Kuyesa kwa magazi kwa hemoglobin ya glycated

Glycated hemoglobin (A1c) ndi gawo linalake la erythrocyte hemoglobin wokhala ndi glucose, ndende yomwe imawonetsa kuchuluka kwa shuga kwazaka pafupifupi miyezi itatu.

Glycohemoglobin, hemoglobin A1c, Hb_A1cglycosylated hemoglobin.

Glycated hemoglobin, hemoglobin A1c, HbA1c, glycohemoglobin, glycosylated hemoglobin.

Kodi ndi zotsalira ziti zomwe zingagwiritsidwe ntchito kafukufuku?

Momwe mungakonzekerere phunzirolo?

1. Osamadya kwa maola awiri 2-3 musanayambe kuphunzira, mumatha kumamwa madzi oyera.
2. Chotsani kupsinjika kwakuthupi ndi kwamalingaliro ndipo musasute kwa mphindi 30 phunzirolo lisanachitike.

Phunziro Mwachidule

Kuyesedwa kwa glycated hemoglobin (A1c) kumathandizira kuyeza kuchuluka kwa shuga m'miyezi itatu yapitayo.

Hemoglobin ndi puloteni yomwe imanyamula oxygen m'maselo ofiira a m'magazi (maselo ofiira amwazi). Pali mitundu ingapo ya hemoglobin yabwinoko, kuphatikiza apo, mitundu yambiri yachilendo yazindikiritsidwa, ngakhale mawonekedwe oyamba ndi hemoglobin A, omwe amapanga 95-98% ya hemoglobin yonse. Hemoglobin A imagawidwa m'magawo angapo, imodzi ndi A1c. Gawo la glucose woyenda m'magazi limamangika ku hemoglobin, ndikupanga hemoglobin yotchedwa glycated hemoglobin. Mukamakwera shuga m'magazi, hemoglobin yambiri imapangidwa. Akaphatikizidwa ndi hemoglobin, glucose amakhalabe "mogwirizana" mpaka kumapeto kwenikweni kwa moyo wa maselo ofiira, amenewo ndi masiku 120. Kuphatikiza kwa shuga ndi hemoglobin A kumatchedwa HbA1c kapena A1c. Glycated hemoglobin imapangika m'magazi ndikuwonekeranso tsiku ndi tsiku, maselo ofiira akale akamwalira, ndipo achinyamata (omwe sanakhalepo glycated) amatenga malo awo.

Kuyesa kwa hemoglobin A1c kumagwiritsidwa ntchito kuwunika momwe odwala apezeka ndi matenda a shuga. Zimathandizira kuwunika momwe glucose amayendetsedwera moyenera pakumwa.

Chiyeso cha hemoglobin A1c chimalembedwa kuti odwala ena azindikire matenda ashuga komanso mkhalidwe wa matenda ashuga kuphatikiza kuyesedwa kopanda shuga m'mimba ndi mayeso ololera a glucose.

Chowonetsera chomwe chimayesedwa peresenti. Odwala omwe ali ndi matenda ashuga ayenera kuyesetsa kuti asakhale ndi gawo lokwanira 7%.

A1c iyenera kuwonetsedwa mu imodzi mwanjira zitatu:

• monga kuchuluka kwa hemoglobin yonse,
• mu mmol / mol, malinga ndi International Federation of Clinical Chemistry and Laboratory Medicine,
• monga zakudya zazambiri za shuga ndi mg / dl kapena mmol / l.

Kodi kafukufukuyu amagwiritsa ntchito chiyani?

• Kuwongolera glucose kwa odwala omwe ali ndi matenda a shuga - kwa iwo, kukhala ndi magazi ake pafupipafupi monga momwe kungathekere ndikofunika kwambiri. Izi zimathandiza kuchepetsa zovuta mu impso, maso, mtima ndi mantha.
• Kuti mudziwe shuga wambiri m'magazi a wodwalayo miyezi ingapo yapitayo.
• Kutsimikizira kulondola kwa njira zomwe zimatengedwa pochiza matenda ashuga ndikudziwa ngati zikufunika kusintha.
• Kuti mudziwe mwa odwala omwe ali ndi matenda osokoneza bongo omwe amapezeka mosavuta m'magazi a magazi. Kuphatikiza apo, mayesowo amatha kukhazikitsidwa kangapo mpaka kuchuluka kwa glucose komwe mukufuna, ndiye kuti kumafunikira kubwerezedwa kangapo pachaka kuwonetsetsa kuti mulingo woyenera umasamalidwa.
• Monga njira yoteteza, kuzindikira matenda ashuga kumayambiriro.

Kodi phunziroli lidzakonzedwa liti?

Kutengera mtundu wa shuga komanso momwe matendawa angachiritsidwire, kuyezetsa kwa A1c kumachitika kawiri mpaka 4 pachaka. Pafupifupi, odwala matenda a shuga amalangizidwa kuti ayesedwe A1c kawiri pachaka. Ngati wodwala wapezeka ndi matenda oyamba kwa nthawi yoyamba kapena muyeso wowongolera sunagwire, kuwunikiranso kumaperekedwanso.

Kuphatikiza apo, kusanthula kumeneku kumayikidwa ngati wodwala akuwakayikira kuti ali ndi matenda ashuga, chifukwa pali zovuta zamagazi am'magazi:

• ludzu lalikulu
• kukodza kwambiri pafupipafupi,
• kutopa,
• kuwonongeka kwamawonekedwe
• kuchuluka kwa matenda.

Zotsatira zake zikutanthauza chiyani?

Mfundo zofunikira: 4.8 - 5.9%.

Kuyandikira kwambiri kwa A1c ndi 7% mwa odwala omwe ali ndi matenda ashuga, ndizosavuta kuwongolera matendawa. Chifukwa chake, pakuwonjezeka kwa kuchuluka kwa hemoglobin ya glycated, chiopsezo cha zovuta zimakulanso.

Zotsatira zakuwunika pa A1c zikutanthauziridwa motere.

Glycated hemoglobin

Zizindikiro zakupangika ndi kufunikira kwa matendawo pakuwunika

Kusanthula kwa hemoglobin ya glycated kumachitika ndi cholinga chotsatira:

• Kuzindikira matenda a carbohydrate metabolism (wokhala ndi glycated hemoglobin wa 6.5%, kupezeka kwa matenda ashuga kumatsimikiziridwa)
• Kuwunika matenda a shuga a mellitus (glycated hemoglobin amakupatsani mwayi wowunika mulingo wa kubwezera matenda kwa miyezi itatu),
• Kuyesedwa kwa kutsatira kwa wodwala chithandizo - kuchuluka kwa kulumikizana pakati pa zomwe wodwalayo akuchita komanso zomwe amalandila kuchokera kwa dotolo.

Kuyesedwa kwa magazi kwa hemoglobin ya glycated amalembedwa kwa odwala omwe amadandaula chifukwa cha ludzu lalikulu, kukodza mopitirira muyeso, kutopa msanga, kuwonongeka kwa mawonekedwe, komanso kuwonjezereka kwa matenda. Glycated hemoglobin ndi njira yowonjezeranso glycemia.

Kutengera mtundu wa matenda a shuga komanso momwe matendawa angachiritsidwire, kuwunika kwa hemoglobin ya glycated kumachitika kawiri mpaka kanayi pachaka. Pafupifupi, odwala matenda ashuga amalimbikitsidwa kupereka magazi kuti ayesedwe kawiri pachaka. Wodwala akapezeka ndi matenda oyamba kwa nthawi yoyamba kapena muyeso wawo sunaphule kanthu, madokotala amathandizanso kuwunika kwa hemoglobin ya glycated.

Kukonzekera ndi kutumiza kwa kusanthula kwa glycated hemoglobin

Kusanthula kwa hemoglobin ya glycated sikutanthauza kukonzekera mwapadera. Magazi safunikira kuthiridwa pamimba yopanda kanthu. Asanatenge sampuli ya magazi, wodwalayo safunikira kudziletsa pakumwa zakumwa, kupewa kukhumudwa kapena kutaya mtima. Mankhwala sangakhudze zotsatira za phunziroli (kupatula mankhwala omwe amachepetsa shuga).

Phunziroli ndi lodalirika kuposa kuyesedwa kwa magazi kapena mayeso okhudzana ndi shuga ndi "katundu". Kuwunikaku kukuwonetsa kuchuluka kwa hemoglobin ya glycated yomwe yakhala yoposa miyezi itatu. Pa fomu, yomwe wodwalayo adzalandila m'manja mwake, zotsatira za kafukufukuyo komanso muyezo wa hemoglobin wa glycated zidzawonetsedwa. Kutanthauzira kwa zotsatira zakuwunika mu chipatala cha Yusupov kumachitika ndi endocrinologist wodziwa zambiri.

Mitundu ya glycated hemoglobin mwa akulu

Nthawi zambiri, kuchuluka kwa hemoglobin wa glycated kumasiyana kuchokera ku 4.8 mpaka 5.9%. Mukamayandikira kuchuluka kwa hemoglobin wa glycated wodwala yemwe ali ndi matenda ashuga mpaka 7%, ndikosavuta kuyendetsa matendawa. Ndi kuchuluka kwa hemoglobin wa glycated, chiopsezo cha zovuta zimakulirakulira.

Glycated hemoglobin index amatanthauziridwa ndi endocrinologists motere:

• 4-6.2% - wodwala alibe matenda ashuga
• Kuchokera pa 5.7 mpaka 6.4% - prediabetes (kulekerera shuga, komwe kumalumikizidwa ndi chiwopsezo cha matenda a shuga),
• 6.5% kapena kupitilira - wodwalayo akudwala matenda a shuga.

Zina zimatha kukhudza ma metric. Odwala omwe ali ndi mitundu yachilendo ya hemoglobin (odwala omwe ali ndi maselo ofiira ofiira), kuchuluka kwa hemoglobin sikudzachepetsedwa. Ngati munthu akudwala hemolysis (kuwonongeka kwa maselo ofiira am'magazi), kuchepa magazi (kuchepa magazi), kutulutsa magazi kwambiri, ndiye kuti zotsatira zake zimawunikanso. Mitengo ya hemoglobin ya glycated imachulukidwa kwambiri chifukwa chosowa chitsulo m'thupi komanso kuthiridwa magazi kumene. Kuyesa kwa hemoglobin kwa glycated sikuwonetsa kusintha kwakukulu m'magazi a magazi.

Mafuta a glycated hemoglobin omwe ali ndi shuga wa tsiku ndi tsiku m'miyezi itatu yapitayo.

Glycated hemoglobin - chodziwika bwino mwa akazi akamabadwa

Kodi glycated hemoglobin mwa akazi ndi chiyani? Ichi ndi gulu linalake la erythrocyte hemoglobin wokhala ndi shuga. Kwa azimayi azaka zopitilira 30, chizolowezi chimawerengeredwa kuti ndi 4,9%, zaka 40 - 5.8%, zaka 50-6.7%, zaka d60-7.6%. Nthawi zambiri, zomwe zimapezeka mu hemoglobin wa glycated mwa azimayi azaka makumi asanu ndi awiri ndi zisanu ndi zitatu ndi 8.6%, pazaka 80 - 9.5%.

Kwa azimayi azaka zopitilira 80, zomwe zimakhala bwino glycated hemoglobin ndi 10,4%. Muzochitika zomwe wodwala amadwala matenda a shuga kwa nthawi yayitali, endocrinologist imatha kukhazikitsa chizolowezi cha iye, kutengera mawonekedwe a thupi komanso kuopsa kwa matendawa.

Momwe mankhwala a hemoglobin a glycated amachokera ku 5.5% mpaka 7%, azimayi amapezeka ndi mtundu wachiwiri wa matenda a shuga. Chizindikiritso kuchoka pa 7% mpaka 8% chikuwonetsa bwino odwala matenda ashuga, kuyambira 8 mpaka 10% - okwanira bwino, kuyambira 10 mpaka 12% - kulipidwa pang'ono. Ngati kuchuluka kwa hemoglobin ya glycated kuposa 12%, matenda a shuga sawerengedwa.

Kuchuluka kwa hemoglobin wa glycated mwa akazi kungawonetse kukhalapo kwa magazi m'thupi, kulolerana kwa glucose, zotsatira za kulowererapo (kuchotsa ndulu). Madokotala anena za kuchuluka kwa hemoglobin yochepetsedwa mwa azimayi pomwe ma plasma ake ali ochepera 4.5%. Mwa amayi apakati, glycated hemoglobin ingakhale yotsika poyerekeza ndi chifukwa cha kuchuluka kwazitsulo tsiku ndi tsiku. Kwa amayi apakati, chitsulo chamasiku onse ndi 15 mg-18 mg, kuyambira 5 mpaka 15 mg. Kuchepa kwa hemoglobin mwa akazi kumatha kuchitika chifukwa cha kutaya mtima kwakutali kwa chiberekero.

Kuchulukitsa ndi kuchepa kwa glycated hemoglobin

Kuchuluka kwa hemoglobin wowonjezereka kumawonetsa pang'onopang'ono, koma kuwonjezeka kwa kuchuluka kwa shuga m'magazi a anthu. Izi sizikusonyeza nthawi zonse matenda a shuga. Carbohydrate metabolism imatha kusokonekera chifukwa cha kulolerana kwa shuga. Zotsatira sizikhala zolondola ndi mayeso omwe aperekedwa molakwika (mutatha kudya, osati pamimba yopanda kanthu).

Kutsika kwa 4% glycated hemoglobin kumatsimikizira kuchuluka kwa shuga m'magazi - hypoglycemia pamaso pa zotupa (pancreatic insulinomas), matenda amtundu (kubadwa kwa glucose tsankho). Mlingo wa hemoglobin wa glycated umatsika ndikugwiritsa ntchito mankhwala osakwanira omwe amachepetsa shuga wamagazi, chakudya chopanda chakudya chamafuta, komanso kuchita masewera olimbitsa thupi, zomwe zimapangitsa kuti thupi lichepe. Ngati glycated hemoglobin yachuluka kapena yachepa, funsani ndi endocrinologist wa chipatala cha Yusupov, yemwe azichita kafukufuku wokwanira ndikupereka mayeso owonjezera a diagnostic.

Momwe mungachepetse glycated hemoglobin

Mutha kuchepetsa kuchuluka kwa hemoglobin wa glycated pogwiritsa ntchito njira zotsatirazi:

• Onjezerani zakudya zamasamba ndi zipatso zambiri zomwe zimakhala ndi fiber yambiri, zomwe zimathandiza kukhazikika kwa shuga m'magazi,
• Idyani mkaka wowonjezereka ndi yogati, yomwe muli calcium yambiri ndi vitamini D, zomwe zimapangitsa kuti shuga azikhala mwamtundu,
• Onjezani kudya kwanu mtedza ndi nsomba, zomwe zimaphatikizapo mafuta a omega-3 acid, omwe amathandizira kuchepetsa kukana kwa insulin ndikuwongolera shuga.

Kuti muchepetse kukana kwa glucose, nyengo ndi sinamoni ndi sinamoni, onjezerani zinthu zanu ku tiyi, kuwaza ndi zipatso, masamba ndi nyama yopanda mafuta. Cinnamon imathandizira kuchepetsa kukana kwa glucose komanso kuchuluka kwa hemoglobin wa glycated. Regencyitologists amalimbikitsa odwala tsiku lililonse kwa mphindi 30 kuti achite masewera olimbitsa thupi omwe amalola shuga komanso glycated hemoglobin bwino. Phatikizani masewera olimbitsa thupi aerobic ndi anaerobic pophunzitsidwa. Kuchita masewera olimbitsa thupi kumatha kuchepetsa shuga wamagazi anu kwakanthawi, pomwe kuchita masewera olimbitsa thupi (kuyenda, kusambira) kumatha kuchepetsa shuga ya magazi anu.

Kuti mupange mayeso a magazi pazomwe zili ndi glycated hemoglobin ndi kulandira upangiri kuchokera kwa endocrinologist woyenerera, itanani foni yolumikizana ndi chipatala cha Yusupov. Mtengo wofufuzira ndi wotsika kuposa momwe mabungwe ena azachipatala ku Moscow alili, ngakhale kuti othandizira ma labotale amagwiritsa ntchito zojambula zaposachedwa za glycated hemoglobin kuchokera kwa opanga otsogolera.

Glycated hemoglobin - ndi chiyani?

