"Igihe kiri mu cyiciro (TIR)" bivuze iki kuri mwe murwaye diyabete? Reka tubimenye neza!

Ese urwaye diyabete? Cyangwa hari umuntu wo mu muryango wawe cyangwa inshuti yawe urwaye diyabete? Noneho ushobora kuba warumvise, cyangwa wenda muganga wawe yavuze kuri iki kintu cyitwa 'Igihe mu buryo busanzwe'. Reka tubiganireho mu buryo bworoshye kandi busobanutse uyu munsi. Nubwo ibi ari bishya gato, ni ikintu gifasha cyane mu kurwanya diyabete.

Iyi "Time in Range" (TIR) ​​ni iki?

Mu magambo make, "Igihe mu cyiciro" (TIR) ​​​​ni igihe umuntu urwaye diyabete ashobora kugumana urugero rw'isukari mu maraso (glucose) mu cyiciro runaka . Tekereza muganga wawe akubwiye kugumisha urugero rw'isukari mu maraso yawe hagati y'uru rugero n'uru. Ibi bipima igihe umara muri urwo rugero.

Ku bantu benshi barwaye diyabete, haba abafite Diyabete yo mu bwoko bwa 1 n'abantu bakuru barwaye Diyabete yo mu bwoko bwa 2, iyi ngano y'ibipimo ikunze kuba hagati ya miligarama 70 na 180 kuri desilita imwe (mg/dL) . Ariko ibi si bimwe kuri buri wese, kandi bishobora gutandukana bitewe n'umuntu ku wundi. TIR ipimwa nk'ijanisha . Abaganga bakunze kuvuga ko ugomba kugerageza kugumisha TIR yawe hejuru ya 70% . Ibyo bivuze ko isukari yo mu maraso yawe igomba kuba iri muri iyo ngano nibura amasaha 17 mu masaha 24 ku munsi. Ni bwo ushobora gutekereza ko diyabete yawe igenzurwa neza.

Ni gute upima iyi TIR neza?

Uburyo bworoshye kandi bunoze bwo kumenya TIR yawe ni ugukoresha Continuous Glucose Monitor (CGM) . Ushobora kuba warigeze kumva iby'iki gikoresho mbere. Mu by'ukuri ni agakoresho gato gashobora kwambarwa gashyirwa munsi y'uruhu rw'ukuboko kwawe cyangwa mu nda yawe . Mu gihe ugifashe, gipima kandi kikandika urugero rwa glucose mu mazi ari munsi y'uruhu rwawe amasaha 24 ku munsi. Ni nk'umupolisi muto ushaka isukari yawe. Hanyuma ushobora gukuramo aya makuru ya glucose ukoresheje porogaramu ihujwe n'igikoresho cya CGM cyangwa porogaramu kuri terefone yawe hanyuma ugakurikirana TIR yawe.

Mu by’ukuri, ushobora kubona igitekerezo gifatika cya TIR yawe ukoresheje uburyo bwo gutobora urutoki . Ariko iyo ubikoze, ugomba kugenzura isukari yawe mu maraso inshuro nyinshi ku munsi . Nubwo bimeze bityo, ntabwo itanga amakuru arambuye nk'aya `CGM`. Tekereza nko kuzenguruka mu mpapuro z'igitabo. Ariko `CGM` ni nko gusoma igitabo cyose! Iguha ishusho yuzuye y'ingano y'isukari mu maraso yawe.

Kubera izi mashini za `CGM`, abantu benshi barwaye diyabete n'abaganga babo ubu bakoresha iyi TIR kugira ngo ibafashe mu kuvura diyabete yabo.Suzuma neza amakuru yawe ya TIR. Urebye amakuru yawe ya TIR, wowe na muganga wawe mushobora kwishyiriraho intego nshya no guhindura gahunda yanyu y'ubuvuzi.

Iyi raporo ya TIR isa ite?

Muri izi raporo za TIR, zikomoka kuri porogaramu zikoreshwa ku mashini za CGM, ingano zitandukanye z'isukari yawe zikunze kugaragara nk'umugozi uhagaze ufite ibara . Biroroshye cyane kubyumva.

• Igihe isukari yawe yari iri hagati y’ibipimo byayo kigaragara mu ibara ry’icyatsi kibisi . Ibi nibyo twese duharanira kunoza.
• Izindi ntera, bivuze igihe urugero rw'isukari ruri hasi cyangwa hejuru, zigaragara mu yandi mabara nk'umuhondo, umuhondo n'umutuku .

Dore uko izi ntera zigaragara kuri raporo isanzwe ya `CGM` (kuva hasi kugeza hejuru):

• Munsi ya 54 mg/dL (< 54 mg/dL) — Hasi cyane (munsi y’intego). Ibi bizagaragara nk'umutuku. Ibi bishobora kuba ibintu biteje akaga.
• Hagati ya 54 mg/dL na 69 mg/dL — Hasi (munsi y’intego). Ibi bishobora gusa n’umuhondo. Iki kandi ni ikintu cyo kwitabwaho.
• Hagati ya 70 mg/dL na 180 mg/dL — iri mu ntera. Ibyo nibyo biri mu ntera y'icyatsi kibisi . Twese turimo kugerageza gutuma iki gice cy'icyatsi kirushaho kuba kinini!
• Hagati ya 181 mg/dL na 250 mg/dL — hejuru (hejuru y’intego). Ibi bisa n'umuhondo.
• Irenga 250 mg/dL (> 250 mg/dL) — Hejuru cyane (hejuru y’intego). Ibi kandi bigaragara nk'ibara ry'umutuku. Ibi bikomeje, ntabwo ari byiza.

Ariko ibuka ko raporo zimwe na zimwe za CGM zishobora kugaragaza aya makuru mu buryo butandukanye. Niba ufite ikibazo cyo gusobanukirwa aya makuru, ni byiza kuvugana na muganga wawe . Bashobora kuyagusobanurira.

TIR yanjye igomba kuba angahe?

Niba urwaye diyabete, urugero rw'isukari mu maraso yawe ni rwo rudasanzwe kuri wewe . Ibyo bivuze ko urugero rw'isukari yawe rutari rumwe n'urwanjye. Wowe na muganga wawe muzahitamo hamwe urugero rw'isukari ikubereye n'ingano y'urwo rugero ugomba gukomezamo. Izi ntego zishobora guhinduka mu buzima bwawe bwose.

Hari ibintu byinshi bishobora kugira ingaruka ku ntego za glucose:

• Umaze igihe kingana iki urwaye diyabete ?
• Imyaka yawe n'ubuzima bwawe muri rusange .
• Ufite izindi ndwara zigira ingaruka ku rugero rw'isukari mu maraso yawe, nko kudakora neza kw'impyiko cyangwa indwara ya gastroparesis .
• Niba ufite indwara z'umutima n'imitsi .
• Indwara aho utazi ibimenyetso by'isukari nke mu maraso (hypoglycemia yo kutamenya)Niba ihari. Ni ukuvuga ko niba utumvise isereri n'ibyuya nk'uko wumva iyo urugero rw'isukari yawe rugabanutse, biba ari akaga gato.
• Niba utwite cyangwa ugerageza gusama , intego zawe zirahinduka cyane muri ibi bihe.

Noneho reka turebe inama rusange zikunze gutangwa.

Intego za TIR ku bantu bakuru benshi barwaye diyabete yo mu bwoko bwa 1 cyangwa ubwoko bwa 2:

• Nibura 70% by'igihe kiri hagati ya 70 na 180 mg/dL (muri gahunda yagenwe).
• Igihe kiri munsi ya 54 mg/dL kigomba kuba kiri munsi ya 1%.
• Igihe kiri hagati ya 54 na 69 mg/dL kigomba kuba kiri munsi ya 4%.
• Igihe kiri hagati ya 181 na 250 mg/dL kigomba kuba kiri munsi ya 25%.
• Igihe kirenze 250 mg/dL kigomba kuba kiri munsi ya 5%.

