Kusala kudya kwa insulin kwa akulu ndi ana

Mukamalemba za mayeso, mpofunika kuti mufotokozere zomwe zikupezeka mulembalo, chifukwa malingana ndi zida za labotale, zikhalidwe ndizosiyana. Ngati labotale yanu ili ndi imodzi mwadongosolo lotchuka kwambiri, ndiye kuti insulini yachangu ndi 2-10 mI / l (ngakhale zida nthawi zambiri zimagwiritsidwa ntchito momwe chizolowezi chimakhala 6-24 mI / l). Kutengera ndi zomwe tafotokozazi, zitha kuganiziridwa kuti insulini ilibe malire.

Chinthu chachikulu chomwe muyenera kudziwa: kuzindikira kumeneku sikumapangidwa malinga ndi kafukufuku mmodzi - kuti mumvetsetse zomwe zikuchitika mthupi, tikufunika mayeso athunthu.

Zambiri

Horoni ya pancreatic yomwe imayendetsa kagayidwe kazakudya, imakhudzidwa ndimatenda a mafuta ndikusunga shuga yamagazi pamlingo woyenera kwambiri, wotchedwa insulin. Mwachilengedwe, ndi mapuloteni omwe amapangidwa kuchokera ku proinsulin m'maselo a kapamba. Kenako imalowa m'magazi ndikuchita ntchito zake. Kuperewera kwake kumadzetsa mphamvu ya kufa kwa maselo, kumapangitsa kuchuluka kwa shuga m'magazi. Zinthu zonsezi zimasokoneza machitidwe amkati omwe amapezeka m'thupi la munthu, zimayambitsa kusokonezeka kwamitundu yambiri ya endocrine. Kafukufuku wokhudza mahormoni awa akuwonetsa:

• Mlingo wa chidwi ndi insulin, i.e., insulin.
• Kuphwanya kagayidwe kachakudya njira.

Komanso kudziwa insulin (neoplasm) ndi matenda osokoneza bongo, momwe mumakhala kuwonongeka kwa zovuta kwa glycogen chakudya mu chiwindi ndi minofu minofu. Kuphatikiza apo, motsutsana ndi maziko a chiphunzitsochi, kuchuluka kwa okosijeni wa glucose, kagayidwe kazakudya zomanga thupi ndi lipids zimachepa, kuchuluka kwa cholesterol yoyipa kumawonjezeka, ndikuwoneka koyipa kwa nayitrogeni.

Matenda a shuga ndi amitundu iwiri:

1. Choyamba, thupi silipanga insulin. Kubwezeretsanso kwake kumachitika mwa kutenga mahomoni, i.e., munthu amalandila chithandizo chamankhwala cha homoni. Chiwerengero cha magawo ofunikira amasankhidwa ndi adokotala kwa wodwala aliyense.
2. Chachiwiri - mahomoni okwanira okwanira amapangidwa. Zotsatira zake, palibe njira yowongolera kuchuluka kwa shuga m'magazi.

Matenda a shuga ndi vuto lalikulu komanso loopsa lomwe limachepetsa moyo wamunthu komanso limadzetsa zovuta zambiri. Chifukwa chake, kudziwitsidwa kwake kwakanthawi mwa kudziwa kuchuluka kwa insulin, kumene, ndikofunikira.

Zisonyezo za kuyezetsa magazi kwa insulin

Dokotala amalimbikitsa izi:

• Kuzindikira matenda amtundu wa endocrine, kuphatikiza matenda a shuga kwa amayi oyembekezera.
• Kuyeza kwa anthu omwe ali ndi vuto la matenda ashuga.
• Kuyang'anira njira ya matenda ashuga.
• Kusankhidwa kwa mlingo wa insulin.
• Kuzindikiritsa kusatetezeka kwa thupi kwa insulin.
• Kupeza zifukwa zochepetsera shuga wamagazi.
• Kukayikira kwa vuto lakunyumba.
• Kunenepa kwambiri.
• Kuyesedwa kwa odwala omwe ali ndi vuto la metabolic, komanso azimayi omwe ali ndi vuto losunga mazira.

Kuphatikiza apo, pozindikira zizindikiro zotsatirazi, madotolo amakupatsanso kafukufuku wofulumira wa insulin (zomwe zimanenedwa m'nkhaniyi):

• Kutalika kumachiritsa mabala,
• chizungulire, chikumbumtima chosavomerezeka, kupenya kawiri
• kufooka, kuchuluka thukuta,
• kusokonezeka kwa kukumbukira
• kutopa kwambiri, kukwiya, kukhumudwa,
• kumangokhala ndi ludzu komanso ludzu,
• kamwa yowuma ndi khungu,
• kusinthasintha kwamphamvu thupi pochita zolimbitsa thupi ndi zakudya,
• mbiri yamatenda amtima ndi tachycardia.

Kukonzekera kusanthula ndi malamulo operekera biomaterial

Kupatula kulandira zolakwika, kusanthula kumachitika isanayambike pharmacotherapy ndi njira zodziwira ngati MRI, ultrasound, CT, radiography, physiotherapy, ndi ena, kapena milungu iwiri itatha. Mwazi wama venous kuchokera m'mitsempha ya ulnar amatengedwa kuti awunike. Nthawi yabwino yokwanira yolemba zotsala zisanu ndi ziwiri mpaka teni m'mawa.

