Ukuxilongwa kwesifo sikashukela kungenziwa ngezindlela ezimbili: ukuxilongwa kwelabhoratri kanye nomlando ngokuthatha ngokuhlolwa nodokotela onguchwepheshe.
Ukubuka konke kwesineke
Ngaphambi kokuba isiguli siqale ukuthatha uchungechunge lwezivivinyo zesifo sikashukela, lolu lwazi olulandelayo kufanele lube selufakiwe ekhadini lakhe:
- Izinga lomonakalo kumanyikwe kanye nenani lamaseli stored agcinwe angakhiqiza i-insulin;
- Ngabe kusebenza kangakanani ukwelashwa okukhona (uma kukhona), izinga lokukhula kwe-insulin yemvelo;
- Ngabe kukhona izinkinga zesikhathi eside, izinga lokuxaka kwazo;
- Zisebenza kanjani izinso
- Izinga lobungozi bezinkinga ezingezekile;
- Ingozi yokuhlaselwa yinhliziyo noma imivimbo.
Ungasibona kanjani isifo sikashukela ngezimpawu?
Ngaphezu kwezindlela zaselebhu, isifo sikashukela sohlobo lokuqala nesesibili kunengqondo ngempela ukuqaphela ngezimpawu zangaphandle. Uma zitholakala, isiguli kufanele sinikeze okungenani okungenani ushukela ushukela ukubheka izinga laso. Ngokushesha lapho kutholakala isifo, okusebenzayo kakhulu kuzoba izindlela zokusekela ezempilo. Uhlobo lwesithombe esinezimpawu lungancika ohlotsheni lwesifo sikashukela.
Uhlobo olu-1
Izimpawu zicacisiwe futhi zivame ukubizwa kakhulu. Lokhu kufaka phakathi:
- Isiguli sihlala somile futhi singadla amalitha amanzi ayi-5 ngosuku;
- Iphunga elifana ne-acetone livela emlonyeni;
- Indlala engaguquki, kuyilapho wonke amakhalori edliwa ngokushesha okukhulu nesiguli sehlisa isisindo;
- Phulukisa kahle zonke izilonda zesikhumba;
- Imvamisa ufuna ukusebenzisa indlu yangasese, inani elikhulu lomchamo nsuku zonke;
- Izilonda ezahlukahlukene zesikhumba (kufaka amathumba nezikhunta);
- Isithombe esinezimpawu sikhula kakhulu futhi kungazelelwe.
2 uhlobo
Isimpawu esibonakalayo kulesi simo sinokucasha ngokwengeziwe. Ngakho-ke, ngesifo sikashukela sohlobo 2, akudingeki ulinde ukuthi izimpawu zande futhi masinyane uye kohlolwa. Izimpawu zalolu hlobo lwesifo sikashukela:
- Amehlo ayawa;
- Isiguli siqala ukukhathala ngokushesha okukhulu;
- Umile nami;
- I-enctisal enursis;
- Ukwakheka okunobutha emaphethelweni aphansi (unyawo lwesifo sikashukela);
- Paresthesia;
- Ubuhlungu bethambo ngesikhathi sokunyakaza;
- I-thrush engenakuthinteka ezigulini;
- Izimpawu zifana ne-wave;
- Isibonakaliso esibonakalayo: Izinkinga zenhliziyo zivela ngqo, kufike ekuhlaselweni yinhliziyo noma ekushayweni yisifo sohlangothi.
Ukuxilongwa kwelabhorethri
Ukuhlaziya, okwenziwa ngesikhathi nangezikhathi ezithile, kwenza ukuthi kubhekwe isimo somzimba isikhathi eside futhi uma kwenzeka ukungasebenzi kahle kutholakale ekuqaleni. Ukuhlonza isifo sikashukela ngokuhlolwa kwelebhu, isiguli sidinga ukwedlula lezi zimaki ezilandelayo:
- Uhlobo lofuzo: HLA DR3, DR4 kanye ne-DQ;
- Uhlobo lwe-immunological: ukuba khona kwama-antibodies kusuka ku-decarboxylase yama-antibodies e-glutamic acid, amaseli eziqhingini zaseLangerhans, i-insulin;
- Uhlobo lweMetabolic: i-glycohemoglobin A1, ukulahleka kokukhiqizwa kwe-insulin yesigaba 1 ngemuva kokuhlolwa kokuhlolwa kwe-glucose ngendlela ye-intravenous.
Ake sibheke ezinye izinhlobo eziyisisekelo zokuhlaziya ngemininingwane engaphezulu.
Ushukela wegazi
Ukuhlolwa kwe-glucose kunganikezwa esiswini esingenalutho futhi kulo lonke usuku (amazinga kashukela ahlala egxuma ngemuva kokudla). Esimweni sokuqala, ukuhlaziya kunikezwa ekuseni, lapho isiguli sidla okokugcina okungenani emahoreni angama-8 edlule. Uma kukhona ucwaningo ngegazi le-capillary, inkomba kufanele isuke ku-3.5 iye ku-5.5 mmol / ilitha.
