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Situatiile in care hemoglobina glicata iti poate pune un diagnostic gresit de diabet

<div class&equals;"b03d97280e765d707d336f444dd9d428" data-index&equals;"1" style&equals;"float&colon; none&semi; margin&colon;0px 0 0px 0&semi; text-align&colon;center&semi;">&NewLine;<div data-type&equals;"&lowbar;mgwidget" data-widget-id&equals;"1671590"> &NewLine;<&sol;div> &NewLine;<script>&lpar;function&lpar;w&comma;q&rpar;&lbrace;w&lbrack;q&rsqb;&equals;w&lbrack;q&rsqb;&vert;&vert;&lbrack;&rsqb;&semi;w&lbrack;q&rsqb;&period;push&lpar;&lbrack;"&lowbar;mgc&period;load"&rsqb;&rpar;&rcub;&rpar;&lpar;window&comma;"&lowbar;mgq"&rpar;&semi; &NewLine;<&sol;script> &NewLine; &NewLine; &NewLine; <script id&equals;"&lowbar;vidverto-362eafc0ba2cb293c4d0e2c47c8d893c">&excl;function&lpar;v&comma;t&comma;o&rpar;&lbrace;var a&equals;t&period;createElement&lpar;"script"&rpar;&semi;a&period;src&equals;"https&colon;&sol;&sol;ad&period;vidverto&period;io&sol;vidverto&sol;js&sol;aries&sol;v1&sol;invocation&period;js"&comma;a&period;setAttribute&lpar;"fetchpriority"&comma;"high"&rpar;&semi;var r&equals;v&period;top&semi;r&period;document&period;head&period;appendChild&lpar;a&rpar;&comma;v&period;self&excl;&equals;&equals;v&period;top&&&lpar;v&period;frameElement&period;style&period;cssText&equals;"width&colon;0px&excl;important&semi;height&colon;0px&excl;important&semi;"&rpar;&comma;r&period;aries&equals;r&period;aries&vert;&vert;&lbrace;&rcub;&comma;r&period;aries&period;v1&equals;r&period;aries&period;v1&vert;&vert;&lbrace;commands&colon;&lbrack;&rsqb;&rcub;&semi;var c&equals;r&period;aries&period;v1&semi;c&period;commands&period;push&lpar;&lpar;function&lpar;&rpar;&lbrace;var d&equals;document&period;getElementById&lpar;"&lowbar;vidverto-362eafc0ba2cb293c4d0e2c47c8d893c"&rpar;&semi;d&period;setAttribute&lpar;"id"&comma;&lpar;d&period;getAttribute&lpar;"id"&rpar;&plus;&lpar;new Date&lpar;&rpar;&rpar;&period;getTime&lpar;&rpar;&rpar;&rpar;&semi;var t&equals;v&period;frameElement&vert;&vert;d&semi;c&period;mount&lpar;"10405"&comma;t&comma;&lbrace;width&colon;720&comma;height&colon;405&rcub;&rpar;&rcub;&rpar;&rpar;&rcub;&lpar;window&comma;document&rpar;&semi;<&sol;script> &NewLine; &NewLine; &NewLine; <div data-ad&equals;"andreilaslau&period;ro&lowbar;sticky&lowbar;mobile&lowbar;custom&lowbar;bottom" data-devices&equals;"m&colon;1&comma;t&colon;0&comma;d&colon;0" class&equals;"demand-supply"><&sol;div>&NewLine;<&sol;div>&NewLine; &NewLine; &NewLine;Hemoglobina glicata &lpar;HbA1c&rpar; este una dintre cele mai utilizate analize pentru diagnosticarea si monitorizarea diabetului zaharat&period; Aceasta reflecta media valorilor glicemiei din ultimele aproximativ 2-3 luni si este considerata un indicator important al controlului glicemic&period; Totusi&comma; exista situatii in care rezultatul poate fi inselator&comma; ducand la un diagnostic eronat de diabet sau&comma; dimpotriva&comma; mascand existenta bolii&period; &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;<h2 class&equals;"wp-block-heading">Ce este hemoglobina glicata&quest;<&sol;h2> &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;Hemoglobina este proteina din globulele rosii responsabila de transportul oxigenului&period; Atunci cand glucoza din sange se ataseaza de hemoglobina&comma; se formeaza hemoglobina glicata&period; Cu cat glicemia este mai mare pe termen lung&comma; cu atat procentul de HbA1c creste&period; &NewLine; &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;In general&comma; valorile sunt interpretate astfel&colon; &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;<ul class&equals;"wp-block-list"> &NewLine; &Tab;<li>Sub 5&comma;7&percnt; – valoare considerata normala&period;<&sol;li> &NewLine; &Tab;<li>Intre 5&comma;7&percnt; si 6&comma;4&percnt; – indica prediabet&period;<&sol;li> &NewLine; &Tab;<li>6&comma;5&percnt; sau mai mare – poate sugera diabet zaharat&comma; daca rezultatul este confirmat prin teste suplimentare&period;<&sol;li> &NewLine;<&sol;ul> &NewLine; &NewLine; &NewLine; &NewLine;<h2 class&equals;"wp-block-heading">De ce poate fi inselator testul HbA1c&quest;<&sol;h2> &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;Hemoglobina glicata nu masoara direct glicemia din momentul recoltarii&comma; ci depinde si de durata de viata a globulelor rosii&period; Orice afectiune care modifica aceasta durata poate influenta rezultatul&period; &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;<h2 class&equals;"wp-block-heading">1&period; Anemia prin deficit de fier<&sol;h2> &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;Persoanele cu deficit de fier pot avea valori fals crescute ale HbA1c&period; Globulele rosii traiesc mai mult decat in mod normal&comma; ceea ce permite acumularea unei cantitati mai mari de glucoza pe hemoglobina&period; In aceste cazuri&comma; cineva poate parea diabetic fara sa aiba glicemia crescuta&period; &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;<h2 class&equals;"wp-block-heading">2&period; Anemia hemolitica<&sol;h2> &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;In anemia hemolitica&comma; globulele rosii sunt distruse mai rapid&period; Deoarece acestea nu raman suficient timp in circulatie&comma; HbA1c poate avea valori fals scazute&comma; chiar daca glicemia este ridicata&period; &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;<h2 class&equals;"wp-block-heading">3&period; Pierderile importante de sange<&sol;h2> &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;Dupa o hemoragie severa sau dupa o interventie chirurgicala cu pierderi mari de sange&comma; organismul produce globule rosii noi&period; Acestea au fost expuse mai putin timp la glucoza&comma; iar rezultatul HbA1c poate fi mai mic decat realitatea&period; &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;<h2 class&equals;"wp-block-heading">4&period; Transfuziile de sange<&sol;h2> &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;O transfuzie poate modifica temporar nivelul hemoglobinei glicate&comma; deoarece sangele primit provine de la o alta persoana si poate avea un nivel diferit al HbA1c&period; &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;<h2 class&equals;"wp-block-heading">5&period; Bolile cronice de rinichi<&sol;h2> &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;Insuficienta renala cronica poate influenta atat durata de viata a globulelor rosii&comma; cat si structura hemoglobinei&comma; ceea ce face ca interpretarea HbA1c sa fie mai dificila&period; &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;<h2 class&equals;"wp-block-heading">6&period; Afectiunile ficatului<&sol;h2> &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;Bolile hepatice severe pot modifica metabolismul si productia globulelor rosii&comma; determinand rezultate care nu reflecta fidel controlul glicemiei&period; &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;<h2 class&equals;"wp-block-heading">7&period; Hemoglobinopatiile<&sol;h2> &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;Persoanele cu variante genetice ale hemoglobinei&comma; cum sunt anemia falciforma sau talasemia&comma; pot avea rezultate inexacte in functie de metoda de laborator utilizata pentru determinarea HbA1c&period; &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;<h2 class&equals;"wp-block-heading">8&period; Sarcina<&sol;h2> &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;In timpul sarcinii&comma; mai ales in trimestrele doi si trei&comma; durata de viata a globulelor rosii este redusa&period; Din acest motiv&comma; HbA1c poate subestima valorile reale ale glicemiei si nu este metoda preferata pentru diagnosticarea diabetului gestational&period; &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;<h2 class&equals;"wp-block-heading">9&period; Administrarea unor medicamente<&sol;h2> &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;Anumite tratamente&comma; precum eritropoietina&comma; suplimentele cu fier administrate recent sau unele medicamente utilizate in chimioterapie&comma; pot modifica rezultatele testului&period; &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;<h2 class&equals;"wp-block-heading">Cand sunt necesare investigatii suplimentare&quest;<&sol;h2> &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;Daca valoarea HbA1c nu corespunde simptomelor sau glicemiilor masurate acasa&comma; medicul poate recomanda investigatii suplimentare&comma; precum&colon; &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;<ul class&equals;"wp-block-list"> &NewLine; &Tab;<li>glicemia à jeun &lpar;pe nemancate&rpar;&semi;<&sol;li> &NewLine; &Tab;<li>testul de toleranta orala la glucoza &lpar;TTGO&rpar;&semi;<&sol;li> &NewLine; &Tab;<li>glicemia recoltata in orice moment al zilei&comma; in prezenta simptomelor sugestive&semi;<&sol;li> &NewLine; &Tab;<li>monitorizarea continua a glicemiei sau masuratori repetate cu glucometrul&period;<&sol;li> &NewLine;<&sol;ul> &NewLine; &NewLine; &NewLine; &NewLine;<h2 class&equals;"wp-block-heading">Cum se stabileste corect diagnosticul de diabet&quest;<&sol;h2> &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;Diagnosticul diabetului nu ar trebui stabilit exclusiv pe baza unui singur rezultat al hemoglobinei glicate&comma; mai ales atunci cand exista afectiuni care pot influenta analiza&period; Medicul ia in considerare istoricul pacientului&comma; simptomele&comma; celelalte analize de sange si&comma; daca este necesar&comma; repeta testarea pentru confirmare&period; &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;<h2 class&equals;"wp-block-heading">Concluzie<&sol;h2> &NewLine; &NewLine; &NewLine; &NewLine; &NewLine;Hemoglobina glicata ramane un instrument extrem de valoros pentru evaluarea controlului glicemiei si pentru diagnosticarea diabetului&period; Cu toate acestea&comma; anumite boli&comma; tratamente sau situatii fiziologice pot determina rezultate fals crescute sau fals scazute&period; De aceea&comma; interpretarea analizei trebuie facuta intotdeauna in context clinic si&comma; atunci cand exista neconcordante&comma; completata cu alte investigatii recomandate de medic&period; Un diagnostic corect este esential pentru alegerea tratamentului potrivit si pentru prevenirea complicatiilor pe termen lung&period;<div class&equals;"b03d97280e765d707d336f444dd9d428" data-index&equals;"3" style&equals;"float&colon; none&semi; margin&colon;0px 0 0px 0&semi; text-align&colon;center&semi;">&NewLine;<center> Publicitate <&sol;center> &NewLine;<script async src&equals;"https&colon;&sol;&sol;pagead2&period;googlesyndication&period;com&sol;pagead&sol;js&sol;adsbygoogle&period;js&quest;client&equals;ca-pub-9353012245817679" &NewLine; crossorigin&equals;"anonymous"><&sol;script> &NewLine;<&excl;-- andreilaslau&period;ro responsiv --> &NewLine;<ins class&equals;"adsbygoogle" &NewLine; style&equals;"display&colon;block" &NewLine; data-ad-client&equals;"ca-pub-9353012245817679" &NewLine; data-ad-slot&equals;"9089118467" &NewLine; data-ad-format&equals;"auto" &NewLine; data-full-width-responsive&equals;"true"><&sol;ins> &NewLine;<script> &NewLine; &lpar;adsbygoogle &equals; window&period;adsbygoogle &vert;&vert; &lbrack;&rsqb;&rpar;&period;push&lpar;&lbrace;&rcub;&rpar;&semi; &NewLine;<&sol;script> &NewLine; &NewLine;<div data-type&equals;"&lowbar;mgwidget" data-widget-id&equals;"1603935"> &NewLine;<&sol;div> &NewLine;<script>&lpar;function&lpar;w&comma;q&rpar;&lbrace;w&lbrack;q&rsqb;&equals;w&lbrack;q&rsqb;&vert;&vert;&lbrack;&rsqb;&semi;w&lbrack;q&rsqb;&period;push&lpar;&lbrack;"&lowbar;mgc&period;load"&rsqb;&rpar;&rcub;&rpar;&lpar;window&comma;"&lowbar;mgq"&rpar;&semi; &NewLine;<&sol;script> &NewLine;&NewLine;<&sol;div>&NewLine;&NewLine;<div style&equals;"font-size&colon; 0px&semi; height&colon; 0px&semi; line-height&colon; 0px&semi; margin&colon; 0&semi; padding&colon; 0&semi; clear&colon; both&semi;"><&sol;div><&sol;p><div class&equals;"amp-ad-wrapper amp&lowbar;ad&lowbar;1 ampforwp-incontent-custom-banner ampforwp-incontent-ad1"><amp-ad width&equals;"336" height&equals;"280" type&equals;"sulvo" data-ad&equals;"andreilaslau&period;ro&lowbar;amp&lowbar;display&lowbar;336x280" class&equals;"demand-supply"><&sol;amp-ad><&sol;div>&NewLine;<&excl;-- WP QUADS Content Ad Plugin v&period; 3&period;0&period;1 -->&NewLine;<div class&equals;"quads-location quads-ad68336 " id&equals;"quads-ad68336" style&equals;"float&colon;none&semi;text-align&colon;center&semi;padding&colon;0px 0 0px 0&semi;" data-lazydelay&equals;"3000">&NewLine;<div class&equals;"quads-ad-label quads-ad-label-new">Advertisement<&sol;div><&excl;-- responsive 1 -->&NewLine;<script async src&equals;"https&colon;&sol;&sol;securepubads&period;g&period;doubleclick&period;net&sol;tag&sol;js&sol;gpt&period;js"><&sol;script>&NewLine;<div id&equals;"andreilaslau&period;ro&lowbar;responsive&lowbar;1">&NewLine; <script>&NewLine; window&period;googletag &equals; window&period;googletag &vert;&vert; &lbrace; cmd&colon; &lbrack;&rsqb; &rcub;&semi;&NewLine; googletag&period;cmd&period;push&lpar;function&lpar;&rpar; &lbrace;&NewLine; var slot &equals; googletag&period;defineSlot&lpar;'&sol;23293390090&sol;andreilaslau&period;ro&sol;andreilaslau&period;ro&lowbar;responsive&lowbar;1'&comma; &lbrack;&lbrack;300&comma; 250&rsqb;&comma; &lbrack;320&comma; 50&rsqb;&comma; &lbrack;728&comma; 90&rsqb;&comma; &lbrack;468&comma; 60&rsqb;&comma; &lbrack;336&comma; 280&rsqb;&comma; 'fluid'&rsqb;&comma; 'andreilaslau&period;ro&lowbar;responsive&lowbar;1'&rpar;&semi;&NewLine;&NewLine; var mapping1 &equals; googletag&period;sizeMapping&lpar;&rpar;&NewLine; &period;addSize&lpar;&lbrack;980&comma; 0&rsqb;&comma; &lbrack;&lbrack;728&comma; 90&rsqb;&comma; &lbrack;468&comma; 60&rsqb;&comma; &lbrack;336&comma; 280&rsqb;&comma; &lbrack;300&comma; 250&rsqb;&comma; 'fluid'&rsqb;&rpar;&NewLine; &period;addSize&lpar;&lbrack;750&comma; 0&rsqb;&comma; &lbrack;&lbrack;728&comma; 90&rsqb;&comma; &lbrack;468&comma; 60&rsqb;&comma; &lbrack;336&comma; 280&rsqb;&comma; &lbrack;300&comma; 250&rsqb;&comma; 'fluid'&rsqb;&rpar;&NewLine; &period;addSize&lpar;&lbrack;320&comma; 0&rsqb;&comma; &lbrack;&lbrack;336&comma; 280&rsqb;&comma; &lbrack;320&comma; 50&rsqb;&comma; &lbrack;300&comma; 250&rsqb;&comma; 'fluid'&rsqb;&rpar;&NewLine; &period;build&lpar;&rpar;&semi;&NewLine;&NewLine; slot&period;defineSizeMapping&lpar;mapping1&rpar;&semi;&NewLine; slot&period;addService&lpar;googletag&period;pubads&lpar;&rpar;&rpar;&semi;&NewLine; googletag&period;enableServices&lpar;&rpar;&semi;&NewLine; googletag&period;display&lpar;'andreilaslau&period;ro&lowbar;responsive&lowbar;1'&rpar;&semi;&NewLine; &rcub;&rpar;&semi;&NewLine; <&sol;script>&NewLine;<&sol;div>&NewLine;&NewLine;<&sol;div>&NewLine;&NewLine;<&sol;p>

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