Kutenga nthawi yayitali insulin ndi dzina lake

Kukonzekera kwa mankhwala a insulin kumasiyana malinga ndi nthawi yayitali, yapakatikati, yayitali komanso kuphatikiza. Insulin yayitali idapangidwa kuti izikhala yolimba momwe timadzi tambiri timene timayambira, timene timapangidwira ndi kapamba. Amagwiritsidwa ntchito pa mtundu woyamba wa 2 komanso mtundu wa matenda a shuga 2, komanso mikhalidwe yomwe kayendetsedwe ka shuga m'magazi limafunikira.

Njira yamachitidwe

Insulin yayitali ndi mankhwala omwe amagwiritsidwa ntchito nthawi yayitali kuti akhale athanzi lambiri la thupi kwa nthawi yayitali. Amatsanzira kupanga insulin ya basal ndi kapamba ndikulepheretsa kukula kwa gluconeogeneis.

Kutsegula kwa nthawi yayitali timadzi timawonedwa pafupifupi maola 4 pambuyo pa jakisoni. Peak okhutira ndiwofatsa kapena osakhalapo, khola lazokhazikika la mankhwalawa limawonedwa kwa maola 8-10. Pakatha pafupifupi maola 28 mutakhazikitsa (kutengera mtundu wa mankhwala), ntchito yake imachepetsedwa mpaka zero.

Insulin yayitali simapangidwira kukhazikika kwa ma spikes mu shuga omwe amapezeka mutatha kudya. Imatsimikizira kuchuluka kwa thupi kutulutsidwa kwa mahomoni.

Mitundu ya mankhwala

Pakadali pano, magulu awiri a mankhwala omwe amagwira ntchito yayitali amagwiritsidwa ntchito - nthawi yayitali komanso yayitali. Ma insulini okhala ndi nthawi yayitali amakhala ndi nthawi yambiri, ngakhale samatchulidwa ngati mankhwala osokoneza bongo. Ma insulini okhala ndi nthawi yayitali amakhala opanda pake. Izi zimaganiziridwa posankha kuchuluka kwa basal hormone.

Kugwiritsa ntchito insulin yayitali pakulimbikitsidwa pazisonyezo izi:

• mtundu 1 shuga
• mtundu 2 shuga
• Kusagwirizana ndi mankhwala amkamwa kuti muchepetse kuchuluka kwa shuga m'magazi,
• kukonzekera opareshoni
• matenda ashuga.

Njira yogwiritsira ntchito

Insulin yokhala ndi nthawi yayitali imapezeka mu mawonekedwe a kuyimitsidwa kapena mayankho a jakisoni. Mothandizidwa ndi subcutaneally, mankhwalawa amakhalabe mu minofu ya adipose kwakanthawi, pomwe pang'onopang'ono ndikuyamba kulowa m'magazi.

Kuchuluka kwa mahomoni kumatsimikiziridwa ndi dokotala aliyense payekha kwa wodwala aliyense. Kupitilira apo, wodwalayo amatha kuwerengetsa payekha payekha payekha kutengera zomwe amalimbikitsa. Mukasintha kuchokera ku insulin ya nyama ndikupanga munthu, ndikofunikira kusankha kachiwiri. Posintha mtundu wina wa mankhwala ndi wina, kuyang'anira kwa dokotala ndikuwunika pafupipafupi kwa kuchuluka kwa shuga m'magazi ndikofunikira. Ngati mukusintha, mlingo womwe waperekedwa umapitilira mayunitsi 100, wodwalayo amatumizidwa kuchipatala.

Jakisoni amachitidwa mosazindikira, nthawi iliyonse kupita kumalo ena. Jakisoni wa insulini amatha kuchitika mu minofu ya triceps, m'chigawo chapafupi ndi navel, kumtunda kwa kanthawi pang'ono kwa gluteus maximus, kapena kumtunda kwa gawo la ntchafu. Kukonzekera kwa insulin sikuyenera kusakanikirana kapena kuchepetsedwa. Syringe siyenera kugwedezeka musanabayidwe. Ndikofunikira kupotoza pakati pamafinya, kuti kapangidwe kake kamakhala kofanana kwambiri ndikuwotha pang'ono. Pambuyo pa jakisoni, singano imasiyidwa pansi pakhungu kwa masekondi angapo kuti iperekenso mankhwala mokwanira, ndikuchotsa.

Kuwerengera Mlingo

Munthu wathanzi wokhala bwinobwino pancreatic ntchito amapanga 24-26 IU ya insulin patsiku, kapena pafupifupi 1 IU pa ola limodzi. Izi zimazindikira mulingo wa basase, kapena wowonjezera, wa insulin yomwe imayenera kuperekedwa. Ngati opaleshoni, njala, kupsinjika kwa psychophysical kuyembekezeredwa masana, mlingo uyenera kuchuluka.

Kuwerengera kuchuluka kwa insulin yoyamba, kuyezetsa m'mimba kopanda kanthu kumachitika. Muyenera kukana chakudya maola 4-5 musanayambe phunzirolo. Ndi bwino kuyamba kusankha mtundu wa insulin yayitali usiku. Kuti mawerengero azikhala olondola, muyenera kudya chakudya chamadzulo kapena musadumphe chakudya chamadzulo.

Ola lililonse, shuga amayeza ndi glucometer. Panthawi yoyesedwa, pasakhale kukwera kapena kutsika kwa shuga ndi 1.5 mmol. Ngati mulingo wa shuga wasintha kwambiri, insulini yoyambira iyenera kukonza.

Bongo

Kuchuluka kwa mankhwalawa kungayambitse hypoglycemia. Popanda thandizo lakuchipatala, zimabweretsa mavuto akulu. Kutembenuka, kusokonezeka kwamanjenje kumachitika, chikomokere cha hypoglycemic sichimachotsedwa, m'malo ovuta vutoli limatha kupha.

Ndi hypoglycemia, ndikofunikira kutenga chakudya champhamvu kwambiri, chomwe chidzakulitsa kuchuluka kwa shuga m'magazi. M'tsogolomu, mudzafunika kuthandizidwa ndi dokotala, kukonza zakudya komanso kupatsa insulin.

Contraindication

Insulin yotalikilapo siloledwa kwa magulu onse odwala. Sitha kugwiritsidwa ntchito kwa hypoglycemia ndi hypersensitivity pazigawo zamankhwala. Imasungidwa mu amayi apakati komanso ana osakwana zaka 6.

Mankhwalawa angagwiritsidwe ntchito molingana ndi katswiri ngati phindu lomwe likuyembekezeredwa limaposa chiopsezo chovuta. Mlingo uyenera kuwerengedwa ndi dokotala nthawi zonse.

Zotsatira zoyipa

Mukamagwiritsa ntchito insulin yayitali, ziyenera kukumbukiridwa kuti kupitirira mlingo kungayambitse hypoglycemia, chikomokere ndi chikomokere. Thupi lawo siligwirizana, redness ndi kuyabwa pa malo jakisoni siziperekedwa.

Insulin yotalikilapo imagwiritsidwa ntchito kokha pakuwongolera shuga, sizithandiza ndi ketoacidosis. Kuchotsa matupi a ketone m'thupi, insulin yochepa imagwiritsidwa ntchito.

Mtundu woyamba wa shuga, insulin yotalikilapo imaphatikizidwa ndi mankhwala osakhalitsa ndipo imakhala ngati chinthu chofunikira kwambiri pochizira. Kusungitsa kuchuluka kwa mankhwalawo chimodzimodzi, tsamba la jakisoni limasinthidwa nthawi iliyonse. Kusintha kuchokera ku insulin yayitali mpaka yayitali kuyenera kuchitika moyang'aniridwa ndi dokotala ndikuyang'aniridwa pafupipafupi kuchuluka kwa shuga m'magazi. Ngati mlingo sukumana ndi zosowa, uyenera kusintha pogwiritsa ntchito mankhwala ena.

Popewa usiku ndi m'mawa hypoglycemia, tikulimbikitsidwa kuchepetsa kuchepetsedwa kwa insulin yayitali ndikuwonjezera mlingo waifupi. Kuwerengera kuchuluka kwa mankhwalawa kumachitika ndi adokotala.

Insulin yayitali imayenera kuwongoleredwa ngati musintha zakudya ndi zochita zolimbitsa thupi, komanso matenda opatsirana, opareshoni, pakati, matenda a impso, ndi endocrine. Mlingo umasinthidwa ndikusintha kwamankhwala, zakumwa zoledzeretsa komanso mothandizidwa ndi zinthu zina zomwe zimasintha kuchuluka kwa shuga m'magazi. Ndi kuchepetsedwa kwambiri kwa hemoglobin ya glycosylated, ziyenera kukumbukiridwa kuti hypoglycemia mwadzidzidzi imatha kuchitika usana ndi usiku.

Njira yosungira

Insulin yayitali yochita kupaka makatoni iyenera kusungidwa pachitseko cha chitseko cha firiji, pomwe kutentha ndi +2. +8 ° С. Zikatero, sizimawuma.

Mutatsegula phukusi, kutentha kwa chosungiracho sikuyenera kupitirira +25 ° C, koma sikuyenera kuchotsedwa mufiriji. Sungani bokosilo kwa ana. Moyo wa alumali wa insulin yosindikizidwa ndi zaka 3, zotsegulidwa - pafupifupi mwezi.

Next Generation Insulin Yaitali

Kwa anthu odwala matenda ashuga, inshuwaransi ya anthu ya NPH komanso zochitika zake zazitali zomwe zilipo. Gome ili pansipa likuwonetsa kusiyana kwakukulu pakati pa mankhwalawa.

Mu Seputembara 2015, insulin yatsopano ya Abasaglar idayambitsidwa, yomwe ili yofanana ndi Lantus yubiquitous.

Wochedwa insulin

Food and Drug Administration (FDA, US FDA) - Bungwe la boma lomwe lachita pansi pa dipatimenti ya zaumoyo ku U.S. mu 2016 lidavomerezanso msonkhano wina wautali wa insulin, Toujeo. Izi zimapezeka pamsika wapanyumba ndipo zimatsimikizira kuyenera kwake pochiza matenda ashuga.

NPH insulini (NPH Neutral Protamine Hagedorn)

Uwu ndi mtundu wa mankhwala a insulin opangira mapangidwe a insulin yaumunthu, koma olemeretsedwa ndi protamine (protein ya nsomba) kuti achepetse mphamvu yake. NPH ndi mitambo. Chifukwa chake, isanayambe makonzedwe, iyenera kuzunguliridwa bwino kusakaniza bwino.

NPH ndi mtundu wotsika mtengo kwambiri wa insulin. Tsoka ilo, imakhala ndi chiopsezo chachikulu cha hypoglycemia ndi kulemera kwakukulu, chifukwa imakhala ndi chiwonetsero chokwanira pantchito (ngakhale zimachitika pang'onopang'ono osati mwachangu ngati insulin pamabowo).

Odwala omwe ali ndi matenda amtundu woyamba 1 amapatsidwa kawiri kawiri la NPH insulin patsiku. Ndipo odwala omwe ali ndi matenda a shuga a 2 amatha jekeseni kamodzi patsiku. Zonse zimatengera kuchuluka kwa shuga m'magazi ndi malingaliro a dokotala.

Ma Anulin a Nthawi Yaitali a Insulin

Insulin, zomwe zimapangidwa ndi mankhwala omwe amasinthika kotero kuti amachedwetsa kuyamwa ndi mphamvu ya mankhwalawo, amadziwika kuti ndi insulin yopanga anthu.

