Ukugcina amazinga ashukela egazi ajwayelekile atholakala ngomsebenzi wohlelo lwe-endocrine. Uma i-carbohydrate metabolism ikhubazekile, lokhu kuholela kokuphazamiseka ekusebenzeni kohlelo lwezinzwa, kufaka phakathi ubuchopho, kanye nokulimala okuhleliwe emithanjeni yegazi.
Ushukela wegazi ophakanyiswa njalo ubhekwa njengesibonakaliso esiyinhloko sokuxilongwa kwesifo sikashukela. Ukukuthola, ukuhlolwa kwegazi kwenziwa esiswini esingenalutho nangemva kokulayisha ushukela, okukuvumela ukuthi usikhombe lesi sifo kusenesikhathi.
Ukuqapha okuqhubekayo kokufundwa kashukela wegazi kusiza ukwelashwa okuyikho kwesifo sikashukela kanye nokuvimbela ukukhuluphala okuxakile kanye nezimo ezingamahlalakhona, okubandakanya i-nephropathy, unyawo lwesifo sikashukela, i-retinopathy, kanye ne-pathologies ye-inhliziyo.
Ngabe inkomba kashukela incike kuphi?
Ukuqinisekisa ukuthi isizukulwane esiqhubekayo samandla ngamaseli omzimba kungenzeka ngenani elilinganayo le-glucose egazini kanye nokugeleza kwalo okungenangqondo ukungena esitokisini. Noma yikuphi ukwephulwa kwale ndlela kubonakala ngezindlela zokuphambuka kusuka kokujwayelekile: i-hypoglycemia ngokwehla koshukela wegazi noma i-hyperglycemia ngokukhula kwayo.
Inkomba ejwayelekile ye-carbohydrate metabolism ingu-3.3 - 5.5 mmol / l lapho inquma ngokushesha ushukela wegazi. Ukushintshashintsha kwemali okungaphakathi kwamaphesenti angama-30 alo mkhawulo kubhekwa njengokuncane futhi, uma kungabangelwa yisifo, umzimba usazobuyisela emikhawulweni ekhonjisiwe.
Lokhu kungaba ngokudla kakhulu (i-hyperglycemia ngemuva kokudla), ukugcwala ngokweqile ngokomzwelo noma ngokomzimba (i-hyperglycemia ngesikhathi sokuxineka), noma ukwehla ushukela ngesikhathi sendlala esifushane.
Amazinga kashukela wegazi azinzile ngokusebenza okuhlelekile kwamanyikwe kanye nesistimu yezinzwa ephakathi. Ama-hormone wezindlala ze-adrenal, isimo samathumbu, izinso nesibindi kuthinta nezinga le-glycemia. Abathengi abakhulu beshukela ubuchopho nomsipha, kanye nezicubu ze-adipose.
Kunezinhlobo eziningi zokulawulwa kwe-carbohydrate metabolism:
- Okuthusayo.
- Isigatshana.
- Hormonal
- I-Renal.
Indlela ye-neural yomthetho yenzeka ngale ndlela: phezu kwezicucu zemicu enozwela.
Lokhu kuholela ekwandeni kwe-catecholamines yegazi, ebangela ukuwohloka kwe-glycogen futhi kwandise i-glycemia.
Uma umnyango we-parasympathetic uvuliwe, lokhu kuhambisana nokwenziwa okusebenzayo kwe-insulin nokufakwa okusheshayo kwama-molecule eglue kulezo izicubu ezincike kwe-insulin, okunciphisa ushukela egazini.
Ukulawulwa okungaphansi kwe-glucose metabolism kuya ngezinga lawo egazini. Izinga lomngcele wokuhlushwa lapho ukwakheka kwalo esibindini lilingana nokusetshenziswa kwezicubu ngu-5.5-5.8 mmol / L.
Ezingeni eliphansi, isibindi siqala ukuhambisa ushukela egazini (ukuwohloka kwe-glycogen) kusebenze). Uma ukufundwa koshukela kukhulu, khona-ke ukuhlanganiswa kwe-glycogen kumaseli emisipha nasezibindini.
Ukulawulwa kwe-Hormonal kwenzeka ngenxa yomsebenzi walo lonke uhlelo lwe-endocrine, kepha i-insulin inethonya elehlukile lokunciphisa amazinga kashukela, kuyilapho bonke abanye beyinyusa. Ukwakheka kwe-insulin kwenzeka ngesimo se-molecule enkulu, engasebenzi futhi ibizwa nge- proinsulin.
Indawo yokukhiqizwa kwe-proinsulin izicubu ze-islet kuma-pancreas. Ngokwanda ushukela wegazi, ama-glucose receptors ayasebenza. Ngemuva kwalokhu, i-molecule ye-proinsulin ingahlukaniswa ibe yi-insulin kanye ne-protein ebophayo ebizwa nge-C-peptide.
Ukulawulwa kwe-Renal kwenzeka ngesikhathi sokuhlunga kwe-glucose ku-glomeruli kanye nokufakwa kwayo okubucayi ku-renal tubules. Ngenxa yalokhu, akukho glucose kumchamo wesibili, okhishwa emzimbeni.
Uma uhlelo lobuciko bezinso lugcwele ngokweqile kwe-plasma glucose, khona-ke luyakhishwa kumchamo. I-Glucosuria yenzeka ngemuva kokuba umkhawulo we-glucose egazini elijikelezayo udluliwe.
Lokhu kwenzeka uma ushukela wegazi uphakeme kuno-9 mmol / L.
Ukuhlolwa kweglucose kwegazi
Ukuze wenze ucwaningo ngesimo se-carbohydrate metabolism, izinkomba zokuzila kwe-glycemia nangemva kokudla ziyahlaziywa. Lokhu, kusetshenziswa indlela yaselebhu noma i-glucometer, engasetshenziswa ekhaya.
Ukuhlaziywa kwenziwa ngemuva kwekhefu lamahora ayishumi lokudla, ngaphandle kokuzivocavoca umzimba, ukubhema, ukudla ukudla noma iziphuzo, kungcono ukusebenzisa amanzi okuphuza ahlanzekile ngenani elincane ukuqeda ukoma kwakho.
Uma isiguli sisebenzisa noma imuphi umuthi, khona-ke ukuhoxa kwaso kumele kuvunyelwane kuqala nodokotela ohambayo ukuze kutholakale imiphumela ethembekile. Inani lokuxilonga luhlolo lwegazi olwenziwa kabili ngezinsuku ezahlukene.
Amanani kashukela ku-mmol / l ekufundweni kwegazi eliphelele:
- Kufika ku-3.3 - hypoglycemia.
- 3-5.5 - ushukela wegazi uvamile.
- 6,6.1 - isifo sikashukela.
- Ngaphezulu kwe-6.1 isifo sikashukela.
Uma usola ukwephulwa kwe-carbohydrate metabolism, i-TSH iyenziwa - ukuhlolwa kokubekezelela ushukela. Udinga ukuyilungiselela - ukungafaki ingcindezi engokomzwelo ngezinsuku ezintathu, akumele kube noshintsho ezondlweni nezifo ezithathelanayo.
Ngosuku lokuhlolwa, ungazibandakanyi kwezemidlalo noma ngokuzikhandla ngokomzimba, ungabhemi.
Ukuhlola ukubekezelela i-glucose kukhonjiswa lapho kunezici eziyingozi zesifo sikashukela i-mellitus, senziwa nge-hypertension ephakeme ephezulu, i-cholesterol ephezulu yegazi, abesifazane abanesifo sikashukela sokukhulelwa, ama-polycystic ovary, ingane ezelwe inesisindo somzimba esingaphezu kwamakhilogremu ayi-4,5, kanye nokukhuluphala, isindwa ifa, emva kweminyaka engama-45.
Ukwenza i-TSH kubandakanya ukuhlolwa kwe-glucose okusheshayo, ukuthatha i-75 g kashukela ngamanzi, khona-ke isiguli kufanele siphumule amahora ama-2 bese kufanele sihlolwe igazi lesibili.
Imiphumela yokuhlolwa komthwalo ushukela ihlolwa ngale ndlela elandelayo:
- Ukubekezelelwa kwe-glucose kukhubazekile, i-mellitus yesifo sikashukela se-latent: ngaphambi kokuhlolwa kwe-6.95 mmol / l, ngemuva kokudla kwe-glucose - 7.8 - 11.1 mmol / l.
