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

Ko te ketoacidosis mate huka (DKA) tetahi raruraru nui e puta ana ina kore e ranea te insulin i roto i to tinana hei awhina i te huka ki te tomo ki o pūtau hei kaha. Engari, ka tīmata to tinana ki te wawahi i te ngako hei wahie, ā, ka hanga ai ngā mea kino e kiia nei ko ngā ketones e tino waikawa ai tō toto.

Ko te tikanga tenei āhuatanga e pā ana ki te hunga mate huka momo 1, engari ka taea hoki te puta ki te hunga mate huka momo 2 i raro i ētahi āhuatanga. Ahakoa he mate whaikāinga te DKA e hiahia ana ki te maimoatanga i te hōhipera tonu, ko te mōhiotanga ki te aha me te pēhea te kite i te āhuatanga ka taea te awhina i a koe ki te mahi tere ina hiahiatia.

He aha ngā tohu o te ketoacidosis mate huka?

Ka tere te whanake o ngā tohu DKA, i roto i te 24 haora, ka taea te whakamaarama i a koe. Ka hoatu e to tinana ngā tohu whakatūpato mārama kei te puta tētahi mea nui.

Ko ēnei ngā tohu tino noa ka pā ki a koe:

• Te matewai nui e kore e ngaro ahakoa te nui o te inu.
• Te mimi nui, ina koa i te pō.
• Te ruaki me te ruaki e ārai ana i a koe ki te pupuri i te kai, i te wai rānei.
• Te mamae o te puku ka tino kaha, ka mamae rānei.
• Te ngoikore, te ngenge rānei e tino nui ana.
• Te poto o te manawa, te manawa tere, te hohonu rānei.
• Te manawa kakara hua e rite ana ki te kai horoi toenga.
• Te pohehe, te uaua rānei ki te arotahi.

Ka kite etahi i te maroke o o ratou kiri me o ratou mangai, ahakoa kei te inu wai ratou. Ko te kakara o te manawa hua e puta ana na te mea kei te tukuna ngā ketones i roto i ō manawa, ā, ko tenei kakara reka tetahi o ngā tohu tuatahi e kitea ana e ngā whānau.

I roto i ngā take tino nui, ka pā pea ki a koe te moe, te uaua ki te noho ara, te ngaro rānei o te mohio. Ko ēnei ngā tohu kua tupu te DKA me te hiahia tonu ki te tiaki mate whaikāinga.

He aha ngā take o te ketoacidosis mate huka?

Ka puta te DKA ina kore e ranea te insulin i roto i to tinana hei neke i te huka mai i tō toto ki roto ki ō pūtau. Kaore he wahie, ka oho to tinana ka tīmata ki te tahuna ngako, ka hanga ai ngā ketones kino i kōrerotia e tātou.

He maha ngā āhuatanga ka taea te whakaoho i tenei mahi kino:

• Te ngaro o ngā rāpoi insulin, te kore rānei e tango i te rongoā insulin.
• Te mate, te mate pāwera rānei, e hiahia ana to tinana ki te nui atu o te insulin i te mea noa.
• Te ahotea nui, te pokanga, te whara rānei e pā ana ki te mana o tō huka toto.
• Te ngakau, te pēhanga rānei o te roro, ka taea te whakakore i ngā mahi noa o to tinana.
• Ētahi rongoā penei i ngā steroids ka taea te whakanui i ngā taumata huka toto.
• Te whakamahi tarukino, te waipiro rānei, ka taea te whakakore i te whakahaere mate huka.
• Te hapu, ina koa ki te kore e pai te whakahaere i te mate huka.

I etahi wa, ko te DKA te tohu tuatahi kei te mate huka tetahi, ina koa te mate huka momo 1. Ka puta tenei na te mea kua pakaru to ratou tinana i te kore o te insulin mo nga wiki, mo nga marama ranei i mua i te wa o te raruraru.

Ahakoa te mea noa te mate huka, ka taea te whakaoho i te DKA ki te kore e whakarite tika koe i to whakahaere mate huka. Ka kite to tinana i te mate hei ahotea ka tukuna ngā homoni e whawhai ana ki te insulin, ka uaua ake te mana o te huka toto.

Nōhea te haere ki te taote mō te ketoacidosis mate huka?

Me rapu tonu koe i te tiaki hauora mate whaikāinga mena ka pā ki a koe tetahi huinga o ngā tohu DKA, ina koa ki te mate huka koe. Kaore tenei hei āhuatanga ka taea te whakaora i te kāinga, te tatari rānei kia pai ake.

Waea atu ki te 111, ki te rūma mate whaikāinga rānei ina:

• Ngā taumata huka toto e mau tonu ana i runga ake i te 250 mg/dL me ngā ketones i roto i tō mimi.
• Te ruaki e ārai ana i a koe ki te pupuri i te kai, i te wai rānei mo te neke atu i te 2 haora.
• Ngā ketones mēha ki te nui i roto i tō mimi ina whakamātautau me ngā ripi ketones.
• Ngā tohu o te maroke nui penei i te wiri, te mangai maroke, te iti rānei o te mimi.
• Te uaua ki te manawa, te manawa tere rānei.
• Te pohehe, te moe, te uaua rānei ki te noho ara.
• Te mamae nui o te puku e kore e pai ake.

Ki te kore koe e mate huka engari kei te pā ngā tohu nei ki a koe, ina koa te kakara hua o te manawa me te matewai nui, me rapu tonu koe i te tiaki hauora. I etahi wa, ko te DKA te huarahi e kitea ai e te iwi kei te mate huka ratou.

Ahakoa kaore koe e tino mohio kei te tino nui ngā tohu, he pai tonu te aro ki te taha tupato me te DKA. Ka tino pai ake ngā taote o te rūma mate whaikāinga ki te kite i a koe mō te whakatūpato teka i te tatari roa rawa mō te awhina.

He aha ngā take morearea mō te ketoacidosis mate huka?

Ahakoa tetahi tangata mate huka ka taea te whanake i te DKA, he maha ngā take e kaha ake ai te ngoikore o etahi ki tenei raruraru nui. Ko te mōhiotanga ki tō morearea whaiaro ka taea te awhina i a koe ki te noho mataara ake mō te aukati.

Ko ngā take morearea tino nui ko ēnei:

• Te mate huka momo 1, ina koa ki te kua tata nei te whakatau, ki te tamariki rānei koe.
• Te ngaro pinepine o ngā rāpoi insulin, te uaua rānei ki te whiwhi rongoā mate huka.
• Te maha o ngā wāhanga DKA i mua.
• Te whakahaere i ngā take hauora hinengaro penei i te pouri, i ngā mate kai rānei.
• Te noho kotahi kaore he pūnaha tautoko hei awhina i te tirotiro i tō mate huka.
• Te whai i ētahi atu āhuatanga hauora e uaua ake ai te whakahaere i te mate huka.
• Te whakamahi i ngā pomu insulin ka taea te kino, te wehe rānei.

Ko ngā tāne taitamariki me te mate huka momo 1 te tino morearea, na te uaua o te whakahaere motuhake i te mate huka mo te wa tuatahi. Ko te ahotea o te kura, te mahi, me ngā pēhanga pāpori ka uaua ake te tiaki mate huka.

Ka taea hoki e te hunga mate huka momo 2 te whanake i te DKA, ina koa i ngā wā o te mate nui, te ahotea rānei, ki te tango rānei ratou i ētahi rongoā e kiia nei ko ngā kaihoroi SGLT2. Ahakoa kaore i te noa i te mate huka momo 2, he āhuatanga nui tonu e kore e tika te whakakahore.

He aha ngā raruraru pea o te ketoacidosis mate huka?

Ka taea e te DKA te arahi ki ētahi atu raruraru nui ki te kore e whakaora tere, tika. Ko te rongo pai ko te tiaki hauora tere, ka ora tonu te nuinga o te iwi kaore he pānga roa.

Heoi, ko ngā raruraru pea ka tino nui, ā, ko ēnei:

• Te maroke nui ka taea te arahi ki te kino o te whatukuhu, ki te kore rānei.
• Ngā taumata potahiuma iti rawa e pā ana ki te rere o te ngakau me te mahi o te uaua.
• Te pupuhi o te roro (cerebral edema), e tino noa ana i ngā tamariki.
• Ngā raruraru toto e taea te whakanui i te morearea o te pēhanga roro, o te ngakau rānei.
• Ngā raruraru o te pūkahukahu tae atu ki te kohinga wai, te hinga rānei.
• Te coma, te mate rānei i roto i ngā take tino nui, kaore i te whakaora.

Ko te raruraru tino awangawanga ko te cerebral edema, kei reira te pupuhi o te roro na te tere o ngā huringa i roto i te matū toto i te wā o te maimoatanga. Koinei te take e tirotiro ana ngā taote i ngā turoro DKA, ka whakarite i te maimoatanga kia ata, kaua e ngana ki te whakatika i nga mea katoa i te wa kotahi.

