Sɛ́ obi a ɔwɔ asikreyare no, wususuw asikre dodow a ɛwɔ wo mogya mu da mũ no nyinaa ho? Wɔte dɛn anɔpa, sɛnea wɔte awia aduan akyi, sɛnea wɔyɛ ansa na wɔada, ne nea ɛkeka ho. Adeɛ baako a wote pii berɛ a wo ne wo duruyɛfoɔ rekasa ne asɛmfua ‘A1C’. Wɔtaa de kyerɛ sɛ ebia asikreyare no nni wo so anaa. Nanso so A1C ne asɛm no nyinaa? Ɛnnɛ yɛbɛka ɔkwan foforo a mfaso wɔ so kɛse a ɛbɛma woanya wo asikreyare ho ntease a emu dɔ sen A1C ho asɛm. Yɛfrɛ no 'Time in Range' anaa 'TIR'.
Dɛn ne Bere a Wɔde Di Dwuma (TIR)?
Sɛ yɛbɛka no tiawa a, Time in Range (TIR) yɛ bere dodow a asikre dodow a ɛwɔ wo mogya mu no kɔ so tra wo "botae" mu awiabere. Wɔtaa susuw eyi sɛ ɔha biara mu nkyem 100.
Afei ebia worebisa wo ho sɛ dɛn ne saa "target range" yi. Wɔ mpanyimfo dodow no ara a wɔwɔ asikreyare a ɛto so 1 anaa 2, nanso ɛnyɛ wɔn nyinaa fam no, saa botae a wɔde asi wɔn ani so yi ne mogya mu glucose dodow a ɛwɔ 70 mg/dL kosi 180 mg/dL .
Mpɛn pii no nnuruyɛfo kamfo kyerɛ sɛ ma wo TIR nkɔ soro boro 70% . Eyi kyerɛ ara ne sɛ ɛsɛ sɛ asikre dodow a ɛwɔ wo mu no yɛ nea ɛwɔ saa dodow no mu anyɛ yiye koraa no nnɔnhwerew 17 wɔ nnɔnhwerew 24 mu da biara.
Yɛbɛyɛ dɛn asusuw TIR yi?
Ɔkwan a eye sen biara na ɛyɛ mmerɛw a wobɛfa so asusuw wo TIR no pɛpɛɛpɛ ne sɛ wode afiri bi a wɔfrɛ no Continuous Glucose Monitor (CGM) bedi dwuma . Eyi yɛ mfiri ketewaa bi a wode hyɛ wo nipadua so. Ɛsusuw glucose dodow a ɛwɔ wo honam ani nsu a ɛwɔ wo honam ani ntam no mu nnɔnhwerew 24 da biara. Afei wubetumi atwe saa data no akɔ app anaa software bi so na woahu nea wo TIR yɛ pɛpɛɛpɛ.
Nokwarem no, ɔkwan a wɔtaa fa so gye mogya fi nsateaa mu nso betumi ama wɔanya TIR no ho adwene bi. Nanso ɛno nti ɛsɛ sɛ wohwɛ wo asikre mpɛn pii da biara. Nanso, nsɛm dodow a wonya fi CGM mu no boro saa koraa. Enti, TIR bo a wonya no nso yɛ nokware yiye.
Ɛnam saa CGM mfiridwuma yi so no, seesei nnipa pii a wɔwɔ asikreyare ne wɔn nnuruyɛfoɔ hwɛ TIR boɔ yi de hwɛ sɛdeɛ wɔn asikreyareɛ ho dwumadie reyɛ adwuma yie. Sɛ wode saa nsɛm yi di dwuma a, wo ne wo duruyɛfo betumi de botae foforo asi w’ani so na moayɛ nsakrae a ɛho hia wɔ w’ayaresa nhyehyɛe no mu.
Ɔkwan bɛn so na mibu Time in Range amanneɛbɔ?
Sɛ wode CGM di dwuma a, TIR amanneɛbɔ no taa kyerɛ wo kɔla a ɛda hɔ gyina hɔ. Ɛnyɛ den sɛ yɛbɛte eyi ase. Green kyerɛ bere a na asikre dodow a ɛwɔ wo mogya mu no yɛ nea ɛfata. Kɔla afoforo (kɔla, borɔdɔma, kɔkɔɔ) kyerɛ bere a na asikre dodow a ɛwɔ wo mogya mu no ntumi nkɔ soro (ɛba fam anaasɛ ɛkɔ soro).
