Semunhu ane chirwere cheshuga, unofunga zvakadini nezvehuwandu hweshuga muropa rako mukati mezuva? Vari sei mangwanani, vari sei mushure mekudya kwemasikati, vari sei vasati varara, nezvimwewo. Chimwe chezvinhu zvaunonzwa kakawanda paunenge uchitaura nachiremba wako izwi rekuti 'A1C'. Rinowanzo shandiswa kuona kana chirwere chako cheshuga chiri pasi pesimba. Asi A1C ndiyo nyaya yese here? Nhasi tichataura nezvenzira itsva uye inobatsira zvikuru ichakupa kunzwisisa kwakadzama kwechirwere chako cheshuga kupfuura A1C. Tinoidaidza kuti 'Time in Range' kana kuti 'TIR'.
Chii chinonzi Time in Range (TIR)?
Zvichitaurwa zviri nyore, Nguva iri muRange (TIR) inguva iyo huwandu hweshuga yeropa rako hunoramba huri mukati me "target range" yako. Izvi zvinowanzo kuyerwa sechikamu.
Zvino ungave uchishamisika kuti "chinangwa cherudzi urwu" chii. Kune vanhu vakuru vazhinji vane chirwere cheshuga cherudzi rwekutanga kana rwechipiri, asi kwete vese, chinangwa cherudzi urwu ndechemazinga eshuga muropa ari pakati pe70 mg/dL ne180 mg/dL .
Vanachiremba vanowanzokurudzira kuchengetedza TIR yako pamusoro pe70% . Izvi zvinongoreva kuti huwandu hweshuga yako hunofanira kunge huri mukati memaawa gumi nemanomwe kubva pamaawa makumi maviri nemana pazuva.
Tinoyera sei TIR iyi?
Nzira yakanakisisa uye iri nyore yekuyera TIR yako nemazvo ndeyekushandisa mudziyo unonzi Continuous Glucose Monitor (CGM) . Uyu mudziyo mudiki waunopfeka mumuviri wako. Unoyera uye unorekodha huwandu hweglucose mu interstitial fluid pasi peganda rako maawa makumi maviri nemana pazuva. Unogona kudhawunirodha data iroro kuapp kana software kuti uone chaizvo kuti TIR yako chii.
Kutaura zvazviri, nzira yakajairika yekutora ropa kubva pamunwe inogonawo kupa pfungwa yeTIR. Asi kuti uite izvozvo unofanirwa kutarisa shuga yako kakawanda pazuva. Zvisinei, huwandu hwedata rakawanikwa kubva kuCGM hwakakura kupfuura izvozvo. Saka, kukosha kweTIR kwakawanikwawo kwakarurama kwazvo.
Nekushandisa tekinoroji iyi yeCGM, vanhu vazhinji vane chirwere cheshuga navanachiremba vavo vava kutarisa kukosha kweTIR uku kuti vaone kuti kurapwa kwavo chirwere cheshuga kuri kushanda zvakanaka sei. Neruzivo urwu, iwe nachiremba wako munogona kuisa zvinangwa zvitsva uye kuita shanduko dzinodiwa pachirongwa chenyu chekurapa.
Ndingaona sei mushumo weTime in Range?
Kana ukashandisa CGM, TIR report inowanzo kukuratidza mutsetse wakamira une ruvara. Izvi zviri nyore kunzwisisa. Girini rinoratidza nguva iyo huwandu hweshuga muropa rako hwaive pakati. Mamwe mavara (yero, orenji, tsvuku) anoratidza nguva iyo huwandu hweshuga muropa rako hwaive hwakaderera (hwakaderera kana hwakakwira).
