Mayeso a kulolera a glucose

Mkonzi wasayansi: M. Merkushev, PSPbGMU im. Acad. Pavlova, bizinesi yamankhwala.
Januware 2019

Mawu: Mayeso a kulolerana ndi glucose, GTT, mayeso a glucose kulolerana, kupindika kwa shuga, kuyesa kwa Glucose (GTT)

Kuyesedwa kwa glucose ndikusanthula kwa Laborator komwe kumazindikira kuchuluka kwa shuga m'magazi opanda kanthu komanso maola awiri mutatha katundu wa carbohydrate. Phunziroli limachitika kawiri: zisanachitike komanso zitachitika zomwe zimatchedwa "katundu".

Kuyesedwa kwa glucose kumakuthandizani kuti mufufuze zingapo zofunika kuzindikiritsa ngati wodwala ali ndi vuto lalikulu la prediabetes, kulolerana kwa shuga kapena shuga.

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.

Dokotala wa endocrinologist, nephrologist, gastroenterologist, dokotala, opaleshoni, komanso othandizira atha kupereka lingaliro kuti liunikiridwe.

Kuyesedwa kwa glucose kumayikidwa pa milandu ili:

glucosuria (shuga wowonjezereka mkodzo) popanda zizindikiro za matenda a shuga komanso ngati shuga ali m'magazi,
Zizindikiro za matenda ashuga, koma shuga ndi mkodzo ndizabwinobwino,
kuwunika kwa odwala omwe ali pachiwopsezo cha matenda ashuga:
- zaka zopitilira 45
- Mndandanda wamtundu wa BMI woposa 25 kg / m 2,
- ochepa matenda oopsa
- kuphwanya lipid kagayidwe,
kubadwa kwamwambo kwa matenda ashuga,
Kutsimikiza kwa insulin kukana kunenepa, kagayidwe kachakudya matenda,
glucosuria motsutsana ndi njira zina:
- chithokomiro (kuchuluka kwa chithokomiro cha mahomoni a chithokomiro),
- kukanika kwa chiwindi
- matenda a kwamkodzo thirakiti
- mimba
Kubadwa kwa ana akulu opima makilogalamu anayi (kuwunika kumachitika kwa mayi wobereka ndi kwa akhanda),
prediabetes (munthawi yomwe biochemistry yamagazi yoyambirira ya glucose idawonetsa zotsatira zapakati pa 6.1-7.0 mmol / l),
wodwala yemwe ali ndi pakati amakhala pachiwopsezo chotenga matenda a shuga (mayesowo nthawi zambiri amachitidwa mu 2nd trimester).
aakulu periodontosis ndi furunculosis
ntchito kwa nthawi yayitali ya okodzetsa, glucocorticoids, syntro estrogen

GTT imaperekedwanso kwa odwala omwe ali ndi mitsempha ya neuropathy molumikizana ndi mayeso a vitamini B12 kuti azindikire kusiyanasiyana kwa mtundu wa matenda ashuga ndi mitundu ina ya ma neuropathies 1.

Chidziwitso: Chofunikira kwambiri ndi mulingo wa C-peptide, womwe umatipatsa mwayi wowunika momwe maselo amatulutsira insulin (islets of Langerhans). Chifukwa cha chizindikiro ichi, mtundu wa matenda a shuga umatsimikizika (wodalira insulini kapena wodziyimira pawokha) ndipo, motero, mtundu wa chithandizo chomwe chikugwiritsidwa ntchito.

Kuyesedwa kwa glucose pakamwa kumakupatsani mwayi wofufuza zovuta zosiyanasiyana za kagayidwe kazakudya, monga matenda a shuga, kulekerera kwa glucose, kudya glycemia, koma sangakuloreni kufotokozera mtundu ndi zoyambitsa matenda a shuga.

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 / m 2	1 mu zaka 3 ndi zotsatira zabwinobwino Kamodzi pachaka chifukwa cha kupatuka pa chizolowezi

Momwe mungawerengere BMI

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

Milandu pomwe kuyesa kwa glucose sikunachitike

GTT siyabwino pankhani zotsatirazi

matenda a mtima aposachedwa kapena stroke,
opaleshoni yaposachedwa (mpaka miyezi itatu),
kutha kwa 3 trimester mwa amayi apakati (kukonzekera kubereka), kubereka ndi nthawi yoyamba pambuyo pawo,
mankhwala oyambilira a magazi anawonetsa shuga omwe amaposa 7.0 mmol / L.
motsutsana ndi maziko a matenda aliwonse owopsa, kuphatikizapo opatsirana.
mukumwa mankhwala omwe amalimbikitsa kuchuluka kwa glycemia (glucocorticoids, mahomoni a chithokomiro, thiazides, beta-blockers, njira zakulera pakamwa).

Makhalidwe Abwinobwino a GTT

4.1 - 7.8 mmol / L

Mafuta pambuyo pa mphindi 60 pambuyo shuga

4.1 - 7.8 mmol / L

Mafuta pambuyo pa mphindi 120 pambuyo shuga

C-peptide kuchuluka

Kunenepa kwambiri kwa amuna
Oncology kapena pancreatic dysfunction,
ECT yowonjezera QT yapakati yodutsa
Kuwonongeka kwa chiwindi chifukwa cha cirrhosis kapena hepatitis.

