Hypoglycemiake eona ntho e ka sehloohong e fokotsang taolo ea glycemic ea lefu la tsoekere la mofuta oa 1.Hypoglycemia e arotsoe ka mekhahlelo e meraro:
• Boemo ba 1 bo tsamaisana le boleng ba tsoekere bo ka tlase ho 3.9 mmol/L (70 mg/dL) le bo boholo ho feta kapa bo lekanang le 3.0 mmol/L (54 mg/dL) mme bo rehilwe jwalo ka boleng ba tlhokomediso.
• Boemo ba 2 ke batsoekere ea maliboleng bo ka tlase ho 3.0 mmol/L (54 mg/dL) mme bo nkuoa e le hypoglycemia ea bohlokoa haholo.
• Boemo ba 3 bo hlalosa hypoglycemia leha e le efe e khetholloang ke boemo bo fetohileng ba kelello le / kapa boemo ba 'mele bo hlokang ho kenella ha motho oa boraro bakeng sa ho hlaphoheloa.
Leha tsena li ne li etselitsoe tlaleho ea liteko tsa tleliniki qalong, li na le thuso ea bongaka.Tlhokomelo e khethehileng e lokela ho etsoa ho thibela boemo ba 2 le 3 hypoglycemia.
Hypoglycemia ea boemo ba 1 e tloaelehile, 'me batho ba bangata ba nang le lefu la tsoekere la mofuta oa 1 ba ba le liketsahalo tse' maloa ka beke.Hypoglycemia e nang le tsoekere e ka tlase ho 3.0 mmol/L (54 mg/dL) e hlaha hangata ho feta kamoo e neng e ananeloa pele.Level 3 hypoglycemia ha e tloaelehe haholo empa e etsahetse ho 12% ea batho ba baholo ba nang le lefu la tsoekere la mofuta oa 1 nakong ea likhoeli tse 6 tlhahlobong ea morao-rao ea lefats'e.Liphuputso tse 'maloa li bonts'itse hore sekhahla sa hypoglycemia ha se theohe, leha ho na le ts'ebeliso e pharalletseng ea li-analogue tsa insulin le CGM, ha lithuto tse ling li bonts'itse molemo ka tsoelopele ena ea kalafo.
Likotsi tsa hypoglycemia, haholo-holo boemo ba 3 hypoglycemia, li kenyelletsa nako e telele ea lefu la tsoekere, botsofali, nalane ea boemo ba morao-rao ba 3 hypoglycemia, ho noa joala, boikoetliso, maemo a tlase a thuto, meputso e tlase ea malapa, lefu le sa foleng la liphio, le IAH.Maemo a Endocrine, joalo ka hypothyroidism, khaello ea adrenal le kholo ea lihormone, le lefu la celiac li ka baka hypoglycemia.Mananeo a khale a lefu la tsoekere a ne a lula a tlaleha hore batho ba nang le maemo a tlase a HbA 1c ba ne ba e-na le litekanyetso tse phahameng ka makhetlo a 2-3 tsa boemo ba 3 ba hypoglycemia.Leha ho le joalo, ho Mofuta oa 1Lefu la tsoekereExchange Clinic Registry, kotsi ea boemo ba 3 ba hypoglycemia e eketsehile eseng feela ho bao HbA 1c ea bona e neng e le ka tlase ho 7.0% (53 mmol/mol), empa le ho batho ba nang le HbA 1c ka holimo ho 7.5% (58 mmol/mol) .
Ho ka etsahala hore ho se be teng ha kamano lipakeng tsa HbA 1c le boemo ba 3 ba hypoglycemia maemong a nnete a lefats'e ho hlalosoa ke ho phomola ha lipehelo tsa glycemic ke ba nang le nalane ea hypoglycemia, kapa ba ferekanyang, joalo ka boits'oaro bo sa lekaneng ba ho itaola bo kenyang letsoho ho tsona ka bobeli.hyper- le hypoglycemic-cemia.Tlhahlobo ea bobeli ea teko ea IN CONTROL, moo tlhahlobo ea mantlha e bonts'itseng phokotso ea boemo ba 3 ba hypoglycemia ho batho ba sebelisang CGM, e bontšitse keketseho ea sekhahla sa boemo ba 3 hypoglycemia ka HbA 1c e tlase, e ts'oanang le e tlalehiloeng DCCT.Sena se bolela hore ho theola HbA 1c ho ntse ho ka hlaha ka kotsi e kholo ea boemo ba 3 ba hypoglycemia.
Ho shoa ho tlohahypoglycemiamofuteng oa 1 lefu la tsoekere ha se ntho e sa reng letho.Teko e 'ngoe ea morao tjena e hlokometse hore batho ba fetang 8% ba shoang ho ba ka tlase ho lilemo tse 56 ba bakiloe ke hypoglycemia.Mokhoa oa sena o rarahane, ho kenyelletsa le cardiac arrhythmias, ts'ebetso ea tsamaiso ea coagulation le ho ruruha, le ho se sebetse ha endothelial.Ntho e ka 'nang ea se ke ea hlokomeloa hantle ke hore boemo ba 3 hypoglycemia bo boetse bo amahanngoa le liketsahalo tse kholo tsa microvascular, lefu la noncardiovascular, le lefu ka lebaka leha e le lefe, le hoja boholo ba bopaki bona bo fumanoa ho batho ba nang le lefu la tsoekere la mofuta oa 2.Mabapi le ts'ebetso ea ts'ebetso ea kelello, thutong ea DCCT le EDIC, kamora lilemo tse 18 tsa ho latela, hypoglycemia e matla ho batho ba baholo ba lilemo tse mahareng ha ea ka ea bonahala e ama ts'ebetso ea neu-rocognitive.Leha ho le joalo, ntle le mabaka a mang a kotsi le mathata a mang, liketsahalo tse ngata tsa hypoglycemia e matla li ne li amahanngoa le ho fokotseha ho hoholo ha psychomotor le katleho ea kelello tse neng li hlokomelehile haholo ka mor'a lilemo tse 32 tsa ho latela.Ho bonahala eka batho ba baholo ba nang le lefu la tsoekere la mofuta oa 1 ba na le bothata bo fokolang ba kelello bo amanang le hypoglycemia, athe hypoglycemia e hlaha hangata ho ba nang le bothata ba ho tseba.Lintlha tsa CGM li ne li sa fumanehe mehleng ea DCCT, kahoo tekanyo ea 'nete ea hypoglycemia e tebileng ha nako e ntse e feta ha e tsejoe.
1. Lane W, Bailey TS, Gerety G, et al.;Lintlha tsa Sehlopha;SWITCH 1. Phello ea insulin degludecvs insulin glargine u100 ho hypoglycemia ho bakuli ba nang le lefu la tsoekere la mofuta oa 1: the SWITCH 1 randomizedclinicaltrial.JAMA2017;318:33–44
2. Bergenstal RM, Garg S, Weinzimer SA, et al.Tšireletseho ea sistimi e nyalisitsoeng ea "insulin" e koetsoeng ho bakuli ba nang le lefu la tsoekere la mofuta oa 1.JAMA 2016;316:1407–1408
3. Brown SA, Kovatchev BP, Raghinaru D, et al.;Sehlopha sa lipatlisiso tsa liteko tsa iDCL.Teko ea likhoeli tse ts'eletseng e sa fetoheng, e mengata ea taolo e koetsoeng ea lefu la tsoekere la mofuta oa 1.N Engl J Med 2019;381:
1707–1717
Nako ea poso: Jul-08-2022