Ngati kapamba wa munthu, panthawi ya chakudya, amapanga kuchuluka kosakwanira kwa insulini yofunikira ya glucose, thupi limafunikira thandizo.

Ndingakuthandizeni bwanji? Mutha kuthandizira pakusunga kanthawi kochepa kokhala ndi insulini kuti chidwi chake chimugwirizane ndi kuchuluka kwakukula kwa glucose wamagazi mukamadya.

Kodi insulin yochepa bwanji? Kodi fanizo ndi mitundu ndi ziti?

Mitundu ya Insulin

Makampani opanga zamankhwala amapereka odwala omwe samangokhala ndi mafupikitsafupi, a insulin a insashin, komanso maulendo atali ndi apakati, nyama, maumboni amtundu wa anthu.

Zochizira mtundu woyamba ndi wachiwiri wa matenda a shuga, endocrinologists amalamula odwala, kutengera mtundu, gawo la matenda, mitundu yosiyanasiyana ya mankhwala, yodziwika ndi nthawi yayitali, kuyambika ndi ntchito.

Chochititsa chidwi: Kwa nthawi yoyamba, mu 1921, insulini idzipatula ku zikondamoyo za ng'ombe. Januware wotsatira adadziwika ndi chiyambi cha mayesero azachipatala a mahomoni mwa anthu. Mu 1923, kupambana kwakukulu kwa akatswiri opanga zamankhwala anapatsidwa mphoto ya Nobel.

Mitundu ya insulin ndi kagwiritsidwe kake (tebulo):

Momwe mungadziwire nthawi yoyenera kuperekera mankhwala, Mlingo, mitundu ya insulin yokonzekera? Ndi endocrinologist yekha yemwe angayankhe funsoli. Osadzilankhulitsa mulimonse.

Zomwe zikuchitika pang'onopang'ono insulin

Thupi labwino limatulutsa timadzi tambiri, nthawi zonse m'maselo a beta a isanger a Langerhans pancreas. Kuphatikizika kwa mahomoni kuphatikizika kumayambitsa kusagwira bwino ntchito, kusokonezeka kwa metabolic pafupifupi machitidwe onse a thupi ndi chitukuko cha matenda a shuga. Pa magawo oyambirira a matenda, odwala nthawi zambiri amapatsidwa insulin.

Insulin yochepa imakhala yofunikira pakakhala kuwonjezeka kwa shuga pambuyo podya:

1. Insulin yochepa imayamba pang'onopang'ono (kuyambira mphindi 20 mpaka 40), ndiye kuti nthawi yochepa imayenera kudutsa pakati pa jakisoni wa mahomoni ndi chakudya.
2. Kuchuluka kwa zakudya zomwe zimayenera kudyedwa pambuyo poti insulini yachangu izikhazikitsidwe kuyenera kukhala koyenera kwa mankhwalawo. Palibe chifukwa chomwe muyenera kusintha kuchuluka kwa chakudya. Zakudya zambiri zimatha kukhala ndi hyperglycemia, kupatula hypoglycemia.
3. Kukhazikitsidwa kwa insulin yochepa-pamafunika zokhwasula-pansi patatha maola awiri awiri pakukonzekera.

Chidwi: Nthawi ya kuwerengera nthawi ndi mlingo wake ikuwonetsedwa - odwala ali ndi machitidwe awo amthupi.Chifukwa chake, mlingo ndi nthawi zimatsimikiziridwa ndi endocrinologist payekha kwa wodwala aliyense.

Jakisoni amayenera kuperekedwa pokhapokha ndi chosawilitsidwa insulini komanso panthawi yokhayo. Mankhwala chikuyendetsedwera, nthawi zina intramuscularly. Ndi malo a jakisoni okha omwe angasinthe pang'ono, omwe safunikira kukonzedwa pambuyo poti jekeseni, kuti mankhwalawo amayenda bwino m'magazi.

Ndikofunika kuti wodwalayo asatengere kupita kwa sing'anga kuti azimuyang'anira nthawi zonse, iye amawunika momwe amadyera komanso moyo wake.

Nthawi zambiri, akatswiri a endocrinologists amapereka insulin yachangu komanso yayitali (nthawi yayitali) nthawi yomweyo:

• mwachangu insulin imayankha mwachangu kukhudzana ndi shuga,
• Kutulutsa komwe kumakhalapo kumakhala ndi gawo linalake la mahomoni m'mitsempha.

Momwe mungadziyimirire pawokha nthawi ya mankhwalawa

Kuti muchite izi, werengani nthawi yomwe kuchuluka kwa glucose m'magazi kumakhala kwakukulu (kulumpha shuga):

• muyenera kulowa muyezo wa mankhwala mphindi 45 musanadye,
• yang'anani kuchuluka kwa shuga pakatha mphindi zisanu zilizonse,
• ngati shuga watsika ndi 0,3 mmol, muyenera kudya nthawi yomweyo chakudya.

Kuwerengeka moyenera kwa mahomoni kumabweretsa kuthandizira kwa matenda osokoneza bongo komanso kupewa mavuto. Mlingo wa kukonzekera kwa insulin kwa akuluakulu umachokera ku 8 PIECES mpaka 24 PIERES, kwa ana - osaposa 8 PIECES patsiku.

Contraindication

Monga mankhwala aliwonse, insulin yothamanga imakhala ndi contraindication ndi zoyipa.

Sichikuperekedwa kwa matenda otere:

• hepatitis, zilonda zam'mimba ndi m'mimba,
• nephrolithiasis, yade,
• zolakwika zamtima zina.

Zotsatira zoyipa zimawonetsedwa ndikuphwanya mlingo: kufooka kwambiri, thukuta lochuluka, malovu, mapindikidwe, pali kupweteka kwakomoka.

Analogi Amfupi a Insulin

Zingasokonezeke bwanji ndi mayina a mankhwala ofananawo mu pharmacy? Insulin yomwe imagwira mwachangu, anthu kapena zithunzi zawo, zimasinthana:

Pomaliza

Insulin yochepa ndi mankhwala osankhidwa ndi endocrinologist kuchiza matenda a shuga.

Kuti mankhwalawa akhale othandiza komanso osavulaza mwanjira ya hypo-, hyperglycemia, kutsatira kwambiri mlingo, nthawi ya makonzedwe, dongosolo la chakudya. Sinthani mankhwalawa ndi analogi pokhapokha mukaonana ndi dokotala.

Ndikofunika kwambiri kudziyimira pawokha kuchuluka kwa shuga m'magazi, nthawi zina kumayesedwa, ndikusintha njira zopewera komanso zochizira.

Insulin - Kukonzekera insulin kukonzekera ndi ma insulin analogues

Marichi 01, 2011 Zamkatimu:

2. Kumanga
3. Maphunziro ndi chinsinsi
4. Zochita za insulin
5. Chilolezo cha insulin
6. Kuyang'anira shuga wamagazi
7. Matenda omwe amayamba chifukwa cha insulin8. Kukonzekera kwa insulin ndi mapangidwe a insulin

M'mbuyomu, kuchuluka kwa insulin pokonzekera malonda kunali 40 IU / ml. Popita nthawi, ndendeyo inakulitsidwa mpaka 100 U / ml.Kukonzekera kwamakono kwa insulini - kumakhala ndi 100 IU / ml, koma ndibwino kutsimikizira izi powunika chizindikiro.

Pansipa pali mndandanda wazokonzekera zonse za insulini - ma insulini ambiri omwe adatuluka ndikupanga zinthu zofunikira kwambiri samasiyidwa mwadala. Opanga dziko lapansi otsogola ndi omwe akuwonetsedwa.

Mwachitsanzo, kupanga kwa Darnitsa kumatulutsa ma insulin pansi pa dzina la Indar kubwereza Insuman, kampani ya Farmak imatenga insulin Lilli ngati maziko, etc.

Polemba gawo ili, tidagwiritsa ntchito makampani opanga insulin ndi gawo la "Kukonzekera insulin" lolemba ndi maswiti. wokondedwa Sayansi I. Yu. Demidova.

Insulin yosavuta kapena yamakristali

Timayambiranso kukonzekera kwa insulini yamalonda kuchokera ku gulu ili, chifukwa awa ndiwo mankhwala oyamba kupeza. Timasiya dala kukonzekera komwe kunalekedwa ndikuwonetsa amakono, oyeretsedwa kwambiri, kuphatikiza opanga, ofanana kwathunthu ndi insulin ya anthu.

- kuyambira - pambuyo pa 15 ... mphindi 20 kuchokera mphindi yoyambira,

- kutalika kokwanira kachitidwe - 6 ... maola 8.

• Actrapid MP - nkhumba, monopic
• Actrapid MC - nkhumba, chimodzi
• Actrapid HM - wopanga, wopanga, wopanga
• Humulin Wokhazikika - munthu, wophatikiza, wosapangika
• Insuman Rapid HM - munthu, wophatikiza, wosapangika

Gulu Lapakatikati la Surfen Insulin Gulu

Gulu lapadera la mankhwala a porcine insulin ndi acid pH. Mankhwalawa anali kutumikiridwa katatu patsiku ndi nthawi ya maola 8. Pambuyo pake, "acidic" ma insulin adatsutsidwa ndikuzunzidwa - m'malo mwake ndimankhwala amakono a nthawi yayitali komanso yayitali. Komabe, odwala ambiri amawakonda mankhwalawo ndipo amawakumbukirabe ndi nostalgia.

- kuyambira - pambuyo pa 1 ... maola 1.5 kuchokera nthawi yoyambira,

- nthawi yonse ya kuchitapo kanthu ndi 10 ... maola 12.

• Insulin B - yemwe amadziwika kuti Berlin insulin. Zopangidwa.
• Monosurfinsulin - yopangidwa ku USSR, itayikanso.

Kutenga nthawi yayitali, NPH imathandizira

Gulu la NPH-insulins - lotchulidwa pambuyo pa wolemba "Neutral Protamine Hagedorn", aka PDI m'mabuku a sayansi a Chirasha aku USSR. Mutha kupeza dzina lakale "Isofan."

NPH insulin imapezeka ndikuwonjezera mapuloteni, zinc ndi phosphate buffer ku yankho la crystalline insulin kuti mukhale ndi pH ya 7.2. Kuyesera koyamba kutsanzira secaltion ya insulin.

Zinamveka kuti jakisoni awiri a insulin yocheperako amalipira kuchuluka kwa shuga m'magazi pambuyo pa chakudya cham'mawa komanso chakudya chamadzulo, ndipo jakisoni imodzi ya NPH idzapereka secretion ya basal ndikuthandizira kukwera kwamasana shuga. Mankhwalawa sanathe tsiku lililonse.

Koma zovuta zilizonse zimasinthidwa kukhala mwayi - makampani amapanga zosakanikirana zopangidwa kale ndikulimbikitsa jekeseni wa insulin kawiri patsiku m'malo mopangira jakisoni wambiri wa 4-5 patsiku.

- kuyambira - nditatha 2 ... maola 4 kuchokera panthawiyi,

- nyengo yonse ya ntchito ndi 16 ... maola 18.

• Protaphane MP - Nkhumba, Monopic
• Protaphane MC - nkhumba, chimodzi
• Protaphane HM - munthu, wophatikiza, wosapangika
• Humulin NPH - munthu, wophatikiza, wosapangika
• Insuman Basal HM - munthu, wophatikiza, wosapangika

Makina osasintha okhazikika a insulin ndi NPH

Zosakanikirana zopangidwa ndi insulin zakonzedwa zidapangidwa ndi opanga insulini kuti azitha kuyang'anira odwala omwe ali ndi matenda osokoneza bongo mu machitidwe a jakisoni awiri patsiku. Onani gawo "Insulin Therapy" kuti mumve zambiri.

Komabe, sizoyenera aliyense - chitsimikiziro chosadziwika cha izi ndi kukhalapo kwa mitundu ingapo yosakanikirana mkati mwa kampani yomweyi yopanga komanso kusowa kwathunthu kwa mankhwala a gululi pamsika wamankhwala.

Mbiri yamachitidwe: zimatengera kapangidwe kazosakaniza - kuchuluka kwambiri kwa insulin, inshuwaransi yamphamvu komanso yofupikitsa.

Pochita izi, osakaniza 30/70 "akhala ndi mizu" - nthawi zina amagwiritsidwa ntchito m'malo mwa NPH-insulin kapena kuphatikiza ndi "insulin" ya insulin yochepa musanadye chakudya chamadzulo.

Oddly mokwanira, chisakanizo cha "fifitifiti" chosakondedwa ndi ambiri endocrinologists ndi odwala: nthawi zambiri chimayambitsa hypoglycemia.

