Mankhwala a insulin: mitundu, zisonyezo, makamaka

Nthawi zambiri, inulin secretion imachitika mosalekeza ndipo imakhala gawo limodzi la mahomoni ola limodzi. Chizindikirochi ndichobisalira kapena poyambira maziko. Kudya kumakwiyitsa mwachangu, ndiko kuti, kuwonjezeka kwa bolus m'ndendende nthawi zambiri. Katemera wolimbikitsidwa ndi magawo 1-2 pa 10 g iliyonse ya mafuta omwe amatengedwa. Pankhaniyi, thupi limasunga malire pakati pa kuzungulira kwa mahomoni a kapamba ndi kufunika kwake.

Odwala omwe ali ndi mtundu woyamba wa matenda amafunika chithandizo chamankhwala, chomwe chimatsenga chinsinsi cha mahomoni m'thupi. Kuti muchite izi, gwiritsani ntchito mitundu yosiyanasiyana ya mankhwala nthawi zosiyanasiyana. Chiwerengero cha jakisoni chimatha kufikira 4-6 patsiku. Odwala omwe ali ndi mtundu wachiwiri wa matenda ashuga, koma opulumutsidwa ndi beta-cell amafunika katatu kuyambitsa kwa mankhwalawa kuti athe kulipira.

Ndondomeko ya insulin yothandizira imakhala ya aliyense payekha kwa wodwala aliyense ndipo zimatengera cholinga chachikulu pakuwongolera glycemic. Mpaka pano, pali mitundu ya chithandizo chotere:

1. Kukhazikitsidwa kwa mankhwala 1 nthawi patsiku kumagwiritsidwa ntchito pochiza odwala omwe ali ndi mtundu woyamba ndi wachiwiri wa matenda.
2. Kuperekera kwa mankhwala 2 kawiri pa tsiku ndi imodzi mwazomwe amadziwika kwambiri ndi odwala omwe ali ndi mtundu woyamba wa matenda a shuga. Mlingo wa mankhwalawa amagawidwa motere: 2/3 ya mlingo musanadye kadzutsa komanso 1/3 chakudya chisanafike.
3. Jakisoni zingapo patsiku - wodwalayo amakhala ndi ufulu wosankha masana, popeza nthawi yakudya ndi jakisoni sichinakhazikitsidwe. Mankhwalawa amaperekedwa katatu kapena kupitirirapo patsiku.

Nthawi zonse, 40% ya mlingo wonsewo umaperekedwa asanagone. Pano, mankhwala a nthawi yayitali komanso nthawi yayitali amagwiritsidwa ntchito. Mlingo wotsalawo umagwiritsidwa ntchito mphindi 30 musanadye katatu kamodzi patsiku. Nthawi zambiri amagwiritsa ntchito mitundu yokhazikika komanso yozama.

Mankhwala a insulin

Endocrinologist ikugwira ntchito pakusankha njira yoyenera kwambiri yoperekera mankhwala ndi kukonza insulin. Ntchito ya udokotala ndikupeza malipiro okwanira a kuphatikiza kagayidwe kachakudya kosakanikirana tsiku lililonse m'magazi a glucose komanso chiopsezo chochepa kwambiri chotenga zovuta za matendawa.

Mukamapangira njira yothandizira kuchipatala, zinthu ngati izi zimaganiziridwa:

• Mawonekedwe a shuga: amalipidwa, osalipidwa.
• Mtundu wa insulin yomwe imagwiritsidwa ntchito komanso kuchuluka kwa mankhwalawa. Mokulirapo mlingo, wosachedwa kuyamwa, koma motalikirapo mphamvu ya mankhwalawo.
• Webusayiti ya jakisoni - ikalowetsedwa ntchafu, kuchuluka kwa mayamwidwe kumakhala kwakukulu kuposa komwe kumabayidwa mapewa. Potere, jakisoni wam'mimba ndiwothandiza kwambiri kuposa jakisoni m'mapewa, omwe amachepetsa.
• Njira yoyendetsera mankhwala makamaka magazi am'deralo. Intramuscular management imadziwika ndi kuyamwa mwachangu, koma mwachidule, jekeseni wa subcutaneous m'malo mwake.
• Kutikita minofu ndi kutentha kwanuko - kuwunikira koyambirira kwa malo a jekeseni kumakulitsa kuchuluka kwa mankhwalawa. Izi zimawonedwa pakukweza kutentha kwa thupi.

Nthawi zambiri, odwala amayamba kugwiritsa ntchito mankhwalawa a insulin:

1. Chikhalidwe - tsiku ndi tsiku makonzedwe a mankhwala osachepera jakisoni, koma chimodzimodzi. Kukonzekera mwachidule komanso kwa nthawi yayitali kumagwiritsidwa ntchito mwa kuchuluka kwa 30:70, ndiye kuti, 2/3 ya mlingo wa tsiku ndi tsiku musanadye kadzutsa ndi 1/3 musanadye chakudya chamadzulo. Chiwembuchi ndi choyenera kwa magulu ochepa a odwala, chifukwa samapereka chindapusa chonse cha mahomoni, chifukwa zosowa zake zimatha kusintha tsiku lonse.
2. Zowopsa - zimafanana ndi katulutsidwe kathupi ka mahomoni. Amakhala ndi jakisoni wokhala ndi nthawi yayitali m'mawa ndi madzulo, komanso jekeseni wocheperako yemwe amagwiritsidwa ntchito nthawi iliyonse asanadye.