Intego ya TIR ku bantu bafite ibyago byinshi byo kugabanuka kw'isukari mu maraso (hypoglycemia):

Ibi ni iby'abantu bakunze kugira isukari nke mu maraso.

• Nibura 50% by'igihe kiri hagati ya 70 na 180 mg/dL (muri rusange).
• Igihe gikoreshwa kiri munsi ya 70 mg/dL kigomba kuba kiri munsi ya 1%.
• Igihe kirenze 250 mg/dL kigomba kuba kiri munsi ya 10%.

Intego za TIR ku bantu bakuru barwaye diyabete yo mu bwoko bwa 1 mu gihe batwite:

Ibi ni ingenzi cyane, kuko bishobora kugira ingaruka ku mwana.

• Nibura 70% by'igihe, ni hagati ya 63 na 140 mg/dL (mu rugero rusanzwe). Urugero ruri hano ruratandukanye gato, urabona? Ni ngombwa cyane kugenzura urugero rw'isukari yawe mu gihe utwite.
• Igihe kiri munsi ya 63 mg/dL kigomba kuba kiri munsi ya 4%.
• Igihe kirenze 140 mg/dL kigomba kuba kiri munsi ya 25%.

Amabwiriza ya diyabete yo mu gihe cyo gutwita na diyabete yo mu bwoko bwa 2 mu gihe cyo gutwita ashobora kuba atandukanye. Na none, aya ni amabwiriza rusange. Ni ngombwa kuganira na muganga wawe ku ntego z'isukari zigufasha cyane kandi zishoboka. Bazakugira inama ku buryo bwiza bwo gukemura ikibazo cyawe.

Ni iyihe sano iri hagati y'iyi TIR na A1C?

Ushobora kuba warumvise iby'iki kizamini cya A1C . Abaganga benshi bagikoresha kugira ngo barebe uburyo diyabete yawe igenzurwa neza. None se, TIR na A1C ni kimwe? Yego, gato.

TIR ipima urugero rw'isukari yawe mu gihe runaka, kuva ku masaha make kugeza ku minsi mike, mu gihe wambaye CGM. Ni nk'ifoto y'igihe gito . Urashobora kubona neza uko isukari yawe ihinduka umunsi ku wundi.

Ariko, A1C ni ikizamini cy'amaraso gikorerwa muri laboratwari . Gipima impuzandengo y'isukari yawe mu byumweru 8 kugeza kuri 12 bishize . Ikizamini cya A1C ntigishobora kukubwira uburyo isukari yawe mu maraso ihindagurika. Gitanga gusa agaciro mpuzandengo.

Mu magambo make:

Tekereza kuri ubu buryo: A1C ni nko gusoma incamake y'ibice by'igitabo.Ariko gukoresha `CGM` no kureba TIR ni nko gusoma igice cyose . Hanyuma urushaho gusobanukirwa neza . Urabyumva? TIR igaragaza neza uko isukari yitwara mu bihe bitandukanye by'umunsi, nyuma yo kurya, nyuma yo gukora imyitozo ngororamubiri.

Kuva mu myaka ya 1960, abaganga n'abarwayi ba diyabete bishingikirizaga cyane cyane kuri A1C kugira ngo barebe uko ubuvuzi bwa diyabete buhagaze. Ariko, kuva aho habereye imashini za CGM, abaganga n'abarwayi babonye ko iyi TIR itanga ishusho y'ingirakamaro kandi nyayo y'imicungire ya diyabete .

Cyane cyane ku bantu barwaye Diyabete yo mu bwoko bwa 1 , igipimo cy'isukari mu maraso gishobora guhinduka cyane mu minsi, ibyumweru, n'amezi. Kubwibyo, igipimo mpuzandengo cya A1C si cyo gipimo nyacyo cy'uburyo ikoreshwa.

Urugero, tekereza kuri ibi bikurikira:

Hari umuntu ufite isukari mu maraso ihora igabanuka cyane kandi ikongera ikazamuka cyane. Ariko A1C ye ishobora kuba iri kuri 7%.

