Ngati glucose m'magazi adakweza, ndiyenera kuchita chiyani?

Kudziwa kuchuluka kwa shuga m'magazi ndikofunikira kuti mupeze matenda a carbohydrate metabolism. Zimayamba kuwunika kwa odwala omwe ali ndi zizindikiro za matenda a shuga kapena omwe ali pachiwopsezo chachikulu cha matendawa.

Chifukwa cha kuchuluka kwa matenda ashuga, makamaka mitundu yomalizira yomwe mulibe chithunzi cha matenda, kusanthula koteroko kumalimbikitsidwa kwa aliyense atakwanitsa zaka 45. Komanso, kuyesedwa kwa magazi kumachitika pakubala, popeza kusintha kwa ma Horona kungayambitse matenda ashuga.

Ngati kupatuka kwa shuga mu seramu yamagazi kuchokera ku chizolowezi kwapezeka, ndiye kuti mayesowo akupitilizabe, ndipo odwala amawasinthira ku zakudya zomwe zili ndi mafuta osavuta a mafuta ndi mafuta.
Ndi chiyani chimapangitsa kuchuluka kwa shuga m'magazi?

Kuchokera kwa chakudya chamagulu omwe amakhala ndi chakudya, munthu amalandira pafupifupi 63% ya mphamvu yofunikira m'moyo. Zakudya zimakhala ndi zovuta komanso zovuta zamafuta. Monosaccharides osavuta ndi glucose, fructose, galactose. Mwa awa, 80% ndi shuga, ndi galactose (kuchokera ku zinthu zamkaka) ndi fructose (kuchokera ku zipatso zotsekemera) amasandukanso shuga mtsogolo.

Zakudya zophatikiza zovuta, monga wowuma wa polysaccharide, zimaswa mchikakamizo cha amylase mu duodenum mpaka glucose kenako zimayamwa m'magazi m'matumbo ang'onoang'ono. Chifukwa chake, mafuta onse m'zakudya amadzapanga ma glucose ndipo amapezeka m'mitsempha yamagazi.

Ngati shuga saperekedwa mokwanira, ndiye kuti imatha kupangika m'thupi m'chiwindi, impso ndi 1% yake imapangidwa m'matumbo. Kwa gluconeogenesis, pomwe mamolekyu atsopano a shuga amawoneka, thupi limagwiritsa ntchito mafuta ndi mapuloteni.

Kufunika kwa shuga kumakumana ndi maselo onse, chifukwa kumafunikira mphamvu. Munthawi zosiyanasiyana patsiku, maselo amafunikira kuchuluka kwa shuga. Kutikita minofu kumafuna mphamvu pa kayendedwe, ndipo usiku tulo, kufunika kwa glucose ndizochepa. Popeza kudya sikugwirizana ndi kudya kwa glucose, amasungidwa kosungirako.

Kutha kusunga shuga mu nkhokwe (ngati glycogen) kumadziwika m'maselo onse, koma ambiri mwa malo amtundu wa glycogen amakhala:

• Maselo a chiwindi ndi hepatocytes.
• Maselo amafuta ndi adipocytes.
• Ma cell a minofu ndi myocyte.

Maselo amenewa amatha kugwiritsa ntchito glucose kuchokera m'magazi pakakhala zochulukirapo ndipo mothandizidwa ndi ma enzymes, amasintha kukhala glycogen, yomwe imaphwanya mpaka shuga ndikuchepa kwa shuga m'magazi. Glycogen amasunga m'chiwindi ndi minofu.

Pamene shuga amalowa m'maselo amafuta, amasinthidwa kukhala glycerin, yomwe ndi gawo lamasitolo amafuta a triglycerides. Ma molekyulu amatha kugwiritsidwa ntchito ngati gwero lamphamvu pokhapokha glycogen onse omwe amapezeka m'malo akatha. Ndiye kuti, glycogen ndi malo osungirako kwakanthawi kochepa, ndipo mafuta ndi malo osungirako kwanthawi yayitali.

Kodi shuga wamagazi amasungidwa bwanji?

Maselo aubongo amafunikira kuti glucose agwire ntchito, koma sangathe kuwayika kapena kuwumba, kotero ntchito zaubongo zimatengera kudya kwa glucose kuchokera mu chakudya. Kuti ubongo ukhale wokhoza kuyendetsa zochitika za m'magazi, wocheperako ayenera kukhala 3 mmol / L.

Ngati pali shuga wambiri m'magazi, ndiye kuti, ngati gawo losakanikirana bwino, limatulutsa timadzi tokha kuchokera m'matipi. Pofuna kuchepetsa kuchuluka kwa shuga, impso zimakufa ndi mkodzo. Kuzungulira kwa glucose m'magazi komwe kumalowera gawo lathu la impso kumayambira 10 mpaka 11 mmol / L. Thupi, komanso shuga, limataya mphamvu zomwe zimalandira kuchokera ku chakudya.

Kudya ndi kugwiritsa ntchito mphamvu pa kayendedwe kumayambitsa kusintha kwa glucose, koma popeza kagayidwe kazachilengedwe kamalamulira kamayendetsedwa ndi mahomoni, kusinthaku kumakhala kosiyanasiyana kuyambira 3.5 mpaka 8 mmol / L. Mukatha kudya, shuga amatuluka, monga chakudya (m'magazi a shuga) kulowa m'matumbo kuchokera m'magazi. Imadyedwa pang'ono ndikusungidwa m'maselo a chiwindi ndi minofu.

Zambiri pazabwino zam'magazi m'magazi zimatulutsidwa ndi mahomoni - insulin ndi glucagon. Insulin imayambitsa kutsika kwa glycemia ndi izi:

1. Zimathandizira kuti maselo agwire glucose m'magazi (kupatula ma hepatocytes ndi maselo amanjenje amanjenje).
2. Imayendetsa glycolysis mkati mwa khungu (pogwiritsa ntchito mamolekyu a glucose).
3. Imalimbikitsa mapangidwe a glycogen.
4. Imalepheretsa kaphatikizidwe wa glucose watsopano (gluconeogeneis).

Kupanga kwa insulin kumachulukitsa ndikuwonjezera kuchuluka kwa shuga, zotsatira zake ndizotheka pokhapokha zikalumikizidwa ndi ma receptors pa membrane wa cell. Natural carbohydrate metabolism imatheka pokhapokha ndi kaphatikizidwe ka insulin mokwanira komanso zochitika za insulin receptors. Izi zimaphwanyidwa mu shuga, kotero glucose wamwazi amakwezedwa.

Glucagon imatanthauzanso mahomoni a pancreatic, amalowa m'mitsempha yamagazi mukatsitsa glucose wamagazi. Makina ake a zochita zake akutsutsana ndi insulin. Ndi gawo la glucagon, glycogen imasweka m'chiwindi ndipo shuga amapangidwa kuchokera pazinthu zopanda mafuta.

Miyezi yochepa ya shuga kwa thupi imawonedwa ngati mkhalidwe wopsinjika, chifukwa chake, ndi hypoglycemia (kapena motsogozedwa ndi zina zopsinjika), tiziwalo ta pituitary ndi adrenal timatulutsa timadzi tambiri totatu - somatostatin, cortisol ndi adrenaline.

Amatinso, monga glucagon, amathandizira glycemia.

Ntchito ya shuga mthupi

Glucose (dextrose) ndi shuga yemwe amapangika pakuwonongeka kwa ma polysaccharides ndipo amatenga nawo mbali mu zochita za thupi.

Glucose imagwira ntchito zotsatirazi m'thupi la munthu:

• limasandulika mphamvu yofunikira pakugwira ntchito kwa ziwalo zonse ndi machitidwe,
• Kubwezeretsa mphamvu pambuyo polimbitsa thupi,
• imapangitsa ntchito yotulutsa ma hepatocytes,
• imayambitsa kupanga ma endorphin, omwe amathandizira kukonza mawonekedwe,
• amathandizira ntchito yamitsempha yamagazi,
• kuthetsa njala
• imayendetsa ntchito za ubongo.

Momwe mungadziwire shuga wamagazi?

Zizindikiro zotsatirazi zingasonyeze kuikidwa kwa muyeso wa glucose m'magazi:

• kutopa kopanda pake,
• kuchepa kwa mphamvu yogwira ntchito,
• kunjenjemera m'thupi
• kutuluka thukuta kwambiri kapena khungu likauma,
• nkhawa
• njala yosalekeza
• kamwa yowuma
• ludzu lalikulu
• kukodza pafupipafupi
• kugona
• kuwonongeka kwamawonekedwe
• chizolowezi chodzola khungu pakhungu,
• mabala aatali omwe samachiritsa.

Mitundu yotsatirayi ya kafukufuku imagwiritsidwa ntchito kudziwa kuchuluka kwa shuga m'magazi:

• mayeso a shuga wamagazi (zamankhwala amwazi),
• kusanthula komwe kumapangitsa kuchuluka kwa fructosamine m'magazi a venous,
• kuyeserera kwa shuga.
• Kutsimikiza kwa glycated hemoglobin wambiri.

Kugwiritsa ntchito kusanthula kwama biochemical, mutha kudziwa kuchuluka kwa shuga m'magazi, nthawi zambiri omwe amakhala mumtunda kuchokera 3,3 mpaka 5.5 mmol / L. Njirayi imagwiritsidwa ntchito ngati kafukufuku wothandiza.

