Matenda a shuga - maupangiri ndi zidule

Matenda a shuga ndi matenda osakhalitsa. Ku Russia, odwala 4 miliyoni omwe ali ndi matenda a shuga, omwe ali ndi masauzande 80,000 a insulin tsiku lililonse, ndipo 2/3 otsala amafunika kuthandizidwa ndimankhwala ochepetsa shuga.

Nthawi yayitali (pafupifupi zaka 60) pokonzekera insulini idapezeka kuchokera ku zinthu zopangidwa ndi nyama: zikondamoyo za nkhumba, ng'ombe (ng'ombe, ng'ombe ya nkhumba). Komabe, pakapangidwe kawo, kutengera mtundu wa zinthu zopaka, makamaka zosadetsedwa, zakhudzana (ma proinsulins, glucagon, somatostatins, etc.) ndizotheka, zomwe zimatsogolera pakupanga kwa insulin antibodies mwa wodwala. Pankhaniyi, kumapeto kwa zaka za m'ma 80. mdziko lathu, kupanga insulin yayifupi, yapakati komanso yayitali

Kutalika kwa kuchitapo kanthu. Mafakitale adayikidwanso pomanganso. Kugulidwa kwa kuchuluka kwa insulin kumapangidwa ku USA, Denmark, Germany.

Kugawidwa kwa insulin pamaziko opanga amaperekedwa

Gulu la mafakitale a insulin

Pakadali pano, insulin yaumunthu (Humulin - human) imapangidwa motsika kudzera ku insulin kapena njira yodziwikiratu yogwiritsa ntchito mabakiteriya kapena yisiti (genetic engineering), yomwe idapezeka kwa zaka 20 zapitazi.

Kugawidwa kwamakono kwa insulin mwa kutalika kwa zochita kumawonetsedwa

Gulu la insulin kutalika kwa nthawi ya zochita

Kugwira ntchito yopanga insulin kwa nthawi yayitali kunayamba mu 1936 ndipo mpaka pano. Kuti achulukitse vutoli, mapuloteni osafunikira a proteni Hagedorn amawonjezeranso ma insulin, chifukwa chomwe amatchedwa NPH insulins (protamine imapezeka kuchokera mkaka wa nsomba, protamine insulin idapangidwa ndi Hagedorn mu 1936). Kapena zinc zimawonjezeredwa, kotero mawu oti "tepi" amawonekera m'm mayina a insulin. Komabe, "insulin yakale" imagwiritsidwabe ntchito ngati njira yochizira matenda amtundu wa 1, pomwe kangapo patsiku, jakisoni wothandizirana ndi insulin posakhalitsa pamodzi ndi insulin.

Ku Russia, magawidwe a insulin malinga ndi nthawi achitapo kanthu amasiyanitsa magulu atatu, poganizira mitundu iwiri yayikulu ya insulini: a) sungunuka insulin (yochepa) ndi b) insulin pakuyimitsidwa (kuchitapo kanthu).

Gulu 1 - kuchita mwachidule: kuyamba kwa mphindi 15-30, kuchuluka pambuyo maola 1.5-3, kutalika kwa maola 4-6.

Gulu 2 - nthawi yayitali yochitapo: isanayambike - pambuyo 1.5 maola, kukwera pambuyo maola 4-12, kutalika kwa maola 12-18.

Gulu lachitatu - lokhalitsa: kuyambika, maola 4-6, kukwera pambuyo maola 10-18, kutalika kwa maola 20- 26

Kutalika kosiyanasiyana kwa zochita kumachitika chifukwa cha zochita za mankhwala:

- amorphous (semilent) - wapakati,

- kristalo (ultralente) - yayitali,

- Kuphatikiza - lembani Tepi ndi Monotard.

1) Ma insulini ofupikira kwambiri komanso achidule

Insulin Lyspro (INN) - Humalog: Kuthamanga kwambiri - pambuyo pa mphindi 10, kuchuluka pambuyo pa maola 0.5-1,5, kutalika kwa maola atatu, jakisoni wa jekeseni, vial, cartridge ya cholembera cha syringe imaperekedwa. Cn B. Yopangidwa ndi Eli Lilly (USA, France).

Mu 1998, kampani ya Novo Nordisk (Denmark) idayambitsa matenda analogue ya insulin NovoRapid (Aspart) ya chipanicho posakhalitsa, yomwe idapangidwanso m'malo mwa amino acid pragine.

Kuchita zinthu mwachidule

a) Zomera za insulin:

Actrapid MS (Denmark, India, Russia),

Suinsulin-Insulin DB (Russia),

b) insulin yamunthu:

Actrapid NM (India),

Actrapid NM Penfill (Denmark),

Insuman Rapid (France / Germany).

2) Ma Insulin Angoyambira Pakati

Chibadwa cha nyama:

Insulong SPP (Croatia) - kuyimitsidwa kwa zinc,

Monotrad MS (Denmark) - kuyimitsidwa kwa zinc,

Protafan MS (Denmark) - isophan-protamine,

Monotard NM (Denmark, India),

Insuman Bazal (France / Germany),

Protafan NM Penfill (Denmark, India).

3) Insulini wokhalitsa

Chibadwa cha nyama:

Biogulin Tape U-40 (Brazil),

Ultratard NM (Denmark, India).

4) NPH-insulin yosakaniza

Izi ndizophatikiza, zomwe zimayimira chisakanizo cha ma insulin osakhalitsa ndi nthawi yaying'ono. Zomwe akuchita ndizofunikira kwambiri, makamaka, nsonga yoyamba chifukwa cha insulin yochepa, yachiwiri - insulin. Zosakaniza zokhazikika zopangidwa kale zimapezeka m'matumba (ma penfillas) a zolembera, koma mutha kusankha gawo la zosakaniza zanuzomwe mungazisinthe pazofunikira za wodwalayo. Manambala omwe amapezeka m'mazina a insulin amatanthauza kufunsa.

Humulin MZ (France)

Mikstard 10-50 NM Penfill (Denmark)

Insuman Comb (France / Germany)

Opanga otsogola amakono kukonzekera insulin: Eli Lilly (USA), Novo Nordisk (Denmark), Aventis (Hochst Marion Roussel) (France / Germany).

Kuti athandizidwe ndi odwala omwe ali ndi matenda a shuga, kuphatikiza ndi insulin m'mbale, zolembera za syringe zimaperekedwa, momwe zitini zimadzazidwa ndikusinthidwa mutatha kuzigwiritsa ntchito (mu mayina a insulin pali syllable "cholembera"), ndi ma syringe omwe amapangidwa kale momwe amapangira zolembera (amatayika pokhapokha atagwiritsidwa ntchito) . Ma singano omwe amapezeka m'makola a syringe ndi ocheperako ndipo amakhala ndi lakuthwa kwambiri laser, zomwe zimapangitsa kuti jakisoni asakhale lopweteka. Mu penfillas mumakhala insulin yosakanikika (yokhazikika kwa masiku 30), motero wodwalayo amatha kunyamula mthumba. Milandu imapereka odwala kwaulere chifukwa chofunikira kunyamula ma syringes ndi ma sterilizer, omwe amasintha kwambiri moyo.

