Kuyeserera kwa Mimba Kuwala

Pa nthawi yomwe mayi ali ndi pakati, mayi aliyense amayenera kukayesedwa ndipo amayesedwa. Kumapeto kwachiwiri - koyambirira kwa nyengo yachitatu ya kubereka, imodzi mwazoyeseza mimba mayeso kulolera. Kuyeza kumeneku kumawonetsa momwe mayi woyembekezera amaphera magazi a shuga.

Chiyeso chololera glucose panthawi yomwe ali ndi pakati chimachitika kuti mupeze matenda a shuga a latent (latent). Kuzindikiritsa kuloleza kwa glucose kosavomerezeka ndi chiopsezo choyambirira cha kukulitsa odwala osagwirizana ndi insulin.

Momwe mungayesere mayeso a shuga pa nthawi yapakati? Chifukwa chiyani njirayi imayikidwa?

Mu trimester yachitatu, azimayi amapatsidwa mayeso angapo oyenera, kuphatikiza kuyeserera kwa glucose. Mukuchita kafukufukuyu, kagayidwe kazakudya m'thupi kamayendera.

Kupatuka kwina kulikonse kungayambitse zovuta kwa mwana yemwe akukula ndipo amafunika kuwunikira nthawi yake. Yesetsani kuchita izi panthawi ya bere, ndikofunikira makamaka kwa iwo omwe ali pachiwopsezo, mwachitsanzo, awonjezera kulemera.

Glucose - Uwu ndiye gwero lokhalokha lamphamvu komanso zopatsa thanzi m'maselo ofiira a magazi omwe amafunika kupatsa ubongo wa munthu magazi. Kudya kwa glucose amapezeka pakudya, komwe kumaphatikizapo chakudya. Zimapezeka osati maswiti, komanso zinthu zachilengedwe: zipatso, zipatso, masamba.

Kanema (dinani kusewera).

Kulowa m'mwazi zakudya zimawonongeka ndikusinthidwa kukhala shuga. Mlingo wokhazikika wa glucose umathandizidwa ndi mahomoni apadera, insulin, yomwe imapangidwa m'mapamba. Kuchuluka kwake kungayesedwe ndi kusanthula shuga. Kwa ntchito yofananira ya thupi mu thupi, magalamu asanu a shuga ndiokwanira.

Pakupewa, ma organic mkati mwa mai woyembekezera amatha kusokonezeka. Kuchulukitsa kwa mahomoni pa nthawi ya pakati zimakhudzanso kagayidwe kazakudya ndipo nthawi zina zimayambitsa kukhumudwa. Kuchuluka kwa shuga m'magazi kumakwera kapena kugwa, ndipo insulin imaleka kuthana ndi kayendetsedwe ka shuga mthupi. Zotsatira zake zopanda pake zingayambitse chitukuko matenda ashuga.

Kuyesedwa kwa magazi kwa glucose kumachitika nthawi Masabata 24-28 a bere pofuna kudziwa kuchuluka kwa chakudya chamafuta. Kafukufuku wokhudzana ndi kuchuluka kwa shuga amakupatsani mwayi kuti muwone kupatuka kwakanthawi zizolowezi komanso kupewa kuyambika kwa matenda ashuga.

Mayeso a popindika shuga chikuwonetsa momwe thupi la mayi limakhalira. Chifukwa cha zitsanzo zamagazi pansi pa shuga, mutha kudziwa ngati kuchuluka kwa insulin.

Popeza phunziroli limachitika pofuna kupewa, mayi woyembekezera amatha kulemba kukana ndime yake. Koma pali zochitika zina pamene pakufunika kuyesa magazi a shuga:

Kukhala wonenepa kwambiri kapena wonenepa kwambiri.

Kupitiliza kuyesa magazi azipiringa muyenera kubweretsa mug, supuni, botolo lamadzi oyera opanda mpweya wokhala ndi kuchuluka kwa malita 0,5 ndi glucose wapadera wamagulu amtundu wa ufa wa magalamu 75, omwe ayenera kugulidwa pasadakhale ku pharmacy. Ndondomeko imatenga maola angapo, kotero mutha kutenga buku kapena magazini nanu. Kusanthula kumaperekedwa pamimba yopanda kanthum'mawa.

Phunziroli lili ndi magawo angapo:

shuga wapano

Sikuti madokotala onse amabweretsa odwala magawo a kafukufukuyu. Kutiadutse moyenera mayeso a glucose ndikupeza zotsatira zolondola kwambiri, mayi woyembekezera ayenera kutsatira malamulo awa:

Osapitiliza kudya musanayesedwe.

Kwa akazi nthawi iliyonse yam'mimba, chizindikiro cha shuga chochokera 3,3 mpaka 5.5 mmol / L Mukamatenga magazi kuchokera ku chala komanso 4.0 mpaka 6.1 mukamachokera mu mtsempha.

Maola 2 mutatha kuchuluka kwa carbohydrate, mawonetsedwe abwinobwino amadzimadzi a shuga osapitirira 7.8 mmol / l. Ngati manambala akapitilira, kuwunika kwa matenda a shuga kumapangidwa.

Kuphwanya shuga m'magazi mu theka loyamba la mimba zingayambitse kusokonekera. Mu theka lachiwiri la nthawi kupatuka kwa chizolowezi cha shuga kumaphatikizapo zosokoneza pakupanga ziwalo zamkati mwa mwana wosabadwayo. Kuyeserera kwa glucose ndiyo njira yothandiza kwambiri yozindikirira ngozi zomwe zingachitike kwa mwana wosabadwayo ndi amayi ake.

Malinga ndi zotsatira za kusanthula kwa shuga m'magazi, zimatsimikizika ngati mayi woyembekezera ali ndi zofunika kuti pakhalepo mochedwa toxicosis ndi gestational matenda ashuga.

Wothandizira ma labotale amayang'ana magazi m'mitsempha yomwe imatengedwa pakapita kanthawi atatha kudya manyuchi am'magazi kuti agwirizane ndi zizindikiro zoyenera. Munthu wathanzi shuga m'magazi mutamwa tambala wokoma m'ma 1-2 maola amabwerera mwakale.

Ngati pa kuyesedwa kuchuluka kwa shuga anapitilira ziwerengero zovomerezeka, mayi woyembekezera amatumizidwanso kuti adzamufotokozere bwino. Zizindikiro zabodza zimatha kuphwanya malamulo okonzekera kusanthula.

Ndi zotsatira zabwino mobwerezabwereza, kufufuza kwathunthu kumayikidwa ndi endocrinologist. Ngati zingachitike kuchuluka kwa shuga m'magazi, mayi woyembekezera amayenera kutsatira zakudya zapadera ndipo tsiku lililonse amayang'anira kuchuluka kwa shuga m'thupi lake.

Amayi ena oyembekezera sayenera kuwunika magazi kuti adziwitse metabolism, kuti asayambitse zovuta. Kuchulukitsa kulikonse komanso matenda m'thupi kumatha kubweretsa zotsatira zolakwika. Njira yodziwira matenda yolembera samalimbikitsidwa ngakhale pakhale mphuno Chotsani kupotoza kwa zizindikiro.

Izi zotsutsana pazotsatira za kuyesa kwa shuga zimasiyanitsidwa:

Mwazi wa shuga wamagazi umaposa 7 mmol / L.