• Mixtard HM 10/90 - osakaniza wopanga Actrapid HM - 10% / Protaphane HM - 90%
• Mixtard HM 20/80 - Sakanizani-Actrapid HM - 20% / Protaphane HM - 80%
• Mixtard HM 30/70 - osakaniza wopanga Actrapid HM - 30% / Protaphane HM - 70%
• Mixtard HM 40/60 - Sakanizani-Actrapid HM - 40% / Protaphane HM - 60%
• Mixtard HM 50/50 - Sakanizani-Actrapid HM - 50% / Protaphane HM - 50%
• Humulin M1 - osakaniza womaliza Humulin Wokhazikika - 10% / Humulin NPH - 90%
• Humulin M2 - osakaniza wopanga Humulin Wokhazikika - 20% / Humulin NPH - 80%
• Humulin M3 - osakaniza wotsiriza Humulin Wokhazikika - 30% / Humulin NPH - 70%
• Insuman Comb 15/85 - Wothira Insuman Rapid HM - 15% / Insuman Basal HM - 85%
• Insuman Comb 25/75 - osakaniza wotsiriza Insuman Wothamanga HM ​​- 25% / Insuman Basal HM - 75%
• Insuman Comb 50/50 - Wosakanikirana ndi Insuman Rapid HM - 50% / Insuman Basal HM - 50%

Wopatsa nthawi yayitali

Gulu la mankhwalawa limaperekedwa kamodzi patsiku ndipo limapangidwira anthu okhawo omwe ali ndi matenda a shuga 2. Chofunikira chachikulu cha matenda a shuga a mtundu 2 ndicho kukana insulini.

Kuti muthane ndi izi, ndikofunikira kukhalabe ndi insulin yambiri m'magazi.

Mankhwalawa ndi oyenera makamaka kwa odwala osakwatiwa okalamba, opuwala, omwe namwino amathandizira kunyumba ndi insulin.

- kuyambira - "Ultralent": pambuyo pa 6 ... maola 8 kuchokera panthawiyi yopanga njira zowongolera,

- "Peak" - 16 ... maola 20,

- nthawi yonse ya kuchitapo kanthu ndi 24 ... maola 36.

• Ultralente - nkhumba, osalowerera
• Humulin U - majini opanga anthu, olemba zinthu awiri
• Ultratard HM - genetic engineering semi-synturity man, monocomponent

Ultra-yochepa-ntchito anthu insulin analogs

Izi ndi zosiyana mwanjira ya amino acid mu B unyolo wa insulin yachilengedwe yamunthu yomwe imapezeka ndi ma genetic engineering. Amapangidwira ntchitoyo pafupi kwambiri ndi mbiri yachilengedwe yamalonda a insulin omwe amaperekedwa kuchokera kunja.

Ubwino ndi kuyambiranso koyambirira komanso kusowa kwa kuwonjezeredwa mobwerezabwereza pambuyo pa jekeseni, zomwe zimafunikira zakudya zowonjezera.

Mpaka pano, Humalog yadutsa mayesero azachipatala - kwa zaka zopitilira 10 pamsika wazachipatala, ali pafupi kutsiriza mayesero azachipatala a Novorapid, ndipo Epidera ali koyambirira kwa ulendowu.

- kuyambira - pambuyo pa 10 ... mphindi 20 kuyambira mphindi yoyambira,

- nthawi yonse ya kuchitapo kanthu ndi 3 ... maola 5.

• Humalog - Humalog, Liz-Pro Insulin
• NovoRapid - Novorapid, Insulin Aspart
• Apidra - mosiyana ndi malamulo, wopanga amawerenga: "Epidera" - Insulin Glulizin

Wokhalitsa wokhala ndi insulin analogues

Amapangira insulin yolepheretsa maselo a pancreatic alpha, kubisa mwachindunji insulin antagonist, glucagon ya mahomoni. Thandizani kuphatikizika kwa glycogen mu chiwindi ndi minofu.

Nthawi yolengezedwa ndi maola 24. Mpaka pano, palibe mankhwala omwe ali m'gululi omwe atsiriza mayeso azachipatala.

Pafupifupi tsiku lomaliza la mayeso azachipatala azaka 10 ndi Lantus, yemwe adayamba kuwonekera pamsika.

- kuyambira - mpaka? Mphindi pambuyo panjira yolowera,

- "nsonga" - palibe, chidwi chimasungidwa pafupifupi chimodzimodzi.

- nthawi yayitali yochitira - mpaka maola 24.

• Lantus - Lantus, insulin Glargin idatengedwa ndi njira yosinthira: kusintha Asparagine amino acid ndi Glycine mu Chingwe ndikuwonjezera ma Arginines awiri pa B chain - mosiyana ndi ma insulin onse omwe amakhala nthawi yayitali, amapezeka ngati jakisoni, osati kuyimitsidwa. Mankhwala okhawo lero omwe amatsimikizira kuchuluka kwa maola 24 pochita.
• Levemir - Levemir, insulin Detemir. Malinga ndi malipoti, nthawi zina pamakhala kufunika kwa jakisoni awiri patsiku.

Zosakanikirana za insulin za anthu zisanachitike

Maonekedwe osakanikirana opangidwa kuchokera pakapangidwe ka insulin chithandizo sichidziwika bwinobwino. Mwinanso wopanga akuyesayesa kusanja nthawi yokwanira ya "tsiku ndi tsiku" yolowerera yopanda insulin ya anthu.

• Novomix 30 - 30% ya munthu insulin analogue ya ultrashort zochita za insulin Aspart / 70% ya protulinated insulin Aspart.
• Humalog M25 - 25% Liz-Pro Ultra Yachidule Yogwiritsa Ntchito Insulin Analogue / 75% Liz-Pro Protaminated Insulin
• Humalog M50 - 50% Liz-Pro Ultra-Short -qobo Human Insulin Analogue / 50% Liz-Pro Protaminated Insulin

Insulin Glargin - momwe mungagwiritsire ntchito cholembera, malangizo apadera, olowa m'malo ndi otsika mtengo komanso kuwunika

Dokotala yemwe ali ndi matenda a shuga amamulemba Lantus, muyezo wa insulin yaumunthu yopangidwa ndi tizilombo ta mabakiteriya omwe amapezeka pogwiritsa ntchito majini opangira majini.

Mafuta osapaka khungu ndi othandizira mahormoni okhala ndi mphamvu yayitali.

Njira yothetsera insulin glargine ndi njira yothandiza yopewera hyperglycemia, imabwera m'mapensulo osavuta kugwiritsa ntchito ndi singano yaying'ono.

Kodi Lantus ndi chiyani

Mankhwalawa ndi insulin yotalikilapo. Lantus ndi dzina lodziwika bwino lazamalonda lopangidwa ndi Sanofi-Aventis. Mankhwalawa amagwiritsidwa ntchito monga cholowa m'malo mwa insulin yaumunthu m'magazi a shuga.

Cholinga cha mankhwalawa ndimayendedwe a glucose metabolism. Lantus imabwera m'mata cartridge agalasi omwe amayikidwa mu ma syringes othandiza. M'kati - phukusi - 5, syringe ili ndi 100 IU yogwira ntchito, ma millilitita atatu amadzimadzi.

Mankhwalawa amakhalanso ndi mayina ena ogulitsa, monga Tujeo SoloStar ndi Lantus SoloStar.

Acidity ya mankhwala imalola kuti apange microprecipitate, kubisala glargine m'magawo ang'onoang'ono kwa nthawi yayitali.

Glargin amalowa mu ligament yokhala ndi insulin receptors, pomwe akuwonetsa katundu yemwe ali pafupi kwambiri ndi insulin yaumunthu, ndikupanga zotsatira zogwirizana.

Mankhwalawa ali ndi phindu pa mulingo wa glucose m'mwazi ndi mayamwidwe ake ndi mafuta komanso minofu yamafupa. Kuchedwa kuyamwa kumapangitsa kuti ikhale ndi phindu lokhalitsa.

Mankhwala amaletsa mapangidwe a shuga mu chiwindi (gluconeogeneis), lipolysis mu adipocytes, amawonjezera kuchuluka kwa mapuloteni apangidwe. Glargin imatha kutengedwa kamodzi patsiku. Imayamba kuchita ola limodzi jakisoni itatha, imakhala ndi mphamvu pambuyo pa maola 29. Insulin Lantus, kuphatikiza pa glargine, imaphatikizaponso magawo othandizira awa:

• metacresol
• nthaka ya chloride
• sodium hydroxide
• glycerol
• hydrochloric acid
• madzi.

Zizindikiro zogwiritsidwa ntchito

Mankhwala a insulin amafunikira kuti akhale ndi thanzi la odwala omwe ali ndi matenda ashuga. Odwala omwe ali ndi vutoli amafunika kugwiritsa ntchito mankhwala a mahomoni kukhazikitsa kagayidwe ka glucose. Kugwiritsa ntchito Glargin kuyenera kuyikidwa ndi katswiri malinga ndi zotsatira za mayeso. Kugwiritsa ntchito pawokha kungakhale ndi zotsatira zosasangalatsa, makamaka kwa achinyamata kapena ana aang'ono.

Mankhwala Lantus jekeseni wa subcutaneous minofu kamodzi patsiku ndi kutsata ndendende nthawi ya jakisoni. Kuchuluka kwa zinthu zomwe zimaperekedwa ndi nthawi yoyenera ya jakisoni ziyenera kutsimikizidwa ndi katswiri.

Jakisoni wa insulin amachitika m'malo a ntchafu, pomwe mankhwalawa amamwa kwambiri komanso pang'onopang'ono. Malo ena oyendetsedwera ndi Lantus ndi matako, dera lamapeto la phewa, ndi khoma lakunja lam'mimba.

Musanalowetse mafuta ochulukirapo, mankhwalawa amayenera kutentha.

Ndikulimbikitsidwa kuti mupeze insulin m'malo osiyanasiyana osankhidwa kuti mupewe zinthu monga lipodystrophy. Lantus imagwiritsidwa ntchito palokha pawokha komanso molumikizana ndi insulin yochepa.

Pamaso pa matenda a shuga a 2 mtundu, mahomoni amagwiritsidwa ntchito limodzi ndi othandizira pakamwa.

Posintha njira yothandizira mankhwalawa, ndikofunikira kusintha mawonekedwe a tsiku ndi tsiku a basal insulin ndi mankhwala ena osokoneza bongo.

Malangizo apadera

Lantus sayenera matenda ashuga a ketoacidosis. Mothandizidwa kulowetsedwa kwa insulin ndi kosavomerezeka, amadzala ndi hypoglycemia.

Zitha kupangidwanso ndi zinthu zotsatirazi: Kusinthana ndi mankhwala ena, kuchita masewera olimbitsa thupi kwambiri, kudya mosakonzekera, matenda omwe amachepetsa kudya kwa insulin (mavuto ndi impso, chiwindi, pituitary, chithokomiro kapena adrenal cortex), kutsutsana ndi mankhwala ena.

Kupezeka kwa ma antibodies ku Lantus kumafunika kusintha kwa mankhwalawa kuti mupewe hyperglycemia.

Kudumpha jakisoni wa insulin, zolakwa posankha kuchuluka kofunikira nthawi zambiri zimayambitsa matenda a hyperglycemia ndi matenda ashuga a ketoacidosis mwa odwala omwe ali ndi matenda a shuga 1.

Ngati mukukhala ndi mavuto a impso, chiwindi, chithokomiro, matenda a Addison komanso zaka zopitilira 65, kusinthana ndi glargine kungafune kusintha mlingo wa Lantus.

Kufunika kopitilira muyeso kumatha kuchitika mokwanira ndi zolimbitsa thupi, ndimatenda kapena kukonza zakudya. Odwala omwe ali ndi vuto losakwanira kwa hepatic, mlingo wa Lantus nthawi zambiri umasinthidwa kutsikira, chifukwa mphamvu ya biotransform insulin imachepa. Ndizosavomerezeka kubaya yankho lomwe lasiya kuwonekera.

Lantus pa nthawi yapakati

Kafukufuku wokhudzana ndi insulin Lantus sanafotokozere za chiwopsezo cha mwana wosabadwayo. Amayi omwe ali ndi mwana amafunika kusamala kwambiri, kuyang'anira kuchuluka kwa shuga m'magazi.

Thupi lachikazi mu trimester yoyamba ya mimba limafunikira insulin yochepa. Pambuyo pobadwa mwana, zinthu zimamuyendera limodzi, koma nthawi zina pamakhala vuto la hypoglycemia.

Kuwunikira mosamala kuchuluka kwa shuga kuyenera kupitilira nthawi yonse yoyamwitsa.

Kuyanjana kwa mankhwala osokoneza bongo

Mbali ya mahomoni ya Lantus imalumikizana mwachangu ndi ma MA inhibitors ndi othandizira a hypoglycemic, komanso ACE inhibitors, fibrate, Pentoxifylline, Disopyramide, Fluoxetine ndi mankhwala ena omwe amathandizira zotsatira zake. Hypoglycemic zotsatira za insulin amachepetsa ndi munthawi yomweyo kugwiritsa ntchito okodzetsa, diazoxide ndi danazole. Zomwezi zimawonedwa pankhani ya mahomoni a estrogen. Insulin Lantus yokhala ndi Pentamidine ingayambitse hypoglycemia.

