Insulin ya odwala matenda ashuga

Tsambali likufotokoza mitundu yosiyanasiyana ya insulini komanso kusiyana pakati pawo. Werengani zomwe mankhwalawa amapezeka pakatikati, pakutalika, kakafupi komanso ka ultrashort. Matebulo abwino amawonetsa zizindikilo zawo, mayina apadziko lonse komanso zambiri zowonjezera.

Werengani mayankho a mafunso:

Mitundu ya insulin yapakatikati ndi yayitali - Protafan, Levemir, Lantus, Tujeo, komanso mankhwala atsopano a Tresiba akuyerekeza. Amauzidwa momwe mungawaphatikizire jakisoni wofulumira musanadye - insulin yochepa kapena imodzi mwazosankha zazifupi Humalog, NovoRapid, Apidra.

Mitundu ya insulin ndi zotsatira zake: nkhani yatsatanetsatane

Mudzalandira zotsatira zabwino kuchokera pamajekeseni ngati mugwiritsa ntchito limodzi ndi malingaliro ena. Werengani zambiri kapena. Kusunga kuchuluka kwa glucose 3.9-5,5 mmol / L khola maola 24 patsiku, monga mwa anthu athanzi, ndizowona. Zambiri patsamba lino ndi zaulere.

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 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.

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. Aunikireni ndi kuwamaliza mwakhama.

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.

Ambiri odwala matenda ashuga omwe amathandizidwa ndi insulin amakhulupirira kuti shuga yochepa ya magazi ndi zizindikiro zake zoopsa sizingapeweke. M'malo mwake, imatha kusunga shuga wokhazikika ngakhale 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 yemwe akufotokoza nkhaniyi ndi bambo wa mwana yemwe ali ndi matenda ashuga 1. Phunzirani momwe mungasinthire zakudya zopatsa thanzi komanso mulingo wa insulin.

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, ndi 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 kwakanthawi ndi ma insulin:

Njira zosavuta sizilola kuyendetsa bwino shuga. Chifukwa chake, tsamba lawebusayiti silikulimbikitsa.

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. Phunzirani kapena.
2. Pitani ku. Anthu odwala matenda ashuga onenepa kwambiri amafunikanso kumwa mapiritsi molingana 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. Panthawi imeneyi, phunzirani ndi kuphunzira malamulo osungira insulin.
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.
7. Werengani nkhaniyo "", ikani piritsi la glucose ku pharmacy ndikuwasunga.
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, maora ndi nthawi yayitali bwanji.
10. Sungani chidule cha kudziletsa. Popita nthawi, chidziwitso chikadzaza, mudzazeni tebulo pansipa. Onaninso zovuta nthawi ndi nthawi.

Werengani za zinthu zomwe zimakhudza chidwi cha thupi pakupanga insulini.

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, amalimbikitsa mwamphamvu Lantus ndi Levemir kuti apange jekeseni 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 kukonzekera kwa insulin yayitali:

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

Ili ndi vuto lalikulu. Njira yokhayo yopewera ndikusinthira, kuti mulingo wofunika wa insulini umachepetsedwa 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, pambuyo pakusintha kwa insulin, amasintha kwambiri. Mlingo umacheperachepera ndipo mungafunike kusintha kuchokera ku chinthu chimodzi kupita kwina. Sitikulimbikitsidwa kuti mugwiritse ntchito, ngakhale mutaperekedwa kwaulere, koma mankhwala ena omwe amakhala atatenga nthawi yayitali alibe. Zomwe tafotokozazi zikufotokozedwa pansipa. Palinso tebulo la mitundu yolimbikitsidwa ya insulin yayitali.

Kwa odwala omwe amatsata zakudya zama carb otsika pang'ono, mankhwala osokoneza bongo () amakhala bwino ngati inshuwaransi musanadye kuposa omwe amafupika. 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.

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 apfupifupi ndi a ultrashort nawonso ali ndi chiopsezo chochepa cha ziwopsezo, makamaka ngati mungawone ndikuwazunza pamiyeso yotsika.

Ndi insulin iti yomwe ili bwino: Humalog kapena NovoRapid?

Mwachizolowezi amakhulupirira kuti makonzedwe aposachedwa kwambiri a Humalog ndi NovoRapid, komanso Apidra, amachita ndi mphamvu yomweyo komanso liwiro. Komabe, akuti Humalog ndi wamphamvu kuposa awiri enawo, ndikuyambiranso kuchita zinthu mwachangu.

Zithandizo zonsezi sizoyenera jakisoni musanadye odwala ashuga omwe amatsata. Chifukwa zakudya zama carb otsika zimakomedwa pang'onopang'ono, ndipo mankhwala a ultrashort amayamba kuchepa shuga m'magazi. Zochita zawo sizikugwirizana kokwanira. Chifukwa chake, pakuwonetsa mapuloteni omwe adyedwa ndi chakudya, ndibwino kugwiritsa ntchito insulin yochepa - Actrapid NM, Humulin Regular, Insuman Rapid GT, Biosulin R kapena ina.

Kumbali inayi, Humalog ndi mankhwala ena a ultrashort amakweza msanga shuga kukhala abwinobwino kuposa achidule. Odwala omwe ali ndi vuto lalikulu la matenda ashuga 1 angafunike kugwiritsa ntchito mitundu itatu ya insulin nthawi yomweyo:

• Chakulitsidwa
• Mwachidule kwa chakudya
• Ultrashort pamilandu yodzidzimutsa, kuthamanga kwa shuga ambiri.

Mwinanso kugwirizanitsa kwabwino kungakhale kugwiritsa ntchito NovoRapid kapena Apidra monga chithandizo chachilengedwe m'malo mwa Humalog ndi insulin yochepa.

Mankhwala amakono, insulin yochepa imathandizira kulipirira matenda a shuga. Ichi ndiye chida chodziwika bwino chothandiza kuti shuga asungidwe m'thupi la wodwalayo. Insulin ndi timadzi tomwe timatulutsa chinsinsi. Kuthandizira thupi la wodwala, insulin yokhala ndi nthawi yayitali komanso nthawi yowonekera yayinso imagwiritsidwa ntchito. Kusankha kwamankhwala kumadalira momwe shuga imawonongera ziwalo zofunika.

Poyamba, insulin idapangidwa pamene imagwira ntchito ndi kapamba wa nyama. Chaka chotsatira, anali atagwiritsidwa ntchito kale ngati mankhwala. Pambuyo pazaka 40, anthu adaphunzira momwe angapangire chinthuchi mchiyeretso chambiri ndi mankhwala. Kwa zaka zambiri, asayansi akhala akupanga insulin yaumunthu. Pomwepo mu 1983, zinthuzi zidagwiritsidwa ntchito kwambiri pochita, ndipo insulin yokonzekera chiyambi cha nyama idaletsedwa. Njira yopangira mankhwalawa ndikuyika zida za jini m'maselo a tizilombo toyambitsa matenda a yisiti kapena tizilombo toyambitsa matenda a E. coli. Pambuyo podziwonetsera, mabakiteriya nawonso amatulutsa timadzi timeneti.

Mankhwala amakono amasiyanasiyana pokhudzana ndi mawonekedwe ndi mawonekedwe a amino acid. Malinga ndi kuchuluka kwa kudziyeretsa, amagawidwa mchikhalidwe, monopic ndi monocomponent.

Ma insulins apafupi (kapena chakudya) amagawidwa m'mitundu iwiri:

1. Insulin yofupikitsa (a regulator, soluble), omwe oimira ake ndi Actrapid NM, Biogulin R. Amadziwikanso ndi mayina monga mankhwala a Humodar R, Actrapid MS, Monodar, Monosuinsulin MK.
2. Ultrashort insulin. Izi ndi ma insulins a analog, amafanana ndi aanthu. Izi zikuphatikiza, mwachitsanzo, Insulin Lizpro (Humalog), Insulin Glulizin (Apidra).

Mankhwala omwe akhala akuchita kwa nthawi yayitali amakhala a insulin komanso osakhalitsa. Amadziwikanso kuti basal. Awa ndi insulin-isophan, insulin-zinc, etc.

Kuphatikiza apo, kugwiritsa ntchito mankhwala omwe nthawi yomweyo amaphatikiza ma insulin omwe amakhala nthawi yayitali komanso amasunga mofulumira amathandizira kwambiri ntchito yaudokotala.

Kafukufuku wowoneka bwino wokhudza momwe mitundu yambiri ya insulin imathandizira munthu ingathandize tebulo 1.

Mwachangu insulin

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:

• 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. Amadziwika ndi gawo losasintha la ma tinthu munthawi ya ma polima. Amalekedwa pang'onopang'ono, mahomoni ambiri atatha kudya samayikidwa.

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 ndi kuthekera kuchepetsedwa mwachangu. 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.

Zambiri za pharmacokinetics zamankhwala

Mwa odwala osiyanasiyana, insulin imachita mosiyanasiyana mthupi. Nthawi yofika pachimake cha zomwe zili mumadzi a m'mimba komanso kuthekera kwakukulu kochepetsera shuga mwa munthu m'modzi kungakhale theka lofanana ndi lina. Zimatengera momwe mankhwalawo amamwa mwachangu pansi pa khungu. Kuchita bwino kwambiri kwa thupi kumayambitsidwa ndi ma insulini a nthawi yayitali komanso nthawi yayitali. Koma osati kale kwambiri, zidapezeka kuti ma insulin omwe amangogwiritsa ntchito nthawi yochepa sakhala otsika pamakhalidwe awo. Popeza kufunikira kwa zakudya zoyenera komanso kuchita masewera olimbitsa thupi, kuwongolera kuchuluka kwa glucose kumakhala kosavuta.

Wodwala aliyense yemwe amadwala matenda a shuga amatengera insulin nthawi zonse. Izi zikuphatikiza:

• anthu omwe samathandizidwa ndi zakudya komanso mapiritsi,
• woyembekezera
• anthu omwe ali ndi chitukuko cha matendawa pambuyo pancreatectomy,
• odwala matenda ashuga ketoacidosis kapena hyperosmolar chikomokere,
• anthu omwe ali ndi mitundu yonse ya shuga omwe amafunikira chithandizo cha postoperative.

Kuchiza muzochitika zonsezi kumayambitsa matenda a glucose komanso njira zonse za metabolic. Kutheka kwakukulu kumatheka chifukwa chophatikiza zakudya zoyenera, masewera olimbitsa thupi ndi jakisoni.

Mlingo watsiku ndi tsiku

Mwa munthu wapakati wolemera bwino, kukula kwake kwa insulin tsiku lililonse kumachokera ku 18 mpaka 40 magawo. Pafupifupi theka la mahomoni omwe thupi limagwiritsa ntchito chinsinsi choyambira. Hafu inayo amapita kukakonza chakudya. Nthawi ya kupanga basal hormone ili pafupifupi gawo limodzi pa ola limodzi.Ndi shuga, kuthamanga uku kumasintha kukhala magawo 6. Anthu onenepa kwambiri amapanga insulin yokwanira kanayi ndikudya. Gawo la mahomoni limawonongedwa m'chiwindi.

Odwala omwe ali ndi matenda amtundu wa 1 amatha kukhala ndi insulin yosiyanasiyana patsiku. Mtengo wapakati wa chizindikirochi umachokera ku zigawo za 0.6 mpaka 0.7 pa 1 kg. Anthu onenepa amafunika mlingo waukulu. Odwala omwe amafunikira magawo a 0,5 okha omwe ali ndi mawonekedwe owoneka bwino kapena ali ndi chotsalira cha insulin.

Monga tanena kale, kufunikira kwa insulin ndi koyambira komanso postprandial. Basal ndi gawo la mahomoni omwe amachepetsa kuphwanya kwa glucose m'chiwindi. Gawo lachiwiri la insulin limathandiza thupi kuyamwa michere. Chifukwa chake, wodwalayo amapatsidwa jakisoni asanadye.

Ambiri odwala matenda ashuga amalandira jakisoni imodzi patsiku. Pankhaniyi, kugwiritsa ntchito insulin ya sing'anga kapena yophatikizika kuchitapo kanthu. Mankhwala osakanikirana nthawi zambiri amaphatikiza ma insulin osakhalitsa komanso kukhudzika kwakutali.

Koma izi nthawi zambiri sizikhala zokwanira kuti mukhale glycemia wokwanira. Muzochitika izi, regimen yovuta kwambiri yamankhwala imagwiritsidwa ntchito. Zimaphatikizapo kukonzekera kwa insulini kwa kuthamanga kwapakati komanso kuthamanga kapena kukhudzika kwakanthawi komanso kochepa. Makina osakanikirana kwambiri. Mankhwala awiri amaperekedwa kwa munthu: asanadye chakudya cham'mawa komanso asanadye chakudya chamadzulo. Potere, mawonekedwe a jakisoni amaphatikiza mahomoni azowonekera pang'ono komanso apakati. Ngati jakisoni chakudya chamadzulo chisanaperekenso shuga wamba, munthu amapatsidwa jakisoni awiri. Choyamba, shuga imalipidwa ndi mankhwala omwe amangokhala pakanthawi kochepa, ndipo asanagone, tepi ya insulin kapena NPH ndiyofunikira.

Munthu aliyense amafunikira insulin m'mawa. Kwa odwala matenda ashuga, kusankha bwino mankhwala a jakisoni amadzulo ndikofunikira kwambiri. Kukula kwa mlingo kumatengera shuga. Amasankhidwa payekhapayekha kwa wodwala aliyense. Chida chothandizira kuperekera insulin mwina ndi chida china chapadera (pampu).

Kuwoneka kwa glucometer kunapangitsa kuti kusavuta kuwerengero. Chida ichi chimakupatsani mwayi wopitilira muyeso wa glycosylated hemoglobin. Chofunika kwambiri pa chithandizo cha insulin yochepa ndizogwirizana ndi ma pathologies, zakudya, mawonekedwe a thupi.

Wochedwa insulin

Chithandizo cha insulin chowonjezera chiyenera kulowa m'malo mwa kutulutsa kwa insulin, koyambirira komanso pambuyo pa chakudya. Mwa anthu odwala matenda ashuga amtundu woyamba, njira yokhayo yobwezeretsanso insulin katulutsidwe ndikugwiritsa ntchito insulin.

Insulin yoyamba ndi pafupifupi 40-60% ya zofunika tsiku ndi tsiku za thupi. Panthawi yabwino, mlingo wa basal insulin uyenera kuvala zosowa pakati pa chakudya, ndipo oyang'anira osakhalitsa insulin azikonza postprandial glycemia.

