Mfundo za kagwiritsidwe ntchito ka insulini posakhalitsa komanso insulin yayitali

Insulin ndi timadzi tomwe timatulutsa ma cell a pancreatic. Ntchito yake yayikulu ndikumapatsa kagayidwe kazakudya ndi "kupindika" glucose yomwe ikukula.

Makina ogwirira ntchito ndi awa: munthu amayamba kudya, pakatha mphindi 5 za insulin, amapanga shuga, amawonjezereka atatha kudya.

Ngati kapamba sagwira ntchito bwino ndipo mahomoni satsekera mokwanira, amakula.

Mitundu yofatsa ya kuloleza kwa glucose sikufuna chithandizo, nthawi zina, simungachite popanda iwo. Mankhwala ena amalowetsedwa kamodzi patsiku, pomwe ena nthawi zonse asanadye.

Makalata ochokera kwa Owerenga

Mutu: Magazi a agogo aakazi abwerera mwakale!

Kupita ku: Webusayiti yoyang'anira

Christina
Moscow

Agogo anga akhala akudwala matenda a shuga kwa nthawi yayitali (mtundu 2), koma posachedwapa mavuto atuluka pamiyendo ndi ziwalo zamkati.

Insulin yochepa-pang'ono imayamba kugwira ntchito pambuyo pakudya pambuyo pa mphindi 30 mpaka 40. Pambuyo pake, wodwalayo ayenera kudya. Kudumpha zakudya sizovomerezeka.

Kutalika kwa mankhwalawa kumafika mpaka maola 5, pafupifupi nthawi yambiri kuti thupi ligaye chakudya. Zochita za mahormoni zimachuluka kwambiri kuposa nthawi yowonjezera shuga mutatha kudya. Kusamala kuchuluka kwa insulin ndi glucose, atatha maola 2,5 kuyamwa kumalimbikitsidwa kwa odwala matenda ashuga.

Kuchita insulin mwachangu nthawi zambiri kumawalembera odwala omwe amakula kwambiri akatha kudya. Mukamagwiritsa ntchito, ndikofunikira kuganizira zanzeru zina:

• kukula kwake kuyenera kukhala kofanana nthawi zonse
• Mlingo wa mankhwalawa amawerengedwa poganizira kuchuluka kwa zakudya zomwe zimadyedwa kuti zithetse kusowa kwa mahomoni m'thupi la wodwalayo,
• ngati kuchuluka kwa mankhwalawo sikuperekedwa mokwanira,
• kukulira mlingo kumayambitsa hypoglycemia.

Onsewa hypo- ndi hyperglycemia ndiowopsa kwambiri kwa wodwala matenda ashuga, chifukwa amatha kuyambitsa zovuta zazikulu.

• Kufunika kudikirira mphindi 30 mpaka 40 musanadye. Nthawi zina, izi zimakhala zovuta kwambiri. Mwachitsanzo, ali panjira, pa chikondwerero.
• Zotsatira zamankhwala sizichitika mwachangu, zomwe zikutanthauza kuti mankhwalawa sayenera kupumula kwaposachedwa kwa hyperglycemia.
• Popeza insulini yotere imakhala ndi mphamvu yayitali, kuwunikira kosafunikira kumafunikira patatha maola 2,5 patatha kubayidwa kuti jekeseni azikhazikika.

Muzochitika zamankhwala, pali odwala matenda ashuga omwe amupeza kuti akutsitsa m'mimba.

Odwala awa amafunika kuti alowe ndi insulin yokwanira 1.5 maola asanadye. Nthawi zambiri, izi ndizosokoneza. Potere, njira yokhayo ndi kugwiritsa ntchito mahomoni a ultrafast action.

Mulimonsemo, ndi dokotala yekhayo amene angakupatseni mankhwala kapena mankhwalawa. Kusintha kuchokera ku mankhwala kupita kwina kuyeneranso kuchitika moyang'aniridwa ndi achipatala.

Pakadali pano, kusankha kwa kukonzekera insulin mwachangu kuli konsekonse. Nthawi zambiri, mtengo umadalira wopanga.

