Njengoba wazi, ngesifo sikashukela, uphawu oluphambili lwalesi sifo amazinga akhuphukile kashukela egazini. Izinkomba ze-glucose ziyisici, ubudisi benqubo ye-pathological kuya ngenani le-glucose.
Yonke le minyaka, le nkomba ibiyiyona ehamba phambili ekutholeni lesi sifo, ngakho-ke, uma kusolwa isifo, udokotela uhlala ebeka isivivinyo segazi se-glucose.
Kungekudala kakhulu, iWorld Health Organisation yancomela olunye ucwaningo, ukuhlolwa kokufundwa kwe-hemoglobin glycated, ukuthola isifo sikashukela. Kuyini lokhu kuhlaziya futhi kudluliswa kanjani?
IGlycated hemoglobin ibizwa nangokuthi i-glycosylated hemoglobin. Lo mqondo uhlanganisa iphesenti le-hemoglobin alpha HbA1, ehlangana nama-molecule eglucose.
Yini i-glycated hemoglobin?
Abaningi bangase bazibuze ukuthi kungani, kubantu abanempilo, i-hemoglobin ayihlangani noshukela, naphezu kokuba khona kweglucose egazini. Imvamisa, izinga le-hemoglobin ye-glycated ejwayelekile kubantu alikho ngaphezu kwamaphesenti angama-5.4, kuyilapho kubadayibhileki le nkomba ihlala ifinyelela futhi idlule namaphesenti angama-6.5.
Lesi simo sihambisana neqiniso lokuthi ngokuqukethwe okwengeziwe kweshukela egazini, ushukela uqala ukubopha ngokuqinile kwiprotheni ye-erythrocyte, ngenxa yalokho i-hemoglobin ye-glycated ikhulisa ama-indices ayo.
IHemoglobin itholakala ngaphakathi kwamangqamuzana abomvu egazi, anesibopho sokulethwa kwamangqamuzana we-oksijini kumaseli nezicubu zomzimba. IHemoglobin inamandla okubopha ku-glucose, lokhu kwenzeka ngendlela yokusabela okuyi-non-enzymatic reaction. Le nqubo ibizwa ngokuthi i-glycation, ngenxa yalokho, kwakheka i-glycated hemoglobin.
Njengoba amangqamuzana abomvu egazi esehlale izinyanga ezintathu, ukuhlolwa kwe-hemoglobin ye-glycated kungakhombisa isilinganiso seshukela egazini ezinyangeni ezintathu ezedlule.
Ngenxa yocwaningo olunjalo, udokotela angathola imininingwane enemininingwane yokuthi lesi sifo siqhubeke kanjani muva nje.
Izinzuzo nobubi bocwaningo
Ngokuya izinkomba ezitholakele, ukuphumelela kwerejimeni yokwelashwa ekhethiwe kuyabhekwa futhi kuphakama nezinga eliphezulu lokukhuphuka koshukela. Futhi, le ndlela yokuxilonga isifo sikashukela inazo zonke izinhlobo zezinzuzo, uma kuqhathaniswa nezinye izinhlobo zocwaningo.
Ikakhulu, ukuhlolwa kwegazi kwe-hemoglobin ye-glycated kunikezwa noma ngabe isiguli sasidla yini. Umphumela wesifundo awudingi ukulinda isikhathi eside kakhulu, maduze nje udokotela uzokwazisa isiguli yonke imininingwane.
Uma i-hemoglobin ye-glycated inyuka, okukhombisa umphumela wokutholwa, izinyathelo kufanele zithathwe ngokuhamba kwesikhathi. Ngenxa yokuhlaziywa, kungenzeka ukuthola ukuqala kwezinguquko kumetabolism we-carbohydrate ngesikhathi, ngenkathi ukuhlolwa kweglucose ejwayelekile akuvunyelwe ukuthola ukwephula okujwayelekile.
