Kodi mlingo wa insulin ndi chiyani? Kodi insulin imakhudza bwanji?

Ma receptor a insulin amapezeka makamaka m'chiwindi, minofu ndi minyewa ya adipose. Amakhala ndi 2 α-subunits yomwe ili kunja kwa khungu ndipo ndi gawo lozindikira, ndipo 2 β -igonjera yomwe imaboweka membrane wa khungu ndipo imakhala ndi ntchito ya tyrosine kinase. Insulin imamangirira ku α-subunits, imawonjezera ntchito ya tyrosine kinase ya β-subunits, yomwe imayambitsa phosphorylation ya mapuloteni mkati mwa cell: mapuloteni omwe amayenda ndi glucose, mapuloteni omwe amayendetsa potaziyamu ndi phosphate ion ku cell, hexokinase, glycogen synthetase ndi ena, zomwe zimatsogolera kusintha kwa metabolic. Kenako zovuta za insulini ndi receptor zimalowa mu khungu, pomwe zimasweka. Receptor imapanganso mu nembanemba, ndipo insulin imalimbikitsa kuyamwa kwa ma amino acid ndi maselo, imayendetsa ntchito ya mapuloteni a ribosomal, kenako imakumbwa ndi lysosomes.

(glucose transporter, glucose activated infusion system)

Kutenga kwa minofu kumachuluka

Zotsatira za thupi za insulin.

Hypoglycemic: kumawonjezera mayendedwe a shuga kudutsa ma membrane am'mimba, amachititsa phosphorylation ya glucose, kumawonjezera kaphatikizidwe ka glycogen, kumalepheretsa glycogenolysis ndi gluconeogeneis.

Zokhudza mafuta kagayidwe:imayambitsa mapangidwe ndi mawonekedwe a triglycerides, imalepheretsa kusintha kwamafuta acid kukhala keto acid, kumachepetsa lipolysis, kutsutsana ndi lipase ya intracellular.

Zokhudza mapuloteni kagayidwe:kumawonjezera kapangidwe ka mapuloteni kuchokera ku amino acid, kumalepheretsa kusintha kwa ma amino acid kukhala ma keto acids.

Zochizira matenda ashuga.

Ana amapanga mtundu wa matenda a shuga 1 mellitus, omwe amayamba chifukwa cha kuwonongeka kwa maselo a pancreatic and komanso kuperewera kwenikweni kwa insulin (autoimmune, idiopathic).

Mlingo wa insulin:kutengera kuchuluka kwa shuga m'magazi, glucosuria, acetonuria. 1 unit ya insulin imagwiritsa ntchito 2,5-5 g shuga. Molondola: gawo limodzi la insulini limachepetsa glycemia ndi 2.2 mmol / l (glucose yachilendo = = 3.3-5.5 mmol / l) kapena 0,3 - 0.8 magawo / kg ya thupi patsiku.

Choyamba, kuchuluka kwakukulu kumatengedwa, ndiye kuti mlingo umasankhidwa payekha. Mukasankhidwa kuti mupeze insulin, kuchuluka kwa glucose m'magazi kumayesedwa mpaka nthawi 7-9 pa tsiku. Kuzindikira kwa ana kuti apange insulini ndikwapamwamba kwambiri kuposa zomwe akulu amachita.

Njira zogwiritsira ntchito insulin.

- Chikhalidwe: insulin yocheperako imayendetsedwa kamodzi kapena mkati mwa 4-5 pa tsiku kwa mphindi 30 musanadye.

- base-bolus (kukulitsidwa): wobwezeretsa insulin mphindi 30 asanadye + jakisoni wa pakati komanso wautali, amakhala ndi insulin, koma osachotsa hyperglycemia ya postprandial, yomwe ma insulin amagwira ntchito mwachidule amachotsa (koposa zonse, humalogue).

Ma insulini amagwiranso ntchito

- kukulitsa kudya ndi kuchepa kwa thupi,

- monga mbali yakuthandizira polarizing,

- ndi matenda a shuga a 2,

- Ndi schizophrenia (coma mankhwala).

