Me pēhea te tātaritanga i te mate huka mellitus
Ko te mate huka he mate pūmua e tohuhia ana e te nui o te huka toto (glucose) nā te ngoikore o te hanga insulin, te mahi insulin, ngā mea e rua rānei. Nā te mea ka taea e te mate huka te whanake āta me te kore e kitea ngā tohu, he maha ngā tāngata ka kitea tō rātou āhua i muri i te whanaketanga o ngā raruraru. Nō reira, he mea nui te mārama ki te tautuhi i te mate huka hei kimi wawe, hei rongoā tika, hei ārai hoki i ngā pānga roa. Ka matapakihia e tēnei tuhinga ngā tohu hei tirotiro, ngā whakamātautau e whakamahia ana, me ngā paearu tautuhi hauora e whakamahia whānuitia ana.
1. Kia Mōhio ki ngā Tohu me ngā Take Tūpono
Ko te tautuhi i te mate huka ka tīmata i te whakapae haumanu. Ka aromatawai te tākuta mēnā he tohu noa, he āhuatanga mōrearea nui rānei kei te tangata.
Ngā tohu tawhito o te mate huka
Ko ngā tohu matarohia e puta pinepine ana ko ngā "3P":
1. Polyuria: te mimi pinepine, inā koa i te pō.
2. Polydipsia: te nui o te matewai.
3. Te maha o ngā whakahāwea: te hiakai tonu ahakoa kua kai.
Ētahi atu tohu ka puta pea:
- Te ngaronga o te taumaha mō te kore take mārama
– Ngāwari te ngenge
– Te tirohanga pōuri
- He uaua te whakaora i ngā patunga
– Ngā mate urutā auau (hei tauira, te kiri, te ara mimi, te mate harore rānei)
– Te wiri, te māuiui rānei o ngā ringa me ngā waewae (neuropathy)
Mō ētahi tāngata—ina koa ko te hunga he mate huka momo 2—he tino ngawari, he ngaro rānei ngā tohu, nō reira he mea nui te whakamātautau taiwhanga.
Ngā āhuatanga mōrearea mō te mate huka momo 2
Ko te hunga whai mate e whai ake nei ka tūtohu kia tirotirohia:
– Te taumaha rawa, te momona rānei (ina koa te ngako o te puku)
– He hītori whānau mō te mate huka
– Te kore o te korikori tinana
– Neke atu i te 45 tau te pakeke (ahakoa kei te piki haere te pānga ki ngā taiohi)
– Te toto toto tiketike, te cholesterol tiketike rānei
– He hītori o te mate huka hāputanga (te mate huka i te wā e hapu ana) te whānautanga rānei o te pēpi neke atu i te 4 kg
– Te mate ovary polycystic (PCOS)
– He hītori o te mate ngakau, te whiu rānei
2. Whakamātautau Taiwhanga mō te Tātaritanga
Ehara i te mea ko ngā tohu anake te take o te mate huka, engari ko ngā hua o te whakamātautau huka toto te take matua. He maha ngā whakamātautau tuatahi e whakamahia ana.
A. Whakamātautau Huka Plasma Nohopuku (FG)
Ka ine tēnei whakamātautau i ngā taumata huka toto i muri i te nohopuku mō te iti rawa i te 8 hāora (ko te tikanga ka mahia i te ata).
Te whakamārama whānui o ngā hua:
– Noa: <100 mgdL - Te mate huka (te huka nohopuku ngoikore): 100–125 Te mate huka: ≥126 (ka whakaūtia mā te whakamātautau anō i tētahi atu rā mēnā kāore he tohu) He whānuitia te whakamahinga o tēnei whakamātautau nā te mea he ngāwari, he iti ake hoki te utu. Heoi, ka pāngia pea ngā hua e ngā āhuatanga ohorere pēnei i te mate pāwera, te ahotea nui, te whakamahinga rānei o ētahi rongoā. B. Whakamātautau HbA1c (Hemoglobin A1c) E whakaahua ana te HbA1c i te taumata huka toto toharite i roto i ngā marama 2–3 kua hipa. kāore e hiahiatia te nohopuku hei tētahi o ngā tikanga tino whai hua mō te aroturuki me te tautuhi i te mate huka. Te whakamaoritanga o ngā hua whānui: Noa: <5,7% Te mate huka: 5,7–6,4% ≥6,5% (me whakaū i ngā tohu i te nuinga o te wā) He tino whai hua te HbA1c hei whakaata i te mana whakahaere mō te wā roa. Ka taea te whakararu i tōna tika e ētahi mate toto toto, ngā mate hemoglobinopathies, ngā mate tākihi C. Whakamātautau Manawanui Huka Waha (OGTT) I roto i tēnei, kei te nohopuku te tūroro, kātahi ka whakamātautauhia kia nohopuku, kātahi ka inu i tētahi otinga 75 karamu). Ka inehia anō te huka i muri i ngā hāora e 2. huka: <140 (manawanui ngoikore): 140–199 ≥200 he maha ngā wā kāore i te tino mārama, ka kitea he manawanui huka ngoikore. Ko te ngoikoretanga he roa te wā e hiahiatia ana hei whakarite tika. D. Plasma Matapōkere (Huka Matapōkere) Ka mahia te whakamātautau i ngā wā katoa o te nohopuku. Ka whakaūtia te tātaritanga mate huka mēnā:
