Zvinorevei kuti "Time in Range" (TIR) ​​​​kune imi vane chirwere cheshuga? Ngationei chaizvo!

Une chirwere cheshuga here? Kana kuti mumwe munhu mumhuri mako kana shamwari yako ane chirwere cheshuga here? Saka ungangodaro wakanzwa, kana kuti pamwe chiremba wako akataura nezvechinhu ichi chinonzi 'Time in Range'. Saka, ngatitaure nezvazvo zviri nyore uye zvakajeka nhasi. Kunyangwe izvi zviri zvitsva, chinhu chinobatsira zvikuru mukudzora chirwere cheshuga.

Chii chinonzi "Nguva iri muRange" (TIR) ​​iyi?

Zvichitaurwa zviri nyore, "Nguva iri muRange" (TIR) ​​​​inguva iyo munhu ane chirwere cheshuga anogona kuchengetedza huwandu hweshuga muropa (glucose) mukati mehuwandu hwakatarwa . Fungidzira chiremba wako achikuudza kuti uchengetedze huwandu hweshuga muropa rako pakati pehuwandu uhwu nehumwe. Izvi zvinoyera kuti unogara kwenguva yakareba sei mukati mehuwandu ihwohwo.

Kune vanhu vazhinji vane chirwere cheshuga, vese vane chirwere cheshuga cheType 1 nevakuru vane chirwere cheshuga cheType 2, huwandu uhwu hunowanzova pakati pe70 ne180 milligrams pa deciliter (mg/dL) . Asi izvi hazvina kufanana kune munhu wese, uye zvinogona kusiyana kubva pamunhu kuenda kune mumwe. TIR inoyerwa sechikamu . Vanachiremba vanowanzo taura kuti edza kuchengetedza TIR yako iri pamusoro pe70% . Izvi zvinoreva kuti shuga yako yeropa inofanira kunge iri muhuwandu ihwohwo kwemaawa angangoita 17 kubva pamaawa makumi maviri nemana pazuva. Ndipo paunokwanisa kufunga kuti chirwere chako cheshuga chakanyatsodzorwa.

Unoyera sei TIR iyi nemazvo?

Nzira iri nyore uye yakarurama yekuziva TIR yako ndeyekushandisa Continuous Glucose Monitor (CGM) . Ungave wakambonzwa nezvechishandiso ichi kare. Chaizvoizvo chishandiso chidiki chinopfekwa chinoiswa pasi peganda reruoko rwako kana dumbu . Paunenge uchichipfeka, chinoramba chichiyera uye chichinyora huwandu hweglucose mu interstitial fluid pasi peganda rako maawa makumi maviri nemana pazuva. Zvakafanana nekamwe kamupurisa kari kutsvaga shuga yako. Unogona kudhawunirodha data iri reglucose uchishandisa software yakabatana neCGM device kana app pafoni yako uye wotevera TIR yako.

Kutaura zvazviri, unogona kuwana pfungwa isina kujeka yeTIR yako nekubata chigunwe nemaoko . Asi kana ukadaro, unofanirwa kutarisa shuga yako yeropa kakawanda pazuva . Kunyangwe zvakadaro, haipe ruzivo rwakadzama se 'CGM'. Funga nezvazvo sekuvhura mapeji ebhuku. Asi 'CGM' yakafanana nekuverenga bhuku rese! Inokupa mufananidzo wakazara wehuwandu hweshuga yako yeropa.

Nekuda kwemichina iyi ye 'CGM', vanhu vazhinji vane chirwere cheshuga pamwe navanachiremba vavo vava kushandisa iyi TIR kuvabatsira kudzora chirwere chavo cheshuga.Ongorora data rako reTIR nemazvo. Nekutarisa data rako reTIR, iwe nachiremba wako munogona kuisa zvinangwa zvitsva uye kuita shanduko dzinodiwa pachirongwa chenyu chekurapa.

Mushumo uyu weTIR wakaita sei?

Mumishumo iyi yeTIR, inobva musoftware iri pamashini eCGM, huwandu hwakasiyana hweshuga yako hunowanzo ratidzwa sebhaa rakamira rine ruvara . Zviri nyore kunzwisisa.

