HYPOGLYCEMIA

Hypoglycemiawaa qodobka ugu weyn ee xaddidaya maareynta glycemic ee nooca 1aad ee sonkorowga.Hypoglycemia waxaa loo kala saaraa saddex heer:
• Heerka 1 wuxuu u dhigmaa qiimaha gulukooska ee ka hooseeya 3.9 mmol/L (70 mg/dL) oo ka weyn ama la mid ah 3.0 mmol/L (54 mg/dL) waxaana lagu magacaabaa qiime digniin ah.
Heerka 2 ayaa loogu talagalaygulukoosta dhiiggaqiyamka ka hooseeya 3.0 mmol/L (54 mg/dL) waxaana loo arkaa hypoglycemia oo muhiim ah.
Heerka 3 wuxuu tilmaamayaa hypoglycemia kasta oo lagu garto isbedel maskaxeed iyo/ama xaalad jireed oo u baahan faragelinta cid saddexaad si ay u soo kabsato.
Inkasta oo kuwan markii hore loo sameeyay ka warbixinta tijaabooyinka bukaan-socodka, haddana waa dhismayaal caafimaad oo faa'iido leh.Feejignaan gaar ah waa in la sameeyaa si looga hortago heerka 2 iyo 3 hypoglycemia.
Heerka 1 hypoglycemia waa wax caadi ah, iyadoo badi dadka qaba nooca 1 ee sonkorowga ay la kulmaan dhowr dhacdo todobaadkii.Hypoglycemia oo leh heerarka gulukooska ee ka hooseeya 3.0 mmol/L (54 mg/dL) waxay dhacdaa in ka badan intii hore loo qadarin jiray.Heerka 3 hypoglycemia waa mid aad u yar laakiin wuxuu ku dhacay 12% dadka qaangaarka ah ee qaba nooca 1aad ee sonkorowga muddo 6 bilood ah baaritaan caalami ah oo dhowaan la sameeyay.Daraasado dhowr ah ayaa muujiyay in heerarka hypoglycemia aysan hoos u dhicin, xitaa iyadoo si ballaaran loo isticmaalo analogs insulin iyo CGM, halka daraasado kale ay muujiyeen faa'iido u leh horumarkan daaweynta.

Khatarta hypoglycemia, gaar ahaan heerka 3 hypoglycemia, waxaa ka mid ah muddada dheer ee sonkorowga, da'da weyn, taariikhda heerka ugu dambeeyay ee 3 hypoglycemia, cabbitaanka khamriga, jimicsiga, heerarka waxbarashada hoose, dakhliga qoyska hoose, cudurka kelyaha ee joogtada ah, iyo IAH.Xaaladaha Endocrine, sida hypothyroidism, adrenal iyo yaraanta hoormoonka koritaanka, iyo cudurka baruurta ayaa laga yaabaa inay soo daadiso hypoglycemia.Xog-ururintii hore ee sonkorowga waxay si joogto ah u diiwaangelisay in dadka leh heerarka HbA 1c hoose ay 2-3 laab ka sarreeyaan heerka 3 hypoglycemia.Si kastaba ha ahaatee, in nooca 1SonkorowgaDiiwaanka Rugta Isweydaarsiga, halista heerka 3 hypoglycemia ayaa kordhay kaliya maaha kuwa HbA 1c ka hooseeyo 7.0% (53 mmol/mol), laakiin sidoo kale dadka qaba HbA 1c ee ka sarreeya 7.5% (58 mmol/mol) .
Waxaa suurtogal ah in maqnaanshaha xiriirka ka dhexeeya HbA 1c iyo heerka 3 hypoglycemia ee goobaha dhabta ah lagu sharraxay nasashada bartilmaameedyada glycemic ee kuwa leh taariikhda hypoglycemia, ama jahwareerka, sida dabeecadaha is-maamul ee aan ku filneyn oo gacan ka geysta labadaba.hyper- iyo hypogly-cemia.Falanqaynta labaad ee tijaabada IN CONTROL, halkaas oo falanqaynta asaasiga ahi ay muujisay hoos u dhaca heerka 3 hypoglycemia ee dadka isticmaalaya CGM, waxay muujisay korodhka heerka 3 hypoglycemia oo leh HbA 1c hoose, oo la mid ah waxa lagu soo sheegay DCCT.Tani waxay tusinaysaa in hoos u dhigista HbA 1c ay wali la iman karto khatar sare oo ah heerka 3 hypoglycemia.
Dhimashada kahypoglycemianooca 1-aad ee sonkorowga ma aha wax fudud.Hal tijaabo oo dhowaan la sameeyay ayaa lagu sheegay in ka badan 8% dhimashada kuwa ka yar 56 sano ay ka timid hypoglycemia.Habka tani waa mid adag, oo ay ku jiraan arrhythmias wadnaha, firfircoonida labadaba habka xinjirowga iyo bararka, iyo cillad la'aanta endothelial.Waxa laga yaabo in aan si fiican loo aqoonsan waa in heerka 3 hypoglycemia uu sidoo kale la xiriiro dhacdooyinka waaweyn ee microvascular, cudurada aan wadnaha iyo xididada ahayn, iyo dhimasho sabab kasta, inkastoo inta badan caddayntan laga helay dadka qaba nooca 2 ee sonkorowga.Marka la eego shaqada garashada, daraasadda DCCT iyo EDIC, ka dib 18 sano oo dabagal ah, hypoglycemia daran ee dadka qaangaarka ah ee da'da dhexe uma muuqan inay saameynayaan shaqada neu-rocognitive.Si kastaba ha ahaatee, ka madax banaan arrimaha kale ee khatarta ah iyo isku-darka, qaybo badan oo hypoglycemia daran ayaa lala xiriiriyay hoos u dhac weyn oo ku yimaada cilmi-nafsiga iyo waxtarka maskaxeed ee ugu caansan ka dib 32 sano oo dabagal ah.Waxay u muuqataa in dadka qaangaarka ah ee qaba nooca 1-aad ee sonkorowga ay aad ugu nugul yihiin cillad maskaxeed oo khafiif ah oo la xiriirta hypoglycemia, halka hypoglycemia ay si joogto ah ugu dhacdo kuwa qaba cillad garaadka.Xogta CGM lama helin xilligii DCCT sidaas darteed heerka dhabta ah ee hypoglycemia halista ah waqti ka dib lama garanayo.
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