Imiphumela yokuxilonga ayithinteki izinqubo zokutheleleka, ukucindezelwa, ukusebenza komzimba kanye nezinye izinto. Ngemuva kokuhlaziya, udokotela angaqinisekisa noma aphikise ukutholakala kwengxabano, lapho izifundo ezijwayelekile zinganikeli imininingwane ephelele.
Kodwa-ke, inqubo yokulinganisa izinga le-hemoglobin ye-glycated inezihibe zayo.
- Le ndlela ebiza kakhulu yokuxilonga iziguli eziningi ingenakukwazi ukuyikhokhela. Kodwa-ke, abaningi bakhetha lolu cwaningo ngenxa yokunemba okuphezulu nokulula kokuhlaziywa.
- Amanani we-hemoglobin we-Glycated anganikeza amanani afinyelela kumaphakathi, kepha angakhombisi izinga eliphakeme. Ukuthola lezi zinombolo, kusetshenziswa indlela ejwayelekile yokuhlonza ushukela wegazi.
- Uma isiguli sine-anemia noma ifa le-hemoglobin isakhiwo, imiphumela yocwaningo lwe-glycosylated hemoglobin izophambuka.
- Njengoba ukuhlolwa kuthathwa njengokubiza kakhulu, akwenziwa kuwo wonke amadolobha, ngakho-ke abanesifo sikashukela abaningi abakwazi ukwenza ucwaningo besebenzisa le ndlela.
- Kukhona umcabango ongavunyelwanga wokuthi i-hemoglobin ye-glycated ingahle ithathe isikhathi uma ushukela onesifo sikashukela ethatha uvithamini C noma u-E ngemithamo emikhulu.
- Ukunyuka kwezinga le-hemoglobin ye-glycosylated kungabhekwa ngezinga elincishisiwe lamahomoni e-thyroid lapho kukhula isimo se-hypothyroidism. Okwamanje, amazinga kashukela wegazi angahle abejwayelekile.
Izinkomba ze-glycated hemoglobin
Izinga le-hemoglobin ye-glycated kumuntu ophilile ngamaphesenti ama-4-6. Leli zinga libonwa kubo bonke abantu, kungakhathalekile ngobudala kanye nobulili bomuntu. Uma idatha yokuhlaziya ingaphandle kwalo mngcele, udokotela ukhomba i-pathology futhi anikeze ukwelashwa okudingekile.
Amanani aphezulu angabonisa izinga eliphakeme likashukela wegazi isikhathi eside esigulini. Kodwa kubalulekile ukuqonda ukuthi ukuphula umthetho akuyona ngaso sonke isikhathi uphawu lwesifo sikashukela.
I-Pathology iphinde ibonwe ngokubekezelela i-glucose engasebenzi kahle noma i-glucose engasebenzi kahle. Isifo sikashukela i-mellitus sitholakala uma i-glycated hemoglobin ingagcini nje kakhulu, kodwa futhi idlula namaphesenti ayi-6.5. Ngamaphesenti ayi-6.0-6.5, kutholakala isifo sangaphambi kwesifo sikashukela, esihambisana nokubekezelelwa kweglucose.
Futhi, umuntu angaba nezinga eliphansi le-glycated hemoglobin egazini. Uma imiphumela yocwaningo ingaphansi kwamaphesenti ama-4, ukuhlaziya kungakhombisa izinga eliphansi loshukela wegazi. Lesi simo kwezinye izimo sibonisa ukuba khona kwe-hypoglycemia.
Ngokuvamile, isizathu se-hemoglobin ephansi glycated ilele ekuthuthukisweni kwe-insulinoma, isimila se-pancreatic esidonsela phambili ukukhiqizwa kwe-insulin. Ngasikhathi sinye, umuntu akanakho ukumelana ne-insulin, futhi amazinga aphezulu kashukela ancipha ngokushesha, okuholela ku-hypoglycemia.
