Ushukela wegazi (ushukela)

Umqondo "wezinga likashukela wegazi" awulungile ngokuphelele, ngoba egazini izinkomba zazo hhayi zonke ushukela (kufaka izinhlobo eziningana zezinto) ezimisiwe, kepha kuphela ushukela. Isitatimende seqiniso kungaba "ushukela wegazi." Kodwa-ke, inketho yokuqala isivele isetshenziswe kabanzi kubantu abavamile kangangokuba yaqala ukusetshenziswa hhayi engxoxweni kuphela, kodwa nasezincwadini zezokwelapha.

I-glucose esegazini - ukukhula kwezinto eziphilayo, okuqinisekisa inkambo efanele yazo zonke izinqubo ezibalulekile kumuntu. Lokhu njalo kuyinkomba ye-carbohydrate metabolism. Ukushintsha izinga layo phezulu noma phansi kuthathwa njengesikhathi sokucabanga ngezinqubo ze-pathological. Okulandelayo yingxoxo yokuthi iyini imvamisa yezinombolo ze-glycemic, izimbangela ezingaba khona nezimpawu zokuphambuka, kanye nemigomo yokusiza abantu abadala nezingane.

Okuningi kushukela

I-glucose ingena emzimbeni womuntu kusuka ngaphandle, kepha futhi ingakhiwa ngezakhiwo zangaphakathi. Ukudla okune-carbohydrate engene emgodini wamathumbu kwehle kuze kube yizindawo ezincane (ama-monosaccharides), kufaka noshukela. Umuthi udonswa odongeni lwamathumbu ungene egazini, okukhuphula ukwanda kokusebenza kwawo (physiological hyperglycemia).

Umzimba womuntu usebenza ngokushelela kangangokuba ezinye izitho zidlulisela isiginali kwabanye ngesidingo 'sokungenela' inqubo ethile. Nge-hyperglycemia, amanyikwe athola isiginali efanayo. Iphonsa ingxenye ye-insulin ye-hormone egazini, umsebenzi wawo okuwukuhambisa ama-molecule kashukela egazini aye ezingxekeni ezihlangene nezicubu.

Amaseli we-Beta - isifunda semfihlo se-insulin yama-pancreas

Kubalulekile! Ngenxa yale nqubo, izinga le-glycemia liyancipha, kuthi izicubu zinikezwe ngezinto ezibonakalayo zamandla.

Ngemuva kokusatshalaliswa kwe-glucose, amanani ayo ekunciphiseni kwegazi, okuvuselela ukuqala kwenqubo ye-gluconeogeneis - ukwakheka kwe-monosaccharide yesibindi kusuka ezintweni ezingewona ama-carbohydrate ngendlela yokubhuka. Ngakho-ke, umzimba uqobo "uphuma ngaphandle" kwezinga le-glycemia, uligcina lisesimweni esamukelekayo.

Ama-hormone awalawula kanjani amazinga kashukela?

Into ebalulekile esebenza ngama-glucose egazini yi-insulin. Ikhiqizwa ngamaseli weziqhingi zeLangerhans-Sobolev zamanyikwe. I-hormone eyinhloko enomphumela ophambene yi-glucagon. Yakhiwa futhi i-gland, kepha amanye amaseli ayo.

Umgomo we-glucagon ubhekwa njengokukhuthaza ukuqhekeka kwe-glycogen esibindini, okuholela ekwakhiweni kwe-monosaccharide "emnandi". Umuthi osebenza ngama-hormone owenziwe i-adrenal gland nawo unomphumela ophambene. Imayelana ne-adrenaline. Kubhekisa kuma-hormone we-contra-hormonal kanye nezinto ezilandelayo:

• norepinephrine;
• glucocorticosteroids;
• ukukhula kwehomoni;
• i-thyroxine.

Yikuphi ukuhlaziya okusetshenziselwa ukukala ukusebenza?

Ushukela wegazi uyahlolwa kukho konke impilo. Lokhu kuyadingeka zombili ngenhloso yokuqinisekisa ukutholakala kwegciwane, futhi njengezinyathelo zokuvimbela. Kwezokwelapha, kusetshenziswa izindlela eziningana eziyisisekelo zelebhu:

• isivinini sokuhlola igazi se-capillary;
• i-venous igazi biochemistry;
• ukuhlolwa komthwalo woshukela (GTT).

Igazi le-capillary lingelinye lama-biomatadium abalulekile ekutholakaleni isimo somzimba jikelele.

