ʻO Glycated (glycosylated) hemoglobin he ʻāpana o ka hemoglobin holoʻokoʻa i ke koko i hoʻopaʻa ʻia i ka glucose. Hoʻoholo ʻia kēia hōʻailona i ka%. ʻO ka nui o ke kō koko, ʻoi aku ka nui o ka hemoglobin e hoʻonui ʻia i ka glycated. ʻO kēia kahi hōʻike koko nui no ka maʻi diabetes a i ʻole ka maʻi diabetes. Hōʻike pololei loa ia i ka pae kiʻekiʻe o ka glucose i loko o ke koko koko i nā mahina 3 i hala. Hāʻawi iā ʻoe i ka maʻi maʻi i ka manawa a hoʻomaka e mālama ʻia. A i ʻole e hōʻoiaʻiʻo ai i ke kanaka inā ʻaʻohe maʻi o ka maʻi maʻi.
Gogcob hemoglobin (HbA1C) - pono āu e ʻike pono ai:
- Pehea e hoʻomākaukau ai a lawe i kēia hoʻāʻo koko;
- ʻO nā pua o ka hemoglobin glycated - kahi papa ʻaina kūpono;
- ʻO ka hemoglobin glycated i nā wahine hāpai
- He aha ka hana inā hoʻokiʻu ʻia ka hopena;
- ʻO ka maʻi maʻi o ka prediabetes, ʻano 1 a me ke ʻano type type 2;
- Ke nānā nei i ka pono o ka mālama maʻi ʻana.
Heluhelu i ka ʻatikala!
E wehewehe koke mākou e pili ana i nā pae like ʻole o ka HbA1C no nā keiki. Hiki ke hoʻāʻo ʻia kēia haʻawina e hoʻohālikelike i ka maʻi diabetes i nā keiki, a ʻo ka mea nui, e nānā i ka pono o ka mālama ʻana. Hoʻopau pinepine ʻia nā ʻōpiopio maʻi i ko lākou mau manaʻo ma mua o nā hoʻokolohua maʻamau, hoʻomaikaʻi i ko lākou koko koko, a no laila e hoʻonani ai i kā lākou hopena hopena diabetes. Me ka hemoglobin glycated, ʻaʻole kēlā me ia helu helu no lākou. Hōʻike pololei kēia noiʻi inā "i hala" ka hewa "i ka 3 mau mahina i hala a alakaʻi i kahi ʻano" pono ". E nānā pū i ka ʻatikala "Type 1 diabetes i nā keiki a me nā ʻōpio."
Nā inoa ʻē aʻe no kēia hōʻailona:
- hemoglobin glycosylated;
- hemoglobin A1C;
- HbA1C;
- a i ʻole A1C.
ʻO kahi hōʻike koko no ka hemoglobin glycated e kūpono no nā poʻe maʻi a me nā kauka. Loaʻa iā ia ma luna o ka hoʻāʻo ʻana i ka hoʻokaʻa koko koko a ma luna o kahi hōʻike hoʻokaʻahaʻa glucose 2 mau hola. He aha kēia mau pōmaikaʻi:
- Hiki ke lawe ʻia ka nānā ʻana no ka hemoglobin glycated i kēlā me kēia manawa, ʻaʻole pono ma ka ʻōpū ʻole;
- ua ʻoi aku ma mua o ka hoʻāʻo ʻana ke koko no ka hoʻokeʻo ʻaina, hiki iā ʻoe ke ʻike i ka maʻi diabetes ma mua;
- ua wikiwiki a ʻoi aku ka maʻalahi ma mua o kahi hoʻāʻo ae hoʻāno hoʻāno glucose 2-hola;
- hiki iā ʻoe ke pane pololei i ka nīnau inā he maʻi a he maʻi nō paha;
- Kōkua i ka ʻike pehea i mālama pono ai ka mea maʻi i kona koko koko i nā mahina 3 i hala iho nei;
- ʻaʻole ka hopena i ka hemoglobin glycated e nā nuances pōkole e like me ke anuanu a paʻakikī paha ke kūlana.
ʻO ke aʻo maikaʻi: i kou hele ʻana e lawe i nā hoʻāʻo koko - i ka manawa like e nānā i kāu pae o ka hemoglobin HbA1C.
Ua aʻo ʻia kēia loiloi e WHO mai 2009 no ka loaʻa ʻana o ke ʻano maʻi diabetes type 1 a me ke ʻano 2, me ka nānā ʻana no ka ʻike pono o ka mālama ʻana.