- Ko te huka toto matapōkere ≥200 mg/dL, ā, e haere tahi ana me ngā tohu matarohia o te mate huka (3Ps) me te mate huka nui rawa atu rānei. He pai tēnei whakamātautau i roto i ngā āhuatanga ohorere, i te wā rānei e puta mai ana he tohu tino mārama ki te tūroro. Mena kāore he tohu noa, he mea tonu te taunaki i tētahi whakamātautau whakaū me te GDP, te HbA1c rānei. 3. Ngā Mātāpono mō te Whakaū i tētahi Tātaritanga I roto i te maha o ngā aratohu hauora, ko te tātaritanga o te mate huka i roto i te hunga kāore he tohu e hiahiatia ana te whakaū. Ko te tikanga tēnei, ki te whakaatu tētahi whakamātautau i te uara mate huka, ka: - Whakahokia te whakamātautau kotahi i tētahi atu rā, ka - Mahi rānei i tētahi atu whakamātautau (hei tauira, GDP, kātahi ko te HbA1c). He mea nui te whakaū nā te mea ka piki ake ngā taumata huka toto mō te wā poto nā te ahotea, te mate pāwera, te kore moe, te whakamahinga rānei o ētahi rongoā (pēnei i ngā corticosteroids). 4. Te Tātaritanga o te Mate Huka: He Wāhanga Kaua e Whakahāweatia Ko te Mate Huka he āhuatanga e teitei ake ana te huka toto i te mea noa engari kāore anō kia tutuki i ngā paearu mō te mate huka. Ehara tēnei i te wāhanga "haumaru"—inaa, he whai wāhitanga koura tēnei wāhanga ki te ārai i te mate huka mā te whakarerekē i te āhua noho. Ka taea te kite i te mate huka i mua i te mate huka mā roto i: - GDP 100–125 mg/dL - HbA1c 5,7–6,4% - OGTT 2-hāora 140–199 mg/dL I tēnei wā, ka tūtohu ngā tākuta kia whakaitihia te taumaha, kia taurite te kai, kia nui ake te korikori tinana, me ngā aromatawai auau. 5. Ngā Whakamātautau Tāpiri i Muri i te Tātaritanga I muri i te tātaritanga o te mate huka, ka whakahaerehia e ngā tākuta ētahi atu whakamātautau hei aromatawai i te āhua whānui o te tinana me te rapu wawe i ngā raruraru, tae atu ki: - Te kōtaha lipid (kolesterol katoa, LDL, HDL, triglycerides) - Te mahi whatukuhu (urea-creatinine, eGFR) - Te whakamātautau mimi mō te albuminuria/microalbumin - Te whakamātautau kanohi (fundoscopy) mō te retinopathy mate huka - Te whakamātautau io me te waewae (te rongo, ngā patunga, te rere o te toto) - Te ine i te toto toto me te taupū taumaha tinana Ko te whāinga he waihanga i tētahi mahere rongoā tika me te ārai i ngā raruraru pēnei i te mate manawa, te whiu, te ngoikore o te whatukuhu, te matapo, tae atu ki te tapahi.
6. Momo 1, Momo 2, me te Mate Huka Hapūtanga: He Rerekē te Tātaritanga? I te nuinga o te wā, he rite tonu ngā paearu huka toto mō te mate huka, engari ka rerekē pea te huarahi haumanu. - He tere ake te puta o te mate huka momo 1, i ētahi wā i roto i ngā tamariki, i ngā taiohi rānei, me ngā tohu kino me te tere o te hekenga taumaha. Ka aromatawai pea ngā tākuta mō te ketoacidosis, ā, i ētahi wā, ka tirohia ngā taumata paturopi, ngā taumata C-peptide rānei hei āwhina i te whakarōpūtanga. - Ka puhoi te whanaketanga o te mate huka momo 2, he maha ngā wā e pā ana ki te momona me te ātete insulin. He maha ngā wā ka kitea mā te tirotiro auau. - Ka tātaritatia te mate huka hapūtanga i te wā hapūtanga mā te whakamātautau motuhake (he OGTT paerewa te tikanga). He mea nui te maimoatanga hei tiaki i te whaea me te pēpi. 7. Āhea Me Mahi te Tirotiro? E taunakihia ana te tirotiro mate huka mō: - Te hunga 45 tau te pakeke, neke atu rānei, inā koa mēnā kei reira ngā āhuatanga mōrearea - Te hunga rangatahi he taumaha rawa/momona, ā, he āhuatanga mōrearea (te toto toto tiketike, te hītori whānau, te PCOS, me ētahi atu) - Ngā wāhine hapū kua whakaritea mō ngā tirotiro hapūtanga (hei kite i te mate huka hapūtanga) Ka taea te auau o te tirotiro i ia 1–3 tau i runga i ngā hua o mua me ngā āhuatanga mōrearea. Whakatau: Ko te tātaritanga o te mate huka he whakakotahitanga o te aromatawai i ngā tohu, ngā āhuatanga mōrearea, me ngā whakamātautau taiwhanga pēnei i te huka nohopuku, te HbA1c, te whakamātautau manawanui huka, me te huka matapōkere. Hei whakarite i te tika, me whakaū pinepine ngā hua rerekē, inā koa mō te hunga kāore he tohu. He mea nui te kitenga wawe, nā te mea ka taea e te mate huka kāore i tautuhia te arahi ki ngā raruraru nui. Mena he tohu, he āhuatanga mōrearea rānei āu, me tirotiro tō huka toto, ka kōrero ki tō tohunga hauora mō te maimoatanga wawe, tika. Mena e hiahia ana koe, ka taea e au te whakarerekē i tēnei tuhinga ki tētahi putanga pūtaiao ake (me ngā tohutoro ki ngā aratohu ADA/WHO) ki tētahi putanga rongonui ake rānei mō ngā blog hauora.
