Ketoacidosis diabetes

ʻO ka ketoacidosis diabetic (DKA) kahi pilikia weliweli e pili ana i ka poʻe me ka maʻi kō. Kū i ka wā e hoʻomaka ai ke kino e wāwahi i ka momona ma kahi wikiwiki i wikiwiki loa. Hoʻomaʻa ke akepaʻa i ka momona i kahi wahie i kapa ʻia ʻo ketones, ka mea e lilo ai ke koko i waikawa.

Hana ʻo DKA ke haʻahaʻa loa ka hōʻailona mai ka insulin i ke kino:

1. ʻAʻole hiki i ka Glucose (kō kō) ke hele i loko o nā hunaola e hoʻohana ʻia ma ke ʻano he wahie.
2. Hana ke akepaʻa i ka nui o ke kō kō.
3. ʻO ka momona ua wāwahi ʻia i ka wikiwiki no ka hana ʻana o ke kino.

Māhele ka momona i ke akepaʻa i wahie i kapa ʻia ketones. Hana ʻia nā ketones e ke akepaʻa ke wāwahi ke kino i ka momona ma hope o ka lōʻihi o kou ʻai ʻana hope loa. Hoʻohana maʻamau kēia mau ketona e nā mākala a me ka puʻuwai. Ke hana wikiwiki ʻia nā ketones a kūkulu i loko o ke koko, hiki ke lilo i mea ʻawahia e ka hana ʻana i ke koko acidic. ʻIke ʻia kēia ʻano ketoacidosis.

ʻO DKA kekahi manawa ka hōʻailona mua o ka maʻi maʻamau ʻo 1 i ka poʻe ʻaʻole i ʻike ʻia. Hiki iā ia ke hana i kekahi i ʻike mua ʻia me ka maʻi diabetes type 1. ʻO ka maʻi, ʻeha, kahi maʻi koʻikoʻi, nā nalo o nā kaha insulina, a i ʻole ke koʻikoʻi o ke kaha ʻana hiki ke alakaʻi iā DKA i ka poʻe me ka maʻi diabetes type 1.

Hiki i nā kānaka me ka maʻi diabetes type 2 ke hoʻomōhala i ka DKA, akā ʻoi aku ka liʻiliʻi a me ka ʻoi ʻole o ke koʻikoʻi. Hoʻokumu pinepine ʻia ia e ke kō kō kōpaʻa lōʻihi ʻole ʻia, nā nalo o nā lāʻau, a i ʻole kahi maʻi nui a maʻi paha.

Hiki i nā ʻōuli maʻamau o DKA ke hoʻopili:

• Hoemi i ka makaʻala
• Hanu hohonu, hanu wikiwiki
• Make wai
• ʻO ka ʻili maloʻo a me ka waha
• Maka helehelena
• ʻO ka urination pinepine a i ʻole ka make wai e mau no hoʻokahi lā a ʻoi
• Hanu ʻaʻala ʻaʻala
• ʻEha poʻo
• ʻOʻoleʻa ka ʻili a ʻeha paha
• ʻO Nusea a me ka luaʻi
• ʻEha ʻeha

Hiki ke hoʻohana ʻia ka hoʻāʻo Ketone i ka ʻano diabetes 1 e pale ai no ka ketoacidosis mua. Hana pinepine ʻia ka hōʻike ketone e hoʻohana ana i kahi mimi a i ʻole kahi laʻana koko.

Hana pinepine ʻia ka hoʻāʻo Ketone ke manaʻo ʻia ʻo DKA:

• ʻO ka hapanui pinepine, hana mua ʻia ka hoʻāʻo mimi.
• Inā maikaʻi ka mimi no nā ketones, ana pinepine ʻia kahi ketone i kapa ʻia ʻo beta-hydroxybutyrate i ke koko. ʻO kēia ka ketone maʻamau maʻamau i ana ʻia. ʻO ka ketone nui ʻē aʻe ʻo acetoacetate.

