Ukuphazamiseka kwe-carbohydrate metabolism ezinganeni kuhlotshaniswa nokukhubazeka kofuzo. Ingozi yesifo sikashukela iyanda uma abazali noma izihlobo ezisondelene nengane zigula.
Ukuze uqale ukwelashwa ngesikhathi, kubalulekile ukwenza ukuxilongwa okuyikho ngokushesha okukhulu. Ngakho-ke, izingane ezivela kwisifo sikashukela esinobungozi obukhulu kufanele zibhekwe udokotela wezingane futhi zihlolwe njalo elebhu.
Isimo somtholampilo sesifo sikashukela ezinganeni singezimpawu eziphansi, bese siziveza njengobunzima obukhulu bunjengomqondo we-ketoacidotic coma. Ngakho-ke, ukungabikho kwezimpawu zesifo sikashukela akuyona njalo ukuqinisekiswa kwempilo yengane.
Yini ethinta ushukela wegazi?
Izindlela ushukela ongena ngazo egazini zingaba ngaphandle nangaphakathi. Ngaphandle, ushukela ungena nokudla. Umkhiqizo ungaqukatha i-glucose emsulwa, okuthi kuyo uma kunjalo iqale ukudonswa emgodini womlomo. Futhi ingatholakala kushukela oyinkimbinkimbi, okufanele uhlukaniswe yi-enzyme - amylase.
I-Sucrose, i-fructose, i-galactose, equkethe ukudla, ekugcineni ibuye ibe ngamangqamuzana eglucose. Indlela yesibili i-glucose ehanjiswa ngayo ihlobene nendlela esheshayo yokuthola - ukwephuka kwe-glycogen. Ngaphansi kwethonya lama-hormone (ngokuyinhloko i-glucagon), i-glycogen ihlephuka ku-glucose iphinde iphinde iphinde ichithe ukwanda kwayo uma ukudla kungatholwa.
Amaseli wesibindi ayakwazi ukukhipha ushukela kusuka kuma-lactate, ama-amino acid kanye ne-glycerol. Le ndlela yokukhiqiza ushukela iba yinde futhi iqala uma izitolo ze-glycogen zinganele ukusebenza ngokomzimba.
Ngemuva kokudla, amazinga kashukela egazi ayanda, okuyilokho ama-receptors emanyikwe asabela ngakho. Ezinye izingxenye ze-insulin zikhishwa ziye egazini. Ngokujoyina ama-receptors kuma-membranes weseli, i-insulin ikhuthaza ukuthathwa koshukela.
Ngaphakathi kwamaseli, ushukela uguqulwa abe ngamangqamuzana e-ATP asetshenziswa njenge-substrate yamandla. Leyo glucose engeke isetshenziswe igcinwa esibindini njenge-glycogen.
Umphumela we-insulin kuma-glucose metabolism ubonakala ngemiphumela enjalo:
- Ukusheshisa ukumuncwa kwe-glucose nama-amino acid, i-potassium, i-phosphates ne-magnesium.
- Iqala i-glycolysis ngaphakathi kweseli.
- Isebenzisa ukwakheka kwe-glycogen.
- Inqanda ukuvela koshukela yisibindi.
- Ikhuthaza ukuhlanganiswa kwamaprotheni.
- Ngcono ukwakheka kwama-acid anamafutha, ukuguqulwa kwe-glucose ibe yi-lipids.
- Yehlisa ukungena kwamafutha acid egazini.
Ngaphezu kwe-insulin, i-glucagon, i-cortisol, i-norepinephrine, i-adrenaline, i-hormone yokukhula ne-thyroid kunomthelela kushukela. Zonke zinomthelela ekwandeni koshukela wegazi.
Izinga likashukela wegazi enganeni
Ngenxa yokusebenza kwala ma-hormone, izinga le-glucose legazi ligcinwa emzimbeni, kepha aliguquki, kepha liyaguquguquka usuku lonke ngokuya ngesakhiwo sokudla esithethwe kanye nokuzivocavoca umzimba. Ezinganeni, isikhathi sokushintshashintsha okunjalo kuncike eminyakeni yobudala.
Itafula elikhombisa ukugcwala koshukela kubonisa amanani aphakathi. Isibonelo, indlela ejwayelekile kashukela wegazi enganeni eneminyaka eyi-8 ibanga kusuka ku-3.3 kuya ku-5.5 mmol / l, kumntwana ononyaka owodwa - 2,75-4.4 mmol / l.
Lezi zinkomba zibonisa i-metabolism ejwayelekile yama-carbohydrate, ehambelana nobudala bengane. Ukuhlaziywa kwenziwa ngesisu esingenalutho, okubonakalayo kungenzeka kube ligazi le-venous ne-capillary. Nge-plasma yegazi, okujwayelekile kuphakeme.
Ukuhlolwa kwegazi okusheshayo kubonisa amazinga ashukela asisekelo. Ukuze uhlole ukuthi ama-pancreas asebenza kanjani, kufanele wazi ukuthi i-glycemia ishintsha kanjani ngemuva kokudla. Ukwenza isivivinyo somthwalo weglucose kukuvumela ukuthi unqume ukuthi i-insulin ilinciphisa ngokushesha kangakanani ushukela wegazi kumanani ajwayelekile, okungukuthi, ukwazi ukubekezelela ushukela.
Ukuhlolwa kokubekezelela kwe-glucose kuyakhonjiswa:
- Okokuhlolwa kwelebhu oshukela noma i-prediabetes.
- Kukhona ukuqunjelwa kwefa.
- Ngokukhuluphala noma ukunciphisa umzimba.
- Ngenkambo eqhubekayo ye-candidiasis, furunculosis.
- Ngokuvamile izingane ezigulayo.
- Ngemuva kwezifo ezinzima ezithathelanayo.
Ngemuva kokuthatha i-glucose ihora, ushukela wegazi ukhuphuka uye phezulu, bese i-insulin isiza ukwehlisa amahora amabili ngemuva kokungenisa. Izinga le-glucose ngemuva kwamahora amabili kusuka ekuphathweni lifinyelela ku-7.8 mmol / l.
Ithebula, onganquma ngalo imbangela yokuduka kokujwayelekile, libonisa ukuthi kwisifo sikashukela le nkomba ingaphezulu kuka-11.1 mmol / l, futhi amanani aphakathi nendawo ahambelana ne-prediabetes.
I-Hypoglycemia
I-hypoglycemia yesikhathi esifushane ivame kakhulu ezinganeni ezisanda kuzalwa ngokubambezeleka kokukhula noma i-asphyxia ngesikhathi sokubeletha. Isidingo sezingane eziseglucose siphindwe kabili izikhathi kunezabantu abadala, futhi nezitolo zazo ze-glycogen ziphansi. Ngokubulawa yindlala noma ukungondleki ezinganeni kusuka onyakeni kuya eminyakeni eyi-9 egazini, ushukela wehla ngaphansi kwe-2.2 mmol / L.
Izimpawu ze-hypoglycemia ezinganeni zibonakaliswa ngokujuluka okungaphezulu, izandla nezinyawo, ukuthuthumela, isikhumba, ukuyaluza, isicanucanu, kanye nokwanda kwenhliziyo. Ngemuva kwalokho, buthakathaka, ikhanda, ubuvuvu, ukozela kufakwa kulezi zibonakaliso.
Ezinganeni ezisanda kuzalwa, izimpawu ze-hypoglycemia ziwukuthi ukozela kanye nokuqina. I-hypoglycemia enkulu iholela ekuqulekeni, ekulahlekelweni yimizwa, ekuqineni nasekuqineni komzimba.
I-Hypoglycemia ezinganeni ingaba ne-pathologies enjalo:
- Isifo sesibindi.
- Izifo ezithathelwanayo.
- I-Congenital hyperinsulinism.
- Ubuthi.
- Ama-tumors
I-Hyperglycemia
Ukwanda koshukela wegazi kwenzeka ngokuntuleka kwe-insulin noma ukukhiqizwa okukhuphukile kwama-hormone okulwa nabathile. Lokhu kuvame ukuhlotshaniswa nesifo sikashukela i-mellitus, ukwanda kwezigameko zazo eziqhubekayo njalo ngonyaka. Ezinganeni, isifo sikashukela ezimeni eziningi sibangelwa ukubhujiswa kwe-autoimmune kwama-pancreas.
Izimbangela eziholela kuhlobo lwe-1 mellitus yesifo sikashukela zivele kuphela ngesiphetho sofuzo. Zingaba ngamagciwane, izinto ezinobuthi, izidakamizwa, ama-nitrate ekudleni nasemanzini, ingcindezi. Isifo sikashukela sohlobo 2 asivamile futhi sihambisana nokukhuluphala, senzeka ezinganeni ezine-genetic genetic pathology edluliselwa ezihlotsheni eziseduze.
Ukuboniswa kwesifo sikashukela ezinganeni kuqala ngokonyuka okwandayo, ukuchama ngokweqile, ukungasebenzi komchamo kanye nokunciphisa umzimba ngokudla okunempilo. Isimpawu esibonakalayo sinciphile ukungatheleleki, umkhuhlane ojwayelekile, izifo zesikhumba, ukutheleleka ngefungus. Ngokuxilongwa sekwephuzile kanye nokungatholakali kokwelashwa, kuba nesimo se-ketoacidotic.
Lapho kutholwa isifo sikashukela i-mellitus, ukukhuphuka kokushukela okusheshayo kwegazi okungaphezulu kuka-6.1 mmol / L kubhekelelwa, futhi ngemuva kokudla kwe-glucose (ukuhlolwa kokubandlululwa kweglucose), kuphezulu kuno-11.1 mmol / L.
Ngaphezu kwesifo sikashukela, i-hyperglycemia yenzeka nge:
- Isithuthwane
- I-endocrine pathology: i-thyrotooticosis, i-adrenal gland pathology, izifo zesifo se-pituitary.
- Isifo se-pancreatic.
- Izifo ezingapheli sezinso kanye nezesibindi.
- Imizwelo enamandla.
- Ukuzivocavoca ngokweqile.
- Ukuthatha izidakamizwa ze-hormonal.
Kwividiyo ekulesi sihloko, uDkt Komarovsky uzokhuluma ngamazinga kashukela ezinganeni.
