Teko ea mali bakeng sa tsoekere (glucose)

Glucose ke monosaccharide e nang le organic e khetholloang ka boleng bo phahameng ba matla. Ke mohloli o ka sehloohong oa matla bakeng sa lintho tsohle tse phelang. Insulin e ikarabella bakeng sa ho monya tsoekere le ho boloka khatello ea eona e le matla. Hormone ena e nkoa e le eona e ithutoang haholo lefatšeng. Tlas'a tšusumetso ea eona, boemo ba tsoekere bo fokotseha. Monosaccharide e kentsoe ka mokhoa oa glycogen.

Teko ea mali bakeng sa tsoekere ke lebitso la ntlo bakeng sa tlhahlobo ea laboratori ea glycemia (glucose ea mali). Boithuto bona boa hlokahala bakeng sa tlhahlobo le taolo ea mathata a metabolism ea carbohydrate, hobane boemo ba glucose haholo bo khetholla boemo bo akaretsang ba motho. Ho kheloha tloaelo ho ea lehlakoreng le lenyane ho bitsoa hypoglycemia, ho ea kholo - hyperglycemia.

Hypoglycemia

Hypoglycemia ke boemo ba methapo e khetholloang ke ho fokotseha ha tsoekere e ka tlase ho 3.5 mmol / L.

Lihlopha tse latelang tse tharo tsa matšoao ke tšobotsi ea hypoglycemia:

1. Adrenergic: ho tšoenyeha, ho ba mabifi, ho tšoenyeha, ho tšaba, ho tsitsipana, ho thothomela, hypertonicity ea mesifa, morusu o hlapollotsoeng, pallor, khatello ea mali.
2. Parasympathetic: tlala, ho nyekeloa, ho hlatsa, ho fufuleloa ho feteletseng, malaise.
3. Neuroglycopenic (ka lebaka la ho bolaoa ke tlala ea methapo ea methapo): ho ferekana kelellong, hlooho e bohloko, ho tsekela, pono e habeli, paresis, aphasia, cramp, ho hloleha ho phefumoloha, ts'ebetso ea pelo le methapo.

Lisosa tse ka sehloohong tsa hypoglycemia ke:

• ho lahleheloa ke metsi ka lebaka la ho hlatsa kapa lets'ollo,
• khaello ea phepo e nepahetseng,
• overdose ea insulin kapa lithethefatsi tse theolelang tsoekere,
• ho ikoetlisa ka ho feteletseng
• mafu a fokolisang
• hypermenorrhea,
• tlhekefetso ea joala
• ho hloleha ha setho se le seng kapa tse ngata
• pancreatic beta cell tumor,
• congenital Fermentopathies e amanang le "glucose metabolism"
• tsamaiso ea methapo ea tharollo ea sodium chloride (NaCl).

Ka hypoglycemia ea nako e telele, puseletso ea nakoana ea carbohydrate metabolism e etsahala. Ka lebaka la glycogenolysis (ho senyeha ha glycogen), boemo ba glycemia boa eketseha.

Ho hlahisa liphetho tsa lipatlisiso ho lokela ho etsoa ke setsebi. Re lokela ho hopola hore haeba melao ea ho fetisa tlhahlobo e sa lateloe, ho ka ba le litholoana tse ntle tsa bohata.

Hypoglycemia hangata e hlaha khahlano le semelo sa liphoso tsa ho ja ho bakuli ba lefu la tsoekere. Sehlopha sena sa bakuli se tlameha ho ba le tekanyetso ea lik'habohaedreite le bona (li-cubes tse 'maloa tsa tsoekere, lero le monate, bara ea chokolete). Teko ea mali bakeng sa tsoekere ea hlokahala ho tsebahatsa hypoglycemia.

Hyperglycemia

Lisosa tse ka sehloohong tsa hyperglycemia:

1. Lefu la tsoekere. Sena ke sesosa sa mantlha sa hyperglycemia e sa foleng. Motheo oa lefu lena ke khaello ea insulin kapa ho hanyetsa lisele.
2. Liphoso lijong. Ka bulimia amanosa, batho ha ba laole boholo ba lijo tse jeoang, ka lebaka leo ba jang bongata ba lik'habohaedreite tse potlakisang lijo.
3. Tšebeliso ea lihlopha tse itseng tsa lithethefatsi. Lithethefatsi tse qholotsa hyperglycemia: lithethefatsi tsa thiazide, lithethefatsi tsa glucocorticoid, nicotinic acid, Pentamidine, li-inhibitors tsa Lase, L-asparaginase, Rituximab, lihlopha tse ling tsa li-antidepressants.
4. Khaello ea Biotin.
5. Maemo a sithabetsang. Tsena li kenyelletsa koluoa ​​ea pelo le methapo ea pelo (stroke, infraction ea myocardial).
6. Mafu a tšoaetsanoang.

Hyperglycemia e tšoauoa ka matšoao a latelang:

• lenyora
• molomo o omileng
• polyuria
• malaise
• ho otsela
• ho theola boima ba 'mele ha o ntse o boloka takatso ea lijo,
• letsoalo
• ho sitisoa ha pono
• ho fokotsa ho itšireletsa mafung,
• phodiso e bohloko ea leqeba
• letlalo la letlalo le boreleli
• tlolo ea kutloelo-bohloko maotong (ka thupelo e telele).

Li-diagnostic tse potlakileng lapeng li loketse batho ba hlokang ho shebeloa tsoekere khafetsa. Bakeng sa tlhahlobo ea tlhahlobo, ho etsoa boithuto ba laboratori.

Hyperlycemia e bonolo (6.7-8.2 mmol / L) ka phomolo e tlang ka nako ha e be kotsi bophelong. Leha ho le joalo, keketseho e sa feleng ea tsoekere e baka mathata a matla a metabolic, e fokotsehile ts'ireletso ea 'mele ea ts'ireletso, le tšenyo ea litho. Mathata a hyperglycemia a ka bolaea. Litlamorao tse mpe ke polyneuropathy, micro and macroangiopathy.

Palo e phahameng ea tsoekere ho basali ba baimana ke sesupo sa lefu la tsoekere. Boemo ba pathological bo eketsa kotsi ea preeclampia, tsoalo pele ho nako, pyelonephritis e mpe, ho senyeheloa ke mpa le mathata a ho beleha. Ho banna ba nang le hyperglycemia e sa foleng, balanoposthitis hangata e bonoa, ho basali - vulvovaginitis.

Matšoao a lefu la tsoekere ha se tšobotsi ea mamello ea tsoekere e sa sebetseng. Empa boemo bo hloka khalemelo ea bongaka.

Hobaneng ha taolo ea glycemia e hlokahala

Teko ea mali bakeng sa tsoekere eu lumella ho lekola boemo ba metabolism ea carbohydrate.

Keketseho ea tsoekere e ka supa maemo a latelang a pathological:

• lefu la tsoekere
• pheochromocytoma,
• thyrotooticosis,
• acromegaly
• Itsenko-Cushing's syndrome,
• hyperparathyroidism ea mantlha,
• zangoloteado,
• glucagonoma
• pancreatic pathology (pancreatitis, mumps e kenyetsang manyeme, cystic fibrosis, hemochromatosis, kankere),
• hepatorenal insuffuff,
• pefo ea autoimmune ho lisele tsa pancreatic beta.

Mabaka a ho fokotsa maemo a tsoekere:

• ho itima lijo nako e telele
• tlolo ea tumello ea lijo tse nang le lik'habohaedreite (lefu la ka mpeng, mala),
• lefu le sa foleng la sebete
• Maloetse a amanang le ho haella ha li-insulin antagonists (hypofunction ea tšoelesa ea qoqotho, grenex ea adrenal le gland ea pituitary),
• hyperinsulinemia (botenya, mofuta o sa rarahanang oa lefu la tsoekere la 2),
• insulinoma
• sarcoidosis
• khaello ea tlhaho ea li-enzyme (lefu la Girke, galactosemia),
• chefo
• mehato ea ho buuoa e amanang le tšilo ea lijo.

Hypoglycemia e bonoa masea a pele ho nako a bo-'mè ba nang le lefu la tsoekere. E boetse e hola ka phepo e sa leka-lekaneng ea lijo tse nang le lik'habohaedreite tse ngata tse bonolo lijong. Sesosa se ka sehloohong sa hyperglycemia ke lefu la tsoekere.

Mokhoa oa ho itokiselletsa tlhahlobo

Ho hlophisoa hantle ha laboratori hoa hlokahala bakeng sa taolo ea glycemic ea laboratori.

Mokhoa oa ho fetisa tlhahlobo:

1. Mali a tšeloa ka mpeng e se nang letho. Bosiu u ka ja feela lijo tse nang le khalori e tlase.
2. Bakeng sa lihora tse 12 ntle le joala, ho tsuba, fokotsa ho ikoetlisa.
3. Ka letsatsi la thuto, u ka noa metsi.
4. Letsatsi le leng pele ho sampole ea mali, lithethefatsi tse amang metabolism ea carbohydrate li hlakotsoe (ntho ena e buisanoe le ngaka).

Liphetho li ka angoa ke ho haella ha boroko, mafu a tšoaetsanoang haholo, maeto a malelele. Tlhahlobo e ke ke ea nkuoa kamora ts'ebetso ea physiotherapeutic, lithuto tsa x-ray, ts'ebetso. Ho hlahloba glycemia, mali a venous kapa a capillary a nkuoa monoaneng.

Tlhahisoleseling ea hore na ho ka khoneha ho lekanya tsoekere lapeng ka glucometer e fumanoa ho ngaka. Li-diagnostic tse potlakileng lapeng li loketse batho ba hlokang ho shebeloa tsoekere khafetsa. Bakeng sa tlhahlobo ea tlhahlobo, ho etsoa boithuto ba laboratori.

Mofuteng oa 1 oa lefu la tsoekere, ho khothalletsoa hore tlhahlobo ea glycemia e kenngoe ente ka mor'a insulin. Mefuteng ka bobeli ea lefu la tsoekere, tsoekere ea mali e hlahlojoa letsatsi le leng le le leng hoseng. Batho ba baholo ba fetang lilemo tse 40 le bakuli ba kotsing (basali ba baimana, batho ba nang le lefutso le lefu la botona) ba eletsoa hore ba lekole glycemia khafetsa.

Ho hlahisa tlhahlobo ea mali bakeng sa tsoekere

Ho khetholla boemo ba tsoekere maling, ho baloa ha data ho li-milimone ka litha e sebelisoa hangata haholo (lebitso - mmol / l). Tabeng ena, ho ka abeloa mefuta e fapaneng ea liteko tsa laboratori:

• Teko ea mali a biochemical bakeng sa boemo ba tsoekere,
• tlhahlobo ea mamello ea tsoekere ea mali ka boikoetliso (liteko tsa ho mamella tsoekere ka mpeng e se nang letho ka boikoetliso),
• Teko ea mamello ea glucose bakeng sa C-peptides,
• glycated hemoglobin
• tshekatsheko ya boemo ba fructosamine,
• tlhahlobo ea boemo ba tsoekere maling maling a basali baimana (tlhahlobo ea mamello ea glucose nakong ea kemolo).

Tekanyo ea tsoekere ea glucose maling a venous le capillary e fapane.

Hypoglycemia hangata e hlaha khahlano le semelo sa liphoso tsa ho ja ho bakuli ba lefu la tsoekere. Sehlopha sena sa bakuli se tlameha ho ba le tekanyetso ea lik'habohaedreite le bona (li-cubes tse 'maloa tsa tsoekere, lero le monate, bara ea chokolete).

Tafole e nang le khaello ea tloaelo ea tlhahlobo ea mali bakeng sa tsoekere

Tlhaloso ka kakaretso

Glucose e le eena motho ea ka sehloohong ea kenyang 'mele oa carbohydrate metabolism ke e' ngoe ea likarolo tsa mantlha tsa mali. Ke ho ba teng ha letšoao lena ka bongata serum ea mali ho tataisoang ho lekola boemo ba metabolism ea carbohydrate. Glucose e fumaneha ka mokhoa o lekanang lipakeng tsa metsoako ea mali le plasma, empa qetellong, e atoloha ho isa tekanyong e itseng. Glucose ea mali e laoloa ke tsamaiso ea methapo ea kutlo (CNS), lihormone tse ling le sebete.

Maemo a mangata a mmele le a mmele a ka baka khatello ea methapo ea tsoekere ea mali, boemo bona bo bitsoa hypoglycemia, 'me keketseho ea eona ke hyperglycemia, e hlahang hangata ho bakuli ba nang le lefu la tsoekere la mellitus (DM). Maemong ana, ho hlahlojoa ha lefu la tsoekere ho thehiloe ka karabo e nepahetseng ho e 'ngoe ea liteko:

• ponahalo ea matšoao a kakaretso a lefu la tsoekere le keketseho e itlhahelang feela ea glucose ea ose 11.1 mmol / l, kapa:
• glucose e potlakileng ea plasma ≥ 7.1 mmol / L, kapa:
• glucose ea boemo ba glucose lihora tse 2 kamora hore a laeloe ka os 75 gramu ea tsoekere ≥ 11.1 mmol / L.

Haeba boithuto ba maemo a tsoekere bo etsoa ho bongata bo nang le lipheo tsa lefu la ho kula kapa ho shebella, joale u ka ipehela ho e ngoe ea matšoao: ebang ke boemo ba glucose bo potlakileng, kapa kamora ho jarolla ka ho le ngoe. Ka moriana o sebetsang, ho netefatsa ts'oaetso ea lefu la tsoekere, hoa hlokahala ho etsa thuto ea bobeli ka le hlahlamang.

Mokhatlo oa Lefatše oa Bophelo o buella hore ho hlahlojoe lero la plasma feela ka lero la mali ("plasma") le fumanoeng ka mali a venous. Maemong ana, lintlha tse latelang tsa tsoekere li nkuoa e le netefatso:

• ho itima lijo ha glucose ea ka tlase ho 6.1 mmol / l ho nkoa e le ntho e tloaelehileng,
• glucose e potlakileng ea plasma ho tloha ho 6,1 mmol / l ho isa ho 7 mmol / l e nkuoa e le mokhoa o potlakileng oa ho itima lijo glycemia,
• lebelo la "glucose" e potlakileng ho feta 7 mmol / L li lekana le tlhahlobo ea lefu la tsoekere pele.

Matšoao a ho khethoa ha tlhahlobo ea mali bakeng sa tsoekere

• lefu la tsoekere la lefu la tsoekere I le II,
• ho lemoha le ho shebella lefu la tsoekere
• lefu la tsoekere
• mamello ea tsoekere e sa sebetseng hantle,
• ho beha leihlo batho ba kotsing ea ho tšoaroa ke lefu la tsoekere la sethoathoa (ho ba motenya, ho feta lilemo tse 45, thaepa lefu la tsoekere ka lapeng),
• ts'oaetso e khethollang ea hypo- le hyperglycemic coma,
• sepsis
• ho thothomela
• lefu la qoqotho
• lefu la litsoelesa tsa adrenal,
• Psychology
• lefu la sebete.

Ho hlahisa sephetho sa tlhahlobo

Keketseho ea tsoekere e ngata:

• lefu la tsoekere ho batho ba baholo le bana,
• physical hyperglycemia: boikoetliso bo leka-lekaneng, khatello ea maikutlo, ho tsuba, ho potlaka ha adrenaline nakong ea ente,
• pheochromocytoma,
• thyrotooticosis,
• acromegaly
• gigantism
• Lefu la Cushing
• pancreatitis e bohloko le e sa foleng
• pancreatitis ka mumps, cystic fibrosis, hemochromatosis,
• makhopho a manyeme,
• mafu a sebete le a liphio,
• hemorrhagic stroke,
• myocardial infarction
• Ho sebelisa litlhare (diuretics, caffeine, lihormone tsa basali tsa thobalano, glucocorticoids),
• likotsi tsa boko le maqeba,
• lefu la sethoathoa
• chefo ea khase ea monoangide.

Ho theoha ha khatello ea tsoekere:

• hyperplasia, adenoma kapa carcinoma ea β-cell ea lihlekehleke tsa Langerhans,
• Langerhans islet
• Lefu la Addison
• adrenogenital syndrome
• hypopituitarism,
• khaello e sa lekanyetsoang ea adrenal cortex,
• ts'ebetso ea qoqotho e fokotsehileng (hypothyroidism),
• masea a tlang pele ho nako
• bana ba tsoaletsoeng ke bo-'mè ba nang le lefu la tsoekere,
• overdose, tsamaiso e sa lokang ea lithethefatsi tsa insulin le molomo
• Tlolo ea molao ea lijo - ho tlola lijo le ho hlatsa kamora ho ja ho bakuli ba nang le lefu la tsoekere.
• maloetse a matla a sebete: cirrhosis, hepatitis ea etiology tse fapaneng, kankere ea mantlha, hemochromatosis,
• Lefu la Girke
• galactosemia,
• mamello e senyehileng ea fructose,
• ho itima lijo nako e telele
• chefo ka joala, arsenic, chloroform, salicylates, antihistamines,
• ho sebelisa meriana (li-anabolic steroid, propranolol, amphetamine),
• ho ikoetlisa ka matla,
• feberu
• malabsorption syndrome,
• ho lahla bothata
• botenya
• mofuta oa 2 lefu la tsoekere,
• meningitis e mpe haholo
• lefu la meningitis,
• meningitis ea cryptococcal,
• encephalitis ka mumps,
• hlahala ea mantlha kapa ea methapo ea mokokotlo,
• meningoencephalitis e seng baktheria,
• menimoencephalitis ea mantlha
• hang-hang hypoglycemia e nang le sarcoidosis.