Pa nthawi yobereka, thupi limakumana ndi nkhawa zambiri. Kuyang'anira kuchuluka kwa shuga m'magazi ndikofunikira chotsani kapena chepetsani chiopsezokuphwanya malamulo insulin kaphatikizidwe. Kutengera malangizo a mayendedwe ndi kusapezeka kwa munthu contraindication shuga kulolerana mayeso siyiopseza mayi ndi mwana wosabadwa, ndipo m'kupita kwanthawi chizindikiritso cha matenda amiseche chimakulolani kusintha kagayidwe kazakudya m'thupi.

Pa nthawi yomwe mayi ali ndi pakati, mayi aliyense amayenera kukayesedwa ndipo amayesedwa. Kumapeto kwachiwiri - koyambirira kwa nyengo yachitatu ya kubereka, imodzi mwazoyeseza mimba mayeso kulolera. Kuyeza kumeneku kumawonetsa momwe mayi woyembekezera amaphera magazi a shuga.

Chiyeso chololera glucose panthawi yomwe ali ndi pakati chimachitika kuti mupeze matenda a shuga a latent (latent). Kuzindikiritsa kuloleza kwa glucose kosavomerezeka ndi chiopsezo choyambirira cha kukulitsa odwala osagwirizana ndi insulin.

Kodi mumayesa bwanji kulolera kwa glucose panthawi yapakati?

Kuyesedwa kwa glucose koyeserera ndi mayeso opsinjika ndi glucose (75 g), omwe ndi mayeso otetezedwa kuti mupeze vuto la kagayidwe kazakudya nthawi yapakati.

Kukonzekera kwamaphunzirowa ndikokhwima komanso mokwanira kuposa kutsimikiza kosavuta kwa kuchuluka kwa shuga m'magazi.

Kuyesaku kumachitika pang'onopang'ono pazakudya zokhazikika (osachepera 150 g wamafuta patsiku) kwa masiku osachepera atatu musanayambe kuphunzira. Phunziroli limachitika m'mawa pamimba yopanda kanthu pambuyo pa kudya kwa maola 8-14. Chakudya chotsiriza chiyenera kukhala ndi 30-50 g yama chakudya. Mankhwala omwe amakhudza glucose wamagazi (multivitamini ndi kukonzekera kwachitsulo komwe kumakhala chakudya, glucocorticoids, β-blockers (mankhwala osokoneza), adrenergic agonists (mwachitsanzo, ginipral) ayenera kumwedwa atatha kuyesedwa ngati nkotheka.

Pa mimba mayeso a shuga katatu magazi amatengedwa kuchokera m'mitsempha ya glucose:

Maziko oyambira (maziko) othamanga a shuga mumagazi amayeza. Mutatenga gawo loyambirira la magazi a venous, glucose amayeza nthawi yomweyo. Ngati kuchuluka kwa shuga ndi 5.1 mmol / L kapena kuposerapo, ndiye kuti matendawo amapangidwa Matenda a shuga. Ngati chizindikirocho chikufanana ndi 7.0 mmol / L kapena kuposa, kuwunikira koyambirira kumapangidwa Kuwonekera (koyamba kupezeka) matenda a shuga pa mimba. M'njira zonsezi, kuyesaku sikudzachitidwanso. Ngati zotsatira zake zili mkati mwa mtundu woyenera, ndiye kuti mayesowo akupitiliza.
Mayeso akamapitiliza, mayi woyembekezera ayenera kumwa glucose kwa mphindi 5, ndipo amakhala ndi shuga 75 g owuma (anhydrite kapena anhydrous) wosungunuka mu 250-300 ml ya madzi ofunda (37-40 ° C) kumwa madzi osapatsa kapena kaboni. Kuyambitsa yankho la glucose kumawoneka ngati chiyambi cha mayeso.
Zotsatira zamagazi zotsatirazi kuti azindikire kuchuluka kwa shuga zam'magazi zotsekemera zimatengedwa 1 ndi maola 2 mutatsitsa shuga. Mukalandira zotsatira zomwe zikuwonetsa Matenda a shuga pambuyo pa sampuli yachiwiri ya magazi, kuyezetsa kumayima ndipo kuyesedwa kwachitatu kwa magazi sikunachitike.

Pazonse, mayi woyembekezera amatha pafupifupi maola 3-4 kutenga mayeso ololera a glucose. Panthawi yoyesedwa, kuchita masewera olimbitsa thupi ndi koletsedwa (simungathe kuyenda, kuyimirira). Mayi woyembekezera azitha ola limodzi pakati pa kumangotenga magazi okha, atakhala pansi mosangalala akuwerenga buku komanso osapanikizika. Kudya kumapangidwa, koma kumwa madzi sikuletsedwa.

Kuchuluka kwa shuga m'magazi pa mimba

Kutanthauzira kwa zotsatira zoyeserera kumachitika ndi obstetrician-gynecologists, akatswiri azachipatala, akatswiri onse. Malangizo apadera ochokera kwa endocrinologist kuti akhazikitse mfundo yophwanya metabolism ya carbohydrate panthawi yapakati sikofunikira.

Nthawi zonse kwa amayi oyembekezera:

kusala venous plasma glucose ochepera 5.1 mmol / L.
pambuyo pa ola limodzi panthawi ya mayeso okhudzana ndi shuga osakwana 10,0 mmol / L.
pambuyo maola 2, ochulukirapo kapena wofanana ndi 7.8 mmol / L ndi ochepera 8.5 mmol / L.

Kuwongolera ndi chithandizo cha amayi apakati omwe ali ndi matenda ashuga

Chithandizo cha zakudya chimawonetsedwa kupatula chakudya chamafuta ochepa am'mimba komanso kuletsa kwamafuta, kugawa chakudya chokwanira tsiku lililonse chakudya chambiri. Mafuta okhala ndi chakudya chamafuta ambiri sayenera kupitirira 38-45% ya zakudya zopatsa mphamvu za tsiku ndi tsiku, mapuloteni 20-25% (1,3 g / kg), mafuta - mpaka 30%. Amayi omwe ali ndi index yolimba ya thupi (BMI) (18 - 24.99 kg / sq. M) akulimbikitsidwa kudya tsiku lililonse kashiamu 30 kcal / kg, owonjezera (kulemera kwa thupi kupitilira 20% 50, BMI 25 - 29). , 99 makilogalamu / sq. M) - 25 kcal / kg, onenepa kwambiri (kulemera kwa thupi kuposa kumene kumatha kuposa 50%, BMI> 30) - 12-15 kcal / kg.

Dosed aerobic masewera olimbitsa thupi poyenda osachepera mphindi 150 pa sabata, akusambira padziwe. Pewani masewera olimbitsa thupi omwe angayambitse kuchuluka kwa kuthamanga kwa magazi (BP) ndi uterine hypertonicity.

Amayi omwe adadwala matenda ashuga ali pachiwopsezo chachikulu chotenga matendawa mtsogolo komanso matenda a shuga am'tsogolo. Chifukwa chake, azimayi awa ayenera kuyang'aniridwa pafupipafupi ndi endocrinologist ndi obstetrician-gynecologist.

Udindo wa shuga m'thupi la munthu

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

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

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

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

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

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

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

Kuchuluka kwa shuga

Nthawi zambiri, misempha ya magazi imachuluka chifukwa chosakwanira kupanga insulin. Zimapangidwa ndi kapamba ndipo zimagwira gawo lofunikira mthupi, chifukwa zimathandiza glucose kulowa m'maselo.

Ngati kuchuluka kwa mahomoni opangidwa ndizotsika kuposa momwe amafunikira, ndiye kuti mpweya wambiri womwe ukubwera umatulutsidwa kudzera mu impso popanda kulowa m'maselo. Chifukwa chake, samalandira michere ndi mphamvu, zomwe zimabweretsa mphamvu yanjala.

Kuyambira sabata 20, kuwonjezeka kwamahomoni enieni kumachitika m'thupi la amayi apakati, kutsekereza kwakukulu kwa insulin.

Kusinthasintha shuga m'magazi oyembekezera, kapamba amawonjezera kuphatikiza kwa mahomoni. Mwa mkazi wathanzi, amatha kuonjeza kangapo poyerekeza ndi momwe thupi limakhalira.

Mwa azimayi ena oyembekezera, pazifukwa zosiyanasiyana, kapamba sangathe kuthana ndi katundu wotere, chifukwa cha kuperewera kwa insulin, komwe kumatha kukhala kocheperako kapena kotheratu. Matendawa amatchedwa matenda a shuga.

Kodi chiwopsezo cha izi ndi chiani:

Kuphwanya kukula kwa ziwalo ndi machitidwe a mwana wosabadwayo. Pambuyo pobadwa, ziwalo za mwana sizigwira ntchito moyenera komanso mokwanira.
Kutaya pathupi komwe kumachitika, makamaka pakati pa milungu 20 yoyamba ya mimba. Izi ndichifukwa choti placenta sangathe kuthana ndi ntchito zake.
Pambuyo pa kubadwa, makanda ambiri amakhala ndi vuto la kupuma, mavuto a mtima, mavuto amitsempha, komanso kuchuluka kwambiri kwa shuga.

Kutsitsa shuga m'magazi kumayambitsa kulakalaka kwa maswiti

Mafuta otsika

Kodi chifukwa chiyani shuga wochepa amapezeka m'magazi? Izi zimachitika pamene kapamba amapanga insulin yambiri, koma shuga wochepa amalowa m'thupi. Akatswiri amatcha mkhalidwewu kuti hypoglycemia, imadziwonekera yokha mwanjira yokwezeka msanga m'magazi a shuga m'magazi.

Izi zitha kukhala chifukwa cha izi:

Kuchita zolimbitsa thupi kwambiri, pomwe thupi limagwiritsa ntchito mphamvu zake mwachangu. Ngati ndizosatheka kuyimitsa masewera olimbitsa thupi, muyenera kuwonjezera zinthu zomwe zili ndi chakudya chamagulu azakudya.Ascorbic acid yokhala ndi glucose imathandizanso.
Kugwiritsa ntchito zakumwa zoledzeretsa komanso zakumwa zoledzeretsa. Zakudya izi zimakhala ndi shuga wambiri, chifukwa cha ichi amatha kuwonjezera kuchuluka kwake m'magazi, ndikutsatira kuchepa mwachangu komanso kowopsa.
Kudya zakudya zing'onozing'ono komanso nthawi yayitali pakati pa chakudya.Izi zimabweretsa kugwiritsa ntchito mphamvu zonse pambuyo pa maola 2-3 mutatha kudya.
Nthawi zambiri mumamwa pafupipafupi zotsekemera ndi ufa, komanso zinthu zomwe zimakhala ndi index yayikulu ya glycemic. Izi zimabweretsa kuwonjezeka kwambiri kwa shuga m'magazi ndikuwonjezera kupanga kwa insulin kwa mayamwidwe ake. Pambuyo pake, kuchuluka kwa glucose kumatsika kwambiri komanso mwachangu. Mayi woyembekezera amamva kusweka, amagona ndipo amakhala ndi chikhumbo champhamvu chodya china chokoma chifukwa cha chosowa. Ngati simuyang'ananso chakudyacho, mtsogolomo mayi woyembekezera adzagwiritsa ntchito maswiti ndi makeke.
Kugwiritsa ntchito mafuta okhala ndi zopatsa mphamvu zochepa. Izi zimabweretsa mphamvu yaying'ono mthupi komanso kuchepa kwambiri kwa shuga m'magazi atatha kumwa shuga. Hypoglycemia yamtunduwu imachitika chifukwa cha kuperewera kwa zakudya m'thupi. Mankhwala, akatswiri amati amayi apakati azigwiritsa ntchito zakudya zokhala ndi kalozera wama glycemic, komanso asinthe menyu komanso zakudya.

Kuchepetsa shuga m'magazi kulinso kovuta kwa mayi wapakati ndi mwana wosabadwa, komanso kuchuluka kwake. Izi zimabweretsa kubadwa kwa mwana wochepa thupi, patsogolo pa ndandanda, chitetezo chochepa komanso mitundu yambiri ya endocrine system.

Kuti khazikitse vutoli, tikulimbikitsidwa kuwonjezera kuchuluka kwa chakudya ndikuonetsetsa kuti pali zakudya zomwe zili ndi index yotsika ya glycemic muzakudya. Zogulitsa zotere zimayamwa mwachangu, chifukwa chomwe shuga amapita pang'onopang'ono m'magazi, zomwe sizimayambitsa kuthamanga kwa glucose komanso kufunikira kwa kupanga insulin yambiri.

Tikukulimbikitsani kuti mudziwe zowunikira za amayi ndi amayi apakati zamagazi awo pomwe anali ndi mwana.

Pakati pa abale anga pali anthu omwe ali ndi matenda ashuga. Nditakhala ndi pakati, ndinkaopa kwambiri kuti ndikadadwala izi. Chifukwa chake, pamasabata 28, kuyesedwa kwa shuga kunachitika. Zizindikiro zonse zinali zabwinobwino, mwana amabadwa wathanzi.

Pathupi, adadya pang'ono ndipo nthawi zambiri, analibe chidwi. Chifukwa cha izi, nthawi zonse ndinali ndi shuga wamagazi. Ndinafunika kusintha chakudya kuti chizolowere.

Ndinali ndi shuga wambiri panthawi yapakati. Zonse chifukwa choti amakonda kusewera masewera. Ndinafunika kusiya kuchita masewera olimbitsa thupi, pokhapokha kuti ndipewe mavuto akukula mwana. Mwana wamkazi adabadwa panthawi.

Magazi a m'magazi ndi chizindikiro chofunikira chokhala ndi thanzi. Pazifukwa izi, ziyenera kuyang'aniridwa pakubadwa kwa mwana. Yang'anirani thanzi lanu komanso kubereka kwanu!

Kusanthula kwa GTT ndi OGTT pa nthawi ya pakati: chifukwa chake nzolembera, zabwinobwino

Mkazi aliyense yemwe wabala amadziwa zomwe mayeso okhudzana ndi glucose ali ndi pakati. Koma omwe akukonzekera koyamba kubweretsanso banjalo, mwina, sanakumane naye ndipo sakudziwa chifukwa chomwe adaikidwira.

Kumbali ina, amayi odziwa ntchito nthawi zambiri sazindikira chifukwa chomwe madokotala amawakakamiza kumwa madzi okoma pamimba yopanda kanthu. Ndizofunikira kudziwa kuti izi zimangomveka zopanda vuto poyang'ana koyamba, koma kwenikweni kuyesaku kumalumikizidwa ndi malingaliro osasangalatsa. Nanga bwanji madokotala akuwona ngati ntchito yawo kuyika vutoli kwa amayi apakati oyembekezera? Tiyeni tiyese kuzindikira.