He aha ka hopena o kēia kaʻina nānā nei:
- manawa o ka lā e hāʻawi lākou i ke koko;
- e hookeai ana paha a mahope o ka ai ana;
- lawe i nā lāʻau lapaʻau ʻē aʻe ma kahi o nā maʻi maʻi;
- hoʻoikaika kino;
- manaʻo kūlana o ka mea maʻi;
- anu a me na maʻi e ae.
No ke aha he hōʻike koko no ka hemoglobin glycated
ʻO ka mea mua, ke ʻike i ka maʻi diabetes a i ʻole ke loiloi i ka loaʻa ʻana o ka mea i loaʻa i ka maʻi maʻi maʻi. ʻO ka lua, i mea e loiloi ai me ka maʻi maʻamau i ka hoʻomau ʻana o ka mea maʻi i ka maʻi a mālama i ke kōʻai koko ma kahi maʻamau.
No ka noiʻana i ka maʻi maʻi, ua hoʻohana maʻamau kēia hōʻailona ma ke (ma ke kau ʻana o ka World Health Organization) mai 2011, a ua lilo ia i mea kūpono no nā maʻi a me nā kauka.
ʻO nā pua o ka hemoglobin glycated
ʻO ka hopena o ka hōʻike ʻana,% | He ia ka mea |
|---|---|
< 5,7 | Me ka metabolism i ka momona, he maikaʻi ʻoe, ʻaʻole liʻiliʻi ka hopena o ka maʻi diabetes |
5,7-6,0 | ʻAʻohe mea maʻi i ka maʻi maʻi, akā, ua hoʻonui ʻia kona pilikia. ʻO ka wā e hoʻololi wale ai i kahi meaʻai haʻahaʻa haʻahaʻa no ka pale. He mea kūpono hoʻi no ke nīnau ʻana i ke ʻano o ka metabolic syndrome a me ka pale ʻana i ka insulin. |
6,1-6,4 | He kiʻekiʻe ka pākuʻi o ka maʻi diabetes. E hoʻololi i kahi nohona olakino olakino a, inā paha, i kahi ʻano haʻahaʻa o ka ʻai. ʻAʻole e haʻalele. |
≥ 6,5 | Hana ʻia kahi maʻi mua ma mua o ka maʻi mellitus no ka maʻi mellitus. Pono e hana hou i nā hoʻokolohua hou e hōʻoia ai a hōʻole paha. Heluhelu i ka ʻatikala "Diagnosis of type 1 and type 2 diabetes." |
ʻO ka haʻahaʻa o ka pae o ka hemoglobin glycated i ka mea maʻi, ʻoi aku ka maikaʻi o kona maʻi maʻa i ka 3 mahina i hala.
ʻO ka kiko o HbA1C i ka pae kiʻekiʻe o ka glucose i loko o ke koko koko no 3 mau mahina
| HbA1C,% | Hoʻopuka, mmol / L | HbA1C,% | Hoʻopuka, mmol / L |
|---|---|---|---|
| 4 | 3,8 | 8 | 10,2 |
| 4,5 | 4,6 | 8,5 | 11,0 |
| 5 | 5,4 | 9 | 11,8 |
| 5,5 | 6,5 | 9,5 | 12,6 |
| 6 | 7,0 | 10 | 13,4 |
| 6,5 | 7,8 | 10,5 | 14,2 |
| 7 | 8,6 | 11 | 14,9 |
| 7,5 | 9,4 | 11,5 | 15,7 |
ʻO ke ʻano koko no ka hemoglobin glycated: nā pono a me nā hemahema
ʻO kahi hōʻike koko no ka HbA1C, hoʻohālikelike ʻia me ka nānā ʻana o ke kō ʻaʻa ʻai, he nui nā pono o ia:
- ʻAʻole koi ʻia kekahi kanaka i ka ʻōpū ʻole;
- mālama pono ʻia ke koko i loko o kahi hōʻike hoʻāʻo a hiki i kahi loiloi mua (preanalytical stabil);
- Hiki i nā glucose o ka plasma wikiwiki ke hoʻololi nui ʻia ma muli o ke koʻikoʻi a me nā maʻi hopohopo, a paʻa paʻa ka hemoglobin glycated
ʻO kahi hōʻike koko no ka hemoglobin glycated e hiki ai iā ʻoe ke ʻike i ka maʻi maʻi ma kahi mua, i ka wā e hōʻike ana kahi hoʻohālikelike i ke kō.
Loaʻa nā hemahema o kahi hoʻokololi koko glycated.
