Insulin yowonjezera, basal ndi bolus: ndi chiyani?

Tsoka ilo, pakadali pano, matenda ashuga ndi matenda oopsa, nthawi zambiri amatsogolera kuimfa. Chaka chilichonse, ziwerengero zakufa zikuchulukirachulukira. Malinga ndi asayansi, pofika chaka cha 2030, matenda ashuga adzakhala njira yomwe nthawi zambiri imatenga miyoyo ya anthu.

Anthu ambiri amaganiza kuti shuga ndi sentensi. Komabe, izi siziri choncho. Zachidziwikire, muyenera kusintha kwambiri moyo wanu ndi kumwa mankhwala tsiku lililonse. Komabe, munthu akhoza kukhala ndi moyo kwa zaka khumi popanda matenda otere.

Nkhaniyi ikufotokoza momwe mungawerengere basulin insulin, chomwe ndi chifukwa chake chikufunika. Sanjani mosamala zidziwitso zoperekedwa kuti zikhale zofunikira kwambiri.

Kodi matenda ashuga ndi chiyani?

Izi ndi matenda a mahomoni omwe amapezeka chifukwa cha kuchuluka kwambiri kwa shuga m'magazi. Vutoli limayambitsa vuto la kapamba. Mwapang'onopang'ono kapena kutha kwathunthu kupanga mahomoni - insulin. Cholinga chachikulu cha chinthu ichi ndikuwongolera shuga. Ngati thupi silitha kuthana ndi shuga payekha, limayamba kugwiritsa ntchito mapuloteni ndi mafuta pazofunikira zake. Ndipo izi zimabweretsa zisokonezo zazikulu mthupi lonse.

Chifukwa chiyani gwiritsani insulin kwa odwala matenda a shuga

Monga tafotokozera pamwambapa, pamaso pa matenda awa, kapamba mwina amasiya kutulutsa insulin ya mahomoni, kapena satulutsa zokwanira. Komabe, thupi limafunanso. Chifukwa chake, ngati mahomoni anu omwe sanakwane, ayenera kukhala ochokera kunja. Pankhaniyi, ma insalins amatenga ngati maziko pazomwe munthu amachita. Chifukwa chake, wodwala aliyense yemwe ali ndi matenda ashuga amayenera kupereka jakisoni wa mankhwalawa. Kuwerengera kwa basulin insulin ndichikhalidwe chofunikira kwambiri kwa wodwala, popeza momwe zimakhalira tsiku ndi tsiku komanso chiyembekezo cha moyo wake zimatengera izi. Ndikofunikira kumvetsetsa momwe mungawerengere moyenera mulingo wa mahomoni awa kuti muwongolere momwe mulili.

Kodi insulin yayitali ndi chiyani?

Insulin yamtunduwu imangotchedwa basal yokha, komanso maziko kapena yayitali. Mankhwala oterowo amatha kukhala ndi mphamvu yapakatikati kapena yayitali, kutengera mawonekedwe a chiwalo chilichonse. Cholinga chake chachikulu ndikulipira insulin mwa odwala omwe ali ndi matenda ashuga. Popeza kapamba sagwira ntchito moyenera odwala matenda ashuga, ayenera kulandira insulin kuchokera kunja. Pachifukwa ichi, mankhwala otere adapangidwa.

About basal insulin

Mumsika wamakono wamankhwala, pali mitundu yambiri ya mankhwala osiyanasiyana omwe ali otetezeka m'thupi la munthu kuposa momwe adalili kale. Zimakhudza thanzi la wodwala, ndipo nthawi yomweyo zimabweretsa zovuta zochepa. Zaka khumi zapitazo, ma insulins apasi amapangidwa kuchokera kuzinthu zomwe zimachokera ku nyama. Tsopano ali ndi maziko aumunthu kapena opanga.

Mitundu ya nthawi yowonekera

Masiku ano, pali mitundu yambiri ya insulin. Kusankhidwa kwawo kumatengera insal level. Mwachitsanzo, mankhwala osokoneza bongo amatha kusokoneza thupi kwa maola khumi ndi awiri mpaka khumi ndi asanu ndi limodzi.

Palinso mankhwala komanso kuwonetsa nthawi yayitali. Mlingo umodzi wa mankhwalawo ndi wokwanira kwa maola makumi awiri ndi anayi, kotero muyenera kulowa mankhwalawo kamodzi kokha patsiku.

Asayansi apanganso jakisoni womasulira. Zotsatira zake zimakhala pafupifupi maola makumi anayi ndi asanu ndi atatu. Komabe, mankhwalawo omwe ali oyenera ayenera kuperekedwa ndi dokotala.

Ma insulin onse oyenera kwambiri amakhala ndi mawonekedwe osangalatsa m'thupi, zomwe sizinganenedwe za mankhwala omwe amakhala ndi kanthawi kochepa. Ma jakisoni otere nthawi zambiri amatengedwa musanadye chakudya kuti muwongolere shuga mwachindunji ndi chakudya. Mankhwala omwe akhala akuchita kwa nthawi yayitali nthawi zambiri amakhala opangidwa, komanso chowonjezera - protamine.

Momwe mungawerengere

Zomwe zimapangitsa insulin kuti ikhale yolimba ndiyothandiza kuthamanga kwama glucose, komanso mwachindunji pakugona. Ichi ndichifukwa chake thupi limakhala lofunikira kwambiri kuti limutengere moyo wabwinobwino.

Ndipo, taganizirani momwe mungawerengere molondola:

• Choyamba muyenera kudziwa kuchuluka kwa thupi lanu,
• chulukitsani zotsatirazo ndi nambala 0,3 kapena 0,5 (choyambirira ndi cha matenda a shuga 2, chachiwiri kwa oyambayo),
• ngati matenda a shuga 1 amakhalapo kwa zaka zopitilira khumi, ndiye kuti zokwanira ziyenera kukwera mpaka 0.7,
• pezani zotsatira makumi atatu pazotsatira, ndikufotokozera zomwe zidachitika, ndikugwiritsa ntchito ziwiri (awa azikhala mankhwalawa madzulo ndi m'mawa).

Komabe, pali mankhwala omwe amatha kutumikiridwa kamodzi patsiku kapena kamodzi masiku awiri. Funsani dokotala wanu za izi ndikuwona ngati mungagwiritse ntchito mankhwala omwe akhala nthawi yayitali.

Mkhalidwe

Ngati basal secretion ya insulini ili ndi vuto, ndipo mwawerengera kuchuluka kwa mankhwalawo omwe amatsanzira, ndikofunikira kuti mudziwe ngati kuchuluka kwake kuli koyenera kwa inu. Kuti muchite izi, muyenera kuchita cheke chapadera, chomwe chimakhala kwa masiku atatu. Kanani chakudya cham'mawa tsiku loyamba, kulumphira chakudya chamasana patsiku lachiwiri, ndipo mudzikudye chakudya chachitatu. Ngati simukumva kulumpha kwapadera masana, ndiye kuti mankhwalawa asankhidwa molondola.

Komwe angabise

Odwala omwe ali ndi matenda ashuga ayenera kuphunzira momwe angadzibweretsere okha, chifukwa matendawa ndi amoyo wonse ndipo amafuna chithandizo cha tsiku ndi tsiku. Onetsetsani kuti mukumvera makamaka kuti mankhwala omwe ali ndi insulin amapangidwira makamaka kuti azigwiritsa ntchito poyambira. Palibe ayi, jekeseni minofu, ndipo koposa - m'mitsempha.

Choyambirira chomwe muyenera kuchita musanalowetsa jekeseni ndikusankha malo abwino kwambiri. Chifukwa chaichi, m'mimba, mapewa, matako ndi m'chiuno ndizoyenera kwambiri. Onetsetsani kuti mwayang'ana khungu lanu. Palibe vuto kuti musalowe ndi singano mu timadontho-timadontho, komanso mu wen, ndi zopanda zina pakhungu. Chokani kutali ndi navel ndi mainchesi asanu. Muperekenso jakisoni, ndikuthandizira masentimita angapo kuchokera ku molekyulu.

Madokotala amalimbikitsa kubayira mankhwalawo m'malo atsopano nthawi iliyonse. Chifukwa chake izi sizipweteka. Komabe, kumbukirani kuti chothandiza kwambiri ndikukhazikitsa kwa mankhwala m'mimba. Poterepa, zinthu zomwe zimagwira zimatha kufalikira thupi lonse.

Momwe mungapangire jakisoni

Mukasankha malo, ndikofunikira kupanga jakisoni moyenera. Musanaikemo singano pansi pakhungu, gwiritsani ntchito bwino malo omwe mwasankha ndi Mowa. Tsopano pukutani khungu, ndikutsalanso singano yomweyo. Koma nthawi yomweyo, lowetsani mankhwalawo pawokha pang'onopang'ono. Dziwani nokha mpaka khumi, kenako tulutsani singano. Chitani mwachangu. Ngati mukuwona magazi, ndiye kuti mwaboola mtsempha wamagazi. Poterepa, chotsani singano ndikuyiyika kudera lina la khungu. Makonzedwe a insulin sayenera kupweteka. Ngati mukumva kupweteka, yesani kukankha singano mozama pang'ono.

Kuwona kufunikira kwa insulin

Wodwala aliyense yemwe ali ndi matenda ashuga ayenera kudziwa payekha kuchuluka kwa insulin yochepa. Kuti muchite izi, muyenera kudziwa bwino lingaliro lotere ngati mkate mkate (XE). Chimodzi mwa zinthu zotere ndi zofanana ndi magalamu khumi ndi awiri a chakudya. Mwachitsanzo, XE imodzi imakhala ndi kagawo kakang'ono ka buledi, kapena theka la bun, kapena theka la ntchito ya vermicelli.

