Ultrashort insulin Humalog, NovoRapid ndi Apidra

Insulin yochepa yaumunthu imayamba kuchita mphindi 30-45 jakisoni, komanso mitundu yaposachedwa ya ultrashort ya insulin Humalog, NovoRapid ndi Apidra - ngakhale mwachangu, pambuyo pa mphindi 10-15. Humalog, NovoRapid ndi Apidra sizomwe zili insulin yaumunthu, koma ma analogues, omwe amasinthidwa, amawongolera poyerekeza ndi insulin ya anthu enieni. Chifukwa cha kachitidwe kawo kosinthika, amayamba kutsitsa shuga m'magazi mofulumira atalowa m'thupi.

Ma Ultrashort insulin analogue adapangidwa kuti azitha kupanikiza msanga shuga yamagazi yomwe imachitika pamene wodwala matenda ashuga akufuna kudya chakudya champhamvu kwambiri. Tsoka ilo, malingaliro awa sagwira ntchito, chifukwa shuga amadumpha kuchokera shuga ngati misala. Ndi kulowa msika wa Humalog, NovoRapid ndi Apidra, tikupitilizabe kutsatira. Timagwiritsa ntchito mankhwala a insulin oti insulin ingachepetse shuga kuti ikhale yokhazikika ngati ilumpha mwadzidzidzi, komanso mwa apo ndi apo pamikhalidwe yapadera musanadye, ndikakhala osavomerezeka kudikirira mphindi 40-45 musanadye.

Jekeseni wa insulin yochepa kapena ya ultrashort musanadye chakudya chofunikira kwa odwala omwe ali ndi matenda amtundu wa 2 kapena shuga, omwe ali ndi shuga yayikulu magazi atatha kudya. Amaganiziridwa kuti mukutsatira kale zakudya zamafuta ochepa, ndikuyesanso, koma njira zonsezi zidathandizira pang'ono. Phunzirani ndi. Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri, monga lamulo, zimapangitsa kuti ayesetse kumangothandizidwa ndi insulin yayitali, monga tafotokozera m'nkhaniyi. Mwina kapamba wanu wa insulin yemwe amakhala nthawi yayitali amapuma bwino ndipo amakwaniritsidwa kotero kuti amatha kuzimitsa shuga m'magazi mutatha kudya, popanda jakisoni wowonjezera wa insulin musanadye.

Momwe mungathanirane ndi matenda ashuga omwe ali ndi insulin yochepa kapena yochepa kwambiri

Ultrashort insulini imayamba kugwira ntchito thupi isanakhale ndi nthawi yolowa mapuloteni ndikusintha ena mwa iwo kukhala glucose. Chifukwa chake, ngati mungayang'ane, ndiye musanadye insulin yochepa ndikwabwino kuposa Humalog, NovoRapid kapena Apidra. Insulin yochepa iyenera kuperekedwa kwa mphindi 45 musanadye. Ino ndi nthawi yoyenera, ndipo wodwala aliyense yemwe ali ndi matenda ashuga amafunika kumafotokozera yekha payekha. Momwe mungachite, werengani. Kuchita mwachangu kwamtundu wa insulin kumatenga pafupifupi maola asanu. Ino ndi nthawi yeniyeni yomwe anthu nthawi zambiri amafunika kugaya chakudya chomwe amadya.

Timagwiritsa ntchito mankhwala a "cellash" a "cell" mwadzidzidzi kuti achepetse shuga kuti akhale bwino ngati angulumuke mwadzidzidzi. Mavuto a shuga amakula pomwe shuga m'magazi amakwezedwa. Chifukwa chake, timayesetsa kutsitsa kuti zikhale zabwinobwino mwachangu, ndipo kwa insulini yocheperako ndiyabwino kuposa yochepa. Ngati muli ndi matenda amtundu wachiwiri wa shuga, ndiye kuti, shuga wokwera msanga amakhala yekha, ndiye kuti simukufunika kuti mupeze insulin yowonjezera kuti muchepetse. Kumvetsetsa momwe shuga ya magazi imakhalira mwa odwala matenda ashuga amangothandiza masiku angapo angapo.

Mitundu ya insulin yochepa kwambiri - imachita zinthu mwachangu kuposa aliyense

Mitundu ya insulashort ya insulin ndi Humalog (Lizpro), NovoRapid (Aspart) ndi Apidra (Glulizin). Amapangidwa ndi makampani atatu osiyanasiyana azachipatala omwe amapikisana nawo. Insulin yochepa yofananira ndi yaumunthu, ndipo ma ultrashort ndi ma analogi, i.e. amasinthidwa, kusinthidwa, poyerekeza ndi insulin yeniyeni ya anthu. Kusintha kuli potengera kuti amayamba kutsitsa shuga wamagazi ngakhale othamanga kuposa amfupi - mphindi 5 mpaka jakisoni.

Ma Ultrashort insulin analogi adapangidwa kuti achepetse kuchepa kwa shuga m'magazi pomwe munthu wodwala matenda ashuga akufuna kudya chakudya champhamvu kwambiri.Tsoka ilo, malingaliro awa sagwira ntchito. Zakudya zopatsa mphamvu, zomwe zimamwe nthawi yomweyo, zimakulitsa shuga m'magazi mwachangu kuposa momwe insulin yayifupi kwambiri ingapangire kuti itsike. Ndi kukhazikitsidwa kwa mitundu yatsopano ya insulin pamsika, palibe amene adaletsa kufunika kotsatira ndi kutsatira. Inde, muyenera kutsatira regimen pokhapokha ngati mukufuna kuwongolera matenda ashuga komanso kupewa zovuta zake.

Ngati mutsatira zakudya zamafuta ochepa a 1 kapena 2 shuga, ndiye kuti insulin yayifupi ya anthu ndiyabwinobwino jakisoni musanadye kuposa anzawo ena ochepa. Chifukwa odwala omwe ali ndi matenda ashuga omwe amadya zakudya pang'ono, thupi limayamba kugaya mapuloteniwo, kenako ndikusintha ena kuti akhale glucose. Uku ndikuchita pang'onopang'ono, ndipo insulin ya ultrashort imayamba kuchita zinthu mwachangu kwambiri. Mitundu yayifupi ya insulin - kulondola. Nthawi zambiri amafunika kuti akhazikitsidwe mphindi 40-45 musanadye chakudya chamafuta ochepa.

Komabe, kwa odwala matenda ashuga omwe amaletsa zakudya zamagulu m'zakudya zawo, ma enamel a ultrashort insulin amathanso kukhala othandiza. Ngati muyeza shuga ndi glucometer ndikupeza kuti ilumpha, ndiye kuti insulini yochepa kwambiri imatsitsa mofulumira kuposa lalifupi. Izi zikutanthauza kuti zovuta za matenda ashuga zimakhala ndi nthawi yochepa kwambiri yopanga. Mutha kubayanso insulin ya ultrashort, ngati mulibe nthawi yoti mudikire mphindi 45 musanayambe kudya. Izi ndizofunikira mu lesitilanti kapena paulendo.

Yang'anani! Maultrashort ma insulin ndi amphamvu kwambiri kuposa amfupi amodzi. Mwachindunji, 1 unit ya Humaloga imatsitsa shuga wamagazi pafupifupi 2,5 kuposa 1 unit ya insulin yochepa. NovoRapid ndi Apidra ndi olimba pafupifupi 1.5 nthawi kuposa insulin. Uwu ndi muyeso wofanana, ndipo kwa wodwala aliyense wodwala matenda ashuga ayenera kudzipangira yekha poyesa ndi kulakwitsa. Momwemo, Mlingo wa ultrashort insulin analogs uzikhala wotsika kwambiri kuposa milingo yofanana ya insulin ya anthu. Komanso, kuyesa kukuwonetsa kuti Humalog imayamba kuchita mwachangu mphindi 5 kuposa NovoRapid ndi Apidra.

Ubwino ndi kuipa kwa ultrashort insulin

Poyerekeza ndi mitundu yaifupi ya insulin yaumunthu, mitundu yatsopano ya ultrashort insulin imakhala ndi zabwino komanso zovuta. Amakhala ndi chiopsezo choyambirira, koma ndiye kuti magazi awo amatsika kuposa ngati mumabayidwa ndi insulin yochepa. Popeza ma insulin a ultrashort ali ndi nsonga zakuthwa, ndizovuta kudziwa kuti ndi zakudya zochuluka ziti zomwe muyenera kudya kuti shuga ya magazi ikhale yabwinobwino. Kuyendetsa bwino kwa insulin yochepa kumakhala bwino kwambiri kosagwirizana ndi kudya kwa thupi, ngati kuyang'aniridwa.

Kumbali inayo, jakisoni wa insulin yocheperako ayenera kuchitika kwa mphindi 40-45 asanadye. Mukayamba kudya mwachangu, ndiye kuti insulin yayifupi sikhala ndi nthawi yochitapo kanthu, ndipo magazi a magazi amalumpha. Mitundu yatsopano ya insulin ya insulin imayamba kugwira ntchito mwachangu, mkati mwa mphindi 10-15 mutabayidwa. Izi ndizothandiza kwambiri ngati simukudziwa nthawi yomwe muyenera kuyamba kudya. Mwachitsanzo, mukadzakhala malo odyera. Ngati mungagwiritse ntchito, tikulimbikitsani kuti mugwiritse ntchito insulin yaifupi anthu musanadye nthawi yovomerezeka. Komanso khalani ndi insulin yochepa kwambiri pakakhala zochitika zapadera.

Zomwe tikuwonetsa zikuwonetsa kuti mitundu ya insulin yomwe imapangidwa ndi insulin imakhudzanso shuga ya magazi osakhazikika kuposa yochepa. Amachita zinthu mosalosera, ngakhale atamwa jekeseni ang'onoang'ono, monga momwe odwala matenda ashuga amatsata, akamatsata zakudya zamagulu ochepa, komanso makamaka ngati atabaya jekeseni wamkulu. Onaninso kuti mitundu ya insulin ya insulin ndiyamphamvu kwambiri kuposa yayifupi. 1 unit ya Humaloga imatsitsa shuga wamagazi ndi pafupifupi 2,5 nthawi yolimba kuposa 1 unit ya insulin yochepa. NovoRapid ndi Apidra ndi olimba pafupifupi 1.5 nthawi kuposa insulin yochepa.Momwemo, mulingo wa Humalog uyenera kukhala pafupifupi 0,4 Mlingo wa insulin yayifupi, komanso mlingo wa NovoRapid kapena Apidra - pafupifupi mlingo wa ⅔. Ichi ndi chidziwitso chofunikira kwambiri chomwe muyenera kufotokozera.

Cholinga chathu chachikulu ndikuchepetsa kapena kuletsa kwathunthu kudumpha m'magazi a magazi mutatha kudya. Kuti izi zitheke, muyenera kupereka jakisoni musanadye ndi nthawi yokwanira kuti insulini iyambe kuchita. Komabe, tikufuna kuti insulini iyambe kutsika shuga m'magazi mukamayamwa chakudya chikuyamwa. Komabe, ngati mutabayira insulansi molawirira kwambiri, shuga wanu wamagazi amatsika mofulumira kuposa chakudya chomwe chimatha kukweza. Kuchita kumawonetsa kuti ndibwino kubaya insulin yochepa mphindi 40-45 musanayambe chakudya chamafuta ochepa. Kusiyana ndi odwala omwe adwala matenda a diabetesic gastroparesis, i.e., akuchedwa kutulutsa m'mimba atatha kudya.

Nthawi zambiri, koma amakumana ndi odwala omwe ali ndi matenda ashuga, omwe mitundu yochepa ya insulini pazifukwa zina imatengedwa kulowa m'magazi makamaka pang'onopang'ono. Amayenera kubaya insulini, mwachitsanzo, maola 1.5 asanadye. Zachidziwikire, izi sizabwino kwambiri. Afunika kugwiritsa ntchito ma analogi aposachedwa a ultrashort musanadye, omwe ali othamanga kwambiri omwe ndi Humalog. Tikutsimikizanso kuti anthu odwala matenda ashuga siamachitika mwadzidzidzi.

Kupitiliza kwa nkhani yomwe mwangowerenga ndi tsamba la "".

Imawerengedwa kuti ndi imodzi mwazomwe akutsogolera chithandizo cha matenda osokoneza bongo chifukwa chakuti imakupatsani mwayi wopeza zotsatira zabwino zowonetsetsa kuti mukhale ndi moyo wokwanira, kutalikitsa nthawi yake komanso kupewa zovuta za zovuta.

Mankhwala a insulin amasonyezedwa:

• Zochizira matenda amtundu 1,
• Ngati njira yodzitetezera kusinthasintha kapamba mu shuga 2,
• Ngati ndizosatheka kulipira mtundu wa shuga wa 2 ndi njira zina zamankhwala.

Ndikofunikira kudziwa: Dokotala wothandizira ayenera kusankha moyenera ma insulin ya anthu ndikuwerengera koyamba kwa mankhwala.

Zambiri zokhudzana ndi Apidra: mawonekedwe, mawonekedwe ndi ma contraindication kuti mugwiritse ntchito

Mwa zofananira zamakono za insulin yaumunthu, mankhwala monga Apidra, insulin yocheperako, othandizira hypoglycemic omwe amathandizira kutsitsa komanso kukhazikika kwa shuga m'magazi a wodwala omwe ali ndi matenda ashuga, amathandizira kusintha mayamwidwe a glucose ndi zotumphukira zama cell ndikuwonjezera kuphatikizana kwa shuga m'maselo a chiwindi, ndikuwonjezera kupanga mapuloteni. Kuchita kwa insulin kumayambira mphindi 10-15 pambuyo pa kubayidwa, komwe kumayerekezedwa ndi katundu ndi insulin yopangidwa ndi kapamba. Amawonetsedwa amitundu 1 ndi 2 shuga.

Zomwe zimagwira ndi insulin glulisin (3,49 mg).

Omwe amathandizira - meta-cresol, sodium chloride, trometanol, polysorbate 20, hydrochloric acid, sodium hydroxide, madzi osungunuka.
Njira yothetsera insulin ndiyowonekera, yopanda utoto.

Zizindikiro zogwiritsidwa ntchito

Ndikofunikira kudziwa: Apidra amangolembera odwala okhawo omwe ali ndi matenda ashuga.

• Kusalolera aliyense payekha mankhwala kapena zinthu zina zake,
• Hypoglycemia.

Malangizo ogwiritsira ntchito mankhwalawa

Mankhwalawa adalowetsedwa pamapewa, pamimba kapena ntchafu, mutha kugwiritsa ntchito njira yopitilira kulowetsedwa mu fiber pansi pa khungu.

Monga lamulo, insulin imabayidwa mphindi 15 kapena chakudya isanachitike, ndipo ndikofunikira kusinthana ndi mawebusayiti kuti musapangitse ngozi ndi zovuta za khungu. Jakisoni atapangidwa, simungathe kufinya jakisoni wa jekeseni, kuti musakhumudwitse mankhwalawo.

Mlingo wa jakisoni kwa wodwala aliyense yemwe ali ndi matenda osokoneza bongo amasankhidwa payekha.

Pankhani ya bongo wambiri, mawonetsedwe:

Ngati pali mtundu wofatsa wa hypoglycemia, ndiye kuti utha kuyimitsidwa mwachangu ndi shuga komanso shuga.Chifukwa chake, madokotala amalimbikitsa kuti odwala onse omwe ali ndi matenda ashuga nthawi zonse azikhala ndi shuga.

Woopsa mitundu ya hypoglycemia, yomwe imayendera limodzi ndi kusazindikira, ndikofunikira kubaya glucagon kapena glucose intramuscularly - kusankha kwa mankhwala kumadalira umunthu wa mapangidwe a shuga wodwala.

Hypoglycemia imadziwikanso ngati mbali imodzi yamagawo oyambira a chithandizo. Monga lamulo, mawonetsero onse osalimbikitsa amapita mwachangu ngati wodwala athe kuwongolera.

Kodi ndingagwiritse ntchito insulin apidra panthawi yapakati?

Chowerengera ichi cha insulin yaumunthu chitha kutengedwa panthawi yomwe mukukhala ndi pakati, koma chitani zinthu mosamala, mosamala kuchuluka kwa shuga ndipo, kutengera ndi iwo, sinthani mlingo wa mahomoni. Monga lamulo, munthawi yoyamba kubereka, mlingo wa mankhwalawa umachepa, ndipo wachiwiri ndi wachitatu, umayamba kuwonjezeka. Pambuyo pobala, kufunika kwa mlingo waukulu wa Apidra kutha, ndiye kuti mankhwalawa amayambiranso.

Kugwiritsa ntchito analogues

Masiku ano, mankhwalawa amatha kusintha m'malo mwake.

Chifukwa cha zotsatira zabwino za mankhwalawa ndi mankhwalawa, masiku ano amawerengedwa ngakhale kwa ana, koma azaka 6 zokha.

Masiku ano, mankhwalawa angathe kugulidwa m'mafakisoni munthawi ya mayankho mabotolo a mayunitsi zana kapena syringes.

Mutha kugula botolo la yankho ku Russia pamtengo wapakati pa ma ruble 2000, seti ya ma pen-syringe (ma PC 5.) - itenga ndalama kuchokera kuma ruble 2100.

Muzipatala za ku Ukraine mutha kugula ma cholembera angapo (ma PC 5.) Pa mtengo wapakati pa 1400 UAH.

Apidra ndi msonkho wobwerezabwereza wa insulin ya anthu, chinthu chachikulu chomwe chimagwira ndi glulisin. Chachilendo cha mankhwalawa ndikuti imayamba kugwira ntchito mwachangu kuposa insulin yaumunthu, koma nthawi yochitapo kanthu ndiyotsika kwambiri.

Mlingo wa insulin iyi ndi yankho la subcutaneous makonzedwe, madzi omveka bwino kapena opanda khungu. Mlingo umodzi wa yankho uli ndi 3.49 mg ya chinthu chogwira ntchito, chomwe ndi wofanana ndi 100 IU a insulin ya anthu, komanso othandizira, kuphatikiza madzi a jakisoni ndi sodium hydroxide.

Mtengo wa insulin Apidra umasiyanasiyana kutengera mtengo waposachedwa. Pafupifupi ku Russia, wodwala matenda ashuga amatha kugula mankhwala a ruble a 2000-3000.

Achire zotsatira za mankhwala

Chochita chofunikira kwambiri cha Apidra ndi kuyendetsa bwino kwa kagayidwe kazigazi m'magazi, insulin imatha kutsitsa shuga, potero imapangitsa kuyamwa kwake ndi zotumphukira:

Insulin imalepheretsa kupanga shuga mu chiwindi cha wodwalayo, adipocyte lipolysis, proteinol, ndikuwonjezera kupanga mapuloteni.

M'maphunziro omwe amachitika pa anthu athanzi komanso odwala matenda a shuga, zidapezeka kuti kupindika kwa glulisin kumathandizira msanga, koma kwakanthawi kochepa, poyerekeza ndi insulin yaumunthu.

Ndi subcutaneous makonzedwe a mankhwala, hypoglycemic zotsatira zidzachitika mkati 10 mpaka mphindi, ndi jekeseni wa intravenous zoterezi zimakhala zofanana mu mphamvu kuchitira anthu insulin. Chipinda cha Apidra chimadziwika ndi ntchito ya hypoglycemic, yomwe imafanana ndi gawo la insulin ya anthu osungunuka.

Apidra insulin imayendetsedwa kwa mphindi 2 chakudya chisanachitike, chomwe chimapangitsa kuti pakhale vuto la postprandial glycemic, lofanana ndi insulin ya anthu, yomwe imaperekedwa mphindi 30 asanadye. Tiyenera kudziwa kuti kuwongolera kotereku ndiko kwabwino koposa.

Ngati glulisin imayikidwa pakatha mphindi 15 itatha kudya, imatha kuwongolera kuchuluka kwa shuga m'magazi, omwe amafanana ndi insulin ya anthu omwe amapatsidwa mphindi ziwiri asanadye.

Insulin imakhala m'magazi kwa mphindi 98.

Malangizo ogwiritsira ntchito mankhwalawa

Chizindikiro chogwiritsira ntchito insulin Apidra SoloStar ndimatenda a shuga a mtundu woyamba ndi wachiwiri, mankhwalawa amatha kuperekedwa kwa akulu ndi ana opitilira zaka 6.Contraindication imakhala hypoglycemia ndi tsankho la munthu pazinthu zilizonse za mankhwalawa.

Panthawi yapakati komanso yoyamwitsa, Apidra imagwiritsidwa ntchito mosamala kwambiri.

Insulin imayendetsedwa musanadye kapena mphindi 15 isanachitike. Amaloledwanso kugwiritsa ntchito insulin mukatha kudya. Nthawi zambiri, Apidra SoloStar amalimbikitsidwa pakatikati insulin chithandizo regimens, wokhala ndi insulin analogues. Kwa odwala ena, amatha kutumizidwa limodzi ndi mapiritsi a hypoglycemic.

Kwa odwala matenda ashuga aliyense, mtundu wa mankhwala ayenera kusankhidwa, poganizira kuti kulephera kwa aimpso, kufunikira kwa timadzi totere kumachepetsedwa kwambiri.

Mankhwala amaloledwa kuperekedwa mosavuta, kulowetsedwa m'dera la mafuta onunkhira. Malo osavuta kwambiri oyendetsera insulin:

Pakufunika kulowetsedwa kosalekeza, mawu oyambawo amachitika kokha m'mimba. Madokotala amalimbikitsa kwambiri kusinthitsa malo owonetsera jakisoni, onetsetsani kuti mukusunga chitetezo. Izi zimalepheretsa kulowa kwa insulin kulowa m'mitsempha yamagazi. Dongosolo la subcutaneous makoma a m'mimba ndi chitsimikizo cha kuyamwa kwa mankhwalawo kuposa momwe amapangira mbali zina za thupi.

Pambuyo jakisoni, koletsedwa kutikita minofu jakisoni, adotolo afotokozere izi pamwambowo mwachidule pa njira yolondola yothandizira mankhwalawo.

Ndikofunikira kudziwa kuti mankhwalawa sayenera kukhala osakanikirana ndi ma insulin ena, kusiyanitsa ndi lamulo ili ndi insulin Isofan. Ngati musakaniza Apidra ndi Isofan, muyenera kuyiyimbira kaye ndipo nthawi yomweyo kumata.

Cartridges iyenera kugwiritsidwa ntchito ndi cholembera cha sytinge ya OptiPen Pro1 kapena ndi chipangizo chofananira, onetsetsani kuti mwatsata zomwe wopangitsayo akupanga:

1. kudzaza katoni
2. kulowa ndi singano
3. kuyambitsa kwa mankhwala.

Nthawi iliyonse musanagwiritse ntchito chipangizocho, ndikofunikira kuti mufufuze; yankho la jekeseni liyenera kukhala lowonekera kwambiri, lopanda mtundu, lopanda mawonekedwe olimba.

Asanaikidwe, cartridge iyenera kusungidwa kutentha kwa maola osachepera 1-2 maola, isanayambike insulin, mpweya umachotsedwa mu cartridge. Makatoni ogwiritsidwanso ntchito sayenera kudzazidwanso; cholembera chija sichitha. Mukamagwiritsa ntchito pampu yopopa pampu kuti mupange insulin yopitilira, kusakaniza ndizoletsedwa!

Kuti mumve zambiri, chonde werengani malangizo oti mugwiritse ntchito. Otsatirawa amadwala mosamalitsa:

• ndi mkhutu waimpso ntchito (pakufunika kuwunikanso mlingo wa insulin),
• ndi vuto la chiwindi (kusowa kwa mahomoni kungachepe).

Palibe chidziwitso pa maphunziro a pharmacokinetic a mankhwalawa odwala okalamba, komabe, ziyenera kukumbukiridwa kuti gulu ili la odwala lingachepetse kufunikira kwa insulin chifukwa cha kuwonongeka kwa aimpso.

Mbale za Apidra insulin zitha kugwiritsidwa ntchito ndi insulin yokhala ndi insulin, syringe ya insulini yokhala ndi muyeso woyenera. Pakapita jakisoni aliyense, singano imachotsedwa mu cholembera ndikuchotsa. Njirayi ikuthandizira kupewa matenda, kutayikira kwa mankhwala osokoneza bongo, kulowa kwa mpweya komanso kutsekeka kwa singano. Simungayesere thanzi lanu ndikugwiritsanso ntchito singano.

Popewa matenda, cholembera chodzazidwa chimangogwiritsidwa ntchito ndi wodwala m'modzi yekha, sichitha kusamutsidwa kwa anthu ena.

Milandu yama bongo osokoneza bongo ndi zovuta zina

Nthawi zambiri, wodwala yemwe ali ndi matenda ashuga amatha kukhala osafunikira monga hypoglycemia.

Nthawi zina, mankhwalawa amachititsa kuti pakhale zotupa pakhungu ndipo amatupa pamalo a jekeseni.

Nthawi zina zimakhala funso ngati wodwala sanatsatire malangizo osinthira malo a insulin.

Zina zomwe zimayambitsa matendawa ndi monga:

1. chokoletsa, urticaria, matupa a chifuwa chachikulu (pafupipafupi),
2. chifuwa cholimba (chosowa).

Ndi chiwonetsero chazomwe zimachitika mthupi mwake, pamakhala ngozi pa moyo wa wodwalayo. Pachifukwa ichi, ndikofunikira kuti mukhale ndi chidwi ndi thanzi lanu ndikumvera zosokoneza zake zazing'ono.

Pakakhala vuto losokoneza bongo, wodwalayo amakhala ndi vuto loti azisinthasintha. Pankhaniyi, chithandizo chikusonyezedwa:

• hypoglycemia - kugwiritsa ntchito zakudya zomwe zimakhala ndi shuga (odwala matenda ashuga ayenera kukhala nawo nthawi zonse)
• kwambiri hypoglycemia ndi kutaya chikumbumtima - kuyimitsidwa kumachitika ndi kuperekera 1 ml ya glucagon subcutaneily kapena mu mnofu, glucose amatha kutumikiridwa kudzera mu minyewa (ngati wodwalayo sayankha glucagon).

Wodwala akangobwerera kumene, ayenera kudya zakudya zochepa.

Zotsatira za hypoglycemia kapena hyperglycemia, pamakhala mwayi woti wodwalayo azikhala wokhazikika, asinthe kuthamanga kwa zochitika zama psychomotor. Izi zimadzetsa chiwopsezo poyendetsa magalimoto kapena machitidwe ena.

Chidwi chachikulu chiyenera kuperekedwa kwa odwala matenda ashuga omwe ali ndi vuto locheperapo kapena osazindikira kwenikweni zomwe zingachitike. Ndikofunikanso pakanthawi kambiri ka shuga kakang'ono kwambiri.

Odwala otere ayenera kusankha pazomwe angayendetsere magalimoto ndi machitidwe ake pawokha.

Momwe amagwiritsidwira ntchito limodzi ndi insulin Apidra SoloStar ndi mankhwala ena, kuwonjezeka kapena kuchepa kwa chiyembekezo cha chitukuko cha hypoglycemia kumatha kuchitika, ndi chikhalidwe kuphatikiza njira izi:

1. matenda amkamwa,
2. ACE zoletsa
3. mafupa
4. Ma Disopyramides,
5. Mao zoletsa
6. Fluoxetine,
7. Pentoxifylline
8. salicylates,
9. Propoxyphene,
10. sulfonamide antimicrobials.

Zotsatira za hypoglycemic zimatha kuchepa kangapo ngati insulin glulisin imayikidwa limodzi ndi mankhwala: diuretics, phenothiazine, mahomoni a chithokomiro, proteinase inhibitors, antipsychotropic, glucocorticosteroids, Isoniazid, Phenothiazine, Somatropin, sympathomimetics.

Pentamidine wa mankhwala pafupifupi amakhala ndi hypoglycemia ndi hyperglycemia. Ethanol, mchere wa lithiamu, beta-blockers, mankhwala a Clonidine amatha kukhala ndi mphamvu ndikuchepetsa mphamvu ya hypoglycemic.

Ngati kuli kofunikira kusamutsa munthu wodwala matenda a shuga kupita ku mtundu wina wa insulin kapena mtundu wina wa mankhwala, kuyang'aniridwa ndi dokotala ndikofunikira. Ngati mulingo wambiri wa insulin wagwiritsidwa ntchito kapena wodwala akangosankha zochita kuti asankhe kusiya kumwa, izi zipangitsa kuti:

Zinthu zonsezi zimawopseza wodwalayo.

Ngati kusinthika kwazomwe zikuchitika panjira yamagalimoto, kuchuluka ndi kuchuluka kwa chakudya chamagwiritsidwe, kusintha kwa Apidra insulin kungafunike. Zochita zolimbitsa thupi zomwe zimachitika mukangodya chakudya zimatha kuwonjezera mwayi wa hypoglycemia.

Mtundu umodzi wa insulini womwe umapezeka m'misika yama shopu ndi insulin apidra. Ichi ndi mankhwala apamwamba kwambiri, omwe, malinga ndi zomwe dokotala amupatsa, angagwiritsidwe ntchito ngati amtundu wa matenda ashuga ngati milandu yawo yomwe siipangidwe mokwanira ndipo iyenera kuvulazidwa. Mankhwala amaperekedwa ndi mankhwala ndipo amafunikira kuwerengedwa mosamala. Amadziwika ndi kukhathamiritsa kwambiri akagwiritsidwa ntchito moyenera.

Kutulutsa Fomu

Amapezeka mu mawonekedwe a yankho la jakisoni. Njira yothetsera vutoli ndi yowonekera, ilibe mtundu komanso fungo lotchulidwa. Takonzeka kutsogoleredwa mwachindunji (sizitanthauza kuti tikonzedwe kapena zina).

Ichi ndi chimodzi mwa mankhwala chomwe chiphatikiza chake chachikulu ndi insulin glulisin. Kupezeka ndi kubwerezanso kwa DNA. Ntchito E. coli kupsinjika.Komanso mu kapangidwe kake pali zinthu zothandiza zofunika pokonzekera kuyimitsidwa.

Imamalizidwa m'njira zosiyanasiyana. Itha kugulitsidwa ngati makatiriji a jakisoni a 3 ml iliyonse. Mu 1 ml ya 100 IU. Njira yolerera yothetsera jakisoni mu vial ndiyotheka. Ndizosavuta kugula insulin apidra kwathunthu ndi cholembera cha sytiitet ya OptiSet. Imathandizira njira yoperekera mankhwala. Yapangidwira cartridge ya 3 ml.

Mtengo wa mankhwalawa posankha ma cartridge 5 a 3 ml ndi 1700 - 1800 rubles.

Zizindikiro, contraindication

Mankhwalawa amagwiritsidwa ntchito ngati matenda a shuga 1 ngati cholowa m'malo mwa insulin yachilengedwe, yomwe samapangidwa mu matendawa (kapena amapangidwa mosakwanira). Itha kuperekedwanso matenda amtundu wachiwiri pokhapokha ngati kukana (chitetezo chokwanira) kumamwa mankhwala a glycemic kukhazikitsidwa.

Ali ndi insulin apidra ndi contraindication. Monga mankhwala aliwonse otere, sangatengedwe ndi chizolowezi kapena kupezeka mwachindunji kwa hypoglycemia. Kusagwirizana ndi chinthu chachikulu chomwe mankhwalawo amagwira kapena zomwe zimapangidwira zimathandizanso kuti ziyimitsidwe.

Kugwiritsa

Malamulo oyambira kuphatikiza mankhwala ali motere:

1. Zoyambitsidwa isanakwane (osapitirira mphindi 15) kapena mukangodya chakudya,
2. Iyenera kugwiritsidwa ntchito limodzi ndi ma insulin omwe akhala akuchita nthawi yayitali kapena mtundu womwewo wa mankhwala amkamwa,
3. Mlingo umayikidwa mosamalitsa payekhapayekha pa nthawi yoonana ndi adokotala.
4. Amayendetsedwa mosasamala,
5. Masamba obayira omwe amakonda: ntchafu, pamimba, minofu yolimba, matako,
6. Muyenera kusinthitsa mawebusayiti,
7. Akayambitsidwa kudzera khoma lam'mimba, mankhwalawo amawamwa ndipo amayamba kuchita zinthu mwachangu,
8. Musamanunitsire jakisoni pamalo operekera mankhwala,
9. Samalani kuti musawononge mitsempha ya magazi,
10. Ngati kuphwanya mtundu wa ntchito kwa impso, ndikofunikira kuchepetsa ndi kupanganso mulingo wa mankhwalawa.
11. Pankhani ya vuto la chiwindi losokoneza, mankhwalawa ayenera kugwiritsidwa ntchito mosamala - maphunziro ngati awa sanachititsidwe, koma pali chifukwa chokhulupirira kuti mulingo wofunikira mu nkhani iyi uyenera kuchepetsedwa, chifukwa kufunika kwa insulin kumachepa chifukwa cha kuchepa kwa glucogeneis.

Musanayambe kugwiritsa ntchito, muyenera kupita kwa dokotala kuti muwerenge kuchuluka kwa mankhwalawa

Epidera wa mankhwalawa ali ndi kufanana pakati pa insulin. Awa ndi ndalama zokhala ndi zomwe zimapangira chimodzimodzi, koma zokhala ndi dzina lina. Amathandizanso thupi. Izi ndi zida monga:

Mukasintha kuchoka ku mankhwala kupita ku wina, ngakhale analogue, muyenera kufunsa dokotala.

Wopanga: Sanofi-Aventis Private Co Ltd. (Sanofi-Aventis Government. Co Ltd.) France

Code PBX: A10AB06

Fomu yotulutsira: Mafuta a kipimo. Yankho la jakisoni.

Zisonyezero zogwiritsidwa ntchito:

Makhalidwe wamba. Zopangidwa:

Zothandiza: insulin glulisin - 100 PIECES (3.49 mg),
zotuluka: metacresol (m-cresol) 3.15 mg, trometamol (tromethamine) 6.0 mg, sodium kolorayidi 5.0 mg, polysorbate 20 0,01 mg, sodium hydroxide kuti pH 7.3, hydrochloric acid mpaka pH 7 3, madzi a jakisoni mpaka 1.0 ml.

Kufotokozera Transparent colorless madzi.

Katundu

Mankhwala Insulin glulisin ndi analogue yobwerezabwereza ya insulin ya anthu, yofanana ndi mphamvu kwa insulin wamba ya anthu.
Chochita chofunikira kwambiri cha insulin ndi insulin analogues, kuphatikizapo insulin glulisin, ndikuwongolera kwa kagayidwe ka shuga. Insulin imachepetsa kuchuluka kwa shuga m'magazi, ndikulimbikitsa kufatsa kwa glucose mwa zotumphukira, makamaka minofu yamatumbo ndi minyewa ya adipose, komanso kuletsa mapangidwe a shuga mu chiwindi. Insulin imachepetsa lipolysis mu adipocytes, linalake ndipo tikulephera kupangira mapuloteni.Kafukufuku wodzipereka kwa odwala omwe ali ndi thanzi labwino komanso odwala omwe ali ndi matenda osokoneza bongo adawonetsa kuti ndi subulinaneous insulin, glulisin amayamba kuchita zinthu mwachangu komanso amakhala ndi nthawi yofupikirapo kuposa kusungunuka kwa insulin yamunthu. Ndi subcutaneous makonzedwe, momwe insulin glulisin, yomwe imachepetsa kuchuluka kwa shuga m'magazi, imayamba pambuyo pa mphindi 10-20. Mothandizidwa ndi mtsempha wa magazi, zotsatira za kuchepetsa kuchuluka kwa shuga m'magazi a insulin glulisin ndi insulle ya insulin yamunthu ndizofanana mu mphamvu. Gawo limodzi la insulin glulisin limakhala ndi zochitika zofanana za hypoglycemic monga gawo limodzi la insulin yaumunthu.
Mu gawo ine kuyesa kwa odwala omwe ali ndi mtundu 1 wa matenda a shuga, mapangidwe a hypoglycemic a insulin glulisin ndi insulle ya insulin yaanthu amaperekedwa mosagwirizana ndi 0,15 U / kg panthawi zosiyanasiyana pokhudzana ndi chakudya chokwanira cha mphindi 15. Zotsatira za phunziroli zidawonetsa kuti insulin glulisin, yomwe idapangidwira mphindi 2 asanadye chakudya, idapereka chiwonetsero chofananira cha glycemic pambuyo chakudya monga insulin ya munthu wosungunuka, kutumikiridwa mphindi 30 asanadye. Pakaperekedwa mphindi ziwiri asanadye, insulin glulisin imapereka chiwongolero chabwinoko pambuyo pa chakudya kuposa chakudya chosungunuka chomwe munthu amakhala nacho pakadutsa mphindi 2 asanadye. Glulisin insulin, yoyendetsedwa pakadutsa mphindi 15 chakudya chitayambika, idaperekanso chiwonetsero chofananira cha glycemic pambuyo paphwando monga chakudya chosungunuka cha anthu, choperekedwa mphindi ziwiri asanadye.
Phunziro lachigawo chomwe ndimachita ndi insulin glulisin, insulin lispro ndi insulle ya insulin yaumunthu pagulu la odwala omwe ali ndi matenda osokoneza bongo komanso kunenepa kwambiri adawonetsa kuti mwa odwala insulin glulisin amakhalanso ndi machitidwe omwe amathandizira. Phunziroli, nthawi yoti ifike 20% ya AUC yonse (dera lomwe linali pansi pa nthawi yopondera) inali mphindi 114 za insulin glulisin, mphindi 121 za insulin lispro ndi mphindi 150 zokhala ndi insulin yaumunthu, ndi AUC (0-2 maola), kuwonetsera komanso ntchito yoyambirira ya hypoglycemic, motero, inali 427 mg / kg ya insulin glulisin, 354 mg / kg kwa insulin lispro, ndi 197 mg / kg ya insulle ya anthu.
Maphunziro azachipatala a mtundu 1.
M'masabata makumi awiri ndi awiri oyesa gawo lachitatu la III, lomwe limayerekezera ndi insulin glulisin ndi insulin lispro, yomwe imayendetsedwa mosakhalitsa asanadye (0¬15 mphindi), odwala omwe ali ndi matenda a shuga 1 omwe amagwiritsa ntchito insulin glargine ngati insulin insulini, insulin glulisin anali kufananizidwa ndi insulin lispro pokhudzana ndi kayendedwe ka glycemic, komwe kunayesedwa ndi kusintha kwa kuchuluka kwa glycosylated hemoglobin (Lb1c) panthawi yophunzira poyerekeza ndi koyambirira. Miyezo yamagazi yofananira idawonedwa, yotsimikiziridwa ndi kudzipenda. Ndi makonzedwe a insulin glulisin, mosiyana ndi mankhwala a insulin, lyspro sanafune kuwonjezeka kwa mlingo wa basal insulin.
Chiyeso cha milungu iwiri cha gawo lachitatu chomwe chimachitika mwa odwala omwe ali ndi matenda a shuga 1 omwe adalandira insulin glargine monga chithandizo choyambira cha basal chinawonetsa kuti mphamvu ya insulin glulisin yoyang'anira mukangomaliza kudya inali yofanana ndi ya insulin glulisin musanadye chakudya 0-15 mphindi) kapena sungunuline wa insulin ya anthu (30-45 mphindi musanadye).
Mwa kuchuluka kwa odwala omwe anamaliza phunziroli, pagulu la odwala omwe adalandira insulin glulisin asanadye, panali kuchepa kwakukulu kwa HL1C poyerekeza ndi gulu la odwala omwe adalandira insulin yaumunthu yosungunuka.

Type 2 shuga
Kuyesedwa kwamankhwala kwa gawo la 26 kwa milungu 26 yotsatiridwa ndi kafukufuku wotsatira wotsatira wa sabata la 26 kunachitika kuti afanize insulin glulisin (0-15 mphindi musanadye) ndi insulin ya insulle ya anthu (30-45 mphindi musanadye), anali kutumikiridwa subcutaneous odwala ndi mtundu 2 matenda a shuga, kuwonjezera ntchito insulin-isofan ngati basal insulin. Mtundu wa odwala wodwalayo unali 34,55 kg / m2. Insulin glulisin adadziwonetsa kuti ali ngati fanizo la insulle yaumunthu poyerekeza ndi kusintha kwa kuwunika kwa HL1C pambuyo pa miyezi 6 ya chithandizo poyerekeza ndi mtengo woyambira (-0.46% wa insulin glulisin ndi -0.30% wa insulle ya insulle ya anthu, p = 0.0029) ndi Pambuyo pa miyezi 12 ya chithandizo poyerekeza ndi mtengo woyambira (-0.23% wa insulini glulisin ndi -0.13% wa insulle yaum sungunuka ya anthu, kusiyana sikofunikira). Phunziroli, odwala ambiri (79%) anasakaniza insulin yochepa ndi insulin-isophan nthawi yomweyo isanalowe. Odwala a 58 panthawi ya kuchepa kwa mankhwalawa amagwiritsa ntchito othandizira pakamwa hypoglycemic ndipo adalandira malangizo kuti apitilize kumwa iwo muyezo womwewo (osasinthika).

Mtundu ndi jenda
M'mayeso azachipatala olamulidwa mwa achikulire, kusiyana pakubwera ndi chitetezo cha insulin glulisin sikunawonetsedwe mukuwunika kwamagulu omwe amasiyana ndi mtundu ndi jenda.

Pharmacokinetics Mu insulin glulisin, m'malo mwa amino acid asparagine wa insulin ya anthu pamalo B3 ndi lysine ndi lysine pamalo B29 okhala ndi glutamic acid amalimbikitsa kuyamwa mwachangu.

Mayamwidwe ndi Bioavailability
Pharmacokinetic nthawi yokhazikika pama odzipereka athanzi komanso odwala omwe ali ndi mtundu woyamba wa 2 komanso mtundu wa matenda ashuga 2 amawonetsa kuti mayamwidwe a insulini glulisin poyerekeza ndi insulle ya insulin yamunthu anali pafupifupi nthawi 2, ndipo kuchuluka kwakukulu kwa plasma (Stax) kunali pafupifupi 2 zina.
Mu kafukufuku yemwe wachitika kwa odwala omwe ali ndi matenda a shuga 1, atatha kulowetsedwa kwa insulin glulisin pa mlingo wa 0.15 U / kg, Tmax (nthawi yoyambira ndende ya plasma) anali mphindi 55, ndipo Stm anali 82 82 1.3 mcU / ml kuyerekezera ndi Tmax ya mphindi 82 ndi Cmax ya 46 ± 1.3 μU / ml ya insulin yaumunthu. Nthawi yokhazikika yokhala ndi kufalikira kwa insulin glulisin inali yochepa (mphindi 98) kuposa yosungunulira munthu insulin (161 mphindi).
Pakafukufuku wa odwala omwe ali ndi matenda a shuga 2 atatha kulowetsedwa kwa insulin glulisin pa mlingo wa 0.2 U / kg, Stax anali 91 mkU / ml wokhala ndi masentimita 78 mpaka 104 mkU / ml.
Ndi subcutaneous makonzedwe a insulin glulisin m'chigawo cha anterior m'mimba khoma, ntchafu, kapena phewa (m'chigawo cha minyewa ya deltoid), mayamwidwe anali mwachangu pamene adalowetsedwa m'chigawo cha khomo lakunja kwam'mimba poyerekeza ndi kuyamwa kwa mankhwalawa. Kuchuluka kwa mayamwidwe kudera lotetemera kunali kwapakatikati.
The bioavailability wa insulin glulisin pambuyo subcutaneous makonzedwe anali pafupifupi 70% (73% kuchokera khoma lamkati lakumbuyo, 71 kuchokera ku minofu ya deltoid ndi 68% kuchokera kudera lachikazi) ndipo anali ndi kusiyana kochepa kwa odwala osiyanasiyana.

Kugawa
Kugawidwa ndi kutulutsidwa kwa insulin glulisin ndi madzi osungunuka pambuyo pa intravenous makonzedwe akufanana, ndikugawa mavitamini 13 malita ndi malita 21 ndi theka la moyo wamphindi 13 ndi 17, motsatana.

Kuswana
Pambuyo pothandizidwa ndi insulin, glulisin imapukusidwa mwachangu kuposa insulin yaumunthu, ndikumakhala ndi moyo wamphindi 42, poyerekeza ndi theka la moyo wosasungunuka wamunthu wamphindi 86.Pakufufuza kwapadera kwamaphunziro a insulin glulisin mwa onse athanzi komanso omwe ali ndi matenda amtundu wa 1 komanso mtundu wa 2, theka la moyo limachokera pamphindi 37 mpaka 75.

Magulu Opatsa Odwala

Odwala omwe ali ndi vuto la impso
Mu kafukufuku wazachipatala omwe amapangidwa mwa anthu omwe alibe magwiridwe antchito osiyanasiyana a impso (creatinine clearance (CC)> 80 ml / min, 30¬50 ml / min, 1/10, wamba:> 1/100, 1/1000, 1 / 10000,

Kusiyana pakati pa mankhwala a insulin

Pakadali pano popanga mankhwala achikhalidwe, mankhwala osokoneza bongo a insulin komanso omwe amakhala nthawi yayitali atapangidwa. Mtundu uliwonse wamankhwala uli ndi magulu ake. Kugawana kotere kumatipatsa mwayi wopatutsa mankhwala kutalika kwake komanso nthawi. Insulin yogwira ntchito yayifupi imatchedwa chakudya, ndipo ndi kuphatikiza kwa nthawi yayitali - basal.

Mwa mankhwala omwe ali ndi nthawi yayitali, mitundu iwiri imasiyanitsidwa: insulin ya nthawi yayitali komanso mankhwala omwe amakhala ndi mphamvu yayitali. Mankhwalawa amagwiritsidwa ntchito kuti azigwiritsa ntchito nthawi zonse potengera insulin. Zitsanzo zamapangidwe opanga nthawi yayitali ndi zonyansa komanso mawonekedwe, ndipo mawonekedwe omwe amatha nthawi yayitali amatha kukhala Lente ndi NPH.

Kukonzekera mwachidule za insulin kumapangidwira kuti athe kuletsa nsonga za chakudya. Ultrashort insulin ikhoza kuyamba ntchito yake mu mphindi 10-15. Mankhwala a insulin omwe amangokhala pakanthawi kochepa amayamba kupereka mphamvu zawo pambuyo pa theka la ola.

Koma kuchuluka kwa mitundu yamitunduyi sikungosiyana pakati pawo. Mwachitsanzo, ICD iyenera kubayidwa mwachindunji m'mimba, zomwe zimathandizira njira yolowetsera chinthu.

Mankhwala a nthawi yayitali ayenera kuyilowetsa mu ntchafu. Mankhwala a ultrashort ndi ma insulin achidule ayenera kuyendetsedwa molumikizana ndi zakudya.

Izi zichitike theka la ola musanadye. Mankhwalawa ndi nthawi yayitali komanso yapakati mukufunika kuti mulowe ndi ora.

Izi zimachitika molingana ndi dongosolo lokhazikika m'mawa ndi madzulo. Mutha kuphatikiza kugwiritsa ntchito kwawo ndi mankhwala othamangira ngati izi zachitika m'mawa.

Kukonzekera mwachangu kumafunikira chakudya chotsatira cha wodwalayo. Simungathe kuphwanya malamulowa, apo ayi ikhoza kuyamba kutsatira hypoglycemia.

Koma mankhwala omwe amapezeka nthawi yayitali samayenderana ndi chakudya, chifukwa ngati kulibe kudya, ndiye kuti mutha kudumpha kudya.

Zotsatira zoyipa za insulin

Mankhwala osokoneza bongo okhala ndi nthawi yayitali, ngati ayambitsidwa pansi pakhungu, amayamba kuwonekera pambuyo pazowonjezera maola angapo. Kuchuluka kwa ntchito zawo kumatha kuyamba atatha maola 6 kapena 8 kuyambira nthawi yoyang'anira. Mwambiri, nthawi yonse yowonekera imakhala pafupifupi maola 10-12. Pali magulu angapo oimira.

Mwachitsanzo, Monotard ndi insulin-zinc, Protafan ndi Monodar ndi mitundu ya monocomponent yozikidwa pa hormone ya nkhumba. Ichi ndi chitsanzo cha insulin isophane. Pali mitundu iwiri ya mankhwala omwe amapangidwa pamaziko a mahomoni amunthu. Mtundu woyamba ndi wopanga. Mulinso Humodar ndi Biogulin. Mtundu wachiwiri, wopangidwa mwabadwa, umaphatikizapo Gensulin, Insuran, Biosulin ndi zina zotero.

Mu shuga mellitus wamtundu wachiwiri, kuphatikiza kwa kuphatikiza komwe kumagwiritsidwa ntchito kungagwiritsidwe ntchito. Amatchedwa zosakaniza kapena mankhwala apadera a biphasic. Amapangidwa ngati chisakanizo cha mankhwala othamangira mwachangu komanso kwa nthawi yayitali. Kuphatikiza apo, ali ndi chizindikiro monga mawonekedwe. Nambala yoyamba ndi kuchuluka kwa mankhwala omwe amagwiritsidwa ntchito mwachidule, ndipo chachiwiri ndi kuchuluka kwa mankhwala omwe atenga nthawi yayitali.

Nthawi zambiri, kuyamwa kwa kuphatikiza kwa mankhwala 2 pa tsiku. Izi zitha kuchitika m'mawa ndi madzulo. Nthawi ya nkhomaliro, mutha kulowa urea sulfonyl wokhala ndi gawo la mibadwo yachitatu. Ndikofunika kuyambitsa kusakaniza theka la ola musanadye. Izi ndichifukwa choti ali ndizinthu zofunikira kuchita mwachangu.

Pakati pa oimira mtundu uwu wa mankhwalawo, magawo awiri amakhala okha.Ndiwopangidwa moperewera, kutengera zomwe anthu amapanga. Zitsanzo za mankhwala oterewa ndi Biogulin, Humodar, Humalog ndi ena. Pali mankhwala a magawo awiri kuchokera pagulu la majini opangidwa kuchokera ku mahomoni amunthu. Izi zikuphatikizapo Gansulin, Insurman, Humalin, etc.

Mukamagwiritsa ntchito insulin, lipodystrophy pamalo jakisoni ingayambe. Lipodystrophy ndi njira yomwe kuchuluka kwa mafuta pansi pa khungu kumacheperachepera.

Nthawi zina, insulin imapangitsa kuti thupi lizigwirizana. Zikatero, muyenera kusiya kugwiritsa ntchito mankhwalawo ndikuisintha ndi analogue yotetezeka.

Kutengera mtundu wa matenda a shuga, mutha kusankha mankhwalawa malinga ndi zina zake: kugwiritsa ntchito nthawi, pafupipafupi, nthawi yayitali.

Mankhwala amakono azithandiza kusankha bwino.

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.

Mitundu yosiyanasiyana ya insulin

Kutengera njira yopangira, kukonzekera kwamtundu wa chibadwidwe ndi kufanana kwa anthu kumayesedwa. Kupanga kwamankhwala kumapeto kumakhala kwachilengedwe, chifukwa kapangidwe kazinthu kazinthu izi ndizofanana ndi insulin yaumunthu. Mankhwala onse amasiyana pakapita nthawi.

Ma insulin omwe amagwira ntchito mwachidule amagwiritsidwa ntchito poyeserera katulutsidwe wamahomoni omwe amakhudzidwa ndi zakudya. Gawo lakumbuyo limathandizidwa ndi mankhwala omwe ali ndi zochita zazitali.

Mankhwalawa amasankhidwa malinga ndi nthawi yochitapo kanthu. Pali jakisoni wa mitundu ili:

• jakisoni wa ultrashort,
• majekiseni afupiafupi
• nthawi yayitali
• jekeseni wautali.

Mitundu iyi ya jakisoni imadziwika ndi nthawi yomwe mankhwalawa amagwira ntchito, kutsika magazi moyenera.

Kuchiza kumachitika nthawi yomweyo ndi mitundu ingapo ya mankhwalawa. Izi zimakuthandizani kuti muzitha kuyendetsa bwino shuga komanso kupewa kuwonjezera kuchuluka kwake.

Pali tebulo momwe tsatanetsatane wa zochita za jekeseni wamtundu uliwonse amafotokozedwera mwatsatanetsatane. Aliyense amene ali ndi matenda ashuga ayenera kuwona izi mu ofesi yawo ya udokotala.

Insulin yogwira ntchito yayifupi imayamba kugwira ntchito pafupifupi theka la ola pambuyo popereka. Kuchuluka kwa mahomoni m'magazi kumachitika pafupifupi maola 3.5 pambuyo pa jakisoni, ndiye kuti mulingo wake umachepa. Pafupifupi, insulin yochepa imakhala pafupifupi maola 5-6.

Ultrashort insulini imayamba kuchita kwenikweni patadutsa mphindi zochepa pambuyo pa kukhazikitsa. Kuzindikira kwakukulu kumafika mphindi 60 pambuyo pa utsogoleri, kenako kutsika pang'onopang'ono kumayamba. Pazonse, insulin ya ultrashort simatha maola opitilira 4.

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.

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.

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.

Mukamagwiritsa ntchito mankhwalawa, ndikofunikira kukhazikitsa chakudya chamagulu ochepa, masewera olimbitsa thupi, moyo wambiri. Ichi ndichifukwa chosatheka kusankha kuchuluka kwa mtundu wa insulin pakadali pano wofunikira.

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

Kutuluka kwa minofu ya pang'onopang'ono ya adipose pang'onopang'ono, mphamvu yogwira imakuthandizani kuti mukhale ndi shuga mkati mwa 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. Zochita zapamwamba. 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.

Chithandizo cha insulin chimaphatikizapo kutsata zachilengedwe zobisika za mahomoni pogwiritsa ntchito mankhwala. 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.

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.

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.

Mitundu ya insulashort ya insulin ndi Humalog (Lizpro), NovoRapid (Aspart) ndi Apidra (Glulizin). Amapangidwa ndi makampani atatu osiyanasiyana azachipatala omwe amapikisana nawo. Insulin yochepa yofananira ndi yaumunthu, ndipo ma ultrashort ndi ma analogi, i.e. amasinthidwa, kusinthidwa, poyerekeza ndi insulin yeniyeni ya anthu. Kusintha kuli potengera kuti amayamba kutsitsa shuga wamagazi ngakhale othamanga kuposa amfupi - mphindi 5 mpaka jakisoni.

Ma Ultrashort insulin analogi adapangidwa kuti achepetse kuchepa kwa shuga m'magazi pomwe munthu wodwala matenda ashuga akufuna kudya chakudya champhamvu kwambiri. Tsoka ilo, malingaliro awa sagwira ntchito. Zakudya zopatsa mphamvu, zomwe zimamwe nthawi yomweyo, zimakulitsa shuga m'magazi mwachangu kuposa momwe insulin yayifupi kwambiri ingapangire kuti itsike. Ndi kukhazikitsidwa kwa mitundu yatsopanoyi ya insulin pamsika, palibe amene adaletsa kufunika kotsatira zakudya zamagulu ochepa ndikutsatira njira zamagulu ochepa. Inde, muyenera kutsatira regimen pokhapokha ngati mukufuna kuwongolera matenda ashuga komanso kupewa zovuta zake.

Ngati mutsatira zakudya zamafuta ochepa a 1 kapena 2 shuga, ndiye kuti insulin yayifupi ya anthu ndiyabwinobwino jakisoni musanadye kuposa anzawo ena ochepa. Chifukwa odwala omwe ali ndi matenda ashuga omwe amadya zakudya pang'ono, thupi limayamba kugaya mapuloteniwo, kenako ndikusintha ena kuti akhale glucose. Uku ndikuchita pang'onopang'ono, ndipo insulin ya ultrashort imayamba kuchita zinthu mwachangu kwambiri. Mitundu yayifupi ya insulin - kulondola. Nthawi zambiri amafunika kuti akhazikitsidwe mphindi 40-45 musanadye chakudya chamafuta ochepa.

Insulin "Apidra" - kwa ana omwe ali ndi matenda ashuga

Unduna wa Zaumoyo ku Israeli wavomereza kugwiritsa ntchito insulin Apidra (insulin Glulizin), analogue ya insulin yofulumira kugwiritsa ntchito ana kuyambira azaka 6 zakubadwa.

Kuvomerezeka kwa kugwiritsa ntchito insulini ya Apidra kwakhazikika pa kafukufuku wamasamba 26 owonetsedwa ndi FDA (US Food and Drug Administration) yomwe idakhudza ana 572. Zotsatira za phunziroli zatsimikizira chitetezo cha kumwa komanso kugwiritsa ntchito mankhwalawa kwa ana ndi achinyamata.

Posachedwa, Apidra insulin adalembetsedwera ku USA ndipo amaloledwa kwa ana azaka 4, m'maiko a EU - kwa ana ndi achinyamata kuyambira zaka 6.

Apidra insulin, yopangidwa ndi kampani yapadziko lonse yamankhwala Sanofi Aventis, ndi analog ya insulin yomwe imagwira mwachangu, yomwe imayamba mwachangu komanso yayitali. Amawonetsedwa kwa odwala omwe ali ndi matenda amtundu wa 1 ndi mtundu wa 2, kuyambira ali ndi zaka 6. Mankhwalawa amapezeka mu mawonekedwe a cholembera kapena inhaler.

Apidra imapatsa odwala kusinthasintha kwakukulu pokhudzana ndi jakisoni ndi nthawi ya chakudya. Ngati ndi kotheka, insulin Apidra ikhoza kugwiritsidwa ntchito ndi insulin yayitali monga Lantus.

Za matenda ashuga

Matenda a shuga ndi matenda osachiritsika, ofala chifukwa cha kuchepa kwa chinsinsi cha insulini ya mahomoni kapena ntchito yake yochepa. Insulin ndi mahomoni ofunikira kuti asinthe shuga (shuga) kukhala mphamvu.

Popeza kapamba pafupifupi kapenanso satulutsa insulin, odwala matendawa amakhala ndi jakisoni wa insulin tsiku lililonse pamoyo wawo. Mtundu wachiwiri wa matenda ashuga, kapamba amapitiliza kupanga insulini, koma thupi limakana kugonjera timadzi tomwe timatulutsa timadzi tomwe timayambira.

Malinga ndi ziwerengero, ana 35,000 omwe ali ndi matenda ashuga amakhala ku Israel. International Diabetes Federation (IDF) ikuyerekeza kuti pali ana 440,000 osakwana zaka 14 omwe ali ndi matenda ashuga amtundu 1 padziko lonse lapansi omwe amapezeka ndi matenda atsopano 70,000 pachaka.

Zomwe zimachitika posankha insulin. Mankhwala otchuka kwambiri

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.

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.

Pali mitundu ingapo ya zolembera za syringe:

• Chodzaza (chokonzeka kugwiritsa ntchito) - 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.

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.

Musanagule mankhwala muchipatala, muyenera kufunsa dokotala za mawonekedwe a pulogalamuyi. Ngakhale kuti chidziwitsochi chili ndi malangizo a mankhwalawa, nthawi zina, kusintha kwa mlingo kungakhale kofunikira.

Kuchuluka kwa insulini inayake kuyenera kupezeka mwachindunji mu mankhwala. Mwatsatanetsatane za mitundu ya insulini ya mahomoni ndi momwe zochita zawo zimasiyanirana, dokotala amatha kudziwa, ndikupereka mankhwala.

Ma insulin a Ultrashort ali ndi mayina otsatirawa: Novorapid, Apidra. Zomwe zili bwino, ndi dokotala yekha yemwe angayankhe, kutengera mawonekedwe a matendawo mwa wodwala wina.

Ma insulin omwe amagwira ntchito mwachidule ali ndi mayina ambiri, omwe amafotokozedwa mwatsatanetsatane pama tebulo mu ofesi ya endocrinologist. N`zosatheka kugwiritsa ntchito mankhwalawo popanda kugwiritsa ntchito katswiri.

Insulin yochita zinthu mwachidule imagwiritsidwa ntchito malinga ndi chiwembu chomwe chili ndi malangizo ogwiritsira ntchito. Komabe, ngati kuli kotheka, muyezo wake umasinthidwa ndi dokotala.

Mankhwala -
681, Mayina Ogulitsa -
125, Zogwira ntchito -
22

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 mahomoni a Ultrashort, monga lamulo, amatchedwa mankhwala opangidwa ndi chibadwa cha insulin ya anthu.

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.

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.

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.

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.

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.

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.

Jakisoni wa insulin amachitika pogwiritsa ntchito syringe ya insulin kapena cholembera. Zotsalazo ndizosavuta kugwiritsa ntchito mosamala mankhwalawa, motero amawakonda. Mutha kuperekanso jakisoni ndi cholembera popanda kuvula zovala zanu, zomwe ndi zosavuta, makamaka ngati ali kuntchito kapena ku sukulu yophunzitsa.

Insulin imalowetsedwa m'matumbo a mafuta am'malo osiyanasiyana, nthawi zambiri imakhala kutsogolo kwa ntchafu, m'mimba ndi phewa. Mankhwala omwe akhala akuchita kwa nthawi yayitali amakonda kubisala ntchafu kapena kunja kwa khola, kumangokhala pang'ono m'mimba kapena phewa.

Chofunikira ndikutsatira malamulo aseptic, ndikofunikira kusamba m'manja musanalowe jakisoni ndikugwiritsa ntchito syringes zokhazo. Kumbukirani kuti mowa umawononga insulini, chifukwa, pambuyo poti jekeseni wathandizidwa ndi antiseptic, ndikofunikira kudikirira mpaka kumira kwathunthu, kenako ndikupitilira ndi mankhwalawa. Ndikofunikanso kupatutsidwa kuchokera pa malo omwe kale anali jekeseni osachepera 2 cm.

Insulin yochepa imapezeka m'njira ziwiri:

1. Potengera ma genetic, mahomoniwa amapangidwa ndi mabakiteriya.
2. Zopanga zokha, pogwiritsa ntchito kusintha kwa ma enzymes a nkhumba.

Mitundu yonse iwiri ya mankhwalawa imatchedwa yaumunthu, chifukwa ndi kapangidwe kake ka amino acid amabwereza kwathunthu mahomoni omwe amapangidwa mu kapamba athu.

Zolemba zogwiritsira ntchito

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.

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.

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 wabwinobwino 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, wodwala ayenera kulowa magawo 7 a prandial mankhwala (1 unit 6 unit).

Mankhwalawa amafuna kusungidwa mosamala. Njira yabwino ndikusunga mankhwala mufiriji. Chifukwa chake sizikuwononga mpaka kumapeto kwa nthawi yowonetsedwa ndi wopanga pa phukusi.

Kutentha kwachipinda, mitundu yonse ya insulini imasungidwa osaposa mwezi umodzi, ndiye kuti mawonekedwe ake amawonongeka kwambiri. Ndikofunika kusunga insulin yayifupi mufiriji, koma osati pafupi ndi mufiriji.

Nthawi zambiri odwala sazindikira kuti mankhwalawa afooka. Izi zimabweretsa kuti mankhwalawa sagwira ntchito, mulingo wa shuga umakwera. Ngati simusintha mankhwalawa panthawi, pamakhala chiwopsezo chachikulu chokhala ndi mavuto akulu, mpaka ndimadwala matenda ashuga.

Palibe chifukwa chakuti mankhwalawo atha kukhala oundana kapena kuwonetsedwa ndi radiation ya ultraviolet. Kupanda kutero, imawonongeka ndipo singagwiritsidwe ntchito.

Anthu ena omwe ali ndi chimbudzi chatsiku ndi tsiku ndipo amatha kucha amapanga mahomoni ambiri: cortisol, glucagon, adrenaline. Amatsutsana ndi insulin. Kubisala kwa mahormoni chifukwa cha umunthu wake kumatha kudutsa mwachangu komanso mwachangu. Mu odwala matenda ashuga, hyperglycemia imatsimikiza m'mawa. Matendawa ndi ofala. Pafupifupi ndizovuta kuthetsa. Njira yokhayo yotuluka ndi jakisoni wa insulin yochepa kwambiri mpaka magawo asanu ndi limodzi, omwe amapangidwa m'mawa kwambiri.

Nthawi zambiri, mankhwala osaneneka amapangira chakudya. Chifukwa chakuchita bwino kwambiri, jakisoni amatha kupatsidwa nthawi ya chakudya komanso mukatha. Kutalika kochepa kwa mphamvu ya insulin kumakakamiza wodwala kuti apange jakisoni yambiri masana, tsanzirani kupanga kwachilengedwe kwa kapamba pazakudya zamafuta am'thupi mu thupi. Ndi kuchuluka kwa zakudya, mpaka nthawi 5-6.

Kuti muchepetse kusokonezeka kwakukulu kwa metabolic mu coma kapena precomatose, ngati matenda ndi ovulala a ultrashort amagwiritsidwa ntchito popanda kulumikizana ndi omwe amakhala nthawi yayitali. Pogwiritsa ntchito glucometer, ndiye kuti, chipangizo chothandiza kudziwa kuchuluka kwa shuga, amawunika glycemia ndikubwezeretsa kuwonongeka kwa matendawa.

Mayina a insulin ya ultrashort sakudziwika kwa aliyense. Amawerengedwa m'nkhaniyi.

Pankhani yomanga thupi, amagwiritsa ntchito katundu wotereyu monga yofunika kwambiri ya anabolic, zomwe ndi izi: maselo amatenga ma amino acid mwachangu, mapuloteni a biosynthesis amawonjezeka kwambiri.

Insulin yocheperako pang'ono imagwiritsidwanso ntchito pomanga thupi. Thupi limayamba kugwira ntchito pakatha mphindi 5 mpaka 10. Ndiye kuti, jakisoni amayenera kuchitika musanadye, kapena mutangomaliza kudya. Kuchuluka kwa insulini kumachitika pakadutsa mphindi 120 pambuyo pake. Mankhwala abwino amatengedwa ngati "Actrapid NM" ndi "Humulin wokhazikika."

Ultrashort insulin popanga thupi sikusokoneza magwiridwe antchito a chiwindi ndi impso, komanso potency.

Zisonyezero zakukhazikitsa insulin yayifupi

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.

Insulin yochepa yodziwika bwino imaphatikizidwa ndi mankhwala osokoneza bongo omwe amakhala ndi nthawi yayitali: amafupikitsidwa musanadye, komanso nthawi yayitali - m'mawa komanso asanagone.Chiwerengero cha jakisoni wa mahomoni sichikhala ndi malire ndipo zimangotengera zosowa za wodwalayo. Kuti muchepetse kuwonongeka kwa khungu, muyezo ndi jakisoni 3 musanadye chakudya chilichonse komanso kuphatikiza jakisoni 3 kukonza hyperglycemia. Ngati shuga amadzuka chakudya chisanafike, makonzedwe opangira mankhwala amaphatikizidwa ndi jekeseni yomwe anakonza.

Mukafuna insulin yayifupi:

1. Mtundu umodzi wa matenda ashuga.
2. 2 mtundu wamatenda pomwe mankhwala ochepetsa shuga salinso othandizira.
3. Matenda a shuga okhathamira okhala ndi shuga wambiri. Kwa gawo losavuta, jekeseni wa 1-2 wa insulin yayitali nthawi zambiri amakhala okwanira.
4. Opaleshoni ya kapamba, yomwe idayambitsa kusokonekera kwa mahomoni.
5. Chithandizo cha pachimake zovuta za matenda ashuga: ketoacidotic ndi hyperosmolar coma.
6. Nthawi yochulukirapo ya insulin: Matenda otentha kwambiri, kugunda kwa mtima, kuwonongeka kwa ziwalo, kuvulala kwambiri.

Kupewa kwa lipodystrophy

Wodwala matenda ashuga amayeneranso kusamala ndi kupewa kupewa lipodystrophy. Maziko ake ndi zolakwika zamagulu olimbitsa thupi, zomwe zimatsogolera pakuwonongeka kwa fiber pansi pa khungu. Maonekedwe a madera otetezedwa chifukwa cha kubayidwa pafupipafupi sikugwirizana ndi kuchuluka kwa mankhwalawa kapena kubwezera bwino matenda a shuga.

Insulin edema, m'malo mwake, ndizovuta zachilengedwe za endocrine. Pofuna kuti musaiwale komwe jakisoni, mutha kugwiritsa ntchito chiwembu chomwe pamimba (mikono, miyendo) chimagawidwa m'magulu masiku a sabata. Pakupita masiku angapo, chivundikiro cha khungu chakumbiracho chimabwezeretsedwa bwino.

Kodi ndichifukwa chiyani ultrashort insulin ndi yabwino kapena yabwinobwino kwa anthu odwala matenda ashuga?

Insulin Apidra (Epidera, Glulisin) - ndemanga

Ndikufuna kunena mawu ochepa, kotero kuti mulankhule mofunafuna motentha, pakusintha kuchoka ku chizimba kupita ku apidra. Ndikutembenukira lero lero. Ndakhala pa Humulin NPH humalogue kwazaka zoposa 10. Ndinaphunzira zabwino ndi zovuta zonse pazomangamanga, zomwe zilipo zambiri. Zaka zingapo zapitazo ndidasinthidwa kupita ku apidra kwa miyezi iwiri ndi iwiri, chifukwa panali zosokoneza mu chipatalachi.

Momwe ndimamvetsetsa, sindinali ndekha. Ndipo mukudziwa, mavuto ambiri omwe ndimayanjanitsidwa nawo kale anazimiririka. Vuto lalikulu ndi kutuluka kwa m'mawa. Shuga pamimba yopanda kanthu panthawi ya apidra mwadzidzidzi adakhazikika. Ndi macheza, komabe, palibe zoyesera zamtundu wa humalogue ndi NPH, kapena kuyesa kwa shuga usiku wonse, sizinaphule kanthu.

Mwachidule, ndidadutsa mayeso, ndidadwala ambiri, ndipo endocrinologist wathu adandilembera apidra m'malo mwa humalogue. Lero ndi tsiku loyamba lomwe ndinapita kukagwira naye ntchito. Zotsatira zake zimakhala zoipa kwambiri. Anachita chilichonse lero mwamtheradi ngati kuti adalowetsa humalogue, ndipo mwina angathira shuga yambiri m'matumba ake. Asanadye chakudya cham'mawa, nthawi ya 8:00 a.m. panali 6,0, zomwe ndikuganiza kuti ndizabwinobwino.

Ndidagwidwa ndi apidra, ndimadya chakudya cham'mawa, zonse zili monga mwa masiku monga XE, ndimafika kuntchito nthawi ya 10:00. Shuga 18,9! Sambani iyi ndi mbiri yanga yonse! Zikuwoneka kuti sindinangobaya. Ngakhale insulin yofupikitsa imatha kupereka zotsatira zabwino. Zachidziwikire, nthawi yomweyo ndidapanga mayunitsi ena 10, chifukwa ndimaona kuti ndizosamveka kupita ndi zoterezi. Pofika masana, nthawi ya 13:30, sk anali kale 11.1. Lero ndimayang'ana shuga ola lililonse ndi theka.

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. Phunzirani kusunga malamulo ndikuwatsata mosamala.

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

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

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

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

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.

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

Momwe mungasankhire insulin yoyenera, yabwino?

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

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

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

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

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

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

Ndi ma jakisoni amtundu wa insulin omwe amachita kamodzi patsiku?

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

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

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

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

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

Mitundu ina yabwino yosakanikirana ndi insulin ndi iti?

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

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

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

Momwe mungapangire insulin pamsika wamafuta?

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

Kodi insulini yabwino kwambiri ndi iti?

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

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

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

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

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

Kodi kukonzekera insulini sikungayambitse bwanji?

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

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

Mitundu ya Insulin-Yaitali

Mitundu ya insulin yomwe imatenga nthawi yayitali imapangidwa kuti isungidwe shuga wamba pamimba yopanda masana, komanso usiku pakamagona. Mphamvu ya jakisoni wa ndalamazo usiku zimayendetsedwa ndi kuchuluka kwa shuga m'magazi m'mawa wotsatira pamimba yopanda kanthu.

Tsamba la Endocrin-Patient.Com limalimbikitsa chithandizo chosagwirizana koma chothandiza kwa matenda amtundu wa 2 komanso matenda a shuga 1 opangidwa ndi Dr. Bernstein. Onerani kanema wake pamitundu yotchuka ya insulin yayitali.

Mankhwala omwe afotokozedwa pansipa samathandizira kutsitsa shuga wambiri, komanso samapangidwira kuthira kwa zakudya zama protein ndi mapuloteni omwe amadyedwa. Osayesa kubwezeretsa jakisoni waifupi kapena wa ultrashort ndi mapiritsi akuluakulu a mankhwala omwe akhala akuchita kwa nthawi yayitali.

Kusunga maziko a insulin m'magazi, mankhwala ogwiritsira ntchito pakati (protafan, NPH) komanso ochita masewera olimbitsa thupi (Lantus ndi Tujeo, Levemir) amagwiritsidwa ntchito. Posachedwa, insulin Treshiba (degludec) yowonjezerapo yogwira ntchito wakhala akuwoneka, yemwe wakhala mtsogoleri chifukwa cha zomwe adachita bwino. Onani tebulo pansipa kuti mumve zambiri.

Therapy 2 matenda a insulini pachikhalidwe amayamba jakisoni wa insulin yowonjezera. Pambuyo pake, amathanso kuwonjezera jakisoni wamankhwala ochepa kapena a ultrashort musanadye. Nthawi zambiri, madokotala amalembera odwala omwe ali ndi matenda a shuga 2 omwe amapita muyezo wa inshuwaransi 10-20 patsiku kapena amaganiza mlingo woyambira malinga ndi kulemera kwa thupi la wodwalayo. Dr. Bernstein akuvomereza njira yodziwonera payekha. Ndikofunikira kuwunika momwe shuga amapangira mkati mwa masiku 3-7, kuyesa ndi glucometer. Pambuyo pake, pulogalamu ya insulin mankhwala imasankhidwa, kusanthula zomwe zapezeka. Izi zikufotokozedwa mwatsatanetsatane pamwambapa.

Kuphatikiza pa mankhwala omwe alembedwa patebulopo, pali mitundu ingapo ya insulin yomwe imagwira ntchito. Dr. Bernstein salimbikitsa kugwiritsa ntchito mankhwalawa, koma muyenera kudziwa za iwo chifukwa ndi otchuka kwambiri. Awa ndi Protafan HM, Humulin NPH, Insuman Bazal GT, Biosulin N ndi ena. Amayamba kuchita pafupifupi maola awiri jekeseni atatha, kukhala ndi kukwera pambuyo pa maola 6 mpaka 10 ndipo kutalika kwa nthawi ndi maola 8-16. Insulin yapakatikati nthawi zambiri imatchedwa protafan. NPH imayimira Hagedorn's Neutral Protamine. Ichi ndiye mapuloteni amanyama omwe amawonjezeredwa kuti achepetse kuchitapo kanthu.

Chifukwa chiyani simuyenera kugwiritsa ntchito sing'anga protafan (NPH):

1. Prostamine yosaloledwa ya Hagedorn nthawi zambiri imayambitsa zovuta zonse.
2. Anthu ambiri odwala matenda ashuga pakapita nthawi amafunika kuyesedwa ndi X-ray pogwiritsa ntchito njira yosiyanitsira pakati kuti ayesetse ziwiya zomwe zimadyetsa mtima. Odwala omwe adalandira jekeseni ya protafan, thupi limasokoneza kwambiri nthawi ya mayeso, nthawi zambiri amakhala osazindikira ngakhale kufa.
3. Anthu odwala matenda ashuga omwe amatsata zakudya zama carb ochepa amakhala ndi insulin. Mu Mlingo wotsika chotere, protafan satha maola 8-9. Akusowa usiku wonse komanso tsiku lonse.

Medium insulin protafan (NPH) sayenera kubayidwa, ngakhale ataperekedwa molingana ndi malangizo aulere, ndipo mankhwala ena omwe akhala akuchita kwa nthawi yayitali adzafunika kugula ndalama zanu.

Ndi insulin iti yomwe ili bwino: Lantus kapena Tujeo?

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

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

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

Kodi pali kusiyana kotani pakati pa insulin yochepa ndi ultrashort?

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

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

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

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

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

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

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

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

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

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

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

Zimatenga nthawi yayitali bwanji kubaya insulin mwachangu?

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

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

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

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

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

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

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

Humalog ndi Apidra - kodi insulin ndi chiyani?

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

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, Dr. Bernstein akuti Humalog ndi wamphamvu kuposa awiri enawo, ndipo ayambanso kuchita zinthu mwachangu.

Mankhwala onsewa siabwino kwenikweni kwa jakisoni musanadye matenda ashuga omwe amatsata zakudya zama carb ochepa. 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.

Ndemanga 16 pa "Mitundu ya insulin ndi zomwe amachita"

Masana abwino Ndili ndi zaka 49, matenda ashuga amtundu 1 adayamba zaka 3 zapitazo, kutalika 169 masentimita, kulemera kwa 56 kg. Funso: Kodi kuyezetsa magazi komwe kumandilola kudziwa kuti ndi insulin iti? Posachedwa ndidasinthira ku Protafan ndi Aktrapid, koma zofananira zonse, redness imakhalabe kwa nthawi yayitali pamalo opangira jekeseni ndi cholembera.

Kodi pali kuyezetsa magazi komwe kumandilola kudziwa kuti ndi insulin iti yomwe ndidzaipayire?

Palibe kusanthula koteroko. Kukonzekera bwino kwambiri kwa insulin kumasankhidwa poyesa komanso zolakwika.

chosinthidwa kukhala Protafan ndi Aktrapid, redness imakhalabe kwa nthawi yayitali pamalo opangira jekeseni ndi cholembera.

Ndikwabwino m'malo mwa protafan ndikugwiritsanso ntchito insulin yotalikilapo. Werengani zambiri mu nkhaniyi.

Ndili ndi zaka 68. Mtundu woyamba wa matenda ashuga, wazaka 40 wazaka. Zili mwatsoka. Pali zovuta. Chidwi kwambiri ndi Fiasp insulin. Ndikufunsani, tiuzeni za iye mwatsatanetsatane momwe mungathere. Tsopano ndinasinthira ku Tresiba - Kolya, ngati kale la Levemir. Zotsatira zake zimakhala zabwino - koyamba nthawi yayitali. Zakudya zomanga thupi. Ndili ndi chizolowezi cha ketoacidosis komanso kusintha koyambira kwa impso, chifukwa chake ndimawopa kudya zakudya zamafuta ochepa. Ngakhale zili bwino bwanji ndi GI yotsika yopanda nsonga! Ndine wokondwa kwambiri kuti ndapeza tsamba lanu! Ndionjezanso: tsopano ndili ndi bolalog Humalog kuyambira 2001. Ndipo ena onse omwe amapangira mankhwalawa posachedwa sagwira ntchito. Ndimakonda Akirapid - Ndimapanga ndikamadya mtedza wambiri kapena nyama, kawirikawiri. Zakhala kale zovuta kwa iye.

Chidwi kwambiri ndi Fiasp insulin. Ndikufunsani kuti munene za iye mwatsatanetsatane

Ultrashort insulini imagwirizana bwino ndi zakudya zama carb otsika, motero mankhwalawa alibe chidwi kwenikweni kwa ine. Ku Russia kulibe chilichonse chokhudza iye, koma ndine waulesi kwambiri kukumba zida zachi Ngerezi.

kusintha kwa impso, chifukwa chake ndimawopa kudya zakudya zamafuta ochepa

Ili ndiye vuto lanu lalikulu. Simuyenera kuchita mantha, koma tengani magazi ndi mkodzo poyesa ntchito ya impso. Werengani zambiri apa - http://endocrin-patient.com/diabet-nefropatiya/. Kutengera ndi zotsatira za kusanthula uku, mutha kusankha bwino ngati zakudya zamafuta ochepa zili bwino kwa inu kapena ngati mwaphonya kale sitima.

Ndine wokondwa kwambiri kuti ndapeza tsamba lanu!

Kwa odwala matenda ashuga omwe sanasinthe kudya kwa Dr. Bernstein, izi ndizothandiza.

Tsopano ndinasinthira ku Tresiba - Kolya, ngati kale la Levemir. Zotsatira zake zimakhala zabwino - koyamba nthawi yayitali.

Ichi ndi chidziwitso chofunikira. Ndemanga za mankhwala Tresib kuchokera kwa odwala omwe amalankhula Chirasha samakwanira Uthenga wanu ndiwothandiza kwa ambiri.

Moni Ndili ndi zaka 15, ndakhala ndikudwala matenda ashuga amtundu 1 kuyambira chilimwe chatha. Shuga amalumpha kuyambira 3-4 mpaka 9-11 mmol / l. Ndidakwanitsa kufika patsamba lanu, ndidachita chidwi ndipo ndimaphunzira kwa maola angapo patsiku. Pambuyo pachipatala choyambirira kuchipatala, thupi langa linakula kwambiri. Tsopano kulemera kwanga ndi 78 kg ndi kutalika kwa masentimita 167. Ndimayesetsa kudya zakudya zachilengedwe ndikusuntha zowonjezereka, koma sizithandiza. Tsoka ilo, ndimakonda kusiya njira yabwino yachipatala. Kodi zakudya zamafuta ochepa zimandithandiza kuchepetsa kunenepa? Pepani koma abzala impso. Kodi ndizowona kuti insulini imakhudza kulemera mwa kusintha glucose kukhala mafuta? Zomwe mumalemba ndizosiyana kwambiri ndi zomwe zimapezeka patsamba lina. Ndiuzeni kuti ndidye ndi chiyani pano? Ndimasewera amtundu wanji omwe ndi bwino kuchita? Kodi ndizotheka kuchepetsa mlingo wa insulin? Ndipo ngati ndi choncho, zochuluka motani? Kodi ma acetone amatha kuwoneka panthawi yakuonda? Funso lina: Kodi kusintha kwa nyengo kumakhudza bwanji anthu odwala matenda ashuga?

Kodi ndizowona kuti insulini imakhudza kulemera mwa kusintha glucose kukhala mafuta?

Inde, iyi ndi imodzi mwamachitidwe ake m'thupi.

Kodi zakudya zamafuta ochepa zimandithandiza kuchepetsa kunenepa?

Mwakutero, mulibe zosankha zina zochepetsera thupi popanda kuvulaza thanzi, kupatula kusintha kwa chakudya chochepa kwambiri cha carb komanso kuchepetsa kufanana kwa insulin.

Nthawi zina odwala matenda ashuga, okhala ndi cholinga chochepetsa thupi, amachepetsa insulini pakulavula magazi awo. Zotsatira zake zimakhala zowopsa.

Kodi ndizotheka kuchepetsa mlingo wa insulin? Ndipo ngati ndi choncho, zochuluka motani?

Odwala omwe ali ndi matenda amtundu wa 1 sangadye zopitilira 30 g zamagalimoto patsiku: 6 g pa chakudya cham'mawa, 12 g pachakudya chamadzulo komanso chakudya chamadzulo, kuchokera ku chakudya chololedwa, kupatula zakudya zomwe zaletsedwa.

Pambuyo pakusintha kwa zakudya za Dr. Bernstein, Mlingo wa insulin umachepetsedwa ndi katatu, nthawi zambiri 5-7. Nthawi yomweyo, kuchuluka kwa shuga m'magazi sikukwera, koma kukula, kudumpha kwake kumachepera.

Zomwe mumalemba ndizosiyana kwambiri ndi zomwe zimapezeka patsamba lina.

Simunakhulupirirebe kuti kukhazikitsidwa kwa malingaliro ovomerezeka sikothandiza kwenikweni?

Kodi ma acetone amatha kuwoneka panthawi yakuonda?

Inde, ndipo palibe chomwe chikuyenera kuchitika pa izi. Pangani shuga wanu pafupipafupi ndikuwasunga m'munsi mwa 9.0 mmol / L. Pindani insulini ngati kuli koyenera kuti milingo ya glucose ikhale mkati. Imwani zamadzi zambiri. Ndipo ndikwabwino kuti musayeze ziphuphu konse, kuti musadandaule ndi zinthu zopusa.

Kodi kusintha kwa nyengo kumakhudza bwanji anthu odwala matenda ashuga?

Ndimasewera amtundu wanji omwe ndi bwino kuchita?

Onani http://endocrin-patient.com/diabet-podrostkov/. Kusankha kwamasewera ndikulingalira. Kukhala ndi moyo wongokhala kumavulaza monga kusuta ndudu khumi ndi zisanu patsiku.

Moni Ndili ndi zaka 51. Kutalika ndi 167 cm, kulemera ndi 70 kg. Ndadwala matenda ashuga amtundu woyamba kwa zaka zambiri. Kohl Insuman Rapid ndi Lantus. Ngati mupitiliza kudya zakudya zama carb otsika, muyenera kudya kwakanthawi bwanji musanadye? Mutatha kudya, muyenera kukhala bwanji? Kuyenda kapena kupuma? Zikomo kwambiri pasadakhale. Ndinali ndi chiyembekezo.

Kodi ndikufunika kubaya insuman Rapid nthawi yayitali bwanji ndisanadye?

Monga insulin ina iliyonse, onani zambiri mu nkhani yomwe mudalemba ndemanga.

Mutatha kudya, muyenera kukhala bwanji? Kuyenda kapena kupuma?

Kuyenda sikungapweteke :).

Moni Ndili ndi zaka 68. Ndakhala ndikuvutika ndi matenda ashuga a 2 kuyambira ndili ndi zaka 45.
Dokotala amangopereka mankhwala a insulin yaulere wamba: Humulin NPH kapena Rinsulin NPH. Ndimamubaya kawiri patsiku m'mawa ndipo madzulo ndimagawo 18. Shuga motsutsana ndi maziko awa anali 11-13.
Nthawi ina, pomwe kunalibe insulin yapakati, adandipatsa Levemir mu Epulo. Posachedwa tsamba lanu, tsopano ndimayesetsa kutsatira zakudya zamagulu ochepa. Ndikosavuta kusintha zizolowezi, koma ndimayesetsa. Poyerekeza izi ndi zakudya komanso jakisoni, shuga a Levemir adatsikira ku 7-8. Milandu ya hypoglycemia yachepa.
Tsopano adotolo amafotokozanso insulini yapakatikati yokha. Ndipo Levemir mu pharmacy ndiokwera mtengo kwa ine - 3500 rubles. Ndiuzeni, ndi kangati momwe muyenera kubayirira insulin yapakati pano?

Ndiuzeni, ndi kangati momwe muyenera kubayirira insulin yapakati pano?

Tsoka ilo, zizolowezi zikuwonetsa kuti insulini wamba simalola kuyendetsa bwino shuga. Ganizirani momwe mungapezere mankhwala amakono.

Moni Zikomo chifukwa chatsamba lothandiza kwambiri! Timatembenukira ku chakudya chamafuta ochepa, kuwerenga zolemba zanu. Abambo (azaka 62) ali ndi matenda ashuga a 2 omwe ali ndi zovuta. Panali zovuta ziwiri zamtima, neuropathy, ndipo posachedwa, stroko yamatumbo. Opaleshoni yammbuyo, purulent epiduritis. Pafupifupi mwezi wathunthu kuchokera nthawi yomwe stroko yam'mimba idachitidwa ndi opaleshoni yam'mbuyo, thupi lonse lomwe linali pansi pa navel lidadwala ziwalo, adakali m'chipatala. Malinga ndi malangizo a endocrinologist, abambo amayika 18 magawo a Rosinsulin P m'mawa ndi madzulo, komanso magawo 8 a Rinsulin NPH musanadye katatu katatu patsiku. Tiuzeni za mankhwalawa. Kodi mumawalangiza kapena kusintha kuchokera kwa iwo kupita kwa ena? Miyezo ya shuga ya abambo akadali apamwamba kwambiri - 13-16, koma mwina izi ndi chifukwa chamachitidwe aposachedwa. Tiyenera kuchepetsa shuga. Zoyenera kuchita ndi insulin?

bambo amaika zigawo 18 za Rosinsulin P yayitali m'mawa ndi madzulo, komanso magawo 8 a Rinsulin NPH musanadye katatu katatu patsiku. Tiuzeni za mankhwalawa.

Kukonzekera kwa insulin komweko kumapeweka kwambiri.

Tiyenera kuchepetsa shuga. Zoyenera kuchita ndi insulin?

Mutha kuyesa kunja mankhwala, makamaka ngati mutha kuwapeza kwaulere.

Abambo (azaka 62) ali ndi matenda ashuga a 2 omwe ali ndi zovuta. Panali zovuta ziwiri zamtima, neuropathy, ndipo posachedwa, stroko yamatumbo. Opaleshoni yammbuyo, purulent epiduritis. Pafupifupi mwezi wathunthu kuchokera nthawi yomwe stroko yam'mimba idachitidwa ndi opaleshoni yam'mbuyo, thupi lonse lomwe limakhala pansi pa msomali limadwala

Pepani koma sitima yanu yanyamuka kale. Kuwongolera matenda a shuga kumafuna kuyesayesa kwakukulu. Sindikudziwa ngati izi zingakupindulitseni.

Moni Mayi anga, atadwala sitiroko, ndi wolumala wa gulu 1, sangathe kuyenda payekha. Malizitsani. Kulemera makilogalamu 90 ndi kukula kwa 156 cm. (Wokondedwa zaka 6) Posachedwa kuchipatala amapatsa rinsulin R kapena biosulin R. Shuga amasunga 11-12.Ndipo mwezi uliwonse timasinthidwa ndi insulin - amapatsidwa zomwe zili mosungiramo chipatala, ndipo mwina pali rinsulin, kapena biosulin, kapena actrapid. Posachedwa adaperekanso biosulin H ndipo adauzidwa kuti alowe jekeseni mwachizolowezi. Ndikudziwa kuti iyi ndi insulin yotsogola, koma adandiuza kuti palibe insulin ina yaulere pakanthawi kake, itenge, apereka. Poyankha madandaulo anga kuti shuga anali ochuluka, ngakhale anali ndi zakudya komanso jakisoni wa panthawi yake, Rinsulin NPH adatilembera ndipo adauzidwa kuti ajekeseni usiku nthawi ya 11 pm ndipo asadyerenso. Ndimayesetsa kuwerenga zonse zokhudzana ndi chithandizo cha mankhwala a insulin ndi matenda a shuga, ndipo ndikuganiza kuti nthawi yakwana yoti ndisiye kuyembekeza chipatala chathu, kusamutsa amayi anga kuti akandipatse mankhwala ndi kuwagula ndekha. Ndikuganiza kugula insulin yochepa ndisanadye komanso imodzi ndikulakalaka usiku, koma sindingathe kusankha ndekha. Chonde thandizirani.

Ndikuganiza kuti ndi nthawi yoti ndisiye kuyembekeza chipatala chathu, kuti ndisamutse amayi anga kuti nawonso azilandira mankhwala

Ino si chaka choyamba kuti ndionere izi. Muyenera kusiya monga zilili. Sitima yanyamuka kale. Kuthandizira mwachangu kungangowonjezera mavuto amayi anu.

Bwino kuti mudzisamalire ngati simukufuna kubwereza zomwe zidzachitike mayi. Muli ndi chibadwa choyipa.

Moni Dzina langa ndine Konstantin. Zaka 42 zakubadwa. Matenda a 2 a shuga ali ndi zaka 15. Poyamba amamwa mapiritsi awiri okha a Siofor awiri a 850 patsiku, kenako Galvus ndi 1000 mg ya metformin inaonjezedwa. M'miyezi isanu ndi umodzi yapitayo, shuga sanachepe. Lantus adasamutsidwira kumagulu a insulin 8 asanagone komanso kuphatikiza mapiritsi. Ndikadali ndi shuga m'mawa. Pafupifupi 15 mwina. Sindigwiritsa ntchito zinthu zoletsedwa. Sindikudya zotsekemera konse. Ndimachita masewera, koma osati pafupipafupi. Kodi mungandipangirenji kuti muchepetse shuga? Kutalika kwa 182 cm, kulemera 78 kg.

Kodi mungandipangirenji kuti muchepetse shuga?

Werengani tsamba lino mosamala ndikutsatira malangizowo. Ngati, inde, mukufuna kukhala ndi moyo.