Ngationei kuti mushumo weCGM unoratidza sei ruzivo.
| Huwandu hweshuga (mg/dL) | Zvinoreva (chinzvimbo) |
|---|---|
| Zvisingasviki 54 (< 54) | Yakaderera Zvikuru / Yakaderera |
| Kubva pamakore 54 kusvika 69 | Yakaderera / Yakaderera |
| 70 kusvika 180 | Zviri pakati nepakati - zvinowanzoonekwa negirini. |
| 181 kusvika 250 | Nzvimbo yepamusoro / yepamusoro |
| Kupfuura 250 (> 250) | Yakakwirira Zvikuru / Yakakwirira Zvikuru |
Mushumo wako weCGM unogona kuratidza ruzivo urwu zvakasiyana. Kana uine mibvunzo nezveizvi, bvunza chiremba wako kuti akutsanangurire.
Nguva Yangu muRange inofanira kunge yakareba sei?
Izvi zvakakosha zvikuru: Chiyero cheglucose chaunoda kushandisa uye chinangwa cheTIR ndezvako chete. Izvi zvinoreva kuti zvinogona kusiyana nezvinangwa zvevamwe vanhu.
Iwe nachiremba wako muchasarudza pamwe chete kuti ndezvipi zvinangwa zvakakunakira. Zvakare, zvinangwa izvi hazvigari zvakafanana muhupenyu hwako hwese uye zvinogona kuchinja nekufamba kwenguva.
Zvinhu zvakaita seizvi zvinobatanidzwa pakusarudza zvinangwa zvako:
- Wava nenguva yakareba sei uine chirwere cheshuga?
- Zera rako uye tarisiro yekurarama.
- Une zvimwe zvirwere zvinokanganisa huwandu hweshuga muropa rako here? (semuenzaniso, kusashanda zvakanaka kweitsvo, gastroparesis)
- Une chirwere chemwoyo here?
- Une kusaziva nezve hypoglycemia here, chirwere chausinganzwe zviratidzo zveshuga yakaderera muropa (hypo)?
- Une pamuviri here kana kuti uri kutarisira kuva nepamuviri?
Zvakanaka, saka ngatitarisei zvimwe zvinangwa zveTIR zvinogamuchirwa. Zvakare, aya ingori mazano akajairika. Chinangwa chako chingave chakasiyana neizvi.
| Zvinangwa zvakafanana kune vanhu vakuru vazhinji vane chirwere cheshuga cherudzi rwekutanga kana rwechipiri | |
|---|---|
| Chinzvimbo | Chinangwa (chikamu chenguva mukati mezuva) |
| Mukati mehuwandu hwakatarwa (70-180 mg/dL) | Zvinenge 70% |
| Mwero wakaderera (54-69 mg/dL) | Zvisingasviki 4% |
| Mwero wakaderera zvikuru (< 54 mg/dL) | Zvisingasviki 1% |
| Mwero wepamusoro (181-250 mg/dL) | Zvisingasviki 25% |
| Mwero wakakwira zvikuru (> 250 mg/dL) | Zvisingasviki 5% |
| Inotarisa avo vari panjodzi huru yekubatwa nehypoglycemia | |
|---|---|
| Mukati mehuwandu hwakatarwa (70-180 mg/dL) | Zvinenge 50% |
| Mwero wakaderera (< 70 mg/dL) | Zvisingasviki 1% |
| Mwero wakakwira zvikuru (> 250 mg/dL) | Zvisingasviki 10% |
| Zvinangwa zvevanhu vane chirwere cheshuga cherudzi rwekutanga panguva yekuzvitakura | |
|---|---|
| Mukati mehuwandu hwakajairika (63-140 mg/dL) | Zvinenge 70% |
| Mwero wakaderera (< 63 mg/dL) | Zvisingasviki 4% |
| Mwero wepamusoro (> 140 mg/dL) | Zvisingasviki 25% |
Zvinangwa zvechirwere cheshuga panguva yekuzvitakura uye chirwere cheshuga cherudzi rwechipiri panguva yekuzvitakura zvinogona kunge zvakasiyana, saka zvakakosha kukurukura nachiremba wako kuti ndezvipi zvinangwa zvinonyanya kukubatsira uye zvinogoneka kwauri.
Chii chiri hukama huripo pakati peA1C neTIR?
Zvakakosha kunzwisisa musiyano uripo pakati pezviviri izvi.