Zotsatira zoyipa

Zotsatira zoyipa zambiri za Glargin zimayenderana ndi kusintha komwe kumayambitsa kagayidwe kazakudya. Mlingo wa Lantus ukapitilira kufunikira kwa insulin, hypoglycemia imayamba, zomwe zimapangitsa kuwonongeka kwa manjenje. Ndikofunikira kuwunika pazotsatira, kuphatikizapo:

• Hypoglycemic zinthu
• kutuluka thukuta kwambiri
• kukomoka mtima,
• kusintha kwadzidzidzi
• njala yayikulu
• kukhumudwa, kusowa tulo,
• kutupa, hyperemia, lipodystrophy, kusapeza bwino m'malo a jekeseni,
• Edema ya Quincke, spasms ya bronchial, urticaria,
• kuwonongeka kwakanthawi kowonekera, matenda ashuga retinopathy.

Migwirizano yogulitsa ndikusunga

Glargin ikupezeka muma pharmacies okha ndi mankhwala. Mapaketi okhala ndi insulin amayenera kusungidwa pa kutentha kwa osachepera awiri osaposa digiri eyiti.

Mutha kukhazikitsa makatoni mkati mwa firiji, koma onetsetsani kuti sakumana ndi chakudya kapena khoma la mufiriji.

Insulin sayenera kuzizirira ndikuwonekera pakhungu. Pewani Lantus kutali ndi ana.

Makampani opanga mankhwala padziko lonse lapansi amapanga mitundu ingapo ya mankhwala.

Poganizira mosamala malingaliro a dokotala, kuchuluka kwa insulin yomwe adakhazikitsa, zikuwoneka kuti ndizotheka kusankha nokha m'malo mwanu.

Kusankhaku kuyenera kupangidwa kuchokera ku mankhwala aku Japan, America ndi Europe, koma ndi bwino kufunsa endocrinologist musanatenge. Zofanizira za Lantus zikuphatikizira:

• Tujeo SoloStar.
• Lantus SoloStar.

Analogs kwa achire zotsatira (mankhwalawa zochizira insulin-wodwala matenda a shuga):

• Khalid
• Anvistat
• Apidra
• B. Insulin
• Berlinsulin,
• Biosulin
• Glyformin
• Depot insulin C,
• Dibikor
• Iletin

Mtengo wa insulin Glargin

Lantus nthawi zambiri amapezeka kwaulere, ndi mankhwala kuchokera kwa endocrinologist. Wodwala akakakamizidwa kuti agule mankhwalawo, ndiye kuti apereka ma ruble 3,000 kapena faifi ku malo ogulitsa mankhwala ku Moscow, mtengo wa insulin lantus umatengera kuchuluka kwa ma syringe.

Kuchita zinthu mwachidule

Mu pharmacology, ma insulin ndi mahomoni apadera omwe amakupatsani mwayi wowongolera kuchuluka kwa shuga m'magazi. Makampani amakono azamankhwala, mankhwalawa amapangidwa m'njira zazikulu.

Amasiyana mumtundu wa zowonjezera, njira zakukonzekera komanso nthawi yayitali. Kutchuka kwambiri ndi insulin yochepa.

Mankhwalawa amapangidwira kuti matendawa akhazikike msanga, komanso angagwiritsidwe ntchito pochiza matenda ashuga.

Amachita insulin kwa nthawi yayitali: mayina, mtengo, fanizo la mankhwala. Mitundu ya insulin ndi zochita zawo

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.

Zisonyezero zakudikirira

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.

Mitundu ya kukonzekera kwa insulin

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:

Makhalidwe a Fomu la Prandial

Ma insandeni a Prandial amadziwika kuti awongolere shuga atatha kudya. Amakhala aafupi komanso a ultrashort ndipo amagwiritsidwa ntchito katatu patsiku musanadye kwambiri. Amagwiritsidwanso ntchito kuti achepetse kuchuluka kwa shuga ndikusunga katulutsidwe ka mahormoni oyambira pogwiritsa ntchito mapampu a insulin.

Mankhwala amasiyanasiyana munthawi yamayambiriro a zochita ndi nthawi yayitali.

Zomwe zimapangidwira posachedwa ndi ultrashort zimaperekedwa pagome:

Njira ya kagwiritsidwe ntchito ndi kuwerengera kwa mankhwala

Insulin imagawitsidwa ku pharmacies kokha mwa mankhwala. Musanagwiritse ntchito mankhwalawa, muyenera kudziwa momwe amagwiritsidwira ntchito mankhwalawa.

Mankhwala amapangidwa mwanjira yothanirana ndi mavutidwe omwe amaphatikizidwa ndi minofu yaying'ono. Pamaso jakisoni wa prandial insulin, ndende ya glucose imayesedwa pogwiritsa ntchito glucometer. Ngati shuga ali pafupi ndi chizolowezi chomwe wodwala amakhala nacho, ndiye kuti mafupiafupi amagwiritsidwa ntchito mphindi 20-30 musanadye, ndipo owonjezera amafupikitsidwa musanadye. Ngati chizindikirocho chimaposa zofunika zovomerezeka, nthawi pakati pa jakisoni ndi chakudya imachulukitsidwa.

Cartridge Insulin Solution

Mlingo wa mankhwala amayeza mu mayunitsi (UNITS). Sichikukonzedwa ndipo imawerengeredwa padera asanadye kadzutsa, nkhomaliro komanso chakudya chamadzulo. Mukafuna kudziwa kuchuluka kwa mankhwalawa, kuchuluka kwa shuga musanadye komanso kuchuluka kwa zakudya zomwe wodwala akufuna kudya zimaganiziridwa.

Kuti musavutike, gwiritsani ntchito lingaliro la gawo la mkate (XE). 1 XU ili ndi magalamu 12-15 a chakudya. Makhalidwe azinthu zambiri amaperekedwa pagome lapadera.

Amakhulupirira kuti 1 unit ya insulin imachepetsa shuga ndi 2.2 mmol / L. Palinso kufunikira kwakukonzekera 1 XE tsiku lonse. Kutengera ndi izi, ndizosavuta kuwerengera kuchuluka kwa mankhwalawa pachakudya chilichonse.

Chiyerekezo cha insulin pa 1 XE:

Tiyerekeze kuti munthu wodwala matenda ashuga ali ndi magawo 8.8 mmol / L osala kudya m'magazi m'mimba yopanda kanthu (kwa cholinga chamwini, 6.5 mmol / L), ndipo akufuna kudya 4 XE pakudya m'mawa. Kusiyana pakati pazowoneka bwino ndi chizindikiro chenicheni ndi 2.3 mmol / L (8.8 - 6.5). Kuti muchepetse shuga kukhala wabwinobwino popanda kuganizira chakudya, 1 UNIT ya insulin imafunikira, ndipo 4 HE ikamagwiritsidwa ntchito, mankhwala ena 6 a PIERES (1.5 PIECES * 4 XE). Chifukwa chake, asanadye, wodwalayo alowe magawo 7 a mankhwala a prandial (1 unit + 6 unit).

Kwa odwala omwe amalandira insulin, chakudya chamafuta ochepa sichofunikira. Kupatula kunenepa kwambiri kapena kunenepa kwambiri. Amalimbikitsidwa kudya 11-17 XE patsiku. Ndi kulimbitsa thupi kwambiri, kuchuluka kwa chakudya chamthupi kumatha kuchuluka mpaka 20-25 XE.

Njira yolowetsera

Mankhwala ochita kupanga mwachangu amapangidwa m'mabotolo, makatiriji ndi zolembera zopangidwa kale. Njira yothetsera vutoli imaperekedwa pogwiritsa ntchito ma insulin, ma syringe ndi mapampu apadera.

Mankhwala omwe sanagwiritsidwe ntchito ayenera kukhala mufiriji. Chida chogwiritsira ntchito tsiku ndi tsiku chimasungidwa kutentha kwanyumba kwa mwezi umodzi.Asanayambike insulin, dzina lake, patency ya singano imayang'aniridwa, kuwonekera kwa yankho ndi tsiku lotha ntchito kumawunikiridwa.

Mitundu ya prandial imalowetsedwa m'matumbo a subcutaneous pamimba. Mderali, yankho limakhala lotanganidwa ndikuyamba kuchitapo kanthu mwachangu. Tsamba la jakisoni mkati mwa malowa limasinthidwa tsiku lililonse.

Njirayi imakupatsani mwayi kupewa lipodystrophy - zovuta zomwe zimachitika ndikuphwanya njira ya njirayi.

Mukamagwiritsa ntchito syringe, ndikofunikira kutsimikizira kuchuluka kwa mankhwalawa omwe amasonyezedwera komanso vial. Monga lamulo, ndi 100 U / ml. Pakukhazikitsa mankhwalawa, khola limapangidwa, jekeseni limapangidwa pakona pa madigiri 45.

NovoRapid Flexpen Chole chogwiritsidwa ntchito kamodzi

Pali mitundu ingapo ya zolembera za syringe:

• Yodzaza (okonzeka kugwiritsa ntchito) - Apidra SoloStar, Humalog QuickPen, Novorapid Flexpen. Mendulo itatha, cholembera uyenera kutayidwa.
• Kuchitikanso, ndi cholembera katemera wa insulin - OptiPen Pro, OptiKlik, HumaPen Ergo 2, HumaPen Luxura, cholembera cha Biomatic.

Cholembera chogwiritsidwa ntchito pobweretsa ma analog a ultrashort Humalog - HumaPen Luxura

Musanagwiritse ntchito, kuyezetsa kumayesedwa ndi momwe umafunikira kwa singano. Kuti muchite izi, pezani magawo atatu a mankhwalawa ndikusindikiza piston. Ngati dontho la yankho litawoneka pamutu pake, mutha kubaya insulini. Ngati zotsatirapo zake zili zopanda pake, kubwereza kumabwerezedwa kawiri, kenako singano imasinthidwa kukhala yatsopano. Ndi mafuta osanjika bwino ophatikizika, makonzedwe a wothandizira amachitika mbali yoyenera.

Pampu za insulin ndi zida zomwe zimathandizira mabisidwe oyambira komanso olimbikitsidwa a secretion ya mahomoni. Amakhazikitsa cartridgeges omwe ali ndi ma ultrashort analogues. Kukhazikika kwakanthawi kochepa kwa yankho mu subcutaneous minofu kumatsitsa mwazonse momwe timadzi timene timayendetsa masana masana ndi usiku, ndipo kuwonjezereka kwa gawo loyambirira kumachepetsa shuga omwe amalandiridwa kuchokera ku chakudya.

Zipangizo zina zimakhala ndi pulogalamu yomwe imayeza glucose wamagazi. Odwala onse omwe ali ndi mapampu a insulin amaphunzitsidwa kuti azisintha ndikuzisamalira.

Pochiza matenda a shuga, mitundu ingapo ya insulini imagwiritsidwa ntchito, imodzi mwa izo ndi yayitali, kapena ya insulin yotalikilapo. Mankhwala ayenera kutha kumwa ndi kuwongolera.

Insulin ndi mankhwala othandizira kupewa matenda ashuga, jekeseni amene amachepetsa kuchuluka kwa shuga m'magazi, ndikuwonjezera mayamwidwe ndi minyewa (chiwindi ndi minofu). Insulin yayitali imatchedwa choncho chifukwa nthawi yake imakhala yambiri kuposa mitundu ina ya mankhwalawo, ndipo izi zimafuna kutsika kochepa.

Zochita za insulin yayitali

Zitsanzo za mayina a mankhwala:

• Lantus
• Insulin Ultralente,
• Insulin Ultralong,
• Insulin Ultratard,
• Levemir,
• Levulin,
• Humulin.

Amapezeka mu mawonekedwe a kuyimitsidwa kapena mayankho a jakisoni.

Kuchita insulin kwa nthawi yayitali kumachepetsa kuchuluka kwa shuga m'magazi, kumalimbitsa mayamwidwe ndi minofu ndi chiwindi, kuthamangitsa kaphatikizidwe kazinthu zopanga mapuloteni, ndikuchepetsa kuchuluka kwa shuga ndi hepatocytes (ma cell a chiwindi).

Ngati kuchuluka kwa insulin yowonjezera kumawerengeredwa molondola, kuyambitsa kwake kumayamba maola 4 pambuyo pa kubayidwa. Chiwongola dzanja chokwanira chiyenera kuyembekezeredwa pambuyo pa maola 8-20 (kutengera mawonekedwe a munthu ndi kuchuluka kwa insulini). Zochita za insulin m'thupi zimachepetsedwa mpaka zero pambuyo pa maola 28 utatha. Zosiyana ndi zomwe zili munthawi imeneyi zikuwonetsa mawonekedwe akunja ndi amkati a thupi la munthu.

Kukhazikika kwa mankhwalawa kumapangitsa kuti insulini ikhale kwakanthawi kwakanthawi, ndipo izi zimapangitsa kuti magaziwo azikhala pang'onopang'ono komanso pang'ono pang'ono.

Zisonyezero zogwiritsa ntchito insulin yayitali

1. Kukhalapo kwa matenda a shuga 1.
2. Kukhalapo kwa matenda ashuga amtundu wa 2.
3. Kuperewera kwa mankhwala pakamwa kuti muchepetse magazi a m'magazi.
4. Gwiritsani ntchito ngati mankhwala othandizira.
5. Ntchito.
6. Matenda a shuga kwa amayi apakati.

