I-411 ku-A1C: Amazinga ajwayelekile e-A1C nezindlela eziyi-15 zokwehlisa i-A1C ephezulu

Imfundo Yezempilo

Ukuhlolwa kwe-hemoglobin A1C kuyinto esondele kakhulu ekhadini lesikweletu sikashukela ongalithola. Noma ngabe umuntu ubenesifo sikashukela iminyaka eminingi noma uma esanda kutholakala, kungenzeka ukuthi uzwile ngalokhu kuhlolwa. Ngokungafani namamitha kashukela egazi abantu abawasebenzisayo ekhaya, i-A1C ilinganisa isilinganiso sikashukela egazini ezinyangeni ezimbalwa ezedlule ngokuhlaziya ukuthi mangaki amangqamuzana e-hemoglobin yesiguli ane-glucose enamathele kuwo. Imiphumela yokuhlolwa ilandelela ukuthi umuntu usilawula kahle kanjani isifo sakhe sikashukela.

Ngabe i-A1C imeleni?

IHemoglobin A1C (HbA1C), evame ukubizwa nge-A1C, imele i-hemoglobin ye-glycosylated. Ukuhlolwa kwe-A1C (kwesinye isikhathi okubizwa ngokuthi yi-HbA1C test noma i-glycohemoglobin test) kunikeza imininingwane yokuthi isifo sikashukela somuntu silawulwa kahle kangakanani. Lokhu ikwenza ngokulinganisa iphesenti lamaprotheni abomvu egazi le-hemoglobin elinoshukela onamathele kuwo futhi ikunikeze isilinganiso sezinyanga ezintathu samazinga eglucose egazini lakho, kuchaza UMarie Bellantoni , MD, i-endocrinologist eqinisekiswe ibhodi e-Center for Endocrinology eMercy Medical eBaltimore. Izinga eliphakeme likashukela egazini, i-glucose enamathela ku-hemoglobin. Imiphumela ihlinzeka iziguli nabahlinzeki bazo bezempilo ngolwazi lokuthi imishanguzo yabo, indlela abadla ngayo, nemithi yabo isebenza kahle kangakanani nokuthi ngabe ukulungiswa kuyadingeka yini.

OKUSHIWO: Imithi yesifo sikashukela kanye nokwelashwa

Ukuhlolwa kwe-A1C

Kunezizathu ezimbalwa udokotela angaphakamisa ukuhlolwa kwe-A1C:

• Ukwenza ukuxilongwa kohlobo lwesibili sikashukela
• Ukuhlolela ama-prediabetes
• Ukuqapha amazinga kashukela egazini
• Ukunquma ukuthi ngabe kudingeka ukwelashwa kulungiswe yini

Ukuhlolwa kwegazi kwe-A1C akuyona eyokuxilonga uhlobo lwesifo sikashukela sohlobo 1, isifo sikashukela sokukhulelwa, noma isifo sikashukela esihlobene ne-cystic fibrosis, ngokusho kweNational Institute of Diabetes and Digestive and Kidney Diseases ( I-NIDDK ).

Ngabe kufanele uzilile ukuhlolwa kwe-A1C kwegazi?

Ngokungafani ne-plasma glucose (FPG) kanye nokuhlolwa kwe-OGTT, asikho isidingo sokuzila ngaphambi kokuhlolwa kwe-A1C. Uma imiphumela yokuhlolwa kwe-A1C ikhombisa ukuthi umuntu unesifo sikashukela noma angahle abe naso, umhlinzeki wezokunakekelwa kwempilo angase asikisele olunye lwalezi zivivinyo ukuqinisekisa imiphumela. Olunye uvivinyo, ukuhlolwa okungahleliwe kwe-plasma glucose, okungadingi ukuzila, nakho kungasetshenziswa. Uma imiphumela ingumngcele noma uma imiphumela yezivivinyo ezahlukahlukene ingafani, udokotela angase asikisele ukuphinda ukuhlolwa emasontweni noma ezinyangeni ezimbalwa.

Zinembe kangakanani izivivinyo ze-A1C?

Amazinga e-A1C akhula kahle ngaphambi kokuqala kwesifo sikashukela, okwenza ukuxilongwa kusenesikhathi kwenzeke ngokusho kwe- Amazinga we-2017 Wokunakekelwa Kwezokwelapha Esifo Sikashukela yi-American Diabetes Association (ADA). Kwesinye isikhathi, noma kunjalo, ezigabeni zokuqala zikashukela, amazinga kashukela egazi awaphakeme ngokwanele ukuthi angabonakala njengenkinga. Izindawo zokuhlola, njengokushisa ebhodini, okokusebenza okusetshenzisiwe, nokuphathwa kwamasampuli, kungathinta imiphumela; kodwa-ke, lokhu kuvame kakhulu ku-glucose esheshayo ye-plasma kanye neI-OGTT kune-A1C. Ukulawulwa kwekhwalithi okuqinile nokuthuthuka ekuhlolweni kwenze ukuhlolwa kwe-A1C kucace kakhulu kunakuqala, ngokusho kwe-NIDDK. Odokotela kufanele bazi amalebhu asebenzisa indlela eqinisekisiwe ye-NGSP yokuhlola amazinga e-A1C. I-NIDDK ixwayisa ngokuthi amasampula egazi athathwe ekhaya noma ahlaziywa ehhovisi lomhlinzeki wezokunakekelwa kwempilo akufanele asetshenziselwe ukuxilongwa.

Kunezimo ezithile zempilo nezimo ezingaphazamisa imiphumela yokuhlolwa. Lokhu kufaka phakathi:

• Ukushoda kwegazi
• Ukuhluleka kwezinso
• Isifo sesibindi
• I-sickle cell anemia
• Ukwelashwa kwe-Erythropoietin
• I-Dialysis
• Ukwehla kwegazi noma ukumpontshelwa igazi

Futhi, ukuhlolwa kungathembeki kubantu base-Afrika, baseMedithera, noma baseNingizimu-mpumalanga ye-Asia, abantu abanelungu lomndeni abane-sickle cell anemia, nalabo abane-thalassemia. Kulabo abawela kula maqembu, umhlinzeki wezokunakekelwa kwempilo angaphakamisa ukuhlolwa okuhlukile noma i-A1C ekhethekile.

I-A1C ihlolwa kaningi kangakanani?

Ukugcina amazinga e-A1C ehlolile, iziguli kufanele zivivinywe njalo. Uma i-A1C ingaphansi kuka-5.7, ekhombisa ukuthi awunaso isifo sikashukela, kufanele uyihlole njalo eminyakeni emithathu, ngokusho kukaRobert Williams, MD, udokotela womndeni nodokotela wezempilo eLakewood, eColorado, kanye nomeluleki wezokwelapha EMediHealth . Uma kuphakathi kuka-5.7 no-6.4, okukhombisa ukuthi usengozini yokuhlaselwa yisifo sikashukela, kufanele usihlole njalo eminyakeni emibili kuya kwemibili. Uma uthola ukuthi unesifo sikashukela esiqinisekisiwe, futhi ushukela wegazi ulawulwa kahle, kufanele uhlolwe i-A1C njalo ezinyangeni eziyisithupha. Uma usuvele unesifo sikashukela nemithi yakho iyashintsha, noma ushukela wegazi lakho awulawulwa kahle, kufanele uhlolwe i-A1C njalo ezinyangeni ezintathu.

Amazinga ajwayelekile e-A1C

Kuneziqondiso ezithile ezijwayelekile zokuhumusha imiphumela ye-A1C. Kodwa-ke, kukhona okuhlukile, ngokusho kwe-ADA. Imihlahlandlela ejwayelekile yilena:

• Ngaphansi kuka-5.7: Ongesona isifo sikashukela
• Phakathi kuka-5.7 no-6.4:Isifo sikashukela
• Phakathi kuka-6.0 no-6.9: Isifo sikashukela esilawulwayo
• Phakathi kuka-7.0 no-8.9: Isifo sikashukela esingalawulwa
• Ngaphezulu kuka-9.0: Kuphakeme ngokujulile

Ukubhekisela, amazinga ajwayelekile e-A1C kubantu abangenawo ushukela angama-4% kuya ku-5.6%.

Lithini izinga elihle le-A1C?

Kubhekwa amazinga aphakathi kuka-5.7 no-6.4 ama-prediabetes . Kubantu abaningi abanesifo sikashukela, inhloso ejwayelekile ye-A1C ukuba nezinga eliphakathi kuka-6.0 no-6.9. Yize kungazwakala sengathi ilitshe elifanele le-A1C lingaphansi kuka-6.0, kulabo abanesifo sikashukela, leli zinga lingakhombisa amazinga kashukela egazini aphansi, angaba yingozi njengamazinga aphezulu kashukela egazini. Uma imiphumela ye-A1C iwela phakathi kuka-7.0 no-8.9, udokotela angaphakamisa izinguquko zendlela yokuphila noma imithi yokusiza ukwehlisa amazinga kulokho okubhekwa njengokulawulwa. Kodwa-ke, kwabanye abantu, la mazinga angahle afaneleke, njenge:

• Labo abanesikhathi sokuphila esilinganiselwe
• Abantu abanesifo sikashukela esinesikhathi eside benenkinga yokufinyelela umgomo ophansi
• Labo abane-hypoglycemia enamandla noma ukungakwazi ukuzwa i-hypoglycemia

Yiliphi izinga eliyingozi le-A1C?

