Tswj cov ntshav qab zib ib txwm muaj peev xwm ua tau nrog kev ua haujlwm zoo ntawm kev ua haujlwm ntawm lub txiav thiab ua haujlwm ntawm endocrine. Qhov teeb meem feem ntau ntawm cov carbohydrate metabolism cuam tshuam nrog ntshav qab zib.
Thaum muaj hnub nyoog hluas, glycemia kuj tseem cuam tshuam los ntawm theem ntawm kev loj hlob hormone thiab hloov mus rau hauv cov concentration ntawm cov tshuaj hormones pw ua ke, yog li tswj cov ntshav qab zib hauv cov hluas thaum muaj 16 xyoo mob ntshav qab zib yog ib txoj haujlwm nyuaj.
Txhawm rau tiv thaiv cov menyuam los ntawm cov teeb meem cuam tshuam nrog kev hloov pauv hauv cov piam thaj hauv ntshav, nrog rau tsim cov xwm txheej rau cov hluas kom loj hlob thiab loj hlob ib txwm, kev saib xyuas tas li thiab tswj cov glycemia yog qhov yuav tsum tau ua.
Cov roj carbohydrate metabolism hauv cov neeg hluas
Nws tau pom tias nyob hauv cov xwm txheej zoo sib xws, cov tub ntxhais hluas qhia tias muaj ntau dua glycated hemoglobin ntau dua li cov neeg laus, txawm hais tias muaj tshuaj insulin ntau dua. Cov tshuaj insulin ib txwm muaj ntau dua nyob rau ntawm cov tub ntxhais hluas hluas dua li ib tus menyuam yaus hnub nyoog lossis 20 xyoo tus neeg mob.
Cov yeeb yam no tau tshwm sim hauv kev sib txuas nrog qhov tseeb tias theem ntawm kev loj hlob hormone nyob rau lub sijhawm tiav nkauj tiav nraug yuav luag ob npaug, thiab kev sib deev steroids los ntawm yuav luag 35%. Qhov no ua rau qhov tseeb tias cov rog tau tawg sai dua thiab muaj cov roj khov dawb ntau dua, uas yog siv los tsim lub zog, thiab insulin rhiab heev dua.
Cov nyhuv ntawm cov tshuaj insulin rau cov hluas yog 30-47% qis dua rau tus neeg mob ntawm 21 xyoo lossis neeg laus. Yog li no, thaum ua kev kho cov tshuaj insulin, kev siv tshuaj loj kawg los ntawm kev siv tshuaj insulin yuav tsum siv, nce qhov ntau zaus ntawm nws txoj kev tswj hwm.
Cov kev xav ntawm lub hlwb uas cuam tshuam rau cov hom mob ntshav qab zib suav nrog:
- Qib siab ntawm kev ntxhov siab.
- Cawv rau noj tsis haum.
- Cov cwj pwm tsis zoo.
- Kev ntxhov siab thiab tus kheej qis.
Yog li, thaum muaj teeb meem uas tshwm sim thaum soj ntsuam kev noj haus thiab kev kho mob, qee kis, ntxiv rau tus kws kho mob endocrinologist, nws yuav tsum koom nrog tus kws kho mob hlwb kom kho txoj kev coj cwj pwm.
Kev ntsuas ntshav qab zib
Txhawm rau txheeb xyuas ntshav qab zib, kev kawm txog kev yoo mov glycemia. Cov lus qhia rau nws siv yuav yog qhov muaj mob muaj keeb thiab qhov tshwm sim ntawm cov tsos mob ntshav qab zib: tus tub hluas pib haus dej ntau thiab nquag mus xyuas chav dej, txawm hais tias yog tsis qab los noj mov zoo thiab nce siab noj cov ntshav qab zib tsawg dua.
Tsis tas li, cov niam txiv tuaj yeem nco tseg ua khaub thuas, ua pob thiab khaus khaus ntawm daim tawv nqaij, ua xoos ua zes ntawm daim tawv nqaij, nce ntau rog, ua tsis taus pa thiab tsis nco qab. Cov laj thawj rau kev kuaj mob tuaj yeem yog ntshav siab thiab qhov muag cuam tshuam.
Yog tias tus tub ntxhais hluas raug kuaj thawj zaug, tom qab ntawd nws raug kuaj ntshav kuaj ntshav qab zib, uas tau ua rau sawv ntxov ua ntej noj mov. Nws yog qhov yuav tsum tau yoo nqhis ua ntej txoj kev tshawb no rau 8 teev los ntawm kev noj mov, rau 2-3 teev los ntawm kev haus luam yeeb thiab kev tawm dag zog lub cev, haus ib qho twg, tsuas yog haus dej. Cov ntshav qab zib cov ntshav rau cov hnub nyoog 13-16 xyoos yog 3.3 - 5.5 mmol / l.
Yog tias theem ntawm glycemia tsis pub dhau 6.9 mmol / L, tab sis nws yog siab dua li ib txwm muaj, tom qab ntawd kev kuaj mob ntawm kev tsis muaj peev xwm zam cov khoom noj tau lees paub los ntawm kev kuaj ntxiv nrog lub suab thaj, thiab yog tias cov ntshav muaj suab thaj ntau dua 7 mmol / L, ces tus kws kho mob ntshav qab zib yog qhov kev txiav txim siab ua ntej ntawm tus kws kho mob.
Cov ua rau tsis mob ntshav qab zib ntsig txog glycemia nce:
- Kab mob siab.
- Noj tshuaj uas muaj cov tshuaj hormones.
- Pathology ntawm lub raum.
- Lub qog ua ntshav lossis mob qog.
- Pituitary lossis hypothalamic metabolic ntshawv siab.
Hyperglycemia cuav tuaj yeem tshwm sim yog tias zaub mov noj ua ntej qhov kev tshawb fawb lossis muaj kev ntxhov siab, lossis kev tawm dag zog lub cev, haus luam yeeb, noj anabolic steroids, haus dej haus cawv lossis muaj caffeine.
Cov piam thaj hauv ntshav tsawg tsawg ua rau lub plab lossis lub plab hnyuv, cov qog ua haujlwm, cov qog qis ntawm cov qog ntshav ntawm lub qog thiab cov qog ua rau cov qog, ua pa, mob rau lub hlwb.
Qee cov kab mob caj ces ua rau cov ntshav qab zib tsawg.
Glycemic tswj nyob rau hauv cov hluas cov ntshav qab zib
Qhov ntsuas ntawm cov piam thaj yuav tsum muaj ntshav qab zib tsawg kawg 2-4 zaug hauv ib hnub. Ib qho kev txiav txim yuav tsum tau ua ua ntej yuav mus pw kom tiv thaiv kev mob ntshav qab zib thaum hmo ntuj. Ib qho ntxiv, nws yog qhov yuav tsum tau ua nrog kev saib xyuas thaum muaj kev hloov pauv ntawm kev noj zaub mov noj, kev sib tw kis las, kabmob sib kis, kev kuaj mob.
Nws yog qhov yuav tsum tau khaws cov ntaub ntawv txog qib qab zib thiab cov koob tshuaj insulin uas tau nkag los. Rau cov hluas, qhov kev xaiv zoo tshaj plaws yuav tau siv cov phiaj xwm tshwj xeeb uas tsim los rau cov khoom siv hluav taws xob.
Kev kawm rau cov hluas hauv cov tsev kawm ntshav qab zib yuav tsum yog ua raws li cov lus pom zoo rau kev kho kom haum rau hauv cov xwm txheej txawv: hnub yug, dej cawv, khoom noj ceev, ncaws pob lossis yuam kom noj mov thiab txhaj tshuaj insulin.
Nrog cov piam thaj kom ntau ntxiv lossis qhov kev cia siab ntxiv, koj yuav tsum txo feem ntawm cov khoom noj lossis kev tawm dag zog. Ib txoj kev xaiv yog nce lub koob tshuaj ntawm luv luv ua yeeb yam insulin, tab sis nco ntsoov tias cov koob tshuaj ntxiv tuaj yeem ua rau nce phaus, zoo li mob ntev dhau ntawm insulin overdose syndrome.
Cov qauv rau kev kho ntshav qab zib rau cov hluas yog:
- Kev yoo cov ntshav cov ntshav qib 5.5-5.9 mmol / L.
- Glycemia tom qab noj mov (tom qab 120 feeb) yog qis dua 7.5 mmol / L.
- Lipid spectrum (hauv mmol / l): cov roj (cholesterol) txog li 4.5; triglycerides qis dua 1.7, LDL tsawg dua 2.5, thiab HDL siab dua 1.1.
- Glycated hemoglobin feem ntau qis dua 6.5%.
- Ntshav siab txog li 130/80 hli RT. Kos duab.
Yuav kom ua tiav cov hom phiaj glycemic uas txo qis kev pheej hmoo ntawm ntshav qab zib muaj teeb meem tsuas yog ua tau thaum npaj kev noj haus.
Koj kuj yuav tsum tau npaj seb yuav noj pes tsawg carbohydrates thiab koob tshuaj insulin, uas tuaj yeem pab lawv qhov nqus.
Yuav ua li cas tiv thaiv cov ntshav qog nyob hauv tus tub hluas muaj ntshav qab zib?
Kev siv tshuaj insulin ntau, uas yog tus qauv tseem ceeb rau kev kho hom 1 ntshav qab zib mellitus thaum tiav hluas, nrog rau kev noj zaub mov tsis xwm yeem thiab ntau dua li kev siv lub cev yog cov muaj kev pheej hmoo rau kev mob ntshav qab zib. Yog li ntawd, cov neeg mob zoo li no yuav tsum nrog lawv haus kua txiv qab zib lossis suab thaj ua ke.
Nrog rau qhov muaj mob me, hypoglycemia yog tshwm sim los ntawm kev tawm tsam ntawm kev tshaib kev nqhis, uas yog nrog ua kom tsis muaj zog, mob taub hau, tshee hnyo ntawm txhais tes thiab ko taw, kev coj tus cwj pwm thiab lub siab ntsws hloov - ntau lub siab tsis tuaj yeem lossis kev nyuaj siab tshwm sim. Tus menyuam yuav kiv taub hau lossis hnov qhov muag tsis zoo.
Nrog rau cov kawm qib siab me, cov hluas yuav plam lawv qhov kev coj ua hauv qhov chaw, coj tus cwj pwm tsis raug thiab tsis paub txog qhov xwm txheej loj, thiab teb tsis zoo rau kev sim kho mob. Nyob rau hauv kev tawm tsam hnyav, cov menyuam poob rau hauv lub plab tsis xis nyob, thiab huam mob tshwm sim.
Cov cai tseem ceeb rau kev tiv thaiv hypoglycemia:
- Cov ntshav qab zib yuav tsum tsis txhob poob qis dua 5 mmol / L.
- Nco ntsoov ntsuas glycemia ua ntej yuav mus pw.
- Yog tias cov piam thaj tsawg dua 5 mmol / l ua ntej noj mov, ces tsis tas txhaj tshuaj ua ntej noj mov, tus menyuam yuav tsum tau noj ua ntej, thiab tom qab ntawd ntsuas ntsuas qab zib thiab txhaj tshuaj insulin.
- Tsis txhob haus cawv haus rau ntawm lub plab khoob.
Kev tawm dag zog feem ntau ua rau cov ntshav qabzib, raws li qhov xav tau ntawm cov piam thaj hauv cov nqaij ntshiv nce, thiab nrog kev tawm dag zog, glycogen tshwj xeeb yog ploj zuj zus. Cov txiaj ntsig ntawm kev ua kis las ncaws pob tuaj yeem kav ntev li 8-10 teev. Yog li, rau cov neeg mob ntshav qab zib, nws raug nquahu kom txo cov koob tshuaj insulin thaum lub sijhawm ua haujlwm ntev.
Txhawm rau tiv thaiv kev tawm tsam ntawm hypoglycemia thaum hmo ntuj, koj yuav tsum tau noj thaum lub sijhawm thiab tom qab kev cob qhia. Cov hluas yuav tsum tau zaub mov noj txhua txhua 45 feeb. Hauv qhov no, koj yuav tsum tau txais ib nrab ntawm cov carbohydrates los ntawm cov txiv hmab txiv ntoo, thiab ntu thib ob yuav tsum muaj cov khoom noj (carbohydrates) sib xyaw - piv txwv li, ib lub ncuav cheese. Nrog rau feem ntau nocturnal hypoglycemia, hloov chav kawm rau thaum sawv ntxov.
Txhawm rau kho qhov mob ntshav qab zib tsawg los yog mob pes nrab, koj yuav tsum noj 10 g suab thaj hauv cov ntsiav tshuaj (ib khob kua txiv lossis haus dej qab zib). Yog tias cov tsos mob tsis ploj, tom qab 10 feeb - rov ua dua. Nrog rau qhov hnyav ntawm txo cov piam thaj, glucagon yuav tsum tau txhaj, tom qab uas tus me nyuam yuav tsum noj.
Qhov phom sij ntawm kev tawm tsam ntau dhau ntawm cov ntshav qog ntshav qab zib hauv ntshav qab zib yog qhov kev puas tsuaj rau lub hlwb tau nce zuj zus tuaj, uas tuaj yeem txo lub peev xwm kev txawj ntse yav tom ntej. Rau cov menyuam yaus, qhov xwm txheej tshwm sim tuaj yeem yog qhov cuam tshuam ntawm cov phooj ywg rau qhov xwm txheej ntawm qhov tsis paub tswj tus cwj pwm.
Qhov phom sij tshwj xeeb tshaj yog thaum tseem hluas yog kev haus dej haus cawv muaj ib qho nyiam ua rau lub ntsej muag hypoglycemia. Nws yuav tsum tau yug los rau hauv lub siab tias thaum muaj kev kub ntxhov hnyav, glucagon tiv thaiv keeb kwm ntawm cov cawv tsis ua hauj lwm, yog li tus tub ntxhais hluas xav tau kev mus pw hauv tsev kho mob sai sai thiab kev tswj hwm cov tshuaj muaj cov ntshav qabzib.
Tus kws tshaj lij los ntawm daim vis dis aus hauv tsab xov xwm no yuav tham txog cov ntshav qab zib cov ntshav ib txwm muaj.