Mawu akuti glycated, kapena monga amatchedwanso glycated hemoglobin, amawerengedwa kuti ndi gawo la protein iyi ndi glucose (GLU). Ma mamolekyulu a Hemoglobin (Hb) ndi amodzi mwa zinthu zomwe zimapezeka m'maselo ofiira a m'magazi - maselo ofiira amwazi. Glucose imalowa mkati mwa membrane wawo, ndikuphatikizana ndi hemoglobin, ndikupanga glycogemoglobin (HbA1c), ndiye gulu la Hb + GLU.

Izi zimachitika popanda kutenga nawo michere, ndipo umatchedwa glycation kapena glycation. Kuchuluka kwa hemoglobin wa glycated m'magazi, mosiyana ndi glucose yaulere (yopanda malire), ndi mtengo wosasintha. Izi zimachitika chifukwa cha kukhazikika kwa hemoglobin mkati mwa matupi ofiira. Nthawi yayitali yokhala ndi maselo ofiira a m'magazi ndi pafupifupi miyezi 4, kenako amawonongedwa pamkaka wofiira wa ndulu.

Kuchuluka kwa glycation kumadalira kuchuluka kwa shuga m'magazi, ndiko kuti, kuchuluka kwa shuga m'magazi ambiri a glycogemoglobin. Ndipo popeza maselo ofiira amakhala ndi moyo kwa masiku 90-120, ndi nzeru kuchita kuyezetsa magazi glycated osatinso kotala. Ndikukonzekera kuti mayeso amawonetsa pafupifupi shuga watsiku ndi tsiku omwe amapezeka miyezi itatu. Pambuyo pake, maselo ofiira amwazi adzasinthidwa, ndipo mawonekedwe ake adzawonetsa kale zomwe zili m'magazi - glycemia masiku 90 otsatira.

Zizindikiro zachilendo za HbA1

Miyezo ya hemoglobin yokhala ndi glycated enieni kwa anthu odwala matenda a shuga amatha kusiyana 4 mpaka 6%. Choyimira chimawerengeredwa ndi kuchuluka kwa HbA1c mpaka kuchuluka kwathunthu kwa maselo ofiira amwazi m'magazi, chifukwa chake, akuwonetsedwa ngati peresenti. Chikhalidwe cha chizindikiro ichi chikuwonetsa kagayidwe kokwanira ka chakudya mu nkhaniyi.

Kuphatikiza apo, izi ndizofunikira kudziwa momwe anthu onse aliri, osawagawa pamsinkhu ndi msambo. Chikhalidwe chopanga matenda a shuga chimawonedwa mwa anthu okhala ndi index ya HbA1c ya 6.5 mpaka 6.9%. Ngati maulalo apitilira chizindikiro cha 7%, izi zikutanthauza kuphwanya kusinthana, ndipo kulumpha kumachenjeza za mkhalidwe wotchedwa prediabetes.

Malire a hemoglobin a glycosylated, omwe amawonetsa momwe odwala matenda ashuga amasiyana, kutengera mitundu ya matenda, komanso magulu azaka za odwala. Achinyamata omwe ali ndi matenda ashuga azisunga HbA1c kutsika kuposa omwe ali achikulire komanso okalamba. Pa nthawi yoyembekezera, shuga ya magazi a glycated imamveka bwino nthawi yoyamba, pomwe m'tsogolo, chifukwa cha kusintha kwa mahomoni, zotsatira zake sizikuwonetsa chithunzi chodalirika.

Nthawi zina zizindikiro zimatha kukhala zosokoneza.Izi zimakonda kuphatikizidwa ndi kupezeka kwa mitundu yosiyanasiyana ya hemoglobin, yomwe imakhala yokhudza thupi (mwa ana mpaka miyezi isanu ndi umodzi) komanso matenda am'mimba (a beta-thalassemia, HbA2 imawonedwa).

Kodi glycated hemoglobin imachuluka bwanji?

Kuchulukitsa kwa chizindikiro ichi kumawonetsa kuwonjezeka kwampweya wamagazi m'magazi a wodwalayo. Komabe, chomwe chimayambitsa kukula sikuti nthawi zonse chimakhala matenda a shuga. Itha kupangidwanso chifukwa cha kulolera m'magazi kwa glucose (kuvomereza) kapena glucose kudya, komwe ndi chizindikiro cha prediabetes.

