ʻO ka maʻi diabetes a me nā nerve

ʻO ka hōʻino ʻia o ke aʻa i kū i ka poʻe me ka maʻi kō, ua kapa ʻia he neuropathy diabetic. ʻO kēia ʻano he pilikia i ka maʻi kō.

I ka poʻe me ka maʻi diabetes, hiki ke hōʻino ʻia nā aʻalolo o ke kino e ka hōʻemi ʻana o ke kahe o ke koko a me ke kiʻekiʻe o ke kō. ʻOi aku paha kēia ʻano ke mālama ʻole ʻia ke kiʻekiʻe o ke kō i ka manawa.

Ma kahi o ka hapalua o ka poʻe me ka maʻi kō e hoʻomāhuahua i nā aʻa nerve. ʻAʻole hoʻomaka nā ʻōuli a hiki i nā makahiki he nui ma hope o ka loaʻa ʻana o ka maʻi kō. ʻO kekahi poʻe i loaʻa i ka maʻi diabetes e ulu lohi ana ua ʻino nā nerve i ka wā e ʻike mua ʻia ai.

ʻO ka poʻe me ka maʻi diabetes ka mea ʻoi aku ka makaʻu no nā pilikia nerve ʻē aʻe ʻaʻole i hoʻokumu ʻia e kā lākou diabetes. ʻAʻole e loaʻa kēia mau pilikia ʻokoʻa i nā ʻōuli like a e holomua i kahi ʻano ʻokoʻa ma mua o ka hōʻino ʻia o nā aʻalolo i hoʻokumu ʻia e ka maʻi kō.

Hoʻonui mālie nā ʻōuli i nā makahiki he nui. Pili nā ʻano o nā ʻōuli iā ʻoe i nā aʻalolo i hoʻopili ʻia.

Hoʻopilikia pinepine ʻia nā ʻūlū i nā wāwae a me nā wāwae. Hoʻomaka pinepine nā ʻōuli ma nā manamana wāwae a me nā wāwae, a hoʻopili ʻia me ke kani ʻana a i ʻole ke puhi ʻana, a i ʻole ka ʻehaʻeha loa. I ka hala ʻana o ka manawa, hiki ke hōʻino ʻia nā aʻa i nā manamana lima a me nā lima. Ke hele a māhuahua ka pohō, e lilo paha kou manaʻo i kou manamana wāwae, mau wāwae, a me nā wāwae. E hele a numb kou ʻili. Ma muli o kēia, hiki iā ʻoe ke:

• ʻAʻole e ʻike ke hehi ʻoe i kahi mea ʻoi
• ʻAʻole maopopo iā ʻoe he ʻūlū a ʻoki liʻiliʻi paha kāu
• Hoʻomaopopo ʻole ke pili kou mau wāwae a lima paha i kahi mea wela a anuanu hoʻi
• Loaʻa nā wāwae e hoʻomoʻo a haki loa

Ke hoʻopili ʻia nā aʻalolo e kāohi i ka digestion, pilikia paha ʻoe i ka ʻai ʻana i ka meaʻai (gastroparesis). Hiki i kēia ke hoʻoikaika i kou diabetes. ʻO ka hōʻino i nā aʻalolo e kāohi ana i ka digestion kokoke pinepine i nā poʻe me ka ʻeha o ke aʻalolo koʻikoʻi i ko lākou wāwae a me nā wāwae. Nā ʻōuli o nā pilikia digestion me:

• Manaʻo piha ma hope o ka ʻai ʻana i kahi meaʻai liʻiliʻi wale nō
• Puʻuwai puʻuwai a me ka momona
• ʻO Nusea, kōpipipiki, a i ʻole diarrhea
• Pilikia i nā pilikia
• Ke hoʻolei nei i ka meaʻai i hoʻoulu ʻole ʻia i kekahi mau hola ma hope o ka pāʻina ʻana

