Mtundu wachiwiri wa matenda a shuga a insulin

Mtundu wachiwiri wa matenda a shuga umayamba mu 90% ya milandu yonse ya kusowa kwa metabolic. Chomwe chimayambitsa matendawa ndi matenda a insulin, pomwe maselo amthupi amasiya kumva za insulin. Koma muzochitika zapamwamba, kapamba amatha kusiya kutulutsa timadzi tambiri.

Komanso, moyo wopanda ntchito umathandizira kukula kwa matenda ashuga amtundu wa 2, omwe umayambitsa kunenepa kwambiri komanso kuphwanya kwina kwa kagayidwe kazakudya. Kenako kuchuluka kwa glucose kumachulukirachulukira, komwe kumakhala ndi poizoni kapamba ndipo maselo ake a beta amafa.

Pazifukwa zina, mtundu wachiwiri wa matenda ashuga umatha kudalira insulini. Koma kodi kukhazikitsidwa kwa mahomoni ndikofunikira nthawi ziti?

Kodi matenda ashuga a 2 amachiritsidwa liti ndi insulin?

Nthawi zambiri matenda amtunduwu amayamba pambuyo pa zaka 40. Kuphatikiza apo, popanga matendawa, wodwalayo akulemera msanga. Pakadali pano, vuto la insulin limayamba, koma zizindikiritso za matenda ashuga sizitha kuwonetsedwa.

Pang'onopang'ono, maselo a beta omwe amachititsa insulin kuti atheretu amatha. Chifukwa chake, chithandizo chimaphatikizira kupangika kwa mahomoni.

Koma nthawi zambiri, matendawa amayendetsedwa popanda jakisoni pogwiritsa ntchito othandizira a hypoglycemic, mankhwala othandizira pakudya, komanso masewera olimbitsa thupi. Koma ngati munthu sakutsatira malamulowa, ndiye kuti pakapita nthawi kapamba wake sangathenso kudzipanga payekha payokha palokha. Ndipo ngati simutenga jakisoni kuchokera ku matenda ashuga, ndiye kuti shuga yamwazi idzakulitsidwa kwambiri, zomwe zimapangitsa kuti pakhale zovuta.

Nthawi zambiri, insulin imaperekedwa kwa odwala omwe amakhala ndi moyo wongokhala. Ndiye kuti, ali ndi kusankha kwa masewera kapena masewera a insulin.

Komabe, kuchita masewera olimbitsa thupi ndi njira yothandiza kwambiri yolimbana ndi matendawa, chifukwa amathandiza kuti maselo azitha kugwira insulin. Chifukwa chake, ngati wodwala matenda ashuga ayamba kukhala ndi njira yolondola, ndiye kuti patapita nthawi mlingo wa insulin udzachepa kapena sadzafuna jakisoni.

Kuphatikiza apo, jekeseni ndiyofunika kwa anthu omwe samatsatira zakudya. Chakudya choterocho chimatanthauzira kuchuluka kwa chakudya chamagulu ochulukitsa, chomwe chimakupatsani mwayi wokana jakisoni kapena kuchepetsa kuchuluka kwake. Komabe, omwe akufuna kuchepa thupi ayeneranso kuchepetsa mapuloteni awo.

Koma kwa odwala matenda ashuga, insulin ndiyofunikira pazifukwa zaumoyo, chifukwa apo ayi wodwala amatha kufa chifukwa cha zovuta za matendawa. Kulephera kwamkati, zigawenga kapena vuto la mtima kumabweretsa imfa.

Zosiyanasiyana za insulin

Ma insulin omwe adalowetsedwa m'thupi la munthu amatha kusintha nthawi yayitali. Mankhwala nthawi zonse amasankhidwa payekha kwa wodwala aliyense.

Kuphatikiza apo, mankhwalawa amasiyanitsidwa ndi chiyambi:

1. Ng'ombe yotengedwa ndi kapamba wama ng'ombe. Zowonongeka - nthawi zambiri zimayambitsa chifuwa. Ndalama zoterezi zimaphatikizapo Ultralente MS, Insulrap GPP, Ultralente.
2. Porcine insulin ndi yofanana ndi anthu, imayambanso kuyambitsa ziwopsezo, koma nthawi zambiri. Nthawi zambiri amagwiritsidwa ntchito Insulrap SPP, Monosuinsulin, Monodar Long.
3. Genetic engineering insulin ndi kufanana kwa IRI yaumunthu. Mitunduyi imapezeka ku Escherichia coli kapena kwa kapamba. Oimira odziwika pagululi ndi Insulin Actrapid, Novomix ndi Humulin, Protafan.

Kugawa nthawi ndi kutalika kwa zotsatirazo kumakhalanso kosiyana. Chifukwa chake, pali insulin yosavuta, yomwe imagwira pambuyo pa mphindi 5, ndipo kutalika kwa vutoli mpaka maola 5.

Insulin yochepa imayamba kugwira ntchito pambuyo pa mphindi 30. Kwambiri ndende zimatheka pambuyo 2,5 maola, ndipo kutalika kwa zotsatira kumatenga maola 5-6.

Mankhwala ochepetsa mphamvu ya pakatikati amakhala olimbitsa thupi kwa maola 15. Kuika maganizo kwawo kumatheka maola angapo pambuyo pa utsogoleri. Tsiku lomwe muyenera kuchita jakisoni 2-3 kuchokera ku matenda ashuga.

Insulin Yotulutsidwa Yogwiritsidwa ntchito ngati mahomoni apansi. Mankhwala omwewo amatenga ndikusunga mahomoni. Mu maola 24, muyenera kuchita mpaka 2 jakisoni. Kuzindikira kwakukulu kumafika patatha maola 24-36.

Pakati pagulu la mankhwalawa omwe amakhala ndi mphamvu yayitali, ndikuyenera kuwunikira ma insulini opanda pake, chifukwa amachitapo kanthu mwachangu ndipo samayambitsa zovuta zosagwiritsidwa ntchito. Mankhwala odziwika kuchokera pagululi akuphatikizapo Lantus ndi Levemir.

Ndalama zophatikizika zimachita theka la ola pambuyo pobayira. Nthawi zambiri, zotsatira zimatha maola 15. Ndipo kuchuluka kwa ndende kumatsimikiziridwa ndi kuchuluka kwa mahomoni mumankhwala.

Mlingo ndi kuchuluka kwa jakisoni ndi mankhwala omwe amathandizidwa ndi dokotala. Mu matenda a shuga amtundu wachiwiri, jakisoni amatha kuchitika kuchipatala kapena kunja, komwe kumatsimikiziridwa ndi momwe wodwalayo alili.

Kugwiritsa ntchito insulin pochizira matenda amishuga 2

Kwa zaka zambiri osalimbana ndi ma DIABETES?

Mutu wa Bungwe: “Mudzadabwitsidwa kuti kumakhala kovuta motani kuchiritsa matenda a shuga tsiku lililonse.

Matenda a shuga a Mtundu Wachiwiri amatchedwa insulin-Independent. Koma mpaka pano, zidakhazikitsidwa kuti pafupifupi odwala onse omwe ali ndi matenda amtunduwu amafunika insulin panthawi inayake yamatendawa. Pochiza matenda a shuga a mtundu wachiwiri, chinthu chachikulu sikuti musaphonye mphindi ndikuwapatsa insulin munthawi yake.

Padziko lonse lapansi, mankhwala a insulin ndi omwe amawongolera kwambiri matenda ashuga. Zimathandizira kusintha bwino kwa odwala matenda ashuga, kuchedwa kuyambika kwa zovuta komanso kutalikitsa moyo.

Type 2 shuga insulin tikulimbikitsidwa:

• kwakanthawi - kukonzekeretsa wodwalayo kuti achite opareshoni kapena ngati pali matenda akulu opatsirana,
• pafupipafupi - ndi kusagwira ntchito kwa mankhwala ochepetsa shuga m'mapiritsi.

Kutalika kwa nthawi kuchokera ku zizindikiritso zoyambirira za matenda a shuga 2 ndikufunika kosalekeza kwa insulin mwachindunji zimatengera zinthu ziwiri. Mwakutero, kuchokera pakuchepa kwa magwiridwe antchito a maselo a beta ndikuwonjezera kukana kwa insulin. Amachepetsa kwambiri nthawi yanthawi imeneyi, chikhalidwe cha hyperglycemia nthawi zonse.

Mwanjira ina, munthu akawongolera matenda ashuga achiwiri (amatsatira zakudya ndipo amamwa mankhwala ochepetsa shuga), ndiye kuti insulin yake imayamba kufulumira.

Kwa odwala matenda ashuga, pali zinthu zingapo zomwe zimapangitsa kuti insulin igonjetse: matenda othandizira, kugwiritsa ntchito mankhwala osokoneza bongo osokoneza bongo, kuwonda, kuchita masewera olimbitsa thupi, kuda nkhawa pafupipafupi. Pamodzi ndi lipo - ndi kawopsedwe wa glucose, amathandizira kuchepa kwa magwiridwe antchito a beta mwa odwala omwe ali ndi matenda a shuga a 2.

Zisonyezo za mankhwala a insulin

Ndi kuchepa kwamphamvu kwa kubisala kwa cell ya beta komanso kusagwira bwino ntchito kwa mankhwala ochepetsa shuga, insulin imalimbikitsidwa m'njira zophatikizira kapena kuphatikiza mankhwala ochepetsa shuga.

Zizindikiro zokwanira zama insulin

• Zizindikiro zakuchepa kwa insulini (mwachitsanzo, kuchepa thupi, zizindikiro za kuwonongeka kwa matenda amtundu wa 2),
• kukhalapo kwa ketoacidosis ndi (kapena) ketosis,
• zovuta zilizonse za matenda a shuga a 2,
• kuchuluka kwa matenda osachiritsika, matenda opatsirana amakulidwe (stroko, gangrene, vuto la mtima), kufunikira kwa maopareshoni, matenda oopsa,
• omwe adapezeka kumene amtundu wachiwiri wa matenda ashuga, omwe amaphatikizidwa ndi shuga wambiri masana komanso pamimba yopanda kanthu, osaganizira kulemera kwa thupi, zaka, kuchuluka kwa matendawa.
• omwe adapezeka kumene amtundu wachiwiri wa matenda ashuga pamaso pa ziwengo ndi zina zotsutsana ndi kugwiritsa ntchito mankhwala kuchokera kwa shuga m'mapiritsi. Matenda a hemorrhagic, matenda a impso ndi chiwindi.
• mimba ndi mkaka wa m`mawere
• kuwonongeka kwambiri kwa impso ndi chiwindi.
• kusowa kwa shuga wowongolera pa mankhwalawa pogwiritsa ntchito mankhwala osachepera shuga ochulukirapo omwenso amathandiza kuti asakanikirane ndi kuphatikiza Mlingo wovomerezeka, komanso kulimbitsa thupi mokwanira,
• precoma, chikomokere.

Mankhwala a insulin amadziwika kuti ali ndi odwala omwe ali ndi matenda a shuga a 2 omwe ali ndi magawo a Laborator otsatirawa:

• kusala shuga m'magazi pamwamba pa 15 mmol / L mwa odwala omwe akukayikira
• kuchuluka kwa plasma ya C-peptide pansipa 0,2 nmol / l pambuyo poyesedwa mwamphamvu ndi 1.0 mg ya glucagon,
• ngakhale munagwiritsa ntchito mankhwala osachepera tsiku lililonse okonzekera shuga, kuthamanga kwa shuga m'magazi kumakhala kokwanira kuposa 8.0 mmol / l, mutatha kudya kwambiri kuposa 10.0 mmol / l,
• mulingo wa glycosylated hemoglobin nthawi zonse umapitirira 7%.

Ubwino wambiri wa insulin pochizira matenda amtundu wa 2 ndi momwe zimachitikira mbali zonse za matenda amtunduwu. Choyamba, zimathandizira kulipirira kusowa kwa mphamvu ya kupanga insulin, yomwe imawonedwa ndi kuchepa kwapang'onopang'ono pakugwira ntchito kwa maselo a beta.

Njira zakuchitikira ndi zotsatira za insulin

Mankhwala a insulin amachitika kuti athetse vuto la glucose ndikusintha ntchito yopanga maselo a beta okhala ndi hyperglycemia wapakati. Poyamba, kukomoka kwa maselo a beta omwe amapezeka m'matumbo ndikupanga insulin kumatha kusintha. Kupanga kwamkati kwa insulin kumabwezeretsedwa ndi kuchepa kwa shuga m'miyezo yabwinobwino.

Kukhazikitsidwa koyambirira kwa insulini kuyesa odwala matenda ashuga a 2 ndi njira imodzi yothandizira odwala kuperewera pakudya ndi masewera olimbitsa thupi, podutsa gawo lokonzekera piritsi.

Njirayi ndiyabwino kwa odwala matenda ashuga omwe amakonda insulin, mmalo mwakugwiritsa ntchito mankhwala ochepetsa shuga. Komanso mwa odwala omwe amachepetsa thupi komanso omwe akuwonetsetsa kuti ali ndi matenda a autoimmune a shuga akulu.

Kutsika kwa chiwindi pakupanga shuga m'magulu 2 a shuga kumafunikira kuponderezedwa kwa njira ziwiri: glycogenolysis ndi gluconeogenesis. Kukhazikitsidwa kwa insulin kumachepetsa hepatic glycogenolysis ndi gluconeogeneis, komanso kukulitsa chidwi cha zotumphukira za insulin. Zotsatira zake, zimakwaniritsidwa "kukonza" zida zonse za matenda a shuga a mtundu 2.

Zotsatira zabwino za insulin mankhwala a shuga

Pali mbali zabwino za kumwa insulin, monga:

• kusala ndi pambuyo chakudya
• kuchuluka kwa mapangidwe a insulin chifukwa cha kukhudzidwa kwa shuga kapena kudya,
• shuga wocheperako,
• kupanga shuga wa chiwindi
• kuyimitsidwa kwa secretion wa glucagon mutatha kudya,
• kusintha kwa mbiri ya lipoproteins ndi lipids,
• kukakamiza kwa lipolysis mutatha kudya,
• kusintha kwa anaerobic ndi aerobic glycolysis,
• kuchepa kwa glycation wa lipoproteins ndi mapuloteni.

Chithandizo cha odwala matenda ashuga chimayang'aniridwa kuti akwaniritse komanso kusamalira kwakanthawi mozama kwa glycosylated hemoglobin, kusala shuga m'magazi ndikatha kudya. Zotsatira zake zidzakhala kuchepetsera kuthekera kwa kakulidwe ndi kupitilira kwa zovuta.

Kukhazikitsidwa kwa insulini kuchokera kunja kumakhala ndi phindu pa chakudya, mapuloteni ndi metabolism yamafuta. Hormone iyi imayambitsa kutsimikizika ndikuletsa kupasuka kwa shuga, mafuta ndi amino acid. Imachepetsa kuchuluka kwa shuga mwakuwonjezera mayendedwe ake mpaka mkati mwa cell kudzera pa khoma la cell la adipocytes ndi myocyte, komanso kuletsa kwa kupanga chiwindi cha glucose (glycogenolysis ndi gluconeogenesis).

Kuphatikiza apo, insulin imayambitsa lipogenesis ndipo imalepheretsa kugwiritsa ntchito mafuta aulere acids mu metabolism ya mphamvu. Imalepheretsa minofu ya proteinol komanso imathandizira kupanga mapuloteni.

Kuwerengetsa kwa insulin

Kusankhidwa kwa mlingo wa mankhwalawo ndi munthu payekha. Zimakhazikitsidwa ndi kulemera kwa odwala matenda ashuga, chithunzi cha chipatala komanso mbiri ya shuga ya tsiku ndi tsiku. Kufunika kwa timadzi timeneti kumadalira kuchuluka kwa insulini komanso kutha kwa chinsinsi cha maselo a beta, omwe amachepetsedwa chifukwa cha kuwopsa kwa glucose.

Odwala a shuga a Type 2 omwe ali ndi kunenepa kwambiri amafunikira kuchuluka kwa insulin kuposa ena kuti akwaniritse kuwongolera. Kuchuluka kwa ma jakisoni ndi kuchuluka kwa insulin patsiku zimadalira kuchuluka kwa shuga m'magazi, kuchuluka kwa odwala matenda ashuga komanso zakudya.

Nthawi zambiri, bolus insulin mankhwala tikulimbikitsidwa. Apa ndi pomwe munthu amakhala ndi insulin analogue (kapena insulin yaying'ono) tsiku lililonse. Kuphatikiza kwa insulin yocheperako komanso yapakatikati (kangapo patsiku kapena musanagone) kapena analogue ya insulin yayitali (yogwiritsidwa ntchito musanayambe kugona) imatheka.

Mankhwala osokoneza bongo a Bolus insulin nthawi zambiri amadziwika ngati mankhwala osokoneza bongo a insulin (kapena analog insulin analogue) amagwiritsidwa ntchito kangapo patsiku. Kuphatikizika kwa insulin yocheperako komanso yapakatikati (asanagone kapena kawiri pa tsiku) kapena analogue ya insulin yayitali (asanagone) ndiyotheka.

Makulidwe a insulin

Njira yothetsera insulin imayendetsedwa mobwerezabwereza. Tsamba la jakisoni liyenera kuyamba kumezedwa bwino. Masamba obayira ayenera kusinthidwa tsiku lililonse.

Wodwalayo amadzipangira yekha jakisoni, chifukwa ndi spitz yapadera yokhala ndi singano yopyapyala kapena cholembera imagwiritsidwa ntchito. Ngati ndi kotheka, zokonda ziyenera kuperekedwa kwa cholembera.

Ubwino wogwiritsa ntchito cholembera:

• ili ndi singano yopyapyala, yomwe imagwiritsa ntchito jakisoni wa insulini yopanda ululu,
• kusakanikira - chipangizocho ndichabwino komanso chosavuta kunyamula,
• insulin yomwe ilowe mu cholembera sichidawonongeka, imatetezedwa ku kutentha ndi zinthu zina zachilengedwe.
• chipangizocho chimakulolani kuti aliyense payekha azikonzekera ndikugwiritsa ntchito osakaniza a insulin.

Osapitirira mphindi 30 ayenera kudutsa pakati pa insulin makonzedwe ndi kudya. Amaloledwa kulowa osaposa ma unit 30 nthawi.

Mitundu ya chithandizo: monotherapy ndi kuphatikiza mankhwala

Pochiza matenda amishuga amitundu iwiri, pali mitundu iwiri ya mankhwala: insulin monotherapy komanso kuphatikiza ndimankhwala ochepetsa shuga m'mapiritsi. Chisankhocho chitha kupangidwa kokha ndi dokotala, kutengera chidziwitso chake komanso zomwe adakumana nazo, komanso mawonekedwe a zomwe wodwalayo ali nawo, kupezeka kwa matenda opatsirana ndi chithandizo chamankhwala.

Ngati monotherapy yokhala ndi mapiritsi ochepetsera shuga sizipangitsa kuti magazi aziwongolera, kuphatikiza mankhwala omwe amapezeka ndi insulin ndi piritsi amalembedwa. Monga lamulo, amaphatikizidwa motere: insulin ndi sulfonylurea, insulini ndi meglitinides, insulin ndi biguanides, insulini ndi thiazolidinediones.

Zovuta zamaphatikizidwe zimaphatikizanso kuwonjezeka kwa zotumphukira zama cell kuti insulin, kuthetseratu kufalikira kwa glucose, komanso kuwonjezeka kwa kupangika kwa insulin.

Monotherapy yokhala ndi mtundu wa 2 wodwala insulin malinga ndi chikhalidwe kapena cholimbitsa. Kupita patsogolo kwakukulu mu endocrinology kumalumikizidwa ndi kusankha kwakukulu kwa insulin, komwe kumapangitsa kukwaniritsa zosowa zonse za wodwala. Pochiza matenda amishuga amtundu wa 2, dongosolo lililonse la insulin makulidwe ndilovomerezeka, lomwe limakupatsani mwayi wopewa kuthana ndi magazi ndikudziteteza ku hypoglycemia yosafunikira.

Malonda a insulin

Kusankha kwa dongosolo la insulini kutsata kumadalira msika wodwala, zodwala matenda, machitidwe zochizira, pamadongosolo azikhalidwe komanso kuthekera kwazinthu.

Dongosolo lachigiriki limatanthawuza chakudya chamagulu a odwala matenda ashuga, komanso zakudya zomwezi tsiku lililonse malinga ndi nthawi ya kudya komanso kuchuluka kwa chakudya. Makonzedwe a insulin jakisoni anakonza mu nthawi ndi mlingo.

Mwanjira imeneyi, wodwalayo sangathe kuyesa shuga wamagazi nthawi zambiri. Choipa cha dongosololi ndikuti palibe kusinthasintha kosinthasintha kwa kuchuluka kwa insulin kusintha magawo a shuga.Wodwalayo amaphatikizidwa ndi zakudya komanso ndondomeko ya jekeseni, yomwe imamulepheretsa kukhala ndi moyo wokhazikika.

Njira yodziwira mankhwala a insulin imagwiritsidwa ntchito m'magulu otsatirawa:

• okalamba odwala matenda ashuga
• odwala omwe sangathe kugwiritsa ntchito mita moyenera ndikuwongolera shuga,
• Anthu odwala matenda ashuga omwe akudwala matenda amisala
• odwala omwe amafunikira chisamaliro chakunja.

