Momwe mungawerengere moyenera kuchuluka kwa insulin mu shuga

—0.4--0.5 U / kg thupi kwa odwala omwe ali ndi matenda a shuga 1,

—0.6 U / kg kwa thupi kwa odwala omwe ali ndi matenda a shuga 1 amtundu woposa chaka chimodzi chifukwa chobwezera zabwino,

—0.7 U / kg zamafuta kwa odwala omwe ali ndi mtundu 1 wa shuga wambiri wopitilira chaka choposa chindapusa chokhazikika,

—0.8 U / kg pamasamba a odwala omwe ali ndi mtundu 1 wa matenda a shuga atha kuwonongeka,

—0.9 U / kg pa thupi la odwala omwe ali ndi mtundu 1 wa matenda a shuga a ketoacidosis,

-1.0 IU / kg thupi la odwala omwe ali ndi mtundu wa 1 shuga mellitus mutha msinkhu kapena III trimester ya mimba.

Monga lamulo, tsiku lililonse mlingo wa insulin woposa 1 U / kg patsiku umawonetsa bongo insulin. Ndi mtundu woyamba wa matenda ashuga 1, kufunika kwa tsiku ndi tsiku insulin ndi magawo 0,5 pa kilogalamu ya thupi. M'chaka choyamba pambuyo kuwonekera matenda ashuga pakhoza kukhala kuchepa kwakanthawi kofunikira mu insulin tsiku ndi tsiku - ichi ndi chomwe chimatchedwa "honeymoon" cha matenda ashuga. M'tsogolomu, zimawonjezeka pang'ono, zowongolera 0,6 mayunitsi. Mu kuwonongeka, makamaka pamaso pa ketoacidosis, mlingo wa insulini chifukwa cha kukana kwa insulin (glucose kawopsedwe) umachuluka ndipo nthawi zambiri umakhala wa 0,7-0.8 PIECES wa insulin pa kilogalamu ya thupi.

Kukhazikitsidwa kwa insulin yochulukirapo kuyenera kutsata njira wamba yolembera insulin mwa munthu wathanzi. Amaperekedwa kawiri pa tsiku (asanadye chakudya cham'mawa, asanadye chakudya chamadzulo kapena usiku) pamlingo wosaposa 50% ya kuchuluka kwa insulin tsiku lililonse. Kukhazikitsidwa kwa insulin yochepa kapena ultrashort kanthu musanadye zakudya zazikulu (kadzutsa, nkhomaliro, chakudya chamadzulo) zimachitika mu Mlingo wowerengeredwa ndi XE. Kufunika kwa tsiku ndi tsiku kwamankhwala am'madzi kumatsimikiziridwa ndi kuchuluka kwa zopatsa mphamvu zomwe zimafunikira wodwala wina, ndipo zitha kukhala 70 mpaka 300 g zamankhwala, zomwe zimachokera ku 7 mpaka 30 XE: pa chakudya cham'mawa - 4-8 XE, pa nkhomaliro - 2-4 XE, pa chakudya chamadzulo - 3-4 He, 3-4 HE ayenera kufotokozedwa mwachidule m'mawa lachiwiri, chakudya chamadzulo masana komanso chakudya chamadzulo.

Insulin panthawi yazakudya zowonjezera, monga lamulo, siziperekedwa. Pankhaniyi, kufunikira kwa insulini kwakanthawi kochepa kapena kwa ultrashort kuyenera kukhala kosangalatsa kuyambira magawo 14 mpaka 28. Mlingo wa insulin waifupi kapena wa ultrashort akhoza kukhala ndipo ayenera kumasiyanasiyana malinga ndi momwe zinthu ziliri komanso mogwirizana ndi zomwe zimapangitsa shuga. Izi zikuyenera kutsimikiziridwa ndi zotsatira za kudziletsa. Chitsanzo: Wodekha mtundu 1 shuga, kudwala zaka 5, chindalama. Kulemera 70 kg, kutalika 168 cm.

Kuwerengeredwa kwa kuchuluka kwa insulini: tsiku lililonse 0,6 PESCES x 70 kg = 42 ZINSINSI za insulin. IPD 50% kuchokera ku 42 PIERES = 21 (yozungulira mpaka 20 PIECES): asanadye kadzutsa - 12 PISCES, usiku 8 PISCES. ICD 42- 20 = ZITHUNZI 22: Asanadye chakudya cham'mawa, PIECES 8-10, asanadye chakudya cham'mawa, 6-8 PISCES, asanadye chakudya, 6-8 PISCES. Kusintha kwina kwa mankhwala a PD Ndipo PD - molingana ndi mseru wa glycemia, ICD - malinga ndi glycemia ndi kumwa kwa XE. Kuwerengera uku ndikuwonetsa ndipo kumafunikira kukonzedwa komwe kumayendetsedwa ndikuwongoleredwa kwa glycemia mlingo ndi kumwa kwa chakudya mu XE. Dziwani kuti pokonza glycemia, ndikofunikira kuganizira mankhwala osakhalitsa a insulin kuti achepetse ziwonetsero zokwanira, kutengera deta iyi:

1 unit ya insulin yochepa kapena ultrashort kanthu amachepetsa glycemia ndi 2.2 mmol / l,

1 XE (10 g yamafuta) imachulukitsa kuchuluka kwa glycemia kuchokera ku 1.7 mpaka 2.7 mmol / l, kutengera mndandanda wamatumbo a glycemic. Chitsanzo: wodwala wodwala matenda ashuga amtundu 1, odwala 5, wodwala. Kulemera makilogalamu 70, kutalika masentimita 168. Kuwerengedwa mlingo wa insulin:

Zofunikira za tsiku ndi tsiku za 0,6 PESCES x 70 kg = 42 ZOPHUNZITSA insulin. Ndipo PD 50% ya 42 PIECES = 21 (yozungulira mpaka 20 PIECES): asanadye kadzutsa -12 PISCES, usiku 8 PIECES. ICD 42 -20 = 22 IU: musanadye chakudya cham'mawa 8-10 IU, musanadye chakudya cham'mawa 6-8 IU, musanadye chakudya cham'mawa 6-8 IU. Kusintha kwina kwa IPD - molingana ndi mseru wa glycemia, ICD - malinga ndi glycemia ndi kumwa kwa XE. Morly glycemia ya 10,6 mmol / l, imaganiziridwa kuti imagwiritsidwa ntchito ndi 4 XE. Mlingo wa ICD uyenera kukhala PIERESI 8 pa 4 XE ndi 2 PIECES kuti "achepetse" (10.6 - 6 = 4.6 mmol / L: 2.2 = 2 PIECES of insulin). Ndiye kuti, m'mawa mu ICD muyenera kukhala magawo 10.

Itha kuganiziridwa kuti kugwiritsa ntchito moyenera malangizo omwe aperekedwa pochizira komanso kutsatira kwambiri kuchuluka kwa glucose othandizira kungathandize odwala kukhala ndi moyo wautali komanso wabwino. Komabe, ayenera kutsimikizira kufunika kogula ma glucometer awo ndikuwunikira pafupipafupi glycemia komanso kuchuluka kwa hemoglobin ya glycated.

