Yintoni kanye kanye uvavanyo lwe-A1C olukuxelela ngamanqanaba eswekile egazini lakho? Masithethe ngayo!

Mhlawumbi ukhe weva oogqirha besithi, "Kufuneka ufumane uvavanyo lwe-A1C." Okanye ukuba kukho umntu kusapho lwakho onesifo seswekile, mhlawumbi ukhe weva ngolu vavanyo lwe-A1C. Luyintoni kanye kanye olu vavanyo lwe-A1C? Yintoni esinokuyifunda kulo? Namhlanje, siza kuthetha ngolu vavanyo lwe-A1C ngendlela elula onokuyiqonda.

Yintoni uvavanyo lwe-A1C?

Ngamafutshane, uvavanyo lwe-A1C luvavanyo olulinganisa amanqanaba eswekile egazini lakho, okanye "iglucose", kwiinyanga ezintathu ezidlulileyo. Iziphumo zinikwa njengepesenti. Okukhona ipesenti iphezulu, kokukhona amanqanaba eswekile egazini lakho ephezulu.

Oogqirha basebenzisa uvavanyo lwe-A1C ngezizathu ezininzi eziphambili:

• Chonga inqanaba elingaphambi kwesifo seswekile (`(Prediabetes)`). Oko kukuthi, inqanaba elikufutshane nokukhula kwesifo seswekile.
• Fumana ukuba unesifo seswekile sohlobo lwesibini na.
• Ukuba unesifo seswekile sohlobo lwesibini okanye isifo seswekile sohlobo loku-1, kubalulekile ukuqonda ukuba isicwangciso sakho sonyango sisebenza kakuhle kangakanani. Inqanaba lakho le-A1C linokukunceda wena nogqirha wakho nigqibe ukuba kufuneka nenze utshintsho kwisicwangciso sakho sonyango.

Uvavanyo lwe-A1C lwenziwa njani?

Oogqirha bavavanya i-A1C ngeendlela ezimbini:

• Amaxesha amaninzi, igazi elincinci litsalwa emthanjeni lize lithunyelwe kwilabhoratri ukuze livavanywe. Le yeyona ndlela ixhaphakileyo. Oku kubizwa ngokuba yi-"Phlebotomist" etsala igazi.
• Enye indlela kukuthatha ithontsi legazi eliseminweni yakho uze ulivavanye. Oku kunokukunika iziphumo kwimizuzu embalwa. Nangona kunjalo, le ndlela isetyenziselwa ukubona ukuba unyango lwakho luhamba njani, kwaye ayisetyenziselwa ukufumanisa isifo esitsha.

Uvavanyo olusebenzisa umthambo ludla ngokuba luchaneke ngakumbi kunovavanyo lokuhlaba ngomnwe.

Ngawaphi amanye amagama ovavanyo lwe-A1C?

Olu vavanyo lwe-A1C lubizwa ngamanye amagama aliqela. Ungaweva la magama:

• IHemoglobin A1C `(Hemoglobin A1C)`
• I-HbA1c `(HbA1c)`
• I-hemoglobin eneGlycated
• Uvavanyo lweGlycohemoglobin `(Uvavanyo lweGlycohemoglobin)`

Yintoni iswekile egazini (iGlucose)?

Imizimba yethu ifumana le `(iGlucose)` okanye iswekile ikakhulu kwiicarbohydrates ekutyeni esikutyayo. Lo ngumthombo ophambili wamandla kwiiseli zomzimba wethu. Igazi lethu lithwala le `(iGlucose)` ukuya kwiiseli kuwo wonke umzimba.

Iinkqubo ezininzi emizimbeni yethu zinceda ukugcina amanqanaba eswekile egazini ekwinqanaba elithile. Eyona ndima ibalulekileyo koku idlalwa yi-hormone ethi ``Insulin``, eveliswa yipancreas yethu.

Ukuba amanqanaba eswekile egazini lakho ahlala ephezulu (i-hyperglycemia), oko kuthetha ukuba i-A1C yakho nayo iphezulu, oko kuthetha ukuba unesifo seswekile. Isifo seswekile senzeka xa ipancreas ingavelisi i-insulin eyaneleyo, okanye xa ubungakanani be-insulin eyivelisayo bunganele, okanye xa umzimba ungakwazi ukusebenzisa i-insulin ngokufanelekileyo.

