Ni iki gipimo cya A1C kikubwira urugero rw'isukari mu maraso yawe? Reka tubiganireho!

Ushobora kuba warumvise abaganga bavuga bati: "Ugomba gupimwa A1C." Cyangwa niba hari umuntu wo mu muryango wawe urwaye diyabete, ushobora kuba warumvise iby'iki kizamini cya A1C. Iki kizamini cya A1C ni iki? Ni iki twakwigiraho? Uyu munsi, turaganira kuri iki kizamini cya A1C mu buryo bworoshye ushobora gusobanukirwa.

Ikizamini cya A1C ni iki?

Muri make, ikizamini cya A1C ni ikizamini gipima urugero rw'isukari mu maraso yawe, cyangwa "Glucose", mu mezi atatu ashize. Ibisubizo bitangwa nk'ijanisha. Uko ijanisha riri hejuru, niko urugero rw'isukari mu maraso yawe rurushaho kuba rwinshi.

Abaganga bakoresha ikizamini cya A1C kubera impamvu nyinshi z'ingenzi:

• Menya intambwe mbere y'uko diyabete itangira (`(Prediabete)`). Ni ukuvuga intambwe yegereye iyo diyabete itangiye kurwara.
• Menya neza niba urwaye diyabete yo mu bwoko bwa 2.
• Niba urwaye diyabete yo mu bwoko bwa 2 cyangwa diyabete yo mu bwoko bwa 1, ni ngombwa gusobanukirwa uburyo gahunda yawe yo kuvura ikora. Urwego rwawe rwa A1C rushobora kugufasha wowe na muganga wawe gufata icyemezo niba ukeneye guhindura gahunda yawe yo kuvura.

Ikizamini cya A1C gikorwa gite?

Abaganga bapima A1C mu buryo bubiri:

• Akenshi, amaraso make akurwa mu mitsi yo mu bwonko akoherezwa muri laboratwari kugira ngo apimwe. Ubu buryo ni bwo bukunze gukoreshwa cyane. Ubu buryo bwitwa "Phlebotomist" gukurura amaraso.
• Ubundi buryo ni ugufata igitonyanga cy'amaraso mu rutoki rwawe ukagipima. Ibi bishobora kuguha ibisubizo mu minota mike. Ariko, ubu buryo bukoreshwa gusa kugira ngo urebe uko ubuvuzi bwawe buhagaze, kandi ntibukoreshwa mu gusuzuma indwara nshya.

Ikizamini gikoresha umutsi ubusanzwe kiba cyiza kurusha ikizamini cyo gutobora urutoki.

Ni ayahe mazina yandi akoreshwa mu kizamini cya A1C?

Iki kizamini cya A1C cyitwa andi mazina menshi. Ushobora kandi kumva aya mazina:

• Hemoglobini A1C `(Hemoglobini A1C)`
• HbA1c `(HbA1c)`
• Hemoglobine ifite glycated
• Ikizamini cya Glycohemoglobin `(Ikizamini cya Glycohemoglobin)`

Isukari yo mu maraso (Glucose) ni iki?

Imibiri yacu ibona iyi '(Glucose)' cyangwa isukari ahanini iva muri karubohidrati mu biribwa turya. Iyi ni yo soko nyamukuru y'ingufu ku turemangingo tw'umubiri wacu. Amaraso yacu ajyana iyi '(Glucose)' mu turemangingo twose tw'umubiri.

Imikorere myinshi mu mibiri yacu ifasha mu kugumana urugero rw'isukari mu maraso mu rugero runaka. Uruhare runini muri ibi rukorwa n'imisemburo ``Insulin``, ikorwa na pancreas yacu.

Niba igipimo cy'isukari mu maraso yawe gihora kiri hejuru (hyperglycemia), bivuze ko A1C yawe nayo iri hejuru, akenshi bivuze ko urwaye diyabete. Diyabete ibaho iyo pancreas idakora insuline ihagije, cyangwa iyo ingano ya insuline ikora idahagije, cyangwa iyo umubiri udashobora gukoresha insuline neza.