Ngakhale zili zofunikira kudziwa kuti matendawa akuwonetsa kusokonezeka kwa metabolic ndipo ali ndi vuto la matenda ashuga. Nthawi zina, pamakhala kuwonetsa konyenga kwa zizindikiro, ndiye kuti sizikugwirizana ndi zomwe zimayambitsa matenda ashuga. Izi zitha kuwonedwa ndi kuchepa kwa magazi m'thupi kapena kutulutsa ndulu - splenectomy.

Kodi chifukwa chikuchepera chizindikiritso ndichiti?

Kutsika kwachinsinsi ichi pansipa 4% kukuwonetsa kuchepa kwakanthawi m'thupi la shuga m'magazi, amenenso ndikupatuka. Kusintha kotereku kumatha limodzi ndi zizindikiro za hypoglycemia - kuchepa kwa shuga m'magazi. Choyambitsa chachikulu cha mawonetseredwe oterewa chimawonetsedwa ngati insulin - chotupa cha kapamba, chomwe chimapangitsa kuphatikizika kwa insulin.

Komanso, monga lamulo, wodwalayo alibe insulin kukana (kukana insulini), ndipo kukhathamiritsa kwakukulu kwa insulin kumayambitsa kuchuluka kwa shuga, komwe kumayambitsa hypoglycemia. Insulinoma sindicho chifukwa chokhacho chomwe chimatsogolera kuchepa kwa hemoglobin ya glycated. Kuphatikiza pa iye, mayiko otsatirawa ndi osiyana:

• mankhwala osokoneza bongo omwe amachepetsa shuga ya magazi (insulin),
• ntchito yayitali yolimbitsa thupi,
• Zakudya zazitali za carb
• adrenal kusowa
• kawirikawiri cholowa m'magulu - kusabadwa kwa shuga m'magazi, matenda a Hirke, matenda a Herce ndi matenda a Forbes.

Kudziwitsa Ubwino wa Kuzindikira

Kafukufuku wokhudza kuchuluka kwa hemoglobin wa glycated ndizochepa kwambiri poyerekeza ndi mayeso a shuga wamagazi ndi mayeso ololera a glucose. Cholepheretsa chachikulu pakudutsa kuwunikaku ndi mtengo wake. Koma mtengo wake wodziwa matenda ndi wapamwamba kwambiri. Ndi njira imeneyi yomwe imapatsa mwayi kudziwa matenda a shuga m'magawo oyambira ndikuyambitsa chithandizo chofunikira panthawi yake.

Komanso, njirayi imalola kuwunika kwa wodwalayo pafupipafupi ndikuwunika momwe njira zochiritsira zimathandizira. Kusanthula kwa hemoglobin m'matumbo kumathandiza kuti odwala omwe shuga yawo yayandikira. Kuphatikiza apo, kufufuzaku kukuwonetsa kudwala kwa wodwala kwa miyezi isanu ndi itatu yapitayo, ndipo ambiri amasiya kudya maswiti awiri okha isanakwane cheki yomwe ikubwera, akuyembekeza kuti dokotala sangadziwe za izi.

Mlingo wa HbA1c umawonetsa kuchuluka kwa ntchito zamafuta a carbohydrate metabolism m'masiku 90-120 apitawo. Matenda a mtunduwu amapezeka pafupifupi milungu isanu ndi umodzi, atabweretsa shugayo mwanjira wamba. Kuphatikiza apo, mwa anthu omwe ali ndi matenda a shuga, hemoglobin wa glycated imatha kuchuluka katatu.

Kodi kuwunika kumayenera kuchitika kangati ndipo kangati pa HbA1c?

Kutengera ndi malingaliro a WHO - World Health Organisation - njirayi imadziwika kuti ndiyo njira yabwino kwambiri yowunikira odwala omwe ali ndi matenda a shuga. Madokotala amalimbikitsa odwala otere kuti azichita mayeso a HbA1c kamodzi kamodzi miyezi itatu. Musaiwale kuti zotsatira zomwe zimapezeka m'ma labotera osiyanasiyana zimasiyana. Zimatengera njira yomwe imagwiritsidwa ntchito pokonza zitsanzo zamagazi.

Chifukwa chake, yankho labwino kwambiri ndikupereka magazi mu labotale yofanana kapena kusankha chipatala chofanizira. Mukamayang'anira chithandizo cha matenda osokoneza bongo, akatswiri amalimbikitsa kukhala ndi HbA1c pafupifupi 7% ndikuwunikiranso nthawi yomwe madokotala adzafike 8%. Manambalawa amagwira ntchito pokhapokha njira zodziwira HbA1c zokhudzana ndi DCCT yotsimikizika (kuwongolera kwa matenda ashuga ndi zovuta zake).

Thandizo! Ziyeso zamankhwala zokhazikitsidwa ndi njira zotsimikiziridwa zimawonetsa kuwonjezeka kwa 1% ya hemoglobin ya glycosylated ndikuwonjezeka kwa plasma glucose pafupifupi 2 mmol / L. HbA1c imagwiritsidwa ntchito ngati chofunikira pazovuta za matenda a shuga. Pa kafukufukuyu, zidatsimikiziridwa kuti kuchepa kwa HbA1c ngakhale 1% kumapangitsa kutsika kwa 45% pachiwopsezo cha kupitirira kwa matenda ashuga retinopathy (kuwonongeka kwa retinal).

Momwe mungakonzekerere kusanthula

Chimodzi mwazinthu zosatsimikizika za phunziroli ndi kusapezeka kwathunthu kwa kukonzekera. Mwayiwu umaperekedwa kwa odwala chifukwa chakuti kusanthula kumawonetsa chithunzichi kwa miyezi 3-4, komanso chifukwa chakuti kuchuluka kwa glucose, mwachitsanzo, chakudya cham'mawa chikadzuka, palibe kusintha kwina komwe kudzachitike. Komanso nthawi ndi zochita zolimbitsa thupi sizingakhudze zotsatira zake.

Maluso apadera amakupatsirani mwayi kuti mupeze chidziwitso choyenera mosasamala kuchuluka kwa zakudya ndi mawonekedwe ake, mankhwala osokoneza bongo, matenda opatsirana komanso opatsirana, mkhalidwe wosakhazikika m'maganizo, komanso mowa.

Ngakhale zotsatira zabwino kwambiri, ngati wodwalayo ali ndi mwayi, ndibwino kukonzekera kuti apereke magazi pamimba yopanda kanthu. Izi ndizofunikira kwambiri ngati munthu atayeza mayeso okhudza shuga ndi zinthu zina zamagazi.

Pakukambirana, endocrinologist iyenera kuchenjezedwa za kukhalapo kwa ma pathologies (mwachitsanzo, matenda a kuchepa magazi kapena kapamba) komanso kuchuluka kwa mavitamini. Ngati wodwalayo watha magazi kwambiri kapena alandila magazi, ndiye kuti njirayo iyenera kuikidwa pambuyo masiku 4-5.

Njira zoperekera magazi

Mutha kupereka magazi kuti muwoneke HbA1c kuchipatala chilichonse chokhala ndi mbiri yofufuza, ponse pa oyang'anira komanso apadera. Kutumiza kuchokera kwa dokotala kudzangofunikira mu malo olembera boma, mwa omwe analipira sikofunikira.

Njira yoyeserera magazi siyosiyana ndi mayeso ena. Monga lamulo, biomaterial imatengedwa kuchokera kumitsempha, koma magazi a capillary, omwe amachotsedwa chala, amagwiritsidwa ntchito m'njira zina. Kudziwunikira lokha, komanso kumasulira kwake, kukonzekera mu masiku 3-4, kotero wodwalayo sayenera kudikirira nthawi yayitali kuti zotsatira zake zitheke.

Kulipiritsa kwa matenda a shuga motsogozedwa ndi HbA1c

Kuphatikiza pakutsimikiza koyambirira kwa matenda a shuga, cholinga chachiwiri chofunikira choyesera zomwe zili ndi hemoglobin ya glycated ndikusunga momwe odwala alili. Ndiko kuti, kupereka chipukuta motsatira malangizowo - kukwaniritsa ndikusunga HbA1c wochepera 7%.

Ndi zizindikiro zotere, matendawa amawaganiziridwa mokwanira, ndipo kuopsa kwa zovuta kumadziwika kuti kochepa. Zachidziwikire, njira yabwino kwambiri ikhoza kukhala kuti ndalamazo sizikhala zopambana kuposa anthu athanzi - 6.5%. Komabe, akatswiri ena amakhulupirira kuti ngakhale chisonyezo cha 6.5% ndi chizindikiro cha matenda omwe samalipiridwa bwino ndipo mavuto amakula.

Malinga ndi ziwerengero, mwa anthu athanzi opatsa thanzi, okhala ndi chakudya chambiri, HbA1c nthawi zambiri imakhala yofanana ndi 4.2-4.6%, yomwe imafanana ndi shuga wambiri wa 4-8,8 mmol / l. Apa amalimbikitsa ndikuyesera kuzisonyezo zotere, ndipo ndizosavuta kukwaniritsa mukasinthira ku chakudya chamafuta ochepa. Tisaiwale kuti shuga wabwinoko imalipidwa, ndiye kuti pamakhala chiwopsezo chachikulu cha hypoglycemia (kuchepa kwa shuga wamagazi) ndi kuperewera kwa hypoglycemic.

Poyesa kupewa matendawa, wodwalayo amayenera kukhala nthawi yayitali pamzere wabwino pakati pa shuga komanso vuto la hypoglycemia. Izi ndizovuta kwambiri, motero wodwalayo amaphunzira ndikuchita moyo wawo wonse. Koma powonetsetsa mosamala zakudya zamafuta ochepa - ndizosavuta. Kupatula apo, chakudya chochepa chomwe wodwala matenda ashuga amalowa m'thupi, akapanda kufunikira mankhwala ochepetsa shuga kapena insulin.

Ndipo kuchepa kwa insulin, momwemonso kumachepetsa chiopsezo cha hypoglycemia. Chilichonse ndichopepuka, chimangokhala zakudya zokha. Kwa odwala okalamba omwe ali ndi matenda ashuga omwe amayembekeza kukhala zaka zosakwana 5 - 7.5-8% ndipo nthawi zina ngakhale apamwamba amatengedwa ngati mfundo zabwino. Mgulu lino, chiopsezo cha hypoglycemia ndiowopsa kwambiri kuposa chiwopsezo cha zovuta. Pomwe ana, achinyamata, achinyamata, komanso amayi oyembekezera amalangizidwa kwambiri kuti ayang'anire chizindikirocho ndikuletsa kuti chisakwere pamwamba 6.5%, komanso kuposa 5%.

Njira zochepetsera magwiridwe antchito

Monga tafotokozera pamwambapa, kuchepa kwa hemoglobin ya glycated kumakhudzana mwachindunji ndi kuchepa kwa ndende yamagazi. Chifukwa chake, kuti muchepetse HbA1c, ndikofunikira kutsatira malingaliro onse a adokotala kuti akonze zomwe zili ndi matenda ashuga.

Izi zimaphatikizapo:

• kutsatira boma ndi mtundu wapadera wa chakudya,
• cheke nthawi zonse shuga,
• masewera olimbitsa thupi olimbitsa thupi komanso masewera ochepa,
• munthawi yomweyo mankhwala mankhwala, kuphatikizapo insulin,
• kutsatira kusiyanitsa koyenera kwa kugona ndi kudzutsidwa,
• kuyendera nthawi yachipatala kuchipatala kuti akawonetsetse momwe alili ndikupeza upangiri.

Ngati zoyesayesa zonse zomwe zachitika zidayambitsa kuti shuga akhalebe masiku angapo, pomwe wodwalayo akumva bwino, izi zikutanthauza kuti malangizowo adachitidwa molondola ndipo njira ziyenera kutsatiridwa. Chifukwa chake, cheke chapafupi kwambiri cha hemoglobin yokhala ndi glycated iyenera kuwonetsa zotsatira zokwanira, ndipo mwakuthekera, kopereka kwotsatira magazi kumakhala komweko.

Kutsika mofulumira kwambiri kwazomwe zimatha kukhala ndi vuto kumatha kuwona, mpaka kutayika kwathunthu. Popeza nthawi yayitali thupi limatha kuzolowera komanso kusinthika mwachangu kumabweretsa zosasinthika. Chifukwa chake, muyenera kutsatira mosamalitsa malangizo a dokotala ndipo musataye mopitirira.