ʻO ka pae pae hana a me ka kūlana o ke olakino o ke kanaka e hilinaʻi nei i ka hemoglobin i ke koko a me ka hana o kāna mau hana. Me ka hoʻonohonoho lōʻihi o ka hemoglobin me ka glucose, ua hana ʻia kahi pūpū koi, kapa ʻia ʻo glycated hemoglobin, ʻo ke ʻano o ka mea pono e kū ʻole i nā ʻōkuhi i hoʻonohonoho ʻia.
Mahalo i ka hoʻokolohua no ka hemoglobin glycated, hiki ke ʻike i ke kāʻei o ka honu i loko o ke kōʻai koko, no ka mea, ʻo nā sela koko ʻōmaʻomaʻo kahi hale mālama hale no ka hemoglobin. E ola ana lākou ma kahi o 112 lā. I kēia manawa, noiʻi ka ʻae e loaʻa iā ʻoe ka ʻike pololei e hōʻike ana i ke ʻano o ka glucose.
ʻO Glycated hemoglobin ka mea i kapa ʻia ʻo glycosylated. Wahi a kēia mau kuhikuhi, hiki iā ʻoe ke hoʻonohonoho i nā kumukūʻai kōpaʻa awelika no 90 lā.
He aha ka ʻike a no ke aha e pono ai?
Hana ʻia ka glycated hemoglobin a i ʻole A1C ma ke ʻano o ke koko ma ka hapa pakeneka. I kēia mau lā, lawe pinepine ʻia kēia noiʻi, no ka mea he nui nā pono.
Me ia, me kāna kōkua ke ʻike ʻole i ka ʻike ʻole i ke kaupaona o ke kō i loko o ke koko, akā ʻike pū kekahi i ka maʻi diabetes ma ka pae mua o ka ulu ʻana. Eia kekahi, hiki ke hoʻopaʻa ʻia ka loiloi HbA1 i kēlā me kēia manawa, me ka mālama ʻole o ka meaʻai.
Hāʻawi ʻo ia ka ʻike ʻana i nā hopena kūpono ʻole, me ke ʻano o ke ʻano maʻamau o kekahi kanaka. No laila, ʻaʻole like me ka hoʻokaʻawale koko, a ʻo kahi hōʻike no ka hemoglobin glycosylated e hāʻawi i kahi pane hilinaʻi a ma hope o ke kāʻei ʻana, ʻeha ʻole, a i ʻole kahi anu.
He mea kūpono ia e pono ke hoʻokō ʻia nā noiʻi ʻaʻole wale me ka maʻi maʻi. I kēlā me kēia manawa, pono ke nānā pono ʻia ka pae o ka hemoglobin glycated no nā poʻe olakino a me nā mea i makemake i ka piha a me ka hypertension, no ka mea, ʻo mua kēia mau maʻi i ka maʻi maʻi.
Kahi ʻia ka loiloi ʻōnaehana ma ia mau hihia:
- sedentary lifestyle;
- makahiki mai 45 mau makahiki (e pono e lawe ʻia ka nānā ʻana 1 mau manawa i ʻekolu mau makahiki);
- ka heleʻana o nā hana o ka glucose;
- predisposition i diabetes;
- ʻōhua wana polycystic;
- maʻi maʻi maʻi gestational;
- wahine i hānai i kahi pēpē ke kaupaona ʻia ma mua o 4 kg;
- nā maʻi maʻi (1 manawa i ka hapalua makahiki).
Ma mua o ka kau ʻana i ka hōʻike HbA1C, pono nā ʻano maʻamau o nā mea e hiki ke ʻike ʻia i kahi papa kūikawā, pono ke kaʻina hana hoʻomākaukau kūikawā.
Eia kekahi, hiki ke hoʻopaʻa ʻia ka loiloi i kēlā me kēia manawa kūpono no ka mea maʻi, me ka manaʻo o kona kūlana olakino a me ke ola o ka lā ma mua.
ʻO ke kumu o ka hemoglobin glycosylated i nā kāne
No ka hoʻokau i ka ʻikepili hemoglobin i loko o ke koko, pono ka mea maʻi e hoʻopaʻa i kahi loiloi kūikawā i ka pūnaehana. He mea kūpono ia i ka ʻike ma ke kanaka olakino maʻi, ʻo ka heluhelu ʻana mai ka 120 a i 1500 g no ka 1 pālolo o ka wai o ka maʻi maʻamau he maʻamau.
Eia nō naʻe, hiki i kēia mau mana hoʻohiki ke hoʻomau ʻia a i ʻole ka nui i ka wā e loaʻa ai i kekahi kanaka nā maʻi o nā kino o loko. No laila, i nā wahine, ke nānā ʻia kahi nui o ka protein i ka wā o ke kāne.
A ʻo ke ʻano o ka hemoglobin glycated i kāne he mai ka 135 g no ka lita. He mea kūpono ia e ʻōlelo ʻia ana nā ʻelele o ka wahine ikaika i nā hōʻailona ma mua o nā wahine. No laila, ma lalo o ka makahiki o 30 mau makahiki, ʻo ka papaʻu he 4.5-5.5% 2, a hiki i 50 mau makahiki - a hiki i 6,5%, ʻoi aku ma mua o 50 mau makahiki - 7%.