Ni ryari nkeneye ikizamini cya A1C?

Niba urwaye diyabete, ugomba kwipimisha A1C nibura kabiri mu mwaka kugira ngo urebe uburyo gahunda yawe yo kuvura ikora. Muganga wawe azakubwira neza inshuro ugomba kubikorera.

Niba utarafatwa na diyabete, ariko ukaba ufite ibimenyetso bikurikira, muganga ashobora gutegeka ko upimwa A1C:

• Inyota ikabije idashira (`(Polydipsia)`)
• Kwihagarika cyane
• Kureba nabi
• Kumva unaniwe igihe cyose (`(Umunaniro)`)

Ushobora kandi gupimwa A1C kugira ngo urebe niba ufite ibyago byo kurwara diyabete yo mu bwoko bwa 2. Ibintu bishobora gutera ibyago birimo:

• Kugira umuntu wo mu muryango urwaye diyabete yo mu bwoko bwa 2.
• Niba warigeze kugira diyabete yo mu gihe cyo gutwita.
• Umubyibuho ukabije.
• Kutagira imyitozo ngororamubiri cyangwa gukora imyitozo ngororamubiri.
• Kuba afite imyaka irenga 35.

Ni gute A1C ibarwa?

Ikizamini cya A1C gishingiye ku kintu cyitwa hemoglobin . Hemoglobini ni igice cy’uturemangingo dutukura tw’amaraso dutwara umwuka wa ogisijeni mu mubiri wose. Iyo hari glucose mu maraso yawe, ifatana na hemoglobine. Ibi byitwa glycation . Uko glucose iba nyinshi mu maraso yawe, niko iyi glucose yiyongera. Kandi, iyi glukome ishobora kumara amezi agera kuri atatu - ni ukuvuga igihe ikigereranyo cy’ubuzima bw’uturemangingo dutukura tw’amaraso.

Ikizamini cya A1C gipima ingano mpuzandengo ya glucose ifatana na hemoglobine uko igihe kigenda gihita. Kubera ko gipima urugero rw'isukari mu maraso uko igihe kigenda gihita, ikizamini cya A1C gishobora kutubwira byinshi ku buzima bwawe kuruta ikizamini kimwe cy'isukari mu maraso.

Ese ngomba kwiyiriza ubusa mbere yo kwipimisha A1C?

Oya. Ntabwo ari ngombwa kwiyiriza ubusa mbere yo gukora ikizamini cya A1C.

Bigenda bite iyo ukoze ikizamini cya A1C?

Dore icyo ushobora kwitega mu isuzuma rya A1C, rikubiyemo gufata amaraso mu mitsi:

• Mu gihe wicaye ku ntebe, umuganga w’indwara z’imitsi (phlebotomist) azashaka umutsi wo mu kuboko kwawe woroshye gukuramo amaraso. Akenshi, amaraso akurwa imbere mu kuboko kwawe, inyuma gato y’inkokora yawe.
• Iyo umutsi ubonetse, aho hantu hasukurwa kandi hagashyirwa imiti yica udukoko.
• Hanyuma urushinge ruto rushyirwa mu mutsi hanyuma hagafatwa ikizamini cy'amaraso. Ibi bishobora kumvikana nk'aho umuntu ashongeshejwe gato.
• Nyuma yo gushyiramo urushinge, amaraso make akusanywa mu muyoboro w'igerageza.
• Iyo amaraso ahagije amaze gukusanywa kugira ngo hakorwe ikizamini, urushinge rurakurwaho maze amaraso agahagarara hakoreshejwe ipamba cyangwa agatambaro k'ipamba.
• Amaherezo, shyira plaster aho ngaho hanyuma urarangije.

Mu gihe cyo gupima A1C, bikozwe hakoreshejwe amaraso mu rutoki, ibi bikurikira bibaho:

• Muganga akubajije urutoki ugomba gukuramo amaraso.
• Urutoki rwawe ruzahanagurwa n'inzoga kandi agatonyanga gato kazakorwa n'urushinge ruto rwitwa "Lancet" (ibi akenshi biba mu gikoresho gito cya pulasitiki).
• Bazagukanda urutoki, bakuremo igitonyanga cy'amaraso, hanyuma bakikusanyirize mu gakoresho gato ka pulasitiki.
• Nyuma yo gupimwa amaraso ahagije, uzahabwa agace k'ipamba cyangwa agatambaro ko gufata ku rutoki rwawe kugira ngo amaraso ahagarike.
• Ibisubizo bishobora kuboneka mu minota mike.

Ese hari ingaruka zishobora guterwa n'ikizamini cya A1C?

Gupima amaraso ni igice gisanzwe kandi cy’ingenzi mu gupima kwa muganga. Ingaruka zo gupima ubwoko bwombi bwa A1C ni nke cyane. Ushobora kugira ibisebe cyangwa ububabare aho amaraso akurwa cyangwa aho urutoki rwawe rukubiswe, ariko ibi bizakira vuba.

Agaciro kanjye ka A1C kavuze iki?

Ibisubizo by'ikizamini cya A1C bitangwa nk'ijanisha. Uyu mubare ukwereka ingano ya poroteyine ya hemoglobine irimo glycated, bivuze ko ifatanye na glucose. Uko ijanisha riri hejuru, niko isukari yo mu maraso yawe yiyongera mu mezi make ashize.

Igipimo cya A1C cyo gusuzuma indwara ni iki gikurikira:

• Iyo iri munsi ya 5.7%, bivuze ko udafite diyabete. (Urwego ruzima)
• Iyo iri hagati ya 5.7% na 6.4%, ifatwa nk'iy'isukari itaratangira. Ibyo bivuze ko diyabete iri hafi kuzamuka.
• Igipimo cya 6.5% cyangwa hejuru y’aho gikunze kugaragaza diyabete yo mu bwoko bwa 2 (`(Diyabete yo mu bwoko bwa 2)`) cyangwa diyabete yo mu bwoko bwa 1 (`(Diyabete yo mu bwoko bwa 1)`).

Niba usanzwe urwaye diyabete, ibisubizo byawe bya A1C bigaragaza uburyo gahunda yawe yo kuvura yagenze neza mu mezi atatu ashize. Ubu buvuzi bushobora kuba burimo ibinini, inshinge za insuline, gupimwa isukari mu maraso kenshi, no guhindura imibereho (nk'imirire n'imyitozo ngororamubiri). Hashingiwe ku gaciro ka A1C yawe, wowe na muganga wawe mushobora guhitamo niba hari impinduka zikenewe ku gahunda yawe yo kuvura.

Ikintu cy'ingenzi ugomba kwibuka ni uko A1C yawe (niba urwaye diyabete) ari impuzandengo y'isukari mu maraso yawe mu mezi make. Ntabwo ari ikimenyetso cy'ubuzima bwawe cyangwa icyemezo cya nyuma cyo kumenya niba ubayeho ubuzima bwiza. Wibuke ko A1C yawe ishobora guhinduka mu buzima bwawe bwose, kandi hari ibintu ushobora gukora kugira ngo ucunge diyabete yawe kandi wongere urugero rwa A1C yawe, nibiba ngombwa.

A1C na glucose isanzwe igereranyijwe (eAG) ni iki?

Laboratwari zimwe na zimwe zitanga ibisubizo bya A1C nk'ijanisha, kandi ibijyanye na byoIgipimo cy’impuzandengo ya glucose (eAG) nacyo cyatanzwe.

Ibarura rya `(eAG)` rihindura ijanisha rya A1C mu bipimo bimwe (miligarama kuri desilita - mg/dL cyangwa milimoles kuri litiro - mmol/L) ukoresha mu gipimo cy’isukari yo mu rugo. Nk’uko A1C yawe ari impuzandengo, `(eAG)` ni agaciro kamwe kerekana impuzandengo y’isukari yo mu maraso yawe mu mezi atatu ashize.

Urugero, A1C ya 7% ingana na `(eAG)` 154 mg/dL (8.6 mmol/L). A1C ya 9% ingana na `(eAG)` 212 mg/dL (11.8 mmol/L).

Igipimo gisanzwe cya A1C ni iki?

Ku muntu udafite diyabete, igipimo gisanzwe cya A1C kiri munsi ya 5.7%.

Igifatwa nk' "ibisanzwe" kandi gifite ubuzima bwiza ku bantu barwaye diyabete biterwa n'intego zawe n'uburyo ubona imiti n'ibikoresho byo kuvura diyabete. Wowe na muganga wawe muzakorana kugira ngo mumenye urugero rw'indwara ya A1C wifuza. Ibi bishobora guhinduka mu buzima bwawe bwose.

Muri rusange, Ishyirahamwe ry’Abanyamerika rishinzwe diyabete risaba ko abantu bakuru benshi barwaye diyabete bihatira kugira A1C ya 7% cyangwa munsi yayo .

Intego yawe ya A1C ishobora kuba iri hejuru ya 7% muri ibi bihe:

• Niba igihe cyo kubaho ari gito.
• Niba ukunze kugira ibihe by'isukari nke cyane mu maraso (`(Hypoglycemia)`) cyangwa utazi ibyo bihe (`(Hypoglycemia utazi)`).
• Niba ufite ingorane zikomeye ziterwa na diyabete (nk'indwara idakira y'impyiko, kwangirika kw'imitsi, cyangwa indwara z'umutima n'imitsi).

Ku rundi ruhande, ku bagore barwaye diyabete yo mu bwoko bwa 1 mu gihe batwite, abaganga muri rusange basaba ko urugero rwa A1C ruguma kuri 6.5% cyangwa munsi yarwo mu gihe cyose batwite. Ibi bikorwa kugira ngo bigabanye ibyago by'ubuzima ku mwana uri mu nda no gukumira gukura cyane kw'umwana uri mu nda (fetal macrosomia).

Ni ikihe gipimo cy’akaga cya A1C?

Uko urugero rwawe rwa A1C rwiyongera, cyane cyane iyo rumaze imyaka myinshi ruri hejuru, ushobora kugira ibibazo nk'ibi bikurikira:

• Indwara z'amaso (`(Retinopathy)`)
• Ibibazo by'impyiko (`(Nephropathy)`)
• Ubumenyi bw'imitsi
• Kudakora neza kw'igifu (Gastroparesis)
• Indwara z'umutima
• Igisebe cy'imitsi

Ubushakashatsi bwagaragaje ko abantu barwaye diyabete bashobora kugabanya ibyago byo kurwara diyabete bagakomeza kugira urugero rwa A1C ruri munsi ya 7% .

Ariko ibuka ko hari izindi mpamvu, nk'ibintu bigize imiterere y'umubiri n'igihe umaze urwaye diyabete, nabyo bishobora kugira ingaruka ku iterambere ry'ibibazo bya diyabete.

Ese koko ikizamini cya A1C ni cyo gikwiye?

Hari ibintu bimwe na bimwe bishobora kugira ingaruka ku buryo ibizamini bya A1C bihagaze neza, harimo:

• Urugero, ibintu bitera imiterere y'uturemangingo (genetic factors), ni ukuvuga ubwoko bwa hemoglobine
• Izindi ndwara
• Imiti imwe n'imwe n'inyongeramusaruro mu mirire
• Amakosa mu gihe cyo gukusanya, gutwara, cyangwa gutunganya ingero kugira ngo zipimwe

Ibi bintu bishobora gutuma umusaruro wawe uba `uri hasi cyane` cyangwa `uri hejuru cyane`. Ibyinshi muri ibi bintu biterwa n'ihindagurika ry'ubuzima n'ubuzima bw'uturemangingo tw'amaraso yawe.

Impinduka za Hemoglobini n'ibisubizo bya A1C

Ubwoko bwa hemoglobine bushobora kugira ingaruka ku bisubizo bya bimwe mu bipimo bya A1C.

Ubwoko bwa hemoglobine mu maraso yawe buterwa n'ibyo uvukana mu turemangingo twawe. Hari ubwoko butandukanye. Ikunze kugaragara cyane ni hemoglobine A. Ubundi bwoko bwa hemoglobine butakunze kugaragara bwitwa hemoglobin variants.

Kugira hemoglobine isanzwe ntabwo byongera ibyago byo kurwara diyabete, ariko bishobora kugira ingaruka ku bisubizo bya A1C. Laboratwari zifite uburyo butandukanye bwo gupima A1C ku maraso hakoreshejwe hemoglobine isanzwe.

Amwe mu moko akunze kugaragara cyane ni:

• Ikiranga Hemoglobine C : Ibi bikunze kugaragara cyane mu bantu b'abirabura, abantu bakomoka muri Afurika y'Iburengerazuba, n'abantu bakomoka muri Amerika y'Amajyepfo n'iyo Hagati, muri Karayibe, no mu Burayi.
• Ikiranga Hemoglobini D : Ibi bikunze kugaragara mu bantu batuye mu Bushinwa, mu Buhinde, muri Turukiya, muri Burezili, no mu bice bimwe na bimwe by'i Burayi.
• Ikiranga Hemoglobine E : Ibi bikunze kugaragara mu Banyamerika bo muri Aziya, cyane cyane abakomoka muri Aziya y'Amajyepfo y'Uburasirazuba.
• Ikiranga Hemoglobine S : Ibi bikunze kugaragara cyane mu birabura n'Abanyamerika b'Abanyamerika bakomoka muri Hisipaniya.

Gupima amaraso bishobora kugaragaza ubwoko bwa hemoglobine. Niba utekereza ko ushobora kuba ufite ubwoko bwa hemoglobine bushobora kugira ingaruka ku bisubizo bya A1C, vugana na muganga wawe.

Impamvu zishobora gutuma A1C yawe iba iri hasi ugereranyije n'uko iri mu by'ukuri

Izi ngingo n'ibihe bishobora gutuma ibisubizo bya A1C byawe biba hasi ugereranije n'urugero rwawe nyakuri:

• Kunywa inzoga nyinshi (`(Indwara yo kunywa inzoga)`)
• Gutera amaraso
• Kunanirwa kw'impyiko mu buryo buhoraho (`(Kunanirwa kw'impyiko mu buryo buhoraho)`)
• Ibikoresho bitera imbaraga za erythropoietin (ESAs)
• Kuva amaraso menshi (`(Kuva amaraso menshi)`)
• Kuba ahantu hirengeye cyane
• Gufata inyunganiramirire y'icyuma
• Kurwara indwara y'umwijima (`(Kurwara indwara y'umwijima)`)
• Gutwita
• Anemia y'urusenda rw'umutsima (`(Anemia y'urusenda rw'umutsima)`)
• Kugabanuka kwa hemolisiyosi na hemolisiyosi (`(Spherosiyosi na hemolisiyosi)`)

Impamvu zishobora gutuma agaciro ka A1C kaba kari hejuru kurusha uko kari mu by'ukuri

Izi ngingo n'ibihe bishobora gutuma ibisubizo byawe bya A1C bizamuka kurusha uko biri mu by'ukuri:

• Anemia, urugero nk'indwara yo kubura icyuma, anemia iterwa n'ubwandu, cyangwa anemia iterwa na kanseri.
• Imiti imwe n'imwe, nk'imiti igabanya ubukana bw'umubiri n'imiti igabanya ubukana bw'umubiri.
• Ubwiyongere bwa triglycerides mu maraso (`(Hypertriglyceridemia)`)
• Gutera ingingo z'umubiri
• Thalassemia (`(Thalassemia)`)
• Kubura Vitamine B12 (`(Kubura Vitamine B12)`)

Ese diyabete ishobora gukira nubwo urugero rwa A1C rwaba ruri hejuru?

Yego, urashobora. Kuba ufite A1C iri hejuru (irenga 6.5%) ntibivuze ko urwaye diyabete. Imiti imwe, nka steroide, cyangwa izindi mpamvu, nk'uburwayi, ishobora kongera by'agateganyo urugero rw'isukari mu maraso yawe. Izindi ndwara, nko kubura amaraso, zishobora gutuma ibisubizo bya A1C byawe bigaragara ko biri hejuru kuruta uko biri mu by'ukuri. Hari kandi amahirwe ko ikizamini gishobora kuba kitari cyo.

Abaganga bakoresha ibizamini birenze kimwe kugira ngo bamenye diyabete. Urugero, ushobora gusabwa gukora ikizamini cya glucose mu maraso cyangwa ikizamini cya A1C. Ariko, muganga wawe azasuzuma neza ibyavuye mu bisubizo byawe kandi akabiganiraho nawe.

Ese A1C ikubwira neza ibijyanye no kuvura diyabete?

Mu myaka ibarirwa muri za mirongo, abaganga n'abantu barwaye diyabete bakoresheje ikizamini cya A1C cyane cyane kugira ngo bapime uburyo ubuvuzi bwabo bukora.

Ariko, cyane cyane ku bantu barwaye diyabete yo mu bwoko bwa 1, igipimo cy'isukari mu maraso gishobora guhinduka cyane mu minsi, ibyumweru, n'amezi. Bityo, A1C ishingiye ku gipimo kandi ntabwo buri gihe itanga ishusho nyayo y'uburyo bwo kuyicunga.

Tekereza kuri uru rugero: Igipimo cy'isukari mu maraso y'umuntu gishobora kuba kiri hasi cyane kandi kiri hejuru cyane, ariko A1C ye ishobora kuba 7%. Igipimo cy'isukari mu maraso y'undi muntu gishobora kuba kiri hafi ya 154 mg/dL, naho A1C ye nayo ikaba 7%.

Vuba aha, hamwe n'ibikoresho byo kugenzura isukari mu buryo buhoraho (CGM) , abaganga n'abantu barwaye diyabete basanze Time in Range (TIR) ​​​​itanga ishusho y'ingirakamaro kandi nyayo y'imicungire ya diyabete.

TIR ni igihe isukari yawe mu maraso yawe iba iri mu rugero rwagenwe. TIR ipimwa nk'ijanisha. Ingano y'isukari mu maraso ishobora gutandukana bitewe n'umuntu, ariko ingano isanzwe ni hagati ya 70 na 180 mg/dL. Ku bantu bakuru benshi barwaye diyabete yo mu bwoko bwa 1 cyangwa ubwoko bwa 2, abaganga babagira inama yo kugerageza kugumisha TIR iri hejuru ya 70% (hafi amasaha 17 mu masaha 24 y'umunsi).

Hamwe na `(CGM)` na `(TIR)`, abaganga n'abantu barwaye diyabete bashobora kubona inshuro isukari yabo mu maraso iba iri hejuru cyangwa iri hasi. Ibi bibafasha guhindura uburyo bwabo bwo kuvura neza.

Amaherezo, ugomba kuvuga...

Bishobora gutera urujijo iyo ibisubizo byawe bya A1C bitameze nk'uko byari byitezwe cyangwa birengeje uko byari byitezwe. Ariko ibuka ko A1C iri hejuru atari ngombwa ko bivuze ko urwaye diyabete. Hari ibintu byinshi bishobora gutuma ibisubizo bitaba ari byo. Muganga wawe azakubwira niba ukeneye gupimwa byinshi. Ntutinye kubaza muganga wawe ibibazo. Barahari kugira ngo bagufashe.

Niba urwaye diyabete, ni ngombwa kwibuka ko A1C yawe ari impuzandengo y'igihe gito y'urugero rw'isukari mu maraso yawe. Hari ibintu ushobora gukora kugira ngo wongere urugero rwawe rwa A1C. Niba wumva uremerewe no kuvura diyabete yawe, vugana na muganga wawe. Muri kumwe, mushobora gushyiraho gahunda yo kuvura diyabete yawe no kugera ku ntego zawe za A1C.

A1C , HbA1c, diyabete, isukari yo mu maraso, isukari y'isukari, hemoglobine, ikizamini cya diyabete