Mtundu 2 wa matenda a shuga ochititsa chidwi ndi hemoglobin

Pochizira mafupa, owerenga athu adagwiritsa ntchito DiabeNot bwino. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Hemoglobin ndi mapuloteni okhala ndi chitsulo omwe amapezeka m'maselo ofiira a m'magazi ndipo amalola maselo ofiira a m'magazi kuti agwire ndi kusamutsa mamolekyulu a oksijeni ku ziwalo zathupi. Ngati mapuloteniwa amasungidwa mu yankho la glucose kwa nthawi yayitali, amadzimanga mu gawo la indissoluble.

Njira imeneyi imatchedwa glycation, ndipo puloteni yosinthayo imatchedwa glycated kapena glycated .Ikupanga glycated hemoglobin ya mtundu A, womwe umadziwika ndi formula HbA1c.

Mwazi wa wodwalayo "ukamvekedwa" kwambiri, mapuloteni ochulukirapo amamangika ku glucose. GH imayezedwa mu kuchuluka kwake kwa hemoglobin yonse. Chowonekera mwa munthu wathanzi ndi 4.8-5.9%, chithunzi cha 6% chimawonetsa prediabetes, pamwamba pa 6.5% - pakuyambira kwa matendawa. Ndi matenda ashuga, zofunikira zimachokera ku 7% mpaka 15.5%.

HbA1c kapena shuga wamagazi: kusanthula kumene kumakhala kolondola kwambiri

Monga mukudziwa, kuchuluka kwa shuga m'magazi athanzi komanso anthu odwala matenda ashuga kukusinthasintha. Ngakhale zikhalidwe za kusanthula ndizofanana, mwachitsanzo, pamimba yopanda kanthu, ndiye kuti zizindikirazo zimasiyanasiyana masika ndi nthawi yophukira, ndikumazizira, munthu atakhala wamanjenje, ndi zina zotero. Chifukwa chake, kuyesedwa kwa shuga yamagazi kumagwiritsidwa ntchito makamaka pofufuza komanso kuwongolera mwachangu matenda ashuga - kuti musankhe mapiritsi a insulin a shuga 1, zakudya kapena mapiritsi ochepetsa shuga a shuga.

Kuwerengeka kwa kuchuluka kwa shuga m'magazi musanadye chakudya (pre-and postprandial hyperglycemia) kumathandizira kudziwa momwe shuga yolipidwira imalipira. Mlingo wa postprandial glucose 5 mmol / l) kusinthasintha kwa tsiku ndi tsiku m'magazi a magazi. Anthu awa nthawi zambiri amakhala ndi zovuta kuposa omwe adakweza HbA1c, koma matupi awo a shuga sasintha kwambiri masana. Chifukwa chake, kuti muchepetse shuga, muyenera kuphatikiza kusanthula kwa glycated hemoglobin ndi mayeso a shuga a m'malo.

Ndimakonda kusanthula kangati

Maselo ofiira amakhala ndi masiku 120 mpaka 125, ndipo kumangiriza kwa hemoglobin ku glucose sikuchitika nthawi yomweyo. Kuti muwone bwinobwino momwe wodwalayo aliri, matenda a shuga 1, amayesedwa miyezi iwiri iliyonse, kwa matenda ashuga 2 - kamodzi miyezi isanu ndi umodzi, ali ndi matenda osokoneza bongo - pakadutsa masabata 10-12. Kwa odwala matenda ashuga, kuchuluka kwa HbAlc sikokwanira kuposa 7%.

Ngati chizindikiro chizidutsa 8-10%, mankhwalawa amachitika molakwika kapena sikokwanira.

Glycated hemoglobin> 12% ikuonetsa kuti shuga silipidwa. Miyezo ya HbA1c imayamba kusintha kukhala bwino pakapita miyezi iwiri mpaka itatu glucose atakhala wabwinobwino.

Kodi glycated hemoglobin wa chandamale?

Mulingo wofunikira wa hemoglobin wa glycated ndi chinthu chamagulu amwazi am'magazi, kuwunika komwe kumakhala kofunikira nthawi zambiri, mwachitsanzo, odwala omwe ali ndi matenda ashuga. Glycated hemoglobin imawonetsa kuchuluka kwa shuga m'magazi ndipo, monga momwe dzinalo limanenera, ndi kuphatikiza mapuloteni am'magazi a hemoglobin ndi glucose.

Ichi ndi chiyani

Glycated hemoglobin imapangidwa ndi thupi chifukwa cha zochita zapadera, pomwe, mothandizidwa ndi michere, amino acid ndi shuga zimalumikizana limodzi. Mukamaliza kuchitazo, mapangidwe a hemoglobin-glucose amapangidwa, omwe amatha kuwonekera ndi njira zodziwira matenda. Izi zimatha kuchitika mwachangu, zimatengera kuchuluka kwa zida zofunika mthupi.

Madokotala aganiza zogawa hemoglobin yotereyi kukhala mitundu itatu:

yoyamba yasankhidwa HbA1a,
chachiwiri ndi HbA1b,
chachitatu ndi HbA1c.

Mitundu yomaliza, HbA1c, imasinthidwa nthawi zambiri.

Mwa anthu omwe ali ndi matenda ashuga, kuchuluka kwa shuga m'magazi nthawi zambiri kumakwezedwa. Zotsatira zake, hemoglobin ya glycated imapangidwa mwachangu kwambiri kuposa thupi lathanzi. Poyesa kuthamanga uku, mutha kudziwa kukhalapo komanso gawo la kukula kwa matenda.

Monga mukudziwa, hemoglobin imakhazikika m'magazi ofiira - maselo ofiira amwazi, omwe moyo wawo umakhala pafupifupi masiku 120. Kuyesa kwa hemoglobin ya glycated, pamaziko a izi, kuyenera kuchitika osati kamodzi, koma m'magawo angapo kwa miyezi itatu kuti muwone kuchuluka kwa thunthu ndi kusintha kwake pamphamvu.

Makhalidwe azikhalidwe ndi zopatuka kuchokera pamenepo

Kukumana kwa hemoglobin wa glycated mwa munthu wathanzi nthawi zambiri kumasungidwa pa 4-6 peresenti, mosasamala za msinkhu komanso vuto la wodwala. Kuzindikira kuyenera kuwonetsa phindu loposa 6 peresenti, ngati chithunzi pamwambapa ndi chizindikiro cha matenda omveka bwino omwe amafunikira kuwunika kofulumira komanso kuchitapo kanthu kuchipatala.

Kuwonjezeka kwa hemoglobin yokhudzana ndi shuga kumawonetsa shuga kwambiri. Monga lamulo, ichi ndi chizindikiro cha matenda a shuga, koma osati nthawi zonse: zovuta za kagayidwe kazakudya zimatha kuchitika pazifukwa zina.

Kulephera kwamphamvu kwa thupi kwa glucose.
Kuphwanya shuga mu magazi omwe amachokera kwa wodwala pamimba yopanda kanthu.

Kuwonjezeka koposa 6 peresenti kumatha kukhala chifukwa choti munthu apezeke ndi matenda a shuga, koma pokhapokha ngati glycated hemoglobin iposa 6.5%. Ngati chizindikirochi chikuyambira pa 6 mpaka 6.5 peresenti, sazindikira, koma aweruze za kukhalapo kwa boma la prediabetes.

Hemoglobin silingangokulitsa, komanso kuchepa. Kugwa kwa mulingo wake pansipa wochepera 4 peresenti kumayendetsedwa ndi chiwonetsero cha zizindikiro za hypoglycemic.

Zifukwa izi zitha kukhala izi:

zolimbitsa thupi kwambiri
Zakudya zopanda pake zomwe zimadya kwambiri mafuta ochepa,
ma genetic pathologies
kukomoka kwa adrenal.

Tiyenera kukumbukira kuti kusintha kwa zomwe zili m'magazi a glycated hemoglobin ndi chizindikiro chabe, koma osati matendawa pawokha.

Mulingo wachitetezo

Ngakhale hemoglobin itasintha, sikuti nthawi zonse kumafuna kukhazikitsidwa kwa njira zochiritsira zilizonse. Anthu ena amakhala ndi chizindikiro chotsimikizika, chomwe kwa iwo chimakhala chizolowezi. Kuphatikiza apo, zinthu zina zimafunikira kuti zigwiritsidwe ntchito pafupifupi 8 peresenti.

Izi zimachitika chifukwa chakuwoneka kwakukulu kwa mawonekedwe a hypoglycemia ngati HbA1c igwera pansi pazomwe mukufuna. Ndipo vutoli limatha kukhala loopsa kwambiri kuposa kukula kwa hemoglobin, ndipo zitha kuchitika kuti kusintha “zinthu” m'matumbo a glycated kumabweretsa mavuto akulu mthupi.

Mlingo wa hemoglobin mwa wachinyamata wathanzi sayenera kukhala woposa 6.5%. Kwa wodwala wotere, njira zodziwika bwino ndizofunikira, popeza momwe wodwalayo amagwirira ntchito komanso kuchuluka kwa moyo wawo zimadalira izi. Koma mwa anthu ena, zotsatira za kuyezetsa magazi zimatha kukhala zabwinobwino, koma nthawi yomweyo, musalankhule za boma labwinobwino kwa nthawi yayitali.

Mulingo wa hemoglobin womwe umapangidwa umakhazikitsidwa payekhapayekha kwa odwala, kutengera zifukwa zina:

odwala matenda ashuga a zaka zapakati (mpaka zaka 45), kwa omwe palibe chiopsezo chokhala ndi vuto la hypoglycemic komanso zovuta zotheka, zimayikidwa pa 6.5%,
odwala omwe ali ndi zoopsa pamwambapa - peresenti 7,
anthu opitilira 45 osakhala ndi chiopsezo chotere, cholinga cha mankhwalawa ndikusunga hemoglobin wa glycated mpaka 7 peresenti, ndipo ndi ngozi - mpaka 7.5%,
okalamba, komanso odwala omwe matenda awo amatha nthawi yayitali asanadutse zaka 5, cholinga chimakhazikitsidwa pa 7.5-8%.

Kusanthula uku kumachitika osati kamodzi, koma mwamphamvu, kuwunika zotsatira zonse ndikuwonetsa pafupifupi miyezi itatu.

Kodi amayesedwa bwanji HbA1c?

Kuyeza uku kuyenera kutengedwa m'mawa, pamimba yopanda kanthu. Madokotala amalimbikitsa kuti musadye osachepera maola 2 musanayende mwanjira imeneyi, mosasamala kanthu kuti zitsanzozo zimatengedwa m'mawa kapena masana.

Monga tanenera mobwerezabwereza, kusanthula kumachitika modabwitsa, kupitirira miyezi itatu. Nthawi zambiri, magawo a hemoglobin amawunikira kamodzi pa sabata, zitsanzo patsiku la kusanthula zimachitika mpaka nthawi 8 kuti zitheke. Chifukwa chake, adotolo azitha kuzindikira kusinthasintha kwakukuru pamlingo.

