Kuchita insulin yayitali: mayina a mankhwala

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

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

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

Kodi chimapereka chithandizo chotere ndi chiani?

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

Malangizo a insulin amachokera pakudziyang'ana pawokha mthupi la shuga pamlungu. Kuphatikiza apo, ziyenera kukumbukiranso momwe timadzi tambiri timafupi komanso tambiri timene timakhudzira thupi.

Ma insulin omwe akhala akugwira ntchito kwa nthawi yayitali ndi a Lantus, Levemir. Amagwiritsidwa ntchito pa mitundu yonse ya shuga ndipo amatumizidwa kamodzi pa tsiku.

Insulin yotalikirapo imayikidwa ngakhale wodwalayo akupanga kale jakisoni wamtundu waufupi (asanadye). Kuphatikizika kumeneku kumakupatsani mwayi wokhala ndi thupi komanso kupewa zovuta zambiri.

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

Kugwiritsa ntchito mosayenera

1. Mankhwala a nthawi yayitali sagwiritsidwa ntchito kukhazikitsa shuga pambuyo podya. Satha kuthana ndi hyperglycemia mwachangu. Izi zikufotokozedwa ndi kutuluka pang'onopang'ono kupita pachimake cha ntchito, zomwe zimasiyana ndi ndalama zazifupi.
2. Jakisoni wapa-nthawi sangawononge thanzi la munthu

• kuchuluka kwa shuga kumadumphadumpha
• Ndikumva kutopa
• zovuta za matenda ashuga zimayamba.

Usiku ndi m'mawa machitidwe

Anthu omwe ali ndi matenda a shuga a 2 amapezeka pafupifupi ali ndi shuga m'mawa kwambiri. Izi zikutanthauza kuti usiku thupi limasowa insulin yayitali. Koma asanakakamize kupatsidwa mahomoni owonjezera, dokotala amayenera kufufuza kuti adye liti munthu womaliza kudya. Ngati chakudya chikuchitika maola asanu kapena ochepera asanagone, ndiye kuti kugwiritsa ntchito mankhwala osokoneza bongo kwa nthawi yayitali sikungathandize kukhazikika kwa shuga.

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

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

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

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

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

Mankhwala omwe akhala akuchita kwa nthawi yayitali

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

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

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

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

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

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

Ultra kutalika kwenikweni

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

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

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

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

Pokhapokha ngati ntchito yoyenera ya insulini yakhala ikuchitika kwa nthawi yayitali, ndizotheka kukwaniritsa chizindikiro chokhazikika pamtalo.

Kwa munthu yemwe ali ndi vuto lalikulu la insulini ya mahomoni, cholinga cha mankhwalawa ndicho kubwereza kwaposachedwa kwambiri kwa katulutsidwe achilengedwe, koyamba komanso kolimbikitsidwa. Nkhaniyi ikufotokozerani za kusankha koyenera kwa mankhwala a basal insulin.

Pakati pa odwala matenda ashuga, mawu akuti "ndikusintha ngakhale pang'ono" ndiwodziwika, chifukwa kumwa kwa insulin komwe kumakhalapo kwa nthawi yayitali kumafunikira.

Insulin yayitali

Kuti athe kutsanzira kubisala kwapansi, amagwiritsa ntchito insulin. Pa matenda ashuga a odwala matenda ashuga pali mawu awa:

• "Insulin yayitali"
• "Basic insulin",
• "Basal"
• Insulin yowonjezera
• "Insulin yayitali."

Mawu onsewa amatanthauza - insulini wokhalitsa. Masiku ano, mitundu iwiri ya ma insulin omwe akhala akuchita kwa nthawi yayitali amagwiritsidwa ntchito.

Insulin ya sing'anga nthawi - zake kumatenga mpaka maola 16:

1. Biosulin N.
2. Insuman Bazal.
3. Protafan NM.
4. Humulin NPH.

Ultra-yaitali insulin - imagwira ntchito kwa maola opitilira 16:

Levemir ndi Lantus amasiyana ndi ma insulini ena osati munthawi yawo yosiyana, komanso paziwonekero zakunja, pomwe gulu loyambirira la mankhwalawo limakhala ndi mtundu wa mitambo yoyera, ndipo asanakayimidwe amafunikira kuti agulidwe.

Kusiyana kumeneku kumachitika chifukwa cha njira zingapo zopangira insulin, koma zina pambuyo pake. Mankhwala a nthawi yayitali yochitapo kanthu amawonedwa kuti ndiopendekera, ndiye kuti, momwe amagwirira ntchito, njira yosatchulika ikuwonekera, chifukwa cha insulin yochepa, komabe pali nsonga.

Ma insulini okhala ndi nthawi yayitali amaonedwa kuti ndi opanda ntchito. Mukamasankha muyeso wa mankhwala oyambira, mawonekedwewo ayenera kukumbukiridwa. Komabe, malamulo apadera a insulini onse amakhalabe chomwecho.

Zofunika! Mlingo wa insulin yomwe yakhalapo kwa nthawi yayitali iyenera kusankhidwa m'njira yoti shuga azikhala m'magazi pakati pa chakudya chokwanira. Kusinthasintha kakang'ono pamlingo wa 1-1.5 mmol / l ndikuloledwa.

Mwanjira ina, ngati mulingo woyenera, shuga m'magazi sayenera kuchepetsedwa, kapena, kuwonjezera. Chizindikiro chiyenera kukhala chokhazikika masana.

Ndikofunikira kufotokozera kuti jakisoni wa insulin yemwe wakhala akuchita nthawi yayitali amachitika m'tchafu kapena pakamwa, koma osati m'mimba ndi mkono. Iyi ndi njira yokhayo yoonetsetsa kuti mayamwidwe akunyowa. Insulin yomwe imagwira ntchito mwachidule imalowetsedwa kumkono kapena pamimba kuti ikwaniritse kwambiri, yomwe iyenera kugwirizana ndi nthawi yomwe chakudya chimalowa.

Insulin yayitali - mlingo usiku

Kusankha kwa mlingo wa insulin yayitali tikulimbikitsidwa kuti muyambe ndi mlingo wa usiku. Wodwala yemwe ali ndi matenda ashuga amayenera kuwunika momwe glucose amagazi usiku. Kuti muchite izi, maola atatu aliwonse ndikofunikira kuyeza miyezo ya shuga, kuyambira ola la 21 ndikutha ndi 6 mmawa tsiku lotsatira.

Ngati imodzi mwazinthu zimasinthasintha kusintha kwa glucose mmwamba kapena, motsikira, kutsikira, izi zikuwonetsa kuti mlingo wa mankhwalawa udasankhidwa molakwika.

Zoterezi, gawo lino lifunika kuwonedwa mwatsatanetsatane. Mwachitsanzo, wodwala amapita kutchuthi ndi shuga wa 6 mmol / L. Nthawi ya 24:00 chizindikirocho chimakwera kufika pa 6.5 mmol / L, ndipo nthawi ya 03:00 chimadzuka mwadzidzidzi kufika pa 8.5 mmol / L. Munthu amakumana ndi m'mawa ndi shuga wambiri.

Zochitikazo zikuwonetsa kuti kuchuluka kwa insulin usiku sikokwanira ndipo mlingo uyenera kuwonjezeka pang'onopang'ono. Koma pali imodzi "koma"!

Ndi kukhalapo kwa chiwonjezeko chotere (komanso chapamwamba) usiku, sizingatanthauze kuperewera kwa insulin nthawi zonse. Nthawi zina hypoglycemia imabisika pansi pa mawonekedwe awa, omwe amapanga mtundu wa "kubwezeretsanso", wowonetsedwa ndi kuchuluka kwa glucose m'magazi.

• Kuti mumvetsetse momwe amapangira shuga usiku, nthawi yolumikizira miyeso iyenera kutsitsidwa kwa ola limodzi, ndiye kuti, imayesedwa ola lililonse pakati pa 24:00 mpaka 03:00 h.
• Ngati kutsika kwa glucose kutsikira kwawonedwa m'malo ano, ndizotheka kuti uku kunali kugwada ”kozunguliridwa ndi kubweza. Pankhaniyi, mlingo wa insulin yofunika sayenera kuchuluka, koma kuchepetsedwa.
• Kuphatikiza apo, chakudya chomwe chimadyedwa patsiku chimakhudzanso kugwira bwino ntchito kwa insulin.
• Chifukwa chake, kuti tiwone molondola momwe insal insulin ilili, sipayenera kukhala ndi shuga komanso insulin yochepa m'magazi kuchokera ku chakudya.
• Kuti muchite izi, chakudya chamadzulo chisanachitike kuyeserera kuyenera kudumphidwa kapena kusinthidwa nthawi isanakwane.

Pokhapokha chakudya ndi insulin yochepa yomwe imayambitsidwa nthawi yomweyo sizingasinthe tanthauzo la chithunzicho. Pazifukwa zomwezo, tikulimbikitsidwa kugwiritsa ntchito zakudya za chakudya chamadzulo zokha, koma osapatula mafuta ndi mapuloteni.

Zinthu izi zimatengedwa pang'onopang'ono ndipo kenako zimatha kuwonjezera shuga, zomwe ndizosafunika kwambiri pakuwunika koyenera kwa insulin usiku.

Insulin yayitali - tsiku lililonse

Kuwona insulini ya basal masana kumakhalanso kosavuta, muyenera kumangokhala ndi njala pang'ono, ndikukhala ndi miyezo ya shuga ola lililonse. Njirayi ikuthandizira kudziwa kuti ndi nthawi yanji yomwe ikuwonjezeka, komanso momwe - kuchepa.

Ngati izi sizingatheke (mwachitsanzo, mwa ana aang'ono), ntchito ya insulin yoyambirira iyenera kuwonedwa nthawi ndi nthawi. Mwachitsanzo, muyenera kudumphira chakudya cham'mawa kaye ndikuyamba kuyerekezera ola lililonse kuchokera nthawi yomwe mumadzuka kapena kuyambira nthawi yomwe mumalowa insulin ya tsiku ndi tsiku (ngati wina wamulembera) mpaka chakudya chamasana. Masiku angapo pambuyo pake, mapangidwewo amabwerezedwanso ndi nkhomaliro, ndipo ngakhale pambuyo pake ndi chakudya chamadzulo.

Ma insulin ambiri omwe akhala akuchita kwa nthawi yayitali amayenera kuperekedwa kawiri pa tsiku (kupatula Lantus, amadzibaya kamodzi).

Tcherani khutu! Zomwe zakonzedwa kale ndi insulin, kupatula Levemir ndi Lantus, zimakhala ndizobisalira, zomwe nthawi zambiri zimachitika patatha maola 6-8 mutabayidwa.

Chifukwa chake, panthawiyi, pakhoza kukhala kuchepa kwa shuga, komwe mlingo wochepa wa "mkate" umafunikira.

Pakusintha mlingo wa insulin ya basal, zonsezi zimalimbikitsidwa mobwerezabwereza. Mwachidziwikire, masiku atatu adzakhala okwanira kuti zitsimikizire zosunthira mbali imodzi kapena ina. Njira zinanso zikuchitidwa mogwirizana ndi zotsatira zake.

Mukawunika insulini yatsiku ndi tsiku, pafupifupi maola 4 ayenera kudutsa pakati pa chakudya, moyenera 5. Kwa iwo omwe amagwiritsa ntchito insulin yayifupi m'malo mwa ultrashort, nthawi imeneyi imayenera kukhala yayitali (maola 6-8). Izi ndichifukwa cha zomwe insulini izi zimachita.

Ngati insulin yayitali yasankhidwa molondola, mutha kupitiliza ndi kusankha insulin yayifupi.

Matenda a diabetes 1 a mtundu (kawirikawiri mtundu wa 2) amadziwa bwino mankhwala a insulin omwe sangakhale nawo popanda. Pali zosankha zingapo za mahomoni awa: kachitidwe kochepa, nthawi yayitali, nthawi yayitali kapena kuphatikiza pamodzi. Ndi mankhwala otere, ndizotheka kubwezeretsanso, kuchepetsa kapena kukulitsa kuchuluka kwa mahomoni mu kapamba.

Insulin yokhala nthawi yayitali imagwiritsidwa ntchito pakafunika nthawi yayitali pakati pa jakisoni.

Kufotokozera kwamagulu

Kutanthauza kwa insulin ndiko kugwiritsira ntchito njira zama metabolic komanso kudyetsa maselo ndi shuga. Ngati mahomoniwa sapezeka m'thupi kapena sanapangidwe kuchuluka, munthu amakhala pachiwopsezo chachikulu, ngakhale kufa.

Kuletsedwa kokhako kusankha gulu lokonzekera insulin nokha. Posintha mankhwala kapena mlingo, wodwalayo ayenera kuyang'aniridwa ndikuwongolera kuchuluka kwa shuga m'magazi a magazi. Chifukwa chake, pochita zinthu zofunika kwambiri zotere, muyenera kupita kwa dokotala.

Ma insulin omwe amakhala nthawi yayitali, omwe mayina awo adzapatsidwa ndi dokotala, nthawi zambiri amagwiritsidwa ntchito limodzi ndi mankhwalawa monga achidule kapena apakati. Pafupipafupi, amagwiritsidwa ntchito pochiza matenda a shuga a 2. Mankhwala oterowo amasunga shuga nthawi zonse chimodzimodzi, osaloleza kutalika kapena pansi.

Mankhwalawa amayamba kukhudza thupi pambuyo pa maola 4-8, ndipo kuchuluka kwa insulini kudzapezekanso pambuyo pa maola 8-18. Chifukwa chake, kuchuluka kwathunthu kwa glucose - 20-30 hours. Nthawi zambiri, munthu amafunika njira imodzi yoperekera jakisoni wa mankhwalawa, nthawi zambiri zimachitika kawiri.

Mitundu yosiyanasiyana ya mankhwala opulumutsa moyo

Pali mitundu ingapo yamitundu iyi ya mahomoni amunthu. Chifukwa chake, amasiyanitsa mtundu wa ultrashort ndi mtundu waufupi, wopitilira komanso wophatikizidwa.

Mitundu yoyamba imakhudza thupi patadutsa mphindi 15 kuchokera kukhazikitsidwa kwake, ndipo kuchuluka kwa insulin kumatha kuwonekera patatha maola 1-2 mutabayidwa. Koma kutalika kwa chinthu m'thupi ndi chochepa kwambiri.

Ngati tilingalira ma insulin omwe akhala akuchita kwa nthawi yayitali, mayina awo akhoza kuyikidwa padera.

Ubwino Wofunika

Insulin yayitali imagwiritsidwa ntchito kutsimikizira molondola zomwe zimachitika mu mahomoni amunthu. Zitha kugawidwa m'magulu awiri: nthawi yayitali (mpaka maola 15) komanso nthawi yayitali, yomwe imafika mpaka maola 30.

Opanga adapanga mtundu woyamba wa mankhwalawo ngati mawonekedwe amadzimadzi amtambo. Asanapereke jakisoni, wodwalayo ayenera kugwedeza chidebecho kuti akwaniritse utoto. Pambuyo pokhapokha pokhapokha amatha kulowa mu subcutaneally.

Insulin yokhala ndi nthawi yayitali imapangidwa kuti iwonjezere pang'ono ndende yake ndikuisunga pamlingo womwewo. Panthawi inayake, nthawi ya kuphatikiza kwakukulu kwa malonda imabwera, pambuyo pake mulingo wake umachepa.

Ndikofunikira kuti musaphonye pamene gawo likhala lopanda pake, pambuyo pake mlingo wotsatira wa mankhwalawo uyenera kuperekedwa. Palibe kusintha kwakuthwa kwa chizindikirocho kumayenera kuloledwa, chifukwa chake adokotala aziganizira zazomwezo m'moyo wa wodwalayo, pambuyo pake adzasankha mankhwala oyenera komanso mlingo wake.

