Ukulimala kwe-carbohydrate metabolism enganeni kuvame kakhulu ukubonakaliswa kwesiphetho sofuzo esihlotshaniswa nokuphulwa kwesakhiwo se-chromosomes. Uma izihlobo ezisondelene nengane zinesifo sikashukela, khona-ke ingane enjalo isengozini futhi idinga ukuhlolwa ngeglucose yegazi.
Lapho kuvela izimpawu ezingase zihambisane nesifo sikashukela, ucingo oluphuthumayo oluya ku-endocrinologist kuphela kwithuba lokugcina impilo enhle, ngoba izici zesifo sikashukela ezinganeni zingakhula ngokushesha kanye nomkhuba wokuqongelela ama-ketones egazini. I-ketoacidosis ingaba ukubonakaliswa kokuqala kwesifo sikashukela kwengane ngesimo sethambo.
Ukuze kutholakale isifo esifanele, ukuqapha i-glucose kungadingekile, ngakho-ke awudingi nje kuphela ukubona izinkomba ze-glycemia esiswini esingenalutho, kodwa futhi nezinga loshukela wegazi ezinganeni ngemuva kokudla.
Ushukela wegazi ezinganeni
Izinga loshukela wegazi enganeni lincike esimweni sempilo kanye nobudala, ngezifo zohlelo lwe-endocrine, ukungasebenzi komzimba, kanye nokudla okungafanele, kungashintsha.
Ngaphandle kwe-glucose, ukukhula nokukhula komzimba wengane akunakuba yikho, ngoba kubalulekile ekwakhiweni kwe-adenosine triphosphoric acid, umthombo wamandla oyinhloko. I-Glycogen isebenza njengendawo yokugcina ushukela emzimbeni. Ifakwa kumaseli wesibindi nezicubu zomsipha ukuze isetshenziswe phakathi nesikhathi lapho ama-carbohydrate avela ekudleni awemukelwa.
I-Glycogen nayo ingadliwa ngesikhathi sokuzivocavoca, inikeze izicubu amandla omsebenzi ojwayelekile. Zonke lezi zinqubo zenzeka ngaphansi kolawulo lobuchopho kanye nezitho ze-endocrine, ezilawula ukuhamba kwe-insulin kanye nama-hormone aphikisayo.
Indima ye-glucose ayikhawulwanga nje kuphela ekubambeni iqhaza kuma-carbohydrate metabolism. Iyingxenye yamaprotheni, kufaka phakathi okwandulelayo kwe-DNA ne-RNA, kanye ne-glucuronic acid, okudingekile ukwenza ubuthi buqedwe, umuthi, kanye nokususa i-bilirubin eyeqile. Ngakho-ke, kubalulekile ukuthi ukunikezwa kwe-glucose kumangqamuzana kuhlala njalo futhi ngamanani ajwayelekile.
Ngokuncipha kwe-glucose yegazi, etholakele ngenxa yama-receptors ezindongeni zemithambo yegazi, izinga layo liyakhuphuka ngenxa yomsebenzi wama-hormone anjalo:
- I-Adrenocorticotropic i-gland evela ku-pituitary gland. Inika i-adrenal gland secretion yama-catecholamines ne-cortisol.
- Ama-Catecholamines akhuthaza ukuqhekeka kwe-glycogen esibindini, ekhiqizwa yizindlala ze-adrenal. Lokhu kufaka phakathi i-adrenaline ne-norepinephrine.
- I-Cortisol esibindini iqala ukwakheka kwe-glucose kusuka ku-glycerol, ama-amino acid nezinye izinto ezingekho i-carbohydrate.
- IGlucagon yakhiwa kumanyikwe, ukuphuma kwayo egazini kubangela ukuwohloka kwezitolo ze-glycogen esibindini kuya kumamolekyuli eglucose.
