Kuaj ntshav rau piam thaj (piam thaj)

Cov kua nplaum yog cov organic monosaccharide uas tus cwj pwm los ntawm lub zog loj. Nws yog cov khoom tseem ceeb ntawm lub zog rau txhua yam tsiaj muaj sia. Cov tshuaj Insulin yog lub luag haujlwm rau qhov nqus ntawm cov piam thaj thiab tswj nws cov concentration. Qhov tshuaj hormones no suav hais tias yog kev kawm tshaj plaws hauv ntiaj teb. Hauv nws cov cawv, cov piam thaj qib yuav tsawg zuj zus. Monosaccharide tau muab tso rau hauv daim ntawv ntawm glycogen.

Kev kuaj ntshav rau cov piam thaj yog lub npe tsev neeg rau kev kuaj ntsuas ntawm glycemia (ntshav qab zib). Txoj kev tshawb no yog qhov tsim nyog rau kev kuaj mob thiab kev tswj hwm kev tsis txaus siab ntawm cov metabolism hauv cov metabolism, txij li cov ntshav qabzib feem ntau txiav txim siab qhov xwm txheej ntawm ib tug neeg. Kev tsis sib txawv ntawm cov cai mus rau sab me dua yog hu ua hypoglycemia, rau ntau dua - hyperglycemia.

Kev ntshav siab

Hypoglycemia yog ib txoj kev mob tshwm sim los ntawm kev txo cov piam thaj hauv qab 3.5 mmol / L.

Hauv qab no peb pawg ntawm cov tsos mob yog tus yam ntxwv ntawm cov ntshav qog ntshav qab zib:

1. Adrenergic: kev ntxhov siab, txhoj puab heev, kev ntxhov siab, qhov kev paub txog kev ntshai, arrhythmia, tshee tshee, mob nqaij hypertonicity, dilated cov menyuam kawm ntawv, pallor, kub siab.
2. Parasympathetic: kev tshaib kev nqhis, xeev siab, ntuav, tawm hws ntau dhau, malaise.
3. Neuroglycopenic (vim yog tshaib plab ntawm lub hauv nruab nrab lub paj hlwb): tsis meej pem, mob taub hau, kiv taub hau, ob lub zeem muag, paresis, mob plab, cramps, ua tsis taus pa, kev ua kom lub plawv dhia, nco qab.

Cov laj thawj tseem ceeb ua rau muaj ntshav txhau yog:

• kua dej tawm vim ntuav lossis raws plab,
• zaub mov tsis zoo,
• kev siv tshuaj ntau dhau ntawm cov tshuaj insulin lossis cov ntshav qab zib,
• kev tawm dag zog ntau dhau
• debilitating kab mob
• hypermenorrhea,
• haus cawv
• ib lossis ntau yam hauv lub cev tsis ua haujlwm,
• tus mob cancer cell pancreatic
• ua rau lub siab tawv ua rau muaj cov metabolism hauv qabzib,
• Kev tso dej tshuaj ntawm cov tshuaj sodium chloride (NaCl).

Nrog lub qog ntshav ntshav lub sijhawm ntev, lub sijhawm luv luv raug mob ntawm cov metabolism ua cov metabolism. Ua tsaug rau glycogenolysis (glycogen tawg), qib ntawm glycemia nce.

Kev txiav txim siab ntawm cov txiaj ntsig ntawm txoj kev kawm yuav tsum tau nqa tawm los ntawm tus kws tshwj xeeb. Nws kuj tseem yuav tsum tau yug hauv siab tias yog cov cai rau kev soj ntsuam tsis pom, ib qho txiaj ntsig tsis zoo yog qhov ua tau.

Kev mob ntshav qab zib feem ntau pib tawm tsam keeb kwm ntawm kev noj zaub mov tsis raug rau cov neeg mob ntshav qab zib. Pawg neeg mob no yuav tsum muaj koob tshuaj carbohydrates nrog lawv (ob peb lub suab thaj, kua txiv qab zib, chocolate chocolate). Kev kuaj ntshav rau qab zib yog xav tau los kuaj ntshav qab zib ntshav qab zib.