Kuyendetsa bwino thupi kosadumpha mwadzidzidzi kumapangitsa kuti inshuwaransi ikhale yogwira mtima kwakanthawi. Gululi la mankhwalawa lili ndi gawo lina: liyenera kutumikiridwa kokha mu ntchafu, osati pamimba kapena m'manja, monga zosankha zina. Izi ndichifukwa cha nthawi yonyamula zinthu, chifukwa m'malo ano zimachitika pang'onopang'ono.

Nthawi ndi kuchuluka kwa kayendetsedwe kazinthu zimatengera mtundu wa wothandizira. Ngati madzi ali ndi mawonekedwe osasinthika amtunduwu, mankhwalawa ali ndi ntchito yapamwamba, ndiye kuti nthawi yayitali ya ndende imachitika mkati mwa maola 7. Ndalamazi zimaperekedwa kawiri pa tsiku.

Ngati mankhwalawa alibe kuchuluka kwakukulu, ndipo zotsatira zake zimasiyana pakapita nthawi, ziyenera kuperekedwa nthawi imodzi patsiku. Chida chake ndi chosalala, cholimba komanso chosasinthasintha. Madziwo amapangidwa monga madzi oyera popanda kukhalapo kwamtambo pansi. Insulin yotenga nthawi yayitali ndi Lantus ndi Tresiba.

Kusankhidwa kwa Mlingo ndikofunikira kwambiri kwa odwala matenda ashuga, chifukwa ngakhale usiku, munthu amatha kudwala. Muyenera kuganizira izi ndikupanga jakisoni wofunikira pa nthawi. Kuti mupange chisankhochi molondola, makamaka usiku, miyezo ya glucose iyenera kutengedwa usiku. Izi zimachitika bwino pakadutsa maola awiri aliwonse.

Kuti akonzekere insulin kukonzekera, wodwalayo ayenera kudya popanda chakudya chamadzulo. Usiku wotsatira, munthu ayenera kutenga miyezo yoyenera. Wodwalayo amagaira zomwe adapeza kwa asing'anga, yemwe, atazipenda, amasankha gulu lolondola la insulin, dzina la mankhwalawo ndikuwonetsa kuchuluka kwake.

Kusankha mlingo masana, munthu ayenera kumakhala ndi njala tsiku lonse komanso kumwa magawo omwewa, koma ola lililonse. Kuperewera kwa zakudya m'thupi kungathandize kupanga chithunzi chokwanira komanso cholondola m'thupi la wodwalayo.

Malangizo ogwiritsira ntchito

Kukonzekera kwa insulin kochepa komanso kwanthawi yayitali kumagwiritsidwa ntchito mwa odwala omwe ali ndi matenda a shuga 1. Izi zimachitika kuti tisunge gawo limodzi la maselo a beta, komanso kupewa kutulutsa ketoacidosis. Odwala omwe ali ndi mtundu wachiwiri wa matenda osokoneza bongo nthawi zina amayenera kupereka mankhwalawa. Kufunika kwa machitidwe oterewa kufotokozedwa mophweka: simungathe kulola kusintha kwa matenda ashuga kuchokera ku mtundu wachiwiri mpaka 1.

Kuphatikiza apo, insulini yokhala ndi nthawi yayitali imalembedwa kupondaponda vuto la m'mawa komanso kukhazikitsa kuchuluka kwa shuga m'mawa (pamimba yopanda kanthu).Kuti akupatseni mankhwalawa, dokotala angakufunseni kuti mupeze zolemba zolimbitsa thupi za milungu itatu.

Insulin yokhala ndi nthawi yayitali imakhala ndi mayina osiyanasiyana, koma odwala ambiri amagwiritsa ntchito mankhwalawa. Mankhwala oterowo safunikira kugwedezedwa musanayambe kutsata, madzi ake amakhala ndi mtundu wowonekera komanso wosasinthika. Opanga amapanga mankhwalawo m'mitundu ingapo: cholembera cha OpiSet (3 ml), makatoni a Solotar (3 ml) ndi dongosolo lomwe lili ndi OptiClick makatoni.

Munjira yomalizirayi, mumakhala ma cartridge 5, lililonse la 5 ml. Poyambirira, cholembera ndi chida chosavuta, koma makatoni amayenera kusinthidwa nthawi iliyonse, kukhazikitsa syringe. M'dongosolo la Solotar, simungasinthe madzimadzi, chifukwa ndi chida chotayikira.

Mankhwala oterowo amathandizira kupanga mapuloteni, lipids, kugwiritsa ntchito komanso kutulutsa minofu yam'magazi komanso minofu ya adipose ndi shuga. Mu chiwindi, kusintha kwa glucose kukhala glycogen kumapangidwira, komanso kumachepetsa shuga la magazi.

Malangizowo akuti amafunikira jakisoni imodzi, ndipo endocrinologist imatha kudziwa mlingo. Izi zimatengera kuopsa kwa matendawa komanso machitidwe ake amwana. Muwapatse ana azaka zopitilira 6 ndi akulu omwe ali ndi matenda a shuga 1 kapena mtundu 2.

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

Werengani mayankho a mafunso:

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

Mitundu ya insulin ndi zotsatira zake: nkhani yatsatanetsatane

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

Ndingatani popanda jakisoni wa insulin?

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

Chikhulupiriro: Zofunikira Pang'ono

Monga mukudziwa, insulin ndi timadzi tomwe timatulutsa ma cell a beta. Imatsika shuga, ndikupangitsa kuti minyewa yake igwire glucose, yomwe imapangitsa chidwi chake m'magazi kuchepa. Muyenera kudziwa kuti mahomoniwa amathandizira kutsimikiza kwamafuta, amalepheretsa kuchepa kwa minofu ya adipose. Mwanjira ina, kuchuluka kwa insulini kumapangitsa kuti kuchepa thupi kuzikhala kosatheka.

Kodi insulin imagwira ntchito bwanji mthupi?

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

Zofunika! Kukonzekera konse kwa insulin kumakhala kosalimba, kuwonongeka mosavuta. Aunikireni ndi kuwamaliza mwakhama.

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

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

Onerani kanema yemwe akufotokoza nkhaniyi ndi bambo wa mwana yemwe ali ndi matenda ashuga 1. Phunzirani zamomwe mungasinthire zakudya komanso zakudya za insulin.

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

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

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

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

Werengani za kukonzekera kwakanthawi ndi ma insulin:

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

Momwe mungasankhire insulin yoyenera, yabwino?

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

1. Phunzirani kapena.
2. Pitani ku. Anthu odwala matenda ashuga onenepa kwambiri amafunikanso kumwa mapiritsi molingana ndi ndandanda yowonjezera pang'onopang'ono.
3. Tsatirani mphamvu ya shuga kwa masiku 3-7, mumayeza ndi glucometer osachepera 4 pa tsiku - m'mawa pamimba yopanda chakudya asanadye chakudya cham'mawa, musanadye chakudya chamadzulo, musanadye chakudya chamadzulo, komanso ngakhale usiku musanagone.
4. Panthawi imeneyi, phunzirani ndi kuphunzira malamulo osungira insulin.
5. Makolo a ana omwe ali ndi matenda amtundu woyamba a shuga ayenera kuwerenga momwe angapangire insulin. Anthu ambiri odwala matenda ashuga nawonso angafunikire izi.
6. Mvetsetsani.
7. Werengani nkhaniyo "", ikani piritsi la glucose ku pharmacy ndikuwasunga.
8. Dzipatseni mitundu ya insulin, syringes kapena cholembera, cholembera cholocha cholondola ndi mizere yoyeserera.
9. Kutengera ndi kuchuluka kwa mankhwalawa, sankhani mankhwalawa a insulin - onani kuti ndi ma jakisoni omwe mumafunikira, maora ndi nthawi yayitali bwanji.
10. Sungani chidule cha kudziletsa. Popita nthawi, chidziwitso chikadzaza, mudzazeni tebulo pansipa. Onaninso zovuta nthawi ndi nthawi.

Werengani za zinthu zomwe zimakhudza chidwi cha thupi pakupanga insulini.

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

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

Ndi ma jakisoni amtundu wa insulin omwe amachita kamodzi patsiku?

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

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

Werengani za kukonzekera kwa insulin yayitali:

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

Ili ndi vuto lalikulu. Njira yokhayo yopewera ndikusinthira, kuti mulingo wofunika wa insulini umachepetsedwa ndi 2-8 nthawi. Ndipo wotsikirapo mlingo, kupatula ntchito yake. Sipangiri kubayidwa mayunitsi opitilira 8 nthawi imodzi. Ngati mukufuna mlingo wapamwamba, gawani pakati pawiri jekeseni ofanana. Apangeni amodzi m'malo osiyanasiyana, kutali ndi inzake, ndi syringe yomweyo.

Momwe mungapangire insulin pamsika wamafuta?

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

Kodi insulini yabwino kwambiri ndi iti?

Palibe yankho la funso ili kwa onse odwala matenda ashuga. Zimatengera mtundu wa matenda anu. Komanso, pambuyo pakusintha kwa insulin, amasintha kwambiri. Mlingo umacheperachepera ndipo mungafunike kusintha kuchokera ku chinthu chimodzi kupita kwina. Sitikulimbikitsidwa kuti mugwiritse ntchito, ngakhale mutaperekedwa kwaulere, koma mankhwala ena omwe amakhala atatenga nthawi yayitali alibe. Zomwe tafotokozazi zikufotokozedwa pansipa. Palinso tebulo la mitundu yolimbikitsidwa ya insulin yayitali.

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

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

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

Humalog ndi Apidra - kodi insulin ndi chiyani?

Humalog ndi Apidra, komanso NovoRapid, ndi mitundu ya insulin ya ultrashort. Amayamba kugwira ntchito mwachangu komanso kuchita zinthu mwamphamvu kuposa mankhwala omwe amangogwiritsa ntchito mwachidule, ndipo Humalog imakhala yachangu komanso yamphamvu kuposa ena. Kukonzekera kwapfupi ndi insulin yeniyeni ya anthu, ndipo ma ultrashort amasinthidwa pang'ono.Koma izi sizifunikira kuti zizolowetsedwa. Mankhwala onse apfupifupi ndi a ultrashort nawonso ali ndi chiopsezo chochepa cha ziwopsezo, makamaka ngati mungawone ndikuwazunza pamiyeso yotsika.

Ndi insulin iti yomwe ili bwino: Humalog kapena NovoRapid?

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

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

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

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

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

Zaka zana limodzi zapitazo, matenda a shuga amawonedwa ngati matenda akupha. Madokotala amadziwa momwe matendawa amawonekera, komanso amatchedwa zosayambitsa - mwachitsanzo, kapena. Ndipo m'zaka khumi zokha zapitazi, asayansi adazindikira ndikuwerengera. Ichi chinali chipulumutso chenicheni kwa odwala matenda ashuga.

Magulu amakonzekera insulin

Njira yayikulu yothandizira matenda a shuga a mtundu woyamba ndikuwonetsa madontho ena a insulin yophatikizidwa m'magazi a wodwala. Malinga ndikuwonetsa payekhapayekha, timadzi timeneti timagwiritsidwanso ntchito pa matenda a shuga a II.

Udindo waukulu wa insulin m'thupi ndi kutenga gawo la kagayidwe kazakudya ndikupanga kuchuluka kwabwino kwa shuga m'magazi.

Chemarology yamakono imagawa kukonzekera kwa insulin m'magulu potengera kuchuluka kwa hypoglycemic (kutsitsa shuga m'magazi) zotsatira:

Kukhalitsa: Zabwino ndi Zabwino

Mpaka posachedwa, kukonzekera kwa insulin kogawika kunagawika m'magulu awiri: apakati komanso okhalitsa. Zaka zaposachedwa, zadziwika pachitukuko cha insulin yayitali nthawi yayitali.

Kusiyanitsa kofunikira pakati pa mankhwala a magulu onse atatu ndi nthawi ya hypoglycemic zotsatira:

• kuchuluka kwa nthawi yayitali ndi 8-12, mwa odwala - mpaka maola 20,
• kuchitapo kanthu kwanthawi yayitali - 20-30 (nthawi zina 36) maola,
• zowonjezera zazitali - zoposa maola 42.

Ma insulini amasungidwe amasungidwe nthawi zambiri amapezeka mu mawonekedwe a kuyimitsidwa ndipo amapangidwira ma subcutaneous kapena intramuscular management

Nthawi zambiri, mwa munthu yemwe alibe matenda a shuga, insulin imapangidwa mosalekeza. Kukonzekera kwa insulin kwa nthawi yayitali kwapangidwa kuti kuyerekezera zomwezo mwa odwala omwe ali ndi matenda a shuga. Ntchito yawo yayitali mthupi ndiyofunikira kwambiri ndi chithandizo chowongolera. Kuchepetsa kuchuluka kwa jakisoni ndi kuphatikiza kwinanso kwa mankhwalawa.

Koma pali kuchepa: ma insulin osakhalitsa sangathe kugwiritsidwa ntchito poyipa matenda ashuga kapena malo oyipa a wodwalayo.

Isofan insulin

Izi zimagwira ntchito mankhwala osokoneza bongo. nthawi yayitali machitidwe. Woimira akhoza kuonedwa ngati French Insuman Bazal GT. Imapezeka mu mawonekedwe a kuyimitsidwa ndi insulin yokhala ndi 40 kapena 100 mayunitsi. Kuchuluka kwa botolo limodzi ndi 10 kapena 5 ml, motsatana.

Chachilendo cha mankhwalawa ndi kulekerera bwino kwake kwa odwala omwe amadziwika kuti amatsutsana ndi insulini zina. Kuphatikiza apo, mankhwalawa amatha kugwiritsidwa ntchito pakuyembekezera amayi ndi kuyamwa Isofan insulin imayendetsedwa kamodzi tsiku lililonse.

Mtengo woyeserera wa phukusi la mabotolo asanu a 5 ml - kuchokera ku ma ruble 1300.

Insulin glargine

Mankhwala kuchitapo kanthu kwa nthawi yayitali ndi yapadera m'njira yake. Chowonadi ndi chakuti insulin yambiri imakhala ndi chotchedwa peak. Ino ndi nthawi yomwe kukhazikika kwa mahomoni m'magazi kumafika pazokwanira. Kugwiritsa ntchito insulin glargine kumachotsa mphindi yapamwamba kwambiri: mankhwalawa amachita mosiyanasiyana komanso mosalekeza. Mankhwalawa amapangidwira tsiku limodzi.

Limodzi mwa mayina amalonda ndi Lantus. Yopangidwa ku France ngati kuyimitsidwa kwa jakisoni wotsekemera. Mtengo wa mankhwalawa ndi pafupifupi ma ruble 3,500 a ma syringes asanu a 3 ml aliyense.

Insulin degludec

Awa ndi dzina lapadziko lonse lamankhwala. kupatula nthawi . Malinga ndi kuyerekezera kwa akatswiri, tsopano lilibe mndandanda wonse padziko lonse lapansi. Mbiri yamalonda - "Tresiba Penfill", dziko lomwe adachokera - Denmark. Kutulutsidwa mawonekedwe - makatiriji okhala ndi mphamvu ya 3 ml (mayunitsi zana a insulin / ml), mu bokosi - makatoni asanu. Mtengo woyerekeza wa mankhwalawo ndi pafupifupi ma ruble 7500.

Mankhwalawa amaperekedwa kamodzi pa maola 24 aliwonse nthawi iliyonse (kupitilizanso kuti azitsatira). Insulin degludec imapangidwira zochizira matenda ashuga odwala akulu, kuphatikizapo omwe ali ndi zaka zopitilira 65. Tsopano sichigwiritsidwa ntchito pochiza matenda a shuga ku unamwino, amayi apakati, komanso mwa ana ndi achinyamata.

Mitundu ya jakisoni

Wodwala matenda a shuga amakakamizika kumwa jakisoni tsiku lililonse, ndipo kangapo patsiku. Kuyambitsa insulin tsiku lililonse kumathandizira kukhazikika kwa mkhalidwe. Popanda mahomoni awa, sizingatheke kutulutsa shuga m'magazi. Popanda jakisoni, wodwalayo amamwalira.

Chithandizo chamakono cha shuga chimapereka mitundu ingapo ya jakisoni. Amasiyana pakutalika komanso kuthamanga.

Pali mankhwala osakhalitsa, a ultrashort, ophatikizika komanso opanga nthawi yayitali.

Mwachidule ndipo amayamba kugwira ntchito pafupifupi mukangoyendetsa. Kuchulukitsa kwakukulu kumatheka mkati mwa ola limodzi kapena awiri, kenako zotsatira za jakisoni zimatha pang'onopang'ono. Mwambiri, mankhwalawa amagwira ntchito pafupifupi maola 4-8. Monga lamulo, ma jakisoni oterewa amalimbikitsidwa kuti aperekedwe pokhapokha chakudya, pambuyo pake kuchuluka kwa shuga m'magazi a wodwalayo kumayamba kuchuluka.

Insulin yotalikilapo imakhala maziko a chithandizo. Imagwira kwa maola 10-28, kutengera mtundu wa mankhwalawa. Kutalika kwa nthawi ya mankhwalawa kumasiyanasiyana mwa wodwala aliyense, kutengera mtundu wa matendawa.

Zina za mankhwala omwe akhala akuchita kwa nthawi yayitali

Insulin yotalikirapo ndiyofunikira kuti mumatsanzira molondola njira yopanga mahomoni anu wodwala. Pali mitundu iwiri ya mankhwalawa - Mankhwala okhala ndi nthawi yayitali (amagwira ntchito kwa maola pafupifupi 15) komanso mankhwala ogwiritsira ntchito nthawi yayitali (mpaka maola 30).

Mankhwala a nthawi yapakatikati ali ndi mawonekedwe othandizira. Insulin imakhala ndi utoto woyera. Musanayambitse mahomoni, muyenera kukwaniritsa utoto.

Pambuyo popereka mankhwalawa, kuwonjezeka kwapang'onopang'ono kwa kuchuluka kwa mahomoni kumawonedwa. Panthawi inayake, pachimake pa mchitidwe wa mankhwalawa amadza, pambuyo pake ndende imayamba kuchepa ndikutha. Ndiye kuti jakisoni watsopano ayenera kupangidwa.

Mlingo wake umasankhidwa kuti mankhwalawa azitha kuyendetsa bwino shuga wa magazi, kupewa kudumphira pakati pa jakisoni. Mukamasankha kuchuluka kwa insulin kwa wodwala, dokotala amaganizira nthawi yochuluka yomwe mankhwalawa amapezeka.

Mbali inanso ndi tsamba la jakisoni. Mosiyana ndi mankhwalawa amagwira ntchito mwachidule, omwe amalowetsedwa pamimba kapena mkono, insulin yayitali imayikidwa m'tchafu - izi zimakuthandizani kuti mukwaniritse kusintha kwa mankhwala mthupi lanu.

Ndiwowonjezereka kosalala kosakanikirana ndi mankhwalawa komwe kumatsimikiza kugwira ntchito kwake ngati jekeseni wa m'munsi.

Kodi kubayira kangati?

Pali mankhwala angapo a insulin. Ambiri aiwo amadziwika ndi kusasinthasintha kwamtambo komanso kupezeka kwa zochitika zapamwamba, zomwe zimachitika pafupifupi maola 7 mutatha kutsata. Mankhwalawa amatumizidwa kawiri pa tsiku.

Mankhwala ena (Tresiba, Lantus) amaperekedwa nthawi imodzi patsiku. Mankhwalawa amadziwika ndi nthawi yayitali yogwira ntchito komanso kuyamwa pang'onopang'ono, popanda kuchuluka kwa ntchito - ndiye kuti, mahomoni omwe amayambitsidwa amachita bwino nthawi yonse yochitayi. Chowonjezera china mwa mankhwalawa ndikuti alibe mtambo ndipo amatha kusiyanitsidwa ndi mtundu wowonekera.

Dokotala pakuthandizanakukuthandizani kusankha mankhwala abwino kwambiri kwa wodwala wina. Katswiriyu amasankha insulini yoyambira kapena yotalikilapo ndipo atchule mayina a mankhwala abwino. Sizikulimbikitsidwa kuti muzisankha nokha insulin yayitali.

Momwe mungasankhire mlingo?

Matenda a shuga sagona usiku. Chifukwa chake, wodwala aliyense amadziwa kufunika koti asankhe mlingo woyenera wa mankhwalawa kuti apewe shuga pamene akupumula usiku.

Kusankha mankhwalawa molondola, muyenera kuyeza shuga m'magazi awiri tsiku lililonse.

Musanayambe kugwiritsa ntchito insulin, nthawi yayitali, ndikulimbikitsidwa kukana chakudya chamadzulo. Usiku, kuchuluka kwa shuga kumayesedwa, ndipo, potengera izi, pamtundu wofunikira wa jakisoni umatsimikizika pambuyo pokambirana ndi dokotala.

Kudziwa tsiku ndi tsiku mankhwala omwe akhala akuchita kwa nthawi yayitali kumafunikiranso njira yapadera. Njira yabwino ndikukana chakudya tsiku lonse ndi milingo ya shuga. Zotsatira zake, pofika madzulo, wodwalayo amadziwa momwe shuga ya m'magazi imakhalira jekeseni chifukwa chokhala nthawi yayitali.

Zotheka zotheka ku jakisoni

Insulin iliyonse, mosasamala kanthu za kutalika kwa nthawi, imatha kuyambitsa zovuta zingapo. Nthawi zambiri, chomwe chimayambitsa zovuta ndi kuperewera kwa zakudya m'thupi, kumwa mankhwala osankhidwa mosayenera, kuphwanya njira yoyendetsera mankhwala. Muzochitika izi, kukula kwa zotsatirazi ndizotheka:

• mawonekedwe a thupi lawo siligwirizana.
• kusapeza bwino pamalowo jekeseni,
• kukula kwa hypoglycemia.

Monga mukudziwa, hypoglycemia imatha kubweretsa zovuta zazikulu, mpaka kukomoka kwa matenda ashuga. Pewani izi mwakutsatira mosamalitsa malangizo onse omwe dokotala amakupatsirani.

Kodi mungapewe bwanji zovuta?

Matenda a shuga ndi matenda oopsa ndipo ndizovuta kupirira. Komabe, wodwala yekha ndiye amene angatsimikizire kukhala ndi moyo wabwino. Kuti tichite izi, ndikofunikira kugwiritsa ntchito njira zonse zomwe zingathandize kupewa zovuta komanso thanzi labwino.

Maziko othandizira matenda amtundu wa shuga ndi jakisoni, koma kudzipereka nokha ndiwowopsa. Chifukwa chake, pa mafunso aliwonse okhudzana ndi mankhwala omwe adalandira, wodwalayo ayenera kufunsa dokotala wokha.

Kuti mumve wathanzi, muyenera kudya moyenera. Insulin imathandizira kuyendetsa magazi m'magazi, koma wodwalayo ayenera kuyesetsa kuti asawakhumudwitse. Kuti izi zitheke, madokotala amatipatsa zakudya zapadera zomwe zithandiza kukhazikika mtima kwa wodwala.

Mankhwala aliwonse omwe amagwiritsidwa ntchito ngati mankhwala ayenera kugwiritsidwa ntchito molingana ndi malangizo a dokotala.

Lantus ndi Levemir ndi mitundu yamakono ya insulin yowonjezera, imabayidwa maola 12-24 aliwonse a mtundu woyamba wa 2 ndi matenda ashuga. Insulin yapakatikati yotchedwa protafan kapena NPH imagwiritsidwabe ntchito. Jakisoni wa insuliniyu amatha pafupifupi maola 8. Mukawerenga nkhaniyi, muphunzira momwe mitundu yonse ya insulini imasiyanirana, yomwe ndi yabwinoko, chifukwa chake muyenera kubayiramo.

Lantus, Levemir ndi Protafan - zonse zomwe muyenera kudziwa:

• Zochita za Lantus, Levemir ndi Protaphane. Zojambula za mtundu uliwonse wa insulin.
• Malangizo a T1DM ndi T2DM okhala ndi insulin yayitali komanso yachangu.
• Kuwerengeredwa kwa Lantus ndi Levemir usiku: malangizo ndi gawo.
• Momwe mungabayire insulin kuti shuga m'mawa yopanda kanthu idakhala yachilendo.
• Kusintha kuchokera ku protafan kupita ku insulin yowonjezera yamakono.
• Ndi insulin iti bwino - Lantus kapena Levemir.
• Momwe mungasankhire mamawa mlingo wa insulin.
• Zakudya zochepetsera kuchepetsa kuchuluka kwa insulin mwa 2-7 nthawi ndikuchotsa shuga wamagazi.

Timaperekanso njira yatsatanetsatane komanso yothandiza yokwaniritsira shuga m'magazi m'mimba yopanda kanthu.

Odwala omwe ali ndi matenda ashuga ayenera kuyamwa insulini usiku komanso / kapena m'mawa kwambiri ngakhale wodwala atalandira jakisoni wa insulin asanadye. Ena odwala matenda ashuga amangofunika chithandizo chokwanira ndi insulin. Ena safuna insulini yowonjezera, koma amapaka insulin yochepa kapena yochepa kwambiri kuti athetse shuga amene amayambika pakudya. Enanso amafunika onse kuti akhale ndi shuga wabwinopo, apo ayi mavuto a shuga angadzakhale.

Insulin yowonjezera singakhale yofunikira, koma jakisoni wofulumira wa insulin amafunikira musanadye. Kapena mosinthanitsa - mumafunikira insulin yowonjezera usiku, ndipo masana mutadya shuga ndizabwinobwino. Kapenanso wodwala matenda a shuga apeza vuto lina. Kutsiliza: ngati endocrinologist amaika odwala onse omwewa mankhwala omwe ali ndi Mlingo wokhazikika wa insulin ndipo sayang'ana zotsatira za kuchuluka kwa shuga, ndiye kuti ndi bwino kukaonana ndi dokotala wina.

Zikomo kwambiri chifukwa chatsamba labwino kwambiri lino, chifukwa chogwiritsa ntchito mosasamala komanso kusamalira anthu omwe akufunika chidziwitso choyenera. Ndinakupezani miyezi iwiri yapitayo ndipo nthawi yomweyo ndinadabwa, chifukwa inenso ndimakonda zaka zanu 10 zapitazo. Kenako madotolo athu adandidzudzula mwamphamvu pa izi ... Tsopano ndidaganiza kutsatira upangiri wako. Ndinali (ndikukutali ndi zonse zomwe zidapita :() tsoka lamkuntho - zaka 20 mtundu wa matenda ashuga 1, lidawonongeka kwambiri, ndi "gulu" lazovuta zambiri. Ngakhale zidali zovuta kuyenda. Ndili ndi zaka 39. Glycated hemoglobin anali 13%. Ndidayesetsa kudya mwachizolowezi, m'mawa nthawi zonse pamakhala shuga wambiri, pamwamba pa 22.0, Chinthu choyamba chomwe ndidachita ndikugawa mlingo wa usiku wa Lantus m'magawo awiri malinga ndi upangiri wanu, ndipo nthawi yomweyo panali zotsatira! Kuyambira tsiku lachiwiri, ndinayamba kusintha pang'onopang'ono kuzakudya zanu. Tsopano ndimawonetsetsa kwambiri. HbA1C yanga idatsikira kufika 6.5% m'miyezi iwiri! Zikomo tsiku lililonse Mulungu ndi inu chifukwa chake. Koma ambiri akufuna kukwaniritsa zomwezo, koma sakudziwa momwe angachitire. Ndimayesetsa kuuza aliyense za izi, ndikulimbikitsa kwambiri malowa - ndikofunikira kudziwa kwa onse omwe ali ndi matenda ashuga!

Kodi ndichifukwa chiyani ndimafunikira insulin yayitali?

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

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

Chifukwa chiyani jakisoni wa insulin Lantus, Levemir kapena protafan:

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

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

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

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

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

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

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

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

Osagwiritsa ntchito "jakisoni imodzi ya Lantus kwa maola 24." Njira imeneyi sikuyenda bwino. Prick Lantus osachepera kawiri patsiku. Chabwinoko kwambiri - kugawa muyeso wa mankhwalawa ndikusankha gawo lake pambuyo pake, pakati pausiku. Mwanjira imeneyi, chiwongolero chanu cha matenda ashuga chizitukuka kwambiri.

Zambiri za insulin ya nthawi yayitali Levemir (Detemir)

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

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

Ndi bwino kubaya Levemir katatu patsiku. Chitani jekeseni imodzi pa 1-3 am kuti muwongolere m'bandakucha.

Ndi insulin yotalikilapo kuposa iti - Lantus kapena Levemir?

Lantus ndi Levemir achita zinthu monga insulin analogues, zomwe apeza posachedwapa pochiza matenda ashuga omwe ali ndi insulin. Ndiwofunikira chifukwa ali ndiwokhazikika pokhapokha popanda nsonga - chithunzi chojambula cha plasma cha mitundu iyi ya insulin chili ndi "mafunde a ndege". Imatengera yachilengedwe.

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

Pa phukusi la Lantus kwalembedwa kuti insulini yonse iyenera kugwiritsidwa ntchito pakatha milungu 4 kapena masiku 30 phukusi lisindikize. Levemir ali ndi mashelufu okhala ndi nthawi yayitali nthawi 1.5, mpaka masabata 6, komanso osagwirizana mpaka milungu 8. Ngati mumatsatira mtundu wa matenda ashuga amtundu wa 2, ndiye kuti mungafunike inshuwaransi yatsiku ndi tsiku. Chifukwa chake, Levemir ikhale yabwino kwambiri.

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

Levemir ali ndi zopindulitsa pang'ono kuposa Lantus. Koma ngati mutenga Lantus kwaulere, ndiye kuti mumulore. Osati kamodzi patsiku, koma katatu patsiku.

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

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

Chifukwa chiyani ndikosayenera kugwiritsa ntchito NPH-insulin (protafan)

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

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

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

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

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

Momwe mungapangire shuga m'mawa wopanda kanthu kuti ukhale wabwinobwino

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

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

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

Zomwe simuyenera kuchita:

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

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

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

Momwe mungawerengere poyambira kuchuluka kwa insulin usiku

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

Odwala onse odwala matenda amtundu 1 amafunika jakisoni wa insulin yowonjezera usiku ndi m'mawa, komanso jakisoni wa insulin yofulumira musanadye. Likukhalira jekeseni 5-6 patsiku. Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri, vutolo limakhala losavuta. Angafunike kubayidwa pafupipafupi. Makamaka ngati wodwala akuwonetsetsa ndipo si waulesi. Odwala a shuga a Type 1 amalangizidwanso kuti asinthane ndi zakudya zochepa. Popanda izi, simudzatha kuwongolera bwino shuga, ziribe kanthu momwe mumawerengera mosamala mulingo wa insulin.

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

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

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

Zitsanzo za kuwerengera muyeso wa Lantus, Levemir kapena Protafan usiku

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

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

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

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

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

Wodwala mtundu uliwonse wa 1 kapena 2 wodwala yemwe amatsatira zakudya zamagulu ochepa ayenera kuphunzira. Ndipo ngati simunasinthebe kudya zakudya zamafuta ochepa, ndiye mukuchita chiyani apa? 🙂

Kukonza mlingo wa insulin yayitali usiku

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

Momwe mungasankhire mulingo woyenera wa insulin usiku:

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

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

Ambiri okhalapo odwala matenda ashuga amafuna kuchuluka kwa mankhwala a insulin usiku umodzi wochepera 8 mayunitsi. Kupatula pa lamuloli ndi odwala a mtundu 1 kapena 2 a shuga, onenepa kwambiri, odwala matenda a shuga, komanso omwe tsopano ali ndi matenda opatsirana. Ngati mukulowetsa insulin usiku umodzi pakapita 7 mayunitsi kapena kupitilira, ndiye kuti malo ake amasintha, poyerekeza ndi waukulu. Zimakhala nthawi yayitali. Hypoglycemia imatha kuchitika musanadye tsiku lotsatira. Kuti mupewe mavutowa, werengani "ndikutsatira malangizowo."

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

Kodi mukufuna majakisoni a insulin yowonjezera m'mawa?

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

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

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

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

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

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

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

Tsoka ilo, kuti musinthe mlingo wa m'mawa wa insulin yayitali, muyenera kusala chimodzimodzi tsiku losakwanira ndikuwona momwe shuga ya magazi imakhalira tsiku lino. Kupulumuka masiku anjala kawiri mu sabata limodzi ndikosasangalatsa. Chifukwa chake, dikirani mpaka sabata lotsatira musanayesenso momwemo kuti musinthe insulin yanu yayitali. Tikugogomezera kuti zovuta zonse izi ziyenera kuchitidwa kokha kwa odwala omwe amasunga shuga yoyenera 4.6 ± 0,6 mmol / l. Ngati kupatuka kwa ± 2-4 mmol / l sikokuvutitsani, ndiye kuti simungathe kuvutitsa.

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

Insulin yowonjezereka ndi Levemir: mayankho a mafunso

Kwa chaka chathunthu ndidatha kuyendetsa bwino matenda anga a shuga, HbA1C idatsikira mpaka 6.5%. Nthawi yomweyo, mlingo wanga wa insulin wokulirapo unagwa nthawi zonse. Tsopano wafika magawo 3-4 patsiku. Zinapezeka kuti mlingo ukakhala wochepa, zochita za jakisoni wa Lantus zimatha pambuyo pa maola 12-18. Maora 24 olonjezedwa sakukwanira. Kodi ndingabale Lantus kawiri patsiku kapena ndikufunika kusinthira ku insulin ina?

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

Ndili ndi matenda a shuga 1 amtundu wazaka 42. Ogwiritsa ntchito insulin protafan + NovoRapid nthawi yayitali. Zaka ziwiri zapitazo, protophanus inasinthidwa ndi Lantus. Pambuyo pake, zinkandivuta kulipira matenda a shuga. Zizindikiro zokhala ndi shuga wambiri komanso wotsika kwambiri zakhala zofanana. Zimadanso nkhawa kuti Lantus ndi NovoRapid sagwirizana bwino, chifukwa awa ndi mitundu iwiri ya insulin kuchokera kwa opanga osiyanasiyana.

Ponena za kusagwirizana kwa Lantus ndi NovoRapid ndi mitundu ina ya insulin kuchokera kwa opanga osiyanasiyana. Awa ndimabodza opusa, osatsimikiziridwa ndi chilichonse. Sangalalani ndi moyo mukalandira insulin yabwino yoyendetsedwa kunja kwaulere. Ngati muyenera kusinthana ndi zapakhomo, ndiye kuti mukukumbukirabe nthawi izi ndi mphuno. About "zakhala zovuta kuti ndilipire matenda ashuga." Pitani ku ntchito zonse zomwe zafotokozedwazi. Ndikupangira kwambiri jekeseni Lantus kawiri patsiku, m'mawa ndi madzulo, ndipo osati kamodzi, monga aliyense amakonda kutero.

Posakhalitsa ndidatulutsidwa m'chipatala kuti ndidwala matenda a shuga 2. Apidra ndi Lantus adalembedwa. Kodi ndizotheka kumangopanga jakisoni wa Apidra musanadye chakudya, osalipira Lantus nthawi yayitali usiku?

Ndikadakhala m'malo mwanu, m'malo mwake, ndikulankhula mosamala Lantus, komanso kawiri patsiku, osati usiku wokha. Pankhaniyi, mutha kuyesa kuchita popanda jakisoni wa Apidra. Pitilizani kuchita ntchito zina zonse monga zikufotokozedwera. Gwiritsani ntchito 1-2 pa sabata. Ngati mumatsata mosamala zakudya, kumwa, ndi zina zambiri, ndiye kuti mwina mwapeza 95% jakisoni wa jakisoni wa insulin. Ngati popanda shuga shuga wanu ukhalabe wabwinobwino, kenaka jekesani Lantus. Jekeseni wa insulin yofulumira musanadye mtundu wachiwiri wa matenda ashuga wofunikira 2 pokhapokha ngati wodwalayo ndi waulesi kwambiri kuti azitsatira zakudya zamagulu pang'ono ndipo nthawi zambiri amatsata njira.

Abambo anga ndi okalamba, amapezeka ndi matenda a shuga a 2, Levemir adalembedwa insulin. Tsoka ilo, palibe aliyense m'banjamo amene amadziwa kuperekera jakisoni. Mungamasule bwanji? Ndimalo ati pamimba? Kodi ndifunika kufafaniza jakisoni ndi mowa? Singano kuti aikidwe kwathunthu kapena nsonga yokha?

Ndi nthawi yanji masana yomwe kuli bwino kupangira jekeseni Levemir? Tsopano ndimalandira jekeseni yanga yam'mawa pa 7.00, ndi jekeseni yamadzulo pa 21.30.

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

Ndili ndi matenda a shuga 1 amtundu wazaka zinayi. Ndimathandizidwa ndi insulin Lantus ndi NovoRapid. Madokotala amalimbikitsa kwambiri kusintha insulin yayitali komanso yochepa kuchokera ku kampani imodzi - Lantus + Apidra kapena Levemir + NovoRapid. Amati ndili ndi mwayi wokulitsa matenda a insulin. Ndipo ngati pali kufanana kwa mitundu iwiri yopanga nthawi imodzi, ndiye kuti palibe zosankha zosinthira kuma insulini ena abwino.

Madokotala anu ali ndi nkhawa ndipo alibe chochita. Ngati m'zaka zinayi simunakhale ndi insulin, ndiye kuti sizingatheke kuti ziziwoneka modzidzimutsa. Ndimatengera izi. osati bwino magazi, komanso amachepetsa mwayi uliwonse chifuwa. Chifukwa pafupifupi zinthu zonse zomwe zingayambitse ziwengo, timapatula chakudyacho, kupatula mazira a nkhuku.

Dokotala wamaso omwe amachita laser coagulation samandiwuza kuti ndisinthe kupita ku Lantus. Amati amatha kuyipa m'maso, imathandizira kukulitsa kwa retinopathy.Kodi izi ndi zowona? Ndadwala matenda ashuga amtundu woyamba kwa zaka 27.

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

Tsopano ndimadzilimbitsa ndekha Lantus 15 tsiku lililonse pa maola 22. Koma ndikuwona kuti pambuyo pa 16.00 kale palibe insulin yokwanira kumbuyo m'magazi. Chifukwa chake, ndikufuna kusinthitsa kuchokera kumayendedwe amodzi kupita ku magwiridwe antchito a nthawi ziwiri. Momwe mungagawire Mlingo muzibayira ziwiri?

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

Mwana wamkazi wazaka 3, mtundu wa 1 shuga. Tsopano timathandizidwa ndi protafan insulin ndipo chilichonse chimakwanira, kubwezeredwa kwa shuga ndikwabwino. Koma tidzakakamizidwa kusinthira ku Lantus kapena Levemir, chifukwa kuperekedwa kwaulere kwa protafan posachedwa kutha. Alangizeni momwe angachitire bwino.

Palibe yankho lomveka bwino la funso lanu. Khalani ndi mayendedwe molingana ndi zotsatira zake. Iyi ndiyo njira yokhayo yomwe mungasankhe zolondola komanso zolimbitsa insulin mwachangu. Ndikupangira chidwi chanu. Amatha kudumpha insulin kwathunthu atasinthana ndi zakudya zoyenera.

Tisanalowetse insulin Levemir yowonjezera, timayeza shuga m'mawa ndi madzulo. Kenako timayeza kachiwiri pambuyo pa ola - ndipo pafupifupi nthawi zonse shuga amakhala wokwera. Chifukwa chiyani limatuluka pambuyo pobayira insulin? Kupatula apo, ziyenera kuchepera m'malo mwake.

Insulin yayitali, yomwe Levemir ndi yake, sicholinga chake kuti achepetse shuga. Cholinga cha kugwiritsidwa ntchito kwake ndizosiyana kotheratu. Shuga mumkhalidwe wanu umakula mothandizidwa ndi zakudya zomwe zadedwa kumene. Izi zikutanthauza kuti mlingo wa insulin yofulumira musanadye sichinasankhidwe molondola. Ndipo, mwina, chifukwa chachikulu ndikudya zakudya zosayenera. Werengani zathu kapena. Kenako phunzirani mosamala zolemba zonse pamutu wakuti "".

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

Osayesa kugwiritsa ntchito insulin yochulukirapo kumene yochepa kapena yopitilira muyeso yofunika. Werengani nkhani zomwe akuti "" ndi "". Muyenera kuchiritsa matenda anu a shuga ndi insulin ngati mukufuna kupewa zovuta zake.

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

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

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

Moni, ndili ndi zaka 23, kutalika kwa 165 cm, kulemera kwa makilogalamu 53, mtundu wa 1 shuga. Matenda ophatikizika, hypothyroidism. Ndimatenga mayunitsi a Lantus 12 m'mawa, gawo la Humalog 1 la nkhomaliro ndi L-thyroxine 75 mg m'mawa pamimba yopanda kanthu. Ndinayamba kutsatira zakudya zamagulu ochepa zama carbohydrate, ndipo kwa mausiku awiri motsatana ndinali ndi hypoglycemia (2.6), ngakhale tsiku lonse msinkhu wa shuga unali 4.1-4.6 komanso pogona 4.6. Pankhaniyi, funso ndi momwe mungapewere hypoglycemia?

Zaka 40, kutalika 173, kulemera 78-79 kg. Mtundu woyamba wa shuga. Ndakhala kwa insulin kwa zaka 22. Zachidziwikire, pali zovuta: impso nthawi zina zimavutitsa (pyelonephritis) ndipo zotengera zamiyendo sizilinso bwino.
Levemir insulin m'mawa ndi madzulo kwa magulu 23, masana 3-4 amakhala ndi Novorapid (kuyambira 4 mpaka 6 mayunitsi). Ndinkafuna kudziwa ngati ndizotheka kusamuka ndekha kuchoka ku Levemir kupita ku Lantus ndekha? Momwe mungawerengere kuchuluka kwa Lantus, ngati amaperekedwa kamodzi patsiku? Palibe nthawi yopita kuchipatala, ntchito siyilola.

Moni, ndili ndi zaka 57, bambo. Sindikudziwa kukula. Kulemera kwake ndi 151 kg. Ndakhala ndikudwala matenda ashuga a 2 kwa nthawi yayitali. Mwa zovuta - sanali proliferative retinopathy, polyneuropathy. Miyendo yanga sindivutitsa kwambiri. Komanso matenda a mtima a ischemic. Angina pectoris. CHF 2, FC 3. Adalandira Glyclazide MV 120 mg, metformin 3.0 g patsiku. Glycemia anali 8-9 mmol / L. Sindikufuna kusintha kalikonse, ngakhale kuti akatswiri azachipatala omwe amatsogolera pachipatalapo adalimbikitsa. Nthawi zambiri mafuta amoto. Dokotala wina wa ma endocrinologist adandipititsa ku insulin mu umodzi mwa zipatala zakuchipatala. Lantus 30 units usiku, insuman mwachangu 14 mayunitsi 3 nthawi ndi metformin 2 nthawi. Moona mtima, sinditsata chakudya. Komabe, ndi shuga wa insulin ndi woipa kwambiri: pamimba yopanda kanthu 9-10 mmol / L, muyeso wosasintha wa 10.7-12.0 mmol / L, asanagone 11.0 mmol / L. Ndichite chiyani?

Nkhani yolipira shuga kwa ana omwe ali ndi insulin yowonjezera. Mwana wanga wamkazi wazaka 6 anapezeka ndi matenda ashuga a mtundu woyamba 1, atapezeka mwezi watha. Atatulutsidwa kuchipatala, adamulembera jakisoni wa insulin - Levemir 1 IU nthawi ya 8 koloko m'mawa ndi NovoRapid wa mayunitsi a 0,5-1. Usiku, insulin yayitali simunayikidwe, chifukwa ngakhale mlingo wochepa wa magawo 0,5 a Levimir, shuga adagwa usiku mpaka hypoglycemia.

Kwa milungu ingapo zonse zinali bwino, koma m'masiku omaliza, shuga maola awiri atatha kudya anayamba kutsika mpaka 4 mmol / l. Zonsezi popanda kusintha pakudya, zolimbitsa thupi ndi zochitika za tsiku ndi tsiku. Ngakhale shuga atakhala 6.0-7.0 mawola awiri atatha kudya, ndiye kuti patadutsa mphindi 30 wina adatsikabe mpaka 4 mmol / L

Mayi anga nawonso ali ndi matenda ashuga kwa zaka 13. Tidakambirana ndi iye ndipo adachepetsa kaye m'mawa Levemir kukhala mayunitsi 0,5, koma sizinapereke zambiri. Kenako adaganiza zochotsa Levimir kwathunthu. Jakisoni wa NovoRapid yekha amene adatsala kuchuluka kwa XE yomwe wadyedwa. Zotsatira zake, masiku atatu omaliza a shuga, tili ndi 5.5-7.5 mmol / L Ngakhale atakhala ndi maphunziro akuthupi, sataya m'munsi mwa 4.8 mmol / l.

Funso ndi ili. Mwina Levimir sakanayenera kuchotsedwa konse, ndi kumangopatsidwa chakudya chamafuta othamanga kuti muchepetse shuga ndi zochitika zolimbitsa thupi? Ndikusokoneza kuti ndikathetsa insulini yotalikilapo, ndidzavutitsanso kapamba ndipo chotsalira cha insulini chitha. Pepani koma sichingandipweteke. Ndiuzeni chonde?

Moni. Ndili ndi zaka 57, kulemera 90 makilogalamu, kutalika masentimita 165. Mtundu 2 wa shuga kwa zaka 9. Mavuto - polyneuropathy, retinopathy, miyendo yopweteka kwambiri. Ndimamwa shuga ndi metformin m'mawa komanso maola 22. Shuga m'mawa 9-11. Dotolo adalamulira kuti magawo 10 a Protafan agwidwe usiku nthawi ya 22 oveni. Kuthamanga shuga 5.5-6.Ngati ndimamwa mapiritsi onse m'mawa, ndiye kuti ndimakhala ndi hypoglycemia masana. Dokotala amalimbikitsa kutenga chilichonse ndikudya zakudya zambiri m'mawa. Ndikuyesera kusinthira ku chakudya chamafuta ochepa wopanda shuga - shuga imasunga 6.5. Koma nthawi zina ndimaphwanya zakudya, ndimafunitsitsa mkate. Ndiye, masana, shuga amalumphira ku 10. Ndikuyenera kuchita chiyani? Mwina mutha kugawa Protafan kukhala m'mawa ndi madzulo ndikutenga metformin? Ndiuzeni, chifukwa dokotala samalimbikitsa kuthetsa matenda ashuga. Glycated hemoglobin m'miyezi itatu yapitayi ya 8,2%, ndiye kuti insulini sanabale. Zikomo

Ndili ndi zaka 34, kutalika 168 cm, kulemera makilogalamu 69. Matenda a shuga 1, omwe adapezeka miyezi 5 yapitayo. Palibe zovuta zilizonse, hypothyroidism yokha ili ndi zaka 15. Dokotala adapereka insulin yowonjezera m'mawa nthawi ya 07.00 12 IU, madzulo a 19,00 8 IU ndi zakudya zoyenera. Ndidasintha zakudya zamafuta ochepa. Ndakhala ndikuyesera kwa masiku atatu, koma sizimagwira - nthawi zonse hypoglycemia 1.2 mpaka 2 mmol / l. usiku ndi usana. Lero, insulin yowonjezera kale yachepa mpaka magawo 2 m'mawa ndi madzulo. M`mawa pa chopanda kanthu m'mimba shuga 4.1, mutatha kadzutsa pambuyo 2 maola - 3.2. Zakudya zokhazokha ndi masamba - 2 hours musanadye shuga 3.1. Kodi ndikulakwitsa chiyani? Ndimadya zakudya zopatsa mapuloteni 350 gr., Carbohydrate 30 gr patsiku.

Moni Wazaka 26, kutalika 174 cm, kulemera 67 kg, mtundu 1 shuga. Palibe zovuta. Ndimalola mayunitsi a Actrapid 8.00-8, mayunitsi a Protafan 12, mayunitsi 13.00-6 Actrapid, magawo a 18.00-8 Actrapid, 23.00 10-12 magawo a Protafan. Vuto lalikulu la insulin ya usiku ndi shuga wambiri m'mawa. Ndinayesa njira zambiri. Ndinkayeza shuga maola atatu aliwonse ndipo izi ndi zotsimikizira za 23.00-6.8 mmol, 3.00-5.2 mmol, 6.00-10 mmol, 8.30-14 mmol. Wotopa kumenyana naye. Madotolo ati kuwonjezera mlingo. Ndikachita izi - nthawi yomweyo hypoglycemia usiku. Ndawerenga nkhani yanu yonena za protafan ndipo ndikufuna kusinthira ku insulin ina, koma madokotala akukhumudwitsa. Ndiuzeni chonde, ndiyenera kukhala bwanji? Ndataya kale mtima. Masana shuga ndi abwinobwino, ndimatenga insulin pambuyo poyesa shuga ndikuwongolera. Ndikufuna ana, koma ndimatenda amtunduwu sizabodza! Thandizo.

Moni, ndiuzeni, kodi ndizotheka kugawanitsa m'mawa ndi jekeseni wa levemir mu jakisoni 2? Tinene kuti kubedwa kwa 21.30, pa 3.30, pa 9.30, ndi 15:30. Levemir adagundika madzulo a 21.50, ndipo m'mawa nthawi ya 6.30. Tsopano ndikuona kuti sindimakwanitsa kuwonjezera nthawi yamadzulo kapena m'mawa. Ngati mlingo ukuwonjezeka, ndiye pafupipafupi matenda a hypoglycemia. Novorapid amasankhidwa molondola. Mtundu woyamba wa matenda ashuga kuyambira 2006, palibe zovuta, pakakhala pano ndi milungu 30, ndili ndi zaka 30. Glycated hemoglobin anali 6.0% pa 26 milungu ya gestation.

Moni Ndili ndi matenda ashuga amtundu woyamba kuyambira 1999, zaka 47, kulemera makilogalamu 63,5. Mwa zovuta - polyneuropathy (zidendene). Anakayezetsa insulin (Lantus, Humalog) kuchipatala. Zakudya zomwe "ndizabwino" kwambiri, ndimangodziwana ndi mafuta ochepa. Komabe, ndikuganiza kuti ndikufunika kugawana nawo Lantus. Jakisoni madzulo, 22-00 kapena, malinga ndi momwe zinthu zilili, pambuyo pake - 14 magawo. Mashuga am'mawa amagwera m'magulu anayi, ndipo dzuwa lamadzulo limachokera ku 10-17, ndipo lalitali limasinthidwa ndikumverera. Chakudya chamadzulo chimakhala pafupifupi 18-30 - 19-00, ndimagona nthawi zambiri mochedwa, nthawi zina pafupi ndi m'mawa, ndiye ndimangodya pafupifupi 24-00: tiyi, cracker, chidutswa cha nyama yophika. Sindikudziwa kuti ndiziwerenga molondola. Pakadali pano ndazindikira kuti mutha kuyesa kugawa m'magawo 9 madzulo ndi magawo 5 usiku (kapena m'mawa?). Mukupangira chiyani?

Moni. Ndili ndi matenda ashuga kwa chaka chimodzi. Dokotala adati Mikstard 30 NM. Ndimabaya kawiri patsiku m'mawa pa maola 8 16 komanso madzulo nthawi 17 maola 14. Mwazi wamagazi mkati mwa 14, sugwera pansi. Ndikumva bwino. Kodi ndizotheka kuwonjezera kuchuluka kwake ndipo padzakhala zovuta zina? Ngati ndizotheka, ndiye kuti mungachite bwanji? Mwina insulini siyabwino? Zikomo patsogolo.

Ndili ndi zaka 34, kutalika 177 cm, kulemera 82 kg, mtundu 1 shuga. Kodi ndiyambireni jekeseni woyamba wa mankhwalawa patsiku?

Ndiuzeni, kodi pamakhala zovuta ngati mungasinthe kuchokera ku Protofan kupita ku Lantus? Mwana amadwala kwa zaka zitatu, mtundu 1 wa matenda ashuga.

Moni, ndili ndi zaka 37, kutalika 178 cm, kulemera kwa makilogalamu 83. Mtundu woyamba wa matenda ashuga, omwe adapezeka kuti wapeza theka chaka chapitacho. Ndimayesetsa kutsatira zakudya zamagulu ochepa.Ndimabweza pokhapokha kamodzi patsiku ndimadya phula yaying'ono yamafuta 30 a chakudya ndi batala. Shuga nthawi zambiri amakhala 4.3-6.5. Nkhani ya insulin ndi Humulin-NPH. Kodi chigamulo chake ndi chiyani? Choyipa kuposa chiwonetsero, choyandikira kwambiri? Ndimakondanso kuyerekezera ndi lantus ndi levemire. Tikuthokoza pasadakhale tsamba lanu komanso chidwi chanu kwa ife.

Ndili ndi zaka 57, kutalika kwa 160 cm, kulemera 80 kg. Matenda a shuga a II. Ndikudwala kwa zaka 14. Shuga pamimba yopanda kanthu m'mawa 8.2, ndiye masana kuyambira 5.9 mpaka 7.9, madzulo 10, usiku pafupifupi 6. Ndimatenga Ongliz, Siofor, magawo 38 a Lantus m'mawa. Siofor madzulo, ndimadya chakudya chamadzulo m'ma 18. Kodi ndimasintha bwanji shuga? Kodi angagawe Lantus m'magawo awiri? Koma ndi zochuluka motani? Kapena kuwonjezera mlingo? Ndipo amatha kupirira jakisoni wa Lantus madzulo?

Moni, Sergey.
Apanso mafunso anga amakhalabe, omwe ndimafunsa pamalondopo, popanda mayankho ...
Ndikukhulupirira nthawi ino kuti mudzapeze yankho, makamaka chifukwa funsoli ndilofunika.
Kupatula kuti ndinayamba kudya zakudya zamagulu ochepa, ndimapitilirabe kumwa Glformin ndi zowonjezera zowonjezera, ndinasankha kubaya insulin.
Endocrinologist adalemba Levemir kuti asachotsedwe, ngakhale cholembera.
Adotolo adandifotokozera kuti muyenera kuyamba ndi mlingo wa magawo 10 usiku. Ndili ndi shuga m'mawa 7.1, nthawi zina zochepa.
Munkhaniyi, ngati ndimamvetsetsa bwino, kodi mukulimbikitsa kuchuluka kwa mayunitsi 1.25 mwa chitsanzo cha zisonyezo zanga? Kusiyana pakati pa shuga m'mawa ndi madzulo ndi 4 mmol, ndili ndi zochepa, ndipo kulemera ndi 80 kg.
Kapena kwinakwake sindinamvetsetse kena kake, kapena ....
Chonde ndiuzeni. Zikomo

Moni Ndine wa endocrinologist, ndipo nditawerenga nkhani yanuyi, ndakwiya kwambiri. Zoti zikutsimikizira kuti mitundu yonse ya insulini yonyansa siyabwino! Ndipo odwala enieni amatha kuwerenga! Izi sizalakwika ndipo zikufunika kuunikidwanso!

Masana abwino
Ndili ndi zaka 26, kutalika 164 cm, kulemera 59 kg. Ndikudwala matenda ashuga amtundu 1 kwa zaka 14. Posachedwa ndabwera patsamba lanu ndipo tsopano ndimatsata zakudya zamagulu ochepa. Ziphuphu zayenda bwino kwambiri. Tsopano ndikusintha mlingo wa Lantus. Zowoneka zam'mawa zakhala zikupezeka mukudwala kwanga konse. Sizikudziwika bwinobwino - ndikumenya Lantus madzulo 21 ndi usiku wina 1-3? Ndipo m'mawa nthawi ya 8 oveni? Kapena kodi woyamba kumwa mankhwalawa ayenera kumwedwa kale kuposa zaka 21? Kapena kodi nthawi ino iyenera kukhazikitsidwa modabwitsa komanso kwa ineyo? Pakadali pano ali ndi 23 maola 16 magawo a Lantus. Shuga pa 23 - mkati mwa 4-6, pa 3 usiku kumatha kukhala ndi hypoglycemia, m'mawa nthawi ya 5.30 m'mawa - 7-8, nthawi ya 8 m'mawa - 10-13. Nthawi zambiri nthawi ya 5.30 m'mawa ndimawonjezera magawo ena a 1-2 a Humalog.

Masana abwino
Ndili ndi zaka 50, ndili ndi matenda ashuga amtundu 1 ndadwala chaka chimodzi, kutalika 167 cm, kulemera 55 kg.
Ndiuzeni, chonde, ndikuyezetsa magazi ati kuti nditsimikizire kuti ndi insulin iti (ndimapanga uti) yemwe ndiyenera kubaya?
Tsopano ndinatembenukira ku protofan ndi actrapid, koma pambuyo pa jekeseni ndi cholembera, syringe red.

Moni. Mwamuna wanga ali ndi zaka 31, ali ndi matenda ashuga 1 kwa zaka zitatu tsopano. Ndawona tsamba lanu ndipo ndaganiza zosinthira kuzakudya zamafuta ochepa. Pakadali pano, zokumana zochepa. Sabata silinathe. Sitingasankhe bwino mlingo wa insulin musanadye kuti shuga asagwere, koma palibe - titha kuthana nawo. M'mbuyomu, adapatsidwa novorapid, koma tsopano apereka insuman Rapid GT ndipo akuti novorpid sadzaperekanso. Insulin yowonjezera ndi lantus. Sindikumvetsa ngati insuman yachangu ndi yochepa kapena yaifupi kwambiri ya insulini? Ndipo kodi ndizotheka kugwiritsa ntchito insulini yochepa kwambiri yokhala ndi chakudya chamafuta ochepa? Ndawerenga kuti mukulimbikitsa zazifupi, koma zikuwoneka kuti amatipatsa njira yabwino. Chonde ndikulangizeni zoyenera kuchita ngati ndi insulin yowonjezera komanso ikugwirizana ndi zakudya zanu? Ndipo funso lina: madotolo adanena kuti ngati atapanga lantus, ndiye kuti pambuyo pake simungathe kudya chilichonse ndikumwa khofi kapena tiyi - kodi sichoncho? Mwamuna nthawi zonse amakhala akuchita lantus asanagone kuti akagone nthawi yomweyo, koma zikuwoneka kuti izi ndizolakwika, chifukwa amatha kukagona 2 koloko m'mawa. Amamwa khofi nthawi yomweyo, chifukwa cha izi, nthawi zina amapereka jekeseni mochedwa. Tithokoze yankho.

Nthawi yokomera tsikulo, ndili ndi zaka 25, kutalika 165, kulemera kwa 56, kudwala matenda amishuga 1 kuyambira wazaka 12 (nthawi yomweyo insulin) Insulin Novorapid 2 mayunitsi pa 1Xe ndi Levemir 16 unit. usiku ku 00,00 ndi m'mawa 15 magawo. nthawi ya 10.00.Nditawerenga nkhani zambiri pa tsamba lanu, ndazindikira kuti ndili ndi Mlingo wambiri wa insulin, ndikuyenera kudziwa kuchuluka kwa kuchuluka kwa mankhwalawo, chifukwa nthawi zambiri m'mawa shuga amadzuka (popanda chochitika cha m'mawa, sindimakhala m'chiuno, nthawi zambiri ndimayeza shuga usiku) makamaka ngati ndimachita panthawi (m'mawa) ) Sindipeza chakudya cham'mawa ndipo sindingayendetse jakisoni. Kuphatikiza apo, ndikangopanga nthabwala popanda chakudya, shuga samachepa, koma m'malo mwake amatha kukula, chakudya mwanjira yachilendo imayamba njirayi. Ndimadya maola 4-6 asanagone, ndimayeza chilichonse. Sindinathe kupeza yankho ndipo madotolo sananene chilichonse. Ndikufuna kusinthira majekiseni atatu amodzi owonjezera, monga momwe mungalangizire. Chonde ndiuzeni ngati ndikupanga nthawi yayitali usiku 00,00, ndipo nthawi ya 10:00 m'mawa, ndiye ndimapanga nthabwala nthawi yanji usiku ndikugawa mankhwalawa? Ndipo kodi ndichofunika kusintha jakisoni wam'mawa ndi maola 9 kapena 8 (ngakhale ili nthawi yabwino kwambiri kwa ine, koma ngati ndi yolondola)? Zambiri, Karina.

Ndimagawa levemire m'magawo anayi a magawo 6 maola 6 aliwonse. Zabwino basi, zikomo. Ndidapeza tsamba lanu pa febulo 7, 2016, ndipo ndidaliwerenga kwa masiku awiri ndipo ndidaganiza zosinthira ku chakudya chamagulu ochepa. Lero ndi February 16, 2016, sabata lomwe ndili pachakudya chanu, shuga sanatulutse)) Ndinali ndi vuto m'mawa kutacha, linathekanso. Kulemekezedwa Kwambiri.

Masana abwino Choyamba, ndikufuna kunena zikomo chifukwa cha ntchito yanu. Tidangodziwa zamasamba. Chinsinsi cha nkhaniyi: Mwana 3 g miyezi 9. Miyezi 1.5 yapitayo, adapeza matenda ashuga 1. Adalemba Protafan ndi Novorapid mu Mlingo wa kavalo! Kunyumba, mothandizidwa ndi zakudya, adatha kuchepetsa Mlingo wambiri kuposa 2 r. Koma shuga amalumpha pang'ono. Tikufuna kupita ku Levemir ndi Actrapid. Koma madotolo onse omwe adalumikizidwa za kusinthaku sawalimbikitsa. Izi zimasokoneza kwambiri. Izi zisanachitike, anali atakwaniritsidwa 100% posinthira, kuti, kunena zowona, mbewu yokaikira yabzalidwa. Chifukwa chiyani akutsutsana? Iwo ati Levemir ku Novo Nordisk sanachite momwe iwo anafunira (mpikisano Lantus). Munthu m'modzi yekha amatiuza kuti tizipita ndipo mnzakeyo - wogwira ntchito pakampani Novo Nordisk.
Komanso, tili ndi vuto linanso - miyezi 7 yapitayo, tinapezeka kuti tili ndi matenda a Perthes. Mwanayo akunama (koma izi ndi za zaka 1-2.
Zoyenera kuchita Thandizani chonde!
P.S. Chifukwa chiyani Lantus ali ndi zaka 6 zokha?

Masana abwino, mwana wanga wamwamuna, wazaka 8, adapezeka ndi matenda ashuga 1 miyezi isanu yapitayo, ife timakhala ndi mayunitsi atatu a Lantus tsiku limodzi, ndipo chakudya chamadzulo nthawi zina 1 unit novorpid. Timayesetsa kutsatira zakudya zamafuta ochepa, koma wopanda zipatso mpaka pano. Chizolowezi choti shuga pamimba yopanda kanthu chimadzuka madzulo, ngakhale zakudya. Asanadye chakudya chamadzulo, akhoza kukhala ndi 140. Kenako, novorapid amagwira ntchito yake ndipo atatha maola awiri atadya chakudya, 105 - 120, pa 3 usiku amadzukanso ku 130-40 ndipo m'mawa 105 -120. Nanga tikusowa Lantus? Koma m'mawa kusukulu amatsika mpaka 70-80, ndipo pambuyo pa chakudya cham'mawa chopatsa thanzi, popanda Novorapid. Kodi njira yabwino kwambiri yovalira lantus ndi iti? Gawani ma Mlingo awiri, umodzi m'mawa ndi 2 usiku. Ndikufuna kuchita chilichonse mwaluso kuti ndisunge nkhokwe zazitali

Tsiku labwino. Mwambiri, tsamba labwino kwambiri .. Ngakhale ndidadwala matenda ashuga kwa zaka 40, ndimapeza zatsopano komanso zothandiza. Mfundo ziwiri. Nthawi ndi nthawi, mu zolemba 1 ndi 2, mitundu ya matenda a shuga imafotokozedwa limodzi, nthawi zina sizikudziwika bwino kuti ndi mawu ati omwe amalembedwera, ngati onsewo adatchulidwa m'ndime yoyamba ya nkhaniyo, ndi mtundu wachiwiri wachiwiri. za woyamba, palibenso mawu. Koma izi ndizofunikira. Kenako. Zomwe zidandimasulira kwathunthu. Kulephera kwakanthawi kofotokoza nthawi yeniyeni monga "idyani chakudya cham'mawa kwambiri musanadye maola 8.5 musanapite kukagona" kapena "kuyeza shuga m'mawa." Chowonadi ndi chakuti dongosolo langa la moyo limawoneka ngati ili. Ndimagona 5 koloko m'mawa. Ndipo ndimadzuka - pa 12 SIKU. Kodi ndizotheka mwanjira ina kumangosonyeza kuchuluka kwa nthawi. Mwachitsanzo: m'mawa insulin iyenera kuchitika pa 7.00. Madzulo - nthawi ya 3.00. Imani shuga pa 5.00. Ndi zina zotero. Aliyense amene angasinthe nthawi yanga ngati yanga - iwo amangowerengeredwa nthawi yoyenera. Koma akakhala mosatekeseka "m'mawa", "usiku" komanso "m'mene adzuka", "sanachedwe kudya" - izi ndi malingaliro osiyanasiyana kwa aliyense ... zimasokoneza. Mufuna kuwonetsedwa kwakwanthawi.

Moni: Ndili ndi zaka 52.Mtundu woyamba wa matenda ashuga, wazaka 12, wolemera 58 makilogalamu. Therapy a Insulin: Apidra ndi Levemir. 8-00 Apidra ndi Levemir. Magawo 4,
13-00 Apidra magawo 5,
18-00 Apidra magulu atatu
22-00 Levemir 5 magawo
Ndimatsatira kudya, kuchita masewera olimbitsa thupi. masewera olimbitsa thupi, ndakhala ndikuyenda kwa Nordic kwa chaka chimodzi, ndimayenda tsiku lililonse nyengo iliyonse, ndimadya chakudya chamadzulo mpaka 19-00, nthawi ya 21-00 ndimayeza shuga wamagazi kuyambira 5-6 mmol, koma m'mawa mpaka 17 mmol. Tsopano ndimadzuka pafupifupi 6 koloko m'mawa, ndimachita nthabwala za Apidra mu 2 PIECES. Mpaka 11 koloko m'mawa shuga amatulutsa, kenako zonse zimabwerezanso. Mlingo wake unasinthidwa ndi endocrinologist ndipo nthawi yoyamba imagwira ntchito, kenako nkuyamba kudumpha. Kuyembekezera uphungu wanu. Ndabwera patsamba lanu mwamwayi, ndawerenga zochepa, ndaphunzira zatsopano za matenda omwe ndimawakonda kwambiri. Ndikufuna kuyesa zakudya zamagulu owonjezera, koma impso yakumanzere imazunguliridwa ndikuchepetsedwa kukula kukhala 74 x 43 mm, kodi ndizotheka kuyesa vuto! Zikomo patsogolo. Chiyembekezo

Moni, ndili ndi zaka 23, kulemera kwa 66-67 makilogalamu, shuga ndimatenda a 1.5 zaka, mtengo wa lantus ku mayiti 22,00 14. Momwe mungagawanitsire mlingo wake komanso nthawi yanji? Pa 22,00 ndi 8.00?

Zaka 39 zakubadwa. Mukazindikira kuti matendawa atsimikizidwa, kuyambira 11.04 pa zakudya zotsika zamoto. Anayamba kuthamanga tsiku lililonse m'mawa, kuchuluka thupi. ntchito. Kusala shuga anali 11.5 - 11.7. Adamwa theka la mapiritsi a shuga kwa masiku 11, mbali yake yakumanja idayamba kupweteka nthawi yomweyo, idasinthika mpaka kotala ndikuima kwathunthu ku 5.05, chifukwa wapezeka ndi LADA - pali ma antibodies opita ku GAD ndi ICA, C-peptide 1.76, insulin 5.0.

Kwa milungu itatu, pa chakudya chokwanira nthawi imodzi cha 6, ndimataya 6 kg. Shuga yachepa ndipo kuchokera pa 2.05 (pah katatu nthawi) yamtengo wapatali kuposa 7.8 sinawonepo. Adokotala anakana kuti "ndikhalebe kotala odwala matenda ashuga" ndipo adandipempha kuti ndisamuke kupita ku insulin, chifukwa pang'ono mpaka lero ndi funso. Adotolo adandiuza ku Levemir, koma ndidangolandira pa 05/31, koma pakadali pano ndidapatsidwa Gensulin N, yomwe sindinadabwe, poganiza kudikirira Levemir. Kwa pafupifupi mwezi umodzi, kudya zakudya zama carb ochepa komanso masewera olimbitsa thupi komwe kumandisunga mu shuga wa 4.6-7.4. Kuphatikiza apo, inali shuga yosala kudya yomwe nthawi zonse imakwezedwa - 6.2 - 7.4, ngakhale idawonekanso 5.8 - 5.9 kangapo. Ngakhale kuti masana ndi madzulo maola awiri mutadya shuga ndizabwinobwino.

Kuyambira pa Meyi 31, pakani 2 levemir. pa 23.00 sanamve kusiyana kwa manambala ndipo tsiku lotsatira anayamba kuwonjezera 1 unit. patsiku lafika kale magawo 7. ndipo m'mawa uno ndidakonza 6.3. Dzulo pambuyo 6 mayunitsi. pa 23.20 mtengo wammawa pa 6.30 anali 6.9.

Ndimadya chakudya chamadzulo nthawi ya 6 p.m. - 6.30 p.m., koma nthawi ya 8.30 p.m. - 9 p.m. Ndikupanga chakudya chamadzulo chachiwiri popanda mapuloteni a nyama - zopangidwa ndi kvash. kabichi kapena beetroot. Ndimagona 23.30 - 0,00, dzukani pa 6.30.

Changu chachikulu tsopano ndi makilogalamu 84 ndikukula kwa 178. Kutsatira zomveka zatsamba lanu, magawo 7. Kodi Levemira ayenera kutsitsa shuga wanga ndi 7 * 63.25 * 2.22 / 84 = 11.6? Ngakhale kuti ziphuphu zanga zimagwirabe ntchito kumapeto kwazonse. Lero ndizidzibaya mayunitsi 8. Sindimadzuka thukuta. Mwambiri, china chake sichili bwino apa. Cholinga changa m'mawa ndicho kukhala ndi shuga wochepa kuposa 6.0, osachepera 5.9, koma sindikudziwa kuchuluka kwake. Ndikhala motere. Kapena kodi ndikulakwitsa?

Moni. Ndili ndi zaka 35. Msinkhu 174. Makilogalamu 55,5 kg. Ndinapeza shuga wambiri nditatha kudya 11 mM / L. Wadutsa glycyl hemoglobin 5.5 mM / L. Ndi peptide 3. Ndili pachakudya. Palibe chimavuta. Kuyambira somatic pali endometriosis. Wogwiritsa ntchito ma cysts amchiberekero. Kuthamanga shuga 4.8-5.0mM / L. Pambuyo kudya pambuyo pa ola 5.5-6mM / L. Kodi ndili ndi matenda osokoneza bongo kapena mtundu umodzi? Kodi ndimachita bwanji ndi insulin? Zikomo chifukwa chatsambali komanso chifukwa chofunsira.

Ndi Lantus panali nocturnal hypoglycemia, ikani nthawi 2: 23:00 - 2-3 magawo ndipo nthawi ya 04:00 - 4-5 mayunitsi. Mu chipatalacho adasamukira ku Levemir: nthawi ya 12:00 - 6, kenako anayesa 9:00 - 6 mayunitsi. Ndikunena kuti mlingo ndi wochepa, wosakwanira madzulo. Anayamba kukhazikitsa Levemir motere: 01:00 - 2 mayunitsi ndi 12:00 -4-5 mayunitsi. Usiku ndi m'mawa dzuwa silingakhalebe labwinobwino. Chonde thandizirani ndi upangiri!

Moni mwana wanga, wazaka 10, kutalika kwa 140 cm 30 kg. Matenda a shuga a Type 1 akudwala zaka 4. Tidalandira levemir 7ed m'mawa nthawi ya 7 am ndi 8ed madzulo nthawi ya 21.00 tsopano atipatsa Lantus ndipo akuti ayike ma unit 14 nthawi imodzi. Ndawerenga patsamba lanu kuti imatha kugawidwa ma jakisoni 2 pa tsiku. Shuga wokhala ndi levemir ndiwabwino pazotheka. Kodi tiyenera kusinthana ndi lantus? Tithokoze yankho.

Zikomo kwambiri chifukwa chazidziwitso patsamba. Ndidasintha zakudya zamafuta ochepa. Ndikufuna kudziwa kuchuluka kwa insulini. Pankhaniyi, ndili ndi funso. Mumalemba kuti: "Chotsatira ndi kudziwa kuchuluka kwa insulini pamtengo wamtengo wapatali." Kodi ndingapeze kuti tebulo ili?

Moni)
Wazaka 45 kulemera 65 makilogalamu mtundu 1 shuga 4,5 zaka
Ngati yochepa insulin kumatenga mpaka 5 maola. ndipo ndimadya ndikatha maola atatu. ndiye kuti mlingo umodzi wa insulini udzagundana ndi wina?
Zosawonekeratu (
Zikomo)

Moni Ndine katswiri wamasewera, ndimadwala matenda a shuga 1, ndili ndi zaka 20. Nthawi zonse ndimabayidwa insulin Actrapid komanso pratofan amawoneka kuti ndi abwinobwino, koma shuga anali kumalumphira nthawi zambiri ndipo nthawi zambiri pamakhala ma gypses, malinga ndi lingaliro la dokotala ndinawasintha kukhala novoropid ndipo levemir ya shuga imayandikira kwambiri. Koma ndinayamba kumva kuti ndikulakwitsa, ndinayamba kugona osagona, ndinataya makilogalamu atatu m'mwezi umodzi, zotsatila mu masewera olimbitsa thupi zimatsika kwambiri, ndimayang'ana ma hypogs a shuga maola 2 aliwonse, sindinatsike kuposa 6 komanso osapitirira 10 nditachoka ndi prtfan kwa Ndi zabwino kwa ine zokha. Mwina ma insulin aja anali ndi mtundu wina wa anabolic st-va ndipo ayi.
Chonde limbikitsani chochita. Chifukwa adotolo akuti ndibwino kungokhala ku Novoropid ndi Levemire, koma posachedwa ndidzakhala ndi mipikisano ndi zotsatira zake
akugwa.
Ndi UV. ATP

Ndinapezeka ndi matenda a shuga 2 zaka 11 zapitazo, ndili ndi zaka 78, kutalika 150 cm, kulemera 80 kg, kunali 85 kg. Ndikuvomereza tsopano. m'mawa Diabeteson 60 mg, mapiritsi awiri ndipo madzulo 12 insulin. Ndipo sabata limodzi lokha ndidadutsa glycated hemoglobin 8.0. Dokotala wanga adatuma Levomir insulin m'mawa kwa mayunitsi 12 ndipo madzulo 14, ndimayesa kubaya insulin kamodzi m'mawa ndisanadye ndipo ndinayamba kudwala. Kupulumutsidwa ndi suprastin. Kuphatikiza pa madzi, sanatenge chilichonse. Nthawi zambiri sindimatha kupita kwa adotolo, chifukwa ndimayambiranso opaleshoni ya msana. Funso: Kodi insulin ya Levomir Flex Pen ikhoza kuyikidwa m'mawa mutatha kudya kadzutsa?

Zowona, matenda a shuga si matenda, koma moyo. Ngati inde, ndiye kuti chakudya chochepa chama carbohydrate m'magawo ang'onoang'ono katatu patsiku, chomwe chimakhala moyo wonse, ngakhale ndikukhala moyo wokangalika komanso kukana kwathunthu chakudya, ndikumva njala yatsiku lonse ndi kubayidwa mobwerezabwereza, ndiye? Kodi tanthauzo la moyo ndi chiyani, ngati zonse zomwe zili pansi pa mtanda chachikulu sizigwira ntchito kunyumba nthawi zonse? Fotokozerani madotolo abwino,
omwe mwina sanamvepo ngati anthu omwe ali ndi matenda ashuga 1, komanso "kusewera" ndi lingaliro lokhazikika. Moyo wanu ndiumoyo wanu, suyenera kuyankhidwa. Fotokozerani mbadwo wachichepere. Zikomo

Masana abwino Ndinapatsidwa matenda ashuga amtundu woyamba. Ndili ndi zaka 26, ndakula 160, kulemera makilogalamu 45. Glycolized hemoglobin-6.1, c-peptide-189. Lantus Yoperekedwa - magawo 8. Shuga wam'mawa amalumphira kuyambira pa 4.2 mpaka 6.0, shuga tsiku ndi tsiku samakwera pamwamba pa 8, ndipo shuga yamadzulo ndizambiri, amatha kukwera mpaka 16. Ndili pakudya. Kodi vuto limakhala chiyani?

Ndiuzeni, chonde, powerengera momwe mankhwalawa amayambira Lantus, pomwe tikuwunika kukula kwa sabata, kodi sitigwiritsa ntchito insulin? Nanga bwanji za insulin yayifupi panthawiyi?

SYRINGES ASATSITSE. Ndinalandira ma syringe 6 a levemir. Asanu a ma piston adatsika pambuyo pobayira angapo. Ena amalowa m'malo oyimitsa pakamwa, ena atabayira. Pankhani yotseka jakisoni, ndinatulutsa singano ndikumenya pisitoni ya syringe ndi nyundo yolunjika. Kenako mutha kupeza mankhwala pang'ono ku syringe. Koma, osandipatsa gawo lomwe ndimafuna, syringe imayambiranso. Ndiyenera kubaya jakisoni kangapo. Zoyenera kuchita Kodi mungapereke bwanji syringes zosalongosoka?

Sergey! Choyamba, ndikufuna ndikuuzeni, zikomo kwambiri chifukwa cha ntchito yanu, mwandithandizadi! Mulungu akupatseni thanzi labwino! Ndili ndi zaka 34, kulemera kwa makilogalamu 86, Msinkhu 176cm. Chaka chapitacho, adapezeka kuti ali ndi matenda a shuga a 2, kulemera kwake kunali makilogalamu 121. Mwadzidzidzi, dziko lapansi linagwa, kwinakwake mu miyezi ingapo ndinapeza tsamba lanu ndipo zinthu zinayenda bwino, zikomo kachiwiri: Chonde ndiuzeni izi: Shuga akusala pamimba yopanda 5.3 kuti sindichita, osati maphunziro akuthupi, mapiritsi osatsitsa, Ndayesa glucophage long500 ndi 1000 nthawi yamadzulo, ndinayesa kusintha chakudya cham'mawa, zotsatira sizinasinthe. Mukatha kudya, imakwera mpaka 6.0, 6.2 mmol, kusiyanasiyana ndikumamwa mowa, mwachitsanzo, 250-300gr aledzera madzulo. whiskey, ndiye m'mawa shuga 4.6, 4,8, ndipo titatha kudya 5.3, ngakhale kuti tsiku lotsatira limadzuka mpaka 5.7, 5.9, pamimba yopanda kanthu ndikutsalira ngati masiku atatu.Ndiuzeni kuti ndi chiyani? Chifukwa chiyani sindingathe kuchepetsa shuga wanga pansi 5.3? Zikomo pasadakhale!

Moni Sergey! Zikomo kwambiri chifukwa chamakalata anu. Pang'onopang'ono ndikudziwani bwino nkhaniyi. Ndikufuna kulandira upangiri, ngakhale kuli chiyembekezo chochepa. Ndilongosola chifukwa chake. Mtundu wa shuga wachiwiri mwa amayi anga. Ali ndi zaka 75, wakhala akudwala pafupifupi zaka 40. Mpaka chaka chino, a Glucovans anali pamapiritsi. Sakonda kuyendera madokotala, pokhapokha nditamukakamiza. Panali zovuta pamutu. Samvera zakudyazo. Ngati akuwopsezedwa, imatha tsiku limodzi, kenako ndikuphwanya. Shuga adayamba kukwera mwamphamvu (mpaka 23) ndipo adotolo adasamukira ku insulin (Levemir) mwachangu. Ndinamukwapula mlingo wa mayunitsi 10-12. - m'mawa shuga adayamba kuchepa mpaka mayunitsi 4-8, nthawi ya 14-18ed. Mlingo wochepetsedwa kukhala 6 mayunitsi. Adotolo adati ndizosatheka ndikusamutsira jakisoni wam'mawa, adati awonjezere mlingo mpaka shuga abwerere mwakale. Tsopano ndinawonjezera mlingo mpaka magawo 18. Shuga m'mawa pamimba yopanda 15, pambuyo maola 2 - 11. , mutatha kudya nkhomaliro m'masiku 2 - 19, ndipo madzulo musanadye (18,00) - magawo 20 .. Sindikudziwa zoyenera kuchita. Amayi samakhala kutali ndi ine, koma sangathe kudzipangira yekha jakisoni. Kuphatikiza pa jakisoni, amatenga mapiritsi a maninil - 2 pa tsiku, galvus - 1 nthawi patsiku, metformin - 2 kawiri. Ndikufuna kuti shuga asinthe, ndimamutsitsira chakudya, koma sindingathe kuchitsatira (ndimagwira). Dotolo adalankhula za insulin yochepa (kwa ine izi nthawi zambiri zimakhala zowopsa). Ndichite chiyani, ndipo ndiyenera kulowera kuti? Ndikovuta kwambiri kupangitsa mayi kuti achite zinazake. Pepani chifukwa cha chilembo chachikuluchi, koma ndili ndi chisokonezo ndipo ndimataya mtima.

Moni Sergey!
Choyamba, ndiloleni ndilumikizane ndi ashuga othokoza awa, abale awo ndi abwenzi omwe ali othokoza kwambiri chifukwa cha tsamba lapaderali ndi chidziwitso chofunikira komanso chofikirachi! Mulungu akudalitseni ndikukugwadirani!
Chaka chino, ndimakhala ndi chisamaliro chachikulu ndi mwana wanga wamwamuna wotsiriza yemwe amadwala ketoacidosis, glyc. 17%, shuga 20 mmol / l. Nkhani yake ndiyofanana: yabweretsedwa m'maganizo, idapezedwa ndi matenda a shuga 1, idavala insulin, idaphunzitsidwa kupaka jakisoni, kuwerengera XE ndipo tsiku la 15 iwo analemba kunyumba 8.3 mmol / l ndi shuga pamimba yopanda kanthu, atatha kudya 11.4 mmol / l ... Kunyumba shuga kuchokera pa 22.2-26.1 mmol / l adagwera ku 2.7-2.4 mmol / l, ngakhale tinapangana mosamala insulin yonse: magawo 7 a Lantus 1 nthawi patsiku ndi magawo 10-14. Actrapid katatu musanadye chakudya chachikulu (chokhala ndi zokhwasula zitatu popanda insulini), ndikuwerengera mosamala XE pamakala.
Banja lathu liri kutali kwambiri ndi zipatala ndi madotolo mu tanthauzo lenileni ndi lophiphiritsa la mawuwa. Kwa zaka 10 zapitazi takhala m'mudzi wina wa Karelian, wopitilira 40 km. kuchokera mumzinda wa Petrozavodsk. Koma, ngakhale amakhala ku Tashkent, likulu la Uzbekistan, ndipo pambuyo pake ku likulu la Oregon, Salim, sanapite kwa madotolo, sanapeze katemera, ngakhale ana atatu omaliza mwa 14 adabadwa kunyumba pabedi ...
Mwana atadwala (adamwa kwambiri, adathamangira kuchimbudzi kwambiri, kuwonda msanga), sindimatha kudziwa zomwe zimamuchitikira, chifukwa sindinakhalepo m'moyo wanga ndinakumana ndi zotere ndipo sindinadziwe choti ndingayembekeze. Pofufuza yankho, ndinayamba kupemphera kwa Mulungu wanga wamoyo, Yesu Kristu, ndipo ananena momveka bwino kuti chifukwa chake chinali shuga yayikulu magazi. Ndinali othokoza kwambiri chifukwa cha thandizo Lake! Koma choti achite tsopano.
Tidamva kuti pali njira yina yodutsira shuga kunyumba, koma kufufuzidwa ndi kufunsidwa kwa anthu ochepa m'mudzi mwathu sizidapatse kanthu. Palibe wina, zikomo Mulungu, yemwe anali ndi matenda ashuga.
Ana okalamba andibweretsera kakalata yakale. Mwanjira yosamveka kwa ine, adandilumikiza kudzera pa foni ya m'manja kwa maora angapo, pomwe ndidatsegula tsamba pa Yandex ndipo nthawi yomweyo ndidakumana ndi banja la Ivan. (Tili othokoza kwambiri kwa inu, Ivan, chifukwa chogawana mavuto anu ndi kupambana kwanu. Mulungu akudalitseni inu ndi mwana wanu wokondedwa ndi banja lanu lonse! Ndikufuna kukambirana ndi banja lanu ... Koma bwanji! Chilichonse chomwe chinali mumtima mwanga kuchokera kwa Mulungu yemwe amandiwongolera, zidatsimikizika ndipo zidadziwika zoyenera kuchita.
Ulemelero kwa Yesu Kristu! Ndimamukonda! Ndiwachifundo komanso wokonzeka kuthandiza! Ndipo amatikonda ife ochimwa kwambiri!
Tidaganiza zopereka magazi ku labotale, komwe tidafika kuchipatala, pomwe ndidakhala masiku 15, pazonse zomwe ndimayenera kuzindikira ndikusamvetsetsa, sizinasiye chikhumbo chosafulumira kubwera kunyumba ndikubwerera kwanu. Chilichonse ndichosavuta kuwerenga, kumvetsetsa ndikuyamba kugwiritsa ntchito pamoyo, kutsanzira chitsanzo chabwino cha Ivan!
Mwana wanga wamkazi Tanya adalemba kalatayi ya tsamba lanu, ndipo chifukwa cha izi tapeza maphikidwe okoma ndi athanzi, komanso mwayi wokumanani ndi inu!
Zachidziwikire, popeza tidazolowera zopezeka pamalopo, nthawi yomweyo tinasinthira kuzakudya zamafuta ochepa, tinatsitsa shuga, ndipo, motero, Mlingo wa insulin, womwe tili okondwa kwambiri ndikuthokoza Mulungu chifukwa chothandizidwa ndi inu chifukwa cha ntchito yanu yosasangalatsa ndi yofunika!
Mosalephera, ndikuphunzira bwino nkhaniyi, mafunso adayamba kuwoneka kuti ndikufuna kuyankhidwa molondola.
1. Momwe mungawerengere insulin usiku ngati shuga m'mawa nthawi zonse umakhala wotsika kuposa madzulo?
2. Mumapereka manambala otsatirawa:
Chakudya cham'mawa - 6 magalamu a chakudya ndi magalamu 86 a protein,
Chakudya chamasana - magalamu 12 a chakudya ndi magalamu a 128 a protein,
Chakudya chamadzulo - 12 magalamu a chakudya ndi 171 magalamu a mapuloteni.
Kodi ndi zofanana tsiku limodzi, osatengera zaka komanso zowonetsa zina? Kapena mwanjira yathu - wazaka 9 zakubadwa, kutalika kwa 130cm., Kulemera 25,5 kg - - muyenera kusintha kena kake? Ndipo zakudya zokhwasula-khola ndizovomerezeka kuwonjezera pa izi, ngati mukufuna kudya?
3. Momwe mungadziwire kuchuluka kwa mafuta otalikira "ochokera ku 86g., 128g. ndi 171g. mapuloteni? Ndipo ayenera kuwerengedwa?
4. Kumene ungabayire insulin yayitali (yochepa, mukafunikira kukabaya pamimba)?

Mimba 25 milungu. Matenda a shuga. Usiku shuga 6,2-6,8, m'mawa pamimba yopanda kanthu 5,9-6,7 Ndimayesetsa kutsatira zakudya zotsika kwambiri za karoti + kaloti ndi zipatso zololedwa ndi tsamba lanu. Dokotala adalemba Levemir mu sabata yoyamba 4 mayunitsi, mu yachiwiri 6 mayunitsi, lachitatu milungu 8 mayunitsi. Zotsatira zake sizikuyenda bwino. Ndili bwino ngati nditagawa mayunitsi 8 jekeseni musanagone komanso usiku?

moni. Zaka 33, kukula 180. kulemera 59. mtundu 1 shuga kuyambira 2013 + hypothyroidism. Chithandizo: eutiroks 100mg. , Levemir 9ed, Actrapid - pakudya. Ndimatsatira NuP ndikulimbikitsa patsamba lanu kuyambira Novembala 2017. Kolya Levemir 03:00 -3ed, 08: 00-3ed, 22: 00-3ed. Ndigona ndi shuga 5.4, 03: 00 = 4.6, 07: 00-4.8, kadzutsa (chakudya bolus Actrapida 2) 40g. mapuloteni, 2-4g. chakudya. Shuga pambuyo 2 maola 6.4. kusuntha kukonza kuti muchepetse Actra 0.5ed. Pambuyo maola 2, shuga 5.3 - nthawi ya nkhomaliro, prick actrapid 1.5ed. ndiye nkhomaliro 65g. mapuloteni, chakudya cha 9g. Shuga pambuyo 2 maola 4.8. Asanadye chakudya, shuga 4.5, chakudya cha 2ed Aktrapida, chamadzulo 65g. Mapuloteni, 9g. chakudya. Shuga pambuyo 2 maola 5.2. Ndipo monga mwa chiwembu ichi tsiku lililonse. Funso langa ndi momwe mungapewere kulumpha m'mawa. Ndidayesera njira zingapo: kuwonjezera kuchuluka kwa insulin yayifupi. adatsitsa muyeso wa insulin yochepa. proses ultrashort novorapid, zochulukirapo - mochepera. Kuchulukitsa ndikuchepetsa kuchuluka kwa mapuloteni. malasha chakudya cham'mawa KOMA palibe chomwe chimathandiza. Njira imodzi = alibe kadzutsa. koma ndikufuna kudya m'mawa, makamaka ngati ndinadya chakudya cham'mawa nthawi ya 18:00. Ndingadzithandizire bwanji? Zikomo patsogolo.

Moni, ndili ndi zaka 62, kutalika 168, kulemera 70, Type 1 shuga kuyambira zaka 20, zopitilira 42, hemoglobin 6.8. Hypothyroidism, thyrox 75 mcg.
Ndimagwiritsa ntchito Dex pakuwongolera shuga. Oyambira akulumpha kwambiri, zaka 40 zapitazo adanena kuti matenda a shuga.
M'zaka zaposachedwa, levemir ndi novo-haraka adalandira jekeseni. Ali ndi chiyembekezo chochepetsa kulumpha mu shuga komanso kupewa hypoglycemia ku 4-6 a.m., adasintha tresib m'malo mwa levemir. Kwa masiku awiri ndimabayila insulin tresiba. Tsoka ilo, endocrinologist adanena kuti tresiba ili ngati levemir, popanda kufotokoza. Ndinaphunzira kuchokera pa intaneti kuti amamujoira kamodzi patsiku. Ndipo ndimabaya jekeseni kawiri patsiku.
Mafunso:
- Mlingo wa levemir anali: 9 m'mawa + 9 usiku, ndimwe kumwa uti kuti ndilandire treshiba? lero jekeseni treshiba 10 m'mawa 1 nthawi, zambiri kuyamba ndi wopanda
Sindinawonetsetse chidziwitsochi, ndimakonza zonse ndi insulin yayifupi,
- kuyamba kulumwa, m'mawa, madzulo kapena usiku?
- Palibe chiwembu kapena zoyeserera m'mutu,
- Sindikumvetsa kusiyana pakati pa levemire ndi treshiba, tresib ikhale yabwino kwa ine.
- kupweteka kwambiri m'mutu kuchokera ku hype, chonde: ndizothandiza chiyani pakumwa kagayidwe kamutu (chodzipangira changa: glycine, gingko, mexidol)

chonde ndiuzeni? zamkhutu tsopano,
osapeza aliyense, posachedwapa wayamba kuwerenga tsambali
zikomo pasadakhale

Mu thupi lathanzi, insulini imasungidwa mosalekeza (chofunikira chachikulu) ndipo imayamba kupangidwa pakafunika kutsika shuga m'magazi (mwachitsanzo, mutatha kudya). Ngati kusowa kwa insulin kupezeka m'thupi la munthu, amafunika kupaka insulin ndi jakisoni, ndiko kuti, insulin.

Udindo wa insulin wa nthawi yayitali (wokhala nthawi yayitali), womwe umapezeka mwa zolembera, umawonetsera kubisalira kwapadera (kosalekeza) kwapancreatic.

Cholinga chachikulu cha mankhwalawa ndikukhazikika pakukhazikika kwa mankhwalawa m'magazi kwanthawi yayitali. Chifukwa chake, amatchedwa basal insulin.

Hormoni iyi imagawidwa m'magulu awiri: mankhwala osokoneza bongo (NPH) omwe amakhala ndi nthawi yayitali komanso analogue.

Next Generation Insulin Yaitali

Kwa anthu odwala matenda ashuga, inshuwaransi ya anthu ya NPH komanso zochitika zake zazitali zomwe zilipo. Gome ili pansipa likuwonetsa kusiyana kwakukulu pakati pa mankhwalawa.

Mu Seputembara 2015, insulin yatsopano ya Abasaglar idayambitsidwa, yomwe imafanana ndi Lantus yubiquitous.

Wochedwa insulin

Food and Drug Administration (FDA, US FDA) - Bungwe la boma lomwe lachita pansi pa dipatimenti ya zaumoyo ku U.S. mu 2016 linavomerezanso mtundu wina wa insulin. Izi zimapezeka pamsika wapanyumba ndipo zimatsimikizira kuyenera kwake pochiza matenda ashuga.

NPH insulini (NPH Neutral Protamine Hagedorn)

Uwu ndi mtundu wa ma insulin opangira momwe amapangira mapangidwe a insulin yaumunthu, koma olemeretsedwa ndi protamine (protein protein) kuti achepetse mphamvu yake. NPH ndi mitambo. Chifukwa chake, isanayambe makonzedwe, iyenera kuzunguliridwa bwino kusakaniza bwino.

NPH ndi mtundu wotsika mtengo kwambiri wa insulin. Tsoka ilo, imakhala ndi chiopsezo chachikulu cha hypoglycemia ndi kulemera kwakukulu, chifukwa imakhala ndi chiwonetsero chokwanira pantchito (ngakhale zimachitika pang'onopang'ono osati mwachangu ngati insulin pamabowo).

Odwala omwe ali ndi matenda amtundu woyamba 1 amapatsidwa kawiri kawiri la NPH insulin patsiku. Ndipo odwala omwe ali ndi matenda a shuga a 2 amatha jekeseni kamodzi patsiku. Zonse zimatengera kuchuluka kwa shuga m'magazi ndi malingaliro a dokotala.

Ma Anulin a Nthawi Yaitali a Insulin

Insulin, zomwe zimapangidwa ndi mankhwala omwe amasinthika kotero kuti amachepetsa kuyamwa ndi mphamvu ya mankhwalawo, amadziwika kuti ndi insulin yopanga anthu.

Lantus, Abasaglar, Tujeo ndi Tresiba ali ndi zochitika zodziwika bwino - nthawi yayitali yogwirira ntchito komanso chiwonetsero chochepa kwambiri cha ntchito kuposa NPH. Mwanjira iyi, kudya kwawo kumachepetsa chiopsezo cha hypoglycemia ndi kulemera. Komabe, mtengo wa analogues ndiwokwera.

Abasaglar, Lantus, ndi Tresiba insulin amatengedwa kamodzi patsiku. Odwala ena amagwiritsanso ntchito Levemir kamodzi patsiku.Izi sizikugwira ntchito kwa odwala matenda ashuga 1 omwe mankhwalawa ndi ochepera maola 24.

Tresiba ndiye mtundu watsopano kwambiri ndipo tsopano ndi wotchipa kwambiri wa insulin pamsika. Komabe, ili ndi mwayi wofunikira - chiopsezo cha hypoglycemia, makamaka usiku, ndizotsika kwambiri.

Insulin imatenga nthawi yayitali bwanji

Udindo wa insulin yayitali ndikuwimira chinsinsi chachikulu cha insulini kudzera m'mapapo. Chifukwa chake, muyezo wofanana wa timadzi tomwe timagazi timatsimikizika pantchito yake yonse. Izi zimathandizira kuti maselo a thupi lathu agwiritse ntchito shuga wosungunuka m'magazi kwa maola 24.

Momwe mungabayitsire insulin

Ma insulini onse omwe akhala akuchita kwa nthawi yayitali amalowetsedwa pansi pa khungu m'malo omwe mumakhala mafuta. Gawo lotsatira la ntchafu ndilabwino kwambiri pazolinga izi. Malowa amalola kuti kulowetsedwa pang'onopang'ono komanso moyenera kwa mankhwalawo. Kutengera ndi nthawi ya endocrinologist, muyenera kuchita jakisoni imodzi kapena iwiri patsiku.

Kubayira pafupipafupi

Ngati cholinga chanu ndikusunga ma jakisoni a insulin otsika kwambiri, ndiye kuti gwiritsani ntchito Abasaglar, Lantus, Toujeo kapena Tresiba analogues. Jakisoni m'modzi (m'mawa kapena madzulo, koma nthawi zonse nthawi yomweyo) amatha kupereka insulin yofananira ndi wotchi.

Mungafunike jekeseni awiri patsiku kuti mukhale ndi mahomoni azambiri zamagazi posankha NPH. Izi, zimakupatsirani kusintha kwa mankhwalawa kutengera nthawi yatsiku ndi zochitika - zapamwamba masana komanso zochepa pogona.

Chiwopsezo cha hypoglycemia pakugwiritsa ntchito insulin

Zatsimikiziridwa kuti anthu omwe amakhala ndi insulin analogues osakhala nthawi yayitali amachititsa kuti hypoglycemia (makamaka hypoglycemia usiku) poyerekeza ndi NPH. Mukamagwiritsa ntchito, zofunika za glycated hemoglobin HbA1c ndizotheka.

Palinso umboni wosonyeza kuti kugwiritsa ntchito mankhwala okhala ndi insulin analoques nthawi yayitali poyerekeza ndi isoflan NPH kumayambitsa kuchepa kwa thupi (ndipo, chifukwa chake, kuchepa kwa kukana kwa mankhwalawa komanso kufunika kwakukulu kwa mankhwalawo).

Kutenga nthawi yayitali insulin ya matenda a shuga a mtundu I

Ngati mukudwala matenda ashuga amtundu 1, kapamba wanu sangathe kupanga insulini yokwanira. Chifukwa chake, mutatha kudya chilichonse, muyenera kugwiritsa ntchito mankhwala omwe amathandizira kubisalira kwa insulin ndi maselo a beta. Ngati mwaphonya jakisoni, pamakhala chiopsezo chokhala ndi matenda ashuga a ketoacidosis.

Mukamasankha pakati pa Abasaglar, Lantus, Levemir ndi Tresiba, muyenera kudziwa zina mwazinthu za insulin.

• Lantus ndi Abasaglar ali ndi mbiri yosyasyalika pang'ono kuposa Levemir, ndipo kwa odwala ambiri, amagwira maola 24.
• Levemir angafunikire kutengedwa kawiri tsiku lililonse.
• Pogwiritsa ntchito Levemir, Mlingo umatha kuwerengeka malinga ndi nthawi ya tsiku, motero kuchepetsa chiopsezo cha nocturnal hypoglycemia ndikuwongolera nthawi yolamulira masana.
• Toujeo, Tresibia mankhwalawa amachepetsa zizindikiro zomwe zili pamwambazi poyerekeza ndi Lantus.
• Muyenera kuganiziranso za zovuta za mankhwala monga zotupa. Izi zimachitika kawirikawiri, koma zimatha kuchitika.
• Ngati mukufunikira kusintha kuchokera ku mankhwala a insulin ofanana ndi NPH, dziwani kuti mlingo wa mankhwalawa mukatha kudya ungafunikire kuchepetsedwa.

Kutenga nthawi yayitali insulin ya matenda a shuga II

Kuchiza matenda a shuga a mtundu II kumayambira pobweretsa zakudya zoyenera komanso mankhwala amkamwa (Metformin, Siofor, Diabeteson, etc. ..). Komabe, pali zochitika zina pomwe madokotala amakakamizidwa kugwiritsa ntchito insulin.

Zofala kwambiri zalembedwa pansipa:

• Kusakwanira kwa mankhwala amkamwa, kulephera kukwaniritsa bwinobwino glycemia ndi glycated hemoglobin
• Contraindication pakamwa
• Kuzindikira matenda ashuga omwe ali ndi ziwonetsero zambiri za glycemic, kuchuluka kwa matenda
• Myocardial infarction, coronary angiography, sitiroko, matenda owopsa, opaleshoni
• Mimba

Mbiri yayitali ya insulin

Mlingo woyambirira nthawi zambiri amakhala mayunitsi 0,2 kg / thupi. Calculator iyi ndi yothandiza kwa anthu popanda kukana insulini, yokhala ndi chiwindi chokhazikika komanso impso. Mlingo wa insulin umayikidwa ndi dokotala wokha (!)

Kuphatikiza pa kutalika kwa nthawi yochitikira (yayitali kwambiri ndi degludec, yocheperako kwambiri ndi ma genetic engineer a insulin-isophan), mankhwalawa amakhalanso osiyana mawonekedwe. Pankhani ya insulin NPH, pachimake chiwonetserochi chimagawidwa nthawi yayitali ndipo chimachitika pakati pa maola 4 ndi 14 jakisoni. Analogue yogwira ntchito ya insulir yaigwira kwa nthawi yayitali imafika pachimake pakati pa maola 6 ndi 8 jakisoni, koma imakhala yochepa kwambiri.

Insulin glargine chifukwa chake imatchedwa basal insulin. Kuphatikiza kwake m'magazi kumakhala kochepa kwambiri, kotero chiopsezo cha hypoglycemia ndichotsika kwambiri.

Matenda a Alzheimer's: zoyambitsa ndi chithandizo. Zomwe muyenera kudziwa

Tsiku labwino kwa onse! Monga ndidalemba kale m'nkhani yanga yaposachedwa "Helo insulin - choyambirira chokhudza mafuta a metabolism", insulin yaumunthu imapangidwa nthawi yonseyo. Kubisirana kwa insulin kumatha kugawidwa m'magulu oyambira ndikulimbikitsidwa.

Mwa munthu yemwe ali ndi vuto la insulin lokwanira, cholinga cha mankhwalawa ndikuwonetsetsa kuti chinsinsi chizigwira bwino ntchito monga momwe mungathere, zonse zoyambira komanso zolimbikitsidwa. Munkhaniyi ndikukuwuzani kusankha momwe mungasankhire insulin yoyenera. Pakati pathu odwala matenda ashuga, mawu akuti "sungani maziko" amagwiritsidwa ntchito, ndipo chifukwa cha ichi payenera kukhala ndi mlingo wokwanira wa insulin.

Wochedwa insulin

Chifukwa chake lero tikulankhula zakumbuyo ndi zoyambira za basal, ndipo m'nkhani yotsatira ndikuuzani momwe mungasankhire mlingo wa chakudya, ndiko kuti, kuphimba kufunika kwa kutetezedwa.

Pofuna kutsata secretion ya basal, insulin ya nthawi yayitali imagwiritsidwa ntchito. Munthu akapezeka ndi matenda ashuga, amatha kupeza mawu oti "insulin", "insulin yayitali", "insulin yayitali", "basal", ndi zina zambiri. Izi zikutanthauza kuti insulin yomwe imagwira ntchito kwa nthawi yayitali imagwiritsidwa ntchito.

Pakadali pano, mitundu iwiri ya ma insulin omwe amagwira ntchito nthawi yayitali amagwiritsidwa ntchito: nthawi yayitali, yomwe imakhala mpaka maola 16, komanso yayitali kwambiri, yomwe imakhala kuposa maola 16. Munkhaniyi ndidalemba kale za izi.

Zoyambirira zikuphatikiza:

• Humulin NPH
• Protafan HM
• Insuman Bazal
• Biosulin N
• Gensulin N

Lachiwiri limaphatikizapo:

Lantus ndi Levemir amasiyana ndi ena osati pakutanthauza kuti amakhala ndi nthawi yosiyana, komanso kuti amawonekera kwathunthu, pomwe ma insulini a gulu loyambalo ali ndi khungu loyera, ndipo asanagwiritse ntchito amafunika kuti adulidwe pakati pa manja kuti vutolo lithe ndi mitambo. Kusiyanaku kukugona m'njira zosiyanasiyana zopanga insulini, yomwe ndimalankhula nthawi ina m'nkhani yoperekedwa kwa iwo ngati mankhwala osokoneza bongo.

Pitilizani? Ma insulini okhala ndi nthawi yayitali kwambiri, i.e., machitidwe awo amatha kutsata, osatchulika kuti ndi achifwamba omwe amangokhala osakwanitsa, komabe osakwanitsa. Pomwe ma insulin ochokera ku gulu lachiwiri amawonedwa ngati opanda ntchito. Ndi gawo ili lomwe limafunikira kuganizira posankha mtundu wa basal insulin. Koma malamulo onse amakhalabe chimodzimodzi kwa insulini zonse.

Chifukwa chake, mlingo wa insulin wa nthawi yayitali uyenera kusankhidwa kuti shuga ya magazi ikhale pakati pa chakudya. Kusintha kusinthasintha pamlingo wa 1-1.5 mmol / L ndikololedwa. Ndiye kuti, ndi mlingo wosankhidwa bwino, shuga wa magazi sayenera kuchuluka kapena kuchepa m'malo mwake. Zizindikiro zosalekeza ziyenera kukhala tsiku lonse.

Ndikufunanso kuwonjezera kuti insulini yokhala ndi nthawi yayitali imagwiridwa m'tchafu kapena pamphumi, koma osati m'mimba kapena mkono, chifukwa mumafunikira kuyamwa pang'onopang'ono komanso kosalala, komwe kungapezeke pokhapokha pobayira. Insulin yomwe imagwira ntchito mwachidule imalowetsedwa m'mimba kapena mkono kuti ikwaniritse bwino, yomwe iyenera kukhala pachimake pakulowetsedwa kwa chakudya.

Yaitali usiku usiku insulin

Ndikulimbikitsidwa kuti muyambe kusankha mtundu wa insulin yayitali usiku. Ngati simunachite izi, onani momwe glucose wamagazi amakhalira usiku. Tengani miyeso kuyamba maola atatu aliwonse - 21:00, 00:00, 03:00, 06:00. Ngati panthawi inayake mumakhala ndi kusinthasintha kwakukulu kwa zomwe zimapangitsa kuti magazi aziwoneka kuti akuchepa kapena, mosiyana, kukulira, ndiye kuti izi zikutanthauza kuti mlingo wa insulin sunasankhidwe bwino.

Pankhaniyi, muyenera kuwona gawo ili mwatsatanetsatane. Mwachitsanzo, mumapita usiku ndi shuga 6 mmol / L, nthawi ya 00:00 - 6.5 mmol / L, ndipo 3:00 imadzuka mwadzidzidzi kufika pa 8.5 mmol / L, ndipo m'mawa mumabwera ndi shuga wambiri. Zinthu zili motere kuti insulini ya usiku sinali yokwanira ndipo ikufunika kuwonjezeka pang'onopang'ono. Koma pali mfundo imodzi. Ngati pali kuwonjezeka koteroko komanso kukwera kwambiri usiku, ndiye kuti sizitanthauza kusowa kwa insulin nthawi zonse. Nthawi zina, imatha kukhala hypoglycemia yotsika, yomwe idapereka koyamba - kuwonjezeka kwa shuga m'magazi.

Kuti mumvetsetse kuti chifukwa chiyani shuga amatuluka usiku, muyenera kuyang'ana nthawi imeneyi ola lililonse. Pazomwe tafotokozazi, muyenera kuyang'ana shuga nthawi ya 00:00, 01:00, 02:00 ndi 03:00 a.m. Ngati kuchepa kwa glucose pakadali pano, ndiye kuti mwina panali "kubisa" kobisika ndi kubwezeretsanso. Ngati ndi choncho, ndiye kuti mlingo wa insulin yoyambira uyenera kuchepetsedwa.

Kuphatikiza apo, mudzavomera ndi ine kuti chakudya chomwe mumadya chimakhudza kuwunika kwa insulin yoyamba. Chifukwa chake, kuti tiwunikire moyenera ntchito ya basal insulin, sipayenera kukhala insulin yocheperako komanso glucose yomwe imabwera ndi chakudya m'magazi. Chifukwa chake, musanayang'anize insulin yausiku, ndikofunikira kuti tidumphire chakudya chamadzulo kapena kudya chakudya chamadzulo m'mbuyomu kuti chakudya ndi insulin yochepa yopangidwira isafotokozere bwino.

Chifukwa chake, tikulimbikitsidwa kuti tidye chakudya chamadzulo chokhacho, kupatula mapuloteni ndi mafuta. Popeza zinthuzi zimaphatikizidwa pang'onopang'ono ndipo pamlingo wina wake zitha kukulitsa shuga, zomwe zingathenso kusokoneza kuyesa koyenera kwa kugwira ntchito kwa insulin usiku.