Levemir kapena Lantus?

Ndi mankhwala ati omwe amakhala bwino: Levemir kapena Lantus, nthawi zambiri amasangalatsa odwala omwe ali ndi matenda ashuga. Mankhwala onse awiriwa ndi mtundu wa insulin ya basal ndipo amadziwika ndi kuchitapo kanthu kwanthawi yayitali. Chifukwa chake, kuti muthe kugwiritsa ntchito bwino kwambiri kwa inu, muyenera kudziwa bwino aliyense payekhapayekha, kulabadira makamaka malingaliro amtundu wa mankhwala, contraindication ndi zotsatira zoyipa zomwe zingachitike mukamachita mankhwala ndi Lantus kapena Levemir.

ZOFUNIKA KUDZIWA! Ngakhale odwala matenda ashuga kwambiri amatha kuchiritsidwa kunyumba, popanda opaleshoni kapena zipatala. Ingowerenga zomwe Marina Vladimirovna akunena. werengani zonena zake.

Kodi pali kusiyana kwanji pakati pa molekyulu ya Lantus ndi insulin ya anthu

Insulin Lantus (Glargin) amapangidwa pogwiritsa ntchito njira zopangira ma genetic. Amapezeka ndi kubwerezabwereza kwa Escherichia coli Escherichia coli bacteria bacteria (K12 tizilombo). Mu molekyulu ya insulin, Glargin anasintha katsitsumzukwa ndi glycine pamalo 21 a A mnyolo, ndipo mamolekyulu awiri a arginine omwe ali pamalo 30 a B unyolo anawonjezeredwa. Kuphatikizidwa kwama molekyulu awiri a arginine ku C-terminus ya B-chain adasintha mawonekedwe a isoelectric kuchokera pH 5.4 mpaka 6.7.

Molekyulu ya Lantus - imasungunuka mosavuta ndi pH yokhala ndi acid. Nthawi yomweyo, imakhala yocheperako kuposa insulin yaumunthu, sungunuka pa pH ya thupi pH ya minofu yapansipansi. Kusintha katsabola wa A21 ndi glycine ndi kosagwirizana bwino. Amapangidwira kuti apatse analogue yaku insulin ya anthu ndikukhazikika. Glulin insulin imapangidwa pa asidi pH ya 4.0, chifukwa chake amaletsedwa kusakanikirana ndi insulin yopangidwa mosavomerezeka pH, komanso kuyipaka ndi mchere kapena madzi osungunuka.

Insulin Lantus (Glargin) imakhala ndi nthawi yayitali chifukwa imakhala ndi mtengo wapadera wotsika wa pH. Kusintha kwa pH kunapangitsa kuti mtundu wamtunduwu wa insulin usungunuke pang'ono pa pH ya thupi ya masamu a subcutaneous. Lantus (Glargin) ndi yankho lomveka bwino. Pambuyo subcutaneous makonzedwe a insulin, iwo amapanga micorecipients mu ndale zosakhalitsa pH wa subcutaneous danga. Insulin Lantus sayenera kuchepetsedwa ndi saline kapena madzi a jekeseni, chifukwa cha izi, pH yake imayandikira mwachizolowezi, ndipo njira yothandizira nthawi yayitali ya insulin idzasokonekera. Ubwino wa Levemir ndikuti ukuwoneka kuti ukuchepetsedwa momwe ungathere, ngakhale izi sizivomerezedwa mwalamulo, werengani zambiri pansipa.

Insulin Levemir (Detemir) ndi analogue wina wokhala ndi insulin yayitali, wopikisana naye ku Lantus, yemwe adapangidwa ndi Novo Nordisk. Poyerekeza ndi insulin yaumunthu, amino acid yomwe ili mu molekyulu ya Levemir idachotsedwa pa malo 30 a B. M'malo mwake, otsala a acid acid, myristic acid, omwe ali ndi maatomu 14 a kaboni, amaphatikizidwa ndi amino acid lysine yomwe ili pamalo 29 a B. Chifukwa cha izi, 98-99% ya insulin Levemir m'magazi pambuyo poti jekeseni amamangirira ku albumin.

Levemir imatengeka pang'onopang'ono kuchokera pamalowo jakisoni ndipo imakhala nthawi yayitali. Kuchedwa kwake kumatheka chifukwa chakuti insulin imalowera m'magazi pang'onopang'ono, komanso chifukwa ma molekyulu a insulin analogue amalowa m'maselo omwe amapita pang'onopang'ono. Popeza mtundu wa insulin ulibe tanthauzo lalikulu, chiwopsezo cha hypoglycemia chimachepetsedwa ndi 69%, ndipo usiku hypoglycemia - ndi 46%. Izi zidawonetsedwa ndi zotsatira za kafukufuku wazaka 2 mwa odwala omwe ali ndi matenda ashuga a 1.

Ndi insulin yotalikilapo kuposa iti - Lantus kapena Levemir?

Lantus ndi Levemir achita zinthu monga insulin analogues, zomwe apeza posachedwapa pochiza matenda ashuga omwe ali ndi insulin. Ndiwofunikira chifukwa ali ndi mawonekedwe okhazikika osapendekera - chithunzi chojambula cha plasma cha mitundu iyi ya insulini chili ndi mtundu wa "mafunde ndege". Imatengera yachilengedwe.

Lantus ndi Detemir ndi mitundu yokhazikika komanso yolosera za insulin. Amagwira pafupifupi odwala osiyanasiyana, komanso masiku osiyanasiyana mwa wodwala yemweyo. Tsopano munthu wodwala matenda ashuga sayenera kusakaniza chilichonse asadzipatse jakisoni wa insulin yayitali, koma izi zisanachitike panali kukangana kwambiri chifukwa cha protafan ndi insulin.

Pa phukusi la Lantus kwalembedwa kuti insulini yonse iyenera kugwiritsidwa ntchito pakatha milungu 4 kapena masiku 30 phukusi lisindikize. Levemir ali ndi mashelufu okhala ndi nthawi yayitali nthawi 1.5, mpaka masabata 6, komanso osagwirizana mpaka milungu 8. Ngati muli ndi chakudya chochepa kwambiri cha matenda a shuga a mtundu woyamba kapena a 2, mwina mudzafunika ma insulin okwanira tsiku lililonse. Chifukwa chake, Levemir ikhale yabwino kwambiri.

Palinso malingaliro (osatsimikiziridwa!) Kuti Lantus amawonjezera chiopsezo cha khansa kuposa mitundu ina ya insulin. Cholinga chake ndikuti Lantus ali ndi mgwirizano wambiri wa kukula kwama hormone omwe amapezeka pamaselo a khansa. Zambiri zokhudzana ndi kutenga kwa Lantus khansa sizinatsimikizidwe, zotsatira zakusaka ndizotsutsana. Koma mulimonse momwe zingakhalire, Levemir ndiotsika mtengo ndipo sizowopsa. Ubwino wake ndiwakuti Lantus sayenera kuchepetsedwa konse, ndipo Levemir - ngati kuli kotheka, azingokhala mwamwayi. Komanso, akayamba kugwiritsa ntchito, Levemir amasungidwa nthawi yayitali kuposa Lantus.

Odwala ambiri omwe ali ndi matenda ashuga komanso endocrinologists amakhulupirira kuti ngati milingo yayikulu imayendetsedwa, ndiye kuti jakisoni imodzi ya Lantus patsiku ndi yokwanira. Mulimonsemo, levemir iyenera kubayidwa kawiri patsiku, chifukwa chake, ndi Mlingo waukulu wa insulin, ndizosavuta kuthandizidwa ndi Lantus. Koma ngati mukutsatira pulogalamu yothana ndi matenda a shuga 1 kapena pulogalamu ya 2 yokhala ndi matenda a shuga, maulalo omwe amaperekedwa pansipa, ndiye kuti simungafunikire kuchuluka kwa insulin yayikulu. Sitigwiritsa ntchito Mlingo wakulu kwambiri kotero kuti amapitiliza kugwira ntchito kwa tsiku lonse, kupatula kwa odwala matenda a shuga a 2 omwe ali ndi kunenepa kwambiri. Chifukwa njira yokhayo ya akatundu yaying'ono yomwe imakulolani kuti muzitha kuyendetsa bwino magazi a shuga amtundu 1 komanso matenda a shuga a 2.

Timakhala ndi shuga wamagazi a 4,6 ± 0,6 mmol / L, ngati anthu athanzi, maola 24 patsiku, kusinthasintha pang'ono tisanadye komanso tisanadye. Kuti mukwaniritse cholinga chofuna kukwaniritsa izi, muyenera kupaka jekeseni wowonjezera kawiri pa tsiku. Ngati matenda a shuga amathandizidwa ndi Mlingo wochepa wa insulin yayitali, ndiye kuti nthawi ya Lantus ndi Levemir ingafanane. Mwakutero, zabwino za Levemire, zomwe tafotokozera pamwambapa, ziwonekera.

Chifukwa chiyani ndikosayenera kugwiritsa ntchito NPH-insulin (protafan)

Mpaka kumapeto kwa zaka zam'ma 1990, mitundu yochepa ya insulin inali yoyera ngati madzi, ndipo ena onse anali mitambo, opaque. Insulin imayamba kukhala yamtambo chifukwa chowonjezera pazinthu zomwe zimapanga zinthu zapadera zomwe zimasungunuka pang'onopang'ono pakhungu la munthu. Mpaka pano, ndi mtundu umodzi wokha wa insulini womwe wakhala wopanda mitambo - nthawi yayitali yochitapo kanthu, yomwe imatchedwa NPH-insulin, imaphatikizanso. NPH imayimira "Hagedorn's Neutral Protamine," puloteni wazomwe nyama.

Tsoka ilo, NPH-insulin imatha kulimbikitsa chitetezo cha mthupi kutulutsa ma antibodies kuti apange insulin. Ma antibodies awa samawononga, koma kumangika gawo la insulin mwachangu ndikupangitsa kuti likhale losagwira. Kenako insulin yomangidwa mwadzidzidzi imayamba kugwira ntchito ngati singakufunenso. Izi ndizofooka kwambiri. Kwa odwala matenda ashuga wamba, kupatuka kwa shuga kwa ± 2-3 mmol / L sikukhudzidwa kwenikweni, ndipo sazindikira. Timayesetsa kukhala ndi shuga yabwinobwino, i.e.6,6 mm 0,6 mmol / l tisanadye komanso titadya. Kuti tichite izi, timachita pulogalamu yanthete ya matenda a shuga 1 kapena mtundu wa 2 wa matenda a shuga. Zoterezi, kusakhazikika kwa sing'anga wa insulin kumaonekera ndikuwononga chithunzicho.

Pali vuto linanso ndi protamine Hagedorn yosaloledwa. Angiography ndikuwunika kwa mitsempha yamagazi yomwe imadyetsa mtima kuti mudziwe kuchuluka komwe amakhudzidwa ndi atherosclerosis. Iyi ndi njira yodziwika bwino yazachipatala. Asanayendetse, wodwalayo amapatsidwa jakisoni wa heparin. Ichi ndi mankhwala osokoneza bongo omwe amalepheretsa mapulateleti kuti asamatikane komanso kutsekereza mitsempha yamagazi ndi magazi. Ndondomekoyo ikamaliza, jakisoni wina amapangidwa - NPH imayendetsedwa kuti "imitsani" heparin. Pochepa peresenti ya anthu omwe amathandizidwa ndi protafan insulin, thupi limakumana ndi zovuta pamenepa, zomwe zimatha kupha.

Mapeto ake ndikuti ngati nkotheka kugwiritsa ntchito zina m'malo mwa NPH-insulin, ndiye kuti ndibwino kuchita izi. Monga lamulo, odwala matenda ashuga amasamutsidwa kuchokera ku NPH-insulin kupita ku insulin analogenes Levemir kapena Lantus. Kuphatikiza apo, amawonetsanso zotsatira zabwino za kayendedwe ka magazi.

Niche yokhayo kumene kugwiritsa ntchito NPH-insulin kumakhalabe koyenera lero kuli ku USA (!) Ana ang'onoang'ono omwe ali ndi matenda a shuga 1. Amafuna mlingo wochepa kwambiri wa insulin kuti alandire chithandizo. Mlingo wake ndiwocheperako kotero kuti insulin imayenera kuchepetsedwa. Ku United States, izi zimachitika pogwiritsa ntchito njira zoperekera insulin dilution zoperekedwa ndi opanga kwaulere. Komabe, kwa insulin analogues ya nthawi yayitali, njira zotere sizipezeka. Chifukwa chake, Dr. Bernstein amakakamizidwa kuti apange jakisoni wa NPH-insulin, yomwe ikhoza kuchepetsedwa katatu patsiku, kwa odwala ake achinyamata.

M'mayiko olankhula Chirasha, njira zothetsera insulin dilution sizipezeka masana ndi moto, ndalama zilizonse, kwaulere. Chifukwa chake, anthu amachepetsa insulin pogula saline kapena madzi a jakisoni m'masitolo. Ndipo zikuwoneka kuti njirayi imagwiranso ntchito kwambiri, kuweruza poyerekeza ndemanga zomwe zapezeka pagulu la anthu odwala matenda ashuga. Mwanjira imeneyi, Levemir (koma osati Lantus!) Wowonjezera insulin. Ngati mumagwiritsa ntchito NPH-insulin kwa mwana, ndiye kuti muyenera kuchepetsa ndi mchere womwewo monga Levemir. Tiyenera kukumbukira kuti Levemir amachita bwino ndipo ndikofunikira kuti ayambe kuyibula. Werengani zambiri mu nkhani ya "Momwe mungapangire insulin kuti mupeze jekeseni wotsika"

Momwe mungapangire shuga m'mawa wopanda kanthu kuti ukhale wabwinobwino

Tiyerekeze kuti mukumwa mlingo wovomerezeka wamapiritsi othandizira a 2 shuga usiku. Ngakhale izi, shuga m'magazi anu m'mimba yopanda kanthu amakhala owonjezera, ndipo nthawi zambiri amakula usiku. Izi zikutanthauza kuti mumafunikira jakisoni wa insulini yowonjezera usiku wonse. Komabe, musanapereke jakisoni, muyenera kuonetsetsa kuti wodwala matenda ashuga amadya maola 5 asanagone. Ngati shuga m'magazi amadzuka usiku chifukwa choti wodwala matenda ashuga amadya chakudya chamadzulo, ndiye kuti insulini ikulimbikitsidwa usiku sichithandiza. Onetsetsani kuti mukukhala ndi chizolowezi chodyera chakudya cham'mawa kwambiri. Ikani chikumbutso pafoni yanu nthawi ya 5.30 p.m. kuti nthawi yakudya, ndikudya chamadzulo 6 k.m. 6. 6.30 p.m. Mukatha kudya chakudya cham'mawa tsiku lotsatira, mudzakhala osangalala kudya zakudya zamaproteni chakudya cham'mawa.

Mitundu yowonjezera ya insulin ndi Lantus ndi Levemir. Pamwambapa m'nkhaniyi takambirana mwatsatanetsatane momwe amasiyana wina ndi mnzake komanso ndi bwino kugwiritsa ntchito. Tiyeni tiwone momwe jakisoni wa insulin yowonjezereka imagwira ntchito usiku. Muyenera kudziwa kuti chiwindi chimagwira makamaka posokoneza insulin m'mawa, mutatsala pang'ono kudzuka. Izi zimatchedwa mbandakucha chodabwitsa. Ndiye amene amayambitsa shuga m'magazi pamimba yopanda kanthu. Palibe amene akudziwa zifukwa zake. Komabe, imatha kulamulidwa bwino ngati mukufuna kukwaniritsa shuga m'mawa pamimba yopanda kanthu. Werengani zambiri mwatsatanetsatane "The Phenomenon of Morning Dawn and How to control it."

Chifukwa chakumayambiriro kwa m'bandakucha, jakisoni wa nthawi yayitali usiku amalimbikitsidwa osaposa maola 8.5 musanadzuke m'mawa. Mphamvu ya jakisoni wa insulin yotalika usiku imachepetsedwa maola 9 pambuyo pa jekeseni. Ngati mukutsatira zakudya zamagulu ochepa a shuga, ndiye kuti mitundu yonse ya insulini, kuphatikizapo insulini yowonjezera usiku, imafunikira yocheperako. Zikakhala zotere, nthawi zambiri zotsatira za jakisoni wamadzulo wa Levemir kapena Lantus amayima usiku usanathe. Ngakhale opanga amati kuchita kwa mitundu iyi ya insulin kumatenga nthawi yayitali.

Ngati jakisoni wanu wamadzulo a insulin yowonjezereka akupitilizabe kugwira ntchito usiku wonse ndipo ngakhale m'mawa, zimatanthawuza kuti mwabayidwa kwambiri, ndipo pakati pausiku shuga limatsika pansi movomerezeka. Zingakhale zabwino, kumakhala zoopsa, komanso zowopsa kwambiri. Muyenera kukhazikitsa alamu kuti mudzuke pambuyo pa maola 4, pakati pausiku, ndikuyezera shuga lanu lamagazi ndi glucometer. Ngati ili pansipa 3.5 mmol / L, ndiye kuti mugawikane mgonero wamadzulo wa insulin yowonjezera m'magawo awiri. Pangani chimodzi mwazigawozi osati pompopompo, koma maola 4.

Zomwe simuyenera kuchita:

Kwezani chakudya chamadzulo cha insulin yochulukirapo mosamala, musathamangire nayo. Chifukwa ngati ndichedwa kwambiri, ndiye kuti pakati pausiku padzakhala hypoglycemia yokhala ndi zoopsa. M'mawa, shuga amawoneka okhuthala kwambiri "nkugudubuka". Izi zimatchedwa chodabwitsa cha Somoji.
Komanso, musakweze m'mawa anu Lantus, Levemir kapena Protafan. Izi sizingathandize kutsitsa shuga ngati akukulitsidwa pamimba yopanda kanthu.
Osagwiritsa ntchito jakisoni 1 wa Lantus kwa maola 24. Ndikofunikira kumangoyika Lantus osachepera kawiri patsiku, ndipo makamaka katatu - usiku, ndikuphatikiza pa 1-3 mamawa komanso m'mawa.

Timalimbikitsanso motere: ngati mlingo wa insulin wa nthawi yayitali umachuluka usiku, ndiye kuti shuga yothamanga sichepa m'mawa wotsatira, koma onjezerani.

Kugawa mlingo wamadzulo wa insulin yowonjezera m'magawo awiri, imodzi yomwe imalowetsedwa pakati pausiku, ndikulondola kwambiri. Ndi regimen iyi, mlingo wonse wamadzulo wa insulin yowonjezera ungathe kuchepetsedwa ndi 10-15%. Ndi njira yabwino kwambiri yolamulirira zodzuka m'mawa ndikukhala ndi shuga yabwinobwino m'mawa pamimba yopanda kanthu. Kubayira usiku usiku kumayambitsa zovuta pang'ono mukazolowera. Werengani momwe mungapangire insulin kuwombera mopanda chisoni. Pakati pausiku, mutha kubaya jekeseni wa insulin wa nthawi yayitali osakonzekereratu ngati mutakonzekera zonsezo madzulo kenako kugona tulo.

