Momwe mungagwiritsire ntchito Levemir Penfill Solution

Levemir Penfill

1 ml ya mankhwala Levemir Penfill ali:

Chinsinsi cha insulin - 100 PESCES.

Omwe amathandizira: metacresol, phenol, mannitol, sodium dihydrogen phosphate disodium, nthaka acetate, sodium chloride, sodium hydroxide, hydrochloric acid, madzi a jekeseni.

1 unit ya insulin detemir imafanana ndi 0,142 mg ya anhydrous desalted insulin detemir. UNITS yogwira ntchito ya mankhwala ndiofanana ndi INE ya insulin yaumunthu

Zotsatira za pharmacological

Levemir Penfill ndi othandizira odwala matenda ashuga. Levemir Penfill ndi analogue yosungunuka ya insulin yaumunthu yokhala ndi zotsatira zosatha. Levemir Penfill sadziwika ndi chiwonetsero chachikulu pochita.

M'mayesero azachipatala, kuwonetseratu kwa zotsatira za Levemir Penfill njira inali yayitali kuposa ija ya insulin glargine komanso kulowerera kwa protulin-insulin Hagedorn.

Kuchuluka kwa nthawi yayitali kwa mankhwalawa kumachitika chifukwa cha kulumikizana kwakukulu pakati pa mamolekyulu azinthu zomwe zimagwira, komanso kuphatikiza kwa albumin kwa iwo kudzera m'matumbo amafuta amafuta pamalo a jekeseni. Poyerekeza ndi ndulu ya protamine-insulin Hagedorn, yogwira ntchito ya levemir penfill imagawidwa pang'onopang'ono mu ziwonetsero. Chifukwa cha njirazi, nthawi ndi kuopsa kwa zochita za insulin zitha kuonekeratu.

Hypoglycemic zotsatira za Levemir Penfill njira imakhudzana ndi kuwonjezeka kwa kupezeka kwa glucose ndi minofu ndi minyewa ya adipose atamangidwa ndi ma cell a insulin, komanso kuchepa kwa kumasulidwa kwa chiwindi ndi chiwindi.

Zotsatira za hypoglycemic za levemir Penfill zimatha mpaka maola 24 ndipo zimatha kukhala zosiyanasiyana kutengera mlingo. Chifukwa cha nthawi yayitali, odwala amatha kugwiritsa ntchito Levemir Penfill solution 1 kapena 2 pa tsiku. Mukamagwiritsa ntchito mankhwalawa kawiri pa tsiku, kukonzanso kwa glycemic kulembedwa pambuyo pa jekeseni 2-3. Amadziwika kuti zoposa 50% ya mphamvu yayikulu ya insulir insulini imatheka maola 3-4 pambuyo pa kukonzekera kwa 0-0-0.4 U / kg kwa wodwalayo (kutalika kwa kutchulidwa kwa hypoglycemic pambuyo pakagwiritsidwa ntchito kwa maola 14).

Pambuyo kukhazikitsidwa kwa njira ya Levemir Penfill, malumikizidwe amtundu wa mankhwalawo, kuchuluka kwake kwathunthu, komanso kutalika kwa nthawi ya hypoglycemic kumadziwika.

Pakuwerenga kwa miyezi 6 yankho la Levemir Penfill mwa odwala omwe ali ndi matenda a shuga 1, panali njira yothandiza kwambiri yolimbana ndi matenda a glycemic osatchulika kwenikweni m'magawo a shuga a serum (pambuyo pokondoweza komanso oyambira) poyerekeza ndi kugwiritsidwa ntchito kwa mankhwala a basal-bolus a NPH.

Kafukufukuyu adawonetsa kusakhalapo kwa vuto la insulin pakulemera kwa thupi la wodwalayo. Kuchepa kwa chiwopsezo cha nocturnal hypoglycemia mwa odwala omwe adalandiridwa ngati mankhwala a basal-bolus insulin akufotokozedwa.

Peak insulini kuchuluka kwa detemir adalembedwa seramu 6-8 maola pambuyo subcutaneous makonzedwe a Levemir Penfill yankho. Miyezo yofanana ndendende ndikukhazikika kwa mankhwala (makonzedwe a mankhwalawa kawiri patsiku) zimatheka pambuyo pobayidwa jakisoni awiri. Poyerekeza ndi insulin ina, Levemir Penfill ali ndi kuthekera kocheperako pakumwazika mphamvu pambuyo pakukonzekera.

Pafupifupi kuchuluka kwa mankhwalawa (pafupifupi 0,1 l / kg) kumawonetsera kufalikira kwa chinthu yogwira mu kama.

Detemir insulin metabolism imafanana ndi ya ambulensi ya amkati. Zopatsa mphamvu za mankhwala zilibe ntchito za hypoglycemic.

Mu maphunziro a vivo ndi a vitro, panalibe njira yofunika kwambiri yolumikizirana ndi mankhwala a insulin ndi mafuta acids komanso mankhwala ena okhudzana ndi mapuloteni.

Kuthetsa insulin kuyipa kumatenga mpaka maola 5-7 ndipo zimatengera kuchuluka kwa mayamwidwe ndi mlingo womwe umayendetsedwa.

Pambuyo subcutaneous makonzedwe, seramu insulin milingo ya detemir ndi yogwirizana ndi mlingo kutumikiridwa.

Maphunzirowa sanawonetse kusintha kwamachitidwe a pharmacokinetic a Levemir Penfill yankho malinga ndi jenda ndi zaka (maphunziro mu odwala amisinkhu yosiyanasiyana, kuphatikiza azaka 6 mpaka 12, wazaka 13 mpaka 17 ndi akulu omwe sanawone kusiyana kwakukulu kwa pharmacokinetics).

Panalibe kusintha kwakukulu mu pharmacokinetic mbiri ya Levemir Penfill yankho mu odzipereka athanzi komanso odwala omwe ali ndi vuto laimpso.

Palibe teratogenic, carcinogenic ndi fetotoxic of Levemir Penfill yankho yomwe yapezeka.

Njira yogwiritsira ntchito

Yankho la Levemir Penfill lakonzedwa kuti likwaniritse makina ake. Kutalika kwakukulu kwa kuchitapo kanthu, mbiri ya zochitika zodziwikiratu komanso chiopsezo chochepa cha hypoglycemia yausiku imapangitsa kusankha molondola mlingo wa Levemir Penfill yankho.

Ndikofunikira kusankha njira ya Levemir Penfill yankho payekhapayekha kwa wodwala aliyense. Mlingo wosankhidwa ukhoza kuperekedwa kamodzi kapena kawiri kutengera zosowa za wodwala aliyense. Ngati katswiri akuonetsa kuti njira yachiwiri ya Levemir Penfil iyende, yachiwiri iyenera kutumikiridwa musanadye chakudya chamadzulo kapena asanagone kapena maola 12 atayamba kulongedza m'mawa.

Kutembenuka kuchokera kukonzekera kosiyanasiyana ka insulin kwa yankho la Levemir Penfill

Odwala omwe kale amagwiritsa ntchito ma insulin kapena othandizira nthawi yayitali ayenera kupatsidwa levemir Penfill. Pakusintha kuchokera ku insulin imodzi kupita ku ina, muyenera kupenda mosamala kuchuluka kwa shuga mu seramu.

Ndi zovuta kuchitira motsutsana maziko a kusintha kwa insulin ya nthawi yayitali, kusintha kwa kusintha kwa mankhwala ndi uthandizi wa insulin wokhala ndi kanthu kochepa kapena mankhwala a hypoglycemic angagwiritsidwe ntchito.

Kusankhidwa kwa njira ya Levemir Penfill yankho

Odwala okalamba komanso anthu omwe ali ndi vuto la chiwindi ndi impso ayenera kuyang'anitsitsa magazi a seramu panthawi ya kusankha kwa mankhwalawa (monga ma insulin ena).

Kufunika kosintha kwa yankho la Levemir Penfill kungachitike ngati mukuwonjezera zochitika zolimbitsa thupi, komanso kusintha kwa zakudya kapena mwadzidzidzi / kufalikira kwamatenda opatsirana.

Kukhazikitsidwa kwa yankho la Levemir Penfill

Njira yothetsera Levemir Penfill imayendetsedwa pang'onopang'ono. Ndikulimbikitsidwa kupaka mankhwalawa m'dera la kunja kwa khoma lam'mimba, phewa kapena ntchafu. Ndikulimbikitsidwa kuti musinthe jekeseni iliyonse.

Ma cartridge a Levemir Penfill adapangidwa kuti azigwiritsidwa ntchito ndi ma syringes a Novo Nordisk okhala ndi singano za NovoFine. Ma cartridge a Levemir Penfill ndi ogwiritsa ntchito payekha, kuyambiranso cartridge ndi koletsedwa. Pochita ndi Levemir Penfill ndi insulini ina ku penfill cartridge, zolembera zophatikizana za mankhwala aliwonse ziyenera kugwiritsidwa ntchito.

Musanayambe makonzedwe a yankho la Levemir Penfill, ndikofunikira kuonetsetsa kuti insulin yosankhidwa ndi yolondola, kuti palibe kuwonongeka kooneka ngati katiriji kapena piston ya rabara. Sizoletsedwa kugwiritsa ntchito yankho kuchokera pama cartridge owonongeka, komanso ngati gawo lowoneka la pisitoni limaposa m'lifupi mwake. Musanagwiritse ntchito cartridge ya Levemir Penfill, nembanemba ya mphira iyenera kutetezedwa ndi ma antiseptic oyenera kuchitira jakisoni wa jekeseni (mwachitsanzo, mowa wa ethyl).

Ndi zoletsedwa kugwiritsa ntchito mankhwala a Levemir Penfill:

• M'mapampu a insulin.
• Ngati kusungidwa kosayenera, komanso pambuyo pa kuzizira.
• Ngati pali kuwonongeka kwa katiriji (kuphatikiza ngati cholembera sichinagwere kapena kathumba katayidwe ndi zovuta zakunja).
• Mtundu kapena kuwonekera kwa yankho kumasintha.

Mankhwala a Levemir Penfill amaperekedwa malinga ndi malangizo a cholembera. Tiyenera kukumbukira kuti mlingo wonsewo woperekedwa jakisoni utatha, singano iyenera kusiyidwa pansi pakhungu kwa masekondi 6 mpaka 10. Singano imayenera kuchotsedwa mu cholembera pang'onopang'ono jakisoni iliyonse (kuteteza kutaya kwa insulin).

Zotsatira zoyipa

Zochitika zambiri zovuta zomwe zimalembedwa panthawi ya mankhwala a Levemir Penfill zimagwirizanitsidwa ndi mlingo wa insulin ndipo ndikuwonetsera kwake pamachitidwe ake a pharmacological.

Nthawi zambiri, hypoglycemia yolumikizana ndi kuchuluka kwa mankhwalawa amalembedwa panthawi ya chithandizo. M'mayesero azachipatala, hypoglycemia yolimba yomwe imafuna chithandizo chamankhwala imapangidwa mu 6% ya odwala omwe amalandila Levemir Penfill. M'pofunika kusankha mosamala mlingo wa insulini, popeza kuti hypoglycemia imapangitsa kuti munthu asamadziwe, azigwiritse ntchito, komanso asokonezeke kwakanthawi kapena kugwira ntchito kwa ubongo. Nthawi zina, hypoglycemia imatha kupha.

Nthawi zina, mutabayidwa jekeseni ya Levemir Penfill, mavuto am'deralo adadziwika pambuyo pa kutsata, makamaka hyperemia, pruritus, ndi minofu edema (m'maphunziro azachipatala, izi zimawonedwa mu 2% ya odwala). Zochitika zambiri zakomweko zimachitika mwa iwo okha ndipo sizinkafuna chithandizo.

M'maphunziro azachipatala, zochitika zotsatirazi za Levemir Penfill solution zidalembedwanso:

• Metabolism: hypoglycemia (kuphatikizapo zizindikiro monga kutsika, thukuta lozizira, kunjenjemera, kuchuluka kwa mantha, kuda nkhawa, kufooka, kusokonezeka chidwi, kugona, kusokonezeka, kusokonezeka, tachycardia, nseru, mutu, kusokonezeka kwakanthawi, njala). Nthawi zina, kwambiri hypoglycemia inalembedwa, kuwonetseredwa kutayika kwa chikumbumtima, kukomoka, kusokonekera kwa ubongo ntchito.
• Zomwe zimachitika mdera: minyewa ya edema, kuyabwa, khungu lake, lipodystrophy (makamaka ndi kukhazikitsa mlingo uliwonse).
• Hypersensitivity: hyperhidrosis, pruritus wodziwika bwino, edema ya Quincke, kupuma movutikira, mantha anaphylactic.
• Ziwalo zamavuto: kuchepa kowoneka bwino, zolakwa zoyesereranso.

Tiyenera kudziwa kuti zochita za hypersensitivity zimakhala zopanda chitetezo pamoyo wa wodwalayo. Ndi kukula kwa zizindikiro zoyambirira za hypersensitivity, wodwalayo ayenera kupita kuchipatala mwadzidzidzi.

Odwala omwe ali ndi matenda ashuga, matenda ashuga a retinopathy amatha kuchitika mokwanira chifukwa cha kuchepa kwa glycosis. Zotsatira izi sizikugwirizana mwachindunji ndi kugwiritsa ntchito njira ya Levemir Penfill, komabe, kusankha kosayenera kwa mankhwalawa kumatha kuyambitsa kukweza ndi kupitirira kwa retinopathy.

Odwala ena omwe ali ndi zotumphukira za neuropathy, ndikusintha kwamphamvu kwa kayendedwe ka glycemic, mawonekedwe osinthika a kupweteka kwa m'mimba amatha kuchitika.

Mimba

Palibe chidziwitso chochepa pakugwiritsira ntchito insulir ya amayi apakati. M'kati mwa maphunziro a levemir Penfill yankho mu nyama, palibe embryotoxic ndi teratogenic zotsatira zomwe zidawululidwa.

Pakati pa nthawi yayitali, kuyang'anira shuga wa seramu ndikofunikira, komwe kumalumikizidwa ndi kusintha kwa insulin nthawi yonse ya mimba. Amayi mu gawo loyamba la kutenga pakati angafunikire kuchuluka kwa insulini, pomwe wachiwiri ndi wachitatu trimester, kufunika kwa insulin kumatha kuchuluka kwambiri. Pambuyo pobereka, mwa odwala ambiri, kufunika kwa insulin kumabweranso koyambirira (komwe kunalembedwa mwana asanabadwe).

Pa mkaka wa m`mawere, azimayi angafunike kusintha kwa mankhwalawa komanso mankhwala a antidiabetesic, komanso kusintha kwa kadyedwe.

Kuyanjana kwa mankhwala osokoneza bongo

Levemir Penfill sagwirizana ndi mankhwala ena omwe angathe kubayidwa. Levemir Penfill samasakanizidwa ndi kulowetsedwa ndi mankhwala a jakisoni mu syringe yomweyo kapena dongosolo.

Mlingo wa insulin uyenera kusinthidwa mukaphatikizidwa ndi mankhwala omwe amasintha ntchito ya insulin kapena zofunika za insulin. Mukamapereka mankhwala, mankhwala ayenera kusamaliridwa ndipo kwa nthawi yoyamba, muziyang'anira kuchuluka kwa shuga wa seramu.

Pali kuchepa kwa insulin kufunikira kophatikiza ndimankhwala osagwirizana ndi beta-adrenoreceptor blockers, monoamine oxidase inhibitors, oral hypoglycemic agents, salicylates, angiotensin-converting enzyme inhibitors ndi mankhwala a ethanol.

Pali chiwopsezo cha insulini kuphatikiza mankhwalawa ndi kukula kwa mahomoni, beta-adrenergic agonists, glucocorticosteroids, mahomoni a chithokomiro, thiazide diuretics ndi danazole.

Tiyenera kudziwa kuti mukamalandira mankhwala a beta-blockers mumadzaza zizindikiro za hypoglycemia ndikuwonjezera nthawi yobwezeretsanso masiku a shuga a seramu.

Ethanol wophatikizira kudya amatha kukulitsa nthawi yayitali komanso kuvuta kwa zotsatira za insulin.

Kugwiritsira ntchito kosakanikirana kwa octreotide / lanreotide kungasinthe kufunika kwa insulin (kutengera kusiyanasiyana kwaumwini, wodwala angafunikire kuwonjezera kapena kuchepa kwa insulin).

Bongo

Lingaliro lenileni la kuledzera kwa insulin silimapangidwa. Ndi kukhazikitsidwa kwa Mlingo wofunika wa insulin wopitilira pazofunikira za wodwalayo, mawonekedwe a hypoglycemia amadziwika. Kukula kwa hypoglycemia kutengera mlingo wa insulin:

• Ndi hypoglycemia yofatsa, odwala amalangizidwa kuti azidya maswiti (mwachitsanzo, zidutswa zingapo za shuga).
• Woopsa kwambiri hypoglycemia, ngati wodwalayo sakudziwa, a glucagon amayenera kubayidwa mosavomerezeka ndikulowetsedwa mu minyewa ya 0,5-1.0 mg (makonzedwe akuyenera kuchitika ndi anthu omwe adalandira malangizo oyenera). Ngati ndi kotheka, kuyambitsa njira ya glucose ya makolo. Kukhazikitsidwa kwa shuga ndikofunikira ngati pambuyo pa mphindi 10-15 kuchokera pakubwera kwa glucagon palibe kusintha pamachitidwe a wodwala.

Popewa kuyambiranso pambuyo poti wodwala ali ndi vuto lakelo, kudya mkamwa wambiri kwamkati kumalimbikitsidwa.

Malo osungira

Levemir Penfill mu cartridge ya ma airtight (musanagwiritse ntchito) amasungidwa kutentha kwa madigiri 2 mpaka 8 Celsius.

Ndi zoletsedwa kumasula mankhwalawa Levemir Penfill.

Moyo wa alumali ndi miyezi 24.

Mukayamba kugwiritsa ntchito cartridge ya Levemir Penfill, muyenera kuyisunga kutentha kutentha kwa kuchipinda (mankhwalawo amagwiritsidwa ntchito ndi ma novo Nordisk amagwira ndikunyamula nawo).

Moyo wa alumali mutayamba kugwiritsa ntchito cartridge ndi masabata 6.

Levemir Penfill ayenera kusungidwa kutali ndi ana.

Mankhwala

Levemir ® FlexPen ® ndi analogue yosungunuka ya basulin insulin yokhala ndi mbiri yayitali yachitetezo, yomwe imagwiritsidwa ntchito ngati basal insulin.

Kuneneratu kwa mankhwalawa kumatchulidwa kwambiri kuposa insulin neutral protamine Hagedorn (NPH-insulin) ndi insulin glargine. Kuchitapo kwa nthawi yayitali kwa mankhwalawa kumachitika chifukwa cha ubale wapamtundu wa insulir insulin m'malo operekera jakisoni ndikuwonjezeranso kwa albumin kwa iwo kudzera m'mphepete mwa mafuta acid. Poyerekeza ndi insulin NPH, insulir ya detemir imafalitsidwa pang'onopang'ono mu zotumphukira za chandamale. Kuphatikiza kwamachitidwe kumeneku kwa kupangika kwa zinthu kumabweretsa kuyamwa kambiri komanso mbiri ya mankhwala Levemir ® FlexPen ® kuposa insulin NPH.

Kutsitsa kwa shuga kwa mankhwalawa ndikulimbikitsa kuthana ndi shuga ndi minyewa pambuyo pomanga insulini ku maselo a minofu ndi mafuta, komanso kuletsa kutulutsidwa kwa glucose ku chiwindi.

Zotsatira za mankhwalawa zimatha mpaka maola 24, kutengera mlingo, womwe umakulolani kuti muchepetse jekeseni imodzi kapena awiri patsiku. Ndi kukhazikitsidwa kwa kukhazikika kwa glycemia kawiri tsiku lililonse kumatheka. Ndi kuyambitsa kwa mankhwala a Levemir ® FlexPen ® pamlingo wa 0,2-0.4 U / kg kulemera kwakukuru koposa 50% ya mphamvuyo kumatheka pambuyo pa maola 3-4 ndipo kumatha pafupifupi maola 14 jekeseni atatha.

Pambuyo subcutaneous makonzedwe a mankhwalawa, monga pharmacological zotsatira (pazotheka, nthawi ya zochita, mphamvu yonse) zimagwirizana ndi mlingo wa mankhwalawa.

M'mayesero azachipatala a nthawi yayitali, kugwiritsa ntchito mankhwalawa Levemir ® FlexPen ® kunasinthasintha kuchepa kwa tsiku ndi tsiku mu glucose othamanga poyerekeza ndi insulin NPH.

Malinga ndi kafukufuku omwe wachitika ndi odwala matenda amtundu wa II omwe amagwiritsa ntchito basal insulin kuphatikiza othandizira a hypoglycemic, kugwiritsa ntchito glycemic control (HbA 1C) ndi Levemir ® FlexPen ® kufananizidwa ndi insulin NPH ndi insulin glargine, pomwe kulemera kochepa (tebulo. 1).

Sinthani kulemera kwa thupi pambuyo pa mankhwala a insulin

Mu gulu la odwala omwe amalandira chithandizo chophatikizidwa ndi ma hypoglycemic othandizira ndi Levemir ® FlexPen ®, milandu ya hypoglycemia usiku imawonedwa pa 61-65% poyerekeza ndi insulin NPH.

Chiyeso chotseguka, chosasankhidwa cha odwala matenda a shuga a mtundu II omwe amagwiritsa ntchito mankhwala oteteza matenda a shuga sichinafike pamlingo wowongolera glycemic, ndipo adayamba ndi nthawi ya sabata 12 m'mene odwala amalandila liraglutide + metformin. Pamapeto pa nthawi imeneyi, mwa odwala 61%, kuchuluka kwa HbA 1C kunachepa

Chithandizo cha matenda a shuga mwa akulu ndi ana okulirapo kuposa 2 years.

Kuyanjana ndi mankhwala ena ndi mitundu ina yoyanjana

Monga mukudziwa, mankhwalawa amakhudza kagayidwe kazakudwala, kamene kamayenera kuganiziridwa posankha kuchuluka kwa insulin.

Mankhwala omwe angachepetse insulin

Oral hypoglycemic agents (PSS), monoamine oxidase inhibitors (MAO), osasankha b-blockers, ACE inhibitors (ACE), salicylates, anabolic steroids ndi sulfonamides.

Mankhwala omwe angakulitse kufunikira kwa insulin

Kulera kwapakamwa, thiazides, glucocorticoids, mahomoni a chithokomiro, sympathomimetics, kukula kwa mahomoni ndi danazole.

• blockers amatha kuteteza zizindikiro za hypoglycemia.

Octreotide / lanreotide imatha kuwonjezeka ndikuchepetsa kufunika kwa insulin.

Mowa umatha kukulitsa mphamvu ya hypoglycemic ya insulin.

Zolemba zogwiritsira ntchito

Asanayende m'malo osiyanasiyana, odwala ayenera kufunsa dokotala, chifukwa izi zimasintha jakisoni wa insulin komanso kudya.

Kusakwanira kwa dosing kapena kusiya kulandira chithandizo (makamaka ndi matenda amtundu wa I) kungayambitse matenda a hyperglycemia ndi matenda ashuga a ketoacidosis. Nthawi zambiri, zizindikiro zoyambirira za hyperglycemia zimayamba pang'onopang'ono kwa maola angapo kapena masiku. Amaphatikizaponso ludzu, kukokana pafupipafupi, kusanza, kusanza, kugona komanso kuyanika pakhungu, pakamwa pouma, kusowa kudya, komanso kununkhira kwa acetone mumlengalenga.

Mtundu woyamba wa matenda a shuga, a hyperglycemia, omwe samathandizidwa, amatsogolera ku matenda ashuga a ketoacidosis, omwe mwina ndi omwe amapha.

Kudumpha zakudya kapena kuchita masewera olimbitsa thupi mosayembekezereka kungayambitse hypoglycemia.

Hypoglycemia imatha kuchitika pamene mlingo wa insulin upambana kwambiri zomwe wodwala amafunikira.

Levemir ® FlexPen ® sayenera kuthandizidwa ndi hypoglycemia kapena ngati akukayikira kuti wodwalayo akuyamba hypoglycemia.

Odwala omwe atukula kwambiri kuchuluka kwa shuga m'magazi chifukwa chokhudza insulin yokwanira amatha kuwona kusintha kwa chizolowezi chawo, okhazikika a hypoglycemia, omwe ayenera kuchenjezedwa pasadakhale. Zizindikiro zoyambirira zamtsogolo zitha kuzimiririka mwa odwala omwe ali ndi matenda ashuga a nthawi yayitali.

Matenda obvuta, makamaka matenda ndi kutentha thupi, nthawi zambiri zimawonjezera kufunikira kwa insulin. Kufunika kosintha kwa mlingo wa insulin kumatha kuchitika ndimatenda omwe amakhudza impso, chiwindi, gren adrenal gland, gland planditary kapena chithokomiro cha chithokomiro.

Mukasamutsira odwala ku mitundu ina ya insulin, zizindikiro zoyambirira za hypoglycemia zimatha kusintha kapena kuchepa pang'ono poyerekeza ndi kukonzekera kwa insulin kale.

Chotsani kuchokera kukonzekera kwina kwa insulin

Kusamutsa wodwala kupita ku mtundu wina kapena mtundu wa insulin kumachitika moyang'aniridwa ndi achipatala. Kusintha kwa ndende, mtundu (wopanga), mtundu, magwero a insulin (yaumunthu kapena analog ya insulin ya anthu) ndi / kapena njira yopangira ingapangitse kusintha kwa insulin. Mukasamutsa wodwala jakisoni wa Levemir ® FlexPen ®, pangafunikire kusintha mlingo wa insulin wambiri. Kufunika kochita kusankha kwa mankhwalawa kumatha kuchitika pakukhazikitsa mankhwala atsopano, komanso pakubwera milungu ingapo kapena miyezi ingapo yogwiritsidwa ntchito.

Jekeseni tsamba lanu

Mukamagwiritsa ntchito kukonzekera kwa insulin, zimachitika paziwonetsero za jakisoni zimayamba kupweteka, kufinya, kuyanika, urticaria, kutupa, kutupa, ndi kutupa. Kusintha pafupipafupi jakisoni kumatha kuchepetsa pafupipafupi kapena kuletsa kukula kwa izi. Amakumana zimatha patapita masiku angapo kapena milungu. Pafupifupi, kusintha kwa jakisoni kumafunikira kutha kwa mankhwalawa Levemir ® FlexPen ®.

Zambiri pakugwiritsa ntchito mankhwalawa kwa odwala omwe ali ndi hypoalbuminemia ochepa. Kuwunikira mosamala za momwe odwala awa akulimbikitsidwa.

Kuphatikiza kwa thiazolidinediones (pioglitazone, rosiglitazone) kukonzekera kwa insulin

Pamene thiazolidinediones amagwiritsidwa ntchito limodzi ndi insulin, milandu yovuta ya mtima yanenedwa, makamaka kwa odwala omwe ali pachiwopsezo cha mtima wosweka. Izi ziyenera kuganiziridwa popereka mankhwala ndi mankhwala a thiazolidatediones ndi insulin. Ndi kuphatikiza kwa mankhwalawa, odwala ayenera kuyang'aniridwa ndi dokotala kuti apangitse zizindikiro ndi zizindikiro za mtima wosakhazikika, kuchuluka kwa thupi komanso kupezeka kwa edema. Pakakhala kuwonongeka mu ntchito ya mtima, mankhwalawa ndi thiazolidatediones ayenera kusiyidwa.

Gwiritsani ntchito pa nthawi yoyembekezera kapena mkaka wa m'mawere.

Levemir ® FlexPen ® ikhoza kugwiritsidwa ntchito panthawi yomwe muli ndi pakati, koma nthawi yomweyo, zabwino zilizonse zomwe zingapezeke zikuyenera kufananizidwa ndikuwonjezereka kwa chiwopsezo cha zotsatira zoyipa mtsogolo.

Ndikulimbikitsidwa kumalimbitsa kuwongolera pakuwongolera chithandizo cha amayi apakati omwe ali ndi matenda ashuga panthawi yonse yomwe ali ndi pakati, komanso pazochitika zomwe akuganiza kuti ali ndi pakati. Kufunika kwa insulin nthawi zambiri kumachepa mu trimester yoyamba ya kutenga pakati ndikuwonjezeka kwambiri mu trimesters yachiwiri ndi yachitatu. Pambuyo pobadwa, kufunikira kwa insulin kumabweza msanga.

M'mayeso otseguka, oyesedwa mwachisawawa omwe amayesedwa ndi amayi apakati (n = 310) omwe ali ndi matenda amtundu 1, gulu limodzi (n = 152) adalandira Levemir ® FlexPen ® mu regalen basal, ndi yachiwiri (n = 158) monga basal insulin - protamine ya ndewu ya Hagedorn (NPH-insulin). Magulu onsewa adalandira bolor ya Novorapid ®.

Cholinga chachikulu cha phunziroli chinali kuwunika momwe Levemir ® FlexPen ® ingathandizire kukhazikitsa shuga wamagazi mwa amayi apakati omwe ali ndi matenda ashuga. Zotsatira zomwe zapezedwa zikuwonetsa kufunikira kofanana ndi kunyansidwa kwa insulin ndi NPH-insulin pa nthawi yapakati, komanso chitetezo chazomwe amagwiritsa ntchito pamimba, kukulitsa khanda lobadwa kumene komanso khanda.

Zowonjezera pazotsatira zomwe zimapezeka pathupi pofika mankhwala atakhazikitsidwa pamsika wa azimayi 300 omwe amathandizidwa ndi Levemir ® FlexPen ® zimawonetsa kuti sizikhudza mimbayo, sizimawonjezera chiwopsezo cha kusabereka kwa mwana wosabadwa ndipo sizikhala ndi vuto kwa mwana wosabadwayo komanso wakhanda.

Kuyesa kwa nyama sikunawululire za Levemir ® FlexPen ® pa kuthekera kobereka.

Sindikudziwika, insulin ya detemir imatulutsidwa mkaka wa m'mawere. Simuyenera kuyembekezera kuti mwana akangobadwa kumene, chifukwa choti m'mimba mumapezeka chakudya chambiri, insulin yodzikongoletsa ngati peptide imalowetsedwa ku ma amino acid.

Panthawi yoyamwitsa, zingakhale zofunikira kusintha mlingo wa insulin ndi zakudya.

Kafukufuku wazinyama sanawonetse vuto pa chonde.

Kutha kukopa momwe zinthu zikuyendera mukamayendetsa magalimoto kapena njila zina.

Kuyankha kwa wodwalayo komanso kuthekera kwake kochita chidwi kukhoza kukhala ndi vuto la hypoglycemia. Izi zitha kukhala zowopsa nthawi zomwe maluso amenewa ali ofunikira makamaka (mwachitsanzo, poyendetsa kapena kugwiritsa ntchito makina).

Odwala ayenera kulangizidwa kuti azichita zinthu zoteteza hypoglycemia musanayendetse. Izi ndizofunikira kwambiri kwa odwala omwe afooka kapena kulibe zizindikiro za kutsogola kwa hypoglycemia kapena zochitika za hypoglycemia zimachitika pafupipafupi. Zikatero, kuyendetsa bwino kuyenera kuyesedwa.

Zotsatira zoyipa

Zotsatira zoyipa zomwe zimapezeka mwa odwala omwe amalandila Levemir ® FlexPen ® ndizowonetsera za pharmacological zochita za insulin. Zomwe zikuyembekezeka kuti zimachitika mwa odwala omwe amamwa mankhwalawa ndi 12%.

Zotsatira zoyipa zambiri za insulin mankhwala ndi hypoglycemia. Kafukufuku wachipatala awonetsa kuti milandu ya hypoglycemia yoopsa, yomwe pakufunika thandizo la ena, imapezeka pafupifupi 6% ya odwala omwe amalandila Levemir ® FlexPen ®.

Zokhudzana ndi jakisoni wa Levemir ® FlexPen ® ndizofala kwambiri kuposa momwe mumagwiritsira ntchito kukonzekera kwa insulin. Izi zimaphatikizira kupweteka, kufiyira, ming'oma, kutupa, kutupa, kutupa, ndi kuyunkhira pamalo a jekeseni. Nthawi zambiri zimatha msanga kwa masiku angapo kapena milungu ingapo ndikupitiliza chithandizo.

Kumayambiriro kwa kugwiritsira ntchito insulini, zolakwika zoyesereranso zimatha kuchitika ndipo edema nthawi zambiri imakhala yochepa. Kusintha kwamphamvu kwa kayendedwe ka shuga m'magazi kungakhudze "ululu wammbuyo wamitsempha," womwe umatha kusintha. Kusintha kwakanthawi kwamayendedwe a glycemic chifukwa cha kukulitsa kwa mankhwala a insulini kungayende limodzi ndi kufalikira kwakanthawi kwa matenda ashuga, pomwe kuwongolera kwakanthawi kokhazikika kwa matenda a glycemic kumachepetsa chiopsezo cha kupitirira kwa matenda ashuga a retinopathy.

Zotsatira zoyipa zotsatirazi zidawonedwa pamayeso azachipatala, zochitikazi zimawonetsedwa molingana ndi magulu a magulu a MedDRA. Ndi pafupipafupi momwe amachitidwira, amagawidwa pakati pa zomwe zimachitika kawirikawiri (≥ 1/10), nthawi zambiri (≥ 1/100, 1/1000,

Kusagwirizana

Mankhwala omwe amawonjezeredwa kuti awononge insulin angayambitse kuwonongeka kwake, mwachitsanzo, kukonzekera komwe kumakhala ndi thiols kapena sulfites. Levemir ® FlexPen ® sangathe kuwonjezeredwa njira kulowetsedwa.

Levemir ® FlexPen ® sayenera kusakanikirana ndi mankhwala ena.

Cholembera cha syringe chosadzaza bwino chomwe chili ndi cholembera cha 3 ml chomwe chimapangidwa ndi galasi (mtundu 1) ndipo chimasindikizidwa mbali imodzi ndi pisitoni ndi rabara wa brongosutyl ndipo inayo ndi cholembera ndi brongosutyl / polyisoprene rabara. Cholembera chakecho ndichopangidwa ndi pulasitiki. 5 kapena 1 syringe cholembera mu katoni.

Malangizo ogwiritsira ntchito

Mukabayidwa jekeseni wa Levemir, monga mtundu wina uliwonse wa insulin, muyenera kutsatira zakudya.

Anthu ambiri odwala matenda ashuga omwe amathandizidwa ndi insulin sawona kuti ndizotheka kupewa kukhala ndi vuto la hypoglycemia. M'malo mwake, izi siziri choncho. Mutha kusunga shuga wokhazikika ngakhale ndi matenda oopsa a autoimmune. Ndipo makamaka, ndi matenda a shuga a 2 ochepa. Palibe chifukwa chakuwonjezera kuchuluka kwa shuga m'magazi anu kuti mudzilimbitse nokha motsutsana ndi hypoglycemia yoopsa. Onerani kanema pomwe Dr. Bernstein akufotokoza nkhaniyi.

Onani pansipa kuti mumve zambiri.

Kodi levemir ndi insulin ya machitidwe ati? Kodi ndizitali kapena zazifupi?

Levemir ndi insulin wa nthawi yayitali. Mlingo uliwonse womwe umaperekedwa umachepetsa shuga mkati mwa maola 18-24. Komabe, odwala matenda ashuga omwe amatsata zakudya zama carb ochepa amafunika Mlingo wochepetsetsa, 2-8 nthawi yotsika kuposa omwe amakhala. Pogwiritsa ntchito mankhwalawa, mphamvu ya mankhwalawa imatha mofulumira, mkati mwa maola 10-16. Mosiyana ndi wastani insulin Protafan, Levemir alibe chiwonetsero chokwanira kuchitapo kanthu. Samalani ndi mankhwala atsopano a Tresib, omwe amakhala nthawi yayitali, mpaka maola 42, komanso bwino.

Levemir si inshuwaransi yayifupi. Sikoyenera malo omwe muyenera kuthana ndi shuga msanga. Komanso, siyenera kunenedwa musanadye chakudya kuti mugwirizane ndi chakudya chomwe odwala matenda ashuga akukonzekera kudya. Pazifukwa izi, kukonzekera kwakanthawi kapena ultrashort kumagwiritsidwa ntchito. Werengani nkhani "Mitundu ya insulin ndi zomwe amachita" mwatsatanetsatane.

Onerani kanema wa Dr. Bernstein. Dziwani chifukwa chake Levemir ali bwino kuposa Lantus. Mvetsetsani kangati patsiku muyenera kulidulira ilo komanso nthawi yanji. Onani kuti mukusunga insulini yanu molondola kuti isawonongeke.

Momwe mungasankhire mlingo?

Mlingo wa Levemir ndi mitundu ina yonse ya insulin uyenera kusankhidwa payekhapayekha. Kwa odwala matenda ashuga akuluakulu, pali malingaliro oyambira kuti ayambe ndi 10 PIECES kapena 0,1-0.2 PIECES / kg. Komabe, kwa odwala omwe amatsata zakudya zama carb otsika kwambiri, mankhwalawa azikhala okwera kwambiri. Onani shuga wanu wamagazi masiku angapo. Sankhani mulingo woyenera wa insulin pogwiritsa ntchito zomwe mwalandira. Werengani zambiri mu nkhani "Kuwerengera Mlingo wa insulin yayitali usiku ndi m'mawa."

Kodi mankhwalawa amafunika kuti alowetse ndani mwa mwana wazaka 3?

Zimatengera zakudya zamtundu wanji mwana wodwala matenda ashuga. Ngati adasinthidwa kudya zakudya zama carb ochepa, ndiye kuti Mlingo wochepetsetsa kwambiri, ngati homeopathic, ungafunike. Mwinanso, muyenera kulowa ku Levemir m'mawa ndi madzulo muzinthu zosaposa 1 unit. Mutha kuyamba ndi mayunitsi 0,25. Kuti mupeze jekeseni yotsika bwino, ndikofunikira kuthira njira yofayira jakisoni. Werengani zambiri za izo apa.

Pakazizira, poizoni wa chakudya ndi matenda ena opatsirana, Mlingo wa insulin uyenera kuchuluka nthawi 1.5. Chonde dziwani kuti kukonzekera kwa Lantus, Tujeo ndi Tresiba sikungathe kuchepetsedwa. Chifukwa chake, kwa ana aang'ono a mitundu yayitali ya insulin, ndi Levemir ndi Protafan yekhayo amene atsalira. Phunzirani nkhani ya “Matenda a Ana A shuga.” Phunzirani momwe mungatalikitsire nthawi yanu ya tchuthi ndikukhazikitsa mtundu wabwino wama shuga.

Momwe mungasinthire Levemir? Kangati patsiku?

Levemir sikokwanira kumangodula kamodzi patsiku. Iyenera kuperekedwa kawiri pa tsiku - m'mawa ndi usiku. Kuphatikiza apo, zochita zamankhwala a madzulo nthawi zambiri sizikhala zokwanira usiku wonse. Chifukwa cha izi, odwala matenda ashuga amatha kukhala ndi zovuta zam'mawa m'mimba yopanda kanthu. Werengani nkhani yoti "Shuga pamimba yopanda kanthu m'mawa: momwe mungabwezeretsere zodabwitsa". Komanso werengani za "insulin management: momwe ndi momwe mungabayitsire".

Kodi mankhwalawa angafanane ndi Protafan?

Levemir ndi wabwino kwambiri kuposa Protafan. Majekeseni a insulin a Protafan satenga nthawi yayitali, makamaka ngati milingo yotsika. Mankhwalawa amakhala ndi puloteni wa nyama, zomwe nthawi zambiri zimayambitsa matupi awo. Ndikwabwino kukana kugwiritsa ntchito protafan insulin. Ngakhale mankhwalawa akaperekedwa kwaulere, ndipo mitundu ina ya insulin yowonjezera idzayenera kugulidwa ndi ndalama. Pitani ku Levemir, Lantus kapena Tresiba. Werengani zambiri mu nkhani "Mitundu ya Insulin ndi Zotsatira Zawo".

Zomwe zili bwino: Levemir kapena Humulin NPH?

Humulin NPH ndi insulin yochita ngati sing'anga, ngati Protafan. NPH ndi protamine ya Hagedorn yosaloledwa, mapuloteni omwewo omwe nthawi zambiri amayambitsa ziwengo. zimachitika. Humulin NPH sayenera kugwiritsidwa ntchito pazifukwa zofanana ndi Protafan.

Levemir Penfill ndi Flekspen: Kusiyana kwake ndi kotani?

Flekspen ndi cholembera chimbale momwe mavekitala a inshuwaransi ya Levemir amaikiramo. Penfill ndi mankhwala a Levemir omwe amagulitsidwa popanda zolembera kuti mugwiritse ntchito syringes yokhazikika ya insulin. Ma cholembera a Flexspen ali ndi gawo la 1 unit. Izi zitha kukhala zosokoneza mankhwalawa a shuga kwa ana omwe amafunikira kuchuluka. Zikatero, ndikofunika kupeza ndikugwiritsa ntchito Penfill.

Levemir alibe ma analogu otsika mtengo. Chifukwa mawonekedwe ake amatetezedwa ndi patent yomwe kuvomerezeka kwake sikunathe. Pali mitundu ingapo yofanana ya insulin yayitali kuchokera kwa opanga ena. Awa ndi mankhwala Lantus, Tujeo ndi Tresiba. Mutha kuphunzira mwatsatanetsatane nkhani iliyonse. Komabe, mankhwalawa onse siotsika mtengo. Insulin-average insulin, monga Protafan, imakhala yotsika mtengo. Komabe, zili ndi zovuta zina chifukwa omwe Dr. Bernstein ndi tsamba la endocrin-patient.com sakulimbikitsani kugwiritsa ntchito.

Levemir kapena Lantus: ndi insulin iti bwino?

Yankho lachilendo la funsoli laperekedwa munkhaniyi ya insulin Lantus. Ngati Levemir kapena Lantus akukwiyirani, pitilizani kugwiritsa ntchito. Musasinthe mankhwala amitundu ina pokhapokha ngati pakufunika kutero. Ngati mukukonzekera kuyamba kubayitsa insulin yayitali, ndiye yesetsani Levemir. Insulin yatsopano ya Treshiba ndiyabwino kuposa Levemir ndi Lantus, chifukwa imatenga nthawi yayitali komanso bwino. Komabe, zimawononga pafupifupi katatu katatu.

Levemir pa mimba

Kafukufuku wamkulu wazachipatala adachitidwa omwe adatsimikizira chitetezo ndi kuyendetsa bwino kwa kayendetsedwe ka Levemir pa nthawi yapakati. Mitundu yampikisano ya insulin Lantus, Tujeo ndi Tresiba sangadzitame chifukwa cha umboni wabwino wotetezedwa. Ndikofunika kuti mayi woyembekezera yemwe ali ndi shuga wambiri amvetsetse momwe angawerengere Mlingo woyenera.

Insulin siyowopsa kwa mayi kapena kwa mwana wosabadwayo, malinga ngati mankhwalawo asankhidwa molondola. Matenda a shuga oyembekezera, ngati atasiyidwa, amatha kubweretsa mavuto akulu. Chifukwa chake, lembani molimba mtima Levemir ngati dokotala wakuuzani kuti muchite izi. Yesani kuchita popanda kulandira insulin, kutsatira zakudya zabwino. Kuti mumve zambiri, onani nkhani za Pregnty Diabetes and Gestational Diabetes.

Levemir wakhala akugwiritsidwa ntchito kuwongolera matenda a shuga a 2 ndikulemba mtundu 1 kuyambira m'ma 2000s. Ngakhale mankhwalawa ali ndi mafani ocheperako kuposa a Lantus, ndemanga zokwanira zasonkhana pazaka zambiri. Ambiri mwaiwo ndi abwino. Odwala amati insulin imachepetsa shuga m'magazi. Nthawi yomweyo, chiopsezo cha hypoglycemia ndichochepa kwambiri.

Gawo lalikulu la ndemanga zalembedwa ndi azimayi omwe amagwiritsa ntchito Levemir pa nthawi yoyembekezera kuti athe kuthana ndi matenda ashuga. Kwenikweni, odwala awa amakhutira ndi mankhwalawo. Sichosokoneza, jakisoni wobala mwana atatha kuthetsedwa popanda mavuto. Kulondola ndikofunikira kuti musapange cholakwika ndi mlingo, koma ndi kukonzekera kwina kwa insulin ndizofanana.

Malinga ndi odwala, chododometsa chachikulu ndikuti cartridge yoyambira iyenera kugwiritsidwa ntchito mkati mwa masiku 30. Ino ndi nthawi yochepa kwambiri. Nthawi zambiri mumayenera kutaya ndalama zonse zosagwiritsidwa ntchito, ndipo pambuyo pake, ndalama zawalipira. Koma mankhwala onse opikisana ali ndi vuto lomweli. Ndemanga za odwala matenda ashuga zimatsimikizira kuti Levemir ndiwopambana ndi pafupifupi insulin Protafan pazinthu zonse zofunika.

Ndemanga 14 pa "Levemire"

Ndikufuna kuthokoza kwanga kwa oyang'anira tsamba lino chifukwa chatsatanetsatane komanso chothandiza kwambiri. Chifukwa cha zakudya zama carb ochepera komanso jakisoni wochepa wa insulin Levemir, shuga yofulumira ndipo mutatha kudya amasungidwa pazinthu wamba, kumverera kwachifundo. Kutsatira kudya koteroko sikovuta konse.

Chifukwa cha zakudya zamafuta ochepa komanso jakisoni wotsika wa Levemir insulin, kusala kudya ndikatha kudya shuga kumakhala komwe kumadalira malire

Zabwino, pitilizani ntchito yabwino.

Ndikukudziwitsani kuti ndidagawa Levemir mu jakisoni 4 patsiku pamiyeso imodzimodzi, onse ndi amodzi pakatha maola 6 - ndipo zotsatira zake zinali zangwiro. Ndidapeza tsamba lanu, ndidaliwerenga kwa masiku awiri, kenako ndikusinthira kuzakudya zama carb ochepa ndikusintha dongosolo langa la jakisoni wa insulin. Lero ndi sabata monga momwe ndiriri muulamuliro watsopano - shuga sichidatuluke! Ndinali ndi vuto la shuga pamimba yopanda kanthu chifukwa m'mawa kutacha - anasankha. Zikomo kwambiri patsamba lino! Owerenga, izi ziyenera kukhulupiliridwa ndikuthandizidwa, monga akunena apa!

shuga sanadzuke! Ndinali ndi vuto la shuga pamimba yopanda kanthu chifukwa m'mawa kutacha - anasankha.

Ndakondwa nanu, pitilizani ntchito yabwinoyi.

Moni, moni! Mwana wanga wamkazi ali ndi zaka 7, matenda ake a shuga ali ndi miyezi isanu ndi umodzi. Tsopano ndikuphunzira zolemba zanu, ndisintha kadyedwe kanga ndi zina zonse, chifukwa kudumpha kwa shuga ndi thanzi la mwana ndikusoweka bwino. M'masabata awiri omaliza, mawanga ofiira adayamba kuwoneka kuchokera pamajekesedwe a Levemir. Ndiuzeni, kodi ndizosowa kapena ayi?

mawanga ofiira adayamba kuwoneka kuchokera jakisoni wa Levemir. Ndiuzeni, kodi ndizosowa kapena ayi?

Palibe amene angayankhe funso motere.

Kusinthana ndi zakudya zama carb otsika - http://endocrin-patient.com/dieta-pri-saharnom-diabete/ - - kumakuthandizani kuti muchepetse mulingo wa insulin yofulumira komanso yayitali nthawi 2-8. Mwa zina, amachepetsa pafupipafupi komanso kuuma kwa thupi lawo siligwirizana.

nditha kusintha zakudya ndi zina zonse

Ili sindili lingaliro lolondola, koma lokha lolondola.

Moni Mwangozi ndapeza tsamba lanu losangalatsa komanso lachilendo. Ndifotokoza momwe ziliri. Ndikuyembekeza kudziwa malingaliro anu. Ndili ndi zaka 59, kutalika 162 cm, kulemera pazaka 8 zapitazi, pang'onopang'ono ndinatsika kuchoka pa 59 mpaka 53 kg. Matenda a 2 a shuga anapezeka mwangozi zaka 7 zapitazo. Zochita ndi mapiritsi. Chaka chino chokha ndidasamutsidwa ku Levemir insulin pa mayunitsi 12 usiku. Panali milandu ya shuga wotsika 2.2-3.0 usiku, kotero dotolo adapenda mankhwalawo ndikuwachepetsa kukhala magawo 8. Pa mlingo uyu, ndinali ndi shuga wabwino 4.8-6.8. Ndinapita kutchuthi chakumwera - ndipo kumeneko, pazifukwa zina, kuchuluka kwa glucose kunali kokulirapo, mpaka 12-13, ngakhale ndidapitilirabe jakisoni wa Levemir. Ndidabwerera kunyumba - zonse zidakhala zabwinobwino. Ndidayesa mapiritsi a Januvius - shuga popanda iwo ndipo motsutsana ndi maziko a kudya kwawo anali omwewo. Funso: Kodi ndilidi ndi matenda ashuga a 2? Ndipo chifukwa chiyani tchuthi cha chilimwe chinakhudza mitengo ya shuga kwambiri?

kodi ndili ndi matenda ashuga a 2?

Ayi, matenda anu amatchedwa shuga a LADA. Palibe phindu kwa inu kumwa mapiritsi aliwonse. Muyenera kutsatira zakudya zamafuta ochepa komanso kubayidwa insulin ngati pakufunika.

chifukwa chiyani tchuthi cha chilimwe chinakhudza mitengo ya shuga kwambiri?

Mwina chifukwa insulin idakwiririka nthawi yoyendera ndikuwonongeka.

Monga lamulo, kupumula, ndipo ngakhale m'malo otentha, kumachepetsa shuga wamagazi, m'malo moipitsa.

Panali milandu ya shuga wotsika 2.2-3.0 usiku, kotero dotolo adapenda mankhwalawo ndikuwachepetsa kukhala magawo 8

Muyenera kuwerengera pawokha mlingo woyenera wa insulin. Yambani ndikuwerenga nkhaniyi - http://endocrin-patient.com/dozy-insulin-otvety/.

Moni Ndili ndi zaka 59, kutalika 182 cm, 80 makilogalamu. Ndakhala ndikuvutika ndi matenda ashuga amtundu 1 kwa zaka 29. Pa insulin kuyambira tsiku loyamba la matenda. Nthawi yotsiriza ndimagwiritsa ntchito magawo 14 a chakudya ndi magulu a Lantus 10 madzulo. Kukakamizidwa kusamutsidwa ku Tujeo. Syringe yoyamba idagwiritsidwa ntchito ndikumalumpha shuga mpaka 20, yowombedwa ndi insulin yochepa. Kumba mpaka zigawo 10. Anabwereranso ku Lantus - zonse zibwerera mwanzeru. Mapeto ake atatha, anasinthana ndi tujeo. Zomwe thupi lidachita zidandikhudza. Shuga adalumphira 20, malo ofiira, monga dermatitis, ndi kuyabwa kudutsa m'thupi. Ndinagula lantus - Ndinalowa m'mbuyomu. Chifukwa chosowa lantus, levemir idaperekedwa. Funso: zinali chiyani ndi ine? Momwe mungasinthire levemir?

Anthu ambiri odwala matenda ashuga amadandaula za zotsatira zoyipa atasintha kupita ku tujeo

Yambani mlingo womwewo wa lantus. Zingafunike kuti muchepetse pang'onopang'ono masiku angapo. Izi ndi za aliyense payekha kwa wodwala aliyense. Sipangakhale kulosera kolondola apa.

Moni Agogo anga aakazi ali ndi zaka 72, kutalika 168 cm, kulemera kwa makilogalamu 93. Kwa nthawi yayitali akhala akuvutika ndi matenda a shuga 2, kuwawa kwa mtima, kupuma movutikira komanso matenda oopsa. Kwa zaka zambiri akhala akumwa mapiritsi: carvedilol, torvacard, zilt, lerkamen, glucophage, thrombotic ass, ramipril, amlodipine. Mwezi watha, adamutsimikizira kuti ayambe kubaya jekeseni wa levemir ndi kusiya kumwa mankhwala oopsa manin. Masiku angapo pambuyo pake, kutupa miyendo yake kunakulirakulira. Madotolo adalangiza kuti ayesedwe magazi chifukwa cha chitsulo. Mulingo wake unachepetsedwa. Veroshpiron, Britomar, ndi Ferro-Folgamm adalembedwanso, kuphatikiza pazomwe zidatchulidwa pamwambapa. Mothandizidwa ndi mankhwalawa, kutupira kumachoka, koma tsopano amadandaula ndi nseru, nthawi zina chizungulire. Mwazi wamagazi umagwira 9-12. Funso: Kodi insulin ingayambitse kutupa ndi mseru? Mwina ena mwa mankhwalawa saphatikizana ndikupereka mavuto? Tithokoze chifukwa cha yankho lanu!

Mwezi watha, adamutsimikizira kuti ayambe kubaya jekeseni wa levemir ndi kusiya kumwa mankhwala oopsa manin.

Bwino pambuyo pake. Ndikofunikanso zomwe agogo amadya. Simungokhala chete pankhaniyi.

Kodi insulin ingayambitse kutupa ndi mseru?

Khansa ya pakhungu - ayi. Kutupa - kotheka. Koma chochititsa china chachikulu ndi kulephera kwa mtima, komwe kumayamba pang'onopang'ono.

Mwina ena mwa mankhwalawa saphatikizana ndikupereka mavuto?

Agogo anu aamuna amatenga mapiritsi angapo am'manja. Mwina ali ndi moyo chifukwa cha izi. Mwa iye, mankhwala kwazaka zambiri adasinthiratu kukonza moyo wabwino.

Kuletsa mapiritsi aliwonse, kuchepetsa mlingo kumatheka pokhapokha povomerezana ndi adokotala, osatinso pakudziyambitsa nokha. Nditha kufunsa adotolo ngati zingatheke kuchotsa Britomar, makamaka Zilt, ngati pakadalibe vuto la mtima. Lerkamen ndi ramipril ali m'gulu lomwelo la mankhwala. Iwo sayenera kutengedwa nthawi yomweyo.

Nkhani yokhudza kuchiza matenda a shuga mwa anthu okalamba ibwera m'manja - http://endocrin-patient.com/diabet-pozhilych-ludej/

Ndili ndi zaka 71, kutalika kwa 170 masentimita, kulemera 75 kg. Matenda a shuga kuyambira 1994, glycated hemoglobin 6.5%. Ndimapanga jabulue jabs a magawo a 3-4 pa chakudya, usiku lantus 16 mayunitsi ndi metformin 1000 mg. Chifukwa chosowa lantus m'mafakisi, ndimasinthana ndi levemire. Ndiuzeni njira zamtundu wambiri, kuchuluka kwa jakisoni.Kodi ndizoyenera kuyesa tujo? Pali ndemanga zoyipa za iye.

Ndiuzeni njira zamtundu wambiri, kuchuluka kwa jakisoni.

Yambani ndi Mlingo wofanana ndi wa Lantus, kenako uoneke.

Kodi ndizoyenera kuyesa tujo? Pali ndemanga zoyipa za iye.

Choyamba, yesani kukhazikitsa bwino chiwongolero chanu cha matenda a shuga ndi Levemir insulin, ndipo koposa zonse, sinthani ku zakudya zamafuta ochepa. Ndipo pokhapokha ngati Levemir sakugwirizana, yesani Tujeo, makamaka Treshiba.

Fomu ya Mlingo:

Subcutaneous Solution

1 ml ya mankhwala ali:
ntchito: insulin detemir - 100 PISCES,

zokopa: glycerol, phenol, metacresol, nthaka acetate, sodium hydrogen phosphate dihydrate, sodium chloride, hydrochloric acid kapena sodium hydroxide, madzi a jekeseni.

Makatoni amodzi amakhala ndi 3 ml ya yankho, lofanana ndi 300 PIERES. Gawo limodzi la insulin detemir lili ndi 0,142 mg ya insulini yopanda mchere. Gawo limodzi la insulin detemir (ED) limafanana ndi gawo limodzi la insulin ya anthu (ME).

Kufotokozera
Yankho lomveka bwino, lopanda utoto.

Malangizo achidule

Levemir ndiye kholo la kampani ya ku Danish ya Novo Nordisk, yomwe imadziwika ndi mankhwala othandizira odwala matenda ashuga. Mankhwalawa adadutsa maphunziro ambiri, kuphatikiza ana ndi achinyamata, pa nthawi yomwe ali ndi pakati. Onsewa sanatsimikize chitetezo cha Levemir okha, komanso kuchita bwino kwambiri kuposa ma insulins omwe amagwiritsidwa ntchito kale. Kuwongolera shuga kumatheka bwino mofananamo matenda ashuga amtundu 1 komanso m'malo okhala ndi vuto lochepa la mahomoni: mtundu 2 kumayambiriro kwa insulin mankhwala ndi matenda a shuga.

Zambiri mwachidule za mankhwalawa kuchokera kuzomwe mungagwiritse ntchito:

Levemir imapanga ma insulin ovuta kuphatikizira - hexamers, imamangiriza mapuloteni pamalo opangira jakisoni, kotero kuti kumasulidwa kwake kwa minofu yapansipansi kumakhala pang'ono komanso koyenda. Mankhwalawa alibe mawonekedwe apamwamba a Protafan ndi Humulin NPH.

Malinga ndi wopanga, zomwe Levemir akuchita ndizabwino kwambiri kuposa zomwe akupikisana nawo kuchokera ku gulu limodzi la insulin - Lantus. Mwa nthawi yogwira ntchito, Levemir idutsa kokha mankhwala amakono komanso okwera mtengo a Tresiba, omwe amapangidwa ndi Novo Nordisk.

Kuthetsa kwa Levemir kapena kutumikiridwa mobwerezabwereza kwa mlingo wosakwanira kumabweretsa kwambiri hyperglycemia ndi ketoacidosis. Izi ndizowopsa makamaka ndi matenda amtundu 1 shuga. Mlingo wowonjezera, kudya zakudya, kulibe zinthu zambiri zomwe zimakhala ndi hypoglycemia. Ngati kunyalanyaza mankhwala a insulini komanso kusinthana kwapafupipafupi kwa glucose wambiri komanso wotsika, zovuta za matenda a shuga zimayambika mwachangu kwambiri.

Kufunika kwa Levemire kumawonjezeka panthawi yamasewera, panthawi ya matenda, makamaka ndi kutentha kwambiri, panthawi yoyembekezera, kuyambira theka lake lachiwiri. Kusintha kwa Mlingo wofunikira kumapangitsa kuti pachimake pakhale kutupa komanso kuchulukirachulukira.

Malangizowo akuwonetsa kuti kwa matenda amtundu 1 wa shuga, kuwerengetsa kwa munthu aliyense kwa wodwala aliyense. Ndi matenda amtundu wa 2, kusankha kwa mankhwalawa kumayamba ndi magawo 10 a Levemir patsiku kapena mayunitsi a 0-0-0.2 pa kilogalamu, ngati kulemera kwake kumasiyananso kwakukulu.

Mwakuchita izi, kuchuluka kumeneku kungakhale kochulukirapo ngati wodwala amatsata zakudya zama carb ochepa kapena ngati akuchita nawo masewera olimbitsa thupi. Chifukwa chake, ndikofunikira kuwerengera kuchuluka kwa insulin yayitali malinga ndi ma algorithms apadera, poganizira glycemia m'masiku ochepa.

Kodi insulin levemir ikuyenda bwanji?

Levemir ndi insulin yayitali. Zotsatira zake ndizotalikirapo kuposa zamankhwala osokoneza bongo - chisakanizo cha insulin ya anthu ndi protamine. Pa mlingo wa mayunitsi 0,3. pa kilogalamu, mankhwalawa amagwira ntchito maola 24. Mlingo wochepera, wocheperako nthawi yogwira ntchito. Odwala omwe ali ndi matenda ashuga, kutsatira zakudya zamafuta ochepa, izi zitha kutha patatha maola 14.

Insulin yayitali silingagwiritsidwe ntchito kukonza glycemia masana kapena pogona. Ngati shuga wokwezeka wapezeka madzulo, ndikofunikira kupanga jakisoni waifupi wa insulin, ndipo pambuyo poti atulutse timadzi tambiri tomwe timatulutsa. Simungasakanize ma insulin analogi amtundu umodzi mu syringe yomweyo.

Kutulutsa Mafomu

Levemir insulin mu vial

Levemir Flexpen ndi Penfill amasiyana mawonekedwe okha, mankhwalawo ali ofanana. Penfill - awa ndi makatiriji omwe amatha kuyikidwa mu ma cholembera kapena kutumizira insulin kuchokera kwa iwo ndi syringe yovomerezeka. Levemir Flexpen - pre-wodzazidwa ndi zolembera zopangira zomwe zimagwiritsidwa ntchito mpaka yankho litatha. Simungathe kuzikulitsanso. Ma cell amakulolani kuti mulowetse insulin muzowonjezera za 1 unit. Afunika kugula padera ndi singano za NovoFayn. Kutengera ndi kukula kwa tinthu tating'onoting'ono, makamaka tating'ono (0.25 mm m'milimita) 6 mm kutalika kapena kupyapyala (0.3 mm) 8 mm amasankhidwa. Mtengo wa paketi ya singano 100 ndi pafupifupi ma ruble 700.

Levemir Flexpen ndi yoyenera kwa odwala omwe ali ndi moyo wokangalika komanso kusowa kwa nthawi. Ngati kufunika kwa insulini kuli kochepa, gawo limodzi la 1 sikulola kuti muimbire molondola mlingo womwe mukufuna. Kwa anthu otere, Levemir Penfill amalimbikitsidwa kuphatikiza cholembera cholondola kwambiri, mwachitsanzo, NovoPen Echo.

Mlingo woyenera

Mlingo wa Levemir amaonedwa kuti ndi wolondola ngati sikuti amasala kudya kokha, komanso hemoglobin wa glycated ali paliponse. Ngati chiphuphu cha matenda a shuga sichokwanira, mutha kusintha insulin yayitali masiku atatu aliwonse. Kuti mudziwe kukonza koyenera, wopangayo amalimbikitsa kutenga shuga wambiri pamimba yopanda kanthu, masiku atatu omaliza akukhudzidwa pakuwerengera

Jekeseni njira

1. Ndi matenda a shuga 1 Malangizo akutsimikizira kukonzekera kwa insulin kawiri: mutadzuka ndi asanagone. Dongosolo lotere limapereka chindapusa kwabwino kwa odwala matenda ashuga kuposa amodzi. Mlingo amawerengedwa mosiyana. Kwa insulin yam'mawa - yozikidwa pa shuga ya tsiku ndi tsiku osala kudya, chifukwa chamadzulo - motengera zoyenera zake zamadzulo.
2. Ndi matenda a shuga a 2 onse osakwatira ndi awiri makonzedwe ndizotheka. Kafukufuku akuwonetsa kuti kumayambiriro kwa mankhwala a insulin, jakisoni imodzi patsiku ndikokwanira kukwaniritsa kuchuluka kwa shuga. Mankhwala okhazikika limodzi safuna kuti munthu awonjezere kuchuluka kwake. Ndi matenda a shuga a nthawi yayitali, insulin yayitali imakhala yanzeru kuthandizira kawiri patsiku.

Gwiritsani ntchito ana

Pofuna kuloleza kugwiritsa ntchito Levemir m'magulu osiyanasiyana a anthu, maphunziro akulu okhudzana ndi odzipereka amafunikira. Kwa ana ochepera zaka ziwiri, izi zimalumikizidwa ndi zovuta zambiri, chifukwa chake, mu malangizo ogwiritsira ntchito, pali malire. Zofananazo zilipo ndi ma insulini ena amakono. Ngakhale izi, Levemir imagwiritsidwa ntchito bwino mu makanda mpaka chaka. Kuthandizirana nawo kumakhala kopambana monga mwa ana okulirapo. Malinga ndi makolo, palibe zoyipa.

Kusintha ku Levemir ndi NPH insulin ndikofunikira ngati:

• shuga yosala kudya siyakhazikika,
• hypoglycemia imawonedwa usiku kapena nthawi yamadzulo,
• mwana wonenepa kwambiri.

Kuyerekeza kwa Levemir ndi NPH-insulin

Mosiyana ndi Levemir, onse a insulin omwe ali ndi protamine (Protafan, Humulin NPH ndi ma analogi awo) ali ndi kutchulidwa kwakukulu, komwe kumawonjezera chiopsezo cha hypoglycemia, kudumpha kwa shuga kumachitika tsiku lonse.

Ubwino Wotsimikiziridwa ndi Levemir:

1. Ili ndi kuthekera kowonekeratu.
2. Amachepetsa mwayi wa hypoglycemia: kwambiri ndi 69%, usiku ndi 46%.
3. Zimapangitsa kuti muchepetse kulemera kochepa ndi matenda a shuga a 2: m'masabata a 26, kulemera kwa odwala ku Levemir kumawonjezera ndi ma kilogalamu 1.2, komanso odwala matenda ashuga a NPH-insulin ndi 2.8 kg.
4. Imayang'anira njala, yomwe imayambitsa kuchepa kwa chidwi cha odwala omwe ali ndi kunenepa kwambiri. Anthu odwala matenda ashuga ku Levemir amathera pafupifupi kcal 160 / tsiku zochepa.
5. Kuchulukitsa katulutsidwe ka GLP-1. Ndi matenda a shuga a 2, izi zimapangitsa kuti awonjezeke insulin yawo.
6. Imakhala ndi phindu pa kagayidwe kamchere wamchere, komwe kumachepetsa chiopsezo cha matenda oopsa.

Drawback yokhayo ya Levemir poyerekeza ndi kukonzekera kwa NPH ndi mtengo wake wokwera. Zaka zaposachedwa, zalembedwera m'ndandanda wa mankhwala ofunikira, chifukwa chake odwala omwe ali ndi matenda ashuga amatha kupeza kwaulere.

Levemir ndi insulin yatsopano kwambiri, motero ilibe mafuta okwera mtengo. Malo omwe ali pafupi kwambiri komanso nthawi yayitali ndi mankhwala osokoneza bongo omwe ali m'gulu la insulin analogues - Lantus ndi Tujeo. Kusunthira ku insulin ina kumafunanso kuti mupeze kuchuluka kwa mankhwalawa ndipo mosakayikitsa kumabweretsa kuwonongeka kwakanthawi pobwezeretsa matenda a shuga, chifukwa chake, mankhwalawa ayenera kusinthidwa pazifukwa zachipatala, mwachitsanzo, ndi tsankho la munthu payekha.

Levemir kapena Lantus - zomwe zili bwino

Wopanga adavumbulutsa zabwino za Levemir poyerekeza ndi mpikisano wake wamkulu - Lantus, yemwe adawonetsa mosangalala malangizo:

Doctor of Medical Science, Mutu wa Institute of Diabetesology - Tatyana Yakovleva

Ndakhala ndikuphunzira matenda a shuga kwa zaka zambiri. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russia Academy of Medical Science idatha kupanga mankhwala omwe amachiritsiratu matenda ashuga. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 98%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipira mtengo wa mankhwalawo. Ku Russia, odwala matenda ashuga mpaka Meyi 18 (kuphatikiza) nditha kuipeza - Kwa ma ruble 147 okha!

• zochita za insulin ndizosatha
• mankhwalawa amapatsa mphamvu zochepa.

Malinga ndi ndemanga, kusiyana kumeneku ndi kosavomerezeka, choncho odwala amakonda mankhwala, mankhwala omwe ndi osavuta kupeza m'derali.

Kusiyanitsa kofunikira ndikofunikira kwa odwala omwe amachepetsa insulin: Levemir imasakanikirana bwino ndi saline, ndipo Lantus amataya zinthu zake pang'ono atasungunuka.

Zoyipa:

Gwiritsani ntchito panthawi yoyembekezera komanso poyamwitsa
Mimba
Pogwiritsa ntchito Levemir ® Penfill ® pa nthawi ya pakati, ndikofunikira kuganizira momwe phindu la kugwiritsira ntchito kwake limaposa ngozi zomwe zingachitike.
Chimodzi mwazoyesedwa zopanda mayeso zokhudzana ndi amayi apakati omwe ali ndi matenda a shuga 1, omwe adaphunzira kufunikira ndi chitetezo cha kuphatikiza mankhwala a Levemir ® Penfill ® ndi insulin aspart (azimayi 152 oyembekezera) poyerekeza ndi isofan-insulin kuphatikiza ndi insulin aspart (Azimayi 158 oyembekezera), sanawonetse kusiyana pakumvetsetsa konse panthawi ya pakati, pazotsatira za pakati, kapena thanzi la mwana wosabadwa ndi wakhanda (onani gawo "

Zotsatira zoyipa:

Zotsatira zoyipa zomwe zimawoneka mwa odwala omwe amagwiritsa ntchito Levemir ® Penfill ® zimadalira kwambiri kumwa komanso zimachitika chifukwa cha kupatsirana kwa mankhwalawa. Hypoglycemia nthawi zambiri zimakhala zotsatira zoyipa kwambiri. Hypoglycemia imayamba ngati mankhwalawa ataperekedwa mothandizidwa ndi kufunika kwa insulin. Kuchokera kuzipatala zamankhwala zimadziwika kuti hypoglycemia yolimba yofunikira yolowererapo imakhala pafupifupi 6% ya odwala omwe amalandila Levemir ® Penfill ®.

Zokhudza malo a jakisoni zimawonedwa nthawi zambiri ndi Levemir ® Penfill ® kuposa poyambitsa insulin ya anthu. Izi zimaphatikizaponso redness, kutupa, kufinya, kutupa, ndi kuyunkhira pamalo a jekeseni. Zambiri zomwe zimachitika pamalo opangira jakisoni ndizochepa komanso zakanthawi, i.e. Kutha kwa mankhwala kwa masiku angapo mpaka milungu ingapo.

Gawo la odwala omwe amalandila chithandizo ndipo omwe akuyembekezeka kukulitsa zovuta zake akuyembekezeredwa ngati 12%. Zomwe zimachitika chifukwa cha zovuta, zomwe zimayesedwa kuti zimakhudzana ndi Levemir ® Penfill ®, panthawi ya mayesero azachipatala, zimafotokozedwa pansipa.

Matenda a metabolism komanso zakudya

Pafupipafupi (> 1/100, 1/100, 1/1 000, 1/1 000, 1/1 000, 1/10 000, ® Penfill ®, itha kuyambitsa kuwonongeka kwa insulin. Levemir ® Penfill ® sayenera kuwonjezera pazowonjezera zothetsera.

Malangizo apadera

Zokhudza mphamvu pakutha kuyendetsa magalimoto ndikugwira ntchito ndi njira
Kuthekera kwa odwala kulolera komanso kuchuluka kwa momwe angachitire kungayambike chifukwa cha hypoglycemia, zomwe zimakhala zowopsa nthawi zomwe maluso amenewa amafunikira makamaka (mwachitsanzo, poyendetsa magalimoto kapena kugwira ntchito ndi makina ndi makina). Odwala ayenera kulangizidwa kuti achitepo kanthu popewa kukula kwa hypoglycemia poyendetsa magalimoto ndikugwira ntchito ndi njira. Izi ndizofunikira kwambiri kwa odwala omwe alibe kapena kuchepa kwa zizindikiro zakutsogolo kwa hypoglycemia kapena akuvutika ndi zochitika zapafupipafupi za hypoglycemia. Muzochitika izi, kuyenera koyendetsa kapena kugwira ntchito yotere kuyenera kuganiziridwa.

Kutulutsa Fomu:

Njira yothetsera makina amtundu wa 100 PIECES / ml.

3 ml iliyonse mu kapu yagalasi yama hydrolytic kalasi yoyamba, yosindikizidwa ndi ma disk a rong brututyl mbali imodzi ndi ma pikitoni a rongosotiryl mbali inayo. Makatoni 5 pazinthu zilizonse za PVC / aluminium zojambulazo. Chithuza chimodzi pamodzi ndi malangizo ogwiritsira ntchito pabokosi lamakatoni.