Glycated Hemoglobin > Zizindikiro

Glycated hemoglobin, kapena glycogemoglobin (mwachidule: hemoglobin A1c, Hb_A1c), Ndi chisonyezo chamwazi cham'magazi chosonyeza shuga m'magazi kwa nthawi yayitali (kuyambira miyezi itatu mpaka inayi), mosiyana ndi kuyeza magazi, zomwe zimapereka lingaliro la kuchuluka kwa shuga m'magazi panthawi ya phunzirolo.

Glycated hemoglobin amawonetsa kuchuluka kwa hemoglobin yamagazi yolumikizidwa mosavomerezeka ndi mamolekyulu a shuga. Glycated hemoglobin imapangidwa chifukwa cha zomwe Maillard amachita pakati pa hemoglobin ndi glucose wamagazi. Kuwonjezeka kwa shuga m'magazi a shuga kumathandizira kwambiri izi, zomwe zimapangitsa kuchuluka kwa hemoglobin m'magazi. Nthawi yonse ya maselo ofiira a m'magazi (ma cell ofiira am'magazi), omwe amakhala ndi hemoglobin, pafupifupi masiku 120 mpaka 125. Ndiye chifukwa chake mulingo wa glycated hemoglobin umawonetsa kuchuluka kwa glycemia pafupifupi miyezi itatu.

Glycated hemoglobin ndi chizindikiro chachikulu cha glycemia kwa miyezi itatu. Mokulira kuchuluka kwa hemoglobin wa glycated, kumakulitsa glycemia m'miyezi itatu yapitayo, ndipo, motero, umakhala pachiwopsezo chotenga matenda a shuga.

Kafukufuku wa hemoglobin wa glycated nthawi zambiri amagwiritsidwa ntchito poyesa mtundu wa chithandizo cha matenda a shuga m'miyezi itatu yapitayo. Ndi mulingo wambiri wa glycated hemoglobin, kukonza chithandizo (mapiritsi a insulin kapena mapiritsi ochepetsa shuga) ndi mankhwala othandizira ayenera kuchitika.

Kodi ndi kuti ndipo muwerenge izi?

Ndikofunika kuti mupeze kuwunikirako osati kuchipatala kapena ku chipatala, koma mu labotale yodziyimira payokha. Zabwino ndi izi ma labotore omwe samagwira, koma amangoyesa. M'mayiko a CIS, malo ogwirira ntchito a Invitro, Sinevo ndi ena ali ndi malo osiyanasiyana komwe mungathe kubwera kudzayesa mayeso ena popanda utsogoleri. Uwu ndi mwayi wabwino, womwe ndi tchimo osagwiritsa ntchito.

Kuchipatala, labotale ikhoza kusokoneza zotsatira za kusanthula, kutengera zolinga zomwe zalembedwazi. Mwachitsanzo, chipatala cha boma chadzaza kwambiri. Pankhaniyi, akuluakulu akhoza kupereka lamulo kuti alembe zotsatila za mayeso a glycated hemoglobin. Chifukwa cha izi, odwala matenda ashuga amatha kupita kwawo mwamtendere ndipo sanapeze chithandizo. M'malo mwake, madokotala amafuna kukopa odwala ambiri kuti "adule" ndalama kuchokera kwa iwo. Atha kukonzekera ndi labotale "yakomweko" kuti odwala matenda ashuga komanso anthu athanzi labwino asokonezedwe.

Kodi kuyezetsa magazi kwa glycated hemoglobin kumawononga ndalama zingati?

M'mabungwe azachipatala a anthu, nthawi zina zimakhala zotheka kuchita mawunikidwe aulere, chifukwa chothandizidwa ndi dokotala. Ngozi zomwe tafotokozazi zikuyenera kufotokozedwa. Kusanthula m'mabotolo odziimira palokha kumalipiridwa zamagulu onse a odwala, kuphatikiza opindulitsa. Komabe, mtengo wa chiwonetsero cha HbA1C mu labotale yangayokha ngotchipa. Chifukwa cha kuchuluka kwake, kafukufukuyu ndi wotsika mtengo kwambiri, komanso wokwera mtengo ngakhale kwa nzika zapamwamba.

Momwe mungakonzekerere mayesowa?

Kusanthula kwa hemoglobin ya glycated ndi kosavuta chifukwa sikutanthauza kukonzekera kwapadera kuchokera kwa odwala. Dziwani kuti maola akutsegulira a labotale, fikani kumeneko nthawi yoyenera ndikupereka magazi kuchokera m'mitsempha. Nthawi zambiri, zotsatira za kusanthula pa HbA1C ndi zizindikiro zina zokusangalatsani inu mutha kuzilandira tsiku lotsatira.

Ndiyenera kupita nayo pamimba yopanda kanthu kapena ayi?

Glycated hemoglobin sayenera kumwedwa pamimba yopanda kanthu. Mwakutero, mutha kukhala ndi chakudya cham'mawa musanapite ku labotale. Koma, monga lamulo, kuwunikirako sikumaperekedwa kokha, koma pamodzi ndi zizindikiro zina zomwe zimafunikira kutsimikiza pamimba yopanda kanthu. Chifukwa chake, mosakayikira, mudzapezeka kuti muli mu labotale m'mawa m'mimba yopanda kanthu.

Tchulani maphunziro ena omwe ndi othandiza kuchita ndi HbA1C. Choyamba, tengani magazi ndi mkodzo poyesa impso zanu. Ndikofunika kuti odwala matenda ashuga azilamulira kuchuluka kwa C-peptide. Kuphatikiza pa shuga komanso cholesterol yambiri, palinso ziwopsezo zina za vuto la mtima ndi sitiroko. Kuyesedwa kwa magazi komwe kumatsimikizira izi: 1. C-reactive protein, homocysteine, fibrinogen. Kuchita zopewa, mutha kupewa matenda a mtima komanso sitiroko osachepera zaka 80.

Kodi hemoglobin wa glycated amayeza chiyani?

Chizindikiro ichi chimayezedwa ngati peresenti. Mwachitsanzo, zotsatira za kusanthula kwanu zinali 7.5%. Awa ndi kuchuluka kwa hemoglobin yemwe amaphatikiza ndi glucose, ndiye kuti, wapangika glycated. 92.5% yotsala ya hemoglobin imakhalabe yachilendo ndipo imapitilizabe kugwira ntchito yake, ndikupereka mpweya m'matipi.

Kuchuluka kwa glucose m'magazi, kumakhala mwayi wopezeka kuti molekyulu ya hemoglobin imalumikizana nayo. Malinga, kuchuluka kwa glycated hemoglobin. Glucose owonjezera, omwe amayendayenda m'magazi a odwala matenda ashuga, amaphatikizana ndi mapuloteni komanso amasokoneza ntchito yawo. Chifukwa cha izi, zovuta pang'onopang'ono zimayamba. Hemoglobin ndi amodzi mwa mapuloteni omwe anakhudzidwa. Kuphatikiza kwa shuga ndi mapuloteni kumatchedwa glycation. Zotsatira zake, izi "zopangidwa zomaliza za glycation" zimapangidwa. Amayambitsa mavuto ambiri, kuphatikizapo zovuta za matenda ashuga m'miyendo, impso ndi mawonekedwe amaso.

Kodi muyenera kangati kuti mumvetse izi?

Choyamba, onani mndandanda wazizindikiro za matenda ashuga. Ngati mita ya shuga m'magazi ikusonyeza kuti muli ndi shuga wabwinobwino ndipo palibe chizindikiro, ndikokwanira kuwona hemoglobin kamodzi pakatha zaka zitatu. Pazaka 60-65, ndibwino kuti muzitenga kamodzi pachaka, makamaka ngati masomphenya ndikukhala bwino zikuyamba kuwonongeka.

Anthu athanzi omwe akuganiza kuti ayamba kudwala matenda ashuga amayenera kuwona HbA1C yawo posachedwa. Ndikulimbikitsidwa kuti odwala matenda ashuga azitha kuyesa osachepera miyezi isanu ndi umodzi iliyonse kuti awone momwe mankhwalawo amathandizira. Koma simuyenera kuzichita kangapo kamodzi pa miyezi itatu iliyonse.

