Target glycated hemoglobin level meza

Gome lachiwonetsero cha glycated hemoglobin kuti aliyense azikhala ndi shuga

Sizofunikira kuti nthawi zonse zizikwaniritsidwa. Inde, zaka komanso jenda sizofunikira kwambiri kotero kuti simungathe kunena zokhudzana ndi thanzi komanso matenda okhudzana ndi nkhaniyi. Nthawi zina zimakhala bwino kupitiliza kuchita zotsatira. Izi ndichifukwa choti chiwopsezo cha hypoglycemia, poyesera kuchepetsa HbA1c, chimakhala ndi ngozi yayikulupo kuposa mapuloteni a glycation.
Mwachitsanzo, odwala omwe ali ndi matenda a shuga a 2, pamaso pa zovuta zamtima, ma episode a hypoglycemia amawonjezera chiopsezo cha myocardial infarction kangapo.
Kwa odwala achichepere, njirayi ndi yovuta, chifukwa kukhalabe ndi chizolowezi pano kumatanthauza kuletsa kukula kwa zovuta zazitali. Nthawi zambiri, akatswiri a endocrinologists amalimbikitsa kuyeserera chizindikiro cha 6.5%.

Simuyenera kudalira chizindikiro ichi. Glycated hemoglobin ndi yachilendo kwa miyezi ingapo. Zimangomvetsetsa kosamveka bwino chithunzichi. Ndikofunikira kwambiri kukwaniritsa kukhazikika kwa glycemic kuti pasapezeke tsankho lina lililonse.
Kuti muwone bwino kubwezeretsedwa ndi kukhazikitsa zomwe mukufuna, muyenera kugwiritsa ntchito ndi mitundu yosiyanasiyana: mbiri ya glycemic, kuchuluka kwa hemoglobin, zambiri za momwe mungakhalire ndi zovuta.

Ngati muli ndi nthawi yayitali ya glycated hemoglobin, thupi limayamba kusinthasintha. Chifukwa chake kutsika kumayenera kuchitika pang'onopang'ono. Mothandizirana ndi izi, yang'anirani momwe zinthu zilili ndi kusintha kwa mitsempha: pitani pafupipafupi kwa ophthalmologist, neurologist ndikukumana ndi matenda a microalbuminuria.

Mitundu ya glycated hemoglobin

Monga tafotokozera pamwambapa, miyambo ya glycogemoglobin imakhazikitsidwa malinga ndi mtundu wachitatu wa "c" - HbA1c. Onani zizindikiro zake zazikulu:

• ochepera 5.7% - palibe matenda a shuga, chiwopsezo cha chitukuko chake ndicochepa kwambiri (mayeso amapatsidwa nthawi 1 muzaka zingapo),
• kuchokera pa 5.7% mpaka 7.0% - chiwopsezo cha matendawa chilidi (kusanthula kumachitika kamodzi kamodzi miyezi isanu ndi umodzi),
• oposa 7% - matenda a shuga amakula (amafunikira kufunsa wa endocrinologist).

Pali tanthauzo latsatanetsatane lazotsatira za kuyesa kwa magazi kwa glycated hemoglobin (mtundu wachitatu wa HbA1c umawerengedwa):

• mpaka 5.7% - kagayidwe kabwino kazachilengedwe,
• 5.7-6.0% - gulu lowopsa la matenda a shuga,
• 6.1-6.4% - chiwopsezo chowonjezereka, chomwe chimapereka njira zingapo zodzitetezera zomwe zimachepetsa kukula kwa matenda osokoneza bongo (zakudya zapadera, moyo wathanzi, zochitika zina zolimbitsa thupi),
• zopitilira 6.5% - kuwunika kwa "matenda oyambitsidwa ndi matenda ashuga", omwe amafunikira mayeso owonjezera a labotale.

Magometi amakalata ophatikizira HbA1c ndi shuga ya magazi a anthu ambiri:

Gome ili likuwonetsa kuchuluka kwa glycogemoglobin wokhala ndi glucose mwa odwala matenda a shuga miyezi itatu.

Kuchepetsa ndi kuchuluka glycated hemoglobin

Ganizirani za zomwe zotsatira za kuchuluka ndi kuchepa kwa glycogemoglobin. Chizindikiro chowonjezeka chimawonetsa pang'onopang'ono, koma kuwonjezeka kwa shuga kwa anthu. Koma zowerengera izi sizimangotanthauza kukula kwa matenda onga a shuga. Carbohydrate metabolism imatha kukhala chifukwa cha kulolera kwa glucose, kapena kuyesedwa kolakwika (mwachitsanzo, mutatha kudya, osati pamimba yopanda kanthu).