Indlela yokuqala yokuxilonga ibhekwa njengengxenye ebalulekile yanoma iliphi iphakheji lokuhlaziya. I-Biomaterial ithathwa ekuseni ngaphambi kokuba ukudla kungene emzimbeni. Kubalulekile ukwenqaba ukudla hhayi kuphela, kodwa nanoma yiziphi iziphuzo, ngaphandle kwamanzi.

Uma umuntu edla imishanguzo, ngokususelwa kwimvume kadokotela oholayo, kufanele alahlwe ngosuku. Uma kungenakwenzeka, udinga ukuthi utshele abasebenzi basebhalabhori ukuthi imiphi imishanguzo eyenziwe.

Ukuhlaziywa kwe-biochemical akuyona indlela emincane yokuhlola imininingwane ye-glycemia. Ushukela wegazi ungatholakala ngasikhathi sinye namazinga ama-transaminases, i-cholesterol, i-bilirubin, ama-electrolyte. Imiphumela yokuxilonga ivumela udokotela ukuthi ahlole isithombe sonke somzimba wendaba. Ukulungiselela le ndlela kuyafana. Kusihlwa, kuvunyelwe isidlo sakusihlwa, ekuseni - ukwenqaba ukudla, kuvunyelwe kuphela amanzi.

Ukuhlolwa kokubekezelela kwe-glucose (ngomthwalo ushukela) akwenzelwa bonke abantu.

Izinkomba zokuqokwa kwakhe yilezi ezilandelayo:

Isimo seglucose egazini ezinganeni

• inani loshukela egazini lisezingeni lomngcele;
• isidingo sokuhlukanisa i-mellitus yesifo sikashukela kanye nokuzwa kwe-insulin;
• ukubhaliswa kwe-hyperglycemia ezimeni ezibandayo ku-anamnesis (ukushaya kwenhliziyo, unhlangothi, inyumoniya);
• isikhathi sokukhulelwa (kusuka emavikini angama-24);
• ukuzalwa kwengane enesisindo esingaphezu kwama-4.5 kg ngesikhathi sokukhulelwa kwangaphambilini (owesifazana udinga ukuhlolwa);
• ukuba khona kwezihlobo nge-endocrinopathy.

Contraindication for GTT yile:

• izinqubo zokuvuvukala ezihambisana nokufakelwa;
• i-pathology yepheshana lesisu;
• isisu sobuhlungu besayensi ngokumelene nesizinda sezimo ezimaxongo;
• i-acomegaly;
• izinqubo zesimila;
• i-pathology ye-gland yegilo.

Isiguli kufanele sinikele ngegazi emthanjeni. Ngemuva kwalokho uphuza isixazululo esimnandi (amanzi ne-glucose powder). Ngezikhathi ezithile, kwenziwa isampula yokuphindaphindwe yalokho okuqukethwe. Udokotela ohambelayo ukhombisa ukuthi yikuphi ukwedlula lokhu kuhlaziya okufanele kwenziwe. Imvamisa, lokhu kwenzeka ngemuva kwesikhashana semizuzu engama-60 no-120.

I-glucose powder ingathengwa ekhemisi

Ngingakwazi ukukala ukusebenza ekhaya?

Okuqukethwe kweglucose egazini akuhlaziywa hhayi kuphela ezimweni zesikhungo sezokwelapha, kodwa nasekhaya. Izilinganiso zenziwa nge-glucometer - idivaysi ephathekayo efakelwe isixhobo sokubhoboza umunwe, imichilo yokuhlola kanye ne-analyzer ekhethekile ekhombisa imiphumela yokuxilonga esibukweni.

Inqubo yokuhlaziya ngokushesha yenziwa ngokulandelayo:

1. Geza izandla kahle, phatha omunye wamagciwane. Lindela ikhambi ukuze lome.
2. Ukuzivocavoca isiza sokuhlwanyelwa esizayo Imvamisa, umunwe ophakathi, oyindandatho, umunwe omncane usetshenziselwa ukubhoboza. Ezinganeni, igazi lingathathwa ezinzwaneni, ezithendeni nasezindlebeni.
3. Usebenzisa i-lancet, efakwe nemitha, yenza ukubhoboza. Amaconsi avelayo asuswa ngokotini owomile.
4. Ithonsi lesibili legazi lisetshenziselwa indawo elashwa ngokukhethekile ngama-reagents on the strip clearance.
5. Ngemuva kwemizuzwana eyi-15 ukuya kwengama-40, isikrini se-glucometer sikhombisa ukuthi ukusatshalaliswa koshukela egazini kuyini. Kuboniswa amayunithi wokulinganisa mmol / l, mg / dl, mg%.

Ushukela wegazi

Amanani we-Glycemia kubantu abadala nasezinganeni ahluke kancane. Ithebula elingezansi liveza izinombolo ezijwayelekile ngeminyaka (mmol / l).

Ezinganeni ezincane, kunokuthambekela kokunciphisa inani, elibhekwa njengesimo sokuphila. Ngeminyaka engu-6-7, izibalo ze-glycemic ezinganeni zifanelana nezabantu abadala. Ekugugeni, okuphambene kuyiqiniso. Ukuthambekela okubonakalayo kokuqukethwe okuphezulu kwe-monosaccharide egazini. Lokhu kungenxa yokuncipha kwamanyikwe, ushintsho emsebenzini wama-hormone aphambanayo.

Imvamisa ngesikhathi sokukhulelwa

Ngesikhathi sokuzala, umzimba wowesifazane uthola ushintsho olukhulu lwekhadinali. Zonke izitho zakhe zangaphakathi zisebenzela ezimbili. Isizinda se-hormonal, esivusa ukuthuthukiswa kokumelana ne-insulin, siyashintsha. Lesi simo singenxa yezinga eliphakeme lamahhala we-placental kanye ne-cortisol ekhiqizwa yizindlala ze-adrenal.

Ukukhulelwa - isikhathi sokubhekisisa okusondele amazinga kashukela wegazi

Uma nje ama-pancreas ekwazi ukugcina izinga le-glycemia ngohlaka olwamukelekayo, izidalwa zowesifazane nengane zivikelwe emathonyeni amabi. Lapho nje izindlela zokunxephezela sezikhathele, kuvela ushukela wokukhula komzimba.

Uhlobo lwesifo lokuthinta lukhula engxenyeni yesibili yokukhulelwa (imvamisa emva kwamasonto angama-22 kuya ku-24). Iqembu lengcuphe lifaka:

• abesifazane abanomlando wesisindo esikhulu somzimba;
• ukuba nokukhuluphala;
• abesifazane abanezihlobo ezine-endocrine pathology;
• umlando wokubelethisa (izingane ezisazalwa, ama-polyhydramnios, ukungahambi kahle kwesisu esikhathini esidlule).

Ngokwesimo sokukhulelwa, izibalo ezifanayo zibhekwa njengasesimweni somuntu omdala onempilo. Izinga elikhulayo le-glycemia lifinyelela ku-6 mmol / l (igazi eliqhamuka emthanjeni) noma lize lifike ku-7.9 mmol / l ngesikhathi se-GTT lingakhombisa ukuthuthukiswa kwe-pathology.

Izinombolo eziphakeme

I-Hyperglycemia ingaba ngokomzimba nangokomzimba. Inketho yokuqala ayidingi umuthi noma okunye ukungenelela. Ikhula ngemuva kokudla kwemikhiqizo yokudla emzimbeni, nokusetshenziswa kwenani lokudla kwe-carbohydrate, ngokumelene nesizinda sokuphazamiseka okukhulu ngokomzimba nangokomzwelo.

I-hyperglycemia yesikhathi esifushane kungenzeka ngale mibandela elandelayo:

• isifo sezinhlungu
• izimo ezishisayo;
• ukuhlaselwa isithuthwane;
• infarction yemisipha yenhliziyo;
• ukuhlaselwa kwe-angina.

Izizathu zokwanda isikhathi eside kwezinombolo ze-glycemic yile:

• isifo sikashukela mellitus;
• izinqubo zesimila;
• ukuvuvukala kwamanyikwe;
• ukulimala okuxakayo;
• i-cystic fibrosis;
• i-pathology ye-gland yegland, izindlala ze-adrenal.

Ukuxilongwa okuhlukile kwezinhlobo zesifo sikashukela, okuyimbangela eyinhloko ye-hyperglycemia

Kunemithi ekwehlisa ukuzwela kwamangqamuzana nezicubu ukungena ku-insulin. Lokhu kufaka phakathi izidakamizwa ze-hormonal, ama-thiazides, ezinye izidakamizwa ze-antihypertensive, ama-COC, ama-catecholamines.

Izimpawu

I-Hyperglycemia ngokomzimba ayinazibonakaliso, ayibonakali. Inqubo ye-pathological ibonakaliswa isithombe esibonakalayo somtholampilo, noma kunjalo, hhayi ezigabeni zokuqala, kodwa kakade esikhathini sokuqhubeka kwesifo. Isibonelo, ngohlobo lwe-1 isifo sikashukela mellitus (esincike ku-insulin), izimpawu zivela lapho amangqamuzana angaphezu kwayi-85% amangqamuzana akha i-insulin efakwa.

