Ultra-yochepa-insulin Apidra

Nkhaniyi idzafanizira ndi insulin ya ultrashort.

Pafupifupi zaka zana, kutulutsidwa kwa mahomoni kwa odwala matenda ashuga kwakhala kofunikira kwambiri pamakampani opanga mankhwala. Zaka zana limodzi ndi zisanu ndi chimodzi zamitundu yoposa makumi asanu ya mankhwala a hypoglycemic. Kodi ndi chifukwa chiyani munthu wodwala matenda ashuga amayenera kuperekera jakisoni wambiri pakanthawi kochepa patsiku? Kodi mankhwalawa amasiyana bwanji wina ndi mnzake, kodi kuchuluka kwa mankhwalawo kumawerengedwa bwanji?

Insulin ndi nthawi yawo

Pakadali pano, mndandanda wonse wa insulini umadziwika. Chizindikiro chofunikira cha zomwe zimapangidwira kwa odwala matenda ashuga ndi gulu, mtundu, kampani yopanga ndi njira yokhazikitsira.

Kutalika kwa nthawi ya ultrashort insulin pa thupi la munthu imatsimikiziridwa ndi magawo angapo: pomwe kupatsidwa kwa insulin kumayamba pambuyo pa jekeseni, kuchuluka kwake, nthawi yonse ya mankhwalawa kuyambira pakuyamba mpaka kumaliza.

Kodi izi zikutanthauza chiyani? Tiyeni tiwone.

Ultrashort insulin ndi amodzi mwa magawo mankhwalawa kuwonjezera pa nthawi yayitali, yosakanikirana komanso yapakati. Ngati titha kuphunzira za kupendekera kwa mahomoni am'magazi pagawo, titha kuwona kuti imakwera kwambiri komanso mapangano mwamphamvu motsatira nthawi.

Pochita, nthawi yafupikitsidwa ndi insulin yochepa komanso ya ultrashort zimatengera zinthu zosiyanasiyana, osati pokhapokha makonzedwe:

• malo olowera mankhwala a hypoglycemic (m'magazi a m'mitsempha yamagazi, pansi pa khungu, mpaka minofu),
• kutikita minofu pakhungu la jekeseni (kumva kulira ndi mankhwalawa kumakulitsa mayamwidwe),
• Kutentha ndi kutentha kwa thupi (kutsika kumapangitsa kuti pang'onopang'ono, komanso kukwera, m'malo mwake, kufulumira),
• kufalikira, pamakhala gawo lina la mankhwalawa m'misempha pansi pa khungu.
• zochita za thupi ndi mankhwala.

Mutazindikira kuchuluka kwa kuchuluka kwa chakudya chofunikira kudya, wodwalayo sangakhale ndi chidwi ndi dzuwa kapena kusamba kotentha, akumva kuti ali ndi shuga. Hypoglycemia ili ndi zizindikiro monga kusokonezeka kwa chikumbumtima, chizungulire, komanso kumva kufooka kwambiri mthupi lonse.

Masiku angapo pambuyo pobayira jekeseni wa ultrashort insulin, kupezeka kwake pansi pakhungu kumawonekera. Pofuna kupewa kuchitika mwadzidzidzi kwa hypoglycemia yomwe ingayambitse chikomokere, wodwala matenda ashuga amayenera kukhala ndi zakudya zokhala ndi chakudya chambiri, chomwe chimakhala ndi shuga, makeke ophika buledi chifukwa cha ufa wapamwamba.

Kuchita bwino kwa jakisoni ndi mahomoni a kapamba kumatsimikiziridwa ndi malo omwe amathandizira. Kuyambira pamimba, mpaka 90% imalowa. Chifukwa, mwachitsanzo, ndi phazi kapena mkono - wochepera ndi 20%.

Pansipa pali mayina odziwika kwambiri a insulin.

Mlingo ndi nthawi

Ma insulin apamwamba-opangidwa ndi makampani osiyanasiyana amatha kugwiritsidwa ntchito mosiyanasiyana. Ultra-yochepa Humalog insulin imapangidwa ku India ndi USA. Novorapid imapangidwa ndi kampani yolumikizana ya Danish-Indian Novo Nordiks. Mankhwala onse awiriwa ndi mitundu ya insulin. Yoyamba ili ndi njira ziwiri zoyikiramo: thumba la ndalama ndi botolo. Hormone Apidra imapangidwa ku Germany ndi Sanofi-Aventis, ndipo ili m'makola a syringe. Zida zonse zomwe zimapangidwa mwapadera zomwe zimawoneka ngati cholembera, sizikukayikira za ma syringe ndi miyambo yachikhalidwe:

• anthu omwe ali ndi vuto lowona amawafuna chifukwa mlingo umatsimikiziridwa ndi kudina komwe kumveka,
• kudzera mwa iwo, mankhwalawa amatha kuperekedwa kudzera mu zovala, m'malo ali onse.
• singano poyerekeza ndi insulin yopyapyala.

Mankhwala obwera kudzalowa ku Russia amalembedwa ku Russia. Moyo wa alumali (mpaka zaka ziwiri - zabwinobwino) komanso masiku opanga amasindikizidwa pa botolo ndikuyika. Ziyembekezero zaku mafakitale opanga zimalankhula zakanthawi. Malangizo ali m'mapaketi, malingaliro azowunikira akuwonetsedwa, ndipo kwa iwo omwe odwala matenda ashuga ayenera kuwongoleredwa.

Kodi amayamba liti kuchitapo kanthu?

Maultrashort ama insulini amayamba kugwira ntchito nthawi yomweyo, patangopita mphindi zochepa atabayidwa pansi pakhungu. Poyambira "lalifupi" - kuyambira mphindi 15 mpaka 30. Kutalika kwa kuchitapo kanthu kumawonjezeka pang'ono. Wodwalayo amva kukhudzidwa kwakukulu komwe kumayambitsa mankhwala a "ultrafast" mu ola limodzi.

Chilimwe chimatenga maola angapo. Amakhala nthawi yayikulowerera chakudya cham'mimba kwambiri, glucose yemwe amalowa m'magazi chifukwa chakuwonongeka kwa michere yambiri. Kuwonjezeka kwa digiri ya glycemia kumalipiridwa ndi insulin yovomerezeka, ngati mlingo unayikidwa molondola.

Nthawi zonse imakhazikitsidwa, yomwe imakhala ndi izi: kuwonjezeka kwa mulingo kumathandizanso kutalika kwa mphamvu ya wothandizira wa hypoglycemic, pamlingo wazomwe akuwonetsedwa mu malangizo. Zowonadi zake, mahomoni othamanga amakhala mpaka maola anayi ngati mulingo wochepera magawo khumi ndi awiri.

Ndi mlingo wokulirapo, nthawi imawonjezeka ndi maola ena awiri. Zopitilira inshuwaransi zopitilira muyeso zaifupi-zochepa sizikulimbikitsidwa nthawi yomweyo. Pali chiopsezo chachikulu cha hypoglycemia. Insulin yochulukirapo singatengeke ndi thupi, imakhala yopanda ntchito ndipo itha kuvulaza.

Mitundu ya "yapakatikati" ndi "yayitali" siyikudziwika, chifukwa wowonjezera wawonjezeredwa. Maonekedwe a ultrashort insulin ndi osiyana. Ndizowoneka bwino komanso yoyera, yopanda mawanga, matulutsa komanso chinyezi. Katundu wakunja uyu amasiyanitsa insulin ndi ultrashort wautali.

Kusiyananso kwinanso pakati pa mitundu ya insulin ndi kugwirira ntchito “kwakanthawi” kudzera m'mitsempha, mkati mwanjira ina komanso mozungulira, komanso "kutalika" - kokhazikika.

Zochita Zoletsedwa

• gwiritsani ntchito mankhwala omwe atha ntchito (kuposa miyezi 2-3),
• gulani mankhwalawa m'malo osavomerezeka,
• kuti amasule.

Muyenera kusamala ndi kampani yatsopano yosapanga. Ndikofunikira kusunga mankhwala mufiriji pa kutentha kwa +2 mpaka +8. Kuti mugwiritse ntchito pakalipano, insulini iyenera kusungidwa kutentha, yoyenera kusungidwa, osati firiji.

Kuyerekezera Mankhwala

Akatswiri nthawi zambiri amapereka mankhwala "Actrapid", "Humulin", "Homor", "Rapid", "Insuman".