Hypoglycemia(yolekereka kwambiri kuposa hyperglycemia):

Tachycardia, thukuta, kunjenjemera, mseru, njala, kukanika kwa chapakati mantha dongosolo (chisokonezo, zodabwitsa khalidwe), encephalopathy, zopweteka, chikomokere.

Thandizo: kadzutsa chakudya cham'mimba, kutsekemera. Ndi coma iv, yankho la shuga 40%.

Lipodystrophym'malo a insulin makonzedwe - kuzimiririka kapena kuwonjezeka kuchuluka kwa subcutaneous mafuta. Amayamba chifukwa chogwiritsa ntchito ma insulin osayeretsedwa bwino, kuphwanya njira zamankhwala operekera mankhwala (ozizira, osagwirizana kwambiri), oyambitsa malo omwewo. Mwachangu komanso mokwanira, insulini imatengedwa kuchokera kuzingwe zam'mimba za khoma lamkati, pang'onopang'ono kuchokera phewa, kutsogolo kwa ntchafu komanso pang'onopang'ono kuchokera kudera lamapulogalamu komanso matako. Zoposa 16 IU za insulin siziperekedwa m'malo amodzi, kamodzi pa masiku 60.

Thupi lawo siligwirizana (kuyabwa, zotupa, ma anaphylactic). Izi ndi zomwe zimachitika chifukwa chakutsuka bwino kwa insulin, pa mankhwala osungira, pa insulin ya nyama. Ndikofunikira kusamutsa wodwala kupita ku mankhwala osafunikira kwambiri a antigengenic (insulin yaumunthu), kuti apereke antihistamines, HA.

Kutupa kwa ubongo, mapapu, ziwalo zamkati.

Kulemera (kunenepa).

Β-cell atrophy, insulin kukana(imakula pamene kufunika kwa insulini kumaposa 2 mayunitsi / kg pa kulemera kwa thupi, ndikuyambitsa magawo opitilira 60 patsiku).

Ma electrolyte amasuntha, kusokonezeka kwa metabolic, kusazindikira, kuletsa kwa Reflex, anuria, matenda a hemodynamic.

Kusiyanitsa ndizovuta: iv 40% glucose solution.

Intravenous drip insulin yocheperako (10-20 IU) + glucose ngati pakufunika.

Kuphatikiza apo, subcutaneally kapena i / m 5-10 IU ya insulin pakuwongolera shuga.

Kulowetsedwa mankhwala - isotonic njira ya sodium kolorayidi, potaziyamu mankhwala enaake.

Pa magazi pH yochepera 7.0 w / w sodium bicarbonate solution.

Cocarboxylase kuti muchepetse kuchuluka kwa ketone.

Type 2 matenda a shuga

Othandizira a hypoglycemic amaikidwa omwe sagwiritsidwa ntchito ngati ana.

Othandizira a hypoglycemic

Zotsatira za pharmacological

Ma insulin omwe ali m'magazi athu ndi mahomoni omwe amalamulira kagayidwe kazachilengedwe, amachepetsa shuga m'magazi, ndikuthandizira kuyamwa glucose.

Munthu amafunika kulandira insulini kuchokera kunja nthawi zoterezi zikayamba kusiya kupangitsa kuti pakhale kuchuluka kokwanira kapena kutulutsa kwambiri. Mlingo wa insulin m'mwazi wa munthu wathanzi ndi 3-20 mkU / ml. Ndi matenda amisempha, matenda a shuga 1 amayamba pang'ono, ndipo matenda amtundu wa 2 amakula ndi insulin yowonjezereka.

Insulin yothandizira kupanga zamankhwala imapangidwa kuchokera ku ziwengo za kapamba, ng'ombe, ndi uinjini wama genetic imagwiritsidwanso ntchito.

Zizindikiro ntchito insulin

Kugwiritsa ntchito kwakukulu kwa mankhwalawa ndi chithandizo cha mtundu 1 wa shuga. Nthawi zina, amagwiritsidwanso ntchito pa matenda a shuga 2.

Mlingo wochepa wa insulin (5-10ED) umagwiritsidwa ntchito pochiza matenda a hepatitis, cirrhosis poyambira gawo, kutopa, furunculosis, acidosis, kusowa bwino m'thupi, chithokomiro.

