ʻO mestitus diabetes mellitus i ka wā hāpai: nā hōʻailona, nā meaʻai

Hoʻoulu ke ʻano maʻi maʻi gestational i ka wā hāpai (gestation) a nalowale hoʻi i ka wā ma ka hānau ʻana. E like me nā maʻi maʻi ʻē aʻe, pili ka maʻi maʻi gestational i kāu hana e hoʻohana ai i ke kō (glucose). ʻO ka mellitus diabetes mellitus e alakaʻi i ke kō koko kiʻekiʻe, hiki ke hoʻopilikia i kou wā hāpai a me ke olakino o kāu pēpē. Ma lalo e noʻonoʻo mākou i nā mea e pili ana i ka manawa o ka mellitus maʻi gestational i ka wā o ka hapai, nā hōʻailona gula, nā hōʻailona, mālama, nā kumu a me nā mea pili i ka pilikia, a noʻonoʻo pū hoʻi i ka pono e pono ai.

Hiki i ka maʻi diabetes ke ulu i kēlā me kēia manawa o ka hapai, akā he mea maʻamau loa i ka hapalua o ka hapai. Hana kēia inā ʻaʻole hiki i kou kino ke hana i ka nui o ka insulin (he hormone e kōkua i ka mālama ʻana i ke kōʻai koko) e hoʻokō i nā pono hou i ka wā hāpai.

Hiki i ke maʻi maʻi Gestational ke pilikia i kāu mau pēpē a i ka wā o ka hānau ʻana. Akā hiki ke hoʻemi ʻia ka pilikia o kēia mau pilikia inā ʻike ʻia ka maʻi a mālama pono ʻia. Hiki i ka wahine hāpai ke mālama i ka maʻi gestational ma o ka ʻai ʻana i nā meaʻai olakino, ka hoʻoikaika kino, a, inā pono, nā lāʻau lapaʻau. Mālama ka nānā ʻana i ke kō koko koko i ke pale ʻana i nā hānau hānau paʻakikī a mālama i ka olakino a me kāu pēpē i ke kiʻekiʻe kiʻekiʻe.

ʻO wai ka mea weliweli no ka maʻi maʻi gestational

Hiki i kekahi wahine ke hoʻomohala i ka maʻi gestational i ka wā hāpai, akā hiki ke hoʻonui ʻia ke kīnā o ka ulu ʻana inā:

ʻO ka pāpū nūhou o kou kino (BMI) ma luna o 30
ʻO kou pēpē ma mua ua kaupaona ʻia ʻo 4,5 kg a ʻoi aku paha i ka wā hānau
Ua loaʻa iā ʻoe ka maʻi gestational ma kahi hapai ma mua
ʻO kekahi o kou mau mākua a mau hoahānau paha he maʻi maʻi a maʻi
ʻO kou moʻomeheu ʻohana he Hema Hema, Kina, ʻAmelika Karepika, a i ʻole Middle East

Inā pili ʻoe i kekahi o kēia mau mea iā ʻoe, pono ʻoe e hāʻawi i ka nānā no ka maʻi maʻi gestational.

Nā hōʻailona o ka maʻi gestational

ʻAʻole maʻa kahi maʻi maʻi Gestational i kahi mau hōʻailona i ʻole. I ka nui o nā hihia, ʻike wale ʻia ka nui o ke koko koko i ka wā e nānā ai i ka glucose. Loaʻa paha kekahi mau wahine i nā hōʻailona inā he kiʻekiʻe loa ke kiʻekiʻe o ke kō koko koko (hyperglycemia). Aia i kēia mau ʻōuli:

ua nui ka makewai
ʻoi aku ka pinepine o ka urination
ka malo maloʻo
mea momona

Akā ua ʻike pinepine ʻia kekahi o kēia mau maʻi i ka wā hāpai, a ʻaʻole pono kahi hōʻailona o ka maʻi maʻi. E kamaʻilio me kāu palakino a ʻole kauka inā āu e hopohopo nei i kekahi mau hōʻailona āu e ʻike nei.

Pehea e hiki ai i ka maʻi gestational ke hoʻopilikia i ka wahine hāpai

ʻO ka hapa nui o nā wahine me ka maʻi maʻi maʻi e hāpai ana i ka wā maʻamau a ʻo nā pēpē hānau. Eia nō naʻe, hiki i kēia ʻano ke kumu i nā pilikia e like me:

Ke nui nui nei kāu keiki ma mua o ka maʻamau - hiki kēia i nā pilikia i ka wā kamaliʻi a me ka hoʻonui i ka hiki ʻana o kahi pauku caesarean.
Polyhydramnios - Laumaha nui nā wai amniotic (ke kahe e hoʻopuni ai i ke keiki) i loko o ka ʻōpū, kahi mea e hiki ai i nā pilikia ma mua o ka hānau ʻana a hānau ʻana paha.
Puka hanau - ka hānau ʻana ma mua o ka 37 wiki o ka hāpai ʻana.
Preeclampsia - He kūlana e hoʻoiho ai i ke koko kiʻekiʻe i ka wā hāpai a hiki ke alakaʻi i nā hoʻopiʻi inā ke waiho ʻia ʻole ʻia.
Hoʻokumu kāu pēpē i ke kō koko haʻahaʻa haʻahaʻa aʻeleʻele paha i ka ʻili a me nā maka (jaundice) ma hope o ka hānau ʻanapono ia e pono ai ka mālama ʻana i ka haukapila.
ʻO ka hala ʻana o kahi pēpē - ʻoiai ʻaʻole ʻehā kēia.

ʻO ka loaʻa ʻana o nā maʻi diabetes gestational i ka wā o ka hapai ka manawa e hoʻonui ʻia ai ʻoe i ka nui o ka hoʻomohala ʻana i ke ʻano maʻi type 2 i ka wā e hiki mai ana.

ʻO ka nānā ʻana o nā maʻi diabetes gestational

I ka manawa o kou kipa mua antenatal ma kahi o 8-12 mau pule o ka make ʻana, e nīnau aku nō kou pale waena me kāu kauka i kekahi mau nīnau e hoʻoholo ai inā he ulu nui paha ka ulu ʻana o ka maʻi gestational. Inā loaʻa i kahi kumu kumu kūpono ʻole paha no ka maʻi maʻi gestational, pono ʻoe e nānā ʻia.

ʻO ka hōʻike screening i hoʻohana ʻia ua kapa ʻia ʻo ia ka hoʻoliʻi hoʻoliʻi glucose (TSH), i hala i ʻelua hola. Loaʻa i kēia hoʻokolohua kahi hōʻike koko ma ke kakahiaka a ʻole ʻoe i ʻai a inu ʻole paha i kekahi mea i ka pō ma mua o ka hoʻāʻo, a hoʻohana i kahi inu wai i ka wā o ka hōʻike. Ma hope o ka hoʻomaha ʻana no ʻelua mau hola, ua lawe ʻia kekahi kiʻi koko mai ou aku nei e ʻike i ke ʻano o ka hoʻohana ʻana o kou kino i ka glucose.

Hoʻohana ʻia ʻo TSH mai 24 a 28 mau pule wikiō. Inā ʻoe i kahi maʻi mellitus maʻi gestational ma mua, e noi ʻia iā ʻoe e loaʻa iā TSH ma mua, ʻaʻole koke ma hope o kāu kipa ʻana i ke kauka, a ʻo kekahi TSH hoʻi i ka 24-28 wiki o gestation inā he ʻano maʻamau ka hōʻike mua. Eia kekahi, hiki ke noi ʻia iā ʻoe e hoʻāʻo iā ʻoe iho i ke kōpaʻa koko koko āu e hoʻohana ai me kahi kuʻekuʻe manamana lima (mika hoʻokahe koko).

Hana no ka maʻi maʻi maʻi gestational

Inā loaʻa iā ʻoe ka mellitus maʻi gestational, ʻo ka hopena o ka hāpai ʻana e hiki ke hōʻemi ʻia e ka kaohi ʻana i kāu koko koko (glucose). Pono nō hoʻi ʻoe ma lalo o ka mālama ʻana e nā kauka i ka wā hāpai a me ka hānau ʻana, ʻike pinepine ʻia nā hana pono a pono e loaʻa i nā pilikia.

Ke nānā nei i ke kōpaʻa koko - nā hōʻailona

E hāʻawi ʻia iā ʻoe i ka lāʻau hoʻāʻo e hiki ai iā ʻoe ke hoʻohana e nānā i kāu kō koko koko. ʻO ka hoʻāʻo ʻana no ke kō koko koko pili i ka hoʻohana ʻana i kahi mea e hou i kou mau manamana lima a kau i kahi kahe o ke koko ma kahi kīkē.

Pehea e nānā ai i kāu kō koko.
I ka manawa a pehea e nānā pinepine ai ʻoe i kāu kōʻai koko - ʻo ka hapa nui o nā wahine me ka maʻi gestational diabetes mellitus e ʻōlelo ʻia e nānā i kā lākou koko koko ma mua o ka ʻaina kakahiaka a i hoʻokahi hola ma hope o kēlā me kēia pāʻina.
Kahuona o 7.2-7.8 mmol / L He hola ma hope o ka manawa maʻamau e noʻonoʻo ʻia ka wā e noʻonoʻo ai i nā nīnū o ka glucose (e hoʻohālikelike paha i ka ʻona a me ka ʻoihana paha. Inā loaʻa iā ʻoe nā māka kiʻekiʻe, a laila e hoʻomalu ʻoe i ka maʻi gestational.

Hiki i ka hoʻololi ʻana i kāu mau meaʻai e hiki ke kōkua i ka mālama ʻana i ke kō koko. Hāʻawi ʻia ʻoe e hāʻawi i kahi ʻāpana i ka mea hana meaʻai hiki ke hāʻawi iā ʻoe i ka ʻōlelo i kāu meaʻai, a hāʻawi ʻia iā ʻoe i kahi lau e kōkua iā ʻoe e hoʻolālā i kāu ʻai.

Pono kaʻai ʻana no ka maʻi maʻi gestational e komo i nā meaʻai holoʻokoʻa he nui, e like me nā lau lau, nā hua, nā huaʻai a pau, a me nā mea ʻai ʻai.

E aʻo ʻia paha ʻoe:

ʻAi pinepine (maʻamau ʻehā mau manawa i ka lā) a pale ʻole i ka kīpī ʻana i nā meaʻai.
Mālama i nā meaʻai ʻai glycemic haʻahaʻae hoʻokuʻu i nā mea honi, e like me ka palaoa pasta, kīpala biki, ka palaoa palaoa, ka ʻōpala branals piha, kaʻulaʻula (beans, pīni, lentils, etc.), granola a meatmeal.
ʻAi nā hua a me nā mea kanu - Kuhi e ʻai ma nā liʻiliʻi ʻelima lawelawe o ka lā.
Hōʻalo i nā meaʻai momona - pono ʻole ʻoe e ʻānai pono i ka ʻai ʻana i nā lepe, akā e hoʻāʻo e kū i ka hoʻohana ʻana i nā ʻaila, e like me nā pan a me nā kuki, me nā mea e pono ai, e like me nā hua, nā huaʻai a me nā hua.
Hōʻalo i nā mea inu momona. - ʻO nā kīʻaha kīʻaha a me nā mea inu kīnā maikaʻi aʻe ma mua o nā mea momona. E makaʻala i nā hua ʻai hua a me nā momona hoʻi i lawe pinepine i ka kō, no laila e heluhelu pono i nā ʻike i mua o ka hoʻohana ʻana.
E hoʻokomo i nā ʻōmole protein (non fat) i loko o kāu meaʻaie like me ka iʻa a me ka ʻai lau ʻole.