Ukudla kubangela ukukhululeka kwamaseli we-beta, okuyisiza sokuhlanganiswa kwe-insulin kumanyikwe. Ngenxa ye-insulin, ama-molecule eglucose anqoba ulwelwesi lwamaseli futhi afakwa ezinqubweni ze-biochemical.
I-insulin futhi ivusa ukwakheka kwe-glycogen kuma-hepatocytes namaseli emisipha, ithuthukisa ukwakheka kwamaprotheni nama-lipids. Emzimbeni ophilile, lezi zinqubo zifaka isandla ekwehliseni izinga le-glycemia ezinkomba zesikhathi sobudala.
Imikhuba yoshukela egazini lengane
Ukuhlolwa kweglucose enganeni kungathathwa emtholampilo noma endaweni yangasese, kepha udinga ukubheka ukuthi uma usebenzisa izindlela ezahlukahlukene zokunquma okujwayelekile, zingahluka, ngakho-ke kufanele ukhethe ilabhorethri eyodwa yokuqapha.
Isimo sengane, isikhathi esidlulile kokondliwa kokugcina, futhi kubalulekile, ngoba izinkomba ze-glycemia ziyaguquka usuku lonke. Ngakho-ke, ngaphambi kokuhlolwa, udinga ukuqeqeshwa.
Ukuhlaziywa kwenziwa ngesisu esingenalutho. Ngemuva kokondliwa kokugcina, okufanele kube amahora angama-10 ngaphambi kokuhlolwa, ingane ingadakwa kuphela ngamanzi ajwayelekile okuphuza. Uma uhlola usana noma usana ngaphambi kwezinyanga eziyisithupha, ngaphambi kokuhlaziywa, ungondla ingane amahora amathathu.
Izingane azinconywa ukuba zixubhe amazinyo, ngoba izimbotshana zezingane ezijwayelekile zimnandi noshukela zingathelwa kuzo. Ezinganeni ezisanda kuzalwa, amazinga kashukela egazi asuka ku-1.7 kuya ku-4,2 mmol / L, ezinganeni - 2,5 - 4.65 mmol / L.
Ezinganeni ezisukela onyakeni owodwa kuya kwengu-14 ubudala, ucwaningo lubhekwa ngaphakathi kwebanga elijwayelekile (mmol / l) nezinkomba ezilandelayo:
- Kusuka onyakeni owodwa kuye eminyakeni eyi-6: 3.3-5.1.
- Kusuka eminyakeni eyisithupha kuya kwengu-12: 3.3-5.6.
- Kusuka eminyakeni engu-12 ubudala nangaphezulu 3.3 -5.5.
Ukuhlolwa kwezingane ezincane lapho kungekho zikhalazo, ezingaba nesifo sikashukela, kwenziwa kanye ngonyaka, futhi uma ingane inesisindo ngefa, khona-ke njalo ezinyangeni ezi-3-4. Izingane ezinjalo zibhaliswe kudokotela wezingane futhi zingabekwa isifundo esijulile se-carbohydrate metabolism.
Uma izinkomba eziphakeme zitholakala ekuhlaziyeni i-glucose, khona-ke udokotela uvame ukutusa ukuthatha futhi, ngoba kungathinteka ekuthambeni kwenqwaba yamamanzi, ukuphazamiseka kokulala, ukugula okubekiwe, kanye nokuphazamiseka kokulala kanye nokudla okunempilo.
Ukuzila kanye namazinga kashukela egazini ngemuva kokudla nakho kungahluka kakhulu.
Khuphula ushukela wegazi ezinganeni
Uma ingane ingafaki zonke izizathu zokuhlaziywa okuyiphutha (ukukhathazeka ngokomzwelo noma ngokomzimba, ukutheleleka), kufanele kwenziwe ukuhlola okwengeziwe kwesifo sikashukela. Ngaphezu kwesifo sikashukela uqobo, ukwanda kweshukela ezinganeni kwenzeka ezigulini zesifo se-pituitary gown, umsebenzi ophazamisekile we-hypothalamus, kanye nokulimana kwezakhi zofuzo zokuzala.
Futhi, i-hyperglycemia enganeni ingenzeka ngezifo ze-yegilo gland, hyperfunction ye-adrenal, imvamisa kakhulu nge-pancreatitis. Akutholakali ngesikhathi, isithuthwane sinokuziveza ngokwanda noshukela. Futhi, ukuthatha ama-hormone e-corticosteroid ukwelapha izifo ezibanga ukukhulisa ushukela wegazi ezinganeni.
Inkinga evame kakhulu yokuphazamiseka kwe-metabolic kubantu abasebasha ukukhuluphala, ikakhulukazi uma amafutha engafakwa ngokulinganayo, kepha esiswini. Kulokhu, izicubu ze-adipose zinempahla ekhethekile yokukhulula izinto egazini ezinciphisa ukuphendula kwamangqamuzana ku-insulin. Futhi yize kungaba khona i-insulin ethe xaxa egazini, kepha umphumela wayo awunakuzibonakalisa.
Uma ushukela wegazi ukhuphuke ngaphezu kwe-6.1 mmol / l futhi ingane inezimpawu ezinjalo ezinesifo sikashukela i-mellitus, uboniswa ukwelashwa ngudokotela wobuchopho. Izimpawu okufanele zidale ukukhathazeka:
- Isifiso njalo sokuphuza.
- Ukuchama kaningi nokuvama, ukulala umbhede.
- Ingane ihlala icela ukudla.
- Kuvela ukuthambekela okwengeziwe kwamaswidi.
- Ayitholi isisindo ngokudla okwandayo.
- Ngemuva kwamahora amabili edlile, ingane iba nobulwelwe, ifuna ukulala.
- Izingane ezincane ziba ngomona noma zibulawe.
Isifo sikashukela i-mellitus kuyaqabukela senzeka ngaphandle kokuvela kwengqondo yofuzo noma ukukhuluphala, kepha inkinga ukuthi ngeke sitholakale ngaso sonke isikhathi, ngakho-ke, uma kukhona izinsolo zesifo sikashukela, ingane kufanele ihlolwe. Ezimweni ezinjalo, kuyahlolwa isivivinyo sokubekezelela ushukela, noma sibizwa nangokuthi "ijika leshukela".
Noma yikuphi ukubonakaliswa kwesifo sikashukela, ngisho nokuhlolwa kwegazi okujwayelekile, futhi uma ingane ngesikhathi sokuzalwa inesisindo esingaphezu kwamakhilogremu ayi-4,5, yayinezihlobo ezinesifo sikashukela, noma kunezifo ezihlasela njalo, izifo zesikhumba, ukungasebenzi kahle kokubuka okungahambi esithombeni esivamile somtholampilo, izinkomba zokuhlola umthwalo.
Ukuhlolwa okunjalo kukhombisa ukuthi likhuphuka kanjani izinga likashukela wegazi ngemuva kokudla, ukuthi likhipha ngokushesha kangakanani i-insulin ngokusetshenziswa kweglucose etholakele, kukhona ingozi eyengeziwe yokuba nesifo sikashukela enganeni.
Ngaphambi kokuhlolwa, awudingi ukulungiswa okukhethekile, ingane kufanele ilandele ukudla okujwayelekile futhi ihlaziye amahora angama-10 ngemuva kokudla kwakusihlwa ekuseni. Ngosuku lovivinyo, ungaphuza amanzi angenalutho. Ingane ihlolelwa ukushesha kwe-glucose nangemva kokuthatha ushukela ngemuva kwemizuzu engama-30, ihora namahora amabili.
Umthamo we-glucose kufanele ubalwe ngokusekelwe kwesisindo somzimba wengane - 1,75 g nge-1 kg. I-glucose powder ihlanjululwe emanzini futhi ingane kufanele uyiphuze. Kubhekwa njengento evamile ezinganeni uma ushukela etholakele etholakala emgodini ongaphansi kwe-7 mmol / l ngemuva kwamahora amabili, kanti uma efinyelela ku-11.1 mmol / l, ingane ibekezelela ukubekeka phansi emzimbeni kuma-carbohydrate, angakhula abe ushukela.