- ke kumukūʻai kiʻekiʻe i hoʻohālikelike ʻia i kahi hoʻāʻo glucose koko i loko o ka mole (akā akā wikiwiki a maʻalahi!);
- i kekahi mau kānaka, ua hōʻemi ʻia ka pilina ma waena o ka pae o HbA1C a me ka palena haʻahaʻa o ka glucose;
- i nā mea maʻi me nā anemia a me nā hemoglobinopathies, ua loli ke ʻano o nā kaila;
- i kekahi mau wahi o ka ʻāina, hiki i nā mea maʻi ke loaʻa ʻole i kēia hoʻokolohua;
- ua manaʻo ʻia inā inā lawe nā kanaka i nā nui o nā huaora C a i ʻole E, a laila he helu hoʻēmi loa ʻia ka gogemobin glycated (ʻaʻole i hōʻike ʻia!);
- nā haʻahaʻa o nā hormone thyroid hiki i ka hoʻonui ʻana i ka HbA1C, akā ʻaʻole i hoʻonui maoli ke kōpaʻa koko.
Inā hōʻemi ʻoe i ka HbA1C e ka liʻiliʻi loa 1%, pehea e hōʻemi ai ka nui o ka hōʻemi o ka maʻi maʻi maʻi maʻi:
| ʻAno maʻi type 1 | Retinopathy (ʻike ʻike) | 35% ↓ |
| Neuropathy | 30% ↓ | |
| Nāwahopathy | 24-44% ↓ | |
| ʻAno maʻi type 2 | ʻO nā hoʻopiʻi micro-vascular āpau | 35% ↓ |
| ʻO ka make kino e pili ana i ka maʻi maʻi | 25% ↓ | |
| Myocardial infarction | 18% ↓ | |
| ʻO ka make kino | 7% ↓ |
ʻO ka hemoglobin Glycated i ka wā hāpai
ʻO ka Glycated hemoglobin i ka wā hapai kekahi o nā hoʻokolohua he nui no ka pale ʻana i ke kō koko. Akā, eia kahi koho maikaʻi loa. I ka wā hapai, ʻoi aku ka maikaʻi o ka hāʻawi ʻole i ka hemoglobin glycated, akā e nānā i nā kahe koko o ka wahine i nā ala ʻē aʻe. E wehewehe i ke kumu o kēia mea, a e kamaʻilio e pili ana i nā koho pololei aʻe.
He aha ka pōʻino o ka hoʻonuiʻana i ke kō i nā wahine hāpai. ʻO ka mea mua, ʻoi aku ka nui o ka hua hānau o ke pēpē, a ma muli o kēia e loaʻa ka hānau paʻakikī. Hoʻonui ka pilikia o ka makuahine a me ke keiki. ʻAʻole e haʻi i ka hopena pōkole o ka lōʻihi o lāua. Hoʻopili i ke kōpaʻa koko i ka wā hāpai a hoʻopau i nā kīʻaha koko, nā ʻōpū, nā maka, a pēlā aku nā hopena o kēia mea ma hope. ʻO ka hānau ʻana he hapalua ke kaua. Pono e lawa pono ana kona ola e ulu iā ia ...
Hiki i ke kō o ke koko i ka wā hāpai a hiki i nā wahine ʻaʻole hoʻi i hoʻopiʻi i ka olakino ma mua. Aia kekahi mau nuances nui maanei:
- ʻAʻole ma kahi o nā koko kiʻekiʻe i kekahi mau hōʻailona. ʻO ka maʻamau ʻaʻole hopohopo ka wahine i kekahi mea, ʻoiai he nui ia - he nunui ka kaupaʻa ʻana he 4-4.5 kg.
- ʻAʻole ala ke Sugar i kahi ʻōpū ʻole, akā ma hope o ka papaʻaina. Ma hope o ka ʻai ʻana, mālama ʻo ia i luna 1-4 o nā hola. I kēia manawa, hana ʻo ia i kāna hana luku. ʻO ka hoʻolaʻa kālā he mea maʻamau ia. Inā hoʻokiʻekiʻe ke kō ma luna o ka ʻōpū ʻole, a laila hewa loa ke ʻano.
No ke aha i kūpono ʻole ai kahi hōʻike koko no ka hemoglobin glycated? No ka mea, hō'ā i kāna hana. Kūlehu ʻo Glycated hemoglobin ma hope o ke mālama ʻia o ke kō koko i mālama ʻia no nā mahina 2-3 mau mahina. Inā kū ka wahine i ke kō, a laila ʻaʻole maʻamau kēia hana ma mua o ka 6 o ka mahina o ka hānau ʻana. I kēia hihia, hoʻonui ʻia ka hemoglobin glycated i 8-9 mau mahina wale nō, ma mua o ka lawe ʻana. Inā ʻaʻole mālama ka wahine hāpai i kona hilo ma mua, a laila loaʻa nā hopena maikaʻi loa iā ia a me kāna pēpē.