Pakupereka, simukuyenera kupita ku chipatala chodziwika bwino, izi zitha kuchitika kuchipatala chilichonse chokhazikitsidwa ndi dokotala. Dokotala amayenera kupereka labotale yolungamitsa kufunika kwa kusanthula koteroko, popanda iwo, pawokha, kupereka magazi a glycated hemoglobin sikugwira ntchito. Ngakhale mutha kupita ku imodzi mwa zipatala zolipiridwa, pomwe zofunika sizokhwima kwambiri.

Mlingo wa hemoglobin wa glycated wa mtundu 1 ndi matenda ashuga 2

Imakhazikika pamisempha ya shuga kwa nthawi yayitali
Zimabwezeretsa kupanga kwa insulin

Glycated hemoglobin ndi chizindikiro chamagazi amomwe amachititsa chidwi cha kuchuluka kwa shuga kwa nthawi yayitali. Glycohemoglobin imakhala ndi shuga ndi hemoglobin. Ndi mulingo wa glycogemoglobin womwe umafotokoza kuchuluka kwa hemoglobin m'magazi omwe amalumikizana ndi mamolekyulu a shuga.

Phunziroli liyenera kuchitika kuti muzindikire matenda omwe ali ndi matenda monga matenda ashuga, kuti muchepetse kusintha kwa mitundu yonse ya zovuta za hyperglycemia. Pa kusanthula, chipangizo chosanthula chapadera chimagwiritsidwa ntchito.

Kuphatikiza apo, magazi a hemoglobin wa glycated amayenera kuperekedwa kuti ayang'anire bwino momwe amathandizira odwala matenda ashuga. Chizindikiro ichi chimatsimikizika ngati gawo la hemoglobin yokwanira.

Ndikofunikira kwa odwala matenda a shuga, ngakhale atakhala kuti ali ndi matendawa, kuti amvetsetse glycated hemoglobin ndi chiyani, komanso chikhalidwe chake cha matenda a shuga. Muyenera kudziwa kuti chizindikirochi chimapangidwa chifukwa cha kuphatikiza kwa amino acid ndi shuga. Kuchuluka kwa mapangidwe ndi kuchuluka kwa maselo ofiira a m'magazi kumalumikizidwa ndi chizindikiro cha glycemia. Zotsatira zake, hemoglobin yotere imatha kukhala yamitundu yosiyanasiyana:

Pazifukwa zomwe kuchuluka kwa shuga mu shuga kumachulukira, kusintha kwa mankhwala komwe kumachitika mu hemoglobin ndi shuga kumadutsa msanga, hemoglobin ya glycosylated imakwera. Kutalika kwa moyo wama cell ofiira a hemoglobin kumakhala pafupifupi masiku 120, chifukwa chake, kusanthula kukuwonetsa kutalika kwa hemoglobin kwa nthawi yayitali kuchoka pachizolowezi.

Chowonadi chonse ndichakuti maselo ofiira amwazi amatha kusungira mu kukumbukira kwawo kuchuluka kwa mamolekyu a hemoglobin omwe, m'miyezi itatu yapitayi, adalumikizidwa ndi mamolekyulu a shuga. Komabe, nthawi imodzimodzi, maselo ofiira a m'magazi amatha kukhala a mibadwo yosiyana, chifukwa chake kuli koyenera kuchita kafukufuku pakatha miyezi iwiri iliyonse.

Kasamalidwe ka shuga

Munthu aliyense ali ndi hemoglobin m'magazi, koma kuchuluka kwa shuga kumakwera katatu, makamaka kwa odwala atatha zaka 49. Ngati chithandizo chokwanira chikuchitika, pakatha milungu isanu ndi umodzi munthu amakhala ndi hemoglobin wabwinobwino m'matenda a shuga.

Ngati mungayerekeze hemoglobin wa matenda a shuga ndi glycated hemoglobin pazomwe zili ndi shuga, kuwunika kwachiwiri kudzakhala kolondola momwe zingatheke. Ikupereka lingaliro lamomwe thupi la wodwala matenda ashuga m'miyezi yaposachedwa.

Pochizira mafupa, owerenga athu adagwiritsa ntchito DiabeNot bwino. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Pambuyo poyesedwa koyambirira kwa magazi kupezeka kuti hemoglobin ya glycated idakwezedwa, pamakhala zizindikiro zowonetsa kusintha kwamankhwala a shuga. Kusanthula uku ndikofunikanso kudziwa kufunikira kwa kuwonjezereka kwa mkhalidwe wamatsenga.

Malinga ndi endocrinologists, ndi kuchepetsedwa kwa nthawi ya glycated hemoglobin, chiopsezo cha matenda ashuga nephropathy ndi retinopathy adzachepa pafupifupi theka. Ndiye chifukwa chake ndikofunikira:

fufuzani shuga pafupipafupi,
kutenga mayeso.

Tsoka ilo, mutha kupereka magazi kuti mupeze kafukufuku wotereyu kumalo osungira anthu wamba ndi m'malo azachipatala. Pakadali pano, zipatala za boma sizikhala ndi zida zapadera.

Amayi ambiri amakhala ndi zofunikira pakuwunika pa nthawi yomwe ali ndi pakati, izi ndizofunikira kuti munthu adziwe matenda a shuga.

Nthawi zina kuyesa kumakhala kosadalirika, chifukwa cha izi ndi kuchepa kwa magazi amayi apakati, komanso kufupikitsika kwanthawi yamoyo m'maselo a m'magazi.

Kodi muyeso, mfundo zake ndi za chiyani

Kuti muwone ngati kuchuluka kwa shuga m'magazi ndikwabwinobwino kapena ayi, njira ziwiri zimagwiritsidwa ntchito nthawi yomweyo - ichi ndi muyeso wopanda shuga wa m'mimba komanso kuyesa kwa glucose. Pakadali pano, kuchuluka kwa shuga kumatha kusiyanasiyana, kutengera ndi zakudya zomwe zimamwa ndi zina. Chifukwa chake, matenda a shuga nthawi zonse satha kupezeka munthawi yake.

Njira yabwino ndikuwunikira hemoglobin ya glycosylated, imakhala yothandiza komanso yolondola, 1 ml yokha yotsala magazi a venous amachokera kwa wodwala. Ndikosatheka kupereka magazi wodwalayo atalandira magazi, amuchita opareshoni, popeza zomwe mwapeza zidzakhala zolondola.

Ngati wodwala matenda ashuga ali ndi chida chapadera chofufuzira kunyumba, zitha kuchitidwa kunyumba. Zipangizo zoterezi zapezeka posachedwa kwambiri pochita madokotala ndi zipatala zamankhwala. Chipangizochi chithandiza kukhazikitsa kuchuluka kwa hemoglobin m'magazi amtundu uliwonse wa wodwala patangopita mphindi zochepa:

Kuti chidziwitso chaumoyo chikhale cholondola, muyenera kutsatira malangizo ogwiritsira ntchito chipangizocho.

Glycosylated hemoglobin wokwera kuphatikiza pa shuga imawonetsa kuchepa kwa mchere. Mlingo wa hba1c, ngati ukuyambira pa 5.5 ndikutha pa 7%, akuwonetsa mtundu woyamba wa matenda ashuga. Kuchuluka kwa zinthu kuyambira 6.5 mpaka 6.9 kukufotokoza za kupezeka kwa hyperglycemia, ngakhale zili choncho ndikofunikira kuperekanso magazi.

Ngati palibe hemoglobin yokwanira mu kusanthula, adokotala adzazindikira hypoglycemia, ndipo izi zitha kuwonetseranso kupezeka kwa hemolytic anemia.

Glycosylated hemoglobin

Mwa munthu wathanzi, mlingo wa hemoglobin wa glycated umachokera ku 4 mpaka 6.5% ya hemoglobin yonse. Mu mtundu 2 wa shuga, kuwunika kukuwonetsa glycogemoglobin kangapo. Kuti achepetse vutoli, choyambirira, akuwonetsedwa kuti atenga zonse zomwe zingatheke kuti achepetse glycemia, pokhapokha ngati izi zingatheke kusintha momwe amathandizira odwala matenda ashuga, kuti akwaniritse gawo la hemoglobin lomwe akufuna kupezeka.

Zatsimikiziridwa mwasayansi kuti pamene kuchuluka kwa hemoglobin ya glycated kuli pafupifupi 1%, shuga amalumphira pomwepo mpaka 2 mmol / L. Ndi glycated hemoglobin yachuluka mpaka 8%, mfundo za glycemia zimachokera ku 8.2 mpaka 10.0 mmol / L. Poterepa, pali zisonyezo zakusintha kwa kadyedwe. Hemoglobin 6 yachilendo.

Pamene glycated hemoglobin chizolowezi cha shuga chikuwonjezeka ndi 14%, izi zikuwonetsa kuti 13-20 mmol / L ya glucose ikuzungulira mu magazi. Chifukwa chake, ndikofunikira kufunafuna chithandizo cha madokotala mwachangu momwe mungathere, vuto lofananalo limatha kukhala lovuta komanso lopangitsa zovuta.

Chizindikiro chachindunji cha kuwunikira kumatha kukhala chizindikiro chimodzi kapena zingapo:

kuwonda popanda chifukwa,
kulimbikira kumva kutopa
kukamwa kosalekeza, ludzu,
kukodza pafupipafupi, kuchuluka kwambiri kwamkodzo.

Nthawi zambiri, zikamera ndi kukhazikika kwa ma pathologies osiyanasiyana zimagwirizanitsidwa ndi kuwonjezeka kwa shuga. Odwala omwe ali ndi kuthamanga kwa magazi komanso kunenepa kwambiri kosiyanasiyana kosiyanasiyana amatha kugwidwa ndi izi.

Odwala amakakamizidwa kumwa mankhwala kuti awonjezere zovuta zawo, chifukwa odwala matenda ashuga ndikofunikira. Pali kuthekera kwakukulu kwamavuto a shuga wamagazi opanda cholowa, komwe ndiko kudziwikiratu kwa matenda a kagayidwe kachakudya ndi matenda ashuga.

Pamaso pa zinthu izi, ndikofunikira kuti magazi azisungunuka nthawi zonse. Kusanthula kunyumba kukuwonetsedwa ngati kuli kofunikira, kuwunika kwathunthu kwa thupi, ndi zovuta zotsimikizika za metabolic, pamaso pa pathologies a kapamba.

Mutha kupeza zotsatira zenizeni zowunikira pokhapokha ngati zofunika zina pamaphunziro zikwaniritsidwa, izi:

Amapereka magazi pamimba yopanda kanthu, chakudya chomaliza sichikhala mochedwa kuposa maola 8 chisanachitike, amamwa madzi oyera opanda mpweya,
Masiku angapo asanalembedwe magazi, amasiya mowa ndi kusuta,
Musanapendeke, musataye chingamu, tsukani mano.

Ndizabwino kwambiri ngati mungasiye kugwiritsa ntchito mankhwala onse musanayese matenda a glycated hemoglobin a shuga. Komabe, simungachite izi nokha, muyenera kufunsa dokotala.

Ubwino ndi kuipa kwa kusanthula

Kuyesedwa kwa magazi kwa hemoglobin ya glycated kuli ndi zabwino komanso zovuta zake. Chifukwa chake, kuwunikaku kumathandizira kukhazikitsa matendawa molondola momwe angathere kumayambiriro kwa chitukuko chake, zimachitika pang'onopang'ono mphindi, sizipereka kukonzekera kwakukulu.

Kuyesedwa kukuwonetsa bwino kukhalapo kwa hyperglycemia, kutalika kwa matendawa, momwe wodwalayo amalamulirira kuchuluka kwa shuga m'magazi. Komanso, zotsatira zake zimakhala zolondola ngakhale pali zovuta zamavuto, kupsinjika ndi kuzizira. Mutha kupeleka magazi mukamamwa mankhwala ena ake.

Ndikofunikanso kuwonetsa zovuta za njirayi, zimaphatikizapo kukwera mtengo kwa phunzirolo, ngati tiyerekeza ndi kutsimikiza kwa shuga m'magazi m'njira zina. Zotsatira zake zimatha kukhala zolakwika ngati pali kuchepa kwa magazi m'thupi la shuga kapena hemoglobinopathy.

Kusanthula kwa hemoglobin ya glycated kungakhale kolakwika ngati wodwala pambuyo pake atenga zochuluka:

ascorbic acid
vitamini E.

Muyenera kudziwa kuti zisonyezo zimachulukanso ngakhale ndi shuga wabwinobwino wamagazi, izi zimachitika ndi mahomoni ambiri a chithokomiro.

Endocrinologists amati ndi mtundu 1 wa shuga, magazi amaperekedwa kwa glycated hemoglobin osachepera kanayi, matenda a shuga a 2 amafunika kuyesedwa pafupifupi kawiri. Odwala ena amatha kuzindikira zambiri, motero amapewa kuyesa mayeso kuti asachite mantha kwambiri komanso kuti asawunike kwambiri. Pakadali pano, mantha otere sadzabweretsa chilichonse chabwino, matendawa apita patsogolo, shuga wamagazi amadzuka mwachangu.

Ndikofunikira kwambiri kuyezetsa magazi mukakhala ndi pakati, ndi hemoglobin yochepetsedwa:

kukula kwa fetal kumachitika
chizindikirochi chitha kupangitsa kuti mayi athetse pakati.

Monga mukudziwa, kubereka mwana kumafuna kuwonjezereka kwa zinthu zomwe zimakhala ndi chitsulo, apo ayi zomwe zili ndi glycated hemoglobin ndizovuta kuzilamulira.

Ponena za odwala a ana, hemoglobin yayitali imakhalanso yowopsa kwa iwo. Komabe, ngakhale chizindikirochi chikupitilira 10%, ndizoletsedwa kuchepetsa msanga, apo ayi kugwa kwakuthwa kudzachepetsa kuwona. Amawonetsedwa kusintha kwa glycogemoglobin pang'onopang'ono.

Kanemayo munkhaniyi ayankhula za mawonekedwe a kusanthula kwa glycated hemoglobin.

Imakhazikika pamisempha ya shuga kwa nthawi yayitali
Zimabwezeretsa kupanga kwa insulin

Kufotokozera kwapfupi

Dzina la Protocol: Matenda a shuga ndi mtundu II ndi II

Code Protocol:

Khodi (ma) ICD-10:
E 10, E 11

Zifupikitso zomwe zimagwiritsidwa ntchito pa protocol:
Type 2 matenda a shuga a mtundu 2,
Mtundu woyamba wa matenda ashuga 1
HbAlc - glycosylated (glycated) hemoglobin
IR - kukana insulini
NTG - kulolerana kwa shuga
NGN - kuphwanya glycemia
SST - kuchepetsa shuga
UIA - microalbuminuria
RAE - Russian Association of Endocrinologists
ROO AVEC - Association of Endocrinologists of Kazakhstan
ADA-American Diabetes Association
AACE / ACE -American Association of Clinical Endocrinologists ndi American College of Endocrinology
EASD- European Diabetes Association
IDF - International Diabetes Federation.

Tsiku Lachitukuko cha Protocol: 23.04.2013

Gulu la Odwala:

Ogwiritsa Ntchito Protocol: endocrinologists, akatswiri azachipatala, akatswiri azamankhwala

Chizindikiro chosagwirizana ndi chidwi: ayi

Glycosylated hemoglobin kuchuluka kwa odwala wathanzi komanso odwala matenda ashuga

Mulingo wa hemoglobin wa glycated (Hb) umawonetsa kuchuluka kwa shuga kwa nthawi yayitali ndipo amatchedwa HbA1C. Glycosylated hemoglobin ndi kuphatikiza kwa glucose ndi hemoglobin.

Kuwerenga izi ndikofunikira kuti tidziwe kuchuluka kwa hemoglobin yomwe imawonetsedwa m'magazi, yomangidwa mosakanikirana ndi mamolekyulu a shuga.

Kusanthula uku ndikofunika kwa azimayi onse, abambo ndi ana kuti azindikire njira yoyambira ya shuga mu mtundu wachiwiri kapena woyamba, ngati munthu ali ndi matenda amisala, kapena ngati pali malingaliro okayikitsa (kapena prerequisites) pakukula kwa matenda ashuga.

Zolemba ndi momwe mungayesere glycosylated Hb

Kusanthula uku ndikwabwino kwambiri kwa onse madokotala ndi odwala. Muli ndi maubwino omveka bwino poyeserera shuga m'magazi ndi kuyesedwa kwa maola awiri shuga. Mapindu ake ndi awa:

Kutsimikiza kwa kusanthula kwa glycosylated Hb kumatha kuchitika nthawi iliyonse yamasana, osati sutra komanso pamimba yopanda kanthu,
Pankhani ya njira yodziwira, kuwunika kwa glycosylated Hb ndikofunikira kwambiri kuposa kuyesa kwa labotale kusala kwa shuga mumagazi mu sutra yachangu, chifukwa chimalola kudziwa matenda ashuga kumayambiriro kwa chitukuko,
Kuyesedwa kwa glycosylated Hb kumakhala kosavuta komanso kosavuta kuposa kuyesa kwa glucose maola awiri,
Chifukwa cha zidziwitso za HbA1C zomwe mwapeza, ndizotheka kuti pamapeto pake muzindikire kukhalapo kwa matenda ashuga (hyperglycemia),
Kuyesedwa kwa matenda a glycosylated Hb kuwonetsa momwe wodwala matenda ashuga awonera mokhulupirika shuga m'miyezi itatu yapitayo,
Chokhacho chomwe chingakhudze kutsimikiza kolondola kwa milingo ya glycosylated Hb ndi kuzizira kapena kupsinjika kwaposachedwa.

Zotsatira zoyesedwa za HbA1C sizimayimira zinthu monga:

nthawi ya tsiku ndi tsiku la kusamba kwa msambo kwa akazi,
chakudya chomaliza
kugwiritsa ntchito mankhwala, kupatula mankhwala a shuga,
zolimbitsa thupi
mkhalidwe wamaganizo wamunthu
zotupa zopatsirana.

Kusiyana kwazomwe zikuchitika pakati pa anthu

Mwa ana ndi achinyamata, zizindikiro sizimasiyana konse. Ngati mwa ana mulingo wokwezeka kapena wocheperapo, ndiye kuti kuyenera kuyang'anitsitsa zakudya za ana, kuwakonzekeretsa mayeso a nthawi zonse kuti zotsatira za kuwunika zikhale zowonjezera kapena zosakwanira.
Amuna ndi akazi alibe kusiyana kulikonse.
Mwa amayi apakati, sibwino kutenga HbA1C kwa miyezi 8-9 yoyembekezera, chifukwa nthawi zambiri zotsatira zimachulukidwa, koma izi ndizolakwika.
M'mapeto omaliza a mimba, kuwunika pang'ono pang'onopang'ono kumakhala kwabwinobwino. Kupatuka kwa zizindikiro za matenda ashuga panthawi yakubala kwa ana kumatha kusokoneza thanzi la mayi wamtsogolo pakubadwa kwa mwana. Impso zimatha kuvutika, ndipo m'tsogolo ana okhala ndi intrauterine Development, kukula kwambiri kwa thupi kumawonedwa, zomwe zimapangitsa kuti pakhale kubereka.

Mitundu yamatchulidwe

Mwa munthu wathanzi, HbA1C sayenera kupitirira 5.7 peresenti m'magazi.

Ngati zomwe zili pamwamba zimachokera ku 5.7% mpaka 6%, ndiye izi zikuwonetsa kuti matendawa angachitike m'tsogolo. Kuti chizindikirocho chikhale chotsika, muyenera kusinthana ndi zakudya zamafuta ochepa kwakanthawi, kenako ndikuchita kafukufuku wachiwiri. M'tsogolomu, tikulimbikitsidwa kuwunika bwino thanzi lanu komanso thanzi lanu. Izi zikufunika kuwunika mosamala kunyumba ndi mu labotale.
Ngati nambala ya zonena ikuchokera ku 6.1-6.4%, ndiye kuti chiwopsezo cha matenda kapena metabolic syndrome ndichokwera kwambiri. Simungachedwe kusinthaku kukhala chakudya chamoto chochepa, muyenera kutsatira moyo wathanzi. Izi sizovuta kuzikonza nthawi yomweyo, koma ngati mumatsatira zakudya zoyenera moyo wanu wonse, ndiye kuti mutha kupewa matenda.
Ngati mulingo wa HbA1C wapitilira 6.5%, ndiye kuti matenda oyambitsidwa amakhazikitsidwa - matenda a shuga, kenako pamayeso ena a Laborator amapezeka kuti ndi a mtundu wanji, woyamba kapena wachiwiri.

Matenda a hemoglobin

Choyamba, muyenera kudziwa kuti kuchuluka kwa magazi m'magazi kungangotanthauza matenda obwera chifukwa cha kuperewera kwa thupi, komanso kuchepa kwa magazi m'thupi. Kuti musatenge matenda oopsa, ndikofunikira mukayezetsa magazi a glycosylated hemoglobin ndikuonetsetsa kuti mulingo wambiri wachitsulo m'thupi.

Ngati zomwe zikuyimira zachitsulo zidatsika kukhala zocheperapo kuposa momwe zimakhalira, ndiye kuti mankhwalawo amathandizidwa kuti abwezeretsenso zinthu zomwe zimapezeka mthupi. Pambuyo mankhwalawa kuchepa magazi m'thupi, ndikofunikira kuti mupange kuyesa kwina kwa hemoglobin.

Ngati kuchepa kwachitsulo sikunapezeke, ndiye kuti kuwonjezeka kwa nkhaniyi kudzalumikizidwa kale ndi carbohydrate metabolism.

Malinga ndi ziwerengero, chifukwa chachikulu chakuwonjezeka kwa glycosylated hemoglobin mu hypergikemia. Potere, kuti muchepetse kuchuluka kwadzaoneni, muyenera:

kutsatira mosamalitsa chithandizo chamankhwala omwe adokotala amapita,
gwiritsitsani chakudya chamafuta ochepa
mumayesedwe pafupipafupi.

Ngati mtengo wa HbA1C uli pansipa, ndiye kuti izi zikusonyeza hypoglycemia. Hypoglycemia imachitika kawirikawiri kwambiri kuposa hyperglycemia.

Izi zimafunikanso kukonza kwambiri pakudya ndikutsatira mosamalitsa pamankhwala omwe wodwala amapita. Mtengo wotsika wa HbA1C ungathenso kuwonetsa magazi a hemolytic.

Ngati munthu wapatsidwa magazi posachedwa kapena wachepetsa magazi, mtengo wa HbA1C umathandizidwanso.

Glycated hemoglobin: chizoloŵezi cha matenda ashuga, kupatuka

Odwala nthawi zambiri amakumana ndi chofunikira chofuna kudziwunikira pawokha za matenda awo. Vutoli silimangokhudza matenda ashuga okha.

Choyamba, muyenera kumvetsetsa mawuwa, popeza olemba osiyanasiyana komanso zida zosiyanasiyana amapereka mayina osiyanasiyana pachizindikirochi, mwa omwe glycated hemoglobin ndi glycosylated hemoglobin amakhala ponseponse, zomwe zili mu shuga ndizofanana ndi anthu athanzi.

Mwachidule, amathanso kutchedwa HbA1c - umo ndi momwe ma labotale azachipatala amawasankhira momwe amapangira mayeso.

Zomwe amawunikira zikuwonetsa

Ndikofunikira kuti mudzaze mipata yokhudzana ndikumatha kuthana ndi hemoglobin wamba komanso glycosylated.

Hemoglobin imapezeka m'maselo ofiira a m'magazi - maselo ofiira a m'magazi omwe amanyamula mpweya ku ziwalo ndi minyewa. Chachilendo chake ndikuti zimamangiriza shuga chifukwa cha pang'onopang'ono non-enzymatic reaction, ndipo chomangira ichi sichingasinthike. Zotsatira zake zimachitika ndi glycosylated hemoglobin. Mu biochemistry, izi zimatchedwa glycation kapena glycation.

Mochulukitsa kuchuluka kwa shuga m'magazi, kuthamanga kwambiri kwa izi. Mlingo wa glycation umawonedwa kwa masiku 90-120, omwe umalumikizidwa ndi nthawi yayitali ya maselo ofiira amwazi.

Mwanjira ina, chizindikiro chimakupatsani mwayi wowunika kuchuluka kwa shuga m'thupi masiku 90-120 kapena kuwerengera mulingo wa glycemia panthawi yomweyo.

Pambuyo pa nthawi imeneyi, maselo ofiira m'magazi amasinthidwa, chifukwa chake, kuchuluka kwa hemoglobin ya glycosylated.

Kutalika kwa moyo wa erythrocyte kukusonyeza kuti sizomveka kupenda wodwala kuti amupatse hemoglobin kopitilira kamodzi pamiyezi 3-4.

Kukula kwa chizindikiro mwa munthu wathanzi

Makhalidwe abwinobwino a chizindikirochi kwa munthu wathanzi amadziwika kuti amapeza 6%. Zoyenerazi ndizothandiza kwa zaka komanso mtundu uliwonse. Malire otsika a chizolowezi ndi 4%. Zotsatira zonse zomwe zimapitilira izi ndi ma pathologies ndipo zimafuna kuwunikira mwatsatanetsatane zomwe zimayambitsa kuchitika.

Amayambitsa kuchuluka kwa hemoglobin wa glycated

Ngati zotsatira zimapezeka ndi kuchuluka kwa chizindikiro ichi, muyenera kuganizira za hyperglycemia yomwe imakhala nthawi yayitali. Koma sizitanthauza kuti nthawi zonse wodwala amadwala matenda ashuga, chifukwa zinthu zina zimawonekera pakati pa zovuta za kagayidwe kazakudya,

kulolerana kwa chakudya chamafuta,
kusala kudya kwa shuga kagayidwe.

Kuzindikira kwa matenda ashuga kumapangidwa pomwe zotsatira zake zimaposa 7%. Zotsatira zake, manambala ochokera ku 6.1% mpaka 7.0% akapezeka, ndiye kuti tikulankhula za predibyte, ndiye kuti, kulolerana kwa zakudya zamafuta kapena kusala kudya kwa glucose.

Zimayambitsa kuchepa kwa glycated hemoglobin

Ngati zotsatirazi ndizotsika kuposa 4%, izi zikutanthauza kuti munthu amakhala ndi shuga wochepa magazi kwa nthawi yayitali, zomwe sizotalikirana nthawi zonse ndi zizindikiro za hypoglycemia. Nthawi zambiri, izi zimapangitsa insulinoma - chotupa mumsempha wa kapamba yemwe amapanga insulini kuposa momwe amafunikira.

Chimodzi mwazinthu zomwe zachitika pamenepa ndi kusowa kwa insulin, chifukwa ngati pali imodzi, ndiye kuti magazi a magazi sangatsike bwino, chifukwa chake, boma la hypoglycemic silidzakula.

Werengani komanso Top Glucometers za 2015

Kuphatikiza pa insulinomas, kuchepa kwa glycemia ndi kuchepa kwa zotsatira za hemoglobin ya glycosylated:

Zakudya zamafuta ochepa kwa nthawi yayitali,
mankhwala osokoneza bongo a insulin kapena mankhwala antidiabetesic,
kuchita masewera olimbitsa thupi mopitirira malire
adrenal kusowa
ma genetic ena osowa - chibadwa cha fructose tsankho, matenda a Herce ndi ena.

Glycosylated Hemoglobin Assay

Mu 2011, World Health Organisation idaganiza zogwiritsa ntchito glycosylated hemoglobin ngati njira yodziwira matenda a shuga.

Ngati chiwerengerochi chadutsa 7,0%, kuzindikira kwake sikungakayikire.

Ndiye kuti, ngati mayesowo adawonetsa glycemia wokwera komanso kuchuluka kwa HbA1c kapena HbA1c yowonjezera kawiri pakatha miyezi itatu, kuzindikira kwa matenda ashuga kumakhazikitsidwa.

Matenda a shuga

Zimachitikanso kuti kufufuza kumeneku kumawerengedwa kwa odwala omwe ali kale ndi vutoli. Amapangidwa kuti azitha kuchepetsa shuga m'magazi ndikusintha Mlingo wa mankhwala ochepetsa shuga.

Nthawi zambiri zimachitika kuti anthu omwe ali ndi matenda a shuga a 2 samakonda kuwongolera milingo ya matendawa.

Izi nthawi zambiri zimachitika chifukwa choti alibe mita yamagalamu kapena ma labotale amakhala kutali kwambiri ndi komwe amakhala.

Chifukwa chake, amawerengera kangapo pamwezi kapena mochepera, ndipo ngati angapeze zotsatira zake moyenera, amaganiza kuti amatha kuwongolera shuga awo. Komabe, izi sizowona konse, popeza kuyezetsa magazi kwa shuga kumawonetsa glycemia kokha panthawi yakumwa magazi, pomwe odwala oterowo sakudziwa mulingo wawo wa postprandial glycemia.

Chifukwa chake, njira yoyenera yoyendetsera glycemic ndiyo kukhalapo kwa glucometer podziyang'anira pawokha glycemic.

Mbiri ya glycemic imaphatikizapo kuwunikira pamimba yopanda kanthu, ndiye musanadye chilichonse komanso maola awiri mutatha kudya komanso pogona.

Ndiko kuwongolera kumeneku komwe kumakupatsani mwayi wowunika wokwanira kuchuluka kwa glycemia ndikuwongolera kugwiritsa ntchito mankhwala a hypoglycemic.

Pakapanda kuwongolera glycemic moyenera, hemoglobin ya glycosylated imabwera kudzapulumutsa, kuwunika chizindikiro ichi m'miyezi itatu yapitayo. Pankhani ya kuchuluka kwa chizindikiro ichi, pamafunika kuchitapo kanthu kuti muchepetse.

Kuyeza kumeneku ndikothandiza kwa anthu odwala matenda ashuga amtundu woyamba, omwe glycosylated hemoglobin amawonetsa kukhalapo kapena kusowa kwa chipukutiro cha matenda. Zowonadi, ngakhale ndi mbiri yabwino ya glycemic, chizindikiritso cha HbA1c chikhoza kukhala chokwanira, chomwe chikufotokozera kukhalapo kwa nocturnal hyperglycemia kapena hypoglycemic ezvinhu ndi chiphuphu chotsatira cha hyperglycemic.

Masewera a Glycosylated Hemoglobin

Sikuti wodwala aliyense amafunika kutsitsa hemoglobin wa glycated kwa munthu wathanzi. Pali odwala ena omwe zimakhala bwino ngati chiwopsezocho chikuwonjezeka pang'ono. Izi zikuphatikiza okalamba ndi odwala omwe akumana ndi zovuta zina. Glycated hemoglobin, chizoloŵezi cha matenda a shuga pankhaniyi chizikhala pafupifupi 8%.

Kufunika kwa mulingo wotere kumachitika chifukwa chakuti pothana ndi zisonyezo zochepa za kusanthula kumeneku, zoopsa zomwe zingayambitse matenda a hypoglycemic, omwe mu ukalamba ndi owopsa kwa wodwala, akhoza kuchuluka. Achinyamata amawonetsedwa kuwongolera kwamphamvu, ndipo ayenera kuyesetsa kwa 6.5% popewa kukula kwa zovuta za matendawa.

Ngati manambala ambiri amapezeka pang'onopang'ono (10% ndi apamwamba), ndiye kuti ndikulimbikitsidwa kuwunikanso njira zanu za matenda ashuga komanso momwe mungachitire kuti mukhale ndi thanzi.

Komabe, ziyenera kukumbukiridwa kuti sikofunikira kuyeserera kutsika kwakukulu kwa chizindikiro ichi, koma, m'malo mwake, chitani pang'onopang'ono, pa 1-1,5% pachaka.

Izi ndichifukwa choti thupi la munthu wotere limazolowera kuchuluka kwa glycemia ndipo zovuta zidayamba kale kupanga m'matumba ang'onoang'ono (maso ndi impso).