• Nguva iyo shuga yako yaive pakati pehuwandu inoratidzwa neruvara rwegirini . Izvi ndizvo zvatinoedza kuvandudza tese.
• Mamwe marudzi, zvichireva nguva apo huwandu hweshuga huri pasi kana kuti hwakakwira, anoratidzwa nemamwe mavara akadai seyero, orenji, uye tsvuku .

Heino maratidzirwo anoitwa mazinga aya pamushumo we "CGM" wakajairika (kubva pasi kusvika kumusoro):

• Zvishoma pane 54 mg/dL (< 54 mg/dL) — Zvakaderera zvikuru (pasi pechinangwa). Izvi zvinoita sezvitsvuku. Izvi zvinogona kuva mamiriro ezvinhu ane njodzi.
• Pakati pe54 mg/dL ne69 mg/dL — Yakaderera (pasi pechinangwa). Izvi zvinogona kutaridzika seorenji. Iyi inzvimbo yekutarisisa zvakare.
• Pakati pe70 mg/dL ne180 mg/dL — iri pakati nepakati. Ndizvo zviri mugirini . Tose tiri kuedza kuita kuti chikamu ichi chegirini chive chikuru!
• Pakati pe181 mg/dL ne250 mg/dL — yakakwirira (pamusoro pechinangwa). Izvi zvinoita seyero.
• Kupfuura 250 mg/dL (> 250 mg/dL) — Yakakwirira kwazvo (pamusoro pechinangwa). Izvi zvinoonekwawo seruvara rutsvuku. Kana izvi zvikaramba zviripo, hazvina kunaka.

Asi yeuka kuti mimwe mishumo yeCGM inogona kuratidza data iri nenzira dzakasiyana. Kana uchinetseka kunzwisisa ruzivo urwu, zvakanaka kutaura nachiremba wako . Vanogona kukutsanangurira.

TIR yangu inofanira kuva yakawanda sei?

Kana uine chirwere cheshuga, huwandu hweshuga yeropa rako hwakasiyana newe . Izvi zvinoreva kuti huwandu hwaunoda hahuna kufanana nehwangu. Iwe nachiremba wako muchasarudza pamwe chete kuti huwandu hupi hwaunoda uye kuti unofanira kugara muhuwandu hwakadii. Zvinangwa izvi zvinogona kuchinja muhupenyu hwako hwese.

Kune zvinhu zvakawanda zvinogona kukanganisa zvinangwa zveglucose:

• Wava nenguva yakareba sei uine chirwere cheshuga ?
• Zera rako nehutano hwako .
• Une zvimwe zvirwere zvinokanganisa huwandu hweshuga muropa rako, zvakaita sekusashanda zvakanaka kweitsvo kana gastroparesis .
• Kana uine chirwere chemwoyo .
• Dambudziko rekuti hauzive zviratidzo zveshuga shoma muropa (hypoglycemia awareness)Kana zviripo. Kureva kuti, kana usinganzwe dzungu nekudikitira zvaunonzwa kana huwandu hweshuga yako hwadzikira, zvine njodzi.
• Kana uri nepamuviri kana kuti uri kuedza kubata pamuviri , zvinangwa zvako zvinochinja zvakanyanya munguva idzi.

Zvakanaka, ngationei kuti ndeapi mazano anowanzo piwa.

Zvinangwa zveTIR kune vanhu vakuru vazhinji vane chirwere cheshuga cherudzi rwekutanga kana rwechipiri:

• Inenge 70% yenguva iri pakati pe70 ne180 mg/dL (mukati mehuwandu hwakatarwa).
• Nguva yacho iri pasi pe54 mg/dL inofanira kunge iri pasi pe1%.
• Nguva iri pakati pe54 ne69 mg/dL inofanira kunge iri pasi pe4%.
• Nguva iri pakati pe181 ne250 mg/dL inofanira kunge iri pasi pe25%.
• Nguva iyo iri pamusoro pe250 mg/dL inofanira kunge iri pasi pe5%.