C-peptide kutsika

Matenda a shuga
Kugwiritsa ntchito mankhwala osokoneza bongo (thiazolidinediones).

Kukonzekera kuyeserera kwa shuga

Pakadutsa masiku atatu mayeso asanachitike, wodwalayo ayenera kutsatira zakudya zabwino popanda choletsa chakudya, osapatula zinthu zomwe zingayambitse kuchepa kwa madzi m'thupi (mankhwala osakwanira amkati, kuchuluka kwa masewera olimbitsa thupi, kupezeka kwamatumbo oyipa),

Musanayesedwe, muyenera kusala kudya kwa maola 8 mpaka 14 (kusanthula kumachitika pamimba yopanda kanthu),

Patsiku lodzaza ndi magazi, mumatha kumwa madzi wamba wamba, kupatula zakumwa zotentha, timadziti, mphamvu, mankhwala othandizira, etc.,

Tisanapendeketse (mphindi 30 mpaka 40), ndikosayenera kutafuna chingamu chokhala ndi shuga, komanso kutsuka mano anu ndi zotulutsa mano (m'malo mwake ndi ufa wamano) ndi utsi,

Madzulo a mayeso ndipo patsiku loletsedwa kumwa mowa ndi mankhwala osokoneza bongo /

Komanso, ndikofunikira kuti mudziteteze ku nkhawa zilizonse zakuthupi ndi zamagetsi patsiku.

Mawonekedwe

Maphunziro onse aposachedwa kapena omalizidwa posachedwapa ayenera kuuzidwa ndi dokotala pasadakhale.

Kuunika sikumachitika munthawi yovutikira ndi njira zopatsirana (zotsatira zabwino zabodza ndizotheka),

Kusanthula sikumataya mtima pambuyo poti aphunzire ndi njira zina (x-ray, CT, ultrasound, fluorography, physiotherapy, kutikita minofu, mayeso a rectal, etc.),

Msambo wamkazi ukhoza kusokoneza kuchuluka kwa shuga, makamaka ngati wodwalayo wasokoneza kagayidwe kazakudya.

Kodi mayeso ololera a glucose amachitika bwanji?

GTT imayikidwa pokhapokha kuti zotsatira za kafukufuku wamayendedwe am'magazi a shuga osaposa 7.0 mmol / L. Ngati lamuloli silinyalanyazidwa, chiwopsezo cha kukomoka kwa shuga mu matenda ashuga chimakulitsidwa.

Kuphatikiza apo, pankhani yachuma chopitilira muyeso m'magazi a venous opitilira 7.8 mmol / l, adotolo ali ndi ufulu wofufuza za matenda ashuga popanda kusankha mayeso owonjezera. Kuyesa kwa glucose, monga lamulo, sikuchitikira ana osaposa zaka 14 (kupatula kuyesedwa kwa ana obadwa kumene malinga ndi zisonyezo).

Madzulo a GTT, biochemistry yamwazi imachitidwa ndipo kuchuluka kwa shuga kwapezeka m'magazi,

Chiyeso chololera cha glucose chimakonzekera m'mawa (kuyambira 8,00 mpaka 11.00). The biomaterial for the Study is a venous magazi, omwe amamwa mwa chofufumitsa kuchokera mu mtsempha wamaubalo,

Atangomaliza kupaka magazi, wodwalayo amapemphedwa kuti amwe njira yothetsera shuga (kapena umaperekedwa kudzera m'mitseko),

Pambuyo maola awiri, omwe amalimbikitsidwa kuti azichita kupumula kwathunthu kwamthupi ndi m'maganizo, kuyezetsa magazi mobwerezabwereza kumachitika. Nthawi zina kusanthula kumachitika m'magawo angapo: pambuyo pa theka loyamba la ola, kenako maola 2-3.

Ndikofunikira kudziwa! Mukukonzekera kuyeserera kwa shuga ndi / kapena pambuyo pake, kunyansidwa pang'ono kumatha kuonekera, komwe kumatha kuthetsedwa ndi gawo la mandimu. Izi sizingakhudze kuchuluka kwa glucose, koma zingathandize kupha kukoma kwa mkamwa mkamwa mwanu mutamwa njira yotsekemera. Komanso, titapatsidwa magazi kangapo mobwerezabwereza, mutu umatha kumva chizungulire, kumatha kumva njala yayikulu, yomwe imalumikizidwa ndi kupanga insulin. Pambuyo pa kuyesedwa, muyenera kukhala ndi mbale zapamwamba komanso zabwino kwambiri.

Mitundu ya mayeso ololera a glucose: mkamwa, mtsempha

Kulekerera kwa glucose kumatanthauza momwe insulin ingatulutsire msanga komanso mogwira mtima maselo. Zitsanzozi zimatsanzira chakudya. Njira yayikulu yodyera shuga ndi pakamwa. Wodwalayo amapatsidwa njira yotsekemera ya kumwa ndi glycemia (shuga wamagazi) amayeza kuyerekeza isanayambe kapena itatha.

Kusagwirizana ndi zakumwa zodzadza ndi glucose ndizosowa kwambiri, ndiye kuti mlingo womwe umafunikira (75 g) utha kubayidwa mu mtsempha. Nthawi zambiri, izi ndizophunzira ndi toxosis yayikulu mwa amayi apakati, kusanza, malabsorption m'matumbo.

Ndipo izi ndizambiri za mahomoni olimbana ndi mahomoni.

Zizindikiro za

Dokotalayo amatumiza njira yoperekera chithandizo ngati matenda a shuga akukayikira. Wodwala atha kukhala ndi zodandaula za:

Ludzu lalikulu, kuchuluka kwamkodzo.
Kusintha kwakuthwa kwambiri kwa thupi.
Kuukira kwanjala.
Kufooka nthawi zonse, kutopa.
Kugona masana, mutatha kudya.
Khungu loyera, ziphuphu, zithupsa.
Kuchepetsa tsitsi.
Kubwezereranso, kuyabwa mu perineum.
Kuchiritsa pang'onopang'ono kwa mabala.
Maonekedwe a mawanga, mfundo patsogolo pa maso, kuchepa kwa maonekedwe owoneka.
Kuchepa kwa chilakolako chogonana, erection.
Kusamba kwamwamuna.
Matendawa, mano otayirira.

Monga lamulo, kuyesedwa kumalimbikitsidwa kumapeto kwa matendawa, komwe ndi mtundu wa matenda a shuga a 2. Kuti muwone kusokonezeka kwa kagayidwe kazakudya, mawonekedwe okhala ndi shuga amasonyezedwa kwa odwala omwe ali ndi:

Kunenepa kwambiri.
Metabolic syndrome (matenda oopsa, kukana insulini, kuthamanga).
Zowopsa zomwe zingayambitse matenda ashuga: cholowa, zaka kuyambira zaka 45, kuchuluka kwa maswiti ndi zakudya zamafuta m'zakudya, kusuta, uchidakwa.
Atherosulinosis yoyambirira: angina pectoris, matenda oopsa, kusokonezeka kwa magazi mu ubongo kapena miyendo.
Polycystic ovary.
Matenda a shuga m'mbuyomu.
Kufunika kwachithandizo chanthawi yayitali ndimafanana a mahomoni a chithokomiro kapena gren adrenal.

Mayeso a kulolera a glucose

Mayeso a Glucose kulolerana (GTT) kapena njira yolekerera shuga ndi njira zina zowunikira zomwe zimathandizira kuzindikira momwe thupi limafunira shuga. Ndi chithandizo chake, chizolowezi cha matenda ashuga, kukayikira kwa matenda oyamba kutsimikizika. Kutengera ndi zolozera, mutha kulowererapo nthawi ndikuchotsa zoopseza. Pali mitundu iwiri ya mayeso:

Kulekerera kwa glucose kapena pakamwa - kuchuluka kwa shuga kumachitika patangopita mphindi zochepa pambuyo pakupereka magazi koyamba, wodwalayo amafunsidwa kuti amwe madzi otsekemera.
Mitsempha - ngati nkosatheka kugwiritsa ntchito madzi mosazungulira, imayendetsedwa kudzera m'mitsempha. Njirayi imagwiritsidwa ntchito kwa amayi apakati omwe ali ndi toxosis yayikulu, odwala omwe ali ndi vuto la m'mimba.

Momwe mungayesere kuyesa kwa glucose

Ngati dotolo akukaikira imodzi mwaz matenda omwe atchulidwa pamwambapa, amapereka njira yowunikira shuga wololera. Njira yakuwonetserayi ndi yachindunji, yopanda chidwi komanso "yodyeka." Iyenera kukonzekera mosamala, kuti musapeze zotsatira zabodza, kenako, limodzi ndi adotolo, sankhani chithandizo chotsani zoopsa ndi zovuta zomwe zingayambike, zovuta za matenda ashuga.

Kukonzekera njirayi

Tisanayesedwe, muyenera kukonzekera mosamala. Kukonzekera kudzaphatikizapo:

choletsa mowa kwa masiku angapo,
musasute tsiku la kusanthula,
uzani adotolo za kuchuluka kwa zolimbitsa thupi,
osamadya zakudya zotsekemera patsiku, osamwa madzi ambiri patsiku la kusanthula, kutsatira zakudya zoyenera,
ganizirani nkhawa
osayesa matenda opatsirana, matenda a postoperative,
kwa masiku atatu, kusiya kumwa mankhwala: kutsitsa-shuga, mahomoni, zolimbikitsa kagayidwe, kukhumudwitsa psyche.

Contraindication

Zotsatira za phunziroli zitha kukhala zosadalirika motsutsana ndi maziko a matenda ophatikizika kapena, ngati kuli koyenera, kugwiritsa ntchito mankhwala omwe angasinthe kuchuluka kwa shuga. Ndikosatheka kuzindikira ngati:

Njira yotupa yotupa.
Kachilombo kapena kachilombo komwe kamayambitsa matenda a malungo.
Kuchulukana kwa zilonda zam'mimba.
Kusokonezeka kwapakati kapena subacute, mwezi woyamba pambuyo pa vuto la mtima, stroko, opaleshoni kapena kuvulala, kubala.
Matenda a Cushing (Syndrome) (kuchuluka katulutsidwe ka cortisol).
Gigantism ndi acromegaly (mahomoni okula owonjezera).
Pheochromocytomas (chotupa cha adrenal gland).
Thirotooticosis.
Kupanikizika kwambiri.
M'mbuyomu omwe adapezeka kuti ali ndi mtundu woyamba wa 2 kapena mtundu wa shuga wachiwiri, kuyezetsa magazi kwa glycated hemoglobin komanso glycemic control musanadye chakudya kapena pambuyo pake amagwiritsidwa ntchito kuti ayendetse.

Kukonzekera komwe kumasintha zotsatira za kuyesa kwa glucose kumaphatikizapo: diuretics, beta-blockers, anticonvulsants ndi mahomoni. Amayi pa nthawi ya msambo ayenera kusiyira matendawa, kusamutsa kuyesedwa ku tsiku la 12th la kuzungulira.

Kukonzekera kukonzekera

Phunzirolo lisanachitike, odwala amalimbikitsidwa nthawi yokonzekera. Ndikofunikira kuti muchepetse zolakwika zomwe zimakhudzana ndi zakudya ndi moyo. Kukonzekera koyenera kumaphatikizapo:

Kwa masiku osachepera atatu, muyenera kusunga zakudya zomwe mumachita tsiku ndi tsiku.
Zakudya zopatsa mphamvu sizitha kupatulidwa kwathunthu pazakudya, koma zochulukirapo zimayenera kutayikidwanso, zomwe zimakhala bwino mndandandawo ndi 150 g.
Amakanizidwa kuti ayambe kudya kapena kudya kwambiri sabata lisanafike tsiku lolemba.
Kwa maola 10 mpaka 14 ndizoletsedwa kutenga chakudya, mowa, khofi kapena msuzi.
M'mawa musanazindikire, mutha kumwa kapu yamadzi popanda zowonjezera.
Sikulimbikitsidwa kuchita masewera olimbitsa thupi, kusuta, kukhala ndi mantha musanayesedwe.

M'mawa, musanapeze matenda, mumatha kumwa kapu yamadzi popanda zowonjezera.

Kodi kusanthula bwanji?

Wofufuzayo ayenera kubwera ku labotale pasadakhale kuti apumule kwa pafupifupi mphindi 20-30, akuwona mtendere wamthupi ndi wamaganizidwe. Kenako anayeza shuga (magazi a glycemia). Pambuyo pake, muyenera kumwa njira yothetsera shuga. Pambuyo pake, miyezo imatengedwa mphindi 30 zilizonse kwa maola awiri. Zotsatira zimagwiritsidwa ntchito popanga glycemic pamapindikira.

Madeti a mayeso okhudzana ndi shuga mwa amayi apakati

Pa nthawi ya bere, dongosolo la endocrine, monga thupi lonse, limamangidwanso. Kwa odwala omwe ali pachiwopsezo, mwayi wopeza njira yokhazikika yodwala shuga. Izi zikuphatikiza:

Milandu yamtundu uliwonse wa matenda ashuga m'banjamo.
Kunenepa kwambiri
Matenda a ma virus m'magawo oyambira.
Pancreatitis
Polycystic ovary.
Kusuta, uchidakwa.
Mbiri yolembetsa: kubadwa kwa mwana wosabadwa m'mbuyomu, matenda ashuga, kubereka, zovuta zokhudzana ndi ana obadwa kale.
Zakudya za Monotonous zopatsa mphamvu zamafuta ambiri.

Amayi oyembekezera omwe ali ndi chimodzi mwazinthu izi amafunikira kuyesedwa kwa glucose kuyambira sabata la 18 la mimba. Kwa wina aliyense, zimaphatikizidwanso muzowumiriza, koma kwakanthawi kuyambira 24th mpaka sabata la 28. Chimodzi mwa mitundu yosiyanasiyana ya shuga ndi kuthamanga kwa glucose komanso kuwonjezeka kwake mutatha kudya (glucose ula) woposa 7.7 mmol / L.

Zotsatira zofananira

Pambuyo pothana ndi vutoli, shuga kuchokera pamlingo woyambirira amawonjezeka ndikukwera mu ola limodzi, kenako kumapeto kwa ora lachiwiri amatsika kumakhalidwe abwino. Ndi matenda a shuga, palibe kuchepa kotero. Pankhani ya vuto lakelo lomwe limatchedwa kulekerera chakudya cha m'mimba (prediabetes), shuga amatsika pambuyo pakuchita masewera olimbitsa thupi, koma osakwaniritsa zofunikira.

Zotsatira zoyeserera za glucose

Zosankha Zokana

Mtengo wapamwamba kwambiri wodziwitsa ndi kuchuluka kwa glycemia. Malinga ndi zotsatira zoyesa, matenda a shuga komanso opatsa thanzi amatha kupezeka. Komanso, mu zovuta zaposachedwa, matenda owopsa, kuvulala, zotsatira zabodza zitha kuchitika. Ngati mukukayikira kuti mwazindikira, ndikulimbikitsidwa kubwereza mayeso pambuyo pa masabata awiri ndikupereka mayeso otsatirawa:

Magazi okhutira ndi insulin ndi proinsulin, mapuloteni wamba.
Kuphatikiza kwamwazi wamagazi ndi mbiri ya lipid.
Urinalysis wa shuga.
Glycated hemoglobin.

Kuyesa kwa shuga mkodzo

Ndi prediabetes komanso shuga yodutsa, zakudya zamagulu ochepa a calcium zimalimbikitsidwa. Izi zikutanthauza kuti shuga, ufa woyera ndi zinthu zonse zomwe zili nazo ziyenera kuphatikizidwa kwathunthu kuzakudya. Chifukwa cha kufooka kwa mafuta kagayidwe, mafuta a nyama ayenera kukhala ochepa. Zochita zolimbitsa thupi zosachepera 30 mphindi tsiku osachepera masiku 5 pa sabata.

Kuchepa kwa glucose nthawi zambiri kumachitika chifukwa chosankhidwa mwanjira yolakwika ya mapiritsi a insulin kapena mapiritsi a shuga. Nthawi zina, izi zimathandizidwa ndi matenda am'matumbo, kapamba, matenda osachiritsika, matenda oopsa a chiwindi, mowa.

Ndipo pali zambiri zokhudza matenda a shuga kwa ana.

Kuyeserera kwa glucose kumatsata chakudya. Kuyeza kwa glucose kumawonetsa momwe chakudya chimapangidwira ndi insulin ya thupi. Amawonetsera onse ngati ali ndi matenda ashuga komanso odwala omwe ali pachiwopsezo. Kudalirika kumafunika kukonzekera. Kutengera zotsatira, kusintha kwa zakudya, zolimbitsa thupi, ndi kugwiritsa ntchito mankhwalawa kumalimbikitsidwa.

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 awiri atatha kudya, 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 wodziwa matenda 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 pazisonyezo zomwe zatchulidwa 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. Zochitika zoterezi sizisonyezo zoyenera kutenga kuyesa 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:

Zoposa zaka 45
Mafuta amtundu 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).
Ovary Polycystic,
Gout
Matenda a periodontal matenda kapena furunculosis,
Kulandila kwa okodzetsa, mahomoni a glucocorticoid ndi ma syntrojeni ophatikizika (kuphatikiza ngati gawo limodzi la njira zakulera pakamwa) kwa nthawi yayitali.

Ngati munthu alibe zina mwa zinthu zomwe zili pamwambapa kapena matenda, koma msinkhu wake ndi wamkulu kuposa zaka 45, ndiye kuti amalimbikitsidwa kuti azichita mayeso oloza 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 pa nthawi yomweyo phindu la mayesolo limakhala lolondola, ndiye kuti liyenera kutengedwa ngati gawo lowunikira 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.

Pambuyo poyeserera kwa shuga

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, nambala yachinayi ndi shuga m'magazi pambuyo pa maola 1.5, ndipo chithunzi chachisanu ndi shuga pambuyo pa maola awiri.

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

Mlingo wololera wa 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
Dongosolo la 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.

Kodi kuyeserera kwa shuga 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.

Gulu la njira yolekerera shuga

Mwapang'onopang'ono, mafomu onse oyesedwa azaumoyo agawidwa m'misasa iwiri. Loyamba limaphatikizapo njira yolankhulirana pakamwa, yomwe imangotanthauza ndi zilembo PGTT pakufupikitsa. Malinga ndi mfundo yomweyo iwo amatchula njira ya pakamwa, kufupikitsa maina ake ku ONTT.

Gulu lachiwiri limapereka kusinthika kwa mtsempha. Koma, ngakhale atakhala kuti zitsanzo za zinthu zachilengedwe zimachitika bwanji pophunzira mu labotale, malamulo okonzekererawo amakhalabe osasinthika.

Kusiyana pakati pa mitundu iwiriyi ndi njira yamaulamuliro a carbohydrate. Uku ndi kulemera kwa glucose, komwe kumachitika mphindi zochepa pambuyo gawo loyambilira la magazi.Mu kamvekedwe kamlomo, kukonzekera kumafuna kugwiritsa ntchito shuga wowerengeka bwino mkati. Dokotala atha kunena kuti ndi mamililita angati omwe amafunikira atafufuza mwatsatanetsatane momwe aliri.

Mwanjira yolowerera, mtundu wa jakisoni umagwiritsidwa ntchito. Mwakutero, mlingo amawerengedwa molingana ndi algorithm yomweyo. Koma mtundu uwu ndi wofunikira pakati pa madokotala chifukwa chovuta kudziwa. Amatembenukiranso pokhapokha ngati wozunzidwayo sangathe kumwa yekha madzi otsekemera kale.

Nthawi zambiri, njira yovutayo imafunika ngati munthu ali woopsa kwambiri. Zomwezi zimagwiranso kwa amayi apakati, omwe amawonetsa momveka bwino za toxosis yayikulu. Njira yothetsera vutoli ndi yoyenera kwa iwo omwe ali ndi chisokonezo pamtundu wa m'mimba.

Chifukwa chake, ngati tili ndi matenda okhudzana ndi kuthekera kwa mayamwidwe abwinobwino a zinthu m'thupi, thupi silingathe kuchita popanda kulimbitsa shuga.

Mtengo wa mitundu iwiri yamapangidwe siosiyana kwambiri ndi wina ndi mnzake. Ngakhale zili choncho, wodwalayo nthawi zambiri amafunsidwa kuti abweretse shuga m'mimba mwake.

Zizindikiro zakuchipatala

Anthu ataganizira zomwe akuchita pobwereza, anthu akuyamba kudandaula kuti apitilanji kukayezetsa ngati alibe matendawa. Koma ngakhale kukayikira kapena kusakhala ndi cholowa chabwinobwino kungakhale zifukwa zofufuzira pafupipafupi kuchokera kwa dokotala.

Ngati wothandizirayo adawona kuti ndikofunikira kupereka chitsogozo chodziwonetsa, ndiye kuti kungochisiya chifukwa chakuwopa kapena malingaliro akuti uku ndikungowononga nthawi ndi lingaliro loipa. Basi monga choncho, madotolo am'mabwalo awo sangatengere shuga.

Nthawi zambiri, mankhwala amathandizidwa ndi madokotala am'madera omwe ali ndi zizindikiro za matenda ashuga, kapena ma gynecologists, endocrinologists.

Gulu la omwe ali ndi mayendedwe ophatikizidwa kwambiri amaphatikizapo odwala omwe:

Matenda a 2 a shuga amakayikiridwa ndipo kudziwika koyenera ndikofunikira.
kwa nthawi yoyamba, akulemba kapena kuwunikiranso njira zamakono zamankhwala zomwe zimapezeka ndi "shuga" wodwala,
muyenera kusanthula mphamvu za kuchira kuti muchepetse mwayi womwe ungakhale wopanda tanthauzo lililonse,
amakayikira digiri yoyamba ya matenda ashuga,
kudziwunikira pafupipafupi kumafunikira,
mtundu wa matenda a shuga omwe akuwoneka, kapena atapezeka kuti wayang'ananso zaumoyo,
prediabetesic mkhalidwe
pali zolakwika pakugwira ntchito kwa kapamba,
zolakwika mu adrenal gland amalembedwa.

Osatinso kawirikawiri, chifukwa chotumiza ku chipinda chodziwitsa odwala ndi chitsimikiziro cha metabolic. Malinga ndi kuwunika kwa anthu ena omwe adachitidwapo ngozi, adawadyetsa poyizoni kuti ayesedwe matenda oyambitsidwa ndi hepatic ntchito kapena matenda omwe amadza chifukwa chakugwiritsidwa ntchito kwa ndowa.

Sizobweretsa zopanda umboni ngati izi ngati munthu wapeza kuphwanya kwa shuga. Mutha kukumana pamzere wa zopereka zamagazi anthu omwe ali ndi matenda osiyanasiyana onenepa. Nutritionists amawatumiza kumeneko kuti akapitirize kumanga pulogalamu yokhayo yopatsa thanzi komanso kuchita masewera olimbitsa thupi.

Ngati mukuwerenga momwe mahomoni amapangidwira thupi ndi kukayikira zamkati za endocrine, zikukwaniritsidwa kuti zizindikiro zakomweko ndizotalikirana, pokhapokha popanda njira yolekerera glucose sichidzaperekedwa. Mukangozindikira kuti mwazindikira, muyenera kupita kuchipinda chofufuzira pafupipafupi. Izi zikuthandizani kuti muzitha kudziletsa pakuwonongeka kwa inshuwaransi.

Chifukwa choti si onse okhala komwe angadziwe komwe angayesedweko, amapita kwa akatswiri odziwa zamankhwala ndi chofunsira chofufuza zowunikira zamomweku. Koma akatswiri akukumbutsa kuti njira yoyambayo idafunikirabe kuyambira ndi zotsatira zazidziwitso zomwe zimapezeka mu mayeso a labotale.

Koma podziwunikira, ma glucometer a m'manja ndi lingaliro labwino. Pafupifupi mankhwala aliwonse omwe amatha kupereka zingapo kuchokera kwa opanga apadziko lonse lapansi omwe mitundu yawo imasiyana pamagwiritsidwe ake.

Koma apa, nawonso, ili ndi mfundo zake:

zida zapanyumba zimangofufuza magazi athunthu,
ali ndi cholakwika chachikulu kuposa zida zoyambira.

Potengera izi, zikuwonekeratu kuti munthu sangakane maulendo kupita kuchipatala. Kutengera ndi zomwe zalembedwa kale, adotolo apanga chisankho pakuwongolera pulogalamu yamachiritso. Chifukwa chake, ngati musanagule chida chonyamula, munthu amatha kulingalirabe ngati gawo lotere ndilofunikira kapena ayi, ndiye kuti izi sizichitika ndi mayeso kuchipatala. Ndikofunikira kuwunika pulogalamu yovomerezeka yomwe idavomerezedwa kale.

Pakugwiritsa ntchito zapakhomo, zida zosavuta ndizoyenera. Amatha kudziwa osati kuchuluka kwa glycemia munthawi yeniyeni. Udindo wawo umaphatikizapo kuwerengera kuchuluka kwa hemoglobin ya glycated, yomwe pazenera la chida chizikhala ndi dzina la "HbA1c".

Contraindication zachipatala

Ngakhale kuti kwa odwala ambiri kuwunikirako sikubweretsa vuto lililonse, komabe pali zotsutsana zingapo. Mwa iwo, koyamba ndi kusalolera kwa chinthu chomwe chingapangitse kuti anthu asagwidwe. Muzochitika zomvetsa chisoni kwambiri, izi zimatha mu kugwedezeka kwapafupipafupi kwa anaphylactic.

Mwa zina ndi zina zomwe zimabweretsa chiopsezo pakupezeka kwa maphunziro a shuga.

Matenda ogwirizana ndi m'mimba thirakiti, lomwe nthawi zambiri limakhudza kuchuluka kwa matenda a kapamba,
pachimake gawo la kutupa,
chotupa chosachiritsika cha mtundu uliwonse chomwe chimawononga kudalirika kwa chithunzi chamankhwala,
Toxicosis yokhala ndi chiwonetsero champhamvu cha izo,
nthawi yantchito.

Zomwe zimasiyanitsidwa padera ndi milandu ya omwe akuzunzidwa omwe, pazifukwa zina, amapuma pogona. Kuletsa koteroko kumakhala kocheperako, zomwe zikutanthauza kuti ndizotheka kuchita kafukufuku ngati zopindulitsa zake ndizopweteketsa.

Chisankho chomaliza chimapangidwa ndi adotolo malinga ndi momwe alili.

Ndondomeko Algorithm

Kudzinyenga lokha sikovuta kwenikweni kukhazikitsa. Vutoli ndi nthawi yokhayo, chifukwa muyenera kukhala pafupifupi maola awiri. Chifukwa chomwe chimakhudza nthawi yayitali ndichosavomerezeka cha glycemia. Pano ndikofunikanso kuganizira momwe ntchito ya pancreatic gland, siyikugwira ntchito mwa onse olemba.

Chiwembu cha momwe kuyesedwako kumakhudzira magawo atatu:

kusala kudya magazi
shuga
mpanda upya.

Nthawi yoyamba kusonkhanitsidwa magazi pambuyo poti wothirayo sanatenge chakudya kwa maola osachepera 8, apo ayi kudalirika kudzapaka. Vuto linanso ndi kukonzekera mopitilira, pamene munthu amadzipha yekha tsiku latsikuli.

Koma ngati chakudya chotsiriza chinali choposa maola 14 apitawa, ndiye kuti izi zimapangitsa kuti zinthu zomwe zasankhidwa zizikhala zosayenera kuti mupitilize kuphunzira mu labotore. Chifukwa cha izi, ndizothandiza kwambiri kupita ku phwando m'mawa, osadya chilichonse m'mawa.

Pa gawo logaya shuga, wozunzidwayo akhoza kumwa “madzi” okonzedweratu kapena kumwa jakisoni. Ngati ogwira ntchito zachipatala adakondera njira yachiwiriyo, ndiye kuti amatenga njira ya shuga ya 50%, yomwe imayenera kuperekedwa pang'onopang'ono pafupifupi mphindi zitatu. Nthawi zina wozunzidwayo amakhala kuti amadzipaka ndi yankho la 25 gm ya glucose. Mlingo wosiyana pang'ono umawonedwa mwa ana.

Ndi njira zina, wodwalayo amatha kutenga "madzi" payekha, magalamu 75 a shuga amachepetsa mu 250 ml ya madzi ofunda. Kwa amayi apakati ndi ana, mlingo umasiyanasiyana. Ngati mayi amachita kuyamwitsa, ndiye kuti muyenera kufunsaninso ndi katswiri pasadakhale.

Makamaka makamaka ndi anthu omwe akuvutika ndi mphumu ya bronchial kapena angina pectoris. Ndiosavuta kwa iwo kudya 20 magalamu a mafuta othamanga. Zomwezi zimachitikiranso kwa omwe adadwala matenda a stroke kapena a mtima.

Monga maziko a yankho, chinthu chogwiritsidwa ntchito sichimatengedwa mu ma ampoules, koma ufa. Koma ngakhale ogula atazipeza mu mankhwalawa muyezo woyenera, ndizoletsedwa kuti azigwira katundu kunyumba. Izi zimatha kudzetsa mavuto akulu.

Gawo lomaliza limaphatikizapo kukonzanso zitsanzo zachilengedwe. Komanso, azichita izi kangapo mkati mwa ola limodzi. Ichi ndi gawo loyenera kudziwa kusinthasintha kwachilengedwe pakupanga magazi. Pokhapokha kuyerekezera zotsatira zingapo ndizotheka kufotokoza chithunzi chachikulu chachipatala.

Njira yotsimikizirira idakhazikitsidwa ndi zochita za metabolism. Momwe zigawo za "manyuchi" zolowa m'thupi zimatha, ndiye kuti kapamba kamayamba kuthana nawo. Pakakhala kuti "curve ya shuga" atakumana ndi mafuta amapitilira zitsanzo zotsatirazi kuti zikhalebe zofanana, ndiye ichi sichizindikiro.

Pabwino kwambiri, izi zikuwonetsa prediabetes, yomwe imafunikira chithandizo chamankhwala mwadzidzidzi kuti isakhale gawo pamene insulin yochulukirapo ikakhala chizolowezi.

Koma akatswiri amakumbukira kuti yankho labwino si chifukwa chodera nkhawa. Komabe, pakupatuka kwina kulikonse, muyenera kuyesanso. Chinsinsi china chakuchita bwino ndikuyenera kukhala kukongoletsa kolondola, ndibwino kupatsa kwa endocrinologist wodziwa zambiri.

Ngati, ndikangoyeseza mobwerezabwereza, ndikuwonetsa zotsatira zofanana, dokotalayo atha kutumiza wodwala kuti akamuzindikire moyandikana. Izi ndizowona gwero lavutoli.

Zachilendo komanso zopatuka

Mfundo yofunikira kwambiri pakusankha ikayenera kukhala yomwe magazi omwe adatengedwa kuti awerenge. Itha kukhala:

Kusiyanaku kudzakhazikitsidwa poti magazi athunthu kapena zigawo zake zokha ndi zomwe zidagwiritsidwa ntchito, zomwe zimatengedwa kuchokera mu mtsempha panthawi yodzipatula kwa plasma. Chala chimatengedwa molingana ndi protocol wamba: chala chimabayidwa ndi singano ndipo chiwerengero choyenera cha zinthu chimatengedwa kuti chisanthule zamitundu iwiri.

Chilichonse chimakhala chovuta kwambiri ndikamapereka zitsanzo kuchokera mu mtsempha. Pano, mlingo woyamba nthawi zambiri umayikidwa mu chubu choyesera chozizira. Njira yoyenera ndi mtundu wa vakuyumu, womwe umapereka malo abwino kwambiri osungira.

Zotetemera zapadera zimawonjezeredwa pachidebe chamankhwala pasadakhale. Amapangidwa kuti apulumutse sampuyo osasintha kapangidwe kake, kapangidwe kake komwe kamateteza magazi ku chidetso cha zinthu zambiri.

Sodium fluoride nthawi zambiri imagwiritsidwa ntchito ngati chosungira. Mlingo umawerengeredwa molingana ndi template yoyenera. Ntchito yake yayikulu ndikuchepetsa njira za enzymatic. Ndipo sodium citrate, yomwe imalembedwanso ndi chizindikiro cha EDTA, ndiye amene amasamala za coagulability.

Pambuyo pokonzekera, chubu choyesera chimatumizidwa ku ayezi kuti akonzekere zida zamankhwala zothandizira kugawa zomwe zili m'magawo osiyanasiyana. Popeza ndi ma plasma okha omwe adzafunikire kuyesa kwa labotale, othandizira ma labotale amagwiritsa ntchito centrifuge yapadera pomwe zinthu zachilengedwe zimayikidwa.

Pambuyo pokonzekera motere, plasma yosankhidwa imatumizidwa ku dipatimenti kuti akapitirize kuphunzira. Chofunikira kwambiri pa gawo lopatsidwa ndikukhala ndi nthawi yoti mudzayike ndalama pang'ono. Kuchulukitsa malire okhazikitsidwa kumawopseza kusokonekera kwotsatira.

Kenako pamabwera gawo lowunika mwachindunji, pomwe njira ya glucose-osmidase nthawi zambiri imawonekera. Malire ake "athanzi" ayenera kukhala osiyanasiyana kuyambira 3.1 mpaka 5.2 mmol / lita.

Pano, enzymatic oxidation, momwe shuga wa oxidase amawonekera, amatengedwa ngati maziko. Kutulutsa ndi hydrogen peroxide. Poyamba, zigawo zopanda utoto, zikaonekera pa peroxidase, pewani kutulutsa. Chowoneka bwino kwambiri chimawonetsedwa, glucose ochulukirapo amapezeka muzitsanzo zosonkhanitsidwa.

Njira yachiwiri yomwe ndi yodziwika kwambiri ndi njira ya orthotoluidine, yomwe imapereka zizindikiritso zodziwika bwino mu 3.3 mpaka 5.5 mmol / lita. Pano, m'malo mwa makina ophatikiza okhatikiza, machitidwe a chikhalidwe chokhala ndi acidic amayambitsidwa. Kukula kwamtunduwu kumachitika chifukwa cha mphamvu ya fungo labwino lochokera ku ammonia wamba.

Momwe zimachitika kuti organic inayake ikayamba, michere ya glucose imayamba kuphatikiza. Monga maziko a chidziwitso chomaliza, tengani mtundu wa mayankho ake.

Malo ambiri azachipatala amakonda njira imeneyi, chifukwa amaliona kuti ndi yolondola kwambiri. Osati pachabe, pambuyo pake, ndi amene amasankhidwa akakhala pansi pa protocol ya GTT.

Koma ngakhale titataya njira ziwiri zomwe zimafunidwa kwambiri, pali mitundu ingapo yamapangidwe ndi ma enzymatic osiyanasiyana. Ngakhale amagwiritsidwa ntchito pafupipafupi, siwosiyana kwambiri ndi mtundu wazidziwitso kuchokera kuzotchuka zina.

M'mawunikidwe apanyumba, zingwe zapadera zimagwiritsidwa ntchito, ndipo pazida zam'manja, matekinoloje a electrochemical amatengedwa ngati maziko. Palinso zida zomwe njira zingapo zimasakanikirana kuti zipereke deta yathunthu.