Isikhathi sokumitha esejwayelekile siyizinyanga eziyi-9. Ngalesi sikhathi, umama wesikhathi esizayo kufanele athathe inani elikhulu lezivivinyo ezahlukahlukene futhi enze izifundo zehadiwe ezahlukahlukene.
Odokotela banaka kakhulu ukuqapha inkomba efana nokujwayelekile kwe-glycated hemoglobin (HbA1c) ngesikhathi sokukhulelwa kocansi olubuthakathaka.
Impela, ngesinye isikhathi amanani atholakele awahambisani nenqubo eyamukelwe, okuholela isidingo sesifundo esingeziwe noma ngisho nokwelashwa.
Kuyadingeka ukwazi izinga le-glycogemoglobin ukusungula iqiniso lokuba khona kweglucose egazini lesiguli. Le ndlela ikuvumela ukuthi uqale ukwelashwa ngaphambi kokuba kwakheke noma ikuphi ukwelashwa okungathinta kabi impilo yowesifazane uqobo nengane engakazalwa.
Isidingo sokuhlolwa kwe-HbA1c ngesikhathi sokukhulelwa
Kwowesifazane ngesikhathi sokukhulelwa, ungathola i-lactin esegazini ngokusebenzisa enye indlela yocwaningo, okungukuthi isilinganiso seHbA1C.
Kuliqiniso, odokotela abaluleki ukuthi bayise kwabesifazane abakhulelwe, ngoba ngemuva komhlaka-1 umphumela ungaba umphumela omuhle.
Le nto ichazwa iqiniso lokuthi isikhathi sekwephuzile siyakwazi ukuholela ekwandeni okungalingani ngenani likashukela. Kunezikhathi lapho lokhu kungaholela ekwandeni okusheshayo kwesisindo sengane (kuze kufike ku-4-4,5 kg).
I-fetus enjalo ekuqaleni kokubeletha kwesinye isikhathi iba imbangela yokulimala kuyo yomntwana nakulowo obelethayo, noma ukuvela kwezinkinga zombili.
Ngenxa yokwanda kweglucose yegazi kwenzeka:
- ukucekelwa phansi kwemithambo yegazi;
- ukusebenza kahle kwezinso;
- ukungaboni kahle
Ngaphezu kwalokho, ama-pathologies anjalo kungenzeka ngenxa yokwanda kwamahora ayi-1-4 enanini le-lactin egazini ngemuva kokudla. Amacala asele okunyuka kwe-glucose awaholeli emiphumeleni emibi.
Ukuntuleka kokufundisa ngocwaningo lweHbA1C kuchazwa iqiniso lokuthi inani likashukela kowesifazane okhulelwe lenyuka kuphela ezinyangeni ezisanda kwedlula. Ukwanda kuqala ngenyanga yesi-6, kuyilapho inani eliphakeme ku-8-9. Lokhu akwenzi ukuba sikwazi ukuqeda ngesikhathi imiphumela emibi emzimbeni kamama nengane esizayo.
Kodwa-ke, kulesi simo, kunendlela yokuphuma - ukudlula isivivinyo sokubekezelela ushukela, okuhlala imizuzu eyi-120, noma ukukala inkomba ye-glucose ekhaya nge-glucometer.
Ukuhlaziywa kutshengisani?
Ucwaningo nge-glycated hemoglobin lukhombisa ubukhona be-glucose egazini isikhashana esithile sokuphumula. Ukuhlaziywa okunjalo kufanele kwenziwe uma kukhona nokusola okuncane kwesifo sikashukela i-mellitus (DM).Akuwona wonke umuntu owazi ukuthi amaseli egazi (amaseli abomvu egazi) ayakwazi ukuphila futhi afeze isiphetho sawo izinsuku ezingama-120. Ngalesi sikhathi, inani le-hemoglobin liqinile. Bese kuba nokuqhekeka kwamangqamuzana abomvu egazi. I-HbA1C, ifomu layo lamahhala, nayo iyashintsha.
Ngenxa yalokho, ushukela ne-bilirubin (umphumela wokuqhekeka kwe-hemoglobin) balahlekelwa ukuxhumana kwabo. Ngokuvamile, i-glycohemoglobin inefomu lamahhala njengeHbA1a. Ukubaluleka kocwaningo kulele kwifomu lesibili.
