Chizindikiro cha kukonzekera kwa insulin

Insulin ndi mankhwala ena ochepetsa shuga, imatha kuyendetsa kagayidwe kazinthu, imalimbikitsa kukhathamiritsa kwa minyewa ndikulimbikitsa kutembenuka kwake kukhala glycogen, komanso imathandizira kulowa kwa glucose m'maselo a minyewa.

Kuphatikiza pa zotsatira za hypoglycemic (kutsitsa shuga), insulin imakhala ndi zotsatirapo zingapo: imawonjezera masitolo a minofu ya glycogen, imalimbikitsa kaphatikizidwe ka peptide, imachepetsa kumwa kwa mapuloteni, ndi zina zambiri.

Kuwonetsedwa kwa insulini kumayendetsedwa ndi kukondoweza kapena kuletsa (kuponderezana) kwa michere ina, glycogen synthetase, pyruvate dehydrogenase, hexokinase imakhudzidwa, lipase ikuyambitsa mafuta acids a minofu ya adipose, lipoprotein lipase, kuchepetsa magazi ndikudya chifukwa chokhala ndi mafuta ambiri.

Mlingo wa biosynthesis ndi secretion (secretion) wa insulin zimatengera kuchuluka kwa shuga m'magazi. Ndi kuwonjezeka kwa zomwe zili mkati mwake, katulutsidwe ka insulin ndi kapamba kumawonjezera, m'malo mwake, kutsika kwa kuchuluka kwa shuga m'magazi kumachepetsa kubisalira kwa insulin.

Pakukhazikitsa zotsatira za insulini, gawo lotsogolera limaseweredwa ndi kulumikizana kwina ndi cholandilira chapadera pamadzi a cell ya cell, ndikupanga insulin receptor zovuta. Zomwe zimapangira insulini limodzi ndi insulin zimalowa mu cell, momwe zimakhudzira kuphatikizana kwa mapuloteni am'magazi, kuwonjezereka kwina kosamveka sikumveka bwino.

Insulin ndiye chithandizo chenicheni cha matenda a shuga; chifukwa amachepetsa hyperglycemia (kuchuluka kwa shuga m'magazi) ndi glycosuria (kukhalapo kwa shuga mumkodzo), amabwezeretsanso kuchuluka kwa glycogen mu chiwindi ndi minofu, amachepetsa kupanga shuga, ndikuchepetsa matenda a shuga m'magazi (kukhalapo kwamafuta m'magazi) Amathandizira wodwalayo.

Insulin yogwiritsira ntchito kuchipatala imapezeka kuchokera ku zikondamoyo za ng'ombe ndi nkhumba. Pali njira yothandizira kuphatikizira mankhwala a insulin, koma ndi osatheka. Posachedwa apanga njira za biotechnological zopangira insulin yaumunthu. Insulin yomwe imapezeka ndi ma genetic engineering imafanana kwathunthu ndi mndandanda wa amino acid wa insulin ya anthu.

Milandu yomwe insulin imapezeka kuchokera ku zikondamoyo za nyama, zodetsa zosiyanasiyana (ma proinsulin, glucagon, kudzipereka, mapuloteni, ma polypeptides, ndi zina zotere) zitha kupezeka pokonzekera chifukwa chosakwanira kuyeretsa. Kukonzekera bwino kwambiri kwa insulin kumatha kuyambitsa mavuto osiyanasiyana.

Njira zamakono zimapangitsa kuti zitheke (monopic - chromatographic oyeretsedwa ndikutulutsa "nsonga" ya insulin), yoyeretsedwa kwambiri (monocomponent) ndikukonzekera insulin. Pakadali pano, mafuta a insulin a insulin amagwiritsidwa ntchito kwambiri. Pazokonzekera za insulin, nyama zimakonda kusankha insulin chifukwa cha nkhumba.

Ntchito ya insulin imatsimikizika kuti ikubadwa (mwa kuthekera kutsika shuga m'magulu a akalulu athanzi) komanso ndi imodzi mwazinthu zachilengedwe (electrophoresis pamapepala kapena chromatography papepala). Pa gawo limodzi la ntchito (UNIT), kapena unit yapadziko lonse lapansi (IE), chitani zochitika za 0404082 mg wa crystalline insulin.

Njira Yogwiritsira Ntchito:

Pochiza matenda a shuga, insulin yokonzekera zosiyanasiyana zimagwiritsidwa ntchito (onani pansipa).

Insulin yogwira ntchito yayifupi imagwiritsidwanso ntchito munjira zina za pathological: kuyambitsa matenda a hypoglycemic (kutsitsa shuga m'magazi) m'njira zina za schizophrenia, monga mankhwala a anabolic (olimbitsa kaphatikizidwe ka protein) ndi kutopa konse, kusowa kwa zakudya, furunculosis , thyrotoxicosis (matenda a chithokomiro), omwe ali ndi matenda am'mimba (atony / kuchepera kwa toni /, gastroptosis / prolfall m'mimba /), hepatitis yayitali (kutupa kwa minyewa ya chiwindi), nyh mitundu ndi matenda enaake chiwindi, komanso chigawo chimodzi "polarizing" zothetsera ntchito azichitira pachimake inatsekeratu insufficiency (mismatch pakati kufunika mtima mpweya ndi yobereka ake).

Kusankhidwa kwa insulin pochiza matenda ashuga kumadalira kuopsa kwa matendawa, momwe wodwalayo alili, komanso kuthamanga kwa nthawi komanso nthawi yayitali ya Hypoglycemic. Cholinga chachikulu cha insulin komanso kukhazikitsa mlingo wa mankhwala imachitika mu chipatala (chipatala).

Kukonzekera kwa insulin kochepa ndi njira zothetsera subcutaneous kapena mu mnofu makonzedwe. Ngati ndi kotheka, amaperekedwanso kudzera m'mitsetse yamkati. Ali ndi mphamvu yochepetsera shuga yochepa komanso yochepa. Nthawi zambiri amathandizidwa kupakidwa mphindi 15 mpaka 15 musanadye chakudya kangapo patsiku. Zotsatira pambuyo pobayira jakisoni wapakati pa mphindi 15 mpaka 20, kufika pazowonjezereka pambuyo pa maola awiri, nthawi yonse yovutikira sichikupita maola 6. Amagwiritsidwa ntchito makamaka kuchipatala kukhazikitsa kuchuluka kwa insulin kwa wodwala, komanso ngati pakufunika kukwaniritsa mwachangu Kusintha kwa ntchito ya insulin mthupi - ndi matenda a shuga komanso precom (kutaya kwathunthu kapena pang'ono pang'ono chifukwa cha kuchuluka kwakukula kwa shuga).

Kuphatikiza pa tog 9, kukonzekera mwachangu insulini kumagwiritsidwa ntchito ngati anabolic othandizira ndipo amalembera, monga lamulo, mumiyeso yaying'ono (4-8 mayunitsi 1-2 patsiku).

Kukonzekera kwa insulin kwa nthawi yayitali (kwa nthawi yayitali) kumapezeka m'mitundu mitundu yosiyanasiyana yokhala ndi kuchepetsa shuga (semylong, yayitali, ultralong). Mankhwala osiyanasiyana, zotsatira zake zimakhala maola 10 mpaka 36. Chifukwa cha mankhwalawa, kuchuluka kwa jakisoni tsiku ndi tsiku kumatha kuchepetsedwa. Nthawi zambiri amapangidwa mu mawonekedwe a kuyimitsidwa (kuyimitsidwa kwa ma tinthu tosagwirizana ndimadzi), kumayendetsedwa kokha kapena intramuscularly, mtsempha wamkati samaloledwa. Pazakudya zokhala ndi matenda ashuga komanso mikhalidwe yoyipa, mankhwalawa amakhala osagwiritsidwa ntchito.

Nthawi zambiri, mankhwala omwe amagwiritsidwa ntchito kwa nthawi yayitali amathandizidwa musanadye chakudya cham'mawa, koma ngati kuli koyenera, jakisoni ikhoza kuchitika maola ena.

Zokonzekera zonse za insulin zimagwiritsidwa ntchito potsatira zakudya. Tanthauzo la kuchuluka kwa mphamvu (kuyambira 1700 mpaka 3000 khal) kuyenera kutsimikiziridwa ndi kulemera kwamthupi la wodwalayo panthawi yamankhwala, ndi mtundu wa zochita. Chifukwa chake, ndi kuchepa kwa zakudya komanso kugwira ntchito zolimbitsa thupi, kuchuluka kwa zopatsa mphamvu patsiku kwa wodwala kuli osachepera 3000, wokhala ndi zakudya zokwanira komanso kukhala ndi moyo wokhazikika, sayenera kupitilira 2000.

Kuyambitsa Mlingo wambiri, komanso kusowa kwa chakudya ndi zakudya, kumayambitsa matenda a hypoglycemic (kutsitsa shuga), kumayendetsedwa ndi kumva njala, kufooka, thukuta, kugwedezeka kwa thupi, kupweteka mutu, chizungulire, kukwiya, chisangalalo . Pambuyo pake, hypoglycemic coma ikhoza kukhala (kuiwalika kwa chikumbumtima, chodziwika ndi kuperewera konse kwa thupi pakukhudzidwa kwakunja chifukwa chakuchepa kwambiri kwa shuga m'magazi) ndikutaya chikumbumtima, kugwidwa, komanso kutsika kwamphamvu kwa mtima. Pofuna kupewa matenda a hypoglycemic, odwala ayenera kumwa tiyi wokoma kapena kudya shuga pang'ono.

Ndi chifuwa cha hypoglycemic (chokhudzana ndi kuchepa kwa shuga wamagazi), yankho la glucose 40% limalowetsedwa m'mitsempha mu 10 ml ml, nthawi zina mpaka 100 ml, koma osatinso.

Malangizo a hypoglycemia (kutsitsa shuga wamagazi) mu mawonekedwe owopsa amatha kuchitika pogwiritsa ntchito minyewa kapena subcutaneous makonzedwe a glucagon.

Zochitika:

Ndi subcutaneous makonzedwe a insulini, lipodystrophy (kuchepa kwa kuchuluka kwa adipose minofu yaying'ono) imatha kupezeka malo a jekeseni.

