Ukugcina ushukela wegazi ojwayelekile kungenzeka ngokusebenza okufanele kwezitho zamanyikwe kanye ne-endocrine. Isifo se-carbohydrate metabolism esivame kakhulu sihlotshaniswa nesifo sikashukela.
Esikhathini sokukhula kobusha, i-glycemia nayo ithonywa amazinga aphakeme ama-hormone okukhula kanye nokushintshashintsha kokugcotshwa kwama-hormone ocansi, ngakho-ke ukugcina ushukela wegazi kwabaseminyakeni engu-16 abanesifo sikashukela kuwumsebenzi onzima.
Ukuze uvikele izingane ezingxenyeni ezihambisana nezinguquko kushukela wegazi, futhi yakhe nezimo zokuthi osemusha akhule futhi akhule ngendlela ejwayelekile, ukuqapha njalo nokulawula i-glycemia kuyadingeka.
I-carbohydrate metabolism kwintsha
Kwatholakala ukuthi ngaphansi kwezimo ezifanayo, intsha ikhombisa izinga eliphakeme le-hemoglobin ye-glycated kuneyabantu abadala, naphezu kokukhula kwemithamo ye-insulin. I-insulini imvamisa ephakeme ebusheni kunengane eneminyaka eyodwa noma isiguli esineminyaka engu-20.
Lesi sici sikhonjiswa maqondana neqiniso lokuthi izinga lama-hormone okukhula esikhathini sokuthomba licishe liphindwe kabili, kanye nama-steroid ocansi cishe acishe abe ngama-35%. Lokhu kuholela eqinisweni lokuthi amafutha aqhekeka phansi ngokushesha bese kwenziwa ama-acid amaningi wamahhala, asetshenziselwa ukukhipha amandla, kanti nokuzwa kwe-insulin kuyancipha.
Umphumela we-insulin kwabasakhulayo ungama-30- 47% ongaphansi kunesiguli seminyaka engama-21 noma umuntu mdala. Ngakho-ke, lapho wenza ukwelashwa kwe-insulin, kufanele kusetshenziswe imithamo emikhulu yamalungiselelo e-insulin, okwandisa imvamisa yokuphatha kwayo.
Izici ezingokwengqondo ezithinta inkambo yesifo sikashukela zifaka:
- Izinga eliphakeme lokukhathazeka.
- Ukuchayeka ezinkingeni zokudla.
- Imikhuba emibi.
- Ukudangala nokuzithemba okuphansi.
Ngakho-ke, uma kwenzeka ubunzima obukhona lapho bebheka ukudla nokwelashwa, kwezinye izikhathi kuyadingeka, ngaphezu kwe-endocrinologist, ukubandakanya udokotela wezengqondo ukulungisa ukusabela kokuziphatha.
Ukuhlolwa ushukela wegazi
Ukubona isifo sikashukela, isifundo sokuzila ukudla kwe-glycemia. Izinkomba zokusetshenziswa kwawo zingaba yimbangela yofuzo nokuvela kwezimpawu ezijwayelekile zesifo sikashukela: osemusha waqala ukuphuza amanzi amaningi futhi uvame ukuvakashela indlu yangasese, naphezu kokudla okuhle nokudla okwandayo kwesisindo esimnandi kuyancishiswa.
Futhi, abazali bayakwazi ukubona umkhuhlane ovela njalo, ukuqubuka komzimba nokulimala kwesikhumba, ulwelwesi lwamafinyila olomile, ukukhathala okuthe xaxa, ukungabekezeleleki nokunganaki. Isizathu sokuhlolwa kungaba umfutho wegazi ophakeme kanye nokukhubazeka okubukwayo.
Uma ingane ihlolwa okokuqala, khona-ke inikezwa ukuhlolwa kwegazi ngoshukela, okwenziwa ekuseni ngaphambi kokudla. Kuyadingeka ukuvimbela ngaphambi kwesifundo amahora angu-8 ekudleni, amahora angama-2-3 ekubhemeni nasekuzivocavoca ngokomzimba, noma yiziphi iziphuzo, ngaphandle kwamanzi. Isilinganiso soshukela wegazi kwabaneminyaka engu-13-16 ubudala ngu-3.3 - 5.5 mmol / l.
Uma izinga le-glycemia lingadluli ku-6.9 mmol / L, kepha liphakeme kakhulu kunokwejwayelekile, lapho-ke ukutholwa kokubekezelelwa kwe-carbohydrate kungafakazelwa ukuhlolwa okungeziwe ngokulayisha kwe-glucose, futhi uma igazi linoshukela ngaphezu kuka-7 mmol / L, khona-ke udokotela wesifo sikashukela uyisiphetho sokuqala sodokotela.
Izimbangela zokwanda kwe-glycemia engahlobene noshukela:
- Isifo sesibindi esingamahlalakhona.
- Ukuphuza imithi equkethe ama-hormone.
- Isifo sezinso.
- Isifo se-yegilo noma i-adrenal gland.
- Izinkinga ze-pituitary noma ze-hypothalamic metabolic.
I-hyperglycemia yamanga ingenzeka uma ukudla kwathathwa ngaphambi kokufunda noma kwaba nokuxineka, noma ukuzikhandla ngokomzimba, ukubhema, ukuthatha ama-anabolic steroid, iziphuzo zamandla noma i-caffeine.
Ushukela omncane wegazi ubangela ukuvuvukala esiswini noma emathunjini, izinqubo zesimila, ukwehla kwamazinga wama-hormone wezindlala ze-adrenal ne-thyroid gland, ubuthi, ukulimala kobuchopho obuhlukumezanayo.
Ezinye izifo zofuzo zingadala ushukela wegazi ophansi.
Ukulawulwa kwe-glycemic kwentsha yesifo sikashukela
Ukulinganisa ushukela kufanele kube noshukela okungenani izikhathi ezingama-2-4 ngosuku. Ukuzimisela okukodwa kufanele kwenziwe ngaphambi kokulala ukuvikela i-hypoglycemia ebusuku. Ngaphezu kwalokho, kuyadingeka ukwenza ukuqapha uma kwenzeka ushintsho ekudleni, emiqhudelwaneni yezemidlalo, izifo ezihambelanayo, izivivinyo.
Kuphoqelekile ukugcina amarekhodi amazinga kashukela nemithamo ye-insulin efakiwe. Kwentsha, inketho engcono kakhulu kungaba ukusebenzisa izinhlelo ezikhethekile eziklanyelwe amagajethi kagesi.
Imfundo yentsha ezikoleni zesifo sikashukela kufanele isuselwe ekuncomeni kokushintshwa kwamthamo ezimweni ezingejwayelekile: izinsuku zokuzalwa, utshwala, ukudla okusheshayo, ezemidlalo noma ikhefu eliphoqelelwe ekudleni nasemjozeni we-insulin.
Ngokunyuka kwamazinga kashukela noma ukukhuphuka okulindelekile, udinga ukunciphisa ingxenye yokudla noma ukuzivocavoca. Enye indlela ukwandisa umthamo we-insulin esebenza kancane, kepha khumbula ukuthi imithamo eyengeziwe ingaholela ekuzuzeni isisindo, kanye ne-insulin overdose syndrome.
Izindlela zokwelashwa okufanele kwesifo sikashukela entsheni yilezi:
- Ukusheshisa amazinga kashukela egazini 5.5-5.9 mmol / L.
- IGlycemia ngemuva kokudla (ngemuva kwemizuzu engu-120) ingaphansi kuka-7.5 mmol / L.
- I-Lipid spectrum (ku-mmol / l): i-cholesterol efinyelela ku-4,5; ama-triglycerides angaphansi kuka-1.7, i-LDL ingaphansi kuka-2,5, kanti i-HDL ingaphezulu kwe-1.1.
- I-hemoglobin ye-Glycated imvamisa ingaphansi kwe-6.5%.
- Umfutho wegazi ufike ku-130/80 mm RT. Ubuciko.
Ukufinyelela imigomo ye-glycemic enciphisa kakhulu ingozi yezinkinga zesifo sikashukela kungenzeka kuphela lapho uhlela ukudla.
Udinga futhi ukuhlela inani lama-carbohydrate athathwe kanye nomthamo we-insulin, ongasiza ukumuncwa kwawo.
Ungakuvimbela kanjani i-hypoglycemia osemusha onesifo sikashukela?
Ukwelashwa kwe-insulin okujulile, okuyindlela eyinhloko yokwelapha isifo sikashukela sohlobo lwe-1 ebusheni, kanye nokudla okungajwayelekile kanye nokuzivocavoca okungaphezu kokujwayelekile umzimba kuyizimpawu zokuhlaselwa i-hypoglycemic. Ngakho-ke, iziguli ezinjengalezi kufanele ngaso sonke isikhathi zibe nazo ujusi noma amashukela oshukela.
Ngezinga eliphansi, i-hypoglycemia ibonakaliswa ngokuhlaselwa yindlala, okuhambisana nobuthakathaka, ikhanda, ukuthuthumela kwezandla nezinyawo, izinguquko zokuziphatha nezimo zemizwa - ukuqubuka noma ukucindezelwa ngokweqile kwenzeka. Ingane ingathola isiyezi noma ukungaboni kahle.
Ngezinga elilinganiselwe, intsha iyakwazi ukulahlekelwa yilokho esikhaleni, iziphathe ngokungafanele futhi ingabazi ubukhulu besimo, futhi iphendule ngolaka emizameni yokwelashwa. Ezimweni zokuhlaselwa kanzima, izingane ziquleka, kuthi lapho kuvela khona amandla.
Imithetho eyisisekelo yokuvikela i-hypoglycemia:
- Ushukela wegazi akufanele uwe ngaphansi kuka-5 mmol / L.
- Qiniseka ukukala i-glycemia ngaphambi kokulala.
- Uma i-glucose ingaphansi kuka-5 mmol / l ngaphambi kokudla, ngakho-ke akunakunikezwa umjovo ngaphambi kokudla, ingane kufanele iqale idle, bese ikala ushukela futhi ifake insulin.
- Ungaphuzi utshwala esiswini esingenalutho.
Ukuzivocavoca kuvame ukuholela kwi-hypoglycemia, njengoba isidingo se-glucose kwezicubu zemisipha sikhuphuka, futhi ngokuzivocavoca okunzulu, izinqolobane ze-glycogen ziyaphela. Umphumela wokudlala imidlalo ungahlala amahora angama-8-10. Ngakho-ke, ezigulini ezinesifo sikashukela, kunconywa ukwehlisa umthamo we-insulin olawulwa ngesikhathi sokusebenza isikhathi eside.
Ukuvimbela ukuhlaselwa kwe-hypoglycemia ebusuku, udinga ukudla phakathi nokuqeqeshwa. Intsha idinga ukudla njalo ngemizuzu engama-45. Kulokhu, udinga ukuthola uhhafu wama-carbohydrate kusuka ezithelo, futhi ingxenye yesibili kufanele ibe nama-carbohydrate ayinkimbinkimbi - ngokwesibonelo, isangweji ushizi. Nge-hypoglycemia ejwayelekile yasesikhathini, idlulisela amakilasi emahoreni okusa.
Ukwelapha i-hypoglycemia emnene noma elinganiselayo, udinga ukuthatha u-10 g we-glucose ezibhebheni (ingilazi eyodwa kasiphu noma isiphuzo esimnandi). Uma izimpawu zingashabalali, khona-ke emva kwemizuzu eyi-10 - phinda. Ngobunzima obukhulu bokwehlisa ushukela, i-glucagon kufanele ifakwe, emva kwalokho ingane kufanele idle.
Ingozi yokuhlaselwa njalo kwe-hypoglycemia kushukela ukuthi ukulimala kwengqondo kukhula kancane kancane, okunganciphisa amakhono obuhlakani esikhathini esizayo. Ezinganeni, isici esibuhlungu kungaba ukusabela kontanga kulezi ziqephu zokuziphatha okungalawulwa.
Okuyingozi kakhulu ebusheni ukusetshenziswa kophuzo oludakayo nokuthambekela kwe-hypoglycemia. Kufanele kukhunjulwe ukuthi uma kwenzeka kuba nokuhlaselwa okunamandla, i-glucagon ngokumelene nesizinda sotshwala ayisebenzi, ngakho-ke osemusha udinga ukungeniswa esibhedlela okuphuthumayo kanye nokuphathwa kwe-glucose okuhlangene.
Isazi esivela kuvidiyo ekulesi sihloko sizokhuluma ngamazinga kashukela ajwayelekile egazi.