Lapho amazinga enyukela ku-9.0, ingozi yokulimala kwezinso nezamehlo kanye ne-neuropathy iyanda. Abanye abantu abasanda kutholakala bangaba namazinga angaphezu kuka-9.0. Izinguquko zokuphila futhi mhlawumbe nemithi yehlisa amazinga ngokushesha. Kumuntu onesifo sikashukela osekunesikhathi eside, amazinga aphakama ngaphezu kuka-9.0 angakhombisa isidingo soshintsho kuhlelo lwabo lokwelashwa.

Amanye amalebhu alinganisela isilinganiso seglucose yegazi (eAG), ehambelana ne- imitha yeglucose yasekhaya ukufundwa (mg / dL), okuvumela iziguli ukuthi ziqonde imiphumela kangcono.

Kungani i-A1C yami iphakeme?

Njengoba izinga likashukela egazini likhuphuka, nawo nama-A1C akhuphuka. I-A1C ephezulu ikhombisa ukuthi ukulawula ushukela egazini akulungile. Lokhu kukodwa akusona isimo esiphuthumayo, kepha kunikeza umhlinzeki wakho wezokunakekelwa kwezempilo isithombe sendlela yeglucose yegazi eye yalawulwa, noma engalawulwa ngayo, kusho uDkt Williams.

Ukulawulwa kabi kwesifo sikashukela noma isidingo sokulungiswa kwemithi kungadala i-A1C ephezulu. Izinguquko zokudla, ukuzivocavoca nsuku zonke, noma ukulungiswa kwemithi kunganciphisa i-A1C ngokushesha. Ngoba Thayipha 2 sikashukela yisifo esiqhubekayo, ukulungiswa ekwelashweni komuntu kungaba yingxenye yenqubo yokulawula isifo sikashukela. Ukulawulwa kabi kwesifo sikashukela akusho njalo ukuthi isiguli senza okuthile okungalungile. Kepha kunezinye izizathu zokuthi kungani amazinga angaphakama.

Njengoba kushiwo ngaphambili, ezinye izimo zempilo zingadala imiphumela esontekile. Lokhu kufaka phakathi isifo sezinso, i-anemia, isifo sesibindi, i-asplenia, ukulahleka kwegazi, i-hypothyroidism, i-uremia, ne-sickle cell anemia. Ezinye izinto ezingaholela ezingeni eliphakeme le-A1C zifaka phakathi ukukhula kweminyaka, ukukhulelwa kanye nesifo sikashukela sokukhulelwa.

Ungaba ne-A1C ephezulu futhi ungabi nesifo sikashukela?

Ngokusho komunye Ucwaningo luka-2009 , 3.8% wabantu abangenawo umlando wesifo sikashukela banezinga eliphakeme le-A1C (ngaphezulu kuka-6.0). Leli qembu kungenzeka kakhulu ukuthi libe nezinye izinto eziyingozi kuhlobo lwesibili sikashukela kanye nesifo senhliziyo. Abaphenyi bathole ukuthi la maqembu alandelayo kungenzeka ukuthi abe ne-A1C ephakeme ngaphandle kokuthola ukuthi unesifo sikashukela:

• Okudala
• Owesilisa
• Abangewona amaSpanishi abamnyama nabaseMelika baseMexico
• Umfutho wegazi ophezulu
• Ukukhuluphala ngokweqile
• Izinga eliphakeme le-C-esebenzayo lamaprotheni

Umphumela ophezulu we-A1C ungakhombisa ukuthi kunenkinga. Ngisho nokwenyuka okuncane kweshukela lakho egazini, ngaphezu kwamazinga ajwayelekile, kungakhuphula ubungozi besifo senhliziyo, noma ngabe awunaso isifo sikashukela esigcwele, kusho uDkt. Bellatoni. Udokotela angabuyekeza imiphumela yokuhlolwa futhi akhulume neziguli ngezinto ezinobungozi nokushintsha kwendlela yokuphila ukuze athuthukise amazinga kashukela egazini.

