Isifo sikashukela i-mellitus yisifo esingadala i-pathologies enzima emzimbeni womuntu. Ngakho-ke, ukutholwa okufika ngesikhathi kohlobo 1 lwesifo sikashukela kubaluleke kakhulu ekwelapheni ngempumelelo kwalesi sifo.
Ukunxephezelwa kwesifo sikashukela kusenesikhathi kusiza ukuvimba ukuthuthukiswa kwezinkinga eziyingozi, njengokulimazeka emithanjeni yemilenze, ukugcwala kwe-lens yeso, ukubhujiswa kwezicubu zezinso nokunye okuningi.
Ukuthuthukiswa kwesifo sikashukela kuboniswa izimpawu zomuntu, 1 njengokuthi ukomela kakhulu, ukuchama ngokweqile, isikhumba esomile, ukukhathala okungamahlalakhona, ukonakala kwe-acuity ebonakalayo, ukuncipha kwesisindo, kanye nokulunywa kwesikhumba. Kodwa-ke, ekuqaleni kwalesi sifo, izimpawu zaso zingase zibe mnene, ngenxa yokuthi isiguli singazithatha zibonise esinye isiguli noma simane sibhale konke ukukhathala.
Ngalesi sizathu, okuwukuphela kwendlela ethembekile yokuthola isiguli esithola ukuthi unesifo sikashukela kungukuxilongwa kwelabhoratri. Okubaluleke kakhulu ukuhlolwa kwegazi okuvumela ukuthi unqume izinga kashukela emzimbeni nezinye izinkomba ezidingekayo.
Izindlela zaselebhu zokuxilonga isifo sikashukela
Kuze kube manje, izindlela eziningi zenziwe ukuthola ushukela elabhorethri. Zingaqhutshwa ngezinhloso ezahlukahlukene, ngokwesibonelo, ukuthola isifo zisencane, ukuthola uhlobo lwesifo sikashukela nokuthola izinkinga ezingaba khona.
Lapho wenza ukuhlolwa kwelabhoratri kwesifo sikashukela i-mellitus, isiguli, njengomthetho, sithatha isampula yegazi nomchamo ukuze sihlaziywe. Ucwaningo lwale manzi omzimba olusiza ekutholeni isifo sikashukela ezigabeni zokuqala kakhulu, lapho ezinye izimpawu zesifo zisekhona.
Izindlela zokuxilongwa kwesifo sikashukela i-mellitus zihlukaniswe ngokuyisisekelo nokwengeziwe. Izindlela eziphambili zokucwaninga zibandakanya:
- Ukuhlolwa ushukela wegazi;
- Ukuxilongwa kwesilinganiso se-glycosylated hemoglobin;
- Ukuhlolwa kokubekezelela kwe-glucose;
- Ukuhlaziywa kobukhona beshukela emchameni;
- Ukuhlolwa komchamo negazi ngokuba khona kwezidumbu ze-ketone nokuxineka kwazo;
- Ukuxilongwa kwamazinga we-fructosamine.
Ezinye izindlela zokuxilonga ezidingekayo ukucacisa ukutholakala kwezifo:
- Funda ngezinga le-insulin egazini;
- Ukuhlaziywa kwama-autoantibodies kumaseli we-beta wama-pancreas akhiqiza i-insulin;
- Ukuxilongwa kwe-proinsulin;
- Ukuhlaziywa kwe-ghrelin, i-adiponectin, i-leptin, i-resistin;
- Ucwaningo nge-IIS-peptide;
- Ukuthayipha kwe-HLA.
Ukuze ubhekane nalezi zivivinyo, udinga ukuthola okudluliselwa ku-endocrinologist. Uzosiza isiguli ekuboneni ukuthi hlobo luni lokuxilonga okudingeka aluhlole, futhi ngemuva kokuthola imiphumela uzokhetha indlela efanelekile yokwelashwa.
Okubaluleke kakhulu ekutholeni umphumela wenhloso isigaba esifanele sokuhlaziywa. Kulokhu, zonke izincomo zokulungiselela ukuxilongwa kwezifo kufanele zibhekwe ngokuqinile. Kubaluleke kakhulu ukuhlola isiguli esinesifo sikashukela i-mellitus, ngoba lezi zindlela zokucwaninga zithinta kakhulu ukwephulwa okuncane kwezimo zokulungiselela.
Ukuhlolwa Koshukela
Ukuxilongwa isifo sikashukela kufanele kuqale ngokuhlolwa kwegazi nge-glucose. Kunezindlela eziningi zokuthumela lolu hlaziyo. Owokuqala futhi ovame kakhulu ukuzila ukudla bese owesibili amahora ngemuva kokudla. Indlela yokuqala ifundile kakhulu, ngakho-ke, lapho wenza ukuxilongwa, ama-endocrinologists ngokuvamile anikeza inkomba yalolu hlobo lokuxilongwa.
Ngaphambi kokudlula kokuhlaziywa, kufanele:
- Ungabuphuzi utshwala amahora angama-24 ngaphambi kokuxilongwa;
- Isikhathi sokugcina sokudla kungakadluli amahora angama-8 ngaphambi kokuhlaziywa;
- Ngaphambi kokuhlaziywa, phuza amanzi kuphela;
- Musa ukuxubha amazinyo akho ngaphambi kokunikelwa kwegazi, ngoba amazinyo angaqukatha ushukela, odonsela ukungenzwa ulwelwesi lwe-mucous lomlomo. Ngesizathu esifanayo, izinsini ezihlafunwayo akufanele zihlafunwe.
Ukuhlaziywa okunjalo kwenziwa kangcono ekuseni ngaphambi kwesidlo sasekuseni. Igazi kuye lithathwa emunweni. Ezimweni ezingavamile, kungafuneka igazi le-venous ukuthola amazinga kashukela.
Imikhuba yoshukela wegazi kumuntu omdala isuka ku-3.2 iye ku-5.5 mmol / L. Inkomba ye-glucose emzimbeni ngenhla kwe-6.1 mmol / l ibonisa ukwephulwa okukhulu kwe-carbohydrate metabolism kanye nokukhula okungenzeka kwesifo sikashukela.
IGlycosylated Hemoglobin Assay
Le ndlela yokuhlolwa kokuxilonga ibaluleke kakhulu ekutholeni isifo sikashukela ezigabeni zokuqala. Ukunemba kokuhlolwa kwe-HbA1C kuphakeme kunolunye uhlobo lokufunda, kufaka phakathi ukuhlola ushukela wegazi.
Ukuxilongwa kwe-hemoglobin ye-glycosylated ikuvumela ukuthi unqume izinga likashukela egazini lesiguli isikhathi eside, kuze kube izinyanga ezi-3. Ngenkathi ukuhlolwa koshukela kunikeza umbono weglue kashukela kuphela ngesikhathi sokufunda.
Ukuhlaziywa kwe-hemoglobin ye-glycosylated akudingi ukulungiswa okukhethekile kusuka esigulini. Ingathathwa nganoma yisiphi isikhathi sosuku, esiswini esigcwele nesingenalutho. Umphumela walokhu kuvivinywa awuthinteki ukusetshenziswa kwemithi ethile (ngaphandle kwamatafula anciphisa ushukela) kanye nokuba khona kwamakhaza noma izifo ezithathelwanayo esigulini.
Ukuhlolwa kwe-HbA1C kunquma ukuthi malini i-hemoglobin egazini lesiguli eboshelwe ushukela. Umphumela walokhu kuhlaziywa uboniswa ngamaphesenti.
Imiphumela yokuhlaziya nokubaluleka kwayo:
- Kufika ku-5.7% kuyinto ejwayelekile. Azikho izimpawu zesifo sikashukela;
- Ukusuka ku-5.7% kuya ku-6.0% isandiso. Lokhu kusikisela ukuthi isiguli sinokuphulwa kwe-carbohydrate metabolism;
- Ukusuka ku-6.1 kuya ku-6.4 yisifo sikashukela. Isiguli kufanele sithathe isinyathelo ngokushesha, kubaluleke kakhulu ukushintsha indlela odla ngayo.
- Ngaphezulu kwe-6.4 - isifo sikashukela. Kuqhubeka ukuhlolwa okwengeziwe ukuthola uhlobo lwesifo sikashukela.
Phakathi kokushiyeka kwalokhu kuvivinywa, kungaphawulwa izindleko zayo eziphakeme kanye nokutholakala kuphela kubahlali emadolobheni amakhulu. Ngaphezu kwalokho, lokhu kuhlaziya akulungele abantu abane-anemia, ngoba kule ndaba imiphumela yabo izoba yephutha.
Ukuhlolwa kokubekezelela kwe-glucose
Lokhu kuhlola kubalulekile ekutholeni isifo sikashukela sohlobo 2. Kuyasiza ukunquma inani lokutholwa kwe-insulin, kanye nokuthola ukuthi izicubu zangaphakathi zesiguli zibucayi kangakanani kule hormone. Ekuhlaziyweni kokubekezelelwa kwe-glucose, kusetshenziswa kuphela igazi lama-venous.
Ukuze imiphumela yokuhlolwa inembe kakhulu, isiguli kufanele senqabe ngokuphelele ukudla amahora ayi-12 ngaphambi kokuqala kokuxilongwa. Ukuhlolwa ngokwako kwenziwa ngokwesikimu esilandelayo:
- Okokuqala, ukuhlolwa kwegazi okusheshayo kuthathwa ezigulini bese kuthi isilinganiso soshukela sokuqala silinganiswe;
- Ngemuva kwalokho isiguli sinikezwa ukudla okungu-75 g. ushukela (ngaphansi kwama-50 gr. no-100 gr.) futhi ngemuva kwemizuzu engama-30 izinga loshukela wegazi liphinde likalwe;
- Ngaphezu kwalokho, le nqubo iphindwa ezinye izikhathi ezintathu - emva kwemizuzu engama-60, 90 ne-120. Sekukonke, ukuhlaziya kuthatha amahora ama-2.
Yonke imiphumela yokuhlola irekhodwe ohlelweni olukuvumela ukuthi udale umbono onembile wokuguliswa kwesiguli. Ngemuva kokuthatha i-glucose, isiguli sanda ushukela wegazi, okuthi ngolimi lwezokwelapha olubizwa ngokuthi isigaba se-hyperglycemic. Ngalesi sigaba, odokotela banquma izici zokufakwa kweglue.
Ekuphenduleni ekwandeni kokufakwa ushukela emzimbeni, ama-pancreas aqala ukukhiqiza i-insulin, esiza amazinga aphansi kashukela. Odokotela babiza le nqubo ngokuthi isigaba se-hypoglycemic. Kubonisa inani nesivinini sokukhiqizwa kwe-insulin, futhi kusiza nokuhlola ukuzwela kwezicubu zangaphakathi kule hormone.
Nge-Type 2 sikashukela mellitus ne-prediabetes ngesikhathi sesigaba se-hypoglycemic, ukwephulwa okukhulu kwe-carbohydrate metabolism kuyabonakala.
Ukuhlolwa okunjalo kuyithuluzi elihle kakhulu lokuthola isifo sikashukela ekuqaleni kwesifo, lapho kucishe kube njenge-asymptomatic.
Ukuhlolwa ushukela womchamo
Ngokwesikhathi sokuqoqwa kwezinto eziphilayo, lokhu kuhlaziywa kuhlukaniswe izigaba ezimbili - ekuseni nansuku zonke. Umphumela onembe kakhulu ukuvumela ukuthi uthole ukuhlaziya umchamo wansuku zonke, okubandakanya ukuqoqwa kwawo wonke umchamo owonakalisiwe kungakapheli amahora angama-24.
Ngaphambi kokuthi uqale ukuqoqa izinto zokuhlaziya, udinga ukulungiselela izitsha ngokufanele. Okokuqala, kufanele uthathe ibhodlela elinamalitha amathathu, uligeze ngokucophelela ngesithambisi sokugeza, bese uhlanza ngamanzi abilayo. Kuyadingeka futhi ukuthi kwenziwe ngesitsha sepulasitiki lapho wonke umchamo oqoqiwe uzothuthelwa elabhorethri.
Umchamo wokuqala ekuseni akufanele uqoqwe, ngoba esifundweni sawo kukhona uhlobo oluhlukile lokuhlaziya - ekuseni. Ngakho-ke, ukuqoqwa koketshezi lwezinto eziphilayo kumele kuqale ngohambo lwesibili lokuya endlini encane. Ngaphambi kwalokhu, udinga ukuzigeza ngokuphelele ngensipho noma ngejeli. Lokhu kuzovikela ukungena kwamagciwane asuka esithweni sangasese somchamo.
Usuku ngaphambi kokuqoqa umchamo ukuze luhlaziywe kufanele:
- Gwema ukuzikhandla emzimbeni;
- Gwema ukucindezela
- Ayikho imikhiqizo engashintsha umbala womchamo, okungukuthi: ama-beet, izithelo zamawolintshi, i-buckwheat.
Ukuhlolwa kwelebhu yomchamo kusiza ekuboneni ubungako beshukela obethulwa umzimba ngosuku. Kumuntu ophile kahle, izinga likashukela kumchamo alikho ngaphezu kwe-0.08 mmol / L. Lelinani likashukela kumchamo kunzima kakhulu ukunquma ukusebenzisa izindlela zokucwaninga zelebhu zanamuhla. Ngakho-ke, kuyemukelwa ngokuvamile ukuthi kubantu abaphilile abukho ushukela kumchamo.
Imiphumela yokufunda kokuqukethwe ushukela womchamo:
- Ngezansi 1.7 mmol / L kuyinto esejwayelekile. Lo mphumela, yize udlula inkomba ejwayelekile yabantu abanempilo, awusiwona uphawu lokugula;
- 1,7 kuye ku-2.8 mmol / L - isandulela sesifo sikashukela. Izinyathelo ezidingekayo kufanele zithathwe ukunciphisa ushukela;
- Ngaphezulu kwe-2.8 - isifo sikashukela.
I-Endocrinologists ibheka ukuba khona kwe-glucose kumchamo njengenye yezimpawu zokuqala zesifo sikashukela. Ngakho-ke, ukuhlaziywa okunjalo kusiza ekutholeni isiguli isikhathi esifanele.
Ukuhlaziywa Kwezinga le-Fructosamine
I-Fructosamine yinto ekhuthaza ukusebenzisana noshukela ngamaprotheni e-plasma egazi. Ngokunquma inani le-fructosamine, izinga eliphakeme likashukela egazini lesiguli esinesifo sikashukela lungatholakala. Ngakho-ke, lolu hlobo lokuxilongwa luvame ukusetshenziselwa ukuthola isifo esinembile.
Ukuthola izinga le-fructosamine, ukuhlolwa kwegazi nge-biochemical kuyasiza. I-biochemistry yegazi ukuhlaziya okuyinkimbinkimbi, ngakho-ke kuyadingeka ukuyithatha esiswini esingenalutho. Ukuhlolwa kwegazi ushukela we-biochemical kwenziwa kuphela ngaphandle kwesizathu.
Ngaphezu kwalokho, phakathi kokudla kokugcina nesampula yegazi kufanele kudlule okungenani amahora ayi-12. Ngakho-ke, kungcono ukubhekana nalolu hlobo lokuxilongwa kwelabhoratri ekuseni ngemuva kokulala.
Utshwala bungathinta kakhulu imiphumela yokuhlolwa, ngakho-ke isiphuzo sokugcina akufanele sibe ngaphansi kosuku ngaphambi kokuhlaziywa. Ngaphezu kwalokho, ukuthola umphumela onqophileko, akunconywa ukubhema ugwayi ngokushesha ngaphambi kokuhlolwa.
Imiphumela Yokuxilonga:
- Kusuka ku-161 kuya ku-285 - okujwayelekile;
- Ngaphezulu kwe-285 - isifo sikashukela.
Kubalulekile ukuqaphela ukuthi i-fructosamine ephezulu kwesinye isikhathi ibonwa ezigulini ezine-hypothyroidism kanye nokwehluleka kwezinso. Ukuphetha, sinikeza ividiyo kule ndatshana nesihloko sokuxilongwa kwesifo sikashukela.