Kuwerengera mlingo wa insulin (imodzi ndi tsiku)

Theoretical algorithm yowerengera tsiku ndi tsiku insulin odwala omwe ali ndi matenda a shuga (DM) mtundu 1 amachitika pogwiritsa ntchito ma coefficients osiyanasiyana: pafupifupi kuchuluka kwa insulini m'thupi kumawerengedwa pa kilogalamu ya kulemera kwenikweni kwa thupi, ngati pali kuchuluka kwa thupi - kuchuluka kwake kumachepa ndi 0,1, ndikuchepa kwake kumawonjezera pofika 0.1:

Kulemera kwa thupi kwa 0.4-0.5 U / kg kwa odwala omwe ali ndi matenda a shuga 1, 0,6 U / kg thupi kwa odwala omwe ali ndi matenda a shuga 1 akupitilira chaka chimodzi pakulipira kwabwino, thupi la 0.7 U / kg kwa odwala omwe ali ndi matenda a shuga 1 amtundu wopitilira chaka chimodzi ndi chindapusa chokhazikika, 0,8 IU / kg yolemetsa kwa odwala omwe ali ndi matenda amtundu wa 1 omwe ali ndi vuto lalikulu, 0,9 IU / kg ya kulemera kwa thupi kwa odwala omwe ali ndi matenda a shuga 1 amtundu wa ketoacidosis, 1, 0 / U kulemera kwa thupi kwa odwala omwe ali ndi matenda a shuga 1 amsinkhu wobereka kapena III trimester ya mimba.

Monga ulamuliro, tsiku lililonse mlingo wa insulin woposa 1 U / kg patsiku umawonetsa bongo wa insulin. Ndi mtundu woyamba wa matenda ashuga 1, kufunika kwa tsiku ndi tsiku insulin ndi magawo 0,5 pa kilogalamu ya thupi.

Zofunika! M'chaka choyamba pambuyo pa kuwonjezeka kwa matenda ashuga, pamatha kuchepa kwakanthawi kokwanira ka insulin - iyi ndiye yotchedwa "honeymoon" ya matenda ashuga. M'tsogolomu, zimawonjezeka pang'ono, zowongolera 0,6 mayunitsi. Mu kuwonongeka, makamaka pamaso pa ketoacidosis, mlingo wa insulini chifukwa cha kukana kwa insulin (glucose kawopsedwe) umachuluka ndipo nthawi zambiri umakhala wa 0,7-0.8 PIECES wa insulin pa kilogalamu ya thupi.

Kukhazikitsidwa kwa insulin yochulukirapo kuyenera kutsata njira wamba yolembera insulin mwa munthu wathanzi. Amaperekedwa kawiri pa tsiku (asanadye chakudya cham'mawa, asanadye chakudya chamadzulo kapena usiku) pamlingo wosaposa 50% ya kuchuluka kwa insulin tsiku lililonse. Kukhazikitsidwa kwa insulin yochepa kapena ultrashort kanthu musanadye zakudya zazikulu (kadzutsa, nkhomaliro, chakudya chamadzulo) zimachitika mu Mlingo wowerengeredwa ndi XE.

Kufunika kwa tsiku ndi tsiku kwamankhwala am'madzi kumatsimikiziridwa ndi kuchuluka kwa zopatsa mphamvu zomwe zimafunikira wodwala wina, ndipo zitha kukhala 70 mpaka 300 g zamankhwala, zomwe zimachokera ku 7 mpaka 30 XE: pa chakudya cham'mawa - 4-8 XE, pa nkhomaliro - 2-4 XE, pa chakudya chamadzulo - 3-4 He, 3-4 HE ayenera kufotokozedwa mwachidule m'mawa lachiwiri, chakudya chamadzulo masana komanso chakudya chamadzulo.

Insulin panthawi yazakudya zowonjezera, monga lamulo, siziperekedwa.

Pankhaniyi, kufunikira kwa insulini kwakanthawi kochepa kapena kwa ultrashort kuyenera kukhala kosangalatsa kuyambira magawo 14 mpaka 28. Mlingo wa insulin waifupi kapena wa ultrashort akhoza kukhala ndipo ayenera kumasiyanasiyana malinga ndi momwe zinthu ziliri komanso mogwirizana ndi zomwe zimapangitsa shuga. Izi zikuyenera kutsimikiziridwa ndi zotsatira za kudziletsa.

Kwa zaka zambiri ndakhala ndikuphunzira za zovuta za DIABETES. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsa odwala matenda ashuga mellitus. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 100%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipilira mtengo wonse wa mankhwalawo. Ku Russia ndi mayiko a CIS odwala matenda ashuga kale Julayi 6 alandire mankhwala - ZAULERE!

Chitsanzo cha kuwerengetsa mlingo wa insulin 1

Wodwala matenda ashuga amtundu 1, wodwala wazaka 5, chipukuta misozi. Kulemera makilogalamu 70, kutalika kwa masentimita 168. Kuwerengedwa kwa kuchuluka kwa insulini: Kufunikira kwa tsiku lililonse kwa 0,6 PESCES x 70 kg = 42 PESCES of insulin. IPD 50% kuchokera ku 42 PIERES = 21 (yozungulira mpaka 20 PIECES): asanadye kadzutsa - 12 PISCES, usiku 8 PISCES. ICD 42- 20 = ZITHUNZI 22: Asanadye chakudya cham'mawa, PIECES 8-10, asanadye chakudya cham'mawa, 6-8 PISCES, asanadye chakudya, 6-8 PISCES.

Kusintha kwina kwa IPD - molingana ndi mseru wa glycemia, ICD - malinga ndi glycemia ndi kumwa kwa XE. Kuwerengera uku ndikuwonetsa ndipo kumafunikira kukonzedwa komwe kumayendetsedwa ndikuwongoleredwa kwa glycemia mlingo ndi kumwa kwa chakudya mu XE.

Dziwani kuti pokonza glycemia, ndikofunikira kuganizira mankhwala osakhalitsa a insulin kuti achepetse ziwonetsero zokwanira, kutengera deta iyi:

1 unit ya insulin yaifupi kapena ya ultrashort action imachepetsa glycemia ndi 2.2 mmol / l, 1 XE (10 g yamafuta) imachulukitsa kuchuluka kwa glycemia kuchokera 1.7 mpaka 2.7 mmol / l, kutengera index ya glycemic ya zinthu.

Njira ya odwala matenda ashuga

Pali njira zisanu za insulin mankhwala:

• mankhwala amodzi a nthawi yayitali kapena yapakati,
• njira ziwiri zapakati
• kuwirikiza kawiri komanso kwapakati mahomoni,
• patatu insulini yowonjezera komanso kuchitapo kanthu mwachangu,
• maziko a botus.

Poyambirira, jakisoni wothandizirayo amaperekedwa mu tsiku lililonse m'mawa musanadye chakudya cham'mawa.

Chithandizo cha mankhwalawa malinga ndi chiwembuchi sichikubwereza zachilengedwe za kapangidwe ka insulin. Muyenera kudya katatu patsiku: chakudya cham'mawa chochepa, chakudya chamadzulo cham'mawa, chakudya chamadzulo chamadzulo komanso chakudya chamadzulo chochepa. Kapangidwe ndi kuchuluka kwa chakudya kumagwirizana ndi kuchuluka kwa zolimbitsa thupi.