Glycosylated hemoglobin ndi glycated hemoglobin: pali kusiyana kotani?

Sizipangitsa kusiyana, ndi chinthu chomwecho. Mayina awiri osiyana amtundu womwewo. Nthawi zambiri gwiritsani ntchito imodzi yosavuta komanso yofulumira kulemba. HbA1C imapezekanso.

Kodi hemoglobin ndi glycosylated ndi chiyani

Ichi ndi chizindikiro cha magazi, chomwe chimawonetsa kuchuluka kwa shuga m'miyezi itatu yapitayo. Mu labotale, kuchuluka kwa maselo ofiira a m'magazi, kapena m'malo mwake, hemoglobin, kumakhala kosakanikirana ndi mamolekyulu a shuga. Mulingo wa chinthu ichi umafotokozedwa peresenti ndikuwonetsa kuchuluka kwa "shuga" m'thupi lonse la maselo ofiira amwazi. Mokulirapo kuchuluka kwake, kumakhala kovuta mawonekedwe amtunduwo.

Mu shuga mellitus, kuchuluka kwa glucose kumawonjezera, limodzi ndi izi kuchuluka kwa hemoglobin ya glycosylated. Odwala omwe ali ndi vutoli, kuchuluka kwa thunthu limasiyana ndi zomwe zimachitika kawiri kawiri. Ndi chithandizo chabwino, pambuyo pa masabata a 4-6, chisonyezo chimabwereranso manambala ovomerezeka, koma vutoli liyenera kupitilizidwa moyo wonse. Kuyesa HbA1c pamtunduwu wa hemoglobin kumathandizira kuwunika bwino kwa chithandizo cha matenda ashuga. Ngati kafukufukuyo adawonetsa kuti kuchuluka kwa mapuloteni okhala ndi glycosylated ayini, ndikofunikira kuchititsa kukonza mankhwalawa.

Kuyesa kwa magazi kwa glycogemoglobin

Amawerengedwa kuti ndi njira yabwinoko yoyeserera magazi. Kutsimikiza kwa glycogemoglobin kumakhala ndi zabwino zambiri, chifukwa zotsatira zake sizisintha malinga ndi zolimbitsa thupi, mtundu wa zakudya usiku komanso mkhalidwe wamalingaliro. Kuyesedwa kwa glucose nthawi imodzi kumatha kuwonetsa kuchuluka kwake, koma sizitanthauza kuti kagayidwe kake ka shuga kakang'ono. Nthawi yomweyo, kuchuluka kwa shuga pamayeso sikumachotsa 100% kusapezeka kwa matendawa.

Assha wa glycated hemoglobin ndi wokwera mtengo. Amawerengera zotere:

Mtundu woyamba wa matenda ashuga, kupezeka koyambirira kwa matenda ashuga 2,
carbohydrate kagayidwe kachakudya ana,
pakati, ngati mayi ali ndi matenda ashuga,
matenda amiseche, omwe amapezeka muzochitika zogonana zoyenera,
kuwunika momwe mankhwalawa alili,
matenda ashuga, momwe chakudya chochuluka amapezeka ndi impso.

Momwe angatenge

Malinga ndi muyezo, antchito ogwira ntchito akufukulidwa amafunsidwa kuti atenge zinthuzo kuti aziwunika pamimba yopanda kanthu, yomwe imathandizira ntchito yawo. Kuti mupeze kuchuluka kwathunthu kwa glycogemoglobin, sikofunikira kukana chakudya cham'mawa, chifukwa chizindikirocho sichofanizira ndi chithunzichi, koma m'miyezi itatu yapitayo. Simungasinthe chilichonse ndi chakudya chimodzi, komabe ndikofunikira kumvetsera ku zomwe akatswiri akufuna kuti musagwiritse ntchito ndalama pokonzanso.

Kutengera ndi mtundu wa wasanthula, magazi adzatengedwa kuchokera ku chala chanu kapena mtsempha. Kukonzekera mwapadera ntchito yosonkhanitsa zinthu sikufunika. Pambuyo pa masiku 3-4, zotsatira za phunzirolo zidzakhala zokonzeka. Ngati kuchuluka kwa glycogemoglobin kuli mkati mwazotheka, kuwunika kuyenera kuchitika pakadutsa kanthawi koyamba mu zaka 1-3. Ngati matenda a shuga akupezeka koyambirira, kafukufukuyu amachitika masiku 180 aliwonse. Ngati dongosolo la mankhwalawo lisintha kapena wodwalayo akulephera kudziyimira pawokha shuga, chizindikirocho chimawunikidwa kamodzi pakapita miyezi itatu.

HbA1c glycated Hb magazi wamba

Kwa amuna, akazi (ndi amayi apakati nawonso), ana, muyezo wa hemoglobin wa glycated m'magazi ndi umodzi - 4 ... 6%. Chilichonse pansipa kapena pamwamba pa malirewa chimatengedwa kuti ndi matenda. Ndi chizindikiro cha 6.5%, munthu amapezeka ndi matenda a shuga. Ngati tingapende manambala mwachindunji, titha kuzindikira izi:

HbA1c mkati mwa 4 ... 5.7%. Carbohydrate metabolism ili, chiwopsezo cha matenda ashuga ndichochepa kwambiri.
5.7 ... 6%. Mwayi wokhala ndi matenda a shuga ukuwonjezeka. Wodwalayo amalangizidwa kuti azikhala ndi zakudya zamafuta ochepa.
6.1 ... 6.4%. Chiwopsezo cha matenda a m'matumbo ndi chachikulu kwambiri. Ndikofunikira kuti munthu athe kuchepetsa kuchuluka kwa zopatsa mphamvu zomwe zimapakidwa ndikusintha kukhala ndi moyo wathanzi.
6.5% ndi zina. Mapeto oyambira - matenda ashuga. Wodwala amapatsidwa maphunziro owonjezera angapo.

Mlingo wa hemoglobin wa glycosylated kwa odwala matenda ashuga ali pansipa 7%. Odwala ayenera kuyesetsa kuzisonyeza, kukhala ndi mtengo wotsika kwambiri. Mu matenda a shuga, ndikofunikira kutsatira malingaliro onse a dotolo, ndiye kuti manambala ake atsikira ku 6.5%, zomwe zikuwonetsa gawo la kubwezeretsedwa ndi kuchepa kwa chiwopsezo cha zovuta. Zochita zathupi zimayenda bwino, ndipo thanzi likhala bwino.

Zomwe zimachitika nthawi ya mimba sizosiyana ndi muyezo. Komabe, mwa mayi amene akuyembekezera mwana, kuchuluka kwake kungakhale kotsika, chifukwa kukula kwa mwana wosabadwayo kumafunikira mphamvu, yomwe imatengedwa ku glucose. Kuphatikizanso, kuwunika kwa hemoglobin ya glycosylated mwa amayi apakati athanzi sikupangika kwa miyezi 8-9, chifukwa chake muyenera kusankha njira yina yolankhulira magazi.

Zimayambitsa kuchuluka glycogemoglobin

Maperesenti a HbA1c, omwe amapitilira zomwe amapitilira, akuwonetsa kuti kwanthawi yayitali kuchuluka kwa shuga m'magazi kwawonjezeka. Chifukwa chachikulu ndikuphwanya kwa kagayidwe kazakudya, kakulidwe ka shuga. Izi zimaphatikizanso kulekerera kwa glucose komanso kusokonezeka kwa glucose pamimba yopanda kanthu (zizindikiro 6.0 ... 6.5%). Zina mwazomwe zimapangitsa ndikupha poyizoni ndi zakumwa zoledzeretsa, mchere wamchere, kusowa kwa ndulu, kulephera kwa impso, komanso kuchepa kwa magazi m'thupi.

Mafuta a glycated hemoglobin

Maperesenti a HbA1c amatha kudziwa kuchuluka kwa shuga m'magazi. Kusanthula kumawonetsa kuchuluka kwa chinthu chilichonse kwa miyezi itatu. Wodwala aliyense yemwe ali ndi matenda ashuga ayenera kudziwa kuti ngakhale kuchepa kwa 1% kumachulukitsa moyo zaka zingapo, kumapangitsa kukhala kwabwinoko komanso kokwanira. Osanyalanyaza kuwunikirako ngati mukukayika kapena muli ndi zofunikira pakuwonetsa.