Ndiludinga nini uvavanyo lwe-A1C?

Ukuba unesifo seswekile, kufuneka wenze uvavanyo lwe-A1C ubuncinane kabini ngonyaka ukuze ubone ukuba isicwangciso sakho sonyango sisebenza kakuhle kangakanani. Ugqirha wakho uza kukuxelela ukuba kufuneka uyenze kangaphi oku.

Ukuba awukafumaniswanga ukuba unesifo seswekile, kodwa uneempawu ezilandelayo, ugqirha unokuyalela uvavanyo lwe-A1C:

• Unxano olugqithisileyo oluhlala luhleli (`(Polydipsia)`)
• Ukuchama kakhulu
• Umbono ofipheleyo
• Ndiziva ndidiniwe ngalo lonke ixesha (`(Ukudinwa)`)

Ungenza uvavanyo lwe-A1C ukuze ubone ukuba usemngciphekweni wokuba nesifo seswekile sohlobo lwesibini. Izinto ezinokubangela umngcipheko ziquka:

• Ukuba nelungu losapho elinesifo seswekile sohlobo lwesibini.
• Ukuba ukhe waba nesifo seswekile sokukhulelwa ngaphambili.
• Ukutyeba kakhulu.
• Ukungawunyamezeli umzimba okanye ukwenza umthambo.
• Ukuba uneminyaka engaphezu kwama-35 ubudala.

Ibalwa njani i-A1C?

Uvavanyo lwe-A1C lusekelwe kwinto ebizwa ngokuba yi-hemoglobin . I-Hemoglobin yinxalenye yeeseli zethu ezibomvu zegazi ezithwala ioksijini emzimbeni wonke. Xa kukho i-glucose egazini lakho, inamathela kule hemoglobin. Oku kubizwa ngokuba yi-glycation . Okukhona i-glucose ininzi egazini lakho, kokukhona oku kunamathela kuyanda. Kwaye, oku kunamathela kunokuhlala malunga neenyanga ezintathu - malunga nobude bobomi beseli ebomvu yegazi.

Uvavanyo lwe-A1C lulinganisa umyinge weglucose enamathele kwi-hemoglobin ngokuhamba kwexesha. Ngenxa yokuba lulinganisa amanqanaba eswekile egazini ngokuhamba kwexesha, uvavanyo lwe-A1C lungasixelela okungakumbi ngempilo yakho kunovavanyo olunye lweswekile egazini.

Ngaba kufuneka ndizile ukutya ngaphambi kovavanyo lwe-A1C?

Hayi. Akunyanzelekanga ukuba uzile ukutya ngaphambi kokuba wenze uvavanyo lwe-A1C.

Kwenzeka ntoni xa usenza uvavanyo lwe-A1C?

Nantsi into onokuyilindela kuvavanyo lwe-A1C, olubandakanya ukuthatha igazi emthanjeni:

• Ngelixa uhleli esitulweni, ingcali ye-phlebotomist (umntu okhupha igazi) iya kukhangela umthambo engalweni yakho okulula ukuwukhupha igazi kuwo. Ngokuqhelekileyo, igazi likhutshwa ngaphakathi kwengalo yakho, ngasemva nje kwengqiniba yakho.
• Nje ukuba kufunyenwe umthambo, loo ndawo iyacocwa ize ibulawe iintsholongwane.
• Emva koko kufakwa inaliti encinci emthanjeni kwaye kuthathwa isampuli yegazi. Oku kunokuvakala ngathi kukuhlatywa kancinci.
• Emva kokufaka inaliti, igazi elincinci liqokelelwa kwityhubhu yovavanyo.
• Nje ukuba kuqokelelwe igazi elaneleyo lovavanyo, inaliti iyasuswa kwaye ukopha kuyamiswa ngokufaka uxinzelelo kwindawo leyo ngeqhekeza lomqhaphu okanye i-gauze.
• Ekugqibeleni, faka iplasta kwindawo leyo uze ugqibe.

