He aha te Koma Mate Huka? Tohutohu, Take, me te Maimoatanga

Ko te koma mate huka tetahi o ngā āhuatanga mate kino e raru ai te ora, ā, ko te nui rawa atu rānei, te iti rawa atu rānei o te huka toto e āhei ai te ngaro o te mohio. Ko te huarahi tenei o tō tinana ki te mutu i te mahi ina kore te huka toto e rite ana, ā, ka puta he āhuatanga kaore e taea e koe te ara ake, te whakautu noa rānei.

Ahakoa te ahua wehi o te kupu "koma mate huka," ko te mōhiotanga ki te aha, me te pehea te aukati i te āhuatanga, ka āhei te awhina i a koe ki te whakapono atu ki te whakahaere i te mate huka. Ko tēnei āhuatanga kino e hiahia ana ki te tiaki hauora tonu, engari mā te tiaki tika o te mate huka, me te matapaki ki ngā tohu whakatūpato, ka taea te aukati.

He aha te koma mate huka?

Ka puta te koma mate huka ina kore te taumata o te huka toto e rite ana, ā, kaore e taea e tō roro te mahi tika, ka āhei ai te ngaro o te mohio. Ko tō roro e hāngai ana ki te whakarato tonu i te huka mō te kaha, ā, ina neke atu te taumata ki runga, ki raro rānei, ka pā te kaha ki te noho ara, te mataara rānei.

Ka taea e tēnei āhuatanga te puta ki te tangata katoa e mate huka ana, ahakoa te momo 1, te momo 2 rānei. Ko te rongo pai, ko ngā koma mate huka ka taea te aukati mā te tirotiro tonu i te huka toto, me te whai i tō mahere whakahaere mate huka pera i te tohutohu a tō rōpū hauora.

He aha ngā tohu o te koma mate huka?

I mua i te puta o te koma mate huka, ka tuku tonu tō tinana i ngā tohu whakatūpato e kore te taumata o te huka toto e rite ana. Ko te mohiotanga ki ēnei tohu wawe ka āhei te awhina i a koe ki te mahi i mua i te kino o te āhuatanga.

Ko ngā tohu e hāngai ana ki te nui rawa atu rānei, te iti rawa atu rānei o te huka toto, ā, ka tupu haere i roto i ngā haora, i ngā rā rānei:

Nui rawa te huka toto (hyperglycemia):

• Nui rawa te matewai me te maha o te mimi
• Te ruaki me te ruaki
• Te manawa kakara hua
• Te manawa hohonu, tere
• Te ngoikore me te ngenge
• Te whakapohehe, te uaua rānei ki te aro
• Te mamae o te puku

Te iti o te huka toto (hypoglycemia):

• Te wiri me te wiri
• Te tere o te ngakau
• Te werawera
• Te hiakai
• Te riri, te huringa ngākau rānei
• Te māuiui, te mārama rānei
• Te whakapohehe, te uaua rānei ki te kōrero

Ina ka kino ake ēnei tohu, ka moe atu koe, ka ngaro rānei te mohio. Mena ka kite koe i tētahi o ēnei tohu whakatūpato, he mea nui kia tirotiro tonu tō huka toto, kia rapu rānei i te awhina hauora mena he nui rawa atu, he iti rawa atu rānei te taumata.

He aha ngā momo koma mate huka?

E toru ngā momo koma mate huka nui, ā, ko ia momo e puta mai ana i ngā rereketanga o te huka toto. Ko te mōhiotanga ki ēnei momo ka āhei te awhina i a koe ki te mohio ki te āhuatanga e pā ana ki a koe, me te whakautu tika.

Te ketoacidosis mate huka (DKA)

Ka puta te DKA ina nui rawa te huka toto, ā, ka tīmata tō tinana ki te wawahi i te ngako mō te kaha, ehara i te huka. Ko tēnei tukanga e hanga ana i ngā mea kino e kiia nei ko ngā ketones e āhei ai te waikawa o tō toto, ka āhei ai ngā raruraru kino.