Ma laboratories ambiri ofufuza akupanga maphunziro kuti apange kukonzekera kwa insulin kwa makonzedwe osakhala a kholo. Makamaka, mu 1998 kunabwera uthenga wokhudza mtundu wa inhalation wa insulin ("diabetesic inhalation system"). Komanso, kuyambira 1999, kukonzekera kwa insulin mkamwa - hexilinsulin - agwiritsidwa ntchito poyesa.

Mankhwala amkamwa ochizira matenda a shuga amatchedwa insulin-kusunga mankhwala ndikuchepetsa magazi.

Kugawidwa kwa mankhwala ochepetsa shuga a pakamwa ndi machitidwe a mankhwala ndi mankhwala awo malinga ndi INN akuwonetsedwa

Kuphatikiza kwamake amkamwa hypoglycemic wothandizira

Mankhwala a Sulfonylurea amalimbikitsa katulutsidwe ka insulin, amkati, zochita zawo ndizosiyana, koma zotsatira zake zimakhala zofanana. Chithunzi 61 chikuwonetsa ntchito zazikulu za INN za mankhwala ochepetsa shuga a zotumphukira za sulfonylurea.

Kuchepetsa shuga S ndikuchokera ku sulfonylureas

Mibadwo yomwe ndimagwiritsa ntchito m'badwo I sulfonylurea yomwe yakhala ikugwiritsidwa ntchito pochiza matenda ashuga kuyambira 60s imaphatikizapo zinthu izi: Carbutamide (INN) - tabu. Cn B Bukarban (Hungary), Chlorpronamide (INN) - tabu. Cn B (Poland, Russia). Pa msika wogulitsa mankhwala pamakhala mankhwala ambiri - omwe amachokera mu mibadwo iwiri:

Glibenclamide (INN) - mankhwala oyamba a m'badwo wa 2, pamsika kuyambira 1969, tabu. Cn B. Pali mayina 21 amalonda a Glibenclamide pamsika wamankhwala, kuphatikiza Gilemal (Hungary), Glibenclamide (Russia, Germany, etc.), Daonil (Germany, India), Maninil (Germany), ndi ena.

Glyclazide (INN) - tabu. Cn B. (Switzerland, India), Glidiab (Russia), Diabeteson (France), ndi zina zambiri.

Glipizide (INN) - tabu. Cn B. Minidiab (Italy), Glibenez (France).

Glycvidone (INN) - tabu. Cn B. Glurenorm (Austria). Glidifen (alibe INN) - tabu. Cn B (Russia). Kuyambira 1995, mankhwala omwe amapezeka mu 3 m'badwo wa sulfonylurea akhazikitsidwa pamsika wapadziko lonse wamankhwala:

Glimeniride (INN) —tab. Cn B. Amaril (Germany). Ndi mphamvu yochepetsera shuga, imakhala yolimba kuposa zotumphukira za m'badwo wa 2, imatengedwa nthawi imodzi patsiku.

Kuyambira m'ma 50's. biguanides anaphatikizidwa ndi kuchuluka kwa mankhwala amkamwa ochizira matenda a shuga. Mulinso zinthu ziwiri zomwe zimagwira, kuphatikiza: Buformin (INN) - dragee, Sp. B. Silubin-retard (Germany), Metformin (INN) - amalepheretsa kupanga kwa glucose pazinthu zopanda mafuta mu chiwindi, amachepetsa kuyamwa kwa chakudya

Dov m'matumbo (adawoneka pamsika wama US ku 1994), tabu. Cn B (Poland, Croatia, Denmark), Gliformin (Russia), Glyukofag (France), Siofor (Germany), ndi ena.

Gulu la alpha-glucosidase inhibitors limaphatikizapo Acarbose (INN), lopangidwa ku Germany pansi pa dzina lazamalonda Gluco-buy, and Miglitol (INN) - Diastabol (Germany). Kapangidwe ka zochita zawo ndikuchepetsa kuchepa kwa mafuta omwe amalowa mthupi kukhala mashuke osavuta (glucose, fructose, lactose). Kumwa mankhwalawa sikalowa m'malo mwa insulin, koma ndi njira ina yothandizira matenda a shuga a 2. Amawerengera odwala ngati kugwiritsa ntchito zakudya sikupangitsa kuti magazi azikhala ndi shuga.

Zochita zofananira pokonzekera sulfonylurea ya m'badwo wachiwiri, koma omwe ali m'gulu lamankhwala omwe amachokera ku carbamoylbenzoic acid, amapatsidwa mphamvu ndi prandial glycemic regators:

Repaglinide (INN) - tabu. Cn B NovoNorm (Denmark),

Nateglinide (INN) - tabu., Starlix (Switzerland).

Mankhwalawa amateteza maselo a beta a pancreatic kuti asatope kwambiri, amadziwika ndi kukonza mwachangu kuti achepetse gawo la postprandial glycemia.

Mwa mankhwala atsopano, ma insulin sensitizer, omwe amapezeka pamsika wamankhwala ku USA ndi Japan mu 1997, ndi glitazones kapena thiazolidinedones. Gulu latsopanoli la zinthu limapereka chidziwitso chabwino chowonjezera kukoka kwa glucose m'misempha yotumphukira ndikuwongolera kagayidwe popanda kuwonjezera kufunika kwa insulin. Komabe, mankhwalawa ali ndi zovuta zina. Mankhwalawa akuphatikizapo:

Rosiglitazone (INN) - tabu., Avandia (France),

Pioglitazone (INN) - tabu., Aktos (USA).

Madokotala akufuna mawonekedwe a msika wogulitsa mankhwala ophatikizira am'kati mwa hypoglycemic, zomwe zimathandiza wodwala kuti azitha kupereka mankhwalawa pogwiritsa ntchito njira zosiyanasiyana. Kuphatikiza apo, monga lamulo, pakuphatikiza, ndizotheka kuchepetsa mlingo wa magawo a anthu, mwakutero kufooketsa mavuto. Mitundu yambiri ya mankhwalawa pamsika waku Russia mpaka pano ikuyimiriridwa ndi mankhwala amodzi:

Glibomet - ili ndi glibenclamide ndi metformin, tabu. (Italy).

Othandizira azitsamba a hypoglycemic akuphatikiza pamodzi. Arfabenii - imakhala ndi mphukira zamagulu abulu, zipatso za nyemba wamba, muzu wa Aralia wa Manchurian kapena

rhizome ndi mizu ya yesero, ananyamuka m'chiuno, mahatchi, St. wort wa St. John, maluwa a chamomile (Russia, Ukraine).

Mu shuga mellitus, mbewu zotsatirazi zingagwiritsidwe ntchito: Aralia, muzu wa Manchurian, tinolo wa Aralia, Psoralei, zipatso zamiyala, ndi zina zambiri.

M'zaka zaposachedwa, mankhwala atsopano awoneka pamsika wamankhwala - Glucagon, wotsutsana ndi insulin, yomwe ndi hormone ya protein-peptide yomwe ikukhudzidwa ndi kayendedwe ka kagayidwe kazachilengedwe. Amagwiritsidwa ntchito pazovuta kwambiri za hypoglycemic zomwe zimapezeka mwa odwala omwe ali ndi matenda osokoneza bongo pambuyo pa jakisoni wa insulin kapena mankhwala amkamwa.

Glucagon (INN) ndi ufa wa lyophilized. ndi zosungunulira jakisoni. Cn B. Gluka, Gene HypoKit (Denmark).

Mfundo za gulu la kukonzekera kwa insulin

Zokonzekera zamakono zonse za insulin, zomwe zimapangidwa ndi makampani opanga mankhwala padziko lonse lapansi, zimasiyana m'njira zingapo. Zomwe zimapangitsa kuti gulu la insulin lipangidwe ndi:

chiyambi
kuthamanga kolowera pakulowetsedwa mthupi ndi nthawi yayitali yothandizirana,
kuyera kwa mankhwalawa komanso njira yodziyeretsera timadzi tambiri.

Kutengera ndi chiyambi, gulu la insulin limakonzekera:

Zachilengedwe - biosynthetic - Mankhwala achilengedwe achilengedwe opangidwa pogwiritsa ntchito kapamba amakondera ng'ombe. Njira zoterezi zimapangidwira matepi a insulin GPP, ultralente MS. Actrapid insulin, insulrap SPP, monotard MS, semilent ndi ena amapangidwa pogwiritsa ntchito nkhumba kapamba.
Zopangira kapena mitundu ya mankhwala a insulin. Mankhwalawa amapangidwa pogwiritsa ntchito njira zopangira ma genetic. Insulin imapangidwa pogwiritsa ntchito ukadaulo wa DNA recombinant. Njirayi imapangitsa insulin monga actrapid NM, homofan, isofan NM, humulin, ultratard NM, monotard NM, etc.

Kutengera njira zakudziyeretsa komanso kuyera kwa mankhwala omwe amayambitsidwa, insulin imasiyanitsidwa:

crystallized komanso osatchulidwa - ruppa imaphatikizapo ambiri a insulin yachikhalidwe. Zomwe zidapangidwa kale ku gawo la Russian Federation, pakadali pano gululi la mankhwala silipangidwa ku Russia,
osasefa komanso osasefedwa ndi miyala, makonzedwe a gululi ndi amodzi kapena amodzi.
crystallized ndikuyeretsedwa pogwiritsa ntchito ma gels ndi ion kusinthana ndi ma chromatography, ma monocomponent othandizira ali m'gululi.

Gulu la crystallized ndi kusefedwa ndi ma cell sieves and ion-exchange chromatography limaphatikizapo Actrapid, Insulrap, Actrapid MS, Semilent MS, Monotard MS ndi Ultralent MS insulin.

Gulu la mankhwala kutengera nthawi yomwe akuyamba kugwira ntchito ndi nthawi yayitali

Kugawika malinga ndi kuthamanga ndi kutalika kwa zochita za insulin zimaphatikizapo magulu otsatirawa a mankhwalawa.

Mankhwala osokoneza bongo omwe ali mwachangu komanso mwachidule. Gululi limaphatikizapo mankhwala monga Actrapid, Actrapid MS, Actrapid NM, Insulrap, Homorap 40, Insuman Rapid ndi ena ambiri. Kutalika kwa mankhwalawa kumayambira mphindi 15-30 pambuyo pa kumwa mankhwala kwa wodwala matenda a shuga. Kutalika kwa mankhwalawa kumawonedwa kwa maola 6-8 pambuyo pa kubayidwa.

Mankhwala okhala ndi nthawi yayitali yochitapo kanthu. Gulu la mankhwalawa limaphatikizapo Semilent MS, - Humulin N, tepi ya Humulin, Homofan, - tepi, tepi ya MS, Monotard MS. Mankhwala omwe ali mgululi a insulin amayamba kuchita 1-2 patatha jakisoni, mankhwalawa amatha kwa maola 12-16. Gululi limaphatikizaponso mankhwala monga Iletin I NPH, Iletin II NPH, Insulong SPP, insulin tepi GPP, SPP, yomwe imayamba kugwira ntchito patatha maola 2-4 jekeseni. Ndipo kutalika kwa nthawi ya insulin m'gulu lino ndi maola 20-24.

Mankhwala ovuta, omwe amaphatikizapo insulin zapakatikati ndi insulin yochepa. Ma protein omwe ali m'gululi amayamba kuchita mphindi 30 pambuyo pobweretsa matenda a shuga mthupi la munthu, ndipo nthawi yovuta imeneyi imachokera ku maola 10 mpaka 24. Kukonzekera kovuta kumaphatikizapo Aktrafan NM, Humulin M-1, M-2, M-3, M-4, insuman comb. 15/85, 25/75, 50/50.

Mankhwala okhalitsa. Gawoli limaphatikizapo zida zamankhwala zomwe zimakhala ndi moyo wogwira ntchito mthupi kuyambira maola 24 mpaka 28. Gulu ili la zida zachipatala limaphatikizapo ultralente, ultralente NM, insulin super SPI, humulin ultralente, ultratard NM.

Kusankha kwa mankhwala ofunikira chithandizo kumachitika ndi endocrinologist chifukwa cha zotsatira za kuyesedwa kwa thupi la wodwalayo.

Makhalidwe aanthawi yochepa

Ubwino wogwiritsa ntchito ma insulin osakhalitsa ndi awa: zochita za mankhwalawa zimachitika mwachangu kwambiri, zimapereka chiwopsezo pamagazi ambiri ofanana ndi thupi, zochita za insulin sizikhala zazifupi.

Choipa cha mtundu uwu wa mankhwala ndi nthawi yochepa yochita zawo. Nthawi yochepa yofunikira imafunikira insulin mobwerezabwereza.