Ngexesha lovavanyo lwe-A1C, olwenziwa ngokuthatha igazi ngomnwe, kwenzeka ezi zinto zilandelayo:

• Ugqirha ukubuza ukuba uthabathe igazi kumnwe onjani.
• Iminwe yakho iya kusulwa ngotywala kwaye kufakwe inxeba elincinci ngenaliti encinci ebizwa ngokuba yi-"Lancet" (oku kudla ngokuba kwisixhobo esincinci seplastiki).
• Baza kucinezela umnwe wakho, bakhuphe ithontsi legazi, baze baliqokelele kwisitya esincinci seplastiki.
• Emva kokuba kuthathwe igazi elaneleyo lovavanyo, uza kunikwa iqhekeza lekotoni okanye i-gauze ukuze ubambe kwincam yeminwe yakho ukuze umise ukopha.
• Iziphumo zihlala zifumaneka kwimizuzu embalwa.

Ngaba kukho naziphi na iingozi kuvavanyo lwe-A1C?

Uvavanyo lwegazi luyinxalenye eqhelekileyo neyimfuneko yovavanyo lwezonyango. Iingozi zazo zombini ezi ntlobo zovavanyo lwe-A1C ziphantsi kakhulu. Unokufumana ukukrweleka okanye ubuhlungu apho igazi litsalwa khona okanye apho umnwe wakho uhlatywa khona, kodwa oku kuya kuphola ngokukhawuleza.

Ithetha ukuthini ixabiso lam le-A1C?

Iziphumo zovavanyo lwe-A1C zinikwa njengepesenti. Eli nani likuxelela ukuba ingakanani iproteni ye-hemoglobin efakwe kwi-glycated, oko kuthetha ukuba inamathele kwi-glucose. Okukhona ipesenti iphezulu, kokukhona amanqanaba eswekile egazini lakho ephezulu kwiinyanga ezimbalwa ezidlulileyo.

Amanqanaba e-A1C okuxilongwa ngala alandelayo:

• Ukuba ingaphantsi kwe-5.7%, oko kuthetha ukuba awunaso isifo seswekile. (Inqanaba elisempilweni)
• Ukuba iphakathi kwe-5.7% kunye ne-6.4%, ithathwa njengesifo seswekile esingaphambi kwexesha. Oku kuthetha ukuba isifo seswekile sisondele ekukhuleni.
• Inqanaba le-6.5% okanye ngaphezulu lidla ngokubonisa ukuba unesifo seswekile sohlobo lwesibini okanye isifo seswekile sohlobo lwe-1.

Ukuba sele unesifo seswekile, iziphumo zakho ze-A1C zibonisa indlela isicwangciso sakho sonyango esisebenze kakuhle ngayo kwiinyanga ezintathu ezidlulileyo. Olu nyango lunokubandakanya iipilisi, i-insulin injections, uvavanyo lweswekile yegazi rhoqo, kunye notshintsho lwendlela yokuphila (njengokutya kunye nokuzilolonga). Ngokusekelwe kwixabiso lakho le-A1C, wena kunye nogqirha wakho ninokugqiba ukuba kukho naluphi na utshintsho olufunekayo kwisicwangciso sakho sonyango.

Eyona nto ibalulekileyo ekufuneka uyikhumbule kukuba i-A1C yakho (ukuba unesifo seswekile) ingumndilili nje wamanqanaba eswekile yakho egazini kwiinyanga ezimbalwa. Ayilophawu lwempilo yakho okanye isigqibo sokugqibela sokuba uphila ubomi obusempilweni na. Khumbula ukuba i-A1C yakho inokutshintsha ubomi bakho bonke, kwaye kukho izinto onokuzenza ukulawula isifo sakho seswekile kunye nokuphucula amanqanaba akho e-A1C, ukuba kuyimfuneko.

Yintoni i-A1C kunye ne-glucose eqhelekileyo eqikelelweyo (eAG)?

Ezinye iilabhoratri zinika iziphumo ze-A1C njengepesenti, kwaye iziphumo ezihambelanayoIxabiso eliqikelelweyo le-glucose (eAG) likwanikwe.

Ubalo lwe-`(eAG)` luguqula ipesenti ye-A1C ibe ziiyunithi ezifanayo (ii-milligrams nge-deciliter nganye - mg/dL okanye ii-millimoles ngelitha nganye - mmol/L) ozisebenzisayo kwi-glucometer yakho yasekhaya. Njengokuba i-A1C yakho ingumyinge, i-`(eAG)` lixabiso elinye elibonisa inqanaba lakho eliqhelekileyo leswekile egazini kwiinyanga ezintathu ezidlulileyo.

