Isivivinyo se-A1C (esaziwa nangokuthi HbA1C, i-hemoglobin A1c, i-hemoglobin eglycated noma i-glycosylated hemoglobin) isilinganiso esihle esiphelele sokunakekelwa kwesifo sikashukela. Ngenkathi ukuqapha kwe-glucose yasekhaya evamile kuthatha ishukela legazi lomuntu ngesikhathi esifanele, amazinga e-A1C akhombisa izinga legazi lomuntu wesilinganiso segazi esikhathini ezinyangeni ezimbili kuya kwezintathu ezedlule.
Isebenza kanjani?
Ungathola ukuhlolwa kwe-A1C ngokudweba kwegazi njalo.
Amahhovisi amaningi odokotela nawo anemishini yokuhlola ye-A1C futhi akwazi ukuthola umphumela ngehlombe elincane legazi elitholakala ekuphoqeni umunwe nge-lancet. Akudingeki ukuba uzila ukudla ukuthola uhlolo lwe-A1C olwenza kube lula kakhulu futhi kungenzeka ukuthi kwenziwe.
I-Hemoglobin A, iphrotheni etholakala ngaphakathi kwamangqamuzana egazi obomvu, ithwala i-oxygen kuwo wonke umzimba. Uma kukhona i-glucose egazini, ingakwazi ukunamathela (glycate) ku-protein ye-hemoglobin. I-glucose engaphezulu egazini kusho ukuthi i-glucose eyengeziwe inamathele ku-hemoglobin kanti amaphesenti aphezulu we-hemoglobin amaprotheni ayagcoba.
Uma i-glucose inamathela kumaprotheni we-hemoglobin , ngokuvamile ihlala isikhathi sokuphila kwe-hemoglobin A amaprotheni-ezinsukwini ezingu-120. Ngakho-ke, nganoma isiphi isikhathi, i-glucose ehlanganiswe ne-hemoglobin A protein ibonisa izinga leshukela legazi ezinyangeni ezimbili kuya kwezintathu zokugcina.
Isivivinyo se-A1C silinganisa ukuthi i- glucose ingakanani inamathele ku-hemoglobin A, noma ngokuqondile, yiziphi amaphesenti ama-protein e-hemoglobin ayesiglycated.
Ngakho-ke, ukuba namaphesenti angu-7 A1C kusho ukuthi amaphesenti angu-7 ama-prothem e-hemoglobin ayesiglycated.
Ukuqonda Izinombolo ze-A1C
Ngomuntu onesifo sikashukela, izinga elijwayelekile le-A1C lingamaphesenti angaba ngu-5. Umkhawulo we-A1C unomkhawulo uthathwa njengamaphesenti angu-5.7-6.4 (lokhu kubhekwe njengama-prediabetes). Kumuntu onesifo sikashukela, ochwepheshe bayavumelani ngandlela-thile kulokho okumele kuhloswe khona ku-A1C.
I-American Diabetes Association (ADA) isincoma i-A1C target okungaphansi kuka-7 noma okulingana namaphesenti angu-7. I-American Association of Endocrinologists yezokwelapha ikhuthaza izinga lama-6.5% noma ngaphansi.
I-ADA iphinde igcizelele ukuthi imigomo ye-A1C kufanele ibe ngabanye. Labo abanesifo sikashukela kufanele bahlole ochwepheshe bezempilo ukuze bafunde ukuthi yini okumele ibe yizinhloso zabo ze-A1C. Isibonelo, kulabo bantu abaye banciphisa isikhathi sokuphila, isifo sikashukela eside kanye nobunzima bokuthola umgomo ophansi, u-hypoglycemia oyingozi, noma izinkinga eziphezulu eziphezulu zesifo sikashukela, isifo sezinzwa, noma isifo senhliziyo, umgomo we-A1C ungase ube ngaphezulu.
Kodwa-ke, kubantu abaningi, i-A1C ephansi ilungile uma nje bengenaso isishukela segazi esincane. Eqinisweni, i-National Institutes of Health (NIH) ithi, ngokuvamile, wonke amaphesenti amaphuzu awela emiphumeleni yokuhlolwa kwegazi le-A1C (isb., Kusuka kumaphesenti angu-8 kuya ku-7%) kunciphisa ingozi yeso, izinso nesifo sezinzwa ngamaphesenti angu-40 .
A1C kuya ku-EAG Izinga elilinganiselwe lezinga le-glucose
Qaphela ukuthi i-A1C ayifani ne-glucose esilinganiselwayo ejwayelekile (eAG), okuyizigaba ezimbili kuya kwezinyanga ezintathu ku mg / dL, kepha i-A1C iqondana ngokuqondile ne-EAG.
Uma uhlola amashukela akho egazi nsuku zonke, izinombolo ozibonayo ekuqapha kwakho nazo zilinganiswa mg / dL. Zibonisa isikhashana ngesikhathi futhi azifani ne-EAG yakho.
Iphesenti le-A1c lingashintshwa ku-ushukela wegazi elilinganisiwe. Isibonelo, isilinganiso segazi se-150 mg / dL (ama-milligram nge-deciliter) sihumusha ku-A1C ngamaphesenti angama-7. Lokhu kungaphezu kokuvamile, uma kunikezwa ukuthi ukutholakala kwesifo sikashukela kuvame ukunikezwa uma amazinga kashukela egazi efika cishe ngo-126 mg / dL.
I-A1c eya ku-EAG Ishadi lokuguqulwa
| HbA1c noma i-A1c | i-EAG | |
| % | mg / dl | mmol / l |
| 6 | 126 | 7.0 |
| 6.5 | 140 | 7.8 |
| 7 | 154 | 8.6 |
| 7.5 | 169 | 9.4 |
| 8 | 183 | 10.1 |
| 8.5 | 197 | 10.9 |
| 9 | 212 | 11.8 |
| 9.5 | 226 | 12.6 |
| 10 | 240 | 13.4 |
Ifomula elisetshenzisiwe yilezi: 28.7 X A1C - 46.7 = eAG.
Ukuvame kangakanani ukuhlolwa kwe-A1C Kuyadingeka?
I-American Diabetes Association incoma ukuthi bonke abantu abangaphezu kuka-45 (abangabonakali uphawu) bahlolwe isifo sikashukela. Lokhu kungasho ukuthi bathola uhlolo lwe-A1C kanye njalo eminyakeni emithathu. Uma ngakolunye uhlangothi, omunye umuntu unomlando oqinile womndeni wesifo sikashukela noma ezinye izici eziphezulu ezingengozini okungase kunconywe ukuthi zihlolwe ngokushesha. Ukwengeza, uma othile ebonakalisa izimpawu futhi ezwa-ukoma okwandisiwe, ukwanda kwendlala, ukwanda kwamanzi noma ukukhathala, ukuhlolwa kwe-A1C kungasetshenziswa njengethuluzi lokuxilonga.
Abantu abanesifo sikashukela kumele bahlole i-A1C njalo ezinyangeni ezintathu; uma ushukela wegazi uzinzile emazingeni aseduze-avamile, kabili ngonyaka kungenzeka kube ngokwanele. Abahlinzeki bokunakekelwa kwezempilo kufanele batshele iziguli ukuthi yini efanele kubo futhi bakwazi ukubaqapha ukuphathwa kwabo ngesifo sikashukela kalula. Ukuhlolwa okungaphezulu kwe-A1C kungase kunconywe uma othile esanda kushintsha uhlelo lwakhe lokwelapha.
Isivivinyo se-A1C sisetshenziselwa ukuhlonza isifo sikashukela nama-prediabetes
Ukuhlolwa kwe-A1C kungasetshenziswa ekuhloleni isifo sikashukela nama- prediabetes . Kwezinye izimo, ukuhlolwa kwe-A1C kungasetshenziswa njengesivivinyo sesibili ukuqinisekisa ukuthi umuntu usengozini noma unesifo sikashukela noma ama-prediabetes. Isibonelo, uma uneshukela egazini egazini eliphakeme noma ngaphezulu kuka 126 mg / dL futhi umhlinzeki wakho wokunakekelwa kwempilo unomdlavuza wesifo sikashukela, angalawula ukuhlolwa kwe-A1C ukuqinisekisa. Ngokusho kweNational Institute of Health, lapho ukuhlolwa kwe-A1C kusetshenziselwa ukuxilongwa, isampula yegazi kumele ithunyelwe ebhokisatri esebenzisa indlela eqinisekisiwe ye-NGSP yokuhlaziywa ukuqinisekisa ukuthi imiphumela ifanisiwe.
Kulungile kangakanani ukuhlolwa kwe-A1C?
I-National Institute of Health ithi, "Umphumela wokuhlolwa we-A1C ungaba ngamaphesenti angu-0.5 aphakeme noma aphansi kunephesenti langempela. Lokhu kusho ukuthi i-A1C ilinganiswe njengamaphesenti angu-7.0 angabonisa i-A1C yangempela noma yikuphi ebangeni kusukela ku-6.5 kuya ku-7.5%. Abahlinzeki bokunakekelwa kwezempilo bangavakashela i-www.ngsp.org ukuthola ulwazi mayelana nokunemba kohlolo lwe-A1C olusetshenziswa yi-laboratory yabo. "
Kodwa, kubalulekile ukukhumbula ukuthi zonke izinhlobo zokuhlolwa kwegazi zihambisana nokuhluka okuhlukile.
Ukulinganiselwa kovivinyo
Ngenkathi i-A1C iyindlela enhle yokulawulwa kwe-glucose jikelele, ayikwazi ukufaka esikhundleni sokuzihlola kwe-glucose yegazi. Njengezinye izivivinyo, imiphumela ingase ihluke kusuka ebhodini kuya kubhubhu. Ukuhlolwa kwe-A1C akulinganisiwe yonke indawo, nakuba umzamo wamazwe omhlaba uqhubeka ukulinganisa ukuhlolwa kwe-A1C ku-International Federation of Clinical Chemistry kanye ne-Laboratory Medicine standard.
Futhi zikhona ezinye izimo lapho ukuhlolwa kwe-A1C kungesivivinyo esihle sokusebenzisa. Isibonelo, ezinye izimo zempilo zingaholela emiphumeleni ephezulu ye-A1C noma imiphumela ephansi ye-A1C.
Imiphumela engamanga A1C ivela kubantu abanezinye izinkinga ezithinta igazi labo noma i-hemoglobin. Isibonelo, umphumela we-A1C ongamanga ungenzeka kubantu abane-anemia, njenge-sickle cell anemia noma i-thalassemia noma labo abanegazi elikhulu. Ngakolunye uhlangothi, umphumela we-A1C ophakanyisiwe ungase uvele kubantu abanezintambo ezincane kakhulu, isibonelo, labo abane-anemia yokuntuleka kwensimbi.
Ezinye izimbangela zemiphumela yamanga A1C zifaka phakathi
- ukuhluleka kwezinso
- isifo sesibindi
Uma uzibuza ukuthi ngabe uhlolo lwe-A1C lulungile yini noma cha, ungathola ulwazi oluthe xaxa kusuka ohlelweni lukazwelonke lwe-National Glycohemoglobin Standardization Programme. Bahlinzeka ngolwazi ngabanikezeli bezempilo mayelana nokuthi yiziphi izivivinyo ze-A1C ezifanele ukuzisebenzisela izinhlobo ezithile ze-hemoglobin ku www.ngsp.org.
Izwi elivela
Uhlolo lwe-A1C luyisilinganiso esihle esiphezulu esisetshenziselwa ukunquma ushukela wegazi ophakathi komuntu phakathi nezinyanga ezimbili kuya kwezintathu. Uhlolo lwe-A1C lusetshenziswa njengethuluzi lokubhekisisa kulabo abanesifo sikashukela, kanye nethuluzi lokuhlola nokuhlola lokuthola ingozi yesifo sikashukela nokuxilongwa. Awunayo ukudla okusheshayo ukuze uthole ukuhlolwa kwe-A1C futhi kuncike kusikhungo sakho somhlengikazi ungase ukwazi ukwenza i-A1C yakho yenziwe ngemiphumela yesikhathi sangempela ehhovisi lakhe. Ukwengeza, ezinye izinto eziguqukayo, ezifana nempilo yakho yonke, iminyaka yobudala, kanye namazinga kashukela egazi, kuzosiza ukucacisa uhla olulodwa olwamukelekayo lwe-A1C nokuthi kufanele uhlolwe kaningi kangakanani. Ngezinye izikhathi uhlolo lwe-A1C ngeke lube yisilinganiso esifanele sokushukela kwegazi, ikakhulukazi uma ungumuntu onomlando we-sickle cell anemia noma isifo sezinso esiphezulu. Uma unemibuzo mayelana ne-A1C yakho, cela ithimba lakho lokunakekela impilo.
Imithombo:
> Isikhungo Sikazwelonke Sesifo Sikashukela kanye Nezifo Zokugula Nezinso Zokugaya. Uhlolo lwe-A1c nesifo sikashukela.
> I- American Diabetes Association. Isivivinyo se-A1C.
> American Association for Clinical Chemistry .. A1C: The Test. .
> Uhlelo lwe-National Glycohemoglobin Standardization Programme. Ukumiswa kwe-IFCC kwe-HbA1c. http://www.ngsp.org/