Kukonzekera kwamakono kwambiri kwa insulin komwe kumayambitsa zovuta zomwe sizigwirizana, komabe, milandu yotereyi siyikusiyidwa. Kukula kwa matenda oopsa sayanjana pafupipafupi kumafunanso kufooka (kuletsa kapena kuletsa ziwopsezo) kugwiritsira ntchito mankhwalawa.

Zoyipa:

Zotsatira zakugwiritsira ntchito insulin ndi matenda omwe amapezeka ndi hypoglycemia, hepatitis yacute, cirrhosis, hemolytic jaundice (chikasu cha pakhungu ndi zotupa za m'maso zimayambitsa kupindika kwa maselo ofiira am'magazi), kapamba (kutupa kwa impso), nephritis (kutupa kwa impso) matenda a impso ogwirizana ndi kuphwanya mapuloteni / amyloid metabolism, urolithiasis, m'mimba ndi zilonda zam'mimba, zotupa za mtima (mtima kulephera chifukwa chakomoka mtima matenda a mavavu ake).

Kusamala kwakukulu kumafunikira pochiza odwala omwe ali ndi matenda osokoneza bongo, omwe akudwala matenda a coronary insufficiency (cholakwika pakati pa kufunikira kwa mpweya ndi kubereka kwake) ndi ubongo wopanda vuto | magazi. Kusamala ndikofunikira pakugwiritsa ntchito insulin! odwala omwe ali ndi matenda a chithokomiro, matenda a Addison (vuto losakwanira la adrenal), kulephera kwa impso.

Njira yovomerezeka ya insulini iyenera kuyang'aniridwa mosamala. Pa trimester yoyamba ya mimba, kufunika kwa insulin nthawi zambiri kumacheperachepera ndikuwonjezeka mu trimesters yachiwiri ndi yachitatu.

Alfa-adrenergic blockers ndi beta-adrenostimulants, ma tetracyclines, salicylates amawonjezera katulutsidwe ka insulin (excretion ya thupi yopangika) insulin. Thiazide diupetics (diuretics), beta-blockers, mowa ungayambitse hypoglycemia.

Malo osungira:

Sungani pa kutentha kuchokera +2 mpaka + 10 * C. Kuzizira kwa mankhwala sikuloledwa.

Depo-N-insulin, Isofaninsulin, Iletin I, Insulinatard, Insulin B, Insulin-B SC, Insulin BP, Insulin M, Insulin Actrapid MS, Insulin Actrapid FM, Insulin Actrapid FM Penfill, Insulin Velosulin, Insulin Tape, Insulin Tape, Insulin, Insulin tambala MK, Insulinlingot, Insulin monotard MK, Insulin monotard NM, Insulin protofan NM penfill, Insulin rapard MK, Insulin semilent MS, Insulin superlente, Insulin ultlente, Insulin ultlente MS, Insulin ultongardum, Insulinlingleng, Insulinlingleng, Insulinlinglong, Insulong, Insulrap GP , Insulrap R, Insulrap SPP, Insuman basal, Insuman comb, Insuman mwachangu, Insuman mwachangu kwa optipena, Comb-N-insulin Hoechst, Tape ilethin I, Tape ilethin II, Monosuinsulin, N-Insulin Hoechst, N-Insulin Hoehst 100 Iletin I, NPH Iletin II, Wokhazikika Iletin I, Wokhazikika Iletin II, Suinsulin, Homorap-100, Homofan 100, Humulin L, Humulin Mi, Humulin Mj, Humulin Mz, Humulin M4, Humulin N, Humulin NPH, Humulin R Humulin S, tepi ya Humulin, Humulin wokhazikika, Humulin ultralente.

1 ml ya yankho kapena kuyimitsidwa nthawi zambiri kumakhala magawo 40.

Kutengera ndi zomwe zimapangidwa, insulini imadzipatula ku zikondamoyo za nyama ndipo imapangidwa pogwiritsa ntchito njira zopangira ma genetic. Malinga ndi kuchuluka kwa kuyeretsedwa, kukonzekera kwa insulini kuchokera ku minofu yanyama kumagawidwa kukhala monopic (MP) ndi monocomponent (MK). Pakadali pano omwe amapezeka kuchokera ku zikondamoyo za nkhumba, zimawonetsedwa ndi cholembera C (SMP - nkhumba monopic, SMK - monocomponent ya nkhumba), ng'ombe - kalata G (ng'ombe: GMP - ng'ombe monopod, GMK - ng'ombe monocomponent). Kukonzekera kwa insulin yaumunthu kumasonyezedwa ndi kalata C.

Kutengera kutalika kwa kuchitapo kanthu, ma insulins amagawidwa:

a) pokonzekera insulin kukonzekera: kuyamba kwa mphindi 15-30, kuchuluka kwa pambuyo 1 / 2-2 maola, nthawi yonse ya maola 4-6,

b) Kukonzekera kwa insulin kukonzekera nthawi yayitali kumakhala ndi mankhwala a nthawi yayitali (kuyambira pambuyo pa maola 1 / 2-2, kuchuluka pambuyo pa maola 3 mpaka 12, kutalika kwa maola 8 mpaka 12), mankhwala omwe akhala akuchita kwa nthawi yayitali (kuyambira pambuyo pa maola 4-8, kuchuluka kwake Pambuyo pa maola 8-18, kutalika konse kwa maola 20-30).

Kukonzekera kofananako:

Ngati mukumva kuperekera mankhwala kwa odwala anu - gawani zotsatira (kusiya ndemanga)! Kodi mankhwalawa adathandizira wodwala, kodi panali zotsatirapo zilizonse zomwe zimachitika panthawi ya chithandizo? Zomwe mukuwona zidzakhala zosangalatsa kwa anzanu komanso odwala.

Ngati mankhwalawa adakulangizani inu ndipo mwalandira chithandizo chamankhwala, ndiwuzeni ngati chinali chothandiza (ngakhale chinakuthandizani), ngakhale panali zovuta zina, zomwe mumakonda / simunazikonde. Anthu zikwizikwi akufuna kuyang'ana pa intaneti zamankhwala osiyanasiyana. Koma ochepa okha ndi omwe amawasiya. Ngati inu panokha simusiya ndemanga pamutuwu - ena onse sangakhale ndi zomwe angawerenge.

Dzinalo: Insulin

Zizindikiro zogwiritsidwa ntchito:
Chizindikiro chachikulu chogwiritsa ntchito insulin ndi mtundu I shuga mellitus (wodwala insulin), koma m'malo ena umalembedwanso mtundu II wa matenda a shuga (osagwirizana ndi insulin).

Machitidwe
Insulin ndi mankhwala ena ochepetsa shuga;
Kuphatikiza pa zotsatira za hypoglycemic (kutsitsa shuga), insulin imakhala ndi zotsatirapo zingapo: imachulukitsa masitolo a minofu ya glycogen, imalimbikitsa kaphatikizidwe ka peptide, imachepetsa kumwa kwa mapuloteni, ndi zina zambiri.
Kuwonetsedwa kwa insulin kumayendetsedwa ndi kukondoweza kapena kuletsa (kuponderezana) kwa michere ina, glycogen synthetase, pyruvate dehydrogenase, hexokinase imapangidwira, lipase ikuyambitsa mafuta acids a adipose minofu, lipoprotein lipase, yomwe imachepetsa "haze" ya seramu yamagazi pambuyo podya mafuta ambiri.
Mlingo wa biosynthesis ndi secretion (secretion) wa insulin zimatengera kuchuluka kwa shuga m'magazi. Ndi kuchuluka kwa zomwe zili mkati mwake, katulutsidwe ka insulin ndi kapamba kumawonjezera, m'malo mwake, kutsika kwa kuchuluka kwa shuga m'magazi kumachepetsa kubisalira kwa insulin.
Pakukhazikitsa zotsatira za insulini, gawo lotsogolera limaseweredwa ndi kulumikizana kwina ndi cholandilira chapadera pamadzi am'mimba, ndi mapangidwe a insulin receptor tata. Kulandila kwa insulini kuphatikiza ndi insulin kumalowa mu cell, momwe kumakhudzira kuphatikizana kwa mapuloteni am'magazi, kuwonjezeranso kwina kwamkati sikumveka bwino.
Insulin ndiye njira yeniyeni yodalirika yodwala matenda a shuga, chifukwa amachepetsa hyperglycemia (kuchuluka kwa shuga m'magazi) ndi glycosuria (kukhalapo kwa shuga mumkodzo), amabwezeretsanso glycogen depot mu chiwindi ndi minofu, amachepetsa kupanga shuga, komanso amachepetsa matenda a shuga. , imathandizira wodwalayo.
Insulin yogwiritsira ntchito kuchipatala imapezeka kuchokera ku zikondamoyo za ng'ombe ndi nkhumba. Pali njira yothandizira kuphatikizira mankhwala a insulin, koma ndi osatheka. M'zaka zaposachedwa, njira zaumbeta zopangira insulin yaumunthu zapangidwa. Insulin yomwe idapangidwa ndi mainjiniering genetic imagwirizana kwathunthu ndi mndandanda wa amino acid wa insulin yamunthu.
Milandu yomwe insulin imapezeka kuchokera ku zikondamoyo za nyama, zodetsa zosiyanasiyana (proinsulin, glucagon, self-statin, mapuloteni, ma polypeptides, ndi zina) atha kukhalapo mu malonda chifukwa chosakwanira kuyeretsa. Zinthu zoyera kwambiri za insulin zimatha kuyambitsa mavuto osiyanasiyana.
Njira zamakono zimapangitsa kuti zitheke kuyeretsedwa (monopic - chromatographic kuyeretsedwa ndikutulutsidwa kwa "nsonga" ya insulin), yoyeretsedwa kwambiri (monocomponent) ndi zinthu zokhala ndi insulin. Pakadali pano, mafuta a insulin a insulin amagwiritsidwa ntchito kwambiri. Pazinthu za insulini zochokera ku nyama, zokonda zimaperekedwa ku insulin yomwe imapezeka kuchokera ku zikondamoyo za nkhumba.
Ntchito ya insulin imatsimikizika kuti ikubadwa (mwa kuthekera kutsika shuga m'magulu a akalulu athanzi) komanso ndi imodzi mwazinthu zachilengedwe (electrophoresis pamapepala kapena chromatography papepala). Pa gawo limodzi la ntchito (UNIT), kapena unit yapadziko lonse lapansi (IE), chitani zochitika za 0404082 mg wa crystalline insulin.

Mlingo ndi Insulin
Pochiza matenda a shuga, insulin zopangidwa mosiyanasiyana mosiyanasiyana zimagwiritsidwa ntchito (onani pansipa).
Insulin yogwira ntchito yayifupi imagwiritsidwanso ntchito munjira zingapo za pathological: kuyambitsa matenda a hypoglycemic (kutsitsa shuga m'magazi) m'njira zina za schizophrenia, monga anabolic (yolimbikitsa kaphatikizidwe kamapuloteni) ndi kutopa kwathunthu, kuperewera kwa zakudya m'thupi, furunculosis (kutulutsa khunyu pakhungu kambiri) ), thyrotoxicosis (matenda a chithokomiro), omwe ali ndi matenda am'mimba (atony / kutayika kwa toni /, gastroptosis / prolfall m'mimba /), hepatitis yayitali (kutupa kwa minyewa ya chiwindi), mitundu yodontha ya chiwindi cirrhosis, komanso gawo la "polarizing" njira zomwe zimagwiritsidwa ntchito pochotsa kuperewera kwa mtima (kusalingalira bwino pakati pa kuchepa kwa oxygen kwa mtima ndi kutulutsa kwake).
Kusankhidwa kwa insulin pochiza matenda ashuga kumadalira kuopsa kwa matendawa, momwe wodwalayo alili, komanso kuthamanga kwa msambo komanso nthawi yayitali yotsitsa shuga. Cholinga chachikulu cha insulin komanso kukhazikitsa mlingo wa mankhwala imachitika mu chipatala (chipatala).
Kukonzekera kwa insulin kochepa ndi njira zothetsera subcutaneous kapena mu mnofu makonzedwe. Ngati ndi kotheka, amaperekedwanso kudzera m'mitsetse yamkati. Ali ndi mphamvu yochepetsera shuga yochepa komanso yochepa. Nthawi zambiri amamuthandizira mphindi 15 mpaka 15 asanadye chakudya kamodzi kapena kangapo tsiku lonse. Zotsatira pambuyo pobayira jekeseni pambuyo pa mphindi 15 mpaka 20, zikufika patadutsa maola 2, nthawi yonse yovutikira sichikupitilira maola 6. Amagwiritsidwa ntchito makamaka kuchipatala kukhazikitsa kuchuluka kwa insulin kwa wodwalayo, nthawi zina pakufunika kukwaniritsa mwachangu Kusintha kwa ntchito ya insulin mthupi - ndi matenda a shuga komanso precom (kutaya kwathunthu kapena pang'ono pang'ono chifukwa cha kuchuluka kwakukula kwa shuga).
Kuphatikiza pa tog 9, zinthu zazifupi zomwe zimapanga insulini zimagwiritsidwa ntchito ngati anabolic ndipo zimayikidwa, monga lamulo, mumiyeso yaying'ono (magawo 4-8 1-2 nthawi tsiku lililonse).
Kukonzekera kwa insulin kwa nthawi yayitali (kwa nthawi yayitali) kumapezeka m'mitundu mitundu yosiyanasiyana yokhala ndi kuchepetsa shuga (semylong, yayitali, ultralong). Pazinthu zosiyanasiyana, zotsatira zake zimakhala maola 10 mpaka 36. Chifukwa cha zinthu izi, kuchuluka kwa jakisoni tsiku ndi tsiku kumatha kuchepetsedwa. Nthawi zambiri amapangidwa mu mawonekedwe a kuyimitsidwa (kuyimitsidwa kwa tinthu tating'onoting'ono tomwe timapangidwa m'madzi), kumayendetsedwa kokha kapena intramuscularly, intravenous makonzedwe samaloledwa. Pazakudya zokhala ndi matenda ashuga komanso zopatsa thanzi, zinthu zazitali sizigwiritsidwa ntchito.
Mukamasankha mankhwala a insulin, ndikofunikira kuonetsetsa kuti nthawi ya kutsika kwambiri kwa shuga ikugwirizana ndi nthawi yomwe mumalemba. Ngati ndi kotheka, zinthu ziwiri zokhala ndi nthawi yayitali zitha kuperekedwa mu syringe imodzi. Odwala ena amafunika osati motalika, komanso mwachangu kuchuluka kwa shuga m'magazi. Ayenera kupereka mankhwala okhala ndi insulin yayitali komanso yochepa.
Nthawi zambiri, zinthu zomwe zimatulutsidwa nthawi yayitali zimatumizidwa musanadye chakudya cham'mawa, koma ngati kuli koyenera, jakisoni amatha kuperekedwanso nthawi zina.
Zinthu zonse za insulin zimagwiritsidwa ntchito ngati zofunika zakudya zakwaniritsidwa. Tanthauzo la kuchuluka kwa mphamvu (kuyambira 1700 mpaka 3000 khal) kuyenera kutsimikiziridwa ndi kulemera kwa thupi la wodwalayo panthawi ya chithandizo, ndi mtundu wa zochita. Chifukwa chake, ndi kuchepetsedwa kwa zakudya zamagulu komanso kulimbitsa thupi, kuchuluka kwa zopatsa mphamvu patsiku kwa wodwala kuli osachepera 3000, okhala ndi zakudya zopatsa thanzi komanso kukhala ndi moyo wokhazikika, sayenera kupitilira 2000.
Kuyambitsidwa kwa waukulu kwambiri, komanso kusowa kwa chakudya ndi chakudya, kumayambitsa vuto la hypoglycemic (kutsitsa magazi), kumayendetsedwa ndi kumverera kwanjala, kufooka, thukuta, kunjenjemera kwa thupi, kupweteka mutu, chizungulire, palpitations, euphoria (popanda chifukwa chabwino) Mu wotsatira hypoglycemic coma imatha kukhala (kusazindikira, komwe kumadziwika ndi kusowa kwathunthu kwa kayendedwe kazinthu zakunja chifukwa chakuchepa kwambiri kwa shuga m'magazi) ndikutaya chikumbumtima, kukhumudwa komanso kutsika kwamphamvu kwa zochitika zamtima. Pofuna kupewa matenda a hypoglycemic, odwala ayenera kumwa tiyi wokoma kapena kudya shuga pang'ono.
Ndi chifuwa cha hypoglycemic (chokhudzana ndi kuchepa kwa shuga m'magazi), yankho la glucose 40% limalowetsedwa m'mitsempha mu 10 ml ml, nthawi zina mpaka 100 ml, koma osatinso.
Malangizo a hypoglycemia (kutsitsa shuga wamagazi) mu mawonekedwe owopsa amatha kuchitika pogwiritsa ntchito minyewa kapena subcutaneous makonzedwe a glucagon.

Zovuta za insulin:
Zotsatira zakugwiritsira ntchito insulin ndi matenda omwe amapezeka ndi hypoglycemia, hepatitis yacute, cirrhosis, hemolytic jaundice (chikasu cha pakhungu ndi zotupa za m'maso zimayambitsa kupindika kwa maselo ofiira am'magazi), kapamba (kutupa kwa impso), nephritis (kutupa kwa impso) matenda a impso ogwirizana ndi kuphwanya mapuloteni / amyloid metabolism, urolithiasis, m'mimba ndi zilonda zam'mimba, zotupa za mtima (mtima kulephera chifukwa cha kutsekeka leumi yamavalo ake).
Kusamala kwakukulu kumafunikira pochiza odwala omwe ali ndi matenda a shuga, omwe ali ndi vuto la kuperewera kwa m'mimba (cholakwika pakati pa kufunika kwa mpweya m'mtima ndi kubereka kwake) ndi vuto laubongo | magazi. Kusamala ndikofunikira pakugwiritsa ntchito insulin! odwala omwe ali ndi matenda a chithokomiro, matenda a Addison (osakwanira ntchito ya adrenal), kulephera kwa impso.
Mankhwala a insulin oyembekezera amayenera kuchitika> moyang'aniridwa kwambiri. Pa trimester yoyamba ya mimba, kufunika kwa insulin nthawi zambiri kumacheperachepera ndikuwonjezeka mu trimesters yachiwiri ndi yachitatu.
Alfa-adrenergic blockers ndi beta-adrenostimulants, ma tetracyclines, salicylates amawonjezera katulutsidwe ka insulin (excretion ya thupi yopangika) insulin. Thiazide diupetics (diuretics), beta-blockers, mowa ungayambitse hypoglycemia.

Zotsatira za insulin:
Ndi subcutaneous makonzedwe a insulin, lipodystrophy (kuchepa kwa kuchuluka kwa minyewa ya adipose mu minofu yaying'ono) imatha kupezeka pamalo a jekeseni.
Zinthu zamakono kwambiri za insulin zomwe sizimayambitsa zovuta zomwe zimayambitsa ziwopsezo, komabe, milandu yotereyi siyikusiyidwa. Kukula kwa matenda oopsa sayanjana nthawi yomweyo kumafooketsa (kuletsa kapena kuletsa ziwopsezo) kugwiritsa ntchito mankhwala ndi kusinthanitsa.

Kutulutsa Fomu:
Syringe insulin imapezeka mu | mabotolo agalasi osindikizidwa ndi zotsekera mphira ndi aluminiyumu yopuma.

Mawu:
Depo-N-insulin, Isofaninsulin, Iletin I, Insulinatard, Insulin B, Insulin-B SC, Insulin BP, Insulin M, Insulin Actrapid MS, Insulin Actrapid FM, Insulin Actrapid FM Penfill, Insulin Velosulin, Insulin Tape, Insulin Tape, Insulin, Insulin tambala MK, Insulinlingot, Insulin monotard MK, Insulin monotard NM, Insulin protofan NM penfill, Insulin rapard MK, Insulin semilent MS, Insulin superlente, Insulin ultlente, Insulin ultlente MS, Insulin ultongardum, Insulinlingleng, Insulinlingleng, Insulinlinglong, Insulong, Insulrap GP , Insulrap R, Insulrap SPP, Insuman basal, Insuman comb, Insuman mwachangu, Insuman mwachangu kwa optipena, Comb-N-insulin Hoechst, Tape ilethin I, Tape ilethin II, Monosuinsulin, N-Insulin Hoechst, N-Insulin Hoehst 100 Iletin I, NPH Iletin II, Wokhazikika Iletin I, Wokhazikika Iletin II, Suinsulin, Homorap-100, Homofan 100, Humulin L, Humulin Mi, Humulin Mj, Humulin Mz, Humulin M4, Humulin N, Humulin NPH, Humulin R Humulin S, tepi ya Humulin, Humulin wokhazikika, Humulin ultralente.