Njira yogwiritsira ntchito

Kuchuluka kwa mahomoni omwe amaperekedwa amatsimikiziridwa ndi adotolo aliyense payekha kwa wodwala aliyense. Mutha kuwerengera nokha mlingowo pokhapokha mukaonana ndi katswiri ndikupanga mayeso a labotale.

Kubetcha insulin nkoletsedwa. Ndikofunikira kupukutira m'manja musanabale. Izi zimathandizira kuti pakhale kupangika kophatikizika kwa mankhwalawa ndikuwotcha nthawi yomweyo mankhwalawo kuchokera kutentha kwa manja.

Pambuyo pa jekeseni, musachotsere singano nthawi yomweyo. Ndikofunikira kusiya masekondi angapo pansi pa khungu kuti mupeze mlingo wokwanira.

Kuwongolera kumayikidwa pakusintha kuchokera ku insulin yakuchokera kwa nyama kukhala munthu. Mlingo ukusankhanso. Komanso, kusintha kwa mtundu wina wa insulini kupita ku wina kuyenera kutsatiridwa ndi kuyang'aniridwa ndi achipatala komanso kuunika kwa magazi pafupipafupi. Ngati kusinthaku kwapangitsa kuti mankhwalawo opatsirana apitirire mayunitsi zana, wodwala amayenera kutumizidwa kuchipatala.

Kukonzekera konse kwa insulin kumayendetsedwa mosadukiza, ndipo jekeseni iliyonse yotsatira iyenera kupangidwa m'malo osiyana. Kukonzekera kwa insulin sikungasakanikiridwe ndi kuchepetsedwa.

Werengani kuchuluka kwa insulin

Kuti magazi a glucose akhalebe obwinobwino tsiku lonse, ndikofunikira kuyambitsa mtundu wa insulin, kapena mlingo woyambira. Msuzi ndimtundu wa insulin wa nthawi yayitali kapena wapakatikati, womwe umapangidwa kuti ukhale ndi shuga wamagazi osadya kapena pamimba yopanda kanthu, monga mwa munthu wathanzi, secretion basal.

Ndi magwiridwe antchito a maselo a pancreatic mwa anthu, 24-26 IU ya insulin imapangidwa tsiku lililonse. Izi zikuchokera pafupi 1 unit pa ola limodzi. Izi zikutanthauza kuti chiwerengero chonse cha insulini ndicho maziko kapena insulin yowonjezera yomwe muyenera kulowa.

Ngati opaleshoni, njala, kupsinjika kwamalingaliro ndi kutulutsa kwakukonzekera, ndiye kuti kuchuluka kwa insulin kofunikira kumafunikiranso.

Kuyesa kwa Insulin

Ndikotheka kumvetsetsa palokha ngati mulingo woyambira umasankhidwa molondola. Uwu ndiudindo wa munthu aliyense wodwala matenda ashuga, chifukwa ngakhale mlingo wa insulin wofotokozedwa ndi dokotala atha kukhala wosayenera kwa vuto lanu. Chifukwa chake, monga akunenera, khulupilirani, koma yang'anani, makamaka ngati zikugwirizana mwachindunji ndi thanzi lanu.

Poyesa, muyenera kusankha tsiku linalake, ndibwino kuti lidzakhale tsiku lopuma, chifukwa muyenera kuyang'anira glucose mosamala. Ndiye, mungayang'anire bwanji ngati mulingo woyenera wa insulin wowonjezereka wakupangira.

1. Osamadya kwa maola asanu.
2. Ola lililonse muyenera kuyeza shuga ndi glucometer.
3. Nthawi yonseyi, hypoglycemia kapena kudumpha kwa glucose wa 1.5 mmol / l sikuyenera kuzindikirika.
4. Kutsika kwa shuga kapena kuchuluka kumawonetsa kufunika kosintha maziko a insulin.

Kuyesedwa koteroko kuyenera kuchitidwa mobwerezabwereza. Mwachitsanzo, mudayang'ana kuchuluka kwanu kwa insulin m'mawa, koma momwe zinthu zilili ndi kusintha kwa glucose masanawa kapena madzulo. Chifukwa chake, sankhani tsiku lina kuti mupeze insulin yamadzulo komanso usiku.

Chokhacho muyenera kukumbukira: kuti insulin yochepa yomwe idalowetsedwa m'mawa sizikhudza shuga wamagazi, kuyesaku kuyenera kuchitika maola 6 pambuyo pakukonzekera kwake (ngakhale patakhala usiku).

Malangizo oyendetsa

Palinso malo owongolera okonzekera insulin yayitali kapena yapakati. Ngati zidzachitike kuti mukayang'ana shuga mu "mfundo" izi ziwonjezereka kapena kuchepetsedwa, ndiye kuti kuyesa koyambira komwe tafotokozazi kuyenera kuchitika.

Ku Lantus, nthawi iliyonse masana, shuga sayenera kupitirira 6,5 ​​mmol / l pamimba yopanda kanthu.

Protafan NM, Humalin NPH, Insumal Bazal, Levemir.Kwa mankhwalawa, malo owongolera ayenera kukhala musanadye chakudya chamadzulo ngati mlingo umaperekedwa m'mawa. Zikatero, ngati mankhwalawa amaperekedwa madzulo, ndiye kuti amayenera kuwongolera m'mawa pamimba yopanda kanthu. M'zochitika zonse zoyambirira ndi zachiwiri, phindu la shuga pamimba yopanda kanthu sayenera kupitirira 6.5 mmol / L.

Ngati mukuwona kuti kuchepa kapena kuchuluka kwa shuga pamimba yopanda kanthu, ndiye kuti simuyenera kusintha mlingo wa insulin nokha! Kuyesa koyambira kuyenera kuchitidwa. Ndipo pokhapokha musinthe mlingo kapena funsani kwa dotolo. Kudumpha kotereku kumatha kuchitika chifukwa cha matenda a m'mawa kapena chifukwa cholakwika cha insulin yamadzulo.

Bongo

Ngakhale kuchuluka kwakuchulukirapo kwa insulin komwe sikukwaniritsa zosowa za thupi kumatha kudzetsa hypoglycemia, yomwe pakufunika kosagwirizana ndi chithandizo chamankhwala kungayambitse wodwala kapena zovuta zazikulu.

Ndi hypoglycemia, wodwalayo ayenera kudya zakudya zamafuta kwambiri, zomwe nthawi yochepa zimachulukitsa shuga m'magazi.

Zingayambitse kukomoka, kusokonezeka kwamanjenje, komanso ngakhale kupweteka. M'tsogolomu, ndikofunikira kuwongolera dokotala ndikuwongolera zakudya komanso kupatsa jekeseni wa insulin yayitali.

Mankhwala Lantus ndi analogue a insulin ya anthu. Amapezeka mu labotale kuchokera ku zida za majini a bakiteriya, E. coli. Amasiyana ndi anthu pokhapokha ngati mamolekyulu awiri a arginine ndi kukhalapo kwa katsitsumzukwa m'malo mwa glycine.

Lantus, monga insulin ina iliyonse, amaletsedwa kusakanikirana ndi mitundu ina ya insulin ndipo, makamaka, ndi mankhwala ochepetsa shuga. Kusakaniza kudzayambitsa insulin yoyipa mosayenera. Choyipa chowopsa chophatikizika kusakanikirana ndicho kukhala mpweya.

Popeza insulin Lantus imakhala ndi ma antibodies aumunthu, mayamwidwe ake ndikukhazikika kwa thupi ndizabwino kwambiri kuposa zomwe zimafanana ndi ma analogues. Komabe, sabata yoyamba ndikofunika kulipira chidwi chochuluka machitidwe a thupi ndi insulin yamtunduwu, makamaka atatha kusintha kuchokera ku mtundu wina.

Lantus amagwiritsidwa ntchito ndi jekeseni wa subcutaneous. Kuwongolera kwamitsempha sikovomerezeka, chifukwa pamakhala chiwopsezo cha hypoglycemia.

Popeza insulin ili ndi zotsutsana zina pakugwiritsira ntchito (kulera, kulephera kwa impso), sizinali zotheka kudziwa zoyipa zoyipa ndi zoletsa izi, chifukwa palibe maphunziro omwe adachitika.

Kwa amayi omwe ali ndi pakati komanso oyamwitsa, kugwiritsa ntchito insulin yayitali ndikotheka, koma kuyang'aniridwa ndi katswiri ndikugwiritsa ntchito njira zothandizirana: mapiritsi ochepetsa shuga, zakudya.

Momwe mungasungire

Muyenera kupeza malo pomwe kutentha kuchokera pa + 2 ° C mpaka + 8 ° C. Nthawi zambiri pamakhala mashelufu a firiji. Ndikofunika kupewa kuzizira kwa insulini, zomwe zikutanthauza kuti simuyenera kusunga majakisoni ndi chidebe mufiriji.

Pewani kufikira ana.

Akatsegulidwa ndikuyamba kugwiritsa ntchito, kutentha kosungirako sikuyenera kupitirira +25 degrees. Tiyenera kukumbukira kuti moyo wa alumali wa insulin mutatseguka ndi masabata anayi.

Patsiku lotha ntchito, kugwiritsa ntchito mankhwalawo koletsedwa.

Mutha kugula insulini yokhayo pokhapokha ngati mukupezeka ndi mankhwala a dokotala.

Mu sayansi ya pharmacological, ma insulin amatchedwa kukonzekera kwapadera kwa steroid komwe kumapangitsa kuti azitha kuwongolera kuchuluka kwa mamolekyulu a shuga m'magazi a wodwala. Masiku ano pantchito yopanga zamankhwala ambiri amapanga ma insulin ambiri. Ambiri omwe ali ndi insulin yayifupi komanso yayitali. Kusiyana kwawo kwakukulu kumaphatikizapo: Mitundu ya zinthu zomwe zimapangidwira zomwe zimapangidwa, njira zopangira zinthuzo ndi nthawi yayitali yochitapo kanthu. Masiku ano, insulin yochepa ndiyotchuka kwambiri.

Kutalika kwa mawonekedwe ake kuli mpaka maola 8.Chida ichi chili ndi cholinga chake - kuyimitsa mwachangu nsonga za chakudya, komanso kuphatikiza mankhwala oyamba a shuga.

Insulin yayitali imagwiritsidwa ntchito kuyerekezera kupangika kwamahomoni m'thupi la munthu kwa maola 24. Kutengera mitundu ya mankhwalawa, imakhala ndi nthawi yochita kuyambira maola 12 mpaka 30. Monga mitundu ya timadzi tambiri totalikirapo, mankhwala a nthawi yayitali komanso yayitali amatulutsidwa. Imachepetsa kwambiri kuchuluka kwa mamolekyulu a shuga omwe amapezeka m'magazi, imatha kukonza minofu ndi chiwindi kuti izitha kuyamwa, imathandizira kapangidwe ka mapuloteni, imachepetsa nthawi yofunikira yopanga mamolekyulu a shuga ndi maselo a chiwindi.

Anthu omwe adakumana ndi matenda oyamba ashuga mwachilengedwe amakhala ndi chidwi ndi mafunso ngati awa: momwe mungasankhire insulini yoyenera komanso yabwino kwa makonzedwe? Izi ndizofunikira kwambiri, chifukwa moyo ndi thanzi la wodwalayo zimadalira kusankha molondola kwa mahomoni ndi kuwerengera kwake.

Zomwe madotolo amati pa matenda ashuga

Doctor of Medical Science, Pulofesa Aronova S. M.

Kwa zaka zambiri ndakhala ndikuphunzira za zovuta za DIABETES. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russia Academy of Medical Science idatha kupanga mankhwala omwe amachiritsiratu matenda ashuga. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 100%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipilira mtengo wonse wa mankhwalawo. Ku Russia ndi mayiko a CIS odwala matenda ashuga kale atha kupeza mankhwala ZAULERE .

Kusankhidwa kwa kukonzekera bwino kwambiri kwa insulin

Kwa odwala matenda ashuga omwe amadalira insulin, ndikofunikira kugwiritsa ntchito mlingo woyenera wa insulin.

Dziwani kuti ndizotheka kusankha mulingo woyenera wa mahomoni woyenera wodwala wina kuchipatala.

Pali malamulo angapo ofunikira omwe madokotala amatha kusankha pa mankhwalawa.