Umzimba wesiguli uzama ukususa ushukela nomchamo. Lokhu kuchaza ukubonakala komchamo ngokweqile, okungezinye zezikhalazo eziphambili zesiguli. Njengoba umuntu achama kakhulu, udinga ukubuyisa isilinganiso soketshezi. Kukhona isifiso se-pathological sokuphuza. Isiguli singadla amalitha amanzi angama-5-7 usuku lonke (ngisho nangesikhathi sokubanda).

Wonke ama-monosaccharide asala esegazini, futhi amaseli abona ukuncipha kwamandla. Lokhu kuchaza isifiso somuntu sokudla kakhulu. Kulokhu, isisindo somzimba asitholwa. Ngokufana, ubuthakathaka, ukuphazamiseka kwendawo yezitho zangasese, izinqubo ezivame ukuvuvukala zenzeka. Isikhumba nolwelwesi lwamafinyila kunokoma ngokweqile, kuqhamuka i-pathological, engapholi isikhathi eside.

Izinkinga

Izinkinga ezingenzeka ze-hyperglycemia zihlukaniswe ngamaqembu amakhulu amakhulu:

• bukhali
• ezingamahlalakhona.

Izinkinga ezinkulu zibangelwa ukukhula komqondo, kwesinye isikhathi ngisho nokufa. Amazinga kashukela aphezulu angadala ukuvela kwe-ketoacidosis, i-lactic acidosis, isimo se-hyperosmolar. Imvamisa, izinkinga ezinjalo ziba khona ngemuva kwesifo sikashukela mellitus. Izici ezinikezayo zingaba yi-pathologies yesimo esithathelwanayo, ukushiswa, ukulimala kwemishini, ukwelashwa ngamaqembu athile emithi.

Zonke izimo ze-hyperglycemic ziyehluka komunye nomunye ngokusebenzisa indlela yokuthuthuka. Nge-ketoacidosis esegazini nomchamo, kuvela izidumbu ze-ketone (acetone). Babukeka njengokudalulwa okukhulu kwamaprotheni namafutha. Isibonakaliso esinegalelo, ngaphezu kwe-polyuria kanye ne-pathological, yiphunga elishiwo i-acetone emoyeni okhipha umoya.

Ukuntula ukwazi - isigaba esibulalayo sokuxinaniswa okukhulu

Isimo se-hyperosmolar sine-pathogenesis ehlukile. Ngenxa yokuqina kwegazi ngokumelene nesizinda sezinamba eziphakeme ze-glycemia, ukuphuma komzimba kwenzeka. Ukubonakaliswa okuyinhloko isikhumba esomile nolwelwesi lwe-mucous, akukho ukudakwa.

I-lactic acidosis ihlotshaniswa nokwephulwa kwe-excretion ye-lactic acid emzimbeni. Kukhona ukukhuphuka okukhulu kwesibalo sawo emzimbeni. Izimpawu ukwehluleka kokuphefumula kanye nokusebenza kwenhliziyo nemithambo yegazi.

Izinkinga ezingamahlalakhona ziyizilonda zemithambo:

• i-retina
• izinso
• imilenze ephansi;
• ubuchopho;
• izinhliziyo.

Usizo

Impilo yakhe eqhubekayo incike ijubane losizo lokuqala esigulini. Kuyadingeka ukubuyisela ibhalansi uketshezi emzimbeni, faka inani elidingekayo le-insulin. Kufanele ngokwejwayelekile i-pH yegazi (ikakhulukazi nge-lactic acidosis), izinga lama-electrolyte.

Izinombolo eziphansi

I-Hypoglycemia ibonwa nge-pathology yephepha lesisu, ukulimala kwesibindi esinzima, ngokubhekene nesizinda se-endocrinopathies (hypofunction of the yegland yegilo), nesimila esidala ukuhlasela i-insulin ngokungalawuleki.

Amanani amancane kashukela angabonakala nangasemuva kwesifo sikashukela. Lokhu kungenxa yomuthi okhethwe ngendlela engafanele wezidakamizwa, ukwephulwa kokudla (ukweqa ukudla), ukuphathwa ngenhloso yezisombululo ezinkulu ngesikhathi sokwelashwa kwe-insulin. I-overdose ye-hormone ingenzeka lapho umuthi ungalawulwa kahle (ngokwesibonelo, emsipha esikhundleni se-subcutaneous).

Izimpawu

Izimpawu ze-hypoglycemia zibonakala ngaphambili kwezimpawu zezinga eliphakeme le-monosaccharide. Iziguli zikhononda ngokuqhaqhazela emilenzeni, ukujuluka ngokweqile, isifiso sokudla kakhulu, ukugcwala kwenhliziyo. Kamuva, isiguli siyaphazamiseka, singakwazi ukugxilisa ukunaka kwakhe, siba enganakwa.

I-Cephalgia iyavela, ukuthuthumela kwezindebe, iveli phambi kwamehlo. Isimo sidinga ukungenelela kwabaqeqeshiwe abasheshayo, ngoba le nkinga nayo ingaphenduka i-coma.

Izinkinga

Abantu bathambekele ezimweni ezivame kakhulu ze-hypoglycemic bahlushwa yi-pathology yesistimu yezinzwa ephakathi, inhliziyo nenhliziyo. Ingqondo yomuntu idla ushukela, futhi ngokuntuleka kwayo emzimbeni kuzoba nendlala yamandla. Amaseli ahamba kancane kancane.

Umehluko ku-coma enamanani andayo noshukela anciphile futhi anciphile

Usizo

Izinga le-Glycemia liphakanyiswa ngosizo lwama-carbohydrate asheshayo:

• amaswidi;
• isinkwa esimhlophe ngejamu;
• izingcezu ezicolisisiwe;
• itiye elimnandi elifudumele;
• amabhisikidi;
• ama-apricots omisiwe.

Ezimweni ezinzima, i-algorithm yesenzo imi ngalendlela elandelayo:

1. Beka isiguli ngasohlangothini lwayo, silawule ukuma kolimi lwaso (ukugwema ukulahla).
2. Umlomo wamahhala kusuka kudoti wokudla.
3. Uma umuntu engazi, kwenqatshelwe ukumphoqa ukuthi aphuze itiye elimnandi.
4. IGlucagon ifakwa emsipha.
5. Ngaphambi kokufika kweqembu lama-ambulensi, qapha izibonakaliso ezibalulekile (umfutho wegazi, ukushaya ngamandla, ukuphefumula).

Ungasigcina kanjani ushukela wegazi ngaphansi kwemikhawulo eyamukelekayo?

Ukuze izinkomba ze-glycemia zihlale ziphakathi kwemikhawulo ejwayelekile, ukusebenzisa ukulungiswa kwesimo kuphela akukwanele. Udinga ukucabanga kabusha ngokudla kwakho, indlela ophila ngayo, umsebenzi womzimba. Lokhu okulandelayo amaphuzu asemqoka akuvumela ukuthi uhlale ulawulwa izinkomba ze-glycemia emzimbeni womuntu ophilile futhi ogulayo.

Umsoco

Ukweqa okunye kokudla, ikakhulukazi ekuseni, kungavusa ukuphambuka kwezinombolo ze-saccharide phezulu noma phansi. Kuya ngokuthi umuntu uthatha noma imuphi umuthi. Kubalulekile ukupenda ukudla okudlayo ukuze kube nokudla okuyi-5-6 ngosuku, ukusabalalisa ukudla kwe-carbohydrate kusetshenziswa okuningana, uphuze namanzi amaningi.

Kubalulekile! Kufanele ulahle uphuzo oludakayo, ushukela (nge-hyperglycemia). Okuncamelayo kunikezwa kumikhiqizo ebilisiwe, eyisitshudeni, enensimbi.

Ukudla okungenamsoco kungathinti kuphela ukusebenza kwama-saccharides, kodwa futhi kukhulisa isisindo somzimba, kukhuphula i-cholesterol emzimbeni

Umsebenzi womzimba

Imidlalo kufanele ibe sempilweni yawo wonke umuntu, kepha ngesilinganiso esithile. Indlela yokuphila engasebenzi, kanye nokuzivocavoca ngokweqile, kuthinta kabi impilo. Abantu abagulayo bakhethwa isethi ekhethekile yokuzivocavoca, engafaka i-yoga, ukubhukuda, ukudansa, ukuhamba ngebhayisikile, ukuhamba ngezinyawo.

Imithi

Iziguli ezinesifo sikashukela zinqunywe i-insulin (uhlobo 1) noma izidakamizwa ezinciphisa ushukela (uhlobo 2). Uhlobo nemilinganiselo yokwelashwa kukhethwa ngokuya ngezinkomba zeglucose egazini, ubulili besiguli, iminyaka yakhe, isisindo somzimba kanye nomthethosisekelo.

Izinga le-monosaccharide egazini kufanele ligadwe minyaka yonke ngumuntu onempilo futhi izikhathi eziningana ngesonto isiguli. Lokhu kuyadingeka ukuvimbela ukuthuthukiswa kwezinkinga kanye nokuqhubeka kwe-pathology.