikaika kino nui a ʻai ʻole i ka lawa e uku ai.
- Inu ʻona ma ka ʻōpū ʻole: Inu ʻona me ka ʻai ʻole.
- Ka hōʻalo ʻana i ka ʻai: ʻAʻole ʻai i ka manawa kūpono.
No ke aha i haʻahaʻa ai ke kō koko o kekahi kanaka me ka ʻole o ka maʻi diabetes?
He mea kākaʻikahi kēia. ʻElua ʻano nui.
1. Reactive Hypoglycemia: Hana ʻia kēia i ʻelua a ʻehā hola ma hope o ka ʻai ʻana . ʻOi loa aku i ka wā e ʻai ai ʻoe i nā meaʻai kiʻekiʻe i nā kalapona maʻalahi e like me ka laiki, ka berena, a me ka ʻuala, hana koke ke kino i ka insulin hou aʻe, e hoʻohaʻahaʻa ana i kou pae kō koko.
2. Ke kō koko haʻahaʻa i ka wā e hoʻokē ʻai ai (Fasting Hypoglycemia): Hiki ke hana ʻia kēia e kekahi mau kumu.
- Ka hoʻohana nui ʻana i ka waiʻona: Inu nui i ka waiʻona me ka ʻai pono ʻole no kekahi mau lā.
- Nā maʻi koʻikoʻi: Nā kūlana e like me ka hāʻule ʻana o ke akepaʻa a i ʻole nā puʻupaʻa.
- Nā pilikia hormonal: Nā kūlana e like me ka lawa ʻole o ka adrenal.
- Nā Tumors: ʻO nā tumors kakaikahi i loko o ka pancreas, e like me ka insulinoma, ke kumu o ka hana nui ʻana o ka insulin.
Inā loaʻa iā ʻoe kēia mau hōʻailona me ka ʻole o ka maʻi diabetes, pono ʻoe e ʻike i ke kauka e ʻike i ke kumu.
He aha e hana ai ke haʻahaʻa ke kō? Nā ʻano lapaʻau
ʻO ka mea a mākou e hana nei ma ʻaneʻi, ʻo ia ka hāʻawi ʻana i ke kino me ke kō (nā kalapona) me ka wikiwiki.
I nā kūlana maʻamau, ʻo ke "Rule 15-15"
He hana maʻalahi loa kēia a maʻalahi hoʻi e hoʻomanaʻo.
1. KaʻAnuʻu Hana 1: E ʻai a inu paha i 15 grams o nā kalapona hana wikiwiki .
2. KaʻAnuʻu Hana 2: E kali i 15 mau minuke .
3. KaʻAnuʻu Hana 3: E ana hou i kou pae kō koko me kāu glucometer.
4. KaʻAnuʻu Hana 4: Inā ʻoi aku ka pae kō ma lalo o 70 mg/dL, e hana hou i nā ʻanuʻu 1, 2, 3.E hana i kēia a hiki i ka hoʻi ʻana o kou pae kō i ka maʻamau.
He aha nā meaʻai i loaʻa he 15 grams o nā kalapona?
- 3-4 papa glucose
- Hapalua kīʻaha (1/2 kīʻaha) o ka wai huaʻai momona a i ʻole ka mea inu palupalu
- He punetune o ke kō, ka meli, a i ʻole ka syrup maple
- Ka hapalua o ka maiʻa liʻiliʻi
Ka mālama ʻana i nā hihia koʻikoʻi (Hypoglycemia koʻikoʻi)
Inā haʻahaʻa ke kō koko o kekahi a huikau, ʻaʻole hiki ke ʻōlelo, a i ʻole ua nalowale ka ʻike , mai hāʻawi iā lākou i ka meaʻai a mea inu paha ma ka waha! ʻO ka hana ʻana pēlā e hiki ai iā lākou ke paʻa i loko o ke ala ea.
1. Hoʻokomo Glucagon: No ka poʻe me ka maʻi diabetes, ua kuhikuhi paha kāu kauka i kahi hoʻokomo glucagon no nā pilikia. E hōʻoia i ka ʻike o kou ʻohana pehea e hoʻohana ai.
2. E hele koke i ka haukapila!: Inā ʻaʻohe ou glucagon a ʻaʻole paha ʻoe i ʻike pehea e hoʻohana ai, e kāhea koke i ka lawelawe ambulance 1990 a i ʻole e lawe i ke kanaka i ka Emergency Treatment Unit (ETU) o ka haukapila kokoke loa.
3. E hoʻohuli i ka mea maʻi i ka ʻaoʻao: Hiki i ka mea maʻi ke luaʻi ma hope o ka hoʻi hou ʻana o ka ʻike. No laila, e hoʻohuli i ka mea maʻi i ka ʻaoʻao e pale aku ai i ka ʻū ʻana.
He aha ka mea e hiki ke hana ʻia e pale aku ai i kēia kūlana?
He mea paʻakikī paha i ka mea me ka maʻi diabetes ke pale loa i kēia, akā hiki nō ke hōʻemi i ke alapine (frequency) o kēia maʻi.
- E hahai i nā ʻōlelo aʻoaʻo lapaʻau: E lawe i ka lāʻau lapaʻau a kāu kauka i kuhikuhi ai me ka pololei a i ka manawa kūpono.
- E makaʻala i ka ʻai a me ka hoʻoikaika kino: Mai hōʻalo i ka ʻai. Inā ʻoe e hoʻoikaika kino, e kamaʻilio me kāu kauka e pili ana i ia mea a e hoʻololi i kāu ʻai inā pono.
- E nānā pinepine i kou pae kō koko: He mea nui loa ia e nānā i kou pae kō koko ma mua a ma hope o ka ʻai ʻana, ma mua a ma hope o ka hoʻoikaika kino, a ma mua o ka hiamoe ʻana.
- E mālama i kahi moʻolelo: I kēlā me kēia manawa i loaʻa iā ʻoe ke kō koko haʻahaʻa, e kākau i lalo i ka manawa, kou pae kō koko, nā mea āu i ʻai ai ma mua, a inā paha ua hoʻoikaika kino ʻoe. E kōkua kēia i kāu kauka e hoʻomohala i kahi hoʻolālā lapaʻau nāu.
ʻO ka mea nui loa, ʻo ia ka mālama ʻana i kou kino. E hana koke i ka wā e ʻike ai ʻoe i nā hōʻailona mua o ke kō koko haʻahaʻa.
Leka Lawe-Home
- ʻO ka hypoglycemia kahi kūlana e hāʻule ai nā pae kō koko i lalo loa. Hiki ke lilo i mea weliweli inā ʻaʻole mālama ʻia.
- E makaʻala i nā hōʻailona e like me ka haʻalulu, ka hou ʻana, ka huikau, a me ka pōloli nui.
- E mālama mau i kekahi mea me ʻoe, e like me nā papa glucose, kahi ʻeke kō, a i ʻole kahi pahu liʻiliʻi o ka wai huaʻai.
- I nā kūlana maʻamau, e hoʻohana i ka "rule 15-15": e lawe i 15 grams o ka glucose, e kali i 15 mau minuke, a e nānā hou i kou kō koko.
- Inā ua poina kekahi, mai hāʻawi i kekahi mea ma ka waha. E kāhea koke aku i kahi kaʻa kaʻa a i ʻole e lawe iā lākou i ka haukapila kokoke loa ʻo Emergency Department (ETU).
- Inā loaʻa pinepine iā ʻoe ke kō koko haʻahaʻa a i ʻole nā hōʻailona o ke kō koko haʻahaʻa me ka ʻole o ka maʻi diabetes, e ʻike pono i kāu kauka.
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