• Ndikofunikira kuyang'ana kuchuluka kwa mamolekyulu a shuga m'magazi kangapo patsiku. Zizindikiro zotsatirazi zimatengedwa ngati zabwinobwino: pamimba yopanda kanthu - 5-6 mmol / l ndipo patatha maola angapo mutatha kudya - 8 mmol / l. Kupatuka kwakukulu kuchokera kuzowonetsa komaliza ndizowonjezera 3 mmol / L.
• Hormon iyi iyenera kusankhidwa poganizira nthawi ya tsiku, kuchuluka kwa mankhwala ochulukitsa a carbohydrate omwe amwedwa, kuchuluka kwa kayendedwe ka wodwalayo asanadye komanso atatha kudya.
• Kuphatikiza apo, kuyenera kuyang'aniridwa kwa kulemera kwa wodwala, kupezeka kwa matenda ena owopsa kapena osachiritsika, nthawi ndi mawonekedwe ogwiritsira ntchito mankhwala ena. Chofunika kwambiri, zizindikirozi ndizomwe zimayikidwa nthawi yopuma ya jakisoni wa insulin yokonzekera nthawi yayitali. Chomwe chimapangitsa izi ndikuchepa kwa kudalira jakisoni panthawi yakudya, chifukwa mukamachigwiritsa ntchito, timadzi tambiri timene timayamwa mu seramu yamagazi a wodwala timapangidwa.
• Mfundo yofunika kwambiri posankha mlingo wabwino wa mankhwala ndikusunga diary yapadera. Patsamba loterolo, zizindikiritso zam'molekyu m'magazi a wodwalayo, kuchuluka kwa mafuta omwe amamwetsa pakudya, ndi kuchuluka kwa kukonzekera kwa insulin yochepa kumalowetsedwa. Kusanthula kumachitika nthawi zambiri pamimba yopanda kanthu. Nthawi zambiri kuchuluka kwa wothandizirayo ndi magawo omwe amwedwa ndi chakudya ndi chiŵerengero cha 2 mpaka 1. Ngati kuchuluka kwa mamolekyu amwazi m'magazi kupitirira zovomerezeka, makonzedwe owonjezerawa akukonzekera kochepa ndikofunikira.
• Yambirani njira ya kusankha mlingo wa insulin ndi jakisoni usiku.Ndi kuyambitsa kwa mahomoni mu kuchuluka kwa magawo 10, nthawi yomweyo asanakagone, malinga ndi kuti mankhwalawa ndi oyenera, shuga m'magazi sadzaposa 7 mmol / L. Pamene, jakisoni wa woyamba mlingo, wodwalayo atuluka thukuta kwambiri, kukulitsa chilimbikitso, m`pofunika kuchepetsa usiku ndi angapo mayunitsi. Mtengo woyenera pakati pa Mlingo wa insulin woperekedwa masana ndi usiku uyenera kukhala 2: 1.

Pomwe mlingo wa mankhwalawa ukwaniritsa zofunikira za thupi, zomwe mamolekyu am'magazi a seramu m'magazi sayenera kusintha kapena kutsika. Kuchuluka kwa glucose sayenera kusinthika masana.

Samalani

Malinga ndi WHO, chaka chilichonse padziko lapansi anthu 2 miliyoni amafa chifukwa cha matenda ashuga komanso zovuta zake. Pokhapokha pakhale thandizo loyenerera la thupi, matenda ashuga amabweretsa mavuto osiyanasiyana, pang'onopang'ono kuwononga thupi la munthu.

Mavuto ambiri omwe amakonda ndi awa: matenda ashuga a m'mimba, nephropathy, retinopathy, zilonda zam'mimba, hypoglycemia, ketoacidosis. Matenda a shuga amathanso kupititsa patsogolo chotupa cha khansa. Pafupifupi nthawi zonse, wodwala matenda ashuga amwalira, akulimbana ndi matenda opweteka, kapena amasintha kukhala munthu wolumala.

Kodi anthu odwala matenda ashuga amatani? Endocrinological Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsiratu matenda ashuga.

Pulogalamu ya Federal "Health Health Nation" ikuchitika, mkati mwa momwe mankhwalawa amaperekedwa kwa aliyense wokhala ku Russian Federation ndi CIS ZAULERE . Kuti mumve zambiri, onani tsamba lovomerezeka la MINZDRAVA.

Kuti mudziwe insulin yabwino kwambiri kwa wodwala winawake, ndikofunikira kusankha mankhwala oyambira. Pofuna kutsimikizira kupanga basal, nthawi zambiri amagwiritsa ntchito kukonzekera kwa insulin yayitali. Tsopano makampani opanga mankhwala amapanga mitundu iwiri ya insulin:

• nthawi yayitali, kugwira ntchito mpaka maola 17. Mankhwalawa akuphatikizapo Biosulin, Insuman, Gensulin, Protafan, Humulin.
• nthawi yayitali kwambiri, zotsatira zawo zimakhala mpaka maola 30. Awa ndi: Levemir, Tresiba, Lantus.

Ndalama za insulini Lantus ndi Levemir ali ndi kusiyana kwakukulu kwa insulini zina. Kusiyana kwake ndikuti mankhwalawa ndiwowonekera bwino ndipo ali ndi nthawi yayitali yogwira wodwala yemwe ali ndi matenda ashuga. Mtundu woyamba wa insulin uli ndi tint yoyera komanso mtundu wina wamafinya, chifukwa chake mankhwalawo amayenera kugwedezeka musanagwiritse ntchito.

Pogwiritsa ntchito mahomoni a nthawi yayitali, nthawi zapamwamba zimatha kuwonedwa mu kupsinjika kwawo. Malangizo a mtundu wachiwiri alibe chochitika ichi.

Mlingo wa kukonzekera kwa insulin yayitali kuyenera kusankhidwa kuti mankhwalawa athetse shuga m'magawo azakudya panthawi yovomerezeka.

Chifukwa chofunikira kuti muchepetse kuyamwa pang'onopang'ono, insulin yayitali imathandizidwa pansi pa khungu la ntchafu kapena matako. Mwachidule - pamimba kapena mikono.

Kukonzekera mwachidule za insulin

Ma insulin omwe amagwira ntchito mwachidule amakhala osungunuka ndipo amatha kusintha mwachangu momwe kagayidwe kachakudya mthupi la munthu kamalumikizana ndi mayamwidwe a shuga.

Mosiyana ndi ma insulin omwe amakhala nthawi yayitali, kukonzekera kwakanthawi kwamahomoni kumakhala ndi njira yofananira yokhala ndi mahomoni omwe mulibe zowonjezera zina.

Chowoneka mosiyanitsa ndi mankhwalawa ndikuti amayamba kugwira ntchito mwachangu ndipo m'nthawi yochepa amatha kutsitsa shuga m'magazi kuti akhale abwinobwino.

Zochita zake zapamwamba za mankhwalawa zimawonedwa pafupifupi maola awiri pambuyo pokhazikitsa, ndiye kuti pakukula kwakeko mwachangu. Pambuyo maola asanu ndi limodzi m'magazi pamakhala zinthu zochepa zomwe zimayendetsedwa ndi mahomoni. Mankhwalawa amawagawa m'magulu otsatirawa kutengera nthawi yomwe akuchita:

• Ochita zinthu mwachidule amaika ntchito mphindi 30 pambuyo pa kutsata. Amalimbikitsidwa kuti asatengedwe pasanathe theka la ola musanadye.
• Ultrashort amaika inshuwaransi yomwe imayamba kugwira ntchito patatha ola limodzi. Mankhwalawa amalimbikitsidwa kumwa pafupifupi mphindi 5 mpaka 10 asanadye kapena atangodya.

Pa tebulo pansipa, kufanizira, kufunika kwa kuthamanga ndi kutalika kwa zochita zamitundu mitundu yamahisitala amakhudzidwa. Mayina a mankhwalawa amaperekedwa mosasamala, popeza pali mitundu yayikulu ya mitundu yawo.

Zinthu zazifupi ndi insulin

Insulin yochepa ndi mankhwala oyera a mahomoni omwe amapangidwa m'njira ziwiri:

• kutengera insulin ya nyama (porcine),
• kugwiritsa ntchito biosynthesis pogwiritsa ntchito ma genetic engineering technology.

Zonsezi, ndi njira ina zomwe zimafanana kwathunthu ndi mahomoni amunthu wachilengedwe, chifukwa chake zimakhala ndi kuchepetsa shuga.

Mosiyana ndi mankhwala omwe akhala akugwiritsidwa ntchito kwa nthawi yayitali, alibe zinthu zina zilizonse zowonjezera, chifukwa chake sizimayambitsa zovuta zilizonse.

Kukhalabe ndi shuga yabwinobwino mwa odwala omwe ali ndi matenda a shuga, ma insulin osakhalitsa, omwe amaperekedwa pafupifupi theka la ola musanadye, nthawi zambiri amagwiritsidwa ntchito.

Ndikofunikira kumvetsetsa kuti wodwala aliyense ali ndi mawonekedwe ake a thupi, chifukwa chake, kuwerengera kwa kuchuluka kwa mankhwala kumachitika nthawi zonse ndi dokotala. Kuphatikiza apo, ndikofunikira kuti kuchuluka kwa zakudya zomwe zimatengedwa ndizofanana ndi mlingo wa insulin. Malamulo oyambira kuperekera mankhwala a mahomoni musanadye motere:

• Kuti mupeze jakisoni, mufunika kugwiritsa ntchito syringe yapadera yokha ya insulin, yomwe imakulolani kuti mupeze mlingo wokhazikika womwe adokotala adapereka.
• Nthawi yoyang'anira iyenera kukhala yokhazikika, ndipo tsamba la majakisidwe liyenera kusinthidwa.
• Malo omwe jakisoniyo anapangidwira silingakonzedwenso, chifukwa momwe mayikidwe achilengedwe a mankhwalawo m'magazi ayenera kukhala osalala.

Ultrashort insulin ndi analogue yosinthika ya insulin ya anthu, izi zikufotokozera kuthamanga kwazotsatira zake. Mankhwalawa adapangidwa ndi cholinga chothandizidwa mwadzidzidzi kwa munthu yemwe wakumanapo ndi shuga m'magazi pazifukwa zosiyanasiyana. Ichi ndichifukwa chake sagwiritsidwa ntchito kawirikawiri pachipatala chovuta kwambiri cha matenda ashuga.

Jakisoni wa insulin ya ultrashort imalimbikitsidwanso panthawi yomwe munthu alibe mwayi woti adikire kwakanthawi asanadye.

Koma pazikhalidwe zokhala ndi zakudya zoyenera, mankhwalawa samalimbikitsidwa kuti atengedwe, chifukwa chakuti imatsika kwambiri chifukwa chochokera pamtengo wambiri, kotero ndizovuta kwambiri kuwerengera mlingo woyenera.

Kulimbitsa Thupi

Ma insulin amfupi ndi a ultrashort amagwiritsidwa ntchito kwambiri masiku ano pomanga thupi. Mankhwala osokoneza bongo amawonedwa ngati othandizira kwambiri a anabolic.

Chomwe chimagwiritsidwa ntchito pomanga thupi ndichakuti insulini ndi mahomoni oyendera omwe amatha kugwira glucose ndikupereka kwa minofu yomwe imayankha izi zikukula mwachangu.

Ndikofunikira kuti othamanga azitha kugwiritsa ntchito mankhwala a mahomoni pang'onopang'ono, potero amazolowera thupi ku mahomoni.Popeza kukonzekera kwa insulini ndi mankhwala olimbitsa thupi mwamphamvu kwambiri, ndizoletsedwa kuwatengera ngati achinyamata othamanga.

Katundu wamkulu wa insulin ndiye kunyamula zakudya. Koma nthawi imodzimodzi, mahomoni amachita ntchitozi mosiyanasiyana, monga:

• mu minofu ya minofu
• mu mafuta m'thupi.

Pankhaniyi, ngati mankhwala a mahomoni atengedwa molakwika, ndiye kuti simungathe kupanga minofu yokongola, koma kuyipa koyipa. Tiyenera kukumbukira kuti mukamalandira mankhwalawa, kuphunzitsa kuyenera kukhala kothandiza.

Pokhapokha pokhapokha, timadzi ta mayendedwe timatulutsa shuga ku minofu yotukuka. Kwa wosewera aliyense yemwe akuchita masewera olimbitsa thupi, mlingo umaperekedwa payekhapayekha.

Amakhazikika pambuyo poyesa kuchuluka kwa shuga m'magazi ndi mkodzo.

Pofuna kuti muchepetse kukula kwa mahomoni m'thupi lanu komanso kuti muchepetse kupanga kwa insulin ndi kapamba, ndikofunikira kupuma pakumwa mankhwala. Mwasankha, sinthani nyengo ya miyezi iwiri ya kumwa mankhwalawo ndikupumula kwa miyezi inayi kuchokera pamenepo.

Malamulo a kumwa mankhwala osokoneza bongo

Popeza ma insulin amafupikitsa komanso a ultrashort omwe ali ndi mankhwala apamwamba ofanana ndi insulin yaumunthu, samayambitsa ziwengo. Koma nthawi zina zotsatira zosasangalatsa monga kuyabwa ndi kuwuma pamalo a jakisoni kumaonedwa.

Tikulimbikitsidwa kuti ma horoni wothandizirana alowetse m'mimba m'mimba atangophunzitsidwa mphamvu. Muyenera kuyamba ndi Mlingo wocheperako ndipo nthawi yomweyo muyenera kuwunika momwe thupi limayambira.

Pafupifupi kotala la ola pambuyo pa jakisoni, chinthu chokoma chiyenera kudyedwa. Chiŵerengero cha mafuta ogwiritsika ntchito kwa gawo lomwe mankhwalawo amaperekedwa ayenera kukhala 10: 1.

Pambuyo pake, pambuyo pa ola limodzi muyenera kudya bwino, ndipo chakudyacho chizikhala ndi zakudya zomwe zili ndi mapuloteni ambiri.

Mankhwala osokoneza bongo ochulukirapo a mankhwala osokoneza bongo kapena makonzedwe ake osayenera angayambitse matenda a hypoglycemic, omwe amalumikizidwa ndi kuchepa kwambiri kwa shuga m'magazi. Pafupifupi nthawi iliyonse mutatha kutenga ultrashort ndi insulin yochepa imayambitsa Hypoglycemia yofatsa. Imadziwulula ndi zizindikiro zotsatirazi:

• chizungulire ndi kudetsa khungu m'maso ndikusintha kwakuthwa kwamphamvu pamthupi,
• njala yayikulu
• mutu
• kugunda kwa mtima
• kutuluka thukuta kwambiri
• nkhawa yamkati ndi kukwiya.

Pambuyo pakuwoneka chimodzi mwazizindikirozi, muyenera kumwa mwachangu kuchuluka kwa chakumwa chokoma, ndipo mutatha theka la ola limodzi mumatha kudya gawo la chakudya chomanga thupi. Komanso chizindikiro cham'mbali cha hypoglycemia ndikochitika kwa chikhumbo chogona.

Palibe zovuta kuchita izi, popeza ndizotheka kukulitsa vutoli. Tiyenera kukumbukira kuti ndi mankhwala osokoneza bongo ambiri aifupi komanso a ultrashort, chikomokere chimatha kuchitika mwachangu kwambiri.

Pofuna kutaya mtima ndi wothamanga, ndikofunikira kufunsa thandizo kuchipatala.

Ubwino wawukulu pokonzekera insulin mukamagwiritsa ntchito polimbitsa thupi ndikuti sangathe kuyesedwa pamayeso oyeserera. Insulin yochepa komanso ya ultrashort ndi mankhwala otetezeka omwe sangawononge molakwika kugwira ntchito kwamkati mwa ziwalo zamkati.

Chofunikanso ndichakuti mankhwala amatha kugula popanda mankhwala komanso mtengo wake, poyerekeza ndi anabolics ena, ndi wotsika mtengo.

Chofunika kwambiri pakukonzekera insulini, koma chofunikira kwambiri nthawi yomweyo, ndikofunikira kuwatenga motsatira ndondomeko yomwe dokotala wakhazikitsa.

Njira yamachitidwe

Kupanga kwa mankhwalawa ndikosavuta - insulini imatenga shuga m'maselo ndikunyamula thupi lonse. Kusamutsa ndikotheka:

• m'matumbo am'mimba - ndichifukwa chake jakisoni wa mahomoni nthawi zambiri amagwiritsidwa ntchito ndi osewera (omanga thupi),
• mu adipose minofu - ndi dosing yosayenera, kugwiritsa ntchito ndalama popanda kuyang'aniridwa ndi katswiri kumayambitsa kunenepa kwambiri.

Kukhazikitsidwa kwakanthawi kokhala ndi mahomoni opanga ma cellacological othandizira subcutaneous, intramuscular, nthawi zina, ma intravenous management samachotsedwa. Jakisoni imachitika ndi syringes yapadera yoika insulin. Ndipo onetsetsani kuti mwadya.

Ku US, asayansi atulutsa chida chatsopano, m'malo mwa jakisoni wa insulin, adayamba kuyamwa ndi mahomoni awa. Pambuyo pakupanga maphunziro azachipatala, asayansi adawona zotsatira zabwino. Pakadali pano, odwala aku US amatha kugula inhalers apadera a insulin yochepa.

Ngati mankhwalawo alowa m'mitsempha kapena pansi pakhungu posachedwa, shuga ya plasma imachepetsedwa kwambiri. Ndipo mutha kuwona mphamvu ya mankhwalawa mkati mwa theka la ola mutatha kutsata.

Kupanga kochita pang'ono

M'masiku amakono azachipatala, mankhwala amapangidwa m'njira ziwiri:

• kutengera ndi porulin insulin
• kugwiritsa ntchito matekinoloje opanga ma genetic - kusintha kwachilengedwe kwa mahomoni a anthu.

Muzochita zawo, onse mankhwalawa amagwirizana kwathunthu ndi timadzi ta munthu. Ndipo zotsatira zake zonse ndi zabwino - kutsitsa-shuga.

Mosiyana ndi mankhwala omwe amagwiritsidwa ntchito kwa nthawi yayitali, zinthuzi sizikhala ndi zowonjezera, chifukwa chake zovuta zoyipa zimasowa kwambiri.

Malangizo ogwiritsira ntchito

Chimalimbikitsa kugwiritsa ntchito jakisoni wa insulin pang'ono:

• tsamba la jakisoni limachiritsidwa ndi yankho la mowa,
• kuti mupeze jakisoni, muyenera kugwiritsa ntchito ma syringe ambiri omwe amagulitsidwa mu mankhwala a insulin,
• ndikofunikira kupatsa mankhwala pang'onopang'ono,

• tsamba la jakisoni likusintha mosalekeza
• insulin yochepa imayendetsedwa kutsogolo kwa khoma lamimba,
• Pambuyo pa makonzedwe, ndikofunikira kuyika mankhwala a thonje osungunuka ndi malo opangira jakisoni, koma sangathe kuwonongeka. The kuyamwa kwa timadzi mu magazi ayenera pang'onopang'ono.

Ultrashort insulin ndi analogue yosinthidwa ya munthu. Mankhwalawa amagwiritsidwa ntchito ngati kulumpha lakuthwa m'magulu a shuga pazifukwa zosiyanasiyana. Mtunduwu umagwiritsidwa ntchito, chifukwa nthawi yake imawonekera kwambiri.

Ngati wodwalayo sangathe kupirira nthawi yofunikira asanadye, dokotala akuwonetsa kugwiritsa ntchito insulin yochepa kwambiri. Ndizovuta kwambiri kuwerengera kuchuluka kwake, chifukwa kuchuluka kwa gawo komwe kumagwira, kutsika kwakuthwa kwambiri kumachitika.

Kugwiritsa ntchito ndalama pamasewera

Masiku ano, kugwiritsa ntchito insulin pamasewera kumagwiritsidwa ntchito kwambiri. Omanga a thupi amadzipaka okha ndi mankhwalawa kuti achulukitse minofu yomanga ndikusintha thupi kuti likhale ndi nkhawa.

Chowonadi ndi chakuti timadzi tating'onoting'ono ndimankhwala abwino a anabolic, ndipo tikayang'aniridwa kuti ataye, sangathe kuwazindikira. Kuphatikiza apo, wogulitsa zamankhwala ali ndi mtengo wotsika mtengo, poyerekeza ndi mitundu ina ya anabolics.

Komabe, wothamanga aliyense ayenera kumvetsetsa kuti ndikaphunzitsidwa mosayenera ndi kumwa, monosaccharides sangasamutsidwe minofu ya minofu, koma kuti minofu ya adipose. Ndipo m'malo moyembekezeredwa komanga minofu, womanga thupi amangolandira mafuta amthupi okha.

Zitsanzo za Hormone

Mpaka pano, njira zotsatirazi zazifupi za insulin ndizodziwika bwino:

• Humalog - ndi ofanana ndi insulin ya anthu. Ili ndi kuyamba koyamba komanso kotsiriza. Kuwonekera kwa thupi kumachitika pakatha mphindi 15, kutalika kwa maola atatu,
• Actrapid NM - mahomoni opanga a munthu ngati gawo la mankhwala. Pambuyo pa mphindi 30, kutsika kwa shuga m'magazi kumayamba. Zotsatira zake zimasungidwa pafupifupi maola 8,
• Insuman Rapid - kapangidwe kake ka mankhwala kamakhala ndi insulin, ofanana ndi kapangidwe ka munthu. Kuchitikaku kumayambira mphindi 25-30 mutatha kugwiritsa ntchito. Kusunga zotsatira mpaka maola 6.

Pali malo ambiri ogulitsa insulin pa intaneti. Kusiyana pakati pawo mu dzina, kapangidwe ndi mtengo.Koma popanda kufunsa katswiri, kudzisankhira pawokha komanso kuyendetsa mankhwalawa kumavulaza wodwala.

Kusunga ndi Kugwiritsa Ntchito Malangizo

Mukamagwiritsa ntchito mahomoni, ndikofunikira kutsatira malamulo osungira mankhwala osavuta, apo ayi ataya katundu wake ndipo palibe zotsatira. Mtundu uliwonse wa mahomoni, malamulo ndi osavuta:

• Iyenera kusungidwa mufiriji, makamaka pakhomo (simungathe kuzizira),
• pambuyo pa jakisoni, botolo limatseka mwamphamvu,
• malonda ndi oyenera mwezi umodzi atatsegula botolo,
• kuwala kwadzuwa sikuvomerezeka
• sansani musanayambe kugwiritsa ntchito,
• Pamaso pa jekeseni, ndikofunikira kulabadira kutetezedwa, kaya pali ma flakes pazomwe mungachite. Onetsetsani kuti mwayang'ana masiku atha

Odwala ayenera kumvetsetsa kuti kutsatira malamulo osungira, dosing ndiye njira yofunikira pamoyo wathanzi. Kuwona malamulo osavuta mukamagwiritsa ntchito, kusunga ndikuphika kwakanthawi kapena ultrashort, zotsatira zake zimakhala zabwino kwambiri. Wodwala samakumana ndi zovuta zilizonse, zovuta komanso zosagwirizana.

Owerenga athu amalemba

Mutu: Matenda a shuga apambana

Ku: my-diabet.ru Administration

Ndili ndi zaka 47, ndinapezeka kuti ndili ndi matenda ashuga a 2. M'masabata angapo ndinapeza pafupifupi 15 kg. Kutopa nthawi zonse, kugona, kumva kufooka, kuwona kunayamba kukhala pansi. Nditakwanitsa zaka 66, ndinali ndikumenya insulin yanga, zonse zinali zoipa kwambiri.

Nayi nkhani yanga

Matendawa adapitilirabe, kukomoka kwakanthawi kunayamba, ambulansi imandibwezera kuchokera kudziko lina. Nthawi zonse ndimaganiza kuti nthawi ino ikhala yomaliza.

Chilichonse chinasintha mwana wanga wamkazi atandilola kuti ndiwerenge nkhani imodzi pa intaneti. Simungayerekeze m'mene ndimamuyamikirira. Nkhaniyi inandithandiza kuthana ndi matenda ashuga, omwe amati ndi osachiritsika. Zaka 2 zapitazi ndidayamba kusuntha kwambiri, nthawi yamasika ndi chilimwe ndimapita kumayiko tsiku lililonse, timakhala ndi moyo wachangu ndi amuna anga, timayenda maulendo ataliatali. Aliyense amadabwitsidwa ndimomwe ndimakwanitsira chilichonse, komwe ndimatha mphamvu zambiri, sakhulupirira kuti ndili ndi zaka 66 zakubadwa.

Ndani akufuna kukhala ndi moyo wautali, wamphamvu komanso kuiwalako za matenda oyipawa kwamuyaya, tengani mphindi 5 ndikuwerenga nkhaniyi.

Pitani pa nkhaniyi >>>

Jakisoni woyamba wa insulin yayitali amachitika usiku ndi miyeso ya shuga yotengedwa maola atatu aliwonse. Pofuna kusintha kwakukulu kuzowonetsa glucose, kusintha kwa mankhwalawa kumapangidwa. Kuti mudziwe zomwe zimayambitsa kuwonjezeka kwa glucose mosakhalitsa, ndikofunikira kuti muphunzire nthawi yayitali pakati pa 00.00 ndi 03.00. Ndi kuchepa kwa magwiridwe, mlingo wa insulin usiku uyenera kuchepetsedwa.

Molondola kwambiri, kuchuluka kwa insulin kofunikira kungadziwike pokhapokha ngati pali shuga komanso chifuwa chachikulu cha insulin m'magazi. Chifukwa chake, popenda insulin ya usiku, muyenera kukana chakudya chamadzulo.

Kuti mupeze chithunzi chothandiza kwambiri, simuyenera kugwiritsa ntchito insulin yochepa, simuyenera kudya mapuloteni kapena zakudya zamafuta

Kuti mudziwe masamba a basal masana, muyenera kuchotsa chakudya chimodzi kapena kudya tsiku lonse. Miyeso imapangidwa ola lililonse.

Musaiwale kuti mitundu yonse ya insulini, kuphatikiza Lantus ndi Levemir, ili ndi katulutsidwe kabwino. Mphindi yayitali kwambiri ya mankhwalawa imachitika patatha maola 6-8 kuchokera nthawi ya makonzedwe. M'mawola awa, kutsika kwa shuga kumachitika, komwe kumakonzedwa ndikudya magawo a mkate.

Malingaliro oterowo ayenera kuchitidwa nthawi iliyonse akasinthidwa. Kuti mumvetsetse momwe shuga imakhalira mukupatsa mphamvu, kungoyesa masiku atatu ndikokwanira. Ndipo pokhapokha pazotsatira zomwe zapezeka, dokotala amatha kupereka mankhwala momveka bwino.

Kuti muwone mahomoni ofunikira masana ndikuwona mankhwala abwino, muyenera kudikirira maola asanu kuchokera nthawi yomwe mumamwa chakudya cham'mbuyomu. Anthu odwala matenda ashuga omwe amagwiritsa ntchito insulin yochepa amayenera kupirira nthawi kuchokera maola 6.Gulu lama insulin lalifupi limayimiriridwa ndi Gensulin, Humulin, Actrapid. Ma insulin a Ultrashort akuphatikizapo: Novorapid, Apidra, Humalog. Ma mahormoni a Ultrashort amachita komanso amafupikitsa, koma adathetsa zoperewera zambiri. Nthawi yomweyo, chida ichi sichingathe kukhutiritsa kufunikira kwa insulin.

Sizotheka kupereka yankho lenileni ku funso loti insulin ndiyabwino kwambiri. Koma pazotsatira za dokotala, mutha kusankha mulingo woyenera wa basal ndi insulin yochepa.

Fotokozani

Ngati muwerenga izi, mutha kuzindikira kuti inu kapena okondedwa anu mukudwala matenda ashuga.

Tinachita kafukufuku, tinaphunzira zambiri za zida ndipo koposa zonse tinayang'ana njira ndi mankhwala ambiri a shuga. Chigamulochi ndi motere:

Ngati mankhwalawa onse akaperekedwa, zinali zotsatira zosakhalitsa, atangomaliza kudya, matendawa amakula kwambiri.

Mankhwala okhawo omwe adapereka chofunikira ndi kusiyana.

Pakadali pano, awa ndiye mankhwala okhawo omwe amachiritsiratu matenda ashuga. Makamaka machitidwe amphamvu a Kusiyanitsa adawonetsa koyambirira kwa matenda ashuga.

Tidafunsa Unduna wa Zaumoyo:

Ndipo kwa owerenga tsamba lathu lino mwayi
khalani ndi kusiyana ZAULERE!

Yang'anani! Milandu yogulitsa mankhwalawa yabodza Kusiyanako kwakhala komweko.
Mukayika lamulo pogwiritsa ntchito maulalo pamwambapa, mumatsimikiziridwa kuti mudzalandira malonda kuchokera kwa wopanga wamkulu. Kuphatikiza apo, mukamayitanitsa pa tsamba lovomerezeka, mumalandira chitsimikizo cha kubweza (kuphatikizapo ndalama zoyendera) ngati mankhwalawo alibe.

Pofuna kuti glucose azikhala pamlingo wa matenda ashuga usiku wonse ndikuonetsetsa kuti m'mimba mulibe kanthu masana, insulini yowonjezera imagwiritsidwa ntchito. Cholinga chake ndikubweretsa timadzi tambiri m'magazi kuti tisayandikire. Insulin yayitali nthawi zambiri imaphatikizidwa ndi yochepa, yomwe imalowetsedwa musanadye chilichonse.

Ndikofunikira kudziwa! Nkhani yatsopano yomwe ikulangizidwa ndi ma endocrinologists a Kuwunika Kwachisawawa Kokulu! Ndi zofunika tsiku lililonse.

Mlingo ndiwofanana payekha, mutha kuwatenga mwanjira zoyesera. Popewa hypoglycemia, kuchuluka koyamba kwa mahomoni kumadzipaka mwadala, kenako kumachepetsa pang'onopang'ono mpaka magazi atasintha

Mlingo wosankhidwa bwino wa insulin yayitali umachepetsa zovuta za matenda ashuga ndipo umalola wodwala kukhalabe wokangalika kwa zaka zambiri.

Kusankhidwa kwa Insulin Yowonjezera

Kutulutsa kwa insulin m'magazi sikuyima mozungulira wotchi, ngakhale kukhalapo kapena kusowa kwa chakudya. Usiku ndi masana, pomwe chakudya chimodzi chakhala chikugwiritsidwa kale ndipo chinacho sichinafike, mawonekedwe am'mbuyomu amakhala osungika. Ndikofunikira kuti shuga amasweke, omwe amalowa m'magazi kuchokera m'masitolo a glycogen. Kuti muwonetsetse maziko, ngakhale khola, kukhazikitsa insulin yayitali ndikofunikira. Kutengera zomwe tafotokozazi, zikuwonekeratu kuti mankhwala abwino ayenera khalani ndi yayitali, yofananira , simunatchulidwe nsonga zazitali ndi zipupa.

Pazolinga izi:

Matenda a shuga ndi kupsinjika kudzakhala chinthu chakale

Matenda a shuga ndi omwe amayambitsa pafupifupi 80% yonse yamikwingwirima ndi kuduladula. Anthu 7 mwa anthu 10 amafa chifukwa cha mitsempha ya mtima kapena ubongo. Pafupifupi nthawi zonse, chifukwa chomaliza chomaliza ndi chimodzimodzi - shuga wamwazi.

Shuga akhoza ndipo amayenera kugwetsedwa, apo ayi. Koma izi sizichiritsa matendawa, koma zimangothandiza kulimbana ndi kufufuza, osati zomwe zimayambitsa matendawa.

Mankhwala okhawo omwe amalimbikitsidwa mwalamulo kwa odwala matenda ashuga komanso ogwiritsidwa ntchito ndi endocrinologists pantchito yawo ndi Ji Dao Diabetes Adhesive.

Kugwiritsa ntchito bwino kwa mankhwalawa, kuwerengera malinga ndi njira yokhazikika (kuchuluka kwa odwala omwe achiwonjezere kuchuluka kwa odwala omwe ali pagulu la anthu 100 omwe adachitiridwa chithandizo):

• Matenda a shuga - 95%
• Kuthetsa kwa mitsempha thrombosis - 70%
• Kuthetsa kwa kugunda kwamtima kwamphamvu - 90%
• Kuthana ndi kuthamanga kwa magazi - 92%
• Kulimbitsa tsiku, kukonza kugona usiku - 97%

Opanga Ji Dao si bungwe lazamalonda ndipo amalipiridwa ndi boma. Chifukwa chake, tsopano wokhala aliyense ali ndi mwayi wopeza mankhwalawo kuchotsera 50%.

Kusankha kwa insulin yayitali ndi udindo wa dokotala. Imatengera kulanga kwa wodwala, kupezeka kwa chinsinsi cha mahomoni ake, chizolowezi cha hypoglycemia, zovuta zamavuto, kuchuluka kwa kusala kwa hyperglycemia.

Momwe mungasankhire insulin yayitali:

1. Nthawi zambiri, zokonda zimaperekedwa kwa ma insulin analogues, omwe ndi othandiza kwambiri komanso amaphunziridwa.
2. Ma Protamine othandizira amagwiritsidwa ntchito nthawi zambiri ngati njira ina ilibe. Ma insulin a NPH amatha kupereka chindapusa chokwanira cha matenda a shuga 2 mtundu woyamba wa mankhwala a insulin, pomwe kufunika kwa mahomoni kumakhalabe kotsika.
3. Tresiba itha kugwiritsidwa ntchito bwino ndi mtundu wa 1 a matenda ashuga, omwe samakonda kutsika magazi ndikuyamba kumva zizindikiro za hypoglycemia koyambirira. Ndi matenda a shuga a 2, Tresib ndiye mtsogoleri wosagonjetseka pamsika wa insulin, chifukwa amaphatikiza bwino ndi othandizira pakamwa, amakhala ndi zotulukapo, ndipo amachepetsa pafupipafupi hypertlycemia yausiku.

Kuchuluka kwa insulin kwa nthawi yayitali kumagawidwa m'mawa ndi usiku makonzedwe, mlingo wawo nthawi zambiri umasiyana. Kufunika kwa mankhwalawa kumatengera kuopsa kwa matenda ashuga. Njira zingapo zapangidwa pakuwerengera kwake. Zonsezi zimafuna magawo angapo a shuga m'magazi. Kusankhidwa kwa mankhwalawa kumatenga nthawi, popeza kuchuluka kwa nthawi yayitali ya insulini kumasinthidwa kulingalira za mawonekedwe a mayamwidwe ndi kuwonongeka kwa mahomoni m'thupi la wodwala winawake. Kukhazikitsidwa kwa mlingo woyambira "ndi diso" kumabweretsa chiwopsezo chachikulu cha matenda ashuga, ndikukulitsa zovuta za matendawa.

Kukula kwa mlingo wosankhidwa bwino ndikubwino kwa kudya kwa glycemia, kuchepa kwamapapo komanso kusapezeka kwa hypoglycemia. Masana, kusinthasintha kwa shuga musanadye kumayenera kukhala ochepera 1.5 mmol / l -.

Kuwerengedwa kwa nthawi yamadzulo

Woyamba kusankha kuchuluka kwa insulin yochulukirapo, iyenera kupereka mulingo wa shuga usiku komanso m'mawa mutadzuka. Mu shuga mellitus, "zodzuka zam'mawa" nthawi zambiri zimawonedwa. Uku ndikuwonjezereka kwa glycemia m'mawa kwambiri, chifukwa cha kuwonjezeka kwa katulutsidwe ka mahomoni komwe kamafewetsa mphamvu ya insulin.Mwa anthu athanzi, kutulutsidwa kwa insulin kumawonjezeka panthawiyi, motero shuga amakhazikika.

Mu shuga mellitus, kusinthasintha kumeneku kungathetsedwe kokha ndi kukonzekera kwa insulin. Kuphatikiza apo, kuchuluka kwa mankhwalawa kumachepetsa shuga m'magazi kuti akhale abwinobwino, koma kumapangitsa kutsika kwambiri kwa glycemia koyambira komanso pakati pausiku. Zotsatira zake, wodwala matenda ashuga amadwala malodza, mtima wake komanso thukuta lake limakulirakulira, mitsempha yake imadwala.

Kuti muthane ndi vuto la hyperglycemia m'mawa, osachulukitsa mlingo wa mankhwalawa, mutha kugwiritsa ntchito chakudya cham'mbuyomu, moyenera - maola 5 musanayambitse insulin yayitali. Munthawi imeneyi, shuga onse azakudya azikhala ndi nthawi yoti adutse m'magazi, kusintha kwa timadzi tambiri tating'onoting'ono kumatha, ndipo insulin yayitali ingasinthe glycogen ku chiwindi.

1. Kuti mudziwe kuchuluka kwa mankhwalawa jakisoni wamadzulo, manambala a glycemic kwa masiku angapo amafunikira. Muyenera kukhala ndi chakudya cham'mawa molondola, kuyeza shuga musanagone, kenako m'mawa mutangodzuka. Ngati m'matumbo glycemia anali wamkulu, miyeso imapitilira masiku ena anayi. Masiku omwe chakudya chidayandikira sachotsedwa pamndandanda.
2. Kuti muchepetse chiopsezo cha hypoglycemia, kusiyana kocheperako pakati pa miyeso iwiriyi kumasankhidwa masiku onse.
3. Chidziwitso cha insulin chimawerengedwa. Uku ndiye kukula kwa kuchepa kwa glycemia atakhazikitsa gawo limodzi la mahomoni. Mwa munthu wolemera makilogalamu 63, gawo limodzi la insulin yowonjezera limatsitsa shuga ndi 4.4 mmol / L pafupifupi. Kufunika kwa mankhwalawa kukukula molingana ndi kulemera. PSI = 63 * 4.4 / kulemera kwenikweni. Mwachitsanzo, ndi kulemera kwa 85 kg, PSI = 63 * 4.4 / 85 = 3.3.
4. Mlingo woyambira amawerengedwa, ndi wofanana ndi kusiyana kocheperako pakati pa miyezo isanayambe kugona ndi m'mawa, yogawidwa ndi PSI. Ngati kusiyana ndi 5, lowetsani nthawi yogona musanadye magawo 5 / 3.3 = 1.5.
5. Kwa masiku angapo, shuga amayeza pambuyo podzuka, kutengera deta iyi, kuchuluka kwa insulini kumasinthidwa. Ndikwabwino kuti musinthe mankhwalawa pakadutsa masiku atatu, kusintha kulikonse kuyenera kupitirira gawo limodzi.

Ndi mtundu 2 wa shuga, shuga m'mawa amatha kukhala otsika kuposa nthawi yogona. Pankhaniyi, insulin yayitali sichikhala ndi jekeseni yamadzulo. Ngati glycemia atatha kudya chakudya chamadzulo, amapanga mankhwala othamanga a mahomoni othamanga. Insulin yayitali pazolinga izi sizingagwiritsidwe ntchito, imayendetsedwa chimodzimodzi.

Ngati kusintha kwa mlingo kumalephera

Hypoglycemia usiku ikhoza kubisika, ndiye kuti, wodwalayo m'maloto samva chilichonse ndipo sakudziwa za kukhalapo kwawo. Kuti mupeze kuchepa kobisika kwa shuga m'magazi, miyezo imachitika kangapo usiku: pa maola 12, 3 ndi 6. Ngati 3 koloko m'mawa glycemia ali pafupi ndi malire ochepa, tsiku lotsatira amayeza pa 1-00, 2-00, 3-00. Ngati chisonyezo chimodzi sichinachite bwino, zimawonetsa bongo

Anthu ena omwe ali ndi matenda ashuga omwe amafunikira insulin yaying'ono amakumana ndi zomwe zimachitika kuti timadzi tambiri timachepa m'mawa, ndipo sikokwanira kuthetsa vuto lodzuka m'mawa. Kuwonjezeka kwa mankhwalawa pamenepa kumabweretsa nocturnal hypoglycemia. Izi zimawonedwa mukamagwiritsa ntchito insulin ya NPH yomwe sinathe, komanso Lantus, Tujeo ndi Levemira.

Njira zothetsera vutoli: zowonjezera makonzedwe a 1-2 magawo a insulin yayitali pa 2-00 kapena poplka yokonza mayunitsi 0,5-1 a kukonzekera kwapafupi pa 4,00.

Ngati pali mwayi wazachuma, mutha kukambirana za kufunikira kwa insulini yayitali ndi dokotala. Zochita za Treshiba usiku wonse, ndiye kuti shuga m'magazi amakhala achilendo popanda jakisoni wowonjezera. Munthawi ya kusintha, kuwongolera pafupipafupi kwa glycemia kumafunika kuti muchepetse kuchepa kwake masana.

Ambiri a endocrinologists amalimbikitsa kusinthira ku Treshiba kokha kuti awonetsetse. Anthu odwala matenda ashuga, omwe othandizira omwe adatsimikizira kuti amapereka ngongoleyo amakhala olipidwa kale chifukwa cha matendawa, akulangizidwa kuti apewe insulin yatsopano mpaka wopangayo atachitapo kafukufuku wokwanira ndipo akudziwa zambiri za mankhwalawo.

Kusankhidwa kwa Mlingo wam'mawa

Insulin yayitali masana imafunikira kuti muchepetse shuga zakudya zikagayidwa kale. Zakudya zomanga thupi kuchokera ku chakudya zimalipitsidwa ndi mahomoni afupiafupi. Kuti mphamvu zake zisasokoneze kusankha kuchuluka kwa insulini yowonjezera, muyenera kufa ndi njala tsiku lina.

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

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

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

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipira mtengo wa mankhwalawo. Ku Russia, odwala matenda ashuga mpaka pa Epulo 4 (kuphatikiza) nditha kuipeza - Kwa ma ruble 147 okha!

Kuwerengetsa kwa tsiku ndi tsiku mlingo wa algorithm:

1. Sankhani tsiku laulere kwathunthu. Idyani chakudya cham'mawa. Pangani kuchuluka kwa magazi mutadzuka, pambuyo pa ola limodzi, kenako katatu pakatha maola anayi aliwonse. Nthawi yonseyi yomwe simutha kudya, madzi okha ndi omwe amaloledwa. Pambuyo muyeso wotsiriza mutha kudya.
2. Sankhani shuga wochepa kwambiri patsiku.
3. Kuwerengera kusiyana pakati pa mulingo uno ndi chandamale, chomwe 5 mmol / l amatengedwa.
4. Muwerenge insulin tsiku lililonse: gawani kusiyana ndi PSI.
5. Pakatha sabata, bwerezani miyezo pamimba yopanda kanthu, ngati kuli kotheka, sinthani mlingo wake potengera deta

Ngati kusala kudya kwanthawi yayitali kuli koletsedwa kwa odwala matenda ashuga, muyezo ungachitike m'magawo angapo: woyamba kulumphira chakudya cham'mawa, tsiku lotsatira - nkhomaliro, tsiku lotsatira - chakudya chamadzulo. Kuchokera pakudya mpaka kuyeza shuga ayenera kutenga maola 5 ngati wodwalayo wavulala jakisoni wofupikiratu wa insulin asanadye, ndi pafupifupi maola 7 ngati insulin ya anthu yagwiritsidwa ntchito.

Mawerengero Achitsanzo

Wodwala wodwala matenda a shuga a mtundu wa 2 wolemera makilogalamu 96 sikokwanira othandizira, motero amamuika mankhwala a insulin. Kuwerengera tsiku ndi tsiku insulin yayitali, timayeza:

Mtengo wocheperako ndi 7.2. Kusiyana kwake ndi gawo la chandamale: 7.2-5 = 2.2. PSI = 63 * 4.4 / 96 = 2.9. Mlingo wofunikira tsiku lililonse = 2.2 / 2.9 = 0,8 mayunitsi, kapena 1 unit. zokhala ndi zozungulira.

Kuyerekeza malamulo a kuwerengera Mlingo wam'mawa ndi wamadzulo

Ndi matenda 2 a shuga, sikofunikira kuti mukhale ndi insulin yayifupi komanso yayitali. Zitha kuzindikirika kuti kapamba payekha imapilira kupereka maziko oyambira, ndipo mahomoni owonjezera safunika. Ngati wodwalayo amatsatira mosamalitsa, sipangakhale chifukwa chochepa cha insulin musanadye. Ngati wodwala matenda ashuga amafuna insulin yayitali kwa onse usana ndi usiku, mlingo wa tsiku ndi tsiku umakhala wotsikirapo.

Pakadutsa matenda a shuga 1, mtundu ndi kuchuluka kwa mankhwalawo amafunikira nthawi zambiri amasankhidwa kuchipatala. Malamulo kuwerengera omwe ali pamwambapa angagwiritsidwe ntchito kusintha mlingo ngati woyamba anali kusiya kupereka chipepeso chabwino.

Zoyipa za NPH-Insulin

Poyerekeza ndi Levemir ndi Lantus, ma NPH-insulins ali ndi zovuta zingapo zazikulu:

• sonyezani kuchuluka kwakukulu kwa ntchito pambuyo pa maola 6, chifukwa chake musayerekeze kubisala kwakumbuyo, komwe kumakhala kokhazikika,
• Kuwonongeka kosasinthika, kotero zotsatira zake zingakhale zosiyanasiyana masiku osiyana,
• Nthawi zambiri zomwe zingayambitse matenda ashuga. Chiwopsezo cha kusinthika kwa anaphylactic chimachulukitsidwa ndi maantibayotiki, ma radiopaque, NSAIDs,
• Ndiwo kuyimitsa, osati yankho, chifukwa chake zimatengera kusakanikirana kwathunthu kwa insulin ndikutsatira malamulo ake.

Ma inshuwiti amakono samakhala opanda zofooka izi, chifukwa chake kugwiritsa ntchito mankhwalawa matenda a shuga ndikofunikira.

Onetsetsani kuti mwaphunzira! Kodi mukuganiza kuti kuyamwa kwa mapiritsi ndi insulini kwa nthawi yonse yokhayo ndi njira yokhayo yosungira shuga m'manja? Sichowona! Mutha kutsimikizira izi nokha ndikuyamba kuzigwiritsa ntchito.

Matenda a 2 a shuga amatchedwanso shuga osadalira insulini. Ichi ndi matenda oopsa omwe amadziwika ndi ...

Popereka mankhwala, dokotalayo ayenera kuphunzira zolemba za wodwalayo, kuwonetsa kuchuluka kwa shuga m'magazi atatu apitawa, makamaka mwezi umodzi kapena iwiri.

Kwa moyo wabwinobwino, insulin yayitali imapangidwa kuti ikhale yoyambira, kwa odwala omwe ali ndi matenda "", omwe amadziwika kuti ali ndi insulin yodziwika ngati "" insulin ".

Basal insulin ndi insulin yomwe imapangidwa m'thupi nthawi zonse 24 tsiku lililonse, mosasamala nthawi ndi kuchuluka kwa kudya. Komabe, mwa odwala omwe ali ndi matenda amtundu wa II, kapamba sangathe kutulutsa timadzi tating'onoting'ono. Jekeseni wambiri wa insulin amapatsidwa 1 m'mawa, asanadye, nthawi zina ziwiri. Mankhwalawa amayamba kugwira ntchito kwathunthu pambuyo pa maola atatu ndipo amakhalapobe mpaka maola 24.

Pochizira matenda amtundu wa 1 shuga, insulin ya basal imathandizika ndi jakisoni afupifupi kapena a ultrashort.

Insulin yokhala nthawi yayitali, omwe mayina awo omwe amaperekedwa pansipa, ndiofunikira pankhani zotsatirazi:

• kukhazikika m'mawa musanadye,
• kusungidwa kwofunikira kwa mahomoni usiku,
• sinthani zovuta zotere ngati "m'mawa kutacha",
• kupewa ndikusunga maselo a beta a mtundu 1 shuga,
• kukhazikika kwa mkhalidwe wamthupi ndi kusungika kwake pakupititsa patsogolo matendawa mtundu wa 2 shuga.

Kukula kwa kuchuluka kwa insulin yayitali kumatsimikiziridwa ndi adokotala okha, atafufuza mwatsatanetsatane wodwala komanso jakisoni wazinthu zingapo. Pofuna kupewa hypoglycemia mu Mlingo woyambirira, kuchuluka kwa mahomoni kumakhala kwakukulu. Kenako, ndendeyo imayamba kuchepa m'magazi a shuga m'magazi.

Insulin yayitali ndikofunikira kugwiritsa ntchito moyenera. Sizothandiza, monga thandizo ladzidzidzi, kukhazikika shuga m'magazi mutatha kudya, monga insulin yochepa kapena yochepa kwambiri. Zochita zake sizothamanga kwambiri. Jekeseni wa insulin wa nthawi yayitali amafunikira kutsatira kwambiri njira ndi ndandanda. Kupatuka kuyambira nthawi yoikidwiratu kumatha kudzetsa zovuta kwa thanzi la wodwalayo, chifukwa chizindikiro cha shuga chamagazi sichikhazikika.

Pogwiritsa ntchito ma insulins omwe akhala akuchita kwa nthawi yayitali, wodwalayo amapatsa thupi lake chilinganizo cholondola kwambiri cha mahomoni amunthu. Mokhazikika, insulin yomwe yakhala ikugwira ntchito kwa nthawi yayitali, mayina omwe tikambirana pansipa, amagawika m'magulu awiri: nthawi yayitali ndi maola 15 ndipo nthawi yayitali ikufika mpaka maola 30.

Atafika poti ndende yayitali kwambiri imangoyenda pang'onopang'ono, insulini yokhala nthawi yayitali imayamba kuchepa pang'onopang'ono popanda kuchitapo kanthu ndikudumpha m'magazi a wodwalayo. Ndipo apa chinthu chofunikira kwambiri ndikusaphonya mphindi yomwe jakisoni itayamba kukhala ziro ndikulowa muyezo wotsatira wa mankhwalawa. Insulin yayitali imakhala ndi zabwino komanso zovuta zake ngati mankhwala ena onse.

• mawu oyambira osavuta
• Njira zamankhwala ndizosavuta komanso zomveka kwa wodwalayo komanso abale ake,
• chizindikiro chotsika cha kuphatikiza kwa luso ndi chidziwitso chofunikira chamankhwala,
• kusowa kwa kuyang'anira kuchuluka kwa shuga m'magazi,
• kudziyang'anira pawokha pa matenda ndi kupitiliza kwa mankhwala ndikotheka.

• chiopsezo chokhazikika cha hypoglycemia,
• hyperinsulinemia yokhazikika, yomwe imawonjezera mwayi wokhala ndi matenda oopsa,
• kudya mwamphamvu ndi jakisoni,
• kunenepa

Mayina Mankhwala Osokoneza bongo

Kusakhalapo kwa zochitika mu insulin yochitika kwa nthawi yayitali kumachitika chifukwa cha kupezeka kwa timadzi tating'onoting'ono timadzi timene timalowa m'magazi, momwe timalowa m'magazi mokwanira. Mlingaliro wa Glargine wa Ph ndiwac acid ndipo izi zimapatula kuyanjana kwake ndi kukonzekera kosatha kwa Ph Ph, i.e. yochepa komanso ya ultrashort insulin.

Mayina odziwika kwambiri a insulin omwe amakhala nthawi yayitali amaperekedwa pagome pofotokozeredwa bwino:

Pochiza matenda a shuga kunyumba, akatswiri akulangizani DiaLife . Ichi ndi chida chapadera:

• Amasinthasintha shuga
• Amayang'anira ntchito ya pancreatic
• Chotsani puffness, limayendetsa madzi kagayidwe
• Imasintha khungu
• Zoyenera akulu ndi ana.
• Alibe zotsutsana

Timapereka kuchotsera kwa owerenga tsamba lathu!

Gulani pa tsamba lovomerezeka

Mankhwala otchuka

Ngakhale panali insulin yayitali, mayina omwe amaperekedwa patebulopo, otchuka kwambiri mpaka pano ndi Lantus ndi Levemir. Tiyeni tiwone chifukwa.

Mankhwala omwe odwala amagwiritsa ntchito nthawi zambiri kuposa ena. Sifunika kugwedezeka musanagwiritse jakisoni, kapangidwe kake ka kuyimitsidwa ndikowonekera komanso kopanda mpweya. Amapezeka mu cholembera, syringe, cartridge, ndi makatiriji makatoni asanu. Kukhalapo kwa chisankho choterocho kumapangitsa wodwala kusankha njira yomwe amavomerezeka kwa iye.