- I-glucose engasebenzi kahle: isilinganiso esingu-1 - 6.1-7 mmol / L, umphumela wesibili - ngaphansi kuka-7.8 mmol / L.
- Isifo sikashukela mellitus: ngaphambi komthwalo - ngaphezu kuka-6.95, nangemva kwalokho - 11.1 mmol / l.
- Imvelo: esiswini esingenalutho - ngaphansi kuka-5.6 mmol / l, ngemuva kokulayisha - ngaphansi kuka-7.8 mmol / l.
Ushukela ophansi
I-Hypoglycemia izwakala uma ukuncishiswa koshukela kufinyelela ku-2.75 mmol / L. Umuntu ophile kahle angazizwa ekhululeka kakhulu noma izimpawu zincane. Ngokwesilinganiso sikashukela esiphakeme njalo, ukubonakaliswa kwe-hypoglycemia kungenzeka ngokuqukethwe okujwayelekile kweglue.
Okujwayelekile kungaba yi-hypoglycemia ngokomzimba ngokuphazamiseka isikhathi eside ekudleni kokudla noma ekusebenzeni isikhathi eside komzimba ngaphandle kokudla okwanele. Ukwehla kwezinga likashukela kuhlotshaniswa nokuphuza umuthi noma utshwala, kanye nezifo.
Izingane ezingazalwa zizalwa zitholakala kalula kwi-hypoglycemia ngoba zinesilinganiso esiphakeme sesisindo sobuchopho kwesisindo somzimba, kanti nengqondo idla inqwaba yoshukela. Ngasikhathi sinye, izinsana azikwazi ukufaka esikhundleni ushukela ngemizimba ye-ketone, ngoba ine-organic ketogenesis.
Ngakho-ke, ngisho nokwehla okuncane koshukela, uma kwenzeka isikhathi eside, kungabangela ukukhula kwengqondo okulimazayo. I-Hypoglycemia iyimpawu yezinsana ezingakabi yisikhathi (kufika ku-2,5 kg wesisindo) noma, uma umama enesifo sikashukela.
I-hypoglycemia esheshayo yenzeka ngalezi zimo ze-pathological:
- Ukuntuleka kwe-adrenal cortex.
- Ukweqisa kwe-sulfonylurea noma amalungiselelo e-insulin.
- I-insulin engaphezulu nge-insulinoma.
- I-Hypothyroidism
- I-Anorexia
- Isibindi esikhulu noma isifo sezinso.
- Umkhuhlane isikhathi eside
- Ukuphazamiseka kokumuncwa amathumbu, ukuhlinzwa esiswini.
- Izinqubo zeTumor, ukuncipha komdlavuza.
I-hypoglycemia eyenzeka kakhulu ibonakaliswa ubuthakathaka, ukuthikamezeka okubukwayo, ikhanda, ukubanga, isiyezi, ukubekeka phansi kwezitho zomzimba, ukwehluleka. Lezi zimpawu zikhawulelwe ukungondleki kahle kwengqondo.
Iqembu lesibili lezimpawu likhula ngokuvuselelwa kokuncishiswa kokukhishwa kwama-hormone okuxinzelela: i-tachycardia, ukujuluka, ukuzwakala, indlala, izandla eziqhaqhazelayo, i-pallor, ukudonswa kweminwe nezindebe. Uma ukwehla kweshukela kuqubuka, kukhula ukhekhe we-hypoglycemic.
Izimpawu zemitholampilo ze-hypoglycemia engapheli zenzeka ngokuncipha kweshukela, okuphindwa isikhathi eside. Lokhu kufaka phakathi: ukuguqulwa kobuntu, ukulahleka kwenkumbulo, ukuwohloka komqondo, ingqondo - ezinganeni - lokhu kubambezeleka kwentuthuko, ukubuyiselwa kwengqondo.
I-Hyperglycemia
I-Hyperglycemia ibhekwa njengokwanda kokuhlungwa kwe-glucose ngaphezulu kuka-5.5 mmol / L. Ungahlotshaniswa nokudla ama-carbohydrate, adonswa ngokushesha. Le nhlobonhlobo ibizwa ngokuthi yi-alimentary noma i-postprandial. Ukunyuka kwengcindezi kushukela kubangelwa yithonya lamahomoni - ama-glucocorticoids nama-catecholamines akhiwa ngalesi sikhathi.
I-hyperglycemia ye-pathological iba nokukhula komsebenzi noma inqubo yamathumbu ezithweni zohlelo lwe-endocrine - i-pituitary gland, i-pancreas, i-adrenal gland noma indlala yegilo. Isifo sikashukela singenye yezimbangela ezivame kakhulu zokwanda kweshukela.
Indlela yokuthuthukiswa kwe-hyperglycemia kushukela sincike ekutheni ibangelwa yini. Uhlobo lokuqala lwesifo lwenzeka ngokumelene nesizinda sokubhujiswa kwe-autoimmune kwamaseli okuvikela insulin. Kwisifo sikashukela sohlobo lwesibili, indima eyinhloko idlalwa ngokumelana ne-tisulin insulin okwenzeka ngesikhathi sokuphazamiseka kwe-metabolic, eyinhloko ibe ukukhuluphala.
Ngokubonakaliswa okujwayelekile kwe-hyperglycemia, kuvela izimpawu eziyinkimbinkimbi emzimbeni:
- Khulisa ukoma.
- Ukudangala, yize umuntu edla kahle.
- Ukuphuma komchamo ovela kaningi.
- Ubuhlungu bekhanda.
- Ubuthakathaka, ukukhathala.
- Umbono ophansi.
- Isikhumba se-Itchy nolwelwesi lwe-mucous olomile.
Ukuguquguquka kwesisindo somzimba kungaboniswa kuphela ngokuncipha kwesisindo (onesifo sikashukela sohlobo 1), kodwa futhi nangokweqile ngokweqile kohlobo lwesibili lwesifo. Lokhu kungenxa yokuthi i-insulin ikhuthaza ukufakwa kwamafutha ezicutshini ezingaphansi. Ngohlobo 1 sikashukela, kuncane kwalo egazini, kanti uhlobo lwesibili lubonakala nge-hyperinsulinemia, ikakhulukazi ekuqaleni kwalesi sifo.
Ukwanda okuhlala isikhathi eside kushukela wegazi kuholela ekwehleni kokungazinzi komzimba, ukuthuthukiswa kwezifo ezithathelwanayo, i-candidiasis, kanye nokwelashwa kancane kwamanxeba nokukhubazeka kwezilonda. Ukuhlinzekwa kwegazi okungalungile kanye nokulimala kwemicu yezinzwa kuholela ekunciphiseni ukuzwela kwamaphethelo aphansi, ukuthuthukiswa kwe-polyneuropathy.
Izinkinga ezijwayelekile zesifo sikashukela ezingena ngeglucose engalapheki egazini zilimaza izinso, i-retina yeso, nokucekelwa phansi kwezindonga zemithambo yegazi emincane nemincane.
I-Hyperglycemia futhi ibangela izinkinga ezinkulu zesifo sikashukela, kubandakanya i-ketoacidosis, hypersmolar coma, lapho amazinga eglucose angafinyelela khona ngo-32 mmol / L nangaphezulu.
I-Hyperglycemia yobulukhuni obuhlukahlukene ngokuya ngesilinganiso sokushukela egazini (mmol / l):
- Ukukhanya - 6.7-8.2.
- Ukwehla okulinganiselwe - 8.3-11.
- Isindayo - Ngaphezulu kwe-11.1
- I-Precoma yenzeka ngo-16.5, amanani aphakeme aholela ekhefeni.
I-Hyperglycemia in diabetesics kwenzeka lapho weqa amaphilisi ukwehlisa ushukela noma ukujova i-insulin, futhi uma umthamo wabo unganele.
Lesi simo singenzeka ngokusetshenziswa kokudla okunama-carbohydrate amaningi, ukunamathiselwa kwesifo esithathelwanayo noma esinye isifo, ukucindezela, ukwehla kwezinga elijwayelekile lomsebenzi womzimba.
Ukuqapha ushukela ngokwakho
Lapho usebenzisa idivaysi yokulinganisa ushukela egazini, kufanele unamathele kubuchwepheshe obulungile ekufundweni kwegazi kanye nemvamisa yokuhlolwa. Ku-mellitus yesifo sikashukela sohlobo lokuqala, iziguli kufanele zinqume okungenani i-glycemia izikhathi ezine ngosuku: kathathu ngaphambi kokudla nangaphambi kokulala.