Ke hōʻino nā aʻalolo i kou puʻuwai a me nā kīʻaha koko, hiki iā ʻoe:

• Manaʻo ʻoe i ke kukui ke kū ʻoe i luna (orthostatic hypotension)
• Loaʻa ka wikiwiki o ka puʻuwai
• ʻAʻole ʻike i ka angina, ka ʻeha o ka umauma e whakatupala nei i ka maʻi puʻuwai a me ka puʻuwai puʻuwai

ʻO nā ʻōuli ʻē aʻe o ka hōʻino nerve ke:

• ʻO nā pilikia moekolohe, ka mea e hoʻopilikia ai i ke kūkulu ʻana i nā kāne a me ka maloʻo a me nā pilikia pilikino i nā wahine.
• ʻAʻole hiki iā ʻoe ke haʻi ke haʻahaʻa loa kāu kō kō.
• Nā pilikia o ka puhā, kahi e hoʻoheheʻe ai i ka mimi a i ʻole hiki ʻole ke hoʻonele i ka ʻōpū.
• ʻO ka hou nui, ʻoiai ke anuanu ka mahana, ke hoʻomaha ʻoe, a i ʻole nā ​​manawa ʻē aʻe.
• Pā nui ka wāwae (sweaty nerve mua).

E hana ka mea mālama ola i kahi hoʻokolohua kino. E ʻike paha ka hōʻike e loaʻa ana iā ʻoe i kēia mau mea:

• ʻAʻohe reflexes a me nā reflexes nāwaliwali i ka kuʻekuʻe wāwae
• Loaʻa ka manaʻo i nā wāwae (nānā ʻia kēia me kahi mea like like me ka palaki i kapa ʻia he monofilament)
• ʻO nā loli i ka ʻili, e like me ka ʻili maloʻo, ka nalo ʻana o ka lauoho, a me nā kui mānoanoa a i ʻole discolored
• Ka nalowale o ka hiki ke ʻike i ka neʻe ʻana o kāu hono (proprioception)
• Ka nalowale o ka hiki ke ʻike i ka haʻalulu i loko o kahi ohe
• Lilo o ka hiki ke ʻike i ka wela a i ʻole ke anuanu
  
• E hoʻokuʻu i ke kahe o ke koko ke kū ʻoe ma hope o ka noho ʻana a i ʻole ke moe ʻana i lalo

ʻO nā hoʻokolohua i kauoha ʻia e komo pū:

• Electromyogram (EMG), kahi hoʻopaʻa leo o ka hana uila i nā mākala
• Nā hoʻokolohua holo māmā nerve (NCV), kahi hoʻopaʻa o ka wikiwiki e hele ai nā hōʻailona ma nā aʻa
• Ke waiho nei i kahi ʻōnaehana Gastric e nānā i ka wikiwiki o ka ʻai i ka ʻōpū a komo i loko o ka ʻōpū liʻiliʻi
• ʻImi i ka papa ʻaina kuli e nānā inā ke kaohi pono ʻana o ka ʻōnaehana i ke kahe o ke koko

E hāhai i ka ʻōlelo aʻoaʻo a kāu mea hāʻawi e pili ana i ka lohi o ka hōʻino ʻana o ke aʻa diabetic.

Kaohi i kou kō kō (glucose) pae e:

• ʻAi i nā meaʻai olakino
• Ke kiʻi i ka hoʻoikaika kino maʻamau
• Ke nānā nei i kāu kō kō i ka manawa pinepine e like me ke kuhikuhi a me ka mālama ʻana i kahi moʻohelu o kāu helu i ʻike ʻoe i nā ʻano o nā meaʻai a me nā hana e hoʻopili i kou kiʻekiʻe kō kō
• Lawe i nā lāʻau a waha ʻia e like me ke kauoha a kāu mea hāʻawi

E mālama i nā ʻōuli o ka hōʻino o ke aʻalolo, hiki i kāu mea hāʻawi ke kuhikuhi i nā lāʻau e mālama ai:

• E hōʻeha i kou mau wāwae, wāwae, a i ʻole nā ​​lima
• ʻO Nusea, ka luaʻi, a i ʻole nā ​​pilikia digestion
• Nā pilikia ʻōpū
• Nā pilikia kūkulu a i ʻole ka maloʻo liʻiliʻi

Inā kuhikuhi ʻoe i nā lāʻau no nā ʻōuli o ka hōʻino o ke aʻalolo, e makaʻala i kēia mau mea:

• ʻOi aku ka liʻiliʻi o ka maikaʻi o nā lāʻau inā kiʻekiʻe ke kō kō.
• Ma hope o kou hoʻomaka ʻana i ka lāʻau, e haʻi i kāu mea hāʻawi inā ʻaʻole hoʻomaikaʻi ke kuʻikuʻi nerve.

Ke loaʻa ʻoe i ka hōʻino nerve i kou mau wāwae, hiki ke hoʻemi i ka manaʻo i kou mau wāwae. ʻAʻole hiki iā ʻoe ke noʻonoʻo iki. A ʻo kahi hopena, ʻaʻole hiki ke hoʻōla maikaʻi kou mau wāwae inā ʻeha lākou. 'O ka mālamaʻana i kou mau wāwae hiki ke pale i nā pilikia liʻiliʻi mai ka liloʻana i mea koʻikoʻi a laila pauʻoe i ka haukapila.

ʻO ka mālama ʻana i kou mau wāwae he:

• Ke nānā nei i kou mau wāwae i kēlā me kēia lā
• Ke kiʻi nei i kahi hoʻokolohua wāwae i kēlā me kēia manawa ke ʻike ʻoe i kāu mea hāʻawi
• Ke komo pono nei i nā kākini a me nā kāmaʻa (e nīnau i kāu mea hāʻawi e pili ana i kēia)

Hiki i nā kumuwaiwai he nui ke kōkua iā ʻoe e ʻike hou e pili ana i ka maʻi kō. Hiki iā ʻoe ke aʻo i nā ala e mālama ai i kāu maʻi diabetic nerve nerve

Hoʻomaha ka mālama ʻana i ka ʻeha a mālama i kekahi mau ʻōuli.

ʻO nā pilikia ʻē aʻe e hoʻomohala pū me:

• ʻO ka maʻi ʻaʻai a ʻōpala paha
• Ulcer wawae diabetes
• Hoʻopilikia ke aʻalolo e hūnā i nā ʻōuli o ka ʻeha o ka umauma (angina) e kūkala nei no ka maʻi puʻuwai a me ka puʻuwai puʻuwai
• Ka nalowale ʻana o kahi manamana wāwae, ka wāwae a i ʻole ka wāwae ma o ka ʻokiʻoki ʻana, pinepine no ka maʻi o ka iwi e ola ʻole ai

Kāhea i kāu mea hāʻawi inā hoʻomohala ʻoe i nā hōʻailona o ka maʻi diabetic neuropathy.

ʻO ka neuropathy diabetic; Diabetes - neuropathy; Diabetes - neuropathy ākea

• Diabetes - ulcer wawae
• ʻAno 2 diabetes - he aha e nīnau aku ai i kāu kauka

• ʻO ka maʻi diabetes a me nā nerve
• ʻŌnaehana ʻōnaehana waena a me ka ʻōnaehana ʻōnaehana peripheral

ʻAhahui Diabetes ʻAmelika. 11. Nā pilikia Microvascular a me ka mālama wāwae: nā kūlana o ka mālama olakino i ka maʻi kō - 2020. Mālama Diabetes. 2020; 43 (Hōʻawi 1): S135-S151. PMID: 31862754 pubmed.ncbi.nlm.nih.gov/31862754/.

Brownlee M, Aiello LP, Sun JK, et al. Nā pilikia o ka maʻi 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 37.