I-411 kwi-A1C: Amanqanaba aqhelekileyo e-A1C kunye neendlela ezili-15 zokunciphisa i-A1C ephezulu

Imfundo yezeMpilo

Uvavanyo lwe-hemoglobin A1C yeyona nto ikufutshane kwikhadi leswekile ongalifumana. Nokuba umntu unesifo seswekile iminyaka okanye ukuba ufumene isifo, kusenokwenzeka ukuba uve malunga nolu vavanyo. Ngokungafaniyo neemitha zeswekile yegazi abantu abazisebenzisayo ekhaya, i-A1C ilinganisa umyinge weswekile yegazi kwezi nyanga zidlulileyo ngokuhlalutya ukuba zingaphi iiseli zehemoglobin zesigulana ezinayo iswekile. Iziphumo zovavanyo zigcina umkhondo wokuba umntu ulawula njani isifo seswekile.

Ima ntoni i-A1C?

IHemoglobin A1C (HbA1C), ebizwa ngokuba yi-A1C, imele ihemoglobin eglycosylated. Uvavanyo lwe-A1C (ngamanye amaxesha lubizwa ngokuba luvavanyo lwe-HbA1C okanye uvavanyo lwe-glycohemoglobin) lubonelela ngolwazi malunga nendlela esilawulwa kakuhle ngayo isifo seswekile somntu. Ikwenza oku ngokulinganisa ipesenti yeprothini yeeseli ezibomvu zehemoglobin eneswekile enamathele kuyo kwaye inike umndilili weenyanga ezintathu kumanqanaba eglucose yegazi, uyacacisa. UMarie Bellantoni , MD, ibhodi eqinisekisiweyo ye-endocrinologist kwiziko le-Endocrinology kwiMercy Medical eBaltimore. Amanqanaba eswekile egazi aphezulu, kokukhona iswekile inamathela kwihemoglobin. Iziphumo zibonelela abaguli kunye nabanikezeli babo bezempilo ngolwazi malunga nokuba unyango lwabo, ukutya, kunye namayeza asebenza njani kwaye nokuba kufuneka kwenziwe uhlengahlengiso kusini na.

Ezinxulumene: Amayeza eswekile kunye nonyango

Uvavanyo lwe-A1C

Kukho izizathu ezimbalwa zokuba ugqirha acebise uvavanyo lwe-A1C:

• Ukwenza uxilongo lohlobo 2 lweswekile
• Ukuvavanya i-prediabetes
• Ukujonga amanqanaba eswekile yegazi
• Ukuchonga ukuba ngaba kufuneka uhlengahlengiso kunyango

Uvavanyo lwegazi lwe-A1C ayilulo olokuchonga uhlobo lweswekile 1, isifo seswekile sokukhulelwa, okanye isifo seswekile esinxulumene ne-cystic fibrosis, ngokweZiko leSizwe leSwekile kunye neDigestive kunye neZifo zeZintso ( I-NIDDK ).

Ngaba kufuneka ukhawuleze kuvavanyo lwegazi lwe-A1C?

Ngokungafaniyo nokuzila ukutya kweglucose glucose (FPG) kunye novavanyo lwe-OGTT, akukho sidingo sokuzila ngaphambi kokuba kuvavanyo lwe-A1C. Ukuba iziphumo zovavanyo ze-A1C zibonisa ukuba umntu unesifo seswekile okanye unokuba nesifo seswekile, umboneleli wezempilo unokucebisa olunye lwezi mvavanyo ukuqinisekisa iziphumo. Olunye uvavanyo, uvavanyo lweplasma glucose olungahleliwe, olungadingi kuzila, lunokusetyenziswa. Ukuba iziphumo zinomda okanye ukuba iziphumo zovavanyo ezahlukeneyo azingqinelani, ugqirha unokucebisa ukuphinda uvavanyo kwiiveki okanye kwiinyanga ezininzi.

Zichane kangakanani iimvavanyo ze-A1C?

Amanqanaba e-A1C akhula kakuhle ngaphambi kokuqala kwesifo seswekile, esenza ukuba ukuxilongwa kwangoko kwenzeke ngokuka Imigangatho ye-2017 yoNyango lwezeMpilo kwiSwekile nguMbutho weSwekile waseMelika (ADA). Ngamanye amaxesha, nangona kunjalo, kumanqanaba okuqala esifo seswekile, amanqanaba eswekile yegazi awaphakamanga ngokwaneleyo ukuba angabonakala njengengxaki. Iindawo zokuvavanya, ezinje ngeqondo lobushushu elebhu, izixhobo ezisetyenzisiweyo, kunye nokuphathwa kweesampulu, zinokuchaphazela iziphumo; Nangona kunjalo, oku kuqheleke kakhulu kwi-glucose yokuzila ukutya kunye neI-OGTT kune-A1C. Ulawulo lomgangatho olungqongqo kunye nenkqubela phambili kuvavanyo lwenze ukuba uvavanyo lwe-A1C luchane ngakumbi kunangaphambili, ngokwe-NIDDK. Oogqirha kufuneka bazi iilabhoratri ezisebenzisa indlela eqinisekisiweyo ye-NGSP yokuvavanya amanqanaba e-A1C. I-NIDDK ilumkisa ukuba iisampulu zegazi ezithathiweyo ekhaya okanye ezihlalutywe kwiofisi yomboneleli wezempilo akufuneki zisetyenziselwe ukuxilonga.

Kukho iimeko zempilo kunye neemeko ezinokubangela iziphumo zovavanyo. Oku kubandakanya:

• Ukunqongophala kwegazi
• Ukungaphumeleli kwezintso
• Isifo sesibindi
• Isifo seanemia
• Unyango lwe-Erythropoietin
• Uxilongo
• Ukuphulukana negazi okanye utofelo-gazi

Kwakhona, uvavanyo alunakuthenjwa kubantu baseAfrika, baseMeditera, okanye baseMzantsi-mpuma weAsia, abantu abanelungu losapho abanesifo se-anemia, kunye nabo bane-thalassemia. Kulabo bawela kula maqela, umboneleli wezempilo unokucebisa uvavanyo olwahlukileyo okanye i-A1C ekhethekileyo.

Uvavanywa kangaphi i-A1C?

Ukugcina amanqanaba e-A1C ejonge, izigulana kufuneka ziphindwe kuvavanyo rhoqo. Ukuba i-A1C ingaphantsi kwe-5.7, ebonisa ukuba awunasifo seswekile, kuya kufuneka uhlolisise yonke iminyaka emithathu, ngokukaRobert Williams, MD, ugqirha wosapho kunye nochwephesha wezempilo eLakewood, eColorado, kunye nomcebisi kwezonyango eMediHealth . Ukuba iphakathi kuka-5.7 no-6.4, ebonisa ukuba usemngciphekweni wokuhlaselwa sisifo seswekile, kuya kufuneka uphinde usijonge rhoqo emva kweminyaka emibini. Ukuba unesifo seswekile esiqinisekisiweyo, kwaye iswekile yegazi lakho ilawulwa kakuhle, kuya kufuneka kuvavanyo lwe-A1C rhoqo kwiinyanga ezintandathu. Ukuba sele unesifo seswekile kwaye amayeza akho ayatshintsha, okanye iswekile esegazini yakho ayilawulwa kakuhle, kuya kufuneka kuvavanyo lwe-A1C rhoqo kwiinyanga ezintathu.

Amanqanaba aqhelekileyo e-A1C

Kukho izikhokelo ngokubanzi zokutolika iziphumo ze-A1C. Nangona kunjalo, kukho ezinye iimeko, ngokwe-ADA. Izikhokelo ngokubanzi zezi:

• Ngaphantsi kuka-5.7: Non-seswekile
• Phakathi kuka-5.7 no-6.4:Isifo seswekile
• Phakathi kuka-6.0 no-6.9: Isifo seswekile esilawulwayo
• Phakathi kuka-7.0 no-8.9: Isifo seswekile esingalawulwayo
• Ngaphezulu kwe-9.0: Ephakamileyo ngokugqibeleleyo

Ukujonga, amanqanaba aqhelekileyo e-A1C kubantu abangenawo isifo seswekile yi-4% ukuya kwi-5.6%.

Lithini inqanaba elungileyo le-A1C?

Amanqanaba aphakathi ko-5.7 no-6.4 ayaqwalaselwa kwisifo seswekile . Kubantu abaninzi abanesifo seswekile, injongo ngokubanzi ye-A1C kukuba kwinqanaba eliphakathi kwe-6.0 kunye ne-6.9. Ngelixa kunokuvakala ngathi i-A1C efanelekileyo ekujoliswe kuyo iphantsi kwe-6.0, kwabo banesifo seswekile, eli nqanaba linokubonisa amanqanaba eswekile esezantsi egazi, anokuba yingozi njengamanqanaba eswekile ephezulu yegazi. Ukuba iziphumo ze-A1C ziwela phakathi kwe-7.0 kunye ne-8.9, ugqirha unokucebisa utshintsho lwendlela yokuphila okanye amayeza okunceda ukuthoba amanqanaba kwinto ethathwa njengokulawulwa. Nangona kunjalo, kwabanye abantu, la manqanaba anokulunga, anje ngala:

• Abo banobomi obulinganiselweyo
• Abantu abanesifo seswekile ekudala benengxaki yokufikelela kwiinjongo ezisezantsi
• Abo bane-hypoglycemia enamandla okanye ukungakwazi ukuqonda i-hypoglycemia

Leliphi inqanaba eliyingozi le-A1C?

Xa amanqanaba enyuka esiya kwi-9.0, umngcipheko wezintso kunye nokonakala kwamehlo kunye ne-neuropathy iyanda. Abanye abantu abasandula ukufumanisa ukuba banokufumana amanqanaba angaphezu kwe-9.0. Ukutshintsha indlela yokuphila kunye nokuba amayeza anokuhlisa amanqanaba ngokukhawuleza. Kumntu onesifo seswekile ekudala simile, amanqanaba anyuka ngaphezulu kwe-9.0 anokubonisa isidingo sotshintsho kwisicwangciso sabo sonyango.

Ezinye iilebhu ziqikelela umyinge wegazi eglucose (eAG), engqinelana imitha yeswekile yasekhaya ukufundwa (mg / dL), ukuvumela abaguli ukuba baziqonde ngcono iziphumo.

Kutheni i-A1C yam iphakamileyo?

Njengoko inqanaba leswekile yegazi inyuka, kunjalo nangamanqanaba e-A1C. I-A1C ephezulu ibonisa ukuba ulawulo lweswekile yegazi alulunganga. Le nto ngokwayo ayisiyongxamiseko, kodwa inika umboneleli wakho wezempilo umfanekiso wendlela i-glucose yegazi eye yalawulwa ngayo, okanye engalawulwanga, utshilo uGqirha Williams.

Ukulawulwa kakubi kweswekile okanye isidingo sokwenza uhlengahlengiso kunyango kunokubangela i-A1C ephezulu. Ukutshintsha kokutya, ukuzivocavoca imihla ngemihla, okanye uhlengahlengiso kumayeza kunokunciphisa ngokukhawuleza i-A1C. Kuba Uhlobo lwe-2 yeswekile sisifo esiqhubela phambili, uhlengahlengiso kunyango lomntu inokuba yinxalenye yenkqubo yokulawula isifo seswekile. Ukulawulwa gwenxa kweswekile akusoloko kuthetha ukuba isigulana senza into engalunganga. Kodwa zikho ezinye izizathu zokuba kutheni amanqanaba aphezulu.

Njengoko bekutshiwo ngaphambili, ezinye iimeko zempilo zinokubangela iziphumo ezibi. Oku kubandakanya isifo sezintso, i-anemia, isifo sesibindi, i-asplenia, ukulahleka kwegazi, i-hypothyroidism, i-uremia kunye ne-sickle cell anemia. Ezinye izinto ezinokukhokelela kwinqanaba eliphezulu le-A1C kubandakanya ukwanda kweminyaka, ukukhulelwa, kunye neswekile yokukhulelwa.

Ngaba unokuba ne-A1C ephezulu kwaye ungabi neswekile?

Ngokutsho komnye Ufundo luka-2009 , Iipesenti ezi-3.8 zabantu abangenayo imbali yeswekile banenqanaba eliphakamileyo le-A1C (ngaphezulu kwe-6.0). Eli qela linokubakho ezinye izinto ezinobungozi kuhlobo lwe-2 yeswekile kunye nesifo sentliziyo. Abaphandi bafumanise ukuba la maqela alandelayo kunokwenzeka ukuba abe ne-A1C ephezulu ngaphandle kokufumana isifo seswekile:

• Mdala
• Indoda
• Abangewona amaSpanish abamnyama nabaseMelika baseMexico
• Uxinzelelo lwegazi
• Ukutyeba kakhulu
• Amanqanaba aphezulu e-C asebenzayo

Iziphumo eziphezulu ze-A1C zinokubonisa ukuba kukho ingxaki. Nokuba ukonyuka kancinci kwiswekile yegazi lakho, ngaphezulu kwamanqanaba aqhelekileyo, kunokunyusa umngcipheko wesifo sentliziyo, nokuba awunaso isifo seswekile, utshilo uGqirha Bellatoni. Ugqirha unokujonga iziphumo zovavanyo kwaye athethe nezigulana malunga nemingcipheko kunye notshintsho kwindlela yokuphila ukuphucula amanqanaba eswekile yegazi.

Ungawathoba njani amanqanaba akho e-A1C

Kubalulekile ukuba amanqanaba e-hemoglobin A1C asondele kwesiqhelo, utshilo uGqirha Bellatoni, Ukunciphisa i-hemoglobin yakho ye-A1C kunciphisa umngcipheko wokuba neengxaki kwisifo seswekile. Nokuba awukwazi ukubuyisela i-A1C yakho kuluhlu oluqhelekileyo, naluphi na uphuculo luyehlisa umngcipheko wokuba neengxaki zesifo seswekile.

Ukulandelwa kweswekile kunye nonyango

• Landela isicwangciso sonyango seswekile : Qonda isicwangciso sonyango ngaphambi kokuba ushiye i-ofisi yomboneleli wezempilo kwaye uxoxe ngemiqobo (ngokweemvakalelo, ngokwasemzimbeni, ngemali) enokukuthintela ekulandeleni le nkqubo. Zimasa lonke utyelelo olulandelayo.
• Rhoqo thatha amayeza amiselweyo : Ukuba umboneleli wezempilo umisele amayeza okunciphisa amanqanaba eswekile yegazi, thatha rhoqo. Abanye abantu bathatha amayeza kuphela xa bengaziva kakuhle, kodwa la mayeza awasebenzi ngaphandle kokuba athathwe ngokungaguquguqukiyo.
• Ukubeka iliso kunye nokulandelela iswekile yegazi : Ukujonga eswekile yegazi rhoqo lelona nyathelo libaluleke kakhulu kulawulo lweswekile, ngokwe i-CDC . Ababoneleli ngezeMpilo banokwazisa abaguli ngeentlobo ezahlukeneyo zeemitha kwaye bancede abaguli bafumane eyona ilungileyo kubo. Ababoneleli banokuthi baxelele abaguli ukuba bajonge kangaphi iswekile yegazi labo kwaye bajolise kwelithini kuluhlu lweswekile yegazi. Gcina ilog yamanqanaba eswekile yegazi lakho ukujonga iipateni kunye nezinto ezibangela iswekile yegazi spikes kunye neelows. Ukuba unxibe esweni iswekile eqhubekayo, ungasebenzisa idatha. Ukufunda ukuba yintoni ebangela ukuba iswekile yegazi inyuke okanye yehle kunokukunceda wenze isicwangciso sokuyigcina ingaguquguquki.

Ukutshintsha kokutya

• Ukuhla ukusinda : Kusenokungafuneki ukuba unciphise ubunzima njengoko ucinga. A Uphando lupapashwe kwi-2019 bafumanise ukuba abantu abanesifo seswekile sohlobo lwesi-2 abanciphise ubunzima bomzimba wabo nge-10% kwisithuba seminyaka emihlanu yokuchongwa kwabo baphumelele ukuxolelwa kwesi sifo. Sebenza nomboneleli wezempilo ukuza kunye nenjongo yokulahleka kwesisindo. Sebenza nesondlo okanye isondlo sokutya ukuze uncede ukudala isicwangciso sokutya esinokwenzeka.
• Cwangcisa ukuthenga ukutya kunye nokutya : Ukutya ekuhambeni kuhlala kubandakanya ukutya okungenampilo. Thatha ixesha lokucwangcisa ukutya kwaye usebenzise abo ukwenza uluhlu lokutya olusempilweni.
• Musa ukungasidli isidlo sakusasa : UKUYA Uphando lupapashwe kwijenali Ukutyeba kakhulu bafumanise ukuba abantu abatya isidlo sakusasa esikhulu esityebile kwiiproteni kunye namafutha banceda ukunciphisa i-A1C kunye noxinzelelo lwegazi.
• Yitya ukutya okusempilweni ngenxalenye efanelekileyo : Cwangcisa isiqingatha seplate yakho ukuba ibe yimifuno ephantsi yesitatshi, iprotheni enye enesine, kunye nesine kwisine. Amanqanaba eswekile yegazi angonyuka ukuba utya kakhulu kunemfuno zomzimba wakho. Sebenzisa izikali zokutya kunye neekomityi zokulinganisa kunye namacephe ukuqinisekisa ukuba izahlulo zifanelekile.
• Ukubeka esweni ukutya kwe-carbohydrate : Yitya iikhabhoyidi ezinefayibha eninzi kunye nezakha mzimba, ezinjengokhozo olupheleleyo, iziqhamo kunye nemifuno, kunye nembotyi. Gwema iicarbs ezifana neelekese, iikeyiki, isonka esimhlophe, irayisi kunye ne-pasta.
• Gcina ishedyuli yokutya: Abanye abantu abanesifo seswekile bakubona kungcono ukutya ngexesha elinye yonke imihla. Amayeza athile eswekile okanye insulin kunokubangela iswekile esegazini ukuba yehle kakhulu ukuba ungatsiba isidlo, ngokuka I-NIDDK . Thetha nomboneleli wezempilo ukuba awuqinisekanga ukuba yeyiphi eyona nkqubo ilungileyo yokutya. Ingcali yesondlo, ingcali yokutya, okanye utitshala oqinisekisiweyo weswekile (CDE) unokukunceda ufumane ukutya okufanelekileyo.

Utshintsho kwindlela yokuphila

• Zilolonge rhoqo : Zombini uqeqesho lwe-aerobic kunye nokumelana kunceda ukunciphisa ulawulo lwe-glycemic, ngokwe-a Uphando lupapashwe kwi-2016 . Ukuzilolonga kuphucula ulawulo lweglucose yegazi, kunciphisa umngcipheko wentliziyo, kunegalelo ekulahlekeni kwesisindo, kunye nokuphucula impilo. Yabantu abane kwisifo seswekile , ukwenza umthambo rhoqo kunokuthintela okanye ukulibazisa ukukhula kwesifo seswekile.
• Hlala uqhubeka : Ukuzigcina usebenze kwenza ukuba umzimba ubuthathaka ngakumbi kwi-insulin, ngokwamaZiko oLawulo lweNtsholongwane kunye noKhuseleko ( i-CDC ). Nangona ukuzilolonga rhoqo kubalulekile, ukwenziwa kwemihla ngemihla kukwajongwa njengokuqina komzimba. Imisebenzi yemihla ngemihla ibandakanya ukwenza igadi, ukuhamba, ukudanisa, ukugunda ingca, ukuqubha, kunye nokwenza umsebenzi wasekhaya.
• Cinga ngezongezelelo: Kukho uphando olulinganiselweyo malunga nokuba izongezo kunye namayeza anokunceda iswekile esezantsi yegazi. Umzekelo, a uphononongo olupapashwe kwi2013 kuvavanywe i-aloe vera yeswekile kwiigundane kwaye yafumanisa ukuba inokunceda. Ukongeza, i Uphando lupapashwe kwi-2017 abantu abafunyenwe benesifo seswekile abasebenzisa umgubo wembewu yefenugreek abanamathuba okufumana isifo seswekile. Kwaye nangona ubungqina buphikisana, a Uhlalutyo lweemeta olwenziwe ngo-2013 ifumanise ukutya isinamon ukunciphisa kakhulu iswekile. I-ADA ayicebisi sinamoni ukunciphisa iswekile, kwaye ayifanelanga ukuba lunyango lodidi lokuqala. Soloko uthetha nomboneleli wezempilo ngaphambi kokuba uthathe amayeza.

Uhlengahlengiso kwengqondo

• Sebenzisa izixhobo zokulawula uxinzelelo: UKUYA Uphando lupapashwe kwi-2018 ifumanise ukuba ukusebenzisa ingqondo ukunciphisa uxinzelelo kukhokelele ekunciphiseni amanqanaba e-A1C kunye nokunyuka kwempilo kunye nempilo ngokubanzi.
• Gwema iingxelo zokukhanyela : Ukuphika kunokuthatha iindlela ezininzi, ngokwefayile ye- NANTSI LAPHO . Gwema ukuthetha (okanye ukucinga) izinto ezinje, Ukuluma nje omnye ngekwenzakalisi, andinaxesha lokutya ndisempilweni namhlanje, okanye isifo sam seswekile asikho nzulu.
• Nxibelelana nabanye abantu abanesifo seswekile : Ukuziva uwedwa kunokwenza kube nzima ngakumbi ukubambelela kwisicwangciso sonyango. Fumana iqela lenkxaso lomntu okanye ukhangele enye kwi-intanethi. Ukunxibelelana nabanye abantu abakwimeko efanayo banokunika inkxaso, isikhokelo kunye noxanduva lokuphendula.

Khumbula, iimvavanyo ze-A1C zilinganisa amanqanaba eswekile yegazi ngaphezulu kweenyanga ezintathu. Indlela yokuphila kunye nokutshintsha kokutya kuthatha iinyanga ezininzi ngaphambi kokwenza ifuthe elibonakalayo.