Amayi okha omwe adapirira ndi kubereka mwana ndi omwe amamvetsa momwe zimakhalira zovuta - kubereka, kuchuluka kwa mavuto ndi nkhawa zomwe mayi woyembekezera akukumana nazo. Koma kuphatikiza ndi toxosis, kutupa kwa miyendo ndi mantha am'mawa, palinso pafupipafupi kukaonana ndi dotolo woyang'anira, ndikumayeserera pafupipafupi - thanzi la mwana liyenera kuyang'aniridwa ndi chisamaliro chonse chomwe chingatheke.

Nthawi zina mzimayi samamvetsetsa chifukwa chomwe amatumizira kuti apereke magazi kapena madzi ena achilengedwe. Nthawi zina, amayamba kukayikira ngati ali ndi vuto lililonse lomwe madokotala sangafune kukambirana. Kupatula apo, azimayi omwe ali ndiudindo ndiopeka!

Ndipo pakungotchulapo kuyesedwa kwa kulolera kwa glucose mwa mayi wapakati, mantha enieni amatha kuyamba - zimveka zachilendo komanso zowopsa.

Pakadali pano, palibe cholakwika chilichonse ndikutenga mayeso a magazi am'mimba kuti mupeze mayeso okhudzana ndi shuga kapena GTT panthawi yapakati. Zoti amamulembera ndizabwinobwino, ndipo izi zokha sizikutanthauza chilichonse choyipa. Ndipo kuyezetsa sikungavulaze mayi kapena mwana. M'malo mwake, zithandiza kuzindikira kupezeka kwa mavuto omwe amafunikira chithandizo chamankhwala mwachangu. Kupatula apo, kuwunika kwa kulolera kwa glucose kumatsimikizira ngati mayi woyembekezera ali ndi matenda otchedwa gestationalabetes - mtundu wa shuga womwe umadziwoneka pawokha pakati.

Mwa mkazi aliyense yemwe akuyembekezera khanda, shuga (m'mawu chabe, shuga) m'magazi amadzuka pazifukwa zachilengedwe. Zowona, mwanjira zambiri sizimachulukana kwambiri kotero kuti mfundo zake zingafanane ndi zisonyezo za matenda ashuga. Kupatula apo, insulin imapangidwa mopikulitsa kuposa momwe zimakhalira - chinthu chomwe m'thupi lathu chimagwira ntchito yokhazikitsa shuga wamagazi ndipo sichilola kuchuluka kwake kwakanthawi. Ndiye kuti, ngati pazifukwa zina kapena shuga wina wadwala kwambiri, insulini iyenera "kutembenuka" ndikusintha kapangidwe ka magazi.

Ngati insulin yotulutsidwa sikokwanira kuthana ndi shuga, kuchuluka kwake m'madzi a m'magazi kumatha kuwonjezeka kwambiri. Ichi ndi matenda osokoneza bongo kapena "shuga woyembekezera." M'malo mwake, uwu ndi mtundu wabwinowu womwe sukunena zakunja, ndipo pambuyo pobadwa umatha. Chifukwa chake musachite mantha. Koma musapumule. Ngati kusanthula kwa glucose kuloza kukhala kotheka, izi zitha kungotanthauza chinthu chimodzi: mimba iyenera kuchitika moyang'aniridwa kwambiri ndi achipatala. Ndi histologic matenda a shuga, mwina mungafunike kuwerenganso njira yanu komanso zakudya zanu, kutsatira zakudya zapadera zomwe simuphatikiza zinthu zingapo, ndikuyambitsa zochitika zolimbitsa thupi (modekha.

Ngakhale kuti matendawa sanamwalire, simungathe kuzimva mopepuka - popanda kutsatira malangizo azachipatala, kukula komanso thanzi la mwana wosabadwa (komanso yanu) kudzakhala pachiwopsezo.

Kodi kulekerera kwa shuga ndi chiyani? Mawu oti "kulolerana" kutanthauza "kulolerana", ndipo m'lingaliro lakuthupi, ndimachitidwe ofooka a thupi (kapena kusowa kwathunthu) pazinthu zilizonse zomwe zimalowetsa iwo. Ndikosavuta kuganiza kuti pamenepa glucose amalowetsedwa m'thupi lanu ndipo amayang'ana momwe amathandizira.

Mukadutsa GTT (ili ndi mayina ena: "shuga katundu" kapena mayeso a OSullivan) ndikofunikira kutsatira zonse - kuphwanyidwa pang'ono kumakhala kobwereza njira yonse.

Zotsatirazi zingakhudze zotsatirazi:

chakudya ndi zakumwa (kuyeserera kumachitika pamimba yopanda kanthu, nkoletsedwa kutenga chilichonse kupatula madzi opanda kanthu mkamwa osachepera maola asanu ndi atatu isanayambe),
Mankhwala (ngati muyenera kumwa mankhwala nthawi zonse, muyenera kudziwitsa dokotala za izi zisanachitike),
kupsinjika kwamthupi kapena kwamaganizidwe,
matenda opatsirana komanso / kapena otupa (kumbukirani kuti ngakhale kuzizira kochepa kumatha kutsitsa kukonzanso kwathunthu).

Kumayambiriro kwa kuyesako, amatenga magazi kuchokera m'mitsempha, kenako amakupatsani kapu yamadzi okoma kwambiri - njira yayikulu yotseka shuga. Tambala iyi imakoma kwambiri ndipo imakhala yoyipa (ena amadwala), koma muyenera kukhala okonzeka kumwa chilichonse mpaka kumapeto kwa mphindi zisanu. Ngati zonse zili mu dongosolo ndi magazi anu musanadye shuga (ndiye kuti, shuga sanatulutsidwe), ola limodzi adzatenganso magazi anu. Ndipo patatha ola limodzi - kachiwiri, ndi zina mpaka kanayi. Izi ndizabwinobwino - motere, madotolo amapeza mphamvu ya zochitika m'magazi anu, ndiye kuti, insulin imagwira ntchito pakapangidwe kake. Zikagwira ntchito kuti zikugwira, amakulolani kupita. Ngati sichoncho, kuyesaku kuyenera kubwerezedwa kuti kuthetsedwe zowerengera zabodza. Mwa njira, amatha kuuka, mwachitsanzo, chifukwa cha kuchepa kwa potaziyamu. Chifukwa chake, ngakhale mutatsatira malamulo, osadya kapena kumwa, ndipo shuga akadali wokwera, izi sizitanthauza kuti muli ndi matenda ashuga.

Amayi onse oyembekezera amatumizidwa kukayendera kulolera kwa glucose, kuyambira sabata la 24 mpaka 32.

Pambuyo pake, sizingatheke kuchita GTT - izi zingakhudze mwana. Ndipo mayeso omwe adakonzedweratu pasadakhale (pa 16 - 18 sabata) atha kuwonetsa kuti muli m'gulu la owopsa. Maguluwa amaphatikizapo:

azimayi onenepa kwambiri
Kunyamula mwana wamkulu kapena kubereka ana akulu,
omwe abale awo ali ndi matenda ashuga
akudwala matenda a shuga gestational panthawi yam'mbuyomu.

Ngati mulibe zomwe zatchulidwa pamwambapa, ndipo mayeso anu akadali achichepere, omasuka kufunsa adotolo chifukwa chake izi zidachitika. Mwambiri, musazengereze kufunsa woyang'anira wanu mafunso aliwonse okhudzana ndi zomwe akupatseni, komanso zomwe zili kwa inu komanso kwa mwana wanu. Njira yofunika kwambiri mdziko lapansi ikuchitika mkati mwa thupi lanu, ndipo ufulu wanu woyera ndikudziwa zomwe zikuchitika pamenepo ndi chifukwa.

Mwazi wamagazi pa nthawi ya pakati: mfundo zoyenera, zapamwamba komanso zotsika

Nkhaniyi imakambirana shuga pamimba. Timalankhula za chizolowezi chake mu 1, 2nd ndi 3 trimester, pomwe amayeza kuyesa kwa icho. Mupeza zomwe kuchuluka kwa shuga m'magazi kumatanthauza.

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

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

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

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

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

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

Kodi Zizindikiro za glucose ziyenera kukhala chiyani panthawi yomwe ali ndi pakati? Ayenera kukhala pamtunda wa 3.3-5.5 mmol / L. Mtengo wovomerezeka wokwanira ndi 6 mmol / L. Zizindikiro zotere ziyenera kusungidwa mu nthawi yonse yoyenga.

Ndi kuwonjezeka kwa glucose pamtunda wa 6 mmol / l, izi zimawonetsa hyperglycemia ndi kuchepa kwa insulin ya mahomoni, komanso kufunikira kwa chisamaliro chamankhwala.

Pakubala kwa mwana, ndikofunikira kuwunika pafupipafupi kuchuluka kwa shuga m'magazi, chifukwa kusinthasintha kwa chizindikirochi kukuwonetsa kukhalapo kwa matenda.

Kuphatikiza apo, ngati simuyang'anira kuchuluka kwa shuga m'magazi, izi zimatha kubweretsa kukula kwa matenda a shuga, makamaka kwa azimayi omwe ali ndi abale omwe ali ndi matenda. Izi zimayambika chifukwa cha kuchuluka kwa matupi a ketone komanso kuchepa kwa kuchuluka kwa amino acid.

Nthawi zina amafunika kudziwa kuchuluka kwa shuga osati m'magazi okha, komanso mkodzo. Munthawi yabwinobwino, sikuyenera kukhala mthupi. Ngati wapezeka mu 3 trimester, ndiye musachite mantha, chifukwa pambuyo pobadwa izi zimatha palokha. Mankhwala, chodabwitsachi chimatchedwa "gestationalabetes", ndipo tsopano chikuchitika mwa theka la amayi oyembekezera.

Nthawi zambiri, atadzuka, kuchuluka kwa shuga m'mayi ambiri oyembekezera kumatsitsidwa ndipo sikupitirira 1.1 mmol / L. Izi ndi zachilengedwe komanso osati zoopsa. Koma ngati amayamba chifukwa cha njala kwanthawi yayitali, ndiye kuti kuchepa kwa glucose wa plasma.

Glucose kulolerana mayeso anachita 28 milungu gestation

Kumayambiriro kwa milungu 28 yoyembekezera, azimayi oyembekezera amalangizidwa kuti akayezetse mayeso ena okhalitsa a shuga. Imachitika m'njira ziwiri: popereka shuga m'mitsempha kapena pomamwa.

Zimadutsa mkati mwa ola limodzi, pomwe nthawi 50 g ya glucose imagwiritsidwa ntchito. Akafika chizindikiro cha 7.8 mmol / l, mayi woyembekezera adzapatsidwa kuyesedwa kwina ndi kuyambitsa makilogalamu a 0,1 a chinthu chokhala maola atatu.

Ngati panthawiyi chizindikirocho chikufika pa 10,5 mmol / l, katswiri amatha kudziwa matenda a shuga.

Mukamawerengera zizindikiro ndikuwonetsa matenda, akatswiri amaganizira zinthu zina zomwe zimapangitsa kuti shuga azithamanga m'magazi, ndi awa:

cholowa
mavuto amanjenje
onenepa kwambiri
m'mbuyomu, ana omwe anali ndi kulemera kwakukulu (4-5 kg) amabadwa.

Komanso omwe ali pachiwopsezo ndi amayi:

omwe ali ndi abale apamtima odwala matenda ashuga,
yemwe anali ndi shuga wambiri m'mimba asanachitike,
zaka zake zimaposa zaka 30,
ndi zipatso zazikulu (kuyambira 4.5 kg),
omwe ali ndi ovary polycystic,
m'mbiri yomwe panali zolakwika poyambira.

Nthawi zambiri, misempha ya magazi imachuluka chifukwa chosakwanira kupanga insulin. Zimapangidwa ndi kapamba ndipo zimagwira gawo lofunikira mthupi, chifukwa zimathandiza glucose kulowa m'maselo.

Kuyambira sabata 20, kuwonjezeka kwamahomoni enieni kumachitika m'thupi la amayi apakati, kutsekereza kwakukulu kwa insulin.

Kusinthasintha shuga m'magazi oyembekezera, kapamba amawonjezera kuphatikiza kwa mahomoni. Mwa mkazi wathanzi, amatha kuonjeza kangapo poyerekeza ndi momwe thupi limakhalira.

Kodi chiwopsezo cha izi ndi chiani:

Kuphwanya kukula kwa ziwalo ndi machitidwe a mwana wosabadwayo. Pambuyo pobadwa, ziwalo za mwana sizigwira ntchito moyenera komanso mokwanira.
Kutaya pathupi komwe kumachitika, makamaka pakati pa milungu 20 yoyamba ya mimba. Izi ndichifukwa choti placenta sangathe kuthana ndi ntchito zake.
Pambuyo pa kubadwa, makanda ambiri amakhala ndi vuto la kupuma, mavuto a mtima, mavuto amitsempha, komanso kuchuluka kwambiri kwa shuga.

Kutsitsa shuga m'magazi kumayambitsa kulakalaka kwa maswiti

Izi zitha kukhala chifukwa cha izi:

Tikukulimbikitsani kuti mudziwe zowunikira za amayi ndi amayi apakati zamagazi awo pomwe anali ndi mwana.

Pathupi, adadya pang'ono ndipo nthawi zambiri, analibe chidwi. Chifukwa cha izi, nthawi zonse ndinali ndi shuga wamagazi. Ndinafunika kusintha chakudya kuti chizolowere.

Magazi a m'magazi ndi chizindikiro chofunikira chokhala ndi thanzi. Pazifukwa izi, ziyenera kuyang'aniridwa pakubadwa kwa mwana. Yang'anirani thanzi lanu komanso kubereka kwanu!

Kanema: Glycated hemoglobin wabwinobwino panthawi yapakati

Tkachuk V. A. Kuyamba kwa maselo endocrinology: monograph. , Nyumba Yofalitsa Nyumba ya MSU - M., 2015. - 256 p.
Stepanova Zh.V. Matenda oyamba ndi mafangasi. Moscow, Kron-Press Publishing House, 1996, masamba 164, kufalitsa makope 10,000.
Oppel, V. A. Maphunziro pa Opaleshoni Yamankhwala ndi Clinical Endocrinology. Buku lachiwiri: monograph. / V.A. Tsutsa. - Moscow: SINTEG, 2014 .-- 296 p.

Ndiloleni ndidziwitse. Dzina langa ndi Elena. Ndakhala ndikugwira ntchito ya endocrinologist kwa zaka zoposa 10. Ndikukhulupirira kuti pakadali pano ndili katswiri pantchito yanga ndipo ndikufuna kuthandiza alendo onse omwe amapezeka pamalowo kuti athetse zovuta osati ntchito. Zinthu zonse za tsambalo amazisonkhanitsa ndikuzikonza mosamala kuti athe kufotokoza zambiri zofunikira. Musanagwiritse ntchito zomwe zikufotokozedwa pa webusaitiyi, kufunsana ndi akatswiri ndizofunikira nthawi zonse.

Pazakuwunikira

Chifukwa chiyani kupereka?

Mayeso a popindika shuga chikuwonetsa momwe thupi la mayi limakhalira. Chifukwa cha zitsanzo zamagazi pansi pa shuga, mutha kudziwa ngati kuchuluka kwa insulin.

Popeza phunziroli limachitika pofuna kupewa, mayi woyembekezera amatha kulemba kukana ndime yake. Koma pali zochitika zina pamene pakufunika kuyesa magazi a shuga:

Kutenga?

Phunziroli lili ndi magawo angapo:

shuga wapano

Kukonzekera njirayi

Sikuti madokotala onse amabweretsa odwala magawo a kafukufukuyu. Kutiadutse moyenera mayeso a glucose ndikupeza zotsatira zolondola kwambiri, mayi woyembekezera ayenera kutsatira malamulo awa:

Osapitiliza kudya musanayesedwe.

Mitundu kutengera trimester

Kwa akazi nthawi iliyonse yam'mimba, chizindikiro cha shuga chochokera 3,3 mpaka 5.5 mmol / L Mukamatenga magazi kuchokera ku chala komanso 4.0 mpaka 6.1 mukamachokera mu mtsempha.

Maola 2 mutatha kuchuluka kwa carbohydrate, mawonetsedwe abwinobwino amadzimadzi a shuga osapitirira 7.8 mmol / l. Ngati manambala akapitilira, kuwunika kwa matenda a shuga kumapangidwa.

Kuphwanya shuga m'magazi mu theka loyamba la mimba zingayambitse kusokonekera. Mu theka lachiwiri la nthawi kupatuka kwa chizolowezi cha shuga kumaphatikizapo zosokoneza pakupanga ziwalo zamkati mwa mwana wosabadwayo. Kuyeserera kwa glucose ndiyo njira yothandiza kwambiri yozindikirira ngozi zomwe zingachitike kwa mwana wosabadwayo ndi amayi ake.

Kulingalira zotsatira

Malinga ndi zotsatira za kusanthula kwa shuga m'magazi, zimatsimikizika ngati mayi woyembekezera ali ndi zofunika kuti pakhalepo mochedwa toxicosis ndi gestational matenda ashuga.

Contraindication

Izi zotsutsana pazotsatira za kuyesa kwa shuga zimasiyanitsidwa:

Zizindikiro ndi contraindication

Malinga ndi mapuloteni a Unduna wa Zaumoyo, kafukufukuyu akuyenera kuchitidwa ndi amayi onse oyembekezera kwa nthawi ya masabata 24 mpaka 28. Chofunika kwambiri ndikusanthula kwa curve kwa shuga panthawi yomwe amayi ali pachiwopsezo. Mwachitsanzo, ngati banja lajambulapo za matenda ashuga kapena wodwalayo mwiniyo kale anali ndi zovuta za kagayidwe kazakudya. Ndikofunika kupenda amayi oyembekezera omwe kuperewera kwa mkodzo wapezeka. Amayi omwe ali pachiwopsezo amaphatikizanso amayi onenepa kwambiri.

Chiyeso cha kulolera kwa glucose (GTT) mwa amayi apakati omwe ali ndi chiopsezo chimachitika mukangomaliza kulembetsa, ndiye kuti kuyambira 24 mpaka 28 milungu.

Upangiri wowunikira umaperekedwa ndi adotolo, ndikuwonetsa kuchuluka kwa monosaccharide. Pali zotsutsana zingapo ku GTT:

Kutsegula kwa glucose kumayesedwa mwa akazi omwe magazi awo amasala kudya opitilira 7.0 mmol / L (5.1 mmol / L m'malo ena).
Osayesa odwala omwe ali ndi zaka 14.
Mu trimester yachitatu, atatenga bere kwa milungu 28, kuchuluka kwa chakudya m'thupi kumakhala koopsa kwa mwana wosabadwayo, motero amachitika mokulira malinga ndi umboni wa dotolo. Pambuyo masabata 32, osasankhidwa.
Mayeso sachitidwa chifukwa cha kutupa, matenda, kufalikira kwa kapamba, kutaya matenda.
Sizikupanga nzeru kuchita kafukufuku wokhudzana ndi kusokonekera kwa glucose kumbuyo kwa pharmacotherapy omwe ali ndi mankhwala omwe amalimbikitsa glycemia.
Kwa amayi apakati omwe ali ndi toxosis yayikulu, kuyesaku ndi koopsa ndi zotsatira zingapo. Mafuta ochulukirapo amabwera ndi zinthu zochepa zosangalatsa ndipo amatha kungokulitsa mseru ndi zizindikiro zina.

Kukonzekera mayeso

Kuti zotsatira za mayeso okhudzika ndi glucose pakhale pakati azikhala odalirika, muyenera kukonzekera bwino phunzirolo. Ndikofunika kuti musasinthe zakudya zomwe mwakhala mukugula kwa masiku atatu GTT isanadye, idyani chakudya chokwanira chopatsa mphamvu. Malamulo abwinobwino olimbitsa thupi panthawiyi amafunikanso. Usiku lisanafike mayeso a kulolera m'magazi, mutha kumwa madzi osachepera maola 8, ndipo simungathe kudya chakudya. Ndikofunika kusiya mowa kwathunthu maola 11 mpaka 15 phunzirolo lisanachitike. Kusuta kumaletsedwanso panthawiyi. Chakudya chomaliza chikuyenera kuphatikiza ndi 30 g wamafuta.

Mukatsatira zingapo mwalamulo izi, kuperekera kwa GTT kudzakhala koyenera, ndipo zotsatira zake zimakhala zodalirika. Ndikwabwino kukaonana ndi dokotala kuti afotokozere mwatsatanetsatane momwe angapatsirire kuyesedwa kwa maola awiri molondola. Ndikofunikira kufunsa iye za zoopsa zomwe zingakhalepo, kuvulaza mwana yemwe sanabadwe, kulimbikitsidwa kwa phunziroli komanso mwayi wosiya.

Zolepheretsa GTT kwa Amayi Oyembekezera

Kuyeserera kwa glucose panthawi yoyembekezera kumaletsedwa panthawi yomwe wodwala:

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

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

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

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

Momwe mungayesere kuyesedwa kwa GTT panthawi yapakati?

Kuyesedwa kwa glucose kopatsa pakati kumayambira ndikutenga magazi kuchokera kumitsempha pakulowera mkono. Kenako wodwalayo amayenera kumwa glucose wosungunuka m'madzi omwe ali ndi kuchuluka kwa 200-300 ml (kuchuluka kwa glucose sungunuka kumawerengeredwa potengera kulemera kwa thupi la wodwalayo, koma osapitirira 75 g). Dziwani kuti madziwo amayenera kuledzera osaposa mphindi 5 mpaka 7.

Kuyeza koyamba kwa shuga kumachitika pambuyo pa ola limodzi, ndiye pambuyo pa maola awiri. Pakadutsa pakati pa kuyeza, wodwala ayenera kukhala wodekha, kupewa zinthu zolimbitsa thupi, kuphatikizapo kuyenda masitepe, komanso kusuta.

GTT mitengo ya azimayi oyembekezera

Zotsatira za phunziroli ndizofunikira kufotokoza bwino za kagayidwe kazachilengedwe m'thupi la mayi wapakati. Komabe, sikokwanira kungodziwitsa zaumwini. Kuti izi zitheke, wodwalayo ayenera kufunsa dokotala wa endocrinologist ndi kupatsanso mayeso ena azachipatala.

Zomwe zaperekedwa pansipa zitha kugwiritsidwa ntchito pazidziwitso zokha. Kugwiritsa ntchito kwawo podzifufuza komanso kusankha mankhwala ndikosavomerezeka. Izi zimatha kudzetsa thanzi komanso zimasokoneza kukula kwa khanda la mwana.

Tebulo likuwonetsa kuchuluka kwa shuga mu seramu yamagazi amkati mwa mayi wapakati malinga ndi World Health Organisation.

Kuyeza nthawi	Miyezo yodziwika mu plasma ya venous magazi, mmol / l	Zotsatira zomwe zikuwonetsa matenda a shuga, mmol / L
Pamimba yopanda kanthu	Pasanathe 5.1	5.1 mpaka 7.5
Ola limodzi mutatha kutenga shuga	Zosakwana 10	Zosakwana 10
Patatha maola awiri mutamwa shuga	Zochepera 8.5	8.5 mpaka 11.1

Iyenera kutsimikizika kuti kusankha kwa zofunikira sikutanthauza zaka komanso msambo wa mkazi.

Kodi kuyesedwa kwa glucose kumachitika bwanji?

Chiyeso chololera glucose kwa odwala omwe si oyembekezera chimachitika chimodzimodzi ndi njira yomwe tafotokozera pamwambapa kwa amayi apakati. Mwachidule Algorithm:

kuyesa kuchuluka kwa shuga m'magazi osatha pambuyo pa maola 8-12 osala kudya,
kudya kwa mphindi 5 za magalamu 75 a madzi a shuga a glucose kapena magalamu 82,5 a monohydrate ya okalamba. Ana ayenera kumwa magalamu 1.75 a shuga wosavuta pa 1 makilogalamu, kulemera kokwanira magalamu 75,
miyeso mobwerezabwereza ya chizindikiro chomwe chikuganiziridwa ikuchitika pambuyo pa 1 ndi maola awiri.

Chofunikira: kuletsa kwa mayesowo ndi kuchuluka kwa magazi mpaka 5,5 mmol / L pamimba yopanda kanthu. Mu izi, phunziroli limathetsedwa, ndipo wodwalayo amapatsidwa chidziwitso chowonjezera pakulimbana ndi insulin.

Kuti mukwaniritse phunziroli, njira ya enzymatic (hexokinase) imagwiritsidwa ntchito ndi zotsatira zomwe zalembedwa pogwiritsa ntchito ma radiation a ultraviolet (UV). Chinsinsi cha njirachi chimakhala ndi magawo awiri motsatizana omwe amachitika motsogozedwa ndi enxme hexokinase.

Glucose amalumikizana ndi molekyulu ya adenosine triphosphate (ATP) kuti apange glucose-6-phosphate + ATP. Kenako, zinthu zomwe zapezeka pansi pa enzymatic zochita za glucose-6-phosphate dehydrogenase zimasinthidwa kukhala 6-phosphogluconate. Zomwe zimachitikazi zimayendera limodzi ndi kubwezeretsa kwa ma molekyulu a NADH, omwe amakonzedwa ndi UV irradiation.

Njirayi idavomerezedwa ngati chofotokozera, chifukwa kuwunika kwake kumakhala koyenera kudziwa kuchuluka kwa chinthu chomwe chikufunidwa.

Zolemba zochepetsa shuga

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

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

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

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

Kuyesedwa kwa glucose kumawonetsa zotsika ngati:

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

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

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

Kodi shuga ndi magazi ndimomwemo kapena ayi?

Yankho la funsoli limatengera zomwe mutuwu ukukambirana. Ngati tikulankhula za kusanthula shuga ndi glucose, ndiye kuti malingalirowo ali ndi tanthauzo lofananalo ndipo atha kuwonedwa kuti matanthauzidwe osinthika. Kugwiritsa ntchito mawu onsewa kumaonedwa ngati koyenera komanso koyenera.

Ngati mukuyankha funsoli kuchokera kumayimidwe akuwona zamapangidwe, ndiye kufanana kwamalingaliro sikulondola. Popeza shuga ndi chinthu chokhala ndi mafuta ochepa. Pankhaniyi, shuga amagawidwa kukhala mono-, di- ndi oligosaccharides. Monosaccharides ndi dzuwa losavuta, ndi mu gawo ili momwe glucose amalowera. Kuphatikizika kwa oligosaccharides kumaphatikizapo zotsalira za 2 mpaka 10 zamasamba osavuta, ndipo ma disaccharides ndi milandu yawo yapadera.

Kodi ndiyenera kumwa GTT kangati?

Madotolo akunena za phunziroli: akatswiri a zamankhwala, dokotala wa ana, endocrinologist, dokotala wa opaleshoni, gynecologist, cardiologist.

Chiyeso chololera cha glucose nthawi yapakati ndikofunikira kwa akazi omwe ali ndi ziwopsezo zambiri. Mwachitsanzo, kukhalapo kwa mbiri yakale ya matenda a chithokomiro, milandu yodziwika ya kuloleza kwa glucose mwa abale apamtima kapena kugwiritsa ntchito zizolowezi zoipa.

Kwa odwala omwe ali ndi zaka zopitilira 45, phunziroli limalimbikitsidwa kuti lizichita pafupipafupi 1 nthawi yazaka zitatu. Komabe, pamaso pa kuchuluka kwambiri kwa thupi ndi zinthu zambiri zowopsa (zofanana ndi azimayi oyembekezera), ndikofunikira kuchita GTT osachepera 1 nthawi pazaka 2.

Ndi chowonadi chokhazikika cha kulolera kwa shuga, maphunzirowa amachitika kamodzi pachaka.

Mwachidule, ziyenera kutsindika:

kuchuluka kwa shuga m'magazi ndikofunikira kuti munthu athe kugwiritsa ntchito njira zamankhwala amwazi, komanso magwiridwe antchito oyenera a mitsempha komanso zochitika zokwanira zamaganizidwe.
GTT ndiyofunikira kutsimikizira kuzindikirika kwa matenda ashuga kapena kupezeka kwawo msanga mwa azimayi panthawi yapakati,
kusanthula koletsedwa ngati zomwe zili zosavuta mwazakudya wodwala woyembekezera ziposa 5.1 mmol / l, osapatsa pakati - 5.8 mmol / l,
kukonzekera koyenera kwa phunziroli kumatsimikizira kulondola kwa zotsatira zomwe zapezeka pa GTT. Chifukwa chake, kusonkhanitsa kwa biomaterial pambuyo panjala yayitali kapena kupsinjika kwakuthupi kumabweretsa kutsika kwakuthwa kwa glucose. Ndipo kumwa mankhwala kuti uchulukitse glycemia kumathandizira kupeza chidziwitso chabodza,
kuyesa kwa glucose kokha sikokwanira kungodziwikitsa. Ndikulimbikitsidwa kuti mupite maphunziro owonjezera kuti muzindikire zovuta za carbohydrate metabolism: C-peptide, insulin ndi proinsulin. Komanso muyeze mulingo wa glycated hemoglobin ndi creatinine m'magazi a seramu.