Kuchulukana kwa fructosamine m'magazi kumakupatsani mwayi woti muganize kuchuluka kwa shuga m'magazi, omwe adakhalapo sabata zitatu zapitazi magazi asanatenge. Njira ikuwonetsedwa poyang'anira chithandizo cha matenda ashuga.

Kuyesedwa kwa glucose kumatsimikizira kuchuluka kwa shuga mu seramu yamagazi, nthawi zambiri pamimba yopanda kanthu komanso pambuyo poti anthu atenga shuga. Choyamba, wodwalayo amapereka magazi pamimba yopanda kanthu, ndiye kuti amamwa yankho la shuga kapena shuga ndikumaperekanso magazi pambuyo maola awiri. Njira imeneyi imagwiritsidwa ntchito pozindikira matenda am'mbuyo a carbohydrate metabolism.

Kuti zisonyezerozo monga zotsatira zamawu azikhala olondola momwe mungathere, muyenera kukonzekera bwino phunzirolo. Kuti muchite izi, tsatirani malamulo awa:

• perekani magazi m'mawa makamaka pamimba yopanda kanthu. Chakudya chotsiriza sichikhala pasanathe maola eyiti magazi asanachitike,
• musanayesedwe, mutha kumwa madzi osapatsa shuga okha opanda shuga,
• osamwa mowa masiku awiri musanalandire magazi,
• masiku awiri asanafike kuwunikira kuti achepetse kupsinjika kwa thupi ndi malingaliro,
• Chotsani kupsinjika masiku awiri mayeso asanachitike,
• kwa masiku awiri musanayeze mayeso simungathe kupita ku sauna, kukakola thupi, x-ray kapena physiotherapy,
• maola awiri musanalandire magazi, musasute,
• ngati mukumwa mankhwala aliwonse, muyenera kudziwitsa dokotala yemwe adakuwunikirani, chifukwa angakhudze zomwe zimachitika potsatira zamankhwala osokoneza bongo. Ngati ndi kotheka, mankhwalawa amachotsedwa kwakanthawi.

Pa njira yofotokozera (pogwiritsa ntchito glucometer), magazi amatengedwa kuchokera pachala. Zotsatira za phunziroli zimakhala zokonzekera mphindi imodzi kapena ziwiri. Kuyeza shuga ndi magazi ndi glucometer nthawi zambiri kumachitika mwa odwala matenda ashuga, monga kuwunika kwawo tsiku ndi tsiku. Odwala payokha amadzazindikira zizindikiro za shuga.

Njira zina zimazindikira shuga wamitsempha. Zotsatira zoyeserera zimaperekedwa tsiku lotsatira.

Kuchuluka kwa shuga m'magazi: tebulo ndi zaka

Kuchuluka kwa shuga mwa azimayi zimatengera zaka, zomwe tebulo lotsatirali likuwonetseratu.

Chikhalidwe cha shuga m'magazi mwa amuna chimodzimodzi monga zimakhalira mwa akazi ndipo zimayambira pa 3,3 mpaka 5.6 mmol / l.

Machitidwe a shuga m'magazi mwa mwana.

Monga tikuonera pagome, shuga wabwinobwino m'magazi amakhala ndi ocheperako kuposa akulu.

Kuyesa kwa Glucose:

Zizindikiro za glycated hemoglobin (shuga m'magazi),%:

• zosakwana 5.7 ndizovomerezeka,
• kuyambira 5.8 mpaka 6.0 - chiwopsezo chachikulu cha matenda a shuga,
• kuyambira 6.1 mpaka 6.4 - prediabetes,
• 6.5 ndi zina - matenda ashuga.

Magazi a glucase pamimba

Kwa azimayi oyembekezera omwe alibe chiopsezo cha matenda a shuga, kuyezetsa magazi amomwe ammwazi komanso kuyeserera kwa glucose kumachitika kwa masabata 24-28.

Ngati mayi ali ndi chiopsezo chotenga matenda a shuga, awa ndi:

• zaka zopitilira 30
• chibadwire
• onenepa kwambiri komanso kunenepa kwambiri.

Zabwinobwino zimawonedwa ndi glucose wamagazi mwa amayi apakati - kuyambira 4 mpaka 5.2 mmol / l.

Hyperglycemia: zomwe zimayambitsa, zizindikiro ndi chithandizo

Hyperglycemia ndikuwonjezereka kwa shuga m'magazi pamwamba pa 5 mmol / L. Odwala amatha kupeza kuwonjezeka kwakanthawi komanso kuwonjezereka kwa shuga m'magazi. Zinthu monga kugwedezeka kwambiri m'maganizo, kutopa kwambiri, kusuta, kugwiritsa ntchito maswiti, komanso kumwa mankhwala ena ake kumatha kudumphitsa kanthawi pang'ono m'magazi a magazi.

Hyperglycemia ya nthawi yayitali imalumikizidwa ndi matenda osiyanasiyana. M'magazi, shuga amawonjezera pazifukwa zotsatirazi:

• matenda a chithokomiro
• matenda adrenal
• matenda a pituitary
• khunyu
• kuledzera kwa kaboni wa monoxide,
• matenda a kapamba
• matenda ashuga.

Odwala amatha kuwona zotsatirazi za hyperglycemia:

• kufooka wamba
• kutopa,
• kupweteka mutu pafupipafupi
• kuchepa thupi popanda chifukwa,
• khungu louma ndi nembanemba
• ludzu kwambiri
• kukodza pafupipafupi
• chizolowezi cha matenda apakhungu a pakhungu,
• mabala atali osasindikizidwa
• chimfine pafupipafupi
• maliseche
• kuwonongeka kwamawonekedwe.

Chithandizo cha hyperglycemia ndicho kudziwa zomwe zimayambitsa. Ngati kuchuluka kwa shuga m'magazi kumayambitsidwa ndi matenda a shuga, ndiye kuti odwala amapatsidwa chakudya chochepa kwambiri, mankhwala ochepetsa shuga, kapena chithandizo chamankhwala a insulin, kutengera mtundu wa nthendayo.

Hypoglycemia: zomwe zimayambitsa, zizindikiro ndi chithandizo

Hypoglycemia mu mankhwala imatchedwa kuchepa kwa shuga m'munsi 3.3 mmol / L.

Nthawi zambiri, hypoglycemia imalembetsedwa kwa odwala matenda a shuga m'mikhalidwe yotsatirayi:

• kusankha molakwika mlingo wa insulin,
• kusala
• ntchito yolimbitsa thupi kwambiri
• uchidakwa
• kumwa mankhwala osagwirizana ndi insulin.

Mwa anthu athanzi, hypoglycemia imatha kuchitika chifukwa chamadya okhwima kapena kufa ndi njala, omwe amakhala ndi masewera olimbitsa thupi kwambiri.

Ndi hypoglycemia, zizindikiro zotsatirazi zingaoneke:

• chizungulire
• mutu
• kukomoka
• kusakhazikika
• kugona
• tachycardia
• kukopa kwa pakhungu
• thukuta kwambiri.

Kuti muwonjezere shuga m'magazi, muyenera kumwa tiyi wokoma, kudya shuga, maswiti kapena uchi. Woopsa milandu pamene chikumbumtima chalephera odwala omwe ali ndi matenda ashuga, shuga wa kulowetsedwa kwa shuga amasonyezedwa.

Pomaliza, ndikufuna kunena ngati muli ndi zizindikiro za hyper- kapena hypoglycemia, funsani katswiri nthawi yomweyo, makamaka katswiri wamkulu. Dotolo adzalembera kafukufuku kuti azindikire kuchuluka kwa shuga m'magazi ndipo ngati kuli koyenera, adzakutengerani kwa endocrinologist kuti mukakambirane.

Onerani kanema wonena za shuga wamagazi.

Timakukondani kwambiri ndipo tikuthokoza ndemanga zanu kuti tili okonzeka kupereka ma ruble 3000 mwezi uliwonse. (pafoni kapena ku banki) kwa omwe amapereka ndemanga zabwino kwambiri pazankhani zilizonse patsamba lathu (malongosoledwe atsatanetsatane)

Kodi shuga ayenera kukhala mulingo wotani m'magazi?

Pofuna kupewa, kuwongolera komanso kuchiza matenda ashuga, ndikofunikira kwambiri kuyeza milingo ya shuga m'magazi.

Chizindikiro chofananira (mulingo woyenera) kwa onse ndi pafupifupi zofanana, sizimatengera jenda, zaka komanso mawonekedwe ena a munthu. Nthawi zambiri ndi 3.5-5,5 m / mol pa lita imodzi ya magazi.

Kusanthula kuyenera kukhala koyenera, kuyenera kuchitika m'mawa, pamimba yopanda kanthu. Ngati shuga ali m'magazi a capillary aposa 5.5 mmol pa lita imodzi, koma ali m'munsi mwa 6 mmol, ndiye kuti izi zimawoneka ngati malire, pafupi ndi chitukuko cha matenda ashuga. Kwa magazi a venous, mpaka 6.1 mmol / lita imadziwika.

Zizindikiro za hypoglycemia mu shuga zimawonetsedwa pakuchepa kwambiri kwa shuga m'magazi, kufooka komanso kusazindikira.

Mutha kuphunzira momwe mungapangire ndikugwiritsa ntchito tincture wa walnuts omwe ali patsamba lino.

