Isivivinyo sokubekezelela i-glucose yisifundo esikhethekile esikuvumela ukuthi uhlole ukusebenza kwamanyikwe. Umsuka wayo ubila kuze kube yilapho kuthathwa umthamo othile kashukela emzimbeni bese kuthi ngemuva kwamahora ama-2 igazi lidonswe ukuze lihlaziywe. Lokhu kuhlolwa kungabizwa nangokuthi ukuhlolwa kokulayisha ushukela, umthwalo ushukela, i-GTT, kanye ne-GNT.
Kuma-pancreas omuntu, kukhiqizwa i-hormone ekhethekile, i-insulin ekwazi ukubheka amazinga kashukela egazini futhi anciphise. Uma umuntu enesifo sikashukela, khona-ke amaphesenti angama-80 noma ngisho nama-90 awo wonke amaseli we-beta azothinteka.
Ukuhlolwa kokubekezelela kwe-glucose kungomlomo futhi kuyangena ngaphakathi, kanti uhlobo lwesibili luyivelakancane kakhulu.
Ngubani okhonjiswa ukuhlolwa kweglucose?
Ukuhlolwa kokubekezelela kwe-glucose ukumelana noshukela kumele kwenziwe ngamazinga kashukela ajwayelekile nawasemngceleni. Lokhu kubalulekile ekuhlukaniseni i-mellitus yesifo sikashukela kanye nokubona izinga lokuvunyelwa kwe-glucose. Lesi simo singabizwa nangokuthi yi-prediabetes.
Ngaphezu kwalokho, ukuhlolwa kokubekezelela i-glucose kungabekwa kulabo okungenani abake baba ne-hyperglycemia ngesikhathi sezimo ezicindezelayo, ngokwesibonelo, ukushaya kwenhliziyo, unhlangothi, inyumoniya. I-GTT izokwenziwa kuphela ngemuva kokujwayelekile kwesimo somuntu ogulayo.
Ekhuluma ngemikhuba, inkomba enhle esiswini esingenalutho izosukela ku-3.3 kuya ku-5.5 mamilitha ngelitha ngalinye legazi lomuntu, lifakiwe. Uma umphumela wokuhlolwa usuyisibalo esingaphezulu kwamamilimitha ayi-5.6, khona-ke ezimweni ezinjalo sizokhuluma nge-glycemia engasebenzi kahle, futhi ngenxa ye-6.1, kuvela isifo sikashukela.
Yini ukunaka ngokukhethekile?
Kuyaqapheleka ukuthi imiphumela ejwayelekile yokusebenzisa ama-glucometer ngeke iveze. Banganikeza ngemiphumela efanele ngokwesilinganiso, futhi banconywa kuphela ngenkathi kwelashwa isifo sikashukela ukuze kulawulwe amazinga kashukela egazini lesiguli.
Akumele sikhohlwe ukuthi amasampula egazi enziwa kusukela emithanjeni ye-ulnar kanye nangomunwe ngasikhathi sinye, nasesiswini esingenalutho. Ngemuva kokudla, ushukela udonswa ngokuphelele, okuholela ekunciphiseni kwezinga lakhona kufinyelela kumamililitha amabili.
Ukuhlolwa kuyindlela yokuvivinya engathí sina futhi yingakho kunconyelwa kakhulu ukuthi ungayikhiqizi ngaphandle kwesidingo esikhethekile.
Kuhlolwa kubani kuye
I-contraindication eyinhloko yokuhlola ukubekezelela i-glucose ifaka:
- isimo esijwayelekile esinzima;
- izinqubo zokuvuvukala emzimbeni;
- ukwephulwa kokudla kokudla ngemuva kokuhlinzwa esiswini;
- izilonda ze-acid kanye nesifo sikaCrohn;
- isisu abukhali;
- ukwanda kwesifo sohlangothi lwe-hemorrhagic, i-edema yamakhemikhali nokuhlaselwa yisifo senhliziyo;
- ukungasebenzi kahle ekusebenzeni okujwayelekile kwesibindi;
- ukungafuneki okwanele kwe-magnesium ne-potassium;
- ukusetshenziswa kwama-steroid nama-glucocorticosteroids;
- izindlela zokuvimbela inzalo;
- Isifo sikaCushing;
- i-hyperthyroidism;
- ukwamukelwa kwe-beta-blockers;
- i-acomegaly;
- pheochromocytoma;
- ukuthatha i-phenytoin;
- i-thiazide diuretics;
- ukusetshenziswa kwe-acetazolamide.
Ungawulungiselela kanjani umzimba isivivinyo se-glucose esezingeni eliphakeme?
Ukuze imiphumela yokuhlolwa kokumelana ne-glucose ibe ngokulungile, kuyadingeka kusengaphambili, okungukuthi izinsuku ezimbalwa ngaphambi kwayo, ukudla kuphela lokho kudla okubonakaliswa izinga elijwayelekile noma eliphakeme lama-carbohydrate.
Sikhuluma ngokudla okuqukethwe kukho kusuka kumagremu ayi-150 noma ngaphezulu. Uma unamathela ekudleni kwe-carb ephansi ngaphambi kokuhlolwa, khona-ke lokhu kuzoba yiphutha elikhulu, ngoba umphumela uzoba yinkomba ephansi ngokweqile yezinga loshukela wegazi lesiguli.
Ngaphezu kwalokho, cishe ezinsukwini ezi-3 ngaphambi kocwaningo okuhlongozwayo, ukusetshenziswa kwezidakamizwa okunjalo akunconywanga: izibeletho zomlomo, i-thiazide diuretics, kanye ne-glucocorticosteroids. Okungenani amahora angama-15 ngaphambi kwe-GTT, akufanele uphuze uphuzo oludakayo futhi udle ukudla.
Kwenziwa kanjani ukuhlolwa?
Ukuhlolwa kokubekezelela ushukela kushukela kwenziwa ekuseni ngesisu esingenalutho. Futhi, ungabhemi ugwayi ngaphambi kokuhlolwa nangaphambi kokuba uqede.
Okokuqala, igazi lithathwa emithanjeni ye-ulnar esiswini esingenalutho. Ngemuva kwalokho, isiguli kufanele siphuze amagremu angama-75 kashukela, ngaphambili owachithwa kumamililitha angama-300 amanzi ahlanzekile ngaphandle kwegesi. Konke uketshezi kufanele kudliwe ngemizuzu emi-5.
Uma sikhuluma ngocwaningo lobuntwana, khona-ke kuleli cala ushukela ubalwa ngesilinganiso sama-gramu ayi-1.75 ngekhilogremu ngayinye yesisindo sengane, futhi udinga ukwazi ukuthi liyini izinga likashukela wegazi ezinganeni. Uma isisindo saso singaphezu kwamakhilogremu angama-43, khona-ke kudingeka umthamo ojwayelekile kumdala.
Amazinga we-glucose azodinga ukukalwa njalo ngehora ngalinye ukuvikela ukweqa iziqalo zikashukela wegazi. Noma yimuphi umzuzu onjalo, izinga lawo akufanele lidlule amamililitha ayi-10.
Kuyaqapheleka ukuthi ngesikhathi sokuhlolwa kwe-glucose, noma yimuphi umsebenzi womzimba uyakhonjiswa, futhi hhayi ukuqamba amanga noma ukuhlala endaweni eyodwa.
Kungani ungathola imiphumela engafanele yokuhlolwa?
Izici ezilandelayo zingaholela emiphumeleni emibi yamanga:
- ukumunca ushukela egazini;
- Ukuvinjelwa ngokuphelele kokuzithwala ngokwama-carbohydrate ngaphambi kovivinyo;
- ukusebenza ngokweqile komzimba.
Umphumela omuhle ongelona iqiniso ungatholwa uma:
- ukuzila isikhathi eside kwesiguli esifundiwe;
- ngenxa yemodi ye-pastel.
Ngabe ihlolwa kanjani imiphumela yokuhlolwa kweglucose?
Ngokusho kweWorld Health Organisation ngonyaka ka-1999, imiphumela yokuthi kuvivinya ushukela okwenziwe ngesisekelo semibukiso yegazi eliphelele yilokhu:
I-18 mg / dl = 1 i-millilile nge-1 litre yegazi,
I-100 mg / dl = 1 g / l = 5.6 mmol,
dl = decilita = 0,1 l.
Esiswini esingenalutho:
- okujwayelekile kuzobhekwa: ngaphansi kuka-5.6 mmol / l (ngaphansi kuka-100 mg / dl);
- nge-glycemia engasebenzi kahle: iqala kusibonakaliso esingu-5.6 kuya ku-6.0 wamamilimitha (ukusuka ku-100 kuye ngaphansi kwama-110 mg / dL);
- kwesifo sikashukela: okujwayelekile kungaphezu kuka-6.1 mmol / l (ngaphezu kwe-110 mg / dl).
2 amahora ngemuva kokudla ushukela:
- okujwayelekile: ngaphansi kwamamilimitha ayisi-7,8 (ngaphansi kwama-140 mg / dl);
- ukubekezelela okungahambi kahle: kusuka ezingeni le-7.8 kuya ku-10,9 mmol (kusukela ngo-140 kuye ku-199 mg / dl);
- isifo sikashukela: ngaphezu kwamamilimitha ayi-11 (amakhulu kuno-200 noma alingana no-200 mg / dl).
Lapho kusungulwa izinga likashukela egazini elithathwe emthanjeni we-cubital, esiswini esingenalutho, izinkomba zizoba ezifanayo, futhi ngemuva kwamahora ama-2 lesi sibalo sizoba ngu-6.7-9,9 mmol ilitha ngalinye.
Ukuhlolwa kokukhulelwa
Ukuhlolwa kokubekezela kokushukela okuchaziwe kuzodidaniswa ngokungafanele nalokhu okwenziwa kwabesifazane abakhulelwe phakathi nesikhathi kusuka kumaviki angama-24 kuye kwangama-28. Kunqunywe ngudokotela wezifo zamazinyo ukukhomba izici zobungozi zesifo sikashukela esenzeka kwabesifazane abakhulelwe. Ngaphezu kwalokho, ukuxilongwa okunjalo kunganconywa yi-endocrinologist.
Emsebenzini wezokwelapha, kunezindlela ezahlukahlukene zokuhlola: ihora elilodwa, amahora amabili neyodwa eyenzelwe amahora amathathu. Uma sikhuluma ngalezo zinkomba okufanele zibekwe lapho kuthathwa igazi esiswini esingenalutho, khona-ke lokhu kuzoba izinombolo ezingekho ngaphansi kuka-5.0.
Uma owesifazane okulesi simo enesifo sikashukela, khona-ke kulokhu izinkomba zizokhuluma ngaye:
- ngemuva kwehora eli-1 - ngaphezulu noma lilingana namamilimitha ayi-10,5;
- ngemuva kwamahora ama-2 - ngaphezu kwe-9.2 mmol / l;
- ngemuva kwamahora ama-3 - ngaphezulu noma alingana no-8.
Ngesikhathi sokukhulelwa, kubaluleke kakhulu ukuqapha njalo ushukela wegazi, ngoba kulesi sikhundla ingane esesibelethweni ingaphansi komthwalo ophindwe kabili, futhi ikakhulukazi, i-pancreas yakhe. Futhi, wonke umuntu unesithakazelo embuzweni wokuthi isifo sikashukela satholakala njengefa.
