He nui te huka toto i te ata, ahakoa he mate huka koe? Me ako tātou mō tēnei 'pānga Somogyi'?

He tangata koe e tango ana i te insulin mō te mate huka? Mena koinā, kua kite koe kua piki ake te taumata huka toto i tō oho ake i te ata? Ahakoa ka tangohia e koe tō rongoā i te pō, ā, ka tūpato koe, he mea miharo kei te mau tonu i a koe i te ata? Ko tētahi take pea ko te 'pānga Somogyi'. Me kōrero tātou mō tēnei me ētahi atu taipitopito .

He aha te pānga Somogyi?

Ki te kī ngāwari, ko te pānga Somogyi ko te hekenga ohorere o te huka toto (hypoglycemia) i te pō e tango ana i te insulin, ā, muri iho ka piki ake te huka toto (hyperglycemia) i te ata. Ka puta tēnei nā te mahi a ētahi homoni i roto i ō tātou tinana. Whakaarohia, i waenganui pō, ka heke whakarere tō huka toto, ā, ka whakaaro tō tinana, "Āe, ka raru tēnei tangata," ka tukuna ngā homoni hei whakaora i a ia. Koia te take ka piki ake ō huka toto i te ata.

I tapaina tēnei i muri i a Tākuta Michael Somogyi, he tākuta nāna i kite tuatahi i te tekau tau atu i 1930. I ētahi wā ka karangatia e ngā tākuta ko te 'rebound hyperglycemia'.

Engari, anei tētahi mea me mōhio koe. He 'ariā' tonu te pānga Somogyi i waenga i ngā kairangahau, arā, he whakaaro noa iho. Arā, kāore anō kia tino whakamātauhia, engari he taunakitanga pūtaiao hei tautoko. I mua, i whakaaro ngā tākuta koinei te take matua o te pikinga o te huka i te ata. Engari kua ara ake ngā pātai mō tēnei whakaaro i roto i ngā rangahau hou, inā koa ko te rangahau e whakamahi ana i te aroturukitanga huka tonu (CGM).

He maha atu anō ngā take e piki ai te taumata o te huka toto i te ata, ehara i te mea ko te pānga Somogyi anake:

• Kāore e ranea te nui o te rongoā e tangohia ana e koe, nā te mea ka puta mai i roto i tō tinana i te pō.
• He āhuatanga e kiia nei ko te āhuatanga o te Ata. (Ka kōrerohia anō hoki tēnei e tātou)
• Kāore i rite te nui o te rongoā i tangohia i te tina ki te nui o te kai.
• He ātete ki te insulin.

He aha te rerekētanga i waenga i te pānga Somogyi me te āhuatanga o te Ata?

Āe, kei te whakaaro pea koe, 'He aha tēnei āhuatanga o te ata?' Ko ēnei e rua ngā mea e piki ai te taumata huka toto i te ata i roto i te hunga mate huka.

Ko te āhua o te atatu he pikinga ā-taiao o te huka toto e puta mai ana i te tukunga o ētahi homoni (pēnei i te cortisol me te homoni tipu) i te atatu. He mea noa tēnei.

Engari i roto i te pānga Somogyi, kei te mahi anō hoki ngā homoni, engari ka puta tēnei nā te hekenga ohorere o te huka (hypoglycemia) i te pō. I te āhuatanga o te ata, kāore te huka e piki ake nā te hekenga o te huka.

Ko tētahi atu mea nui, ko te āhuatanga o te ata, tētahi o ngā tino take o te pikinga o te huka toto i te ata , he mea noa ake i te pānga Somogyi.

He aha ngā tohu o te pānga Somogyi?

Ko te tohu matua o te pānga Somogyi ko te pikinga o te taumata huka toto ina ara ake koe i te ata. Ahakoa tirohia tō mita huka toto, mēnā rānei kei te whakamahi koe i tētahi taputapu CGM (Continuous Glucose Monitoring), ka whakaatuhia he teitei ō taumata huka i te ata.

I runga i te teitei o tō huka toto, ka pāngia pea koe e ēnei tohu ina ara ake koe i te ata:

• Te matewai pinepine (polydipsia).
• Te hiakai nui atu i te tikanga.
• Te mimi pinepine.
• Te mamae o te upoko.
• Te pōuri me te riri (te pukuriri).

He aha i puta ai te pānga Somogyi?

E ai ki te ariā o te pānga Somogyi, ki te tino heke te taumata huka o tō toto (hypoglycemia) i waenganui pō i a koe e moe ana nā te insulin e tangohia ana e koe, ka ngana tō tinana ki te 'whakaora' i a koe mai i taua āhua huka iti.

Ka tukuna e te tinana ētahi homoni mō tēnei 'mahi whakaora'. Ko ngā mea matua ko:

• Te adrenaline
• Ngā corticosteroids
• Homoni tipu
• Glucagon

Mā ēnei homoni ka nui ake te huka, te huka rānei, i te mea noa, e tukuna ana e tō ate ki roto i tō toto. Mā tēnei tukunga o te huka ka piki ake te taumata o te huka i roto i tō toto. Mena he mate huka tōu, kāore tō repe taiaki e whakaputa i te nui o te insulin hei whakahaere i tēnei taumata huka kua piki ake, kāore rānei e whakaputa i te nui o te insulin. Koinei te take e noho teitei tonu ai ō taumata huka toto.

Mō te tangata kāore he mate huka, ka whakahaere maoritia e te tinana ngā taumata huka toto, ā, ka pupuri i aua taumata i roto i tētahi awhe. Koia te take kāore te pānga Somogyi e pā ki te hunga kāore he mate huka.

Me pēhea te kimi i tētahi tākuta pēnei?

Ina hoki, ehara te pānga Somogyi i te tino take o te pikinga o te huka toto i te ata, nō reira he uaua ki te tautuhi. Ā, e ai ki taku kōrero i mua, e kī ana ngā rangahau hou ehara pea i te take o te pikinga o te huka toto i te ata. Nō reira, he uaua pea, ki te kore e taea, mā te tākuta te tautuhi tika mā te kī, 'Āe, koinei te take.'

Mena he maha ngā wā ka nui te huka toto i te ata, he pai ake te kōrero ki tō tākuta, māna koe e āwhina ki te whakahaere i tō mate huka. Ka tirohia e ia te piki me te heke o te huka toto, ā, ka rapua te take. Ko te huarahi tino whai hua ki te mahi i tēnei ko te whakamahi i tētahi taputapu CGM (Continuous Glucose Monitoring).

Mena kāore koe e whakamahi ana i te CGM, tera pea ka kī atu tō tākuta kia tirohia e koe ō taumata huka toto i ētahi wā i te rā. Hei tauira:

• E rua hāora i muri i te tina.
• I mua i te moenga.
• I waenganui pō (hei tauira, i te 2, i te 3 rānei i te ata).
• I te oho ake i te ata.

Hei tāpiri, ka kīia atu kia tuhia e koe ngā taipitopito pēnei i ngā kai ka kainga e koe i te pō, te nui o te kai e kainga ana e koe, ā, mēnā ka whakakori tinana koe i te pō, he aha te momo whakakori tinana ka mahia e koe me te roa o te wā.

Mā te kohikohi i ēnei mōhiohio katoa ka taea e te tākuta te whakatau i te pūtake o te huka toto tiketike i te ata.

Me pēhea te rongoā i te pānga Somogyi?

I muri i te mahi tahi a kōrua ko tō tākuta ki te whakatau i te āhua o te pikinga o te huka toto i te pō, ka tohutohu rātou i a koe mō ngā huringa ka taea e koe te mahi hei āwhina i te ārai i ngā pikinga huka toto i te ata. Kia maumahara, he rerekē te tinana o te katoa, ā, he maha ngā āhuatanga e pā ana ki ngā taumata huka toto. Nō reira, he rerekē pea ngā mea ka taea e koe te mahi hei ārai i ngā pikinga huka toto i te ata i ia tangata, i ia tangata.

Ka tūtohu pea tō tākuta i ētahi mea pēnei i:

• Te whakarerekē i te horopeta o tō rongoā mate huka, o te insulin rānei.
• Te whakarerekē i ngā momo kai ka kainga e koe mō te tina. Hei tauira, me kai pea koe i ngā kai he nui ake te pūmua, te warowaihā, te ngako rānei, me iti ake rānei te kai i aua kai.
• Ki te taea, mā te huri ki tētahi papu insulin ka taea e koe te whakahaere tika ake i ngā horopeta o tō insulin.
• Te whakarerekē i te wā o te whakakori tinana i te pō.

He aha ngā raruraru ka pā mai i tēnei?

Ahakoa ko te pānga Somogyi te tino take o te pikinga o te huka toto i te ata, e rua ngā mea nui e whakamāramahia ana. Me ngana te hunga mate huka ki te karo i ēnei raruraru e rua:

• Te pikinga tonu o te huka toto.
• Ka puta te iti o te huka toto (hypoglycemia) i te pō.

Te pikinga tonu o ngā taumata huka toto

I te mea ka piki tonu ō taumata huka toto, ka piki ake ō taumata HbA1c (A1C), ā, ka heke iho tō Wā i roto i te Awhe (TIR). Ka ine te whakamātautau HbA1c i ō taumata huka toto toharite i ngā marama e toru kua hipa. Ko te TIR te ōrau toharite o ngā rā kei roto ō taumata huka toto i te awhe whainga.

Ka kino haere ō taumata A1c me TIR, inā koa mēnā kua roa e mau ana, ka nui ake te tūponotanga o te whakawhanake i ngā raruraru mai i te mate huka. Ko ētahi tauira o ēnei raruraru ko:

• Ngā mate kanohi (Retinopathy)
• Ngā raruraru whatukuhu (Nephropathy)
• Neuropati
• Mate ngakau

Kua whakaatuhia e ngā rangahau ka taea e te hunga mate huka te whakaiti i te mōrearea o ēnei raruraru mēnā ka pupuri i ō rātou taumata A1c i raro i te 7%.

He raruraru pumau te huka toto tiketike i te ata, ā, ki te kore e rongoatia, ka noho teitei tonu ō taumata huka toto mō ngā haora maha i te rā. Ka piki ake te tūponotanga o te whakawhanake i ngā raruraru mate huka i roto i te wā.

Ngā wā o te huka toto iti i te pō

Mō te tini o te hunga mate huka, ko te iti o te huka toto, ko te hypoglycemia rānei, ko te wā e heke ai te huka toto ki raro iho i te 70 mg/dL (mirakaramu ia te terita).

Ina heke te taumata huka toto, he maha nga tāngata e pa ana ki enei tohu:

• Te āhua e wiri ana tō tinana.
• Te tino hiakai (polyphagia).
• Te werawera me te mātao.
• Pōuriuri, he āhua māuiui.
• Ka piki ake te tere o te manawa.

Heoi, ki te heke tō huka toto i a koe e moe ana, tera pea ka roa te wā ka ara ake koe ka kite i ngā tohu. He mea morearea tēnei, ā, ka taea e te hypoglycemia nui te whakararu i te ora. Tērā pea he rerekē ngā tohu o te huka toto iti i te pō, tae atu ki:

• Te kore moe, te kore e pai ki te moe.
• Ka ngenge, ka kore e aro ki te kaupapa ina ara ake koe i te ata.
• Te moemoeā kino.
• Ka mākū ngā kākahu, ngā moenga rānei e mau ana koe i te werawera.

Ahakoa ngā tohu e whakaaro ana koe he iti te huka toto, he mea nui kia tirohia tō taumata huka toto kia kite ai koe i tōna iti. Mā tēnei koe e āwhina ki te whakatau me pēhea te rongoā. Hei rongoā i te hypoglycemia, me kai koe i ngā warowaihā tere te mahi, arā, he huka (pērā i te wai panana, i te wai āporo rānei).

Mena he iti te huka toto i te pō, me kōrero koe ki tō tākuta mō tēnei mea. Ka taea e kōrua te whakarerekē i tā kōrua mahere whakahaere mate huka kia kore ai e puta anō.

Āhea ahau me toro atu ki te tākuta?

Mena kei te piki tonu te huka toto i te ata, he mea nui kia kōrero koe ki tō tākuta e āwhina ana i a koe ki te whakahaere i tō mate huka. Ka taea e ia te whakamātautau i ō taumata huka toto, te whakatau mena ko te pānga Somogyi te take, mena he mea kē atu kei te haere, me te taunaki i tētahi mahere maimoatanga e tika ana māu.

He tino hoha, he tino koretake hoki te pikinga o te huka toto i te ata. Kāore he otinga kotahi e tika ana mō tēnei. Nō reira, tera pea ka roa te wā ki te kimi i te otinga tika māu. Ka taea e tō tākuta te āwhina i a koe ki te whakatau i te huarahi mahi pai rawa atu. Kaua e wehi ki te tono āwhina mai i a rātou. Mā te mahi inaianei ka āwhina i a koe ki te karo i ngā raruraru poto me te wā roa.

Hei whakamutunga, ko te mea tino nui (Karere hei tango i te kāinga)

Āe, kua mārama ake koe ināianei ki te pānga Somogyi i kōrerohia e tātou. Kia maumahara, ehara i te mea koinei anake te take o te pikinga o te huka i te ata. Engari, he mea nui kia mōhio koe ki tēnei.

• Ko te mea nui, ki te mea kei te piki tonu tō huka toto i te ata, kaua e warewarehia. Me kōrero ki tō tākuta.
• Mena kei te whakamahi koe i te CGM (Continuous Glucose Monitoring), rapua te awhina a tō tākuta kia tika ai te tātari i ngā raraunga.
• He tino morearea te iti o te huka toto (hypoglycemia) i te pō. Mēnā kei a koe ētahi o ēnei tohu, me kōrero anō hoki ki tō tākuta .
• Kōrerohia tō kai, tō whakakori tinana, me te horopeta o ngā rongoā ki tō tākuta, ka whakarerekē kia rite ki te mea e tino pai ana mōu.

He wero te noho tahi me te mate huka, engari mā te whakahaere tika, ka taea e koe te noho ora. Kaua e wehi, kei te pai?

Te pānga o te Somogyi, te mate huka, te pikinga o te huka i te ata, te whakahekenga toto, te whakahekenga toto, te insulin