Hypoglycemia

Hypoglycemiabụ isi ihe na-egbochi njikwa glycemic nke ụdị ọrịa shuga 1.A na-ekewa hypoglycemia n'ime ọkwa atọ:
• Ọkwa 1 dabara na uru glucose dị n'okpuru 3.9 mmol/L (70 mg/dL) na karịa ma ọ bụ nhata 3.0 mmol/L (54 mg/dL) ma kpọọ aha ya dị ka uru njikere.
• Ọkwa 2 bụ makaglucose ọbaraN'okpuru 3.0 mmol / L (54 mg / dl) ma na-ewere hypoglycemia dị mkpa na ụlọ ọgwụ.
• Ọkwa 3 na-akọwapụta hypoglycemia ọ bụla nke ọnọdụ uche gbanwere na/ma ọ bụ ọnọdụ anụ ahụ chọrọ enyemaka nke onye ọzọ maka mgbake.
Ọ bụ ezie na e bu ụzọ mepụta ihe ndị a maka mkpesa nnwale ụlọ ọgwụ, ha bụ ihe nrụpụta ụlọ ọgwụ bara uru.Ekwesịrị itinye nlebara anya pụrụ iche iji gbochie ọkwa nke 2 na 3 hypoglycemia.
Ọkwa 1 hypoglycemia bụ ihe a na-ahụkarị, na ọtụtụ ndị nwere ụdị ọrịa shuga 1 na-enwe ọtụtụ ngosipụta kwa izu.Hypoglycemia nwere ọkwa glucose dị n'okpuru 3.0 mmol / L (54 mg / dL) na-apụta ọtụtụ ugboro karịa ka anyị ghọtara na mbụ.Ọkwa 3 hypoglycemia abụghị ihe a na-ahụkarị mana ọ mere na 12% nke ndị okenye nwere ụdị ọrịa shuga 1 n'ime ọnwa 6 na nyocha nyocha zuru ụwa ọnụ na nso nso a.Ọtụtụ ọmụmụ egosila na ọnụ ọgụgụ nke hypoglycemia agbadabeghị, ọbụlagodi na-agbasawanye ojiji nke analogues insulin na CGM, ebe ọmụmụ ndị ọzọ gosipụtara uru na ọganihu ọgwụgwọ ndị a.

Ihe ize ndụ maka hypoglycemia, karịsịa ọkwa 3 hypoglycemia, gụnyere ogologo oge nke ọrịa shuga, ịka nká, akụkọ ihe mere eme nke ọkwa 3 hypoglycemia na nso nso a, ịṅụ mmanya na-aba n'anya, mgbatị ahụ, ọkwa agụmakwụkwọ dị ala, obere ego ezinụlọ, ọrịa akụrụ na-adịghị ala ala, na IAH.Ọnọdụ endocrine, dị ka hypothyroidism, ụkọ homonụ na-eto eto, na ọrịa celiac nwere ike ịkpalite hypoglycemia.Ebe nchekwa data ọrịa shuga merela ochie na-edekọkarị na ndị nwere ọkwa HbA 1c dị ala nwere ọnụọgụ 2-3 dị elu nke ọkwa 3 hypoglycemia.Agbanyeghị, na ụdị 1Ọrịa shuga mellitusNdekọ ụlọ ọgwụ mgbanwe, ihe ize ndụ nke hypoglycemia na-abawanye ọ bụghị naanị na ndị HbA 1c dị n'okpuru 7.0% (53 mmol / mol), kamakwa n'ime ndị nwere HbA 1c karịa 7.5% (58 mmol / mol).
Ọ ga-ekwe omume na enweghị mmekọrịta dị n'etiti HbA 1c na ọkwa 3 hypoglycemia na ntọala ụwa bụ nke a kọwara site na izu ike nke ebumnuche glycemic nke ndị nwere akụkọ ihe mere eme nke hypoglycemia, ma ọ bụ ihe mgbagwoju anya, dị ka àgwà njide onwe onye na-ezughị ezu nke na-enye aka na abụọ ahụ.hyper- na hypoglycemic-cemia.Nyocha nke abụọ nke ule IN CONTROL, ebe nyocha mbụ gosipụtara mbelata ọkwa 3 hypoglycemia na ndị mmadụ na-eji CGM, gosipụtara mmụba nke ọkwa 3 hypoglycemia na HbA 1c dị ala, dị ka ihe a kọrọ na DCCT.Nke a pụtara na mbelata HbA 1c ka nwere ike nwee nnukwu ihe egwu nke ọkwa 3 hypoglycemia.
Onwu sitere nahypoglycemiana ụdị ọrịa shuga 1 abụghị ihe dị mkpa.Otu nnwale na nso nso a kwuru na ihe karịrị 8% nke ọnwụ maka ndị na-erubeghị afọ 56 sitere na hypoglycemia.Usoro maka nke a dị mgbagwoju anya, gụnyere ọrịa obi arrhythmias, ịgbalite ma usoro coagulation na mbufụt, na nkwụsị nke endothelial.Ihe nwere ike ọ gaghị amata nke ọma bụ na ọkwa 3 hypoglycemia na-ejikọta ya na nnukwu ihe omume microvascular, ọrịa na-abụghị nke obi, na ọnwụ site na ihe ọ bụla, ọ bụ ezie na ọtụtụ n'ime ihe akaebe a sitere n'aka ndị nwere ụdị ọrịa shuga 2.N'ihe gbasara ọrụ ọgụgụ isi, na nyocha DCCT na EDIC, mgbe afọ 18 gachara, nnukwu hypoglycemia dị n'etiti ndị okenye adịghị emetụta ọrụ neu-rocognitive.Otú ọ dị, n'adabereghị n'ihe ndị ọzọ dị ize ndụ na ọrịa ndị ọzọ, ihe ndị ọzọ na-akpata hypoglycemia siri ike jikọtara ya na mbelata dị ukwuu na psychomotor na arụ ọrụ nke uche bụ nke kachasị ama mgbe afọ 32 gasịrị.Ọ dị ka ndị toro eto nwere ụdị ọrịa shuga nke 1 na-adịkarị mfe inwe nhụsianya dị nro nke metụtara hypoglycemia, ebe hypoglycemia na-apụtakarị na ndị nwere nsogbu ọgụgụ isi.Enweghi data CGM na oge DCCT ya mere amaghi oke oke hypoglycemia siri ike ka oge na-aga.
1. Lane W, Bailey TS, Gerety G, et al.;Ozi otu;Mgbanwe 1. Mmetụta insulin degludecvs insulin glargine u100 na hypoglycemia na ndị ọrịa nwere ụdị ọrịa shuga 1: SWITCH 1 randomized Clinicaltrial.JAMA2017;318:33-44
2. Bergenstal RM, Garg S, Weinzimer SA, et al.Nchekwa nke usoro nnyefe insulin nke ngwakọ mechiri emechi na ndị ọrịa nwere ụdị ọrịa shuga 1.JAMA 2016;316:1407–1408
3. Brown SA, Kovatchev BP, Raghinaru D, et al.;otu iDCL Trial Research Group.Ọnwụnwa isii na-agbapụtaghị nke ọma, nnwale multicenter nke njikwa mechiri emechi na ụdị ọrịa shuga 1.N Engl J Med 2019;381:
1707–1717