Kodi glycemia: kuthamanga magazi

Monga momwe amafotokozera matanthauzidwe a shuga, kupezeka kwake kumadziwika bwino ndipo kumachokera pazotsatira za kafukufuku wamagazi. Chidziwitso chokhacho chofunikira (chokwanira komanso chokwanira) cha matenda ashuga ndichochuluka m'magazi a shuga (Gome 1).

Pankhani ya zovuta za metabolic, kupezeka kwake si vuto. Amakhazikika mwa wodwala yemwe ali ndi zizindikiro za matenda ashuga (polyuria, polydipsia, kuchepa kwa thupi, ndi zina zotere), ngati kuchuluka kwa shuga m'magazi a venous amaposa 11.1 mmol / L pamalo aliwonse osakhalitsa masana.

Koma matenda ashuga amatha kupangika pang'onopang'ono, popanda kuonekeratu matenda atangoyamba matendawa, ndikuwonekera pokhapokha pokhazikika pokhazikika pa hyperglycemia komanso pambuyo pofundira chakudya (postprandial hyperglycemia). Potere, njira zodziwira matenda ashuga ndizosala kudya kwa glycemia komanso / kapena 2 patatha kuchuluka kwa carbohydrate - 75 g shuga. Komabe, vutoli ndikuti njira zakuzindikiritsa zovuta za carbohydrate metabolism mu zomwe zimadziwika kuti mayeso a glucose kulolerana (PTTG) nthawi zambiri zimawunikiridwa. Kuphatikiza apo, mfundo zomwe zimagwiritsidwa ntchito pofufuza zovuta zomwe zimadwala matenda a shuga - kuvutikirana kwa glucose (NTG) komanso kusala kwamatenda glycemia (IAT) - sizinavomerezedwebe ndi gulu la anthu odwala matenda ashuga padziko lonse lapansi. Popeza kuti matendawa ndi omwe atsimikizira kuti mankhwalawo ndi omwe amathandizire chithandizo, tikambirana mwatsatanetsatane za vutoli.

Mizere ya glycemic ku PTG, kulekanitsa athanzi ndi iwo omwe ali ndi vuto la metabolism ya carbohydrate, amasankhidwa kuti achepetse chiopsezo cha zovuta za microvascular zomwe zimagwirizanitsidwa ndi metabolism ya carbohydrate. Kafukufuku wapadera awonetsa kuti chiopsezo chokhala ndi matenda ashuga a retinopathy akuchulukirachulukira pamene kuthamanga kwa shuga m'magazi kumatha 6.0-6.4 mmol / L, ndipo pambuyo pa 2 hours ku PTTG kupitirira 10,3 mmol / L komanso pamene hemoglobin ya glycated imapitirira 5, 9-6%. Kutengera ndi izi, Katswiri wa Katswiri wa Matenda a shuga ku America mu Diagnosis ndi Gulu la Matenda a shuga mu 1997 anasintha njira zomwe zakhazikitsidwa kale za kuchepa kwa kagayidwe kazakudya mozungulira momwe amachepetsa. Kuphatikiza apo, kuwunikira kowonjezereka kwa data kunachitika kuti muchepetse kusasiyana mu kufunikira kwapang'onopang'ono kwa microangiopathy yothamanga glycemia komanso pambuyo pa maola 2 ku PTG. Zotsatira zake, mfundo zotsatirazi za shuga m'magazi a venous zimasankhidwa kuti apeze matenda a shuga: pamimba yopanda kanthu - 7.0 mmol / l, ndipo patatha maola awiri - 11.1 mmol / l. Kupitilira izi zikuwonetsa matenda a shuga. Adatengedwa ndi WHO mu 1998 kuti apezeke ngati ali ndi matenda ashuga mwa amuna ndi akazi osakhala ndi pakati (Alberti KG et al., Diabetes Med 15: 539-553, 1998).

Dziwani kuti kuchuluka kwa shuga m'magazi omwe amayeza nthawi imodzi kumadalira ngati amayesedwa m'magazi athunthu kapena m'magazi am'magazi komanso ngati magazi ali amkati kapena capillary (onani Mndandanda 1). Poyerekeza ndi magazi a venous, capillary arteriosis ndiye kuti ndi shuga wambiri kuposa magazi a venous omwe amayenda kuchokera ku zimakhala. Chifukwa chake, kuchuluka kwa shuga m'magazi a capillary ndikwapamwamba kuposa venous. Mtengo wa glycemia m'magazi athunthu ndi wotsika kuposa m'magazi am'magazi, chifukwa glucose umachepetsedwa ndi unyinji wama cell ofiira amwazi omwe mulibe glucose. Komabe, kusiyana kwa kutsata kwa glucose pama media awa kumawonekera kwambiri pansi pazakudya zambiri motero amanyalanyazidwa pamimba yopanda kanthu. Kunyalanyaza kuchuluka kwa mayeso a shuga m'magazi (kwathunthu, capillary, kapena madzi a m'magazi) kumatha kupangitsa kuchuluka kwa chakudya choyambirira cha carbohydrate kagayidwe kachakudya ndi matenda osokoneza bongo m'maphunziro a matenda. Koma kuchitira kwachizolowezi kuchipatala, izi ndizofunikanso chifukwa chazovuta zomwe zimapezeka ndi glycemic values ​​pafupi ndi malire.

Njira zoyenera kudziwa matenda ashuga ndi mitundu ina ya hyperglycemia (WHO, 1999 ndi 2006). Mfundo Zabwino za Plasma Zowunikidwa
monga ogwiritsira ntchito kwambiri pazachipatala

Nthawi yophunzira
mu PTTG

Ndondomeko ya glucose (mmol / l)

kapena mutatha maola 2 mu PTTG kapena mwangozi **

Kulekerera kwa shuga

ndipo nditatha maola 2 mu PTTG

Matenda othamanga a glycemia

ndipo nditatha maola 2 mu PTTG

Kusala kudya kwa glycemia - magazi m'magawo m'mawa mutatha kudya osachepera maola 8, koma osapitilira maola 14.

** glycemia yopanda pake - kuchuluka kwa shuga m'magazi nthawi iliyonse masana (nthawi zambiri masana), mosasamala nthawi yakudya.

Kutengera ndi zomwe tafotokozazi, kufunika kwa glycemia mu plousma wamagazi ndikulondola kwambiri, chifukwa mu nkhani iyi kuchuluka kwa maselo ofiira ammimba sikumachotsedwera ndipo kuchuluka kwa magazi pakuchitika kwa capillary glycemia sikukhudzidwa. Pankhaniyi, akatswiri a matenda ashuga amakonda kugwiritsa ntchito njira zofufuzira za plousma wamagazi, komanso, ngakhale kuchuluka kwa glucose sikumatsimikizika mu plasma, ndiye kuti amasinthidwa kukhala plasma, ndipo m'magawo angapo a glucometer amakono. Poganizira izi, mtsogolomo, Zizindikiro zonse za glycemic zomwe zimafotokozeredwa zimawonetsa kuchuluka kwa plasma yamagazi, pokhapokha atanena mwanjira ina. Chifukwa chake, tigwiritsa ntchito njira zomwe zaperekedwa mu tebulo losavuta lozindikira (tebulo 2).

