Kuyesedwa kwa hemoglobin ya glycated: zomwe zimachitika mwa amuna ndi akazi omwe ali ndi matenda ashuga

Nyuzipepala yaku Britain yofalitsa zotsatira za kuyesera komwe kumayenera kukhazikitsa kudalirika kwa hemoglobin ya glycosylated komanso chiopsezo cha kufa pakati pa amuna. HbA1C idayendetsedwa mu odzipereka a mibadwo yosiyana: kuchokera pa zaka 45 mpaka 79. Kwenikweni, anali anthu athanzi (opanda matenda ashuga).

Mwa amuna omwe amawerengera glucose mpaka 5% (pafupifupi), kuphedwa kwamunthu kunali kochepa kwambiri (makamaka kuchokera ku kugunda kwa mtima ndi stroko). Kuchulukitsa chizindikirochi ndi 1% chokha komwe kumawonjezera mwayi waimfa ndi 28%! Malinga ndi zotsatira za lipotilo, mtengo wa HbA1C wa 7% umawonjezera chiopsezo chaimfa ndi 63% (poyerekeza ndi chizolowezi), ndipo 7% ya anthu odwala matenda ashuga nthawi zonse amawonedwa ngati zotsatira zabwino!

Kuyesedwa kwa hemoglobin ya glycated ndi kafukufuku wofunikira, mtundu wa zilembo zam'magazi zomwe zimakupatsani mwayi wofufuza bwino matenda ashuga. Zimathandizira kuyendetsa bwino ntchito ya chithandizo chake.

Ntchito yayikulu ya hemoglobin ndikupereka mpweya m'maselo. Puloteni iyi imagwirizana ndi mamolekyulu a shuga. Ndizomwe zimatchedwa glycosylated hemoglobin. Mashuke ochulukirapo m'magazi, hemoglobin yochulukirapo imapangidwa, yomwe imadziwika ndi chiwopsezo cha matenda ashuga ndi zotsatira zake.

Pakadali pano, mayesowa ndi ofunikira ku hyperglycemia, amakupatsani mwayi wofufuza matenda ashuga pamene mitundu ina ya mayeso sikukonza. Kuwunikaku kumathandizira kuzindikira bwino matenda a shuga m'magawo oyambira. Kuyesedwa koteroko kumathandizira odwala matenda ashuga kumvetsetsa momwe adayang'anira bwino glycemia kwa masiku 90-100, momwe shuga imayendera mwachangu, komanso ngati mankhwala osankhidwa omwe amachepetsa shuga ndi othandiza.

Ubwino ndi kuipa kwa njirayi

Ma molekyulu a glucose m'magazi amatenga ndi maselo ofiira amwazi. Zotsatira zake ndimapangidwe osasunthika ngakhale mapuloteni awa akafa mu ndulu. Katunduyu wa iwo amathandizira kuzindikira vuto molawirira kwambiri, pomwe mayeso wamba sanamvebe kusintha m'magazi.

Kusanthula musanadye kumakupatsani mwayi wofufuza shuga, mutatha kudya - kumawunikira momwe katundu wake alili. Glycated hemoglobin mu shuga mellitus amayesa glycemia m'miyezi itatu yapitayo. Kodi njira yowerengera iyi ndi iti?

• Kuyesereraku kungachitike osati m'mawa, pafupi ndi kukomoka kwa njala, mayesowo akuwonetsa chithunzi cholondola kwambiri, kuwulula matenda ashuga pamlingo wa prediabetes.
• Kukhazikika kwa preanalytical - magazi omwe amatengedwa kunja kwa labotale amatha kusungidwa mpaka kuyezetsa kwa vitro.
• HbA1C imathandizira kuwunika kuchuluka kwa kubwezeretsa shuga mwa odwala matenda ashuga kuti asankhe mtundu woyenera wa mankhwala a hypoglycemic.
• Choyimira sichimatengera kupsinjika, matenda, zolakwika mu chakudya, kumwa mankhwala aliwonse.
• Kulemba kwawo kumachitika mwachangu, kosavuta komanso kotsika mtengo kuposa mayeso okhudzana ndi shuga, omwe amatenga maola awiri.

Ndi anemia, hemoglobinopathy kapena mavuto ndi chithokomiro, komanso kuchuluka kwakudya m'zakudya za mavitamini E ndi C, zotsatira zake sizabwino. Njirayi sioyenera kuyesa pachimake hyperglycemia.

Chiyeso chosagwira ntchito kwa amayi apakati. Chithunzi chojambula chimatha kuwoneka pokhapokha pa mwezi wa 8-9, pomwe mavuto akuwonekera kale mu trimester yachiwiri. Pali odwala omwe amachepetsa kulumikizana pakati pa mtengo wa HbA1C ndi kuwerengera kwa glucose.

Zoyipa zake zikuphatikiza mtengo wa mayeso: mtengo wapakati pa ntchito ndi ma ruble 520 kuphatikiza ma ruble ena okwana 170 ndi mtengo wamapulogalamu a magazi a venous. Si dera lililonse lomwe limakhala ndi mwayi wofufuzidwa.

Chifukwa chiti mudutsa mayeso chotere?

Hemoglobin ndi puloteni yomwe imakhala ndi chitsulo ndipo imatha kunyamula oxygen m'thupi lonse. Maselo ofiira amthupi amakhala ndi miyezi 3-4 yokha, ndikomveka kuyesa HbA1C mayeso pafupipafupi.

Kuchedwa kopanda enzymatic kumapereka mgwirizano wamphamvu wa glucose ndi hemoglobin. Pambuyo pa glycation, glycosylated hemoglobin imapangidwa. Kukula kwa zomwe zimachitika zimatengera kuwerengera kwa mita mu nthawi yoyendetsa. HbA1C imakupatsani mwayi wopenda magazi m'masiku 90-100.

Tisanayesedwe pafupipafupi, odwala matenda ashuga "ambiri amakhala ndi malingaliro," kuyesa kukonza chithunzithunzi. Mukamayesa HbA1c, chinyengo chotere sichigwira ntchito, zolakwika zonse muzakudya ndi mankhwala zidzakumbukiridwa.

Zina mwa njira zopezekera pazanema zidanenedwa ndi Pulofesa E. Malysheva:

Miyezo ya HbA1c

Popanda zizindikiro za matenda ashuga, mfundo za HbA1C zimachokera ku 4-6%. Amawerengeredwa poyerekeza ndi kuchuluka konse kwa maselo ofiira am'magazi. Chizindikirochi chikuwonetsa metabolism wabwino wa chakudya.

Mwayi wokhala ndi matenda “okoma” umawonjezeka ndi mfundo za HbA1C kuchoka pa 6.5 mpaka 6.9%. Ngati atha kugunda kwa 7%, izi zikutanthauza kuti kagayidwe ka lipid kamakhala kovuta, ndipo kusintha kwa shuga kumachenjeza za prediabetes. Malire a hemoglobin a glycated (zomwe zili mu shuga mellitus) amasiyana ndi mitundu yosiyanasiyana ya shuga komanso magulu osiyanasiyana. Kusiyanaku kukuwonekera bwino pagome.

Ndikofunika kuti achinyamata azisamalira HbA1C yawo poyerekeza ndi odwala matenda ashuga. Kuwunikira kwa hemoglobin ya glycated kwa amayi apakati kumakhala kotheka kwa miyezi 1-3, mtsogolomo, kusintha kwa mahomoni sikupereka chithunzi cholondola.

HbA1C ndi hemoglobin wakupha

Fatog hemin imapezekanso mwa akhanda. Mosiyana ndi ma analogues, mawonekedwewa amatulutsa mpweya wabwino m'maselo. Kodi hemoglobin yomwe imapha imakhudza umboni?

Zambiri za okosijeni zomwe zimakhala m'magazi zimathandizira njira ya makutidwe ndi okosijeni, ndipo chakudya chimasinthidwa kukhala glucose mwachangu ndikusintha kofanana ndi glycemia. Izi zimakhudza kugwira ntchito kwa kapamba, kupanga insulin ndi hemoglobin wa glycated mu shuga.

Zambiri za kuyesa kwa hemoglobin ya glycated - mu kanema:

Zinthu za phunziroli

Mwayi wofunikira pakuwunika hemoglobin ya glycosylated ndi kusowa kwa kufunika kwakukonzekera kulikonse komanso kuthekera kwakuti kuchititse nthawi yovomerezeka. Njira zapadera zimapangitsa kuti zitheke kupeza chithunzi chodalirika mosasamala zakudya kapena mankhwala, matenda opatsirana, nkhawa, kapenanso mowa.

Kuti mupeze chithunzi cholondola cha zotsatira zake, tikulimbikitsidwa kuti tisadye chakudya cham'mawa, chifukwa wodwala, monga lamulo, amayesedwa mozama, ndipo izi zingakhudze mayeso ena. Mu tsiku limodzi kapena awiri mutha kudziwa zotsatira zake. Pokambirana ndi endocrinologist, muyenera kumuuza za matenda anu am'mimba, matenda a kapamba, komanso kugwiritsa ntchito mavitamini.

Zotsatira zoyeserera zimatha kukhala zosiyanasiyana posankha ma labotore osiyanasiyana. Zimatengera njira zomwe amagwiritsa ntchito kuchipatala. Kuti mutsate zamphamvu zakukula kwa matendawa, ndikofunika kuyeserera nthawi zonse malo amodzi. Ndikofunikira kuyesedwa pafupipafupi: kwakhazikitsidwa mwachipatala kuti kuchepa kwa HbA1 ngakhale 1% moyenera kumachepetsa zovuta.

Kodi HbA1 yafupika?

Kufunika kwa HbA1 m'munsi mwabwinobwino m'matenda a shuga kumatanthauza hypoglycemia. Momwe amadziwikiratu amadziwika nthawi zambiri kuposa kupitilirapo. Ndi dzino lokoma, ndikugwiritsa ntchito maswiti nthawi zonse, kapamba amagwira ntchito kuvala, kutulutsa timadzi tambiri tambiri. Zofunikira zoyambira ndikupanga ma neoplasms momwe ma b-cell amapanga insulin yambiri.

Kuphatikiza pa matenda ashuga komanso zokonda za dzino lokoma, palinso zifukwa zina zotsika HbA1:

• Zakudya zazitali za carb
• Matenda a m'magazi ogwirizana ndi glucose tsankho;
• Ral and hepatic pathologies;
• Anemia
• Mavuto ndi hypothalamus;
• Kusakwanira kwa minofu;
• Mankhwala osokoneza bongo ambiri a insulin.

Kuti mudziwe zoyambitsa zomwe zimakhudza gawo la glycated hemoglobin mu shuga mellitus, ndikofunikira kuyesedwa kwathunthu.

Pa gulu la anthu odwala matenda ashuga okhala ndi moyo wautali wazaka 5, HbA1 yopitilira 8% ndiye chizolowezi, chifukwa amatha kukhala ndi hypoglycemia kuposa kuwopseza matenda ashuga. Muubwana ndi unyamata komanso panthawi yomwe muli ndi pakati, ndikofunikira kusunga HbA1C mpaka 5%.

Zomwe zimapangitsa kuti HbA1 iwonjezeke

Kupitilira muyeso wa hemoglobin wa glycated mu mtundu 1 kapena mtundu 2 kungatanthauze hyperglycemia. Matenda a pancreatic nthawi zambiri amapezeka ngati kupenda kwa HbA1 kuli pamwamba pa 7%. Zizindikiro za 6-7% zimawonetsa kulekerera kwa glucose komanso zovuta zama metabolic.

Kwa amayi apakati ndi ana, kuyang'ana hemoglobin wa glycated sikuli kofunikira kuposa kwa okalamba. Mukanyalanyaza malangizowa, zovuta zapakati pa kubereka kwa mwana, kubadwa msanga, komanso kuwonongeka kwa thanzi la mayiyo ndizotheka. Hemoglobin yotsika mumtunduwu ndivuto wamba, chifukwa zofuna zawo zachitsulo ndizokwera kwambiri (mpaka 15 - 18 mg).

Hyperglycemia imadziwika kuti imangokhala ndi mitundu yosiyanasiyana ya matenda ashuga, komanso matenda a chithokomiro, kulephera kwa chiwindi, kusokonezeka kwa hypothalamus (gawo la ubongo lomwe limayang'anira ntchito ya gland ya endocrine).

Ngati ana akweza hemoglobin (10%) ya glycated, nzoopsa kuyigwetsa pansi kwambiri, mwanayo amayamba kuona. Ngati vutoli lokha silinathetsedwe kwa nthawi yayitali, litha kuchepetsedwa ndi mankhwala ndi 1% pachaka.

Glycemic control kunyumba

Ndi mtundu uliwonse wa matenda ashuga, boma la magazi anu liyenera kuwunika tsiku lililonse kuti musinthe katundu, zakudya kapena mlingo wa mankhwala ngati kuli kofunikira. Nthawi zambiri mita ya shuga imayang'ana kuti shuga asala kudya, maola awiri mutatha kadzutsa, musanadye chakudya chamadzulo komanso usiku.

