Ndichite chiyani ngati ndaphonya jakisoni wa insulin wa nthawi yayitali?

07/19/2013 A shuga 3 ndemanga

Usiku sunagone chifukwa cha zolakwika ziwiri. Zomwezi ndizofunikira kwa makolo onse a novice a ana omwe ali ndi matenda ashuga.

Choyipa choyamba. Palibe chifukwa chake mutengere insulin ndi syringe kuchokera ku kuchuluka kwa cholembera!

Vutoli liziwoneka kuti likuwonekeratu, koma likufunika kumvekeredwa. Mwana akadali wocheperako, ndiye kuti mankhwalawa ndi ochepa. Mapensulo amtundu wa insulin amalola insulin kuti ivulidwe ndikulondola kwa gawo limodzi. Kulondola koteroko nthawi zambiri kumakhala kosakwanira kwa ana, ndizomwe takumana nazo: ndi 1 unit ya insulin - shuga imalumphira, ndi 2 - pansi ndipo muyenera kuwayeza pafupipafupi kuti musagwire hypoglycemia. Tidasankha kuyesa kubayitsa mayunitsi 1.5 a insulini yifupi (tili ndi Humulin R), yomwe tidagulako paketi ya syringes yodziwika bwino (pogwiritsa ntchito cholembera chokha, ndikukukumbutsani, simungathe kulowa tizigawo ting'onoting'ono).

Kodi insulin ingatenge kuti? Tsegulani zochulukirapo? Pepani. Zinkawoneka zanzeru kumangoyimba muyezo womwe ungafunikire ndi syringe kuchokera ku ampoule yomwe yaikidwapo kale mu cholembera. Ndikulembanso motalikirapo: NGAKHALE KUTI SITIYENSE PA CHIYANI CHONSE. Ngati mukufuna kugwiritsa ntchito ma syringe ndi ma syringe panjira limodzi, muyenera kugwiritsa ntchito ma puroules awiri osiyana!

Zomwe zidalipira zolakwika. Iwo adachotsa singano ku cholembera, amatenga muyeso wa 1.5 ndi syringe ya nkhomaliro. Chilichonse chiri bwino, koma sanazindikire kuti atamwa mankhwalawo kuchokera ku cholembera, kuponderezana kumamu kunatsika, ndiye kuti, cholembera cha cholembera sichitha. Chifukwa chake, sitinangopereka mankhwala a insulin madzulo osazindikira! Piston amangoyenda, osafinya kalikonse pansi pakhungu, ngakhale insulin, ngakhale mpweya. Tidali otsimikiza kuti zonse zili bwino, mutha kudya, choncho tidapereka chakudya chamadzulo ndi chakudya pambuyo pa maola awiri. Ndipo, asanagone, anayeza ndi kudabwitsidwa pamene anawona shuga wopitilira 20! Kuchokera kuti?! Tisiyeni tizinike, kaya ndi "kutulutsa" kuchokera ku "gip" wosadziwika (mwana wanga wamkazi adagona nthawi yayitali asanadye), kapena china. Guipa sanaphatikizidwe m'njira yovomerezeka: kuyeza shuga mumkodzo. Ndikukumbutseni: ngati pali shuga mumkodzo mutangopeza shuga wambiri, ndipo theka la ola palibe shuga mu mkodzo watsopano, izi zikutanthauza kuti panali kubwereranso kwina kuchokera ku hypoglycemia. Tinali ndi shuga. Ndidatenga cholembera ndikuyesa kutulutsa mayunitsi angapo mumlengalenga. Ayi! Ndipo zowonekerazo zidadza.

Apanso za kulakwitsa koyamba. ASATSITSE INSULIN KUCHOKA KUMAPETO SYRINGE HANDLES.

Chifukwa chomwe zakukhathamira zotsekemera zinali zotsimikizika, koma choti achite? Imbani endocrinologist? Padutsa theka teni usiku ...

Adayamba kukayikira endocrinologist wotchedwa Intaneti. Kodi muyenera kuchita chiyani ngati mutaphonya jakisoni wa insulin? Koti muthawireni ngati makolowo ndi opusa ndipo sakudziwa malamulo a sayansi ndipo amatenga insulin mwachindunji kuchokera ku cholembera? Kodi ndizotheka kutulutsira insulin yocheperako pambuyo pake, ndiye kuti, mutadya?

Izi ndi zomwe zidachitika. Ndilemba zomwe mungachite kuti mukhale ndi zoyenera, osati kwa ife tokha.

1) Ngati kuwombera kwa insulin yayitali kubayidwa, komwe kumabayidwa kamodzi patsiku (lantus), ndiye kuti simukufunika kuti mupeze jakisoni pa ola limodzi, muyenera kuyesetsa kulipirira kusowa kwa insulin yoyamba pakuchita zolimbitsa thupi patsiku: kuyenda kwambiri, masewera olimbitsa thupi, ndi zina zambiri, kuwotcha shuga owonjezera mwachilengedwe: kuwonjezera zochita zolimbitsa thupi.

