Njengomntu onesifo seswekile, ucinga kangakanani ngamanqanaba eswekile egazini lakho imini yonke? Banjani kusasa, banjani emva kwesidlo sasemini, banjani ngaphambi kokulala, njalo njalo. Enye yezinto oziva kakhulu xa uthetha nogqirha wakho ligama elithi 'A1C'. Lidla ngokusetyenziswa ukumisela ukuba isifo sakho seswekile siphantsi kolawulo. Kodwa ngaba i-A1C lilonke ibali? Namhlanje siza kuthetha ngendlela entsha neluncedo kakhulu eya kukunika ukuqonda okunzulu ngesifo sakho seswekile kune-A1C. Siyibiza ngokuba yi-'Time in Range' okanye 'TIR'.
Yintoni iTime in Range (TIR)?
Ngamafutshane, iTime in Range (TIR) lixesha emini apho amanqanaba eswekile egazini lakho ehlala ngaphakathi "koluhlu olujoliswe kulo." Oku kudla ngokulinganiswa njengepesenti.
Ngoku usenokuba uyazibuza ukuba loluphi olu "luhlu olujoliswe kulo". Kubantu abadala abaninzi abanesifo seswekile sohlobo 1 okanye sohlobo 2, kodwa kungengabo bonke, olu luhlu olujoliswe kulo luluhlu lweglucose egazini oluphakathi kwe -70 mg/dL kunye ne-180 mg/dL .
Oogqirha ngokubanzi bacebisa ukugcina i-TIR yakho ingaphezulu kwe-70% . Oku kuthetha ukuba amanqanaba eswekile yakho kufuneka abe ngaphakathi kolo luhlu ubuncinane iiyure ezili-17 kwiiyure ezingama-24 ngosuku.
Silinganisa njani le TIR?
Eyona ndlela ilungileyo nelula yokulinganisa ngokuchanekileyo i-TIR yakho kukusebenzisa isixhobo esibizwa ngokuba yi-Continuous Glucose Monitor (CGM) . Esi sisixhobo esincinci osinxiba emzimbeni wakho. Silinganisa kwaye sirekhoda amanqanaba eglucose kulwelo olungaphakathi kwesikhumba sakho iiyure ezingama-24 ngosuku. Emva koko ungakhuphela loo datha kwi-app okanye kwisoftware ukuze ubone ukuba yintoni kanye kanye i-TIR yakho.
Enyanisweni, indlela eqhelekileyo yokuthatha igazi ngomnwe ingakunika umbono othile nge-TIR. Kodwa ngenxa yoko kuya kufuneka ujonge iswekile yakho izihlandlo ezininzi ngemini. Nangona kunjalo, ubungakanani bedatha efunyenwe kwi-CGM bungaphezulu kakhulu koko. Ke ngoko, ixabiso le-TIR elifunyenweyo nalo lichanekile kakhulu.
Ngale teknoloji ye-CGM, abantu abaninzi abanesifo seswekile kunye noogqirha babo ngoku bajonga eli xabiso le-TIR ukuze bavavanye ukuba ulawulo lwabo lweswekile lusebenza kakuhle kangakanani. Ngale datha, wena kunye nogqirha wakho ninokubeka iinjongo ezintsha kwaye nenze utshintsho olufunekayo kwisicwangciso senu sonyango.
Ndiyibona njani ingxelo yeTime in Range?
Ukuba usebenzisa i-CGM, ingxelo ye-TIR idla ngokukubonisa ibha ethe nkqo enemibala. Kulula ukuyiqonda le nto. Uluhlaza lubonisa xa amanqanaba eswekile egazini lakho ebephakathi. Eminye imibala (etyheli, eorenji, ebomvu) ibonisa xa amanqanaba eswekile egazini lakho ebengaphandle (aphantsi okanye aphezulu).
Makhe sijonge indlela ingxelo eqhelekileyo yeCGM ebonisa ngayo ulwazi.
| Inqanaba leswekile (mg/dL) | Intsingiselo (isimo) |
|---|---|
| Ngaphantsi kwama-54 (< 54) | Isezantsi kakhulu / Ingaphantsi koluhlu |
| Ukususela kuma-54 ukuya kuma-69 | Ixabiso eliphantsi / elingaphantsi |
| 70 ukuya kwi-180 | Iphakathi - idla ngokuboniswa ngombala oluhlaza. |
| 181 ukuya kuma-250 | Umgangatho ophezulu / ongaphezulu |
| Ngaphezulu kwama-250 (> 250) | Phezulu kakhulu / Ngaphezulu kakhulu |
Ingxelo yakho ye-CGM ingabonisa olu lwazi ngendlela eyahlukileyo. Ukuba unemibuzo malunga noku, cela ugqirha wakho akucacisele.
Ixesha lam kwiRange lifanele libe lide kangakanani?
Oku kubaluleke kakhulu: Uluhlu lwakho lweglucose kunye ne-TIR target zihlukile kuwe. Oku kuthetha ukuba zinokwahluka kwiinjongo zabanye abantu.
Wena nogqirha wakho niza kugqiba kunye ukuba zeziphi iinjongo ezikulungeleyo. Kwakhona, ezi njongo azihlali zifana ubomi bakho bonke kwaye zinokutshintsha ngokuhamba kwexesha.
Izinto ezinje ngezi zibalulekile xa umisela usukelo lwakho:
- Unexesha elingakanani unesifo seswekile?
- Ubudala bakho kunye nolindelo lwakho lobomi.
- Ngaba unezinye izifo ezichaphazela amanqanaba eswekile egazini lakho? (umz., ukungasebenzi kakuhle kwezintso, i-gastroparesis)
- Ngaba unesifo sentliziyo?
- Ngaba unesifo sokungazi nge-hypoglycemia, imeko apho ungaziboni iimpawu zeswekile ephantsi egazini (hypo)?
- Ukhulelwe okanye unethemba lokukhulelwa?
Kulungile, makhe sijonge ezinye zeenjongo ze-TIR ezamkelwa rhoqo. Kwakhona, ezi ziingcebiso nje eziqhelekileyo. Injongo yakho isenokuba yahlukile kule.
| Iinjongo eziqhelekileyo kubantu abadala abaninzi abanesifo seswekile sohlobo 1 okanye uhlobo 2 | |
|---|---|
| Imeko | Ithagethi (ipesenti yexesha emini) |
| Ngaphakathi koluhlu olumiselweyo (70-180 mg/dL) | Ubuncinane i-70% |
| Inqanaba eliphantsi (54-69 mg/dL) | Ngaphantsi kwe-4% |
| Inqanaba eliphantsi kakhulu (< 54 mg/dL) | Ngaphantsi kwe-1% |
| Inqanaba eliphezulu (181-250 mg/dL) | Ngaphantsi kwe-25% |
| Inqanaba eliphezulu kakhulu (> 250 mg/dL) | Ngaphantsi kwe-5% |
| Ijolise kwabo basengozini enkulu ye-hypoglycemia | |
|---|---|
| Ngaphakathi koluhlu olumiselweyo (70-180 mg/dL) | Ubuncinane i-50% |
| Inqanaba eliphantsi (< 70 mg/dL) | Ngaphantsi kwe-1% |
| Inqanaba eliphezulu kakhulu (> 250 mg/dL) | Ngaphantsi kwe-10% |
| Iinjongo zabantu abanesifo seswekile sohlobo loku-1 ngexesha lokukhulelwa | |
|---|---|
| Ngaphakathi koluhlu oluqhelekileyo (63-140 mg/dL) | Ubuncinane i-70% |
| Inqanaba eliphantsi (< 63 mg/dL) | Ngaphantsi kwe-4% |
| Inqanaba eliphezulu (> 140 mg/dL) | Ngaphantsi kwe-25% |
Iinjongo zesifo seswekile sokukhulelwa kunye nesifo seswekile sohlobo lwesibini ngexesha lokukhulelwa zinokwahluka, ngoko ke kubalulekile ukuxoxa nogqirha wakho ngeenjongo eziluncedo nezinokwenzeka kuwe.
Yintoni ubudlelwane phakathi kwe-A1C kunye ne-TIR?
Kubaluleke kakhulu ukuqonda umahluko phakathi kwezi zimbini.
- I-TIR (Ixesha eliPhakathi) sisilinganiselo esibonelela ngolwazi malunga nokuguquguquka kwamanqanaba eswekile yakho kwixesha leeyure okanye iintsuku.
- I-A1C luvavanyo lwegazi olubonisa umgangatho weswekile egazini lakho oqhelekileyo kwiinyanga ezi-2-3 ezidlulileyo .
Cinga nge-A1C njengokufunda isishwankathelo sesahluko kwincwadi. Ikunika umbono omncinci. Kodwa i-TIR ifana nokufunda isahluko sonke, igama ngalinye, isivakalisi ngasinye. Ufumana yonke inkcukacha ngokucacileyo. I-A1C ayikuniki naluphi na ulwazi malunga nokuba iswekile yakho iphezulu okanye iphantsi kangakanani.
Kutheni i-A1C inokukhohlisa?
Cinga ngaba bantu babini.
1. Umntu wokuqala: Amanqanaba eswekile egazini lakhe ayatshintshatshintsha imini yonke. Ngamanye amaxesha aphantsi kakhulu (hypo), ngamanye amaxesha aphakama kakhulu.
2. Umntu wesibini: Inqanaba leswekile yakhe egazini lihlala lizinzile imini yonke, malunga ne-154 mg/dL.
Bobabini aba bantu banokuba ne-A1C ye-7%. Kuba i-A1C iphakathi nje. Nangona kunjalo, amaxabiso abo e-TIR ahluke ngokupheleleyo. I-TIR yomntu wokuqala iphantsi kakhulu. Oko kuthetha ukuba umzimba wabo usengozini enkulu yokufumana iziphumo ebezingalindelekanga zesifo seswekile.
Kwakhona, abantu abanezi meko zilandelayo banokuba namaxabiso angachanekanga e-A1C:
- I-anemia
- Iindidi zeHemoglobin
- Ukunqongophala kwesinyithi
- Ukukhulelwa
- Isifo sesibindi
Okwangoku, i-TIR ayizukuthatha indawo yovavanyo lwe-A1C ngokupheleleyo. Uphando olude lwamashumi eminyaka lubonise ukuba amanqanaba e-A1C anokuxela kwangaphambili umngcipheko wakho wokuba neengxaki zeswekile. Yiyo loo nto oogqirha besebenzisa zombini i-A1C kunye ne-TIR kunye ukuze bafumane umfanekiso opheleleyo nochanekileyo wolawulo lwakho lweswekile.
Kutheni iTime in Range (TIR) ibalulekile?
I-TIR ikunika umfanekiso ocacileyo ngakumbi wokuguquguquka kwamanqanaba eswekile egazini okubangelwa sisifo seswekile. Izinto ezinje ngokutya esikutyayo, umthambo esiwenzayo, amayeza esiwasebenzisayo, kunye namanqanaba ethu oxinzelelo zonke zichaphazela amanqanaba eswekile egazini. Xa ujonga idatha yakho ye-TIR, ungayiqonda indlela nganye kwezi zinto echaphazela ngayo ngqo amanqanaba eswekile egazini lakho.
Umzekelo, khawucinge ukuba ubunomkhuhlane kangangeveki. Xa ujonga ingxelo yakho ye-TIR ngaloo veki, ubona ukuba ixabiso lakho le-TIR lehle kakhulu. Emva koko, kwixesha elizayo xa ugula, ungathetha nogqirha wakho malunga nendlela yokuyilungiselela kunye nokulawula isifo sakho seswekile kwangaphambili.
I-TIR kunye neengxaki zesifo seswekile
Uphando lubonise ukuba kukho unxibelelwano phakathi kwamaxabiso aphantsi e-TIR kunye neengxaki ezibangelwa sisifo seswekile.
Ukwahluka kwe-Glycemic kunokunyusa uxinzelelo lwe-oxidative kunye nokuvuvukala emzimbeni, okunokonakalisa iiseli emzimbeni. Uphando lufumanise ukuba olu tshintsho luphezulu kumanqanaba eswekile egazini lunyusa umngcipheko we:
- Ukwanda kwe-hypoglycemia.
- Umngcipheko okhulayo wesifo sentliziyo.
- Ukuphazamiseka kokusebenza kwengqondo kunye nengqondo (umsebenzi wokuqonda).
- Ukuncipha komgangatho wobomi.
Ngaphezu koko, olunye uphando lufumanise ukuba abantu abanesifo seswekile sohlobo lwesibini abane-TIR ephantsi kunye nokuguquguquka okuphezulu kweswekile egazini banamathuba amaninzi okuba ne-retinopathy enzulu enxulumene nesifo seswekile. Olunye uphando lufumanise unxibelelwano oluqinileyo phakathi kwe-TIR ephantsi kunye ne-cardiovascular autonomic neuropathy.
Konke oku kubonisa indlela ekubaluleke ngayo ukugcina ixabiso lakho le-TIR likwinqanaba eliphezulu.
Ndingaliphucula njani ixesha lam kwiRange?
Eyona ndlela iphambili yokuphucula i-TIR yakho kukuchonga kanye kanye izinto ezichaphazela amanqanaba eswekile yakho. Oku kungathatha ixesha. Kungavakala ngathi luvavanyo lwesayensi olungapheliyo.
Ngoko ke, yiba nobubele kuwe . Musa ukuzama ukutshintsha yonke into ngaxeshanye, gxila kwinto enye ngexesha.
Khawucinge ukuba uqaphela ukuba amanqanaba eswekile egazini lakho aya enyuka kuphela emva kwesidlo sakusasa yonke imihla. Ngoko ke, qaphela imikhwa yakho kunye nemisebenzi yakho ngelo xesha.
Umzekelo, izinto ezinje ngezi zinokubangela ukuba iswekile yegazi inyuke emva kwesidlo sakusasa:
- Lifikile ixesha lokuthatha amayeza akho esifo seswekile (njenge-insulin).
- Idosi yeyeza.
- Ibhalansi yokutya okutyayo kunye nezondlo ezikuyo (iicarbohydrate, amafutha, iiproteni).
- Amanye amayeza onokuwasela kusasa.
- Ukusela into ene-caffeine, njengekofu, kusasa.
Lo ngumzekelo omnye nje. Isifo seswekile sisifo esinzima kakhulu. Zininzi iindlela zokunceda ukuphucula i-TIR yakho. Khumbula rhoqo, ngaphambi kokuba wenze naluphi na utshintsho kwisicwangciso sakho sonyango, thetha nomntu ogxile kwisifo seswekile, njengogqirha we-endocrinologist okanye ingcali yokhathalelo lweswekile eqinisekisiweyo (CDCES), okanye ubuncinane ugqirha wakho oqhelekileyo.
Ixesha elikwi-Range (TIR) liyindlela entsha neluncedo kakhulu yokulinganisa ulawulo lwesifo seswekile. Ekuqaleni, kunokubonakala kunzima ukuqonda lonke olu lwazi kunye nedatha ye-TIR. Kodwa ungakhathazeki. Ugqirha wakho uza kukuchazela konke kwaye akuncede usebenzise eli xabiso le-TIR ukuze ufumane inzuzo. Kunye, ninokulandelela indlela i-TIR yakho etshintsha ngayo ngokuhamba kwexesha kwaye nilungise isicwangciso sakho solawulo ngokufanelekileyo.
Umyalezo Wokuya Ekhaya
- 'Ixesha eliphakathi' (TIR) lipesenti yexesha apho inqanaba leswekile egazini lakho lingaphakathi koluhlu olujoliswe kulo.
- Oku kunika umfanekiso ocacileyo noneenkcukacha ngakumbi wendlela amanqanaba eswekile yakho atshintsha ngayo imini yonke kunovavanyo lwe-A1C.
- Injongo yakho ye-TIR imiselwa nguwe kunye nogqirha wakho kunye. Ayifani kuye wonke umntu.
- Ukusebenzisa idatha ye-TIR, wena kunye nogqirha wakho ninokwenza izigqibo ezingcono malunga nonyango.
- Ngokuphucula amanqaku akho e-TIR, unganciphisa umngcipheko weengxaki zexesha elide ezibangelwa sisifo seswekile.
- Olu luhambo. Asikuko konke okuza kulunga ngoko nangoko. Yiba nobubele kuwe, utshintsho oluncinci lunokwenza umahluko omkhulu.
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