Gome lophweka lofufuzira momwe matenda a shuga ndi matenda oyamba a carbohydrate metabolism (NTG * ndi NGN **) amapezeka ndi kuchuluka kwa shuga m'magazi a venous mu muyeso wololera pakamwa wa glucose (75 g glucose)

Glucose m'madzi a m'magazi a venous (mmol / l)

2 h postprandial

Pamimba yopanda kanthu
kapena
2 h postprandial

Pamimba yopanda kanthu
ndi
pambuyo 2 maola

2 h postprandial

2 h postprandial

** NGN - kuphwanya glycemia.

Pakuwona umboni watsopano wokhudza kuchepa / kupewa kwa kusintha kwa matenda opatsika shuga kulowererapo kapena metformin. Engl J Med 346: 393-403, 2002) adaganiziridwa kuti afotokoze kumasulira kwa zotsatira za PTTG. Makamaka, kutanthauzira kwa kotchedwa kwapakati pakati pa kusala kwa glycemic komanso pambuyo pa maola 2 ku PTTG, pamene glycemia imapitilira zofunikira, koma sikufika pamlingo wofanana ndi matenda ashuga: (1) kuyambira 6.1 mpaka 6.9 mmol / l pamimba yopanda kanthu. ndi (2) kuchokera pa 7.8 mpaka 11.0 mmol / L pambuyo pa maola 2 ku PTG. Akufunsidwa kuti azindikire matenda a NTG pamilandu imeneyi pomwe PTTG itatha maola 2 gawo la glycemia lili m'magawo 7.8-11.0 mmol / L, ndipo kuthamanga kwa glucose ochepera ndi osakwana 7.0 mmol / L (kuphatikiza zabwinobwino!) . Kumbali inayi, mu nkhani iyi, NTG imagawika pawiri: a) "yodziwika" NTG, pomwe glycemia imangowonjezereka pambuyo pa maola 2, b) NTG + NGN - pamene glycemia imachulukitsidwa pamimba yopanda kanthu komanso pambuyo pa maola awiri. Komanso, zidawonetsedwa kuti kuwonjezeka kwa glycemia pankhani ya NTG + NGN ndikosavomerezeka pakukula kwa zovuta za matenda amtundu wa shuga kuposa "kudzipatula" NTG kapena "kudzipatula" NGN (wopanda NTG). Chiwerengero cha zovuta zam'mbuyo izi zamatenda a carbohydrate, omwe tidazindikira mwa anthu am'chigawo cha Moscow, chikufotokozedwa. 3.

Nthawi yomweyo, kuchititsa PTG ndi njira yolemetsa pamutuwu, makamaka ngati muwona kuti kuphwanya kwa kagayidwe kazinthu ndi kuchuluka kwa shuga m'magazi a venous, monga momwe akuwonetsera muzozindikira matenda. Ndipo mayeso pawokha ndiokwera mtengo kwambiri kuti ugawire anthu osiyanasiyana. Pankhaniyi, American Diabetesic Association inapempha kuti maphunziro azambiri azigwiritsa ntchito tanthauzo la kusala kudya glycemia ndipo adayambitsa lingaliro latsopano - kuphwanya glycemia (IHN). Chitsulo cha NGN ndikusala shuga wa plasma kuyambira 6,1 mpaka 6,9 mmol / L. Zikuwonekeratu kuti pakati pa anthu omwe ali ndi NGN pakhoza kukhala anthu omwe ali ndi NTG. Ngati PTTG idapangidwira wodwala yemwe ali ndi NGN (yomwe sikuti imakakamizidwa, makamaka ngati chithandizo chazaumoyo sichilola) ndipo pambuyo pa maola 2 mulingo wa glucose wabwinobwino, ndiye kuti matenda a NGN sasintha. Kupanda kutero, matendawa amasintha kukhala NTG kapena matenda oopsa a shuga, kutengera kuchuluka kwa glucose wa 2 pambuyo pa 2T ku PTG. Chifukwa chake, titha kusiyanitsa njira zotsatirazi zakuphwanya kagayidwe kazachilengedwe, kutengera kuti PTG yachita kapena ayi.

1. Shuga mellitus, wongopezeka ndi zotsatira za kafukufuku wosabereka wa glycemia masana - glycemia woposa 11.0 mmol / L.

2. Matenda a shuga omwe amapezeka ndi zotsatira za PTG:

glycemia  7.0 mmol / l pamimba yopanda kanthu komanso  11.1 mmol / l atatha maola 2,

glycemia  7.0 mmol / l pamimba yopanda kanthu, koma 11.1 mmol / l atatha maola 2,

glycemia 7.0 mmol / L pamimba yopanda kanthu komanso  11.1 mmol / L pambuyo 2 maola.

kusala kudya kwa glucose a 6.1 mmol / l ndipo patatha maola awiri mu PTTG 7.8-11.0 mmol / l ("pekee" NTG),

kusala kudya kwa glycemia m'gulu la 6.1-6.9 ndipo patatha maola awiri mu PTTG mulitali 7.8-11.0 mmol / l (NTG + NGN),

kudya glycemia mu 6.1-6.9 mmol / l ndi glycemia osadziwika pambuyo maola 2 ku PTG,

kusala kudya kwa glycemia m'gulu la 6.1-6.9 mmol / l ndi 7.8 mmol / l (zabwinobwino) patatha maola awiri mu PTTG ("yodziwika" NGN).

Pa tebulo. Chithunzi 4.3 chikuwonetsa kuchuluka kwa zomwe zimachitika m'chigawo cha Moscow za zovuta zonse za carbohydrate metabolism, zowerengeredwa malinga ndi zotsatira za kafukufuku wa PTTG wamkulu pakati pa anthu omwe sanapezeke ndi vuto lililonse la carbohydrate metabolism. Ndizosangalatsa kudziwa kuti ndi omwe amangopezeka kuti ali ndi matenda ashuga, 7.2% ya odwala amapezeka, omwe amadziwika kwambiri polembetsedwa ndi madokotala omwe ali ndi matenda a shuga (2.2%), i.e. omwe amachiza matenda a shuga kwa dokotala pawokha. Chifukwa chake, kuunika kwa anthu odwala matenda ashuga kumawonjezera kuzindikira kwake.