Malo osungira:
Sungani pa kutentha kuchokera +2 mpaka + 10 * C. Kuzizira kwa zinthu sikuloledwa.

Zokhudza Insulin:
1 ml ya yankho kapena kuyimitsidwa nthawi zambiri kumakhala magawo 40.
Kutengera ndi zomwe zimapangidwa, insulini imadzipatula ku zikondamoyo za nyama ndipo imapangidwa pogwiritsa ntchito njira zopangira ma genetic. Malinga ndi kuchuluka kwa kuyeretsedwa, kukonzekera kwa insulini kuchokera ku minofu yanyama kumagawidwa kukhala monopic (MP) ndi monocomponent (MK). Pakadali pano omwe amapezeka kuchokera ku zikondamoyo za nkhumba, zimawonetsedwa ndi cholembera C (SMP - nkhumba monopic, SMK - monocomponent ya nkhumba), ng'ombe - kalata G (ng'ombe: GMP - ng'ombe monopod, GMK - ng'ombe monocomponent). Kukonzekera kwa insulin yaumunthu kumasonyezedwa ndi kalata C.
Kutengera kutalika kwa kuchitapo kanthu, ma insulins amagawidwa:
a) mankhwala osokoneza bongo a insulin: kuyamba kwa mphindi 15-30, kuchuluka kwa maola 1 / 2-2, kutalika kwa maola 4-6,
b) Zogwira ntchito kwa insulin nthawi yayitali zimaphatikizapo nthawi yayitali (kuyamba pambuyo pa maola 1 / 2-2, kuchuluka pambuyo pa maola 3-12, kuchuluka kwa maola 8-12), zinthu zazitali (kuyambira pambuyo 4-8 maola, nsonga Pambuyo pa maola 8-18, kutalika konse kwa maola 20-30).

Yang'anani!
Musanagwiritse ntchito mankhwalawa, muyenera kufunsa dokotala.
Malangizowo amaperekedwa kuti mudziwe nokha ".

Ntchito yayikulu ya insulini ya mahomoni sikuti kungotsitsa kuchuluka kwa glucose pamlingo wabwinobwino, komanso kudzipulumutsa, komanso michere ina yomwe munthu amalandila ndi chakudya, ku maselo onse amthupi. Chotsatira cha insulini chomwe chili pamwamba pa selo lililonse ndipo ntchito yake ndikusamutsa michere ndi insulini mkati imathandizira kuti ma cell azitha kupeza zinthuzo.

Ngati kapamba, komwe mahomoni amapangidwa, sagwira ntchitoyo ndipo samatulutsa mokwanira, munthuyo samalandira mphamvu kuchokera ku chakudya chomwe wadya. Ngakhale kuchuluka kwa glucose m'magazi ndikokwera, sagwiritsira ntchito cholinga chake, ndipo ma cell omwe sanalandilidwe amayamba kumva njala ndikumwalira kwakanthawi.

Choyamba, izi zimabweretsa zovuta mu thupi, kenako kufa. Pazaka zopitilira 100 zapitazo, wodwala yemwe adapezeka ndi matenda a shuga adathetsedwa. Koma atapezeka ndi insulin, odwala matenda ashuga ali ndi mwayi wokhala ndi moyo wathanzi, makamaka chifukwa kukonzekera kwa insulin kumapezeka mosavuta kuti kugulitsidwe: mtengo wake umakhala wotsika mtengo ndipo ungagulidwe ku pharmacy iliyonse.

Mankhwala a gulu la pharmacological samayikidwa insulin nthawi yomweyo: amatero pambuyo pa mapiritsi omwe amachepetsa mphamvu ya shuga osagwira. Mawonekedwe a mankhwalawo ndi amtundu wopanda khungu kapena wachikasu. Zomwe zimapangidwira jakisoni wanyumba zimapangidwa m'mabotolo, mawonekedwe omasulidwa ndi mamilimita asanu ndi khumi. Insulin yogwiritsira ntchito mankhwala ndi mawonekedwe amasulidwe a oyera a hygroscopic, mafuta osungunuka a madzi.

Palibe njira zina zobayira jakisoni, zimaperekedwa mosavuta, m'mitsempha kapena m'mitsempha (yokhayo, yokhala ndi insulin yochepa m'madzi yomwe imabayidwa kudzera m'mitsempha. Jakisoni wotsekemera komanso mu mnofu umathandizidwa ndi insulin kapena jakisoni wa insulin. Chipangizocho chili ndi mawonekedwe oyendetsera bwino, mahomoniwo amawonetsedwa pogwiritsa ntchito batani, choncho amatha kunyamula nanu ndipo ngakhale mwana amatha kubayitsa.

Ndi izo, wodwala matenda ashuga sangangodzipatsa jakisoni yekha, komanso mosamala kumwa mankhwalawa molondola. Chipangizocho ndi chothandiza, chimagwira ntchito pokhapokha pa cartridge, ndi okwera mtengo kwambiri, kotero si aliyense angakwanitse kugula, makamaka mukaganizira kuti odwala matenda ashuga amafunikira zida zitatu zotere.

Insulin m'mapiritsi sichigwiritsidwa ntchito ngati mankhwala, chifukwa mawonekedwe amtunduwu samasokoneza thupi monga jakisoni wotsekemera, wamitsempha kapena wamkati. Zowona, asayansi amati adatha kupanga mankhwala othandizira pakamwa omwe sadzagwira ntchito kuposa jakisoni, koma njira yotulutsira mankhwalawa m'mayesero azachipatala sanadutsebe ndipo ikukula.

Chiyambi

Malinga ndi gulu, kukonzekera kwa insulin kumasiyanitsidwa ndi chiyambi, nthawi yochitapo kanthu, mulingo wa kuyeretsa. Zopangira insulini zimapangidwa pamaziko a mahomoni omwe amapezeka kuchokera ku kapamba ka ng'ombe, nkhumba ndi njira yochita kupanga, kukhala chithunzi cha mahomoni amunthu. Beulin insulin imasiyana ndi mahomoni amunthu m'magulu atatu a amino acid, omwe pambuyo pake amatha kupweteketsa mtima kwambiri komanso asayambitse zovuta zam'tsogolo mtsogolo.

Thupi laumunthu limatenga bwino insulini ya nkhumba: imasiyana ndi mahomoni amunthu ndi amino acid imodzi, chifukwa chake siligwirizana, ngakhale ilinso ndi proinsulin ndi C-peptide zosayambitsa zomwe zimayambitsa ziwengo. Chifukwa chake, makamaka kwa omwe ali ndi vuto la ziwengo, kukonzekera bwino kwambiri kwa insulin kumapangidwa komwe kumachepetsa kupezeka kwake, komanso fanizo la mahomoni amunthu, omwe amapezeka chifukwa cha uinjinijeni (amatchedwa "insulin yaumunthu", kutsimikizira kuti ndi ndani).

Monga gawo la mahomoni opanga, palibe proinsulin yomwe imayambitsa ziwopsezo, chifukwa chake imakhala yolimba ndi thupi, kuyanjana ndi matupi awo kumakhala kosowa kwambiri ndipo chinthucho sichimakhala ndi zotsutsana.

Hormoni iyi imapangidwa ndi yisiti yofufumitsa yokhala ndi michere yapakati komanso yosinthidwa mwanjira ya mtundu wa E. coli, yomwe imatha kupanga insulin yaumunthu. Popeza kuchuluka kwa zinthu zomwe zimapangidwira ndizambiri, asayansi amakonda kuganiza kuti insulin ya nyama posachedwa idzasinthidwa.

Nthawi yovomerezeka

Mankhwala a gulu la mankhwala a insulin amasiyana mu nthawi yayitali: ndi yayifupi, yapakati komanso yayitali.Zogulitsa zomwe zimachitika mwachidule (pafupifupi maora sikisi) zimadziwika ndi kuthamanga kwa thupi: zimayamba kuzikhudza pakatha theka la ola pambuyo pa kukhazikitsidwa ndipo zimatha maola awiri kapena atatu atatha kubayidwa.

Zinthu zomwe zimatchulidwa ngati mankhwala a nthawi yayitali pakati pazogawidwa zimakhala ndi zinc, chifukwa timadzi timene timamasulidwa pang'onopang'ono. Amayamba kuchita pambuyo pake - atatha maola awiri, mitengo yayitali ikhoza kuwonedwa pambuyo pa maola 8-14, zotsatira zimatha pafupifupi tsiku limodzi.

Kupanga mankhwala kwa nthawi yayitali kunayambitsidwa ndi kufunika kothandizira odwala jakisoni wambiri wa insulin (pafupifupi katatu mpaka kanayi patsiku): chifukwa psyche imakumana ndi vuto lililonse jakisoni iliyonse, chifukwa chake imapangitsa kupweteka. Kuphatikiza apo, atabayira mobwerezabwereza m'dera la jakisoni, hematomas amatha kupanga kapena matenda amatha kulowa.

Nthawi zina, madokotala amalangiza kuphatikiza insulin. Pankhaniyi, ndikofunikira kugula mankhwala kuchokera kwa wopanga omwewo mumafakitore, popeza mawonekedwe omwe amamasulidwa ndi makampani osiyanasiyana, ngakhale samasiyana, ndi jakisoni; monga gawo, zinthu zosiyanasiyana zimawonjezeredwa zomwe zimayenera kusinthana wina ndi mnzake ngati atagulidwa kwa opanga osiyanasiyana.

pali kukonzekera kwa insulin, nthawi yake kuyambira maola 24 mpaka 36. Amayamba kukhudza thupi maola awiri atatha kulowetsa, nthawi yayitali kwambiri ndi maola 16 mpaka 20, kenako imayamba kuchepa.

Mankhwalawa nthawi zambiri amaperekedwa kwa odwala omwe samva kwenikweni insulin, ndiwothandizanso okalamba kapena omwe ali ndi vuto lowona omwe sangathe kupereka jakisoni pawokha ndipo zimadalira pakufika kwa namwino. Njira yotulutsira mankhwala omwe akhala akuchita kwa nthawi yayitali ndi mabotolo osabala 5 ndi 10 ml okhala ndi zotsekera mphira.