Ali machitidwe awo ofanana ndendende ndi mahomoni achilengedwe. Amakhala ndi kusiyana kumodzi - angagwiritsidwe ntchito koyamba komanso mtundu wachiwiri wa matenda ashuga. Kuphatikiza apo, amatha kugwiritsidwa ntchito ndi odwala omwe ali ndi ketoocytosis komanso pambuyo pa opaleshoni, panthawi yapakati.

Wodziwika kwambiri pakati pa ma insulin a ultrashort ndi Humalog, yemwe nthawi zina amachititsa zovuta, adadzikhazikitsa ngati mankhwala othandiza kwambiri.

Apidra ndi kopitilira muyeso wa insulin Novorapid amadziwika pang'ono pafupipafupi. Ndi insulin glulisin kapena yankho la liproinsulin. Pochita, onse ndi ofanana. Pambuyo pa makonzedwe, kuchuluka kwa shuga m'magazi kumatsika, thanzi la wodwalayo limayamba kuyenda bwino.

Milandu Yogwiritsa Ntchito Mwapadera

Anthu ena omwe ali ndi chimbudzi chatsiku ndi tsiku ndipo amatha kucha amapanga mahomoni ambiri: cortisol, glucagon, adrenaline. Amatsutsana ndi insulin. Kubisala kwa mahormoni chifukwa cha umunthu wake kumatha kudutsa mwachangu komanso mwachangu. Mu odwala matenda ashuga, hyperglycemia imatsimikiza m'mawa. Matendawa ndi ofala. Pafupifupi ndizovuta kuthetsa. Njira yokhayo yotuluka ndi jakisoni wa insulin yochepa kwambiri mpaka magawo asanu ndi limodzi, omwe amapangidwa m'mawa kwambiri.

Nthawi zambiri, mankhwala osaneneka amapangira chakudya. Chifukwa chakuchita bwino kwambiri, jakisoni amatha kupatsidwa nthawi ya chakudya komanso mukatha. Kutalika kwakanthaŵi kwa mphamvu ya insulin kumapangitsa wodwala kuchita jakisoni yambiri masana, tsanzirani kupanga kwachilengedwe kwa kapamba pamankhwala omwe amapezeka ndi thupi. Ndi kuchuluka kwa zakudya, mpaka nthawi 5-6.

Kuti muchepetse kusokonezeka kwakukulu kwa metabolic mu coma kapena precomatose, ngati matenda ndi ovulala a ultrashort amagwiritsidwa ntchito popanda kulumikizana ndi omwe amakhala nthawi yayitali. Pogwiritsa ntchito glucometer, ndiye kuti, chipangizo chothandiza kudziwa kuchuluka kwa shuga, amawunika glycemia ndikubwezeretsa kuwonongeka kwa matendawa.

Mayina a insulin ya ultrashort sakudziwika kwa aliyense. Amawerengedwa m'nkhaniyi.

Zowerengera zamtundu wa ultrafast insulin

Kutsimikiza kwa doses kumadalira ntchito ya kapamba kuti apange insulin yake. Mphamvu zake ndizosavuta kutsimikizira. Amakhulupirira kuti chiwalo cha endocrine chokhala ndi thanzi labwino chimapanga kuchuluka kotere kwa tsiku, kotero kuti magawo 0,5 pa kilogalamu imodzi ya kulemera ndikofunikira. Ndiye kuti, ngati kuli kotheka, kwa munthu wodwala matenda ashuga wambiri makilogalamu 70 kuti alipire 35 malo kapena kupitilira, titha kuyankhula za kuyimitsidwa kwathunthu kwa zochitika za maselo a pancreatic.

Pankhaniyi, insulin ya ultrashort ndiyofunikira, kuphatikizapo nthawi yayitali, pazigawo izi: 40 mpaka 60 kapena 50 mpaka 50.

Njira yovomerezeka imatsimikiziridwa ndi endocrinologist. Ngati kapamba adalephera pang'ono kulimbana ndi ntchito yotere, kuwerengera koyenera ndikofunikira.

Kufunika kwa thupi la "ultrafast" tsiku lonse kumasinthanso. Pakudya m'mawa m'mawa amafunikira kawiri kuposa mkate womwe wagwiritsidwa ntchito, masana - imodzi ndi theka, madzulo - yemweyo. Ndikofunikira kulingalira zochitika zamasewera ndi masewera olimbitsa thupi ochitidwa ndi wodwala. Ngati katundu ali wochepa, mlingo wa insulin nthawi zambiri umasinthika.

Mukamapangira, mwachitsanzo, ndibwino kuti mudye mpaka magawo anayi a buledi mothandizidwa ndi glycemia wabwinobwino.

Momwe mungasankhire mankhwala?

Mitundu ya insulin yomwe imatenga nthawi yayitali imapangidwa kuti isungidwe shuga wamba pamimba yopanda masana, komanso usiku pakamagona. Mphamvu ya jakisoni wa ndalamazo usiku zimayendetsedwa ndi kuchuluka kwa shuga m'magazi m'mawa wotsatira pamimba yopanda kanthu.

Kuchita zinthu mwachangu insulin ndi mankhwala afupipafupi komanso a ultrashort. Amakankhidwa musanadye, komanso, ngati kuli kotheka, kulipira mwachangu kuchuluka kwa shuga m'magazi. Amachitapo kanthu mwachangu kuti apewe kuchuluka kwa shuga pambuyo chakudya.

Tsoka ilo, ngati zakudya za anthu odwala matenda ashuga zimadzaza ndi zakudya zoletsedwa, ndiye kuti mitundu yothamanga ya insulin siyigwira bwino ntchito. Ngakhale Humalog yofulumira kwambiri yochepa kwambiri sangathe kuthana ndi chakudya chopezeka m'maswiti, chimanga, zopangidwa ndi ufa, mbatata, zipatso ndi zipatso.

Kuonjezera shuga pasanathe maola ochepa mukatha kudya kumalimbikitsa kukula kwa zovuta za matenda ashuga. Vutoli litha kuthetsedwa kokha mwa kusiya kwathunthu zinthu zoletsedwa. Kupanda kutero, majekeseni sangakhale othandiza kwenikweni.

Mpaka 1996, kukonzekera mwachangu insulini ya anthu kumadziwika kuti ndikovuta kwambiri. Kenako kunabwera ultrashort Humalog. Kapangidwe kake kanasinthidwa pang'ono poyerekeza ndi insulin yaumunthu kuti ipangitse kufalitsa ndi kupititsa patsogolo ntchitoyi. Posakhalitsa, mankhwala ofanana Apidra ndi NovoRapid adatulutsidwa pambuyo pake.

Chithandizo cha boma chimati odwala matenda ashuga amatha kudya chakudya chilichonse mosamala. Mankhwala osachedwa a ultrashort amalingaliridwa kuti amasamalira chakudya chomwe amadya.

Tsoka ilo, pochita izi sikugwira ntchito. Pambuyo kudya zakudya zoletsedwa, kuchuluka kwa shuga m'magazi kumakhalabe kokwezeka kwa nthawi yayitali. Chifukwa cha izi, zovuta za shuga zimayamba.

Anthu odwala matenda ashuga omwe amaika insulin mwachangu asanadye amafunika kudya katatu pa tsiku, pakatha maola 4-5. Chakudya chamadzulo chizikhala maola 18-19. Kukhazikika ndi osafunika. Zakudya zabwino sizingakupindulitseni, koma zingakupwetekeni.

Kuti muteteze molondola ku zovuta za matenda ashuga, muyenera kusunga shuga mumitundu yosiyanasiyana ya maola 400-5,5 mmol / l tsiku lililonse. Izi zitha kuchitika pokhapokha mutasinthira ku chakudya chamafuta ochepa. Zakudya zamankhwala zimathandizidwa mosamala ndi ma jakisoni a insulin ochepa, owerengeka molondola.

Kwa odwala matenda ashuga omwe amatsatira zakudya zamafuta ochepa, mankhwala osakhalitsa amakhala bwino pakudya musanadye kuposa Humalog, Apidra, kapena NovoRapid. Zakudya zololedwa zimatengedwa pang'onopang'ono. Amawonjezera shuga m'magazi osati kale kuposa maola 1.5-3 atatha kudya.

Humalog ndi cholowa m'malo mwa DNA m'malo mwa insulin ya anthu. Amagwiritsidwa ntchito pochiza odwala omwe ali ndi matenda osokoneza bongo kuti asunge magazi.

Nkhaniyi ifotokoza zina mwa mawonekedwe a Humalog, mtengo, Mlingo ndi wopanga.

Mlingo weniweni wa mankhwalawa umatsimikiziridwa payekhapayekha ndi dokotala wopezekapo, chifukwa zimatengera momwe wodwalayo alili.

Nthawi zambiri amalimbikitsidwa kugwiritsa ntchito mankhwalawa musanadye, komabe, ngati kuli koyenera, angathe kumwedwa mutatha kudya.

Humalog 25 imayendetsedwa makamaka mosazindikira, koma nthawi zina njira yolowerera imatheka.

Kutalika kwa chochita kumatengera zinthu zingapo. Kuchokera pa mlingo womwe wagwiritsidwa ntchito, komanso malo opaka jakisoni, kutentha kwa thupi la wodwalayo komanso zochitika zina zolimbitsa thupi.

Mlingo wa mankhwala a Humalog 50 umatsimikizidwanso payekha ndi adotolo, kutengera kuchuluka kwa shuga m'magazi.

Jakisoni amaperekedwa kokha m'mitsempha, m'chiuno, ntchafu, kapena pamimba.

Kugwiritsa ntchito mankhwalawa kwa jakisoni wovomerezeka sikovomerezeka.

Pambuyo pakuwona mlingo woyenera, tsamba la jakisoni liyenera kusinthidwa kuti linagwiritsidwe osatinso kamodzi masiku 30.

Chithandizo chachikulu cha mankhwalawa chifukwa cha matenda a shuga a insulin. Cholinga chake ndikuti shuga azikhala nthawi zonse m'magazi a wodwala. Mankhwala apulogalamu yamakono apanga mitundu ingapo ya insulini, yomwe imawonetsedwa ndi kutalika kwa ntchito yawo. Chifukwa chake, pali mitundu isanu ya mahormoneyi kuchokera ku ultrashort mpaka kuchitapo kanthu kwa nthawi yayitali.

Poyamba, insulini yokhala ndi nthawi yochepa idapangidwira odwala omwe amatha kuphwanya zakudya zomwe dokotala amafunsa - kudya zakudya zomwe zimapezeka m'mimba mosavuta. Masiku ano njira zake zimakhala bwino ndipo zimagwiritsidwa ntchito ngati mankhwalawa amachokera ku mtundu woyamba wa shuga 1, makamaka ngati wodwala watuluka m'magazi a shuga atatha kudya.

ICD yothamanga kwambiri-yayitali ndi chinthu chowoneka bwino chomwe chimayamba kugwira ntchito nthawi yomweyo. Chifukwa chake, kuphatikiza insulin yochepa kwambiri pambuyo pakulowetsa m'mimba kumatha kukhala ndi zotsatira (kuchepetsa kuchuluka kwa shuga m'magazi) mphindi imodzi yokha.

Pafupifupi, ntchito yake imatha kuyamba mphindi 1 - 20 pambuyo pa kukhazikitsa. Kuchuluka kwake kumatheka pambuyo pa ola limodzi, ndipo nthawi yowonekera imasiyana kuchokera maola atatu mpaka asanu. Ndikofunikira kwambiri kudya mwachangu kuti muchepetse hyperglycemia.

Kuchita mwachangu insulin, mankhwala ofunikira:

Insulin yamakono yogwira ntchito mwachangu, monga ultrashort, ili ndi mawonekedwe.Amadziwika ndi pang'onopang'ono - kuchepa kwa shuga m'magazi kumadziwika kuti theka la ola mutatha kukonza.

Zotsatira zazifupi kwambiri zimatheka pambuyo pa maola 2-4, komanso nthawi yovumbulutsidwa ndi thupi ndikutali - imagwira ntchito kwa maola 6-8. Ndikofunika kwambiri osamadyetsa theka la ola pambuyo poti insulini yayifupi idalowa m'thupi.

Kutalika kwa insulin yochepa kwa maola 6 mpaka 8

1 ml ya yankho kapena kuyimitsidwa nthawi zambiri kumakhala magawo 40.

Zotsatira zakugwiritsira ntchito insulin ndi matenda omwe amapezeka ndi hypoglycemia, hepatitis yacute, cirrhosis, hemolytic jaundice (chikasu cha pakhungu ndi zotupa za m'maso zimayambitsa kupindika kwa maselo ofiira am'magazi), kapamba (kutupa kwa impso), nephritis (kutupa kwa impso) matenda a impso ogwirizana ndi kuphwanya mapuloteni / amyloid metabolism, urolithiasis, m'mimba ndi zilonda zam'mimba, zotupa za mtima (mtima kulephera chifukwa chakomoka mtima matenda a mavavu ake).

Chisamaliro chachikulu chimafunikira popewa odwala omwe ali ndi matenda osokoneza bongo, omwe akudwala matenda a coronary insufficiency (cholakwika pakati pa kufunikira kwa mpweya ndi kuperekera kwake) komanso kufalikira kwa ziwongo.

Njira yovomerezeka ya insulini iyenera kuyang'aniridwa mosamala. Pa trimester yoyamba ya mimba, kufunika kwa insulin nthawi zambiri kumacheperachepera ndikuwonjezeka mu trimesters yachiwiri ndi yachitatu.

Alfa-adrenergic blockers ndi beta-adrenostimulants, ma tetracyclines, ma salicylates amawonjezera kubisala kwa amkati (extretion of the body made) insulin. Thiazide diupetics (diuretics), beta-blockers, mowa ungayambitse hypoglycemia.

Zizindikiro: hypoglycemia (kufooka, “thukuta” “thukuta”

Masiku ano, mankhwala a insulin ndi imodzi mwa njira zabwino zochizira matenda ashuga ndipo ngati wodwalayo akutenga chidwi ndi thanzi lake, amachita mosamala kwambiri, amadziwa momwe angawerengere kuchuluka kwa mahomoni, ndiye kuti posachedwa, ali ndi shuga yokhazikika m'magazi, amatha kusiya kugwiritsa ntchito insulin komanso khalani moyo wabwino.

Mitundu yonse ya insulini imagawidwa mwachidule, ultrashort, yapakati komanso yayitali. Aliyense wa iwo ali ndi katundu ndi zomwe zimapangitsa wodwala yemwe ali ndi matenda osokoneza bongo: ena amachita pambuyo pa mphindi 30 atalowetsedwa mthupi, ena pambuyo mphindi 15, ena pambuyo pa ola limodzi, ndi zina zambiri.

Mosasamala mtundu wa insulini, chinthu chachikulu kwa wodwalayo ndi mtundu woyenera wa kayendedwe ka mahomoni ndi kusankha kwa mlingo womwe umafunikira, chifukwa Mlingo wambiri kapena wotsika wa mahomoni amakhalanso ndi mbali zake zovuta ndipo amatha kuyambitsa mavuto osiyanasiyana.

Ultrashort insulin ndi liwu laposachedwa kwambiri pamakampani amakono azachipatala. Kusiyana kwake kwakukulu kuchokera ku mitundu ina ya mahomoni ndikuti imatha kuchita mwachangu kwambiri - kuchokera kwa mphindi 0 mpaka 15 mutabayidwa.

Ma ultrashort analogi a insulin amaphatikizira Novorapid, Humalog, Apidra. Izi ndizofanizira za insulin ya anthu, zomwe zakhala zikuyenda bwino kuyambira pamenepo yambani kuchita zinthu mwachangu kwambiri kuposa mankhwala ena.

Poyamba, insulin ya ultrashort idapangidwa makamaka kwa odwala omwe ali ndi shuga omwe amatha "kuwononga" ndikudya zakudya zopatsa mphamvu, zomwe zimayambitsa spikes lakuthwa mu shuga. Koma popeza palibe "ambiri odzipha" pakati pa anthu odwala matenda ashuga, mankhwala osokoneza bongo opitilira kwakanthawi abwera pamsika, omwe masiku ano amathandizira kuchepetsa shuga ngati angadumphe kwambiri kapena pakudya asanadye, pomwe wodwala alibe nthawi yodikirira mphindi 40, musanayambe chakudya chanu.

Ultrashort insulin imawonetsedwa pochizira mitundu yonse iwiri ya matenda a shuga pamene ali ndi shuga yambiri atatha kudya.

Zomwe zimagwira ndi glulisin, mamolekyu ake amasiyana ndi amino acid omwe amapezeka m'thupi. Chifukwa cha izi, glulisin samangopanga mankhwala ophatikizika amkati komanso pansi pa khungu, kotero imalowa mwachangu m'magazi atangolowa jekeseni.

Zothandizira zothandizira zimaphatikizapo m-cresol, chloride ndi sodium hydroxide, sulfuric acid, tromethamine. Kukhazikika kwa yankho kumaperekedwa ndi kuwonjezeredwa kwa polysorbate. Mosiyana ndi kukonzekera kwina kwapafupi, insulin Apidra ilibe zinc. Njira yothetsera vutoli imakhala ndi pH yosavomerezeka (7.3), choncho imatha kuchepetsedwa ngati mulingo wochepa kwambiri ukufunika.

Sizingagwiritsidwe ntchito hypoglycemia. Ngati shuga ndi ochepa asanadye, ndi bwino kupatsa Apidra pang'ono pambuyo poti glycemia ikhale yachilendo.

Hypersensitivity kuti gilluzin kapena othandiza mbali yankho.

Zotsatira zoyipa za Apidra ndizofala mitundu yonse ya insulin. Malangizo ogwiritsira ntchito amafotokozera mwatsatanetsatane za zonse zomwe zingachitike osavomerezeka. Nthawi zambiri, hypoglycemia yolumikizana ndi mankhwala osokoneza bongo amawonekera. Amayenda limodzi ndi kunjenjemera, kufooka, kukwiya. Kukula kwa hypoglycemia kukuwonetsedwa ndi kuchuluka kwa mtima.

Hypersensitivity zimachitika mu mawonekedwe a edema, zotupa, redness ndizotheka jekeseni malo. Nthawi zambiri zimatha pambuyo pa masabata awiri ogwiritsa ntchito Apidra. Zosiyanasiyana zokhudza zonse zimachitika kawirikawiri, zomwe zimafunikira kuti insulini isinthidwe mwachangu.

Kulephera kutsatira njira ya utsogoleri ndi mikhalidwe ya munthu yopanga minofu ingayambitse lipodystrophy.

Insulin Apidra sichimasokoneza mimba yathanzi, sizikhudza chitukuko cha intrauterine. Mankhwalawa amaloledwa kugwiritsidwa ntchito mwa amayi apakati omwe ali ndi mitundu 1 ndi 2 shuga komanso matenda a shuga.

Kafukufuku wazomwe angathe kuti Apidra adutse mkaka wa m'mawere sanachitike. Monga lamulo, ma insulini amalowera mkaka wochepa kwambiri, pambuyo pake amamugaya m'mimba mwa mwana. Kuthekera kwa insulin kulowa m'magazi a mwana kumathetsedwa, ndiye kuti shuga yake sidzatha. Komabe, pali chiopsezo chochepa cha mwana wosadwala yemwe angayambire glulisin ndi zina mwa yankho.

Mphamvu ya insulin yachepa: Danazol, Isoniazid, Clozapine, Olanzapine, Salbutamol, Somatropin, Terbutaline, Epinephrine.

Kukulira: Disopyramide, Pentoxifylline, Fluoxetine. Clonidine ndi reserpine - angatseke zizindikiro za kuyambika kwa hypoglycemia.

Mowa umachulukitsa kubwezeretsanso kwa matenda a shuga komanso kumatha kupangitsa munthu kukhala ndi hypoglycemia, choncho kugwiritsidwa ntchito kwake kuyenera kuchepetsedwa.

Mankhwala amapatsa Apidra mu zolembera za SoloStar syringe. Adayika cartridge ndi yankho la 3 ml ndi kuchuluka kwa U100, m'malo mwa cartridge sikunaperekedwe. Syringe cholembera gawo - 1 unit. Mu phukusi la zolembera 5, ndi 15 ml kapena ma 1500 okha a insulin.

Apidra imapezekanso m'mabotolo 10 ml. Mankhwalawa amagwiritsidwa ntchito m'malo azachipatala, koma amathanso kugwiritsidwa ntchito podzaza mpope wa insulin.

Ntchito Yomanga

Pankhani yomanga thupi, amagwiritsa ntchito katundu wotereyu monga yofunika kwambiri ya anabolic, zomwe ndi izi: maselo amatenga ma amino acid mwachangu, mapuloteni a biosynthesis amawonjezeka kwambiri.

Insulin yocheperako pang'ono imagwiritsidwanso ntchito pomanga thupi. Thupi limayamba kugwira ntchito pakatha mphindi 5 mpaka 10. Ndiye kuti, jakisoni amayenera kuchitika musanadye, kapena mutangomaliza kudya. Kuchuluka kwa insulini kumachitika pakadutsa mphindi 120 pambuyo pake. Mankhwala abwino amatengedwa ngati "Actrapid NM" ndi "Humulin wokhazikika."

Ultrashort insulini pakumanga thupi sikusokoneza magwiridwe antchito a chiwindi ndi impso, komanso potency.

Kodi

Insulin ndi mahomoni opangidwa ndi maselo a beta a kapamba. Pakuthamanga kwa chiyambi cha zotsatira zake komanso nthawi yayitali, agawika magawo ang'ono: aafupi, a ultrashort, mankhwala osokoneza bongo apakati komanso nthawi yayitali.

Njira zakuchitapo kanthu mwadzidzidzi zimadziwika kuti ndi insulin yochepa kwambiri, yomwe imayamba kuchita zinthu mwachangu, ndiye kuti, imatha kuchepetsa kwambiri kuchuluka kwa shuga m'magazi.

Kuchuluka kwa achire kwambiri komwe ma insulin akuwonetsa kukulembedwera theka la ola pambuyo pothandizidwa ndi mahomoni.

Chifukwa cha jakisoni, kuchuluka kwa shuga kumasinthidwa kukhala milingo yovomerezeka, ndipo mkhalidwe wa odwala matenda ashuga umakhala bwino. Komabe, insulin yong'ambika imachotsedwa mwachangu mthupi - mkati mwa maola 3-6, omwe shuga wowonjezera nthawi zonse amafunikira kugwiritsa ntchito mankhwala omwe atenga nthawi yayitali.

Zojambula

Anthu onse ndi osiyana, motero insulini imatha kukhala ndi zotsatira zosiyana mthupi. Komanso nthawi yakukwaniritsa zomwe zikuwonetsa kuchuluka kwa shuga ndikukhazikitsa mankhwala zimatha kusiyanasiyana mosiyanasiyana.

Kupambana kwakukulu kumakhala ndi ma insulin, omwe amawonjezeredwa nthawi yayitali. Komabe, zimatsimikiziridwa kuti insulin yochepa sikuti imakhala yotsika pang'ono kuposa momwe zimakhalira ndi nthawi yayitali malinga ndi momwe othandizira amathandizira. Koma wodwala aliyense ayenera kukumbukira kufunika ko kutsatira zakudya komanso zolimbitsa thupi.

Ma insulin akakhala kanthawi kochepa kulowa m'magazi, munthu ayenera kudya, apo ayi kuchuluka kwa shuga kumatha kutsika kwambiri, zomwe zimayambitsa hypoglycemia.

Mankhwalawa amafunika kusungidwa mosamala. Njira yabwino ndikusunga mankhwala mufiriji. Chifukwa chake sizikuwononga mpaka kumapeto kwa nthawi yowonetsedwa ndi wopanga pa phukusi.

Kutentha kwachipinda, mitundu yonse ya insulini imasungidwa osaposa mwezi umodzi, ndiye kuti mawonekedwe ake amawonongeka kwambiri. Ndikofunika kusunga insulin yayifupi mufiriji, koma osati pafupi ndi mufiriji.

Nthawi zambiri odwala sazindikira kuti mankhwalawa afooka. Izi zimabweretsa kuti mankhwalawa sagwira ntchito, mulingo wa shuga umakwera. Ngati simusintha mankhwalawa panthawi, pamakhala chiwopsezo chachikulu chokhala ndi mavuto akulu, mpaka ndimadwala matenda ashuga.

Palibe chifukwa chakuti mankhwalawo atha kukhala oundana kapena kuwonetsedwa ndi kuwala kwama radiation. Kupanda kutero, imawonongeka ndipo singagwiritsidwe ntchito.

Zomwe zili patsamba lino zimangoperekedwa pazophunzitsira zodziwika bwino, sizitanthauza chidziwitso komanso kulondola kwa zamankhwala, sikuwongolera kuchitapo kanthu. Osadzisilira.

Malangizo ogwiritsira ntchito ndi kusamalira Popeza Apidra® ndi njira yothetsera, kupumulanso musanagwiritse ntchito sikufunika.

Mbale za m'mabotolo a Apidra ® zimapangidwa kuti zigwiritsidwe ntchito ndi ma insulin omwe ali ndi muyeso woyenera wa gawo ndikugwiritsira ntchito pulogalamu ya pampu ya insulin.

Kupitiliza kopitilira kosunthika kophatikizidwa ndi dongosolo la pampu The Apidra® itha kugwiritsidwa ntchito popitiliza kulowetsedwa kwa insulin (NPI) pogwiritsa ntchito pampu yoyenera kulowetsedwa kwa insulin ndi ma catheters oyenera komanso malo osungira.

Malangizo obwezeretsera ndi osungirako ayenera kusinthidwa maola 48 aliwonse kutsatira malamulo a aseptic. Odwala omwe amalandila Apidra® kudzera mu NPI ayenera kukhala ndi insulin ina m'malo mwake ngati pulogalamu ya pampu italephera.

OptiSet ® Zodzaza ndi Zingwe za Syringe Musanagwiritse ntchito, yang'anani cartridge mkati mwa cholembera. Iyenera kugwiritsidwa ntchito pokhapokha yankho likakhala lowonekera, lopanda utoto, lilibe tinthu tolimba tomwe timayimira, ndikufanana, madzi.

Zilembera zopanda kanthu za OptiSet ® siziyenera kugwiritsidwanso ntchito ndipo ziyenera kutayidwa .. Kuti tipewe kutenga kachilomboka, cholembera chodzaza chisanachitike chiyenera kugwiritsidwa ntchito ndi wodwala m'modzi yekha osasamutsidwira wina.

Kugwiritsa ntchito cholembera cha OptiSet® Syringe PenBe musanagwiritse ntchito cholembera cha OptiSet ®, werengani mosamala chidziwitso chogwiritsa ntchito.

Chidziwitso chofunikira pakugwiritsa ntchito OptiSet® Syringe pen. Nthawi zonse gwiritsani ntchito singano yatsopano pakugwiritsa ntchito ina iliyonse. Gwiritsani masingano okha oyenera cholembera cha OptiSet ® Musanalowe jekeseni aliyense, nthawi zonse muziyeserera cholembera kuti chitha kugwiritsidwa ntchito (onani pansipa).

Ngati cholembera chatsopano cha OptiSet ® chikagwiritsidwa ntchito, kufunikira kwa kuyesa kugwiritsa ntchito kuyenera kuchitika pogwiritsa ntchito zigawo 8. Zoyikiratu zisanakhazikitsidwe ndi wopanga.

Osatembenuza wokonza mlingo (kusintha kwa mlingo) mutakanikiza batani loyambilira la jekeseni .. Cholembera cha insulin chomwechi chimapangidwa kuti chitha kugwiritsidwa ntchito ndi wodwala yekhayo. Simungamupereke kwa munthu wina ..

Wina akavulala wodwala, ayenera kusamalidwa mwapadera kuti apewe kuvulala mwangozi ndi matenda opatsirana .. Musagwiritse ntchito cholembera cha sytige yowonongeka cha OptiSet ®, kapena ngati simukutsimikiza zolondola zake ..

yankho la insulini liyenera kukhala loonekera, lopanda utoto, lopanda tinthu tolimba tomwe tili ndi mawonekedwe ofanana ndi madzi. Osagwiritsa ntchito cholembera cha sytige ya OptiSet ® ngati njira ya insulin ndi yopanda mitambo, ili ndi utoto kapena tinthu tating'onoting'ono.

Kuphatikiza singano Mukachotsa kapu, samalirani ndikulowetsa singano ndi cholembera. Kuyang'ana kukonzekera kwa cholembera kuti mugwiritse ntchito.

Kwa cholembera chatsopano komanso chosagwiritsidwa ntchito, cholembera cha mankhwalawo chiyenera kukhala chokwanira 8, monga momwe opanga kale amapangira.

Chowunikacho chimangotembenukira mbali imodzi. Tulutsani batani loyambira kwathunthu kuti muthe kumwa. Osazungulira wosankha wa mankhwalawo mutatha batani yoyambira kutulutsira kunja.

Sungani chophimba chakunja kuti mupeze singano yomwe mwagwiritsa ntchito. Mukagwira cholembera ndi singano ndikuloza, ikani pang'onopang'ono zitsulo za insulini ndi chala chanu kuti thovu lakutsogolo lithe kuluka ndi singano.

Pambuyo pake, kanikizani batani loyambira njira yonse. Ngati dontho la insulin litulutsidwa kuchokera kunsonga ya singano, cholembera cha singano ndi singano zikugwira ntchito moyenera. Ngati dontho la insulin silikuwoneka pamphumi ya singano, muyenera kubwereza kuyesa kwa cholembera kuti mugwiritse ntchito mpaka insulini imapezeka kumapeto kwa singano.

Kusankha kwa insulin mlingo Mlingo wa mayunitsi 2 mpaka 40 mayunitsi akhoza kuikidwa mu zowonjezera za 2 mayunitsi. Ngati mlingo wopitilira mayunitsi 40 ukufunika, uyenera kutumikiridwa pobayira ziwiri kapena zingapo. Onetsetsani kuti muli ndi insulin yokwanira muyezo woyenera.

Mlingo wotsalira wa insulin pachidebe chowonekera cha insulin umawonetsa kuchuluka kwa insulini yomwe imatsala mu cholembera cha sytiitet ya OptiSet ®. Mlingowu sungagwiritsidwe ntchito kumwa mankhwala a insulin. Ngati piston wakuda wayambira mzere wachikuda, ndiye kuti pali magawo 40 a insulin.

Ngati pisitoni yakuda ili kumapeto kwa bala ya utoto, ndiye kuti pali mitundu ya insulin yokwanira 20. Wosankha mlingo uyenera kutembenukiridwa mpaka muvi womupereka uwonetsa mlingo womwe mukufuna. .

Onani ngati mlingo woyenera wadzaza. Onani kuti batani loyambira limasuntha molingana ndi kuchuluka kwa insulin yomwe yasiyidwa mu thanki ya insulin. Batani loyambira limakupatsani mwayi kuti muwone ngati ndi kumwa uti.

Mukamayesedwa, batani loyambira liyenera kupitilizidwa mphamvu. Mzere womaliza wowoneka bwino pabatani wayambira kuchuluka kwa insulin yomwe yatengedwa. Pomwe batani loyambira likhala, pamwamba pamtambo wonsewo ndiwowoneka.

Makina a insulin omwe ndi ophunzitsidwa bwino ayenera kufotokozera momwe angaperekere jakisoni kwa wodwalayo. Singano iyenera kuperekedwa mwachangu. Kungodinanso kukusiyani pomwe batani la jekeseni litakankhidwa njira yonse.

Kuchotsa singano Pambuyo jekeseni aliyense, singano imayenera kuchotsedwa mu cholembera ndikuchotsa. Izi zimathandiza kupewa matenda, komanso kutayika kwa insulini, kudya kwa mpweya komanso kuthekera kwa singano. Singano sayenera kugwiritsidwanso ntchito.

Pambuyo pake, bwezerani chipewa pa cholembera.

Cartridges Cartridges iyenera kugwiritsidwa ntchito limodzi ndi cholembera cha insulin, monga OptiPen® Pro1 kapena ClickSTAR ®, komanso mogwirizana ndi malingaliro omwe ali muzidziwitso zoperekedwa ndi wopanga chipangizocho.

Siyenera kugwiritsidwa ntchito ndi ma syringe ena omwe amathanso kudzaza, popeza kulondola kwa dosing kumangokhazikitsidwa ndi ma syringe a OptiPen® Pro1 ndi KlikSTAR ® Malangizo a wopanga ogwiritsira ntchito zolembera za OptiPen® Pro1 kapena KlikSTAR ® pokhudzana ndi kulongedza katiriji jakisoni wa insulini uyenera kuchitidwa moyenera.

Yenderani cartridge musanagwiritse ntchito. Iyenera kugwiritsidwa ntchito pokhapokha yankho likakhala lomveka bwino, lopanda utoto, lopanda zinthu zolimba zowoneka. Tisanayike katiriji mu cholembera chosakanizira, katirijiyu ayenera kukhala otentha kwa maola awiri.

Pamaso pa jekeseni, thovu ndi mpweya ziyenera kuchotsedwa mu katoni (onani malangizo ogwiritsira ntchito cholembera). Malangizo ogwiritsira ntchito cholembera uyenera kutsatiridwa mosamalitsa. Makatoni opanda kanthu sangakwaniritsidwe.

Ngati cholembera cha OptiPen ® Pro1 kapena chinsinsi cha syringe chawonongeka, sichingagwiritsidwe ntchito .Ngati cholembera sichingagwire ntchito molondola, yankho limatha kutengedwa kuchokera ku cartridge kupita mu syringe ya pulasitiki yoyenera insulin pamakina a 100 PIECES / ml ndikuyambitsa wodwala.

Zambiri zokhudzana ndi Apidra: mawonekedwe, mawonekedwe ndi ma contraindication kuti mugwiritse ntchito

Zomwe zimagwira ndi insulin glulisin (3,49 mg).

Omwe amathandizira - meta-cresol, sodium chloride, trometanol, polysorbate 20, hydrochloric acid, sodium hydroxide, madzi osungunuka.

Ndikofunikira kudziwa
: Apidra amangolembera odwala okhawo omwe ali ndi matenda ashuga.

• Kusalolera aliyense payekha mankhwala kapena zinthu zina zake,
• Hypoglycemia.

Amapezeka mu mawonekedwe a yankho la jakisoni. Njira yothetsera vutoli ndi yowonekera, ilibe mtundu komanso fungo lotchulidwa. Takonzeka kutsogoleredwa mwachindunji (sizitanthauza kuti tikonzedwe kapena zina).

Ichi ndi chimodzi mwa mankhwala chomwe chiphatikiza chake chachikulu ndi insulin glulisin. Kupezeka ndi kubwerezanso kwa DNA. Vuto la E. coli lidagwiritsidwa ntchito. Komanso mu kapangidwe kake pali zinthu zothandiza zofunika pokonzekera kuyimitsidwa.

Imatsirizika mosiyanasiyana. Itha kugulitsidwa mu mawonekedwe a majekiseni makilogalamu a 3 ml iliyonse. Mu 1 ml ya 100 IU. Njira yolerera yankho la jekeseni mu botolo ndiyotheka. Ndizosavuta kugula insulin apidra kwathunthu ndi cholembera cha sytiitet ya OptiSet. Imathandizira njira yoperekera mankhwala. Yapangidwira cartridge ya 3 ml.

Mtengo wa mankhwalawa posankha ma cartridge 5 a 3 ml ndi 1700 - 1800 rubles.

Odwala ku Apidra ali ndi zofunikira zowonetsa shuga, sangakwanitse kudya zochepa okhwima kuposa odwala matenda ashuga omwe amakhala ndi insulin yochepa. Mankhwala amachepetsa nthawi kuchokera ku chakudya kupita ku chakudya, sikufuna kutsatira kwambiri zakudya komanso zokhwasula-khwasula.

Ngati wodwala matenda ashuga azitsatira zakudya zama carb zotsika mtengo, ntchito ya Apidra insulin ikhoza kukhala yothamanga, chifukwa chakudya chopatsa thanzi sichikhala ndi nthawi yokweza shuga wamagazi pofika nthawi yomwe mankhwalawa amayamba kugwira ntchito. Pankhaniyi, ma insulin afupiafupi koma osakhala a ultrashort amalimbikitsidwa: Actrapid kapena Humulin Regular.

Njira yoyendetsera

Malinga ndi malangizo, insulin Apidra imayendetsedwa musanadye. Ndikofunika kuti pakati pa chakudya panali pafupifupi maola 4. Poterepa, zotsatira za jakisoni awiri sizipindana, zomwe zimathandiza kuti matenda ashuga azitha.

Glucose sayenera kuwerengedwa pasanathe maola 4 jakisoni atalandira, jakisoni wa mankhwala atamaliza ntchito. Ngati pambuyo poti shuga achulukitsidwa, mutha kupanga zomwe zimatchedwa kukonza poplite. Zimaloledwa nthawi iliyonse masana.

Mankhwalawa ndi ofanana mu katundu, mawonekedwe, mtengo. Onse Apidra ndi NovoRapid ndi zinthu opanga odziwika ku Europe, chifukwa chake palibe kukayikira pamtundu wawo. Onse a insulin ali ndi omwe amasilira pakati pa madokotala ndi odwala matenda ashuga.

1. Apidra amasankhidwa kuti agwiritsidwe ntchito pamapampu a insulin. Chiwopsezo chobisa dongosolo lino ndichipinda 2 poyerekeza ndi cha NovoRapid. Amaganiza kuti kusiyana kumeneku kumalumikizidwa ndi kukhalapo kwa polysorbate komanso kusapezeka kwa zinc.
2. NovoRapid ikhoza kugulidwa m'makalata ndipo imagwiritsidwa ntchito m'matumba atatu mu 0.5, zomwe ndizofunikira kwa odwala matenda ashuga omwe amafunika Mlingo wochepa wa mahomoni.
3. Wapakati tsiku lililonse insulin Apidra ndi ochepera 30%.
4. NovoRapid ndiyosachedwa pang'ono.

Kupatula kusiyanako, sizikukhudzana ndizomwe mungagwiritse - Apidra kapena NovoRapid. Kusintha kwa insulini kupita kwina kumangolimbikitsidwa pokhapokha pazotsatira zamankhwala, nthawi zambiri izi zimakhala zotsutsana kwambiri.

Mukamasankha pakati pa Humalog ndi Apidra, ndizovuta kwambiri kunena zomwe zili bwino, chifukwa mankhwalawa onse ali ofanana nthawi ndi mphamvu yogwira. Malinga ndi akatswiri a matenda ashuga, kusintha kwa insulin imodzi kupita kwina kumachitika popanda zovuta, nthawi zambiri zophatikizana zowerengera sizisintha.

Kusiyana komwe kunapezeka:

• Apidra insulin imathamanga kuposa Humalog, imalowa m'magazi mwa odwala omwe ali ndi kunenepa kwambiri kwa visceral,
• humalog ingagulidwe popanda zolembera,
• mwa odwala ena, Mlingo wa kukonzekera konse kwa ultrashort ndi ofanana, ndi insulin yayitali yochepa yogwiritsa ntchito Apidra kuposa momwe mumagwiritsira ntchito Humalog.

Chiwerengero cha jakisoni patsiku

Odwala ambiri amangofunika jakisoni imodzi patsiku. Monga lamulo, izi ndizovuta zazitali komanso zazitali za insulin, komanso othandizira (kuphatikizapo ultrashort ndi mahomoni apakati).

Kwa odwala matenda ashuga, jakisoni imodzi patsiku sikokwanira. Mwachitsanzo, m'malo ovuta kwambiri, monga kuyenda kwa ndege, chakudya chosasankhidwa mu malo odyera, ndi chifukwa chake amagwiritsa ntchito zida zoyankhira mwachangu.

Komabe, ali ndi zovuta zina chifukwa chosadalirika - amachita zinthu mwachangu kwambiri komanso posachedwa ndipo atulutsidwa m'thupi mwachangu. Chifukwa chake, adotolo ayenera kuyikira dongosolo la mankhwalawa, motsogozedwa ndi kafukufuku wa zasayansi yantchito.

Choyamba, zindikirani mulingo wa kusala kudya kwa glycemia, kusinthasintha kwake masana. Muyeneranso kuchuluka kwa glucosuria pamphamvu, masana. Pambuyo pa izi, mankhwala amathandizidwa, omwe, motsogozedwa ndi kuchuluka kwa kuchepa kwa hyperglycemia ndi glucosuria, amatha kusintha malingana ndi Mlingo. Ndikotheka kutsitsa hypoglycemia mwa kubaya glucagon m'matumbo kapena subcutaneally.

Odwala matenda ashuga ayenera kudziwa zizindikiro za hypoglycemia kuti izi zitheke pakapita nthawi

Mavuto

Vuto lodziwika bwino lomwe limagwiritsidwa ntchito pochotsa matenda a shuga ndi hypoglycemia (kuchepa kwambiri kwa shuga m'magazi), omwe angadziwike chifukwa chopereka milingo yayikulu ya mankhwalawa kapena kudya mafuta okwanira mu chakudya.

Mkhalidwe wa hypoglycemic umaonekera kwambiri: wodwalayo ayamba kunjenjemera, pali kugunda kwamtima, nseru, kumverera kwanjala. Nthawi zambiri wodwalayo amadzimva kuti wamva milomo ndi lilime.

Ngati simukuletsa izi mwachangu, ndiye kuti wodwalayo atha kuzindikira, akhoza kuyamba kudwala. Amayenera kusintha matenda ake mwachangu: kudya zakudya zotsekemera, kumwa shuga pang'ono, kumwa tiyi wokoma.

Kupewa kwa lipodystrophy

Wodwala matenda ashuga amayeneranso kusamala ndi kupewa kupewa lipodystrophy. Maziko ake ndi zolakwika zamagulu olimbitsa thupi, zomwe zimatsogolera pakuwonongeka kwa fiber pansi pa khungu. Maonekedwe a madera otetezedwa chifukwa cha kubayidwa pafupipafupi sikugwirizana ndi kuchuluka kwa mankhwalawa kapena kubwezera bwino matenda a shuga.

Insulin edema, m'malo mwake, ndizovuta zachilengedwe za endocrine. Pofuna kuti musaiwale komwe jakisoni, mutha kugwiritsa ntchito chiwembu chomwe pamimba (mikono, miyendo) chimagawidwa m'magulu masiku a sabata. Pakupita masiku angapo, chivundikiro cha khungu chakumbiracho chimabwezeretsedwa bwino.

Kodi ndichifukwa chiyani ultrashort insulin ndi yabwino kapena yabwinobwino kwa anthu odwala matenda ashuga?

Katundu ndi limagwirira ntchito za ultrashort insulin

Kuchita kwa insulin ya ultrashort kumayamba kale kuposa momwe thupi la wodwala limakhalira ndi nthawi yokwanira mapuloteni omwe amalandidwa ndi chakudya ndikuwasintha kukhala glucose. Ngati wodwala awona zakudya zoyenera, ndiye kuti safunika kugwiritsa ntchito mankhwala a insulin.

Ultrashort insulin imathandizira pa nthawi imeneyi pakafunika kubweretsa msanga shuga mwachangu kuti mitengo yake yayikulu isadzetse zovuta. Ichi ndichifukwa chake chithandizo chofulumira choterechi ndikofunikira komanso insulin ya inshuwaransi ndiyabwino kwambiri kuposa yochepa chabe.

Ngakhale wodwala yemwe ali ndi matenda ashuga azitsatira zomwe dokotalayo wapereka komanso kukhala ndi moyo woyenera, angafunike insulini yochepa kwambiri. Mwachitsanzo, kuwonjezeka kowopsa kwamas shuga.

Kutengera izi, wodwalayo, powerengera Mlingo wa insulin ya ultrashort, ayenera kuwerengetsa mosamala mlingo wake pogwiritsa ntchito zoyeserera.

Mankhwala a Humalog amatha kuzimitsa kupendekera kwakanthawi mu shuga! Phunzirani tsatanetsatane powerenga nkhaniyi.

Mankhwala Insulin glulisin ndi analogue yobwerezabwereza ya insulin yaumunthu, yofanana ndi potency kukhala yabwinobwino insulin yaumunthu.Chofunikira kwambiri cha insulin ndi insulin analogues, kuphatikizapo insulin glulisin, ndikuwongolera kwa kagayidwe ka shuga.

Insulin imachepetsa kuchuluka kwa shuga m'magazi, ndikulimbikitsa kufatsa kwa glucose mwa zotumphukira, makamaka minofu yamatumbo ndi minyewa ya adipose, komanso kuletsa mapangidwe a shuga mu chiwindi. Insulin imachepetsa lipolysis mu adipocytes, linalake ndipo tikulephera kuphatikiza mapuloteni.

Kafukufuku wodzipereka kwa odwala omwe ali ndi thanzi labwino komanso odwala omwe ali ndi matenda osokoneza bongo adawonetsa kuti ndi subulinaneous insulin, glulisin amayamba kuchita zinthu mwachangu komanso amakhala ndi nthawi yofupikirapo kuposa kusungunuka kwa insulin yamunthu.

Ndi subcutaneous makonzedwe, momwe insulin glulisin, yomwe imachepetsa kuchuluka kwa shuga m'magazi, imayamba pambuyo pa mphindi 10-20. Mothandizidwa ndi mtsempha wa magazi, zotsatira za kuchepetsa kuchuluka kwa shuga m'magazi a insulin glulisin ndi insulle ya insulin yamunthu ndizofanana mu mphamvu.

Gawo limodzi la insulin glulisin imakhala ndi zochitika zofanana za hypoglycemic ngati gawo limodzi la insulin yaumunthu. Mu gawo lomwe ndimayesa odwala ambiri omwe ali ndi matenda a shuga 1, mapiritsi a hypoglycemic omwe amaperekedwa ndi insulin glulisin ndi insulle ya insulin yaumunthu kg pa nthawi zosiyanasiyana poyerekeza ndi mphindi 15 yazakudya.

Zotsatira za phunziroli zidawonetsa kuti insulin glulisin, yomwe idapangidwira mphindi 2 asanadye chakudya, idapereka chiwonetsero chofananira cha glycemic pambuyo chakudya monga insulin ya munthu wosungunuka, kutumikiridwa mphindi 30 asanadye.

Pakaperekedwa mphindi ziwiri asanadye, insulin glulisin imapereka chiwongolero chabwinoko pambuyo pa chakudya kuposa chakudya chosungunuka chomwe munthu amakhala nacho pakadutsa mphindi 2 asanadye. Glulisin insulin, yoyendetsedwa pakadutsa mphindi 15 chakudya chitayambika, idaperekanso chiwonetsero chofananira cha glycemic pambuyo paphwando monga chakudya chosungunuka cha anthu, choperekedwa mphindi ziwiri asanadye.

Phunziro lachigawo chomwe ndimachita ndi insulin glulisin, insulin lispro ndi insulle ya insulin yaumunthu pagulu la odwala omwe ali ndi matenda osokoneza bongo komanso kunenepa kwambiri adawonetsa kuti mwa odwala insulin glulisin amakhalanso ndi machitidwe omwe amathandizira.

Phunziroli, nthawi yoti ifike 20% ya AUC yonse (dera lomwe linali pansi pa nthawi yopondera) inali mphindi 114 za insulin glulisin, mphindi 121 za insulin lispro ndi mphindi 150 zokhala ndi insulin yaumunthu, ndi AUC (0-2 maola), kuwonetsera komanso ntchito yoyambirira ya hypoglycemic, motero, inali 427 mg / kg ya insulin glulisin, 354 mg / kg kwa insulin lispro, ndi 197 mg / kg ya insulle ya anthu.

Zoyesa zamankhwala zamtundu 1. M'milingo ya milungu 26 ya gawo lachitatu la III, lomwe limayerekezera ndi insulin glulisin ndi insulin lispro, imathandizidwa mosagwirizana asanadye (0¬15 mphindi) kwa odwala omwe ali ndi matenda a 1 a shuga omwe ali ndi insulin monga basulin insulin glargin, insulini glulisin inali yofanana ndi inspro insulin poyerekeza ndi glycemic control, yomwe idayesedwa ndikusintha kwa ndende ya glycosylated hemoglobin (L1L1c) panthawi yophunzira poyerekeza ndi yoyamba.

Miyezo yamtengo wapatali yamagazi inawonedwa, yodziwunikira. Ndi makonzedwe a insulin glulisin, mosiyana ndi mankhwala a insulin, lyspro sanafune kuwonjezeka kwa mlingo wa basal insulin.

Chiyeso cha milungu iwiri cha gawo lachitatu chomwe chimachitika kwa odwala omwe ali ndi matenda a shuga 1 omwe adalandira insulin glargine monga chithandizo choyambira cha basal chinawonetsa kuti mphamvu ya insulin glulisin yoyang'anira mukangomaliza kudya inali yofanana ndi ya insulin glulisin musanadye chakudya 0-15 mphindi) kapena sungunuka wa munthu (30-45 mphindi musanadye).

Mwa kuchuluka kwa odwala omwe anamaliza phunziroli, pagulu la odwala omwe adalandira insulin glulisin asanadye, kuchepa kwakukulu kwa HL1C kumawonetsedwa poyerekeza ndi gulu la odwala omwe adalandira insulin yaumunthu yosungunuka.

Type 2 shuga mellitus Chiwonetsero chazachipatala cha masabata a 26 omwe amatsatiridwa ndi kafukufuku wotsatira wama sabata a 26 adachitidwa kuti afanize insulin glulisin (0-15 mphindi asanadye) ndi insulle ya munthu wosungunuka (mphindi 30-45 chakudya) ), omwe amathandizidwa mosagwirizana ndi odwala omwe ali ndi matenda a shuga 2, kuphatikiza pogwiritsa ntchito insulin-isophan ngati basulin insulin.

Mtundu wa odwala wodwalayo unali 34,55 kg / m2. Insulin glulisin adadziwonetsa kuti ali ngati fanizo la insulin yaumunthu poyerekeza ndi kusintha kwa kuwunika kwa HL1C pambuyo pa miyezi 6 ya chithandizo poyerekeza ndi mtengo woyambira (-0.46% wa insulin glulisin ndi -0.30% wa insulle ya insulle ya anthu, p = 0.0029) ndi Pambuyo pa miyezi 12 ya chithandizo poyerekeza ndi mtengo woyambira (-0.23% wa insulini glulisin ndi -0.13% wa insulle yaum sungunuka ya anthu, kusiyana sikofunikira).

Phunziroli, odwala ambiri (79%) anasakaniza insulin yochepa ndi insulin-isophan nthawi yomweyo isanalowe. Odwala a 58 panthawi ya kuchepa kwa mankhwalawa amagwiritsidwa ntchito pakamwa hypoglycemic othandizira ndipo adalandira malangizo kuti apitilize kumwa iwo omwewo (osasinthika) mlingo.

Chiyambo ndi ukazi M'mayesero azachipatala omwe amayendetsedwa mwa akulu, panalibe kusiyana pakukhazikika komanso kufunikira kwa insulin glulisin pakuwunika kwamagulu omwe amasiyanitsidwa ndi mtundu ndi jenda.

Pharmacokinetics Mu insulin glulisine, kulowetsedwa kwa amino acid asparagine wa insulin yaumunthu pamalo B3 ndi lysine ndi lysine pamalo B29 ndi glutamic acid amalimbikitsa kuyamwa mwachangu.

Mayamwidwe ndi Bioavailability nthawi ya ndende ya nthawi yogwira odzipereka odwala komanso odwala omwe ali ndi mtundu woyamba wa 2 ndi matenda osokoneza bongo akuwonetsa kuti mayamwidwe a insulini glulisin poyerekeza ndi insulin ya insulin yaumunthu inali pafupifupi nthawi ziwiri ndipo kuchuluka kwa plasma komwe kumachitika (Stax) kunali pafupifupi 2 zina zambiri.

Mu kafukufuku yemwe wachitika kwa odwala omwe ali ndi matenda a shuga 1, atatha kulowetsedwa kwa insulin glulisin pa mlingo wa 0,15 U / kg, Tmax (nthawi yoyambira ndende ya plasma) anali mphindi 55, ndipo Stm anali 82 ± 1.3 mcU / ml poyerekeza ndi Tmax yamphindi 82 ndi Cmax ya 46 ± 1.3 μU / ml ya insulin yaumunthu.

Nthawi yochezeka kwambiri mu kufalikira kwa insulin glulisin inali yochepa (mphindi 98) kuposa ya insulin ya munthu (161 Mphindi). Pakafukufuku wa odwala omwe ali ndi matenda a shuga 2 pambuyo pa kulowererapo kwa insulin glulisin pa 0,2 U / kg Stax anali 91 mcED / ml wokhala ndi malo amtundu wa 78 mpaka 104 mcED / ml.

Ndi subcutaneous makonzedwe a insulin glulisin m'chigawo cha anterior m'mimba khoma, ntchafu, kapena phewa (mu deltoid minofu dera), mayamwidwe anali mwachangu pamene adalowetsedwa m'chigawo cha khomo lamkati lakumbuyo poyerekeza ndi kuyamwa kwa mankhwala m'chigawo cha ntchafu.

Mulingo woyipa kwambiri kuchokera ku dera loti deltoid anali wapakatikati .. Kuchita bwino kwambiri kwa insulin glulisin pambuyo pa kayendetsedwe ka mafupipafupi kunali pafupifupi 70% (73% kuchokera kukhoma lamkati lamkati, 71 kuchokera ku minofu yolumikizana ndi 68% kuchokera kudera lazachikazi) ndipo anali ndi kusiyana kochepa mwa odwala osiyanasiyana.

Kugawa ndikugawa kwa insulin glulisin ndi sungunuka wa insulin ya anthu pambuyo pakutsata makonzedwe ofanana ndi ofanana, ndikugawa mavitamini 13 malita ndi malita 21 ndi theka la moyo wa 13 ndi mphindi 17, motsatana.

Kuchoka Pambuyo pokhazikika pokhazikitsa insulini, glulusin imachotsedwa mofulumira kuposa insulin yaumunthu, ndi theka lamoyo la mphindi 42, poyerekeza ndi theka la moyo wosungunuka wa munthu wa mphindi 85.

Magulu Opatsa Odwala

Odwala ndi aimpso kulephera Mu kafukufuku wamankhwala wochitidwa mwa anthu opanda magwiridwe osiyanasiyana a impso (creatinine chilolezo (CC)> 80 ml / min, 30¬50 ml / min, apidra, kanthu, insulin, ultrashort

Ubwino ndi kuipa

Poyerekeza ndi mitundu yochepa ya insulin, munthu amatha kudziwa zabwino ndi zovuta zake mu ma ultrashort apenekedwe aposachedwa. Amakhala ndi pachimake pa zochitika, koma ndiye kuti magazi ake amachepetsa kuposa momwe mungapangire jakisoni wosavuta wa insulin. Popeza kuti insulin ya ultrashort ili ndi chimfine, nkovuta kudziwa kuchuluka kwa chakudya chopatsa thanzi chomwe muyenera kudya kuti muchepetse shuga. Mphamvu yochepa ya insulini yochepa imakhala yogwirizana ndi kuphatikitsidwa kwa chakudya ndi chakudya chamafuta pang'ono kuposa kuwononga shuga.

Koma pali mbali ina. Jakisoni waifupi wa insulin amachitika mphindi 40-45 asanadye. Mukayamba kudya mwachangu, ndiye kuti insulini yamtunduwu sikhala ndi nthawi yochitapo kanthu, ndipo shuga wamagazi amadzuka kwambiri. Mitundu yaposachedwa kwambiri ya insulin imachita mofulumira kwambiri, itatha mphindi 10-15 pambuyo pa jakisoni, ndipo izi ndizothandiza kwambiri, chifukwa munthu sakudziwa nthawi yomwe ayenera kudya. Mwachitsanzo, pachakudya chodyera. Kutengera chakudya chamagulu ochepa, kumalimbikitsidwa nthawi zambiri kugwiritsa ntchito insulin ya anthu musanadye. Komanso, insulin yayifupi kwambiri iyenera kusungidwa ngati pakufunika kutero. Kuchita kumawonetsa kuti insulin ya ultrashort ilibe gawo yokhazikika pa shuga wamagazi kuposa lalifupi. Zotsatira zake sizikulosera, ngakhale jakisoni atapangidwa mu Mlingo wocheperako, monga momwe odwala omwe ali ndi matenda ashuga amadya zakudya zamagulu ochepa, makamaka makamaka pamlingo waukulu. Kuphatikiza apo, ziyenera kukumbukiridwa kuti mitundu ya insulin ya insulin ndiyamphamvu kwambiri kuposa yayifupi. Gawo limodzi la Humaloga lidzachepetsa shuga ndi pafupifupi 2.5 nthawi yogwira kwambiri poyerekeza ndi gawo limodzi la insulin yochepa. Apidra ndi Novorapid ndi 1.5 nthawi amphamvu kuposa insulin yochepa. Chifukwa chake, kuchuluka kwa Humalog kuyenera kukhala kofanana ndi gawo limodzi la magawo anayi a insulin yayifupi, Apidra kapena NovoRapida - magawo awiri atatu. Ichi ndi chidziwitso chowonekera chomwe chikutsimikiziridwa.

Tsopano tikudziwa omwe insulin ndi ultrashort.

Ntchito yayikulu ndikuchepetsa kapena kuletsa kwathunthu kudumpha mu shuga mutatha kudya. Kuti muchite izi, jakisoni imachitika musanadye chakudya ndi nthawi yayitali kuti muyambe kugwira insulin. Kumbali imodzi, anthu akufuna kutsika magazi m'magazi panthawi yomwe zinthu zomwe zimayamwa zimayamba kuwonjezera. Komabe, ndi jekeseni kwambiri kwambiri, shuga amayamba kugwa mofulumira kuposa momwe amathandizira ndi chakudya. Kuchita kumawonetsa kuti ndikofunikira kupangira insulin yochepa pafupifupi mphindi 40-45 musanadye chakudya chamagulu ochepa. Chokha kupatula odwala ndi chitukuko cha matenda ashuga gastroparesis - yafupika chapamimba atatha kudya. Anthu odwala matenda ashuga samapezeka kawirikawiri pomwe, pazifukwa zina, insulin yochepa imalowerera m'magazi pang'onopang'ono. Amamukakamiza kuti amubaye ola ndi theka asanadye. Izi ndizosokoneza. Pankhaniyi, muyenera kugwiritsa ntchito mankhwala aposachedwa a ultrashort, omwe othamanga kwambiri ndi Humalog.