Inani lokuxilonga lokuhlola ukubekezelela ushukela

Abantu abaningi bayazi ukuthi isifo sikashukela yisifo esingamahlalakhona esihambisana nokukhubazeka kwe-carbohydrate metabolism emzimbeni futhi kungaholela ekukhuleni kwezinkinga ezisongela impilo.

Kepha bambalwa abayazi ukuthi ezimweni eziningi, ukuphazamiseka kwe-carbohydrate metabolism kwenzeka kudala ngaphambi kokuxilongwa.

Futhi lezi ziphazamiso zingabonakala zisencane futhi zivikele ukukhula kwalesi sifo esibi. Enye yezindlela zokuhlonza isimo se-prediabetesic ukuhlolwa kokubekezelela ushukela.

Luyini uvivinyo lokubekezelela ushukela?

Ukuhlolwa kokubekezelela kwe-glucose (GTT, i-glucose loading test) kungenye yezindlela zokuhlaziywa kwegazi, ezingasetshenziswa ukuthola ukubekezelelwa kwe-glucose engasebenzi kahle kwamaseli womuntu.

Kusho ukuthini lokhu? I-glucose ingena emzimbeni womuntu ngokudla, ifakwe emathunjini, bese ifakwa egazini, isuka lapho, isebenzisa ama-receptors akhethekile, idluliselwa kumaseli wezicubu, lapho ngesikhathi sokuphendula okuyinkimbinkimbi kwamakhemikhali iphenduka "amandla kaphethiloli", okudingeka ukusebenza komzimba okujwayelekile.

Ukuhlinzekwa kwe-glucose kumangqamuzana kugcina i-insulin, i-hormone yamanyikwe, okukhishelwa ukuphendula ukwanda kokuhlungwa koshukela egazini. Kepha kwesinye isikhathi le carbohydrate ebalulekile ayikwazi ukungena ngokuphelele emangqamuzaneni, okwenzeka lapho ama-receptors ala maseli ancishiswa ukuzwela, noma uma ukukhiqizwa kwe-insulin kumanyikwe kukhubazeka. Lesi simo sibizwa ngokuthi ukwephula ukubekezelela i-glucose, okuthi esikhathini esizayo kungaholele ekubonakalisweni kwezimpawu zesifo sikashukela.

Izinkomba zokunikela

Udokotela wakho angakuyala ukuhlolwa kokubekezelela ushukela kwezinye izimo ezithile.

Uma ingozi enkulu yokuthola isimo se-prediabetesic esigulini sikhonjwa ngesisekelo sokuhlolwa okuphelele:

• idatha emlandweni wokuphila: ukwanda kwesifo kwalesi sifo; ukuba khona kwe-pathology yezitho zesistimu yenhliziyo, izinso, isibindi, amanyikwe; ukuphazamiseka kwe-metabolic (gout, atherossteosis);
• idatha yokuhlolwa nokubuzwa kwesiguli: ukukhuluphala ngokweqile; izikhalazo zokoma njalo, ukuchama kaningi, ukukhathala okusheshayo;
• idatha yocwaningo lwelabhorethri: ukukhuphuka kwesikhashana kwejubane lokudla ushukela wegazi (hyperglycemia); ukutholwa kwe-glucose kumchamo (glucosuria).

Futhi:

• lapho ubheka ukwaneliseka kwendlela enqunyelwe yokwelapha isifo sikashukela nokulungiswa kwayo ngokwemiphumela yokuhlolwa;
• ngesikhathi sokukhulelwa - ukuthola ukutholakala kwesifo sikashukela okufika ngesikhathi.

Contraindication

I-GTT akufanele yenziwe uma enye yalezi zimo ezilandelayo itholakele esigulini:

• izimo ngemuva kokuhlaselwa yisifo senhliziyo, unhlangothi, ukuhlinzwa, ukuzalwa kwengane;
• izifo ezesabekayo zomuntu kanye nezifo ezithathelanayo;
• ezinye izifo ezingama-gastrointestinal (isifo sikaCrohn, isilonda se-peptic sesisu kanye ne-duodenum);
• isisu esibuhlungu (ukulimala kwezitho zesisu);
• i-pathologies yesistimu ye-endocrine, lapho kukhuphuka khona ushukela egazini (isifo sika-Itsenko-Cushing, i-acromegaly, pheochromocytoma, hyperthyroidism).

Futhi, isivivinyo sokubekezelela ushukela asenzelwa izingane zize zifike eminyakeni eyi-14.

Ukulungiselela ukuhlolwa

Ukuthola imiphumela yangempela yohlolo lokubekezelela ushukela, ngaphambi kokuthatha i-biomaterial for ukuhlaziywa, kubalulekile ukwenza izinyathelo zokulungiselela.

Ezinsukwini ezintathu ngaphambi kokuhlolwa, udinga ukuqhubeka nokudla njengenjwayelo, ngaphandle kokunciphisa ngenhloso amaswidi kumenyu yansuku zonke. Ngaphandle kwalokho, ukugcwala koshukela wegazi kuzokwehla, okuzoholela esiphethweni esingalungile.

Ngaphezu kwalokho, lapho ubhekisa ku-GTT, kufanele utshele udokotela imininingwane yokuthi ubaphuza yiphi. Ngemuva kokuncoma kwengcweti, imishanguzo ekhulisa amazinga kashukela wegazi kufanele ingafakwa izinsuku eziningana (izindlela zokuvimbela inzalo ngomlomo, i-beta-blockers, hydrochlorothiazide, phenytoin, acetazolamide, amalungiselelo we-iron).

Usuku olwandulela isivivinyo sokulayisha ushukela, kwenqatshelwe ukuphuza utshwala, ikofi. Ukubhema kuyenqatshelwe.

I-biomaterial yesivivinyo ithathwa ingemuva kwempilo ephelele yomzimba yomuntu, ekuseni, ngokuqinile esiswini esingenalutho (okungenani amahora angu-8 emva kokudla kokugcina, kodwa futhi futhi akukho ngaphezu kwamahora ayi-16 wokuzila ukudla). Ngaphambi kokufaka isampula, kunconywa ukuthi uhlale futhi uphumule buthule imizuzu eminingana.

Ngabe kwenziwa kanjani ukuhlaziya?

Inqubo yokuhlola ukubekezelela i-glucose ingaba nokuhlukahluka ngokuya ngenhloso yocwaningo, isimo sempilo sesiguli kanye nemishini yelebhu lapho kuzohlaziywa khona.

Igazi leVenous noma le-capillary lingasetshenziselwa ukwenza isivivinyo sokuxineka. I-biomaterial ithathwa ngezigaba eziningana.

Ekuqaleni, igazi linikezwa esiswini esingenalutho, okungcono ngesikhathi kusuka ku-8 kuye ku-9 ekuseni. Okulandelayo, kwenziwa umthwalo we-carbohydrate ophethe nge-glucose solution.

Kubalulekile ukwazi ukuthi umthwalo we-carbohydrate wenziwa kuphela uma, ngokusho kwemiphumela yokuhlolwa kwegazi kokuqala, izinga le-plasma glucose lingadluli ku-6.7 mmol / L.

Lapho ihanjiswa ngomlomo, isiguli sinikezwa ukuthi siphuze isisombululo se-glucose imizuzu emi-5, esilungiswa ngokuqeda i-75 g kashukela ku-200 ml wamanzi afudumele, kwabesifazane abakhulelwe - i-100 g, yengane ikhambi ilungiswa ngesilinganiso esingu-1.75 g we-glucose nge-1 kg yesisindo somzimba kepha hhayi ngaphezu kwe-75 gr. Ukuze wamukelwe kahle, ujusi omncane wemvelo ungafakwa kwisisombululo.

Ngemuva kwalokho, amahora amaningi, isiguli sithathwa kaningi nge-biomaterial. Amasu ahlukahlukene ayenzeka - amasampula egazi angenziwa njalo ngemizuzu engama-30 noma kanye ngehora. Sekukonke, kuze kuthathwe amasampula amane aphindaphindwe. Lapho wenza isivivinyo ngesikhathi sokukhulelwa, ngemuva kokuphuza ikhambi elimnandi, igazi lithathwa kabili njalo ngehora.

Ngenkathi ulinde ukuthathwa kabusha kwe-biomaterial, ngemuva kokuthwala umthwalo we-carbohydrate, kufanele futhi ungadli, uphuze itiye noma ikhofi, intuthu. Ungathatha izingcosana ezimbalwa zamanzi ahlanzekile asekhona.

I-Decoding GTT

Inani lokuxilonga ekuhloleni imiphumela yokuhlolwa yizinga le-glucose kwiplasma yegazi, enqunywe ngemuva kohlolo lokulayisha ushukela, oluhlobene nezinga lokuzila ukudla.

Uhlelo lokuhumusha lwemiphumela luvezwa ethebula:

Imiphumela ye-GTT izosiza ekuboneni hhayi isifo sikashukela kuphela, kepha nasekuxilongeni kwe-pathologies yezinye izitho zomzimba.

Ngakho-ke, ukukhuphuka okubukhali nokuncipha okwalandela okubukhali kwe-glucose ngemuva kokuphuza isisombululo esimnandi kukhombisa ukuqaphela kwe-gland yegilo Futhi ngokukhula kancane kokuhlushwa ushukela ku-plasma, umuntu angakusola ukuba khona kwe-malabsorption yezakhi zamathumbu emathunjini.

Izimbangela Zokuhlanekezela

Izici eziningana zingathonya ukwahluka emiphumeleni ye-GTT.

Izici zesimo somzimba wesiguli ngesikhathi sokudla ngokweqile:

• umphumela ongelona iqiniso ungatholwa ngokuncipha kokuqukethwe kwe-potassium ku-plasma yegazi, ngokuphulwa kwesibindi, ukusebenza kwezindlala ze-endocrine;
• umphumela ongalungile wamanga kungenzeka ngezifo zesisu ezihambisana nokufakwa kweglue glucose.

Futhi:

• ukulungiselela okungafanele kwesiguli ukuze kuhlaziywe (ukuncishiswa ngenhloso kwama-carbohydrate kwimenyu, ukuzikhandla okukhulu ngokomzimba, ukuphuza utshwala, izidakamizwa ezishintsha ukuhlangana kweglucose egazini, ukubhema);
• ukwephulwa kwendlela yokuhlaziya (amasu wokulinganisa amasampula egazi, ukungahambisani nemibandela kanye nesikhathi sokuthuthwa kwezinto eziphilayo zaselabhorathri).

Ukuhlolwa Kweglucose Yokukhulelwa

Ngesikhathi sokukhulelwa, i-GTT ibekelwa umsolwa onesifo sikashukela sokukhulelwa (GDM). I-GDM yindlela yesifo sikashukela ekhula ngesikhathi sokuhlelwa kabusha komzimba ngesikhathi sokukhula kombungu.

Izinga likashukela wegazi elikhuphukile lingaba nomthelela ongemuhle ekuthuthukisweni kombungu, inkambo yokukhulelwa kanye namathuba okulethwa ngempumelelo.

Ngakho-ke, bonke omama besikhathi esizayo, lapho berejista, banikela ngegazi ukunquma izinga le-glucose kulo, futhi isikhathi esingamasonto angama-24-28 bathunyelwa ngudokotela ozobamba ukukhulelwa ukuthi ayohlola ukuhlolwa kwe-glucose yomzimba. Uma kutholakala izici zobungozi (umlando we-mestitus yesifo sikashukela sokukhulelwa, isifo sikashukela emndenini oseduze, ukukhuluphala), lolu cwaningo lwenziwa nangaphambilini, lapho kubhaliswa (ngemuva kwamasonto ayi-16).

Ngaphambi kokuthumela i-biomaterial ekuhlolweni kokulayisha ushukela, owesifazane okhulelwe futhi udinga ukulungiswa ngokucophelela (kulandela ukudla okujwayelekile, ukwenqaba ikofi, utshwala, ukubhema, ukuqeda ukuzikhandla okukhulu ngokomzimba, ukuhoxa kwezidakamizwa ngokubambisana nodokotela oya khona).

Ukuhunyushwa kwemiphumela ye-GTT eyenziwa ngesikhathi sokukhulelwa kwehlukile.

Izinkomba zezinkomba zokugxila kwe-glucose ku-plasma yegazi esiswini esingenalutho nangemva kwesikhathi sokuhlolwa ngemuva kokwethulwa kohlu lwe-glucose etafuleni:

Ukuxilongwa kwe-GDM kungenziwa ngokwandisa amanani okungenani izinkomba ezimbili eziboniswe kuthebula.

Lapho wenza ukuxilongwa okuyiqiniso, i-endocrinologist izonikeza ukwelashwa okulungisa amazinga kashukela egazini futhi kuvimbele ukukhula kwezifo ezinzima zesifo.

Izinto zevidiyo eziphathelene noshukela wegazi ngesikhathi sokukhulelwa:

Uma kutholakala ukuphazamiseka kokukhuthazelela i-glucose ngokwemiphumela yokuhlolwa, udokotela uzonikeza izincomo ngokulungiswa kwendlela yokuphila (umsoco, ukuqedwa kwemikhuba emibi, ukwanda kwezimoto) ukuvimbela ukukhula kwezimpawu zesifo ngokuzayo.

Futhi uma uqala ukulandela izincomo zikadokotela ngesikhathi esifanele, ungabambezela ukuthuthukiswa kwalesi sifo, noma usigweme ngokuphelele futhi uvikele ikusasa elijabulisayo ngaphandle kokuthatha izidakamizwa ezonciphisa ushukela nsuku zonke futhi usebenzise i-glucometer njalo.