Obani Abayidingayo Nalokho Ongalindela?
Ukuhlolwa Kwokubekezela KweMixed Meal (MMTT) kudinga ukuthi umuntu aphuze "isidlo esixutshwe," njengokukhulisa noma ukuqinisekisa, okuqukethe, amaprotheni, ama-carbohydrates, namafutha. Umgomo wokuhlola ukukala ukuthi ingakanani i-insulini yakho engayenza ekuphenduleni ukudla. Lapho umzimba womuntu usebenza ngendlela efanele, isiphuzo senza ushukela egazini likhuphuke, futhi ngenxa yalokho ama-pancreas akhipha insulini ngokwanele ukuze avuselele ushukela wegazi.
Kodwa-ke, izimo ezithile zingabangela ukuba ama-pancreas asebenze ngendlela engafanele-angase akhiqize i-insulin emincane kakhulu noma encane kakhulu. Ukuze uqonde le nqubo kangcono ngesikhathi se-MMTT, igazi lisuka ku-IV ukukala isitoreji se-beta cell. Amaseli e-Beta angama-cell aveza i-insulin, ngakho-ke ukulinganisa ukugcina kwawo kubalulekile ekuqondeni umsebenzi we-insulin. Ngesikhathi i-MMTT isetshenziswa kakhulu kubantu abane-type 1 yesifo sikashukela, ingasetshenziswa ngezizathu ezengeziwe. Futhi nakuba i-MMTT ibizwe ngokuthi i- standard standard ye-beta cell reserve test, ingavame ukusetshenziswa emitholampilo ikakhulukazi ngenxa yokuphazamiseka kwayo-ingadla isikhathi futhi ingabhubhisi. Esikhundleni salokho, i-MMTT isetshenziswe kaningi njengethuluzi lokulinganisa kuzilungiselelo zocwaningo, njengokuhlolwa kocwaningo lwezokwelapha.
Ngabe Ubani Oyocelwa Ukuba athathe Ukuhlolwa Kwokubekezelela Ukudla Okuxubile?
Isizathu esiyinhloko sokuthi udokotela angathanda yini isiguli ukuthatha i-MMTT ukuthola ukuthi i-pancreas yakho iphumelela kangakanani ekukhiqizeni i-insulin.
Ngokwesibonelo, imiphumela yokuhlola ibonisa ukuthi ama-pancreas akhiqiza i-insulin, iveza i-insulini engaphezulu, noma ayikhiqizi i-insulini nhlobo. Ngezansi uzothola ezinye izimo mayelana nokuthi i-MMTT ingasetshenziswa kanjani:
- Uma unomntwana omncane kakhulu oye wathola ukuthi unesifo sikashukela sohlobo 1 kanye nodokotela bakhe bazama ukuthola ukuthi ingakanani insulini ayesenza.
- Uma ungumuntu othola ushukela ophansi wegazi, amahora amabili kuya kwabathathu ngemuva kokudla, isimo sezokwelapha esibizwa ngokuthi i-hypoglycemia esisebenzayo , futhi awunayo isifo sikashukela, udokotela wakho angalinganisa impendulo yakho yeglucose esidlweni futhi aqinisekise uma umzimba ukhulula insulin ngokweqile ekuphenduleni ukudla.
- Uma ungumuntu oye wahlinzwa ukuhlinzwa kwe-gastric bypass futhi uye waba neziqephu ze-post yokudla hypoglycemia.
- Uma ungumuntu osolwa ngokuthi i-insulinoma eneziqephu eziphindaphindiwe ze-hypoglycemia.
- Uma ungumuntu ohlanganyela esilingo somtholampilo, i-MMTT ingahlinzeka ngesisindo somzimba esiphezulu kune-insulin kusukela amaseli e-beta we-pancreas alalela ama-amino acids athile kanye nama-fatty acids ngaphezu kwe-glucose. Isibonelo: ukuhlolwa kocwaningo kungasebenzisa ukuhlolwa kwe-MMTT ekuthuthukiseni izidakamizwa, ukuhlola ukusebenza kwezinhlobo ezithile zokwelapha, njenge-pumpul insumini, i-goncagon -like peptide (GLP-1) i-agonists, kanye nabaqaphi be-glucose eqhubekayo.
Yini Ongayilindela Ngaphambi Kokuhlolwa?
Kubalulekile ukuthi uzila ukudla amahora angu-8 ngaphambi kokuhlolwa. Akufanele uphuze noma udle noma yini, ngaphandle kwamanzi, amahora ayisishiyagalombili ngaphambi kokuqala kokuhlolwa. Uma usungile okuthile ngengozi, ngisho nento engabalulekile, njenge-candy noma i-sugary gom, kufanele uphinde uhlaziye uhlolo.
Ithimba lakho lezokwelapha lingakutshela ukuthi unciphise ukuzivocavoca okunamandla, utshwala, i-caffeine, nokusebenzisa ugwayi ngosuku ngaphambi kokuhlolwa ngoba lezi zinto zingathonya insulin ukuzwela.
Hlela ukugqoka izingubo ezikhululekile. Uma ingane yakho ingenawo ovivinyweni, ungamenza ukuba alethe ingubo ekhethekile noma isilwane esithende njengendlela yokududuza.
Yini Okufanele Uyilindele Phakathi Novivinyo?
Kufanele ulindele ukuba khona ukuhlolwa kwamahora ambalwa, njengoba ukuhlola kwangempela kuthatha ubuncane bamahora amabili futhi kukhona ukulungiselela okubandakanyeka nakho. Kukhona ucwaningo olwenziwe, kodwa, ngokuphumelela kokunciphisa ukuhlolwa kwamaminithi angu-90, nokwenza isampula segazi elilodwa kuphela.
Uma unemibuzo mayelana nobude bokuhlala kwakho, cela ithimba lakho lezokwelapha ngaphambi kosuku lokuhlolwa. Nakhu ongayilindela ukuhlolwa kwakho:
- Lapho ufika, uzobhalisa futhi ube nokuphakama kwakho nesisindo esilinganiselwe.
- Okulandelayo, uzobekwa egumbini lesiguli lapho uzothola khona isikhala esiphezulu (IV). I-IV isetshenziselwa ukudweba amasampuli egazi. Ukuba ne-IV ibekwe kungakhathazeki kancane, ikakhulukazi kwengane encane ngakho kubalulekile ukuyilungiselela.
- Uma i-IV isethelwe, uzophuza isiphuzo sokondla okuketshezi, njengokukhushulwa. Lesi siphuzo siyakuthanda ngendlela efanayo ne-milk shake futhi ivela ezinhlobonhlobo zama flavour.
- Igazi lisuka ku-IV njalo ngemva kwemizuzu engama-30 ngaphezu kwamahora amabili.
- Ngesikhathi ulinde, ungabuka ithelevishini, vala amehlo akho, ufunde noma wenze noma yini eyenza ukhululeke.
Yini Ongayilindela Ngemva Kokuhlolwa?
Ngemuva kokuthi uqedile ukuhlolwa, imiphumela ithunyelwe kubhabhu. Ngokuvamile imiphumela ithatha amasonto ambalwa ukukhiqiza-uzokuzwa kudokotela wakho lapho efika. Akufanele uzizwe noma yimiphi imiphumela emibi, ngaphandle kokungahambi kahle emzimbeni we-IV.
Ukuhlolwa kokulondeka kokudla okungaxilwanga ku-Mixed Meal kuhluke ekuhlolweni kwe-Oral Glucose Ukubekezela
Ungase uzibuze-ingabe i-MMTT ifana nokuhlolwa kwe- Oral Glucose Tolerance Test (OGTT) ? Uma uke waba ne-OGTT esikhathini esidlule, uzokwazi ukuthi lezi zivivinyo ziyafana kodwa azifani ngokufanayo.
I-OGTT iyisikhombisa esihle sokubekezelelana kwe-glucose futhi isetshenziselwa ngokuhlanganyela nezinye izivivinyo, ezifana nokuzila i-Blood Glucose (FBG) ne-Hemoglobin A1c ukuxilonga ama-prediabetes, isifo sikashukela, kanye neskrini sokushukela kwesifo sikashukela.
Ngokufanayo ne-MMTT, kufanele uthathe lokhu kuhlolwa lapho uzila ukudla amahora ayisishiyagalombili. Kodwa-ke, ngokuphambene nokuphuza ukudla okuxubile, ngesikhathi se-OGTT umuntu ucela ukufaka umthwalo we-glucose kuphela, okulingana nama-gramu angu-75 we-glucose (ushukela) oqhekekile emanzini.
Imiphumela ye-OGTT ingasiza otholampilo ukuba banqume, ukungasebenzi kahle kweglucose yokudla (i-IFG) nokungahambisani kahle kwe-glucose (IGT). I-IFG ne-IGT ayikwazi ukuthola ukuthi isebenzise i-MMTT kusukela kulolu daba linikeza inselele yomlomo we-glucose engavumelekile.
I-Mixed Meal Test Isingasetshenziselwa Ukuxilonga I-Type 1 Isifo sikashukela
I-MMTT ingasiza ekutholeni izigaba zokuqala zokungahambisani kwe-glucose, kodwa ayisetshenziselwa ukuxilonga isifo sikashukela sohlobo lwe-1. Esikhundleni salokho, ezigulini ezinokwempawu, i-American Diabetes Association incoma ukuthi i-blood glucose kufanele isetshenziselwe ukuxilonga ukuqala kokuqala kwesifo sikashukela sohlobo 1. Ngokubambisana, ukuhlolwa kwe-c-peptide noma ukuhlolwa kwe-autoantibodies (kokubili ukuhlolwa kwegazi) kungaqinisekisa ukuxilongwa kwesifo sikashukela sohlobo 1.
Ukuhlolwa kwesifo sikashukela sohlobo lwe-1 singakwazi ukuthola isifo sikashukela
Uhlobo lwe-1 lwesifo sikashukela luvame ukutholakala ngemva kokuba lesi sifo sithuthukile sibe izigaba kamuva. Ngokuthuthuka kwezokwelapha, manje sinekhono lokuhlola isifo sikashukela sohlobo lwe-1 esimweni sesilingo sokucwaninga, kumalungu omndeni wezinga lokuqala, noma ukuhambisana nesifo sikashukela sohlobo 1. Ukuhlolwa kuqukethe ukuhlolwa kwephaneli ye-autoantibodies. Esikhathini sikashukela, yizi-autoantibodies, ezikhombisa ukuvuselelwa kokuhlaselwa kwezidumbu ngamaseli e-beta-producing beta e-pancreas, ngaleyo ndlela ekugcineni kubangele amaseli e-beta afe. I-American Diabetes Association ithi lokhu okulandelayo:
[It] manje icacile ezifundweni zezihlobo zokuqala zeziguli ezine-type 1 yesifo sikashukela sokuthi ukuphikelela okuphikisanayo kwama-autoantibodies amabili noma ngaphezulu kungumqondo oqondile we-hyperglycemia yomtholampilo nesifo sikashukela. Izinga lokuqhubekela phambili lixhomeke eminyakeni yobudala bokutholwa kwe-antibody, inani lama-antibodies, i-antibody specificity, ne-antibody titer.
Ukusebenzisa i-autoantibodies ukusiza ukunquma ingozi yesifo sikashukela kunganciphisa izinga le-ketoacidosis yesifo sikashukela, kusize abacwaningi ekwakheni izifundo zokuvimbela, okungase kubambezele ukuqhubekela phambili kwesifo, futhi basize abantu baqonde futhi balungiselele kangcono lesi sifo.
Kubalulekile ukuphawula ukuthi ngenxa yokuthi une-autoantibodies akusho ukuthi unesifo sikashukela sohlobo lwe-insulin oluxhomekile ngokuphelele; kunalokho kungase kusho ukuthi amathuba okuthuthukisa wona ayanda. Uma ungathanda ulwazi oluningi mayelana nenqubo yesiteji ungakwazi ukufinyelela amazinga aseMelika Wokunakekelwa Kwezifo Sikashukela .
Izwi elivela
Ukuvivinywa kokulondeka okudliwayo okudliwayo kudinga ukuthi umuntu aphuze isiphuzo, njengokukhuphula, ngenkathi igazi lidonsa yonke imizuzu engama-30 amahora amabili. Kuyisivivinyo esikhulu ukusiza ukunquma ikhono lomuntu lokwenza i-insulin, okwenza kube ithuluzi elilinganiselwe lokulinganisa. Kodwa, ukuhlolwa kungaba okungahambi kahle futhi kunzima ukwenza ngenxa yokuzibophezela nokuzinikela kwesikhathi. Ngakho-ke, isetshenziswe kakhulu kakhulu esimisweni somtholampilo-njengehhovisi lakho lodokotela.
Kwezinye izimo noma kunjalo, odokotela bangayisebenzisa, isibonelo, ukuhlolwa kwe-hypoglycemia esebenzayo. Ngokuqondile, uma uhlanganyela esilingo somtholampilo, ungase ucelwe ukuthatha eyodwa. Uma uhlela ukuthatha lokhu kuhlolwa, ungakhathazeki. Nakuba ukuhlolwa kungase kube isikhathi esiningi, akubuhlungu futhi akubanga neze imiphumela emibi.
Khumbula, futhi, ukuthi lo mvivinyo awusetshenziswanga ukuhlola noma yiluphi uhlobo lwesifo sikashukela. Futhi njalonjalo, uma usola ukuthi wena noma umuntu omthandayo angase abe nesifo sikashukela ngenxa yezimpawu ezisolisayo, njengokunyuka ukwanda, ukwandisa ukuchama, ukukhathala, ukulamba ngokweqile, ukulahlekelwa isisindo, njll xhumana nethimba lakho lokunakekela impilo ngokushesha.
> Imithombo:
> I-American Diabetes Association. Amazinga Wokunakekelwa Kwezokwelapha Esifo Sikashukela - 2017. Ukunakekelwa Kweshukela . 2017 Jan; 38 (I-Suppl 1): S1-132.
> Besser, R et. al. Izifundo ezivela ekuvivinyweni kokuxilongwa kokudla kokudla. Ukunakekelwa yisifo sikashukela 36: 195-201, 2013
> Cincinnati Izingane. Ukuhlolwa kokubekezela kokudla okuxubile.
> I-Koh, A, i-Mixed test tolerance test (MMTT) ngokuhlolwa kwe-glucose tolerance tolerance (OGTT) ngemuva kokufakelwa isitshalo se-clinic ephumelelayo (CIT)
> ProSciento. Isivivinyo somlomo we-glucose ukubekezelelana kanye nokuhlolwa kokuxilongwa kokudla okuxubile kweshidi.