Isifo sikashukela singenye yezifo eziyingozi. Inika isiguli imizwa eminingi engemnandi futhi inomthelela ekwakhiweni kwezinkinga eziningi.
Ngenxa yalesi sizathu, isiguli esinesifo sikashukela sithola ukudluliselwa ezinhlotsheni eziningi zokuhlolwa, imiphumela yaso evumela ukwakheka kwenhloso ngesimo sempilo sesiguli.
Olunye lwezinhlobo zokuhlolwa kwelebhu ukuthi ochwepheshe banamuhla baphendukela kuzo kaningi ukubheka igazi ukuthi lifinyelela yini i-hemoglobin ye-glycated.
IGlycosylated hemoglobin: yini?
Yini i-hemoglobin ejwayelekile, wonke umuntu uyazi. Kodwa umqondo onjengokuthi “glycosylated hemoglobin” udangalisa inani elithile leziguli.
Eqinisweni, konke kulula. IHemoglobin inesici esisodwa sobuntu - ihlangana ngokushesha ne-glucose ejikeleza egazini.
Futhi le nqubo ayinakuguqulwa. Ngenxa yalokhu kusabela, kuvela i-glycosylated hemoglobin noma i-HbA1c. Le nkomba ilinganiswa ngo-%.
Lapho likhuphuka kakhulu i-hemoglobin yegazi, liba ngcono amathuba okuba nezinqubo zesifo sikashukela emzimbeni.
Inani lokuxilonga lokuhlolwa kwegazi kwe-HbA1c
Ukuhlola igazi lakho ukuthola amazinga e-HbA1c kuyindlela ethembekile yokuthola isifo sikashukela.
Ngenxa yalesi sizathu, ochwepheshe bavame ukunquma iziguli ezinezimpawu ezibonisa ukuthi kungenzeka ukuthi sinesifo sikashukela, ukunikela ngegazi kwe-hemoglobin ye-glycated.
Ucwaningo lukuvumela ukuthi uthole umphumela onembe kunayo yonke ohambelana nezinga le-glycosylated hemoglobin ku-plasma ezinyangeni ezi-3 ezedlule. Iqiniso ngukuthi ama-molecule eglucose asebenze namaseli abomvu egazi akha i-solid solid engaphuli ngisho nangemva kokuba ukwakheka kudlule izicubu zomgogodla.
Ngenxa yalesi sici, ungayibona inkinga ngezigaba zokuqala lapho ezinye izivivinyo zingakhombisi ukuba khona kwe-pathology. Njengoba usuthole umphumela wokuhlaziywa, ungaqinisekisa ukutholakala okuyingozi, noma ukwenqabele ukuba khona kwesifo sikashukela, kuqinisekisa isiguli.
Ungakuthatha kanjani ukuhlolwa kwegazi nge-biochemical?
Inzuzo enkulu yokuhlolwa kwegazi ezingeni le-hemoglobin ye-glycated ukungabi bikho kwesidingo sezinqubo zokulungiselela.
Ukuhlaziywa kungathathwa nganoma yisiphi isikhathi sosuku, lapho kufaneleka isiguli. Kunoma ikuphi, umphumela uyoba olunembile.
Ngokucwaninga, umsizi welebhu uzothatha inani elithile legazi le-venous esigulini, njengaphakathi kokuhlaziywa okujwayelekile. Kepha ukuthola isithombe esinembe kakhulu kusuka kwasekuseni, kungcono ukungasigodli. Kuyadingeka nokuhlehlisa isivivinyo uma isiguli simpontshelwa igazi ngosuku olwandulelayo, noma sihlaselwe ukopha kakhulu.
Uma uphasa ukuhlaziya ngemuva kwemicimbi enjalo, kungenzeka ukuthola umphumela ngephutha elibalulekile noma elingabalulekile. Kuyafaneleka futhi ukunaka iqiniso lokuthi ama-laboratories ahlukene angasebenzisa izindlela ezahlukile zokufunda i-biomaterial, ngakho-ke imiphumela ingahluka.
