Iziguli ezingama-400 million ezinesifo sikashukela zibhalisiwe emhlabeni, cishe inani elifanayo alikwazi ukutholwa okunjalo. Ngakho-ke, ukuhlolwa kwegazi kwe-glucose kudume kakhulu kokubeletha emtholampilo nasezikhungweni zokuxilonga.
Izinkinga ekutholakalweni kwesifo sikashukela ukuthi isikhathi eside, sizibonakalisa kabi noma sizenza ezinye izifo. Futhi ngisho nokuxilongwa kwelabhoratri, uma kunikezwe uhla oluphelele lokuhlolwa, alukwazi ukubona ushukela ngokushesha.
Ngaphezu kwalokho, imiphumela yesifo sikashukela i-mellitus, izinkinga zaso emithanjeni yegazi, izinso, amehlo angaphenduki. Kungakho kunconyelwa ukubheka amazinga eglucose egazini hhayi kuphela ezigulini ezinesifo sikashukela, kodwa futhi nakusola noma ikuphi ukusola kwe-carbohydrate metabolism. Lokhu kuyiqiniso ikakhulukazi ezigulini ezisengozini yokuba nesifo sikashukela.
Yini ongayifunda ohlolweni lweglucose legazi?
Ushukela wegazi ubizwa ngokuthi i-glucose, ehamba ngemithambo yegazi, ungena kuzo zonke izitho nomangqamuzana omzimba. Ihanjiswa emikhunjini ngamathumbu (kusuka ekudleni) kanye nesibindi (okwenziwe kusuka kuma-amino acid, glycerol kanye ne-lactate), futhi kungatholwa ngokuhlukanisa izitolo ze-glycogen emisipha nasesibindi.
Umzimba awunakusebenza ngaphandle kwe-glucose, ngoba amandla akhiqizwa kuwo, amaseli abomvu egazi, izicubu zemisipha zinikezwa nge-glucose. I-insulin isiza ukudonsa ushukela. Ukuphuma kwayo okuyinhloko kwenzeka lapho kudliwa. Le hormone yenza i-glucose kumaseli ukuze isetshenziswe ekuthomeni kokunye kwe-ATP futhi ingxenye igcinwe esibindini njenge-glycogen.
Ngakho-ke, izinga elikhulile loshukela (ushukela) libuyela kumanani alo wangaphambili. Imvamisa, umsebenzi we-pancreas, i-adrenal glands, uhlelo lwe-hypothalamic-pituitary kuhloswe ngalo ukuqinisekisa ukuthi i-glycemia isezingeni elincane. Amanani asukela ku-3.3 kuya ku-5.5 mmol / L, ushukela uyatholakala kumaseli, kepha awacholwa emchameni.
Noma yikuphi ukuphambuka kusuka ezinkombeni ezijwayelekile zomzimba kunzima ukukubekezelela. Ukhuphuka ushukela wegazi kungaba kulezo zimo ze-pathological:
- Isifo sikashukela mellitus.
- Ama-antibodies kuma-insulin ekushintsheni kwe-autoimmune.
- Izifo zohlelo lwe-endocrine: indlala ye-adrenal, indlala yegilo, izitho zayo ezilawulayo - i-hypothalamus kanye ne-pituitary gland.
- I-pancreatitis, isimila se-pancreas.
- Isifo sesibindi noma isifo sezinso esingamahlalakhona.
Ukuhlolwa kwegazi ushukela kungakhombisa umphumela ongaphezulu kokujwayelekile ngemizwa eqinile, ukucindezelwa, ukuzikhandla okulinganiselayo ngokomzimba, ukubhema, ukuthatha imishanguzo ye-hormonal, ikhafeine, i-estrogen ne-diuretic, izidakamizwa ze-antihypertensive.
Ngokukhula okukhulu kwezinga loshukela, kuvela ukoma, isifiso esandayo sokudla, ukuwohloka kwenhlalonhle ejwayelekile, ukuchama kuba kaningi. Uhlobo olunzima lwe-hyperglycemia luholela ekhefeni, elandulelwa yisicanucanu, ukuhlanza, ukubonakala kwe-acetone emoyeni okhipha umoya.
Ukwanda okungapheli kwe-glucose egazini elijikelezayo kuholela ekunciphiseni kokuhlinzekelwa kwegazi, ukuzivikela komzimba, ukuthuthukiswa kwezifo nomonakalo kwimicu yezinzwa.
Akunakubungozi kangako ebuchosheni nasekuhlaselweni kokugxila okuphansi koshukela egazini. Lokhu kwenzeka lapho kwakhiwa i-insulin eningi (ikakhulukazi emathunjini), isifo sezinso noma sesibindi, sinciphise ukusebenza kwe-adrenal, hypothyroidism. Imbangela ejwayelekile ukugcwala ngokweqile kwe-insulin kushukela.
Izimpawu zokuwa ushukela zivezwa ngendlela yokujuluka, ubuthakathaka, ukuthuthumela emzimbeni, ukwanda kokukhathazeka, bese kuba nokuphazamiseka kokuqwashisa, futhi uma usizo lunganikezwa, isiguli siwela ebuthakathakeni.
Yiziphi izivivinyo ezingabekwa kwabasolwa abanesifo sikashukela?
Ngosizo lokuxilongwa kwebhubhoratri, kungenzeka ukusungula hhayi i-mellitus yesifo sikashukela kuphela, kodwa futhi nokuyihlukanisa kwezinye izifo ze-endocrine lapho ukwanda ushukela wegazi kuwuphawu lwesibili, kanye nesifo sikashukela esenzeka kamuva.
Ukuhlolwa kwegazi okujwayelekile kungathathwa ngaphandle kokuvakashela udokotela, ngentando. Uma ukuhlolwa kwegazi ushukela kunqunyiwe, ukumiswa kwaso kubantu abadala ngokwesilinganiso esisetafuleni kwenziwa ngudokotela okhiphe okudluliselwe. Kusukela ukuhlola umphumela, bese uliqhathanisa nesithombe somtholampilo, uchwepheshe kuphela onga.
Ngokuhlolwa okujwayelekile, ukuhlaziywa kwe-glycemia kuphakathi kokuphoqelekile. Ukuqapha njalo okuqukethwe kwayo kunconywa kubantu abakhuluphele kanye nomfutho wegazi ophakeme. Iqembu lengozi lifaka iziguli ezinezihlobo zegazi lazo ezitholakala zinemetabolism carbohydrate metabolism: ukubekelwa phansi ushukela, ushukela.
Izinkomba zokuhlaziywa yilezi:
- Isifiso sokudla nokoma njalo kwanda.
- Ubuthakathaka obukhulayo.
- Ukuchama kaningi.
- Ukushintshwa okubukhali kwesisindo somzimba.
Ukuhlolwa kweglucose yegazi kuyindlela yokuqala futhi evame ukubekelwa ukutholwa. Ukuhlaziywa kwenziwa ngesampula yezinto ezibonakalayo ezivela emthanjeni noma kusetshenziswa igazi le-capillary kusuka emunweni. Ngaphezu kwalokho, izinkomba ezijwayelekile zikashukela egazini le-venous ziphezulu ngo-12%, ezithathwa ngodokotela.
Ukunqunywa kokuhlushwa kwe-fructosamine. Le iprotheni exhunywe noshukela. Ukuhlaziywa kubekelwe ukuthola isifo sikashukela nokuhlola umphumela wokwelashwa. Le ndlela yenza ukuthi sikwazi ukubona imiphumela yokwelashwa ngemuva kwamasonto ama-2. Isetshenziselwa ukulahleka kwegazi kanye ne-hemolytic anemia. Akukhonjwanga ngokulahleka kwamaprotheni nge-nephropathy.
Ukuhlaziywa kokuhlushwa kwe-hemoglobin ye-glycated egazini. I-hemoglobin ihlangana noshukela, olinganiswa njengephesenti le-hemoglobin esegazini. Kuyadingeka ukulawula isinxephezelo sikashukela ngoba sikhombisa amanani aphakathi kashukela wegazi cishe ezinsukwini ezingama-90 ngaphambi kocwaningo.
Le nkomba ibhekwa njengethembekile, ngoba ayixhomekile kokudla okunempilo, ngokomzwelo noma ngokomzimba, isikhathi sosuku.
Ukuhlolwa kokubekezelela kwe-glucose kwenza sikwazi ukuhlola ukukhipha i-insulin njengempendulo ekuphuzeni i-glucose. Okokuqala, umsizi weelebhu unquma i-glycemia esheshayo, bese kuthi amahora 1 no-2 ngemuva kokulayisha ushukela.
Ukuhlolwa kuhloselwe ukuthola ukuthi kunesifo sikashukela uma ukuhlolwa kokuqala kokushukela okushukela sekukhombisile ukwanda. ushukela. Ukuhlaziywa akwenziwa nge-glycemia ngenhla kwe-11.1, ngemuva kokubeletha kwengane, ukuhlinzwa, ukuhlaselwa yisifo senhliziyo.
Ungayihlola kanjani imiphumela yokuhlolwa?
Ukuhlaziywa ngakunye kunamanani akhona okubhekiswa kuwo (okujwayelekile), ukuphambuka kuwo kunenani lokuxilonga. Ukuhlola kahle umphumela wokucwaninga, ngemuva kokuhlaziywa kwenziwa, udinga ukuqhathanisa umphumela nezinkomba zelebhu lapho yenziwa khona.
Ngakho-ke, kunconyelwa ukusebenzisa ilabhorethri eyodwa noma wazi indlela yokucwaninga. Ngaphezu kwalokho, ngenxa yokwethenjwa kokuhlaziywa, kuyadingeka ukulandela ngokucophelela imithetho yokuqalisa kwayo: ukungafaki ngokuphelele ubusuku obandulela utshwala, zonke izifundo, ngaphandle kwe-hemoglobin ye-glycated, zenziwa ngokuqinile esiswini esingenalutho. Akufanele kube nezifo ezithathelanayo kanye nengcindezi.