2) Ngati kuwombera kwa insulin ya nthawi yayitali kubayidwa, komwe kumabayidwa kawiri patsiku (Humulin NPH, Protofan ndi zina), ndiye kuti theka la mwaphonya liyenera kuwonjezeredwa kuwombera kosoweka. Sindinaphunzire tsatanetsataneyu, chifukwa siife amene.

3) Ngati kuwombera kwa insulin yochepa sikusowa, ndipo mumaganizira nthawi yomweyo mutatha kudya kapena mkati mwa ola limodzi kapena awiri mutatha. Pankhaniyi, tikulimbikitsidwanso kuti tizilimbitsa muyeso womwe taphonya, ndikuchepetsa nthawi yomwe mwaphonya. Ndiye kuti, monga momwe ndikumvera, ngati mutha kudya mutangodya, mutha kupaka jakisoni wathunthu (kapena kuchepetsa pang'ono), ndikulipira "chosagwirizana" ndi kadzutsonono pambuyo pake (kuti mupeze kuchuluka kwa insulin yayifupi).

4) Ngati jakisoni wa inshuwaransi ya bolus yakusowa, ndipo izi zidamveka maola angapo mutatha kudya (monga ife). Potere, makamaka ngati shuga amachoka pamlingo, amathandizidwanso kubayitsa insulin yayifupi, koma muyezo wochepetsedwa kwambiri. Kuthana ndi hyperglycemia.

Ndipo apa tidalakwitsa kachiwiri. Kapena kodi ndikulakwitsa.

Tinalowetsa gawo la insulini potulutsa singano pambuyo pa masekondi 5 (m'malo 10), tikuyembekeza kuti mwanjira imeneyi mutenga theka, kapena, kapena gawo laling'ono. Koma sanazindikire kuti nthawi yolondera inali pafupifupi 12 usiku.

Tidalowetsa 23:40. Mwana wanga wamkazi anali wokwiya, kulumpha (chabwino, shuga kwambiri, mphamvu zowonjezera). Galloped, vilated, kuti abweretse 20-ku. (Pambuyo pake adazindikira kuti ndi shuga wambiri kotero ndizosatheka kutsitsa masewera olimbitsa thupi - MM pambuyo pa mwezi) Kenako anagona ndipo anagona. Mkazi nawonso. Ndipo ndili ponseponse ndipo ndayamba kuwerenga nkhaniyo pa intaneti mozama, ndikuwona kuti penapake pali vuto. Malingaliro osavuta akuti chakudya chamadzulo ndi chakudya chamadzulo chimatha kale, ndipo zotsalira za shuga kuchokera kuzakudyazi zimazimitsidwa mwachangu, koma patatha maola awiri (pafupifupi pakati pa usiku wa 2 ndi 3!), Insulin ikanayamba kugwira ntchito kwathunthu ndipo titha kupeza hypoglycemia yamphamvu yosadziwika. Ndipo kenako zidayamba kukhala zowopsa kotero kuti maloto onsewo adasowa penapake. Ndikhazikitsa alamu kwa mausiku awiri nditha. Zotsatira zake, iwo sanagone kwambiri usiku, kumayeza shuga theka lililonse la ola kapena ola, kuti asaphonye mawaya. Ndilemba zomwe mwapeza, ndikuganiza kuti zitha kudzakhala zothandiza kwa ine komanso kwa aliyense amene ayang'ana patsamba ili pofunafuna yankho lavutoli.

Chifukwa chake, tidaphonya jakisoni wamadzulo wa insulin, kudya kawiri popanda insulin (ndikuganiza kuti ndi).

1) Pa 19:30 shuga anali 8.0 Anayeza musanadye chakudya chamadzulo kuti adziwe kuchuluka kwa chakudya chamomwechi. Chabwino, chabwino, pafupifupi chizolowezi chathu mpaka pano kulumpha shuga. "Jekeseni" (osadziwa kuti insulini siliyendetsedwe) magawo awiri a insulin, akuyembekeza kuti akhale ndi chakudya chamadzulo. Tinadya chakudya chamadzulo, titatha maola awiri tinali ndi chakudya. Chilichonse chimakhala ngati kuti insulin yagwiritsidwa ntchito.

2) 23:10. Tinaganiza zoyeza ngati titha kukagona ndipo modzidzimutsa tawona shuga 21.5 mol! Mumvetsetsa zifukwa zake (onani pamwambapa). Adayamba kuganiza ndikuyang'ana choti achite. Ndinaganiza kuti tiziyeza mu theka la ola ndipo ngati pali kuchepa, ndiye kuti tiyenera kusanza bwino, kupita kokagona ndikugona. Mwina inali yolondola? (ayi, sichoncho! - MM patatha mwezi umodzi)

3) 23:40. Timaziyezanso - 21.6 Ndiye kuti, zimakwera! Tisankha kudula chimodzi.

