Ukubona izinga le-glucose esegazini isifundo esidingekayo ukuthola iziyaluyalu ze-carbohydrate metabolism. Kuqala ukuhlolwa kweziguli ezinezimpawu zokuphazamiseka kwesifo sikashukela noma ezisengozini enkulu yalesi sifo.
Ngenxa yokwanda kwesifo sikashukela, ikakhulukazi izinhlobo zokugcina lapho kungekho sithombe somtholampilo salesi sifo, lokho kuhlaziywa kuyanconywa kuwo wonke umuntu ngemuva kokufika eminyakeni engama-45 ubudala. Futhi, ukuhlolwa kweshukela kwegazi kwenziwa ngesikhathi sokukhulelwa, ngoba ushintsho ngemuva kwehomoni kungadala isifo sikashukela sokukhulelwa.
Uma kuphambuka ushukela ku-serum yegazi kusuka kokujwayelekile kutholakala, khona-ke ukuhlolwa kuyaqhubeka, kanti iziguli zidluliselwa ekudleni ezinokuqukethwe okuphansi kwama-carbohydrate namafutha.
Yini enquma izinga likashukela egazini?
Ukusuka kuma-carbohydrate aqukethe ekudleni, umuntu uthola cishe ama-63% wamandla adingekayo empilweni. Ukudla kuqukethe ama-carbohydrate alula futhi ayinkimbinkimbi. Ama-monosaccharides alula yi-glucose, i-fructose, i-galactose. Kulawa, i-80% yi-glucose, ne-galactose (kusuka emikhiqizweni yobisi) ne-fructose (kusuka ezithelo ezinhle) ibuye ibe yi-glucose ngokuzayo.
Ama-carbohydrate ayinkimbinkimbi okudla, njengesitashi se-polysaccharide, ehla ngaphansi kwethonya le-amylase e-duodenum kuya glucose abese efaka egazini emathunjini amancane. Ngakho-ke, wonke ama-carbohydrate ekudleni ekugcineni aphenduka ama-glucose amangqamuzana futhi agcina emithanjeni yegazi.
Uma i-glucose ingahlinzekwanga ngokwanele, khona-ke ingahle ihlanganiswe emzimbeni esibindini, izinso kanye ne-1% layo kwakhiwa emathunjini. I-gluconeogenesis, lapho kuvela khona amangqamuzana amasha eglucose, umzimba usebenzisa amafutha namaprotheni.
Isidingo se-glucose sitholakala ngawo wonke amaseli, ngoba siyadingeka ngamandla. Ngezikhathi ezahlukahlukene zosuku, amaseli adinga inani elingalingani likashukela. Amandla emisipha ayadingeka ngesikhathi sokunyakaza, futhi ebusuku ngesikhathi sokulala, isidingo se-glucose sincane. Njengoba ukudla kungahambisani nokusetshenziswa kweglucose, kugcinwa endaweni yokugcina.
Leli khono lokugcina i-glucose esitokisini (njenge-glycogen) livame kuwo wonke amaseli, kepha iningi lawo wonke amadepho e-glycogen aqukethe:
- Amaseli wesibindi angama-hepatocytes.
- Amaseli wamafutha ngama-adipocytes.
- Amaseli omsipha ama-myocyte.
Lawa maseli angasebenzisa ushukela osuka egazini ngokweqile kwawo futhi ngosizo lwama-enzyme aliguqule libe yi-glycogen, ehlehlela phansi kushukela ngokuncipha koshukela wegazi. Izitolo ze-Glycogen esibindini nasemisipha.
Lapho i-glucose ingena kumaseli wamafutha, iguqulwa ibe yi-glycerin, okuyingxenye yezitolo ezinonile zama-triglycerides. Lezi zinhlayiya zingasetshenziswa njengomthombo wamandla kuphela lapho wonke ama-glycogen asezitokisini esetshenzisiwe phezulu. Okusho ukuthi, i-glycogen iyindawo yesikhashana yesikhashana, futhi amafutha ayindawo yokugcina isikhathi eside.
Igcinwa kanjani ushukela wegazi?
Amangqamuzana obuchopho anesidingo njalo sokuthi i-glucose isebenze, kepha awukwazi ukuyikhipha noma ukuhlanganisa, ngakho-ke ukusebenza kobuchopho kuncike ekuphuzeni ushukela ekudleni. Ukuze ingqondo ikwazi ukugcina umsebenzi we-glucose egazini, ubuncane kumele bube ngu-3 mmol / L.
Uma kunoshukela omningi egazini, khona-ke, njengesakhi esisebenzayo se-osmotically, sidonsela uketshezi kusuka kuzicubu. Ukuze kwehliswe izinga likashukela, izinso zilubumba ngomchamo. I-glucose egazini lapho inqoba khona umkhawulo wezinso isuka ku-10 iye ku-11 mmol / L. Umzimba, kanye noshukela, ulahlekelwa amandla atholakala ekudleni.
Ukudla kanye nokusetshenziswa kwamandla ngesikhathi sokunyakaza kuholela ekushintsheni kwezinga le-glucose, kepha njengoba imvelo ejwayelekile ye-carbohydrate ilawulwa ngamahomoni, lokhu kuguquguquka kububanzi kusuka ku-3.5 kuye ku-8 mmol / L. Ngemuva kokudla, kuphakama ushukela, njengoba ama-carbohydrate (ngesimo sikashukela) engena emathunjini ephuma egazini. Igqokwa kancane futhi igcinwe kumaseli wesibindi nemisipha.
Umphumela omkhulu kokuqukethwe kweglucose osegazini kukhishwa ngama-hormone - i-insulin neglucagon. I-insulin iholela ekunciphiseni kwe-glycemia ngezenzo ezinjalo:
- Isiza amaseli abambe ushukela egazini (ngaphandle kwama-hepatocytes namaseli wesistimu yezinzwa).
- Isebenza i-glycolysis ngaphakathi kweseli (isebenzisa ama-molecule eglue).
- Ikhuthaza ukwakheka kwe-glycogen.
- Inqanda ukuvela kweglucose entsha (gluconeogeneis).
Ukukhiqizwa kwe-insulin kukhuphuka ngokugxila kweglucose okwandayo, isenzo sawo kungenzeka kuphela uma sihlangene nama-receptors kulwelwesi lweseli. I-carbohydrate metabolism ejwayelekile kungenzeka kuphela ngokuhlanganiswa kwe-insulin ngesilinganiso esanele nomsebenzi we-insulin receptors. Lezi zimo ziphulwa kushukela, ngakho-ke i-glucose yegazi iphakeme.
IGlucagon futhi ibhekisela kuma-pancreatic mahormone, ingena emithanjeni yegazi lapho yehlisa ushukela wegazi. Indlela esebenza ngayo ihlukile kune-insulin. Ngokuzibandakanya kwe-glucagon, i-glycogen iyabhidlika esibindini bese kuthi ushukela usungulwe kumakhemikhali angenayo i-carbohydrate.
Amazinga kashukela aphansi omzimba abhekwa njengesimo sokuxineka, ngenxa yalokho, ene-hypoglycemia (noma ngaphansi kwethonya lezinye izinto zokucindezela), i-pituitary kanye ne-adrenal gland ikhipha ama-hormone amathathu - somatostatin, cortisol ne-adrenaline.
Nabo, njenge-glucagon, bakhulisa i-glycemia.
IGlucose
Njengoba okuqukethwe ushukela osegazini kuphansi kakhulu ekuseni ngaphambi kokudla kwasekuseni, izinga legazi lilinganiswa ikakhulukazi ngalesi sikhathi. Isidlo sokugcina sinconywa amahora angama-10-12 ngaphambi kokuxilongwa.
Uma izifundo zinqunyelwe inani eliphakeme kakhulu le-glycemia, khona-ke bathatha igazi ihora elilodwa ngemuva kokudla. Bangakwazi futhi ukukala izinga okungahleliwe ngaphandle kokubhekisela ekudleni. Ukutadisha umsebenzi wezinto ezifakwayo, kuhlolwa igazi nge-glucose kwenziwa amahora ama-2 ngemuva kokudla.
Ukuhlola umphumela, kusetshenziswa i-transcript lapho kusetshenziswa amagama amathathu: i-standardoglycemia, i-hyperglycemia ne-hypoglycemia. Ngokuvumelana nalokhu, lokhu kusho: ukugcwala kwe-glucose egazini kuyinto evamile, ephezulu kanye namazinga kashukela.
Futhi kunendaba ukuthi i-glucose yanqunywa kanjani, njengoba ama-laboratories ahlukene angasebenzisa lonke igazi, i-plasma noma into leyo kungaba yi-serum yegazi. Ukuhunyushwa kwemiphumela kufanele kucabangele izici ezinjalo:
- Izinga le-glucose ku-plasma yegazi liphakeme kunawo wonke ngo-11.5 - 14.3% ngenxa yokuqukethwe kwamanzi okuhlukile.
- U-5% ushukela omningi ku-serum ukwedlula i-plasma ehlukahlukene.
- Igazi le-capillary liqukethe ushukela omningi kunegazi le-venous. Ngakho-ke, isimo soshukela egazini le-venous kanye negazi le-capillary lihlukile.
Ukuhlushwa okujwayelekile egazini lonke esiswini esingenalutho kungu-3.3 - 5.5 mmol / L, ukukhuphuka okuphezulu kungafika ku-8 mmol / L ngemuva kokudla, futhi amahora amabili ngemuva kokudla, izinga likashukela kufanele libuyele kuleso sikhathi elaliphambi kokudla.
Amanani abucayi womzimba yi-hypoglycemia ngezansi kwe-2.2 mmol / L, njengoba kuqala indlala yamangqamuzana obuchopho, kanye ne-hyperglycemia ngenhla kwama-25 mmol / L. amazinga kashukela akhuphukile kumanani anjalo angaba nenkambo yesifo sikashukela engafakwanga.
Sihambisana nekhefu elisongela impilo.
I-Hyperglycemia kushukela
Imbangela ejwayelekile yokwanda kokujikeleza ushukela ushukela. Ngalesi sifo, i-glucose ayikwazi ukungena emangqamuzaneni ngoba i-insulin ayakhiqizwa noma akwanele ukufakwa okujwayelekile kwama-carbohydrate. Izinguquko ezinjalo ziwuphawu lohlobo lokuqala lwesifo.
Uhlobo lwesibili sikashukela luhambisana nokushoda kwe-insulin, ngoba kune-insulin egazini, kodwa ama-receptors amangqamuzana awakwazi ukuxhuma kuwo. Lesi simo sibizwa ngokuthi yi-insulin ukumelana.
I-mellitus yesifo sikashukela esenzeka okwesikhashana ingaba khona ngesikhathi sokukhulelwa futhi inyamalale emva kokubeletha. Kuhlotshaniswa nokwenyuka kokuhlanganiswa kwama-hormone yi-placenta. Kwabanye besifazane, isifo sikashukela sokukhulelwa siholela ekuphikeni kwe-insulin bese sithayipha isifo sikashukela esingu-2.
Isifo sikashukela sesibili sihambisana ne-endocrine pathologies, ezinye izifo zesimila, nezifo ze-pancreatic. Ngokululama, ukubonakaliswa kwesifo sikashukela kuyanyamalala.
Izimpawu ezejwayelekile zesifo sikashukela zihlotshaniswa nokwedlula umkhawulo wezinso we-glucose - 10-12 mmol / L. Ukuvela kwe-glucose kumchamo kuholela ekunyukeni kokuphuma kwamanzi. Ngakho-ke, i-polyuria (ukwanda kokuchama) ibangela ukomisa, isebenze maphakathi nokomela. Isifo sikashukela sibuye sibonakaliswe ngokunyuka kokudla kanye nokushintshashintsha kwesisindo, ukungatheleleki kokugomela.
Ukuxilongwa isifo sikashukela kususelwa ekutholakaleni kweziqephu ezimbili ze-hyperglycemia esheshayo ngenhla kuka-6.1 mmol / l noma ngemuva kokudla ngaphezu kuka-10 mmol / l. Amanani angafiki kulelo banga, kepha angaphezulu kokujwayelekile noma kunesizathu sokucabanga ukwephulwa komzimba we-carbohydrate metabolism, kwenziwa izifundo ezithile:
- Ukuhlolwa kokubekezelela kwe-glucose
- Ukunqunywa kwe-glycated hemoglobin.
Ukuhlolwa kokubekezelela ushukela kukala ukuthi umzimba umunca kanjani ama-carbohydrate. Umthwalo wenziwa - isiguli sinikezwa u-75 g we-glucose kanti ngemuva kwamahora ama-2 izinga laso akufanele lidlule ku-7.8 mmol / l. Kulokhu, lokhu kuyinkomba ejwayelekile. Esikhathini sikashukela, ingaphezu kwe-11.1 mmol / L. Amanani aphakathi nendawo aqukethwe enkambweni yamuva yesifo sikashukela.
