E mōhio ana tātou ki te Coma e pā ana ki te Mate Huka?

Tērā pea ka maumahara koe ki tētahi tangata e pāngia ana e te mate huka, he mema whānau, he hoa rānei. I ētahi wā kua rongo tātou mō ēnei tāngata ka ngaro whakarere te māramatanga, ka kore e taea te kōrero, ā, i ētahi wā ka hinga. He tino morearea tēnei mate, ā, he mate morearea hoki. Koia mātou i whakaaro ai i tēnei rā ki te kōrero mō tēnei mate ka puta mai i te mate huka, e kiia nei e ngā tākuta, ko te `(Diabetes-Related Coma)`. Mā te mōhio tika ki tēnei ka āwhina i a tātou ki te tiaki i ō tātou whanaunga.

He aha te Koma e pā ana ki te Mate Huka? He whakarāpopototanga noa iho...

I te whakarapopototanga, he mate kino, he mate morearea te koma mate huka e puta ana ina tino teitei rawa te taumata huka toto (hyperglycemia) ina tino iti rawa rānei (hypoglycemia). Ko te "koma" he āhua o te kore mohio katoa, pērā i te moe hohonu, ā, kāore e taea te whakaara ake mā te kōrero. Heoi, kei te ora tonu rātou ahakoa kua ngaro te mohio. He mate tēnei e hiahia ana kia awhina hauora ohorere.

E toru ngā take matua mō tēnei āhuatanga morearea.

E toru ngā huarahi matua e taka ai te tangata mate huka ki te koma. Me titiro tātou ki ēnei:

1. Te Āhua Hyperosmolar Hyperglycemic (HHS)

2. Ketoacidosis e pā ana ki te mate huka (DKA)

3. Te huka toto nui

Nā, me kōrero tātou mō ia o ēnei me ētahi atu kōrero taipitopito, āe?

1. He aha te āhua hyperosmolar hyperglycemic (HHS)?

Ko tēnei āhuatanga, e kiia nei ko te HHS, he mea tino noa i roto i te hunga whai mate huka momo 2. Ka puta mai ina tino teitei te taumata o te huka toto (glucose) (neke atu i te 600 mg/dL) mō te wā roa. Ka taea e tēnei te meinga tō tinana kia ngaro te nui o te wai, ka arahi ki te matewai nui, te pōhēhē, me ētahi atu tohu. Ki te kore e rongoatia wawetia, ka arahi pea ki te koma.

2. He aha te Ketoacidosis e pā ana ki te mate huka (DKA)?

He mate morearea anō hoki te mate e kiia nei ko te "DKA". Ko te nuinga o te wā ka pā ki te hunga whai "Huka Momo 1" (ka pā ki te hunga kua pāngia kētia, me te hunga kāore i te mōhio kei a rātou). Heoi, ka pāngia anō hoki te hunga whai Huka Momo 2 i ētahi wā.

Ka puta te DKA ina kore e ranea te insulin i roto i tō tinana (he mea tūturu, he mea tango mai rānei i waho). E mōhio ana koe, he mea nui te insulin kia uru ai te huka i roto i ō tātou toto, te glucose, ki roto i ō tātou pūtau, kia whakamahia ai hei pūngao. Nō reira, ina kore, ina kore rānei e ranea te insulin, ka tīmata te tinana ki te wawahi i te ngako hei pūngao. Ina pakaru te ngako, ka tukuna ngā matū e kiia nei ko ngā ketone ki roto i te toto.

Ina piki ake te nui o ngā `(ketones)` i roto i te tinana o te tangata mate huka, ka āta `(waikawa)` te toto. Mēnā kāore tēnei e rongoatia i te wā tika, ka puta he koma. Ko te taumata huka toto o te tangata mate huka he nui ake i te 250 mg/dL. Engari kia maumahara, ko te tino take o te `(DKA)` ko te korenga o te `(insulin)` me te pikinga o ngā `(ketones)`, ehara i te huka toto anake. Ka pāngia pea ētahi mate huka e te `(DKA)` ahakoa he nui ake te huka i te 250 mg/dL.

3. He aha te hypoglycemia kino?

Koinei te tuatoru o ngā take. Mēnā ka heke te taumata huka toto ki raro iho i te 40 mg/dL, ka kiia he mate kino "hypoglycemia". He tino morearea hoki tēnei mō te ora.

Kei te mōhio koe, ko te pūtake matua o te pūngao mō tō tātou tinana, inā koa te roro, ko te `(huka)`. Nō reira, ina heke te taumata huka toto, kāore e taea e te tinana te mahi tika. Mena ka heke te taumata huka ki raro i te 40 mg/dL, e ai ki te kōrero, tera pea ka pāngia koe e ngā huringa i roto i tō tinana me tō hinengaro, ā, kāore e taea e koe te mahi i tetahi mea. Mena kāore tēnei mate `(hypoglycemia)` kino e rongoatia mō te wā roa, tera pea ka taka koe ki te koma.

Ko tēnei āhua kino o te hypoglycemia ka tino kitea i roto i te hunga e tango ana i te insulin mō te mate huka, i ētahi momo pire mate huka rānei pērā i te sulfonylureas.

He aha ngā tohu o te koma mate huka? Me pēhea tātou e mōhio ai ki tēnei?

E toru ngā āhuatanga matua o te koma:

• Te kore mārama: He rite ki te moe hōhonu rawa. Ahakoa te nui o tāu kōrero, he tino uaua, tata kore e taea, te whakaara i a koe.
• Te kore urupare a ngā kanohi: Ka noho kati tonu ngā kanohi. Kāore he urupare ina whakatuwherahia ngā kanohi. Heoi, i ētahi wā ka puta he urupare ā-whakaaro i roto i ngā kanohi ki ngā mea pēnei i te mārama.
• Te korenga o te urupare ā-tinana: Kāore he nekehanga ā-hinengaro. Heoi anō, tera pea ka kitea ētahi nekehanga ā-whakaaro.

Nā, kia tirohia tātou he aha ngā tohu e puta mai ana i mua i te urunga ki te koma i roto i ngā āhuatanga `(DKA)`, `(HHS)` me ngā āhuatanga `(hypoglycemia)` kino kua whakahuatia ake nei. Ki te mōhio wawe koe ki ēnei, ka taea e koe te karo i tētahi aituā nui.

Ngā tohu e pā ana ki te koma i roto i te DKA:

• Whakapairuaki me te ruaki.
• Mamae puku.
• Te manawa tere, te manawa hōhonu (e kiia ana tēnei e ngā tākuta ko te "manawa Kussmaul"). Ka taea te puta i roto i te manawataki kotahi.
• He kakara hua i te manawa.
• E tino ngenge ana, e ngoikore ana hoki.
• Te pōhēhē, te rangirua rānei.
• Te hekenga o te mataara.

Ngā tohu e pā ana ki te koma i roto i te āhua `(HHS)`:

• Ngā huringa hinengaro: te pōhēhē, te pōrangi, te moemoeā.
• Me te mea kei te tata koe te ngaro i te mārama.
• Te waha maroke me te matewai nui (polydipsia).
• Te mimi pinepine.
• Te tirohanga pōuri, te ngaro rānei o te tirohanga.
• Te ngoikore o te tinana, i ētahi wā ka pā ki te taha kotahi o te tinana.

Ko ngā tohu e pā ana ki te koma i roto i te hypoglycemia kino ko:

• Te tirohanga pōuri, te tirohanga takirua rānei.
• Te ranu o ngā kupu i te wā e kōrero ana.
• Te ngaro o te taurite, me te uaua ki te mahi i ngā mea.
• Te pōhēhē.
• He rite ngā haurangi ki te mate pāwera.

Ki te kite koe i tētahi o ēnei tohu, kaua e warewaretia. He pai ake te rapu tohutohu hauora tonu.

Me aha tātou mēnā ka ngaro te mārama o te tangata nā te mate huka? (Āwhina tuatahi)

Whakaarohia tētahi i tō rohe ka ngaro whakarere te mārama o tōna hinengaro nā te mate huka. Anei ētahi mea ka taea e koe te mahi:

• Waea atu ki te 1990 tonu atu, ka tikina he waka tūroro. Ki te mōhio koe he mate huka te tangata, me kōrero atu hoki ki te kaiwhakahaere o te 1990.
• Kaua e hoatu he kai, he inu rānei ki a rātou. Tērā pea ka kōroke rātou.
• Āta tahuri te tangata ki tōna taha kia kore ai e āraia te ara manawa e te huware, e te ruaki rānei.
• Kia tae mai rā anō te waka tūroro, me whai i ngā tohutohu a te kaiwhakahaere o te tau 1990.

Ki te tika te mahi, he tino āwhina tēnei ki te whakaora i te ora o taua tangata.