Pono nā kāne e lawe i ka hoʻoliʻu koko koko, ʻoi aku ma hope o nā makahiki he kanahā. Ma hope o nā mea a pau, pinepine i kēia manawa ua loaʻa ka momona nui, ʻo ia kahi o ka mea mua i ka maʻi diabetes. No laila, ʻike koke ʻia ka maʻi koke, e nui aʻe ka hoʻomaikaʻi ʻana i kāna mālama ʻana.
He kūʻokoʻa, pono ke haʻi e pili ana i ka carboxyhemoglobin. ʻO kēia kekahi protein ʻē aʻe i kahi o ka kemika o ka hoʻopili o ke koko, ka hui pū ʻana o ka hemoglobin a me ka carbon monoxide. Pono e kuhikuhi pū ʻia kona mau ʻōmaʻomaʻo, inā 'aʻole, e hele ka pololi oxygen, hōʻike ʻia e nā hōʻailona hōʻalili o ke kino.
Inā kiʻekiʻe loa nā kumuhana o ka hemoglobin glycated, a laila e hōʻike ana i kēia i ke ʻano o kekahi ʻano patolo. No laila, ke hoʻololiʻole nei i ka kaohi o ke kaila o ke koko i loko o ke kanaka e hōʻike ana i ka loaʻa ʻana o kahi maʻi latent e koi koke i ka maʻi a me ka mālama.
Ma muli o nā hopena o ka hōʻike ʻoi aku ka kiʻekiʻe ma mua o ka maʻamau, hiki i ka etiology o ke ʻano ke ʻano:
- diabetes mellitus;
- pōpilikia ʻana;
- nā maʻi maʻi;
- nā hana pulthary;
- ka nui o ka waiora B i ke kino;
- maʻi hōʻeha a me ke aloha holo ʻole;
- wela e wela;
- pohō nui o ke koko;
- hemoglobinemia.
Inā hoʻemi ʻia ka hemoglobin glycosylated, a laila paʻa nā kumu o kēia ʻano i ka anemia iron deficit progressive e kūʻē ana i ka hoʻomaka ʻana o ka pōloli o ka oxygen. Hoʻopilikia kēia maʻi no ke kino, e like me ka mea i hōʻike ʻia e nā hōʻailona o ka hoʻohālikelike, ka malaise a me ka make i ke ola ʻole.
Aia paha he mau kumu no ka haʻahaʻa o nā haʻahaʻa haʻahaʻa ma ke koko. Hoʻopili kēia ma ka hypoglycemia, nā maʻi e hoʻoheheʻe i ka huhū, ka hānau ʻana, ka nele o ka vitamin B12 a me ka folic acid. Pēlā nō hoʻi ka pae haʻahaʻa o ka hemoglobin glycated i mālama ʻia i nā maʻi lēʻeha, ka hoʻokahe ʻana o ke koko, nā hoʻoilina a me nā maʻi autoimmune, nā ʻōpio, i ka wā o ka lactation a me ka hihia o nā ʻōnaehana o ka ʻōnaehana.
ʻO ka hōʻailona nui o ka loiloi HbA1C i loko o ka maʻi mellitus
ʻOiaiʻo ia he mea like ʻole ka hoʻoliʻiliʻi o ka hoʻoliʻi ʻana o ke koko mai ka maʻamau ma ke ʻano liʻiliʻi. No laila, me ka maʻi maʻamau o ka maʻi 2, ka mea, i ka poʻe maʻi nā maʻi, ma ka hihia o ka insulin insulin i ka wā e hoʻohaʻahaʻa ana i nā kiko glucose i nā helu maʻamau (6.5-7 mmol / l), aia kahi hopena o ka hoʻomohalaʻana i ka hypoglycemia.
Hoʻopilikia maikaʻi loa kēia kūlana no nā maʻi maʻi. ʻO ia ke kumu i pāpā ʻia ai e hoʻohaʻahaʻa i ka pae o ka glycemia i nā pae maʻamau o kahi kanaka olakino.
Ma ke ʻano 2 diabetes mellitus, ua nānā ʻia ke ʻano o ke ʻano o ka hemoglobin glycosylated e pili ana i ka makahiki, ka hele ʻana o nā hoʻopiʻi a me ka hopena o ka hypoglycemia.
ʻO ka maʻamau maʻamau ka ʻike maʻamau ʻo ka maʻi maʻi maʻa 2 a i ʻole he ʻelemakule paha. No nā poʻeʻelemakule, ʻo ke kumu maʻamau me ka ʻole o ka hoʻopiʻi ʻana o ka maʻi i ka 7.5% ma ke kaʻe o ka glucose o 9.4 mmol / L, a inā he mau pilikia / 8% a 10.2 mmol / L. No nā mea maʻi ma waena, ʻo 7% a me 8.6 mmol / L, me ka 47.5% a me 9.4 mmol / L e manaʻo ʻia he mea maʻamau.