Esimweni lapho kuthathwa khona igazi le-venous, umkhawulo ophansi uyefana, futhi isilinganiso esingu-6.1 mmol / litre.
Ukunikela ngegazi ngemuva kokudla (cishe amahora ambalwa) kunikezwa ukuhlaziya ukuthi ukudla kudonswa kanjani futhi zonke izakhi zomzimba zidilizwa kanjani. Izinga lingahluka esigulini ngasinye.
Lokhu kwenziwa kokubili elabhorethri nasekhaya. Ukuze wenze konke ekhaya, udinga ithuluzi elikhethekile - i-glucometer. Kuthengiswa emakhemisi.
I-insulin ne-proinsulin
I-insulin ikhiqizwa kumaseli we-pancreatic beta. Emzimbeni, kuyadingeka ukuze kuncishiswe ukugcwala koshukela egazini, kusabalalise emangqamuzaneni. Uma lungekho, ushukela usala egazini, igazi liqala ukuqina, amafomu egazi abe maningi. IProinsulin iyisisekelo sokwakha i-insulin.
Kukalwe ukuthola ama-insulinomas. Izinga lale nto landa ngezinhlobo 1 no-2 zesifo sikashukela.
I-peptide
Lokhu kuyingxenye ye-molecule ye-insulin. Inokuphila okuyingxenye ende kune-insulin, ngakho-ke kulula kakhulu ukunquma ukuba khona kwesifo sikashukela. Ukwehla kwenani le-C-peptide kungenxa yokuntuleka kwe-insulin yemvelo. Kwandisa ukugcwala kwe-insulinoma.
IGlycated Hemoglobin
Engxenyeni ye-hemoglobin ye-glycated, i-molecule ye-glucose ihambisana ne-valine kulayini we-chain-cell we-hemoglobin. Kuhlobene ngqo nokuhlushwa ushukela. Lokhu kuyinkomba ejwayelekile yokuqina kwe-carbohydrate metabolism ezinyangeni ezi-2 zokugcina ngaphambi kokuthatha isivivinyo. Ijubane lokukhiqizwa kwalolu hlobo lwe-hemoglobin lincike ngqo kubulukhuni be-hyperglycemia. Izinga lakhona lenziwa ngokujwayelekile kumaviki awu-5 ngemuva kokuqiniswa kwamazinga kashukela wegazi.
Izinga le-hemoglobin ye-glycated inqunywa lapho kuba nesidingo sokulawula izinqubo ze-metabolic, kanye nokuqinisekisa ukuzinza kwemvelo kweleveli yale nto. Ochwepheshe (ezimweni zesifo sikashukela abasolwayo) batusa ukuthatha ukuhlaziywa okungenani isikhathi esingu-1 ezinyangeni ezi-4. Ngenqubo ejwayelekile yamanje yokufakwa kwe-carbohydrate, inkomba ingaphansi kuka-5.7.
Le ngenye yezindlela eziyisisekelo zokuhlola iziguli zanoma yibuphi ubulili nobudala. Igazi le-hemoglobin ye-glycated linikelwa kuphela kusuka kumthambo.
I-Fructosamine
Lokhu kuhlaziya kwenziwa njalo emavikini ama-3 (ngakho-ke, umphumela wamanje uzokhonjiswa ngalesi sikhathi kuphela). Ukuhlaziywa kwenziwa ngemetabolism yoshukela nama-carbohydrate esigabeni sokuhlonza lesi sifo nokubheka ukusebenza kahle kwezindlela zokwelashwa ngesikhathi sokwelashwa. Igazi le-venous elithathwe esiswini esingenalutho liyahlolwa. Imvamisa, izinkomba kufanele zibe ngale ndlela elandelayo:
- Kuze kube yiminyaka eyi-14 - kusuka ku-190 kuye ku-270 μmol / litre;
- Ngemuva - kusuka ku-204 kuye ku-287 μmol / litre.
Ku-diabetesics, leli zinga lingasukela ku-320 liye ku-370 μmol / litre. Ngokwezinga eliphakeme le-fructosamine, iziguli zivame ukutholakala zisehluleka ngokwezinso kanye ne-hypothyroidism, i-nephropathy yesifo sikashukela kanye ne-hypoalbuminemia.
Isibalo segazi esiphelele
Ukuhlaziywa kwezinkomba eziningi zezingxenye ezahlukahlukene zegazi. Izinga labo kanye nokuba khona kwezinto ezithile ezingathandeki kukhombisa isimo somzimba jikelele futhi kubonisa zonke izinqubo ezenzeka kukho.
Esikhathini sikashukela, isifundo esinjalo siqukethe izigaba ezimbili: ukuthatha i-biomaterial esiswini esingenalutho kanye nothango ngokushesha ngemuva kokudla.
Isimo sezinkomba ezinjalo siyahlaziywa:
- I-Hematocrit. Isilinganiso samanzi e-plasma kanye namaseli abomvu egazi kunqunywa. Lapho i-hematocrit iphezulu - isiguli kungenzeka sibe ne-erythrocytosis, i-anemia ne-hyperhydrate kungenzeka. Izinga le-hematocrit liwela abesifazane abakhulelwe abakhulelwe sekwephuzile.
- Amapulatifomu. Uma inani labo lilincane, khona-ke igazi aligqokile kahle, lokhu kungaba wuphawu lokutheleleka kwe-latent noma izinkinga zokuhlangana. Uma kunamapuleti amaningi, ukuvuvukala nezifo ezahlukahlukene kwenzeka (kufaka phakathi isifo sofuba).
- IHemoglobin. Ukunciphisa i-hemoglobin kukhombisa ukwephula ukwakheka kwegazi, ukuba khona kokopha kwangaphakathi noma i-anemia. Izinga lazo likashukela likhuphuka ngokuphelelwa ngamandla.
- Amangqamuzana amhlophe egazi. Izinga elikhulayo - ukuthuthukiswa kokuvuvukala, i-leukemia. Yehlisiwe - kaningi ukugula kwemisebe.
I-Urinalysis ne-ultrasound yezinso
Ukuba khona kwesifo sikashukela kuthinta isimo sezinso, ngakho-ke lezi zifundo zenziwa (umchamo wakheka ezinso). Ngokuhlaziywa okujwayelekile komchamo, kuyahlaziywa:
- Umbala we-biomaterial, ubukhona besediment, inkomba ye-acidity kanye nokubonakala;
- Ukwakheka kwamakhemikhali;
- Amandla adonsela phansi (ukuqapha ukusebenza kwezinso namandla abo okukhiqiza umchamo);
- Izinga le-glucose, amaprotheni ne-acetone.
Kulesi sihlaziyo, izinga le-microalbumin kumchamo nalo liyaqoshwa. Ukuze udlulise ukuhlaziya okujwayelekile, udinga umchamo, owakhululwa maphakathi nosuku, uqoqwe esitsheni esingenantambo. I-biomaterial ilungele ukuhlaziywa kuphela kungakapheli usuku ngemuva kokubanjwa. Kumuntu ophile kahle, imithambo ye-microalbumin kuphela ebonakala kumchamo; esigulini, ukugxila kwaso kuphezulu. Isikhombi esingamukeleki sisuka ku-4 siye ku-300 mg.
Nge-ultrasound, kunakwa ubukhulu bezinso, ushintsho esakhiweni sazo, ukuba khona kokungasebenzi kahle. Imvamisa avela ezigabeni ezi-3-4 zesifo sikashukela.
I-biochemistry yegazi
Igazi nalo lithathwa esiswini esingenalutho. Kukhona ukuhlaziywa kwezinkomba eziningi zezinto ezinjalo:
Ushukela;- Kipase;
- I-Creatine phosphokinase;
- Alkaline phosphatase;
- I-Creatinine;
- Isikwele;
- Bilirubin;
- Urea
- Amylase;
- I-Cholesterol;
- I-AST ne-ALT.
Ushukela;Ukuhlolwa kwe-Ophthalmologic
Njengoba unesifo sikashukela, amehlo egula, ingozi yokuthola izifo ze-retina yeso, ikhathalogu ne-glaucoma iyanda. Lokhu kungenxa yokuwohloka kwemithambo yegazi nokukhula kwe-retinopathy yesifo sikashukela. Izindonga zemithambo ziba ntekenteke kakhulu, ngenxa yokuthi okushintshwa yi-fundus, ama-hemorrhages kanye nokunwebeka kwemikhosi kuvela.
I-Electrocardiogram
Ngenxa yenani elikhulu loshukela, uhlelo lwezinhliziyo luyawohloka. Iziguli ezinesifo sikashukela zivame ukuba nemivimbo kanye nokuhlaselwa yisifo senhliziyo, i-myocardiopathy, ne-coronary artery isifo.
Ukuhlaziywa okunjalo kumele kuthathwe okungenani izinyanga eziyisithupha. Uma isiguli sineminyaka engaphezu kwengama-40 ubudala - njalo ngekota.
Kubalulekile ukukhumbula ukuthi lolu luhlu olujwayelekile lokuhlolwa okuhlolwa isifo sikashukela.
Ochwepheshe, ngokuya ngecala elithile, bangaqokwa kanye nezifundo ezengeziwe. Uma uthola ukuthi unezimpawu zangaphandle zohlobo 1 noma isifo sikashukela esingu-2, musa ukudonsa bese ubhekisa ezindleleni zokuxilongwa kwelabhoratri.