Zizindikiro zazikulu zakugwiritsira ntchito ma insulin osakhalitsa ndizotsatirazi:

Chithandizo cha anthu omwe amadwala matenda a shuga a insulin. Mukamagwiritsa ntchito mankhwalawa, kayendetsedwe kake ndi kosasangalatsa.
Chithandizo cha mitundu yayikulu ya odwala omwe alibe insulin amadalira achikulire.
Ngati wodwala matenda ashuga hyperglycemic chikachitika. Mukamachita mankhwala a mankhwalawa, mankhwalawa amaperekedwa pang'onopang'ono komanso m'mitsempha.

Kusankha kwa mlingo wa mankhwalawa ndi nkhani yovuta ndipo imachitika ndi endocrinologist. Mukafuna kudziwa kuchuluka kwake, muyenera kuganizira momwe thupi la wodwalayo lilili.

Njira imodzi yosavuta yowerengetsera kuchuluka kwa mankhwalawa ndikuti 1 gramu ya shuga mkodzo iyenera kuphatikizidwa ndi 1U ya mankhwala okhala ndi insulin. Jakisoni woyamba wa mankhwala amachitika moyang'aniridwa ndi dokotala pachipatala.

Kutalika kwa insulin mawonekedwe

Kapangidwe ka insulin ya nthawi yayitali kumaphatikiza mapuloteni angapo komanso buffer yamchere, yomwe imakupatsani mwayi wokhala ndi kuyamwa pang'onopang'ono komanso nthawi yayitali ya mankhwala m'thupi la wodwalayo.

Mapuloteni omwe amapanga mankhwalawa ndi protamine ndi globin, ndipo zovuta zimakhala ndi zinc. Kukhalapo kwa zinthu zowonjezera pakukonzekera kosavuta kumasinthira kanthu pachimake pa nthawi yake. Kuyimitsidwa kumatenga pang'onopang'ono, ndikupereka insulin yochepa m'magazi a wodwalayo kwanthawi yayitali.

Ubwino wogwiritsa ntchito mankhwala osakhalitsa

kufunika kwa jekeseni ochepera m'thupi la wodwalayo,
kupezeka kwa pH yayikulu mu mankhwalawa kumapangitsa kuti jakisoni asamapweteke.

Zovuta zakugwiritsa ntchito gululi ndi:

kusowa kwa nsonga pogwiritsa ntchito mankhwalawa, omwe samalola kugwiritsa ntchito gululi la mankhwalawa pochiza mitundu yayikulu ya matenda ashuga, mankhwalawa amagwiritsidwa ntchito pokhapokha ngati pali mitundu yofooka ya matendawa.
Mankhwala saloledwa kulowa mitsempha, kuyambika kwa mankhwalawa mthupi ndi jekeseni wamkati kungayambitse kukula kwa embolism.

Masiku ano, pali mitundu yambiri ya mankhwala okhala ndi insulin omwe amakhala nthawi yayitali. Kubweretsa ndalama kumachitika pokhapokha pobaya jekeseni wa subcutaneous.

Mitundu ya insulin ndi njira zamtundu wa insulin zothandizira matenda ashuga

Munkhaniyi muphunzira:

Ndi matenda monga matenda a shuga, muyenera kumwa mankhwala pafupipafupi, nthawi zina jakisoni wa insulin ndiye njira yokhayo yoyenera. Masiku ano, pali mitundu yambiri ya insulin ndipo wodwala aliyense amene ali ndi matenda ashuga ayenera kudziwa mitundu iyi ya mankhwalawa.

Mu shuga mellitus, kuchuluka kwa insulini (mtundu 1) kumachepetsedwa, kapena kumva mphamvu ya minofu kupita ku insulin (mtundu 2), ndipo chithandizo chamankhwala cholimbitsa thupi chimagwiritsidwa ntchito pothandiza kuthana ndi shuga.

Kanema (dinani kusewera).

Mtundu woyamba wa matenda ashuga, insulin ndiye chithandizo chokhacho. Mtundu wachiwiri wa matenda ashuga, mankhwalawa amayamba ndimankhwala ena, koma m'mene matenda amapitilira, jakisoni wa mahomoni nawonso amadziwikanso.

Mwa chiyambi, insulin ndi:

Nkhumba. Amachotsedwa m'matumbo a nyama izi, zofanana kwambiri ndi munthu.
Kuchokera kwa ng'ombe. Nthawi zambiri pamakhala zovuta zina za insulin iyi, chifukwa zimasiyana kwambiri ndi ma cell aanthu.
Wamunthu Amagwiritsa ntchito mabakiteriya.
Umisiri wamtundu. Zimapezeka kuchokera ku nkhumba, pogwiritsa ntchito matekinoloje atsopano, chifukwa cha izi, insulin imakhala yofanana ndi anthu.

Pofika nthawi:

zochita za ultrashort (Humalog, Novorapid, etc.),
zochita zazifupi (Actrapid, Humulin Regular, Insuman Rapid ndi ena),
nthawi yayitali yochita (Protafan, Insuman Bazal, etc.),
wogwira ntchito kwa nthawi yayitali (Lantus, Levemir, Tresiba ndi ena).

Ma insulin afupia ndi a ultrashort amagwiritsidwa ntchito musanadye chilichonse kuti apewe kulumikizana ndi glucose komanso kusintha momwe mulili. .

Kumbukirani kuti kufulumira kwa mankhwalawa kumayamba, kufupikitsa nthawi yake yochitapo kanthu. Ma insulin osakhalitsa pang'ono amayamba kugwira ntchito pambuyo pakudya kwa mphindi 10, chifukwa chake ayenera kugwiritsidwa ntchito musanayambe kudya kapena atangodya. Amakhala ndi mphamvu kwambiri, pafupifupi nthawi ziwiri mwamphamvu kuposa mankhwala osokoneza bongo. Kutsitsa kwa shuga kumatenga pafupifupi maola atatu.

Mankhwalawa sagwiritsidwa ntchito kawirikawiri pachipatala chovuta kwambiri cha matenda ashuga, chifukwa momwe amawagwirira ntchito osalamulirika ndipo zotsatira zake zimakhala zosadalirika. Koma ndizofunikira ngati wodwala matenda ashuga adadya, ndikuyiwala kulowa insulin yochepa. Mothandizidwa ndi izi, jakisoni wa mankhwala a ultrashort amathetsa vutoli ndikuwonjezera msanga shuga.

Insulin yogwira ntchito yayifupi imayamba kugwira ntchito pambuyo pa mphindi 30, imaperekedwa kwa mphindi 15-20 musanadye. Kutalika kwa ndalamazi ndi pafupifupi maola 6.

Ndondomeko ya insulin

Mlingo wa mankhwala ochitika msanga amawerengedwa ndi dokotala, ndipo amakuphunzitsani za wodwalayo ndi njira ya matendawa. Komanso, mankhwalawa omwe angagwiritsidwe ntchito amatha kusinthidwa ndi wodwala malinga ndi kuchuluka kwa mkate womwe wagwiritsidwa ntchito. 1 unit yaifupi yogwira insulin imayambitsidwa pa 1 mkate. Kuchuluka kovomerezeka komwe kungagwiritsidwe ntchito kamodzi ndi gawo limodzi pa kilogalamu imodzi ya kulemera kwa thupi, ngati izi zatheka.

Kukonzekera kwapafupipafupi ndi ultrashort kumayendetsedwa mosadukiza, ndiko kuti, m'minyewa yamafupipafupi yamafuta, izi zimapangitsa kuti magazi azilowa pang'onopang'ono komanso mofananirana.

Kuti muwerenge molondola kuchuluka kwa insulin yochepa, ndikofunikira kuti odwala matenda ashuga asungireko diary komwe chakudya chimawonjezera (kadzutsa, nkhomaliro, etc.) akusonyeza, shuga atatha kudya, mankhwala omwe adathandizidwa ndi jekeseni ya shuga pambuyo pobayira. Izi zithandiza wodwalayo kuzindikira momwe mankhwalawo amakhudzira glucose makamaka mwa iye.

Ma insulin afupia ndi a ultrashort amagwiritsidwa ntchito pothandizidwa mwadzidzidzi pokonzekera ketoacidosis. Pankhaniyi, mankhwalawa amaperekedwa kudzera m'mitsempha, ndipo zimachitika nthawi yomweyo. Zotsatira zake mwachangu zimapangitsa mankhwalawa kukhala othandizira othandizira madokotala azadzidzidzi komanso malo othandizira odwala kwambiri.

Zokonzekera zonse za insulin zopangidwa ndi makampani opanga mankhwala padziko lapansi zimasiyana makamaka m'njira zitatu zazikulu:

1) Zoyambira,

2) potengera kuthamanga kwa zotsatira ndi nthawi yawo,

3) molingana ndi njira ya kuyeretsa komanso kuchuluka kwa kuyera kwamakonzedwe.

I. Poyambirira kusiyanitsa:

a) zachilengedwe (zachilengedwe), zachilengedwe, zamankhwala okonzera insulin zopangidwa kuchokera ku zikondamoyo, mwachitsanzo, tepi ya insulini GPP, ultralente MS ndi nkhumba zambiri (mwachitsanzo, actrapid, insulrap SPP, monotard MS, semilent, etc.),

b) zopangidwa kapena, ndendende, mitundu yapadera, ma insuline a anthu. Mankhwalawa amapezeka pogwiritsa ntchito njira zopangira ma genetic kudzera muukadaulo wa maumboni a DNA, chifukwa chake amatchedwa DNA recombinant insulin kukonzekera (actrapid NM, homofan, isofan NM, humulin, ultratard NM, monotard NM, etc.).

II. Malinga ndi njira yoyeretsera komanso kuyera kwa mankhwalawa amadziwika:

a) crystallized (oyeretsedwa bwino), koma osasankhidwa - awa ndi ambiri mwazomwe zimatchedwa "zachikhalidwe" za insulin zomwe zimapangidwa kale m'dziko lathu (insulin), koma osaleka,

b) crystallized ndi kusefedwa kudzera miyala ("molekyulu sieve") - otchedwa osakwatiwa kapena mono-nsonga insulins (actrapid, insulrap, etc.),

c) crystallized ndi oyeretsedwa kudzera "molekyulu sieve" ndi ion kusinthana chromatography

- otchedwa monocompitute insulins (actrapid MS, semilent MS, monotard MS, ultralent MS).

Ma crystallized, koma ma insulin osasinthidwa ndi chromat, ali ngati lamulo, lomwe limachitika mwadzidzidzi kukonzekera kwa insulin. Amakhala ndi zosayambitsa zosiyanasiyana m'njira yama mamolekyu a proinsulin, glucagon, C-peptide (omanga Ai B-unyolo wa proinsulin), somatostatin ndi mapuloteni ena. Pokonzekera izi, zomwe zili mu proinsulin ndizoposa ma 10,000 ma miliyoni miliyoni.

Kukonzekera kwambiri kwa insulini (mwa kusefa kudzera m'matumbo), kotchedwa monopic, popeza nsonga imodzi yokha imawoneka pa chromatogram, imakhala ndi zosakwana 3000 (kuyambira 50 mpaka 3000), komanso zina zowonjezera bwino za monocomponent - zosakwana tinthu tating'onoting'ono tokwana 10 miliyoni. Kukonzekera monocomponent kukukhala kofunikira. III. Kuthamanga kwa zoyambira zamtsogolo ndi nthawi yayitali kusiyanitsa:

a) mankhwala osokoneza bongo (actrapid, actrapid NM, insulrap, homeopath 40, insuman mwachangu, etc.). Kukhazikika kwa mankhwalawa kuli mwa mphindi 15-30, kutalika kwa maola ndi maola 6-8,

b) mankhwala a nthawi yayitali kuchitira (kuyambika kwa pambuyo pa maola 1-2, kutalika kwa zotulukazo ndi maola 12-16), - MS selente, - Humulin N, tepi ya humulin, homofan, - tepi, MS tepi, MS monotard (2-4 maola ndi maola 20-24 motsatana),

- Iletin I NPH, Iletin II NPH,

- insulong SPP, insulin tepi GPP, SPP, etc.

c) mankhwala a nthawi yayitali osakanikirana ndi insulin yochepa: (koyamba kwa mphindi 30, nthawi 10 mpaka 24),

- Humulin M-1, M-2, M-3, M-4 (kutalika kwa nthawi mpaka maola 12-16),

- insuman chip. 15/85, 25/75, 50/50 (zolondola kwa maola 10-16).

g) mankhwala omwe akhala akuchita kwa nthawi yayitali:

- tepi yapamwamba kwambiri, tepi ya Ultra, TM yapamwamba kwambiri (mpaka maola 28),

- insulin superlente SPP (mpaka maola 28),

- Humulin ultralente, ultratard NM (mpaka maola 24-28).

ACTRAPID, yochokera ku masamba a beta a pancreatic inguluwe, imapangidwa ngati njira yokonzekera mabotolo 10 ml, nthawi zambiri imakhala ndi zochitika za 40 PIECES mu 1 ml. Imaperekedwa ndi makolo, nthawi zambiri pansi pa khungu. Mankhwalawa (monga mankhwala onse amtundu wocheperako wa insulin) amatha msanga kuchepetsa shuga. Zotsatira zimayamba pambuyo pa mphindi 15 mpaka 20, ndipo nsonga yogwira ntchito imadziwika pambuyo pa maola 2-4. Kutalika konse kwa zotsatira za hypoglycemic ndi maola 6-8 mwa akulu, ndi kwa ana mpaka 8-10 maola.