Ngakhale kuchuluka kwa mankhwala omwe akhala akuchita kwa nthawi yayitali kumatenga nthawi yayitali, madokotala amakonda insulin yochepa komanso yapakati. Odwala amalekerera bwino: ngati zotsatira za mankhwala omwe amaperekedwa ndizoposa maola makumi awiri ndi anayi, m'mawa pamakhala vuto la hypoglycemia.

Njira Zolandirira

Ndi mtundu wanji wa mankhwala ochokera ku gulu la insulini kuti mutenge, ndi muyezo womwe Mlingo, uyenera kutsimikiziridwa ndi dokotala ndikupereka malangizo enieni: Zizindikiro pamlingo uliwonse ndi payekhapayekha ndipo palibe njira imodzi yokonzanso. Mlingo wa shuga m'magazi uyenera kuyang'aniridwa nthawi zonse ndipo ngati kuli koyenera, kusinthidwa.

Ngati timalankhula za mahomoni omwe kapamba wa munthu wathanzi amatulutsa, ndiye kuti kuchuluka kwake patsiku ndi kochokera 30 mpaka 40. Zomwezo (monga 30 mpaka 50) zimafunika kwa munthu wodwala matenda ashuga, ngakhale atakhala kuti anali ndi insulin. Pankhaniyi, 2/3 yokhazikika iyenera kutengedwa m'mawa, ena - madzulo. Kupanga kusintha kuchokera ku chinyama kupita ku insulin yaumunthu, malingana ndi malangizo, mankhwalawo nthawi zonse amachepetsedwa, chifukwa mahomoni opanga majini amakhala bwino ndi thupi.

Amakhulupilira kuti zotsatira zabwino zimatha kupezeka ndikuphatikiza mankhwala apafupipafupi komanso apakatikati; motero, dongosolo la kayendetsedwe ka mankhwala limadalira. Pakati pa mitundu yayikulu ya mankhwala, zotsatirazi zikuchitidwa:

m'mawa pakudya kadzutsa, imwani mankhwalawa nthawi yayitali, komanso nthawi yayitali (momwe mungachitire izi, adokotala adzakuuzani). Asanadye - kudya pang'ono, usiku, pa maola 22 kapena 23 - kukonzekera kwapakatikati,
insulin yokhala ndi nthawi yochepa yochita, jekerani musanadye chakudya cham'mawa, chakudya chamasana komanso chakudya chamadzulo, musanagone, 23 koloko - kukonzekera kwa insulin kwa nthawi yayitali kapena yapakatikati,
insulini yapakatikati kapena yayitali m'mawa, yochepa - asanadye chakudya cham'mawa, chakudya chamadzulo komanso chakudya chamadzulo (njirayi ndiyosavuta poyerekeza ndi yoyamba).

Ngati dokotala watumiza mankhwala amodzi okha, mankhwala omwe ali ndi kanthawi kochepa amalimbikitsidwa kuti alowe m'malo katatu patsiku, nthawi yayitali - kawiri pa tsiku: jakisoni amayenera kuperekedwa kwa mphindi 45 musanadye chakudya cham'mawa komanso musanadye. Mfundo ina yomwe siyiyenera kuiwalika pokamba za kugwiritsa ntchito insulin ndiyakuti insulini yosalowerera imatha kubayidwa osati kudzera mu intramuscularly kapena subcutaneally, komanso kudzera m'mitsempha. Mankhwala omwe akhala akuchita kwa nthawi yayitali (mawonekedwe a 5 ndi 10 ml) sayenera kutumikiridwa.

Zotsatira zoyipa

Insulin ilibe zotsutsana: ngati chinthu chimodzi sichabwino, chitha kusinthidwa ndi china, koma mavuto amayamba. Ndikofunika kwambiri pochiza matenda ashuga kudziwa kuchuluka kwake: kudzilimbitsa kapena kuchepetsa mlingo ndi woletsedwa. Onse chifukwa cha kusowa kwa glucose komanso kuchuluka kwazomwe mukuchitika, mutha kugwa ndi kufa (malinga ndi ziwerengero, anayi mwa odwala omwe ali ndi zaka zosakwana makumi asanu amafa pazifukwa izi).

Vuto lina lodziwika bwino ndi ziwengo, zomwe zimachitika pakukonzekera kwa insulin. Pazizindikiro zoyambirira (kuoneka ngati kuyabwa, kukula kwa thanzi), muyenera kufunsa dokotala ndikusintha insulin ya anthu. Ndikofunika kusintha motere kuchipatala moyang'aniridwa ndi dokotala, komwe kuli kotheka kuyang'anira kuchuluka kwa shuga ndikuwongolera mlingo woyenera.

Zina zomwe zimachitika ndi kukhala atrophy kapena hypertrophy ya adipose minofu pa malo a jekeseni. Vutoli limakhala nthawi zambiri pogwiritsa ntchito insulin ya ng'ombe ndipo ndizosowa kwambiri mukamagwiritsa ntchito mankhwala othandizira kapena mafuta a insulin. Izi sizibweretsa zovulaza, koma malo a jakisoni amayenera kusinthidwa, chifukwa mayamwidwe a insulini amakhala ndi vuto. Izi zikuyenera kuchitika pothandizana ndi adotolo, popeza gawo lililonse la thupi lili ndi kusiyanasiyana kwa mankhwalawo.

Insulin ndi mankhwala ena ochepetsa shuga. , imatha kuyendetsa kagayidwe kazachilengedwe, imathandizira kukoka minofu ndikuyambitsa kusintha kwake kukhala glycogen, imathandizanso kulowerera kwa glucose m'maselo a minofu.
Kuphatikiza pa zotsatira za hypoglycemic (kutsitsa shuga), insulin imakhala ndi zotsatirapo zingapo: imawonjezera masitolo a minofu ya glycogen, imalimbikitsa kaphatikizidwe ka peptide, imachepetsa kumwa kwa mapuloteni, ndi zina zambiri.

Kuwonetsedwa kwa insulin kumayendetsedwa ndi kukondoweza kapena kuletsa (kuletsa) kwa michere ina , glycogen synthetase, pyruvate dehydrogenase, hexokinase imapangidwira, lipase ikuyambitsa mafuta acids a adipose minofu, lipoprotein lipase, kuchepetsa magazi pambuyo chakudya chamafuta ambiri, tikulephera.
Mlingo wa biosynthesis ndi secretion (secretion) wa insulin zimatengera kuchuluka kwa shuga m'magazi.
Ndi kuchuluka kwa zomwe zili mkati mwake, katulutsidwe ka insulin ndi kapamba kumawonjezera, m'malo mwake, kutsika kwa kuchuluka kwa shuga m'magazi kumachepetsa kubisalira kwa insulin.

Pakukhazikitsa zotsatira za insulini, gawo lotsogolera limaseweredwa ndi kulumikizana kwina ndi cholandilira chapadera pamadzi am'mimba, ndi mapangidwe a insulin receptor tata.
Cholandirira insulin limodzi ndi insulin chimalowa m'chipindacho , komwe zimakhudza kuphatikizika kwa mapuloteni am'magazi, kuphatikiza kwina kwamtunduwu sikumveka bwino.
Insulin ndiye chithandizo chenicheni cha matenda a shuga; chifukwa amachepetsa hyperglycemia (kuchuluka kwa shuga m'magazi) ndi glycosuria (kukhalapo kwa shuga mumkodzo), amabwezeretsanso kuchuluka kwa glycogen mu chiwindi ndi minofu, amachepetsa kupanga shuga, ndikuchepetsa matenda a shuga m'magazi (kukhalapo kwamafuta m'magazi) , Amathandizira wodwalayo .

Insulin yogwiritsira ntchito kuchipatala imapezeka kuchokera ku zikondamoyo za ng'ombe ndi nkhumba . Pali njira yothandizira kuphatikizira mankhwala a insulin, koma ndi osatheka.
Posachedwa apanga njira za biotechnological zopangira insulin yaumunthu. Insulin yomwe idapangidwa ndi mainjiniering genetic imagwirizana kwathunthu ndi mndandanda wa amino acid wa insulin yamunthu.
Milandu yomwe insulin imapezeka kuchokera ku zikondamoyo za nyama, zodetsa zosiyanasiyana (ma proinsulin, glucagon, kudzipereka, mapuloteni, ma polypeptides, ndi zina zotere) zitha kupezeka pokonzekera chifukwa chosakwanira kuyeretsa.
Kukonzekera bwino kwambiri kwa insulin kumatha kuyambitsa mavuto osiyanasiyana.

Njira zamakono zimapangitsa kuti zitheke (monopic - chromatographic oyeretsedwa ndikutulutsa "nsonga" ya insulin), yoyeretsedwa kwambiri (monocomponent) ndikukonzekera insulin.
Pakadali pano, mafuta a insulin a insulin amagwiritsidwa ntchito kwambiri.
Pazokonzekera za insulin, nyama zimakonda kusankha insulin chifukwa cha nkhumba.

Ntchito ya insulin imatsimikizika biologic (mwakutha kutsitsa glucose wamagazi mu akalulu athanzi) ndi imodzi mwanjira zanzeru (electrophoresis pa pepala kapena chromatography papepala). Pa gawo limodzi la ntchito (UNIT), kapena unit yapadziko lonse lapansi (IE), chitani zochitika za 0404082 mg wa crystalline insulin.

Chizindikiro chachikulu chogwiritsa ntchito insulin ndi mtundu I shuga mellitus (wodwala insulin), koma m'malo ena umalembedwanso mtundu II wa matenda a shuga (osagwirizana ndi insulin).

Mankhwalawa matenda a shuga gwiritsani insulin kukonzekera kosiyana kachitidwe .
Mwachangu insulin komanso munjira zina za pathological zomwe zimayambitsa matenda a hypoglycemic (kutsitsa shuga m'magazi) m'njira zina za schizophrenia, monga anabolic (kuwonjezera mapuloteni kaphatikizidwe) wothandizira kutopa kwathunthu, kusowa kwa zakudya m'thupi, furunculosis (angapo purulent kutupa kwa khungu), thyrotoxicosis (matenda a chithokomiro) matenda a m'mimba (matenda a m'mimba) (matenda am'mimba / kuchepa kwa kamvekedwe,, gastroptosis / kuchuluka kwa m'mimba /), matenda a kutupa chiwindi (kutupa kwa minofu ya chiwindi), mitundu yoyambira ya matenda a chiwindi, komanso chigawo "polarizing" zothetsera ntchito azichitira pachimake inatsekeratu insufficiency (mismatch pakati kufunika mtima mpweya ndi yobereka ake).

