Yikuphi ngempela ukuhlolwa kwe-A1C okukutshela ngamazinga kashukela egazini lakho? Ake sixoxe ngakho!

Cishe uke wezwa odokotela bethi, "Udinga ukuhlolwa kwe-A1C." Noma uma othile emndenini wakho enesifo sikashukela, kungenzeka ukuthi uke wezwa ngalokhu kuhlolwa kwe-A1C. Kuyini ngempela lokhu kuhlolwa kwe-A1C? Yini esingayifunda kukho? Namuhla, sizoxoxa ngalokhu kuhlolwa kwe-A1C ngendlela elula ongayiqonda.

Kuyini ukuhlolwa kwe-A1C?

Kalula nje, ukuhlolwa kwe-A1C kuwukuhlolwa okukala amazinga kashukela egazini lakho, noma "i-glucose", ezinyangeni ezintathu ezedlule. Imiphumela inikezwa njengephesenti. Uma iphesenti liphezulu, amazinga kashukela egazini lakho aphezulu.

Odokotela basebenzisa ukuhlolwa kwe-A1C ngezizathu eziningana eziyinhloko:

• Thola isigaba ngaphambi kwesifo sikashukela (`(Prediabetes)`). Okusho ukuthi, isigaba esiseduze nokukhula kwesifo sikashukela.
• Thola ukuthi unesifo sikashukela sohlobo 2 yini ngempela.
• Uma unesifo sikashukela sohlobo lwesibili noma isifo sikashukela sohlobo 1, kubalulekile ukuqonda ukuthi uhlelo lwakho lokwelashwa lusebenza kahle kangakanani. Izinga lakho le-A1C lingakusiza wena nodokotela wakho ukuthi ninqume ukuthi nidinga ukwenza izinguquko ohlelweni lwenu lokwelashwa.

Kwenziwa kanjani ukuhlolwa kwe-A1C?

Odokotela bahlola i-A1C ngezindlela ezimbili:

• Ngokuvamile, inani elincane legazi likhishwa emthanjeni bese lithunyelwa elabhorethri ukuze lihlolwe. Lena yindlela evame kakhulu. Lokhu kubizwa ngokuthi "i-Phlebotomist" ekhipha igazi.
• Enye indlela iwukuthatha ithonsi legazi esihlokweni somunwe wakho bese ulihlola. Lokhu kungakunika imiphumela ngemizuzu embalwa. Kodwa-ke, le ndlela isetshenziswa kuphela ukubona ukuthi ukwelashwa kwakho kuhamba kanjani, futhi ayisetshenziselwa ukuxilonga isifo esisha.

Ukuhlolwa okusebenzisa umthambo ngokuvamile kunembe kakhulu kunokuhlolwa kokubhoboza ngomunwe.

Yimaphi amanye amagama okuhlolwa kwe-A1C?

Lolu vivinyo lwe-A1C lubizwa ngamanye amagama amaningana. Ungase uzwe nalawa magama:

• I-Hemoglobin A1C `(I-Hemoglobin A1C)`
• I-HbA1c `(HbA1c)`
• I-hemoglobin ene-glycated
• Ukuhlolwa kwe-Glycohemoglobin `(Ukuhlolwa kwe-Glycohemoglobin)`

Kuyini ushukela egazini (i-glucose)?

Imizimba yethu ithola le `(Glucose)` noma ushukela ikakhulukazi kuma-carbohydrate ekudleni esikudlayo. Lona umthombo oyinhloko wamandla amangqamuzana emizimba yethu. Igazi lethu lithwala le `(Glucose)` liye kumaseli kuwo wonke umzimba.

Izinqubo eziningi emizimbeni yethu zisiza ukugcina amazinga kashukela egazini esezingeni elithile. Indima ebaluleke kakhulu kulokhu idlalwa yi-hormone ethi ``Insulin``, ekhiqizwa yi-pancreas yethu.

Uma amazinga kashukela egazini lakho ephakeme njalo (i-hyperglycemia), okusho ukuthi i-A1C yakho nayo iphakeme, ngokuvamile kusho ukuthi unesifo sikashukela. Isifo sikashukela senzeka lapho i-pancreas ingakhiqizi i-insulin eyanele, noma lapho inani le-insulin eliyikhiqizayo linganele, noma lapho umzimba ungakwazi ukusebenzisa i-insulin ngendlela efanele.

