Te whakamārama i ngā hua whakamātautau HbA1c: ngā awhe noa, prediabetes me te mate huka

Ko te HbA1c tētahi o ngā tau whai hua rawa i tētahi pūrongo toto, ā, tētahi o ngā mea pōrearea rawa, nā te mea e rua ōna waeine, ā, he paku rerekē ngā rohe i waenga i ngā whenua. Ka whakamārama tēnei aratohu i ngā hua whakamātautau HbA1c i ia hīkoi: te mea e inea ana e te tau, te pānui i te % me te mmol/mol, me ngā mea ka whakahē pea. He kōrero whānui, ehara i te tautohu mate.

He aha tā te HbA1c e tino ine ana

Ka piri te huka i tō toto ki te haemoglobin, te pūmua e kawe ana i te hāora i roto i ngā pūtau toto whero. Ka nui ake te huka i tō toto, ka nui ake te haemoglobin ka kapi. Ka ora ngā pūtau toto whero mō te tata ki te rua ki te toru marama, nō reira ka hoatu e te HbA1c he whakaahua o tō huka toto toharite i te tata ki ngā marama e toru kua hori.

Tērā pea ka kite hoki koe i te ingoa A1C, haemoglobin A1c, glycated haemoglobin, glycohaemoglobin rānei. Ko te whakamātautau kotahi tonu.

Ētahi mea e puta mai ana i tēnei:

• Kāore koe e hiahia ki te nohopuku (kaua e kai). He iti rawa te neke i te kai kotahi, nō reira ka taea te tango toto i tētahi wā o te rā.
• Kāore e whakaatu i ngā teitei me ngā hakahaka. Ka whakamāenetia ngā piki me ngā heke poto i te roanga o te rā.
• Ko ngā wiki tata nei e hira rawa ana. He nui ake te pānga o tō huka toto i te tata ki te marama kua hori ki te hua i ngā wiki o mua.

E rua ngā waeine: % me mmol/mol

Ka pūrongo ngā taiwhanga i te HbA1c ki tētahi, ki ngā mea e rua rānei o ngā waeine e rua:

• Ko te ōrau (%) te waeine tawhito, ā, koinei tonu te mea e whakamahia ana i te US.
• Ko te mmol/mol te waeine ā-ao. I huri te UK ki a ia i 2009, ā, he maha ngā taiwhanga ināianei e tā ana i ngā mea e rua.

Kāore e taea te whakawhiti i ngā ine e rua, koinā te take ka whakaahua pea te hua "53" me te hua "7" i te toto kotahi.

HbA1c mmol/mol ki te %: me pēhea te huri

Mai i te % ki te mmol/mol: tangohia te 2.15, kātahi ka whakarea ki te 10.929.

Mai i te mmol/mol ki te %: whakawehea ki te 10.929, kātahi ka tāpiri i te 2.15.

Anei ngā uara noa kua mahia, me te glucose (huka toto) toharite whakatau tata (eAG) e rite tata ana ki ia mea. He toharite wā roa te eAG, nō reira kāore e rite ki tētahi pānuitanga mita kotahi.

HbA1c %	HbA1c mmol/mol	eAG mmol/L	eAG mg/dL
6.0	42	7.0	126
6.5	48	7.8	140
7.0	53	8.6	154
7.5	58	9.4	169
8.0	64	10.2	183
9.0	75	11.8	212
10.0	86	13.4	240

Ko ngā tīwae mmol/mol me mmol/L nō tētahi tūtohi hurihanga a te NHS, ko te tīwae mg/dL nō te American Diabetes Association.

Te whakamārama i ngā hua whakamātautau HbA1c: noa, prediabetes me te mate huka

Ko ēnei ngā awhe e whakamahia ana hei tirotiro i ngā pakeke mō te mate huka momo 2. Kia mōhio, he paku rerekē ngā wāhi e tuhia ai te rārangi prediabetes (kua teitei ake te huka toto, engari kāore anō kia eke ki te mate huka) e ngā aratohu US me UK.

HbA1c %	HbA1c mmol/mol	Te tikanga noa
I raro i te 5.7	I raro i te 39	Awhe noa
5.7 ki te 5.9	39 ki te 41	Prediabetes i ngā aratohu US; noa i ngā aratohu UK
6.0 ki te 6.4	42 ki te 47	Prediabetes i ngā aratohu US me UK
6.5 neke atu rānei	48 neke atu rānei	Kei te awhe mate huka; i te nuinga o te wā ka whakaūngia ki tētahi whakamātautau tuarua

Nō te NIDDK me te CDC ngā tau US. Nō Diabetes UK me NHS Scotland ngā tau UK.

Te tikanga o te "HbA1c noa"

He tohu pai te HbA1c noa, engari he whakaahua kotahi. Mēnā he take mōrearea mō te mate huka momo 2 kei a koe, mā tō tākuta e kī āhea tirotiro anō ai.

Te tikanga o te awhe prediabetes HbA1c

Ko te tikanga o te awhe prediabetes HbA1c, kua teitei ake tō huka toto i te mea pai, engari kāore i tino teitei kia kīia he mate huka. I roto i taua awhe, ka teitei ake te tau, ka teitei ake te mōrearea. E tūtohu ana ngā aratohu US kia tirotirohia anō ia kotahi ki te rua tau.

Kei te awhe mate huka

Kāore e ranea te hua kotahi o te 6.5% (48 mmol/mol) neke atu rānei ko ia anake mēnā kāore ō tohumate. Ko te aratohu i te US me te UK, me mahi anō te whakamātautau, me whakaū rānei ki tētahi whakamātautau glucose, i mua i te tautohu mate. Ehara hoki te HbA1c i te whakamātautau tika mō te tautohu i te mate huka momo 1, i te mate huka rānei ka tīmata i te hapūtanga.

Whakamātautau taiwhanga, whakamātautau whare haumanu rānei?

Mō te tautohu mate, e kī ana ngā aratohu US me ahu mai te toto i tētahi ia toto (vein), ā, me haere ki tētahi taiwhanga e whakamahi ana i tētahi tikanga whai tiwhikete. Ka whai hua pea ngā whakamātautau HbA1c tere "point-of-care" ka mahia i tētahi whare haumanu, engari ko ngā pūrere kua whakaaetia anake i ngā wāhi whai tiwhikete e whai tikanga ana mō te tautohu mate.

Te HbA1c me te whakamātautau glucose wero matimati

Ka whakautu ēnei tau e rua i ngā pātai rerekē. Ko te pānuitanga glucose wero matimati he whakaahua o tō huka toto i taua wā, ā, ka huri ki te kai, te korikori me te ahotea. Ko te HbA1c he toharite āta neke o ngā marama e rua ki te toru kua hori. Ko te hunga e whakamahi ana i te insulin, i ētahi atu rongoā mate huka rānei, he maha ngā wā e hiahia ana ki ngā mea e rua: ngā wero matimati hei whakahaere i ia rā, me te HbA1c kia kite i te āhua whānui.

Mēnā kei a koe kē te mate huka

Ko te HbA1c te ara matua e tirotiro ai tō tīma mate huka i te āhua o ngā mea i te roanga o te wā.

• He whaiaro ngā whāinga. E tūtohu ana te American Diabetes Association i raro i te 7% (53 mmol/mol) mō te nuinga o ngā pakeke he mate huka tō rātou. E kī ana a Diabetes UK ko te 48 mmol/mol (6.5%) iti iho rānei te mea pai rawa. Ka teitei ake pea tō ake whāinga mēnā he mōrearea mōu te huka toto hakahaka.
• Te auau: i te nuinga o te wā, ia toru ki te ono marama, ā, kotahi, e rua rānei ngā wā ia tau i te iti rawa.
• He noa ngā panoni iti. Ka paku rerekē ngā whakamātautau anō ahakoa i te tauira kotahi. Ka hoatu e te NIDDK te tauira, ko te hua 6.8% ka hoki mai pea ki tētahi tau mai i te 6.4% ki te 7.2% i tētahi whakamātautau anō.

Ngā mea e pā ana ki te HbA1c

Nā te mea kei ngā pūtau toto whero me te haemoglobin te HbA1c, ko ngā mea e huri ana i ērā ka whakapōhēhē pea i te tau. Pātai ki tō tākuta mō tēnei mēnā e pā ana tētahi o ēnei ki a koe:

• Anaemia (te iti rawa o te haemoglobin). Ka whakateitei teka pea te rino tino hakahaka i te HbA1c. Ka pā pea hoki ētahi atu mate toto.
• Te ngaronga toto hou, te whakaurunga toto rānei. Ka huri ēnei i te ranunga o ngā pūtau toto whero, nō reira kāore pea e taea te whakawhirinaki ki te HbA1c mō tētahi wā i muri.
• Ētahi momo haemoglobin. Ko ngā rerekētanga tuku iho o te haemoglobin, he noa ake i te hunga he whakapapa Awherika, Mediterranean, Āhia ki te Tonga-mā-rāwhiti rānei, me ngā mate pērā i te sickle cell disease, thalassaemia rānei, ka raweke pea i ētahi tikanga taiwhanga. Ko te nuinga o te hunga he momo rerekē tō rātou, kāore he tohumate, ā, kāore pea rātou e mōhio. Ehara i ia tikanga taiwhanga ka pāngia.
• Te hapūtanga. I te tīmatanga o te hapūtanga, ka whakaata tonu pea te hua i te huka toto i mua i te hapūtanga. E whakarārangi ana ngā aratohu US i te tīmatanga me te mutunga o te hapūtanga hei wā ka hē pea ngā hua.
• Te rahua whatukuhu, te mate ate me te dialysis. Ka huri pea ēnei i ngā hua.
• Ētahi rongoā. E whakaingoa ana ngā aratohu US i ngā opioid me ētahi rongoā HIV, ā, e kī ana a Diabetes UK i ngā steroid. Kaua rawa e whakamutu i tētahi rongoā me te kore kōrero ki tō tākuta.
• Te māuiui, te ahotea nui rānei. E whakarārangi ana a Diabetes UK i ēnei e rua hei mea ka huri pea i tō hua.

He tohu whai hua: mēnā kāore e hāngai ana tō HbA1c me ō pānuitanga glucose, kōrero ki tō tākuta. Tērā pea ka tūtohu rātou i tētahi whakamātautau rerekē.

Ngā pātai mō tō hua

• Kei tēhea waeine tōku hua, ā, ko ēhea rohe e whakamahia ana e taku taiwhanga?
• He hua hou tēnei, he wāhanga rānei o tētahi ia?
• Kei te pā rānei te anaemia, tētahi māuiui hou, te ngaronga toto, tētahi rongoā rānei?
• He aha te whāinga e tika ana mōku, ā, āhea whakamātautau anō ai au?

Āhea rapu ai i te āwhina ohotata

Ka whakaatu te hua HbA1c i te toharite mō te wā roa, engari ko te hua tino teitei, tērā pea he tino teitei tō huka toto ināianei, ā, tērā pea me aromatawai hohoro, nō reira whakapā atu ki tō tākuta ā tata nei, kaua e waiho mō muri. Ka ohotata pea te huka toto tino teitei. Waea atu ki tō nama ohotata ā-rohe, haere rānei ki tētahi tari ohotata mēnā he teitei tō huka toto, ā, e rongo ana koe i te ruaki, e ruaki ana rānei, he mamae puku, he tere ake tō whakaha i te tikanga, e tino hiamoe ana, e pōraruraru ana rānei, e kite ana i te kakara huarākau i tō hā, he teitei rānei ō ketones.

Te mātakitaki i te ia

He whai hua rawa te HbA1c puta noa i ngā whakamātautau maha. Mēnā ka tukuake koe i ō pūrongo ki a Saluvo, e rua ngā tauira AI ka pānui i ia mea, ka whakaū koe i ngā uara e rerekē ana tā rāua pānui, ā, ka kite koe i te neke o tō HbA1c mai i tētahi pūrongo ki tētahi. Kawea taua ia ki tō toronga e whai ake nei, kia whakatau tahi kōrua ko tō tākuta i tōna tikanga.