E ʻike i ke ʻano diabetes mellitus type 2, ke ʻano pinepine nei kahi hōʻike glycated hemoglobin. Ma hope o nā mea a pau, aʻo ia ka noiʻi ʻana e hiki ai iā ʻoe ke ʻike i ka maʻi i ka wā mua a hoʻoweliweli i ka kūlana o ka prediabetes. ʻOiai e loaʻa ana me ka prediabetes i ke koina o ke kō koko koko i loko o ka pae maʻamau.
Hōʻike ka hōʻike ʻo HbA1C i ka hoʻohaʻahaʻa i ka glucose, ma ke kipi ʻana kahi a ke kino i hoʻokaʻawale i ka insulin, a ʻo ka hapa nui o ka glucose i waiho ʻia i loko o ke kahawai a ʻaʻole i hoʻohana ʻia e nā cell. Eia kekahi, ʻo ka maʻi maʻamau e hiki ai i ka mālama ʻana i ka maʻi maʻi me ke kōkua o ke ʻano kino a me ka mālama ʻana i ka lāʻau me ka ʻole e lawe i nā lāʻau lapaʻau haʻahaʻa.
Nui nā kāne e ʻeha nei i ka maʻi diabetes no ka makahiki hoʻokahi a me ke ana ʻana i ka nui o ka glycemia me kahi glucometer e noʻonoʻo nei no ke kumu e pono ai lākou e hoʻāʻo no ka hemoglobin lepo. ʻO ka pinepine, noho maikaʻi nā hōʻailona ma kahi lōʻihi, kahi e noʻonoʻo ai i kahi kanaka i uku ʻia ka maʻi diabetes.
No laila, hiki i ka hoʻomohala kūlohelohe hiki i ke kūlike no ka maʻamau (6.5-7 mmol / l), a ma hope o ka ʻaina ʻaina e hoʻonui lākou i 8.5-9 mmol / l, kahi mea e hōʻike ana i kahi maʻa. ʻO kēlā ʻano hanu o kēlā me kēia lā e hoʻoholo ai i ka maʻamau o ka neʻe o ka hemoglobin glycated. Loaʻa paha nā hopena o ka hōʻike ʻana i nā maʻi maʻi e hoʻololi i ka nui o nā lāʻau lapaʻau hoʻohaʻa ʻana i ke kō a i ʻole insulin.
Eia nō naʻe, ua manaʻo kekahi o nā mea maʻi me ka maʻi diabetes type 2 he lawa ka lawa o ka lawe ʻana iā 2-3 e ana i ka ʻelua o nā palima kōʻai o ka mahina i hoʻokahi mahina. Eia kekahi, ʻaʻole hoʻohana kekahi mau maʻi hānai i kahi glucometer.
ʻOiai ka hana maʻamau o ka hemoglobin glycosylated e pale i ka hoʻomohala ʻana o nā hoʻopiʻi.
Nā kūlana loiloi
Pehea e lawe ai i ka hemoglobin glycated - ma kahi ʻōpū ʻole a i ʻole? I ka ʻoiaʻiʻo, ʻaʻole kūpono ia. Hiki ke lawe ʻia ka loiloi ʻaʻole ma kahi ʻōpū ʻole.
Hoʻololi ʻia ka hoʻokolohua hemoglobin glycated e hana ʻia ma kahi o nā manawa 4 i ka makahiki, a ʻoi aku ka maikaʻi ma ka ʻoihana like ʻole. Eia nō naʻe, me ka hoʻokaʻawale iki ʻana i ke koko, e hoʻokō ai i ka hoʻoneʻe ʻana a i ʻole ka hāʻawi kālā, pono e hoʻopiʻi ʻia ka noiʻi.
Pono ke kauka e kau i kahi referral no ka nānā ʻana, inā aia nā kumu maikaʻi. Akā hiki i nā lawelawe diagnostic e hiki ke hoʻohana i ka mālama i nā pae hemoglobin.
Ma ke kānāwai, e ʻike ʻia nā hopena i nā lā 3-4. Kālua ʻia ke koko no ka nānā ʻana mai he vein.
ʻO ke ala e maʻalahi a maʻalahi hoʻi no ka ana ʻana i ka ʻai hemoglobin i loko o ke koko ka hoʻohana ʻana o kahi glucometer. Hiki ke hoʻohana kūʻokoʻa i kēia polokalamu, kahi e hiki ai iā ʻoe ke nānā i ke kiʻekiʻe o ka glyceobemia pinepine e loaʻa i ke kiʻi kūpono loa.
He mea kūpono ia he pono ʻole e hoʻomākaukau kūikawā no ka hoʻoili ʻana. He ʻeha a wikiwiki ke kaʻina hana. Hiki ke hāʻawi i ke koko ma kekahi keʻena, akā inā he mau lāʻau lapaʻau. A ke hoʻomau nei ka wikiō ma kēia ʻatikala i ke kumuhana o ka pono no ka hoʻāʻo ʻana no ka hemoglobin glycated.