Ngidinga nini ukuhlolwa kwe-A1C?

Uma unesifo sikashukela, kufanele wenze ukuhlolwa kwe-A1C okungenani kabili ngonyaka ukuze ubone ukuthi uhlelo lwakho lokwelashwa lusebenza kahle kangakanani. Udokotela wakho uzokutshela ukuthi kufanele ukwenze kangaki lokhu.

Uma ungakatholakali unesifo sikashukela, kodwa unezimpawu ezilandelayo, udokotela angase akucele ukuthi uhlolwe i-A1C:

• Ukoma ngokweqile okuqhubekayo (`(Polydipsia)`)
• Ukuchama ngokweqile
• Umbono ofiphele
• Ukuzizwa ukhathele ngaso sonke isikhathi (`(Ukukhathala)`)

Ungathola futhi ukuhlolwa kwe-A1C ukuze ubone ukuthi usengozini yokuthola isifo sikashukela sohlobo 2. Izici eziyingozi zifaka:

• Ukuba nelungu lomndeni elinesifo sikashukela sohlobo lwesibili.
• Uma uke waba nesifo sikashukela sokukhulelwa ngaphambilini.
• Ukukhuluphala ngokweqile.
• Ukuntuleka komsebenzi noma ukuvivinya umzimba.
• Ukuba neminyaka engaphezu kwengu-35 ubudala.

Ibalwa kanjani i-A1C?

Ukuhlolwa kwe-A1C kusekelwe kokuthile okubizwa nge -hemoglobin . I-hemoglobin yingxenye yamaseli ethu abomvu egazi athwala umoya-mpilo kuwo wonke umzimba. Uma kukhona i-glucose egazini lakho, inamathela kule hemoglobin. Lokhu kubizwa ngokuthi i-glycation . Uma i-glucose iningi egazini lakho, kulapho lokhu kunamathela kuyanda khona. Futhi, lokhu kunamathela kungahlala cishe izinyanga ezintathu - okucishe kube yisikhathi sokuphila esimaphakathi seseli elibomvu legazi.

Ukuhlolwa kwe-A1C kulinganisa isilinganiso se-glucose esinamathele ku-hemoglobin ngokuhamba kwesikhathi. Ngenxa yokuthi kulinganisa amazinga kashukela egazini ngokuhamba kwesikhathi, ukuhlolwa kwe-A1C kungasitshela okwengeziwe ngempilo yakho kunokuhlolwa okukodwa kukashukela egazini.

Ingabe ngidinga ukuzila ukudla ngaphambi kokuhlolwa kwe-A1C?

Cha. Akudingeki uzile ukudla ngaphambi kokwenza ukuhlolwa kwe-A1C.

Kwenzekani uma wenza ukuhlolwa kwe-A1C?

Nakhu ongakulindela esivivinyweni se-A1C, esihilela ukuthatha igazi emthanjeni:

• Ngesikhathi uhleli esihlalweni, udokotela we-phlebotomist (umuntu okhipha igazi) uzofuna umthambo engalweni yakho okulula ukukhipha igazi kuwo. Ngokuvamile, igazi likhishwa ngaphakathi kwengalo yakho, ngemuva nje kwendololwane yakho.
• Uma sekutholakale umthambo, indawo iyahlanzwa futhi ihlanzwe ngamagciwane.
• Bese kufakwa inaliti encane emthanjeni bese kuthathwa isampula yegazi. Lokhu kungase kuzwakale njengokugwazwa okuncane.
• Ngemva kokufaka inaliti, igazi elincane liqoqwa epayipini lokuhlola.
• Uma igazi elanele seliqoqiwe ukuze kuhlolwe, inaliti iyasuswa bese ukuphuma kwegazi kunqanyulwa ngokufaka ingcindezi endaweni ngendwangu yekotini noma i-gauze.
• Ekugcineni, faka iplasta khona lapho bese uqedile.

Ngesikhathi sokuhlolwa kwe-A1C, okwenziwa ngokuthatha igazi ngomunwe, kwenzeka izinto ezilandelayo:

• Udokotela uyakubuza ukuthi uzothatha igazi kuluphi umunwe.
• Iminwe yakho izosulwa ngotshwala bese kwenziwa ukubhoboza okuncane ngenaliti encane ebizwa ngokuthi "i-Lancet" (lokhu kuvame ukuba sedivayisini encane yepulasitiki).
• Bazocindezela umunwe wakho, bakhiphe ithonsi legazi, bese beliqoqa esitsheni esincane sepulasitiki.
• Ngemva kokuthathwa igazi elanele lokuhlolwa, uzonikezwa ucezu lukakotini noma i-gauze ukuze ulubambe esicongweni somunwe wakho ukuze umise ukopha.
• Imiphumela ngokuvamile ingatholakala ngemizuzu embalwa.

Ingabe zikhona izingozi zokuhlolwa kwe-A1C?

Ukuhlolwa kwegazi kuyingxenye evamile nedingekayo yokuhlolwa kwezokwelapha. Izingozi zazo zombili izinhlobo zokuhlolwa kwe-A1C ziphansi kakhulu. Ungase uzwe imihuzuko noma ubuhlungu lapho igazi likhishwa khona noma lapho umunwe wakho uhlatshwa khona, kodwa lokhu kuzophola ngokushesha.

Lisho ukuthini inani lami le-A1C?

Imiphumela yokuhlolwa kwe-A1C inikezwa njengephesenti. Le nombolo ikutshela ukuthi ingakanani iphrotheni ye-hemoglobin efakwe i-glycated, okusho ukuthi inamathele ku-glucose. Uma iphesenti liphezulu, amazinga kashukela egazini lakho abe phezulu ezinyangeni ezimbalwa ezedlule.

Amazinga e-A1C okuxilongwa ami kanje:

• Uma kungaphansi kuka-5.7%, kusho ukuthi awunaso isifo sikashukela. (Izinga eliphilile)
• Uma kuphakathi kuka-5.7% no-6.4%, kubhekwa njengesifo sikashukela sangaphambi kwesikhathi. Lokhu kusho ukuthi isifo sikashukela siseduze nokukhula.
• Izinga elingu-6.5% noma ngaphezulu livame ukukhombisa isifo sikashukela sohlobo 2 noma isifo sikashukela sohlobo 1.

Uma usuvele unesifo sikashukela, imiphumela yakho ye-A1C ikhombisa ukuthi uhlelo lwakho lokwelashwa lusebenze kahle kangakanani ezinyangeni ezintathu ezedlule. Lokhu kwelashwa kungafaka amaphilisi, imijovo ye-insulin, ukuhlolwa kashukela egazini njalo, kanye nezinguquko zendlela yokuphila (njengokudla nokuzivocavoca). Ngokusekelwe enanini lakho le-A1C, wena nodokotela wakho ninganquma ukuthi kukhona yini izinguquko ohlelweni lwakho lokwelashwa ezidingekayo.

Into ebaluleke kakhulu okufanele uyikhumbule ukuthi i-A1C yakho (uma unesifo sikashukela) iyisilinganiso nje samazinga kashukela egazini lakho ezinyangeni ezimbalwa. Akusona isibonakaliso sempilo yakho noma isinqumo sokugcina sokuthi uphila impilo enempilo yini. Khumbula ukuthi i-A1C yakho ingashintsha impilo yakho yonke, futhi kunezinto ongazenza ukuze uphathe isifo sikashukela sakho futhi uthuthukise amazinga akho e-A1C, uma kudingeka.

Iyini i-A1C kanye ne-glucose evamile elinganisiwe (eAG)?

Amanye amalabhorethri anikeza imiphumela ye-A1C njengephesenti, kanye nesilinganiso esihambisanayoInani elilinganiselwe le-glucose (eAG) linikezwa futhi.

Isibalo se-`(eAG)` siguqula iphesenti le-A1C libe amayunithi afanayo (ama-milligram nge-deciliter - mg/dL noma ama-millimoles ngelitha - mmol/L) owasebenzisa ne-glucometer yakho yasekhaya. Njengoba nje i-A1C yakho iyisilinganiso, i-`(eAG)` iyinani elilodwa elibonisa izinga lakho likashukela egazini elimaphakathi ezinyangeni ezintathu ezedlule.