Ngaphezu kwalokhu kwephulwa, izici ezilandelayo zingaholela emazingeni kashukela aphansi nokugxiliswa kwe-hemoglobin ephansi ye-glycated:
- Ukuhambisana nokudla okune-carb ende;
- Ukusetshenziswa kwenombolo enkulu yezidakamizwa ezinciphisa ushukela kanye ne-insulin;
- Ukuba khona kwemithwalo ende ende;
- Ukuba khona kokuntuleka kwe-adrenal;
- Ukukhonjwa kwezifo ezingajwayelekile zofuzo ngohlobo lwesifo sikaHerce, isifo sika-von Girke, isifo seForbes, ukungabekezelelani njengelifa le-fructose.
Uma i-hemoglobin ye-glycated esegazini etholwe ngenxa yokuhlaziywa ingafiki amaphesenti angama-5.7, i-carbohydrate metabolism kubantu ayinamkhawulo futhi nengozi yokuba nesifo sikashukela incane. Ngezinkomba ezisuka kumaphesenti angama-5.7 kuya kwayi-6.0, ithuba lokuqalwa kwesifo lenyuka, ukusenza lesi simo sibejwayelekile, kufanele ulandele indlela odla ngayo futhi uphile impilo enempilo.
Inkomba yamaphesenti ayi-6.1 kuya kwayi-6.4 ikhombisa ubungozi obukhulu bokuthola isifo sikashukela. Umuntu kufanele alandele ukudla okuqinile, alandele indlela ethile yokudla, futhi adle ukudla okwamukelekayo kuphela. Uma imiphumela yocwaningo ilingana noma idlula ngamaphesenti angama-6.5, udokotela wenza ukuxilongwa kokuqala - isifo sikashukela.
Ukuze uthole ukuxilongwa okuqondile futhi ugweme amaphutha, kwenziwa izifundo eziningana ngemuva kwesikhathi esithile.
Ukwehlisa amaphesenti we-hemoglobin ye-glycated, kunciphisa ubungozi besifo.
Ungakuthola kuphi futhi kanjani ukuhlolwa kwegazi kwe-glycated hemoglobin
Ukuhlolwa kwegazi ukuthola inani le-hemoglobin ye-glycated kunikezwa endaweni yokuhlala emtholampilo noma esikhungweni sezokwelapha esizimele. Uma isifo sikashukela sihlolelwa imali, kudingeka ukuthi kudluliselwe kudokotela.
Ukuhlaziya ushukela we-glycated ukuthi ungathatha kanjani? Kule ndlela yokuxilonga, awudingi ukulandela noma yimiphi imithetho ethile. Ukuhlaziywa kuvunyelwe ukuthatha noma umuntu asanda kudla. Iqiniso ukuthi idatha ye-hemoglobin ye-glycated ibonisa amanani kashukela ezinyangeni ezintathu ezedlule, hhayi endaweni ethile ngesikhathi.
Okwamanje, abanye odokotela batusa ukuthi bahlolwe igazi esiswini esingenalutho ukuze bagweme amaphutha okungenzeka futhi bangaphinde bahlolwe. Asikho isidingo sokulungiselela isifundo nganoma iyiphi indlela.
Ungathola imiphumela yokuhlolwa kwegazi kwe-glycated hemoglobin ezinsukwini ezintathu kuya kwezine emva kokuba onesifo sikashukela ephumelele isivivinyo. Isampula yegazi yenziwa kaningi okwenziwe i-vein, kepha kunezindlela ezithile zokuthi i-biological material yocwaningo ithathwa emunweni.Izindleko zokuhlaziywa zingama-ruble angama-400-800, ngokuya ngesifunda.
