Sugar 32 a 32
Makemake ʻoe e ʻike i ka mea e hana inā he koko koko he 32? A laila e nānā hou aʻe.
Ia wai: | ʻO ke ʻano o ka paukū gula 32? | He mea e hana ai: | Ka palena o ke kō: | |
ʻO ka wāʻaole o ka wā pākeke ma lalo o 60 mau makahiki | Ke hoʻolaha nei | Kāhea i kahi ambulance! ʻO Coma hiki. | 3.3 - 5.5 | |
Ma hope o ka ʻai ʻana i nā pākeke ma lalo o 60 | Ke hoʻolaha nei | Kāhea i kahi ambulance! ʻO Coma hiki. | 5.6 - 6.6 | |
Ma kahi ʻōpū ʻole mai 60 a 90 mau makahiki | Ke hoʻolaha nei | Kāhea i kahi ambulance! ʻO Coma hiki. | 4.6 - 6.4 | |
Kaʻaʻai ma luna o 90 mau makahiki | Ke hoʻolaha nei | Kāhea i kahi ambulance! ʻO Coma hiki. | 4.2 - 6.7 | |
ʻO ka hoʻomaha ʻana ma nā keiki i lalo o 1 makahiki | Ke hoʻolaha nei | Kāhea i kahi ambulance! ʻO Coma hiki. | 2.8 - 4.4 | |
ʻO ka wāʻaʻai o ka keiki i ka makahiki 1 a hiki i ka 5 mau makahiki | Ke hoʻolaha nei | Kāhea i kahi ambulance! ʻO Coma hiki. | 3.3 - 5.0 | |
ʻO ka wikiwiki ʻana i nā keiki mai ka 5 mau makahiki o nā makahiki a me nā ʻōpio | Ke hoʻolaha nei | Kāhea i kahi ambulance! ʻO Coma hiki. | 3.3 - 5.5 |
ʻO ke kaulike o ke kō koko koko mai ka manamana lima ma kahi ʻōpū ʻole i nā pākeke a me nā ʻōpio mai 3.3 a 5.5 mmol / l.
Inā he gula 32, a laila makemake ʻia ka hale hoʻokipa! Kāhea i kahi ambulance! Me ke kōpaʻa ma mua o 30, hiki i kahi comc hyperclycemic coma.
ʻO nā kumu, ke nānā ʻana a me nā hōʻailona
Hiki i nā pae kōhi koko ke ʻano no nā kumu like ʻole, ma ka manawa o ka hana kino, ke ʻano haʻuki, ke ʻano paʻakikī, a ma ka wā hāpai. ʻO kaʻaiʻai kūponoʻole, hoʻohui ʻana, hiki i nā loli ke hoʻololi i ka pilikia me ke kō.
Aia i mua o nā maʻi endocrine, e hoʻopilikia ana ka hana ʻana o ka hormone; ke kamaʻilio nei mākou e pili ana i ka maʻi a Cush, pheochromocytoma, thyrotoxicosis. I kēia hihia, ʻo ke kiʻekiʻe o ke kō, ʻoi aku ka ikaika o ka huna ʻana o nā kūpeʻe.
Hiki ke hoʻolaʻa ʻia nā kaʻina metabolic i ke kino me nā pathologies o ka pancreas, malignant a me nā neignlasme benign. Hoʻomaʻama pinepine, ʻike ka hiʻi i loko o ka glucose me ka hoʻohana lōʻihi ʻana o ka hormonal, nā lāʻau lapaʻau steroid, diuretics a me nā hoʻomālamalama hānau hānau.
Hoʻopilikia pū kekahi naʻau i nā mākau glycemia, nā maʻi like ʻole:
ʻO ka mea mua e hana inā ua hoʻonui ke kō o ke koko i kahi hōʻeha koʻikoʻi he 32 mmol / lita ka mea e hoʻopau i nā kumu o kēia ʻano. ʻAʻole hiki ke kapa ʻia nā hihia i ka maʻi hyperglycemia kahi hōʻailona o ka maʻi maʻi, akā i kēia hihia he mea nui ia e hana pono i nā ala āpau i hiki ʻole ai ke kūlana.
