Kua rongo koe i tētahi huarahi hou hei whakamahi i te insulin mō te hunga mate huka? (Papu Insulin)

Mena kei te noho koe me te Mate Huka Mellitus, he uaua pea te tango i te insulin i ētahi wā i te rā, tika? Tērā pea ka hoha koe ki te werohanga, ki te tango rānei me te pene. Engari, i mōhio koe, kei reira ngā huarahi hou, tino ngāwari ki te mahi i tēnei i nāianei. Ko tētahi o aua huarahi ko te papu insulin . Me kōrero taipitopito atu tātou mō tēnei i tēnei rā?

He aha te papu insulin?

He kupu ngāwari noa iho, he taputapu hauora iti, ka taea te mau, e tuku ana i te iti o te insulin ki raro i tō kiri, tata tonu tonu. Whakaarohia he rite ki tētahi pouaka wai hua iti, ki tētahi kete kāri rānei. He maha ngā papu he rorohiko.

He huarahi pai tēnei hei whakakapi i ngā werohanga maha o ia rā (MDI) mā te whakamahi i te ngira, i te pene rānei. He tino whai hua tēnei mō te hunga e tino hiahia ana ki te insulin.

Kei te tere haere te hangarau papu insulin i te mākete. Pērā i ngā papu katoa e wātea ana i te United States i tēnei wā, kua hangaia kia mahi tahi me te hangarau CGM (Continuous Glucose Monitoring), he taputapu e ine tonu ana i ō taumata huka toto. Ko te tikanga o tēnei ka taea e ēnei papu hou te whakarerekē aunoa i te nui o te insulin e hiahiatia ana e koe i taua wā, i runga i ō taumata huka toto.

Me pēhea te mahi a tēnei (Papu Inihuarangi)?

Ka mahi tēnei papu insulin mā te whai i te huarahi e tukuna ai e tō tātou repe taiaki te insulin. E rua ngā huarahi matua e tukuna ai te insulin ki tō tinana:

1. Te Whakatutuki i ngā Hiahia o te Insulin Tuturu

Ko te mea ka tupu, ka whiwhi tonu tō tinana i tētahi nui iti o te insulin i te roanga o te rā, i ia hāora, i ia hāora. Ka kiia tēnei ko te 'insulin taketake' . Koinei te mea e ea ai ngā hiahia taketake o tō tinana mō te insulin.

I mōhio koe he rerekē te nui o te insulin taketake e hiahiatia ana e ō tātou tinana i ngā wā rerekē o te rā? Hei tauira, he nui ake te insulin taketake e hiahiatia ana e te tini o te tangata i te ata i tō te ahiahi. Nā te mea he nui ake te homoni cortisol e tukuna ana e ō tātou tinana i te ata. Nā tēnei cortisol ka piki ake te taumata huka toto.

Me kōrero koe ki tō tākuta, ā, me whakarite he 'reiti taketake' e pai ana ki a koe, arā, te nui o te insulin e hiahiatia ana e koe i ia hāora. I roto i te wā, i te mea ka huri tō tinana, ka huri hoki ō tikanga o ia rā, me whakarerekē e koe tēnei 'reiti taketake'. He maha ngā papu inaianei ka taea te whakarite aunoa i tēnei reiti taketake i runga i ngā raraunga e puta mai ana i tō (CGM). Ka taea hoki e koe te whakarite 'ā-ringa', arā, ā-ringa, mā te whakamahi i te reiti kua whakaritea ngātahitia e kōrua ko tō tākuta.

2. Te hoatutanga o te insulin mō ngā kai me te wā e piki ake ai te huka toto (Bolus Insulin)

Koinei te tikanga tuarua. Ina kai koe i tētahi kai, ina teitei ake rānei tō taumata huka toto i te nui kua tūtohutia, ka hoatu ki a koe te nui o te insulin e hiahiatia ana i te wā kotahi . Ka kiia tēnei ko te 'bolus insulin' .

Ina tāuruhia e koe te nui o ngā warowaihā i roto i te kai e kainga ana e koe me te taumata huka toto i taua wā ki roto i te papu, ka tatauhia, ka kīia atu hoki te nui o te 'bolus' insulin e hiahiatia ana. I te nuinga o te wā, mā te papu tonu e tohu te nui e tika ana. Ka taea e koe te tirotiro mēnā he tika, te hanga i ngā huringa iti mēnā e tika ana, me te whakaū kei te hiahia koe ki te hoatu insulin.

He aha atu ngā āhuatanga kei reira?

He rerekē ngā āhuatanga hangarau me ngā tautuhinga o ia momo papu insulin, o ia waitohu. Anei ētahi tauira:

• Ko te kaha ki te mahi tahi me te hangarau (CGM) hei whakanui, hei whakaiti, hei whakamutu rānei i te tukunga o te insulin mō te wā poto i runga i ngā taumata huka toto.
• Ko te kaha ki te whakanui, ki te whakaiti rānei i te 'Reiti Pūmau' mō tētahi wā, e ai ki tāu e hiahia ana (hei tauira, i te wā e whakakorikori ana).
• He whakaoho kei reira mō ngā mea pēnei i te wā e iti ana te pākahiko, i te wā rānei kua tata pau te puna insulin.
• Mena kei te hono te CGM ki tētahi papu, ka whakamōhio atu hoki ki a koe mēnā kua neke atu te taumata huka o tō toto i te awhe kua tūtohutia.
• Te āheinga ki te hono atu ki ngā taupānga waea me ētahi atu taputapu atamai.

Ngā Momo Papu Insulin

E rua ngā momo matua o ngā papu insulin: ko ērā he ngongo me ērā kāore he ngongo.

1. Ngā Papu Inulin Ngongo

E ai ki te ingoa, he ngongo roa, angiangi kei tēnei papu. Ko tēnei ngongo te mea e kawe ana i te insulin mai i te papu ki tētahi ngongo iti e kiia nei ko te 'cannula' i raro i tō kiri. Me titiro tātou ki ētahi o ōna wāhanga:

• Mīhini papu me te hangarau:He mea hanga tēnei papu ki te kirihou me te konganuku. He mata kei roto hei tiro me te tīpako i ngā tautuhinga me ngā raraunga. He kātere, he puna rānei, kua whakakiia ki te insulin. I runga i te waitohu, ka taea te whakamahi hei pākahiko whakakapi, hei pākahiko whakahou rānei. He rerekē te nui o te insulin ka taea te whakauru ki roto i tēnei puna i ia papu ki ia papu. Engari ka whakakīia noa e koe ki te nui e whakamahia ana e koe mō ngā rā e rua, e toru rānei. Ka taea e koe te whakauru i tēnei papu ki roto i tō pēke, te here rānei ki tētahi kākahu, pērā i ō tarau.
• Te ngongo me te huinga werohanga: He ngongo torutoru inihi te roa e kawe ana i te insulin mai i te puna insulin i roto i te papu ki te huinga werohanga e whakatakotoria ana i raro i tō kiri. Ka piri te huinga werohanga ki te kiri mā te rīpene piri, ā, he ngongo kirihou iti, ngāwari (cannula) kei raro i te kiri. He torutoru mirimita noa te roa o te cannula. Ka taea e koe te wero i te huinga werohanga mā te ringa, ka taea rānei e koe te whakamahi i tētahi taputapu iti e haere tahi mai ana. He ngira kei te cannula e uru ana mā roto i te kiri ka uru ki roto i te ngira. Kātahi ka tangohia te ngira, ka waiho ko te cannula anake i raro i te kiri. Ka taea tēnei te mahi i runga i tō ringa o runga, tō puku, tō hope, tō hope, tō huha rānei.

I te nuinga o te wā, me whakawhiti te ipu me te huinga werohanga i ia rua, i te toru rānei rā. Mēnā ka pau te insulin, me whakawhiti te ipu. Me whakamahi i tētahi huinga werohanga hou, i tētahi ipu, me tētahi ngongo hou i ia wā. Heoi, ka taea te whakamahi i te papu mō ētahi tau.

Ahakoa he ātete wai ētahi papu ngongo, he tokomaha te hunga e momotu ana i a rātou mai i te huinga werohanga ina kaukau, ina ruku rānei. Kātahi ka taea te hono anō. Ko ētahi he ātete wai anake, kāore i te tino ātete wai.

2. Ngā Papu Inihurini Kore-Tube / Ngā Papu Pātaki

He ngongo kirihou ngāwari anō hoki (he 'cannula') kei roto i te kiri o ēnei papu. Heoi, kei roto i te 'pod' kotahi te puna insulin me te 'cannula', he wāhanga iti nei te āhua. Ka taea te whakapiri atu ki te kiri mā te whakamahi i te papaki piri. Kāore he ngongo e kitea ana. Kātahi ka whakahaerea ā-waea mā te whakamahi i tētahi 'mana whakahaere' ringaringa.

Kotahi noa te whakamahinga o ia 'Pod'. Pērā i te papu me te ngongo, me whakawhiti i ia rua, i ia toru rā. Me whakawhiti mēnā ka pau te insulin.

I mua i te whakamau i te Pod, ka whakakīia te ipu ki te insulin, ka whakapiri i te rīpene piri ki tō kiri. Kātahi, ina pēhi koe i te pātene, ka puta te ngira i roto i te cannula i roto i te Pod, ka werohia te kiri, ka hoki ki roto i te Pod. Ko te cannula anake e toe ana i raro i te kiri. Ka taea hoki te whakamau ki tō ringa o runga, puku, hope, papa, huha rānei.

Ko te mea motuhake, he ātete-wai ēnei papu kore-tube, nō reira ka taea te mau i a koe e kaukau ana, e haere ana rānei i roto i te wai.

He aha ngā momo papu insulin e wātea ana i te mākete?

He rerekē ngā momo papu insulin i ngā whenua rerekē o te ao. Anei ētahi o ngā momo rongonui e wātea ana i te mākete o Amerika i tēnei wā:

• Pūnaha Pancreas Bionic iLet® (he papu me te ngongo)
• Medtronic MiniMed™ (he maha ngā momo papu wiwi)
• Omnipod® (he maha ngā momo papu kore-rākau)
• Tandem® t:slim (he maha ngā momo papu wiwi)

Tērā tētahi atu papu kore-ngāwari e kiia nei ko te Accu-Chek® Solo Micropump System e wātea ana i te UK, e tatari ana kia whakaaetia e te US (FDA - Food and Drug Administration). Tērā pea ka kitea e koe ētahi o ēnei momo hou, ētahi atu momo hou rānei i Sri Lanka. Ko te mea pai ko te pātai atu ki tō tākuta mate huka mō tēnei.

Ko wai ka whakamahi i tēnei papu insulin?

Ka taea e te tangata mate huka e hiahia ana ki te tango i te insulin hangai te whakamahi i te papu insulin. Ko te tikanga o tēnei:

• Mō te hunga he mate huka momo 1 - ko te tikanga he tamariki nohinohi me ngā pakeke.
• Mō ētahi tāngata he mate huka momo 2.
• He pai anō hoki te papu mō te hunga mate huka momo 3c, te mate huka 'Monogenic' rānei.

He tau iti rawa te whakamahinga o ia momo papu, e whakaaetia ana e ngā tari pēnei i te FDA. Ko ētahi papu ka whakaaetia kia whakamahia e ngā tamariki mai i te 2 tau te pakeke. He maha atu anō ka whakaaetia kia whakamahia e te hunga neke atu i te 7 tau te pakeke.

Ko te papu insulin tētahi o ngā huarahi maimoatanga mō te whakahaere i te mate huka – he whakatau whaiaro tēnei. Ka taea e koe (e tāu tamaiti rānei) te whakaaro ki te whakamahi i tētahi papu mēnā:

• Mena he uaua ki a koe te whakahaere i ō taumata huka toto ahakoa kua tangohia he werohanga (MDI) i ngā wā maha i te rā.
• Ki te hiahia koe ki te whakarerekē i te nui o te insulin e hoatu ana e koe kia tika ake, kia rite ki tāu e pai ai.
• Mena he tangata koe kāore e taea te mahi i ō mahi o ia rā, i ō wā kai rānei, ā, he tangata hurihuri hoki koe.
• Mena he iti noa te nui o te insulin e hiahiatia ana. He maha ngā wā ka pā tēnei ki ngā tamariki nohinohi me ngā pēpi e mate huka ana.
• Mena he gastroparesis tōu (arā, he puhoi te nakunaku me te mimiti o te kai).
• Mena he 'Āhuatanga o te Ata' (arā, mena ka piki te huka toto i te ata anake).
• Mena kei te tumanako koe kia hapu.

Ko wai kāore e pai ki te whakamahi i te papu insulin?

Ehara ngā papu insulin i te kōwhiringa pai mō te katoa – he maha ngā take kāore pea te papu e pai mōu, mō tāu tamaiti rānei, tae atu ki:

• Mena he uaua ki a koe te whakamahi i ō ringaringa me ō matihao: Me whakamahi koe i ō ringaringa me ō matihao ki te whakakī i te puna insulin, ka pēhi i ngā pātene papu. Mena he uaua ki a koe te whakamahi i ō ringaringa, ahakoa he mate pēnei i te mate rumatiki, i te mate neuropathy rānei, he uaua pea te whakamahi i te papu.
• Mena he ngoikore tō tirohanga, he matapo rānei: Mena he ngoikore tō tirohanga, tera pea he iti noa iho ō whiringa ki te hangarau Pump. Me whai whakaaro koe ki ngā mea pēnei i te rahi o te mata Pump, te mārama o te tuhinga, te rahi o ngā reta me ngā tau, me te rama o muri.
• Mena he uaua ki a koe te pupuri i te papu: Hei tauira, mena he uaua ki a koe, ki tāu tamaiti rānei te pupuri i te papu, he mate pāwera kiri nui rānei, kāore pea he pai mō te papu nā te mea me pupuri tonu e koe.

He aha ngā painga o te whakamahi i te papu insulin?

He maha ngā painga o te whakamahi i te papu insulin i te tango i ngā werohanga maha (MDI) i ngā wā maha i te rā:

• Te āheinga ki te whakarerekē i te nui o te insulin e hoatu ana (i roto i ētahi papu) kia ōrite ki ngā kai me ngā mahi whakakori tinana rerekē. Mā tēnei ka taea te horopeta insulin tika ake.
• Ka taea te whakakotahi i te tuku insulin me te hangarau CGM.
• Te āhei ki te 'tikiake' i ngā raraunga. Mā tēnei koe me tō tākuta mate huka (Endocrinologist) e āwhina ki te whakarite pai ake i tāu mahere maimoatanga.
• He pai ake te whakahaere i te huka toto. Kua whakaatuhia e ngā rangahau i roto i ngā pakeke me ngā tamariki he pai ake te whakahaere i te huka toto o te hunga e whakamahi ana i te papu mo te wa roa i te hunga e whakamahi ana i ngā MDI.
• Ko tētahi mea e kīia ana e te tini o te hunga e huri ana mai i te MDI ki te papu insulin, ko te nui o te whakapainga o tō rātou kounga oranga .
• Te whakaiti i te auau o ngā werohanga insulin.

He maha ngā tohunga mate huka (ngā tohunga endocrine) e akiaki ana i te whakamahinga o ēnei papu nā te mea kua whakamātauhia ōna painga.

He aha ngā ngoikoretanga o ngā papu insulin?

Haunga ngā painga, tera pea ētahi ngoikoretanga. Ina whakaritea ki ngā werohanga (MDI), ko tētahi o ngā ngoikoretanga nui o ngā papu insulin ko ngā raruraru ka puta mai i te whakaurunga o te insulin ki roto i te tinana.

Ngā raruraru pea i te wā e whiwhi ana i te insulin:

Ka taea ēnei te puta mai i ngā take maha:

• Te piko, te mau rānei o te cannula: Ka piko, ka mau rānei te cannula nā te pēhanga mai i te kiko i raro i te kiri. Mā tēnei ka kore e uru te insulin ki roto i te tinana.
• Te Whakatiotanga o te Inisinu: I roto i ētahi rā, ka taea e te inisinu te whakatio i roto i te cannula, i te ngongo rānei. Tērā pea ka kore koe e whiwhi i te nui tika o te inisinu. Koia te take e tūtohutia ana kia hurihia ngā huinga werohanga me ngā papu kore ngongo i ia rua, i ia toru rā.
• Te Momotu i te Huinga Werohanga: Ki te whakamahi koe i tētahi papu me te ngongo, tera pea ka wetekina te ngongo i te huinga werohanga. Mā tēnei ka turuturu te insulin i roto i te ngongo, kaua ki roto i tō tinana.
• Te pupuhi, te kohi toto rānei (Hematoma) i te wāhi i werohia ai: Mena he pupuhi nui kei te taha o te cannula, he toto totoka rānei, e kore te insulin e mimiti tika.
• Ngā ngongo pakaru, kua purua rānei: Ka raru pea, ka whati rānei te ngongo o te papu (hei tauira, ka ngaua e tō mōkai te ngongo). Ahakoa tērā, kāore te insulin e tukuna ki te tinana.
• Ngā Raru o te Rīpene Piripiri: Ka piri ngā Huinga Werohanga me ngā Papu Kore-Tube ki te kiri mā te piripiri. Ka taea ēnei te tango mā te kore e mōhiotia, te tango wawe rānei. Ka taea te whakamahi i tētahi atu piripiri hei ārai i tēnei.
• Te rahunga o te papu: I ētahi wā onge, ka pakaru pea tō papu insulin, ka kore rānei e mahi tika. Tērā pea ka pau te pākahiko.

I ētahi wā, ka kitea e tō papu he ārai, ā, ka whakamōhio atu koe kia whakawhitia te papu, te huinga werohanga rānei. Engari i ētahi wā, hei tauira, ki te puta te ngongo i te huinga, kāore pea te papu e kite i te raruraru. Ki te whakamahi koe i te CGM, ka kite pea koe kua teitei rawa te huka toto, he tohu pea tēnei kei te raru tō tukunga insulin.

Ko te mea tino nui: Ki te kore koe e whakamahi i te insulin mō tētahi wā – he torutoru hāora noa iho – ka nui ake tō tūponotanga ki te pāngia e te hyperglycemia me te mate morearea e kiia nei ko te diabetic ketoacidosis (DKA) .

Nā ēnei raruraru tuku insulin, ki te whakamahi koe i te papu, he mea nui kia whai mahere tārua tonu koe. Tērā pea ka pēnei te āhua:

• Ina wehe atu koe i te whare, mauria atu ngā taputapu e pā ana ki te insulin me te papu.
• Kia tata te insulin, te ngira werohanga, te pene insulin rānei mō te werohanga.
• Puritia te nama ratonga kiritaki a te kamupene nāna i hanga te papu kia taea ai e koe te tiki awhina wawe mena he raruraru hangarau tāu.

Hei ārai, hei kite rānei i ēnei raruraru i te wā wawe, me tirotiro i tō papu me/ranei tō kete werohanga i te iti rawa kotahi i te rā. He mea nui anō hoki kia tirohia tonutia ō taumata huka toto.

He aha atu anō ngā ngoikoretanga?

Haunga ngā ngoikoretanga matua kua whakahuatia i runga ake nei, tera atu ētahi atu āhuatanga ka kitea pea e koe he ngoikoretanga:

• Utu: Ka nui ake te utu o ngā papu me ngā taputapu insulin i te rongoā insulin (MDI). Ka rerekē tēnei utu i runga i tō mahere inihua hauora.
• Me tūpato tonu koe ki tō tinana: He taputapu anō ia papu e hono ana ki tō tinana. He maha ngā huarahi mohio hei whakamahi i ēnei, engari me roa te wā e mōhio ai koe ki te whakamahi.
• Te nui o ngā taonga e hiahiatia ana: Ki te whakaritea ki te MDI, he nui ake ngā taonga e hiahiatia ana e ngā papu insulin – "taonga" – i te papu insulin. Me whai wāhi hei penapena i aua mea ki te kāinga, ā, me kawe e koe ētahi atu putea ina haere koe, inā koa i ngā haerenga roa.
• Ngā mate pāwera ki ngā piripiri: Tērā pea ka pāngia ētahi tāngata e ngā mate pāwera ki ngā piripiri e whakamahia ana i runga i ngā papu insulin me ngā kete werohanga.

He aha ngā mea hei whakaaroaro māu i te wā e whiriwhiri ana i tētahi papu insulin?

He whakatau nui te whiriwhiri i tētahi papu insulin. Ā, he maha ngā mea hei whakaaroaro. Ko te rongo pai, he nui ngā mōhiotanga a ngā kamupene papu mō tēnei mea, ā, he kaiako anō hoki ā rātou hei whakautu i ō pātai. He rauemi pai anō hoki tō tākuta mate huka.

Anei ētahi mea hei whakaaroaro, hei pātai hoki i te wā e whiriwhiri ana i tētahi papu:

• He papu ngongo, he papu kore ngongo rānei tāu e hiahia ana? He aha ngā painga me ngā ngoikoretanga o ia momo?
• He aha te taumaha, te rahi, me te āhua o te papu?
• Ko ēhea ngā papu e hipokina ana e tō inihua hauora, he aha ngā utu e pā ana ki aua papu, ā, e hia te utu i ia tau?
• He pēhea te ratonga kiritaki a te kamupene e hanga ana i te papu?
• Me pēhea koe e whiwhi whakangungu ai?
• He pēhea te hononga o tēnei papu ki te hangarau CGM?
• Kia pēhea te roa ka taea e au te huri ki tētahi papu hou?
• He ātete wai/he ārai wai rānei?
• He aha ngā momo tautuhinga me ngā kaupapa tuku insulin e wātea ana?
• He aha ngā momo whakaoho me ngā whakatūpato kei reira? He tangi, he wiri rānei?
• Ka taea e koe te pānui mārama i ngā mata o te papu?
• He aha ngā taputapu atamai ka taea te hono atu?
• He pēhea te ngāwari o te whakamahi (mā te whakamahi noa)?
• He aha ngā pūmanawa e wātea ana hei tango i ngā raraunga ka taea e koe te tohatoha ki tō tākuta?

Hei whakamutunga, ngā mea hei maumahara

Nō reira, he kōwhiringa ngāwari, he kōwhiringa watea hoki te papu insulin mō te tini o te tangata ki te tango insulin. He maha ngā tāngata mate huka e kite ana he māmā ake te papu insulin i te werohanga.

Ko te mea nui , ehara te papu insulin i te mea pumau. Ki te tīmata koe ki te whakamahi i te papu, ā, kāore koe e pai ki a ia, ka taea e koe te hoki ki te werohanga i ngā wā katoa.

He mahi uaua te whiriwhiri i waenga i ngā momo papu maha kei te mākete. Heoi, kia maumahara mā tō tākuta mate huka koe e āwhina ki te whakatau tika māu. Nō reira, kōrero atu ki tō tākuta mō tēnei mea.

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