Kuyesererana kwa glucose: momwe mungatengere, kuzindikira kwa kuyezetsa magazi

Mulingo wapamwamba wofanana ndi mayeso a glucose kuloleza ndi 6.7 mmol / l, wotsikirapo amatenga shuga koyamba, malire omveka bwino a phunziroli kulibe.

Potsitsa zolemba zowonetsa, tikulankhula za mitundu yonse yamatenda, zimaphatikizapo kuphwanya kwa kagayidwe kazakudya, glucose kukana. Ndi maphunziro omaliza a matenda a shuga a mtundu wachibiri, Zizindikiro zimawonedwa pokhapokha ngati zovuta zimachitika (kupsinjika, kuledzera, zoopsa, poyizoni).

Ngati kagayidwe kachakudya kakukula, kumakhala ndi mavuto ena azaumoyo omwe angayambitse imfa ya wodwalayo. Matendawa ndi monga myocardial infarction, ochepa matenda oopsa, kuchepa kwa mtima.

Zoyipa zina zikuphatikiza:

ntchito yambiri ya chithokomiro,
mitundu yonse yamatenda oyendetsera,
kuvutika kwamanjenje
matenda ashuga
zotupa njira mu kapamba (pachimake, aakulu).

Kuyesedwa kwa glucose pakamwa si chizolowezi chochita, komabe, aliyense ayenera kudziwa kupindika kwa shuga kudziwa zovuta zake.

Kusanthula kuyenera kuchitika ndi matenda ashuga otsimikizika.

Ndani ayenera kuyang'aniridwa mwapadera

ShugaManWomanSanizani shuga yanu kapena sankhani jenda kuti mupeze malingaliroLevel0.58 Kuyang'ana osapezedwaTchulani zaka za manAge45 KusakaNot anapezaYambirani zaka za mkaziAge45

Kuyesedwa kwa glucose kumayesedwa makamaka kwa odwala omwe ali pachiwopsezo cha matenda a shuga a 2. Chosafunikanso kwambiri ndicho kusanthula kwa matenda a pafupipafupi kapena mosakhazikika, zomwe zimayambitsa kuphwanya kagayidwe kazakudya, kakulidwe ka shuga.

Cholinga chake ndi pa anthu omwe abale awo am'magazi ali kale ndi matenda ashuga, onenepa kwambiri, matenda oopsa ndipo amakhala ndi vuto la lipid metabolism. The endocrinologist akuwunikira kuwunikira ndi shuga kwa atherosulinotic zotupa zam'mimba, matenda a gouty, hyperuricemia, njira yayitali ya matenda a impso, mitsempha ya mtima, mtima ndi chiwindi.

Chiwopsezo chilinso chiwopsezo cha glycemia, kuthamangitsidwa kwa shuga mkodzo, odwala omwe ali ndi mbiri yoletsa kuzimiririka, atatha zaka 45, omwe ali ndi matenda osachiritsika, ma neuropathy a etiology osadziwika.

Muzochitika zomwe zawerengedwa, kuyesedwa koyenera kuyenera kuchitika ngakhale ngati zizindikiro za glycemia posala zili mkati moyenera.

Zomwe zingakhudze zotsatira

Ngati munthu akukayikiridwa chifukwa cha kutsekeka kwa glucose, insulini singasokoneze shuga yowonjezera, ayenera kudziwa kuti zinthu zingapo zimatha kukhudza zotsatira za mayeso. Mavuto ololera a glucose nthawi zina amapezeka mwa anthu opanda shuga.

Cholinga chakulekerera kwa kulolerana ndichizolowezi chomaliza kudya maswiti ndi ma confectionery, zakumwa zokoma za kaboni. Ngakhale ntchito yogwira ntchito yazida, inshuwaransi m'magazi imakwera, ndipo kukana kwake kumachepa. Kuchita zolimbitsa thupi kwambiri, kumwa mowa, kusuta fodya wamphamvu, komanso kupsinjika maganizo m'mawa wa phunziroli kungathandizenso kuchepetsa kukana kwa glucose.

Amayi oyembekezera panjira ya kusinthika adapanga njira yoteteza ku hypoglycemia, koma madokotala akutsimikiza kuti izi zimapweteketsa kuposa zabwino.

Matenda a glucose amaphatikizidwanso ndi kunenepa kwambiri, ambiri odwala matenda ashuga ndi onenepa kwambiri. Ngati munthu akuganiza za thanzi lake ndikupeza chakudya chochepa kwambiri:

apeza thupi lokongola,
kukupangitsani kumva bwino
kuchepetsa mwayi wokhala ndi matenda ashuga.

Matenda am'mimba am'mimba amathandizira kugwira ntchito kwa mayeso ololera, mwachitsanzo, malabsorption, motility.

Izi, ngakhale ndizowonetsa thupi, ziyenera kupangitsa munthu kuganizira za thanzi lawo.

Kusintha zotsatira mu njira yoyipa kuyenera kukakamiza wodwala kuti ayambenso kudya, aphunzire kudziletsa.

Udindo wa shuga m'thupi la munthu

Momwe mungapangire shuga m'thupi? Kuti muchite izi, ndikokwanira kudya maswiti, zipatso zambiri ndi ndiwo zamasamba, shuga wotsekemera kapena uchi, komanso zinthu zomwe zimakhala ndi wowuma.

Pa nthawi yomwe muli ndi pakati, ndikofunikira kuyang'anira kuwerengedwa kwa glucose

Kuti mukhale ndi mulingo woyenera wa zinthu mthupi, insulin yofunikira imafunikira, ndikupereka chokwanira. Kuchulukitsa kapena kutsika kwamtunduwu kumatanthauza kukhalapo kwa matenda oopsa, mwachitsanzo, matenda a shuga, omwe amapangidwa ndi insulin.

Kugwiritsa ntchito maswiti kapena uchi kumathandizira kukulitsa kuchuluka kwa shuga m'magazi. Izi zimagwira monga chizindikiro kuti thupi lipitirize kugwira ntchito kwa insulini kuti maselo azitha kuyamwa zinthu komanso mphamvu zomwe adalandira, komanso kuchepetsa kuchuluka kwa glucose.

Kuphatikiza apo, timadzi tating'onoting'ono timene timapangitsa kuti shuga asungidwe kwambiri ndi thupi chifukwa chomwa mphamvu kwambiri.

Chofunika kwambiri pakukhudzidwa ndi msambo. Popeza kusalinganika kwa chinthuchi kumapangitsa kukula kwa matenda omwe ali ndi pakati mwa mayi wapakati, zimabweretsa vuto pakukula kwa mwana wosabadwayo.

Pofuna kudziwa kuchuluka kwa shuga m'magazi, ntchito yapadera yotchedwa glucometer imagwiritsidwa ntchito. Itha kugulidwa modziyimira pawokha pamankhwala, mtengo wamba wa chipangizocho ndi ma ruble 700-1000. Kuphatikiza apo, muyenera kugula zingwe zapadera zoyesa, mtengo wawo umakhudzidwa ndi kuchuluka kwa phukusi ndi wopanga. Mtengo wapakati wamiloza yoyeserera ndi ma ruble 1200-1300 pazinthu 50.

Momwe mungayesere mayeso a glucose panthawi yapakati

Kuti zidziwitso za glucose zikhale zodalirika, ndikofunikira kukonzekera bwino kusanthula. Ndikofunika kuti muchepetse kuchuluka kwake kapena muchepetseni maswiti ndi makeke, zipatso ndi ndiwo zamasamba zomwe zimakhala ndi wowuma kwambiri kuchokera muzakudya masiku angapo njira isanachitike. Muyenera kuyiwalanso zakumwa zoledzeretsa (kodi mukukumbukira kuti sizikulimbikitsidwa kuledzera panthawi yapakati?!).

Kusanthula kumaperekedwa pamimba yopanda kanthu, chakudya chomaliza sichikhala mochedwa kuposa 8 pm. Pankhaniyi, amaloledwa kumwa madzi oyera opanda mafuta. M'mawa sikulimbikitsidwa kutsuka mano ndi kutafuna chingamu, chifukwa amatha kupotoza zotsatira za kusanthula.

Pofufuza, amatha kugwiritsa ntchito magazi a venous ndi magazi a capillary (kuyambira chala).

Shuga mellitus - mliri wa zaka za zana la 21

Kukula mwachangu kwa zochitika zamtunduwu kunapangitsa kukula kwa miyezo yatsopano pamankhwala komanso kuzindikira matenda a shuga. World Health Organisation idapanga mutu wa UN Resolution mu 2006. Chikalatachi chinali ndi malingaliro ku mayiko onse Amembala "kuti apange njira zamtundu uliwonse zopeweretsera matenda amtunduwu."

Zotsatira zowopsa za kufalikira kwa mliri wa matenda amtunduwu ndi kuchuluka kwa zovuta zamitsempha yamagazi. Odwala ambiri omwe ali ndi matenda a shuga amakhala ndi nephropathy, retinopathy, ziwiya zazikulu za mtima, ubongo, ndi zotumphukira za miyendo. Mavuto onsewa amadzetsa kulumala kwa odwala mwazinthu zisanu ndi zitatu mwa khumi, ndipo mwa awiriwo - zotsatira zoyipa.

Pamenepa, Federal State Budgetary Institution "Endocrinological Science Science Center of Russian Academy of Medical Science" motsogozedwa ndi Unduna wa Zaumoyo ku Russia adasintha "ma algorithms othandizira odwala omwe ali ndi hyperglycemia". Malinga ndi zotsatira za kafukufuku wamatenda omwe bungweli lakhala likuchita kuyambira 2002 mpaka 2010, titha kulankhula za kuchuluka kwakuchulukirapo kwa odwala omwe akudwala matendawa kuchulukitsa kwa odwala omwe adalembetsa maulendo anayi. Chifukwa chake, matenda a shuga ku Russia amatsimikiziridwa mwa aliyense wokhala ndi khumi ndi anayi.

Kusindikiza kwatsopano kwa Algorithms kumayang'ana kwambiri pamomwe munthu angadziwire zolinga zakuthandizira pakuwongolera kagayidwe kazachilengedwe ndi zizindikiro zamagazi. Komanso, maudindo okhudzana ndi zovuta zamitsempha yamagazi adakonzedwanso, zosintha zatsopano paziwonetsero za matenda a shuga zimayambitsidwa, kuphatikiza panthawi ya phwando.

Mfundo yoyeserera ya labotale

Monga mukudziwa, insulin ndi timadzi timene timatembenuza glucose m'magazi ndikuyenda nawo ku cell iliyonse mthupi mothandizidwa ndi mphamvu ya ziwalo zosiyanasiyana zamkati. Ndi kusakwanira katemera wa insulin, tikulankhula za matenda ashuga 1. Ngati timadzi timeneti timapangidwa mokwanira, koma mphamvu yake ya glucose imalephera, matenda a shuga a 2 amapezeka. M'magawo onsewa, kutenga mayeso a glucose kumatsimikizira kuchuluka kwa kuchuluka kwa kuchuluka kwa shuga yamagazi.

Zizindikiro zakuyang'anira

Masiku ano, kuyesa koteroko kwa maabara kungadutse kuchipatala chilichonse chifukwa cha kuphweka komanso kupezeka kwa njirayi. Ngati mukukayikira kuti chiwopsezo cha glucose chikuvuta, wodwalayo amalandila kwa dokotala ndipo amatumizidwa kukayezetsa magazi. Pomwe phunziroli limachitika, muchipatala kapena pachipatala cha payekha, akatswiri amagwiritsa ntchito njira imodzi pochita kafukufuku wa ma lableti a magazi.

Chiyeso chololera shuga nthawi zambiri chimasankhidwa kuti chidziwitse kapena kusala shuga. Pozindikira matenda a shuga, nthawi zambiri sipakufunika mayeso opsinjika. Monga lamulo, kupitilira index ya glucose m'magazi kumakhazikika mokwanira mu ma labotale.

Nthawi zambiri pamakhala zochitika zomwe kuchuluka kwa shuga m'magazi kulibe kanthu pamimba yopanda kanthu, kotero, wodwalayo, akamayezetsa magazi pafupipafupi, amakhala ndi zotsatirapo zabwino. Kuyeserera kwa shuga m'magazi, mosiyana ndi njira yodziwikiratu yoyeserera, imakupatsani mwayi wodziwa kuti insulini ingayambitse shuga ndendende pakadzaza thupi. Ngati kuchuluka kwa shuga m'magazi ndikokwera kwambiri kuposa kwazonse, koma nthawi yomweyo kuyesedwa kochitika pamimba yopanda kanthu sikuwonetsa matenda, prediabetes imatsimikiziridwa.

Madotolo amawona zochitika zotsatirazi ngati maziko a PHTT:

kukhalapo kwa zizindikiro za matenda ashuga okhala ndimayeso amtundu woyeserera, ndiye kuti, matendawa sanatsimikizidwe kale,
kubadwa kwamtundu (nthawi zambiri, matenda ashuga amatengedwa ndi mwana kuchokera kwa mayi, bambo, agogo),
kuchuluka kwa shuga m'thupi musanadye, koma palibe zizindikiro zenizeni za matendawa.
glucosuria - kukhalapo kwa shuga mumkodzo, womwe suyenera kukhala mwa munthu wathanzi,
kunenepa kwambiri komanso kunenepa kwambiri.

Nthawi zina, kuyesedwa kwa glucose kumatha kugamulidwanso. Nanga ndi ziti zomwe zingasonyeze kuwunika kumeneku? Choyamba, mimba. Kafukufukuyu amachitika mu trimester yachiwiri, mosasamala kanthu kuti miyambo yothamanga ya glycemia ndiyokwera kwambiri kapena ili mkati mwazolowera - azimayi oyembekezera onse amapitilira kuyesedwa kwa glucose popanda kusiyapo.

Kulekerera kwa glucose mwa ana

Adakali ang'ono, odwala omwe ali ndi vuto la matenda amatengedwa kuti akafufuze. Nthawi ndi nthawi, mayesowa amayenera kukhala mwana yemwe adabadwa wolemera kwambiri (woposa makilogalamu 4) komanso wonenepa kwambiri akamakula. Kusokonezeka kwa khungu ndi kuchiritsidwa koyipa kwa abrasions yaying'ono, mabala, zikanga - zonsezi komanso ndizofunikira kudziwa mulingo wa shuga. Pali ma contraindication angapo a mayeso ololera a glucose, omwe akufotokozedwa pambuyo pake, chifukwa chake, kusanthula kumeneku sikuchitika popanda kufunika kwapadera.

Kodi njira zimayenda bwanji

Kusanthula kwa ma labotale kumachitika kokha moyang'aniridwa ndi oyang'aniridwa ndi achipatala. Umu ndi momwe kuyeserera kwa shuga kumachitikira:

M'mawa, wodwala pamimba yopanda kanthu, wodwalayo amapereka magazi kuchokera m'mitsempha. Mosakhalitsa otsimikiza mtima ndende mu izo. Ngati sichidutsa muyeso, pitani pagawo lotsatira.
Wodwalayo amapatsidwa madzi otsekemera, omwe amayenera kumwa. Amakonzedwa motere: 75 g shuga limawonjezeredwa 300 ml ya madzi. Kwa ana, kuchuluka kwa glucose mu yankho kumatsimikiziridwa pamlingo wa 1.75 g pa 1 kg ya kulemera.
Pakupita maola angapo pambuyo pobweretsa madzi, magazi a venous amatengedwanso.
Mphamvu zosintha pamlingo wa glycemia zimayesedwa ndipo zotsatira za mayeso zimaperekedwa.

Kuti mupewe zolakwika komanso zolakwika, kuchuluka kwa shuga kumatsimikizika pambuyo popewa magazi. Kutenga nthawi yayitali kapena kuzizira sikuloledwa.

Kusintha kwa zotsatira zachitsanzo

Zotsatira zake zimawunikidwa poyerekeza ndi zizindikiro wamba, zomwe zimatsimikiziridwa mwa anthu athanzi. Ngati zomwe zapezeka zimaposa mitundu yomwe idakhazikitsidwa, akatswiri amafufuza bwino.

Kwa zitsanzo zam'mawa zodwala kuchokera kwa wodwala pamimba yopanda kanthu, chizolowezi chosakwana 6.1 mmol / L ndicho chizolowezi. Ngati chizindikiro sichidutsa 6.1-7.0 mmol / l, amalankhula za prediabetes. Pankhani yopeza zotsatira zopitilira 7 mmol / l, palibe kukayika kuti munthuyo ali ndi matenda a shuga. Gawo lachiwiri la kuyesaku silikuchitika chifukwa cha chiwopsezo chomwe chatchulidwa pamwambapa.

Maola angapo mutatenga njira yotsekemera, magazi ochokera m'mitsempha amatengedwanso. Pakadali pano, mtengo wosaposa 7.8 mmol / L uonedwa ngati wofanana. Zotsatira zopitilira 11.1 mmol / L ndi umboni wosaneneka wa matenda ashuga, ndipo prediabetes imapezeka ndi mtengo pakati pa 7.8 ndi 11.1 mmol / L.

Chiyeso chololera m'magazi ndi mayeso owonjezera a labotale omwe amalemba momwe mayankho a kancreas amapangira kuchuluka kwa shuga. Zotsatira za kusanthula sikungowonetsa matenda a shuga okha, komanso matenda ena amthupi osiyanasiyana. Zowonadi, kuphwanya kulekerera kwa glucose sikukuchulukitsa kokha, komanso kopanda chidwi.

Ngati shuga m'magazi ndi ocheperako, izi zimatchedwa hypoglycemia. Ngati alipo, adokotala atha kuganiza za matenda monga kapamba, kuchepa kwa magazi, komanso matenda a chiwindi. Glucose m'magazi omwe ali pansipa akhoza kukhala chifukwa cha mowa, chakudya kapena poyizoni wa mankhwala osokoneza bongo, kugwiritsa ntchito mankhwala osokoneza bongo. Nthawi zina hypoglycemia imayendera limodzi ndi kuchepa kwa magazi m'thupi. Mulimonse momwe zingakhalire, mutakhala ndi mayeso otsika a mayeso a glucose, titha kulankhula zofunikira pakuwunika njira zina zowunika.

Kuphatikiza pa matenda a shuga ndi prediabetes, kuwonjezereka kwa glycemia kumatha kuthandizanso kudziwa vuto losagwirizana ndi endocrine system, matenda a chiwindi, impso komanso matenda a mtima.

Biochemical matenda a carbohydrate kagayidwe kachakudya

Chiyeso chololera cha glucose chimafunika kuyang'anira kuchuluka kwa shuga m'magazi. Imachitika popanda kuyesetsa pogwiritsa ntchito ndalama zochepa. Kusanthula uku ndikofunika kwa odwala matenda ashuga, anthu athanzi komanso amayi oyembekezera pakadali pano.

Ngati ndi kotheka, kulolerana kwa shuga kumatha kutsimikizika ngakhale kunyumba. Phunziroli limachitika onse akulu ndi ana azaka 14. Kutsatira malamulo ofunikira kumakupatsani mwayi kuti ukhale wolondola.

Pali mitundu iwiri ya GTT:

Zosiyanasiyana za kuwunikirazi ndizosiyana ndi njira yobweretsera chakudya. Chiyeso chololera pakamwa cha glucose chimawonedwa ngati njira yosavuta yofufuzira. Mukungofunika kumwa madzi otsekemera patapita mphindi zochepa kuchokera kukhatikiza magazi koyamba.

Kuyeserera kwa glucose pogwiritsa ntchito njira yachiwiri kumachitika ndikuyika yankho mu mtsempha. Njirayi imagwiritsidwa ntchito pamene wodwala sangathe kumwa yankho lokha payekha. Mwachitsanzo, kuyeserera kwapakati pa glucose kumawonetsedwa kwa amayi apakati omwe ali ndi toxosis yayikulu.

Zotsatira zoyeserera magazi zimayesedwa patatha maola awiri kudya shuga mthupi. Malo omwe akutchulidwawa ndi mphindi yoyamba ya zitsanzo zamagazi.

Kuyesedwa kwa glucose kumayambira pakuphunzira momwe zida zobisika zimathandizira kulowa kwake m'magazi. Kuphatikiza kwa kagayidwe kazachilengedwe kamene kamakhala ndi zake. Kuti glucose akhazikike bwino, mumafunikira insulini yomwe imayang'anira mulingo wake. Kuperewera kwa insulin kumayambitsa hyperglycemia - kupitilira muyeso wa monosaccharide mu seramu yamagazi.

Mayeso osavuta komanso odalirika

Mwanjira ina, yofala, milandu (kusakwanira kwa zida zamagetsi zomwe zimapangidwa, kuchuluka kwa mahomoni otsutsana, zina), kuchuluka kwa shuga m'magazi kumatha kuwonjezeka kwambiri ndikuyambitsa mkhalidwe wotchedwa hypergikemia. Othandizira ambiri amatha kuyambitsa kuchuluka ndi kusakhazikika kwa kukhazikika kwa zinthu zokhudzana ndi hyperglycemic, komabe, chakuti chifukwa chachikulu chowonjezeka chosavomerezeka m'magazi ndimatenda a insulin sichikukayikiranso - chifukwa chake kuyesa kwa glucose, "shuga yokhazikika", GTT kapena kuyeserera kwa glucose kumagwiritsidwa ntchito kwambiri paziwonetsero za matenda a shuga. Ngakhale GTT imagwiritsidwa ntchito ndikuthandizira pakuzindikira matenda ena, nawonso.

Kuyesedwa kosavuta kwambiri komanso kotchuka kwa kulolera kwa glucose kumawerengedwa kuti ndi katundu umodzi wama chakudya omwe amamwa pakamwa. Kuwerengera kumachitika motere:

Magalamu 75 g osungunuka ndi kapu yamadzi ofunda amaperekedwa kwa munthu yemwe salemedwa ndi mapaundi owonjezera,
Kwa anthu omwe ali ndi kulemera kwakukulu, komanso amayi omwe ali ndi pakati, mlingowo umakulitsidwa mpaka 100 g (koma osatinso!),
Amayesetsa kuti asamachulukitse ana, motero manambala amawerengedwa mosamala malinga ndi kulemera kwawo (1.75 g / kg).

Pambuyo 2 maola shuga atamwa, amalamulira shuga, amatenga zotsatira za kusanthula musanayambe kuchita masewera olimbitsa thupi (pamimba yopanda kanthu) ngati gawo loyambirira. Mchitidwe wa shuga wamagazi pambuyo pakumeza "madzi" otsekemera otere sayenera kupitilira muyeso 6.7 mmol / l, ngakhale m'malo ena chizindikiro chotsika chikhoza kuwonetsedwa, mwachitsanzo, 6.1 mmol / l, chifukwa chake, mukamayala kusanthula, muyenera kuyang'anitsitsa labotale yoyeserera.

Ngati pambuyo pa maola 2-2,5 shuga atakwera kufika pa 7.8 mmol / L, ndiye kuti kufunika kwake kumapereka chifukwa cholembetsira kuphwanya kwa shuga. Pamtunda wa 11.0 mmol / L - kukhumudwitsa: glucose sakhala mwachangu momwe amagwiritsidwira ntchito, kupitilizabe kukhalabe pamitengo yapamwamba, yomwe imakupangitsani kuti muganize za matenda oyipa (DM), omwe amapatsa wodwalayo moyo WOSAKHALA wokoma - wokhala ndi mita ya shuga, zakudya, mapiritsi ndi pafupipafupi kuyendera endocrinologist.

Ndipo umu ndi momwe kusinthira kwa njira zakuzindikirazi kumawonekera pagome kutengera mkhalidwe wa kagayidwe kazachilengedwe ka magulu a anthu:

Zotsatira za kusanthula	Kuthamanga magazi a m'magazi (mmol / l)	Shuga m'magazi a capillary 2 patatha shuga, mmol / l
Mwa anthu athanzi	mpaka 5.5 (mpaka 6.1 kutengera njira)	zosakwana 6.7 (njira zina zosakwana 7.8)
Ngati kulolerana kwa glucose kumayikiridwa	pamwambapa 6.1 koma pansipa 6.7	zopitilira 6.7 (kapena m'malo ena antchito - zoposa 7.8), koma zosakwana 11.0
Kuzindikira: matenda ashuga	pamwambapa 6.7	zopitilira 11.1

Pakadali pano, pogwiritsa ntchito kutsimikiza kokhako kwa zotsatira zakuphwanya chakudya, mutha kudumphanso pamwamba pa "shuga yokhotakhota" kapena osadikirira kuti igwere mpaka pomwe ili. Pankhaniyi Njira zodalirika ndizoyesa kuchuluka kwa shuga nthawi 5 pasanathe maola atatu (1, 1,5, 2, 2,5, maola atatu mutatha kudya shuga) kapena kanayi mphindi 30 zilizonse (muyeso wotsiriza pambuyo pa maola 2).

Tikubwereranso ku funso la momwe kusanthuleku kumaperekedwera, komabe, anthu amakono sakhutitsidwanso ndikungofotokoza tanthauzo la phunziroli. Afuna kudziwa zomwe zikuchitika, zomwe zingakhudze zotsatira zomaliza komanso zomwe zikuyenera kuchitika kuti asalembetsedwe ndi endocrinologist, monga odwala omwe amapereka mankhwala aulere kwa mankhwala omwe amagwiritsidwa ntchito masiku a shuga.

Zachilendo ndi kupatuka kwa mayeso okhudzana ndi shuga

Mulingo woyeserera wowonjezera shuga uli ndi malire apamwamba a 6.7 mmol / l, mtengo woyambira wa chizindikiritso chomwe shuga amapezeka m'magazi umatengedwa ngati malire. mwa anthu athanzi labwino, limabwerera ku zotsatira zake zoyambirira, pomwe odwala matenda ashuga "amakakamira" kwambiri. Pankhaniyi, malire apansi a zikhalidwe, pazonse, kulibe.

Kutsika kwa mayeso okweza shuga (kutanthauza kulephera kwa glucose kubwerera kumalo ake a digito) kumatha kuwonetsa zochitika zosiyanasiyana za thupi, zomwe zimayambitsa kuphwanya kagayidwe kazakudya komanso kuchepa kwa kulolera kwa shuga:

Matenda a shuga a II a mtundu wachiwiri, osawonetsa zizindikiro za matendawa m'malo abwinobwino, koma amakumbukira mavuto omwe ali mthupi panthawi zovuta (kupsinjika, kuwonongeka, poyizoni ndi kuledzera),
Kukula kwa metabolic syndrome (insulin resistance syndrome), yomwe imaphatikizanso matenda oopsa a mtima (matenda oopsa, kuchepa kwa mtima, kulowetsedwa kwa myocardial), nthawi zambiri kumapangitsa munthu kufa mwadzidzidzi.
Ntchito yogwira ntchito kwambiri ya chithokomiro cha chithokomiro komanso England
Kuvutika kwamitsempha yamanjenje,
Kusokonezeka kwa kayendedwe kazoyang'anira (kuchuluka kwa zochitika m'madipatimenti imodzi) a dongosolo la ziwonetsero zamagetsi,
Matenda a gestational (panthawi yoyembekezera),
Njira zotupa (pachimake komanso zopweteka), zotulutsidwa mu kapamba.

Dziwani kuti ngakhale GTT siyoyesa mayeso a labotale, aliyense ayenera kukumbukira "zopindika za shuga" kotero kuti pazaka zina komanso panthawi zina sayenera kuphonya kukula kwa matenda oopsa monga shuga ndi metabolic. matenda Ndipo koposa zonse, muyenera kukumbukira za kuyesedwa kwa glucose koyenera panthawi yake, popeza zamatsenga zazindikira kale zofunikira, ndipo munthuyu wawonjezera gulu lowopsa.

Ndani akuwopseza kuti azilamulidwa mwapadera

Chiyeso chololera glucose, choyambirira komanso chofunikira, ndizovomerezeka kwa anthu omwe ali pachiwopsezo (kukula kwa mtundu II matenda a shuga). Zochitika zina za pathological zomwe zimakhala nthawi ndi nthawi, koma nthawi zambiri zimayambitsa kuphwanya kagayidwe kazakudya komanso kukula kwa matenda a shuga. ali mdera lapadera:

Milandu ya matenda ashuga m'banjamo (matenda ashuga achibale),
Kunenepa kwambiri (BMI - index of body more than 27 kg / m 2),
Mbiri yolemetsa yolepheretsa kubereka (kuchotsa mimbayo, kubereka, mwana wosabadwa) kapena matenda ashuga panthawi ya pakati,
Matenda oopsa a magazi (kuthamanga kwa magazi pamwamba pa 140/90 mm Hg)
Kuphwanya mafuta kagayidwe (zowonetsa ma lipid sipekitiramu),
Vuto la kuwonongeka kwa mtima
Hyperuricemia (kuchuluka kwa uric acid m'magazi) ndi gout,
Kuchulukitsa kwakanthawi kwamasamba a mkodzo ndi mkodzo (wokhala ndi nkhawa yamaganizidwe, ma opaleshoni, njira zina) kapena kuchepa kwamkati kosasintha pamlingo wake,
Kutalika kwa matenda a impso, chiwindi, mtima ndi mtsempha wamagazi.
Kuwonetsedwa kwa metabolic syndrome (zosankha zingapo - kunenepa kwambiri, matenda oopsa, matenda a lipid metabolism, kuwundana kwamagazi),
Matenda opatsirana
Neuropathy wa komwe sikudziwika,
Kugwiritsa ntchito mankhwala a diabetogenic (okodzetsa, mahomoni, ndi zina),
Zaka ndi zaka 45.

Kuyesedwa kwa glucose pamavuto awa ndikofunikira kuchita, ngakhale kuti shuga m'magazi omwe atengedwa pamimba yopanda kanthu sikupitilira zomwe zimadziwika.

Zomwe zimakhudza zotsatira za GTT

Munthu yemwe amakayikiridwa chifukwa chololeza glucose kuvomerezeka ayenera kudziwa kuti zinthu zambiri zimatha kusintha zotsatira za "curve", ngakhale atakhala kuti matenda a shuga saopsezedwa:

Ngati mumadzilimbitsa thupi ndi ufa, makeke, maswiti, mchere wambiri ndi zinthu zina zotsekemera tsiku ndi tsiku, ndiye kuti shuga wolowa m'thupi sangakhale ndi nthawi yogwiritsira ntchito popanda kuyang'ana ntchito yayikulu ya zida zamagetsi, ndiye kuti kukonda zakudya zotsekemera zitha kuwonetsedwa pakuchepa kwa kulolera kwa shuga,
Kuchulukitsa kwamisempha (maphunziro ndi othamanga kapena olimbikira ntchito), omwe sanathetsedwe tsiku lisanafike komanso patsiku lowunikira, zingayambitse kuloleza kwa glucose komanso kusokoneza zotsatira,
Okonda utsi wa fodya amakhala pachiwopsezo chokhala ndi mantha chifukwa "chiyembekezo" chophwanya chakudya cha carbohydrate metabolism chitha kutuluka tsiku loti pasakhale chidziwitso chokwanira chosiya chizolowezi choyipa. Izi ndizofunikira kwambiri kwa iwo omwe mayeso asanasunthidwe amasuta ndudu zingapo, kenako ndikumathamangira kumalo osungirako mankhwalawo, pomwepo zimakupweteketsani kawiri (musanatenge magazi, muyenera kukhala kwa theka la ola, kupumula ndikukhala odekha, chifukwa chofotokozedwa kupsinjika kwa m'maganizo zimatithandizanso kupotoza zotsatira),
Pa nthawi yoyembekezera njira yoteteza yomwe idapangidwa pakusintha kwa hypoglycemia imayatsidwa, yomwe, malinga ndi akatswiri, imabweretsa mwana wosabadwayo kuvulaza koposa dziko la hyperglycemic. Pankhaniyi, kulolera kwa glucose mwachilengedwe kumatha kuchepetsedwa pang'ono. Zotsatira "zoyipa" (kuchepa shuga m'magazi) ndikothekanso kuvomereza kusintha kwamankhwala pakuwonetsa metabolism ya carbohydrate, zomwe zimachitika chifukwa mahomoni a kapamba a mwana amene wayamba kugwira ntchito, akuphatikizidwa pantchito,
Kulemera kwambiri - Chizindikiro sichingakhale chathanzi, onenepa ali pachiwopsezo cha matenda angapo, pomwe matenda ashuga, ngati satsegula mndandandawo, sakhala malo omaliza. Pakadali pano, kusintha zotsatira zoyesa sizabwino chifukwa cha anthu omwe ali ndi mapaundi owonjezera, koma osadwala matenda ashuga. Mwa njira, odwala omwe adagwira nthawi ndikuyamba kudya kwambiri sanakhale ochepa komanso okongola, komanso adasiya kutsatira mndandanda wa odwala omwe angadzadwalitse endocrinologist (chinthu chachikulu sichakuti asaleke kutsatira zakudya zabwino),
Miyezo yololera ya glucose imathanso kukhudzidwa. mavuto am'mimba (chosokoneza mafuta ndi / kapena mayamwidwe).

Zinthu zomwe tatchulazi, zomwe ngakhale zimagwirizanirana (mosiyanasiyana) kuzowonekera kwamthupi, zitha kupangitsa munthu kukhala wamantha kwambiri (ndipo mwina sangatero pachabe). Kusintha zotsatira sikutha kunyalanyazidwa nthawi zonse, chifukwa kufunitsitsa kokhala ndi moyo wathanzi kumagwirizana ndi zizolowezi zoipa, kapena kunenepa kwambiri, kapena kulephera kuyendetsa bwino malingaliro anu.

Thupi limatha kupirira kukhudzika kwanthawi yayitali pachinthu chosasangalatsa, koma kusiya nthawi inayake. Ndipo kuphwanyidwa kwa kagayidwe kazakudya sikungakhale kopeka, koma zenizeni, komanso kuyesa kwa glucose kungathe kutsimikizira izi. Zowonadi, ngakhale mkhalidwe wakuthupi kwambiri monga mimba, koma kumapitirira ndi kulolerana kwa glucose, amatha kutha ndi matenda ena (shuga mellitus).

Momwe mungayesere kuyeserera kwa glucose kuti mupeze zotsatira zoyenera

Kuti mupeze zotsatira zodalirika za kuyesedwa kwa glucose, munthu amene ali mawa lake kupita ku labotale ayenera kutsatira malangizo osavuta:

Masiku atatu lisanachitike phunziroli, ndikosayenera kusintha kena kake m'moyo wanu (njira yantchito ndi kupuma, chizolowezi chochita masewera olimbitsa thupi popanda changu chokwanira), komabe, mankhwalawa amayenera kuwongoleredwa pang'ono ndikutsatira kuchuluka kwa chakudya chamagetsi omwe adalimbikitsidwa ndi adokotala patsiku (≈125 -150 g) ,
Chakudya chomaliza musanayambe kuphunzira chisanathe maola 10,
Popanda ndudu, khofi ndi zakumwa zoledzeretsa, muyenera kupitiliza pafupifupi theka la ola (maola 12),
Simungathe kudzilimbitsa nokha ndi masewera olimbitsa thupi (masewera ndi zina zosangalatsa zimayenera kukhazikitsidwa kwa tsiku limodzi kapena awiri),
Ndikofunikira kuthamangira pakumwa mankhwala ena (okodzetsa, mahomoni, ma antipsychotic, adrenaline, tiyi kapena khofi) dzulo,
Ngati tsiku la kusanthula likugwirizana ndi msambo mu msambo mwa akazi, phunziroli liyenera kuyambiranso
Kuyesako kungawonetse zotsatira zolakwika ngati magazi adaperekedwa panthawi yamalingaliro mwamphamvu, atachitidwa opaleshoni, mkati mwa njira yotupa, ndi matenda a chiwindi (zakumwa zoledzeretsa), zotupa za kutupa kwa hepatic parenchyma ndi matenda am'mimba otayika.
Mitengo yolakwika ya digito ya GTT imatha kutha ndi kuchepa kwa potaziyamu m'magazi, kuphwanya kwa magwiridwe antchito a chiwindi ndi endocrine pathology.
Mphindi 30 asanafike pakutsata magazi (kuchokera pachala), munthu wobwera kudzayesedwa amakhala pansi osakhazikika ndikuganiza za chinthu china chabwino.

Muzochitika zina (zokayikitsa), kutsitsa kwa glucose kumachitika ndikuyiyendetsa pamitsempha, ikayenera kuchitika motere - adokotala asankha.

Kodi kusanthula bwanji?

Kuwunika koyamba kumaperekedwa pamimba yopanda kanthu (zotsatira zake zimatengedwa ngati gawo loyambirira), kenako zimapatsa shuga kuti amwe, kuchuluka kwake komwe kumayikidwa molingana ndi momwe wodwalayo alili (mwana, munthu onenepa kwambiri, pakati).

Kwa anthu ena, madzi otsekemera a shuga amatengedwa pamimba yopanda kanthu angayambitse nseru. Kuti mupewe izi, ndikofunikira kuwonjezera kuchuluka kwa citric acid, komwe kungalepheretse zomverera zosasangalatsa. Pa zolinga zomwezi, zipatala zamakono zimatha kupereka mtundu wa glucose kugwedezeka.

Mukamwa “chakumwa” cholandilidwa, munthu amene akuyesedwayo amapita “kukayenda” kutali ndi labotale. Kuwunikira kotsatira kukafika, ogwira ntchito azaumoyo adzanena, zimatengera nthawi yayitali bwanji ndikuwunika kwawo kumachitika pafupipafupi (theka la ola, ola limodzi kapena awiri? 5, 4, 2, kapena ngakhale kamodzi?). Zikuwonekeratu kuti odwala ogona amagona mu "dipatimenti ya shuga" mu dipatimenti yothandizira (wogwira ntchito yothandizira) amabwera yekha.

Pakadali pano, odwala ena amafunitsitsa kuti ayesetse kuchititsa maphunziro pawokha, osachoka panyumba. Chabwino, pamlingo wina, kusanthula shuga kunyumba kumatha kuonedwa ngati kutsanzira kwa TGG (kusala ndi glucometer, kadzutsa kofanana ndi magalamu 100 a chakudya, kuwongolera kukwera ndi kuchepa kwa shuga). Inde, wodwala ndibwino kuti asawerengere ma coefficients omwe atanthauziridwa kutanthauzira kwa ma glycemic ma curve. Amangodziwa zofunikira zomwe zimayembekezeredwa, ndikuzifanizira ndi phindu lomwe adapeza, amalemba kuti zisaiwale, ndipo pambuyo pake amadziwitsa adotolo za iwo kuti afotokozere mwatsatanetsatane chithunzi cha matendawo.

Mu labotale, glycemic yokhotakhota itayesedwa pambuyo poyesedwa kwa magazi kwakanthawi ndikuwonetsa chiwonetsero cha glucose (kuwuka ndi kugwa) kuwerengetsa hyperglycemic ndi ma coefficients ena.

Coefficient ya Baudouin (K = B / A) imawerengeredwa potengera kuchuluka kwa kuchuluka kwa glucose okwera kwambiri (pachimake) panthawi yophunzira (B - max, numerator) kufikira ndende yoyambirira ya shuga yamagazi (Aisk, kudya chosimba). Nthawi zambiri, chizindikirochi chili mu mitundu 1.3 - 1.5.

Rafalsky coefflication, yomwe imatchedwa post-glycemic, ndiyo kuchuluka kwa kuchuluka kwa glucose patatha maola 2 munthu atamwa madzi ozizira amadzimadzi (manambala) omasulira a shuga. Kwa anthu omwe sadziwa mavuto ndi kuphwanya kagayidwe kazakudya, chizindikirochi sichikupitilira zomwe zimakhazikitsidwa (0.9 - 1.04).

Zachidziwikire, wodwalayo mwiniwake, ngati angafunenso, atha kukonza, kujambula china chake, kuwerengera ndikuganiza china chake, koma ayenera kukumbukira kuti mu labotale, njira zina (zamankhwala amuzolengedwa) zimagwiritsidwa ntchito kuyeza kuchuluka kwa mafuta pakanthawi ndikupanga chiwembu. . Glucometer yomwe imagwiritsidwa ntchito ndi anthu odwala matenda ashuga imapangidwira kuti iwunikidwe mwachangu, chifukwa chake, kuwerengera kwake kuzomwe akuwonetsa kungakhale kolakwika komanso kungosokoneza.

Zoyambitsa ndi zizindikiro

Pamene vuto la carbohydrate metabolism likachitika, kulolerana kwa shuga kumawonedwa. Ichi ndi chiyani NTG imayendera limodzi ndi kuwonjezeka kwa shuga m'magazi kuposa pamenepa, koma osati mopitirira muyeso wa matenda ashuga. Izi zimagwirizana ndi njira yayikulu yodziwira matenda a metabolic, kuphatikiza matenda a shuga a 2.

Ndizosangalatsa kuti masiku ano, NTG imatha kupezeka ngakhale mwana. Izi zimachitika chifukwa cha vuto lalikulu la anthu - kunenepa kwambiri, komwe kumayipitsa thupi la ana. M'mbuyomu, matenda ashuga akadali achichepere adayamba chifukwa cha chibadwidwe, koma tsopano matendawa ayamba kukhala chifukwa chamakhalidwe osayenera.

Amakhulupirira kuti zinthu zosiyanasiyana zimatha kupangitsa izi. Izi zimaphatikizira kubadwa kwa genetic, kukana insulini, mavuto a kapamba, matenda ena, kunenepa kwambiri, kulephera kuchita masewera olimbitsa thupi.

Chimodzi mwa zoyipitsidwa ndi njira ya asymptomatic. Zizindikiro zowopsa zimawoneka ndi matenda amtundu wa 1 ndi mtundu wa 2. Zotsatira zake, wodwalayo sachedwa kuthandizidwa, osadziwa mavuto azaumoyo.

Nthawi zina, m'mene NTG imakulira, zizindikilo za matenda a shuga zimawonetsedwa: ludzu lalikulu, kumva pakamwa pouma, kumwa kwambiri, komanso kukodza pafupipafupi. Komabe, zizindikiritso zotere sizikhala gawo zana latsimikiziro lodziwikiratu.

Kodi zizindikiro zomwe zalandiridwa zikutanthauza chiyani?

Mukamayesa mayeso okhudzana ndi glucose pakamwa, chinthu chimodzi chiyenera kuganiziridwa. Magazi ochokera mu mtsempha mu zochitika wamba amakhala ndi monosaccharide pang'ono kuposa magazi amtundu wotengedwa kuchokera kumunwe.

Kutanthauzira koyesedwa kwa magazi pakamwa kwa glucose kumawunikidwa malinga ndi mfundo zotsatirazi:

Mtengo wabwinobwino wa GTT ndiye glucose wamagazi 2 patatha kukhazikitsidwa kwa zotsekemera sizidutsa 6.1 mmol / L (7.8 mmol / L wokhala ndi sampuli yamagazi venous).
Kulekerera kwapakati - chisonyezo pamwamba pa 7.8 mmol / L, koma ochepera 11 mmol / L.
Odwala matenda ashuga mellitus - mitengo yayikulu, yomwe ndi yoposa 11 mmol / L.

Njira imodzi yowunikira ili ndi zovuta zina - mutha kudumpha kuti muchepetse shuga. Chifukwa chake, zambiri zodalirika zimapezeka poyesa shuga mu nthawi 5 mumaola atatu kapena 4 pa theka lililonse la ola. Shupe yokhotakhota, yomwe nthawi zambiri siyenera kupitirira kuchuluka kwa 6.7 mmol / l, mwa anthu odwala matenda ashuga amasungunuka kwambiri. Pankhaniyi, phala la shuga lathyathyathya limawonedwa. Pomwe anthu athanzi amawonetsa mofulumira.

Zizindikiro ndi zotsutsana kwa GTT

Zisonyezero za mayeso:

Mlozera wamasamba ambiri ndi wofanana ndi 30 kg / m2 kapena kupitilira chizindikiro ichi,
Kubadwa kwa mwana wamkulu (wolemera zoposa makilogalamu anayi) m'mimba yapitayi,
kuthamanga
matenda a mtima
mbiri yakubala,
shuga m'modzi mwa abale,
matenda ashuga okalamba m'mbuyomu
fibroids, thumba losunga mazira la polycystic kapena endometriosis musanakhale ndi pakati.

Nthawi yomweyo, GTT siyikulimbikitsidwa pazinthu zotsatirazi:

Ndi toxicosis (zambiri za toxicosis nthawi yapakati >>>),
pambuyo pa opaleshoni pamimba chifukwa cha malabsorption,
zilonda zam'mimba komanso kutupa kwam'mimba
mu pachimake matenda opatsirana kapena kutupa mthupi,
ndi matenda amtundu wa endocrine,
mukamamwa mankhwala omwe amasintha shuga.

Njira zoyesera magazi ndi zigawo zake

Tiyenera kunena nthawi yomweyo kuti ndikofunikira kutsimikizira zowerengera zikuzindikira kuti magazi omwe adasanthulidwa panthawi yoyesedwa.

Mutha kulingalira magazi onse a capillary komanso magazi a venous. Komabe, zotsatira sizosiyana kwambiri. Chifukwa chake, mwachitsanzo, ngati tiwona zotsatira za kusanthula magazi kwathunthu, ndiye kuti zidzakhala zochepa poyerekeza ndi zomwe zimapezeka panthawi yoyesa zigawo zamagazi zomwe zimapezeka kuchokera ku mtsempha (plasma).

Ndi magazi athunthu, zonse ndi zomveka: adalasa chala ndi singano, adatenga dontho la magazi kuti liwunikidwe bwino. Pazifukwa izi, pamafunika magazi ambiri.

Ndi venous ndizosiyana pang'ono: zitsanzo zoyambirira za magazi kuchokera mu mtsempha zimayikidwa mu chubu choyesera chozizira (ndikwabwino, ndithudi, kugwiritsa ntchito chubu yoyesera, ndiye kuti makina owonjezera omwe asungidwe magazi sangakhale ofunika), omwe ali ndi mankhwala osungirako omwe amakupatsani mwayi kuti mupulumutseni sampuli mpaka mayeso omwe. Ili ndi gawo lofunikira kwambiri, chifukwa zinthu zosafunikira siziyenera kusakanikirana ndi magazi.

Zosungidwa zingapo nthawi zambiri zimagwiritsidwa ntchito:

6mg / ml yonse ya sodium fluoride

Imachepetsa ma enzymatic njira m'magazi, ndipo panthawi imeneyi imawaletsa. Chifukwa chiyani izi ndizofunikira? Choyamba, magazi samayikidwa pachabe mu chubu chozizira. Ngati mudawerengapo kale nkhani yathu ya hemoglobin ya glycated, ndiye kuti mukudziwa kuti kutentha, "hemoglobin" ndi "shuga", magazi atakhala ndi shuga wambiri kwa nthawi yayitali.

Kuphatikiza apo, chifukwa cha kutentha komanso kugwiritsa ntchito mpweya, mpweya umayamba “kuzimiririka” mwachangu. Amasungunuka, amakula poizoni. Pofuna kupewa izi, kuphatikiza ndi sodium fluoride, chophatikizira china chimawonjezeredwa ku chubu choyesera.

Zimasokoneza kuchuluka kwa magazi.

Kenako chubu chimayikidwa pa ayezi, ndipo zida zapadera zimakonzedwa kuti zigawike magazi kukhala zigawo zikuluzikulu. Plasma ndiyofunikira kuti ipangidwe pogwiritsa ntchito centrifuge ndipo, pepani chifukwa cha tautology, kuphatikiza magazi. Plasma imayikidwa mu chubu china choyesera ndipo kuwunika kwake mwachindunji kwayamba kale.

Zachinyengo zonsezi ziyenera kuchitika mwachangu ndipo mkati mwakanthawi kamphindi makumi atatu. Ngati plasma yapatulidwa pambuyo pa nthawi iyi, ndiye kuti kuyesa kungaganizidwe kwalephera.

Kuphatikiza apo, ponena za kusanthula kwina kwa magazi a capillary ndi venous. Laborator angagwiritse ntchito njira zosiyanasiyana:

glucose oxidase njira (masiku 3.1 - 5.2 mmol / lita),

Kuti tizinena mosavuta komanso mosakhazikika, zimakhazikika pa enzymatic oxidation ndi shuga oxidase, pamene hydrogen peroxide imapangidwa kumalo ogulitsira. Orthotolidine yopanda utoto, mothandizidwa ndi peroxidase, amapeza mtundu wowoneka bwino. Kuchuluka kwa tinthu tina tokhala ngati utoto "kumayankhula" zamagalasi. Zochulukirapo za izo, zimachulukanso kuchuluka kwa shuga.

Njira ya orthotoluidine (masiku 3.3 - 5.5 mmol / lita)

Ngati poyambirira pali makutidwe a okosijeni malinga ndi enzymatic reaction, ndiye kuti izi zimachitika mwa acidic sing'anga ndipo mphamvu yake imachitika mothandizidwa ndi mankhwala onunkhira ochokera ku ammonia (iyi ndiye orthotoluidine). Zomwe organic zimachitika, zimachitika chifukwa cha zomwe glucose aldehydes imatulutsa. Ma machulukidwe amtundu wa "momwe" yankho limayambira akuwonetsa kuchuluka kwa shuga.

Njira ya orthotoluidine imawonedwa yolondola kwambiri, motero, imagwiritsidwa ntchito kwambiri pakuwunika magazi ndi GTT.

Mwambiri, pali njira zambiri zodziwira glycemia omwe amagwiritsidwa ntchito poyesa ndipo onse agawidwa m'magulu akulu akulu: colometric (njira yachiwiri, yomwe tidawunikira), enzymatic (njira yoyamba, yomwe tidawunikira), reductometric, electrochemical, strips test (yogwiritsidwa ntchito mu glucometer ndi ena ojambula ojambula)

Magazi a venous 2 patatha maola 2 mutatha chakudya

kuzindikira	mmol / lita
chizolowezi	Kuyesedwa kwa glucose kwamimba - kufunikira koyenera kapena kuyesedwa kosafunikira

Cholinga cha kafukufuku wamtunduwu kwa mayi woyembekezera m'mayi ambiri chimayambitsa vuto ndipo izi ndizomveka. Mchitidwewo nthawi zambiri umayambitsa kusasangalala ndi mseru, chizungulire. Kuphatikiza apo, kuyesa kwamphamvu kwa shuga kumachitika m'mawa, kwa maola angapo (pafupifupi 3). Pakadali pano (komanso tsiku lakale pokonzekera phunziroli), zakudya zamtundu uliwonse siziyenera kuyikidwa pambali, zomwe zokhala ndi "woyembekezera" nthawi zambiri zimabweretsa zovuta zina. Ndi chifukwa chomwechi azimayi ambiri “otsogola” amakana kuphunzira.
Kodi chifuno cha kusanthula kwamtunduwu ndi chovomerezeka motani?

Kulekerera kwa glucose pa nthawi yapakati. Ndani ali pachiwopsezo

Mwa zinthu zowopsa zomwe zimafunikira kuwunika kowonjezerapo ngati mayeso apezeke kulolera kwa shuga, pali:

Kukwanira kokwanira kwa mayi wapakati (index index imapitirira 30).
Pa kuyesedwa kwa magazi kwa shuga, komwe kunachitika pomwe mayi wapakati amalembetsa, kuphatikiza kwa glucose m'magazi kunalembedwa chizindikiro choposa 5.1 mmol / l.
Mbiri yakusokonekera kwa matenda ashuga yomwe ilipo (pakalepi).
Kusanthula kwa mkodzo kunawonetsa kupezeka kwa shuga mumkodzo panthawi yapakati.
Kupezeka kwa wachibale wapakati (wapafupi) wokhala ndi matenda a shuga.
Mayi wamtsogolo amakhala ndi mwana wosabadwa wamkulu, kapena panali kubadwa kwa mwana wamkulu m'mbuyomu.
Zaka za mayi woyembekezera "zidadutsa" pakhomo la zaka 35.

Kukhalapo kwa chimodzi mwazinthu zomwe zatchulidwa pamwambapa ndi umboni wovomerezera mayeso ololera. Kuphatikiza apo, kupezeka kwa “zomwe zikukulitsa” nthawi zambiri kumakhala kotsimikiza popanga kafukufuku wolekerera shuga kawiri - mkazi akamafunsira kulembetsa (kusanthula kwakanthawi kozindikira zomwe zili ndi shuga) komanso munthawi yachiwiri ya kubereka.

Kuyesa kwa glucose pamimba: Kukonzekera mayeso

Kukonzekera koyenera kusanthula ndi chimodzi mwazofunikira kwambiri pazotsatira zofufuzira zodalirika.

Masiku ochepa (masiku atatu akukwanira) mayeso, mayi woyembekezera asamachotsere zakudya zake zonse zonona, zonunkhira, khofi, makeke komanso nyama zosuta. Mwa njira, mkazi "pamudindo" sayenera kugwiritsa ntchito zinthu zabwino nthawi yonseyi. Chakudya chosalowerera ndendende ndi bwino.
Kumwa mankhwala kumathanso kukhudza zotsatira za phunziroli, zomwe zimabweretsa zotsatira zabodza. Makamaka mawu awa amagwira ntchito: multivitamini, mankhwala okhala ndi chitsulo, mankhwala ochepetsa kuthamanga kwa magazi, okodzetsa, mahomoni acorticosteroid. Mukamamwa mankhwala aliwonse, mayi woyembekezera ayenera kudziwitsa adokotala za mankhwalawo.
Ndikofunika kwambiri kusungitsa zochitika zamagalimoto nthawi zonse, kuti 'musagone pansi', koma osakhala achangu kwambiri.
Chakudya chomaliza patsiku lachiyeso chiyenera kuchitika pafupifupi maola 8 (makamaka maola 10 mpaka 14). Munthawi imeneyi, mumatha kumwa madzi okha.
Amaletsedwanso kusuta ndi kudya mowa (womwe umaphatikizidwa kwa amayi apakati).
Mano amayenera kukhala otenthetsedwa usiku. Musanadutse kuwunikirako, ndibwino kudumphadumpha njira za ukhondo, chifukwa zida zina zamano zitha kupotoza zotsatira zoyesa.
Yesetsani kuti musakhale ndi chisangalalo chochulukirapo komanso zochitika zopsinja.

Mlingo wa glucose panthawi yapakati: kuchepa kwa zotsatira zoyeserera

Kutanthauzira kwa zotsatira zoyeserera kumadalira deta yomwe yapezeka chifukwa cha kuyeza kwapakati katatu kwa mulingo wothandizidwa ndi shuga m'magazi. Kuganizira zotsatira zake, mutha kudalira zotsatirazi:

1. Zizindikiro za kuchuluka kwa shuga mumagazi pazomwe zimapezedwa kwachilengedwe pamimba yopanda kanthu ndipo ndi:

pansipa ya 5.1 - 5.5 mmol / l (poganizira za ma labotale) - zofunikira,
m'magawo a 5.6 - 6.0 mmol / l - kupatuka pakukakamira kwa shuga,
6.1 mmol / L kapena kuposerapo ndikukayikira kwa matenda ashuga (m'mabotolo angapo chizindikiro ichi chiri m'mitundu 7 mmol / L ndi kutalika).

2. Kuyeza kwa kuphatikiza shuga pambuyo mphindi 60 pambuyo pakupangika kowonjezereka kwa chakudya chamafuta:

zosakwana 10 mmol / l - monga,
m'magawo a 10.1 - 11.1 mmol / l - kupatuka pakukhululuka kwa shuga,
11.1 mmol / L kapena kuposerapo - anthu omwe akuwaganizira kuti ali ndi matenda ashuga.

3. Kukhazikika kwa shuga mumphindi 120 pambuyo pobweza shuga:

zosakwana 8.5 mmol / l zimawonetsa zofananira,
m'magawo a 8.6 - 11.1 mmol / l - kupatuka pakukakamira kwa shuga,
11.1 mmol / L ndipo pamwambapa ndikupatuka koonekera, mwina matenda a shuga.

Kulemba kwake kumatenga nthawi yayitali bwanji

Nthawi yabwino kwambiri ya njirayi imawerengedwa kuti ndi mwezi wa 6-7. Nthawi zambiri, mayeserowa amatengedwa pakadutsa milungu 25 mpaka 29.

Ngati msungwanayo akuwonetsa kuti ali ndi vuto, awerenge nthawi imodzi:

Mu gawo loyambirira la bere, kuyesa kwa glucose kumayesedwa kwa masabata 15-19.
Mu trimester yachiwiri kwa masabata 25-29.
Mu nyengo yachitatu, mpaka milungu 33 ya bere.

Zambiri

Glucose ndi chakudya chophweka chomwe chimapangidwa ndi zakudya wamba ndikuphatikizidwa m'magazi m'matumbo aang'ono. Ndiamene amapatsa dongosolo lamanjenje, ubongo ndi ziwalo zina zamkati ndi machitidwe a thupi ndi mphamvu. Kuti mukhale ndi thanzi labwino komanso zipatso zambiri, milingo ya glucose iyenera kukhazikika. Mahomoni a pancreatic: insulini ndi glucagon amawongolera kuchuluka kwake m'magazi. Ma mahomoni awa ndi okana - insulin kutsitsa shuga, ndipo glucagon, m'malo mwake, imawonjezera.

Poyamba, kapamba amatulutsa molekyulu ya proinsulin, yomwe imagawidwa m'magawo awiri: insulin ndi C-peptide. Ndipo ngati insulin itatha kukhala m'magazi kwa mphindi 10, ndiye kuti C-peptide imakhala ndi moyo wautali - mpaka mphindi 35 mpaka 40.

Chidziwitso: mpaka posachedwa, amakhulupirira kuti C-peptide ilibe phindu kwa thupi ndipo sichita ntchito iliyonse. Komabe, zotsatira za kafukufuku waposachedwa zawonetsa kuti mamolekyulu a C-peptide ali ndi ma receptor enaake pamtunda omwe amalimbikitsa kutuluka kwa magazi. Chifukwa chake, kutsimikiza kwa mulingo wa C-peptide kukhoza kugwiritsidwa ntchito bwino kuti mupeze zovuta zobisika za kagayidwe kazakudya.

Mukamachita GTT

M'badwo	Mkhalidwe wathanzi	Pafupipafupi
zaka zopitilira 45	kuchuluka kwa thupi kusowa kwa ziopsezo	1 mu zaka 3 ndi zotsatira zabwinobwino
woposa zaka 16	kukhalapo kwa chimodzi mwazinthu zowopsa kuchuluka kwa thupi makilogalamu oposa 25 kg / m2	1 mu zaka 3 ndi zotsatira zabwinobwino Kamodzi pachaka chifukwa cha kupatuka pa chizolowezi

Momwe mungawerengere BMI

BMI = (misa, kg): (kutalika, m) 2

Makhalidwe ndi abwinobwino (palibe shuga)

Kuthamanga shuga	4.1 - 5.9 mmol / L
Glucose pambuyo mphindi 30 pambuyo shuga	6.1 - 9.4 mmol / L
Mafuta pambuyo pa mphindi 60 pambuyo shuga	6.7 - 9.4 mmol / L
Mafuta atatha mphindi 90 pambuyo shuga	5.6 - 7.8 mmol / L
Mafuta pambuyo pa mphindi 120 pambuyo shuga	4.1 - 6.7 mmol / l

Zolepheretsa GTT kwa Amayi Oyembekezera

Kuyeserera kwa glucose panthawi yoyembekezera kumaletsedwa panthawi yomwe wodwala:

ili pagawo la matenda opatsirana owopsa,
amamwa mankhwala omwe amakhudzika ndi shuga wa magazi,
adafikira trimester yachitatu (masabata 32).

Nthawi yocheperako pambuyo poti matenda asamutsidwa kapena mankhwala atachotsedwa komanso ngati kuyezetsa ndi masiku atatu.

Zomwe zimalepheretsa kuwunikidwanso ndikuwonjezera shuga m'magazi omwe amamwa kwa wodwala m'mawa pamimba yopanda 5.1 mmol / l).

Komanso, kusanthula sikumachitika ngati wodwala ali ndi matenda opatsirana komanso otupa.

Zolemba zochepetsa shuga

Zizindikiro zakuchepa kwa glucose m'thupi zitha kuwonedwa panthawi inayake masana (m'mawa kapena madzulo), ndipo kuuma kwawo kumatengera kuchuluka kwa kutsika kwa shuga m'magazi. Ngati mtengo wa shuga wagwera mpaka 3,4 mmol / l, ndiye kuti munthu akumva kukwiya, kutsika kamvekedwe, kuchepa kwa ntchito ndi kufooka wamba kapena kufooka. Monga lamulo, kukonza vutoli, ndikokwanira kumwa chakudya cham'thupi.

Ngati kusowa kwa shuga kumayenderana ndi kukula kwa matenda ashuga, wodwalayo amamva:

kuwonongeka kwakuthwa,
kuphwanya kwa thermoregulation ndipo, chifukwa chake, kutentha kapena kuzizira.
kutuluka thukuta kwambiri
kupweteka mutu komanso chizungulire,
kufooka kwa minofu
kuchepa kwa chidwi ndi kukumbukira,
kudya pafupipafupi, ndi nseru nditadya
dontho mu zowoneka bwino.

Zochitika zowawa zimatsatiridwa ndi kukomoka, kugunda kwamphamvu, kukomoka, kukomoka, ndi kupweteka. Ndikofunika kulipira mosamala panthawi yowonekera kwambiri kwa hypoglycemia ndikupereka chithandizo chamankhwala chofunikira.

Kuyesedwa kwa glucose kumawonetsa zotsika ngati:

wodwalayo amatenga mankhwala omwe amathandizira kuchepetsa shuga wambiri, monga insulin,
wofunsidwa akuwonetsa insulinoma. Matendawa amaphatikizidwa ndi kupangika kwa neoplasm, yomwe imayamba kugwira mwachangu chinthu chofanana ndi insulin. Gawo limodzi mwa magawo atatu a neoplasms limapezeka mu mawonekedwe oyipa ndi kufalikira kwa metastases. Matendawa amakhudza anthu azaka zilizonse: kuyambira akhanda mpaka okalamba.

Kukula kwa zotsatirazi kumatengera mtundu wa chotupacho, chokhala ndi chisonyezo - kuchira kwathunthu kumawonedwa. Ma neoplasms owopsa omwe ali ndi metastases amathandizira kwambiri matendawa. Komabe, ziyenera kutsimikiziridwa pamlingo wapamwamba wamalingaliro amtundu wamtundu wazomwe zimachitika chifukwa cha mankhwala a chemotherapeutic.

Kuchepa kwa zinthu kumalembedwanso pambuyo poti wodwalayo atadwala nthawi yayitali kapena atachita masewera olimbitsa thupi kwambiri. Kuzindikira kwa zotsatira zotere ndizochepa. Mphamvu ya zinthu zakunja pazazinthu zachilengedwe yazinthu zakufa siziyenera kuphatikizidwa ndipo kafukufukuyo amangobwerezedwa.

Kodi phunziroli likufunika?

Kuyesedwa kwa GTT panthawi yapakati ndikofunikira kwa azimayi onse omwe ali ndi udindo. Izi ndichifukwa choti matenda amiseche amapezeka mwa iwo 14 mwa milandu. Ambiri molakwika amakhulupirira kuti izi zimangowonjezera kukula kwa khanda ndipo, monga chotulukapo, zimabweretsa kubadwa kovuta.

Koma izi sizovuta zonse zomwe matendawa amatulutsa.

Komanso, zimasokoneza thanzi la mayi ndi mwana. Kuperewera kwa insulin kosalamulirika kumayambitsa mavuto a mtima, chiwindi, impso ndi ubongo. Mtundu wonyalanyaza wa matendawa ungachititse kuti musokonezeke komanso kubadwa kwa mwana wakufa.

Zizindikiro zomwe zimawonetsa matenda ashuga

Kuwunikira kwa GTT ndiye kuyesa kwakukulu komwe kumathandizira kuzindikira kuphwanya kwamphamvu kwa carbohydrate panthawi yapakati.

Kuzindikiritsidwa kwa matenda ashuga kumatsimikiziridwa pamaso pa zosachepera 2 mwa zizindikiro zotsatirazi:

mayeso opanda kanthu m'mimba adawonetsa kuchuluka kwa shuga oposa 5.3 mmol / l,
phunziroli 1 ola pambuyo shuga atawulula kuchuluka kwa 10.0 mmol / l,
kuyezetsa magazi maola 2 atatha kugwiritsa ntchito njira yapadera yowonetsa 8.6 mmol / l,
Zambiri zomwe zapezeka pambuyo pa maola atatu kupitilira 7.7 mmol / L.

Ngati, pamiyeso yoyamba ya magazi, mayi woyembekezerayo anali ndi index ya shuga 7.0 mmol / l, ndiye kuti matenda a shuga wokhazikika amakhazikitsidwa nthawi yomweyo. Pankhaniyi, kafukufuku wowonjezera wokhala ndi shuga woletsedwa., chifukwa izi zitha kusokoneza thanzi la mayi komanso kukula kwa mwana wosabadwayo.

Ngati zapezeka zovuta pambuyo poyeserera, adotolo amafufuza kubwereza kwa GTT patadutsa masiku angapo, koma milungu iwiri yotsatira. Ngati mwanjira iyi, kafukufukuyu adawonetsa kuchuluka kwa kuchuluka kwa shuga pamagazi, ndiye kuti kumazindikiridwa kumatsimikiziridwa.

Kutenga zotsatira za mayeso oyamba ngati maziko kumawoneka kuti sikulakwa, popeza mayiyo akhoza kungonyalanyaza malangizo omwe akukonzekera mayesowo.

Zotsatira zikakhala zolakwika

Zina zomwe zimatithandizanso zimatha kukhudzanso kudalirika kwa zosowa zomwe zapezeka pakuwunika kwa GTT.

Chifukwa chake, nthawi zina dokotala amakayikira zotsatira zake, ngati mayi woyembekezera alembedwa:

kusowa kwa potaziyamu, magnesium,
kulakwitsa kwa dongosolo la endocrine,
chitukuko cha matenda
mavuto ndi kuthedwa nzeru,
kuchita zolimbitsa thupi kwambiri, mpaka kumasuka kosunthika pakaunikidwe ka glucose,
kugwiritsa ntchito mankhwala okhala ndi shuga, chitsulo, komanso ma beta-blockers, glucocorticosteroids pa gawo lokonzekera.

Chiwopsezo chofuna kupatuka pa chizolowezi chakhanda

Kuti mukhale ndi pakati yabwino, ndikofunikira kuti placenta imadzipangira kuchuluka kwamahomoni cortisol, lactogen, estrogen. Ndi mankhwala abwinobwino a insulin, kaphatikizidwe kake sikasokoneza. Koma muzochitika zake zochepetsedwa, njira yachilengedweyi imasokonekera, chifukwa kapamba sakwaniritsa ntchito yake mokwanira.

Izi zimakhudza osati thanzi la mayi wamtsogolo, komanso kukulira kwa mwana.

Mukazindikira matendawa pakatha milungu 20, mwayi wokhala ndi vuto lakakhazikika kwa mwana wosabadwayo umacheperachepera, koma mwayi woti mwana wosabadwayo aberekane ukuwonjezeka. Izi zikutanthauza kuti unyinji wa mwana uzikula, chifukwa kapamba wake sangathe kugwira ntchito mokwanira motero sangathe kupirira shuga wambiri.

Zotsatira zake, izi zimapangitsa kukula kwa lamba, m'chiwindi, mtima, komanso kumakwiyitsa kukula kwa mafuta ochepetsa mphamvu. Kukula kwakukulu kwa mwana wosabadwayo ndi kofunikira kuti munthu abadwe nthawi yayitali, popeza kuti lamba la phewa lomwe limakulirakulira sililola kuti mwana agonjetse ufulu wa kubala.

Kubereka kwakanthawi kumawopseza hypoxia, kuvulala, kuwonongeka kwa ziwalo zamkati mwa mwana ndi mkazi.

Chochitika china chimatha kuyambitsidwa ndikuti kukula kwakukulu kwa mwana wosabadwayo mkati mwa chiberekero kumabweretsa kubadwa msanga, pomwe maukonde a ziwalo zam'mimba ndi ziwalo za mwana zinalibe nthawi yopanga bwinobwino. Kubadwa koyambirira ndi koopsa kwambiri kuti mapapu a mwana sangathe kupumira mpweya kuchokera kunja, popeza amalephera kuchuluka kwa chinthu chomwe amafunacho - wogwiritsa ntchito.

Poterepa, mwanayo amaikidwa m'bokosi lapadera kuti mpweya wabwino uzigwira m'mapapu.

Mayina a mayeso a kulolera glucose (mayeso a glucose ofunitsitsa, mayeso a 75 g shuga, mayeso a kulolera glucose)

Pakadali pano, dzina la njira yolekerera shuga (GTT) amavomerezedwa ku Russia. Komabe, pochita mayina ena amagwiritsidwanso ntchito kutanthauza ma labotale omwewo njira yodziwitsazomwe zimagwirizana mwanjira yofanana ndi mawu akuti kulolera shuga. Kuyanjana koteroko kwa mawu akuti GTT ndi awa: mayeso okhudzana ndi glucose (OGTT), mayeso a glucose kulolerana (PHTT), mayeso okhudzana ndi shuga (TSH), komanso mayeso okhala ndi 75 g ya shuga, kuyesedwa kwa shuga, ndikumanga ma curve a shuga. Mchizungu, dzina la njira yantchito iyi limasonyezedwa ndi mawu oti glucose kulolerana mayeso (GTT), mayeso a glucose kulolerana (OGTT).

Chowonetsa ndi chifukwa chiyani kuyesa kwa glucose kuli kofunikira?

Chifukwa chake, kuyesedwa kwa glucose ndikutsimikiza kuchuluka kwa shuga (glucose) m'magazi pamimba yopanda kanthu ndipo patatha maola awiri atatenga yankho la 75 g la shuga kusungunuka mu kapu yamadzi. Nthawi zina, kuyezetsa kwakukulu kwa glucose kumachitika, momwe shuga ya magazi imatsimikiziridwa pamimba yopanda kanthu, mphindi 30, 60, 90 ndi 120 mutagwiritsa ntchito yankho la 75 g shuga.

Nthawi zambiri, kuthamanga kwa magazi ofunika kuyenera kusintha pakati pa 3.3 - 5.5 mmol / L kwa magazi kuchokera chala, ndi 4.0 - 6.1 mmol / L kwa magazi kuchokera m'mitsempha. Ola limodzi munthu atamwa madzi a 200 ml amadzimadzi m'mimba yopanda kanthu, pomwe 75 g ya shuga imasungunuka, shuga ya magazi imakwera mpaka mlingo waukulu (8 - 10 mmol / l). Ndiye, pamene glucose wolandirayo umakonzedwa ndikulowetsedwa, kuchuluka kwa shuga m'magazi kumatsika, ndipo maola 2 atatha kumwa, 75 g ya glucose imayamba kukhala yabwinobwino, ndipo ndi ochepera 7.8 mmol / l kwa magazi kuchokera chala ndi mtsempha.

Ngati maola awiri mutatha kudya magalamu 75, shuga wambiri ndi 7.8 mmol / L, koma m'munsi mwa 11.1 mmol / L, izi zikuwonetsa kuti kuphwanya kwachilengedwe kwa chakudya. Ndiye kuti, chakudya chamafuta m'mthupi la munthu chimatengedwa ndimatenda pang'onopang'ono, koma pakadali pano zovuta izi zimalipilitsidwa ndikubisalira mwachinsinsi, popanda kuonekera kwa matenda. M'malo mwake, kuchuluka kwa shuga m'magawo awiri mutatha kumwa magalamu 75 g kumatanthawuza kuti munthu akupanga kale shuga, koma sanapeze mtundu wowonjezera wa mawonekedwe onse okhala ndi matendawa. Mwanjira ina, munthuyo wadwala kale, koma gawo la matenda am'mbuyomu, ndiye chifukwa chake palibe zizindikiro.

Chifukwa chake, zikuwonekeratu kuti phindu la kuyesa kwa glucose ndilokulira, popeza kuwunika kosavuta kumeneku kumakupatsani mwayi wazidziwitso zamatenda a carbohydrate metabolism (shuga mellitus) kumayambiriro, mukakhala kuti mulibe zizindikiro zamankhwala, koma ndiye mutha kuthana ndi kupewa kupangika kwa matenda ashuga akale. Ndipo ngati zovuta zaposachedwa zama metabolism a carbohydrate, zomwe zapezeka ndikuyesa mayeso a glucose, zitha kuwongoleredwa, kubwezeretsedwanso komanso kupewa kutukuka kwa matendawa, ndiye kuti pa nthawi ya matenda ashuga, pomwe matenda atapangidwa kale, ndizosatheka kuchiritsa matendawa, koma ndizotheka kungokhala mwanjira yokhazikika pakulandila shuga m'magazi, ikuchedwa kuoneka ngati zovuta.

Tiyenera kukumbukira kuti kuyesa kwa glucose kumalola kudziwitsidwa koyambirira kwa zovuta zaposachedwa zamatenda a carbohydrate, koma sizipanga kusiyana pakati pa mitundu yoyamba ndi yachiwiri ya matenda a shuga, komanso zomwe zimayambitsa kukula kwa matenda a matenda am'mimba.

Popeza kufunikira komanso kudziwa zambiri zazomwe zimayesa mayeso a glucose, kusanthula uku ndikoyenera kuchita pamene akukayikira kuphwanya kwaposachedwa kwa kagayidwe kazakudya. Zizindikiro za matenda obwera chifukwa cha carbohydrate metabolism ndi awa:

Magazi a shuga m'magazi amakhala apamwamba kuposa mafuta, koma m'munsi mwa 6.1 mmol / L chifukwa cha magazi kuchokera chala ndi 7.0 mmol / L kwa magazi ochokera m'mitsempha.
Maonekedwe a shuga mumkodzo poyerekeza ndi shuga wabwinobwino,
Ludzu lalikulu, kukoka pafupipafupi komanso kupukutira, komanso chilimbikitso chambiri motsutsana ndi shuga wabwinobwino wamwazi,
Kukhalapo kwa shuga mumkodzo panthawi yapakati, thyrotoxicosis, matenda a chiwindi kapena matenda opatsirana opatsirana,
Neuropathy (kusokoneza mitsempha) kapena retinopathy (kusokonezeka kwa retina) pazifukwa zosadziwika.

Ngati munthu ali ndi vuto lakapangidwe kagayidwe kazakudya, ndiye kuti amalimbikitsidwa kuyezetsa mayeso a glucose kuti atsimikizire kukhalapo kapena kusakhalapo koyambirira kwa matenda.

Anthu omwe ali ndi thanzi labwino kwambiri omwe ali ndi shuga m'magazi ndipo alibe zizindikiro za kagayidwe kachakudya sangafunike kuyesa mayeso a glucose, popeza ndi osathandiza kwenikweni. Komanso, sikofunikira kuchita mayeso a kulolera glucose kwa iwo omwe ali ndi shuga othamanga kwambiri am'magazi omwe amafanana ndi shuga mellitus (oposa 6.1 mmol / L chifukwa cha magazi kuchokera chala ndi oposa 7.0 a magazi ochokera m'mitsempha), chifukwa zovuta zawo ndizodziwikiratu, sichobisika.

Zisonyezo za kuyeserera kwa shuga

Chifukwa chake, kuyesedwa kwa glucose kumayesedwa kuti aphedwe potsatira izi:

Zotsatira zokayikitsa za kutsimikiza kwa glucose (m'munsi mwa 7.0 mmol / l, koma pamwamba pa 6.1 mmol / l),
Mwangozi mwazindikira kuchuluka kwa shuga m'magazi chifukwa chapanikizika,
Mwadzidzidzi patapezeka kupezeka kwa glucose mkodzo poyerekeza ndi shuga wabwinobwino komanso kusowa kwa zizindikiro za matenda osokoneza bongo (kuchuluka kwa ludzu ndi chilakolako chofuna kudya, pafupipafupi komanso kukodza kwadzaoneni),
Kupezeka kwa zizindikiro za shuga pamayendedwe abwinobwino a shuga,
Mimba (kudziwa matenda ashuga)
Kukhalapo kwa shuga mumkodzo mkati mwa chithokomiro, matenda a chiwindi, retinopathy, kapena neuropathy.

Ngati munthu ali ndi zonsezi pamwambapa, ndiye kuti ayenera kupitiliza kuyesa kwa glucose, popeza pamakhala chiopsezo chachikulu cha maphunziro a shuga. Ndipo ndizoyenera kutsimikizira kapena kukaniratu matenda obwera chifukwa cha shuga ngati izi zimachitika kuti mayeso okhudzana ndi shuga agwidwe, omwe amakupatsani "kuwulula" kuphwanya kowopsa kwa kagayidwe kazakudya m'thupi.

Kuphatikiza pazowonetsa pamwambapa, pali zochitika zingapo momwe kumalangidwira kuti anthu azipereka magazi pafupipafupi kuti akayeze mayeso a glucose, popeza ali ndi chiopsezo chachikulu chotenga matenda a shuga. Zoterezi sizizindikiro zoyenera kutenga kuyeserera kwa glucose, koma ndikofunika kwambiri kuti nthawi ndi nthawi musanthule izi kuti mupeze matenda ashuga kapena matenda abwinobwino panthawi yoyambirira.

Mikhalidwe yofananira yomwe imalimbikitsidwa kupimitsa mayeso a glucose nthawi zambiri imapezekanso kupezeka kwa matenda kapena mikhalidwe yotsatira mwa munthu:

Zaka zopitilira 45
Mndandanda wamkulu woposa 25 kg / cm 2,
Kupezeka kwa matenda ashuga kwa makolo kapena abale a magazi,
Khalidwe labwino
Matenda a shuga m'mimba mbuyomu,
Kubadwa kwa mwana wolemera kuposa makilogalamu 4.5,
Kubala mwana asanabadwe, kubereka mwana wosabadwa wakufa, kupita padera m'mbuyomu,
Matenda oopsa
Miyezo ya HDL m'munsi mwa 0.9 mmol / L ndi / kapena triglycerides pamwambapa 2.82 mmol / L,
Kukhalapo kwa matenda aliwonse a mtima dongosolo (atherosulinosis, matenda a mtima, ndi zina).
Thumba lam'mimba lamabele,
Gout
Matenda a periodontal matenda kapena furunculosis,
Kulandila kwa okodzetsa, mahomoni a glucocorticoid ndi ma estrogens opanga (kuphatikiza ngati gawo la njira zothandizira pakamwa) kwanthawi yayitali.

Ngati munthu alibe zina mwa zinthu zomwe zili pamwambapa kapena matenda, koma zaka zake ndi zaka zoposa 45, ndiye kuti amalimbikitsidwa kuti azichita mayeso ololera a glucose kamodzi pazaka zitatu.

Ngati munthu ali ndi zikhalidwe ziwiri kapena matenda kuchokera pamwambapa, ndiye kuti amalimbikitsidwa kuti azitha kuyesa mayeso a glucose mosalephera. Ngati nthawi yomweyo kuyesedwa kumakhala koyenera, ndiye kuti kuyenera kutengedwa ngati gawo loyeserera patatha zaka zitatu zilizonse. Koma zotsatira zoyesedwa sizili zachilendo, ndiye kuti muyenera kuchita chithandizo chomwe dokotala wakupatsani ndikuwunikanso kamodzi pachaka kuti muwone momwe matendawa akuwonekera komanso momwe akuwonekera.

Contraindication for glucose kulolerana mayeso

Kuyesedwa kwa glucose kumayesedwa kwathunthu kwa iwo omwe adazindikira kale matenda a shuga, ndipo pamene kuthamanga kwa shuga m'magazi ndi 11.1 mmol / L kapena kuposa! Muzochitika zotere, GTT simachitidwa konse, chifukwa kutsekemera kwa glucose kumatha kupangitsa kukula kwa vuto la hyperglycemic.

Komanso kuyeserera kwa glucose kumayesedwa milandu pomwe pali zinthu zomwe zingakhudze zotsatira zake ndikuzipangitsa kukhala zolondola, ndiye kuti zabodza kapena zabodza. Koma muzochitika zotere, kuponderezana nthawi zambiri kumakhala kwakanthawi, kugwira ntchito mpaka chinthu chomwe chimakhudza mayeso chitha.

Chifukwa chake, kuyesa kwa glucose sikuchitika mu milandu yotsatirayi:

Nthawi yodwala yamatenda aliwonse, kuphatikiza yopatsirana (mwachitsanzo, kupuma kwamatenda opatsirana, kufalikira kwa zilonda zam'mimba, matumbo kukhumudwa, etc.),
Myocardial infaration, adavutika osakwana mwezi wapitawu,
Nthawi ya kupsinjika kwakukuru komwe munthuyo ali
Kuvulala, kubala mwana kapena kuchititsa opaleshoni kudikirira miyezi yochepera 2 - 3 yapitayo,
Mankhwala osokoneza bongo a chiwindi
Hepatitis
Kusamba kwa akazi,
Mimba ndizopitilira masabata 32,
Kumwa mankhwala omwe amalimbikitsa shuga m'magazi (adrenaline, caffeine, rifampicin, glucocorticoid mahomoni, mahomoni a chithokomiro, diuretics, njira zakulera pakamwa, antidepressants, psychotropic mankhwala, beta-blockers (atenolol, bisoprolol, etc.). Musanayambe kuyesa mayeso a shuga, muyenera kusiya kumwa mankhwalawa kwa masiku osachepera atatu.

Momwe mungayesere kuyesa kwa glucose?

Wodwalayo amabwera ku labotale, pomwe pamimba yopanda kanthu amatenga magazi kuchokera ku chala kapena kuchokera m'mitsempha kuti adziwe kuchuluka kwa shuga. Pambuyo pake, njira ya glucose imakonzedwa, ndikuloledwa kumwa kwa mphindi zisanu mu sips yaying'ono. Ngati yankho lake likuwoneka lokoma komanso lonyoza, ndiye kuti zipatso zingapo za mandimu kapena zipatso za mandimu zongowonjezeredwa kumene zimawonjezedwanso kwa iye.

Njira yothetsera shuga itatha kumwa, nthawi imawoneka, ndipo wodwalayo amakhala momasuka ndikupempha maola awiri otsatira kuti akhale phee kuchipatala popanda kuchita ntchito iliyonse. Ndikofunika kuti mungowerenga buku lomwe mumalikonda maola awiriwa. Kwa maola awiri mutatha kudya shuga, simungathe kudya, kumwa, kusuta, kumwa mowa ndi mphamvu, kuchita masewera olimbitsa thupi, kukhala wamanjenje.

Pakatha maola awiri mutamwa njira yothetsera shuga, magazi amatengedwanso kuchokera mu mtsempha kapena kuchokera mu chala ndipo kukhathamira kwa shuga mumagazi kumatsimikiziridwa. Ndiye kufunika kwa shuga m'magazi patatha maola awiri mutatenga njira yothetsera shuga yomwe imachitika chifukwa cha kuyesedwa kwa shuga.

Nthawi zina, kuyezetsa kwakukulu kwa glucose kumachitika komwe magazi amatengedwa kuchokera ku chala kapena kuchokera mu mtsempha wamphindi 30, 60, 90 ndi 120 mutatha kutenga njira ya shuga. Nthawi iliyonse, kuchuluka kwa shuga mumagazi kumatsimikiziridwa, ndipo mfundo zomwe zimapezedwa zimapangidwira pa graph pomwe nthawi imakonzekeredwa pa X-axis ndikukumana kwa shuga wamagazi kumakonzedwa pa Y-axis. Zotsatira zake ndi chithunzi chomwe mulingo wabwinobwino wa shuga utatha mphindi 30 mutatha kugwiritsa ntchito njira ya shuga, ndipo pambuyo pa mphindi 60 ndi 90, misempha ya magazi imatsika mosalekeza, mpaka pafupifupi mphindi zisanu zopanda kanthu zam'mimba pofika mphindi ya 120.

Magazi akatengedwa kuchokera pachala patatha maola awiri atamwa njira ya shuga, phunziroli limawerengedwa kuti ndi lathunthu. Pambuyo pake, mutha kuchoka ndikuchita ntchito zanu zonse masana.

Njira yothetsera glucose yoyeserera glucose imakonzedwa mwanjira yomweyo - kuchuluka kwina kwa shuga kumasungunuka mu kapu yamadzi. Koma kuchuluka kwa shuga kumatha kukhala kosiyana, ndipo zimatengera zaka komanso kulemera kwa thupi la munthu.

Chifukwa chake, kwa akuluakulu abwinobwino omanga ndi thupi labwinobwino, 75 g ya shuga imasungunuka mu 200 ml ya madzi. Kwa akuluakulu onenepa kwambiri, kuchuluka kwa glucose amawerengedwa payekhapayekha poyerekeza ndi 1 g ya glucose pa 1 kg yolemera, koma osapitirira 100. Mwachitsanzo, ngati munthu akulemera makilogalamu 95, ndiye kuti kuchuluka kwa glucose kwa iye ndi 95 * 1 = 95. Ndipo ndi 95 g yomwe imasungunuka. mu 200 ml ya madzi, ndikuwapatsa madzi akumwa. Ngati munthu akulemera makilogalamu 105, ndiye kuti kuchuluka kwa shuga kwa iye ndi 105 g, koma kuchuluka kwa 100 g kumaloledwa kupasuka. Chifukwa chake, kwa wodwala wolemera makilogalamu 105, muyeso wa glucose ndi 100 g, womwe umasungunuka mu kapu yamadzi ndikupatsidwa chakumwa .

Kwa ana omwe thupi lawo limachepera 43 kg, muyeso wa glucose amawerengedwa payekhapayekha, kutengera muyeso wa 1.75 g pa 1 kg yolemera. Mwachitsanzo, mwana amalemera makilogalamu 20, zomwe zikutanthauza kuti muyezo wa glucose kwa iye ndi 20 * 1.75 g = 35 g. Chifukwa chake, kwa mwana wolemera makilogalamu 20, 35 g ya shuga amasungunuka mu kapu yamadzi. Ana omwe ali ndi thupi lolemera kuposa makilogalamu 43 amapatsidwa shuga wamkulu wanthawi zonse, ndiwo 75 g pagalasi lamadzi.

Pambuyo poyeserera kulolera kwa glucose

Kuyesedwa kwa glucose pakumalizidwa, mutha kudya chakudya cham'mawa ndi chilichonse chomwe mukufuna, kumwa, komanso kubwereranso ku kusuta ndi kumwa mowa. Mwambiri, kuchuluka kwa glucose nthawi zambiri sikuti kumayambitsa kuwonongeka komanso sikumakhudza mkhalidwe wazomwe zimachitika, chifukwa chake, mutatha kuyesedwa kwa glucose, mutha kuchita bizinesi yanu iliyonse, kuphatikiza kugwira ntchito, kuyendetsa galimoto, kuwerenga, ndi zina zambiri.

Zotsatira zoyeserera za glucose

Zotsatira zakuyesa kwa glucose ndi manambala awiri: imodzi ndiyo kuchuluka kwa shuga m'magazi, ndipo chachiwiri ndi kuchuluka kwa shuga m'magawo awiri mutatenga shuga.

Ngati kuyesedwa kwa glucose kowonjezereka kwachitika, zotsatira zake ndi manambala asanu. Manambala oyamba ndi kuchuluka kwa shuga la magazi. Manambala achiwiri ndi shuga m'magazi patatha mphindi 30 atayamba kugwiritsa ntchito njira ya glucose, gawo lachitatu ndi shuga pambuyo ola limodzi atalowa mu glucose solution, manambala anayi ndi shuga m'magazi pambuyo pa maola 1.5, ndipo chiwerengero chachisanu ndi shuga pambuyo pa maola awiri.

Magazi a shuga omwe amapezeka pamimba yopanda kanthu ndikatha kutenga yankho la shuga amawayerekeza ndi abwinobwino, ndipo amapanga lingaliro la kukhalapo kapena kusowa kwa matenda a kagayidwe kazakudya.

Mayeso a kulolera a glucose

Nthawi zambiri, kuthamanga kwamagazi ndimagazi a 3.3 - 5.5 mmol / L kwa magazi kuchokera chala, ndi 4.0 - 6.1 mmol / L kwa magazi ochokera m'mitsempha.

Mulingo wambiri wamagazi pambuyo maola awiri atatha kugwiritsa ntchito njira ya glucose nthawi zambiri umakhala wochepera 7.8 mmol / L.

Hafu ya ola mutatha kugwiritsa ntchito njira yothetsera shuga, shuga wamagazi ayenera kutsika kuposa ola, koma apamwamba kuposa pamimba yopanda kanthu, ndipo ayenera kukhala pafupifupi 7-8 mmol / L.

Mulingo wambiri wa magazi ola limodzi mutatha kutenga njira ya shuga uyenera kukhala wapamwamba kwambiri, ndipo uyenera kukhala pafupifupi 8 - 10 mmol / L.

Mlingo wa shuga pambuyo maola 1.5 mutatha kugwiritsa ntchito njira yothetsera shuga uyenera kukhala wofanana ndi theka la ola, ndiye kuti pafupifupi 7 - 8 mmol / L.

Decoding glucose kulolerana mayeso

Kutengera ndi zotsatira za mayeso a kulolera kwa glucose, adokotala atha kupanga zifukwa zitatu: mwachizolowezi, prediabetes (kulolerana kwa shuga) ndi shuga mellitus. Makhalidwe a shuga pamimba yopanda kanthu komanso maola awiri mutatha kugwiritsa ntchito njira yothetsera shuga, yoyenerana ndi iliyonse mwanjira zitatuzi zomaliza, zikuwonetsedwa pansipa.

Chikhalidwe cha kagayidwe kazakudya	Kuthamanga shuga	Shuga wamagazi patatha maola awiri atamwa njira ya shuga
Norm	3,3 - 5.5 mmol / L wa magazi a chala 4.0 - 6.1 mmol / L kwa magazi ochokera m'mitsempha	4.1 - 7.8 mmol / L wa magazi ndi zala zamitsempha
Matenda a shuga (kulekerera shuga)	Osachepera 6.1 mmol / L kwa magazi a chala Osachepera 7.0 mmol / L kwa magazi ochokera m'mitsempha	6.7 - 10.0 mmol / L wa magazi a chala 7.8 - 11.1 mmol / L kwa magazi ochokera m'mitsempha
Matenda a shuga	Kupitilira 6.1 mmol / L kwa magazi aminwe Kuposa 7.0 mmol / L kwa magazi ochokera m'mitsempha	Kupitilira 10.0 mmol / L kwa magazi aminwe Kuposa 11.1 mmol / L kwa magazi ochokera m'mitsempha

Kuti mumvetsetse zomwe zimachitika izi kapena munthu amene adalandira molingana ndi mayeso ololera wa glucose, muyenera kuyang'ana kuchuluka kwa shuga komwe amawunikira akukhudzidwapo. Kenako, onani zomwe (zabwinobwino, prediabetes kapena matenda ashuga) zimatanthauzira kuchuluka kwa shuga, komwe kunagwera podziwunikira.

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Kodi kuyesedwa kwa glucose kumachitika kuti?

Kuyesedwa kwa glucose kumachitika pafupifupi m'malo onse antchito am'magulu azachipatala ndi m'machipatala azachipatala wamba komanso m'zipatala. Chifukwa chake, kupanga kafukufukuyu ndikosavuta - ingopita ku labotale ya boma kapena chipatala chawekha. Komabe, ma laboratori aboma nthawi zambiri samakhala ndi glucose woyeserera, ndipo pankhaniyi muyenera kugula ufa wa glucose nokha ku pharmacy, mubweretse, ndipo ogwira ntchito kuchipatala apanga yankho ndikuchita mayesowo. Glucose ufa nthawi zambiri amagulitsidwa ku malo ogulitsa anthu, omwe ali ndi dipatimenti yolemba, ndipo m'makatani apadera a mankhwala amapezeka kuti kulibe.