Mankhwalawa amatha kugwiritsidwa ntchito kuti athetse vuto lamanjenje, kuchiza uchidakwa, mitundu ina ya schizophrenia.

Njira yogwiritsira ntchito

Kwenikweni, mankhwalawa amalowetsedwa m'matumbo kapena pansi pa khungu, ovulala kwambiri amakomoka.

Mlingo wofunikira wa mankhwalawa umatsimikiziridwa payokhapokha malinga ndi zotsatira za kusanthula, incl. Zambiri pa kuchuluka kwa shuga, insulini m'magazi, kotero mutha kupereka zikhalidwe zovomerezeka zokha.

Mlingo wofunika wa insulin ya odwala matenda a shuga amachokera ku 10-40 ED patsiku.

Ndikudwala matenda ashuga, palibe magawo opitilira 100 patsiku omwe angathe kutumikiridwa, komanso ndi intravenous makonzedwe, osapitilira 50 magawo patsiku.

Zisonyezero zina, mankhwalawa adapangidwira Mlingo wochepa - 6-10ED / tsiku.

Kwa jakisoni wa insulin, syringe yapadera imagwiritsidwa ntchito, ndi singano yomanga, kapangidwe kake kamene kamapatsa kuyambitsa zonse zomwe zili popanda zotsalira, zomwe zimakupatsani mwayi wotsatira mlingo weniweni wa mankhwalawo.

Musanisonkhanitse insulini mu mawonekedwe a kuyimitsidwa mu syringe, zomwe zili mu vial ziyenera kugwedezeka kuti zipange kuyimitsidwa koyenera

Childs, tsiku lililonse mlingo kutumikiridwa awiri kapena atatu Mlingo. Jakisoni amachitika theka la ola, ola limodzi asanadye. Kuchita kwa insulin, limodzi lokha la mankhwalawo, kumayamba pambuyo pa theka la ola, ola limodzi ndi kumatenga maola 4-8.

Kuchita kwa insulin jekeseni kudzera mkati kwa mphindi 20-30., Mwaziwo umatsikira pamlingo woyambirira pambuyo pa ola limodzi kapena awiri.

Zotsatira zoyipa

Mankhwala akaperekedwa mosavuta, lipodystrophy imayamba. Komanso, mankhwalawa amatha kuyambitsa chifuwa.

Insulin yomwe idakwezedwa chifukwa cha bongo wake wambiri imatha kudzetsa vuto la hypoglycemic. Zizindikiro: kupendekera kwachulukidwe, thukuta, kufooka, kupuma movutikira, chizungulire, palpitations, kawirikawiri - chikomokere, kukokana, kuperewera, kuzindikira.

Insulin: mitengo yamapulogalamu apakompyuta

Syringe sfm insulin 3x comp 1ml n20 (u40 ​​/ u100 26g 0.45x12)

Syringe bd insulini yaying'ono + 0.5ml n10 (u100 g29 0.33x12.7)

Syringe bd insulini yaying'ono + 1ml n10 (u40 ​​30g 0.3x8)

Syringe bd insulin yaying'ono-bwino + 1ml n10 (u100 g30 0.3x8)

Syringe bd insulin yaying'ono + demi 0.3ml n10 (u100 g30 0.3x8)

Insulin Protafan NM kuyimitsidwa. d / jekeseni 100ME / ml 10ml

Insulin Actrapid NM yankho la jakisoni 100ME / ml 10ml

Syringe sfm insulin 3x comp 1ml n100 (u100 29g 0.33x12.7)

Syringe sfm insulin 3x comp 1ml n100 (u40 ​​29g 0.33x12.7 ind pack)

Insulin Actrapid NM Penfill yankho la jakisoni 100 IU / ml makadi 3ml No. 5

Insulin Protafan NM Penfill Susp. d / inject100ME / ml makadi 3ml N5

Insulin Humulin M3 Susp. d / jakisoni makadi a 100 IU / ml. 3ml №5

Insulin Humulin Wokhazikika yankho r / d makadi 100 IU / ml. 3ml №5

Insulin Humalog rr d / jekiseni makadi a 100ME / ml. 3ml №5

Insulin Apidra Solostar yankho la jakisoni 100ME / ml 3ml No. 5 spr-pen.

Zambiri zokhudzana ndi mankhwalawa ndizofanana, zimaperekedwa pazidziwitso ndipo sizilowa m'malo mwa malangizo aboma. Kudzipatsa nokha mankhwala kuopsa!

Amayi ambiri amatha kusangalala mwakuganizira za thupi lawo lokongola pakalilore kuposa kugonana. Chifukwa chake, akazi, yesetsani kuyanjana.

Munthu amene amamwa mankhwala opondeleza nthawi zambiri amakhalanso ndi nkhawa. Ngati munthu athana ndi kukhumudwa paokha, ali ndi mwayi wonse wakuyiwalako zamtunduwu mpaka kalekale.

Poyamba zinkakhala kuti kumatheka kumapangitsa thupi kukhala ndi mpweya wabwino. Komabe, izi zidatsutsidwa. Asayansi atsimikizira kuti ukamadzuka, munthu amazizira ubongo ndikusintha magwiridwe ake.

Mabakiteriya mamiliyoni ambiri amabadwa, amoyo ndi kufa m'matumbo athu. Amatha kuwoneka pa kukula kwakukulu, koma ngati atakhala palimodzi, akhoza kukhala mu kapu ya khofi yokhazikika.

Magawo anayi a chokoleti chakuda ali ndi zopatsa mphamvu pafupifupi mazana awiri. Chifukwa chake ngati simukufuna kukhala bwino, ndibwino kuti musadye zopitilira awiri patsiku.

Kuti tinene ngakhale mawu afupi komanso osavuta, timagwiritsa ntchito minofu 72.

Mu 5% ya odwala, antidepressant clomipramine amayambitsa kuphipha.

Chiwindi chanu chikasiya kugwira ntchito, imfa imatha pakatha tsiku limodzi.

Mwazi wa munthu "umayenda" m'matumbo omwe akukakamizidwa kwambiri, ndipo ngati umphumphu wake waphwanyidwa, amatha kuwombera mpaka 10 metres.

Chiwindi ndi chiwalo cholemera kwambiri m'thupi lathu. Kulemera kwake pafupifupi 1.5 kg.

Matenda osowa kwambiri ndi matenda a Kuru. Oimira okha a fuko la Fore ku New Guinea amadwala naye. Wodwala amafa chifukwa cha kuseka. Amakhulupirira kuti chomwe chimayambitsa matendawa ndicho kudya ubongo wa munthu.

Mankhwala ambiri poyamba anali ogulitsidwa ngati mankhwala osokoneza bongo. Mwachitsanzo, a heroin adagulitsidwa ngati mankhwala a chifuwa. Ndipo cocaine adalimbikitsidwa ndi madokotala ngati opaleshoni komanso ngati njira yowonjezerera kupirira.

Pochezera pafupipafupi pakama pofufuta, mwayi wokhala ndi khansa yapakhungu umawonjezeka ndi 60%.

Pa moyo, munthu wamba amapanga miyala yocheperako yoposa awiri.

Impso zathu zimatha kuyeretsa malita atatu a magazi mphindi imodzi.

Chiwerengero cha antchito aku ofesi chakwera kwambiri. Izi ndizodziwika kwambiri m'mizinda yayikulu. Ntchito yamaofesi imakopa amuna ndi akazi.

Kutalika kwa zochita za mankhwala

Mankhwala, mankhwala a zotsatirazi amadziwika:

• mwachidule
• kopitilira muyeso
• nthawi yayitali yowonekera
• nthawi yayitali yowonekera.

Kugwiritsa ntchito mtundu umodzi kapena mitundu ya insulini kumatengera momwe wodwalayo alili komanso chithandizo cha matenda ashuga. Mitundu yosiyanasiyana ya insulin imasiyana pakati pawo mwa kapangidwe kake komanso kapangidwe kake. Mtundu uliwonse wa mankhwala, malangizo ogwiritsira ntchito amapangidwira mogwirizana ndi izi.

Kuphatikiza apo, pali zofunika zina zomwe zimayenera kuchitika mukamachita insulin. Mankhwala aliwonse a insulini ali ndi zisonyezo zina zogwiritsira ntchito ndi contraindication.

