Ana samun daidaituwa na matakan sukari na jini ta hanyar aikin endocrine. Idan metabolism din mara nauyi, wannan yana haifar da rikice-rikice a cikin aiki na tsarin jijiya, ciki har da kwakwalwa, da lalata lalatattun tasoshin jini.
Ana ɗaukaka ƙara yawan sukari na jini akai-akai shine babban alamar alama don ciwon sukari. Don ƙayyade shi, ana yin gwajin jini a kan komai a ciki kuma bayan nauyin sukari, wanda ya ba ka damar gano cutar a farkon matakin.
Cigaba da karantawa game da karatuttukan sukari na jini yana taimakawa daidaituwa game da ciwon sukari da kuma rigakafin cutar mahaifa da yanayi mai narkewa, wanda ya hada da cutar nephropathy, ƙafafun ciwon sukari, retinopathy, harma da cututtukan zuciya.
Menene alamomin sukari ya dogara?
Tabbatar da ci gaba da ƙarni na makamashi ta sel jikin yana yiwuwa tare da isasshen adadin glucose a cikin jini da kwarararwar da ba ta rufe shi a cikin tantanin. Duk wani cin zarafin wannan kayan yana bayyana kanta a cikin hanyar karkacewa daga al'ada: hypoglycemia tare da raguwar sukari na jini ko hauhawar jini tare da haɓakawa.
Manunin al'ada na metabolism metabolism shine 3.3 - 5.5 mmol / l lokacin da ake ƙayyade glucose jini. Sauye-sauye tsakanin kashi 30% na wannan iyakar ana ɗaukar su ne marasa mahimmanci kuma, idan cutar ba ta haifar da su ba, jiki zai dawo da su zuwa iyakokin da aka nuna.
Wannan na iya kasancewa yayin cin abinci (hyperglycemia bayan cin abinci), motsin rai ko rashi na jiki (hyperglycemia a lokacin damuwa), ko faɗuwar sukari a cikin ɗan gajeren yunwar.
An daidaita matakan sukari na jini ta hanyar aikin da ke gudana na ƙwayar cuta da tsarin juyayi na tsakiya. Kwayoyin halittar jijiyoyin adrenal, yanayin hanji, kodan da hanta suma suna shafar matakin ƙwayar cuta. Babban masu sayen sukari sune kwakwalwa da tsoka, da kuma tsotse nama.
Akwai nau'ikan tsari iri iri na metabolism:
- Mara tsoro.
- Sauya.
- Hormon
- Renal.
Hanyar hanya mafi kyau ta tsari yana faruwa ta wannan hanyar: a kan ɗumbin ɗumbin ɗumbin tausayi.
Wannan yana haifar da karuwa a cikin catecholamines na jini, wanda ke haifar da glycogen gushewa da haɓaka glycemia.
Idan aka kunna sashen parasympathetic, wannan yana hade da aiki mai karfi na insulin da kuma hanzarta shigar kwayoyin kwayoyin a cikin wadannan kyallen da suke dogaro da insulin, wanda ke rage glucose a cikin jini.
Substa'idar aiki na glucose metabolism ya dogara da matakin shi cikin jini. Matsakaicin iyaka na hankali wanda tsarinsa a cikin hanta yayi daidai da amfanin nama shine 5.5-5.8 mmol / L.
A ƙananan matakin, hanta fara samar da glucose ga jini (ana kunna glycogen fashewa). Idan karatun sukari ya fi girma, to, aikin glycogen a cikin ƙwayar tsoka da ƙwayoyin hanta ya fi rinjaye.
Dokar Hormonal tana faruwa ne sakamakon aikin gaba ɗaya na tsarin endocrine, amma insulin yana da tasirin rage tasirin girma a matakan sukari, yayin da duk sauran ke ƙaruwa. Samuwar insulin yana faruwa ne ta hanyar babban kwayar halitta, wanda baya aiki kuma ana kiran shi proinsulin.
Wurin samar da aikin proinsulin shine islet nama a cikin koda. Tare da karuwa a cikin sukari na jini, ana kunna masu karuwar glucose. Bayan wannan, ana iya raba kwayar ta proinsulin cikin insulin da wani sinadari mai rikitarwa wanda ake kira C-peptide.
Enala'idar azabtarwa na faruwa ne a lokacin shafawar glucose a cikin glomeruli da ɗaukar abin da ya karɓa a cikin tubules na koda. Sakamakon wannan aikin, babu wani glucose a cikin fitsari na biyu, wanda aka keɓe daga jiki.
Idan tsarin ƙwayar cuta ta yara ta cika da matsanancin ƙwayar plasma na glucose, to, an fesa shi a cikin fitsari. Glucosuria yana faruwa ne bayan da matakin farko na glucose a cikin jini wanda yake gudana.
Wannan na faruwa ne idan sukarin jini ya wuce 9 mmol / L.
Gwajin glucose na jini
Don gudanar da nazarin yanayin yanayin metabolism, abubuwan da ke nuna alamun glycemia na azumi da kuma bayan cin abinci ana nazarin. Don wannan, ana amfani da hanyar gwaji ko glucometer, wanda za'a iya amfani dashi a gida.
An gudanar da binciken ne bayan hutu na awa 10 a cikin cin abinci, ban da aikin motsa jiki, shan sigari, cin abinci ko abin sha, zai fi kyau amfani da tsabtataccen ruwan sha a cikin karamin adadin don shawo ƙishirwa
Idan mai haƙuri ya yi amfani da kowane magunguna, to, dole ne a yarda da dawowar su da farko tare da likitan halartar don samun sakamako mai aminci. Darajar ganewar asali gwajin jini ne wanda ake yi sau biyu akan ranaku daban.
Uesimar sukari a cikin mmol / l a cikin binciken da ke tattare da ƙwayar jini mai sankarar fata:
- Har zuwa 3.3 - hypoglycemia.
- 3-5.5 - sukari na jini al'ada ne.
- 6-6.1 - ciwon suga.
- Sama da 6.1 shine ciwon sukari.
Idan kuna zargin cin zarafin metabolism, ana aiwatar da TSH - gwajin haƙuri na glucose. Kuna buƙatar shirya shi - don ware damuwa na damuwa a cikin kwana uku, bai kamata a sami canje-canje ga abinci mai gina jiki da cututtuka masu yaduwa ba.
Ranar jarrabawar, kada ku shiga wasanni ko aiki mai ƙarfi, kada ku sha taba.
An nuna gwajin haƙuri a cikin glucose a gaban abubuwan da ke haifar da haɗari ga mellitus na ciwon sukari, ana yin shi tare da hauhawar jini, ƙwayar jini, mata waɗanda ke da ciwon sukari na mahaifa, ƙwayoyin polycystic, yaro da aka haife tare da nauyin jiki fiye da 4.5 kilogiram, tare da kiba, ɗaukar nauyi na gado, bayan da shekara 45 da haihuwa.
Gudanar da TSH ya ƙunshi yin gwajin glucose na jini mai azumi, shan 75 g na glucose tare da ruwa, to mai haƙuri ya kasance ya huta na awa 2 kuma ya kamata ya yi gwajin jini na biyu.
Sakamakon gwajin nauyin sukari kamar haka:
- Haƙuri na rashin daidaituwa na glucose, latent diabetes mellitus: kafin gwajin 6.95 mmol / l, bayan ciwan glucose - 7.8 - 11.1 mmol / l.
- Gurasar azumi mai rauni: ma'aunin 1 - 6.1-7 mmol / L, sakamakon na biyu - ƙasa da 7.8 mmol / L.
- Ciwon sukari (mellitus): kafin ɗaukar kaya - fiye da 6.95, da kuma bayan - 11.1 mmol / l.
- Al'ada: a kan komai a ciki - ƙasa da 5.6 mmol / l, bayan loda - ƙasa da 7.8 mmol / l.
Gluarancin glucose
Ana jin cutar rashin karfin jiki idan rage sukari ya kai 2.75 mmol / L. Aoshin lafiya yana iya jin ƙoshin maida hankali ko bayyanar cututtuka ba su da yawa. Tare da matakin sukari mai haɓaka koyaushe, alamun hypoglycemia na iya faruwa tare da abun ciki na glucose na al'ada.
Na al'ada na iya zama hypoglycemia na jiki tare da tsawaita tsawan lokaci a cikin abincin abinci ko tsawan aikin jiki ba tare da isasshen abinci mai gina jiki ba. Rage yawan cututtukan ƙwayar cuta yana haɗuwa da shan magani ko barasa, kazalika da cututtuka.
Yaran da ba su haifuwa ba sun fi saurin kamuwa da cutar sankara saboda suna da babban nauyi na nauyin kwakwalwa zuwa nauyin jiki, kuma kwakwalwar tana cinye dumbin glucose. A lokaci guda, jarirai ba zasu iya maye gurbin glucose tare da jikin ketone ba, tunda suna da ketogenesis na halitta.
Sabili da haka, koda karamin digo na sukari, idan ya faru akan tsawan lokaci, na iya haifar da ci gaban ilimi. Hypoglycemia shine halayyar yara masu tsufa (har zuwa kilogiram 2.5 na nauyi) ko, idan uwar tana da ciwon suga.
Azumin hypoglycemia yana faruwa da irin wannan yanayin:
- Adrenal bawo insufficiency.
- Doa yawan adadin ƙwayoyin sulfonylurea ko shirye-shiryen insulin.
- Wuce insulin tare da insulinoma.
- Hypothyroidism
- Rashin Cutar
- Mai tsananin hanta ko cutar koda.
- Ciwon zazzabi.
- Rashin narkewa a cikin hanji, tiyata akan ciki.
- Tsarin Tumor, raunin kansa.
Ana nuna rashin ƙarfi a cikin jiki da rauni, rauni na gani, ciwon kai, sanadiyyar hura ciki, tsananin rauni, ƙoshin sassan jiki, raɗaɗi. Wadannan alamomin suna iyakance ga cutar rashin kwakwalwa.
Groupungiya ta biyu ta bayyanar cututtuka ta haɓaka tare da kunnawa na ramawa game da sakin abubuwan ba ji ba gani: tachycardia, sweating, palpitations, yunwa, hannuwa mai girgiza, pallor, tingling yatsunsu da lebe. Idan digon sukari ya ci gaba, ƙwayar cuta ta jini ke haɓaka.
Bayyanar cututtuka na cututtukan cututtukan jini na faruwa tare da raguwar matsakaici a cikin sukari, wanda aka maimaita shi tsawon lokaci. Waɗannan sun haɗa da: canjin hali, asarar ƙwaƙwalwa, dementia, psychosis, a cikin yara - wannan jinkiri ne na ci gaba, jinkirta tunani.
Hyperglycemia
Hyperglycemia ana ɗauka a matsayin karuwa ne a cikin taro na glucose sama da 5.5 mmol / L. Ana iya hulɗa dashi tare da ɗaukar ƙwayar carbohydrates, wanda aka sha da sauri. Wannan nau'in ana kiran shi alimentary ko postprandial. Yunƙurin tashin hankali na sukari yana faruwa ne sakamakon tasirin hormones - glucocorticoids da catecholamines waɗanda aka kafa a wannan lokacin.
Kwayar cututtukan ƙwaƙwalwar ƙwayar cuta ta haɓaka tare da haɓaka aiki ko tsari na tumor a cikin gabobin tsarin endocrine - glandon, ƙwayar huhu, glandar adrenal ko cikin glandar thyroid. Ciwon sukari mellitus shine ɗayan manyan abubuwanda ke haifar da ci gaba a cikin sukari.
Hanyar haɓakar haɓakar hyperglycemia a cikin ciwon sukari ya dogara da abin da ke haifar dashi. Nau'in cuta ta farko tana faruwa ne akan asalin asarar kwayoyin cutar insulin dake rufe jikin mutum. Ga masu ciwon sukari na nau'in na biyu, babban rawa ana kunna shi ta juriya na insulin nama wanda ke faruwa yayin rikicewar metabolism, babban shine kasancewa kiba.
Tare da alamu bayyanar cututtuka na hyperglycemia, alamun bayyanar cututtuka masu zuwa suna tasowa cikin jiki:
- Thirstara yawan ƙishirwa.
- Jin kai, duk da cewa mutum ya ci abinci da kyau.
- Akai-akai da kwafin fitarwa na fitarwa.
- Ciwon kai.
- Rashin ƙarfi, gajiya.
- Visionaramin gani.
- Itchy fata da bushewar mucous membranes.
Za'a iya bayyanar da sauye-sauye a cikin nauyin jiki ba kawai ta hanyar asarar nauyi ba (tare da nau'in ciwon sukari na 1), amma kuma ta hanyar yawan kiba a cikin nau'in cuta ta biyu. Wannan shi ne saboda gaskiyar cewa insulin yana inganta adon mai a cikin ƙananan ƙwayoyin nama. Tare da nau'in ciwon sukari na 1, babu kadan a cikin jini, nau'in na biyu an san shi da hyperinsulinemia, musamman a farkon cutar.
Prolongara yawan jini a cikin jini yana haifar da raguwa cikin rigakafi, haɓaka cututtukan cututtuka, candidiasis, da jinkirin warkar da raunuka da raunin ulcerative. Rashin ƙarancin jini da lalacewar ƙwayoyin jijiya suna haifar da ragewar ji na ƙananan ƙarshen, haɓakar polyneuropathy.
Rashin rikitarwa na yau da kullun na ciwon sukari mellitus wanda ke haɓaka tare da ƙwayar cuta mai narkewa a cikin jini sune lalacewar kodan, ƙyallen ido, da lalata ganuwar manyan ƙananan jini.
Hyperglycemia kuma yana haifar da mummunan rikice-rikice na ciwon sukari, ciki har da ketoacidosis, hypersmolar coma, wanda matakan glucose na iya zuwa 32 mmol / L kuma mafi girma.
Hyperglycemia yana da tsananin bambance bambancen dangane da maida hankali na glucose a cikin jini (a mmol / l):
- Haske - 6.7-8.2.
- Verarfin matsakaici - 8.3-11.
- Mai Girma - Sama da 11.1
- Precoma yana faruwa ne a 16.5, adadin mafi girma yana haifar da komputa.
Hyperglycemia a cikin masu ciwon sukari yana faruwa lokacin da kuka tsallake magungunan don rage sukari ko allurar insulin, sannan kuma idan adadinsu bai isa ba.
Wannan yanayin na iya faruwa tare da yin amfani da abinci mai narkewa a jiki, haɗe-haɗe na kamuwa da cuta ko wata cuta, damuwa, raguwa a matakin yau da kullun na aiki.
Kula da sukari
Lokacin amfani da na'ura don auna glucose a cikin jini, dole ne ka bi ingantaccen fasaha don nazarin jini da yawan gwaje-gwaje. A cikin ciwon sukari na mellitus na nau'in farko, marasa lafiya ya kamata su ƙayyade yawan ƙwayar cuta aƙalla sau 4 a rana: sau uku kafin abinci da kafin lokacin kwanciya.
Hakanan ana iya buƙatar ƙarin ma'aunin a cikin dare, bayan tsananin aiki na jiki ko canje-canje masu mahimmanci a cikin abinci mai gina jiki. Hakanan ana ba da shawarar cewa kula da sukari da kanka lokaci-lokaci bayan an gama cin abinci (bayan awanni 2).
A nau'in na biyu, marasa lafiya na iya zama a kan maganin insulin ko shan magungunan masu ciwon sukari, kuma haɗuwa tare da insulin da ke aiki tare da magunguna don rage sukari shima ana yin su.
Idan an wajabta mai haƙuri da ƙwayar insulin, to, tsarin binciken daidai yake da na farkon masu ciwon sukari. Idan ya sami allura guda daya a rana ko allunan kawai, to yawanci ya isa a auna sukari sau daya, amma a lokuta daban-daban na rana.
Lokacin amfani da shirye-shiryen insulin, wanda ya ƙunshi insulin mai tsawo da gajere, ana aiwatar da iko sau biyu a rana. Tare da kowane zaɓi na magani, ya kamata a zana ginshiƙi sau ɗaya a mako, yana nuna ma'aunin sau 4 na glycemia.
Idan hanyar ciwon sukari tana tafiya tare da kaifi mai yawa a cikin sukari, to, yawan nunin ya kamata ya zama mafi girma, ya kamata likita ya shawarce shi. Hakanan yana ƙaddara matakin glucose mai mahimmanci ga kowane haƙuri, dangane da shekaru, salon rayuwa, nauyin jikin.
Ka'idojin ka'idodi na gudanar da aikin sa-kai a kan sukari na jini:
- Jinin yatsu ya fi dacewa da nazari; za a canza wurin falle.
- Ana aiwatar da allurar ne daga gefe, zurfin kada ya kasance fiye da milimita 2-3.
- Duk abubuwanda zasu zama bakararre ne kuma koyaushe mutum yayi
- Tare da zubar da jini mara kyau, kafin bincike, yi masa yatsa kuma wanke hannuwanku da ruwa mai ɗumi da bushe.
- Kafin aunawa, kuna buƙatar tantance lamba akan kwalban tare da tsinke gwaji da kan allon mitir.
- Ba a yi amfani da digo na farko don bincike ba, ana buƙatar cire shi tare da busassun auduga.
- Comparfafa ƙarfi na yatsa yana haifar da haɗuwa da jini tare da ƙwayar nama, wanda ke juyar da sakamakon.
Aiwatar da digo na jini kawai a gefen tsiri gwajin, wanda aka yi alama a baki. Kafin aunawa, tsirin gwajin dole ne ya kasance a cikin kwalban da aka rufe, saboda yana da laima ga danshi. Ba za a iya ɗauka ba daga kwalban tare da yatsun rigar. Hakanan, ba za ku iya canza wuraren ajiya na tsaran gwajin ba, saboda takaddun asali sun ƙunshi kayan ɓoye.
Dole ne a adana igiyoyin a cikin busassun wuri a zazzabi na ɗakin, kafin a yi amfani da buƙatar tabbatar cewa ranar karewa da aka nuna akan kunshin bai wuce ba. Bayan kammalawa, irin waɗannan matakan gwajin na iya gurbata sakamakon aunawa.
Don bayyanar gwaje-gwaje, ana amfani da tsinkaye na gani don tantance sukari na jini.Za za'a iya amfani dasu idan babu glucometer. Hakanan zaka iya mayar da hankali kan sakamakon ƙuduri ta amfani da irin wannan tsinannun lokacin gano jikin ketone a cikin jini da fitsari.
Bidiyo a cikin wannan labarin yana nuna yadda zaka iya auna sukarin jini da kansa.