4) 01:10 Usiku. Timayeza magazi a mwana wamkazi wogona. 6.9! Ndiye kuti, mu ola limodzi ndi theka shuga adatsika ndi magawo oposa 14! Ndipo nsonga zakuchitapo kanthu sizinayambe. Zimakhala zowopsa pang'ono.

5) 01:55 Timayeza: 3.5! Mu mphindi makumi anayi ndi zisanu - kawiri! Kuyambira 6.9 mpaka 3.5. Ndipo nsonga yantchito ya insulin idayamba! Pochita mantha timadzutsa mwana wanga wamkazi ndi kutipangira madzi akumwa ndikudya makeke. Mwanayo amagona, amawuma magalamu 30-50 amadzimadzi kumapeto kwake ndikukukutira chiwindi china kuti "makolo oyipa, omwe samudyetsa kapena kum'gwirira pakati pausiku," achotse. Osakanidwa.

6) 02:21 S shuga: 5.1. Phew! Madzi okhala ndi ma cookies adagwira ntchito. Zabwino. Timalinganiza kuyesanso, ngati zitsika, ndiye kuti tidyetsabe.

7) 02:51 Shuga: 5.3. Zabwino. Zochita za insulin yochepa zimatha. Timalumikizidwa.

8) 06:10. M'mawa Tikuyang'ana. Shuga: 4.7. Osati chachikulu, koma osati choyipa. Kodi mudakwanitsa? ... "Tikuyenera kuwonanso mu ola lina, kuti tisasiye kutsutsa ..." Koma palibe mphamvu. Timalumikizidwa.

9) 9:00. Popewa kuyerekezera kwam'mawa, pafupifupi theka la eyiti adapereka uchi kwa mwana wamkazi wagona pamutu wa supuni. Zotsatira zake, nthawi ya 9 a.m. mita ikuwonetsa kupendekera kwapadera kwa 8.00 mol. Ndiye kuti, ngakhale uchi wocheperako wotere unadzutsa shuga kuchokera pa 4 mpaka 8!

Zonse Zikuwoneka kuti zalimbana ndi vuto loyamba limodzi (losowa insulini usiku). Pa mtengo wa kugona osagona komanso mitsempha ya makolo ndi zala za mwana wamkazi yemwe ndi wokalamba kwambiri. Kodi anachita molondola? Kapena munayenera kuthamanga, kudumpha kuti mwanjira ina mugwe pansi, kenako kugona usiku wonse ndi mashuga ambiri? Kodi zinali zolakwika kubaya Inesulin usiku, kuyesera kulipirira zomwe zinasowa? Sindikudziwa. Koma ndikhulupilira kuti zomwe tafotokozazi zitha kuthandiza wina kuti apange chisankho chanzeru pazotheka.

Pitani jakisoni wa insulin

Popeza mankhwalawa amtundu wa shuga amachitika mu mawonekedwe a inulin m'malo mwa mankhwala osalekeza, kupendekera kwa mankhwala ndi mwayi wokhazikika wokhala ndi shuga.

Kugwiritsa ntchito bwino insulin kukonzekera kungalepheretse kusinthasintha kwa shuga komanso kupewa zovuta za matenda ashuga:

1. Kukula kwa chikomokere, chomwe ndi chowopsa m'moyo: ketoacidosis, lactactacidosis, hypoglycemia.
2. Kuwonongeka kwa mtima khoma - yaying'ono- ndi macroangiopathy.
3. Matenda a shuga.
4. Mawonedwe akuchepera - retinopathy.
5. Zilonda zamanjenje - diabetesic neuropathy.

Njira yabwinoko yogwiritsira ntchito insulin ndiyo kubwereza mtundu wake wolimbitsa thupi kulowa m'magazi. Pachifukwa ichi, ma insulins a nthawi zosiyanasiyana amagwiritsidwa ntchito. Kuti apange magazi okwanira nthawi zonse, insulin yayitali imayendetsedwa kawiri pa tsiku - Protafan NM, Humulin NPH, Insuman Bazal.

Insulin yofupikitsa imagwiritsidwa ntchito m'malo mwa kutulutsidwa kwa insulin poyankha chakudya. Amayambitsidwa musanadye katatu pa tsiku - musanadye chakudya cham'mawa, chakudya chamasana komanso musanadye. Pambuyo jekeseni, muyenera kudya chakudya pakadutsa mphindi 20 mpaka 40. Poterepa, mlingo wa insulini uyenera kupangidwa kuti utenge kuchuluka kwamafuta ena.