Ubwino wa mankhwala osakhalitsa a insulin (actrapid):

1) Chitapo kanthu mwachangu

2) perekani ndende yokhudza thupi

3) Chitani mwachidule.

Choyipa chachikulu ndikutalika kwa nthawi, komwe pamafunika kubayidwa mobwerezabwereza. Zisonyezero zogwiritsira ntchito insulin yokonzekera:

1. Chithandizo cha odwala omwe amadwala matenda a shuga a insulin. Mankhwalawa amaperekedwa pansi pa khungu.

2. M'mitundu yoopsa kwambiri yamankhwala osokoneza bongo omwe samatengera insulin mwa akulu.

3. Ndi matenda ashuga (hyperglycemic). Potere, mankhwalawa amaperekedwa pansi pa khungu komanso m'mitsempha.

Mlingo wa insulin ndi funso lovuta kwambiri, chifukwa kusankha kwa Mlingo ndikofunikira.

Njira imodzi yachangu kwambiri yowerengetsera kuchuluka kwa insulin ndikulowa gawo limodzi la insulin pa gramu imodzi ya shuga mkodzo wa wodwalayo. Jakisoni woyamba wa insulin komanso kusankha bwino kwa mankhwalawa amachitidwa kuchipatala. Nthawi yomweyo, amayesetsa kuti asankhe mtundu wina wa mankhwala, koma ena. Wodwalayo amalamula kuti adye chakudya chonse kwa sabata limodzi.

4. Nthawi zambiri, mankhwalawa amagwiritsidwa ntchito ngati anabolic othandizira ana omwe ali ndi vuto logona kwambiri. Pankhaniyi, mankhwalawa amaperekedwa pansi pa khungu kuti azilimbitsa mtima.

Malinga ndi chiwonetserochi, mankhwalawa amagwiritsidwa ntchito mwa odwala omwe ali ndi kuchepa kwa zakudya m'thupi, kuperewera kwa zakudya m'thupi, furunculosis, thyrotooticosis, kusanza, ndi matenda a chiwindi.

5. Mankhwala osokoneza bongo amatha kukhala gawo la chisakanizo cha polarum (potaziyamu, glucose, ndi insulin) kukhalabe ndi vuto la mtima m'magazi (pamene zochitika za hypocalysis zimachitika, mwachitsanzo, pakamwa ndi mtima wamtima glycosides).

6. M'chipatala cha amisala, mankhwalawa adagwiritsidwa ntchito kale pochiritsa odwala omwe ali ndi schizophrenia (pokhutiritsa kukomoka kwa hypoglycemic). Tsopano umboniwu mulibe, popeza pali mankhwala ambiri a psychotropic.

7. Mankhwala osokoneza bongo amasonyezedwa kwa odwala omwe samadalira insulin omwe amadalira shuga nthawi yayitali, popeza othandizira a hypoglycemic alibe zotsatira za teratogenic.

8. Anthu omwe ali ndi matenda osokoneza bongo omwe samadalira insulin panthawi yamatumbo komanso njira zina zazikulu zopangira opaleshoni, omwe ali ndi matenda opatsirana.

Kuphatikiza pa insulin yokonzekera mwachidule komanso mwachangu, zochita za insulin nthawi yayitali zimabisidwa. Kupezeka kwa mapuloteni akuluakulu pokonzekera izi - protamine ndi globin, zinc, komanso buffer yamchere imasintha kuchuluka kwa kuyambika kwa hypoglycemic zotsatira, nthawi yochita zambiri, mwachitsanzo, kuchuluka kwa kuchitapo kanthu komanso nthawi yayitali yochitapo kanthu. Chifukwa cha kusakaniza koteroko, kuyimitsidwa kumapezeka, komwe kumakumwa pang'onopang'ono, ndikukhalabe ndi mlingo wochepa wa mankhwalawa m'magazi kwa nthawi yayitali. Tsopano pali zokonzekera zambiri za insulin (onani gulu). Mankhwalawa onse amaperekedwa kokha.

Ubwino wokonzekera insulin yayitali:

1) mankhwala amaperekedwa kawiri kapena kamodzi patsiku,

2) mankhwalawa amakhala ndi pH yayikulu, yomwe imapangitsa kuti jakisoni wawo asakhale wowawa komanso insulini imagwira ntchito mwachangu.

1) kusowa kwa chiwonetsero cha thupi, chomwe chimatanthawuza kuti mankhwalawa sangaperekedwe kwa odwala omwe ali ndi matenda oopsa a shuga ndipo ayenera kugwiritsidwa ntchito pamafomu ochepera komanso odziletsa,

2) Mankhwala sayenera kubayidwa m'mitsempha (kupewa embolism),

Kukonzekera kwa insulin: mayina, pharmacology ndi limagwirira zake

International Diabetes Federation ilosera kuti podzafika 2040 kuchuluka kwa odwala matenda a shuga kudzakhala anthu pafupifupi 624 miliyoni. Pakadali pano, anthu 371 miliyoni ali ndi matendawa. Kufalikira kwa matendawa kumalumikizidwa ndi kusintha kwa chikhalidwe cha anthu (moyo wokhalitsa, wambiri, kusowa zochita zolimbitsa thupi) komanso zosokoneza zakudya (kugwiritsidwa ntchito kwa mankhwala apamwamba ogulitsa mafuta azinyama).

Anthu akhala akudziwa za matenda ashuga kwa nthawi yayitali, koma kupezeka kwamankhwala omwe amathandizira matendawa kunachitika zaka zana zapitazo, pomwe matendawa adatha muimfa.

Mbiri ya zomwe zapezeka komanso kupanga insulin yochita kupanga

Mu 1921, dokotala waku Canada Frederick Bunting ndi womthandizira, wophunzira zachipatala, a Charles Best, adayesetsa kupeza kulumikizana pakati pa kapamba ndi kuyamba kwa matenda ashuga. Pazofufuza, pulofesa ku Yunivesite ya Toronto, a John MacLeod, adawapatsa ma labotale okhala ndi zida zofunika ndi agalu 10.

Madotolo adayamba kuyeserera kwawo ndikuchotsa zikwanirizo mu agalu ena, kupumulirako adamanga ma ducts amachikondwerero asanachotsedwe. Kenako, chiwalo cha atrophied chimayikidwa kuti chisazizidwe mu njira ya hypertonic. Pambuyo pa thawing, mankhwala omwe amapezeka (insulin) amaperekedwa kwa nyama yokhala ndi chofufumitsa komanso chipatala cha matenda a shuga.

Zotsatira zake, kuchepa kwa shuga m'magazi ndikusintha kwa magwiridwe antchito ndi galu. Zitatha izi, ofufuzawo adaganiza zoyesa kutulutsa insulini kuchokera ku zikondamoyo za ng'ombe ndipo adazindikira kuti mutha kuchita popanda kunyamula mitsempha.Njirayi sinali yophweka komanso yotenga nthawi.

Bunting ndi Best adayamba kuyeseza anthu nawonso. Chifukwa cha mayeso azachipatala, onse awiri adamva chizungulire komanso ofooka, koma padalibe zovuta zakumwa ndi mankhwalawo.

Mu 1923, Frederick Butting ndi John MacLeod adalandira Mphotho Nobel chifukwa cha insulin.

Kukonzekera kwa insulini kumapezeka kuchokera ku zopangidwa ndi nyama kapena anthu. Poyambirira, kapamba wa nkhumba kapena ng'ombe amagwiritsidwa ntchito. Nthawi zambiri amayambitsa ziwengo, motero akhoza kukhala owopsa. Izi ndizofunikira makamaka kwa inshuwaransi ya bovine, kapangidwe kake kamasiyana kwambiri ndi anthu (ma amino acid m'malo mwa amodzi).

Pali mitundu iwiri ya insulin yakonzekereratu:

opanga
chimodzimodzi ndi anthu.

Insulin yaumunthu imapezeka pogwiritsa ntchito njira zopangira ma genetic. kugwiritsa ntchito michere ya yisiti ndi E. coli bacteria bacteria. Ndizofanana ndendende ndi mahomoni opangidwa ndi kapamba. Apa tikulankhula za kusintha kwa majini a E. coli, omwe amatha kupanga insulini yopangidwa ndi chibadwa cha anthu. Insulin Actrapid ndiye mahomoni oyamba kupezeka mwaukadaulo wa majini.

Zosiyanasiyana insulin pochiza matenda ashuga amasiyana wina ndi mzake m'njira zingapo:

Kutalika kwa nthawi.
Kuthamanga kwa zochita pambuyo pa kupatsidwa mankhwala.
Njira yotulutsira mankhwala.

Malinga ndi nthawi yowonekera, kukonzekera kwa insulin ndi:

ultrashort (othamanga)
mwachidule
lalitali
lalitali
kuphatikiza

Mankhwala a Ultrashort (insulin apidra, insulin humalog) amapangidwa kuti azitha kuchepetsa shuga m'magazi. Zimayambitsidwa musanadye, zomwe zimachitika pang'onopang'ono mkati mwa mphindi 10-15. Pambuyo maola angapo, mphamvu ya mankhwalawa imayamba kugwira ntchito kwambiri.

Mankhwala osokoneza bongo mwachidule (insulin Actrapid, insulin mwachangu)amayamba kugwira ntchito theka la ola pambuyo pa makonzedwe. Kutalika kwawo ndi maola 6. Ndikofunikira kupatsa insulin mphindi 15 musanadye. Izi ndizofunikira kuti nthawi yakudya michere m'thupi igwirizane ndi nthawi yovutikira mankhwalawa.

Kuyamba mankhwala apakatikati (insulin protafan, insulin humulin, insulin basal, insulin yatsopano yosakanikirana) sizitengera nthawi yakudya. Nthawi yowonetsedwa ndi maola 8-12anayamba kukhala okangalika patatha maola awiri jekeseni.

Kutalika kwambiri (pafupifupi maola 48) kwa thupi kumapangidwa ndi mtundu wautali wa kukonzekera kwa insulin. Imayamba kugwira ntchito maola anayi mpaka asanu ndi atatu pambuyo pa utsogoleri (tresiba insulin, flekspen insulin).

Kukonzekera kosakanikirana ndi kusakanikirana kwa ma insulin osiyanasiyana kutulutsa. Kuyamba kwa ntchito yawo kumayamba theka la ola jakisoni, ndipo kutalika kwa ntchito ndi maola 14-16.

Mwambiri, munthu amatha kusiyanitsa zabwino za fanizo monga:

kugwiritsa ntchito njira zopanda ndale, osati zama acid,
ukadaulo wosinthasintha wa DNA
kutuluka kwachuma chatsopano mu zamankhwala zamakono.

Mankhwala onga a insulin amapangidwa ndikusinthanso ma amino acid kuti athandize kugwiritsa ntchito bwino mankhwala, mayamwidwe awo ndi kutulutsa kwawo. Ayenera kupitilira insulini ya anthu pazinthu zonse ndi magawo:

Mankhwala (mapiritsi a insulin kapena jakisoni), komanso muyezo wa mankhwalawa ayenera kusankhidwa kokha ndi katswiri woyenera. Kudzichiritsa nokha kumangokulitsa matendawa ndikuwapanikiza.

Mwachitsanzo, kuchuluka kwa insulin kwa odwala omwe ali ndi matenda a shuga a 2 kuwongolera shuga akhale akulu kuposa a 1 matenda ashuga. Nthawi zambiri, insulin ya botus imaperekedwa ngati kukonzekera kwakanthaŵi kwa insulin kumagwiritsidwa ntchito kangapo patsiku.

Lotsatira ndi mndandanda wa mankhwala omwe amagwiritsidwa ntchito kwambiri pochiza matenda ashuga.

Gulu la insulin malinga ndi nthawi ya ntchito: tebulo ndi mayina

Insulin ndi mahomoni a protein-peptide omwe amapangidwa ndi maselo a pancreatic beta.

Molekyulu ya insulin m'mapangidwe ake imakhala ndi maunyolo awiri a polypeptide. Chingwe chimodzi chimakhala ndi ma amino acid 21, ndipo chachiwiri chimakhala ndi ma amino acid 30. Zomangira zimalumikizidwa pogwiritsa ntchito milatho ya peptide. Kulemera kwa molekyu ndi pafupifupi 5700. Pafupifupi nyama zonse, molekyulu ya insulin ndi yofanana, kupatula mbewa ndi makoswe, insulini mumakolo amanyama ndiosiyana ndi insulin mwa nyama zina. Kusiyana kwina pakati pa insulin mu mbewa ndikuti amapangidwa m'njira ziwiri.

Kufanana kwakukulu kwa kapangidwe kake ndi pakati pa insulin ya anthu ndi nkhumba.

Kukhazikitsidwa kwa ntchito za insulin kumachitika chifukwa cha kupezeka kwa kulumikizana kwake ndi ma receptor enaake omwe amapangidwira pamtunda wa membrane wa cell. Pambuyo poyanjana, insulin receptor tata imapangidwa. Zotsatira zovuta zimalowa mu cell ndikukhudza kuchuluka kwakukulu kwa kagayidwe kachakudya.

Pazinyama zoyamwitsa, ma insulin receptor amapezeka pafupifupi mitundu yonse yam'maselo momwe thupi limapangidwira. Komabe, maselo omwe akulimbana ndi ma cell, omwe ndi hepatocytes, myocyte, lipocytes, amatha kutengeka kwambiri ndi kupangika pakati pa receptor ndi insulin.

Insulin imatha kukopa pafupifupi ziwalo zonse ndi thupi lathu, koma zofunika kwambiri ndi minofu ndi minyewa ya adipose.

Ndipo

Nsulin ndi gawo lofunikira la carbohydrate metabolism m'thupi. Hormayo imathandizira kuyendetsa glucose kudzera mu membrane wa maselo ndikugwiritsa ntchito kwake mkati mwa mkati.

Ndi gawo la insulin, glycogen imapangidwa m'maselo a chiwindi kuchokera ku glucose. Ntchito ina yowonjezera ya insulin ndikuponderezedwa kwa kuwonongeka kwa glycogen ndikusintha kwake kukhala glucose.

Pankhani yakuphwanya m'thupi la kapangidwe ka timadzi tating'onoting'ono, matenda osiyanasiyana amatuluka, omwe amachititsa kuti ashuga.

Pakakhala vuto la insulin m'thupi, makulidwe ake kuchokera kunja amafunikira.

Mpaka pano, akatswiri azamankhwala apanga mitundu ingapo ya phula iyi, yomwe imasiyana m'njira zambiri.

Zokonzekera zamakono zonse za insulin, zomwe zimapangidwa ndi makampani opanga mankhwala padziko lonse lapansi, zimasiyana m'njira zingapo. Zomwe zimapangitsa kuti gulu la insulin lipangidwe ndi:

chiyambi
kuthamanga kolowera pakulowetsedwa mthupi ndi nthawi yayitali yothandizirana,
kuyera kwa mankhwalawa komanso njira yodziyeretsera timadzi tambiri.

Kutengera ndi chiyambi, gulu la insulin limakonzekera:

Zachilengedwe - biosynthetic - Mankhwala achilengedwe achilengedwe opangidwa pogwiritsa ntchito kapamba amakondera ng'ombe. Njira zoterezi zimapangidwira matepi a insulin GPP, ultralente MS. Actrapid insulin, insulrap SPP, monotard MS, semilent ndi ena amapangidwa pogwiritsa ntchito nkhumba kapamba.
Zopangira kapena mitundu ya mankhwala a insulin. Mankhwalawa amapangidwa pogwiritsa ntchito njira zopangira ma genetic. Insulin imapangidwa pogwiritsa ntchito ukadaulo wa DNA recombinant. Njirayi imapangitsa insulin monga actrapid NM, homofan, isofan NM, humulin, ultratard NM, monotard NM, etc.

Kutengera njira zakudziyeretsa komanso kuyera kwa mankhwala omwe amayambitsidwa, insulin imasiyanitsidwa:

crystallized komanso osatchulidwa - ruppa imaphatikizapo ambiri a insulin yachikhalidwe. Zomwe zidapangidwa kale ku gawo la Russian Federation, pakadali pano gululi la mankhwala silipangidwa ku Russia,
osasefa komanso osasefedwa ndi miyala, makonzedwe a gululi ndi amodzi kapena amodzi.
crystallized ndikuyeretsedwa pogwiritsa ntchito ma gels ndi ion kusinthana ndi ma chromatography, ma monocomponent othandizira ali m'gululi.

Gulu la crystallized ndi kusefedwa ndi ma cell sieves and ion-exchange chromatography limaphatikizapo Actrapid, Insulrap, Actrapid MS, Semilent MS, Monotard MS ndi Ultralent MS insulin.

Mitundu iti ya insulin ndi nthawi yake yochita

Kupanga kwa insulini m'thupi lathu kumasintha. Kuti mahomoni alowe m'magazi kuti atsanzire kutulutsa kwake komwe, odwala matenda ashuga amafunika mitundu yosiyanasiyana ya insulin. Mankhwalawa omwe amatha kukhala m'misempha yayitali kwa nthawi yayitali ndipo amalowerera m'magazi amagwiritsidwa ntchito kuti glycemia ikhale ndi pakati pa chakudya. Insulin, yomwe ikufika mofulumira m'magazi, imafunikira kuti muchepetse shuga m'matumbo pazakudya.

Ngati mitundu ndi Mlingo wa mahomoni amasankhidwa molondola, glycemia mu odwala matenda ashuga komanso anthu athanzi amasiyana pang'ono. Poterepa, akuti shuga imalipidwa. Kubwezera matendawa ndi cholinga chachikulu cha mankhwalawo.

Insulin yoyamba idapezeka kuchokera ku nyama, kuyambira pamenepo yakhala ikusinthidwa koposa kamodzi. Tsopano mankhwala osokoneza bongo a nyama sagwiritsidwanso ntchito, adasinthidwa ndi ma genetic engineering hormone ndi ma insulin analogies atsopano. Mitundu yonse ya insulini yomwe tili nayo ingagawike m'magulu molingana ndi kapangidwe ka molekyulu, nthawi yayitali, kapangidwe kake.

Njira yothetsera jakisoni ikhoza kukhala ndi mahomoni amitundu yosiyanasiyana:

Wamunthu. Adalandira dzina ili chifukwa amabwereza kwathunthu kapangidwe ka insulin m'matumbo athu. Ngakhale ma molekyuli adachitika mokwanira, kutalika kwa insulin yamtunduwu ndi kosiyana ndi kwamoyo. Hormone yochokera ku kapamba imalowa m'magazi nthawi yomweyo, pomwe mahomoni opanga amatenga nthawi kuti ayamwe kuchokera kuzinthu zowononga.
Insulin analogues. Thupi lomwe limagwiritsidwa ntchito limapangidwa ngati insulin yaumunthu, ntchito yofanana ndi yochepetsera shuga. Nthawi yomweyo, zotsalira za amino acid zochepa zomwe zimakhala mu molekyulu zimasinthidwa ndi wina. Kusintha kumeneku kumakupatsani mwayi kufulumizitsa kapena kuchepetsa liwiro la mahomoni kuti mubwereze mwatsatanetsatane kapangidwe ka thupi.

Mitundu yonse iwiri ya insulini imapangidwa ndi mainjiniine. Homoni imatheka chifukwa chokakamiza kuti isakanikize tizilombo toyambitsa matenda a Escherichia coli kapena yisiti, pambuyo pake mankhwalawa amatsukidwa kambiri.

Popeza nthawi ya insulin ikhoza kugawidwa m'magulu awa: