Amanyathelo okukhusela iingxaki kwi-Diabetics Ukuba noNyango oluPhezulu loPhando
Isifo sikashukela sisigxina esibangela ukunyuka (kunye nokunciphisa) amanqanaba eshukela legazi , kwaye kunokukhokelela kwinkqubo yeentlanzi, iisetyhula kunye neengxaki zokukhusela i-immune. Ama-Amerika angaphezu kwezigidi ezingama-25 angafani nohlobo lwe-diabetes, kwaye zombini unokubangela iingxaki kubantu abakucwangcisa iinkqubo zokuzikhethela. Phakathi kokuhlinzwa okhethwayo okuqhelekileyo kukutyunjwa okutshintshwayo kunye nokuguqulwa kwamadolo, ukutshintshwa kwe- hip kunye nokutshintshwa kwegxala.
Abantu abanesifo sikashukela, okanye baye baphakamisa izinga le-glucose yegazi nangaphandle kokuba bafumane ukuxilongwa kwesifo sikashukela, kufuna ukucwangcisa ngokucophelela ukunceda ukukhusela iingxaki ngenxa yezinga elingalawulwa yi-glucose yegazi. Kwinqaku elihle, iinzame zokulawula isifo sikashukela kunye nokuphuculwa kolawulo lwezinga le-glucose yegazi kunokuba nempembelelo emihle ngokunciphisa ingozi ephathelene nokuhlinzwa.
Ukuphakanyiswa kweSety Sugar
Phantse iipesenti ezi-8 zabantu abahlala endaweni edibeneyo e-United States banokuthi bafake i-I okanye bandise i-II yeswekile. Ukuba ukufumanisa i-diabetes kwandisa ingozi yokutshintshwa okuhlanganyelweyo. Ukongezelela koko, ukwanda kwengozi kuhambelana nendlela kakuhle (okanye ngokungafanelekileyo) elawulwa ngamanqanaba e-glucose egazi ngexesha lotyando. Ukufumana ukuxilongwa kwesifo sikashukela akuthethi ukuba awukwazi ukuqhuba ngokutshintshwa ngokubambisana, kuthetha nje ukuba ingozi yokuhlinzwa ingaba phezulu, kwaye yonke into enokwenzeka ukuba yenziwe ukuba unciphise ingozi eyongeziweyo yeengxaki.
Isifo sikashukela sinokubangela iingxaki kwiisetyhula zomzimba, zesifo kunye neendlela zokuzivikela. Isifo se-Microvascular (umonakalo emitanjeni yegazi encinci) sinokunciphisa ukuhamba kwegazi kunye nokunikezelwa kwe-oksijini endaweni yokuphulukiswa kokucoca. Umsebenzi wokuzikhusela omzimba awukwazi nje ukuphazamisa inkqubo yokhuselo lomzimba, kodwa wenza umzimba unomdla wokukhusela intsholongwane.
Iziphumo zophando zabantu abanesifo sikashukela ngokugqithiseleyo kukuba abo abanesifo sikashukela kwiindlela ezahlukeneyo zokugqirha, kungekhona nje ukutshintshwa ngokubambisana. Izifundo zibonise umngcipheko okhulayo kunye nokuhlinzwa kwamathambo kubandakanya ukuhlinzwa kweenyawo, ukuhlinzwa kwemigudu, kunye nokutyatywa kwamathambo. Olunye uqeqesho lwezonyango luye lwaba nemizekelo yesifo sikashukela esichengeni seengxaki ezinokwenzeka. Kwakhona, ezi ziphumo zivame ukuhambelana nobunzima beemeko ngokubhekiselele ekusebenzeni kakuhle, okanye kakubi, amazinga e-glucose egazi.
Impembelelo kwiMingcipheko yokuThengiswa koMzimba
Kukho iindlela ezininzi apho abantu abanesifo sikashukela bachaphazelekayo xa betyathwa ngokutsha. Isifo sikashukela sikwandisa umngcipheko weengxaki ezininzi , kungekhona enye ingakumbi. Ezinye ezinye malunga neengxaki ezibonwe kwizigulana zesifo sikashukela ezibandakanyekileyo zibandakanya:
- Umngcipheko ophezulu wokusuleleka: Ubungozi bokungena emngciphekweni ngenye yezona nkalo ngokubhekiselele kwiinkalo zokubambisana ngokutsha. Xa ukusuleleka kokutshintshwa ngokubambisana kwenzeka, utyando olongezelelweyo luhlala lufunekayo, kwaye ngokuqhelekileyo izifakelo kufuneka zisuswe ukwenzela ukunyanga intsholongwane.
- Ingozi ephakamileyo yeengxaki zokuphilisa iilonda: Ukuphulukiswa kwe-incision yokugonywa kubonakala ngokuthe ngqo, kodwa imithombo yamanzi, inxeba ye-necrosis, kunye neengxaki zokungaphili ziyakwenzeka kubantu abanesifo sikashukela. Isibhengezo sokuphefumula esingasiphilwanga sisisifo sentsholongwane kubantu abanokutshintshwa ngokuhlanganyela.
- Umngcipheko ophezulu weengxaki zonyango: Uninzi lweemeko zonyango kubandakanya ukugula, izifo zokugonywa kwamanzi, kunye ne-pulmonary embolism zinakho konke kubantu abanesifo sikashukela.
- Ukwandisa umngcipheko wokumpontshelwa igazi: Ukutshintshelwa kwezinto kuqhubeka kunqabile emva kokutshintshwa okufanayo. Ngamachiza amatsha kunye nobuchule bokuvalwa kwezilonda, amathuba okumpontshelwa igazi sele ehla kakhulu. Nangona kunjalo, umngcipheko uphezulu kubantu abanesifo sikashukela.
- Ukongezwa komngcipheko wokufa: Oku kukhwankqisayo ukucinga, kwaye nangona umngcipheko wokufa ohambelana nokutshintshwa ngokubambisana kuncinci kakhulu, akunjalo. Ukongezelela, abantu abaye balawulwa kakubi ngesifo sikashukela banomngcipheko ophezulu wokufa kunye nokuhlinzwa okukhethiweyo njengokutshintshwa ngokubambisana.
Ukulawula iiGlucose zeGazi
Kukho iindaba ezilungileyo! Ndiya kuthiya ukuzisa iindaba ezimbi etafileni, kwaye akukho mbuzo ukuba abantu abanengxaki yokulawula iswekile yegazi badla ngokujamelana neengxaki zempilo ezinzima. Iindaba ezilungileyo kukuba ngokuphucula ukulawulwa kweeshukela zegazi, ngaphaya kwexesha elifutshane kunye nexesha elide, ingozi yokuba nokutshintshwa ngokubambisana akufanele ikhuphuke ngokuphawulekayo.
Izifundo ezininzi zibonise ukuba iingozi ezikhankanywe kweli nqaku zihambelana ngokuthe ngqo kunye nendlela ukuphathwa kweThukela yegazi. Oku kuyinyaniso yokulawula ushukela wegazi phezu kweenyanga ezijikelezayo, kunye neentsuku ezijikelezayo. Ngoko ke, iinzame zokuzinzisa nokulawula iswekile yegazi ngokutya, ukuzivocavoca, amayeza kunye nezinye iindlela kunokunceda ukukhusela iingxaki ezinxulumene nokuhlinzwa okuhlanganyelweyo.
Igazi leeshukela imilinganiselo ngokuqhelekileyo lilinganiswa ngenye yeendlela ezimbini:
- Iqondo le-glucose: Iqondo le-glucose yegazi lidla ngokulinganiswa xa lizila ukudla (kungekudala ngaphambi kokutya, kungekudala) kunye no-70-100. Kubantu abanesifo sikashukela esilawulwa kakuhle, le nombolo ingaba kwi-90-130. Igazi le-glucose amazinga lingavuka ngokuphawulekayo, ngakumbi kubantu abanesifo sikashukela. Emva kokutya, akuqhelekanga ukuba sisondele kuma-200 okanye ngaphezulu kumntu onesifo sikashukela, kanti kubantu abangenalo mqathango, i-blood glucose ayifuni ngaphezu kwe-125.
- I-Hemoglobin A1c : I-hemoglobin A1c, okanye i-HbA1c, ngumlinganiselo wamanqanaba e-blood glucose aphakathi kweenyanga eziphambili kovavanyo. Ayiniki i-snapshot yesikhashana ngexesha, kodwa kunoko umxholo jikelele wokuthi, okanye ngokungafanelekileyo, ukulawula iishukela zegazi. Umntu ongenayo i-diabetes uya kuba ne-hemoglobin level A1c malunga no-5.0, kanti umntu onesifo sikashukela ungaphezu kwama-6.5 (nangona kukho ukungavumelani kwizinga elichanekileyo elichaza isifo sikashukela, abaninzi banokuvumelana kwi-6.5 ukuya ku-7.0). Xa usebenza ukulungelelanisa ukuphathwa kwegazi i-glucose, utshintsho kwi-hemoglobin A1c lunokuthatha inyanga ukufumana.
Zomibini zale miqathango zinokunceda ngeendlela ezahlukeneyo, kodwa akukho phelele. Umzekelo, ukuba negazi lezinga le-glucose level ngaphezu kwama-200 ngexesha lokutshintshwa ngokubambisana liboniswe ukuba liyingozi yenkxalabo, nokuba i-A1c ilawulwa kakuhle. Ngokufanayo, ukuba negazi eliqhelekileyo kwi-glucose ngosuku lotyando ekusetyenzisweni kwe-A1c ephezulu akuthethi ukuba usengozini. Zomibini iimvavanyo zingancedisa abantu ukulawula ukulawulwa kwe-glucose nokunciphisa ubungozi babo obuhlobene nokuhlinzwa okwenziwa ngokuhlanganyela.
Ngaba Kufuneka Kube neCutoff?
Ezinye iindawo zokufakelwa ezihlanganyelweyo ziye zazisa inkqubo apho zifuna umphumo othile wokuvavanya ukuze kuqhutywe ukutyunjwa okuhlanganyelweyo. Uvavanyo oluqhelekileyo olusetyenziswa rhoqo yi-hemoglobin A1c. Ngomgudu wokuqinisekisa ukuba abantu abahlala endaweni yokujoyina ngokubambisana banesifo sikashukela ngokufanelekileyo, amanye amaziko adinga i-hemoglobin A1c ethile, kubanjwe kwinqanaba elingaphantsi kwe-7.5 okanye ngaphantsi kwe-8.
Kuyathakazelisa ukuba i-hemoglobin A1c mhlawumbi ayilona vavanyo elungileyo ukuchaza ubungqina beengxaki ezinxulumene nokutshintshwa ngokubambisana, kodwa luvavanyo olulungele ukufumana, kwaye lunikeza uphawu olucacileyo lokuba umntu angakwazi njani ukulawula amanqanaba eeshukela egazi. Ngokuchanekileyo yiyiphi inombolo ekhuselekile, kwaye into engekhoyo, ingquzulwano, kodwa ezinye iindawo zokutshintshwa ngokudibanisa ziye zachazela i-cutoff yazo kule nkqubo.
Uphononongo olutshanje lwe-rejistration replacement registry yezigulane ezingama-18,000 zifumene ukuba i-cutoff kweli qela yayingu-hemoglobin A1c ye-8.0 okanye ngaphezulu. Kulezi zigulane, kwakukho umngcipheko ophezulu wokusuleleka kwintsholongwane kunye neengxaki zokuphilisa. Ngengxelo entle, ingozi enkulu yeengxaki kwili qela lezigidi ezingama-18,000 zazincinci (malunga neepesenti eziyi-1), kwaye nangona ubungozi bebuphindwe kabini kubantu abane-A1c ngaphezu kwe-8, ingozi yayingama-2 ekhulwini.
ILizwi
Oku kuzwakale njengeendaba ezininzi ezimbi, ngoko ke ndiphelise ngokulungileyo: Amawaka abantu abanesifo sikashukela bayaphumelela ngokuguqulwa ngokutsha kunye nokuguqulwa komzimba ngamnye ngonyaka. Nangona kukho ingozi eyongeziweyo yokuxhatshazwa kweengxaki, ezo ngozi zingaphathwa. Ukulawula amanqanaba eeshukela egazi, ngokukodwa ngexesha lokuhlinzwa, kucingelwa ukuba yinto ebalulekileyo ekulawuleni le mingcipheko. Abantu abanesifo sikashukela akufanele batyatshwe ngokutsha, kodwa bafanele basebenze noogqirha babo ukuba balungiselele ukulawula ishukela egazini ukuze bagcine ubungozi babo obunxulumene nokuhlinzwa okwenziwa ngokuhlanganyela ngokuphantsi.
> Imithombo:
> Rizvi AA, Chillag SA, Chillag KJ. Ulawulo lwe-diabetes kunye ne-hyperglycemia kwizigulane ezenziwa ngophando lwezilonda "J Am Acad Orthop Surgery. 2010 Julayi; 18 (7): 426-35.
> IStanton T. "I-HbA1c Ingozi yokuThatshazwa kweNtsholongwane echonga iSifo sikashukela. Epreli 2017.
> Uhl RL, uRenenbaum AJ, iDipreta JA, Desemone J, Mulligan M. "Isifo sikashukela sisigxina: ukubonakaliswa kwesifo se-musculoskeletal kunye neengxaki zengxubusho ye-orthopedic surgeon" J Am Acad Orthop Surg. 2014 Mar; 22 (3): 183-92.