Lantus SoloStar: malangizo ogwiritsira ntchito

Lantus® SoloStar® iyenera kuyendetsedwa mosavomerezeka kamodzi patsiku nthawi iliyonse, koma tsiku lililonse nthawi imodzi.

Odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga, Lantus® SoloStar ® angagwiritsidwe ntchito ngati monotherapy komanso kuphatikiza mankhwala ena a hypoglycemic. Cholinga cha shuga wamagazi, komanso Mlingo ndi nthawi ya makonzedwe kapena makonzedwe a hypoglycemic ayenera kutsimikizika ndi kusintha payekha. Kusintha kwa dose kungafunikenso, mwachitsanzo, pakusintha kuchuluka kwa thupi la wodwalayo, moyo wake, kusintha nthawi ya mlingo wa insulin kapena zinthu zina zomwe zingakulitse chiwonetsero chakukula kwa hypo- kapena hyperglycemia (onani magawo "Malangizo apadera"). Kusintha kulikonse kwa insulin kuyenera kuchitika mosamala komanso moyang'aniridwa ndi achipatala.

Lantus® SoloStar® si insulin yosankha yochizira matenda ashuga a ketoacidosis.

Pankhaniyi, makonda amayenera kuperekedwa kwa kulowetsedwa kwa insulin.

Mu mankhwalawa othandizira kuphatikiza jakisoni wa basal ndi prandial insulin, 40-60% ya mlingo wa insulin tsiku lililonse wa insulin glargine nthawi zambiri amatumizidwa kuti akwaniritse zosowa za insulin.

Odwala omwe ali ndi matenda a shuga a mtundu wa 2 omwe amamwa mankhwala a hypoglycemic pakamwa, kuphatikiza mankhwalawa kumayamba ndi gawo la insulin glargine magawo 10 kamodzi patsiku ndipo njira yotsatira ya mankhwalawa imasinthidwa payekhapayekha.

Kwa odwala onse omwe ali ndi matenda ashuga, kuyang'anira kuwunika kwa shuga m'magazi kumalimbikitsidwa.

Kusintha kuchokera ku chithandizo ndi mankhwala ena a hypoglycemic kupita ku Lantus® SoloStar®

Mukasamutsa wodwala ku njira yochiritsira yogwiritsa ntchito nthawi yayitali kapena insulini yodwala pakanthawi kogwiritsa ntchito Lantus® SoloStar ® kukonzekera, kungakhale kofunikira kusintha kuchuluka (kutalika) ndi nthawi ya oyambitsa insulin kapena analogue yochepa masana kapena kusintha Mlingo wamankhwala osokoneza bongo a hypoglycemic .

Mukasamutsa odwala kuchokera jakisoni imodzi ya insulin isofan masana kupita ku mankhwala amodzi masana, Lantus® SoloStar ®, Mlingo woyamba wa insulin nthawi zambiri sasinthidwa (ndiye kuti kuchuluka kwa mankhwalawa a Lantus® SoloStar ® pa tsiku ofanana ndi kuchuluka kwa IN insulin isofan patsiku kumagwiritsidwa ntchito )

Posamutsa odwala kuti ayambe kutumiza insulin-isophan kawiri masana kupita kuntchito imodzi ya Lantus® SoloStar® asanagone kuti achepetse vuto la hypoglycemia usiku ndi m'mawa kwambiri, mankhwalawa a insulin glargine nthawi zambiri amachepetsedwa ndi 20% (poyerekeza ndi mlingo wa tsiku ndi tsiku insulin-isophane), kenako imasinthidwa malinga ndi yankho la wodwalayo. Lantus® SoloStar® sayenera kusakanikirana ndi insulin ina yokonzekera kapena kuchepetsedwa. Onetsetsani kuti ma syringe alibe zotsalira zamankhwala ena. Mukasakaniza kapena kuchepetsera, mawonekedwe a insulin glargine amatha kusintha pakapita nthawi.

Mukasintha kuchokera ku insulin ya anthu kupita ku Lantus® SoloStar ® ndipo mkati mwa masabata oyamba pambuyo pake, kuwunikira mosamala metabolic (kuyang'anira kuchuluka kwa shuga m'magazi) moyang'aniridwa ndi achipatala akulimbikitsidwa, ndikuwongolera mtundu wa insulin ngati pakufunika. Monga ma fanizo ena a insulin yaumunthu, izi ndizofunikira kwambiri kwa odwala omwe, chifukwa cha kupezeka kwa ma antibodies a insulin ya anthu, ayenera kugwiritsa ntchito Mlingo waukulu wa insulin ya anthu.Odwala oterowo, akamagwiritsa ntchito insulin glargine, kusintha kwakukulu poyankha kutsata insulin kumawonedwa.

Ndi bwino kagayidwe kachakudya ndi kuchuluka kwa minyewa kumva insulin, pangafunikire kusintha mlingo wa insulin.

Kusakaniza ndi kuswana

Lantus® SoloStar® sayenera kusakanikirana ndi ma insulini ena. Kusakaniza kungasinthe kuchuluka kwa nthawi / mphamvu ya Lantus® SoloStar ® ndikutsogolera ku mpweya.

Magulu apadera a odwala

Mankhwala Lantus® SoloStar® angagwiritsidwe ntchito mwa ana opitilira zaka 2. Ntchito ana osaposa zaka 2 sizinaphunzire.

Odwala okalamba

Kwa odwala okalamba omwe ali ndi matenda a shuga, ndikulimbikitsidwa kugwiritsa ntchito Mlingo woyambirira, kuwonjezereka kwawo pang'onopang'ono komanso kugwiritsa ntchito Mlingo wowonjezera.

Mankhwala a Lantus® SoloStar ® amaperekedwa ngati jekeseni wa subcutaneous. Lantus® SoloStar ® sicholinga cha kuwongolera kwakanthawi.

Kutalika kwazinthu zambiri za insulin glargine zimawonedwa pokhapokha ngati zimayambitsidwa ndi mafuta osaneneka. Mtsempha wa magazi a chizolowezi subcutaneous mlingo zingayambitse kwambiri hypoglycemia.

Lantus® SoloStar ® iyenera kuphatikizidwa ndi mafuta ochulukirapo a m'mimba, mapewa kapena m'chiuno.

Masamba a jakisoni amayenera kusinthana ndi jakisoni aliyense watsopano m'malo omwe analimbikitsidwa kuti apatsidwe mankhwala. Monga momwe zimakhalira ndi mitundu ina ya insulini, kuchuluka kwa mayamwidwe, ndipo, chifukwa, zoyambira ndi nthawi yake yochitikira, zimatha kusiyanasiyana mothandizidwa ndi zochitika zolimbitsa thupi komanso kusintha kwina kwa wodwalayo.

Lantus® SoloStar® ndi yankho lomveka bwino, osati kuyimitsidwa. Chifukwa chake, kupumulanso musanagwiritse ntchito sikofunikira.

Panthawi yolakwika ya cholembera cha Lantus® SoloStar ®, insulin glargine imatha kuchotsedwa mu katiriji mu syringe (yoyenera insulin 100 IU / ml) ndipo jakisoni wofunikira ukhoza kupangidwa.

Mankhwala

Glulin insulin idapangidwa ngati analogue ya insulin yaumunthu, yomwe imakhala yochepa kwambiri osagwirizana nawo. Ku Lantus ® SoloStar ®, imasungunuka kwathunthu chifukwa cha chilengedwe cha acidic yankho la jakisoni (pH 4). Pambuyo pakuyambitsa minofu yaying'ono, njira yokhala ndi acidic imatha, yomwe imayambitsa kutuluka kwa microprecipitates, komwe kuchuluka kwa insulin glargine kumasulidwa nthawi zonse, komwe kumapereka kosalala (kopanda mapikisano) komanso mbiri yomwe ikuyembekezeka nthawi yayitali, komanso nthawi yayitali ya mankhwalawo.

Insulin glargine imapangidwira 2 metabolites yogwira - M1 ndi M2 (onani gawo "Pharmacokinetics").

Kulumikiza kwa Insulin:

Kafukufuku wa in vitro akuwonetsa kuti kuyanjana kwa insulin glargine ndi metabolites M1 ndi M2 kwa insulin receptor yamunthu ndikofanana ndi insulin yamunthu.

IGF-1 receptor binding (insulin-like grow factor 1):

Kuyanjana kwa insulin glargine kwa IGF-1 receptor kuli pafupi maulendo 5-8 peresenti kuposa kuyanjana ndi insulin yaumunthu (koma pafupifupi 70-80 nthawi yotsika kuposa kuyanjana ndi IGF-1 kwa cholandirira ichi), pomwe metabolites M1 ndi M2 imamangira ku IGF receptor -1 ndi kuyanjana, kuchepa pang'ono kwa insulin ya anthu.

Chiwonetsero chonse cha insulin (insulin glargine ndi metabolites) chake, chomwe chimatsimikizika kwa odwala omwe ali ndi matenda a shuga I, chinali chotsika kwambiri kuposa zomwe zimafunikira pakumanga hafu ya IGF-1 receptor komanso kuyambitsa njira ya mitogen-proliferative. IGF-1 receptor. Endo native IGF-1 mukumazungulira kwazinthu zimatha kuyambitsa mayendedwe a mitogen-proliferative, koma zochizira zama insulin zomwe zimagwiritsidwa ntchito pochizira insulin, kuphatikizapo insulin mankhwala a Lantus ® SoloStar ®, ndizotsika kwambiri poyerekeza ndi pharmacological,kofunikira kukhazikitsa njira ya IGF-1-mediated.

Chochita chofunikira kwambiri cha insulin, kuphatikiza insulin glargine, ndikuwongolera kagayidwe ka shuga. Insulin ndi kufananiza kwake kumachepetsa kuchuluka kwa shuga m'magazi ndikulimbikitsa kudya kwake ndi zotumphukira zake, makamaka minofu yamatumbo ndi minyewa ya adipose, komanso poletsa mapangidwe a shuga m'chiwindi. Insulin imalepheretsa adipocyte lipolysis ndi proteinol, pamene ikupanga kuphatikiza mapuloteni.

Kafukufuku wachipatala komanso wa pharmacological atsimikizira kufanana kwa milingo yofanana ya insulin glargine ndi insulin ya anthu atakhazikitsa mankhwalawa. Monga insulin iliyonse, mawonekedwe a insulin glargine pakapita nthawi akhoza kukhudzidwa ndi zochitika zolimbitsa thupi komanso zinthu zina.

Kafukufuku wogwiritsa ntchito njira ya kukonzekera kwa euglycemic state, komwe kunachitika ndi kutenga nawo gawo odzipereka komanso odwala omwe ali ndi matenda amtundu wa I, adawonetsa kuti, mosiyana ndi NPH (ndale protamine Hagedorn) ya insulin yaumunthu, kuyambika kwa kuchitira insulin glargine pambuyo pothandizidwa ndi subcutaneous pambuyo pake popanda kuchititsa nsapato mu shuga m'magazi, ndipo nthawi yake imakhalapo.

Zotsatira za amodzi mwa kafukufuku pakati pa odwala zikuwonetsedwa pazithunzi pansipa.

Zochitika mu odwala omwe ali ndi matenda amtundu wa I.

Nthawi (maola) yomwe idadutsa pambuyo pakupereka mankhwala

Mapeto a nthawi yowonera

* Amatanthauzira monga kuchuluka kwa glucose komwe kumayambitsidwa kuti ukhalebe wamagulu a glucose nthawi zonse (pafupifupi ola limodzi).

Kutalika kwa nthawi yayitali ya insulin glargine imakhala yolumikizidwa mwachindunji ndi kuyamwa pang'onopang'ono, komwe kumapangitsa kuti mankhwalawa azigwiritsidwa ntchito kamodzi patsiku. Mphamvu yochepa ya insulin ndi mawonekedwe ake, monga insulin glargine, imatha kukhala ndi kusiyana pakati komanso kuphatikizana.

M'mayesero azachipatala atakhazikitsidwa ndi insulin glargine ndi insulin ya anthu, zizindikiro za hypoglycemia kapena kutsutsana kwa mayankho a mahomoni zinali zofanana mwa odzipereka athanzi komanso odwala matenda a shuga a mtundu woyamba.

Mphamvu ya insulin glargine (yomwe imayendetsedwa 1 patsiku) patsiku la matenda ashuga imayesedwa panthawi yoyesedwa zaka zisanu, mankhwala oyerekeza omwe anali ndi insulin NPH (kutumikiridwa 2 kawiri pa tsiku) komanso omwe amachitika ndi kutenga kwa odwala 1024 odwala matenda ashuga a mtundu II, momwe kupitirira kwa retinopathy ndi mfundo zitatu kapena kupitilira apo kunawonedwa pamlingo womwe unagwiritsidwa ntchito mu Phunziro la Early Treatment Diabetesic Retinopathy Study (ETDRS). Kupita patsogolo adawunika pogwiritsa ntchito kujambula kwa fundus. Panalibe kusiyana kwakukulu pang'onopang'ono pakati pa kupitirira kwa matenda ashuga a retinopathy ndi makonzedwe a Lantus ® insulin ndi insulin NPH.

Kafukufuku wa ORIGIN (Outcome Reduction with Initial Glargine INtervention, "Kuchepetsa chiopsezo cha zotsatira zoyipa za chipatala ndi oyang'anira a glargine management") anali kafukufuku wamitundu mitundu, wosasankhidwa, wophunzirira 2 x 2 wa maphunziro omwe amapangidwa mwa odwala 12,537 omwe ali ndi ngozi yamtima yayikulu (SS), omwe adaletsa kusala kudya kwa glycemia (PHN) kapena kulekerera kwa glucose (PTH) (12% ya omwe akutenga nawo gawo) kapena mtundu II shuga mellitus, omwe adalandira ≤1 Mlingo wa mankhwala antidiabetesic (88% ya omwe akuchita nawo). Ophunzira nawo adasinthidwa mosasinthika (1: 1) kuti alandire insulin glargine (n = 6264), mlingo womwe umasungidwa usanakwaniritse shuga m'magazi a m'magazi a ≤95 mg / dl (5.3 mmol / L), kapena chithandizo chamankhwala wamba (n = 6273).

Chizindikiro choyamba pamapeto ophatikizidwa oyambilira anali nthawi mpaka chimayambitsa kufa ndi EU chifukwa, choyambitsa matenda osapweteka, ndi chiphaso chachiwiri, ndikuti chidziwitso chachiwiri chakumapeto kwa nthawi yayitali chinali nthawi mpaka kuwonekera koyamba kwazinthu zonsezi za njira yayikulu yotsiriza kapena kuchititsa njira yosinthira (coronary, carotid kapena zotumphukira), kapena kuchipatala chifukwa cha mtima.

Mapeto apachiwiri anali ndi zoyipa zonse zakufa komanso mathero ophatikizika a zochitika zazing'ono.

Insulin glargine sizinasinthe chiopsezo chokhala ndi matenda a SS komanso kufa ndi zoyambitsa za EU poyerekeza ndi chithandizo chamankhwala wamba. Panalibe kusiyana pakati pa insulin glargine ndi chithandizo chamankhwala pazowonetsa zonse ziwiri zoyambira kumapeto, mu gawo limodzi la malekezero, kuphatikiza zotsatirapo zoyipa zamatenda, muimfa pazifukwa zonse, kapena pamapeto ophatikizika a zochitika za microvascular.

Mlingo wamba wa insulin glargine kumapeto kwa maphunzirowa anali 0.42 U / kg Kumayambiriro kwa phunziroli, HbA1c wamba pakati pa omwe anali nawo anali 6.4%, ndipo motsutsana ndi momwe chithandizo chikuwerengera, HbA1c idachokera ku 5.9 mpaka 6.4% m'gululi la insulin glargine komanso kuchokera 6.2% mpaka 6.6% pagululi muyezo mankhwala nthawi yonse yowonera.

Zomwe zimachitika kwambiri hypoglycemia (zoperekedwa ngati kuchuluka kwa owerenga momwe zochitika zotere zimawonedwera pazaka zana zamankhwala odwala) anali 1.05 m'gululi la insulin glargine ndi 0.30 pagulu lachipatala chotsimikizika, komanso pafupipafupi pamagawo otsimikiziridwa Hypoglycemia yofatsa inali 7.71 mu gulu la insulin glargine ndi 2.44 mu gulu lachipatala lodziwika bwino. Pa kafukufukuyu wazaka 6, 42% ya odwala omwe ali mgululi la insulin glargine samakumana ndi ziwopsezo za hypoglycemia.

Paulendo womaliza, womwe udachitika motsutsana ndi chithandizo cha mankhwalawo, kuwonjezeka kwa thupi kuchokera pamlingo woyambira gulu la insulin glargine ndi pafupifupi 1.4 makilogalamu ndikuchepa kwake ndi pafupifupi 0,8 kg pagulu lodziwika bwino.

Ana ndi achinyamata

Panthawi yoyesedwa mosamalitsa odwala, ana (azaka 6 mpaka 15), odwala matenda a shuga I mellitus (n = 349) adalandira basal-bolus insulin chithandizo kwa masabata 28, momwe adalowetsedwa ndi insulin nthawi zonse asanadye. Glulin insulin idaperekedwa 1 nthawi usiku, ndipo insulin NPH imayendetsedwa kamodzi kapena kawiri pa tsiku. M'magulu onse awiriwa, zotsatira za kuchuluka kwa hemoglobin ya glycosylated komanso kuchuluka kwa hypoglycemia, limodzi ndi mawonetsedwe azachipatala, zinali zofanana, komabe, kuchepa kwa glucose wofulumira poyerekeza ndi koyambira kunali kwakukulu mu gulu lomwe limalandira insulin glargine poyerekeza ndi gulu lomwe limalandira NPH. Komanso, mu gulu la insulin glargine, kuopsa kwa hypoglycemia kunali kocheperako. Odwala 143 omwe adalandira insulin glargine panthawi ya kafukufukuyu anapitiliza chithandizo ndi insulin glargine mkati mopitilira muyeso wa kafukufukuyu, kutsata kwapakati komwe kunali zaka ziwiri. Ndi chithandizo chanthawi zonse ndi insulin glargine, palibe chizindikiro chatsopano chowopsa chomwe chidalandiridwa.

Kafukufuku woyerekeza wapakati pa insulin glargine kuphatikiza insulin lispro ndi mankhwala a NPH insulin komanso ochiritsira amtundu wa insulin (mtundu uliwonse wa mankhwalawa umagwiritsidwa ntchito masabata 16 mwachisawawa) unachitika mwa achinyamata 26 omwe ali ndi matenda a shuga a II azaka za 12 mpaka 18. Monga momwe phunziroli lili pamwambapa pakati pa ana, kuchepa kwa glucose ofulumira kuyerekeza ndi koyambira kunali kwakukulu kwambiri m'gululi lomwe limalandira insulin glargine poyerekeza ndi gulu lomwe insulin / insulin yachibadwa ya anthu imayendetsedwa ndi NPH. Zosintha mu HbA1c mulingo wa hemoglobin poyerekeza ndi gawo loyambirira zinali zofanana m'magulu onse awiriwa, komabe, ma glycemic indices ausiku anali okwera kwambiri mu gulu la insulin glargine / insulin lispro kuposa gulu la insulin / la insulin NPH, pomwe mitengo yotsika kwambiri inali 5.4 mm ndi 4.1 mm.Chifukwa chake, zochitika za nocturnal hypoglycemia zinali 32% m'gulu la insulin glargine / insulin lispro ndi 52% m'gulu la insulin / labwin insulin NPH.

Kafukufuku wamasabata 24 adachitika m'magulu ofanana, momwe ana 125 omwe ali ndi matenda a shuga a 2 ndi 6 zaka adatenga nawo mbali, pomwe insulin glargine, yomwe idapangidwira kamodzi patsiku m'mawa, idayerekezedwa ndi NPH-insulin, yomwe idapangidwira imodzi kapena kawiri tsiku lililonse monga basal insulin. Ophunzira m'magulu onse awiriwa adalandira jakisoni wa insulin asanadye.

Cholinga chachikulu cha phunziroli chinali kuwonetsa kuti insulin NPH osachepera ilibe phindu pa insulin glargine yokhudzana ndi chiwopsezo chonse cha hypoglycemia, sizinatheke, ndipo motsutsana ndi maziko a zochitika za insulin, kuchuluka kwa pafupipafupi pamagulu a insulin glargine: Kugwiritsa ntchito NPH (95% CI) = 1.18 (0.97-11.44).

Kusintha kwa glycosylated hemoglobin komanso kuchuluka kwa glucose m'magulu onsewa anali ofanana. Palibe zatsopano zokhudzana ndi chitetezo cha mankhwalawa omwe aphunziridwa mu kafukufukuyu.

Kuyerekeza ndende ya insulini mu odzipereka omwe ali ndi thanzi labwino komanso odwala omwe ali ndi matenda opatsirana a shuga kunawonetsa kuyamwa pang'onopang'ono komanso kwa nthawi yayitali. Chifukwa chake, zopezeka za insulin glargine zimafanana ndi mbiri ya mankhwala a pharmacodynamic pakapita nthawi. Chithunzi chomwe chili pamwambapa chikuwonetsa ntchito ya insulin glargine ndi NPH ya insulin.

Ndi kukhazikitsidwa kwa insulin glargine kamodzi patsiku, ndendezo yofananira imafikiridwa kale masiku 2 - 4 jekeseni woyamba.

Ndi mankhwala opaka mkati, theka la moyo wa insulin glargine ndi insulin ya anthu anali ofanana.

Pambuyo pokonzekera insulin kukonzekera Lantus ® SoloStar ® odwala matenda a shuga, insulin glargine imapangidwa mwachangu kumapeto kwa carboxyl kumapeto kwa beta kuti apange ma metabolites awiri ogwira ntchito - M1 (21A-glycine-insulin) ndi M2 (21A-glycine-des-30B-threonine- insulini). M'magazi am'magazi, gawo lalikulu lozungulira ndi metabolite M1. Kuwonetsedwa kwa M1 kumawonjezeka molingana ndi kuchuluka kwa mankhwalawa a Lantus ® SoloStar ® insulin. Zambiri za pharmacokinetic ndi pharmacodynamic zimawonetsa kuti zotsatira za jekeseni wa subcutaneous wa insulin Lantus ® SoloStar ® imagwirizanitsidwa makamaka ndi kukhudzana ndi M1. Ambiri mwa omwe anali nawo pa kafukufukuyu analibe insulin glargine ndi metabolite M2, ndipo pomwe zomwe zitha kutsimikizika, kutsimikiza kwawo sikudalira kuchuluka kwa insulini Lantus ® SoloStar ®.

M'mayeso azachipatala, popenda ma subgroups omwe amapangidwa ndi zaka komanso jenda, panalibe kusiyana pakati pa chitetezo ndi kufunikira pakati pa odwala omwe amalandira insulin glargine ndi anthu onse owerengera.

Ana ndi achinyamata

Mankhwala a pharmacokinetics a ana a zaka zapakati pa 2 ndi ochepera zaka 6 ndi mtundu wa matenda a shuga I amamuwunika pa kafukufuku wina wamankhwala (onani gawo la Pharmacological). Mwa ana omwe amalandila insulin glargine, kuchuluka kwa plasma kwambiri kwa insulin glargine ndi metabolites yake yayikulu (M1 ndi M2) imatsimikiziridwa. Zinapezeka kuti kusintha kwa ma plasma mozama kumafanana kwa akulu, ndipo palibe umboni womwe unapezeka pokomera insulin glargine kapena metabolites yake pogwiritsa ntchito mankhwalawa.

Deta Yotetezera

Zambiri zam'mbuyomu zomwe zimapezeka mu maphunziro a chitetezo pamankhwala, kawopsedwe omwe amagwiritsidwa ntchito mobwerezabwereza, genotoxicity, kuthekera kwatsoka ndi poizoni pakubereka, sizinawopseze anthu.

Zochita zamankhwala

Gawo logwira la lantus limakhala ndi ubale wa insulin receptors ofanana ndi kuyanjana ndi insulin ya anthu. Glargine imamangiriza ku IGF-1 insulin receptor maulendo 5-8 mochulukirapo kuposa insulin yamunthu, ndipo ma metabolites ake amakhala ofooka.

The achire ndende ya wophatikizika wa yogwira gawo la insulin ndi metabolites ake m'magazi a odwala matenda amtundu 1 shuga ndi yotsika kuposa koyenera kuonetsetsa kulumikizana kwapakati ndi IGF-1 receptors ndikupititsa patsogolo njira ya mitogenic-proliferative yolumikizidwa ndi receptor iyi.

Njira imeneyi nthawi zambiri imayendetsedwa ndi amkati IGF-1, koma njira zochizira za insulin zomwe zimagwiritsidwa ntchito mu insulin mankhwala ndizotsika kwambiri kuposa kutsimikizika kwa pharmacological kofunikira kuyambitsa makina kudzera IGF-1.

Ntchito yayikulu ya insulin iliyonse, kuphatikiza glargine, ndikuwongolera kwa glucose metabolism (carbohydrate metabolism). Insulin lantus imathandizira kudya shuga ndi adipose ndi minofu minofu, chifukwa chomwe shuga ya plasma imachepa. Komanso, mankhwalawa amalepheretsa kupanga shuga m'magazi.

Insulin imayambitsa kaphatikizidwe kazakudya zomanga thupi mthupi, pomwe tikulepheretsa njira za proteinolysis ndi lipolysis mu adipocytes.

Kafukufuku wa zamankhwala ndi zamankhwala adawonetsa kuti akaperekedwa ndi mtsempha wa magazi, mulingo wofanana wa insulin glargine ndi insulin ya anthu ndi ofanana. Kuchita kwa insulin glargine pakapita nthawi, monga oimira ena pamndandanda uno, kumadalira zochitika zolimbitsa thupi komanso zinthu zina zambiri.

Ndi subcutaneous makonzedwe, mankhwalawa Lantus amatenga pang'onopang'ono, kotero kuti amatha kugwiritsidwa ntchito kamodzi patsiku. Ndikofunika kukumbukira kuti pali kutanthauzira kosiyanasiyana kwamtundu umodzi muzochitika za insulin pakapita nthawi. Kafukufuku awonetsa kuti mphamvu ya diabetesic retinopathy ilibe kusiyana kwakukulu mukamagwiritsa ntchito insulin glargine ndi insulin NPH.

Mukamagwiritsa ntchito Lantus mwa ana ndi achinyamata, kukula kwa nocturnal hypoglycemia kumawonedwa pafupipafupi kuposa gulu la odwala omwe amalandira insulin NPH.

Mosiyana ndi insulin NPH, glargine chifukwa cha kuyamwa pang'onopang'ono sizimayambitsa kukwera pambuyo pakukhazikitsa. The kuchuluka kwa ndende ya mankhwala mu madzi am`magazi zimawonedwa pa 2 - 4th tsiku la mankhwala ndi limodzi tsiku makonzedwe. Hafu ya moyo wa insulin glargine pamene kutumikiridwa m`thupi limafanana ndi nthawi yomweyo ya insulin.

Ndi kagayidwe ka insulin glargine, mapangidwe awiri opanga M1 ndi M2 amachitika. Jekeseni wa subcutaneous wa Lantus amakhala ndi zotsatira zawo makamaka chifukwa cha kuwonetseredwa kwa M1, ndipo M2 ndi insulin glargine sizipezeka mu maphunziro ambiri.

Kugwiritsa ntchito kwa mankhwala Lantus ndi chimodzimodzi m'magulu osiyanasiyana odwala. Pa phunziroli, ma subgroups amapangidwa ndi zaka komanso jenda, ndipo zotsatira za insulin mwa iwo zinali zofanana ndi anthu ambiri (malinga ndi momwe zimakhalira ndi chitetezo). Mwa ana ndi achinyamata, maphunziro a pharmacokinetics sanachitike.

Zizindikiro zogwiritsidwa ntchito

Lantus amatumizidwa kuchiza matenda a shuga omwe amadalira odwala ndi ana opitirira zaka zisanu ndi chimodzi.

Mankhwalawa amagwiritsidwa ntchito poika mankhwalawa, amaletsedwa kuyikha intra. Kukhalitsa kwa mphamvu ya lantus kumalumikizidwa ndi kuyambitsa kwake mu mafuta ochepa.

Ndikofunika kwambiri kuti musaiwale kuti kudzera mu mtsempha wa intravenous wa mankhwalawa, mankhwalawa amatha kuyamba. Mukamagwiritsa ntchito mankhwalawa, malamulo angapo amayenera kuonedwa:

1. Munthawi yamankhwala, muyenera kutsatira njira inayake ndikuti jakisoni moyenera.
2. Mutha kulowa mankhwalawo m'mimba, komanso mu ntchafu kapena minofu yolumikizika. Palibe kusiyana kwakanthawi kachipembedzo ndi njira izi.
3. Jekeseni iliyonse imayendetsedwa bwino pamalo atsopano mkati mwa malo omwe analimbikitsidwa.
4. Simungathe kubereka Lantus kapena kusakaniza ndi mankhwala ena.

Lantus ndi insulin yokhala nthawi yayitali, choncho iyenera kuperekedwa kamodzi patsiku, makamaka nthawi imodzi.Mlingo wofunikira wa munthu aliyense amasankhidwa payekha, komanso mlingo ndi nthawi yoyang'anira.

Ndi chovomerezeka kupereka mankhwala Lantus kwa odwala omwe ali ndi vuto la matenda a shuga 2 limodzi ndi antidiabetesic othandizira pakamwa.

Ndikofunikira kudziwa kuti magawo a zochita za mankhwalawa ndi osiyana ndi zigawo zina za mankhwala ena omwe ali ndi insulin.

Odwala okalamba amafunika kusintha mlingo, chifukwa amatha kuchepa kwa insulin chifukwa cha kuwonongeka kwa impso. Komanso, mwa odwala omwe ali ndi vuto la chiwindi, kufunika kwa insulin kumatha kuchepa. Izi ndichifukwa choti insulin metabolism imachepetsa, ndipo gluconeogeneis imachepetsedwa.

Kusintha ku Lantus ndi mitundu ina ya insulin

Ngati munthu adagwiritsapo kale ntchito mankhwala osokoneza bongo a nthawi yayitali komanso yayitali, ndiye kuti akusintha kupita ku Lantus, ayenera kusintha mawonekedwe a inulin, komanso kuwunikiranso mankhwala ena ochizira.

Kuchepetsa chiopsezo cha hypoglycemia m'mawa ndi usiku, ndikusintha kawiri ka basal insulin (NPH) kukhala jakisoni imodzi (Lantus), mlingo wa basal insulin uyenera kuchepetsedwa ndi 20-30% masiku makumi awiri oyamba. Ndipo mlingo wa insulin wothandizidwa pokhudzana ndi chakudya ufunika kuwonjezeka pang'ono. Pakatha milungu iwiri kapena itatu, kusintha kwa mlingo kuyenera kuchitidwa payekhapayekha kwa wodwala aliyense.

Ngati wodwalayo ali ndi antibodies ku insulin ya anthu, ndiye kuti mukamagwiritsa ntchito Lantus, mayankho a thupi kusintha majakisoni a insulin, omwe angafunenso kuwunikiridwa kwa mlingo. Zimafunikanso pakusintha moyo wamunthu, kusintha thupi kapena zina zomwe zimakhudza momwe machitidwe a mankhwala aliri.

Lantus wa mankhwalawa amayenera kuperekedwa kokha pogwiritsa ntchito zolembera za OptiPen Pro1 kapena ClickSTAR syringe. Musanayambe kugwiritsa ntchito, muyenera kuphunzira mosamala malangizo a cholembera ndikutsatira malangizo onse omwe akupanga. Malamulo ena ogwiritsa ntchito zolembera:

1. Ngati chigwacho chasweka, ndiye kuti muyenera kutaya ndi chatsopano chogwiritsidwa ntchito.
2. Ngati ndi kotheka, mankhwala ochokera ku cartridge amatha kuperekedwa ndi syringe yapadera ya insulin yokhala ndi mayunitsi a 100 ml.
3. Katoniyo amayenera kusungidwa kutentha kwa maola angapo asanayikidwe mu cholembera.
4. Mutha kugwiritsa ntchito makatiriji okhawo omwe mawonekedwe a yankho sanasinthe, mtundu wake ndikuwonekera, palibe kuwongolera konse komwe kumawonekera.
5. Musanalowetse yankho mu katiriji, onetsetsani kuti mumachotsa thovu (momwe mungachitire izi, amalembedwa malangizo a cholembera).
6. Makatoni othandizira ndi oletsedwa.
7. Pofuna kupewa mwadzidzidzi insulini ina m'malo mwa glargine, ndikofunikira kuyang'ana pa jekeseni iliyonse.

Zotsatira zoyipa

Nthawi zambiri, odwala ndi osafunika chifukwa ntchito mankhwala Lantus ndi hypoglycemia. Amayamba ngati mankhwalawa amaperekedwa pa mlingo wopitirira womwe umafunikira wodwalayo. Zotsatira zotsatirazi zingayambenso kuyambitsidwa kwa Lantus:

• Kuchokera ziwalo zam'maganizo ndi zamanjenje - dysgeusia, kuwonongeka mu kuwona kwamphamvu, retinopathy,
• pakhungu, komanso minyewa yodutsa - lipohypertrophy ndi lipoatrophy,
• hypoglycemia (kagayidwe kachakudya),
• mawonetseredwe a ziwopsezo - kufupika ndi khungu pakhungu pakubaya, urticaria, anaphylactic shock, bronchospasm, edema ya Quincke,
• Kuchedwa kwa ayoni ayoni m'thupi, kupweteka kwa minofu.

Tiyenera kukumbukira kuti ngati hypoglycemia imakula pafupipafupi, ndiye kuti chiopsezo chokhala ndi mavuto mu ntchito yamanjenje ndi chambiri. Hypoglycemia yomwe imakhalapo kwa nthawi yayitali ndi yoopsa ku moyo wa wodwalayo.

Pochiza ndi insulin, ma antibodies amatha kupanga mankhwala.

Mwa ana ndi achinyamata, Lantus amatha kukhala ndi zotsatira zosafunikira monga kupweteka kwa minofu, kuwonetsa matupi awo, komanso kupweteka pamalo opaka jekeseni. Mwambiri, kwa akulu ndi ana onse, chitetezo cha Lantus chili pamodzimodzi.

Contraindication

Lantus sayenera kutumizidwa kwa odwala omwe ali ndi vuto la mankhwala kapena othandizira pazinthu, komanso anthu omwe ali ndi hypoglycemia.

Mwa ana, Lantus amatha kutumikiridwa pokhapokha akafika zaka zisanu ndi chimodzi kapena kupitirira.

Monga mankhwala osankhidwa pochiza matenda a shuga a ketoacidosis, mankhwalawa sanalembedwe.

Lantus iyenera kugwiritsidwa ntchito mosamala kwambiri kwa odwala omwe ali ndi chiwopsezo chambiri chaumoyo pakachitika nthawi ya hypoglycemia, makamaka kwa odwala omwe amachepetsa ziwalo zamatumbo kapena zotupa za m'mimba kapena proliferative retinopathy.

Ndikofunikira kusamala kwambiri ndi odwala omwe mawonetsedwe awo a hypoglycemia amatha kuphimbidwa, mwachitsanzo, ndi autonomic neuropathy, matenda amisala, kukula pang'onopang'ono kwa hypoglycemia, komanso njira yayitali ya matenda a shuga. M'pofunikanso kupereka Lantus mosamala kwa anthu achikulire ndi odwala omwe asintha ku insulin ya anthu kuchokera ku mankhwala ochokera kwanyama.

Mukamagwiritsa ntchito Lantus, muyenera kuyang'anira mosamala muyezo wa anthu omwe ali pachiwopsezo chachikulu cha kukhala ndi hypoglycemia yayikulu. Izi zitha kuchitika:

1. kukulitsa chidwi cha maselo ku insulin, mwachitsanzo, pakuchotsa zinthu zomwe zimayambitsa kupsinjika,
2. kusanza ndi kusanza
3. Zakudya zopanda mafuta, kuphatikiza kudya zakudya,
4. kumwa mowa
5. kuperekera mankhwala munthawi yomweyo.

Mankhwala a Lantus, ndibwino kuti musamachite nawo zinthu zina zofunika kuchita chisamaliro, chifukwa hypoglycemia (monga hyperglycemia) imatha kupangitsa kuchepa kwa maonedwe ndi chidwi.

Lantus ndi pakati

Mwa amayi apakati, palibe maphunziro azachipatala a mankhwalawa omwe adachitika. Zambiri zidapezeka pokhapokha pakutsatsa malonda (pafupifupi 400 - 1000 milandu), ndipo akuwonetsa kuti insulin glargine ilibe vuto lililonse pakubala komanso kukula kwa mwana.

Kuyesa kwanyama kwawonetsa kuti insulin glargine ilibe vuto lililonse kwa mwana wosabadwayo ndipo siyikuwononga kwambiri kubereka.

Amayi oyembekezera Lantus amatha kutumizidwa ndi dokotala ngati kuli kofunikira. Ndikofunikira panthawi imodzimodzi kuyang'anira kuchuluka kwa shuga ndikuchita zonse kuti zikhale, komanso kuwunikira momwe amayi akuyembekezera nthawi yomwe akukonzekera. Mu trimester yoyamba, kufunika kwa insulin kumatha kuchepa, ndipo m'nthawi yachiwiri ndi yachitatu, makulidwe. Mwana akangobadwa kumene, kufunikira kwa thupi kwa zinthu izi kumatsika kwambiri ndipo hypoglycemia imayamba.

Ndi mkaka wa m`mawere, ntchito Lantus amathanso kuyang'aniridwa mosamala pa mlingo wa mankhwalawa. Akamamwa m'matumbo am'mimba, insulin glargine imagawika ma amino acid ndipo sichimupweteketsa mwana pakuyamwa. Malangizo omwe glargine amadutsa mkaka wa m'mawere, malangizo mulibe.

Kuchita ndi mankhwala ena

Ndi munthawi yomweyo kugwiritsa ntchito mankhwala Lantus ndi njira zina zomwe zimakhudza kagayidwe kazakudya, kusintha kwa mankhwalawa ndikofunikira.

Kuchepetsa kwa shuga kwa shuga kumapangidwira ndi mankhwala am'mimba a shuga, angiotensin-kutembenuza mphamvu zoletsa, disopyramides, fibrate, monoamine oxidase inhibitors, fluoxetine, pentoxifylline, salicylates, propoxyphene, sulfonamides.

Mphamvu ya hypoglycemic ya Lantus imachepetsedwa ndi zochita za danazol, diazoxide, corticosteroids, glucagon, diuretics, estrogens ndi progestins, somatotropin, sympathomimetics, isoniazid, phenothiazine zotumphukira, olanzapine, proteinase inhibitors, clozapine.

Mankhwala ena, monga clonidine, beta-blockers, lithiamu ndi ethanol, onse amatha kupititsa patsogolo ndi kufooketsa mphamvu ya Lantus.

Malangizo ogwiritsira ntchito munthawi yomweyo mankhwalawa ndi pentamidine amawonetsa kuti hypoglycemia imayamba kuchitika, yomwe pambuyo pake imakhala hyperglycemia.

Bongo

Mlingo wambiri wa mankhwala Lantus amatha kupweteka kwambiri, kwa nthawi yayitali komanso koopsa, komwe ndi kowopsa paumoyo komanso wodwala. Ngati mankhwala osokoneza bongo sanafotokozeredwe bwino, amatha kuyimitsidwa pogwiritsa ntchito chakudya.

Panthawi yomwe hypoglycemia imayamba, wodwala ayenera kusintha moyo wake ndikusintha mlingo womwe umayenera kugwiritsidwa ntchito.

Mlingo

1 ml yankho lili

yogwira pophika - insulin glargine (magawo a insulin) 3.6378 mg (100 mayunitsi)

omwe amapeza yankho mu cartridge: metacresol, zinc chloride, glycerin (85%), sodium hydroxide, hydrochloric acid wokhazikika, madzi a jakisoni.

omwe amapeza yankho mu vial: metacresol, polysorbate 20, zinc chloride, glycerin (85%), sodium hydroxide, hydrochloric acid wokhazikika, madzi a jekeseni.

Transparent wopanda khungu kapena pafupifupi wopanda mafuta.

Mlingo ndi makonzedwe

Lantus® ili ndi insulin glargine - analog ya insulin yokhala ndi nthawi yayitali. Lantus® iyenera kugwiritsidwa ntchito kamodzi patsiku, nthawi iliyonse patsiku, koma nthawi yomweyo, tsiku lililonse.

Mlingo (Mlingo ndi nthawi ya makonzedwe) wa Lantus ayenera kusankhidwa payekhapayekha. Kwa odwala omwe ali ndi matenda a shuga a mtundu wa 2, Lantus® itha kugwiritsidwanso ntchito ndi mankhwala apakamwa.

Zochita za mankhwalawa zimafotokozedwanso m'mayunitsi. Magawo awa ndi odziwika okha kwa Lantus ndipo safanana ndi INE ndipo zigawo zomwe zimagwiritsidwa ntchito kufotokoza mphamvu za zochita za ma insulin ena (onani. Pharmacodynamics).

Okalamba okalamba (≥ zaka 65)

Mwa odwala okalamba, kuchepa kwapang'onopang'ono kwaimpso kungayambitse kuchepa kwamphamvu kwa insulin.

Matenda aimpso

Odwala omwe ali ndi vuto laimpso, insulin ingafune kuchepa chifukwa cha kuchepa kwa insulin.

Kuchepa kwa chiwindi ntchito

Odwala omwe ali ndi vuto la chiwindi, kusowa kwa insulin kumatha kuchepa chifukwa cha kuchepa kwa gluconeogeneis ndikuchepetsa metabolism ya insulin.

Kutetezeka ndi kugwiritsa ntchito mankhwalawa Lantus® kwatsimikiziridwa mu achinyamata ndi ana azaka 2 ndi akulu (onani "Pharmacodynamics"). Lantus® sanaphunzitsidwe mwa ana osakwana zaka 2.

Kusintha kuchokera ku insulin ina kupita ku Lantus®

Posintha njira yochizira ndi insulin ya nthawi yayitali kapena insulin yokhala ndi mankhwala a Lantus, zingakhale zofunikira kusintha mlingo wa insal insulin ndikuwongolera chithandizo cha antidiabetesic nthawi yomweyo (Mlingo ndi nthawi ya makonzedwe owonjezera osakanikirana a insulin kapena okhazikika a mankhwala a insulin. ndalama).

Kuchepetsa chiwopsezo cha usiku kapena m'mawa kwambiri hypoglycemia, odwala omwe amasintha kuchokera ku regimen iwiri ya insal NPH kupita ku regimen imodzi ndi Lantus ayenera kuchepetsa mlingo wawo wa tsiku ndi tsiku wa 205 wa insulin ndi 20-30% m'milungu yoyamba yamankhwala.

M'masabata oyamba, kuchepetsa kwa mankhwalawa kuyenera kulipiriridwa pang'ono pakukweza mlingo wa insulin womwe umagwiritsidwa ntchito pakudya, nthawi imeneyi, mankhwalawa asinthidwe pawokha.

Monga ma enulin ena, mwa odwala omwe amalandira Mlingo wambiri wa insulin chifukwa cha kupezeka kwa ma antibodies a insulin ya anthu, ndizotheka kusintha mayankho a insulin panthawi ya mankhwala a Lantus.

Panthawi yosinthira ku Lantus® komanso milungu yoyamba itatha, kuwunikira mosamala zizindikiro za metabolic kumafunika.

Momwe ma metabolic control amayenda bwino, ndipo chifukwa chake, chidwi cha minofu pakuwonjezereka kwa insulin, kusintha kwina kwa mankhwala kungafunikire. Kusintha kwa magazi kungafunikenso, mwachitsanzo, ndikusintha kwa thupi kapena momwe wodwalayo asinthira, kusintha kwa nthawi ya insulin komanso zina, zomwe zikubwera kumene zomwe zikuwonjezera kutsimikiza kwa hypoglycemia kapena hyperglycemia (onani "Malangizo apadera").

Lantus® iyenera kuyendetsedwa mosakakamiza. Lantus® sayenera kutumikiridwa kudzera m'mitsempha. Kuchita kwa nthawi yayitali kwa Lantus kumachitika chifukwa cha kuyambitsidwa kwake pamafuta obisika. Mitsempha yodziwika yokhazikika ya subcutaneous mlingo ungayambitse kwambiri hypoglycemia. Palibenso kusiyana kwakukulu pakumveka kwa seramu insulin kapena shuga pambuyo poyambika ndi Lantus mpaka khoma lam'mimba, minofu yolimba, kapena ntchafu. Ndikofunikira kusintha malo a jekeseni mkati mwa malo omwewo nthawi iliyonse. Lantus® sayenera kusakanikirana ndi insulin ina kapena kuchepetsedwa. Kusakanikirana ndikusintha kungasinthe nthawi / zochita; Kuti mupeze malangizo mwatsatanetsatane wokhudza mankhwalawa, onani pansipa.

Malangizo apadera ogwiritsa ntchito

Ma cartridge a Lantus ® azigwiritsidwa ntchito pokhapokha ndi cholembera cha OptiPen®, ClickSTAR®, Autopen® 24 (onani "Malangizo Apadera").

Malangizo a wopanga kuti azigwira cholembera zodulira katiriji, ma nozzles, komanso kayendetsedwe ka insulini ziyenera kuyang'aniridwa bwino.

Ngati cholembera cha insulin chawonongeka kapena chasokonekera (chifukwa cha kuwonongeka kwa makina), iyenera kutayidwa ndipo cholembera chatsopano cha insulin chikuyenera kugwiritsidwa ntchito.

Ngati cholembera sichikuyenda bwino (onani malangizo okhudza cholembera), ndiye kuti yankho limatha kuchotsedwa mu katoni ndikulowetsamo (100 mayunitsi / ml yoyenera insulin) ndikujowina.

Asanalowetse cholembera, cartridge iyenera kusungidwa kwa maola 1-2 kutentha kwa firiji.

Yenderani cartridge musanagwiritse ntchito. Itha kugwiritsidwa ntchito pokhapokha yankho likakhala lowonekera, lopanda utoto, lopanda mawonekedwe olimba komanso lokhazikika. Popeza Lantus® ndi yankho, sizifunikira kupumulanso musanagwiritse ntchito.

Lantus® sayenera kusakanikirana ndi insulin ina kapena kuchepetsedwa. Kusakaniza kapena kuchepetsa kungasinthe mawonekedwe ake / mawonekedwe;

Mafuta opakidwa mpweya ayenera kuchotsedwa mu katiriji musanalowe (jekeseni malangizo). Makatoni opanda kanthu sangakwaniritsidwe.

Zolembera ziyenera kugwiritsidwa ntchito ndi ma cartantges a Lantus®. Ma cartridge a Lantus® ayenera kugwiritsidwa ntchito pokhapokha ndi zolembera zotsatirazi: OptiPen®, ClickSTAR® ndi Autopen® 24, siziyenera kugwiritsidwa ntchito ndi zolembera zina zongobwezeretsanso, popeza kulondola kwa dosing ndikodalirika kokha ndi zolembera.

Yang'anani vial musanagwiritse ntchito. Itha kugwiritsidwa ntchito pokhapokha yankho likakhala lowonekera, lopanda utoto, lopanda mawonekedwe olimba komanso lokhazikika. Popeza Lantus® ndi yankho, sizifunikira kupumulanso musanagwiritse ntchito.

Lantus® sayenera kusakanikirana ndi insulin ina kapena kuchepetsedwa. Kusakaniza kapena kuchepetsa kungasinthe nthawi / zochita; kusakaniza kumatha kubweretsa mpweya.

Ndikofunikira nthawi zonse kuyika chizindikiro pa insulin musanadye jekeseni iliyonse, kuti musasokoneze insulin glargine ndi ma insulin ena (onani "Maupangiri Apadera").

Makulidwe olakwika a mankhwalawa

Milandu yanenedwa pomwe mankhwalawo amasakanikirana ndi ma insulin ena, makamaka, ma insulin omwe amangogwiritsa ntchito mwachidule anali kuyendetsedwa m'malo mwa glargine molakwika. Pamaso jekeseni aliyense, ndikofunikira kuyang'ana chizindikiro cha insulin kuti mupewe chisokonezo pakati pa insulin glargine ndi ma insulin ena.

Kuphatikiza kwa Lantus ndi pioglitazone

Milandu yakulephera kwa mtima imadziwika pamene pioglitazone imagwiritsidwa ntchito limodzi ndi insulin, makamaka kwa odwala omwe ali ndi chiopsezo cha mtima. Izi ziyenera kukumbukiridwa popereka kaphatikizidwe ka pioglitazone ndi Lantus. Ngati chithandizo chophatikizidwa chalamulidwa, odwala ayenera kuwunikidwa kuti awone zizindikiro ndi chizindikiro cha kulephera kwa mtima, kunenepa kwambiri, ndi kutupa. Pioglitazone iyenera kusiyidwa ngati chizindikiro chilichonse chamtima chikaipiraipira.

Mankhwalawa sangaphatikizidwe ndi mankhwala ena. Ndikofunikira kuti ma syringe asakhale ndi zinthu zina.

Zotsatira zoyipa

Hypoglycemia, njira yovuta kwambiri yogwiritsira ntchito mankhwala a insulin, imatha kukhala ngati mlingo wa insulin ndiwokwera kwambiri poyerekeza ndi kufunika kwa insulin, zochitika zazikulu za hypoglycemia, makamaka zobwerezabwereza, zitha kuwononga dongosolo lamanjenje. Kugwedezeka kwa nthawi yayitali kapena kupweteka kwambiri kwa hypoglycemia kukhoza kumuvulaza. Odwala ambiri, Zizindikiro za neuroglycopenia zimayambitsidwa ndi zizindikiritso za adrenergic. Mokulira, kuchuluka kwa glucose m'magazi kumacheperachepera, kumamvekera kwambiri ndi zomwe zimachitika pokana kutsutsana ndi zomwe zimachitika.

Zochita zamankhwala osokoneza bongo

Zinthu zingapo zimakhudza kagayidwe ka glucose ndipo zimapangitsa kusintha kwa insulin glargine.

Zinthu zomwe zimathandizira kuchepetsa kutsika kwa glucose m'magazi ndikuwonjezera chiwopsezo cha hypoglycemia zimaphatikizira antidiabetesic agents, angiotensin-akatembenuka enzyme inhibitors (ACEs), disopyramides, fibrate, fluoxetine, monoamine oxidase inhibitors (MAOs), pentoxifylilides ndi pentoxifylilides.

Zinthu zomwe zitha kufooketsa mphamvu ya shuga m'magazi zimaphatikizira mahomoni a corticosteroid, danazole, diazoxide, diuretics, glucagon, isoniazid, estrogens ndi progestogens, zotuluka za phenothiazine, somatropin, sympathomimetics (mwachitsanzo, epinephrine (adrenbutine) , mankhwala a atypical antipsychotic (mwachitsanzo, clozapine ndi olanzapine) ndi ma proteinase inhibitors.

Beta-blockers, clonidine, mchere wa lithiamu ndi mowa zimatha kutsitsa ndikuchepetsa mphamvu ya insulin m'magazi. Pentamidine imatha kuyambitsa hypoglycemia, ndipo nthawi zina imatsatiridwa ndi hyperglycemia.

Kuphatikiza apo, mothandizidwa ndi mankhwala achifundo monga β-blockers, clonidine, guanethidine ndi reserpine, zizindikiro za kutsutsa kwa adrenergic zitha kukhala zofatsa kapena zosakhalapo.

Malangizo apadera

Lantus® si insulin ya kusankha pa matenda a matenda ashuga a ketoacidosis. Zikatero, njira yolimbikira ya insulin yochepa imalimbikitsidwa.

Musanafike pokonzekera kusintha kwa mlingo wa glucose osakwanira kapena kuwonekera kwa magawo a hypoglycemia kapena hyperglycemia, ndikofunikira kuyang'ana kulondola kwa kutsata njira, mankhwala a jekeseni, njira yolondola yoyendetsera ndi zina zonse zofunika. Kusamutsa wodwala kupita ku mtundu wina kapena mtundu wa insulin kuyenera kuchitika moyang'aniridwa ndi achipatala. Zosintha mu mphamvu yakuchitikira, mtundu (wopanga), mtundu (wakuchita pang'ono, NPH, tepi, wogwira ntchito nthawi yayitali, ndi zina zotere), chiyambi (chinyama, munthu, analogi ya insulin ya anthu) ndi / kapena njira yopangira zitha kubweretsa kufunika kofuna kusintha mlingo.

Kukhazikitsidwa kwa insulin kungapangitse kupanga kwa ma insulin.Nthawi zina, chifukwa cha kupezeka kwa ma antibodies amenewo ku insulin, pangafunike kusintha kuti mupeze insulin kuti muchepetse chizolowezi cha hyperglycemia kapena hypoglycemia (onani "Zotsatira zoyipa").

Nthawi ya kukonzekera kwa hypoglycemia zimatengera mawonekedwe a omwe agwiritsa ntchito insulin, chifukwa chake amatha kusintha ngati njira ya chithandizo isinthidwa. Chifukwa chopezeka pafupipafupi insulin panthawi ya mankhwala a Lantus, osachepera usiku, koma kwambiri hypoglycemia m'mawa kwambiri. Kusamalidwa makamaka kuyenera kuchitika ndikuwunika kuwunika kwamagazi a glucose mwa odwala omwe zochitika za hypoglycemia zimatha kukhala ndizofunikira zamankhwala, mwachitsanzo, makamaka ndi stenosis yamitsempha yamitsempha yamagazi kapena mitsempha yamagazi yopatsira ubongo (chiwopsezo cha mtima ndi matenda a m'magazi a hypoglycemia), ndipo komanso ngati pakukulitsa retinopathy, makamaka ngati chithandizo chamatenda ndi zithunzi sichinachitike (chiopsezo cha khungu lakachedwa kutsatira hypoglycemia).

Odwala ayenera kuchenjezedwa za momwe matenda a harbinger a hypoglycemia samanenedwera. M'magulu ena omwe ali pachiwopsezo, zizindikiro za kutsogola kwa hypoglycemia zimatha kusintha, kutaya mphamvu kapena ngakhale kusapezeka.

Izi zimaphatikizapo odwala:

Ndi kusintha kwakukulu kwa glycemic control

Ndi kukula pang'onopang'ono kwa hypoglycemia

Pambuyo pochotsa ku insulin ya nyama kupita ku insulin ya anthu

Ndi autonomic neuropathy

Ndi mbiri yayitali ya matenda ashuga

Matenda amisala

Ndi chithandizo chanthawi yomweyo ndimankhwala ena (onani "Drug Interaction").

M'mikhalidwe yotere, hypoglycemia yayikulu (ndi kutayika kwa chikumbumtima) ingachitike wodwalayo atazindikira kuti ali ndi hypoglycemia.

The yaitali kuchita subcutaneous insulin glargine angachedwe kuchira hypoglycemia. Ngati mankhwalawa a hemoglobin abwinobwino kapena kuchepetsedwa azindikiridwa, mwayi wobwereza, wosazindikira (makamaka usiku) zochitika za hypoglycemia ziyenera kuganiziridwa.

Kutsatira kwa dosing ndi regimens ya zakudya, kayendetsedwe koyenera ka insulini, komanso kudziwa zizindikiro zomwe zikulosera hypoglycemia ndikofunikira kuti muchepetse chiopsezo cha hypoglycemia. Zinthu zomwe zimawonjezera kutsimikiza kwa hypoglycemia zimafunikira kuyang'aniridwa mosamala, kupezeka kwawo kungaphatikizepo kufunikira kwa kusintha kwa mlingo.

Izi zikuphatikiza:

Sinthani tsamba la jakisoni

Kuchuluka kwa insulin (mwachitsanzo, kuchotsa zopsinjika)

Osazolowera, kuchita zolimbitsa thupi kwambiri kapena kwanthawi yayitali

Matenda oyamba (mwachitsanzo, kusanza, kutsekula m'mimba)

Kuphwanya zakudya ndi zakudya

Kudumpha chakudya

Mowa

Mavuto ena a endocrine osawerengeka (mwachitsanzo, hypothyroidism ndi kuchepa kwa pituitary kuchepa kapena kuchepa kwa adrenocortical)

Chithandizo chothandizirana ndi mankhwala ena.

Pamaso pa matenda apakati, kuyang'anira wodwala kagayidwe kake ndikofunikira. Nthawi zambiri, kutsimikiza kwa ma ketoni mu mkodzo kumawonetsedwa, nthawi zambiri pamakhala kufunika kwa kusintha kwa insulin. Kufunika kwa insulin nthawi zambiri kumachuluka. Odwala omwe ali ndi matenda amtundu woyamba wa shuga ayenera kupitiliza kudya zakudya zamagulu, ngakhale zazing'ono, ngakhale atakhala kuti sangatenge chakudya chochepa kapena atha kudya, kapena kusanza ndi zina, ndipo sayenera kudumpha jakisoni insulin

Kuyesedwa kwa mayesero azachipatala pachitetezo ndi kufunikira kwa insulin glargine mwa amayi apakati sikunachitike.Chiwerengero chochepa cha azimayi oyembekezera (kuyambira pa 300 mpaka 1000 zotsatira za pakati) omwe adalandira chithandizo cha insulin glargine amawonetsa kusapezeka kwa zovuta za insulin glargine pa mimba komanso kusapezeka kwa kawopsedwe ka fetal / neonatal ndikuwonetsa kuyambitsa kusokonezeka kwa insulin glargine. Maphunziro oyesera samawonetsa kawopsedwe kaziberekidwe. Pa nthawi ya pakati, ngati pakufunika kuchitika, kugwiritsa ntchito Lantus ndikotheka.

Kwa odwala omwe ali ndi shuga wokhazikika kapena wothandizira, ndikofunikira kwambiri kuti azikhala ndi nthawi yayitali yokhala ndi pakati. Kufunika kwa insulini mu nthawi yoyambirira ya mimba kumatha kuchepa, nthawi zambiri kumachulukirachulukira kwachiwiri komanso kwachitatu. Pambuyo pobadwa, insulini ikucheperachepera (chiwopsezo cha hypoglycemia). Kuwunikira mosamala kuchuluka kwa shuga m'magazi kumafunika.

Sizikudziwika ngati insulin glargine imadutsa mkaka wa m'mawere wa anthu. Zotsatira za metabolic za insulin glargine, zimatengedwa mwangozi, khanda lobadwa kumene kapena mwana wakhanda samayembekezeredwa, chifukwa insulin glargine, monga peptide, imasinthidwa kukhala amino acid m'matumbo amunthu. Amayi omwe akuyamwitsa angafunikire kusintha kwa insulin ndi zakudya.

Kafukufuku wammbuyo samawonetsa kukhalapo kwa zotsatira zoyipa za insulin glargine pa chonde.

Zomwe zimachitika chifukwa cha mankhwalawa amatha kuyendetsa galimoto kapena njira zoopsa

Mphamvu ya wodwalayo yokhazikika, mawonekedwe ake amagetsi amatha kuwonongeka chifukwa cha hypoglycemia kapena hyperglycemia, kapena, mwachitsanzo, chifukwa cha kuwonongeka kwa mawonekedwe. Izi zitha kukhala zowopsa nthawi zomwe maluso amenewa ali ofunika kwambiri (mwachitsanzo, poyendetsa kapena kugwiritsa ntchito makina).

Odwala ayenera kulangizidwa mosamala kuti apewe kukula kwa hypoglycemia panthawi yoyendetsa. Izi ndizofunikira kwambiri kwa iwo omwe ali ndi zovuta kapena zosatsalira za hypoglycemia, komanso kwa iwo omwe ali ndi gawo la hypoglycemia. Ndikofunikira kudziwa ngati ndibwino kuyendetsa galimoto kapena makina ogwira ntchito m'malo otere.

Tulutsani mafomu ndi ma CD

Yothetsera subcutaneous makonzedwe a 100 PIECES / ml

3 ml ya yankho mu cartridge yamagalasi owoneka bwino. Katirijiyo amasindikizidwa kumbali imodzi ndi choletsa cha brkidutyl ndikuwombedwa ndi chipewa cha aluminium, inayo ndi brwaputyl plunger.

Pa ma cartridge 5 mu chovala cholumikizira kuchokera ku filimu ya polyvinyl chloride ndi zojambulazo za aluminium.

Pazithunzithunzi 1 zoyambirira pamodzi ndi malangizo ogwiritsira ntchito kuchipatala ndi zilankhulo zaku Russia, ikani bokosi.

Njira yothetsera jekeseni wa subcutaneous 100 PIECES / ml

10 ml yankho mumabotolo amtundu wamagalasi owoneka bwino, opanda khungu, otsekemera ndi ma chlorobutyl oyimitsa ndikugudubuka ndi zisoti zotayidwa ndi zotengera zoteteza zopangidwa ndi polypropylene.

Kwa botolo limodzi, limodzi ndi malangizo ogwiritsira ntchito zachipatala m'boma ndi zilankhulo zaku Russia, ikani bokosi lamatoni.

Malo osungira

Sungani pamtunda wa 2 mpaka 8 ° C pamalo amdima.

Osamawuma! Pewani patali ndi ana!

Mukatha kugwiritsa ntchito koyamba, cartridge yomwe idayikiridwa mu chida ikhoza kugwiritsidwa ntchito kwa milungu 4 ndikusungidwa pamtunda wosaposa 25 ° C (koma osati mufiriji).

Mutatsegula botolo, njirayi itha kugwiritsidwa ntchito kwa milungu 4 ndikusungidwa pamtunda osapitirira 25 ° C (koma osati mufiriji).

Moyo wa alumali

Zaka 2 (botolo), zaka zitatu (cartridge).

Osagwiritsa ntchito tsiku lotha ntchito likusonyezedwa phukusi.

Insulin Lantus (Glargine): Dziwani zonse zomwe mukufuna. Pansipa mupeza zalembedwa m'chinenerochi.Werengani kuchuluka kwa magawo omwe muyenera kulowa ndi momwe, muwerengere mankhwalawa, momwe mungagwiritsire ntchito cholembera cha Lantus Solostar. Mvetsetsani nthawi yayitali jekeseni wa mankhwalawa atayamba kugwira ntchito, omwe insulin ndiyabwino: Lantus, Levemir kapena Tujeo. Ndemanga zambiri za odwala omwe ali ndi matenda a shuga 2 ndi 1 amaperekedwa.

Glargin ndi timadzi tambiri tomwe timapanga kwa nthawi yayitali ndi kampani yotchuka yapadziko lonse Sanofi-Aventis. Mwina iyi ndiye insulin yotchuka kwambiri kwa odwala matenda ashuga achi Russia. Jakisoni wake amafunika kuthandizidwa ndi njira zamankhwala zomwe zimakulolani kuti mukhale ndi shuga 3.9-5,5 mmol / l khola maola 24 patsiku, monga mwa anthu athanzi. Dongosolo lomwe lakhala ndi matenda ashuga kwa zaka zopitilira 70 limalola akuluakulu ndi ana omwe ali ndi matenda ashuga kudziteteza ku zovuta zowopsa.

Werengani mayankho a mafunso:

Long insulin Lantus: nkhani yatsatanetsatane

Dziwani kuti insulin Lantus yowonongeka imawoneka yowoneka bwino. Mwa mawonekedwe a mankhwalawa, ndizosatheka kudziwa mtundu wake. Simuyenera kugula insulin ndi mankhwala okwera mtengo kuchokera m'manja mwanu, malinga ndi kulengeza kwanu. Pezani mankhwala a shuga kuchokera kuzipatala zotchuka zomwe zimatsatira malamulo osungira.

Malangizo ogwiritsira ntchito

Mukabayidwa kukonzekera kwa Lantus, monga mtundu wina wa insulin, muyenera kutsatira zakudya.

Zosankha zamadyedwe kutengera ndi matendawa:

Anthu ambiri odwala matenda ashuga omwe amaba jakisoni wa insulin amawona kuti ndizosatheka kupewa matenda a hypoglycemia. M'malo mwake, imatha 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 yemwe akufotokoza nkhaniyi. Phunzirani momwe mungasinthire zakudya zopatsa thanzi komanso mulingo wa insulin.

Onani pansipa kuti mumve zambiri.

Lantus ndi mankhwala ochita chiyani? Kodi ndizitali kapena zazifupi?

Lantus ndi wa insulin.Jekeseni aliyense wa mankhwalawa amachepetsa shuga m'magazi 24. Komabe, jakisoni imodzi patsiku sikokwanira. amalimbikitsa jakisoni wa insulin yayitali kawiri pa tsiku - m'mawa ndi madzulo. Amakhulupirira kuti Lantus imawonjezera chiopsezo cha khansa, ndipo ndikwabwino kusinthana ndi Levemir kuti mupewe izi. Onani vidiyoyi kuti mumve zambiri. Nthawi yomweyo, phunzirani kusungira bwino insulini kuti isawonongeke.

Anthu ena, pazifukwa zina, amafunafuna insulini yochepa yotchedwa Lantus. Mankhwala oterowo sagulitsidwa ndipo sanakhalepo.

Mutha kubaya insulini usiku komanso m'mawa, komanso kubayitsa imodzi mwamankhwala otsatirawa musanadye: Actrapid, Humalog, Apidra kapena NovoRapid. Kuphatikiza pazomwe zili pamwambazi, pali mitundu ingapo ya insulin yomwe imagwira mwachangu yomwe imamasulidwa ku Russian Federation ndi mayiko a CIS. Musayese kubwezeretsa jakisoni waifupi kapena wa insulin ya m'mimba musanadye ndi waukulu waukulu. Izi zimabweretsa kukula kwa pachimake, ndipo pambuyo pake zovuta za matenda ashuga.

Werengani za mitundu ya insulin yothamanga yomwe ingaphatikizidwe ndi Lantus:

Amakhulupirira kuti Lantus alibe chochita, koma amatsitsa shuga chimodzimodzi 18 maola. Komabe, ambiri omwe ali ndi matenda ashuga pazowunikira zawo pamapulogalamu amati akadali ndi nsonga, ngakhale ofooka.

Insulin glargine imachita bwino kuposa mankhwala ena a nthawi yayitali. Komabe, imagwira ntchito bwino kwambiri, ndipo jakisoni wake aliyense amatenga maola 42. Ngati ndalama zilola, ndiye lingalirani m'malo mwa Tresib ndi mankhwala atsopano.

Ndi zigawo zingati za Lantus zomwe zimayenera kudula komanso liti? Momwe mungawerengere mlingo?

Mulingo woyenera wa insulin yayitali, komanso ndandanda ya jakisoni, zimatengera mawonekedwe a matenda a shuga wodwala. Funso lomwe mudafunsa liyenera kuyankhidwa limodzi. Werengani nkhaniyo ”. Chitani monga momwe zalembedweramo.

Mitundu ya mankhwala a insulin yokhazikika yopangidwa sikungapereke shuga yokhazikika ya magazi, ngakhale wodwalayo atadwala matenda ashuga. Chifukwa chake, sichikulimbikitsa kugwiritsidwa ntchito kwawo ndipo tsamba sililembapo za iwo.

Chithandizo cha matenda a shuga a insulin - komwe mungayambire:

Kodi mlingo wa mankhwalawa uyenera kukhala wotani usiku?

Mlingo wa Lantus usiku zimatengera kusiyana kwa shuga m'mawa pamimba yopanda kanthu komanso usiku watha. Ngati kuchuluka kwa shuga m'magazi m'mimba yopanda shuga m'mimba ya shuga imakhala yotsika kuposa usiku wam'mbuyo, simukuyenera kubaya insulin yayitali usiku. Chifukwa chokhacho chofuna kugona usiku ndikulakalaka kadzuka ndi shuga wabwino m'mawa wotsatira. Werengani zambiri zomwe zalembedwa m'magazini ya "Shuga pamimba yopanda kanthu m'mawa: momwe mungabwezeretsere zachilendo".

Ndibwino kuti mukubaya Lantus: madzulo kapena m'mawa? Kodi ndizotheka kuchedwetsa jakisoni wamadzulo m'mawa?

Madzulo ndi m'mawa jakisoni wa insulin yowonjezera amafunikira pazifukwa zosiyanasiyana. Mafunso okhudzana ndi cholinga chawo komanso kusankha kwa mankhwalawa amayenera kuyankhidwa pawokha. Monga lamulo, nthawi zambiri pamakhala zovuta ndi index index yam'mawa pamimba yopanda kanthu. Kuti mubwezere mwakale, chitani jakisoni wa insulin yayitali usiku.

Ngati munthu wodwala matenda ashuga ali ndi kuchuluka kwa shuga m'magazi pamimba yopanda kanthu, sayenera kubayira Lantus usiku konse.

Jakisoni wam'mawa wa insulin yayitali amapangidwira kuti shuga asakhazikike masana m'mimba yopanda kanthu. Simungayese kubwezeretsa jakisoni wa mankhwala ambiri Lantus m'mawa, kukhazikitsidwa kwa insulin asanadye. Ngati shuga wanu amadumphira mukatha kudya, muyenera kugwiritsa ntchito mitundu iwiri ya insulini nthawi yomweyo - yowonjezera komanso yachangu. Kuti mudziwe ngati mukufunika kupaka jekeseni wautali m'mawa, muyenera kufa ndi njala tsiku limodzi ndikutsatira mphamvu ya shuga m'magazi.

Jakisoni wamadzulo sayenera kupititsidwa m'mawa. Ngati mwakhazikitsa shuga m'mawa m'mimba yopanda kanthu, musayese kuzimitsa ndi mlingo waukulu wa insulin yayitali. Gwiritsani ntchito izi mwachidule kapena ultrashort. Onjezerani mlingo wa Lantus insulin usiku wotsatira.Kuti mukhale ndi shuga wabwinobwino m'mimba yopanda kanthu, muyenera kudya chakudya cham'mawa kwambiri - maola 4-5 musanagone. Kupanda kutero, jakisoni wa insulin yayitali usiku sizithandiza, ngakhale mlingo utakhala waukulu bwanji.

Mutha kupeza mitundu yosavuta ya Lantus insulin pamasamba ena kuposa omwe amaphunzitsidwa ndi Dr. Bernstein. Mwapadera, ndikulimbikitsidwa kuti mupeze jakisoni imodzi patsiku.

Komabe, mitundu yosavuta ya mankhwala a insulin sikuyenda bwino. The odwala matenda ashuga omwe amawagwiritsa ntchito amadwala pafupipafupi hypoglycemia komanso spikes mu shuga. Popita nthawi, amakumana ndi zovuta zomwe zimafupikitsa moyo kapena kusintha munthu kukhala wolumala. Kuti muthane bwino matenda a shuga a mtundu woyamba kapena a 2, muyenera kusinthira zakudya zamafuta ochepa, werengani nkhaniyo powerengera za insulin yayitali, ndikuchita zomwe ukunena.

Kodi mlingo waukulu wa Lantus insulin patsiku ndi uti?

Palibe mtundu wokhazikika wa tsiku ndi tsiku wa Lantus insulin. Ndikulimbikitsidwa kuichulukitsa mpaka shuga m'magazi a odwala matenda ashuga akhale owonjezereka.

M'magazini azachipatala, odwala onenepa omwe ali ndi matenda amtundu wa 2 omwe amalandila mankhwala 100-150 patsiku amafotokozedwa. Komabe, kukwera tsiku ndi tsiku mlingo wa mankhwalawo umayamba.

Mkulu wama glucose amalumpha mosalekeza, nthawi zambiri pamakhala kuukira kwa hypoglycemia. Kuti mupewe mavutowa, muyenera kutsatira zakudya zamafuta ochepa ndikubaya ma insulin otsika omwe amafanana nawo.

Mlingo woyenera wamadzulo ndi m'mawa wa Lantus insulin uyenera kusankhidwa payekhapayekha. Ndizosiyana kwambiri kutengera zaka, kulemera kwa thupi kwa wodwala komanso kuopsa kwa matenda ashuga. Ngati mukufunikira kubaya ma unit oposa 40 patsiku, ndiye kuti mukuchita zina zolakwika. Mwambiri, osati kutsatira zakudya zotsika zamoto. Kapena kuyesa kubayira jakisoni wa insulin musanadye ndikumayambiriro kwa Mlingo waukulu wa glargine wa mankhwala.

Odwala onenepa kwambiri omwe ali ndi matenda a shuga a 2 amalimbikitsidwa kwambiri kuchita masewera olimbitsa thupi. Kuchita masewera olimbitsa thupi kumawonjezera chidwi cha thupi lanu ku insulin. Izi zipangitsa kuti azitha kugawa mosiyanasiyana mankhwalawa. Funsani kuti kuyendetsa Qi ndi chiani.

Odwala ena amatha kukoka chitsulo mu masewera olimbitsa thupi kuposa kuthamanga. Zimathandizanso.

Chimachitika ndi chiani ngati muphonya jakisoni?

Mudzakhala ndi shuga wambiri chifukwa chosowa insulin mthupi. Molondola, chifukwa cha kulakwitsa kwa msana wa insulin ndi kufunikira kwa thupi. Kuchuluka kwa glucose okwanira kumathandizira kukulitsa zovuta zovuta za matenda ashuga.

Woopsa milandu, zovuta pachimake kuonedwa: matenda ashuga ketoacidosis kapena hyperglycemic chikomokere. Zizindikiro zawo ndi kusokonezeka kwa chikumbumtima. Amatha kupha.

Kodi nditha kubayitsa usiku Lantus komanso nthawi yomweyo ultrashort insulin musanadye?

Mwauli - mutha. Komabe, ngati mukukumana ndi vuto la shuga m'mimba pamimba yopanda kanthu, ndikofunikira kuti mupeze Lantus usiku mochedwa momwe mungathere musanagone. Insulin yachangu musanadye chakudya chamadzulo, mudzafunika kulowa maora angapo m'mbuyomu.

Ndikofunikira kuti mumvetsetse cholinga cha jakisoni iliyonse yomwe yatchulidwa mufunso. Muyenera kuthandizanso kusankha molondola kuchuluka kwa insulin yokonzekera mwachangu komanso yayitali. Werengani mu nkhani "Mitundu ya Insulin" mwatsatanetsatane za mankhwala azifupi komanso a ultrashort.

Lantus wa matenda ashuga amtundu wa 2

Lantus akhoza kukhala mankhwala omwe insulin yothandizira mtundu wa matenda a shuga 2 imayamba nawo. Choyamba, amasankha jakisoni wa insulin iyi usiku, kenako m'mawa. Ngati shuga akupitiliza kudya mutatha kudya, mankhwala ena aafupi kapena a ultrashort amawonjezeredwa ku regulin ya insulin - Actrapid, Humalog, NovoRapid kapena Apidra.

Komabe, choyambirira, muyenera kukhazikitsa jakisoni wa insulin yayitali. Mutha kuchita popanda kutumizira mwachangu mankhwala musanadye. Werengani nkhani yakuti "Type 2 shuga insulin" kuti mumve zambiri.

Amati insulin yatsopano yowoneka bwino idawonekera m'malo mwa Lantus. Kodi mankhwalawa ndi chiani?

Mankhwala atsopano opangidwa bwino amatchedwa Tresiba (degludec). Yense ya jakisoni wake imagwira ntchito mpaka maola 42. Mukasinthira ku insulin iyi, zimakhala zosavuta kusunga shuga wabwinobwino m'mimba yopanda kanthu m'mawa. Tsoka ilo, Tresiba imawonabe ndalama zowirikiza katatu kuposa Lantus, Levemir ndi Tujeo. Komabe, ndikofunikira kusintha kuti musinthe ngati ndalama zimapereka mwayi wotere. Boma, ndikulimbikitsidwa kuperekera insulin kamodzi patsiku. Komabe, Dr. Bernstein akulangizani kuti muthane ndi jekeseni watsiku ndi tsiku jakisoni - madzulo ndi m'mawa. Ngakhale kuti kuchuluka kwa jakisoni sikungachepe, kusinthira ku Tresib insulin kumathandizabe. Chifukwa shuga wamagazi azikhala bwino. Adzakhala khola.

Ndi insulin iti yomwe ili bwino: Lantus kapena Tujeo? Kodi pali kusiyana kotani pakati pa awiriwa?

Tujeo imakhala ndi chinthu chimodzi monga Lantus - insulin glargine. Komabe, kuchuluka kwa insulini mu yankho la Tujeo ndi katatu maulendo - 300 IU / ml. Mwakutero, mutha kupulumutsa pang'ono ngati mupita ku Tujeo. Komabe, ndibwino kusatero. Kuwona za matenda ashuga okhudza insulin ya Tujeo ndizovuta zambiri. Mwa odwala ena, atasintha kuchoka ku Lantus kupita ku Tujeo, shuga ammwazi amalumpha, mwa ena, pazifukwa zina, insulin yatsopano mwadzidzidzi imasiya kugwira ntchito. Chifukwa chokhala ndi chidwi chambiri, nthawi zambiri imakulira ndikuphimba singano ya cholembera. Tujeo mokalipa sanakalipira kunyumba zokha, komanso m'mabizinesi a shuga a Chingerezi. Chifukwa chake, ngati kuli kotheka, ndibwino kupitilizabe kupha Lantus osasintha. Ndikofunika kusinthira ku Tresiba insulin yatsopano pazifukwa zomwe tafotokozazi.

Ndi insulin iti yomwe ili bwino: Lantus kapena Levemir?

Treshib insulin isanafike, Dr. Bernstein adagwiritsa ntchito Levemir kwa zaka zambiri, osati Lantus. Mu 1990s, zolemba zingapo zidawonekera, ndikuti Lantus imawonjezera chiopsezo cha mitundu ina ya khansa. Dr. Bernstein adatenga malingaliro awo mozama, adasiya kubaya jakisoni wa insulin ndikudziyambitsa kwa odwala. Kampani yopanga idayamba kukangana - ndipo mchaka cha 2000 panali zolemba zambiri zonena kuti mankhwala a Lantus ndi otetezeka. Kwambiri, ngakhale insulin glargine imawonjezera chiopsezo cha mitundu ina ya khansa, ndiye pang'ono. Izi siziyenera kukhala chifukwa chopita ku Levemire.

Ngati mungalowe mu Lantus ndi Levemir muyezo womwewo, ndiye kuti jekeseni wa Levemir atha pang'ono pang'ono. Iwo amavomerezeka jekeseni wa Lantus kamodzi patsiku, ndipo Levemir - 1 kapena 2 kawiri pa tsiku. Komabe, pochita, mankhwalawa onse amafunika kubayidwa katatu patsiku, m'mawa ndi madzulo. Jakisoni imodzi patsiku sikokwanira. Kutsiliza: ngati Lantus kapena Levemir akuyenera kukhala bwino, pitilizani kugwiritsa ntchito. Kusintha kupita ku Levemir kuyenera kuchitika pokhapokha pakufunika. Mwachitsanzo, ngati mtundu wina wa insulini umayambitsa ziwengo kapena samaperekanso kwaulere. Komabe, insulin Tresiba yatsopanoyo ndi nkhani ina. Amachita bwino koposa. Ndikofunika kusinthira ngati mtengo wokwera suuletsa.

Lantus mwina ndi insulin wodziwika bwino kwambiri kwa anthu odwala matenda ashuga kwa zaka zambiri. Mpikisano wake wamkulu, Levemir, ali ndi mafani ochepa. Tresiba yatsopano yotsogola idangowoneka posachedwa. Imagulitsidwa pamtengo wokwera kwambiri motero sangatenge gawo lalikulu pamsika, ngakhale ili ndi zida zake zowongolera. Pazaka zambiri zogwiritsidwa ntchito, ndemanga zambiri zapeza za mankhwala a Lantus. Amalemba makamaka ndi odwala, ndipo nthawi zina ndi madokotala.

Ndemanga zoyipa za Lantus insulin zimasiyidwa ndi odwala omwe samatsatira zakudya zama carb ochepa komanso / kapena kumwa kamodzi patsiku. Mankhwala osavuta a insulin omwe amachititsa kuti magazi azikhala ndi shuga m'magazi, komanso kupindika kwa hypoglycemia.

Jekeseni wa mankhwala Lantus 1 nthawi patsiku akufa. Imawonetsetsa kuti anthu odwala matenda ashuga asamakhale bwino, zotsatira zoyesa za hemoglobin, komanso kukula pang'onopang'ono kwa zovuta zovuta.Zotsatira zoyipa kwambiri zimakhala mwa iwo omwe akuyesera kuti abweretse insulin yachangu musanadye jakisoni wa Mlingo waukulu wa nthawi yayitali.

Insulin Lantus: Mtundu wa 2 wodwala wowunika

Kusinthana ndi zakudya zamafuta ochepa kumatha kuchepetsa ma insulin pofika nthawi 2-8. Mlingo wa mankhwala a nthawi yayitali komanso yofulumira amachepetsa. Pochepetsa mlingo wa insulini, amakhala wolimba kwambiri ndipo amachepetsa chiwopsezo cha kugwa. Matenda a shuga a 2 kapena 1 amatha kuwongoleredwa bwino ndi insulin Lantus, kutsatira zakudya zamafuta ochepa. Kuti mumve zambiri, onani nkhani ya "Type 1abetes control" kapena "Step-by-step chithandizo cha matenda ashuga a 2." Komabe, odwala matenda ashuga, omwe amadziwa njira za Dr. Bernstein ndipo amawathandizira malinga ndi chikhalidwe chawo, a Levemir, osati Lantus. Chifukwa chake, nkovuta kupeza ndemanga yokhudza mankhwalawa kwa anthu omwe amaletsa zakudya zamagulu m'zakudya zawo ndikulowetsa Mlingo wochepa wa mahomoni.

Ngati simunayambe kugwiritsa ntchito insulin yayitali, yesani Levemir kapena Tresiba koyamba. Koma ngati mukukhulupirira kale kuti Lantus akukuyenererani, pitilizani kumugunda. Wodwala aliyense ali ndi matenda ake a shuga. Zokumana nazo za munthu wina nthawi zambiri sizikhala zogwirizana ndi zomwe muli nazo. Osangokhala ndi jakisoni kamodzi patsiku. Muyenera kuwerengera ndalamazo molingana ndi njira yomwe tafotokozera. Onetsetsani kuti kusintha zakudya zamafuta ochepa kumachepetsa kwambiri. Lembani ndemanga yanu pankhani yogwiritsa ntchito mankhwalawa Lantus m'mawu a nkhaniyi.

Ndemanga 16 pa "Lantus"

Ndili ndi zaka 49, kulemera kwa makilogalamu 79, matenda ashuga amtundu 2, zovuta zambiri. Kolya Lantus, komanso asanadye Novorapid. Posachedwa, ululu m'mimba wakhala ukusokoneza. Nthawi zambiri amadutsa atatha kudya. Kodi chifukwa chake chingakhale chiyani? Kodi kukonzekera insulin kumatha kupereka zovuta zoterezi?

Kodi kukonzekera insulin kumatha kupereka zovuta zoterezi?

M'malo mwake, awa ndi amodzi mwa zovuta za matenda ashuga zomwe simungathe kuzilamulira.

Onani gastroenterologist wanu.

Moni. Ndili ndi zaka 53, kutalika 164 masentimita, kulemera kwa makilogalamu 54. Ndili ndi matenda a shuga 1, omwe adapezeka mu Marichi 2015. Chifukwa cha zakudya zama carb zotsika mtengo komanso njira zina za Dr. Bernstein, ndidachepetsa maselo a Lantus kuyambira 16 mpaka 7, komanso Apidra kuyambira magawo 12 mpaka 2 + 2 + 2 patsiku. Ndiuzeni chonde, ndingayende bwanji? Ndikufuna kusiya insulin. Ndidamva kuti Lantus ndiwovuta kwambiri kuchotsa kuchokera mthupi komanso zovulaza kuposa Apidra. Kodi ndingangosiya insulin yokhayo ndisanadye?

Ndikufuna kusiya insulin.

Osatinso kulota. Chifukwa muli ndi matenda a shuga a autoimmune.

Ndidamva kuti Lantus ndiwovuta kwambiri kuchotsa kuchokera mthupi komanso zovulaza kuposa Apidra.

Izi ndiye zamkhutu. Mumafunsabe ogulitsa mbewu mumsika.

Muyezo shuga kangapo patsiku, tsatirani zakudya. Mvetsetsani zomwe muyenera kuchita mukakhala kozizira komanso nthawi zina. Sinthani muyeso wa insulin ngati pakufunika, koma osalota ndikupereka jakisoni kwathunthu.

Ndili ndi CD1 yokhala ndi maphunziro ovuta, kuyambira ndili mwana. Insulin ya basal - Lantus. Hypoglycemia yafupipafupi imakhala yodetsa nkhawa kwanthawi yayitali - ndikulota, thukuta komanso palpitations. Komanso shuga wosasinthika m'mawa pamimba yopanda kanthu. Nditha kudya zakudya zomwezo masiku ambiri motsatira, jekeseni ndi insulin yomweyo. Pankhaniyi, shuga m'mawa wotsatira akhoza kukhala kuchokera pa 2.7 mpaka 13.8 mmol / L.

Pezani tsamba lanu, ndinachita chidwi ndikuphunzira nkhani. Anasintha zakudya zamafuta ochepa, anagawa jekeseni wa Lantus wa tsiku ndi tsiku jakisoni 2. Chepetsani 2,5 nthawi. Koma vuto la nocturnal hypoglycemia ndi shuga wosokoneza m'mimba yopanda kanthu silinathe. Kodi mungalangize kanthu? Sindingathe kupita ku Levemir kapena Tresib, chifukwa mankhwalawa samapereka kwaulere. Ndili ndi mantha kuti andikakamiza kusinthira ku Tujeo, komwe malinga ndi ndemanga ndi koyipa kwambiri kuposa Lantus.

Anasintha zakudya zamafuta ochepa, anagawa jekeseni wa Lantus wa tsiku ndi tsiku jakisoni 2.

Ili ndiye lingaliro labwino.

Mwina simukudzibaya nokha ndi subcutaneous, koma jakisoni wa intramuscular chifukwa cha njira yolakwika ya jakisoni.Pankhaniyi, mankhwalawa amatengeka mwachangu, amayamba ndi hypoglycemia, ndipo m'mawa zake zimatha molawirira kwambiri.

Palibe zifukwa zina zamavuto anu omwe amabwera m'mutu mwanga.

Moni Mwana wamwamuna wazaka 15 adapezeka kwa nthawi yoyamba ali ndi matenda a shuga 1 milungu 3 yapitayo.Lantus adapatsidwa mayunitsi 20. madzulo ndi Apidra chakudya. Kodi ndizotheka kutsina Apidra nthawi yomweyo ndi Lantus pa 9 p.m. ngati shuga yachuluka chifukwa chowerengedwa molakwika XE? Zikomo!

Kodi ndizotheka kutsina Apidra nthawi yomweyo ndi Lantus?

Jekeseni wa insulin yayitali komanso yofulumira imapangidwa popanda wina ndi mnzake, kuthetsa mavuto osiyanasiyana.

Pambuyo pakutsata insulin yofulumira, Dr. Bernstein adalangiza kudikirira maola 4-5 musanapange jekeseni wotsatira. Sikoyenera kuti milingo iwiri yamphamvu ya insulin yogwira ntchito nthawi yomweyo mthupi. Izi zimagwira ntchito kwa odwala matenda ashuga omwe amatsata zakudya zama carb ochepa.

Funso lanu limawonetsa kuti simunafune kugwiritsa ntchito insulin. Yambani ndi nkhaniyi - http://endocrin-patient.com/dozy-insulin-otvety/. Ngati ndinu aulesi kwambiri kuti musunthiretu pamutuwu, osadalira zotsatira zabwino.

Miyezi 4 yapitayo, ndidatsimikizira mwamuna wanga yemwe ali ndi matenda ashuga a mtundu 2 kuti asinthane ndi zakudyazi kuti azikhala ndi ine. Adapumula, koma ndidachita nthawi yomweyo ndikukopa komanso "mphamvu zofewa." Asanayambe zakudya zamafuta ochepa, mankhwala ake a Lantus insulin a tsiku ndi tsiku anali magawo 43. Anayesetsanso kuchepetsa zakudya ndipo adatenga mapiritsi a Glucofage 500 mg 2 kawiri pa tsiku. Ngakhale zonsezi, zizindikiro za neuropathy zinayamba kumuvutitsa. Anadandaula makamaka za kupweteka kwa mwendo. Shuga wamagazi nthawi zambiri anali 8-9. Mwachidziwikire, mwezi uliwonse ankadwaliraku. Pambuyo pa masiku 10 a chakudya chochepa kwambiri, tinabereka insulin! Palibe chifukwa chodulira, ngati shuga akadakhalabe ndi 5.3-6.3 mmol / l. Ululu wamiyendo unapita mwachangu kwambiri kuposa momwe walonjezera patsamba lino.

Miyezi 4 yapitayo, ndidatsimikizira mwamuna wanga yemwe ali ndi matenda ashuga a mtundu 2 kuti asinthane ndi zakudyazi kuti azikhala ndi ine. Adapumula, koma ndidachita nthawi yomweyo ndikukopa komanso "mphamvu zofewa."

Sikuti aliyense wodwala matenda ashuga ali ndi mwayi wokhala ndi mkazi wanzeru komanso wodzipereka.

Shuga wamagazi nthawi zambiri anali 8-9. Mwachidziwikire, mwezi uliwonse ankadwaliraku.

Gawo la glucose 8-9 limakhala lokwanira 1.5-2 nthawi kuposa anthu athanzi. Zosadabwitsa kuti wodwalayo adayamba kukulira ndikupanga zovuta za matenda ashuga.

Pambuyo pa masiku 10 a chakudya chochepa kwambiri, tinabereka insulin!

Si onse odwala matenda ashuga amene ali ndi matenda ofatsa. Mlingo wa insulin umachepetsedwa kwambiri, koma sindilonjeza aliyense pasadakhale kuti ndidzalumpha kwathunthu kuchokera ku jakisoni. Osamachita izi mopanda kuwonjezeka shuga!

Palibe chifukwa chodulira, ngati shuga akadakhalabe ndi 5.3-6.3 mmol / l.

Osataya insulin kapena kuibisa patali kwambiri. Mungafunike kuyambiranso jakisoni kwakanthawi kuzizira kapena matenda ena.

Moni Dzina langa ndi Tatyana, wazaka 35 zakubadwa, kutalika kwa 165 cm, kulemera 67 kg, mtundu 1 shuga. Mbiri yoyipa yodwala, hemoglobin yomaliza ya 16.1%. Zakudya kwa ine ndizovuta kuposa kuwomberedwa - Sindingathe kupirira m'maganizo ndi mthupi, mashuga "amachoka" ndi ine ndikamachita insulin momwe ndimafunira.

Hypoglycemia ndi osowa kwambiri. Ambiri shuga ndi 11-24 mmol / L. Ndikuganiza kuti mfundo ndi jakisoni ndi Mlingo. Mwambiri, zikuwoneka kwa ine kuti 40 magawo owonjezera ndi 50 mayendedwe ofupikira patsiku ndi pang'ono. Vutoli ndikuti insulin yanga imasintha nthawi zonse. Nthawi zambiri awa ndi Protafan, Humalog, tsopano Lantus ndi Actrapid. Izi, panjira, imandikwana bwino, ndikuweruza ndi shuga.

Kodi ndikuchita chiyani tsopano:

1) Kusunthidwa ku zakudya zowuma malinga ndi chakudya. Sikuti ndimangoganiza, koma ndasiya kwathunthu zinthu zingapo.
Ndili ndi mantha a chakudya chochepa cha carb ndi ma jerks anga.

2) Kukanidwa kwa insulin kwa insulin m'malo mothandizidwa ndi actrapid.

3) Kuchepetsa kuchuluka kwa XE mpaka 15 patsiku, kuyamba kudya nthawi yomweyo m'magawo ofanana. Cholinga ndikuthana ndi Mlingo ndikuchepetsa SC osachepera 8-10 mmol / L.

Ndinaganiza zogawa mlingo wa Lantus.Tsopano ndimabaya mayunitsi 38 usiku nthawi ya 22-00. Kodi nthawi yoyamba kubedwa m'mawa ndi chiyani ndipo ndi chiyani? Ndimaganiza kuti mumafunikira magawo 25 madzulo ku 22-00 ndi 12 units m'mawa pa 8-00 kapena ayi?

Ndili ndi maola 5 pakati pa chakudya - kodi zokhwasula-khwasula ndizofunikira komanso zotheka? Ndinawerenga kuti ndi insulin Humalog ndibwino kuti mutsitse SK yapamwamba. Koma sindikumvetsa kuti ungayike bwanji? Pamodzi ndi actrapid, kapena chiyani?

Zikuwoneka kuti zogulitsa zopanda michere siziyenera kuwonjezera SC. Kodi atha kumeza ludzu lamkuntha lanjala?

hemoglobin yomaliza ndi 16.1%. Zakudya zandivuta kuposa kuphedwa

Ndizodabwitsa kuti mudakali ndi moyo. Ndikadakhala kuti ndine inu, ndikadathetsa mavuto okhala ndi cholowa.

Anakana ultrashort insulin mokomera actrapid.

Izi sizikupanga nzeru osatembenukira ku zakudya zotsika kwambiri za carb zomwe zafotokozedwa apa - HTTP://endocrin-patient.com/dieta-pri-saharnom-diabete/

Ndinaganiza zogawa mlingo wa Lantus. Kodi nthawi yoyamba kubedwa m'mawa ndi chiyani ndipo ndi chiyani?

Izi ndizomwe munthu aliyense payekha, onani http://endocrin-patient.com/dlinny-insulin/. Popanda kusinthira pakudya chokhwima, mankhwalawa sangakhale othandiza.

Ndinawerenga kuti ndi insulin Humalog ndibwino kuti mutsitse SK yapamwamba. Koma sindikumvetsa kuti ungayike bwanji? Pamodzi ndi actrapid, kapena chiyani?

Kuwerengedwa mwachangu insulin Mlingo wa chakudya, komanso kuthanso shuga - http://endocrin-patient.com/raschet-insulin-eda/

Zikuwoneka kuti zogulitsa zopanda michere siziyenera kuwonjezera SC. Kodi atha kumeza ludzu lamkuntha lanjala?

Ndinaganiza zakudyazo. Mlingo umayenera kuwonjezeka wa insulin yayitali komanso yayitali, Thandizani kumvetsetsa bwanji za shuga m'mawa? Zoyenera kuchita nazo? Chakudya chotsiriza ku 18,00, ndinayika Actrapid pazakudya. Kenako nthawi ya 10 k.m. ndidabaya insulin yokwanira. Nthawi yomweyo ndimayeza shuga - chizindikiro cha 7, palibe hypo usiku. Kuyeza kwa glucose nthawi zosiyanasiyana usiku sikunawonetse kuchuluka kulikonse, sikuchepera. Oscillations zosaposa 1,5 mmol / l. M'mawa ndimaba jakisoni ndikuwunika shuga pa 7.00 - nthawi zonse pamakhala 10. Ndidayesa kuwonjezera nthawi yamadzulo - hypoglycemia usiku. Ndinayesa kusamutsa mlingo wamadzulo pambuyo pake - zovuta zamisala yamadzulo zimayamba. Tapeza kuti kuchuluka kwa glucose kumakwera kwambiri m'chigawo cha 5 oveni m'mawa. Kodi kuthetsa vutoli?

Tapeza kuti kuchuluka kwa glucose kumakwera kwambiri m'chigawo cha 5 oveni m'mawa. Kodi kuthetsa vutoli?

M'malo anu, pali njira ziwiri zokha, zonse ziwiri zimakhala ndi zovuta:
1. Sinthani kuchokera ku Lantus kupita ku Tresiba insulin, ngakhale mutayenera kugula ndi ndalama yanu. Tresiba ndi yabwino chifukwa imasunga usiku mpaka m'mawa.
2. Dzukani pa koloko ya alamu pakati pausiku kuti mupereke insulin. Odwala ena amapaka jekeseni wa mankhwala a 1-2 mwachangu, ena - owonjezera.

Moni Tsopano ndimabowula Lantus kamodzi patsiku, usiku, koma ndikumvetsetsa kuti nthawi yakusinthira kawiri. Mlingowo unakwera kuchoka pa 10 mpaka 24 mayunitsi, komabe sikuyenda bwino. M'mawa ndi m'mawa, hypoglycemia imachitika kawirikawiri. Ndipo mpaka dzulo usiku chochita jakisoni dzulo silikutha. Ndi magawo angati kuti aike usiku, ndipo zochuluka motani m'mawa?

Tsopano ndimabowula Lantus kamodzi patsiku, usiku, koma ndikumvetsetsa kuti nthawi yakusinthira kawiri.

Ndi magawo angati kuti aike usiku, ndipo zochuluka motani m'mawa?

Palibe yankho lenileni la funsoli.

Ndimayamba ndi 50% usiku komanso zofanana m'mawa, ndikuyesa zosankha zingapo, chilichonse kwa masiku atatu. Tsiku limodzi silokwanira kungoganiza.

Ndikukumbutsani kuti muyenera kumangoyala usiku mochedwa kwambiri musanapite kukagona. M'mawa - mutangodzuka. Pali okonda mlingo wa tsiku ndi tsiku, nawonso, wogawika pawiri - m'mawa ndi masana.

Mankhwala

Glulin insulin ndi chithunzi cha insulin yaumunthu yomwe imapezedwa ndi mabakiteriya a DNA amtunduwu Escherichia coli (K12 tizilombo).

Glulin insulin imapangidwa ngati analogue ya insulin yaumunthu, yodziwika ndi low solubility m'malo osagwirizana nawo. Monga gawo lakukonzekera kwa Lantus ® SoloStar ®, imasungunuka kwathunthu, yomwe imatsimikiziridwa ndi momwe asidi amachitikira panjira yovulaza (pH 4). Pambuyo poyambitsa mafuta osunthika, acidic yankho limaphatikizidwa, zomwe zimayambitsa kupangidwa kwa microprecipitates, komwe ma insulin glargine amatulutsidwa nthawi zonse, ndikupereka chithunzi chokwanira, chosalala (chopanda).

Insulin glargine imapukusidwa kwa metabolites awiri ogwira ntchito M1 ndi M2 (onani "Pharmacokinetics").

Kuyankhulana ndi insulin receptors: the kinetics of binding to insulin receptors in insulin glargine and its metabolites - M1 ndi M2 - ndiyomwe ili pafupi kwambiri ndi insulin yaumunthu, chifukwa chake insulin glargine imatha kugwira zotsatira zofanana ndi za insulin.

Chofunikira kwambiri cha insulin ndi mapangidwe ake, kuphatikiza ndi insulin glargine, ndiko kukhazikitsidwa kwa glucose metabolism. Insulin ndi kufananiza kwake kumachepetsa kuchuluka kwa glucose m'magazi, kumapangitsa kuti mayamwidwe azikhala ndi zotumphukira (makamaka mafupa am'mimba ndi adipose minofu) ndikuletsa kupangika kwa glucose m'chiwindi.

Insulin imalepheretsa lipolysis mu adipocytes komanso inhibits proteinolysis, pamene ikukula kaphatikizidwe ka mapuloteni.

Kuchita kwa nthawi yayitali kwa insulin glargine kumakhudzana mwachindunji ndi kuchepetsedwa kwa mayamwidwe ake, omwe amalola kuti mankhwalawa azigwiritsidwa ntchito kamodzi patsiku. Pambuyo pa kayendetsedwe ka sc, kuyambira kwa zochita zake kumachitika pakati pa ola 1. Nthawi yayitali yochita ndi maola 24, okwera ndi maola 29. Kutalika kwa nthawi ya insulin ndi mawonekedwe ake, monga insulin glargine, amatha kusiyanasiyana pakati pa anthu osiyanasiyana kapena amodzi munthu yemweyo.

Kuchita kwa Lantus ® SoloStar ® mwa ana opitilira zaka 2 ndi mtundu wa matenda a shuga 1 - Komanso, mwa ana azaka 2-6, kuchuluka kwa hypoglycemia komwe kumawonekera pakanthawi masana ndi insulin ndipo usiku poyerekeza ndi kugwiritsa ntchito insulin-isophan (motero, pafupifupi 25,5 episode motsutsana ndimakalata 33 mwa wodwala mmodzi pachaka chimodzi). Pazaka zisanu zotsatila za odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga, palibe kusiyana kwakukulu pakukula kwa matenda ashuga omwe amapezeka ndi insulin glargine poyerekeza ndi insulin-isophan.

Chiyanjano ndi ma receptors a insulin-like grow factor 1 (IGF-1): kuyanjana kwa insulin glargine ya IGF-1 receptor ndi okwera pafupifupi 5-8 kuchulukirapo kuposa insulin yamunthu (koma pafupifupi 70-80 nthawi yotsika kuposa ya IGF-1), nthawi yomweyo, poyerekeza ndi insulin ya anthu, ma insulin metabolites a glargine M1 ndi M2 ali ndi mgwirizano wotsika pang'ono wa IGF-1 receptor.

Chiwonetsero chonse cha insulin (insulin glargine ndi metabolites) chotsimikizika mu odwala 1 a shuga, chinali chotsika kwambiri poyerekeza ndi kuchuluka kwa mankhwala osokoneza bongo a IGF-1 receptors ndikutsata kwa njira ya mitogenic proliferative yomwe idayambika kudzera pa IGF-1 receptors. Kuzungulira kwa thupi kwa endo native IGF-1 kumatha kuyambitsa njira ya matogenic proliferative, komabe, chithandizo cha insulin chomwe chimatsimikiziridwa nthawi ya insulin, kuphatikiza chithandizo ndi Lantus ® SoloStar ®, ndizotsika kwambiri poyerekeza ndi ma pharmacological omwe amafunikira kuyambitsa njira ya mitogenic proliferative.

Kafukufuku ORIGIN (Kuchepetsa Zotsatira ndi Initial Glargine INtervention) anali mayiko, multicenter, osasankhidwa, opangidwa mu 12,537 odwala omwe ali pachiwopsezo chachikulu chotenga matenda a mtima komanso zovuta kusala shuga (IHF), kuvutitsidwa kwa glucose (NTG) kapena mtundu woyambira wa matenda a shuga 2. : 1): gulu la odwala omwe amalandira insulin glargine (n = 6264), yomwe idasungidwa kuti ikwaniritse kuthamanga kwa magazi glucose (GKN) ≤5.3 mmol, ndi gulu la odwala omwe amalandila chithandizo chamankhwala (n = 6273). Mapeto oyamba a phunziroli inali nthawi isanayambike imfa yamtima, kukhazikitsidwa koyamba kwa infarction yopanda magazi kapena kupha, ndipo chotsatira chachiwiri chinali nthawi isanayambike zovuta zilizonse pamwambapa kapena isanachitike njira yosinthira mafupa (coronary, carotid oripheral artery) , kapena asanagonekere kuchipatala chifukwa cha chotupa cha mtima.

Omaliza ochepa anali anthu omwe amafa pazifukwa zilizonse komanso pazotsatira zingapo. Kafukufuku CHIYAMBI idawonetsa kuti chithandizo cha insulin glargine poyerekeza ndi chithandizo chokwanira cha hypoglycemic sichinasinthe chiopsezo chokhala ndi vuto la mtima kapena kufa kwa mtima, panalibe zosiyana pamiyeso ya gawo lililonse lomwe limapanga mfundo zomaliza, zakufa pazomwe zimayambitsa, ndi chisonyezo chophatikizika cha zotsatira za microvascular.

Kumayambiriro kwa phunziroli, malingaliro a HbA1c apakati anali 6.4%. Makhalidwe a Median HbA1c panthawi yamankhwala anali osiyanasiyana 5.9-6.4% mu gulu la insulin glargine ndi 6.2-6.6% mu gulu lachipatala nthawi zonse. Mu gulu la odwala omwe amalandira insulin glargine, zochitika za hypoglycemia zowopsa zinali zochitika za 1.05 pazokwanira zaka zana zamankhwala, komanso pagulu la odwala omwe adalandira hypoglycemia, zigawo za 0.3 pa 100 ya zaka zothandizira odwala. Chiwopsezo cha hypoglycemia yofatsa chinali magawo 7.71 pazaka zana zothandizira odwala omwe ali ndi gulu la odwala omwe amalandira insulin glargine, komanso zochitika za 2.44 pazaka 100 zothandizira odwala omwe ali pagulu la odwala omwe amalandila hypoglycemia. Mu kafukufuku wazaka 6, milandu 42 ya hypoglycemia siinawonedwe mu 42% ya odwala omwe ali mu gulu la insulin glargine.

Wam'kati mwa kusintha kwa thupi poyerekeza ndi zotsatira paulendo womaliza wa mankhwalawa anali 2.2 kg kwambiri m'gululi la insulin glargine kuposa gulu lonse la mankhwala.

Pharmacokinetics

Kafukufuku woyerekeza wa plasma wozungulira wa insulin glargine ndi insulin-isofan mwa anthu athanzi ndi odwala omwe ali ndi matenda osokoneza bongo pambuyo pa sc mankhwala osokoneza bongo adawonetsa kuyamwa pang'onopang'ono komanso kwa nthawi yayitali, komanso kusapezeka kwa nsonga ya kuchuluka kwa insulin glargine poyerekeza ndi insulin-isofan. Ndi kamodzi kamodzi tsiku ndi tsiku mankhwala a Lantus ® SoloStar ® C ss insulin glargine m'magazi amatheka pambuyo masiku 2-4 ndi kutsata kwa tsiku ndi tsiku.

Ndi pa / kumayambiriro kwa T 1/2 insulin glargine ndi insulin ya anthu anali ofanana. Pamene insulin glargine idalowetsedwa pamimba, phewa, kapena ntchafu, palibe kusiyana kwakukulu komwe kunapezeka mu seramu insulin. Poyerekeza ndi insulin ya anthu apakati, insulin glargine imadziwika ndi kusinthasintha kochepa mu mbiri ya pharmacokinetic, onse omwewo komanso odwala osiyanasiyana. Mwa munthu wopanikizika ndi mafuta, insulin glargine imakonzedwa pang'ono kuchokera kumapeto a carboxyl (C-end) ya β-chain (beta-chain) ndikupanga ma metabolites awiri a M1 (21 A G1y-insulin) ndi M2 (21 A G1y-des- 30 B -Thr-insulin). Kwambiri, metabolite M1 imazungulira m'madzi a m'magazi. Kuwonetsera kwadongosolo kwa metabolite M1 kumawonjezeka ndi kuwonjezeka kwa mlingo.

Kuyerekeza kwa pharmacokinetics ndi dataacodynamics ndikuwonetsa kuti zotsatira za mankhwalawa zimachitika makamaka chifukwa cha kuwonetsa kwa metabolite ya M1. Mwa kuchuluka kwa odwala, insulin glargine ndi metabolite M2 sizikanakhoza kupezeka mu kayendedwe kazinthu. Nthawi zina pomwe panali zotheka kudziwa insulin glargine ndi metabolite M2 m'magazi, kutsata kwawo sikudalira kuchuluka kwa Lantus ® SoloStar ®.

Magulu apadera a odwala

Zaka ndi jenda. Zambiri pazokhudza zaka ndi jenda pa pharmacokinetics ya insulin glargine sizipezeka. Komabe, izi sizinayambitse kusiyana pakubwera kwa mankhwalawo ndikuyenda bwino kwa mankhwalawa.

Kusuta. M'mayeso azachipatala, kusanthula kwamagulu ochepa sikunawonetse kusiyana pakukhazikika ndikuchita bwino kwa insulin glargine ya gulu ili la odwala poyerekeza ndi ambiri.

Kunenepa kwambiri Odwala onenepa sanawonetse kusiyana kosatetezeka ndikuyenda bwino kwa insulin glargine ndi insulin-isophan poyerekeza ndi odwala omwe ali ndi thupi labwino.

Ana. Mu ana omwe ali ndi matenda a shuga 1 a zaka 2 mpaka 6, kuchuluka kwa insulin glargine ndi metabolites yake yayikulu M1 ndi M2 m'magazi am'magazi lisanafike mlingo wofanana ndi womwe umachitika mwa akulu, zomwe zikusonyeza kusapezeka kwa insulin glargine ndi metabolites ake ntchito mosalekeza insulin glargine ana.

Mimba komanso kuyamwa

Odwala ayenera kudziwitsa dokotala za mimba yomwe ilipo kapena yakonzekera.

Panalibe mayesero azachipatala omwe amayesedwa mwachisawawa pakugwiritsa ntchito insulin glargine mwa amayi apakati.

Chiwerengero chochulukirapo (zotsatira zopitilira 1000 za kubereka poyeserera komanso kuyembekezera kutsata) ndi kugulitsa pambuyo pogwiritsira ntchito insulin glargine kunawonetsa kuti sanakhale ndi zotsatirapo zake pamaphunziro ndi zotsatira za kubereka kapena mkhalidwe wakakhanda, kapena thanzi la mwana wakhanda.

Kuphatikiza apo, pofuna kuyesa chitetezo cha insulin glargine ndi insulin-isophan ntchito kwa amayi apakati omwe ali ndi vuto lakale kapena gestational matenda osokoneza bongo, kuwunika kwa meta-kuyesedwa kwa mayesero asanu ndi atatu a kuchipatala kunachitika, kuphatikiza azimayi omwe amagwiritsa ntchito insulin glargine pa nthawi yoyembekezera (n = 331) ndi insulin isophane (n = 371). Kufufuza uku

M'maphunziro a zinyama, palibe deta yachindunji kapena yosalunjika yomwe idapezeka pa embryotoxic kapena fetotoxic zotsatira za insulin glargine.

Kwa odwala omwe ali ndi matenda osokoneza bongo omwe alipo kale kapena a gestational matenda a shuga, ndikofunikira kuti azitha kuyang'anira machitidwe a metabolic panthawi yonse yoletsa kupewa kupezeka kwa zotsatira zosakhudzana ndi hyperglycemia.

Mankhwala Lantus ® SoloStar ® angagwiritsidwe ntchito pa nthawi ya pakati pazifukwa zamankhwala.

Kufunika kwa insulin kumatha kuchepa mu trimester yoyamba ya kubereka, komanso, kuchuluka, panthawi yachiwiri komanso yachitatu.

Mwana akangobadwa kumene, kufunika kwa insulini kumachepa msanga (chiopsezo cha hypoglycemia chikuwonjezeka). Pansi pa izi, kuwunikira mosamala kuchuluka kwa shuga m'magazi ndikofunikira.

Odwala pa mkaka wa m`mawere angafunikire kusintha Mlingo wa insulin ndi zakudya.

Zotsatira za pharmacological

Mankhwala

Glulin insulin ndi chithunzi cha insulin yaumunthu yomwe imapezedwa ndi mabakiteriya a DNA amtunduwu Escherichia coli (K12 tizilombo).

Glulin insulin imapangidwa ngati analogue ya insulin yaumunthu, yodziwika ndi low solubility m'malo osagwirizana nawo. Monga gawo lakukonzekera kwa Lantus ® SoloStar ®, imasungunuka kwathunthu, yomwe imatsimikiziridwa ndi momwe asidi amachitikira panjira yovulaza (pH 4). Pambuyo poyambitsa mafuta osunthika, acidic yankho limaphatikizidwa, zomwe zimayambitsa kupangidwa kwa microprecipitates, komwe ma insulin glargine amatulutsidwa nthawi zonse, ndikupereka chithunzi chokwanira, chosalala (chopanda).

Insulin glargine imapukusidwa kwa metabolites awiri ogwira ntchito M1 ndi M2 (onani "Pharmacokinetics").

Kuyankhulana ndi insulin receptors: the kinetics of binding to insulin receptors in insulin glargine and its metabolites - M1 ndi M2 - ndiyomwe ili pafupi kwambiri ndi insulin yaumunthu, chifukwa chake insulin glargine imatha kugwira zotsatira zofanana ndi za insulin.

Chofunikira kwambiri cha insulin ndi mapangidwe ake, kuphatikiza ndi insulin glargine, ndiko kukhazikitsidwa kwa glucose metabolism.Insulin ndi kufananiza kwake kumachepetsa kuchuluka kwa glucose m'magazi, kumapangitsa kuti mayamwidwe azikhala ndi zotumphukira (makamaka mafupa am'mimba ndi adipose minofu) ndikuletsa kupangika kwa glucose m'chiwindi.

Insulin imalepheretsa lipolysis mu adipocytes komanso inhibits proteinolysis, pamene ikukula kaphatikizidwe ka mapuloteni.

Kuchita kwa nthawi yayitali kwa insulin glargine kumakhudzana mwachindunji ndi kuchepetsedwa kwa mayamwidwe ake, omwe amalola kuti mankhwalawa azigwiritsidwa ntchito kamodzi patsiku. Pambuyo pa kayendetsedwe ka sc, kuyambira kwa zochita zake kumachitika pakati pa ola 1. Nthawi yayitali yochita ndi maola 24, okwera ndi maola 29. Kutalika kwa nthawi ya insulin ndi mawonekedwe ake, monga insulin glargine, amatha kusiyanasiyana pakati pa anthu osiyanasiyana kapena amodzi munthu yemweyo.

Kuchita kwa Lantus ® SoloStar ® mwa ana opitilira zaka 2 ndi mtundu wa matenda a shuga 1 - Komanso, mwa ana azaka 2-6, kuchuluka kwa hypoglycemia komwe kumawonekera pakanthawi masana ndi insulin ndipo usiku poyerekeza ndi kugwiritsa ntchito insulin-isophan (motero, pafupifupi 25,5 episode motsutsana ndimakalata 33 mwa wodwala mmodzi pachaka chimodzi). Pazaka zisanu zotsatila za odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga, palibe kusiyana kwakukulu pakukula kwa matenda ashuga omwe amapezeka ndi insulin glargine poyerekeza ndi insulin-isophan.

Chiyanjano ndi ma receptors a insulin-like grow factor 1 (IGF-1): kuyanjana kwa insulin glargine ya IGF-1 receptor ndi okwera pafupifupi 5-8 kuchulukirapo kuposa insulin yamunthu (koma pafupifupi 70-80 nthawi yotsika kuposa ya IGF-1), nthawi yomweyo, poyerekeza ndi insulin ya anthu, ma insulin metabolites a glargine M1 ndi M2 ali ndi mgwirizano wotsika pang'ono wa IGF-1 receptor.

Chiwonetsero chonse cha insulin (insulin glargine ndi metabolites) chotsimikizika mu odwala 1 a shuga, chinali chotsika kwambiri poyerekeza ndi kuchuluka kwa mankhwala osokoneza bongo a IGF-1 receptors ndikutsata kwa njira ya mitogenic proliferative yomwe idayambika kudzera pa IGF-1 receptors. Kuzungulira kwa thupi kwa endo native IGF-1 kumatha kuyambitsa njira ya matogenic proliferative, komabe, chithandizo cha insulin chomwe chimatsimikiziridwa nthawi ya insulin, kuphatikiza chithandizo ndi Lantus ® SoloStar ®, ndizotsika kwambiri poyerekeza ndi ma pharmacological omwe amafunikira kuyambitsa njira ya mitogenic proliferative.

Kafukufuku ORIGIN (Kuchepetsa Zotsatira ndi Initial Glargine INtervention) anali mayiko, multicenter, osasankhidwa, opangidwa mu 12,537 odwala omwe ali pachiwopsezo chachikulu chotenga matenda a mtima komanso zovuta kusala shuga (IHF), kuvutitsidwa kwa glucose (NTG) kapena mtundu woyambira wa matenda a shuga 2. : 1): gulu la odwala omwe amalandira insulin glargine (n = 6264), yomwe idasungidwa kuti ikwaniritse kuthamanga kwa magazi glucose (GKN) ≤5.3 mmol, ndi gulu la odwala omwe amalandila chithandizo chamankhwala (n = 6273). Mapeto oyamba a phunziroli inali nthawi isanayambike imfa yamtima, kukhazikitsidwa koyamba kwa infarction yopanda magazi kapena kupha, ndipo chotsatira chachiwiri chinali nthawi isanayambike zovuta zilizonse pamwambapa kapena isanachitike njira yosinthira mafupa (coronary, carotid oripheral artery) , kapena asanagonekere kuchipatala chifukwa cha chotupa cha mtima.

Omaliza ochepa anali anthu omwe amafa pazifukwa zilizonse komanso pazotsatira zingapo. Kafukufuku CHIYAMBI idawonetsa kuti chithandizo cha insulin glargine poyerekeza ndi chithandizo chokwanira cha hypoglycemic sichinasinthe chiopsezo chokhala ndi vuto la mtima kapena kufa kwa mtima, panalibe zosiyana pamiyeso ya gawo lililonse lomwe limapanga mfundo zomaliza, zakufa pazomwe zimayambitsa, ndi chisonyezo chophatikizika cha zotsatira za microvascular.

Kumayambiriro kwa phunziroli, malingaliro a HbA1c apakati anali 6.4%.Makhalidwe a Median HbA1c panthawi yamankhwala anali osiyanasiyana 5.9-6.4% mu gulu la insulin glargine ndi 6.2-6.6% mu gulu lachipatala nthawi zonse. Mu gulu la odwala omwe amalandira insulin glargine, zochitika za hypoglycemia zowopsa zinali zochitika za 1.05 pazokwanira zaka zana zamankhwala, komanso pagulu la odwala omwe adalandira hypoglycemia, zigawo za 0.3 pa 100 ya zaka zothandizira odwala. Chiwopsezo cha hypoglycemia yofatsa chinali magawo 7.71 pazaka zana zothandizira odwala omwe ali ndi gulu la odwala omwe amalandira insulin glargine, komanso zochitika za 2.44 pazaka 100 zothandizira odwala omwe ali pagulu la odwala omwe amalandila hypoglycemia. Mu kafukufuku wazaka 6, milandu 42 ya hypoglycemia siinawonedwe mu 42% ya odwala omwe ali mu gulu la insulin glargine.

Wam'kati mwa kusintha kwa thupi poyerekeza ndi zotsatira paulendo womaliza wa mankhwalawa anali 2.2 kg kwambiri m'gululi la insulin glargine kuposa gulu lonse la mankhwala.

Pharmacokinetics

Kafukufuku woyerekeza wa plasma wozungulira wa insulin glargine ndi insulin-isofan mwa anthu athanzi ndi odwala omwe ali ndi matenda osokoneza bongo pambuyo pa sc mankhwala osokoneza bongo adawonetsa kuyamwa pang'onopang'ono komanso kwa nthawi yayitali, komanso kusapezeka kwa nsonga ya kuchuluka kwa insulin glargine poyerekeza ndi insulin-isofan. Ndi kamodzi kamodzi tsiku ndi tsiku mankhwala a Lantus ® SoloStar ® C ss insulin glargine m'magazi amatheka pambuyo masiku 2-4 ndi kutsata kwa tsiku ndi tsiku.

Ndi pa / kumayambiriro kwa T 1/2 insulin glargine ndi insulin ya anthu anali ofanana. Pamene insulin glargine idalowetsedwa pamimba, phewa, kapena ntchafu, palibe kusiyana kwakukulu komwe kunapezeka mu seramu insulin. Poyerekeza ndi insulin ya anthu apakati, insulin glargine imadziwika ndi kusinthasintha kochepa mu mbiri ya pharmacokinetic, onse omwewo komanso odwala osiyanasiyana. Mwa munthu wopanikizika ndi mafuta, insulin glargine imakonzedwa pang'ono kuchokera kumapeto a carboxyl (C-end) ya β-chain (beta-chain) ndikupanga ma metabolites awiri a M1 (21 A G1y-insulin) ndi M2 (21 A G1y-des- 30 B -Thr-insulin). Kwambiri, metabolite M1 imazungulira m'madzi a m'magazi. Kuwonetsera kwadongosolo kwa metabolite M1 kumawonjezeka ndi kuwonjezeka kwa mlingo.

Kuyerekeza kwa pharmacokinetics ndi dataacodynamics ndikuwonetsa kuti zotsatira za mankhwalawa zimachitika makamaka chifukwa cha kuwonetsa kwa metabolite ya M1. Mwa kuchuluka kwa odwala, insulin glargine ndi metabolite M2 sizikanakhoza kupezeka mu kayendedwe kazinthu. Nthawi zina pomwe panali zotheka kudziwa insulin glargine ndi metabolite M2 m'magazi, kutsata kwawo sikudalira kuchuluka kwa Lantus ® SoloStar ®.

Magulu apadera a odwala

Zaka ndi jenda. Zambiri pazokhudza zaka ndi jenda pa pharmacokinetics ya insulin glargine sizipezeka. Komabe, izi sizinayambitse kusiyana pakubwera kwa mankhwalawo ndikuyenda bwino kwa mankhwalawa.

Kusuta. M'mayeso azachipatala, kusanthula kwamagulu ochepa sikunawonetse kusiyana pakukhazikika ndikuchita bwino kwa insulin glargine ya gulu ili la odwala poyerekeza ndi ambiri.

Kunenepa kwambiri Odwala onenepa sanawonetse kusiyana kosatetezeka ndikuyenda bwino kwa insulin glargine ndi insulin-isophan poyerekeza ndi odwala omwe ali ndi thupi labwino.

Ana. Mu ana omwe ali ndi matenda a shuga 1 a zaka 2 mpaka 6, kuchuluka kwa insulin glargine ndi metabolites yake yayikulu M1 ndi M2 m'magazi am'magazi lisanafike mlingo wofanana ndi womwe umachitika mwa akulu, zomwe zikusonyeza kusapezeka kwa insulin glargine ndi metabolites ake ntchito mosalekeza insulin glargine ana.

Zisonyezero za mankhwala Lantus ® SoloStar ®

Matenda a shuga omwe amafunikira chithandizo cha insulin mwa akulu, achinyamata ndi ana opitilira 2 years.

Contraindication

Hypersensitivity insulin glargine kapena zilizonse zothandiza za mankhwala,

zaka za ana mpaka zaka 2 (kusowa kwa data yazachipatala pakugwiritsa ntchito).

Ndi chisamaliro: azimayi oyembekezera (kuthekera kwa kusintha kufunika kwa insulin panthawi yapakati komanso pambuyo pobala mwana).

Mimba komanso kuyamwa

Odwala ayenera kudziwitsa dokotala za mimba yomwe ilipo kapena yakonzekera.

Panalibe mayesero azachipatala omwe amayesedwa mwachisawawa pakugwiritsa ntchito insulin glargine mwa amayi apakati.

Chiwerengero chochulukirapo (zotsatira zopitilira 1000 za kubereka poyeserera komanso kuyembekezera kutsata) ndi kugulitsa pambuyo pogwiritsira ntchito insulin glargine kunawonetsa kuti sanakhale ndi zotsatirapo zake pamaphunziro ndi zotsatira za kubereka kapena mkhalidwe wakakhanda, kapena thanzi la mwana wakhanda.

Kuphatikiza apo, pofuna kuyesa chitetezo cha insulin glargine ndi insulin-isophan ntchito kwa amayi apakati omwe ali ndi vuto lakale kapena gestational matenda osokoneza bongo, kuwunika kwa meta-kuyesedwa kwa mayesero asanu ndi atatu a kuchipatala kunachitika, kuphatikiza azimayi omwe amagwiritsa ntchito insulin glargine pa nthawi yoyembekezera (n = 331) ndi insulin isophane (n = 371). Kufufuza uku

M'maphunziro a zinyama, palibe deta yachindunji kapena yosalunjika yomwe idapezeka pa embryotoxic kapena fetotoxic zotsatira za insulin glargine.

Kwa odwala omwe ali ndi matenda osokoneza bongo omwe alipo kale kapena a gestational matenda a shuga, ndikofunikira kuti azitha kuyang'anira machitidwe a metabolic panthawi yonse yoletsa kupewa kupezeka kwa zotsatira zosakhudzana ndi hyperglycemia.

Mankhwala Lantus ® SoloStar ® angagwiritsidwe ntchito pa nthawi ya pakati pazifukwa zamankhwala.

Kufunika kwa insulin kumatha kuchepa mu trimester yoyamba ya kubereka, komanso, kuchuluka, panthawi yachiwiri komanso yachitatu.

Mwana akangobadwa kumene, kufunika kwa insulini kumachepa msanga (chiopsezo cha hypoglycemia chikuwonjezeka). Pansi pa izi, kuwunikira mosamala kuchuluka kwa shuga m'magazi ndikofunikira.

Odwala pa mkaka wa m`mawere angafunikire kusintha Mlingo wa insulin ndi zakudya.

Zotsatira zoyipa

Zotsatira zoyipa zotsatirazi zimaperekedwa pamakina a ziwalo malinga ndi kuchuluka kwa pafupipafupi kwa zomwe zimachitika (malinga ndi gulu la Medical Dictionary pazoyang'anira MedDRA ): Nthawi zambiri - ≥10%, nthawi zambiri - ≥1- (zida zamankhwala, zofananira)

Rp: Lantus 100 ME / ml - 10 ml
D.t.d: Na. 5 mu amp.
S: SC, mlingo umayikidwa ndi endocrinologist.

Zotsatira za pharmacological

Lantus ndi hypoglycemic insulin kukonzekera. Lantus imakhala ndi insulin glargine - analogue ya insulin ya anthu, yomwe imakhala yochepa kwambiri osagwirizana nawo. Insulin glargine mu njira ya Lantus imasungunuka kwathunthu chifukwa cha acidic sing'anga, komabe, ikayambitsidwa ndi minyewa yotsekera, asidiyo samasankhidwa ndipo microprecipitate imapangidwa, pomwe ochepa insulin glargine imamasulidwa. Chifukwa chake, mbiri yosalala yodalira nthawi ya insulin mu plasma imatheka popanda nsonga ndi madontho. Kuphatikiza apo, mapangidwe a microprecipitate amapereka nthawi yayitali ya mankhwala Lantus. Kuyanjana kwa gawo lomwe limagwiritsidwa ntchito ndi mankhwala Lantus kupita ku insulin receptors ndiwofanana ndi insulin ya anthu.
Zomwe zimamangidwa ku IGF-1 receptor ya insulin glargine ndizochulukirapo ka 5-8 kuposa zomwe zimapangira insulin yamunthu, ndipo ma metabolites ake ndi otsika pang'ono kuposa insulin yamunthu.Chiwonetsero chonse cha insulin (gawo lomwe limagwira ntchito ndi ma metabolites), yotsimikizika mwa odwala omwe ali ndi matenda a shuga 1, anali otsika kwambiri kuposa zomwe zimafunikira kuti pakhale theka lokwanira kumanga kwa IGF-1 receptors komanso magwiritsidwe amtsogolo a mitogenic-proliferative limagwidwa ndi receptor uyu. Endo native IGF-1 imatha kugwira ntchito yotulutsa mitogen-prolifative, koma njira zochizira zotsekemera zomwe zimagwiritsidwa ntchito pochizira insulin ndizotsika kwambiri poyerekeza ndi ma pharmacological omwe amafunikira kuyambitsa makina oyendetsedwa ndi IGF-1.

Ntchito yayikulu ya insulin, kuphatikiza insulin glargine, ndikuwongolera kwa kagayidwe kazakudya (glucose metabolism). Pankhaniyi, mankhwala a Lantus amachepetsa shuga m'magazi (chifukwa cha kuchuluka kwa glucose omwe amapezeka ndi zotumphukira zake: ma adipose ndi minofu minofu), komanso amalepheretsa kupangika kwa shuga m'chiwindi. Insulin imalepheretsa dongosolo la lipolysis mu adipocytes ndi proteinolysis, pomwe munthawi yomweyo kuchititsa kuyamwa kwa mapuloteni. Kafukufuku wa zamankhwala ndi a pharmacological adatsimikizira kufanana kwa Mlingo wofanana wa insulin ndi insulin glargine pambuyo pakupanga kwamankhwala. Chikhalidwe cha insulin glargine pakapita nthawi, monga insulin ina, chimayendetsedwa ndi zochitika zolimbitsa thupi komanso zinthu zina. Kuchepetsa pang'onopang'ono pambuyo pothandizidwa ndi subcutaneous makonzedwe kumalola kugwiritsa ntchito mankhwala Lantus kamodzi patsiku. Kuchulukana kofananira kwakukulu mu mawonekedwe amachitidwe a insulin pakapita nthawi. Maphunzirowa sanawonetse kusiyana kwakukulu pakukula kwa matenda ashuga retinopathy omwe ali ndi insulin glargine ndi insulin NPH. Mu ana ndi achinyamata ogwiritsa ntchito mankhwala Lantus, kukula kwa nocturnal hypoglycemia sikunachitike kawirikawiri (kuyerekeza ndi gulu lomwe limalandira insulin NPH).
Insulin glargine imalowetsedwa pang'onopang'ono ndipo simapanga chiwonetsero chazinthu pambuyo povulaza subcutaneous (poyerekeza ndi insulin NPH). Ndi kuyambitsidwa kwa insulin glargine kamodzi patsiku, kutsata kwa kufanana kumakwaniritsidwa patsiku la 2-4th la mankhwala. Ndi mtsempha wamagazi, theka la moyo wa insulin glargine limafanana ndi la insulin ya anthu.
Insulin glargine imapangidwa kuti ipange mitundu iwiri yogwira (M1 ndi M2). Zotsatira za jekeseni wa subcutaneous wa mankhwala Lantus zimagwirizana kwambiri ndi kuwonetseredwa kwa M1, pomwe insulin glargine ndi M2 sizinapezeke mwa ambiri omwe amapezeka nawo pa kafukufukuyu. Palibe kusiyana pakati pa kugwiritsidwa ntchito kwa mankhwala a Lantus m'magulu osiyanasiyana a odwala; pakupita maphunziro m'magulu opangidwa ndi zaka komanso jenda, panalibe kusiyana kulikonse ndi kuchuluka kwa anthu malinga ndi kufunikira ndi chitetezo. Mwa ana ndi achinyamata, maphunziro a pharmacokinetic sanachitike.

Kutulutsa Fomu

Lantus jakisoni wa 3 ml katiriji, makatoni 5 amaikidwa mu chithuza chamtundu, 1 chithuza chonyamula chikwatu.

Zomwe zili patsamba lomwe mukuwona zimapangidwa kuti zidziwitso zokha komanso sizimalimbikitsa kudzipatsa mankhwala mwanjira iliyonse. Chidacho chimapangidwa kuti chizolowere akatswiri azachipatala kuti awonjezere zambiri zamankhwala ena, potero amawonjezera luso lawo. Kugwiritsa ntchito mankhwalawa "" mosakayikira kumakupatsani mwayi wofunsa katswiri, komanso malingaliro ake pa njira yogwiritsira ntchito ndi kuchuluka kwa mankhwala omwe mwasankha.