Malangizo popereka magazi a insulin:

1. Chakudya chotsiriza chikuyenera kukhala maola khumi musanadye mankhwala.
2. Kwa masiku angapo, chotsani mopitirira muyeso pamthupi ndi m'malingaliro, kugwiritsa ntchito zakumwa zoledzeretsa ndi mphamvu zamagetsi.
3. Kwa masiku awiri, kupatula kumwa mankhwala (monga momwe adavomerezera ndi adotolo).
4. Kwa tsiku limodzi musadye zonunkhira ndi mafuta, komanso zonunkhira.
5. Patsiku loperekera limaloledwa kumwa madzi omwe alibe gasi ndi mchere. Kuyambira ana amatenga biomaterial ola limodzi mutatha kudyetsa. Kusuta musanapendeke ndikulimbikitsidwa.
6. Kwambiri mphindi makumi atatu mpaka makumi atatu kafukufukuyu asanaphunzire, muyenera kumasuka, khalani pansi. Ndikofunika kukumbukira kuti kupsinjika kulikonse kwamalingaliro kapena thupi kumaletsedwa, chifukwa kupanikizika kumabweretsa kutulutsa kwa insulin m'magazi.

Zotsatira za phunziroli zikhale zokonzekera tsiku lotsatira. Kusala kwa insulin kumadalira jenda, zaka, ndi njira yomwe imagwiritsidwa ntchito mu labotale.

Chifukwa chiyani kuli kofunikira kudziwa mulingo wanu wa insulin?

Insulin ndiye mahomoni ofunika kwambiri omwe amayang'anira njira za metabolic m'thupi la munthu. Kuyeza kwachangu kwa kupangika kwake kumachitika mwa anthu omwe amasonyezedwanso kafukufuku wotchedwa "glucose-insulin curve," kapena kuyesa kwa glucose. Kuti mupeze kuchuluka kwambiri kwa insulini, chitani zotsekemera ndi shuga. Asanachite mayeso otere, madokotala amasiya mankhwala awa: salicylates, estrogens, corticosteroids, hypoglycemic. Apo ayi, zotsatira zake zidzasokonekera.

Zachilengedwe zimaperekedwa pamimba yopanda maola khumi ndi khumi ndi umodzi. Akuluakulu amatenga muyezo wa magalamu 70 a shuga. Kuyamwa magazi kumachitika katatu: pamimba yopanda kanthu kenako, pakatha mphindi makumi asanu ndi limodzi mphambu zana limodzi. Dziwani matenda ashuga ngati chimodzi mwazisanzo zinali zapamwamba. Kuphatikiza apo, amayesa kudya. Pamimba yopanda kanthu, shuga, insulin ndi C-peptide amatsimikizika m'magazi a munthu. Kenako wodwalayo amachepetsa madzi akumwa komanso chakudya kwa maola makumi awiri ndi anayi. Kuphatikiza apo, maola asanu ndi limodzi aliwonse, kusanthula kwa zomwe zikuwonetsa katatu kumachitika.

Kodi insulin yayikulu komanso yotsika imatanthawuza chiyani?

Insulin yothamanga kwambiri ikuwonetsa:

• Matenda a Cushing
• acromegaly
• mtundu 2 shuga
• kugwiritsa ntchito nthawi yayitali corticosteroids, kulera kwapakamwa komanso mankhwala a Levodopa.

Kuphatikiza apo, imapezeka mwa anthu onenepa kwambiri omwe ali ndi fructose ndi galactose tsankho.

Kuchuluka kwa mahomoni awa kumapangitsa kuti pakhale hypoglycemia, yomwe imadziwika ndi chipatala chotsatira: chizungulire, kukhumudwa, thukuta kwambiri, kuchuluka kwa mtima, komanso kuwonongeka kwa mawonekedwe. Kuperewera kwa glucose kumatha kupweteketsa thupi kenako kufa.

Kulowetsedwa m'munsi mwa insulin yolimbitsa thupi kumawonedwa mu mtundu woyamba wa matenda ashuga, kuperewera kwa pituitary, kutupa kwa kapamba.

Kulumikiza C-peptide

Peptide iyi ndi insulin ndi zinthu zotsiriza za kutembenuka kwa proinsulin m'maselo a pancreatic. M'magazi iwo amawachotsa muyezo wofanana. Hafu ya moyo wa C-peptide mu plasma ndi makumi awiri, ndipo insulin ndi mphindi zinayi zokha. Izi zikufotokozera kuchuluka kwakukulu kwa peptide yolumikizira m'magazi, i.e, ndi chikhomo chokhazikika. Kusanthula kwa C-peptide ndikulimbikitsidwa:

• Kusankha njira zamatenda a shuga.
• Kuwona kuthekera kwa zotheka mu fetal mwa amayi apakati omwe ali ndi matenda ashuga.
• Polycystic ovary syndrome.
• Matenda a shuga kwa achinyamata onenepa kwambiri.
• Matenda a insulinoma.
• Kusiyanitsa kosiyanitsa mtundu woyamba ndi wachiwiri wa matenda ashuga.
• Kuzindikiritsa ndi kuwongolera chikhululukiro cha achinyamata matenda ashuga.
• Kuunika kotsalira kwa maselo a beta mwa odwala omwe ali ndi matenda ashuga akamamwa insulin.
• Kukula kwa matenda ashuga.
• Kusabereka.
• Hypoglycemia wokayikitsa.
• Kuunika kwa insulin katulutsidwe matenda a impso.
• Kuwongolera pambuyo pancreatic resection.

Kuyika pazotsatira za kusanthula. Chikhalidwe cha C-peptide (ng / ml)

Gawo lovomerezeka ndi kuchokera pa 0.78 mpaka 1.89. Kulowerera m'munsimu mwabwinobwino kumaonekera ndi:

• mtundu 1 shuga
• hypoglycemia,
• zopsinjitsa
• Kuchotsa kwa gawo limodzi la kapamba.

Mlingo wa C-peptide owonjezera pazowongolera zamagulu amodzi mwa zinthu zotsatirazi:

• insulinoma
• kulephera kwa aimpso,
• kumwa mankhwala ena a mahomoni
• hypoglycemia pamene akutenga mapiritsi a gulu la zotumphukira za sulfonylurea.

Mulingo wovomerezeka wa insulini (μU / ml)

Kwa munthu wathanzi, zomwe zimafotokozedwa zimakhala kuyambira atatu mpaka makumi awiri. Mlingo wa insulin m'magazi opanda kanthu mwa akazi umatengera zaka, kusintha kwa mahomoni, kumwa mankhwala ena. Ngati mayi amatenga mankhwala a mahomoni, kuphatikiza kulera kwapakamwa, ndiye kuti ndikofunikira kudziwitsa katswiri wa zamankhwala, chifukwa mu nkhani iyi, kuchuluka kwa insulini si chinthu chachilendo. Masana, kuchuluka kwa mahomoniwa kumasintha mobwerezabwereza, motero mfundo zake zovomerezeka zimaperekedwa m'malo osiyanasiyana. Kupatuka kuzolowera nthawi zambiri sikuti kumangotchulidwa ngati zam'tsogolo. Kuti muzindikire zomwe zimayambitsa komanso, ngati pakufunika kusintha, mayeso owonjezera ndi upangiri wofunikira ndikofunikira.

Ithandizira kumvetsetsa zomwe zimachitika mu insulin mwa akazi pofika zaka, tebulo pansipa.

Mwa amayi apakati, gawo lake lovomerezeka limakwera kufika pa 28, chifukwa panthawiyi mphamvu zambiri zimafunikira kuti mwana athe kukula bwino ndi kukhazikika kwake. Munthawi imeneyi, placenta imapanga mahomoni omwe amachulukitsa kuchuluka kwa shuga m'magazi, ndipo amagwira ntchito monga yotulutsa insulin. Zotsatira zake, kuchuluka kwa glucose kumakwera, kumalowa m'matumbo mwa placenta, kukakamiza kapamba kuti agwire ntchito modabwitsa ndikupanga insulin yambiri. Izi zimawonedwa ngati zachilengedwe ndipo sizifunika kukonza.

Malamulo a insulin m'magazi pamimba yopanda kanthu mwa amayi omwe ali ndi udindo zimadalira nthawi yayitali. M'masabata oyamba, kufunikira kumachepetsedwa pang'ono, kotero, kumasulidwa kwa timadzi m'magazi kumachepetsedwa. Ndipo kuyambira wachiwiri trimester, kupanga insulini kwakhala kukukula. Ngati panthawiyi zikondamoyo zimagwira ntchito yake, ndiye kuti shuga ndi yabwinobwino. Nthawi zina pomwe kapangidwe ka insulin yambiri sikotheka, matendawa amakula. Mu trimester yachitatu, kukana insulini kumachulukirapo ndi makumi asanu, ndipo insulin yopanga. Pambuyo pobereka, kufunika kwa mahoni kumachepa kwambiri, kaphatikizidwe ka timadzi timeneti kumachepa, matenda a shuga amadzazimiririka.

Ndizovuta kwambiri kuti anthu omwe ali ndi vuto logonana, omwe ali onenepa kwambiri kapena matenda ashuga, kubereka mwana. Chomwe chimapangitsa izi ndizoti thupi limakhala likuvutika nthawi zonse. Makolo onse ayenera kukhala ndi insulin ya 3 mpaka 25 kuti akhale ndi mwana wathanzi. Gome la zikhalidwe za insulin mwa akazi mwaubwino zili munkhaniyi (onani pamwambapa).

Pankhani ya kuchepa kwa insulin, kusayenda bwino kwa minyewa kumachitika ndipo zimavuta kuti thupi lilimbane ndi katundu wambiri. Pakadali pano, ntchito yayikulu ndikusunga ntchito zofunika. Owonjezera amaonedwa ngati cholepheretsa kukhala mayi wachimwemwe.