Pafupipafupi mitundu yosiyanasiyana ya zovuta za carbohydrate metabolism, yoyamba idapezeka
ku PTTG (pagulu la anthu a m'chigawo cha Lukhovitsky ndi mzinda wa Zhukovsky, dera la Moscow, IA Baaukov "Matenda oyamba a kagayidwe kazakudya: kupezeka matenda, kuwunika, kuwunika." - M, 2009)

Zosankha zamatenda a carbohydrate metabolism zomwe zapezeka mu PTG

Glycemia mu PGTT

mwa anthu omwe anali ndi PTG

"Matenda a shuga" pamimba yopanda kanthu komanso pambuyo pa maola awiri

"Matenda a shuga" pamimba yopanda kanthu komanso yodabwitsa pakatha maola awiri

Kusala kudya kwa "matenda ashuga" ndi NTG patatha maola awiri

"Matenda a shuga" pambuyo 2 mawola ndi chizolowezi pamimba yopanda kanthu

"Matenda a shuga" pambuyo 2 maola ndi IHF (T2DM + IHF)

Norma mu 2 hours

Zosadziwika pambuyo 2 maola

Ponena za NTG ndi NGN, m'malingaliro achilendo akunenedwa kuti apatule kwambiri NTG ndi NGN, kutanthauza za NTG pokhapokha pakuwonjezeka kwa glycemia pambuyo 2 maola osiyanasiyana 7.8-11.0 mmol / l. Ndipo NGN, imapezeka, imangopezeka ndi kuwonjezeka kwakanthawi kotsika kwa kudya kwa glycemia kosiyanasiyana kwa 6.1-6.9 mmol / l. Mwanjira iyi, mtundu wina wamavuto oyamba a metabolism carbohydrate amawonekera - kuphatikiza kwa NGN ndi NTG. Kuthekera kwa chigawo choterocho kumakhala koyenera chifukwa cha zovuta zingapo za zovuta izi komanso tanthauzo losiyana la mtundu uliwonse mwa mitundu itatu yamatenda oyambira a kagayidwe kazakudya ndipo, motero, njira zosiyanasiyana zopewera matenda ashuga.

Choyamba, adaganizirana, kuti apatule NGN pakati pa zovuta za carbohydrate metabolism kuti ngakhale popanda zotsatira za PTTG, kokha mwa kusala kudya glycemia, adotolo anali ndi chifukwa cholembera njira zomwe zingalepheretse kusintha kwa NGN kupititsa patsogolo shuga. Tiyenera kudziwa kuti kusala ndi gypcemia ya postprandial imawonetsa njira zosiyanasiyana zokhudzana ndi thupi, chifukwa chake ali ndi ubale wosiyana ndi matenda a matenda a shuga. Kusala kudya kwa glycemia kumakhala kofunikira pakupanga shuga ndi chiwindi. Zotsatira zake, NGN makamaka imawonetsa kukana kwa chiwindi kwa insulin. Mu basal (postabsorption) boma, glucose ambiri amatengedwa ndi minyewa yosadalira insulini (makamaka ubongo). Poganizira kuti glucose clearance imaphanikizidwa mu boma la postabsorption ndi zotumphukira zotengera insulin (minofu ndi mafuta), chifukwa chake, iwo amatenga gawo laling'ono la shuga kuchokera m'magazi, ndipo chifukwa cha NGN sichingathe kufotokozedwa ndi insulin kukokana ndi zotumphukira. Komanso, basal insulin secretion imakhalabe yokhazikika kwa nthawi yayitali, ngakhale kwa anthu omwe ali ndi matenda osokoneza bongo kwambiri, motero kulephera kwa insulin sikufotokozera kuchuluka kwa kusala kudya kwa glycemia mwa anthu omwe ali ndi IH.

Mosiyana ndi izi, postprandial glycemia imangotengera kuzindikira kwa insulin komanso zotumphukira zomwe zimadalira insulin, komanso pakubisalira kwa insulin chifukwa cha maselo a beta, chifukwa chake NTG imawonetsa kuthekera kwa insulini pazotupa komanso zotupa za insulin.

IHF ndi njira yofooka yopititsa patsogolo matenda a atherosulinotic mtima, mosiyana ndi NTG, chidziwitso cholimba champhamvu chodziwika bwino cha matenda am'matumbo komanso matenda opha ziwalo (The DECODE Study Group. Kulekerera kwa kufa ndi kufa kwa kufa: kuyerekezera kwa WHO ndi American Diabetes Association diagnostic maitiro. Lancet 1: 617-621, 1999). Kusiyana kumeneku kumawonetsera kuyanjana kwa NTG ndi metabolic syndrome ndi minofu insulin. NGN ndi NTG ndizovuta kwambiri pakubweretsa T2DM, ndipo kuchuluka kwawo ku Russia kumachitikanso.

Kugwiritsa ntchito pofuna kupulumutsa zithandizo z azaumoyo pakuwonetsa kuchuluka kwa matenda ashuga, kufufuza kokha glycemia kapena glycemia patatha maola 2 ku PTTG kumachepetsa kwambiri kuchuluka kwa anthu odwala matenda ashuga. Mwachitsanzo, mwa anthu okhala m'chigawo cha Moscow pakati pa anthu azaka zapakati pa 45-75, kuchuluka kwa matenda ashuga omwe kale sanadziwike kunali 11% malinga ndi zotsatira za PTTG ndi 7.8% malinga ndi kafukufuku wofufuza chabe wa glycemia.

Pomaliza, kukambirana kwawonetsero wa matenda ashuga kutengera zotsatira za kafukufuku wa glycemic ayenera kulabadira zinthu zofunika zotsatirazi. Choyamba, gluceter onse amakono omwe adapangidwa kuti azilamulira glycemia mwa odwala kunyumba sayenera (!) Pakupezeka kwa matenda a shuga, chifukwa alibe kulondola koyenera poyesa shuga wa shuga kuti adziwe shuga. Kachiwiri, chipangizo chowongolera cha HemoCue Glucose 201+ (Sweden) chitha kugwiritsidwa ntchito ngati njira imodzi yoyesera magazi a shuga kuti apezeke matenda a shuga, omwe angagwiritsidwe ntchito poyang'ana shuga m'magazi a capillary, oyenera kuzindikira matenda a shuga, kuphatikizapo shuga yambiri, chifukwa chokwanira. Dziwani kuti pali zida ziwiri zamtunduwu, imodzi imasinthasintha magazi a capillary m'magazi a magazi a venous, ndipo enawo satero. Pakadali pano, ndi zida za HemoCue Glucose 201+ zokha (Sweden) zomwe zalandiridwa ku Russia, zomwe sizichita kutembenuka koteroko, chifukwa chake mtengo wa kusala glycemia wa magazi a capillary ndi 5.6 mmol / L pazida izi. Pankhaniyi, kuchuluka kwa shuga m'magazi onse a capillary amathanso kusintha m'magulu a plasma ofanana: chifukwa, ndizokwanira kuzichulukitsa chifukwa cha 1.11 (malingana ndi malingaliro a International Federation of Clinical Chemistry (IFCC) - Kim SH, Chunawala L., Linde R., Reaven. Kufanizirana kwa GM kwa 1997 ndi 2003 American Diabetes Association> Zokhudza Kuwonongeka kwa Kuwonongeka Kwakukula kwa Ziphuphu, Matenda Osautsa Mumtima a Coronary, ndi Matenda a Mtima a Coronary mu Nkhani Yogwiritsa Ntchito Matenda Othandizira Amer Col a Card 2006, 48 (2): 293 -297).