Momwe mungawerengere poyambira kuchuluka kwa insulin usiku

Cholinga chathu chachikulu ndikusankha Mlingo wa Lantus, Levemir, kapena Protafan kuti shuga osala kudya asungidwe wamba 4.6 ± 0,6 mmol / L. Zimakhala zovuta kwambiri kupanga shuga m'mawa pamimba yopanda kanthu, koma vutoli limathetsedwanso ngati mungayesere. Momwe mungathetse izi tafotokozazi.

Odwala onse odwala matenda amtundu 1 amafunika jakisoni wa insulin yowonjezera usiku ndi m'mawa, komanso jakisoni wa insulin yofulumira musanadye. Likukhalira jekeseni 5-6 patsiku. Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri, vutolo limakhala losavuta. Angafunike kubayidwa pafupipafupi. Makamaka ngati wodwalayo atsatira zakudya zamagulu ochepa osapatsa ulesi kuchita masewera olimbitsa thupi mosangalala. Odwala a shuga a Type 1 amalangizidwanso kuti asinthane ndi zakudya zochepa. Popanda izi, simudzatha kuwongolera bwino shuga, ziribe kanthu momwe mumawerengera mosamala mulingo wa insulin.

Choyamba, timayeza shuga ndi glucometer 10-12 pa tsiku kwa masiku 3-7 kuti timvetse momwe zimakhalira. Izi zikutipatsa chidziwitso nthawi yanji yomwe muyenera kubayira insulin. Ngati ntchito ya ma cell a beta a kapamba ikasungidwa pang'ono, ndiye kuti mwina ndizotheka kupaka jakisoni usiku kapena zakudya zina. Ngati wodwala yemwe ali ndi matenda a shuga a 2 amafunikira jakisoni wa insulin yayitali, ndiye kuti choyamba Lantus, Levemir kapena Protafan amayenera kubayidwa usiku.Kodi jakisoni wa insulin wa nthawi yayitali amafunikira m'mawa? Zimatengera zizindikiro za mita. Dziwani momwe shuga lanu limakhalira masana

Choyamba, timawerengera poyambira kuchuluka kwa insulin, kenako m'masiku otsatirawa timasintha mpaka zotsatira zovomerezeka

Pakupita masiku 7, timayeza shuga ndi glucometer usiku, ndipo m'mawa wotsatira pamimba yopanda kanthu.
Zotsatira zalembedwa pagome.
Timawerengera tsiku lililonse: shuga m'mawa pachabe chopanda kanthu m'mimba dzulo usiku.
Timataya masiku omwe odwala matenda ashuga adadyapo kale kuposa maola 4-5 asanagone.
Tikupeza mtengo wocheperako wowonjezera kuwonekera panthawiyi.
Buku lofufuza liziwona momwe 1 UNIT ya insulin imatsitsira shuga. Izi zimatchedwa putative insulin sensitivity factor.
Gawani kuchuluka kochepa kwa shuga usiku uliwonse ndi kuchuluka kwa mphamvu ya insulin. Izi zimatipatsa mlingo woyambira.
Finyani madzulo amawerengera kuchuluka kwa insulin. Tinakhazikitsa alamu kuti tidzuke pakati pausiku ndikuyang'ana shuga.
Ngati shuga usiku ali m'munsi mwa 3.5-3.8 mmol / L, mlingo wa insulin wamadzulo uyenera kutsitsidwa. Njira imathandizira - kusamutsa gawo lina mwa jakisoni yowonjezera nthawi ya 1-3 am.
M'masiku otsatirawo, timachulukitsa kapena kuchepetsa mlingo, kuyesa jakisoni wosiyanasiyana, mpaka m'mawa shuga timakhala pakati pa 4.6 ± 0.6 mmol / L, nthawi zonse popanda usiku hypoglycemia.

Zitsanzo za kuwerengera muyeso wa Lantus, Levemir kapena Protafan usiku

Tikuwona kuti deta ya Lachinayi imayenera kutayidwa, chifukwa wodwala amamaliza kudya mochedwa. M'masiku ena onse, kupeza shuga wambiri patsiku lililonse kunali Lachisanu. Zinakwana 4.0 mmol / L. Timatenga kukula kocheperako, osati kupitirira kapena pafupifupi. Cholinga chake ndi chakuti mlingo woyambira wa insulini ukhale wochepera m'malo motalika. Izi zimathandizanso wodwala kuti asadutse hypoglycemia yausiku. Gawo lotsatira ndikupeza kuchuluka kogwirizana kwa chidwi chofuna kutulutsa insulini kuchokera pamtengo wa tebulo.

Tiyerekeze kuti wodwala yemwe ali ndi matenda ashuga a 1, kapamba uja asiya kutulutsa insulin yake yonse. Pamenepa, 1 unit ya insulin yowonjezera imatsitsa shuga wamagazi ndi pafupifupi 2.2 mmol / L mwa munthu wolemera makilogalamu 64. Mukamayesa kwambiri, mankhwalawo amayamba kufooka kwambiri. Mwachitsanzo, kwa munthu wolemera makilogalamu 80, 200 kg / L * 64 kg / 80 kg = 1.76 mmol / L adzapezedwa. Timathetsa vuto lolemba gawo limodzi kuchokera ku koyamba maphunziro a masamu.

Kwa odwala omwe ali ndi matenda amtundu woyamba wa shuga, timangomutenga mwachindunji. Koma kwa odwala omwe ali ndi matenda a shuga a mtundu wa 2 kapena mtundu 1 wa shuga. Tiyerekeze kuti kapamba wanu akupanga insulin. Kuti tithane ndi chiwopsezo cha hypoglycemia, choyamba tilingalira za "mbali" yomwe gawo limodzi la insulini yowonjezera limatsitsa shuga ndi 4.4 mmol / l ndipo limalemera 64 kg. Muyenera kudziwa kufunika kwa kulemera kwanu. Pangani gawo, monga momwe tafotokozera pamwambapa. Kwa mwana yemwe akulemera 48 kg, 4.4 mmol / L * 64 kg / 48 kg = 5.9 mmol / L adzapezedwa. Kwa wodwala yemwe wadwala bwino matenda a shuga a 2 ndipo ali ndi kulemera kwa 80 makilogalamu, padzakhala 4.4 mmol / l * 64 kg / 80 kg = 3.52 mmol / l.

Tapeza kale kuti kwa odwala athu, kuchuluka kochepa kwa shuga m'magazi usiku uliwonse kunali 4,5 mmol / L. Kulemera kwake kwa thupi ndi 80 kg. Kwa iye, malinga ndi kuwunika "kosamala" kwa 1 U wa insulin yayitali, adzachepetsa magazi ndi 3.52 mmol / L. Pankhaniyi, kwa iye, mlingo woyambira wa insulin yowonjezera usiku udzakhala zigawo za 4.0 / 3.52 = 1.13. Pitani kumayendedwe apafupi a 1/4 PIECES ndikupeza 1.25 PISCES. Kuti mupeze jekeseni yochepa chonchi, muyenera kuphunzira momwe mungapangire insulin. Lantus sayenera kuchepetsedwa. Chifukwa chake, iyenera kudulidwa 1 unit kapena nthawi yomweyo 1.5 mayunitsi. Ngati mumagwiritsa ntchito Levemir m'malo mwa Lantus, ndiye kuti muthira kuti mupeze molondola 1.25 PIECES.

Chifukwa chake, adayika jekeseni woyambira wa insulin yayitali usiku. M'masiku otsatirawa, timakonza - kuchulukitsa kapena kuchepa mpaka shuga m'mawa pamimba yopanda kanthu ndikukhazikika pa 4.6 ± 0,6 mmol / l. Kuti mukwaniritse izi, muyenera kusiyanitsa mlingo wa Lantus, Levemir kapena Protafan wausiku ndi prick gawo kenaka pakati pausiku. Werengani malingaliro pamwambapa mu gawo "Momwe Mungapangire Kuti shuga Aziwonjezeka Mmawa".

Wodwala wa mtundu uliwonse 1 kapena mtundu wa 2 wodwala yemwe ali ndi zakudya zochepa za chakudya amafunika kuphunzira momwe angapangire insulin kuti mupeze jekeseni yotsika. Ndipo ngati simunasinthebe kudya zakudya zamafuta ochepa, ndiye mukuchita chiyani apa?

Chifukwa chake, tidaganizira momwe tingawerengere kuchuluka koyambira kwa insulin usiku. Ngati mwaphunzira masamu kusukulu, ndiye kuti mutha kuthana nawo. Koma chimenecho chinali chiyambi chabe. Chifukwa mlingo woyambira ungakhale wotsika kwambiri kapena wapamwamba kwambiri. Kusintha kwa mlingo wa insulin yayitali usiku, mumalemba shuga anu m'magazi kwa masiku angapo, kenako m'mawa m'mimba yopanda kanthu. Ngati kuchuluka kwambiri kwa shuga patsiku lililonse sikunapweteke kuposa 0.6 mmol / l - ndiye kuti mankhwalawo ndi olondola. Pankhaniyi, muyenera kuganizira masiku okhawo omwe mudadya pasanadutse maola opitilira 5 musanakagone. Kudya msanga ndi chizolowezi chofunikira kwa odwala matenda ashuga omwe amathandizidwa ndi insulin.

Ngati kuchuluka kwambiri kwa shuga patsiku usiku kupitirira 0,6 mmol / L - zikutanthauza kuti mankhwalawa a mankhwalawa amadzakulanso insulin amayenera kuwonjezeka. Kodi angachite bwanji? Ndikofunikira kuonjezera ndi 0,25 PIECES masiku atatu aliwonse, ndipo tsiku lililonse kuwunika momwe izi zingakhudzire kuchuluka kwa shuga usiku. Pitilizani kuonjezera mlingo pang'onopang'ono mpaka m'mawa m'mawa osapitirira 0,6 mmol / L apamwamba kuposa shuga lanu lamadzulo. Werengani werengani momwe mungayang'anire zochitika za m'mawa.

Momwe mungasankhire mulingo woyenera wa insulin usiku:

Muyenera kuphunzira kudya m'mawa kwambiri, maola 4-5 musanagone.
Ngati mutadya chakudya chamadzulo, ndiye kuti tsiku lotere silili loyenera kusintha kwa insulin usiku.
Kamodzi pa sabata pamasiku osiyanasiyana, yang'anani shuga yanu pakati pausiku. Iyenera kukhala osachepera 3.5-3.8 mmol / L.
Onjezerani mlingo wamadzulo wa insulin yochulukirapo ngati masiku atatu mzere shuga m'mimba yopanda kanthu imaposa 0.6 mmol / L kuposa momwe idalili dzulo asanagone.
Malangizo am'mbuyo - lingoganizirani za masiku omwe mudadya kadzutsa!
Kwa odwala omwe ali ndi matenda amtundu wa 1 ndi mtundu wa 2 omwe amatsata zakudya zamafuta ochepa. Mlingo wa insulin wautali usiku wonse tikulimbikitsidwa kuti uwonjezeke ndi osapitirira 0,25 magawo atatu aliwonse. Cholinga ndikudzibweretsera nokha momwe mungathere kuchokera ku nocturnal hypoglycemia.
Zofunika! Ngati mudakulitsa kuchuluka kwa insulin yamadzulo - masiku awiri otsatira, onetsetsani kuti muli ndi shuga pakati pausiku.
Kodi mungatani ngati shuga usiku mwadzidzidzi sakhala yocheperako kapena yolakwika? Chifukwa chake, muyenera kuchepetsa mlingo wa insulin, yomwe imabayidwa musanagone.
Ngati mukufunikira kuchepetsa mlingo wamadzulo wa insulin yowonjezereka, tikulimbikitsidwa kusamutsa gawo lina la jekeseni yowonjezera pa 1-3 am.

Hypoglycemia yausiku ndimavuto am'mawa ndimwambo wosasangalatsa komanso wowopsa ngati mukukhala nokha. Tiyeni tiwone momwe mungapewere ngati mukungoyamba kuchiza matenda anu a shuga ndi jakisoni wa insulin yowonjezera usiku. Khazikitsani alamu kuti ikudzutsireni maola 6 mutawombera. Mukadzuka, pimani magazi anu ndi glucometer. Ngati ili m'munsi mwa 3.5 mmol / l, idyani chakudya pang'ono kuti pasakhale hypoglycemia. Yang'anirani shuga yanu usiku m'masiku oyamba a inshuwaransi ya shuga, komanso nthawi iliyonse mukamayesetsa kuwonjezera kuchuluka kwa insulin usiku umodzi. Ngakhale amodzi mwa milandu yotereyi akutanthauza kuti mlingo uyenera kuchepetsedwa.

Matenda ambiri odwala matenda ashuga omwe amachititsa kuti munthu akhale ndi shuga wambiri pamafunika kuchuluka kwa insulin usiku umodzi wocheperako ma unit 8. Kupatula pa lamuloli ndi odwala a mtundu 1 kapena 2 a shuga, onenepa kwambiri, odwala matenda a shuga, komanso omwe tsopano ali ndi matenda opatsirana. Ngati mukulowetsa insulin usiku umodzi pakapita 7 mayunitsi kapena kupitilira, ndiye kuti malo ake amasintha, poyerekeza ndi waukulu. Zimakhala nthawi yayitali. Hypoglycemia imatha kuchitika musanadye tsiku lotsatira. Kuti mupewe mavutowa, werengani "Momwe mungapangire jakisoni waukulu wa insulin" ndikutsatira malangizowo.

Ngati mukufuna kumwa kwamadzulo kwa Lantus, Levemir kapena Protafan, ndiko kuti, kupitilira mayunitsi 8, ndiye kuti titha kugawaniza pakati pausiku. Madzulo, odwala matenda ashuga amakonza zofunikira zonse, ndikukayika koloko pakati pausiku, kuwombera pomuyimbira osakomoka, ndipo nthawi yomweyo amagonanso. Chifukwa cha izi, zotsatira za chithandizo cha matenda a shuga zimayenda bwino kwambiri. Ndikofunika kuti pasakhale vuto kuti tipewe hypoglycemia komanso kuti tipeze shuga m'mawa m'mawa. Komanso, zovuta zoterezi sizingakhale zochepa mutadziwa bwino jakisoni wa insulin wopanda ululu.

Chifukwa chake, tidaganiziratu momwe tikhazikitsire Latnus, Levemir kapena Protafan usiku. Choyamba, timazindikira ngati tingachite izi konse. Ngati zina zikufunika, ndiye kuti tikuwerengera ndikuyamba kumwa. Ndipo timakonza mpaka shuga m'mawa pamimba yopanda kanthu ndichizolowezi 4.6 ± 0,6 mmol / l. Pakati pausiku, sikuyenera kugwera pansi pa 3.5-3.8 mmol / L. Chowunikira chomwe mudaphunzira pawebusayiti yathu ndikuti mutenge chowonjezera chowonjezera cha insulin pakati pausiku kuti muziwongolera zochitika zam'mawa. Gawo lamankhwala lamadzulo limasamutsira iwo.

Tsopano tiyeni tiganizire za m'mawa mulingo wa insulin. Koma apa pakubwera zovuta. Kuti muthane ndi zovuta ndi jakisoni wa insulin yowonjezera m'mawa, muyenera kufa ndi njala masana kuyambira chakudya chamadzulo. Timabaya Lantus Levemir kapena Protafan kuti tisunge shuga wamba. Usiku mumagona ndi kugona mwanjira yachilengedwe. Ndipo masanawa kuyang'anira shuga m'mimba yopanda kanthu, muyenera kukana kudya. Tsoka ilo, iyi ndiye njira yokhayo yowerengera mlingo wa mmawa wa insulin. Njira ili pansipa ikufotokozedwa mwatsatanetsatane.

Tiyerekeze kuti mumalumpha shuga masana kapena imakwezeka pang'ono. Funso lofunika kwambiri: kodi shuga wanu amawonjezeka chifukwa cha zakudya kapena pamimba yopanda kanthu? Kumbukirani kuti insulin yowonjezera ikufunika kuti shuga ikhale yofulumira, komanso mwachangu - kupewa kuchuluka kwa shuga m'magumbo mukatha kudya. Timagwiritsanso ntchito insulin ya insulin kuti muchepetse shuga kukhala abwinobwino ngati angadumphe.

Kutha shuga m'magawo mutatha kudya insulin yochepa, kapena kubayirira insulin m'mawa kuti shuga asakhale bwino m'mimba yopanda dzuwa tsiku lililonse ndizosiyana. Chifukwa chake, ndikofunikira kudziwa momwe shuga yanu imakhalira masana, ndipo atatha kupereka mankhwala a insulini patsiku. Madokotala osaphunzira komanso odwala matenda ashuga amayesa kugwiritsa ntchito insulin yayifupi patsiku lomwe likufunika nthawi yayitali, mosinthana. Zotsatira zake zimakhala zomvetsa chisoni.

Ndikofunikira poyesa kudziwa momwe shuga yanu imakhalira masana. Kodi imatuluka ngati chakudya kapena pamimba yopanda kanthu? Tsoka ilo, muyenera kufa ndi njala kuti mumve izi. Koma kuyesera ndikofunikira. Ngati simukufunika jakisoni wa insulin yotalika usiku kuti mulipirire zomwe zachitika m'mawa, ndiye kuti sizingatheke kuti shuga lanu liziwuka masana pamimba yopanda kanthu. Komabe mukuyenera kuwunika ndikuwonetsetsa. Komanso, muyenera kuchita zoyeserera ngati mutaba jakisoni wa insulin yowonjezera usiku.

Momwe mungasankhire mlingo wa Lantus, Levemir kapena Protafan m'mawa:

Patsiku loyesera, musadye chakudya cham'mawa kapena chamasana, koma konzekerani kudya chakudya chamadzulo maola 13 mutadzuka. Iyi ndi nthawi yokhayo yomwe mumaloledwa kudya mochedwa.
Ngati mukumwa Siofor kapena Glucofage Long, ndiye kuti mumwa mankhwalawa m'mawa.
Imwani madzi ambiri tsiku lonse, mutha kugwiritsa ntchito tiyi ya zitsamba popanda shuga. Osamwalira ndi njala. Kofi, cocoa, tiyi wakuda ndi wobiriwira - ndibwino kuti musamwe.
Ngati mukumwa mankhwala a shuga omwe angayambitse hypoglycemia, ndiye kuti lero musamawatenge ndipo nthawi zambiri mungowasiya. Werengani kuti ndi mapiritsi ati a shuga omwe ali oyipa komanso abwino.
Pimani magazi anu ndi mita ya shuga m'magazi mukadzuka, kenako pambuyo pa ola limodzi, pambuyo maola 5, pambuyo maola 9, pambuyo maola 12 ndi maola 13 musanadye chakudya. Mwathunthu, mudzatenga miyezo 5 masana.
Ngati pakati pa maola 13 a kusala kudya kwatsiku ndi tsiku shuga adachulukanso kuposa 0,6 mmol / l ndipo sanagwe, ndiye kuti mufunika jakisoni wa insulin yokwanira m'mimba yopanda kanthu. Timawerengera kuchuluka kwa Lantus, Levemir kapena Protafan a jakisoni awa momwemonso ndi insulin yowonjezera usiku.

