I-HYPOGLYCEMIA

I-Hypoglycemiayeyona nto iphambili yokunciphisa i-glycemic yohlobo lwe-1 yeswekile.I-Hypoglycemia ihlelwa ngamanqanaba amathathu:
• Inqanaba le-1 lihambelana nexabiso le-glucose elingaphantsi kwe-3.9 mmol / L (70 mg / dL) kwaye lingaphezulu okanye lilingana ne-3.0 mmol / L (54 mg / dL) kwaye libizwa ngokuba lixabiso lokulumkisa.
• Inqanaba lesi-2 leleiswekile yegaziixabiso elingaphantsi kwe-3.0 mmol / L (54 mg / dL) kwaye ithathwa njengeyona nto ibalulekileyo ekliniki ye-hypoglycemia.
• Inqanaba lesi-3 lichaza nayiphi na i-hypoglycemia ebonakaliswe yimeko yengqondo etshintshileyo kunye / okanye isimo somzimba esifuna ukungenelela komntu wesithathu ukuze alulame.
Nangona ezi zaphuhliswa ekuqaleni ukuze kunikwe ingxelo yolingo lwezonyango, ziluncedo kulwakhiwo lweklinikhi.Ingqwalasela ekhethekileyo kufuneka yenziwe ukukhusela inqanaba le-2 kunye ne-3 ye-hypoglycemia.
Inqanaba loku-1 le-hypoglycemia lixhaphakile, kwaye uninzi lwabantu abanesifo sikashukela sohlobo loku-1 bafumana iziqendu ezininzi ngeveki.I-Hypoglycemia enamanqanaba eglucose angaphantsi kwe-3.0 mmol/L (54 mg/dL) yenzeka kaninzi kunokuba bekuxatyiswa ngaphambili.Inqanaba le-3 ye-hypoglycemia ayiqhelekanga kodwa yenzeke kwi-12% yabantu abadala abanesifo sikashukela sohlobo lwe-1 kwixesha leenyanga ze-6 kuhlalutyo lwakutsha nje lwehlabathi.Izifundo ezininzi zibonise ukuba amazinga e-hypoglycemia awazange ehle, nangona ukusetyenziswa okubanzi kwe-insulin analogs kunye ne-CGM, ngelixa ezinye izifundo zibonise inzuzo ngale nkqubela phambili yonyango.

Imingcipheko ye-hypoglycemia, ngakumbi inqanaba le-3 ye-hypoglycemia, ibandakanya ixesha elide lesifo sikashukela, ubudala, imbali yenqanaba le-3 ye-hypoglycemia yamva nje, ukusela utywala, ukuzivocavoca, amanqanaba emfundo ephantsi, imivuzo ephantsi yekhaya, isifo sezintso ezingapheliyo, kunye ne-IAH.Iimeko ze-Endocrine, ezifana ne-hypothyroidism, i-adrenal kunye nokusilela kwehomoni yokukhula, kunye nesifo se-celiac kunokunyusa i-hypoglycemia.Ugcino-lwazi oludala lweswekile lubhalwe ngokungaguquguqukiyo ukuba abantu abanamanqanaba asezantsi e-HbA 1c babenezinga eliphezulu le-2-3 lenqanaba le-3 ye-hypoglycemia.Nangona kunjalo, kudidi loku-1Isifo seswekileIRegistry yeKliniki yokuTshintsha, umngcipheko wenqanaba le-3 hypoglycemia awunyuswanga kuphela kwabo bane-HbA 1c ingaphantsi kwe-7.0% (53 mmol / mol), kodwa nakubantu abane-HbA 1c ngaphezulu kwe-7.5% (58 mmol / mol) .
Kunokwenzeka ukuba ukungabikho kobudlelwane phakathi kwe-HbA 1c kunye nenqanaba le-3 ye-hypoglycemia kwimimiselo yehlabathi yokwenyani kuchazwa ngokuphumla kweethagethi ze-glycemic ngabo banembali ye-hypoglycemia, okanye i-confounders, njengokuziphatha okungonelanga kokuzilawula okufaka isandla kuzo zombini.hyper- kunye ne-hypoglycemia.Uhlalutyo lwesibini lwelingo lwe-IN CONTROL, apho uhlalutyo oluphambili lubonise ukunciphisa kwinqanaba le-3 ye-hypoglycemia kubantu abasebenzisa i-CGM, babonise ukunyuka kwezinga le-3 ye-hypoglycemia kunye ne-HbA 1c ephantsi, efana neyokuxelwa kwi-DCCT.Oku kuthetha ukuba ukwehlisa i-HbA 1c kusenokubangela umngcipheko wenqanaba lesi-3 le-hypoglycemia.
Ukufa ukusukai-hypoglycemiakuhlobo loku-1 lwesifo seswekile asinto ingenamsebenzi.Olunye ulingo lwakutsha nje luphawule ukuba ngaphezulu kwe-8% yokusweleka kwabo bangaphantsi kweminyaka engama-56 basuka kwi-hypoglycemia.Inkqubo yale nto iyinkimbinkimbi, kubandakanywa i-arrhythmias ye-cardiac, ukusebenza kwenkqubo yokudibanisa kunye nokuvuvukala, kunye nokungasebenzi kakuhle kwe-endothelial.Yintoni enokuthi ingaqatshelwa kakuhle kukuba inqanaba le-3 ye-hypoglycemia iphinda idibaniswe neziganeko ezinkulu ze-microvascular, isifo se-noncardiovascular, kunye nokufa kuyo nayiphi na isizathu, nangona ubuninzi bobu bungqina bufumaneka kubantu abanesifo sikashukela sohlobo lwe-2.Ngokumalunga nomsebenzi wokuqonda, kwi-DCCT kunye ne-EDIC isifundo, emva kweminyaka eyi-18 yokulandelelana, i-hypoglycemia enzima kubantu abadala abaneminyaka ephakathi ayizange ibonakale ichaphazela umsebenzi we-neu-rocognitive.Nangona kunjalo, ngokuzimeleyo kwezinye izinto ezinobungozi kunye ne-comorbidities, iziqendu ezininzi ze-hypoglycemia enzima zidibene nokunciphisa okukhulu kwi-psychomotor kunye nokusebenza kwengqondo okuphawulekayo emva kweminyaka eyi-32 yokulandelwa.Kubonakala ngathi abantu abadala abanesifo sikashukela sohlobo loku-1 basengozini enkulu yokuphazamiseka kwengqondo ehambelana ne-hypoglycemia, ngelixa i-hypoglycemia isenzeka rhoqo kwabo banokukhubazeka kwengqondo.Idatha ye-CGM yayingafumaneki kwixesha le-DCCT kwaye ngoko ubungakanani bokwenene be-hypoglycemia enzima ngokuhamba kwesikhathi ayaziwa.
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