Kusankhidwa kwa insulin pochiza matenda ashuga kumadalira kuopsa kwa matendawa, momwe wodwalayo alili, komanso kuthamanga kwa nthawi komanso nthawi yayitali ya Hypoglycemic.
Kukhazikitsidwa koyambirira kwa insulin ndi kukhazikitsidwa kwa mankhwalawa makamaka kumachitika mu chipatala (zipatala).

Kukonzekera mwachidule insulin - Izi ndi njira zothetsera subcutaneous kapena mu mnofu makonzedwe.
Ngati ndi kotheka, amaperekedwanso kudzera m'mitsetse yamkati.
Ali ndi mphamvu yochepetsera shuga yochepa komanso yochepa.
Nthawi zambiri amathandizidwa kupakidwa mphindi 15 mpaka 15 musanadye chakudya kangapo patsiku.
Zotsatira pambuyo subcutaneous jakisoni amapezeka 15-20 Mphindi, ukufika pazipita pambuyo 2 hours, yonse nthawi ya zochita si zoposa 6 maola.
Amagwiritsidwa ntchito makamaka kuchipatala kukhazikitsa mtundu wa insulin yofunikira kwa wodwala, komanso ngati pakufunika kusintha kosangalatsa pantchito ya insulin mthupi - wodwala matenda ashuga komanso precom (kutaya kwathunthu kapena pang'ono pang'ono kwa chikumbumtima chifukwa chakuwonjezereka kwadzidzidzi kwa shuga m'magazi) .
Kuphatikiza apo, kukonzekera kwakanthaŵi kwa insulin kumagwiritsidwa ntchito ngati anabolic wothandizirana ndipo amalembera, monga lamulo, mumiyeso yaying'ono (4-8 mayunitsi 1-2 patsiku).

Kukonzekera kwa insulin kwa nthawi yayitali amapezeka mu mitundu yosiyanasiyana ya mulingo wokhala ndi nthawi yosiyanasiyana yotsitsa shuga (semylong, yayitali, ultralong).
Mankhwala osiyanasiyana, zotsatira zake zimatenga maola 10 mpaka 36.
Chifukwa cha mankhwalawa, mutha kuchepetsa kuchuluka kwa jakisoni tsiku lililonse.
Nthawi zambiri amapangidwa mwa mawonekedwe a kuyimitsidwa. (kuyimitsidwa kwa tinthu tokhazikika tomwe timadzi tomwe timatulutsa mu madzi), kumayendetsedwa kokha kapena intramuscularly, mtsempha wamkati samaloledwa. Pazakudya zokhala ndi matenda ashuga komanso mikhalidwe yoyipa, mankhwalawa amakhala osagwiritsidwa ntchito.

Mukamasankha kukonzekera kwa insulin, ndikofunikira kuonetsetsa kuti nthawi ya kutsika kwambiri kwa shuga ikugwirizana ndi nthawi yomwe mumamwa.
Ngati ndi kotheka, mankhwala 2 a nthawi yayitali amatha kuperekedwa mu syringe imodzi.
Odwala ena amafunika osati motalika, komanso mwachangu kuchuluka kwa shuga m'magazi. Ayenera kupatsidwa mankhwala okhala ndi insulin.
Nthawi zambiri mankhwala ogwira ntchito kwa nthawi yayitali amaperekedwa musanadye chakudya cham'mawa komabe, ngati pangafunike, jakisoni itha kuchitika nthawi zina.

Zokonzekera zonse za insulin zimagwiritsidwa ntchito potsatira zakudya.
Tanthauzo la kuchuluka kwa mphamvu (kuyambira 1700 mpaka 3000 khal) kuyenera kutsimikiziridwa ndi kulemera kwamthupi la wodwalayo panthawi yamankhwala, ndi mtundu wa zochita. Chifukwa chake, ndi kuchepa kwa zakudya komanso kugwira ntchito zolimbitsa thupi, kuchuluka kwa zopatsa mphamvu patsiku kwa wodwala kuli osachepera 3000, wokhala ndi zakudya zokwanira komanso kukhala ndi moyo wokhazikika, sayenera kupitilira 2000.

Kukhazikitsidwa kwa Mlingo wambiri, komanso kuchepa kwa chakudya ndi zakudya, kumayambitsa vuto la hypoglycemic (kutsitsa shuga) limodzi ndi kumva njala, kufooka, thukuta, kunjenjemera kwa thupi, kupweteka mutu, chizungulire, palpitations, euphoria (kusalingalira zopanda chiyembekezo) kapena kupsa mtima.
Pambuyo pake, hypoglycemic coma ikhoza kukhala (kuiwalika kwa chikumbumtima, chodziwika ndi kuperewera konse kwa thupi pakukhudzidwa kwakunja chifukwa chakuchepa kwambiri kwa shuga m'magazi) ndikutaya chikumbumtima, kugwidwa, komanso kutsika kwamphamvu kwa mtima.
Pofuna kupewa matenda a hypoglycemic, odwala ayenera kumwa tiyi wokoma kapena kudya shuga pang'ono.

Ndi hypoglycemic (yogwirizana ndi kuchepa kwa shuga) magazi 40% yankho la glucose imalowetsedwa mu mtsempha mu 1040 ml, nthawi zina mpaka 100 ml, koma osatinso.
Malangizo a hypoglycemia (kutsitsa shuga) m'magazi owopsa angathe kuchitidwa ntchito mu mnofu kapena subcutaneous makonzedwe a glucagon.

Ndi subcutaneous makonzedwe a insulini, lipodystrophy (kuchepa kwa kuchuluka kwa adipose minofu yaying'ono) imatha kupezeka malo a jekeseni.

Kusamalidwa kwakukulu kumafunikira pochiza odwala omwe ali ndi matenda osokoneza bongo, omwe akudwala matenda a coronary insufficiency (cholakwika pakati pa kufunikira kwa mpweya ndi kubereka kwake) ndi kuwonongeka kwa ubongo | magazi.
Kusamala ndikofunikira pakugwiritsa ntchito insulin kwa odwala omwe ali ndi matenda a chithokomiro, matenda a Addison (vuto losakwanira la adrenal), komanso kulephera kwa aimpso.

Mankhwala a insulin oyembekezera amayenera kuyang'aniridwa bwino.
Pa trimester yoyamba ya kubereka, kufunika kwa insulin nthawi zambiri kumacheperachepera ndikuwuka mu trimesters yachiwiri ndi yachitatu.
Alfa-adrenergic blockers ndi beta-adrenostimulants, ma tetracyclines, salicylates amawonjezera katulutsidwe ka insulin (excretion ya thupi yopangika) insulin.
Thiazide diupetics (diuretics), beta-blockers, mowa ungayambitse hypoglycemia.

Kuyanjana ndi
mankhwala ena
kudzera:

Mphamvu ya hypoglycemic ya insulin imakulitsidwa hypoglycemic mankhwala m'kamwa, Mao zoletsa, Ace zoletsa, carbonic anhydrase zoletsa, kusankha beta-blockers, bromocriptine, octreotide, sulfonamides, anabolic mankhwala, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, lifiyamu, mankhwala okhala ndi Mowa .

Hypoglycemic zotsatira za insulin zimafooka njira zakulera za pakamwa, corticosteroids, mahomoni a chithokomiro, thiazide okodzetsa, heparin, ma tridclic antidepressants, sympathomimetics, danazole, clonidine, calcium njira blockers, diazoxide, morphine, phenytoin, nikotini.

Mothandizidwa ndi reserpine ndi salicylates, kufooka komanso kuwonjezeka kwa machitidwe a mankhwalawa ndizotheka.
Mankhwala okhala ndi thiol kapena sulfite, akaphatikizidwa ndi insulin, amachititsa kuti awonongeke.

Pa mimba, mtundu wa insulin, mlingo wake ndi makonzedwe ake amatsimikiziridwa ndi adokotala.
Ngati njira yoyambira yosankhidwa siyabwino, ndikofunikira kukaonana ndi dokotala ndikusankha, makamaka, njira yabwino kwambiri yovomerezeka.

Zizindikiro : kufooka kwa minofu, kufooka pang'ono, njala, kupindika mphamvu, kufinya, kufinya, kupindika, kupweteka kwa mutu, kumatuluka pafupipafupi, kutafuna, kutopa kwa chikumbumtima, kuponderezana, kapena kukwiya, zinthu zosagwirizana ndipo pomaliza, chikomokere.

Chithandizo cha vuto la hypoglycemic iyenera kuyamba pomwe.
Muzochepa, ndikokwanira kupereka tiyi wokoma, timadziti ta zipatso, uchi.
Mukakhala ndi chikumbumtima chokwanira (chikomokere) pomwepo jekeseni wa shuga (10-20 ml ya glucose 20-25%).
Pokhapokha ngati mwina kubaya jakisoni wa njira ya glucose, tikulimbikitsidwa kupaka kulowetsedwa kwa 0.001-0.002 g ga glucagon kapena 0,5 ml ya yankho la 0.1% ya adrenaline hydrochloride pansi pa khungu.
Tiyenera kukumbukira kuti pakukhazikitsa adrenaline, mavuto amatha kuchitika - palpitations, kunjenjemera, kuthamanga kwa magazi, nkhawa, ndi zina zambiri.

Syringe insulin ikupezeka m'mbale zagalasi zosindikizidwa ndi zoletsa za mphira ndi aluminium yopuma.
M'mabotolo 10 ml, mu bokosi 5 ma PC kapena mu penfill (makatiriji) 1.5 ndi 3 ml zolembera ma syringe .

Zokonzekera za insulin (zonse ziwiri ndi ma cartridge) omwe sagwiritsidwe ntchito, ziyenera kusungidwa pa 2-8 ° C m'malo opanda kanthu , i.e. mufiriji (makamaka pashelufu pansi), kutali ndi mufiriji.
Kutentha kumeneku, amasunga zachilengedwe komanso zofunikira kwambiri mpaka nthawi ya alumali yomwe ikusonyezedwa phukusi. Insulin siyenera kuyikidwa mukamauluka pa ndege kuti mupewe ngozi yozizira.
Kutentha kwambiri kosungirako kumayambitsa kutsika kwapang'onopang'ono kwa zochita za mankhwala. Kuwala kwam'masiku mwachindunji kumakhudzanso zovuta, zomwe zikufulumizitsa kuchepa kwa zochita za thupi ndi 100 nthawi.
Transulin ya mafuta osungunuka amatha kupendekeka ndikuyamba kukhala kwamitambo . Ma granules ndi ma flakes amapanga kuyimitsidwa kwa insulin. Kuphatikizidwa kwa kutentha ndikugwedezeka kwa nthawi yayitali kumathandizira njirayi.

Botolo la insulin lomwe wodwalayo angagwiritse ntchito amatha kusungidwa kutentha kwambiri osapitirira 25 ° C, m'malo ampaka milungu 6. Nthawi imeneyi imachepetsedwa mpaka masabata 4 mukamagwiritsa ntchito ma cartfillamu a Penfill, chifukwa zolembera za syringe nthawi zambiri zimatengedwa m'thumba lanu kutentha kotentha pang'ono. Mbale za insulin zimatha kusungidwa mufiriji kwa miyezi itatu itatha kugwiritsidwa ntchito koyamba.

Frozen insulin siyingagwiritsidwe ntchito pambuyo poyipitsa. Izi ndizowona makamaka pakuyimitsidwa. Mukamazizira, makhiristo kapena tinthu tating'onoting'ono timachulukana ndipo samasungunuka pambuyo pang'onopang'ono, zomwe zimapangitsa kuti zikhale zosatheka kuyimitsidwanso. Chifukwa chake, chiopsezo chobweretsa mlingo wosakwanira chimakulitsidwa kwambiri.

Insulin iyenera kuonedwa kuti iwonongeka. Mitundu ya insulin yomwe singathe kugwiritsidwa ntchito posintha, kutulutsa kapena kuwoneka ngati tinthu tosiyidwa.
Kuyimitsidwa kwa insulin, yomwe ikasakanikirana sikupanga kuyimitsidwa koyera kapena kukhala ndi ziphuphu, ulusi, kusintha mtundu, sikuyenera kugwiritsidwa ntchito.

1 ml ya yankho kapena kuyimitsidwa nthawi zambiri kumakhala magawo 40.
Kutengera ndi zomwe zimapangidwa, insulini imadzipatula ku zikondamoyo za nyama ndipo imapangidwa pogwiritsa ntchito njira zopangira ma genetic.

Malinga ndi kuchuluka kwa kuyeretsedwa, kukonzekera kwa insulini kuchokera ku minofu yanyama kumagawidwa kukhala monopic (MP) ndi monocomponent (MK).
Pakadali pano omwe amapezeka kuchokera ku zikondamoyo za nkhumba, zimawonetsedwa ndi cholembera C (SMP - nkhumba monopic, SMK - monocomponent ya nkhumba), ng'ombe - kalata G (ng'ombe: GMP - ng'ombe monopod, GMK - ng'ombe monocomponent).
Kukonzekera kwa insulin yaumunthu kumasonyezedwa ndi kalata C.

Kutengera kutalika kwa kuchitapo kanthu, ma insulins amagawidwa:
- kukonzekera insulin kukonzekera : kuyamba kwa mphindi 15-30, nthawi yayitali pambuyo maola 1 / 2-2, Kutalika kwa maola 4 mpaka 6,
- kukonzekera insulin kukonzekera phatikizani mankhwala omwe ali ndi nthawi yayitali yochita (kuyambira pambuyo pa maola 1 / 2-2, kuchuluka pambuyo pa maola 3-12, kuchuluka kwa maola 8-12), mankhwala osokoneza bongo kwa nthawi yayitali. kutalika kwa maola 20-30).

Masiku ano, makampani opanga mankhwala amapanga mitundu yambiri ya insulin. Pakadali pano, mitundu ingapo ya insulin imagwiritsidwa ntchito ngati mankhwala.

Gulu la ma insulins nthawi zambiri limatsimikizika kutengera nthawi yomwe achitapo kanthu pambuyo pokonza thupi la munthu. Mankhwala, mankhwala a nthawi yotsatirawa amasiyanitsidwa:

ultrashort
mwachidule
nthawi yayitali yochita
mankhwala oledzera.

Kugwiritsa ntchito mtundu umodzi wa insulin kutengera mtundu wa wodwalayo komanso njira zake za mankhwala a shuga a shuga.

Mitundu yosiyanasiyana ya insulin imasiyana wina ndi mnzake pakapangidwe kake ndi kapangidwe kake. Pa mtundu uliwonse wa kukonzekera kwa insulin, malangizo ogwiritsira ntchito amapangidwa mogwirizana ndi mawonekedwe a kapangidwe kake ndi njira yokonzekera.

Kuphatikiza apo, pali zofunika zina zomwe ziyenera kutsatiridwa popanga insulin. Kukonzekera konse kwa insulin kumakhala ndi zisonyezo ndi ma contraindication ogwiritsira ntchito.

Mankhwala

Detemir insulin ndi chosungunira basal analogue a insulin yaumunthu, nthawi yayitali yokhala ndi mbiri yosavuta kuchitapo kanthu, yomwe imapangidwa ndi recombinant DNA biotechnology pogwiritsa ntchito Saccharomyces cerevisiae. Insulin imamangirira ku ma receptor enieni, potero polimbana ndi zotsatira zachilengedwe. Insulin imayendetsa kagayidwe kazigawo. Amachepetsa kuchuluka kwa shuga m'magazi, ndikulimbikitsa kudya kwake ndi minofu ya thupi ndikupangitsa gluconeogeneis. Insulin imathandizira mapuloteni a biosynthesis, amalepheretsa proteinolysis ndi lipolysis m'maselo a mafuta. Pazipita kuchuluka kwa insulir insulini mu magazi seramu amafikiridwa pambuyo 6 - 8 pambuyo makonzedwe. Ndi regimen ya makonzedwe kawiri patsiku, kufanana kwa insulin Detemir m'magazi seramu zimatheka pambuyo 2 mpaka 3 jakisoni. Kusiyanitsa kwapakati pa fungo la insulin kumachepa poyerekeza ndi kukonzekera kwina kwa insulin. Mu pharmacokinetics ya insulin detemir, palibe kusiyana kwakukulu pakati pa amuna ndi akazi komwe kunapezeka. Kuchulukitsa kwapakati pa kugawa kwa insulin detemir kuli pafupifupi 0,1 l / kg .Kupanga kutulutsa insulin kuli kofanana ndi kukonzekera kwa insulin ya anthu, zinthu zonse za metabolic sizigwira ntchito. Palibe kuyanjana kwakukulu pakati pa insulin detemir ndi mafuta acids kapena mankhwala ena omwe amamangiriza mapuloteni. Moyo wotsiriza wa theka ndi jekeseni wa subcutaneous zimatengera mlingo wa mankhwalawa komanso kuchuluka kwa kuyamwa kwa minofu yaying'ono ndipo ndi maola 5 mpaka 7.

Matenda a shuga ndi odwala omwe ali ndi zaka 2.

Mlingo wa chinyengo cha insulin

Dululir ya Detemir imangoyikidwa kwa subcutaneous makonzedwe, mankhwalawa sangathe kutumikiridwa kudzera m'mitsempha, chifukwa izi zingayambitse hypoglycemia. Mlingoyo umatsimikiziridwa molingana ndi zosowa za wodwala. Kusintha kwa Mlingo kungafunike ngati zakudya zomwe wodwala akudwala zasintha, zochitika zake zolimbitsa thupi zitha, kapena odwala. Detemir insulin ingagwiritsidwe ntchito ngati mtundu wa monotherapy komanso ndi bolus insulin, komanso mankhwala a hypoglycemic a pakamwa. Detemir insulin imatha kuperekedwa nthawi iliyonse yabwino masana, koma mutakhazikitsa jakisoni, muyenera kutsatira tsiku lililonse. Detemir insulin imalowetsedwa pang'onopang'ono kudera lachiberekero cham'mimba khoma, ntchafu, phewa, gluteal kapena malo otentha. Masamba a jakisoni ayenera kusinthidwa pafupipafupi kuti muchepetse chiwopsezo cha lipodystrophy. Monga momwe amakonzera insulin ena, odwala okalamba ndi odwala omwe ali ndi vuto la impso kapena kwa chiwindi, amawunika kwambiri magawo a shuga wamagazi ndikusintha kwa mankhwala a munthu. Monga momwe amakonzera insulini ina, ndikofunikira kuti mupenyetsetsetsetsetsetsetsikulu wamagazi pakamasulira komanso m'milungu yoyamba yopanga mankhwala atsopano.
Dululir ya Detemir imakhala ndi mphamvu yayitali (mpaka tsiku).
Chithandizo cha Detemir insulin sichikukweza thupi.
Ulendo wautali, womwe umalumikizidwa ndi kusintha kwa magawo a nthawi, wodwalayo ayenera kufunsa dokotala, chifukwa kusintha nthawi kumatanthauza kuti wodwalayo azidzabayira insulin ndikudya nthawi ina.
Kusiyidwa kwa mankhwalawa kapena kumwa mankhwala osakwanira kungayambitse matenda a hyperglycemia kapena matenda ashuga a ketoacidosis. Hyperglycemia nthawi zambiri imayamba pang'onopang'ono kwa maola angapo kapena masiku. Zizindikiro za hyperglycemia zimaphatikizapo kukodza pafupipafupi, ludzu, nseru, kusanza, redness ndi kuyanika pakhungu, kuwodzera, pakamwa kowuma, kununkhira kwa acetone mu mpweya wotopa, kutaya mtima. Popanda chithandizo choyenera, hyperglycemia imatsogolera ku matenda ashuga a ketoacidosis ndi kufa.
Hypoglycemia imatha kukhala ndi zochitika zosakonzekera zolimbitsa thupi kapena kudumpha zakudya ngati mlingo wa insulin ndiwokwera kwambiri poyerekeza ndi kufunika kwa insulin. Pakalipira kagayidwe kazakudya kwa odwala, zomwe zimachitika m'tsogolo mwa hypoglycemia zimatha kusintha, odwala ayenera kudziwitsidwa za izi. Ndi kuphunzira kwa nthawi yayitali matenda ashuga, zizindikiritso zomwe zimachitika nthawi zambiri zimatha.
Concomitant pathology, makamaka yothandizidwa ndi kutentha thupi komanso matenda opatsirana, nthawi zambiri imakulitsa kufunikira kwa insulin.
Kusintha kwa mankhwala a insulin kuwonongeka kungafunikenso ngati wodwala ali ndi matenda a chiwindi, impso, adrenal gland, chithokomiro England.
Pali malipoti a kakulidwe ka matenda osalephera a mtima mu mankhwalawa odwala omwe ali ndi thiazolidatediones limodzi ndi kukonzekera kwa insulin, makamaka ngati wodwalayo ali ndi chiopsezo chotukuka kwa mtima wodwala. Izi zimayenera kukumbukiridwa popereka mankhwala odwala ndi kuphatikiza insulin ndi thiazolidinediones. Ndi chithandizo chophatikizika chotere, ndikofunikira kuchita mayeso azachipatala a odwala kuti muwone zomwe akuwona ndi zizindikiro zakulephera kwa mtima, kupezeka kwa edema, kuwonda. Ngati zizindikiro za kulephera kwa mtima zizindikirika kapena zayamba kufooka, chithandizo cha thiazolidinedione ziyenera kusiyidwa.
Ndi hypoglycemia, yomwe imatha kukhazikika ngakhale mutatenga Detemir, kuthamanga kwa zomwe zimachitika komanso kuthekera kwazowunikira kumasokonezedwa. Chifukwa chake, ndi chitukuko chake, odwala ayenera kupewa kuchita nawo zinthu zina zomwe zimafunikira makamaka kuthamanga ndi psychomotor reaction (kuphatikizapo magalimoto oyendetsa).

Mimba komanso kuyamwa

Mukamagwiritsa ntchito mankhwalawa panthawi yomwe muli ndi pakati, ndikofunikira kuganizira zabwino zomwe mayi akuyembekezera komanso chiopsezo cha mwana wosabadwayo. M'modzi mayeso a chipatala amodzi omwe sanasungidwe mwachisawawa, panalibe kusiyana pakubala, pakubadwa kwa chitetezo nthawi yonse yomwe ali ndi pakati, paumoyo wa mwana wakhanda ndi mwana wakhanda poyerekeza kukonzekera kwa insulin ndi detemir ndi insulin. Zowonjezera zokhudzana ndi chitetezo ndi kugwiritsa ntchito bwino kwa chithandizo cha mankhwala panthawi yogulitsa pambuyo potsatsa zikuwonetsa kusapezeka kwa zovuta zosafunikira zomwe zingayambitse kusokonezeka kwina kapena kuwonongeka kwa mwana wosabadwayo. Mu nyama, poizoni wa mankhwala omwe amapezeka pakaberekedwe ka magazi sanawonekere. Amayi oyembekezera omwe ali ndi matenda ashuga amafunikira kuwunika mosamala panthawi yonse yomwe ali ndi pakati, komanso pakukonzekera kutenga pakati. Mu trimester yoyamba ya kubereka, kufunika kwa insulin nthawi zambiri kumachepera ndipo msinkhu wachiwiri ndi wachitatu trimesters. Kufunika kwa insulin pambuyo pobadwa mwana mwachangu kumabwereranso pamlingo womwe unali asanakhale ndi pakati. Palibe chidziwitso kaya ngati insulin imalowa mu Detemir mkaka wa m'mawere. Amaganiziridwa kuti mankhwalawa samakhudza metabolism m'thupi la makanda pakuyamwa, popeza mankhwalawa ndi peptide omwe amawonongeka mosavuta m'matumbo am'mimba amino acid omwe amamwe thupi. Munthawi ya kuyamwitsa mwa akazi, kusintha kwa zakudya ndi kumwa kwa insulin kungafunike.

Zotsatira zoyipa za insulin

Matenda a metabolism: hypoglycemia (Zizindikiro za hypoglycemia: thukuta lozizira, kuchuluka kwa kutopa, khungu, kunjenjemera, kuda nkhawa, kufooka, kutopa kwachilendo, kusokonezeka, kugona, kuchepa kwa ndende, njala yayikulu, kupweteka mutu, nseru, masomphenya opanda nzeru, kutaya chikumbumtima, kukhudzika, kusokonezeka kwakanthawi kapena kusasintha kwa ntchito ya ubongo, imfa).
Zovuta zamtundu uliwonse ndi zomwe zimachitika pamalo opangira jakisoni: zimachitika zam'deralo hypersensitivity (kutupa, redness, kuyabwa pamalo jakisoni), lipodystrophy, edema.
Matenda owononga chitetezo chamthupi: urticaria, thupi lawo siligwirizana, zotupa pakhungu, kuyabwa, thukuta, angioedema, kusokonezeka m'matumbo, zovuta za kupuma, kunachepetsa kuthamanga kwa magazi.
Zowonongeka: mavuto obwezeretsera, matenda ashuga retinopathy.
Machitidwe amanjenje: zotumphukira neuropathy.

Kuchita kwa insulin kunyansidwa ndi zinthu zina

Pali mankhwala omwe amakhudza kufunika kwa insulin. Zotsatira za hypoglycemic za insulin zimaphatikizidwa ndi glucocorticosteroids, njira zakulera zamkamwa, mahomoni okhala ndi chithokomiro, thiazide diuretics, somatropin, heparin, sympathomimetics, tridclicant antidepressants, danazole, pang'onopang'ono calcium njira blockers, clonidine, diafin oxide, Mphamvu ya hypoglycemic ya insulin imapangidwira ndi monoamine oxidase inhibitors, mankhwala osokoneza bongo a hypoglycemic, angiotensin otembenuza enzyme inhibitors, osasankha beta-blockers, carbonic anhydrase inhibitors, bromocriptine, anabolic steroids, sulfonamide mankhwala, tetracycline phospholife, tetracycline phospholife. zomwe zimakhala ndi ethanol. Octreotide ndi lanreotide zimatha kuchepetsa ndikukulitsa kufunikira kwa insulin. Mothandizidwa ndi salicylates ndi reserpine, onse kuwonjezeka ndi kufooka kwa zochita za mankhwala ndizotheka. Mowa umatha kukulitsa komanso kukulitsa mphamvu ya insulin. Beta-blockers amatha kuphimba mawonetsedwe a hypoglycemia ndikuchedwa kuchira pambuyo pa hypoglycemia. Mankhwala ena, mwachitsanzo, omwe ali ndi magulu a sulfite kapena thiol, akaphatikizidwa ndi insulin, detemir ikhoza kuwononga. Dermul ya Detemir siyenera kuwonjezeredwa ku kulowetsedwa.

Bongo

Mlingo wapadera womwe mankhwala osokoneza bongo a insulini amakhala nawo asanakhazikitsidwe, koma hypoglycemia imatha kukula pang'onopang'ono pokhazikitsa mlingo waukulu wa wodwala. Chithandizo: wodwala atha kuchotsa shuga wofatsa pogwiritsa ntchito shuga, shuga, komanso zakudya zopatsa mphamvu zamagulu ambiri. Chifukwa chake, odwala matenda a shuga ayenera kunyamula maswiti, shuga, msuzi wa zipatso wokoma, ma cookie.
Mu hypoglycemia yayikulu, wodwalayo akapanda kudziwa, m`pofunika jakisoni 0,5 - 1 mg wa glucagon mosadukiza kapena m'mitsempha, kapena jekeseni yankho la glucose (dextrose) kudzera m'mitsempha. M'pofunika kuperekanso shuga m'mitsempha ngati wodwalayo asadzayambenso kumva mphindi 10 mpaka 15 pambuyo pa kutsekeka kwa glucagon. Pobwezeretsa chikumbumtima kuti muthane ndi matenda obwera chifukwa cha hypoglycemia, wodwalayo amalimbikitsidwa kudya chakudya chomwe chili ndi chakudya chamagulu ambiri.

Kodi insulin ndi chiyani?

Insulin ndi kukonzekera kwa mapuloteni-peptide a mahomoni. Insulin imagwiritsidwa ntchito ngati chida chothandiza pochiza matenda ashuga.

Insulin ndi mahomoni omwe amathandizira kagayidwe kazakudya ndipo amathandiza kuchepetsa kuchuluka kwa shuga m'magazi a wodwala. Kuchepetsa chakudya m'magazi kumatheka chifukwa cha kuchuluka kwa shuga pogwiritsa ntchito zinthu zotengera insulin mothandizidwa ndi insulin. Insulin imathandizira pakupanga glycogen ndi maselo a chiwindi ndikulepheretsa kusintha kwamafuta ndi ma amino acid kukhala chakudya.

Ndi kusowa kwa insulin mthupi la munthu, kuwonjezeka kwa shuga m'magazi kumawonedwa. Kuwonjezeka kwa shuga m'magazi kumatsutsa kukula kwa matenda a shuga komanso zovuta zina. Kuperewera kwa insulini m'thupi kumachitika chifukwa cha zovuta m'matumbo, zomwe zimawoneka chifukwa cha kusakhazikika kwa dongosolo la endocrine, pambuyo povulala kapena chifukwa cha kulumikizana mwamphamvu kwamalingaliro m'thupi komwe kumachitika chifukwa cha zovuta zina.

Kukonzekera komwe kumakhala ndi insulin kumapangidwa kuchokera ku minofu ya zikondamoyo za nyama.

Nthawi zambiri, kupanga mankhwala kumagwiritsa ntchito minyewa ya kapamba wama ng'ombe ndi nkhumba.

Zizindikiro ntchito insulin kukonzekera

Pofuna kuthana ndi mankhwala osokoneza bongo omwe ali ndi insulin, pamafunika kumwa magalamu 100 a mikate yoyera, tiyi wokoma kapena supuni zingapo za shuga pazizindikiro zoyambirira.

Pamaso pa zizindikiro za kutekemera, shuga ayenera kuperekedwa kwa wodwalayo kudzera m'mitsempha. Ngati ndi kotheka, mutha kuphatikiza adrenaline modzichepera.

Kusamala makamaka kumafunikira pakugwiritsa ntchito mankhwala opangira insulin odwala omwe ali ndi matenda osokoneza bongo, pamaso pa kupezeka kwa coronary komanso pakuwona zovuta pamitsempha yamagazi. Pankhani yogwiritsa ntchito insulin yayitali, kuyesa kwamkodzo mkodzo ndi magazi ake kuti mupeze zomwe zili ndi shuga momwemo. Kafukufuku ngati amenewa kuti afotokozere nthawi yoyenera kumwa mankhwalawa kuti mukwaniritse zabwino.

Kupereka mankhwalawa, ma syringes apadera kapena ma syringe apadera amagwiritsidwa ntchito nthawi zambiri.