Tsoka ilo, kuti musinthe mlingo wa m'mawa wa insulin yayitali, muyenera kusala chimodzimodzi tsiku losakwanira ndikuwona momwe shuga ya magazi imakhalira tsiku lino. Kupulumuka masiku anjala kawiri mu sabata limodzi ndikosasangalatsa. Chifukwa chake, dikirani mpaka sabata lotsatira musanayesenso momwemo kuti musinthe insulin yanu yayitali. Tikugogomezera kuti njira zovutazi ndizofunikira kwa odwala okha omwe amatsatira zakudya zamafuta ochepa ndikuyesetsa kukhala ndi shuga yokhazikika 4.6 ± 0,6 mmol / L. Ngati kupatuka kwa ± 2-4 mmol / l sikokuvutitsani, ndiye kuti simungathe kuvutitsa.

Ndi matenda 2 a shuga, ndizotheka kuti mumafunikira jakisoni wa insulin mwachangu musanadye, koma simukufunika jakisoni wa insulin yowonjezera m'mawa. Komabe, izi sizinganenedwe popanda kuyesera, chifukwa chake musakhale aulesi kuzichita.

Tiyerekeze kuti mwayamba kuchiza matenda amishuga amtundu wa 2 ndi jakisoni wowonjezera usiku, ndipo mwina m'mawa. Pakapita kanthawi, mudzatha kupeza mlingo woyenera wa insulini kuti musunge shuga yathamanga yamagazi 24 tsiku lililonse. Zotsatira zake, kapamba amatha kudziwa kuti ngakhale popanda jakisoni wa insulin mwachangu amathetsa kuchuluka kwa shuga mutatha kudya. Izi zimachitika kawirikawiri ndi mtundu wofatsa wa 2 shuga. Koma ngati mutadya shuga m'magazi anu limapitilirabe kupitilira 0.6 mmol / L kuposa momwe limakhalira ndi anthu athanzi, ndiye kuti mumafunikanso jakisoni wa insulin yochepa musanadye. Kuti mumve zambiri, onani "Kuwerengera mlingo wa insulin yachangu musanadye."

Insulin yowonjezereka ndi Levemir: mayankho a mafunso

Glycated hemoglobin inatsika mpaka 6,5% - zabwino, komabe pali ntchito yofunika kuchita :). Lantus amatha kumenyedwa kawiri patsiku. Kuphatikiza apo, tikupangira kuti aliyense achite izi kuti athandize kuwongolera matenda ashuga. Pali zifukwa zina zosankhira Levemir m'malo mwa Lantus, koma ndizochepa. Ngati Lantus amaperekedwa kwaulere, koma Levemir - ayi, kenaka jekesani modekha kawiri pa tsiku insulin yomwe boma limakupatsirani.

Ponena za kusagwirizana kwa Lantus ndi NovoRapid ndi mitundu ina ya insulin kuchokera kwa opanga osiyanasiyana. Awa ndimabodza opusa, osatsimikiziridwa ndi chilichonse. Sangalalani ndi moyo mukalandira insulin yabwino yoyendetsedwa kunja kwaulere. Ngati muyenera kusinthana ndi zapakhomo, ndiye kuti mukukumbukirabe nthawi izi ndi mphuno. About "zakhala zovuta kuti ndilipire matenda ashuga." Sinthani ku chakudya chamafuta ochepa ndikutsatira njira zina zonse zomwe zatchulidwa mu pulogalamu yathu ya matenda ashuga a Type 1. Ndikupangira kwambiri jekeseni Lantus kawiri patsiku, m'mawa ndi madzulo, ndipo osati kamodzi, monga aliyense amakonda kutero.

Ndikadakhala m'malo mwanu, m'malo mwake, ndikulankhula mosamala Lantus, komanso kawiri patsiku, osati usiku wokha. Pankhaniyi, mutha kuyesa kuchita popanda jakisoni wa Apidra. Sinthani ku chakudya chamafuta ochepa ndikutsatira zochitika zina zonse monga zikufotokozedwera mu pulogalamu yachiwiri ya matenda a shuga. Chitani shuga yonse ya magazi podziyang'anira kamodzi pa sabata.Ngati mumatsatira zakudya mosamala, imwani mankhwalawa mtundu wachiwiri wa matenda ashuga, komanso makamaka kuchita masewera olimbitsa thupi mosangalala, ndiye kuti mwina mwapeza 95% jakisoni wa jakisoni wa insulin. Ngati popanda shuga shuga wanu ukhalabe wabwinobwino, kenaka jekesani Lantus. Jekeseni wa insulin yofulumira musanadye mtundu wachiwiri wa matenda ashuga wofunikira 2 pokhapokha ngati wodwalayo ndi waulesi kwambiri kuti azitsatira zakudya zamagulu pang'ono ndipo nthawi zambiri amatsata njira.

Werengani nkhani ya "Insulin Injection Technique". Yesani pang'ono - ndipo phunzirani momwe mungapangire jakisoniyo mopweteka. Izi zidzabweretsa mpumulo ku banja lanu lonse.

Inde, zilipo. Komanso, muyenera kugula Lantus kapena Levemir ndalama zanu, mmalo mwakugwiritsa ntchito "average" yaulere. Chifukwa - adakambirana mwatsatanetsatane.

Neuropathy, phokoso la matenda ashuga komanso zovuta zina zimatengera momwe mumakwanitsira kuti shuga yanu ikhale pafupi ndi yachibadwa. Ndi mtundu wanji wa insulin yomwe mumagwiritsa ntchito ilibe vuto lililonse ngati ikuthandizira kulipira matenda a shuga. Ngati mungasinthe kuchoka pa protafan kupita ku Levemir kapena Lantus monga insulin yowonjezera, ndiye kuti kutenga matenda a shuga kumakhala kosavuta. Anthu odwala matenda ashuga adachotsa kupweteka komanso zizindikiro zina za neuropathy - izi zimachitika chifukwa chakuti asintha magazi. Ndipo mitundu yapadera ya insulin ilibe chochita nayo. Ngati mukusamala ndi neuropathy, ndiye werengani nkhaniyi pa alpha lipoic acid.

Poyesa jakisoni wa insulin yowonjezera, mutha kusintha shuga yanu m'mawa popanda kanthu. Ngati mumadya zakudya zopatsa thanzi, zodzaza ndi chakudya, muyenera kugwiritsa ntchito milingo yayikulu ya Levemir. Poterepa, yesani kumwa mankhwalawa madzulo 22.00-00.00. Kenako nsonga ya machitidwe ake idzakwana 5,00-8,00 m'mawa, pomwe chodabwitsa cha m'bandakucha chikuwoneka momwe mungathere. Ngati mutasintha zakudya zamafuta ochepa ndipo zakudya zanu za Levemir ndizochepa, tikulimbikitsidwa kusinthana ndi jakisoni 3 kapena 4 patsiku kuchokera pakukonzekera kwa nthawi ya 2. Poyamba, izi ndizovuta, koma mumazolowera, ndipo shuga m'mawa umayamba kukusangalatsani.

Madokotala anu ali ndi nkhawa ndipo alibe chochita. Ngati m'zaka zinayi simunakhale ndi insulin, ndiye kuti sizingatheke kuti ziziwoneka modzidzimutsa. Ndimatengera izi. Zakudya zamagulu ochepa zama shuga sizimangoyambitsa shuga m'magazi, komanso zimachepetsa mwayi wokhala ndi ziwopsezo zilizonse. Chifukwa pafupifupi zinthu zonse zomwe zingayambitse ziwengo, timapatula chakudyacho, kupatula mazira a nkhuku.

Ayi, sizowona. Panali mphekesera zoti Lantus amasokoneza khansa, koma sizinatsimikizidwe. Khalani omasuka kusintha kuchokera ku protafan kupita ku Levemir kapena Lantus - insulin analogues. Pali zifukwa zazing'ono zomwe zimakhala bwino kusankha Levemir kuposa Lantus. Koma ngati Lantus amaperekedwa kwaulere, koma Levemir - ayi, ndiye kuti mupeze insulin yaulere yapamwamba kwambiri. Zindikirani Timalimbikitsa jakisoni wa Lantus kawiri kapena katatu patsiku, osati kamodzi.

Simukuwonetsa zaka zanu, kutalika, kulemera, mtundu wa matenda ashuga komanso kutalika kwachabe. Palibe mayankho omveka bwino a funso lanu. Mutha kugawa magawo 15 pakati. Kapena muchepetse muyeso wonse mwa magawo awiri a 1-2 ndikugawa pakati. Kapena mutha kumangoyipa kwambiri madzulo kuposa m'mawa kuti muchepetse zodzuka zam'mawa. Zonsezi ndiz payekha. Chitani kudziletsa kwathunthu kwa shuga wamagazi ndikuwongoleredwa ndi zotsatira zake. Mulimonsemo, kusinthana ndi jakisoni imodzi ya Lantus patsiku mpaka masiku olondola.