Hari undi muntu ufite igipimo cy'isukari mu maraso kidahinduka cyane, kingana na 154 mg/dL. A1C ye ishobora no kuba iri kuri 7%.

Urabona? Nubwo A1C yabo ari imwe, agaciro ka TIR kabo gashobora gutandukana cyane. TIR y'umuntu wa mbere iri hasi kuko ahora hanze y'urwego rw'intego. Aba afite ibyago byinshi byo kurwara hypoglycemia.

Nanone, ikizamini cya A1C gishobora kuba kidahuje n'ukuri ku bantu bafite indwara zikurikira:

• Anemia (kubura amaraso).
• Ubwoko bwa hemoglobine.
• Kubura icyuma.
• Gutwita.
• Indwara y'umwijima.

Ubunyangamugayo bw'agaciro ka A1C bushobora kandi gutandukana hagati y'abantu batandukanye.

Ariko, uko ibintu bimeze ubu, kuza kwa TIR ntibivuze ko ibizamini bya A1C bitazaba bigikoreshwa . Ubushakashatsi bumaze imyaka myinshi bwagaragaje ko urugero rwa A1C rushobora guhanura iterambere cyangwa gukumira ibibazo bya diyabete. Kubwibyo, abaganga barimo guhuza ibizamini bya TIR na A1C kugira ngo babone ishusho yuzuye y'imicungire y'isukari.

Kuki iyi TIR ari ingenzi cyane?

TIR iguha ishusho nyayo y’ihindagurika ry’isukari mu mubiri riterwa na diyabete. Tekereza ku bintu byinshi bigira ingaruka ku rugero rw’isukari yawe, nko kurya, imyitozo ngororamubiri ukora, imiti ufata, n’urwego rw’imihangayiko yawe ! Rero, kureba amakuru ya TIR yawe (cyane cyane iyo ukoresha `CGM`) bishobora kuguha gusobanukirwa neza uburyo ibi bintu bitandukanye bigira ingaruka ku rugero rw’isukari yawe .

Urugero, ushobora kubona ko TIR yawe yagabanutse iyo ufite umuriro mu gihe cy'icyumweru. Cyangwa, ushobora kubona ko isukari mu maraso yawe yiyongereye cyane nyuma yo kurya ibiryo runaka, kandi TIR yawe yagabanutse. Iyo ubonye ikintu nk'icyo, ushobora kubaza muganga wawe uti 'Nigute nakwitegura neza kugenzura diyabete yanjye ubutaha nzongera kurwara?' Cyangwa, ushobora kwibaza uti 'Ubwo bwoko bw'ibiryo bungiraho izihe ngaruka, kandi se nkwiye guhindura uburyo mbirya?' Mu yandi magambo, TIR ishobora kuba ubufasha bukomeye mu gucunga diyabete yawe mu buryo bujyanye n'imibereho yawe .

Ese ibibazo bya diyabete bishobora kubaho TIR iramutse igabanutse?

Ubushakashatsi kuri ibi buracyakomeje, ariko ubushakashatsi buriho bwagaragaje ko uko urugero rwa TIR rugabanuka, ibyago byo kurwara indwara ziterwa na diyabete byiyongera .

Ubushakashatsi bwerekana ko ihindagurika rikomeye ry’isukari mu maraso (ryitwa ihindagurika rya glycemic) rishobora kongera stress ya oxidative no kubyimba mu mubiri. Izi ndwara zishobora kwangiza uturemangingo . Hari ubushakashatsi bwahuje iri hindagurika rikomeye rya glucose na:

• Ingaruka zo kugabanuka kw'isukari mu maraso (hypoglycemia).
• Ingaruka zo kurwara indwara z'umutima n'imitsi ziyongera.
• Kudakora neza kw'imikorere y'ubwonko.
• Kugabanuka k'ubuzima.