Momma yɛnhwɛ sɛnea CGM amanneɛbɔ a wɔtaa de di dwuma no da nsɛm adi.
| Asikre dodow (mg/dL) . | Nkyerɛase (gyinabea) . |
|---|---|
| Ennu 54 (< 54) . | Ɛba fam yiye / Below-range |
| 54 kosi 69 na ɛwɔ hɔ | Low / Below-range a ɛba fam |
| 70 kosi 180 na ɛwɔ hɔ | In-range - a wotaa kyerekyere no wo green mu. |
| 181 kosi 250 na ɛwɔ hɔ | Ɔsoro / Above-range |
| Bɛboro 250 (> 250) . | Ɔkorɔn yiye / Above-range |
Ebia wo CGM amanneɛbɔ no bɛda saa nsɛm yi adi wɔ ɔkwan soronko so. Sɛ wowɔ nsɛmmisa bi fa eyi ho a, bisa wo duruyɛfo ma ɔmma wo nkyerɛkyerɛmu.
Ɛsɛ sɛ me Time in Range no tenten yɛ ahe?
Eyi ho hia yiye: Wo glucose target range ne TIR target yɛ soronko ma wo. Eyi kyerɛ sɛ ebia wɔyɛ soronko wɔ afoforo botae ahorow ho.
Wo ne wo duruyɛfo no bɛbom asi botae ahorow a eye ma wo ho gyinae . Afei nso, botae ahorow yi ntra hɔ sɛnea ɛte wɔ w’asetra nyinaa mu na ebetumi asesa bere a bere kɔ so no.
Nneɛma te sɛ eyinom ba bere a worekyerɛ wo botae ahorow no:
- Bere tenten ahe na woanya asikreyare?
- Mfe a woadi ne wo nkwa nna.
- So wowɔ aduruyɛ mu tebea afoforo a ɛka asikre dodow a ɛwɔ wo mogya mu? (sɛ nhwɛso no, asaabo a entumi nyɛ adwuma yiye, yafunu mu yare) .
- So wowɔ koma ne ntini mu yare?
- So wowɔ asikre a ɛba fam a wunnim, tebea a nte nka sɛ asikre a ɛwɔ wo mogya mu a ɛba fam (hypo) ho sɛnkyerɛnne?
- So woanyinsɛn anaasɛ wowɔ anidaso sɛ wubenyinsɛn?
Okay, enti momma yɛnhwɛ TIR botae ahorow bi a wɔtaa gye tom. Bio nso, eyinom yɛ nyansahyɛ ahorow a wɔde ma wɔ ɔkwan a ɛkɔ akyiri so ara kwa. Ebia wo botae no bɛyɛ soronko wɔ eyi ho.
| Botae ahorow a mpanyimfo dodow no ara a wɔwɔ asikreyare a ɛto so 1 anaa Ɔkwan 2 taa de si hɔ | |
|---|---|
| Gyinabea | Botae (bere ɔha biara mu nkyem 100 wɔ awiabere mu) . |
| Wɔ dodow a wɔakyerɛw (70-180 mg/dL) mu . | Anyɛ yiye koraa no, 70% . |
| Nea ɛba fam (54-69 mg/dL) . | Ennu 4% . |
| Ne dodow a ɛba fam koraa (< 54 mg/dL) . | Ennu 1% . |
| Nneɛma a ɛkɔ soro (181-250 mg/dL) . | Ennu 25% . |
| Ɛkɔ soro yiye (> 250 mg/dL) . | Ennu 5% . |
| Ɛde n’ani si wɔn a asiane kɛse wom sɛ asikre dodow a ɛbɛkɔ fam no so | |
|---|---|
| Wɔ dodow a wɔakyerɛw (70-180 mg/dL) mu . | Anyɛ yiye koraa no, 50% . |
| Nneɛma a ɛba fam (< 70 mg/dL) . | Ennu 1% . |
| Ɛkɔ soro yiye (> 250 mg/dL) . | Ennu 10% . |
| Botae ahorow a wɔde asi wɔn ani so ama nnipa a wɔwɔ asikreyare a ɛto so 1 bere a wɔyem | |
|---|---|
| Wɔ dodow a ɛfata mu (63-140 mg/dL) . | Anyɛ yiye koraa no, 70% . |
| Nneɛma a ɛba fam (< 63 mg/dL) . | Ennu 4% . |
| Nneɛma a ɛkɔ soro (> 140 mg/dL) . | Ennu 25% . |
Ebia botae ahorow a ɛwɔ nyinsɛn mu asikreyare ne asikreyare a ɛto so abien ho wɔ nyinsɛn mu no bɛyɛ soronko, enti ɛho hia sɛ wo ne wo duruyɛfo susuw botae ahorow a ɛboa wo kɛse na ɛyɛ nokware ma wo ho.
Abusuabɔ bɛn na ɛda A1C ne TIR ntam?
Ɛho hia paa sɛ yɛte nsonsonoe a ɛda saa abien yi ntam no ase.
- TIR (Time in Range) yɛ susudua a ɛma nsɛm a ɛfa nsakrae a ɛba wo asikre dodow mu wɔ nnɔnhwerew anaa nna bi mu ho.
- A1C yɛ mogya mu nhwehwɛmu a ɛkyerɛ sɛ asikre dodow a ɛwɔ wo mogya mu wɔ asram 2-3 a atwam no mu .
Fa no sɛ A1C sɛ worekenkan ti bi a ɛwɔ nhoma bi mu no mu nsɛm tiawa. Ɛma wunya adwene kakra. Nanso TIR te sɛ nea worekenkan ti no nyinaa, asɛmfua biara, kasamu biara. Wo nsa ka biribiara a ɛkɔ akyiri pefee. A1C mma wo nsɛm biara a ɛfa sɛnea wo asikre dɔɔso anaasɛ ɛba fam ho.
Dɛn nti na A1C betumi ayɛ nea ɛdaadaa nkurɔfo?
Susuw nnipa baanu yi ho hwɛ.
1. Onipa a odi kan: Asikre dodow a ɛwɔ ne mogya mu no sakra da mũ no nyinaa. Ɛtɔ da bi a wɔba fam paa (hypo), ɛtɔ da bi a wɔkɔ soro paa.
2. Onipa a ɔto so abien: Ne mogya mu asikre dodow kɔ so yɛ nea ɛyɛ pɛpɛɛpɛ da mũ no nyinaa, bɛyɛ 154 mg/dL.
Ebia saa nnipa baanu yi nyinaa wɔ A1C a ɛyɛ 7%. Efisɛ A1C yɛ nea wɔkyekyem pɛpɛɛpɛ. Nanso, wɔn TIR gyinapɛn ahorow no yɛ soronko koraa. Onipa a odi kan no TIR no sua koraa. Ɛno kyerɛ sɛ wɔn nipadua no wɔ asiane kɛse mu sɛ wobenya asikreyare ho nsunsuanso bɔne.
Afei nso, ebia nnipa a wɔwɔ tebea horow a edidi so yi benya A1C gyinapɛn ahorow a ɛnteɛ:
- Mogya a ɛtɔ kɔ nipadua mu
- Hemoglobin ahorow a ɛsono emu biara
- Iron a enni nipadua mu
- Nyinsɛn a wɔde di dwuma
- Mmɛn mu yare
Mprempren de, TIR rensi A1C sɔhwɛ no ananmu koraa. Nhwehwɛmu a wɔayɛ mfe du du pii ada no adi sɛ A1C dodow betumi akyerɛ asiane a ɛwɔ hɔ sɛ wubenya asikreyare ho nsɛnnennen. Ɛno nti na nnuruyɛfo de A1C ne TIR nyinaa bom di dwuma de nya wo asikreyare ho dwumadie ho mfonini a edi mũ na ɛyɛ pɛpɛɛpɛ no.
Dɛn nti na Time in Range (TIR) ho hia?
TIR ma wuhu nsakrae a ɛba asikre dodow a ɛba mogya mu a asikreyare ba no ho mfonini pefee. Nneɛma te sɛ aduan a yedi, apɔw-mu-teɛteɛ a yɛyɛ, nnuru a yɛnom, ne yɛn adwennwen dodow nyinaa ka asikre dodow a ɛwɔ mogya mu. Sɛ wohwɛ wo TIR data a, wubetumi ate sɛnea nneɛma yi mu biara nya asikre dodow a ɛwɔ wo mogya mu so nkɛntɛnso tẽẽ no ase.
Sɛ nhwɛso no, fa no sɛ wo ho yɛɛ wo hyew dapɛn biako. Sɛ wohwɛ wo TIR amanneɛbɔ saa dapɛn no a, wuhu sɛ wo TIR bo no so atew kɛse. Afei, bere foforo a wobɛyare no, wubetumi ne wo duruyɛfo akasa akyerɛ sɛnea wubesiesie wo ho ama no na woadi kan adi wo asikreyare no ho dwuma.
TIR ne asikreyare ho nsɛnnennen
Nhwehwɛmu ada no adi sɛ abusuabɔ bi wɔ TIR dodow a ɛba fam ne nsɛnnennen a asikreyare de ba no ntam.
Glycemic nsakrae betumi ama oxidative stress ne inflammation akɔ soro wɔ nipadua no mu, na ebetumi asɛe nkwammoaa a ɛwɔ nipadua no mu. Nhwehwɛmu ada no adi sɛ asikre dodow a ɛsakra kɛse yi ma asiane a ɛwɔ hɔ sɛ:
- Asikreyare a ɛba fam a ɛkɔ soro.
- Asiane a ɛkɔ soro sɛ obi benya koma ne ntini mu yare.
- Adwene ne adwene mu dwumadi a ɛyɛ mmerɛw (adwene mu dwumadi).
- Asetra pa a ɛrekɔ fam.
Bio nso, nhwehwɛmu bi daa no adi sɛ asikreyare a ɛto so abien a TIR sua na asikre a ɛwɔ mogya mu no sakra kɛse no taa nya aniwa mu yare a emu yɛ den a ɛfa asikreyare ho. Nhwehwɛmu foforo hui sɛ abusuabɔ a emu yɛ den da TIR a ɛba fam ne koma ne ntini mu ntini a ɛma mogya tu no ntam.
Eyi nyinaa kyerɛ sɛnea ɛho hia sɛ wobɛma wo TIR bo no akɔ so ayɛ nea ɛsen biara.
Mɛyɛ dɛn atumi ama me Bere a Meyɛ wɔ Range no atu mpɔn?
Ɔkwan titiriw a wobɛfa so ama wo TIR atu mpɔn ne sɛ wubehu nneɛma pɔtee a ɛreka asikre dodow a wowɔ no. Eyi betumi agye bere kakra. Ebetumi ate nka ankasa sɛ nyansahu mu sɔhwɛ a enni awiei.
Enti, da ayamye adi kyerɛ wo ho . Mmɔ mmɔden sɛ wobɛsesa biribiara prɛko pɛ, fa w’adwene si ade biako so bere koro mu.
Fa no sɛ wuhu sɛ asikre dodow a ɛwɔ wo mogya mu no kɔ akyiri sen biara bere a woadi anɔpaduan awie da biara. Enti, ma w’ani si wo suban ne wo dwumadi ahorow so saa bere no.
Sɛ nhwɛso no, nneɛma te sɛ eyinom betumi ama asikre a ɛwɔ mogya mu akɔ soro bere a wɔadi anɔpaduan awie no:
- Ɛyɛ bere a ɛsɛ sɛ wonom wo asikreyare aduru (te sɛ insulin).
- Aduru no dodow a wɔde ma.
- Nnuan a wudi ne aduannuru a ɛwɔ mu (carbohydrates, srade, protein) a ɛkari pɛ.
- Nnuru afoforo a ɛsɛ sɛ wɔnom anɔpa.
- Biribi a caffeine wom te sɛ kɔfe a wɔnom anɔpa.
Eyi yɛ nhwɛso biako pɛ. Asikreyare yɛ tebea a emu yɛ den yiye. Akwan pii wɔ hɔ a wobɛfa so aboa ma wo TIR atu mpɔn. Kae bere nyinaa sɛ ansa na wobɛyɛ nsakrae biara wɔ w’ayaresa nhyehyɛe mu no, wo ne obi a ne ho akokwaw wɔ asikreyare ho, te sɛ endocrinologist anaa asikreyare ho ɔbenfo a ɔwɔ adansedi krataa (CDCES), anaa anyɛ yiye koraa no wo duruyɛfo a ɔtaa yɛ no nkasa.
Time in Range (TIR) yɛ metric foforo a mfaso wɔ so kɛse a wɔde susuw asikreyare ho dwumadie. Mfiase no, ebia ɛbɛyɛ te sɛ nea ɛyɛ den kakra sɛ yɛbɛte TIR ho nsɛm ne data yi nyinaa ase. Nanso mma ɛnhaw wo. Wo duruyɛfoɔ bɛkyerɛkyerɛ ne nyinaa mu na waboa wo ama wode TIR boɔ yi adi dwuma ma ɛso aba wo mfasoɔ. Mobɛbom ahwɛ sɛnea mo TIR sesa bere tenten na moayɛ nsakrae wɔ mo nhyehyɛe a mohwɛ so no mu sɛnea ɛfata.
Nkrasɛm a Wɔde Kɔ Fie
- ‘Time in Range’ (TIR) yɛ bere ɔha biara mu nkyem a asikre dodow a ɛwɔ wo mogya mu no wɔ nea wɔde asi wɔn ani so no mu.
- Eyi ma wunya sɛnea wo asikre dodow sesa da mũ no nyinaa ho mfonini a emu da hɔ na ɛkɔ akyiri sen A1C sɔhwɛ no.
- Wo ne wo duruyɛfo no bom na ɛkyerɛ w’ankasa TIR botae. Ɛnyɛ ade koro wɔ obiara fam.
- Sɛ wode TIR data di dwuma a, wo ne wo duruyɛfo betumi asi gyinae pa wɔ ayaresa ho.
- Ɛdenam wo TIR nkyerɛwde a wobɛma atu mpɔn so no, wubetumi atew asiane a ɛwɔ hɔ sɛ wubenya nsɛnnennen a ɛtra hɔ kyɛ a asikreyare de ba no so.
- Eyi yɛ akwantu. Ɛnyɛ biribiara na ɛbɛkɔ yiye ntɛm ara. Da ayamye adi kyerɛ wo ho, nsakrae nketenkete betumi ama nsakrae kɛse aba.
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