Julia Martynovich (Peshkova)

Omaliza maphunziro, mu 2014 adachita maphunziro apamwamba ku Federal State Budget Educational Institution of Higher Education ku Orenburg State University ndi digiri ya Microbiology. Omaliza maphunziro a digiri yoyamba FSBEI HE Orenburg State Agrarian University.

Mu 2015 Institute of Cellular and Intracellular Symbiosis of the Ural Branch of the Russian Academy of Sciences apitilanso maphunziro apansi pa pulogalamu yowonjezera yaukadaulo "Bacteriology".

Laureate mpikisano wa All-Russian pantchito yabwino yasayansi mukutchedwa "Biological Sayansi" wa 2017.

Njira ya GTT

Momwe mungayesere kuyeserera kwa glucose panthawi yapakati? Choyamba, muyenera kukonzekera bwino phunzirolo, kuwunika malangizo onse a dokotala. Kuyesedwa kumayamba ndikuti magazi amatengedwa kuchokera m'mitsempha pamimba yopanda kanthu kuti uwunikidwe ndikuwonetsa kuti shuga ndi yokhazikika, ndiye kuti chakudya cham'thupi chimachitika. Ma labotore ena amakhala asanatengeko chala ndikuwala glucose pogwiritsa ntchito timiyeso. Ngati chizindikiro chopezekacho chiposa mtengo wa 7.5 mmol / l, kuchuluka kwa chakudya sikumachitika.

Njira yosavuta ndiyo kuyesa kwa glucose kulolera mayeso (PHTT), pamene wodwala amamwa yankho la glucose ndi madzi mu mphindi 5. Malinga ndi zomwe zikuwonetsa, kuyesa koteroko sikutheka, mwachitsanzo, chifukwa cha toxosis yayikulu, glucose imathandizidwa kudzera m'mitsempha. Mlingo wa monosaccharide mu ma labotore osiyanasiyana ndi osiyana, zimachitika 75g kapena 100g. Dokotala ayenera kudziwa izi.

Pambuyo ponyamula chakudya, shuga imayezedwa m'magawo awiri: pambuyo pa ola limodzi, ndiye pambuyo pa maola awiri. Sizoletsedwa kusuta ndikuwonjezera zolimbitsa thupi mpaka kuyesa kumatha. Ngati mfundo zopangira shuga pang'onopang'ono zikakhala zosadziwika bwino, ichi chikhoza kukhala chizindikiro cha matenda ashuga. Komabe, kuwunika kotsimikizika kumatha kupangidwa pambuyo poyankhulana ndi endocrinologist. Pofuna kufotokozera zovuta za matenda a carbohydrate metabolism, kuyezetsa magazi kwa glycated hemoglobin ndi mankhwala.

Kusintha ndi kutanthauzira kwa zotsatira

Njira zoyesera za matenda a glycemic zimakhazikitsidwa ndi WHO. Mitsempha yamagazi m'magazi a m'magazi (75 ga):

m'mawa pamimba yopanda kanthu - osakwana 5.1 mmol / l,
pambuyo 1 ora - zosakwana 10 mmol / l,
pambuyo 2 maola - zosakwana 8.5 mmol / l.

Kuphwanya shuga kulolerana (NTG) kutsimikizika ndi izi:

m'mawa pamimba yopanda kanthu - kuyambira 5.1 mpaka 7 mmol / l,
kapena ola limodzi mutatha kukhathamiritsa chakudya - 10 mmol / l kapena kupitilira,
kapena maola awiri pambuyo pake, kuyambira 8,5 mpaka 11.1 mmol / L.

Mitsempha yambiri yamagazi a m'magazi yambiri ikusonyeza matenda ashuga. Komabe, kupindika kwa shuga pamimba nthawi yayitali kumakhala chifukwa chabwinobwino chokhudzana ndi opaleshoni yaposachedwa, matenda owopsa, kumwa mankhwala ena, komanso kupsinjika kwambiri. Kuti mupewe matenda olakwika a kulolera m'magazi, muyenera kutsatira malamulo okonzekera kuyesedwa ndikuuza dokotala zinthu zomwe zingasokoneze zotsatira zake.

Chizindikiro chowonekera cha matenda a shuga ndi kuchuluka kwa malire a 7 mmol / L pamiyeso yotengedwa pamimba yopanda kanthu kapena malire a 11.1 mmol / L pamtundu wina uliwonse.

Kodi ndiyeneranso kuvomera kuyesedwa?

Kupereka mayeso ololera a glucose panthawi yomwe muli ndi pakati ndi nkhawa ya azimayi ambiri. Amayi amtsogolo akuopa kuti izi zitha kukhala ndi vuto pa mwana wosabadwa. Mchitidwe womwewo pawokha umadzetsa kusasangalala ndi mseru, chizungulire, ndi zizindikiro zina. Osanena kuti ndikofunikira kugawa mayeso okweza shuga osachepera maola atatu m'mawa, pomwe simungadye. Ichi ndichifukwa chake nthawi zambiri amayi oyembekezera amakhala ndi chidwi chosiya kuphunzira. Komabe, muyenera kuzindikira kuti lingaliro lotere ndilovomerezeka bwino ndi dokotala. Afufuze kuthekera kwa phunziroli pazinthu zosiyanasiyana, kuphatikizapo kutalika kwa wodwala, momwe mimba imachitikira, ndi zina zambiri.

Mosiyana ndi ife, ku Europe ndi USA kuwunika kwa glucose sikumachitika ndi amayi omwe ali ndi chiopsezo chochepa chotenga matenda a glycemic. Chifukwa chake, kukana kuyesedwa kumawoneka koyenera kwa amayi apakati omwe amagwera mgululi. Kuti tigwe pansi pa tanthauzo lachiwopsezo chochepa, zonena zonsezi ziyenera kukhala zowona:

Simunakhalepo ndi nthawi yomwe kuyezetsa kunawonetsa kuti kuchuluka kwa shuga m'magazi sikwabwinobwino.
Mtundu wanu uli ndi chiopsezo chochepa cha matenda ashuga.
Mulibe achibale oyamba (makolo, mchimwene, kapena mwana) yemwe ali ndi matenda ashuga a 2.
Muli zaka zochepera 25 ndipo muli ndi thupi labwino.
Simunakhale ndi zotsatira zoyipa za GTT panthawi yam'mbuyomu.

Musanayime kuyezetsa magazi, ganizirani za zomwe zimachitika chifukwa chodwala matenda ashuga. Amakhala ndi zovuta zambiri kwa mwana ndi mayi yemwe, ndipo zimawonjezera mwayi wokhala ndi matenda amtundu wa 2 azimayi omwe ali ndi vuto nthawi yayitali.

Kafukufuku akuti pafupifupi azimayi 7% omwe akukumana ndi mavuto oterewa. Chifukwa chake, ngati pali nkhawa pang'ono, ndibwino kudziwa mbiri ya glycemic. Ndiye, ngakhale ndi kuchuluka kwawonjezeka, kuyesayesa kwa madokotala kungachepetse zoopsa ku thanzi lawo komanso chitukuko cha mwana. Zakudya zapadera za kuloleza kwa glucose komanso malangizo angapo omwe mumalandira munthu nthawi zambiri amalimbikitsidwa.