Zogulitsa zilizonse zimakhala ndi kuchuluka kwa XE. Muyenera kuwerengera, poganizira kuchuluka kwa gawo lanu, komanso mitundu yazogulitsa. Kuti muchite izi, gwiritsani ntchito tebulo ndi miyeso yapadera. Komabe, posachedwa muphunzira momwe mungadziwire kuchuluka kwa chakudya ndi dzanja, kotero kufunika kwa masikelo ndi gome kumangosowa.

Mankhwala otchuka kwambiri

Mpaka pano, pali kuchuluka kwakukulu kwa mankhwala omwe amapangidwa pamaziko a insulin yopanga, omwe amapangidwa kuti apereke mphamvu yapakati komanso yayitali. Onani otchuka a iwo:

• Mankhwala osokoneza bongo monga Protafan ndi InsumanBazal amawonetsedwa ndi madokotala kwa odwala omwe amafunikira mankhwala a nthawi yayitali. Zochita zawo zimatenga pafupifupi maola khumi kapena khumi ndi zisanu ndi zitatu, kotero, jakisoni amayenera kuperekedwa kawiri pa tsiku.
• "Humulin", "Biosulin" ndi "Levemir" amatha kukhala ndi tanthauzo lalitali. Jakisoni imodzi ndi yokwanira pafupifupi maola khumi ndi zisanu ndi zitatu kudza makumi awiri ndi zinayi.
• Koma mankhwala ngati Tresiba amakhala ndi nthawi yayitali. Zotsatira zake zimatha pafupifupi maola makumi anayi ndi asanu ndi atatu, motero mutha kugwiritsa ntchito mankhwalawa kamodzi pakatha masiku awiri. Ichi ndichifukwa chake mankhwalawa amatchuka kwambiri pakati pa odwala matenda a shuga.

Monga mukuwonera, kuchuluka kwa mitundu yosiyanasiyana ya mankhwala omwe ali ndi nthawi yosiyanitsa yambiri kumatanthauza basal insulin. Komabe, ndi mtundu wanji wa mankhwala okhala ndi insulin omwe ali oyenera mwa inu muyenera kudziwa kuchokera kwa katswiri. Palibe chifukwa choti musachite nawo masewera a amateur, monga mankhwala osankhidwa mosayenera kapena cholakwika cha kuchuluka kwa mankhwalawa kumabweretsa zotsatira zoyipa, mpaka kukomoka.

Matenda a shuga ndi matenda oopsa omwe amatha kusintha kwambiri moyo wanu. Komabe, simuyenera kutaya mtima, chifukwa mutha kukhalabe munthu wosangalala. Chachikulu ndichakuti musinthe moyo wanu, ndikumwa mankhwala ofunikira panthawi. Malinga ndi madotolo, odwala omwe saayiwala kumwa insulin ndi omwe amakhala ndi moyo nthawi yayitali kuposa omwe amaiwala kutero.

Kugwiritsa ntchito insulin insulin ndi gawo limodzi la moyo wa odwala omwe ali ndi matenda ashuga. Matendawa sangathe kuchira, koma mutha kuwongolera matenda anuwo.

Chitani masewera olimbitsa thupi kuyambira muli mwana. Idyani moyenera, chitani masewera olimbitsa thupi, komanso mwaluso ndikusintha ntchito ndikupumula. Samalirani thanzi lanu ndipo mudzawona momwe limakusamalirani. Dzisamalire ndi kukhala wathanzi.

Katundu wa basal insulin kukonzekera

Oyambira kapena, monga amatchedwanso, ma insulin oyambira kumbuyo ndi mankhwala osokoneza bongo kapena a nthawi yayitali. Amapezeka ngati kuyimitsidwa komwe kumapangidwira jakisoni wongoganiza kokha. Kuyambitsa basulin insulin mu mtsempha kumakhala kofowoka.

Mosiyana ndi ma insulin omwe amangokhala osakhalitsa, ma insulin a basal samawonekera komanso amawoneka ngati madzi amvula. Izi ndichifukwa choti ali ndi zosyanasiyana zosiyanasiyana, monga zinc kapena protamine, zomwe zimasokoneza kuyamwa mwachangu kwa insulin ndipo potero imathandizira kuchitapo kanthu.

Pakusunga, zodetsa izi zimatha kutulutsa, motero, musanabayidwe, ayenera kukhala osakanikirana ndi zinthu zina za mankhwalawa. Kuti muchite izi, gubuduzani botolo m'manja mwanu kapena mutembenuzire kangapo. Kugwedeza mankhwala koletsedwa.

Mankhwala amakono kwambiri, omwe amaphatikiza Lantus ndi Levemir, ali ndi mawonekedwe owonekera, popeza alibe zopanda pake. Kuchita kwa ma insulin kumeneku kunapitilira chifukwa cha kusintha kwa maselo a mankhwalawa, omwe samawalola kuti amwe mofulumira.

Kukonzekera kwa insulin ndi nthawi yayitali:

Dzina lamankhwala	Mtundu wa insulin	Machitidwe
Protafan NM	Isofan	Maola 10-18
Insuman	Isofan	Maola 10-18
Humulin NPH	Isofan	Maola 18-20
Biosulin N	Isofan	Maola 18-24
Gensulin N	Isofan	Maola 18-24
Levemire	Kudzifufuza	Maola 22-25
Lantus	Glargin	Maola 24-29
Tresiba	Degludek	40-42 maola

Chiwerengero cha jakisoni wa basal insulin patsiku zimatengera mtundu wa mankhwala omwe amagwiritsidwa ntchito ndi odwala. Chifukwa chake mukamagwiritsa ntchito Levemir, wodwalayo ayenera kupanga jakisoni awiri a insulin patsiku - usiku komanso nthawi yayitali pakati pa chakudya. Izi zimathandizira kukhala ndi basulin insulin yambiri mthupi.

Kukonzekera kwa insulin kwakanthawi, monga Lantus, kumachepetsa jakisoni jakisoni imodzi patsiku. Pachifukwa ichi, Lantus ndi mankhwala otchuka kwambiri kwa odwala matenda ashuga. Pafupifupi theka la odwala omwe amapezeka ndi matenda a shuga amagwiritsa ntchito.

Momwe mungawerengere mlingo wa basal insulin

Insulin insal ndi yofunika kwambiri pakuwongolera odwala matenda ashuga. Ndikusowa kwa insulini yakumbuyo yomwe imayambitsa zovuta kwambiri mthupi la wodwalayo. Popewa kukula kwa ma pathologies omwe angakhalepo, ndikofunikira kusankha mulingo woyenera wa mankhwalawa.

Monga tafotokozera pamwambapa, mlingo wa insulin ya tsiku ndi tsiku uyenera kukhala wa 24 mpaka 28. Komabe, muyezo umodzi wa insulin yoyambira wabwino kwa odwala onse omwe alibe matenda a shuga kulibe. Aliyense wodwala matenda ashuga ayenera kudziwa kuchuluka kwa mankhwalawo.

Pankhaniyi, zinthu zambiri zosiyanasiyana ziyenera kukumbukiridwa, monga zaka za wodwalayo, kulemera kwake, kuchuluka kwa shuga m'magazi ndi zaka zingati zomwe akudwala matenda ashuga. Pokhapokha ngati izi, chithandizo chonse cha matenda a shuga chizitha kukhala chothandizadi.

Kuti awerenge mlingo woyenera wa insulin, wodwalayo ayenera kudziwa kaye kuchuluka kwake. Izi zitha kuchitika pogwiritsa ntchito njira yotsatirayi: index mass body = kulemera (kg) / kutalika (m²). Chifukwa chake, ngati kukula kwa wodwala matenda ashuga ndi 1.70 m ndipo kulemera kwake ndi makilogalamu 63, ndiye kuti kuchuluka kwake kwa thupi kudzakhala: 63 / 1.70² (2.89) = 21.8.

Tsopano wodwala amafunika kuwerengetsa thupi lake labwino. Ngati index ya thupi lake lenileni ili pamtunda kuchokera pa 19 mpaka 25, ndiye kuti muwerenge kuchuluka kwabwino, muyenera kugwiritsa ntchito kalozera wa 19. Izi ziyenera kuchitika malinga ndi njira yotsatira: 1.70² (2.89) × 19 = 54.9≈55 kg.

Inde, kuti muwerenge kuchuluka kwa insulin ya basal, wodwalayo amatha kugwiritsa ntchito thupi lake lenileni, komabe, izi sizoyenera pazifukwa zingapo:

• Insulini imatanthauzira za anabolic steroids, zomwe zikutanthauza kuti zimathandiza kuwonjezera kulemera kwa munthu. Chifukwa chake, kukula kwamlingo wa insulin, momwe wodwalayo angachiritsire,
• Kuchuluka kwa insulini ndizowopsa kuposa kuperewera kwawo, chifukwa kungayambitse kwambiri hypoglycemia. Chifukwa chake, ndibwino kuyamba ndi ochepa, kenako ndikuwonjezera pang'onopang'ono.

Mlingo wa insulin ya basal imatha kuwerengedwa pogwiritsa ntchito njira yosavuta, motere: Kulemera kwa thupi × 0,2, i.e. 55 × 0.2 = 11. Chifukwa chake, tsiku lililonse mlingo wa insulin woyambira uyenera kukhala magawo 11. Koma mawonekedwe oterewa samakonda kugwiritsidwa ntchito ndi anthu odwala matenda ashuga, chifukwa ali ndi zolakwika zambiri.

Palinso mtundu wina wovuta wowerengera kuchuluka kwa insulin ya kumbuyo, yomwe imathandizira kupeza zotsatira zolondola kwambiri. Kuti izi zitheke, wodwalayo ayenera kuwerengera muyeso wa insulin yonse tsiku ndi tsiku, basal ndi bolus.

Kuti adziwe kuchuluka kwa insulin yomwe wodwala amafunikira tsiku limodzi, ayenera kuchulukitsa kulemera koyenera kwa thupi ndi chinthu chofanana ndi nthawi yayitali ya matenda ake:

1. Kuyambira chaka chimodzi mpaka zaka 5 - mgwirizano wa 0,5,
2. Kuchokera pa zaka 5 mpaka zaka 10 - 0,7,
3. Zoposa zaka 10 - 0,9.

Chifukwa chake, ngati wodwalayo ali ndi makilogalamu 55, ndipo wakhala akudwala matenda ashuga kwa zaka 6, ndiye kuti awerenge kuchuluka kwake kwa insulin kuli kofunikira: 55 × 0.7 = 38.5. Zotsatira zomwe zimapezeka zimafanana ndi mulingo woyenera wa insulin tsiku lililonse.

Tsopano, kuchokera ku kuchuluka kwathunthu kwa insulin, ndikofunikira kupatula gawo lomwe liyenera kuwerengera ndi basulin insulin. Izi sizovuta kuchita, chifukwa monga mukudziwa, kuchuluka kwathunthu kwa insulin sikuyenera kupitirira 50% ya kuchuluka kwa insulin yokonzekera. Ndipo ndibwino kwambiri ngati zingakhale 30 40% ya mlingo watsiku ndi tsiku, ndipo 60 yotsalayo idzatengedwa ndi insulin.

Chifukwa chake, wodwalayo ayenera kuwerengera zotsatirazi: 38.5 ÷ 100 × 40 = 15.4. Powonjezera zotsatira zake, wodwalayo alandira mlingo woyenera kwambiri wa insulin, yomwe ndi magawo 15. Izi sizitanthauza kuti kumwayu sikufuna kusintha, koma kuyandikira kwambiri ku zosowa za thupi lake.

Momwe mungasinthire mlingo wa basal insulin

Pofuna kudziwa kuchuluka kwa insulini yakumbuyo zamankhwala pochiza matenda amishuga 1, wodwalayo ayenera kuyesa mayeso apadera oyambira. Popeza chiwindi chimapangitsa glycogen kuzungulira wotchi, muyezo woyenera wa insulini uyenera kuyesedwa usana ndi usiku.

Kuyeza kumeneku kumachitika kokha pamimba yopanda kanthu, chifukwa chake, panthawi yake, wodwalayo ayenera kukana kwathunthu kudya, kudumpha chakudya cham'mawa, lumbiro kapena chakudya chamadzulo. Ngati kusinthasintha kwa shuga m'magazi panthawi ya mayeso sikupitilira 1.5 mmol ndipo wodwalayo sawonetsa zizindikiro za hypoglycemia, ndiye kuti mlingo wa basulin insulin ndiwofunika.

Ngati wodwala anali ndi dontho kapena kuchuluka kwa shuga m'magazi, Mlingo wa insulin wakumbuyo umafunika kuwongoleredwa mwachangu. Kuchulukitsa kapena kuchepera kwa mulingo sayenera kupitirira 2 mayunitsi. nthawi imodzi osaposa 2 pa sabata.

Chizindikiro china chomwe chimagwiritsidwa ntchito ndi wodwala kwa nthawi yayitali chimagwiritsidwa ntchito ndi shuga m'magazi nthawi yayitali. Pankhaniyi, sayenera kupitirira malire a 6.5 mmol.

Kuchita mayeso oyambira usiku:

• Patsikuli, wodwalayo ayenera kudya chakudya cham'mawa momwe angathere. Ndi bwino ngati chakudya chomaliza chichitike osaposa 6 pm. Izi ndizofunikira kuti panthawi yoyeserera, zochita za insulin yayifupi, zoperekedwa pakudya chamadzulo, zitheke. Monga lamulo, izi zimatenga pafupifupi maola 6.
• Nthawi ya 12 a.m., jakisoni amayenera kuperekedwa poyendetsa subcutaneous sing'anga (Protafan NM, InsumanBazal, Humulin NPH) kapena insulin yayitali (Lantus).
• Tsopano mukuyenera kuyeza shuga wamagazi maola awiri aliwonse (2 koloko, 4:00, 6:00 ndi 8:00), kuzindikira kusinthasintha kwake. Ngati sizidutsa 1.5 mmol, ndiye kuti mankhwalawa amasankhidwa molondola.
• Ndikofunikira kuti musaphonye kuchuluka kwa insulin, yomwe mankhwala osokoneza bongo amapezeka patatha pafupifupi maola 6. Ndi mlingo woyenera pakali pano, wodwalayo sayenera kutsika kwambiri m'magulu a shuga komanso kukula kwa hypoglycemia. Mukamagwiritsa ntchito Lantus, zinthuzi zitha kudumphidwa, popeza zilibe ntchito zapamwamba.
• Kuyesaku kuyenera kutha ngati asanayambe wodwala anali ndi hyperglycemia kapena kuchuluka kwa glucose kukwera pamwamba pa 10 mmol.
• Pamaso pa mayeso, palibe chifukwa muyenera kuchita jakisoni waifupi wa insulin.
• Ngati pakuyesa wodwalayo wadwala matenda a hypoglycemia, ayenera kuyimitsidwa ndipo kuyesaku kuyenera kuyimitsidwa. Ngati shuga yamagazi, m'malo mwake, yakwera pamlingo wowopsa, muyenera kupanga jakisoni wochepa wa insulin yochepa ndikulepheretsa mayeso mpaka tsiku lotsatira.
• Kukonza molondola kwa insulin ya basal ndikotheka pokhapokha pazotsatira zitatu zotere.

Kuchita zoyesa masana masana:

• Kuti muchite izi, wodwalayo ayenera kusiyiratu kudya m'mawa ndipo m'malo mwa insulin yochepa, jekeseni insulin.
• Tsopano wodwalayo ayenera kuyang'ana kuchuluka kwa shuga m'magazi ola lililonse asanadye chakudya chamadzulo. Ngati idagwa kapena kuchuluka, mulingo wa mankhwalawa uyenera kusinthidwa, ngati ukhalebe, ndiye kuti ukhale wofanana.
• Tsiku lotsatira, wodwalayo ayenera kudya chakudya cham'mawa nthawi zonse ndikupanga jakisoni wa insulin yochepa komanso yapakati.
• Chakudya chamasana ndi kuwombera kwina kwa insulin yayifupi kuyenera kudumphidwa. Maola 5 mutatha kadzutsa, muyenera kuyang'ana shuga wanu wamagazi koyamba.
• Kupitilira apo, wodwalayo ayenera kuyang'ana kuchuluka kwa shuga m'thupi ola lililonse mpaka chakudya chamadzulo. Ngati palibe kupatuka kwakukulu kunawonedwa, mulingo woyenera.

Kwa odwala omwe amagwiritsa ntchito insulin Lantus ya matenda a shuga, palibe chifukwa chochitira tsiku lililonse mayeso. Popeza Lantus ndi insulin yayitali, iyenera kuperekedwa kwa wodwala kamodzi kokha patsiku, asanagone. Chifukwa chake, ndikofunikira kuyang'ana kuchuluka kwake pamlingo wokha usiku.

Zambiri zamitundu ya insulin zimaperekedwa mu kanema munkhaniyi.

Kodi chithandizo chachikulu cha mankhwala a bolus insulin ndi chiyani?

Matenda a shuga a insulin amatha kukhala akale kapena oyambira (olimbikitsidwa). Tiyeni tiwone kuti ndi chiyani komanso ndi zosiyana. Muyenera kuwerenga kuti, "Momwe insulini imayang'anira shuga wa magazi mwa anthu athanzi komanso zomwe zimasintha ndi matenda ashuga." Mukamvetsetsa bwino nkhaniyi, mukamachita bwino pochiza matenda ashuga.

Mwa munthu wathanzi yemwe alibe shuga, kachidutswa kakang'ono kwambiri ka insulin nthawi zonse kamazungulira m'magazi othamanga. Izi zimatchedwa basal kapena basal insulin concentration. Zimalepheretsa gluconeogenesis, i.e., kusintha kwa malo ogulitsa mapuloteni kukhala glucose. Ngati panalibe plasma insulin concentration, ndiye kuti munthuyu "amasungunuka kukhala shuga ndi madzi," monga momwe madokotala akale amafotokozera amfawo chifukwa cha matenda a shuga a mtundu woyamba.

M'mimba yopanda kanthu (panthawi yogona komanso pakati pa chakudya), kapamba wathanzi amatulutsa insulini. Gawo lake limagwiritsidwa ntchito kuti likhale ndi khola la insulin m'magazi, ndipo gawo lalikulu limasungidwa. Izi zimatchedwa bolus chakudya. Zofunika ngati munthu ayamba kudya kuti azitha kudya zakudya zomwe zadyedwa ndipo nthawi yomweyo aletse kulumpha mu shuga.

Kuyambira pomwe chakudya chimayamba komanso kwa maola pafupifupi 5, thupi limalandira insulin. Uku ndikutulutsa kofinya ndi kapamba wa insulin, yomwe idakonzedwa pasadakhale. Zimachitika mpaka glucose onse wazakudya atengeke ndi minyewa yochokera m'magazi. Nthawi yomweyo, mahomoni otsutsana amachitanso kanthu kuti shuga m'magazi asatsike kwambiri komanso hypoglycemia isachitike.

Basis-bolus insulin mankhwala - amatanthauza kuti "baseline" (basal) ndende ya insulini m'magazi imapangidwa ndi jakisoni wa sing'anga kapena wa nthawi yayitali usiku ndi / kapena m'mawa. Komanso, phulusa la insulin (paphiri) la insulin mukatha kudya limapangidwa ndi jakisoni wowonjezera wa insulin yaifupi kapena ya ultrashort musanadye nawo. Izi zimapangitsa, ngakhale pang'ono, kutsanzira kugwira ntchito kwa kapamba wabwino.

Chithandizo cha insulin chachikhalidwe chimaphatikizanso kuyambitsa insulini tsiku lililonse, yoikika munthawi yake ndi mlingo. Poterepa, wodwala matenda a shuga sakonda kuyeza kuchuluka kwa shuga m'magazi ake ndi glucometer. Odwala amalangizidwa kuti azidya zakudya zomwezo tsiku lililonse. Vuto lalikulu ndi izi ndikuti palibe kusinthasintha kosinthasintha kwa mlingo wa insulini kukhala shuga. Ndipo odwala matenda ashuga amakhala "omangika" kuzakudya ndi dongosolo la jakisoni wa insulin. Mu chikhalidwe cha insulin mankhwala, jakisoni awiri a insulin nthawi zambiri amapatsidwa kawiri patsiku: yochepa komanso yapakati nthawi yochitapo kanthu. Kapena kusakaniza kwa mitundu yosiyanasiyana ya insulin kumabayira m'mawa ndi madzulo ndi jakisoni imodzi.

Mwachiwonekere, chithandizo cha matenda ashuga a shuga chimakhala chosavuta kuposa maziko. Koma, mwatsoka, nthawi zonse zimabweretsa zotsatira zosakhutiritsa. Ndikosatheka kupeza chipukutiro chabwino cha matenda a shuga, ndiko kuti, kubweretsa kuchuluka kwa shuga m'magazi pafupi ndi zikhalidwe zabwinobwino ndi chithandizo cha mankhwala a insulin. Izi zikutanthauza kuti zovuta za matenda ashuga, zomwe zimayambitsa kulumala kapena kufa msanga, zikukula mwachangu.

Chithandizo cha insulin chachikhalidwe chimagwiritsidwa ntchito pokhapokha ngati ndizosatheka kapena zosatheka kupatsa insulini molingana ndi chiwembu chokhazikika. Izi zimachitika pomwe:

• okalamba odwala matenda ashuga, ali ndi moyo wotsika,
• wodwala ali ndi matenda amisala
• wodwala matenda ashuga sangathe kuwongolera shuga m'magazi ake,
• wodwala amafunikira chisamaliro chakunja, koma ndizosatheka kupereka mtundu.

Kuti muthane ndi matenda a shuga ndi insulin pogwiritsa ntchito njira yofunikira ya mankhwala oyambira a bolus, muyenera kuyeza shuga ndi glucometer kangapo masana. Komanso, wodwalayo azitha kuwerengera kuchuluka kwa insulin yayitali komanso yofulumira kuti asinthe mlingo wa insulin pakali pano shuga.

Momwe mungasinthire mankhwala a insulin a matenda a shuga 1 kapena 2

Amaganiziridwa kuti muli kale ndi zotsatira za kudziletsa kwathunthu kwa shuga m'magazi odwala matenda a shuga masiku 7 otsatizana. Malangizo athu ndi a odwala matenda ashuga omwe amatsata zakudya zamafuta ochepa ndikugwiritsa ntchito njira yopepuka. Ngati mutsatira zakudya “zopatsa thanzi”, zodzaza ndi mafuta, ndiye kuti mutha kudziwa kuchuluka kwa insulini m'njira zosavuta kuposa zomwe zafotokozedwa mu nkhani zathu. Chifukwa ngati zakudya za anthu odwala matenda ashuga zili ndi chakudya chamagetsi, ndiye kuti simungapewe magazi.

Momwe mungapangire regimen ya insulin - njira iliyonse:

1. Sankhani ngati mukufuna jakisoni wa insulin yochulukirapo usiku.
2. Ngati mukufuna jakisoni wa insulin yowonjezera usiku, ndiye kuwerengera poyambira, ndikusintha patsiku lotsatira.
3. Sankhani ngati mukufuna jakisoni wa insulin yowonjezera m'mawa. Izi ndizovuta kwambiri, chifukwa poyesera muyenera kudumpha chakudya cham'mawa komanso nkhomaliro.
4. Ngati mukufuna jakisoni wa insulin yowonjezereka m'mawa, ndiye muwerengereni mlingo woyambira wa insulin, ndikusintha kwa masabata angapo.
5. Sankhani ngati mukufuna jakisoni wa insulin yachangu musanadye chakudya cham'mawa, chakudya chamadzulo ndi chakudya chamadzulo, ndipo ngati ndi choncho, chakudya chofunikira chisanachitike, komanso chisanafike - sichoncho.
6. Muyenera kuwerengera poyambira mwachidule kapena insulin ya insulin musanadye.
7. Sinthani Mlingo wamtundu waifupi kapena wa ultrashort musanadye, malinga ndi masiku apitawa.
8. Chitani kafukufuku kuti mudziwe kuti ndi mphindi zingati musanadye jakisoni.
9. Phunzirani momwe mungawerengere kuchuluka kwa insulini yochepa kapena ya ultrashort pamilandu mukafuna kusintha matenda a shuga.

Momwe mungakwaniritsire mfundo 1-4 - werengani mu nkhani ya "Lantus and Levemir - insulin. Asinthe shuga m'mimba yopanda kanthu m'mawa. " Momwe mungakwaniritsire mfundo 5-9 - werengani muzolemba "Ultrashort insulin Humalog, NovoRapid ndi Apidra. Human Short Insulin ”komanso“ jakisoni wa Insulin musanadye. Momwe mungachepetse shuga kuti akhale wabwinobwino ngati ukukwera. " M'mbuyomu, muyenera kuphunziranso nkhani ya "Kuchiza matenda a shuga ndi insulin. Mitundu ya insulin ndi iti. Kusunga Malamulo a Insulin. ” Apanso, tikukumbukira kuti zosankha zakufunika kwa jakisoni wa insulin yowonjezera komanso yachangu zimapangidwa popanda china. Mmodzi wodwala matenda ashuga amangofunika insulini yowonjezera usiku ndi / kapena m'mawa. Ena amangowonetsa jakisoni wa insulin yachangu musanadye kotero kuti shuga akhalebe wabwinobwino atatha kudya. Chachitatu, insulin yayitali komanso yachangu imafunikira nthawi yomweyo. Izi zimatsimikiziridwa ndi zotsatira za kudziletsa kwathunthu kwa shuga m'magazi 7 otsatizana.

Tidayesera kufotokoza m'njira yofikirika komanso yomveka ya momwe angapangire bwino dongosolo la insulin yodwala matenda amtundu 1 komanso matenda a shuga. Kuti mudziwe insulin yomwe mungabayire, munthawi iti komanso munthawi iti, mumayenera kuwerenga zolemba zazitali, koma zidalembedwa mchilankhulo chomveka bwino. Ngati muli ndi mafunso, afunseni mu ndemanga, ndipo tidzayankha mwachangu.

Chithandizo cha matenda a shuga amtundu 1 omwe ali ndi jakisoni wa insulin

Odwala onse omwe ali ndi matenda amtundu wa 1, kupatula okhawo omwe ali ofatsa kwambiri, ayenera kulandira jakisoni wa insulin musanadye. Nthawi yomweyo, amafunika jakisoni wa insulin yowonjezera usiku ndi m'mawa kuti akhalebe shuga wamba. Ngati muphatikiza insulin yowonjezera m'mawa komanso madzulo ndi jakisoni wa insulin yachangu musanadye, izi zimakupatsani mwayi wowerengeka kapenanso wa munthu wathanzi.

Werengani zida zonse zomwe zili mgululi "Insulin pochiza matenda amtundu 1 komanso matenda a shuga a 2." Yang'anirani mwapadera zolembedwa "Zowonjezera insulin Lantus ndi Glargin. Kati NPH-Insulin Protafan ”ndi“ jekeseni wa insulin mwachangu musanadye. Momwe mungachepetse shuga kukhala wabwinobwino ngati wadumpha. " Muyenera kumvetsetsa bwino chifukwa chake insulin yayitali imagwiritsidwa ntchito komanso yomwe imathamanga. Dziwani njira yochepetsera nkhawa yokhazikika yokhala ndi shuga wabwinobwino pomwe nthawi yomweyo mumalipira insulin.

Ngati muli ndi kunenepa kwambiri pamaso pa matenda a shuga 1, ndiye kuti mapiritsi a Siofor kapena Glucofage atha kukhala othandiza kuchepetsa kuchuluka kwa insulin ndikupangitsa kuti muchepe mosavuta. Chonde imwani mapiritsi awa ndi dokotala, osadzipatsa nokha.

Mtundu wachiwiri wa insulin ndi mapiritsi

Monga mukudziwa, chomwe chimayambitsa matenda a shuga a 2 ndikuchepa kwa chidwi cha maselo kuchitira insulin (insulin kukana). Odwala ambiri omwe ali ndi vutoli, kapamba amapitiliza kupanga insulini yake, nthawi zina imapitilira kuposa anthu athanzi. Ngati shuga lanu la m'magazi lalumpha mutatha kudya, koma osachulukitsa, ndiye kuti mutha kuyesa kuloweza jakisoni wa insulin yofulumira musanadye ndi mapiritsi a Metformin.

Metformin ndi chinthu chomwe chimakulitsa chidwi cha maselo kuti apange insulin. Ili ndi mapiritsi Siofor (kuchitapo kanthu mwachangu) ndi Glucophage (kumasulidwa kosasunthika). Izi ndizotheka kwambiri kwa odwala omwe ali ndi matenda a shuga a 2, chifukwa amatha kumwa mapiritsi ambiri kuposa jakisoni wa insulin, ngakhale atatha kudziwa jakisoni wopanda vuto. Musanadye, m'malo mwa insulin, mutha kuyesa kumwa mapiritsi a Siofor othamanga, ndikuwonjezera pang'onopang'ono.

Mutha kuyamba kudya osapitirira mphindi 60 mutatha kumwa mapiritsi. Nthawi zina zimakhala zosavuta kubayitsa jakisoni waifupi kapena wa ultrashort musanadye kuti mutha kudya pambuyo pa mphindi 20-45. Ngati, ngakhale mutamwa mlingo waukulu wa Siofor, shuga amadzuka chakudya, ndiye kuti jakisoni wa insulin amafunikira. Kupanda kutero, zovuta za matenda ashuga zimayamba. Kupatula apo, muli kale ndi zovuta zoposa zaumoyo. Sikunali kokwanira kuwonjezera kudula mwendo, khungu kapena kulephera kwa impso kwa iwo. Ngati pali umboni, ndiye kuti muthandizire matenda anu a shuga ndi insulin, musakhale opusa.

Momwe mungachepetse Mlingo wa insulin ndi matenda a shuga a 2

Kwa matenda a shuga a 2, muyenera kugwiritsa ntchito mapiritsi omwe ali ndi insulin ngati munenepa kwambiri ndipo mlingo wa insulin wowonjezera usiku ndi magawo 8-10 kapena kuposerapo. Pankhaniyi, mapiritsi a shuga oyenera amathandizira kukana insulin ndikuthandizira kuchepetsa insulin. Zingawonekere, ndi mwayi wanji? Kupatula apo, mukufunikabe kupanga jakisoni, mosasamala kanthu kuti muyezo wa insulin muli syringe. Chowonadi ndi chakuti insulini ndiye mahomoni akuluakulu omwe amachititsa kuti mafuta azikhala pansi. Mlingo waukulu wa insulin umapangitsa kuchuluka kwa thupi, kuletsa kuchepa kwa thupi ndikuwonjezera mphamvu ya insulin. Chifukwa chake, thanzi lanu lidzakhala lopindulitsa kwambiri ngati mungachepetse kuchuluka kwa insulin, koma osati pamtengo wowonjezera shuga.

Kodi mapiritsi ogwiritsira ntchito piritsi omwe ali ndi insulin ya matenda 2 a shuga ndi ati? Choyamba, wodwalayo amayamba kumwa mapiritsi a Glucofage usiku, limodzi ndi jakisoni wa insulin yowonjezera.Mlingo wa Glucofage umakulitsidwa pang'onopang'ono, ndipo amayesa kutsitsa insulin yayitali pakanthawi kochepa ngati miyeso ya shuga m'mimba yopanda kanthu ikusonyeza kuti izi zitha kuchitika. Usiku, zimalimbikitsidwa kutenga Glucophage, osati Siofor, chifukwa imatenga nthawi yayitali ndipo imakhala usiku wonse. Glucophage imakhalanso yocheperako kuposa Siofor kuyambitsa kukhumudwa. Pambuyo pakukula kwa Glucofage pang'onopang'ono mpaka kuchuluka, pioglitazone ikhoza kuwonjezeredwa kwa iyo. Mwina izi zithandizanso kuchepetsa kuchuluka kwa insulin.

Amaganiza kuti kutenga pioglitazone motsutsana ndi jakisoni wa insulin pang'ono kumakulitsa chiopsezo cha mtima wosweka. Koma Dr. Bernstein amakhulupirira kuti phindu lomwe lingakhalepo limaposa chiwopsezocho. Mulimonsemo, ngati mungazindikire kuti miyendo yanu ikutupa pang'ono, musiyeni kumwa pioglitazone. Glucophage ndiyokayikitsa yomwe ingayambitse zovuta zina kusiyanitsa kugaya zakudya, kenako osatero. Ngati, chifukwa cha kutenga pioglitazone, sikutheka kuchepetsa kuchuluka kwa insulin, ndiye kuti ndiye kuti kuthetsedwa. Ngati, ngakhale mutatenga mlingo waukulu wa Glucofage usiku, sizinali zotheka kuti muchepetse kuchuluka kwa insulin yayitali, ndiye kuti mapiritsi awa nawonso adathetsedwa.

Ndizoyenera kukumbukira apa kuti maphunziro akuthupi amalimbikitsa kukhudzidwa kwa maselo kuti apatsenso insulin nthawi zambiri zamphamvu kuposa mapiritsi a shuga. Phunzirani momwe mungapangire masewera olimbitsa thupi mosangalala ndi matenda a shuga 2, ndikuyamba kusuntha. Maphunziro akuthupi ndi mankhwala ochizira matenda amitundu iwiri, omwe amakhala m'malo achiwiri akatha kudya zakudya zamagulu ochepa. Kukana jakisoni wa insulini kumapezeka mu 90% ya odwala omwe ali ndi matenda a shuga 2, ngati mutsatira zakudya zamagulu ochepa ndipo nthawi yomweyo mumachita maphunziro olimbitsa thupi.

Pambuyo powerenga nkhaniyi, muphunzira momwe mungapangire mtundu wa insulin yodwala matenda a shuga, ndiko kuti, kupanga zisankho zokhudzana ndi insulin, munthawi yanji komanso muyezo uti. Talongosola za kusiyanasiyana kwa mankhwala a insulin a matenda a shuga 1 komanso mtundu 2 wa matenda ashuga. Ngati mukufuna kupeza chindapusa chabwino cha matenda ashuga, ndiko kuti, kuti mubweretse shuga m'magazi anu monga momwe kungathekere, muyenera kumvetsetsa mosamala momwe mungagwiritsire ntchito insulin pazomwezi. Muyenera kuwerenga nkhani zazitali mu insulin yotchedwa "Insulin pochiza matenda amtundu 2 komanso matenda a shuga." Masamba awa onse adalembedwa momveka bwino momwe zingathere komanso kupezeka kwa anthu opanda maphunziro a udokotala. Ngati muli ndi mafunso, ndiye mutha kuwafunsa mu ndemanga - ndipo tidzayankha nthawi yomweyo.

Moni Mayi anga ali ndi matenda ashuga a 2. Ali ndi zaka 58, masentimita 170, 78 kg. Mavuto - matenda ashuga retinopathy. Monga adanenera dokotala, adamwa Glibomet kawiri pa tsiku kwa mphindi 15 asanadye. Zaka 3 zapitazo, adokotala adayambitsa insulin protafan m'mawa ndi madzulo a magawo 14-12. Mafuta othamanga kwambiri anali 9-12 mmol / L, ndipo pofika madzulo amatha kufika 14-20 mmol / L. Ndidazindikira kuti atasankhidwa kukhala protafan, retinopathy idayamba kupita patsogolo, izi zisanachitike ndi vuto lina - phazi la matenda ashuga. Tsopano miyendo yake sikuwavutitsa, koma ali pafupi saona. Ndili ndi maphunziro a udokotala ndipo ndimamugwirira ntchito yonse. Ndidaphatikiziranso tini yochepetsera shuga komanso zopatsa mphamvu zamagulu m'zakudya zake. Miyezi ya shuga idayamba kutsikira mpaka 6-8 mmol / L m'mawa ndi 10-14 madzulo. Kenako ndidaganiza zochepetsa mapiritsi ake a insulin ndikuwona momwe kuchuluka kwa shuga m'magazi kumasinthira. Ndinayamba kuchepetsa mlingo wa insulin ndi 1 unit sabata limodzi, ndikuwonjezera kuchuluka kwa Glibomet kukhala mapiritsi atatu patsiku. Ndipo lero ndikumusisita m'magawo atatu m'mawa ndi madzulo. Koma chosangalatsa ndichakuti mulingo wa glucose ndi womwewo - 6-8 mmol / L m'mawa, 12-14 mmol / L madzulo! Kodi zinafika poti tsiku lililonse la Protafan lingasinthidwe ndi ma bioadditives? Mkulu wa glucose akakhala wamkulu kuposa 13-14, ndimabayitsa AKTRAPID 5-7 IU ndipo mulingo wotseka shuga umabweranso wamba. Chonde ndiuzeni ngati zinali zoyenera kuti amupatse mankhwala a insulin konse. Komanso, ndidazindikira kuti mankhwalawa amamuthandiza kwambiri. Ndikufuna kudziwa zambiri za mankhwala othandiza kwambiri pochiza matenda a shuga a 2 komanso retinopathy. Zikomo!

> Monga adokotala adalembera, adatenga Glibomet

Glibomet imaphatikizapo glibenclamide. Amanena za mapiritsi owononga a shuga, omwe timalimbikitsa kusiya. Sinthani ku metformin yoyera, i.e. Siofor kapena Glucofage.

> zinali zoyenera konse
> kuperekera mankhwala a insulin?

Tikukulimbikitsani kuti muyambe kulandira mankhwala a insulini mwachangu ngati shuga itatha chakudya kudumphira pamwamba pa 9.0 mmol / L osachepera kamodzi ndipo pamwamba pa 7.5 mmol / L pachakudya chochepa chamafuta.

> phunzirani zambiri zamankhwala othandiza kwambiri

Nayi nkhani "Kuchiritsa kwa Matenda A shuga", mupeza zonse pamenepo. Ponena za retinopathy, njira yabwino ndikukhwimitsa shuga m'magazi potsatira pulogalamu yathu yachiwiri ya matenda ashuga. Mapiritsi ndipo ngati kuli kotheka, laser coagulation yamitsempha yamagazi - yoyikidwa ndi ophthalmologist.

Moni Mwana wanga wamkazi ali ndi matenda ashuga 1. Ali ndi zaka 4, kutalika kwa 100 cm, kulemera kwa 16 kg. Pa insulin mankhwala kwa zaka 2.5. Jekeseni - magawo anayi a Lantus 4 m'mawa komanso chizungulire cha chakudya chamitundu iwiri. Shuga m'mawa 10-14, m'mawa shuga 14-20. Ngati, asanagone, 0,5 ml imodzi ya humalogue idasokonekera, ndiye kuti m'mawa shuga amawonjezeka kwambiri. Tinayesetsa kuyang'aniridwa ndi madokotala kuti tiwonjezere muyeso wa mayunitsi a lantus 4 ndi humalogue ndi mayunitsi a 2,5. Kenako mawa ndi chakudya chamadzulo mulingo wambiri wa insulin, madzulowo tinali ndi acetone mkodzo wathu. Tidasinthira kumayendedwe a lantus 5 ndi gawo la 2 mayunitsi, koma shuga amakhalabe okwera. Nthawi zonse amatilembera ku chipatala tili ndi shuga tili ndi zaka 20. Kunyumba, timayambanso kusintha. Mtsikanayo amagwira ntchito, shuga atayamba kulimbitsa thupi amayamba kukula. Tikutenga zakudya zamagetsi kuti muchepetse shuga. Ndiuzeni momwe ndingakwaniritsire shuga abwinobwino? Mwinanso insulini yokhala nthawi yayitali siyabwino kwa iye? M'mbuyomu, poyamba anali pa protofan - kuchokera kwa iye mwana anali ndi ma cramp. Zotsatira zake, ziwengo. Kenako anasamukira ku levemir - maphikidwewo anali okhazikika, zinafika poti amangoyika levemir okha usiku. Ndipo adasinthidwa bwanji ku lantus - shuga amakhala wokwera nthawi zonse.

> Ndiwuzeni momwe ndingakwaniritsire shuga wabwinobwino?

Choyamba, sinthani ku chakudya chochepa chamafuta ndikuchepetsa mulingo wanu wa insulin malinga ndi shuga. Pangani shuga ndi glucometer osachepera 8 pa tsiku. Phunzirani mosamala zolemba zathu zonse pansi pamutu wa insulin.

Pambuyo pake, ngati muli ndi mafunso, afunseni.

Ngakhale mwana yemwe ali ndi matenda amtundu woyamba amadya "monga wina aliyense," kukambirana zina ndi zopanda pake.

Zinkawoneka kuti mukudziwa zambiri zazokhudza matenda a shuga monga LADA. Chifukwa chiyani izi kapena ndikuyang'ana kwina kolakwika?

> kapena kodi ndikuyang'ana kwina kolakwika?

Nkhani yatsatanetsatane yokhudza mtundu wa shuga wa LADA 1 mu mawonekedwe ofatsa apa. Ili ndi chidziwitso chapadera kwa odwala omwe ali ndi matenda amtunduwu. Ku Russia, palibe kwina kulikonse.

Moni
Ndili ndi matenda ashuga a 2. Ndinasinthira kudya zakudya zamagulu ochepa zam'thupi 3 masabata apitawa. Ndimatenganso m'mawa ndi madzulo Gliformin piritsi limodzi la 1000 mg. Shuga m'mawa pamimba yopanda kanthu, musanadye chakudya komanso musanadye chakudya nthawi yofananira - kuyambira 5.4 mpaka 6, koma kulemera kwake sikuchepa.
Kodi ndifunika kusinthitsa insulini m'malo mwanga? Ngati ndi choncho, mu Mlingo uti?
Zikomo!

> kulemera sikuchepetsedwa

msiyeni iye yekha

> Kodi ndikufunika panjira yanga?
> kusinthana ndi insulin?

Moni Ndili ndi zaka 28, kutalika 180 masentimita, kulemera kwa makilogalamu 72. Ndadwala matenda ashuga amtundu woyamba kuyambira 2002. Insulin - Humulin P (36 mayunitsi) ndi Humulin P (28 mayunitsi). Ndinaganiza zoyeserera - kuti ndiwone momwe matenda anga a shuga az amakhalira. M'mawa, osadya chilichonse, adayeza shuga - 14.7 mmol / l. Anabaya insulin R (mayunitsi atatu) ndikupitilizanso kusala, ndikumwa madzi okha. Pofika madzulo (18:00) anayeza shuga - 6.1 mmol / l. Sindinapereke insulin. Ndinapitilizabe kumwa madzi okha. Ku 22,00 shuga wanga anali kale 13 mmol / L. Kuyesaku kudatenga masiku 7. Kwa nthawi yonse yosala kudya, amamwa madzi amodzi. Kwa masiku asanu ndi awiri m'mawa, shuga anali pafupifupi 14 mmol / L. Pofika 6:00 p.m. adamenya insulin Humulin R yachibadwa, koma pofika 10 p.m. shuga adakwera 13 mmol / l. Pa nthawi yonse yosala kudya, sipanakhalepo ndi hypoglycemia. Ndikufuna ndidziwe kuchokera kwa inu chifukwa chamakhalidwe anga omwe amavuta, chifukwa sindinadye chilichonse? Zikomo

Ndikufuna ndidziwe kuchokera kwa inu chifukwa chamakhalidwe anga omwe ali ndi shuga

Matenda a kupsinjika omwe amatulutsidwa ndi tiziwalo timene timatulutsa timayambitsa timagazi ta shuga tambiri ngakhale mu kusala. Chifukwa cha matenda amtundu 1, mulibe insulin yokwanira kulumpha.

Muyenera kusinthira ku chakudya chamafuta ochepa, ndipo koposa zonse, kuti muphunzire ndikugwiritsa ntchito njira zowerengera molondola mankhwala a insulin. Kupanda kutero, nyama yankhosa imangoyang'ana pakona.

Chowonadi ndi chakuti poyamba, ndikadwala, shuga anali osadukiza, akumadula insulin yokwanira. Pakapita kanthawi, "dokotala m'modzi wanzeru" adalangiza njira yosala kudya, yomwe amati ndiyanjala imatha kuchiritsidwa matenda ashuga. Nthawi yoyamba yomwe ndimakhala ndi njala masiku 10, yachiwiri inali kale 20. Shuga anali ndi njala pafupifupi 4.0 mmol / L, sizinakwere pamwamba, sindinabayire insulin konse. Sindinachiritse matenda ashuga, koma mlingo wa insulin unachepetsedwa kukhala magawo 8 patsiku. Nthawi yomweyo, thanzi lathunthu linasintha. Pakupita nthawe, iye adagumanambo njala. Ndisanayambe, ndinamwa madzi ambiri a apulosi. Popanda jakisoni wa insulin, adakhala ndi njala masiku 8. Panalibe mwayi woyeza shuga nthawi imeneyo. Zotsatira zake, ndidagonekedwa m'chipatala ndi acetone mu mkodzo +++, ndi shuga 13.9 mmol / L. Zitachitika izi, sindingachite popanda insulini konse, kaya ndidadya kapena ayi. Ndikofunikira kumayamwa mulimonse. Ndiuzeni chonde, chachitika ndi chiyani mthupi langa? Mwinanso chifukwa chenicheni si nkhawa yamafuta? Zikomo

zomwe zidachitika mthupi langa?

Simunamwe madzi osakwanira mukusala, zomwe zidapangitsa kuti mkhalidwewo ukhale woipa kwambiri kotero kuti kuchipatala kunali kofunikira

Masana abwino Ndikufuna upangiri wanu. Amayi akhala akuvutika ndi matenda a shuga a 2 kwazaka pafupifupi 15. Tsopano ali ndi zaka 76, kutalika 157 cm, kulemera 85 kg. Miyezi isanu ndi umodzi yapitayo, mapilitsi anasiya kukhala ndi shuga. Adatenga maninil ndi metformin. Kumayambiriro kwa mwezi wa June, glycated hemoglobin anali 8.3%, tsopano mu Seputembara 7.5%. Mukamayeza ndi glucometer, shuga nthawi zonse amakhala 11-15. Nthawi zina anali wopanda m'mimba 9. Magazi a biochemistry - Zizindikiro ndizabwinobwino, kupatula cholesterol ndi TSH yowonjezereka pang'ono. Endocrinologist anasamutsa mayi kupita ku insulin Biosulin N kawiri pa tsiku, m'ma 12 mayunitsi, madzulo magawo 10, komanso mapiritsi a mannil mamawa ndi madzulo asanadye. Timabaya insulini kwa sabata limodzi, pomwe "mavinidwe" a shuga. Zimachitika 6-15. Kwenikweni, zizindikiro 8-10. Kupanikizika nthawi ndi nthawi kumakwera mpaka 180 - amachita ndi Noliprel forte. Miyendo imasunthidwa pafupipafupi chifukwa cha ming'alu ndi zilonda - pomwe zonse zili bwino. Koma miyendo yanga imandipweteka kwambiri.
Mafunso: Kodi ndizotheka kuti pa msinkhu wake azitsatira zakudya zamagulu ochepa? Chifukwa chiyani shuga “amalumpha”? Njira yolakwika yolowera, singano, mlingo? Kapena kodi ingoyenera kukhala nthawi yoti musinthe? Insulin yolakwika? Ndikuyembekezeradi yankho lanu, zikomo.

kodi ndizotheka kuti pa msinkhu wake azitsatira zakudya zamagulu ochepa?

Zimatengera momwe impso zake zilili. Kuti mumve zambiri, onani nkhani yakuti “Zakudya za impso ndi matenda a shuga.” Mulimonsemo, musinthane ndi zakudya izi ngati simukufuna kuyenda pa amayi anu.

Chifukwa sikuti mukuchita zonse bwino.

Timatsatira malangizo onse a endocrinologist - zikukwaniritsidwa, adokotala amalemba njira zolakwika?

Kodi mungachite bwanji? Kupatula maninil, kuwonjezera insulini?

Kodi dokotala amakulemberani chithandizo cholakwika?

Pali tsamba lathunthu lokhudza madotolo am'nyumba omwe amachiza matenda molakwika 🙂

Choyamba, fufuzani impso. Zowonjezera, onani nkhani yokhudza chithandizo cha matenda a shuga 2 + a jakisoni a insulin ndi ofunikira, chifukwa milanduyi siyinayanjidwe.

Sankhani mtundu woyenera wa insulin monga momwe zalembedwera patsamba lanu. Ndikofunika kuti muzigwiritsa ntchito mitundu ya insulin yokhazikika komanso yofulumira, osati zomwe mudalamulidwa.

Zikomo Tiphunzira.

Moni, kodi ndimabayirira insulin molondola m'mawa makumi atatu ndi atatu a protafan komanso madzulo komanso ndimatha kudya chakudya chamagulu 30, ndinadumphadumpha shuga ndipo sindimadya chakudya, koma ndimamwa nthawi yomweyo, ndinapumira 1 ndikuwonjezera shuga m'mawa ndi m'mawa.

Moni. Mwamuna wanga ali ndi matenda ashuga a 2 kuyambira 2003. Mwamuna wazaka 60 amakhala pamapiritsi amankhwala osiyanasiyana omwe amalimbikitsa madokotala (siofor, glucophage, pioglar, onglise,) Chaka chilichonse amathandizidwa kuchipatala, koma shuga anali kukulira nthawi yonseyi. Kwa zaka 4 zapitazi, shuga anali oposa 15 ndipo adafika pa 21. Chifukwa cha insulin iwo sanasamutsire ake, zinali 59. Kwa zaka 1.5 zapitazi, ndinataya makilogalamu 30 nditatenga Victoza (ndikubaya jekeseni kwa zaka 2) monga momwe dokotala wanenera. Ndipo ndinatenga onglise ndi glycophage 2500. Shuga sanagwere pansi 15. Pa chithandizo chotsatira mu Novembala, insulin ya AKTAPID inalembedwa pa 8 mayunitsi katatu patsiku ndipo usiku LEVOMIR 18ED. Ku chipatala, acetone +++ adapezeka atazindikira momwe mankhwalawo amathandizira, adazengereza, mayunitsi 15 adalembedwa zotsatana ndi acetone ndi shuga. Acetone amasunga nthawi zonse mkati mwa 2-3 (++) Amamwa madzi 1.5-2 malita tsiku lililonse. Sabata yapitayi, adatembenukiranso kuchipatala, m'malo mwa Actrapid, NOVO RAPID adalembedwa ndipo mankhwalawo amayenera kutengedwa okha, ndipo adotolo wa acetone sayenera kulabadira acetone. Mwamuna wanga sakumva bwino. Kumapeto kwa sabata tikufuna kusinthira ku NOVO RAPID. Kodi mungandiuze pa mlingo uti? Ndingakhale wothokoza kwambiri. Mwamuna alibe zizolowezi zoyipa.

Kodi tanthauzo la chakudya chochepa chamagulu owonjezera? Zachinyengo zamtundu wanji? Ndine mtundu wa 1 wodwala matenda ashuga wazaka 20. Ndimalola kudya chilichonse! Nditha kudya keke yapancake. Ndimangopanga insulin yambiri. Ndipo shuga ndi wabwinobwino. Knead ine chakudya chochepa chama carob, chonde?

Masana abwino
Ndili ndi zaka 50. Zaka 4 mtundu 2 shuga. Adagonekedwa kuchipatala ndi shuga 25 mmol. Kusankhidwa: magawo 18 a lantus usiku + metformin 0,5 mg ndi mapiritsi 3-4 pa tsiku ndi chakudya. Mutatha kudya chakudya chamafuta (zipatso, mwachitsanzo), kumakhala kumang'ambika kuderalo mwendo wapansi ndipo sindimakonda. Koma ndimaganiza kuti popanda ma carbohydrate ndizosatheka kwathunthu, makamaka popanda zipatso, pali mavitamini. Shuga m'mawa osapitilira 5 (5 ndi osowa kwambiri, m'malo mwa 4), nthawi zambiri amakhala pansi pa 3.6-3.9. mutatha kudya (pambuyo maola 2) mpaka 6-7. Nditaphwanya zakudya zinali mpaka 8-9 kangapo.
Ndiuzeni, ndingamvetsetse bwanji kuti ndisunthire bwanji, ngati ndisiyiratu mankhwala - ndimachepetsa mapiritsi kapena insulin? komanso momwe ndingachitire bwino m'malo anga? Madokotala safuna kwenikweni kuchita chilichonse. Zikomo patsogolo.

Ndili ndi matenda a T2DM kwa zaka 30, ndimaba jekeseni Levemir m'magawo 18 m'mawa ndipo madzulo ndimamwa metformin + glimepiride 4 m'mawa + Galvus 50 mg 2 nthawi, komanso shuga m'mawa 9-10 masana 10-15. Kodi pali regimens ina ndi mapiritsi ochepa? Dokotala masana insulin salimbikitsa glycated hemoglobin 10

Moni Ndili ndi matenda ashuga a 2. Ndili ndi zaka 42 ndipo ndimalemera makilogalamu 120. kutalika 170. Dokotala adandiwuza kuti ndithandizire insulin musanadye mayunitsi 12 a Novorapid komanso usiku 40 mayunitsi Tujeo. Shuga masana osakwana 12 sizichitika. M'mawa m'ma 15-17. Kodi ndili ndi chithandizo choyenera komanso mungalangize chiyani?

Masana abwino Ngati mungadziwe ngati ndidapatsidwa chithandizo choyenera malinga ndi kusanthula kwa C-peptide, zotsatira za 1.09, insulin 4.61 μmE / ml, TSH 1.443 μmE / ml, Glycohemoglobin 6.4% Glucose 7.9 mmol / L, ALT 18.9 U / L Cholesterol 5.41 mmol / L, Urea 5.7 mmol / L pakadali pano pali 8-15 shuga 5.0 ngati sindidya chilichonse kwa theka la tsiku. Msinkhu 1.72 wolemera 65kg unakhala, anali 80kg. zikomo

Zowongolera Bolus

Monga mukukumbukira, insulin sensitivity factor imagwiritsidwa ntchito kuwerengera bolus yokonzanso, yomwe imatsimikiza kuchuluka kwa glucose amachepetsa ndikuyambitsa gawo limodzi la insulin. Mwachitsanzo, insulin sensitivity factor 10 ikusonyeza kuti gawo limodzi la insulini likaperekedwa, shuga m'magazi amatsika ndi 10 mmol / L.

Kuti muwone kuyendetsa bwino kwa bolus yodzikongoletsa, glucose wamagazi amayeza pamaso pa insulin kasamalidwe komanso pambuyo pa maola awiri ndi anayi (nthawi yayikulu ya insulin) itatha. Ndi mlingo woyenera wa zotsekemera zotsekemera, kuchuluka kwa shuga m'magazi 2 pambuyo pake kumachepera pafupifupi 50% ya kutsika komwe kumayembekezereka, ndipo kumapeto kwa nthawi yayitali ya insulini, magawo a glucose ayenera kukhala pamlingo womwe akufuna (kusala kwa shuga m'magazi omwe mukukonzekera).

Chongani bolus yoikonza:

• Ziphuphu zowongolera zimawerengeredwa potengera insulin sensitivity factor(PSI)
• Muyerekeze shuga 2 ndi 4 maola pambuyo bolus kukonzaKB)
• Muyeze KB ya hyperglycemia ndi kusapezeka kwa mankhwala ndi zakudya m'maola atatu omaliza
• Ndi mlingo woyenera wa KB, kuchuluka kwa shuga m'magazi:

- Maola 2 pambuyo pa kutsitsidwa kwatsitsidwa ndi pafupifupi 50% ya kutsika komwe akuyembekezeka,
- Maola 4 pambuyo pa kutsata ali pamulingo womwe akufuna

Chithunzi chikuwonetsa momwe kuchuluka kwa glucose m'magazi kumayenera kutsikira pambuyo pakupanga.

Chithunzi 1. Kutsika kwachilendo kwa shuga m'magazi (GC) pambuyo pa kutsatakukonza bolus

Tiyerekeze kuti 9:00 munthu ali ndi shuga wamagazi okwanira 12 mmol / L ndi chandamale 6 mpaka 8 mmol / L ndi PSI ya 5. Amapereka jekeseni imodzi ya mankhwala a bolus insulin (panalibe chakudya), ndipo patatha maola 2 shuga m'magazi anachepa kufika pa 6.5 mmol / L, ndipo patatha maola 4 nthawi ya 13:00 mulingo wama glucose anali m'munsi mwa chandamale ndipo amafikira 4 mmol / L.

Pankhaniyi, shuga wotsika wamagazi kumapeto kwa gawo lalikulu la kukonzanso kumawonetsa bolus yowonjezera, muyenera kuwonjezera PSI ndi 10-20% mpaka 5.5-6 pazokhalamo zowerengera za bolus, kuti nthawi yotsatira pampu ifotokozere chimodzimodzi jekeseni insulin yochepa.

Chithunzi 2. KB - bolus yokonza, PSI - insulin sensitivity factor

Kwina, maola 4 pambuyo pa kukhazikitsidwa kwa bolus yolembera, shuga wamagazi anali pamwamba pa gawo lazomwe akufuna. Panthawi imeneyi, insulin sensitivity factor iyenera kuchepetsedwa kuti insulin yambiri ilowe.

Chithunzi 3. KB - bolus yokonza

Chakudya

Kuwerengera botus la chakudya, chakudya chamafuta chimagwiritsidwa ntchito. Kuunika chakudya chochuluka kumafunikira kuchuluka kwa shuga m'magazi musanadye, maola awiri ndi anayi mutatha kudya. Ndi mlingo wokwanira wa botolo lazakudya, phindu la shuga kumapeto kwa gawo lalikulu la insulin, pambuyo pa maola 4, liyenera kukhala mkati mwa mtengo woyambirira musanadye. Kuwonjezeka pang'ono kwa shuga m'magazi kumaloledwa pambuyo pa maola awiri pakuperekedwa kwa chakudya, izi zimachitika chifukwa cha kupanikizika kwa insulin panthawiyi, popeza ndi mafuta am'magazi am'magazi ofanana ndi oyambirirawo, kutsika kwamphamvu kwa glucose kumachitika, komwe kungayambitse hypoglycemia.

Onani zakudya

• Chakudya cham'mimba chimawerengeredwa potengera kuchuluka kwa chakudya (UK)
• Pangani shuga m'magazi musanadye, maola awiri ndi anayi mutatha kudya
• Ndi muyezo woyenera wa PB, ma glucose amawerengera:

- Maola awiri mutatha kudya 2-3 mmol / l kuposa mtengo woyambira,
- Maola 4 mutatha kudya mkati mwa mtengo woyambirira

Chithunzi 4. Kuchepetsa mwachizolowezi mu HA mukamayambitsa bolus ya chakudya (BE). UK - chakudya cholimbitsa;; chakudya -

Kulimbitsa thupi

Ngati maola awiri mutatha kudya, magazi anu ndi awa:

• kuchuluka kwa 4 mmol / l poyerekeza ndi gawo musanadye - onjezerani UK ndi 10-20%,
• kutsika ndi oposa 1-2 mmol / l poyerekeza ndi gawo musanadye - kuchepetsa UK ndi 10-20%

Chithunzi 5. BE - chakudya chakudyacho

Ingoganizirani kuti mutatha kupereka chakudya chambiri m'magawo asanu ndi 9:00 pambuyo pa maola awiri, shuga wa magazi anali wapamwamba ndi 2 mmol / l, ndipo pambuyo pa maola 4 shuga wa magazi anali wotsika kwambiri kuposa momwe adadyera kale. Pankhaniyi, chakudya chambiri chinali chochuluka. Muyezo wazakudya zowonjezera mafuta ayenera kuchepetsedwa kotero kuti chowerengera cha bolus chiwerengere kuchepa kwa insulin.

Chithunzi 6. BE - chakudya chakudyacho

Nthawi inanso, shuga m'magazi 4 pambuyo chakudya adakhala apamwamba kuposa zoyambira, zomwe zimawonetsa kusowa kwa chakudya. Ndikofunikira kuwonjezera chakudya chamafuta kuti mupeze insulin yowerengeka ndi bolus Calculator.

Mukaphatikiza bolus yokonza ndi bolus ya chakudya (mwachitsanzo, ndi kuchuluka kwa shuga m'magazi musanadye), nkovuta kwambiri kuyesa mlingo woyenera wa bolus iliyonse, chifukwa chake tikulimbikitsidwa kuyesa malo owongolera ndi bolus ya chakudya pokhapokha maulamu awa akaperekedwa padera.

Unikani kuchuluka kwa zoyambira ndi zotsekemera pa chakudya pokhapokha zitaperekedwa mosiyana ndi mnzake.

Ndi chiyani chomwe chimakhudza insulin?

Kuchuluka kwa insulin pachakudya chilichonse, kapena "chakudya chochuluka" mwa munthu aliyense, zimatengera zinthu zingapo. Choyambirira, zowonadi, izi ndi kuchuluka kwa chakudya chamafuta omwe munthu watenga kapena woti atenge, komanso kuchuluka kwa munthu payekha pakati pa chakudya ndi insulin - chakudya chokwanira. Chakudya chopatsa mphamvu, monga lamulo, amasintha masana. Anthu ambiri omwe ali ndi matenda ashuga amakhala ndi mphamvu m'mawa komanso otsika madzulo. Izi ndichifukwa choti mu theka loyambirira la tsiku, kuchuluka kwa mahomoni otsutsana kumakhala kwakukulu, komwe kumachepetsa mphamvu ya insulin.

Chinthu china chofunikira chomwe chimakhudza insulin ndi kupezeka kwa chakudya. Mutha kufunsa kuti: bwanji, chifukwa chakum'mimba chimatengera kuchuluka kwa chakudya chamafuta? Ngakhale kuti zopangidwazo sizikhudzanso mwachindunji kuchuluka kwa insulini yomwe imayendetsedwa, zimatengera kwakukulu kuti chakudyacho chithandiza kuchuluka kwa shuga m'magazi.

Gome 1. Zomwe zimapangitsa kuti pakhale magawo akuluakulu a chakudya

Kodi ndichifukwa chiyani kuli kofunikira kulingalira kapangidwe ka chakudya? Zakudya zosiyanasiyana, ngakhale zili ndi mafuta ochulukirapo, zimatha kuwonjezera shuga m'magazi m'njira zosiyanasiyana. Kukula kwa shuga m'magazi mutatha kudya zimatengera kuchuluka kwa chakudya m'mimba, zomwe zimatengera chakudya, komanso zinthu zina zingapo. Kuti tikwaniritse kuyendetsa bwino matenda a shuga, zinthu izi ziyenera kulingaliridwa kuti zithetse shuga wokwanira wamagazi mukatha kudya.

Gome 2. Zomwe zimakhudza kuchuluka kwa kuchuluka kwa glucose wamagazi mukatha kudya

Pancreas wathanzi amabisa insulini, kutengera momwe shuga amatulutsira: ngati shuga alowa m'magazi pang'onopang'ono, kapamba amapanga insulini pang'onopang'ono; ngati chakudya chamafuta chikafika mofulumira, kapamba amatulutsa insulin yambiri nthawi yomweyo.

Mukamagwiritsa ntchito zolembera za syringe, njira yokhayo yokhazikitsira insulin ndikuyendetsa insulin yonse nthawi imodzi kapena kuigawa m'magawo angapo, zomwe zimatha kukhala zovuta komanso zimayambitsa zovuta zina. Mukamagwiritsa ntchito pampu ya insulin, mipata yambiri imawonekera chifukwa cha kupezeka kwa mitundu yosiyanasiyana ya makulidwe a bolus komanso kusowa kwa jakisoni.

Mitundu ya Boluses

Mwa chikhalidwe cha mawu oyamba, pali mitundu ingapo ya mabulamu (ngakhale chakudyacho ndi chakumaso kapena chosintha). Ntchito yayikuru yamitundu yosiyanasiyana ya mabulusulo a insulin ndikuwongolera kapangidwe kazakudya (potengera kuthamanga ndi kutalika kwa kuchuluka kwa shuga m'magazi), nthawi ya chakudya komanso insulin. Pafupifupi mitundu yonse ya mapampu a insulini pali mitundu itatu yoyendetsedwa ndi bolus: standard bolus, extension bolus, double bolus.

Gawo 3. Mitundu ya Boluses

Double Bolus (Wachiwiri Wakumaso Bolus)

Mtundu wamtunduwu ndi kuphatikiza kwa awiri apitawo (chifukwa chake dzina "kuphatikizika"), ndiko kuti, gawo la insulin limabayidwa nthawi yomweyo, ndipo gawo limalowetsedwa pang'onopang'ono kwakanthawi kambiri. Mukakonza mtundu uwu wa bolus, muyenera kukhazikitsa kuchuluka kwa insulini, kuchuluka kwa insulin yomwe muyenera kulowa nthawi yomweyo (mafunde oyamba), komanso kutalika kwa funde lachiwiri. Mtundu wa bolus ungagwiritsidwe ntchito mukamamwa zakudya zophatikiza zamafuta kwambiri komanso zopatsa mphamvu m'mimba (pizza, mbatata yokazinga).

Mukamagwiritsa ntchito chopondera pawiri, musagawane ndi funde lolowera kwambiri
50%, ndipo kutalika kwa funde lachiwiri kunakhala kuposa maola awiri.

Kuchuluka kwa insulini pamafunde oyamba ndi achiwiri, komanso kutalika kwa gawo lachiwiri, zimatengera mtundu wa chakudya, kuchuluka kwa shuga m'magazi musanadye, ndi zina. Muyenera kuyeseza kuti mupeze mawonekedwe oyenera a bolus. Kwa nthawi yoyamba, sikulimbikitsidwa kupaka jakisoni woposa 50% ya insulin yonse, ndipo nthawi yoyendetsedwayo iyenera kupitilira maola opitilira 2. Popita nthawi, mutha kudziwa magawo oyenera a inu kapena mwana wanu omwe angakuthandizeni shuga wamagazi mukatha kudya.

Superbolus

Superbolus - uku ndikoyambitsa gawo la basal insulin mu njira yowonjezera ya inshuwaransi, pomwe kuphatikiza kwa basulin insulin kumayimitsidwa kwathunthu kapena kuchepetsedwa.

Kuchulukitsa mlingo wa insulin chifukwa cha basal kungakhale kothandiza ngati pakufunikira mwachangu insulin. Superbolus imatha kuyambitsidwa chakudya, mwachitsanzo, pankhani ya chakudya chokhala ndi index yayikulu ya glycemic kapena pankhani ya chakudya "chofulumira".

Chithunzi 7. Superbolus wa chakudya

Mutatha kudya "mwachangu" ndi magawo 6 a chakudya chilichonse, shuga wa magazi amatuluka kupitirira 11 mmol / l. Potere, mlingo woyambira wa maola 2 mutatha kudya ndi 1 U / ola. Pofuna kuyambitsa superbolus, ndizotheka kuyatsa VBS 0% kwa maola awiri, ndipo panthawiyi magawo awiri a insulin sadzalandira. Ma 2 PIECES a insulin amayenera kuwonjezeredwa ku bolus ya chakudya (6 + 2 PIECES). Chifukwa cha superbolus wa magawo 8, kuchuluka kwa shuga m'magazi mukatha kudya kumakhala kochepa poyerekeza ndi bolus wamba.

Komanso, superbolus imatha kuyambitsidwa kuti ikonzedwe pamlingo wokwanira wamagazi m'magazi, kuti muchepetse glucose wamagazi kuti azitha kupeza zofunika posachedwa.

Chithunzi 8. Kukonzanso kwa Superbolus

Kupereka superbolus, mlingo woyambira umazimitsidwa (VBS - mulingo woyambira wosakhalitsa 0%) kwa maola awiri. Mlingo wa insulin wosayendetsedwa panthawiyi mwachangu 1 U / ola 2 2 U. Insulin yoyambira iyi imawonjezeredwa ku bolus yokonza. Mulingo woyenera wa insulini wambiri wamagulu a shuga ndi 4 PISCES, kotero superbolus idzakhala 6 PIERES (4 + 2 PIECES). Kukhazikitsidwa kwa superbolus kumachepetsa glucose wamagazi mwachangu ndikukwaniritsa mipherezo munthawi yochepa poyerekeza ndi bolus yokhazikika.

Kumbukirani kuti mukamagwiritsa ntchito superbolus, insulin yonse yovomerezeka imawonedwa kuti imagwira ntchito, ngakhale kuti gawo lake, kwenikweni ndi mlingo woyambira. Kumbukirani izi mukamayambitsa bolodi yotsatira.

I.I. Dedov, V.A. Peterkova, T.L. Kuraeva D.N. Laptev