Mwazi wamagazi: abwinobwino, mitundu ya maphunziro, momwe angakonzekerere kusanthula

Kuchuluka kwa shuga m'magulu a akazi ndi amuna ndi 3.3-6.1 mmol / l. Kupatuka kwakukuru komanso / kapena kutalika kwakutali kumawonetsa kusuntha kwa ma pathologies, makamaka hypoglycemia ndi hyperglycemia.

Glucose ndiye gawo lalikulu lamphamvu la thupi. Zakudya zamafuta zomwe zimadyedwa zimaphwanyidwa kukhala shuga wosavuta, womwe umatengedwa ndi matumbo ochepa ndikulowa m'magazi. Ndi magazi, shuga amafalikira thupi lonse, kupereka mphamvu ya minofu. Mothandizidwa ndi iye, kupanga insulini, mahomoni a kapamba, amalimbikitsa kusamutsidwa kwa glucose mu cell, kukhalabe ndi gawo lina la shuga m'magazi ndikugwiritsa ntchito. Chiwindi, zotupa zowonjezera, mahomoni ena amathandizira kusungitsa kuchuluka kwa glucose mkati mwa thupi.

Mkulu wa glucose wa 7.8-11 amadziwika ndi prediabetes, kuwonjezereka kwa chizindikiro pamwamba pa 11 mmol / l kumawonetsa shuga mellitus.

Chifukwa chiyani mumadziwa shuga

Mwakulankhula, glucose ndi gwero lamphamvu kwa maselo ambiri amthupi. Chifukwa cha kukhalapo kwa glucose m'maselo am'munthu, njira zambiri zofunika zimachitika. Glucose amalowa m'thupi lathu ndi chakudya chomwe chimadyedwa, chifukwa chake, chifukwa cha insulin (chinthu chogwira ntchito chomwe chimapangidwa ndi maselo a kapamba), chimang'ambika m'magulu tosavuta tomwe timalowa m'magazi. Nthawi zambiri, munthu amakhala ndi kudalira: analandira shuga = amapanga insulini. Ndi matenda ashuga, chiwembuchi chimaphwanyidwa. Ngati munthu ali ndi zizindikiro zotsatirazi, ndiye kuti ndikofunikira kuyesa kwaulere kuti mupeze kuchuluka kwa shuga m'magazi. Zizindikiro

Ludzu lalikulu pakamwa louma.
Kuyamwa mwachangu.
Zofowoka pafupipafupi.
"Mano" a acetone ochokera mkamwa.
Zosangalatsa pamtima.
Kukhalapo kwa kunenepa kwambiri.

Kuphwanya ziwalo za masomphenya. Kudziwa kuchuluka kwa shuga m'magazi kumapangitsa kukayikira kukula kwa matenda ashuga munthawi yake, kusankha njira yoyenera yoyeserera, ndikusintha mankhwalawa panthawi ya chithandizo. Amalola wodwala, wokhala ndi malire amtunda (malire ochepera) a shuga, asinthe chimodzi mwazovuta za matenda ashuga tsogolo labwino. Nthawi zambiri, zomwe zimayambitsa matenda obwera chifukwa cha matenda ashuga ndizotengera, komanso momwe zimasinthira okalamba.

Kukonzekera mtima

Pofufuza, magazi ochokera m'msempha komanso chala ndi choyenera. Kusantikako kumachitika pamimba yopanda bata. Musanapereke magazi, muyenera kusiya kumwa mankhwalawo. Chifukwa chake ndikofunika kuti usikuwo musamagwiritse ntchito zakudya zamafuta, ufa ndi "zotsekemera" (mikate yoyera, pasitala, zakumwa zozizilitsa kukhosi, timadziti tosiyanasiyana, confectionery, ndi zina).