Isibonelo, i-A1C engu-7% ilingana no-`(eAG)` ongu-154 mg/dL (8.6 mmol/L). I-A1C engu-9% ilingana no-`(eAG)` ongu-212 mg/dL (11.8 mmol/L).

Iyini inani elijwayelekile le-A1C?

Kumuntu ongenaso isifo sikashukela, inani elijwayelekile le-A1C lingaphansi kuka-5.7%.

Lokho okubhekwa "njengokuvamile" nokunempilo kubantu abanesifo sikashukela kuncike emigomweni yakho kanye nokufinyelela kwakho emithini nasemithini yokulawula isifo sikashukela. Wena nodokotela wakho nizosebenzisana ukunquma ububanzi be-A1C eniyiqondile. Lokhu kungashintsha impilo yakho yonke.

Ngokuvamile, i-American Diabetes Association incoma ukuthi abantu abadala abaningi abanesifo sikashukela bahlose i-A1C engu-7% noma ngaphansi .

Inhloso yakho ye-A1C ingaba ngaphezu kuka-7% kulezi zimo:

• Uma isikhathi sokuphila sinqunyelwe.
• Uma uneziqephu ezivamile zoshukela wegazi ophansi kakhulu (`(Hypoglycemia)`) noma ungazazi lezi ziqephu (`(Hypoglycemia unawareness)`).
• Uma unezinkinga ezinkulu ezibangelwa isifo sikashukela (njengesifo sezinso esingamahlalakhona, ukulimala kwemizwa, noma isifo senhliziyo).

Ngakolunye uhlangothi, kwabesifazane abanesifo sikashukela sohlobo 1 ngesikhathi sokukhulelwa, odokotela ngokuvamile batusa ukugcina amazinga e-A1C ku-6.5% noma ngaphansi phakathi nokukhulelwa. Lokhu kwenzelwa ukunciphisa izingozi zempilo kumntwana osanda kuzalwa nokuvimbela ukukhula ngokweqile kwengane esanda kuzalwa (i-fetal macrosomia).

Iyini izinga eliyingozi le-A1C?

Njengoba izinga lakho le-A1C likhuphuka, ikakhulukazi uma lihlala liphezulu iminyaka eminingi, kungenzeka kakhulu ukuthi ube nezinkinga ezifana nalezi:

• Izinkinga zamehlo (`(Retinopathy)`)
• Izinkinga zezinso (`(Nephropathy)`)
• Izinkinga zemizwa (`(I-Neuropathy)`)
• Ukungasebenzi kahle kwesisu (i-Gastroparesis)
• Isifo senhliziyo
• Isifo sohlangothi

Ucwaningo lukhombisile ukuthi abantu abanesifo sikashukela banganciphisa ingozi yabo yokuthola izinkinga zesifo sikashukela ngokugcina amazinga e-A1C engaphansi kuka-7% .

Kodwa khumbula, ezinye izici, njengezici zofuzo kanye nokuthi usunesikhathi esingakanani unesifo sikashukela, nazo zingathinta ukukhula kwezinkinga zesifo sikashukela.

Ingabe ukuhlolwa kwe-A1C kunembile ngempela?

Ezinye izici zingathinta ukunemba kokuhlolwa kwe-A1C, okuhlanganisa:

• Izici zofuzo, isibonelo, ukuhlukahluka kwe-hemoglobin
• Ezinye izimo zezokwelapha
• Eminye imithi kanye nezithako zokudla okunempilo
• Amaphutha ngesikhathi sokuqoqwa, ukuthuthwa, noma ukucutshungulwa kwamasampula ukuze ahlolwe

Lezi zici zingabangela ukuthi umphumela wakho ube `phansi ngamanga` noma `uphakeme ngamanga`. Eziningi zalezi zici zibangelwa ukushintshashintsha kwesikhathi sokuphila kanye nempilo yamaseli akho abomvu egazi.

Izinhlobo ze-Hemoglobin kanye nemiphumela ye-A1C

Izinhlobo ze-hemoglobin zingathinta imiphumela yokuhlolwa kwe-A1C okuthile.

Uhlobo lwe-hemoglobin egazini lakho lunqunywa yilokho okuzuza njengefa ezizakhini zakho zofuzo. Kunezinhlobo ezahlukene. Evame kakhulu yi-hemoglobin A. Ezinye izinhlobo ze-hemoglobin ezingajwayelekile kangako zibizwa ngokuthi ama-hemoglobin variants.

Ukuba nohlobo lwe-hemoglobin akukhulisi ingozi yakho yokuba nesifo sikashukela, kodwa kungathinta imiphumela ye-A1C. Amalebhu anezindlela ezahlukene zokuhlola i-A1C egazini ngohlobo lwe-hemoglobin.

Ezinye zezinhlobo ezivame ukubonakala yilezi:

• Isici se-Hemoglobin C : Lokhu kuvame kakhulu kubantu abamnyama, abantu bozalo lwaseNtshonalanga Afrika, kanye nabantu abavela eNingizimu neMelika Ephakathi, eCaribbean, naseYurophu.
• Isici se-Hemoglobin D : Lokhu kuvamile kubantu abahlala eShayina, eNdiya, eTurkey, eBrazil, nakwezinye izingxenye zaseYurophu.
• Isici se-Hemoglobin E : Lokhu kuvamile phakathi kwabantu base-Asia baseMelika, ikakhulukazi labo abadabuka eNingizimu-mpumalanga ye-Asia.
• Isici se-Hemoglobin S : Lokhu kuvame kakhulu kubantu abamnyama nabaseMelika baseHispanic.

Ukuhlolwa kwegazi kungahlonza izinhlobo ze-hemoglobin. Uma ucabanga ukuthi ungase ube nohlobo lwe-hemoglobin olungathinta imiphumela yakho ye-A1C, khuluma nodokotela wakho.

Izizathu zokuthi kungani i-A1C yakho ingaba ngaphansi kunalokho eyikho ngempela

Lezi zimo nezimo zingabangela ukuthi imiphumela yakho ye-A1C ibe ngaphansi kunezinga lakho langempela:

• Ukusetshenziswa kotshwala ngokweqile (`(Inkinga yokusebenzisa utshwala)`)
• Ukumpontshelwa igazi
• Ukwehluleka kwezinso okungapheli (`(Ukwehluleka kwezinso okungapheli)`)
• Ama-Erythropoietin-stimulating agents (ama-ESA)
• Ukopha ngokweqile (`(Ukopha)`)
• Ukuhlala endaweni ephakeme kakhulu
• Ukuthatha izithasiselo zensimbi
• I-Cirrhosis yesibindi (`(I-Cirrhosis yesibindi)`)
• Ukukhulelwa
• I-anemia ye-sickle cell (`(i-anemia ye-sickle cell)`)
• I-Spherocytosis kanye ne-hemolytic anemia (`(I-Spherocytosis kanye ne-hemolytic anemia)`)

Izizathu zokuthi kungani amanani e-A1C angaba phezulu kunalokho akhona ngempela

Lezi zimo nezimo zingabangela ukuthi imiphumela yakho ye-A1C ibe phezulu kunalokho eyikho ngempela:

• I-anemia, isibonelo i-anemia yokuntuleka kwensimbi, i-anemia ebangelwa ukutheleleka, noma i-anemia ebangelwa umdlavuza.
• Eminye imithi, njengemithi yokucindezela amasosha omzimba kanye nemithi yokuvimbela i-protease.
• Ukwanda kwama-triglyceride egazini (`(Hypertriglyceridemia)`)
• Ukufakelwa isitho somzimba
• I-Thalassemia (`(Thalassemia)`)
• Ukuntuleka kwe-Vitamin B12 (`(Ukuntuleka kwe-Vitamin B12)`)

Ingabe isifo sikashukela singalapheka noma amazinga e-A1C ephezulu?

Yebo, ungakwazi. Ukuthi nje une-A1C ephezulu (ngaphezu kuka-6.5%) akusho ukuthi unesifo sikashukela. Eminye imithi, njenge-steroids, noma ezinye izici, njengokugula, ingakhuphula amazinga kashukela egazini okwesikhashana. Ezinye izimo, njenge-anemia, zingenza imiphumela yakho ye-A1C ibonakale iphakeme kunalokho eyikho ngempela. Kukhona futhi ithuba lokuthi ukuhlolwa kungase kungabi nembile.

Odokotela basebenzisa izivivinyo ezingaphezu kweyodwa ukuze bathole isifo sikashukela. Isibonelo, ungase ucelwe ukuthi wenze isivivinyo se-glucose yegazi esisheshayo noma isivivinyo se-A1C. Kodwa-ke, udokotela wakho uzobuyekeza imiphumela yakho ngokucophelela futhi axoxe nawe ngayo.

Ingabe i-A1C ikutshela ngokunembile ngokuphathwa kwesifo sikashukela?

Sekungamashumi eminyaka odokotela nabantu abanesifo sikashukela besebenzisa ukuhlolwa kwe-A1C ngokuyinhloko ukuze bahlole ukuthi ukwelashwa kwabo kusebenza kahle kangakanani.

Kodwa-ke, ikakhulukazi kubantu abanesifo sikashukela sohlobo 1, amazinga kashukela egazini angashintshashintsha kakhulu ngokuhamba kwezinsuku, amasonto, nezinyanga. Ngakho-ke, i-A1C isekelwe ebangeni eliphakathi futhi ayinikezi ngaso sonke isikhathi isithombe esinembile sokuphathwa.

Isibonelo, cabanga ngalokhu: Amazinga kashukela egazini lomuntu othile ahlala eshintshashintsha, kodwa i-A1C yakhe ingaba ngu-7%. Amazinga kashukela egazini lomunye umuntu ahlala ecishe abe ngu-154 mg/dL, kanti i-A1C yakhe ingaba ngu-7%.

Muva nje, ngokwethulwa kwamadivayisi okuqapha ushukela okuqhubekayo (i-CGM) , odokotela nabantu abanesifo sikashukela bathole ukuthi i-Time in Range (TIR) ​​​​inikeza isithombe esiwusizo nesinembile sokuphathwa kwesifo sikashukela.

I-TIR isikhathi lapho izinga likashukela egazini lakho lingaphakathi kwebanga eliphakanyisiwe eliphakanyisiwe. I-TIR ilinganiswa njengephesenti. Amazinga okuhlosiwe kashukela egazini angahluka kumuntu nomuntu, kodwa ububanzi obujwayelekile bokuhlosiwe buphakathi kuka-70 no-180 mg/dL. Kwabaningi abantu abadala abanesifo sikashukela sohlobo 1 noma sohlobo 2, odokotela batusa ukuzama ukugcina i-TIR ingaphezu kuka-70% (cishe amahora angu-17 ngosuku lwamahora angu-24).

Nge-`(CGM)` kanye ne-`(TIR)`, odokotela nabantu abanesifo sikashukela bangabona ukuthi amazinga kashukela egazini labo aphezulu noma aphansi kangaki. Lokhu kubasiza ukuthi bahlele izindlela zabo zokwelapha ngokunembe kakhudlwana.

Ekugcineni, kufanele uthi...

Kungaba yinto edidayo uma imiphumela yakho ye-A1C ingekho njengoba kulindelekile noma ingaphezu kwalokho obekulindelekile. Kodwa khumbula, i-A1C ephezulu akusho ukuthi unesifo sikashukela. Kunezici eziningi ezingabangela ukuthi imiphumela ingabi yinembile. Udokotela wakho uzokutshela uma udinga ukuhlolwa okwengeziwe. Ungesabi ukubuza udokotela wakho imibuzo. Bakhona ukukusiza.

Uma unesifo sikashukela, kubalulekile ukukhumbula ukuthi i-A1C yakho iyisilinganiso sesikhashana nje samazinga kashukela egazini lakho. Kunezinto ongazenza ukuze uthuthukise amazinga akho e-A1C. Uma uzizwa ukhungathekile ngokuphatha isifo sikashukela sakho, khuluma nodokotela wakho. Ndawonye, ​​ningakha uhlelo lokuphatha isifo sikashukela sakho futhi nifinyelele imigomo yenu ye-A1C.

I- A1C, i-HbA1c, isifo sikashukela, ushukela wegazi, i-glucose, i-hemoglobin, ukuhlolwa kwesifo sikashukela