He aha te tikanga o te "Wā i roto i te Awhe" (TIR) ​​mō koutou e mate huka ana? Kia mōhio tātou!

He mate huka tōu? He mate huka rānei tō tētahi o tō whānau, tō hoa rānei? Tērā pea kua rongo koe, kua kōrero rānei tō tākuta mō tēnei mea e kīia nei ko te 'Wā i roto i te Awhe'. Nō reira, me kōrero tātou mō tēnei mea i tēnei rā, kia māmā noa iho, kia mārama hoki. Ahakoa he mea hou tēnei, he mea tino āwhina i te whakahaere i te mate huka.

He aha tēnei "Wā i te Awhe" (TIR)?

Ki te kī māmā noa, ko te "Wā i roto i te Awhe" (TIR) ​​te roa o te wā ka taea e te tangata mate huka te pupuri i ō rātou taumata huka toto (glucose) i roto i tētahi awhe ūnga . Whakaarohia tō tākuta e kī ana kia puritia ō taumata huka toto i waenga i tēnei awhe me tēnei awhe. Mā tēnei ka ine i te roa o tō noho i roto i taua awhe.

Mō te nuinga o te hunga mate huka, arā, te hunga mate huka momo 1 me ngā pakeke mate huka momo 2, ko tēnei awhe whāinga kei waenganui i te 70 me te 180 mirikaramu ia teririta (mg/dL) . Engari kāore tēnei i te rite mō te katoa, ā, ka rerekē pea i ia tangata, i ia tangata. Ka inehia te TIR hei ōrau . Ko te tikanga, me ngana tonu tō TIR ki te pupuri i te 70% i runga ake i te 70% . Ko te tikanga, me noho tō huka toto ki roto i taua awhe mō te 17 hāora pea i roto i ngā hāora 24 ia rā. Koinei te wā ka taea e koe te kī kua pai te whakahaere i tō mate huka.

Me pēhea te ine tika i tēnei TIR?

Ko te huarahi māmā me te huarahi tino tika ki te kimi i tō TIR ko te whakamahi i te Aroturuki Huka Tonu (CGM) . Kua rongo pea koe mō tēnei taputapu i mua. He taputapu iti nei e mau ana i raro i te kiri o tō ringaringa, o tō puku rānei . I a koe e mau ana, ka ine tonu, ka tuhi hoki i ngā taumata huka i roto i te wai i waenganui i tō kiri , 24 hāora ia rā. He rite ki tētahi kaitirotiro iti e rapu ana i tō huka. Kātahi ka taea e koe te tango i ēnei raraunga huka mā te whakamahi i te pūmanawa e hono ana ki te taputapu CGM, i tētahi taupānga rānei i runga i tō waea, ka whai i tō TIR.

Ina hoki, ka taea e koe te whiwhi whakaaro whānui mō tō TIR mā te wero ā-ringa i ō maihao . Engari ki te mahi koe i tēnā, me tirotiro e koe tō huka toto i ētahi wā i te rā . Ahakoa rā, kāore e whakaratohia he raraunga taipitopito pērā i te 'CGM'. Whakaarohia he rite ki te huri i ngā whārangi o te pukapuka. Engari he rite te 'CGM' ki te pānui i te pukapuka katoa! Ka hoatu he pikitia katoa mō ō taumata huka toto.

Nā ēnei mīhini 'CGM', he tokomaha te hunga mate huka me ā rātou tākuta e whakamahi ana i tēnei TIR hei āwhina i a rātou ki te whakahaere i tā rātou mate huka.Aromatawai tika i ō raraunga TIR. Mā te tirotiro i ō raraunga TIR, ka taea e kōrua ko tō tākuta te whakatakoto whāinga hou me te hanga i ngā huringa e tika ana ki tō mahere maimoatanga.

He aha te āhua o tēnei pūrongo TIR?

I roto i ēnei pūrongo TIR, i ahu mai i te pūmanawa i runga i ngā mīhini CGM, ko ngā awhe rerekē o ō taumata huka ka whakaaturia hei pae poutū tae . He tino ngāwari ki te mārama.

• Ko te wā i roto ai tō taumata huka i te awhe e whakaaturia ana i te kākāriki . Koinei tā tātou katoa e whai ana kia whakapai ake.
• Ko ētahi atu awhe, arā, ko ngā wā e iti ana, e teitei ana rānei ngā taumata huka, ka whakaaturia i roto i ētahi atu tae pērā i te kōwhai, te karaka, me te whero .

Anei te whakaaturanga o ēnei awhe i runga i tētahi pūrongo `CGM` noa (mai i raro ki runga):

• I raro iho i te 54 mg/dL (< 54 mg/dL) — Tino iti (i raro iho i te whāinga). Ka puta he whero. He āhuatanga morearea pea tēnei.
• I waenganui i te 54 mg/dL me te 69 mg/dL — Iti (kei raro iho i te whāinga). Tērā pea he karaka te āhua o tēnei. He wāhanga anō hoki tēnei hei aro atu.
• I waenganui i te 70 mg/dL me te 180 mg/dL — kei roto i te awhe. Koinā te mea kei roto i te kākāriki . Kei te ngana katoa tātou ki te whakanui ake i tēnei wāhanga kākāriki!
• I waenganui i te 181 mg/dL me te 250 mg/dL — teitei (kei runga ake i te ūnga). He rite te āhua ki te kōwhai.
• Neke atu i te 250 mg/dL (> 250 mg/dL) — Tino teitei (kei runga ake i te ūnga). Ka puta anō hoki tēnei hei tae whero. Ki te haere tonu tēnei, ehara i te mea pai.

Engari kia maumahara, tera pea ka rerekē te whakaatu a ētahi pūrongo CGM i ēnei raraunga. Mena he uaua ki a koe te mārama ki ēnei mōhiohio, he mea pai kia kōrero koe ki tō tākuta . Ka taea e rātou te whakamārama atu ki a koe.

Kia pēhea te nui o taku TIR?

Mena he mate huka tōu, he mea motuhake ki a koe te awhe whāinga mō ō taumata huka toto . Arā, kāore tō awhe whāinga i rite ki tāku. Mā kōrua ko tō tākuta e whakatau tahi ko tēhea awhe whāinga te mea pai mōu, me te nui o taua awhe me whai tonu koe kia mau. Ka rerekē pea ēnei whāinga puta noa i tō oranga.

He maha ngā āhuatanga ka pā ki ngā whāinga huka:

• Kia pēhea te roa o tō mate huka ?
• Tō tau me tō hauora whānui .
• Kei a koe ētahi atu āhuatanga hauora e pā ana ki ō taumata huka toto, pērā i te ngoikore o te mahi a ō whatukuhu , te gastroparesis rānei.
• Mena kei a koe te mate pūnaha toto .
• He āhuatanga kāore koe e mōhio ki ngā tohu o te huka toto iti (te kore mōhio ki te hypoglycemia)Mena kei reira. Ara, ki te kore koe e rongo i te whanoke me te werawera e pā ana ki a koe ina heke tō taumata huka, he ahua mōrearea.
• Mena kei te hapu koe, kei te ngana rānei kia hapu , ka tino rerekē ō whāinga i ēnei wā.

Āe, kia titiro tātou he aha ngā taunakitanga whānui e tukuna ana.

Ngā whāinga TIR mō te nuinga o ngā pakeke he mate huka momo 1, momo 2 rānei:

• Neke atu i te 70% o te wā i waenga i te 70 me te 180 mg/dL (i roto i te awhe kua whakaritea).
• Me iti iho i te 1% te wā e heke iho ai te taumata i te 54 mg/dL.
• Me iti iho i te 4% te wā i waenga i te 54 me te 69 mg/dL.
• Me iti iho i te 25% te wā i waenga i te 181 me te 250 mg/dL.
• Me iti iho i te 5% te wā e neke ake ana i te 250 mg/dL.

Ko ngā whāinga TIR mō te hunga he nui ake te mōrearea o te huka toto iti (hypoglycemia):

He mea tēnei mā te hunga he iti te huka toto.

• Neke atu i te 50% o te wā i waenga i te 70 me te 180 mg/dL (i roto i te awhe noa).
• Me iti iho i te 1% te wā e pau ana i raro i te 70 mg/dL.
• Me iti iho i te 10% te wā e neke ake ana i te 250 mg/dL.

Ngā whāinga TIR mō ngā pakeke e pāngia ana e te mate huka momo 1 i te wā e hapu ana:

He mea tino nui tēnei, nā te mea ka pā ki te pēpi.

• Neke atu i te 70% o te wā, kei waenga i te 63 me te 140 mg/dL (i te awhe noa). He rerekē te awhe i konei, kei te kite koe? He mea tino nui te whakahaere i ō taumata huka i te wā e hapū ana.
• Me iti iho i te 4% te wā e heke iho ai te taumata i te 63 mg/dL.
• Me iti iho i te 25% te wā e neke ake ana i te 140 mg/dL.

Tērā pea he rerekē ngā aratohu mō te mate huka hapūtanga me te mate huka momo 2 i te wā e hapū ana. He aratohu whānui anō ēnei. He mea nui kia kōrero tahi koe me tō tākuta mō ngā whāinga huka e tino whai hua ana, e tino pono ana hoki mōu. Mā rātou koe e tohutohu mō te huarahi mahi pai rawa atu mō tō āhuatanga.

He aha te whanaungatanga i waenga i tēnei TIR me te A1C?

Kua rongo pea koe i tēnei whakamātautau A1C . He maha ngā tākuta e whakamahi ana i tēnei hei tirotiro i te pai o te whakahaere i tō mate huka. Nō reira, he rite tonu te TIR me te A1C? Ae, he iti noa iho.

Ka ine te TIR i te whānuitanga o ō taumata huka i roto i tētahi wā, mai i ētahi hāora ki ētahi rā, i a koe e mau ana i te CGM. He rite ki tētahi tirohanga poto . Ka taea e koe te kite tika i te panonitanga o tō huka i ia rā, i ia rā.

Heoi, he whakamātautau toto te A1C e mahia ana i roto i te taiwhanga . Ka ine i ō taumata huka toto toharite i roto i ngā wiki 8 ki te 12 kua hipa . Kāore e taea e te whakamātautau A1C te whakaatu ki a koe te piki me te heke o tō huka toto. Ka homai noa he uara toharite.

Hei whakarāpopototanga:

Whakaarohia pēnei: ​​He rite te A1C ki te pānui i tētahi whakarāpopototanga o tētahi upoko pukapuka.. Engari ko te whakamahi i te `CGM` me te titiro ki te TIR he rite ki te pānui i te upoko katoa . Kātahi ka whiwhi koe i te māramatanga hohonu ake, me te mārama ake . Kei te mārama koe? E whakaatu mārama ana te TIR i te whanonga o te huka i ngā wā rerekē o te rā, i muri i te kai, i muri i te whakakori tinana.

Mai i te tekau tau atu i 1960, kua whakawhirinaki ngā tākuta me ngā tāngata mate huka ki te A1C hei aromatawai i te pai o te whakahaere i te mate huka. Heoi, mai i te taenga mai o ngā mīhini CGM, kua kite ngā tākuta me ngā tūroro he pai ake, he tika ake hoki te pikitia o te whakahaere i te mate huka e tēnei TIR .

Ina koa mō te hunga mate huka momo 1 , ka rerekē haere ngā taumata huka toto i roto i ngā rā, i ngā wiki, me ngā marama. Nō reira, ehara i te mea ko te uara A1C toharite te mehua tika mō te whakahaere i a rātou.

Hei tauira, whakaarohia:

Tērā tētahi tangata e tino heke ana, e tino teitei ana anō hoki ōna taumata huka toto. Engari tera pea ka eke tōna A1C ki te 7%.

Tērā tētahi atu tangata kei te pumau tonu te taumata huka toto i te nuinga o te wā, arā, i te 154 mg/dL. Tērā pea ka eke tōna A1C ki te 7%.

Titiro? Ahakoa he rite tonu ō rātou A1C, ka rerekē rawa ngā uara TIR. He iti ake te TIR o te tangata tuatahi nā te mea kei waho tonu ia i te awhe whainga. He nui ake te mōrearea o te hypoglycemia.

Waihoki, kāore pea te whakamātautau A1C e tika mō te hunga whai i ēnei āhuatanga e whai ake nei:

• Te kore toto (te ngoikore o te toto).
• Ngā rerekētanga o te hemoglobin.
• Te korenga o te rino.
• Te haputanga.
• Mate ate.

Ka rerekē pea te tika o ngā uara A1C i waenga i ngā taupori rerekē.

Heoi, i tēnei wā, ko te taenga mai o te TIR ehara i te mea ka tawhito te whakamātautau A1C . Kua whakaatuhia e ngā tekau tau o te rangahau ka taea e ngā taumata A1C te tohu i te whanaketanga, te ārai rānei i ngā raruraru mate huka. Nō reira, kei te whakakotahi ngā tākuta i ngā whakamātautau TIR me te A1C kia whiwhi ai i tētahi pikitia whānui ake o te whakahaere huka.

He aha te hiranga o tēnei TIR?

Mā te TIR ka kitea he pikitia tika ake mō ngā piki me ngā heke o ngā taumata huka e pā ana ki te mate huka. Whakaarohia te maha o ngā mea e pā ana ki ō taumata huka, pērā i te kai e kainga ana e koe, te whakakori tinana e mahia ana e koe, ngā rongoā e tangohia ana e koe, me tō taumata ahotea ! Nō reira, mā te tirotiro i ō raraunga TIR (ina koa ka whakamahia he 'CGM') ka taea e koe te mārama ake ki te pānga tika o ēnei āhuatanga ki ō taumata huka .

Hei tauira, ka kite pea koe kua heke tō TIR ina pāngia koe e te kirika mō te wiki. Tērā pea ka kite koe kua piki ake tō huka toto i muri i te kai i tētahi kai motuhake, ā, kua heke tō TIR. Ina kite koe i tētahi mea pēnei, ka taea e koe te pātai ki tō tākuta, 'Me pēhea taku whakarite pai ake ki te whakahaere i taku mate huka i te wā e pāngia ai ahau e te mate?' Tērā pea ka whakaaro koe, 'He aha te pānga o taua momo kai ki ahau, ā, me whakarerekē e au taku kai?' Arā, he āwhina nui te TIR ki te whakahaere i tō mate huka i tētahi huarahi e pai ana ki tō āhua noho .

Ka puta pea ngā raruraru mate huka mēnā ka heke te TIR?

Kei te haere tonu ngā rangahau mō tēnei mea, engari kua kitea e ngā rangahau o nāianei ka piki ake te mōrearea o ngā raruraru e pā ana ki te mate huka i te hekenga o ngā taumata TIR .

E whakaatu ana ngā rangahau ka taea e ngā piki me ngā heke nui o te huka toto (e kiia nei ko te glycemic variability) te whakanui ake i te ahotea waikura me te mumura i roto i te tinana. Ka taea e ēnei āhuatanga te kino i ngā pūtau . Kua hono ētahi rangahau i ēnei piki me ngā heke nui o te huka ki:

• Te pikinga ake o te mōrearea o te huka toto iti (hypoglycemia).
• Te pikinga ake o te mōrearea o te mate pūnaha toto.
• Te ngoikore o te mahi hinengaro.
• Te hekenga o te kounga o te oranga.

I tua atu, i kitea i roto i tētahi rangahau he nui ake te mōrearea o te hunga mate huka momo 2 he iti te TIR me te nui o te rerekētanga o te glycemic i roto i ō rātou toto ki te retinopathy e pā ana ki te mate huka, he raruraru o te mate huka e pā ana ki ngā kanohi . I kitea i roto i tētahi atu rangahau he hononga nui te iti o te TIR ki te nui ake o te mōrearea o te neuropathy pūnaha cardiovascular autonomic, he mate io e pā ana ki te pūnaha pūnaha cardiovascular .

Nō reira, e whakaatu ana ēnei rangahau i te hiranga o te pupuri i tō TIR kia teitei rawa . I a ngā kairangahau e ako ana, ka taea e ngā tohunga mate huka te whakarerekē i ēnei whāinga TIR ā muri ake nei.

Me pēhea taku whakanui i taku TIR?

Ko te mea nui hei whakapai ake i tō TIR ko te mōhio he aha te mea e pā ana ki ō taumata huka . Tērā pea ka roa te wā. Inaa, he rite ki te whakamātautau pūtaiao mutunga kore. Nō reira, he mea nui kia arotahi ki tētahi āhuatanga i ia wā, kia atawhai hoki ki a koe anō . Kaua e mataku, engari ngana ki te āta whakatau i ēnei mea.

Ki te kite koe kei te piki haere, kei te heke rānei ō taumata huka i ētahi wā o te rā, tirohia ō tikanga me ō mahi i taua wā.

Hei tauira, ka kite pea koe kei te piki haere tonu ō taumata huka i muri i te parakuihi. He maha ngā take e pā ai tēnei:

• Ehara i te wā tika ki te tango i tō rongoā mate huka (hei tauira, te insulin ).
• Kāore i te rawaka, te nui rawa rānei o te horopeta rongoā.
• Te taurite o ngā kai e kainga ana e koe me ngā matūkai matua kei roto (ngā warowaihā, te ngako, me te pūmua) . Tērā pea he nui rawa ngā warowaihā e kainga ana e koe.
• Ētahi atu rongoā hei tango i te ata (ka pā pea ētahi rongoā ki ngā taumata huka toto).
• Te inu i ngā inu kei roto te kawheine pēnei i te kawhe i te ata (ka pā tēnei ki ētahi tāngata).

He tauira noa iho tēnei. He tino uaua te mate huka. He maha ngā rautaki hei āwhina i a koe ki te whakapai ake i tō TIR. Pērā i ngā wā katoa, ina whakaaro koe ki te huri i tō mahere whakahaere, he pai ake te mahi tahi me tētahi tohunga mate huka (hei tauira, he endocrinologist) he tohunga tiaki me te mātauranga mate huka whaimana (CDCES) rānei. Ka taea e rātou te ārahi i a koe i roto i te tukanga me te whakautu i ō pātai.

Karere Tangohia ki te Kāinga

Nō reira, he huarahi hou, he huarahi tino whai hua hoki tēnei "Wā i roto i te Awhe" (TIR) ​​mō te hunga mate huka ki te ine i tā rātou whakahaere huka. I ētahi wā, he uaua te mārama ki ngā mōhiohio TIR me ō raraunga huka. Kaua e manukanuka, ka taea e koe te taunga haere ki tēnei mea.

Kia maumahara, kei reira tonu tō tākuta hei āwhina i a koe ki te mārama ki tō TIR me te whakamahi i tēnei hei painga mōu. Mā te mahi tahi, ka taea e kōrua te aroturuki i te huringa o tō TIR i roto i te wā, me te whakarerekē i ō rautaki whakahaere. He wero te noho me te mate huka, engari mā ngā taputapu hou pēnei i ēnei, ka taea te whakangawari ake. Kāore koe i te mokemoke, ā, he maha ngā tāngata ka taea te āwhina i a koe i tēnei haerenga.

`Mate huka, Wā i roto i te Awhe, TIR, Huka, Taumata Huka Toto, CGM, A1C