Ndi mankhwalawa, hypoglycemia imachitika nthawi zambiri usana ndi usiku. Malowa sanali oyenera kwa odwala matenda ashuga amtundu 1. Odwala omwe ali ndi mtundu wachiwiri wa matenda amafunika kumwa mapiritsi ochepetsa shuga motsatana ndi jakisoni.

Kuchita insulin kawiri ndi mankhwala apakati kumaphatikizapo kuyambitsidwa kwa mankhwala musanadye chakudya cham'mawa komanso chamadzulo.

Mlingo watsiku ndi tsiku umagawika pawiri pawiri pa 2 mpaka 1. Kuphatikiza, chiwembuchi chili pachiwopsezo cha hypoglycemia. Chobwereza ndicho chomwe chimaphatikiza chiwembucho ku boma ndi zakudya.

Wodwala ayenera kudya osachepera 4-5. Kubaya jakisoni wowerengeka komanso wosakhalitsa wa pancreatic timadzi kumaonedwa kuti ndi koyenera kwambiri kwa ana ndi akulu. Mankhwalawa amaperekedwa m'mawa ndi madzulo.

Mlingo wa tsiku ndi tsiku umatengera kudya, zolimbitsa thupi. Kuchepetsa chiwembucho mu chakudya cholimba: mukapatuka pa dongosolo la mphindi 30, kuchepa kwambiri kwa insulin kumachitika, zizindikiro za hypoglycemia zimawonekera.Makonzedwe atatu a insulin yayitali komanso yochepa imaphatikizira jakisoni m'mawa, masana ndi madzulo.

Asanadye chakudya cham'mawa, wodwalayo amafunika kubayidwa ndikukonzekera kwakanthawi komanso pang'ono, asanadye nkhomaliro - chakudya chochepa, asanadye - asadye.

Dongosolo-bolus scheme lili pafupi kwambiri ndi zachilengedwe kupanga insulin. Mlingo wathunthu umagawika m'magawo awiri: theka loyamba ndi lalifupi, ndipo chachiwiri ndi mtundu wa nthawi yayitali wa mankhwala.

2/3 ya mahomoni owonjezera amathandizidwa m'mawa ndi masana, 1/3 madzulo. Chifukwa chogwiritsa ntchito Mlingo wocheperako, chiopsezo cha hypoglycemia ndi chocheperako.

Kodi gawo limodzi la insulini limachepetsa bwanji magazi?

Madokotala azindikira kuti gawo la insulini limachepetsa glycemia ndi 2 mmol / L. Mtengo wake umapezeka mosayesa ndipo umaperekedwa.

Mwachitsanzo, mwa odwala matenda ashuga, gawo lamankhwala limatha kuchepetsa shuga ndi mmol / L ochepa. Zambiri zimatengera zaka, kulemera, kadyedwe, ntchito zolimbitsa thupi za wodwala, mankhwala omwe amagwiritsidwa ntchito.

Mwachitsanzo, kwa ana, amuna ndi akazi owonda omwe amakhala ndi chidwi chachikulu pakulimbitsa thupi, mankhwalawa amakhala ndi zotsatira zambiri. Mankhwala amasiyana mphamvu: Ultid-yochepa Apidra, NovoRapid ndi Humalog ali ndi mphamvu nthawi 1.7 kuposa Actrapid wamfupi.

Mtundu wa matenda umakhudzanso. Mwa anthu osadalira insulini, gulu la mahomoni limatha kutsitsa shuga kuposa odwala omwe ali ndi matenda omwe amadalira insulin. Izi ndichifukwa choti mwa anthu omwe ali ndi mtundu wachiwiri wa matenda ashuga, kapamba amatulutsa insulin pang'ono.

Momwe mungawerengere jekeseni wa jakisoni wa insulin?

Odwala matenda ashuga asungitse kuchuluka kwa shuga m'dera la 4.6-5.2 mmol / L. Chifukwa chake, muyenera kudziwa mtundu wa insulin yovomerezeka.

Zinthu zotsatirazi zikuthandizira kuwerengera:

• mtundu wa matenda,
• Kutalika kwa maphunzirowa
• kukhalapo kwa zovuta (matenda ashuga polyneuropathy, kulephera kwa impso),
• kulemera
• kutenga zina zowonjezera kuchepetsa shuga.

Kuwerengera Mlingo wa matenda a shuga 1

Ndi matenda amtunduwu, insulin siyopangika ndi kapamba. Chifukwa chake, pafupifupi tsiku lililonse mlingo umalimbikitsidwa kuti ugawidwe pakati pa mankhwala omwe ali ndi nthawi yayitali (40-50%) ndi yochepa (50-60%).

Kuchuluka kwa insulini kumawerengeredwa potengera kulemera kwa thupi ndikufotokozedwa m'magawo (UNITS). Ngati pali mapaundi owonjezera, ndiye kuti chokwanira chikuchepa, ndipo ngati pali kulemera - onjezerani ndi 0,1.

Chofunikira cha insulin tsiku lililonse chimaperekedwa pansipa:

• kwa omwe apezeka ndi matendawa posachedwa, momwe muliri ndi 0.4-0.5 U / kg,
• kwa odwala opitilira chaka chimodzi ndi malipiro abwino - 0,6 PESCES / kg,
• kwa anthu omwe ali ndi matenda okhala ndi nthawi yoposa chaka komanso kulipidwa osakhazikika - 0,7 PISCES / kg,
• mu ketoacidosis - 0,9 PIECES / kg,
• pa kuwonongeka - 0,8 PIECES / kg.

Kuwerengera kuchuluka kwa matenda ashuga a 2

Mtundu wachiwiri wa odwala matenda ashuga amawonjezera insulin.

Mankhwala omwe amangokhala pang'ono amalumikizidwa ngati kapamba atatha.

Kwa anthu omwe ali ndi vuto la endocrinological lomwe langopezedwa kumene, mulingo woyambirira wa mankhwalawa ndi 0.5 U / kg. Komanso, kukonza kumachitika masiku awiri.

Madokotala amalimbikitsa kuperekera mahomoni pa mlingo wa 0,4 U / kg pachikhululukiro. Ngati munthu wayamba kudwala matenda a shuga kwa nthawi yayitali, ndiye kuti mulingo woyenera wa mankhwalawo ndi 0,7 U / kg.

Mlingo wosankha mwana komanso wachinyamata

Kwa ana omwe ali ndi vuto la hyperglycemia kwa nthawi yoyamba, ma endocrinologists amapatsa mayunitsi 0,5 / kg patsiku.

Pankhani ya kuwonongeka ndi kusowa kwa katulutsidwe ka timadzi ndi kapamba, 0,7-0.8 U / kg ndi mankhwala. Ndi chiphuphu chokhazikika, pali kuchepa kwa zofunikira za insulin mpaka 0,4-0,5 U / kg.

Kuwerengera mlingo wa insulin kukonzekera kwa amayi apakati

Kudziwa mlingo woyenera wa mayi wapakati ndikofunika osati kwa mkazi yekha, komanso kwa mwana wake. M'milungu yoyamba 13, ndikulimbikitsidwa kubayitsa 0,6 U / kg, kuyambira 14 mpaka 26 - 0,7 U / kg, kuyambira 27 mpaka 40 - 80 U / kg.

Ambiri a tsiku ndi tsiku mlingo ayenera kuperekedwa pamaso kadzutsa, ndi ena - madzulo.

Ngati kuperekako kwakonzedwa kuti kuchitike pogwiritsa ntchito gawo la cesarean, ndiye kuti jakisoni wa insulin sanachitike patsiku la opareshoni.

Ndikosavuta kusankha nokha mlingo. Chifukwa chake, ndibwino kuti adotolo azichita izi kuchipatala.

Mndandanda wa zitsanzo za jekeseni woyenera wa jakisoni

Matenda a shuga amawopa mankhwalawa, ngati moto!

Muyenera kungolemba ...

Kuti mumvetsetse bwino momwe mungawerengere moyenera mulingo wa insulin, tebulo ili m'munsiyi likusonyeza zitsanzo:

Kodi kudziwa nthawi yayitali bwanji jekeseni asanapange jakisoni?

Zimatenga nthawi yayitali bwanji kuti mupeze insulin kutengera mtundu wa mankhwalawa. Mwachitsanzo, mankhwala othandizira pang'onopang'ono amayamba kutsika shuga pambuyo mphindi 10.

Chifukwa chake, jekeseni iyenera kuchitidwa mphindi 10-12 chakudya chisanachitike. Insulin yochepa imagwiritsidwa ntchito mphindi 45 musanadye.

Zochita za wothandizira nthawi yayitali zimayamba pang'onopang'ono: zimabayidwa ola limodzi asanadye kadzutsa kapena chakudya chamadzulo. Ngati simumayang'anira nthawi yokhazikika, ndiye kuti hypoglycemia ikhoza kuyamba. Kuti muchepetse kuukira, muyenera kudya kena kake lokoma.

Thupi la munthu aliyense payekha ndipo limazindikira insulin mosiyana. Chifukwa chake, ndikwabwino kudziwa nthawi yomwe pakati panu pakubayidwa ndi zakudya.

Makanema okhudzana nawo

Pazokhudza malamulo a mankhwalawa a matenda a shuga tsiku limodzi komanso tsiku lililonse:

Chifukwa chake, odwala matenda ashuga ayenera kudziwa momwe angawerengere moyenera kuchuluka kwa insulini yomwe imayendetsedwa kuti imve bwino komanso kupewa kutulutsa zovuta za matenda.

Kufunika kwa timadzi timeneti kumatengera kulemera, zaka, nthawi komanso kuopsa kwa matenda. Akuluakulu amuna ndi akazi sayenera kubayitsa zoposa 1 U / kg patsiku, ndipo ana - 0,4-0.8 U / kg.

Chitsanzo cha kuwerengetsa mlingo wa insulin 2

Wodwala matenda a shuga 1, odwala zaka 5, zolipirira. Kulemera makilogalamu 70, kutalika kwa masentimita 168. Kuwerengedwa kwa kuchuluka kwa insulini: Kufunikira kwa tsiku lililonse kwa 0,6 PESCES x 70 kg = 42 PESCES of insulin. IPD 50% kuchokera ku 42 PIECES = 21 (yozungulira mpaka 20 PIECES): asanadye kadzutsa -12 PISCES, usiku 8 PIECES. ICD 42 -20 = 22 IU: musanadye chakudya cham'mawa 8-10 IU, musanadye chakudya cham'mawa 6-8 IU, musanadye chakudya cham'mawa 6-8 IU.

Kusintha kwina kwa IPD - molingana ndi mseru wa glycemia, ICD - malinga ndi glycemia ndi kumwa kwa XE. Morly glycemia ya 10,6 mmol / l, imaganiziridwa kuti imagwiritsidwa ntchito ndi 4 XE. Mlingo wa ICD uyenera kukhala PIERESI 8 pa 4 XE ndi 2 PIECES kuti "achepetse" (10.6 - 6 = 4.6 mmol / L: 2.2 = 2 PIECES of insulin). Ndiye kuti, m'mawa mu ICD muyenera kukhala magawo 10.

Itha kuganiziridwa kuti kugwiritsa ntchito moyenera malangizo omwe aperekedwa pochizira komanso kutsatira kwambiri kuchuluka kwa glucose othandizira kungathandize odwala kukhala ndi moyo wautali komanso wabwino. Komabe, ayenera kutsimikizira kufunika kogula ma glucometer awo ndikuwunikira pafupipafupi glycemia komanso kuchuluka kwa hemoglobin ya glycated.

Ndili ndi zaka 47, ndinapezeka kuti ndili ndi matenda ashuga a 2. M'masabata angapo ndinapeza pafupifupi 15 kg. Kutopa nthawi zonse, kugona, kumva kufooka, kuwona kunayamba kukhala pansi.

Nditakwanitsa zaka 55, ndinali nditadzibaya kale ndi insulin, zonse zinali zoipa kwambiri. Matendawa adapitilirabe, kukomoka kwakanthawi kunayamba, ambulansi imandibwezera kuchokera kudziko lina. Nthawi zonse ndimaganiza kuti nthawi ino ikhala yomaliza.

Chilichonse chinasintha mwana wanga wamkazi atandilola kuti ndiwerenge nkhani imodzi pa intaneti. Simungayerekeze m'mene ndimamuyamikirira. Nkhaniyi inandithandiza kuthana ndi matenda ashuga, omwe amati ndi osachiritsika. Zaka 2 zapitazi ndidayamba kusuntha zowonjezereka, nthawi yamasika ndi chilimwe ndimapita kumayiko tsiku lililonse, ndikumalima tomato ndikugulitsa pamsika. Azakhali anga amadabwa ndimomwe ndimapangira chilichonse, komwe ndimapeza mphamvu zambiri, sakhulupirira kuti ndili ndi zaka 66.

Ndani akufuna kukhala ndi moyo wautali, wamphamvu komanso kuiwalako za matenda oyipawa kwamuyaya, tengani mphindi 5 ndikuwerenga nkhaniyi.

Momwe mungawerengere kuchuluka kwa insulin mu mtundu I wa shuga

Momwe mungawerengere tsiku ndi tsiku insulin ya mwana yemwe ali ndi matenda a shuga a mtundu woyamba? Funso limakhala pa makolo, ndipo simumalandira yankho kuchokera kwa madokotala. Osati chifukwa madokotala sakudziwa, koma chifukwa, mwina, sakhulupirira makolo osakhazikika.

Tamverani! Sitimfuna kwa wopanga tsitsi kuti atipatse lumo, kuti tidzipukuta tokha, ngakhale kukhala kwathu bwino kumadalira kumeta bwino. Koma kumbali ina, madokotala onse amalankhula zakufunika kwakudziyang'anira pawokha kuti adziwe matenda ashuga. Kudziletsa koyenera sikungakhale kosankha, monga: "Mumaphunzira kuwerengera XE, koma m'mene ndikuwerengera Lantus, osadandaula!"