Uma inani eliphakeme liphawulwa, khona-ke lokhu kuvuma ukutholakala kwesifo sikashukela. Izici zesifundo sikashukela ezinganeni yilezi:
- Ukuqala okungazelelwe.
- Inkambo enkulu.
- Ukuthambekela ketoacidosis.
- Ngokuvamile thayipha isifo sikashukela esi-1 ngesidingo sokwelashwa kwe-insulin.
I-latent (ifenisha yamuva) isifo sikashukela i-mellitus ivame ukwenzeka ngesifo sohlobo 2 kanye nokuthambekela kokukhuluphala, kanye ne-hepatitis noma ukulimala kwegciwane.
Izingane ezinjalo zikhonjiswa umkhawulo wama-carbohydrate ekudleni kwawo kanye nokwehla okuphoqelekile kwesisindo somzimba kuye kokujwayelekile.
Ukwehlisa ushukela wegazi enganeni
Ukwehlisa ushukela ngaphansi kokujwayelekile ezinganeni kungenzeka ngesikhathi sokulamba, ikakhulukazi lapho kungenakwenzeka ukuphuza amanzi anele, nezifo zesistimu yokugaya ukudla, lapho, naphezu kokudla, ingane iphula ukugaya kwayo ngama-enzyme e-pancreatic. Lokhu kungaba ne-pancreatitis esigabeni esibuhlungu noma esingamahlalakhona.
Ukugeleza kweglucose evela emathunjini kunciphisa nge-gastroenteritis, colitis, malabsorption syndromes, izifo zamathumbu, kanye nobuthi. Imbangela ye-hypoglycemia ku-mellitus yesifo sikashukela ebuntwaneni yizifo ze-endocrine ezinokuncipha kokusebenza kwesitho kanye nokuncipha kokukhululwa kwama-hormone kusuka kwizindlala ze-adrenal, gland.
Futhi, ukuhlaselwa kwe-hypoglycemia kutholakala ngokukhuluphala. Lokhu kungenxa yokweqiwa kwe-insulin egazini - lapho kudliwa ngama-carbohydrate alula, ukuvuselela okwengeziwe kokuqothuka kwayo kubangelwa futhi ushukela wehla egazini ngaphansi kwamazinga ajwayelekile.
Amacala angavamile we-hypoglycemia avela lapho:
- I-insulinoma isimila esidala ukwehla ngokweqile kwe-insulin.
- Ukulimala kobuchopho noma ukukhubazeka okuthuthukayo.
- Ukunobuthi nge-arsenic, chloroform, izidakamizwa, usawoti wezinsimbi ezisindayo.
- Izifo zegazi: i-leukemia, i-lymphoma, hemoblastosis.
Imvamisa, ekwelashweni kwesifo sikashukela ezinshukela ezinganeni, lapho kukhethwa umthamo we-insulin, ukusebenza komzimba, ukungondleki kahle, izingane zingathola ukuhlaselwa nge-hypoglycemic. Bangakhula benempilo ephelele. Kuvele ukukhathazeka, ukuvusa isisu nokujuluka. Kuzoba wusizo ukufunda i-athikili yethu ekuvinjelweni kwesifo sikashukela ezinganeni.
Uma ingane ikwazi ukukhuluma, imvamisa icela amaswidi noma ukudla. Lapho-ke isiyezi, ikhanda, ukuvevezela kwezandla kuyavela, ukwazi kuyaphazamiseka, nengane iwele, kuvela isifo esikhoxayo. Ezimweni ezinjalo, udinga ukuthatha ngokushesha i-glucose, ushukela noma ujusi omnandi. Ividiyo ekulesi sihloko izoqhubeka nesihloko sokuhlolwa ushukela egazini.