Zvinangwa zveTIR kuvanhu vane njodzi yepamusoro yekudzikira kweshuga muropa (hypoglycemia):

Izvi ndezvevaya vanowanzova neshuga shoma muropa.

• Inenge 50% yenguva iri pakati pe70 ne180 mg/dL (mukati mehuwandu hwakajairika).
• Nguva inoshandiswa pasi pe70 mg/dL inofanira kunge iri pasi pe1%.
• Nguva iyo iri pamusoro pe250 mg/dL inofanira kunge iri pasi pe10%.

Zvinangwa zveTIR kuvanhu vakuru vane chirwere cheshuga cherudzi rwekutanga panguva yekuzvitakura:

Izvi zvakakosha zvikuru, nekuti zvinogona kukanganisa mwana.

• Kanenge 70% yenguva, iri pakati pe63 ne140 mg/dL (muhuwandu hwakajairika). Huwandu hwehuwandu pano hwakasiyana zvishoma, munoona? Zvakakosha kudzora huwandu hweshuga yako panguva yekuzvitakura.
• Nguva yacho iri pasi pe63 mg/dL inofanira kunge iri pasi pe4%.
• Nguva iyo iri pamusoro pe140 mg/dL inofanira kunge iri pasi pe25%.

Nzira dzinoshandiswa pakurapa chirwere cheshuga panguva yekuzvitakura uye chirwere cheshuga cherudzi rwechipiri panguva yekuzvitakura dzinogona kusiyana. Zvakare, idzi ndidzo nzira dzakajairika. Zvakakosha kukurukura nachiremba wako kuti ndeapi matanho eglucose anonyanya kubatsira uye anoshanda kwauri. Vachakupa mazano ekuti ungatora sei matanho akakodzera ekugadzirisa dambudziko rako.

Chii chiri hukama huripo pakati peTIR iyi neA1C?

Pamwe wakambonzwa nezvebvunzo iyi yeA1C . Vanachiremba vazhinji vanoishandisa kuona kuti chirwere chako cheshuga chiri kudzorwa sei. Saka, TIR neA1C zvakafanana here? Ehe, zvishoma.

TIR inoyera huwandu hweglucose yako kwenguva yakati rebei, kubva pamaawa mashoma kusvika kumazuva mashoma, paunenge wakapfeka CGM. Zvakafanana nemufananidzo wenguva pfupi . Unogona kuona chaizvo kuti shuga yako inochinja sei zuva nezuva.

Zvisinei, A1C kuongororwa kweropa kunoitirwa murabhoritari . Kunoyera huwandu hweshuga mumuviri wako mumavhiki masere kusvika gumi nemaviri apfuura . Kuongororwa kweA1C hakugone kukuudza kuti shuga yako yeropa inochinja sei. Kunongopa huwandu hweavhareji chete.

Zvichitaurwa zviri nyore:

Funga nezvazvo nenzira iyi: A1C yakafanana nekuverenga pfupiso yechitsauko chebhuku.Asi kushandisa `CGM` wotarisa TIR kwakafanana nekuverenga chitsauko chose . Wobva wanzwisisa zvakadzama uye zvine hungwaru . Unonzwisisa here? TIR inoratidza zvakajeka kuti shuga inoita sei panguva dzakasiyana dzezuva, mushure mekudya, mushure mekurovedza muviri.

Kubva kuma1960, vanachiremba nevanorwara nechirwere cheshuga vanga vachinyanya kuvimba neA1C kuti vaone kuti kurapwa kwechirwere cheshuga kuri kufamba sei. Zvisinei, kubva pakatanga kushandiswa michina yeCGM, vanachiremba nevarwere vakaona kuti TIR iyi inopa mufananidzo unobatsira uye wakarurama wekurapa chirwere cheshuga .

Kunyanya kuvanhu vane chirwere cheshuga cherudzi rwekutanga , huwandu hweshuga muropa hunogona kuchinja-chinja zvakanyanya nekufamba kwemazuva, mavhiki, uye mwedzi. Saka, avhareji yehuwandu hweA1C haisiyo nzira chaiyo yekurapa chirwere ichi.

Semuenzaniso, funga nezve:

Pane mumwe munhu ane huwandu hweshuga muropa rake huri kuramba huchidzikira zvakanyanya uye hwakakwira zvakare. Asi A1C yake inogona kunge iri 7%.

Pane mumwe munhu ane huwandu hweshuga muropa hwakagadzikana pa154 mg/dL kazhinji. A1C yake inogonawo kuva 7%.

Maona? Kunyangwe A1C yavo yakafanana, TIR yavo inogona kusiyana zvikuru. TIR yemunhu wekutanga yakaderera nekuti anogara ari kunze kwenzvimbo yakatarwa. Ari panjodzi huru yehypoglycemia.

Uyewo, bvunzo yeA1C ingasave yakarurama kune vanhu vane zvirwere zvinotevera:

• Kushaya ropa (anemia).
• Mhando dzeHemoglobin.
• Kushaikwa kwesimbi.
• Kubata pamuviri.
• Chirwere chechiropa.

Kururama kweA1C kunogonawo kusiyana pakati pevanhu vakasiyana.

Zvisinei, sezvazviri, kuuya kweTIR hazvirevi kuti bvunzo dzeA1C dzichange dzisisina basa . Makumi emakore ekutsvagisa akaratidza kuti mazinga eA1C anogona kufanotaura kukura kana kudzivirira matambudziko echirwere cheshuga. Nokudaro, vanachiremba vari kusanganisa bvunzo dzeTIR neA1C kuti vawane mufananidzo wakazara wekutarisira glucose.

Sei TIR iyi ichikosha kudaro?

TIR inokupa mufananidzo wakarurama wekuchinja-chinja kwemazinga eshuga kunouya nechirwere cheshuga. Funga kuti zvinhu zvingani zvinokanganisa huwandu hweshuga yako, zvakaita sechikafu chaunodya, maekisesaizi aunoita, mishonga yaunotora, uye huwandu hwekushushikana kwako ! Saka, kutarisa data rako reTIR (kunyanya kana uchishandisa `CGM`) kunogona kukupa kunzwisisa kuri nani kwekuti zvinhu izvi zvakasiyana-siyana zvinokanganisa sei zvakananga huwandu hweshuga yako .

Semuenzaniso, unogona kuona kuti TIR yako yadzikira kana uine fivha kwevhiki rese. Kana kuti, unogona kuona kuti shuga yako yeropa yakawedzera zvakanyanya mushure mekudya chimwe chikafu, uye TIR yako yadzikira. Paunoona chimwe chinhu chakadai, unogona kubvunza chiremba wako kuti, 'Ndingagadzirira sei zviri nani kudzora chirwere changu cheshuga nguva inotevera pandicharwara?' Kana kuti, ungafunga kuti, 'Chikafu ichocho chinondikanganisa sei, uye ndinofanira kuchinja madyiro andinoita here?' Nemamwe mashoko, TIR inogona kubatsira zvikuru mukugadzirisa chirwere chako cheshuga nenzira inoenderana nemararamiro ako .

Matambudziko echirwere cheshuga anogona kuitika here kana TIR ikadzikira?

Tsvagiridzo pamusoro peizvi ichiri kuenderera mberi, asi zvidzidzo zviripo zvakawana kuti sezvo huwandu hweTIR huchidzikira, njodzi yezvinetso zvine chekuita nechirwere cheshuga inowedzera .

Zvidzidzo zvinoratidza kuti kuchinja kukuru kwehuwandu hweshuga muropa (kunonzi glycemic variability) kunogona kuwedzera oxidative stress uye kuzvimba mumuviri. Izvi zvinogona kukanganisa masero . Dzimwe ongororo dzakabatanidza kuchinja kukuru kweshuga muropa ne:

• Kuwanda kwenjodzi yekuderera kweshuga muropa (hypoglycemia).
• Kuwanda kwenjodzi yezvirwere zvemwoyo.
• Kukanganisika kwebasa rekuziva.
• Kudzikira kwehupenyu.