Zotsatira zake sizingakhale zolondola ngati munaphwanya chilichonse mukamapaka magazi. Komanso, kupotoza kumatha kuchitika chifukwa cha nkhawa, kudwala, kuvulala kwambiri. Zikatero, muyenera kufunsa dokotala.

Homoni yayikulu yomwe imayambitsa kuchepetsa magazi ndi insulin. Amapangidwa ndi kapamba, kapenanso maselo ake a beta.

Mahomoni amalimbikitsa kuchuluka kwa shuga:

• Adrenaline ndi norepinephrine zopangidwa ndi adrenal glands.
• Glucagon, wopangidwa ndi maselo ena apachifinya.
• Mahomoni a chithokomiro.
• "Lamula" mahomoni opangidwa mu ubongo.
• Cortisol, corticosterone.
• Zinthu zokhala ngati mahormone.

Ntchito yamachitidwe amthupi mthupi imayang'aniridwanso ndi dongosolo la mantha amanjenje.

Nthawi zambiri, shuga wamagazi mwa azimayi ndi abambo omwe amawunikira bwino sayenera kupitirira 5.5 mmol / l, koma pali kusiyana pang'ono pazaka, zomwe zikuwonetsedwa patebulo pansipa.

Chifukwa chiyani shuga wa seramu amatha kukwezedwa

Ngati shuga mu seramu yamagazi achulukitsidwa, ndiye ichi sichizindikiro cha matendawa.Tsiku lililonse timachita zinthu mwachizolowezi, timalimbikitsidwa kwambiri. Ndi anthu ochepa omwe amadziwa, koma thupi lathu limalandira mphamvu pazinthu zonsezi chifukwa cha kuwonjezereka kwa glucose. Imafikiridwa m'magazi a anthu ndipo imakhala ndi mphamvu ku ziwalo zonse ndi ziwalo kudzera m'matumbo, ndikuwadyetsa, ndikupereka mphamvu kuti igwire bwino ntchito.

Kuphatikizika kwa shuga m'magazi a anthu ndi chizindikiro chofunikira kwambiri. Ndiye amene amapatsa madotolo lingaliro lakelo momwe wodwalayo amayambira komanso kupezeka kwa matenda mthupi. Mlingo wabwinobwino wa shuga mu seramu umatengedwa ngati chizindikiro kuyambira 3,3 mpaka 5.5 mmol / L. Ngati tizingolankhula mwapadera za chizolowezi cha shuga wamagazi, ndiye mu mwana ndi wamkulu chizindikiro ichi chidzakhala chimodzimodzi.

Pali milandu yambiri yomwe kuchuluka komwe kumawonekera ngati koyenera. Izi zimawonedwa pa nthawi yoyembekezera, komanso matenda atatha kuchira. Nthawi zina shuga amatuluka chifukwa cha kupsinjika, kusuta, kuchita masewera olimbitsa thupi, kapena kusangalala. Zikatero, kudziunjikira kwa zinthu mokha kumabwerera kwazinthu pakapita maola ochepa, ndiye kuti sikutanthauza kulowererapo.

Mankhwala amakono ali ndi njira zingapo zodziwira kuchuluka kwa shuga m'magazi am'magazi. Ngati mulingo ndi wokwera, muyenera kusintha kadyedwe ndikutsatira zakudya. Onetsetsani kuti mwasiya kudya zakudya zamafuta ndipo nthawi yomweyo onetsetsani zomwe zimachitika kapamba kuti musatenge shuga. Kuti muzindikire kuchuluka kwa glucose wathanzi labwino komanso panthawi yomwe muli ndi pakati, magazi a venous amakokedwa.

Zomwe zimapangitsa kuchuluka kwa shuga ndi, monga lamulo, matenda a endocrine system, chiwindi, impso, kapamba ndi matenda a shuga. Mankhwala amathanso kukulitsa chiwonetsero, kapena m'malo mwake, Mlingo wawo wosalondola kapena kugwiritsa ntchito mankhwala osokoneza bongo, mankhwala oletsa kubereka pakamwa, komanso mankhwala osokoneza bongo.

Zizindikiro za shuga wam'magazi ndi awa:

• pakamwa kowuma kosalekeza
• Maonekedwe a zithupsa,
• kuyabwa
• kukodza pafupipafupi
• mkodzo wowonjezeka
• machiritso ofooka ndi okhalitsa
• kuwonda
• chilala chambiri,
• kuchepa chitetezo chokwanira
• kutopa ndi kufooka mthupi lonse.

Zizindikiro zomwe zili pamwambazi zimatha kuchitika limodzi kapena mosiyana. Ngati mungawone mfundo ziwiri pamndandandawo, ndiye kuti ndi chifukwa chabwino kukaonana ndi dokotala ndi kukayezetsa.

Mankhwala amakono amatchula matenda angapo, chizindikiro chachikulu chomwe ndi shuga wambiri:

• matenda ashuga
• pheochromocytoma,
• thyrotoxicosis,
• Cushing's syndrome
• chilonda chachikulu komanso chamba
• zotupa mu kapamba,
• matenda ammbuyo
• khansa ya chiwindi
• chiwindi.

Iliyonse mwa matendawa ndiyowopsa ndipo imatha kubweretsa zovuta zina, zomwe sizingatheke kuzipatula kunja kwa chipatala.

Ngati shuga wanu wapezeka paliponse, muyenera kutsatira zakudya. Malangizo otsatirawa akuyenera kutsatiridwa:

• chepetsani zopatsa mphamvu zonse za chakudya chomwe mumadya tsiku lonse,
• osatengera zakudya zomwe zili ndi chakudya chamafuta kwambiri,
• Idyani zamasamba atsopano ndi zipatso zomwe zili ndi mavitamini ambiri,
• samalani zakudya zowoneka bwino, idyani m'magawo ochepa a 5-6 patsiku,
• Osamadya kwambiri ndipo osagona ndi mimba yodzaza.

Mukapimidwa mozama, poganizira zaka zanu, kulemera ndi momwe thupi lanu lilili, dokotala adzakupatsani zakudya zomwe mungadye. Palibe chifukwa chomwe muyenera kugwiritsa ntchito zakudya zomwe zimaperekedwa kwa mnzanu omwe ali ndi matenda omwewo. Zakudya zomwe zimamuthandiza zimatha kukuvulazani ndikuwonjezeranso vuto lanu.

Monga mukudziwa, glucose amalowa mthupi ndi chakudya, motere, komanso pofuna kuthana ndi munthu amene ali ndi kuchuluka kwa zinthuzi m'magazi, muyenera kukonza menyu tsiku ndi tsiku. Kuti muchepetse shuga, muyenera kusiyiratu zinthu monga izi:

• pasitala
• mikate yoyera
• vinyo ndi madzi otumphuka,
• mbatata.

Zakudya ziyenera kuphatikizapo zakudya zomwe zimathandizira kuziziritsa bwino:

Kumbukirani kuti kuwunika kamodzi sikutanthauza chilichonse. Ngati matendawa atsimikiziridwa pakubwereza mobwerezabwereza, ayenera kuyamba kulandira chithandizo. Pazochitika zoyipa kwambiri, dokotala akupatseni mankhwala othandizira kuchepetsa magazi. Mwa mankhwala othandiza kuchepetsa shuga, mutha kugwiritsa ntchito izi:

Njira yoyendetsera ndi mlingo wake zikuwonetsedwa bwino ndi dokotala. Ndi zoletsedwa kugwiritsa ntchito mankhwalawa pamwena. Nthawi zina, kumwa mankhwala molakwika kungayambitse vuto lakumwa.

Palinso njira zina zothanirana ndi glucose wokwanira mthupi, koma amapereka zotsatira zabwino kuphatikiza ndi mankhwala a chikhalidwe.

Makhalidwe a shuga m'magazi tsiku lonse amakhala osagwirizana, kutengera mphamvu ya minofu, magawo azakudya pakati pa zakudya ndi kuchuluka kwa mphamvu yamafuta. Mu njira zingapo za pathological, kayendedwe ka shuga m'magazi kamasokonekera, komwe kumayambitsa hypo- kapena hyperglycemia. Pakukhudzidwa kwa shuga m'maselo, maselo abwinobwino amafunikira. insulin - mahomoni apamba.

Ndi kuchepa kwake (shuga mellitus), glucose sangadutse mu maselo, mulingo wake m'magazi umakwezedwa, ndipo maselo amafa ndi njala.

Kuyeza kwa shuga m'magazi ndiye kuyesa kwakukulu kwachipatalachi pakuwunika, kuwunika chithandizo cha matenda ashuga, kumagwiritsidwa ntchito pozindikira zovuta zina za kagayidwe kazakudya.

Kuchuluka kwa seramu glucose (hyperglycemia):

• shuga kwa akulu ndi ana,
• kupsinjika kwakuthupi kapena m'malingaliro (kupsinjika, kusuta, adrenaline kuthamanga nthawi ya jekeseni),
• endocrine pathology (pheochromocytoma, thyrotoxicosis, acromegaly, gigantism, Cushing's syndrome, somatostatinoma),
• matenda a kapamba (chifuwa chachikulu cha kapamba komanso kapamba), kapamba ndi mumps, cystic fibrosis, hemochromatosis, zotupa za kapamba),
• matenda a chiwindi ndi impso,
• matenda am'matumbo,
• kukhalapo kwa ma antibodies kuma insulin receptors,
• kumwa thiazides, caffeine, estrogens, glucocorticoids.

Seramu glucose kutsitsa (hypoglycemia):

• matenda a kapamba (hyperplasia, adenoma kapena carcinoma, maselo a beta a maselo a Langerhans - insulinoma, kusakwanira kwa ma alpha-maselo a islets - kuperewera kwa glucagon),
• endocrine matenda (matenda a Addison, adrenogenital syndrome, hypopituitarism, hypothyroidism),
• muubwana (makanda asanakwane, ana obadwa kwa amayi omwe ali ndi matenda ashuga, ketotic hypoglycemia),
• mankhwala osokoneza bongo a hypoglycemic ndi insulin,
• matenda oopsa a chiwindi (cirrhosis, hepatitis, carcinoma, hemochromatosis),
• zotupa zomwe sizipweteka pancreatic: khansa ya adrenal, khansa yam'mimba, fibrosarcoma,
• Fermentopathy (glycogenosis - Matenda a Girke, galactosemia, kulolerana kwa fructose),
• magwiridwe antchito - yogwira hypoglycemia (gastroenterostomy, postgastroectomy, Autonomic, matenda am'mimba motility matenda)
• mavuto a kudya (kusala kudya kwanthawi yayitali, malabsorption syndrome),
• poyizoni ndi arsenic, chloroform, salicylates, antihistamines, kuledzera
• kuchita zolimbitsa thupi mwamphamvu,
• kutenga anabolic steroids, propranolol, amphetamine.

Kuzindikira shuga yamagazi ndi imodzi mwazomwe zimayesedwa kwambiri pakufufuza zamankhwala pachipatala. Glucose amatsimikiza mu plasma, seramu, magazi athunthu. Malinga ndi Diabetes Laboratory Diagnosis Manual yoperekedwa ndi American Diabetes Association (2011), sikulimbikitsidwa kuyeza shuga m'magazi pofufuza matenda a shuga, chifukwa ndikugwiritsa ntchito plasma yomwe imakulolani kuti mupeze zitsanzo za centrifuge mwachangu kuti mupewe glycolysis osadikirira kuti apange fomu.

Kusiyana kwa kutsata kwa shuga m'magazi athunthu ndi madzi a m'magazi kumafunikira chisamaliro chapadera pakumasulira zotsatira. Kuchuluka kwa shuga m'magazi a plasma ndikwambiri kuposa magazi onse, ndipo kusiyana kumatengera phindu la hematocrit, chifukwa chake, kugwiritsidwa ntchito kwa zophatikizika zina kuyerekeza kuchuluka kwa shuga m'magazi ndi plasma kungayambitse zolakwika. Malinga ndi malingaliro a WHO (2006), njira yokhazikika yodziwira shuga ayenera kukhala njira yodziwira shuga m'magazi a venous. Kuchuluka kwa shuga m'magazi a venous ndi capillary magazi sikumasiyana pamimba yopanda kanthu, komabe, patatha maola awiri mutatsitsa shuga, kusiyana ndikofunikira (Gome).

Mulingo wa glucose mu zitsanzo zachilengedwe umakhudzidwa kwambiri ndi kusungidwa kwake. Mukasunga zitsanzo kutentha kwa firiji, glycolysis imapangitsa kuchepa kwakukulu kwa shuga. Sodium fluoride (NaF) imawonjezeredwa ku gawo la magazi kuti tiletse glycolysis njira ndi kukhazikika kwamisempha. Mukatenga zitsanzo zamagazi, malinga ndi lipoti la katswiri wa WHO (2006), ngati kulekanitsidwa kwakanthawi kwa plasma sikungatheke, pepala lonse la magazi liyenera kuyikidwa mu chubu choyesera chomwe chili ndi glycolysis inhibitor, yomwe iyenera kusungidwa mu ayezi mpaka plasma itatulutsidwa kapena kuwunikira kuchitidwa.

Zizindikiro za phunziroli

• Kuzindikira ndikuwunika matenda ashuga
• matenda a endocrine dongosolo (matenda a chithokomiro England, adrenal gland, pituitary gland),
• matenda a chiwindi
• kunenepa
• mimba

Zinthu zomwe mungatenge ndikuzisunga. Phunziroli lisanachitike, ndikofunikira kupatula nkhawa zamaganizidwe ndi thupi.

Makamaka, venous plasma. Zoyeserera ziyenera kupatulidwa kuchokera pazomwe zimapangidwa pasanathe mphindi 30 mutatenga magazi, kupewa hemolysis.

Zitsanzo ndizokhazikika osaposa maola 24 pa 2-8 ° C.

Njira yofufuzira. Pakadali pano, mu labotale, njira za enzymatic zodziwira kuchuluka kwa shuga - hexokinase ndi gluidose oxidase - amagwiritsidwa ntchito kwambiri.

• Lembani 1 kapena 2 shuga
• matenda ashuga
• matenda a endocrine dongosolo (acromegaly, pheochromocytoma, Cushing's syndrome, thyrotooticosis, glucomanoma),
• hemachromatosis,
• chilonda chachikulu komanso chamba
• Cardiogenic mantha
• matenda a chiwindi ndi impso,
• masewera olimbitsa thupi, kupsinjika kwambiri pamalingaliro, kupsinjika.

• Mankhwala osokoneza bongo a insulin kapena hypoglycemic odwala omwe ali ndi matenda ashuga,
• matenda a kapamba (hyperplasia, zotupa) zomwe zimayambitsa kuphwanya kapangidwe ka insulin,
• kuchepa kwa mahomoni omwe ali ndi zotsutsana,
• glycogenosis,
• matenda oncological
• kulephera kwambiri kwa chiwindi, kuwonongeka kwa chiwindi komwe kumayambitsa poizoni.
• matenda am'mimba thirakiti yomwe imasokoneza kuyamwa kwa chakudya cham'mimba.
• uchidakwa
• kuchita zolimbitsa thupi mwamphamvu, machitidwe.

ZOKHUDZA MALANGIZO OGWIRITSIRA NTCHITO DALITSITSANI

Kutsimikiza kwa shuga (shuga) mu seramu yamagazi, ndizotheka bwanji?

Ministry of Health of the Russian Federation: “Chotsani mita ndi zingwe zoyesa. Palibenso Metformin, Diabetes, Siofor, Glucophage ndi Januvius! Mgwireni ndi izi. "

Seramu yamagazi ndi madzi am'magazi omwe micrinogen imachotsedwa. Zimapezeka ndi kuphatikizika kwachilengedwe kwa plasma kapena mpweya wa fibrinogen pogwiritsa ntchito calcium calcium. Muli ma antibodies ambiri am'magazi. Imayikidwa padera poyesa matenda, antibody titer (kuwunika kwawo bwino) komanso kuwunika kwa zamankhwala.

Seramu ndi chinthu chofunikira kwa mankhwala ambiri pochiza matenda opatsirana ndi poyizoni.

M'mayeso a labotale a kuchuluka kwa shuga, magazi athunthu, madzi a m'magazi ndi seramu angagwiritsidwe ntchito. Pankhaniyi, mumakonda kupatsidwa madzi am'madzi, momwe mumakhala kuchuluka kwa glucose monga zofunikira, 11-14% kuposa kuchuluka kwa shuga m'magazi athunthu - chifukwa cha madzi osiyanasiyana. Seramu yake imakhala ndi 5% kuposa plasma.

Popanga shuga mu seramu yamagazi, chizolowezi chokhazikitsidwa ndi achikulire ndicho kuchuluka kwa 3.5-5.9 mmol / l, ndi kwa ana - 3,3-5.6 mmol / l. Kukwezedwa kwa seramu glucose - hyperglycemia - kumatha chifukwa cha endocrine pathologies, kuphatikizapo: matenda a shuga, thyrotooticosis, gigantism, acromegaly, ndi ena. Matenda a kapamba nthawi zambiri monga pancreatitis, zotupa, ndi cystic fibrosis amathanso kutsogolera.

Stroke, myocardial infarction, ndi kukhalapo kwa ma antibodies kuma insulin receptors ndizinthu zomwe zimatsimikizira kuchuluka kwa shuga m'magazi. Kuwonjezeka kwa ndende ya shuga kumatha kuchitika chifukwa cha caffeine, estrogen, glucocorticoids ndi thiazides.

Mankhwala amafunanso ndalama kwa odwala matenda ashuga. Pali mankhwala anzeru amakono aku Europe, koma samangokhala chete. Kuti.

Chomwe chimatchedwa "physiological hyperglycemia" sichachilendo - kuwonjezeka kwa shuga omwe amapsinjika ndi kupsinjika kapena mwamphamvu kwambiri, komanso kusuta, kuchita masewera olimbitsa thupi, komanso kumasulidwa kwa adrenaline.

Monga mukuwonera, pali zifukwa zambiri zowonjezera kuchuluka kwa shuga m'magazi, ndizosiyana, koma njira zochepetsera kuchuluka kwa shuga ndizofanana, ndipo zimagwira ntchito iliyonse.

Ngati, popanga kuchuluka kwa shuga, zotsatira zake zimaposa zofunikira, ndikofunikira kutsatira malamulo otsatirawa mu chakudya:

1) tsatirani kadyedwe kokhala ndi zopatsa mphamvu "zosavuta" - shuga, fructose ndi glucose,

2) kuchepetsa kuchuluka kwa mafuta muzakudya zanu ndikukulitsa kudya zamafuta ochepa,

3) gwiritsani ntchito zakudya zochepa zowonjezera ndi antioxidants - carotene, chromium, mavitamini C ndi E, popeza momwe amapangira zomwe sanaphunzire mpaka pano,

4) kudya zakudya zambiri zamtundu, zomwe zimakonzanso chakudya cham'mimba, zimasungabe kukhudzika kwa nthawi yayitali ndikudziyamwa zokha ndikuchotsa zochuluka m'thupi.

Ndinadwala matenda ashuga kwa zaka 31. Tsopano ali wathanzi. Koma, makapisozi awa sangafikire anthu wamba, safuna kugulitsa mankhwala, sizopindulitsa kwa iwo.

Palibe ndemanga ndi ndemanga pano! Chonde fotokozerani malingaliro anu kapena fotokozerani china chake ndikuwonjezera!

1. 
   Matenda a Endocrine ndi mimba pamafunso ndi mayankho. Kuwongolera kwa madotolo, E-noto - M., 2015. - 272 c.
2. 
   Daeidenkoea E.F., Liberman I.S. Mitundu ya matenda ashuga. Leningrad, yosindikiza nyumba "Mankhwala", 1988, 159 mas.
3. 
   Brooke, C. Upangiri wothandizira ma Pediatric Endocrinology / C. Brooke. - M: GEOTAR-Media, 2017 .-- 771 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 webusayiti, kukambirana ndi akatswiri ndizofunikira nthawi zonse.

Kuyesedwa kwa shuga m'magazi: momwe ndingatenge ndipo nditha kudziwa pawokha zotsatira za phunziroli?

Zosintha m'magazi a shuga m'magazi nthawi zambiri sizikhala zachilendo kwa anthu. Mutha kuphunzira za kupatuka pokhapokha poyesa mayeso. Ichi ndichifukwa chake madokotala amalimbikitsa mwamphamvu kuti miyezi isanu ndi umodzi iliyonse yoyesedwa wa shuga azipatsidwa kwa abambo ndi amayi opitilira zaka 40, komanso osaganizira jenda ndi zaka - kwa wina aliyense wonenepa kwambiri kapena amene ali ndi vuto lotengera mtundu wa matenda ashuga.

M'dziko lathu, anthu opitilira 5% amadwala matendawa. Chifukwa chake, kufunikira kwa kuwunika kwa glucose kumawonekera. Kodi ungapereke bwanji kusanthula ndikumasulira zotsatira zake? Tidzakambirana pankhaniyi. Chifukwa chiyani timayesedwa kuyesa kwa shuga?

Glucose - Ichi ndi carbohydrate yosavuta (monosaccharide), yomwe imagwira gawo lofunikira mthupi, chifukwa ndiye gwero lamphamvu. Maselo onse amthupi la munthu amafunikira glucose, chinthu ichi ndi chofunikira kwa ife kwa moyo ndi njira za metabolic monga mafuta m'magalimoto.

Kuchuluka kwa glucose m'magazi kumakupatsani mwayi wofufuza momwe thanzi la anthu lilili, ndikofunikira kwambiri kukhalabe ndi mulingo wambiri pazinthu izi. Shuga wamba yemwe amapezeka muzakudya, mothandizidwa ndi mahomoni apadera, insulin, imasweka ndikulowa m'magazi.

Kudya kwambiri shuga kumatha kusokoneza dongosolo lovuta komanso kumawonjezera kuchuluka kwa shuga m'magazi. Momwemonso, muyeso ungakhumudwe ngati munthu sakudya kapena sakudya monga momwe amafunira.

Kenako kuchuluka kwa glucose kumatsika, zomwe zimapangitsa kuchepa kwa mphamvu ya maselo aubongo. Kusagwirizana ndikotheka ndi kukanika kwa pancreatic, komwe kumatulutsa insulin. Udzu wambiri, kukamwa kowuma, kukoka pafupipafupi, thukuta, kufooka, chizungulire, kununkhira kwa acetone kuchokera mkamwa, palpitations wamtima - zizindikirozi ndizizindikiro zakuyesa magazi kwa glucose.

Masekondi khumi aliwonse, munthu m'modzi amadwala. Matenda a shuga ndi gawo lachinayi padziko lonse la matenda oopsa.

Kuyesedwa kwa shuga wamagazi Carbohydrate metabolism imabweretsa chiopsezo ku thanzi la munthu. Tidzapeza momwe tingapezere matendawa nthawi iliyonse. Njira zothandizira ma labotale ndizotsatira zamagazi zomwe zimayesedwa mu labotale, ndikulolani kukhazikitsa chithunzi cholondola cha matenda.

Maphunziro awa ovuta amapangitsa kuti azitha kudziwa ngati pali cholakwika chophwanya kagayidwe kazakudya ndikuwonetsa matenda.

Mapazi amwazi

Phunziroli ndi njira yodziwitsa anthu ena onse, imagwiritsidwa ntchito poyezetsa magazi komanso pofuna kupewa. Kusanthula kwa zamankhwala kumakupatsani mwayi wowunika osiyanasiyana mu thupi, kuphatikiza kuchuluka kwa shuga m'magazi.

Zida zakuwunikira zimatumizidwa ku labotale yachilengedwe. Kuyesedwa kwa magazi kwa kulolera kwa shuga ndi "katundu" (kuyeserera kwa glucose pamimba yopanda kanthu ndi katundu).

Kuyeza kumeneku kumakupatsani mwayi wolemba kuchuluka kwa shuga m'magazi a m'magazi. Kuthamanga kuyesa kwa magazi. Kenako amamwa kapu yamadzi momwe glucose amasungunuka kwa mphindi 5. Zitatha izi, kuyesedwa kumachitika mphindi 30 zilizonse kwa maola awiri. Kusanthula kumeneku kumakupatsani mwayi wofufuza matenda ashuga ndikuzindikira kulolerana kwa shuga.

Malingaliro a kudziwa shuga

Mlingo wa kuchuluka kwa shuga ungafufuzidwe ndi:

1. matenda a gren adrenal, England
2. Kusokonezeka ndi matenda a chiwindi.
3. matenda ashuga, mosasamala mtundu wake,
4. kudziwa kulekerera kwa glucose mwa omwe ali ndi vuto la matenda ashuga,
5. onenepa kwambiri
6. shuga kwa amayi apakati,
7. Kusintha kwa kulolerana kwa shuga.

Muyenera kudziwa kuti tanthauzo lake likufunika kusiya zakudya kwa maola 8 musanawunike. Kusanthula ndikwabwino kutenga magazi m'mawa. Kupitilira muyeso konse, kupsinjika kwamthupi ndi m'malingaliro, sikumaperekedwanso.

Seramu, kapena mwanjira ina, madzi a m'magazi, amalekanitsidwa ndi maselo patatha maola awiri pambuyo poti magazi awatenge. Kuphatikiza apo, mutha kugwiritsa ntchito chubu yapadera yokhala ndi glycolysis inhibitors. Ngati zoterezi sizikwaniritsidwa, ndiye kuti onamizira onama akhoza.

Kusanthula kwa shuga m'magazi kumakhudza njira izi:

• kafukufuku wa reductometric, zimatengera kuthekera kwa glucose pobwezeretsa mchere wa nitrobenzene ndi mchere wamkuwa,
• kafukufuku wa enzymatic mwachitsanzo, njira ya glucose oxidase,
• njira yochitira mitundu, njira yapadera yosonyezera kutentha kwa chakudya chamafuta.

Njira ya glucose oxidase ndikuwunika kuchuluka kwa shuga mumkodzo ndi magazi pamimba yopanda kanthu. Njirayi imachokera ku glucose oxidation anachita mu michere ya glucose oxidase ndikupanga hydrogen peroxide, yomwe oxidizing orthotolidine pa peroxidase.

Magetsi othamanga a glucose amawerengedwa ndi njira ya Photometric, pomwe kukula kwamtundu kumayerekezedwa ndi graph.

Zochita zamankhwala zimatha kudziwa shuga:

1. m'magazi a venous, pomwe zinthu zofunika kuzisanthula ndi magazi ochokera m'mitsempha. Openda okhazikika amagwiritsidwa ntchito,
2. m'magazi a capillary, omwe amachotsedwa chala. Njira yofala kwambiri, pakuwunika mumafunikira magazi pang'ono (chizolowezi sichaposa 0.1 ml). Kuwunikiranso kumachitidwanso kunyumba ndi zida zapadera - glucometer.

Mitundu yobisika (yowoneka bwino) yamitsempha yamafuta

Kuti muzindikire zobisika, ndiye kuti, mitundu yaying'ono yamatenda am'mimba ogwiritsa ntchito, kuyesa kwa glucose pakamwa kapena kuyesa kwa glucose pamagwiritsidwe ntchito.

Chonde dziwani: ngati kuchuluka kwa glucose m'magazi a venous otengedwa pamimba yopanda kanthu ndi apamwamba kuposa 15 mmol / l, ndiye kuti matenda a shuga sangachitike.

Kafukufuku wovomerezeka wa glucose wobisika pamimba yopanda kanthu, amachititsa kuti asatengere chilichonse chomwe chimakhudzana ndi kusowa kwa chimbudzi, komanso kuyamwa kwa chakudya cham'mimba.

Kwa masiku atatu isanayambike phunzirolo, wodwalayo amamulembera zakudya zomwe zimakhala pafupifupi 150 g tsiku lililonse. Kusanthula kumachitika pamimba yopanda kanthu. Glucose imayendetsedwa pamitseko ya 0,5 g / kg thupi, mwa njira ya 25% yothetsera mphindi imodzi kapena ziwiri.

Mu madzi amkati am'madzi am'magazi, kuchuluka kwa glucose kumatsimikiziridwa nthawi 8: 1 pamimba yopanda kanthu, ndipo nthawi zina 3, 5, 10, 20, 30, 45, ndi 60 maminiti pambuyo poyambira shuga. Mlingo wa plasma insulin ukhoza kutsimikizika limodzi.

Kutheka kogwiritsa ntchito magazi kumawonetsera kuchuluka kwa glucose m'magazi pambuyo pakupanga kwake kwamkati. Nthawi yomweyo, nthawi yomwe imatenga kuchepetsa kuchuluka kwa shuga ndi 2 nthawi imatsimikizika.

Fomula yapadera imawerengera izi: K = 70 / T1 / 2, pomwe T1 / 2 ndi kuchuluka kwa mphindi zomwe zimafunikira kuchepetsa shuga wa magazi ndi 2, pakatha mphindi 10 kulowetsedwa.

Ngati zonse zili mkati mwa malire abwinobwino, ndiye kuti mphindi zochepa shuga atayamba kubayidwa, magazi ake othamanga amafika pamtunda wapamwamba - mpaka 13.88 mmol / L. Mankhwala a insulin okwanira amawonekera mphindi zisanu zoyambirira.

Mkulu wama glucose amabwerera ku mtengo wake woyamba pambuyo pa mphindi 90 kuchokera poyambira kusanthula. Pambuyo maola awiri, zomwe zili ndi glucose zimatsikira pansi pomwe, ndipo patatha maola atatu, mulingo wabwerera.

Zinthu zotsatirazi za glucose zomwe zilipo:

• mwa anthu omwe ali ndi matenda ashuga ali pansipa 1.3. Peak insulin ndende ikupezeka maminiti asanu mutayamba kusanthula,
• mwa anthu achikulire athanzi omwe alibe matenda a kagayidwe kazakudya, kuchuluka kwake ndi kwakukulu kuposa 1.3.

Hypoglycemic ndi hyperglycemic coefficients

Hypoglycemia ndi njira ya pathological yomwe imamasulira kukhala shuga wotsika wamagazi.

Hyperglycemia ndi chizindikiro cha matenda, chomwe chimawonetsa kuchuluka kwa glucose pazambiri za seramu.

Mulingo wapamwamba umawoneka ndi matenda a shuga kapena matenda ena a endocrine.

Zambiri pazochitika za kagayidwe kazakudya zitha kupezeka mutawerengetsera maumboni awiri ofufuza shuga:

• kuchuluka kwa gluerglycemic ndiko kuchuluka kwa shuga mu ola limodzi, mpaka pamlingo wopanda kanthu,
• kuchuluka kwa hypoglycemic ndiko kuchuluka kwa shuga m'magawo 2 mutatha kulumikiza mulingo wake pamimba yopanda kanthu.

Mwa anthu athanzi, kuchuluka kwaubwinobwino kwa hypoglycemic kumachepera 1.3, ndipo kuchuluka kwa hyperglycemic sikupitilira 1.7.

Ngati malingaliro abwinobwino a chisonyezo chimodzi apitilira, ndiye kuti izi zikuwonetsa kuti kulolera kwa glucose kumachepetsedwa.

Glycosylated hemoglobin ndi mulingo wake

Hemoglobin yotere imadziwika kuti HbA1c. Iyi ndi hemoglobin, yomwe yalowa mu mankhwala osapanga enzymatic yokhala ndi monosaccharides, ndipo, makamaka, ndi glucose, yomwe ili m'magazi ozungulira.

Chifukwa cha izi, chotsalira cha monosaccharide chimaphatikizidwa ndi molekyulu ya mapuloteni. Kuchuluka kwa hemoglobin ya glycosylated yomwe imawonekera mwachindunji pakukhazikika kwa shuga m'magazi, komanso nthawi yayitali yogwirizana ndi njira yokhala ndi shuga komanso hemoglobin.

Ndiye chifukwa chake zomwe zili mu glycated hemoglobin zimatsimikiza kuchuluka kwa glucose m'magazi nthawi yayitali, yomwe ikufanana ndi nthawi ya molekyu ya hemoglobin. Ndipafupifupi miyezi itatu kapena inayi.

Zifukwa zoperekera phunziroli:

1. kuwunika ndi kuzindikira matenda ashuga,
2. kuyang'anira matenda nthawi yayitali ndikuwunika momwe anthu omwe ali ndi matenda ashuga,
3. kusanthula kobwezeretsa matenda a shuga,
4. kuwunikira kowonjezereka kwa mayeso ololera wa glucose monga gawo lazindikiritso wa shuga wodwala pang'ono kapena mkhalidwe wodutsa matenda,
5. matenda ashuga am'mimba panthawi yapakati.

Mulingo woyenera komanso wofanana wa hemoglobin wa glycated pochita ndi thiobarbituric acid amachokera ku 4.5 mpaka 6, 1 peresenti ya molar, monga momwe kusanthula kukuwonera.

Kutanthauzira kwa zotsatira kumakhala kovuta ndi kusiyana kwa teknoloji ya ma labotale ndi kusiyana kwa anthu omwe adaphunzira. Kutsimikiza ndikovuta, chifukwa kufalikira kwa mfundo za hemoglobin. Chifukwa chake, mwa anthu awiri omwe ali ndi shuga wambiri, amatha kufikira 1%.

Makhalidwe amakula pomwe:

1. matenda a shuga ndi zina zomwe zimadziwika ndi kulolerana kwa shuga,
2. kudziwa kuchuluka kwa malipiro: kuyambira 5.5 mpaka 8% - shuga wolipidwa, kuyambira 8 mpaka 10% - nthenda yolipiridwa bwino, kuyambira 10 mpaka 12% - nthenda yolipiridwa pang'ono. Ngati peresentiyo ndi yoposa 12, ndiye kuti izi ndi shuga.
3. kuchepa kwachitsulo
4. splenectomy
5. kuchuluka kwabodza, chifukwa cha kuchuluka kwambiri kwa fetal hemoglobin.

Makhalidwe amatsika pamene:

• magazi
• hemolytic anemia,
• kuthira magazi
• hypoglycemia.

Glycated hemoglobin

Phunziroli lidawunikira kulumikizana kwa hemoglobin ndi glucose. Shuga wambiri, yemwe amalalikira kwambiri pa glycogemoglobin. Kusanthula kumakupatsani mwayi kuti muyerekeze kuchuluka kwa glycemia (glucose m'magazi) kwa miyezi 1-3 isanachitike kafukufukuyu.

Mosiyana ndi hemoglobin ya glycated, kuchuluka kwa fructosamine kumawonetsa kuchuluka kwa kuchuluka kapena kwakanthawi (kwakanthawi) kwamkaka wa shuga osati kwa miyezi 1-3, koma kwa masabata 1-3 isanachitike kafukufukuyu. Kuyesaku kumapangitsa kuti athe kuwunika momwe mankhwalawo amathandizira hyperglycemia ndipo ngati pakufunika kutero, sinthani mankhwalawo.

Komanso, kuwunikaku kukuwonetsedwa kuti amayi apakati azindikire matenda ashuga komanso odwala matendawa. Kusanthula kwa lactate: ichi ndi chizindikiro cha zomwe zili lactic acid wopangidwa ndi thupi panthawi ya anaerobic (yopanda oxygen) kagayidwe kazakudya.

Gellational shuga mellitus ndikuphwanya kulekerera kwa glucose komwe kumachitika nthawi yapakati. Kulimba kwamphamvu kwa glucose m'magazi kumachuluka kwazomwezo, kumakhala pachiwopsezo chotenga macrosomia (kukula kwambiri ndi kulemera kwakuthupi kwa mwana wosabadwayo).

Izi zimatha kubala mwana asanakwane, komanso kuvutikira mwana kapena mayi nthawi yobereka. Chifukwa chake, mukakhala ndi pakati, muyenera kuyang'anira shuga wamagazi - ichi ndi chitsimikizo cha chitetezo kwa onse mayi ndi mwana wamtsogolo.

Phunziro losonyeza

Njirayi imachokera pazomwe zimachitika ngati kusanthula kwa labotale, koma zimatenga nthawi yochepa ndipo zitha kuchitidwa kunyumba. Dontho la magazi limayikidwa pa Mzere wozungulira womwe umayikidwa mu glucose oxidase biosensor wa glucometer, ndipo patapita mphindi zochepa mutha kuwona zotsatira zake.

Njira yowonetsera Amayesedwa kuti ndi mayeso oyenera, koma amawonetsedwa kwa iwo omwe ali ndi matenda osokoneza bongo - kuwunikira kotere kumakupatsani mwayi wopewa shuga tsiku lililonse. Momwe mungaperekere magazi kuti musanthule shuga? Njira zonse zasayansi zoyezera shuga wa magazi zimakhudza kuyeza magazi kuchokera m'mitsempha kapena chala cham'mawa pamimba yopanda kanthu.

Izi sizikukonzekera kukonzekera mwapadera, koma mawa amakulimbikitsidwa kuti musamapanize mopitilira muyeso, kudya kwambiri, kumwa mowa. Ngati ndi kotheka, musanatero, muyenera kukana kumwa mankhwala.

Ponena ndi njira yowonetsera, magazi owunikira amachotsedwa chala nthawi iliyonse masana. Katswiri wokhawo yemwe amatha kutanthauzira mayesowa ndikuwonetsetsa. Komabe, tiyeni tiyese kupeza zisonyezo.

Miyezo Yokhutira

Mukadutsa kuyesedwa kwa magazi kwa mwana mpaka zaka ziwiri, mankhwalawa amachokera ku 2.78 mpaka 4,4 mmol / L, mwana wakhanda wazaka ziwiri mpaka zisanu ndi chimodzi - kuyambira 3.3 mpaka 5 mmol / L, m'misukulu ya ana asukulu - kuyambira 3,3 ndipo osapitilira 5.5 mmol / l. Nthawi zonse kwa akulu: 3.89-55,83 mmol / L; mwa anthu okalamba opitilira 60, kuchuluka kwa shuga kuyenera kukhala mpaka 6.38 mmol / L.

Zopatukira

Ngati kupenda kwamabuku kumawonetsa kuti mulingo shuga okwera (hyperglycemia), izi zitha kuwonetsa matenda otsatirawa:

matenda a shuga a mellitus, vuto la endocrine, kapamba kapweteka kapenanso matenda a chiwindi, matenda a impso.

Ngati, m'malo mwake, shuga amachepetsa (hypoglycemia), dokotala atha kukuwuzani matenda otsatirawa: wodwala matenda a kapamba, matenda a chiwindi, hypothyroidism, poyizoni ndi arsenic, mowa kapena mankhwala osokoneza bongo.

Mukamasulira mayesedwe ndi katundu, chisonyezo "7.8-11.00 mmol / L" chimawonetsa mkhalidwe wodwalayo wa wodwala. Ndipo ngati kuwunikirako kunawonetsa zotsatira pamwambapa 11.1 mmol / l, izi zitha kuwonetsa matenda ashuga. Ngati mulingo wa lactic acid m'magazi ndiwokwezeka, mu 50% ya izi zikusonyeza shuga.

Kutsitsa fructosamine kungakhale chizindikiro cha hyperthyroidism, nephrotic syndrome, matenda a shuga a nephropathy. Kupatuka kuzinthu zomwe zili mu glycated hemoglobin zitha kuonetsa kupezeka kwa matenda osokoneza bongo, ngati chizindikiro chimaposa 6.5%.

Komabe, kupitilira zowonjezera zomwe sizikutanthauza kuzindikiritsa komaliza. Kusintha kwa kuchuluka kwa shuga m'magazi kumatha kuchitika chifukwa cha kupsinjika, kumwa mowa kwambiri, kupsinjika kwamthupi komanso m'maganizo, kukana zakudya zabwino, ndi zina zambiri. Kuti afotokozere za matendawo, dokotalayo ayenera kupereka mayeso ena.

Kukonzekera kwa kusanthula

Ndikulimbikitsidwa kuti mutenge magazi kuti mukafufuze pamimba yopanda kanthu, mutha kumwa madzi okha. Popeza chakudya chomaliza, osachepera 8, koma osadutsa maola 14 ayenera kudutsa. Zitsanzo zamagazi zakufufuzira ziyenera kuchitika musanamwe mankhwala (ngati nkotheka) kapena osapitirira sabata ziwiri atachotsedwa.

Dokotala atha kukulemberani phunziroli ndi katundu kapena zakudya zovomerezeka. Sikulimbikitsidwa kuti mupereke magazi kuti aunikidwe mukangomvera radiology, fluorography, ultrasound - kafukufuku, mayeso a rectal kapena njira zolimbitsa thupi.

Zambiri za Katswiri

Glucose - Ndi chakudya chopepuka (monosaccharide), chomwe ndi gwero lamphamvu mthupi. Kuphatikizika kwa shuga m'magazi kumayendetsedwa ndi mahomoni amtundu, omwe amapangidwa ndi kapamba ndikupereka shuga m'maselo.

M'dziko lathu, anthu opitilira 5% amadwala matendawa. Ndikofunika kukumbukira kuti miyezo yokhudza kuchuluka kwa shuga m'magazi imasiyanasiyana kwa capillary ("kuchokera pachala") ndi magazi a venous. Musanaunike, muyenera maola 8 kuti musadye zakudya zilizonse kapena zotsekemera.

Ndikofunika kukumbukira kuti miyezo yokhudza kuchuluka kwa shuga m'magazi imasiyanasiyana kwa capillary ("kuchokera pachala") ndi magazi a venous. Musanaunike, muyenera maola 8 kuti musadye zakudya zilizonse kapena zotsekemera.

Kuti mudziwe kuchuluka kwa shuga (shuga) m'magazi, ndikofunikira kuyesedwa kwa magazi (shuga yoyesa magazi). Kuchuluka kwa shuga m'magazi ndikusintha ndipo zimatengera ntchito ya minofu ndi magawo azakudya.

Kusinthasintha kumeneku kumachulukirachulukira pamene malamulo a shuga m'magazi asokonekera, zomwe zimachitika mwanjira zina za m'magazi pomwe kuchuluka kwa shuga m'magazi kumatha kuchuluka (hyperglycemia) kapena kuchepa (hypoglycemia).

Hyperglycemia nthawi zambiri imapezeka mwa odwala matenda a shuga. Matenda a shuga ndi chifuwa chachikulu chokhala ndi vuto la insulin. Kuzindikira koyambirira kumatha kuchitika poyesa kuyesa kwa shuga (shuga yoyesa magazi).

Mitundu ina ya matenda a shuga imafotokozedwanso: matenda ashuga omwe ali ndi vuto lachiberekero mu ntchito ya pancreatic β-cell, vuto la genetic in insulin, matenda a exocrine gawo la kapamba, endocrinopathies, matenda ashuga ophatikizidwa ndi mankhwala osokoneza bongo, shuga yomwe imayambitsa matenda, mitundu yachilendo ya matenda osokoneza bongo okhudzana ndi matenda ashuga.

Hypoglycemia imapezeka m'njira zingapo za m'magazi, kuphatikiza ndi kuperewera kwambiri kwa kupuma kwa akhanda, toxosis ya amayi apakati, kusowa kwa enzyme, Raya syndrome, chiwindi ntchito, insulin, zotupa zotupa za insulin, insulin, zotupa za insulin.

Ngati mayeso a shuga m'magazi adawonetsa kuchepa kwa shuga m'magazi (hypoglycemia) kufikira ovutikirapo (pafupifupi 2,5 mmol / L), ndiye kuti izi zitha kuchititsa kuti kusokonezeka kwa dongosolo lamkati lamanjenje. Izi zikuwonetsedwa ndi kufooka kwa minofu, kugwirizanitsa bwino kayendedwe, chisokonezo. Kutsika kwina kwa shuga m'magazi kungayambitse kukomoka kwa hypoglycemic.

Glucose (Serum)

Glucose - Chizindikiro chachikulu cha kagayidwe kazakudya m'magazi ndi wofunikira kwambiri wamagetsi pakusunga ntchito zofunika za maselo. Mlingo wa chinthu ichi umayendetsedwa ndi zochitika za ziwalo za parenchymal ndi dongosolo la neuroendocrine. Hormone yayikulu yomwe imagwiritsa ntchito glucose m'misempha ndi insulin.

Kuti mudziwe kuchuluka kwa shuga mu seramu, biomaterial imatengedwa kuchokera m'mitsempha. Kusanthula kumachitika ndi:

matenda a shuga, kuwunika kwa magwiridwe antchito a matenda ashuga, amaganiziridwa hypoglycemia, mtima wa kagayidwe kachakudya metabolism mu pachimake hepatitis ndi kapamba.

Kuti muphunzire seramu yamagazi, ndikofunikira kuti mumutenge pamimba yopanda kanthu, pafupifupi maola 8 ayenera kudutsa kuchokera nthawi yomaliza chakudya. Tsiku lisanafike phunziroli, sikulimbikitsidwa kuti muzidya zakudya yokazinga ndi mafuta, mowa. Kusanthula kumayenera kuchitika musanamwe mankhwala kapena osapitilira sabata ziwiri atachotsedwa.

Zomwe zimachitika mwa munthu wamkulu zimatengedwa kuti ndi zamtengo wapatali kuyambira 3,88 mpaka 6.38 mmol / L, mwa ana - 3.33-555 mmol / L. Dokotala yekha ndi amene amatha kutanthauzira komanso kuzindikira moyenera. Zomwe mwapeza sizingagwiritsidwe ntchito podzifufuza nokha.

Zizindikiro zazikulu zamagazi abwinobwino

Glucose ndi othandizira ofunikira maselo amthupi. Mlingo wa shuga m'magazi masana ungasinthe chifukwa cha zinthu zosiyanasiyana zakunja, monga zochitika zolimbitsa thupi, zakudya, kupsinjika, ndi zina zotere.insulin, kuchuluka kwa glucose kuyenera kukhalabe kuzisonyezo zina zodziwika bwino.

Nthawi zambiri, shuga amayendetsedwa mosamalitsa kotero kuti imapezeka ndi ziwalo za thupi lathu ngati mphamvu, pomwe sipangakhale owonjezera mumkodzo.

Zizindikiro zabwinobwino ndizomwe zili mumtundu wa:

pamimba yopanda kanthu - 3.3-5.5 mmol / l, mutatha kudya - osaposa 6.1 mmol / l. Zizindikiro kutengera zaka (pamimba yopanda kanthu): ana akhanda - 2.2-3.3 mmol / l, ana - 3,3-5.5 mmol / l, akuluakulu - 3.5-5.9 mmol / l, pambuyo pa 60 zaka - 4.4-6.4 mmol / l. Pa nthawi yoyembekezera - 3,3-6.6 mmol / L.

Ndi kupatuka kosalekeza kwa zizindikiro za shuga m'magazi kunthawi zonse, pamakhala chiwopsezo chachikulu chakuwonongeka kwa mitsempha ndi mitsempha, zomwe zimabweretsa matenda owopsa a ziwalo zamunthu ndi machitidwe.

Njira zokhazikitsira shuga m'magazi

Kukhazikitsa zizindikiro za shuga mu seramu yamagazi, mitundu yosiyanasiyana ya zitsanzo imagwiritsidwa ntchito:

pamimba yopanda kanthu (basal), ma 2 maola mutatha kudya, ngakhale mutadya (mosasamala).

1. Kuthamanga mayeso a shuga

Pa kusanthula kumeneku, malinga ndi zofunikira zachipatala, magazi osala kudya ayenera kumwedwa. Izi zikutanthauza kuti chakudyacho chikuyenera kuyimitsidwa maola 8 mpaka 12 mayeso asanayesedwe. Kuphatikiza apo, musanachite kafukufukuyu, simungathe kusuta, kumva zolimbitsa thupi.

Ndikofunikanso kuganizira kuti zotsatira zake zitha kukhudzidwa ndikugwiritsa ntchito mankhwala ena (mwachitsanzo, salicylates, maantibayotiki, vitamini C, ndi zina), kupsinjika kwa malingaliro, kumwa mowa, kusala kudya kwina, etc.

2. Kusanthula kwa glucose mukatha kudya

Izi zimachitika pambuyo pa chakudya, osati kale kuposa pambuyo pa maola 1.5−2. Zabwinobwino pamilandu iyi ndizisonyezo zosaposa 6.1 mmol / l. Amakhulupirira kuti pofuna kuzindikira matenda a shuga kapena matenda ena, ndikofunikira kuphatikiza mayeso awiri: pamimba yopanda kanthu ndikatha kudya.

3. Kusanthula kwa glucose mosasamala kanthu za chakudya

Kusanthula uku kumagwiritsidwa ntchito molumikizana ndi maphunziro ena. Ndikofunikira kuyesa kuchuluka kwa shuga m'magazi a munthu wonse, komanso kuwongolera chithandizo cha matenda omwe amkachitika ndi shuga m'magazi a shuga, mwachitsanzo, ndi matenda a shuga.

Ndikofunika kulingalira kuti pakuwunika zamankhwala am'mwazi, magazi amatha kutengedwa kuchokera ku chala kapena kuchokera mu mtsempha. Komanso, misempha ya m'magazi yotengedwa kuchokera m'mitsempha idzakhala 12% kuposa momwe magazi amachotsedwa chala.

Shuga wapamwamba

Mwazi wamagazi - hyperglycemia, zimapangitsa kuti shuga wopezeka m'magazi ambiri, asalowetsedwe ndi minofu yonse. Kuphatikizika kwamphamvu kwa shuga pankhaniyi kumathandizira kusokonezeka kwa metabolic, mapangidwe a zinthu zopangidwa ndi poizoni, komanso poizoni wambiri m'thupi.

Kuwonjezeka kwa shuga m'magazi kungasonyeze mwachindunji kupezeka kwa matenda osokoneza bongo, komanso chidziwitso:

mawonetseredwe akuthupi (masewera olimbitsa thupi, kupsinjika, matenda, etc.), matenda a endocrine (pheochromocyte, thyrotoxicosis, acromegaly, Cushing's syndrome, gigantism, glucagonoma, etc.), matenda a kapamba (pancreatitis, chotupa cham'mimba, etc.), kukhalapo kwa zina matenda (stroke, matenda a mtima, angina pectoris, matenda a chiwindi, impso, ndi zina).

Zochepetsedwa

Shuga wamagazi ochepa - hypoglycemia. Pamene kuwerenga kwa glucose kumatsika kuposa 3.3 mmol / L, wodwalayo amatuluka thukuta, kufooka, kutopa, kunjenjemera mthupi lonse, kumangokhala ndi njala, kuchuluka kwa chisangalalo, kuchuluka kwa mtima.

Kutsika kwa shuga m'magazi kungasonyeze hypoglycemia mu shuga mellitus, komanso kukhalapo kwa:

matenda a kapamba, matenda a chiwindi, matenda a endocrine (hypopitarism, hypothyroidism, matenda a Addison, ndi zina), zovuta zamagulu (kuwonongeka kwamitsempha yama neva, gastroenterostomy, etc.).

Makhalidwe a shuga m'magazi tsiku lonse amakhala osagwirizana, kutengera mphamvu ya minofu, magawo azakudya pakati pa zakudya ndi kuchuluka kwa mphamvu yamafuta. Mu njira zingapo za pathological, kayendedwe ka shuga m'magazi kamasokonekera, komwe kumayambitsa hypo- kapena hyperglycemia.

Kuyeza kwa shuga m'magazi ndiye kuyesa kwakukulu kwachipatalachi pakuwunika, kuwunika chithandizo cha matenda ashuga, kumagwiritsidwa ntchito pozindikira zovuta zina za kagayidwe kazakudya.

Kuchuluka kwa seramu glucose (hyperglycemia):

shuga mellitus mu akulu ndi ana, kupsinjika kwakuthupi kapena m'maganizo (kupsinjika, kusuta, adrenaline kuthamanga panthawi ya jekeseni), endocrine pathology (pheochromocytoma, thyrotoxicosis, acromegaly, gigantism, Cushing's syndrome, somatostatinoma), matenda a kapamba (chifuwa chachikulu komanso kapamba), kapamba mumps, cystic fibrosis, hemochromatosis, zotupa zam'mimba, matenda a chiwindi ndi impso, matenda amitsempha, kupindika kwa myocardial, kukhalapo kwa ma antibodies ku insulin receptors, thiazide makonzedwe , caffeine, estrogen, glucocorticoids.

Seramu glucose kutsitsa (hypoglycemia):

matenda a kapamba (hyperplasia, adenoma kapena carcinoma, maselo a beta a isanger a Langerhans - insulinoma, kusakwanira kwa maselo a alpha a islets - kuperewera kwa glucagon), endocrine pathology (matenda a Addison, adrenogenital, hypopituitarism, hypothyroidism), mu ana (mwa ana wobadwa kwa amayi omwe ali ndi matenda a shuga, ketotic hypoglycemia, mankhwala osokoneza bongo a hypoglycemic ndi insulin, matenda oopsa a chiwindi (matenda amtundu wa chiwindi, hepatitis, carcinoma, hemochromatosis) zotupa: khansa ya adrenal, khansa yam'mimba, fibrosarcoma, Fermentopathy (glycogenosis - Matenda a Girke, galactosemia, matenda opatsirana a fructose), magwiridwe antchito - kusinthika kwa hypoglycemia (gastroenterostomy, postgastrectomy, matenda a patonomic, kuvulala kwam'mimba, kusokoneza kwa m'mimba, m'mimba kwambiri, m'mimba. malabsorption syndrome), poyizoni ndi arsenic, chloroform, salicylates, antihistamines, kuledzera, kuchita masewera olimbitsa thupi, zikhalidwe zaumoyo, kudya nabolicheskih steroids propranolol, amphetamine.

Kodi kuchuluka kwa shuga kwa magazi kwa munthu ndi kotani?

Chikhalidwe cha shuga m'magazi a anthu popanda matenda a shuga ndi 3.3-7.8 mmol / L.
Ndi kuchuluka kwa shuga kwa 4 mpaka 10, munthu wodwala matenda ashuga kwa zaka makumi ambiri sadzakhala ndi mavuto akulu.

Shuga wamba wamagazi mwa amuna, akazi ndi ana ndi 3.33-5,55 mmol / L (m'magazi onse a capillary), m'magazi am'magazi - 4.22-6.11 mmol / L. Izi zili ngati mutapereka magazi pamimba yopanda kanthu.

Mtundu woyamba wa matenda a shuga a mellitus (wodalira insulini) amawona kuti ndi wofunika ngati kuchuluka kwa shuga komanso kusinthasintha kwa tsiku ndi tsiku sikupitirira 10 mmol / l. Ndi mtundu uwu wa shuga, kuchepa kwa glucose mu mkodzo mpaka 20-30 g patsiku kumaloledwa.

Mtundu Wachiwiri wa matenda a shuga a mellitus (osadalira insulini) amakhala ndi njira zowonjezera zowonjezera: glucose othamanga sayenera kupitirira 6.0 mmol / l, ndipo pakusinthasintha kwa tsiku ndi tsiku sikuyenera kupitirira 8.25 mmol / l. Mu mkodzo, shuga sayenera kupezeka (aglucosuria).