Jekeseni insulini yokhayo ikhoza kukhala yopanda tanthauzo. Chifukwa cha izi, malo otetezeka komanso abwino kwambiri ndi mawonekedwe amapewa ndi kumbuyo kwa mapewa, kutsogolo kwa m'chiuno kapena gawo lawo lam'mbali, pamimba, kupatula dera loyambitsirapo. Nthawi yomweyo, insulin kuchokera pakhungu lam'mimba imalowa m'magazi mwachangu kuposa malo ena.

Chifukwa chake, tikulimbikitsidwa kuti odwala m'mawa, komanso, ngati pakufunika kuthandizira kuchepetsa hyperglycemia (kuphatikiza polumitsa jakisoni), jekeseni insulini m'mimba khoma.

Kuwala kwa wodwala matenda ashuga, ngati atayiwala jakisoni, zimatengera mtundu wa jakisoni yemwe wasowa komanso kuchuluka kwa omwe amadwala matendawa. Ngati wodwala wasowa jakisoni wa insulin yayitali, ndiye njira zotsatirazi ziyenera kutengedwa:

• Mukabayidwa katatu patsiku - kwa maola 12, gwiritsani ntchito insulin yochepa chabe malinga ndi malamulo omwe amapezeka musanadye. Kuti mupeze jakisoni yemwe wasowa, onjezani zolimbitsa thupi kuti muchepetse magazi. Onetsetsani kuti mwapanga jekeseni wachiwiri.
• Wodwala yemwe ali ndi vuto la shuga atavulaza insulin kamodzi, ndiye kuti, mankhwalawa amapangidwira maola 24, ndiye kuti jakisoni lingachitike maola 12 atatha, koma mlingo wake uyenera kuchepetsedwa ndi theka. Nthawi ina mukadzalowa mankhwalawa nthawi yokhazikika.

Ngati mukusowa kuwombera kwa insulin yayifupi musanadye, mutha kuyikamo mukangotha ​​kudya. Ngati wodwalayo adakumbukira kuti wapita mochedwa, ndiye kuti muyenera kuwonjezera katundu - pitani m'masewera, pitani kokayenda, kenako kuyeza mulingo wamagazi. Ngati hyperglycemia ndi yapamwamba kuposa 13 mmol / l, tikulimbikitsidwa kuphatikiza inshuwaransi 1-2 mwa insulin yochepa kuti tipewe kudumphira shuga.

Ngati kutumikiridwa molakwika - m'malo mwa insulin yochepa, wodwala matenda a shuga amawonjezera nthawi yayitali, ndiye kuti mphamvu zake sizokwanira kukonza zakudya zamagulu azakudya. Chifukwa chake, muyenera kutulutsa insulin yayifupi, koma nthawi yomweyo muyezo kuchuluka kwa glucose maola awiri aliwonse komanso kukhala ndi mapiritsi ochepa a glucose kapena maswiti ndi inu kuti muchepetse shuga mpaka hypoglycemia.

Ngati jakisoni wamfupi adabayidwa m'malo mwa insulin yotalikilapo, ndiye kuti jakisoni wophonyayo amayenera kuchitika, popeza muyenera kudya chakudya chamagulu owonjezera a insulin, ndikuchita kwake kumatha nthawi yofunikira isanachitike.

Ngati insulin yambiri yagwiritsidwa jekeseni kuposa momwe ikufunira kapena jakisoniyo itachitika molakwika kawiri, ndiye kuti muyenera kuchita izi:

1. Onjezani kudya shuga wambiri kuchokera ku zakudya zamafuta ochepa okhala ndi zovuta zamapangidwe amkaka - chimanga, masamba ndi zipatso.
2. Jekeseni glucagon, wotsutsana ndi insulin.
3. Pangani glucose kamodzi pa maola awiri aliwonse
4. Chepetsani kupsinjika kwakuthupi ndi kwamaganizidwe.

Zomwe sizikulimbikitsidwa kwa odwala omwe ali ndi matenda ashuga ndizowonjezera kawiri mlingo wa insulin, chifukwa izi zimapangitsa kuti shuga ayambe kutsika. Chofunikira kwambiri ndikudumpha mlingo ndikuwonetsetsa kuchuluka kwa shuga m'magazi mpaka atakhazikika.

Chinsinsi cha jakisoni

Kuphonya kwa insulin kwa mtundu woyamba wa shuga ndikosafunikira makamaka chifukwa choopsa chodwaladwala ndipo wodwalayo agwa.

Shuga amachepetsedwa nthawi yomweyo! Matenda a shuga m'kupita kwa nthawi angayambitse matenda ambiri, monga mavuto amawonedwe, khungu ndi tsitsi, zilonda zam'mimba, zilonda zam'mimba komanso matenda otupa! Anthu amaphunzitsa zinzake zowawa kuti azisintha shuga. werengani.

