Kudziwa kuchuluka kwa shuga m'magazi ndikofunikira kuti mupeze matenda a carbohydrate metabolism. Zimayamba kuwunika kwa odwala omwe ali ndi zizindikiro za matenda a shuga kapena omwe ali pachiwopsezo chachikulu cha matendawa.
Chifukwa cha kuchuluka kwa matenda ashuga, makamaka mitundu yaposachedwa momwe mulibe chithunzi cha matenda, kusanthula koteroko kumalimbikitsidwa kwa aliyense atakwanitsa zaka 45. Komanso, kuyesedwa kwa magazi kumachitika pakubala, popeza kusintha kwa ma Horona kungayambitse matenda ashuga.
Ngati kupatuka kwa shuga mu seramu yamagazi kuchokera ku chizolowezi kwapezeka, ndiye kuti mayesowo akupitilizabe, ndipo odwala amawasinthira ku zakudya zomwe zili ndi mafuta osavuta a mafuta ndi mafuta.
Ndi chiyani chimapangitsa kuchuluka kwa shuga m'magazi?
Kuchokera kwa chakudya chamagulu omwe amakhala ndi chakudya, munthu amalandira pafupifupi 63% ya mphamvu yofunikira m'moyo. Zakudya zimakhala ndi zovuta komanso zovuta zamafuta. Monosaccharides osavuta ndi glucose, fructose, galactose. Mwa awa, 80% ndi shuga, ndi galactose (kuchokera ku zinthu zamkaka) ndi fructose (kuchokera ku zipatso zotsekemera) amasinthidwanso kukhala glucose.
Zakudya zomanga thupi zovuta, monga wowuma wa polysaccharide, zimaswa mchikakamizo cha amylase mu duodenum mpaka glucose kenako zimayamwa m'magazi m'matumbo ang'onoang'ono. Chifukwa chake, mafuta onse m'zakudya amadzapanga ma glucose ndipo amapezeka m'mitsempha yamagazi.
Ngati shuga saperekedwa mokwanira, ndiye kuti imatha kupangika m'thupi m'chiwindi, impso ndi 1% yake imapangidwa m'matumbo. Kwa gluconeogenesis, pomwe mamolekyu atsopano a shuga amawoneka, thupi limagwiritsa ntchito mafuta ndi mapuloteni.
Kufunika kwa glucose kumakumana ndi maselo onse, chifukwa amafunika mphamvu. Nthawi zosiyanasiyana patsiku, maselo amafunikira kuchuluka kwa shuga. Mphamvu ya minofu yofunikira pakuyenda, ndipo usiku pakugona, kufunika kwa glucose ndizochepa. Popeza kudya sikugwirizana ndi kudya kwa glucose, amasungidwa kosungirako.
Kutha kusunga glucose m'malo osungirako (monga glycogen) ndizofala m'maselo onse, koma ambiri a malo amtundu wa glycogen amakhala:
- Maselo a chiwindi ndi hepatocytes.
- Maselo amafuta ndi adipocytes.
- Ma cell a minofu ndi myocyte.
Maselo amenewa amatha kugwiritsa ntchito glucose m'magazi ndi kuchuluka kwake komanso mothandizidwa ndi ma enzymes amasintha kukhala glycogen, yomwe imaphwanya shuga ndikupezeka m'magazi. Glycogen amasunga m'chiwindi ndi minofu.
Pamene glucose amalowa m'maselo amafuta, amasinthidwa kukhala glycerin, yomwe ndi gawo lamasitolo amafuta a triglycerides. Ma molekyulu angagwiritsidwe ntchito ngati gwero lamphamvu pokhapokha glycogen onse m'matangadza atagwiritsidwa ntchito. Ndiye kuti, glycogen ndi malo osungirako kwakanthawi kochepa, ndipo mafuta ndi malo osungirako nthawi yayitali.
Kodi shuga wamagazi amasungidwa bwanji?
Maselo aubongo amafunikira kuti glucose agwire ntchito, koma sangathe kuwayika kapena kuwumba, kotero ntchito zaubongo zimatengera kudya kwa glucose pazakudya. Kuti ubongo ukhale wokhoza kuyendetsa zochitika za m'magazi, wocheperako ayenera kukhala 3 mmol / L.
Ngati pali shuga wambiri m'magazi, ndiye kuti, ngati gawo losakanikirana bwino, limatulutsa timadzi tokha kuchokera m'matipi. Kuti achepetse shuga, impso zimakufa ndi mkodzo. Kuzungulira kwa glucose m'magazi komwe kumatha kuthana ndi gawo la impso kumayambira 10 mpaka 11 mmol / L. Thupi, komanso shuga, limataya mphamvu zomwe zimalandira kuchokera ku chakudya.
Kudya ndi kugwiritsa ntchito mphamvu pa kayendedwe kumayambitsa kusintha kwa glucose, koma popeza kagayidwe kazachilengedwe kamalamulo kamayendetsedwa ndi mahomoni, kusinthaku kumakhala kosiyanasiyana kuyambira 3.5 mpaka 8 mmol / L. Mukatha kudya, shuga amatuluka, monga chakudya (m'magazi a shuga) kulowa m'matumbo kuchokera m'magazi. Imadyedwa pang'ono ndikusungidwa m'maselo a chiwindi ndi minofu.
Zambiri pazabwino zam'magazi m'magazi zimatulutsidwa ndi mahomoni - insulin ndi glucagon. Insulin imayambitsa kutsika kwa glycemia ndi izi:
- Zimathandizira kuti maselo agwire glucose m'magazi (kupatula ma hepatocytes ndi maselo amanjenje amanjenje).
- Imayendetsa glycolysis mkati mwa khungu (pogwiritsa ntchito mamolekyu a glucose).
- Imalimbikitsa mapangidwe a glycogen.
- Imalepheretsa kaphatikizidwe wa glucose watsopano (gluconeogeneis).
Kupanga kwa insulin kumawonjezera kuchuluka kwa glucose, zochita zake zimatheka pokhapokha zikalumikizidwa ndi ma receptors pa membrane wa cell. Natural metabolism metabolism imatheka pokhapokha ndi kaphatikizidwe ka insulin mokwanira komanso zochitika za insulin receptors. Izi zimaphwanyidwa mu shuga, motero glucose amakwezedwa.
Glucagon imatanthauzanso mahomoni a pancreatic, amalowa m'mitsempha yamagazi mukatsitsa glucose wamagazi. Limagwirira zake zochita ndi yosemphana ndi insulin. Ndi gawo la glucagon, glycogen imasweka m'chiwindi ndipo shuga amapangidwa kuchokera pazinthu zopanda mafuta.
Miyezi yochepa ya shuga pamthupi imawonedwa ngati mkhalidwe wopanikizika, chifukwa chake, ndi hypoglycemia (kapena motsogozedwa ndi zina zopsinjika), tiziwalo ta pituitary ndi adrenal timatulutsa timadzi tambiri totatu - somatostatin, cortisol ndi adrenaline.
Amakhalanso, monga glucagon, amathandizira glycemia.
Glucose
Popeza zakudya zomwe zili m'magazi ndizotsika kwambiri m'mawa musanadye chakudya cham'mawa, kuchuluka kwa magazi kumayesedwa makamaka pakadali pano. Chakudya chomaliza chimalimbikitsidwa maola 10-12 musanazindikire.
Ngati maphunziro amaperekedwa kwa glycemia okwera kwambiri, ndiye kuti amatenga magazi ola limodzi mutatha kudya. Amathanso kuyeza mulingo wosakonzeka popanda chakudya. Kuphunzira ntchito yamatenti oyeserera, kuyezetsa magazi kwa glucose kumachitika patatha maola 2 mutatha kudya.
Kuti muwone zotsatira zake, cholembedwa chimagwiritsidwa ntchito momwe mawu atatu amagwiritsidwa ntchito: Normoglycemia, hyperglycemia ndi hypoglycemia. Chifukwa chake, izi zikutanthauza kuti: kuchuluka kwa shuga m'magazi ndikwabwinobwino, kuthamanga kwa shuga.
Zilinso ndi vuto la momwe glucose adadziwira, popeza ma labotore osiyanasiyana amatha kugwiritsa ntchito magazi athunthu, madzi a m'magazi kapena zinthuzo zitha kukhala seramu yamagazi. Kutanthauzira kwa zotsatirazi kuyenera kuzilingalira izi:
- Mlingo wa shuga m'magazi am'magazi ndiwambiri kuposa lonse ndi 11.5 - 14.3% chifukwa cha madzi osiyanasiyana.
- Mafuta ochulukirapo 5% mu seramu kuposa plasma.
- Magazi a capillary amakhala ndi shuga ochulukirapo kuposa magazi a venous. Chifukwa chake, shuga mu magazi a venous ndi magazi a capillary ndi osiyana.
Kuzungulira kwazonse m'magazi athunthu pamimba yopanda kanthu ndi 3.3 - 5.5 mmol / L, kukwera kwakukulu kungakhale mpaka 8 mmol / L mutatha kudya, ndipo maola awiri mutatha kudya, shugayo ayenera kubwerera pamlingo womwe anali asanadye.
Makhalidwe ofunikira kwa thupi ndi hypoglycemia pansipa 2.2 mmol / L, momwe kufa kwa maselo aubongo kumayambira, komanso hyperglycemia pamwambapa 25 mmol / L. kuchuluka kwa shuga pamitengo imeneyi kumatha kukhala ndi shuga.
Zimaphatikizidwa ndi kupweteka koopsa m'moyo.
Hyperglycemia mu shuga
Chochititsa chachikulu chomwe chimapangitsa kuti shuga azungulira ndizosavuta. Ndi matenda awa, glucose sangathe kulowa m'maselo chifukwa insulini siipangidwa kapena sikokwanira kuthira kwachilengedwe kwa mafuta. Kusintha kotereku ndi chizindikiro cha mtundu woyamba wa matenda.
Mtundu wachiwiri wa matenda a shuga umayendera limodzi ndi kuchepa kwa insulin, chifukwa mumakhala ma insulin m'magazi, koma ma cell a maselo sangathe kulumikizana nawo. Vutoli limatchedwa insulin kukana.
Matenda a shuga a kanthawi kochepa amatha kuchitika panthawi yoyembekezera komanso amatha pambuyo pobadwa kwa mwana. Amalumikizidwa ndi kuwonjezereka kwa mahomoni ndi placenta. Mwa azimayi ena, matenda amishuga amapititsa patsogolo kukana kwa insulin ndi matenda a shuga a 2.
Matenda a shuga achiwiri amakhalanso ndi endocrine pathologies, matenda ena otupa, komanso matenda a kapamba. Ndi kuchira, mawonekedwe a shuga amatha.
Zizindikiro zina za shuga zimagwirizanitsidwa ndi kupitilira gawo lachiwopsezo cha shuga - 10-12 mmol / L. Maonekedwe a shuga mumkodzo amatsogolera pakuchuluka kwa madzi. Chifukwa chake, polyuria (kukodza kwambiri) kumayambitsa kusowa kwamadzi, ndikuyambitsa pakati pa ludzu. Matenda a shuga amadziwikanso ndi chilimbikitso chowonjezereka komanso kusinthasintha kwa thupi, kuchepa kwa chitetezo chokwanira.
Laboratory kuzindikira matenda ashuga zimatengera kuzindikiridwa kwa magawo awiri a kusala kudya kwa hyperglycemia pamtunda wa 6.1 mmol / l kapena mutatha kudya zoposa 10 mmol / l. Ndi mfundo zomwe sizimafika pamlingo wotere, koma ndizoposa zomwe zimachitika kapena pali chifukwa choganiza kuti kuphwanya chakudya mu metabolism, maphunziro ena amachitika:
- Mayeso a kulolerana ndi glucose
- Kudziwa hemoglobin wa glycated.
Kuyesedwa kwa glucose kumayesa momwe thupi limapangira chakudya. Katunduyo amachitidwa - wodwalayo amapatsidwa shuga wa magalamu 75 ndipo atatha maola 2 mulingo wake sayenera kupitirira 7.8 mmol / l. Poterepa, ichi ndi chizindikiro chodziwika bwino. Mu shuga, ali pamwamba 11.1 mmol / L. Makhalidwe apakati amapezeka m'njira yatsopano ya matenda ashuga.
Mlingo wa glycosylation wa hemoglobin (mgwirizano ndi mamolekyulu a shuga) suwonetsa kuchuluka kwa shuga m'masiku 90 apitawa. Kukula kwake kumakhala pafupifupi 6% ya hemoglobin yonse ya magazi, ngati wodwala ali ndi matenda ashuga, zotsatira zake zimakhala zapamwamba kuposa 6.5%.
Kulekerera kwa glucose kolakwika kumawonekera ndi mfundo zapakati pa kafukufukuyu.
Matenda a shuga osakhudzana ndi shuga
Kuwonjezeka kwa shuga m'magazi ndikosakhalitsa komanso nkhawa zambiri. Chitsanzo chikhoza kukhala kudodometsa kwa cardiogenic pakuwukira kwa angina pectoris. Hyperglycemia imayendera limodzi ndi kuperewera kwa vuto la kuperewera kwa zakudya m'thupi mwa mitundu yambiri ya chakudya mu bulimia.
Mankhwala amatha kuyambitsa kuchuluka kwa shuga m'magazi: mahomoni, okodzetsa, oopsa, osachepera beta-blockers, kuchepa kwa vitamini H (biotin), komanso kumwa ma antidepressants. Mlingo waukulu wa caffeine umathandizanso kuti munthu akhale ndi shuga wambiri.
Shuga wochepa amachititsa kuperewera kwa vuto lamanjenje chapakati, komwe kumabweretsa kuphatikizira kwa adrenaline, komwe kumawonjezera shuga m'magazi ndipo kumayambitsa zizindikiro zazikulu za hypoglycemia:
- Kuchuluka kwanjala.
- Kuchuluka kwamtima.
- Kutukwana.
- Gwiranani chanza.
- Kusakwiya ndi nkhawa.
- Chizungulire
Mtsogolomo, zizindikirazi zimagwirizanitsidwa ndi mawonekedwe amanjenje: kuchepetsedwa kwa chidwi, kuwonongeka kwa kayendedwe ka malo, kuzindikira kayendedwe, kuwonongeka kwa mawonekedwe.
Progressive hypoglycemia imayendera limodzi ndi zizindikiro zoyipa za kuwonongeka kwa ubongo: kusokonekera kwa kalankhulidwe, kusachita bwino, kukhumudwa. Kenako wodwalayo amayamba kukomoka, kukomoka. Popanda chithandizo choyenera, chikomokere cha hypoglycemic chingathe kupha.
Zomwe zimayambitsa hypoglycemia nthawi zambiri ndimagwiritsidwe ntchito molakwika a insulin: jakisoni wopanda zakudya, mankhwala osokoneza bongo, osachita masewera olimbitsa thupi, kumwa mankhwala kapena kugwiritsa ntchito zakumwa zoledzeretsa, makamaka osakhala ndi chakudya chokwanira.
Kuphatikiza apo, hypoglycemia imachitika ndi zotere:
- Chotupa pa malo a beta cell a kapamba, momwe insulin imapangidwira ngakhale ndi shuga wochepa wamagazi.
- Matenda a Addison - kufa kwa maselo a adrenal kumabweretsa kuchepa kwa kudya kwa cortisol m'magazi.
- Kulephera kwa hepatatic kwambiri hepatitis, cirrhosis kapena khansa ya chiwindi
- Mitundu ikuluikulu ya mtima ndi kulephera kwa impso.
- Mu akhanda onenepa kwambiri kapena obadwa msanga.
- Matenda amtundu.
Kuchepa kwa shuga m'magazi kumapangitsa kuchepa kwa madzi m'thupi komanso kudya kosayenera ndi chakudya chamafuta ambiri, omwe amachititsa kuti insulini itulutsidwe kwambiri. Kusiyana kwa kuchuluka kwa shuga m'magazi kumawonedwa mwa azimayi pa msambo.
Chimodzi mwazomwe zimayambitsa matenda a hypoglycemia chingakhale chotupa chomwe chimayambitsa kufooka kwa thupi. Kuchulukitsa kwamchere kwa mchere kumalimbikitsa kuchepetsedwa kwa magazi ndipo, motero, kutsitsa shuga mu izo.
Kanemayo munkhaniyi akukamba za kuchuluka kwa shuga m'magazi.