ʻO nā hōʻike ʻē aʻe no ketoacidosis:

• Ke kinoea koko arterial
• Pākuʻi metabolic maʻamau, (kahi hui o nā hoʻokolohua koko e ana i kāu pae sodium a me potassium, hana a me nā hana ʻē aʻe, a me nā āpau anion)
• Hōʻoia glucose toto
• Ana ana i ke koko
• Hōʻike koko Osmolality

ʻO ka pahuhopu o ka mālama ʻana e hoʻoponopono i ka pae kō kō kiʻekiʻe me ka insulin. ʻO kahi pahuhopu ke hoʻololi i nā wai i nalowale ma o ka urination, ka nele o ka makemake, a me ka luaʻi inā loaʻa kēia mau ʻōuli iā ʻoe.

Inā loaʻa ʻoe i ka maʻi diabetes, malia paha ua haʻi aku kāu mea mālama ola iā ʻoe pehea e ʻike ai i nā hōʻailona hōʻailona o DKA. Inā manaʻo ʻoe he DKA kāu, e hoʻāʻo no nā ketones e hoʻohana ana i nā kaha mimi. Hiki i kekahi mau mika glucose ke ana i ke koko ketones. Inā aia nā ketones, kāhea koke aku i kāu mea hāʻawi. MAI hoʻolohi. E hāhai i nā ʻōkuhi āu i hāʻawi ʻia.

Pono paha ʻoe e hele i ka haukapila. Ma laila, e loaʻa iā ʻoe ka insulin, nā wai, a me nā lāʻau ʻē aʻe no DKA. A laila e ʻimi a mālama nā mea hoʻolako i ke kumu o DKA, e like me ka maʻi.

Pane ka hapa nui o ka poʻe i ka mālama ʻana i loko o 24 mau hola. I kekahi manawa, ʻoi aku ka lōʻihi o ke ola.

Inā mālama ʻole ʻia ʻo DKA, hiki i ka maʻi ke make a make paha.

ʻO nā pilikia olakino i loaʻa mai DKA pū kekahi o kēia mau mea:

• Kūkulu ka wai i ka lolo (edema cerebral)
• Kū ka naʻau i ka hana (hopu ka naʻau)
• Hewa ʻole nā ​​hakuʻala

He pilikia olakino pinepine ʻo DKA. Kāhea i kāu mea hāʻawi inā ʻike ʻoe i nā ʻōuli o DKA.

E hele i ka lumi pilikia a kāhea paha i ka helu pilikia kūloko (e like me 911) inā ʻo ʻoe a i ʻole ʻohana o ka ʻohana me ka maʻi diabetes kekahi o kēia mau mea:

• Hoemi i ka ʻike
• Hanu hua
• ʻO Nusea a me ka luaʻi
• Hī pilikia

Inā he maʻi diabetes ʻoe, e aʻo e ʻike i nā hōʻailona a me nā hōʻailona o DKA. ʻIke i ka manawa e hoʻāʻo ai no nā ketones, e like me ka wā e maʻi ana ʻoe.

Inā ʻoe e hoʻohana i ka pauma insulin, e nānā pinepine e ʻike i ke kahe ʻana o ka insulin i loko o ka paipu. E nānā pono ʻaʻole i ālai ʻia ka paipu, kinked a i hoʻokaʻawale ʻia paha mai ka pauma.

DKA; Ketoacidosis; Diabetes - ketoacidosis

• Hoʻokuʻu ka meaʻai a me ka insulin
• Hōʻike hoʻomanawanui glucose
• Pahu Insulina

ʻAhahui Diabetes ʻAmelika. 2. Hoʻokaʻawale a me ka hōʻailona o ka maʻi kō: nā kūlana o ka mālama olakino i ka maʻi kō - 2020. Mālama Diabetes. 2020; 43 (Hōʻawi 1): S14-S31. PMID: 31862745 pubmed.ncbi.nlm.nih.gov/31862745/.

Atkinson MA, Mcgill DE, Dassau E, Laffel L. ʻAno 1 diabetes. I: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. ʻO Williams Textbook of Endocrinology. 14th ed. Piladelapia, PA: Elsevier; 2020: chap 36.

Maloney GE, Glauser JM. ʻO ka maʻi diabetes a me nā maʻi o ka homeostasis glucose. I: Nā paia RM, Hockberger RS, Gausche-Hill M, nā ʻaoʻao. ʻO Rosen's Emergency Medicine: Nā Manaʻo Manaʻo a me ka hana lapaʻau. 9th ed. Piladelapia, PA: Elsevier; 2018: chap 118.