Nguye okwazi ukukhombisa inkambo efanelekile yenqubo yokushintshanisa ye-hydrocarbon. Lapho kunamazinga akhuphukile we-glycated hemoglobin, kukhona ukukhuphuka kwenani le-lactin egazini.
Njengomphumela, ucwaningo lukhombisa:
- amathuba we-hypoglycemia;
- isigaba sokuqala sesifo sikashukela;
- imiphumela yokwelashwa kwesifo "esimnandi"
Unganikela kanjani ngegazi: ukulungiselela isifundo
Ucwaningo olwenziwa nge-HbA1C kufanele lwenziwe ngesisu esingenalutho, kanti umthambo wowesifazane uzodingeka ukuze kuthathwe amasampula egazi, lapho udokotela ethatha khona amasampula.
Kumele kuqashelwe ukuthi ngesikhathi sokuhlaziywa, inkomba ye-glucose yamanje ayinandaba nhlobo, ngoba izinga eliphakathi nezinyanga ezi-4 zokugcina lizosebenza njengomphumela.
Ayikho imithetho ekhethekile yokulungiselela inqubo. Ngaphambi kovivinyo, awudingi ukuzikhipha amandla ngendlala ngokunciphisa imikhawulo yokudla kwakho. Kepha ukuzivocavoca umzimba akulungile, futhi awudingi ukusebenzisa amanani amaningi.
Umuntu osebenza elabhorethri ngakho konke ukunemba uzothatha igazi elingene emizuzwini embalwa nje. Ukuhlaziywa kuzodinga cishe i-4-5 ml yegazi. Kuliqiniso, kusukela ngonyaka ka-2004, lolu cwaningo lwenziwe ngendlela ethe xaxa, okungukuthi ngokuthatha isampula emunweni.
Ngemuva kokuba inqubo isiqediwe, isiguli siyakwazi ukuzwa ukuhlaselwa okuncane komala, isiyezi, futhi lapho sigxotshwa, kuye kuthiwe i-hematoma engasho lutho. Lezi zimpawu akufanele zibangele ukwethuka, njengoba empeleni thatha amahora angu-1-1,5.
I-hemoglobin ye-Glycated ngesikhathi sokukhulelwa: kujwayelekile
Uhlobo oluchaziwe lokufunda, odokotela bazama ukungabeki wonke umuntu wesifazane ezikhundleni. Ngaphandle kokwethenjwa komphumela wokugcina uma kwenzeka ukhulelwe, inani lomphumela liyakwazi ukubonisa imininingwane engalungile.
Le nto ihlotshaniswa nezinguquko emzimbeni womama esizayo. Athinta inkomba ye-lactin, okuholela ekukhuleni kwayo ngokushesha.
Kodwa-ke, ngaphandle kokukhuphuka kwezinga likashukela ngesikhathi sokuthwala ingane, kukhona nezinga elithile lokuqukethwe kwalo, okwedlulela kwalo okusongela ukuqala kwemiphumela emibi impela:
| Ukuxinana kwe-glucose | Ukuhlehlisa |
| 4,5-6% | standard kukho konke ukukhulelwa |
| 6 - 6,3% | kukhona ubungozi besifo sikashukela sokukhulelwa |
| ngaphezu kwe-6.3% | kutholakala ukuthi kunesifo sikashukela sokukhulelwa |
Kumele kuqashelwe ukuthi ukukhulelwa akuvimbeli ukwanda kwenani le-lactin. Njengoba kuphawuliwe ngenhla, ngesikhathi sezinyanga ezingama-6-9, umzimba wesifazane ukhonjiswa imithwalo engathi sína, okuholela ekwandeni kashukela okungenamkhawulo.
Ngeshwa, cishe akunakwenzeka ukuthola ukwanda okubukhali kwe-glucose ngesikhathi, ngoba ukuhlaziywa kwe-glycohemoglobin kuzobonisa umphumela ojwayelekile ezinsukwini ezingama-120 ezedlule.
Izinga le-glycosylated hemoglobin kushukela wokukhulelwa kwabesifazane
Ukugula kuchaziwe ngenxa yokunyuka ngokushesha kwamanani eglucose ngesikhathi sokuzala kwengane. Isifo esinjalo singathinta kabi impilo yengane ekhulayo.
Uma lesi sifo sakha ezinyangeni zokuqala, khona-ke ukuphuma kwesisu kungenzeka.
Ingozi enkulu ikhona ekuthini kwakhiwe iziphikiso ezahlukahlukene ezithinta izitho zesistimu yenhliziyo, ubuchopho. Lapho lesi sifo sitholakala ku-2nd trimester, kuba nokwanda okusheshayo kwesisindo se-fetus nokudla kwayo.
Kwesinye isikhathi lokhu kuphambuka kuholela ekwakhekeni kwengane ngemuva kokuzalwa kwe-hyperinsulinemia. Mina. akanawo amandla okuthola ushukela kunina, kungaleso sizathu amazinga akhe ehla emazingeni abucayi. Kumele kwaziwe ukuthi inani elijwayelekile le-HbA1C kwisifo sikashukela sokukhulelwa singama-6.5-7%.
Izimbangela nengozi yokuphambuka kwesikhombisi esisezingeni
Izinga elijwayelekile le-hemoglobin ye-glycosylated liyahluka phakathi kwe-4-6% yevolumu ye-hemoglobin ephelele. Lapho umhlaziyi enikeza umphumela cishe we-6.5%, udokotela wenza ukuxilongwa kwe-prediabetes bese enquma isiguli esiyinkimbinkimbi esigulini.
Uma inani lidlula i-6.6%, umuntu obonwayo utholakala ukuthi unesifo sikashukela. I-HbA1C eyengeziwe ikhombisa inqubo yokukhula isikhathi eside koshukela emzimbeni.
Khulisa i-glycogemoglobin can:
- i-anemia ngenxa yokushoda kwe- iron;
- i-hyperglycemia ene-lactin ekhuphukile yegazi;
- ukumpontshelwa igazi, njengoba le nqubo iphakamisa kakhulu inani loshukela elitholwa ngumzimba.
Ngaphezu kwalokho, inkomba ye-HbA1C ingancipha:
- i-anemia;
- ukopha kakhulu ngenxa yokulimala, ukuhlinzwa, ukukhulelwa;
- ukubhujiswa kwe-pathological kwamangqamuzana egazi, okuholela ekuqhekekeni kweziboshwa ze-glucose ne-hemoglobin;
- izinhlobo ezahlukahlukene ze-hemoglobin.
Ukuqapha amazinga kashukela kubaluleke kakhulu kowesifazane osesimweni, ngoba ukusala kwaso kubeka engcupheni enkulu enganeni engakazalwa.
I-Pathology imvamisa iholela ekwandeni kwesisindo se-fetus, kwesinye isikhathi esiba imbangela:
- ukuzalwa ngaphambi kwesikhathi;
- ukulimala inqubo yokuzalwa kwengane (izinyembezi kumama noma ukulimala ekhanda lengane).
Amavidiyo ahlobene
Mayelana nezimo ze-hemoglobin ye-glycated kwabesifazane abakhulelwe kule vidiyo:
Kuwo wonke umuntu wesifazane, kubaluleke kakhulu ukuqapha impilo yakhe, ngaphambi kokukhulelwa, nangesikhathi sokuzala ingane. Ngaphezu kwalokho, kuyadingeka ukuthi kuqashwe njalo izinguquko ezincane kakhulu empilweni, ikakhulukazi lapho ziba zimbi.
Umuzwa oqhubekayo wokukhathala, ukuchama njalo, umlomo owomile - uphawu ngalunye olunjalo akufanele lushiywe ngaphandle kokunakwa okufanele. Ngemuva kwakho konke, kuvame ukukhombisa ukuqala kwentuthuko noma inkambo yesifo "esimnandi".
Ngalesi sizathu, lapho bavela, kuyadingeka ukuthi ngokushesha babhekane nenkambo yokuhlolwa, ukuthola iseluleko se-endocrinologist. Nguye ongabeka inkambo efanelekile yokwelashwa, ezovikela ubungozi bokukhula kwe-pathology kubo bobabili umama okhulelwe kanye nengane.