Mu matenda a shuga, jakisoni ndi gawo lofunikira pobwezeretsanso matendawa. Jakisoni watsiku ndi tsiku ndiwofunikira kwa odwala matenda ashuga, chifukwa amatha kukhazikika pamatenda a metabolic mthupi komanso kupewa zovuta. Chofunikira kwambiri ndi majakisoni a insulini mu mtundu 1 wa shuga, pomwe maselo achikondwerero samatulutsa kapena kupanga mahomoni osakwanira kuti aphwanye shuga yomwe ilipo. Ndi mtundu wachiwiri wa matenda, majekeseni amatembenukiranso.

Jakisoni woyenera amawona kuti ndi jakisoni, amene amaphatikizidwa ndi khungu. Malo abwino a jakisoni ndi mapewa (kumbuyo, mbali), ntchafu (kutsogolo, mbali), m'mimba, kupatula msuzi. Ndi kudzera m'mimba pomwe insulin imafika mofulumira komwe ikupita. Kugwiritsa ntchito bwino insulin mokwanira kungathandize kuchepetsa mwayi wamavuto.

Zotsatira za kudumpha jakisoni

Kudumphira jakisoni ndikuwoneka ndikukula kwa magazi. Matenda a shuga ndi matenda omwe alibe insulin yake, ndichifukwa chake amafunika kuperekedwa kuchokera kunja kuti agwetse shuga omwe alowa m'thupi. Ngati mahomoni satuluka pakapita nthawi, glucose imadziunjikira, zomwe zimayambitsa zotsatira zosafunikira mwanjira yakukomoka, ndikutsatiridwa ndi kuwonongeka kwa matenda ashuga komanso kukomoka kwa hyperglycemic. Kuphatikiza apo, kusinthasintha kwa glucose kumatha kukhala zovuta kwambiri. Molondola, kugwiritsa ntchito jakisoni wa insulin kudzakuthandizani kupewa zovuta ndi zotsatirazi:

• Zosangalatsa za chikomokere: ketoacidosis, hypoclycemia ndi lactactacidosis.
• Zida zowonongeka - retinopathy.
• A shuga ndi nephro- ndi neuropathy.
• Kuwonongeka kwa makoma amitsempha yamagazi - macro- ndi microangiopathies.

Zoyenera kuchita ndikulumpha jakisoni wa insulin?

• Kudumpha jakisoni mukamatenga insulin yayitali kawiri patsiku kumakonzedwa ndikumayambira maola 12 otsatira. Kapenanso, mutha kulimbitsa thupi.
• Mukamagwiritsa ntchito insulin tsiku lililonse (yovomerezeka kwa maola 24), mlingo wofunikira wongodumpha ndi theka la jakisoni wa tsiku lililonse pambuyo maola 12 kuchokera nthawi yodumphadumpha. Ndipo pangani jekeseni wotsatira malinga ndi dongosolo.
• Kudumpha insulini yopangira chakudya (bolus) siowopsa - mutha kuyilowetsa mukatha kudya, kutsatira shuga m'magazi 2 aliwonse. Mukadumphira pamlingo wa 13 mmol / L, mlingo wa insulin yochepa umayenera kutsikira ku chakudya chotsatira.
• Sitikulimbikitsidwa kupaka insulin yayitali m'malo mwake yokhala yochepa - pali chiopsezo kuti woyamba sangathe kupirira shuga pambuyo pudya, ndibwino kutsina mahomoni a bolus. Koma ndikofunikira kuchepetsa shuga kuti muchepetse hypoglycemia.
• Mukabayidwa kwakanthawi m'malo mwa yayitali, muyenera kupanga njira yotsalira. Koma muyenera kuwonjezera thupi ndi XE yoyenera ndikuwunika nsonga za jakisoni.
• Pogwiritsa ntchito kuchuluka kwa mahomoni, ndikofunikira kusamalira chakudya chamagulu othamanga.

Zolemba ndi zolemba

Zolemba zatsiku ndi tsiku zimathandizira kuthana ndi kukumbukira zopanda mphamvu ndikutsata ndandanda yolondola. Choyipa cha njirayi ndi kukumbukira komweko kwa munthu.Kupatula apo, kuyiwala kulemba nthawi yomwe mumamwa mankhwalawo kapena osatenga bukuli ndi inunso vuto. Kuphatikiza apo, njirayi si ya aulesi, popeza zonse zojambulidwa zimatenga nthawi.