Ichi ndi chiyani

Insulin ndi kukonzekera kwa ma protein a peptide. Amagwiritsidwa ntchito ngati mankhwala apadera pochiza matenda ashuga. Izi ndi timadzi timene timatulutsa kagayidwe kazakudya ndipo timachepetsa kuchuluka kwa shuga m'magazi. Kuchepetsa mafuta amthupi kumatheka ndi kuwonjezeka kwa shuga ndi ma insulin omwe amadalira insulin motsogozedwa ndi insulin, omwe amalimbikitsa kapangidwe ka glycogen ndi maselo a chiwindi ndikuletsa kutembenuka kwa amino acid ndi mafuta kukhala chakudya.

Koma pali zovuta zina za insulin thupi.

Ngati akusowa?

Ndi kuchepa kwake, kuchuluka kwa shuga kumawonedwa, komwe kumayambitsa kupezeka kwa matenda a shuga ndi zovuta zina. Kuperewera kwa insulin kumachitika chifukwa cha kusintha kwa kapamba, komwe kumachitika chifukwa cha kusokonezeka kwa zochitika za endocrine system, pambuyo povulala kapena nthawi yayikulu pamaganizidwe omwe amaphatikizidwa ndi zochitika zopsinja.

Mankhwala amapangidwa kuchokera kuzinthu zonyamula zikondamoyo.

Chithandizo cha matenda ashuga

Insulin imadziwika kuti ndi mankhwala enieni othandizira matenda a shuga, chifukwa amachepetsa hyperglycemia, amabwezeretsanso kupezeka kwa glycogen m'maselo a chiwindi ndi minofu, amachepetsa mapangidwe a shuga, amachepetsa matenda a shuga. Insulin yogwiritsira ntchito kuchipatala imapezeka kuchokera ku zikondamoyo za nkhumba ndi ng'ombe. Pali njira yopangira insulin, koma pakadali pano siyotheka. Njira zopangira mankhwala opangira insulin yaumunthu zapangidwa. Insulin yomwe imapezeka ndi ma genetic engineering imagwirizana kwathunthu ndi amino acid mfululizo wa insulin ya anthu.

Muzochitika zomwe mankhwalawa amachokera ku gland yanyama, zodetsa zosiyanasiyana (glucagon, proinsulin, mapuloteni, kudzipangitsa, polypeptides, etc.) zitha kuwonedwa mu malonda chifukwa chakuyeretsa kosakwanira. Zakudya zoyeretsedwa bwino zimatha kuyambitsa mavuto osiyanasiyana.

Culin pancreas insulin ndi wotchuka kwambiri masiku ano. Crystalline insulin yamunthu imagwiritsidwanso ntchito kwambiri.

Zochita za chinthuchi zimatsimikiziridwa mwatsatanetsatane. Pazinthu chimodzi chimodzi (gawo lapadziko lonse lapansi), ntchito ya 0,04082 mg wa insulin imatengedwa.

Tisanalingalire momwe insulini imakhudzira thupi ndi zoyipa za chinthu ichi, timazindikira momwe zimayikidwa.

Zisonyezero zakudikirira

Zizindikiro za kuikidwa ndi kupezeka kwa thupi la mitundu yodalira matenda a shuga. Mlingo wocheperako, angagwiritsidwe ntchito pochiza matenda ena a chiwindi. Ngati ndi kotheka, n`zotheka kugwiritsa ntchito mankhwalawa pochiza matenda amisala ndi minyewa.

Insulin ikhoza kukhala ndi izi:

• Chithandizo ndi kupewa acidosis,
• kupewa kufooka thupi,
• thyrotoxicosis,
• furunculosis,
• matenda a shuga
• urticaria, eczema, etc.

Ndi zakumwa zoledzeretsa ndi schizophrenia

Kugwiritsa ntchito insulin pothana ndi uchidakwa komanso mitundu ina ya matenda a chinzonono kwawonetsa zotsatira zabwino. Pa mankhwala a schizophrenia, insulinocomatous mankhwala amalembera, momwe mlingo wa insulin umalowetsedwa m'thupi la wodwalayo womwe sungathe kuyambitsa hypoglycemic. Nthawi zina, mankhwala okhala ndi insulin amaperekedwa kwa odwala panthawi yopumira.

