Mankhwala osokoneza bongo ambiri amachititsa kuti pakhale chipere

Mankhwala osokoneza bongo a insulin ndi imodzi mwazinthu zowopsa zomwe zingachitike osati mwa odwala omwe ali ndi matenda a shuga, komanso mwa anthu athanzi kapena athanzi nthawi zina.

Kodi chiopsezo chachikulu pa thanzi la anthu ndi chiyani pakabuka vuto, momwe mungathandizire munthu yemwe walandira insulin yambiri komanso zina zambiri zomwe zimafunikira kuti aphunzire mwatsatanetsatane.

Kodi insulin ndi chiyani

Insulin ndi mahomoni apamba. Kuyambira 1922, chinthu ichi chakhala ngati mankhwala ochiritsira odwala omwe ali ndi matenda ashuga.

Kuti mumvetsetse zomwe insulin imachita, kwa omwe akufotokozedwayo, komanso ngati kuchuluka kwa mankhwala a insulin omwe angayambitse imfa, ndikofunikira kuphunzira mwatsatanetsatane momwe amagwiritsidwira ntchito mankhwala. Tizigawo ta glucose timalowa m'magazi tikatha kudya. Gawo la shuga limatengedwa ndi ma cellular nthawi yomweyo, ndipo zotsalazo zimasungidwa "posungira".

Insulin imagwira shuga, ndikusintha kukhala glycogen. Ngati insulin itapangidwa pang'ono, dongosolo lonse la glucose limasokonekera.

Kuchuluka kwa shuga m'thupi kumabweretsa hyperglycemia, ndipo mankhwala ambiri a insulin ali ndi zotsatirapo zina - hypoglycemia, mpaka kukula kwa chikomokere.

Kufunika kwa Inulin

Jakisoni wa insulin ndi gawo limodzi mwa njira zachipatala zothandizira odwala omwe ali ndi matenda ashuga. Jakisoni wosaiwalika angayambitse kuwonongeka kwakukalipa, komanso kukhazikitsa muyeso waukulu wa mankhwalawo.

Aliyense amene ali ndi vuto la matenda a shuga mellitus (T1DM) ayenera kumwa insulin pafupipafupi. Komabe, anthu athanzi lathunthu amakhala ndi insulin. Mwachitsanzo, kuti akwaniritse zotsatira zabwino, omanga thupi komanso othamanga ena amapaka jakisoni ngati amodzi mwa mapulogalamu a anabolic ovuta.

Mitundu ya bongo

Mankhwala osokoneza bongo kwambiri omwe amatsogolera kuimfa amatha kukhala pazifukwa zosiyanasiyana. Sizotheka nthawi zonse kupeza mlingo woyenera wa odwala matenda ashuga, womwe umatulutsa chitukuko cha matenda a chifuwa (insulin overdose syndrome).

Malangizo olakwika a insulini amachititsa kuti njira ya matenda ashuga ikhale yovuta komanso yosakhazikika. Zotsatira zake, matenda amayamba.

Wopeza nthawi yake atazindikira kuchuluka kwa vuto la hypoglycemia komanso kusintha moyenera, wodwalayo amatha kupeza mpumulo. Zoneneratu zabwino. Ndikofunikira kupanga miyezo mwadongosolo ndikuphunzira momwe mungayendetsere nokha magazi.

Zifukwa zakukhalira kwamiseche

Mlingo wotetezeka kwa munthu yemwe alibe matenda ashuga si wopitilira 4 IU. Omanga thupi nthawi zina amagwiritsa ntchito molakwika timadzi tambiri, ndikuchulukitsa kuchuluka kwake nthawi 5. Anthu odwala matenda ashuga chifukwa cha zochizira majakisoni 25 mpaka 50 IU a insulin.

Mankhwala osokoneza bongo a insulin omwe ali ndi matenda ashuga komanso anthu athanzi amatha kuchita izi:

1. Cholakwika chamakina mu kipimo
2. Kukhazikika kwa nthawi imodzi
3. Zolakwika pakuwerengedwa kwa mlingo watsopano, chisokonezo pakukonzekera, kusowa kwa katswiri yemwe samamvetsetsa othandizira mahomoni a nthawi yayitali komanso yaying'ono,
4. Kuphwanya mayendedwe a zochita (popanda kumwa mankhwala oyenera),
5. Kunyalanyaza chakudya pambuyo poyambitsa mahomoni,
6. Kusintha kwa mtundu watsopano wamankhwala
7. Mankhwala olakwika paumoyo wathanzi kwa munthu wathanzi (chifukwa cha anthu, kunyalanyaza kwachipatala),
8. Kugwiritsa ntchito molakwika upangiri wamankhwala
9. Nthawi yomweyo kumwa mankhwala a insulin, kumamwa magawo akuluakulu (mkhalidwe umakhala wovuta makamaka ngati wodwala matenda ashuga satenga gawo loyenerera la chakudya motsutsana ndi kuchuluka kwa kulimbitsa thupi).

Mlingo wamba wa insulin ukuunikidwanso kwa amayi apakati omwe ali ndi matenda ashuga. Ndikofunikira kwambiri kuchita izi munthawi yoyamba kubereka. Kuzindikira kwa insulini kumawonjezeka ndi kulephera kwa aimpso, kuwonongeka kwa chiwindi.

Ngakhale Mlingo waung'ono wa insulin ungayambitse vuto la hypoglycemia, ngati simungaganizire za mitundu yapadera ya anthu kapena mawonekedwe a thupi osakhalitsa.

Mlingo: njira zobisika zamankhwala

Zochita za insulin zimayeza mu ED kapena ME. 1 unit ya hormone ndi ofanana 1 24 mg ya crystalline insulin. Kwa anthu omwe amadwala matenda a shuga ogwirizana ndi insulin, njira zonse zapangidwa zomwe zimawonetsa kuwerengera moyenera mlingo umodzi komanso tsiku lililonse wa mankhwalawa.

Pakumuwerengera aliyense wodwala, dokotala amayenera kuyang'anira zotsatirazi:

• Mtundu wamankhwala
• Kodi insulin (yochepa kapena yayitali) imagwira ntchito bwanji?
• M'badwo
• Kulemera
• Kukhalapo kwa matenda osachiritsika,
• Khalidwe labwino
• Nthawi yomwe mankhwalawa adzaperekedwe.

Kuwerengera kwa mulingo woyenera kwambiri ndi njira yovuta. Chovuta chitha kulowa nthawi iliyonse. Mukamasankha mankhwala ndikupanga dongosolo la kayendetsedwe kake, kumwa kwa CL (mikate ya mkate) ndikofunikira.

Mndandanda wamtundu wa glycemic wa chilichonse chophatikizidwa ndizofunikira pano, komanso kuchuluka kwa magawo a chakudya ndi zochitika zenizeni zomwe munthu amalandira.

Zizindikiro zoyambirira za bongo

Ndi bongo wa insulin, kukula kwa hypoglycemia ndikotheka, kudutsa mu chikomokere. Zizindikiro zomwe zimawonetsa kuchuluka kwa mahomoni amayamba kukula pang'onopang'ono, makamaka zikafika poti zimachitika mopitirira muyeso.

Zizindikiro zoyambirira zomwe zikuwonetsa kuchuluka kwa zigawo za insulin mthupi:

• Mkulu kwambiri acetone,
• Kulemera
• Nthawi ndi nthawi, kumakhala kufooka.

The pachimake mawonekedwe a bongo amakhala ndi kukula kwa hypoglycemic syndrome. Mawonekedwe:

• Chikumbumtima
• Opusa kwathunthu
• Chizungulire
• Cephalgia

Hypoglycemia ndi chikomokere

Kuphatikizika kwa zizindikiro kumakhala kotsimikizika, ndipo ndizosatheka kusokoneza hypoglycemia ndi zina zokhudzana ndi matenda, makamaka ngati zimadziwika za mbiri yodwala ya wodwalayo komanso za kayendetsedwe ka insulin.

Kukomoka kwambiri, kuwonetsa kuyambiranso kwa vuto la kuchepa kwa thupi, kumayendetsedwa ndi izi:

1. Palibe thukuta
2. Kuthamanga kwa magazi kugwa kwambiri, mpaka kugwa,
3. Matenda a khunyu ndi otheka,
4. Kupuma pafupipafupi koma nthawi ndi nthawi
5. Ana sakulabadira kuwalako,
6. Mawonekedwe amaso amayenda pang'onopang'ono komanso asymmetrically,
7. Kutulutsa minofu yonse,
8. Kutembenuka mkati modabwitsa.

Thandizo lazadzidzidzi

Mwadzidzidzi kuchuluka kwa insulin yochulukirapo kuzindikirika, kosavuta kwa ma aligorith popereka chithandizo chadzidzidzi choyamba. Ngati chiwonetsero cha hypoglycemic chayamba kumene kuchitika, munthu akudandaula za kufooka komanso kugwedezeka kwa manja, ndipo thukuta lakuzizira latuluka pamphumi pake, ayenera kum'patsa tiyi wotsekemera ndi kuyitanira ambulansi.

Ngati tikulankhula za anthu odwala matenda ashuga omwe ali ndi "chidziwitso", ayenera kukhala ndi njira yoyezera kuchuluka kwa shuga. Ngati muli ndi zizindikiro zowopsa, muyenera kuyeza kuchuluka kwa glucose m'magazi, kenako kudya michere yaying'ono.

Kupewa mankhwala osokoneza bongo ambiri a insulin

Wodwala amayenera kuperekera insulin panthawi yomwe amavomerezedwa, kuyang'anira kuchuluka kwa mankhwalawo.

Amamuona ngati wabwinobwino ngati wodwala matenda ashuga azichita yekha. Ma syringe apadera ndiofunikira kwambiri kugwiritsa ntchito. Zonse zomwe zimafunikira kwa munthu, piyani muyeso womwe mukufuna ndiku kulowamo mosamala.

Ma Unites akuwonetsedwa pamakala. Podziwa kuchuluka kwake, ndi bwino kuti wodwalayo athe kuyimba kuchuluka kwa zonsezo. Majekiseni amaperekedwa musanadye kapena mutatha kudya. Ichi ndi lingaliro lofunikira ndipo endocrinologist imauza wodwalayo za izi, kangapo kuyang'ana kufunikira kwa kutsatira malangizowo.

Jekeseni umachitika m'mimba. Dera lino silikhala lovuta kuchita masewera olimbitsa thupi mwadzidzidzi, chifukwa chake kuyamwa kwa insulin kudzakhala kolondola kwambiri. Ngati mukulowetsa mankhwalawa m'minyewa yam'munsi, matumbo am'mimba amakhala ochepa.

Kuyendetsa bwino insulin komanso kutsatira malamulo onse kungathandize kuti munthu wodwala matenda ashuga asangalale komanso asamaope kuwonongeka mwadzidzidzi. Chofunikira china chotsatira ndikutsatira zakudya zokhwima.

Mbiri ya matenda ashuga

Kwa zaka zambiri osalimbana ndi ma DIABETES?

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

Mbiri ya anthu odwala matenda ashuga imakhudzana ndi mbiri ya anthu. Mwambi wa matenda ashuga ndi umodzi wakale kwambiri! Zinali zotheka kuthetsa izi chifukwa cha sayansi yamakono, kuphatikiza maumisiri opanga ma genetic ndi chidziwitso cha ma cell ndi ma cell maselo.

• Phunziro la matenda ashuga
• Matchulidwe amakono
• Mbiri ya matenda ashuga m'masiku
• Mankhwala omwe adasintha dziko lapansi
• Nthawi ya insulin isanachitike
• Sobolev amagwira ntchito
• Kupezeka kwa insulin
• Yambani kugwiritsa ntchito insulin
• Katswiri wa Majini a Insulin
• Gawo latsopano pakusintha kwa matenda ashuga
• Kupambana mochizira matenda a shuga 1
• Kupambana mochizira matenda a shuga amitundu iwiri

Asayansi ndi madokotala akale, a Middle Ages ndi apano athandiza pa kafukufukuyu. Za matenda ashuga amadziwika kalekale ku BC ku Greece, Egypt, Rome.

Pofotokoza Zizindikiro za matendawa, mawu monga "kufooketsa" ndi "zopweteka" amagwiritsidwa ntchito. Kodi kupita patsogolo kwamatenda ano kwapita patsogolo motani ndipo madokotala amagwiritsa ntchito njira yanji masiku athu ano?

Phunziro la matenda ashuga

Mbiri ya kamvedwe asayansi ka shuga imalumikizidwa ndi kusintha kwa malingaliro otsatirawa:

• madzi osakwanira. Akatswiri achi Greek azaka zamakedzana amafotokoza za kuchepa kwa madzi ndi ludzu losatha,
• shuga kulephera. M'zaka za zana la chisanu ndi chiwiri, asayansi adawonetsa kusiyana pakati pa mkodzo wotsekemera komanso wopanda pake. Mawu akuti "shuga" adayamba kuwonjezeredwa ku mawuwo, omwe kuchokera ku Chilatini amatanthauza "wokoma ngati uchi." Insipid amatchedwa matenda ashuga, omwe amayamba chifukwa cha zovuta za mahomoni kapena matenda a impso.
• okwera magazi. Asayansi atadziwa momwe angadziwire shuga m'magazi ndi mkodzo, adazindikira kuti poyamba magazi a hyperglycemia sangawonekere mkodzo. Kufotokozera kwazomwe zimayambitsa matendawa kunathandizanso kuwunikanso lingaliro la glucose kuterera, zidapezeka kuti kapangidwe ka glucose kosungidwa ndi impso sikasokonekera,
• kusowa kwa insulini. Asayansi ayesa kuyesa kuti atachotsa kapamba, matendawa amapezeka. Adanenanso kuti kusowa kwa mankhwala osakanikirana kapena "zisumbu za Langerhans" kumapangitsa kukula kwa matenda ashuga.

Mbiri ya matenda ashuga m'masiku

Tiyeni tiwone momwe madokotala adapita patsogolo pophunzira za matenda a shuga

• II c. BC e. Dokotala wachi Greek Demetrios waku Apamania adapereka matendawo,
• 1675. Dokotala wakale waku Roma a Areataus adafotokoza kukoma kwa mkodzo,
• 1869. Wophunzira ku Germany wazachipatala Paul Langerhans adasanthula kapangidwe kake kapamba ndipo adawonetsa maselo omwe amagawika gland. Pambuyo pake zidawululidwa kuti chinsinsi chopangidwa mwa iwo chimagwira gawo lofunikira pakukumba,
• 1889. Mehring ndi Minkowski adachotsa kapamba kwa nyama ndipo potero adayambitsa matenda ashuga,
• 1900. Mukufufuza nyama, Sobolev adapeza kulumikizana pakati pa matenda ashuga ndi kapamba,
• 1901. Wofufuza waku Russia a Sobolev adatsimikizira kuti mankhwala omwe amapangidwira kuti insulin, amapangidwa ndimatumba a pancreatic - islets of Langerhans,
• 1920. Kukhazikitsa njira yosinthira zakudya,
• 1920. Kupulumutsidwa kwa insulin ya agalu kuchokera ku kapamba
  1921. Asayansi aku Canada adagwiritsa ntchito njira za Sobolev ndikulandila insulini yeniyeni,
• 1922. Kuyesa koyamba kwa matenda a insulin mwa anthu,
• 1936. Harold Percival adagawa shuga kukhala mtundu woyamba ndi wachiwiri,
• 1942. Kugwiritsira ntchito sulfonylurea ngati mankhwala othana ndi shuga omwe amakhudza matenda a shuga a 2,
• The 50s. Mapiritsi oyamba ochepetsa shuga adawoneka. Anayamba kugwiritsidwa ntchito pochiza odwala matenda a shuga 2,
• 1960. Mphoto ya Nobel chifukwa cha kupezeka kwa njira yogwiritsira ntchito immunochemical pakuyeza magazi a insulin,
• 1960. Mapangidwe a insulin yaumunthu adakhazikitsidwa,
• 1969. Kapangidwe ka glucometer yoyamba kunyamula,
• 1972. Mphoto yodziwira kapangidwe kazinthu zothandizira kugwiritsa ntchito ma X-ray. Mapangidwe atatu a molekyulu a insulin adakhazikitsidwa,
• 1976. Asayansi aphunzira kupanga insulin ya anthu,
• 1988. Tanthauzo la metabolic syndrome,
• 2007. Chithandizo chatsopano pogwiritsa ntchito masentimita omwe mumachokera kuti mumafupa anu. Chifukwa cha izi, munthu safuna jakisoni wa insulin kwa nthawi yayitali.

Nthawi ya insulin isanachitike

Dokotala wakale waku Roma dzina lake Areataus m'zaka za zana lachiwiri BC adafotokoza kale za matendawa. Anamupatsa dzina, lomwe m'Chigiriki limatanthawuza "kudutsa." Dotolo amayang'anitsitsa odwala, omwe anaganiza kuti madzi omwe amamwa kwambiri amangozungulira thupi lonse. Ngakhale amwenye akale adawona kuti mkodzo wa anthu omwe ali ndi matenda ashuga amakopa nyerere.

Madokotala ambiri samayesa kungodziwa zomwe zimayambitsa matendawo, komanso kupeza njira zothanirana ndi matendawa. Ngakhale panali chidwi choterechi, sikunathe kuchiritsa matendawa, omwe amachititsa kuti odwala azunzidwe komanso kuvutika. Madokotala anayesera kuchitira odwala mankhwala azitsamba komanso kuchita masewera olimbitsa thupi. Anthu ambiri omwe anamwalira, monga momwe amadziwira masiku ano, ali ndi nthenda ya autoimmune.

Lingaliro la "matenda a shuga" limapezeka kokha m'zaka za zana la chisanu ndi chiwiri, pomwe dokotala Thomas Willis adazindikira kuti mkodzo wa anthu odwala matenda ashuga umakoma kwambiri. Mfundo imeneyi kwakhala chofunikira pofufuza matenda. Pambuyo pake, madokotala adapeza kuchuluka kwa shuga m'magazi. Koma chimayambitsa kusinthaku mkodzo ndi magazi ndi chiyani? Kwa zaka zambiri, yankho la funsoli silidadziwikebe.

Sobolev amagwira ntchito

Thandizo lalikulu pakuphunzira za matenda a shuga linapangidwa ndi asayansi aku Russia. Mu 1900, Leonid Vasilievich Sobolev adachita kafukufuku wazowunikira komanso woyesa wa kupanga insulini. Tsoka ilo, Sobolev adakanidwa kuthandizira zakuthupi.

Wasayansiyo adamuyesa mu labotale ya Pavlov. M'kati mwa zoyesazo, Sobolev adazindikira kuti zisumbu za Langerhans zimatengapo kagayidwe kazachilengedwe. Wasayansiyo adalimbikitsa kugwiritsa ntchito kapamba wa nyama zazing'ono kuti apange mankhwala omwe amatha kuchiza matenda ashuga.

Popita nthawi, endocrinology inabadwa ndikupanga - sayansi ya ntchito ya gland ya endocrine. Ndipamene madokotala adayamba kumvetsetsa bwino kamangidwe ka matenda ashuga. Katswiri wazanyama Claude Bernard ndiye woyambitsa endocrinology.

Kupezeka kwa insulin

M'zaka za zana la khumi ndi chisanu ndi chinayi, katswiri wazamakhalidwe wa ku Germany Paul Langerhans adayang'anitsitsa zikondwerero, ndikupeza kwapadera. Wasayansi uja adalankhula za ma cell a gland, omwe amachititsa kuti insulini ipange. Apa ndipamene ubale wolunjika unakhazikitsidwa pakati pa kapamba ndi matenda ashuga.

Kumayambiriro kwa zaka za m'ma 2000, dokotala waku Canada Frederick Bunting komanso wophunzira zachipatala Charles Best, yemwe adamuthandiza, adalandira insulin kuchokera ku minofu ya pancreatic. Anayeseza galu wodwala matenda ashuga, momwe ma kapamba ankawonekera.

Iwo adalowetsa insulin yake ndikuwona zotsatira - kuchuluka kwa shuga m'magazi kunatsika kwambiri. Pambuyo pake, insulin idayamba kubisidwa kuchokera ku zikondamoyo za nyama zina, monga nkhumba. Wasayansi waku Canada adalimbikitsidwa kuyesa kupanga njira yochizira matenda ashuga mwangozi - awiri mwa abwenzi ake apamtima adamwalira ndi matendawa. Chifukwa cha kusinthaku, Macleod ndi Bunting mu 1923 adalandira Mphotho Nobel mu physiology kapena mankhwala.

Ngakhale bunting asanafike, asayansi ambiri adamvetsetsa mphamvu ya kapamba pamakina a shuga, ndipo adayesa kudzipatula pa chinthu chomwe chingakhudze shuga m'magazi, koma kuyesa konse konse kudatha. Tsopano asayansi akumvetsa chifukwa chomwe alephera. Vutoli linali loti asayansi analibe nthawi yopatula zomwe angafunike, chifukwa ma enzymes opanga ma pancreatic amapanga insulin m'maselo a protein.

Mothandizidwa ndi kulowererapo kwa opaleshoni, Frederick Bunting adaganiza zoyambitsa kusintha kwa kapamba ndi kuteteza maselo omwe amapanga insulin kuchokera ku zotsatira za michere yake, ndipo atatha kuyesayesa kudzipatula pa tinthu timene timatulutsa.

Kuyesera kwake kudachita bwino. Miyezi isanu ndi itatu yokha yoyesera nyama, asayansi adatha kupulumutsa munthu woyamba. Patatha zaka ziwiri, insulin idamasulidwa pamsika wamafakitale.

Ndizosangalatsa kuti chitukuko cha asayansi sichinathe pomwepo; adatha kudzipatula za insulin m'matumba a ng'ombe ang'onoang'ono, momwe insulin idapangidwira kuchuluka kokwanira, koma ma enzyme opukusa chakudya anali asanapangidwe. Zotsatira zake, adakwanitsa kuchirikiza moyo wa galu wodwala matenda ashuga masiku 70.

Yambani kugwiritsa ntchito insulin

Jakisoni woyamba wa insulin adaperekedwa kwa Leonard Thompson wazaka 14, yemwe amangomwalira ndi matenda ashuga. Kuyesera koyamba sikunakhale kopambana konse, popeza kuti kuchotsedwako sikunatsukidwe bwino chifukwa cha kuyipa kwa mnyamatayo.

Asayansi anapitiliza kuyesetsa kukonza mankhwalawa, pambuyo pake mnyamatayo adalandilanso jekeseni wachiwiri, yemwe adamuukitsa. Nkhani yokhudza kugwiritsa ntchito bwino insulin kwakhala nyimbo zakunja konse. Asayansi anaukitsa kwenikweni odwala omwe ali ndi vuto lalikulu la matenda ashuga.

Katswiri wa Majini a Insulin

Gawo lotsatira pakupanga asayansi inali kupanga zamankhwala zomwe zingakhale ndi katundu womwewo ndipo zitha kukhala ndi maselo ofanana ndi insulin yaumunthu. Izi zidatheka chifukwa cha biosynthesis, asayansi ayambitsa insulini ya anthu.

Kupanga koyamba kwa insulin koyambirira kwa zaka za 1960 kunachitika nthawi yomweyo ndi Panagiotis Katsoyanis ku University of Pittsburgh ndi Helmut Zahn ku RFTI Aachen.

Insulin yoyamba yopangidwa ndi chibadwa cha anthu idapezedwa mu 1978 ndi Arthur Riggs ndi Keiichi Takura ku Beckman Research Institute ndikutenga gawo kwa Herbert Boyer kuchokera ku Genentech pogwiritsa ntchito ukadaulo wa DNA (rDNA), adapangitsanso kukonzekera koyamba kwa insulin - Beckman Research Institute mu 1980 ndi Genentech mu 1982 (pansi pa dzina la Humulin).

Gawo latsopano pakusintha kwa matenda ashuga

Kukula kwa insulin analogues ndi gawo lotsatira la matenda a shuga. Izi zidapangitsa kusintha kwakukulu pamiyoyo ya odwala komanso kunapereka mwayi wokhala ndi moyo wonse. Mavuto a insulin amatha kukwaniritsa malamulo ofanana a carbohydrate metabolism, omwe amakhala mwa munthu wathanzi.

Ma insulin analogi poyerekeza ndi ma insulin ochiritsira amakhala okwera mtengo kwambiri chifukwa chake si aliyense angakwanitse. Komabe, kutchuka kwawo kukuchulukirachulukira, ndipo pali zifukwa zitatu izi:

• Ndikosavuta kuthana ndi matendawa komanso kukhazikika pamatenda a wodwalayo,
• Nthawi zambiri pamakhala kupanikizika kwamphamvu m'magazi am'magazi, komwe kumawopseza kukula kwa chikomokere,
• kuphweka ndi kugwiritsa ntchito mosavuta.

Kupambana mochizira matenda a shuga 1

Asayansi adachita kafukufuku wochepa, pomwe nthawi idawululidwa kuti amatha kugwiritsa ntchito mankhwala oyesera atsopano kuti abwezeretse mphamvu ya thupi yopanga insulin, ndipo izi zimachepetsa kufunika kwa jakisoni.

Asayansi anayesa mankhwalawa kwa odwala makumi asanu ndi atatu omwe ali ndi matenda a shuga 1. Anapatsidwa kukonzekera kwa anti-CD3 komwe kumasokoneza chitukuko cha autoimmune reaction. Pa kuyesa uku, zotsatirazi zidapezeka: kufunika kwa jakisoni wa insulin kutsika ndi 12 peresenti, pomwe kutulutsa kwa insulin kumawonjezeka.

Komabe, chitetezo cha njira zina zamankhwala sichili pamwamba kwambiri. Izi ndichifukwa cha kupezeka kwa mavuto kuchokera ku hematopoietic system. Odwala omwe adamwa mankhwalawa panthawi ya mayesero azachipatala adakumana ndi vuto longa chimfine, kupweteka kwa mutu ndi kutentha thupi. Pali maphunziro awiri odziyimira pawokha a mankhwalawa.

Ndikofunikanso kudziwa maphunziro omwe akuchitika ku America. Kuyesa kwachitika kale pa nyama zokhala ndi matenda ashuga a mtundu woyamba. Mankhwala atsopanowa nthawi zambiri amathetsa kufunika kowunikira pafupipafupi kuchuluka kwa shuga ndi jakisoni wa insulin. Zimatenga mlingo umodzi wokha, womwe umazungulira m'magazi, ndipo ngati pakufunika kuchitika, kuchitika kwake kumachitika.

Kupambana mochizira matenda a shuga amitundu iwiri

Mankhwala ena aposachedwa a matenda a shuga a 2 amapangidwira kuti awonjezere chidwi cha thupi kwa insulin. Komabe, asayansi aku America ananena njira ina yosiyana polimbana ndi matendawa. Chofunikira chake ndikuchepetsa kupanga shuga m'chiwindi.

Popanga kuyesera nyama, zidapezeka kuti chifukwa cha kuletsa mapuloteni ena m'chiwindi, kupanga shuga kumachepa ndipo mulingo wake m'magazi umachepa.

Ndipo asayansi aku New Zealand amakhulupirira kuti anakwanitsa kuthana ndi vuto la matenda ashuga a mtundu wa 2. Njira yawo ndikugwiritsa ntchito zolimbitsa thupi ndi keratin Tingafinye.

Asayansi adayesa mayeso azachipatala mwa anthu, pomwe m'modzi mwa wodwalayo adazindikira kuwongolera kugona komanso kusokonezeka, pomwe winayo anali ndi kuchepa kwa magazi m'magazi. Mu makumi makumi asanu peresenti ya milandu, misempha ya shuga idabwezeretseka. Ndili m'mawa kwambiri kunena za zomwe wapeza, popeza phunziroli likupitirirabe.

Chifukwa chake, matekinoloje opanga ma genetic omwe amagwiritsidwa ntchito pochiza matendawa ndi zozizwitsa kwambiri. Komabe, kufunika kwa matenda ashuga sikumataya tanthauzo lake. Chaka chilichonse anthu ochulukirachulukira amakhalanso ndi vuto la matenda oopsawa.

Kukhala ndi moyo wabwino, kuphatikizapo kudya mokwanira komanso kuchita masewera olimbitsa thupi, kumathandiza kupewa matenda. Musakhale nokha ndi vuto lanu, kulumikizana ndi katswiri. Dokotala adzatsegula mbiri yanu ya zamankhwala, akupatseni malangizo othandizira ndikupereka chithandizo choyenera.

Asayansi saleka kuyesa kupanga mankhwala omwe atha kuthetseratu matendawa. Koma mpaka izi zitheke, kumbukirani kuti kuzindikira koyambirira matendawa ndi njira yothandiza kuti muchiritse. Osakokera ndi dokotala, kukayezetsa, ndikukhala wathanzi!

Kuchita ndi mankhwala ena

Mankhwalawa amapezeka mu njira yothetsera jakisoni wotsekemera komanso wamkati. Aspart insulin ndi gulu la mankhwala omwe amapangidwa pogwiritsa ntchito matekinoloje a bioengineering. Amapezeka pobwereza DNA ya mtundu wa Saccharomyces cerevisiae, ndikusinthidwa kwa amino acid.

The pharmacological zochita za yogwira mankhwala umalimbana mayamwidwe, kuti muchepetse shuga la magazi kwa odwala matenda a shuga.

Insulin aspart imapanga insulin receptor zovuta zomwe zimapereka njira zotsatirazi:

• Mayendedwe a glucose,
• Enzime kaphatikizidwe
• Glycogenogenesis
• Lipid kagayidwe, mkati mwa shuga
• Kusungidwa kwa glycogen mu hepatocytes.

Aspart ndi mtundu wapamwamba kwambiri wopangira insulin. Poyerekeza ndi insulin wamba ya anthu, amachepetsa mapangidwe a hexamers okhazikika omwe amachepetsa kuyamwa kwa mankhwalawa.

Pali mitundu iwiri momwe ma aspart amapangidwira:

1. Gawo limodzi. Yankho lomveka, limakhala ndi kanthawi kochepa (maola 3-5), pambuyo pa kayendetsedwe ka subcutaneous. Iperekeni kuti muchepetse glycemia mukamadya zakudya zamatumbo.
2. Biphasic. Kuphatikizika kophatikizidwa mwa mawonekedwe a kuyimitsidwa kumaperekedwa kokha pochizira matenda amtundu wa 2 shuga. zachokera kuphatikiza kwa insulin yayifupi ndi mankhwala osokoneza bongo. Kutsitsa kwa shuga kumatenga mpaka maola 6.

Popeza fomu yokhala ndi gawo limodzi imakhala ndi kuyamwa kwakanthawi komanso kagayidwe kazinthu, imagwiritsidwa ntchito ngati gawo la zovuta kuchiritsa ndi insulin. Mankhwala a Biphasic amagwiritsidwa ntchito ngati njira ina yochepetsera mankhwala otsitsa shuga a pakamwa, kapena motsatana nawo.

Zofunika! Biphasic insulin aspart ndi yoletsedwa kuperekedwa kudzera m'mitsempha, komanso pampu ya insulin.

Insulin Lizpro (Humalog) ndi mankhwala ochepetsa mphamvu yochepa omwe amatha kugwiritsidwa ntchito ngakhale popanga shuga kwa odwala azaka zosiyanasiyana. Chida ichi ndi chidziwitso cha insulin yaumunthu, koma ndikusintha kakang'ono m'mapangidwewo, omwe amakupatsani mwayi wofikitsa mwachangu thupi.

Chipangizocho ndi njira yokhala ndi magawo awiri, yomwe imayambitsidwa m'thupi kudzera mkati, mwamitsempha kapena kudzera m'mitsempha.

Mankhwala, kutengera wopanga, ali ndi izi:

• Sodium heptahydrate hydrogen phosphate,
• Glycerol
• Hydrochloric acid
• Glycerol
• Metacresol
• Zinc oxide

Pogwiritsa ntchito mfundo zake, Insulin Lizpro amafanana ndi mankhwala ena okhala ndi insulin. Zigawo zomwe zimagwira zimalowa mthupi la munthu ndikuyamba kuchita ziwonetsero zama cell, zomwe zimapangitsa kuti glucose ayambe.

Mphamvu ya mankhwalawa imayamba pakadutsa mphindi 15-20 pambuyo pa kukhazikitsa, zomwe zimakupatsani mwayi wowgwiritsa ntchito mwachindunji pakudya. Chizindikirochi chimatha kusiyanasiyana kutengera malo ndi njira yogwiritsira ntchito mankhwalawa.

Popereka mankhwala a Humalog, dokotala wopezekapo ayenera kuganizira zomwe mukumwa kumwa kale. Zina mwa izo zimatha kuwonjezera ndi kuchepetsa zochita za insulin.

Zotsatira za Insulin Lizpro zimatheka ngati wodwala atenga mankhwala ndi magulu otsatirawa:

• Mao zoletsa,
• Sulfonamides,
• Ketoconazole,
• Sulfonamides.

Ndi kugwiritsanso ntchito mankhwalawa mankhwalawa, ndikofunikira kuchepetsa mlingo wa insulin, ndipo wodwala ayenera, ngati nkotheka, akane kumwa nawo.

Zinthu zotsatirazi zimachepetsa mphamvu ya Insulin Lizpro:

• Njira za kulera
• Ma estrogens
• Glucagon,
• Nikotini.

Mlingo wa insulin pamenepa uyenera kuchuluka, koma ngati wodwalayo akana kugwiritsa ntchito zinthu izi, mpofunika kusintha kwachiwiri.

M'pofunikanso kuganizira zina mwazakudya ndi Insulin Lizpro:

1. Pakuwerengera kuchuluka kwake, dokotala ayenera kuganizira kuchuluka ndi chakudya chomwe odwala amadya,
2. Mu matenda a chiwindi ndi impso, mlingo umayenera kuchepetsedwa.
3. Humalog imatha kuchepetsa ntchito ya kuyenda kwa mitsempha, yomwe imakhudza kuchuluka kwake, ndipo izi zimabweretsa ngozi, mwachitsanzo, kwa eni magalimoto.

Insulin Lizpro (Humalog) imakhala ndi mtengo wokwera kwambiri, chifukwa chomwe odwala nthawi zambiri amapita kukafuna ma analogues.

Mankhwala otsatirawa akhoza kupezeka pamsika omwe ali ndi mfundo zomwezi:

• Monotard
• Protafan
• Rinsulin
• Pakati
• Khalid.

Ndi zoletsedwa kuti asankhe mankhwalawo m'malo mwake. Choyamba muyenera kulandira upangiri kuchokera kwa dokotala, chifukwa kudzipanga nokha kungayambitse imfa.

Ngati mukukayikira luso lanu lazinthu, chenjezo katswiri za izi. Kapangidwe kamankhwala aliwonse kumasiyanasiyana malinga ndi omwe akupanga, chifukwa cha momwe mphamvu yamomwe mankhwalawo amachitikira m'thupi la wodwalayo imasintha.

Insulin Lizpro (dzina lodziwika bwino ndi Humalog) ndi imodzi mwazinthu zamphamvu kwambiri zomwe odwala matenda ashuga amatha kusintha msanga magazi.

Mankhwalawa amagwiritsidwa ntchito nthawi zambiri mitundu yosagwiritsa ntchito insulin (1 ndi 2), komanso chithandizo cha ana ndi amayi apakati. Kuwerengera kolondola kwa mankhwalawa, Humalog sikubweretsa mavuto komanso amakhudza thupi pang'ono.

Mankhwalawa amatha kutumikiridwa m'njira zingapo, koma zofala kwambiri ndizosavuta, ndipo opanga ena amapereka chida chija ndi jakisoni wapadera yemwe munthu angagwiritse ntchito osakhazikika.

Ngati ndi kotheka, wodwala yemwe ali ndi matenda ashuga amatha kupeza maupikisano mu malo ogulitsa mankhwala, koma popanda kufunsana ndi katswiri, kugwiritsa ntchito kwawo nkoletsedwa. Insulin Lizpro imagwiritsidwa ntchito ndi mankhwala ena, koma nthawi zina kusintha kwakofunikira kwa mankhwalawa kumafunikira.

Kugwiritsa ntchito mankhwalawa pafupipafupi sikungosokoneza, koma wodwalayo ayenera kutsatira njira yapadera yomwe ingathandize thupi kuti lizolowera zinthu zina.

Kuledzera kwambiri kwa insulin kumatha kuchitika mopitirira muyeso wa mankhwalawa ndipo kumawonetsedwa mu chikomokere mwa matenda oopsa.

Chofunikira! Kuchepa kwambiri kwa shuga m'magazi kumachitika patatha maola 2-4 pambuyo pobayira jakisoni wa mankhwala ochiritsira (ndikupereka mankhwala okhazikika, hypoglycemia sichitchulidwa kwenikweni, koma imatha mpaka maola 8).

Zizindikiro zochokera mkati mwa dongosolo lamanjenje ndizogwirizana kwambiri ndi kuchuluka kwa shuga mumagazi a cerebrospinal kuposa m'magazi, motero kuopsa kwa zizindikirozi sikugwirizana kwenikweni ndi kuchuluka kwa hypoglycemia.

Kuthekera kwa poizoni wa mankhwala kumadalira makamaka kusinthasintha kwakukulu kwa Mlingo wa kusinthasintha kwakukulu pakubwezeretsanso insulin. Kusintha koteroko kumachitika osati mwa anthu osiyanasiyana, komanso kwa odwala omwewo omwe ali ndi matenda ashuga.

Achibwebwe a boma la hypoglycemic ndi kufooka, kunjenjemera (kapena "kumanjenjemera") m'manja, njala, malovu, kutuluka thukuta, kumva kutentha .

Ndi kuwonjezeka kwa hypoglycemia, vuto lalikulu limatha kukhala ndikutha kukumbukira komanso kukhumudwa. Popeza wodwala wodwala matenda ashuga amatha kupweteka komanso kukomoka chifukwa cha jakisoni wa insulin, ndikofunikira kudziwa kusiyana pakati pawo:

• Matenda a matenda ashuga amakula pang'onopang'ono patapita nthawi yayitali.
• hypoglycemic coma yomwe imayamba chifukwa cha insulin imayamba msanga komanso kutha kuzindikira kumatha kuchitika ngakhale osakuwonetseratu tawatchulawa, kupuma kuli kwabwinobwino, kulibe kununkhira kwa acetone, thukuta limadziwika kuti, kamvekedwe ka minofu sikachepetsedwa, kukokana kumatha kuchitika, kusintha kwa mtima kumakhala kosakhazikika wodekha).

Popewa poyizoni wa insulin, muyenera kuchita izi:

• ngati kuli kotheka, musamapange jakisoni usiku ngati wodwalayo sayang'aniridwa ndi akatswiri odziwa ntchito zamankhwala, chifukwa hypoglycemia imatha kuyamba usiku pamene wodwala alibe thandizo (jakisoni wa mankhwala olimba omwe amaperekedwa usiku ndi otetezeka pazifukwa zomwe zanenedwa pamwambapa),
• kuphunzira wodwala ndi zotsogola zam'magazi a hypoglycemic zomwe zitha kuwononga thanzi, komanso kufunikira konyamula chakudya cham'mimba mosavuta (bun, crackers, shuga, maswiti).

Ngati pali zotsogola zam'magazi a hypoglycemic, wodwalayo ayenera kudya 100-200 g mkate kapena supuni 2-3 za shuga. Kukomoka kukachitika, wodwala amayenera kupatsidwa shuga wambiri 50 ml ya 40% shuga.

Chenjezo: Ngati sizotheka kupereka jakisoni wambiri, 500 ml ya shuga 6% mwanjira imodzi kapena 150 ml ya glucose 10% mu enema iyenera kuperekedwa. Subcutaneous jakisoni wa 0,5-1 ml ya adrenaline amachititsa glycogenolysis mu chiwindi, amalimbikitsa shuga, motero amatha m'malo mwake kutuluka kwa glucose kuchokera kunja.

Komabe, yotsimikizika ndiyodalirika, ndipo glucose wamkati uyenera kuti uthandizidwe ndi subcutaneous, rectal, kenako makonzedwe apakamwa ngati pakumva kupweteka kwambiri.

Mitundu ya Pancreatic Enzymes

Ndi mwa iwo momwe insulin imapangidwira. Akatswiri ambiri opanga ma genetic, akatswiri azamankhwala komanso akatswiri ofufuza zamatsenga amatsutsana pankhani yokhudza kuphatikizidwa kwa chinthuchi. Koma palibe aliyense wa asayansi akudziwa mpaka pamapeto momwe B-cell imatulutsa insulini.

M'mitundu yamtunduwu, mitundu iwiri ya mahomoni imapangidwa. Loyamba ndi lakale kwambiri, kufunikira kwake kwa thupi ndikwakuti, pokhapokha ngati chinthu cha proinsulin chimapangidwa.

Akatswiri akukhulupirira kuti ndilo lomwe linayambitsa insulini yodziwika kale.

Horm yachiwiri idasintha masinthidwe osinthika ndipo imakhala chithunzi chamtundu woyamba wa mahomoni, iyi ndi insulin. Asayansi amati zimapangidwa motengera dongosolo lotsatira:

1. Thupi la insulini limapangidwa m'maselo a B chifukwa cha kusintha kwamasinthidwe. Kuchokera pamenepo, imalowa m'zigawo za Golgi. Mu organelleyi, insulin imayamba kugwiritsidwa ntchito ndi mitundu ina ya mankhwala.
2. Monga tikudziwira, kaphatikizidwe ndi kudziunjikira kosiyanasiyana kwa mankhwala osiyanasiyana kumachitika mu kapangidwe ka Golgi. C-peptide imamveka pamenepo mothandizidwa ndi ma enzyme osiyanasiyana.
3. Pambuyo pamagawo onsewa, insulin yofunikira imapangidwa.
4. Chotsatira ndi kuyika kwa ma protein a protein mu ma granules apadera achinsinsi. Mwa iwo, thunthu limadziunjikira ndipo limasungidwa.
5. Mtsinje wa shuga ukakwera pamwamba pazovomerezeka, insulin imayamba kumasulidwa ndikuchita.

Malangizo akupanga insulini amadalira mphamvu ya glucose-sensor ya B-cell, imapereka kuchuluka pakati pakupanga shuga m'magazi ndi insulin. Ngati munthu adya chakudya chomwe chili ndi chakudya chamagulu ambiri, insulin yambiri imayenera kumasulidwa, yomwe iyenera kugwira ntchito mwamphamvu kwambiri.

Pang'onopang'ono, kuthekera kopanga insulin mu ma pancreatic isens kumafooka. Chifukwa chake, pamene zokolola za kapamba zimachepa palimodzi, shuga ya magazi imakulanso. Ndizomveka kuti anthu azaka zopitilira 40 amakhudzidwa kwambiri ndi kupangika kwa insulin.

Zikondamoyo zimapanga mitundu yambiri yazinthu zofunikira. Amasiyana ndi ziwalo zina za thupi chifukwa zimatha kubisa nthawi imodzi komanso zobisika nthawi imodzi.

Gawo la exocrine limakhala moposa 95% ya kuchuluka kwa kapamba onse. Mpaka 3% imagwera pamabwalo achinyumba (amatchedwanso timadzi tating'ono ta Langerhans), momwe amapangidwira:

Zilumba za Langerhans amazunguliridwa ndi ma capillaries ambiri, motero amalandila michere yambiri yomwe ikufunika kuti zitsimikizike njira zobisika.

Mahomoni omwe amapangidwa mkati mwake amakhudza pafupifupi njira zonse za metabolic m'thupi.

Dzina lamalonda ndi mawonekedwe omasulira

Aspart imapangidwa zonse zabwino komanso ngati gawo lokonzekera zovuta. Pali mitundu ingapo yamomwe mulingo wothandizila ndi insulin aspart. Dzina lazamalonda limatengera mawonekedwe ndi mankhwalawo.

Chizindikiro ichi ndi cha kampani ya Danish Novo Nordisk.

Momwe mungapangire kubwezeretsa kuchuluka kwa mahomoni

Madokotala sangathe kubwezeretsanso ntchito za ma pancreatic islets.

Njira yayikulu yothanirana ndi kusowa kwa insulin ndi kulowetsa zinthu izi kuchokera kunja.

Chifukwa chaichi, nyama ndi ma insulini opangira zinthu amagwiritsidwa ntchito. Mankhwala a insulin amatengedwa ngati njira yayikulu yobwezeretsanso zinthu mu shuga, nthawi zina zimayendetsedwa ndi chithandizo chamankhwala cha hormone. Kuchepetsa kugwiritsidwa ntchito kwa mankhwalawa gwiritsani ntchito zakudya zapadera za carb.

Kuchita kwa insulin pa kagayidwe kachakudya ka mphamvu ndi michere ndi zovuta. Kukhazikitsidwa kwa zotsatira zake zambiri zimatengera luso la insulin kuti isinthe ntchito za ma enzymes ena.

• Kachitidwe ka michere yomwe imathandizira glycolysis (makulidwe a molekyulu ya shuga kuti apange mamolekyulu awiri a pyruvic acid kuchokera pamenepo),
• Kuponderezedwa kwa glycogeneis - kupanga shuga ndi zinthu zina m'maselo a chiwindi,
• Kuphatikiza kwamphamvu ma molekyulu a shuga,
• Kupangitsa glycogen kupanga ndi mahomoni a insulin omwe amathandizira polymerization a mamolekyulu a glucose kukhala glycogen ndi minyewa ndi maselo a chiwindi.

Kuchita kwa insulin kumachitika chifukwa cha mapuloteni olandirira. Ndi protein ya membrane yovuta ya mtundu wophatikizika. Mapuloteniwa amapangidwa kuchokera ku subunits a ndi b, omwe amapangidwa ndi polypeptide unyolo.

Insulin yolumikizidwa ndi tinthu a, ikalumikizidwa, mawonekedwe ake amasintha. Pakadali pano, tinthu b timakhala tyrosine kinase yogwira ntchito. Pambuyo pa izi, gulu lonse la zimachitikira limayambitsidwa ndikuyambitsa ma enzyme osiyanasiyana.

Asayansi sanaphunzirepo bwino momwe kulumikizana kwa insulin ndi zolandirira. Amadziwika kuti mkati mwa nthawi ya diacylglycerols ndi inositol triphosphate amapangidwa, omwe amachititsa kuti proteinasease C.

Monga mukuwonera, kukhazikitsidwa kwa kuchuluka kwa glucose ndi njira yamagulu ambiri komanso yovuta kwambiri. Zimayendetsedwa ndi ntchito yolumikizana ya chamoyo chonse ndi zinthu zina zambiri. Malangizo a mahormoni ndi amodzi mwofunikira kwambiri pakuyendetsa bwino zinthu motere.

Nthawi zambiri, mulingo wa shuga uyenera kukhala pakati pa 2.6 ndi 8.4 mmol / lita imodzi ya magazi. Posunga mulingo uwu (kuphatikiza mahomoni a hypoglycemic), mahomoni okula, glucagon ndi adrenaline amatenganso mbali.

Ngati kuchuluka kwa shuga m'magazi kumagwera pansi pazomwe zikuchitika, thupi la insulin limayamba kuchepa (pomwe siliyenera kusiya).

Minyewa ya shuga ikakhala yotsika kwambiri, mahomoni amtundu wa hyperglycemic amayamba kumasulidwa (amatchedwanso kuti contrainsular). Amakhazikika moyenera shuga. A shuga ochepa kwambiri magazi amatchedwa hypoglycemia.

Mkhalidwe uwu ndi wowopsa kwa thupi chifukwa chosowa mphamvu ndi michere yomwe imafunikira pakugwira ntchito yathupi yonse. Kuchuluka kwambiri kwa hypoglycemia ndi hypoglycemic coma.

Zinthu izi zimapangitsa kuti shuga amasulidwe. Kupsinjika kwa mahomoni ndi adrenaline, kuphatikizapo kuletsa kutulutsa kwa insulin m'magazi. Chifukwa chake, mulingo woyenera kwambiri umasungidwa.

Kugwiritsa ntchito biphasic aspart

Njira yogwiritsira ntchito ndi Mlingo wa mankhwalawa zimatengera mtundu wa matenda, mtundu wa matenda, kupezeka kwa matendawa ndi kuchuluka kwa odwala.

Malangizo onse, amitundu iwiri ya aspart, ndi awa:

• Majakisoni amayikidwa pang'onopang'ono (m'mizere yamafuta), popeza insulin yochepa pang'ono imataya katundu wake ndipo imatulutsa msanga m'thupi, ndi jekeseni wamitsempha.
• Masamba a jakisoni amayenera kusinthidwa pafupipafupi, chifukwa mafuta amatha kupanga mu mafuta.
• Madera a Lipodystrophic,
• Singano sikulimbikitsidwa kuti igwiritsidwenso ntchito pofuna kupewa matenda.

Momwe mungagwiritsire ntchito insulin aspart? Malangizo ogwiritsira ntchito ali ndi malangizo osiyanasiyana am'magawo awiri komanso mankhwala a gawo limodzi.

Woimira gulu ili la mankhwala a hypoglycemic ndi NovoRapid. Ndi mankhwala osokoneza bongo omwe ali ndi nthawi yochepa. Mphamvu ya glycemic imawonekera pambuyo pa mphindi 10-20, atatha kubaya jekeseni kapena kulowetsedwa.

Kusungitsa glycemia wabwinobwino, popanda magawo a kuchuluka kapena kuchepa kwa shuga (kunja kwa magawo abwinobwino), kuwunikira mosamala kuchuluka kwa shuga m'magazi ndikofunikira.

Imachitika pogwiritsa ntchito njira zotsatirazi:

• Madzi a glucose mita
• CGMS system yothandizira pampu (pulogalamu yowunikira shuga wamagetsi).

Muyeso uyenera kumwedwa musanadye komanso mutamaliza kudya. Kuwerengera molondola kwa mlingo umodzi wa mankhwalawa, kuchuluka kwa shuga musanadye chakudya kumaganiziridwa, ndipo mfundo za pambuyo pake zimagwiritsidwa ntchito kukonza zizindikiro.

NovoRapid imayendetsedwa pang'onopang'ono pogwiritsa ntchito syringe ya insulin ya U 100, cholembera kapena pampu ya insulin. Kuwongolera kwa intraven kumaloledwa kokha ndi ogwira ntchito oyenerera azachipatala, pazoyang'anira mwadzidzidzi. Kuchuluka kwa mayunitsi a jekeseni amodzi a mankhwala amatsimikiziridwa ndi dokotala.

Kufunikira kwa tsiku ndi tsiku kumawerengeredwa payekhapayekha, kutengera mphamvu ya wodwalayo komanso kulemera kwa thupi. Zofunikira masiku onse zili mumtundu wa 0,5-1 ED / kg pa thupi. Simungathe kulowa muyezo wa tsiku ndi tsiku wa aspart nthawi yomweyo, chifukwa izi zimabweretsa hypoglycemia ndi chikomokere. Mlingo umodzi umawerengeredwa payokha pachakudya chilichonse chomanga thupi.

LAPANI ZOTSATIRA! Kuwerengera limodzi mlingo wa NovoRapid kumachitika poganizira zigawo za mkate (XE) zomwe zimadyedwa mukamadya.

Kufunika kwakanthawi kothana ndi insulin kumadalira mphamvu ya thupi ndi ntchito, komanso nthawi ya tsiku. M'mawa m'mawa, kufunikira kumatha kuwonjezeka, ndipo pambuyo polimbitsa thupi kwambiri kapena madzulo - amatha kuchepa.

NovoMix (woimira biphasic aspart) amagwiritsidwa ntchito kwa odwala omwe ali ndi matenda amtundu wa 2. Mlingo woyenera, kumayambiriro kwa mankhwala, ndi magawo 12, omwe amaperekedwa madzulo, asanadye. Kuti mupeze zotsatira zoyendetsedwa bwino, akuyenera kugawa gawo limodzi mumagawo awiri. Ndi mawu oyambira, amaika magawo 6 a NovoMix asanadye chakudya cham'mawa komanso madzulo, komanso asanakadye.

Makina okhazikika a biphasic aspart okha ndi omwe amaloledwa. Kuti muthane ndi kuchuluka kwa shuga ndikusintha kwa mankhwalawa, ndikofunikira kuyeza kuchuluka kwa magazi. Kusintha kwa Mlingo kumachitika pambuyo pakupanga dongosolo la mbiri yanu, poganizira kuthamanga kwa shuga (m'mawa, pamimba yopanda kanthu), kwa masiku atatu.

Insulin Lizpro imagwiritsidwa ntchito pochiza odwala matenda a shuga, ngakhale atakhala kuti ndi amuna kapena akazi komanso zaka. Chipangizocho chimakhala ndi zizindikiro zapamwamba kwambiri ngati wodwala amakhala ndi moyo wopanda vuto, makamaka kwa ana.

Humalog imayikidwa ndi dokotala wokhazikika ndi:

1. Lembani 1 ndi 2 mtundu wa mellitus wa shuga - pamapeto pake, kokha ngati kumwa mankhwala ena sikumabweretsa zotsatira zabwino,
2. Hyperglycemia, yomwe siyimalimbikitsidwa ndi mankhwala ena.
3. Kukonzekera wodwalayo kuti achite opareshoni,
4. Kusagwirizana ndi mankhwala ena okhala ndi insulin,
5. The kupezeka kwa matenda zinthu zikusokoneza njira ya matenda.

Njira yogwiritsira ntchito mankhwalawa yovomerezeka ndi wopanga ndi yopanda tanthauzo, koma malinga ndi momwe wodwalayo alili, wothandiziridwayo amatha kuthandizidwa kudzera mu mnofu komanso m'mitsempha. Ndi njira yodutsa, malo abwino kwambiri ndi m'chiuno, phewa, matako ndi m'mimba.

Kukhazikika kwa makulidwe a Insulin Lizpro nthawi yomweyo amatsutsana, chifukwa izi zingapangitse kuwonongeka kwa khungu pakhungu.

Gawo lomweli silingagwiritsidwe ntchito kuperekera mankhwala oposa 1 mwezi pamwezi. Ndi subcutaneous makonzedwe, mankhwalawa angagwiritsidwe ntchito popanda kupezeka kwa akatswiri azachipatala, koma pokhapokha ngati dotolo linasankhidwa ndi katswiri.

Nthawi ya kukhazikitsidwa kwa mankhwalawa imapangidwanso ndi dokotala, ndipo iyenera kuonedwa mosamala - izi zimathandiza kuti thupi lizolowerana ndi boma, komanso liperekenso mphamvu yautali wa mankhwala.

Kusintha kwa Mlingo kufunikira pa:

• Kusintha zakudya ndikusinthira ku chakudya chochepa kapena chamtundu wazakudya zambiri,
• Kupsinjika mtima
• Matenda opatsirana
• Kugwiritsa ntchito mankhwala ena
• Kusintha kuchokera ku mankhwala ena omwe amagwira ntchito mwachangu omwe amakhudza kuchuluka kwa glucose,
• Kuwonetsera kulephera kwa impso,
• Mimba - kutengera ndi trimester, kufunikira kwa thupi pakusintha kwa insulin, motero ndikofunikira
• Pitani kwa omwe amakupatsani chithandizo chazaumoyo pafupipafupi ndikuyeza kuchuluka kwa shuga.

Kusintha pamalingaliro kungafunikenso pakusintha wopanga Insulin Lizpro ndikusintha pakati pa makampani osiyanasiyana, popeza aliyense wa iwo amasintha momwe amapangidwira, zomwe zingakhudze kugwiriridwa kwa mankhwalawo.

Zomwe zimachitika mthupi ngati mulibe insulini

Choyamba, mayendedwe a shuga amasokonezeka. Palibe insulin, palibe ma activation omwe amapezeka ndi shuga. Zotsatira zake, mamolekyulu a glucose amakhalabe m'magazi. Pali mavuto ena awiri pa:

1. Mkhalidwe wamagazi. Chifukwa cha kuchuluka kwa shuga, imayamba kunenepa. Zotsatira zake, magazi amawunda, amatseka kuyenda kwa magazi, zinthu zopindulitsa komanso oxygen sizilowa ziwalo zonse za thupi. Kusala komanso kufa pambuyo pake kwa maselo ndi minofu kumayamba. Thrombosis imatha kudzetsa matenda oopsa monga varicose mitsempha (m'malo osiyanasiyana a thupi), khansa ya m'magazi ndi matenda ena akuluakulu. Nthawi zina, kuundana kwa magazi kumatha kupangitsa kuti magazi azing'ambika.
2. Njira za masabolic mu cell. Glucose ndiye gwero lalikulu lamphamvu kwa thupi. Ngati sikokwanira, njira zonse za mkati zimayamba kuchepa. Chifukwa chake, khungu limayamba kusokonekera, silisintha, silikukula. Kuphatikiza apo, shuga yasiya kutembenukira kukhala nkhokwe yamphamvu ndipo, ngati pali kusowa kwa mphamvu, minofu ya minofu singathe, koma minofu yamatenda. Munthu amayamba kuchepa thupi msanga, amakhala wofooka komanso wa dystrophic.

Kachiwiri, njira za anabolism zidzasokonekera. Ma Amino acids m'thupi ayamba kumizidwa kwambiri ndipo, chifukwa chosowa, sipadzakhala mutu wazophatikizira mapuloteni komanso kubwereza kwa DNA. MaIoni pazinthu zingapo amayamba kulowa m'maselo mu zinthu zosakwanira, chifukwa chomwe kusinthanitsidwa kwa mphamvu kudzapangidwira.

Popeza anti-catabolic zotsatira zimapangidwanso, njira zamatumbo zimayamba kupezeka mthupi.

Lipolysis imapereka kupanga kwakukulu kwambiri kwa ATP (mphamvu) ikamalephereka - mafuta acids amasinthidwa osati mphamvu, koma kukhala mafuta. Protein hydrolysis imathandizidwanso, chifukwa chomwe mapuloteniwo amawonongeka. Kusowa kwake kumakhudza mkhalidwe wa minofu.

Njira izi za ma cell pafupifupi zimakhudza nthawi yayitali. Zimakhala zovuta kuti munthu achite ntchito zatsiku ndi tsiku, akumva kupweteka mutu, chizungulire, nseru, ndipo amayamba kuzindikira. Ndi kuchepa thupi kwambiri, akumva njala yanyama.

Kuperewera kwa insulin kungayambitse matenda akulu.

Ndi matenda ati omwe angayambitse kusokoneza insulin?

Matenda ofala kwambiri omwe amachitika chifukwa cha kuwonongeka kwa insulin ndi matenda a shuga. Iagawika m'mitundu iwiri:

1. Wodalira insulin. Choyambitsa ndichisokonezo cha pancreatic, chimatulutsa insulini yochepa kwambiri kapena sichimatulutsa konse. Mu thupi, njira zomwe tafotokozazi zimayamba. Odwala omwe ali ndi matenda amtundu woyamba 1 amapatsidwa insulin kuchokera kunja. Izi zimachitika kudzera ndimankhwala apadera a insulin. Amatha kukhala a insulin ya nyama kapena chilengedwe. Ndalama zonsezi zimaperekedwa ngati njira zovomerezeka. Nthawi zambiri, jakisoni amaikidwa pamimba, phewa, phewa kapena kutsogolo kwa ntchafu.
2. Insulin yodziyimira payokha. Matenda a shuga amtunduwu amadziwika chifukwa chakuti kapamba amapanga insulin yokwanira, pomwe minofu yake imagwirizana ndi izi. Amasiya kuzindikira insulin, chifukwa chomwe wodwala amakhala ndi hyperglycemia. Zikatero, shuga amawongolera ndi kuwongolera zakudya. Zakudya zamafuta ochulukitsa zimachepetsedwa ndipo mndandanda wazakudya zonse zomwe zimadyedwa umaganiziridwa. Wodwalayo amangololedwa kudya zakudya zopatsa mphamvu pang'onopang'ono.

Palinso ma pathologies ena omwe kuperewera kwachilengedwe kumapezeka ndi insulin:

• Matenda a chiwindi (chiwindi cha mitundu yonse, matenda amitsempha ndi ena),
• Cushing's Syndrome (kuchuluka kwama mahomoni omwe adrenal cortex imatulutsa)
• Kunenepa kwambiri (kuphatikiza kunenepa kosiyanasiyana),
• Insulinoma (chotupa chomwe chimangotulutsa magazi m'magazi)
• Myotonia (matenda a minyewa ya m'mitsempha yamagazi yomwe mumayenda mosafunikira komanso kukokana kwa minofu),
• Mahomoni okula ochulukirapo,
• Kukana insulini
• Kusowa kwanyengo,
• Tumors mu adrenal gland (kaphatikizidwe wa adrenaline, yemwe amawongolera shuga, amakhala operewera),
• Matenda ena a kapamba (zotupa, kapamba, zotupa, matenda obadwa nawo, ndi zina).

Kutopa kwakuthupi ndi kwamaganizidwe kungayambitsenso insulin. Zochitika zoterezi ndizovomerezeka chifukwa chakuti mikhalidwe iyi thupi limagwiritsa ntchito malo ambiri osungirako kuti libwezeretse homeostasis.

Komanso, zomwe zimayambitsa khalidweli zimatha kukhala moyo wosakhalitsa, matenda osiyanasiyana opatsirana komanso opatsirana. Milandu yapamwamba yomwe imakhudzana ndi kuperewera kwa insulin, munthu amatha kudwala insulin kapena Somoji syndrome.

Chithandizo cha izi pathologies ndicholinga chokhazikika pamlingo wa insulin. Nthawi zambiri, madokotala amatipatsa mankhwala okhala ndi insulin kapena nyama. Ngati matenda a pathological anali chifukwa cha kuchuluka kwa shuga m'thupi, zakudya zapadera zimayikidwa.

Maselo a B ali ndi mphamvu zowonjezera ndipo nthawi zonse amatulutsa insulini yambiri kuposa momwe thupi limafunira. Koma ngakhale zochulukirapo izi zimalowetsedwa ndi thupi ngati munthu amadya maswiti komanso zakudya zina.

• Insulinoma. Ili ndi dzina la chotupa chotupa chomwe chili ndi ma cell a B. Chotupa choterechi chimayendera limodzi ndi zofanana ndi zochitika za hypoglycemic.
• Mankhwala a insulin. Awa ndi liwu loti zizindikiro zovuta zomwe zimawoneka ndi mankhwala osokoneza bongo ambiri. Mwa njira, zadzidzidzi za insulin m'mbuyomu zimagwiritsidwa ntchito pochita zamisala pofuna kuthana ndi matenda a schizophrenia.
• Somoji syndrome ndi insulin yosatha.

Gulu lachiwirili limaphatikizapo zinthu zopanda pake zomwe zimayamba chifukwa cha kuchepa kwa insulin kapena kuyamwa. Choyamba, ndi mtundu woyamba wa matenda ashuga. Awa ndi matenda a endocrine omwe amayambitsidwa ndi vuto la shuga.

Zikondazo zimatulutsa insulin yokwanira. Poyerekeza ndi kulepheretsa kagayidwe kazakudya, wodwalayo amakula. Izi ndizowopsa chifukwa zimawonjezera chiopsezo cha matenda a mtima.

Komanso, munthu amatha kukhala ndi matenda ashuga a 2. Nthendayi ndiyosiyana pang'ono pakumveka kwa maphunzirowa. M'magawo oyamba a matenda, kapamba amapanga insulin yokwanira.

Nthawi yomweyo, thupi pazifukwa zina limakhala losagwirizana ndi insulini, ndiye kuti, siligwirizana ndi zomwe zimachitika m'thupi la munthu. Matendawa akapita patsogolo, kapangidwe ka insulin m'matumbo amayamba kuponderezedwa ndipo chifukwa chake amakhala wosakwanira.

Contraindication ndi zoyipa

Posankha mankhwala, dokotala wopezekapo amayenera kuganizira zonse zomwe zimachitika m'thupi la wodwalayo.

Insulin Lizpro imaphatikizidwa mwa anthu:

1. Ndi chidwi chochulukirapo pazinthu zazikulu kapena zowonjezera,
2. Ndi kuchuluka kwambiri kwa hypoglycemia,
3. Momwe mumakhala insulinoma.

Ngati wodwalayo ali ndi chimodzi mwa zifukwa izi, mankhwalawo ayenera kusinthidwa ndi omwe omwewa.

Pogwiritsa ntchito mankhwalawa odwala matenda ashuga, zotsatirazi zoyipa zimawonedwa:

1. Hypoglycemia - ndiyoopsa kwambiri, imachitika chifukwa cha mlingo wosankhidwa mosamala, komanso ndi mankhwala omwe mumadzipaka nokha, imatha kubweretsa imfa kapena kusokonezeka kwakukulu kwa zochitika zaubongo,
2. Lipodystrophy - imachitika chifukwa cha jakisoni womwewo, pofuna kupewa, ndikofunikira kusintha malo omwe pakulimbikitsidwa
3. Chiwopsezo - chimawonekera kutengera mawonekedwe a thupi la wodwalayo, kuyambira pakuwonjezeranso kuperewera kwa jakisoni, ndikutha ndi kuwonongeka kwa anaphylactic,
4. Zowonongeka za zida zowonera - ndi kumwa kolakwika kapena kusalolera payekhapayekha ziwalo, retinopathy (kuwonongeka kwa kufinya kwa vuto la maso chifukwa cha kusokonezeka kwa mitsempha) kapena kuperewera kwamawonekedwe pang'ono, nthawi zambiri kumadziwonetsedwa mudakali ana kapena kuwonongeka kwa dongosolo lamtima.
5. Zomwe zimachitika mdera lanu - m'malo a jakisoni, redness, kuyabwa, redness ndi kutupa zimatha, zomwe zimadutsa thupi litazolowera.

Zizindikiro zina zimatha kuonekera patapita nthawi yayitali. Ngati muli ndi mavuto, siyani kumwa insulini ndikuwonana ndi dokotala. Mavuto ambiri nthawi zambiri amathetsedwa ndikusintha kwa mlingo.

Pali zinthu zingapo zomwe zimalimbikitsa kugwiritsa ntchito insulin aspart mosamala. Contraindication ndi zoletsa zimagwira kumagawo onse osankha limodzi ndi mitundu yonse ya mankhwala. Chowonongera chachikulu ndikusalolera kwa chinthu chimodzi ndi zinthu zina zomwe zimapanga mankhwalawo.

Mosamala kwambiri, amalembedwa pazaka 2, popeza mayesero azachipatala m'gulu lino sanachitidwe.

Zoletsa zingapo zimadziwika pakuphatikizidwa kwa aspart, ndimankhwala ena:

1. Thiol sulfites ndi mankhwala osokoneza bongo amawononga aspart,
2. Mapiritsi a Hypoglycemic, thioctic acid, beta-blockers, komanso maantibayotiki ena amalimbikitsa mphamvu ya hypoglycemic,
3. Gulu la thiazolidinedione limakulitsa chiopsezo cholephera mtima.

Nthawi zina, ma antibodies amapangidwa m'magazi omwe amachepetsa glycemic effect ya aspart. Kukonzekera kosakwanira kapena kowonjezereka kwa mankhwalawa, kuwerengera molakwika kwa mlingo umodzi, kungayambitse hyperglycemia kapena hypoglycemia.

CHITSANZO Mankhwala osokoneza bongo amatsogolera ku chikomokere ndi kufa.

Zotsatira zoyipa ndizobadwa mderalo, kuwonekera pamalo opangira jekeseni. Pambuyo pa jekeseni, kufupika pang'ono kapena kutupa, kuyabwa, ma hematomas ang'onoang'ono amatha kuonedwa. Ndi kusiya kwadzaoneni kwa wodwala kuchokera nthawi yayitali ya hypoglycemic, kupweteka kwakanthawi kwam'mimba kupweteka kwa m'mimba komanso matenda ashuga a m'mimba amayamba.

Ntchito yake yayikulu ndikukhalabe ndi shuga yokwanira bwino. Amapangidwa mu gawo limodzi la kapamba monga ma pancreatic islets. Kuwona kwamtunduwu m'thupi kungayambitse matenda angapo.

Insulin ndi michere yambiri ya gulu la peptide, yomwe imakhudza njira zonse za cellular ndi generalized. Ntchito yake yayikulu ndikuwongolera zamagalimoto owonjezera. Amawongolera mphamvu zamagetsi ndi zinthu zamagulu osiyanasiyana m'thupi. Kusowa kwake ndikuwoneka ndikuphwanya njira zonsezi.

Kuperewera kwa insulin kungayambitse matenda ashuga komanso matenda ena owopsa. Ena mwa iwo sangathe kuchiritsika ndipo amakhalabe ndi munthuyo moyo wonse. Kuperewera kwamphamvu kwa chinthuchi nthawi zina kumatha kupha.

Mndandanda wa mankhwala Insulin Lizpro

Mtengo wa mankhwalawa umatengera mawonekedwe omwe insulin aspart imapangidwira. Mtengo wa mankhwala osokoneza bongo ndi ma analogu akuwonetsedwa patebulopo.

Ma Analogs a aspart ali ndi vuto lofananalo, koma amapangidwa pamaziko a zinthu zina zomwe zimagwira ntchito. Mankhwalawa amapangidwira kuti apatsidwe mankhwala.

Insulin aspart ndi wothandizira wa hypoglycemic. Ilibe kuchuluka kwakukulu kwa contraindication ndipo imagwiritsidwa ntchito ngati gawo la zovuta kuchiza matenda a shuga mellitus, mitundu yonse iwiri. Mankhwalawa ndi oyenera ana ndi akulu, komanso okalamba.