Chikumbutso cha foni

Njira yabwino komanso yamakono yokumbutsa za dongosolo la jakisoni. Koma ngakhale kuti ndi yosavuta, ilinso ndi zovuta. Batire yosamangidwa, kuthina kwa gadget kosayembekezereka, kugwiritsa ntchito modekha - zonsezi zitsogolera kuti chikumbutso sichigwira ntchito, ndipo wodwala matenda ashuga adzaphonya jakisoni. Ntchito yothandiza pankhaniyi ikhoza kukhala kugwedezeka kwa chida, komwe machitidwe opanda phokoso, chilichonse chidzagwira ntchito panthawi ya chikumbutso.

Mapulogalamu amajambulidwe

Mapulogalamu ambiri apadera apangidwa omwe amagwiritsidwa ntchito bwino ndi odwala matenda ashuga. Mapulogalamu omwe amagwira ntchito zosiyanasiyana ndipo amathandizira kupewa glycemia. Chitonthozo cha pulogalamuyi ndikuti pakugwiritsa ntchito mutha kuyendetsa thupi pazakudya zonse, nthawi yakumwa majakisoni, zina.

Ntchito zamankhwala

Ntchito zowonetsedwa, mapulogalamu a chikumbutso omwe amawonetsa chidziwitso cha nthawi yomwe ilandilidwe posankha pama foni a m'manja, mapiritsi ndi wotchi yolumikizira. Komanso wopanda chopondera. Vuto lalikulu ndikudumpha zidziwitso. Cholinga chachikulu ndikusasamala kapena kusowa kwa munthu pafupi ndi gadget panthawi ya chikumbutso. Zitsanzo za ntchito zotere:

Kuyika zolembera Zamphaka

Kukongoletsa ma cholembera mu mitundu yosiyanasiyana sikuthandizira kuti musaiwale za jakisoni wofulumira, komanso kukumbutsani kuti ndi pati komanso komwe mlingo wa insulin uli. Chowonadi ndi chakuti ma syringe ndi ofanana, koma mankhwala mkati ndi osiyana. Pali njira zambiri zolembera chida cha jakisoni. Loyamba ndi losavuta, muyenera kusankha zolembera za mitundu yosiyanasiyana mu mankhwala. Chachiwiri ndi kulemba zolembera ndi zomata.

Hyperglycemia polumpha jakisoni wa insulin

Zizindikiro zoyambirira za kuchuluka kwa magazi ndi jakisoni wosaiwalika ndikumatha ludzu komanso mkamwa owuma, mutu, komanso kukodza pafupipafupi. Khansa ya m'mimba, kufooka kwambiri m'matenda a shuga, komanso kupweteka kwam'mimba kumawonekeranso. Mishuga ya shuga imatha kuwonjezeka ndi mlingo wowerengeka wosayenera kapena kudya chakudya chochuluka, kupsinjika ndi matenda.

Ngati simutenga chakudya chambiri mu nthawi yokhala ndi vuto la hypoglycemia, ndiye kuti thupi likhoza kulipirira izi pakokha, pomwe kusokonezeka kwa mahomoni kumakhala ndi shuga wamagazi kwakanthawi.

Kuti muchepetse shuga, muyenera kuwonjezera kuchuluka kwa insulin yosavuta ngati, mukayezedwa, chizindikiro chimakhala pamwamba pa 10 mmol / l. Ndi kuchuluka kumeneku, kwa owonjezera atatu 3 mmol / l, mayunitsi 0,25 amatumizidwa kwa ana amasukulu, mayunitsi 0,5 kwa ana asukulu, magawo 1 - 2 kwa achinyamata ndi akulu.

Ngati kudumpha insulini kunayamba chifukwa cha matenda opatsirana, kutentha kwambiri, kapena kukana chakudya chifukwa chochepa kudya, ndiye kuti kupewa zovuta mu mawonekedwe a ketoacidosis, tikulimbikitsidwa:

• Maola atatu aliwonse, muyezo kuchuluka kwa shuga m'magazi, komanso matupi a ketone mumkodzo.
• Siyani kuchuluka kwa insulin kosasintha kwa nthawi yayitali, ndikuwongolera hyperglycemia ndi insulin yochepa.
• Ngati shuga wa magazi apamwamba kuposa 15 mmol / l, acetone imatuluka mkodzo, ndiye kuti jekeseni aliyense asanadye ayenera kuchuluka ndi 10-20%.
• Pa mulingo wa glycemia wofikira 15 mmol / L ndikutsata kwa acetone, mlingo wa insulin yochepa umachulukitsidwa ndi 5%, ndikuchepetsa mpaka 10, mlingo wapitalo uyenera kubwezeretsedwanso.
• Kuphatikiza pa jakisoni wamkulu wamatenda opatsirana, mutha kuyendetsa humalog kapena NovoRapid insulin osachepera maola 2, komanso insulin yayifupi - maola 4 mutatha jakisoni womaliza.
• Imwani zakumwa zosachepera lita imodzi patsiku.