Okukhonjiswa nguhlaziyo: ukuqondisisa imiphumela yocwaningo
Ukutholwa ngokufanele, kusetshenziswa izindlela ezisetshenziswe yi-World Health Organisation.
Inkomba engaphansi kuka-5.7% ikhombisa ukuthi isiguli sijwayelekile nge-carbohydrate metabolism futhi asisongeli ukuthuthukiswa kwesifo sikashukela. Uma umphumela ungamaphesenti angaphezu kuka-6.5%, khona-ke isiguli sithuthukisa isifo sikashukela.
Inani 6-6.5% libonisa i-prediabetes. Futhi, ezigulini ezinesifo sikashukela, udokotela oholayo angasungula isilinganiso esithile se-glycosylated hemoglobin, esizobhekwa njengesijwayelekile kuye uqobo. Ezimweni ezinjalo, indlela ejwayelekile izoba ku-6.5% iye ku-7.5%.
Ngaphezu kwesifo sikashukela, ukwanda kwe-hemoglobin ye-glycated kuze kufike ku-6% nakho kungadala:
- izinhlobo ezahlukahlukene ze-hemoglobinopathies;
- ukuhlinzwa kwesigaqa;
- ukuntuleka kwensimbi emzimbeni.
Izimiso
Izindinganiso zokuthola isimo sesiguli zingase zehluke ezigabeni ezahlukahlukene zezakhamizi. Amaqembu ahlukile ahlukaniswa lapho i-glycated hemoglobin indices ibalwa ngawodwana.
Kwabesilisa nabesifazane abadala
Kwabadala bobulili obuqinile, ochwepheshe basebenzisa lezi zindinganiso ezilandelayo.Ngaphansi kweminyaka yobudala engama-30, umkhawulo wabesilisa ubhekwa njengomkhawulo we-4,5-5,5%.
Kuze kube yiminyaka engama-50, inkomba kumuntu ophilile akufanele idlule ku-6.5%. Lapho efika indoda eneminyaka engama-50 noma ngaphezulu, isibalo sibhekwa njenge-7%. Kwabesifazane asebekhulile, isilinganiso se-hemoglobin ye-glycated ngesikhathi sokuya esikhathini siyokwehla kancane kunokobulili obuqinile.
Ngezinsuku ezisele, izinkambiso zobulili obuhle zizobe zifana nakwabesilisa. Ngakho-ke, ngaphansi kweminyaka engama-30, imibundu ye-4,5-5,5% ibonwa njengejwayelekile kwiziguli ezinempilo.
Kuze kube yiminyaka engama-50, ukugcwala kwe-hemoglobin ye-glycosylated kungafinyelela ku-5.5-6.5% emzimbeni wesifazane onempilo. Ngemuva komkhawulo weminyaka engama-50, u-7% uthathwa njengowamukelekayo.
Ezinganeni
Imvelo ye-hemoglobin ye-glycated ezinganeni isuka ku-4 iye ku-5.8-6%. Ngaphezu kwalokho, lesi sikhombisi asincike ebulilini bengane, indawo yokuhlala nasendaweni yesimo sezulu.
Okuhlukile kuyintsha. Izinga labo le-glycated hemoglobin lingafinyelela ku-6%, okungabhekwa njenge-pathology.
Kodwa-ke, izinkambiso ezinjalo zezinsana zingezesikhashana. Ngemuva kwezinyanga ezi-2, izinga lezinto ezisemzimbeni wazo kufanele lifane nelijwayelekile.
Ngesikhathi sokukhulelwa
Ngesikhathi sokukhulelwa, noma yikuphi ukukhubazeka akusona isiqinisekiso esiqondile sesifo sikashukela. Iqiniso ngukuthi omama abakhulelwe bavame ukuhlupheka ngenxa yokuphelelwa amandla, i-anemia, i-toxicosis enzima, engenawo umthelela omuhle kakhulu ezingeni le-glycosylated hemoglobin egazini.
Njengomthetho, ukuhlolwa okwengeziwe kowesifazane kuyadingeka ukuthola ukuxilongwa kwesifo sikashukela sokukhulelwa.
