Te Whakahaere Manaaki Kaiwhakawhanau i ngā Take Mate Huka Momo 1
Pendahuluan
Ko te mate huka momo 1 (T1DM) he mate pūnaha ārai mate mau tonu e kore ai e taea e te repe taiaki te whakaputa i te nui o te insulin. He maha ngā wā ka tīmata tēnei mate i te tamarikitanga, i te taiohitanga rānei, engari he maha ngā wāhine whai T1DM ka taea te hapu me te whānau me te tiaki tika a te kaiwhakawhanau. I roto i te horopaki o te whānautanga, he mate tino mōrearea te T1DM nā te mea ka pā ki te hauora o te whaea me te tamaiti i roto i te pēpi, i te wā e hapu ana, e whānau ana, me te wā i muri i te whānautanga. Nō reira, he mahi nui tā ngā kaiwhakawhanau ki te kite wawe, ki te aroturuki, ki te ako, ki te mahi tahi me ngā tohunga ngaio, me te tautoko hinengaro-pāpori kia tutuki ai ngā whāinga whakahaere huka toto me te ārai i ngā raruraru.
Ngā Ariā Taketake o te Mate Huka Momo 1 i te Wā Hapūtanga
Ko te mate huka momo 1 e tohuhia ana e te korenga o te insulin, e hiahiatia ana te rongoā insulin mō te wā katoa. I te wā e hapu ana, ka taea e ngā huringa homoni o ngā taumata o te lactogen placental tangata (hPL), te progesterone, te cortisol, me te hormone tipu placental te whakanui ake i te ātete insulin, inā koa i ngā toru marama tuarua me tuatoru. Nō reira, ka rerekē pea ngā hiahia insulin: he maha ngā wā ka heke i te toru marama tuatahi nā te whakapairuaki me te ruaki me te pikinga o te aro ki te insulin, engari ka piki tere i ngā toru marama e whai ake nei. Ka taea e ngā taumata huka toto kore e whakahaeretia te whakanui ake i te mōrearea o ngā raruraru pēnei i te hypoglycemia kino, te ketoacidosis mate huka (DKA), te preeclampsia, te mate, te polyhydramnios, te whānautanga wawe, me ngā raruraru fetal pēnei i te macrosomia, te hypoglycemia neoplasm, me te raruraru manawa.
Ngā Whāinga o te Whakahaere Manaaki Kaiwhakawhanau
Ko te whāinga matua o te tiaki a te kaiwhakawhanau i ngā wāhine he mate huka momo 1, ko te pupuri i ngā taumata huka toto hauora, te ārai i ngā raruraru ohorere me ngā raruraru mau tonu, te whakarite i te tipu pai o te kukune, me te whakarite mō te whānautanga haumaru me te wā i muri i te whānautanga. Hei tāpiri, ko te arotahi o te tiaki ko te whakapai ake i te piripono o te whaea ki te rongoā insulin, te kai, te korikori tinana tika, me te kaha o te whaea ki te kite i ngā tohu morearea pēnei i te hypoglycemia me te ketoacidosis.
Aromatawai Whakawhanau
He mea nui te aromatawai whānui i ngā wāhine hāpu e pangia ana e te mate huka momo 1 (DM). Me kohikohi e ngā kaiwhakawhanau ngā raraunga mō ō rātou hītori hauora (te roa o te DM, te tikanga insulin, te auau o te hypoglycemia, te hītori o te DKA), ngā raruraru (nephropathy, retinopathy, neuropathy), te hītori whānau (te mate pāwera, te whānautanga wawe, te pēpi nui), me ngā tikanga noho (te kai, te mahi, te piri ki ngā tirotiro). Me uru ki te whakamātautau tinana te toto totoka, te taumaha, te āhua wai, ngā tohu o te mate, me te whakamātautau whānau e tika ana mō te tau hāpu.
Hei tāpiritanga, he mea nui te aroturuki i te huka toto (SMBG). Me aromatawai ngā kaiwhakawhanau mēnā kei te tika te whakahaere a te whaea i te whakamātautau, te auau o te whakamātautau, me te tauira o ngā hua (te huka toto nui i te nohopuku/muri i te kai, te rerekētanga, te huka toto nui i te pō rānei). Me aroturuki hoki ngā raraunga taiwhanga pēnei i te HbA1c, te mahi a te whatukuhu, me ngā whakamātautau mimi (proteinuria, ketonuria) me te mahi tahi me te tākuta. Ka mahia te aroturukitanga o te pēpi mā te ine i te teitei o te fundus uterine, te nekehanga o te pēpi, me te tuku atu ki ngā ultrasound raupapa hei aromatawai i te tipu, te nui o te wai amniotic, me te āhua o te whenua.
Te Tātaritanga/Te Tāutu i ngā Raru Whānau
Ko ngā raruraru whānau e puta pinepine ana i roto i ngā whaea he mate huka momo 1 ko: te mōrearea o te kore taurite o te huka toto, te mōrearea o te preeclampsia, te mōrearea o te mate (ina koa te ara mimi), te mōrearea o te polyhydramnios, me te mōrearea o te aukati i te tipu o te kukune (macrosomia, te aukati rānei i te tipu i roto i ngā take o ngā raruraru toto). I te taha hinengaro, ka pāngia pea ngā whaea e te manukanuka mō te haumaru o te kukune, te taumahatanga o te rongoā insulin, me te wehi o te hypoglycemia. Me tautuhi ngā kaiwhakawhanau i ngā āhuatanga whakaoho pēnei i te koretake o te kai, te horopeta insulin hē, te kore tautoko whānau rānei.
Te Whakamahere Manaaki Kaiwhakawhanau
Ko te whakamahere manaaki e arotahi ana ki te aroturukitanga kaha, te mātauranga, me te mahi tahi. Ko ētahi o ngā wāhanga matua o te whakamahere ko:
1. Te whakahaere i te huka toto kua arotahihia
Mā ngā kaiwhakawhanau ka āwhina i ngā whaea kia mārama ki ngā whāinga huka e taunakitia ana e ngā kaimahi hauora, te hiranga o ngā kai auau, me te wā e tukuna ai te insulin. He mea nui anō hoki te mātauranga mō te whakamahinga o te insulin, ngā tikanga werohanga, te rokiroki insulin, me te huri i ngā wāhi werohanga.
2. Te mātauranga kai me te oranga
Me whakanui i tētahi kai me ngā warowaihā kua whakawhāitihia, ngā rahinga kai taurite, me ngā wā kai auau. Ka taea e ngā kaiwhakawhanau te ārahi i ngā whaea ki te waihanga i ngā mahere kai māmā, pono hoki e tika ana mō te ahurea me te ōhanga. Ka taea te whakatenatena i te korikori tinana māmā ki te taurite mena kāore he ārai whānau.
3. Te ārai me te kite i ngā raruraru
Me whakamārama he mahere mō te aroturuki i te toto toto, ngā tohu o te preeclampsia (te ānini nui, te tirohanga pōuri, te pupuhi), ngā tohu o te hypoglycemia (te wiri, te werawera, te whanoke), me ngā tohu o te DKA (te whakapairuaki me te ruaki, te mamae o te puku, te manawa tere, te manawa ketone). Me whakaako hoki te whaea ki te wā e rapu awhina hauora tonu ai.
4. Te aroturuki i te tipu me te oranga o te kukune
Mā ngā kaiwhakawhanau ka tere ake te toro atu ki te whānau pēpi (ANC). Ka mahi tahi rātou mō ngā whakamātautau ultrasound raupapa, ngā aromatawai wai amniotic, me ngā whakamātautau oranga o te pēpi pērā i te whakamātautau kore-ahotea (NST) e ai ki te tohu.
5. Te whakarite mō te whānautanga
Me whakamahere te whānautanga, me te whai whakaaro ki te āhua o te whaea me te tamaiti i roto i te pēpi. Ka mahi tahi ngā kaiwhakawhanau me ngā tākuta ki te whakatau i te wā me te tikanga whānau, inā koa mēnā he macrosomia, he preeclampsia, he raruraru rānei. Kei roto i te whakamahere te whakarite mō te pēpi hou, nā te mea kei te mōrearea ngā pēpi ki te hypoglycemia i muri i te whānautanga.
Te Whakatinanatanga o te Manaaki Kaiwhakawhanau
I te wā o te mahi, ka aroturukihia e te kaiwhakawhanau ngā tohu ora, ngā hua o te SMBG, me ngā amuamu a te whaea. Ka tukuna tonutia te tohutohu kia mau tonu ai te whaea ki te rongoā insulin me te kai. Mena ka pāngia te whaea e te hypoglycemia, me whakarato e te kaiwhakawhanau te āwhina tuatahi e ai ki tana mana, pēnei i te hoatu i te puna huka tere mena kei te mōhio te whaea, me te tuku tohutohu mena he kino te mate, he ngoikore rānei te mōhio.
I te wā e whānau ana, me aro turuki pinepine ake te huka toto nā te mea ka pā te tukanga whānau ki ngā hiahia o te insulin. Ko ētahi tikanga ka whakamahi i ngā maturuturu insulin me ngā werohanga huka toto i roto i ngā hōhipera, nō reira me mārama ngā kaiwhakawhanau ki ngā mātāpono me te aro turuki mō ngā tohu o te hypoglycemia/hyperglycemia i te wā e whānau ana. Ka mahia te aro turuki tata ki te tere o te ngakau o te kukune (FHR) hei kite i te mamae o te kukune.
Aromatawai
Kei roto i te aromatawai mēnā kei te tutukihia ngā whāinga whakahaere huka toto, mēnā kei te mārama te whaea, ā, kei te kaha ki te whakahaere i a ia anō, me mēnā he tohu o ngā raruraru. Kei roto hoki i te aromatawai ngā hua aroturuki i te kukune, te pikinga o te taumaha o te whaea, te toto toto tiketike, me te piri ki ngā haerenga tiaki i mua i te whānautanga. Mēnā ka kitea he raruraru pēnei i te whakahaere huka toto ngoikore, ngā tohu rānei o te preeclampsia, me arotake te mahere tiaki, ā, me tīmata he tuku.
Te Tiaki i te Whānautanga me te Wā Whakatō Utu
Me aro nui hoki ngā whaea whai mate huka momo 1 ki te wā whānautanga. Whai muri i te whānautanga o te whenua whānau, ka heke te ātete ki te insulin, nō reira ka tino heke te hiahia mō te insulin. Me aroturuki ngā whaea i ō rātou huka toto hei ārai i te hypoglycemia, inā koa i te wā e whāngai ana i te pēpi, ka taea te whakaheke i ngā taumata huka. E taunakihia tonutia ana te whāngai ū nā te mea he pai mō te whaea me te pēpi, engari me pupuri tonu e ngā whaea te nui o ngā kaora me te whakarite i tētahi wā kai hauora.
Ko ngā pēpi i whānau mai i ngā whaea he mate huka momo 1 kei te mōrearea ki te mate huka toto i te pēpi hou, me aroturuki te tīma pēpi hou i te huka toto. He mahi tā ngā kaiwhakawhanau ki te tautoko i te tīmatanga o te whāngai ū i te wā wawe, te whakaako i ngā whaea mō ngā tohu o te huka toto i te pēpi (te ngoikore, te uaua ki te whāngai ū, ngā haurangi), me te whakarite kia whai i te tirotiro i muri i te tukunga atu ki te whare.
Te Mahi Ngātahi me ngā Tohutohu
Kāore e taea e ngā kaiwhakawhanau anake te whakahaere i te mate huka momo 1 i te wā e hapu ana. He mea nui te mahi tahi me ngā tākuta whānau me ngā tākuta wahine, ngā tākuta whare/ngā tohunga endocrine, ngā tohunga kai, me te tīma pēpi hou. Ko ngā kaiwhakawhanau te hononga, e whakarite ana i te haere tonu o te tiaki, te whakarongo a te whaea ki ngā tohutohu, me te whakarite i te tukunga wawe mēnā ka puta he raruraru.
Whakamutunga
Ko te whakahaere i te tiaki a te kaiwhakawhanau mō te mate huka momo 1 me whai huarahi whānui e uru ana ki te aromatawai hohonu, te aroturuki i te huka toto, te mātauranga tonu, te kimi raruraru, me te mahi tahi a ngā tohunga ngaio. Mā te tiaki a te kaiwhakawhanau kua whakaritea me te auau, ka nui ake te tūponotanga o ngā wāhine whai mate huka momo 1 ki te haputanga hauora, ki te whānau haumaru, me te whānautanga o te pēpi i roto i te āhua pai. He mea nui te tūranga o te kaiwhakawhanau hei hoa mō te whaea i roto i te whakahaere o ia rā, te whakarato mātauranga, me te whakarite i te haumaru o te whaea me te tamaiti i roto i te aroturukitanga me ngā tuku tika.