Mukadwala, ana aang'ono amatha kukana chakudya, makamaka pakakhala nseru ndi kusanza, kuti athe kusinthana ndi zipatso kapena mabulosi chifukwa cha nthawi yochepa, kupatsa maapulo wowonda, uchi

Kodi musaiwale za jakisoni wa insulin?

Zomwe zodumpha pamodzo sizingadalire wodwala, chifukwa chake, aliyense amene amalimbikitsa jekeseni wothandizira matenda a shuga ndi insulin tikulimbikitsidwa:

Notepad kapena mafomu apadera kuti mudzaze ndi chizindikiro cha nthawi, jakisoni, komanso deta yonse ya shuga.

Ikani chizindikiro pafoni yanu yam'manja, kukukumbutsani kuti mulowe insulin.

Ikani pulogalamuyi pafoni yanu, piritsi kapena pa kompyuta kuti muwongolere shuga. Mapulogalamu apaderawa amakupatsani mwayi kuti nthawi yomweyo musunge diary ya chakudya, shuga komanso kuwerengetsa mlingo wa insulin. Izi zikuphatikizapo NormaSahar, Magazini ya Matenda a shuga, Shuga.

Gwiritsani ntchito ntchito zamankhwala pazida zomwe zikuwonetsa nthawi yomwe mumamwa mankhwalawa, makamaka mukamagwiritsa ntchito mapiritsi ena a insulin pochiza matenda oyanjana: Mapiritsi anga, chithandizo changa.

Zilembera ma syringe zolembera okhala ndi zomata pathupi kuti musasokonezedwe.

Ngati jakisoni adaphonya chifukwa chosapezeka amodzi mwa mitundu ya insulin, ndipo sakanakhoza kupeza, popeza mulibe mankhwala kapena pazifukwa zina, ndiye kuti ndizotheka kuyambiranso insulin. Ngati palibe insulin yochepa, ndiye kuti insulin yotalikilapo iyenera kuyilidwa panthawi yomwe chakudya chake chikugwirizana ndi nthawi yakudya.

Ngati pali insulin yochepa yokha, ndiye kuti muyenera kupaka jekeseni pafupipafupi, kuganizira kuchuluka kwa shuga, kuphatikiza musanagone.

Mukadakhala kuti mwaphonya kumwa mapiritsi othandizira odwala matenda a shuga a mtundu wachiwiri, ndiye kuti atha kutengedwa nthawi ina, chifukwa chindapusa cha chiwonetsero cha glycemia ndi mankhwala amakono a antiidiabetes sichimamangiriridwa kuti mulembe njira. Sizoletsedwa kawiri kuchuluka kwa mapiritsi ngakhale miyala iwiri itasowa.

Kwa odwala matenda a shuga, ndizowopsa kukhala ndi shuga yayikulu magazi akapepuka jakisoni kapena kukonzekera kwa piritsi, koma kukhazikika kwa kugwidwa pafupipafupi kwa hypoglycemic, makamaka paubwana, kumatha kutsogolera mapangidwe olimbitsa thupi, kuphatikizapo kukula kwamaganizidwe, kotero kusintha kwa mlingo woyenera ndikofunikira.

Ngati mukukayika za kulondola kwawonjezeranso kuchuluka kwa mankhwalawa kapena kusintha kwa mankhwalawa, ndiye kuti kuli bwino kufunsa chithandizo chapadera kuchokera kwa endocrinologist. Kanemayo munkhaniyi akuwonetsa ubale wa insulin ndi shuga m'magazi.

Kodi mungatani ngati simunapereke jakisoni pa nthawi yake?

Sipangakhale lamulo limodzi muzochitika zonse, chifukwa zinthu zambiri ziyenera kukumbukiridwa. Pakati pawo: yapita nthawi yayitali bwanji kuchokera nthawi yomwe anafunika kupanga jakisoni ndi mtundu wa insulin yomwe mumagwiritsa ntchito.

Pansipa tidzakupatsani upangiri wamba, koma ngati mukukayikira zoti muchite munthawi inayake, ndibwino kufunsa dokotala kuti akupatseni malangizo (mtsogolo, zotere zikadzachitika, mudzakhala okonzekera bwino).

Pitani basal / insulin yayitali (1 nthawi patsiku)

• Ngati mukuiwala kubaya insulin yayitali / yoyambira ndikukumbukira za izi posachedwa (patangopita maola awiri kuchokera nthawi X), mutha kuchita mlingo wokhazikika. Pankhaniyi, ndikofunikira kukumbukira: insulin idapangidwa mochedwa kuposa masiku onse, chifukwa chake, imagwira ntchito mthupi lanu motalikirapo kuposa masiku onse. Chifukwa chake, pamakhala chiwopsezo cha kukhala ndi hypoglycemia.
• Ngati maola opitilira 2 adatha kuchokera nthawi yomwe X (i.e., nthawi yovomerezeka), ndipo simukudziwa zoyenera kuchita, mukambirane ndi dokotala. Ngati palibe zomwe zikuchitika, shuga m'magazi amayamba kuyamba.
• Ngati mupanga insulin (yayitali) insulini madzulo, mutha kuyesa algorithm iyi: kumbukirani kudumpha jakisoni mpaka 2 a.m. - lowetsani mlingo wa insulin wochepetsedwa ndi 25-30% kapena magawo 1-2 pa ola lililonse lomwe ladutsa X. Ngati watsala ndi maola opitilira 5 musanadzuke, yeretsani magazi anu ndikubaya insulini yochepa.

Njira ina (ya owonda masamu):

• Werengani kuti ndi maora angati adutsa kuyambira nthawi X (Chitsanzo: kuchita magawo a Lantus 14 pa 20,00, tsopano 2.00. Chifukwa chake, maola 6 adutsa). Gawani nambala iyi ndi 24 (maola / tsiku) - 6: 24 = 0.25
• Chulukitsani kuchuluka kwa insulin. 0.25 * 14 PIECES = 3.5
• Chotsani nambala yomwe mwalandira kuchokera pa mlingo wamba. 14ED - 3.5ED = 10.5 ED (kuzungulira mpaka 10). Mutha kulowa mu mayeso a 2.00 10 a Lantus.

Short / Ultra Short / Bolus Insulin Skip

• Ngati mumayiwala kupanga jakisoni wa insulin musanadye (bolus insulin) ndikuganiza za izi posachedwa (pasanathe maola 2 kuchokera poyambira chakudya), mutha kupanga insulini yonse.
• Kumbukirani: insulin idayambitsidwa pambuyo pake, motero, idzagwira ntchito nthawi yayitali. Panthawi imeneyi, pimani magazi anu pafupipafupi.
• Dzimvereni nokha, ngati mukumva zilizonse zomwe zimafanana ndi hypoglycemia, yeretsani shuga.

• Ngati mwaiwala kupanga phwando chakudya musanadye ndipo maola opitilira 2 atadutsa chakudya, izi ndizovuta kwambiri, chifukwa mwina chakudya chotsatira kapena kugona. Mutha kuwonjezera magawo angapo jakisoni wotsatira musanadye, koma pokhapokha ngati muyeza magazi.
• Ngati simukudziwa zoyenera kuchita ngati muli ndi insulin yambiri kapena ingapo, muyenera kufunsa dokotala kuti akupatseni malangizo.

Kudumpha jakisoni ndi regimen ya jakisoni iwiri (basal, insulin yayitali, NPH-insulins)

• Ngati mwaphonya jakisoni wam'mawa ndipo pasanathe maola 4 kuchokera pa X, mutha kulowa muyezo wabwino. Patsikuli, mudzafunika kuyeza shuga wamagazi pafupipafupi, chiopsezo cha hypoglycemia chikuwonjezeka.
• Ngati maola opitilira 4 adatha, iduleni jakisoniyo ndikutenga kachiwiri. Khazikitsani shuga wambiri m'magazi pobayira insulin yayifupi kapena yopitilira muyeso.
• Ngati mwayiwala za jakisoni wanu musanadye chakudya ndikukumbukira madzulo, jekeseni insulin yotsika musanagone. Zoposa theka ndizokwanira, koma muyenera kuyang'ana izi poyesa shuga wamagazi. Magazi a shuga amayenera kufufuzidwa usiku kupewa usiku hypoglycemia.

Kuyang'anira Magazi a shuga & a Ketone

• anaphonya jakisoni wa insulin, muyenera kuyeza shuga m'magazi pafupipafupi kuposa maola 24 otsatira kuti muchepetse kutuluka kapena, pakapanda kuchepa kwa shuga wamagazi (hyperglycemia ndi hypoglycemia, motero).
• munthu amene ali ndi matenda a shuga a mtundu woyamba kapena a 2 mtundu wa shuga wochepa kwambiri wopanga insulin yawo, khalani okonzeka kuyeza kuchuluka kwa ma ketoni mumkodzo wanu kapena magazi ngati shuga ya magazi ikwera pamwamba pa 15 mmol / L.
• mudzuka ndi shuga wambiri, nseru komanso ma ketoni okwera m'magazi anu kapena mkodzo, zomwe zikutanthauza kuti muli ndi vuto la kuchepa kwa insulin. Lowani 0.1 U / kg ya insulin yochepa kapena yowonjezera yochepa ndikuyesa shuga m'magazi 2 atatha. Ngati magazi a glucose sanatsike, lowetsani mlingo wina wa 0,1 U / kg thupi. Ngati mukumvabe kuti mukusanza kapena ngati kusanza kumachitika, muyenera kupita kuchipatala msanga.