Cholimbacho chimalimbikitsidwa, ndi jakisoni, kutsanzira zachilengedwe kupanga insulin. Ali ndi zabwino zambiri zogwiritsa ntchito pulogalamuyi pa matenda ashuga, koma kuigwiritsa ntchito kumakhala kovuta.

Mfundo zofunika kuzikulitsa insulini:

• maziko-borus njira insulin mankhwala,
• Zakudya zopepuka, masinthidwe amtundu uliwonse wa insulini kukhala chakudya chake komanso kuchuluka kwa chakudya
• kufunika kudziwa shuga m'magazi kangapo patsiku.

Mavuto a Insulin Therapy

Nthawi zina pamakhala zovuta za mankhwalawa amitundu yachiwiri:

• thupi lawo siligwirizana
• Hypoglycemic zinthu
• postinsulin lipodystrophy.

Mavuto amakula, nthawi zambiri chifukwa chosagwirizana ndi malamulo a insulin.

Cholinga chachikulu cha chithandizo cha matenda amtundu wa 2 ndikukhazikika shuga m'magazi, kuchedwetsa zovuta, kukulitsa chiyembekezo cha moyo.

Pochizira mafupa, owerenga athu adagwiritsa ntchito DiabeNot bwino. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Zonsezi zitha kuchitika pogwiritsa ntchito mankhwala a insulin panthawi yake. Mankhwala amakono atsimikizira kutha kwawo komanso chitetezo pakuwapatsa mankhwala ngakhale mitundu yayikulu ya matenda ashuga.

Matenda a shuga

Insulin ndi mahomoni opangidwa ndi kapamba. Amayang'anira kayendedwe ka magazi. Pamene insulini ilowa m'thupi, makutidwe ndi okosijeni amayamba: glucose amawonongeka kukhala glycogen, mapuloteni ndi mafuta. Ngati vutoli limakwanira kulowa m'magazi, nthendayi imatchedwa shuga mellitus.

Mtundu wachiwiri wa matenda ashuga, wodwalayo amafunika kubwezeretsa kuperewera kwamahomoni kosalekeza ndi jakisoni. Pogwiritsa ntchito moyenera, insulin imangopindulitsa, koma ndikofunikira kusankha mosamala mlingo wake komanso pafupipafupi.

Chifukwa chiyani odwala matenda ashuga amafuna insulin?

Insulin ndi mahomoni omwe amapangidwa kuti azitsatira kuchuluka kwa shuga m'magazi. Ngati pazifukwa zina zimakhala zochepa, matenda a shuga amapangidwa. Mu mtundu wachiwiri wa matenda awa, sizingatheke kulipirira kusowa ndi mapiritsi okha kapena zakudya zoyenera. Pankhaniyi, jakisoni wa insulin ndi mankhwala.

Idapangidwa kuti ibwezeretse magwiridwe antchito a oyang'anira, omwe kapamba wowonongeka sangathenso kupereka. Mothandizidwa ndi zinthu zoipa, chiwalochi chimayamba kuonda ndipo sichingathenso kubereka mahomoni okwanira. Pankhaniyi, wodwalayo amapezeka ndi matenda a shuga 2. Yambitsani kupatuka kotereku:

• Maphunziro osavomerezeka a shuga
• Mafuta ochulukirapo a glucose - pamwambapa 9 mmol / L,
• Kumwa mankhwala ozikidwa ndi sulfonylurea mokulira.

Zisonyezo za insulin

Kukanika kwa pancreatic ndiye chifukwa chachikulu chomwe anthu amakakamizidwa kubaya insulin. Chiwalo ichi cha endocrine ndichofunikira kwambiri pakuwonetsetsa zochita za thupi. Ngati yasiya kugwira ntchito kapena ngati ikuchita pang'ono, kulephera kwina kwa ziwalo zina ndi machitidwe ena kumachitika.

Maselo a beta omwe amayenda ndi kapamba amapangidwa kuti apange insulin yachilengedwe. Mothandizidwa ndi ukalamba kapena matenda ena, amawonongeka ndikufa - sangatulutsenso insulin. Akatswiri amati kwa anthu omwe ali ndi mtundu woyamba wa matenda ashuga pambuyo pa zaka 7-10, pakufunikanso chithandizo chotere.

Zifukwa zazikulu zomwe zimapangira insulin ndi izi:

• Hyperglycemia, momwe shuga m'magazi amakwera kwambiri kuposa 9 mmol / l,
• Cancreaticigue kapena matenda,
• Mimba mwa mkazi yemwe ali ndi matenda ashuga
• Kukakamizidwa kwa mankhwala osokoneza bongo omwe ali ndi mankhwala a sulfonylurea,
• Kuchulukitsa kwa matenda osakhudzana ndi kapamba.

Komanso, timadzi timtunduwu timathandiza kusinthitsa njira yotupa mthupi la chibadwa china chilichonse mopanda kupweteka. Jakisoni wa insulini amaperekedwa kwa anthu omwe ali ndi neuropathy, yomwe imayendera limodzi ndi kupweteka kwambiri, komanso atherosulinosis. Kuti thupi lizigwira ntchito bwino, mankhwala a insulin amasonyezedwa kwa azimayi oyembekezera komanso oyembekezera.

Chifukwa cha kusazindikira kwawo, odwala ambiri amayesetsa kuti asayambe mankhwalawa nthawi yayitali. Amakhulupirira kuti iyi ndiye mfundo yoti tisabwerenso, zomwe zikuwonetsa matenda oopsa. Zowonadi, palibe cholakwika ndi jakisoni wotere. Insulin ndi chinthu chomwe chingathandize thupi lanu kugwira ntchito mokwanira, ndipo muyenera kuiwala za matenda anu osachiritsika. Ndi jakisoni wokhazikika, mudzatha kuiwala za mawonekedwe oyipa a shuga 2.

Mitundu ya insulin

Opanga zamankhwala amakono akuyambitsa kuchuluka kwakukulu kwa mankhwalawa kutengera insulin. Hormoneyi imangopangidwira kuti ikhale yothandizira kukonza matenda ashuga. Kamodzi m'magazi, imamanga glucose ndikuchotsa m'thupi.

Mpaka pano, insulini ndi yamtundu uwu:

• Zochita zazifupi - zimachitika nthawi yomweyo,
• Zochita zazifupi - zimasiyana pang'onopang'ono komanso moyenerera,
• Kutalika kwapakatikati - yambani kugwira ntchito patatha maola 1-2 mutatha,
• Kutenga nthawi yayitali - mawonekedwe ofala kwambiri, omwe amathandizira kuti thupi lizigwira ntchito kwa maola 6-8.

Insulin yoyamba idabadwa ndi anthu mu 1978. Apa ndipomwe asayansi aku Britain adakakamiza E. coli kupanga mahomoni awa. Kupanga zochuluka kwa ma ampoules ndi mankhwalawa kunayamba mchaka cha 1982 ndi United States. Mpaka nthawi imeneyo, anthu omwe ali ndi matenda a shuga a 2 adakakamizidwa kubaya jakisoni wa nkhumba. Mankhwalawa nthawi zambiri ankayambitsa mavuto. Masiku ano, insulin yonse inachokera ku zopangidwa, motero mankhwalawa samayambitsa zotsatirapo zilizonse.

Kukhazikitsa Insulin Therapy

Musanapite kwa dokotala kuti apange mtundu wa mankhwala a insulin, muyenera kuchita kafukufuku wokhudza shuga.

Kuti muchite izi, tsiku lililonse kwa sabata muyenera kupereka magazi a shuga.

Mukalandira zotsatira za phunziroli, mutha kupita kwa katswiri. Kuti mupeze zotsatira zowona, musanatenge magazi kwa milungu ingapo, yambani kukhala moyo wabwinoko komanso wolondola.

Ngati, mutatha kudya, kapamba amafuniranso insulin ina, sizingatheke kupewa mankhwala. Madokotala, kuti apange njira yoyenera ndi yothandizila ya insulin, ayankhe mafunso otsatirawa:

1. Ndikufuna jakisoni wa insulin usiku?
2. Ngati ndi kotheka, mlingo amawerengedwa, pambuyo pake mlingo wa tsiku ndi tsiku umasinthidwa.
3. Kodi ndifunika jakisoni wa insulin wa nthawi yayitali m'mawa?
   Kuti achite izi, wodwalayo amayikidwa kuchipatala ndipo amayesedwa. Samamupatsa chakudya cham'mawa komanso nkhomaliro, amaphunzira momwe thupi limachitikira. Pambuyo pake, kwa masiku angapo m'mawa, insulin yokhala ndi nthawi yayitali imabayidwa, ngati kuli koyenera, mlingo umasinthidwa.
4. Ndikufuna jakisoni wa insulin musanadye? Ngati ndi choncho, zisanachitike, zomwe sizofunika.
5. Mlingo woyambira wa insulin yochepa musanadye chakudya.
6. Kuyesera kumachitika kuti muwone kuchuluka kwa insulini yomwe muyenera kubaya musanadye.
7. Wodwalayo amaphunzitsidwa kupatsa insulin okha.

Ndikofunikira kwambiri kuti wothandizidwa azamalonda azithandizira pantchito yopanga insulin. Mlingo wofanana komanso nthawi yoyang'anira imawerengedwa aliyense payekha kwa wodwala aliyense. Ena mwa iwo amafunika jakisoni usiku kapena m'mawa, pomwe ena amafunikira chithandizo chokwanira.

Kupitilira mankhwala a insulin

Type 2 shuga mellitus ndi matenda opita patsogolo pomwe kulimba kwa ma cell a pancreatic beta amayamba kuchepa. Pamafunika kupitilira kwa mankhwala opangidwira kuti thupi likhale ndi shuga. Ganizirani. Kuti mlingo wa yogwira ntchito uyenera kusinthidwa pafupipafupi - nthawi zambiri umachulukana. Popita nthawi, mufika pa mapiritsi ambiri. Madokotala ambiri sakonda mtundu uwu wa mankhwalawa, chifukwa umabweretsa zovuta zambiri mthupi.

Mlingo wa insulin ukakhala wapamwamba kuposa mapiritsi, dokotala amakusinthirani jakisoni. Kumbukirani kuti uwu ndi mankhwala osachiritsika omwe mudzalandira kwa moyo wanu wonse. Mlingo wa mankhwalawa udzasinthanso, chifukwa thupi limazolowera kusintha.

Chosiyana chokha ndi pamene munthu amatsata zakudya zapadera.

Pankhaniyi, mlingo womwewo wa insulini ungamuthandize kwa zaka zingapo.

Mwachizolowezi, izi zimachitika mwa anthu omwe adapezeka kuti ali ndi matenda opatsirana a shuga koyambirira. Ayeneranso kukhala ndi zochitika zapantchito, ndipo kupanga kwa cell-beta ndikofunikira kwambiri. Ngati munthu wodwala matenda ashuga atha kubwezeretsa kulemera kwake, amadya moyenera, amasewera masewera, amachita zonse zotheka kubwezeretsa thupi - amatha kuchita ndi insulin yaying'ono. Idyani zakudya zabwino ndikukhala ndi moyo wathanzi, ndiye kuti simuyenera kuwonjezera kuchuluka kwa insulini.

Mlingo waukulu wa sulfonylurea

Kubwezeretsa ntchito za kapamba ndi zisumbu zokhala ndi maselo a beta, kukonzekera kwa sulfonylurea ndi mankhwala. Pulogalamu yotere imakwiyitsa gawo la endocrine kuti lipange insulini, chifukwa choti shuga ya m'magazi imasungidwa kwambiri. Izi zimathandiza kukhazikika bwino munthawi zonse mthupi. Nthawi zambiri, mankhwala otsatirawa amaperekedwa chifukwa chaichi:

Mankhwalawa onse ali ndi mphamvu yolimbikitsa ku kapamba. Ndikofunika kwambiri kuyang'anira mlingo womwe adokotala adasankha, chifukwa kugwiritsa ntchito sulfonylurea yochulukirapo kungayambitse kuwonongeka kwa kapamba. Ngati mankhwala a insulin amachitidwa popanda mankhwalawa, ntchito ya pancreatic idzaphimbidwa kwathunthu m'zaka zochepa chabe. Imakhalabe ndi magwiridwe antchito kwa nthawi yayitali, ndiye kuti simukuyenera kuti muwonjezere insulin.

Mankhwala opangidwa kuti azisamalira thupi ndi matenda a shuga a mtundu wachiwiri amathandizira kubwezeretsa kapamba, komanso kuziteteza ku zotsatira zoyipa za zinthu zakunja ndi zamkati. Komanso, kuti mukwaniritse zabwino kwambiri, muyenera kutsatira zakudya zapadera. Ndi chithandizo chake, ndizotheka kuchepetsa kuchuluka kwa shuga m'magazi, komanso kukwaniritsa bwino mapuloteni, mafuta ndi chakudya m'thupi.

Achire zotsatira za insulin

Insulin ndi gawo lofunika kwambiri m'moyo wa anthu odwala matenda ashuga a 2. Popanda mahomoni awa, amayamba kuvutika kwambiri, zomwe zimabweretsa hyperglycemia komanso zotsatirapo zowopsa. Madokotala adazindikira kale kuti chithandizo chokwanira cha insulini chimathandizira wodwalayo kuti awonetsere zovuta za matenda ashuga, komanso kuwonjezera moyo wake. Mothandizidwa ndi timadzi timeneti, ndizotheka kubweretsa kuchuluka kwa shuga m'magazi ndi shuga pamlingo woyenera: pamimba yopanda kanthu ndikatha kudya.

Insulin ya odwala matenda ashuga ndi njira yokhayo yowathandizira kuti azimva bwino ndikuiwala za matenda awo. Mankhwala osankhidwa moyenera amatha kuletsa matendawa, komanso kuletsa kukula kwa zovuta zazikulu. Insulin mu Mlingo woyenera sangathe kuvulaza thupi, komabe, ndi bongo wambiri, hypoglycemia ndi hypoglycemic coma ndizotheka, zomwe zimafuna chithandizo chamankhwala mwachangu. Therapy ndi timadzi timeneti timayambitsa zotsatirazi zochizira:

1. Kuchepetsa shuga wamagazi mukatha kudya komanso pamimba yopanda kanthu, pochotsa matenda a hyperglycemia.
2. Kupititsa patsogolo kwa mahomoni mu kapamba poyankha kudya.
3. Kutsika kwa kagayidwe kachakudya, kapena gluconeogeneis. Chifukwa cha izi, shuga amachotsedwa mwachangu kumadera omwe siopatsa mafuta.
4. Lipolysis yafupika mukatha kudya.
5. Mapuloteni achepa achulukitsidwa m'thupi.

Mankhwala odziwika a insulini okwanira amakhudza bwino njira za metabolic mthupi: lipid, chakudya, mapuloteni. Komanso, kutenga insulin kumathandizira kukhazikitsa kuponderezana ndi shuga, ma amino acid ndi lipids. Chifukwa cha insulin, ndizotheka kukwaniritsa metabolism yogwira mafuta. Izi zimathandizira kudzipatula kwachilengedwe kwa lipids yaulere m'thupi, komanso kuphatikiza mapuloteni am'minyewa.

Pachikhalidwe, matenda ashuga amtundu wa 2 amaonedwa kuti ndi mtundu wa matenda omwe amadzisamalira payekha. Mwandimomwene, izi siziri choncho. Odwala ambiri omwe ali ndi matenda oterewa sikuti amangokonda, komanso ndikofunikira kugwiritsa ntchito fanizo la mahomoni amunthu kuti athe kulipira chokhazikika komanso kuchepetsa chiopsezo cha zovuta zazikulu.

Ngati mtundu wa 2 matenda a insulin afunikira

Pakadali pano, odwala ambiri ndi madokotala akuchedwa kwambiri kuyambitsa kuyamba kwa insulin. Ndipo pali zifukwa zina zotithandizira. Komabe, pakadali pano, asayansi akuganiza kwambiri za kuthekera kosintha kwa mankhwala a mahomoni kwa odwala. Kupatula apo, zotsatirapo zamankhwala othandizira zimawonetsa kuti kuperekera mankhwala a insulin panthawi yake kumatha kusintha kwambiri moyo wa anthu odwala matenda ashuga, ndikukuthandizani kuti mukhalebe obisika la mahomoni ofunika kwa zaka zambiri.

Nthawi zambiri, chithandizo choterechi chimagwiritsidwa ntchito ngati achinyamata odwala matenda ashuga omwe samakhala ndi vuto lolemera, koma omwe ali pachiwopsezo cha matenda opatsirana oyambitsidwa ndi matenda osachiritsika. Chifukwa china choperekera jakisoni ndi kusakwaniritsidwa kwa othandizira a hypoglycemic, pamene kudya pafupipafupi mankhwala sikubwezerani zabwino. Komanso, izi zikuchulukirachulukira.

Thandizo lothandizidwa ndi ulesi limafunidwa ndi anthu ambiri omwe ali ndi mbiri yodwala matenda oopsa. Ofufuzawo aku America akuti patatha zaka 10, anthu ambiri omwe ali ndi matenda ashuga a 2, kufunsa adotolo: "momwe mungachitire?", Akulangizidwa kuti ayambe kumwa insulini nthawi zonse. Akuti pafupifupi 30% ya anthu omwe ali ndi matenda ashuga a 2 kwa zaka zoposa 10 amadalira insulin kwenikweni.

Nthawi zina chifukwa chachikulu choika mahomoni ndimtundu wa ketoacidosis, nthawi zambiri sakhala mkhalidwe wa odwala. Chizindikiro chofunikira kumayambiriro kwa chithandizo chogwira ntchito ndikusintha kwakuthwa mu mawonekedwe, mawonekedwe a matchulidwe a matenda a shuga (ludzu, profuse diuresis, kamwa yowuma, kuchepa thupi ndi chidwi chowonjezera).

Zizindikiro Zokwanira: maopareshoni, zotupa zazikulu, zotupa zamagazi, aimpso ndi chiwindi. Amayi oyembekezera omwe adapezeka kuti adapezeka kuti ali ndi matendawa sangathe kugwiritsa ntchito mapiritsi a phula nthawi ya bere (amatsutsana), motero amasunthidwa kwakanthawi.

Chifukwa chiyani odwala amakana insulin mankhwala

Chifukwa chachikulu chokana chithandizo choyenera ndicho mantha aumwini.Ma stereotyp mu gulu amalimbikitsa malingaliro osayenera pa insulin, kukupangitsani kuganiza kuti sizingatheke kukana jakisoni. Zowonadi, mawu awa ndi oona kwa mtundu woyamba wa matenda ashuga. Matenda a shuga a Mtundu Wachiwiri ndi osiyana ndi ena, motero amakhudzidwa mosiyanasiyana pakayambitsa insulin yakunja. Nthawi zambiri, chithandizo chotere ndimayendedwe osakhalitsa (mwachitsanzo, miyezi itatu), chomwe chimalola kusintha zizindikiritso ndikuchepetsa kuchepa kwa matendawa.

Chinanso chomwe chikuchititsa mantha ndi kuopsa kwa hypoglycemia, yomwe nthawi zambiri anthu amagwiritsa ntchito insulin. Inde, ndikusadziletsa kokwanira, zoopsa zilipo, koma zimatha kugwiritsidwa ntchito ndipo, ndi njira yoyenera, ndizovuta zina zochepa.

Nthawi zambiri, odwala okalamba omwe sangathe kusintha mulingo woyenera wa mankhwalawa, kuiwala kupanga jakisoni wokhazikika kapena omwe sawona bwino (nthawi zambiri amakhala ndi zovuta ndi kukhazikitsidwa kwa mapiritsi a syringe pens) amakana insulin. Komanso, gulu ili la odwala nthawi zambiri silikuwonetsa madandaulo aliwonse, chifukwa chiwonetsero cha matenda osokoneza bongo ndi "m'badwo".

Kuperewera kwa kudziwunikira mokhazikika ndi vuto lomwe limafala pafupifupi kwa odwala onse omwe ali ndi matenda amtundu wa 2, chifukwa thanzi la anthu awa nthawi zambiri silimadwala, chifukwa chake zimakhala zovuta kwambiri kuti akhulupirire kufunikira kwa chithandizo chokwanira komanso kudziletsa.

Kodi mankhwala a insulini a shuga 2 ali bwanji?

Pochiza matenda a shuga a mtundu wachiwiri, ma insulin omwewo amagwiritsidwa ntchito pochiza matenda a shuga 1 a mellitus. Nthawi zambiri amalimbikitsa kufupika komanso kwa ultrashort (lispro, aspart) kwa jabs chakudya, owonjezera, lantus ndi detemir amakondedwa, chifukwa amakulolani kuti muchepetse kagayidwe kazachilengedwe ndipo ndi ofatsa.

Pakadali pano, njira zingapo zakhala zikugwiritsa ntchito bwino kupatsira analogue yakunja ya pancreatic hormone yeniyeni mwa odwala matenda a shuga.

• Kusintha kwathunthu kwa mankhwala obwezeretsanso a insulin, pamene zakudya, mapiritsi ochepetsa shuga, ndi njira zina zochiritsira matenda a shuga zidayamba kukhala zosakwanira. Chiwembuchi chimatha kusiyanasiyana kamodzi pa jakisoni 1 nthawi patsiku mpaka kulowa m'magazi monga mtundu 1 wa shuga.

• Njira zophatikizika: jakisoni ndi mankhwala a hypoglycemic amagwiritsidwa ntchito nthawi imodzi. Zosakanikirana zosakanikirana pano ndizangodzipatula, osankhidwa pamodzi ndi adokotala. Njira iyi imawonedwa ngati yabwino kwambiri. Nthawi zambiri, insulin yowonjezera (nthawi 1-2 patsiku) komanso kumwa tsiku lililonse mankhwala amkamwa kuti muchepetse shuga la magazi kumaphatikizidwa. Nthawi zina asanadye chakudya cham'mawa, kukhazikitsidwa kwa insulin yosakanikirana kumasankhidwa, popeza kufunika kwam'mawa sikulepheretsedwanso ndi mapiritsi.

• Kusintha kwakanthawi kwa jakisoni. Monga taonera kale, makamaka njira imeneyi ndi yoyenera kuchita maopaleshoni akuluakulu, kuvulala kwambiri, kuthina, kuvulala, kutenga pakati, kuchepa kwamphamvu kwa insulin, komanso kuchuluka kwambiri kwa hemoglobin.

Chithandizo cha insulin choyambirira: ngozi kapena njira yokhayo yoyenera

Popeza zotsatira zabwino zakulipira matenda a shuga a mtundu wachiwiri pa insulin amakakamiza madokotala kuti alimbikitse momwe angachiritsire matendawa, odwala ambiri, komanso madokotala, amapezeka ali pamavuto: "nthawi yakupereka insulin ndi iti?". Kumbali ina, kuopa kumvetsetsa kwathunthu kwa wodwalayo kumapangitsa madokotala kuchedwetsa nthawi yomweyo, mavuto azachipatala omwe amapita patsogolo salola kuti insulini ichitike kwakanthawi. Munthawi zonsezi, chisankho chimapangidwa payekhapayekha.

Kumbukirani, njira zilizonse zochizira endocrine pathologies zitha kugwiritsidwa ntchito mutakambirana ndi adokotala! Kudzipatsa nokha mankhwala kukhala koopsa.

Pankhani ya insulin, mankhwala a insulin komanso kuyerekeza kwake ndi mapiritsi ochepetsa shuga

Zochizira matenda a shuga a mitundu yoyamba ndi yachiwiri, insulin imagwiritsidwa ntchito nthawi zambiri. Hormone iyi imalipira kuphwanya kagayidwe kazakudya, imachepetsa mwayi wamavuto.

Odwala amapatsidwa mankhwala osiyanasiyana malinga ndi zomwe amapanga. Kodi ndi zinthu ziti zomwe mungagwiritse ntchito monga insulin ndi insulin, zomwe nkhaniyi ikunena.

Kodi ndichifukwa chiyani insulini ikufunika pochiza matenda ashuga?

Ngati munthu wakana insulini, ndiye kuti maselo a ziwalo amalephera kuyamwa glucose ndikuyamba kumva njala. Izi zimakhudza kugwira ntchito kwa machitidwe onse: chiwindi, chithokomiro, impso, ndi ubongo zimayamba kuvutika.

Matenda a shuga amakhudza ziwalo zonse

Matenda a shuga osaphatikizika amabweretsa kupunduka, kukomoka, ndi kufa.. Mu mtundu woyamba wa matenda, ngati kapamba sangathe kutulutsa insulini, kuwonjezereka kwa mahomoni ndi kofunikira.

Gwiritsani ntchito mankhwala a nthawi yayitali komanso yochepa. Ngati ma jakisoni ochulukirapo, ndibwino kuti mubwezeretsenso kagayidwe kazakudya, kamene kamafanana ndi zolimbitsa thupi.

Zowonetsa ndi malingaliro athunthu

Masiku ano, odwala oposa 30% omwe amapezeka ndi matenda a shuga amapatsidwa jakisoni wa insulin. Zizindikiro zokwanira zamankhwala ndi awa:

Anthu ambiri odwala matenda ashuga safuna kulandira mankhwala a insulin. Koma ndi mtundu woyamba wa matenda palibe kusankha: kwa thanzi labwino, chithandizo cha moyo wonse ndichofunikira.

Malamulo ndi mfundo za insulin yothandizira matenda ashuga

Mankhwala aliwonse amakhala ndi zoyipa.

Chiwopsezo chokhala ndi zizindikiro zosasangalatsa kumbuyo kwa jakisoni wa insulini kumachulukitsa ndi Mlingo wosayenera, kuphwanya kosungidwa kwa zinthu.

Wodwala amatha kupeza vuto la hypoglycemia, lipodystrophy, chifuwa, komanso kusowa koonera. Kuti muchepetse mavuto omwe amabwera chifukwa cha insulin, muyenera kudziwa mfundo ndi kutsatira malamulo a mankhwala.

Ndi matenda a shuga 1

Kusinthasintha kwapafupi kwambiri kwa shuga m'magazi kuti pakhale kwachilengedwe pakubadwa ndikotheka kutsatira malamulo ndi mfundo izi:

• Pafupifupi tsiku lililonse azigwirizana ndi masoka omwe amapanga insulin ndi kapamba,
• kagawireni mankhwalawa malinga ndi chiwembuchi: 2/3 m'mawa, nkhomaliro ndi madzulo, 1/3 usiku,
• phatikizani insulin yayifupi ndi yayitali,
• jakisoni amalimbikitsidwa musanadye,
• musagwiritsidwe mankhwala opitilira 16 mankhwala osaneneka.

Ndi matenda a shuga kwa ana

Kuchulukitsa chiyembekezo cha moyo wa mwana, kuti muchepetse zovuta zoyambitsa matendawa, ndikofunikira:

• phatikizani insulin yayifupi ndi mankhwala omwe atenga nthawi yayitali,
• Kodi jakisoni wa mahomoni nthawi yayitali kawiri kapena katatu patsiku,
• Ana opitirira zaka 12 kuti achite zochiritsika zolimba,
• sinthani mlingo ndi gawo,
• ndi kukhudzika kwambiri, prick kuchepetsedwa analogues.

Zimakhala zovuta kwa mwana wodwala matenda ashuga kumaliza dongosolo la sukulu: jakisoni wa mankhwala ayenera kuperekedwa nthawi inayake. Kuti muchepetse chithandizo, kubisa matendawa kwa ana ena, sankhani chithandizo cha pampu. Pampu imangotulutsa timadzi tomwe timalowa m'thupi tikamakula.

Pa nthawi yoyembekezera

Pa nthawi yomwe mayi ali ndi pakati, matenda osokoneza bongo amatha kuchitika. Kufunika kwa insulin mwa mkazi munthawi ya mayeso kumawonjezeka.

Kuti mukhale ndi thanzi labwino, ndibwino kutsatira malamulowa:

• Nthawi zambiri sinthani mankhwala (pamenepa, kagayidwe kamadziwika ndi kusakhazikika),
• Sinthani ku insulin ya anthu (matupi awo sagwirizana kawirikawiri amapezeka pa iyo kuposa nkhumba kapena bovine),
• kuteteza hyperglycemia, kutenga jakisoni awiri patsiku,
• ntchito mankhwala apakatikati, aafupi,
• kuti shuga asamuke usiku, asanagone, muyenera kupaka jekeseni wa mankhwala osakhalitsa,
• shuga sangakhale wowongolera ndi mapiritsi.

Kusankha moyenera mankhwalawa komanso njira zake za insulin.

Mbali za zolimbitsa, basal bolus ndi pump insulin

Madokotala amagwiritsa ntchito njira zolimbikira, zapamwamba ndi zoyeserera pokonza popereka mahomoni a pancreatic kuchitira odwala. Njira yoyamba imakhazikitsidwa ndi kutsanzira kutulutsa kwachilengedwe kwa mahomoni masana.

Njira yowonjezereka imadziwika ndi zotere:

• jakisoni angapo amapangidwa patsiku,
• ntchito mankhwalawa
• yaitali mankhwala jekeseni yaingʻono Mlingo wa mawonekedwe a basal jekeseni,
• nthawi ya jakisoni imasankhidwa potengera nthawi yomwe munthu akufuna kudya.

Chinsinsi cha chithandizo choyambira cha bolus ndikuti m'mawa kapena madzulo, insulin yayitali kapena yayifupi. Chifukwa chake kuyerekezera kwa magwiridwe antchito a kapamba kumatheka. Gawo limodzi la mahomoni limakhala ndi insulin yokwanira, yachiwiri imalepheretsa kuchuluka kwa shuga.

Zina za mankhwala a insulin pump:

• kuphatikiza mitundu yonse ya mahomoni jekeseni imodzi,
• Kuchepetsa kuchuluka kwa jakisoni
• okhazikika mankhwala makonzedwe
• kuthekera kotsanzira ntchito zachilengedwe za kapamba.

Ndi mtundu wanji wa chithandizo chomwe chiri choyenera kwa wodwalayo, adokotala amasankha pamaziko a mayeso.

Kodi ndikufunika kupaka insulin ngati shuga ndi yabwinobwino?

Mtundu wachiwiri wa matenda ashuga, kapamba amatha kutulutsa timadzi tambiri tambiri. Chifukwa chake, nthawi zina munthu amakhala ndi shuga.

Ngati glycemia yachangu ndi 5.9, ndipo mutatha kudya sapitilira 7 mmol / l, ndiye kuti insulini ikhoza kusiyidwa kwakanthawi.

Koma nthawi yomweyo, muyenera kuwunika momwe zinthu ziliri ndikuwongolera kuchuluka kwa shuga m'magazi ndi zingwe zoyeserera.

Zoyenera kuchita mukaphonya jakisoni?

Zimachitika kuti munthu waiwala kubaya insulin. Algorithm yothandizira kuti azichita zina zimadalira kangati patsiku lomwe wodwala amapanga jakisoni:

• Ngati mlingo umodzi ukusowa mukabayitsa mahomoni owonjezera kawiri patsiku, ndikofunikira kusintha glycemia m'magawo 12 otsatira ndi mankhwala osakhalitsa. Kapena onjezani zolimbitsa thupi kuti kugwiritsa ntchito shuga kwachilengedwe kuchitika,
• Ngati mankhwalawa amaperekedwa kamodzi patsiku, ndiye kuti atatha maola 12 kuchokera pa jakisoni wosowa, apangileni jakisoni theka.
• mukadumphira insulin, mankhwalawa amayenera kuperekedwa mofulumira mukatha kudya. Mutha kuwonjezera zochita zolimbitsa thupi ndikuwonetsetsa kuchuluka kwa shuga. Ngati glucometer amawonetsa glycemia ya 13 mmol / l, ndiye chifukwa chake ndikuyenera kuyambitsa magawo a 1-2 a mahoni afupiafupi.

Adrenaline ndi insulin ndi zosiyana ziwiri pazinthu zomwe zikuchitika.

Malinga ndi Endocrinology Research Center ya Russia, insulin unit imachepetsa kuchuluka kwa shuga ndi 2 mmol / l, ndipo 1 ml ya adrenaline imaletseratu kugunda kwa hypoglycemic.

Ndikofunikira kudziwa kuti insulini (adrenaline) imachita mosiyanasiyana pa odwala matenda ashuga: kudalira zaka, kulemera, zolimbitsa thupi za munthu. Chifukwa chake, mankhwala osokoneza bongo amakhudza anthu achinyamata komanso owonda, ana kwambiri.

Kuti mumvetsetse kuchuluka kwa maselo a insulin omwe amachepetsa shuga, komanso kuchuluka kwake kwa adrenaline kumatha, kudzera m'mitundu.

Kodi ndikadziwe chiyani za jakisoni wa matenda ashuga?

Katemera wa matenda a shuga a 2 ayenera kuchitika pogwiritsa ntchito syringes zapadera. Pamaso pawo pali zizindikiro zomwe zimazindikira kuchuluka kwa mankhwalawo.

Komabe, pakalibe ma syringes a insulin, syringes zothandizirana 2 ml zitha kugwiritsidwa ntchito. Koma pankhaniyi, jakisoni amatha bwino motsogozedwa ndi dokotala.

Mbale zosavomerezeka ziyenera kusungidwa mufiriji, ndi zotseguka kutentha kwa firiji, chifukwa kuzizira kumafooketsa mphamvu ya mahomoni. Anthu odwala matenda ashuga amatha kupatsidwa jakisoni mu:

Komabe, kunyowa kwabwinobwino kumachitika ngati jakisoni wapangidwa m'mimba, momwe machitidwe ake amayenda kwambiri. Koma malowa asinthidwe, kuchoka pamalo a jekeseni womaliza ndi masentimita awiri. Kupatula apo, zisindikizo zimayamba kupanga pakhungu.

Musanayambe njirayi, sambani m'manja ndi sopo. Malo oyambitsa ndi chivundikiro chomata amasesedwa ndi mowa (70%).

Nthawi zambiri mukadzaza syringe, mumalowa mpweya wochepa, womwe umatha kusintha pang'ono. Chifukwa chake, ndikofunikira kuti muphunzire malangizo a kayendetsedwe koyenera.

Choyamba, zisoti zimachotsedwa mu syringe, kenako mpweya womwe umasonkhanitsidwa mkatimo muyeso wofanana ndi kuchuluka kwa insulin. Kenako, singano imayikidwa mu vial ndi mankhwalawo, ndipo mpweya wodziunjikira umamasulidwa. Izi sizimalola kuti phukusi lipangike m'botolo.

Chingwecho chizikhala cholunjika, chizigwirizira ndi chala chanu chaching'ono ndi dzanja lanu. Kenako, pogwiritsa ntchito piston, ndikofunikira kujambula mu syringe magawo 10 kuposa momwe akufunira.

Pambuyo pa piston, wothandizirayo amatsanuliranso m'botolo, ndipo singano imachotsedwa. Poterepa, syringe iyenera kukhala yowongoka.

Nthawi zambiri ndi shuga amapanga jakisoni wa orral. Ubwino wa njirayi ndi kusowa kwa kufunika kodzaza syringe ndi zovuta kutsata kwa mankhwalawa.

Ngati Protafan insulin imagwiritsidwa ntchito, njira yodzazira syringe imasiyana pang'ono. Mankhwalawa amakhala ndi nthawi yotha kuchitapo kanthu, amapezekanso m'mabotolo.

NPH-insulin ndi chinthu chowoneka bwino ndi mtundu wa imvi. Musanagwiritse ntchito, botolo lomwe lili ndi chipangizocho liyenera kugundidwa kuti lipereke matope m'madzi. Kupanda kutero, zotsatira za mankhwalawa sizingakhalire bwino.

Singano imamizidwa mumtsuko ndi mankhwalawo monga tafotokozera pamwambapa. Zitachitika izi, vial iyenera kumenyedwa nthawi 10 ndipo mankhwalawo amayenera kutengedwa mu syringe kwambiri. Madzi owonjezera akathiridwa m'mbale, syringe imachotsedwa.

Ndondomeko ya Zakudya Zaukhondo ndi Kuyang'anira Magazi a Magazi

Ndikofunikira kuti munthu wamkulu komanso mwana yemwe wapezeka ndi matenda ashuga azitsatira zakudya zamafuta ochepa. Zitsanzo zamagetsi:

• kadzutsa (4 XE) - gawo la phala la chimanga, kapu imodzi ya mkaka,
• chakudya (1 XE) - zipatso
• nkhomaliro (2 XE) - nyama, masamba, mbatata yosenda,
• tiyi wamadzulo (1 XE) - zipatso
• chakudya chamadzulo (4 XE) - phala ndi saladi, nsomba yophika,
• asanagone (1 XE) - kagawo ka mkate wathunthu ndi tiyi.

Zogulitsa zimatsutsana:

Chinsinsi cha Latin insulin

Onse odwala matenda ashuga ayenera kulembedwa ndi endocrinologist. Ali ndi ufulu kulandira insulin yaulere.

Chinsinsi cha Latin chimaperekedwa chomwe chikuwoneka ngati ichi:

• Rp: Insulini 6 ml (40 ED - 1 ml).
• Nthano zachabe No. 10.
• Jekeseni 10 ED (0.25 ml) pansi pakhungu katatu pa tsiku mphindi 20 musanadye.

Kodi zopanga insulin zabwino kwambiri ndi ziti?

Mankhwala a insulin amakono komanso omwe amagwiritsidwa ntchito masiku onse ndi awa:

• Chichewa. Awa ndi mankhwala abwino kwambiri. Amachepetsa shuga m'mphindi 15. Muli insulin yaumunthu. Sungani shuga wambiri kwa maola atatu,
• Gensulin N. Chithandizo chapakatikati. Amachepetsa shuga pambuyo ola limodzi pakatha maola 20. Malinga ndi malangizo, imakhala ndi zoyipa zochepa.
• Lantus. Uwu ndi mtundu wa mankhwala wokhalitsa. Zovomerezeka kwa maola 40.

Jakisoni wa insulin kapena mapiritsi: ndibwino bwanji?

Matenda a shuga amtundu woyamba amathandizidwa ndi insulin yokha. Odwala omwe ali ndi mtundu wachiwiri wa matenda angagwiritse ntchito mapiritsi kapena jakisoni.

Fomu ya kapisolo ndizosavuta kugwiritsa ntchito ndipo imapereka kuyang'anira kwa chilengedwe cha glucose. Nthawi yomweyo mapiritsi amakhudza kayendedwe ka chiwindi ndi impso.

Ndi kusankha kolakwika kwa mankhwalawo, pamakhala ngozi yotenga mtima. Zilonda pankhaniyi ndizotetezeka ndipo zimatha 100% kulowa m'malo mwa kapamba.

Makanema okhudzana nawo

About insulin chithandizo cha matenda a shuga a 1 ndi 2 mu kanema:

Chifukwa chake, shuga imathandizidwa ndi mapiritsi ochepetsa shuga kapena jakisoni wa insulin. Njira yoyamba ndi yoyenera kwa odwala amtundu wachiwiri. Chithandizo cha jakisoni ndiyo njira yokhayo yotumizira anthu omwe ali ndi mtundu woyamba wa matenda.

Insulin Therapy ndi Type 2 Shuga

Ntchito yazaumoyo ikuwoneka mwachangu pakuwonjezeka kwa kufalikira kwa matenda ashuga padziko lonse lapansi.Komanso, mayiko otukuka komanso otukuka pachuma amapezanso matendawa mofanananso.

Kuphatikiza apo, si akulu okha omwe amadwala matenda a shuga. Kuchulukirachulukira kumawonekera kwa ana ndi achinyamata.

Musaiwale kuti shuga mellitus (DM) yayamba kukhala nthaka yachonde yopititsa patsogolo mtima komanso matenda am'mimba.

Kodi shuga wamwazi ndi wowopsa motani?

Amakhulupirira kuti kuwonjezeka kwa shuga m'magazi kumakhudza kama wam'kati mwa michere komanso kuchepa kwa chizindikirochi kungakhale kothandiza pakukula kwa matenda ashuga nephropathy ndi retinopathy. Shuga wokwera, kapena hyperglycemia, nthawi zina zimakhala zovuta kuyendetsa ndipo nthawi zambiri kukwaniritsidwa kwa manambala sikuchitika.

Kukula uku kumachitika chifukwa cha magwiridwe osagwirizana a ma pancreatic beta cell. Ndiye chifukwa chake odwala omwe ali ndi matendawa mtundu 2 shuga Palibe zotsatirapo zabwino mukamamwa mankhwala ochepetsa shuga.

Chiwerengero chachikulu cha hyperglycemia sichikonzedwa, chithandizo chokwanira cha hypoglycemic sichikuchitika. Pankhani imeneyi, chiwopsezo cha zovuta za matendawa chimawonjezeka kangapo.

Kodi matenda osokoneza bongo ndi ati?

Mawu akuti "matenda a inertia" amatanthauza kusowa kwa mankhwala komanso kuthandizira kwa chithandizo chamankhwala pokhapokha ngati zikuwonetsa kuzipatala. Izi zimatchulidwa kwambiri pakugwiritsa ntchito kukonzekera kwa insulin.

Ichi ndichifukwa chake, pofuna kukonza njira zamankhwala ndikuchepetsa zovuta, ndikofunikira kugwiritsa ntchito glycemic mwachangu.

Kugwiritsa ntchito insulin koyambirira,, motero, kungakhale koyenera.

Zoyang'ana mukukwaniritsa Normoglycemia?

Pali mitundu itatu ya tizilombo toyambitsa matenda yomwe imayenera kukhazikitsidwa kuti ipangitse chiwongolero chokwanira cha glycemic:

• Kuperewera kwa insulin
• Kukana insulini
• Kuphwanya zochita za insulin.

Insulin yokha ndi yomwe ingachite mokwanira ndikuchotsera mfundo zonsezi.

Kulongosola kwa kukana insulini komanso kugwiritsa ntchito pamodzi kwa insulin

Maselo olimbana, mwachitsanzo, mafuta kapena minofu, amalimbana ndi insulini chifukwa cha kusachita bwino kwa zolandilira za insulin pamaso pawo kapena chifukwa cha kuwonongeka kwa zida za post-receptor.

Chifukwa chake, kuchuluka kwa shuga m'magazi kumachitika, ndipo ma cell a beta a kapamba (kapamba) amalabadira hyperglycemia ndi kuchuluka kwa insulin. Komabe, izi sizibweretsa zotsatira zabwino.

Popita nthawi, kuchuluka kwa insulin yosakanikirana kumachepa - kuchepa kwa insulin kumayamba. Pankhaniyi, hyperglycemia imangokulira.

Izi zikuwonetsa kuti kasamalidwe koyenera komanso koyenera ka glycemia kumapewetsa zovuta zambiri pakupanga shuga.

Chithandizo cha insulin choyambirira chimayambika, ndizosavuta kuyang'anira kuchuluka kwa glycemia mwa odwala omwe ali ndi matendawa mtundu 2 shuga. Pali kukambirana kwamkangano komanso kutsutsana za nthawi yokhudza mankhwala a insulin.

Sizingathekebe kuti mudzapeze mtundu wina wa yankho labwino.

Momwe mungabayire

Musanapange jakisoni wa matenda a shuga a 2, muyenera kukonza botolo la mankhwala ndi 70% ya mowa. Muyeneranso kupukuta dera lomwe thupi lanu limapangira jakisoni.

Khungu liyenera kuphatikizidwa ndi zala zanu kuti mutenge mawonekedwe, momwe mumafunikira kuyika singano. Insulin imayendetsedwa ndikanikizira wopangayo. Koma simuyenera kuchotsa singano yomweyo, chifukwa mankhwalawa amatha kutayikira. Pankhaniyi, fungo la Metacrestol lidzamveka.

Komabe, musabwezeretsenso mankhwalawa. Muyenera kungoona zotaika mu zolemba zodziletsa. Ngakhale mita ikuwonetsa kuti shuga akukwezedwa, chipepeso chimafunikabe kuchitika pokhapokha mphamvu ya insulin itatha.

Malo omwe khungu limapangidwira jakisoni amatha kutuluka magazi. Kuti muchepetse madontho a magazi m'thupi ndi zovala, kugwiritsa ntchito hydrogen peroxide ndikofunikira.

Ndizofunikira kudziwa kuti kuwonjezera pa insulin ya matenda a shuga, jakisoni wa Actovegin ndi vitamini B nthawi zambiri amamulembera (jakisoni wamkati kapena subcutaneous). Zotsirizazo zimagwiritsidwa ntchito ngati gawo la zovuta mankhwala a polyneuropathy. Actovegin ndiyofunikira vuto la matenda ashuga omwe amathandizidwa ndi IM, iv kapena amatengedwa pakamwa.

Ndikofunika kudziwa kuti njira ya i / m yoyendetsera sikuti ndiyosiyana ndi subcutaneous. Koma pankhani yomalizayi, simuyenera kuchita khungu.

Singano imayikidwira mbali yakumanja mu minofu ya minofu ku ¾. Pankhani ya njira yolowerera, njira yotere iyenera kuchitidwa ndi dokotala kapena namwino wodziwa ntchito. Koma jakisoni a iv samachitika kawirikawiri pomwe wodwalayo ali ndi vuto lalikulu.

Kuphatikiza apo, ndi matenda a shuga a 2, thioctic acid imagwiritsidwa ntchito nthawi zambiri. Itha kuyambitsidwa m'thupi mu / kukapanda kuleka kapena imatengedwa ngati mapiritsi.

Kupezeka kwa insulin

Insulin inatsegulidwa mu 1921 mumzinda wa Toronto. Ichi ndi chimodzi mwazofunikira kwambiri komanso zofunikira kwambiri ndizopeza zamankhwala nthawi yonse yomwe ilipo.

Pambuyo pazopezazo, insulin idayeretsedwa ndikuyamba kuyigwiritsa ntchito mwa anthu. Wodwala woyamba anali Leonard Thompson, yemwe adalandira insulin yoyeretsa pa Januware 11, 1922 mu chipatala cha Toronto.

Pambuyo pake, kupanga mankhwala omwe amapanga kuyeretsa kwapadera kunakhazikitsidwa.

Izi insulin idachokera ku nyama, inali ndi kanthawi kochepa, ndipo kuyambira 3 mpaka 4 jakisoni patsiku amafunikira kuti achire azitha.

Mu 1980, kupanga insulin yaanthu idakhazikitsidwa. Komabe, insulin iyi sinathebe kupatsa mtundu wa anthu ufulu wodziimira pakulimbana ndi matenda ashuga, motero ma fanizo a insulin yaumunthu omwe ali ndi nthawi yosiyanasiyana yopanga kanthu adapangidwa.

Mankhwala apamwamba kwambiri amapereka mwayi wotere:

• Insulin yochita ntchito mwachidule amayenera kupereka chiwongola dzanja, chomwe chimaphatikizidwa ndi zakudya,
• Kugwiritsa ntchito insulin nthawi yayitali.

Pansi pa zikhalidwe za thupi, pafupifupi theka la insulin yotulutsidwa imakhala mu basal yayitali. Zotsalira zimaperekedwa ndi insulin yayifupi, yomwe imapangidwa poyankha kudya.

Zisonyezo za insulin mankhwala a 2 shuga

Malinga ndi akatswiri a matenda ashuga ku Europe, mankhwala a insulin sayenera kuyamba molawirira kwambiri komanso osachedwa.

Osati chilonda, chifukwa kusakwanira kwachinsinsi kungakhale kwachiwiri kwa insulinitensity, komanso chifukwa cha chiopsezo cha hypoglycemia.

Sanachedwe, chifukwa ndikofunikira kukwaniritsa kuyenera koyenera ka glycemic.

Momwe mungayambitsire mankhwala a insulin?

Type 2 shuga matenda m'malingaliro onse, kuyendetsa insulin patsogolo pang'onopang'ono ndi nkhani ya nthawi.

Pakadali pano, imatengedwa kuti ndi yachikhalidwe kupatsa mankhwala awiri ochepetsa shuga. Pambuyo pazaka 10-15 kumwa mapiritsi, amapita kumapeto - insulin.

Kuchedwa kwa njirayi chithandizo kumafotokozedwanso ndikuti jakisoni ndi ofunika, hypoglycemia ikhoza kukhala, ndipo wodwalayo amatha kulemera kwambiri. Komabe, odwala ambiri amakhulupirira kuti zotsatira zake ndizosakhazikika, zolimba pang'ono.

Zomwe sizikuyenda bwino zimachepetsa chithandizo ngati chithandizo chosankhidwa mosayenera chidayambitsa zovuta pafupipafupi za hypoglycemic.

Dziwani kuti kuperekedwa kwa nthawi yochepa ya mankhwala a insulin kumayambiriro kwa matendawo kumatha kubweretsa kuchotsedwa kwa nthawi yayitali komanso kufanana kwa glycemia popanda chifukwa chogwiritsira ntchito mankhwala ochepetsa shuga.

Komabe, ambiri omwe amatsatira endocrinologists savomereza njirayi ndipo amalimbikitsa chithandizo chamankhwala. Zachidziwikire, pali nthawi zina pomwe kuyamba kwa insulin kuyenera kwambiri.

Mwachitsanzo, ndi kugwiritsa ntchito mankhwala osachepetsa shuga m'migawo yoyambirira, insulin imayikidwa. Kuchokera ku mankhwalawa, moyo wabwino komanso kukhutira kwa wodwala ndi chithandizo kumachulukitsidwa kangapo.

Kafukufuku wambiri awonetsa kuti hyperinsulinemia ndiyomwe imayambitsa kukula kwa atherosulinosis. Kuphatikiza apo, kugwiritsidwa ntchito koyambirira kwa insulin ngati mankhwala kumatha kubweretsa kupangika kwa matenda a mtima (CHD). Koma mpaka pano, palibe zambiri zolondola komanso zodalirika pankhani yolumikizayi.

Musanayambe mankhwala a insulin, ndikofunikira kudziwa ndikuganizira zinthu zingapo zomwe zingakhudze njirayi. Kuchokera kwa iwo tikuwonetsa kuti:

• kulemera kwa thupi
• zonena za moyo
• Kukhalapo, kuopsa kwa kusintha kwamphamvu kwambiri,
• Kulephera kwa chithandizo cham'mbuyomu.

Kuti muwonetsetse kuti chithandizo cha insulin ndi chofunikira, ndikofunikira kudziwa kuchuluka kwa maselo a pancreatic beta pozindikira kuchuluka kwa C-peptide yopanga.

Muyenera kuyamba mankhwalawa a insulin a 2 matenda a shuga:

• ali ndi hyperglycemia yayikulu komanso yayikulu mankhwala ochepetsa shuga,
• kuwonda mwadzidzidzi
• otsika C-peptide.

Monga chithandizo chakanthawi, insulin imayikidwa ngati pakufunika kuchepetsa matenda a glucose omwe ali ndi kuchuluka kwa magazi. Kafukufuku wasonyeza kuti mankhwala a insulin amachepetsa kwambiri mwayi wokhala ndi zovuta za microvascular.

Ubwino wa Chithandizo cha Insulin Yoyambirira

Mtundu 2 wa shuga, mankhwala a insulin ali ndi zotsatirazi zabwino komanso zabwino zake:

• amathetsa kuwopsa kwa shuga m'magazi,
• kukhazikitsidwa kwa insulin koyambirira kwa matendawa kumapangitsa kukula kwa chikhululukiro,
• kusanthula mwachangu kwa glycemia kumakupatsani mwayi wambiri tsiku ndi tsiku,
• ndi kuchuluka kwa matenda ashuga, ndikofunikira kubwezeretsa kuchuluka ndi insulin m'magazi,
• Njira yodziwira chithandizo cha insulin imapereka chitetezo kwa wodwala kuchokera ku matenda a hypoglycemia ndi matenda ashuga.

Type 2 matenda a shuga: chithandizo cha insulin

Matenda a shuga ndi matenda osachiritsika omwe amapezeka m'moyo wonse. Mwa anthu omwe ali ndi matenda a shuga a 2, ntchito ya maselo a pancreatic beta amapezeka ndi pafupifupi 5% pachaka kuyambira pomwe matendawa amapezeka.

Chifukwa chake, pakupita nthawi, mphamvu ya mankhwala othandizira pakudya, kuchita masewera olimbitsa thupi ndikuchiritsira mapiritsi ochepetsa shuga amachepetsa ndipo anthu amafika poti amakakamizidwa kuchita jakisoni wa insulin.

Yambikani ndi kuphatikiza insulin ndi mankhwala a pakamwa Metformin, kapena sinthani kwathunthu ku insulin.

Munkhaniyi tikambirana makamaka za chithandizo cha odwala matenda amishuga amtundu wa 2 omwe ali ndi insulin.