Glycogemoglobin wocheperako (mpaka 4%) amawonetsa shuga wochepa m'magazi aanthu, koma titha kulankhula za hypoglycemia. Zoyambitsa za hypoglycemia zitha kukhala:

• chotupa (pancreatic insulinoma),
• kugwiritsa ntchito kwambiri mankhwala a hypoglycemic,
• Zakudya zingapo zama carb zotsika mtengo (mwachitsanzo, zakudya za wa mu chombo, zakudya zama protein zopanda michere, ndi zina),
• matenda osachiritsika pamtundu wa majini (omwe amalolera kubereka),
• kulimbitsa thupi kwambiri komwe kumayambitsa kutopa kwa thupi, ndi zina zambiri.

Ndi chizindikiro chowonjezeka kapena chochepetsedwa cha glycogemoglobin, muyenera kufunsa katswiri yemwe adzakupatseni mayeso owonjezera a magazi

Glycated hemoglobin

Nthawi zambiri, kuyezetsa magazi kwa glycated hemoglobin kumaperekedwa kuchipatala komwe amakhala (mwachitsanzo, chipatala). Kuti muchite izi, muyenera kupita kukawunikanso pakuwunika koyenera kuchokera kwa endocrinologist kapena akatswiri azachipatala. Ngati mungaganize zolumikizana ndi kuchipatala cholipira chofufuzira kuti mukakufufuzeni, simudzafunikira chithandizo.

Magazi pakuwunika kumeneku amaperekedwa pamimba yopanda kanthu (mutatha kudya ayenera kutenga pafupifupi maola 12), chifukwa mukatha kudya shuga akhoza kusintha. Kuphatikiza apo, masiku angapo magazi asanaperekedwe, kudya zakudya zamafuta ndizochepa, zakumwa zoledzeretsa, kuphatikizapo mankhwala omwe amakhala ndi zakumwa zoledzeretsa, siziphatikizidwa. Pomwepo musanatengere magazi (pa ola limodzi) osavomerezeka kuti musute, kumwa misuzi, tiyi, khofi (wopanda kapena wopanda shuga). Kumwa madzi oyera okha (opanda mpweya) ndikololedwa. Alangiziridwa kukana kuyeserera kwakuthupi kwakanthawi. Ngakhale akatswiri ati palibe kusiyana: zomwe zikuwonetsa zikuwonetsa kuchuluka kwa shuga m'miyezi itatu yapitayi, osati patsiku kapena nthawi yeniyeni. Nthawi zambiri, zomwe zimasungidwa zimatengedwa kuchokera m'mitsempha ya wodwala, koma m'nthawi yathu ino njira zingapo zapangidwa pamene izi zitha kuchitika kuchokera pachala.

Malingaliro ena oyesa magazi a glycated hemoglobin ayenera kuganiziridwa:

• mwa odwala ena, kuphatikizika kwa kuchuluka kwa HbA1C ndi shuga weniweni
• kupotoza kwa zomwe zikuwonetsedwa mkati mwa kuchepa kwa magazi m'thupi ndi hemoglobinopathy,
• kusowa kwa zida ndi zida zamavuto kumadera ena a dziko lathu,
• yokhala ndi mahosi ochepa a chithokomiro, chisonyezo cha HbA1C chiwonetsanso msika wokwera, ngakhale shuga sichikhala pamwamba.

Sitikulimbikitsidwanso kuti muwunike izi mukamakhala ndi pakati, chifukwa zotsatira zabodza zimatha kupezeka, zomwe zimatha kutsika kwa glycogemoglobin. Izi ndi chifukwa chosowa chachitsulo mthupi la mayi woyembekezera (kuyerekezera: munthu wamba amafunika 5-15 mg pazitsulo patsiku, kwa amayi apakati - 15-18 mg).

1. Kuyesedwa kwa magazi kwa hemoglobin ya glycated ndikofunikira kwenikweni kwa wodwalayo, osati kwa adokotala.
2. Kudziyang'anira wega wamagazi (mwachitsanzo, kugwiritsa ntchito glucometer) sikungasinthe kusinthaku ndi HbA1C, popeza izi ndi njira zosiyaniraniratu ndi matenda.
3. Ngakhale kusinthasintha kochepa tsiku ndi tsiku m'magazi a shuga, koma mosalekeza, komanso chifukwa chabwino cha HbA1C, zoopsa zingapo zovuta ndizotheka.
4. Kuchepetsa kwambiri ma glycogemoglobin amaloledwa pang'onopang'ono pa 1% pachaka, kuchepa kwambiri kumatha kubweretsa zotsatira zosakhala bwino komanso zotsatirapo zake.