Ungawehlisa kanjani amazinga akho e-A1C

Kubalulekile ukuthola amazinga akho e-hemoglobin A1C asondele kokujwayelekile ngangokunokwenzeka, kusho uDkt. Bellatoni, Ukwehlisa i-hemoglobin yakho i-A1C kunciphisa ubungozi bokuthola izinkinga zesifo sikashukela. Noma ungeke ukwazi ukubuyisela i-A1C yakho ebangeni elijwayelekile, noma ikuphi ukuthuthuka kwehlisa ubungozi bezinkinga zesifo sikashukela.

Ukulandelwa nokwelashwa kwesifo sikashukela

• Landela uhlelo lwakho lokwelashwa kwesifo sikashukela : Qonda uhlelo lokwelashwa ngaphambi kokushiya ihhovisi lomhlinzeki wezokunakekelwa kwempilo bese nixoxa ngezithiyo (ezingokomzwelo, ezingokomzimba, ezezimali) ezingakuvimbela ekulandeleni lolu hlelo. Yiya kuzo zonke ukuvakashelwa okulandelwayo.
• Hlala uphuza imithi oyinikiwe : Uma umhlinzeki wezempilo enikeze imishanguzo yokwehlisa amazinga kashukela egazini, yisebenzise njalo. Abanye abantu baphuza imithi kuphela uma bengazizwa kahle, kepha le mithi ayisebenzi ngaphandle kokuthi ithathwe ngokungaguquguquki.
• Gada futhi ulandelele ushukela wegazi : Ukuqapha ushukela wegazi njalo kuyisinyathelo esibaluleke kakhulu ekuphathweni kwesifo sikashukela, ngokusho kwe- i-CDC . Abahlinzeki bezempilo bangazisa iziguli ngezinhlobo ezahlukene zamamitha futhi basize iziguli zithole okungcono kakhulu kuzo. Abahlinzeki bangatshela neziguli ukuthi baluhlole kangaki ushukela wegazi nokuthi yini ibanga leshukela labo elihlosiwe. Gcina ilog yamazinga kashukela egazini lakho ukuze ufune amaphethini kanye nezimbangela zama-spikes kashukela egazini naphansi. Uma ugqoka i-glucose monitor eqhubekayo, ungasebenzisa idatha. Ukufunda ukuthi yini eyenza ukuthi ushukela wegazi ukhuphuke noma wehle kungakusiza ukuthi wakhe uhlelo lokuwugcina ungaguquguquki.

Izinguquko zokudla

• Ukwehla kwesisindo : Ungahle ungadingi ukunciphisa isisindo njengoba ucabanga. A ucwaningo olushicilelwe ku-2019 bathole ukuthi abantu abanesifo sikashukela soHlobo 2 abanciphisa isisindo sabo somzimba ngo-10% kungakapheli iminyaka emihlanu betholakele bathola ukuxolelwa yilesi sifo. Sebenza nomhlinzeki wezokunakekelwa kwempilo ukuze ube nomgomo wokunciphisa isisindo. Sebenza nesazi sokudla okunomsoco noma isazi sokudla ukuze usize ukudala uhlelo lokudla olungenzeka.
• Hlela ukuthenga ukudla nokudla : Ukudla usohambweni kuvame ukufaka ukudla okungenampilo. Thatha isikhathi ukuhlela ukudla bese usebenzisa lokho ukudala uhlu lokudla okunempilo.
• Ungeqi ibhulakufesi : TO isifundo sishicilelwe kumagazini Ukukhuluphala ngokweqile bathole ukuthi abantu abadle ibhulakufesi elikhulu elinothe ngamaprotheni namafutha basize ukunciphisa i-A1C nomfutho wegazi.
• Yidla ukudla okunempilo okunezingxenye ezifanele : Hlela uhhafu wepuleti lakho ukuba ube imifino enesitashi esincane, amaprotheni ayine wesine, kanye nohlamvu lwesine oluphelele. Amazinga kashukela egazini angakhuphuka uma udla kakhulu kunalokho okudingwa ngumzimba wakho. Sebenzisa izikali zokudla nezinkomishi zokulinganisa nezinkezo ukuqinisekisa ukuthi izingxenye zifanelekile.
• Ukuqapha ukudla kwe-carbohydrate : Yidla ama-carbs ane-fiber ephezulu nezakhamzimba, okufana nokusanhlamvu okuphelele, izithelo nemifino ephelele, nemidumba. Gwema ama-carbs afana noswidi, amakhekhe, isinkwa esimhlophe, ilayisi ne-pasta.
• Namathela esimisweni sokudla: Abanye abantu abanesifo sikashukela bakuthola kungcono ukudla ngasikhathi sinye usuku ngalunye. Imithi ethile yesifo sikashukela noma insulini kungadala ukuthi ushukela wegazi wehle kakhulu uma weqa ukudla, ngokusho kwe- I-NIDDK . Khuluma nomhlinzeki wezokunakekelwa kwempilo uma ungenaso isiqiniseko sokuthi uhlelo lokudla olungcono kakhulu luyini. Isazi sokudla okunomsoco, isazi sokudla, noma uthisha oqinisekisiwe wesifo sikashukela (CDE) angakusiza ekutholeni ukudla okufanele.

Izinguquko zendlela yokuphila

• Vocavoca umzimba njalo : Kokubili ukuqeqeshwa kwe-aerobic nokumelana kusiza ukunciphisa ukulawulwa kwe-glycemic, ngokusho kwe-a Ucwaningo olushicilelwe ngo-2016 . Ukuzivocavoca umzimba kuthuthukisa ukulawulwa kweglucose egazini, kunciphisa izinto ezinobungozi zenhliziyo, kube nomthelela ekwehliseni isisindo, futhi kuthuthukise impilo. Okwabantu abane ama-prediabetes , ukuzivocavoca umzimba njalo kungavimbela noma kubambezele uhlobo lwesibili lwesifo sikashukela.
• Qhubeka nokunyakaza : Ukuzigcina usebenza kusebenze kwenza umzimba uzwele kakhulu kwi-insulin, ngokusho kwamaCenter for Disease Control and Prevention ( i-CDC ). Yize ukuzivocavoca umzimba njalo kubalulekile, ukwenziwa kwansuku zonke kubhekwa njengokuvivinya umzimba ngokulingene. Imisebenzi yansuku zonke ifaka phakathi ingadi, ukuhamba, ukudansa, ukugunda utshani, ukubhukuda, nokwenza umsebenzi wasendlini.
• Cabanga ngezithako: Kunocwaningo olunqunyelwe lokuthi izithasiselo namakhambi kungasiza yini ukwehlisa ushukela egazini. Isibonelo, a ukubuyekeza okushicilelwe ngo-2013 ihlolwe i-aloe vera yesifo sikashukela kumagundane futhi yathola ukuthi kungasiza. Ngokwengeziwe, a Ucwaningo olushicilelwe ku-2017 bathole abantu abane-prediabetes abasebenzisa imbewu yempuphu yefenugreek abanamathuba amancane okuthola ukuxilongwa kwesifo sikashukela. Futhi yize ubufakazi buphikisana, a ukuhlaziywa kwe-meta okwenziwe ngo-2013 kutholakale isinamoni elidlayo linciphisa kakhulu i-glucose. I-ADA ayincomi isinamoni ukunciphisa i-glucose, futhi akufanele kube ukwelashwa komugqa wokuqala. Njalo khuluma nomhlinzeki wezokunakekelwa kwempilo ngaphambi kokuthatha izithasiselo.

Ukulungiswa kwengqondo

• Sebenzisa amathuluzi wokulawula ukucindezeleka: TO Ucwaningo olushicilelwe ku-2018 ithole ukuthi ukusebenzisa ukucabanga ukuze unciphise ukucindezeleka kuholele ekunciphiseni amazinga e-A1C kanye nenhlalakahle kanye nempilo ejwayelekile.
• Gwema izitatimende zokuphika : Ukuphika kungathatha izinhlobo eziningi, ngokusho kwe- NAKHU . Gwema ukusho (noma ukucabanga) izinto ezifana nokuthi, Ukulunywa okukodwa ngeke kulimaze, anginaso isikhathi sokudla okunempilo namuhla, noma Isifo sami sikashukela asibi kakhulu.
• Xhuma nabanye abantu abanesifo sikashukela : Ukuzizwa uwedwa kungenza kube nzima kakhulu ukunamathela kuhlelo lokwelashwa. Thola iqembu lokusekela ngaphakathi noma lifune okukodwa ku-inthanethi. Ukuxhumana nabanye abantu abasesimweni esifanayo kunganikeza ukusekelwa, ukuholwa, nokuziphendulela.

Khumbula, ukuhlolwa kwe-A1C kukala amazinga kashukela ngaphezu kwezinyanga ezintathu. Izinguquko zokuphila nezindlela zokudla zithatha izinyanga ezimbalwa ngaphambi kokwenza umthelela onengqondo.