Inā kūpono ʻole ka gogemobly glycated a me ka hoʻāʻo ʻana i ka hoʻokaʻa koko glucose, a laila pehea e nānā ai i ke kō i loko o nā wahine hāpai? Pane: pono pono e nānā ma hope o ka ʻai ʻana i nā lā he 1-2 mau hebedoma. No ka hana i kēia, hiki iā ʻoe ke lawe i kahi hōʻike hoʻokaʻomaʻo hoʻokaʻina o 2 mau manawa i loko o ka hale hana. Akā he hanana lōʻihi a paʻakikī kēia. E maʻalahi ka kūʻai ʻana i kahi mika mika koko koko kūpono a hoʻopaʻa ʻia i ke kō, 30, 60 a me 120 mau minuke ma hope o ka ʻaina. Inā ʻaʻole ʻoi aku ka hopena ma mua o 6.5 mmol / l - maikaʻi loa. I ka pā ana o 6.5-7.9 mmol / l - hoʻomanawanui. Mai 8.0 mmol / l a kiʻekiʻe aʻe - hewa, pono ʻoe e hana i nā hana e hōʻemi ai i ke kō.
Mālama i kahi meaʻai haʻahaʻa-haʻahaʻa kaʻai, akā eʻai i nā hua, kāloti, a me nā beets i kēlā me kēia lā e pale ai i ka ketosis. I ka manawa like, ʻaʻole ʻo ke hapai ke kumu e ʻae ai iā ʻoe iho e overeat me nā pālua a me nā huahana palaoa. No ka ʻike hou aku, e ʻike i nā ʻatikala Pregnant Diabetes and Gestational Diabetes.
ʻO nā pahuhopu maʻi maʻi HbA1C
ʻO ke kauā ʻana no ka maʻi maʻi maʻi e hoʻokō a mālama i ka pae HbA1C o <7%. I kēia hihia, ua manaʻo ʻia ka maʻi diabetes, heʻuʻuku ka hopena. ʻOiaʻiʻo, ʻoi aku ka maikaʻi inā ke ʻohe ʻia ka glycated hemoglobin i loko o ka maʻamau maʻamau no ka poʻe olakino, i.e., HbA1C <6.5%. Eia nō naʻe, manaʻoʻiʻo ʻo Dr. Bernstein me ka hemoglobin glycated o 6,5%, ua uku ʻia ka maʻi diabetes, a hoʻomohala koke kona mau ʻōuli. I ke olakino olakino, nā poʻe anuanu me ka metabolism, ʻo ka hemoglobin glycated maʻamau pinepine ka 4.2–4.6%. Ua kūpono kēia i ka pae kiʻekiʻe glucose glucose o 4-4.8 mmol / L. ʻO kēia ka pahuhopu e pono ai mākou e hakakā i ka mālama ʻana i ka maʻi maʻi maʻi, a ʻo kēia ʻaʻole hiki ke paʻakikī i ka hoʻokō inā huli ʻoe i kahi meaʻai haʻahaʻa-mea haʻahaʻa no ke ʻano type type like type 2 paha.
ʻO ka pilikia ʻoi aku ka maikaʻi o ka maʻi o ka mea maʻi maʻa, ʻoi aku ka kiʻekiʻe o ka hypoglycemia wikiwiki a me ka comog hypoglycemic coma. Ke hoʻāʻo nei e kaohi i kona maʻi diabetes, pono ka mea maʻi e mālama i kahi kaulike ma waena o ka pono e mālama i ke kōpaʻa koko haʻahaʻa a me ka hoʻoweliweli o ka hypoglycemia. He kiʻi paʻakikī kēia e aʻo ai i kahi maʻi hānai a me nā hana i ka wā o kona ola. Akā inā ʻoe e hele i kahi meaʻai momona a me ka olakino haʻahaʻa haʻahaʻa, a laila e maʻalahi ka ola. No ka mea ʻaʻole ka liʻiliʻi o nā mea kālaiʻai a ʻai ʻoe, ʻo ka mea pono ʻoe e pono ai i ka insulin a me nā mea hoʻohiolo haʻahaʻa. A me ka liʻiliʻi o ka insulin, ka haʻahaʻa o ka hopena o ka hypoglycemia. Maikaʻi a me ka maikaʻi.