Mwa abambo, kuchuluka kwa insulin yofulumira kumakhala kosakhazikika, kosiyana ndi amuna kapena akazi, ndipo kuyambira 3 mpaka 25. Mu theka lolimba, zizindikiro zimangotengera zaka, komanso kulemera, ndiye kuti, ndizokulirapo, ndizokulirapo. thupi limafunikira insulin. Kuphatikiza apo, minofu ya adipose yowonjezera imathandizira kuchepetsa kuchuluka kwa insulin receptors, zomwe zimabweretsa kuchepa kwa chidwi cha mahomoni. Ndi m'badwo, malire am'munsi komanso apamwamba amasunthira kumtunda. Mlingo wa insulin m'magazi opanda kanthu mwa amuna omwe ali ndi zaka zapakati pa zaka makumi asanu (kuyambira zaka makumi asanu) kuchokera pa 6 mpaka 35. Izi zimachitika chifukwa cha zifukwa zotsatirazi:

• Thupi limafunikira mphamvu zambiri kuti likhale ndi moyo wathunthu.
• Kupitilira kwa mankhwala othandizira kuchiza matenda osachiritsika.
• Zovuta zapafupipafupi.
• Kufooka kwa chitetezo chathupi.
• Akuchepetsa mphamvu ya insulin.

Ana ndi akhama pantchito kuposa achikulire, choncho amafunika mphamvu zambiri. Ngati kulemera kwa mwana kumakhala pakati pa malire ndipo palibe zizindikiro za hypoglycemia, ndiye kuti kuwonjezeka pang'ono kwa insulin pazowonjezera zomwe zimasonyezedwa pansipa sikungachitike ngati nkhawa. Chomwe chimapangitsa izi ndizosasinthika kwachilengedwe komanso kukula. Mlingo wa insulin pamimba yopanda ana:

• Makanda ndi akhanda mpaka chaka - kuyambira atatu mpaka khumi ndi asanu:
• Preschoolers - kuyambira anayi mpaka khumi ndi zisanu ndi chimodzi,
• Kuyambira azaka zisanu ndi ziwiri mpaka khumi ndi ziwiri - kuyambira atatu mpaka khumi ndi zisanu ndi zitatu.
• Mu achinyamata, kuyambira anayi mpaka 19.

Nthawi yakutha msambo, malire ake amachepera mpaka asanu.

Mlingo wa insulin (μU / ml) mukatha kudya

Mitundu ya insulin pamimba yopanda kanthu ndikatha kudya idzakhala yosiyana, chifukwa mukatha kudya ntchito za kapamba zimapangidwira ndipo mahomoni ambiri amapangidwa. Zotsatira zake, kuchuluka kwake m'magazi kumawonjezeka. Komabe, izi zimagwira ntchito kwa akulu okha. Mu ana, kuchuluka kwa insulini palokha kumayamwa.

Kuchuluka kwa insulin, monga glucose m'magazi, kumachitika kamodzi ndi theka mpaka maola awiri mutatha kudya. Chifukwa cha kuwunikaku, ntchito ya kapamba ndi momwe amachitira ndi kupanga kwa mahomoni imawunikiridwa. Zotsatira zake zimawunikidwa ndi kuchuluka kwa shuga ndi ndende ya insulin, popeza zizindikirozi zimadalirana ndipo zimasiyanasiyana molingana. Kwa azimayi ndi abambo, malire ovomerezeka amachokera pa 26 mpaka 28. Kwa amayi oyembekezera ndi okalamba, kuyambira 28 mpaka 35. Mwana ali ndi zaka 19.

Zimayambitsa Insulin Resistance

Kukana kwa insulini kumachitika mwakuthupi, i.e., kwabwinobwino nthawi zina zaumoyo, komanso zam'thupi.

Zifukwa zolimbira insulin:

• mimba
• unyamata
• kugona usiku
• ukalamba
• Gawo lachiwiri la kusamba kwa akazi,
• chakudya chamafuta ambiri.

Zoyambitsa matenda a insulin:

• kunenepa
• zolakwika zachilengedwe za molekyulu ya insulin, zolandilira ndi zochita zake,
• kusowa kwa masewera olimbitsa thupi
• kudya zakudya zopatsa thanzi kwambiri
• matenda a endocrine (thyrotooticosis, matenda a Itsenko-Cushing, sintomegaly, pheochromocytoma, etc.),
• kumwa mankhwala ena (mahomoni, ma adrenergic blockers, ndi ena otero),
• kusuta

Zizindikiro ndi insulin

Chizindikiro chachikulu chokhala ndi insulin kukaniza kunenepa kwambiri pamimba. Kunenepa kwambiri pamimba ndi mtundu wa kunenepa kwambiri komwe minofu ya adipose imayikidwa makamaka pamimba ndi torso yapamwamba.

Choopsa kwambiri ndichakuti kunenepa kwamkati pamimba, minofu ya adipose imadziunjikira mozungulira ziwalo ndikuwasokoneza magwiridwe ake oyenera. Matenda a chiwindi chamafuta, atherosrance

Adipose minofu pamimba ndi yotakataka. Zambiri zomwe zimapanga zamoyo zomwe zimathandizira kuti zipangidwe zimapangidwa:

• atherosulinosis,
• matenda oncological
• ochepa matenda oopsa
• matenda olowa
• thrombosis
• kukanika kwa mchiberekero.

Kunenepa kwambiri pamimba kumatha kutsimikiziridwa panokha kunyumba. Kuti muchite izi, pimani m'chiuno ndikugawikirani kuzungulira m'chiuno. Nthawi zambiri, chizindikiro ichi sichidutsa 0.8 mwa akazi ndi 1.0 mwa amuna.

Chizindikiro chachiwiri chofunikira cha kukana insulin ndi wakuda acanthosis (acanthosis nigricans). Black acanthosis ndikusintha khungu pakapangidwe kachulukidwe kakang'ono ndi khungu m'makola amtundu wa khungu (khosi, axillary cavities, mammary gland, groin, intergluteal fold.

Mwa akazi, kukana kwa insulin kumawonetsedwa ndi polycystic ovary syndrome (PCOS). PCOS imayendetsedwa ndi kusamba, kusabereka ndi hirsutism, kukula kwambiri kwa tsitsi laimuna.

Matenda a insulin

Chifukwa cha kukhalapo kwa kuchuluka kwa njira za pathological zomwe zimakhudzana ndi insulin kukaniza, zinali zachikhalidwe kuphatikiza onsewo kukhala insulin resistance syndrome (metabolic syndrome, syndrome X).

Metabolic syndrome imaphatikizapo:

1. Kunenepa kwam'mimba (m'chiuno:> 80 cm mwa akazi ndi> 94 cm mwa amuna).
2. Matenda oopsa a arterial (kuchulukitsa kwamphamvu kwa kuthamanga kwa magazi pamwamba pa 140/90 mm Hg).
3. Matenda a shuga kapena kulekerera kwa glucose.
4. Kuphwanya cholesterol metabolism, kuchuluka kwa zigawo zake "zoyipa" komanso kuchepa kwa "zabwino".

Kuopsa kwa metabolic syndrome kuli pachiwopsezo chachikulu cha ngozi zam'mitsempha (stroke, kugunda kwa mtima, ndi zina zambiri). Amatha kupewedwa pochepetsa kulemera kwake komanso kuwongolera kuthamanga kwa magazi, komanso magawo a shuga ndi magazi.

Njira zodziwikitsa

Mwa njira zachindunji zodziwira kukana insulin, yolondola kwambiri ndi euglycemic hyperinsulinemic clamp (EHC, clamp test). Kuyesedwa kwa clamp kumakhala munthawi yomweyo kukonzanso minyewa ya glucose ndi mayankho a insulin kwa wodwala. Ngati kuchuluka kwa insulin sikumayenderana (kupitirira) kuchuluka kwa shuga, amalankhula za insulin.

Pakadali pano, mayeso owoneka ngati opondera amagwiritsidwa ntchito pofufuza, popeza ndizovuta kuchita, amafunika maphunziro apadera komanso kulumikizana.

Mayeso a kulolerana a glucose (PHTT)

Chiyeso chololera pakamwa cha glucose chimachitika motere. Wodwalayo amapereka magazi pamimba yopanda kanthu, kenako amamwa yankho lomwe lili ndi 75 g shuga, ndikuyambiranso kuwunikanso pambuyo pa maola awiri. Kuyesaku kumawunika kuchuluka kwa shuga, komanso insulin ndi C-peptide. C-peptide ndi mapuloteni omwe insulin imamangidwa mu depot yake.

Kusokonekera kwa glycemia komanso kuphwanya glucose kumawoneka ngati prediabetes ndipo nthawi zambiri amakhala ndi insulin. Ngati mayesowo agwirizanitsa ndi kuchuluka kwa shuga ndi milingo ya insulin ndi C-peptide, kuwonjezereka mwachangu kumapeto kumasonyezanso kupezeka kwa insulin.

Kuyeserera kwa shuga mkati mwa magazi (VVGTT)

Chiyeso chololera mkati mwa glucose chofanana ndi PGTT. Koma pankhaniyi, glucose imathandizidwa pamitsempha, kenako, pakanthawi kochepa, zowunikira zomwezo zimawunikiridwa mobwerezabwereza monga momwe zimakhalira ndi PGTT. Kusanthula kumeneku ndikodalirika kwambiri pamene wodwala ali ndi matenda am'mimba omwe amasokoneza mayamwidwe a glucose.

Kuwerengera kwa insulin kukana indices

Njira yosavuta kwambiri komanso yotsika mtengo kwambiri yodziwira insulin kukana kuwerengera mawonekedwe ake. Pachifukwa ichi, munthu amangofunikira kupereka magazi kuchokera mu mtsempha. Magazi a insulin ndi glucose adzatsimikizidwa ndipo mafayilo a HOMA-IR ndi caro amawerengedwa pogwiritsa ntchito njira zapadera. Amadziwikanso kuti insulin kukana kusanthula.

NOMA-IR Index - kuwerengera, zikhalidwe ndi matenda

NOMA-IR Index (Homeostasis Model Test of Insulin Resistance) imawerengeredwa pogwiritsa ntchito njira zotsatirazi:

NOMA = (glucose level (mmol / l) * mulingo wa insulini (μMU / ml)) / 22.5

Zifukwa zokulitsira index ya NOMA:

• insulin kukana, zomwe zikuwonetsa chitukuko cha matenda a shuga, atherosulinosis, polycystic ovary syndrome, kawirikawiri motsutsana ndi maziko a kunenepa kwambiri,
• Matenda a shuga (matenda ashuga),
• matenda a endocrine (thyrotooticosis, pheochromocytoma, etc.),
• kumwa mankhwala ena (mahomoni, ma adrenergic blockers, mankhwala ochepetsa mafuta m'thupi),
• matenda a chiwindi osachiritsika
• matenda opatsirana pachimake.

Caro index

Mlozerawu ndiwowonetsanso.

Caro index = mulingo wa shuga (mmol / L) / mulingo wa insulin (μMU / ml)

Kutsika kwa chizindikiro ichi ndi chotsimikizika chotsutsira insulin.

Kuyesedwa kwa insulini kumaperekedwa m'mawa popanda kanthu, pambuyo pakupuma kwa maola 10 mpaka 14 pakudya. Ndi osafunika kuwapatsa pambuyo kupsinjika kwambiri, munthawi yodwala kwambiri komanso kuchulukitsa kwa matenda osachiritsika.

Kutsimikiza kwa shuga m'magazi, insulin ndi C-peptide

Kudziwa kuchuluka kwa shuga, insulin kapena C-peptide m'magazi, pokhapokha pozindikira zina, sikungosintha. Iyenera kuganiziridwanso zovuta, chifukwa kuwonjezeka kwa glucose m'magazi kungawonetse kukonzekera koyeserera, ndipo insulin yokha - yokhudza kuyambitsa kwa insulini kuchokera kunja momwe mawonekedwe a jakisoni. Pokhapokha pakuwonetsetsa kuti kuchuluka kwa insulin ndi C-peptide ndizokwera kwambiri kuposa zomwe zimayembekezera pamlingo wopatsidwa wa glycemia, titha kulankhula za insulin.

Chithandizo cha kukana insulini - zakudya, masewera, mankhwala

Pambuyo pofufuza, kudutsa mayeso ndikuwerengera ma NOMA ndi ma caro indices, chinthu choyamba chomwe chimadetsa nkhawa munthu ndi momwe angachiritsire kukana insulin. Ndikofunikira kumvetsetsa apa kuti kukana insulini ndizomwe zimachitika nthawi zina. Idapangidwa munjira ya kusinthika ngati njira yosinthira nyengo zakusowa kwa nthawi yayitali. Ndipo kuchitira thupi kukana insulin muunyamata, kapena nthawi ya pakati, sikofunikira.

Pathological insulin kukana, zomwe zimatsogolera pakukula kwa matenda oopsa, ayenera kuwongoleredwa.

Mfundo ziwiri ndizofunikira pakuchepetsa thupi: kuchita masewera olimbitsa thupi pafupipafupi komanso kutsatira kwambiri zakudya zopatsa mphamvu.

Zochita zolimbitsa thupi zizikhala pafupipafupi, aerobic, katatu pa sabata kwa mphindi 45. Thamanga, kusambira, kulimbitsa thupi, kuvina. Pakati pamakalasi, minofu imagwira ntchito mwachangu, ndipo mwa iwo mumapezeka kuchuluka kwa ambiri a insulin. Mwakuchita zolimbitsa thupi, munthu amatsegula timadzi tambiri ku ma receptor ake, kuthana ndi kukana.

Zakudya zoyenera ndikutsatira zakudya zochepa zopatsa mphamvu ndizofunikira kwambiri pakuchepetsa thupi komanso kuchiza matenda a insulin ngati masewera. Ndikofunikira kuti muchepetse kwambiri kudya zakudya zosavuta zamafuta (shuga, maswiti, chokoleti, mankhwala ophika buledi). Menyu yotsutsa insulin iyenera kukhala ndi chakudya cha 5-6, servings iyenera kuchepetsedwa ndi 20-30%, yesani kuchepetsa mafuta a nyama ndikuwonjezera kuchuluka kwa fiber mu chakudya.

Pochita, nthawi zambiri zimapezeka kuti kuchepetsa thupi kwa munthu wodwala insulin sikophweka. Ngati, kutsatira kadyedwe komanso kuchita masewera olimbitsa thupi okwanira, kuchepa thupi sikulephera, mankhwala amalembedwa.

Metformin ndi yomwe imagwiritsidwa ntchito kwambiri. Imawonjezera chidwi cha minofu kuti ipangire insulin, imachepetsa mapangidwe a shuga m'chiwindi, imathandizira kumwa kwa glucose ndi minofu, ndikuchepetsa mayamwidwe ake m'matumbo. Mankhwalawa amatengedwa pokhapokha ngati akuwongolera adokotala ndipo amawongolera, popeza ali ndi zovuta zingapo komanso contraindication.

Kodi kuyezetsa magazi a insulin kumawonetsa chiyani?

Kuyesedwa kwa magazi kwa insulin pamimba yopanda kanthu kumatengedwa ngati mayeso ofunikira. Kukwanira kwathunthu kapena pang'ono pancreatic hormone kaphatikizidwe kumachitika pazaka zilizonse. Malinga ndi zotsatira za kuyezetsa magazi kwa insulini, ziwoneka kuti kuchuluka kwake sikumagwirizana ndi ntchito yake. Mwa achichepere ndi ana, chiwonetsero cha matenda ashuga chimachitika mwachangu komanso mwachindunji, ndipo makamaka kudzera mwa ketoacidosis. Mbiri ya glycemic mu yovuta kwambiri imakwera kuposa mamilion khumi ndi asanu pa lita. Zinthu zapoizoni ndi mankhwala oopsa zimadziunjikira m'magazi. Zimasokoneza kulowerera kwa glucose m'maselo ndikuchepetsa kuchuluka kwa insulin mthupi.

Kuwerengera kwathunthu kwa magazi kumatengedwa pamimba yopanda kanthu kapena ayi?

Funso limakonda kufunsidwa kwa madotolo. Monga kuyezetsa kwa insulin, kuchuluka kwathunthu kwa magazi kumatengedwa pamimba yopanda kanthu. Kupatula kumangokhala muzochitika zadzidzidzi, zomwe zimaphatikizapo zochitika zadzidzidzi, mwachitsanzo, appendicitis. Zomangamanga zimatengedwa kuchokera kumunwe kapena kuchokera mu mtsempha. Mukakusonkhanitsa magazi a venous, pamodzi ndi kusanthula kwapadera, kafukufuku amathanso kuthandizidwa pakuwonetsa zina, kuphatikizapo insulin.

Insulin Zomwe zimachitika mwa akazi akamabadwa (patebulo)

Mlingo wa insulin wabwinobwino mwa amuna ndi akazi ndi wofanana, pali kusiyana pang'ono pazochitika zina.

Nthawi zina pamene glucose wambiri m'thupi akwera, kapamba amayamba kupanga insulin mwachangu. Nthawi ngati izi mu thupi la mkazi wathanzi limachitika nthawi yakutha, pakati komanso kukalamba.

Zonsezi zikuwonetsedwa bwino pama tebulo omwe ali pansipa:

Mulingo wa insulin m'mwazi wa mkazi umasiyanasiyana malinga ndi zaka zake. Pakupita kwa zaka, imakwera modabwitsa.

Mulingo wa insulin m'magazi mwa amuna

Mwa amuna, komanso mwa akazi, zomwe zimakhala ndi insulini m'thupi zimasiyana ndi zaka.

Mukakalamba, mphamvu zowonjezera zimafunikira, chifukwa chake, pambuyo pa makumi asanu ndi limodzi mwa amuna, monga akazi, kuchuluka kwa insulin komwe kumapangidwa kumakulirakulira ndikufika 35 mced / l.

Madzi a insulin. Zomwe zimachitika mwa ana ndi achinyamata

Ana ndi achinyamata amapanga gulu lapadera. Ana safunanso mphamvu zowonjezera, motero kupanga mahomoni awa sikukuwoneka pang'ono. Koma nthawi yakutha msuzi, chithunzicho chimasintha kwambiri. Poyerekeza ndi kufalikira kwa mahomoni ambiri, kuchuluka kwa insulin m'mwazi mwa achinyamata kumakulirakulira.

Miyezo ya insulin ikamasinthasintha kuposa manambala omwe akuwonetsedwa, izi zikutanthauza kuti munthuyo amakhala wathanzi. Nthawi yomwe mahomoni omwe ali pamwambapa, matendawa amapezeka pakapita zaka zambiri, njirazi zimatha kusinthika.

Insulin ndi mahomoni okhala ndi khalidwe. Pali zinthu zambiri zomwe zimakhudza kuchuluka kwake - kupsinjika, kuchuluka kwa thupi, matenda a kapamba, koma nthawi zambiri kusokonezeka kumachitika chifukwa cha matenda a shuga.

Zizindikiro zonena kuti pali kuwonjezeka kwa insulin - kuyabwa, pakamwa pouma, mabala amtundu wochiritsa, chilimbikitso chokwanira, koma nthawi yomweyo chizolowezi choonda.

Zomwe zimachitika ngati insulini ili pansi pazomwe zikuwonetsa kuti ikuchita masewera olimbitsa thupi kwakanthawi kapenanso kuti munthu ali ndi matenda a shuga a mtundu woyamba. Matenda a kapamba sayeneranso kutsutsidwa. Nthawi zambiri pamizerezi pamawonjezeredwa pallor, palpitations, kukomoka, kusakwiya, thukuta.

Momwe mungadziwire kuchuluka kwa insulin?

Kusanthula kumafunika kuti mudziwe zomwe zili mu insulin. Pali mitundu iwiri yayikulu yosanthula - mutatha kukweza shuga komanso pamimba yopanda kanthu. Kuti muzindikire matenda a shuga, muyenera kuyeseza zonsezi. Phunziro lotere litha kuchitidwa mu chipatala chokha.

Mlingo wa insulin m'mwazi wa amayi ndi abambo pamimba yopanda kanthu

Kusanthula kumeneku kumachitika m'mimba yopanda kanthu m'mawa, kuti zotsatira zake ziziwoneka bwino, ndikulimbikitsidwa kuti musadye osachepera maola 12 musanatenge magazi. Chifukwa chake, kuwunika kumeneku kumayikidwa m'mawa, komwe kumakupatsani mwayi wokonzekera bwino magazi.