Ko tēnei momo he tino noa ki ngā tāngata e mate huka momo 1 ana, engari ka taea hoki te puta ki ngā tāngata e mate huka momo 2 ana i te wā o te mate kino, te ahotea rānei. Ko te kakara hua o te manawa he tohu whakatūpato o te DKA.

Te āhuatanga hyperosmolar hyperglycemic (HHS)

Ko te HHS e pā ana ki te nui rawa o te taumata huka toto, i runga ake i te 600 mg/dL, engari kaore he hanga ketone e kitea ana i te DKA. Ka mātotoru, ka piripiri tō toto, ka uaua ai te mahi tika o tō tinana.

Ko tēnei āhuatanga he tino noa ki ngā tāngata e mate huka momo 2 ana, ā, ka tupu haere i roto i ngā rā, i ngā wiki rānei. Ko te maroke kino he āhuatanga matua o te HHS.

Te hypoglycemia kino

Ka puta tēnei ina he iti rawa te taumata huka toto, i raro i te 50 mg/dL. Kaore tō roro e whiwhi huka hei mahi, ka āhei ai te whakapohehe, te ngau, ka ngaro rānei te mohio.

Ka taea te puta tere te hypoglycemia kino, i roto i ngā meneti pea, ina koa ki te nui rawa te insulin, te rongoā mate huka rānei i inu koe kaore i kai.

He aha ngā take o te koma mate huka?

Ka puta te koma mate huka ina whakakotahi ngā take maha ki te pēhi i tō huka toto ki ngā taumata kino. Ko te mōhiotanga ki ēnei take ka āhei te awhina i a koe ki te mahi i ngā mahi hei aukati i tēnei raruraru kino.

Ko te take taketake e hono ana ki te insulin – ahakoa he iti rawa, he nui rawa rānei, te kaha rānei o tō tinana ki te whakamahi tika.

Ngā take o te koma huka nui:

• Te ngaro o ngā rongoā insulin, mate huka rānei
• Te mate, te mate huaketo rānei e whakanui ana i te huka toto
• Te kai i ngā warowai nui atu i te noa kaore i whakaritea te rongoā
• Te ahotea mai i te pokanga, te whara, te mamae ngākau rānei
• Ngā rongoā motuhake penei i ngā steroids
• Te mate huka kaore i kitea
• Te mahi kino o te pomu insulin

Ngā take o te koma huka iti:

• Te nui rawa o te insulin, te rongoā mate huka rānei
• Te whakarere i ngā kai, te iti rānei i te whakamahere
• Te inu waipiro kaore i kai
• Te mahi nui atu i te noa kaore i whakaritea te rongoā, te kai rānei
• Te ruaki, te kore rānei e taea te pupuri i te kai
• Te tango i ētahi rongoā e pā ana ki ngā rongoā mate huka

I etahi wā, ka taea e ngā take iti ake te whakauru ki te koma mate huka. Ka uru pea ēnei ki te mate whatukuhu, ate rānei, te mate ngakau, te mate hormone onge rānei e pā ana ki te whakahaere huka toto.

Nōhea te haere ki te taakuta mō te koma mate huka?

Waea atu ki te 111 tonu mena kaore tetahi e ara ake, tetahi rānei e kore e taea te ara ake, ina koa ki te mate huka. Ko te koma mate huka he āhuatanga mate tonu e hiahia ana ki te whakaora i te hohipera – kaore he huarahi haumaru ki te whakaora i te kāinga.

Me rapu hoki koe i te awhina hauora tonu mena ka kite koe i ēnei tohu whakatūpato, ahakoa i mua i te ngaro o te mohio:

• Te huka toto i runga ake i te 400 mg/dL, i raro i te 50 mg/dL rānei
• Te ruaki me te kore e taea te pupuri i ngā wai
• Ngā tohu o te maroke kino
• Te uaua ki te manawa, te tere rānei o te manawa
• Te kakara hua o te manawa
• Te whakapohehe kino, te uaua rānei ki te noho mataara
• Te mamae o te uma, te tere rānei o te ngakau

Kaua e tatari kia pai ake ngā tohu. Ko te tere o te whiwhi i te whakaora hauora, ko te pai o ō tūmanako ki te karo i ngā raruraru kino, ki te ora katoa hoki.