Popeza kuti A 1 c yaphatikizidwa kale ngati njira yodziwira matenda osokoneza bongo, imayesedwanso pakali pano poyerekeza ndi mwayi wokhala ndi matenda a shuga, ofanana ndi NGN komanso NTG yokhayokha. Zakhazikitsidwa kuti chiopsezo chokhala ndi matenda ashuga pambuyo pazaka 5 ku 5.5% ≤ A 1 c A 1 c A 1 s (Zhang X. et al. A1c mulingo ndi chiwopsezo chamtsogolo cha matenda ashuga: kuwunika mwadongosolo. Diabetes Care 2010, 33: 1665 -1673). Chifukwa chake, ndikofunikira kulingalira kuchuluka kwa A1c kwa 5.7-6.4% monga chisonyezo cha chiwopsezo chachikulu chotenga matenda ashuga pamutuwu, ndiko kuti, monga chizindikiro cha prediabetes (American Diabetes Association: Diagnosis and Classization of Diabetes Mellitus. : S 62- S 69). Ndipo pankhaniyi, anthu omwe ali ndi chizindikiro cha A1c ayenera kudziwitsidwa za chiwopsezo chowonjezereka cha matenda ashuga ndi mtima kuti awapatse dongosolo loyenera la kupewa.

Komanso, mwa anthu omwe ali ndi 6% ≤A1

Masiku ano, zinthu zotsatirazi zoopsa zomwe zapezeka ndizomwe zimayambitsa kufunikira kozindikiritsa matenda a asymptomatic a 2 matenda a shuga:

1. Mndandanda wama miniti ≥ 25 kg / m2 ndi imodzi mwazinthu zowonjezera izi:

• zolimbitsa thupi
• shuga kwa achibale a digiri yoyamba ya ubale (makolo ndi ana awo)
• azimayi ngati abereka mwana wolemera oposa 4 kg kapena wokhala ndi GDM kale
• matenda oopsa oopsa ≥ 140/90 mm RT. Art. kapena antihypertensive mankhwala
• HDL-C, 250 mg% (2.82 mmol / L)
• azimayi omwe ali ndi polycystic ovary syndrome
• HbA 1 c ≥5.7%, kulekerera kwa glucose kapena kusala bwino kwa shuga
• Matenda ena a m'magazi omwe insulin imayamba (kunenepa kwambiri, kukokana kwa matenda akuda, etc.)
• mbiri yamtima

2. Pakalibe zizindikiro zomwe zili pamwambapa, kuyezetsa matenda a shuga kuyenera kuchitidwa kwa aliyense wazaka zopitilira 45.

3. Ngati zotsatira za munthu amene adasankhidwazo zinali zabwinobwino, ndiye kuti kuyezetsa matenda a shuga kuyenera kubwerezedwa zaka zirizonse zitatu kapena kupitilira apo kutengera zotsatira ndi zovuta zake.

Zizindikiro za Hyperglycemia

Nthawi zambiri, kuwonjezeka kwa shuga m'thupi kumaonekera mwa odwala omwe ali ndi matenda a shuga kapena mwa anthu omwe ali ndi chiyembekezo chodwala. Nthawi zina hyperglycemia imatha kuchitika, ndipo zizindikiro zake zimafanana ndi matenda ena.

Nthawi zambiri kukula kwa glycemia kumayambitsa kupsinjika kosalekeza, kudya zakudya zopezeka ndi mpweya wambiri, kudya kwambiri, ndikukhalitsa. Zizindikiro zazikulu za glycemia zokhala ndi shuga wambiri zimaphatikizapo:

• ludzu losalekeza
• kuyabwa pakhungu,
• kukodza pafupipafupi,
• kuwonda kapena phindu
• kumangokhala wotopa
• kusakhazikika.

Pogwiritsa ntchito shuga wambiri wamagazi, kuchepa kwakanthawi kochepa kapenanso kukomoka kumatha kuchitika. Ngati pakuyesa magazi kudapezeka kuti shuga apezeka, ndiye kuti izi sizikuwonetsa matenda a shuga.

Mwinanso awa ndi malire amalire omwe akuwonetsa kuphwanyidwa kwa dongosolo la endocrine. Mulimonsemo, glycemia yemwe ali ndi vuto la kusamba uyenera kuyesedwa.

Zizindikiro za hypoglycemia

Kutsika kwa shuga kapena hypoglycemia kumakhala kokhazikika kwa anthu athanzi akamachita masewera olimbitsa thupi kwambiri kapena kutsatira kwambiri zakudya zomwe zili ndi mpweya wochepa. Kwa odwala matenda a shuga, kupezeka kwa hypoglycemia kumalumikizidwa ndi mlingo wosankhidwa bwino wa insulin, nthawi zina zimachitika.

Zizindikiro zotsatirazi ndizodziwika bwino za hypoglycemia:

1. njala,
2. chizungulire chopitilira
3. kuchepa kwa magwiridwe
4. nseru
5. kufooka thupi limodzi ndi kugwedeza pang'ono,
6. osasiya malingaliro a nkhawa ndi nkhawa,
7. tuluka thukuta.

Nthawi zambiri hypoglycemia imatsimikiziridwa mwachisawawa panthawi yoyeserera yotsatira labotale. Nthawi zambiri anthu omwe ali ndi hypoglycemia samalabadira zomwe akuwonetsa ndipo ndizovuta kwambiri kudziwa kuchepa kwa shuga m'thupi. Ndi shuga wotsika kwambiri, munthu amatha kugwa.

Njira za Shuga

Kuti mudziwe kuchuluka kwa glycemia pamankhwala amakono, njira ziwiri zazikulu zimagwiritsidwa ntchito.

1. Kuyesedwa kwa magazi kwa shuga.
2. Mayeso a kulolera a glucose

Mtundu woyamba wa kusanthula ukuchokera pa kudziwa kuchuluka kwa glycemia wodwala m'magazi omwe atengedwa pamimba yopanda kanthu. Magazi amachotsedwa chala cha munthu. Iyi ndi njira yodziwika kwambiri yodziwira glycemia mwa anthu.

Glycemia wokwera sindiye nthawi zonse amangosonyeza munthu wodwala matenda a shuga. Nthawi zambiri, zowonjezera zowunikira zitha kuchitidwa kuti zitsimikizire izi.

Kuti tiwonetsetse kuti matendawa ndi olondola, kuyezetsa magazi ena ambiri kwa shuga, titha kunena kuti uwu ndi mtundu wa kuyesa kwa matenda ashuga. Panthawi yoyesedwa, wodwalayo ayenera kupatula kwathunthu kumwa zakumwa zomwe zimakhudza mayendedwe a mahomoni.

Kuti mupeze zambiri zodalirika, dokotala amaperekanso kuwunikira kwa shuga. Chomwe chimatsimikizira izi:

1. Wodwala amayesa magazi mosamala,
2. Atatha kusanthula, 75 ml imatengedwa. madzi osungunuka
3. Patatha ola limodzi, kuyezetsanso magazi kwachiwiri kumachitika.

Ngati mulingo wa glucose m'magazi uli m'magawo 7.8-10.3 mmol / l, ndiye kuti wodwalayo amamuwunikira. Mlingo wa glycemia pamtunda wa 10,3 mmol / L umawonetsa kukhalapo kwa odwala matenda ashuga.