Hoʻohana pilikino

Hoʻopau ka hana kino i ke kahe o ke koko, no laila, ʻo ke ʻano kino kino hiki ke lilo i ala maikaʻi e hana ai i ka maʻi diabetes gestational. E hoʻomaopopo ʻia ʻoe e pili ana i ka maluhia i ka wā hāpai. ʻO ka ʻōlelo aʻoaʻo holoʻokoʻa e mālama i ka hana maʻa mau loa i kēlā me kēia pule i ka liʻiliʻi o 150 mau minuke (2 mau hola a me 30 mau minuke). ʻO kahi hana pilikino maʻalahi loa kēlā me kēia hana e hoʻonui ai i kou puʻuwai a hoʻomaikaʻi wikiwiki ʻoe, e like me ka brisk hele wāwae a ʻauʻau paha.

Nā lāʻau lapaʻau

Inā emi kou koko koko i hoʻokahi pule a ʻelua paha ma hope o ka hoʻololi ʻana i kou mau papaʻai a hoʻomaʻamaʻa pinepine ʻia, a i ʻole he nui aʻe ke kō o kou koko, hiki iā ʻoe ke hāʻawi ʻia e ka mālama ʻana. Hiki iā ia ke mau papa (maʻamau Metformin) ai ʻole inikini insulin.

Hiki ke piʻi nui ka nui o ke kōpaʻa koko ma mua o ka wā e holomua ana kāu ʻōpiopio, no laila inā hoʻokele maikaʻi ʻia kou pae koko koko i ka manawa mua, pono paha ʻoe e inu i ka lāʻau lapaʻau ma hope o ka wā hapai. E pau kēia mau lāʻau lapaʻau ma hope o ka hānau ʻana.

Metformin e lawe i ka papa papa i ʻekolu manawa i ka lā, ma ke ʻano he ai a ma hope o ka ʻai.

Hiki i ke kumu ʻo Metformin nā hopena pili aʻe:

ʻaʻole kū maikaʻi
utuka
ʻōpū ʻōpū
maʻiʻaʻa (ʻeha)
lilo ka momona

I kekahi manawa, hoʻohana ʻia kekahi lāʻau lapaʻau ʻē aʻe i ke ʻano o nā papa. ʻO Glibenclamide.

Injecti Insulin

Insulin hiki paha ke kau ʻia inā:

ʻAʻole hiki iā ʻoe ke lawe i ka metformin a i ʻole i ka hopena o nā hopena ʻaoʻao.
ʻAʻole kaohi ʻia kāu kō koko koko e Metformin.
He koko koko koko nui kou.
He nui loa kāu pēpē a palu loa i nā puhaka i loko o kou ʻōpū (polyhydramnios).

Ua lawe ʻia ka Insulin ma ke ʻano he ʻaha a e hōʻike ʻia ʻoe pehea e hana ai iā ʻoe iho. Aia ma muli o ke ʻano o ka insulin i kuhikuhi ʻia no ʻoe, pono ʻoe e hāʻawi ʻia i nā injections ma mua o ka ʻai ʻana, i ka wā e moe ai, a i ʻole e ala ai.

E hōʻike ʻia ʻoe i ka nui o ka insulin e pono ai e lawelawe. Māhuahua ka nui o ke kō koko koko i ka wā e holomua ana ka hānau ʻana, no laila pono ke hoʻonui ʻia ka nui o ka insulin i ka wā lōʻihi.

Hiki i ka Insulin ke alakaʻi i ka emi nui o ke kō o ke koko (hypoglycemia). ʻO nā hōʻailona o ka hoʻokaʻa koko haʻahaʻa:

ka manaʻo o ka unsteadiness a me ka hikiʻole
kaohuu
pololi
ʻaʻala
paʻakikī paʻakikī

Inā ʻike ʻoe i kekahi o kēia mau ʻōuli, pono ʻoe e nānā i kou pae momona koko - e nīnau koke i kahi kauka inā he haʻahaʻa loa ia.

