Baaritaanka sonkorta HbA1c: heerka caadiga ah, jadwalka iyo waxa natiijadaadu ka dhigan tahay

Sonkorta dhiiggaaga saddexdii bilood ee la soo dhaafay oo hal tiro ah. Halkan ka baro sida loo akhriyo, waxa beddela, iyo goorta ay mudan tahay inaad dhakhtar u tagto.

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Jawaab degdeg ah

Waa maxay heerka caadiga ah ee sonkorta HbA1c?

HbA1c caadi ah waa ka hooseeya 5.7% (39 mmol/mol). 5.7% ilaa 6.4% (39 ilaa 47 mmol/mol) waa heerka sonkorowga ka horreeya (prediabetes), 6.5% (48 mmol/mol) ama ka badanna waa heerka sonkorowga (macaanka), oo dhakhtarku ku xaqiijiyo baaritaan labaad. HbA1c waxay muujisaa celceliska sonkorta dhiiggaaga qiyaastii saddex bilood, mana u baahnid inaad soonto.

Ii sharax warbixintaydaWax ka weydii natiijadayda

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Shaxda heerarka

Jadwalka heerka caadiga ah ee HbA1c

Dadka waaweyn ee aan horay u qabin sonkorow, sida ay dejiyeen Ururka Sonkorowga Maraykanka (American Diabetes Association) iyo Ururka Caafimaadka Adduunka (WHO).

NatiijadaHbA1c (%)HbA1c (mmol/mol)Waxa ay inta badan ka dhigan tahay
CaadiKa hooseeya 5.7%Ka hooseeya 39Sonkorta dhiiggaagu waxay ku jirtay heerkii caadiga ahaa.
Sonkorow ka hor (prediabetes)5.7% ilaa 6.4%39 ilaa 47Way ka sarreysaa caadiga. Waa waqti wanaagsan oo wax laga qabto, maxaa yeelay inta badan way soo dhici kartaa.
Heerka sonkorowga6.5% ama ka badan48 ama ka badanWaxay ku jirtaa heerka sonkorowga. Dhakhtarku wuxuu ku xaqiijiyaa baaritaan la celiyo ama mid labaad.

Shaybaarradu waxay daabici karaan heerar tixraac oo wax yar kala duwan, markaa eeg kan ku qoran warbixintaada. Boqortooyada Ingiriiska, NICE waxay u isticmaashaa 42 ilaa 47 mmol/mol (6.0% ilaa 6.4%) heerka khatarta sare.

U beddel HbA1c-gaaga celceliska sonkorta dhiigga

Qor lambarka warbixintaada ku jira. Waxaad arki doontaa celceliska sonkorta (glucose) ee la qiyaasay ee uu u taagan yahay, iyo heerka uu ku jiro.

Celceliska sonkorta ee la qiyaasay
125 mg/dL
7.0 mmol/L
Natiijo isku mid ah, cabbirka kale
42 mmol/mol
Heerka
Heerka prediabetes (sonkorow ka hor)

Hal natiijo ma aha go'aan cudur. Sonkorowga waxa lagu xaqiijiyaa baaritaan mar kale la sameeyo ama nooc labaad oo baaritaan ah.

Bartilmaameedyada caadiga ah ee HbA1c haddii aad horay u qabtid sonkorow

Bartilmaameedka qof walba si gaar ah ayaa loogu dejiyaa. Kuwani waa meelaha caadiga ah ee laga bilaabo sida ku qoran ADA Standards of Care; dhakhtarkaagu wuxuu kuu dejin karaa mid kale.

YaaBartilmaameedka caadiga ah (%)mmol/mol ahaan
Dadka waaweyn ee sonkorowga qaba badankoodKa hooseeya 7%Ka hooseeya 53
Dadka waayeelka ah ee caafimaadka qabaKa hooseeya 7.0% ilaa 7.5%Ka hooseeya 53 ilaa 58
Dadka waayeelka ah ee qaba dhowr xaaladood oo kaleKa hooseeya 8%Ka hooseeya 64
Uur iyo sonkorowKa hooseeya 6% haddii ay ammaan tahay, haddii kale ka hooseeya 7%Ka hooseeya 42, haddii kale ka hooseeya 53
Carruurta iyo dhallinyarada sonkorowga qabaKa hooseeya 7%Ka hooseeya 53

Bartilmaameedka waa la hoos u dhigaa ama kor loo qaadaa iyadoo lagu salaynayo khatarta sonkorta oo kaa dhacda, xaaladahaaga kale iyo da'daada.

Maxay cabbirtaa baaritaanka sonkorta HbA1c?

HbA1c waxay u taagan tahay glycated haemoglobin (waxaad sidoo kale arki kartaa glycosylated haemoglobin, A1C ama HbA1c). Dadka qaar waxay u yaqaanaan baaritaanka sonkorta saddexda bilood. Hemoglobin waa borotiinka unugyada cas ee dhiigga ku jira ee qaada ogsijiinta. Sonkorta dhiiggaaga ku jirta ayaa ku dhegta, inta sonkortu badnaataba waxaa badanaya hemoglobin-ka ay daboosho.

Unugyada cas waxay noolaadaan qiyaastii saddex bilood, sidaa darteed HbA1c waxay muujisaa celceliska sonkorta dhiiggaaga labadii ilaa saddexdii bilood ee la soo dhaafay, iyadoo bishii ugu dambaysay ay ugu culus tahay. Taasi waa sababta ay u degan tahay: hal casho oo macaan ama hal subax oo walbahaar leh si dhib ah ayay u beddelaan, mana u baahnid inaad soonto baaritaanka ka hor.

Dhakhaatiirtu saddex siyood ayay u isticmaalaan: si ay u ogaadaan sonkorowga iyo heerka ka horreeya (prediabetes), si ay u arkaan sida daaweynta sonkorowgu u shaqaynayso, iyo si ay u qiimeeyaan khatarta dhibaatooyinka sonkorowga muddo ka dib.

Sidee HbA1c ugu xiran tahay celceliska sonkorta dhiigga?

HbA1c-gaaga waxaa loo beddeli karaa celceliska sonkorta la qiyaasay (estimated average glucose, eAG), oo ah tirada uu qalabka sonkorta ee guriga ku celcelin lahaa haddii aad habeen iyo maalin baari lahayd. Beddelkani wuxuu ka yimid daraasadda ADAG (Nathan iyo asxaabtiis, Diabetes Care, 2008).

HbA1cmmol/molCelceliska sonkorta (mg/dL)Celceliska sonkorta (mmol/L)
5%31975.4
6%421267.0
7%531548.6
8%6418310.2
9%7521211.8
10%8624013.4
11%9726914.9
12%10829816.5

Qiyaastan waa celcelis. Laba qof oo isku HbA1c leh waxay yeelan karaan maalmo aad u kala duwan: mid sonkortiisu degan tahay, mid kalena ay kor iyo hoos u boodayso. Haddii aad isticmaasho qalabka sonkorta ama sensor, akhrisyadaas ayaa sheegaya inta kale ee sheekada.

Maxay ka dhigan tahay HbA1c sare?

5.7% ilaa 6.4% (prediabetes, sonkorow ka hor). Sonkorta dhiiggaagu way ka sarraysay caadiga, laakiin ma gaadhin heerka sonkorowga. Waa wax badan, inta badan calaamado ma laha, waana waqtiga ugu fiican ee wax laga qabto: barnaamijka Diabetes Prevention Program ee Maraykanka, dadkii lumiyay qiyaastii 7% miisaankooda oo firfircoonaa waxay hoos u dhigeen fursadda ay ugu dhacaan sonkorowga nooca 2 in ka badan kala bar.

6.5% ama ka badan (heerka sonkorowga). Hal natiijo oo halkan ah kaligeed ma aha ogaanshaha cudurka. Haddii aadan qabin calaamado cad oo sonkor sare ah mooyee, dhakhtarku wuxuu ku celiyaa HbA1c ama wuxuu baaraa sonkorta soonka (fasting glucose) ama glucose tolerance test si uu u xaqiijiyo.

Horay ma u qabtaa sonkorow? Haddii ay ka kacdo bartilmaameedkaaga, inta badan waxay ka dhigan tahay in qorshaha dib loo eego: daawooyinka, cuntada, dhaqdhaqaaqa, hurdada, walbahaarka iyo xanuunnada kale dhammaantood kor ayay u qaadi karaan. Tirada u gee dhakhtarka kaa daweeya sonkorowga, intii aad adigu wax beddeli lahayd.

HbA1c waxay sidoo kale u muuqan kartaa mid ka sarreysa celceliskaaga dhabta ah marka la qabo dhiig-yarida yaraanta birta, fiitamiin B12 ama folate oo yar, cudurka kelyaha oo horumaray, ama kadib marka beeryarada la saaro.

Maxay ka dhigan tahay HbA1c hoose?

Dadka badankood ee aan sonkorowga qabin, natiijo ku jirta qaybta hoose ee heerka caadiga ah waa war wanaagsan oo keliya.

Waxay u muuqan kartaa mid ka hooseysa celceliskaaga dhabta ah marka unugyada cas loo beddelayo si ka dhakhso badan sidii caadiga ahayd: kadib dhiig badan oo kaa baxay ama dhiig lagugu shubay, noocyada qaar ee dhiig-yarida, qaybta labaad ee uurka, cudurka kelyaha oo horumaray oo lagu daweeyo erythropoietin, ama cudurrada beerka qaarkood. Qaar ka mid ah noocyada kala duwan ee hemoglobin (sida sickle cell trait, ama HbE, oo ku badan Koonfurta iyo Koonfur-bari Aasiya) waxay ka dhigi karaan hababka baaritaanka qaarkood inay akhriyaan hoose ama sare.

Haddii aad qaadato insulin ama kiniinnada sonkorta hoos u dhiga oo HbA1c-gaagu aad u hooseeyo, waxay ka dhigan kartaa inay sonkortu kaa dhacdo marar badan. Taasi waxay mudan tahay inaad dhakhtarkaaga wacdo, gaar ahaan haddii ay kugu dhaceen gariir, dhidid ama wareer.

Goorma ayaan HbA1c ahayn baaritaanka saxda ah?

Maadaama HbA1c ay ku xiran tahay unugyada cas, dhakhaatiirtu waxay isticmaalaan baaritaannada sonkorta (fasting glucose, glucose tolerance test ama fructosamine test) marka:

  • aad uur leedahay, gaar ahaan sonkorowga uurka (gestational diabetes), oo lagu baaro glucose tolerance test
  • dhawaan dhiig badan kaa baxay ama dhiig lagugu shubay
  • aad qabto dhiig-yari, nooc kale oo hemoglobin ah, ama cudurka kelyaha ama beerka oo horumaray
  • sonkorowga nooca 1 uu si degdeg ah u bilaabmi karo, inta badan ilmo ama qof dhallinyaro ah oo harraad iyo miisaan lumis qaba, halkaas oo aysan ammaan ahayn in la sugo saddex bilood si HbA1c u soo gaarto

Sidee baaritaanka sonkorta saddexda bilood loo sameeyaa?

  • Looma baahna inaad soonto. Waad cuni kartaa oo cabbi kartaa sidii caadiga ahayd.
  • Waa muunad yar oo dhiig ah oo laga qaado xididka gacantaada, ama farta oo la mudo rugaha caafimaadka qaarkood.
  • Natiijadu inta badan isla maalinta ayay soo baxdaa ama hal ilaa laba maalmood gudahood.
  • U sheeg shaybaarka ama dhakhtarkaaga haddii aad uur leedahay, aad qabto dhiig-yari ama cudurka kelyaha, ama dhiig lagugu shubay ama dhiig badan kaa baxay saddexdii bilood ee la soo dhaafay.

Imisa jeer ayaad baarsiisaa HbA1c?

Kuwani waa muddooyinka caadiga ah ee ku qoran ADA Standards of Care:

  • Natiijo caadi ah, sonkorow ma jiro: dadka waaweyn waxaa la baaraa laga bilaabo da'da 35, ama ka hor haddii ay miisaan dheeraad ah leeyihiin iyo khataro kale, saddexdii sanoba mar haddii natiijadu caadi ahaato.
  • Prediabetes (sonkorow ka hor): sannadkiiba mar.
  • Sonkorow, bartilmaameedka ku jira: ugu yaraan sannadkii laba jeer.
  • Sonkorow, daaweynta dhawaan la beddelay ama aan bartilmaameedka gaarin: qiyaastii saddexdii biloodba mar.

Maxaa caawiya haddii HbA1c-gaagu sarreeyo?

HbA1c si tartiib ah ayay isu beddeshaa, markaa isbeddel kasta sii labo ilaa saddex bilood si uu u muuqdo.

  • Dhaqdhaqaaq badso. Qiyaastii 150 daqiiqo toddobaadkii oo socod degdeg ah ama wax la mid ah, oo loo qaybiyo maalmaha badankood, iyo xoogaa jimicsi muruq xoojin ah.
  • Ku beddel cabbitaannada macaan iyo istaarijka la sifeeyay (shaah sonkor leh, casiir, rooti cad, bariis badan) biyo, khudaar, digir iyo misir, iyo badar dhan.
  • Miisaan yar dhim haddii aad miisaan dheeraad ah leedahay. Luminta 5% ilaa 7% miisaanka jirka ayaa horeba isbeddel la cabbiri karo keenta.
  • Hurdada iyo walbahaarka sidoo kale way muhiim yihiin. Hurdo yar iyo walbahaar dheer labaduba sonkorta dhiigga ayay kor u qaadaan.
  • Daawooyinka waa go'aanka dhakhtarkaaga. Dad badan ayaa u baahan, taasina ma aha guuldarro. Weligaa ha bilaabin, ha joojin, hana beddelin daawo sonkorow adigoon dhakhtarkaaga la tashan.

Goorta aad dhakhtar aragto

Ballan qabso

  • HbA1c-gaagu waa 6.5% (48 mmol/mol) ama ka badan markii ugu horreysay: u tag dhakhtar guud ama dhakhtarka sonkorowga 1 ilaa 2 toddobaad gudahood si loo xaqiijiyo loona qorsheeyo tallaabooyinka xiga.
  • Waxay ku jirtaa heerka prediabetes (5.7% ilaa 6.4%): u tag dhakhtar guud bisha soo socota gudaheeda si aad u qorsheysaan sida hoos loogu dhigo.
  • Waxaad qabtaa sonkorow oo HbA1c-gaagu wuu ka sarreeyaa bartilmaameedkaaga, ama wuu ka hooseeyaa 6% iyadoo aad qaadato insulin ama kiniinnada sonkorta hoos u dhiga: u sheeg dhakhtarka kaa daweeya sonkorowga 1 ilaa 2 toddobaad gudahood.
  • Had iyo jeer waad harraadsan tahay, kaadi badan ayaad kaadshaa, miisaan ayaad lumisaa adigoon isku dayin, ama araggaagu wuu xumaaday: u tag dhakhtar dhowr maalmood gudahood, ka hor haddii ay sii xumaanayso.

Hadda raadso gargaar degdeg ah (wac lambarka gurmadka degdegga ah ee deegaankaaga) haddii qof sonkor sare qaba uu leeyahay:

  • matag aan joogsanayn, neef qoto dheer ama degdeg ah, ama neefta oo ur miro macaan leh
  • wareer, lulmo aad u daran, ama in si dhib ah loo toosiyo
  • calaamadaha sonkor aad u hoosaysa oo aan fiicnaanin kadib marka sonkor la qaato: gariir, dhidid, wareer, suuxid ama qallal

Tirada HbA1c kaligeed weligeed ma aha xaalad degdeg ah. Calaamadahan ayaa ah.

Ma haysataa warbixintaada? Faham qiime kasta, ma aha HbA1c oo keliya.

Saluvo waxay warbixintaada oo dhan kuu akhrisaa erayo fudud, luqaddaada: waxa qiime kastaa ka dhigan yahay, kuwa ka baxsan heerka caadiga ah, iyo su'aalaha aad dhakhtarkaaga u qaadanayso.

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Su'aalaha dadku weydiiyaan

  • HbA1c waxay u taagan tahay glycated haemoglobin, oo sidoo kale loo yaqaan glycosylated haemoglobin ama haemoglobin A1c. "Hb" waa hemoglobin, borotiinka unugyada cas ee qaada ogsijiinta, "A1c"-na waa qaybta sonkortu ku dhegto. Baaritaanku wuxuu cabbiraa inta hemoglobin-kaaga ah ee sonkor ku dhegan tahay, taas oo muujisa celceliska sonkorta dhiiggaaga qiyaastii saddex bilood.

  • Dadka waaweyn ee aan sonkorowga qabin, HbA1c caadi ah waa ka hooseeya 5.7% (39 mmol/mol). 5.7% ilaa 6.4% waa heerka prediabetes (sonkorow ka hor), 6.5% ama ka badanna waa heerka sonkorowga. Shaybaarradu waxay daabici karaan heerar tixraac oo wax yar kala duwan, markaa natiijadaada la barbar dhig heerka ku qoran warbixintaada.

  • 5.7% (39 mmol/mol) waa halka uu ka bilaabmo heerka prediabetes, markaa wax yar ayay ka sarreysaa caadiga. Ma aha sonkorow, inta badanna waa marxaladda ugu fudud ee dib loogu celin karo dhaqdhaqaaq badan, cabbitaanno macaan oo yar iyo miisaan yar oo la dhimo. Dib u baar qiyaastii sannad kadib, ama ka hor haddii dhakhtarkaagu kuu sheego.

  • 6.5% (48 mmol/mol) waa xadka heerka sonkorowga. Hal natiijo oo heerkan ah inta badan waxaa lagu xaqiijiyaa HbA1c la celiyo ama baaritaanka sonkorta soonka ka hor inta aan cudurka la sheegin, haddii aadan sidoo kale qabin calaamado cad sida harraad joogto ah iyo miisaan lumis mooyee. U tag dhakhtar guud hal ilaa laba toddobaad gudahood.

  • Haddii aadan qabin sonkorow, 7% waxay ku jirtaa heerka sonkorowga waxayna u baahan tahay inaad dhakhtar u tagto hal ilaa laba toddobaad gudahood si loo xaqiijiyo. Haddii aad horay u qabtid sonkorow, 7% waa bartilmaameed caadi ah oo dad badan oo waaweyn leeyihiin, markaa waxay noqon kartaa meesha saxda ah ee dhakhtarkaagu doonayo. Bartilmaameedkaaga gaarka ah wuxuu ku xiran yahay da'daada, xaaladahaaga kale iyo khatarta sonkorta oo kaa dhacda.

  • HbA1c 10% (86 mmol/mol) waxay ka dhigan tahay in celceliska sonkorta dhiiggaagu ahaa qiyaastii 240 mg/dL (13.4 mmol/L) dhowrkii bilood ee la soo dhaafay, oo aad uga sarreeya bartilmaameedka. Waxay u baahan tahay in dhakhtar eego dhowr maalmood gudahood, ma aha bilo. Raadso gargaar degdeg ah haddii uu jiro matag, neef degdeg ah, wareer ama lulmo aad u daran.

  • Maya. Heerarka lagu ogaado prediabetes iyo sonkorowga waa isku mid dadka waaweyn ee da' kasta. HbA1c wax yar ayay kor u kacdaa marka la gaboobo xitaa dadka caafimaadka qaba, laakiin kuma filna inay beddesho xadadka. Waxa da'da la beddelma waa bartilmaameedka dadka horay u qaba sonkorowga: dadka waayeelka ah inta badan waxaa la siiyaa bartilmaameed wax yar ka sarreeya, sida ka hooseeya 7.5% ama 8%, si looga fogaado in sonkortu ka dhacdo.

  • Maya. HbA1c waxay muujisaa sonkorta dhiiggaaga qiyaastii saddex bilood, markaa cunto aad baaritaanka ka hor cuntay ma beddesho. Waad cuni kartaa oo cabbi kartaa si caadi ah. Haddii dhakhtarkaagu isla booqashadaas kuu dalbay sonkorta soonka (fasting glucose) ama baaritaanka dufanka (lipid), raac tilmaamaha soonka ee kuwaas.

  • Natiijo caadi ah oo aan sonkorow jirin, dadka waaweyn inta badan waxaa la baaraa saddexdii sanoba mar laga bilaabo da'da 35. Prediabetes, sannadkiiba mar. Sonkorow, ugu yaraan sannadkii laba jeer marka aad bartilmaameedka ku jirto, iyo qiyaastii saddexdii biloodba mar kadib isbeddel daaweyn ama marka aad ka sarreyso bartilmaameedka.

  • Haa, mararka qaarkood. Waxay si been ah u sarrayn kartaa marka la qabo dhiig-yarida yaraanta birta ama fiitamiin B12 oo yar, waxayna si been ah u hoosayn kartaa kadib dhiig luminta ama dhiig lagu shubo, uurka dambe, noocyada dhiig-yarida qaarkood, cudurka kelyaha oo horumaray, ama noocyada kala duwan ee hemoglobin sida HbE ama sickle cell trait. Haddii tiradu aysan la jaanqaadin akhrisyada sonkortaada ama calaamadahaaga, dhakhtarkaaga weydii baaritaan sonkorta (glucose) ah.

  • Sonkorta soonka (fasting blood sugar) waa sawir hal mar ah: sonkortaada hal waqti oo keliya, kadib 8 saacadood ama ka badan oo aadan wax cunin. HbA1c waa celcelis qiyaastii saddex bilood ah mana u baahna soon. Sonkorta soonka oo ah 126 mg/dL (7.0 mmol/L) ama ka badan iyo HbA1c oo ah 6.5% ama ka badan labaduba waxay ku jiraan heerka sonkorowga; dhakhaatiirtu inta badan labada ayay wada isticmaalaan.

  • HbA1c waxay raacdaa unugyada cas, oo noolaada qiyaastii saddex bilood, markaa isbeddelka badankiisu wuxuu muuqdaa labo ilaa saddex bilood gudahood. Xoogaa hoos u dhac ah ayaa muuqan kara afar ilaa lix toddobaad kadib. Taasi waa sababta dhakhaatiirtu inta badan dib ugu baaraan qiyaastii saddex bilood kadib isbeddel cunto, dhaqdhaqaaq ama daawo.

  • Inta badan, haa. Dad badan ayaa HbA1c-dooda dib ugu celiya heerka caadiga ah iyagoo si joogto ah u dhaqdhaqaaqa, yareeya sonkorta iyo istaarijka la sifeeyay, hagaajiya hurdada, oo luminaya 5% ilaa 7% miisaankooda haddii ay miisaan dheeraad ah leeyihiin. Xitaa marka aysan si buuxda caadi ugu noqon, isbeddelladaas waxay aad u yareeyaan fursadda lagu qaado sonkorowga nooca 2.

  • Si taxaddar leh ayaa loo isticmaalaa. HbA1c si dabiici ah ayay u hoosaysaa qaybta labaad ee uurka, markaa way seegi kartaa sonkor sare. Sonkorowga uurka waxaa lagu baaraa glucose tolerance test, inta badan inta u dhexeysa toddobaadyada 24 ilaa 28. Haweenka qabay sonkorow uurka ka hor inta badan HbA1c ayaa sidoo kale loo baaraa, iyadoo kooxda daryeelkoodu dejiso bartilmaameedka.

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Ilaha

  1. American Diabetes Association: Understanding A1C
  2. American Diabetes Association: Standards of Care in Diabetes
  3. CDC: A1C test for diabetes and prediabetes
  4. NIDDK (NIH): The A1C test and diabetes
  5. MedlinePlus: Hemoglobin A1C (HbA1c) test
  6. NICE guideline NG28: Type 2 diabetes in adults
  7. Nathan DM et al. Translating the A1C assay into estimated average glucose values. Diabetes Care 2008

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