Insulin yofulumira: malangizo ogwiritsira ntchito, tebulo loyambira

Chithandizo chachikulu cha mankhwalawa chifukwa cha matenda a shuga a insulin. Cholinga chake ndikuti shuga azikhala nthawi zonse m'magazi a wodwala. Mankhwala apulogalamu yamakono apanga mitundu ingapo ya insulini, yomwe imawonetsedwa ndi kutalika kwa ntchito yawo. Chifukwa chake, pali mitundu isanu ya mahormoneyi kuchokera ku ultrashort mpaka kuchitapo kanthu kwa nthawi yayitali.

Kodi

Insulin ndi mahomoni opangidwa ndi maselo a beta a kapamba. Pakuthamanga kwa chiyambi cha zotsatira zake komanso nthawi yayitali, agawika magawo ang'ono: aafupi, a ultrashort, mankhwala osokoneza bongo apakati komanso nthawi yayitali. Madokotala amalembera chithandizo, mtundu wa mankhwala ndi mlingo, kutengera mtundu wa wodwalayo, kuopsa kwa matendawa, zikuwonetsa kuyesedwa kwa ma laboratori.

Amadziwika ngati mwadzidzidzi insulinomwe amayamba kuchita mwachangu kwambiri, ndiye kuti, amatha kuchepetsa kwambiri kuchuluka kwa shuga m'magazi.

Kuchuluka kwa achire kwambiri komwe ma insulin akuwonetsa kukulembedwera theka la ola pambuyo pothandizidwa ndi mahomoni.

Chifukwa cha jakisoni, kuchuluka kwa shuga kumasinthidwa kukhala milingo yovomerezeka, ndipo mkhalidwe wa odwala matenda ashuga umakhala bwino. Komabe yochepa kuchita insulin imatulutsidwa msanga mthupi - mkati mwa maora 3-6, omwe shuga wowonjezera nthawi zonse amafuna kugwiritsa ntchito mankhwalawa kwa nthawi yayitali.

Kugawa kwa mahomoni nthawi yayitali

Poyambirira yochepa kuchita insulin adapangidwira odwala omwe amatha kuphwanya zakudya zomwe adokotala adapereka - kuti adye zakudya zomwe zimapezeka m'mimba mosavuta. Masiku ano njira zake zimakhala bwino ndipo zimagwiritsidwa ntchito ngati mankhwalawa amachokera ku mtundu woyamba wa shuga 1, makamaka ngati wodwala watuluka m'magazi a shuga atatha kudya.

ICD yothamanga kwambiri-yayitali ndi chinthu chowoneka bwino chomwe chimayamba kugwira ntchito nthawi yomweyo. Chifukwa chake kwenikweni insulin atamwa, amatha kukhala ndi vuto (kuchepetsa kuchuluka kwa shuga m'magazi) mphindi imodzi yokha. Pafupifupi, ntchito yake imatha kuyamba mphindi 1 - 20 pambuyo pa kukhazikitsa. Kuchuluka kwake kumatheka pambuyo pa ola limodzi, ndipo nthawi yowonekera imasiyana kuchokera maola atatu mpaka asanu. Ndikofunikira kwambiri kudya mwachangu kuti muchepetse hyperglycemia.

Kuthamanga kwambiri insulin yochepaMankhwala Ofunika:

Zamakono kudya insulin, komanso ultrashort, ili ndi mawonekedwe owonekera. Amadziwika ndi pang'onopang'ono - kuchepa kwa shuga m'magazi kumadziwika kuti theka la ola mutatha kukonza. Zotsatira zazifupi kwambiri zimatheka pambuyo pa maola 2-4, komanso nthawi yovumbulutsidwa ndi thupi ndikutali - imagwira ntchito kwa maola 6-8. Ndikofunika kwambiri osadyetsa theka la ola pambuyo insulin yochepa alowa mthupi.

Kutalika kwa insulin yochepa kwa maola 6 mpaka 8

Njira zofulumira zolimba za ultrashort:

Zojambula

Anthu onse ndi osiyana, motero insulini imatha kukhala ndi zotsatira zosiyana mthupi. Komanso nthawi yakukwaniritsa zomwe zikuwonetsa kuchuluka kwa shuga ndikukhazikitsa mankhwala zimatha kusiyanasiyana mosiyanasiyana. Kupambana kwakukulu kumakhala ndi ma insulin, omwe amawonjezeredwa nthawi yayitali. Komabe, zimatsimikiziridwa kuti insulin yochepa Sichotsika mulingo wamba komanso nthawi yayitali molingana ndi kugwiritsa ntchito bwino kwa njira zochizira. Koma wodwala aliyense ayenera kukumbukira kufunika ko kutsatira zakudya komanso zolimbitsa thupi.

Njira yolondola kwambiri yomwe imayambitsidwa m'thupi insulin yochepa, monga ultrashort, ndi jakisoni m'mimba. Chimodzi mwazinthu zazikulu ndi kudya kwa mahomoni m'magazi nthawi yomweyo asanadye. Monga momwe malangizo amagwiritsidwira ntchito, jakisoni wa mankhwalawa ayenera kukhala mphindi 20-30 asanadye. Mphamvu ya mankhwalawa imadalira bwino chakudya.

Pambuyo ochita zinthu zazifupi Lowani m'magazi, munthu ayenera kudya, apo ayi kuchuluka kwa shuga kumatha kutsika kwambiri, zomwe zimayambitsa hypoglycemia.

Chiwerengero cha jakisoni patsiku

Odwala ambiri amangofunika jakisoni imodzi patsiku. Monga lamulo, izi ndizovuta zazitali komanso zazitali za insulin, komanso othandizira (kuphatikizapo ultrashort ndi mahomoni apakati). Zotsirizirazi ndizabwino kwambiri, chifukwa zimaphatikizira insulin mwachangu komanso mankhwala omwe amakhala nthawi yayitali.

Kwa odwala matenda ashuga, jakisoni imodzi patsiku sikokwanira. Mwachitsanzo, m'malo ovuta kwambiri, monga kuyenda kwa ndege, chakudya chosasankhidwa mu malo odyera, ndi chifukwa chake amagwiritsa ntchito zida zoyankhira mwachangu. Komabe, ali ndi zovuta zina chifukwa chosadalirika - amachita zinthu mwachangu kwambiri komanso posachedwa ndipo atulutsidwa m'thupi mwachangu. Chifukwa chake, adotolo ayenera kuyikira dongosolo la mankhwalawa, motsogozedwa ndi kafukufuku wa zasayansi yantchito.

Choyamba, zindikirani mulingo wa kusala kudya kwa glycemia, kusinthasintha kwake masana. Muyeneranso kuchuluka kwa glucosuria pamphamvu, masana. Pambuyo pa izi, mankhwala amathandizidwa, omwe, motsogozedwa ndi kuchuluka kwa kuchepa kwa hyperglycemia ndi glucosuria, amatha kusintha malingana ndi Mlingo. Ndikotheka kutsitsa hypoglycemia mwa kubaya glucagon m'matumbo kapena subcutaneally.

Odwala matenda ashuga ayenera kudziwa zizindikiro za hypoglycemia kuti izi zitheke pakapita nthawi

Mavuto

Vuto lodziwika bwino lomwe limagwiritsidwa ntchito pochotsa matenda a shuga ndi hypoglycemia (kuchepa kwambiri kwa shuga m'magazi), omwe angadziwike chifukwa chopereka milingo yayikulu ya mankhwalawa kapena kudya mafuta okwanira mu chakudya.

Mkhalidwe wa hypoglycemic umaonekera kwambiri: wodwalayo ayamba kunjenjemera, pali kugunda kwamtima, nseru, kumverera kwanjala. Nthawi zambiri wodwalayo amadzimva kuti wamva milomo ndi lilime.

Ngati simukuletsa izi mwachangu, ndiye kuti wodwalayo atha kuzindikira, akhoza kuyamba kudwala. Amayenera kusintha matenda ake mwachangu: kudya zakudya zotsekemera, kumwa shuga pang'ono, kumwa tiyi wokoma.

Zotsatira ndi kusintha kwamphamvu kwa thupi

Mankhwala amakono kuti athetse dongosolo la endocrine samabweretsa zotsatira zoyipa kapena chifuwa. Komabe, zinthu zotere ndi kuphwanya malamulo ndizotheka:

• Chimodzi mwazomwe chimawonekera kwambiri ndi matenda apakhungu omwe amayamba chifukwa cha ziwengo ndi insulin.
• Zowonongeka zowoneka zimatha kumayambiriro kwenikweni kwa mankhwala a insulin, amatha kudzimiririka okha pakatha milungu iwiri.
• Edema, yomwe imathanso kuoneka m'masiku oyamba a chithandizo, imangokhala yokha.
• Zotsatira zoyipa zochepa zomwe zimaphatikizidwa ndi lipodystrophy zomwe zimapezeka patsamba la jakisoni angapo. Pali lipoatrophy, yomwe imawonetsedwa ndi kusintha kwa dystrophic mu subcutaneous adipose minofu, ndi lipohypertrophy - kukula kwambiri kwamafuta a subcutaneous. Pofuna kupewa zoterezi, malangizo ogwiritsa ntchito amalimbikitsa kusintha malo a jakisoni pafupipafupi.
• Zomwe zimachitika mdelalo (kuyimitsa kodetsa nkhuni, kuwoneka kwa mayina obisika, zotupa zam'deralo) zitha kuchitika chifukwa chosakwanira kuyeretsa chinthucho kuchokera ku zodetsa. Nthawi zambiri, mavuto oterewa amachitika mukamagwiritsa ntchito mankhwala ozikidwa pa insulin ya nyama, bovine kapena porcine.

Ngati zovuta zoyipa zimachitika mwatsatanetsatane, tikulimbikitsidwa kuti m'malo mwa mankhwalawa pakhale kuphatikizidwa ndi mankhwala a anthu omwe amapezeka munthawi yochepa.

Aliyense amene wapezeka ndi matenda ashuga ayenera kugwira ntchito ndi anthu omwe amapezeka ku endocrinologist, osasintha udindo wawo pakakhala thanzi. Choyamba, muyenera kudya moyenera, kudziwa kuwerengera kwake kwa mankhwalawa, kudziwa mayeso am'magazi anu, kuchita masewera olimbitsa thupi, kuchita masewera osemphana ndi mankhwala omwe dokotala wakupatsani.

Insulin yochepa ya shuga

Insulin yochepa imalowetsedwa m'thupi mphindi 30 mpaka 40 asanadye, pambuyo pake odwala matenda ashuga ayenera kudya. Pambuyo pokonzekera insulin, kudumpha chakudya sikuloledwa. Wodwalayo amasankha nthawi yeniyeni payekha payekha, kuganizira mawonekedwe a thupi, njira ya matenda ashuga komanso mtundu wa chakudya.

Ndikofunikira kutsatira malamulo onse omwe adokotala adapereka, chifukwa mtundu waufupi wa insulin uli ndi zochitika zake zapamwamba, zomwe ziyenera kugwirizana ndi nthawi yowonjezereka m'magazi a wodwalayo atatha kudya.

Ndikofunikanso kudziwa kuti mulingo wa chakudya womwe umamwetsa nthawi yomweyo, kotero kuti mulingo wa insulin womwe umayendetsedwa unkawerengedwa ndipo umatha kulipirira kuchepa kwa mahomoni.

Kuperewera kwa insulin kungayambitse kuchuluka kwa shuga m'magazi, ndipo kumwa kwambiri, m'malo mwake, kumachepetsa kwambiri shuga. Zosankha zonse ziwirizi ndizosavomerezeka, chifukwa zimabweretsa zotsatira zoyipa.

Nthawi zambiri amathandizidwa ndi odwala matenda ashuga ngati kuchuluka kwa glucose wawo atakwera atatha kudya. Ndikofunikira kuti odwala amvetsetse kuti zotsatira za insulin yochepa ndizambiri nthawi zambiri kuposa nthawi yowonjezereka ya shuga pambuyo podya.

Pachifukwa ichi, odwala matenda ashuga ayenera kukhala ndi zina zowonjezera pakatha maola atatu kapena atatu pambuyo pa kuperekedwa kwa insulini kuti abwezeretse shuga m'magazi abwinobwino ndi kupewa kukula kwa hypoglycemia.

Momwe mungapangire insulin yochepa

• Mosasamala mtundu wa insulin yocheperako yomwe imaperekedwa, wodwalayo ayenera kumangopereka chakudya chisanachitike.
• Insulin yochepa imakhala bwino ngati itengedwa pakamwa, zomwe zimakhala zopindulitsa kwambiri komanso zotetezeka kwa odwala matenda ashuga.
• Kuti mankhwala obayidwa azilowetsedwa mofananamo, sikofunikira kuti muthetsere jekeseni malo osungirako musanapereke insulin yayifupi.
• Mlingo wa insulin yochepa umayikidwa palokha. Potere, achikulire amatha kulowa magawo 8 mpaka 24 patsiku, ndipo ana osaposa magawo 8 patsiku.

Kuti wodwala azitha kuwerengera payokha kuchuluka kwa mahomoni omwe amaperekedwa, pali zomwe zimatchedwa insulin. Mlingo umodzi wa insulin waifupi umakhala ndi mlingo womwe umawerengeredwa kuti umalowe pachakudya, ndi mlingo wochepetsera shuga. Pankhaniyi, zigawo zonse ziwiri ziyenera kukhala zofanana ndi zero.

• Ngati kuchuluka kwa shuga m'magazi opanda kanthu ndikwabwinobwino, pamenepa, gawo lachiwiri, lomwe limapangidwa kuti muchepetse shuga, lidzakhala zero. Mtengo woyamba udzatengera kuchuluka kwa mikate yomwe amakonza kudya ndi chakudya.
• Ngati magazi a shuga ali pamimba yopanda kanthu ndikufanana ndi 11.4 mmol / lita, pamenepa, mlingo wochepetsera shuga ukhale magawo awiri. Mlingowo amawerengedwa potengera kuchuluka kwa chakudya chomwe chimakonzedwa kuti muzidya ndi chakudya, kuganizira kwambiri za kulakalaka.
• Ngati wodwala matenda ashuga ali ndi malungo chifukwa cha chimfine, mtundu wochepa wa insulin nthawi zambiri umaperekedwa mu mlingo womwe umapangidwira malungo afupiafupi. 10 peresenti ya tsiku ndi tsiku mlingo ndi magawo anayi kuphatikiza mlingo wa mkate woti adyedwe.

Mitundu ya Insulin Yafupifupi

Masiku ano m'masitolo apadera mutha kupeza mitundu yambiri ya insulin, kuphatikizapo:

Ndikofunika kumvetsetsa kuti posankha insulin yayifupi yomwe yapezeka kuchokera ku kapamba a nyama, nthawi zina, zotsatira zoyipa zimawonedwa chifukwa chosagwirizana ndi thupi la munthu.

Osatengera mtundu wa insulin yomwe idasankhidwa, mlingo wake uyenera kuyang'aniridwa mosamala.

Muyenera kugwiritsa ntchito kaimidwe ka insulin pafupipafupi, sinthani malo a jakisoni ndikutsatira malamulo osungira ndikugwiritsa ntchito insulin yayifupi.

Kugwiritsa ntchito insulin kuti muchepetse shuga

Magazi a wodwala amatha kuchuluka chifukwa cha zifukwa zosiyanasiyana. Ngati wodwala matenda ashuga ali ndi shuga wamagazi opitirira 10 mmol / lita, makonzedwe owonjezera a insulin amafunika.

Pofuna kuti zisamayende bwino, pali tebulo lapadera la odwala matenda a shuga, omwe amawonetsa kuchuluka kwa insulin pazomwe zikuwonetsa shuga.

Musanatenge njira zofunikira kuti shuga akhale magazi, muyenera kupenda chifukwa chowonjezeka cha shuga m'magazi. Simungachepetse shuga mwachangu kwambiri komanso muyezo waukulu. Kugwiritsa insulin kwambiri kungangovulaza thanzi, kumapangitsa kutsika kwakukulu kwa shuga m'magazi. Pambuyo pake, shuga amawonjezereka kwambiri ndipo wodwalayo adzakumana ndi kudumpha kwa shuga.

Ngati magazi a glucose apamwamba kuposa 16 mmol / lita, sikofunikira kuti muwonjezere kuchuluka pamwambapa komwe kukuwonetsedwa pagome. Ndikulimbikitsidwa kuyambitsa mtundu waifupi wa insulini pamiyeso ya ma unit 7, pambuyo pake, atatha maola anayi, shuga wa shuga ayenera kuyesedwa ndipo ngati kuli koyenera, mahomoni ochepa amayenera kuwonjezeredwa.

Ngati kuchuluka kwa shuga m'magazi kumakhala kokwezeka kwa nthawi yayitali, muyenera kufunsa dokotala ndikuyesa mayesowo a mkodzo kukhalapo kwa matupi a ketone. Makamaka, zingwe zoyeserera zitha kugwiritsidwa ntchito kuti mupeze ma acetone mu uriket urine. Kuyesa shuga mu mkodzo, timizere tofanana ta Urigluk timagwiritsidwa ntchito.

Kukhazikitsidwa kwa insulin yochepa ndi acetone mu mkodzo

Acetone mumkodzo amatha kudzikundikira pakakhala kusowa kwa chakudya m'zakudya zomwe zimadyedwa, maselo atasowa mphamvu ndipo amagwiritsa ntchito mafuta ngati mafuta.

Pakusweka kwamafuta mthupi, kupanga matupi owopsa a ketone, omwe amatchedwanso acetone, kumachitika. Nthawi yomweyo, shuga wamwazi amatha kutsika ndipo nthawi zambiri amatsika pansi pazovuta.

Ndi shuga wambiri komanso kupezeka kwa acetone mthupi, kusowa kwa insulin m'magazi kumawonedwa. Pachifukwa ichi, wodwala matenda ashuga ayenera kupereka nthawi yomweyo 20% ya tsiku lililonse la insulin yochepa.

Ngati maola atatu mutatha kuperekera mahomoni, kuchuluka kwa shuga m'magazi kumakhalabe okwera komanso acetone imakwezedwa, muyenera kubwereza njirayi maola atatu aliwonse.

Chowonadi ndi chakuti acetone amawononga insulin mwachangu, kutsekereza momwe zimakhudzira thupi. Ngati kuchepa kwa shuga m'magazi kwa 10-12 mmol / lita, muyenera kulowa mulingo woyenera wa insulin ndikudya zakudya zopatsa thanzi, pambuyo pake wodwala amabwerera ku regimen yake yovomerezeka. Acetone imatha kukhalabe m'thupi kwakanthawi, koma ndikofunikira kuwunika kuchuluka kwa shuga m'magazi ndikusintha shuga momwemo.

Ndi kutentha kowonjezera

Ngati munthu wodwala matenda ashuga akudwala matenda opitirira madigiri 37,5, muyenera kuyeza shuga m'magazi ndikuwonjezera mlingo wa insulin yochepa. Nthawi yonse ya kusintha kwa kutentha, insulini iyenera kuperekedwa musanadye.Pafupifupi, mlingo uyenera kuwonjezeka ndi 10 peresenti.

Ndi kuwonjezeka kwa kutentha kwa thupi mpaka madigiri 39 ndi kupitirira apo, Mlingo wa insulin tsiku lililonse umachuluka ndi 20-25 peresenti. Nthawi yomweyo, palibe nzeru kubaya insulin yayitali, chifukwa imayamba kuwola mwachangu chifukwa cha kutentha kwambiri.

Mlingo wake uyenera kugawidwa tsiku lonse ndikuwathandizira pambuyo pa maola 3-4. Zitatha izi, muyenera kudya chakudya chamafuta ochepa, mpaka kutentha kwa thupi kumabwerera kwazonse. Acetone ikawoneka mkodzo, ndikofunikira kusinthira ku insulin yofotokozedwa pamwambapa.

Chitani masewera Olimbitsa Thupi Mwachidule

Ngati glucose wa magazi ndi woposa 16 mmol / lita, ndikofunikira kupanga zonse kuti thupi lanu lizisintha. Pambuyo pokhapokha izi, zolimbitsa zolimbitsa thupi zimaloledwa. Kupanda kutero, izi zitha kubweretsa kuwonjezeka kowopsa kwa shuga m'magazi.

Ndi kuchuluka kwa shuga m'magazi mpaka 10 mmol / lita, maphunziro akuthupi, m'malo mwake, amathandizira kuchepetsa kuchuluka kwa shuga m'thupi. Kuchita masewera olimbitsa thupi mopitirira muyeso kumatha kuyambitsa hypoglycemia. Ngati zolimbitsa thupi ndizakanthawi kochepa, tikulimbikitsidwa kuti musasinthe Mlingo wa insulin, koma kudya chakudya champhamvu kwambiri theka lililonse la ola.

Ngati mukufuna kuchita masewera olimbitsa thupi kwa nthawi yayitali, insulini imachepetsedwa ndi 10-50 peresenti, kutengera mphamvu komanso nthawi yayitali yamasukulu. Ndikulimbitsa thupi kwanthawi yayitali, kuwonjezera pakanthawi kochepa, insulin yambiri imachepera.

Ndikofunika kukumbukira kuti mutatha kuchita masewera olimbitsa thupi, shuga wambiri amatha kuwonjezera pakatha masiku awiri kapena atatu. Pachifukwa ichi, muyenera kusintha kuchuluka kwa insulini yoyendetsedwa, pang'onopang'ono kubwerera ku regimen yokhazikika ya mahomoni.

Mitundu ya insulin mwanjira yoyambira

Pazaka zingapo zakhala zikuchitika kuti pakhale insulin Therapy, magulu angapo achilengedwe a chinthu chodabwitsachi apangidwa, omwe amasiyanasiyana mwachangu pakuwonekera kwa thupi.

Izi ndi insulin zokonzekera izi:

• mtundu wa ultrashort
• mtundu wamfupi
• zochita zapakati
• kuchitapo kanthu kwa nthawi yayitali
• kuphatikiza.

Aliyense wa iwo amagwiritsidwa ntchito mosiyanasiyana madwala.

Insulin imapezeka m'njira zosiyanasiyana:

1. Kuchokera pamatumba a nkhumba - Monodar ultralong kapena Insulrap SPP.
2. Kuchokera ku maselo a bovine - Insulrap GLP kapena Ultralente.
3. Okonzanso chibadwa.

Mtundu wotsiriza wopangidwa ndi mankhwalawa amadziwika kuti ndiwovomerezeka kwambiri malinga ndi bioavailability komanso kusowa kwa zotsatira zoyipa, umapezeka mu mawonekedwe a insulin pansi pazina izi:

• Khalid
• Novorapid
• Lantus
• Insulin humulin,
• Insulin Humalog,
• Insulin Novomix,
• Protafan.

Pa mabokosi opanga mankhwala azilemba NM, komanso za nyama - MS.

Gwiritsani ntchito pa nthawi yoyembekezera

Chithandizo cha Actrapid chololedwa ngati wodwala ali ndi pakati. Nthawi yonseyi, ndikofunikira kuti mulamulire kuchuluka kwa shuga ndikusintha mlingo. Chifukwa chake, mkati mwa trimester yoyamba, kufunika kwa mankhwalawa kumachepa, panthawi yachiwiri ndi yachitatu - motsutsana, imawonjezeka.

Pambuyo pobereka, kufunikira kwa insulin kumabwezeretsedwera pamlingo womwe unali usanakhale ndi pakati.

Panthawi ya mkaka wa m'mawere, kuchepetsa mankhwala kungakhale kofunikira. Wodwala amafunika kuwunika mosamala kuchuluka kwa shuga kuti magazi asatayike panthawi yomwe kufunika kwa mankhwala kumakhazikika.

Amaloledwa kugwiritsidwa ntchito panthawi yoyembekezera komanso atabereka mwana, popeza mankhwalawo ndi otetezeka thupi la mwana. Amayi omwe ali mu trimester yoyamba, kufunika kwa insulin kumatha kuchepa, pomwe m'miyezi yotsatira, nthawi zambiri amadzuka. Chithandizo chikuyenera kuchitika moyang'aniridwa ndi adokotala. Matenda a hypoglycemia ndi owopsa kwa mwana.

Zizindikiro zosokoneza bongo

Mankhwala osokoneza bongo amatsogolera pakukula kwa hypoglycemia kapena hypoglycemic coma.

Zizindikiro zake ndi:

• njala
• kufooka
• chinyezi cha pakhungu
• womvera
• kupuma movutikira
• ukali ndi kusokonekera,
• chizungulire
• mutu
• kupulumuka
• palpitations
• kunjenjemera miyendo
• kukokana
• kulephera kudziwa.

Nthawi zambiri, odwala omwewo amawona zoyamba za matenda a hypoglycemic ndipo amatha kuchitapo kanthu: amamwa tiyi wokoma, msuzi, kudya maswiti kapena chidutswa cha shuga. Ngati izi sizichitika, m'nthawi yochepa kwambiri yomwe munthu wagwa. Pankhaniyi, ndikofunikira kupereka chithandizo chamankhwala mwadzidzidzi mu mawonekedwe a intravenous makonzedwe a 40% a shuga komanso kuchipatala kwa wodwala.

Mankhwala ochita mwachidule

Mwa mankhwala a gulu la insulin omwe amangokhala pang'ono, othandizira awa ndi omwe amadziwika:

• Insuman Rapid,
• Humulin Wokhazikika,
• Insulin Solubis,
• Khalid
• Gensulin R.

Insulin yosavuta imachita motere:

• kuyamba kwa theka la ola pambuyo pa utsogoleri,
• kuchuluka kwa ndende m'magazi pambuyo pa maola 2,5,
• Kutalika kwa ntchitoyo ndi pafupifupi 1/4 masiku.

ICD imagwiritsidwa ntchito mwa odwala omwe ali ndi shuga ambiri atatha kudya komanso mwa mankhwala okha.

Kuyanjana kwa mankhwala osokoneza bongo

Mwa mayina omwe amapezeka kwambiri pakukonzekera insulini mu endocrinology, zotsatirazi zitha kusiyanitsidwa:

• Lizpro Humalog,
• Aspart Novorapid,
• Glulisin Apidra.

Mphamvu ya kapangidwe kake ka mankhwalawa imatengera magawo awa:

1. Kuyambika kwa kudya kwa insulin m'mwazi mu mphindi 15 zoyambirira.
2. Pachimake pantchitoyo chimafika patatha ola limodzi ndi theka.
3. Mchitidwewu umatha kwa masiku 1/6.

Nthawi zambiri mtundu wa insulin wa ultrashort umagwiritsidwa ntchito kukonza zinthu zosiyanasiyana:

1. Kuchuluka kwa shuga m'magazi m'maganizo.
2. Mwanjira ya anabolic ya othamanga.
3. Ndi kutopa kwambiri.
4. Ndi hyperthyroidism.
5. Kuwongolera mamvekedwe am'mimba.
6. Pofuna kukonza hepatitis ndi matenda enaake.
7. Monga gawo la mankhwala kukonza mtima.

Insulin ya nthawi yayitali imayimiriridwa ndi zinthu izi:

• Insuman Bazal,
• Humulin NPH,
• Humodar br
• Insulin Novomix,
• Protafan.

Amachita motere:

1. Kuyamba kwa ntchito patatha maola atatu.
2. Peak pachimake pamachitika pa ola la chisanu ndi chimodzi.
3. Kutalika kwa kukhalapo kwa thupi la munthu kumafika pakati pa tsiku.

Osamayendetsa limodzi ndi ma insulini ena.

Zinthu zomwe zingalimbikitse mphamvu ya mankhwalawa:

• mankhwala akumwa a hypoglycemic,
• bromocriptine
• MAO, ATP ndi kaboni anhydrase inhibitors,
• sulfonamides,
• osasankha beta-blockers,
• anabolic steroids
• octreotide
• ketoconazole,
• pyridoxine
• cyclophosphamide,
• manzeru
• onjezerani
• Kukonzekera kwa lifiyamu
• mebendazole,
• fenfluramine,
• theofylline
• kukonzekera kokhala ndi Mowa.

Malangizo ogwiritsira ntchito mankhwalawa

Malangizo ogwiritsira ntchito mankhwalawa akuwonetsa kuti Mlingo uyenera kuwerengera kutengera mtundu wa glycemia. Ngati ndi kotheka, mankhwalawa amaperekedwa limodzi ndi ma insulin omwe amakhala nthawi yayitali, kapena mankhwala amkamwa a sulfonylurea.

Jakisoni amachitidwa mosazindikira m'malo oterowo a thupi la wodwalayo:

Masamba a jakisoni ayenera kusinthidwa kuti asagwiritsidwe ntchito koposa nthawi 1 pamwezi. Osapereka jakisoni m'malo omwe muli mitsempha yamagazi yomwe ili pafupi kwambiri.

Anthu omwe ali ndi vuto la kuchepa kwa magazi ndi impso amatha kukhala ndi insulini yambiri komanso kufunikira kwake. Izi zimafuna kuwunika pafupipafupi kwa glycemia komanso kukonza kwa nthawi yake.

Pepala la Humalog syringe (Humapen) tsopano likupezeka; ndi losavuta kugwiritsa ntchito. Pali zosankha zingapo zamtunduwu, zochepa kwambiri zimamaliza mayunitsi 0,5.

Njira zoterezi zikugulitsidwa:

1. Humapen Luxura. Chogulitsirachi chimakhala ndi skrini yamagetsi yomwe imawonetsa nthawi ya jakisoni womaliza komanso kukula kwa mlingo womwe waperekedwa.
2. Humapen Ergo. Chogwirira bwino ndi mulingo woyenera wa mtengo ndi mtundu.

Insulin Lizpro, ndi cholembera cha syapinge cha Humapen amagulitsidwa pamtengo wokwanira ndipo amawunikira zabwino.

Mlingo wake umasankhidwa ndi katswiri wozikidwa pazowunikira ndi zosowa za thupi la insulin.

"Rinsulin P" imayendetsedwa mosavuta, mkati kapena m'mitsempha mphindi 30 asanadye. Ndi monotherapy, jakisoni amawonetsedwa katatu patsiku, malinga ndi zosowa zapadera, dokotala amatha kuwonjezera kuchuluka kwa jakisoni mpaka zisanu ndi chimodzi.

Gulu la mankhwala "NPH" limayendetsedwa kokha.

Masamba a jakisoni amatha kutulutsidwa m'malo awa:

• m'chiuno
• matako
• m'mimba (khoma lakunja kwamkati),
• mapewa.

Ndikofunikira nthawi zonse kusintha mfundo za jakisoni kuti mupewe lipodystrophy. Ndikofunikira kuphunzitsa wodwalayo kasamalidwe koyenera ka mankhwalawo, kuti asalowe mumtsempha wamagazi.

Mankhwala omwe akutsatiridwa ayenera kukhala otentha kwambiri.

Contraindication

Matenda akuluakulu omwe insulin imayikidwa ndi matenda a shuga. Imapezeka m'mitundu ingapo: matenda ashuga amtundu woyamba (wodalira insulini) komanso wachiwiri (insulin-Independent).

Mu mtundu woyamba wa matenda ashuga, kugwiritsa ntchito timadzi tamankhwala kumakhala kofunikira, chachiwiri - monga momwe dokotala akunenera, mwachitsanzo, ngati pali shuga wotsogola wokhala ndi shuga wambiri m'magazi, omwe sangachepetsedwe ndi mapiritsi ochepetsa shuga.

Zizindikiro zina zogwiritsidwa ntchito:

• ketoacidotic zinthu
• chiwindi ndi chiwindi matenda a chiwindi,
• matenda apakhungu amkhungu,
• chikanga
• ziphuphu,
• psoriasis
• Matenda a chithokomiro,
• cachexia
• schizophrenia
• uchidakwa.

Lizpro biphasic insulin idapangidwa pogwiritsa ntchito ukadaulo wa DNA. Kuchita ndi receptor ya nembanemba wa cytoplasmic wa maselo kumachitika, insulin-receptor tata imapangidwa, yomwe imalimbikitsa njira mkati mwa maselo, kuphatikizapo kaphatikizidwe ka michere yofunika.

Kuchepa kwa kuchuluka kwa shuga m'magazi kumafotokozedwa ndikuwonjezereka kwa kayendedwe kake ka intracellular, komanso kuwonjezeka kwa mayamwidwe ndikulowetsa maselo. Shuga amatha kuchepa chifukwa chakuchepa kwa kuchuluka kwa kapangidwe kake ka chiwindi kapena kukondoweza kwa glycogenogeneis ndi lipogenesis.

Lyspro insulin ndi mtundu wina wa DNA womwe umasiyananso m'njira zotsalira za lysine ndi proline amino acid pamalo a 28 ndi 29 a insulin B. Mankhwalawa ali ndi 75% protamine kuyimitsidwa ndi 25% lyspro insulin.

Mankhwalawa ali ndi zotsatira za anabolic komanso malamulo a shuga. Mu minofu (kupatula minofu ya muubongo), kusintha kwa glucose ndi ma amino acid mu cell kumathandizira, zomwe zimapangitsa kuti glycogen ipangidwe ndi shuga mu chiwindi.

Mankhwalawa amasiyana ndi ma insulin ochiritsira omwe amapezeka mwachangu pakuthamanga kwa thupi ndi zotsatira zoyipa zochepa.

Mankhwalawa amayamba kuchita pambuyo pa mphindi 15, chifukwa cha kuyamwa kwambiri. Chifukwa chake, chitha kuperekedwa kwa mphindi 10-15 chakudya chisanafike. Insulin yokhazikika imayendetsedwa osakwana theka la ola.

Kuchuluka kwa mayamwidwe kumakhudzidwa ndi tsamba la jakisoni ndi zina. Pachimake pazochitikazo zimawonedwa mu maola 0,5 - 2,5. Insulin Lizpro amachita kwa maola anayi.

Lizpro insulin mmalo amasonyezedwa kwa anthu odwala mtundu 1 shuga, makamaka vuto la insulin. Kuphatikiza apo, imagwiritsidwa ntchito pazinthu zotere:

• postprandial hyperglycemia,
• subcutaneous insulin kukana mu pachimake mawonekedwe.

Mankhwalawa amagwiritsidwanso ntchito ngati mtundu wachiwiri wa matenda osokoneza bongo omwe amatsutsana ndi hypoglycemic.

Lizpro insulin imatha kupatsidwa mankhwala omwe amalumikizana nawo.

Insulin Lizpro ali ndi zotsutsana zotsatirazi:

• tsankho
• achina,
• insulinoma.

Kusalolera kumafotokozedwa munthawi yomweyo:

1. urticaria
2. angioedema ndi malungo,
3. kupuma movutikira
4. kutsitsa magazi.

Maonekedwe a hypoglycemia amawonetsa kuti kuchuluka kwa mankhwalawa amasankhidwa molakwika kapena kulakwitsa ndiko kusankha kolakwika komwe akukhala kapena njira ya jakisoni. Mtundu wa insulin suyenera kuperekedwa kudzera m'mitsempha, koma modumphira.

Nthawi zina mankhwalawa amatha.

Lipodystrophy imapangidwa ngati jakisoni wongoganiza unapangidwa molakwika.

Zizindikiro zotsatirazi za mankhwala osokoneza bongo amasiyana siyana:

• ulesi
• thukuta
• kugunda kwamtima
• njala
• nkhawa
• paresthesia mkamwa,
• khungu
• mutu
• kunjenjemera
• kusanza
• kuvutika kugona
• kusowa tulo
• Kukhumudwa
• kusakhazikika
• machitidwe osayenera
• zovuta zowoneka ndi zolankhula,
• glycemic chikomokere
• kukokana.

Ngati munthu akudziwa, ndiye kuti dextrose mkatimo akuwonetsedwa. Glucagon imatha kutumikiridwa kudzera m'mitsempha, subcutaneous ndi intramuscularly. Pamene hypoglycemic coma ikapangidwa, mpaka 40 ml ya 40% dextrose solution imayendetsedwa kudzera m'magazi. Kuchiza kumapitirira mpaka wodwalayo atatuluka.

Nthawi zambiri, anthu amalekerera Insulin Lizpro popanda zotsatira zoyipa.

Nthawi zina, phwando limatha kusiyanasiyana ndikuchepa kwa magwiridwe antchito.

• Matenda a shuga a mtundu woyamba ndi wachiwiri.
• Matenda a shuga panthawi yoyembekezera.
• Momwe kuvomerezedwa kwa kagayidwe kazakudya kwa anthu odwala matenda ashuga.

• Hypersensitivity pamagawo a mankhwala.
• Hypoglycemia.

Mtengo ndi fanizo la mankhwala

Pakadali pano, Insulin Lizpro imagulitsidwa pamtengo wa 1800 mpaka 2000 rubles.

Mtundu wina wa insulin yakunja ndi insulin aspar.

Ndikofunikira kukumbukira kuti simungagwiritse ntchito Insulin Lizpro pamtundu wa kusankha pawokha. Mankhwalawa amayenera kumwedwa pokhapokha ataikidwa ndi adokotala. Mlingo nawonso ndiudokotala.

Kufotokozera ndi malamulo ogwiritsa ntchito Lizpro insulin zimaperekedwa mu kanema munkhaniyi.

"Rinsulin R" mu botolo la 10 ml umawononga ma ruble 470. "Rinsulin NPH" - ma ruble 530. Makatoni - kuchokera ku ma ruble a 1000.

Ndemanga Zahudwala

Victoria, wazaka 38. Ndine wodwala matenda ashuga.

Kwa nthawi yayitali, madokotala samatha kupeza insulin yoyenera, shuga anali akudumphira mosalekeza, zomwe zimayambitsa mavuto ndi masomphenya, impso ndi ziwalo zina. Chaka chapitacho, adotolo adamuwuza Antrapid.

Ndayiwala za zovuta za hypoglycemia, tsopano chinthu chachikulu ndikokwanira kudya osangokhala ndi zochita zolimbitsa thupi. Poyerekeza ndi kusanthula kwa glio, shuga samangokhala okhazikika, koma amakhalanso chimodzimodzi.

Mwambiri, mankhwalawa ali ndi mawunikidwe abwino. Odwala odwala matenda ashuga amafotokozera kusakhazikika, mtengo wokwanira komanso kuchita bwino. Koma ena amati insulini iyi sinawakwane.

Ochita zinthu mwachidule: mayina a mankhwala osokoneza bongo ndi njira yogwiritsira ntchito

Insulin ndi mahomoni omwe amapangidwa ndi ma cell a endocrine a kapamba. Ntchito yake yayikulu ndikusunga carbohydrate bwino.

Kukonzekera kwa insulini kumaperekedwa kwa odwala matenda ashuga. Vutoli limadziwika ndi kuperewera kwakwanira kwa mahomoni kapena kuphwanya kwake kuchitapo mu zotumphukira zimakhala. Mankhwala amasiyana mu kapangidwe ka mankhwala ndi kutalika kwa zotsatira zake. Mitundu yayifupi imagwiritsidwa ntchito kuchepetsa shuga yemwe wakudya ndi chakudya.

Insulin imalembedwa kuti imasinthasintha kuchuluka kwa shuga m'magawo osiyanasiyana a shuga. Zowonetsa kugwiritsa ntchito mahomoni ndi mitundu yotsatirayi yamatendawa:

• Mtundu woyamba wa shuga wokhudzana ndi kuwonongeka kwa autoimmune ku maselo a endocrine komanso kukula kwa kuperewera kwathunthu kwa mahomoni,
• Mtundu Wachiwiri, womwe umadziwika ndi kusowa kwa insulini chifukwa chakusokeka kaphatikizidwe kake kapenanso kuchepa kwa chidwi cha zotumphukira zake pakuchita kwake,
• matenda amishuga azimayi apakati
• kapamba mawonekedwe a matendawa, omwe amayamba chifukwa cha pancreatitis yovuta kapena yopweteka,
• mitundu yopanda chitetezo cha pathology - syndromes of Wolfram, Rogers, MODI 5, matenda a neonatal shuga ndi ena.

Kuphatikiza pa kuchepa kwa shuga, kukonzekera kwa insulin kumakhala ndi mphamvu ya anabolic - amathandizira pakukula kwa minofu ndikupanga mafupa. Katunduyu amagwiritsidwa ntchito pomanga thupi. Komabe, mu malangizo omwe angagwiritsidwe ntchito, chizindikirochi sichinalembetsedwe, ndipo kuyendetsa mahomoni kwa munthu wathanzi kumawopseza kuponya kwakuthwa kwa magazi - hypoglycemia. Zinthu zoterezi zimatha kutsatiridwa ndi kusokonezeka kwa chikumbumtima ndi imfa.

Kutengera njira yopangira, kukonzekera kwamtundu wa chibadwidwe ndi kufanana kwa anthu kumayesedwa. Kupanga kwamankhwala kumapeto kumakhala kwachilengedwe, chifukwa kapangidwe kazinthu kazinthu izi ndizofanana ndi insulin yaumunthu. Mankhwala onse amasiyana pakapita nthawi.

Masana, mahomoni amalowa m'magazi othamanga mosiyanasiyana. Secretion yake yoyambira imakupatsani mwayi wokhala ndi shuga wokhazikika mosasamala zakudya. Kutulutsa kwa insulin komwe kumachitika pakudya. Poterepa, kuchuluka kwa glucose omwe amalowa mthupi ndi zakudya zomwe zimakhala ndi zakudya zamafuta amachepetsa. Ndi shuga, njira izi zimasokonekera, zomwe zimabweretsa zotsatirapo zoyipa. Chifukwa chake, chimodzi mwazinthu zothandizira kuchiritsa matendawa ndikobwezeretsa mtundu woyenera wa kutulutsidwa kwa ma cell m'mwazi.

Katizidwe katemera wa insulin

Ma insulin omwe amagwira ntchito mwachidule amagwiritsidwa ntchito poyeserera katulutsidwe wamahomoni omwe amakhudzidwa ndi zakudya. Gawo lam'mbuyo limathandizira mankhwala omwe atenga nthawi yayitali.

Mosiyana ndi mankhwala othamanga kwambiri, mitundu yowonjezereka imagwiritsidwa ntchito mosasamala chakudya.

Gulu la insulin limafotokozedwa pagome:

Insulin yochita mwachidule ndi mahomoni enaake omwe amafunikira kuwongolera kuchuluka kwa shuga m'magazi. Imayambitsa ntchito ya magawo a kapamba nthawi yayifupi, ndipo imasungunuka kwambiri.

Mwachizolowezi, insulini yokhala ndi nthawi yochepa imaperekedwa kwa anthu omwe gawo lamtunduwu wa endocrine amatha kupangiratu timadzi tokha. Kuphatikizika kwakukulu kwa mankhwalawa m'magazi kumadziwika pambuyo pa maola awiri, kumachotsedwa kwathunthu m'thupi mkati mwa maola 6.

Mthupi la munthu, magawo amtundu wa kapamba ndi omwe amapanga insulin. Popita nthawi, ma cell a beta samatha kugwira ntchito zawo, zomwe zimapangitsa kuti magazi azikhala ndi shuga ambiri.

Insulin yochepa ikamalowa m'thupi, imayambitsa zomwe zimapangitsa kuti shuga azigwira. Izi zimathandiza kuti shuga asanduke shuga ndi mafuta. Komanso, mankhwalawa amathandizira kukhazikitsa mayamwidwe a shuga m'magazi a chiwindi.

Dziwani kuti mankhwala ngati amenewo mapiritsi sangabweretse mtundu uliwonse wa matenda ashuga 1. Poterepa, zigawo zomwe zimagwira zimagwera kwathunthu m'mimba. Pankhaniyi, jakisoni ndikofunikira.

Kuti musamavutike kuyendetsa ntchito ma syringes, ma syringes kapena mapampu a insulin amawaika. Insulin yofupikitsa imapangidwira zochizira matenda a shuga m'magawo oyamba.

Kuti chithandizo cha insulin chochepa chikhale chothandiza momwe mungathere, malamulo ena ambiri ayenera kutsatira:

• Kubaya jekeseni ndikofunikira musanadye.
• Jekeseni imaperekedwa pakamwa pofuna kupewa.
• Kuti insulini imamwidwe wogawana, tsamba la jakisoni liyenera kutetezedwa kwa mphindi zingapo.
• Kumbukirani kuti kusankha kwa mankhwala omwe ali ndi ntchito kuyenera kuperekedwa ndi adokotala okha.

Mlingo uliwonse wa insulin yochepa uyenera kuwerengera aliyense payekhapayekha. Kuti muchite izi, odwala ayenera kudziwa bwino ulamuliro. Mlingo umodzi wa mankhwalawa amapangira chakudya, chomwe ndi chofanana mumtengo umodzi.

Yesaninso kutsatira malangizo awa:

1. Ngati kuchuluka kwa shuga m'magazi ndikwabwinobwino, ndiye kuti kuchuluka kwake kwa mankhwalawa kuti muchepetse kukhala zero. Mlingo wa zomwe zimagwiritsidwa ntchito umatengedwa kutengera kuchuluka kwa mikate yomwe amafunika kukonzedwa.
2. Ngati mulingo wambiri wa glucose ndiwokwera kwambiri kuposa wabwinobwino, ndiye kuti pa gawo lililonse la mkate pazikhala ma insulin awiri. Pankhaniyi, muyenera kulowa nawo musanadye.
3. Panthawi ya matenda opatsirana kapena pakutupa, Mlingo wa insulin ukuwonjezeka ndi 10%.

Posachedwa, anthu adabayidwa pokhapokha ndi insulin yopanga, yomwe ili yofanana kwambiri ndi zochita za anthu. Ndiotsika mtengo kwambiri, motetezeka, sizoyambitsa mavuto. Ma hormone a nyama omwe adagwiritsidwa ntchito kale - omwe amachokera m'magazi a ng'ombe kapena nkhumba.

Mwa anthu, nthawi zambiri ankayambitsa mavuto osiyanasiyana. Insulin yokhala ndi nthawi yochepa imapangidwira kuti imathandizira kupanga zachilengedwe pancreatic insulin. Pankhaniyi, munthu ayenera kudya chakudya chokwanira kuti asataye mtima kwambiri m'magazi.

Ndizosatheka kunena mosasamala kuti ndi insulin yochepa ndiyiti yabwino. Dokotala m'modzi yekha ndiye ayenera kusankha izi kapena mankhwalawa. Adzachita izi ataphunziridwa mozama. Pankhaniyi, ndikofunikira kuganizira zaka, jenda, kulemera, kuuma kwa matendawa.

Ubwino wakutsata insulini yochepa ndikuti umayamba kugwira ntchito mkati mwa mphindi 15-20 pambuyo pa kuperekedwa. Komabe, imagwira ntchito kwa maola angapo. Mankhwala odziwika bwino ndi Novorapid, Apidra, Humalag.

Insulin yogwira ntchito yayifupi imagwira ntchito kwa maola 6-8, zonse zimatengera wopanga ndi mlingo wa chinthu chomwe chikugwira. Yake kwambiri mumagazi amapezeka patatha maola 2-3 pambuyo pake.

Magulu otsatirawa a insulin ndi omwe amadziwika:

• Umisiri wa Majini - Rinsulin, Actrapid, Humulin,
• Zopanga - Biogulin, Humodar,
• Monocomponent - Monosuinsulin, Actrapid.

Ndizosatheka kunena mosasamala kuti ndi insulin yochepa ndiyiti yabwino. Mankhwala ena ayenera kuperekedwa mwa njira iliyonse ndi dokotala. Komanso, onse ali ndi Mlingo wosiyanasiyana, kutalika kwa zochita, zoyipa ndi zoyipa.

Ngati mukufunika kusakaniza ma insulin osiyanasiyana nthawi, muyenera kusankha mankhwala kuchokera kwa omwewo. Chifukwa chake zidzakhala zothandiza kwambiri ngati zikugwiritsidwa ntchito limodzi. Musaiwale kudya utatha mankhwala kuteteza chitukuko cha matenda ashuga.

Nthawi zambiri, insulin imapangidwira kukonzekera kwa ntchafu, ntchafu, kutsogolo, kapena pamimba. Nthawi zina, makonzedwe a intramuscular kapena intravenous amasonyezedwa. Odziwika kwambiri ndi makatiriji apadera, omwe amatha kulowa nawo mankhwalawo.

Jakisoni wotsekemera uyenera kuchitika kwa theka la ola kapena ola limodzi asanadye. Popewa kuvulaza khungu, tsamba la jakisoni limasinthasintha. Mukatha kubaya, pukuta khungu lanu kuti lifulumire njira yoyendetsera.

Yesetsani kuchita chilichonse mosamala kuti zoteteza zisalowe m'mitsempha yamagazi. Izi zimabweretsa kumverera kowawa kwambiri. Ngati ndi kotheka, insulini yocheperako imatha kusakanikirana ndi mahomoni ofananawo. Pankhaniyi, kuchuluka kwa jekeseni ndi kapangidwe kake ka majakisidwe kuyenera kusankhidwa ndi adokotala.

Akuluakulu omwe ali ndi matenda a shuga amatenga magawo 8 mpaka 24 a insulin tsiku lililonse. Pankhaniyi, mlingo umatsimikiziridwa malinga ndi chakudya. Anthu omwe ali ndi Hypersensitive kwa zigawo zikuluzikulu, kapena ana sangatenge zosaposa ma Uniti 8 patsiku.

Ngati thupi lanu silikuwona bwino timadzi tambiri, ndiye kuti mutha kumwa mankhwala ambiri. Kumbukirani kuti kusuntha kwa tsiku ndi tsiku sikuyenera kupitirira 40 Misonkhano patsiku. Pafupipafupi kugwiritsa ntchito pamenepa maulendo 800, koma ngati kuchepetsedwa ndi insulin yayitali - pafupifupi 3.

Ngati munthu wakhala akutenga insulin yocheperako kwa nthawi yayitali, ndipo pakali pano pakufunika kuti amusinthe kuti amuchiritse ndi mahomoni ofananawo a nthawi yayitali, amatumizidwa kuchipatala. Kusintha konse kuyenera kuyang'aniridwa ndi ogwira ntchito pachipatala.

Chowonadi ndi chakuti zochitika ngati izi zimatha kupangitsa kuti acidosis ikhale ndi matenda osokoneza bongo kapena matenda ashuga. Njira zoterezi ndizowopsa kwa anthu omwe ali ndi vuto laimpso kapena chiwindi.

Insulin yochepa pakapangidwe kake monga mankhwala ili pafupifupi chimodzimodzi ndi zomwe zimapangidwa ndi thupi la munthu. Chifukwa cha izi, mankhwalawa nthawi zambiri samayambitsa matupi awo sagwirizana. Nthawi zina, anthu amamva kuyabwa ndikusokonekera pamalo opangira jakisoni wa chinthucho.

Akatswiri ambiri amalimbikitsa kubaya insulin m'mimba. Chifukwa chake amayamba kuchita zinthu mwachangu kwambiri, ndipo mwayi wolowa m'magazi kapena mitsempha ndizochepa kwambiri. Kumbukirani kuti pambuyo pa mphindi 20 pambuyo pa jakisoni muyenera kudya kanthu kena kokoma.

Ola limodzi pambuyo jakisoni ayenera kukhala chakudya chokwanira. Kupanda kutero, mwayi wokhala ndi vuto la hypoglycemic ndiwambiri. Munthu amene amapatsidwa insulin ayenera kudya bwino komanso mokwanira. Zakudya zake ziyenera kukhazikitsidwa ndi zakudya zomanga thupi zomwe zimadyedwa ndi masamba kapena chimanga.

Ngati mutadzibaya insulin yochulukirapo, pamakhalanso chiwopsezo chokhala ndi vuto la hypoglycemic motsutsana ndi kuchepa kwakukulu kwa ndende yamagazi.

Mutha kuzindikira kukula kwazomwe zikuwonetsedwa:

• Njala yayikulu
• Kusanza ndi kusanza
• Kuzunguzika
• Mdima m'maso
• Chisokonezo
• Kuchulukitsa thukuta
• Zosangalatsa pamtima
• Kumverera kwa nkhawa komanso kusakwiya.

Ngati mukuazindikira kuti muli ndi vuto limodzi la insulin yocheperako, muyenera kumwa nthawi yomweyo tiyi wotsekemera momwe mungathere. Zizindikiro zikafooka, gwiritsani ntchito gawo lalikulu la mapuloteni ndi chakudya. Mukachira pang'ono mudzasowa kugona.

Kumbukirani kuti kugwiritsa ntchito insulin posakhalitsa pamafunika kutsatira malamulo ena.

1. Muyenera kusunga mankhwalawo mufiriji, koma osati mufiriji,
2. Mbale zotseguka sizisungidwa,
3. M'mabokosi apadera ndizovomerezeka kusunga insulin yotseguka kwa masiku 30,
4. Ndi zoletsedwa kusiya insulini padzuwa lotseguka,
5. Osasakaniza mankhwalawa ndi mankhwala ena.

Musanagwiritse ntchito mankhwalawa, onetsetsani ngati madzi abwera, ngati madziwo akhala akuthambo. Komanso nthawi zonse muziyang'anira kutsatira malo osungira, komanso tsiku lotha ntchito. Izi zokha ndizomwe zithandiza kusunga moyo ndi thanzi la odwala, komanso sizingalole kukula kwazovuta zilizonse.

Ngati pali zoyipa zilizonse chifukwa chogwiritsa ntchito, muyenera kufunsa dokotala, chifukwa kukana kugwiritsa ntchito insulin kungayambitse zotsatira zoyipa kwambiri.

Nthawi zambiri, insulin yochepa imagwiritsidwa ntchito pomanga thupi. Zimawonjezera magwiridwe antchito ndi kupirira kwa munthu, komanso zimagwiritsidwa ntchito pakuuma. Mwa zabwino zosakayikira za mankhwalawa, munthu amatha kusiyanitsa kuti palibe mayeso amodzi omwe amatha kudziwa chinthu chomwechi m'magazi - chimasungunuka ndikulowa kapamba.

Dziwani kuti ndizoletsedwa kudzipereka nokha mankhwalawa, izi zimatha kubweretsa zotsatirapo zovuta, monga kuwonongeka m'moyo wabwino kapena kufa. Anthu omwe amamwa insulin amayenera kupereka magazi pafupipafupi kuti aziyang'anira kuchuluka kwa shuga.

Insulin yochepa: njira yothandizira, mitundu ya mankhwala, njira yogwiritsira ntchito

Kukonzekera kwa insulin ndi gawo limodzi la njira zovuta zochizira matenda a insulin omwe amadalira insulin komanso mtundu wa 2. Chimodzi mwazinthu zowopsa za matendawa ndi vuto la hyperglycemic. Kugwiritsa ntchito insulin m'malo mwachidule kumakupatsani mwayi wokhala ndi shuga wamagazi ambiri, kupewa mavuto obwera chifukwa chachikulu.

Matenda a metabolism amachititsa kusokonezeka kwa magwiridwe azinthu zama glucose komanso excretion. Nthawi zambiri, amagwira ntchito ngati gwero lamphamvu kwa thupi. Insulin ndi mahomoni opangidwa ndi kapamba omwe amakhudzidwa ndi kufalitsa ndi kutulutsa shuga. Mu matenda a shuga, dongosolo la endocrine limalephera kuchipanga mokwanira.

Insulin yochita kupanga mwachidule idapangidwa zaka 20 zapitazo. Analogue ya hormone ya anthu imapezeka m'njira ziwiri. Loyamba limakhala kudzera muubwino wa majini: kapangidwe ka mabakiteriya osinthika ma genetic ndikupanga mahomoni kuchokera ku proinsulin yotengedwa kuchokera kwa iwo. Chachiwiri ndi kupangika kwa timadzi tokhala ndi insulin ya nyama - nkhumba kapena bovine.

Pambuyo pa makonzedwe, insulin yochepa imamangiriza kwa ma receptor pa membrane wa cell, kenako imalowetsa. Hormalo limayendetsa zochita zamanja. Izi zimawonekera makamaka m'maselo otengera insulin a chiwindi, adipose ndi minofu minofu.

Insulin imayendetsa kagayidwe, imakhudza shuga wamagazi. Homoni imachita nawo kayendedwe ka glucose kudzera membrane wa cell, imalimbikitsa kusintha kwa shuga kukhala mphamvu. Glycogen imapangidwa kuchokera ku shuga m'magazi. Kuchita kwa insulin kumeneku kumapangitsa kutsika kwa shuga m'magazi, komwe kumalepheretsa kupitilira kwa shuga komanso kupezeka kwa hyperglycemia.

Kutalika kwa mayamwidwe ndi zochita za insulin zimadalira malo a jakisoni, mlingo ndi kuchuluka kwa yankho. Komanso kayendedwe ka magazi ndi kamvekedwe ka minofu zimakhudza njirayi. Zotsatira zamankhwala zimatengera umunthu wake wodwala aliyense.

Kukhazikitsidwa kwa insulin kumalola odwala matenda ashuga kuti azilamulira thupi, kuyambitsa metabolism yamafuta, komanso kupewa kupezeka kwamavuto am'magazi a mtima ndi mantha.

Kukonzekera kwa insulin kumasiyana kutengera nthawi yomwe mayamwidwe am'mimba ndi zochita zake. Ma insulin aatali amatha kusintha kuchuluka kwa shuga m'magazi mkati mwa masiku 1-1,5, mwa kuyerekezera ndi mahomoni oyambira omwe samagwirizanitsidwa ndi kudya.

Zofanana zimapangidwa ndi mankhwala a nthawi yayitali. Zotsatira zake zimawonedwa pambuyo pa maola 1-5 ndipo zimatha pafupifupi maola 12-16.

Kuchita insulin kwakanthawi kochepa kumachepetsa kuchuluka kwa shuga m'magazi, kutsutsana ndi kutulutsidwa kwa mahomoni ogwirizana ndi kudya. Amayambitsidwa theka la ola asanadye. Njira za ultrashort kanthu ndizothamanga kwambiri.

Insulin yofupikirako imatha kupangidwira majini (Actrapid NM, Rinsulin R, Humulin Regula), kapangidwe kake (Humudar R, Biogulin R) kapena nkhumba (Actrapid MS, Monosuinsulin MK).

Dokotala amawona mtundu ndi mankhwalawa a mankhwalawo, poganizira zomwe wodwalayo ali ndi zaka, zomwe akuwonetsa, momwe akuwonekera. Musanagwiritse ntchito insulin, onetsetsani kuti mwawerengera malangizowo. Ma insulin amafupikitsidwa amatha kuthandizidwa ngati monotherapy kapena kuphatikiza ndi mankhwala omwe akhala akuchita kwa nthawi yayitali.

Mlingo watsiku ndi tsiku wa insulin yochepa kwa akulu ndi magawo 8-24, kwa ana - osaposa magawo 8. Chifukwa cha kutulutsidwa kwa mahomoni amakula m'magazi, mlingo wa achinyamata ukuwonjezeka. Wodwala amatha kuwerengera payekha payekha. 1% ya timadzi timene timakhala ndi mlingo wofunika wothandizirana ndi mkate, ndi mlingo wochepetsera kuchuluka kwa shuga m'magazi. Zonsezi ndizofanana ndi zero. Kwa odwala matenda ashuga omwe ali ndi kulemera kwambiri, kuchuluka kwake kumachepetsedwa ndi 0,1, ndi kulemera kosakwanira kumawonjezereka ndi 0.1. Mlingo wa 0,4-0,5 U / kg amawerengedwa kwa odwala omwe ali ndi matenda a shuga 1. Kutengera mtundu wa mankhwalawa, jakisoni 1 mpaka 6 patsiku amatha kukhazikitsidwa.

Mlingo umatha kusinthidwa.Kuchulukitsa kwake kumafunikira pakukaniza kwa mahomoni, kuphatikiza ndi corticosteroids, kulera, antidepressants ndi okodzetsa ena.

Mankhwalawa amaperekedwa pogwiritsa ntchito insulin kapena pampu yapadera. Chida choterocho chimalola njirayi kuti ichitike molondola kwambiri, zomwe sizingachitike ndi syringe wamba. Mutha kulowa yankho lomveka bwino popanda kunyengerera.

Wothandizirana mwachangu ndi insulin imaperekedwa kwa mphindi 30 mpaka 40 musanadye. Pambuyo pa jekeseni, musadumphe zakudya. Kupereka pambuyo pa mlingo uliwonse womwe waperekedwa uyenera kukhala womwewo. Patatha maola awiri mutadya mbale yayikulu, muyenera kukhala ndi kachakudya. Izi zingathandize kukhala ndi milingo yamagazi.

Kuti muchepetse kufalikira kwa insulin, malo osankhidwa amayenera kutenthetsedwa pang'ono povulala. Malowo a jakisoni sangathe kutentheka. Jakisoni amachitika mosazindikira m'mimba.

Ndi kuwonjezeka kwa ndende ya magazi, muyeso wowonjezera wa insulin umafunika mosasamala kanthu.

Insulin yofupikitsa nthawi zambiri imagwiritsidwa ntchito ndi othamanga omwe akuchita nawo masewera olimbitsa thupi. Zotsatira zamankhwala ndizofanana ndi zotsatira za anabolic. Insulin yochepa imayendetsa kayendedwe ka glucose kumaselo onse amthupi, makamaka minofu yamatumbo. Izi zimathandizira kuti chiwonjezeke komanso kusamalira kamvekedwe ka minofu. Potere, adotolo amakhazikitsa mlingo payekha. Njira yovomerezeka imatha miyezi iwiri. Pambuyo pakupuma kwa miyezi 4, mankhwalawa amatha kubwerezedwa.

Ndi shuga wa 16 mmol / L, zolimbitsa thupi zolimba sizingatheke. Ngati Zizindikiro sizidutsa 10 mmol / l, m'malo mwake, kusewera masewera kumathandizira kuchepetsa kuchuluka kwa shuga.

Nthawi zina, ndikusowa kwa chakudya chamafuta m'thupi, thupi limayamba kugwiritsa ntchito matupi a adipose ngati mphamvu. Ikagawika, matupi a ketone otchedwa acetone amasulidwa. Pankhani ya shuga wamagazi ambiri komanso kupezeka kwa ma ketoni mu mkodzo, wodwalayo amafunika kuwonjezeredwa kwa insulin yochepa - 20% ya tsiku ndi tsiku. Ngati palibe kusintha komwe kumadziwika pambuyo pa maola atatu, mubwereze jakisoni.

Anthu omwe ali ndi matenda ashuga okhala ndi kutentha kwapamwamba kwamthupi (mpaka +37 о С) amafunika kuchita glucometry ndi insulin. Pafupifupi, tsiku lililonse mlingo umakulitsidwa ndi 10%. Pa kutentha mpaka +39 ° C, mlingo wa tsiku ndi tsiku umachulukitsidwa ndi 20-25%. Mothandizidwa ndi kutentha kwambiri, insulin imawonongeka mwachangu, chifukwa chake, mawonekedwe a hyperglycemia ndi otheka. Mlingo wa tsiku ndi tsiku uyenera kugawidwa ndikugawiridwa ndi maola 3-4.

Kapangidwe ka ma antibodies ku insulin kungapangitse kuti zochita zamtunduwu zizigwirizana. Izi zimayambitsa kukana kwa insulin. Nthawi zambiri, kukana kwa mahomoni kumawonedwa ndikuyamba kwa nkhumba kapena bovine insulin.

Mankhwala omwe amangokhala ndi kanthawi kochepa samayambitsa mavuto. Thupi lawo siligwirizana nthawi zambiri limachitika mu mawonekedwe a kuyabwa kwa khungu, redness. Nthawi zina kukwiya pamalowa jakisoni kumadziwika.

Pogwiritsa ntchito bongo mopitirira muyeso kapena kugwiritsa ntchito molakwika insulin, hypoglycemic syndrome ndiyotheka, yodziwika ndi kuchepa kwamphamvu kwa shuga m'magazi. Zizindikiro za hypoglycemia: chizungulire, kupweteka mutu, njala yayikulu, kuthamanga kwa mtima, kuchuluka thukuta, nkhawa komanso kusakwiya. Kuti muthane ndi zizindikirazi, muyenera kumwa njira yothetsera shuga, pakatha mphindi 15 mpaka 20 - tengani gawo lomwe lili ndi mapuloteni ambiri komanso chakudya. Osagona: izi zimatha kuyambitsa kuyambika kwa hypoglycemic coma.

Kuchita insulin mwachangu mwachangu komanso moyenera kumatulutsa shuga. Chithandizo choterochi chimathandizira odwala matenda ashuga kuti azikhala mwamphamvu komanso kuti apewe zovuta.

Odwala omwe ali ndi vuto la insulini lawo lomwe amafunikira jakisoni wa moyo wonse wokhala ndi timadzi timeneti. Insulin yofupikitsa imagwiritsidwa ntchito ngati gawo limodzi la zovuta kuchizira matenda a shuga. Ngati mankhwalawa, ma dosages ndi nthawi yoyendetsera idasankhidwa molondola, shuga wamagazi amatha kusinthidwa kwa nthawi yayitali, zomwe zimapewe zovuta zingapo za matenda "okoma".

Komanso, insulin yayifupi ingagwiritsidwe ntchito kuyimitsa shuga kwa wodwala panthawi yamagetsi owonjezereka: ndi ketoacidosis, matenda akulu ndi kuvulala. Mukamagwiritsa ntchito pampu ya insulin, mwina ndi okhawo amene mungadziwe mankhwala.

Insulin yochepa imapangidwira kubwereza chinsinsi cha mahomoni pakuwonjezeka kwa glucose wamagazi. Nthawi zambiri amamudulira theka la ola asanadye. Munthawi imeneyi, amakwanitsa kuthira magazi kuchokera kumafuta am'magazi ndikuyamba ntchito kuti muchepetse shuga. Molekyulu ya insulin yochepa imakhala ndi mawonekedwe ofanana ndi mahomoni omwe amapangidwa m'thupi, motero gulu ili la mankhwala limatchedwa insulin yaumunthu. Palibe zowonjezera mu botolo kupatula zoteteza. Insulin yochepa imadziwika ndi zochita zachangu, koma zazifupi. Mankhwalawo akangolowa m'magazi, shuga m'magazi amatsika kwambiri, pambuyo pake hormoneyo imawonongeka.

Anthu odwala matenda ashuga amatenga insulin pang'ono, kuchokera pamenepo imalowetsedwa m'magazi. M'magawo oyambiranso, makonzedwe amkati amagwiritsidwa ntchito. Njirayi imakuthandizani kuti muchepetse zovuta zovuta za matenda ashuga ndikuyankha panthawi yake pakufunika kwakanthawi kwa kusintha kwa mahomoni panthawi yopuma.

Mwachizolowezi, insulin yocheperako imaphatikizidwa ndi mankhwala apakatikati ndi ogwiritsira ntchito nthawi yayitali: yochepa imaperekedwa musanadye, komanso yayitali - m'mawa komanso asanagone. Chiwerengero cha jakisoni wa mahomoni sichikhala ndi malire ndipo zimangotengera zosowa za wodwalayo. Kuti muchepetse kuwonongeka kwa khungu, muyezo ndi jakisoni 3 musanadye chakudya chilichonse komanso kuphatikiza jakisoni 3 kukonza hyperglycemia. Ngati shuga amadzuka chakudya chisanafike, makonzedwe opangira mankhwala amaphatikizidwa ndi jekeseni yomwe anakonza.

Mukafuna insulin yayifupi:

1. Mtundu umodzi wa matenda ashuga.
2. 2 mtundu wamatenda pomwe mankhwala ochepetsa shuga salinso othandizira.
3. Matenda a shuga okhathamira okhala ndi shuga wambiri. Kwa gawo losavuta, jekeseni wa 1-2 wa insulin yayitali nthawi zambiri amakhala okwanira.
4. Opaleshoni ya kapamba, yomwe idayambitsa kusokonekera kwa mahomoni.
5. Chithandizo cha pachimake zovuta za matenda ashuga: ketoacidotic ndi hyperosmolar coma.
6. Nthawi yochulukirapo ya insulin: Matenda otentha kwambiri, vuto la mtima, kuwonongeka kwa ziwalo, kuvulala kwambiri.

Njira yoyenera kwambiri yothandizira kuperekera insulin pakumwa matenda a shuga tsiku ndi tsiku ndiyosavuta. Kuthamanga ndi kuperewera kwa mayankho munkhaniyi ndizodziwikiratu, zomwe zimakupatsani mwayi wokwanira kudziwa kuchuluka kwa mankhwalawa. Mphamvu yotsitsa shuga imawonedwa mwachangu ngati jakisoni wachitika m'mimba, pang'onopang'ono paphewa ndi ntchafu, komanso ngakhale pang'ono m'matumbo.

Ma insulin afupia amayamba kugwira ntchito theka la ola pambuyo pa utsogoleri, kukhathamiritsa kwakukulu ndi maola 2. Pambuyo pachimake, chochitikacho chimayamba msanga. Zotsalira zotsalira zimatengera mlingo umodzi womwe umaperekedwa. Ngati magawo 4-6 a mankhwalawa alowa m'magazi, kuchepa kwa shuga kumawonedwa mkati mwa maola 6. Pa mlingo wa magawo opitilira 16, chochitikachi chimatha mpaka maola 9.

Insulin imaloledwa panthawi yoyembekezera komanso poyamwitsa, chifukwa sichilowa m'magazi a mwana ndi mkaka wa m'mawere.

Atakwaniritsa ntchito zake, insulin yochepa imasweka ndikupanga ma amino acid: 60% ya timadzi timene timagwiritsidwa ntchito impso, 40% m'chiwindi, gawo laling'ono limalowa mkodzo osasinthika.

Insulin yochepa imapezeka m'njira ziwiri:

1. Potengera ma genetic, mahomoniwa amapangidwa ndi mabakiteriya.
2. Zopanga zokha, pogwiritsa ntchito kusintha kwa ma enzymes a nkhumba.

Mitundu yonse iwiri ya mankhwalawa imatchedwa yaumunthu, chifukwa ndi kapangidwe kake ka amino acid amabwereza kwathunthu mahomoni omwe amapangidwa mu kapamba athu.

Mankhwala wamba:

Makampani opanga mankhwala amapanga mitundu yambiri ya mankhwala a mahomoni kuti athandizire shuga. Chimodzi mwa izo ndi insulin yochepa. Imatha kusintha matenda a shuga mwa odwala omwe ali ndi matenda osokoneza bongo nthawi yochepa, zomwe zimapangitsa kukhala chida chofunikira kwambiri.

Insulin ikangoyambitsidwa, imasungunuka ndipo imasinthasintha mwachangu njira za metabolic zomwe zimagwirizanitsidwa ndi kuyamwa kwa shuga.

Mosiyana ndi mankhwala omwe akhala akuchita kwa nthawi yayitali, amakhala ndi yankho loyera la mahomoni popanda zowonjezera zina. Kuchokera ku dzinalo ndizodziwikiratu kuti akatha kuyambitsa, amayamba kugwira ntchito mwachangu, ndiye kuti, kwakanthawi kochepa amatsitsa shuga. Koma panthawi imodzimodziyo, amasiya kuchitapo kanthu mwachangu kuposa mankhwala omwe amakhala ndi nthawi yayitali pochita, monga momwe tikuwonera pachitsanzo chotsatira:

Zovala zazifupi zimagwiritsidwa ntchito zokhazokha kapena kuphatikiza ndi mahomoni okhala ndi nthawi yayitali. Amaloledwa kulowa mpaka 6 pa tsiku. Nthawi zambiri, amawalemba ngati:

• kuyambiranso,
• chosafunikira thupi insulin,
• othandizira opaleshoni
• zophulika
• matenda a shuga - ketoacidosis.

Kodi insulin yayifupi imagwira ntchito mpaka liti?

Ndi subcutaneous makonzedwe, mphamvu yayitali kwambiri ya mankhwalawa imawonedwa, yomwe imachitika pakadutsa mphindi 30 mpaka 40, nthawi yomwe chimbudzi cha chakudya chodyedwa chimachitika.

Mutatha kumwa mankhwalawa, nsonga ya insulin imatheka pambuyo pa maola awiri ndi atatu. Kutalika kumatengera mlingo womwe umaperekedwa:

• ngati ma 4 UNITS - 6 UNITS, nthawi yodziwika bwino ndi pafupifupi maola 5,
• ngati 16 mayunitsi kapena kupitilira apo, itha kufika maola 6-8.

Pambuyo pakutha kwa chochitikacho, mankhwalawa amachotsedwa m'thupi ndi mahomoni olimbana ndi mahomoni.

Pali zokonzekera zambiri za insulin zomwe zimakhalapo mwachidule, zomwe mankhwalawa omwe ali patebulopo ndi otchuka kwambiri:

Zosindikizira zomwe zalembedwazo zimawoneka ngati zomangamanga pamtundu wa anthu, kupatula Monodar, womwe umatchedwa nkhumba. Amapezeka mu mawonekedwe a njira yosungunuka mumbale. Zonse zimapangidwa kuti athandize odwala matenda amtundu wa 1 komanso a 2 matenda ashuga. Nthawi zambiri zotchulidwa musanayambe mankhwala.

Mankhwala sanaperekedwe kwa azimayi oyembekezera komanso oyembekezera, chifukwa insulini yamtunduwu simalowa m'matumbo ndi mkaka wa m'mawere.

Izi ndi zomwe zapangidwa posachedwapa mu pharmacology. Amasiyana ndi mitundu ina yonse monga momwe zimakhalira nthawi yomweyo, ndikupanga shuga m'magazi. Mankhwala odziwika bwino ndi awa:

Mankhwalawa ndi fanizo la munthu la munthu. Ndiwothandiza panthawi yomwe muyenera kudya, koma kuchuluka kwake sikudziwika, pakakhala zovuta kudziwa kuchuluka kwa insulin yokumba. Mutha kudya kaye, kenako kuwerengera ndi kumwa mankhwalawo. Popeza zochita za insulin ndizothamanga, chakudya sichikhala ndi nthawi yokwanira.

Insulin iyi ya ultrashort idapangidwa kuti izigwiritsidwa ntchito pamene anthu omwe ali ndi matenda ashuga amaswa zakudya zawo ndikudya maswiti ambiri kuposa omwe adalimbikitsa. Nthawi zambiri muzochitika zotere mumakhala kuchuluka kwambiri kwa shuga, komwe kumatha kubweretsanso thanzi. Kenako mankhwalawa atha kuthandiza. Nthawi zina, pamene wodwala sangathe kudikirira kwa mphindi 40, ndikulakwira chakudyacho kale, inshuwaransi yamtunduwu ikhoza kuphatikizidwanso.

Insulin yotereyi sikuti imaperekedwa kwa odwala omwe amatsatira malamulo onse azakudya. Nthawi zambiri, ngati ambulansi yokha yolumphira shuga.

Sipakhudzidwa mu amayi apakati omwe ali ndi matenda a shuga. Amaloledwa kugwiritsidwa ntchito, ngakhale pali toxosis ya mimba.

Phindu la ultrashort insulini ndikuti:

• muchepetse kuchuluka kwa shuga m'magazi usiku, makamaka kumayambiriro kwa kutenga pakati,
• thandizirani kusintha matendawa msanga mwa mayi woyembekezera panthawi ya cesarean,
• kuchepetsa chiopsezo cha zovuta mukatha kudya.

Mankhwalawa ndi othandiza kwambiri mwakuti amatha kusinthitsa shuga pakanthawi kochepa, pomwe mankhwalawa amathandizidwa pang'ono, omwe amathandiza kupewa zovuta zingapo.

Momwe mungawerengere insulin yochepa - njira za anthu odwala matenda ashuga

Pali njira zingapo zowerengera mtundu umodzi wa insulin yochepa, womwe umapezeka pansipa:

Mlingo umodzi wothandizirana ndi insulin mwachidule samangotengera kuchuluka kwa shuga m'magazi, komanso zakudya zomwe zimamwa. Chifukwa chake, pakuwerengera nkoyenera kuganizira mfundo zotsatirazi:

• Gawo la muyeso wa chakudya chamagulu ndi ma mkate (XE). Chifukwa chake, 1 XE = 10 g shuga,
• Pa XE iliyonse muyenera kulowa gawo limodzi la insulin. Kuti muwerengedwe molondola kwambiri, tanthauzo lake limagwiritsidwa ntchito - 1 unit ya insulin imachepetsa mahomoni ndi 2.0 mmol / l, ndi 1 XE ya chakudya chamafuta imakwera ku 2.0 mmol / l, kotero pa 0.28 mmol / l iliyonse yomwe imaposa 8, 25 mmol / l, 1 unit ya mankhwala imayendetsedwa,
• Ngati chakudyacho chilibe chakudya, kuchuluka kwa mahomoni m'magazi sikukwera.

Kuti kuwerengera kumakhala kosavuta, tikulimbikitsidwa kusunga zolemba motere:

Mawerengero Achitsanzo: Ngati mulingo wa glucose ndi 8 mmol / l musanadye, ndipo zakonzedwa kuti mudye 20 g ya chakudya chama carbohydrate kapena 2 XE (+4.4 mmol / l), ndiye kuti mutadya shuga mutha kufika pa 12,4, pomwe zizolowereka 6. Chifukwa chake, ndikofunikira kuyambitsa magawo atatu a mankhwalawa kotero kuti index ya shuga igwere ku 6.4.

Mlingo uliwonse wa insulin umasinthidwa ndi adotolo, koma sayenera kukhala apamwamba kuposa ma PIECES, omwe amawerengedwa pa kilogalamu imodzi ya kuchuluka kwake. Uwu ndiye mlingo waukulu.

Mankhwala osokoneza bongo amatha kubweretsa zovuta.

Nthawi zambiri, dokotala amatsatira malamulo otsatirawa:

• Ngati matenda a shuga a mtundu woyamba wangopezedwa kumene, muyezo wosaposa 0,5 / kg mankhwala.
• Ndikulipirira kwabwino chaka, mankhwalawa ndi 0.6 U / kg.
• Ngati kusakhazikika kumawonedwa mu mtundu 1 wa shuga, shuga amasinthasintha, ndiye kuti 0,7 U / kg amatengedwa.
• Ndi matenda a shuga ophatikizika, mlingo ndi 0.8 IU / kg.
• Ndi ketacidosis, 0,9 U / kg amatengedwa.
• Ngati pakati mu trimester yomaliza ndi mayunitsi 1.0 / kg.

Mitundu yonse ya insulini nthawi zambiri imayendetsedwa chimodzimodzi asanadye. Ndikulimbikitsidwa kuti musankhe madera amthupi la munthu pomwe mitsempha yayikulu ya magazi siyidutsa, pali ma amana amafuta ochepa.

Ndi makonzedwe a venous, zochita za insulin zidzakhala nthawi yomweyo, zosavomerezeka pamankhwala amasiku onse. Chifukwa chake, kuyamwa kwa mankhwalawa kumalimbikitsidwa, zomwe zimapangitsa kuti mayendedwe a insulin ayambe kulowa m'magazi.

Mutha kusankha pamimba, koma osasuntha mkati mwa masentimita 6 kuchokera ku navel. Pamaso pa jekeseni, muyenera kutsuka malowa ndikusamba m'manja ndi sopo ndikuuma. Konzani chilichonse chomwe chikufunika munjira yake: syringe yotayidwa, botolo lokhala ndi mankhwala komanso pedi. Onetsetsani kuti mwamaliza bwanji!

Kenako, muyenera kutsatira malangizo awa:

1. Chotsani kapu ku syringe, ndikusiya kapu ya mphira.
2. Chitani ndi singano ndi mowa ndikuyika mosamala mu botolo ndi mankhwala.
3. Sonkhanitsani kuchuluka kwa insulin.
4. Tulutsani singano ndikutulutsa mpweya, kutsogoza wopondayo mpaka dontho la insulin lithe.
5. Ndi chala chachikulu ndi chofiyira, tengani kachikopa kakang'ono. Ngati subcutaneous mafuta wosanjikiza ndi wandiweyani, ndiye kuti timayambitsa singano pamakona madigiri 90, ndi yopyapyala - singano ndiyofunika kupendekeka pang'ono pakona madigiri 45. Kupanda kutero, jekeseni sangakhale wosinjirira, koma wamitsempha. Ngati wodwalayo alibe kulemera kwambiri, ndibwino kugwiritsa ntchito singano yopyapyala komanso yaying'ono.
6. Pang'onopang'ono komanso bwino insulin. Kuthamanga kuyenera kukhala kumayeso limodzi
7. Syringe ikapanda kanthu, chotsani singano yomweyo pansi pa khungu ndikumasula khola.
8. Ikani kapu yoteteza pa singano ya syringe ndikuitaya.

Simungakhale malo amodzi nthawi zonse, ndipo mtunda kuchokera pa jakisoni wina kupita kwina uzikhala wa masentimita awiri. Majekeseni enanso: koyambirira m'ntchafu imodzi, kenako kwina, kenako kumatako. Kupanda kutero, kuphatikizika kwamafuta kumatha kuchitika.

Kuchuluka kwa mahomoni kumadalira kusankha malo.Mofulumira kuposa zonse, insulin imatengedwa kuchokera kukhoma lakutsogolo kwa m'mimba, kenako mapewa ndi matako, ndipo pambuyo pake kuchokera kutsogolo kwa ntchafu.

Ndikofunika kubayira m'mimba, kuti chochitikacho chichitike mwachangu akangodya.

Kuti mudziwe zambiri zamomwe mungagwiritsire ntchito kupatsa insulin, onani nkhani iyi kapena kanema wotsatira:

Pomaliza, ndikofunikira kudziwa kuti simungathe kusankha nokha mankhwala osankha mwachidule, kusintha mlingo wake popanda mankhwala a dokotala. Ndikofunikira kukhazikitsa, pamodzi ndi endocrinologist, dongosolo la kayendetsedwe kake malinga ndi regimen ndi kuchuluka kwa chakudya chomwe chimatengedwa. Ndikofunika kuti musinthe nthawi zonse jakisoni, sungani bwino mankhwalawo, onani masiku omwe atha. Ndipo pakusintha pang'ono komanso zovuta, funsani dokotala.

1. 
   Wayne, A.M. Hypersomnic Syndrome / A.M. Wayne. - M.: Mankhwala, 2016 .-- 236 p.
2. 
   Sukochev Goa syndrome / Sukochev, Alexander. - M: Ad Marginem, 2018 .-- 304 c.
3. 
   Akhmanov, Matenda a M.S. Chilichonse chomwe muyenera kudziwa (+ DVD-ROM) / M.S. Akhmanov. - M: Vector, 2010 .-- 352 p.

Ndiloleni ndidziwitse. Dzina langa ndi Elena. Ndakhala ndikugwira ntchito ya endocrinologist kwa zaka zoposa 10. Ndikukhulupirira kuti pakadali pano ndili katswiri pantchito yanga ndipo ndikufuna kuthandiza alendo onse omwe amapezeka pamalowo kuti athetse zovuta osati ntchito. Zinthu zonse za tsambalo amazisonkhanitsa ndikuzikonza mosamala kuti athe kufotokoza zambiri zofunikira. Musanagwiritse ntchito zomwe zikufotokozedwa pa webusaitiyi, kufunsana ndi akatswiri ndizofunikira nthawi zonse.