Waihoki, ina kitea wawe te DKA ka whakaorahia i roto i te hōhipera, ko te nuinga o te iwi ka ora tonu. Ko te matua ko te tiki awhina hauora tere i te ngana ki te whakahaere i ngā tohu ma to koe.

Me pēhea te aukati i te ketoacidosis mate huka?

Ko te rongo pai mō te DKA ko te nuinga ka taea te aukati ma te pai o te whakahaere mate huka me te matauranga. Ka taea te karo i te nuinga o ngā take ma te noho i runga i te mana o tō huka toto me te mohio ki te wa hei rapu awhina.

Ko ēnei ngā rautaki aukati tino whai hua:

• Tangohia tō insulin kia rite ki te whakahau, ahakoa kei te mate koe.
• Tirohia tō huka toto ake i te wa o te mate, te ahotea, te huringa rānei o te mahi.
• Whakamātautau mō ngā ketones ina neke atu i te 250 mg/dL tō huka toto, ina rānei e kore koe e pai.
• Noho makuku ma te inu wai nui, ina koa i te wā o te wera, o te mate rānei.
• Whai mahere rā mate kua mahi tahi me tō rōpū hauora i mua.
• Pupuri i ngā taputapu mate whaikāinga o te insulin me ngā rauemi whakamātautau.
• Kakahu whakaatu hauora e whakaatu ana kei te mate huka koe.

Ko te ako ki te whakamātautau mō ngā ketones he mea nui rawa. Ka taea e koe te hoko i ngā ripi whakamātautau ketones i te nuinga o ngā whare rongoā, he ngāwari te whakamahi me ngā tauira mimi, me te toto rānei. Ko te whakamātautau mō ngā ketones ina mate koe, ina nui rānei tō huka toto ka taea te hoatu i te whakatūpato wawe kei te whanake pea te DKA.

Ko te hanga i tetahi mahere whakahaere rā mate me tō taote i mua he mea mohio rawa. Me whai i roto i tenei mahere te wa hei karanga mō te awhina, te whakarite i tō insulin, ngā kai hei kai, me te wa hei whakamātautau mō ngā ketones.

Me pēhea te whakatau i te ketoacidosis mate huka?

Ka taea e ngā taote te whakatau i te DKA tere ma te whakamahi i te huinga o ngā whakamātautau toto, ngā whakamātautau mimi, me te tirotiro tinana. Ko te tikanga he ngāwari te whakatau na te mea ka hanga e te DKA tētahi tauira motuhake o ngā huringa i roto i te matū o tō tinana.

Ko ngā whakamātautau matua ka whakamahia e tō taote ko ēnei:

• Te whakamātautau huka toto hei tirotiro i te teitei o tō huka toto.
• Te whakamātautau ketone toto hei ine i te taumata o ngā ketones kino i roto i tō toto.
• Te whakamātautau hau toto arterial hei tirotiro i te waikawa o tō toto.
• Te panui matū whānui hei tirotiro i te mahi o tō whatukuhu me ngā taumata waipiro.
• Ngā whakamātautau mimi hei rapu i ngā ketones me ngā tohu o te maroke.
• Te tau o te toto katoa hei tirotiro i ngā tohu o te mate pāwera.

Ka mahi hoki tō taote i tetahi tirotiro tinana, e tirotiro ana i ngā tohu o te maroke, ngā tauira manawa, me te ara o te hinengaro. Ka ui ratou ki ō tohu, ki te mate tata nei, ki te whakaae rongoā, ki ētahi atu take pea mō te wāhanga DKA.

I etahi wā, ka hiahiatia pea ngā whakamātautau atu hei whakatau i te mea i whakaoho i te DKA, penei i ngā X-rays uma hei tirotiro i te mate pūkahukahu, ngā ahurea toto hei rapu i te mate pāwera, te EKG rānei hei tirotiro i te rere o tō ngakau.

He aha te maimoatanga mō te ketoacidosis mate huka?

Ka puta te maimoatanga DKA i te hōhipera, ka arotahi ki te whakatika i ngā raruraru i whakaoho i te raruraru. Ka mahi ngā rōpū hauora kia ata ki te whakahoki i te toenga noa o tō tinana kaore e hanga atu ngā raruraru.