He aha ngā take morearea mō te koma mate huka?

Ahakoa tetahi tangata e mate huka ana ka taea te whanake i te koma mate huka, ko ētahi take e whakanui ana i tō morearea. Ko te matapaki ki ēnei take morearea ka āhei te awhina i a koe me tō rōpū hauora ki te tango i ngā whakaritenga atu hei aukati i tēnei raruraru kino.

Ko ētahi take morearea ka taea e koe te whakahaere, ko ētahi atu e pā ana ki tō hītori hauora, ngā āhuatanga hauora o nāianei rānei:

Ngā take morearea ka taea te whakahaere:

• Te whakahaere huka toto kino, te tirotiro kore rānei
• Te whakarere i ngā rongoā insulin, rongoā rānei
• Te kore e whai i tō mahere kai mate huka
• Te kore o ngā tirotiro hauora noa
• Te nui o te inu waipiro
• Te kore o te mahere whakahaere mate

Ngā take morearea hauora:

• Te mate huka momo 1 (te morearea nui ake mō te DKA)
• Te hītori o ngā āhuatanga mate huka o mua
• Ngā āhuatanga mate roa atu penei i te mate ngakau, te mate whatukuhu rānei
• Ngā mate maha, ngā whara rānei e whakaora ana
• Ngā āhuatanga hauora hinengaro e pā ana ki te tiaki whaiaro mate huka
• Te pakeke i runga ake i te 65 (te morearea nui ake mō te HHS)

I tua atu, ko ētahi āhuatanga ora ka whakanui wawe i tō morearea, penei i te mate nui, te pokanga, te hapu, te ahotea ngākau nui rānei. I ēnei wā, ko te mahi tata atu ki tō rōpū hauora he mea nui ake.

He aha ngā raruraru pea o te koma mate huka?

Ka āhei te koma mate huka ki te arahi i ngā raruraru kino e pā ana ki ngā pūnaha tino maha o tō tinana. Engari, mā te whakaora tere, ka taea te aukati, te whakaiti rānei i ēnei raruraru.

Ko te roa o te noho o te tangata i roto i te koma mate huka kaore i te whakaora, ko te nui ake o te morearea o te kino pumau:

Ngā raruraru tonu:

• Te pupuhi o te roro (cerebral edema)
• Te maroke kino me te pakaru
• Ngā rereketanga o te ngakau
• Te iti rawa o te potassium
• Ngā raruraru toto
• Te kore mahi whatukuhu
• Ngā raruraru manawa

Ngā raruraru roa:

• Te kino pumau o te roro
• Ngā raruraru mahara, ngā huringa mohio rānei
• Te whakanui o te morearea o ngā āhuatanga mate huka o muri
• Te tere o ngā raruraru mate huka penei i te kino o ngā io
• Ngā pānga hinengaro tae atu ki te manukanuka mō te whakahaere huka toto

Ko te rongo pai, ko te nuinga o ngā tāngata e whiwhi ana i te whakaora tere mō te koma mate huka ka ora katoa kaore he pānga pumau. Koinei te take he mea nui te mohiotanga ki ngā tohu whakatūpato wawe, me te rapu i te awhina hauora tonu mō tō hauora roa me tō oranga pai.

Me pēhea te aukati i te koma mate huka?

Ko te aukati i te koma mate huka he mea tino taea mā te whakahaere tonu i te mate huka, me te matapaki ki ngā tohu whakatūpato o tō tinana. Ko te matua ko te pupuri i ngā taumata huka toto pumau, me te mohio ki te whakautu ina tīmata te neke atu.

Ko ēnei ngā rautaki aukati tino whai hua ka taea e koe te whakamahi i ia rā:

Ngā tikanga aukati o ia rā:

• Tirohia tō huka toto i ia wā pera i te tohutohu a tō taakuta
• Tangohia ngā rongoā me te insulin pera i te tohutohu
• Whai i tō mahere kai, me te tatau i ngā warowai
• Noho makuku mā te inu wai
• Te mahi i ia wā, engari whakaritea te kai me te rongoā
• Pupuri i te huka tere-mahi mō ngā wāhanga huka toto iti
• Kakahu i ngā whakapaipai whakamōhiotanga hauora

Te whakarite mō ngā āhuatanga motuhake:

• Hangaia he mahere whakahaere mate mō te rā kino me tō rōpū hauora
• Ako ki te whakamātautau mō ngā ketones ina nui te huka toto
• Mōhio ki te wā e waea atu ai ki tō taakuta, ki te haere rānei ki te rūma mate urupare
• Pupuri i ngā hononga urupare
• Pupuri i ngā taputapu mate huka atu
• Whakaako i ngā mema whānau mō ngā tohu mate huka urupare

Kia mahara, he ngāwari ake te aukati i te whakaora. Mā te noho pumau ki tō mahi tiaki mate huka, me te korerorero tonu ki tō rōpū hauora, ka taea e koe te whakaiti i tō morearea ki te wheako i te āhuatanga mate huka.

Me pēhea te whakatau i te koma mate huka?

Ko te whakatau i te koma mate huka e pā ana ki ngā whakamātautau toto tere, me te tirotiro tinana hei whakatau i te take o te ngaro o te mohio, me te pehea te whakaora i te tino whai hua. Ko ngā rōpū hauora āwhina kua whakangungua ki te mohio me te whakautu ki ngā āhuatanga mate huka tere.

Ko te tukanga whakatau i te nuinga o te wā ka tere rawa atu i te rūma mate urupare:

Ngā whakamātautau tonu:

• Te ine i te taumata huka toto
• Te whakamātautau ketone (toto, mimi rānei)
• Te tātaritanga hau toto hei tirotiro i ngā taumata waikawa
• Te tātaritanga matū whānui mō ngā electrolytes
• Te tirotiro i te toto toto me te tere o te ngakau

Ngā whakamātautau atu pea:

• Te tatau toto katoa hei tirotiro i te mate huaketo
• Ngā whakamātautau mahi whatukuhu
• Te tirotiro i te tere o te ngakau (EKG)
• Te X-ray uma mena he raruraru manawa
• Te aromatawai neurological ina ara

Ko tō hītori hauora, me ētahi mōhio mai i ngā mema whānau mō ngā tohu hou, ngā huringa rongoā, te mate rānei e āhei te awhina i ngā taakuta ki te mōhio ki te take o te koma. Ko ēnei mōhio e ārahi ana i ngā whakatau whakaora, ā, e āhei ana te awhina i te aukati i ngā wāhanga o muri.

He aha te maimoatanga mō te koma mate huka?

Ko te maimoatanga mō te koma mate huka e aro ana ki te whakahoki i ngā taumata huka toto ki te noa, mā te tautoko i ngā mahi nui o tō tinana. Ko te maimoatanga motuhake e hāngai ana ki te nui rawa atu rānei, te iti rawa atu rānei o tō huka toto, engari ko ngā take katoa e hiahia ana ki te whakauru hauora tonu.

Ko te maimoatanga āwhina e tīmata ana i mua atu i tō tae atu ki te hohipera, ā, ka haere tonu i te wāhanga tiaki matua:

Mō te koma huka nui (DKA/HHS):

• Ngā wai IV hei whawhai ki te maroke
• Te rongoā insulin hei whakaiti i te huka toto
• Te whakakapi i ngā electrolytes penei i te potassium me te sodium
• Te whakaora i ngā take taketake penei i te mate huaketo
• Te tirotiro tata ki te mahi ngakau me te whatukuhu

Mō te koma huka iti:

• Te otinga huka (huka) IV
• Te whakauru glucagon mena he uaua te uru atu ki te IV
• Te tirotiro tonu i te huka toto
• Te whāngai haere mai ina ara, te kaha rānei ki te horomia
• Te whakarite rongoā hei aukati i te puta mai anō

Ko te maimoatanga e toru haora ki ngā rā pea, e hāngai ana ki te kino o te koma, me te tere o te whiwhi i te tiaki hauora. I roto i tēnei tukanga, ko ngā rōpū hauora e tirotiro ana i tō ahunga whakamua, ā, e whakarite ana i te maimoatanga i te pai ake o tō āhuatanga.

Ina pumau koe, ka mahi ngā taakuta me koe ki te mōhio ki te take o te koma, me te pehea te aukati i te puta mai anō mā te whakahaere pai ake o te mate huka.

Me pēhea te whakahaere i te mate huka i te kāinga i muri i te koma mate huka?

Ko te ora mai i te koma mate huka e hiahia ana ki te aro nui ki tō whakahaere mate huka, ā, i te nuinga o te wā e pā ana ki te whakarite i tō mahi o ia rā. Ka hoatu e tō rōpū hauora ngā tohutohu motuhake e hāngai ana ki te take o tō koma, me te pehea te whakautu o tō tinana ki te maimoatanga.

I ngā wiki tuatahi i muri i te tukunga, me tirotiro koe i tō huka toto i te nuinga atu i te noa:

Te mahi tirotiro whakanuia:

• Tirohia te huka toto i te iti rawa e 4 nga wa i te ra, te tohutohu ranei
• Whakamātautau mō ngā ketones mena ka piki ake te huka toto i runga ake i te 250 mg/dL
• Pupuri i ngā rārangi taipitopito o te huka toto, te kai, me ngā tohu
• Whakapaua koe i ia rā hei tirotiro i ngā huringa wai
• Tangohia ngā rongoā pera i te tohutohu, ahakoa kei te pai koe

Ngā whakaritenga noho ora:

• Whai i te mahinga kai pumau me ngā wāhanga i inehia
• Noho makuku, engari karohia te nui o te inu wai
• Hoki ki te mahi i te iti mā te whakaae a te taakuta
• Whiwhi moe tika, me te whakahaere i ngā taumata ahotea
• Karohia te waipiro kia kī mai tō taakuta he haumaru

Pea ka hiahia koe ki te whakarite i ō rongoā mate huka, ngā rongoā insulin rānei i muri i te koma mate huka. Kaua rawa e whakarereke i ngā rongoā – mahi tonu me tō rōpū hauora hei whakarite i ngā whakaritenga ki tō mahere whakaora.

Me pēhea te whakarite mō tō hui taakuta i muri i te koma mate huka?

Ko te whakarite mō ngā hui whai muri i te koma mate huka e āhei te whakarite kia whiwhi koe i te painga nui mai i tō wā me ngā kaiwhakarato hauora. Ko ēnei haerenga he mea nui mō te aukati i ngā āhuatanga mate o muri, me te whakapai ake i tō whakahaere mate huka.

I mua i tō hui, kohikohia ngā mōhio nui e āhei te awhina i tō taakuta ki te mōhio ki tō āhuatanga o nāianei:

Ngā mōhio hei kawea mai:

• Ngā rārangi huka toto mai i te tukunga
• Rārangi o ngā rongoā katoa me ngā rongoā
• Tuhinga o ngā tohu, ngā āwangawanga rānei
• Ngā pātai mō te whakahaere mate huka
• Ngā tohutohu tukunga rūma mate urupare
• Ngā kāri inihua me te whakamōhiotanga hauora

Ngā pātai hei ui ki tō taakuta:

• He aha te take o taku koma mate huka?
• Me pēhea te aukati i tēnei?
• Me whakarite rānei ōku rongoā?
• Me pehea te maha o te tirotiro i taku huka toto inaianei?
• He aha ngā tohu whakatūpato me titiro atu ahau?
• Nōhea me waea atu ahau ki a koe, ki te haere rānei ki te rūma mate urupare?

Kaua e whakaroa ki te kawea mai tetahi mema whānau, hoa rānei ki tō hui. Ka āhei te awhina i a koe ki te mahara ki ngā mōhio nui, me te tautoko i a koe e mahi ana ki te whakapai ake i tō mahere whakahaere mate huka.

He aha te mea nui mō te koma mate huka?

Ko te koma mate huka he raruraru kino, engari ka taea te aukati i te mate huka e hiahia ana ki te awhina hauora tonu. Ahakoa te ahua wehi, ko te mōhiotanga ki ngā tohu whakatūpato, me te pupuri i te whakahaere huka toto pai ka āhei te awhina i a koe ki te karo i tēnei āhuatanga mate.

Ko te mea nui rawa atu hei mahara, ko tō tinana e tuku ana i ngā tohu whakatūpato i mua i te puta o te koma mate huka. Mā te tirotiro i tō huka toto i ia wā, te tango i ngā rongoā pera i te tohutohu, me te mohio ki te wā e rapu awhina ai, ka taea e koe te noho haumaru, te hauora.

Mena kei a koe ētahi āwangawanga mō ō taumata huka toto, te whakahaere mate huka rānei, kaua e whakaroa ki te whakapiri atu ki tō rōpū hauora. Kei reira rātou hei tautoko i a koe ki te noho pai me te mate huka, me te aukati i ngā raruraru penei i te koma mate huka.

Ngā pātai maha e ui ana mō te koma mate huka

P1: Ka taea te mate i te koma mate huka?

Ae, ko te koma mate huka ka mate pea mena kaore i te whakaora tere. Engari, mā te tiaki hauora tonu, ko te nuinga o ngā tāngata ka ora katoa. Ko te matua ko te mohiotanga ki ngā tohu whakatūpato wawe, me te rapu i te whakaora āwhina tonu. Ko te whakaora hauora hou kua pai ake te ora mō ngā āhuatanga mate huka.

P2: E hia te roa te ora mai i te koma mate huka?

Ko te wā ora e rerekē ana e hāngai ana ki te kino o te koma, me te tere o te tīmatanga o te whakaora. Ko te nuinga o ngā tāngata ka ara ake i roto i ngā haora i te tīmatanga o te whakaora, engari pea ka toru rā te ora katoa. Ko te pumau katoa o te huka toto, me te hoki ki ngā mahi noa e puta ana i roto i te wiki mā te tiaki hauora tika.

P3: Ka taea te puta te koma mate huka ahakoa te tango tonu i aku rongoā?

Ae, ka taea tonu te puta te koma mate huka ahakoa te whakamahi tonu i ngā rongoā. Ko te mate, te mate huaketo, te ahotea, ngā āhuatanga hauora atu rānei ka taea te whakakore i tō mahi whakahaere mate huka noa. Koinei te take he mea nui te whai i te mahere rā kino, me te mohio ki te wā e rapu awhina ai mō te tangata katoa e mate huka ana.

P4: He tino noa te koma mate huka ki te momo 1, ki te momo 2 rānei o te mate huka?

Ko ngā momo koma mate huka rerekē he tino noa ki ngā momo mate huka rerekē. Ko te ketoacidosis mate huka (DKA) he tino noa ki te mate huka momo 1, ko te āhuatanga hyperosmolar hyperglycemic (HHS) he tino noa ki te mate huka momo 2. Engari, ko ngā momo mate huka e rua ka taea te wheako i tetahi momo āhuatanga mate huka.

P5: Ka kino rānei te roro i muri i te koma mate huka?

Ko te nuinga o ngā tāngata e whiwhi ana i te whakaora tere mō te koma mate huka ka ora katoa kaore he kino pumau o te roro. Ko te morearea o ngā pānga pumau e whakanui ana i te roa o te noho o te tangata kaore i te whakaora. Koinei te take he mea nui te awhina hauora tonu – ko te whakaora wawe e tiaki ana i tō roro me ētahi atu okana mai i te kino.