Kusanthula

Kusanthula kumachitika ndi a paramedic - othandizira ma labotale omwe amagwiritsa ntchito njira zosiyanasiyana. Njira imodzi yodziwika ndi glucose oxidase ndi kinetic. M'mawu osavuta, mfundo ya njirayi ndi yokhazikika pakuzindikira gawo la mayamwidwe (shuga ndi reagent), lomwe limayambitsa kusanthula kwa biochemical. Ndikofunika kudziwa kuti pakutsimikiza mtima kwa glucose mu biochemical Analyser, venous magazi (magazi otembenuka) amasankhidwa. Magazi a capillary nthawi zambiri amawunikidwa pazida zapadera ("glucose"). Ma glucometer onyamula ndi otchuka kwambiri, momwe kuyezetsa kumafunikira - Mzere ndi dontho la magazi a wodwala kuchokera pachala. Ndipo pakapita masekondi angapo, kuchuluka kwa glucose m'magazi a capillary kumaonekera pawonetsero la mita.

Kuchulukitsa ndikuchepetsa shuga

Kuchulukitsa kwa glucose:

Ndi matenda a chithokomiro komanso kapamba.
Ndi matenda ashuga.
Ndi oncological matenda a kapamba.
Ndi matenda a impso, chiwindi.

Kuchepetsa kwa glucose:

Pathology ya kapamba, momwe mumakhala kuphwanya kupanga kwa insulin.
Ndi kuphwanya kapangidwe ka mahomoni achilengedwe (gawo la ubongo).
Zikondamoyo.
Kumwa mankhwala.
Mankhwala osokoneza bongo ambiri a insulin.

Kupewa

"Matendawa ndi osavuta kupewa kupewera kuchiritsa" - mawuwa, ndi njira, ndi oyenera kupewa matenda ashuga. Ndipo kupewa matenda ashuga kumalumikizidwa ndi kutsimikiza kwa nthawi ya kuchuluka kwa shuga ndi glycated hemoglobin. Mwamwayi, anthu ambiri padziko lonse lapansi amagwiritsa ntchito shuga m'magazi, zomwe zimathandiza anthu, makamaka omwe ali ndi matenda ashuga, kudziwa kuchuluka kwa shuga molondola.

Mwazi wamagazi

Kudziwa kuchuluka kwa shuga m'magazi, monga kuyezetsa magazi konse, ndi njira imodzi yodziwika yoyeserera yachipatala. Magazi a glucose amatha kuyezetsedwa payokha kapena pakuwunika magazi a biochemical. Mwazi wa glucose ungatengedwe kuchokera ku chala kapena mtsempha. Mtundu wa shuga m'magazi a capillary ndi akulu 3,3-5,5 mmol / l, mu venous - 3.7-6.1 mmol / l, mosaganizira jenda. Mkulu wa glucose wa 7.8-11 amadziwika ndi prediabetes, kuwonjezereka kwa chizindikiro pamwamba pa 11 mmol / l kumawonetsa shuga mellitus.

Mayeso a kulolera a glucose

Glucose kulolerana mayeso ndi katundu - katatu muyezo wa shuga ndende ndi imeneyi pambuyo chakudya katundu. Pa phunziroli, wodwala amatenga magazi oyamba a venous, kuti adziwe kuchuluka kwa shuga. Kenako amapereka kumwa shuga. Pakatha maola awiri, gawo lamwazi kuchokera m'mtsempha limatengedwanso. Kusanthula koteroko kumavumbula kusokonezeka kwa glucose komanso mavuto obwera chifukwa cha carbohydrate metabolism.

Amayesedwa ngati abwinobwino ngati zosaposa 5.5 mmol / L za glucose zimatsimikiziridwa mu gawo lamagazi osala, ndipo pambuyo maola awiri - osakwana 7.8 mmol / L. Chizindikiro cha 7.8-11.00 mmol / L pambuyo poti kuthira shuga kukuwonetsa kulolerana kwa shuga ndi prediabetes. Matenda a shuga amapezeka ngati kuchuluka kwa shuga mgawo loyamba la magazi kupitilira 6.7 mmol / L, ndipo kwachiwiri - 11.1 mmol / L.

Kuyesererana kwa glucose pakakhala pakati

Kafukufuku akuchitika kuti adziwe matenda a shuga. Kusintha kwa thupi pa nthawi ya pakati kumatha kuyambitsa kuphwanya kagayidwe kazakudya, popeza chikhazikitso, kukhazikika kwa insulin kumakulanso. Mlingo wabwinobwino wa glycemia umasinthasintha masana panthawi yomwe ali ndi pakati mosiyanasiyana 3.3-6.6 mmol / l.

Hypoglycemia imakhala ndi mphamvu yokhala ndi maselo, operewera mphamvu m'thupi.

Chiyeso chololera cha glucose pa nthawi yoyembekezera chimachitika m'magawo awiri. Kafukufuku woyamba wovomerezeka onse azimayi oyembekezera mpaka masabata 24. Phunziro lachiwiri limachitika pa sabata la 24-28 la mimba. Pankhani ya ultrasound zizindikiro zamiseche mu mwana wosabadwayo, pamaso pa zinthu monga glucosuria, kunenepa kwambiri, cholowa chamtsogolo kwa matenda ashuga, mbiri yokhudza matenda a gestational matenda a shuga, kuyesedwa kumachitika tsiku lakale - masabata a 16-18. Ngati ndi kotheka, amakhazikitsidwanso, koma osapitilira sabata la 32.

Momwe mungachepetse shuga ndi kuchuluka kwa momwe mungafunire kumwa? Glucose mu mawonekedwe a ufa imaphatikizidwa ndi madzi 250-200 ml. Ngati mayesowa ali maola atatu, ndiye kuti tengani 100 g ya glucose, kuti muphunzire maola awiri, kuchuluka kwake ndi 75 g, pa mayeso a ola limodzi - 50 g.

Kwa amayi apakati, kuwonjezeka pang'ono kwa kuchuluka kwa shuga m'magazi pambuyo chakudya kumakhala kakhalidwe, pomwe kumakhalabe kwabwino pamimba yopanda kanthu. Kuwonjezeka kwa shuga wamagazi mwa mayi wapakati yemwe alibe matenda a shuga, ola limodzi mutatha kutenga katundu sayenera kupitirira 7.7 mmol / L. Matenda a shuga a Gestational amadziwika ngati kuchuluka kwa glucose pamiyeso yoyamba kudutsa 5.3 mmol / L, pambuyo pa ola limodzi kumakhala kwakukulu kuposa 10 mmol / L, atatha maola 2 anali oposa 8,6 mmol / L, atatha maola atatu amaposa 7.7 mmol / L.

Glycated Hemoglobin Assay

Katswiri a glycated hemoglobin (wolongosoledwa mu mawonekedwe a HbA1c) - kutsimikiza kwa shuga wamagazi kwa nthawi yayitali (miyezi 2-3). Kuyesereraku kumakupatsani mwayi wodziwira matenda ashuga kumayambiriro, kuwunika momwe mankhwalawo amathandizira, kudziwa kuchuluka kwa chiphuphu chomwe matendawa amatenga.

Hyperglycemia ndi chizindikiro cha kufooketsa chakudya cha metabolism, chimawonetsa kukula kwa matenda a shuga kapena matenda ena a endocrine.

Mlingo wa hemoglobin wa glycated umachokera ku 4 mpaka 6%. Mlingo wa hemoglobin glycation ndiwokwera kwambiri, ndipo kuchuluka kwa shuga m'magazi. Ngati shuga m'magazi ali pagulu kuyambira 6 mpaka 6.5%, ndiye kuti tikulankhula za prediabetes. Chizindikiro pamtundu wa 6.5% chikuwonetsa matenda ashuga, kuwonjezeka kwa 8% kapena kuposerapo ndi matenda ashuga otsimikizika kumawonetsa kuperewera kwa mankhwala. Kuchulukitsa kwa glycation kumakhalanso kotheka ndi kulephera kwaimpso, kuchepa kwa magazi m'thupi, matenda a kapamba, pambuyo pa splenectomy. Kutsika kwa hemoglobin wa glycated m'munsimu 4% kumatha kuwonetsa insuloma, kusowa kwa adrenal, boma litatha magazi, mankhwala osokoneza bongo a hypoglycemic othandizira.

Kutsimikiza kwa peptide

Kuyesedwa kwa magazi ndi tanthauzo la C-peptide ndiko kusiyanitsa koyimira mtundu 1 ndi mtundu wa 2 matenda a shuga, kuwunika kwa maselo a beta omwe amapanga insulin yawoyawo. Chikhalidwe cha C-peptide ndi 0.9-7.1 ng / ml. Kuchulukitsidwa kwake kwa magazi kumawonedwa ndi mtundu wachiwiri wa insulini wosadalira insulin, insulinoma, kulephera kwa impso, khansa ya mutu wapa pancreatic β-cell. Kutsika kwa C-peptide m'magazi kungathe kuwonetsa mtundu wa 1 shuga mellitus, hypoglycemia chifukwa cha insulin, zakumwa zoledzeretsa, komanso kupezeka kwa ma antibodies kuma insulin receptors.

Kutsimikiza kwa lactate level

Kutsimikiza mtima kwa ndende ya lactic acid (lactate) m'magazi kumachitika pofuna kuwunika chiopsezo cha lactic acidosis, zovuta za matenda a shuga. Mulingo wa lactate m'magazi a munthu wamkulu umasiyana ndi 0.5-2 mmol / l, mwa ana chizindikiro ichi ndiwambiri. Mwa zamankhwala ndizofunika kungowonjezera kuchuluka kwa lactate. Mkhalidwe womwe kuchuluka kwa lactate m'magazi kumadutsa 3 mmol / L kumatchedwa hyperlactatemia.

Kusintha kwa thupi pa nthawi ya pakati kumatha kuyambitsa kuphwanya kagayidwe kazakudya, popeza chikhazikitso, kukhazikika kwa insulin kumakulanso.

Mlingo wa lactate ukhoza kuchuluka mu shuga, mtima, khansa, kuvulala, matenda, omwe amadziwika ndi minyewa yolimba, yokhala ndi vuto laimpso ndi chiwindi. Mowa komanso mankhwala ena amathanso kuyambitsa lactic acidosis.

Tsimikizirani ma insulin antibodies

Kuyesedwa kwa magazi kwa ma antibodies ku insulin - chizindikiritso cha ma antibodies ena omwe amalumikizana ndi ma antijeni a thupi lanu, kuwunika kwa kuchuluka kwa autoimmune kuwonongeka kwa maselo a pancreatic beta, amagwiritsidwa ntchito pozindikira insulin yomwe imadalira shuga. Zomwe zili mu antibodies za autoimmune kupita ku insulin ndi 0-10 U / ml. Kuwonjezeka kumatha kuwonetsa mtundu wa shuga 1, matenda a Hirat, matupi awo sagwirizana ndi insulin, ndi polyendocrine autoimmune syndrome. Zotsatira zoyipa ndizomwe zimachitika.

Kusanthula Kwambiri kwa Fructosamine

Kudzipereka kwa ndende ya fructosamine (gulu la shuga ndi albumin) - kutsimikiza mtima kwa shuga 14 masiku 14. Makhalidwe amathandizidwe pakuwonekera kwa fructosamine ndi 205–285 μmol / L. Pa kuchuluka kwa matenda a shuga, kusinthasintha kwa mtengo kumatha kukhala kosiyanasiyana 286-320 µmol / L; mu gawo lowumbidwa, fructosamine imakwera mpaka 370 µmol / L ndi kupitilira. Kuwonjezeka kwa chizindikiro kungasonyeze kulephera kwa aimpso, hypothyroidism. Miyezi yokwera ya fructosamine ikhoza kuwonetsa kukula kwa matenda a shuga, kulephera kwa impso, matenda a chiwindi, kuvulala ndi zotupa za mu ubongo, kuchepa kwa chithokomiro, kusokonekera kwa shuga. Kuchepetsa kumawonetsa kuchepa kwa mapuloteni ndi thupi chifukwa cha chitukuko cha matenda ashuga, nephrotic syndrome, hyperthyroidism. Kuwunika zotsatira za kusanthula kuti mudziwe momwe mankhwalawo amathandizira, gwiritsani ntchito zomwe zikuwonetsedwa.

Matenda a shuga a Gestational amadziwika ngati kuchuluka kwa glucose pamiyeso yoyamba kudutsa 5.3 mmol / L, pambuyo pa ola limodzi kumakhala kwakukulu kuposa 10 mmol / L, atatha maola 2 anali oposa 8.6 mmol / L, pambuyo maola atatu amaposa 7.7 mmol / L.

Kuyesedwa kwa shuga m'magazi mwachangu

Kafukufuku wofufuza kuti azindikire kuchuluka kwa shuga m'magazi kunyumba amagwiritsidwa ntchito kuwongolera glycemia m'mitundu yodalira shuga. Pa njirayi, ma glucometer kunyumba ndi zingwe zapadera zoyeserera zimagwiritsidwa ntchito, pomwe dontho la magazi kuchokera chala limayikidwa. Odwala matenda ashuga ayenera kusunga shuga pamlingo wa 5.5-6 mmol / L.

Momwe mungakonzekerere ndi momwe mungawerengere

Kuyeserera kwambiri kwa ma laboratory kumapangitsa kuti munthu atenge zinthuzo m'mawa, atatha kudya kwa maola 8 mpaka 14. Madzulo a phunziroli, simuyenera kudya mafuta, okazinga, kupewa kupsinjika kwakuthupi komanso kwamalingaliro. Pamaso pa njirayi, madzi oyera okha ndi omwe amaloledwa. Ndikofunikira kupatula mowa masiku awiri lisanawunitsidwe, m'maola ochepa - siyani kusuta. Phunzirolo lisanachitike, ndikudziwa dokotala, siyani kumwa mankhwala omwe amakhudza zotsatirapo zake.

Kusanthula kwa hemoglobin ya glycated kumakhala kosavuta kutenga, zotsatira zake sizimadalira nthawi ya tsiku lomwe magazi amaperekedwa, sikuyenera kutengedwa pamimba yopanda kanthu.

Ndi osavomerezeka kuchita mayeso a shuga wamagazi pambuyo pa njira zochizira, ntchito, ndimatenda opatsirana owopsa, kukokoloka kwa chifuwa chachikulu, pakapita msambo.

Chifukwa chiyani kuyesedwa kwa shuga kumayikidwa?

Mlingo wa glycemia (glucose wamagazi) ukhoza kukhala wabwinobwino, wotsika kapena wokwera. Ndi kuchuluka kwa shuga, hypoglycemia imapezeka, ndi otsika - hyperglycemia.

Hyperglycemia ndi chizindikiro cha kufooka kwa kagayidwe kazakudya, umaonetsa kukula kwa matenda a shuga kapena matenda ena a endocrine. Pankhaniyi, kuphatikizidwa kwa zizindikiro kumapangidwa, komwe kumatchedwa hyperglycemic syndrome:

mutu, kufooka, kutopa,
polydipsia (kuchuluka ludzu),
polyuria (pokodza pokodza)
ochepa hypotension,
kuwonongeka kwamawonekedwe
kuwonda
kukonda matenda opatsirana,
kuchiritsa pang'onopang'ono mabala ndi zikwapu,
kukomoka mtima,
Khungu lowuma komanso loyera
kuchepa kwamphamvu kwamiyendo.

Hyperglycemia yomwe imakhalapo kwa nthawi yayitali imabweretsa kuwonongeka pafupifupi ziwalo zonse ndi minofu, komanso kuchepa kwa chitetezo chathupi.

Mlingo wa hemoglobin wa glycated umachokera ku 4 mpaka 6%. Mlingo wa hemoglobin glycation ndiwokwera kwambiri, womwe umakweza shuga m'magazi.

Hypoglycemia imakhala ndi mphamvu yokhala ndi maselo, kuperewera mphamvu kwa thupi. Hypoglycemic syndrome ili ndi mawonekedwe awa:

mutu
kufooka
tachycardia
kunjenjemera
diplopia (masomphenya apawiri),
kutuluka thukuta kwambiri
kukokana
kukhumudwa
kulephera kudziwa.

Pofufuza zizindikiro zomwe zili pamwambapa, dokotalayo amayambitsa kuyesedwa kwa magazi a shuga. Kuphatikiza apo, kuyezetsa shuga kumawonetsedwa mu milandu yotsatirayi: