Kuyesedwa kwa hemoglobin ya glycated: zomwe zimachitika mwa amuna ndi akazi omwe ali ndi matenda ashuga

Nyuzipepala yaku Britain yofalitsa zotsatira za kuyesera komwe kumayenera kukhazikitsa kudalirika kwa hemoglobin ya glycosylated ndi chiopsezo cha kufa pakati pa amuna. HbA1C idayendetsedwa mu odzipereka a mibadwo yosiyana: kuchokera pa zaka 45 mpaka 79. Kwenikweni, anali anthu athanzi (opanda matenda ashuga).

Mwa amuna omwe amawerengera glucose mpaka 5% (pafupifupi), kuphedwa kwamunthu kunali kochepa kwambiri (makamaka kuchokera ku kugunda kwa mtima ndi stroko). Kuchulukitsa chizindikirochi ndi 1% chokha komwe kumawonjezera mwayi waimfa ndi 28%! Malinga ndi zotsatira za lipotilo, mtengo wa HbA1C wa 7% umawonjezera chiopsezo cha kufa ndi 63% (poyerekeza ndi chizolowezi), ndipo 7% ya munthu wodwala matenda ashuga nthawi zonse amawonedwa ngati zotsatira zabwino!

Kuyesedwa kwa hemoglobin ya glycated ndi kafukufuku wofunikira, mtundu wa zilembo zam'magazi zomwe zimakupatsani mwayi wofufuza bwino matenda ashuga. Zimathandizira kuwunika momwe mankhwalawa amathandizira.

Ntchito yayikulu ya hemoglobin ndikupereka mpweya m'maselo. Puloteni iyi imagwirizana ndi mamolekyulu a shuga. Ndizomwe zimatchedwa glycosylated hemoglobin. Mashuga ochulukirapo m'magazi, hemoglobin yochulukirapo imapangidwa, yomwe imadziwika ndi chiwopsezo cha matenda ashuga ndi zotsatira zake.

Pakadali pano, mayesowa ndi ofunikira ku hyperglycemia, amakupatsani mwayi wofufuza matenda ashuga pamene mitundu ina ya mayeso sikukonza. Kuwunikaku kumathandizira kuzindikira bwino matenda a shuga m'magawo oyambira. Kuyesedwa koteroko kumathandiza anthu odwala matenda ashuga kumvetsetsa momwe adayang'anira bwino glycemia kwa masiku 90-100, momwe shuga imayendera mwachangu, komanso ngati mankhwala omwe asankhidwa omwe amachepetsa shuga ndi othandiza.

Ubwino ndi kuipa kwa njirayi

Ma molekyulu a glucose m'magazi amatenga ndi maselo ofiira amwazi. Zotsatira zake ndimapangidwe osasunthika ngakhale mapuloteni awa akafa mu ndulu. Katunduyu wa iwo amathandizira kuzindikira vuto molawirira kwambiri, pomwe mayeso wamba sanamvebe kusintha m'magazi.

Kusanthula musanadye kumakulolani kudziwa shuga, mutatha kudya - kumawunikira zomwe zili pansi pake. Glycated hemoglobin mu shuga mellitus amayesa glycemia m'miyezi itatu yapitayo. Kodi njira yowerengera iyi ndi iti?

Kuyesereraku kungachitike osati m'mawa, pafupi ndi kukomoka kwa njala, mayesowo akuwonetsa chithunzi cholondola kwambiri, kuwulula matenda ashuga pamlingo wa prediabetes.
Kukhazikika kwa preanalytical - magazi omwe amatengedwa kunja kwa labotale amatha kusungidwa mpaka kuyezetsa kwa vitro.
HbA1C imathandizira kuwunika kuchuluka kwa chiphuphu cha shuga mu shuga, kuti musankhe mtundu woyenera wa mankhwala a hypoglycemic.
Choyimira sichimatengera kupsinjika, matenda, zolakwika mu chakudya, kumwa mankhwala aliwonse.
Kuyesako kumakhala kofulumira, kosavuta komanso kotsika mtengo kuposa mayeso a shuga a chikhalidwe, omwe amatenga maola awiri.

Ndi anemia, hemoglobinopathy kapena mavuto ndi chithokomiro, komanso kuchuluka kwakudya m'zakudya za mavitamini E ndi C, zotsatira zake sizabwino. Njirayi sioyenera kuyesa pachimake hyperglycemia.

Chiyeso chosagwira ntchito kwa amayi apakati. Chithunzi chojambula chimatha kuwonekera pokhapokha mwezi wa 8-9, pomwe mavuto akuwonekera kale mu trimester yachiwiri. Pali odwala omwe amachepetsa kulumikizana pakati pa HbA1C ndi kuwerengera kwa glucose.

Zowonazo ndizophatikiza mtengo wa mayeso: mtengo wapakati pazantchito ndi ma ruble 520 kuphatikiza ma ruble ena okwana 170 ndi mtengo wamtengo wapatali wamagazi. Si dera lililonse lomwe limakhala ndi mwayi wofufuzidwa.

Chifukwa chiyani muyenera kuyesedwa?

Hemoglobin ndi puloteni yomwe imakhala ndi chitsulo ndipo imatha kunyamula oxygen m'thupi lonse. Maselo ofiira amthupi amakhala ndi miyezi 3-4 yokha, ndikulondola kuti ayesedwe HbA1C ndi pafupipafupi chotere.

Kuchedwa kopanda enzymatic kumapereka mgwirizano wamphamvu wa glucose ndi hemoglobin. Pambuyo pa glycation, glycosylated hemoglobin imapangidwa. Kukula kwa zomwe zimachitika zimatengera kuwerengera kwa mita mu nthawi yoyendetsa. HbA1C imakupatsani mwayi wopenda magazi m'masiku 90-100.

Tisanayesedwe pafupipafupi, odwala matenda ashuga "ambiri amakhala ndi malingaliro," kuyesa kukonza chithunzithunzi. Mukamayesa HbA1c, chinyengo ichi sichikugwira ntchito, zolakwika zonse muzakudya ndi mankhwala azikumbukiridwa.

Zina mwa njira zopezekera pazanema zidanenedwa ndi Pulofesa E. Malysheva:

Miyezo ya HbA1c

Popanda zizindikiro za matenda ashuga, mfundo za HbA1C zimasinthasintha mosiyanasiyana 4-6%. Amawerengeredwa poyerekeza ndi kuchuluka konse kwamaselo ofiira am'magazi. Chizindikirochi chikuwonetsa metabolism wabwino wa chakudya.

Kuthekera kotenga matenda "okoma" kumawonjezeka ndi mfundo za HbA1C kuchokera ku 6.5 mpaka 6.9%. Ngati atha kugunda kwa 7%, izi zikutanthauza kuti kagayidwe ka lipid kamakhala kovuta, ndipo kusintha kwa shuga kumachenjeza za prediabetes. Malire a hemoglobin a glycated (zomwe zili mu shuga mellitus) amasiyana mitundu ya matenda ashuga komanso amisinkhu yosiyanasiyana. Kusiyanaku kukuwonekera bwino pagome.

Ndikofunika kuti achinyamata azisamalira HbA1C yawo poyerekeza ndi odwala matenda ashuga. Kuwunikira kwa hemoglobin ya glycated kwa amayi apakati kumakhala kotheka kwa miyezi 1-3, mtsogolomo, kusintha kwa mahomoni sikupereka chithunzi cholondola.

HbA1C ndi hemoglobin wakupha

Fatog hemin imapezekanso mwa akhanda. Mosiyana ndi ma analogues, mawonekedwewa amatumiza mpweya wabwino m'maselo. Kodi hemoglobin yomwe imapha imakhudza umboni?

Zambiri za okosijeni zomwe zimakhala m'magazi zimathandizira njira ya makutidwe ndi okosijeni, ndipo chakudya chimasinthidwa kukhala glucose mwachangu ndikusintha kofanana ndi glycemia. Izi zimakhudza kugwira ntchito kwa kapamba, kupanga insulini ndi hemoglobin wa shuga.

Zambiri za kuyesa kwa hemoglobin ya glycated - mu kanema:

Zinthu za phunziroli

Mwayi wofunikira pakuwunika hemoglobin ya glycosylated ndi kusowa kwa kufunika kwakukonzekera kulikonse komanso kuthekera kwakuti kuchititse nthawi yovomerezeka. Njira zapadera zimapangitsa kuti zitheke kupeza chithunzi chodalirika mosasamala zakudya kapena mankhwala, matenda opatsirana, nkhawa, kapenanso mowa.

Kuti mupeze chithunzi cholondola cha zotsatira zake, tikulimbikitsidwa kuti tisadye chakudya cham'mawa, chifukwa wodwala, monga lamulo, amayesedwa mozama, ndipo izi zingakhudze mayeso ena. Mu tsiku limodzi kapena awiri mutha kudziwa zotsatira zake. Pokambirana ndi endocrinologist, muyenera kumamuwuza za kuchepa kwa magazi, matenda a kapamba, komanso kugwiritsa ntchito mavitamini.

Zotsatira zoyeserera zimatha kukhala zosiyanasiyana posankha ma labotore osiyanasiyana. Zimatengera njira zomwe amagwiritsa ntchito kuchipatala. Kuti mutsate zamphamvu zakukula kwa matendawa, ndikofunika kuyeserera nthawi zonse malo amodzi. Ndikofunikira kuyesedwa pafupipafupi: kwakhazikitsidwa mwachipatala kuti kuchepa kwa HbA1 ngakhale 1% moyenera kumachepetsa zovuta.

Mtundu wa LED

Mavuto omwe angakhalepo

Kuchepetsa chiopsezo,%

Mtundu woyamba wa shuga

Retinopathy

Nephropathy

25-40

Type 2 shuga

Micro ndi macroangiopathy

Imfa chifukwa cha matenda ashuga

Kufa kwathunthu

Kodi HbA1 yafupika?

Kufunika kwa HbA1 m'munsi mwabwinobwino m'matenda a shuga kumatanthauza hypoglycemia. Momwe amadziwikiratu amadziwika nthawi zambiri kuposa kupitilirapo. Ndi dzino lotsekemera, ndikugwiritsa ntchito maswiti nthawi zonse, kapamba amagwira ntchito kuvala, kutulutsa timadzi tambiri tambiri. Zofunikira zoyambira ndikupanga ma neoplasms momwe ma b-cell amapanga insulin yambiri.

Kuphatikiza pa matenda ashuga komanso zokonda za dzino lokoma, palinso zifukwa zina zotsika HbA1:

Zakudya zazitali za carb
Matenda a m'magazi ogwirizana ndi kusungunuka kwa glucose payekha,
Njira zam'mbuyo komanso zotupa,
Anemia
Mavuto ndi hypothalamus,
Katundu wosakwanira wamisempha
Mankhwala osokoneza bongo ambiri a insulin.

Kuti mupeze zomwe zimayambitsa matenda a glycated hemoglobin mu shuga mellitus, ndikofunikira kuyesedwa kwathunthu.

Pa gulu la anthu odwala matenda ashuga omwe amakhala ndi moyo wautali wazaka 5, HbA1 ikhale yodziwika mpaka 8%, chifukwa amatha kukhala ndi hypoglycemia kuposa kuwopsa kwa matenda ashuga. Muubwana ndi unyamata komanso panthawi yomwe muli ndi pakati, ndikofunikira kusunga HbA1C mpaka 5%.

Zomwe zimapangitsa kuti HbA1 iwonjezeke

Kupitilira muyeso wa hemoglobin wa glycated mu mtundu 1 kapena mtundu 2 kungatanthauze hyperglycemia. Matenda a pancreatic amapezeka pafupipafupi pamene kusanthula kwa HbA1 kuli pamwamba pa 7%. Zizindikiro za 6-7% zimawonetsa kulekerera kwa glucose komanso zovuta zama metabolic.

Kwa amayi apakati ndi ana, kuyang'ana hemoglobin wa glycated sikuli kofunikira kuposa kwa okalamba. Mukanyalanyaza malangizowa, zovuta zapakati pa kubereka kwa mwana, kubadwa msanga, komanso kuwonongeka kwa thanzi la mayiyo ndizotheka. Hemoglobin yotsika mumtunduwu ndivuto wamba, chifukwa zofunika zawo zachitsulo ndizokwera kwambiri (mpaka 15 - 18 mg).

Hyperglycemia imadziwika kuti imangokhala ndi mitundu yosiyanasiyana ya matenda ashuga, komanso matenda a chithokomiro, kulephera kwa chiwindi, kusokonezeka kwa hypothalamus (gawo laubongo lomwe limayang'anira ntchito ya gland ya endocrine).

Ngati ana akwezeka hemoglobin (kuyambira 10%) glycated hemoglobin, ndizowopsa kuigwetsa pansi kwambiri, mwanayo amayamba kuona. Ngati vutoli lokha silinathetsedwe kwa nthawi yayitali, litha kuchepetsedwa ndi mankhwala ndi 1% pachaka.

Glycemic control kunyumba

Ndi mtundu uliwonse wa matenda ashuga, boma la magazi anu liyenera kuwunika tsiku lililonse kuti musinthe katundu, zakudya kapena mlingo wa mankhwala ngati kuli kofunikira. Nthawi zambiri mita ya shuga imayang'ana kuti shuga asala kudya, maola awiri mutatha kadzutsa, musanadye chakudya chamadzulo komanso usiku.

Mtundu wachiwiri wa matenda ashuga, ngati wodwala salandira jakisoni wa insulin, njira ziwirizo ndizokwanira. Kuchulukitsa kwa wodwala aliyense kumatsimikiziridwa ndi dokotala. Zotsatira za ashuga a glucometer amalembedwa mu diary kuti ayese mbiriyo mumphamvu. Ndikulimbikitsidwa kuyang'ana shuga pa nthawi yomwe muli ndi pakati, nthawi yoyenda, ndi minofu kapena kutopa kwambiri.

Ngati matenda ashuga apezeka kale ndipo akupita patsogolo, simuyenera kungokhala pa mayeso amodzi a HbA1C. Sichikuwonetsa kusintha kwa kapangidwe ka magazi ndi katundu wa carbohydrate, kuthandiza kusintha molondola moyo.

Odwala ena a shuga samawongolera glycemia, pofotokoza chisankho chawo chifukwa chakuti kusokonezeka kosafunikira kumakhudza deta yoyesa.

Zomwe zotsatira zoyesazi zimanena zimatha kumvetsetsa.

HbA1C,%	Glucose, mmol / L	HbA1C,%	Glucose, mmol / L
4	3,8	8	10,2
4,5	4,6	8,5	11,0
5	5,4	9	11,8
5,5	6,5	9,5	12,6
6	7,0	10	13,4
6,5	7,8	10,5	14,2
7	8,6	11	14,9
7,5	9,4	11,5	15,7

Momwe mungasungire dzuwa lanu la plasma

Malangizo apadera amafuna kuti odwala matenda ashuga a HbA1C akhale pansi pa 7%. Pokhapokha, matenda a shuga amalipiridwa mokwanira, ndipo chiwopsezo cha zovuta ndizochepa.

Mwapang'ono, zakudya zama carb zotsika zimathetsa vutoli, koma kuchuluka kwa chiphuphu cha shuga kumayenderana mwachindunji ndi zovuta za hypoglycemic. Luso la kumverera bwino pakati pamaopsezo a hypoglycemia ndi hyperglycemia, wodwala matenda ashuga amaphunzira moyo wake wonse.

Glycated hemoglobin ndi deta ya masiku 90-100, ndipo ndizosatheka kuiletsa m'nthawi yochepa, ndipo ndiyowopsa. Chofunikira chachikulu pakulipira kwa glycemia ndi kupewa zovuta pamavuto a carbohydrate metabolism ndikutsatira kwambiri zakudya.

Zakudya zotetezeka kwambiri ndizapuloteni: nyama, nsomba, mazira, mkaka, popanda thupi sizingakhale bwino.
Kuchokera pa zipatso ndi ndiwo zamasamba, ndibwino kuti musankhe zomwe zimamera pamwamba pa nthaka: nkhaka, kabichi, zukini, mapeyala, maapulo, mandimu, nkhanu. Zomera zozikika ndi zipatso zotsekemera (mphesa, nthochi, mapeyala) zimadyedwa mu nyengo yoposa 100 g ndipo mosiyana ndi zinthu zina.
Matenda a shuga ndi nyemba ndi othandiza, nandolo amathanso kudyedwa zobiriwira. Nyemba za nyemba ndi chida chotsimikiziridwa chochepetsera shuga.
Ngati muli ndi vuto losafuna kudya chinthu chokoma, ndibwino kuti mutenge magawo 30 a chokoleti chamdima wakuda (pafupifupi 70% cocoa) kuposa omwe amatchedwa ma candies a odwala matenda ashuga omwe ali ndi fructose.
Kwa okonda chimanga, ndibwino kuti musankhe zakudya zamafuta pang'ono, zomwe zimamwa nthawi yayitali ndipo zimakonzedwa bwino. Balere imakhala ndi index yotsika kwambiri ya glycemic, koma imakhala ndi gluten. Mpunga wakuda, mphodza, mphira, ndi oats zina nthawi zina zimatha kuphatikizidwa muzakudya.

Chakudya chizikhala chopindika, mpaka katatu pa tsiku. Mapuloteni ndi zakudya zamafuta kwambiri zimadyedwa mosiyana. Kuchiritsa kwamoto pazinthu - zofatsa: kuwongolera, kuphika, kuwonda.

Kuti muchepetse kunenepa, kusangalala, kukhala wathanzi, komanso, shuga, ndikofunikira kuti mupange masewera olimbitsa thupi anu pafupipafupi, poganizira zaka ndi thanzi lanu.

Kuwunikira pafupipafupi kwa hemoglobin ya glycosylated mu shuga mellitus ndikofunikira kubwezeredwa kwabwino kwa glycemic. Zovuta zomwe zimawululidwa panthawiyi zimathandiza kukonza njira zochizira, kupewa zovuta za matenda ashuga. Chiyeso cha HbA1 chimaphatikizidwa ndi European Association of Endocrinologists mu zovuta za zolembera zoyenera kuti azindikire matenda a shuga.

Kuti mumve zambiri panjira yoyesera ya HbA1, onani vidiyo: