NovoMix® 30 FlexPen® Insulin aspart magawo awiri

Yogwira pophika: 1 ml ya kuyimitsidwa kwa jakisoni uli ndi 100 IU / ml ya insulin aspart (rDNA) (30% sungunuka wa insulini ndi 70% insulopu ya insulin.

1 cholembera cha syringe chili ndi 3 ml, womwe ndi wofanana ndi mayunitsi 300

1 unit (OD) ndi 6 nmol kapena 0,035 mg wa desalted anhydrous insulin aspart,

Omwe amathandizira: glycerin, phenol, metacresol, zinc chloride, sodium chloride, sodium phosphate, dihydrate, protamine sulfate, sodium hydroxide, kuchepetsedwa hydrochloric acid, madzi a jakisoni.

Mankhwala

NovoMix ® 30 FlexPen ® ndi kuyimitsidwa kwamitundu iwiri kosungunulira insulin (an-insulin analog) ndi aspart crystallized insulin ndi protamine (sing'anga-insulin analog). Kuyimitsidwa kumakhala ndi insulin aspart yochepa komanso nthawi yayitali pochita 30/70. Ndi kuyambitsa Mlar ofanana Mlingo, insulin ndiwofanana ndi insulin.

Kuchulukitsa kwa shuga kwa insulin ndikulimbikitsa kutuluka kwa glucose pogwiritsa ntchito minofu pambuyo pomangiriza insulini mpaka ma cell a minofu ndi mafuta, komanso kuletsa kutulutsa kwa glucose ku chiwindi.

NovoMix ® 30 FlexPen ® imayamba kuchita mphindi 10-20 pambuyo pa kuperekera mankhwala. Kuchuluka kwake kumachitika pambuyo pa maola 1-4 Kutalika kwa kuchitapo kanthu mpaka maola 24.

Mu kafukufuku wazachipatala yemwe adatenga miyezi itatu ndikufanizira kuyang'anira kwa NovoMix ®30 FlexPen ® ndi biphasic insulin ya anthu 30 asanadye chakudya cham'mawa komanso chakudya chamadzulo mwa odwala omwe ali ndi mtundu wa I ndi mtundu II shuga, adawonetsedwa kuti poyambitsidwa kwa novoMix ® 30 FlexPen ® glucose Pambuyo pa chakudya chonse (kadzutsa ndi chakudya chamadzulo), inali yotsika kwambiri poyerekeza ndi makonzedwe a anthu a insulin 30.

Popanga ma meta-analysis, omwe anaphatikiza mayeso 9 azachipatala kwa odwala omwe ali ndi mtundu woyamba wa II komanso mtundu wa II, zidadziwika kuti, poyerekeza ndi insulin 30 ya anthu, kugwiritsa ntchito NovoMix ®30 asanadye chakudya cham'mawa komanso chakudya chamadzulo kumabweretsa chiwongolero cha glucose chamagulu kwambiri. kuchuluka kwapakati pa shuga m'magawo atatha kadzutsa, nkhomaliro ndi chakudya chamadzulo.

Ngakhale kuti kuthamanga kwa glucose kudali kokwanira mwa odwala omwe amalandila chithandizo cha NovoMix ®30, mulingo wa glycosylated hemoglobin, ndizomwe zikuwonetsa kuwongolera kwathunthu kwa glycemic, anali yemweyo.

Pakafukufuku wazachipatala, odwala omwe ali ndi matenda a shuga II (anthu 341), omwe adagawika m'magulu molingana ndi mfundo zosasinthika, adangolandira NovoMix ® 30 kapena NovoMix ® 30 osakanikirana ndi metformin kapena metformin limodzi ndi sulfonylureas. Pambuyo pa chithandizo cha milungu 16, kuchuluka kwa HbA 1c mwa odwala omwe amalandila NovoMix ® 30 ndi metformin kapena metformin ndi sulfonylurea momwemo. Phunziroli, mu 57% ya odwala, kuchuluka kwa HbA 1c kunali kwakukulu kuposa 9%. Mwa odwalawa, pochiza NovoMix ® 30 ndi metformin, kuchepa kwa HbA 1c kunali kofunika kwambiri kuposa kuphatikiza kwa metformin ndi sulfonylurea.

Pakufufuza kwa odwala amtundu wa shuga a mtundu II, momwe mankhwalawa amagwiritsidwa ntchito pokhapokha ngati mankhwala a hypoglycemic sanathe, anagwiritsidwa ntchito kawiri kawiri tsiku lililonse ndi NovoMix 30 (odwala 117) kapena makonzedwe a insulin glargine (116 odwala) tsiku lililonse. Pambuyo pa chithandizo cha masabata 28, NovoMix â 30 yotsatana ndi kusankha kwa mlingo, HbA 1C idatsika ndi 2.8% (mtengo wapakati wa HbA 1C utaphatikizidwa mu phunziroli = 9.7%). Munthawi ya chithandizo cha NovoMix â 30, 66% ya odwala adafika pamlingo wa HbA 1C pansi pa 7%, ndipo 42% adafika kwa odwala omwe anali pansi pa 6.5%, pomwe kusala kwa plasma glucose kutsika ndi pafupifupi 7 mmol / L (kuyambira 14.0 mmol / l musanalandire chithandizo mpaka 7.1 mmol / l).

Mukamayendetsa meta-odwala omwe ali ndi matenda amtundu wachiwiri wa shuga, zidadziwika kuti ndi NovoMix® 30 chiopsezo chokhala ndi hypoglycemia usiku komanso hypoglycemia yocheperako idachepetsedwa poyerekeza ndi insiphorous ya insulin ya 30. Nthawi yomweyo, chiwopsezo cha zochitika za hypoglycemia masana chinali okwera odwala omwe amalandira NovoMix ® 30.

Ana ndi achinyamata. Kafukufuku wa masabata a 16 omwe adachitika kwa odwala 167 a zaka 10-18 poyerekeza mphamvu ya kusunga postprandial glycemic pomvera NovoMix 30 ndi zakudya pogwiritsa ntchito insulin / biphasic human insulin 30 yokhala ndi insulin NPH asanagone. Nthawi yonse yophunzira m'magulu onse awiriwa, kuchuluka kwa HbA 1C kunatsalira pamlingo womwe unaphatikizidwa ndi phunziroli, popanda kusiyana kulikonse pazochitika za hypoglycemia pakati pa NovoMix 30 ndi biphasic insulin 30.

Pakufufuza kwapawiri kwa khungu (masabata 12 pa maphunziro aliwonse) kochitikira pagulu laling'ono la ana (anthu 54) Pazaka 6-12, kuchuluka kwa ziwonetsero za hypoglycemia ndi kuchuluka kwa glucose kunali kochepa kwambiri pochiritsidwa ndi NovoMix â 30 kuyerekezera ndi insulin ya anthu ya biphasic 30. Mlingo wa HbA 1C kumapeto kwa maphunzirowo unatsika kwambiri m'gululi omwe amalandila insulin 30 ya anthu kuposa 30 mgulu lomwe limalandira NovoMix â 30.

Okalamba. Ma pharmacodynamics a NovoMix â 30 sanaphunzitsidwe mu odwala okalamba. Komabe, kafukufuku wosasintha wa khungu wakhungu wosapangidwa kamodzi adachitika omwe amafananitsa ndi pharmacokinetics ndi pharmacodynamics of insulin aspart ndi soluble human insulin mwa odwala 19 omwe ali ndi mtundu II matenda a shuga omwe amakhala ndi zaka 65-83 zaka (zikutanthauza zaka 70). Kusiyana kwapadera kwa pharmacodynamics (GIR max, AUC GIR, 0-120 min) pambuyo pa kuperekera kwa inshuwaransi kapena insulin ya anthu mwa odwalawa kunali kofanana ndi kwa anthu athanzi kapena odwala matendawa.