Ngokuvamile, izinkomba ezithile ezijwayelekile zisetshenziselwa ukuxilongwa kokuqala:
- uma umphumela wokuhlaziywa kukhombisa kuze kufike ku-5.7%, ubungozi bokuthola isifo sikashukela buncane, futhi i-carbohydrate metabolism ijwayelekile;
- esimweni lapho ukuhlaziya kukhombisa u-5.7-6.0%, umama okhulelwe angatholakala nesifo sikashukela. Kungenzeka ukuvimba ukuthuthuka okuqhubekayo kwezinqubo zesifo sikashukela futhi kusebenze i-carbohydrate metabolism ngokubheka ukudla okune-carb ephansi;
- inkomba ye-6.1-6.4% ikhombisa ukuthi ingozi yokuba nesifo sikashukela iphezulu kakhulu, futhi umama okhulelwe usesimweni “somngcele”;
- izinkomba ze-6.5% noma ngaphezulu, isifo sikashukela siyakhula. Ukunquma ukuthi hlobo luni lokugula olwenzeka kowesifazane, kudingeka olunye uhlolo.
Ngoshukela
Izinga le-hemoglobin ye-glycosylated ye-diabetesics inqunywa udokotela ohambayo ngokusekelwe ezimweni zomzimba ngamunye, ubudala besiguli, inani lezinkinga namanye amaphuzu.Njengomthetho, odokotela basebenzisa isibalo se-6.5%.
Kwezinye izimo, le nkomba ingafinyelela umkhawulo ka-8.0-8.5%.
Uma ubheka isimo sezokwelapha sisonke, khona-ke izibalo ezijwayelekile ezigulini ezinesifo sikashukela zizoba zohlobo 1, isibalo se-6.5% noma ngaphezulu. Ngohlobo 2 sikashukela, i-6.5-7.0% ibhekwa njengejwayelekile.
Uma i-glycosylated hemoglobin ingaphezulu kokujwayelekile, kusho ukuthini lokhu?
Uma isiguli kutholakale ukuthi sine-hemoglobin ephakeme ye-glycosylated, lokhu akusho ukuthi unesifo sikashukela.
Ukwanda kwezinkomba kungadala izinkinga kuma-pancreas, ezimweni ezicindezelayo, ukungasebenzi kahle kwinqubo ye-metabolic, kanye nokwephula isizinda sehomoni yomzimba.
Futhi, inkomba ethile yokudla nemithi engadala ushintsho oluhambisanayo ingadala ukugxuma kwinkomba.
Izizathu zokwehla ngezansi okujwayelekile
Kunezizathu eziningi ezingadala ukuncipha koshukela wegazi futhi, ngenxa yalokho, ukwehla kwe-glycosylated hemoglobin.
Izimbangela zifaka i-hypoglycemia ebangelwa ukusebenza ngokweqile nokudla okuhlala isikhathi eside “okulambile”.
Futhi, imbangela yokwehla kwezinga le-hemoglobin ye-glycated kuya ku-4% noma ngaphansi kungaba i-hemolytic anemia, ukopha okungaphakathi kwangaphandle, ukumpontshelwa igazi, ukuthatha izidakamizwa ezinciphisa ushukela nokucindezelwa okuyisisekelo.
Ezimweni ezinjalo, kungenzeka ukuthi siphinde senze ucwaningo ukuthola ukuxilonga okunempilo futhi, uma kunesidingo, thola izindlela zokuqeda inkinga ekhona.
Amavidiyo ahlobene
Mayelana ne-glycosylated hemoglobin ekuvidiyo:
Ukuhlolwa kwegazi kwe-glycosylated (glycated) hemoglobin kuyindlela ethembekile yokuhlola umzimba ukuthambekela kwesifo sikashukela noma inkambo esebenzayo yezinqubo zesifo sikashukela. Ngakho-ke, ungakushayi indiva ukuhlolwa uma uthola ukuthi udluliselwe kudokotela wakho.
Ukuphasa isivivinyo kuzokuvumela ukuthi ukhombe ukuphambuka ezigabeni zokuqala futhi uthathe izinyathelo ezifika ngesikhathi okuhloswe ngazo ukuqinisekisa ukuthi lesi sifo silawulwa ngokuphelele.