Izilinganiso ezingezekile nazo zingadingeka ebusuku, ngemuva kokuzivocavoca kakhulu komzimba noma izinguquko ezibalulekile ezondweni. Kuyanconywa nokuthi ukuzihlola ngokwakho ushukela kwenziwe ngezikhathi ezithile ngemuva kokudla (ngemuva kwamahora ama-2).
Ohlelweni lwesibili, iziguli zingathola ukwelashwa nge-insulin noma ziphuze amaphilisi alwa nesifo sikashukela, bese kuthi ukwelashwa okuhlanganiswe nge-insulin esebenza isikhathi eside namaphilisi okunciphisa ushukela kuyenziwa.
Uma isiguli sinqunyelwe ukwelashwa kwe-insulin okuqinisiwe, lapho-ke irejimeni yokufunda iyafana nohlobo lokuqala lwesifo sikashukela. Uma ethola umjovo owodwa ngosuku noma amaphilisi kuphela, lapho kuvame ukwanela ushukela kanye, kepha ngezikhathi ezahlukahlukene zosuku.
Lapho usebenzisa amalungiselelo e-insulin, aqukethe i-insulin ende futhi emfushane, ukulawulwa kwenziwa kabili ngosuku. Noma iyiphi inketho yokwelashwa, ishadi kufanele lidwetshwe kanye ngesonto, libonisa izilinganiso ezi-4 ze-glycemia.
Uma inkambo yesifo sikashukela ihambisana nokushintshashintsha okukhulu kwezinga likashukela, khona-ke imvamisa yokulinganisa kufanele ibe nkulu, kufanele icetyiswe ngudokotela. Inquma nenqanaba le-glucose eliqondisiwe kwisiguli ngasinye, kuya ngeminyaka, indlela yokuphila, isisindo somzimba.
Imithetho eyisisekelo yokuqhuba ukuzihlola ushukela wegazi:
- Igazi leminwe likulungele kangcono ukuhlaziywa; isayithi le-punning lidinga ukushintshwa.
- Umjovo wenziwa kusukela ohlangothini, ukujula akufanele kube ngaphezu kwamamilimitha angama-2-3.
- Zonke izinto ezidliwayo kumele zibe nezingcolile futhi zihlale zingabantu.
- Ngokujikeleza kwegazi okungekuhle, ngaphambi kokuhlaziywa, thambisa umunwe wakho bese ugeza izandla ngamanzi afudumele bese womile.
- Ngaphambi kokulinganisa, udinga ukuqinisekisa ikhodi esebhodleleni ngemichilo yokuhlola nakwisikrini semitha.
- I-drop yokuqala yocwaningo ayisetshenziswa, idinga ukususwa ngephedi likotini elomile.
- Ukucindezelwa okunamandla komunwe kuholela ekuxubeni kwegazi nge-fluid fluid, okuhlanekezela umphumela.
Faka isicelo sethonsi segazi kuphela emaphethelweni webhande lokuhlola, elimakwe mnyama. Ngaphambi kokulinganisa, umucu wokuhlola kufanele ube sebhodleleni elivalekile ngokuqinile, ngoba uzwela umswakama. Ngeke ithathwe ebhodleleni ngeminwe emanzi. Futhi, awukwazi ukushintsha izindawo zokugcina zemichilo yokuhlola, ngoba ukufaka kwangempela kuqukethe i-desiccant.
Imichilo kufanele igcinwe endaweni eyomile ekushiseni kwegumbi, ngaphambi kokusebenzisa kudingeka uqiniseke ukuthi usuku lokuphelelwa isikhathi oluboniswe kwiphakheji aludlulanga. Ngemuva kokuphothulwa, imichilo yokuhlola enjalo ingahlanekezela umphumela wokulinganisa.
Ngokuthola ukuxilongwa okuzwakalayo, imichilo ebonakalayo isetshenziselwa ukunquma ushukela wegazi .. Ingasetshenziswa uma kungekho glucometer. Ungase futhi ugxile kumphumela wokuzimisela ngokusebenzisa imichilo enjalo lapho uthola imizimba ye-ketone egazini nomchamo.
Ividiyo ekulesi sihloko ikhombisa ukuthi ungalinganisa kanjani ushukela wegazi ngokuzimela.
