HYPOGLYCEMIA

Hypoglycemiandiye chinthu chachikulu chomwe chimalepheretsa kasamalidwe ka glycemic wa matenda a shuga 1.Hypoglycemia imagawidwa m'magulu atatu:
• Mulingo woyamba umagwirizana ndi kuchuluka kwa shuga pansi pa 3.9 mmol/L (70 mg/dL) ndi wamkulu kuposa kapena wofanana ndi 3.0 mmol/L (54 mg/dL) ndipo amatchulidwa ngati chenjezo.
• Level 2 ndi yaglucose wamagaziMlingo wochepera 3.0 mmol/L (54 mg/dL) ndi wofunikira kwambiri ku hypoglycemia.
• Level 3 imasonyeza hypoglycemia iliyonse yodziwika ndi kusintha kwa maganizo ndi / kapena thupi lomwe likufunika kuthandizidwa ndi munthu wina kuti achire.
Ngakhale izi zidapangidwa poyambirira kuti zipereke malipoti azachipatala, ndizopanga zamankhwala zothandiza.Kusamala kwambiri kuyenera kuchitidwa kuti mupewe mulingo wa 2 ndi 3 wa hypoglycemia.
Level 1 hypoglycemia ndiyofala, ndipo anthu ambiri omwe ali ndi matenda a shuga 1 amakhala ndi magawo angapo pa sabata.Hypoglycemia yokhala ndi shuga pansi pa 3.0 mmol/L (54 mg/dL) imachitika nthawi zambiri kuposa momwe amayamikirira kale.Level 3 hypoglycemia ndiyocheperako koma idachitika mwa 12% mwa akulu akulu omwe ali ndi matenda a shuga 1 m'miyezi 6 pakuwunika kwaposachedwa kwapadziko lonse lapansi.Kafukufuku wambiri wawonetsa kuti chiwopsezo cha hypoglycemia sichinachepe, ngakhale kugwiritsa ntchito ma insulin analogues ndi CGM kufalikira, pomwe maphunziro ena awonetsa kupindula ndi kupita patsogolo kwamankhwala uku.

Zowopsa za hypoglycemia, makamaka mlingo wa 3 hypoglycemia, umaphatikizapo nthawi yayitali ya matenda a shuga, ukalamba, mbiri yaposachedwapa ya 3 hypoglycemia, kumwa mowa, masewera olimbitsa thupi, maphunziro otsika, ndalama zochepa zapakhomo, matenda a impso, ndi IAH.Matenda a Endocrine, monga hypothyroidism, kuchepa kwa adrenal ndi kukula kwa hormone, ndi matenda a celiac angayambitse hypoglycemia.Zolemba zakale za matenda a shuga zalembedwa mosalekeza kuti anthu omwe ali ndi milingo yotsika ya HbA 1c anali ndi milingo ya 2-3 ya hypoglycemia.Komabe, mu Type 1Matenda a shugaExchange Clinic Registry, chiwopsezo cha hypoglycemia mulingo 3 chinawonjezeka osati mwa omwe HbA 1c anali pansi pa 7.0% (53 mmol / mol), komanso mwa anthu omwe ali ndi HbA 1c pamwamba pa 7.5% (58 mmol / mol).
Ndizotheka kuti kusowa kwa ubale pakati pa HbA 1c ndi level 3 hypoglycemia m'malo enieni akufotokozedwa ndi kupumula kwa milingo ya glycemic ndi omwe ali ndi mbiri ya hypoglycemia, kapena zosokoneza, monga kulephera kudziwongolera komwe kumathandizira onse awiri.hyper- ndi hypoglycemia.Kusanthula kwachiwiri kwa kuyesa kwa IN CONTROL, komwe kusanthula koyamba kunawonetsa kuchepa kwa 3 hypoglycemia mwa anthu omwe amagwiritsa ntchito CGM, kunawonetsa kuwonjezeka kwa mlingo wa 3 hypoglycemia ndi kuchepa kwa HbA 1c, mofanana ndi zomwe zinanenedwa mu DCCT.Izi zikutanthauza kuti kutsika kwa HbA 1c kumatha kubwerabe ndi chiopsezo chachikulu cha Level 3 hypoglycemia.
Imfa kuchokerahypoglycemiamu mtundu 1 shuga si wang'ono.Kafukufuku wina waposachedwa adawonetsa kuti anthu opitilira 8% omwe amafa kwa ochepera zaka 56 anali chifukwa cha hypoglycemia.Njira ya izi ndizovuta, kuphatikizapo mtima wa arrhythmias, kutsegula kwa dongosolo la coagulation ndi kutupa, ndi endothelial dysfunction.Zomwe sizingadziwike bwino ndikuti 3 hypoglycemia imalumikizidwanso ndi zochitika zazikulu za microvascular, noncardiovascular disease, ndi imfa kuchokera pazifukwa zilizonse, ngakhale zambiri za umboniwu zimachokera kwa anthu omwe ali ndi matenda a shuga a 2.Pankhani yachidziwitso, mu kafukufuku wa DCCT ndi EDIC, pambuyo pa zaka 18 zotsatiridwa, hypoglycemia yayikulu mwa akulu azaka zapakati sikuwoneka kuti ikukhudza ntchito ya neu-rocognitive.Komabe, mopanda ziwopsezo zina ndi zovuta zina, magawo ambiri a hypoglycemia yayikulu adalumikizidwa ndi kuchepa kwakukulu kwa psychomotor ndi magwiridwe antchito amisala omwe adadziwika kwambiri pambuyo pa zaka 32 zotsatiridwa.Zikuwoneka kuti okalamba omwe ali ndi matenda a shuga 1 amakonda kulephera kuzindikira pang'ono komwe kumayenderana ndi hypoglycemia, pomwe hypoglycemia imachitika pafupipafupi mwa omwe ali ndi vuto la kuzindikira.Zambiri za CGM sizinalipo mu nthawi ya DCCT ndipo chifukwa chake kuchuluka kwa hypoglycemia yayikulu pakapita nthawi sikudziwika.
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