- Lapho kutholakala ukuthi unesifo sikashukela, ukuhlolwa kwegazi kwe-glycated hemoglobin kufanele kuhlolwe okungenani njalo ezinyangeni ezintathu. Usebenzisa le datha, udokotela uzokwazi ukulandelela amandla aqondile ezinguquko, ahlole ukusebenza kwerejimeni yokwelashwa ekhethiwe bese kuthi uma kunesidingo, ashintshe ukwelashwa.
- Lapho i-prediabetes yomuntu nokuhlolwa kwegazi kwangoko kukhombisa izinga le-hemoglobin ye-glycated amaphesenti angama-5.7-6.4, kunengozi enkulu yokuthola lesi sifo, isiguli kufanele sihlolwe okungenani kanye ngonyaka. Uma imiphumela yokuxilonga ikhombisa amaphesenti angama-7, ukuhlaziya kwenzeka njalo ezinyangeni eziyisithupha.
- Uma kungekho lesi sifo kanye nezimpawu zesifo sikashukela, ukuhlolwa kwenziwa kanye njalo eminyakeni emithathu ngenhloso yokuvikela. Uma izinga le-glucose egazini lingalawulwa kahle, ukuxilongwa kwenziwa njalo ezinyangeni ezintathu. Ucwaningo futhi lwenzeka ngesikhathi sokufakwa esikhundleni kwerejimeni yokwelashwa.
Uma izinkomba ezitholakele zingabaza, yini engenzeka uma isiguli sine-pathology yegazi ngesimo se-hemolytic anemia, ezinye izindlela zokuxilonga zaselabhoratri ziyasetshenziswa.
Olunye lolo hlobo lokufunda ukuvivinya i-gincosylated albhamuin noma i-fructosamine.
Le nto inikeza imininingwane ngesimo se-carbohydrate metabolism emasontweni amabili kuya amathathu edlule.
Yehlise i-hemoglobin ye-glycated
Isinyathelo sokuqala ukubukisisa okudlayo bese ushintshela ekudleni okhethekile okwelapha. Odokotela batusa ukudla imifino nezithelo eziningi ngangokunokwenzeka - i-fiber izothuthukisa isimo somzimba jikelele, amazinga aphansi kashukela futhi asize ukugcina amazinga kashukela evamile.
Futhi i-fiber ewusizo ngamanani amakhulu itholakala emasimini, obhanana, amakhambi amasha. Ngaphezu kwalokho, udinga ukuphuza ama-yoghurts nobisi lwe-nonfat, aqukethe i-calcium ne-vithamini D, okuzosiza ekuqiniseni uhlelo lwe-cart -age cartilage, ngcono inqubo yokugaya ukudla, kanye nokwenza amazinga kashukela egazini abe ngokwejwayelekile. Ikakhulu kaningi, le mikhiqizo kufanele idliwe ngabantu abathola isifo sikashukela sohlobo 2.
Kubalulekile futhi ukuthi udle amantongomane nezinhlanzi ezinamafutha amancane, aqukethe ama-asidi we-Omega-3, asiza ukunciphisa ukumelana ne-insulin ye-hormone. Ngenxa yalokhu, izinga le-glucose egazini lilawulwa, umsebenzi wohlelo lwezinhliziyo luyathuthuka, futhi izinga le-cholesterol liyancipha.
I-Cinnamon, okufanele ihlale isetafuleni lesifo sikashukela, inegalelo ekwehlelweni kokungamelana ne-insulin. Kepha ukudla noma yiziphi izinongo kufanele kube ngamanani amancane. Ngendlela, kungenzeka ukusebenzisa i-kefir enesinamoni ukwehlisa ushukela wegazi.
Ngaphezu kokudla okunempilo, kubalulekile ukwandisa umsebenzi wokuzivocavoca, ukubuka isimo sokulala esinempilo, ukuhola impilo enempilo, nokugwema izimo ezicindezelayo.
Kungani udinga ukuhlaziywa kwe-hemoglobin ye-glycated futhi nokuthi uyithatha kangaki izotshela ividiyo ekulesi sihloko.