Palibe yankho lomveka bwino la funso lanu. Chitani kudziletsa kwathunthu kwa shuga wamagazi ndikuwongoleredwa ndi zotsatira zake. Iyi ndiyo njira yokhayo yomwe mungasankhe zolondola komanso zolimbitsa insulin mwachangu. Ndikukulimbikitsani kuyankhulana ndi makolo a mwana wazaka 6 wazaka 6. Amatha kudumpha insulin kwathunthu atasinthana ndi zakudya zoyenera.

Insulin yayitali, yomwe Levemir ndi yake, sicholinga chake kuti achepetse shuga. Cholinga cha kugwiritsidwa ntchito kwake ndizosiyana kotheratu. Shuga mumkhalidwe wanu umakula mothandizidwa ndi zakudya zomwe zadedwa kumene. Izi zikutanthauza kuti mlingo wa insulin yofulumira musanadye sichinasankhidwe molondola. Ndipo, mwina, chifukwa chachikulu ndikudya zakudya zosayenera. Werengani pulogalamu yathu ya Matenda A shuga A Type 1 kapena Type 2 Shuga. Kenako, phunzirani mosamala zolemba zonse za mgulu la Insulin.

M'nkhaniyi, mwaphunzira mwatsatanetsatane zomwe Lantus ndi Levemir, insulin-yaitali, komanso a NPH-insulin protafan ali. Tazindikira chifukwa chake kuli koyenera kugwiritsa ntchito jakisoni wa insulini yowonjezera usiku ndi m'mawa, ndipo chifukwa chiyani sizolondola. Chinthu chachikulu chomwe chikufunika kuphunziridwa: insulin yowonjezera-imakhala ndi shuga. Sicholinga chodzimitsa kulumpha mu shuga mutatha kudya.

Osayesa kugwiritsa ntchito insulin yochulukirapo kumene yochepa kapena yopitilira muyeso yofunika. Werengani zolembedwa "Ultrashort Insulin Humalog, NovoRapid ndi Apidra. Insulin Yachidule ya anthu ”komanso“ jakisoni wa insulin yofulumira musanadye. Momwe mungachepetse shuga kukhala wabwinobwino ngati wadumpha. " Muyenera kuchiritsa matenda anu a shuga ndi insulin ngati mukufuna kupewa zovuta zake.

Tidawona momwe tingawerengere kuchuluka koyenera kwa insulin yochulukirapo usiku ndi m'mawa. Malangizo athu ndiosiyana ndi zomwe zalembedwa m'mabuku odziwika komanso zomwe zimaphunzitsidwa ku "sukulu ya shuga". Mothandizidwa ndi kudziyang'anira pawokha shuga, onetsetsani kuti njira zathu ndizothandiza, ndizopatula nthawi. Kuti muwerenge ndikusintha kuchuluka kwa insulin yowonjezera m'mawa, muyenera kudumphira chakudya cham'mawa komanso nkhomaliro. Izi ndizosasangalatsa kwambiri, koma, tsoka, njira yabwinoko kulibe. Kuwerengera ndikusintha kuchuluka kwa insulini yowonjezera usiku ndikosavuta, chifukwa usiku, mukamagona, simukudya mulimonse.

Wowonjezera insulin Lantus, Levemir ndi protafan amafunikira kuti shuga wabwinobwino asakhale pamimba yopanda kanthu kwa tsiku limodzi.
Ultrashort ndi insulin yochepa - kuthetsa shuga yowonjezereka yomwe imachitika mukatha kudya.
Musayese kugwiritsa ntchito mankhwala osokoneza bongo okwanira m'malo obayira jakisoni mwachangu musanadye!
Ndi insulin iti yomwe ili bwino - Lantus kapena Levemir? Yankho: Levemir ali ndi mwayi wocheperako. Koma ngati mutenga Lantus kwaulere, ndiye kuti mumulore.
Mtundu wachiwiri wa matenda ashuga, jekeseni woyamba amawonjezera insulin usiku ndi / kapena m'mawa, kenako ndikulimbitsa insulin musanadye.
Ndikofunika kuti musinthe kuchoka pa protafan kupita ku Lantus kapena Levemir, ngakhale mutagula insulini yatsopano chifukwa cha ndalama zanu.
Pambuyo pakusintha ku chakudya chochepa chamafuta a shuga 1, 2, mitundu ya insulin yonse imachepetsedwa nthawi 2-7.
Nkhaniyi imapereka malangizo a pang'onopang'ono a momwe angawerengere kuchuluka kwa insulini yowonjezera usiku ndi m'mawa. Afufuzeni!
Ndikulimbikitsidwa kutenga jekeseni wowonjezera wa Lantus, Levemir kapena Protafan pa 1-3 a.m. kuti athe kuwongolera bwino zomwe zimachitika m'mawa.
Anthu odwala matenda ashuga, omwe amadya chakudya chamadzulo maola 4-5 asanagone komanso kuwonjezera jekeseni wowonjezera nthawi ya 1 koloko, amakhala ndi shuga m'mimba m'mimba yopanda kanthu.

Ndikukhulupirira kuti nkhaniyi yakhala ikuthandizani. Ngati ndi kotheka, ndikofunikira kusintha m'malo mwa NPH-insulin (protafan) m'malo mwa Lantus kapena Levemir kuti muthe kusintha zotsatira za chithandizo cha matenda ashuga. Mu ndemanga, mutha kufunsa mafunso pochiza matenda a shuga ndi mitundu yambiri ya insulini. Oyang'anira tsambalo sachedwa kuyankha.

Makina ogwira ntchito

Mankhwala a Levemir ndi analogue a insulin ya anthu. Imakhala ndi machiritso a nthawi yayitali ndipo imagwiritsidwa ntchito kwambiri pochiza matenda ashuga. Gawo logwira ntchito la Levemir limagawidwa pang'onopang'ono pamwamba pa minofu, ndipo chifukwa cha izi, mphamvu ya mankhwalawa imakulanso. Matenda a shuga m'magazi amatheka chifukwa cha kuyamwa kwa glucose ndi minofu ndikuchepetsa kumasulidwa kwake ndi chiwindi. Kutalika kwa nthawi ya achire a Levemir ndi maola 24 ndipo, chifukwa cha izi, insulin yayitali ingagwiritsidwe ntchito 1 kapena 2 kawiri pa tsiku. Pankhaniyi, mankhwalawa amayamba kugwira ntchito pambuyo pa maola 4-6, matendawa amapezeka pambuyo pa maola 10-18. Odwala omwe ali ndi matenda a shuga 2 omwe adayikidwa kuti apange jekeseni wa Levemir ndikumayamwa othandizira hypoglycemic nawo, kuchepa kwa pafupipafupi kwa nocturnal hypoglycemia kunadziwika.

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.

Mankhwala "Lantus" amachita, monga mawonekedwe ake - amachepetsa shuga. Komabe, zochizira zotsatira za mankhwalawa zimatheka chifukwa cha insulin glargine yomwe ili pakapangidwe kake. "Lantus" ndiwonso mankhwala omwe akhala akuchita kwa nthawi yayitali, nsonga zake zimapezeka m'maola 8-10. Pambuyo poyambitsa mafuta ochulukirapo, yankho, mothandizidwa ndi acidity, limapanga microprecipitates, pomwe insulin imatulutsidwa pafupipafupi, ndikupanga kuchuluka kwa mankhwalawa kwakanthawi.

Dimka Shergin analemba 03 Apr, 2017: 118

Escherichia coli (Escherichia coli, lat. Escherichia coli, wamba E. coli) ndi mtundu wa bakiteriya woipa woboola m'miyala, wopanga anaerobes, omwe ndi gawo la microflora yachilendo yam'mimba ya munthu.

Pali mitundu yambiri ya Escherichia coli (Escherichia coli), kuphatikizapo mitundu yoposa zana ya "enterovirome") Mitundu, yophatikizidwa m'magulu anayi: enteropathogenic, enterotoxigenic, enteroinvasive ndi enterohemorrhagic. Palibe kusiyana pamakhalidwe pakati pa pathogenic ndi Escherichia wopanda pathogenic.

Oleg Savitsky analemba 03 Apr, 2017: 217

Zikomo kwambiri pofotokoza mankhwala omwe amagwiritsidwa ntchito m'gawo lathu lakumbuyo. Detemir, likukhalira, si insulini konse. Onani. Ngati mungayike nkhani yokhudza insulin yamakono m'mabuku anu, OSATSITSA "mabotolo", osayima ndi syringe, musanene. Awa ndi zithunzi wamba zaka 20 zapitazo, ndipo shuga nawonso amapentedwa. Mwa njira, mukamapereka fanizo la glucometer, kumbukirani kuti kuli bwino kubaya chala "kuchokera mbali", osaloza mwachindunji pilo, monga momwe mwawonera pazithunzi zam'mbuyomu. Kwa zaka zoposa 10 akugwiritsa ntchito, Lantus sanakumane ndi mabotolo ake, uyu ndiye "zaka zomaliza". Kutulutsidwa mawonekedwe - makatiriji a mayunitsi 300, kapena, monga lamulo, zolembera za SoloStar syringe. Mu Orel, kodi Lantus amamasulidwa bwanji? Mwambiri, Lantus ndi Levemir uyu, zikuwoneka kuti ndi okalamba kale, "" "" kumeneko "amakwaniritsa mndandandawo ndi mankhwala atsopano, abwinonso, ofanana. Lembani bwino za chithandizo chamakono cha matenda ashuga pafoni kapena zokhudza zamankhwala am'deralo komanso kupulumutsidwa mozizwitsa. Chonde kusiyanitsa mitundu ya shuga, osachepera 1 ndi 2.

Elena Antonets adalemba 03 Apr, 2017: 219

Zowonjezera zazing'ono pazankhaniyi

Ndinafotokoza kale nkhaniyi apa https://moidiabet.ru/blog/zame ......

Chifukwa chake, ndimalemba zomwe ndidalemba pang'ono.

Pakadali pano pakupanga mankhwala, ma insulin onse a HUMAN GENE-ENGINEERING amapezeka ndi mainjiniya ndipo amatipanga ndi E. colli E. coli kapena Saccharomyces cerevisiae yisiti, momwe "chidutswa" cha DNA chasinthidwa kukhala munthu. Ndikufotokozera izi pafupifupi. Ndani amasamala, werengani pa intaneti, chabwino, mwina apa: http: //pandia.ru/text/80/138/5 ...
Mawu akuti "analogue" mu Chirasha "ndi ofanana m'njira zina." Chifukwa chake, zokhudzana ndi ma insulins, ANALOGUES ndi insulini zaumunthu zomwe zasintha kapangidwe ka molekyulu. Izi zikuphatikiza:

1. ULTRA-SHORT insulins, imasiyana mosiyanasiyana mwachangu komanso nthawi yayifupi. Izi ndi:

HUMALOG (lispro) - ma amino acid omwe ali m'malo 28 ndi 29 a insulin B-chain amasinthana mu molekyulu ya inulin yaumunthu.

NOVORAPID (aspart) mu molekyu ya insulin ya anthu, amino acid proline yomwe ili pamalo B28 imasinthidwa ndi aspartic acid.

APIDRA (glulisin) - mu molekyulu ya insulin yaumunthu, amino acid asparagine yomwe ili m'malo B3 imasinthidwa ndi lysine, ndipo lysine imasinthidwa ndi glutamic acid m'malo a B29, omwe amatsogolera kumwera kwa mankhwalawo.

2. Ma insulin okhala ndi nthawi yayitali (mapangidwe osagwirizana ndi insulin ya anthu). Izi ndi:

LEVEMIR (detemir) imapangidwa ndimabuku a DNA ogwiritsidwanso ntchito pogwiritsa ntchito Saccharomyces cerevisiae. Ndi tsamba losungunuka la insulin ya anthu omwe akhala akuchita zinthu zazitali mwachinsinsi. Kuchita kwa nthawi yayitali kwa mankhwala a Levemir® FlexPen ® ndi chifukwa chodziyimira pawokha wa maselo a insulir kumalo operekera jakisoni ndikumangidwa kwa mamolekyulu a mankhwala kuti a albumin adalumikizane ndi mbali yamafuta acid (onani malangizo a boma).

LANTUS (glargine) ndi analogue ya insulin ya munthu yomwe imapangidwanso ndi mabakiteriya a DNA a mtundu wa Escherichia coli (tizilombo ta K12). Glulin insulin imapangidwa ngati analogue ya insulin yaumunthu, yodziwika ndi low solubility m'malo osagwirizana nawo. Mu kapangidwe ka mankhwala Lantus® ndimasungunuka kwathunthu, womwe umatsimikiziridwa ndi momwe asidi amachitikira panjira yothetsera jakisoni (pH 4). Pambuyo poyambitsa mafuta ochulukirapo, acidic solution imatha, yomwe imatsogolera pakupanga microprecipitate, komwe ma insulin glargine amatulutsidwa, kupereka chithunzithunzi chosalala, chopanda tsinde "nthawi yovuta", Komanso kuchuluka kwa mankhwala kwa nthawi yayitali (onani malangizo a boma). Kutalika kochedwa kwa maola ndi maola 24, okwera ndi maola 29.

TUJEO Solo Star (yemweyo glargine, pokhapokha pazokonzekera 300 IU mu 1 ml). Ndikudziwitsani padera padera: chifukwa cha kuchuluka kwambiri, a Tujeo apanga kachipinda kakang'ono kwambiri koyerekeza ndi malo ochepa (poyerekeza ndi 100ME / ml glargine), motero Tujeo pang'onopang'ono komanso kwa nthawi yayitali amatulutsidwa kuchokera pamalo okutsikira m'magazi ndipo ali ndi zambirilathyathyathya»Mbiri ya zochita poyerekeza ndi Lantus. Kutalika kwa Tujeo - mpaka maola 36.

3. TRESIBA FLEX TACH (degludec) - analogue ya insulin ya anthu SUPERLONGLY akuchita (mpaka maola 40). Pambuyo pakubaya kwa subcutaneous, imapangika sungunulamu yambiri yosungiramo malo osungirako, momwe mumakhala kuyamwa kosalekeza kwa insludec m'mitsempha, ndikupereka chithunzi cha nthawi yayitali komanso chokhazikika cha mankhwalawo (onani malangizo oyenera).

Chosangalatsa))): 1 makilogalamu a insulini amatha kupezeka mu 25 cubic Fermenter (bioreactor) pogwiritsa ntchito Escherichia coli, kapena. mwa mitu 35,000 ya nyama zaulimi, monga zinachitidwira usanayambike umisiri.

Mankhwala "Levemir"

Kuti mupeze chithandizo chachikulu mukamagwiritsa ntchito mankhwalawa, ndikofunikira kuzigwiritsa ntchito moyenera, kuwona magawidwe a dosing osati kupitirira nthawi yolimbikitsidwa.

Insulin Levemir imalembedwa kwa wodwala aliyense payekhapayekha, kutengera kuwonongeka kwa matendawa ndi mawonekedwe a thupi lake. Ndikofunika kukumbukira kuti kudzichiritsa nokha kumangokulitsa vutoli, motero munthawi yamankhwala, muyenera kutsatira malingaliro onse a dokotala woyenera. Nthawi zambiri Levemir amatchulidwa 1-2 pa tsiku. Komabe, kusintha kwa mankhwalawa kungafunike ngati wodwala akuchita zolimbitsa thupi kapena wasintha zakudya zina zomwe amakhala nazo.

"Levemir" amatchulidwa onse ngati monotherapy komanso kuphatikiza othandizira a hypoglycemic. Nthawi yoyambitsa insulin yayitali ingakhale yabwino kwa wodwala.Komabe, mtsogolomo ndikofunikira kutsatira nthawi yokhazikitsidwa ndi jakisoni woyamba. Madokotala a matenda ashuga omwe amafunika kusinthira ku Levemir kuchokera ku mitundu ina ya insulin ayenera kuwunika muyezo ndikuwonetsetsa mayamwidwe a seramu panthawi ya kusintha.

Mankhwala Lantus

Kuti mugwiritse ntchito mankhwala osokoneza bongo "Lantus" zolembera zapadera za syringe cholinga chake. Pamaso pa mankhwala, ndikofunikira kuwerenga malangizo awo osapatuka pazomwe wopanga akupanga. Ngati cholembera sichinayende bwino, iyenera kutayidwa ndipo chinthu chatsopano chatengedwa. Mutha kujambula yankho kuchokera kuma cartridge muma syringe omwe amapangidwira kumayambiriro kwa insulin, ndikupanga jakisoni. Mankhwalawa amaperekedwa kamodzi patsiku, mosamalitsa nthawi imodzi. Mlingo ndi nthawi ya maphunzirowo amasankhidwa payekhapayekha kwa wodwala. Ndikofunika kudziwa kuti ngati chakudya chatha, shuga amatha magazi kuposa anthu 0,6 mmol / l, ndiye kuti adokotala angakuwonjezereni insulin yochepa musanadye.

Contraindication ndi zoyipa

Kuti mudziwe chomwe chiri bwino: "Lantus" kapena "Levemir", ndikofunikira kuyerekeza kukhalapo kwa zinthu zoletsa kugwiritsa ntchito mankhwala. Chifukwa chake, "Lantus" silivomerezeka kuti ligwiritsidwe ntchito ndi anthu omwe ali ndi chidwi chochulukirapo pazigawo zake. Palibe mankhwala omwe amalembedwa mwa ana osakwana zaka 6, komanso azimayi omwe amabala mwana. Mankhwala "Levemir" ali ndi malire omwe angagwiritsidwe ntchito ngati analogi yake yofananira.

Kusiyana pakati pa Levemir ndi Lantus kulibe kwenikweni ndipo izi sizodabwitsa, chifukwa amachita ntchito yofanana yamankhwala. Zofanana ndi mankhwala komanso mavuto. Mukamagwiritsa ntchito mankhwalawa, wodwala angakumane ndi zovuta zosayenera:

kutsika kwa shuga m'magazi,
kuwonongeka kwamawonekedwe
Edincke's edema,
Kutupa pa malo a jekeseni,
kuphwanya kwamafuta amkati,
kusungidwa sodium mthupi,
kunjenjemera
kumverera kwa nkhawa
kutopa,
kutsika kwa khungu,
mantha
chisokonezo
nseru
kukomoka mtima,
mutu
kutsitsa magazi
kuvutika kupuma.

Bweretsani ku zomwe zalembedwa

Madokotala alibe mgwirizano pa omwe mankhwalawo aperekedwa ndi othandiza kwambiri. Kafukufuku wina wasonyeza kuti Levemir akuwonetsa kuchepetsa shuga kuposa Lantus. Komabe, kayendetsedwe kazinthu zamagulu a glucose zoperekedwa ndi Levemir ndi Lantus zinali zofanana. Ndiponso, pakati pa mankhwalawa pamlingo womwewo panali chiopsezo cha hypoglycemia. Pankhaniyi, mutha kudziwa kuti ndi mankhwala ati omwe angathandize kwambiri matenda a shuga pambuyo poyeserera kamodzi ndi mankhwala achiwiri.

Kodi zikuwonekabe zosatheka kuchiritsa matenda ashuga?

Poona kuti mukuwerenga izi tsopano, kupambana polimbana ndi shuga wambiri sikuli kumbali yanu.

Ndipo mudaganizapo kale za chithandizo kuchipatala? Ndizomveka, chifukwa matenda ashuga ndi matenda oopsa, omwe, ngati sanapatsidwe, amatha kufa. Udzu wokhazikika, kukodza mwachangu, masomphenya osalala. Zizindikiro zonsezi mumazidziwa nokha.

Koma kodi ndizotheka kuchitira zomwe zimayambitsa m'malo mothandizira? Timalimbikitsa kuwerenga nkhani yokhudza matenda aposachedwa a shuga. Werengani nkhani >>

Momwe mungasinthire kuchokera ku Lantus kupita ku Levemir

Onse a Levemir ndi Lantus amafananizira ndi insulin yaumunthu, yomwe imasiyana pang'ono pakati pawo, yomwe imafotokozedwa pang'onopang'ono.

Ngati wodwala akufunsa momwe angasinthire kuchoka ku Lantus kupita ku Levemir, ndiye kuti ndikulimbikitsidwa kuti azichita izi moyang'aniridwa ndi dokotala ndikuganizira momwe moyo wa wodwalayo ulili, kuchuluka kapena kuchita zolimbitsa thupi moyenera.

Momwe mungakhalire moyo wathanzi ndi matenda a shuga a 2

Matenda a shuga ndi njira ya moyo. Matenda aliwonse sangathe. Odwala ali ndi moyo wopitilira ...

Mankhwalawa onse ndi m'badwo watsopano wa insulin. Onsewa amaperekedwa kwa odwala omwe ali ndi matenda a shuga amtundu woyamba 1, kamodzi pa maola 12-24 kuti akhalebe ndi shuga.

Mankhwalawa amagwiritsidwa ntchito pokhapokha, njira zina zimatha kubweretsa kukomoka kwa glycemic coma.

Pa mankhwalawa, Lantus amaperekedwa mosamala pakanthawi kochepa, amawerengera, popeza mankhwalawa amakhala ndi mphamvu yayitali. Ndi zoletsedwa kusakaniza Lantus ndi mitundu ina ya insulin kapena mankhwala. Therapy iyenera kuchitika molingana ndi malingaliro a madokotala komanso moyang'aniridwa ndi dokotala.

Mawonekedwe

Glargin - insulini, yomwe ndi gawo la Lantus, ndimatsanzira mahomoni aumunthu ndipo amasungunuka pamalo osalolera kwa nthawi yayitali.

Kusagwirizana ndi mankhwala ena sikungaganiziridwe popereka mankhwala kwa odwala omwe ali ndi matenda a shuga 2. Poterepa, ndizotheka kuphatikiza ndimankhwala ena amkamwa.

Milandu ya insulin yotsika

Matenda aimpso. Nthawi zambiri omwe amapezeka mwa odwala okalamba ndipo ndi chifukwa chakuchepa kwa insulin.
Odwala omwe ali ndi matenda a chiwindi. Mu gululi la odwala, pali kuchepa kwa gluconeogeneis ndi metabolism ofooka, chifukwa chomwe kufunika kwa mahomoni kumachepa.

Malangizo ogwiritsira ntchito

Mankhwalawa amaperekedwa pang'onopang'ono kwa odwala okulirapo kuposa zaka zisanu ndi chimodzi. Mlingo umodzi umaperekedwa kamodzi pamimba, m'chiuno kapena m'mapewa. Ndikulimbikitsidwa kuti musinthe gawo la ntchito ndikulongosola kulikonse. Mothandizidwa ndi intravenous a mankhwalawo ndi oletsedwa, chifukwa pali chiopsezo chokhala ndi vuto la hypoglycemia.

Mukamasintha kuchokera ku mankhwala ena omwe mumagwiritsa ntchito mankhwala ena othandizira odwala, kusintha kwa chithandizo chofanana, komanso Mlingo wa basal insulin, ndikotheka.

Pofuna kupewa kupezeka kwa hypoglycemia, mlingo umachepetsedwa ndi 30% m'mwezi woyamba wa chithandizo. Munthawi imeneyi, tikulimbikitsidwa kuti muwonjezere mlingo wa insulin yochepa pokhapokha zinthu zikhazikika.

Ndi zoletsedwa kusakaniza kapena kuthira Lantus ndi mankhwala ena. Izi zikuwoneka ngati kusinthika kwa nthawi ya zochita za glargine ndi mapangidwe a zochitika zokhazokha. Nthawi yoyamba yatsopano ya mankhwalawa, ndikofunikira kuwongolera kuchuluka kwa shuga m'magazi.

Zotsatira zoyipa

Choyipa choopsa kwambiri chogwiritsidwa ntchito ndi mankhwala Lantus ndi kukula kwa hypoglycemia.

Komabe, pali zingapo zoyipa osati zoyipa zomwe zimachitika chifukwa chotenga Lantus:

myalgia
bronchospasm
urticaria
retinopathy
lipoatrophy,
cholhypertrophy,
kuchepa kwa masomphenya
anaphylactic shock,
Edincke's edema,
Kutupa pa malo a jekeseni.

Tiyenera kudziwa kuti ngati zonsezi zitachitika, muyenera kufunsa dokotala kuti musinthe mankhwalawo. Njira yotalikira yazizindikiro zowopsa imakhala yowonongeka mumitsempha yamagetsi kapena kukulira mkhalidwe wa wodwalayo mpaka kufa.

Kodi ndizotheka kufa ndi matenda ashuga

Matenda a shuga ndi matenda ofala kwambiri a endocrine. Uku ndi matenda owopsa. Mpaka pano ...

Kodi ndichifukwa chiyani ndimafunikira insulin yayitali?

Insulin Lantus wa nthawi yayitali, Levemir kapena Protafan ndi ofunikira kuti shuga azisala kudya. Pulogalamu yaying'ono ya insulin imayenda m'magazi a anthu nthawi zonse. Izi zimatchedwa insulin (maziko) a insulin. Zikondazo zimapatsa insulini ya basal mosalekeza, maola 24 patsiku. Komanso, poyankha chakudya, amaperekanso kwambiri magazi kwambiri. Izi zimatchedwa mlingo wa bolus kapena bolus.

Mabolamu amawonjezera insulin ndende kwakanthawi kochepa. Izi zimapangitsa kuti kuzimitsa msanga shuga wowonjezereka yemwe amapezeka chifukwa chazakudya zomwe zidadyedwa. Odwala omwe ali ndi matenda amtundu 1, kapamba samatulutsa insal kapena insulin. Jekeseni wambiri wa insulin amapereka insulin, insal insulin. Ndikofunikira kuti thupi "lisadzigaye" mapuloteni ake komanso sizichitika matenda ashuga a ketoacidosis.

Chifukwa chiyani jakisoni wa insulin Lantus, Levemir kapena protafan:

Sinthani shuga kusala magazi nthawi iliyonse masana, makamaka m'mawa.
Kuti mupewe matenda a shuga a mtundu 2 asasanduke shuga woopsa 1.
Ndi mtundu 1 wa shuga - sungani gawo la maselo a beta amoyo, muteteze kapamba.
Kupewa matenda ashuga a ketoacidosis ndi zovuta komanso zowopsa.

Cholinga china chakuchizira matenda a shuga ndi insulin yayitali ndikuletsa kuphedwa kwa maselo ena apanchipic beta. Jekeseni wa Lantus, Levemir kapena Protafan amachepetsa katundu pa kapamba. Chifukwa cha izi, maselo ochepa kwambiri a beta amafa, ambiri a iwo amakhalabe ndi moyo. Zilonda za insulin zowonjezera usiku ndi / kapena m'mawa zimawonjezera mwayi kuti matenda a shuga a 2 sangathe kudwala matenda ashuga amtundu woyamba. Ngakhale kwa odwala omwe ali ndi matenda amtundu 1, ngati gawo la ma beta litha kukhalabe lamoyo, matendawa amayenda bwino. Shuga samadumphadumpha, amakhala ngati ali bwinobwino.

Insulin yomwe imatenga nthawi yayitali imagwiritsidwa ntchito pazinthu zina zosiyana kwambiri ndi insulin isanadye. Sicholinga chofafaniza shuga wa magazi mukatha kudya. Komanso, siyenera kugwiritsidwa ntchito kuti ibweretsereni shuga msanga ngati ingadzere mwa inu. Chifukwa insulin yomwe imakhalapo nthawi yayitali sichichedwa kutero. Kuti mumvetsetse zakudya zomwe mumadya, gwiritsani ntchito insulin yochepa kapena yochepa kwambiri. Zomwechonso zimachitika kuti shuga ibweretsedwe mwachangu.

Ngati mukuyesera kupanga mitundu yambiri ya insulini yokhala ndi insulin yowonjezera, zotsatira za chithandizo cha matenda ashuga zidzakhala zopanda pake kwambiri. Wodwalayo amakhala ndi shuga wambiri m'magazi, zomwe zimayambitsa kutopa kwambiri komanso kukhumudwa. Pakangotha zaka zochepa, mavuto adzaoneke omwe amapangitsa munthu kukhala wolumala.