Qog Ntshav

Cov ua tseem ceeb ntawm hyperglycemia:

1. Mob ntshav qab zib mellitus. Qhov no yog qhov tseem ceeb etiological ntawm tus mob hyperglycemia. Lub hauv paus ntawm tus kab mob no yog insulin tsis txaus lossis daim tawv tsis kam ua haujlwm.
2. Cov uas tsis nyob ntawm cov zaub mov. Nrog rau bulimia nervosa, tib neeg tsis tswj tus nqi ntawm cov zaub mov noj, qhov txiaj ntsig ntawm qhov uas lawv haus cov khoom noj sai ntawm cov zaub mov carbohydrates.
3. Kev siv qee pawg tshuaj. Cov tshuaj uas ua rau mob hyperglycemia: thiazide diuretics, glucocorticoid tshuaj, nicotinic acid, Pentamidine, protease inhibitors, L-asparaginase, Rituximab, qee pab pawg ntawm cov tshuaj tiv thaiv kab mob.
4. Biotin tsis muaj peev xwm.
5. Txoj kev ntxhov siab. Cov no suav nrog cov kev mob plawv mob ntshav sai (mob stroke, myocardial infarction).
6. Kis tau cov kab mob.

Hyperglycemia yog tus cwj pwm los ntawm cov tsos mob hauv qab no:

• kev nqhis dej
• qhov ncauj qhuav
• polyuria
• malaise
• tsaug zog
• ntse poob phaus thaum tswj qhov qab los noj mov,
• kev tshee
• pom kev pom
• txo kev tiv thaiv,
• qhov txhab kho qhov txhab tsis zoo
• khaus tawv
• ua txhaum ntawm kev xav zoo nyob rau hauv cov nqua (nrog ntev chav kawm).

Kev kuaj mob hauv tsev sai yog qhov tsim nyog rau cov neeg uas xav tau soj ntsuam tas li ntawm cov piam thaj. Txog kev tshuaj ntsuam, kev sim kuaj sim ntsuas.

Me hyperglycemia (6.7-8,2 mmol / L) nrog kev pab kho kom raws sij hawm tsis ua rau muaj kev phom sij. Txawm li cas los xij, kev mob siab ntxiv, ntev zuj zus nyob rau hauv cov piam thaj ua rau lub cev qhov hnyav tsis txaus, ua rau lub cev tsis muaj zog tiv thaiv kab mob, thiab lub cev puas. Teeb meem ntawm hyperglycemia tuaj yeem ua rau neeg tuag taus. Cov kev rau mob hnyav yog mob polyneuropathy, micro thiab macroangiopathy.

Cov piam thaj ntau hauv cov poj niam cev xeeb tub yog qhov cim ntawm ntshav qab zib mob tsis tsaug zog. Mob pathological ua rau muaj kev pheej hmoo ntawm preeclampsia, yug ntxov ntxov, mob pyelonephritis, nchuav menyuam thiab muaj teeb meem thaum yug los. Hauv cov txiv neej nrog mob hyperglycemia, mob pob txha caj qaum feem ntau pom, hauv cov poj niam - vulvovaginitis.

Cov tsos mob ntawm tus mob ntshav qab zib tsis yog yam ntxwv ua rau muaj kev ua kom lub siab tsis zoo. Tab sis cov zwj ceeb yuav tsum kho kom raug.

Vim li cas kev tswj hwm glycemia xav tau

Kev kuaj ntshav rau cov piam thaj tso cai rau koj soj ntsuam lub xeev ntawm cov metabolism hauv cov metabolism.

Kev nce ntxiv nyob rau hauv qabzib yuav qhia tias cov kab mob hauv qab no:

• mob ntshav qab zib mellitus
• pheochromocytoma,
• thyrotoxicosis,
• acromegaly
• Itsenko-Cushing's syndrome,
• thawj hyperparathyroidism,
• somatostinoma,
• glucagonoma
• pancreatic pathology (mob pancreatitis, tus mob qog uas ua rau hlab ntsha, mob cystic fibrosis, hemochromatosis, mob cancer),
• hepatorenal tsis txaus,
• autoimmune kev ntxhov siab rau pancreatic beta hlwb.

Cov laj thawj rau kev txo cov ntshav qabzib:

• lub caij nyoog yoo mov
• ua txhaum ntawm assimilation ntawm cov khoom noj carbohydrate (pathology ntawm lub plab, hnyuv),
• kab mob siab
• cov kab mob cuam tshuam nrog kev tsis txaus ntawm insulin antagonists (hypofunction ntawm lub qog gland, adrenal cortex thiab pituitary caj pas),
• ua haujlwm hyperinsulinemia (rog dhau, hom tsis yooj yim 2 mob ntshav qab zib mellitus),
• tshuaj insulinoma
• mob sarcoidosis
• yug los ua tsis muaj cov enzymes (Tus kab mob Girke, galactosemia),
• lom
• kev phais mob rau ntawm txoj hnyuv.

Kev soj ntsuam ntshav qabzib yog pom nyob rau ntawm cov menyuam mos ntawm cov niam uas muaj ntshav qab zib ua ntej. Nws kuj tseem niaj hnub nthuav dav nrog kev noj zaub tsis muaj lub cev sib xyaw nrog kev nplua nuj ntawm cov carbohydrates yooj yim hauv cov zaub mov noj. Lub hauv paus tseem ceeb ntawm hyperglycemia yog ntshav qab zib.

Yuav npaj li cas rau kev tsom xam

Kev kuaj kom zoo yog qhov xav tau rau kev kuaj ntshav glycemic.

Yuav ua li cas kom dhau qhov kev txheeb xyuas:

1. Luag muab cov ntshav ntawm lub plab tas. Hmo ua ntej koj tuaj yeem noj cov zaub mov muaj protein tsawg thiab muaj calorie tsawg.
2. Rau 12 teev tsis suav nrog haus cawv, haus luam yeeb, txwv kev tawm dag zog.
3. Hnub ntawm kev kawm, koj tuaj yeem haus dej.
4. Ib hnub ua ntej kuaj ntshav, cov tshuaj uas cuam tshuam rau cov metabolism hauv carbohydrate yuav raug muab tso tseg (cov khoom no tau tham nrog tus kws kho mob).

Qhov tshwm sim yuav cuam tshuam los ntawm kev pw tsis tsaug zog, mob sib kis tau yooj yim, mus ncig ua si ntev. Kev tsom xam tsis tuaj yeem coj tom qab cov txheej txheem kho lub cev, kev tshawb nrhiav xoo hluav taws xob, kev ua haujlwm. Txhawm rau kuaj glycemia, venous lossis capillary ntshav tau los ntawm tus ntiv tes.

Cov ntaub ntawv ntawm seb nws puas tuaj yeem ntsuas cov suab thaj hauv tsev nrog glucometer tau los ntawm kws kho mob. Kev kuaj mob hauv tsev sai yog qhov tsim nyog rau cov neeg uas xav tau soj ntsuam tas li ntawm cov piam thaj. Txog kev tshuaj ntsuam, kev sim kuaj sim ntsuas.

Hauv hom 1 ntshav qab zib, nws raug nquahu kom kuaj glycemia ua ntej txhua txoj kev txhaj tshuaj insulin. Hauv ob hom ntshav qab zib, cov ntshav qab zib tau soj ntsuam txhua hnub thaum sawv ntxov. Cov neeg laus muaj hnub nyoog tshaj 40 xyoo thiab cov neeg mob uas muaj kev pheej hmoo (poj niam cev tsis tab seeb, cov neeg muaj keeb kwm caj ces thiab rog rog) tau qhia kom ua tib zoo saib xyuas glycemia

Kev txiav txim siab kuaj ntshav rau qab zib

Txhawm rau txiav txim siab txog qib ntawm cov piam thaj hauv cov ntshav, qhov kev suav ntawm cov ntaub ntawv hauv millimoles ib liter yog feem ntau siv (kev tsim qauv - mmol / l). Hauv qhov no, ntau hom kev kuaj sim tuaj yeem muab tau:

• Kev kuaj ntshav biochemical rau cov piam thaj,
• kuaj ntshav tso ntshav qab zib nrog kev tawm dag zog (kuaj ntshav qabzib nyob ntawm lub plab khoob nrog kev tawm dag zog),
• kuaj ntshav qabzib rau C-peptides,
• tsom xam hemoglobin,
• tsom xam rau qib fructosamine,
• tshawb xyuas txog theem ntawm cov piam thaj hauv cov ntshav ntawm cov poj niam cev xeeb tub (kuaj ntshav qab zib nyob hauv plab thaum cev xeeb tub).

Qhov ntsuas ntawm cov piam thaj hauv cov ntshav txhaws thiab cov hlab ntsha yog qhov sib txawv.

Kev mob ntshav qab zib feem ntau pib tawm tsam keeb kwm ntawm kev noj zaub mov tsis raug rau cov neeg mob ntshav qab zib. Pawg neeg mob no yuav tsum muaj koob tshuaj carbohydrates nrog lawv (ob peb lub suab thaj, kua txiv qab zib, chocolate chocolate).

Ib lub rooj nrog ib qho kev rhuav tshem ntawm cov cai ntawm ntshav kuaj ntshav qab zib

Kev piav qhia dav dav

Cov kua nplaum ua tus neeg tseem ceeb koom nrog cov metabolism hauv cov kev ua kom lub cev yog ib qho ntawm cov roj ntsha tseem ceeb hauv cov ntshav. Nws yog qhov muaj tseeb ntau ntau qhov muaj ntawm qhov cim no hauv ntshav cov ntshav uas tau ua hauv kev txheeb xyuas lub xeev ntawm cov metabolism hauv carbohydrate. Cov piam thaj muaj kwv yees li ntawm cov sib npaug ntawm cov ntshav thiab ntshav, tab sis tom kawg, nws los ntau rau qee yam. Cov ntshav qab zib yog tswj los ntawm lub hauv nruab nrab lub paj hlwb (CNS), qee cov tshuaj hormones, thiab lub siab.

Ntau lub pathological thiab physiological ntawm lub cev tuaj yeem ua rau muaj kev nyuaj siab ntawm cov ntshav qabzib hauv cov ntshav, tus mob no hu ua hypoglycemia, thiab nws qhov nce yog hyperglycemia, uas tshwm sim feem ntau hauv cov neeg mob ntshav qab zib mellitus (DM). Hauv qhov no, kev kuaj mob ntshav qab zib mellitus tau tsim nrog cov lus teb zoo rau ib qho ntawm cov kev ntsuam xyuas:

• kev tshwm sim ntawm kev saib xyuas cov tsos mob ntshav qab zib feem ntau ntxiv rau kev nce ntshav hauv ntshav khov ≥ 11.1 mmol / l, lossis:
• kev yoo plasma ntshav khov ose 7.1 mmol / L, lossis:
• ntshav qabzib theem 2 teev tom qab thauj ib tus os 75 grams qabzib ≥ 11.1 mmol / L.

Yog tias qhov kev kawm txog qib qabzib yog nqa tawm hauv cov pejxeem uas muaj kabmob sib kis lossis soj ntsuam lub hom phiaj, tom qab ntawd koj tuaj yeem txwv koj tus kheej rau ib ntawm cov ntsuas: txawm tias qib ntawm cov piam thaj, lossis tom qab kev thauj khoom ib os. Hauv kev siv tshuaj, kom paub meej tias kuaj mob ntshav qab zib, nws yog ib qho tsim nyog yuav tau tshawb fawb thib ob rau hnub tom qab.

Lub Koom Haum Kev Noj Qab Haus Huv Hauv Ntiaj Teb pom zoo rau kev kuaj ntshav ntshav qab zib tsuas yog ntshav tau los ntawm kev yoo cov ntshav txha caj qaum. Hauv qhov no, cov ntsiab lus qab zib hauv qab no yog suav tias yog cov pov thawj:

• yoo plasma ntshav piam thaj ntau dua 6.1 mmol / l suav hais tias ib txwm muaj,
• kev yoo plasma ntshav qab zib los ntawm 6.1 mmol / l txog 7 mmol / l suav hais tias yog qhov tsis haum sai glycemia,
• yoo plasma cov ntshav qabzib nyob rau ntau tshaj 7 mmol / L yog sib npaug rau kev ntsuas ua ntej ntshav qab zib.

Kev taw qhia txog kev teem ntshav kuaj ntshav qab zib

• ntshav qab zib mellitus hom I thiab II,
• kuaj thiab saib xyuas ntshav qab zib
• mob ntshav qab zib
• tsis hnov ​​lus qabzib zoo,
• soj ntsuam cov tib neeg muaj feem yuav muaj ntshav qab zib mellitus (rog, muaj hnub nyoog 45 xyoos, hom I mob ntshav qab zib hauv tsev neeg),
• qhov txawv txav ntawm hypo- thiab hyperglycemic coma,
• sepsis
• poob siab
• cov mob qog
• pathology ntawm cov qog adrenal,
• pituitary pathology,
• daim siab mob.

Kev txiav txim siab ntawm qhov kev ntsuam xyuas tshwm sim

Muaj qabzib ntau ntxiv:

• mob ntshav qab zib rau cov neeg laus thiab menyuam yaus,
• physiological hyperglycemia: qoj ib ce, kev nyuaj siab ntxhov plawv, haus luam yeeb, adrenaline nrawm thaum txhaj tshuaj,
• pheochromocytoma,
• thyrotoxicosis,
• acromegaly
• gigantism
• Cushing's syndrome
• Mob leeg thiab mob ntsws laus,
• mob caj pas nrog mob qog, cystic fibrosis, hemochromatosis,
• pancreatic hlav,
• mob siab thiab mob raum,
• hemorrhagic mob stroke,
• myocardial infarction
• noj tshuaj noj (diuretics, caffeine, poj niam txiv neej pw ua ke, glucocorticoids),
• mob hlwb thiab qog,
• qaug dab peg
• Cov pa carbon monoxide lom.

Txo cov piam thaj hauv siab:

• hyperplasia, adenoma lossis carcinoma ntawm β-hlwb ntawm islets ntawm Langerhans,
• Langerhans islet cell-lub cev tsis muaj zog,
• Addison's disease
• adrenogenital syndrome
• Kev Ua Siab Ncaj
• mob ntev tsis txaus ntawm adrenal cortex,
• lub qog ua haujlwm (hypothyroidism),
• ua ntej yug menyuam
• cov menyuam yug los ntawm leej niam muaj ntshav qab zib,
• kev siv ntau dhau, kev tswj hwm tsis ncaj ncees ntawm cov tshuaj insulin thiab cov tshuaj hypoglycemic,
• ua txhaum ntawm kev noj haus - hla zaub mov noj, nrog rau ntuav tom qab noj hauv cov neeg mob ntshav qab zib,
• mob siab rau daim siab ntau: kab mob siab, kab mob siab ntawm ntau yam kev mob siab, thawj mob cancer, hemochromatosis,
• Girke tus kab mob
• galactosemia,
• tsis hnov ​​qab fructose kam rau ua,
• lub caij nyoog yoo mov
• lom nrog cawv, arsenic, chloroform, salicylates, antihistamines,
• noj tshuaj noj (anabolic steroids, propranolol, amphetamine),
• siv dag zog lub cev,
• npaws
• malabsorption syndrome,
• pob tseg mob syndrome
• rog dhau
• yam 2 mob ntshav qab zib,
• mob rau cov leeg mob hauv hlwb,
• tuberculous meningitis,
• cryptococcal mob rau daim npluag qhwv,
• mob caj pas mob qog,
• lub taub loj lossis metastatic hlav ntawm lub pia mater,
• tsis mob-cov kab mob meningoencephalitis,
• thawj amoebic meningoencephalitis,
• tshwm sim ntog ntshav qab zib nrog sarcoidosis.