Ko te tikanga ko te maimoatanga he maha ngā waahanga matua:

• Ngā wai IV hei whakakapi i te wai me te tote kua ngaro i tō tinana na te mimi nui.
• Te rongoā insulin i hoatuhia ma te IV hei awhina i te whakaheke i te huka toto me te mutu i te hanga ketone.
• Te whakakapi waipiro, ina koa te potahiuma, e heke ana te kino i te wā o te maimoatanga.
• Te tirotiro tata o te matū toto me ngā whakamātautau taiwhanga pinepine.
• Te maimoatanga o ētahi atu āhuatanga i whakaoho i te DKA.
• Te huri haere ki ō rongoā mate huka noa.

Ko te tikanga ka roa te tukanga maimoatanga i te 12 ki te 24 haora, kei reira koe e tirotirohia ana. Ka tirotirohia e tō rōpū hauora tō huka toto, ngā ketones, me ngā waipiro i ia torutoru haora kia mohio ai kei te pai haere nga mea katoa.

Ko tetahi mea nui hei mohio ko te maimoatanga ka ata. Kaore ngā taote e ngana ki te whakatika i nga mea katoa i te wa kotahi na te mea ka taea e ngā huringa tere te whakaoho i ngā raruraru, ina koa te pupuhi o te roro i ngā turoro taitamariki.

Me pēhea te tiaki i a koe i te wā o te ora mai i te ketoacidosis mate huka?

Ka haere tonu te ora mai i te DKA ahakoa kua wehe koe i te hōhipera. Me whai wā tō tinana ki te ora tonu, me tino tupato koe ki tō whakahaere mate huka mo tētahi wā.

Ko ēnei ngā mea ka tūmanakohia e koe i te wā o tō ora:

• Te ngenge, te ngoikore rānei mo etahi ra i te ora mai o tō tinana.
• Te hiahia ki te inu wai atu hei awhina i ō whatukuhu ki te ora.
• Te maha atu o ngā hui whakarite me tō rōpū hauora.
• Pea ka hiahia ki ngā whakaritenga wa poto ki tō rongoā insulin.
• Te tirotiro i tō huka toto ake i te mea noa.
• Te hoki haere ki ō kai me ō mahi noa.

He mea noa te ahua ohorere i muri i te wāhanga DKA. He maha ngā iwi e wehi ana, e riri ana, e ohorere ana rānei ki te wheako. He tika ēnei kare-a-roto, ā, ko te kōrero ki tō rōpū hauora, ki tō whānau, ki tetahi kaiwhakaako rānei ka tino awhina.

Koinei hoki te wā pai hei arotake i te mea i arahi ki te wāhanga DKA me te mahi tahi me tō rōpū hauora hei aukati i ngā take a muri ake nei. Ko te nuinga o te iwi e pā ana te DKA kotahi kaore e puta ano na te mea ka tino mataara ake ratou ki to ratou tiaki mate huka. Ma te tautoko me te mātauranga tika, ka taea e koe te whakahaere i tō mate huka me te ora i te ora roa, hauora.

Me pēhea te whakarite mō tō hui taote?

Ahakoa kei te kite koe i tō taote mō te whakarite i muri i te DKA, i te mea rānei kei te awangawanga koe mō ngā tohu, ko te whakarite ka taea te awhina i a koe ki te whiwhi i te nuinga o tō haerenga. Ko te whakarite pai ka whakarite kia kaua e wareware koe i ngā korero nui ina ahua ahotea koe, ina rānei e kore e pai.

I mua i tō hui, kohikohia ēnei korero nui:

• Ngā pānui huka toto tata nei me ētahi atu tauira kua kitea e koe.
• Rārangi katoa o ngā rongoā katoa, tae atu ki ngā rāpoi me te wā.
• Ngā kōrero mō ētahi atu mate tata nei, ahotea, te huringa rānei o tō mahi.
• Ngā tohu kua pā ki a koe me te wā i tīmata ai.
• Ngā hua whakamātautau ketone mena kua tirotiro koe i te kāinga.
• Ngā pūrongo mō te aukati i ngā wāhanga a muri ake nei.

Tuhia ō pūrongo i mua kia kaua e wareware i te wā o te hui. Ko ngā pūrongo noa ko te uiui mō te whakarite i te insulin i te wā o te mate, te wa hei whakamātautau mō ngā ketones, me ngā tohu whakatūpato hei maataki.

Ki te kua tata nei koe ki te DKA, kia pono ki tō taote mō ētahi atu wero kei te whakahaere koe i te mate huka. Ahakoa he uaua ki te whiwhi rongoā, te uaua ki te mahara ki ngā rāpoi, te uaua rānei ki te kai me te whakakori tinana, ka taea e tō rōpū hauora te awhina mena ka mohio ratou ki te mea kei te puta.

He aha te mea nui mō te ketoacidosis mate huka?

Ko te mea nui hei mahara mō te DKA ko te raruraru nui engari ka taea te aukati i te mate huka. Ma te pai o te whakahaere huka toto, te matauranga o ngā tohu whakatūpato, me te tiaki hauora tere ina hiahiatia, ko te nuinga o te iwi mate huka kaore e pā te DKA.

Ki te whanake koe i ngā tohu o te DKA, ko te rapu i te tiaki hauora tere ka taea te aukati i ngā raruraru nui ka awhina i a koe ki te ora tonu. Kaua e ngana ki te whakakaha, ki te whakahaere rānei i ngā tohu ma to koe – e hiahia ana te DKA ki te maimoatanga hauora ngaio i roto i te hōhipera.

Kia mahara ko te whai i tetahi wāhanga o te DKA kaore e tikanga kei te tūmanako koe ki te nui ake. He maha ngā iwi e whakamahi ana i te wheako hei whakaoho ki te whakapai ake i to ratou whakahaere mate huka, kaore e tūtaki ki tenei raruraru. Ma te tautoko me te mātauranga tika, ka taea e koe te whakahaere i tō mate huka me te ora i te ora roa, hauora.

Ngā pūrongo noa e pā ana ki te ketoacidosis mate huka

Ka taea te DKA me ngā taumata huka toto noa?

Ae, ko tenei āhuatanga e kiia nei ko te euglycemic DKA, ka taea te puta ina iti rawa te teitei o ngā taumata huka toto, ahakoa noa. He mea noa ake i te hunga e tango ana i ētahi rongoā mate huka e kiia nei ko ngā kaihoroi SGLT2, i te wā o te hapu, ina rānei kaore tetahi i te kai nui. Ka taea tonu te puta o ngā ketones me te kohinga waikawa ahakoa kaore he huka toto tino teitei, koinei te take he mea nui te whakamātautau mō ngā ketones ina kore koe e pai.

E hia te roa te ora mai i te ketoacidosis mate huka?

Ko te nuinga o te iwi ka tīmata te pai ake i roto i te 12 ki te 24 haora i te tīmatanga o te maimoatanga hōhipera, engari ko te ora tonu ka roa i te maha o ngā rā ki te wiki. Ko te tikanga ka hoki te matū toto ki te noa i roto i te ra, i te rua rānei, engari ka ngenge, ka ngoikore rānei koe mo etahi atu rā i te ora tonu o tō tinana. Ko te raupapa tika e whakawhirinaki ana ki te nui o te DKA me te tere o te whiwhi maimoatanga.

Ka taea te whakaoho i te ketoacidosis mate huka e te ahotea anake?

Ahakoa kaore e taea e te ahotea hinengaro, tinana rānei te whakaoho tika i te DKA, ka taea te whakaoho nui ma te whakanui i tō huka toto me te whakanui i ngā hiahia insulin o tō tinana. Ko te ahotea ka tukuna ngā homoni penei i te cortisol e kore ai e whai hua te insulin, ka arahi pea ki te DKA ki te kore e whakarite tika koe i tō whakahaere mate huka. Koinei te take he mea nui te whai i tetahi mahere mō te whakahaere i te mate huka i ngā wā ahotea.

He rite te ketoacidosis mate huka ki te ketosis mai i te kai?

Kāo, he rerekē ngā āhuatanga nei. Ko te ketosis kai mai i te kai iti-carb e whakaputa ana i ngā rahinga iti, mana o ngā ketones e kore e tino waikawa tō toto. Ko te DKA e pā ana ki te nui o te hanga ketone e hanga ana i te kohinga waikawa mate kino i roto i tō toto. Ko te hunga kaore he mate huka e whai ana i ngā kai ketogenic kaore e whanake i te DKA na te mea ka taea tonu e o ratou tinana te whakaputa i te insulin hei aukati i ngā taumata ketone kino.

Ka taea te aukati i te DKA ki te kite koe kei te tīmata?

Ki te hopu koe i ngā tohu whakatūpato wawe ka mahi tere, ka taea pea te aukati i te DKA tino nui ma te tirotiro i tō huka toto me ngā ketones, te tango atu i te insulin kia rite ki te whakahau a tō kaiwhakarato hauora, te noho makuku, me te rapu awhina hauora tere. Heoi, ina tino whakatūria ngā tohu DKA, ka hiahia koe ki te maimoatanga hōhipera. Koinei te take he mea nui te tirotiro huka toto noa me te whai i tetahi mahere whakahaere rā mate mō te whakauru wawe.