Mtundu wachiwiri wa matenda ashuga, ngati wodwala salandira jakisoni wa insulin, njira ziwirizo ndizokwanira. Kuchulukitsa kwa wodwala aliyense kumatsimikiziridwa ndi dokotala. Zotsatira zakuwerengedwa kwa glucometer zalembedwa ndi wodwala matenda ashuga m'mawu kuti azitha kuyang'ana mbiriyo mozama. Ndikulimbikitsidwa kuyang'ana shuga pa nthawi yomwe muli ndi pakati, nthawi yoyenda, ndi minofu kapena kutopa kwambiri.

Ngati matenda a shuga apezeka kale ndipo akupita patsogolo, simuyenera kungoyesedwa pa mayeso amodzi a HbA1C. Sichikuwonetsa kusintha kwa kapangidwe ka magazi ndi katundu wa carbohydrate, kuthandiza kusintha molondola moyo.

Odwala ena a shuga samawongolera glycemia, pofotokoza chisankho chawo chifukwa chakuti kusokonezeka kosafunikira kumakhudza deta yoyesa.

Zomwe zotsatira zoyesazi zimanena zimatha kumvetsetsa.

Momwe mungasungire dzuwa lanu la plasma

Malangizo apadera amafuna kuti odwala matenda ashuga a HbA1C akhale pansi pa 7%. Pokhapokha, matenda a shuga amalipiridwa mokwanira, ndipo chiwopsezo cha zovuta ndizochepa.

Mwapang'ono, zakudya zama carb zotsika zimathetsa vutoli, koma kuchuluka kwa chiphuphu cha shuga kumayenderana mwachindunji ndi zovuta za hypoglycemic. Luso la kumverera bwino pakati pamaopsezo a hypoglycemia ndi hyperglycemia, wodwala matenda ashuga amaphunzira moyo wake wonse.

Glycated hemoglobin ndi deta ya masiku 90-100, ndipo ndizosatheka kuiletsa m'nthawi yochepa, ndipo ndiyowopsa. Chofunikira chachikulu pakulipira kwa glycemia ndi kupewa zovuta pamavuto a carbohydrate metabolism ndikutsatira kwambiri zakudya.

1. Zakudya zotetezeka kwambiri ndizapuloteni: nyama, nsomba, mazira, mkaka, popanda thupi kukhalapo bwino.
2. Mwa zipatso ndi ndiwo zamasamba, ndibwino kuti musankhe zomwe zimamera pamwamba pa nthaka: nkhaka, kabichi, zukini, mapeyala, maapulo, mandimu, nkhanu. Masamba ozizira ndi zipatso zotsekemera (mphesa, nthochi, mapeyala) zimadyedwa mu nyengo yoposa 100 g komanso mosiyana ndi zinthu zina.
3. Matenda a shuga ndi nyemba ndizothandiza, nandolo zimatha kudyedwa zobiriwira. Nyemba za nyemba ndi chida chotsimikiziridwa chochepetsera shuga.
4. Ngati muli ndi vuto losafuna kudya chinthu chokoma, ndibwino kuti muthe kumwerekera makilogalamu (30 g) ya chokoleti chamdima wakuda (osachepera 70% cocoa) kuposa omwe amatchedwa ma candies a odwala matenda ashuga omwe ali ndi fructose.
5. Kwa okonda chimanga, ndibwino kuti musankhe zakudya zamafuta pang'ono, zomwe zimamwa nthawi yayitali ndipo zimakonzedwa bwino. Balere imakhala ndi index yotsika kwambiri ya glycemic, koma imakhala ndi gluten. Mpunga wakuda, mphodza, mphira, ndi oats zina zimatha kuphatikizidwa muzakudya.

Chakudya chizikhala chopindika, mpaka katatu pa tsiku. Mapuloteni ndi zakudya zamafuta kwambiri zimadyedwa mosiyana. Kuchiritsa kwamoto pazinthu - zofatsa: kuwongolera, kuphika, kuwonda.

Kuti muchepetse kunenepa, kusangalala, thanzi, komanso, shuga, ndikofunikira kuti mupange masewera olimbitsa thupi anu pafupipafupi, poganizira zaka ndi thanzi lanu.

Kupitiliza kosalekeza kwa glycosylated hemoglobin mu shuga mellitus ndikofunikira kuti kubwezeredwe koyenera kwa glycemic. Zovuta zomwe zimawululidwa panthawiyi zimathandiza kukonza njira zochizira matendawa komanso kupewa zovuta za matenda ashuga. Kuyesedwa kwa HbA1 kumaphatikizidwa ndi European Association of Endocrinologists mu zovuta za zolozera zovomerezeka pakuzindikira matenda ashuga.

Kuti mumve zambiri panjira yoyesera ya HbA1, onani vidiyo: