Teko ea mamello ea glucose e ile ea eketseha, glycated hemoglobin e tloaelehileng

Tlhahlobo ea lefu la tsoekere mellitus (DM) e sebelisang tlhahlobo ea mamello ea glucose (PHTT) le hemoglobin (HbA1c) ea bakuli ba ile ba etsoa har'a bakuli ba 127 ba nang le mabaka a kotsi ea lefu la tsoekere la mofuta oa 2. Ho sibolloa ha lefu la tsoekere mellitus ho latela boemo ba HbA1c ho ne ho le tlase ho feta motheong oa PHTT (31% khahlano le 43%). Boemo ba HbA1c> 7% bo lula bo tsamaisana le tlhahlobo ea lefu la tsoekere ka mokhoa oa PHTT. Leha ho le joalo, boemo ba HbA1c ba PHTT.

Phokotso ea litekanyetso tsa tlhahlobo ea lefu la tsoekere le hakanngoa ho tsoa liphatsong tsa liteko tsa mamello ea tsoekere ea molomo le boemo ba glycated hemoglobin (HbA1c)

Palo ea lipatlisiso tsa bakuli ba 127 ba nang le lefu la tsoekere la mofuta oa 2 mellitus (T2DM) ba kotsing ea tlhahlobo ea mamello ea glucose (OGTT) le HbA1c ka mabaka a tlhahlobo ea mali. HbA1c e bontšitse bakuli ba nang le lefu la tsoekere ho feta OGTT (31% vs 43%). HbA1c> 7% le OGTT li ne li ts'oana ho netefatsa lefu la tsoekere, empa ts'ebetso ea HbA1c OGTT ho netefatsa ts'oaetso.

Lingoloa tsa saense e bua ka sehlooho se reng "Tebellano ea lintlha tsa tlhahlobo ea lefu la tsoekere ho ea ka liphetho tsa tlhahlobo ea mamello ea glucose le boemo ba hemoglobin HbA1c"

Tlhaloso ea lintlha tsa tlhahlobo ea lefu la tsoekere ho ea ka liphetho tsa tlhahlobo ea mamello ea glucose le boemo ba hemoglobin HbA1c

Federal State Budgetary Institution "Setsi sa Saense sa Endocrinological" sa Lefapha la Bophelo la Mokhatlo oa Russia, Moscow

Phokotso ea litekanyetso tsa tlhahlobo ea lefu la tsoekere le hakanngoa ho tsoa liphatsong tsa liteko tsa mamello ea tsoekere ea molomo le boemo ba glycated hemoglobin (HbA1c)

Setsi sa lekhetho sa lichelete sa "muso" Setsi sa Lipatlisiso sa Endocrinological ", Lekala la Bophelo la Russia, Moscow

Tlhahlobo ea lefu la tsoekere mellitus (DM) e sebelisang tlhahlobo ea mamello ea glucose (PHTT) le hemoglobin (HbA1c) ea bakuli ba ile ba etsoa har'a bakuli ba 127 ba nang le mabaka a kotsi ea lefu la tsoekere la mofuta oa 2. Ho sibolloa ha lefu la tsoekere mellitus ho latela boemo ba HbA1c ho ne ho le tlase ho feta motheong oa PHTT (31% bapisoa le 43%). Boemo ba HbA1c> 7% bo lula bo tsamaisana le tlhahlobo ea lefu la tsoekere ka mokhoa oa PHTT. Leha ho le joalo, HbA1c 7% le OGTT li ne li tšoana ho tiisa lefu la tsoekere, empa HbA1c ha ke fumane seo u se hlokang? Leka ts'ebeletso ea khetho ea lingoliloeng.

lintlha tse kae tse kotsing ea kholo ea lefu la tsoekere la mofuta oa 2 (T2DM). Lintho tse kotsi li kenyeletsa lilemo> lilemo tse 45, ho nona haholo kapa ho nona haholo (BMI> 25 kg / m2), nalane ea lelapa ea T2DM (batsoali kapa banab'abo ba nang le T2DM), ho ikoetlisa ka mokhoa o tlase, ho sitisa ho itima lijo glycemia (NGN) kapa ho holofala ha glucose (NTG) nalane, lefu la tsoekere la monyako kapa nalane e kholo ea lesea. Phuputso eo e ne e sa kenyeletse bakuli ba fumanang kalafo ea hypoglycemic kapa kalafo ea ho ja.

Boemo ba HbAlc bo ne bo ikemiselitse ho bakuli bohle, mme ha ho ka feta matsatsi a 3 hamorao, PHTT e tloaelehileng e ile ea etsoa ka 75 g ea glucose ka boikemisetso ba ho futhumala glucose le 120 min ka mor'a mojaro oa carbohydrate. Mosebetsi ona o ananetsoe ke komiti ea melao ea boitšoaro ea FSBI ENC. Bakuli bohle ba saena tumello e ngotsoeng e nang le tsebo ea ho nka karolo teko ea bongaka.

Tsoekere ea Serum e ne e ikemiselitse ho moetsi oa lihlahisoa oa Architect c4000 biochemical (Abbott Diagnostics, Abbott Park, IL, USA) a sebelisa lisebelisoa tse tloaelehileng tsa moetsi. Glycated hemoglobin (HbA1c) e ile ea khethoa ke ts'ebetso e phahameng ea metsi chromatography ho mohlahlobi oa D10 (Bio-Rad) ho latela maemo

Lethathamo 1. Tlhahlobo ea tekanyetso ea lefu la tsoekere le mafu a mang a glycemic (WHO, 1999-2006)

Carbohydrate metabolism

Mofuta o mongata oa mali a bitsoang plasma glycemia (mmol / L)

Norm SD NTG NGN

7.0 6.1 le 11.1> 7.8 mme ha ke fumane seo o se hlokang? Leka ts'ebeletso ea khetho ea lingoliloeng.

Sehlopha se kotsing e kholo ea lefu la tsoekere

Ha e hlalosoe Ha e hlalositsoe> 6.5

Ho tsamaellana le litekanyetso tsa tlhahlobo ea mathata a metabolism ea carbohydrate ka PHTT le boemo ba HbA1c (liperesente tsa bakuli).

Todike. Mokhoa o netefalitsoe ke NGSP (Lenaneo la Sechaba la Glycohemoglobin Standartization).

Ho latela liphetho tsa HRTT le boemo ba HbAlc, lithuto li ile tsa aroloa ka lihlopha tse tharo: batho ka bomong ba se nang mathata a carbohydrate metabolism (tloaelehileng), sehlopha se kotsing e kholo ea T2DM, le sehlopha se nang le T2DM e sa tsoa fumanoa. Sehlopha se kotsing e kholo ea T2DM se kenyeletsa bakuli ba nang le NGN, NTG, kapa motsoako oa bobeli. Bakuli ba abetsoe sehlopha se nang le T2DM ho latela liphetho tsa PHTT tlasa e 'ngoe ea maemo a latelang: boteng ba keketseho ea nako e le' ngoe ea glycemia lenaneng la lefu la tsoekere ho anamnesis + keketseho ea nako e le 'ngoe ea glycemia maemong a lefu la tsoekere nakong ea PHTT. Bakuli ba abetsoe sehlopha se nang le T2DM maemong a HbA1c tlasa e 'ngoe ea maemo a latelang: boteng ba keketseho ea nako e le' ngoe ea glycemia maemong a lefu la tsoekere historing ea + HbA1 ho lefu la tsoekere.

fapaneng> 6.5%, keketseho e le 'ngoe ea glycemia nakong ea PHTT + HL1c maemong a lefu la tsoekere.

Tafoleng. 1 le 2, ho hlahisoa mekhoa ea ho hlahloba mafu a amanang le metabolism ea carbohydrate.

Liphetho le puisano

Tlhahlobo e lekantsoeng ea ho sibolla mafu a ho senyeha ha metabolism ea carbohydrate e sebelisang PGTT le boemo ba HL1c bo bonts'itse tsitsipano pakeng tsa liphetho tsa liteko tsena (bona setšoantšo).

