Isifo sikashukela sikhula ngokuntuleka kwe-insulin noma ukulahleka kokuzwela kwe-receptor kuyo. Isibonakaliso esiyinhloko sesifo sikashukela yi-hyperglycemia.
I-Hyperglycemia ukwanda kwe-glucose yegazi. Ukuze kube lula, igama livame ukushintshwa igama elithi "ushukela wegazi." Ngakho-ke, ushukela kanye noshukela egazini kuyinto efanayo noma ukuthi akukho mehluko phakathi kwabo.
Ngokombono wokubukwa kwe-biochemistry, ushukela neglucose kunomehluko, ngoba ushukela ngendlela yakhe emsulwa awunakusetshenziselwa amandla. Ngokwesifo sikashukela, inhlala-kahle nokulindelwa kwempilo yeziguli kuya ngezinga le-glucose (ushukela) egazini.
Ushukela neglucose - iqhaza kwezondli kanye nemetabolism
Ushukela, otholakala kumhlanga, i-beet, ushukela, isundu, isundu, ubizwa ngokuthi ushukela. I-Sucrose emathunjini iphulwe yaba yi-glucose ne-fructose. I-Fructose ingena kumaseli ngokwayo, futhi ukusebenzisa ushukela, amaseli adinga i-insulin.
Izifundo zanamuhla zikhombisile ukuthi ukusetshenziswa ngokweqile kwama-carbohydrate alula, afaka ushukela, i-fructose, i-sucrose, i-lactose, kuholela ezifweni ezinzima ze-metabolic:
- Isifo sokuqina kwemithambo yegazi
- Isifo sikashukela i-mellitus, kanye nezinkinga ngendlela yomonakalo ohlelweni lwezinzwa, imithambo yegazi, izinso, ukulahleka kombono kanye nokukhubazeka okusongela impilo.
- Isifo senhliziyo, isifo se-myocardial infarction.
- Umfutho wegazi ophakeme.
- Ingozi yeCerebrovascular, stroke.
- Ukukhuluphala ngokweqile
- Ukonakala kwamafutha kwesibindi.
Okubaluleke kakhulu isincomo ekuvinjelweni okubukhali koshukela kubantu asebekhulile abanenkinga yokukhuluphala ngokweqile kanye ne-arterial hypertension. Ama-carbohydrate atholakala okusanhlamvu okungahlutshiwe, izithelo, imifino kanye nama-legumes akubeki ingozi emzimbeni, ngoba isitashi ne-fructose kuzo akubangeli ukukhuphuka okubukhali koshukela.
Ngaphezu kwalokho, i-fiber ne-pectin equkethwe emikhiqizweni yemvelo kuvame ukususa i-cholesterol eyeqile kanye noshukela emzimbeni. Ngakho-ke, umzimba unakekela ukuthi ungawathola kuphi amakhalori adingekayo. Ama-carbohydrate amaningi ayindlela engathandeki kunazo zonke.
I-glucose yezitho zomzimba ingumnikezeli wamandla akhiqizwa emangqamuzaneni ngesikhathi se-oxidation.
Imithombo ye-glucose isitashi ne-sucrose ekudleni, kanye nasezitolo ze-glycogen esibindini; ingakhiwa kuma-lactate nama-amino acid ngaphakathi komzimba.
Ushukela wegazi
I-carbohydrate metabolism emzimbeni, futhi ngenxa yalokho izinga leshukela, ilawulwa ngama-hormone anjalo:
- I-insulin - yakhiwa kumaseli we-beta wamanyikwe. Yehlisa ushukela.
- IGlucagon - ihlanganiswe kumaseli we-alpha we-pancreas. Kwandisa ushukela egazini, kudala ukuwohloka kwe-glycogen esibindini.
- ISomatotropin ikhiqizwa kwi-lobe engaphandle ye-pituitary gland, iyi-contra-hormonal (isenzo esiphambene ne-insulin) i-hormone.
- I-Thyroxine ne-triiodothyronine - ama-hormone e-thyroid, abangela ukwakheka kwe-glucose esibindini, avimbele ukunqwabelana kwawo kwezicubu zemisipha nesibindi, akhuphule ukusetshenziswa kwamaseli nokusebenzisa ushukela.
- I-Cortisol ne-adrenaline kukhiqizwa ungqimba lwe-cortical of the adrenal glands ephendula ezimweni ezicindezelayo zomzimba, ezikhulisa amazinga kashukela egazini.
Ukunquma ushukela wegazi, kwenziwa isisu esingenalutho noma ukuhlolwa kwegazi okuyi-capillary. Ukuhlaziywa okunjalo kukhonjisiwe: kwesifo sikashukela esisolisayo, umsebenzi okhubazekile we-yegilo gland, i-pituitary gland, isibindi nezindlala ze-adrenal.
I-glucose yegazi (ushukela) ibhekelwe ukuthi ihlole ukwelashwa ngamaphilisi we-insulin noma okwehlisa ushukela uma kunezimpawu ezifana:
- Khulisa ukoma
- Ukuhlaselwa yindlala, kuhambisana nekhanda, isiyezi, izandla eziqhaqhazelayo.
- Khulisa ukuphuma komchamo.
- Ubuthakathaka obukhali.
- Ukwehla kwesisindo noma ukukhuluphala.
- Ngokuthambekela kwezifo ezithathelwanayo njalo.
Isimo esijwayelekile somzimba sisezingeni elingama-mmol / l ukusuka ku-4.1 kuye ku-5.9 (njengoba kuchazwe indlela ye-glucose oxidative) yamadoda nabesifazane abaneminyaka engu-14 kuye kwengama-60. Emaqenjini abantu abadala, inkomba iphezulu, ezinganeni kusuka emavikini amathathu kuya kwayi-14, izinga kusuka ku-3.3 kuya ku-5.6 mmol / l lithathwa njengokujwayelekile.
Uma inani lale nkomba liphezulu, lokhu kungaba uphawu lwesifo sikashukela kwasekuqaleni. Ukuze uxilongeke ngokunembile, udinga ukwenza ucwaningo nge-glycated hemoglobin, ukuhlolwa okubekezelela ushukela, udlulise umchamo ushukela.
Ngaphezu kwesifo sikashukela i-mellitus, njengesibonakaliso sesibili, ushukela ophakeme ungaba nezifo ezifana nalezi:
- I-pancreatitis kanye nama-tumany pancreatic.
- Izifo zezitho ze-endocrine: i-pituitary, yegilo kanye nezindlala ze-adrenal.
- Esikhathini esibi sokushaywa unhlangothi.
- Nge-infyoction ye-myocardial.
- Nge-nephritis engapheli kanye ne-hepatitis.
Umphumela walolu cwaningo ungathinteka: ukugcwala ngokweqile ngokomzimba nangokomzwelo, ukubhema, ukuthatha i-diuretics, amahomoni, i-beta-blockers, i-caffeine.
Lesi sikhombisi sincipha ngokweqile kwe-insulin nezinye izidakamizwa zesifo sikashukela, indlala, ubuthi nge-arsenic notshwala, ukuvivinya umzimba ngokweqile, ukuthatha ama-anabolic steroid. I-Hypoglycemia (kwehlisa ushukela wegazi) kwenzeka nge-cirrhosis, umdlavuza nokuphazamiseka kwe-hormonal.
Izinga le-glucose egazini ngesikhathi sokukhulelwa lingakhuphuka, futhi ngemuva kokubeletha ingane ingabuyiselwa kokujwayelekile. Lokhu kungenxa yokwehla kokuzwela kwe-insulin ngaphansi kwethonya lesizinda esishintshiwe samahomoni. Esimweni lapho izinga eliphakeme likashukela liphikelela, lokhu kwandisa ubungozi be-toxicosis, ukuphuka kwesisu, kanye ne-renal pathology.
Uma ulinganisa ushukela wegazi kanye, isiphetho asikwazi ukubhekwa njengethembekile ngaso sonke isikhathi. Ucwaningo olunjalo lubonisa kuphela isimo samanje somzimba, esingathinteka ngokudla, ingcindezi kanye nokwelashwa kwezidakamizwa. Ukuhlola ngokugcwele i-carbohydrate metabolism, kusetshenziswa izivivinyo ezilandelayo:
- Ukubekezelelwa kwe-glucose (ngokuzivocavoca).
- Okuqukethwe hemoglobin glycated.
Ukuhlolwa kokubekezelela ushukela kuyadingeka ukuze kuvivinywe ukuthi umzimba uphendula kanjani ekuphuzeni i-glucose. Kusetshenziselwa ukuthola isifo sikashukela esise-latent, ushukela onesifo seglue evamile, kanye nokuxilonga isifo sikashukela kwabesifazane abakhulelwe, noma ngabe bekungekho ukwanda koshukela wegazi ngaphambi kokukhulelwa.
Ucwaningo lunqunyelwe lapho kungekho khona izifo ezithathelwanayo, umsebenzi omuhle, imishanguzo ethinta amazinga kashukela kufanele ikhanseliwe ezinsukwini ezintathu ngaphambi kokuhlolwa (ngemvume kuphela udokotela ohambelayo). Kuyadingeka ukugcina irejimeni ejwayelekile yokuphuza, ungashintshi ekudleni, utshwala bunqatshelwe ngosuku. Ukudla kokugcina kunconyelwe amahora angu-14 ngaphambi kokuhlaziywa.
Ukuhlolwa kwegazi ushukela onomthwalo weziguli kuyakhonjiswa:
- Ngokubonakaliswa kwe-atherosulinosis.
- Ngokwanda okuqhubekayo komfutho wegazi.
- Uma kwenzeka kwesisindo somzimba esibalulekile.
- Uma izihlobo ezisondelene zinesifo sikashukela.
- Iziguli ezine-gout.
- Nge-hepatitis engamahlalakhona.
- Iziguli ezine-metabolic syndrome.
- Nge-neuropathy yemvelaphi engaziwa
- Iziguli ezithatha ama-estrogens, ama-hormone e-adrenal, nama-diuretics isikhathi eside.
Uma abesifazane bephuphunyelwa yisisu ngesikhathi sokukhulelwa, ukuzalwa ngaphambi kwesikhathi, ingane lapho izalwa inesisindo esingaphezu kuka-4,5 kg noma yazalwa ine-malformations, kufanele kwenziwe isivivinyo sokubekezelela ushukela. Lokhu kuhlaziywa kuphinde kuchazwe esimweni sokukhulelwa okufile, isifo sikashukela sokukhulelwa, i-polycystic ovary.
Ukuhlolwa, isiguli silinganiswa ne-glucose level futhi sinikezwa njengomthwalo we-carbohydrate ukuphuza i-75 g ye-glucose encibilikisiwe emanzini. Ngemuva kwalokho, ngemuva kwehora namahora amabili, isilinganiso siyaphindwa.
Imiphumela yokuhlaziywa ihlaziywa kanjena:
- Imvamisa, ngemuva kwamahora ama-2, ushukela wegazi (ushukela) ungaphansi kuka-7.8 mmol / L.
- Kufika ku-11.1 - isifo sikashukela se-latent.
- Ngaphezu kwe-11.1 - isifo sikashukela.
Olunye uphawu oluthembekile lokuxilonga ukuhlonza kwezinga le-hemoglobin ye-glycated.
I-Glycosylated hemoglobin ivela emzimbeni ngemuva kokuxhumana kwe-glucose egazini nge-hemoglobin equkethwe amangqamuzana abomvu egazi. I-glucose ethe xaxa egazini, yilapho kwakheka khona i-hemoglobin enjalo. Amangqamuzana egazi abomvu (amaseli egazi abhekene nokudluliselwa komoya-mpilo) aphile izinsuku ezingama-120, ngakho-ke lokhu kuhlaziya kukhombisa isilinganiso se-glucose esivamile ezinyangeni ezi-3 ezedlule.
Ukuxilongwa okunjalo akudingi ukulungiswa okukhethekile: ukuhlaziya kufanele kwenziwe esiswini esingenalutho, phakathi nesonto eledlule akufanele kube nokumpontshelwa kwegazi nokulahlekelwa okukhulu kwegazi.
Ngosizo lokuhlaziywa kwe-hemoglobin ye-glycated, ukukhethwa okufanele komthamo wemithi yeziguli ezinesifo sikashukela kuyabhekwa, kusiza ukuthola ama-spikes emazingeni kashukela okunzima ukulandelela ngesilinganiso esivamile seshukela.
I-hemoglobin ye-Glycated ilinganiswa njengephesenti lenani eliphelele le-hemoglobin esegazini. Ibanga elijwayelekile lale nkomba lisuka kumaphesenti ayi-4,5 kuye kwangama-6.5.
Uma izinga liphakeme, khona-ke lokhu kuyinkomba yokuxilongwa kwesifo sikashukela noma ukumelana okungahambi kahle kuma-carbohydrate. Amanani aphezulu nawo angaba ne-splenectomy, ukushoda kwensimbi.
I-hemoglobin ye-Glycated iyancipha:
- nge-glucose ephansi (hypoglycemia);
- ukopha noma ukumpontshelwa igazi, isisindo segazi elibomvu; glycated hemoglobin assay
- nge-hemolytic anemia.
Ukwelashwa kwesifo sikashukela i-mellitus noma ukubekezelela okungahambi kahle kuma-carbohydrate, ukuqapha ushukela wegazi kubalulekile, ngoba ukwelashwa kwalesi sifo, isilinganiso sezinkinga, kanye nezimpilo zeziguli kuncike kuso.
Imininingwane yokuhlolwa ushukela wegazi inikezwe kuvidiyo ekulesi sihloko.