ʻOhi ʻia

Hiki i ke maʻi maʻi kanalima ke hoʻonui i ka hopena o kāu keiki e ulu i nā pilikia, e like me ke kaumaha. Ma muli o kēia, e hāʻawi ʻia ʻoe i ka mālama antenatal hou, no laila hiki ke nānā pono ʻia kāu pēpē.

Eia nā hopena i hiki iā ʻoe ke hāʻawi:

ʻO ka ultrasound scan (ultrasound) i ka manawa o 18-20 mau pule o ka hāpai ʻana e nānā i ke kūlana o kāu keiki no nā mea moʻokāne.
Ke kikowaena ma 28, 32 a me 36 mau pulekiaʻi i ka ulu o kāu pēpē a me ka nui o ka wai amniotic, a me nā hoʻokele maʻamau mai 38 mau pule.

Ka hānau keiki

ʻO ka manawa kūpono no ka hānau ʻana i nā wahine me ka maʻi maʻi gestational maʻamau ka 38-40 mau pule. Inā kū iki kou koko koko i loko o ka maʻamau maʻamau a ʻaʻohe ou pilikia olakino a i ke olakino paha o kāu pēpē, hiki iā ʻoe ke kali a hoʻomaka ka hānau maoli.

Akā inā ʻaʻole ʻoe i hānau ma mua o ka lā 6 o ka hebedoma 40, a laila e noi ʻia e hānau ai a i ʻole he cesarean mahele. Hiki ke hāpai ʻia kahi hānau hānau inā loaʻa ʻoe i kāu hopohopo e pili ana i kou olakino a me ke olakino o kāu pēpē, a inā i ʻole mālama maikaʻi ʻia kou koko koko. Pono ʻoe e hānau i loko o ka haukapila, kahi i hiki i nā mea mālama olakino ke hoʻolako i ka mālama kūpono no kāu keiki 24 mau lā i ka lā.

Inā hele ʻoe i ka haukapila e hānau ai, e lawe i kāu kaila hoʻāʻo i ke koko a me kekahi mau lāʻau lapaʻau āu e lawe ai. ʻO ka maʻamau, pono ʻoe e hoʻomau i ka nānā ʻana i kāu koko koko a lawe i kāu lāʻau lapaʻau a hiki i kou lā kūpono i ka wā hānau. I ka wā hānau keiki, e nānā ʻia nā pae glucose koko e nā kauka. Pono kekahi wahine i ka hāʻule o ka insulin e pale i kā lākou koko koko.

Ma hope o ka hānau ʻana

Hiki iā ʻoe ke ʻike maʻamau, hopu a hānai i kāu pēpē ma hope o ka hānau ʻana. He mea koʻikoʻi loa e hoʻomaka e hānai i kāu pēpē i ka hiki o ka hānau ʻana (ma loko o 30 mau minuke), a no kēlā me kēia mau hola 2-3 a hiki i kona pae koko koko. E nānā ʻia ka honu koko o kāu pēpē i ʻelua a ʻehā mau hola ma hope o ka hānau ʻana. Ina he haʻahaʻa, pono ia i ka ʻai manawa pōkole ma o ka wai a iʻa a hoʻoheheʻe paha.

Inā maikaʻi ʻole kāu keiki a nele pono paha i ke nānā pono ʻana, e nānā nui ʻia ʻo ia ma kahi keʻena kūikawā no nā keiki hou. ʻO kekahi lāʻau lapaʻau āu i lawe ai e kāohi i kāu kō koko koko ke kū pinepine ma hope o ka hānau ʻana. Oe ke aʻo pinepine ʻia e nānā i kāu kō koko koko i hoʻokahi a i ʻelua mau lā ma hope o ka hānau ʻana.

Inā ola ʻoe a me kāu keiki, hiki iā ʻoe ke hoʻi maʻamau i ka home ma hope o 24 mau hola. 6-13 mau pule ma hope o ka hānau ʻana, pono ʻoe e loaʻa i ke ʻano hoʻoliʻi e nānā ai i ka maʻi maʻi. ʻO kēia no ka mea liʻiliʻi o nā wahine me ka maʻi maʻi gestational i hāpai i ke kō koko koko ma hope o ka wā hāpai.

Inā maʻamau ka hopena, e hōʻike ʻia ʻoe e hōʻike i kahi hōʻike maʻi maʻi makahiki. ʻO kēia ma muli o ka loaʻaʻana o nā wahine me ka maʻi gestational i ka nui o ka ulu ʻana o ka hoʻomohala ʻana i ke ʻano maʻi type 2.

Nā hopena lōʻihi e pili ana i ka maʻi maʻi gestational

Hoʻopau hele nā maʻi maʻi gestational ma hope o ka hānau ʻana o ka pēpē, akā ʻoi aku ka nui o nā wahine i ʻeha ʻia ke ulu aʻe:

ʻO ka maʻi diabetes gellational mellitus hou i nā wā hāpai.
ʻO ka maʻi maʻi type 2 he ʻano ola pau ʻole.

Pono ʻoe e loaʻa i kahi hoʻāʻo koko 6-13 mau pule ma hope o ka hānau ʻana e nānā no ka maʻi maʻi. Inā he maʻi maʻamau kou koko, e aʻo ʻia ʻoe e hoʻāʻo iā ʻoe i kēlā me kēia makahiki. Inā ʻoe e hoʻomau i nā hōʻailona o ke kō o ke koko, e like me ka nui o ka makewai, pono ka hoʻonaninani pinepine ʻia ma mua o ka maʻamau, a me ka waha maloʻo - mai kali ʻoe i ka hōʻike maʻi maʻamau.

Pono ʻoe e hoʻokolo ʻia i ke koko inā hiki i kou maikaʻi, ʻoiai me ka poʻe he nui i ka maʻi diabetes ʻaʻole loaʻa nā hōʻailona o kēia maʻi. E ʻike ʻia ʻoe e pili ana i nā mea āu e hana ai e hōʻemi i kou hopena i ka hoʻomohala ʻana i ka maʻi diabetes, no ka laʻana, e mālama i ke koʻikoʻi o kou kino, ʻai kino a me ka maʻamau, etc.

Ma muli o kekahi mau noiʻi, ua manaʻo ʻia nā keiki i loaʻa i ka maʻi gestational i ka maʻi hānau ʻana i ka wā hāpai a ʻoi paha e hoʻomake i ka maʻi diabetes a i ka maʻi paha i ka wā ʻelemakule.

Hoʻolālā Mea Hoʻolālā

Inā ua loaʻa iā ʻoe ka maʻi gestational ma mua a ke hoʻolālā nei e lilo i ka hapai, pono ʻoe e hoʻāʻo i ka maʻi maʻi. Inā loaʻa iā ʻoe ka maʻi maʻi, pono ʻoe e hele i ka haukapila ma mua o ka ʻāʻī ʻana e hōʻoia ʻo ka mālama ʻana i kou maʻi.Inā he māmala ʻoe, kamaʻilio me kāu kauka a ʻōlelo i ka maʻi gestational i ka wā o kou hāpai ʻana.

Inā hōʻike ʻoe i nā hoʻokolohua ʻaʻole loaʻa ʻoe i ka maʻi diabetes, e noi ʻia ʻoe e hoʻomālamalama ʻia i ka glucose hou koke o kāu kipa ʻana i ke haukaʻi, a laila e ʻōlelo ʻia nō hoʻi ke hana i kahi hōʻike screening lua ma hope o 24-28 mau pule inā he ʻano mua ka hōʻike mua.

Hiki ke noi ʻia iā ʻoe e hoʻomaka e hoʻāʻo i kāu kiʻekiʻe glucose koko iā ʻoe iho e hoʻohana ana i kahi pākīkī o ka manamana lima, e like me kāu i hana ma ke wā o ka maʻi gestational ma mua o ka wā hapai.