Ndi matendawa, matenda a shuga amafunikira chithandizo cha insulin. Insulin yochepa ndi insulin yayitali imagwiritsidwa ntchito pochiza matendawa. Moyo wamunthu wodwala matenda ashuga kwambiri umatengera kutsatira malangizo onse azachipatala.

Insulin yowonjezereka yogwira mtima imafunikira pamene kusala kudya kwa shuga m'magazi kumafunikira kusintha. Lantus amadziwikanso ngati insulin yodziwika kwambiri kwa nthawi yayitali mpaka pano, yomwe wodwalayo amayenera kuperekedwa kamodzi pa maola 12 kapena 24.

Imatsimikiza kufunika kwa chithandizo cha insulini ndikusankha mankhwala ena ndi dokotala, ndipo kupita patsogolo kwa mankhwalawa kumatengera matendawo.

Insulin yayitali imakhala ndi katundu wodabwitsa, imatha kutsanzira mahomoni achilengedwe omwe amapangidwa ndi maselo a kapamba.Nthawi yomweyo, amakhala ofatsa pamaselo oterowo, amathandizira kuchira, komwe mtsogolo limalola kukana insulin.

Jekeseni wa insulin wa nthawi yayitali ayenera kuperekedwa kwa odwala omwe amakhala ndi shuga wambiri masana, koma akuyenera kuwonetsetsa kuti wodwalayo amadya chakudya pasanathe maola 5 asanagone. Komanso, insulin yayitali imapangidwira chizindikiro cha "m'mawa kutacha", maselo a chiwindi akayamba usiku wodwalayo asanadzuke, asokoneze insulin.

Ngati insulin yayifupi ikufunika kubayidwa masana kuti muchepetse kuchuluka kwa glucose omwe amabwera ndi chakudya, ndiye kuti insulin yayitali imatsimikizira maziko a insulini, imathandizira kupewa, imathandizanso kubwezeretsa maselo a pancreatic beta. Jekeseni wa insulin wa nthawi yayitali amayenera kuthandizidwa kale chifukwa amathandizira wodwalayo kuonetsetsa kuti matenda amtundu wa 2 sangadutse matenda oyamba.

Kuwerengera molondola kwa mlingo wa insulin yayitali usiku

Kuti mukhale ndi moyo wabwinobwino, wodwalayo ayenera kuphunzira momwe angawerengere molondola kuchuluka kwa Lantus, Protafan kapena Levemir usiku, kotero kuti msanga wama glucose amasungidwa pa 4.6 ± 0.6 mmol / l.

Kuti muchite izi, mkati mwa sabata muyenera kuyeza kuchuluka kwa shuga usiku ndi m'mawa pamimba yopanda kanthu. Kenako muyenera kuwerengera mtengo wa shuga m'mamawa mtengo wake wa dzulo usiku ndikuwerengera kuchuluka, izi zikuwonetsa chisonyezo chochepa chofunikira.

Mwachitsanzo, ngati kuchuluka kochepa kwa shuga ndi 4.0 mmol / l, ndiye kuti gawo limodzi la insulin yayitali ingachepetse chizindikirocho ndi 2.2 mmol / l mwa munthu wolemera makilogalamu 64. Ngati kulemera kwanu ndi makilogalamu 80, ndiye kuti timagwiritsa ntchito njira zotsatirazi: 2.2 mmol / L * 64 kg / 80 kg = 1.76 mmol / L. Mlingo wa insulin kwa munthu wolemera makilogalamu 80 uyenera kukhala magawo 1.13, chiwerengerochi chimakhala chozungulira kufika kotala ndipo timalandira 1.25E.

Tiyenera kudziwa kuti Lantus sangathe kuchepetsedwa, chifukwa chake imafunikira kubayidwa ndi 1ED kapena 1,5ED, koma Levemir imatha kuchepetsedwa ndikuvulaza ndi mtengo wofunikira. M'masiku otsatirawa, muyenera kuwunika momwe shuga angakhalire kudya ndikuwonjezera kapena kuchepetsa kuchuluka kwake. Amasankhidwa moyenera komanso molondola ngati, mkati mwa sabata limodzi, shuga osala kudya saposa 0.6 mmol / l, ngati mtengo wake umakhala wokwera, ndiye yesani kuwonjezera kuchuluka kwa mankhwala ndi mayunitsi a 0.25 masiku atatu aliwonse.

Kuchita insulin nthawi yayitali: imalembedwa liti ndipo imagwiritsidwa ntchito bwanji

Palibe machiritso athunthu padziko lapansi omwe ali ndi matenda ashuga. Koma kugwiritsa ntchito mankhwala kwa nthawi yayitali kumatha kuchepetsa kuchuluka kwa jakisoni ofunikira ndikuthandizira kwambiri moyo.

Kodi tanthauzo la insulin yayitali mthupi la munthu ndi chiyani? Mankhwala apakati komanso a nthawi yayitali amathandizidwa ndi odwala matenda ashuga kawiri pa tsiku (m'mawa ndi madzulo) ndipo ndizofunikira. Kuchita bwino kwa insulin yayitali kumachitika pambuyo pa maola 8-10, koma kuchepa kwa shuga kumawonekera pambuyo pa maola 3-4.

Momwe mungasankhire mlingo wa insulin yokwanira kwa munthu: mavitamini ang'onoang'ono (osapitirira 10) amagwira ntchito kwa maola pafupifupi 12, kuchuluka kwakukulu kwa mankhwalawa - mpaka tsiku. Ngati insulin yowonjezereka imafotokozedwa mu Mlingo wopitilira mayunitsi 0,6 pa 1 makilogalamu, ndiye kuti jakisoni imachitika m'njira zingapo m'malo osiyanasiyana (phewa, ntchafu, m'mimba).

Kodi chimapereka chithandizo chotere ndi chiani?

Insulin yomwe imatenga nthawi yayitali imafunikira kuti glucose isinthe. Katswiri wokhazikika, pamaziko a kudziletsa kwa wodwalayo, ndi omwe angadziwe ngati wodwalayo amafunikira jakisoni wa mankhwala omwe amangokhala pang'ono musanadye nawo komanso nthawi yayitali komanso yayitali.

Ndikofunikira. Insulin yomwe imatenga nthawi yayitali ndichosinthira kwathunthu kwa masamba oyambira omwe amaperekedwa ndi kapamba. Imachepetsa kufa kwa maselo a beta.

Usiku ndi m'mawa machitidwe

Anthu omwe amawapeza ndi pafupifupi m'mawa amakhala ndi shuga.Izi zikutanthauza kuti usiku thupi limasowa insulin yayitali. Koma asanakakamize kupatsidwa mahomoni owonjezera, dokotala amayenera kufufuza kuti adye liti munthu womaliza kudya. Ngati chakudya chikuchitika maola asanu kapena ochepera asanagone, ndiye kuti kugwiritsa ntchito mankhwala osokoneza bongo kwa nthawi yayitali sikungathandize kukhazikika kwa shuga.

Yofotokozedwa bwino ndi akatswiri komanso chodabwitsa cha "m'bandakucha." Atatsala pang'ono kudzuka, chiwindi chimatulutsa mahomoni mwachangu, zomwe zimatsogolera ku hyperglycemia. Ndipo ngakhale mutasintha mlingo, izi zimathandizanso.

Zokhudza thupi la izi zimatsimikizira njira ya jakisoni: jakisoni amapangidwa maola asanu ndi atatu kapena ochepera nthawi yofananira yodzuka. Pambuyo maola 9-10, insulin yotalikilapo imakhala yofooka.

Mankhwala omwe akhala akuchita kwa nthawi yayitali sangakhale ndi shuga m'mawa. Izi zikachitika, ndiye kuti adokotala adalemba kuchuluka kwa mahomoni. Kuchuluka kwa mankhwalawa kumakhala ndi hypoglycemia. M'maloto, panjira, imadziwonetsa yokha mwa nkhawa komanso zoopsa usiku.

Kuti mupewe izi, mutha kuchita cheke izi: maola anayi mutatha jakisoni, muyenera kudzuka ndikuyeza mulingo wama gluu. Ngati chizindikirocho chili chochepera 3.5 mmol / l, ndikofunikira kuti mupeze insulin yayitali m'magawo awiri - nthawi yomweyo musanagone komanso pambuyo maola 4 ena.

Kugwiritsa ntchito njirayi kumakupatsani mwayi wochepetsera mlingo mpaka 10-15%, kuwongolera zodabwitsa za "m'mawa m'mawa" ndikudzuka ndi shuga.

Mankhwala omwe akhala akuchita kwa nthawi yayitali

Mwa mahomoni omwe atenga nthawi yayitali, mayina otsatirawa nthawi zambiri amapezeka (malinga ndi radar):

Zitsanzo ziwiri zomaliza zimadziwika kuti zimakhudza kwambiri shuga. Insulin yotalika chotere imalowetsedwa kamodzi patsiku ndipo siziwonjezera kukula kwa hypoglycemia usiku. Imawerengedwa kuti ikulonjeza pa gawo la mankhwala a insulin.

Mphamvu yotalikirapo ya Lantus insulin (mtundu wa kumasula kwa glargine) imatha kufotokozedwa ndi kuyamwa pang'onopang'ono ndi makonzedwe a subcutaneous. Zowona, kuti musunge izi, nthawi iliyonse muyenera kusankha tsamba latsopano.

Mlingo wa Lantus insulin ndi mankhwala okhazikika a shuga m'thupi (mpaka tsiku). Chogulitsacho chimapezeka m'mak cartridge ndi syringe pens yokhala ndi 3 ml ndi mabotolo okhala ndi 10 ml ya mankhwalawa. Kutalika kwa kuchitapo kanthu kuchokera pa maola 24 mpaka 29. Zowona, chisonkhezero chake tsiku lonse zimadalira thupi.

Mtundu woyamba wa matenda ashuga, Lantus yemwe amakhala akuchita insulin nthawi yayitali ndiye woyamba kumwa mankhwala, ndipo wachiwiri amatha kuphatikizidwa ndi mankhwala ena ochepa omwe amachepetsa shuga.

Mukasinthira kuchokera kwa zitsanzo zazifupi ndi zapakati pa insulin yayitali m'masiku oyamba, mlingo ndi ndandanda ya jakisoni imasinthidwa. Mwa njira, m'zaka zaposachedwa, chizolowezi china chakhala chikuwonekera molingana ndi omwe odwala akufuna kuyesa kupita nawo kwa mankhwala opitilira muyeso kuti achepetse kuchuluka kwa jakisoni ndikuwongolera moyo.

Ultra kutalika kwenikweni

Ma insulini omwe akhala akuchita kwa nthawi yayitali omwe atchulidwa pamwambapa ndi othandiza kwambiri. Kuwonekera kwathunthu kumawasiyanitsa: safunikira kugwedezeka, kukunikizidwa m'manja kuti mutsimikizire kugawika kwa matope. Pamodzi ndi Lantus, Levemir ndi mankhwala okhazikika kwambiri, mawonekedwe ake ndi ofanana kwa odwala matenda ashuga omwe ali ndi mitundu yonse iwiri yamatenda.

Ndikofunika kudziwa kuti mitundu yayitali ikadalipo pang'ono pantchito yawo. Nawonso, mankhwalawa alibe. Ndipo chododometsa chiyenera kukumbukiridwa pakukonzekera kwa mlingo.

Mankhwala oyambira amawerengeredwa potengera momwe angakhalirebe shuga yokhazikika yamagazi. Kusintha kwovomerezeka sikoposa 1.5 mmol / l. Komabe, izi siziyenera kuchitika patangotha ​​tsiku limodzi jekeseni. Monga lamulo, mankhwala owonjezereka amakankhidwa m'tchafu kapena matako.Apa, mafutawo amachepetsa kuyamwa kwa timadzi m'magazi.

Nthawi zambiri, odwala matenda ashuga osadziwa amayesa kuloweza lalifupi ndi insulin yayitali, yomwe singachitike. Kupatula apo, mitundu iliyonse ya mahomoni ndiyofunikira kuchita ntchito yofotokozedwa mosamalitsa. Chifukwa chake, ntchito ya wodwalayo ndikuonetsetsa mosamalitsa chithandizo chamankhwala cha insulin.

Pokhapokha ngati agwiritsidwa ntchito moyenera, amakhala ndi insulin nthawi yayitali.

Wokhala insulin yayitali komanso dzina lake

Matenda a shuga amadziwika ndi kulephera kwa thupi kugwetsa glucose, chifukwa chomwe chimakhazikika m'magazi, zimayambitsa kusokonezeka kwakukulu pakugwira ntchito kwa minofu ndi ziwalo zamkati. Izi zikachitika chifukwa chosakwanira kupanga insulin ndi kapamba.

Ndipo kuti apange mahomoni awa m'thupi, madokotala amapereka insulin yayitali kwa odwala awo. Kodi ndi chiyani ndipo mankhwalawa amagwira ntchito bwanji? Izi ndi zina zambiri tidzazikambirana tsopano.

Chifukwa chiyani ma jakisoni a insulin amafunikira?

Insulin yolimbitsidwa imapereka kusala kudya kwa glucose mwachangu. Mankhwalawa amatchulidwa ndi dokotala pokhapokha ngati wodwala ayesa kuyeza magazi ake mkati mwa mlungu.

Potere, ma insulin afupiafupi, apakati kapena ataliatali amatha kukhazikitsidwa. Zothandiza kwambiri pamenepa, mwachidziwikire, ndimankhwala ogwirira ntchito kwa nthawi yayitali. Mankhwalawa amagwiritsidwa ntchito pochiza matenda amtundu wa 2. Anayambitsidwa kudzera m`nsinga 1-2 pa tsiku.

Dziwani kuti insulin yotalikirapo imatha kutumizidwa ngakhale odwala matenda ashuga omwe adadzipatsa kale majekeseni osakhalitsa. Chithandizo choterechi chimakupatsani mwayi othandizira komanso kupewa mavuto ambiri.

Zofunika! Kukhazikitsidwa kwa insulin yochita ntchito kwa nthawi yayitali kumachitika pakakhala kukanika kokwanira (imaleka kutulutsa timadzi tating'onoting'ono) ndipo kufa mwachangu kwa maselo a beta kumawonedwa.

Insulin yayitali imayamba kugwira ntchito pambuyo pa maola 3-4 Poterepa, pali kuchepa kwa shuga m'magazi ndikusintha kwakukulu pamachitidwe a wodwala. Kuchuluka kwake kwa kugwiritsidwa ntchito kumawonedwa pambuyo pa maola 8-10. Zotsatira zake zimatha kukhala maola 12 mpaka 24 ndipo zimatengera mlingo wa insulin.

Zocheperako zimakupatsani mwayi kuti mupeze insulini mu kuchuluka kwa mayiti a 8010. Amachitapo kanthu kwa maola 14-16. Insulin mu kuchuluka kwa magawo makumi awiri. ndi kuthekera kosunga shuga m'magazi pafupifupi tsiku limodzi. Dziwani kuti ngati mankhwalawa ndi mankhwala ochepetsa mayunitsi oposa 0.6. pa kilogalamu imodzi ya kulemera, ndiye kuti jakisoni 2-3 amaikidwa nthawi yomweyo m'malo osiyanasiyana a thupi - ntchafu, mkono, m'mimba, ndi zina zambiri.

Ndikofunikira kugwiritsa ntchito insulin yokwanira bwino. Siligwiritsidwa ntchito kukhazikitsa glucose wamagazi mukatha kudya, chifukwa sichichita mwachangu, mwachitsanzo, insulin. Komanso, jakisoni wa insulin ayenera kukonzekera.

Ngati mungadumphe nthawi ya jakisoni kapena kukulitsa / kufupikitsa kusiyana pamaso pawo, izi zitha kubweretsa kuwonongeka muzochitika za wodwalayo, popeza kuchuluka kwa glucose "kumadumpha" nthawi zonse, zomwe zimapangitsa kuti pakhale zovuta.

Kuchita insulini kwa nthawi yayitali

Jekeseni wothandizirana kwa nthawi yayitali amalola odwala matenda ashuga kuti athetse kufunika kwa kumwa mankhwalawa kangapo patsiku, chifukwa amalamulira shuga m'magazi tsiku lonse. Kuchita izi kumachitika chifukwa chakuti mitundu yonse ya insulini yokhala nthawi yayitali imakhala ndi mankhwala othandizira kuti akhale ogwira ntchito.

Kuphatikiza apo, mankhwalawa ali ndi ntchito inanso - amachepetsa njira yolembera shuga m'thupi, potero amapereka kusintha kwa zomwe wodwalayo ali nazo. Zotsatira zoyambirira pambuyo pa jekeseni zimawonedwa kale pambuyo pa maola 4-6, pomwe zimatha kupitiliza kwa maola 24-36, malingana ndi kuopsa kwa njira ya matenda ashuga.

Mayina a mankhwala omwe amakhala ndi insulin nthawi yayitali:

Mankhwalawa ayenera kuyikidwa ndi adokotala okha, chifukwa ndi ofunikira kwambiri, omwe angapewe kuwonongeka pambuyo pobayira. Mankhwalawa amaperekedwa mosavuta m'matako, matako ndi mikono yakutsogolo.

Ndikofunikira kusunga mankhwalawa pamtunda wa minus 2 degree (ndikotheka mufiriji). Izi zimapangitsa kuti makutidwe ndi okosijeni a mankhwalawo komanso mawonekedwe a granular osakanikirana nawo. Musanagwiritse ntchito, botolo liyenera kugwedezeka kuti zomwe zili mkati mwake zithe.

Watsopano omwe akhala akuchita insulin amasiyanitsidwa ndi kutalika kwa zotsatira ndi kapangidwe kake. Agawidwa m'magulu awiri:

• zofanana ndi mahomoni amunthu,
• zoyambira nyama.

Zoyambazo zimapezeka kuchokera kapamba wama ng'ombe ndipo zimalekeredwa bwino ndi 90% ya odwala matenda ashuga. Ndipo zimasiyana ndi insulin ya chilengedwe chanyama pokhapokha mwa ma amino acid. Mankhwalawa ndi okwera mtengo kwambiri, koma kukhala ndi zabwino zambiri :

• kuti mupeze kuchuluka kwa achire kwambiri, kukhazikitsa milingo yaying'ono ndikofunikira,
• lipodystrophy pambuyo makonzedwe awo amawonedwa pafupipafupi,
• Mankhwalawa samayambitsa zotsatira zoyipa ndipo angagwiritsidwe ntchito mosavuta kuwongolera shuga m'magazi a omwe ali ndi matendawa.

Nthawi zambiri, anthu osazindikira odwala matenda ashuga osavomerezeka amangoima m'malo mwa mankhwala omwe amangotenga nthawi yayitali. Koma ndizosatheka kuchita izi. Kupatula apo, iliyonse mwa mankhwalawa imagwira ntchito yake. Chifukwa chake, pofuna kusinthitsa shuga m'magazi ndikuyenda bwino, palibe chifukwa chomwe mungasinthire mosamalitsa chithandizo. Dokotala yekha ndiye ayenera kuchita izi.

Kubwereza mwachidule

Mankhwala osokoneza bongo, omwe mayina awo adzafotokozeredwe pansipa, sayenera kugwiritsidwa ntchito popanda kulandira dokotala! Kugwiritsa ntchito molakwika kumabweretsa zotsatirapo zoyipa kwambiri.

Mankhwala chikuyendetsedwera, osapitirira 1 nthawi patsiku. Ndikulimbikitsidwa kupereka jakisoni pogona nthawi yomweyo. Kugwiritsa ntchito Basaglar nthawi zambiri kumakhala limodzi ndi mawonekedwe a mavuto mwa zomwe ambiri ndi:

• chifuwa
• kutupa kwa m'munsi m'munsi ndi kumaso.

Ichi ndi chimodzi mwa mankhwala abwino kwambiri, omwe ndi analogue a insulin ya anthu. 90% ya odwala amaloledwa bwino. Mwa odwala matenda ashuga okha, kugwiritsidwa ntchito kwake kumawonetsa kuyipa kwa matupi awo sagwirizana ndi lipodystrophy (omwe amagwiritsidwa ntchito kwa nthawi yayitali).

Tresiba ndi insulin yokhala ndi nthawi yayitali yomwe imatha kuyendetsa shuga m'magazi mpaka maola 42. Mankhwalawa amaperekedwa kamodzi pa tsiku nthawi yomweyo. Mlingo wake umawerengedwa aliyense payekha.

Kutalika kwa mankhwalawa kwa mankhwalawa kumachitika chifukwa chakuti omwe amapanga amathandizira pakuwonjezera insulin ndi maselo amthupi komanso kuchepa kwa chiwonetsero cha zinthuzi ndi chiwindi, zomwe zimapangitsa kutsika kwakukulu kwa shuga m'magazi.

Koma chida ichi chili ndi zovuta zake. Akuluakulu okha ndi omwe amatha kugwiritsa ntchito, ndiye kuti, imaphatikizidwa kwa ana. Kuphatikiza apo, kugwiritsidwa ntchito kwake pochiza matenda ashuga sikungatheke mwa azimayi panthawi yoyamwa, chifukwa izi zimatha kusokoneza thanzi la mwana wosabadwa.

Ndi analogue of insulin ya anthu. Imayendetsedwa mosavuta, nthawi imodzi patsiku limodzi.Imayamba kugwira ntchito 1 ola limodzi pambuyo pa utsogoleri ndipo imagwira ntchito kwa maola 24. Ali ndi analogue - Glargin.

Chodabwitsa cha Lantus ndikuti chitha kugwiritsidwa ntchito pazaka zopitilira 6. Mwambiri, kulekerera bwino. Okha odwala matenda ashuga okha ndi omwe amapangitsa kuti thupi liziganiza, kutupira, komanso kufooka kwa milomo.

Pofuna kupewa kukula kwa lipodystrophy ndikugwiritsa ntchito mankhwalawa kwa nthawi yayitali, tikulimbikitsidwa kusintha tsamba la jekeseni. Mutha kuzichita m'mapewa, ntchafu, m'mimba, matako, ndi zina zambiri.

Ndi sungunuka basal analogue wa insulin yamunthu. Zovomerezeka kwa maola 24, zomwe zimachitika chifukwa cha kudziyimira pawokha kwa mamolekyulu a insulir m'deralo la jakisoni ndikumangidwa kwa mamolekyulu a mankhwala kuti a albumin ndi unyolo wamafuta acid.

Mankhwalawa amaperekedwa pang'onopang'ono katatu patsiku, kutengera zosowa za wodwala. Zitha kupangitsanso kupezeka kwa lipodystrophy, chifukwa chake malo a jekeseni amayenera kusinthidwa nthawi zonse, ngakhale jakisoni atayikidwa m'dera lomwelo.

Kumbukirani kuti ma insulin omwe akhala akuchita kwa nthawi yayitali ndi mankhwala amphamvu omwe ayenera kugwiritsidwa ntchito mosamalitsa malinga ndi chiwembu, osaphonya nthawi ya jakisoni. Kugwiritsa ntchito mankhwalawa kumapangidwira ndi dokotala, komanso mlingo wawo.

Gwero lofunikira lamphamvu kwa anthu ndi chakudya chopatsa mphamvu, chomwe chimakhudzidwa ndimayendedwe ambiri m'maselo a thupi. Ngakhale zabwino zonse, zochulukirapo zimakhala ndi zovuta za metabolic zamitundu mitundu.

Zotsatira zake ndi kusintha kosasintha mu ziwalo zamkati ndi ntchito zomwe iwo amachita. Mkhalidwe wamoyo ukuipiraipira kwambiri, ndipo kukhazikitsidwa kwa zochitika za tsiku ndi tsiku kumakhala ntchito yosatheka. Mavuto omwewo amawonekera chifukwa chogwiritsa ntchito molakwika kapamba, m'malo ovuta.

Maselo a beta sangathe kutulutsa timadzi tambiri timagulu tambiri timene timayang'anira kuchuluka kwa shuga, poganizira miyambo yomwe imagwirizana ndi thupi. Akatswiri amatcha njirayi insulin.

Mankhwala omwe amapezeka ndi mtundu wina wa matenda a shuga omwe amadalira insulin, dokotala yemwe akupezekapo akhoza kukupatsani mankhwala a insulin omwe angokhala nthawi yayitali komanso mayankho a insulin, mayina ndi opanga omwe adzaperekedwe mu nkhaniyi.

Kwa ambiri, sichinsinsi kuti shuga, kusowa kwa timadzi timene timapangika mwachilengedwe kumaloŵedwa m'malo ndi fanizo. Masewera olimbitsa thupi, thupi, poyankha kuwonjezeka kwa shuga, mwachitsanzo, mutatha kudya, limapereka chisonyezo kwa kapamba kuti achepetse ndikamasula mahomoni.

Nthawi yomweyo, nthawi yonse yotsala (zakudya zakunja), thupi limasunthira lokha kuzunzidwa kofunikira. Mu shuga, munthu payekha amakakamizidwa kuti azisungabe izi pogwiritsa ntchito mankhwala.

Ndikofunikira. Mlingo woyenera wa mitundu yosiyanasiyana ya insulini amasankhidwa malinga ndi malingaliro omwe adotolo adatengera ndi zomwe wodwala akuonetsa, mbiri ya wodwala, mayeso a labotale, ndi moyo wawo.

Kugwira kwathunthu kwa kapamba mwa munthu wathanzi kumalola thupi kuyendetsa kagayidwe kazakudya nthawi yokhazikika masana. Komanso kuthana ndi katundu wamafuta mukamadya kapena njira zopatsirana ndi zotupa m'matenda.

Chifukwa chake, kuti tisungitse shuga m'magazi, timadzi timene timakhala ndi katundu wofanana, koma kuthamanga kwina, timafunikira. Tsoka ilo, pakadali pano, sayansi sinapeze yankho lavutoli, koma chithandizo chovuta ndi mitundu iwiri ya mankhwala monga insulin yayitali komanso yayifupi yakhala chipulumutso kwa odwala matenda ashuga.

Tebulo 1. Mndandanda wa mitundu yosiyanasiyana ya insulin:

Kuphatikiza pazomwe zili pamwambazi, palinso zinthu zina za insulin, ndiye kuti, kuyimitsidwa, komwe kumakhala ndi mahomoni onse awiri. Kumbali imodzi, izi zimachepetsa kwambiri kuchuluka kwa jakisoni wofunidwa ndi wodwala matenda ashuga, omwe ndi kuphatikiza kwakukulu. Komabe, pankhaniyi, ndikovuta kukhala ndi kagayidwe kazachilengedwe.

Pogwiritsa ntchito mankhwalawa, ndikofunikira kuyang'anira kuchuluka kwa chakudya chamafuta, zochitika zolimbitsa thupi. Ichi ndichifukwa chosatheka kusankha kuchuluka kwa mtundu wa insulin pakadali pano wofunikira.

Homoni yokhala nthawi yayitali

Nthawi zambiri, timadzi tambiri timene timayambira kumbuyo timatchulidwanso kuti maziko. Kudya kwake kumapereka thupi kwa insulin kwa nthawi yayitali.

Kuchuluka kwa minofu ya pang'onopang'ono ya adipose pang'onopang'ono, chinthu chogwira chimakuthandizani kukhalabe ndi malire masiku onse. Monga lamulo, zosaposa jakisoni katatu patsiku ndizokwanira izi.

Malinga ndi kutalika kwa nthawi, agawidwa m'mitundu itatu:

1. Kutalika kwapakati . Hormoni imayamba kugwira ntchito pambuyo pa 1.5 mawola ambiri atakhazikitsa mankhwala, motero, jekeseni pasadakhale. Poterepa, mphamvu ya thunthu limapezeka osakwana maola 3-12. Nthawi yodziwika kuchokera kwa wothandizirana pakati ndi kuyambira pa maola 8 mpaka 12, choncho, wodwala matenda ashuga ayenera kugwiritsa ntchito katatu katatu kwa maola 24.
2. Kuwonetsedwa nthawi yayitali. Kugwiritsa ntchito njira yamtunduwu kwakukhalitsa kwa ma horoni kungakupatseni chiyambi cha timadzi tambiri tomwe timatha kukhalabe ndi shuga tsiku lonse. Kutalika kwa kuchitapo kwake (maola 16-18) ndikokwanira pamene mankhwalawa amathandizira m'mimba popanda kanthu komanso madzulo asanagone. Mtengo wapamwamba kwambiri wa mankhwalawa ndi wa maola 16 mpaka 20 kuchokera nthawi yomwe umalowa m'thupi.
3. Wopatsa nthawi yayitali . Oyenera makamaka kwa okalamba ndi anthu olumala omwe amapatsidwa nthawi yayitali ya zinthu (maola 24 mpaka 36), ndipo, kutsika kwa kayendetsedwe ka kayendetsedwe kake (1 p. Mu maola 24). Kuchitikaku kumayambira maola a 6-8, ndi chiwonetsero chazinthu zambiri mkati mwa maola 16 mpaka 20 mutalowa mu minofu ya adipose.

Kutsatira mawonekedwe achilengedwe obisika a mahomoni pogwiritsa ntchito mankhwala osokoneza bongo. Tsoka ilo, ndizosatheka kukwaniritsa zowonetsa bwino pogwiritsa ntchito mtundu umodzi wokha wamtundu wokhala ndi ma hormone. Ichi ndichifukwa chake ma insulin osakhalitsa sakhala ofunikira kwenikweni.

Ma ehoni ofulumira

Dzinalo la mtundu uwu wa mahomoni limadzilankhulira lokha.

Mosiyana ndi mankhwala omwe akhala akugwira ntchito kwa nthawi yayitali, omwe amafupikitsidwa amapangidwa kuti abwezere kuthamanga kwa glucose m'thupi chifukwa cha zinthu monga:

• kudya
• kuchita masewera olimbitsa thupi mopitirira malire
• kukhalapo kwa njira zopatsirana ndi zotupa,
• kupsinjika kwakukulu ndi zinthu.

Kugwiritsa ntchito zakudya zamagulu mu chakudya kumawonjezera chidwi chawo m'magazi ngakhale akumamwa insulini yayikulu.

Pofika nthawi yayitali, mahomoni ochita zinthu mwachangu amagawidwa m'magulu awiri:

1. Mwachidule. Kukonzekera kwanthaŵi yochepa ya insulin pambuyo pa makonzedwe kumayamba kugwira ntchito pasanathe mphindi 30-60. Kukhala ndi chiwopsezo chokwera kwambiri, nsonga ya kukhathamira kopambana imakwaniritsidwa patatha maola 2-4 mutatha kumwa. Malinga ndi kuyerekezera kwapakati, zotsatira za mankhwalawa sizimatha maola opitilira 6.
2. Ultrashort insulin. Analogue yosinthidwa iyi ya mahomoni amunthu ndiwosiyana ndi ena chifukwa amatha kuchita zinthu mwachangu kuposa insulin. Pakadutsa mphindi 10 mpaka jakisoni, chinthu chogwira ntchito chikuyamba kugwira ntchito pakhungu ndipo chimatuluka patadutsa maola atatu jakisoni atayamba kubayidwa. Zotsatira zimatha kwa maola 3-5. Kuthamanga komwe njira yothetsera mankhwala a ultrashort imalumikizidwira m'thupi, kumakulolani kuti mumwe musanadye kapena mutangomaliza kumene.

Ndikofunikira.Kukhazikika kwa zochita za wodwala matenda ashuga kuyenera kuyenderana ndi nthawi ya chimbudzi cha chakudya ndi mayamwidwe a chakudya kuchokera pamenepo. Nthawi ya kukhazikitsidwa kwa mankhwalawa, poganizira mtundu wa insulin ndi katundu wa thupi ndi chakudya chamagulu, muyenera kuvomerezana.

Kusankhidwa kwa hormone yoyenera kugwiritsidwa ntchito kumangokhala payekha, monga momwe zimakhalira pa mayeso a labotale, kuchuluka kwa matenda a munthu wodwala matenda ashuga, mbiri yathunthu, moyo wawo. Chosafunikira kwenikweni ndi mtengo wa mankhwalawo, chifukwa cha momwe amagwiritsidwira ntchito. Monga lamulo, iwo umachulukana mosiyanasiyana molingana ndi zovuta za kupanga kwa mankhwala, dziko lopangira, kulongedza.

Zomwe zimachitika posankha insulin. Mankhwala otchuka kwambiri

Kuchokera pazomwe zili mu gawo lapitalo la nkhaniyi, zikuwonekeratu kuti insulin yochepa ndiyani, koma osati nthawi yokhayo ndi kuthamanga kwake ndikofunikira. Mankhwala onse ali ndi mawonekedwe awo, analogue ya human pancreatic hormone sichili choncho.

Mndandanda wazinthu zamankhwala omwe muyenera kulabadira:

• gwero la chiphaso
• digiri ya kuyeretsa
• kusamalira
• pH ya mankhwalawa
• wopanga ndi kusakaniza katundu.

Chifukwa chake, mwachitsanzo, analogue ya komwe nyama zimapangidwa ndikuchiritsa kapamba wa nkhumba ndikuyeretsa. Mankhwala opangidwa ndi theka, nyama zomwezi zimatengedwa ngati maziko ndipo pogwiritsa ntchito njira ya kusintha kwa enzymatic, insulin imapezeka pafupi ndi zachilengedwe. Tekinoloje izi nthawi zambiri zimagwiritsidwa ntchito ngati timadzi tambiri.

Kupanga mainjiniya kwapangitsa kuti zibwererenso maselo enieni a insulin yaumunthu omwe amapangidwa kuchokera ku Escherichia coli ndi kusintha kwasinthidwe. Ma mahormoni a Ultrashort nthawi zambiri amatchedwa amunthu.

Zovuta kwambiri kupanga zothetsera zimayeretsedwa kwambiri (chopanga-mono). Zopanda zodetsa zambiri, ndizochulukirapo ndipo zimachepetsa zolakwika chifukwa zimagwiritsidwa ntchito. Chiwopsezo cha mawonekedwe awomwe amagwiritsidwa ntchito pogwiritsa ntchito analogue ya hormone imachepetsedwa.

Kukonzekera kwa njira zosiyanasiyana zopangira, mitengo yowonekera, mafakitale, mitundu, ikhoza kuyimiridwa ndi kutsata kosiyanasiyana. Chifukwa chake, gawo lomwelo la insulin ingagwiritsidwe ntchito syringe.

Kugwiritsa ntchito mankhwala osokoneza bongo acidity ndikwabwino, izi zimapewa kusapeza bwino pa malo a jekeseni. Komabe, mtengo wa ndalama zotere umakhala wokwera kwambiri kuposa acidic.

Popeza kunja, sayansi ili patsogolo kwambiri pa sayansi yam'nyumba, ndizovomerezeka kuti makhwala ochokera kumayiko otukuka ndiwabwino komanso othandiza. Katundu wofunikira kuchokera kwa opanga odziwika ndiwotsika mtengo kwambiri.

Ndikofunikira. Chofunika kwambiri pakulimbitsa mankhwala a insulin si dziko lomwe limapangidwira, momwe mankhwalawo amagwiritsidwira ntchito ndi kugwiritsidwa ntchito kwawo pogwiritsa ntchito mahomoni atali ndi aafupi.

Mankhwala otchuka kwambiri achidule achidule

Popeza kuti chamoyo chilichonse chimachita chilichonse payokha ndipo chiwopsezo cha mankhwala a mtundu winawake chimatha kukhala chosiyana. Pogwiritsa ntchito regimen ya insulin, momwe mankhwalawa amathandizidwa katatu patsiku musanadye, odwala matenda ashuga nthawi zambiri amagwiritsa ntchito mayina amafupikidwe a insulin, omwe amaperekedwa pagome.

Tebulo Na. 2. Mndandanda wa othandizira odwala matenda a shuga nthawi zambiri amauza akatswiri.

Dzinalo	Kufotokozera
	Insulin ya biosynthet yaumunthu yomwe imapezeka ndi ma genetic engineering njira. Yogwira pophika: hormone yothetsera vuto la mono-ofanana ndi anthu. Amagwiritsidwa ntchito ngati 1 matenda ashuga, komanso kukana kukonzekera piritsi ndi matenda a shuga a 2.
	Human recombinant semisynthet insulin, ilibe gawo la acidity. Wopanga dziko Ukraine.
	Ndibwino kuti mukuwerenga Mankhwala okhala ndi majini okhala ndi zinthu zina zomwe zimayambitsa matenda a shuga. Anthu (DNA - recombinant). Dziko lopanga France.
	Kukonzekera kwa nyama ya nkhumba pakamagwiritsidwa ntchito, komwe kumatha kusakanikirana ndi kukonzekera kwakanthawi kokhala ndi protamine sulfate monga depot kupanga chinthu.
	Makina osinthira amtundu wa anthu amasinthidwa chifukwa cha ukadaulo wa DNA. Nthawi zambiri, analogi ya insulin yaumunthu imapangidwa mu 40/100 IU, m'mabotolo kapena makatoni ogwiritsira ntchito zolembera. Pafupifupi njira zonse zamakono za gulu la insulin zimakhala ndi zotsutsana pang'ono kuposa zomwe zimakhalapo kale. Ambiri aiwo amaloledwa kugwiritsidwa ntchito pa nthawi yoyembekezera komanso mkaka wa m'mawere. Ndikofunikira. Ndikofunika kugwiritsa ntchito mosamala ndi insulin yochepa komanso mapiritsi, jakisoni, ndi mankhwala ena. Ena mwaiwo amatha kuchepetsa kapena kuwonjezeranso mavuto a antidiabetes. Ndikofunikira kufunsa katswiri ndikuphunzira mosamala gawo la malangizidwe pazokhudzana ndi mankhwala ena. Kukonzekera kwa Ultrashort Ngakhale kuti insulin yotsalira-yayifupi idapangidwa kuti ikhale thandizo ladzidzidzi la kudumpha kwa glucose, ndikuchotsa munthu ku vuto la hyperglycemic, tsopano imagwiritsidwa ntchito pochizira insulin. Pakadali pano, ziyeso zamankhwala zamalizidwa kumaliza ndi mahomoni atatu okonzekera zomwezo. Tebulo No. 3. Mndandanda wa antidiabetic othandizira ma ultrashort. Dzinalo Kufotokozera Recombinant insulin (lispro) imayamwa kwambiri, chifukwa imagwira mwachangu kuposa momwe timadzi timapangidwira mwachilengedwe. Wopanga France. Biotechnologically adapanga recombinant analogue ya insulin ya anthu (aspart). Zimawonjezera kuyendetsa shuga kwa intracellular. Kupanga Denmark. Insulin gluisin ndi insulin yowonjezereka ya anthu, mphamvu yake yomwe imafanana ndi mahomoni opangidwa mwachilengedwe. Kupanga France. Asanalange jakisoni wocheperako, munthu ayenera kuwerengera ndikuwongolera kuchuluka kwa chakudya chomwedwa ndi chakudya pasadakhale. Izi ndichifukwa choti mlingo wowerengera wa yankho umaperekedwa kwa mphindi 30 mpaka 40 musanadye. Nthawi zambiri, odwala matenda ashuga omwe amakhala ndi ndandanda yoyendayenda yomwe kumakhala kovuta kuneneratu nthawi yakudya pasadakhale amavutika kuwongolera kagayidwe kazakudya. Sizovuta kwa makolo a ana omwe ali ndi matenda ashuga. Mwana akakhala kuti alibe chakudya chokwanira kapena ngati mwanayo wakana kudya, pang'onopang'ono insulin imadzakhala yochuluka, zomwe zingayambitse matenda oopsa a hypoglycemia. Mankhwala othamanga kwambiri a gulu la ultrashort ndi abwino chifukwa amatha kutengedwa nthawi yomweyo ndi chakudya kapena pambuyo pake. Izi zimapangitsa kuti athe kusankha bwino mankhwalawa pakadali pano. Ndikofunikira. Hypoglycemia ilinso yovutanso kuposa kukwera kwakuthwa kwa shuga m'magazi. Kuperewera kwa glucose kumayambitsa kuwonongeka kwa maselo amafuta kuti apange mphamvu, zomwe zimayambitsa poizoni chifukwa chodzikundikira matupi a ketone. Tiyenera kudziwa kuti mainjiniya a sayansi ndi majini samayimilira. Asayansi akusintha ndikusintha mankhwala omwe alipo, ndikupanga mitundu yatsopano komanso yosinthika kutengera iwo. Mitundu yosiyanasiyana ya mapampu a insulini ayamba kutchuka, kukulolani kuti mukhale ndi moyo wakhama wosapeza bwino chifukwa cha jakisoni. Chifukwa cha izi, moyo wa anthu omwe amadalira insulin akuchulukirachulukira. Zida zamakanema zimakupatsani mwayi wowona bwino momwe mungagwiritsire ntchito mankhwalawa. Makampani opanga mankhwala amapanga mitundu yambiri ya mankhwala a mahomoni kuti athandizire shuga. Chimodzi mwa izo ndi insulin yochepa.Imatha kusintha matenda a shuga mwa odwala omwe ali ndi matenda osokoneza bongo nthawi yochepa, zomwe zimapangitsa kukhala chida chofunikira kwambiri. Lingaliro la insulin yochepa Insulin ikangoyambitsidwa, imasungunuka ndipo imasinthasintha mwachangu njira za metabolic zomwe zimagwirizanitsidwa ndi kuyamwa kwa shuga. Mosiyana ndi mankhwala omwe akhala akuchita kwa nthawi yayitali, amakhala ndi yankho loyera la mahomoni popanda zowonjezera zina. Kuchokera ku dzinalo ndizodziwikiratu kuti akatha kuyambitsa, amayamba kugwira ntchito mwachangu, ndiye kuti, kwakanthawi kochepa amatsitsa shuga. Koma panthawi imodzimodziyo, amasiya kuchitapo kanthu mwachangu kuposa mankhwala omwe amakhala ndi nthawi yayitali pochita, monga momwe tikuwonera pachitsanzo chotsatira: Kodi insulin yamtunduwu imalembedwa liti? Zovala zazifupi zimagwiritsidwa ntchito zokhazokha kapena kuphatikiza ndi mahomoni okhala ndi nthawi yayitali. Amaloledwa kulowa mpaka 6 pa tsiku. Nthawi zambiri, amawalemba ngati: njira yotsitsimutsa chosafunikira thupi insulin, othandizira opaleshoni zophulika matenda a shuga - ketoacidosis. Kodi insulin yayifupi imagwira ntchito mpaka liti? Ndi subcutaneous makonzedwe, mphamvu yayitali kwambiri ya mankhwalawa imawonedwa, yomwe imachitika pakadutsa mphindi 30 mpaka 40, nthawi yomwe chimbudzi cha chakudya chodyedwa chimachitika. Mutatha kumwa mankhwalawa, nsonga ya insulin imatheka pambuyo pa maola awiri ndi atatu. Kutalika kumatengera mlingo womwe umaperekedwa: ngati ma 4 UNITS - 6 UNITS, nthawi yodziwika bwino ndi pafupifupi maola 5, ngati 16 mayunitsi kapena kupitilira apo, itha kufika maola 6-8. Pambuyo pakutha kwa chochitikacho, mankhwalawa amachotsedwa m'thupi ndi mahomoni olimbana ndi mahomoni. Mitundu ya insulin yofatsa Pali zokonzekera zambiri za insulin zomwe zimakhalapo mwachidule, zomwe mankhwalawa omwe amapezeka pagome ndi otchuka kwambiri: Zosindikizidwa zomwe zalembedwazo zimawoneka ngati zomangamanga pamtundu wa anthu, kupatula Monodar, womwe umatchedwa nkhumba. Amapezeka mu mawonekedwe a njira yosungunuka mumbale. Zonse zimapangidwa kuti athandize odwala matenda amtundu wa 1 komanso a 2 matenda ashuga. Nthawi zambiri zotchulidwa musanayambe mankhwala. Mankhwala sanaperekedwe kwa azimayi oyembekezera komanso oyembekezera, chifukwa mtunduwu wa insulini sunalowe m'matumbo ndi mkaka wa m'mawere. Ultra Wotenga Nthawi Ya Insulin Izi ndi zomwe zapangidwa posachedwapa mu pharmacology. Amasiyana ndi mitundu ina yonse monga momwe zimakhalira nthawi yomweyo, ndikupanga shuga m'magazi. Mankhwala odziwika bwino ndi awa: Mankhwalawa ndi fanizo la munthu la munthu. Ndiwothandiza panthawi yomwe muyenera kudya, koma kuchuluka kwake sikudziwika, pakakhala zovuta kudziwa kuchuluka kwa insulin yokumba. Mutha kudya kaye, kenako kuwerengera ndi kumwa mankhwalawo. Popeza zochita za insulin ndizothamanga, chakudya sichikhala ndi nthawi yokwanira. Insulin iyi ya ultrashort idapangidwa kuti izigwiritsidwa ntchito pamene anthu omwe ali ndi matenda ashuga amaswa zakudya zawo ndikudya maswiti ambiri kuposa omwe adalimbikitsa. Nthawi zambiri muzochitika zotere mumakhala kuchuluka kwambiri kwa shuga, komwe kumatha kubweretsanso thanzi. Kenako mankhwalawa atha kuthandiza. Nthawi zina, pomwe wodwala sangathe kudikirira kwa mphindi 40, ndikulakwira chakudyacho kale, inshuwaransi yamtunduwu ikhoza kuphatikizidwanso. Insulin yotereyi sikuti imaperekedwa kwa odwala omwe amatsatira malamulo onse azakudya. Nthawi zambiri, ngati ambulansi yokha yolumphira shuga. Sipakhudzidwa mu amayi apakati omwe ali ndi matenda a shuga. Amaloledwa kugwiritsidwa ntchito, ngakhale pali toxosis ya mimba. Phindu la ultrashort insulin ndikuti: muchepetse kuchuluka kwa shuga m'magazi usiku, makamaka kumayambiriro kwa kutenga pakati, thandizirani kusintha matendawa msanga mwa mayi woyembekezera panthawi ya cesarean, kuchepetsa chiopsezo cha zovuta mukatha kudya. Mankhwalawa ndi othandiza kwambiri mwakuti amatha kusinthitsa shuga pakanthawi kochepa, pomwe mankhwalawa amathandizidwa pang'ono, omwe amathandiza kupewa zovuta zingapo. Kuwerengera kuchuluka kwa zakudya zomwe zimamwa Mlingo umodzi wothandizirana ndi insulin mwachidule samangotengera kuchuluka kwa shuga m'magazi, komanso zakudya zomwe zimamwa. Chifukwa chake, pakuwerengera nkoyenera kuganizira mfundo zotsatirazi: Chiyeso cha chakudya chamoto ndi magawo a buledi (XE). Chifukwa chake, 1 XE = 10 g shuga, Pa XE iliyonse muyenera kulowa gawo limodzi la insulin. Kuti muwerengedwe molondola kwambiri, tanthauzo lake limagwiritsidwa ntchito - 1 unit ya insulin imachepetsa mahomoni ndi 2.0 mmol / l, ndi 1 XE ya chakudya chamafuta imakwera ku 2.0 mmol / l, kotero pa 0.28 mmol / l iliyonse yomwe imaposa 8, 25 mmol / l, 1 unit ya mankhwala imayendetsedwa, Ngati chakudyacho chilibe chakudya, kuchuluka kwa mahomoni m'magazi sikukwera. Mawerengero Achitsanzo : Ngati mulingo wa glucose ndi 8 mmol / l musanadye, ndipo zakonzedwa kuti mudye 20 g ya chakudya chama carbohydrate kapena 2 XE (+4.4 mmol / l), ndiye kuti mutadya shuga mutha kufika pa 12,4, pomwe zizolowereka 6. Chifukwa chake, ndikofunikira kuyambitsa magawo atatu a mankhwalawa kotero kuti index ya shuga igwere ku 6.4. Mulingo woyenera wa osakwatira Mlingo uliwonse wa insulin umasinthidwa ndi adotolo, koma sayenera kukhala apamwamba kuposa ma PIECES, omwe amawerengedwa pa kilogalamu imodzi ya kuchuluka kwake. Uwu ndiye mlingo waukulu. Mankhwala osokoneza bongo amatha kubweretsa zovuta. Nthawi zambiri, dokotala amatsatira malamulo otsatirawa: Ngati matenda a shuga a mtundu woyamba wangopezedwa kumene, muyezo wosaposa 0,5 / kg mankhwala. Ndikulipirira kwabwino chaka, mankhwalawa ndi 0.6 U / kg. Ngati kusakhazikika kumawonedwa mu mtundu 1 wa shuga, shuga amasinthasintha, ndiye kuti 0,7 U / kg amatengedwa. Ndi matenda a shuga ophatikizika, mlingo ndi 0.8 IU / kg. Ndi ketacidosis, 0,9 U / kg amatengedwa. Ngati pakati mu trimester yomaliza ndi mayunitsi 1.0 / kg. Momwe mungabayitsire insulin yochepa? (kanema) Mitundu yonse ya insulini nthawi zambiri imayendetsedwa chimodzimodzi asanadye. Ndikulimbikitsidwa kuti musankhe madera amthupi la munthu pomwe mitsempha yayikulu ya magazi siyidutsa, pali ma amana amafuta ochepa. Ndi makonzedwe a venous, zochita za insulin zidzakhala nthawi yomweyo, zosavomerezeka pamankhwala amasiku onse. Chifukwa chake, kuyamwa kwa mankhwalawa kumalimbikitsidwa, zomwe zimapangitsa kuti mayendedwe a insulin ayambe kulowa m'magazi. Mutha kusankha pamimba, koma osasuntha mkati mwa masentimita 6 kuchokera ku navel. Pamaso pa jekeseni, muyenera kutsuka malowa ndikusamba m'manja ndi sopo ndikuuma. Konzani chilichonse chomwe chikufunika munjira yake: syringe yotayidwa, botolo lokhala ndi mankhwala komanso pedi. Onetsetsani kuti mwamaliza bwanji! Chotsani kapu ku syringe, ndikusiya kapu ya mphira. Chitani ndi singano ndi mowa ndikuyika mosamala mu botolo ndi mankhwala. Sonkhanitsani kuchuluka kwa insulin. Tulutsani singano ndikutulutsa mpweya, kutsogoza wopondayo mpaka dontho la insulin lithe. Ndi chala chachikulu ndi chofiyira, tengani kachikopa kakang'ono. Ngati subcutaneous mafuta wosanjikiza ndi wandiweyani, ndiye kuti timayambitsa singano pamakona madigiri 90, ndi yopyapyala - singano ndiyofunika kupendekeka pang'ono pakona madigiri 45. Kupanda kutero, jekeseni sangakhale wosinjirira, koma wamitsempha. Ngati wodwalayo alibe kulemera kwambiri, ndibwino kugwiritsa ntchito singano yopyapyala komanso yaying'ono. Pang'onopang'ono komanso bwino insulin. Kuthamanga kuyenera kumayendera yunifolomu pakukonzekera. Syringe ikapanda kanthu, chotsani singano yomweyo pansi pa khungu ndikumasula khola. Ikani kapu yoteteza pa singano ya syringe ndikuitaya. Simungathe kumangodandaula malo omwewo, ndipo mtunda kuchokera pa jakisoni wina kupita kwina uyenera kukhala wa masentimita awiri. Kupanda kutero, kuphatikizika kwamafuta kumatha kuchitika. Kuchuluka kwa mahomoni kumadalira kusankha malo.Mofulumira kuposa zonse, insulin imatengedwa kuchokera kukhoma lakutsogolo kwa m'mimba, kenako mapewa ndi matako, ndipo pambuyo pake kuchokera kutsogolo kwa ntchafu. Ndikofunika kubayira m'mimba, kuti chochitikacho chichitike mwachangu akangodya. Kuti mudziwe zambiri zamomwe mungagwiritsire ntchito kupatsa insulin, onani nkhani iyi kapena kanema wotsatira: Pomaliza, ndikofunikira kudziwa kuti simungathe kusankha nokha mankhwala osankha mwachidule, kusintha mlingo wake popanda mankhwala a dokotala. Ndikofunikira kukhazikitsa, pamodzi ndi endocrinologist, dongosolo la kayendetsedwe kake malinga ndi regimen ndi kuchuluka kwa chakudya chomwe chimatengedwa. Ndikofunika kuti musinthe nthawi zonse jakisoni, sungani bwino mankhwalawo, onani masiku omwe atha. Ndipo pakusintha pang'ono komanso zovuta, funsani dokotala. Kukonzekera mwachidule za insulin Ma insulin omwe amagwira ntchito mwachidule amakhala osungunuka ndipo amatha kusintha mwachangu momwe kagayidwe kachakudya mthupi la munthu kamalumikizana ndi mayamwidwe a glucose. Mosiyana ndi ma insulin omwe amakhala nthawi yayitali, kukonzekera kwakanthawi kwamahomoni kumakhala ndi njira yofananira yokhala ndi mahomoni omwe mulibe zowonjezera zina. Chowoneka mosiyanitsa ndi mankhwalawa ndikuti amayamba kugwira ntchito mwachangu ndipo m'nthawi yochepa amatha kutsitsa shuga m'magazi kuti akhale abwinobwino. Zochita zake zapamwamba za mankhwalawa zimawonedwa pafupifupi maola awiri pambuyo pokhazikitsa, ndiye kuti pakukula kwakeko mwachangu. Pambuyo maola asanu ndi limodzi m'magazi pamakhala zinthu zochepa zomwe zimayendetsedwa ndi mahomoni. Mankhwalawa amawagawa m'magulu otsatirawa kutengera nthawi yomwe akuchita: Ochita zinthu mwachidule amaika ntchito mphindi 30 pambuyo pa kutsata. Amalimbikitsidwa kuti asatengedwe pasanathe theka la ola musanadye. Ultrashort amaika inshuwaransi yomwe imayamba kugwira ntchito patatha ola limodzi. Mankhwalawa amalimbikitsidwa kumwa pafupifupi mphindi 5 mpaka 10 asanadye kapena atangodya. Pa tebulo pansipa, kufanizira, kufunika kwa kuthamanga ndi kutalika kwa zochita zamitundu mitundu yamahisitala amakhudzidwa. Mayina a mankhwalawa amaperekedwa mosasamala, popeza pali mitundu yayikulu ya mitundu yawo. Zinthu zazifupi ndi insulin Insulin yochepa ndi mankhwala oyera a mahomoni omwe amapangidwa m'njira ziwiri: kutengera insulin ya nyama (porcine), kugwiritsa ntchito biosynthesis pogwiritsa ntchito ma genetic engineering technology. Zonsezi, ndi njira ina zomwe zimafanana kwathunthu ndi mahomoni amunthu wachilengedwe, chifukwa chake zimakhala ndi kuchepetsa shuga. Mosiyana ndi mankhwala omwe akhala akugwiritsidwa ntchito kwa nthawi yayitali, alibe zinthu zina zilizonse zowonjezera, chifukwa chake sizimayambitsa zovuta zilizonse. Kukhalabe ndi shuga yabwinobwino mwa odwala omwe ali ndi matenda a shuga, ma insulin osakhalitsa, omwe amaperekedwa pafupifupi theka la ola musanadye, nthawi zambiri amagwiritsidwa ntchito. Ndikofunikira kumvetsetsa kuti wodwala aliyense ali ndi mawonekedwe ake a thupi, chifukwa chake, kuwerengera kwa kuchuluka kwa mankhwalawa kumachitika nthawi zonse ndi dokotala. Kuphatikiza apo, ndikofunikira kuti kuchuluka kwa zakudya zomwe zimatengedwa ndizofanana ndi mlingo wa insulin. Malamulo oyambira kuperekera mankhwala a mahomoni musanadye motere: Kuti mupeze jakisoni, mufunika kugwiritsa ntchito syringe yapadera yokha ya insulin, yomwe imakulolani kuti mupeze mlingo wokhazikika womwe adokotala adapereka. Nthawi yoyang'anira iyenera kukhala yokhazikika, ndipo tsamba la majakisidwe liyenera kusinthidwa. Malo omwe jakisoniyo anapangidwira silingakonzedwenso, chifukwa momwe mayikidwe achilengedwe a mankhwalawo m'magazi ayenera kukhala osalala. Ultrashort insulin ndi analogue yosinthika ya insulin ya anthu, izi zikufotokozera kuthamanga kwazotsatira zake.Mankhwalawa adapangidwa ndi cholinga chothandizidwa mwadzidzidzi kwa munthu yemwe wakumanapo ndi shuga m'magazi pazifukwa zosiyanasiyana. Ichi ndichifukwa chake sagwiritsidwa ntchito kawirikawiri pachipatala chovuta kwambiri cha matenda ashuga. Jakisoni wa insulin ya ultrashort imalimbikitsidwanso panthawi yomwe munthu alibe mwayi woti adikire kwakanthawi asanadye. Koma pazikhalidwe zokhala ndi zakudya zoyenera, mankhwalawa samalimbikitsidwa kuti atengedwe, chifukwa chakuti imatsika kwambiri chifukwa chochokera pamtengo wambiri, kotero ndizovuta kwambiri kuwerengera mlingo woyenera. Kulimbitsa Thupi Ma insulin amfupi ndi a ultrashort amagwiritsidwa ntchito kwambiri masiku ano pomanga thupi. Mankhwala osokoneza bongo amawonedwa ngati othandizira kwambiri a anabolic. Chomwe chimagwiritsidwa ntchito pakupanga thupi ndikuti insulin ndi mahomoni oyendera omwe amatha kugwira glucose ndikupereka kwa minofu yomwe imayankha izi zikukula mwachangu. Ndikofunikira kuti othamanga azitha kugwiritsa ntchito mankhwala a mahomoni pang'onopang'ono, potero amazolowera thupi ku mahomoni. Popeza kukonzekera kwa insulini ndi mankhwala olimbitsa thupi mwamphamvu kwambiri, ndizoletsedwa kuwatengera ngati achinyamata othamanga. Katundu wamkulu wa insulin ndiye kunyamula zakudya. Koma nthawi imodzimodzi, mahomoni amachita ntchitozi mosiyanasiyana, monga: mu minofu ya minofu mu mafuta m'thupi. Pankhaniyi, ngati mankhwala a mahomoni atengedwa molakwika, ndiye kuti simungathe kupanga minofu yokongola, koma kuyipa koyipa. Tiyenera kukumbukira kuti mukamalandira mankhwalawa, kuphunzitsa kuyenera kukhala kothandiza. Pokhapokha pokhapokha, timadzi ta mayendedwe timatulutsa shuga ku minofu yotukuka. Kwa wosewera aliyense yemwe akuchita masewera olimbitsa thupi, mlingo umaperekedwa payekhapayekha. Amakhazikika pambuyo poyesa kuchuluka kwa shuga m'magazi ndi mkodzo. Pofuna kuti muchepetse kukula kwa mahomoni m'thupi lanu komanso kuti muchepetse kupanga kwa insulin ndi kapamba, ndikofunikira kupuma pomwa mankhwalawo. Mwasankha, sinthani nyengo ya miyezi iwiri ya kumwa mankhwalawo ndikupumula kwa miyezi inayi kuchokera pamenepo. Malamulo a kumwa mankhwala osokoneza bongo Popeza ma insulin amafupikitsa komanso a ultrashort omwe ali ndi mankhwala apamwamba ofanana ndi insulin yaumunthu, samayambitsa ziwengo. Koma nthawi zina zotsatira zosasangalatsa monga kuyabwa ndi kuwuma pamalo a jakisoni kumaonedwa. Tikulimbikitsidwa kuti ma horoni wothandizirana alowetse m'mimba m'mimba patangophunzitsidwa mphamvu. Muyenera kuyamba ndi Mlingo wocheperako ndipo nthawi yomweyo muyenera kuwunika momwe thupi limayambira. Pafupifupi kotala la ola pambuyo pa jakisoni, chinthu chokoma chiyenera kudyedwa. Chiŵerengero cha mafuta ogwiritsika ntchito kwa gawo lomwe mankhwalawo amaperekedwa ayenera kukhala 10: 1. Pambuyo pake, pambuyo pa ola limodzi muyenera kudya bwino, ndipo chakudyacho chizikhala ndi zakudya zomwe zili ndi mapuloteni ambiri. Mankhwala osokoneza bongo ochulukirapo a mankhwala osokoneza bongo kapena makonzedwe ake osayenera angayambitse matenda a hypoglycemic, omwe amalumikizidwa ndi kuchepa kwambiri kwa shuga m'magazi. Pafupifupi nthawi iliyonse mutatha kutenga ultrashort ndi insulin yochepa imayambitsa Hypoglycemia yofatsa. Imadziwulula ndi zizindikiro zotsatirazi: chizungulire ndi kudetsa khungu m'maso ndikusintha kwakuthwa kwamphamvu pamthupi, njala yayikulu mutu kugunda kwa mtima kutuluka thukuta kwambiri nkhawa yamkati ndi kukwiya. Pambuyo pakuwoneka chimodzi mwa izi Komanso chizindikiro cham'mbali cha hypoglycemia ndikochitika kwa chikhumbo chogona. Simungachite izi m'magulu, chifukwa mutha kukulitsa vutoli.Tiyenera kukumbukira kuti ndi mankhwala osokoneza bongo ambiri aifupi komanso a ultrashort, chikomokere chimatha kuchitika mwachangu kwambiri. Pofuna kutaya mtima ndi wothamanga, ndikofunikira kufunsa thandizo kuchipatala. Ubwino wawukulu pokonzekera insulin mukamagwiritsa ntchito polimbitsa thupi ndikuti sangathe kuyesedwa pamayeso oyeserera. Insulin yochepa komanso ya ultrashort ndi mankhwala otetezeka omwe sangawononge molakwika kugwira ntchito kwamkati mwa ziwalo zamkati. Chofunikanso ndichakuti mankhwala amatha kugula popanda mankhwala komanso mtengo wake, poyerekeza ndi anabolics ena, ndi wotsika mtengo. Chofunika kwambiri pakukonzekera insulini, koma chofunikira kwambiri nthawi yomweyo, ndikofunikira kuwatenga motsatira ndondomeko yomwe dokotala wakhazikitsa. Kwa munthu yemwe ali ndi vuto lalikulu la insulini ya mahomoni, cholinga cha mankhwalawa ndicho kubwereza kwaposachedwa kwambiri kwa katulutsidwe achilengedwe, koyamba komanso kolimbikitsidwa. Nkhaniyi ikufotokozerani za kusankha koyenera kwa mankhwala a basal insulin. Pakati pa odwala matenda ashuga, mawu akuti "ndikusintha ngakhale pang'ono" ndiwodziwika, chifukwa kumwa kwa insulin komwe kumakhalapo kwa nthawi yayitali kumafunikira. Insulin yayitali Kuti athe kutsanzira kubisala kwapansi, amagwiritsa ntchito insulin. Pa matenda ashuga a odwala matenda ashuga pali mawu awa: "Insulin yayitali" "Basic insulin", "Basal" Insulin yowonjezera "Insulin yayitali." Mawu onsewa amatanthauza - insulini wokhalitsa. Masiku ano, mitundu iwiri ya ma insulin omwe akhala akuchita kwa nthawi yayitali amagwiritsidwa ntchito. Insulin ya sing'anga nthawi - zake kumatenga mpaka maola 16: Biosulin N. Insuman Bazal. Protafan NM. Humulin NPH. Ultra-yaitali insulin - imagwira ntchito kwa maola opitilira 16: Levemir ndi Lantus amasiyana ndi ma insulini ena osati munthawi yawo yosiyana, komanso paziwonekero zakunja, pomwe gulu loyambirira la mankhwalawo limakhala ndi mtundu wa mitambo yoyera, ndipo asanakayimidwe amafunikira kuti agulidwe. Kusiyana kumeneku kumachitika chifukwa cha njira zingapo zopangira insulin, koma zina pambuyo pake. Mankhwala a nthawi yayitali yochitapo kanthu amawonedwa kuti ndiopendekera, ndiye kuti, momwe amagwirira ntchito, njira yosatchulika ikuwonekera, chifukwa cha insulin yochepa, komabe pali nsonga. Ma insulini okhala ndi nthawi yayitali amaonedwa kuti ndi opanda ntchito. Mukamasankha muyeso wa mankhwala oyambira, mawonekedwewo ayenera kukumbukiridwa. Komabe, malamulo apadera a insulini onse amakhalabe chomwecho. Zofunika! Mlingo wa insulin yomwe yakhalapo kwa nthawi yayitali iyenera kusankhidwa m'njira yoti shuga azikhala m'magazi pakati pa chakudya chokwanira. Kusinthasintha kakang'ono pamlingo wa 1-1.5 mmol / l ndikuloledwa. Mwanjira ina, ngati mulingo woyenera, shuga m'magazi sayenera kuchepetsedwa, kapena, kuwonjezera. Chizindikiro chiyenera kukhala chokhazikika masana. Ndikofunikira kufotokozera kuti jakisoni wa insulin yemwe wakhala akuchita nthawi yayitali amachitika m'tchafu kapena pakamwa, koma osati m'mimba ndi mkono. Iyi ndi njira yokhayo yoonetsetsa kuti mayamwidwe akunyowa. Insulin yomwe imagwira ntchito mwachidule imalowetsedwa kumkono kapena pamimba kuti ikwaniritse kwambiri, yomwe iyenera kugwirizana ndi nthawi yomwe chakudya chimalowa. Insulin yayitali - mlingo usiku Kusankha kwa mlingo wa insulin yayitali tikulimbikitsidwa kuti muyambe ndi mlingo wa usiku. Wodwala yemwe ali ndi matenda ashuga amayenera kuwunika momwe glucose amagazi usiku. Kuti muchite izi, maola atatu aliwonse ndikofunikira kuyeza miyezo ya shuga, kuyambira ola la 21 ndikutha ndi 6 mmawa tsiku lotsatira. Ngati imodzi mwazinthu zimasinthasintha kusintha kwa glucose mmwamba kapena, motsikira, kutsikira, izi zikuwonetsa kuti mlingo wa mankhwalawa udasankhidwa molakwika. Zoterezi, gawo lino lifunika kuwonedwa mwatsatanetsatane.Mwachitsanzo, wodwala amapita kutchuthi ndi shuga wa 6 mmol / L. Nthawi ya 24:00 chizindikirocho chimakwera kufika pa 6.5 mmol / L, ndipo nthawi ya 03:00 chimadzuka mwadzidzidzi kufika pa 8.5 mmol / L. Munthu amakumana ndi m'mawa ndi shuga wambiri. Zochitikazo zikuwonetsa kuti kuchuluka kwa insulin usiku sikokwanira ndipo mlingo uyenera kuwonjezeka pang'onopang'ono. Koma pali imodzi "koma"! Ndi kukhalapo kwa chiwonjezeko chotere (komanso chapamwamba) usiku, sizingatanthauze kuperewera kwa insulin nthawi zonse. Nthawi zina hypoglycemia imabisika pansi pa mawonekedwe awa, omwe amapanga mtundu wa "kubwezeretsanso", wowonetsedwa ndi kuchuluka kwa glucose m'magazi. Kuti mumvetsetse momwe amapangira shuga usiku, nthawi yolumikizira miyeso iyenera kutsitsidwa kwa ola limodzi, ndiye kuti, imayesedwa ola lililonse pakati pa 24:00 mpaka 03:00 h. Ngati kutsika kwa glucose kutsikira kwawonedwa m'malo ano, ndizotheka kuti uku kunali kugwada ”kozunguliridwa ndi kubweza. Pankhaniyi, mlingo wa insulin yofunika sayenera kuchuluka, koma kuchepetsedwa. Kuphatikiza apo, chakudya chomwe chimadyedwa patsiku chimakhudzanso kugwira bwino ntchito kwa insulin. Chifukwa chake, kuti tiwone molondola momwe insal insulin ilili, sipayenera kukhala ndi shuga komanso insulin yochepa m'magazi kuchokera ku chakudya. Kuti muchite izi, chakudya chamadzulo chisanachitike kuyeserera kuyenera kudumphidwa kapena kusinthidwa nthawi isanakwane. Pokhapokha chakudya ndi insulin yochepa yomwe imayambitsidwa nthawi yomweyo sizingasinthe tanthauzo la chithunzicho. Pazifukwa zomwezo, tikulimbikitsidwa kugwiritsa ntchito zakudya za chakudya chamadzulo zokha, koma osapatula mafuta ndi mapuloteni. Zinthu izi zimatengedwa pang'onopang'ono ndipo kenako zimatha kuwonjezera shuga, zomwe ndizosafunika kwambiri pakuwunika koyenera kwa insulin usiku. Insulin yayitali - tsiku lililonse Kuwona insulini ya basal masana kumakhalanso kosavuta, muyenera kumangokhala ndi njala pang'ono, ndikukhala ndi miyezo ya shuga ola lililonse. Njirayi ikuthandizira kudziwa kuti ndi nthawi yanji yomwe ikuwonjezeka, komanso momwe - kuchepa. Ngati izi sizingatheke (mwachitsanzo, mwa ana aang'ono), ntchito ya insulin yoyambirira iyenera kuwonedwa nthawi ndi nthawi. Mwachitsanzo, muyenera kudumphira chakudya cham'mawa kaye ndikuyamba kuyerekezera ola lililonse kuchokera nthawi yomwe mumadzuka kapena kuyambira nthawi yomwe mumalowa insulin ya tsiku ndi tsiku (ngati wina wamulembera) mpaka chakudya chamasana. Masiku angapo pambuyo pake, mapangidwewo amabwerezedwanso ndi nkhomaliro, ndipo ngakhale pambuyo pake ndi chakudya chamadzulo. Ma insulin ambiri omwe akhala akuchita kwa nthawi yayitali amayenera kuperekedwa kawiri pa tsiku (kupatula Lantus, amadzibaya kamodzi). Tcherani khutu! Zomwe zakonzedwa kale ndi insulin, kupatula Levemir ndi Lantus, zimakhala ndizobisalira, zomwe nthawi zambiri zimachitika patatha maola 6-8 mutabayidwa. Chifukwa chake, panthawiyi, pakhoza kukhala kuchepa kwa shuga, komwe mlingo wochepa wa "mkate" umafunikira. Pakusintha mlingo wa insulin ya basal, zonsezi zimalimbikitsidwa mobwerezabwereza. Mwachidziwikire, masiku atatu adzakhala okwanira kuti zitsimikizire zosunthira mbali imodzi kapena ina. Njira zinanso zikuchitidwa mogwirizana ndi zotsatira zake. Mukawunika insulini yatsiku ndi tsiku, pafupifupi maola 4 ayenera kudutsa pakati pa chakudya, moyenera 5. Kwa iwo omwe amagwiritsa ntchito insulin yayifupi m'malo mwa ultrashort, nthawi imeneyi imayenera kukhala yayitali (maola 6-8). Izi ndichifukwa cha zomwe insulini izi zimachita. Ngati insulin yayitali yasankhidwa molondola, mutha kupitiliza ndi kusankha insulin yayifupi. Gwero lofunikira lamphamvu kwa anthu ndi chakudya chopatsa mphamvu, chomwe chimakhudzidwa ndimayendedwe ambiri m'maselo a thupi. Ngakhale zabwino zonse, zochulukirapo zimakhala ndi zovuta za metabolic zamitundu mitundu. Zotsatira zake ndi kusintha kosasintha mu ziwalo zamkati ndi ntchito zomwe iwo amachita.Mkhalidwe wamoyo ukuipiraipira kwambiri, ndipo kukhazikitsidwa kwa zochitika za tsiku ndi tsiku kumakhala ntchito yosatheka. Mavuto omwewo amawonekera chifukwa chogwiritsa ntchito molakwika kapamba, m'malo ovuta. Maselo a beta sangathe kutulutsa timadzi tambiri timagulu tambiri timene timayang'anira kuchuluka kwa shuga, poganizira miyambo yomwe imagwirizana ndi thupi. Akatswiri amatcha njirayi insulin. Mankhwala omwe amapezeka ndi mtundu wina wa matenda a shuga omwe amadalira insulin, dokotala yemwe akupezekapo akhoza kukupatsani mankhwala a insulin omwe angokhala nthawi yayitali komanso mayankho a insulin, mayina ndi opanga omwe adzaperekedwe mu nkhaniyi. Kwa ambiri, sichinsinsi kuti shuga, kusowa kwa timadzi timene timapangika mwachilengedwe kumaloŵedwa m'malo ndi fanizo. Masewera olimbitsa thupi, thupi, poyankha kuwonjezeka kwa shuga, mwachitsanzo, mutatha kudya, limapereka chisonyezo kwa kapamba kuti achepetse ndikamasula mahomoni. Nthawi yomweyo, nthawi yonse yotsala (zakudya zakunja), thupi limasunthira lokha kuzunzidwa kofunikira. Mu shuga, munthu payekha amakakamizidwa kuti azisungabe izi pogwiritsa ntchito mankhwala. Ndikofunikira. Mlingo woyenera wa mitundu yosiyanasiyana ya insulini amasankhidwa malinga ndi malingaliro omwe adotolo adatengera ndi zomwe wodwala akuonetsa, mbiri ya wodwala, mayeso a labotale, ndi moyo wawo. Kugwira kwathunthu kwa kapamba mwa munthu wathanzi kumalola thupi kuyendetsa kagayidwe kazakudya nthawi yokhazikika masana. Komanso kuthana ndi katundu wamafuta mukamadya kapena njira zopatsirana ndi zotupa m'matenda. Chifukwa chake, kuti tisungitse shuga m'magazi, timadzi timene timakhala ndi katundu wofanana, koma kuthamanga kwina, timafunikira. Tsoka ilo, pakadali pano, sayansi sinapeze yankho lavutoli, koma chithandizo chovuta ndi mitundu iwiri ya mankhwala monga insulin yayitali komanso yayifupi yakhala chipulumutso kwa odwala matenda ashuga. Tebulo 1. Mndandanda wa mitundu yosiyanasiyana ya insulin: Kuphatikiza pazomwe zili pamwambazi, palinso zinthu zina za insulin, ndiye kuti, kuyimitsidwa, komwe kumakhala ndi mahomoni onse awiri. Kumbali imodzi, izi zimachepetsa kwambiri kuchuluka kwa jakisoni wofunidwa ndi wodwala matenda ashuga, omwe ndi kuphatikiza kwakukulu. Komabe, pankhaniyi, ndikovuta kukhala ndi kagayidwe kazachilengedwe. Pogwiritsa ntchito mankhwalawa, ndikofunikira kuyang'anira kuchuluka kwa chakudya chamafuta, zochitika zolimbitsa thupi. Ichi ndichifukwa chosatheka kusankha kuchuluka kwa mtundu wa insulin pakadali pano wofunikira. Zisonyezero zakudikirira Insulin imalembedwa kuti imasinthasintha kuchuluka kwa shuga m'magawo osiyanasiyana a shuga. Zowonetsa kugwiritsa ntchito mahomoni ndi mitundu yotsatirayi yamatendawa: Mtundu woyamba wa shuga wokhudzana ndi kuwonongeka kwa autoimmune ku maselo a endocrine komanso kukula kwa kuperewera kwathunthu kwa mahomoni, Mtundu Wachiwiri, womwe umadziwika ndi kusowa kwa insulini chifukwa cha chilema pakuphatikizika kwake kapena kuchepa kwa chidwi cha zotumphukira pazomwe zimachitika, matenda a shuga azimayi oyembekezera kapamba mawonekedwe a matendawa, omwe amayamba chifukwa cha pancreatitis yovuta kapena yopweteka, Mitundu yopanda chitetezo cha matenda - matenda am'magazi a Wolfram, Rogers, MODY 5, matenda a neonatal shuga ndi ena. Kuphatikiza pa kuchepa kwa shuga, kukonzekera kwa insulin kumakhala ndi mphamvu ya anabolic - amalimbikitsa kukula kwa minofu ndikupanga mafupa. Katunduyu amagwiritsidwa ntchito pomanga thupi. Komabe, mu malangizo omwe angagwiritsidwe ntchito, chizindikirochi sichinalembetsedwe, ndipo kuyendetsa mahomoni kwa munthu wathanzi kumawopseza kuponya kwakuthwa kwa magazi - hypoglycemia. Zinthu zoterezi zimatha kutsatiridwa ndi kusokonezeka kwa chikumbumtima ndi imfa. Makhalidwe a Fomu la Prandial Ma insandeni a Prandial amadziwika kuti awongolere shuga atatha kudya. Amakhala aafupi komanso a ultrashort ndipo amagwiritsidwa ntchito katatu patsiku musanadye kwambiri. Amagwiritsidwanso ntchito kuti achepetse kuchuluka kwa shuga ndikusunga katulutsidwe ka timadzi tambiri tokhala ndi mapampu a insulini. Mankhwala amasiyanasiyana munthawi yamayambiriro a zochita ndi nthawi yayitali. Zomwe zimapangidwira posachedwa ndi ultrashort zimaperekedwa pagome: Njira ya kagwiritsidwe ntchito ndi kuwerengera kwa mankhwala Insulin imagawitsidwa ku pharmacies kokha mwa mankhwala. Musanagwiritse ntchito mankhwalawa, muyenera kudziwa momwe amagwiritsidwira ntchito mankhwalawa. Mankhwala amapangidwa mwanjira yothanirana ndi mavutidwe omwe amaphatikizidwa ndi minofu yaying'ono. Pamaso jakisoni wa prandial insulin, ndende ya glucose imayesedwa pogwiritsa ntchito glucometer. Ngati shuga ali pafupi ndi chizolowezi chokhazikitsidwa kwa wodwalayo, ndiye kuti mafupiafupi amagwiritsidwa ntchito mphindi 20-30 musanadye, ndipo owonjezera ochepa kwambiri musanadye. Ngati chizindikirocho chimaposa zofunika zovomerezeka, nthawi pakati pa jakisoni ndi chakudya imachulukitsidwa. Cartridge Insulin Solution Mlingo wa mankhwala amayeza mu mayunitsi (UNITS). Sichikukonzedwa ndipo imawerengeredwa padera asanadye kadzutsa, nkhomaliro komanso chakudya chamadzulo. Mukafuna kudziwa kuchuluka kwa mankhwalawa, kuchuluka kwa shuga musanadye komanso kuchuluka kwa zakudya zomwe wodwala akufuna kudya zimaganiziridwa. Kuti musavutike, gwiritsani ntchito lingaliro la gawo la mkate (XE). 1 XU ili ndi magalamu 12-15 a chakudya. Makhalidwe azinthu zambiri amaperekedwa pagome lapadera. Amakhulupirira kuti 1 unit ya insulin imachepetsa shuga ndi 2.2 mmol / L. Palinso kufunikira kwakukonzekera 1 XE tsiku lonse. Kutengera ndi izi, ndizosavuta kuwerengera kuchuluka kwa mankhwalawa pachakudya chilichonse. Chiyerekezo cha insulin pa 1 XE: Tiyerekeze kuti munthu wodwala matenda ashuga ali ndi 8.8 mmol / L yosala kudya magazi m'mawa pamimba yopanda kanthu (ali ndi cholinga chimodzi cha 6.5 mmol / L), ndipo akufuna kudya 4 XE pakudya m'mawa. Kusiyana pakati pazowoneka bwino ndi chizindikiro chenicheni ndi 2.3 mmol / L (8.8 - 6.5). Kuti muchepetse shuga kukhala wamba popanda kuganizira chakudya, 1 UNIT ya insulin ndiyofunikira, ndipo ndi 4 XE, ma 6 UNITS ena a mankhwalawa (1.5 UNITS * 4 XE) amafunikira. Chifukwa chake, asanadye, wodwalayo alowe magawo 7 a mankhwala a prandial (1 unit + 6 unit). Kwa odwala omwe amalandira insulin, chakudya chamafuta ochepa sichofunikira. Kupatula kunenepa kwambiri kapena kunenepa kwambiri. Amalimbikitsidwa kudya 11-17 XE patsiku. Ndi kulimbitsa thupi kwambiri, kuchuluka kwa chakudya chamthupi kumatha kuchuluka mpaka 20-25 XE. Njira yolowetsera Mankhwala ochita kupanga mwachangu amapangidwa m'mabotolo, makatiriji ndi zolembera zopangidwa kale. Njira yothetsera vutoli imaperekedwa pogwiritsa ntchito ma insulin, ma syringe ndi mapampu apadera. Mankhwala omwe sanagwiritsidwe ntchito ayenera kukhala mufiriji. Chida chogwiritsira ntchito tsiku ndi tsiku chimasungidwa kutentha kwanyumba kwa mwezi umodzi. Asanayambike insulin, dzina lake, patency ya singano imayang'aniridwa, kuwonekera kwa yankho ndi tsiku lotha ntchito kumawunikiridwa. Mitundu ya prandial imalowetsedwa m'matumbo a subcutaneous pamimba. Mderali, yankho limakhala lotanganidwa ndikuyamba kuchitapo kanthu mwachangu. Tsamba la jakisoni mkati mwa malowa limasinthidwa tsiku lililonse. Njirayi imakupatsani mwayi kupewa lipodystrophy - zovuta zomwe zimachitika ndikuphwanya njira ya njirayi. Mukamagwiritsa ntchito syringe, ndikofunikira kutsimikizira kuchuluka kwa mankhwalawa omwe amasonyezedwera komanso vial. Monga lamulo, ndi 100 U / ml. Pakukhazikitsa mankhwalawa, khola limapangidwa, jekeseni limapangidwa pakona pa madigiri 45. NovoRapid Flexpen Chole chogwiritsidwa ntchito kamodzi Pali mitundu ingapo ya zolembera za syringe: Yodzaza (okonzeka kudya) - Apidra SoloStar, Humalog QuickPen, Novorapid Flexpen. Mfundoyi ikatha, cholembera uyenera kutayidwa. Kuchitikanso, ndi cholembera katemera wa insulin - OptiPen Pro, OptiKlik, HumaPen Ergo 2, HumaPen Luxura, cholembera cha Biomatic. Cholembera chogwiritsidwa ntchito pobweretsa cholumikizira cha ultrashort Humalog - HumaPen Luxura Musanagwiritse ntchito, kuyezetsa kumayesedwa ndi momwe umafunikira kwa singano. Kuti muchite izi, pezani magawo atatu a mankhwalawa ndikusindikiza piston. Ngati dontho la yankho litawoneka pamutu pake, mutha kubaya insulini. Ngati zotsatirapo zake zili zopanda pake, kubwereza kumabwerezedwa kawiri, kenako singano imasinthidwa kukhala yatsopano. Ndi mafuta osanjika bwino ophatikizika, makonzedwe a wothandizira amachitika mbali yoyenera. Pampu za insulin ndi zida zomwe zimathandizira mabisidwe oyambira komanso olimbikitsidwa a secretion ya mahomoni. Amakhazikitsa cartridgeges omwe ali ndi ma ultrashort analogues. Kukhazikika kwakanthawi kochepa kwa yankho mu subcutaneous minofu kumatsitsa mwazonse momwe timadzi timene timayendetsa masana masana ndi usiku, ndipo kuwonjezereka kwa gawo loyambirira kumachepetsa shuga omwe amalandiridwa kuchokera ku chakudya. Zipangizo zina zimakhala ndi pulogalamu yomwe imayeza glucose wamagazi. Odwala onse omwe ali ndi mapampu a insulin amaphunzitsidwa kuti azisintha ndikuzisamalira. Zambiri Mpaka pano, njira yokhayo yothandizira matenda amtundu wa shuga 1 ndikuwonetsetsa kuti wodwalayo ali bwino kudzera mu jakisoni wa insulin. Padziko lonse lapansi, asayansi akufufuza pafupipafupi njira zina zothandizira odwala. Mwachitsanzo, madotolo amakambirana za kuthekera kwa kupanga kwa maselo abwinobwino a pancreatic beta. Kenako akukonzekera kuperekera odwala kuti achotse matenda ashuga. Koma pakadali pano njira imeneyi sipadadutsa mayesero azachipatala, ndipo ndizosatheka kulandira chithandizo chotere ngakhale mkati mwazoyeserera. Si odwala onse omwe angathe kuvomereza pomwepo nthawi yomweyo, ena amaganiza kuti pakapita nthawi, shuga amakhazikika popanda chithandizo. Koma, mwatsoka, ndi matenda osokoneza bongo omwe amafuna insulini, izi sizingachitike mwaokha. Anthu ena amayamba kubaya insulini pokhapokha atagonekedwa kuchipatala, pomwe matendawa adayamba kale kusewera. Ndikwabwino kuti musabweretse izi, koma kuyamba mankhwalawa molondola ndikusintha moyo wanu pang'ono. Kupeza kwa insulin kunali kusintha kwasayansi, chifukwa odwala matenda ashuga asanakhale ochepa, ndipo moyo wawo unali woipa kwambiri kuposa anthu athanzi. Mankhwala amakono amalola odwala kukhala ndi moyo wabwinobwino ndipo akumva bwino. Amayi achichepere omwe ali ndi vutoli, chifukwa cha chithandizo ndi matenda, nthawi zambiri amatha kutenga pakati ndikubereka ana. Chifukwa chake, ndikofunikira kuyandikira mankhwala a insulin osati kuchokera pakuwoneka zoletsa zina za moyo, koma kuchokera pakuwona mwayi weniweni wokhala ndi thanzi komanso thanzi kwa zaka zambiri. Mukamatsatira malangizo a dokotala okhudza chithandizo cha mankhwala a insulin, kuopsa kwa zotsatila za mankhwalawa kumachepetsedwa. Ndikofunika kusunga insulin molingana ndi malangizo, kutumikirani Mlingo womwe dokotala wakupatsani, ndikuwunika tsiku lotha ntchito. Kuti mumve zambiri pazotsatira za insulin ndi malamulo omwe angakuthandizeni kupewa, onani nkhaniyi. Momwe mungapangire jakisoni? Kuchita bwino kwa njira yoperekera insulin kumatengera momwe wodwalayo amaperekedwera. Algorithm yoyeneranso kuperekera insulin ndi iyi: Malowo a jakisoni amayenera kuthandizidwa ndi antiseptic ndikuwuma bwino ndi ma napache kuti mowa utha kutuluka pakhungu (ndikuyambitsa kwa ma insulin ena otere siofunikira, chifukwa ali ndi mankhwala ophera tizilombo toyambitsa matenda). Syringe ya insulin imayenera kuyimba kuchuluka kwa mahomoni ofunikira. Mutha kuyamba kutola ndalama zochulukirapo, kenako kuti mumasule mpweya kuchokera ku syringe kupita ku chenicheni. Tulutsani mpweya, onetsetsani kuti mulibe mimbulu yayikulu mu syringe. Ndi manja oyera, muyenera kupanga khola la khungu ndikulowetsa mankhwalawo ndikuyenda mwachangu. Singano iyenera kuchotsedwa, atagwira jekeseni ndi thonje. Kuchepetsa tsamba la jakisoni sikofunikira. Limodzi mwa malamulo akuluakulu operekera insulin ndikuyipeza pansi pa khungu, osati pamalo a minofu. Jakisoni wa intramuscular angayambitse kuyamwa kwa insulin komanso kupweteka, kutupa m'derali. Dera loyendetsedwa ndi insulin ndi zofunika kusintha: mwachitsanzo, m'mawa mutha kubaya insulin m'mimba, nthawi ya nkhomaliro - pa ntchafu, kenako pamphumi, ndi zina zambiri. Izi ziyenera kuchitidwa kuti lipodystrophy isachitike, kutanthauza kuti kuchepa kwa mafuta onunkhira. Ndi lipodystrophy, zida zomwe zimayamwa insulin zimasokonekera, mwina sizingalowe mwachangu ngati tikufunika. Izi zimakhudza mphamvu ya mankhwalawa komanso zimawonjezera chiopsezo cha spikes mwadzidzidzi m'magazi a magazi. Jekeseni wothandizila matenda a shuga a 2 Insulin yokhala ndi matenda a shuga a 2 sagwiritsidwa ntchito kawirikawiri, chifukwa matendawa amakhudzana kwambiri ndi zovuta za metabolic m'malo ocheperako poyerekeza ndi insulin. Nthawi zambiri, timadzi timeneti timapangidwa ndi ma cell a pancreatic beta. Ndipo, monga ulamuliro, wokhala ndi matenda amtundu wa 2, amagwira ntchito pafupipafupi. Mwazi wamagazi ukuwonjezeka chifukwa cha kukana insulini, ndiko kuti, kuchepa kwa chidwi cha minofu kufikira insulin. Zotsatira zake, shuga sangalowe m'magazi am'magazi, mmalo mwake, amadziunjikira m'magazi. Mtundu wachiwiri wa matenda ashuga komanso kusintha pafupipafupi m'magazi a shuga, maselo amenewa amatha kufa kapena kufooketsa zomwe amagwira. Pankhaniyi, kuti athetse vuto, wodwalayo amayenera kupweteka kwakanthawi kapena kubwereza insulin. Komanso, jakisoni wa mahomoni angafunike kuti thupi likhalebe lolimba panthawi yofalitsa matenda opatsirana, omwe ndi mayeso enieni a chitetezo cha matenda ashuga. Kapamba pakadali pano atha kutulutsa insulin yokwanira, popeza imathanso chifukwa chakumwa thupi. Mu mtundu wofatsa wa matenda a shuga a 2, odwala nthawi zambiri samatha mapiritsi ochepetsa shuga. Amayendetsa matendawa pokhapokha mothandizidwa ndi zakudya zapadera komanso kuchita masewera olimbitsa thupi mopepuka, osayiwala mayeso omwe adokotala amakhala nawo komanso kuyezetsa magazi. Koma munthawi imeneyi pomwe insulin imalembedwa kuti ichotse khungu kwakanthawi, ndibwino kutsatira malangizowo kuti akhalebe osunga matendawa mtsogolo. Mitundu ya insulin Pofika nthawi ya zochita, ma insulini onse amatha kugawidwa m'magulu otsatirawa: kopitilira muyeso kochepa zochita zazifupi zochita zapakati kuchitapo kanthu kwanthawi yayitali. Ultrashort insulin imayamba kuchita mphindi 10-15 pambuyo pa kubayidwa. Zotsatira zake m'thupi zimatha kwa maola 4-5. Mankhwala ochita kupanga mwachidule amayamba kuchita pafupifupi theka la ola pambuyo pobayira. Kutalika kwa kukopa kwawo ndi maola 5-6. Ultrashort insulin imatha kutumikiridwa nthawi isanayambe kapena itangotha ​​chakudya. Insulin yochepa imalimbikitsidwa kuti iperekedwe pokhapokha chakudya, chifukwa samayamba kuchita mwachangu kwambiri. Insulin yochita pakati, pakudya, imayamba kuchepetsa shuga pokhapokha maola awiri, ndipo nthawi yodziwika bwino imafika maola 16. Mankhwala osakhalitsa (owonjezeredwa) amayamba kukhudza kagayidwe kazakudya pambuyo pa maola 10-12 ndipo samachotsedwa m'thupi kwa maola 24 kapena kupitilira. Mankhwala onsewa ali ndi ntchito zosiyanasiyana. Ena mwa iwo amaperekedwa nthawi yomweyo musanadye chakudya kuti muchepetse postprandial hyperglycemia (kuchuluka kwa shuga mutatha kudya). Insulin zapakatikati ndi zazitali zimaperekedwa kuti zitha kukhalabe ndi shuga masana mosalekeza tsiku lonse.Mlingo ndi makonzedwe amasankhidwa payekhapayekha kwa munthu aliyense wodwala matenda ashuga, kutengera zaka zake, kulemera kwake, machitidwe a matenda ashuga komanso kupezeka kwa matenda amodzimodzi. Pali pulogalamu ya boma yotumiza insulin kwa odwala omwe ali ndi matenda ashuga, omwe amapereka kwaulere mankhwalawa kwa onse omwe akufunika. Udindo wazakudya Ndi matenda a shuga amtundu uliwonse, kupatula mankhwala a insulin, ndikofunikira kuti wodwala azitsatira zakudya. Mfundo zachikhalidwe zochizira odwala ndizofanana kwa odwala omwe ali ndi mitundu yosiyanasiyana ya matendawa, komabe pali zovuta zina. Odwala omwe ali ndi matenda a shuga omwe amadalira insulin, zakudya zake zingakhale zochulukirapo, popeza amalandila timadzi timeneti kuchokera kunja. Ndi chithandizo chosankhidwa bwino komanso matenda opatsirana bwino a shuga, munthu amatha kudya pafupifupi chilichonse. Zachidziwikire, timangolankhula zokhazokha komanso zopangidwa mwachilengedwe, popeza zakudya zosavuta ndi zakudya zopanda pake siziperekedwa kwa odwala onse. Nthawi yomweyo, ndikofunikira kuperekera insulin kwa odwala matenda ashuga ndikutha kuwerengera moyenera kuchuluka kwa mankhwalawa, kutengera kuchuluka kwa chakudya. Maziko a odwala omwe amapezeka ndi matenda a metabolic ayenera kukhala: Masamba atsopano ndi zipatso zokhala ndi chisonyezo chotsika kapena chapakati cha glycemic, mafuta ochepa mkaka, chimanga chokhala ndi chakudya pang'onopang'ono pakupanga, kudya nyama ndi nsomba. Anthu odwala matenda ashuga omwe amathandizidwa ndi insulin nthawi zina amatha kugula buledi ndi maswiti achilengedwe (ngati alibe matendawa). Odwala omwe ali ndi mtundu wachiwiri wa matenda ashuga ayenera kutsatira zakudya zowonjezera, chifukwa momwemo ndi zakudya zomwe ndizo maziko a chithandizo. Nyama ndi nsomba ndizofunikanso kwambiri kwa wodwala wodwala, chifukwa ndi gwero lamapuloteni, omwe, ndizomwe zimamanga maselo. Zakudya zochokera kuzinthu izi ndizoyenda bwino, zophika kapena zophika, zopatsa mphamvu. Ndikofunikira kupereka zokonda zamitundu yochepa yamafuta ndi nsomba, osachulukitsa mchere wambiri mukamaphika. Zakudya zonona, zophika komanso zosuta sizilimbikitsidwa kwa odwala omwe ali ndi mtundu uliwonse wa matenda ashuga, mosasamala mtundu wa chithandizo komanso kuuma kwa matendawa. Izi ndichifukwa choti mbale zotere zimadzaza kapamba ndikuwonjezera chiopsezo cha matenda amtima. Anthu odwala matenda ashuga ayenera kutha kuwerengera kuchuluka kwa mkate mu chakudya komanso mlingo woyenera wa insulini kuti mulingo wachepetsa shuga. Zonsezi zobisika ndi malingaliro, monga lamulo, amafotokozedwa ndi endocrinologist pakufunsana. Izi zimaphunzitsidwanso mu "sukulu za matenda ashuga", zomwe nthawi zambiri zimagwira ku malo azachipatala apadera a endocrinology. Ndi chiyani china chofunikira kudziwa za matenda ashuga ndi insulin? Mwinanso, odwala onse omwe amapezeka kamodzi ali ndi nkhawa amakhala ndi nthawi yayitali bwanji atakhala ndi matenda ashuga komanso momwe matendawa amakhudzira moyo wawo. Yankho lomveka bwino la funsoli mulibe, chifukwa zonse zimatengera kuuma kwa matendawa komanso momwe munthuyo aliri pamatenda ake, komanso pamalo omwe adapezeka. Wodwala wodwala matenda a shuga 1 atangoyamba kumene, amayamba kukhalanso ndi moyo wabwino kwazaka zikubwerazi. Dokotala ayenera kusankha mankhwalawa, kuyesa kulikonse pakudzipaka nokha kungathe kulephera. Nthawi zambiri, wodwalayo amasankhidwa koyamba kuti akhale ndi insulin yayitali, yomwe amadzayendetsa usiku kapena m'mawa (koma nthawi zina amalimbikitsidwa kuti ajambulidwe kawiri patsiku). Kenako pitani powerengera kuchuluka kwa insulin yochepa kapena ya ultrashort. Ndikofunika kuti wodwalayo agule kuchuluka kwakhitchini kuti adziwe kulemera kwake kwenikweni, zopatsa mphamvu za calorie ndi kapangidwe kazinthu zamagulu a mbale (kuchuluka kwa mapuloteni, mafuta ndi chakudya m'matumbo). Posankha mulingo woyenera wa insulin yochepa, wodwalayo ayenera kuyeza shuga m'magazi atatu masiku onse asanadye, komanso maola 2,5 atatha, ndikujambulira izi mu diary.Ndikofunikira kuti masiku ano posankha mtundu wa mankhwalawa, mphamvu yamatsamba omwe munthu amadya chakudya cham'mawa, nkhomaliro komanso chakudya chamadzulo ndizofanana. Itha kukhala chakudya chosiyanasiyana, koma ziyenera kukhala ndi mafuta, mapuloteni komanso chakudya. Posankha mankhwala, madokotala nthawi zambiri amalimbikitsa kuti ayambe ndi kuchepetsa Mlingo wa insulin ndikuwonjezera pang'onopang'ono ngati pakufunika. Endocrinologist amawerengera kuchuluka kwa kuchuluka kwa shuga masana, asanadye komanso pambuyo pake. Sikuti odwala onse amafunika kubayira insulin yochepa nthawi iliyonse asanadye - ena mwa iwo amafunika kupanga jakisoni kamodzi kapena kangapo patsiku. Palibe chiwembu chogwiritsira ntchito mankhwalawa; chimapangidwa nthawi zonse ndi dokotala aliyense payekhapayekha, poganizira zomwe matendawa amatenga ndi zambiri. Ndi matenda a shuga, ndikofunikira kuti wodwalayo apeze dokotala woyenera yemwe angamuthandize kusankha chithandizo chabwino ndikukuwuzani momwe zimavutira kusintha moyo watsopano. Insulin ya matenda a shuga 1 ndi mwayi wokhawo wodwala wokhala ndi thanzi labwino kwa nthawi yayitali. Kutsatira malingaliro a madokotala ndikuwonetsetsa kuti shuga ali m'manja mwake, munthu amatha kukhala moyo wonse, womwe siwosiyana kwambiri ndi moyo wa anthu athanzi. Akulimbikitsidwa Mtedza wa kapamba: zakudya zoletsedwa komanso zololedwa, zabwino ndi zovuta za mtedza, ndemanga Glucometer Icheck: mtengo ndi malangizo, malangizo ogwiritsira ntchito Matenda a shuga: Zizindikiro ndi chithandizo Kusiya Ndemanga Yanu Popular Nkhani Kodi chakudya chosavuta (chofulumira) chamafuta ndimotani? Tebulo la mankhwala ndi mndandanda Zakudya za shuga Glucometer Bayer Contour TS (Bayer Contour TS) Kuwongolera matenda a shuga Kodi ndizotheka kudya tsabola wa belu chifukwa cha kapamba ndi momwe amathandizira Zakudya za shuga Posts Popular Chithandizo ndi kupewa Diabetesalong - (Diabetesalong) malangizo Chithandizo ndi kupewa 2018 Malangizo a Diabetesalong ogwiritsira ntchito: Mitengo muma pharmacie opezeka pa intaneti: Diabetesalong ndi zotumphukira za sulfonylureas zam'badwo wachiwiri, mankhwala a hypoglycemic pakugwiritsa ntchito pakamwa. ... Stevia - wochokera - Leovit - ndiwotchi wachilengedwe? Zakudya za shuga Zoyenera kuchita ngati ukununkhira acetone mu mkodzo wako Zizindikiro Ndikotheka kutenga chromium picoline ya matenda ashuga, contraindication Mankhwala Gulu MankhwalaNkhaniMatenda a shugaZogulitsa odwala matenda ashugaAmasanthulaZinaMitundu ndi MitunduMatenda a shuga kwa ana ndi achinyamataZifukwaKukakamizidwa Kusankha Mkonzi Masamba obayira a insulin Mitundu ndi Mitundu, 2018 Mellitus wodwala matenda a shuga: Zizindikiro ndi mankhwala Matenda a shuga, 2018 Abambo thanzi Matenda a shuga, 2018 Posts Popular Maphikidwe oyamba a matenda ashuga a 2 Zakudya za shuga, 2018 Viktoza - malangizo * ogwiritsidwa ntchito Chithandizo ndi kupewa, 2018 Mankhwala a Glimepiride kuti muchepetse shuga mu shuga Mankhwala, 2018 pobedidijabetes.org © Copyright 2024. All Rights Reserved. | Matenda Atsoka!