He kanaka anei ʻoe i loaʻa i ka maʻi diabetes? A laila pono ʻoe e hopohopo mau e pili ana i kou pae kō koko, ʻeā? Akā ua lohe anei ʻoe i kahi maʻi koʻikoʻi loa e hiki ke hoʻoweliweli i ke ola e hele mai me ka maʻi diabetes? ʻO ia ka mea a mākou e kamaʻilio nei i kēia lā. Ua kapa ʻia kēia ma ke ʻano lapaʻau ʻo Diabetic Ketoacidosis , a i ʻole (DKA) no ka pōkole. He mea nui loa ia no kou palekana e ʻike pono i kēia.
I ka ʻōlelo maʻalahi, he aha ʻo DKA?
ʻAe, e ʻōlelo kākou penei. ʻO ka insulin kahi hormone e kōkua i nā cell o ko mākou kino e hoʻohana i ka glucose, a i ʻole ke kō, no ka ikehu. Ke lawa ʻole ka insulin o ka mea maʻi diabetes, a i ʻole ke hana pono ʻole ka insulin i loaʻa iā lākou, ʻaʻole hiki i nā cell ke hoʻohana i ke kō i loko o ke koko.
A laila manaʻo ko kākou kino, "Auē, ua pau koʻu ikehu." No laila, hoʻohana ke kino i kahi ala ʻē aʻe e hana ai i ka ikehu. ʻO ia ke puhi ʻana i ka momona i loko o ke kino. Ke puhi ʻia ka momona ma kēia ʻano, hoʻokuʻu ʻia kahi kemika i kapa ʻia ʻo ketones i loko o ke koko ma ke ʻano he huahana ʻaoʻao. He mea maʻamau ka loaʻa ʻana o kekahi mau ketones. Akā i ka wā e nānā ʻole ʻia ai kēia kaʻina hana no ka mea ʻaʻohe insulin, nui nā ketones e hōʻiliʻili i loko o ke koko. He ʻano waikawa kēia mau ketones. No laila, i ka wā e hōʻiliʻili ai lākou i loko o ke koko, lilo ko kākou koko i waikawa.
ʻO ia ka mea a mākou e kapa aku nei he DKA, a i ʻole Ketoacidosis , ke lilo ke koko i ʻakika. He kūlana weliweli loa kēia. Inā ʻaʻole i mālama ʻia i ka manawa kūpono, hiki iā ia ke alakaʻi i ka make.
Inā ʻoi aku ka nui o ke kō koko ma mua o 240 mg/dL , he mea naʻauao ke nānā i kāu mau pae ketone i kēlā me kēia 4-6 hola. ʻO ka pae kō koko ma luna o 250 mg/dL ua manaʻo ʻia ʻo ia ka hoʻomaka ʻana o DKA. Inā ʻoi aku ka nui o ke kō koko ma waho o ka pae maʻamau, e kamaʻilio koke me kāu kauka .
Āhea ʻoe e hele ai i kahi haukapila ulia pōpilikia (ETU)?
Inā he 300 mg/dL a ʻoi aku paha kou pae kō koko a ʻaʻole e iho mai ana, a inā hoʻomau ʻoe i ka luaʻi, manaʻo luhi loa, a i ʻole he mau hōʻailona o DKA e like me ka paʻakikī o ka hanu ʻana, e hele koke i ka ʻOihana Pilikia kokoke loa (ETU) .
He ʻelua mau mea like ʻole ʻo Ketoacidosis a me Ketosis?
ʻAe, ʻoiai ua like ke kani ʻana o kēia mau huaʻōlelo ʻelua, he ʻelua mau kaʻina hana ʻokoʻa loa lāua.
- Ketosis: Hana ʻia kēia ke ʻai ʻoe i kahi meaʻai haʻahaʻa i nā kalapona (e like me ka berena, ka laiki, ka pasta) (e.g., ka ʻai keto). A laila puhi ke kino i ka momona no ka ikehu. Maanei pū kekahi, hana ʻia nā ketones, akā hana ʻia ia ma ke ʻano i kāohi ʻia. No ka mea, ua lawa ka insulin i loko o ke kino. ʻAʻole he kūlana weliweli ʻo Ketosis.
- Ketoacidosis (DKA):Hana ʻia kēia ma muli o ka nele o ka insulin. Hōʻiliʻili nui nā ketones, e lilo ai ke koko i ʻakika. He mea hoʻoweliweli kēia i ke ola.
He aha nā hōʻailona o DKA?
Hiki ke ʻike koke ʻia nā hōʻailona o DKA. I kekahi manawa, ʻike mua ʻia ke kanaka me ka maʻi diabetes ma hope o ko lākou loaʻa ʻana o DKA. He mea nui e makaʻala i kēia mau hōʻailona.
| Nā hōʻailona o ka DKA - e makaʻala! | |
|---|---|
| Nā Hōʻailona Mua | |
| ʻOi aku ka pinepine o ka mimi ʻana ma mua o ka maʻamau | Hoʻonui ʻia nā pae ketone i loko o ka mimi a i ʻole ke koko |
| Manaʻo nui i ka make wai | Ka maloʻo ʻana |
| Ke kiʻekiʻe o ke kō koko (ʻoi aku ma mua o 250 mg/dL) | ʻEha poʻo nui |
| Nā Hōʻailona Mahope/Koʻikoʻi | |
| Ka luaʻi a me ka luaʻi | ʻEha kino, ʻūlū ʻana o nā ʻiʻo, manaʻo palaualelo |
| Waha maloʻo a me ka ʻili | Luhi nui |
| Ka huikau, ka nalowale o ka ʻike | Paʻakikī ka hanu ʻana, hanu wikiwiki |
| He ʻala hua (ʻono) ma ka hanu | ʻeha ka ʻōpū |
| Inā loaʻa iā ʻoe kēia mau hōʻailona, e hele koke i ke kauka lapaʻau! Inā haʻahaʻa a kiʻekiʻe paha kou pae ketone a loaʻa iā ʻoe nā hōʻailona i luna, inā ʻoi aku kou kō koko ma mua o 300 a ʻaʻole i emi iho, inā ua luaʻi ʻoe no nā hola he ʻelua a ʻoi, inā ʻala hua kou hanu, inā luhi loa ʻoe a māmā paha ke poʻo, a inā paʻakikī iā ʻoe ke hanu, mai hoʻokaʻulua . | |
He aha nā kumu nui o DKA?
ʻOiai ʻo ke kumu nui o DKA ka nele o ka insulin, aia kekahi mau kumu e hiki ai ke alakaʻi i ke kūlana.
- ʻAʻole lawe pono i ka insulin: Hoʻonui kēia pilikia inā ʻaʻole ʻoe e lawe i ka nui o ka insulin i kuhikuhi ʻia e kāu kauka i ka manawa kūpono a i ʻole inā ʻoe e hōʻalo i kahi nui. I kekahi manawa, ʻo ka hoʻohana ʻana i ka insulin i pau ka lāʻau hiki ke lilo i kumu.
- Nā maʻi: Ke loaʻa iā ʻoe ke kuni, ke anu, ka maʻi ʻōpū mimi (UTI), a i ʻole ka maʻi pneumonia, hana kou kino i nā hormones stress (e like me ka cortisol a me ka adrenaline). Hoʻopilikia kēia mau hormones i ka hana o ka insulin. No laila, ʻoi aku ka nui o kou loaʻa ʻana o DKA i nā lā āu e maʻi ai.
- Nā hopena ʻē aʻe ma ke kino: Hoʻonui pū ʻia ka pilikia o DKA ma muli o ka hoʻonui ʻia o ke kaumaha ma ke kino, e like me ke ʻoki kino ʻana, ke komo ʻana i kahi ulia, a i ʻole ka loaʻa ʻana o ka hōʻeha puʻuwai a i ʻole ka hahau ʻana.
- ʻO ka maʻi diabetes i ʻike ʻole ʻia: ʻO ka poʻe i ʻike ʻole he maʻi diabetes ko lākou, ʻoiai ka poʻe me ka maʻi diabetes Type 1, hiki ke hoʻomohala i ka DKA.
- Nā kumu ʻē aʻe: ʻO ka inu nui ʻana i ka waiʻona, kekahi hoʻohana ʻana i nā lāʻau lapaʻau, ka hāpai ʻana, a me kekahi mau lāʻau lapaʻau (e like me corticosteroids) hiki ke hana iā DKA. Inā loaʻa iā ʻoe ka maʻi diabetes, he mea nui e haʻi i kāu kauka ma mua o ka lawe ʻana i kekahi lāʻau lapaʻau hou.
Pehea e hiki ai iā ʻoe ke pale aku i ka hoʻomohala ʻana o DKA?
ʻO ka mea pōmaikaʻi, he maʻi hiki ke pale ʻia ʻo DKA, a ʻo ke kī ka mālama pono ʻana i kāu maʻi diabetes.
E hoʻomanaʻo, ʻo ʻoe ke kuleana no ka mālama ʻana i kāu maʻi diabetes. He mea nui e mālama i kou kino me ka hahai ʻana i nā ʻōlelo a kāu kauka.
Eia kekahi mau mea hiki iā ʻoe ke hana e pili ana i ia mea:
- E nānā pinepine i kou pae kō koko: E nānā i kou pae kō koko i nā manawa he nui i ka lā, e like me ke kuhikuhi a kāu kauka. E ho'āʻo e mālama iā lākou i loko o ka pae i ʻōlelo ʻia.
- E lawe pono i ka lāʻau lapaʻau:E lawe i ka insulin a i ʻole nā lāʻau lapaʻau maʻi diabetes i ka manawa kūpono, ma ka nui kūpono. Mai hōʻalo i nā lāʻau.
- E ʻai pono: E hahai pono i ka papaʻai i hāʻawi ʻia iā ʻoe.
- E inu i ka wai nui: E inu i ka wai a me nā wai me ke kō ʻole.
- E hana i kahi hoʻolālā no nā lā maʻi: E kamaʻilio me kāu kauka ma mua e pili ana i ke ʻano o ka nānā ʻana i kou kō koko a me nā pae ketone ke loaʻa iā ʻoe ke kuni a anu paha, a inā pono ʻoe e hoʻololi i kāu nui o ka insulin.
- E nānā i nā ketones: E nānā i nā ketones i kēlā me kēia manawa ke kiʻekiʻe aʻe kou kō koko ma mua o 240 mg/dL. Hiki iā ʻoe ke hana i kēia me ka hoʻohana ʻana i nā ʻāpana mimi a i ʻole kekahi mau glucometers.
- E mākaukau no kahi pilikia: E hoʻolālā mua i ka mea e hana ai a me kahi e hele ai inā ʻike ʻia nā hōʻailona DKA.
He aha nā lāʻau lapaʻau no DKA ma ka haukapila?
Ke hele ʻoe i kahi ETU me nā hōʻailona o DKA, e hana wikiwiki nā kauka e kāohi i kou kūlana. Hāʻawi pinepine ʻia kēia lāʻau lapaʻau ma ka haukapila.
1. Nā wai i loko o ke koko: Hāʻawi ʻia ka saline ma o ke koko e kāohi i ka maloʻo ʻana o ka wai a hoʻoponopono i ke kaulike kemika o ke koko.
2. ʻInisulina: Hāʻawi ʻia ka ʻinisulina ma o ka intravenous e hoʻōki i ka hoʻokumu ʻia ʻana o nā ketones a kaohi i nā pae kō koko.
3. Hoʻololi i ka Electrolyte: Hoʻolilo ka DKA i ke kino i ka nalowale o nā minelala koʻikoʻi (electrolytes) e like me ka sodium a me ka potassium. ʻOiai he mea nui kēia no ka hana o ka puʻuwai, nā ʻiʻo, a me nā aʻalolo, hoʻololi ʻia lākou ma o ka saline.
4. Lapaʻau no nā maʻi: Inā he maʻi ke kumu o DKA, hāʻawi ʻia nā lāʻau antibiotic.
Hiki ke hoʻomalu ʻia ke kūlana i loko o 24 mau hola, akā inā koʻikoʻi ke kūlana, hiki ke lōʻihi ka manawa.
Leka Lawe-Home
- He mea weliweli loa ka Diabetic Ketoacidosis (DKA) a he pilikia hoʻoweliweli hoʻi i ke ola.
- ʻO kēia ke kumu o ka nele o ka insulin i ke kino, ka puhi ʻana i ka momona no ka ikehu, a me ka hōʻiliʻili nui ʻana o nā ketones (nā waikawa) i loko o ke koko.
- ʻO nā hōʻailona nui ka make wai nui, ka mimi pinepine, kahi ʻala hua ma ka hanu, ka huikau, a me ka luhi nui.
- Inā loaʻa iā ʻoe kēia mau hōʻailona, ʻoiai inā kiʻekiʻe kou pae kō koko, e hele koke i ka lumi pilikia o ka haukapila (ETU).
- Hiki iā ʻoe ke pale aku i ka DKA ma ka kaohi pono ʻana i kāu maʻi diabetes, ka lawe pono ʻana i kāu mau lāʻau lapaʻau, a me ke alakaʻi ʻana i kahi nohona olakino. E kamaʻilio pinepine me kāu kauka e pili ana i kēia.
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