1
5 Pocket Jean - 30 / Indigo
$ 404.6 $ 304.6
30
30
32
34
Indigo
Indigo
-
+
5 Pocket Jean - 30 / Indigo
$ 404.6 $ 304.6
30
30
32
34
Indigo
Indigo
-
+
5 Pocket Jean - 30 / Indigo
$ 404.6 $ 304.6
30
30
32
34
Indigo
Indigo
-
+
5 Pocket Jean - 30 / Indigo
30
30
32
34
Indigo
Indigo
-
+
$ 404.6 $ 304.6
5 Pocket Jean - 30 / Indigo
30
30
32
34
Indigo
Indigo
-
+
$ 404.6 $ 304.6
5 Pocket Jean - 30 / Indigo
$ 404.6 $ 304.6
30
30
32
34
Indigo
Indigo
-
+
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28)","#pibtn-icon-font-size":"16px","#continue-text":"Jatka ostoksia","#continue-display":"inline-block","#continue-width":"100px","#continue-height":"42px","#continue-effect-hover":"raise","#continue-font-size":"13px","#continue-font-weight":"400","#continue-font-style":"normal","#continue-text-decoration":"none solid rgb(255, 255, 255)","#continue-color":"rgb(255, 255, 255)","#continue-color-hover":"rgb(255, 255, 255)","#continue-background-color":"rgb(128, 83, 157)","#continue-background-color-hover":"rgb(240, 128, 80)","#continue-border-width":"0px","#continue-border-color":"rgb(0, 0, 0)","#continue-border-color-hover":"rgb(0, 0, 0)","#continue-border-radius":"5px","#checkout-text":"Kassa","#checkout-display":"block","#checkout-width":"100px","#checkout-height":"42px","#checkout-effect-hover":"raise","#checkout-font-size":"13px","#checkout-font-weight":"400","#checkout-font-style":"normal","#checkout-text-decoration":"none solid rgb(255, 255, 255)","#checkout-color":"rgb(255, 255, 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{"#popup-showup-effect":"bounceDownIn","#popup-width":"850px","#popup-font-family":"News_Cycle","#popup-padding":"30px","#popup-background-color":"rgb(255, 255, 255)","#popup-border-width":"0px","#popup-border-color":"rgb(255, 255, 255)","#popup-border-radius":"5px","#product-title-display":"inline","#product-title-font-size":"16px","#product-title-font-weight":"700","#product-title-font-style":"normal","#product-title-text-decoration":"none solid rgb(0, 0, 0)","#product-title-text-align":"left","#product-title-color":"rgb(0, 0, 0)","#success-alert-text":"Product successfully added to your shopping cart","#success-alert-display":"block","#success-alert-font-size":"18px","#success-alert-font-weight":"700","#success-alert-font-style":"normal","#success-alert-text-decoration":"none solid rgb(40, 167, 69)","#success-alert-text-align":"left","#success-alert-color":"rgb(40, 167, 69)","#additional-quantity-text":"Quantity","#additional-subtotal-text":"Subtotal","#additional-total-text":" Total ","#additional-display":"block","#additional-font-size":"14px","#additional-font-weight":"400","#additional-font-style":"normal","#additional-text-decoration":"none solid rgb(0, 0, 0)","#additional-text-align":"left","#additional-color":"rgb(0, 0, 0)","#item-count-text-text":"There are {number} tems in your cart.","#item-count-text-display":"block","#item-count-text-font-size":"18px","#item-count-text-font-weight":"700","#item-count-text-font-style":"normal","#item-count-text-text-decoration":"none solid rgb(0, 0, 0)","#item-count-text-text-align":"left","#item-count-text-color":"rgb(0, 0, 0)","#cart-note-text":"Add a note for admin","#cart-note-display":"block","#cart-note-font-size":"14px","#cart-note-font-weight":"700","#cart-note-font-style":"normal","#cart-note-text-decoration":"none solid rgb(0, 0, 0)","#cart-note-text-align":"left","#cart-note-color":"rgb(0, 0, 0)","#continue-text":"CONTINUE SHOPPING","#continue-display":"inline-flex","#continue-width":"170px","#continue-height":"43px","#continue-font-size":"12px","#continue-font-weight":"400","#continue-font-style":"normal","#continue-text-decoration":"none solid rgb(255, 255, 255)","#continue-color":"rgb(255, 255, 255)","#continue-color-hover":"rgb(228, 228, 228)","#continue-background-color":"rgb(0, 0, 0)","#continue-background-color-hover":"rgb(0, 0, 0)","#continue-border-width":"0px","#continue-border-color":"rgb(0, 0, 0)","#continue-border-color-hover":"rgb(0, 0, 0)","#continue-border-radius":"0px","#checkout-text":"PROCEED TO CHECKOUT","#checkout-display":"inline-flex","#checkout-width":"169px","#checkout-height":"43px","#checkout-font-size":"12px","#checkout-font-weight":"400","#checkout-font-style":"normal","#checkout-text-decoration":"none solid rgb(255, 255, 255)","#checkout-color":"rgb(255, 255, 255)","#checkout-color-hover":"rgb(228, 228, 228)","#checkout-background-color":"rgb(0, 0, 0)","#checkout-background-color-hover":"rgb(0, 0, 0)","#checkout-border-width":"0px","#checkout-border-color":"rgb(0, 0, 0)","#checkout-border-color-hover":"rgb(0, 0, 0)","#checkout-border-radius":"0px","#tocartbtn-text":"GO TO CART","#tocartbtn-display":"none","#tocartbtn-width":"160px","#tocartbtn-height":"41px","#tocartbtn-font-size":"12px","#tocartbtn-font-weight":"400","#tocartbtn-font-style":"normal","#tocartbtn-text-decoration":"none solid rgb(255, 255, 255)","#tocartbtn-color":"rgb(255, 255, 255)","#tocartbtn-color-hover":"rgb(224, 224, 224)","#tocartbtn-background-color":"rgb(0, 0, 0)","#tocartbtn-background-color-hover":"rgb(0, 0, 0)","#tocartbtn-border-width":"0px","#tocartbtn-border-color":"rgb(0, 0, 0)","#tocartbtn-border-color-hover":"rgb(0, 0, 0)","#tocartbtn-border-radius":"0px"}
{"#stickybar-display":"none","#stickybar-action":"goto_checkout","#stickybar-font-family":"News_Cycle","#stickybar-background-color":"rgb(246, 247, 251)","#stickybar-height":"70px","#stickybar-position":"position_top","#stickybar-offset":"0px","#stickybar-display-type":"alwayshow","#stickybar-title-font-size":"16px","#stickybar-title-color":"rgb(0, 0, 0)","#stickybar-title-font-weight":"500","#stickybar-title-font-style":"normal","#stickybar-title-text-decoration":"none solid rgb(0, 0, 0)","#stickybar-buynow-text":"BUY NOW","#stickybar-buynow-width":"130px","#stickybar-buynow-height":"35px","#stickybar-buynow-font-size":"11px","#stickybar-buynow-effect-hover":"slide","#stickybar-buynow-font-weight":"700","#stickybar-buynow-font-style":"normal","#stickybar-buynow-text-decoration":"none solid rgb(255, 255, 255)","#stickybar-buynow-color":"rgb(255, 255, 255)","#stickybar-buynow-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-background-color":"rgb(37, 37, 37)","#stickybar-buynow-background-color-hover":"rgb(37, 37, 37)","#stickybar-buynow-border-width":"0px","#stickybar-buynow-border-color":"rgb(255, 255, 255)","#stickybar-buynow-border-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-border-radius":"15px"}
{"#stickybar-display":"flex","#stickybar-action":"goto_checkout","#stickybar-font-family":"News_Cycle","#stickybar-background-color":"rgb(255, 255, 255)","#stickybar-height":"70px","#stickybar-position":"position_top","#stickybar-offset":"0px","#stickybar-display-type":"alwayshow","#stickybar-title-font-size":"16px","#stickybar-title-color":"rgb(0, 0, 0)","#stickybar-title-font-weight":"500","#stickybar-title-font-style":"normal","#stickybar-title-text-decoration":"none solid rgb(0, 0, 0)","#stickybar-buynow-text":"BUY NOW","#stickybar-buynow-width":"130px","#stickybar-buynow-height":"35px","#stickybar-buynow-font-size":"11px","#stickybar-buynow-effect-hover":"slide","#stickybar-buynow-font-weight":"700","#stickybar-buynow-font-style":"normal","#stickybar-buynow-text-decoration":"none solid rgb(255, 255, 255)","#stickybar-buynow-color":"rgb(255, 255, 255)","#stickybar-buynow-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-background-color":"rgb(242, 108, 79)","#stickybar-buynow-background-color-hover":"rgb(242, 108, 79)","#stickybar-buynow-border-width":"0px","#stickybar-buynow-border-color":"rgb(255, 255, 255)","#stickybar-buynow-border-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-border-radius":"2px"}
{"#stickybar-action":"goto_checkout","#stickybar-display":"flex","#stickybar-font-family":"News_Cycle","#stickybar-background-color":"rgb(255, 255, 255)","#stickybar-height":"70px","#stickybar-position":"position_top","#stickybar-offset":"0px","#stickybar-display-type":"alwayshow","#stickybar-title-font-size":"16px","#stickybar-title-color":"rgb(0, 0, 0)","#stickybar-title-font-weight":"500","#stickybar-title-font-style":"normal","#stickybar-title-text-decoration":"none solid rgb(0, 0, 0)","#stickybar-buynow-text":"BUY NOW","#stickybar-buynow-width":"230px","#stickybar-buynow-height":"70px","#stickybar-buynow-font-size":"11px","#stickybar-buynow-effect-hover":"slide","#stickybar-buynow-font-weight":"700","#stickybar-buynow-font-style":"normal","#stickybar-buynow-text-decoration":"none solid rgb(255, 255, 255)","#stickybar-buynow-color":"rgb(255, 255, 255)","#stickybar-buynow-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-background-color":"rgb(17, 17, 17)","#stickybar-buynow-background-color-hover":"rgb(17, 17, 17)","#stickybar-buynow-border-width":"0px","#stickybar-buynow-border-color":"rgb(0, 0, 0)","#stickybar-buynow-border-color-hover":"rgb(0, 0, 0)","#stickybar-buynow-border-radius":"0px"}
{"#stickybar-display":"flex","#stickybar-action":"goto_checkout","#stickybar-font-family":"News_Cycle","#stickybar-background-color":"rgb(242, 108, 79)","#stickybar-height":"70px","#stickybar-position":"position_top","#stickybar-offset":"0px","#stickybar-display-type":"alwayshow","#stickybar-title-font-size":"16px","#stickybar-title-color":"rgb(255, 255, 255)","#stickybar-title-font-weight":"500","#stickybar-title-font-style":"normal","#stickybar-title-text-decoration":"none solid rgb(255, 255, 255)","#stickybar-buynow-text":"BUY NOW","#stickybar-buynow-width":"230px","#stickybar-buynow-height":"70px","#stickybar-buynow-font-size":"11px","#stickybar-buynow-effect-hover":"none","#stickybar-buynow-font-weight":"700","#stickybar-buynow-font-style":"normal","#stickybar-buynow-text-decoration":"none solid rgb(255, 255, 255)","#stickybar-buynow-color":"rgb(255, 255, 255)","#stickybar-buynow-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-background-color":"rgb(0, 0, 0)","#stickybar-buynow-background-color-hover":"rgb(0, 0, 0)","#stickybar-buynow-border-width":"0px","#stickybar-buynow-border-color":"rgb(0, 0, 0)","#stickybar-buynow-border-color-hover":"rgb(0, 0, 0)","#stickybar-buynow-border-radius":"0px"}
{"#stickybar-display":"flex","#stickybar-action":"goto_checkout","#stickybar-font-family":"News_Cycle","#stickybar-background-color":"rgb(255, 255, 255)","#stickybar-height":"70px","#stickybar-position":"position_top","#stickybar-offset":"0px","#stickybar-display-type":"alwayshow","#stickybar-title-font-size":"16px","#stickybar-title-color":"rgb(0, 0, 0)","#stickybar-title-font-weight":"500","#stickybar-title-font-style":"normal","#stickybar-title-text-decoration":"none solid rgb(0, 0, 0)","#stickybar-buynow-text":"BUY NOW","#stickybar-buynow-width":"130px","#stickybar-buynow-height":"35px","#stickybar-buynow-font-size":"11px","#stickybar-buynow-effect-hover":"none","#stickybar-buynow-font-weight":"700","#stickybar-buynow-font-style":"normal","#stickybar-buynow-text-decoration":"none solid rgb(255, 254, 254)","#stickybar-buynow-color":"rgb(255, 254, 254)","#stickybar-buynow-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-background-color":"rgb(242, 108, 79)","#stickybar-buynow-background-color-hover":"rgb(244, 72, 35)","#stickybar-buynow-border-width":"0px","#stickybar-buynow-border-color":"rgb(255, 255, 255)","#stickybar-buynow-border-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-border-radius":"0px"}
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Viikkotehtävä 1