Tiyeneranso kukumbukiranso kuti zizindikiro za mayesowa zimatha kusintha chifukwa cha kuchepa kwa magazi, magazi, hemolysis, chifukwa izi zimakhudza kukhazikika kwa moyo wama cell ofiira.

Kodi hemoglobin ndi glycosylated ndi chiyani?

Pafupifupi wophunzira aliyense kuchokera ku maphunziro a biology amadziwa za hemoglobin. Kuphatikiza apo, kuchuluka kwa hemoglobin kumatsimikizika pakudutsa kuyezetsa kwa magazi, chifukwa chake dzinali limadziwika kwa aliyense. Hemoglobin imakhala m'maselo ofiira a m'magazi, omwe, omwe amanyamula mamolekyu a oxygen m'misempha ndi ziwalo zonse za anthu. Pali chinthu china mu hemoglobin - chimamangiriza ku glucose chifukwa chosachita enzymatic. Izi (glycation) sizingasinthe. Zotsatira zake, hemoglobin yodabwitsa kwambiri.

Chifukwa chiyani glycosylated hemoglobin amakhala ndi magazi m'miyezi itatu yapitayo? ...

Mlingo wa kumanga kwa hemoglobin ku glucose ndiwokwera kwambiri, wokwera kwambiri wa glycemia, i.e., kuchuluka kwa shuga m'magazi. Ndipo popeza maselo ofiira a m'magazi "amakhala" pakanthawi masiku 90-120 okha, kuchuluka kwa glycation kumatha kuwonedwa pokhapokha. M'mawu osavuta, podziwa kuchuluka kwa hemoglobin ya glycosylated, kuchuluka kwa "cholengedwa" kwam'mimba kumakhala pafupifupi miyezi itatu. Pogwiritsa ntchito kusanthula uku, mutha kudziwa kuchuluka kwa shuga tsiku lililonse m'miyezi itatu yapitayo.

Pamapeto pa nyengoyi, kukonzanso pang'onopang'ono kwa maselo ofiira a m'magazi kumawonedwa, chifukwa chake tanthauzo lotsatirali liziwonetsa kuchuluka kwa glycemia m'masiku 90-120 otsatira ndi zina zotero.

Posachedwa, World Health Organisation yatenga glycosylated hemoglobin ngati chisonyezero chomwe matenda aweruzidwe akuweruzidwa. Mwanjira ina, ngati endocrinologist akonza shuga wambiri wodwala ndikuwakweza glycosylated hemoglobin, atha kupima matenda osokoneza bongo popanda njira zowonjezera zowunikira.

Chifukwa chake, chizindikiro cha HBA1c chimathandizira pakuzindikira matenda ashuga. Chifukwa chiyani chizindikirochi ndichofunikira kwa odwala omwe ali ndi matenda a shuga?

Kafukufuku wokhudza glycosylated hemoglobin ndikofunikira kwa odwala omwe ali ndi mtundu woyamba komanso wachiwiri wa matenda a shuga. Kusanthula kwa ma laboratory kumeneku kuwunika kuyeserera kwa mankhwalawo komanso kukwana kwa mtundu womwe wasankhidwa wa insulin kapena hypoglycemic ya pakamwa.

Choyamba, ndikofunikira kuyeza kuchuluka kwa hemoglobin ya glycosylated kwa odwala omwe samakonda kugwiritsa ntchito mizere yoyesera kwa glucometer ndikuyezera shuga m'magazi kwambiri (odwala ena amafotokoza izi poti atapeza kuchuluka kwambiri kwa glycemic, amapezeka mwachangu) khalani okhumudwa, opsinjika, ndipo izi zimapangitsa kuti shuga iwonjezeke, bwalo loipa limabuka).

Koma chidzachitike ndi chiyani ngati glucose wa magazi sanatsimikizike kwa nthawi yayitali, kulungamitsa izi ndi lingaliro lomwe talitchulalo? Sitingathe kuwongolera shuga wamagazi, zomwe zikutanthauza kulipirira matendawa. Izi zikuthandizani kuti mupange zovuta za matenda ashuga.

Pokhapokha pongoyang'anitsitsa za matenda ashuga komanso malingaliro omwe katswiri waluso angakuthandizeni kuti muthane ndi matenda anu ndikukhala ndi moyo wathanzi, monga wina aliyense.

Kwa ena, kuyeza pafupipafupi kumakhala koyipa chifukwa cha kukwera mtengo kwa njirayo. Komabe, $ 40-50 yowonjezera yomwe imagwiritsidwa ntchito mwezi uliwonse idzakupulumutsani ku mtengo waukulu wobwezeretsa thanzi mtsogolo.