Byongeye kandi, ubushakashatsi bumwe bwagaragaje ko abantu barwaye diyabete yo mu bwoko bwa 2 bari bafite TIR nkeya kandi bafite ubwinshi bw'ibinure mu mubiri (glycemic variability) bari bafite ibyago byinshi byo kurwara retinopathy iterwa na diyabete, ikibazo cya diyabete gikora ku maso . Ubundi bushakashatsi bwagaragaje ko TIR nkeya ifitanye isano rikomeye n'ibyago byinshi byo kurwara indwara z'umutima n'imitsi, indwara y'imitsi igira ingaruka ku mikorere y'umutima n'imitsi .

Rero, ubu bushakashatsi bwerekana akamaro ko gukomeza TIR yawe hejuru uko bishoboka kose . Uko abashakashatsi bamenya byinshi, impuguke mu bya diyabete zishobora guhindura izi ntego za TIR mu gihe kizaza.

Nigute nakongera TIR yanjye?

Icy'ingenzi cyo kunoza TIR yawe ni ukumenya neza icyagize ingaruka ku rugero rwa glucose mu mubiri wawe . Ibi bishobora gufata igihe. Mu by'ukuri, bishobora kumera nk'igerageza rya siyansi rihoraho. Rero, ni ngombwa kwibanda ku kintu kimwe kimwe no kwigirira neza . Ntugatinye, kandi gerageza kubisobanukirwa buhoro buhoro.

Niba ubonye ko urugero rw'isukari mu mubiri wawe rukomeza kwiyongera cyangwa kugabanuka mu bihe runaka by'umunsi, suzuma neza ingeso zawe n'ibikorwa byawe muri icyo gihe.

Urugero, ushobora kubona ko urugero rw'isukari mu mubiri wawe rukomeza kwiyongera nyuma ya saa sita. Hari impamvu nyinshi zishobora gutuma ibi bibaho:

• Ntabwo ari igihe gikwiye cyo gufata imiti yawe ya diyabete (urugero: insuline ).
• Ingano y'imiti idahagije cyangwa irenze urugero.
• Ingano y'ibiribwa urya n'intungamubiri z'ingenzi zirimo (karubohidrati, ibinure na poroteyine) . Ushobora kuba urya karubohidrati nyinshi cyane.
• Indi miti yo gufata mu gitondo (imiti imwe ishobora kugira ingaruka ku rugero rw'isukari mu maraso).
• Kunywa ibinyobwa birimo kafeyine nka kawa mu gitondo (ibi bigira ingaruka kuri bamwe).

Uru ni urugero rumwe gusa. Diyabete ni indwara igoye cyane . Hari ingamba nyinshi zishobora kugufasha kunoza TIR yawe. Nkuko bisanzwe, iyo urimo gutekereza guhindura gahunda yawe yo kuyicunga, ni byiza gukorana n'inzobere mu ndwara ya diyabete (urugero: inzobere mu by'indwara z'imitsi) cyangwa inzobere mu kwita ku ndwara ya diyabete (CDCES) . Bashobora kugufasha muri iyo nzira no gusubiza ibibazo byawe.

Ubutumwa bwo kujyana mu rugo

Rero, ubu buryo "Igihe mu Gipimo" (TIR) ​​​​ni uburyo bushya kandi bufite akamaro cyane ku bantu barwaye diyabete bwo gupima imicungire y'isukari yabo. Gusobanukirwa amakuru ya TIR n'amakuru ya sukari yawe rimwe na rimwe bishobora kugorana gato. Ntugahangayike, ushobora kumenyera buhoro buhoro.

Wibuke ko muganga wawe ahora ahari kugira ngo agufashe gusobanukirwa TIR yawe no kuyikoresha neza. Muri kumwe, mushobora gukurikirana uburyo TIR yawe ihinduka uko igihe kigenda gihita no guhindura ingamba zo kuyicunga uko bikwiye. Kubana na diyabete ni ikibazo, ariko hamwe n'ibikoresho bishya nk'ibi, bishobora koroshywa gato. Ntabwo uri wenyine, kandi hari abantu benshi bashobora kugufasha muri uru rugendo.

"Diyabete, Igihe mu gihe runaka, TIR, Glucose, Urugero rw'isukari mu maraso, CGM, A1C