Zotsutsana ndi zoyipa za insulin zidzaperekedwa pansipa.

Kodi insulin imasemphana ndi chiyani?

Insulin ili ndi malire komanso contraindication kuti mugwiritse ntchito.Zochitika zotsatirazi zam'magazi zimaphatikizidwa pamndandanda wa zotsutsana:

• kapamba
• chiwindi
• yade
• kukhalapo kwa calculi mu impso komanso nthawi yowonjezera matenda a impso,
• matenda amtima owala,
• zilonda zam'mimba.

Kuphatikiza pa matenda omwe ali pamwambapa, ma insulin amaphatikizidwa pazotsatirazi:

• kupezeka kwa wodwala wodwala matenda a shuga ogwirizana ndi insulin -
• hypoglycemia kapena prerequisites mwadzidzidzi,

Malangizo apadera

Chomwe chimalepheretsa kugwiritsa ntchito mankhwalawa ndi kupezeka kwakanthawi kovuta kwa mankhwala omwe insulin ilipo.

Mankhwala ambiri omwe ali ndi insulin samalimbikitsidwa pochiza matenda ashuga panthawi yoyembekezera komanso mkaka wa m'mawere. Pakadali pano, mankhwala omwe amapangidwa pamaziko a insulin yakuchokera kwa nyama ayenera kugwiritsidwa ntchito.

Zotsatira zoyipa za insulin

Zotsatira zoyipa zomwe zimagwiritsidwa ntchito pakugwiritsira ntchito insulin zimawonekera pazochitika za bongo panthawi ya jakisoni. Pankhaniyi, kuwonjezeka kwa magazi pazinthu zomwe zimawonedwa. Izi zimathandizira kukhazikitsa dziko la hypoglycemia, komwe kumayambitsa kugwedezeka kwa hypoglycemic.

Izi ndizotsatira zoyipa za insulin mthupi la munthu, koma pali zina.

Kuchulukitsa msika wake kumathandizira thukuta, chizungulire, kuwonjezeka kwa chinsinsi cha tiziwalo tating'onoting'ono komanso kukula kwa kupuma movutikira. Ndi mankhwala osokoneza bongo osaneneka popanda kudya mankhwala osokoneza bongo kapena zakudya zopatsa mphamvu zamafuta ambiri, kumatha kuzindikira komanso kugwidwa. Kuwonongeka pambuyo pake kumayambitsa kukomoka kwa hypoglycemic.

Kodi kupewa izi?

Kuti muthane ndi vuto la kumwa mopitirira muyeso, muyenera kudya mikate yoyera 100, supuni zochepa za shuga kapena kapu ya tiyi wokoma, mutha kudya apulo.

Ngati zizindikiro zakuda kwambiri zikuwonekera, wodwalayo ayenera kubaya jekeseni m'mitsempha. Ngati ndi kotheka, subcutaneous makonzedwe a adrenaline angagwiritsidwenso ntchito.

Zotsatira zoyipa za insulin ziyenera kudziwika ndi aliyense wodwala matenda ashuga.

Kusamala kwina kumafunikira mukamagwiritsa ntchito mankhwala opangira matenda a shuga, makamaka akayamba kusowa kwa magazi komanso vuto la kusokonekera kwa magazi. Pankhani yogwiritsa ntchito nthawi yayitali ya insulin kukonzekera, kuwunika mwadongosolo mkodzo ndi mkhalidwe wamagazi ndikutsimikiza kuchuluka kwa shuga mwa iwo kumafunika. Phunziroli likuthandizani kumvetsetsa nthawi yomwe ingakhale yoyenera kuperekera mankhwala ochepetsa mavuto a insulin.

Kupereka mankhwala opangidwa ndi insulin, ma syringes apadera kapena ma syringes amagwiritsidwa ntchito, zomwe zimatengera mtundu wa insulin yomwe imagwiritsidwa ntchito mu insulin.

Momwe mungagwiritsire ntchito mankhwalawa kuti mupewe zovuta za insulin mu shuga?