Minkä takia verensokerin omaseuranta on tärkeää?

Terveydenhuollossa diabeetikoiden verensokereiden seurannassa käytetään lähinnä vain paastosokereiden seurantaa terveydentilan arvioimisessa. Seurannat ovat muutaman vuoden välein - jos silloinkaan. Pelkkä kerran satunnaisesti otettu paastosokeri antaa hyvin suppean kuvan sokeriaineenvaihdunnastasi. 

Paastosokeri kuvaa vain paastotilaa, mikä on vain pieni osa vuorokaudesta. Monella diabeetikolla paastosokeri voi olla lähes viitearvon sisällä, mutta mitattaessa aterian jälkeisiä sokereita todetaan, että henkilö viettää suurimman osan päivästä hyperglykemiassa (korkea verensokeri)  Toisekseen päivien välillä on paljon vaihtelua, eli tämän ja ensi viikon aamun paastosokerin tulos voi olla aivan erilainen. 

Miten suoritetaan hyvä sokeriaineenvaihdunnan analyysi?

Onnistunut verensokerin seuranta koostuu ainakin kahdesta asiasta:

1. Mitataan HbA1c, eli keskisokeri ,eli pitkäsokeri. HbA1c eli keskisokeri on viimeisen 2-3 kuukauden keskilukema, ja kuvaa punasoluihin kiinnittyneiden glukoosimolekyylien (sokerin) määrää.

2. Mitatataan useamman päivän parimittauksien keskiarvo. Verensokerin omaseuranta pitää riittävän kattavan analyysin suorittamiseksi tehdä vähintään kolmen tai viiden päivän omaseurantana. Jokaisena päivänä pitäisi ottaa paastolukema (pian heräämisen jälkeen) ja tulos vähintään kahden aterian (esimerkiksi aamupalan ja päivällisen) yhteydessä. Ateriamittauksilla tarkoitetaan mittauksia, jossa verensokeri otetaan välittömästi ennen ateriaa ja 1,5-2 tuntia syömisen jälkeen.


Tarkemmin eri mittauslukemista ja näiden tulkitsemisesta: 

Paastotilassa otettu verensokerin mittaustulos kuvaa sitä, kuinka paljon oma maksa tuottaa verenkiertoon sokeria. Paastotilassa elimistömme pitää huolen siitä, että aivot, jotka eivät pysty käyttämään muuta kuin glukoosia energiaksi, eivät jäisi ilman energiaa. Aivomme vaativat keskimäärin 500 kcal energiaa vuorokaudessa, mikä on noin neljännes koko energiantarpeesta. Maksan tehtävä on tilanteissa, joissa elimistö ei saa ruoasta tarpeeksi hiilihydraatteja, tuottaa verenkiertoon glukoosia joko proteiineista tai glykogeenista eli glukoosivarastosta.

Yleensä tätä prosessia hillitsee ja säätelee insuliini. Insuliini pysyy jatkuvasti verenkierrossa myös paastotilassa ja pitää huolen siitä, että maksa ei tuottaisi turhan paljon sokeria, joka vahingoittaisi meitä. Ongelmia syntyy tilanteessa, jossa maksa on rasvoittunut ja siihen on kehittynyt insuliiniresistenssi. Insuliiniresistenssi aiheuttaa sen, että insuliinin sokerin tuotantoa hillitsevä vaikutus laskee paastotilassa ja maksa tuottaa virheellisen paljon sokeria verenkiertoon. Paastotilassa ei lähes koskaan ole ongelmana insuliinin puute vaan maksan insuliiniresistenssi.

Terveen elimistön paastosokeri pysyy alle 5,7 mmol/l :n tasolla. Voidaan siis sanoa, että esidiabetes tai metabolinen oireyhtymä alkaa kun verensokeri on enemmän kuin 5,7 mmol/l, joka viittaa alkavaan sokeriaineenvaihduntaongelmaan. Diagnostisesti merkittävä ja diabeteksen kriteerit täyttävä on paastosokeriarvo on >7,0 mmol/l.

Ateriamittaukset tapahtuvat paastotilan ulkopuolisena aikana eli silloin kun elimistöön tulee ulkopuolelta energiaa ruoasta. Ateriamittaukset näyttävät, kuinka tehokkaasti pystyy elimistö “poistamaan” ylimääräisen verensokerin verenkierrosta. Normaalitilanteessa, jossa elimistön sokeriaineenvaihdunta toimii tehokkaasti, erittää haima isomman määrän insuliinia verenkiertoon, joka aiheuttaa sen, että lähinnä lihakset ja rasvakudos pystyvät ottamaan vastaan kaiken ruoasta tulleen hiilihydraatin, jotta sen turhan korkea pitoisuus ei vahingoittaisi meidän elimistöämme. Ateriamittausten tulkitseminen on haasteellisempaa, koska tähän vaikuttaa monia muuttujia: insuliiniresistenssi lihaksissa ja rasvakudoksessa sekä insuliinin erityksen lasku. Melkein aina tyypin 2 diabeteksessa on olemassa kummatkin. Diagnoosivaiheessa on haiman insuliinituotannosta jäljellä yleensä enää noin 20 % ja sen lisäksi insuliiniresistenssi lihaksissa vähentää senkin insuliinimäärän vaikutusta.

Korkeat aterian jälkeiset lukemat kertovat meille sitä, että elimistön kyky poistaa tehokkaasti ruoasta tullut hiilihydraattia on merkittävästi laskenut. Poikkeukselliset verensokeripiikit ruoan jälkeen ovat isoin akuutti verisuonia vaurioittava tekijä. Jos insuliiniresistenssi on enemmän pysyvä fysiologinen tilanne, sitten insuliinin erityksen kyky haimasta heikkenee jokaisena sairastettuna vuotena (tätä kutsutaan beetasolujen toimintahäiriöksi). Mitä pidempään on kestänyt diabetes, sitä todennäköisempää on, että insuliinin puute on tärkeämmässä roolissa. Useimmiten alkuvaiheessa elimistö pystyy ylimääräisen verensokerin poistamaan verenkierrosta, mutta se tapahtuu hitaammin kuin terveellä ihmisellä. Tämän takia 1,5-2 tuntia ateriasta on standardi - terveessä elimistössä siinä ajassa poistuu verenkierrosta ylimääräinen sokeri, vaikka kuinka paljon sitä ruoasta tulisikin. Jos aterioiden väli on riittävän pitkä, voidaan edellyttää, että ennen seuraavaa ateriamittausta, on hidastuneesti toimiva sokeriaineenvaihdunta pystynyt kuitenkin poistamaan suurimman osan ylimääräisestä verensokerista. Jos verensokeri pysyy koholla vielä yli 4 tuntia ateriasta sitten se on merkki siitä, että kyseessä ei ole enää pelkästään hidastunut sokerin poisto verenkierrosta, vaan pidemmälle edennyt sokeriaineenvaihdunnan sairaus. Normaalisti verensokeri laskee aterian jälkeen alle 8 mmol/l tasolle. 8-11 mmol/l luokitellaan heikentynyt sokerinsiedoksi, joka on alkavan sokeriaineenvaihdunnan häiriön merkki. Pitkälle edennyt sokeriaineenvaihdunnassa aterianjälkeiset verensokerit nousevat yli 11 mmol/l ja tämä täyttää 2 tyypin diabeteksen diagnoosikriteerit. Ennen ateriaa mitatuille verensokereille ei ole virallisia viitearvoja, mutta toimivassa sokeriaineenvaihdunnassa (edellyttäen, että aterioiden väli on useita tunteja), ne laskee alle 7 mmol/l tasoille.