Zoyenera kuchita kuti muchepetse mlingo wa insulin yoperekedwa?

Kudya zakudya zopatsa mphamvu kwambiri kumayambitsa shuga wambiri, amene amafunika jakisoni wa insulin. Komabe, kuchuluka kwa mahomoni ambiri omwe amalowetsedwa kumatha kuchepetsa kwambiri shuga, zomwe zimapangitsa kuti hypoglycemia, iyenso ikhale ndi zovuta zake.

Chifukwa chake, muyenera kuyang'anitsitsa kuchuluka kwa chakudya chamafuta, chifukwa momwe mankhwalawa amachepetsera. Ndipo izi zikuthandizani kuti muziwongolera molondola kuchuluka kwa shuga m'magazi.

Zakudya zomanga thupi ziyenera kusinthidwa ndi mapuloteni, amenenso ali chinthu chopatsa thanzi, komanso mafuta azamasamba athanzi. Mu gulu la zomwe zaloledwa kukhala ndi matenda a shuga a 2 ndi:

1. tchizi
2. kudya nyama
3. mazira
4. nsomba zam'nyanja
5. soya
6. masamba, makamaka obiriwira, koma osati mbatata, popeza ali ndi mafuta ambiri,
7. mtedza
8. kirimu ndi batala pang'ono,
9. yogati yopanda mafuta komanso yogulitsa tchire.

Mbale, maswiti, zakudya zokhuthala, kuphatikiza masamba ndi zipatso, ziyenera kuchotsedwa muzakudya. Tiyeneranso kusiya kanyumba tchizi ndi mkaka wonse.

Ndizofunikira kudziwa kuti mapuloteni amawonjezera kuchuluka kwa shuga, koma ndi zochepa. Chifukwa chake, kudumphira koteroko kumatha kuzimitsidwa msanga, zomwe sizinganenedwe za chakudya chamafuta.

Zofunikanso m'moyo wa munthu wodwala matenda ashuga amene safuna kudalira insulin uyenera kukhala masewera. Komabe, katundu ayenera kusankhidwa posamalira, mwachitsanzo, kuthamanga kwapadera. Mutha kupita kukasambira, kupalasa njinga, tenisi kapena masewera olimbitsa thupi ndi masewera olimbitsa thupi. Momwe mungayang'anire insulin adzakuwuzani ndikuwonetsa kanemayo munkhaniyi.

Njira zazikulu zakugwiritsira ntchito mankhwala a insulin

Cholinga cha mankhwala a insulini ndikukhazikika m'magazi a glucose kuti zitheke kupindika.

Mukamawerengera kuchuluka kwa insulini, kufunikira kwa tsiku ndi tsiku kwa wodwala ka insulin kumawerengeredwa poyamba. Mwa munthu wathanzi, chofunikira cha tsiku ndi tsiku chimakhala pafupifupi 30-70 U / tsiku, pomwe basal secretion ya 1 U / h.

Pakudya, pamakhala kuchuluka kwa insulin - pafupifupi magawo 1-2 pa 10 g ya chakudya chambiri chakudya. Nthawi yomweyo, muyeso wina umawonedwa pakati pa kuchuluka kwa insulin m'magazi ndi kufunika kwa thupi la munthu.

Odwala omwe ali ndi matenda a shuga 2, chizoloŵezi cha tsiku ndi tsiku chimawerengedwa mosiyanasiyana, poganizira moyo wa munthu.

Otsatirawa ndi zitsanzo zojambula:

- pamaso pathupi kapangidwe ka insulin wamba, kapena ka 0.3-0.8 U / kg,

- pamaso pa insulin yaying'ono kwambiri yopanga anthu omwe ali ndi matenda a nthawi yayitali, kufunikira ndi 0.7-0.8 U / kg,

- chifukwa cha matenda omwe angopezedwa kumene - 0.5 U / kg,

- atatha kulipira, mankhwalawo amachepetsa kukhala 0,3-0.4 U / kg.

Komabe tikubwereza kuti zonsezi zimawerengeredwa mosiyanasiyana.

Mankhwala ndi insulin, mitundu iwiri ya mankhwala a shuga amatha kusiyanitsidwa:

Chithandizo cha mankhwala a insulin imakhala ndi jakisoni wa tsiku ndi tsiku 2 pa tsiku la mitundu iwiri ya insulin (yowonjezera komanso yocheperako) musanadye chakudya cham'mawa komanso musanadye.

Nthawi zakudya ziyenera kusinthidwa malinga ndi nthawi ya jakisoni wa insulin ndipo iyenera kuyang'aniridwa mosamalitsa.

Mwanjira imeneyi, odwala amasakaniza insulin yochepa komanso yayitali ndikupanga jakisoni (2/3 ya zofunika tsiku ndi tsiku) mphindi 30 asanadye chakudya cham'mawa ndi mphindi 15 asanadye (1/3 ya zofunika tsiku ndi tsiku).

Ngati mumagwiritsa ntchito ma insulin analogi osakhalitsa, ndiye kuti mutha kupanga jakisoni musanadye. Onetsetsani kuti mukuyang'ana kuchuluka kwa shuga.

Nthawi yomweyo amasintha moyo wawo, kupezeka kwa zochitika zolimbitsa thupi ndi kuchuluka kwa chakudya (kuchuluka kwa chakudya chamagulu mu XE).

Ngati pali zochitika zolimbitsa thupi, mlingo wa insulin uyenera kuchepetsedwa musanadye chakudya kuti muchepetse vuto la hypoglycemia (kutsitsa shuga).

Nthawi zambiri, chithandizo chamankhwala sichokwanira kukweza kuchuluka kwa glucose m'magazi ndikusintha analimbitsa mankhwala. Ndi chithandizo chamtunduwu, odwala amadzipaka jakisoni wochepa 3 pakanthawi kadzutsa, chakudya chamadzulo ndi chakudya chamadzulo, ndipo kawiri pa tsiku amadzipatsa jakisoni wa insulin wa nthawi yayitali komanso asanagone (nthawi zambiri amakhala maola 22-23).

Mlingo wa insulin yochepa udzasinthasintha malinga ndi chakudya komanso kuchuluka kwa shuga musanadye. Mwa awa, pafupifupi 60-50% ya mlingo wa tsiku ndi tsiku amagwera ma insulin osakhalitsa (ogawidwa malinga ndi kuchuluka kwa chakudya) ndipo 40-50% imagwera pama insulin (2/3 m'mawa ndi 1/3 madzulo).

Kwambiri mankhwala amathandizira kukhazikika m'magazi a glucose kuposa chithandizo chamankhwala.

Kapenanso, ma insulin oyenda pakatikati komanso insulin yocheperako amatha kusakanikirana komanso kutumikiridwa kawiri pa tsiku ndipo chakudya chimasinthidwa nthawi ya jakisoni. Jakisoni imodzi imalungamitsidwa ndi mulingo wokhazikika wa glucose komanso kuchepetsedwa tsiku lililonse kwa insulini (osakwana 30-40 U / tsiku). Nthawi zambiri Mlingo 2/3 umaperekedwa musanadye kadzutsa komanso 1/3 musanadye chakudya chamadzulo.

Pali njira zambiri zoyendetsera insulin ndipo adokotala amawasankha mosiyanasiyana.

- musanadye chakudya cham'mawa, magawo 7 a insulin yochepa amaperekedwa,

- nthawi ya nkhomaliro - magawo 10 a insulin yayifupi,

- musanadye chakudya cham'ma 7 kachiwiri cha insulin yochepa.

Nthawi yomweyo, magawo 10 a insulin-sing'anga amalekedwa m'mawa ndipo 6 magulu ake a mankhwalawa. Poterepa, onetsetsani kuti mwayang'ana shuga. Ngati m'mawa adawuka, ndiye:

- ndi shuga 11-12 mmol / l-on 2U kuwonjezera kuchuluka kwa insulin yochepa musanadye,

- pa 13-15 mmol / l-pa magawo anayi a insulin yochepa,

- pa 16-18 mmol / l-pa 6 magawo a insulin yochepa,

- pamwambapa 18 mmol / l-pa magawo 12 a insulin yochepa.

Kumbukirani kuti mlingo wa insulin yayitali nthawi ya masana uyenera kukhala wowirikiza kawiri kuposa maola amadzulo, kuti mupewe usiku hypoglycemia. Osagona ndi shuga shuga wamadzulo a 5.6 mmol / L kapena kutsikira - mwakutero mukuyenera kukumana ndi hypoglycemia. Pankhaniyi, mlingo wa insulin uyenera kukhala wocheperako komanso chakudya.

Anthu omwe ali ndi matenda a shuga a 2 ayenera kuwongolera kuchuluka kwa shuga pafupipafupi monga amachitira ndi matenda amtundu 1 shuga - osachepera kanayi pa tsiku (nthawi zina nthawi zambiri).

Malangizo ena othandiza: mutabayidwa jekeseni wocheperako patatha maola awiri, muyenera kudya, ndipo pambuyo pobayidwa jakisoni wambiri wa insulin uyenera kuchitidwa maola 4 aliwonse, komaliza nthawi yayitali mpaka maola 1-2 musanagone.

Zoyambira zamatenda a insulin kwa odwala omwe ali ndi matenda a shuga a 2 ndizofanana zofanana ndi omwe amathandizidwa ndi matenda amtundu wa 1 shuga, komabe pali kusiyana komwe kungachitikebe pakubisidwa kwa insulin.

Ndipo kumbukirani: dokotala yekha ndi amene angakuthandizeni kusankha mitundu yoyenera yamankhwala!

Malangizo pankhani yodzipenda wekha wa matenda ashuga omwe tikambirana munkhani zotsatirazi.

Penyani shuga wanu wamagazi mosamala ndikukhala wathanzi!

Mankhwala a shuga

Chithandizo cha matenda a shuga chimaphatikizapo kuikidwa kwa mankhwala, kugwiritsa ntchito zitsamba, masewera olimbitsa thupi komanso kudya No. 9. Chakudya chizikhala chosinthika komanso chokwanira. Zakudya ziyenera kumwedwa kangapo pa tsiku.

Chithandizo cha mankhwala osokoneza bongo

Ndi matenda a shuga, regimen ya jakisoni wambiri wa insulin nthawi zonse amakhazikika. Izi ndizofunikira makamaka kwa matenda ashuga amtundu woyamba, chifukwa amadziwika kuti amadalira insulin. Mtundu 2 wa shuga, mankhwala a insulin sagwiritsidwa ntchito pazochitika zonse. Ndi endocrinologist wokhayo amene amapanga mankhwala a insulin, potengera kuchuluka kwa shuga, machitidwe a matenda am'mimba ndi zina zofunika.

Malamulo oyambira a insulin