Pono e noʻonoʻo hou i kāu mau ʻai e ʻai ai, pono ʻoe e ʻōnaehana ʻokoʻa i ka pae o ke kō me ka hoʻohana ʻana i kahi mea momona maoli a i ʻole e hoʻopili i kahi hale lapaʻau no ka nānā ʻana. Akā ʻaʻole kūpono ke kuhi ʻana e hana i nā mea hoʻomaʻamaʻa a me nā ʻano ʻē aʻe o ke ʻano pilikino i kēia hihia, no ka mea he hiki ke hoʻonāukiuki ka nui o ka glycemia.
Pono ka mea e hoʻomanaʻo e hoʻomanaʻo i nā ʻōnaehana home no ka hoʻoholo ʻana i nā ʻōmaʻomaʻo glucose e hoʻonohonoho mau ʻia e ana i ke kaila koko, no laila e hoʻohaʻahaʻa ʻia ka hopena i loaʻa i kekahi hihia e 12%. Pono ʻia kahi noiʻi i nā manawa he nui i ka lā, inā ma mua o ka hōʻailona mau glycemia he 32 mau kuhi, akā ʻaʻole i hōʻike ʻia ka maʻi mellitus i loko o nā kānaka. Ke kōkua nei kēia ala e pale i ka hoʻomohala ʻana o ka maʻi i ka wā kūpono a hoʻopau i nā kumu kumu paha ke ʻano o ka pathological.
Me ka piʻi nui o ka kō, ua ʻōlelo aku ke kauka i kahi hōʻike hoʻokaʻawale glucose hou, e hiki iā ʻoe ke hoʻoholo i ke ʻano mua o ka maʻi diabetes - prediabetes. ʻO ka maʻamau, pono kahi ʻano noiʻi e hoʻoponopono i ka maʻi diabetes a me ka hoʻāla ʻana i nā glucose.
Ua kuhikuhi ʻia ka loiloi ʻaʻole i nā poʻe āpau, akā aia wale nō ma luna o nā mea maʻi māhuahua ma mua o 40 mau makahiki a ʻoi paha ka pilikia no ka maʻi maʻi.
Hoʻohui ʻia nā hoʻololi i nā ʻōkuhi glucose i loko o ke kanaka, ua ʻike ʻia nā hōʻailona ʻano:
- kūwaho pinepine ʻole a urination,
- nāwaliwali nui loa, nāwaliwali, ka āpau,
- ka hoēmi ʻana i loko o ka hiʻona maikaʻi,
- nawaliwali pale pale āiʻi, maʻi pāpaʻi pinepine,
- ka ʻūʻā o ka ʻili,
- hoemi a hoʻonui ʻia paha i ka momona ma waena o ka loaʻa ʻana o ka paona wikiwiki a i ke kaumaha paha.
Kēia mau hōʻailona, me kahi glycemic index of 32, e hāʻawi no ka hiki ke hiki i ke kauka a me ka hoʻomaka ʻana o kahi papa lapaʻau.
Nā hōʻailona o ke Kāi Waiwai
ʻO ka papa kuʻuna o nā hōʻailona o waho o ke kaila koko nui e pili ana:
- Pau ʻole makewai.
- ʻO ka wikiwiki, loaʻa ʻole ka momona koʻikoʻi.
- Kūʻai pinepine.
- ʻEha nā maʻi momona o ka maʻi.
- ʻO ka ʻili maloʻo a me ka membous nā membrane.
- ʻO nā pilikia kikoʻī, nā kikoʻī o nā ʻĀina noho.
- Naokuii.
- Hoʻokomo ʻia ka pale ʻole e pale ai i nā maʻi, nā hōʻeha hōʻeha maikaʻi.
- Pānuhū leo hohonu, ʻano ʻano nui o ka hyperventilation.
- Ma nā lāʻau koʻikoʻi o ka hyperglycemia, dehydration koʻikoʻi, ketoacidosis, ʻike mua ʻole, a i kekahi mau hiʻohiʻona, ʻike ʻia.
Pono e hoʻomaopopo ʻia he hiki i nā hōʻailona ma luna nei ke hōʻailona i nā hōʻailona o nā maʻi like ʻole, no laila, inā ʻike ʻia nā liʻiliʻi ʻole o nā hōʻike hōʻike kino, pono ʻoe e ʻimi i ke kauka a hana i nā hoʻokolohua e hoʻoholo ai i ke ʻano maʻi.
Nā kumu kumu
ʻO ka pinepine, ʻo ke kumu o ka hōʻailona:
- Naʻi maʻi mellitus. I ka nui o nā hihia, ʻo ka hōʻike kino o ka maʻi hyperglycemia ke kumu nui o kēia maʻi.
- ʻAʻohe meaʻai kūpono. ʻO nā hōʻeha koʻikoʻi o ka meaʻai maʻamau, a me ka mea nui o ka waihona kiʻekiʻe-calorie o ka meaʻai, hiki ke alakaʻi i nā ʻano o ka hyperglycemia a ʻaʻole i pili me kāna ʻano maʻi.
- ʻĀkau. ʻO ka hyperglycemia post-stress ka mea maʻamau no nā poʻe maʻi me ka pale ʻole o ka nāwaliwali, ʻo ka pinepine o ke kū ʻana i ke kua o ka hoʻomohala ʻana o kahi kaʻina hana pili kūloko.
- ʻO nā maʻi ʻehaʻeha ākea o kahi ākea ākea.
- ʻO ka ʻae i nā helu o nā lāʻau - rituximab, corticosteroids, niacin, manuahi asparaginase, beta-blockers, 1-2 hanauna antidepressants, protease inhibitors, thiazide diuretics, fentimidine.
- ʻO ka nele o ke maʻi i ke kino, nā huaora o ka pūʻulu B.
Nā kumu o ke Kumukā kiʻekiʻe ma nā pākeke a me nā wahine hāpai wahine
E like me ka hōʻike ʻana i nā lāʻau lapaʻau, ma 90 ka nui o nā hihia e hoʻomau nei i ka maʻi hyperglycemia maʻi maʻamau i ka pākeke he hōʻike hōʻike o ka mellitus maʻi diabetes, ʻo ka hapanui o ke ʻano o ke ʻano 2. ʻO nā mea maikaʻi ʻē aʻe nā mea maʻamau i hoʻolilo ʻole ʻia i ka poli i loko o ka hiamoe a me ke ala ʻana, ke kaumaha, ma ka hana, a me ke ʻano maʻalahi e hele pū ʻia ana e ka obesity.
Hōʻalo ka nui o ke kō kōʻai koko i loko o nā wahine hāpai - ka maʻi hyperglycemia ma hope iki i ke ʻano kūlohelohe, pili pū me ka hoʻoponopono hou ʻana i ke kino ma ke ʻano he nui a me ka loli ʻana o ka hormonal (i ka ʻano pilikino), a he ʻano ʻano maʻi maʻamau o ka maʻi mellitus - ka mea i kapa ʻia ka maʻi gestational, huki a wehe pinepine ʻia ma hope o ka hānau ʻana. Inā ma ka hihia mua ua lawa nā loiloi maʻamau o ka maʻi o ka mea maʻi, ma ka lua o kahi maʻi, ʻike ʻia kekahi maʻi i ka 4-5 pākēneka o nā wahine i kahi wahi hoihoi e hōʻeha ʻia i ka ʻōpio a me ke olakino o ka makuahine makemake, no laila ua kaukaʻi nā loea i kahi lapaʻau koʻikoʻi e noʻonoʻo ana i ka physiology o kēia manawa maʻi.
ʻO nā kumu o ke kō koko nui i nā pēpē a me nā keiki
I nā keiki o ke kula mua a me ka wā ʻōpio, ʻike pinepine ʻia ka hyperglycemia me nā nui o nā mea - ke kīhū, ka hoʻonaninani, ke ʻano a me ka hoʻomohala ʻana i nā hanana infectious a me nā maʻi kūleʻa e pili ana i ke kua o ka hoʻōla ʻana o ka hoʻōla ʻana o ka hormone contraous contraous-hormon, ka mea i hoʻoili ʻia i ka nui me ka ulu ikaika o ke kino. ʻO nā hihia pilikino wale nō, ma hope o ka haʻalele ʻana i nā kumu i luna a pau, ua ʻike ʻia nā keiki me ka maʻi mellitus i ka maʻi nui, ʻo ka ʻano nui o ka lā 1st.
Pono ʻo Hyperglycemia o nā pēpē i ka nānā kūikawā - ia i nā kumu he nui, ʻaʻole i pili i nā kumu kumu o nā hōʻailona i nā keiki a me nā pākeke. I ka nui o nā hihia, he nui ka hoʻonui ʻana i ke kōhi koko no ka neʻe ʻana o ka lawelawe intravenous glucose i nā keiki hou me ka liʻiliʻi o ke kino. I nā pēpē mua i ke wā mua o ke ola, ʻo ka hyperglycemia kahi hōʻike o ka nele o kahi hormon e wāwahi i ka proinsulin, pinepine ma ke ʻano o ke kūleʻa piha ʻana i ka insulin.