Ambiri kuchuluka kwa shuga m'miyezi itatu yapitayi, mmol / l

Carbohydrate metabolism mkati mwa malire abwinobwino, palibe shuga

Prediabetes, shuga yowonjezera, mankhwala osakwanira amtunduwu

Subcompensated shuga mellitus, ndikofunikira kuyang'ana pa zovuta zomwe zingachitike

Matenda osapatsidwa shuga omwe sasintha

Vidiyo: zomwe glycated hemoglobin imawonetsa pakupenda

Chifukwa chiyani kuli kofunikira kuphunzira HbA1c nthawi ndi nthawi? Werengani funso ili, chomwe chimawunikira kuti mupezeke matenda a shuga ndi mapindu ake. Pambuyo poonera vidiyoyi, muwona kuti kuphunzira za glycogemoglobin ndi njira yatsopano komanso yothandiza yophunzirira zambiri za kagayidwe kazachilengedwe ndikuwongolera moyo wanu - muchepetse ufa ndi zakudya zotsekemera, onjezerani zochitika zolimbitsa thupi.

Dziwani hemoglobin wa glycated

Hemoglobin ndi gawo limodzi lama cell ofiira a m'magazi - magazi m'magazi omwe ali ndi vuto lonyamula mpweya ndi kaboni dayokisi. Shuga ikadutsa membrane wa erythrocyte, zimachitika. Amino acid ndi shuga zimayenderana. Zotsatira zake zimachitika ndi glycated hemoglobin.

Hemoglobin imakhala yokhazikika mkati mwa maselo ofiira a m'magazi, chifukwa chake, mlingo wa chizindikirochi umakhala wokhazikika kwa nthawi yayitali (mpaka masiku 120). Kwa miyezi 4, maselo ofiira amagwira ntchito yawo. Pambuyo pa nthawi imeneyi, amawonongedwa ndi zamkati zofiira za ndulu. Pamodzi ndi iwo, njira yowonongeka imadutsa glycohemoglobin ndi mawonekedwe ake aulere. Pambuyo pake, bilirubin (mankhwala omaliza a kuphwanya kwa hemoglobin) ndi glucose samamanga.

Fomu ya glycosylated ndichizindikiro chofunikira kwa odwala omwe ali ndi matenda ashuga komanso mwa anthu athanzi. Kusiyanako kumangokhala pakungoganiza.

Kodi kuzindikira kumatenga gawo lanji?

Pali mitundu ingapo ya hemoglobin ya glycated:

Muzochita zachipatala, mtundu wotsiriza umapezeka kwambiri. Njira yolondola ya kagayidwe kazakudya ndi zomwe glycated hemoglobin imawonetsa. Kuphatikizika kwake kumakhala kokwanira ngati mulingo wa shuga ndiwopamwamba kuposa wabwinobwino.

Mtengo wa HbA1c amayeza ngati peresenti. Chizindikirochi chimawerengedwa ngati gawo la kuchuluka kwa hemoglobin voliyumu.

Kuyesedwa kwa magazi kwa hemoglobin ya glycated ndikofunikira ngati mukukayikira matenda ashuga ndikuwunika momwe thupi limayankhira chithandizo cha matenda. Amanena zolondola. Mwa kuchuluka kwa kuchuluka, mutha kuweruza shuga m'magazi atatu apitawa.

Endocrinologists amagwiritsa ntchito bwino chizindikiro ichi pakupezeka mitundu ya matenda am'mbuyomu, pakakhala kuti palibe chizindikiro chodziwika bwino cha matendawa.

Chizindikiro ichi chimagwiritsidwanso ntchito ngati chikhomo chomwe chimazindikiritsa anthu omwe ali pachiwopsezo chotenga zovuta za matenda ashuga. Gome limawonetsa zizindikiritso zam'magulu azaka, zomwe akatswiri amatsogolera.

Kuthekera kwa kukhala ndi hypoglycemia (kuchepa kwa shuga) mu shuga

Mayeso wamba amatayika kwambiri motsutsana ndi kumbuyo kwake. Kusanthula pa HbA1c ndizopindulitsa komanso zosavuta.

Nthawi zonse kwa akazi

Mkazi aliyense ayenera kulabadira kuchuluka kwa hemoglobin ya glycated m'thupi. Kupatuka kwakukulu kuchokera kuzikhalidwe zovomerezeka (tebulo pansipa) - zikuwonetsa zolephera izi:

Matenda a matenda osiyanasiyana.
Kusowa kwazitsulo.
Kulephera kwina.
Makoma ofooka amitsempha yamagazi.
Zotsatira za opareshoni.

Zomwe zimachitika mwa akazi zizikhala mu izi:

Gulu la Zaka (zaka)

Ngati kusiyanasiyana kwapezeka pazomwe zikuwonetsedwa, ndikofunikira kuyesedwa, komwe kungakuthandizeni kuzindikira zomwe zimayambitsa kusintha kwa shuga.

Miyezo ya Amuna

Mwa amuna, chiwerengerochi ndi chachikulu kuposa chachikazi. Zomwe zimachitika m'badwo zimasonyezedwa patebulo:

Gulu la Zaka (zaka)

Mosiyana ndi amayi, oimira ogonana amphamvu, phunziroli liyenera kuchitidwa pafupipafupi. Izi ndizowona makamaka kwa amuna opitilira 40.

Kulemera msanga kungatanthauze kuti munthu wayamba kudwala matenda ashuga. Kutembenukira kwa katswiri pazizindikiro zoyambirira kumathandizira kuzindikira matendawa m'magawo oyambira, zomwe zikutanthauza chithandizo chanthawi yake komanso chothandiza.

Mikhalidwe ya ana

Mu mwana wathanzi, kuchuluka kwa "shuga pawiri" ndikofanana ndi kwa munthu wamkulu: 4.5-6%. Ngati matenda a shuga adapezeka ali ana, ndiye kuti kuwongolera mosamalitsa pakutsatira ndi zomwe zikuchitika kumachitika. Chifukwa chake, ana omwe ali ndi matendawa popanda chiopsezo cha zovuta ndi 6.5% (7.2 mmol / l glucose). Chizindikiro cha 7% chimawonetsera kukhala ndi hypoglycemia.

Mwa odwala matenda ashuga achinyamata, chithunzi chonse cha matendawa chitha kubisika. Izi zitha kuchitika ngati adapereka kuwunika m'mawa pamimba yopanda kanthu.

Mitundu ya amayi apakati

Pa nthawi yomwe mayi ali ndi pakati, thupi la mkazi limasintha. Izi zimakhudza kuchuluka kwa shuga. Chifukwa chake, zomwe zimachitika nthawi ya pakati mwa mayi ndi zosiyana pang'ono ndi momwe zimakhalira:

Paubwana, ndi 6.5%.
Wapakatikati amafanana ndi 7%.
Mwa amayi apakati "okalamba", mtengo wake uyenera kukhala osachepera 7.5%.

Glycated hemoglobin, momwe zimakhalira nthawi yoyembekezera iyenera kuwunika miyezi 1.5 iliyonse. Popeza kusanthula uku kumatsimikizira momwe mwana wamtsogolo adzakhalire ndi kumva. Kupatuka pamalingaliro kumakhudza kwambiri mkhalidwe wa "puzozhitel" wokha, komanso amayi ake:

Chizindikiro pansipa chimakhala chofanana ndi mulingo wachitsulo ndipo chingayambitse kulepheretsa chitukuko cha fetal. Muyenera kuwunikiranso momwe mumakhalira, idyani zipatso ndi masamba ambiri.
Mulingo wambiri wa "shuga" hemoglobin umawonetsa kuti mwana akhoza kukhala wamkulu (kuchokera ku makilogalamu 4). Chifukwa chake, kubadwa kudzakhala kovuta.

Mulimonsemo, kuti muwongolere zolondola, muyenera kufunsa dokotala.

Malangizo kwa odwala matenda ashuga

Kuwunikira kwa hemoglobin ya glycated amaperekedwa pakuwunika, pomwe wodwalayo amadziwa kale za matenda ake. Cholinga cha phunziroli:

Magazi a shuga.
Kukonza Mlingo wa mankhwala ochepetsa shuga.

Chikhalidwe cha matenda ashuga chimakhala pafupifupi 8%. Kusungabe gawo lalitali chonchi kumachitika chifukwa cha kuzolowera thupi. Ngati chizindikirocho chikugwa kwambiri, izi zimayambitsa chitukuko cha dziko la hypoglycemic. Izi ndizowona makamaka kwa anthu okalamba. Mbadwo wachichepere uyenera kuyesetsa kwa 6.5%, izi zimathandiza kupewa zovuta.

Gulu lazaka zapakatikati (%)

Ukalamba ndi chiyembekezo cha moyo. ”Views: 185178

Kodi hemoglobin ndi glycated (glycosylated)

Kunena zowona, kukhalapo kwa mapuloteni amtunduwu kulinso m'magazi a munthu wathanzi. Inde, simunalakwitse, glycated hemoglobin ndi puloteni yomwe imapezeka m'magazi m'maselo ofiira am'magazi - maselo ofiira am'magazi, omwe amakhala ndi shuga kwa nthawi yayitali.

Zotsatira za kuyamwa komanso "kokoma" ndi shuga wosungunuka m'magazi aanthu (umatchedwa Maillard reaction, polemekeza msisitikali waku France yemwe adaphunzira izi mwatsatanetsatane wa makemikolo) popanda kuwonetsa ma enzyme aliwonse (ndiye mphamvu yamafuta yomwe ili ndi gawo lalikulu) hemoglobin yathu imayamba, munjira yeniyeni ya mawu, kuti "olemba".

Zachidziwikire, zomwe zili pamwambazi ndizofanizira kopanda tanthauzo komanso kophiphiritsa. Njira ya "caramelization" ya hemoglobin imawoneka yovuta kwambiri.

Glycated hemoglobin

Zokhudzana ndi njira iyi, ndiye kupezeka kwa magazi a chamoyo chilichonse chomwe mwanjira ina chimagwiritsa ntchito chakudya. Monga tikudziwa kale, ma carbohydrate, monga zotsatira za carbohydrate enzymatic metabolism, amadzipangira mphamvu zenizeni - glucose, gwero lofunikira lamphamvu kwamankhwala amunthu komanso lokha lomwe lingapezeke wopanga zida zazikulu, mutu wazinthu zonse ndi zochitika mu thupi la munthu - ubongo.

Kutalika kwa moyo wa hemoglobin, wokhazikika mu "suti ya shuga", zimatengera chiyembekezo cha maselo ofiira a magazi okha. Nthawi ya "ntchito" yawo ndi yayitali ndipo imatenga masiku pafupifupi 120.

Pakuwonetsetsa magazi a anthu, nthawi yayitali ya masiku 60 amatengedwa.

Izi zimachitika pazifukwa zingapo, chimodzi mwazomwe zimapanga thupi kuti zisinthe, chifukwa chomwe, kuchuluka kwake, kuchuluka kwa maselo ofiira m'magazi, kumasintha mosalekeza. Momwemo, kutsimikizira kwa biochemical kudzakhala ndi mtengo wapakati, womwe umadalira kuwunika kwa shuga m'miyezi itatu yapitayo ndikuwonetsa mkhalidwe wa metabolism ya carbohydrate panthawiyi.

Kuchokera apa tikufika pamalingaliro osavuta awa:

Kuchuluka kwa glucose m'magazi a anthu ndikuchepetsa pang'onopang'ono ndi thupi (kapena kuwachotsa ndi mkodzo kapena kusungidwa), hemoglobin yowonjezereka kwambiri imapangika m'magazi a anthu.

Timanenanso kuti, popeza kuchuluka kwa glucose kumakhalapo kwa nthawi yayitali, chifukwa chake, pali zovuta zina ndi kapamba, ma cell a β-cell omwe:

kupanga insulin yaying'ono kwambiri,
sizipanga konse,
lipange muyezo woyenera, koma zosintha zazikulu zachitika kale m'thupi la munthu, zomwe zikuchititsa kutsika kwa maselo kuti insulin (izi zitheke, mwachitsanzo, ndi kunenepa kwambiri)
chifukwa cha kusintha kwa majini, insulini yomwe imapangidwa ndi "yoyipa," ndiye kuti, singathe kukwaniritsa udindo wake mwachindunji (kugawa, kutulutsa shuga), pomwe m'magazi a munthu zingakhale zokwanira, koma sizigwira ntchito konse.

Mitundu ina ya mayeso, monga ultrasound (ultrasound), ithandiza kudziwa zovuta zomwe zachitika ndi kapamba kapenanso zovuta za matenda ashuga "zomwe adaziyambitsa" kale.

Zotsatira zomaliza ziyenera kukhudzidwa ndi zinthu zingapo:

njira yoyeserera magazi yoyesedwa (kuchokera pa chala kapena mu mtsempha)
mtundu wa wasanthula (mwa chida kapena momwe magazi amayesedwa kapena ziwiya zake)

Sikuti pachabe tidangoyang'ana pakadali pano, chifukwa zotsatira zake zimakhala zotsutsa. Ngati tingayerekezere zotsatira zomwe tapeza titatha kugwiritsa ntchito chosindikiza ("nyumba") chojambulidwa ndikuyang'ana lipoti la katswiri lomwe limaperekedwa ku labotore, kuchuluka kwake mwina sikungafanane. Komabe, awunikiranso momwe magazi alili, ndipo apereka lingaliro lina lofananira: ngati kuchuluka kwa hemoglobin wa glycated m'magazi kumachulukitsidwa kapena kuli m'milingo yovomerezeka.

Chifukwa chake, ndikwabwino kuyendetsa wekha kudzera mu mtundu womwewo wa kusanthula.

Zambiri za hemoglobin ya fetal ndi kuthekera kwake kuonjezera kuchuluka kwa mapuloteni "okoma" m'maselo ofiira a magazi

Imapezeka kwambiri mwa makanda osabadwa, ndipo masiku 100 atabadwa imazimiririka pafupifupi.

HbF nthawi zambiri imakhala yochepera 1% ya hemoglobin yonse, ndipo imapezeka mwa akulu. Zimasiyanasiyana chifukwa chakuti imatha "kupitilira" mpweya wambiri pamtunda wa mayendedwe - mitsempha. Popanda mpweya wokwanira, mwana sangathe kukula msanga, mwina akhoza kuopsezedwa kuti adzabadwa mwana wosabadwa.

Koma munthu wachikulire safuna hemoglobin yamtunduwu. Mapapu opangidwa kale amamuthandiza kusefa mpweya, womwe, ambiri mwa mapulaneti, amakonda kusuta osapembedza.

Koma chifukwa chiyani HbF imakhudza kuchuluka kwa hemoglobin "yokoma"?

Ndipo zonse ndizosavuta. Tilitchule kuti "oksijeni" kapena "mpweya", chifukwa chake, chifukwa cha kuchuluka kwa mpweya m'magazi, njira zambiri zophatikiza okosijeni mthupi la munthu, zimathandizira kwambiri.

Koma! Mnzathu "airy", wachikulire yemwe amakonda chilichonse chokoma komanso zochuluka, amaikira nkhumba yeniyeni. HbF imapanga malo okhala "acidic", chifukwa chake, motsogozedwa ndi okosijeni ndi ma enzyme, mafuta amadzimadzi amachititsa kuti glucose azikhala mofulumira (ndiye kuti gawo loyamba la metabolism ya carbohydrate limachitika kangapo mwachangu). Izi zimatsogolera, mwachidziwikire, pakuwonjezereka kwakukulu komanso mofulumira kwambiri kwa shuga.

Kapamba mwachidziwikire samayembekezera chinyengo chonyansa ngati ichi (osasiya odwala matenda ashuga, omwe kale "amapuma") ndipo sangathe kulimbana ndi ntchito yake - kutulutsa mahomoni, makamaka insulin. Chifukwa chake, pamene kapamba mu hysteria akuyesera kuti athetse vutoli, shuga pang'onopang'ono "amapempha" maselo ofiira amwazi ndipo, mwachiwonekere, mulingo wa "caramelised" hemoglobin m'magazi umakwera.

Koma, chabwino, palibe zochuluka za "oxygen" iyi m'magazi, motero, palibe chodandaula. Komabe, nthawi zina pamakhala zovuta zina, zomwe, mwadzidzidzi, sizichitika kawirikawiri ndipo zimangochitika ngati zosafunikira. Ndipo ndichabwino kuti zili choncho, chifukwa sitibwereza mawu akuti: "Chilichonse chikuyenera kukhala choperewera!" Musaiwale lamulo ili!

Zomwe zimawonetsa ndizomwe zimakhalira ndi matenda ashuga

Ndipo kotero, tafika pamenepa. Wodwalayo akapereka magazi, nthawi yina iyenera kudutsa (zonse zimatengera mtundu wa chosinkhira) musanadziwe zotsatira zomaliza. Nthawi zambiri, nthawi yotsogolera imasiyana kuchokera kwa mphindi zochepa (ngati mukugwiritsa ntchito chosakanizira cha magazi amoyo), maola kapena tsiku limodzi.

Zowonjezera

Ngati hemoglobin "wokoma" imasungidwa pamalo okwera, ndiye kuti zochitika zotsatirazi zimachitika:

shuga mellitus (Komanso, kuzindikira kumeneku sikuyenera kukhala kwa odwala onse omwe ali ndi protein yambiri ya "zotsekemera")
hyperglycemia (shuga wamagazi ochulukirapo, 5.5 mmol / lita)
kuchepa kwachitsulo
splenectomy (mkhalidwe wapadera wa munthu, chikhalidwe cha opaleshoni, chifukwa chomwe ndulu imachotsedwa)
mwa amayi apakati ndikotheka: kubadwa kwa mwana wolemera kwambiri, mwana wobadwa wakhanda, mwana akhoza "kusungidwa" chiyembekezo chakulembeka matenda a shuga a 2
kuchuluka kwa HbA1c kumakhudza mwachindunji momwe mtima wamunthu uliri

Kodi tikupeza chiyani pamenepa?

Zapezeka kuti pali kufanana kwina, komwe kuchuluka kwa mapuloteni "otsekemera" m'magazi ofiira kumabweretsa kuwonongeka m'mitsempha yama coronary.

HbA1c yochulukirapo, zotengera zowonongeka kwambiri!

Ndipo izi zimakhudza molunjika kukula kwa zovuta zamtima (matenda a mtima, kugunda, zovuta zam'kati, atherosclerosis, etc.)

Mwina tsopano ndimaliza mwachangu, koma mwa lingaliro langa lachiwonetsero, zikuwonekeratu kuti pamaso pa mtundu wovuta kwambiri wa matenda a shuga, mapuloteni onse omwe shuga amatha kufikira "amatha". Ndi zomwe zidachulukira (magazi a nthawi yayitali a hyperglycemia), magazi "okoma" amakhala ovuta ndipo amawonongeratu chilichonse, chifukwa chake: mavuto ndi impso, maso, mitsempha yamagazi imawonongeka, ndipo popanda iwowo chilichonse mthupi chimatha, chifukwa ma metabolic (carbohydrate, lipid, ndi ena otero). d.) kuphwanyidwa. Zimagwedeza thupi lonse! Chifukwa chake, vuto lalikulu ndi hyperglycemia, pomwe mapuloteni ambiri m'thupi la munthu amatsitsidwa.

Zotsatira zochepa

hypoglycemia (shuga m'magazi ochepera, 3.3 mmol / lita)
hemolytic anemia (matenda omwe amawononga kwambiri maselo ofiira a magazi)
kutaya magazi (chifukwa chake,, kuchuluka kwa maselo ofiira a magazi kumachepa)
kuthira magazi (chopereka cha magazi omwe aperekedwa kapena zida zake)
mwa amayi apakati ndikotheka: kubadwa msanga, kubadwa kwa mwana asanachitike kapena wobadwa kale

Chifukwa chake, nkoyenera kuyesetsa kufunikira kwa hemoglobin m'magazi, koma musaiwale kuti m'badwo uliwonse umakhala ndi chikhalidwe chake!

Kuchuluka kapena kuperewera kulikonse kumabweretsa zotsatirapo zoyipa, momwe thupi lonse ndi chitetezo chake m'thupi chimagwedezeka.

Kutsata ubale wa glycemia ndi HbA1c

Gome lotsatirali silikuwonjezedwa mwangozi pankhaniyo. Mukadakhala osamala, ndiye kuti zalembedwa mu kukumbukira kwanu mfundo ya ubale wolunjika wa "caramelized" hemoglobin ndi glucose. Chifukwa chake, kuchuluka kwake kumadalira kuchuluka kwa shuga m'magazi ndi nthawi ya "kugwiritsidwa ntchito" kwake kapena kudya kwa thupi.

HbA1c%	Glucose mmol / L	HbA1c%	Glucose mmol / L
4.0	3.8	8.0	10.2
4.5	4.6	8.5	11.0
5.0	5.4	9.0	11.8
5.5	6.8	9.5	12.6
6.0	7.0	10.0	13.4
6.5	7.8	10.5	14.2
7.0	8.6	11.0	14.9
7.5	9.4	11.5	15.7

Mwachidule, timati tikulimbikitsidwa kuti tiunikenso izi:

amayi apakati pa milungu 10 mpaka 12 ya bere
Pozindikira mtundu 1 wa matenda ashuga 1 nthawi imodzi mwa kotala la chaka (miyezi 3)
mukazindikira mtundu 2 wa matenda ashuga 1 nthawi iliyonse pa miyezi isanu ndi umodzi (miyezi 6)

Kusanthula chikhalidwe

Mtundu wa kusanthula	biochemical (kuthamanga kwa cation kusinthana chromatography)
Mutu	glycated (glycosylated) hemoglobin, HbA1c, A1c
Zomwe zikufufuzidwa	magazi athunthu ndi anticoagulant (EDTA)
Kukonzekera	malamulo apadera safunikira asanaperekedwe magazi
Zizindikiro	kuwunika matenda ashuga kuwongolera matenda ashuga matenda, komanso pofufuza matenda a endocrine kuphatikiza pa mayeso a kulolera kwa glucose pakupezeka kwa prediabetes ndi metabolic syndrome 10 mpaka 12 milungu yoyembekezera (komanso odwala matenda a gestational) kutsimikiza kwa mulingo wa chindapusa cha matenda ashuga (kuwunika kwamankhwala abwino)
Unit	% ya kuchuluka kwa hemoglobin m'magazi (okwana)
Lero	kuchokera maola angapo mpaka tsiku limodzi (kuphatikiza magazi osonyeza)
Chikhalidwe chamunthu wathanzi	4.5 — 6.5
Ndi adotolo ati amatipatsa	othandizira endocrinologist azachipatala
Zochuluka motani	labotale: kutengera mtundu wa chosinkhira kuchokera ku ma ruble 500 ndi pamwamba kunyumba: mtengo wakuwunika wosakanizika wamankhwala kuchokera ku ma ruble 2,000 ndi kupitilira apo
Nchiyani chimatsimikizira zotsatira zabodzazi?	kuthira magazi hemolysis magazi

Ngati mwapeza cholakwika, chonde sankhani gawo ndikusindikiza Ctrl + Enter.

Kodi glycated hemoglobin ndi chiyani?

Glycated kapena glycosylated hemoglobin ndiye wopanga hemoglobin ndi glucose. Glucose amalowa mu membala wa erythrocyte ndikumangiriza ku hemoglobin chifukwa cha zomwe Maillard anachita: ili ndiye dzina la kuphatikiza kwa shuga ndi ma amino acid omwe amapezeka m'thupi.

Glycated hemoglobin ndi chidule ngati glycohemoglobin.

Mankhwala, monga momwe amalembedwera, zoterezi zimagwiritsidwa ntchito:

Mosiyana ndi kuchuluka kwa shuga wamagazi m'magazi, kuchuluka kwa glycogemoglobin kumakhala kosasintha ndipo sikudalira zinthu zakunja. Imasunga ndikuwonetsa chidziwitso cha kuchuluka kwa shuga mu maselo ofiira m'moyo wawo wonse.

Kodi hemoglobin ya glycated imawonetsa chiyani?

Glycohemoglobin ndi chizindikiro cha magazi pamagazi, kutengera kuchuluka kwa shuga m'magazi. Ndi kuchuluka kwake, kusakanikirana kwa glucose ndi hemoglobin kumathandizira, zomwe zimapangitsa kuti pakhale glycated hemoglobin.

Mlingo wa HbA1C umawonetsa kuchuluka kwa shuga m'masiku 120-125 apitawa: ndi kuchuluka kwa maselo ofiira m'magazi omwe amasunga zambiri za kuchuluka kwa glycogemoglobin.

HbA1C imawonetsa digiri ya matenda ashuga

Mitundu ya glycogemoglobin

Kuchuluka kwa hemoglobin ya glycated sikudalira mtundu kapena zaka: izi ndizofanana kwa amuna ndi akazi, ana ndi achikulire.

Kwa munthu wathanzi, piritsi la kuchuluka kwa glycogemoglobin m'magazi limagwiritsidwa ntchito:

Zochepera 4.0%	Mulingo wachepa wa glycogemoglobin. Chithandizo chofunikira.
4.0 mpaka 5.5%	Mulingo wabwinobwino wa hemoglobin wa glycated, palibe chiopsezo cha matenda ashuga.
5.6 mpaka 6.0%	Kuopsa kwa matenda ashuga. Ndikofunikira kusintha moyo, zakudya komanso kugona.
6.0 mpaka 6.4%	Prediabetes boma. Kufunsira kwa endocrinologist ndikofunikira kuti muchepetse kuyambika kwa matendawa.
Zoposa 6.5%	Matenda a shuga.

Pa nthawi ya pakati, chifukwa cha kuchuluka kwa mahomoni ndi shuga, ziwerengerozi zimatha kusiyanasiyana. Miyezi yonseyi imatengedwa kuti ndi glycated hemoglobin osaposa 6.0%. Ngati mtengo wake ndi wokwera kuposa wabwinobwino, muyenera kufunsa dokotala: zomwe zingakhale chifukwa cha matenda ashuga.

Mu matenda a shuga mellitus, pamene kuchuluka kwa hemoglobin ya glycosylated ikachuluka, chizolowezi cha kupezeka kwake m'magazi chimakhazikitsidwa ndi gawo la chandamale.

Ili ndi kuchuluka kwa chiwerengero chomwe chimawonetsera kuchuluka kwa glycogemoglobin pazisonyezo zosiyanasiyana:

Mavuto	Mpaka zaka 30	Zaka 30 mpaka 50	Patatha zaka 50
Palibe chiopsezo cha hypoglycemia kapena mavuto akulu.	Zosakwana 6.5%	6.5 mpaka 7.0%	7.0 mpaka 7.5%
Chiwopsezo chachikulu cha zovuta kapena hypoglycemia yayikulu	6.5 mpaka 7.0%	7.0 mpaka 7.5%	7.5 mpaka 8.0%

Kupatukana ndi zaka chifukwa cha ngozi ya hypoglycemia kwa okalamba. Mukakalamba, matendawa amatha kupha, chifukwa chake ndikofunikira kusunga shuga wambiri m'magazi.

Zifukwa zopatuka kuchoka pazikhalidwe wamba

Kupatuka kwachilengedwe kwa glycogemoglobin yachilengedwe kumachitika chifukwa cha matenda osiyanasiyana komanso matenda amthupi.

Zifukwa zodziwika bwino:

Kuchulukitsa kwa HbA1C
Matenda a shuga	Kuwonjezeka kwa shuga wamagazi kumawonedwa ndi mtundu uliwonse wa shuga. Mutha kuchepetsa kuchuluka kwa shuga ndikusintha kwa moyo wanu komanso kugwiritsa ntchito insulin.
Kulekerera kwa shuga	Mtundu womaliza wa matenda ashuga ochitika chifukwa cha chibadwidwe chamthupi pambuyo povutirapo yovuta kapena chifukwa chokhala ndi moyo wosayenera. Ngati kuphwanya sikunakonzedwe, kumayamba kukhala shuga.
Matenda a ndulu ndi splenectomy	Ndulu ndiyo imayambitsa kutaya maselo ofiira a magazi, choncho nthenda zazikulu kapena kuchotsedwa kwa chiwalochi zimapangitsa kuti glycogemoglobin iwonjezeke m'magazi.
Mankhwala	Kugwiritsa ntchito ma steroid, ma antidepressants, ma tranquilizer, ndi mapiritsi ambiri othandizira kubereka amatha kukulitsa kuchuluka kwa glucose. Ndi kuchuluka kwambiri kwa glycogemoglobin, muyenera kusiya kumwa ndalama izi.
Matenda a Endocrine	Matenda a endocrine dongosolo, zomwe zimapangitsa kuti maholide ambiri amasulidwe, nthawi zambiri zimakweza milingo yamagazi. Zotsatira zake zitha kukhala zazakanthawi kapena zokhazikika.
Kuchepetsa kwa HbA1C
Hemolytic anemia	Ndi matendawa, kuwonongeka kwa maselo ofiira a m'magazi kumachitika, komwe kumachepetsa kuchuluka kwa hemoglobin ndi glycogemoglobin mu plasma.
Insulinoma	Chotupa cha pancreatic chomwe chimakwiyitsa kuchuluka kwa insulin. Amathandizira shuga komanso amachepetsa kuchuluka kwake m'magazi, komwe kumapangitsa hemoglobin wochepa.
Kutaya magazi, kuthiridwa magazi	Ndikataya kwambiri magazi kapena poika magazi, gawo lamaselo ofiira latayika, ndipo ambiri mwa iwo amakhala ndi glycogemoglobin. Izi zimayambitsa kupatuka kuzolowera.
Zakudya zazitali za carb	Chakudya chochepetsedwa ndi mafuta amthupi chimachepetsa kuchuluka kwa shuga m'magazi: amatha kupanga kuchokera kumapuloteni ndi mafuta, koma izi zimachitika pang'onopang'ono. Zotsatira zake, glycohemoglobin imatsika pang'onopang'ono.

Momwe mungakonzekerere phunzirolo?

Kuyesa kwa glycogemoglobin sikutanthauza kukonzekera mwapadera. Mlingo wake sudalira pazinthu zakunja, kotero phunzirolo lisanayambe kudya ndi kumwa, kusewera masewera, kumwa mankhwala aliwonse. Mutha kuyesa nthawi iliyonse yabwino masana, ndipo sizingakhudze zotsatira.

Simuyenera kuyezetsa ndi kuchepa kwa hemoglobin m'magazi, komanso kusintha kwa maselo am'magazi ofiira.

Izi zitha kuchitika:

ndi magazi, kuphatikiza pakusamba,
ndi magazi: kuchepa kwachuma ndi hemolytic,
atayika magazi,
kulephera kwambiri kwa aimpso,
ndi mowa kapena poyizoni wazitsulo.

Komanso, zotsatira zoyeserera zitha kupotozedwa ndi mtundu wocheperako wa mahomoni a chithokomiro.

Simungathe kuwunikira matenda a impso

Zakudya zoyenera

Ndi mtundu 2 wa shuga komanso kuchuluka kwa glycogemoglobin, wodwalayo akulimbikitsidwa kulandira manambala 9. Zakudyazo zimachepetsa kukhalapo kwa zakudya zomwe zimakhala ndi shuga m'zakudya, ndikuzisintha ndi zopsinja shuga. Mkate oyera, pasitala ndi mbatata, zakumwa za shuga ndi shuga siziletsedwa. Amaloledwa masamba, mafuta ndi nyama.

Ngati muli ndi glycogemoglobin yokwanira, muyenera kudya nyama yambiri.

Ndi glycogemoglobin yafupika, muyenera kudya mapuloteni ochulukirapo ndi chakudya chamagulu. Mtedza ndi nyemba, ndiwo zamasamba, buledi, tirigu, zipatso zosiyanasiyana, nyama yochepa yamafuta ndi mkaka umalimbikitsidwa. Pewani khofi, zakumwa za gasi, komanso zakudya zamafuta kwambiri.

Ngati mumadya moyenera, glucose wanu amabwerera mwachizolowezi.

Zochita zolimbitsa thupi

Ndi mulingo wambiri wa glucose, zolimbitsa thupi zolimbitsa thupi ziyenera kuphatikizidwa ndi regimen ya tsiku ndi tsiku, kuthandizira kugwiritsa ntchito glucose ochulukirapo komanso kusunga thupi bwino. Iyenera kuchita nawo kuyenda ndikuyenda pang'onopang'ono, kusambira, kuyendetsa njinga, masewera a mpira ndizovomerezeka. Masewera owonjezera amayenera kupewedwa.

Kuthamangira ndi kuchita masewera olimbitsa thupi ndi kwabwino kwa kuchuluka kwa shuga.

Dzikoli

Kukula kwakanthawi kwamagazi a glucose kumatha kuchitika chifukwa cha zovuta, kuchuluka kwa nkhawa, kukhumudwa, mantha, komanso kukhumudwa. Komanso, ma antidepressants angakhudze kuchuluka kwa shuga.

Kupsinjika pafupipafupi kumatha kuwonjezera magazi

Kuti muchepetse kukhudzika mtima ndikuthana ndi mavuto amisempha omwe amayambitsa kuchuluka kwa shuga, muyenera kufunsa katswiri wamalingaliro.

Voterani nkhaniyi
(4 mitengo, pafupifupi 5,00 pa 5)

Kukonzekera kuwerenga

Hb_A1 (hemoglobin alpha-1) ndiye mtundu wa hemoglobin wodziwika bwino - umakhala ndi 96-98% ya kuchuluka kwa mapuloteni onse m'thupi. Selo yofiira iliyonse imakhala ndi mamolekyulu a hemoglobin pafupifupi 270 miliyoni, omwe, pakapita kanthawi kochepa osapanga enzymatic - glycation - amaphatikizana ndi shuga m'magazi a m'magazi. Mchitidwe wa glycation sukusintha, ndipo kuthamanga kwake kumakhala kofanana ndi mulingo wa glycemia. Glycated hemoglobin amatchedwa Hb_A1c. Zotsatira zakuwunikaku zikuwonetsa kuchuluka kwa glycemia kwa masiku 90 mpaka 120 (nthawi imeneyi imadalira theka la moyo wa chiwonongeko cha maselo ofiira a magazi), koma masiku 30 omaliza musanatenge kuwunikirako ali ndi zotsatira zazikulu kwambiri - 50% ya mtengo wa Hb_A1c chifukwa cha iwo.

Mfundo za Hb zimawonedwa ngati zabwinobwino_A1c kuchokera 4% mpaka 5.9%. Matenda a shuga Hb_A1c ikwera, yowonetsa chiopsezo chachikulu chotenga retinopathy, nephropathy ndi zovuta zina. International Diabetes Federation ikulimbikitsa kusunga kuchuluka kwa Hb_A1c pansipa 6.5%. Mtengo wa Hb_A1cKupitilira 8%, zikutanthauza kuti matenda ashuga sawongolera bwino ndipo chithandizo chikuyenera kusinthidwa.

Kutanthauzira kwa zotsatira kumalephereka ndi kusiyana kwa matekinoloje a labotale komanso kusiyana kwa odwala - kufalikira kwa mfundo za Hb_A1c mwa anthu awiri omwe ali ndi shuga wambiri, amatha kufikira 1%.

Gome ili pansipa likuwonetsa ubale pakati pa glycated hemoglobin ndi shuga wamagazi ochepa.

HBA1C (%)	Pakati pa shuga (m'mol / L)	Akuluakulu a shuga (mg / dL)
4	2,6	47
5	4,5	80
6	6,7	120
7	8,3	150
8	10,0	180
9	11,6	210
10	13,3	240
11	15,0	270
12	16,7	300

Kuwunikaku kunapangidwa potsatira kuti njira ya hematopoiesis ndi kusintha kwa maselo ofiira ammagazi amayenda bwino, kotero zotsatira zake zimatha kupindika chifukwa chotaya magazi kwambiri, komanso ndi hemolytic anemia (mwachitsanzo, ndi matenda a cell ofwara). Pankhaniyi, njira ina ikhoza kukhala kuyeza mulingo wa fructosamine - mapuloteni a glycosylated plasma, omwe amagwiritsa ntchito ngati chisonyezo cha glycemia kwa masabata 2-3 isanafike nthawi ya muyeso.

Pakuwunika kwa hemoglobin ya glycated, 3 cc amatengedwa. magazi a venous. Kuwunikira kumatha kuchitika nthawi iliyonse, kusala kudya sikofunikira - izi sizimakhudza kwambiri zotsatira za kusanthula.

Zisonyezo pacholinga cha kusanthula:

Kuzindikira ndikuwunika shuga.
Kuyang'anira kwa nthawi yayitali maphunzirowa ndikuwunika chithandizo cha odwala omwe ali ndi matenda ashuga.
Kuwona mulingo wazomwe kulipira anthu odwala matenda ashuga.
Kuphatikiza pa kuyesedwa kwa shuga wa glucose (kuyeserera kwa glucose poyeserera matenda a prediabetes, shuga woopsa).
Kuyesa kwa amayi apakati a shuga omwe ali ndi pakati.

Kukonzekera kuwerenga

Mlingo wa hemoglobin wa glycated samatengera nthawi yatsiku, zolimbitsa thupi, chakudya, mankhwala, kapena momwe wodwalayo akumvera. Zinthu zomwe zimafupikitsa "zaka" zapakati pama cell ofiira a magazi (magazi atachepa kwambiri, ndi hemolytic anemia) zitha kuchepetsa zotsatira za mayeso.

Kodi ndichifukwa chiyani glucose yachilendo komanso glycated hemoglobin imakwezedwa?

Odwala odziwa matenda ashuga amatha kukwanitsa kuchuluka kwa shuga nthawi iliyonse. Podziwa kuti apereka magazi a shuga, amatha kumwa mapiritsi pasadakhale kapena kubaya jakisoni wa insulin. Mwanjira imeneyi, amachepetsa chidwi cha abale ndi anzawo omwe ali ndi chidwi. Izi nthawi zambiri zimachitidwa ndi achinyamata odwala matenda ashuga komanso odwala okalamba.

Komabe, ngati wodwalayo aphwanya regimen, zotsatira za kusanthula kwa hemoglobin ya glycated zikuwonetsa izi. Mosiyana ndi kuyezetsa magazi kwa shuga, sichitha kuzimiririka. Umu ndi mwayi wake wapadera wowunika momwe ntchito yochizira kagayidwe kachakudya imagwirira ntchito.

Nthawi zina anthu odwala matenda ashuga amabwera, omwe shuga amawuka masana ndi madzulo, ndipo m'mawa amakhala abwinobwino. Amatha kukhala ndi kuchuluka kwa shuga m'magazi pamimba yopanda kanthu ndipo nthawi yomweyo amawonjezera hemoglobin wa glycated. Anthu otere ndi osowa. Kwa odwala ambiri, kuchuluka kwa shuga m'mawa m'mimba yopanda vuto ndi vuto lalikulu.

Kodi chizindikirochi chimadziwika bwanji?

Mlingo wa hemoglobin wa glycated kwa akazi ndi wofanana ndi amuna. Manambala enieniwo amaperekedwa pamwambapa. Mutha kuzindikira bwino zotsatira zakusanthula kwanu. Zomwe tikutsata HbA1C ndizoyimira pawokha. Amayi atatha zaka 60 ayenera kuyesetsa kuti asapitirire 5.5-5.7%. Kuwongolera kwabwino kwa kagayidwe kazakudya kumapangitsa kuti pakhale kupuma kwabwino, kupewa kupunduka ndi kufa msanga.

Zoyenera kuchita ngati glycated hemoglobin atakwezedwa

Glycated hemoglobin imatha kukwezedwa kwa zaka zambiri popanda kuyambitsa zisonyezo. Mwanjira ina, matenda a shuga kapena matenda ashuga amatha kuchitika kwa nthawi yayitali. Anthu, monga lamulo, amati kuwonongeka kwa masomphenya ndi thanzi labwino chifukwa cha kusintha kwokhudzana ndi ukalamba.