Umzekelo, i-A1C ye-7% ilingana ne-`(eAG)` 154 mg/dL (8.6 mmol/L). I-A1C ye-9% ilingana ne-`(eAG)` 212 mg/dL (11.8 mmol/L).

Yintoni ixabiso eliqhelekileyo le-A1C?

Kumntu ongenaso isifo seswekile, ixabiso eliqhelekileyo le-A1C lingaphantsi kwe-5.7%.

Oko kuthathwa njengento "eqhelekileyo" nesempilweni kubantu abanesifo seswekile kuxhomekeke kwiinjongo zakho kunye nokufikelela kwakho kumayeza nezixhobo zokulawula isifo seswekile. Wena nogqirha wakho niza kusebenzisana ukumisela uluhlu lwe-A1C olujoliswe kuyo. Oku kunokutshintsha ubomi bakho bonke.

Ngokubanzi, i-American Diabetes Association icebisa ukuba uninzi lwabantu abadala abanesifo seswekile lujonge i-A1C ye-7% okanye ngaphantsi .

Ujoliso lwakho lwe-A1C lunokuba ngaphezulu kwe-7% kwezi meko:

• Ukuba ixesha lokuphila lilinganiselwe.
• Ukuba uneziganeko ezihlala zikhona zeswekile ephantsi kakhulu egazini (`(Hypoglycemia)`) okanye awuzazi ezo ziganeko (`(Hypoglycemia ukungaqondi)`).
• Ukuba uneengxaki ezinkulu ezibangelwa sisifo seswekile (ezifana nesifo sezintso esingapheliyo, umonakalo wemithambo-luvo, okanye isifo sentliziyo).

Kwelinye icala, kubafazi abanesifo seswekile sohlobo loku-1 ngexesha lokukhulelwa, oogqirha ngokubanzi bacebisa ukugcina amanqanaba e-A1C kwi-6.5% okanye ngaphantsi ngexesha lokukhulelwa. Oku kwenzelwa ukunciphisa iingozi zempilo kwi-fetus nokuthintela ukukhula okugqithisileyo kwe-fetus (fetal macrosomia).

Yintoni inqanaba eliyingozi le-A1C?

Njengoko inqanaba lakho le-A1C lisanda, ingakumbi ukuba lihlala liphezulu kangangeminyaka emininzi, kunokwenzeka ukuba ube neengxaki ezifana nezi:

• Iingxaki zamehlo (`(Retinopathy)`)
• Iingxaki zezintso (i-Nephropathy)
• I-Neuropathy
• Ukungasebenzi kakuhle kwesisu (iGastroparesis)
• Isifo sentliziyo
• Istroke

Uphando lubonise ukuba abantu abanesifo seswekile banokunciphisa umngcipheko wabo wokuba neengxaki zeswekile ngokugcina amanqanaba e-A1C engaphantsi kwe-7% .

Kodwa khumbula, ezinye izinto, ezifana nezinto ezibangela ufuzo kunye nokuba unexesha elingakanani unesifo seswekile, zinokuchaphazela nokukhula kweengxaki zeswekile.

Ngaba uvavanyo lwe-A1C luchanekile ngokwenene?

Ezinye izinto zinokuchaphazela ukuchaneka kovavanyo lwe-A1C, kuquka:

• Izinto zemfuza, umzekelo, iinguqu ze-hemoglobin
• Ezinye iimeko zonyango
• Amanye amayeza kunye nezongezo zesondlo
• Iimpazamo ngexesha lokuqokelelwa, ukuthuthwa, okanye ukucutshungulwa kweesampuli ukuze zivavanywe

Ezi zinto zinokubangela ukuba iziphumo zakho zibe `phantsi ngokungeyonyani` okanye `ziphakame ngokungeyonyani`. Uninzi lwezi zinto lubangelwa kukutshintshatshintsha kobomi kunye nempilo yeeseli zakho ezibomvu zegazi.

Iintlobo zeHemoglobin kunye neziphumo ze-A1C

Iindidi ze-hemoglobin zinokuchaphazela iziphumo zezinye iimvavanyo ze-A1C.

Uhlobo lwe-hemoglobin egazini lakho luxhomekeke kwinto oyizuzileyo kwiijini zakho. Kukho iintlobo ezahlukeneyo. Ezona zixhaphakileyo yi-hemoglobin A. Ezinye iintlobo ze-hemoglobin ezingaqhelekanga zibizwa ngokuba zii-hemoglobin variants.

Ukuba ne-hemoglobin variant akuyongezi umngcipheko wokuba nesifo seswekile, kodwa kunokuchaphazela iziphumo ze-A1C. Iilabhoratri zineendlela ezahlukeneyo zokuvavanya i-A1C egazini nge-hemoglobin variant.

Ezinye zezona ntlobo zixhaphakileyo zezi:

• Uphawu lweHemoglobin C : Olu luqheleke kakhulu kubantu abamnyama, abantu abazalwa eNtshona Afrika, kunye nabantu abavela eMzantsi naseMbindini Melika, kwiCaribbean, naseYurophu.
• Uphawu lweHemoglobin D : Oku kuqhelekile kubantu abahlala eTshayina, eIndiya, eTurkey, eBrazil, nakwezinye iindawo zaseYurophu.
• Uphawu lweHemoglobin E : Oku kuqhelekile phakathi kwabemi baseAsia baseMelika, ingakumbi abo bavela kuMzantsi-mpuma Asia.
• Uphawu lweHemoglobin S : Oku kuxhaphake kakhulu kubantu abamnyama nabaseMelika abangamaHispanic.

Uvavanyo lwegazi lunokuchonga iintlobo ezahlukeneyo ze-hemoglobin. Ukuba ucinga ukuba unokuba nohlobo oluthile lwe-hemoglobin olunokuchaphazela iziphumo zakho ze-A1C, thetha nogqirha wakho.

Izizathu zokuba kutheni i-A1C yakho isenokuba iphantsi kunokuba injalo ngokwenene

Ezi meko kunye neemeko zinokubangela ukuba iziphumo zakho ze-A1C zibe phantsi kunezinga lakho lokwenyani:

• Ukusetyenziswa kotywala ngokugqithisileyo (`(Ingxaki yokusebenzisa utywala)`)
• Utofelo-gazi
• Ukungasebenzi kakuhle kwezintso okungapheliyo (`(Ukungasebenzi kakuhle kwezintso okungapheliyo)`)
• Iiarhente ezivuselela i-erythropoietin (ii-ESA)
• Ukopha kakhulu (`(Ukopha igazi)`)
• Ukuhlala kwindawo ephakamileyo
• Ukuthatha izongezo zesinyithi
• Isifo sokuqaqamba kwesibindi (`(Isifo sokuqaqamba kwesibindi)`)
• Ukukhulelwa
• I-anemia yeseli yesikele (`(i-anemia yeseli yesikele)`)
• I-Spherocytosis kunye ne-hemolytic anemia (`(I-Spherocytosis kunye ne-hemolytic anemia)`)

Izizathu zokuba amaxabiso e-A1C anokuba phezulu kunokuba enjalo ngokwenene

Ezi meko kunye neemeko zinokubangela ukuba iziphumo zakho ze-A1C zibe phezulu kunokuba zinjalo ngokwenene:

• I-anemia, umzekelo i-anemia yokungabikho kwesinyithi, i-anemia ebangelwa lusulelo, okanye i-anemia ebangelwa ngumhlaza.
• Amanye amayeza, afana namayeza okunciphisa umzimba kunye nama-protease inhibitors.
• Ukwanda kwee-triglycerides egazini (`(Hypertriglyceridemia)`)
• Ukufakelwa amalungu omzimba
• I-Thalassemia (`(Thalassemia)`)
• Ukunqongophala kweVithamin B12 (`(Ukunqongophala kweVithamin B12)`)

Ngaba isifo seswekile singanyangeka nokuba amanqanaba e-A1C aphezulu?

Ewe, unako. Ukuba une-A1C ephezulu (ngaphezulu kwe-6.5%) akuthethi ukuba unesifo seswekile. Amanye amayeza, anjenge-steroids, okanye ezinye izinto, ezifana nokugula, anokunyusa okwethutyana amanqanaba eswekile egazini lakho. Ezinye iimeko, ezifana ne-anemia, zinokwenza iziphumo zakho ze-A1C zibonakale ziphezulu kunokuba zinjalo ngokwenene. Kukwakho nethuba lokuba uvavanyo lusenokungachaneki.

Oogqirha basebenzisa uvavanyo olungaphezulu kolunye ukuze bafumanise isifo seswekile. Umzekelo, unokucelwa ukuba wenze uvavanyo lweglucose yegazi lokuzila ukutya okanye uvavanyo lwe-A1C. Nangona kunjalo, ugqirha wakho uya kuhlola iziphumo zakho ngononophelo aze axoxe nawe ngazo.

Ngaba i-A1C ikuxelela ngokuchanekileyo ngolawulo lwesifo seswekile?

Kangangamashumi eminyaka, oogqirha kunye nabantu abanesifo seswekile bebesebenzisa uvavanyo lwe-A1C ngokuyintloko ukulinganisa ukuba unyango lwabo lusebenza kakuhle kangakanani.

Nangona kunjalo, ingakumbi kubantu abanesifo seswekile sohlobo loku-1, amanqanaba eswekile egazini anokutshintshatshintsha kakhulu ngokuhamba kweentsuku, iiveki, kunye neenyanga. Ke ngoko, i-A1C isekelwe kumyinge kwaye ayisoloko inika umfanekiso ochanekileyo wolawulo.

Cinga ngalo mzekelo: Amanqanaba eswekile egazini lomntu anokuba phantsi kakhulu kwaye aphezulu kakhulu, kodwa i-A1C yakhe inokuba yi-7%. Amanqanaba eswekile egazini lomnye umntu anokuba malunga ne-154 mg/dL rhoqo, kwaye i-A1C yakhe inokuba yi-7%.

Kutshanje, ngokuqaliswa kwezixhobo zokujonga i-glucose rhoqo (i-CGM) , oogqirha kunye nabantu abanesifo seswekile bafumanise ukuba i-Time in Range (TIR) ​​​​inika umfanekiso oluncedo nochanekileyo wolawulo lweswekile.

I-TIR lixesha apho inqanaba leswekile egazini lakho lingaphakathi koluhlu olucetyisiweyo. I-TIR ilinganiswa njengepesenti. Uluhlu lweeswekile egazini lunokwahluka kumntu nomntu, kodwa uluhlu oluqhelekileyo luphakathi kwama-70 kunye nama-180 mg/dL. Kwabaninzi abantu abadala abanesifo seswekile sohlobo 1 okanye uhlobo 2, oogqirha bacebisa ukuba bazame ukugcina i-TIR ingaphezulu kwama-70% (malunga neeyure ezili-17 ngosuku lweeyure ezingama-24).

Nge-`(CGM)` kunye ne-`(TIR)`, oogqirha kunye nabantu abanesifo seswekile banokubona ukuba amanqanaba eswekile egazini labo aphezulu okanye aphantsi kangaphi. Oku kubanceda ukuba balungelelanise iindlela zabo zonyango ngokuchanekileyo.

Ekugqibeleni, kufuneka uthi...

Kunokuba yinto ephazamisayo xa iziphumo zakho ze-A1C zingalindelwanga okanye zingaphezulu kunokuba bekulindelwe. Kodwa khumbula, ukuba ne-A1C ephezulu akuthethi ukuba unesifo seswekile. Zininzi izinto ezinokubangela ukuba iziphumo zingachaneki. Ugqirha wakho uza kukuxelela ukuba ufuna uvavanyo olongezelelekileyo. Ungoyiki ukubuza ugqirha wakho imibuzo. Bakho ukuze bakuncede.

Ukuba unesifo seswekile, kubalulekile ukukhumbula ukuba i-A1C yakho ngumyinge wexeshana nje wamanqanaba eswekile yakho egazini. Kukho izinto onokuzenza ukuphucula amanqanaba akho e-A1C. Ukuba uziva uxinezelekile malunga nokulawula isifo sakho seswekile, thetha nogqirha wakho. Kunye, ningenza isicwangciso sokulawula isifo sakho seswekile kwaye nifikelele kwiinjongo zenu ze-A1C.

I- A1C, i-HbA1c, isifo seswekile, iswekile yegazi, iswekile, i-hemoglobin, uvavanyo lweswekile