Isiguli sidinga ukulungiselela ukuhlolwa kwegazi ushukela ne-cholesterol ezinsukwini ezimbalwa ngaphambi kokubeletha. Ngosuku locwaningo, iziguli azivunyelwe ukubhema, ukuphuza noma yini ngaphandle kokuphuza amanzi nokuzivocavoca. Uma isiguli sithatha umuthi wokwelapha isifo sikashukela noma izifo ezihlangene, lapho-ke kudingeka axhumanise ukuhoxa kwabo nodokotela.
Umbhalo weglue glucose ku-mmol / l:
- Kufika ku-3.3 - izinga eliphansi, i-hypoglycemia.
- 3 - 5.5 - okujwayelekile.
- I-6 - 6.1 - ukumelana noshukela, noma isimo se-prediabetes sikhubazekile.
- 0 (kusuka emthanjeni) noma u-6.1 kusuka emunweni - isifo sikashukela.
Ukuhlola ukusebenza kahle kwe-mellitus therapy, kukhona elinye ithebula lapho umuntu angathatha khona izinkomba ezilandelayo: i-glycemia ifinyelela ku-6.0 mmol / l - uhlobo lwe-2 isifo sikashukela sinenkambo ebuyisiwe, futhi ngohlobo lwesifo sikashukela esingu-1 lo mngcele uphakeme - kufinyelela ku-10,0 mmol / l. Ucwaningo kufanele lwenziwe ngesisu esingenalutho.
Ukuhlaziywa kokuhlaziywa kwe-fructosamine kungachazwa njengokulandelayo: izinga eliphakeme elivumelekile le-fructosamine ngu-320 μmol / l. Kubantu abanempilo, inkomba imvamisa ayiphezulu kune-286 μmol / L.
Ku-mellitus enxephekile yesifo sikashukela, ukuguquguquka kwamanani kungaba ku-286-320 μmol / L; esigabeni esinciphile, i-fructosamine ikhuphuka ibe ngu-370 μmol / L nangaphezulu. Ukwanda kwesikhombi kungakhombisa ukwehluleka kokusebenza kwezinso, i-hypothyroidism.
Izinga elincishisiwe libhekene nokulahleka kwamaprotheni kumchamo, kanye nephropathy yesifo sikashukela. Umphumela wamanga ukhombisa ukuhlolwa nge-ascorbic acid.
Ukunqunywa kwesilinganiso se-hemoglobin ephelele futhi ye-glycated. Umphumela ukhombisa iphesenti elihlobene nenani eliphelele le-hemoglobin:
- Uma ingaphezulu kuka-6.5 noma ilingana no-6.5%, khona-ke lokhu kuyinkomba yokuxilongwa kwesifo sikashukela.
- Uma kuluhlu lwamaphesenti ayi-6.0 kuya ku-6.5, khona-ke ingozi yokuthola isifo sikashukela, i-prediabetes iyanda.
- Uma kungaphansi kwamaphesenti ayi-6, khona-ke lesi yisilinganiso se-glycated hemoglobin.
I-overestimation yamanga yenzeka nge-splenectomy noma i-iron defence anemia. Ukwehla okungamanga kwenzeka nge-hemolytic anemia, ngemuva kokopha kakhulu noma ukumpontshelwa igazi.
Ukuhlola imiphumela yokuhlolwa kokubekezelela kwe-glucose, inkomba ye-glycemic ihlolwe ngemuva kwamahora ama-2 ngemuva kokuba isiguli sithathe isisombululo se-glucose. Isifo sikashukela sibhekwa njengesiqinisekisiwe uma ushukela wegazi ukhuphuka ngaphezu kuka-11.1 mmol / L.
Futhi izinkomba ezisukela ku-7.8 kuya ku-11.1 mmol / L zihlobene ne-latent sikashukela mellitus, izwe lomngcele. Uma, ngemuva kwamahora ama-2, i-glycemia ingaphansi kuka-7.8 mmol / l, khona-ke akukho ukwephulwa kwe-carbohydrate metabolism.
Kwabesifazane abakhulelwe, izindlela zokuhlola kanye nobuchwepheshe bokuhlola umthwalo behluke kancane. Ukuxilongwa kususelwa kushukela wegazi osheshayo (izinkomba ku-mmol / L) esiswini esingenalutho kusuka ku-5.1 kuye ku-6.9, kuyandisa ibe yi-10 ngemuva kwehora futhi kuguquguquke amahora ama-2 ngemuva kokudla ushukela egreyidi kusuka ku-8.5 kuya ku-11 mmol / L.
Ukuhlolwa okugcwele, ukuhlolwa kwezinso nezinso, iphrofayili ye-lipid, ukuhlolwa komchamo we-glucose ne-protein nakho kungabekwa. Ekuhlonzweni okuhlukile kwezinhlobo zesifo sikashukela, ukuhlolwa kokubekezelela ushukela kwenziwa ngokuzimisela kanyekanye kwe-C-peptide.
Kwividiyo ekulesi sihloko, isihloko sokukhishwa kokuhlolwa kwegazi ngoshukela siyaqhubeka.