Kuchiza kwa HbA1C okwera kwambiri kwa odwala ambiri kumakhala ndi kutsatira njira ya 2 yothetsera matenda a shuga. Dongosololi ndiloyeneranso kwa odwala omwe ali ndi prediabetes, osati T2DM yokha. Anthu owerengeka, komanso ana ndi achinyamata amafunika kuthandizidwa ndi matenda ashuga amtundu woyamba. Kuti mumvetsetse za matendawa, ndikofunika kuti mukayezetse magazi a C-peptide.

Kodi kutenga metformin kumakhudza bwanji kuchuluka kumeneku?

Kutenga metformin muyezo waukulu tsiku lililonse mapiritsi atatu a 850 mg amachepetsa glycated hemoglobin osaposa 1-1,5%. Mankhwalawa amathandiza anthu okhawo onenepa kwambiri, koma osati odwala ochepa thupi omwe ali ndi matenda a shuga a autoimmune. Nthawi zambiri zochita zake sizokwanira, ndipo mumafunikabe kubaya insulin.

Chithandizo chachikulu ndimakudya a carb otsika, ndipo metformin imangomaliza. Palibe phindu kumwa mapiritsiwa kwinaku mukumapitiliza kudya zakudya zoyipa zomwe zimadzaza ndi chakudya. Tchulani chidwi ndi Glucophage ndi Glucophage Long - mankhwala oyamba a metformin, omwe amadziwika kuti ndi othandiza kwambiri.

Kodi glycated hemoglobin 5.9% amatanthauza chiyani mwa mwana kapena wamkulu?

Sindikhulupirira madokotala omwe akunena kuti kuchuluka kwa hemoglobin ya glycated ya 5.9% ndikwabwinobwino. Kusanthula koteroko kuyenera kukupangitsani kusamala. Mwana kapena wamkulu yemwe ali ndi chizindikiro chotere amatha kupezeka ndi matenda a shuga. Kuti mupewe kupitirira kwa matendawa komanso kukula kwa zovuta, munthu yemwe ali ndi vuto la kusintha kwa chakudya mu thupi ayenera kusintha moyo wake. Ndi banja lake lonse.

Zotsatira za kuwunika kwa HbA1C kwa 5.9% zimati chiyani?

Akuluakulu onenepa amatha kukhala ndi matenda ashuga amtundu wa 2.
Ana ndi achinyamata, komanso akulu oonda mpaka zaka 35 mpaka 40 - mtundu 1 wa shuga ungayambe.
Mwa anthu ocheperako a zaka zapakati, LADA, shuga ya autoimmune yakale mu akulu, amatha kukhala. Awa ndi matenda ofatsa poyerekeza ndi T1DM. Komabe, kuti mupeze kuyendetsa bwino ndikofunikira kuti jekeseni insulin mu Mlingo wotsika.

Glycated hemoglobin 5.9% - wokwera pang'ono. Monga lamulo, sizimayambitsa zizindikiro zilizonse. Ndinu mwayi kuti muzindikire zovuta za kagayidwe kake ka chakudya koyamba. Mukayamba kudya zakudya zamafuta ochepa ndikuyamba kutenga njira zina zochizira, ndizosavuta kukwaniritsa kuyang'anira matenda.

Kodi zachilendo ndizosiyana ndi matenda ashuga komanso kwa anthu athanzi?

Odwala odwala matenda ashuga omwe akufuna kukhala ndi moyo wabwinobwino komanso kupewa zovuta, ayenera kuyesetsa kukhala ndi hemoglobin wambiri monga anthu athanzi. Mwachidziwikire, osapitirira 5.7%, ndibwino mpaka 5.5%. Mutha kukwaniritsa izi ngakhale mutakhala ndi matenda osokoneza bongo a mtundu woyamba 1, komanso makamaka ndi matenda amtundu wachiwiri wa shuga. Phunzirani ndikutsatira ndondomeko ya 2 yothetsera matenda a matenda ashuga kapena mtundu 1 wa pulogalamu yoletsa matenda ashuga.

Maziko olamulira bwino matenda ashuga ndi chakudya chochepa kwambiri. Kudya zakudya zopatsa thanzi kumakwaniritsidwa ndi misampha ina ya anthu odwala matenda ashuga, omwe adapangidwa ndi Dr. Bernstein, ndi a Sergey Kushchenko ofotokozedwa ku Russia pamalowa. Madokotala nthawi zambiri amati kuchuluka kwa HbA1C kwa odwala matenda ashuga ndiokwera kuposa kwa anthu athanzi. Ili ndi bodza lomwe limamveka bwino m'makutu a odwala, koma ndiowopsa.

Kodi chiwopsezo cha hemoglobin chandamale cha odwala matenda ashuga ndi chiani?

Pali algorithm yovomerezeka mwalamulo ndi Unduna wa Zaumoyo posankha mtundu wa hemoglobin wa munthu. Amalembedwa m'chinenedwe cha abstruse, koma mawonekedwe ake ndi osavuta. Ngati wodwala amakhala ndi moyo wochepetsetsa, ngakhale kuchuluka kwa HbA1C ndizovomerezeka. Mwachitsanzo, 8.0-8.5%. Ndikokwanira kungoyesa zochepa chabe kuti muchepetse matenda a shuga kuti musataye khungu chifukwa cha shuga wambiri. Ndipo zovuta zazikulu zovuta nthawi iliyonse sizikhala ndi nthawi yoti zikule.

Komabe, ndi uti wa odwala matenda ashuga omwe amayenera kuperekedwa mgululi omwe ali ndi moyo wotsika? Dr. Bernstein ali ndi kusagwirizana kwakukulu ndi mankhwala ovomerezeka pankhaniyi. Madokotala amayesa kupatsa odwala ambiri momwe angathere gulu ili kuti awachotsere ndikuchepetsa ntchito yawo.

Kutalika kochepa kwa moyo ndi kwa anthu omwe ali ndi matenda osakhazikika a oncological. Komanso, chidziwitso chovuta cha odwala omwe akudwala dialysis ndipo osatha kupanga impso. Sikoyenera kugwiritsitsa moyo kwa anthu olumala omwe akumana ndi stroko yoopsa.

Komabe, nthawi zina, odwala matenda ashuga sayenera kudzipereka. Ndikulimbikitsidwa mokwanira, amatha kukhala ndi moyo wautali komanso wathanzi, kuchitira nsanje anzawo kapena ngakhale mbadwo wachichepere. Izi zikugwiranso ntchito kwa odwala omwe adasiya kuwona, kupulumuka mwendo mwendo kapena vuto la mtima.Ambiri odwala matenda ashuga ayenera kuyesetsa kuwonetsa hemoglobin wa glycated, monga mwa anthu athanzi, osapitirira 5.5-5.7%.

Chithandizo chamankhwala chimanena kuti mafakisoni a HbA1C, monga anthu athanzi labwino, sangatheke popanda jekeseni wa insulin yayikulu kapena kumwa mapiritsi owononga a 2 shuga. Mankhwalawa amachititsa kukhala ndi hypoglycemia pafupipafupi (shuga wamagazi ochepa). Zoterezi zimatha kukhala zosasangalatsa komanso zoopsa kwambiri.

Komabe, kusinthika kwa chakudya chamafuta ochepa nthawi zambiri kumawonjezera mphamvu ya chithandizo cha matenda a shuga, ndikuchotsa zotsatirapo zoyipa. Odwala omwe amasinthana ndi dongosolo la Dr. Bernstein, Mlingo wa insulin nthawi zambiri umagwa 5-7. Palibe chifukwa chomwa mapiritsi owopsa Diabeteson, Amarin, Maninil ndi ena. Zoopsa zambiri za hypoglycemia zimatha. Pafupipafupi maukali modekha amachepetsa kwambiri.

Osayesa kudzisankhira mtundu wa hemoglobin wa munthu wina aliyense. Kusunga shuga wamagazi ndi HbA1C, monga mwa anthu athanzi, ndicholinga chenicheni. Pewani matenda anu ashuga ndi njira zomwe zikufotokozedwa patsamba lino. Popeza mwapeza zotsatira zabwino, mukutsimikiziridwa kuti mudziteteze pakukula kwa zovuta pamiyendo, mawonekedwe amso ndi impso.