Mu insulin aspart, amino acid proline yomwe ili pamalo 28 mwa B unyolo wa insulini imaloledwa ndi asidi, amachepetsa mapangidwe a hexamers, monga momwe amanenera pokonzekera insulin ya anthu. Mu gawo losungunuka la NovoMix 30, gawo la insulin aspart ndi 30% ya insulini yonse, imatengedwa m'magazi kuchokera ku subcutaneous minofu mwachangu kuposa sungunuka wa insulle ya biphasic insulin yaumunthu. 70% omwe atsala ali mu mawonekedwe a crystalline a protamine-insulin aspart, omwe amatenga nthawi yayitali omwe ndi ofanana ndi insulin NPH. Kuchuluka kwa insulini mu seramu yamagazi pambuyo pa kukhazikitsidwa kwa NovoMix 30 ndi 50% kuposa, ndipo nthawi yakufikira ndi theka la biphasic insulin ya anthu 30. Mwa odzipereka amoyo wathanzi, pambuyo pa subcutaneous makonzedwe a NovoMix 30 pamlingo wa 0,20 U / kg yolemera thupi serum insulin aspart idatheka pambuyo pa mphindi 60, inali 140 ± 32 pmol / L. Hafu ya moyo wa NovoMix ® 30 (t½), yomwe imawonetsa kuyamwa kwa kachigawo kakang'ono ka protamine, kanali pafupifupi maola 8-9. Magulu a insulin a insulini amabwerera ku maola 15-18 pambuyo pothandizidwa ndi subcutaneous. Odwala omwe ali ndi matenda a shuga a 2, ambiri anawapeza atakwanitsa mphindi 95 atakhazikitsa ndipo amakhala osachepera maola 14.

Okalamba. Ma pharmacokinetics a NovoMix â 30 sanaphunzitsidwe mu odwala okalamba. Komabe, kusiyana kwakukhazikika pazotsatira za pharmacokinetics pambuyo pa kuperekedwa kwa insulin aspart kapena insulin yaumwini mwa odwala omwe ali ndi mtundu II shuga mellitus (wazaka 65-83, zaka zapakati pa 70 zaka) anali ofanana mwa anthu athanzi kapena odwala matendawa. Odwala okalamba komanso osakhazikika, kuchuluka kwa mayamwidwe kumachepa, monga zikuwonekera ndi nthawi yayitali kuti mufikire kuchuluka kwa insulini m'magazi a max (82 min ndi malo osakanikirana a 60-120 min). Mtengo wa C max unali wofanana ndi wa odwala omwe ali ndi matenda a shuga a 2 aang'ono kwambiri komanso otsika pang'ono poyerekeza ndi odwala matenda ashuga a mtundu woyamba.

Matenda a impso ndi kwa chiwindi.

Ma pharmacokinetics a NovoMix ® 30 sanaphunzirepo mwa odwala omwe ali ndi vuto laimpso kapena kwa chiwindi ntchito.

Ana ndi achinyamata. Ma pharmacokinetics a NovoMix â 30 sanaphunziridwe ana ndi achinyamata. Komabe, mwa ana (azaka 6 mpaka 12) ndi achinyamata (azaka 13 mpaka 17) omwe ali ndi matenda amtundu woyamba 1, a pharmacokinetics ndi pharmacodynamics a soluble aspart insulin adaphunzira. Zinatengedwa mwachangu kwa odwala a magulu onse awiri, pomwe ma ma t max anali ofanana ndi akuluakulu. Pakalipano, mtengo wa C max m'misinkhu yosiyanasiyana anali osiyanasiyana mosiyanasiyana, zomwe zikuwonetsa kufunikira kwa kusankha kwa mankhwala a insulin.

Deta Yotetezera.

Zambiri zam'mbuyomu zomwe zimapezeka pamaziko a maphunziro apakhalidwe pachitetezo cha mankhwala, kuwopsa kwa mankhwala omwe amapezeka kawiri kawiri, mankhwala osokoneza bongo, komanso kuwopsa kwa kubereka, sizinawonetse chiopsezo kwa anthu.

Mu mayeso a in vitro, kuphatikizapo kumangiriza ma insulin ndi ma IGF-1 zolandilira komanso zotsatira zake pakukula kwa maselo, insulin aspart imakhala ngati insulin yaumunthu. Kafukufuku adawonetsanso kuti kudzipatula kumangiriza kwa insulin receptors kwa insulin aspart ndi ofanana ndi insulin ya anthu.

Mlingo

Kuyimitsidwa kwa makina oyang'anira, 100 PESCES / ml

1 ml ya kuyimitsidwa kuli

ntchito yogwira - insulin aspart 100 U (3.5 mg) (30% sungunuka wa insulin ndi 70% insulini puloteni imakhala yotuluka ndi protamine),

obwera: zinc, glycerol, phenol, metacresol, sodium hydrogen phosphate dihydrate, sodium chloride, protamine sulfate, hydrochloric acid, sodium hydroxide, madzi a jekeseni.

Kuyimitsidwa koyera poyera, pakasungidwa, kumapangidwira kukhala chowonekera, chopanda utoto kapena chosawoneka bwino komanso choyera. Mukasakaniza zomwe zalembera, kuyimitsidwa koyenera kuyenera kupanga.

Mlingo ndi makonzedwe

NovoMix® 30 FlexPen ® idapangidwa kokha kwa subcutaneous makonzedwe. NovoMix® 30 FlexPen ® sayenera kuperekedwa konsekonse, chifukwa izi zingayambitse hypoglycemia. Kuyang'anira kwa NovoMix® 30 FlexPen ® kuyeneranso kupewedwa. Osagwiritsa ntchito NovoMix ® 30 FlexPen ® chifukwa cha kulowerera kwa insulin (PPII) pamapampu a insulin.

Mlingo wa mankhwalawa umatsimikiziridwa ndi dokotala aliyense payekha, malinga ndi kuchuluka kwa shuga m'magazi.

Odwala omwe ali ndi matenda a shuga a mtundu wa 2, NovoMix ® 30 FlexPen ® amatha kutumikiridwa monga mankhwala amodzi komanso kuphatikiza kwa mankhwala a hypoglycemic m'malo omwe kuchuluka kwa glucose sikulamulidwa mokwanira ndi mankhwala amkamwa a hypoglycemic okha.

Kwa odwala omwe ali ndi matenda a shuga a mtundu wachiwiri, mlingo woyambira wa NovoMix® 30 FlexPen ® ndi magawo 6 m'mawa ndi 6 magawo 6 madzulo (chakudya cham'mawa ndi chakudya chamadzulo, motero). Amaloledwanso kutenga magawo 12 a NovoMix® 30 FlexPen ® kamodzi patsiku madzulo. Potsirizira pake, mutatha kutenga magawo 30 a mankhwalawa, ndikulimbikitsidwa kuti musinthe kumwa NovoMix® 30 FlexPen ® kawiri pa tsiku, ndikugawa mlingo mu magawo ofanana (ndi kadzutsa ndi chakudya chamadzulo, motero). Kusintha kotetezeka kotenga NovoMix® 30 FlexPen ® katatu patsiku ndikotheka pakugawa mlingo wa m'mawa m'magawo awiri ofanana ndikutenga magawo awiri m'mawa ndi masana.

Odwala omwe ali ndi insulin (mwachitsanzo, chifukwa cha kunenepa kwambiri), kufunikira kwa insulin tsiku ndi tsiku kumatha kuwonjezereka, ndipo odwala omwe ali ndi chinsinsi cha insulin, amatha kuchepetsedwa.

Gome lotsatirali likulimbikitsidwa kuti musinthe mlingo:

Mwazi wamagazi musanadye

KusinthaMlingo NovoMix® 30

NovoMix® 30 FlexPen ® iyenera kutumikiridwa musanadye. Ngati ndi kotheka, NovoMix® 30 FlexPen ® ikhoza kutumikiridwa patangotha ​​chakudya.

Kutentha kwa insulin yoyenera kuyenera kukhala kutentha kwambiri.

NovoMix® 30 FlexPen ® iyenera kuperekedwa mwachangu mu ntchafu kapena kunja kwamimba khoma. Ngati angafune, mankhwalawa amatha kuperekedwa kwa phewa kapena matako.

Ndikofunikira kusintha malo a jekeseni mkati mwa anatomical dera kuti muchepetse kukula kwa lipodystrophy.

Monga kukonzekera kwina konse kwa insulin, kutalika kwa nthawi ya NovoMix® 30 FlexPen ® kutengera mlingo, malo oyendetsera, kutsika kwa magazi, kutentha ndi mulingo wakuchita zolimbitsa thupi. Kudalira kwa mayamwidwe a NovoMix® 30 FlexPen ® pa malo opangira jakisoni sanaphunzire.

