Ukushintshashintsha kwezimpawu ekugayeni kweglucose egazini lomuntu kwenzeka cishe ngokungenakuphikwa, kungenzeka ukuthi ufunde ngokuchezuka ngenxa yokudlula kokuhlolwa kuphela.
Ngakho-ke, odokotela batusa okungenani kanye ezinyangeni eziyisithupha ukunikela ngegazi emazingeni kashukela, ikakhulukazi kwabesifazane nabesilisa ngemuva kweminyaka yobudala engama-40.
Futhi, lolu cwaningo ngeke luvikele iziguli ezinesisindo somzimba esithe xaxa kanye nokuba khona kofuzo olusengcupheni yesifo sikashukela.
Isifo sikashukela singasolwa ngenxa yokushayeka okujwayelekile, ukoma, umlomo owomile kanye nezinguquko ezingenakubangela isisindo somzimba, zombili izinhlangothi ezinkulu nezincane.
Kungani kuhlolwa ushukela wegazi?
I-glucose iyi-carbohydrate elula, idlala indima ebalulekile, ngoba i-monosaccharide ingumthombo omkhulu wamandla. Ushukela uyadingeka kuwo wonke amaseli omzimba impilo ejwayelekile, uqinisekise zonke izinqubo ze-metabolic.
Izinga le-glycemia lisiza ukuhlola isimo sempilo yabantu, liyadingeka ukuyigcina isezingeni elamukelekayo. Ushukela ungena emzimbeni ngokudla, bese wephulwa yi-insulin ye-hormone bese ungena egazini.
Lapho kukhula ushukela ekudleni, kulapho kufanele kukhiqize khona i-insulin kakhudlwana. Kodwa kufanele kuqondwe ukuthi inani elilinganiselwe le-insulin lilinganiselwe, ushukela owedlulele ubekwa kumaseli wezicubu ze-adipose, izicubu nesibindi.
Ngokudla ngokweqile ushukela, kungekudala, ukwephulwa kohlelo oluyinkimbinkimbi nokwanda kwe-glycemia kwenzeka. Isithombe esifanayo senzeka ngokungavimbi kokudla, lapho ukudla komuntu kungahlangabezani nesidingo esidingekayo. Kulokhu:
- ushukela wokuxineka wehla;
- kwehlise ukusebenza kwengqondo.
Ukungalingani okufanayo kungenzeka futhi ngokuphulwa kwe-pancreas, ebhekele ukukhiqizwa kwe-insulin.
Izimpawu eziphambili okufanele zishukumise umuntu ukuba abonane ngokuphuthumayo nodokotela we-endocrinologist futhi anikele ngegazi ushukela kungaba ukoma ngokweqile, umlomo owomile, ukujuluka ngokweqile, ubuthakathaka emzimbeni, ukukhuphuka kwenhliziyo kanye nesiyezi.
Izibalo ezisemthethweni azinakulinganiswa, namuhla eRussia cishe abantu abayizigidi eziyi-9 banesifo sikashukela. Kucatshangwa ukuthi ngemuva kweminyaka eyi-10 inani leziguli ezinokwephulwa okunjalo lizophinda kabili.
Cishe njalo ngemizuzwana eyi-10, amacala ama-2 esifo sikashukela aqinisekiswa emhlabeni wonke. Ngemizuzwana eyi-10 efanayo, umuntu onesifo sikashukela ufa endaweni ethile emhlabeni, ngoba sekuyisikhathi eside kwaziwa ukuthi isifo sikashukela yisifo sesine esiholela ekufeni.
Kodwa-ke, ukugwema ukufa kunengqondo impela uma unikela ngegazi ushukela ngendlela esifike ngesikhathi futhi usigcina silawulwa yilesi sifo.
Ukuhlolwa kweglucose yegazi
Ukushintsha ibhalansi ezinqubweni ze-metabolic kubeka ingozi enkulu esigulini nasempilweni yakhe. Odokotela bangancoma ukuhlolwa koshukela okuhlukahlukene ukuthola iziphazamiso. Kunezindlela ezinjalo zaselabhorethri: ukuhlaziya kwe-biochemical kwegazi likashukela, ukumelana noshukela, ukuhlolwa kokukhuthazelela ushukela we-C-peptide, ukuhlaziya okunye kwe-hemoglobin ye-glycated.
Ukuhlolwa kweglucose ye-biochemical kwenziwa esikhungweni sezokwelapha, kuyasiza ukuthola ukuguquguquka kwe-glycemia, ukubona isithombe esigcwele salesi sifo. I-biochemistry kashukela wegazi isiza ukumisa ukuphazamiseka kwe-metabolic kanye ne-concretization yalesi sifo.
Ukuhlolwa kwegazi kwe-biochemical kanye noshukela okujwayelekile kungasetshenziswa njenge-prophylaxis yesifo sikashukela, ukulawula isifo esiqinisekisiwe. I-biochemistry yegazi izosiza ukunquma hhayi kuphela ukuqoqwa koshukela, kepha nezinye izinkomba ezibalulekile.
Ukuhlolwa kwegazi kokumelana noshukela ngeke kusasebenza futhi kukhiqize, kubizwa nangokuthi ukuhlolwa ngomthwalo we-carbohydrate. Ukuhlaziywa kuzokhombisa okuqukethwe ushukela ku-plasma yegazi:
- okokuqala, isiguli sinika igazi ekuseni esiswini esingenalutho;
- kungakapheli nemizuzu emi-5 ngemuva kwalokho, uphuza isixazululo eglue.
Ngemuva kwalokhu, kuyadingeka ukwenza amasampula njalo ngehora lehora, isikhathi senqubo singamahora ama-2. Lolu cwaningo luzoveza ubukhona besifo sikashukela i-mellitus, ukubekezelelwa kwe-glucose.
Ukuhlolwa kokubekezelela kwe-glucose kwe-C-peptide kwenziwa ukulinganisa ukusebenza kwamaseli we-pancreatic beta abhekene nokukhiqizwa kwe-insulin. Ukuhlaziywa kuyadingeka ukuthola kahle uhlobo lwesifo sikashukela: esincike kakhulu ku-insulin. Ukuhlola kubaluleke kakhulu kunoma yiluphi uhlobo lwe-pathology.
Ukunikela ngegazi kungabuye kusetshenziselwe ukunquma izinga le-hemoglobin ye-glycated, phakathi kokuhlaziywa, ukuxhumana kwe-hemoglobin noshukela wegazi kunqunywe. I-glucose ethe xaxa ijikeleza emzimbeni, lizokhuphuka izinga le-hemoglobin ye-glycated. Ukuhlolwa kweglucose kusiza ukuhlola i-glycemia ngaphezulu kwezinyanga ezi-3. Ngokwezincomo ze-WHO, ucwaningo olunjalo luyindlela engcono kakhulu futhi edingekayo ukulawula inkathi yesifo sikashukela salezi zinhlobo zombili.
Indlela inezinzuzo zayo ezisobala kanye nobubi obukhulu. Ukuhlanganiswa okukhulu kokuhlaziywa ngukuthi:
- amalungiselelo athile awadingeki kuwo;
- igazi lithathwa nganoma yisiphi isikhathi sosuku.
Ukuhlolwa kwe-protein glucose-protein kubizwa ngokuthi isivivinyo se-fructosamine. Umehluko omkhulu phakathi kwale ncazelo kashukela ukuthi ukuhlaziya kukhombisa ushintsho emazingeni e-glycemia amasonto angama-1-3 ngaphambi kokuthatha isampula yegazi.
Ukuhlolwa kusiza ukuhlola ikhambi lokwelashwa kwe-hyperglycemia, futhi uma kunesidingo, lungisa inkambo yokwelashwa. Imvamisa, ukuhlolwa okunjalo kunconyelwa ukuthi kunikezwe abesifazane abakhulelwe ukuthola i-mentitus yesifo sikashukela kanye ne-anemia.
Ukubala okuphelele kwegazi kungabekwa kanye nokuhlolwa kwe-lactate (lactic acid). I-lactate ikhiqizwa ngumzimba ngenxa ye-anaerobic ushukela metabolism (ngaphandle kwe-oxygen). Ukuhlaziywa okunjalo kuzotshela mayelana ne-acid acidization ngenxa yokuqongelelwa kwe-lactate, i-lactocytosis, njengomthetho, kuwuphawu lwesifo sikashukela.
Enye indlela yokuhlola ushukela ngokweqile ukuhlolwa kwegazi kwesifo sikashukela sabesifazane abakhulelwe (gestational). Ishukela elinjalo ukwephula ukumelana noshukela, lapho likhuphuka kakhulu i-glycemia, kulapho amathuba okuba khona isifo esinjengalezi macrosomy, ukubonakaliswa kwalo kube:
- ukhuluphele we-fetus;
- ukukhula ngokweqile.
Lokhu kungaholela ekuzalweni ngaphambi kwesikhathi, kulimaze umama nengane. Ngalesi sizathu, ngesikhathi sokukhulelwa, umuntu wesifazane kufanele azinakekele futhi abheke noshukela wegazi lakhe. Izinto ezibonakalayo zithathwa emthanjeni.
Ekhaya, ukuthola wena uqobo kanye nokuqapha inkambo yesifo sikashukela esiqinisekisiwe, isifundo esidingekayo nge-glucometer siyadingeka. Ukuhlaziywa kwe-glucose kukusiza ukuba uzihlole ngokwanda noma ukuncipha koshukela ngemizuzwana. Odokotela babheka indlela ebonakalayo njengeyokuhlola okungenzeka, kepha isifo sikashukela asikwazi ukwenza ngaphandle kwayo.
Ngaphambi kwenqubo, bahlanza izandla zabo ngensipho bese bezesula. Ngemuva kwalokho, besebenzisa isikhafu, benza ukubhoboza kweminwe, basule amaconsi okuqala wegazi ngephedi likotini, bese kuthi kwesesibili:
- kusetshenziswe kumucu wokuvivinya;
- ibekwe kumamitha.
Idivayisi ingagcina inani elithile lezilinganiso kwimemori yayo.
Unganikela kanjani ngegazi futhi ulungiselele, okubhaliwe
Noma yiziphi izindlela zokuhlonza amazinga kashukela wegazi kukhonjiswa ukuthi aqale ngokulungiselela. Ucwaningo lweglucose yegazi lwenziwa esiswini esingenalutho, igazi lithathwa emunweni noma e-ulnar vein. Cishe amahora angama-8-10 ngaphambi kwenqubo, kufanele wenqabe ukudla, uzilungiselele ukuthi ziphuza amanzi ahlanzekile ngaphandle kwegesi.
Unganikela kanjani ngegazi? Ngaphambi kocwaningo, awukwazi ukuzivocavoca, ukubhema, ukuphuza utshwala, ukuba novalo. Ngaphandle kwalokho, ukuhlaziywa kuzokhombisa ukwanda koshukela noma ngabe i-hyperglycemia ephikelelayo ingabhekwa. Akudingekile ukuthi wesabe ocwaningweni olunjalo, amava ezinzwa azokuba nomphumela omubi emiphumeleni nasenhlalakahleni yesiguli.
Ukuzimisela ushukela wegazi ekhaya usebenzisa i-glucometer kungenzeka nganoma yisiphi isikhathi sosuku, noma ngabe kudliwe ngemuva kokudla. Ngakho-ke, umbuzo wokuthi ungalungiselela kanjani awufanele. Uma umuntu onesifo sikashukela esaba ukubhoboza umunwe wakhe ukuze axilongwe, angabuza izihlobo zakhe ngalokhu noma axhumane nesikhungo sezokwelapha.
Udokotela we-endocrinologist kuphela ongaxilonga, aqinisekise noma asiphikise, kepha isiguli kufanele sibe nombono ngamazinga kashukela egazini. Ekuhlolweni kwegazi okune-biochemical, amazinga kashukela azoba ejwayelekile:
- iminyaka yengane ifinyelela eminyakeni emi-2 - ukusuka ku-2.78 kuya ku-4,4 mmol / l;
- iminyaka engu-2-6 iminyaka - ukusuka ku-3.3 - 5 mmol / l;
- iminyaka engu-6-15 ubudala - 3.3 - 5.5 mmol / l;
- abadala - 3.89 - 5.83 mmol / l.
Kuyaphawuleka ukuthi njengoba iminyaka yobudala yomzimba, indlela ejwayelekile yoshukela iyashintsha. Ukwanda kwesilinganiso kwenzeka ngemuva kweminyaka yobudala engama-60, ngokwesilinganiso ezigulini ezinjalo le nani izoba ngu-6.38 mmol / l.
Uma ukuhlolwa kwegazi kwenzelwa ukumelana noshukela, amanani ayisethenjwa angama-7.8 mmol / L. Lapho unquma izinkomba ze-lactic acid, inkomba ejwayelekile izosuka ku-0,5 iye ku-2.2 mmol / l.
Ukuhlolwa kwegazi kokuqukethwe kwe-fructosamine kufanele kukhombise emadodeni i-118-282 μmol / L, kwabesifazane kusuka ku-161 kuya ku-351 μmol / L. Imvamisa ye-hemoglobin ye-glycated izoba ngu-5.7%, kuyisimo sokuthi le nkomba iyafana ezinganeni, kubantu abadala, emadodeni nakwabesifazane abasebancane nabadala.
Kungani ushukela wegazi uphakanyisiwe noma wehliswe
I-biochemistry ikhombise ukweqile kwe-glucose, khona-ke udokotela ukhuluma nge-hyperglycemia. Isimo esinjalo se-pathological singakhombisa ubukhona besifo sikashukela kanye nokunye ukuphazamiseka kohlelo lwe-endocrine. Izimbangela zingaba izinso, isibindi, inkambo yesifo esibi noma esingelapheki yenqubo yokuvuvukala kuyi-pancreas (isifo se-pancreatitis).
Ukwehla kokuxineka koshukela egazini, kusolakala ukuthi izifo zepancreas, isibindi kanye nokuningi kwama-hormone e-thyroid. Ukwehla kwe-glycemia kungaba ubufakazi bokuthi ubuthi ngezidakamizwa, i-arsenic, notshwala.
Uma ucabanga ngemiphumela yokuhlolwa kokugaywa kwe-glucose, lapho uphuza isisombululo se-glucose, izinombolo ezitholakalayo 7.8-11.00 mmol / L zizoba uphawu lwe-prediabetes, futhi lapho umphumela wedlula u-11.1 mmol / L, isifo sikashukela siba yisifo sokuqala sokuxilongwa.
Uma izinkomba ze-lactic acid zanda, engxenyeni yamacala lokhu kukhombisa isifo sikashukela, izinga elifanayo lezinto lizoba umphumela:
- ukuqina kwesibindi;
- izifo ezinzima ze-vascular;
- glycogenosis.
Izinga eliphansi le-lactic acid kwezinye izimo libonisa i-anemia.
Lapho inani le-fructosamine liphezulu kakhulu, isiguli sizosolwa nangokuthi sibangelwa isifo sikashukela, ukubekezelela ushukela obabhemayo, ukuhluleka kwe-renal renal, i-mellitus yesifo sikashukela, kanye ne-cirrhosis. Amazinga aphansi we-fructosamine azokhombisa ubukhona be-hyperthyroidism, nephropathy yesifo sikashukela, ne-nephrotic syndrome. Nginovalo lokuthi ukuxilongwa okuningi kungenziwa ngasikhathi sinye.
Uma i-hemoglobin ye-glycated iphambuka kokujwayelekile futhi umphumela ungaphezulu kwe-6.5%, isifo sikashukela cishe ngaso sonke isikhathi siyaqinisekiswa, ngoba lokhu kuhlaziya kukhombisa izinga likashukela esikhathini eside. Akunakwenzeka ukuthonya umphumela wayo, igazi lithathwa ukuze licwaningwe ngisho nasezigulini ezinomkhuhlane, ngemuva kokuhlushwa yingcindezi.
Kumele kubhekwe ukuthi ukweqiwa noma ukwehla ushukela wegazi akukakhombisi ukutholwa kokugcina nesifo sikashukela. Kungenzeka ukuthi ukuphambuka kokujwayelekile bekungumphumela wokusetshenziswa kotshwala, ukukhuphuka ngokomzimba, ukucindezela kwengqondo, ukwenqatshwa kokudla okune-carb ephansi nezinye izinto. Ukucacisa ukutholakala kokuxilongwa, udokotela kufanele abele iziguli ezengeziwe izivivinyo.
Ungakuhlola kanjani ushukela kuzotshela uchwepheshe kule vidiyo ekulesi sihloko.
