Glycated (glycosylated) hemoglobin ndi gawo limodzi lathunthu la hemoglobin lomwe limazungulira m'magazi lomwe limamangidwa ndi glucose. Chizindikiro ichi chimayeza mu%. Mwazi wamagazi ochulukirapo, kuchuluka kwa hemoglobin kudzadulidwa. Uku ndikuyezetsa magazi kofunikira kwa odwala matenda ashuga kapena amisala. Zimawonetsa molondola kuchuluka kwa shuga m'magazi m'miyezi itatu yapitayo. Amakulolani kuti muzindikire matenda ashuga panthawi ndikuyamba kuthandizidwa. Kapenanso musimikizireni munthu ngati alibe matenda ashuga.
Glycated hemoglobin (HbA1C) - zonse zomwe muyenera kudziwa:
- Momwe mungakonzekerere ndikuyesera magazi awa;
- Mitundu ya hemoglobin ya glycated - tebulo losavuta;
- Glycated hemoglobin mwa amayi apakati
- Zoyenera kuchita ngati zotsatira zake zakwezedwa;
- Kuzindikira matenda am'mbuyomu, mtundu 1 ndi matenda ashuga 2;
- Kuwunika momwe chithandizo cha matenda ashuga chimayendera.
Werengani nkhaniyo!
Tidzafotokozera mwachangu kuti miyezo ya HbA1C ya ana ndi chimodzimodzi kwa akulu. Kusanthula uku kungagwiritsidwe ntchito kuzindikira matenda ashuga mu ana, ndipo koposa zonse, kuwunika momwe mankhwalawa alili. Achinyamata omwe amadwala matenda ashuga nthawi zambiri amasuntha malingaliro awo asanakhale ndi mayeso a nthawi zonse, amalimbitsa shuga wawo wamagazi, ndipo potero amapeza zotsatira zawo zowongolera matenda ashuga. Ndi hemoglobin wa glycated, kuchuluka kotere sikumawagwira. Kuwunika kumeneku kukuwonetsa bwino ngati odwala matenda ashuga "adachimwa" m'miyezi itatu yapitayo kapena adakhala moyo "wolungama". Onaninso nkhani yakuti “Mtundu woyamba wa matenda ashuga wa ana ndi achinyamata.”
Mayina ena chizindikiro ichi:
- glycosylated hemoglobin;
- hemoglobin A1C;
- HbA1C;
- kapena A1C chabe.
Kuyesedwa kwa magazi kwa hemoglobin ya glycated ndi koyenera kwa odwala ndi madokotala. Muli ndi maubwino wopitilira muyeso wama shuga a magazi ndi mayeso opitilira shuga a maola awiri. Izi ndi zabwino:
- kusanthula kwa hemoglobin ya glycated imatha kutengedwa nthawi iliyonse, osati pamimba yopanda kanthu;
- ndizolondola kuposa kuyezetsa magazi chifukwa cha kusala kudya, zimakupatsani mwayi kuti muzindikire shuga;
- imakhala yachangu komanso yosavuta kuposa mayeso a shuga a maola awiri;
- limakupatsani mwayi woyankha funso ngati munthu ali ndi matenda a shuga kapena ayi;
- amathandizira kudziwa momwe wodwala matenda ashuga amawongolera shuga m'magazi atatu apitawa;
- hemoglobin wa glycated samakhudzidwa ndi mfundo zazifupi monga kuzizira kapena zinthu zovuta.
Malangizo abwino: mukapita kukayezetsa magazi - nthawi yomweyo onani kuchuluka kwa hemoglobin HbA1C.
Kusanthula uku kwalimbikitsidwa ndi WHO kuyambira 2009 kuti adziwe matenda amtundu 1 komanso matenda amtundu wa 2, komanso kuwunika momwe mankhwalawo alili.
Zotsatira zakuwunika izi sizimadalira:
- nthawi ya tsiku pomwe amapereka magazi;
- kusala kudya kapena mutatha kudya;
- kumwa mankhwala kusiyapo mapiritsi a shuga;
- zolimbitsa thupi;
- mkhalidwe wodwala;
- chimfine ndi matenda ena.
Chifukwa chiyani kuyezetsa magazi kwa glycated hemoglobin
Choyamba, kuti mupeze matenda ashuga kapena kuwunika kuti munthu akhale ndi matenda ashuga. Kachiwiri, pofuna kuwunika ndi matenda ashuga momwe wodwalayo amatha kutsata matenda ndikusunga shuga pafupi ndi masiku abwinobwino.
Pozindikira matenda ashuga, chizindikirochi chakhala chikugwiritsidwa ntchito (pamalangizo a World Health Organisation) kuyambira 2011, ndipo chakhala chokwanira kwa odwala komanso madokotala.
Mitundu ya glycated hemoglobin
Zotsatira za kusanthula,% | Kodi zikutanthauza chiyani |
|---|---|
< 5,7 | Ndi kagayidwe kazakudya inu muli bwino, chiopsezo cha matenda a shuga ndichochepa |
5,7-6,0 | Palibenso matenda a shuga, koma chiwopsezo chake chikuwonjezeka. Yakwana nthawi yosinthira ku chakudya chochepa cha carb kupewa. M'pofunikanso kufunsa kuti metabolic syndrome ndi insulin kukana ndi chiyani. |
6,1-6,4 | Chiwopsezo cha matenda ashuga ndichokwera kwambiri. Sinthani kukhala ndi moyo wathanzi, makamaka, ndikudya zakudya zamagulu ochepa. Paliponse pomwe titha. |
≥ 6,5 | Kuzindikira koyambirira kumapangidwa ndi matenda a shuga. Ndikofunikira kuchita zowonjezera zina kuti mutsimikizire. Werengani nkhani yofotokoza matenda a matenda a shuga 1 komanso 2. ” |
Kutsika kwa hemoglobin m'magazi, momwemo shuga yakeyo idalipidwa m'miyezi itatu yapitayo.
Makulidwe a HbA1C pa kuchuluka kwa shuga m'magazi atatu kwa miyezi itatu
| HbA1C,% | Glucose, mmol / L | HbA1C,% | Glucose, mmol / L |
|---|---|---|---|
| 4 | 3,8 | 8 | 10,2 |
| 4,5 | 4,6 | 8,5 | 11,0 |
| 5 | 5,4 | 9 | 11,8 |
| 5,5 | 6,5 | 9,5 | 12,6 |
| 6 | 7,0 | 10 | 13,4 |
| 6,5 | 7,8 | 10,5 | 14,2 |
| 7 | 8,6 | 11 | 14,9 |
| 7,5 | 9,4 | 11,5 | 15,7 |
Kuyesedwa kwa magazi kwa hemoglobin ya glycated: zabwino ndi zovuta
Kuyesedwa kwa magazi kwa HbA1C, kuyerekeza ndi kusanthula shuga wosala kudya, kuli ndi maubwino angapo:
- munthu samayenera kukhala ndi mimba yopanda kanthu;
- magazi amasungika mosavuta mu chubu choyeserera mpaka kusanthula posachedwa (preanalytical solid);
- kusala kudya kwa m'magazi glucose amatha kusiyanasiyana chifukwa cha kupsinjika ndi matenda opatsirana, ndipo hemoglobin ya glycated imakhazikika
Kuyesedwa kwa magazi kwa hemoglobin ya glycated kumakupatsani mwayi woti muzindikire matenda ashuga kumayambiriro, pamene kupenda shuga kosala kudya kumawonetsabe kuti zonse zili bwino.
Zovuta zoyesa magazi a hemoglobin glycated:
- mtengo wokwera poyerekeza ndi kuyesa kwa shuga m'magazi am'madzi (koma mwachangu komanso osavuta!);
- mwa anthu ena, kuphatikiza pakati pa HbA1C ndi kuchuluka kwa shuga kumachepa;
- odwala omwe ali ndi magazi m'thupi komanso hemoglobinopathies, zotsatira za kusanthula zimasokonekera;
- M'madera ena a dziko, odwala sangakhale ndi kochita kuyeserera;
- zimaganiziridwa kuti ngati munthu atenga Mlingo wambiri wa mavitamini C ndi / kapena E, ndiye kuti kuchuluka kwa hemoglobin ya glycated kumakhala kotsika kwambiri (sikutsimikiziridwa!);
- Kuchepa kwa mahomoni a chithokomiro kungachititse kuti HbA1C iwonjezeke, koma magazi a magazi samachuluka kwenikweni.
Ngati muchepetsa HbA1C ndi 1%, chiwopsezo cha matenda a shuga chikuchepa bwanji?
| Mtundu woyamba wa shuga | Retinopathy (masomphenya) | 35% ↓ |
| Neuropathy (dongosolo lamanjenje, miyendo) | 30% ↓ | |
| Nephropathy (impso) | 24-44% ↓ | |
| Type 2 shuga | Mavuto onse a mtima-mtima | 35% ↓ |
| Imfa yokhudzana ndi matenda a shuga | 25% ↓ | |
| Myocardial infaration | 18% ↓ | |
| Kufa kwathunthu | 7% ↓ |
Glycated hemoglobin pa nthawi yapakati
Glycated hemoglobin pa nthawi yomwe ali ndi pakati ndi imodzi mwazomwe angathe kuyesa magazi a shuga. Komabe, uku ndikusankha koyipa. Pa nthawi yomwe muli ndi pakati, ndibwino kuti musapereke hemoglobin wa glycated, koma kuyang'ana shuga wamagazi ake m'njira zina. Tiyeni tifotokozere chifukwa chake zili choncho, ndikuyankhula pazina zolondola.
Kodi chiwopsezo chochuluka cha shuga mu amayi apakati ndi chiyani? Choyamba, chakuti mwana wosabadwayo amakula kwambiri, ndipo chifukwa cha izi padzakhala kubadwa kovuta. Kuopsa kwa mayi ndi mwana kumachuluka. Osanenapo zoyipa zazitali za onsewo. Kuchulukitsa kwa magazi panthawi yomwe ali ndi pakati kumawononga mitsempha yamagazi, impso, kupenya kwamaso, ndi zina. Kukhala ndi mwana ndi theka nkhondo. Ndikofunikira kuti akhale ndi thanzi lokwanira kuti amulere ...
Mwazi wamagazi panthawi yokhala ndi pakati umatha kuchuluka ngakhale mwa azimayi omwe sanadandaulepo za thanzi lawo kale. Pali mbali ziwiri zofunika pano:
- Shuga wapamwamba samayambitsa chilichonse. Nthawi zambiri mkazi samayikira chilichonse, ngakhale ali ndi chipatso chachikulu - chimphona cholemera makilogalamu 4-4,5.
- Shuga samatuluka pamimba yopanda kanthu, koma akatha kudya. Atatha kudya, amakweza maola 1-4. Pakadali pano, akuchita ntchito yake yowononga. Kusala shuga nthawi zambiri. Ngati shuga amakwezedwa pamimba yopanda kanthu, ndiye kuti nkhaniyo ndiyabwino kwambiri.
Chifukwa chiyani kuyezetsa magazi kwa glycated hemoglobin sikulinso koyenera? Chifukwa samvera mochedwa. Glycated hemoglobin imangokulira kokha shuga atatha kukwezedwa kwa miyezi iwiri. Ngati mayi akweza shuga, ndiye kuti izi nthawi zambiri sizichitika kale kuposa mwezi wa 6 wamayi. Pankhaniyi, hemoglobin ya glycated idzachulukitsidwa pakangotha miyezi 8-9, isanadutse kale. Ngati mayi woyembekezera samayang'anira shuga wake m'mbuyomu, ndiye kuti padzakhala zotsatirapo zoipa kwa iye ndi mwana wake.
Ngati glycated hemoglobin komanso kuyeza magazi kwa glucose sizoyenera, ndiye kuti mungayang'anire bwanji shuga kwa amayi apakati? Yankho: liyenera kufufuzidwa mukamadya pafupipafupi milungu iwiri iliyonse. Kuti muchite izi, mutha kuyesa mayeso a glucose a maola awiri mu labotale. Koma ichi ndi chochitika chachitali komanso chotopetsa. Ndiosavuta kugula mita yolondola ya glucose panyumba ndi kuyeza shuga 30, 60 ndi mphindi 120 mutatha kudya. Ngati zotsatira zake sizabwino kuposa 6.5 mmol / l - zabwino kwambiri. Muli mitundu 6.5-7.9 mmol / l - yolekerera. Kuyambira 8.0 mmol / l ndikukwera - zoyipa, muyenera kuchita zinthu zochepetsera shuga.
Sungani chakudya chamagulu owonjezera, koma idyani zipatso, kaloti, ndi beets tsiku lililonse kuti muchepetse ketosis. Nthawi yomweyo, kukhala ndi pakati sikungakhale chifukwa chodzilola kuti mudye kwambiri ndi maswiti ndi mankhwala a ufa. Kuti mumve zambiri, onani nkhani za Pregnty Diabetes and Gestational Diabetes.
Zolinga za matenda a shuga a HbA1C
Kuvomerezeka kwa odwala matenda ashuga ndikukwaniritsa ndi kusunga HbA1C ya <7%. Potere, shuga imawerengedwa bwino, ndipo zovuta zomwe zimakhala zovuta ndizochepa. Zachidziwikire, ndibwino kwambiri ngati index ya glycated hemoglobin ili mkati mwenimweni mwa anthu athanzi, i.e., HbA1C <6.5%. Komabe, Dr. Bernstein amakhulupirira kuti ngakhale ndi hemoglobin ya glycated ya 6.5%, shuga silipira bwino, ndipo mavuto ake amakula msanga. Mwa anthu athanzi, owonda omwe ali ndi kagayidwe kazachilengedwe, hemoglobin wa glycated nthawi zambiri ndi 4.2-4.6%. Izi zikufanana ndi kuchuluka kwa shuga m'magazi a 4-4.8 mmol / L. Ndi zomwe tiyenera kuyesetsa kuthandizira matenda ashuga, ndipo izi sizovuta kwenikweni kuti musinthe ngati mutayamba kudya shuga wochepa kwambiri wa mtundu woyamba kapena wa shuga wachiwiri.
Vutoli ndikuti thanzi la wodwala limalipidwa bwino, momwemonso chiwopsezo cha hypoglycemia ndi hypoglycemic chikomokere. Kuyesa kuthana ndi matenda ake a shuga, wodwalayo ayenera kukhalabe wolimba pakati pa kufunika kokhala ndi shuga wamagazi pang'ono komanso kuwopseza kwa hypoglycemia. Ili ndi luso lovuta lomwe wodwala matenda ashuga amaphunzira ndi kuchita pamoyo wake wonse. Koma ngati mutsatira zakudya zopatsa thanzi komanso zopatsa thanzi, ndiye kuti moyo suvuta. Chifukwa mafuta ochulukirapo omwe mumadya, ochepa mungafunikire mapiritsi a insulini kapena ochepetsa shuga. Ndipo kuchepa kwa insulin, kumachepetsa chiopsezo cha hypoglycemia. Zosavuta komanso zothandiza.
Kwa okalamba omwe akuyembekeza kukhala ndi moyo wochepera zaka 5, kuchuluka kwa hemoglobin wa glycated kumawoneka ngati kwabwino 7.5%, 8% kapenanso kukwera. Mu gulu la odwala, chiopsezo cha hypoglycemia ndi chowopsa kuposa mwayi wokhala ndi vuto la shuga. Nthawi yomweyo, ana, achinyamata, amayi apakati, anthu aang'ono kwambiri - ndikulimbikitsidwa kuyesa ndikusunga mtengo wawo wa HbA1C <6.5%, kapena kuposa pamenepo, pansi pa 5%, monga Dr. Bernstein amaphunzitsira.
Algorithm yosankha payekha zolinga za matenda a shuga malinga ndi HbA1C
| Chikhazikitso | M'badwo | ||
|---|---|---|---|
| achichepere | pafupifupi | okalamba ndi / kapena chiyembekezo chamoyo * <zaka 5 | |
| Palibe zovuta kapena chiwopsezo cha hypoglycemia | < 6,5% | < 7,0% | < 7,5% |
| Zovuta zingapo kapena chiwopsezo cha hypoglycemia | < 7,0% | < 7,5% | < 8,0% |
* Chiyembekezo cha moyo - chiyembekezo chamoyo.
Magazi a glucose otsatirawa komanso maola awiri mutatha kudya (postprandial) azigwirizana ndi izi:
| HbA1C,% | Kusala shuga wa plasma / chakudya musanadye, mmol / l | Madzi a m'magazi a plasma maola awiri atatha kudya, mmol / l |
|---|---|---|
| < 6,5 | < 6,5 | < 8,0 |
| < 7,0 | < 7,0 | < 9,0 |
| < 7,5 | < 7,5 | <10,0 |
| < 8,0 | < 8,0 | <11,0 |
Kafukufuku wotalikirapo m'ma 1990 ndi 2000 adatsimikizira motsimikiza kuti kuyezetsa magazi kwa hemoglobin ya glycated kumalola kuneneratu kwamatenda a shuga kukhala koopsa komanso koyenera kuposa kusala plasma glucose.
Kangati kuti muyesedwe magazi a glycosylated hemoglobin:
- Ngati hemoglobin HbA1C yanu ndiyotsika kuposa 5.7%, zikutanthauza kuti mulibe matenda osokoneza bongo ndipo kuwopsa kwake ndikosakwanira, choncho muyenera kungoyang'anira chizindikirochi kamodzi pachaka chilichonse.
- Glycosylated hemoglobin yanu ili pakati pa 5.7% - 6.4% - mutengerenso chaka chilichonse chifukwa pali chiwopsezo cha matenda a shuga. Yakwana nthawi yoti musinthe zakudya zamagulu ochepa kuti muchepetse matenda a shuga.
- Muli ndi matenda ashuga, koma mumawongolera bwino, i.e. HbA1C sichidutsa 7%, - Panthawiyi, madokotala amalangizira kuchita kuyambiranso miyezi isanu ndi umodzi.
- Ngati mwayamba kuchiza matenda anu ashuga kapena kusintha mtundu wanu wa mankhwala, kapena ngati simungathe kuwongolera shuga, ndiye kuti muyenera kudziwa bwino HbA1C miyezi itatu iliyonse.
Timalimbikitsa kuti odwala azikayezetsa magazi a glycosylated hemoglobin ndi magazi ena onse ndi mkodzo - osati m'malo aboma, koma m'malo antchito apadera. Ndizofunikira m'makampani "amtaneti", ndiye kuti, m'mabizinesi akuluakulu apadziko lonse kapena apadziko lonse lapansi. Chifukwa pali mwayi waukulu kuti kusanthula kudzakuchitirani, m'malo mongalemba zotsatira "kuchokera padenga".