Kusintha kwa magazi kungafunikenso ngati wodwala ali ndi matenda a impso, chiwindi, mkhutu wa adrenal ntchito, pituitary gland kapena chithokomiro cha chithokomiro.

Kufunika kosinthidwa kwa mlingo kumatha kuonekanso posintha zolimbitsa thupi kapena zakudya zomwe wodwala amadya. Kusintha kwa Mlingo kungafunike posamutsa wodwala kuchokera ku mtundu wina wa insulin kupita ku ina.

Okalamba komanso odwala a senile

NovoMix® 30 FlexPen ® ikhoza kugwiritsidwa ntchito mwa odwala okalamba, komabe, zomwe zimawagwiritsa ntchito limodzi ndi mankhwala am'mlomo a hypoglycemic odwala omwe ali ndi zaka zoposa 75 ndizochepa.

Odwala omwe ali ndi vuto la impso kapena hepatic, kuchepa kwa insulin kumatha kuchepetsedwa.

Mwa odwala okalamba, ndikofunikira kuwunika kuchuluka kwa shuga m'magazi ndikusintha mlingo wa insulini wa insulin wotengera deta yaumwini.

Ana ndi achinyamata

NovoMix® 30 FlexPen ® ikhoza kugwiritsidwa ntchito pochiza ana ndi achinyamata azaka zopitilira zaka 10 milandu ikakhala kuti amakonda kugwiritsa ntchito insulin yosakanizika kale. Zambiri zamankhwala azachipatala zimapezeka kwa ana azaka za 6 mpaka 9.

Njira zopewera:

NovoMix® 30 FlexPen® ndi singano ndizongogwiritsa ntchito nokha. Osadzazitsanso katoni katemera.

NovoMix® 30 FlexPen ® siyingagwiritsidwe ntchito ngati ikasakaniza siyikhala yoyera komanso yamitambo.

Ndikofunikira kusakaniza kuyimitsidwa kwa NovoMix® 30 FlexPen ® musanagwiritse ntchito. Osagwiritsa ntchito NovoMix ® 30 FlexPen ® ngati angozizira. Ponyani singano pambuyo pa jekeseni iliyonse.

Zotsatira zoyipa

Zotsatira zoyipa zomwe zimapezeka mwa odwala omwe amagwiritsa ntchito NovoMix® 30 FlexPen® amadalira kwambiri mlingo wa mankhwalawa komanso chifukwa cha kupatsirana kwamatenda.

Izi ndizotsatira zamawonekedwe azovuta zomwe zimadziwika pamayeso azachipatala, omwe amawonedwa ngati ogwirizana ndi kugwiritsa ntchito NovoMix® 30 FlexPen ®. Pafupipafupi amayesedwa motere: Nthawi zambiri (≥ 1/10), nthawi zambiri (≥ 1/100 to

Kutulutsa mawonekedwe, ma CD ndi kapangidwe kake

Kuyimitsidwa kwa s / c kukongoletsa kwamtundu yoyera, kopanda pake (popanda zipu, mapale amatha kuwonekera), mutapatulidwa, kumafinya, ndikupanga choyera komanso chosawoneka bwino, komanso chosangalatsa chosakanizira, kuyimitsidwa koyenera kuyenera.

Othandizira: glycerol - 16 mg, phenol - 1.5 mg, metacresol - 1.72 mg, nthaka ya zinc. - 19.6 μg, sodium kolorayidi - 0,877 mg, sodium hydrogen phosphate dihydrate - 1,25 mg, protamine sulfate

0,33 mg wa sodium hydroxide

2.2 mg, hydrochloric acid

1,7 mg, madzi d / i - mpaka 1 ml.

3 ml (300 PIECES) - makatoni (5) - matuza (1) - mapaketi a makatoni.

Zotsatira za pharmacological

Ndi kuyimitsidwa kw magawo awiri komwe kumakhala kuphatikiza kwa insulin analogues: soluble insulin anart (30% yochepa-insulin analog) ndi makulitsidwe a insulin analogue (70%-insulin analog).

Kutsika kwa shuga m'magazi kumachitika chifukwa cha kuwonjezereka kwa mayendedwe ake obisika pambuyo pomumanga kwa biphasic insulin kupita ku insulin zolandilira minofu ndi mafuta minyewa komanso munthawi yomweyo kuletsa kwa shuga m'magazi.

Zotsatira zoyipa

Pa mbali ya chitetezo chathupi: pafupipafupi - urticaria, zotupa pakhungu, zotupa pakhungu, kawirikawiri - anaphylactic reaction.

Kuchokera kumbali ya kagayidwe ndi zakudya: pafupipafupi - hypoglycemia.

Kuchokera ku dongosolo lamanjenje: kawirikawiri - zotumphukira za neuropathy (zotupa za neuropathy).

Kuchokera kumbali ya gawo la masomphenyawo: pafupipafupi - zolakwika zatsopano, matenda ashuga retinopathy.

Kuchokera pakhungu ndi subcutaneous zimakhala: pafupipafupi - lipodystrophy.

Zotsatira zambiri: pafupipafupi - edema.

Mimba komanso kuyamwa

Zochitika zamankhwala zokhala ndi pakati ndizoperewera.

Munthawi ya kuyambika kwa kutenga pakati komanso panthawi yonseyo, ndikofunikira kuyang'anitsitsa momwe odwala omwe ali ndi matenda osokoneza bongo amayang'anira ndikuwonetsetsa kuchuluka kwa shuga m'magazi. Kufunika kwa insulini, monga lamulo, kumachepera mu trimester yoyamba ndipo pang'onopang'ono kumawonjezeka pang'onopang'ono wachiwiri komanso wachitatu wokonzekera kutenga pakati. Pambuyo pobadwa, kufunikira kwa insulin kumabwereranso msanga momwe kunaliri asanakhale ndi pakati.

Panthawi yoyamwitsa, imatha kugwiritsidwa ntchito popanda zoletsa. Kukhazikitsidwa kwa insulin kwa mayi woyamwitsa sikuopseza mwana. Komabe, kusintha kwa mlingo kungakhale kofunikira.

Gwiritsani ntchito ana

Sichikulimbikitsidwa kwa ana ochepera zaka 6, monga mayesero azachipatala sanachitike.

Itha kugwiritsidwa ntchito pochiza ana ndi achinyamata azaka zopitilira zaka 10 ngati ntchito ya insulin yosakaniza isanachitike. Zambiri zamankhwala azachipatala zimapezeka kwa ana azaka za 6-9.

Malangizo apadera

Asananyamuke ulendo wamtunda wophatikizapo kusintha kwa malo, wodwalayo ayenera kufunsa dokotala, chifukwa kusintha nthawi kumatanthauza kuti wodwalayo ayenera kudya ndi kupatsa insulin panthawi ina.

Mlingo wosakwanira wa mankhwalawa kapena kusiya kulandira chithandizo, makamaka mtundu wa matenda a shuga 1, angayambitse kukula kwa hyperglycemia kapena matenda ashuga a ketoacidosis. Monga lamulo, zizindikiro zoyambirira za hyperglycemia zimawonekera pang'onopang'ono, kwa maola angapo kapena masiku. Zizindikiro za hyperglycemia ndi ludzu, kutuluka kwamkodzo, nseru, kusanza, kugona, kufooka ndi khungu, pakamwa pouma, kusowa chilimbikitso, komanso mawonekedwe a fungo la acetone m'mlengalenga. Popanda chithandizo choyenera, hyperglycemia odwala omwe ali ndi matenda amtundu wa 1 angayambitse matenda a shuga a ketoacidosis, vuto lomwe lingathe kupha.

Kudumpha zakudya kapena kuchita masewera olimbitsa thupi mosakonzekera kungayambitse matenda a hypoglycemia. Hypoglycemia imatha kukhazikikanso ngati mlingo wa insulin ndiwokwera kwambiri poyerekeza ndi zosowa za wodwala.

Pambuyo kulipirira kagayidwe kazakudya, mwachitsanzo, ndi insulin yothandizira, odwala amatha
Zizindikiro wamba za hypoglycemia kusintha, zomwe odwala ayenera kudziwa. Zizindikiro zachilendo zimatha kutha ndi matenda a shuga.

Matenda okhala ndi vuto limodzi, makamaka opatsirana komanso kutentha thupi, nthawi zambiri amalimbikitsa kufunika kwa insulin. Kusintha kwa magazi kungafunikenso ngati wodwala ali ndi matenda a impso, chiwindi, mkhutu wa adrenal ntchito, pituitary gland kapena chithokomiro cha chithokomiro.

Mukasamutsa wodwala ku mitundu ina ya insulini, zizindikiro zoyambirira za hypoglycemia zimatha kusintha kapena kuchepa kwambiri poyerekeza ndi omwe amagwiritsa ntchito mtundu wakale wa insulin.

Kusamutsa wodwala kupita ku mtundu wina wa insulin kapena kukonzekera kwa insulin kwa wopanga wina kuyenera kuchitika moyang'aniridwa ndi achipatala. Mukasintha ndende, mtundu, wopanga ndi mtundu wa anthu (insulin yaumunthu, analog ya insulin yaumunthu) pokonzekera insulin ndi / kapena njira yopangira, kusintha kwa mlingo kungafunike.

Milandu yokhudzana ndi matenda a mtima omwe amayamba chifukwa cha kulephera kwa mtima adanenedwa mothandizidwa ndi odwala omwe ali ndi thiazolidinediones kuphatikiza kukonzekera kwa insulin, makamaka ngati odwala oterewa ali pachiwopsezo chotukuka kwa mtima wosalephera. Izi zimayenera kukumbukiridwa popereka mankhwala ophatikiza ndi thiazolidatediones ndi insulin yokonzekera odwala. Ndi mankhwala osakanikirana oterowo, ndikofunikira kuchita mayeso azachipatala kwa odwala kuti azindikire zizindikiritso za mtima kulephera, kulemera kwa thupi ndi kupezeka kwa edema. Ngati zizindikiro za kulephera kwa mtima zikuchulukirachulukira kwa odwala, chithandizo ndi thiazolidatediones ziyenera kusiyidwa.

Zokhudza mphamvu pakutha kuyendetsa magalimoto ndi zida

Kuthekera kwa odwala kulolera komanso kuthamanga kwazomwe zimachitika kungawonongeke panthawi ya hypoglycemia, zomwe zimatha kukhala zowopsa nthawi zomwe maluso amenewa amafunikira makamaka (mwachitsanzo, poyendetsa magalimoto kapena kugwiritsa ntchito makina ndi makina).

Odwala ayenera kulangizidwa kuti achitepo kanthu popewa kukula kwa hypoglycemia mukamayendetsa. Izi ndizofunikira kwambiri kwa odwala omwe alibe kapena kuchepa kwa kutsogolera kwa matupi opangira hypoglycemia kapena akuvutika ndi zochitika zapafupipafupi za hypoglycemia. Muzochitika izi, kuyendetsa bwino ndikuchita ntchito yotereyi kuyenera kuganiziridwa.

Kuyanjana kwa mankhwala osokoneza bongo

Pali mankhwala angapo omwe amakhudza kufunika kwa insulin. Hypoglycemic zotsatira za insulin patsogolo mankhwala m'kamwa hypoglycemic, Mao zoletsa, zoletsa Ace, carbonic anhydrase zoletsa si kusankha beta-blockers, bromocriptine, sulfonamides, anabolic mankhwala, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, mankhwala lifiyamu salicylates .

Mphamvu ya pakamwa ya hypoglycemic ya insulini imachepetsedwa ndi kulera kwapakamwa, glucocorticosteroids, mahomoni a chithokomiro, thiazide diuretics, heparin, tridclic antidepressants, sympathomimetics, somatropin, danazole, clonidine, ofunda calcium calcium blockers, diazoxide, morphine.

Beta-blockers amatha kufinya zizindikiro za hypoglycemia.

Octreotide / lanreotide imatha kuwonjezeka ndikuchepetsa kufunikira kwa insulin.

Mowa ungapangitse kapena kuchepetsa mphamvu ya insogulin.