Kua pāngia koe e tēnei mate huka? Ahakoa kei te tango koe i tō rongoā i te pō, ā, kei te whakahaeretia pai ō taumata huka toto, ina ara ake koe i te ata ka tirohia tō mita huka toto, he tino teitei tō huka toto. Tērā pea kei te whakaaro koe, "Āe, kāore au i te mōhio mēnā i nui taku insulin i te pō." Engari ko te take mō tēnei he mea tino rerekē i tō whakaaro. I tēnei rā kei te kōrero tātou mō tētahi āhuatanga ka taea te whakapae i ngā wā pēnei, engari kāore i te tino mōhiotia. Ko te 'pānga Somogyi' tēnā.
He aha te Pānga Somogyi?
I te whakarapopototanga, ko te Pānga Somogyi ko te hekenga rawa o te taumata huka toto (hypoglycemia) i waenganui pō i a koe e moe ana, ā, ka tukuna e tō tinana ngā homoni hei whakautu, ka piki rawa te taumata huka toto (hyperglycemia) ina ara ake koe i te ata. He rite ki te here rapa e pakaru ana ki tetahi taha ina tukuna. I ētahi wā ka kiia tēnei ko te "rebound hyperglycemia."
I kitea tuatahitia tēnei i te tekau tau atu i 1930 e te tākuta ko Michael Somogyi tōna ingoa, koia i tapaina ai te mate ki tōna ingoa.
Engari he mea nui tēnei kia mārama. Kāore anō kia whakaarohia e ngā kaipūtaiao he mea kua whakamanahia 100% te Pānga Somogyi, he 'ariā' noa iho. Ko te tikanga, ahakoa he taunakitanga pūtaiao e whakaatu ana ka taea tēnei, kāore te katoa e whakaae ana. I mua, i whakaaro ngā tākuta koinei te take matua o te huka toto tiketike i te ata, engari kua ara ake ngā pātai mō tēnei whakaaro i roto i ngā hangarau hou, inā koa ko te taenga mai o te aroturukitanga huka tonu (CGM).
Heoi, he mea tino nui kia mōhio koe ki tēnei hei tētahi o ngā take maha mō te huka toto tiketike i te ata.
He aha ētahi atu take mō te huka toto tiketike i te ata?
I mua i te tohu noa i te pānga Somogyi, he maha atu anō ngā take noa o te huka toto tiketike i te ata.
- Kāore i te rawaka te horopeta o te rongoā: Ki te iti rawa te rongoā mate huka, te insulin rānei e tangohia ana i te pō, ka ngaro pea tōna whai huatanga i te ata, ā, ka piki ake te huka toto.
- Te Āhuatanga o te Ata: Koinei te tino take o te huka toto tiketike i te ata. Me titiro tātou ki tēnei me ētahi atu taipitopito.
- Kāore i te ōrite te horopeta o te tina me te horopeta rongoā: Ki te kore e tatauhia te horopeta insulin kia ōrite ki te nui o ngā warowaihā e kainga ana i te tina, ka piki ake pea ngā taumata huka toto i te ata.
- Te Ātete ki te Insulin: He āhuatanga e kore ai e aro tika ngā pūtau o te tinana ki te insulin.
He aha te rerekētanga i waenga i te Pānga Somogyi me te Āhuatanga o te Ata?
Ahakoa e rua ēnei e piki ake ai te huka toto i te ata, he rerekētanga nui kei waenganui i a rāua. Hei tangata mate huka, he tino āwhina te mārama ki tēnei rerekētanga māu.
Ko te Āhuatanga o te Ata, ko te wā e tukuna ai e ō tātou tinana ētahi homoni (pēnei i te cortisol me te homoni tipu) i te ata pō (tata ki te 3-4 i te ata). Ka piki ake te taumata huka toto i ēnei homoni. He pono anō hoki tēnei mō te hunga kāore he mate huka, engari ka whakaputa, ka whakahaere hoki ō rātou tinana i te insulin. Kāore e taea e te hunga mate huka tēnei mahi, nō reira he tiketike ō rātou taumata huka toto i te ata.
Engari he rerekē te Pānga Somogyi . Ka puta mai i te hekenga o te huka toto (hypoglycemia) i waenganui pō. I te Wāhi Ata, kāore he hekenga o te huka toto i te pō.
Kia maumahara noa: He tukanga homoni tūturu te āhuatanga o te ata. Ko te pānga Somogyi te urupare ohorere a te tinana ki te hekenga o ngā taumata huka i te pō.
Kia titiro tātou ki ngā rerekētanga matua i waenganui i ngā mea e rua.
| Āhuatanga | Pānga Somogyi | Te Āhua o te Ata |
|---|---|---|
| Te pūtake | Te iti o te huka toto i waenganui pō (hypoglycemia) . | Ka tukuna noatia e te tinana ngā homoni i te ata. |
| Ngā taumata huka i te 2-3 i te ata | He maha ngā wā i te taumata iti . | He maha ngā wā i ngā taumata noa, i ngā taumata teitei rānei . |
| He aha tēnei e tupu nei? | Ka tukuna e te tinana ngā homoni hei whakautu ki te iti o te huka. | He tukanga noa tēnei e whakareri ana i te tinana mō ngā mahi o te rā. |
| E kitea whānuitia ana | He onge noa iho. | He tino noa. |
He aha ngā tohu o te pānga Somogyi?
Ko te tohu matua o tēnei ko te nui o te huka toto ina ara ake koe i te ata. Heoi anō, tera pea ka pāngia koe e ngā tohu o te iti o te huka toto i te pō.
Ngā tohu o te huka toto tiketike i te ata (Hyperglycemia)
- Te nui haere o te matewai: Te āhua nei kāore koe e whiwhi ana i te nui o te wai ahakoa te nui o tāu inu.
- Mimi pinepine: Te hiahia kia mimi pinepine atu i te tikanga.
- Te nui haere o te hiakai: Ka nui ake te hiakai i te ata.
- Mamae upoko: Mamae upoko i te oho ake i te ata.
- Riri: Te riri mō ngā mea iti noa.
Ngā tohu o te huka toto iti i te pō (Nocturnal Hypoglycemia)
Kāore pea koe e kite i ēnei tohu nā te mea kei te moe koe.
- Te werawera i te moe: Te nui o te werawera ka mākū ngā whāriki me ngā pajama.
- Moemoeā kino: Te oho ake i te moe i muri i te moemoeā whakamataku.
- Moe kore e okioki: E hurihuri ana, e moe kore e okioki.
- Te ngenge i te oho ake i te ata: Te ngenge me te hiamoe i te ata, ahakoa i muri i te moe pai.
Mena kei a koe ēnei tohu i te pō, ā, he nui te huka toto i te ata, tera pea ka whakapae koe kei te pāngia koe e te pānga Somogyi.
He aha tēnei e tupu nei? He aha te take?
Whakaarohia, i werohia koe ki te insulin i te pō, i whakakorikori tinana rānei koe i mua i te tina. Nā konei, i waenganui pō i a koe e moe ana, kāore koe i te mōhio, ka tino heke te taumata huka toto ('hypoglycemia').
I tēnei wā, ka whakaaro tō tinana, "Āe, ka puta he mea kino!" Nō reira ka mahi te tinana i ngā mahi ohorere hei "whakaora" i a koe. Arā, ka tukuna e ia ētahi homoni ki roto i te toto ka whakahohehia i ngā wā ohorere.
- Te adrenaline
- Ngā corticosteroids
- Homoni tipu
- Glucagon
Ka honoa ēnei homoni ki te tuku tohu ki tō ate kia "Whakauruhia te huka ki roto i ō toto!" Kātahi ka tukuna ohoreretia e te ate te nui o te huka kua rongoatia ki roto i ō toto.
Ki te pā tēnei ki tētahi kāore he mate huka, ka whakaputa te tinana i te insulin hei whakahaere i te pikinga o ngā taumata huka. Engari nā te mea kāore e taea e tō tinana he mate huka te mahi i tēnā, ka piki haere tonu ngā taumata huka, ā, ina ara ake koe i te ata, ka kite koe i ngā taumata huka teitei (hyperglycemia) . Koinā te mea ka tupu, he māmā noa iho.
Me pēhea rawa te kitea e koe tēnei āhuatanga?
I te mea he maha ngā take mō te huka toto tiketike i te ata, he uaua pea te whakatau mēnā koinei te pānga Somogyi. Waihoki, e ai ki tā mātou i kōrero ai i mua ake nei, nā te mea kāore tēnei e kiia he take tino noa i ēnei rā, he uaua pea te "tātari" i tēnei mate e te tākuta.
Ko te mea pai rawa atu, ki te mea kei te piki tonu te huka toto i te ata, ko te kōrero ki tō tākuta mate huka mō tēnei mea. Ka ngana ia ki te kimi i te take mā te tirotiro i te āhua o te huringa o ō taumata huka toto.
Ko te huarahi pai ki te mahi i tēnei ko te whakamahi i tētahi taputapu Aroturuki Huka Tonu (CGM). Mā tēnei ka taea e koe te kite i tētahi kauwhata mārama o te panonitanga o ngā taumata huka toto i te pō katoa.
Mena kāore koe e whakamahi ana i te CGM, ka kī atu pea tō tākuta kia mahi koe i tētahi mea pēnei:
| Wā | Me aha? |
|---|---|
| E rua hāora i muri i te tina | Inehia, tuhia hoki tō taumata huka toto. |
| I mua i te haere ki te moenga | Inehia anō tō taumata huka toto, ka tuhituhi ki raro. |
| I waenganui pō (hei tauira, 2-3 i te ata) | Whakatakotoria he whakaoho, whakatika, tirohia tō taumata huka toto, ka tuhituhi. (Koinei te whakamātautau tino nui.) |
| Ina ara ake koe i te ata | Inehia tō taumata huka toto mō te wā whakamutunga, ka tuhituhi ki raro. |
Mā te mahi i tēnei mō ētahi rā, me te whakaatu i ngā inenga ki tō tākuta, ka taea e ia te mōhio ki ngā āhuatanga o te pō. Mena he iti tō huka toto i waenganui pō, ā, he teitei i te ata, tera pea ko te pānga Somogyi tēnei.
He aha ngā otinga ka taea te mahi mō tēnei?
Kia kitea te pūtake, me mahi tahi kōrua ko tō tākuta ki te kimi i tētahi otinga. He rerekē te katoa, nō reira kāore he otinga kotahi e pai ana mō te katoa. Tērā pea ka roa te wā ki te kimi i te mea e pai ana mōu.
Whakatūpato: Kaua rawa e whakarerekē i te horopeta o tō insulin, o ētahi atu rongoā mate huka rānei, me te kore e kōrero tuatahi ki tō tākuta. Mā te pēnei ka tino iti, ka tino teitei rānei ō taumata huka toto.
Tērā pea ka tūtohu tō tākuta i ētahi rongoā pēnei i ēnei:
- Te whakarerekē i tō horopeta insulin, i tō horopeta rongoā rānei: Tērā pea ka tonoa koe kia whakaitihia te horopeta o tō insulin i te pō.
- Te whakarerekē i tō tina: Tērā pea ka tohutohuhia koe kia whakarerekē i te nui o ngā warowaihā, pūmua, ngako rānei e kainga ana e koe mō te tina. Tērā pea ka tohutohuhia koe kia kai i tētahi kai iti i mua i te moe.
- Te Huri ki te Papu Insulin: Mena ka taea, ka taea e te papu insulin te awhina i te whakahaere tika ake i ngā horopeta insulin.
- Te whakarerekē i te wā o tō whakangungu: Ki te whakakori tinana koe i te ahiahi, i te pō rānei, ka hiahia pea koe ki te whakarerekē i te wā, i te kaha rānei o tō whakangungu.
He aha ngā raruraru ka pā mai mēnā ka kore e arohia tēnei?
Ahakoa te puta o te pānga Somogyi, e rua ngā take matua e tika ana kia mōhio tātou e te hunga mate huka:
1. Te piki haere tonu o te huka toto.
2. Te mōrearea o te iti o te huka toto i te pō.
1. Te piki haere tonu o te huka toto
Kāore e pai mō te whakahaere whānui i te mate huka mēnā he nui ngā taumata huka toto mō ngā haora torutoru i ia ata. Ka taea e ia te whakanui ake i te uara o tō `A1C`. He whakamātautau `A1C` e whakaatu ana i te toharite o ngā taumata huka toto mō ngā marama e toru kua hipa. Mā te uara `A1C` teitei mō te wā roa ka nui ake te tūponotanga o ngā raruraru mai i te mate huka.
- Te pakaru o te kanohi (Retinopathy)
- Te pakaru o te whatukuhu (Nephropathy)
- Neuropathy (e pā ana ki ngā io)
- Mate ngakau
2. Te mōrearea o te iti o te huka toto i te pō
He tokomaha ngā tāngata ka pāngia e ngā tohu o te hypoglycemia ina heke te huka toto ki raro i te 70 mg/dL. Tērā pea ka wiriwiri rātou, ka hiakai, ka werawera. Engari ki te puta tēnei i a koe e moe ana, tērā pea kua roa rawa te kite i ngā tohu me te whakaara i a koe. Ka taea e te hypoglycemia kino te whakararu i te ora.
Mena he maha ngā wā ka iti te huka toto i a koe i te pō, me kōrero koe ki tō tākuta mō tēnei mea. Me whakarerekē pea tō mahere maimoatanga hei ārai i tēnei mea.
Āhea koe me tino kite i te tākuta?
Mena he nui tonu te huka toto i a koe e ara ake ana i te ata, kaua e warewarehia. He mea nui kia kōrero koe ki tō tākuta mate huka. Ka taea e ia te tirotiro i ō inenga, te whakatau mena ko te pānga Somogyi te take, ko te āhuatanga o te Ata, he mea kē atu rānei, ā, ka hoatu ki a koe te maimoatanga pai rawa atu māu.
He tino whakarihariha te nui o te huka toto i te ata. Engari nā te mea kāore he rongoā kotahi e tika ana mō te katoa, tera pea ka roa te wā ki te kimi i te rongoā tika māu. Kia manawanui, me te mahi tahi me tō tākuta. Mā te mahi inaianei ka āwhina nui i a koe ki te karo i ngā raruraru poto me te roa.
Karere Tangohia ki te Kāinga
- Mena he mate huka tōu, he maha ngā take e teitei ai te huka toto i te ata. Ko te Pānga Somogyi tētahi o aua take.
- Ka puta te pānga Somogyi hei tauhohenga a te tinana ki te iti o te huka toto (hypoglycemia) i te pō.
- Ka taea te whakapae i tēnei mena he nui te huka toto i te ata, me ngā āhuatanga pēnei i te werawera i te pō me ngā moemoeā kino.
- Ko te huarahi pai ki te kimi i te tino take ko te ine i te huka ahakoa i waenganui pō, mā te whakamahi rānei i tētahi mīhini CGM.
- Kaua rawa e whakarerekē i te horopeta o tō insulin, o tō rongoā mate huka rānei, me te kore e pātai atu ki tō tākuta.
- Ka taea e koe te whakahaere pai i tēnei āhuatanga mā te kore e manukanuka, engari mā te kōrero ki tō tākuta me te tiki i tētahi mahere maimoatanga tika.
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