No nā poʻe kahiko me ka manaʻolana i ke ola i haʻahaʻa ʻia ma lalo o 5 mau makahiki, e nānā ʻia ka nui o ka hemoglobin glycated ma kahi 7,5%, 8% a i ʻole ke kiʻekiʻe aʻe. I kēia pūʻulu o nā mea maʻi, ʻoi aku ka paʻakikī o ka hypoglycemia i ka hopena o ka hoʻomohala ʻana i nā hopena hoʻopiʻi o ka maʻi maʻi. Ma ka manawa like, nā keiki, nā ʻōpio, nā wahine hāpai, ka poʻe o nā makahiki ʻōpio - ua paipai ʻia a hoʻāʻo a mālama i ko lākou waiwai HbA1C <6.5%, a ʻoi aku paha, ma lalo o 5%, e like me ka aʻo ʻana mai o Dr. Bernstein.
Algorithm no ke koho pilikino i nā pahuhopu mālama maʻi maʻi i nā huaʻōlelo o HbA1C
| ʻIterlelo Ola | Makau | ||
|---|---|---|---|
| ʻōpio | awelika | makua a / pe ola paha i ka ola * <5 mau makahiki | |
| ʻAʻole ka'ōlelo koʻikoʻi a i ʻole ka hopena o ka hypoglycemia koʻikoʻi | < 6,5% | < 7,0% | < 7,5% |
| ʻO nā hoʻopiʻi koʻikoʻi a i ʻole ulia o ka hypoglycemia koʻikoʻi | < 7,0% | < 7,5% | < 8,0% |
* Loaʻa ke ola - ola ka manaʻo.
ʻO ka pae ʻai glucose plasma e kū nei a me 2 mau hola ma hope o ka pāʻina (postprandial) e pili ana i kēia mau waiwai hemoglobin glycated:
| HbA1C,% | Hoʻopau ʻaʻa plasma glucose / ma mua o ka ʻai, mmol / l | Plasma glucose 2 mau hola ma hope o kahi pāʻina, mmol / l |
|---|---|---|
| < 6,5 | < 6,5 | < 8,0 |
| < 7,0 | < 7,0 | < 9,0 |
| < 7,5 | < 7,5 | <10,0 |
| < 8,0 | < 8,0 | <11,0 |
ʻO nā haʻawina lōʻihi ma ka 1990s a me 2000 ka hōʻoia i hōʻoia i kahi hōʻike koko no ka hemoglobin glycated e hiki ai ke wānana i ka hopena o ka ulu ʻana o nā hoʻopiʻi maʻi diabetes a ʻaʻole hoʻi he maikaʻi a ʻoi aku ka maikaʻi o ka glucose glucose.
Ehia mau e lawe ai i ke ʻano koko no ka hemoglobin glycosylated:
- Inā he hemoglobin HbA1C kou haʻahaʻa ma lalo o 5.7%, ʻo ia ka mea, ʻaʻohe maʻi ahakanaka a hewa ʻole kona hopena, no laila e pono ʻoe e kaohi i kēia kuhikuhi i hoʻokahi manawa i kēlā me kēia ʻekolu makahiki.
- ʻO kou pae hemoglobin glycosylated ma waena o 5.7% - 6,4% - lawe hou iā ia i kēlā me kēia makahiki no ka mea he piʻi nui ka maʻi o ka maʻi diabetes. ʻO ka manawa āu e hoʻololi ai i kahi meaʻai haʻahaʻa haʻahaʻa e pale ai i ka maʻi maʻi.
- Loaʻa iā ʻoe kou maʻi diabetes, akā hoʻokele pono ʻoe, i.e. ʻAʻole iʻoi aku ka HbA1C i ka 7%, - i kēia kūlana, ke aʻo nei nā kauka e hana i kahi reanalysis i kēlā me kēia mau mahina.
- Inā hoʻomaka ʻoe e mālama i kou maʻi maʻi a hoʻololi i kāu hoʻoponopono o ke ʻano lāʻau lapaʻau, a inā ʻaʻole hiki ʻole ʻoe i ke kaomi maikaʻi i ka honu koko, a laila pono ʻoe e nānā pono iā HbA1C i kēlā me kēia ʻekolu mahina.
Manaʻo mākou e lawe i nā mea maʻi i kahi hōʻike koko no ka hemoglobin glycosylated a me nā hoʻokolohua āpau a me ke ʻano āpau - ʻaʻole i nā hui lehulehu, akā i nā laboratory pilikino. He makemake ia i nā pūnaehana "ʻoihana", ʻo ia hoʻi, i loko o nā nui lehulehu a i ʻole nā limahana hana honua. No ka mea aia he hanana nui ʻē aʻe e hana ʻia ka loiloi iā ʻoe, ma mua o ka kākau ʻana i ka hopena "mai ka lihi".