Uyezve, imwe ongororo yakawana kuti vanhu vane chirwere cheshuga cherudzi rwechipiri vaiva neTIR yakaderera uye glycemic variability yakakwira vaiva nenjodzi huru yekurwara neretinopathy ine chekuita nechirwere cheshuga, dambudziko rechirwere cheshuga rinokanganisa maziso . Imwe ongororo yakawana kuti TIR yakaderera yakabatana zvakanyanya nenjodzi huru yemwoyo autonomic neuropathy, chirwere chetsinga chinokanganisa hurongwa hwemwoyo .

Saka, zvidzidzo izvi zvinoratidza kukosha kwekuchengetedza TIR yako yakakwira sezvinobvira . Sezvo vaongorori vachidzidza zvakawanda, nyanzvi dzechirwere cheshuga dzinogona kuchinja zvinangwa zveTIR mune ramangwana.

Ndingawedzera sei TIR yangu?

Chinhu chikuru chekuvandudza TIR yako ndechekuona kuti chii chiri kukanganisa huwandu hweglucose mumuviri wako . Izvi zvinogona kutora nguva. Kutaura zvazviri, zvinogona kunzwa sekuyedza kwesainzi kusingaperi. Saka, zvakakosha kutarisa pane chimwe chinhu panguva uye kuzviitira mutsa . Usavhunduke, uye edza kunzwisisa zvinhu izvi zvishoma nezvishoma.

Kana ukaona kuti huwandu hweshuga mumuviri wako hunoramba huchikwira kana kudzikira pane dzimwe nguva dzezuva, nyatsoongorora maitiro ako nemabasa ako panguva iyoyo.

Semuenzaniso, unogona kuona kuti huwandu hweshuga mumuviri wako hunoramba huchikwira mushure mekudya kwemangwanani. Pane zvikonzero zvakati wandei nei izvi zvingave zvichiitika:

• Haisi nguva yakakodzera yekunwa mishonga yako yechirwere cheshuga (semuenzaniso insulin ).
• Kusakwana kana kuti kunyanyisa kupiwa kwemushonga.
• Kuenzana kwezvikafu zvaunodya uye zvinovaka muviri zvikuru zvirimo (makabhohaidhiretsi, mafuta, uye mapuroteni) . Ungave uchidya makabhohaidhiretsi akawandisa.
• Mimwe mishonga yekunwa mangwanani (mimwe mishonga inogona kukanganisa huwandu hweshuga muropa).
• Kunwa zvinwiwa zvine caffeine zvakaita sekofi mangwanani (izvi zvinokanganisa vamwe vanhu).

Uyu muenzaniso mumwe chete. Chirwere cheshuga chirwere chakaoma zvikuru . Kune nzira dzakawanda dzinogona kukubatsira kuvandudza TIR yako. Semazuva ese, paunenge uchifunga nezvekuchinja chirongwa chako chekutarisira, zvakanaka kushanda nenyanzvi yechirwere cheshuga (semuenzaniso, endocrinologist) kana nyanzvi yezvekurapa chirwere cheshuga (CDCES) . Vanogona kukutungamira kuburikidza nemaitiro acho uye kupindura mibvunzo yako.

Mharidzo Yekuenda Nayo Kumba

Saka, iyi "Time in Range" (TIR) ​​​​inzira itsva uye inobatsira zvikuru kune vanhu vane chirwere cheshuga yekuyera manejimendi yavo yeglucose. Kunzwisisa ruzivo rweTIR nedata rako reglucose dzimwe nguva kunogona kuoma. Usanetseke, unogona kujaira zvishoma nezvishoma.

Yeuka kuti chiremba wako anogara aripo kuti akubatsire kunzwisisa TIR yako uye kuishandisa kuti zvikubatsire. Pamwe chete, munogona kutevera kuti TIR yako inochinja sei nekufamba kwenguva uye kugadzirisa nzira dzako dzekutarisira zvinoenderana. Kurarama nechirwere cheshuga idambudziko, asi nezvishandiso zvitsva zvakaita seizvi, zvinogona kuitwa kuti zvive nyore. Hausi wega, uye kune vanhu vazhinji vanogona kukubatsira parwendo urwu.

'Chirwere cheshuga, Nguva iri muRange, TIR, Glucose, Huwandu hweShuga muRopa, CGM, A1C