Lantus, Abasaglar, Tujeo ndi Tresiba ali ndi zochitika zodziwika bwino - nthawi yayitali yogwirira ntchito komanso chiwonetsero chochepa kwambiri cha ntchito kuposa NPH. Mwanjira iyi, kudya kwawo kumachepetsa chiopsezo cha hypoglycemia ndi kulemera. Komabe, mtengo wa analogues ndiwokwera.

Abasaglar, Lantus, ndi Tresiba insulin amatengedwa kamodzi patsiku. Odwala ena amagwiritsanso ntchito Levemir kamodzi patsiku. Izi sizikugwira ntchito kwa odwala matenda ashuga 1 omwe mankhwalawa ndi ochepera maola 24.

Tresiba ndiye mtundu watsopano kwambiri ndipo tsopano ndi wotchipa kwambiri wa insulin pamsika. Komabe, ili ndi mwayi wofunikira - chiopsezo cha hypoglycemia, makamaka usiku, ndizotsika kwambiri.

Insulin imatenga nthawi yayitali bwanji

Udindo wa insulin yayitali ndikuwimira chinsinsi chachikulu cha insulini kudzera m'mapapo. Chifukwa chake, muyezo wofanana wa timadzi tomwe timagazi timatsimikizika pantchito yake yonse. Izi zimathandizira kuti maselo a thupi lathu agwiritse ntchito shuga wosungunuka m'magazi kwa maola 24.

Momwe mungabayitsire insulin

Ma insulini onse omwe akhala akuchita kwa nthawi yayitali amalowetsedwa pansi pa khungu m'malo omwe mumakhala mafuta. Gawo lotsatira la ntchafu ndilabwino kwambiri pazolinga izi. Malowa amalola kuti kulowetsedwa pang'onopang'ono komanso moyenera kwa mankhwalawo. Kutengera ndi nthawi ya endocrinologist, muyenera kuchita jakisoni imodzi kapena iwiri patsiku.

Kubayira pafupipafupi

Ngati cholinga chanu ndikusunga ma jakisoni a insulin ochepera momwe mungathere, gwiritsani ntchito Abasaglar, Lantus, Toujeo, kapena Tresiba analogues. Jakisoni m'modzi (m'mawa kapena madzulo, koma nthawi zonse nthawi yomweyo) amatha kupereka insulin yofananira ndi wotchi.

Mungafunike jekeseni awiri patsiku kuti mukhale ndi mahomoni azambiri zamagazi posankha NPH. Izi, zimakupatsirani kusintha kwa mankhwalawa kutengera nthawi yatsiku ndi zochitika - zapamwamba masana komanso zochepa pogona.

Chiwopsezo cha hypoglycemia pakugwiritsa ntchito insulin

Zatsimikiziridwa kuti ma insulin anime omwe amakhala nthawi yayitali amakhala osayambitsa hypoglycemia (makamaka hypoglycemia usiku) poyerekeza ndi NPH. Mukamagwiritsa ntchito, zofunika za glycated hemoglobin HbA1c ndizotheka.

Palinso umboni wosonyeza kuti kugwiritsa ntchito mankhwala okhala ndi insulin analoques nthawi yayitali poyerekeza ndi isoflan NPH kumayambitsa kuchepa kwa thupi (ndipo, chifukwa chake, kutsika kwa kukana kwa mankhwalawa komanso kufunika kwathunthu kwa mankhwalawo.

Kutenga nthawi yayitali insulin ya matenda a shuga a mtundu I

Ngati mukudwala matenda ashuga amtundu 1, kapamba wanu sangathe kupanga insulini yokwanira. Chifukwa chake, mutatha kudya chilichonse, muyenera kugwiritsa ntchito mankhwala omwe amathandizira kubisalira kwa insulin ndi maselo a beta. Ngati mwaphonya jakisoni, pamakhala chiopsezo chokhala ndi matenda ashuga a ketoacidosis.

Mukamasankha pakati pa Abasaglar, Lantus, Levemir ndi Tresiba, muyenera kudziwa zina mwazinthu za insulin.

• Lantus ndi Abasaglar ali ndi mbiri yosyasyalika pang'ono kuposa Levemir, ndipo kwa odwala ambiri, amagwira maola 24.
• Levemir angafunikire kutengedwa kawiri tsiku lililonse.
• Kugwiritsa ntchito Levemir, Mlingo umatha kuwerengeka malinga ndi nthawi ya tsiku, motero kuchepetsa chiopsezo cha nocturnal hypoglycemia ndikuwongolera kuwongolera kwa nthawi masana.
• Toujeo, Tresibia mankhwalawa amachepetsa zizindikiro zomwe zili pamwambazi poyerekeza ndi Lantus.
• Muyenera kuganiziranso za zovuta za mankhwala monga zotupa. Izi zimachitika kawirikawiri, koma zimatha kuchitika.
• Ngati mukufunikira kusintha kuchokera ku mankhwala a insulin ofanana ndi NPH, dziwani kuti mlingo wa mankhwalawa mukatha kudya ungafunikire kuchepetsedwa.

Kutenga nthawi yayitali insulin ya matenda a shuga a mtundu II

Chithandizo cha matenda a shuga a mtundu II nthawi zambiri chimayamba ndi kuyambitsa zakudya zoyenera komanso mankhwala amkamwa (Metformin, Siofor, Diabeteson, etc. ..). Komabe, pali zochitika zina pomwe madokotala amakakamizidwa kugwiritsa ntchito insulin.

Zofala kwambiri zalembedwa pansipa:

• Kusakwanira kwa mankhwala amkamwa, kulephera kukwaniritsa bwinobwino glycemia ndi glycated hemoglobin
• Contraindication pakamwa
• Kuzindikira matenda ashuga omwe ali ndi ziwonetsero zambiri za glycemic, kuchuluka kwa matenda
• Myocardial infarction, coronary angiography, sitiroko, matenda owopsa, opaleshoni
• Mimba

Mbiri yayitali ya insulin

Mlingo woyambirira nthawi zambiri amakhala mayunitsi 0,2 kg / thupi. Calculator iyi ndi yothandiza kwa anthu popanda kukana insulini, yokhala ndi chiwindi chokhazikika komanso impso. Mlingo wa insulin umayikidwa ndi dokotala wokha (!)

Kuphatikiza pa kutalika kwa nthawi yochitikira (yayitali kwambiri ndi degludec, yocheperako kwambiri ndi ma genetic engineer a insulin-isophan), mankhwalawa amasiyana maonekedwe. Pankhani ya insulin NPH, pachimake chiwonetserochi chimagawidwa nthawi yayitali ndipo chimachitika pakati pa maola 4 ndi 14 jakisoni. Analogue yogwira ntchito ya insulir yaigwira kwa nthawi yayitali imafika pachimake pakati pa maola 6 ndi 8 jekeseni, koma imakhala yochepa kwambiri komanso yochepa.

Insulin glargine chifukwa chake imatchedwa basal insulin. Kuphatikiza kwake m'magazi kumakhala kochepa kwambiri, kotero chiopsezo cha hypoglycemia ndichotsika kwambiri.

Matenda a Alzheimer's: zoyambitsa ndi chithandizo. Zomwe muyenera kudziwa

Kukonzekera kwa mankhwala a insulin kumasiyana malinga ndi nthawi yayitali, yapakatikati, yayitali komanso kuphatikiza. Insulin yayitali idapangidwa kuti izikhala yolimba momwe timadzi tambiri timene timayambira, timene timapangidwira ndi kapamba. Amagwiritsidwa ntchito pa mtundu woyamba wa 2 komanso mtundu wa matenda a shuga 2, komanso mikhalidwe yomwe kayendetsedwe ka shuga m'magazi limafunikira.

Kufotokozera kwamagulu

Kutanthauza kwa insulin ndiko kugwiritsira ntchito njira zama metabolic komanso kudyetsa maselo ndi shuga.Ngati mahomoniwa sapezeka m'thupi kapena sanapangidwe kuchuluka, munthu amakhala pachiwopsezo chachikulu, ngakhale kufa.

Kuletsedwa kokhako kusankha gulu lokonzekera insulin nokha. Posintha mankhwala kapena mlingo, wodwalayo ayenera kuyang'aniridwa ndikuwongolera kuchuluka kwa shuga m'magazi a magazi. Chifukwa chake, pochita zinthu zofunika kwambiri zotere, muyenera kupita kwa dokotala.

Ma insulin omwe amakhala nthawi yayitali, omwe mayina awo adzapatsidwa ndi dokotala, nthawi zambiri amagwiritsidwa ntchito limodzi ndi mankhwalawa monga achidule kapena apakati. Pafupipafupi, amagwiritsidwa ntchito pochiza matenda a shuga a 2. Mankhwala oterowo amasunga shuga nthawi zonse chimodzimodzi, osaloleza kutalika kapena pansi.

Mankhwalawa amayamba kukhudza thupi pambuyo pa maola 4-8, ndipo kuchuluka kwa insulini kudzapezekanso pambuyo pa maola 8-18. Chifukwa chake, kuchuluka kwathunthu kwa glucose - 20-30 hours. Nthawi zambiri, munthu amafunika njira imodzi yoperekera jakisoni wa mankhwalawa, nthawi zambiri zimachitika kawiri.

Zosiyanasiyana zamankhwala opulumutsa moyo

Pali mitundu ingapo yamitundu iyi ya mahomoni amunthu. Chifukwa chake, amasiyanitsa mtundu wa ultrashort ndi mtundu waufupi, wopitilira komanso wophatikizidwa.

Mitundu yoyamba imakhudza thupi patadutsa mphindi 15 kuchokera kukhazikitsidwa kwake, ndipo kuchuluka kwa insulin kumatha kuwonekera patatha maola 1-2 mutabayidwa. Koma kutalika kwa chinthu m'thupi ndi chochepa kwambiri.

Ngati tilingalira ma insulin omwe akhala akuchita kwa nthawi yayitali, mayina awo akhoza kuyikidwa padera.

Ubwino Wofunika

Insulin yayitali imagwiritsidwa ntchito kutsimikizira molondola zomwe zimachitika mu mahomoni amunthu. Zitha kugawidwa m'magulu awiri: nthawi yayitali (mpaka maola 15) komanso nthawi yayitali, yomwe imafika mpaka maola 30.

Opanga adapanga mtundu woyamba wa mankhwalawo ngati mawonekedwe amadzimadzi amtambo. Asanapereke jakisoni, wodwalayo ayenera kugwedeza chidebecho kuti akwaniritse utoto. Pambuyo pokhapokha pokhapokha amatha kulowa mu subcutaneally.

Insulin yokhala ndi nthawi yayitali imapangidwa kuti iwonjezere pang'ono ndende yake ndikuisunga pamlingo womwewo. Panthawi inayake, nthawi ya kuphatikiza kwakukulu kwa malonda imabwera, pambuyo pake mulingo wake umachepa.

Ndikofunikira kuti musaphonye pamene gawo likhala lopanda pake, pambuyo pake mlingo wotsatira wa mankhwalawo uyenera kuperekedwa. Palibe kusintha kwakuthwa kwa chizindikirocho kuyenera kuloledwa, chifukwa chake adokotala aziganizira zazomwezo m'moyo wa wodwalayo, pambuyo pake adzasankha mankhwala oyenera ndi mlingo wake.

Kuyendetsa bwino thupi kosadumpha mwadzidzidzi kumapangitsa kuti inshuwaransi ikhale yogwira mtima kwakanthawi. Gululi la mankhwalawa lili ndi gawo lina: liyenera kutumikiridwa kokha mu ntchafu, osati pamimba kapena manja, monga zosankha zina. Izi ndichifukwa cha nthawi yonyamula zinthu, chifukwa m'malo ano zimachitika pang'onopang'ono.

Nthawi ndi kuchuluka kwa kayendetsedwe kazinthu zimatengera mtundu wa wothandizira. Ngati madzi ali ndi mawonekedwe osasinthika amtunduwu, mankhwalawa ali ndi ntchito yapamwamba, ndiye kuti nthawi yayitali ya ndende imachitika mkati mwa maola 7. Ndalamazi zimaperekedwa kawiri pa tsiku.

Ngati mankhwalawa alibe kuchuluka kwakukulu, ndipo zotsatira zake zimasiyana pakapita nthawi, ziyenera kuperekedwa nthawi imodzi patsiku. Chida chake ndi chosalala, cholimba komanso chosasinthasintha. Madziwo amapangidwa monga madzi oyera popanda kukhalapo kwamtambo pansi. Insulin yotenga nthawi yayitali ndi Lantus ndi Tresiba.

Kusankhidwa kwa Mlingo ndikofunikira kwambiri kwa odwala matenda ashuga, chifukwa ngakhale usiku, munthu amatha kudwala. Muyenera kuganizira izi ndikupanga jakisoni wofunikira pa nthawi. Kuti mupange chisankhochi molondola, makamaka usiku, miyezo ya glucose iyenera kutengedwa usiku. Izi zimachitika bwino pakadutsa maola awiri aliwonse.

Kuti akonzekere insulin kukonzekera, wodwalayo ayenera kudya popanda chakudya chamadzulo. Usiku wotsatira, munthu ayenera kutenga miyezo yoyenera. Wodwalayo amagaira zomwe adapeza kwa asing'anga, yemwe, atazipenda, amasankha gulu lolondola la insulin, dzina la mankhwalawo, ndikuwonetsa kuchuluka kwake.

Kusankha mlingo masana, munthu ayenera kumakhala ndi njala tsiku lonse komanso kumwa magawo omwewa, koma ola lililonse. Kuperewera kwa zakudya m'thupi kungathandize kupanga chithunzi chokwanira komanso cholondola m'thupi la wodwalayo.

Malangizo ogwiritsira ntchito

Kukonzekera kwa insulin kochepa komanso kwanthawi yayitali kumagwiritsidwa ntchito mwa odwala omwe ali ndi matenda a shuga 1. Izi zimachitika kuti tisunge gawo limodzi la maselo a beta, komanso kupewa kutulutsa ketoacidosis. Odwala omwe ali ndi mtundu wachiwiri wa matenda osokoneza bongo nthawi zina amayenera kupereka mankhwalawa. Kufunika kwa machitidwe oterewa kufotokozedwa mophweka: simungathe kulola kusintha kwa matenda ashuga kuchokera ku mtundu wachiwiri mpaka 1.

Kuphatikiza apo, insulini yokhala ndi nthawi yayitali imapatsidwa mphamvu yoletsa kukonzekera kwa m'mawa komanso kukhazikitsa kuchuluka kwa shuga m'mawa (pamimba yopanda kanthu). Kuti akupatseni mankhwalawa, dokotala angakufunseni kuti mupeze zolemba zolimbitsa thupi za milungu itatu.

Insulin yokhala ndi nthawi yayitali imakhala ndi mayina osiyanasiyana, koma odwala ambiri amagwiritsa ntchito mankhwalawa. Mankhwala oterowo safunikira kugwedezeka musanayambe kutsata, amadzimadzi amakhala ndi mtundu wowonekera komanso wosasinthika. Opanga amapanga mankhwalawo m'mitundu ingapo: cholembera cha OpiSet (3 ml), makatoni a Solotar (3 ml) ndi dongosolo lomwe lili ndi OptiClick cartridgeges.

Munjira yomalizirayi, mumakhala ma cartridge 5, lililonse la 5 ml. Poyambirira, cholembera ndichida chofunikira, koma makatoni amayenera kusinthidwa nthawi iliyonse, kukhazikitsa syringe. M'dongosolo la Solotar, simungasinthe madzimadzi, chifukwa ndi chida chotayikira.

Mankhwala oterowo amathandizira kupanga mapuloteni, lipids, kugwiritsa ntchito ndi kutulutsa minofu yam'magazi komanso minofu ya adipose ndi shuga. Mu chiwindi, kusintha kwa glucose kukhala glycogen kumapangidwira, komanso kumachepetsa shuga la magazi.

Malangizowo akuti amafunikira jakisoni imodzi, ndipo endocrinologist imatha kudziwa mlingo. Izi zimatengera kuopsa kwa matendawa komanso machitidwe ake amwana. Muwapatse ana azaka zopitilira 6 ndi akulu omwe ali ndi matenda a shuga 1 kapena mtundu 2.

Kwa munthu yemwe ali ndi vuto lalikulu la insulini ya mahomoni, cholinga chamankhwala ndicho kubwereza kwaposachedwa kwambiri kwa katulutsidwe achilengedwe, koyamba komanso kolimbikitsidwa. Nkhaniyi ikufotokozerani za kusankha koyenera kwa mankhwala a basal insulin.

Pakati pa odwala matenda ashuga, mawu akuti "ndikusintha ngakhale pang'ono" ndiwodziwika, chifukwa kumwa kwa insulin komwe kumakhalapo kwa nthawi yayitali kumafunikira.

Insulin yayitali

Kuti athe kutsanzira kubisala kwapansi, amagwiritsa ntchito insulin. Pa matenda ashuga a odwala matenda ashuga pali mawu awa:

• "Insulin yayitali"
• "Basic insulin",
• "Basal"
• Insulin yowonjezera
• "Insulin yayitali."

Mawu onsewa amatanthauza - insulini wokhalitsa. Masiku ano, mitundu iwiri ya ma insulin omwe akhala akuchita kwa nthawi yayitali amagwiritsidwa ntchito.

Insulin ya sing'anga nthawi - zake kumatenga mpaka maola 16:

1. Biosulin N.
2. Insuman Bazal.
3. Protafan NM.
4. Humulin NPH.

Ultra-yaitali insulin - imagwira ntchito kwa maola opitilira 16:

Levemir ndi Lantus amasiyana ndi ma insulini ena osati nthawi yawo yambiri, komanso kuwonekera kwawo kwathunthu, pomwe gulu loyambirira la mankhwalawo limakhala ndi mtundu wamtambo yoyera, ndipo asanayende pamafunika kukhazikitsidwa pamiyeso, pomwepo yankho limakhala lofanana mitambo.

Kusiyana kumeneku kumachitika chifukwa cha njira zingapo zopangira insulin, koma zina pambuyo pake. Mankhwala a nthawi yayitali yochitapo kanthu amaonedwa kuti ndi achichepere, kutanthauza kuti, m'njira zawo, njira yomwe siinatchulidwepo ikuwoneka, ngati kwa ma insulin apafupi, komabe pali nsonga.

Ma insulini okhala ndi nthawi yayitali amaonedwa kuti ndi opanda ntchito. Mukamasankha muyeso wa mankhwala oyambira, mawonekedwewo ayenera kukumbukiridwa. Komabe, malamulo apadera a insulini onse amakhalabe chomwecho.

Zofunika! Mlingo wa insulin yomwe yakhalapo kwa nthawi yayitali iyenera kusankhidwa m'njira yoti shuga azikhala m'magazi pakati pa chakudya chokwanira. Kusinthasintha kakang'ono pamlingo wa 1-1.5 mmol / l ndikuloledwa.

Mwanjira ina, ngati mulingo woyenera, glucose m'magazi sayenera kuchepa, kapena, kuwonjezera. Chizindikiro chiyenera kukhala chokhazikika masana.

Ndikofunikira kufotokozera kuti jakisoni wa insulin yemwe wakhala akuchita nthawi yayitali amachitika m'tchafu kapena pakamwa, koma osati m'mimba ndi mkono. Iyi ndi njira yokhayo yoonetsetsa kuti mayamwidwe akunyowa. Insulin yomwe imagwira ntchito mwachidule imalowetsedwa kumkono kapena pamimba kuti ikwaniritse kwambiri, yomwe imayenera kukhala yogwirizana ndi nthawi ya chakudya.

Insulin yayitali - mlingo usiku

Kusankha kwa mlingo wa insulin yayitali tikulimbikitsidwa kuti muyambe ndi mlingo wa usiku. Wodwala yemwe ali ndi matenda ashuga amayenera kuwunika momwe magazi amapezeka m'magazi usiku. Kuti muchite izi, maola atatu aliwonse ndikofunikira kuyeza miyezo ya shuga, kuyambira ola la 21 ndikutha ndi 6 mmawa tsiku lotsatira.

Ngati imodzi mwazinthu zazikulu kusinthasintha kwa glucose kumayang'aniridwa kumayang'ana m'mwamba kapena, motsikira, kutsikira, izi zikuwonetsa kuti mlingo wa mankhwalawa udasankhidwa molakwika.

Zoterezi, gawo lino lifunika kuwonedwa mwatsatanetsatane. Mwachitsanzo, wodwala amapita kutchuthi ndi shuga wa 6 mmol / L. Nthawi ya 24:00 chizindikirocho chimakwera kufika pa 6.5 mmol / L, ndipo nthawi ya 03:00 chimadzuka mwadzidzidzi kufika pa 8.5 mmol / L. Munthu amakumana ndi m'mawa ndi shuga wambiri.

Zochitikazo zikuwonetsa kuti kuchuluka kwa insulin usiku sikokwanira ndipo mlingo uyenera kuwonjezeka pang'onopang'ono. Koma pali imodzi "koma"!

Ndi kukhalapo kwa chiwonjezeko chotere (komanso chapamwamba) usiku, sizingatanthauze kuperewera kwa insulin nthawi zonse. Nthawi zina hypoglycemia imabisika pansi pa mawonekedwe awa, omwe amapanga mtundu wa "kubwezeretsanso", wowonetsedwa ndi kuchuluka kwa glucose m'magazi.

• Kuti mumvetsetse momwe amapangira shuga usiku, nthawi yolumikizira miyeso iyenera kutsitsidwa kwa ola limodzi, ndiye kuti, imayesedwa ola lililonse pakati pa 24:00 mpaka 03:00 h.
• Ngati kutsika kwa glucose kutsikira kwawonedwa m'malo ano, ndizotheka kuti uku kunali kugwada ”kozunguliridwa ndi kubweza. Pankhaniyi, mlingo wa insulin yofunika sayenera kuchuluka, koma kuchepetsedwa.
• Kuphatikiza apo, chakudya chomwe chimadyedwa patsiku chimakhudzanso kugwira bwino ntchito kwa insulin.
• Chifukwa chake, kuti tiwone molondola momwe insal insulin ilili, sipayenera kukhala ndi shuga komanso insulin yochepa m'magazi kuchokera ku chakudya.
• Kuti muchite izi, chakudya chamadzulo chisanachitike kuyeserera kuyenera kudumphidwa kapena kusinthidwa nthawi isanakwane.

Pokhapokha chakudya ndi insulin yochepa yomwe imayambitsidwa nthawi yomweyo sizingasinthe tanthauzo la chithunzicho. Pazifukwa zomwezo, tikulimbikitsidwa kugwiritsa ntchito zakudya za chakudya chamadzulo zokha, koma osapatula mafuta ndi mapuloteni.

Zinthu izi zimatengedwa pang'onopang'ono ndipo kenako zimatha kuwonjezera shuga, zomwe ndizosafunika kwambiri pakuwunika koyenera kwa insulin usiku.

Insulin yayitali - tsiku lililonse

Kuwona insulini ya basal masana kumakhalanso kosavuta, muyenera kumangokhala ndi njala pang'ono, ndikukhala ndi miyezo ya shuga ola lililonse. Njirayi ikuthandizira kudziwa kuti ndi nthawi yanji yomwe ikuwonjezeka, komanso momwe - kuchepa.

Ngati izi sizingatheke (mwachitsanzo, mwa ana aang'ono), ntchito ya insulin yoyambirira iyenera kuwonedwa nthawi ndi nthawi. Mwachitsanzo, muyenera kudumphira chakudya cham'mawa kaye ndikuyamba kuyerekezera ola lililonse kuchokera nthawi yomwe mumadzuka kapena kuyambira nthawi yomwe mumalowa insulin ya tsiku ndi tsiku (ngati wina wamulembera) mpaka chakudya chamasana. Masiku angapo pambuyo pake, mapangidwewo amabwerezedwanso ndi nkhomaliro, ndipo ngakhale pambuyo pake ndi chakudya chamadzulo.

Ma insulin ambiri omwe akhala akuchita kwa nthawi yayitali amayenera kuperekedwa kawiri pa tsiku (kupatula Lantus, amadzibaya kamodzi).

Tcherani khutu! Zomwe zakonzedwa kale ndi insulin, kupatula Levemir ndi Lantus, zimakhala ndizobisalira, zomwe nthawi zambiri zimachitika patatha maola 6-8 mutabayidwa.

Chifukwa chake, panthawiyi, pakhoza kukhala kuchepa kwa shuga, komwe mlingo wochepa wa "mkate" umafunikira.

Mukamasintha kuchuluka kwa insulin ya basal, zonsezi zimalimbikitsidwa mobwerezabwereza. Mwachidziwikire, masiku atatu adzakhala okwanira kuti zitsimikizire zosunthira mbali imodzi kapena ina. Njira zinanso zikuchitidwa mogwirizana ndi zotsatira zake.

Mukamaunika insulin ya tsiku ndi tsiku, pafupifupi maola 4 ayenera kudutsa pakati pa chakudya, moyenera 5. Kwa iwo omwe amagwiritsa ntchito insulin yayifupi m'malo mwa ultrashort, nthawi imeneyi izikhala yotalikirapo (maola 6-8). Izi ndichifukwa cha zomwe insulini izi zimachita.

Ngati insulin yayitali yasankhidwa molondola, mutha kupitiliza ndi kusankha insulin yayifupi.

Matenda a shuga a Type 1 samachiritsidwa. Kuti khazikitse mkhalidwe, wodwala ayenera tsiku ndi tsiku. Pali mitundu ingapo ya mankhwala a timadzi iyi, koma choyambirira pakati pawo ndi insulin.

Popanda insulini, thupi limatha kugwira ntchito moyenera. Hormone iyi imayang'anira protein, mafuta ndi carbohydrate metabolism. Palibe, kapena ndende zochepa, njira za metabolic m'thupi zimachepa. Izi zimabweretsa zovuta zowopsa zomwe zimatha kupha.

Odwala onse omwe ali ndi matenda ashuga amafunikira insulin, makamaka mankhwala omwe amakhala kwa nthawi yayitali. Matendawa amakula chifukwa chosapezeka m'thupi la wodwala yemwe amapanga mahomoni ake, insulin, yomwe imayang'anira njira zama metabolic komanso glucose. Chifukwa chake, mankhwala amakono omwe amagwira ntchito kwa nthawi yayitali amalola kuti thupi la wodwalayo lizigwira ntchito.

Matenda a shuga ndi owopsa chifukwa cha zovuta zake. Insulin yomwe imaperekedwa kwa wodwala, mwachitsanzo, kuchitapo kanthu kwa nthawi yayitali, kumapewa kuyambitsa zovuta izi, zomwe nthawi zambiri zimayambitsa kufa.

Mukamasankha insulin yaing'onoting'ono kapena yayitali, mayina omwe nthawi zina amasokonezeka, ndikofunikira kuti musamadziyike. Ngati mukufunikira kusintha mankhwalawa kapena kusintha mlingo wa tsiku ndi tsiku, funsani dokotala.

Mitundu ya jakisoni

Wodwala matenda ashuga amakakamizidwa kumwa jakisoni tsiku lililonse, ndipo kangapo patsiku. Kuyambitsa insulin tsiku lililonse kumathandizira kukhazikika kwa mkhalidwe. Popanda mahomoni awa, sizingatheke kutulutsa shuga m'magazi. Popanda jakisoni, wodwalayo amamwalira.

Chithandizo chamakono cha shuga chimapereka mitundu ingapo ya jakisoni. Amasiyana pakutalika komanso kuthamanga.

Pali mankhwala osakhalitsa, a ultrashort, ophatikizika komanso opanga nthawi yayitali.

Yofupikitsa ndikuyamba kugwira ntchito pafupifupi mukangoyendetsa. Kuchulukitsa kwakukulu kumatheka mkati mwa ola limodzi kapena awiri, kenako jekeseni pang'onopang'ono limatha. Mwambiri, mankhwalawa amagwira ntchito pafupifupi maola 4-8.Monga lamulo, majekeseni oterewa amakulimbikitsidwa kuti aperekedwe mukangodya, pambuyo pake kuchuluka kwa shuga m'magazi a wodwalayo kumayamba kuchuluka.

Insulin yotalikilapo imakhala maziko a chithandizo. Imagwira kwa maola 10-28, kutengera mtundu wa mankhwalawa. Kutalika kwa nthawi ya mankhwalawa kumasiyanasiyana mwa wodwala aliyense, kutengera mtundu wa matendawa.

Zina za mankhwala omwe akhala akuchita kwa nthawi yayitali

Insulin yotalikilapo ndiyofunikira kuti athe kutsanzira molondola momwe amapangira mahomoni ake mu wodwala. Pali mitundu iwiri ya mankhwalawa - Mankhwala okhala ndi nthawi yayitali (amagwira ntchito kwa maola pafupifupi 15) komanso mankhwala opangira nthawi yayitali (mpaka maola 30).

Mankhwala a nthawi yapakatikati ali ndi mawonekedwe othandizira. Insulin imakhala ndi utoto woyera. Musanayambitse mahomoni, muyenera kukwaniritsa utoto.

Pambuyo popereka mankhwalawa, kuwonjezeka kwapang'onopang'ono kwa kuchuluka kwa mahomoni kumawonedwa. Panthawi inayake, pachimake pa mchitidwe wa mankhwalawa amadza, pambuyo pake ndende imayamba kuchepa ndikutha. Ndiye kuti jakisoni watsopano ayenera kupangidwa.

Mlingo wake umasankhidwa kuti mankhwalawa azitha kuyendetsa bwino shuga wa magazi, kupewa kudumphira pakati pa jakisoni. Mukamasankha kuchuluka kwa insulin kwa wodwala, dokotala amaganizira nthawi yochuluka yomwe mankhwalawa amapezeka.

Mbali inanso ndi tsamba la jakisoni. Mosiyana ndi mankhwalawa amagwira ntchito mwachidule, omwe amalowetsedwa pamimba kapena mkono, insulin yayitali imayikidwa m'chafu - izi zimakuthandizani kuti mukwaniritse kusintha kwa mankhwala mthupi lanu.

Ndiwowonjezereka kosalala kosakanikirana ndi mankhwalawa komwe kumatsimikiza kugwira ntchito kwake ngati jekeseni wa maziko.

Kodi kubayira kangati?

Pali mankhwala angapo a insulin. Ambiri aiwo amadziwika ndi kusasinthasintha kwamtambo komanso kupezeka kwa zochitika zapamwamba, zomwe zimachitika pafupifupi maola 7 mutatha kutsata. Mankhwalawa amatumizidwa kawiri pa tsiku.

Mankhwala ena (Tresiba, Lantus) amaperekedwa nthawi imodzi patsiku. Mankhwalawa amadziwika ndi nthawi yayitali yogwira ntchito komanso kuyamwa pang'onopang'ono, popanda chiwopsezo chochita - ndiye kuti, timadzi tambiri tomwe timayambitsa timagwira bwino ntchito nthawi yonse yochitayo. Chowonjezera china mwa mankhwalawa ndikuti alibe mtambo ndipo amatha kusiyanitsidwa ndi mtundu wowonekera.

Dokotala pakuthandizanakukuthandizani kusankha mankhwala abwino kwambiri kwa wodwala wina. Katswiriyu amasankha insulini yoyambira kapena yotalikilapo ndipo atchule mayina a mankhwala abwino. Sizikulimbikitsidwa kuti muzisankha nokha insulin yayitali.

Momwe mungasankhire mlingo?

Matenda a shuga sagona usiku. Chifukwa chake, wodwala aliyense amadziwa kufunika koti asankhe mlingo woyenera wa mankhwalawa kuti apewe shuga pamene akupumula usiku.

Kusankha mankhwalawa molondola, muyenera kuyeza shuga m'magazi awiri tsiku lililonse.

Musanayambe kugwiritsa ntchito insulin, nthawi yayitali, ndikulimbikitsidwa kukana chakudya chamadzulo. Usiku, kuchuluka kwa shuga kumayesedwa, ndipo, potengera izi, kutalika kwa jakisoni kumatsimikiziridwa pambuyo pokambirana ndi dokotala.

Kudziwa tsiku ndi tsiku mankhwala omwe akhala akuchita kwa nthawi yayitali kumafunikiranso njira yapadera. Njira yabwino ndikukana chakudya tsiku lonse ndi milingo ya shuga. Zotsatira zake, pofika madzulo, wodwalayo amadziwa momwe shuga ya m'magazi imakhalira jekeseni chifukwa chokhala nthawi yayitali.

Zotheka zotheka ku jakisoni

Insulin iliyonse, mosasamala kanthu za kutalika kwa nthawi, imatha kuyambitsa zovuta zingapo. Nthawi zambiri, chomwe chimayambitsa zovuta ndi kuperewera kwa zakudya m'thupi, kumwa mankhwala osankhidwa mosayenera, kuphwanya njira yoyendetsera mankhwala. Muzochitika izi, kukula kwa zotsatirazi ndizotheka:

• mawonekedwe a thupi lawo siligwirizana.
• kusapeza bwino pamalowo jekeseni,
• kukula kwa hypoglycemia.

Monga mukudziwa, hypoglycemia imatha kubweretsa zovuta zazikulu, mpaka kukomoka kwa matenda ashuga. Pewani izi mwakutsatira mosamalitsa malangizo onse omwe dokotala amakupatsirani.

Kodi mungapewe bwanji zovuta?

Matenda a shuga ndi matenda oopsa ndipo ndizovuta kupirira. Komabe, wodwala yekha ndiye amene angatsimikizire kukhala ndi moyo wabwino. Kuti tichite izi, ndikofunikira kugwiritsa ntchito njira zonse zomwe zingathandize kupewa zovuta komanso thanzi labwino.

Maziko othandizira matenda amtundu wa shuga ndi jakisoni, koma kudzipereka nokha ndiwowopsa. Chifukwa chake, pakakhala mafunso aliwonse okhudzana ndi mankhwala omwe amaperekedwa, wodwalayo ayenera kufunsa dokotala wokha.

Kuti mumve wathanzi, muyenera kudya moyenera. Insulin imathandizira kuyendetsa magazi m'magazi, koma wodwalayo ayenera kuyesetsa kuti asawakhumudwitse. Kuti izi zitheke, madokotala amatipatsa zakudya zapadera zomwe zithandiza kukhazikika mtima kwa wodwala.

Mankhwala aliwonse omwe amagwiritsidwa ntchito ngati mankhwala ayenera kugwiritsidwa ntchito molingana ndi malangizo a dokotala.