Gulu la insulin kukonzekera

International Diabetes Federation ilosera kuti podzafika 2040 kuchuluka kwa odwala matenda a shuga kudzakhala anthu pafupifupi 624 miliyoni. Pakadali pano, anthu 371 miliyoni ali ndi matendawa. Kufalikira kwa matendawa kumalumikizidwa ndi kusintha kwa chikhalidwe cha anthu (moyo wokhalitsa, wambiri, kusowa zochita zolimbitsa thupi) komanso zosokoneza zakudya (kugwiritsidwa ntchito kwa mankhwala apamwamba ogulitsa mafuta azinyama).

Anthu akhala akudziwa za matenda ashuga kwa nthawi yayitali, koma kupezeka kwamankhwala omwe amathandizira matendawa kunachitika zaka zana zapitazo, pomwe matendawa adatha muimfa.

Mbiri ya zomwe zapezeka komanso kupanga insulin yochita kupanga

Mu 1921, dokotala waku Canada Frederick Bunting ndi womthandizira, wophunzira zachipatala, a Charles Best, adayesetsa kupeza kulumikizana pakati pa kapamba ndi kuyamba kwa matenda ashuga. Pazofufuza, pulofesa ku Yunivesite ya Toronto, a John MacLeod, adawapatsa ma labotale okhala ndi zida zofunika ndi agalu 10.

Madotolo adayamba kuyeserera kwawo ndikuchotsa zikwanirizo mu agalu ena, kupumulirako adamanga ma ducts amachikondwerero asanachotsedwe. Kenako, chiwalo cha atrophied chimayikidwa kuti chisazizidwe mu njira ya hypertonic. Pambuyo pa thawing, mankhwala omwe amapezeka (insulin) amaperekedwa kwa nyama yokhala ndi chofufumitsa komanso chipatala cha matenda a shuga.

Zotsatira zake, kuchepa kwa shuga m'magazi ndikusintha kwa magwiridwe antchito ndi galu. Zitatha izi, ofufuzawo adaganiza zoyesa kutulutsa insulini kuchokera ku zikondamoyo za ng'ombe ndipo adazindikira kuti mutha kuchita popanda kunyamula mitsempha. Njirayi sinali yophweka komanso yotenga nthawi.

Bunting ndi Best adayamba kuyeseza anthu nawonso. Chifukwa cha mayeso azachipatala, onse awiri adamva chizungulire komanso ofooka, koma padalibe zovuta zakumwa ndi mankhwalawo.

Mu 1923, Frederick Butting ndi John MacLeod adalandira Mphotho Nobel chifukwa cha insulin.

Kodi insulin imapangidwa ndi chiyani?

Kukonzekera kwa insulini kumapezeka kuchokera ku zopangidwa ndi nyama kapena anthu. Poyambirira, kapamba wa nkhumba kapena ng'ombe amagwiritsidwa ntchito. Nthawi zambiri amayambitsa ziwengo, motero akhoza kukhala owopsa. Izi ndizofunikira makamaka kwa inshuwaransi ya bovine, kapangidwe kake kamasiyana kwambiri ndi anthu (ma amino acid m'malo mwa amodzi).

Pali mitundu iwiri ya insulin yakonzekereratu:

• opanga
• chimodzimodzi ndi anthu.

Insulin yaumunthu imapezeka pogwiritsa ntchito njira zopangira ma genetic. kugwiritsa ntchito michere ya yisiti ndi E. coli bacteria bacteria. Ndizofanana ndendende ndi mahomoni opangidwa ndi kapamba. Apa tikulankhula za kusintha kwa majini a E. coli, omwe amatha kupanga insulini yopangidwa ndi chibadwa cha anthu. Insulin Actrapid ndiye mahomoni oyamba kupezeka mwaukadaulo wa majini.

Gulu la insulin

Zosiyanasiyana insulin pochiza matenda ashuga amasiyana wina ndi mzake m'njira zingapo:

1. Kutalika kwa nthawi.
2. Kuthamanga kwa zochita pambuyo pa kupatsidwa mankhwala.
3. Njira yotulutsira mankhwala.

Malinga ndi nthawi yowonekera, kukonzekera kwa insulin ndi:

• ultrashort (othamanga)
• mwachidule
• lalitali
• lalitali
• kuphatikiza

Mankhwala a Ultrashort (insulin apidra, insulin humalog) amapangidwa kuti azitha kuchepetsa shuga m'magazi. Zimayambitsidwa musanadye, zomwe zimachitika pang'onopang'ono mkati mwa mphindi 10-15. Pambuyo maola angapo, mphamvu ya mankhwalawa imayamba kugwira ntchito kwambiri.

Mankhwala osokoneza bongo mwachidule (insulin Actrapid, insulin mwachangu)amayamba kugwira ntchito theka la ola pambuyo pa makonzedwe. Kutalika kwawo ndi maola 6. Ndikofunikira kupatsa insulin mphindi 15 musanadye. Izi ndizofunikira kuti nthawi yakudya michere m'thupi igwirizane ndi nthawi yovutikira mankhwalawa.

Kuyamba mankhwala apakatikati (insulin protafan, insulin humulin, insulin basal, insulin yatsopano yosakanikirana) sizitengera nthawi yakudya. Nthawi yowonetsedwa ndi maola 8-12anayamba kukhala okangalika patatha maola awiri jekeseni.

Kutalika kwambiri (pafupifupi maola 48) kwa thupi kumapangidwa ndi mtundu wautali wa kukonzekera kwa insulin. Imayamba kugwira ntchito maola anayi mpaka asanu ndi atatu pambuyo pa utsogoleri (tresiba insulin, flekspen insulin).

Kukonzekera kosakanikirana ndi kusakanikirana kwa ma insulin osiyanasiyana kutulutsa. Kuyamba kwa ntchito yawo kumayamba theka la ola jakisoni, ndipo kutalika kwa ntchito ndi maola 14-16.

Mavuto amakono a insulin

Mwambiri, munthu amatha kusiyanitsa zabwino za fanizo monga:

• kugwiritsa ntchito njira zopanda ndale, osati zama acid,
• ukadaulo wosinthasintha wa DNA
• kutuluka kwachuma chatsopano mu zamankhwala zamakono.

Mankhwala onga a insulin amapangidwa ndikusinthanso ma amino acid kuti athandize kugwiritsa ntchito bwino mankhwala, mayamwidwe awo ndi kutulutsa kwawo. Ayenera kupitilira insulini ya anthu pazinthu zonse ndi magawo:

1. Insulin Humalog (Lyspro). Chifukwa cha kusintha kwa kapangidwe ka insulini iyi, imalowa mu thupi mwachangu kuchokera ku malo a jakisoni. Kuyerekeza insulin yaumunthu ndi humalogue kunawonetsa kuti poyambitsa chidziwitso chapamwamba kwambiri chomaliza chimatheka mwachangu ndipo ndichipamwamba kuposa kuchuluka kwa anthu. Kuphatikiza apo, mankhwalawa amachotseredwa mwachangu ndipo patatha maola 4 ndende yake imatsikira ndikufunika koyamba. Ubwino wina wa kukhudzika kwa munthu ndi kudziyimira pawokha kwakanthawi kokhala pakumwa.
2. Insulin Novorapid (aspart). Insulin iyi imakhala ndi nthawi yochepa yogwira ntchito, zomwe zimapangitsa kuti azitha kuyendetsa bwino glycemia mukatha kudya.
3. Levemir insulin penfill (detemir). Ichi ndi chimodzi mwazinthu za insulin, zomwe zimadziwika pang'onopang'ono komanso zimakwaniritsa kufunikira kwa wodwala yemwe ali ndi matenda osokoneza bongo a basal insulin. Uku ndikuwonetsa nthawi yayitali, wopanda chochita.
4. Insulin Apidra (Glulisin). Ikutulutsa mphamvu ya ultrashort, katundu wa metabolic amafanana ndi insulin yosavuta yamunthu. Zoyenera kugwiritsidwa ntchito kwa nthawi yayitali.
5. Glulin insulin (lantus). Amadziwika ndi kuwonetsedwa kwa nthawi yayitali, kugawa kopanda thupi mthupi lonse. Potengera momwe imagwirira ntchito, insulin lantus imafanana ndi insulin yaumunthu.

Kukonzekera kwa insulin

Mankhwala (mapiritsi a insulin kapena jakisoni), komanso muyezo wa mankhwalawa ayenera kusankhidwa kokha ndi katswiri woyenera. Kudzichiritsa nokha kumangokulitsa matendawa ndikuwapanikiza.

Mwachitsanzo, kuchuluka kwa insulin kwa odwala omwe ali ndi matenda a shuga a 2 kuwongolera shuga akhale akulu kuposa a 1 matenda ashuga. Nthawi zambiri, insulin ya botus imaperekedwa ngati kukonzekera kwakanthaŵi kwa insulin kumagwiritsidwa ntchito kangapo patsiku.

Lotsatira ndi mndandanda wa mankhwala omwe amagwiritsidwa ntchito kwambiri pochiza matenda ashuga.

Magulu a mahormone

Pali magawo angapo pamaziko a omwe endocrinologist amasankha mtundu wa chithandizo. Mwa chiyambi ndi mitundu, mitundu yotsatila ya mankhwala imasiyanitsidwa:

• Insulin yopangidwa kuchokera ku zikondamoyo za oimira ng'ombe. Kusiyana kwake ndi mahomoni amthupi la munthu ndikupezeka kwa mitundu ina itatu ya amino acid, yomwe imakhudza kupangika kwa zinthu zingapo zosagwirizana.
• Porcine insulin ili pafupi kwambiri ndi mankhwala opangidwa ndi mahomoni amunthu. Kusiyana kwake ndikusinthidwa kwa amino acid amodzi mumapuloteni.
• Kukonzekera kwainsomba kumasiyana ndi mahomoni oyambira a anthu kuposa momwe amapangira ng'ombe. Amagwiritsidwa ntchito kwambiri.
• Mndandanda wa anthu, womwe umapangidwa m'njira ziwiri: kugwiritsa ntchito Escherichia coli (insulin yaumunthu) ndikusintha amino acid “yosayenera” mu timadzi ta porcine (mtundu wopangidwa ndi majini).

Chothandizira

Kupatukana kwotsatira kwa mitundu ya insulin kumatengera kuchuluka kwa zigawo zina. Ngati mankhwalawo ali ndi kapangidwe ka kapamba amtundu umodzi wa nyama, mwachitsanzo, nkhumba kapena ng'ombe yokhayo, amatanthauza othandizira a monovoid. Ndi kuphatikiza pamodzi kwa mitundu ingapo ya nyama, insulin imatchedwa kuphatikiza.

Kuchuluka kwa kuyeretsa

Kutengera kufunikira kwa chiyeretso cha chinthu chomwe chimagwira ntchito m'thupi, magawo awa alipo:

• Chida chachikhalidwe ndikupangitsa kuti mankhwalawa akhale amadzimadzi ndi acid ethanol, kenako ndikumasefa kusefera, mchere wambiri ndi makristalo nthawi zambiri. Njira yotsuka sinayende bwino, popeza zochuluka zodetsa zimakhalabe pakapangidwe kazinthu.
• Mankhwala a Monopik - mgawo loyamba la kuyeretsa pogwiritsa ntchito njira yachikhalidwe, kenako kusefa pogwiritsa ntchito gelisi yapadera. Mlingo wa zosayera ndizochepa poyerekeza ndi njira yoyamba.
• Zogulitsa monocomponent - kuyeretsa kwakukuru kumagwiritsidwa ntchito ndi kuzungulira kwa ma cell ndi ion chromatography, yomwe ndi njira yabwino kwambiri kwa thupi la munthu.

Kuthamanga ndi kutalika

Hormonal mankhwala amakhala okhazikika kuti kuthamanga kwa zotsatira zake ndi kutalika kwa zochita:

• kopitilira muyeso
• mwachidule
• nthawi yayitali
• kutalika (kutalika)
• kuphatikiza (kuphatikiza).

Makina a zochita zawo amatha kukhala osiyanasiyana, omwe katswiri amaganizira posankha mankhwala othandizira.

Ultrashort

Zapangidwa kuti muchepetse magazi. Mitundu ya insulin iyi imayendetsedwa musanadye, chifukwa chogwiritsa ntchito chimawonekera mphindi 10 zoyambirira. Mphamvu yogwira kwambiri ya mankhwalawa imayamba, pakatha ola limodzi ndi theka.

Analogue ya insulin yaumunthu ndikuyimira gulu la ultrashort action. Amasiyana ndi mahomoni apansi pamakonzedwe a ma amino acid ena. Kutalika kwa kuchitapo kanthu kumatha kufika maola 4.

Amagwiritsidwa ntchito ngati mtundu 1 wa shuga, kulekerera mankhwala a magulu ena, kukana insulini mu mtundu wachiwiri wa shuga, ngati mankhwala amkamwa sangathandize.

Mankhwala a Ultrashort ozikidwa ndi insulin. Amapezeka ngati njira yopanda utoto mu cholembera. Iliyonse imakhala ndi 3 ml ya mankhwala ofanana ndi 300 PISCES ya insulin. Ndi chithunzi cha mahomoni amunthu omwe adapangidwa ndi ntchito ya E. coli. Kafukufuku akuwonetsa kuthekera kwa kupereka mankhwala kwa amayi munthawi yakubereka mwana.

Woimira wina wotchuka wa gululi. Ntchito kuchiza akuluakulu ndi ana pambuyo 6 zaka. Ntchito mosamala pochiza odwala ndi okalamba. Mlingo woyeserera amasankhidwa payekha. Amabayidwa pang'onopang'ono kapena pogwiritsa ntchito pulogalamu yapadera yopopera.

Kukonzekera kwakanthawi

Oimira gulu lino amadziwika kuti zochita zawo zimayambira mphindi 20-30 ndipo zimatha mpaka maola 6. Ma insulin afupiafupi amafunikira makonzedwe a mphindi 15 chakudya chisanafike. Maola ochepa mutatha jakisoni, ndikofunikira kupanga "snack" yaying'ono.

Muzochitika zina zamankhwala, akatswiri amaphatikiza kugwiritsa ntchito kukonzekera kwapfupi ndi ma insulin omwe amakhala nthawi yayitali. Unikani za momwe wodwalayo alili, tsamba la oyang'anira mahomoni, mulingo komanso mawonekedwe a shuga.

Oimira otchuka kwambiri:

• Actrapid NM ndi mankhwala opangidwa ndi majini omwe amathandizidwa mosagwirizana komanso mwamitsempha. Intramuscular management ndiyothekanso, koma pokhapokha motsogozedwa ndi katswiri. Ndi mankhwala omwe mumalandira.
• "Humulin pafupipafupi" - amapatsidwa mankhwala a shuga omwe amadalira insulin, matenda omwe angopezedwa kumene komanso panthawi yoyembekezera ndi matenda omwe amadzisokoneza okha ndi insulin. Subcutaneous, intramuscular and intravenous management ndikotheka. Amapezeka m'makalata ndi mabotolo.
• Humodar R ndi mankhwala opangira theka omwe amatha kuphatikizidwa ndi ma insulin apakati. Palibe zoletsa zogwiritsidwa ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere.
• "Monodar" - amatchulidwa matenda amtundu 1 ndi 2, kukana mapiritsi, munthawi ya bere. Kukonzekera kwa nyama ya nkhumba.
• "Biosulin R" ndi mtundu wopangidwa ndi majini omwe amapezeka m'mabotolo ndi ma cartridge. Amakhala ndi "Biosulin N" - insulin ya nthawi yayitali yochitapo kanthu.

Ma Insulin Yapakatikati

Izi zikuphatikiza mankhwala omwe nthawi yayitali ili mgulu la 8 mpaka 12 maola. Mlingo wa 2-3 ndi wokwanira patsiku. Amayamba kuchita pakatha maola awiri jakisoni.

• njira zopangira ma genetic - "Biosulin N", "Insuran NPH", "Protafan NM", "Humulin NPH",
• kukonzekera kwapawiri - "Humodar B", "Biogulin N",
• nkhumba insulins - "Protafan MS", "Monodar B",
• kuyimitsidwa kwa zinc - "Monotard MS".

"Kutalika" mankhwala

Kukhazikika kwa ndalama kumachitika pambuyo pa maola 4-8 ndipo kumatha kukhala mpaka masiku 1.5-2. Ntchito yayikulu imawonetsedwa pakati pa maola 8 mpaka 16 kuchokera nthawi yomwe jakisoni.

Mankhwalawa ndi amisala amtengo wapatali. Zomwe zimagwira pophika ndi insulin glargine. Mosamala limayikidwa pa mimba. Gwiritsani ntchito mankhwalawa a shuga ana osakwana zaka 6 osavomerezeka. Imayendetsedwa mosavuta kamodzi patsiku nthawi yomweyo.

"Insulin Lantus", yomwe imagwira ntchito kwa nthawi yayitali, imagwiritsidwa ntchito ngati mankhwala amodzi komanso kuphatikiza ndi mankhwala ena omwe amatsitsa kuchepetsa shuga. Amapezeka m'matumba a syringe ndi ma cartridge a pampu. Amangotulutsidwa ndi mankhwala okha.

Ophatikizira a biphasic

Awa ndi mankhwala osokoneza bongo omwe amayimitsidwa, omwe amaphatikizira insulin "yochepa" komanso insulin ya nthawi yayitali mwanjira zina. Kugwiritsa ntchito ndalama zotere kumakuthandizani kuti muchepetse kuchuluka kwa jakisoni wofunikira pakati. Oimira akulu pagululi afotokozedwa pagome.

Malo osungira

Mankhwala ayenera kusungidwa mufiriji kapena mafiriji apadera. Botolo lotseguka silingasungidwe m'boma lino kwa masiku opitilira 30, popeza malonda amalandidwa.

Ngati pakufunika mayendedwe ndipo sikutheka kunyamula mankhwalawo mufiriji, muyenera kukhala ndi thumba lapadera ndi firiji (gel kapena ayezi).

Kugwiritsa ntchito insulin

Mankhwala onse a insulin amatengera mitundu ingapo yamankhwala:

• Njira yachikhalidwe ndikuphatikiza mankhwala achidule komanso achidule kwa anthu 30/70 kapena 40/60, motsatana. Amagwiritsidwa ntchito pochiza anthu okalamba, odwala osazindikira komanso odwala omwe ali ndi vuto lamisala, chifukwa palibe chifukwa chowunikira glucose mosalekeza. Mankhwala amaperekedwa kawiri pa tsiku.
• Njira yowonjezereka - mlingo wa tsiku ndi tsiku umagawidwa pakati pa mankhwala osakhalitsa komanso achizungu. Yoyamba imayambitsidwa ndikudya, ndipo yachiwiri - m'mawa ndi usiku.

Mtundu wa insulin womwe mumafunikira umasankhidwa ndi adokotala, poganizira zomwe zingachitike:

• zizolowezi
• zochita za thupi
• kuchuluka kwa mawu oyamba ofunikira
• kuchuluka kwa miyezo ya shuga
• zaka
• Zizindikiro zamagalasi.

Chifukwa chake, masiku ano pali mitundu yambiri ya mankhwalawa pochiza matenda a shuga. Njira yosankhidwa bwino ya mankhwala komanso kutsatira malangizo aukatswiri kuthandizanso kukhala ndi milingo yama glucose m'njira zovomerezeka ndikuwonetsetsa kuti ikugwira ntchito yonse.