Tsiku loti lisanachitike, zakudya zamafuta onse, maswiti amachotsedwa pamakonzedwe a wodwala, mowa uyenera kupewedwanso. Kupanda kutero, zotsatira zomwe zapezedwa sizingafanane ndi zenizeni, zomwe zingapangitse njira yodziwira bwino matenda.

Kuphatikiza pazosintha pa menyu, mtsogolo mwa kusanthula, ndikofunikira kuti mukhale ndi moyo wopuma - kusiya masewera olimbitsa thupi, kulimbikira zolimbitsa thupi, yesetsani kupewa zochitika zapamtima. Kusiya kusuta tsiku lisanafike kusanthula sikungakhale kopusa.

Pambuyo pakugona, musanapereke magazi kuti muwoneke, simungadye kapena kumwa chilichonse kupatula madzi oyera okha. Magazi amatengedwa kuchokera pachala, nthawi zina, magazi a venous amatengedwa, komanso pamimba yopanda kanthu.

Kuphatikiza pa kuyesedwa kwa magazi, madokotala nthawi zambiri amakupatsirani kuyesa kwa mapangidwe am'mimba, zomwe zimathandizira kudziwa zifukwa zosokoneza insulin.

Zotsatira zitha kukhala zochepa poyerekeza ndi tebulo lomwe lili pamwambapa. Chifukwa chake chisonyezo chokhazikika kwa munthu wamkulu chizikhala magawo kuchokera pa 1.9 mpaka 23 mked / l. Kwa ana ochepera zaka 14, chizindikiro ichi chimatha kukhala pakati pa 2 mpaka 20 mcd / l. mwa amayi omwe ali ndiudindo, chizindikiro ichi chidzakhala chofanana ndi 6 mpaka 27 mked / l.

Kuchuluka kwa shuga kwa insulin

Kuti mumvetsetse mwachangu komanso moyenera momwe thupi limatulutsira insulini, kuyezetsa kumachitika kuti mupeze timadzi tosungidwaku pambuyo poti tikhala ndi insulin. Kukonzekera njira yodziwitsira matenda kumachitika chimodzimodzi monga momwe zinalili kale. Simungathe kudya osachepera maola 8, kusuta, kumwa mowa komanso kuchita masewera olimbitsa thupi kuyenera kusiyidwa.

Nthawi yonseyi, simungathe kupanga zochita zolimbitsa thupi, kusuta. Pambuyo maola awiri, magazi amatengedwa kuti awunikidwe, kuyeza mulingo wa insulin.

Pakupereka zitsanzo, wodwalayo amafunika kukhala wodekha, apo ayi zotsatira zake sizingakhale zolondola.
Pambuyo pa kusanthula koteroko, magawo otsatirawa amakhala zizizindikiro zodziwika bwino: kwa munthu wamkulu, ziwerengerozi zimachokera pa 13 mpaka 15 mced / L, kwa mayi wokhala ndi mwana chizolowezi chikhala manambala kuyambira pa 16 mpaka 17 mced / L, kwa ana ochepera zaka 14, manambala kuyambira 10 azikhala achizolowezi mpaka 11 mced / l.

Nthawi zina, kungakhale koyenera kuwunikira kawiri kuti muzindikire zomwe zili m'madzi a insulin. Kusanthula koyamba kumachitika m'mimba yopanda kanthu m'mawa, pambuyo pake wodwalayo amapatsidwa shuga kuti amwe ndipo pambuyo maola awiri kuyezetsa magazi kumabwerezedwa. Kusanthula kophatikizidwa kudzapereka chithunzithunzi chowonjezera cha zotsatira za insulin.

Kodi kuchuluka kwa insulin kumatha bwanji?

Pambuyo podya, mapuloteni, mafuta ndi zakudya zimaloŵa m'thupi, kapamba amayamba kupanga mwachangu ma hormone kuti pakhale kuyamwa koyenera kwa mitundu iyi yonse. Ndiye kuti, kuchuluka kwa insulin kumawonjezeka kwambiri, chifukwa chake ndizosatheka kudziwa molondola kuchuluka kwa insulin mthupi la munthu mutatha kudya. Chakudya chikakonzedwa, zinthu za insulin zimabweranso mwakale.

Mchitidwe wa insulin mukatha kudya umachuluka ndi 50-75% yokhazikika, popeza nthawi imeneyi kuchuluka kwa glucose m'magazi kumakwera. Mukatha kudya pambuyo pa maola awiri ndi theka, inshuwaransi itatu kwambiri iyenera kubwerera mwakale.

Momwe mungakhalire wabwinobwino

Kwa anthu omwe akukumana ndi mavuto ndi kupanga bwino kwa insulini, zakudya zamafuta ochepa ndizofunikira. Kusunga shuga wabwinobwino, motero insulin, ndizovuta, koma ndizotheka.

Ndikofunikira kusiya batala kuphika ndi sinamoni ndikuyang'ana zamasamba, mbewu monga chimanga, zipatso zosamwa, tiyi. Kuchuluka kwa lokoma kuyenera kuwongoleredwa momveka bwino ndipo kumakhala koyenera kusintha m'malo mwazipatso zosapsa ndi zipatso zouma. Kuyambira nyama ndibwino kukonda ng'ombe ndi nyama ina yopendekera.