Kuti mupeze dongosolo la mankhwala, ndikofunikira kudziwa kuchuluka kwa glycemia ndikuwunikira nthawi zonse. Izi zikuthandizani kusankha mlingo woyenera kwambiri. Komanso, odwala amalangizidwa kuti azisunga diary yapadera, ndikujambulamo m'miyeso yama mkate, kuchuluka kwa timadzi tambiri, zochitika zolimbitsa thupi ndi zovuta zomwe zimadza. Chifukwa cha izi, ndizotheka kusanthula zolakwika zamankhwala ndikuwongolera zomwe mwaphunzira.

Werengani za pompo insulin mankhwala munkhaniyi.

Virtuoso Insulin Therapy

Chithandizo china cha matenda ashuga ndi njira ina yotchedwa fortoso insulin therapy. Njirayi idapangidwa ndi dokotala waku Peru, a Jorge Kanales, omwe adadwala matenda amtunduwu kuyambira ali mwana. Njira yake idakhazikitsidwa pakuwunikira zovuta zonse zomwe zimapangidwa ndi maselo a beta a kapamba. Kanales adatsimikizira kuti chilichonse chopangidwa ndi thupi, monga insulini, chimagwira ntchito zokhudzana ndi chilengedwe ndipo ndizofunikira pamavuto a metabolic.

Virtuoso insulini imakupatsani mwayi wosankha mlingo woyenera kwambiri wa mahomoni omwe amaperekedwa kwa odwala omwe ali ndi matenda amtundu wa 2 komanso a 2. Chinsinsi cha njirayi pakugwiritsa ntchito ma coefficients:

• Chakudya - ichi ndiye mgawo la mkate, ndiye kuti kuchuluka kwa insulin chifukwa cha kuyamwa kwa gawo limodzi la chakudya.
• Kuwongolera ndi chizindikiro cha glycemic, ndiye kuti kuchuluka kwa insulin pa 1 mmol / l glucose m'magazi kuposa kuchuluka kwazomwe zimachitika.

Ma coefficients amawerengedwa molondola kwambiri kwa malo 4 omaliza, koma padera pa nthawi isanayambike kadzutsa, kuyambira m'mawa mpaka chakudya cham'mawa ndikatha chakudya chatha. Mlingo woyerekeza umakhala wazigawo zonse za 0,5 zamahomoni omwe amapatsidwa. Mtengo uwu ndi gawo la mankhwalawa mukugwiritsa ntchito syringe ya insulin.

Malinga ndi kafukufuku, pogwiritsa ntchito njira ya mankhwala a incloso, wodwala wokhala ndi thupi lolemera makilogalamu 70 ndikuyeretsa magazi shuga maulendo 4-5 patsiku amatha kuusunga mulingo wa 4-7 mmol / l tsiku lonse.

Anakulitsa Insulin Therapy

Chodabwitsa cha regimen iyi ndikuti mlingo wa tsiku ndi tsiku umagawidwa pakati pa insulin yochepa (yogwiritsidwa ntchito mukatha kudya) ndikuchitapo kanthu nthawi yayitali (imagwiritsidwa ntchito m'mawa komanso pogona kuti mugwiritse secretion ya basal).

Zambiri za njira yolimbikitsidwira:

• Kutsatira kwa secretion wa mahomoni: basal ndi chakudya.
• Kupewa mavuto ndi kuwongolera kwa kagayidwe kachakudya mthupi.
• Kufunika kochita phunziroli powerengera kuchuluka kwa mankhwala ndi makonzedwe a mankhwalawo.
• Kudziwona wekha pafupipafupi.
• Kuchuluka kwa hypoglycemia.

Dongosolo loyang'anira mahomoni amawerengedwa ndi endocrinologist. Dokotala amakumbukira kufunika kwa tsiku ndi tsiku kwa zopatsa mphamvu. Wodwalayo amamulembera zakudya zomwe zimawerengera zakudya zomwe zimawerengedwa m'magawo a mkate, ndi mapuloteni ndi mafuta m'magalamu. Kutengera ndi deta zonsezi, kuchuluka kwa mankhwalawa tsiku lililonse kumatsimikiziridwa, komwe kumagawidwa tsiku lonse.

Mwachitsanzo, ngati munthu wodwala matenda ashuga amapanga jakisoni 3 kokha patsiku, ndiye kuti mahomoni ofupikirapo komanso nthawi yayitali amawatumizira chakudya cham'mawa komanso chakudya cham'mawa, komanso yochepa asanadye chakudya chamadzulo. Malinga ndi chiwembu china, mankhwala achidule komanso apakatikati amagwiritsidwa ntchito musanadye chakudya cham'mawa, nthawi yochepa musanadye chakudya chamadzulo komanso nthawi yapakatikati musanayambe kugona. Njira yoyenera yoyendetsera mankhwalawa mulibe, aliyense, wodwala aliyense amakhala ndiokha.

Mfundo za regimen yowonjezerayo ndikuti poti ma jakisoni opangidwa nthawi zambiri, zimakhala zosavuta kusinthanitsa ndi zosowa za odwala tsiku lonse. Mulimonsemo, jekeseni iliyonse isanachitike, ndikofunikira kudziwa kuchuluka kwa glycemia ndikuyeza muyeso wa insulin. Kupambana kwamankhwala kumakhazikitsidwa paudindo wa wodwala ndikuwazindikira kwake ma nuances a njira.

Bolus insulin mankhwala

Munthawi yabwinobwino, kuchuluka kwa insulin kumawoneka m'magazi pamimba yopanda kanthu, ndiye kuti. Zikondwererozo zimalimbitsa mahomoni pakati pa chakudya. Gawo limodzi la insulini limasinthasintha ndipo limasunga shuga m'magazi, kuletsa kudumpha kwake, ndipo lachiwiri limachita nawo chakudya.

Kuyambira pachiyambire kudya chakudya mpaka maola 5-6 mutatha kudya, zomwe zimatchedwa bolus insulin zimapangidwa m'thupi. Imaponyedwera m'mwazi mpaka shuga wonse atalowetsedwa ndi maselo ndi minyewa ya thupi. Pakadali pano, mahomoni azomwe akuchita, zomwe ndi, zotsutsana nawo, amaphatikizidwa mu ntchitoyi. Amaletsa kusintha kwamisempha.

Mankhwala a insulin a Bolus amatengera kudzikundikira kwa mahomoni ndikukhazikitsa mankhwala osakhalitsa kapena otenga nthawi yayitali m'mawa / asanagone. Njirayi imakuthandizani kuti muzitsatira magwiridwe antchito a omwe akhudzidwa.

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Chithandizo cha mankhwala a insulin

Njira yodziwika bwino kwambiri ya matenda a shuga ndi njira yachikhalidwe kapena yophatikizira. Zimakhazikika pakuphatikiza mitundu yonse ya mankhwala jekeseni imodzi.

• Chiwerengero cha jakisoni sichidutsa 1-3 patsiku.
• Palibe chifukwa chowunikira kosalekeza kwa zizindikiro za glycemic.
• Kukhala bwino.
• Oyenera odwala okalamba komanso omwe ali ndi vuto lamaganizidwe, komanso odwala osaphunzitsidwa bwino.

Koma njirayi imafuna kutsatira kwambiri zakudya zomwe zimadalira mlingo wa mankhwalawo. Ndikofunikanso kutsatira zomwe timachita tsiku ndi tsiku ndikukhalabe olimbitsa thupi. Payenera kukhala zakudya zisanu ndi zisanu ndi chimodzi patsiku panthawi yolimbikitsidwa.

Mlingo wa tsiku ndi tsiku wa insulin amawerengedwa ndi endocrinologist, kenako ndikugawa malinga ndi dongosolo:

• 2/3 - chakudya choyamba.
• 1/3 - chakudya chisanafike.

Kuchuluka kwa mahomoni ochita ntchito kwa nthawi yayitali kuyenera kukhala m'mitundu ya 60-70%, ndi lalifupi 30-40%. Nthawi yomweyo, odwala omwe amagwiritsa ntchito njira zamwambo ali pachiwopsezo chotenga matenda a atherosulinosis, hypokalemia, ndi ochepa hypertension.

Type 1 matenda a shuga a insulin

Mtundu woyamba wa shuga 1 umadziwika ndi kuperewera kwenikweni kwa insulin. Zikondamoyo sizitulutsa timadzi kapena kutulutsa timadzi tambiri pamlingo wochepa kwambiri, womwe sungathe kupanga shuga. Kutengera izi, chithandizo cha insulin ndi gawo lofunikira.

Kuchiza kumakhazikika pakukhazikika kwa mahomoni, popanda zomwe kukomoka kwa ketoacidotic kapena hyperglycemic kumayamba. Mankhwalawa amateteza matenda a glycemia, amathandizira kukula komanso kugwira ntchito kwathunthu kwa thupi. Amasinthiratu ntchito yokhudza thupi ya kapamba.

Pali mitundu ingapo ya insulin yomwe imagwiritsidwa ntchito pochiza matenda amtundu 1

• Kuchita pang'ono - jekeseni pamimba yopanda chakudya musanadye. Imayamba kuchita mphindi 15 pambuyo pa jakisoni, nsonga ya ntchito imayamba pambuyo pa mphindi 90-180. Kutalika kwa ntchito yake kumatengera mlingo, koma monga lamulo, ndiola maola osachepera 6-8.
• Kuwonetsedwa kwapakatikati - kutumikiridwa m'mawa ndi madzulo. Zotsatira akuyamba pambuyo 2 mawola jakisoni ndi nsonga ya ntchito pambuyo 4-8 maola. Imagwira ntchito maola 10-18.
• Kuwonekera kwa nthawi yayitali - kumayamba kugwira ntchito patatha maola 4-6 jakisoni, ndipo ntchito yayikulu imayamba pambuyo maola 14. Zotsatira zamtunduwu wa mankhwala ndizopitilira maola 24.

Dongosolo la mankhwala ndi mlingo wake amawerengedwa ndi adotolo, poganizira zinthu zambiri. Wodwalayo akuwonetsedwa kumayambiriro kwa mankhwala oyambira 1-2 pa tsiku, komanso musanadye chakudya chilichonse - bolus. Kuphatikiza kwa njirazi kumatchedwa njira ya bolus, ndiko kuti, kayendetsedwe kambiri ka mahomoni. Imodzi mwa mitundu ya njirayi ndi insulin Therapy.

Chiwembu chogwiritsira ntchito mahomoni a mtundu woyamba wa shuga ndi motere:

• Asanadye chakudya cham'mawa, yochepa ndikuchita insulin.
• Asanadye - chakudya chochepa.
• Asanadye - chakudya chochepa.
• Asanagone - amakhala nthawi yayitali.

Malinga ndi kafukufuku, njira yokhazikitsidwa yoyenera komanso yolingaliridwa moyenera mu 75-90% ya milandu yamatendawa imalola kuti isinthidwe ndikusiya chikhululukiro chakanthawi ndikukhazikitsa njira yochepetsera, ndikuchepetsa kukula kwa zovuta.

Type 2 matenda a shuga a insulin

Mtundu wachiwiri wa matenda ashuga ndi osadziimira pawokha, ndiye kuti thupi silifunikira mahomoni ena owonjezera. Koma nthawi zina, chitetezo cha mthupi chimagwira maselo a pancreatic beta. Chifukwa cha izi, gawo lalikulu la maselo omwe timadzi timene timatulutsa timamwalira. Izi zimachitika ndi kadyedwe kosasangalatsa komanso kosapatsa thanzi, moyo wopumira, komanso kupsinjika kwakanthawi.

Zizindikiro zazikulu za mankhwala a insulin a 2 matenda a shuga ndi awa:

• Kuchulukitsa kwa matenda osachiritsika kapena matenda opatsirana a m'thupi.
• Opaleshoni yotsatira.
• Matupi a Ketone mkodzo.
• Zizindikiro zakulephera kwa insulin.
• Kuphwanya impso, chiwindi.
• Mimba komanso kuyamwa.
• Kuthetsa madzi m'thupi
• Precoma, chikomokere.

Kuphatikiza pazomwe zafotokozeredwa pamwambapa, insulini imalembedwa kuti pakhale matenda oyamba a shuga komanso kuchuluka kwa shuga pamimba yopanda kanthu, yomwe imapitilira tsiku lonse. Kuwongolera kwina kwa horoni ndikofunikira pamene glycated hemoglobin ili pamwamba pa 7%, kuchuluka kwa C-peptide kumakhala m'munsi mwa 040 nmol / L, pambuyo pazoyang'anira mkati mwa 1.0 mg ya glucagon.

Chithandizo chimachitika molingana ndi chiwembu chopangidwa ndi adokotala. Chithandizo chake ndikuwonjezereka kwapang'onopang'ono mu Mlingo woyambira. Njira zazikulu zotsatirazi za insulin makulidwe zimasiyanitsidwa:

• Jekeseni imodzi ya mankhwala a nthawi yayitali kapena kuchita nthawi yayitali musanadye kadzutsa kapena asanagone.
• Kusakaniza kwa wobiriwira pakati komanso kwa nthawi yayitali kumathandizira kuchuluka kwa 30:70 mu jekeseni imodzi yokhazikika musanadye kadzutsa kapena musanadye chakudya chamadzulo.
• Kuphatikiza kwa mankhwala apakatikati kapena yochepa / yochepa yochepa musanadye chilichonse, i.e. 3-5 jekeseni patsiku.

Mukamagwiritsa ntchito mahomoni a nthawi yayitali, mulingo wambiri wa magawo 10 patsiku umalimbikitsidwa, nthawi yomweyo. Ngati matenda a pathological akupitilizabe kuyenda, ndiye kuti wodwalayo amasamutsidwira kumankhwala onse a insulin. Kukhazikika kwa mahomoni opanga ndi kofunikira kwa odwala omwe samamwa mankhwala osokoneza bongo kuti achepetse shuga la shuga ndipo samatsatira malangizo oyambira okondweretsa.

Mimba insulin mankhwala

Matenda a shuga omwe amapezeka pa nthawi ya mimba si matenda athunthu. Pathology imawonetsa kuthekera kwa kusagwirizana ndi zosavuta za shuga ndipo ndiwopseza matenda a shuga. Pambuyo pobadwa, matendawa amatha kutha kapena kupita patsogolo.

Nthawi zambiri, zovuta m'matumbo zimayenderana ndi kusintha kwa mahomoni. Palinso zinthu zingapo zomwe zikuthandizira pakukula kwa matendawa:

• Kunenepa kwambiri.
• Matenda a metabolism.
• Amayi omwe ali ndi zaka zopitilira 25.
• Mbiri yakale ya matenda ashuga.
• Polyhydramnios ndi zina zambiri.

Ngati matenda a shuga akakhala kwa nthawi yayitali ndipo kuchuluka kwa glucose sikuchepa, dokotala amamulembera insulin. Pakati pathupi, ndimatha kupatsa insulini yokhala ndi shuga wamba. Zilonda zimasonyezedwa m'malo otere:

• Kutupa kwambiri kwa minofu yofewa.
• Kukula kwambiri kwa mwana wosabadwayo.
• Polyhydramnios.

Popeza kagayidwe kachakudya mthupi la mayi woyembekezera sikakhazikika, kusinthasintha kwapafupipafupi kumachitika. Monga lamulo, mankhwalawa amaperekedwa pamaso pa kadzutsa 2/3 ya mankhwalawa, ndiko kuti, pamimba yopanda kanthu komanso nthawi yogona 1/3 ya kumwa. Mankhwala a insulin othandizira gestational shuga amakhala ndi mankhwala achidule komanso osakhalitsa omwe amaphatikizana. Kwa amayi omwe ali ndi mtundu woyamba wa shuga, jakisoni amapangidwa kawiri kapena kuposa tsiku limodzi. Kubayidwa pafupipafupi ndikofunikira kuti muchepetse m'mawa komanso postprandial hyperglycemia.

Kuti mwana abadwe mu matenda a gestational matenda opambana azitha kuchita bwino, ndikofunikira kuwunika mayendedwe a glucose munthawi yonse ya mankhwala omwe amalipira zakudya za metabolism, komanso mkati mwa miyezi 2-3 mwana atabadwa. Kuphatikiza apo, munthu ayenera kutsatira mosamalitsa zomwe amupeza kuchipatala, popeza kuti pali chiopsezo chotukula macrosomia, ndiko kuti, pomwe kubadwa kwachilengedwe sikungatheke ndipo gawo la cesarean limachitika.

Kodi jakisoni wa insulin ndi liti?

Mankhwala a insulin ndi a:

• mtundu 1 shuga
• matenda ashuga ketoacidosis - vuto loopsa la matenda osokoneza bongo omwe angayambitse imfa,
• schizophrenia.

Kungakhale kofunikira kuperekanso insulin panthawi yoyamba chithandizo cha matenda a shuga.

Mu shuga mellitus mtundu 2 insulin mankhwala Malangizo zotchulidwa:

• Anazindikira matenda ashuga, ngati munthu amalephera kugwiritsa ntchito mankhwala omwe amachepetsa shuga,
• anapezeka kwa nthawi yoyamba, limodzi ndi kuchuluka kwa shuga tsiku lonse,
• kusagwira ntchito kwa mankhwala ochepetsa shuga,
• kuwonongeka kwakukulu kwa impso ndi chiwindi.
• Zizindikiro za insulin,
• kuchuluka kwa matenda osachiritsika,
• matenda opatsirana
• kufunika koperekera opaleshoni,
• ketoacidosis - kupezeka kwa matupi a ketone mkodzo,
• matenda a magazi
• mimba ndi mkaka wa m`mawere
• kusowa kwamadzi
• makomedwe ndi chikomokere.

Basis-bolus insulin mankhwala

Mwa munthu wathanzi pamimba yopanda kanthu, kuphatikizira kwa insulin kumakhala kokhazikika. Chizindikiro ichi chimatchedwa choyambirira, kapena choyambira, chizolowezi. Mukamadya, shuga ochulukirapo motsogozedwa ndi mahomoni amasinthidwa kukhala glycogen ndikusungidwa mu minofu yamafuta. Ngati thupi silitulutsa insulin yokwanira, ndiye kuti shuga mumazinthu akuchulukitsitsa amadziunjikira m'magazi.

Insulin yoyamba imapangidwa pakudya. Pakati pa kuyamba kumwa ndi maola 5 otsatira, timadzi tomwe timapangidwa timomwe timathandiza maselo kutulutsa shuga.

Ndi basal-bolus insulin Therapy, insulin yochepa kapena yayitali imayendetsedwa m'mawa kapena madzulo, zomwe zimapangitsa kutsata magwiridwe achilengedwe a kapamba.

Chithandizo cha makolo

Kuphatikiza mankhwala a insulin, mitundu yonse iwiri ya kukonzekera insulini imayendetsedwa nthawi imodzi, zomwe zimathandiza kuchepetsa kuchuluka kwa jakisoni (1 mpaka 3 jakisoni patsiku). Koma palibe njira yofanizira kugwira ntchito kwa kapamba, zomwe zimapangitsa kuti sizingatheke kulipira chakudya chokwanira cha carbohydrate metabolism yamtundu 1 shuga.

Mu regimen yophatikizika, wodwalayo amapanga jakisoni wa 1-2 tsiku lililonse, amapanga magawo awiri mwa atatu a insulin yayikulu komanso gawo limodzi mwa magawo atatu aifupi.

Chithandizo cha pampu

Pampu ya insulin ndi chida chapadera chamagetsi chomwe chimavulaza insulin yochepa kapena yochepa kwambiri pakadontho kakang'ono pansi pa khungu kuzungulira koloko.

Kuchiza kwa insulin kumachitika m'njira zingapo:

• kuperekera kosalekeza kwa insulin ndi Mlingo wocheperako, pomwe kuthamanga kwa thupi kumapangidwira,
• Malangizo a bolus - wodwalayo amangodziyimira yekha kuchuluka kwa jakisoni ndi kuchuluka kwa mankhwalawo.

Njira yopitiliza imatsata kuteteza kwakumaso kwa mahomoni, komwe kumapangitsa kuti pakhalenso insulin yayitali. Malangizo a bolus amalimbikitsidwa musanadye kapena kuwonjezeka kwa index ya glycemic. Zimakuthandizani kuti mulowe m'malo mwachidule ndi insulin.

Ngati muphatikiza regimen yopitilira komanso ya bolus, ndiye kuti kugwira ntchito kwa kapamba kumatsutsidwa momwe kungathekere. Pankhaniyi, catheter ayenera kusinthidwa pambuyo masiku 2-3.

Chisamaliro chachikulu

Ngati wodwala yemwe ali ndi matenda a shuga sakhala wonenepa kwambiri komanso samva kukhudzika mtima, ndiye kuti kukonzekera kwa insulin kumachitika tsiku lililonse mu theka la kilogalamu imodzi kapena kilogalamu imodzi ya kulemera kwa thupi. Mothandizidwa ndi insulin Therapy, masinthidwe achilengedwe a timadzi amakhudzidwa.

Malamulo a insulin

Ndi kuyambitsa kwa insulin, ndikofunikira kukwaniritsa zina:

• kuwerengetsa moyenera kuchuluka kwa mankhwalawo kuti athe kugwiritsa ntchito shuga,
• mahomoni opanga ogwiritsiridwa ntchito amayenera kutsata kwathunthu katulutsidwe wopangidwa ndi kapamba (mwachitsanzo, oyambitsa ayenera kukhala wakhama kwambiri mutatha kudya).

Kufunika kotsatira izi pamwambapa kumafotokozedwa ndi maulimi a insulin, momwe mlingo wa tsiku lililonse wa mahomoni umagawidwira pang'onopang'ono komanso insulin.

Jekeseni wa insulin nthawi zambiri amaperekedwa m'mawa kapena madzulo. Amatengera kwathunthu mahomoni omwe amapangidwa ndi kapamba.

Insulin yochepa imayendetsedwa mutatha kudya chakudya chamafuta ambiri. Pankhaniyi, mlingo wa mankhwalawa umatsimikiziridwa payekhapayekha, poganizira kuchuluka kwa mikate yazakudya.

Kusintha kwa Mlingo

Kutengera ndi nthawi ya kuchitapo kanthu, mitundu inayi ya insulin imasiyanitsidwa: ultrashort, yochepa, yapakati, yayitali, kapena yayitali. Kutalika kwa zochita kukuwonetsedwa mu malangizowo, koma amatha kusiyanasiyana kutengera umunthu wake. Chifukwa chake, mankhwalawa nthawi zambiri amasankhidwa ndi adokotala kuchipatala malinga ndi zotsatira za mayeso.

Kenako kusintha kwa mlingo kumapangidwa. Chifukwa chaichi, wodwalayo amasunga diary ya zakudya ndipo glycemia imayang'aniridwa. Cholemba chimalemba kuchuluka kwa chakudya ndi zochita zolimbitsa thupi. Kuchuluka kwa chakudya kumawerengeredwa m'magawo a mkate: 1 mkate wofanana umafanana 25 g mkate kapena 12 gramu wamafuta.

Nthawi zambiri, gawo limodzi la insulin limafunikira kutaya mkate umodzi, koma nthawi zina pamafunika mayunitsi 2.5.

Mtundu woyamba wa matenda a shuga a insulin

Pochiza odwala omwe ali ndi matenda a shuga omwe amadalira insulin, jakisoni wa basal insulin amaperekedwa nthawi 1-2 patsiku, ndipo mabuloni amapaka jekeseni musanadye, zomwe zimachotsa kwathunthu chitetezo chamthupi cha mahomoni opangidwa ndi kapamba. Chithandizo chofananira cha matenda a shuga chimatchedwa regimen yokhala ndi maulamuliro angapo, kapena chithandizo choyambira cha bolus. Kusiyanasiyana kwa mankhwalawa ndi kwamphamvu insulin.

Malangizo a mankhwalawa komanso mulingo woyenera wodwala amasankhidwa ndi dokotala, poganizira zomwe zimachitika mthupi ndi zovuta zomwe zilipo. Nthawi zambiri, insulin ya basal ndi 30-50% ya mlingo wa tsiku ndi tsiku.

Mtundu wachiwiri wa matenda a shuga a insulin

Ndi matenda a shuga osadalira insulin, wodwalayo akuwonjezera pang'onopang'ono timadzi tating'onoting'ono tomwe timapangidwa kuti muchepetse kuchuluka kwa shuga m'magazi. M'magawo oyamba, magawo 10 a basal insulin amayenera kuperekedwa patsiku, makamaka nthawi imodzi.

Ngati, pophatikiza jakisoni wa kukonzekera koyambira ndi mapiritsi omwe amachepetsa shuga, matendawa akupitilizabe kupita patsogolo, ndiye kuti dokotala adzasinthiratu wodwalayo ku regimen ya jakisoni. Muthanso kugwiritsa ntchito maphikidwe a mankhwala achikhalidwe, mutakambirana ndi dokotala. Pankhaniyi, palibe chifukwa chomwe mungathe kuletsa insulin mankhwala, yomwe imawopseza ndi zovuta zowopsa.

Zinthu za insulin mankhwala pochiza ana

Thupi la ana limasiyana kwambiri ndi wamkulu. Chifukwa chake, popereka mankhwala a insulin, njira ya munthu payekha ndiyofunika kuti mugwiritse ntchito njira zosavuta kwambiri zochiritsira matenda ndikupeza chotsatira choyenera, choyimiriridwa ndi chiphuphu. Nthawi zambiri, ana amalimbikitsidwa kupereka mankhwalawa katatu patsiku. Kuti muchepetse kuchuluka kwa jakisoni, insulin yochepa komanso yapakati amaphatikizidwa.

Mwa odwala achichepere, thupi limakhudzidwa kwambiri ndi chithandizo cha insulin. Chifukwa chake, mulingo wa mankhwalawo umasinthidwa m'magawo angapo kuti magawo ake azisiyanasiyana osaposa magawo awiri nthawi imodzi. Ngati ndi kotheka, kusintha magawo anayi ndikotheka, koma kamodzi. Sikoyenera kusintha nthawi imodzi pamiyeso yam'mawa ndi yamadzulo.

Zosintha zomwe zidapangidwa muyezo ziziwonekera pokhapokha masiku ochepa.

Mankhwala apakati a insulin

Amayi oyembekezera amapatsidwa mankhwala a insulini kuti azikhala ndi glucose pamlingo wina:

• m'mawa pamimba yopanda kanthu - 3.3-5.6 mamililita pa lita,
• mutatha kudya - milimita 5.6-7.2 pa lita.

Kuti muwone kuyipa kwa chithandizo, shuga m'magazi amayang'aniridwa kwa miyezi iwiri. Chifukwa chakuti pakakhala pathupi kagayidwe kangathe kusintha, zidzakhala zofunikira kusintha kaimidwe ka insulin.

Pankhani ya shuga wodalira insulin, njira yolimbikitsidwa kwa amayi apakati ndikuyendetsa mankhwalawa kamodzi pa tsiku, zomwe zimathandiza kupewa glycemia ya postprandial ndi m'mawa.

Kukhazikitsidwa kwa ma insulin achidule komanso apakati kumalimbikitsidwa musanadye chakudya choyamba komanso chotsatira. Pankhaniyi, ndikofunikira kugawa molondola: magawo awiri mwa atatu a tsiku lililonse amagwiritsidwa ntchito jakisoni wam'mawa ndi gawo limodzi mwa magawo atatu a madzulo.

Amayi ambiri amalangizidwa kuti azigwiritsa ntchito mankhwalawa musanadye chakudya, koma asanagone, kuti asachitike mwadzidzidzi usiku ndi m'mawa.

Mankhwala a insulin chifukwa cha matenda amisala

Muzochita zamisala, chithandizo cha insulin nthawi zambiri chimaperekedwa kwa schizophrenia. Jekeseni imachitika m'mawa m'mimba yopanda kanthu. Amayamba ndikupereka mankhwalawa anayi a mankhwalawa, pang'onopang'ono kuwonjezera mankhwalawo mpaka 8. Chidziwitso cha mankhwalawa ndikuti chithandizo cha insulin sichichitika Loweruka ndi Lamlungu.

Mankhwala a insulin a schizophrenia amachitika m'magawo atatu.

Pa gawo loyambirira la wodwalayo, amawasunga munthawi ya maola atatu. Kenako, kuti abwezeretsenso glucose kukhala wabwinobwino, wodwalayo amapatsidwa tiyi wokoma kwambiri (ayenera kutentha), momwemo magalamu 150 a shuga amawonjezeredwa, ndi chakudya cham'mawa chodzaza ndi chakudya. Zotsatira zake, shuga wa magazi amawonjezeka, zomwe zimapangitsa kuti schizophrenic ibwerere mwakale.

Gawo lotsatira ndikuwonjezera kuchuluka kwa insulin, chifukwa chomwe wodwalayo amatha kuyimitsidwa, amapita kumalo oponderezedwa otchedwa stupor. Pambuyo poti stuporyo itakula, amadikirira mphindi 20, kenako nkumaletsa kuukira kwa hypoglycemia. Pachifukwa ichi, mamililita 20 a njira ya shuga 40% amathandizidwa pogwiritsa ntchito dontho. Wodwalayo akabwerera kumalo komwe amakhala, amamwa ndi madzi a shuga (magalamu 150-200 a shuga amatsitsidwa m'mililita 200 yamadzi ofunda), tiyi wokometsedwa bwino komanso chakudya cham'mawa chopatsa thanzi.

Pa gawo lachitatu, apitiliza kuwonjezera kuchuluka kwa mankhwalawa tsiku lililonse. Zotsatira zake, wodwalayo amagwera pamalire a malire pakati pa stupor ndi chikomokere. Munthawi imeneyi, wodwalayo amatha kupirira osaposa theka la ola, ndikuchotsa hypoglycemia molingana ndi chiwembu chomwechi chomwe chimagwiritsidwa ntchito mu gawo lachiwiri la mankhwalawa.

Mankhwalawa a schizophrenia, magawo 20-30 a insulin mankhwala amachitika, pomwe wodwalayo amayamba kukhala wovuta. Kenako mlingo wa mankhwalawo umachepetsedwa ndikuchotsedwa kwathunthu.

Kodi mankhwala a insulin amachitika bwanji?

Mankhwalawa insulin, njira yotsatirayi imagwiritsidwa ntchito:

• gawo la thupi lomwe lakonzedwerapo kulowetsedwa.
• pambuyo jekeseni wa mankhwala, chakudya sayenera kumwedwa pasanathe theka la ola,
• makonzedwe a zopitilira 30 za insulin masana zimatsutsana.

Mlingo weniweni wa insulin ndi njira yoyenera yoyendetsera masankho imasankhidwa ndi dokotala, poganizira zomwe wodwalayo ali nazo. Kuti mupeze jakisoni, mutha kugwiritsa ntchito ma syringe ena wamba okhala ndi singano zopyapyala, kapena ma syringe, omwe atchuka kwambiri pakati pa odwala matenda a shuga.

Kugwiritsa ntchito cholembera kumakhala ndi zabwino zingapo:

• singano yapadera imachepetsa ululu pakhungu,
• kugwiritsa ntchito
• kuthekera kopereka jakisoni nthawi iliyonse komanso m'malo osiyanasiyana.

Mbale zokhala ndi mankhwalawa zimagulitsidwa ndi zolembera zina za syringe, zomwe zimakupatsani kuphatikiza mitundu yambiri ya insulin ndikugwiritsa ntchito mitundu yosiyanasiyana ya mankhwala ndi mitundu.

Mu matenda a shuga a mitundu yonse iwiri, insulin mankhwala imachitika molingana ndi chiwembu chotsatira:

• Asanadye chakudya cham'mawa, wodwalayo amavulala insulin yochepa kapena yayitali,
• musanadye nkhomaliro, timadzi tating'onoting'ono timabayidwa,
• musanadye chakudya chamadzulo, ndikofunikira kuperekera insulin yayifupi,
• asanagone, wodwalayo amapanga jakisoni wa mankhwala a nthawi yayitali.

Magawo angapo a thupi amadziwika kuti amagwiritsidwa ntchito pobayira insulin. Kuphatikiza apo, m'dera lililonse, mankhwalawa amamwetsedwa pama liwiro osiyanasiyana. Kuchuluka kwazomwe zimachitika ndi m'mimba. Ngati mumasankha jekeseni yolakwika, ndiye kuti insulini ingakhale kuti ilibe vuto.

Zotsatira zamankhwala a insulin

Mankhwala a insulin amawonedwa kuti ndi othandiza ngati amakulolani kupeza zotsatirazi:

• kuthamanga shuga - mamiliyoni 4,4-7 pa lita imodzi,
• pambuyo pa chakudya glucose - 6.7-11.1 mamililita pa lita,
• zomwe zimapezeka mu hemoglobin wa glycated si ochepera 8%,
• kuchepa kwambiri kwa shuga m'magazi osapitiliza kamodzi pa sabata.

Mavuto a Insulin

Mankhwala a insulin, ngakhale amapindulitsa kwambiri odwala omwe ali ndi matenda ashuga, amatha kuyambitsa zovuta zosafunikira: chifuwa, hypoglycemia, kapena lipodystrophy.

Vuto lodziwika bwino ndimomwe limapangitsa kuti asagwidwe ndi malo a jakisoni. Nthawi zambiri vuto lofananalo limadza pamene tekinoloje yopanga insulin ikasokonekera: mankhusu akhungu kapena owonda kwambiri akagwiritsidwa ntchito, kukonzekera kozizira kumagwiritsidwa ntchito jakisoni, tsamba la jakisoni limasankhidwa molakwika.

Hypoglycemia imayamba chifukwa cha kuchuluka kwa insulinp kapena kusala kudya kwanthawi yayitali. Komanso chomwe chimayambitsa vutoli chimatha kukhala nkhawa kwambiri, kukhala ndi nkhawa kwambiri, kugwira ntchito zolimbitsa thupi. Pankhaniyi, wodwalayo amakhala ndi chikhumbo champhamvu, thukuta limayamba kumasula kwambiri, tachycardia ndi kunjenjemera kwa malekezero amawonedwa.

Lipodystrophy - kuphindikika kwa mafuta osakanikirana pamalo operekera jakisoni. Pofuna kupewa izi, tikulimbikitsidwa kupereka jakisoni m'malo osiyanasiyana, koma kuti muchepetse kugwiritsa ntchito bwino mankhwalawa.