Kudziyang'anira pawokha kumatenda tsiku ndi tsiku komanso ola limodzi. Ndipo pafupipafupi, makolo a ana odwala matenda ashuga amapanga zisankho zazikulu, zenizeni, zathanzi ndi moyo wa ana awo. Chifukwa chake, funso "zomwe muyenera kudziwa ndi zomwe simuyenera kudziwa" sizoyenera konse. Zachidziwikire - chilichonse kuti mudziwe, kumvetsetsa ndikutha kutero.

Ndidatenga monga American waku America ngati maziko a kumvetsetsa kwanga kwa insulin. Choyamba, chifukwa anthu aku America samafotokozera bwino, ndipo chachiwiri, chifukwa dongosolo la America limachita ndi Israeli, ndipo ichi ndi chinthu choyamba chomwe tidakumana nacho atatha kuwonetsa matenda athu a shuga.

Chifukwa chake, tiyenera kudziwa chiyani za kuchuluka kwa insulin tsiku lililonse?

Chofunikira tsiku lililonse cha insulini chimawerengeredwa pa kilogalamu imodzi ya thupi labwino kwambiri. Ndiye kuti, chimodzi chomwe chimapangidwa ndi asayansi kwa mwana wamba. Ndipo ana oterowo, monga mukudziwa, mulibe chilengedwe. Koma kuti tisawope "mankhwala osokoneza bongo", tikudziwa kuti mlingo wa insulin yolumikizidwa uyenera kusinthasintha pakati pamagawo 0,3-0.8 / kg patsiku.

Ana omwe ali ndi mtundu wa matenda a shuga omwe ndimawadziwa kumene amamulembera mayunitsi 0,5 / kg patsiku. Ndi kuwonongeka kwa matenda a shuga ndi kusakhalapo kwa mankhwala obisika a insulin, kufunikira kwake ndi magawo a 0.7-0.8 / kg. Pamaso pa chindapusa chokhazikika cha matenda a shuga, kufunika kwa insulin kumachepetsedwa kukhala magawo 0.4-0,5 / kg.

Izi ndizomwe zikuyimira. Tsopano tiyeni tiwone ngati mlingo wa insulin wa tsiku lililonse wa mwana wathu amawerengeredwa molondola. Pali njira yofunikira, yomwe madokotala amapangira insulin. Zikuwoneka ngati:

X = 0,55 x kulemera / kg (Mankhwala okwanira tsiku ndi tsiku a insulin (basal + bolus) = 0,55 x pa munthu aliyense wolemera kilogalamu.

X = kulemera / lb: 4 (Izi ndi ngati mumayeza kulemera mapaundi, koma sitiganizira zafanizoli, ndizofanana ndi kakhazikidwe kamakilogamu, ndipo sikofunikira kwambiri kwa ife).

Ngati thupi likulimbana ndi insulin kwambiri, mufunika mankhwala ambiri. Ngati thupi limakonda kwambiri insulin, ndiye kuti insulin ingafunike.

Tinene kuti mwana akulemera makilogalamu 30. Kuchulukitsa kulemera kwake ndi 0.55. Timalandira 16.5. Chifukwa chake, mwana uyu ayenera kulandira magawo a 165 a insulin tsiku lililonse. Mwa iwo, mwachitsanzo, mayunitsi 8 ndi okwanira insulin ndipo 8.5 ndi insulin yochepa musanadye (kadzutsa 3 + nkhomaliro 2,5 + chakudya chamadzulo 3). Kapena magawo 7 ndi basal insulin ndipo 9,5 ndi bolus.

Upangiri! Kachitidwe kokha ndi komwe kungawonetse moyenera kuchuluka kwa insulini, ngati 40-50% ikuyenera kuwerengedwa ndi basulin insulin, ndipo otsalawo azabalalitsidwa pazakudya zomwe zimakhala ndi insulin.

Koma tikudziwa motsimikiza: kulibe matenda a shuga! Timangoyesa kutsatira tanthauzo la golide, koma ngati sizikukwanira ... Chabwino, tikusuntha pakatikati komwe tikufuna.

Kutengera ndi zomwe ndakumana nazo, nditha kunena kuti m'chigawo chathu 13, malamulo onse a shuga omwe timawadziwa adayamba kuvina. Ndipo amavinabe, kusuntha kuchokera ku gaak kupita kuvina kwa St. Witt. Ndili ndi "kupuma" kale sikokwanira kukwera nawo kumapazi.

Mwana amakula ndi masentimita 14 mchaka, koma pafupifupi chaka sichinkalemera! Posachedwa pomwe wayamba kuti akhale bwino. Ndipo apa si insulin, koma majini. Chifukwa chake aliyense anakulira m'mabanja athu. Koma ubongo wa kholo sugona: mwana amadya pang'ono! Koma kudya zochulukirapo - prick kwambiri, ndikuwerengera njira sikumalolezedwanso.

Koma formula imakhazikitsidwa "kulemera" kwabwino! Ndipo ungazipeze bwanji mu kutha? Timasowabe 8-10 makilogalamu ku zabwino! Ndiye pamaziko a zomwe mungawerengere tsiku ndi tsiku insulin: kutengera kulemera kwenikweni kapena koyenera? Ngati titengera izi, ndiye kuti tili ndi insulini. Ndi "abwino" - ochulukirapo. Tinakhazikika pa "golide" wathu.

Ndikuganiza kuti izi ndizowona osati kutha msinkhu kwa achinyamata, ana akhama komanso mosagwirizana amakula pazaka 5, komanso pazaka 7-8, ndi khumi.

Komabe, tikufuna njira zowerengera. Monga nsanamira za malire ku Europe. Palibe chifukwa chogwiritsa ntchito kasamalidwe ka miyambo, koma ndichabwino kudziwa kuti simulinso ku Czech Republic, koma ku Germany kapena ku Poland. Pokhapokha chifukwa pamalo opangira mafuta gasi lina likugwiritsidwa kale ntchito, ndipo yanu singatengedwe. Mukudziwa zambiri - mukuyenda mofatsa. Chifukwa chake, timatenga chilinganizo, ndikukhulupirira, kudziyesa tokha ndikukhalabe ndi moyo.

Momwe mungawerengere kuchuluka kwa insulin mwanzeru?

Insulin ndi timadzi tomwe ma kapamba amayang'anira. Odwala omwe ali ndi matenda ashuga, kufunika kwa insulini kumakweza pang'ono poyerekeza ndi anthu athanzi, motero nthawi zambiri matendawa amaperekedwa jekeseni wowonjezera wa mankhwala.

Chofunikira! Chifukwa chakuti mawonekedwe a thupi la munthu aliyense ndi munthu payekha, chifukwa chilichonse cha matenda ashuga, muyezo wake wa insulin umafunika. Ophunzira endocrinologists amadziwa momwe angawerengere mlingo wa insulin molondola, chifukwa chake ngati kuli kofunikira, pezani thandizo kwa akatswiri odziwa bwino, osathetsa vutoli.

Kodi muyenera kuchita chiyani mutapezeka kuti muli ndi matenda ashuga?

Kumbukirani kuti panthawi yomwe mwapezeka ndi matenda ashuga, chinthu choyamba chomwe muyenera kuda nkhawa ndi cholembera momwe muyenera kulowetsamo zidziwitso zama shuga a magazi.

Kuphatikiza apo, zambiri za kuchuluka kwa mikate zomwe zimadyedwa patsiku ziyenera kulembedwa. Dokotala wanu angakuthandizeni kupanga tebulo lotere. Njira iyi ingakuthandizeni kuwerengera muyeso wa insulin yomwe mumafunikira patsiku.

Gawo lotsatira, lofunika kwambiri komanso lofunikira liyenera kukhala kugula kwa glucometer, komwe mutha kuyeza kuchuluka kwa shuga m'magazi kwakanthawi kochepa kulikonse. Akatswiri amalimbikitsa kuyeza kuchuluka kwa shuga musanadye, komanso maola awiri mutatha.

Makhalidwe abwinobwino ndi 5-6 mmol pa lita imodzi musanadye, ndipo opitilira maola asanu ndi atatu mutatha maola awiri mutatha. Koma ndikofunikira kudziwa kuti pa vuto lililonse lomwe chizindikiro ichi chimasiyanasiyana, ndichifukwa chake kuti muwerenge kuchuluka kwa insulini muyenera kulumikizana ndi dokotala yemwe angadziwe pokhapokha mutayezera kuchuluka kwa shuga panthawi 6 mpaka 7.

Panthawi yopanga miyezo, muyenera kuganizira nthawi yatsiku, kuchuluka kwa chakudya chamafuta, komanso masewera olimbitsa thupi. Muyenera kukumbukiranso zinthu zina zomwe zimakhudza kuchuluka kwa shuga m'magazi - kutalika, kulemera kwa thupi, mawonekedwe a nthawi yomwe katswiri wina wakupatsani, komanso kupezeka kwa matenda osiyanasiyana osachiritsika. Zizindikiro zonsezi ndizofunika kwambiri mukamamwa insulin yayitali, yomwe siimayimitsidwa pakudya.

Kuphatikiza apo, ndikofunikira kudziwa kuti nthawi yayitali yomwe munthu amamwa insulin kudzera mu jakisoni, thupi limachepetsa. Ngati matendawa atenga nthawi yayitali kwambiri, kapamba amapitiliza kupanga insulin, yofunikira kwambiri mthupi. Nthawi yomweyo, mlingo wa insulin uyenera kuchuluka pang'onopang'ono kuti usavulaze thanzi.

Ndi dokotala wa endocrinologist, mutasanthula mozama machitidwe onse a thupi lanu, omwe angapereke lingaliro pakuwonjezera kuchuluka kwa insulin, komanso kupaka utoto wokwanira. Kuphatikiza apo, odwala matenda ashuga amayenera kuwunikira miyezi isanu ndi umodzi kuchipatala, kapena kunja, kuti madokotala azitha kuyang'ana kusintha konse mthupi.

Kuti mupeze molondola kuchuluka kwa insulin, ndikofunikira kuti mukhale ndi chidziwitso chapadera, komanso kukhala ndi chidziwitso chomwe chingapezeke pogwiritsa ntchito zida zamakono zogwiritsira ntchito mankhwala mosamala kwambiri. Chifukwa chake, kuti mukhale ndi moyo wautali komanso wachimwemwe, odwala matenda ashuga ayenera kutsatira mosasamala zofunikira zonse za madotolo.

Chiwerengero chowerengera

Tiyeni tiyese kuwerengera za kuchuluka kwa insulin. Chifukwa chake insulin chithandizo imakhala ndi zigawo ziwiri (bolus - yochepa komanso ya ultrashort insulin komanso basal - insulin yayitali).

1. Kwa anthu omwe ali ndi chinsalu chotsalira cha insulin (mfundo iyi iyenera kuyang'aniridwa ndi endocrinologist), mlingo woyambira wa tsiku ndi tsiku ndi 0.3-0,5 U / kg wa PERFECT BODY WEIGHT (womwe umawerengeredwa pogwiritsa ntchito njira ya kukula-100) Pali njira zambiri zolondola, koma kwambiri komanso osazindikira. Popeza kuti tikuopa kupitilira, tikuganiza kuti mwasungabe zinsinsi zanu.

Zili choncho 0,5ED * 50kg = 25ED (timatenga 24, chifukwa mu syringes yogawa pa 2 PIECES)

2. Mlingo wa tsiku ndi tsiku umagawidwa pakati pa basal ndi bolus 50/50. Ine.e. Magawo 12 ndi 12.

Basal, mwachitsanzo, LEVIMER - 12 PISCES patsiku (ngati gawo limodzi la insulin limatenga nthawi yayitali kuposa mayunitsi 12, ndiye kuti timagawa ndi 2, mwachitsanzo 14 - zikutanthauza 8 m'mawa komanso 6 tisanadye chakudya) M'mikhalidwe yathu, sizofunikira.
Bolusnaya -. NOVORAPID - magawo anayi musanadye kadzutsa, nkhomaliro ndi chakudya chamadzulo.

3. Pambuyo pa izi, timatsatira kufa kosasintha (werengani za zakudya pamwambapa)

4. Pambuyo pa tsiku, timatenga mbiri ya glycemic.

Mwachitsanzo, zidzakhala motere:

musanadye chakudya cham'mawa 7.8 maola awiri 2 mukatha kudya kadzutsa - 8.1 musanadye nkhomaliro maola 4,6 patsiku maola awiri mutatha kudya chakudya chamadzulo. 8.1

Kutanthauzira kwa zotsatira:

Mlingo wa bolus musanadye chakudya cham'mawa sikokwanira, chifukwa glycemia atatha kadzutsa oposa 7.8 ==> onjezani magawo awiri a Novorapid - zimapezeka kuti asanadye kadzutsa ndikofunikira kuti musayike 4, koma magawo 6. Asanadye nkhomaliro - momwemonso Koma musanadye chakudya - zonse zili bwino - siyani magawo anayi

Tsopano tiyeni tisunthire kupita ku basal insulin. Muyenera kuyang'ana ziwerengero za glycemic musanadye kadzutsa (shuga yofulumira) ndipo nthawi ya 23:00 ayenera kukhala pazigawo za 3.3-5.3. Likukhalira kuti m'mawa shuga amawonjezeka - mutha kugawanitsanso mlingo mu magawo awiri. (8 m'mawa ndi enanso 4 madzulo) ngati ziwerengerozi zimapezeka nthawi yomweyo, ndiye kuti timawonjezera 2 ED ku mlingo wa nkhomaliro wa insulin yowonjezera. (kuyambira m'mawa ndikwezeka).

Pambuyo pa masiku awiri, kubwerezanso mbiri ya glycemic ndikubwereza zonse zomwe zanenedwa pamwambapa, ziwerengero ziyenera kukhazikika.

p / w milungu iwiri ya fructosamine p / w glycated hemoglobin (ngati imakwezedwa (monga momwe mumafunira), ndiye kuti shuga siyalipidwa)

Pokhapokha NDIDZATSITSITSA ZAUTHENGA uwu USIYENSE KUGWIRITSITSITSITSITSITSITI INU POPANDA KUTSOGOLA. Sindikumveranso UTHENGA WABWINO WONSE.

Buku lamalangizo

Mukapezeka kuti muli ndi matenda a shuga, yambani kuyimba diary yomwe imalemba shuga wanu wamagazi ndi kuchuluka kwake kwa zakudya zomwe mumadya nthawi ya kadzutsa, nkhomaliro komanso chakudya chamadzulo.

Langizo: Gulani mita ya shuga m'magazi kuti muziyang'anira shuga wanu wamagazi nthawi zonse. Zotsatira zomwe muyenera kudalira powerengera kuchuluka kwa insulin ndi 5-6 mmol / L pamimba yopanda kanthu komanso osapitirira maola 8 mmol / L 2 mutatha kudya. Komabe, pamodzi payekha, kupatuka kuzizindikiro izi pafupifupi 3 mmol / l ndikuloledwa. Panthawi ya kusankha kwa mankhwalawa, tikulimbikitsidwa kuyeza kuchuluka kwa shuga m'magazi mpaka 6-7 patsiku.

Mukamayendera, onetsetsani kuti mwalingalira nthawi ya tsiku lomwe muyeso umapangidwira, kuchuluka kwa chakudya chamafuta, komanso kuchuluka kwa magalimoto. Musaiwale za zina zowonjezera zomwe zimakhudza shuga m'magazi: kulemera kwa thupi ndi kutalika, kukhalapo kwa matenda ena osachiritsika, regimen yoyendetsedwa ndi akatswiri ena. Ndizofunikira kwambiri pakuwerengedwa kwa insulin yomwe imakhalapo kwa nthawi yayitali.

Tcherani khutu: "chidziwitso" chambiri cha matenda ashuga, chimachepetsa "inshuwarani" wekha, yomwe kwakanthawi imapitiliza kupangidwa ndi kapamba. Komabe, simuyenera kuwonjezera kwambiri kumwa kwake musanapemphedwe ndi endocrinologist ndikuwunikiratu ngati mwapezeka kuchipatala. Odwala omwe ali ndi matenda ashuga amayenera kuwunika osachepera 1 pachaka.

Wobayira jakisoni wa insulin nthawi zambiri amaperekedwa kuti achepetse kuchuluka kwa shuga m'magazi. Mlingo wake umatengera:

kuchuluka kwa XE komwe mukufuna kudya pakudya (osapitirira 6), kusala kudya kwa magazi, komanso kuchita masewera olimbitsa thupi mutatha kudya. 1 XU nthawi zambiri imafuna kukhazikitsidwa kwa magawo awiri a insulin yochepa. Ngati pakufunika kuti muchepetse kwambiri shuga m'magazi, ndiye kuti pa "kowonjezera" 2 mmol / L, 1 unit ya ICD imayendetsedwa.

Kusankhidwa kwa mlingo wa insulin yomwe imatenga nthawi yayitali kumayamba ndi jakisoni wambiri. Chifukwa chake, ngati mumalowa magawo 10 musanagone, m'mawa mfundo zamagazi sayenera kupitirira 6 mmol / l ndi mlingo wokwanira. Ngati mwapereka mankhwala oterewa, thukuta lanu lakulirakulira ndipo chikhumbo chanu chikukulirakulira, muchepetse ndi ziwalo ziwiri. Chiwerengero pakati pausiku ndi tsiku mlingo uyenera kukhala 2: 1.

Zotsatira zake pakuwerengera mlingo wa insulin. Kuwerengera bwanji?

Tawona kale mu zolemba zam'mbuyomu kuti mtengo (mtengo) wa gawo la insulini umasintha tsiku lonse. Zimasintha mogwirizana ndi zigawo za mkate (XE) komanso mogwirizana ndi shuga. Chifukwa chake, munthu aliyense yemwe akudwala matenda ashuga ayenera kudziwa momwe angapangire mlingo wa insulin, mukusintha masana. Nthawi zambiri, anthu ambiri omwe ali ndi matenda ashuga amakhala ndi zotere tsiku lonse:

M'mawa, insulini ndi "yotsika mtengo" - ndiye kuti, kuchuluka kwa insulini kumafunikira kuti pakhale chakudya chamagulu omwe amadya ndi chakudya komanso kuchepetsa shuga. Masana, insulin "imakwera pamtengo" - mlingo wa insulin womwe umafunika kuchepetsa shuga m'magazi ndikulipira chakudya cham'thupi umachepetsedwa. Nthawi zambiri ndimatenga mtengo wamasiku onse a insulin ngati 1: 1 mpaka magawo a mkate ndipo, kuyambira pamenepo, ndimawerengera zakonzanso zam'mawa ndi zamadzulo. Madzulo, insulini ndi "yotsika mtengo" - insulin yotsika imagwiritsidwa ntchito pakupanga mikate ya mkate kapena kutsika shuga m'magazi kuposa m'mawa ndi masana.

Momwe mungadziwire zolondola coefficients za mtengo wa insulin, ndi momwe mungazigwiritsire ntchito, ndiye kuti, kuwerengera mlingo wa insulin?

Tiyeni tione chitsanzo.

Pa 1: 1 mlingo wa inshuwaransi ya botus, timamwa mlingo wa masana - timakhala ndi nthawi kuyambira maola 10 mpaka 14 (koma dziwani kuti zonse ndizofunikira pakokha - mutha kukhala ndi gawo lina - kudziwa chilichonse pokhapokha ngati muli ndi nthawi komanso chidziwitso). Pakadali pano, mwana wanga wamwamuna wazaka zisanu ndi zitatu amakhala ndi chakudya chambiri ndi chakudya chamasana (ngati tili kunyumba kumapeto kwa sabata kapena tchuthi), kapena nkhomaliro chabe (pambuyo pa sukulu).

Mwachangu, powerengera, komanso kuyesa ndi zolakwika, timapeza mtengo pachimake cha insulin, monga tidachita apa. Tiyeni titenge zinthu zomwezo: mtengo wa insulin mogwirizana ndi kutsika shuga wambiri ndi 4,2 mmol / l, pokhudzana ndi magawo a mkate (kuchokera pamlandu wachiwiri) - 0,9XE.

Chakudya chotsatira, timaganizira chakudya chamadzulo. Timalingalira za XE mndandanda wazakudya zathu ndipo timatsimikiza kuti tidzadya chakudya chamoto ku 2.8 XE. Mlingo wa insulini pa "mtengo" watsiku ndi tsiku uzikhala 2.8 * 0.9 = 2.5 magawo. Kutengera chidziwitso cha anthu ena odwala matenda ashuga, sitiyika pachiwopsezo cha hypoglycemia - ndipo patsogolo tidzachepetsa insulin ndi 20%:

Mayunitsi 2,5 - (2,5 * 20/100) = mayunitsi 2.0 a insulin.

Timayeza shuga m'magazi tisanadye - 7.4 mmol / L. Timaika "deuce", timadya chakudya chamadzulo. Timayeza kuchuluka kwa glycemia pambuyo maola 2 (popeza tili ndi Humalog, ndipo imatha pafupifupi maola 2). Timakhala ndi shuga m'magazi - 5.7 mmol / L. Mwazi wa magazi unachepa, ndiye kuti mlingo wa inshuwaransi yomwe timabayidwa tisanadye chakudya chokwanira chimaperekedwa ndi chakudya komanso timatsitsa glycemia ndi:

7.4 mmol / L - 5.7 mmol / L = 1.7 mmol / L.

Tikuwona kuchuluka kwa mlingo wa botus womwe unayamba kutsika magazi:

1 unit ya insulin - imachepetsa shuga m'magazi ndi ma insulin a 4.2 mmol / L X - amachepetsa shuga la magazi ndi 1,7 mmol / L

X = 1 * 1.7 / 4.2

X = 0,4 - zambiri za insulini zochokera ku mayunitsi a 2,5 omwe tinalowa tisanadye chakudya tidapita m'magazi a shuga, zomwe zikutanthauza kuti magawo 2.1 otsalawo adagwiritsidwa ntchito pakugwira zigawo za 2.8 zama mkate. Chifukwa chake, chakudya chamadzulo chamadzulo chimakhala chofanana ndi:

2.8 / 2.1 = 1.3 - ndiye kuti, gawo limodzi la insulini limaperekera chakudya kwa 1.5 XE.

Mwa mfundo zomwezi, timachita kuwerengera komanso kuwerengera chakudya cham'mawa, kokha sitimatsitsa mlingo wa bolus isanachitike, koma kuonjezera, kapena, ngati pali mantha a hypoglycemia, achisiye chimodzimodzi masana.

Mwachitsanzo, konzekerani chakudya cham'mawa chomwe chili ndi chakudya ku 3 XE. Timawerengera bolus pamtengo watsiku ndi tsiku wa insulin: 3.0 * 0.9 = 2.7 magawo a insulin. Popeza zomwe takumana nazo za anthu odwala matenda ashuga, pomwe, ngati lamulo, insulin "ili yotsika mtengo" m'mawa, tidzayambitsa magawo atatu.

Timayeza shuga m'mawa tisanadye kadzutsa - 5.4 mmol / L. Timayika mayunitsi a 3.0 a bolus insulin (tili ndi humalogue) ndipo timadya chakudya cham'mawa ku 3 XE. Pambuyo pa maola awiri (nthawi yayitali), timayeza kuchuluka kwa shuga - 9.3 mmol / L. Chifukwa chake kuchuluka kwathu kwa botus sikokwanira kulipirira magawo atatu a buledi ndipo ena mwa iwo amapita kukawonjezera glycemia. Timawerenga gawo ili:

9.3-5.4 = 3.9 mmol / L - mulingo wamafuta wamwazi wakwera pamtengo uwu.

Podziwa mtengo wa chakudya chamagulu a shuga a shuga kuchokera palemba lolingana (3.4 mmol / L), titha kuwerengetsa kuchuluka kwa mafuta omwe amapezeka kuti achulukitse kuchuluka kwa shuga m'magazi:

1 XE - imawonjezera shuga m'magazi ndi 3.4 mmol / L X XE - imakulitsa shuga wamagazi ndi 3.9 mmol / L

X = 1 * 3.9 / 3.4

X = 1.1 mayunitsi a mkate amapita kukawonjezera shuga. Kapena, mwachidule, mlingo wa insulin wa bolus sunali wokwanira 1.1 XE. Timapeza magawo ena onse a buledi omwe anali okwanira insulin (gawo lochapidwa):

Chifukwa chake, tinayambitsa magawo atatu a insulin musanadye chakudya cham'mawa, adatilola kuti titenge chakudya champhamvu kokha 1.9XE, 1.1XE yotsalira idapita kukakulitsa glycemia. Momwemo, m'mawa kukonza mgwirizano wa insulin pakudya kadzakhala kofanana ndi:

3,0/1,9=1,58 - ndiye kuti, kuti mukalandire thupi la buledi 1 wa chakudya cham'mawa, magawo a insulin okwanira 1.6 adzafunika.

Pomaliza, ndikufuna kukumbutsani kuti mulingo wambiri, kukonza zina, mtengo wama insulin ndi mikate ya mkate ndi munthu payekha ndipo amawerengedwa padera pa aliyense wodwala matenda a shuga. Mfundo zomwe zaperekedwa munkhaniyi ndizofunikira ndipo zimangoperekedwa pongofotokozera mfundo za kuwerengera. Kugwiritsa ntchito ngati malangizo okonzedwa sikuletsedwa.

Mlingo wa tsiku ndi tsiku wa insulin, kuwerengera

Kuchepetsa shuga kwa odwala matenda a shuga ndi kugwiritsa ntchito insulin, mapiritsi, mankhwala ochepetsa shuga ndi mankhwala azitsamba. Zisonyezero zoika insulin:

mtundu I shuga mellitus, mtundu II matenda ashuga mellitus pa vuto la mankhwala osakwanira othandizira kudya ndi pakamwaacogosis, precomatous zinthu, kuchepa thupi, kutenga pakati, kuyamwa, polyneuropathy, angiopathy ndi kukula kwa zilonda zam'mimba. matenda, chithandizo cha opaleshoni, kuwonongeka kwa chiwindi ndi impso.

Njira ya insulin mankhwala

kwambiri chisamaliro - - subcutaneous angapo jakisoni wakufotokozera yemwe akuchita posachedwapa matenda a shuga, panthawi yomwe ali ndi pakati, ndi ketoacidosis, mtsempha wozungulira makonzedwe osakhalitsa a insulin mu chikomokere, njira yoyambira ya insulin.

Mukapezeka kuti mwazindikira koyamba, mlingo wa insulin tsiku lililonse umatsimikizika potengera kuchuluka kwa magawo 0,5 pa kilogalamu imodzi yakulemera. Mlingo wa tsiku ndi tsiku umasankhidwa mu regimen yolimbitsa thupi (5-6 jakisoni wa insulin yochepa).

Munthawi yonse ya mankhwala a basal-bolus regimen, muyezo wa basal insulin ndi insulini yowonjezera jakisoni asanadye amagawidwa motere:

Chitsanzo. Wodwalayo adalimbikitsa kuchuluka kwa insulin 42 magawo patsiku. Gawo limodzi mwa magawo khumi ndi atatu (14) lidzakhala insulin yokhala nthawi yayitali. Mlingo wotsalira - 28 PIERES amagawidwa motere: 10 PISCES asanadye chakudya cham'mawa, 10 PESCES asanadye nkhomaliro komanso 6 PISCES asanadye.

Kuchita insulin kwa nthawi yayitali kuyenera kuperekedwa nthawi yamadzulo nthawi yomweyo monga jakisoni wa insulin yochepa (mankhwala a nthawi yayitali) kapena m'mawa (mankhwala osokoneza bongo osakhalitsa).

Kugwiritsa ntchito pulogalamu ya "Artificial pancreas" ("Biostator") kunapangitsa kuti athe kuwerengetsa molondola momwe thupi limafunira insulin. Pafupifupi, munthu amafunika pafupifupi magawo 40 a insulini patsiku kuti apitirize kukhala ndi shuga homeostasis.

Chifukwa chake, popereka mankhwala a insulin, ndikofunikira kuti muthe kuyang'ana pa mankhwalawa monga pazokwanira nthawi yoyambayo. Kuwongolera kowonjezereka kumachitika molingana ndi mbiri ya glycemic ndi glucosuric.