- TIR (Nguva iri muRange) chiyero chinopa ruzivo nezvekuchinja-chinja kwehuwandu hweshuga yako mukati memaawa kana mazuva.
- A1C kuongororwa kweropa kunoratidza huwandu hweshuga muropa rako mumwedzi miviri kusvika mitatu yapfuura .
Funga nezveA1C sekuverenga pfupiso yechitsauko mubhuku. Inokupa pfungwa diki. Asi TIR yakafanana nekuverenga chitsauko chose, izwi rega rega, mutsetse wega wega. Unowana zvese zvakajeka. A1C haikupi ruzivo rwekuti shuga yako yakakwira kana yakaderera sei.
Sei A1C ichigona kutsausa?
Funga nezvevanhu ava vaviri.
1. Munhu wekutanga: Huremu hweshuga muropa rake hunochinja-chinja mukati mezuva. Dzimwe nguva hunenge hwakaderera zvakanyanya (hypo), dzimwe nguva hunenge hwakakwira zvakanyanya.
2. Munhu wechipiri: Huwandu hweshuga muropa rake hunoramba hwakagadzikana mukati mezuva rose, hunosvika 154 mg/dL.
Vanhu ava vese vanogona kunge vaine A1C ye7%. Nekuti A1C inongova yepakati nepakati. Zvisinei, TIR yavo yakasiyana zvachose. TIR yemunhu wekutanga yakaderera zvikuru. Izvi zvinoreva kuti muviri wavo uri panjodzi huru yekubatwa nechirwere cheshuga.
Uyewo, vanhu vane zvirwere zvinotevera vanogona kunge vaine A1C values dzisina kururama:
- Kushaya ropa
- Mhando dzeHemoglobin
- Kushaikwa kwesimbi
- Pamuviri
- Chirwere chechiropa
Parizvino, TIR haisi kuzotsiva zvachose bvunzo yeA1C. Makumi emakore ekutsvaga akaratidza kuti mazinga eA1C anogona kufanotaura njodzi yako yekuve nematambudziko echirwere cheshuga. Ndosaka vanachiremba vachishandisa A1C neTIR pamwe chete kuti vawane mufananidzo wakazara uye wakarurama wekutarisira kwako chirwere cheshuga.
Sei Nguva iri muRange (TIR) yakakosha?
TIR inokupa mufananidzo wakajeka wekuchinja-chinja kwehuwandu hweshuga muropa kunouya nechirwere cheshuga. Zvinhu zvakaita sechikafu chatinodya, maekisesaizi atinoita, mishonga yatinotora, uye huwandu hwedu hwekushushikana zvese zvinokanganisa huwandu hweshuga muropa. Paunotarisa data rako reTIR, unogona kunzwisisa kuti chimwe nechimwe chezvinhu izvi chinokanganisa sei zvakananga huwandu hweshuga muropa rako.
Semuenzaniso, fungidzira kuti waive nefivha kwevhiki rese. Paunotarisa mushumo wako weTIR vhiki iyoyo, unoona kuti kukosha kweTIR yako kwaderera zvakanyanya. Zvadaro, nguva inotevera yaunorwara, unogona kutaura nachiremba wako nezvekuti ungagadzirira sei uye kutarisira chirwere chako cheshuga pachine nguva.
TIR uye matambudziko echirwere cheshuga
Tsvagiridzo yakaratidza kuti pane hukama pakati peTIR yakaderera uye matambudziko anokonzerwa nechirwere cheshuga.
Kusiyana kweglucose mumuviri kunogona kuwedzera kushushikana kwe oxidative uye kuzvimba mumuviri, izvo zvinogona kukuvadza masero mumuviri. Ongororo yakawana kuti kusiyana uku kwakanyanya kwehuwandu hweshuga muropa kunowedzera njodzi ye:
- Kuwedzera kwehuwandu hwehypoglycemia.
- Kuwanda kwenjodzi yezvirwere zvemwoyo.
- Kukanganisika kwekushanda kwepfungwa nepfungwa (kushanda kwepfungwa).
- Kuderera kwehupenyu.
