Kuyesa kwa shuga (shuga)

Glucose ndi organos monosaccharide yodziwika ndi mphamvu yayikulu. Ndiye gwero lalikulu lamphamvu yazamoyo zonse. Insulin ndiyo imayambitsa kuyamwa kwa glucose ndikusunga ndende yake. Hormone iyi imawonedwa ngati yophunziridwa kwambiri padziko lapansi. Mothandizidwa ndi iye, kuchuluka kwa shuga kumachepa. Monosaccharide imayikidwa mu glycogen.

Kuyesedwa kwa shuga ndi dzina lanyumba lochizira labotale ya glycemia (glucose wamagazi). Kafukufukuyu ndikofunikira kuti azindikire komanso kuwongolera kusokonezeka kwa kagayidwe kazakudya, popeza kuchuluka kwa glucose makamaka kumatsimikizira momwe munthu alili. Kupatuka kuchoka pachiwonetsero mpaka mbali yaying'ono kumatchedwa hypoglycemia, kwakukulu - hyperglycemia.

Hypoglycemia

Hypoglycemia ndi mkhalidwe wa pathological wodziwika ndi kuchepa kwa shuga m'munsi mwa 3.5 mmol / L.

Magulu atatu otsatirawa a zizindikiro ndi a hypoglycemia:

1. Adrenergic: nkhawa, kukhala wankhanza, kuda nkhawa, mantha, kusinthasintha, kunjenjemera, minyewa yofinya, kufooka kwamadzi, pallor, matenda oopsa.
2. Parasympathetic: Njala, nseru, kusanza, thukuta kwambiri, malaise.
3. Neuroglycopenic (chifukwa cha njala yamkati wamanjenje): kusokoneza, kupweteka mutu, chizungulire, kupenya kawiri, paresis, aphasia, kukokana, kupuma, kulephera kwamtima, kuzindikira.

Zoyambitsa zazikulu za hypoglycemia ndi:

• kuchepa kwamadzi chifukwa chosanza kapena kutsegula m'mimba,
• kusadya bwino,
• mankhwala osokoneza bongo a insulin kapena mankhwala ochepetsa shuga;
• kuchita masewera olimbitsa thupi mopitirira malire
• matenda ofooketsa
• Hypermenorrhea,
• uchidakwa
• kulephera kamodzi kapena zingapo,
• chotupa cha pancreatic beta,
• kobadwa nako Fermentopathies ogwirizana ndi shuga kagayidwe,
• mtsempha wa magazi makonzedwe a sodium kolorayidi (NaCl).

Ndi hypoglycemia yomwe imatenga nthawi yayitali, kubwezeretsa kwakanthawi kochepa kwa metabolism kumachitika. Chifukwa cha glycogenolysis (kuphulika kwa glycogen), kuchuluka kwa glycemia kumakulanso.

Kuwunikira zotsatira za kafukufukuyu kuyenera kuchitika ndi katswiri. Tiyeneranso kukumbukira kuti ngati malamulo oyendetsera kusanthula sanawonedwe, zotheka zimapezeka.

Hypoglycemia nthawi zambiri imayamba motsutsana zakumbuyo yolakwika yazakudya kwa odwala matenda ashuga. Gulu ili la odwala liyenera kukhala ndi kuchuluka kwa chakudya chamagulu (shuga ochepa, madzi otsekemera, kapu ya chokoleti). Kuyesedwa kwa shuga kumafunika kuti mupeze matenda a hypoglycemia.

Hyperglycemia

Zomwe zimayambitsa hyperglycemia:

1. Matenda a shuga. Ichi ndiye chinthu chachikulu chodwalitsa cha hyperglycemia. Maziko a matendawa ndi kusowa kwa insulini kapena kukana minofu.
2. Zolakwika mu chakudya. Ndi bulimia amanosa, anthu samalamulira kuchuluka kwa zakudya zomwe zimadyedwa, chifukwa chake amamwa chakudya chambiri chomanga thupi.
3. Kugwiritsa ntchito kwamagulu ena a mankhwala. Mankhwala osokoneza bongo omwe amapangitsa hyperglycemia: mankhwala a thiazide diuretics, glucocorticoid mankhwala, nicotinic acid, Pentamidine, proteinase inhibitors, L-asparaginase, Rituximab, magulu ena a antidepressants.
4. Kuperewera kwa biotin.
5. Zinthu zovuta. Izi zimaphatikizapo kuwonongeka kwamtima kwamatenda am'mimba (stroko, infarction myocardial).
6. Matenda opatsirana.

Hyperglycemia amadziwika ndi izi:

• ludzu
• kamwa yowuma
• polyuria
• malaise
• kugona
• Kuchepetsa thupi kwambiri pakudya
• mantha
• kuwonongeka kwamawonekedwe
• utachepa chitetezo chokwanira,
• kuchiritsa kwamabala
• Khungu
• kuphwanya zamkati mwamiyendo (ndi njira yayitali).

Kuzindikira kwanyumba mofulumira ndi koyenera kwa anthu omwe amafunikira kuyang'anira shuga. Kwa mayeso owunika, kafukufuku wa zasayansi amachitidwa.

Hypoflycemia yofatsa (6.7-8.2 mmol / L) yopuma panthawi yake sikubweretsa ngozi. Komabe, kuchuluka kosalekeza kwa shuga kumayambitsa kusokonezeka kwakukulu kwa metabolic, kuchepa chitetezo cha mthupi, komanso kuwonongeka kwa ziwalo. Mavuto a hyperglycemia akhoza kupha. Zotsatira zoyipa kwambiri ndi polyneuropathy, yaying'ono ndi macroangiopathy.

Kuchuluka kwa shuga mwa amayi apakati ndi chizindikiro cha matenda amishuga. The pathological mkhalidwe kumawonjezera chiopsezo cha preeclampia, kubadwa msanga, pachimake pyelonephritis, pathupi ndi kubadwa zovuta. Amuna omwe ali ndi matenda oopsa a hyperglycemia, balanoposthitis nthawi zambiri amawonedwa, mwa akazi - vulvovaginitis.

Zizindikiro za matenda ashuga sizodziwika ngati kulekerera shuga. Koma vutolo limafunikira kukonzedwa kuchipatala.

Chifukwa chake kuyang'anira glycemia ndikofunikira

Kuyesedwa kwa shuga kumakupatsani mwayi wofufuza za kagayidwe kazachilengedwe.

Kuwonjezeka kwa glucose kungawonetse zotsatirazi zamikhalidwe:

• matenda ashuga
• pheochromocytoma,
• thyrotoxicosis,
• acromegaly
• Itsenko-Cushing's syndrome,
• hyperparathyroidism yoyamba,
• somatostinoma,
• glucagonoma
• matenda a kapamba (pancreatitis, nyansi zokhudzana ndi kapamba, cystic fibrosis, hemochromatosis, khansa),
• hepatorenal kusowa,
• autoimmune kukwiya kwa ma cell a pancreatic beta.

Zifukwa zochepetsera shuga:

• kusala kudya kwanthawi yayitali
• kuphwanya kwamphamvu chakudya chakudya (matenda am'mimba, matumbo),
• matenda a chiwindi osachiritsika
• Matenda ogwirizana ndi insulin antagonists (hypofunction ya chithokomiro England, adrenal cortex ndi pituitary gland),
• ntchito hyperinsulinemia (kunenepa kwambiri, mtundu wovuta wa matenda ashuga 2),
• insulinoma
• sarcoidosis
• kuperewera kwatsopano kwa michere (matenda a Girke, galactosemia),
• poyizoni
• chithandizo cha opaleshoni pamimba.

Hypoglycemia imawonedwa mwa makanda asanakwane azimayi omwe ali ndi matenda ashuga. Amakhalanso ndi zakudya zopanda thanzi zomwe zimakhala ndi chakudya chambiri m'zakudya. Choyambitsa chachikulu cha hyperglycemia ndi matenda ashuga.

Momwe mungakonzekerere kusanthula

Kukonzekera koyenera kwa labotale kumafunikira kuti pakhale kulamulidwa kwa labotale.

Momwe mungasinthire kusanthula:

1. Magazi amatengedwa pamimba yopanda kanthu. Madzulo mumatha kudya zakudya zama protein ochepa zokha.
2. Kwa maola 12 kupatula mowa, kusuta, kuchepetsa kuchita masewera olimbitsa thupi.
3. Patsiku la phunziroli, mutha kumwa madzi.
4. Tsiku limodzi musanalandire magazi, mankhwala omwe amakhudza kagayidwe kazakudya amathetsedwa (izi zimakambidwa ndi dokotala).

Zotsatira zake zimatha kukhudzidwa ndi kusowa tulo, matenda opatsirana pachimake, maulendo ataliatali. Kuwunikaku sikungatengedwe pambuyo panjira ya physiotherapeutic, maphunziro a x-ray, ntchito. Kuyesa glycemia, magazi a venous kapena capillary amatengedwa kuchokera pachala.

Zambiri zokhuza ngati ndizotheka kuyeza shuga kunyumba ndi glucometer zimapezeka kuchokera kwa dokotala. Kuzindikira kwanyumba mofulumira ndi koyenera kwa anthu omwe amafunikira kuyang'anira shuga. Kwa mayeso owunika, kafukufuku wa zasayansi amachitidwa.

Mtundu woyamba wa shuga, ndikulimbikitsidwa kuti glycemia imayesedwe isanachitike jakisoni aliyense wa insulin. M'magulu onse awiri a shuga, shuga a magazi amawunika tsiku lililonse m'mawa. Akuluakulu azaka zopitilira 40 ndi odwala omwe ali pachiwopsezo (amayi oyembekezera, anthu omwe ali ndi vuto lotengera matenda obadwa nawo) amalangizidwa kuyang'anira glycemia pafupipafupi.

Kutsatsa magazi mayeso a shuga

Kuti mudziwe kuchuluka kwa glucose m'magazi, kuwerengetsa kwa ma millimili pa lita imodzi kumagwiritsidwa ntchito nthawi zambiri (kusankha - mmol / l). Potere, mitundu yosiyanasiyana ya mayeso a labotale ingapatsidwe:

• kuyesa kwa magazi pa zaminyewa zam'magazi,
• kuyeserera kwa shuga m'magazi ndi kuchita masewera olimbitsa thupi (kuyesa kwa glucose pamimba yopanda kanthu),
• kuyeserera kwa shuga kwa C-peptides,
• glycated hemoglobin
• kusanthula kwa kuchuluka kwa fructosamine,
• kusanthula kwa kuchuluka kwa shuga m'magazi a amayi apakati (kuyesa kwa glucose pakumeta).

Mlingo wa kuchuluka kwa shuga m'magazi a venous ndi capillary ndi osiyana.

Hypoglycemia nthawi zambiri imayamba motsutsana zakumbuyo yolakwika yazakudya kwa odwala matenda ashuga. Gulu ili la odwala liyenera kukhala ndi kuchuluka kwa chakudya chamagulu (shuga ochepa, madzi otsekemera, kapu ya chokoleti).

Gome ndi kuphwanya shuga

Kufotokozera Kwambiri

Glucose monga munthu wofunikira mu chakudya chamafuta am'thupi ndi amodzi mwa magawo a magazi. Ndizowona kuchuluka kwa chizindikiro ichi mu seramu yamagazi komwe kumawongoleredwa poyesa mkhalidwe wa metabolism ya carbohydrate. Glucose pafupifupi imapezeka m'gulu la zinthu za m'magazi ndi madzi a m'magazi, koma chakumapeto kwake, imakhala yambiri. Mwazi wamagazi umayendetsedwa ndi dongosolo lamkati lamanjenje (CNS), mahomoni ena, ndi chiwindi.

Matenda ambiri a m'magazi komanso a thupi amatha kupangitsa kuti magazi azikhala ndi magazi, matendawa amatchedwa hypoglycemia, ndipo kuchuluka kwake ndi hyperglycemia, komwe kumachitika kawirikawiri kwa odwala matenda a shuga mellitus (DM). Pankhaniyi, kupezeka kwa mayeso a shuga kumakhazikitsidwa ndi yankho limodzi mwayeso:

• kuwoneka kwa zizindikiro zamatenda azishuga kuphatikiza kuchuluka kwa shuga m'magazi ≥ 11.1 mmol / l, kapena:
• kusala plasma shuga ≥ 7.1 mmol / L, kapena:
• shuga wa plasma maola 2 mutatsitsa magawo 75 a shuga ≥ 11.1 mmol / L.

Ngati kuphunzira kwa kuchuluka kwa glucose kumachitika mwa anthu okhala ndi miliri yotsatila kapena yowonera, ndiye kuti mutha kudziwonetsa nokha ku chimodzi mwazizindikiro: mwina msanga wa glucose, kapena mutatsitsa pa os. Mankhwala othandiza, kutsimikizira matenda omwe ali ndi matenda ashuga, ndikofunikira kuti mupange kafukufuku wachiwiri tsiku lotsatira.

Bungwe Loona za Umoyo pa Dziko Lonse lalimbikitsa kuti pakhale kuyesedwa kwa m'magazi a plasma kokha komwe kumapezeka chifukwa chofulumira kudya magazi. Pankhaniyi, kutsata kwa glucose komwe kumatsimikiziridwa kumatsimikiziridwa kuti ndiko kutsimikizira:

• kusala plasma glucose wochepera 6.1 mmol / l amaonedwa ngati abwinobwino,
• kusala kudya kwa plasma glucose kuyambira 6.1 mmol / l mpaka 7 mmol / l amawonedwa ngati kusala kudya kwa glycemia,
• kusala kwam'magazi glucose ochulukirapo 7 mmol / L ndi ofanana ndikuwonetseratu matenda ashuga.

Zizindikiro zoika magazi mayeso a shuga

• matenda a shuga a I ndi II,
• kuzindikira ndi kuwunika matenda ashuga
• matenda ashuga
• kulolerana kwa shuga,
• kuwunika anthu omwe ali pachiwopsezo chotenga matenda a shuga (kunenepa kwambiri, woposa zaka 45, lembani matenda ashuga m'banjamo),
• kuzindikira kwapadera kwa hypo- ndi hyperglycemic coma,
• sepsis
• kugwedeza
• matenda a chithokomiro
• matenda amisempha ya adrenal,
• zamanyazi
• matenda a chiwindi.

Kutulutsa zotsatira za kuwunika

Kuchulukitsa kwa shuga:

• shuga kwa akulu ndi ana,
• physiological hyperglycemia: zolimbitsa thupi, kupsinjika, kusuta, adrenaline mothamanga pakabaya,
• pheochromocytoma,
• thyrotoxicosis,
• acromegaly
• gigantism
• Cushing's syndrome
• chilonda chachikulu komanso chamba
• kapamba ndi mumps, cystic fibrosis, hemochromatosis,
• zotupa zapachifuwa,
• matenda a chiwindi ndi impso,
• hemorrhagic stroke,
• myocardial infaration
• kumwa mankhwala (okodzetsa, tiyi kapena khofi, mahomoni ogonana achikazi, glucocorticoids),
• ubongo ukuvulala ndi zotupa,
• khunyu
• poizoni wa monoxide.

Kuchepa kwa kuchuluka kwa shuga:

• Hyperplasia, adenoma kapena carcinoma wa β-cell of islets of Langerhans,
• Langerhans islet α-cell kuchepa,
• Matenda a Addison
• adrenogenital syndrome
• hypopituitarism,
• kusakwanira kwa adrenal kotekisi,
• kuchepa kwa chithokomiro (hypothyroidism),
• makanda asanakwane
• ana obadwa kwa amayi omwe ali ndi matenda ashuga,
• bongo, osagwirizana ndi insulin ndi pakamwa hypoglycemic mankhwala,
• kuphwanya zakudya - kulumpha zakudya, komanso kusanza mutatha kudya odwala.
• matenda akulu a chiwindi: cirrhosis, hepatitis osiyanasiyana etiologies, khansa yoyamba, hemochromatosis,
• Matenda a Girke
• galactosemia,
• kulolerana kwa fructose,
• kusala kudya kwanthawi yayitali
• poyizoni ndi mowa, arsenic, chloroform, salicylates, antihistamines,
• kumwa mankhwala (anabolic steroids, propranolol, amphetamine),
• kulimbitsa thupi kwambiri,
• malungo
• malabsorption syndrome,
• kutaya matenda
• kunenepa
• lembani matenda ashuga 2
• menthitis pachimake,
• chifuwa chachikulu cham'mimba,
• matenda a mencitis a cryptococcal,
• encephalitis ndi mumps,
• chotupa choyambirira kapena chosakanizira cha chotchacho,
• meningoencephalitis yopanda mabakiteriya,
• chachikulu amoebic meningoencephalitis,
• ozungulira hypoglycemia ndi sarcoidosis.