Ukudla ukudla okuqukethe inani elikhulu likashukela namafutha ezilwane, okuhlanjululwa kusuka ekudleni kokudla, kuqhathaniswa nesizinda sokuphila okuhlala phansi nendawo engathandeki kuholela eqinisweni lokuthi izigameko zoshukela lwesifo sikashukela ziyanda.
Le ndlela ayiphawuleki kuphela ekugugeni, kodwa nasezigulini ezingaphansi kweminyaka engu-18 ubudala.
Uhlobo lokuqala lwesifo sikashukela luqoshwa kaningi, ukukhula kwalo kuhlotshaniswa nokubhujiswa kwe-autoimmune kwamanyikwe ngaphansi kwethonya lezinto ezinobuthi, imithi noma ukutheleleka ngegciwane.
Ukuze kutholakale isifo sikashukela, kuhlonzwa i-elebhu - ucwaningo lweglucose yegazi.
Ushukela ojwayelekile
Iglucose yegazi ikhombisa amandla omzimba wokukhiqiza nokuphendula i-insulin. Ngokuntuleka kwayo kwe-glucose ekudleni, izitolo ze-glycogen noma ezisanda kusungulwa esibindini azinakungena esitokisini. Izinga layo eliphakeme legazi linomphumela omubi ohlelweni lokujikeleza kwegazi nolwezinzwa.
Ushukela wegazi uyenyuka futhi uvamile. Lokhu kwenzeka lapho ukubhema, ukuzikhandla ngokomzimba, injabulo, ukucindezela, ukuthatha inani elikhulu lekhofi, imithi eqenjini lemithi ye-hormonal noma ye-diuretic, izidakamizwa ezilwa nokuvuvukala.
Ngokusebenza okuvamile kwamanyikwe nokuzwa okuhle kwamangqamuzana ukuya ku-insulin, ngokushesha kufinyelela ezingeni lomzimba. I-Glycemia ingakhula nezifo zezitho ze-endocrine, i-pancreatitis nezinqubo ezingapheli zokuvuvukala esibindini.
Ukuhlolwa kwegazi likashukela kunqunywa lapho kusolwa i-pathology efanayo, kepha kaningi isetshenziselwa ukuthola i-mellitus yesifo sikashukela, kufaka phakathi ukuhamba kwe-latent. Isimo se-glycemia sibhekwa njenge-3.3-5.5 mmol / l. Ukuphambuka kubhekwa ngale ndlela.
- Ushukela ongaphansi kuka-3.3 mmol / L - hypoglycemia.
- Ngaphezulu kokujwayelekile, kepha hhayi ngaphezulu kwesilinganiso sikashukela se-6.1 mmol / l - prediabetes.
- Ushukela wegazi 6.1 nangaphezulu - ushukela.
Ukuhlolwa kwegazi okusheshayo kukodwa kungenzeka kunganele ukuthola isifo esifanele, ngakho-ke isifundo siyaphindwa.
Ngaphezu kwalokho, kuqhutshwa ukuhlaziywa kwezimpawu zalesi sifo kanye nokuhlolwa komthwalo ushukela, kanye nokuzimisela kwe-glycated hemoglobin.
Izimpawu zika Ushukela Ophezulu
Izimpawu zesifo sikashukela zihambisana ne-glucose ephezulu yemikhumbi. Lesi simo siholela ekukhulisweni kwezicubu zomzimba emgudwini wegazi ngenxa yokuthi ama-molecule eglucose asebenza ngokungajwayelekile, adonsela amanzi.
Ngaso leso sikhathi, izitho zomzimba azinawo amandla, ngoba ushukela uwumthombo oyinhloko wokuphinda uqhume. Izimpawu zesifo sikashukela zidalulwa ikakhulukazi lapho amazinga kashukela edlula i-9-10 mmol / L. Ngemuva kwaleli nani lokubhula, ushukela uqala ukudalulwa izinso ngomchamo, ngasikhathi sinye uketshezi oluningi selulahleka.
Ukuqala kwesifo sikashukela kungashesha ngohlobo loku-1, noma kancane kancane, okubonakala kakhulu ohlotsheni 2 lwesi sifo. Imvamisa, ngaphambi kwezimpawu ezisobala, isifo sikashukela sidlulela esigabeni esibi. Kungatholwa kuphela ngokuhlolwa kwegazi okukhethekile: ukuhlolwa kwama-antibodies kuma-pancreas kanye ne-insulin (uhlobo 1 sikashukela) noma ukuhlolwa kokubekezelelwa kweglucose (uhlobo lwesibili).
Izimpawu eziphambili zalesi sifo:
- Ubuthakathaka obuqhubekayo nokukhathala.
- Ukuqaqanjelwa ngesifiso sokudla.
- Umlomo owomile nokoma okukhulu.
- Ukuphuma komchamo ngokweqile, ukunxenxa njalo ebusuku.
- Ukuphulukiswa kwenxeba isikhathi eside, ukuqubuka kwesikhumba esikhumbeni, ukulunywa kwesikhumba.
- Umbono wehlisiwe.
- Izifo ezithathelwanayo ezijwayelekile.
Ukuhlolwa kweglucose kwegazi kukhonjiswa lapho kuvela ngisho eyodwa yezimpawu, ikakhulukazi uma kunesifo sofuzo - amacala kashukela ezihlotsheni eziseduze. Ngemuva kweminyaka engama-45, lokho kuvivinywa kufanele kwenziwe kuwo wonke umuntu okungenani kanye ngonyaka.
Ukusolwa kwesifo sikashukela kungavela ngokukhuluphala ngokweqile, ukwanda okuqhubekayo nokuqhubekayo kwengcindezi yegazi, cholesterol ephezulu egazini, ne-candidiasis ephikelelayo.
Kwabesifazane, ukwephulwa kwe-carbohydrate metabolism kwenzeka phambi kwezinguquko ze-polycystic kuma-ovari, inzalo, ukuzalwa kwengane enesisindo esingaphezu kuka-4.5 kg, ukungahambi kahle kwesisu, ukukhubazeka kwengane.
Ukuhlolwa komthwalo we-glucose
Yini okufanele uyenze uma ushukela wegazi etholakala ngaphezu kokujwayelekile? Ukuze kutholakale ukutholakala kwesifo sikashukela noma ukuhlukahluka kwaso, kuhlolwa okwenziwa ekudleni. Imvamisa, ngemuva kokudla ushukela okuvela ekudleni okuqukethe ama-carbohydrate, ukukhipha okwandisiwe kwe-insulin kuqala.
Uma sekwanele futhi ukusabela kwama-cell receptors kuyinto ejwayelekile, khona-ke amahora angama-1-2 ngemuva kokudla ushukela kungaphakathi kwamangqamuzana, futhi i-glycemia isezingeni lamanani wokuphila. Ngokushoda kwe-insulin okuhlobene nesihlobo noma ngokuphelele, igazi lihlala ligcwele ushukela, bese izicubu zibulawa yindlala.
Ngokusebenzisa lolu cwaningo, kungenzeka ukubona izigaba zokuqala zesifo sikashukela, kanye nokungabekezeleli kwe-glucose, okungashabalala noma kuguqulwe kube ushukela weqiniso. Ukuhlolwa okunjalo kukhonjiswa kulezi zimo ezilandelayo:
- Azikho izimpawu ze-hyperglycemia, kepha ushukela emchameni, kwatholakala ukuthinteka kwansuku zonke.
- Ukwanda koshukela kwavela ngesikhathi sokukhulelwa, ngemuva kwezifo zesibindi noma i-thyroid gland.
- Ukwelashwa isikhathi eside ngezidakamizwa ze-hormonal kwenziwa.
- Kukhona okuqhamukayo kwesifo sikashukela, kepha akunazimpawu zalokho.
- Kutholwe nge-polyneuropathy, i-retinopathy noma i-nephropathy yemvelaphi engaziwa.
Ngaphambi kokuqokwa kokuhlolwa, akunconywa ukwenza ushintsho kwisitayela sokudla noma ushintshe izinga lokuzivocavoca komzimba. Ucwaningo lungahlehliswa lube kwesinye isikhathi uma isiguli sithola isifo esithathelwanayo noma kukhona ukulimala, ukulahlekelwa ngokweqile kwegazi ngaphambi nje kokuhlolwa.
Ngosuku lokuqoqwa kwegazi, awukwazi ukubhema, futhi ngosuku olwandulela ukuhlolwa ungabuphuzi utshwala. Umuthi kufanele uvumelane nodokotela okhiphe okudluliselwe esifundweni. Udinga ukuza elabhoratri ekuseni ngemuva kwamahora we-8-10 wokuzila, akufanele uphuze itiye, ikhofi noma iziphuzo ezimnandi.
Ukuhlolwa kwenziwa ngale ndlela elandelayo: bathatha igazi esiswini esingenalutho, bese isiguli siphuza u-75 g we-glucose ngendlela yesisombululo. Ngemuva kwamahora ama-2, amasampula egazi ayaphindwa. Isifo sikashukela sibhekwa njengokufakazelwa uma i-glycemia esheshayo (igazi le-venous) ingaphezulu kuka-7 mmol / L, futhi amahora ama-2 ngemuva kokudla ushukela mkhulu kune-11.1 mmol / L.
Ebantwini abaphilile, la manani aphansi, ngokulandelana - ngaphambi kokuhlolwa aze afike ku-6.1 mmol / l, nangemva kokungaphansi kuka-7.8 mmol / l. Zonke izinkomba phakathi kwe-mellitus ejwayelekile nesifo sikashukela zihlaziywa njengesimo se-prediabetesic.
Iziguli ezinjalo zikhonjiswa ukwelashwa kokudla ngomkhawulo kashukela nefulawa emhlophe, imikhiqizo equkethe amafutha ezilwane. Imenyu kufanele ilawulwe yimifino, inhlanzi, ukudla kwasolwandle, imikhiqizo yobisi enamafutha aphansi, amafutha emifino. Ukulungiselela iziphuzo nokudla okumnandi usebenzisa ama-sweeteners.
Kunconywa ukwandisa ukusebenza komzimba, izidakamizwa eziqukethe i-metformin (kuphela enconyelweni kadokotela). Ukulungiswa kwesisindo somzimba lapho kukhona ukukhuluphala kunomthelela omuhle kuma-carbohydrate metabolism.
Futhi, ukuze kuqiniswe umsoco we-carbohydrate metabolism, ukwehla kwe-cholesterol yegazi kanye nomfutho wegazi kuyadingeka.
IGlycated Hemoglobin
Amangqamuzana kashukela egazi abopha amaprotheni, awenze glycate. Amaprotheni anjalo alahlekelwa yizakhiwo zawo futhi angasetshenziswa njengophawu lwesifo sikashukela. Izinga le-hemoglobin ye-glycated lisivumela ukuthi sihlole ukuthi i-glycemia ishintshe kanjani ezinyangeni ezi-3 ezedlule.
Imvamisa, ucwaningo lubekelwa ukulawula ushukela onxephezelwe ngesikhathi sokwelashwa. Ngenhloso yokuxilongwa okuyisisekelo kwesifo sikashukela i-mellitus, ukuhlaziya okufanayo kungenziwa kumacala angabazayo, ukukhipha imiphumela engathembekile. Le nkomba ayithinteki ekudleni, ekucindezelekeni, emithini, ezinkambisweni zokutheleleka.
Ukulinganiswa kwe-hemoglobin ye-glycated kukhombisa ukuthi angakanani amaphesenti ahlobene nayo yonke i-hemoglobin yegazi. Ngakho-ke, ngokulahlekelwa okukhulu kwegazi noma ukumnika kwezixazululo ze-infusion, kungahle kube nezinamba zamanga. Ezimweni ezinjalo, ukuhlolwa kweziguli kudinga ukuthi kuhlehliswe amasonto angama-2-3.
Imiphumela yokunqunywa kwe-hemoglobin ye-glycated:
- Ngaphezulu kwe-6.5% isifo sikashukela.
- Izinga le-glycated hemoglobin lingaphansi kuka-5.7%
- Isikhathi esiphakathi kuka-5.8 no-6.4 yisifo sangaphambi kwesifo sikashukela.
Ushukela omncane wegazi
I-Hypoglycemia inomphumela omubi ohlelweni lwezinzwa oluphakathi, ngoba amangqamuzana obuchopho awakwazi ukuqongelela ushukela egcinweni, ngakho-ke, kudingeka ukuthi abe khona njalo egazini ngezinga lamanani ajwayelekile.
Ukwehla ushukela okungapheli ezinganeni kuholela ekubuyiseleni ngokomqondo. Ukuhlasela kanzima kungabulala. Ziyingozi ikakhulukazi lapho i-glucose iwa ngesikhathi lapho isiguli sishayela imoto noma silawula ezinye izindlela emsebenzini.
Izimbangela zokunciphisa ushukela zivame kakhulu izinkinga zokunciphisa ushukela okwehlisa ushukela. Izimo ezinje zidalwa yikho kokubili umthamo ongalungile kanye necebo lokuphathwa kwe-insulin, ikhefu elide ekudleni, ukuphuza utshwala, ukugabha noma isifo sohudo, ukuthatha imishanguzo elwa namagciwane.
Ngaphezu kwalokho, ushukela ophansi kwenzeka ezigweni zamathumbu ngokungenisa okuncishisiwe kwezakhi zomzimba, ukulimala kwesibindi okunamandla, ukwehla kwe-pathological emsebenzini wezitho ze-endocrine, izinqubo zesimila kumanyikwe, nakwezinye izindawo.
Izimpawu eziphambili zezimo ze-hypoglycemic zifaka:
- Ukwanda kwendlala.
- Ukuqhaqhazela imilenze.
- Isikhala sokunakwa esingalungile.
- Ukucasuka.
- Izimpawu zenhliziyo.
- Ubuthakathaka nekhanda.
- Ukudideka esikhaleni.
Ngokulashwa okungafanele, isiguli siwela ku-glycemic coma. Ezimpawu zokuqala zokunciphisa ushukela, udinga ukuthatha ukudla noma iziphuzo ezinoshukela: amaphilisi kashukela, isiphuzo sezithelo, udle amaswidi ambalwa, isipuni esisodwa soshukela noma uphuze itiye elimnandi, ulamula.
Kuthiwani uma isiguli singazi futhi singakwazi ukugwinya ngokwaso? Kulesi simo, udinga ukumngenisa esibhedlela ngokushesha okukhulu, lapho iGlucagon izongena khona nge-intramuscularly, nekhambi le-glucose engama-40% emthanjeni. Ngemuva kwalokhu, izinga leshukela likalwa ngempela futhi, uma kunesidingo, ukuphathwa kwezidakamizwa kuphindwa.
Ividiyo ekulesi sihloko izokhuluma ngamazinga kashukela ajwayelekile egazi.