Ho palo ea bakuli ba hlahlobiloeng, boemo ba HL1c bo ile ba bolela esale pele ho ba teng ha lefu la tsoekere ha le bapisoa le PGTT (31% bapisoa le 43%).

Lintlha tsa lingoliloeng li fana ka maikutlo a hore tlhahlobo ea lefu la tsoekere ka boemo ba HL1c ha e senole ho feta palo ea bakuli ba nang le lefu la tsoekere ha le bapisoa le PGTT. Liphetho tsa lithuto tse entsoeng Denmark, UK, Australia,

Greenland, Kenya le India li bonts'a phapang e kholo lithutong tse ipapisitseng le liphetho tsa PHTT le boemo ba HL1c. Khafetsa ea liketsahalo tsa tšibollo ea tlhahlobo ea phofshoana ea PHTT le boemo ba НЛЛ1с lithutong tsena li fapane ho tloha ho 17 ho isa ho 78%. Mekhatlo e mengata ea lefats'e ea lefu la tsoekere ha e khothalletse ho sebelisa boemo ba HL1c e le mokhoa oa tlhahlobo ea lefu la tsoekere ka lebaka la khaello ea mokhoa le ho hloka tlhaiso-leseling ka litšobotsi tsa morabe oa hemoglobin glycation.

Thutong ea rona, liphetho tsa ho fumanoa ha lefu la tsoekere litekong tse peli li kopane feela maemong a HL1c> 7%. Ho 6.5 7%, palo ea bakuli ba tšoaelitsoeng ba nang le lefu la tsoekere e lumellana ka botlalo le seo ha ba sebelisa tekanyetso ea tlhahlobo ea khauta - PHT. Le ha ho le joalo, boemong ba НЛЛ1с

Likarabo tse 15

U bone kae "ke karolo ea 0,1 lekholong feela e tloaelehileng"? Na o sentse kaofela matšoao a liteko tsa glucose. 'Me e phatlalalitsoe ka ho hanyetsa insulin. Hape, ho latela liprotheine tsa sejoale-joale, ho bona leha e ka ba ka phoso ho fumanoa ha glycemia ka holimo ho 11.1 mmol / l ke ketsahalo ea ho theha lefu la tsoekere hanghang.

Ebile, ho molemo ho qala ka ho tlosa phoso ea laboratori. Pheta, haeba ho khonahala, liteko ka bobeli ka laboratoring e ngoe.

Elena, ka nako eo ho hlakile - lefu la tsoekere. Mohlomong o bontšitse eseng khale haholo, mme hemoglobin ea glycosylated ha e e-so be le nako ea ho nka khato. Ke khothaletsa haufinyane hore ke phethe tlhahlobo ea mali bakeng sa insulin, C-peptide le index ea NOMA (matšoao a boemo ba tšebetso ba pancreatic le insulin) mme ke ikopanye le endocrinologist ka boeena bakeng sa kalafo ka liphetho.

Joale qala ho latela ho ja. No. 9 (tlhaiso-leseling e fumanehang hohle marang-rang, ka hona ha ke e qope), khetha lihlahisoa tse nang le index ea glycemic ka tlase ho 50.
U ka boela oa nka phytosborne Arfazetin halofo ea khalase makhetlo a 3 ka letsatsi metsotso e 30 pele ho lijo ho ea ka morero "matsatsi a 14 a ho ja + matsatsi a 14 a phomolo".

Ke lokela ho etsa eng haeba ke na le potso e tšoanang empa e fapaneng?

Haeba ha u fumane tlhaiso-leseling e hlokahalang lipakeng tsa likarabo tsa potso ena, kapa haeba bothata ba hau bo fapane hanyane le bo hlahisitsoeng, leka ho botsa ngaka potso e eketsehileng leqepheng le tšoanang haeba a le ntlheng ea potso ea sehlooho. U ka botsa potso e ncha, 'me kamora nakoana lingaka li tla e araba. Ke mahala. U ka batla tlhaiso-leseling e nepahetseng mabapi le litaba tse tšoanang leqepheng lena kapa ka leqephe la patlo ea sebaka seo. Re tla leboha haholo haeba o re khothaletsa ho metsoalle ea hau ho liwebosaete tsa batho ba etsang metsoalle.

Medportal 03online.com e fana ka lipuisano tsa bongaka ka ngollano le lingaka sebakeng sa marang-rang. Mona u fumana likarabo ho litsebi tsa 'nete tse sebetsang tšimong ea hau. Hajoale, sebaka sena se fana ka likeletso maemong a 48: allergist, anesthetist-resuscitator, venereologist, gastroenterologist, hematologist, geneticologist, gynecologist, homeopath, dermatologist, ngaka ea bana, ngaka ea bana, ngaka ea bana, ngaka ea bana, ngaka ea bana , ngaka ea mafu a tšoaetsanoang, ngaka ea methapo ea pelo, setsebi sa methapo ea mafu, ngaka ea puo, ngaka ea 'mele, setsebi sa bongaka, bongaka ba methapo, ngaka ea methapo, ngaka ea masapo, ngaka ea masapo le masapo ngaka ea bongaka, ngaka e buoang ngaka, ngaka ea mafu a mafu a kelello, ngaka ea mafu a mafu a kelello, ngaka ea mafu a methapo, ngaka ea methapo, ngaka ea methapo, ngaka ea maoto

Re araba lipotso tse 96.28%..

Lefu la tsoekere

Prediabetes (e tsejoang hape e le "prediabetes"), prediabetes - boemo bo etelletseng pele kholo ea lefu la tsoekere, hangata e le mofuta oa 2. Mmuso oa prediabetesic o tšoauoa ka tsoekere e phahameng ea mali (tsoekere), empa ha e phahame haholo hoo ho ka fumanoang hore o na le lefu la tsoekere la mofuta oa 2.

Hangata lefu la tsoekere le hloka leeme, empa lenyora le matla (le matlafatsang), ho ntša metsi khafetsa, tlala e sa feleng le pono e lerootho ke sesupo se tšosang se hlokang tlhokomelo ea bongaka e tsoang ho ngaka ea methapo ea kutlo.

Ho ba teng ha prediabetes ha ho bolele ho fokotseha ha boemo bona ho mofuta oa lefu la tsoekere la mofuta oa 2, leha ho le joalo, ho hloka mehato e reretsoeng ho fokotsa likotsi, haholo: ho fokotsa boima ba 'mele, ho tlohela mekhoa e mebe, ho eketsa ts'ebetso ea' mele, 'me maemong a mang, kalafo ea lithethefatsi.

Prediabetes e bonoa ke e 'ngoe ea liteko tse tharo (tse tšohliloeng sehloohong sena): tsoekere e potlakileng ea mali (glucose) (GKN), tlhahlobo ea mamello ea glucose (GTT) le hemoglobin A1c.

Haeba prediabetes e sa fumanoe ka nako, sena se ka lebisa ho ha e fetohe litlamorao: nts'etsopele ea mofuta oa lefu la tsoekere la mofuta oa 2, hammoho le mathata a mang a maloetse a pelo le methapo e meholo ea mali, mafu a methapo ea methapo le liphio, ho senyeha hoa pono, ho otloa.

Ho sa le joalo, European Journal of Endocrinology e phatlalalitse tlhahlobo mabapi le lefu la masapo a lefu la tsoekere la mofuta oa 1.

Lefu la tsoekere

Lefu la tsoekere, lefu la tsoekere, lefu la tsoekere, ho ea ka ICD-10 - E10-E14 - sehlopha sa maloetse a endocrine a tšoauoang ke boemo bo phahameng ba tsoekere bo maling (tsoekere) maling ka lebaka la khaello e phethahetseng ea "(DM 1) kapa amanang (ho DM 2) khaello ea li-pancreatic hormone. litsoelesa tsa insulin. Lefu la tsoekere le tsamaea le bokuli mefuta eohle metabolism: protheine, mafura, lik'habohaedreite, metsi-letsoai le liminerale.

Lefu la tsoekere le bonahatsoa ke matšoao a latelang: lenyora (DM 1 le DM 2), monko oa acetone o tsoang molomong le 'meleng oa acetone ka har'a moroto (DM 1), boima ba' mele bo fokolitsoeng (DM 1, ho DM 2 - methating ea morao), hammoho le ho ruruha ho feteletseng. liso tsa leoto, pholiso e bohloko ea leqeba.

Metsoalle e lulang e le teng ea lefu la tsoekere ke: maemo a phahameng a tsoekere moriring (glycosuria, glucosuria), ketonuria (acetonuria, 'mele ea acetone ka har'a moroto), hangata ha ho na liprotheine tse ngata ka har'a moroto (albinuria, proteinuria) le hematuria (mali a morao ka moroto). Ntle le moo, karabelo ea moroto ho lefu la tsoekere hangata e fetoha lehlakoreng la acid.

Mofuta oa 1 oa lefu la tsoekere (mofuta oa 1 lefu la tsoekere, o itšetlehileng ka insulin, mocha, ho ea ka ICD-10 - E10) ke lefu la autoimmune la endocrine system le ikhethang ka ka ho felletseng khaello ea insulin, ka lebaka la hore sesole sa 'mele, ka mabaka a sa hlaka kajeno, se hlasela le ho senya lisele tsa pancreatic beta tse hlahisang insulin. Mofuta oa 1 oa lefu la tsoekere o ka ama motho leha e le ofe lilemong, empa lefu lena le hlaha hangata ho bana, lilemong tsa bocha le ho batho ba baholo ba ka tlase ho lilemo tse 30.

Mofuta oa lefu la tsoekere la mofuta oa 2 (lefu la tsoekere la mofuta oa 2, le sa itšetlehang ka insulin, ho latela ICD-10 - E11) ke lefu le se nang autoimmune le tšoailoeng ke mong ka khaello ea insulin ka lebaka la tlolo ea ho hokahana ha insulin le lisele tsa methapo. Lefu la tsoekere la mofuta oa 2 hangata le ama batho ba kaholimo ho lilemo tse 40. Lisosa tsa lefu lena le tsona ha li utloisisoe ka botlalo, empa batho ba nang le botenya ba kotsing.

Ho sebelisoa liteko tse tharo ho fumana lefu la tsoekere.

1. Glucose e potlakisang
2. Teko ea mamello ea glucose
3. Teko ea hemoglobin ea glycated.

Ho potlakisa glucose ea mali

Ho potlakisa glucose e potlakisang, FPG ke mofuta oa tlhahlobo ea mali e sebelisetsoang ho lekola tsoekere ea mali. Teko e etsoa ka mpeng e se nang letho, mokuli ha aa lokela ho ja lijo le lino (ntle le metsi) bakeng sa lihora tse 8-12 pele thuto e qala. Teko e ka etsoa ka bobeli ka boikemelo, ho sebelisoa marang-rang a liteko tsa tsoekere ea mali kapa metsero ea tlhahlobo ea glucose, le ka laboratoring. Teko ea tsoekere e potlakileng ea mali ke karolo ea tlhahlobo ea mamello ea glucose ea molomo.

Teko ea mamello ea glucose

Teko ea mamello ea glucose, tlhahlobo ea mamello ea glucose, GTT, tlhahlobo ea mamello ea glucose, OGTT - tlhahlobo e entsoeng feela kahare ho sebopeho sa laboratori ea bongaka.

Matsatsing a mararo a pele ho tlhahlobo, mokuli o lokela ho latela lijo tse tloaelehileng ntle le ho inehela ho ja lik'habohaedreite. Ho hlokahala hape ho hana ho sebelisa meriana, ho noa joala, ho ikoetlisa ho eketsehileng.

Nakong ea tlhahlobo, qalong mokuli o lekanya boemo ba tsoekere ea mali e potlakileng, ka mor'a moo a fuoa seno se nang le ligrame tse 75 tsa glucose (ligrama tse 1,75 ka kilogram ea boima ba 'mele ho bana). Kamora mojaro oa tsoekere ea molomo, tsoekere ea mali e lekanngoa metsotso e meng le e meng e 30 (ho etsa kemiso e bapisoang) bakeng sa lihora tse peli. Nako ea thuto e ka fetoloa mme ea fihla ho lihora tse 6 (joalo ka ha u laetsoe ke ngaka).

Tekanyo ea tsoekere ea mali e ka tlase ho lihora tse 7.0 mmol / L lihora tse 2 kamora ho qala tlhahlobo ea mamello ea tsoekere e nkuoa e le ntho e tloaelehileng. Boemong ba ho feta 7,0, empa ka tlase ho 11.0 mmol / l, liphetho tsa liteko li nkuoa e le tlolo ea mamello ea glucose, li supa prediabetes. Ho fumana sephetho ka index ea tsoekere ea mali e fetang 11,0 mmol / L ho hakanngoa hore ke boteng ba lefu la tsoekere.

Tobetsa 'me u arolelane sehlooho le metsoalle ea hau:

Teko ea hemoglobin ea Glycated

Glycated hemoglobin, hemoglobin e glycosylated, glycogemoglobin, hemoglobin A1c, Hb_A1c - letšoao la mali a biochemical le bonts'ang tekanyo ea glucose ea mali ka nako e telele (ho fihlela matsatsi a 90) pele ho tlhahlobo.

Glycated hemoglobin e thehoa ka lebaka la khokahanyo e liehang ea enzymatic ea butle-butle e sa hlahiseng hemoglobin A (Mayar reaction) e fumanehang liseleng tse khubelu tsa mali. Sekhahla sa karabelo ena le palo ea hemoglobin e thehiloeng e itšetleha ka tekanyo ea glucose e ngata maling nakong ea bophelo ba lisele tse khubelu tsa mali (ho fihlela matsatsi a 120, leha ho le joalo, lisele tse khubelu tsa mali tse potoloha maling li na le nako e fapaneng ea bophelo, boleng bo tlase bo nkuoa lipalong).

Ka lebaka la karabelo ea Maillard, ho thehiloe mefuta e 'maloa ea hemoglobin e fapaneng, ho kenyeletsoa Hb_A1c, e atileng ka bongata mme e fana ka mohopolo o nepahetseng haholoanyane oa boteng ba lefu la tsoekere (haeba le teng).

Kahoo, Hb_A1c senola liperesente hemoglobin A maling a ka mokhoa o sa fetoheng e hokahaneng le limolek'hule tsa tsoekere. Ha boemo ba tsoekere bo le maling bo eketseha, "hemoglobin" e phahameng e tla eketseha.

Tafole ea likamano lipakeng tsa glycated hemoglobin (ka%) le glucose e tloaelehileng ea mali (mmol / l).

Glucose ea mali (mmol / l)

Bakeng sa tlhahlobo, boitokisetso bo khethehileng ha bo hlokehe, mali ohle a sebelisetsoa ho hlahlojoa, thuto e etsoa ho sebelisoa li-capillary electrophoresis.

Lintlha

Lintlha le litlhaloso tsa litaba "Ho kopanya liteko tsa tsoekere ea mali ho tla ntlafatsa ho fumanoa hoa lefu la tsoekere."

Georgia State University, Georgia State University, GSU ​​ke univesithi ea lipatlisiso tsa sechaba ea Amerika e fumanehang Atlanta, Georgia, USA. E thehiloe ka 1913, Georgia State University kajeno ke e 'ngoe ea liunivesithi tsa thuto tse nne naheng ea Georgia, tseo ho tloha ka Mots'eanong 2017 li ntseng li ithuta

Baithuti ba 25,000. Univesithi e na le likolo le likolo tse robeli, tseo Sekolo sa Baoki le Basebetsi ba Bongaka le Sekolo sa Bophelo ba Sechaba li amanang ka kotloloho le bongaka. Liithuti tse tsebahalang tsa University of Georgia State ke William Duvall (sebini se etelletseng pele sa Alice ho Chains), sebapali sa lifilimi sa Amerika Julia Roberts, Ken Lewis (molaoli ea ka sehloohong oa Bank of America), lipalo tse ling tsa lipolotiki le tsa sechaba, liroki, batšoantšisi, baatlelete le libini.