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HYPOGLYCEMIA

HYPOGLYCEMIA

Hypoglycemiandicho chinhu chikuru chinodzikamisa glycemic management yemhando 1 chirwere cheshuga.Hypoglycemia inokamurwa muzvikamu zvitatu:
• Level 1 inoenderana nehuwandu hweglucose huri pasi pe 3.9 mmol/L (70 mg/dL) uye yakakura kudarika kana kuenzana ne3.0 mmol/L (54 mg/dL) uye yakadomwa sechiratidzo chechenjedzo.
• Level 2 ndeyeglucose yeropakukosha kuri pasi pe3.0 mmol/L (54 mg/dL) uye inoonekwa seyakakosha hypoglycemia.
• Nhamba ye3 inoratidzira chero hypoglycemia inoratidzirwa nekuchinjwa kwehutano hwepfungwa uye / kana chimiro chemuviri chinoda kupindira kwevatatu kuti vadzoke.
Kunyangwe izvi zvakatanga kugadzirirwa kuongororwa kwekiriniki yekuzivisa, zvinobatsira kiriniki inovaka.Kunyanya kutarisisa kunofanira kuitwa kudzivirira level 2 uye 3 hypoglycemia.
Level 1 hypoglycemia yakajairika, uye vanhu vazhinji vane chirwere cheshuga 1 vane zvikamu zvakawanda pavhiki.Hypoglycemia ine mazinga eglucose ari pasi pe3.0 mmol/L (54 mg/dL) inoitika kakawanda kupfuura yaimbofarirwa.Level 3 hypoglycemia haina kunyanya kuwanda asi yakaitika mu12% yevanhu vakuru vane chirwere cheshuga 1 mukati memwedzi mitanhatu munguva pfupi yapfuura yekuongorora pasi rose.Ongororo dzinoverengeka dzakaratidza kuti mazinga e hypoglycemia haana kuderera, kunyangwe nekupararira kwakapararira kushandiswa kwe insulin analogs uye CGM, nepo zvimwe zvidzidzo zvakaratidza kubatsirwa nekufambira mberi kwekurapa uku.

https://www.sejoy.com/blood-glucose-monitoring-system/

Njodzi dze hypoglycemia, kunyanya nhanho 3 hypoglycemia, inosanganisira kureba kwenguva yechirwere cheshuga, kuchembera, nhoroondo yechangobva kuitika nhanho 3 hypoglycemia, kunwa doro, kurovedza muviri, yakaderera dzidzo, mari yakaderera yemhuri, chirwere cheitsvo chisingaperi, uye IAH.Endocrine mamiriro, akadai se hypothyroidism, adrenal uye kukura kwehomoni kushomeka, uye chirwere chechiliac chinogona kukonzera hypoglycemia.Databhesi dzekare dzechirwere cheshuga dzakagara dzichinyorwa kuti vanhu vane yakaderera HbA 1c mazinga vaive ne2-3-yakapetwa mazinga epamusoro 3 hypoglycemia.Nekudaro, mune Type 1Chirwere cheshugaExchange Clinic Registry, njodzi yezinga 3 hypoglycemia yakawedzerwa kwete chete kune avo vane HbA 1c yaiva pasi pe7.0% (53 mmol / mol), asiwo muvanhu vane HbA 1c pamusoro pe7.5% (58 mmol / mol).
Zvinogoneka kuti kusavapo kwehukama pakati peHbA 1c uye nhanho 3 hypoglycemia mumamiriro ezvinhu epasirese inotsanangurwa nekuzorora kwezvinangwa zveglycemic nevaya vane nhoroondo ye hypoglycemia, kana confounders, senge kusakwana kwekuzvibata kwekuzvibata kunobatsira kune ese ari maviri.hyper- uye hypoglycemia.Kuongororwa kwechipiri kwe IN CONTROL muedzo, apo kuongorora kwekutanga kwakaratidza kuderedzwa kwezinga 3 hypoglycemia kune vanhu vanoshandisa CGM, yakaratidza kuwedzera kwehuwandu hwehuwandu hwehutachiona hweH 3 neHbA 1c yakaderera, yakafanana neyakashumwa muDCCT.Izvi zvinoreva kuti kudzikisa HbA 1c kunogona kuramba kuchiuya nengozi yepamusoro yezinga 3 hypoglycemia.
Kufa kubvahypoglycemiamurudzi rwekutanga chirwere cheshuga hachisi chinhu chidiki.Imwe ongororo ichangoburwa yakacherekedza vanopfuura 8% yevakafa kune avo vari pasi pemakore makumi mashanu nematanhatu vaive kubva kuhypoglycemia.Iyo nzira yeizvi yakaoma, kusanganisira cardiac arrhythmias, activation yezvose zviri zviviri coagulation system uye kuzvimba, uye endothelial dysfunction.Izvo zvingave zvisinganyatsozivikanwi ndezvokuti nhanho 3 hypoglycemia inobatanidzawo nezviitiko zvikuru zve microvascular, noncardiovascular disease, uye rufu kubva kune chero chikonzero, kunyange zvazvo huzhinji hwehupupu huno hunowanikwa kubva kuvanhu vane chirwere cheshuga chechipiri.Nezvehutano hwekuziva, muDCCT uye EDIC yekudzidza, mushure memakore gumi nemasere ekutevera, hypoglycemia yakaoma pakati pevakuru vepakati haina kuonekwa inokanganisa neuro-rocognitive basa.Zvisinei, yakasununguka kune dzimwe njodzi dzinokonzera uye kuwirirana, zvikamu zvakawanda zve hypoglycemia zvakanyanya zvakabatanidzwa nekuderera kukuru mu psychomotor uye kushanda kwepfungwa izvo zvakanyanyozivikanwa mushure memakore 32 ekutevera.Zvinoita sekuti vanhu vakura vane Type 1 chirwere cheshuga vanowanzotarirwa nekusagadzikana kwekuziva kwakabatana ne hypoglycemia, nepo hypoglycemia inowanzoitika kune avo vane kusaziva.CGM data yakanga isipo munguva yeDCCT uye saka chiyero chechokwadi che hypoglycemia chakakomba nekufamba kwenguva hachizivikanwi.
1. Lane W, Bailey TS, Gerety G, et al.;Ruzivo rweBoka;SHANDURA 1. Mhedzisiro ye insulin degludecvs insulin glargine u100 pane hypoglycemia kune varwere vane chirwere cheshuga 1: the SWITCH 1 randomizedclinicaltrial.JAMA2017;318:33-44
2. Bergenstal RM, Garg S, Weinzimer SA, et al.Kuchengeteka kweiyo yakasanganiswa yakavharwa-loop insulin yekuendesa system mune varwere vane Type 1 chirwere cheshuga.JAMA 2016;316:1407–1408
3. Brown SA, Kovatchev BP, Raghinaru D, et al.;iDCL Muedzo Research Group.Mwedzi mitanhatu randomized, multicenter muedzo wekuvhara-loop control mumhando ye 1 chirwere cheshuga.N Engl J Med 2019;381:
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Nguva yekutumira: Jul-08-2022