Werengani komanso Kodi mawonekedwe a acetone mu mkodzo wa wodwala matenda ashuga

Ndi kuchepa kwambiri kwa glucose, vuto la m'mimba limatha kukhazikika, pomwepo, lingayambitse kuchepa kwambiri kwa ntchito ya impso kapena kusawona. Izi zimatsimikiziridwa mwasayansi, komanso kuti kusinthasintha pamlingo wa glycemia m'malire mpaka 5 mmol / l sikumayambitsa kukula koopsa kwa zovuta zamitsempha.

Ndiye chifukwa chake kuwongolera koyenera kwa glycosylated hemoglobin pamodzi ndi mbiri ya glycemic kwa odwala omwe ali ndi mitundu yonse ya shuga ndikofunikira, chifukwa pakakhala kuti palibe kuyendetsa bwino, munthu samadziwa kuchuluka kwa shuga komwe kumakwera ndikutsika mwa iye.

Kodi kusanthula kumaperekedwa bwanji?

Kuti mudziwe chizindikiro ichi, ndikofunikira kupereka magazi kuchokera m'mitsempha. Nthawi zambiri kuunikako kumatha kuchitika ku chipatala, koma si ma labotale onse m'mabungwe a boma omwe amachita. Chifukwa chake, zitha kuchitidwa mu labotale yokhayokha, ndipo kuwongolera sikofunikira.

Nthawi zambiri, ma laboratories amalimbikitsa kupereka magazi pamimba yopanda kanthu, chifukwa akatha kudya magazi amasintha kapangidwe kake. Koma kuti muwone chizindikiritso ichi, zilibe kanthu kuti mungabwere kudzadya pamimba yopanda kanthu kapena mukatha kudya, chifukwa imawonetsa glycemia wapakati kwa miyezi itatu, ndipo osati pakadali pano.

Komabe, ndibwino kupita ku labotale popanda chakudya cham'mawa, kuti muchepetse zovuta zowunikiranso ndikusinthanso ndalama. Kudzinyenga sikutanthauza kukonzekera.

Nthawi zambiri zotsatira zimakhala zokonzeka m'masiku ochepa, koma pali zida zapadera - clover, zomwe zimapereka zotsatira mu mphindi 10. Kulondola kwa chipangizocho ndiwokwera kwambiri, pafupifupi 99%, komanso kulakwitsa pang'ono.

Nthawi zambiri, magazi amatengedwa kuchokera mu mtsempha, koma pali njira zina zochotsetsa magazi kuchokera pachala. Omalizawa amatanthauza zida za clover.

Momwe mungachepetse glycosylated hemoglobin

Kutsika kwa magwiridwe a kusanthula kumeneku kukugwirizana mwachindunji ndikusintha kwa shuga komanso kuchepa kwa mbiri ya glycemic. Ndikofunikira kutsatira malangizo a adotolo pankhani ya chithandizo cha matenda ashuga. Malangizowa akuphatikizapo:

kutsatira malangizo azakudya,
kudya kwakanthawi kake ndi kuyamwa kwa mankhwala ochepetsa shuga,
magulu olimbitsa thupi
Kutsatira ndi zochitika za tsiku ndi tsiku
kudziletsa kwa glycemia kunyumba.

Ngati zadziwika kuti kutsatira malangizo omwe ali pamwambapa kumapereka zotsatira zabwino komanso kuchuluka kwa glycemia kunayamba kuchepa, komanso kukhala bwino, ndiye kuti wodwalayo ali m'njira yoyenera. Mwinanso, kuwunika kotsatira kudzakhala kwabwino kuposa koyambirira.

Malingaliro achidule

Kusanthula kwa HbA1c sikuyenera kutengedwanso pafupipafupi, koma osachepera kamodzi pamiyezi itatu iliyonse.
Kusanthula sikungakhale njira yongowunikira shuga wama gluceter kapena labotale.

Kutsika kwakukulu kwa chizindikirocho sikulimbikitsidwa.

Mulingo woyenera wa HbA1c sizitanthauza kuti glycemia yanu idalinso yabwino.

Muyenera kuyeserera gawo lanu la HbA1c.

Izi ndizofunikira kwambiri pakuwongolera glycemia komanso kukwanira kwa chithandizo chamankhwala.

Glycosylated Hemoglobin - Mwachizolowezi

Glycosylated hemoglobin (glycosylated hemoglobin) ndi hemoglobin yamagazi ofiira omwe amakanika ku glucose.

Zomwe zidapangidwazo:

Glycated hemoglobin (glycated hemoglobin)
Glycogemoglobin (glycohemoglobin)
Hemoglobin A1c (hemoglobin A1c)

Hemoglobin-Alpha (HbA), yomwe ili m'magazi ofiira amunthu, polumikizana ndi shuga wamagazi "imadzipereka yokha" - imachita glycosylates.

Mukakhala ndi shuga m'magazi ambiri, glycosylated hemoglobin (HbA1) yomwe imatha kupanga maselo ofiira m'moyo wake wamasiku 120. Maselo ofiira a "mibadwo" yosiyanasiyana amayendayenda m'magazi nthawi yomweyo, masiku 60-90 amatengedwa nthawi yayitali ya glycation.

Mwa zigawo zitatu za glycosylated hemoglobin - HbA1a, HbA1b, HbA1c - yotsiriza ndiyokhazikika kwambiri. Kuchuluka kwake kumatsimikiziridwa mu ma laboratori azachipatala.

HbA1c ndi chisonyezo chamwazi chamagazi chomwe chimawonetsa kuchuluka kwa glycemia (kuchuluka kwa glucose m'magazi) m'miyezi isanu ndi umodzi yapitayo.

Kuyesedwa kwa magazi kwa HbA1c - muyezo, momwe mungatengere

Kuyesedwa kwa glycosylated hemoglobin ndi njira yodalirika yayitali yogwiritsira ntchito shuga wanu wamagazi.

Kuwunika kwa glycemia mwa odwala matenda a shuga.

Kuyesedwa kwa HbA1c kumakupatsani mwayi wofufuza momwe chithandizo cha matenda ashuga chimachitikira - ngakhale ziyenera kusinthidwa.

Kuzindikira koyambira kwa magawo a shuga (kuphatikiza pa kuyesedwa kwa shuga).
Kuzindikiritsa "shuga woyembekezera."

Palibe kukonzekera kwapadera kwa magazi a HbA1c komwe kumafunikira.

Wodwalayo amatha kupereka magazi kuchokera mu mtsempha (2,5-3.0 ml) nthawi iliyonse masana, mosasamala kanthu za kudya, nkhawa / kupsinjika, kapena mankhwala.

Zifukwa zabodza:
Kutaya magazi kwambiri kapena zinthu zomwe zimakhudza njira yopangira magazi ndi chiyembekezo chokhala ndi maselo ofiira am'magazi (cell cell, hemolytic, kuchepa kwazitsulo, etc.), zotsatira za kusanthula kwa HbA1c zitha kukhala zabodza.

Mlingo wa hemoglobin wa glycosylated ndi wofanana kwa azimayi ndi abambo.

/ zonena /
HbA1c = 4,5 - 6.1%
Zofunikira za HbA1c za matenda ashuga

Gulu la odwala	Mulingo woyenera wa HbA1c
Type 1 ndi Type 2 Diabetes
Odwala a 2 matenda a shuga omwe ali pachiwopsezo chachikulu cha matenda amtima

Mtengo wa HbA1c> 7.0-7.5% mwa odwala omwe ali ndi matenda osokoneza bongo amawonetsa kusagwira / kusakwanira kwa mankhwalawa - pali chiwopsezo chachikulu chokhala ndi zovuta za matenda ashuga.

Kuyesedwa kwa HbA1c - decryption

HBA1s%	Shuga wamba wamagazi masiku 90 apitawo Mmol / l	Kutanthauzira
* Sankhani phindu HbА1с	2,6	Malire otsika

Ngati mukumva ludzu pafupipafupi, kusanza, kugona, komanso kuvutika kukodza pafupipafupi, perekani magazi kwa HbA1c ndi kukaonana ndi endocrinologist.

Odwala omwe ali ndi matenda a shuga amalimbikitsidwa kuti adziwe kuchuluka kwa hemoglobin ya glycosylated pakapita miyezi iwiri iliyonse. Chithandizo cha matenda ashuga chimawerengedwa kuti chipambana ngati kuli kotheka kukwaniritsa ndikusunga mfundo za HbA1c pamlingo woyenera - zosakwana 7%.

Kusanthula kwa glycated hemoglobin: mu ana, zimayambitsa kupatuka kwa zizindikiro ndi njira zawo

Glycated hemoglobin (yemwenso imatchedwa glycosylated) ndi gawo la hemoglobin m'magazi lomwe limalumikizidwa mwachindunji ndi glucose.

Chizindikiro ichi chimayezedwa ngati peresenti. Shuga wambiri amapezeka m'magazi, omwe amawonjezereka.

Muyezo wa hemoglobin wa glycated mwa ana umafanana ndi zomwe munthu wamkulu amachita. Ngati pali kusiyana, ndiye kuti nthawi zambiri pamakhala zopanda pake.

Kodi ichi ndi chiyani?

Chizindikirochi chimathandizira kuwonetsa shuga m'magazi kwa miyezi itatu.

Izi ndichifukwa choti nthawi yayitali ya moyo wama cell ofiira omwe hemoglobin imakhala ndi miyezi itatu kapena inayi. Kuchepa kwa zovuta kumakulira ndi kukula kwa zizindikiro zomwe zimapezeka chifukwa cha kafukufuku.

Ngati chizindikiro monga glycated hemoglobin, chizoloŵezi cha matenda a shuga kwa ana ndichurukirapo, ndikofunikira kuyamba chithandizo.

Zopindulitsa

Kuyesedwa kwa glucose hemoglobin kuli ndi mapindu angapo pakuyesa kukhulupirika kwa shuga, komanso kuyesedwa kwa magazi musanadye:

kulondola kwa zotsatira sizikhudzidwa ndi zinthu monga chimfine kapena nkhawa,
imakupatsani mwayi wodziwa matenda poyambira,
kufufuza kumachitika mwachangu, mophweka ndipo nthawi yomweyo amayankha funso ngati akudwala kapena ayi,
kusanthula kumakupatsani mwayi wofufuza ngati wodwalayo anali ndi mphamvu zowongolera shuga.

Chifukwa chake, nthawi ndi nthawi ndikofunikira kuyesedwa ndi anthu athanzi. Izi ndizofunikira kwambiri kwa iwo omwe ali pachiwopsezo, mwachitsanzo, ndi onenepa kwambiri kapena amakonda kuchita matenda oopsa. Phunziroli limapangitsa kuti azindikire matendawa zisanachitike zizindikiritso zoyambirira. Kwa ana, kusanthula uku ndikofunika kwambiri kudziwa kuwopsa kwa zovuta zomwe zingachitike.

Ngati glycogemoglobin imaposa nthawi yayitali kwa nthawi yayitali, komanso ngati ikukula pang'onopang'ono, madokotala adzazindikira matenda a shuga.

Mulingo ukatsitsidwa, umatha kuchitika pazifukwa monga kuthiridwa magazi, kuchitidwa opareshoni, kapena kuvulala. Pazinthu izi, chithandizo choyenera chimaperekedwa, ndipo patapita kanthawi zizindikilo zimabwereranso.

Mitundu ya hemoglobin ya glycated mwa ana: kusiyana kwa mawonekedwe

Ponena za chizindikiro monga glycosylated hemoglobin, muyezo wa ana ndi kuyambira 4 mpaka 5.8-6%.

Ngati zoterezi zimapezeka chifukwa cha kusanthula, izi zikutanthauza kuti mwana samadwala matenda ashuga. Komanso, izi sizimatengera zaka za munthu, jenda, komanso nyengo yomwe akukhalamo.

Zowona, pali chimodzi chimodzi. Mu makanda, m'miyezi yoyambirira ya moyo wawo, kuchuluka kwa glycogemoglobin kumatha kuchuluka. Asayansi amati izi zimachitika chifukwa chakuti fetog hemin imapezeka m'magazi a akhanda. Izi ndizosakhalitsa, ndipo pofika chaka chimodzi ana awachotsa. Koma malire apamwamba sayenera kupitirira 6%, ngakhale atakhala ndi zaka zingati.

Ngati palibe zovuta za kagayidwe kazakudya zam'mimba, chizindikiro sichitha kufika pamwambapa. M'malo pamene hemoglobin ya glycated mwa mwana ndi 6 - 8%, izi zitha kuwonetsa kuti shuga itha kuchepetsedwa chifukwa chogwiritsa ntchito mankhwala apadera.

Ndi glycohemoglobin yokhala ndi 9%, titha kulankhula za kubwezera kwabwino kwa shuga kwa mwana.

Nthawi yomweyo, izi zikutanthauza kuti chithandizo cha matendawa ndichofunika kusintha. Kuchuluka kwa hemoglobin, wochokera ku 9 mpaka 12%, kumawonetsa kuchepa mphamvu kwa zinthu zomwe zimatengedwa.

Mankhwala omwe mumalandira amathandizira pang'ono, koma thupi la wodwala laling'ono limafooka. Ngati mulingo uposa 12%, izi zikuwonetsa kusowa kwa mphamvu yakuwongolera. Pankhaniyi, matenda a shuga kwa ana salipidwa, ndipo chithandizo chomwe chikuchitika sichimabweretsa zotsatira zabwino.

Mlingo wa hemoglobin wa glycated wa mtundu 1 wa shuga mwa ana ali ndi zofanana. Mwa njira, matendawa amatchedwanso matenda a shuga a achinyamata: nthawi zambiri matendawa amapezeka mwa anthu ochepera zaka 30.

Matenda a 2 a shuga ndi osowa kwambiri muubwana. Pankhani imeneyi, kuwunika momwe mwanayo alili ndikofunikira kwambiri, chifukwa pali chiopsezo chachikulu cha njira yachiwiri yodalira insulin. Pankhani yaukali motsutsana ndi minyewa yam'mitsempha, komanso mitsempha yamagazi, imakhala yofanana ndi matenda a shuga 1.

Ndi zazikulu (kangapo) zowonetsera zololeka, pali chifukwa chilichonse chokhulupirira kuti mwana ali ndi zovuta: chiwindi, impso, ndi matenda a ziwalo zamasomphenya. Chifukwa chake, kuyeserera kuyenera kuchitika pafupipafupi, chifukwa kumakupatsani mwayi wowunika momwe mankhwalawo amathandizira.

Matenda a mtundu wa zizindikiro

Tiyenera kukumbukira kuti kupitilira muyeso wa hemoglobin wa glycated kumatha kuwonjezeka onse chifukwa cha kuphwanya kwa kagayidwe kazachilengedwe ndi kuchepa kwa chitsulo.

Ngati pali kukayikira kwa magazi m'thupi, zimakhala zomveka pambuyo poyesa hemoglobin kuti ayang'anire zomwe zili m'thupi.

Monga lamulo, kuchuluka kwa hemoglobin ya glycated mwa ana kumakulitsidwa chifukwa cha hyperglycemia. Kuti muchepetse mulingo uwu, ndikofunikira kutsatira malingaliro onse a dotolo, kutsatira zakudya zochepa zamagulu azakudya ndipo mumabwera pafupipafupi kukayezetsa.

Ngati munthu wapezeka ndi matenda osokoneza bongo kapena zina zomwe zimayenderana ndi kuphwanya kagayidwe kazakudya, ndikofunikira kuyang'anitsitsa zakudya. Izi zikuthandizira kuchepetsa magazi ndikuletsa mavuto.

Masamba, zipatso, nyama yopendekera ndi nsomba ndiye zakudya zabwino kwambiri zothetsera shuga m'magazi

Ndikofunikira kukana chokoleti, maswiti ndi tchizi chamafuta, ndikuwachotsa ndi zipatso ndi zipatso. Mchere ndi kusunthanso amafunikanso kuchotsedwa, koma masamba, nyama yotsika ndi nsomba, mtedza udzalandiridwa. Kwa matenda ashuga amtundu wa 2, yogati yachilengedwe, yopanda mafuta komanso mkaka wamafuta ochepa ndiyothandiza.

Tiyenera kukumbukira kuti kugwetsa msanga shuga msanga kumakhala kwakuopsa pa thanzi la mwana. Izi ziyenera kuchitika pang'onopang'ono, pafupifupi 1% pachaka. Kupanda kutero, lakuthwa ndi kumvetsetsa kwamaso zitha kuwonongeka. Popita nthawi, ndikofunikira kukwaniritsa kuti chizindikiro monga glycated hemoglobin mwa ana sichidutsa 6%.

Ngati index ya HbA1C ili pansipa, ingasonyeze kukula kwa hypoglycemia. Matendawa samachitika pafupipafupi, koma pakuzindikira pamafunika chithandizo chamankhwala mosamalitsa.

Ana aang'ono omwe ali ndi matenda ashuga ayenera kuyang'aniridwa pafupipafupi ndi makolo awo ndi owathandizira. Pansi pa chikhalidwe choyenera kubwezeredwa kwa matenda, wodwala matenda ashuga amakhala pafupifupi wathanzi.

Kodi muyenera kuyesedwa kangati?

Ndikofunikira kudziwa! Popita nthawi, mavuto okhala ndi shuga amatha kubweretsa matenda ambiri, monga mavuto amaso, khungu ndi tsitsi, zilonda zam'mimba, zilonda zam'mimba komanso ngakhale zotupa za khansa! Anthu amaphunzitsa zomwe zinawawa kuti azisintha shuga yawo kuti asangalale ...

Kuchulukitsa kwa mayeso kutengera ndi matendawo.

Ngati chithandizo cha matenda ashuga chayamba kumene, ndikofunikira kuti mukayezetse miyezi itatu iliyonse: izi zikuthandizani kusankha njira yabwino kwambiri yamankhwala.

Ngati muyezo wa hemoglobin wa glycosylated mu ana ukuwonjezeka mpaka 7% pakapita nthawi, kuyesa kungachitike miyezi isanu ndi umodzi iliyonse. Izi zithandizira kuzindikira moyenera nthawi ndikusintha.

Milandu yomwe matenda a shuga sapezeka, komanso zizindikiro za glycogemoglobin zili mkati moyenera, zidzakhala zokwanira kuyeza zizindikiro zaka zitatu zilizonse. Ngati zomwe zili mu 6.5%, izi zikusonyeza kuti pali mwayi wokhala ndi matenda ashuga. Chifukwa chake, ndibwino kumayesedwa kamodzi pachaka, pamene kuli kofunikira kutsatira zakudya zamagulu ochepa.

Makanema okhudzana nawo

Pakuyezetsa magazi kwa hemoglobin ya glycated:

Ndikwabwino kuyesedwa mu labotale yachinsinsi yomwe ili ndi mbiri yabwino komanso malingaliro abwino. Zachipatala za boma sizikhala ndi zida zoyenera pofufuza. Zotsatira zakonzeka masiku atatu. Ayenera kujambulidwa ndi dokotala, kudzizindikira yekha, kuwonjezera pamenepa, pakokha pamakhala mankhwala osavomerezeka.

Kuwongolera kwa HbA1C kapena kuwunika kwa hemoglobin: chizolowezi cha matenda a shuga, kufunika kuyeza kuchuluka kwa glucose pogwiritsa ntchito mayeso ena

Kuwongolera kwathunthu chithandizo cha matenda ashuga komanso dziko momwe mungakhalire ndi endocrine pathology, ndikofunikira kuchita mayeso apadera. Kuyeza kwamasiku onse kwa shuga pogwiritsa ntchito glucometer yachikhalidwe kapena yosasokoneza popanda chala chanu - izi ndi njira zokhazo zomwe zimafunikira.

Pakatha miyezi itatu iliyonse, wodwalayo amayenera kukayezetsa magazi a glycated hemoglobin. Chikhalidwe cha matenda ashuga ndichizindikiro chofunikira. Kutengera ndi malamulo, mfundo sizikupitilira malire ovomerezeka. Madokotala amalimbikitsa odwala matenda ashuga kuti azolowera kudziwa kusiyanasiyana kwa matenda a HbA1C.

Kodi glycated hemoglobin

Thupi limadziunjikira ngati chida chamachitidwe azomwe zimapangidwira amagetsi - glucose, omwe amamangiriza kwa Hb m'maselo ofiira a magazi. Kuchuluka kwa shuga komwe kumadumphira m'magazi kumachitika kwakanthawi, kukwera kwambiri kwa glycogemoglobin.

Malinga ndi endocrinologist, wodwala matenda ashuga ayenera kupenda bwino kuti amvetse bwino za HbA1C.

Kodi hemoglobin ya glycated imawonetsa chiyani? Zotsatira zoyesazi zikuwonetsa kuopsa kwa endocrine pathology komanso kuchuluka kwa chipukutiro, magwiridwe antchito yovuta.

Magazi ochokera pachala chaching'ono cha shuga komanso mayeso ena a glucose omwe ali ndi katundu samapereka chithunzi chonse cha momwe wodwalayo alili, kafukufuku wa kuchuluka kwa HbA1C akuwonetsa momwe kuchuluka kwa glucose kwasinthira m'miyezi itatu yapitayo.

Chizindikiro cha matenda ashuga

Mlingo wa glycogemoglobin zimatengera zinthu zingapo:

Zabwino zonse ndizoyambira pa 4.6 mpaka 5.7%. Zizindikiro za A1C mkati mwa malire awa - kuchuluka kwa glucose sikukwera kuposa zizindikiro zovomerezeka, manambalawa akuwonetsa chiopsezo chochepa cha endocrine pathology. Anthu odwala matenda ashuga ayenera kulimbana ndi shuga kuti azichita bwino.

Palibe machitidwe okhwima a glycogemoglobin a matenda ashuga, koma ndizofunikira ngati mavutowo amapitilira 7-7,5%.

Kumbukirani kuti matendawa amapangidwira pama glucose oposa 6.5% ndipo kuwonjezeraku kumakhala kwakukulira chifukwa cha zovuta zazikulu.

Hyperglycemia ukalamba imakhudza thupi lofooka pafupipafupi, nthawi zambiri limaphatikizidwa ndi kunenepa kwambiri komanso matenda oopsa, chiwopsezo cha matenda a mtima, atherosclerosis, komanso matenda a ischemic.

Ubwino ndi Kuwonongeka kwa Kusanthula

Kafukufuku wokhudza kuchuluka kwa glycogemoglobin amayamikiridwa kwambiri ndi akatswiri:

kuyezetsa kumapereka chidziwitso chochuluka kuposa kutenga magazi kuchokera pachala chala ndikuchita mayeso a shuga (okhala ndi katundu),
ngati pali umboni, kuwunikirako kumatha kuchitika ngakhale mutadya,
chimfine, mphamvu zolimbitsa thupi, mavuto amanjenje samasokoneza zotsatira zoyesa,
musanayambe phunziroli, simuyenera kusiya mankhwala omwe kale ankapereka,
njirayi imakupatsani mwayi wofuna kudziwa matenda omwe ali ndi matenda ashuga, kudziwa momwe amapatukira poyambira,
Kafukufuku akuwonetsa bwino ngati hyperglycemia imayamba,
kusanthula kwakanthawi (kanthawi 4 pachaka) kumakupatsani chithunzi chokwanira cha kuchuluka kwa matenda ashuga komanso kugwiritsa ntchito bwino kwa mankhwalawa.

Zoyipa:

mayesowa ndi ovuta, m'malo ochepa si ma labotor onse omwe ali ndi zida zowunikira A1C,
mtengo wa kafukufukuyu ndiwokwera kuposa zopereka zamagazi kwa shuga kapena mayeso ena a shuga,
motsutsana ndi mbiri ya hemoglobinopathy ndi kuchepa magazi, zotsatira zolakwika ndizotheka,
kuwonjezeka kwa glycogemoglobin mfundo ndi kuwunika kolakwika kwa zotsatira zake ndizotheka kwa odwala omwe ali ndi hyperthyroidism - kupanga kwambiri mahomoni a chithokomiro.

Kukonzekera kuwerenga

Momwe mungatenge hemoglobin wa glycated? Chidziwitso kwa odwala:

onetsetsani kuti mwabwera ku labotale m'mawa, makamaka musanadye,
Phunziro lisanachitike, simungasinthe zakudya zomwe mumadya posachedwa kuti zosokoneza zikhale zochepa,
mayesowa akuwonetsa kusintha kwa nthawi yayitali, zochitika zolimbitsa thupi kapena nkhawa patsiku lachiwonetsero sichimakhudzanso zizindikiro,
kafukufukuyu musanagwiritse ntchito mavitamini E ndi C ambiri, kuti zotsatira zake zitheke,
Ngati atayika magazi kapena atatuluka magazi, muyenera kudikirira milungu iwiri,
Onetsetsani kuti mwayesa mu labotale imodzi kuti zotsatira zake zikhale zolondola.

Zofunika! Mu matenda a shuga, muyenera kuyesa kuyesedwa kwa A1C kanayi pachaka. Kuwona nthawi ndi nthawi kumathandizira kumvetsetsa momwe magwiridwe a shuga amayambira pakapita chaka.

Makhalidwe abwino

Cholinga chachikulu cha matenda a shuga ndikupeza mtundu wovomerezeka wa matenda a shuga. Mu endocrine pathology, mfundo za HbA1C siziyenera kuloledwa kupitirira 7%. Kusasunthika kwa mfundo kumalimbikitsa chindapusa cha matenda a shuga, kuchepetsa chiopsezo cha zovuta.

Pa nthawi yobereka, mwa ana, nthawi yakutha msinkhu, HbA1C sayenera kupitirira 6.5%, moyenera - osakwana 5%.

Mukakalamba, glycogemoglobin iyenera kutsika kuposa 7.5%, kuchuluka kwa zopitilira 8% sikuyenera kuloledwa.

Kuchulukitsa zizindikiro nthawi zambiri kumabweretsa zovuta: mavuto a mtima, kukakamiza, m'mimba, chapakati chamanjenje, kukulira kwa zomwe zikuchitika, kukula kwa "phazi la matenda ashuga".

Cholinga chomwe mukuyesetsa ndichakuti muchepetse phindu la glycogemoglobin kufikira anthu athanzi - osapitirira 4.6%. Kutengera malamulo a zakudya, kuchita masewera olimbitsa thupi, kusapezeka kwa mankhwala osokoneza bongo, kumwa mankhwala azitsamba ndi mankhwala othandizira odwala matenda ashuga, ndizowona kukwaniritsa zizindikiro zovomerezeka.

Chakudya chamafuta ochepa chimathandizira kuti HbA1C ikhale pa 4,6-5%. Anthu odwala matenda ashuga amatha kulandira insulin yocheperako, nthawi zambiri samatha kupanga mankhwala opanga kukhazikitsa shuga.

Ndikofunika kuti asangopitilira: kuchepa kwa chakudya chamthupi kumatha kutsogola hypoglycemia - kuperewera kwa shuga.

Kuperewera kwa mphamvu kumasokoneza ntchito ya thupi lonse, kuphatikiza ubongo, minofu, mtima, kuthamanga, kuchepa, machitidwe ofunikira komanso ntchito zamagulu amadzimadzi zimasokonekera. Zotsatira zake ndikukula kwa vuto la hypoglycemic.

Kulephera kuthandiza, shuga wotsika kwambiri, wodwala amatha kufa.

Akatswiri a matenda ashuga amalimbikitsa nthawi zonse kusungitsa diary ya chakudya, kuphunzira zambiri za matenda, njira zowongolera mayendedwe a shuga. Ndikofunikira kukhala ndi miyala yazakudya kunyumba, zolembedwa za glycemic ndi insulin index ya zinthu. Kuwunikira tsiku ndi tsiku (maulendo 4-6 patsiku) shuga amakhala kupewa hyper- ndi hypoglycemia.

Kulemba zotsatira

Kuzunza kwa HbA1C kukuwonetsa mwayi wokhala ndi matenda ashuga:

glycogemoglobin imakhala pansi pa 5.7%. Mulingo woyenera wa kagayidwe kazachilengedwe, chiopsezo cha endocrine pathologies ndizochepa,
mfundo kuyambira 5.7 mpaka 6%. Kuthekera kwa kusokonezeka kwa metabolic kumachulukitsidwa, pali chiwopsezo cha kuchuluka kwa shuga. Ndikofunika kuti muzisamalira zakudya, kuchita masewera olimbitsa thupi, kukhala opanda mantha, osagwiritsa ntchito kwambiri ntchito. Kuphwanya malamulo kungayambitse kukula kwa matenda ashuga,
mfundo kuyambira 6.1 mpaka 6.4%. Ngati malingaliro a zakudya zopatsa thanzi, zolimbitsa thupi, kupsinjika pafupipafupi, osagona tulo, mwayi wokhala ndi shuga ukuwonjezereka,
mfundo zopitilira pakhomo la 6.5%. Wodwala amalandira chitsimikiziro choyambirira cha kukula kwa matenda ashuga. Ndikofunikira kuchita mayeso ena ochulukirapo kuti muwonetsetse: hyperglycemia yopitilira ikuwonetsedwa.

Zomwe zimayambitsa komanso Zizindikiro za kupatuka

Mulingo wa HbA1C ukuwonjezeka:

kuphwanya kagayidwe kazakudya sikumawonetsa kukhalapo kovomerezeka kwa matenda ashuga, koma mitengo yayikulu imatsimikizira: kuchuluka kwa shuga kwachulukitsidwa kwa nthawi yayitali,
Chifukwa chimodzi: kulolera shuga
china chomwe chimapangitsa kusungunuka kwa shuga m'mawa, asanadye.

Ndi hyperglycemia, zovuta za zizindikiritso zina zimawonekera:

kulakalaka kudya ndi kulemera,
pafupipafupi kusintha kosinthika
thukuta kapena kuwuma pakhungu.
ludzu losatha
pokodza kwambiri kuposa masiku onse
kuchiritsa kwamabala
kudumphira m'magazi,
tachycardia
kusakwiya, mantha akulu kwambiri,
kuwonda tsitsi, kukula kwa alopecia,
nembanemba youma, candidiasis, stomatitis, ming'alu pakona pakamwa.

Makhalidwe a HbA1C ndi ocheperako:

kuphwanya - chifukwa cha chotupa mu zotupa zapansi: pali kuchuluka kwa insulini,
china chomwe chikuchititsa chidwi ndi kugwiritsa ntchito molakwika zakudya zamafuta ochepa, kutsika kwamphamvu kwa glucose: kuchuluka kwa glycogemoglobin ndi ochepera 4.6%,
Mlingo wowonjezera wa mankhwala ochepetsa shuga.

Ndi kuchepa kwambiri kwa ndende ya A1C, zizindikiro zimayamba:

kugwirana chanza
kuchepetsedwa kwa mavuto
kutuluka thukuta kwambiri
kufooka
kuzizira
chizungulire
kufooka kwa minofu
kukoka dontho.

Kufunika kokweza kuchuluka kwa shuga, apo ayi chikumbumtima cha hypoglycemic chingachitike. Munthu wodwala matenda ashuga nthawi zonse azikhala ndi chidutswa cha chokoleti kuti awonjezere shuga.

Njira zowongolera

Nthawi zambiri, odwala amakumana ndi HbA1C yayikulu. Ndikofunikira kudziwa momwe mungachepetsere mulingo wa glycogemoglobin kuti zisonyezo zikhale zoperewera, koma osagwera pazofunikira.

Ndikofunikira kumvera malingaliro a akatswiri a matenda ashuga:

sunga buku lazakudya, sankhani zinthu zomwe mungagwiritse ntchito tsiku ndi tsiku, kukumbukira GI, AI, XE, kapangidwe kake ndi mphamvu zamagetsi. Zothandiza zamasamba ndi zipatso zopanda mankhwala Zogulitsa zololedwa zimakhala ndi glycemic yotsika komanso cholozera cha insulin: zomwe zikuwonetsedwa zimawonetsedwa m'magome apadera a AI, GI. Pali mndandanda wa XE wamitundu yambiri yazakudya,
kangapo patsiku, malinga ndi malingaliro a endocrinologist, yang'anirani ndikuwonetsa kuchuluka kwa shuga m'magazi,
kuchitira zolimbitsa thupi minyewa imagwiritsidwa ntchito kwambiri, mphamvu zama metabolism zimachepa, chiopsezo cha hyperglycemia chimachepa,
onetsetsani kuchuluka kwa chakudya chamagulu omwe amalowa mthupi. Ndikofunika kutsatira zakudya zamafuta ochepa, koma ndi njirayi, muyenera kuyang'anitsitsa kuchuluka kwa shuga. Odwala ena amaletsa kudya zakudya zamafuta ochepa kotero kuti thupi lipere mphamvu. Minyewa, maselo am'magazi, ubongo umakhala ndi njala, wokhala ndi mfundo zofunika kwambiri za glucose, ndipo umakhala ndi kuphwanya kwakukulu, womwe umafanso kwambiri ndi imfa.

Kuwunika momwe dongosolo la endocrine limatha patatha zaka 40, ndi kuyambika kwa matenda ashuga, ndikofunikira kulumikizana ndi chipatala panthawi yake kuti aunike A1C. Kufotokozera za glycated hemoglobin chizindikiro kumathandizira madokotala kumvetsetsa momwe angapangire matenda oopsa a shuga. Ngati mukupatuka pa chizolowezi, muyenera kudziwa chomwe chimayambitsa kuphwanya, yambani kulandira chithandizo motsogozedwa ndi endocrinologist.

Kanema woyesa magazi a glycated hemoglobin, yomwe imakhala yabwino kwa odwala komanso madokotala. Zili ndi maubwino pa kuyezetsa magazi kwa shuga ndi mayeso a maola awiri opatsirana:

Zizindikiro

Mndandanda wa njira zoyambira komanso zowonjezera zodziwira matenda
Asanapangidwe kuchipatala: KLA, OAM, magazi a microreaction, b / chem. An. Magazi, ECG, fluorography.
Kuyesa kwa shuga wamagazi:
kusala - amatanthauza shuga m'mawa, mutatha kusala kudya kwa maola osachepera 8 komanso osaposa maola 14.
- mwachisawawa - zimatanthawuza kuchuluka kwa shuga nthawi iliyonse yamasana, mosasamala nthawi yakudya. PHTT ndi mayeso a kulekerera kwa glucose. Zimachitika ngati kukayikira kwamphamvu kwa glycemia kumveketsa bwino matendawa.
Malamulo pochita PGTT:
Kuyesedwa kuyenera kupitilira kusala kudya kwa maola osachepera 8. Pambuyo pakusala magazi, woyeserera amayenera kumwa magalamu 75 a madzi osungunuka osungunuka mu 250-300 ml ya madzi osaposa mphindi 5. Pambuyo pa maola awiri, kuyesedwa kwachiwiri kwa magazi kumachitika.
PGTT sachitidwa:
- motsutsana ndi maziko a matenda owopsa
- Pazithunzi zakugwiritsa ntchito kwakanthawi mankhwala omwe amalimbitsa glycemia (glucocorticoids, mahomoni a chithokomiro, thiazides, beta-blockers, etc.)

DIAGNOSTIC YA DIABETES
Njira zoyenera kudziwa matenda ashuga komanso mavuto ena a glycemic
(WHO, 1999-2006)

Nthawi yodziwitsa	Glucose ndende, mmol / l
	Magazi onse a capillary	Vuto la plousma
NORM
Pamimba yopanda kanthu ndi maola awiri pambuyo PGTT
	Matenda a shuga
Pamimba yopanda kanthu Kapena Maola 2 pambuyo PGTT Kapena Kutanthauzira kopanda tanthauzo	≥ 6,1

≥ 11,1
≥ 11,1≥ 7,0

≥ 11,1
≥ 11,1 Kulekerera kwa shuga Pamimba yopanda kanthu
Ndipo
Maola 2 pambuyo PGTT Matenda othamanga a glycemia Pamimba yopanda kanthu
Ndipo
Maola 2 pambuyo PGTT≥ 5.6 ndi≥ 6.1 ndi Matenda a shuga Pamimba yopanda kanthu
Kapena
Maola 2 pambuyo PGTT
Kapena
Kutanthauzira kopanda tanthauzo≥ 6,1≥ 7,0
≥ 7,8
≥ 7,8
≥ 11,1
≥ 11,1

Njira zoyenera HbAlc - monga njira yodziwira matenda ashuga:
Mu 2011, WHO idavomereza kugwiritsa ntchito HbAlc pozindikira matenda a shuga. Monga njira yodziwira matenda a shuga, mulingo wa HbAlc ≥ 6.5% unasankhidwa. Mulingo wa HbAlc wofikira pa 6.0% umawoneka kuti ndi wabwinobwino, malinga ndi momwe zimatsimikiziridwa ndi njira ya National Glicohemoglobin Standardization Program (NGSP), malinga ndi njira yoyimira ya matenda ashuga a shuga ndi mavuto a DC (DCCT). HbAlc mndandanda wa 5.7-6.4% ikuwonetsa kukhalapo kwa NTG kapena NGN.

Zolinga zochizira mtundu 1 ndi mtundu 2 wa shuga
Zakudya Zopatsa Thupi
(Zolinga zamankhwala)
Kusankhidwa kwa zolinga za chithandizo cha munthu payekha zimadalira zaka za wodwalayo, nthawi yomwe akukhala moyo, kukhalapo kwa zovuta zazikulu komanso chiopsezo cha hypoglycemia yayikulu.
Algorithm yosankhidwa payekha pazolinga zamankhwala malinga ndiHbalc

ZAKA
achichepere	pafupifupi	Wokalamba ndi / kapena chiyembekezo chokhala zaka 5
Palibe zovuta ndi / kapena chiopsezo cha hypoglycemia
Pali zovuta zovuta komanso / kapena chiwopsezo cha hypoglycemia

* Izi zofunika sizimagwira ntchito kwa ana, achinyamata komanso amayi apakati. Magulu olamulira a glycemic pazotsatira zamtunduwu wa odwala amakambidwa m'zigawo zoyenera.
** mulingo wabwinobwino malinga ndi miyezo ya DCCT: mpaka 6%.

Zizindikiro za lipid metabolism control

HbAlc **	Madzi a m'magazi a Plasma Pamimba yopanda kanthu / musanadye, mmol / l	Madzi a m'magazi a Plasma Maola awiri mutatha kudya, mmol / l

Zizindikiro	Zofunika pa Target, mmol / L *
Zizindikiro	amuna	azimayi
C cholesterol chonse
LDL cholesterol
HDL cholesterol	>1,0	>1,2
triglycerides

chizindikiro	mfundo zofunika
Kuthamanga kwa magazi a systolic	≤ 130
Kuthamanga kwa magazi kwa diastolic	≤ 80

Madandaulo ndi mbiri yachipatala
Mtundu woyamba wa shuga: ili ndi poyambira chowonekera: ludzu, polyuria, kuchepa thupi, kufooka, etc. Mtundu uwu wa matenda ashuga umadziwika kwambiri ndi achinyamata, kuphatikizapo ana. Komabe, imatha kuwonekera koyamba paukalamba, kuphatikizanso okalamba. Awa ndi omwe amatchedwa LADA - shuga (shuga pang'onopang'ono).
Matenda a shuga a Mtundu Wachiwiri: Zizindikiro sizakudziwika ndipo zimatha kupezekanso m'matenda ena ambiri: kufooka, kuchepa mphamvu, kuchepa kwa magwiridwe antchito, chidwi. T2DM imadziwika kwambiri mwa akulu. Komabe, m'zaka zaposachedwa pakhala kuwonjezeka kwa milandu yamatendawa mwa ana.
Kufufuza kumachitika kuti muzindikire odwala omwe angakhale ndi matenda ashuga kapena prediabetes.
Pakadali pano, kuwunikira kumathandizidwa kudziwa kuti pali matenda a shuga a mtundu wa 2 okha.
- kuthekera koyezera zodziwika popewa chitetezo
- njira zawo zowunikira sizofanana
- palibe mgwirizano pa nkhani yaukadaulo ngati pakuchitika zotsatira zoyenera za oyesererapo chizindikiro
- pafupipafupi a LED 1 otsika
- kuyambitsa matenda pachimake nthawi zambiri kumakupatsani mwayi wodziwitsa matenda anu

Kuyeserera kwakuthupi
Njira Zowunika za DM 2
Kusanthula kumayamba ndi kusala glycemia. Pankhani yakupeza standardoglycemia kapena kusala kudya glycemia (NGN) - ochulukirapo 5.5 koma osakwana 6.1 mmol / l m'magazi a capillary komanso oposa 6.1, koma osakwana 7.0 mmol / l mu plasma ya venous, kuyesedwa kwa glucose koloza pakamwa kumayesedwa ( PGTT).
PGTT- imalola kuzindikira anthu omwe ali ndi NTG.
Zowonera
Anthu onse azaka zopitilira 45 amawonekera, makamaka kukhala ndi chimodzi mwazinthu zowopsa:
kunenepa kwambiri (BMI wamkulu kuposa kapena wofanana 25 kg / m 2
kumangokhala
achibale oyamba omwe ali ndi matenda ashuga
Amayi omwe ali ndi mbiri yokhala ndi mwana wosabadwayo wamkulu kapena wodwala matenda ashuga
matenda oopsa (140/90 mm Hg)
- Mulingo wa HDL 0,9 mmol / L (kapena 35 mg / dl) ndi / kapena triglyceride level 2.2 mmol / L (200 mg / dl)
- kukhalapo kwa shuga wolekerera m'mbuyomu kapena kusala kwamphamvu kwa glucose
- milandu ya mtima
Zizindikiro za Matenda Omwe Atsimikizika
polycystic ovary syndrome
* Ngati mayesowo ndiabwinobwino, ayenera kubwerezedwa zaka zitatu zilizonse.
Anthu osakwana zaka 45 amayesedwa. onenepa kwambiri komanso / kapena chinthu china choopseza matenda a shuga:
- moyo wongokhala
Achibale a 1st omwe ali ndi matenda ashuga
Amayi omwe ali ndi mbiri yokhala ndi mwana wosabadwayo wamkulu kapena wodwala matenda ashuga
Hyperlipidemia kapena matenda oopsa
* Ngati mayesowo ndiabwinobwino, ayenera kubwerezedwa zaka zitatu zilizonse.
Kuyeza kwa amayi onse apakati Nthawi zambiri pakati pa milungu 24 mpaka 28 ya bere.
Amayi omwe ali ndi vuto la matenda amisala amayenera kuyesedwa matenda ashuga / prediabetes 6-12 milungu ingapo atabadwa.
Ana nawonso amafunika kuwunika. kuyambira wazaka 10 kapena kumayambiriro kwa kutha, ngati pali onenepa kwambiri komanso chinthu china choopsa cha matenda ashuga:
Achibale a 1st omwe ali ndi matenda ashuga
- anthu okhala ndi chiwopsezo chachikulu cha matenda ashuga
zinthu zogwirizana ndi insulin
ana ochokera kwa amayi omwe ali ndi matenda ashuga kapena matenda a gestational
* Ngati mayesowo ndiabwinobwino, ayenera kubwerezedwa zaka zitatu zilizonse.