Izinga le-glycosylation le-hemoglobin (ukuzihlanganisa nama-molecule eglucose) alikhombisi isilinganiso seglucose legazi ezinsukwini ezingama-90 ezedlule. Ukujwayelekile kwayo kuze kube yi-6% ye-hemoglobin ephelele yegazi, uma isiguli sinesifo sikashukela, umphumela ungaphezulu kuka-6.5%.
Ukubekezelela i-glucose engasebenzi kahle kutholakala ngamanani aphakathi kulolu cwaningo.
Izinguquko ze-glucose ezingahambisani noshukela
Ukwanda koshukela wegazi kungokwesikhashana ngengcindezi enkulu. Isibonelo kungaba ukushaqeka kwe-cardiogenic ekuhlaselweni kwe-angina pectoris. I-Hyperglycemia ihambisana nokungondleki ngendlela yokudla okungalawulwa kokudla okuningi kwe-bulimia.
Imithi ingadala ukwanda kokugcwala kwe-glucose egazini: ama-hormone, ama-diuretics, ama-hypotensive, ikakhulukazi ukungakhethi kwe-beta-blockers, ukusweleka kwe-Vitamin H (biotin), kanye nokuthatha imishanguzo. Imithamo emikhulu ye-caffeine nayo inomthelela kushukela wegazi ophezulu.
I-glucose ephansi ibangela ukungondleki kohlelo lwezinzwa oluyinhloko, okuholela ekwandisweni kokukhula kwe-adrenaline, okunyusa ushukela wegazi futhi kubangele izimpawu eziyimpawu enkulu ye-hypoglycemia:
- Ukwanda kwendlala.
- Ukushaya kwenhliziyo njalo futhi.
- Ukujuluka.
- Ukuxhawula isandla.
- Ukucasuka nokukhathazeka.
- Isiyezi
Esikhathini esizayo, izimpawu zihambisana nokubonakaliswa kwe-neurological: ukuncipha okuncishisiwe, ukuthambekela kokukhubazeka kwendawo, discoordination of ukunyakaza, ukungasebenzi kahle kwamehlo.
I-hypoglycemia ethuthukayo ihambisana nezimpawu ezigxile ekulimaleni kobuchopho: ukukhubazeka kwenkulumo, ukungaziphathi kahle, ukwehluleka. Lapho isiguli siqala ukoma, siphele amandla, sikhulu ukhula. Ngaphandle kokwelashwa okufanele, i-hypoglycemic coma ingabulala.
Izimbangela ze-hypoglycemia imvamisa ukusetshenziswa kabi kwe-insulin: umjovo ngaphandle kokudla, i-overdose, ukuzivocavoca umzimba okungahleliwe, ukuthatha imishanguzo noma ukusebenzisa kabi utshwala, ikakhulukazi ngokudla okunganele.
Ngaphezu kwalokho, i-hypoglycemia yenzeka nge-pathologies enjalo:
- Isimila endaweni yama-beta cell of pancreas, lapho kukhiqizwa khona i-insulin naphezu koshukela omncane wegazi.
- Isifo sika-Addison - ukufa kwamangqamuzana e-adrenal kuholela ekwehlekeni kokudla kwe-cortisol egazini.
- Ukwehluleka kwe-Hepatic ku-hepatitis enzima, i-cirrhosis noma umdlavuza wesibindi
- Izinhlobo ezinzima zenhliziyo nokuhluleka kwezinso.
- Ezinganeni ezisanda kuzalwa ezinesisindo noma ukuzalwa ngaphambi kwesikhathi.
- Ukuhlukumezeka kwezakhi zofuzo.
Ukwehla ushukela wegazi kubangela ukomisa kanye nokudla okungafanele nge-predominance yama-carbohydrate acolisisiwe, okubangela ukukhuthaza ngokweqile kokukhishwa kwe-insulin. Ukwahluka kwamazinga kashukela egazini kuyabonakala kwabesifazane ngesikhathi sokuya esikhathini.
Enye yezimbangela zokuhlaselwa kwe-hypoglycemia kungaba izinqubo zamathumbu ezibangela ukudangala komzimba. Ukuphathwa okuningana kwekhambi le-saline kugqugquzela i-dilution yegazi futhi, ngokufanele, kunciphisa izinga loshukela kuyo.
I-video ekulesi sihloko ikhuluma ngezinga loshukela wegazi.
