Ukwehlisa ukuhlolwa kweshukela ngomthwalo: izinkambiso nezimbangela zokungabekezelelwa kwe-glucose

Izinga likashukela wegazi lomuntu liyinkomba ebaluleke kakhulu yokusebenza komzimba okuzinzile, futhi ukuphambuka kwenani lakhona kwelejwayelekile kungaholela kwizinguquko ezingenakulungiseka ezonakalisa impilo. Ngeshwa, noma ukushintshashintsha okuncane kumanani asymptomatic, futhi ukutholwa kwawo kungenzeka kuphela ngokusebenzisa izindlela zaselebhu, okungukuthi, ukunikela ngegazi ukuze kuhlaziywe.

Olunye lolo cwaningo luvivinyo lokubekezelela ushukela (olwaziwa njengohlolo lwe-glucose glucose).

Ngenxa yokuntuleka kwezimpawu zokushintsha kokuqala kumanyikwe, odokotela batusa ukuthi abesilisa nabesifazane abasengcupheni yesifo sikashukela baphumelele lolu vivinyo.

Mayelana nokuthi ngubani odinga ukuvivinywa, nokuthi ukwazi ukuthola kanjani imiphumela kuzoxoxwa ngayo kulesi sihloko.

Izinkomba zokuhlaziywa

Ukuhlolwa kokubekezelelwa kwe-glucose ukuvivinya kwezinga lokuqunjelwa kwe-insulin enkulu kakhulu.

Ukusetshenziswa kwayo kubalulekile ekuboneni ukwehluleka okufihliwe enkambisweni ye-carbohydrate metabolism kanye nesifo sikashukela esingelapheki.

Abantu abaphilile bangaphandle (kufaka phakathi izingane) abaneminyaka engaphansi kwengama-45 bayanconywa ukuba bahlolwe isivivinyo se-GTT njalo eminyakeni emithathu, bese kuthi lapho sebekhulile - njalo ngonyaka, kusukela ukutholwa kwalesi sifo esisezingeni lokuqala kuselashwa kakhulu.

Imvamisa, ochwepheshe abanjengochwepheshe we-Therapist, i-endocrinologist ne-gynecologist (okuvame kakhulu ukuthi abe yi-neurologist kanye ne-dermatologist) bathunyelwe ukuthi bayohlola ukuhlolwa kwe-glucose.

Iziguli ezilashelwa ukwelashwa noma ukuhlolwa zithola ukudluliselwa uma ziye zatholakala noma zaphawulwa ngale nkinga elandelayo:

• ukukhuluphala
• osolisayo uhlobo 2 lwesifo sikashukela ukukuqinisekisa;
• ukukhethwa noma ukulungiswa kwenkambo yokwelashwa kwesifo sikashukela sohlobo 2;
• ukuba khona kwesifo sikashukela sokukhulelwa noma izinsolo zalo;
• Thayipha isifo sikashukela sohlobo 1 (sokuzithiba);
• i-metabolic syndrome;
• isifo sikashukela;
• ukubekezelela ushukela okhubazekile;
• ukuphazamiseka ekusebenzeni kwamanyikwe, izindlala ze-adrenal;
• ukuphazamiseka kwesibindi, i-pituitary gland;
• ezinye izifo ze-endocrine.

Abantu abahlushwa yilezi zifo ezingenhla futhi okuhloswe ngazo ukwenza isivivinyo se-GTT kumele balandele imithetho ethile belungiselela ukuze ukutolika kwemiphumela kube kunembe ngangokunokwenzeka.

Imithetho yokulungiselela ifaka:

1. Ngaphambi kokuhlolwa, isiguli kufanele sihlolwe ngokucophelela ukuba khona kwezifo ezingathinta amagugu asebenzayo;
2. ezinsukwini ezintathu ngaphambi kokuhlolwa, isiguli kufanele silandele ukudla okujwayelekile (ngaphandle kokudla) ngokudla okuphoqelekile kwama-carbohydrate okungenani angama-150 g ngosuku, futhi futhi kungashintshi izinga lokuzivocavoca okujwayelekile komzimba
3. ezinsukwini ezintathu ngaphambi kokuhlolwa, ukusetshenziswa kwemithi engashintsha izinkomba zokuhlaziywa (isibonelo: i-adrenaline, ikhafeine, izithiyo zokuvimbela inzalo, ama-diuretics, ama-antidepressants, izidakamizwa ze-psychotropic, i-glucocorticosteroids) kufanele zikhishwe;
4. kungakapheli amahora angama-8 kuya kwangaphambi kocwaningo, ukudla notshwala kumele kungafakwa eceleni, futhi futhi kungabhemi. Kodwa-ke, ukunqaba ukudla amahora angaphezu kwe-16 kubuye kuphikiswe;
5. lapho uthatha isampula, isiguli kufanele sizole. Futhi, akufanele kuvezwe i-hypothermia, ukuzivocavoca noma ukubhema;
6. awukwazi ukuvivinya ngesikhathi sezimo ezicindezelayo noma eziwohlokayo, futhi emva kwazo, ngemuva kokuhlinzwa, ukuzalwa kwengane, ngezifo ezithathelanayo, i-hepatitis kanye ne-cirrhosis, nokuya esikhathini, ngokufakwa kwe-glucose okungaphazamiseki emgodini wokugaya ukudla.

Ngesikhathi sokuhlolwa, abasizi belebhu bathatha igazi esiswini esingenalutho, ngemuva kwalokho i-glucose ifakwe emzimbeni womuntu ohlolwayo ngenye yezindlela ezimbili: ngomlomo noma ngaphakathi.

Imvamisa, abantu abadala banikezwa isixazululo sikashukela namanzi ngesilinganiso sama-75 g / 300 ml okufanele bawaphuze, kuyilapho ikhilogremu ngayinye inesisindo esingaphezu kuka-75 kg, kufakwa i-1 g, kepha kungabi ngaphezu kwe-100 g.

Ezinganeni, isilinganiso sinqunywa - 1,75 g / 1 kg yesisindo, kepha akufanele idlule i-75 g.

Ukwethulwa kwe-glucose ngokusebenzisa umthambo kusetshenziswa kuphela ezimweni lapho isiguli singakwazi ukuphuza isixazululo esimnandi, ngokwesibonelo, sinobuthi obunamandla besifo sowesifazane okhulelwe noma onesifo sokuqaqanjelwa yisisu. Kulokhu, i-glucose iyoncibilika ngesilinganiso se-0,3 g nge-1 kg yesisindo somzimba futhi ifakwe emthanjeni.

Ngemuva kokuphathwa kwe-glucose, okunye ukuhlola ushukela wegazi kwenziwa ngokuya ngesikimu esisodwa:

• zakudalalapho kuthathwa amasampula njalo ngemizuzu engama-30. kungakapheli amahora ama-2;
• yenziwe lulalapho isampula yegazi yenziwa khona ngemuva kwehora namahora amabili.

Ukuthola imiphumela yohlolo lokubekezelela ushukela

Izinga le-glucose egazini elithathwe esiswini esingenalutho linenani elingu- <5.5 mmol / L, ngemuva kwemizuzu engama-30-90 ngemuva kokwethulwa komthwalo weglucose, inkomba kufanele ibe ngu- 11. 11.0 mmol / L, nangemva kokuphumula kwamahora amabili - <7.8 mmol / L .

Ukwephulwa kokubekezelelwa kwe-glucose kuqoshwa ezingeni likashukela olungenalutho lwe-7.8 mmol / L, kepha <11.0 mmol / L.

Ukuxilongwa kwesifo sikashukela kuyiqiniso lapho izinga likashukela wegazi lithathwa esiswini esingenalutho lilingana nenani le-> 6.1 mmol / L no> 11.1 mmol / L ngemuva kokulayisha ushukela.

Isibonakaliso seglucose yegazi esinquma ukwephulwa kokubekezelelwa kwe-glucose noma isifo sikashukela, kuyadingeka ukuhlolwa kwegazi okwengeziwe ukuqinisekisa ukutholwa.

Uma izivivinyo ezimbili noma ngaphezulu zenziwa ngokunqunyelwa kwezinsuku ezingama-30 zikhombisa ukukhuphuka kwezinga le-glucose, khona-ke ukubonwa kuyatholakala kuqinisekisiwe.

Ukuhlolwa kokubekezelela kwe-glucose: iminyaka ejwayelekile

Izinga le-glucose legazi elithathwe esiswini esingenalutho bese kuthi ngemuva kokulayisha ushukela kufakwe ngokuhlukahluka kwamanani amanani, kuye ngeminyaka nesimo somuntu somuntu.

Ngakho-ke, izinga elijwayelekile likashukela wegazi ngenxa yokuhlaziywa kwe-biochemical:

• kusuka ku-2.8 kuya ku-4,4 mmol / l - kumntwana aze afike eminyakeni emibili;
• kusuka ku-3.3 kuya ku-5.0 mmol / l - ezinganeni ezineminyaka emibili kuya kwayisithupha;
• kusuka ku-3.3 kuya ku-5.5 mmol / l - wezingane zesikole;
• kusuka ku-3.9, kepha hhayi ephakeme kuno-5.8 mmol / l - kubantu abadala;
• kusuka ku-3.3 kuya ku-6.6 mmol / l - ngesikhathi sokukhulelwa;
• kuze kufike ku-6.3 mmol / l - kubantu abangaphezu kweminyaka engu-60.

Ukuhlaziywa ngomthwalo weglucose, umkhawulo ojwayelekile unqunywe ezingeni elingezansi kuka-7.8 mmol / L kuzo zonke izigaba zobudala.

Uma lona wesifazane esesikhundleni, khona-ke izinkomba ezilandelayo zokuhlaziywa ngemuva kokulayisha ushukela zizokhuluma ngokuba khona kwesifo sakhe sikashukela:

• ngemuva kwehora eli-1 - lilingana noma likhulu kune-10.5 mmol / l;
• ngemuva kwamahora ama-2 - alingana noma angaphezulu kuka-9.2 mmol / l;
• ngemuva kwamahora ama-3 - alingana noma angaphezulu kuka-8.0 mmol / l.

Izimbangela zokuphambuka emiphumeleni yokuhlola ukubekezelela ushukela

Ukuhlolwa kokubekezelela kwe-glucose kuwukuhlaziywa okuningqili kwamahora lapho imiphumela erekhodiwe yokusabela kwama-pancreas ekuphathweni kwe-glucose ngezikhathi ezihlukile (okubizwa ngokuthi “ushukela curve”) kungabonisa inani elikhulu le-pathologies nezifo zezinhlelo zomzimba ezihlukene. Ngakho-ke, noma ikuphi ukuphambuka phezulu noma phansi kusho ukwephulwa okuthile.

Izinga elikhulayo

Ukwanda kweshukela emiphumeleni yokuhlolwa kwegazi (hyperglycemia) kungakhombisa ukuphazamiseka emzimbeni, njengokuthi:

• ukuba khona kwesifo sikashukela nokukhula kwayo;
• izifo zohlelo lwe-endocrine;
• izifo ze-pancreatic (i-pancreatitis, i-acute noma i-chronic);
• izifo ezahlukahlukene zesibindi;
• isifo sezinso.

Lapho uhumusha isivivinyo ngomthwalo woshukela, inkomba edlula okujwayelekile, okungukuthi i-7.8-11.1 mmol / l, ikhombisa ukwephulwa kokubekezelela i-glucose noma i-prediabetes. Umphumela we-11.1 mmol / L ukhombisa ukuxilongwa kwesifo sikashukela.

Inani elincishisiwe

Uma ushukela wegazi ungaphansi kwamanani ajwayelekile (i-hypoglycemia), izifo ezifana:

• ama-pathologies ahlukahlukene we-pancreas;
• i-hypothyroidism;
• isifo sesibindi;
• ubuthi noma ubuthi bezidakamizwa, kanye nobuthi be-arsenic.

Futhi, inkomba ephansi ikhombisa ubukhona be-iron defence anemia.

Kukuziphi izimo lapho umphumela ongamanga wokuhlolwa kwegazi ushukela onomthwalo?

Ngaphambi kokuhlola ukubekezelelwa kwe-glucose, udokotela kufanele acabangele izinto ezimbalwa ezibalulekile ezingathinta imiphumela yocwaningo.

Izinkomba ezingahlanekezela imiphumela yocwaningo zifaka:

• imikhuhlane kanye nezinye izifo emzimbeni;
• ushintsho olubi ezingeni lezinga lomzimba ngaphambi kokuhlolwa, futhi ukuncipha kwalo kanye nokwanda kwalo kuthinteka ngokulinganayo;
• ukuthatha imishanguzo ethinta amazinga kashukela;
• ukuphuza iziphuzo eziqukethe notshwala, okuthi ngisho nasekuthambeni okuncane kushintsha imiphumela yokuhlolwa;
• ukubhema ugwayi;
• inani lokudla okumnandi okudliwayo, kanye nenani lamanzi adakiwe (izindlela ezijwayelekile zokudla);
• ukucindezelwa okwenzeka njalo (noma yikuphi okuhlangenwe nakho, ukuphazamiseka kwemizwa kanye nezinye izimo zengqondo);
• ukululama kwe-postoperative (kulokhu, lolu hlobo lokuhlaziywa luyaphulwa).

Amavidiyo ahlobene

Mayelana nemigomo yokuhlolwa kokubekezelela kwe-glucose nokuphambuka kwemiphumela yokuhlaziywa kuvidiyo:

Njengoba ubona, ukuhlolwa kokubekezelela ushukela kusiza kakhulu maqondana nezinto ezithonya umphumela wazo, futhi kudinga izimo ezikhethekile zokwenza. Ngakho-ke, isiguli kufanele sixwayise udokotela ohamba naye kusengaphambili ngazo zonke izimpawu, izimo noma izifo ezikhona azitholile.

Ukuphambuka okuncane kusuka ezinkomba ezijwayelekile zokubekezelelwa kwe-glucose kungaholela emiphumeleni eminingi emibi, ngakho-ke ukuhlolwa okujwayelekile kovivinyo lwe-GTT kuyisihluthulelo sokuthola lesi sifo ngesikhathi, kanye nokuvinjwa kwesifo sikashukela. Khumbula: i-hyperglycemia yesikhathi eside ithinta ngqo uhlobo lwezinkinga zokugula ushukela!