Kodi "Time in Range (TIR)" imatanthauza chiyani kwa inu omwe muli ndi matenda ashuga? Tiyeni tidziwe bwino!

Kodi muli ndi matenda a shuga? Kapena wina m'banja mwanu kapena mnzanu ali ndi matenda a shuga? Ndiye mwina mwamvapo, kapena mwina dokotala wanu walankhula za chinthu chotchedwa 'Time in Range'. Choncho, tiyeni tikambirane za izi momveka bwino komanso momveka bwino lero. Ngakhale izi ndi zatsopano pang'ono, ndi chinthu chomwe chimathandiza kwambiri poletsa matenda a shuga.

Kodi "Time in Range" (TIR) ​​iyi ndi chiyani?

Mwachidule, "Nthawi Yokhala ndi Matenda a Shuga" (TIR) ​​​​ndi nthawi yomwe munthu wodwala matenda ashuga angathe kusunga shuga m'magazi mwake mkati mwa nthawi inayake . Tangoganizirani dokotala wanu akukuuzani kuti musunge shuga m'magazi mwanu pakati pa nthawi iyi ndi nthawi iyi. Izi zimayesa nthawi yomwe mumakhala mkati mwa nthawi imeneyo.

Kwa anthu ambiri omwe ali ndi matenda a shuga, onse omwe ali ndi matenda a shuga a Mtundu 1 ndi akuluakulu omwe ali ndi matenda a shuga a Mtundu 2, nthawi zambiri amakhala pakati pa 70 ndi 180 mamiligalamu pa decilita (mg/dL) . Koma izi sizili zofanana kwa aliyense, ndipo zimatha kusiyana kuchokera kwa munthu ndi munthu. TIR imayesedwa ngati peresenti . Madokotala nthawi zambiri amanena kuti yesani kusunga TIR yanu pamwamba pa 70% . Izi zikutanthauza kuti shuga m'magazi mwanu iyenera kukhala muyeso umenewo kwa maola osachepera 17 kuchokera maola 24 patsiku. Pamenepo ndi pamene mungaganize kuti matenda anu a shuga ndi olamulidwa bwino.

Kodi mumayesa bwanji TIR iyi molondola?

Njira yosavuta komanso yolondola yodziwira TIR yanu ndikugwiritsa ntchito Continuous Glucose Monitor (CGM) . Mwina mudamvapo za chipangizochi kale. Ndi chipangizo chaching'ono chomwe chimavalidwa chomwe chimayikidwa pansi pa khungu la mkono wanu kapena m'mimba . Mukakhala nacho, chimayesa ndikulemba kuchuluka kwa shuga m'madzi am'mimba pansi pa khungu lanu maola 24 patsiku. Zili ngati katswiri wofufuza shuga yemwe akufunafuna shuga wanu. Kenako mutha kutsitsa deta iyi ya shuga pogwiritsa ntchito pulogalamu yolumikizidwa ku chipangizo cha CGM kapena pulogalamu pafoni yanu ndikutsata TIR yanu.

Ndipotu, mutha kupeza lingaliro lovuta la TIR yanu mwa kubaya chala chanu ndi dzanja . Koma ngati muchita zimenezo, muyenera kuyang'ana shuga m'magazi anu kangapo patsiku . Ngakhale zili choncho, sizipereka zambiri mwatsatanetsatane monga `CGM`. Taganizirani ngati kusanthula masamba a buku. Koma `CGM` ili ngati kuwerenga buku lonse! Imakupatsani chithunzi chonse cha kuchuluka kwa shuga m'magazi mwanu.

Chifukwa cha makina a `CGM` awa, anthu ambiri omwe ali ndi matenda a shuga ndi madokotala awo tsopano akugwiritsa ntchito TIR iyi kuti awathandize kuthana ndi matenda awo a shuga.Yesani molondola deta yanu ya TIR, zomwe zingakuthandizeni inu ndi dokotala wanu kukhazikitsa zolinga zatsopano ndikupanga kusintha kofunikira pa dongosolo lanu la chithandizo.

Kodi lipoti la TIR ili likuwoneka bwanji?

Mu malipoti awa a TIR, omwe amachokera ku mapulogalamu a makina a CGM, mitundu yosiyanasiyana ya shuga yanu nthawi zambiri imawonetsedwa ngati bala loyimirira lamitundu yosiyanasiyana . N'zosavuta kumvetsetsa.

• Nthawi yomwe shuga wanu unali mkati mwa nthawi yomwe mukufuna imawonetsedwa mu mtundu wobiriwira . Izi ndi zomwe tonse timayesetsa kukonza.
• Mitundu ina, kutanthauza nthawi yomwe shuga imakhala yotsika kapena yokwera, imawonetsedwa mumitundu ina monga yachikasu, lalanje, ndi yofiira .

Umu ndi momwe ma range awa amawonetsedwera pa lipoti la `CGM` lachizolowezi (kuyambira pansi mpaka pamwamba):

• Zochepera 54 mg/dL (< 54 mg/dL) — Zochepa kwambiri (pansi pa cholinga). Izi zimawoneka zofiira. Izi zitha kukhala zoopsa.
• Pakati pa 54 mg/dL ndi 69 mg/dL — Yotsika (pansi pa cholinga). Mwina iyi ndi lalanje. Iyinso ndi gawo lofunika kuliganizira.
• Pakati pa 70 mg/dL ndi 180 mg/dL — mkati mwa mtunda. Ndicho chimene chili mu mtundu wobiriwira . Tonse tikuyesera kukulitsa gawo lobiriwira ili!
• Pakati pa 181 mg/dL ndi 250 mg/dL — okwera (pamwamba pa cholinga). Izi zikuwoneka ngati zachikasu.
• Kuposa 250 mg/dL (> 250 mg/dL) — Pamwamba kwambiri (pamwamba pa cholinga). Izi zimawonekeranso ngati mtundu wofiira. Ngati izi zipitirira, sizili bwino.

Koma kumbukirani kuti malipoti ena a CGM angawonetse izi mosiyana. Ngati mukuvutika kumvetsetsa izi, ndi bwino kulankhula ndi dokotala wanu . Angakufotokozereni.

Kodi TIR yanga iyenera kukhala yochuluka bwanji?

Ngati muli ndi matenda a shuga, mulingo wa shuga m'magazi mwanu ndi wosiyana ndi wanu . Izi zikutanthauza kuti mulingo wa shuga m'magazi mwanu si wofanana ndi wanga. Inu ndi dokotala wanu mudzasankha pamodzi mulingo wa shuga womwe uli woyenera kwa inu komanso mulingo womwe muyenera kukhala nawo. Zolinga izi zitha kusintha moyo wanu wonse.

Pali zinthu zingapo zomwe zingakhudze zomwe zili mu glucose:

• Kodi mwakhala ndi matenda a shuga kwa nthawi yayitali bwanji ?
• Zaka zanu ndi thanzi lanu lonse .
• Muli ndi matenda ena omwe amakhudza kuchuluka kwa shuga m'magazi mwanu, monga kulephera kugwira ntchito kwa impso kapena gastroparesis .
• Ngati muli ndi matenda a mtima .
• Matenda omwe simukudziwa zizindikiro za shuga wotsika m'magazi (hypoglycemia)Ngati zilipo. Izi zikutanthauza kuti, ngati simukumva chizungulire ndi thukuta monga momwe mumamvera shuga wanu akatsika, ndi zoopsa pang'ono.
• Ngati muli ndi pakati kapena mukufuna kutenga mimba , zolinga zanu zimasintha kwambiri nthawi imeneyi.

Chabwino, tsopano tiyeni tiwone malangizo omwe nthawi zambiri amaperekedwa.

Zolinga za TIR kwa akuluakulu ambiri omwe ali ndi matenda a shuga amtundu woyamba kapena wachiwiri:

• Osachepera 70% ya nthawi pakati pa 70 ndi 180 mg/dL (mkati mwa mlingo wovomerezeka).
• Nthawi yomwe ili pansi pa 54 mg/dL iyenera kukhala yochepera 1%.
• Nthawi pakati pa 54 ndi 69 mg/dL iyenera kukhala yochepera 4%.
• Nthawi pakati pa 181 ndi 250 mg/dL iyenera kukhala yochepera 25%.
• Nthawi yomwe ili pamwamba pa 250 mg/dL iyenera kukhala yochepera 5%.

Cholinga cha TIR kwa anthu omwe ali pachiwopsezo chachikulu cha shuga wotsika m'magazi (hypoglycemia):

Izi ndi za anthu omwe nthawi zambiri amakhala ndi shuga wochepa m'magazi.

• Osachepera 50% ya nthawi pakati pa 70 ndi 180 mg/dL (mkati mwa mulingo woyenera).
• Nthawi yogwiritsidwa ntchito pansi pa 70 mg/dL iyenera kukhala yochepera 1%.
• Nthawi yomwe ili pamwamba pa 250 mg/dL iyenera kukhala yochepera 10%.

Zolinga za TIR kwa akuluakulu omwe ali ndi matenda a shuga amtundu woyamba panthawi ya mimba:

Izi ndizofunikira kwambiri, chifukwa zingakhudze mwana.

• Osachepera 70% ya nthawi, ndi pakati pa 63 ndi 140 mg/dL (muyeso wabwinobwino). Mlingo wa shuga pano ndi wosiyana pang'ono, mukuona? Ndikofunikira kwambiri kuwongolera kuchuluka kwa shuga m'magazi anu panthawi ya mimba.
• Nthawi yomwe ili pansi pa 63 mg/dL iyenera kukhala yochepera 4%.
• Nthawi yomwe ili pamwamba pa 140 mg/dL iyenera kukhala yochepera 25%.

Malangizo a matenda a shuga a mimba ndi matenda a shuga a mtundu wachiwiri panthawi ya mimba angakhale osiyana. Apanso, awa ndi malangizo wamba. Ndikofunikira kukambirana ndi dokotala wanu zomwe zili ndi shuga zomwe zingakuthandizeni kwambiri komanso zenizeni kwa inu. Adzakupatsani malangizo a momwe mungachitire bwino pa vuto lanu.

Kodi pali ubale wotani pakati pa TIR iyi ndi A1C?

Mwina mwamvapo za mayeso a A1C awa. Madokotala ambiri amagwiritsa ntchito mayesowa kuti aone momwe matenda anu a shuga akulamuliridwira bwino. Ndiye, kodi TIR ndi A1C ndi chinthu chimodzi? Inde, pang'ono.

TIR imayesa kuchuluka kwa shuga m'magazi anu pakapita nthawi, kuyambira maola ochepa mpaka masiku angapo, pamene mukuvala CGM. Zili ngati chithunzi cha kanthawi kochepa . Mutha kuwona momwe shuga wanu amasinthira tsiku ndi tsiku.

Komabe, A1C ndi mayeso a magazi omwe amachitidwa mu labu . Amayesa kuchuluka kwa shuga m'magazi anu m'masabata 8 mpaka 12 apitawa . Mayeso a A1C sangakuuzeni momwe shuga m'magazi mwanu amasinthira. Amangopereka mtengo wapakati.

Mwachidule:

Taganizirani izi motere: A1C ili ngati kuwerenga chidule cha mutu wa buku.Koma kugwiritsa ntchito `CGM` ndikuyang'ana TIR kuli ngati kuwerenga mutu wonse . Kenako mumamvetsetsa bwino kwambiri . Kodi mukumvetsa? TIR imasonyeza bwino momwe shuga imagwirira ntchito nthawi zosiyanasiyana za tsiku, mutatha kudya, mutatha kuchita masewera olimbitsa thupi.

Kuyambira m'ma 1960, madokotala ndi odwala matenda ashuga akhala akugwiritsa ntchito A1C kuti aone momwe kasamalidwe ka matenda ashuga kakuyendera. Komabe, kuyambira pomwe makina a CGM adabwera, madokotala ndi odwala azindikira kuti TIR iyi imapereka chithunzi chothandiza komanso cholondola cha kasamalidwe ka matenda ashuga .

Makamaka kwa anthu omwe ali ndi matenda a shuga a mtundu woyamba , kuchuluka kwa shuga m'magazi kumatha kusinthasintha kwambiri pakapita masiku, milungu, ndi miyezi. Chifukwa chake, kuchuluka kwa shuga m'magazi si nthawi zonse komwe kumayesa bwino momwe amayendetsera.

Mwachitsanzo, taganizirani izi:

Pali munthu amene shuga m'magazi mwake imakhala yotsika kwambiri komanso yokwera kwambiri. Koma A1C yake ikhoza kukhala 7%.

Palinso munthu wina amene shuga m'magazi mwake ndi wokhazikika pafupifupi 154 mg/dL nthawi zambiri. A1C yake ikhozanso kukhala 7%.

Mukuona? Ngakhale kuti A1C yawo ndi yofanana, TIR yawo ingakhale yosiyana kwambiri. TIR ya munthu woyamba ndi yotsika chifukwa nthawi zonse imakhala kunja kwa cholinga chake. Ali pachiwopsezo chachikulu cha hypoglycemia.

Komanso, mayeso a A1C sangakhale olondola mwa anthu omwe ali ndi matenda awa:

• Kuchepa kwa magazi (kusowa kwa magazi).
• Ma hemoglobin osiyanasiyana.
• Kusowa kwa chitsulo.
• Mimba.
• Matenda a chiwindi.

Kulondola kwa ma A1C kumathanso kusiyana pakati pa anthu osiyanasiyana.

Komabe, monga momwe zilili, kubwera kwa TIR sikutanthauza kuti mayeso a A1C sadzatha . Kafukufuku wa zaka makumi ambiri wasonyeza kuti milingo ya A1C imatha kulosera kukula kapena kupewa mavuto a matenda a shuga. Chifukwa chake, madokotala akuphatikiza mayeso a TIR ndi A1C kuti apeze chithunzi chokwanira cha kasamalidwe ka shuga.

Nchifukwa chiyani TIR iyi ndi yofunika kwambiri?

TIR imakupatsani chithunzi cholondola cha kusinthasintha kwa shuga m'magazi komwe kumabwera ndi matenda a shuga. Ganizirani zinthu zingati zomwe zimakhudza shuga wanu, monga chakudya chomwe mumadya, masewera olimbitsa thupi omwe mumachita, mankhwala omwe mumamwa, ndi kuchuluka kwa nkhawa yanu ! Chifukwa chake, kuyang'ana deta yanu ya TIR (makamaka mukamagwiritsa ntchito `CGM`) kungakuthandizeni kumvetsetsa bwino momwe zinthu zosiyanasiyanazi zimakhudzira shuga wanu m'magazi .

Mwachitsanzo, mungazindikire kuti TIR yanu yachepa mukakhala ndi malungo kwa sabata imodzi. Kapena, mungazindikire kuti shuga m'magazi mwanu yakwera kwambiri mutadya chakudya china chake, ndipo TIR yanu yatsika. Mukawona chinthu chonga chimenecho, mutha kufunsa dokotala wanu kuti, 'Ndingakonzekere bwanji bwino kuwongolera matenda anga a shuga nthawi ina ndikadwala?' Kapena, mungaganize kuti, 'Kodi chakudya chamtunduwu chimandikhudza bwanji, ndipo kodi ndiyenera kusintha momwe ndimadyera?' Mwa kuyankhula kwina, TIR ingakhale yothandiza kwambiri posamalira matenda anu a shuga m'njira yoyenera moyo wanu .

Kodi mavuto a shuga angachitike ngati TIR yachepa?

Kafukufuku pa izi akupitirirabe, koma kafukufuku waposachedwapa wapeza kuti pamene kuchuluka kwa TIR kumachepa, chiopsezo cha mavuto okhudzana ndi matenda a shuga chimawonjezeka .

Kafukufuku akusonyeza kuti kusinthasintha kwakukulu kwa shuga m'magazi (kotchedwa kusiyana kwa glycemic) kumatha kuwonjezera kupsinjika kwa okosijeni ndi kutupa m'thupi. Izi zitha kuwononga maselo . Kafukufuku wina wagwirizanitsa kusinthasintha kwakukulu kwa shuga ndi:

• Kuwonjezeka kwa chiopsezo cha shuga wotsika m'magazi (hypoglycemia).
• Kuwonjezeka kwa chiopsezo cha matenda a mtima.
• Kusokonezeka kwa ntchito ya ubongo.
• Kuchepa kwa moyo.

Kuphatikiza apo, kafukufuku wina adapeza kuti anthu omwe ali ndi matenda a shuga amtundu wachiwiri omwe anali ndi TIR yotsika komanso kusinthasintha kwakukulu kwa glycemic anali pachiwopsezo chachikulu cha retinopathy yokhudzana ndi matenda a shuga, vuto la matenda a shuga lomwe limakhudza maso . Kafukufuku wina adapeza kuti TIR yotsika imagwirizanitsidwa kwambiri ndi chiopsezo chachikulu cha matenda a mtima ndi mitsempha yamagazi, matenda amitsempha omwe amakhudza dongosolo la mtima .

Choncho, maphunzirowa akusonyeza kufunika kosunga TIR yanu mokweza momwe mungathere . Pamene ofufuza akuphunzira zambiri, akatswiri a matenda a shuga angasinthe zolinga za TIR izi mtsogolomu.

Kodi ndingawonjezere bwanji TIR yanga?

Chinsinsi chowongolera TIR yanu ndikupeza chomwe chikukhudza kuchuluka kwa shuga m'magazi anu . Izi zingatenge nthawi. Ndipotu, zitha kumveka ngati kuyesa kosatha kwa sayansi. Chifukwa chake, ndikofunikira kuyang'ana pa chinthu chimodzi nthawi imodzi ndikukhala okoma mtima kwa inu nokha . Musachite mantha, ndipo yesani kuzindikira zinthuzi pang'onopang'ono.

Ngati mukuona kuti kuchuluka kwa shuga m'magazi anu kukupitirira kukwera kapena kutsika nthawi zina za tsiku, yang'anani mosamala zizolowezi zanu ndi zochita zanu panthawiyo.

Mwachitsanzo, mungazindikire kuti kuchuluka kwa shuga m'magazi anu kumapitirira kukwera mutatha kudya kadzutsa. Pali zifukwa zingapo zomwe izi zingachitikire:

• Si nthawi yoyenera kumwa mankhwala anu a shuga (monga insulin ).
• Mlingo wosakwanira kapena wopitirira muyeso wa mankhwala.
• Kuchuluka kwa zakudya zomwe mumadya komanso michere yayikulu yomwe ili m'thupi (chakudya, mafuta, ndi mapuloteni) . Mwina mukudya chakudya chambiri chopatsa mphamvu.
• Mankhwala ena oti mumwe m'mawa (mankhwala ena amatha kukhudza kuchuluka kwa shuga m'magazi).
• Kumwa zakumwa zokhala ndi caffeine monga khofi m'mawa (izi zimakhudza anthu ena).

Ichi ndi chitsanzo chimodzi chokha. Matenda a shuga ndi vuto lovuta kwambiri . Pali njira zingapo zomwe zingakuthandizeni kukonza TIR yanu. Monga mwachizolowezi, mukaganizira zosintha dongosolo lanu loyang'anira, ndi bwino kugwira ntchito ndi katswiri wa matenda a shuga (monga katswiri wa endocrinologist) kapena katswiri wodziwa bwino za chisamaliro ndi maphunziro a matenda a shuga (CDCES) . Angakutsogolereni mu ndondomekoyi ndikuyankha mafunso anu.

Uthenga Wopita Nawo Kunyumba

Kotero, "Time in Range" (TIR) ​​​​iyi ndi njira yatsopano komanso yothandiza kwambiri kwa anthu odwala matenda ashuga kuti ayesere kasamalidwe ka shuga m'magazi awo. Kumvetsetsa zambiri za TIR ndi deta yanu ya shuga nthawi zina kumakhala kovuta. Musadandaule, mutha kuzolowera pang'onopang'ono.

Kumbukirani, dokotala wanu nthawi zonse amakhalapo kuti akuthandizeni kumvetsetsa TIR yanu ndikugwiritsa ntchito bwino. Pamodzi, mutha kutsatira momwe TIR yanu imasinthira pakapita nthawi ndikusintha njira zanu zoyendetsera matenda moyenerera. Kukhala ndi matenda a shuga ndi vuto, koma ndi zida zatsopano ngati izi, zitha kupangidwa kukhala zosavuta. Simuli nokha, ndipo pali anthu ambiri omwe angakuthandizeni paulendowu.

'Matenda a Shuga, Nthawi Yosiyanasiyana, TIR, Shuga, Mulingo wa Shuga M'magazi, CGM, A1C