Whakamātautau HbA1c: te taumata tika o te huka toto, te tūtohi me te tikanga o tō hua

Ko te HbA1c te glycated haemoglobin (ka kite hoki koe i te glycosylated haemoglobin, A1C, HbA1c rānei). Ko te haemoglobin te pūmua i roto i ngā pūtau toto whero e kawe ana i te hāora. Ka piri te huka o tō toto ki a ia, ā, ka nui ake te huka, ka nui ake hoki te haemoglobin ka kapi i te huka.

Ka ora ngā pūtau toto whero mō ngā marama e toru pea, nō reira ka whakaata te HbA1c i tō huka toto toharite mō ngā marama e rua ki te toru kua pahure, ā, ko te marama whakamutunga te mea nui rawa. Koinā te take e pūmau ai: kotahi te tina reka, kotahi rānei te ata ahotea, kāore e tino nekehia, ā, kāore he take kia nohopuku i mua i te whakamātautau.

E toru ngā āhua e whakamahia ai e ngā rata: hei kimi i te mate huka me te prediabetes, hei titiro he pēhea te pai o te maimoatanga mate huka, hei aromatawai i te tūraru o ngā raruraru o te mate huka i roto i te wā.

Ka taea tō HbA1c te huri hei estimated average glucose (eAG, te huka toto toharite e matapaetia ana), arā, te toharite ka puta mai i tētahi mita ā-kāinga mēnā ka tirohia e koe i ngā hāora katoa o te rā. I ahu mai te tātaitanga i te rangahau ADAG (Nathan me ōna hoa mahi, Diabetes Care, 2008).

He toharite te matapae. Tokorua ngā tāngata he ōrite te HbA1c, engari tērā pea he tino rerekē ō rāua rā: kotahi e pūmau ana, ko tētahi e piki ana, e heke ana. Mēnā e whakamahi ana koe i tētahi mita huka, i tētahi pūoko (sensor) rānei, mā aua tatauranga e kōrero te toenga o te kōrero.

5.7% ki te 6.4% (prediabetes). Kua teitei ake tō huka toto i te noa, engari kāore anō kia tae ki te taumata mate huka. He mea noa tēnei, kāore he tohumate i te nuinga o te wā, ā, koinei te wā pai rawa ki te mahi: i te US Diabetes Prevention Program, ko ngā tāngata i heke te 7% pea o tō rātou taumaha, i noho korikori tonu, i heke iho i te haurua tō rātou tūponotanga ki te mate huka momo tuarua (type 2 diabetes).

6.5% neke atu rānei (taumata mate huka). Kotahi noa te hua i konei, ehara anake i te whakatau. Ki te kore ōu tohumate mārama o te huka toto teitei, ka mahia anō e te rata te HbA1c, ka tirohia rānei te fasting glucose, te glucose tolerance test rānei hei whakaū.

Kei a koe kē te mate huka? Ki te piki ake i tō whāinga, i te nuinga o te wā me titiro anō ki te mahere: ka taea e ngā rongoā, te kai, te korikori, te moe, te ahotea me ētahi atu māuiui te whakapiki. Kawea te tau ki te rata e tiaki ana i tō mate huka, kaua e whakarerekē i tētahi mea māu anō.

Tērā pea ka teitei ake te HbA1c i tō toharite tūturu ina he anaemia nā te korenga rino, ina iti te huaora B12, te folate rānei, ina he mate whatukuhu taumaha, ina kua tangohia rānei te spleen.

Mō te nuinga o te hunga kāore he mate huka, ki te kei te wāhanga iti o te taumata tika tō hua, he rongo pai noa iho tēnā.

Tērā pea ka iti iho te hua i tō toharite tūturu ina tere ake te whakakapi o ngā pūtau toto whero i te noa: i muri i te rere toto nui, i te whakaurunga toto (transfusion) rānei, i ētahi momo anaemia, i te haurua tuarua o te hapūtanga, i te mate whatukuhu taumaha e maimoatia ana ki te erythropoietin, i ētahi mate ate rānei. Ko ētahi haemoglobin variants (pērā i te sickle cell trait, i te HbE rānei, he mea kitea whānuitia i Āhia ki te Tonga me Āhia ki te Tonga-mā-Rāwhiti) ka iti, ka teitei rānei te pānui a ētahi tikanga whakamātautau.

Mēnā e kai ana koe i te insulin, i ngā pire whakaheke huka rānei, ā, he tino iti tō HbA1c, tērā pea he auau ō wā huka iti. He take tēnā kia waea atu ki tō rata, ina koa mēnā kua wiri koe, kua werawera, kua pōhēhē rānei i ētahi wā.

I te mea e whirinaki ana te HbA1c ki ngā pūtau toto whero, ka whakamahi kē ngā rata i ngā whakamātautau huka (fasting glucose, glucose tolerance test, fructosamine test rānei) ina:

• kei te hapū koe, ina koa mō te mate huka hapū (gestational diabetes), ka tirohia ki te glucose tolerance test
• kua rere nui tō toto i nā tata nei, kua whiwhi whakaurunga toto rānei koe
• he anaemia tōu, he haemoglobin variant, he mate whatukuhu, mate ate taumaha rānei
• tērā pea kei te tere tīmata te mate huka momo tuatahi (type 1 diabetes), i te nuinga o te wā i tētahi tamaiti, taiohi rānei e matewai ana, e heke ana te taumaha, ā, ehara i te mea haumaru te tatari mō ngā marama e toru kia whai ake te HbA1c

• Kāore he take kia nohopuku. Ka taea e koe te kai me te inu pērā i te tikanga.
• He tauira toto iti mai i tētahi uaua toto i tō ringa, he werohanga matimati rānei i ētahi whare haumanu.
• I te nuinga o te wā ka hoki mai ngā hua i taua rā anō, i roto rānei i te rā kotahi ki te rua.
• Kōrero ki te taiwhanga, ki tō rata rānei mēnā kei te hapū koe, he anaemia, he mate whatukuhu rānei tōu, kua whiwhi whakaurunga toto rānei, kua rere nui rānei tō toto i ngā marama e toru kua pahure.

Ko ēnei ngā wā noa i ngā ADA Standards of Care:

• He tika te hua, kāore he mate huka: ka tirohia ngā pakeke mai i te 35 tau, i mua atu rānei mēnā he taumaha nui me ētahi atu take tūraru, ā, ia toru tau mēnā ka noho tika tonu te hua.
• Prediabetes: kotahi i te tau.
• Mate huka, kua tae ki te whāinga: kia rua i te tau, neke atu rānei.
• Mate huka, kātahi anō ka hurihia te maimoatanga, kāore rānei i te whāinga: ia toru marama pea.

He pōturi te neke o te HbA1c, nō reira tukuna kia rua ki te toru marama kia kitea ai tētahi panonitanga.

• Korikori ake. Kia 150 meneti pea i te wiki o te hīkoi tere, o tētahi korikori ōrite rānei, kua horahia ki te nuinga o ngā rā, me ētahi mahi whakakaha.
• Whakawhitia ngā inu huka me ngā māmaoa kua tukatukahia (te tī kua whakarekahia, te wai hua rākau, te parāoa mā, ngā wāhanga raihi nui) ki te wai, ki ngā huawhenua, ki ngā pīni, ki ngā kākano katoa (whole grains).
• Whakahekea paku tō taumaha mēnā he taumaha nui koe. Mā te heke o te 5% ki te 7% o te taumaha tinana, ka kitea kē he rerekētanga.
• He mea nui hoki te moe me te ahotea. Mā te moe poto me te ahotea roa ka piki te huka toto.
• Mā tō rata e whakatau ngā rongoā. He tokomaha te hunga e hiahia ana ki ērā, ā, ehara tēnā i te korenga. Kaua rawa e tīmata, e whakamutu, e whakarerekē rānei i tētahi rongoā mate huka me te kore kōrero ki tō rata.