Uyezve, imwe ongororo yakawana kuti vanhu vane chirwere cheshuga cherudzi rwechipiri vane TIR yakaderera uye shuga yakakwira muropa vane mukana wakakura wekuva nezvirwere zvakakomba zve retinopathy zvine chekuita nechirwere cheshuga. Imwe ongororo yakawana hukama hwakasimba pakati peTIR yakaderera uye cardiovascular autonomic neuropathy.
Zvese izvi zvinoratidza kukosha kwazvakaita kuchengetedza kukosha kweTIR yako padanho repamusoro.
Ndingavandudza sei Nguva Yangu muRange?
Nzira huru yekuvandudza TIR yako ndeyekuona kuti chii chaizvo chiri kukanganisa huwandu hweshuga yako. Izvi zvinogona kutora nguva. Zvinogona kunzwa sekuyedza kusingaperi kwesainzi.
Saka, iva nemutsa kwauri . Usaedza kuchinja zvinhu zvese panguva imwe chete, tarisa pane chimwe chinhu panguva imwe chete.
Fungidzira kuti waona kuti huwandu hweshuga muropa rako hunongoderera mushure mekudya kwemangwanani zuva rega rega. Saka, nyatsoteerera maitiro ako nemabasa ako panguva iyoyo.
Semuenzaniso, zvinhu zvakaita seizvi zvinogona kukonzera kukwira kweshuga muropa mushure mekudya kwemangwanani:
- Yasvika nguva yekunwa mishonga yako yechirwere cheshuga (senge insulin).
- Chipimo chemushonga.
- Kuenzana kwezvekudya zvaunodya uye zvinovaka muviri zviri mazviri (makabhohaidhiretsi, mafuta, mapuroteni).
- Mimwe mishonga yekunwa mangwanani.
- Kunwa chimwe chinhu chine caffeine, senge kofi, mangwanani.
Uyu muenzaniso mumwe chete. Chirwere cheshuga chirwere chakaoma zvikuru. Kune nzira dzakawanda dzekubatsira kuvandudza TIR yako. Gara uchiyeuka, usati waita chero shanduko kuchirongwa chako chekurapa, taura nemumwe munhu ane ruzivo nezvechirwere cheshuga, akadai sechiremba we endocrinologist kana nyanzvi yezvekurapa chirwere cheshuga (CDCES), kana kuti chiremba wako wenguva dzose.
Nguva muRange (TIR) ichi chiyero chitsva uye chinobatsira zvikuru pakuyera manejimendi echirwere cheshuga. Pakutanga, zvingaita sekunge zvakaoma kunzwisisa ruzivo urwu rwese rweTIR nedata. Asi musazvidya moyo. Chiremba wenyu achatsanangura zvese uye achakubatsirai kushandisa TIR iyi kuti zvikubatsirei. Pamwe chete, munogona kutevera kuti TIR yenyu inochinja sei nekufamba kwenguva uye kugadzirisa hurongwa hwenyu hwekutarisira zvinoenderana.
Mharidzo Yekuenda Nayo Kumba
- 'Nguva muRange' (TIR) ndiyo chikamu chenguva iyo huwandu hweshuga muropa rako huri mukati mehuwandu hwakatarwa.
- Izvi zvinopa mufananidzo wakajeka uye wakadzama wekuti huwandu hweshuga yako hunochinja sei mukati mezuva kupfuura bvunzo yeA1C.
- Chinangwa chako cheTIR chinosarudzwa newe nachiremba wako pamwe chete. Hazvina kufanana kune wese munhu.
- Uchishandisa data reTIR, iwe nachiremba wako munogona kuita sarudzo dziri nani pamusoro pekurapwa.
- Nekuvandudza TIR score yako, unogona kuderedza njodzi yezvinetso zvenguva refu zvinokonzerwa nechirwere cheshuga.
- Rwendo urwu. Hazvisi zvese zvichafamba zvakanaka ipapo ipapo. Zviitire mutsa, shanduko diki dzinogona kuita mutsauko mukuru.
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