Ungayithatha kanjani i-glycated hemoglobin: esiswini esingenalutho noma cha?

Ngeshwa, inani labantu abatholakala benesifo sikashukela liyanda minyaka yonke. Ngemuva kokuhlolwa kwegazi, iziguli kufanele zibuye zihlolwe i-hemoglobin ye-glycated, ukuthi zingayithatha kanjani esiswini esingenalutho noma cha, udokotela oholayo uyanquma.

Ukuhlaziywa okunjalo kunqunywa lapho isiguli siveza ukugcwala okwandisiwe koshukela egazini le-venous noma le-capillary. Ucacisa isithombe esigcwele salesi sifo, ngosizo lwaso kungenzeka ukuthi kusungulwe uhlobo lwesifo sikashukela.

Kodwa-ke, ukuhlolwa kwe-hemoglobin ye-glycated kuthatha isikhathi esiningi: kubonisa isilinganiso se-glucose egazi ezinyangeni ezintathu ezedlule. Kuyini nokuthi ungakuthatha kanjani? Ake sizame ukuthola.

Yini i-glycated hemoglobin?

Ukuba yi-molecule ekhethekile yamaprotheni, i-hemoglobin iyingxenye yamangqamuzana abomvu egazi. Umsebenzi wawo oyinhloko ukudlulisa umoya-mpilo kusuka emaphashini kuye kuwo wonke izicubu zomzimba, futhi kuwo - ukubuya kwe-carbon dioxide (CO₂) emuva emaphashini. Le molekyuli yamaprotheni iyingxenye yazo zonke izidalwa ezinesistimu yokujikeleza.

IHemoglobin ihlukaniswe izinhlobo eziningi, kepha i-hemoglobin-A ibhekwa njengejwayelekile kakhulu. Lolu hlobo lubiza ama-95% we-hemoglobin ephelele emzimbeni. IHemoglobin-A nayo ihlukaniswe izakhi eziningana, enye yazo eyi-A1C. Nguye okwazi ukubopha ku-glucose, obizwa nge-glycation noma glycation. Futhi izazi zezinto eziphilayo eziningi zibiza lezi zinqubo ngokuthi ukusabela kukaMaillard.

Inani le-hemoglobin ye-glycated lisiza ukunquma ukuthi ngabe umzimba we-carbohydrate awunampilo, ikakhulukazi isifo sikashukela sanoma yiluphi uhlobo. Kunobudlelwano obuqondile phakathi kwezinga le-glucose nezinga le-glycation: ukukhuphuka ushukela wegazi, i-glycation kakhudlwana.

Isikhathi sokutadisha singenxa yokuthi isikhathi sokuba khona nokusebenza kwamangqamuzana abomvu egazi kuthatha izinyanga ezintathu.

Ngakho-ke, ukugxila kwe-glucose kubhekwe kahle kulezi zinhlaka zesikhathi.

Ngubani odinga ukuhlolwa?

Uma siqhathanisa ukuhlolwa kwegazi ngoshukela nokuhlolwa kwegazi kwe-hemoglobin ye-glycated, khona-ke lokhu kwamuva ngokuqinisekile kunembe kakhulu.

Lapho udlulisa ukuhlaziya okujwayelekile, imiphumela ingathintwa yizici eziningi, ngokwesibonelo, isiguli singahamba kakhulu ngamaswidi, sithola isifo esithathelwanayo noma isifo segciwane, sisinde ekuvuselelekeni ngokomzwelo nokunye okunjalo. Ukuhlaziywa kwe-hemoglobin ye-glycated, eyenziwe isikhathi esingaphezu kwezinyanga ezintathu, kungakhombisa ngokunembile okuqukethwe ushukela esigulini.

Kunemigomo yalolu cwaningo kubantu abaphilile. Kepha ngokuthuthuka kwesifo sikashukela, izinga likashukela lidlula kakhulu la manani ajwayelekile. Ucwaningo lwenziwa hhayi nje kuphela ukuthola ukuthi hlobo luni lwe-pathology, kodwa futhi nokuhlaziya ukusebenza kahle kokwelashwa kwalo. Uma kwenzeka kunemiphumela yokuhlolwa okuphezulu, udokotela ulungisa isimo sokwelashwa kwesiguli, noma ngabe kungukuwelashwa kwe-insulin noma ukuthatha izidakamizwa ze-hypoglycemic.

Ngakho-ke, uchwepheshe oholayo unquma isigaba sokufunda kulezi zimo ezilandelayo:

• ukuxilongwa nokuqinisekiswa kokusebenza ngempumelelo kokwelashwa;
• ukuqaphela isikhathi eside kokwelashwa kwesifo sikashukela;
• imininingwane eyengeziwe yokuhlaziywa kwe-glucose;
• ukuhlolwa kowesifazane ngenkathi ezala ingane ukuthola ukuthi unesifo sikashukela.

Njenganoma yikuphi okunye ukuhlola, ukuhlolwa kwe-hemoglobin ye-glycated kunezimpawu zayo nemithetho yokulethwa, okumele ilandelwe ngakho konke ukungathí sina.

Imithetho yokulungiselela ukuhlaziya

Eqinisweni, ukulungiselela ukunikela ngegazi akunayo imithetho ekhethekile. Abaningi banesifiso sokuthi bangayithatha kanjani: esiswini esingenalutho noma cha? Akukhathalekile, ngakho-ke akudingeki ukhathazeke uma umuntu ngokungazelelwe enenkomishi yetiye noma yekhofi ekuseni. Ucwaningo olwenziwe cishe izinyanga ezintathu luzokwazi ukuthola inani le-hemoglobin ephelele ye-glycated.

Ukuhlaziywa, kuthathwa igazi le-venous, imvamisa yothango kungamasentimitha ayi-3 cubic. Ngaphezu kwalokho, ingahanjiswa nganoma yisiphi isikhathi sosuku, hhayi ekuseni kuphela. Ukuhlolwa ngeke kuthinteke injabulo noma isiguli somuthi. Kepha ukulahleka okukhulu kwegazi ngaphambi kokucwaninga kuhlanekezela imiphumela yako. Lokhu kusebenza nakwabesifazane abanezikhathi ezisindayo. Ngakho-ke, esikhathini esinjalo, isiguli kufanele sikhulume nodokotela, ozokuhlehlisa ukuhlolwa isikhashana.

Lapho isiguli sithola umphumela wokuhlolwa kwesandla, futhi lokhu kuvame ukuthatha izinsuku ezingaphezu kwezingu-3, ​​sibona "i-HbA1c" - lokhu kungukuqokwa kokuhlolwa kwe-hemoglobin ye-glycated. Amanani angavezwa amayunithi ahlukene, isibonelo, ku-%, mmol / mol, mg / dl kanye no-mmol / L.

Okukhathazayo iziguli ezihlaziywa okokuqala ngqa yintengo.

Uma unikela ngegazi emtholampilo yangasese, khona-ke ngokwesilinganiso kufanele uchithe kusuka kuma-ruble angama-300 kuye kwangama-1200.

Amanani ajwayelekile we-glycated hemoglobin

Izinkomba ze-glycated hemoglobin azimele ngobulili nobudala.

Kubantu abaphilile, amanani aqala ku-4 kuye ku-6%.

Ukuphambuka kwenkomba phezulu noma phansi kungakhombisa ukwephulwa kwe-carbohydrate metabolism kanye nesifo sikashukela.

Amanani we-hemoglobin alandelayo aqukethe isimo somzimba:

1. Kusuka ku-4 kuye ku-6% kuyinto ejwayelekile.
2. Ukusuka ku-5.7 kuye ku-6.5% ukwephula ukubekezelela i-glucose, okungakhombisa ukuthuthukiswa kwe-prediabetes.
3. Kusuka ku-6.5% - isifo sikashukela.

Ngaphezu kwalokho, noma umuntu ephilile, kufanele abhekane nalolu vivinyo ngezikhathi ezithile lapho enezihlobo ezinesifo sikashukela.

Abesifazane abakhulelwe nabo kudingeka bahlolwe ngoba isifo sikashukela sokukhulelwa kuyinto evamile. Ngesikhathi sokuzala kwengane, izinguquko ezithile zenzeka emzimbeni kamama okhulelwe, ikakhulukazi i-hormonal. I-placenta ikhiqiza ama-hormone aphikisana ne-insulin. Ngenxa yalokhu, i-pancreas ayihambelani nomthwalo, futhi umzimba womuntu wesifazane ukhubazekile. Bacwaninga ngokuyinhloko lapho:

• isakhi sofuzo kushukela;
• ukukhuluphala;
• i-polyhydramnios;
• i-polycystic ovary;
• ingane ezelwe.

Yiziphi izinkambiso ze-hemoglobin ye-glycated yesifo sikashukela? Lesi sifo sithinta abesifazane kaningi ukwedlula abesilisa. Kukholelwa ukuthi inani elifanele lesifo sikashukela liyi-6.5%, ngakho-ke iziguli kufanele zilwele ukufeza lolu phawu. Ezinye izinkomba zingakhombisa:

1. Ngaphezu kuka-6% - okuqukethwe ushukela okuphezulu.
2. Ngaphezu kwe-8% - ukwehluleka ukwelashwa.
3. Ngaphezu kwe-12% - ukulaliswa esibhedlela ngokuphuthumayo kuyadingeka.

Eqinisweni, akuwona wonke umuntu ophumelela ukufinyelela enkombeni engu-6.5%, kepha ungakhungatheki, ngoba izinga le-hemoglobin ye-glycated lithinteka yizici ngazinye nezifo ezihlanganyele.

Kunoma ikuphi, udinga ukubonana nodokotela ozokuchaza konke ngendlela efinyelelekayo.

Izizathu zokwanda noma ukwehla kwezinkomba

Isifo sikashukela akuyona ukuphela kwembangela yoshintsho emazingeni e-HbA1c.

Ukuthola isici esithinta okuqukethwe kwaso, kuyadingeka ukuthi kuhlolwe ngokuphelele.

Ngaphezu “kwesifo esimnandi”, ukubekezelelwa kwe-glucose engathinteki nakho kungathinta i-hemoglobin ye-glycated.

Ukubekezelela ushukela okhubazekile kuvame ukubangelwa yi:

• ukushoda kwensimbi emzimbeni;
• ukungasebenzi kwe-pancreatic;
• ukwehluleka kwezinso;
• okuqukethwe okuphezulu kwe-fetus hemoglobin ezinganeni ezisanda kuzalwa, okubuyela kokujwayelekile kungakapheli izinyanga ezintathu.

Ukunciphisa okuqukethwe kwe-hemoglobin ye-glycated akwenzeki kaningi, kepha lokhu kuyingozi enkulu. Ukwehla kwesikhombisi esingezansi kwe-4% kungathinteka:

1. isimo se-hypoglycemic;
2. Ukwehluleka kanye / noma kwesibindi;
3. Ukwehla kwegazi okubalulekile;
4. Ukusebenza okungahambi kahle kohlelo lokujikeleza kwegazi;
5. I-hememotic anemia;
6. I-pancreas engasebenzi kahle.

Imvamisa lapho kugxotshwa ushukela omningi egazini, isiguli sizwa ukukhathala, ukozela, isiyezi. Ngezindlela ezibucayi kakhulu, kungahle kube nokuphazamiseka kwemizwa kanye nokukhubazeka okubukwayo. Kodwa-ke, lesi simo siyingozi kakhulu, ngoba kungaholela ekwakhiweni kwekoma noma nokufa imbala.

Izindlela zokunciphisa i-HbA1c

Njengoba izinga le-hemoglobin ne-glucose ye-glycated liyizinkomba ezincike komunye nomunye, ukwehla kokuqukethwe ushukela kufaka ukwehla kwe-HbA1c.

Ayikho imiyalo ethile.

Kufanele uhambisane nemithetho eyisisekelo yokugcina izinga elijwayelekile likashukela kushukela.

Ukuze wenze lokhu, kunconywa ukuthi:

1. Ukudla okufanele. Isiguli kufanele singafaki ekudleni noma yimuphi amaswidi, namakhekhe, ukudla okuthosiwe nokunamafutha. Kufanele adle izithelo nemifino emisha, imikhiqizo yobisi edonsa kancane, nokudla okune-fiber eningi. Landela izimiso zokwelashwa kwesifo sikashukela futhi usebenzise uketshezi olwanele.
2. Indlela yokuphila esebenzayo. Lokhu akusho ukuthi udinga ukuzikhipha amandla ngokweqile ngokuzivocavoca ngokweqile. Ekuqaleni, ukuhamba emoyeni omusha kwanele okungenani imizuzu engama-30 ngosuku. Ngemuva kwalokho ungaguqula imisebenzi yakho yangaphandle ngemidlalo yezemidlalo, ukubhukuda, i-yoga nokunye.
3. Ukuqashwa njalo kokuqukethwe ushukela. Abantu abanesifo sikashukela abanesifo sohlobo loku-1 kudingeka bahlole izinga le-glycemic ngaphambi kokwelashwa kwe-insulin ngayinye, futhi ngohlobo 2 - okungenani kathathu ngosuku.
4. Ukulawulwa okufika ngesikhathi kwezidakamizwa ze-hypoglycemic nemijovo ye-insulin. Kuyadingeka ukulandela imithamo efanele nesikhathi sokusetshenziswa kwezidakamizwa.

Ngaphezu kwalokho, kufanele uvakashele udokotela njalo ukuthola izeluleko nezincomo.

Imiphumela yokuxilongwa kungaziwa

Isiguli singabekezelela izimpawu zesifo sikashukela nezinye izifo isikhathi eside, kodwa ungalokothi ufune usizo lochwepheshe.

Isimo sengqondo sokunganaki emzimbeni wakho singaba nemiphumela emibi.

Ngokuxilongwa kwesifo sikashukela okungalindelekile, izinqubo ezingenakuphikwa ziyathulwa ezinwebeka cishe kuzo zonke izitho zomuntu.

Ukuqhubeka kwe-pathology kuholela ezinkingeni ezinjalo:

• I-Nephropathy, isb. Ukulimala kwezinso ku-mellitus yesifo sikashukela;
• i-retinopathy yesifo sikashukela - ukuvuvukala kwe-retina, lapho umbono uphazamiseka khona;
• i-angiopathy - ukulimala kwemithambo okuholela ekusebenzeni kahle;
• unyawo lwesifo sikashukela - ukuzindla nokuxina kwamaphethelo aphansi ngengozi ye-gangrene.
• ukuphazamiseka okuhlukahlukene kwe-microcirculation yemithambo;
• ama-cataracts ayimbangela enkulu yokulahleka kombono kushukela;
• i-encephalopathy - ukulimala kobuchopho obangelwa ukushoda komoya-mpilo, ukuphazamiseka kokujikeleza, ukufa kwamangqamuzana ezinzwa;
• i-arthropathy yisifo esihlangene esibangelwa ukulahleka kukasawoti we-calcium.

Njengoba ukwazi ukubona, la ma-pathologies ayingozi impela futhi adinga ukunakwa okukhethekile. Ngakho-ke, kubaluleke kakhulu ukuthi ungathathi nje kuphela isivivinyo se-glycated hemoglobin, kodwa futhi nokunye ukuhlolwa okudingekile. Ekwamukeleni, udokotela uzochazela isiguli ukuthi sikudlulisa kanjani ngendlela efanele, bese sithola imiphumela yocwaningo. Inqubo enjalo izosiza ngokuqondile ukuthola isiguli esinesifo sikashukela noma isifo se-carbohydrate metabolism.

Kwividiyo ekulesi sihloko, isihloko sokuhlaziywa kwe-hemoglobin ye-glycated siyaqhubeka.