Izinyathelo Zokuvimbela Izinkinga Ezisifo Sikashukela Uma Unokuhlinzwa Okuhlanganyelwe Okuhlangene
Isifo sikashukela sisimweni esibangele amazinga ashukela egazini (futhi ayancipha) okwandisiwe (futhi ancipha) , futhi angaholela ohlelweni lwezinzwa, izinkinga zamasosha, kanye nezivikelo zokuzivikela. Abantu abangaphezu kwezigidi ezingama-25 baseMelika banomhlobo we-I noma u-Type II wesifo sikashukela, futhi bobabili bangabangela izinkinga kubantu abacubungula izinqubo zokuhlinzwa ezikhethiwe. Phakathi kokuhlinzekwa okuvame ukukhethwa kukho ukuhlinzwa okunye okubandakanya ukufaka esikhundleni sokuguqa , ukuguqulwa kwe-hip , nokushintshwa kwehlombe.
Abantu abane-diabetes mellitus, noma baye baphakamisa amazinga e-glucose egazi ngisho nangaphandle kokuthola ukuxilongwa kwesifo sikashukela, badinga ukuhlela ngokucophelela ukusiza ukuvimbela izinkinga ngenxa yezinga elingalawulwa yi-glucose yegazi. Ngombono omuhle, imizamo yokulawula isifo sikashukela nokuphathwa ngcono kwezinga legazi legazi kungaba nomthelela omuhle ngokunciphisa izingozi ezihlobene nokuhlinzwa.
I-Blood Sugar ephakanyisiwe
Cishe amaphesenti ayisishiyagalombili abantu abathintekayo ekuhlanganyeleni e-United States bafana nohlobo lwe-I noma uhlobo lwe-diabetes II. Ukutholakala kwesifo sikashukela kukhulisa izingozi zokuhlinzwa ngokuhlanganyela. Ngaphezu kwalokho, lokho kwanda engcupheni kuyahambisana nokuthi kahle (noma ngokungafanele) ukulawula ama-glucose egazi ngesikhathi sokuhlinzwa. Ukuthola ukuthi uhlaselwe yisifo sikashukela akusho ukuthi awukwazi ukuqhubeka nokufakelwa okuhlangene, kusho nje ukuthi izingozi zokuhlinzwa zingase zibe ngaphezulu kakhulu, futhi konke okusemandleni kufanele kwenziwe ukuze kuncishiswe ingozi eyengeziwe yokubhekana nezinkinga.
Isifo sikashukela senza izinkinga emzimbeni, amasosha, kanye namasosha omzimba. Izifo ezinezinambuzane (umonakalo emithonjeni yegazi encane kunazo zonke) zinganciphisa ukugeleza kwegazi nokuthunyelwa kwe-oksijini endaweni yokuhlanza ukuhlinzwa okuphulukisayo. Umsebenzi we-immune oshintshiwe awukwazi nje ukulimaza isimiso somzimba wokuvikela omzimba, kodwa futhi wenze umzimba ube nesifo sokutheleleka kwebhaktheriya.
Imiphumela yokuhlinzwa yabantu abanesifo sikashukela ivame kakhulu ukuthi labo abangenayo isifo sikashukela ngezinqubo ezihlukahlukene zokuhlinzwa, hhayi nje ukushintshwa okuhlangene. Ucwaningo luye lwabonisa ingozi ekhuphuka ngokuhlinza ngamathambo kuhlanganise nokuhlinzeka ngezinyawo, ukuhlinza umgogodla, kanye nokuhlinzwa kokuqhekeka. Okunye okukhethekile okuhlinzekwayo futhi kunezibonelo zesifo sikashukela kuba yingozi yengozi yezinkinga ezingenzeka. Futhi, le miphumela ivame ukuhambisana nokuqina kwesimo ngokwemigomo yokuthi kahle kangakanani noma amazinga egazi we-glucose angalawulwa.
Impikiswano Engozini Yokuguqulwa Okuhlangene Okuhlangene
Kunezindlela eziningana lapho abantu abanesifo sikashukela bathinteka lapho behlinzwa ngokuhlanganyela. Isifo sikashukela sandisa ingozi yezimo eziningana , hhayi eyodwa kuphela. Okunye okunye okuphathelene nezinkinga ezitholakala ezigulini zesifo sikashukela ezibandakanya ukujoyina zihlanganisa:
- Ingozi enkulu yokutheleleka: Ingozi yokutheleleka ingenye yezinto eziphathelene nokuhlinzwa okuhlanganyelwe. Lapho ukutheleleka kokushintshaniswa okuhlangene kwenzeka, ukuhlinzeka okungeziwe kuyadingeka njalo, futhi ngokuvamile izimpande kufanele zisuswe ukuze uphulukise ukutheleleka.
- Izinkinga eziphakeme zokubhekana nezinkinga zokuphulukisa isilonda: Ukuphulukiswa kokuchotshozwa okuhlinzekwa kubonakala kuqondile, kodwa ukugeleza okuqhubekayo, i-necrosis enxeba, nokubhekwa okungenakuphulukisa kungatholakala kubantu abanesifo sikashukela. Ukukhishwa okuhlinzekwa okungaphili kahle kuyimbangela yokutheleleka kubantu abanokufakelwa ngokuhlanganyela.
- Ingozi enkulu yezokwelapha: Izimo eziningi zezokwelapha kuhlanganise ne-pneumonia, ukutheleleka kwe-urinary, kanye ne-embolism ye-pulmonary kungaba khona kakhulu kubantu abanesifo sikashukela.
- Ukwandisa ingozi yokumpontshelwa igazi: Ukuthungathwa kuya ngokuya kungavamile ngemva kokushintshwa okujwayelekile. Ngemithi emisha kanye namasu okuvala amagundane, amathuba okumpompela ahla kakhulu. Noma kunjalo, ingozi iphezulu kubantu abanesifo sikashukela.
- Ukwanda kwezinga lokufa: Lokhu kuyesabisa ukucabanga ngakho, futhi ngenkathi ingozi yokufa ehlobene nokushintshaniswa okuhlanganyene ncane kakhulu, akuyona inhlawulo. Ngaphezu kwalokho, abantu abanesifo sikashukela esingalawulwa kahle banomngcipheko ophezulu wokufa ngokuhlinzwa okukhethwa njengokwenziwa ngokuhlanganyela.
Ukulawula Izinga Legazi Le-Glucose
Kukhona izindaba ezinhle! Ngiyazonda ukuletha izindaba ezimbi njalo etafuleni, futhi akukho mbuzo ukuthi abantu abanenkinga yokulawula ushukela wegazi ngokuvamile badinga izinkinga zezokwelapha ezinzima. Izindaba ezinhle ukuthi ngokuthuthukisa izinga lokushukela kwegazi, ngaphezu kokubili isikhathi esifushane nesikhathi eside, izingozi zokuba esikhundleni sokujoyina akudingeki zikhuphuke ngokuphawulekayo.
Ucwaningo oluningi luye lwabonisa ukuthi izingozi ezibalulwe kulesi sihloko zihambisana kakhulu nokuthi ushukela wegazi lulawulwa kangakanani. Lokhu kuyiqiniso ekulawuleni ushukela wegazi ngaphezulu kwezinyanga eziseduze nokuhlinzwa, nasezinsukwini eziseduze nokuhlinzwa. Ngakho-ke, imizamo yokuqiniswa nokulawula ushukela wegazi ngokudla, ukuvivinya umzimba, imithi, nezinye izindlela kungasiza ekuvimbeleni izinkinga ezihlobene nokuhlinzwa okuhlanganyelwe okuhlangene.
Izindwangu zeshukela zegazi ngokuvamile zilinganiswa ngenye yezindlela ezimbili:
- Izinga le-glucose: Izinga lika-glucose legazi livame ukulinganiswa uma kuzila (ngaphambi nje kokudla, kungakapheli) nokuzungeze u-70-100. Kubantu abanesifo sikashukela esilawulwa kahle, le nombolo ingaba phakathi kuka 90-130. Amazinga weglucose egazi angakhuphuka ngokuphawulekayo, ikakhulukazi kubantu abanesifo sikashukela. Ngemuva kokudla, akuyona into engavamile ukusondela ku-200 noma ngaphezulu kumuntu onesifo sikashukela, kanti kubantu abangenalo lesi simo, i-glucose yegazi ngokuvamile ayihambi ngaphezu kwe-125.
- I-Hemoglobin A1c : I-hemoglobin A1c, noma i-HbA1c, isilinganiso sezinga eliphakathi kwegazi le-glucose ngaphezu kwezinyanga ezandulele ukuhlolwa. Akunikezi isifinyezo somzuzwana ngesikhathi, kodwa kunomqondo ojwayelekile wokuthi kahle, noma ngokungafanele, ilawulwa ushukela wegazi. Umuntu ongenayo isifo sikashukela uzoba ne-hemoglobin A1c ezinganiselwa ku-5.0, kanti umuntu onesifo sikashukela angaphezu kuka-6.5 (nakuba kukhona ukungavumelani ngaphezu kwezinga eliqondile elichaza isifo sikashukela, iningi liyavumelana phakathi kuka-6.5 kuya ku-7.0). Uma usebenza ukulungisa ukuphathwa kwegazi, ukuguquka kwe-hemoglobin A1c kungathatha izinyanga ukuzithola.
Zombili lezi zinyathelo zingasiza ngezindlela ezahlukene, kodwa futhi aziphelelanga. Isibonelo, ukuba nezinga legazi le-glucose ezingaphezu kuka-200 ngesikhathi sokujoyina ngokuhlanganyelwe kuboniswe ukuthi kuyisici esiyingozi ngenxa yezinkinga, ngisho noma i-A1c ilawulwa kahle. Ngokufanayo, ukuba ne-glucose yegazi evamile ngosuku lokuhlinzeka ekuhlinzekeni kwe-A1c ephezulu akusho ukuthi awunengozi. Zombili izivivinyo zingasiza abantu ukuphatha ukulawulwa kwe-glucose futhi banciphise izingozi zabo ezihlobene nokuhlinzwa kokujoyina okuhlanganyelwe.
Ingabe Kufanele Kube Cutoff?
Ezinye izikhungo zokufakelwa ezihlangene ziye zasungula uhlelo oludingayo umphumela othize wokuhlola ukuze uqhubeke nokuhlinzwa okuhlanganyelwe kokujoyina. Isivivinyo esivame ukusetshenziswa kakhulu yi-hemoglobin A1c. Ngomzamo wokuqinisekisa ukuthi abantu abahlala endaweni yokujoyina ndawonye bane-diabetes elawulwa kahle, ezinye izikhungo zidinga umphumela othize we-hemoglobin A1c, njengezinga elingezansi 7.5 noma ngaphansi kwe-8.
Ngokuthakazelisayo, i-hemoglobin A1c cishe ayilona uvivinyo olungcono kakhulu ukubikezela ukuthi kungenzeka ukuthi ukuhlukunyezwa kuhlobene nokushintshaniswa okuhlangene, kodwa kuyindlela elula yokuthola, futhi inikeza ubufakazi obuhle bokuthi umuntu angakwazi kanjani ukulawula amazinga azo ushukela egazini. Ngokuqondile ukuthi iyiphi inombolo ephephile, futhi okungekho, ingxabano, kodwa ezinye izikhungo zokufakelwa ezihlangene ziye zachazela ukuhlukunyezwa kwazo kulezi zinqubo.
Ucwaningo lwamuva lwendlela yokubhalisa ehlombe yeziguli ezingaphezu kwezingu-18,000 lithole ukuthi i-cutoff kuleli qembu yayiyi-hemoglobin A1c ka-8.0 noma ngaphezulu. Kulezi ziguli, kwakukhona ingozi ephezulu yokutheleleka okujulile nezinkinga zokuphulukisa. Ngomqondo omuhle, ingozi enkulu yezinkinga kuleli gembu leziguli ezingu-18,000 laliphansi kakhulu (cishe amaphesenti angu-1), kanti nakuba ingozi yayiba kabili kubantu abane-A1c kuka-8, ingozi yayisemaphesenti amabili kuphela.
Izwi elivela
Lokhu kuzwakale njengezindaba eziningi ezimbi, ngakho-ke ngivumele ngiphele ngokuhle: Izinkulungwane zabantu abane-diabetes zitholwa ngokuhlinzwa ngokuphumelelayo nokuguqula impilo yonke ngonyaka. Nakuba kungase kube nezingozi ezingaphezu kwezinkinga zokuhlinzwa, lezo zingozi zingalawulwa. Ukulawula amazinga kashukela egazi, ikakhulukazi ngesikhathi sokuhlinzwa, kucatshangwa ukuthi yisici esibaluleke kakhulu ekulawuleni lezi zingozi. Abantu abanesifo sikashukela akufanele besabe ukushintshwa okuhlangene, kodwa kufanele basebenze nodokotela babo ukuze balungise ukulawula ishukela egazini labo ukuze bagcine izingozi zabo ezihlobene nokuhlinzwa okuhlanganyelwe okunye okuphansi.
> Imithombo:
> Rizvi AA, Chillag SA, Chillag KJ. "Ukulawulwa kwesifo sikashukela kanye ne-hyperglycemia kulabo ababhekene nokuhlinzwa kwemithi" J Am Acad Orthop Surg. 2010 Jul; 18 (7): 426-35.
> I-Stanton T. "I-HbA1c Ingozi Yokuvikela Ingculazi Eboniswa Ngesifo Sesifo Sikashukela Iziguli Eziguquka Ngamahlombe" AAOSNow. April 2017.
> Uhl RL, Rosenbaum AJ, Dipreta JA, Desemone J, Mulligan M. "Isifo sikashukela: ukubonakaliswa kwezicubu ze-musculoskeletal kanye nokucubungula ngokuphathelene nodokotela ohlinzayo wamazinyo" J Am Acad Orthop Surg. 2014 Mar; 22 (3): 183-92.