Ndikofunikira kuyang'anitsitsa thanzi lanu mosamala, kupewa zonse zovuta za matenda ashuga. Ndipo apa zilibe kanthu kuti mukuyenereradi kwa endocrinologist wanu, koma chakuti mankhwala amakono sanapezebe njira yochiritsiratu matenda ashuga. Kodi tinganene chiyani za zovuta zake? Wodwala amatha, kudula mwendo kapena kuchotsa impso, koma palibe amene angabwezeretse thanzi lake ngati njira zomwe zatulukira m'ziwalo zatha kale. Chifukwa chake, ndikofunikira kuyesa kuti asadzuke. Ngati matenda a shuga sanakhalepo, koma munthu ali pachiwopsezo cha matendawa, ndikofunikira kupewa.

Kwa odwala omwe samakonda kugwiritsa ntchito mawupu oyeserera, ndikofunikira nthawi ndi nthawi (miyezi itatu iliyonse) osachepera mumapereka magazi kuti atsimikizidwe glycosylated hemoglobin. Ngati zotulukazo zikuchulukitsidwa, chitani kanthu mwachangu kuti muchepetse.

M'pofunikanso kudziwa mulingo wa glycosylated hemoglobin wa mtundu 1 shuga mellitus, ngakhale wodwalayo nthawi zambiri amayeza kuchuluka kwa shuga m'magazi, ndipo zizindikiro zake ndizochulukirapo. Zikakhala choncho, zitha kuchitika kuti ngakhale shuga wambiri ndi wabwinobwino, hemoglobin ya glycosylated imakulitsidwa. Izi zitha kukhala chifukwa chowonjezeka kwambiri cha glycemia atangodya kapenanso usiku pomwe samayesa chizindikiro ichi.

Gometi ya hemoglobin ya glycosylated kufikira kuchuluka kwa shuga m'masiku 90-120 apitawa:

Mulingo wa hemoglobin wa Target glycosylated mwa okalamba ndi achinyamata

Mndandanda wa zigawo za glycosylated hemoglobin wa magulu atatu a odwala:

Chofunikira chofunikira: sizokhazikika monga momwe glycosylated hemoglobin amasonyezera kuti shuga m'magazi miyezi itatu yapitayo sanadutse momwe amagwiritsidwira ntchito. Ichi ndi chisonyezero chapakati, ndipo sichikuwonetsa, mwachitsanzo, kuti zakudya zisanachitike shuga nthawi zambiri ndi 4.1 mmol / L, ndipo pambuyo, nenani, 8.9 mmol / L. Ngati kusiyana kuli kokulirapo, ndiye kuti zotsatira za kusantakuku zitha kukhala zolakwika. Chifukwa chake, tikulimbikitsidwa kuti tisamangochepetsa kuwunika kwa glycosylated hemoglobin, komanso kudziwa kuchuluka kwa shuga m'magazi 2 pa tsiku. Izi pamwambapa zimagwira ntchito kwa odwala omwe ali ndi matenda a shuga 2, okhala ndi vuto 1 la shuga muyenera kuyeza shuga pafupipafupi.

Chifukwa chiyani izi ndizofunikira?

• glycated hemoglobin iyenera kuwezedwa kamodzi miyezi itatu. Kuyeza pafupipafupi sikumveka, kuyeza kochepa sikulinso bwino. Kutengera zotsatira za kusanthula, tengani njira zina.
• Kusanthula kwa labotali ndikofunikira, choyambirira, kwa inu! Izi sizomwe zimachitika mukapereka magazi ku chipatala "cha ziwonetsero".
• Kuyeza kwa chizindikirocho sikulowa m'malo mwa kutsimikiza kwa glycemia.
• Ngati glycosylated hemoglobin imakhala yokhazikika, koma kulumikizana kwakukulu m'magazi a shuga wamagazi (mwachitsanzo, mukatha kudya komanso musanadye), simutetezedwa ku zovuta za matenda ashuga.
• Hemoglobin wautali wa glycosylated uyenera kuchepetsedwa pang'onopang'ono - 1% pachaka.
• Pofunafuna hemoglobin yabwino kwambiri ya glycosylated, musaiwale za zaka zanu: zomwe zili bwino kwa achinyamata zitha kuchepetsedwa kwa inu.

Dziwani hemoglobin wa glycated

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

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

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

Kodi kuzindikira kumatenga gawo lanji?

Pali mitundu ingapo ya hemoglobin ya glycated:

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

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

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

Chizindikirochi chimagwiritsidwanso ntchito ngati chikhomo chomwe chimazindikiritsa anthu omwe ali pachiwopsezo chotenga zovuta za matenda ashuga. Gome likuwonetsa zisonyezo za magulu azaka, omwe ali akatswiri okhazikika.