Chithandizo cha glycemia

Glycemia amafunikira chithandizo chamankhwala. Amasankhidwa ndi dokotala munthawi iliyonse malinga ndi kuchuluka kwa shuga, zaka komanso kulemera kwa wodwalayo, komanso pazinthu zina zingapo. Komabe, chithandizo chingakhale chothandiza ngati munthu sasintha zizolowezi zake osasintha moyo wake.

Malo apadera pothandizira glycemia amapatsidwa zakudya. Wodwala aliyense yemwe ali ndi shuga wambiri m'thupi ayenera kudya mankhwala, mafuta okhala ndi index yotsika ya glycemic.

Onse omwe ali ndi hyperglycemia ndi hypoglycemia, zakudya ziyenera kuchitika m'magawo ang'onoang'ono a 5-6 patsiku. Chakudyacho chiyenera kukhala makamaka ndi mapuloteni komanso chakudya chamagulu. Izi ndi zinthu zomwe zimatha kudzaza thupi ndi mphamvu kwa nthawi yayitali.

Pochiza glycemia, anthu sayenera kuyiwala za kuyesetsa zolimbitsa thupi. Izi zitha kukhala njinga, kuthamanga kapena kukwera maulendo.

Glycemia kwa nthawi yayitali sangathe kudziwonetsa, komabe, akapezeka, ndikofunikira kuti ayambe kulandira mankhwalawa.

Glycemia - ndi chiyani?

Thupi laumunthu ndi dongosolo lovuta. Imodzi mwazofunikira kwambiri kwa iye ndi glycemia. Ichi ndi chiyani Mawuwo ndi ochokera ku Chigriki ndipo amaphatikizanso magawo awiri, omwe amatanthauzidwa kuti: "magazi" ndi "wokoma". Mwanjira ina, glycemia ndiye chinthu chofunikira kwambiri m'thupi chamoyo chomwe chitha kuyang'aniridwa ndikuwonetsa zomwe zili ndi magazi m'magazi - chakudya, chomwe ndi gwero lamphamvu kwambiri komanso lamphamvu kwa maselo ndi minyewa (yoposa 50% yamphamvu yomwe imagwiritsidwa ntchito ndi thupi imapangidwa ndikuwonjezera mphamvu yake zinthu).

Chofunikira pa chizindikirochi ndichokhazikika. Kupanda kutero, ubongo umangosiya kugwira ntchito moyenera. Kodi njira yokhayo yakhalira yokhala ndi chiwalo monga glycemia ndi chiyani? Mulingo wake umachokera pa 3,4 mpaka 5.5 mmol pa lita imodzi yamagazi.

Mwazi wamagazi utagundika kwambiri kapena kukwera kwambiri, ndiye kuti munthu atha kuzindikira, ayamba kupsinjika. Coma ndizovuta kwambiri chifukwa chokweza kapena kutsitsa shuga.

Mawu akuti "glycemia"

M'zaka za zana la XIX, katswiri wazinthu zakuthambo waku France, a Claude Bernard, pofotokozera chizindikiro cha shuga kapena shuga m'magazi a chinthu chamoyo, adatsimikiza za mawuwo.

Magulu a glycemia amatha kukhala abwinobwino, okwera, kapena kutsika. Malire a kuchuluka kwa shuga m'magazi amachokera ku 3.5 mpaka 5.5 mmol / l.

Njira yoyenera yogwiritsira ntchito ubongo ndi thunthu lonse limatengera kukhazikika kwa chizindikirochi. Ngati magazi a glucose ndi otsika, ndiye kuti amalankhula za hypoglycemia, ndipo ngati apamwamba kuposa masiku onse, amalankhula za hyperglycemia. Zonsezi ziwiri ndizowopsa, chifukwa kupitilira pazinthu zovuta ndizovuta kwa munthu amene akukomoka ngakhale kukomoka.

Glycemia: Zizindikiro

Ngati kuchuluka kwa shuga m'magazi kumakhala koyenera, ndiye kuti zizindikiro za glycemia sizikuwoneka, chifukwa thupi limagwirira ntchito bwino bwino. Mitundu yosiyanasiyana kwambiri imawonekera pokhapokha ngati aphwanya.

Kuchulukitsa komanso kuchepa kwa glycemia: ndi chiyani?

Ngati manambala a phindu lovomerezeka akapitilira, ndiye kuti hyperglycemia imadziwonetsa yokha. Vutoli limagwirizana makamaka ndi anthu odwala matenda ashuga. Chifukwa chosowa insulini yawo yomwe, kuchuluka kwa shuga kumakwera m'magazi a odwalawa atatha kudya.

Ndipo kusowa kwake mthupi kumatchedwa hypoglycemia. Dziwani kuti matendawa ndi amodzi a anthu athanzi labwino omwe amadya kwambiri kapena kuchita masewera olimbitsa thupi mopitirira muyeso. Kuphatikiza apo, odwala matenda a shuga amathanso kukhala ndi vuto la hypoglycemia ngati pali mankhwala osokoneza bongo ochulukirapo kapena mlingo wa insulin wosankhidwa molakwika.

Hyperglycemia

Shuga glycemia yokhala ndi misempha yayitali yotchedwa gluerglycemia. Zizindikiro zake zitha kukhala izi:

• Khungu
• ludzu lalikulu
• kusakhazikika
• kukodza pafupipafupi
• kutopa,
• muzochitika zazikulu, kusowa kwa chikumbumtima kapena chikomokere kumatha kuchitika.

Hypoglycemia

Ngati palibe shuga yamagazi yokwanira, ndiye kuti imatchedwa hypoglycemia. Zina mwazizindikiro zake ndi:

• kumva kwamphamvu njala
• kuphwanya mgwirizano wapakati,
• kufooka wamba
• chizungulire
• nseru
• kutayika kwa chikumbumtima kapena chikomokere.

Momwe mungadziwire kuchuluka kwa glycemia?

Pali njira ziwiri zikuluzikulu zomwe zingakuthandizeni kudziwa shuga. Loyamba ndi kuyesa kwa glucose, chachiwiri ndi muyezo wama glucose pogwiritsa ntchito kuyezetsa magazi.

Chizindikiro choyamba chomwe madokotala amazindikira ndicho kuphwanya glycemia, koma sikuwonetsa kuti pali matenda. Iyi ndi njira yofala kwambiri, yomwe imapangira kudziwa kuchuluka kwa shuga m'magazi a capillary mutatha kusala kwa maola asanu ndi atatu. Magazi amatengedwa kuchokera pachala m'mawa pambuyo tulo.

NGN (kusokonezeka kwapang'onopang'ono glycemia) ndi mkhalidwe womwe glucose womwe umapezeka m'magazi othamanga (plasma) plasma ali pamwamba pa mulingo woyenera, koma pansi pa mtengo wolumikizira, womwe umakhala chizindikiro cha matenda a shuga. Mwachitsanzo, mtengo wamalire wa 6.4 mmol / L umaganiziridwa.

Kumbukirani kuti kuti mutsimikizire zolosera ndikuzindikiritsa moyenera, muyenera kuchititsa maphunziro amenewo kawiri. Ziyenera kuchitika masiku osiyana osiyanitsa zolakwika zamalo. Kuphatikiza apo, kuti mupeze zotsatira zodalirika, ndikofunikira kuti musamwe mankhwala a mahomoni.

Kafukufuku wowonjezera ndi kuyesa kwa shuga. Monga lamulo, zimachitika pofotokozera za matenda awo. Potsatira mayeso, njirayi ndi ili:

• kuyesedwa kwa glucose koyenera kumachitika.
• woyeserera amatenga magalamu 75 a shuga pamlomo (nthawi zambiri amakhala ngati njira yothirira madzi),
• patatha maola awiri, kuyesedwa kwachiwiri ndi kuyesedwa kwa magazi kumachitika.

Zizindikiro zomwe zapezedwa zimawonedwa ngati zabwinobwino ngati sizifika 7.8 mmol / L. Chizindikiro chofanana ndi matenda a shuga ndi kuphatikizira kwa glucose wopitilira 10.3 mmol / L. Ndi chizindikiro cha 10,3 mmol / l, akuwonetsa kuti akupitilira mayeso owonjezera.

Glycemia: achite chiyani?

Ngati ndi kotheka, dokotala amalembera chithandizo cha glycemia.

Komabe, ndi matendawa, chinthu chofunikira kwambiri ndikutsatira zakudya zoyenera. Odwala omwe ali ndi matenda ashuga ayenera kusamala kwambiri ndi kusamala pa machitidwe a chakudya monga mndandanda wa glycemic. Chinsinsi cha kukhala ndi thanzi labwino ndikudya zakudya zama index zochepa.

Zakudya zosafunanso kwenikweni. Pankhani ya hyperglycemia, komanso vuto la hypoglycemia, ndikofunikira kudya zakudya zopatsa mphamvu (zinthu zomwe zimayamwa nthawi yayitali mthupi ndipo nthawi yomweyo zimapereka mphamvu kwa nthawi yayitali), zimakhalapo, koma pang'ono ndi pang'ono. Komanso, zakudya ziyenera kukhala zochepa m'mafuta komanso zomanga thupi zambiri.

Glycemia: mankhwala

Ngati mukuphwanya glycemia, chithandizo ndi mankhwala dokotala. Maziko othandizira ndi kusintha kwa moyo wa wodwalayo. Muzovuta kwambiri, kugwiritsa ntchito mankhwala ndikotheka. Kutsatira zakudya ndizofunikira kwambiri pakuchiza glycemia.

Anthu omwe ali ndi matenda ashuga ayenera kusankhika posankha zakudya: zakudya zokha zomwe zili ndi glycemic index yotsika ndiyomwe ziyenera kudyedwa. Ndipo ndi milingo yayikulu komanso yotsika glucose, muyenera kutsatira zakudya zopatsa mphamvu: idyani pang'ono, koma nthawi zambiri.

Kuchokera pazosankha muyenera kuchotsa "chakudya choyipa" chamagulu (mwachitsanzo, zoyera zamafuta ndi shuga) ndikuchepetsa mafuta. Maziko ake azakudya ayenera kukhala zovuta ma carbo - zinthu zomwe zimapatsa thupi mphamvu kwa nthawi yayitali. Komanso, pazikhala chakudya chokwanira cha mapuloteni.

Kuchita zolimbitsa thupi moyenera ndi kuwonjezeranso kunenepa kwambiri ndi chinthu china chofunikira kwambiri pothandizira glycemia.

Nthawi zambiri, zizindikiro za kuphwanya kuchuluka kwa shuga m'magazi sizimawonekera konse kapena zimagwirizanitsidwa ndi matenda ena ndipo zimapezeka mwadzidzidzi. Zikatero, simungakane kulandira chithandizo, ngakhale wodwalayo ali bwino. Tiyenera kudziwa kuti nthawi zina glycemia imayamba chifukwa cha chibadwidwe, ndipo anthu omwe amatengera matenda oterewa amalimbikitsidwa kumayezetsa magazi pafupipafupi.

Zizindikiro za glycemia

Pokhala ndi kuchuluka kwa shuga m'magazi, zizindikiro za glycemia sizimawoneka, chifukwa thupi limagwira bwino ndikuthana ndi katundu. Muzochitika ngatizochitika zikaphwanyidwa, mawonetseredwe osiyanasiyana amomwe amachitika.

Ngati phindu lovomerezeka (hyperglycemia) litaposa, zizindikiro za glycemia zimakhala motere:

• Ludzu lalikulu
• Khungu loyera
• Kukodza pafupipafupi
• Kusakwiya
• Kutopa,
• Kutha kwa chikumbumtima ndi chikomokere (makamaka muzovuta zazikulu).

Matenda a hyperglycemia ndi achilendo makamaka kwa odwala matenda a shuga. Mwa odwalawa, chifukwa chosowa kapena kuchepa kwa insulin yawo atatha kudya, shuga m'magazi amadzuka (postprandial glycemia).

Kusintha kwina pakugwira ntchito kwa thunthu lonse kumachitika ndi hypoglycemia. Ndikofunika kudziwa kuti nthawi zina mkhalidwewu umadziwika ndi anthu athanzi lathunthu, mwachitsanzo, kulimbitsa thupi kwambiri kapena kudya kwambiri, komanso odwala omwe ali ndi matenda osokoneza bongo, ngati mlingo wa insulin umasankhidwa molakwika kapena mankhwala osokoneza bongo a hypoglycemic.

Pankhaniyi, zizindikiro za glycemia ndi izi:

• Kumva kwamphamvu njala
• Chizungulire ndi kufooka wamba,
• Kuchepetsa mseru
• Kugwirizana kwamiseche,
• Coma kapena kutaya mtima (muzovuta).

Kuwona mulingo wa glycemia

Kuti mudziwe kuchuluka kwa glycemia, njira ziwiri zazikulu zimagwiritsidwa ntchito:

• Muyezo wa shuga wamagazi
• Mayeso a kulolera a glucose.

Chizindikiro choyamba chowoneka ndikuphwanya kudya kwa glycemia, komwe sikuwonetsa matenda. Iyi ndi njira yodziwika bwino, yomwe imakhala yopanga kuchuluka kwa shuga m'magazi a capillary (kuyambira chala) mutasala kudya kwa maola asanu ndi atatu (nthawi zambiri m'mawa atagona).

Kuchepetsa kusala kudya kwa glycemia, kapena IHF, ndi mkhalidwe momwe chakudya cham'madzi chamasamba (kapena magazi) chimaposa mulingo wabwinobwino, koma chiri pansi pamtengo wamtengo wapatali womwe umakhala chizindikiro cha matenda a shuga. Chizindikiro cha 6.2 mmol / L chimawerengedwa kuti ndi malire.

Mukuyenera kudziwa kuti kuti mutsimikizire zolosera ndikuwunikira koyenera, ndikofunikira kuti muchite kafukufuku mwina kawiri, ndipo ndikofunikira pamasiku osiyanasiyana kupewa zolakwika zamalo. Kuti mukhale wodalirika pazotsatira za kusanthula, ndikofunikira kuti musamwe mankhwalawa omwe amakhudza maziko a mahomoni.

Kuti mumvetse bwino vutoli, kuwonjezera pakuzindikira glycemia yofulumira, ndikofunikira kuchita kafukufuku wachiwiri: kuyesa kwa glucose. Njira zoyeserera izi ndi motere:

• Kuthamanga magazi
• Wodwala amatenga shuga wa magalamu 75 (nthawi zambiri amakhala njira yankhono yamadzi),
• Mobwerezabwereza sampuli yamagazi ndi kusanthula patatha maola awiri mutatsitsa pakamwa.

Ziwerengero zomwe zapezedwa zimadziwika kuti ndizabwinobwino mpaka 7.8 mmol / l, ngati zifika pa 10,3 mmol / l, ndikofunika kuyesedwa. Chizindikiro cha matenda ashuga ndichopitirira 10.3 mmol / L.

Zoyambitsa ndi zizindikiro

Pali mitundu iwiri ya zonyansa zam'magazi: hypoglycemia imadziwika ndi shuga m'magazi ochepa, ndipo hyperglycemia imakwezedwa. Matenda a glycemia opatsirana amatha kuchitika pazifukwa zosiyanasiyana:

• Choyambitsa matenda ambiri chimakhala chotupa, kapena ndi gawo la matenda ena.
• Fodya wosuta fodya kapena mowa mwauchidakwa amatha kukhala chifukwa chakuthamanga kwa glycemia.
• Nthawi zina chimayambitsa matenda a chiwindi.
• Kuphwanya kumachitika chifukwa cha kunenepa kwambiri, chifukwa cha kusintha kwa moyo (zoletsa zazikulu pazakudya, kuwonjezera zolimbitsa thupi).
• Matenda a ana ndi obadwa nako (kusakwanira kwa kugwira ntchito kwa chiwindi).
• Kukula kwa shuga kumakhala kofala mwa anthu odwala matenda ashuga. Amakhala ndi kuchepa (kapena kusowa) kwa insulin yawo, ndipo chifukwa chake, atatha kudya, glucose imakwera.

Pali mitundu ingapo ya hyperglycemia. Zolimbitsa thupi zimachitika mutatha chakudya chokhala ndi chakudya chamagulu. Iyi ndi njira yabwinobwino, koma imatha kukhala yovuta pakumazunza kwa zakudya zotere. Postprandial glycemia imadziwika chifukwa chakuti pambuyo paphikidwe wamba, shuga amawuka pamiyeso yovuta. Palinso mitundu yamafungo, yamafuta komanso yovuta.

Zizindikiro za hyperglycemia ndi izi:

• ludzu lochulukirapo
• Khungu
• kukodza pafupipafupi
• kuchuluka kukwiya
• Kukula msanga kwa kutopa,
• njala yopanda malire
• kufooka
• kuphwanya mgwirizano wamgwirizano,
• kutayika kwa chikumbumtima komanso kugona.

Hypoglycemia imatha kupezekanso mwa anthu athanzi omwe amadya kwambiri, kudya masewera olimbitsa thupi. Ndi vuto lolakwika la insulin, matendawo angayambike kwa odwala matenda a shuga. Izi ndizowopsa mthupi la munthu.

Zizindikiro zakuchepa kwa kusala kudya kwa glycemia ndi izi:

• kutuluka thukuta kwambiri
• kumva milomo ndi zala,
• njala yachilengedwe
• palpitations,
• kunjenjemera
• womvera
• kufooka.

Ndi kuphwanya kwatchulidwa, zizindikiro zowonjezereka zitha kudziwika: kupweteka kwambiri kwa mutu, ma vasospasms, kuwona kawiri, ndi zizindikiro zina zamavuto apakati amanjenje. Nthawi zina kudya glycemia kumawonetsedwa ndi kusowa tulo komanso kukhumudwa.

Kodi amadziwika bwanji?

Kuzindikira kwa glycemia kumachitika pamimba yopanda kanthu pogwiritsa ntchito njira zasayansi. Mlingo wa chitukuko umatsimikiziridwa munjira zapadera. Kuti mudziwe ndi kuliphunzira, kuyezetsa magazi kwachitika. Kuyesedwa kwa shuga m'magazi kumachitika pamimba yopanda kanthu tulo titagona usiku.

Ndikofunikira kuyesedwa kangapo (osachepera - 2) pamasiku osiyanasiyana kuti tipewe zolakwika ndikuwonetsetsa. Ndi glycemia wolumala, kuchuluka kwa shuga kumapitilira zomwe zimachitika, koma ndizotsika kuposa manambala omwe amawonetsa kuyambika kwa matendawa.

Chiyeso chololera cha glucose ndi kafukufuku wotsatira wofunikira. Imachitika m'magawo angapo. Choyamba, kuyezetsa magazi kwabwinobwino kumatengedwa, ndiye kuti wodwalayo ayenera kumwa 75 ga shuga, ndipo pambuyo pa maola 2 amawunikanso kachiwiri. Imatsimikiza kuchuluka kwa shuga ndi momwe thupi limagwiritsira ntchito.

Kwa odwala, kusanthula kwapadera kungaperekedwe - mbiri ya glycemic. Cholinga chake ndikudziwa kusinthasintha kwa shuga kwa tsiku ndi tsiku, izi ndizofunikira pakukhazikitsidwa kwa chithandizo. Mbiri ya glycemic imatsimikiziridwa ndi kuyezetsa magazi kwapadera mobwerezabwereza masana nthawi zina. Munthawi imeneyi, munthu amadya ndandanda, koma amayesetsa kutsatira zomwe amakonda ndi zosowa zake.

Momwe tiyenera kuchitira

Ngati glycemia yayamba kusala bwino, adokotala amakupatsani chithandizo, koma maziko a malangizowo ndi kusintha moyo wawo. Chofunikira kwambiri pakukonzanso thanzi ndikutsatira zakudya. Kuwongolera kwa glycemia kumachitika chifukwa cha kudya moyenera. Odwala ayenera kusankha zakudya zamagulu a glycemic ochepa, azidya pafupipafupi, koma m'malo ochepa, onjezani chakudya "zovuta" kuzakudya zawo. Ndikofunikira kwambiri kupatula shuga, mikate yoyera, ndi mafuta ophikira muzakudya. Ndikofunikira kuti muchepetse kuchuluka kwa mafuta, ndipo zinthu zopangira mapuloteni ziyenera kukhalapo zochuluka.

Kuchulukitsa zolimbitsa thupi ndikofunikira. Zakudya zoyenera komanso kuchita masewera olimbitsa thupi mokwanira kumapangitsa kuti muchepetse thupi. Ofufuza akunja akuti ngati munthu ayenda kang'ono tsiku lililonse, ndiye kuti chiwopsezo cha matenda a shuga chimachepetsedwa katatu. Muzovuta zambiri, shuga amakhala ndi mankhwala.

Anthu nthawi zambiri samatengera kufunikira kwa chizindikiro cha glycemia, ndipo nthawi zina amalakwitsa kuwawona ngati matenda ena, motero ndikofunikira kupimidwa magazi nthawi ndi nthawi. Ndikofunika kwa anthu omwe ali ndi vuto lobadwa ndi matenda ashuga, amayenera kuyesedwa ndi pafupipafupi.

Zithandizo za anthu

Zithandizo zotsimikiziridwa zimathandiza kuchepetsa shuga m'magazi. Pali njira zambiri zopewera. Zakumwa zomwe zatsika shuga pang'ono ndi tiyi wa linden, osakaniza a madzi a beet ndi mbatata ndi kuwonjezera kwa Yerusalemu artichoke, decoction wa oats.

Chida chothandiza ndi mapira. Maphala ogawanitsidwa bwino amalimbikitsidwa kuti atenge mu mawonekedwe owuma, 5 g katatu patsiku, kutsukidwa mkaka.

Matenda othamanga a glycemia ndi vuto lomwe limadutsa matenda a shuga. Mu International Classifier of Diseases (ICD), matendawa amatanthauza matenda a endocrine ndipo amadziwika ndi kuchepa kwa insulin. Malinga ndi ICD, uwu ndi matenda osokoneza bongo komanso owopsa momwe matenda a kagayidwe kachakudya komanso kuchuluka kwakukulu kumachitika. Kuzindikira kwa "kusala kudya kwa glycemia" ndi chifukwa chachikulu choganiza, kulingaliranso moyo wanu komanso kupewa kupewa matenda ashuga.

Matenda a shuga ali pafupi kwambiri matenda ashuga.

Mwina mwazindikira kale kuti pakati pa manambala omwe ali m'magawo awiri a tebuloyo “ndikuviika” - nanga bwanji kuyambira 5.6 mpaka 6.1 mmol / l pamimba yopanda 7.8-11.1 mmol / l mutatha kuthira shuga? Izi ndi zomwe posachedwapa zatchedwa prediabetes. Mutuwu ndi wovuta kwambiri, ndipo tsopano tizingolankhula za diagnostic, ndipo patapita nthawi pang'ono tidzakambirana mwatsatanetsatane zomwe zili zenizeni. Mwakulankhula, matenda am'mbuyomu amatha kukhala m'magulu awiri - kusala glycemia komanso kuwonongeka kwa shuga.

Tebulo Na. 4. Matenda a shuga (kusokonekera kwa glycemia)

matanthauzidwe chonse

capillary

magazivenous

plasma Pamimba yopanda kanthu5,6-6,1 (100-110)6,1-7,0 (110-126) Maola 2 pambuyo PGTTTebulo Na. 5. Matenda a shuga (kulekerera shuga)

matanthauzidweGlucose concentration (glycemia), mmol / l (mg / dl) chonse

capillary

magazivenous

plasma Pamimba yopanda kanthuKuyesa kwa glucose

Ndani ayenera kuyesedwa

1. Kwa abale onse apamtima a odwala matenda ashuga.
2. Anthu onenepa kwambiri (BMI> 27), makamaka ngati pali kunenepa kwambiri. Izi zimangotanthauza odwala omwe ali ndi androgenic (wamwamuna) wonenepa kwambiri komanso (kapena) wapezeka kale wambiri ma insulin. Ndifotokoza kuti ndi mtundu wa kunenepa kwambiri wa androgenic, kuchuluka kwa mafuta pamimba pamimba.
3. Amayi omwe ali ndi mseru wamwazi wokwanira kapena mawonekedwe a glucose mumkodzo wawo panthawi yapakati.
4. Amayi omwe ali ndi vuto la ovary la polycystic, padera, komanso kubereka ana asanakwane.
5. Amayi a ana omwe ali ndi vuto lobadwa nalo kapena wolemera thupi pobadwa (oposa 4.5 kg).
6. Odwala omwe ali ndi kuthamanga kwa magazi, kuthamanga kwa magazi a "zoipa" cholesterol ndi uric acid.
7. Anthu omwe akudwala matenda osachiritsika a chiwindi, impso, matenda amtima (kupatula povuta kwambiri aimpso ndi chiwindi kulephera - mayesowo ndi osadalirika).
8. Odwala omwe ali ndi matenda a periodontal, furunculosis ndi matenda ena a pustular omwe amakhala nthawi yayitali, mabala ochiritsa osavulala.
9. Anthu omwe amachulukitsa kuchuluka kwa glucose panthawi yovuta (maopareshoni, kuvulala, matenda othandizira).
10. Odwala omwe amatenga mankhwala ena kwanthawi yayitali - corticosteroids, kulera kwa mahomoni, okodzetsa, etc.
11. Odwala omwe ali ndi vuto la neuropathy la osadziwika.
12. Onse amoyo wathanzi atakwanitsa zaka 45 (nthawi 1 m'mazaka 2).

Momwe mungakonzekerere phunzirolo

1. Osamwa mowa kwa masiku atatu mayeso ake asanachitike. Pankhaniyi, muyenera kudya zakudya zonse.
2. Madzulo a phunziroli, ndikofunikira kupewa kuchita masewera olimbitsa thupi.
3. Chakudya chotsiriza sichikhala pasanathe maola 9-12 maphunziro asanachitike. Izi zimakhudzanso zakumwa.
4. Musanatenge magazi oyamba, komanso nthawi ya 2 "mayeso", musasute.
5. Asanayesedwe, ndikofunikira kupatula njira zonse zamankhwala osamwa mankhwala.
6. Kuyesaku sikulimbikitsidwa nthawi yayitali kapena itangotha ​​(kufalikira kwamatenda osachiritsika), munthawi ya kupsinjika, komanso munthawi yamagazi oyenda magazi.
7. Panthawi yoyeserera (maola 2) muyenera kukhala pansi kapena kugona (osagona!). Pamodzi ndi izi, ndikofunikira kupatula zochitika zolimbitsa thupi ndi hypothermia.

Chinsinsi cha njirayi

Magazi amatengedwa pamimba yopanda kanthu, pambuyo pake wodwalayo akapatsidwa njira yotsekemera yosamveka - 75 g ya shuga wosungunuka amasungunuka mu kapu yamadzi (250 ml).

Kwa ana, kuchuluka kwa glucose amawerengedwa pamaziko a 1.75 g pa 1 kg ya kulemera, koma osapitirira 75. Anthu onenepa amawonjezera 1 g pa 1 kg imodzi ya kulemera, koma osaposa 100 g yonse.

Nthawi zina citric acid kapena mandimu amangowonjezeredwa panjirayi kuti athandize kukoma ndi kulolera kwa zakumwa.

Pambuyo maola 2, magazi amatengedwanso ndipo kuchuluka kwa glucose muzitsanzo zoyambirira ndi zachiwiri zimatsimikiziridwa.

Ngati zikuwonetsa kuti zonse zili mkati moyenera, kuyeseraku kumawoneka kuti sikwabwino, komwe kumawonetsa kusowa kwa zovuta za carbohydrate metabolism.

Ngati chimodzi mwazizindikiro, ndipo makamaka zonse zikupatuka pa chizolowezi, tikulankhula za prediabetes kapena matenda ashuga. Zimatengera kuchuluka kwa kupatuka.

Gawani "Matenda a shuga ali pafupi kwambiri matenda ashuga."