Hiki ke kau ʻia i ke ʻano o ka hyperglycemia ma ka hoʻopuka ʻana o ka glucocorticosteroids, sepsis fungal, ʻehaʻeha o ka hanu, hypoxia. E like me ka hōʻike ʻana o nā lāʻau lapaʻau hou, ʻoi aku ka nui o ka hapalua o nā pēpē hou e hiki mai nei no ke kumu hoʻokahi a i ʻole kekahi i ka ʻoihana mālama koʻikoʻi e hōʻike i kahi kiʻekiʻe o ke kō. ʻOiai ka hopena o nā glucose kiʻekiʻe ma mua o ka hypoglycemia classical, ʻoi aku ka nui o ka hopena o nā hoʻopiʻi a me ka loaʻa o ka make.
Naʻi hoʻolika
ʻO kahi hoʻonohonoho o nā hana diagnostic maʻamau e ʻike i ke kiʻekiʻe o ke kōpaʻa koko kiʻekiʻe e loaʻa i nā palapala a me nā hōʻike. Inā loaʻa iā ʻoe ka hyperclycemia maʻalahi, hikiʻole ke hoʻoholo pono iā ia iho me ke kōkua o kahi glucoseometer maʻalahi. I kēia hihia, ʻoi aku ka maikaʻi o ke nīnau aku i ke kauka nāna e kuhikuhi i nā hoʻokolokolo kūpono.
- Kaʻaʻai koko. ʻO ka hana maikaʻi orthotoluidine, kahi e hoʻoholo ai i ka hoʻoliʻi o ka glucose i ka plasma me ka ʻole o ka manaʻo i nā mea hōʻemi ʻē aʻe. Hāʻawi ʻia i ke kakahiaka ma kahi ʻūhā ʻole (12 mau hola ma mua o ke kaomi ʻana he pono e hōʻole i ka ʻai ʻana i ka meaʻai, nā lāʻau lapaʻau a me nā hana kino). Inā hōʻike ka maʻi maʻa mua i nā kuʻuna mai ka maʻamau, kuhikuhi ke alakaʻi i ka mea maʻi i nā haʻawina hou.
- ʻAno hoʻouka. Lawe ʻia ʻo ia ma nā kūlana o ka haukapila o ke lā / pōʻaiapuni. I ke kakahiaka, hāʻawi ʻia ke koko ma ka ʻōpū ʻole, e pili ana i nā lula o ke ala mua, ma hope o ka huikala ʻia o ka glucose i loko o ke kino a ma hope o kekahi mau hola, ua hoʻohālikelike hou ʻia ke koko. Inā hoʻonui ʻia nā hopena o ka paepae nānā mua o 11 mmol / L, mālama pinepine ke kauka i ka "hyperglycemia".
- ʻO ka wehewehe ʻana i ke ʻano. Hāʻawi koko ke hoʻokaʻawale ʻana i nā ʻāpana ʻē aʻe - i ka nui, ka waʻa uric, ergonin, creatinine. Hāʻawi iā ʻoe e hoʻomaʻamaʻa i ka maʻi maʻi a ʻike i nā pilikia e pili ana - e laʻa, nephropathy maʻi maʻi.
Hiki paha nā hopena
ʻO ka Hyperglycemia kahi hōʻailona wale nō e hōʻike ana i kahi malfle i nā ʻōnaehana o ke kino a me ka maʻi diabetes paha. Akā naʻe, ʻaʻole kēia ka manaʻo me ka nui o ke kō koko koko ʻaʻohe ʻōpiopio. ʻO ka hopena e hopena ka hopena o kēia kūlana pathological he ketoacidosis. ʻO kēia keʻaʻaʻana o nā kaola kalama e hoʻonui nui i ke kao o nā kino ketone i ka plasma koko, ʻoi loa ka kūʻē i ke kua o ke ʻano maʻi o kekahi ʻano decompensation, kahi e hoʻonāukiuki ai i ka ketonuria, arrhythmia, ka hanu wikiwiki, ka holomua wikiwiki o ka maʻi sluggish i hiki i ke kino, i ka wai. I kekahi mau pilikia, i ka loaʻa ʻole o kahi pane lapaʻau kūpono kūpono, ulu kahi maʻi diabetes / hyperglycemic coma, a ma hope o ka hāʻule ʻana o ka pH (acidity o ke kino) i ka 6.8, ua kū mai ka make ma kahi maʻi.
Pehea e hoʻohaʻahaʻa ai i ke kō koko?
Hoʻolakoʻo Hyperglycemia therapy i ka manawa o ka hoʻopau ʻana i ke kiʻekiʻe o ka glucose koko kiʻekiʻe, me ka mālama ʻana i ka maʻi ma lalo o nā maʻi i kumu i kēia ʻano maʻi.
ʻO nā lāʻau lapaʻau a me nā lāʻau lapaʻau e hoʻohaʻahaʻa i ke kō koko:
- Paʻi pūlea o ka insulin. Koho ʻia ka dosage ho‘okahi, me kahi o kahi kūlana precomatic, hoʻohana ʻia nā mea hana ultra-pōkole o ka wikiwiki wikiwiki loa i hoʻohana ʻia - humalog, humulin.
- ʻO ka hoʻohana nui ʻana i nā mea ʻai waha hypoglycemic. Nā hui o nā lāʻau lapaʻau e pili ana i nā likika benzoic, sensitizers, A-glucosidase inhibitors, phenylalanine amino acid, sulfonylureas - maninyl, metformin, etc.
- Inu nui. ʻO kahi hopena palupalu o ka pā kuhi i nā kī paʻakikī o ka hyperglycemia.
- Hana kino kino (me nā hua maʻalahi o ke ʻano o ke ʻano).
- I loko o ka manawa waena - he meaʻai paʻa.
ʻAlaʻai me ka Meaʻai
Mai ka hoʻomau i ka hyperglycemia ma ka nui o nā hihia he hōʻike ia o ka maʻi mellitus, he mea kūpono ke ʻano kūpono no ka mālama pono ʻana i ka pilikia.
He mea nui loa ia i ka hoʻokomoʻana i kahi meaʻai i kahi hihia o ka wehe ʻana i ka maʻi maʻi type 1. ʻO ka pae keʻokoʻa i nā meaʻai e pili ana i nā kaona momona maʻalahi, a me ka nui o ka koina o ka ʻai ʻana i nā kalala, a me nā momona a me nā protein.
Hōʻemi ka nui o ke kōʻai koko
I nā huahana o ka huahana kūlohelohe, me kahi kiʻekiʻe o ka glucose i ke koko, pono e koho i nā mea i loaʻa ka haʻahaʻa glycemic index. Pono ia e hoʻomaopopo ʻole ʻia ka ʻai e hoʻemi ana i ke kō - nā mea a pau i ʻike ʻia i kēia manawa haʻahaʻa haʻahaʻa glycemic i ʻole e hoʻonui i kona kiʻekiʻe, akā ʻaʻole hiki ke neʻokeʻe kūʻokoʻa i kahi kanaka o ka hyperglycemia.
- Seʻa - nā ʻōpala, nā kapaki a me nā lobi spiny kekahi o nā haʻahaʻa glycemic haʻahaʻa.
- ʻO ka pipi ʻoa - i ka ʻike ʻuʻuku.
- Kāliki, zucchini, paukena, lau ʻele.
- Kāweka, soy, broccoli.
- ʻĀʻā pū.
- Kekahi ʻano hua - lemons, avocados, grapefruit, cherries.
- ʻO nā kukala, kamato, nā pepa pepa, celery, kāloti, asparagus, horseradish.
- Kaona momona hou, Ierusalema artichoke.
- Kekahi ʻano ʻano mea ʻala - ʻōmole, mustard, kinamona.
- Nāʻaila - linseed aiʻole raspovye.
- ʻO nā meaʻai momona ka momona ka mea i loaʻa nā kīlani, nā nati (walnuts, cashews, almonds) a me nā cereals (oatmeal).
- Nā Lalamila
ʻO nā hua āpau o luna o nā hua inoa "green green" a hiki iā ʻoe ke hoʻohana iā lākou me ka makaʻu ʻole no ka poʻe me ka hyperglycemia.
Hoʻoikaika ka lāʻau lapaʻau hou i ka meaʻai me kekahi o nā mea nui i ka hoʻoponopono ʻana i ka maikaʻi o ke ola a me ke olakino o nā mea maʻi me ka maʻi hyperglycemia, kahi mea nui i ka mālama ʻana i ka maʻi maʻi ʻaʻai a hiki i ka uku kūpono o ka metabolism.
No nā poʻe maʻi e ʻike ʻia me nā maʻi maʻi mua, pono ke kīleʻa a nui ke ʻano. Ma ke ʻano maʻi maʻi maʻi 2, ke alakaʻi pinepine ʻia ka meaʻai kūpono e hoʻoponopono i ke kaumaha o ke kino.
ʻO ka manaʻo maʻamau o kahi papa meaʻai, he ʻāpana berena, ka like me ka 10 mau o nā potoma. No nā poʻe me hyperglycemia, ua hoʻomohala ʻia nā papa kikoʻī e kuhikuhi ana i kēia mahele no ka nui o nā meaʻai o kēia wā i ka meaʻai.
Ke hoʻoholo nei i ka hoʻonui ʻana o kēlā me kēia lā, pono ke kāpae i kekahi meaʻai hoʻolaʻa, ʻūlū, ke kō a me ke kaupalena ʻana i ka nui e like me ka pasta, kaʻai keʻokeʻo, ka ʻihi / semolina, a me nā mea ʻai me nā hāmeʻa refractory, e kālū ana i nā meaʻai me ka nui o ka mea ʻai e hoʻolaʻa ʻia. a mai poina i ka lilo ʻana o ka polyunsaturated / saturated fatty acid.
Hoʻomaopopo ʻia e ʻai i ka meaʻai i ka hapa, e hoʻomohala i kahi papaʻai i kēlā me kēia lā no ʻekolu mau a me ka 2-3 hou aʻe. ʻO kahi papa hana o kēlā me kēia lā no ka 2 tausani mau kaloli no kahi kanaka me ka hyperglycemia me nā hoʻopiʻi ʻole a me ka papa kuhikuhi e pili ana:
- ʻAiʻina 1 - 50 mauʻa o ka palaoa ʻeleʻele, hoʻokahi hua manu, 5 mau pā o ka pata, he ʻōmole waiū, 40 mau kekelē o ka cereal i ʻae ʻia.
- ʻAiʻina 2 - 25 mauʻaina o ka palaoaʻeleʻele, 100 kalama o ka hua a me nā kao puʻupuʻu momona haʻahaʻa.
- ʻAla awakea - 50 mauʻa o ka i ʻae ʻia, 100 mauʻu o ka ʻiʻo momona a me nā ʻuala, 20 mau huaʻai o ka hua maloʻo, 200 kalama o nā lau lau a me 10 mau lau o ka aila ʻaila.
- Snack - 25 mauleʻa o ka berena uliuli a me 100 mau lau o ka hua / waiū.
- Kaʻaina - 25 kalama o ka berena, 80 mau pā o ka iʻa o nā haʻahaʻa haʻahaʻa haʻahaʻa a i ʻole kai eʻai ana, 100 kalama o ka ʻuala, nā mea kanu, a me nā huaʻai, 10 karamu o ka aila ʻaila.
- Ma mua o ka hele ʻana e moe - 25 grama o ka papa a me kahi aniani o nā kefir haʻahaʻa.
Hiki i nā mea hou ke hoʻololi ʻia e nā kaulike calorie ma loko o nā pūʻulu kumu ʻehā nui:
- Nā mea kanu, nā hua / hua, ka ʻai, nā cereals.
- Kākoʻo ʻai kīkaha, nā iʻa momona liʻiliʻi / ʻai.
- ʻŌmole ʻaʻa, kaʻaila, pata.
- ʻO ka waiū / hua a me nā mea like ʻole e loaʻa i nā ʻano meaʻai like ʻole.
ʻO ka hoʻohana ʻana o nā mea momona, i kaulana loa i ka hoʻomaka ʻana o ke kenekulia hou, e hoʻopiʻi ʻia nei e nā pūʻulu nui o nā mea kanu olakino no ka nui o kā lākou mākeke nui, no laila ʻaʻole mākou e manaʻo i ka hōʻino iā lākou, i nā hihia koʻikoʻi, me ka hoʻohana nui ʻia i kāu papaʻai i kēlā me kēia lā.