Kuchita insulin mwachangu mwachangu

Insulin yachangu yaumunthu imayamba kugwira ntchito mkati mwa mphindi 30-45 mutatha jakisoni, mitundu yamakono yotsalira ya insulin (Apidra, NovoRapid, Humalog) - ngakhale mwachangu, imangofunika mphindi 10-15. Apidra, NovoRapid, Humalog - uyu si insulin kwenikweni yaumunthu, koma ma analogues ake abwino.

Komanso, poyerekeza ndi insulin yachilengedwe, mankhwalawa ndi abwino chifukwa amasinthidwa. Chifukwa cha machitidwe ake abwino, mankhwalawa, atalowa m'thupi, amachepetsa msanga kuchuluka kwa shuga m'magazi.

Ma analulin obwera posachedwa-pang'onopang'ono adapangidwa kuti apangitse kuthamanga kwa shuga m'magazi. Vutoli limachitika nthawi zambiri pamene wodwala matenda ashuga amafuna kudya chakudya champhamvu kwambiri.

Mwakuchita, mwatsoka, lingaliroli silinadziyeseke lokha, popeza kugwiritsa ntchito zinthu zoletsedwa chifukwa cha matenda ashuga, mulimonse, kumadzutsa shuga.

Ngakhale mankhwalawa monga Apidra, NovoRapid, Humalog ali m'manja mwa odwala, wodwala matenda ashuga amayenera kutsatira zakudya zamafuta ochepa. Ma enamel a Ultrafast amagwiritsidwa ntchito m'njira zomwe zimafunikira kuti achepetse shuga msanga momwe zingathere.

Chifukwa china chomwe nthawi zina muyenera kupangira insulin ya ultrashort ndi pamene sikungatheke kuyembekezera mphindi 40-45 musanadye, ndikofunikira kuti muyambe kupatsidwa insulin.

Mofulumira kapena jakisoni wa insulin musanadye chakudya chofunikira kwa odwala matenda ashuga omwe amakhala ndi hyperglycemia atatha kudya.

Osati nthawi zonse ndi matenda ashuga, zakudya zamagulu ochepa zamafuta ndi mankhwala olembetsedwa amakhala ndi zotsatira zoyenera. Nthawi zina, njira izi zimapatsa wodwala nkhawa yochepa chabe.

Anthu odwala matenda amtundu wa 2 amamveka bwino kuyesa kuchiza okhawo omwe ali ndi insulin. Zingakhale kuti kukhala ndi nthawi yopuma kuchokera pakukonzekera insulini, kapamba imakhudzidwa ndipo imayamba kudzipanga payokha komanso kutulutsa magazi mu glucose popanda kuyambitsa jakisoni woyamba.

Mulingo uliwonse wamankhwala, lingaliro la mtundu wa insulin, kuchuluka kwake ndi maola ovomerezeka amachitika pokhapokha wodwalayo atadziyang'anira yekha shuga masiku osachepera asanu ndi awiri.

Kuti apange chiwembuchi, onse adokotala ndi wodwala ayenera kuchita ntchito molimbika.

Kupatula apo, mankhwala abwino a insulin sayenera kufanana ndi chithandizo chamankhwala (jakisoni 1-2 patsiku).

Mofulumira komanso mankhwala a insulin

Ultrashort insulin imayamba kugwira ntchito yake kale kwambiri kuposa momwe thupi la munthu limayambira ndikusunga mapuloteni, ena omwe amasinthidwa kukhala glucose. Chifukwa chake, ngati wodwala amatsata zakudya zama carb ochepa, insulin yochepa, yoyendetsedwa musanadye, ndibwino kuposa:

Kuthira insulin mwachangu imayenera kuperekedwa kwa mphindi 40-45 chakudya chisanafike. Nthawi ino ndi yodziwika, ndipo kwa wodwala aliyense imakhazikitsidwa chimodzimodzi. Kutalika kwa zochitika zazifupi ma insulin pafupifupi maola asanu. Ndi nthawi imeneyi kuti thupi la munthu lifunika kugaya chakudya kwathunthu.

Ultrashort insulin imagwiritsidwa ntchito m'njira zosayembekezereka pamene shuga yotsitsidwa imafulumira kwambiri. Mavuto a shuga amakula munthawi yomwe kuchuluka kwa shuga m'magazi kumawonjezeka, motero ndikofunikira kuti achepetse ngati pakukula. Ndipo pankhaniyi, mahomoni a ultrashort amachita bwino.

Ngati wodwala akudwala matenda a shuga "osakhazikika" (shuga amawoneka mwaokha ndipo zimachitika mwachangu), jakisoni wowonjezera wa insulin pamenepa safunika. Izi ndizotheka ndi matenda a shuga a mtundu wachiwiri.

Insulin yomaliza

Ma insulini othamanga kwambiri amaphatikizapo Apidra (Glulisin), NovoRapid (Aspart), Humalog (Lizpro). Mankhwalawa amapangidwa ndi makampani atatu omwe amapikisana nawo. Insulin yachilendo yamunthu ndiyifupi, ndipo ultrashort - awa ndi ma fanizo, ndiye kuti amawongolera poyerekeza ndi insulin yeniyeni ya anthu.

Chomwe chikuwongolera ndikuti mankhwalawa amachepetsa kwambiri shuga kuposa ochepa. Zotsatira zimachitika mphindi 5-15 pambuyo pa kubayidwa. Ma insulin a Ultrashort adapangidwa kuti azitha kuthandiza anthu odwala matenda ashuga nthawi ndi nthawi kuti azidya zakudya zam'mimba.

Koma izi sizinakwaniritse. Mulimonsemo, chakudya chopatsa mphamvu zimachulukitsa shuga mwachangu kuposa momwe insulin yamakono yochepa kwambiri ingapangitsire. Ngakhale pakhale mitundu yatsopano ya insulin pamsika wamafuta, kufunikira kwa zakudya zamagulu ochepa a shuga kumakhalabe kofunikira. Iyi ndi njira yokhayo yopewera zovuta zazikulu zomwe zimabweretsa matenda obisika.

Kwa odwala matenda ashuga a mtundu 1 ndi 2, kutsatira zakudya zamagulu ochepa, anthu a insulin omwe amawoneka kuti ndi abwino kwambiri jakisoni asanadye, m'malo mwa mayeso a ultrashort. Izi ndichifukwa choti thupi la wodwala yemwe ali ndi matenda ashuga, akudya michere yambiri, choyamba amathira mapuloteni, ndipo mbali ina imasandulika kukhala glucose.

Izi zimachitika pang'onopang'ono, ndipo zochita za ultrashort insulin, m'malo mwake, zimachitika mwachangu kwambiri. Pankhaniyi, ingogwiritsani ntchito insulin yochepa. Insulin yodula iyenera kukhala mphindi 40-45 musanadye.

Ngakhale zili choncho, ma insulini othamanga kwambiri amathanso kukhala othandiza kwa odwala matenda ashuga omwe amaletsa kudya zakudya zamagulu. Ngati wodwala adziwona shuga wambiri pakudya glucometer, pamenepa ma insulin amathandiza kwambiri.

Ultrashort insulin imatha kukhala yothandiza musanadye chakudya m odyera kapena paulendo pomwe sipangakhale njira yodikirira mphindi 40-45.

Zofunika! Ma insulin afupiafupi amayenda mwachangu kwambiri kuposa amfupi wamba. Pankhaniyi, Mlingo wa ultrashort analogs wa mahomoni ayenera kutsika kwambiri poyerekeza ndi Mlingo wa insulin yochepa ya anthu.

Kuphatikiza apo, mayesero azachipatala adawonetsa kuti zotsatira za Humalog zimayamba mphindi 5 kale kuposa momwe mumagwiritsira ntchito Apidra kapena Novo Rapid.

Zabwino ndi zoyipa za ultrafast insulin

Ma analogi apamwamba kwambiri a insulin (ngati akuyerekeza ndi mahomoni amfupi a anthu) ali ndi zabwino komanso zovuta zina.

• Peak pachimake pazochita. Mitundu yatsopano ya insulin ya ultrashort imayamba kugwira ntchito mwachangu - pambuyo pa jekeseni pambuyo pa mphindi 10-15.
• Kuchita kosalala mwachidule kumapangitsanso kuti thupi lizikhala ndi chakudya chokwanira, pokhapokha ngati wodwalayo amatsatira zakudya zamagulu ochepa.
• Kugwiritsira ntchito insulin ya ultrafast ndikosavuta kwambiri pamene wodwala sangadziwe nthawi yotsatira chakudya, mwachitsanzo, ngati ali panjira.

Mothandizidwa ndi chakudya chamafuta ochepa, madokotala amalimbikitsa kuti odwala awo, mwachizolowezi, azigwiritsa ntchito insulin ya anthu musanadye, koma mankhwalawo akhale ochepa pakakhala nthawi yapadera.

1. Mafuta a m'magazi amatsika kuposa pambuyo pobayira jekiseni lalifupi lalifupi.
2. Ma insulin amafupifupi amayenera kuperekedwa kwa mphindi 40-45 musanayambe kudya.Ngati simumayang'anira nthawi yino ndikuyamba chakudyacho kale, kukonzekera kochepa sikungakhale ndi nthawi yoyambira, ndipo magazi ake amalumpha.
3. Chifukwa chakuti kukonzekera kwa insulin kopambana kumakhala ndi nsonga zakuthwa, ndizovuta kwambiri kuwerengera molondola kuchuluka kwa mafuta omwe amayenera kudyedwa nthawi ya chakudya, kotero kuti kuchuluka kwa shuga m'magazi ndikwabwinobwino.
4. Zochita zimatsimikizira kuti mitundu yomaliza ya insulini sikhala yokhazikika pazotsika zamagazi m'magazi kuposa zazifupi. Zotsatira zake sizikulosera ngakhale atavulazidwa pang'ono. Palibe chifukwa cholankhulira pamlingo waukulu pankhaniyi.

Odwala ayenera kukumbukira kuti mitundu yomaliza ya insulin ndiyamphamvu kwambiri kuposa othamanga. 1 unit ya Humaloga ichepetsa shuga la magazi kuchulukitsa ka 2,5 kuposa mphamvu imodzi ya insulin. Apidra ndi NovoRapid ndi pafupifupi 1.5 nthawi yayikulu kuposa insulin yochepa.

Malinga ndi izi, mlingo wa Humalog uyenera kukhala wofanana ndi 0,4 Mlingo wa insulin yofulumira, komanso mlingo wa Apidra kapena NovoRapida - pafupifupi mlingo wa ⅔. Mlingo uwu umawoneka kuti ndiwowonekera, koma mlingo weniweni umatsimikiziridwa muzochitika zonse zatsopano.

Cholinga chachikulu chomwe munthu aliyense wodwala matenda ashuga amayenera kuchita ndikuchepetsa kapena kupewa kupeweratu matenda a m'mimba. Kuti mukwaniritse cholinga, jakisoni musanadye uyenera kuchitika ndi nthawi yayitali, ndiye kuti, dikirani nthawi ya insulini ndipo kenako yambani kudya.

Mbali inayi, wodwalayo amayesetsa kuwonetsetsa kuti mankhwalawa ayamba kutsika magazi mokhazikika panthawi yomwe chakudya chikuyamba kuchuluka. Komabe, ngati jakisoni wachita bwino pasadakhale, shuga m'magazi angachepe mofulumira kuposa chakudya chomwe chidzawonjezera.

Pochita, zatsimikiziridwa kuti jakisoni waifupi wa insulin ayenera kupatsidwa mphindi 40-45 asanadye. Lamuloli siligwira ntchito kwa omwe ali ndi matenda ashuga omwe ali ndi mbiri ya matenda a shuga a gastroparesis (chapambuyo pang'onopang'ono atatha kudya).

Nthawi zina, komabe, odwala amapezeka omwe ma inshuwaransi amafupikiramo amatayika m'magazi makamaka pang'onopang'ono pazifukwa zina. Odwala amayenera kupanga jakisoni wa insulin pafupifupi maola 1.5 asanadye. Mwachilengedwe, izi ndizosokoneza. Zili kwa anthu oterowo kuti kugwiritsa ntchito ma ultrashort insulin analogu ndizofunikira kwambiri. Chothamanga kwambiri pa iwo ndi Humalog.

Njira yamachitidwe

Matenda a metabolism amachititsa kusweka mu njira ya mayamwidwe ndi kutulutsa shuga. Nthawi zambiri, amagwira ntchito ngati gwero lamphamvu kwa thupi. Insulin ndi mahomoni opangidwa ndi kapamba omwe amakhudzidwa ndi kufalitsa ndi kutulutsa shuga. Mu matenda a shuga, dongosolo la endocrine limalephera kuchipanga mokwanira.

Insulin yochita kupanga mwachidule idapangidwa zaka 20 zapitazo. Analogue ya hormone ya anthu imapezeka m'njira ziwiri. Loyamba limakhala kudzera mu kupanga ma genetic: kapangidwe ka mabakiteriya osinthika ma genetic ndikupanga mahomoni kuchokera ku proinsulin yotengedwa kuchokera kwa iwo. Chachiwiri ndi kupangika kwa timadzi tokhala ndi insulin ya nyama - nkhumba kapena bovine.

Pambuyo pa makonzedwe, insulin yochepa imamangiriza kwa ma receptor pa membrane wa cell, kenako imalowetsa. Hormalo limayendetsa zochita zamanja. Izi zimawonekera makamaka m'maselo omwe amadalira insulin, chiwindi ndi adipose.

Insulin imayendetsa kagayidwe, imakhudza shuga wamagazi. Homoni imachita nawo kayendedwe ka glucose kudzera mu membrane wa cell, imalimbikitsa kusintha kwa shuga kukhala mphamvu. Glycogen imapangidwa kuchokera ku shuga m'magazi.

Kutalika kwa mayamwidwe ndi zochita za insulin zimadalira malo a jakisoni, mlingo ndi kuchuluka kwa yankho. Komanso kayendedwe ka magazi ndi kamvekedwe ka minofu zimakhudza njirayi. Zotsatira zamankhwala zimatengera umunthu wake wodwala aliyense.

Kukhazikitsidwa kwa insulin kumalola odwala matenda ashuga kuti azilamulira thupi, kuyambitsa metabolism yamafuta, komanso kupewa kupezeka kwamavuto am'magazi a mtima ndi mantha.

Chifukwa chiyani tikufunika majakisoni?

Matenda a shuga a Mtundu Wachiwiri amadziwika chifukwa cha kuchepa kwa kapamba komanso kuchepa kwa ntchito ya maselo a beta, omwe ali ndi udindo wopanga insulini.

Kuchita izi sikungakhudze magazi a glucose. Izi zitha kumveka chifukwa cha glycated hemoglobin, yomwe imawonetsa kuchuluka kwa shuga m'miyezi 3 yapitayo.

Pafupifupi onse odwala matenda ashuga ayenera kusamala ndi nthawi zonse chizindikiritso chake. Ngati ichulukitsa malire a zonse (motsutsana ndi chithandizo cha mapiritsi a nthawi yayitali), ndiye njira yoyenera yosinthira makulidwe a insulin.

Achibale athu omwe ali ndi matenda a shuga, pitani jakisoni zaka 12 mpaka 15 atatha matendawa. Izi zimachitika ndi kuwonjezeka kwakukulu kwa shuga komanso kuchepa kwa hemoglobin ya glycated. Komanso kuchuluka kwa odwalawa kumawonjezera matendawa.

Madokotala amafotokozera njirayi mwakulephera kukwaniritsa miyezo yapadziko lonse lapansi, ngakhale kuli kwina kwamakono kwamakono. Chimodzi mwazifukwa zazikulu izi ndi kuwopa odwala matenda ashuga a jekeseni a moyo.

Ngati wodwala yemwe ali ndi matenda osokoneza bongo sakudziwa kuti insulin ndiyabwino, akukana kusintha jakisoni kapena kusiya, ndiye kuti amakhala ndi shuga wambiri. Mkhalidwe wotere ungayambitse kukula kwa zovuta pa thanzi ndi moyo wa munthu wodwala matenda ashuga.

Ma hormone osankhidwa bwino amathandizira kuti wodwalayo akhale ndi moyo wathunthu. Chifukwa cha zida zamakono zapamwamba zogwiritsidwanso ntchito, zidatha kuchepetsa kusasangalala komanso kupweteka kuchokera ku jakisoni.

Mitundu ya kukonzekera kwa insulin

Insulin yaumunthu imanena za mahomoni omwe amapanga kapamba. Amagwiritsidwa ntchito pochiza matenda ashuga. Kuti muthane ndi chizolowezi cha kapamba, wodwalayo amapaka jakisoni:

• zotsatira zazifupi
• zopitilira
• nthawi yayitali yochita.

Mtundu wa mankhwalawa umatsimikizika potengera thanzi la wodwala komanso mtundu wa matenda.

Mitundu ya insulin

Insulin idapangidwa koyamba kuchokera ku zikondamoyo za agalu. Patatha chaka chimodzi, mahomoniwa adagwiritsidwa ntchito kale. Zaka zina 40 zidapita, ndipo zidatheka kupanga insulin mosiyanasiyana.

Pakapita kanthawi, zinthu zofunikira kwambiri zodziyeretsa. Pambuyo pazaka zowerengeka, akatswiri adayamba kupanga kapangidwe ka insulin ya anthu. Kuyambira 1983, insulini idayamba kupangidwa pamakampani ambiri.

Zaka 15 zapitazo, matenda ashuga ankawagwiritsa ntchito zopangidwa ndi nyama. Masiku ano, ndi oletsedwa. M'mafakitala, mutha kupeza zokonzekera zaumisiri, kupanga ndalama izi kutengera kutengera kwa chinthu cha gene mu cell ya microorganism.

Kusiyana pakati pa zida zonse zamankhwala zomwe zilipo lero ndi:

• munthawi yowonekeranso, ochita masewera olimbitsa thupi kwa nthawi yayitali, wokhala ndi insulini mwachidule komanso insulin.
• mogwirizana ndi amino acid.

Palinso mankhwala ena omwe amaphatikizidwa kuti "zosakaniza", omwe ali ndi insulin yokhala ndi nthawi yayitali komanso yochepa. Mitundu yonse 5 ya insulin imagwiritsidwa ntchito pazolinga zawo.

Ma insulin omwe amagwira ntchito mwachidule, nthawi zina a ultrashort, ndi mayankho a crystalline zinc-insulin ovuta ndi mtundu wa pH wosaloledwa. Ndalamazi zimagwira mwachangu, komabe, zotsatira zake za mankhwalawa ndizosakhalitsa.

Monga lamulo, mankhwalawa amaperekedwa kwa mphindi 30-55 musanadye.Mankhwala ofanana amatha kuthandizidwa kudzera mu mnofu komanso m'mitsempha, komanso insulin.

Wothandizila wa ultrashort akamalowa m'mitsempha, shuga ya plasma imatsika kwambiri, zotsatira zake zimatha kuchitika pambuyo pa mphindi 20-30.

Ndi kuphwanya kwa kupanga mahomoni olimbana ndi mahomoni, mulingo wamagazi sawonjezeka kwa maola angapo pambuyo pa jakisoni wa mankhwala, chifukwa umakhudza thupi komanso mutachotsa magazi.

Mahomoni ochita kupanga mwachidule ayenera kubayidwa m'mitsempha:

1. pakutsitsimuka komanso kusamalidwa kwambiri,
2. odwala matenda ashuga a ketoacidosis,
3. ngati thupi lisintha mwachangu kufunika kwa insulini.

Odwala omwe ali ndi njira yokhazikika ya matenda a shuga, mankhwalawa nthawi zambiri amatengedwa limodzi ndi zotsatira zazitali komanso nthawi yayitali.

Kulipiritsa chotulutsira, zinthu zothandiziridwa zimagwiritsidwa ntchito. Izi sizimalola kuti insulini ikhale pansi pa khungu pakhungu pang'onopang'ono.

Masiku ano, timadzi tating'onoting'ono timayendetsedwa mu mawonekedwe a hexamers. Mamolekyu a chinthuchi ndi ma polima. Hexamers amatengeka pang'onopang'ono, zomwe sizimalola kufikira kuchuluka kwa insulin ndende ya plasma ya munthu wathanzi atatha kudya.

Mayesero ambiri azachipatala adachitidwa, chifukwa chake, zida zothandiza kwambiri, mayina a otchuka kwambiri

1. Aspart insulin
2. Lizpro-insulin.

Mitundu ya insulin iyi imatengedwa kuchokera pansi pakhungu katatu katatu poyerekeza ndi insulin ya anthu. Izi zimabweretsa kuti gawo lalikulu kwambiri la insulin m'magazi limafikiridwa mwachangu, ndipo njira yochepetsera glucose imathamanga.

Ndi kuyambitsa kuphika kwa mphindi 15 musanadye, zotsatira zake zidzakhala zofanana ndi jakisoni wa insulin kwa munthu mphindi 30 asanadye.

Ma mahomoni amphamvu yothamanga kwambiri amaphatikiza lyspro-insulin. Ndi zotumphukira za insulin ya anthu yomwe imapezeka ndikusinthana kwa proline ndi lysine m'matcheni a 28 ndi 29 B.

Pazifukwa izi, lipro-insulin imakhala ndi zotsatira zake, koma zotsatira zake zimakhala kwakanthawi. Lipro-insulin iwina poyerekeza ndi mankhwala ena amtunduwu pazinthu zotsatirazi:

• imapangitsa kuchepetsa kuopseza kwa hypoglycemia ndi 20-30%,
• Kuchepetsa kuchuluka kwa A1c glycosylated hemoglobin, komwe kumawonetsa chithandizo chokwanira cha matenda ashuga.

Popanga insulin, gawo lofunikira limaperekedwa m'malo mwa proartic acid m'malo mwa Pro28 mu B. Monga lyspro-insulin, mankhwalawa, omwe amalowa m'thupi la munthu, posakhalitsa amagawanika kukhala opanga monoma.

Mu shuga mellitus, mankhwala a insulin amatha kukhala osiyana. Nthawi yapamwamba kwambiri ya kuchuluka kwa plasma insulin komanso zotsatira zazikulu zochepetsera shuga zimatha kusiyana ndi 50%. Kukula kwinanso kwa kusinthika koteroko kumadalira kuchuluka kosiyanasiyana kwa mankhwala kuchokera kuzinthu zowoneka bwino. Komabe, nthawi ya insulin yayitali komanso yochepa ndiyosiyana.

Kutengera ndi insulin, ndikofunikira kubaya mahomoni nthawi zonse m'matumbo a subcutaneous.

Izi zikugwiranso ntchito kwa odwala omwe sangathe kuchepetsa kuchuluka kwa shuga m'magazi chifukwa cha zakudya komanso mankhwala omwe amachepetsa shuga, komanso azimayi omwe ali ndi matenda osokoneza bongo panthawi yomwe ali ndi pakati, odwala omwe ali ndi matenda omwe amapangidwa chifukwa cha pacreatectomy.

Chithandizo cha insulin ndi chofunikira pa matenda monga:

1. hyperosmolar chikomokere,
2. matenda ashuga ketoacidosis,
3. pambuyo opaleshoni kwa odwala matenda a shuga,
4. pomwe chithandizo cha insulin chimathandizira kuti shuga akhale mu plasma,
5. Kuchotsa kwina kwa metabolic metabolologies.

Zotsatira zabwino zimatheka pogwiritsa ntchito njira zovuta zochizira:

Munthu wokhala ndi thanzi labwino komanso wathanzi labwino amapanga magawo 18-40 patsiku, kapena mayunitsi 0,2-0,5 / kg wa insulin yayitali.Pafupifupi theka la bukuli ndi chimbudzi cha m'mimba, chotsalacho chimapukutidwa mutatha kudya.

Hormayo imapangidwa mawunitsi a 0.5-1 pa ola limodzi. Shuga atalowa m'magazi, kuchuluka kwa katulutsidwe ka timadzi timeneti kumakwera mpaka ku magawo 6 pa ola limodzi.

Anthu onenepa kwambiri komanso omwe ali ndi insulin kukana omwe amadwala matenda ashuga amatha kupanga ma insulini mwachangu kangapo podya. Pali kulumikizana kwa mahomoni omwe amapangidwa ndi portal system ya chiwindi, komwe gawo limodzi limawonongeka ndipo silimafikira magazi.

1. Kwenikweni, chizindikirochi chimasiyana kuchokera pa 0,6 mpaka 0,7 mayunitsi / kg.
2. Ndi kulemera kambiri, kufunikira kwa insulin kumawonjezeka.
3. Munthu akamafuna mayunitsi 0,5 okha patsiku, amakhala ndi maholide okwanira kapena thupi labwino.

Kufunika kwa insulin ya mahomoni ndi amitundu iwiri:

Pafupifupi theka la zosowa za tsiku ndi tsiku ndi za basal fomu. Hormone iyi imathandizira kupewa kufalikira kwa shuga mu chiwindi.

Mu mawonekedwe a posachedwa, zofunika tsiku lililonse zimaperekedwa ndi jakisoni musanadye. Timadzi timadzi timatenda timadzi timene timayamwa.

Kenako njira yothandizira mankhwalawo imagwiritsidwa ntchito kukhala yovuta kwambiri, pomwe insulini yokhala ndi nthawi yayitali kapena insulini yocheperako kapena yogwiritsira ntchito mwachangu insulin imagwiritsidwa ntchito limodzi.

Nthawi zambiri wodwala amathandizidwa molingana ndi mtundu wosakanikirana wa mankhwala, akaperekera jakisoni imodzi pakudya kadzutsa, ndi wina nthawi ya chakudya. Hormone mu nkhani iyi imakhala ndi insulin ya nthawi yayifupi komanso nthawi yayitali.

Mtengo wa insulin umatsimikiziridwa payekhapayekha, kutengera mtundu wa shuga m'magazi. Chifukwa cha kuchuluka kwa ma glucometer, tsopano ndikosavuta kuyeza kuchuluka kwa hemoglobin m'magazi, ndipo kwakhala kovuta kudziwa kukula kwa mahomoni, kutengera zinthu izi:

• matenda ophatikizika
• madera ndi kuya kwakufa,
• ntchito minofu m'dera jakisoni,
• magazi
• zakudya
• zolimbitsa thupi
• mtundu wa mankhwala
• kuchuluka kwa mankhwalawa.

Kukhazikitsidwa kwa insulin ngati njira yothanirana ndi matenda ashuga lero ndi njira yokhayo yothetsera matenda a hyperglycemia mu mtundu woyamba wa 1, komanso mu mtundu wachiwiri wa matenda a insulin.

Mankhwala a insulin amachitika m'njira yoti kukulitsa kubweretsereni kwa mahomoni m'thupi lathu.

Chifukwa chake, mankhwala osokoneza bongo osiyanasiyana omwe amalumikizidwa ku minofu ya subcutaneous amagwiritsidwa ntchito. Ma insulin amatenga nthawi yayitali kutulutsa kwa mahomoni, komwe sikumakhudzana ndi kumeza kwa chakudya m'matumbo, ndipo ma insulin amafupikitsa komanso a ultrashort amathandiza kutsika glycemia atatha kudya.

Insulini amatanthauza ma mahomoni omwe amakhala ndi mayendedwe osiyanasiyana ophunzitsira. Poyamba, m'masamba achisangalalo, monga m'maselo a beta, mumakhala ma amino acid okwanira 110, omwe amatchedwa preproinsulin. Puloteni yamkati imalekanitsidwa ndi iyo, ma proinsulin amawonekera. Mapuloteni awa amawaika m'miyala, pomwe amagawidwa mu C-peptide ndi insulin.

Njira yapafupi kwambiri ya amino acid ya insulin. M'malo mwa threonine mmenemo, unyolo B umakhala ndi alanine. Kusiyana kwakukulu pakati pa bovine insulin ndi insulin yaumunthu ndi zotsalira za 3 amino acid.

Kuphatikizika kwamakonzedwe amakono a insulin mu ma labotale kumachitika pogwiritsa ntchito ma genetic engineering. Biosynthetic insulin ndi yofanana mumapangidwe amino acid amunthu, amapangidwa pogwiritsa ntchito ukadaulo wa DNA. Pali njira ziwiri zazikulu:

1. Kaphatikizidwe ka mabakiteriya osinthidwa.
2. Kuchokera proinsulin wopangidwa ndi bacterium yosinthidwa ma genet.

Kulakwitsa kwa Matenda A shuga

Sikuti nthawi zonse mankhwalawa amalimbikitsa insulini ngati mutha kugwiritsa ntchito insulin yanu. Chifukwa china chingakhale izi:

• chibayo
• chimfine
• Matenda ena akuluakulu
• kulephera kugwiritsa ntchito mankhwala pamapiritsi (ndimomwe thupi limagwirira chakudya, mavuto a chiwindi ndi impso).

Kusinthana ndi jakisoni kutha kuchitika ngati wodwala matenda ashuga akufuna kukhala moyo wabwino kapena, osatha kutsatira njira yokhazikika komanso yotsika ya carb yotsika.

Jekeseni sangathe mwanjira iliyonse yazaumoyo. Mavuto aliwonse omwe akanakhalapo pakubwera kwa jakisoni amathanso kungoona ngati mwangozi komanso mwangozi. Komabe, musataye nthawi yomwe pali insulin yambiri.

Chomwe chimapangitsa izi siziri insulini, koma kukhalapo nthawi yayitali ndimagazi osavomerezeka a shuga. Ayi, molingana ndi ziwerengero zamayiko osiyanasiyana, mukasinthana ndi jakisoni, nthawi yayitali yomwe munthu amakhala ndi moyo ndi kuchuluka kwake.

Ndi kuchepa kwa kuchuluka kwa hemoglobin wa glycated ndi 1 peresenti, mwayi wa zovuta zotsatirazi zimachepa:

• myocardial infarction (14 peresenti),
• kudula kapena kufa (43%),
• michere yamavuto (37 peresenti).

Malangizo ogwiritsira ntchito

Insulin yochepa imanena za mankhwala omwe amapezeka mu zinc-insulin pazosagwirizana ndi ma pH a pH. Mankhwalawa amagwira ntchito mwachangu, koma kutalika kwa mphamvu yake pakanthawi kochepa.

Amapatsidwa mankhwala osokoneza bongo theka la ola musanadye, mwina kudzera m'mitsempha. Akamamwa, amachepetsa kwambiri shuga. Kuchuluka kwa insulini yochepa kumatheka mkati mwa theka la ola pambuyo pakulowetsa.

Mankhwalawa amachotseredwa mwachangu ndi mahomoni olimbana ndi mahomoni monga glucagon, catecholamine, cortisol ndi STH. Zotsatira zake, mulingo wa shuga umakwatiranso mkhalidwe wake woyambirira. Ngati mahomoni olimbana ndi mahomoni m'thupi samapangidwa moyenera, zomwe zili mu shuga sizikwera kwa nthawi yayitali. Insulin yochita zinthu mwachidule imagwira ntchito pama cellular ngakhale atachotsedwa magazi.

Ikani insuliniyo pamaso pa zinthu izi:

• matenda ashuga ketoacidosis wodwala,
• ngati pakufunikanso kusamalanso ndi chisamaliro chachikulu,
• kusowa kwa thupi kosafunikira kwa insulin.

Ndi shuga wokwezeka nthawi zonse, mankhwala amtunduwu amaphatikizidwa ndi mankhwala omwe amagwira ntchito kwa nthawi yayitali komanso mankhwala ochepetsa mphamvu.

Ndi bwino kukhazikitsa mankhwala musanadye. Kenako insulin imalowetsedwa mwachangu, imayamba kugwira ntchito nthawi yomweyo. Mankhwala ena amtunduwu amadzimeza m'madzi ndikuwamwa pakamwa. Jekeseni wa subcutaneous amachitika theka la ola musanadye. Mlingo wa mankhwala amasankhidwa payekha.

Sungani ma insulin apafupi mu ma dispens apadera. Kwa iwo, kukonzekera kogwiritsa ntchito kumagwiritsidwa ntchito. Izi zimachepetsa chiopsezo cha crystallization ya mankhwalawa akaperekedwa pang'onopang'ono kwa wodwala mosadukiza. Hexamers tsopano ndiofala.

Izi zimapangitsa asayansi kupanga semisynthetic analogous zinthu mu mawonekedwe a monomers ndi ma dimers. Chifukwa cha maphunziro, mankhwala angapo adalekanitsidwa kunja komwe kumatchedwa lyspro-insulin ndi aspart-insulin.

Kukonzekera kwa insulin kumeneku kumakhala kothandiza katatu chifukwa cha mayamwidwe ambiri. Hormalo imafika mofulumira kwambiri m'magazi, ndipo shuga amachepetsa mwachangu. Kukonzekera kwa semisynthet kukonzekera mphindi 15 asanadye chakudya m'malo mwa makonzedwe a munthu insulin theka la ola musanadye.

Ma lizpro-insulins ndi ma mahashoni a ultrashort omwe amapezeka mwa kusintha chiŵerengero cha lysine ndi proline. Hexamers, kulowa mkati mwa plasma, kuwola kukhala olamulira. Motere, momwe mankhwalawo amathandizira msanga kuposa omwe amagwiritsa ntchito mwachangu ma insulin. Tsoka ilo, nthawi yolimbikitsira thupi ndiyofupikitsa.

Ubwino wa mankhwalawa umaphatikizanso kuchepa kwa chiopsezo cha hypoglycemia komanso kuthekera kuchepetsa msanga glycosylated hemoglobin.Chifukwa cha izi, matenda ashuga amalipiridwa bwino.

Mankhwala odziwika kwambiri omwe amachita pakatha mphindi 15 atamwa. Awa ndi Apidra, Humalog ndi Novorapid. Kusankha kwa mankhwala kumatengera mtundu wa wodwala, tsamba la jakisoni, Mlingo.

Dokotala amawona mtundu ndi mankhwalawa a mankhwalawo, poganizira zomwe wodwalayo ali ndi zaka, zomwe akuwonetsa, momwe akuwonekera. Musanagwiritse ntchito insulin, onetsetsani kuti mwawerengera malangizowo. Ma insulin amafupikitsidwa amatha kuthandizidwa ngati monotherapy kapena kuphatikiza ndi mankhwala omwe amakhala nthawi yayitali.

Mlingo watsiku ndi tsiku wa insulin yochepa kwa akulu ndi magawo 8-24, kwa ana - osaposa magawo 8. Chifukwa cha kutulutsidwa kwa mahomoni amakula m'magazi, mlingo wa achinyamata ukuwonjezeka. Wodwala amatha kuwerengera payekha payekha.

1% ya timadzi timene timakhala ndi mlingo wofunika wothandizirana ndi mkate, ndi mlingo wochepetsera kuchuluka kwa shuga m'magazi. Zonsezi ndizofanana ndi zero. Kwa odwala matenda ashuga omwe ali ndi kulemera kwambiri, kuchuluka kwake kumachepetsedwa ndi 0,1, ndi kulemera kosakwanira kumawonjezereka ndi 0.1.

Mlingo umatha kusinthidwa. Kuchulukitsa kwake kumafunikira pakukaniza kwa mahomoni, kuphatikiza ndi corticosteroids, kulera, antidepressants ndi okodzetsa ena.

Mankhwalawa amaperekedwa pogwiritsa ntchito insulin kapena pampu yapadera. Chida choterocho chimalola njirayi kuti ichitike molondola kwambiri, zomwe sizingachitike ndi syringe wamba. Mutha kulowa yankho lomveka bwino popanda kunyengerera.

Wothandizirana mwachangu ndi insulin imaperekedwa kwa mphindi 30 mpaka 40 musanadye. Pambuyo pa jekeseni, musadumphe zakudya. Kupereka pambuyo pa mlingo uliwonse womwe waperekedwa uyenera kukhala womwewo. Patatha maola awiri mutadya mbale yayikulu, muyenera kukhala ndi kachakudya. Izi zingathandize kukhala ndi milingo yamagazi.

Kuti muchepetse kufalikira kwa insulin, malo osankhidwa amayenera kutenthetsedwa pang'ono povulala. Tsamba la jakisoni silingathenso. Jakisoni amachitika mosazindikira m'mimba.

Ndi kuwonjezeka kwa ndende ya magazi, muyeso wowonjezera wa insulin umafunika mosasamala kanthu.

Kutalika kapena kufupikitsa?

Kuti mupeze kubisala kwapansi, ndichizolowezi kugwiritsa ntchito insulin. Mpaka pano, pharmacology imatha kupereka mitundu iwiri ya mankhwalawa. Itha kukhala insulin ya nthawi yayitali (yomwe imagwira ntchito mpaka maola 16) ndi kuwonetsa nthawi yayitali (nthawi yake imakhala yoposa maola 16).

Mahomoni a gulu loyamba amaphatikizapo:

1. Gensulin N,
2. Humulin NPH,
3. Insuman Bazal,
4. Protafan HM,
5. Biosulin N.

Levemir ndi Lantus amasiyana kwambiri ndi mankhwala ena onse chifukwa amakhala ndi nthawi yosiyanitsidwa ndi thupi la odwala matenda ashuga ndipo amawonekeratu. Insulin ya gulu loyamba ndi yoyera matope.

Asanagwiritse ntchito, zomwe zimagwiritsidwa ntchito ndi iwo ziyenera kugulitsidwa mosamala pakati pa kanjedza kuti mupeze yankho lofanana ndi mitambo. Kusiyana kumeneku kumachitika chifukwa cha njira zosiyanasiyana zopangira mankhwala.

Ma insulini ochokera pagulu loyamba (nthawi yayitali) ndiwopamwamba. Mwanjira ina, nsanja ya chisautso imatha kuyambika pakuchita kwawo.

Mankhwala ochokera ku gulu lachiwiri samadziwika ndi izi. Ndizinthu izi zomwe ziyenera kukumbukiridwa posankha mulingo woyenera wa insulin. Komabe, malamulo apadera a mahomoni onse ndi ofanana.

Kuchuluka kwa kutalika kwa insulin kuyenera kusankhidwa kotero kuti izitha kusungitsa shuga m'magazi pakati pa zakudya pazovomerezeka. Mankhwala amaphatikizapo kusinthasintha kakang'ono pamtunda kuchokera pa 1 mpaka 1.5 mmol / L.

Insulin yotalikilapo iyenera kubayidwa pang'onopang'ono mpaka ntchafu kapena matako.Chifukwa chakufunika koyamwa mosavuta komanso pang'onopang'ono, jakisoni m'manja ndi m'mimba ndizoletsedwa!

Zilonda m'malo awa zimapatsa zotsatirazi. Insulin yochepa-yoika, yomwe imagwiritsidwa ntchito pamimba kapena mkono, imapereka chiwongola dzanja chokwanira panthawi yomwe imayamwa chakudya.

Magulu apadera a odwala

Insulin yofupikitsa nthawi zambiri imagwiritsidwa ntchito ndi othamanga omwe akuchita nawo masewera olimbitsa thupi. Zotsatira zamankhwala ndizofanana ndi zotsatira za anabolic. Insulin yochepa imayendetsa kayendedwe ka glucose kumaselo onse amthupi, makamaka minofu yamatumbo.

Izi zimathandizira kuti chiwonjezeke komanso kusamalira kamvekedwe ka minofu. Pankhaniyi, mlingo umatsimikiziridwa ndi dokotala payekhapayekha. Njira yovomerezeka imatha miyezi iwiri. Pambuyo pakupuma kwa miyezi 4, mankhwalawa amatha kubwerezedwa.

Ndi shuga wa 16 mmol / L, zolimbitsa thupi zolimba sizingatheke. Ngati Zizindikiro sizidutsa 10 mmol / l, m'malo mwake, kusewera masewera kumathandizira kuchepetsa kuchuluka kwa shuga.

Nthawi zina, ndikusowa kwa chakudya chamafuta m'thupi, thupi limayamba kugwiritsa ntchito matupi a adipose ngati mphamvu. Ikagawika, matupi a ketone otchedwa acetone amasulidwa.

Pankhani ya shuga wamagazi ambiri komanso kupezeka kwa ma ketones mu mkodzo, wodwalayo amafunikira zowonjezera insulin - 20% ya tsiku ndi tsiku. Ngati palibe kusintha komwe kumadziwika pambuyo pa maola atatu, mubwereze jakisoni.

Anthu odwala matenda ashuga okhala ndi kutentha okwanira kwamthupi (mpaka 37 ° C) amafunika kuchita glucometry ndi insulin. Pafupifupi, tsiku lililonse mlingo umakulitsidwa ndi 10%. Kutentha mpaka 39 ° C, mlingo wa tsiku ndi tsiku umachulukitsidwa ndi 20-25%.

Momwe mungaswe usiku?

Madokotala amalimbikitsa kuti odwala matenda ashuga ayambe jekeseni wa insulin nthawi yayitali. Komanso, onetsetsani kuti mukudziwa komwe mungabayire insulin. Ngati wodwalayo sakudziwa momwe angachitire izi, ayenera kumwedwa mosiyanasiyana maola atatu aliwonse:

Ngati nthawi iliyonse wodwala yemwe ali ndi matenda ashuga akadumphadumpha zizindikiritso za shuga (utachepa kapena kuwonjezeka), ndiye pamenepa, mlingo womwe ukugwiritsidwa ntchito uyenera kusintha.

Muzochitika zoterezi, ziyenera kukumbukiridwa kuti kuwonjezeka kwa glucose sikuti nthawi zonse kumachitika chifukwa cha kuchepa kwa insulin. Nthawi zina izi zimatha kukhala umboni wa latent hypoglycemia, yomwe yamveka ndi kuwonjezeka kwa glucose.

Kuti mumvetsetse chifukwa cha kuchuluka kwa shuga usiku, muyenera kuganizira bwino nthawi yonseyo. Poterepa, pakufunika kuwunika kuchuluka kwa glucose kuyambira 00.00 mpaka 03.00.

Ngati pakhala kuchepa mkati mwake munthawiyi, ndiye kuti pali wolemekezeka wotchedwa "proxy" wokhazikika. Ngati ndi choncho, ndiye kuti mlingo wa insulin wa nocturnal uyenera kuchepetsedwa.

Aliyense endocrinologist anganene kuti chakudya chimakhudza kwambiri kuwunika kwa insulin mthupi la wodwala matenda ashuga. Kuyerekeza kolondola kwambiri kwa kuchuluka kwa insulin ya basal kumatheka pokhapokha ngati palibe shuga m'magazi omwe amabwera ndi chakudya, komanso insulini yokhala ndi nthawi yayitali.

Pachifukwa ichi, musanayanize insulini yanu usiku, ndikofunikira kudumpha chakudya chanu chamadzulo kapena kudya chakudya chamadzulo kwambiri kuposa masiku onse.

Kuti mudziyang'anire, ndikofunika kusiya kumwa mapuloteni ndi mafuta nthawi yamadzulo komanso musanayang'ane shuga. Ndikwabwino kupatsa chidwi ndi zinthu zamafuta.

Izi ndichifukwa choti mapuloteni ndi mafuta zimatengedwa ndi thupi pang'onopang'ono ndipo zimatha kuwonjezera kwambiri misempha ya shuga usiku. Mkhalidwewo, umakhala cholepheretsa kupeza zotsatira zoyenera za insulin ya usiku.

Zotsatira zoyipa

Kapangidwe ka ma antibodies ku insulin kungapangitse kuti zochita zamtunduwu zizigwirizana. Izi zimayambitsa kukana kwa insulin. Nthawi zambiri, kukana kwa mahomoni kumawonedwa ndikuyamba kwa nkhumba kapena bovine insulin.

Mankhwala omwe amangokhala ndi kanthawi kochepa samayambitsa mavuto. Thupi lawo siligwirizana nthawi zambiri limachitika mu mawonekedwe a kuyabwa kwa khungu, redness. Nthawi zina kukwiya pamalowa jakisoni kumadziwika.

Pogwiritsa ntchito bongo mopitirira muyeso kapena kugwiritsa ntchito molakwika insulin, hypoglycemic syndrome ndiyotheka, yodziwika ndi kuchepa kwamphamvu kwa shuga m'magazi. Zizindikiro za hypoglycemia: chizungulire, kupweteka mutu, njala yayikulu, kuthamanga kwa mtima, kuchuluka thukuta, nkhawa komanso kusakwiya.

Kuti muthane ndi zizindikirazi, muyenera kumwa njira yothetsera shuga, pakatha mphindi 15 mpaka 20 - tengani gawo lomwe lili ndi mapuloteni ambiri komanso chakudya. Osagona: izi zimatha kuyambitsa kuyambika kwa hypoglycemic coma.

Kuchita insulin mwachangu mwachangu komanso moyenera kumatulutsa shuga. Chithandizo choterochi chimathandizira odwala matenda ashuga kuti azikhala mwamphamvu komanso kuti apewe zovuta.

Masana maselo

Poyesa insulin ya masana masana, imodzi mwa chakudya siyiyenera kuyikidwa kunja. Mwabwino, mutha kukhala ndi njala tsiku lonse, kwinaku mukuyesa kuchuluka kwa glucose ola limodzi. Izi zimapereka mwayi wowona bwino nthawi ya kuchepa kapena kuwonjezeka kwa shuga m'magazi.

Kwa ana aang'ono, njira yodziwitsira matenda sioyenera.

Pankhani ya ana, insulin yoyambira iyenera kuwunikiridwa nthawi yodziwika. Mwachitsanzo, mutha kudumphira chakudya cham'mawa ndikuwayeza kuchuluka kwa magazi ola lililonse:

• kuyambira mwana akamadzuka,
• popeza jakisoni wa insulin yofunika.

Amapitilizabe miyeso musanadye chakudya chamadzulo, ndipo atatha masiku angapo muyenera kulumphira nkhomaliro, kenako ndi chakudya chamadzulo.

Pafupifupi insulin yonse yowonjezereka iyenera kubayidwa kawiri pa tsiku. Chosiyana ndi mankhwala a Lantus, omwe amalowetsedwa kamodzi patsiku.

Ndikofunika kukumbukira kuti ma insulin onse omwe ali pamwambapa, kupatula Lantus ndi Levemir, ali ndi mtundu wa pobisalira. Monga lamulo, nsonga za mankhwalawa zimachitika mkati mwa maola 6-8 kuchokera nthawi yomwe chiwonetserochi chikuwonekera.

Madokotala amalimbikitsa kubwereza cheke cha basal insulin pakusintha kulikonse. Ndikokwanira masiku atatu kuti mumvetsetse mphamvu imodzi. Kutengera ndi zotsatira zake, dokotala adzalembera zoyenera kuchita.

Kuti mupeze insulini yatsiku ndi tsiku ndikumvetsetsa kuti insulin ndiyabwino, dikirani maola 4 kuchokera pachakudya chanu chapita. Nthawi yoyenera imatha kutchedwa maola 5.

Izi ndizofunikira chifukwa cha zinthu zina zomwe zimapangitsa kuti inshuwaransi ipangidwe thupi la wodwala. Ma Ultrashort insulins (Novorapid, Apidra ndi Humalog) samvera lamuloli.

Ndingatani popanda jakisoni wa insulin?

Anthu odwala matenda ashuga, omwe ali ndi vuto lochepetsa shuga, amatha kusunga shuga wabwinobwino popanda kugwiritsa ntchito insulin. Komabe, ayenera kudziwa bwino mankhwala a insulin, chifukwa nthawi iliyonse amayenera kupanga jakisoni panthawi ya chimfine ndi matenda ena opatsirana. Panthawi yamavuto ambiri, kapamba amayenera kutsimikiziridwa ndi kuperekera mankhwala a insulin. Kupanda kutero, mutadwala kwa kanthawi kochepa, matendawa amathanso kudwala kwa moyo wanu wonse.

Chikhulupiriro: Zofunikira Pang'ono

Monga mukudziwa, insulin ndi timadzi tomwe timatulutsa ma cell a pancreatic beta. Imatsika shuga, ndikupangitsa kuti minyewa yake igwire glucose, yomwe imapangitsa chidwi chake m'magazi kuchepa. Muyenera kudziwa kuti mahomoniwa amathandizira kutsimikiza kwamafuta, amalepheretsa kuchepa kwa minofu ya adipose. Mwanjira ina, kuchuluka kwa insulini kumapangitsa kuti kuchepa thupi kuzikhala kosatheka.
Mulingo
Fotokozerani za msinkhu wa abambo kapena sankhani amuna kapena akazi kuti mulingalire Level 5.8 Sonyezani Zomwe m'badwo wa bambo Age 45 Sonyezani zaka za mkazi Age Age 45

Kodi insulin imagwira ntchito bwanji mthupi?

Munthu akayamba kudya, zikondamoyo zimatulutsa timadzi tambiri tambiri mu mphindi 2-5. Amathandizira kusintha shuga m'magazi atatha kudya kuti isangokhalitsa kwa nthawi yayitali komanso zovuta za shuga zilibe nthawi yopanga.

Zofunika! Kukonzekera konse kwa insulin kumakhala kosalimba, kuwonongeka mosavuta. Phunzirani kusunga malamulo ndikuwatsata mosamala.

Komanso m'thupi nthawi iliyonse insulin yaying'ono imazungulira m'mimba yopanda kanthu ndipo ngakhale munthu atakhala ndi njala masiku ambiri mzere. Mlingo wa mahomoni m'mwaziwo umatchedwa maziko. Zikadakhala ziro, kusintha kwa minofu ndi ziwalo zamkati kukhala glucose kukadayamba. Asanayambitse jakisoni wa insulin, odwala matenda amtundu wa 1 amwalira ndi izi. Madokotala akale adafotokozera maphunzirowo ndi kutha kwa matenda awo "monga wodwalayo atasungunuka kukhala shuga ndi madzi." Tsopano izi sizikuchitika ndi odwala matenda ashuga. Choopseza chachikulu chinali zovuta zovuta.

• Kodi zimayamba kudontha liti?
• Mlingo wa insulini waukulu kwambiri ndi uti patsiku
• Kuchuluka kwa insulini ingati pa chakudya chimodzi (XE) yama chakudya
• Kodi gawo limodzi la insulini limachepetsa bwanji shuga
• Kuchuluka kwa UNIT ya insulini kumafunika kuti muchepetse shuga ndi 1 mmol / l
• Zotsatira za jakisoni zikaonekera ndipo shuga amayamba kugwa
• Kuchuluka kwa mankhwala omwe angalepheretse odwala matenda ashuga kukhala ndi shuga wambiri
• Kangati patsiku muyenera kubaya insulin, nthawi yanji ya tsiku
• Pofika maola angapo jekeseni azikhala ndi shuga
• Kodi ndizomwe zimawerengetsera kuchuluka kwa insulin kwa ana
• Zomwe zimachitika ngati mutaba jakisoni kwambiri
• Kodi ndikofunikira kumata ngati shuga ndi wabwinobwino kapena wotsika
• Chifukwa chiyani shuga sichigwa pambuyo pakubayidwa jakisoni

Ambiri odwala matenda ashuga omwe amathandizidwa ndi insulin amakhulupirira kuti shuga yochepa ya magazi ndi zizindikiro zake zoopsa sizingapeweke. M'malo mwake, mutha kusunga shuga wabwinobwino ngakhale mutakhala ndi matenda oopsa a autoimmune. Ndipo makamaka, ndi matenda a shuga a 2 ochepa. Palibe chifukwa chakuwonjezera kuchuluka kwa shuga m'magazi anu kuti muthe kutsutsana ndi hypoglycemia yoopsa.

Onerani kanema pomwe Dr. Bernstein akufotokoza nkhaniyi ndi bambo wa mwana yemwe ali ndi matenda a shuga 1. Phunzirani momwe mungasinthire zakudya zopatsa thanzi komanso mulingo wa insulin.

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Pofuna kupereka mwachangu mlingo waukulu wa insulini kuti akometse chakudya, maselo a beta amatulutsa ndi kudziunjikira timadzi tating'onoting'ono timene timadya. Tsoka ilo, popanda matenda aliwonse a shuga, njirayi imasokonezeka poyambirira. Anthu odwala matenda ashuga ali ndi malo ochepa ogulitsira inshuwaransi kapamba. Zotsatira zake, shuga m'magazi atatha kudya amakhalanso okwera kwa maola ambiri. Pang'onopang'ono izi zimayambitsa zovuta.

Mulingo woyambira wa insulin woyambira umatchedwa maziko. Kuti chikhale choyenera, chitani jakisoni wa mankhwala omwe akhala akuchita kwa nthawi yayitali usiku komanso / kapena m'mawa. Awa ndi ndalama zomwe zimatchedwa Lantus, Tujeo, Levemir, Tresiba ndi Protafan.

Werengani za kukonzekereratu kwa insulin: Levemir Lantus Tujeo Tresiba

Tresiba ndi mankhwala odziwika bwino kwambiri kotero kuti oyang'anira tsambalo adakonza kanema wazokhudza izi.

Mlingo waukulu wa mahomoni, womwe umayenera kuperekedwa mwachangu kuti chakudya chithe, umatchedwa bolus. Kuti mupatse thupi, jakisoni waifupi kapena wa insulin ya m'mimba musanadye. Kugwiritsa ntchito limodzi nthawi yomweyo mwachangu insulin kumatchedwa insulin-bolus regimen of insulin. Imawonedwa ngati yovuta, koma imapereka zotsatira zabwino.

Werengani za kukonzekera kwapafupifupi ndi ka insulin kofikira: Actrapid Humalog Apidra NovoRapid

Njira zosavuta sizilola kuyendetsa bwino shuga. Chifukwa chake, Dr. Bernstein ndi endocrin-patient.com sawalimbikitsa.

Momwe mungasankhire insulin yoyenera, yabwino?

Sizotheka kuthamangitsa shuga ndi insulin mwachangu.Muyenera kukhala masiku angapo kuti mumvetsetse zonse, kenako ndikupaka jakisoni. Ntchito zazikulu zomwe muyenera kuthana:

1. Onani ndondomeko ya sitepe yachiwiri yamatenda a 2 kapena njira yoletsa matenda ashuga.
2. Sinthani ku chakudya chamafuta ochepa. Anthu odwala matenda ashuga kwambiri amafunikanso kumwa mapiritsi a metformin malinga ndi ndandanda yowonjezera pang'onopang'ono.
3. Tsatirani mphamvu ya shuga kwa masiku 3-7, mumayeza ndi glucometer osachepera 4 pa tsiku - m'mawa pamimba yopanda chakudya asanadye chakudya cham'mawa, musanadye chakudya chamadzulo, musanadye chakudya chamadzulo, komanso ngakhale usiku musanagone.
4. Pakadali pano, phunzirani kumwa jakisoni wa insulin mopweteka ndikuphunzira malamulo osungira insulini.
5. Makolo a ana omwe ali ndi matenda amtundu woyamba a shuga ayenera kuwerenga momwe angapangire insulin. Anthu ambiri odwala matenda ashuga nawonso angafunikire izi.
6. Mvetsetsani momwe mungawerengere kuchuluka kwa insulin yayitali, komanso kusankha kuchuluka kwa insulini musanadye.
7. Phunzirani nkhani ya "Hypoglycemia (shuga Yochepa ya Magazi)", yokhala ndi mapiritsi a glucose mumasitolo ndikuwathandiza.
8. Dzipatseni mitundu ya insulin, syringes kapena cholembera, cholembera cholocha cholondola ndi mizere yoyeserera.
9. Kutengera ndi kuchuluka kwa mankhwalawa, sankhani mankhwalawa a insulin - onani kuti ndi ma jakisoni omwe mumafunikira, maola ndi ma mankhwala ati.
10. Sungani chidule cha kudziletsa. Popita nthawi, chidziwitso chikadzaza, mudzazeni tebulo pansipa. Onaninso zovuta nthawi ndi nthawi.

Pazinthu zomwe zimakhudza chidwi cha thupi pakupanga insulin, werengani apa. Onaninso:

• Zomwe zimayimira shuga wa magazi amayikidwa kuti apange jakisoni
• Mulingo wambiri uti wa mahomoni a anthu odwala matenda ashuga patsiku
• Kuchuluka kwa insulini ingati pa chakudya chimodzi (XE) yama chakudya
• Kodi gawo limodzi la insulini limachepetsa bwanji shuga
• Ndi mahomoni angati omwe amafunikira kuti muchepetse shuga ndi 1 mmol / l
• Nthawi yanji ya tsiku ndibwino kubaya insulin
• Shuga sagwa pambuyo pobayira: zotheka

Kodi makonzedwe a insulin yayitali amatha kugawidwa popanda kugwiritsa ntchito mankhwala apafupifupi ndi a ultrashort?

Osaba jakisoni wamkulu wa insulin yayitali, ndikuyembekeza kupewa kuchuluka kwa shuga mutatha kudya. Komanso, mankhwalawa sathandizira pamene mukufunikira kuti muchepetse shuga wokwanira msanga. Kumbali inayi, mankhwala achidule komanso osakhalitsa omwe amamwetsa asanadye sangapereke maziko olimba a kukhazikitsa kagayidwe m'mimba yopanda kanthu, makamaka usiku. Mutha kudwala ndi mankhwala amodzi kokha mwa odwala matenda ashuga kwambiri.

Ndi ma jakisoni amtundu wa insulin omwe amachita kamodzi patsiku?

Mankhwala omwe akhala akuchita kwa nthawi yayitali Lantus, Levemir ndi Tresiba amaloledwa kutumizidwa kamodzi patsiku. Komabe, Dr. Bernstein amalimbikitsa kwambiri Lantus ndi Levemir jakisoni kawiri patsiku. Mwa odwala matenda ashuga omwe amayesa kuwombera kamodzi amtunduwu wa insulin, kuwongolera kwa glucose nthawi zambiri kumakhala kopanda ntchito.

Tresiba ndiye insulin yatsopano kwambiri, ndipo jekeseni aliyense amakhala ndi maola 42. Itha kudulidwa kamodzi patsiku, ndipo nthawi zambiri imakhala ndi zotsatirapo zabwino. Dr. Bernstein anasinthana ndi Levemir insulin, yomwe adakhala akugwiritsa ntchito kwazaka zambiri. Komabe, amapangira jakisoni wa Treshiba kawiri patsiku, monga Levemir anali jekeseni. Ndipo onse odwala matenda ashuga amalangizidwa kuti achite zomwezo.

Werengani za kukonzekereratu kwa insulin: Levemir Lantus Tujeo Tresiba

Madokotala ena a shuga amayesa kubweretsa insulin yofulumira musanadye kangapo patsiku ndi jakisoni imodzi tsiku lililonse la mankhwala ambiri. Izi zimadzetsa zovuta. Osapita motere.

Werengani momwe mungapangire insulin kuwombera mopanda chisoni. Mukadziwa njira yolondola ya jakisoni, sizingakukhudzeni kuchuluka kwa jakisoni tsiku lililonse. Ululu wa jakisoni wa insulin silili vuto, ndiye kuti ulibe.Apa kuti muphunzire kuwerengera molondola mlingo - inde. Ndipo kwambiri, kuti mudzipatse nokha mankhwala abwino ochokera kunja.

Ndondomeko ya jakisoni ndi insulin Mlingo uyenera kusankhidwa payekhapayekha. Kuti muchite izi, yang'anirani machitidwe a shuga m'magazi kwa masiku angapo ndikukhazikitsa malamulo ake. Mapaipi amathandizidwa ndi kayendetsedwe ka insulin panthawi imeneyi ngati sangathe kupirira pawokha.

Mitundu ina yabwino yosakanikirana ndi insulin ndi iti?

Dr. Bernstein salimbikitsa kugwiritsa ntchito zosakanikirana zopangidwa okonzekera - Humalog Remix 25 ndi 50, NovoMix 30, Insuman Comb ndi ena onse. Chifukwa kuchuluka kwa insulin yayitali komanso yachangu mkati mwawo sikungagwirizane ndi omwe mukusowa. Anthu odwala matenda ashuga omwe amapaka jakisoni wopanga bwino, sangapewe magazi m'magazi. Gwiritsani ntchito mitundu iwiri yosiyanasiyana nthawi imodzi - yowonjezera komanso yochepetsetsa kapena ya ultrashort. Osakhala aulesi ndipo osasunga pa iwo.

Zofunika! Jekeseni wa insulin yemweyo mulingo wofanana, womwe umatengedwa masiku osiyanasiyana, angathe kuchita zinthu mosiyana. Mphamvu yamachitidwe awo imatha kusiyanasiyana ndi ± 53%. Zimatengera malo komanso kubaya kwa jakisoni, zolimbitsa thupi za anthu odwala matenda ashuga, kuchuluka kwa madzi mthupi, kutentha, ndi zina zambiri. Mwanjira ina, jakisoni yemweyo sangakhale ndi vuto lililonse masiku ano, ndipo mawa amatha kuyambitsa shuga m'magazi.

Ili ndi vuto lalikulu. Njira yokhayo yopewera ndikusinthira kuzakudya zama carb ochepa, chifukwa chomwe kuchuluka kwa insulin kumachepetsedwa ndi 2-8 nthawi. Ndipo wotsikirapo mlingo, kupatula ntchito yake. Sipangiri kubayidwa mayunitsi opitilira 8 nthawi imodzi. Ngati mukufuna mlingo wapamwamba, gawani pakati pawiri jekeseni ofanana. Apangeni amodzi m'malo osiyanasiyana, kutali ndi inzake, ndi syringe yomweyo.

Momwe mungapangire insulin pamsika wamafuta?

Asayansi aphunzira kupanga mtundu wa Escherichia coli wosinthidwa mwanjira ya E. coli kuti apange insulin yoyenera anthu. Mwanjira imeneyi, mahomoni apangidwa kuti achepetse shuga m'magazi kuyambira m'ma 1970. Asanadziwe zaukadaulo ndi Escherichia coli, odwala matenda ashuga adadzipaka okha ndi insulin ya nkhumba ndi ng'ombe. Komabe, ndizosiyana pang'ono ndi anthu, komanso zodetsa zosafunikira, chifukwa cha zomwe zimachitika kawirikawiri komanso zovuta. Hormone yochokera ku nyama sigwiritsidwanso ntchito ku West, ku Russia Federation ndi mayiko a CIS. Insulin yonse yamakono ndi mankhwala a GMO.

Kodi insulini yabwino kwambiri ndi iti?

Palibe yankho la funso ili kwa onse odwala matenda ashuga. Zimatengera mtundu wa matenda anu. Komanso, mutasintha zakudya zamafuta ochepa, zofunika za insulin zimasintha kwambiri. Mlingo umacheperachepera ndipo mungafunike kusintha kuchokera ku chinthu chimodzi kupita kwina. Sitikulimbikitsidwa kugwiritsa ntchito sing'anga Protafan (NPH), ngakhale itaperekedwa kwaulere, koma mankhwala ena ogwiritsira ntchito nthawi yayitali - ayi. Zomwe tafotokozazi zikufotokozedwa pansipa. Palinso tebulo la mitundu yolimbikitsidwa ya insulin yayitali.

Kwa odwala omwe amatsata zakudya zama carb otsika, mankhwala osakhalitsa (Actrapid) amakhala bwino ndi inshuwaransi kuposa chakudya chochepa kwambiri. Zakudya zama carb otsika zimatengedwa pang'onopang'ono, ndipo mankhwala a ultrashort amagwira ntchito mwachangu. Izi zimatchedwa chiwonetsero chazakuchita. Sipangofunika kudula Humalog musanadye, chifukwa sichichita mwachangu, nthawi zambiri chimayambitsa shuga. Kumbali inayo, Humalog bwino kuposa wina aliyense amathandizira kutsitsa shuga wowonjezera, chifukwa amayamba kuchita zinthu mwachangu kuposa mitundu ina ya ultrashort ndipo, makamaka, insulin yochepa.

Dr. Bernstein ali ndi matenda osokoneza bongo a mtundu woyamba ndipo akhala akuwalamulira bwinobwino kwa zaka zopitilira 70. Amagwiritsa ntchito mitundu itatu ya insulin:

1. Kukula - Mpaka pano, Tresiba ndiye yabwino kwambiri
2. Mwachidule - jakisoni musanadye
3. Ultrashort - kuchepetsedwa Humalog - pazofunikira mwadzidzidzi mukafunikira kuthimitsa shuga wamagazi ambiri

Ndi ochepa odwala matenda ashuga omwe angafune kuyamwa ndi mankhwala atatu. Mwinanso kugwirizanitsa kwabwino kumangokhala kwa awiri - owonjezera komanso achidule. M'malo mofupikitsa, mutha kuyesa kudulira NovoRapid kapena Apidra musanadye. Tresiba ndiye njira yabwino kwambiri yothandizira insulin yayitali, ngakhale ili ndi mtengo wokwera kwambiri. Chifukwa - werengani pansipa. Ngati ndalama zilola, gwiritsani ntchito. Mankhwala obwera kunja mwina ndi abwino kuposa am'nyumba. Zina mwazopangidwira kunja, kenako zimapita ku Russian Federation kapena ku mayiko a CIS ndikuziyika pomwepo. Pakadali pano, palibe zidziwitso zokhudzana ndi momwe chiwembuchi chimakhudzira mtundu wa zinthu zomalizidwa.

Kodi kukonzekera insulini sikungayambitse bwanji?

Mahomoni ochokera ku zikondamoyo za nkhumba ndi ng'ombe nthawi zambiri zimayambitsa mavuto. Chifukwa chake, sizigwiritsidwanso ntchito. Pamabwalo, odwala matenda ashuga nthawi zina amadandaula kuti asintha kukonzekera kwa insulin chifukwa cha chifuwa ndi kusalolerana. Anthu otere ayenera choyamba kudya zakudya zamafuta ochepa. Odwala omwe amachepetsa zakudya zamagulu m'zakudya zawo amafunika Mlingo wochepa kwambiri. Allergies, hypoglycemia, ndi mavuto ena amapezeka pafupipafupi mwa iwo omwe amapaka jekeseni wamba.

Insulin yeniyeni yaumunthu ndi mankhwala omwe amangokhala osakhalitsa Actrapid NM, Humulin Regular, Insuman Rapid GT, Biosulin R ndi ena. Mitundu yonse yautali ndi ultrashort zochita ndi analogues. Asayansi anasintha pang'ono kapangidwe kake kuti azikongoletsa malo. Ma analogs samachititsa kuti thupi lizigwirizana nthawi zambiri kuposa insulin yochepa ya anthu. Osawopa kuzigwiritsa ntchito. Kupatula kokha ndi mahomoni ocheperako omwe amatchedwa protafan (NPH). Ikufotokozedwa mwatsatanetsatane pansipa.

Werengani za kupewa ndi kuchiza mavuto: Maso (retinopathy) Impso (nephropathy) Matenda a shuga Atsitsi: miyendo, mafupa, mutu

Ndi insulin iti yomwe ili bwino: Lantus kapena Tujeo?

Tujeo ndi Lantus yemweyo (glargin) yemweyo, kokha mwa iwo omwe amamuwonjezera katatu. Monga gawo la mankhwalawa, 1 unit ya insulin glargine yotsika mtengo kuposa mutabaya jekeseni wa Lantus. Mwakutero, mutha kusunga ndalama ngati mungasinthe kuchoka ku Lantus kupita ku Tujeo muyezo womwewo. Chida ichi chikugulitsidwa chokwanira ndi zolembera zapadera za syringe zomwe sizikufuna kutembenuka kwa mlingo. Wodwala matenda ashuga amangoyambitsa kuchuluka kwa UNITS, osati mamililita. Ngati kuli kotheka, ndibwino kuti musasinthe kuchoka ku Lantus kupita ku Tujeo. Ndemanga za anthu odwala matenda ashuga za kusintha kwamtunduwu zimakhala zotsutsa kwambiri.

Mpaka pano, insulin yayitali kwambiri si Lantus, Tujeo kapena Levemir, koma mankhwala atsopano a Tresib. Amachita nthawi yayitali kuposa omwe amapikisana nawo. Kugwiritsa ntchito, muyenera kugwiritsa ntchito nthawi yochepa ndikukhalabe ndi shuga m'mawa pamimba yopanda kanthu.

Tresiba ndi mankhwala atsopano okhala ndi mwayi wokhala ndi mtengo wokwera pafupifupi katatu kuposa Lantus ndi Levemir. Komabe, mutha kuyesa kusintha, ngati ndalama zilola. Dr. Bernstein anasinthira ku Tresib ndipo akusangalala ndi zotsatirazi. Komabe, akupitilizabe kumubaya kawiri patsiku, monga momwe a Levemir adagwiritsidwapo kale. Tsoka ilo, sakusonyeza kuti mlingo wa tsiku ndi tsiku uyenera kugawidwa jekeseni awiri. Mwinanso, ambiri amayenera kuperekedwa madzulo, ndipo gawo laling'ono liyenera kusiyidwa m'mawa.

Mitundu yosiyanasiyana ya insulin

Kuchita zinthu mwachangu insulin ndi mankhwala afupipafupi komanso a ultrashort. Amakankhidwa musanadye, komanso, ngati kuli kotheka, kulipira mwachangu kuchuluka kwa shuga m'magazi. Amachitapo kanthu mwachangu kuti apewe kuchuluka kwa shuga pambuyo chakudya.

Tsoka ilo, ngati zakudya za anthu odwala matenda ashuga zimadzaza ndi zakudya zoletsedwa, ndiye kuti mitundu yothamanga ya insulin siyigwira bwino ntchito.Ngakhale Humalog yofulumira kwambiri yotsika mtengo sangathe kuthana ndi chakudya chopezeka m'maswiti, chimanga, zopangidwa ndi ufa, mbatata, zipatso ndi zipatso. Kuonjezera shuga pasanathe maola ochepa mukatha kudya kumalimbikitsa kukula kwa zovuta za matenda ashuga. Vutoli litha kuthetsedwa kokha mwa kusiya kwathunthu zinthu zoletsedwa. Kupanda kutero, majekeseni sangakhale othandiza kwenikweni.

Werengani za kukonzekera kwapafupifupi ndi ka insulin kofikira: Actrapid Humalog Apidra NovoRapid

Mpaka 1996, kukonzekera mwachangu insulini ya anthu kumadziwika kuti ndikovuta kwambiri. Kenako kunabwera ultrashort Humalog. Kapangidwe kake kanasinthidwa pang'ono poyerekeza ndi insulin yaumunthu kuti ipangitse kufalitsa ndi kupititsa patsogolo ntchitoyi. Posakhalitsa, mankhwala ofanana Apidra ndi NovoRapid adatulutsidwa pambuyo pake.

Chithandizo cha boma chimati odwala matenda ashuga amatha kudya chakudya chilichonse mosamala. Mankhwala osachedwa a ultrashort amalingaliridwa kuti amasamalira chakudya chomwe amadya.

Tsoka ilo, pochita izi sikugwira ntchito. Pambuyo kudya zakudya zoletsedwa, kuchuluka kwa shuga m'magazi kumakhalabe kokwezeka kwa nthawi yayitali. Chifukwa cha izi, zovuta za shuga zimayamba. Vuto linanso: Mlingo waukulu wa insulini amachita mosayembekezereka, zomwe zimayambitsa shuga m'magazi ndi hypoglycemia.

Anthu odwala matenda ashuga omwe amaika insulin mwachangu asanadye amafunika kudya katatu pa tsiku, pakatha maola 4-5. Chakudya chamadzulo chizikhala maola 18-19. Kukhazikika ndi osafunika. Zakudya zabwino sizingakupindulitseni, koma zingakupwetekeni.

Kuti muteteze molondola ku zovuta za matenda ashuga, muyenera kusunga shuga mumitundu yosiyanasiyana ya maola 400-5,5 mmol / l tsiku lililonse. Izi zitha kuchitika pokhapokha mutasinthira ku chakudya chamafuta ochepa. Zakudya zamankhwala zimathandizidwa mosamala ndi ma jakisoni a insulin ochepa, owerengeka molondola.

Kwa odwala matenda ashuga omwe amatsatira zakudya zamafuta ochepa, mankhwala osakhalitsa amakhala bwino pakudya musanadye kuposa Humalog, Apidra, kapena NovoRapid. Zakudya zololedwa zimatengedwa pang'onopang'ono. Amawonjezera shuga m'magazi osati kale kuposa maola 1.5-3 atatha kudya. Izi zimagwirizana ndi zochita za insulin yayifupi, mwachitsanzo, Actrapid NM, Humulin Regular, Insuman Rapid GT kapena Biosulin R. Ndipo mankhwala osokoneza bongo ochepa kwambiri amayamba kuchita mwachangu kuposa momwe tingafunire.

Mitundu ya insulin yochepa kwambiri

Werengani werengani mayankho a mafunso omwe amafunsidwa kawirikawiri ndi odwala matenda ashuga.

Kodi pali kusiyana kotani pakati pa insulin yochepa ndi ultrashort?

Mlingo wofupikira wa insulin yochepa umayamba kuchita pambuyo pa mphindi 30-60. Zochita zake zimathetsedwa mkati mwa maola 5. Ultrashort insulin imayamba ndipo imatha mofulumira kuposa lalifupi. Amayamba kutsika shuga m'magazi 10 mpaka 10.

Actrapid ndi mankhwala ena a insulin yochepa ndizofanana ndi mahomoni amunthu. Ma mamolekyulu a ultrashort akukonzekera Humalog, Apidra ndi Novorapid amasinthidwa pang'ono poyerekeza ndi insulin ya anthu kuti apititse patsogolo zochita zawo. Tikugogomezera kuti mankhwala a ultrashort samayambitsa chifuwa nthawi zambiri kuposa insulin yochepa.

Kodi ndikofunikira kudya mutatha jakisoni waifupi kapena wa insulin ya insulin?

Funso likuwonetsa kuti simudziwa za kugwiritsa ntchito insulin mwachangu kwa anthu odwala matenda ashuga. Werengani mosamala nkhaniyo "Kuwerengera mlingo waifupi ndi ultrashort insulin". Mankhwala abwino a insulini yachangu - ichi si chidole! Manja opanda kanthu, amatha ngozi.

Monga lamulo, jakisoni waifupi ndi wa insulin ya inshuwaransi amaperekedwa musanadye kuti chakudya chomwe chadyedwa sichikuwonjezera shuga. Ngati mutabaya insulin mwachangu kenako ndikulumpha zakudya, shuga amatha kugwa ndipo zizindikiro za hypoglycemia zitha kuwoneka.

Nthawi zina odwala matenda ashuga amadzibaya ndi mankhwala osafunikira kwambiri a insulin, pomwe kuchuluka kwawo kwa glucose ndikulumpha ndipo amafunika kuchepetsedwa mwachangu. Zikatero, sikofunikira kudya jakisoni.

Osadzibaya nokha, komanso ngakhale zochepa, kwa mwana wodwala matenda ashuga, aafupi kapena a ultrashort insulin, kufikira mutazindikira momwe mungawerengere mlingo wake. Kupanda kutero, hypoglycemia, kusazindikira, ngakhale kufa kungachitike. Werengani pano mwatsatanetsatane popewa komanso kuchiza shuga wochepa wamagazi.

Ndi insulin iti yomwe ili bwinoko: yayifupi kapena kopitilira muyeso?

Ultrashort insulin imayamba kuchita zinthu mwachangu kuposa zazifupi. Izi zimapangitsa kuti odwala matenda ashuga ayambe kudya pafupifupi atangolowa jakisoni, osawopa kuti shuga ya magazi ilumpha.

Komabe, insulin yochepa-yochepa siyigwirizana bwino ndi chakudya chamafuta ochepa. Chakudya cha matenda ashuga ichi, popanda kukokomeza, ndicodabwitsa. Anthu odwala matenda ashuga omwe anasintha, ndibwino kuti mulowe mwachidule Actrapid musanadye.

Ndikofunikira kuti muthe kudulira insulin yochepa musanadye, komanso kugwiritsa ntchito ultrashort mukafuna kuthamangitsa shuga wambiri. Komabe, m'moyo weniweni, palibe m'modzi mwa anthu odwala matenda ashuga omwe amakhala ndi mitundu itatu ya insulini nthawi yomweyo. Kupatula apo, mumafunikirabe mankhwala omwe mwakhala nawo. Kusankha pakati pa insulin yochepa komanso ya ultrashort, muyenera kunyengerera.

Werengani za kukonzekera kwapafupifupi ndi ka insulin kofikira: Actrapid Humalog Apidra NovoRapid

Zimatenga nthawi yayitali bwanji kubaya insulin mwachangu?

Monga lamulo, mlingo womwe umayendetsedwa wa insulin yochepa kapena wa ultrashort umatha kugwira ntchito pambuyo maola 4-5. Anthu ambiri odwala matenda ashuga amadzibayira ndi insulin yofulumira, kudikirira maola awiri, kuyeza shuga, ndikupanga jab ina. Komabe, Dr. Bernstein savomereza izi.

Musalole milingo iwiri ya insulin mwachangu kuti ichite munthawi yomweyo mthupi. Onani kuchuluka kwa maola 4-5 pakati pa jakisoni. Izi zimachepetsa pafupipafupi komanso mwamphamvu kuzunza kwa hypoglycemia. Werengani zambiri za kupewa ndi kuchiza matenda a shuga ochepa pano.

Odwala omwe ali ndi shuga yayikulu omwe amakakamizidwa kubaya jakisoni waifupi kapena wa ultrashort musanadye, mudye kwambiri katatu pa tsiku ndikupereka mahoni musanadye. Pamaso jakisoni, muyenera kuyeza mulingo wa glucose kuti musinthe mlingo wa insulin.

Kutsatira boma ili, nthawi iliyonse mutha kulowa muyezo wa insulin yofunikira kuti chakudya chikhale, ndipo nthawi zina muwonjezere kuchepetsa shuga. Mlingo wa insulin yofulumira yomwe imakupatsani mwayi kuti muzitha kuyamwa chakudya umatchedwa bolus chakudya. Mlingo wofunikira kusintha mtundu wa glucose wokwera umatchedwa bolus.

Mosiyana ndi nyumba yoperekera zakudya, malo owongolera samayendetsedwa nthawi iliyonse, koma pokhapokha pakufunika. Muyenera kutha kuwerengera molondola chakudya ndi kukonza mabotolo, ndipo osaba jakisoni wa mankhwala nthawi iliyonse. Werengani zambiri mu nkhani "Kuwerengera Mlingo wamfupi ndi ma cell a insulin".

Kusungitsa nthawi yayitali ya 4-5 pakati pa jakisoni, muyenera kuyesa kudya m'mawa kwambiri. Kuti mudzuke ndi shuga wabwinobwino m'mimba yopanda kanthu, muyenera kudya chakudya chamadzulo pasanafike 19:00. Ngati mutsatira malangizowo pa chakudya cham'mawa, ndiye kuti mudzakhala ndi chidwi cham'mawa.

Anthu odwala matenda ashuga omwe amatsata zakudya zama carb ochepa amafunikira kuchepa kwambiri kwa insulin, poyerekeza ndi odwala omwe amathandizidwa malinga ndi regimens yodziwika bwino. Ndipo kuchepetsa mlingo wa insulin, mokhazikika amakhala mavuto ocheperako.

Humalog ndi Apidra - kodi insulin ndi chiyani?

Humalog ndi Apidra, komanso NovoRapid, ndi mitundu ya insulin ya ultrashort. Amayamba kugwira ntchito mwachangu komanso kuchita zinthu mwamphamvu kuposa mankhwala omwe amangogwiritsa ntchito mwachidule, ndipo Humalog imakhala yachangu komanso yamphamvu kuposa ena. Kukonzekera kwapfupi ndi insulin yeniyeni ya anthu, ndipo ma ultrashort amasinthidwa pang'ono.Koma izi sizifunikira kuti zizolowetsedwa. Mankhwala onse apfupipafupi ndi a ultrashort nawonso ali ndi chiopsezo chochepa kwambiri cha chifuwa, makamaka ngati mumatsata zakudya zama carb ochepa ndikuwapatsa mankhwala ochepa.

Kutulutsa mawonekedwe, kapangidwe kake ndi ma CD

Ikupezeka onse ngati mtundu wa kuyimitsidwa kwa kayendetsedwe ka ma subcutaneous mu mbale ("Humulin" NPH ndi MZ), komanso mawonekedwe a makatoni okhala ndi cholembera (“Humulin Regular”). Kuyimitsidwa kwa oyang'anira sc kumamasulidwa mu 10 ml. Mtundu wa kuyimitsidwa ndi mitambo kapena milky, voliyumu ya 100 IU / ml mu cholembera cha 1.5 kapena 3 ml. M'katoni, masipikendi 5 a pulasitiki.

Kuphatikizikako kumaphatikizapo insulin (yaumunthu kapena ya biphasic, 100 IU / ml), zotuluka: metacresol, glycerol, protamine sulfate, phenol, zinc oxide, sodium hydrogen phosphate, madzi a jakisoni.

Opanga INN

Dzinalo lapadziko lonse lapansi ndi insulin-isophan (umisiri wa chibadwa cha anthu).

Imapangidwa makamaka ndi Lilly France SAAS, France.

Zoyimira ku Russia: "Eli Lilly Vostok S.A."

"Humulin" imasiyana pamtengo malinga ndi mtundu wa kumasulidwa: mabotolo kuchokera ku ma ruble 300-500, makatoni kuchokera ku ruble 800-1000. Mtengo ungasiyane m'mizinda yosiyanasiyana.

Zotsatira za pharmacological

"Humulin NPH" ndi insulin yowonjezera ya anthu. Imayendetsa kagayidwe ka glucose, imachepetsa mulingo wake ndikuwonjezera mphamvu yake m'maselo ndi minyewa, ndikufulumizitsa mapuloteni a anabolism. Kutumiza kwa glucose kumisempha kuchokera m'magazi kumawonjezeka, komwe kumapangitsa chidwi chake. Ilinso ndi zotsatira za anabolic komanso anti-catabolic pamatipi amthupi. Ndi kukonzekera kwa insulin. The achire zotsatira kuwonetseredwa 1 ora pambuyo makonzedwe, hypoglycemic - kumatenga maola 18, nsonga kukonzekera - pambuyo 2 maola mpaka maola 8 kuchokera nthawi yochoka.

Humulin pafupipafupi ndikulinganiza mwachidule insulin.

Humulin MZ ndi chisakanizo cha insulin yochepa komanso yapakati. Imayendetsa mphamvu yotsitsa shuga mthupi. Imadziwonekera yokha theka la ola pambuyo pa jakisoni, kutalika ndi maola 18-24, kutengera mawonekedwe a thupi ndi zinthu zina zakunja (zakudya, zolimbitsa thupi).

Pharmacokinetics

Mlingo wa mawonetseredwe amathandizidwe umadalira malo a jakisoni, mlingo womwe umayendetsedwa ndi mankhwala osankhidwa. Imagawidwa mosiyanasiyana munsiyo, simalowerera mkaka wa m'mawere ndi placenta. Imawonongeka makamaka mu impso ndi chiwindi ndi enzyme insulinase, yomwe imatsitsidwa ndi impso.

• Mtundu wodwala matenda a shuga.
• Mimba mwa odwala omwe ali ndi matenda ashuga oopsa (okhala ndi vuto la kudya).

Bongo

Chomwe chimachitika pokhudzana ndi bongo mopitirira muyeso ndi hypoglycemia. Zizindikiro zake ndi:

• ulesi, kufooka,
• thukuta lozizira
• khungu
• kukomoka mtima,
• kunjenjemera
• paresthesia m'manja, mapazi, milomo, lilime,
• mutu.

Pamaso pa zizindikiro izi mu vuto la hypoglycemia, shuga kapena shuga ayenera kumwedwa. ndiye kulumikizana ndi katswiri kuti asinthe mlingo kapena zakudya.

Zinthu zikafika povuta, njira ya glucagon imayendetsedwa - intramuscularly / subcutaneously, kapena njira yokhazikika ya glucose - kudzera m'mitsempha. Akazindikira kuti wabwezeretsedwa, amapatsidwa chakudya chomwe chimakhala ndi chakudya chambiri chamafuta. Mwachiwonekere, kuperekanso chithandizo kwa dokotala wopezekapo kumafunikira.

Kuyanjana kwa mankhwala osokoneza bongo

Zochita za Humulin zimalimbikitsa:

• mapiritsi ochepetsa shuga,
• zoletsa za MAO, ACE, kaboni anhydrase,
• imidazoles
• anabolic steroids
• antidepressants - monoamine oxidase inhibitors,
• tetracycline mankhwala opha tizilombo,
• Mavitamini B,
• Kukonzekera kwa lifiyamu
• Hypotonic mankhwala ochokera pagulu la ACE zoletsa ndi beta blockers,
• theofylline.

Mankhwala omwe molumikizana nawo osavomerezeka:

• mapiritsi olembera
• ma analcics
• calcium blockers,
• mahomoni a chithokomiro,
• glucocorticosteroids,
• okodzetsa
• mankhwala antidepressants,
• yambitsa zochitika zachisoni zamanjenje.

Zonsezi zimalepheretsa zotsatira za "Humulin", zimafooketsa mphamvu zake. Amaletsedwanso kugwiritsa ntchito mitundu ina ya mankhwala.

Malangizo apadera

Katswiri wokhawo yemwe amatha kusamutsa wodwala ku mankhwala ena okhala ndi insulin. Kusintha kwa Mlingo kumafunikira nthawi ndi nthawi, choncho muyenera kumayesa pafupipafupi ndikuonana ndi dokotala. Kufunika kwa insulini kumatha kuchepa kapena kuwonjezeka kutengera zinthu zambiri zofanana m'thupi ndi kunja kwake.

Nthawi zambiri, mavuto obwera chifukwa cha mankhwalawa samayambitsidwa ndi Humulin yokha, koma ndi jakisoni wosayenera kapena kugwiritsa ntchito zida zosayeretsa.

Kwa wodwala panthawi ya hypoglycemia, kuchuluka ndi kuyankha kumatha kutsika, chifukwa chake, magalimoto oyendetsa sayenera.

Mimba komanso kuyamwa

Ndikofunikira kudziwitsa adokotala za kukonzekera kukhala ndi pakati kapena kutha kwake. Izi zikufunika kukonza mankhwalawo. Kufunika kwa insulin kwa odwala matendawa omwe ali ndi matenda ashuga nthawi zambiri kumachepetsedwa mu trimester yoyamba, koma kumawonjezeka kwachiwiri komanso kwachitatu. Pa mkaka wa m`mawere, chithandizo ndi kusintha zakudya zimafunikanso. Pazonse, Humulin sanawonetse mutagenic mu mayeso onse, choncho chithandizo cha amayi ndi chothandiza kwa mwana.

Biosulin kapena mwachangu: chabwino ndi chiti?

Izi ndi zinthu zomwe zimapezeka panjira ya biosynthetic (DNA recombinant) chifukwa cha kusintha kwa enzymatic kwa porcine insulin. Ali pafupi kwambiri ndi insulin yaumunthu. Onse ali ndi zotsatira zakanthawi kochepa, chifukwa chake nkovuta kunena kuti wabwino ndi uti. Chisankho pazakusankhidwa chimachitika ndi katswiri.

Fananizani ndi fanizo

Kuti mumve mankhwala omwe ndi oyenera kugwiritsa ntchito, lingalirani za analogues.

Protafan. Chithandizo chogwira ntchito: insulin yaumunthu.

Kupanga: Novo Nordisk A / S Novo-Alle, DK-2880 Baggswerd, Denmark.

Mtengo: yankho kuchokera ku ma ruble 370, ma cartridge kuchokera ku 800 rubles.

Zochita: hypoglycemic wothandizira wa nthawi yayitali.

Ubwino: zochepa zotsutsana ndi zoyipa zochepa, zoyenera kwa amayi apakati komanso oyamwitsa.

Sangagwiritsidwe ntchito molumikizana ndi thiazolidinediones, popeza pali chiopsezo cholephera kwamtima, komanso choperekedwa ndi intramuscularly, pokhapokha.

Khalid. Chithandizo chogwira ntchito: insulin yaumunthu.

Wopanga: "Novo Nordisk A / S Novo-Alle, DK-2880" Baggswerd, Denmark.

Mtengo: yankho kuchokera ku ma ruble 390, makatoni - kuchokera ku ruble 800.

Zochita: hypoglycemic chinthu chaifupi.

Ubwino: Woyenera kwa ana ndi achinyamata, amayi oyembekezera komanso oyembekezera, amatha kuperekedwako mosadukiza kapena mwaubongo, wosavuta kugwiritsa ntchito kunja kwa nyumba.

Zitha kugwiritsidwa ntchito ndi zinthu zogwirizana, sizingagwiritsidwe ntchito limodzi ndi thiazolidatediones.

Cholinga chilichonse cha analogue chikuyenera kuvomerezedwa ndi katswiri. Dokotala wokhawo amene akupezekapo, potengera zotsatira za mayeso, ndi omwe amasankha kuti asinthe mankhwalawo kukhala wodwala. Kugwiritsa ntchito palokha insulin zina ndizoletsedwa!

Olga: "Ndi chosavuta kwambiri kuti imabwera ngati ma cartridge. Apongozi anu akhala ali ndi matenda a shuga kwa nthawi yayitali, muyenera kuwunika pafupipafupi momwe angathere komanso kupatsa jakisoni osati kunyumba. Atakhutira ndi zotsatirazi, akumva bwino kwambiri. "

Svetlana: “Anamuuza Humulin ali ndi pakati. Zinali zovuta kuvomereza, mwadzidzidzi zimakhudza mwana. Koma adotolo adatsimikizira kuti awa ndi mankhwala otetezeka, ngakhale ana amafunsidwa. Ndipo chowonadi chimathandiza, shuga adakhala wabwinobwino, osakhala ndi zotsatirapo zake! ”

Igor: “Ndili ndi matenda ashuga 1. Ndikokwera mtengo kuchiza mulimonse, chifukwa ndikufuna mankhwala atithandizire. Adotolo adandipatsa "Humulin", ndakhala ndikugwiritsa ntchito kwa miyezi isanu ndi umodzi tsopano.Kuyimitsidwa ndikotsika mtengo, koma ndikosavuta kwa ine kugwiritsa ntchito ma cartridge. Zambiri, ndakhutira: Ndachepetsa shuga ndipo mtengo wake ukunena. ”

Pomaliza

"Humulin" ndi yothandiza kwambiri komanso yotetezeka ku chithandizo cha matenda a shuga. Kugwiritsa ntchito mankhwalawa kumathandizira kukhala ndi shuga wabwinobwino wamagazi ndipo kumawononga nthawi yochepa pamajekeseni. Anthu ambiri omwe amagwiritsa ntchito mankhwalawa amangosiya ndemanga zabwino, zomwe zimasonyezanso kudalirika kwake komanso mtundu wake.

Insulin yachilengedwe komanso yapangidwe

Insulini amatanthauza ma mahomoni omwe amakhala ndi mayendedwe osiyanasiyana ophunzitsira. Poyamba, m'masamba achisangalalo, monga m'maselo a beta, mumakhala ma amino acid okwanira 110, omwe amatchedwa preproinsulin. Puloteni yamkati imalekanitsidwa ndi iyo, ma proinsulin amawonekera. Mapuloteni awa amawaika m'miyala, pomwe amagawidwa mu C-peptide ndi insulin.

Njira yapafupi kwambiri ya amino acid ya insulin. M'malo mwa threonine mmenemo, unyolo B umakhala ndi alanine. Kusiyana kwakukulu pakati pa bovine insulin ndi insulin yaumunthu ndi zotsalira za 3 amino acid. Ma antibodies amapangidwa pama insulin a nyama mthupi, omwe angayambitse kukana kwa mankhwala omwe amaperekedwa.

Kuphatikizika kwamakonzedwe amakono a insulin mu ma labotale kumachitika pogwiritsa ntchito ma genetic engineering. Biosynthetic insulin ndi yofanana mumapangidwe amino acid amunthu, amapangidwa pogwiritsa ntchito ukadaulo wa DNA. Pali njira ziwiri zazikulu:

1. Kaphatikizidwe ka mabakiteriya osinthidwa.
2. Kuchokera proinsulin wopangidwa ndi bacterium yosinthidwa ma genet.

Phenol ndi cholembera choteteza ku kuipitsidwa kwakanthawi kochepa ka insulini; insulin yayitali imakhala ndi paraben.

Cholinga cha insulin
Kupanga kwa mahomoni m'thupi kumapitilira ndipo kumatchedwa secaltion basal kapena maziko. Udindo wake ndikuwonetsetsa kuti shuga azikhala momasuka kunja kwa chakudya, komanso kuyamwa kwa glucose obwera kuchokera ku chiwindi.

Mukatha kudya, zakudya zamafuta zimalowa m'magazi kuchokera m'matumbo monga glucose. Kuti mumvetsetse pamafunika insulin yowonjezera. Kutulutsa kwa insulin m'magazi kumatchedwa secretion ya chakudya (postprandial), chifukwa, pambuyo pa maola 1.5-2, glycemia imabweranso muyeso wake, ndikalandira glucose kulowa m'maselo.

Mtundu 1 wa shuga, insulini silingapangidwe chifukwa cha kuwonongeka kwa autoimmune m'maselo a beta. Kuwonetsedwa kwa matenda ashuga kumachitika munthawi yomwe chiwonongeko chotheratu cha minofu ya islet. Mtundu woyamba wa matenda ashuga, insulin imabadwa kuyambira masiku oyamba a matendawa komanso moyo.

Mtundu wachiwiri wa matenda ashuga umatha kulipiriridwa ndi mapilitsi, ndikapita nthawi yayitali matendawa, kapamba amataya mphamvu kuti apange mahomoni akeawo. Zikatero, odwala amalowetsedwa ndi insulin limodzi ndi mapiritsi kapena ngati mankhwala.

Insulin imapangidwanso kuti ivulaze, kuchita opaleshoni, kutenga pakati, matenda, ndi zina zomwe shuga sangathe kuchepetsedwa pogwiritsa ntchito mapiritsi. Zolinga zomwe zimakwaniritsidwa ndikuyambitsa insulin:

• Sinthanso magazi a shuga, komanso kupewa kuti achulukane kwambiri mukatha kudya chakudya.
• Chepetsa shuga mkodzo.
• Muzipewa kupuma kwambiri kwa hypoglycemia ndi matenda a shuga.
• Muzikhala ndi thupi lokwanira.
• Sinthani mafuta kagayidwe.
• Sinthani moyo wabwino kwa anthu odwala matenda ashuga.
• Pofuna kupewa misempha komanso mitsempha ya matenda ashuga.

Zizindikiro zoterezi zimadziwika ndi njira yabwino yophunzirira matenda a shuga. Ndi chiphuphu chokwanira, kuchotsedwa kwa zizindikiro zazikuluzikulu za matendawa, hypo- ndi hyperglycemic coma, ndi ketoacidosis amadziwika.

Nthawi zambiri, insulini yochokera ku kapamba imadutsa mu chotupa cha chotupa mu chiwindi, pomwe imawonongeka hafu, ndipo ndalama zotsalazo zimagawidwa mthupi lonse. Zomwe zimayambitsa insulin pansi pa khungu zimawonetsedwa chifukwa zimalowa m'magazi mochedwa, komanso m'chiwindi ngakhale pambuyo pake. Chifukwa chake, shuga wamagazi amakwezedwa kwakanthawi.

Motere, mitundu yosiyanasiyana ya insulini imagwiritsidwa ntchito: insulin yofulumira, kapena insulin yochepa, yomwe muyenera kubayidwa musanadye, komanso kukonzekera insulin yayitali (insulin yayitali), yogwiritsidwa ntchito kamodzi kapena kawiri pakukhazikika kwa glycemia pakati pa chakudya.

Kodi insulin imagwira ntchito bwanji?

ShugaManWomenSomenShuga yanu kapena sankhani jenda kuti mupeze ndemangaLevel0.58 Kuyang'ana osapezedwaTchulani zaka za manAge45 KusakaNot anapezaYambirani zaka za mkaziAge45

Kukonzekera kwa insulini, monga mahomoni achilengedwe, kumangiriza zolandilira pa membrane wa cell ndikulowa nawo. Mchipindamo, motsogozedwa ndi timadzi tating'onoting'ono tomwe timayambitsa ma biochemical reaction. Ma receptor oterewa amapezeka m'matupi onse, ndipo nthawi zambiri pamaselo olimbana. Kuti zimadalira insulin zimaphatikizira maselo a chiwindi, adipose ndi minofu minofu.

Insulin ndi mankhwala ake imayendetsa pafupifupi ma metabolic onse omwe amalumikizidwa, koma kuthana ndi shuga pamagazi ndikofunikira. Hormoni imapereka kusuntha kwa glucose kudzera mu membrane wa khungu ndikulimbikitsa kugwiritsidwa ntchito kwake njira yofunika kwambiri yopezera mphamvu - glycolysis. Glycogen imapangidwa kuchokera ku glucose m'chiwindi, ndipo mapangidwe a mamolekyulu atsopano amachepetsedwa.

Zotsatira za insulin zimawonekera chifukwa chakuti kuchuluka kwa glycemia kumatsika. Malangizo a insulin kaphatikizidwe ndi katulutsidwe amathandizidwa ndi shuga ndende - kuchuluka kwa glucose kumayambitsa, ndipo otsika amalepheretsa katulutsidwe. Kuphatikiza pa shuga, kaphatikizidwe kamakhudzidwa ndi zomwe zimakhala m'magazi (glucagon ndi somatostatin), calcium ndi amino acid.

Mphamvu ya kagayidwe ka insulin, komanso mankhwala osokoneza bongo omwe ali ndi zomwe zili mkati mwake, amawonetsedwa motere:

1. Imaletsa kuchepa kwamafuta.
2. Imalepheretsa mapangidwe a matupi a ketone.
3. Mafuta ocheperako amalowa m'magazi (amawonjezera chiopsezo cha atherosulinosis).
4. Mu thupi, kuwonongeka kwa mapuloteni kumalephereka ndipo kapangidwe kawo kamathandizira.

Mayamwidwe ndi kufalitsa insulin mthupi

Kukonzekera kwa insulin kumalowetsedwa m'thupi. Kuti muchite izi, gwiritsani ntchito ma syringe omwe amatchedwa insulin, syringe pens, pampu ya insulin. Mutha kubayira mankhwala pansi pa khungu, m'misempha ndi m'mitsempha. Pakulamulira kwa intravenous (pankhani ya chikomokere), ma insulin okhazikika pokhapokha (ICD) ndi omwe ali oyenera, ndipo njirayi imagwiritsidwa ntchito nthawi zambiri.

The pharmacokinetics ya insulin zimatengera jakisoni malo, Mlingo, ndende ya yogwira mankhwala. Komanso, magazi akuyenda pamalo a jakisoni, zochitika za minofu zimatha kukhudza kuchuluka kwa kulowa m'magazi. Kuthiridwa mwachangu kumaperekedwa ndi jakisoni kukhoma lamkati lakumbuyo; mankhwalawa omwe amayikidwa m'chigobere kapena pansi pa phewa amaponderezedwa kwambiri.

M'magazi, 04-20% ya insulin imamangidwa ndi ma globulins, mawonekedwe a ma antibodies kwa mankhwala amatha kuyambitsa zotsatira zoyanjana ndi mapuloteni, ndipo, chifukwa chake, insulin. Kutsutsa kwa mahomoni kumakhala kotheka ngati nkhumba kapena insulini yolembedwa.

Mbiri ya mankhwalawa singafanane ndi odwala osiyanasiyana, ngakhale mwa munthu m'modzi zimasinthasintha.

Chifukwa chake, pamene deta pazomwe zimachitika ndikuchotsa theka la moyo zimaperekedwa, ma pharmacokinetics amawerengedwa molingana ndi zowonetsa pafupifupi.