He aha te take e ngaro ai te māramatanga i te mate huka? (He māmā noa iho ngā take)

E ai ki tā tātou i kōrero ai i mua, e toru ngā tino take o te koma mate huka, tika? Koia ēnei:

• Āhua huka toto tiketike rawa `(HHS)`.
• Te ketoacidosis mate huka (DKA).
• Te huka toto tino iti (te huka toto tino iti).

Ko te HHS me te DKA he āhuatanga e tino heke ai te nui o te wai o te tinana, ka arahi ki te matewai nui. Ka taea e tēnei matewai te arahi ki te koma.

I tētahi atu taha, i roto i te hypoglycemia kino, kāore te roro e whiwhi i te nui o te huka (glucose) e hiahiatia ana e ia. He mea nui te huka kia pai ai te mahi a te roro. Ina ngaro, ka "kati" te roro, ā, ka taea e koe te moe pōuri. Kua mārama koe?

Ko wai kei te nui ake te mōrearea ki te whakawhanake i te koma mate huka?

Ko te hunga katoa e pāngia ana e te mate huka (tae atu ki te hunga kāore anō kia kitea he mate huka) kei te tūpono ki te pāngia e te mate huka koma. Heoi, he rerekē te tūponotanga i runga i te momo mate huka:

• He nui ake te mōrearea o te hunga mate huka momo 1 ki te moe pōrearea, nā te DKA, nā te hypoglycemia kino rānei. Nā te mea me whakamahi tonu te hunga mate huka momo 1 i te insulin, ā, he nui ake te rerekētanga o ō rātou taumata huka toto i te hunga mate huka momo 2.
• Ko te hunga mate huka momo 2 he nui ake te tūponotanga ka moe pōrearea rātou nā te HHS i te DKA, te hypoglycemia kino rānei.

He aha ētahi atu āhuatanga mōrearea?

Haunga ēnei mea, tera atu anō ētahi mea ka piki ake te mōrearea o te koma mate huka:

• Te whakawhanake i ētahi atu mate.
• Kei te pokangahia.
• Ngā whara tinana (Whara).
• Ngā raruraru ki te pūnaha tuku insulin (hei tauira, te pene insulin, te kore mahi tika o te papu).
• Te wareware, te pekepeke, te nui rawa rānei o te insulin e tangohia ana.
• Kāore i te whakahaere tika i te mate huka (hei tauira, te kore e tirotiro i ngā taumata huka toto i ia rā, te kore e tango tika i ngā rongoā).
• `(Te kore mōhio ki te hypoglycemia)` (arā, te kore mōhio ki ngā tohu tōmua o te huka toto iti).
• Te inu waipiro.
• Te whakamahinga o ngā raau taero.

Me pēhea te tautuhi tika a ngā tākuta i te koma mate huka?

He āhuatanga ohorere hauora te koma mate huka e hiahia ana kia rongoatia tonutia. Me kawe ki te hōhipera te hunga e mate ana i te koma.

Ka taea e ngā tākuta te tautuhi wawe i te mate huka mā te tango i tō hītori hauora, te tirotiro i ō taumata huka toto (whakamātautau huka toto), me te whakahaere i ētahi atu whakamātautau hei tirotiro i ngā ketone me tō hauora whānui.

Koia te mea nui kia mau i te poroporo, i te hei rānei mō te hunga mate huka. Mēnā he āhuatanga ohorere, ka taea e ngā tākuta te kite, ā, ka taea e rātou te whakatau tere. He mea nui anō hoki kia mōhio tō whānau, ō hoa, me ō hoa mahi kei te mate huka koe. Pērā ai, ka mōhio rātou ki te mea hei mahi i roto i te āhuatanga ohorere.

Me pēhea te rongoā i te koma mate huka?

He rerekē te maimoatanga mō te koma mate huka i runga i te pūtake , engari me kawe tonu ki te hōhipera.

Te rongoā mō te koma i puta mai i te `(DKA)` me te `(HHS rānei):

• Wai IV: Ka hoatu ēnei hei whakatika i te matewai me te kore taurite o ngā electrolytes.
• Inihurini: Ka hoatu pea e te tīma hauora te inihurini ki a koe mā te werohanga IV, mā te werohanga kiri rānei.
• Ētahi atu maimoatanga: Tērā pea ka hoatu ētahi atu maimoatanga hei āwhina i a koe ki te ora. Kei roto i ēnei ko te rongoā i ngā mate hauora, i ngā mate pāwera rānei e hua ai te nui o te huka toto.

Te rongoā mō te koma i puta mai i te hypoglycemia nui:

• Te hukarokina ohorere:He momo hangai tēnei o te homoni glucagon. Ka taea te hoatu e te tangata e arohaina ana, e te tākuta rānei hei werohanga, hei rehu ihu rānei (i runga i te momo). Ka mahi te glucagon hangai mā te tuku i te hukahuka e rongoa ana i roto i te ate, ka piki ake te taumata huka toto.

Ko te mea nui: Ahakoa ka hoatu e tetahi e tata ana ki a koe he `(glucagon)`, me tino hiahia koe ki te maimoatanga hōhipera. Me hoatu e rātou he `(glucagon)` ki a koe, ka waea atu ki te 1990 tonu.

Mena ka puta ake ētahi atu raruraru, pērā i te ngoikore o ngā okana, ka hiahiatia pea he maimoatanga hauora tāpiri.

He aha tā tātou e taea ai te ārai i te koma mate huka?

Hei ārai i te koma mate huka, he mea nui kia mōhio koe ki ngā tohu whakatūpato wawe o te hypoglycemia (DKA), te hypoglycemia (HHS), me te hypoglycemia. Kōrero ki tō tākuta mō ngā mahi ka taea e koe te mahi hei rongoā i ēnei āhuatanga i mua i te kino haere.

Me toro atu ki te tākuta tonu mēnā:

• Mena he 300 mg/dL, he teitei ake rānei te taumata huka toto i ngā wā e rua karapīpiti ana, kāore he take e kitea ana.
• Mena he iti te huka toto (kei raro iho i te 70 mg/dL) ā, kāore e hoki anō ki te āhua noa i muri i ngā whakamātautau e toru ki te rongoā (hei tauira, ngā papa hukahuka, ngā inu huka), waea atu ki tō tākuta, ki te 911 rānei i taua wā tonu.

Ka taea e te tangata te ora i te koma mate huka? He pānga roa kei reira?

Ae, ka taea te karo i te koma mate huka mena ka rongoatia wawetia te take matua. Heoi, ka taea hoki e ētahi tāngata te pāngia e te whara roro tuturu. Ki te kore e rongoatia wawetia, ā, ki te kore e rongoatia tika, ka mate pea rātou.

Ko te reiti mate mō te DKA kei waenga i te 0.2% me te 2.5%. Ko te hunga e mate pōrearea ana, e pāngia ana e te hypothermia, ā, e iti ana te putanga mimi (oliguria) ka pāngia e ngā hua kino rawa atu.

Tata ki te 20% o te hunga whai HHS ka mate i tēnei mate. Ko te hunga ka pāngia e te koma me/ranei te toto toto iti, he kino te āhua o te mate.

Kia pēhea te roa ka taea e koe te noho i roto i te koma mate huka?

Ko te roa o te wā e noho ana koe i roto i te koma mate huka e whakawhirinaki ana ki te tere o te whiwhi i te maimoatanga tika. Ko te huarahi anake hei whakamutu i tēnei momo koma ko te whakahoki i ō taumata huka toto me te insulin ki ngā taumata hauora. Ka taea anake tēnei mā te awhina a ngā tohunga hauora. Kāore te tangata i roto i te koma mate huka e hoki mai te māramatanga i a ia anō.

Ki te kore te tangata e noho pōrearea ana pēnei e whiwhi maimoatanga i te wā tika, tera pea ka mate ia. He rerekē te "wā" i ia kēhi, i ia tangata. Koia te mea nui kia tere tonu te rapu āwhina.

Hei whakarāpopototanga, anei ngā mea hei maumahara mā tātou (Karere hei tango ki te kāinga):

Ahakoa he mea tino morearea te koma mate huka, he maha ngā wā ka taea te ārai.

• Ko te mea nui,Kia tūpato ki ngā tohu whakatūpato o te `(DKA)`, `(HHS)` me te huka toto iti, ā, me mahi wawe ina kite koe i aua tohu.
• Mena kei a koe ngā tohu o tēnei mate, waea atu ki tō tākuta tonu atu.
• He tino whakamataku ngā raruraru mate huka, engari ko te mōhio me te noho rite te huarahi pai hei ārai i aua raruraru.
• Kaua e mangere ki te pātai atu ki tō tākuta mō āu pātai e pā ana ki te whakahaere i tō mate huka, i ēnei raruraru rānei. He mea nui tō hauora ki a koe.

Mate huka, Koma, DKA, HHS, Hauātanga toto, Huka toto, Inirini, Āwhina tuatahi, Ngā raruraru mate huka, Ngaronga o te mahara