Gome: "Ochita zinthu mwachangu"

"" Ndi analogue ya insulin yamunthu. Mafuta osapaka utoto omwe amapezeka m'mabotolo atatu amililita atatu. Njira yovomerezeka yoyendetsera ndiyopanda njira komanso yolowerera. Kutalika kwa kuchitapo kanthu mpaka maola 5.Zimatengera Mlingo wosankhidwa ndi kuwonongeka kwa thupi, kutentha kwa thupi la wodwalayo, komanso tsamba la jakisoni.

Ngati kuyambitsa kunali pansi pa khungu, ndiye kuti kuchuluka kwa mahomoni ambiri m'magazi kudzakhala theka la ola - ola.

Humalog imatha kutumikiridwa musanadye, komanso pambuyo pake. Kuwongolera kwa subcutaneous kumachitika m'mapewa, m'mimba, matako kapena ntchafu.

Yogwira pophika mankhwala a Novorapid penfill ndi insulin. Uku ndi kuwonetsera kwa mahomoni amunthu. Amadzimadzi opanda mtundu, wopanda chinyengo. Mankhwalawa amaloledwa kwa ana opitirira zaka ziwiri. Nthawi zambiri, kufunika kwa insulin kuyambira 0.5 mpaka 1 UNITS, kutengera kulemera kwa odwala matenda ashuga.

"Apidra" ndi mankhwala achijeremani omwe mankhwala ake ndi insulin glulisin. Ichi ndi chinanso china cha ma hormone amunthu. Popeza kafukufuku wokhudzana ndi mankhwalawa sanachitike pa amayi apakati, kugwiritsa ntchito kwake gulu la odwala nkosayenera. Zomwezo zimapita kwa akazi akumiyala.

Rosinsulin R ndi mankhwala opangidwa ndi Russia. Mankhwala omwe amapangika amapangidwa ndi majini amtundu wa insulin. Wopanga amalimbikitsa kuti ayendetsedwe posakhalitsa chakudya chisanafike kapena 1.5-2 pambuyo pake. Musanagwiritse ntchito, ndikofunikira kupenda mosamala zamadzimadzi kutipezeka matope, matope. Pankhaniyi, mahomoni sangathe kugwiritsidwa ntchito.

Zotsatira zoyambirira za kukonzekera kwa insulin mwachangu ndi hypoglycemia. Mawonekedwe ake ofatsa safuna kusintha kwa mankhwalawa ndi chisamaliro chamankhwala. Ngati shuga wochepa wadutsa pamlingo woyenera kapena wovuta kwambiri, thandizo lachipatala lofunikira likufunika. Kuphatikiza pa hypoglycemia, odwala amatha kukhala ndi lipodystrophy, pruritus, ndi urticaria.

Nicotine, COCs, mahomoni a chithokomiro, mankhwala opha tizilombo komanso mankhwala ena amachepetsa mphamvu za insulin pa shuga. Pankhaniyi, muyenera kusintha mlingo wa mahomoni. Ngati mankhwala ena amatengedwa ndi odwala tsiku lililonse, ayenera kudziwitsa adotolo za izi.

Monga mankhwala aliwonse, kukonzekera insulin mwachangu kumakhala ndi zotsutsana. Izi zikuphatikiza:

• matenda ena amtima, makamaka chilema,
• pachimake yade
• matenda am'mimba
• chiwindi.

Pamaso pa matenda oterewa, njira yochizira imasankhidwa payekhapayekha.

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

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

Insulin yayitali

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

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

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

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

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

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

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

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

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

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

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

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

Insulin yayitali - mlingo usiku

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

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

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

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

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

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

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

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

Insulin yayitali - tsiku lililonse

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

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

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

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

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

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

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

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

Mankhwala a insulin amatanthauza kugwiritsa ntchito mankhwala a insulin. Njirayi imagwiritsidwa ntchito kwambiri osati pothandizira matenda a shuga; komanso m'maganizo, ndi matenda a chiwindi, kutopa, furunculosis ndi matenda a chithokomiro. Pali chiwerengero chachikulu cha mankhwala opangidwa omwe amagawidwa m'magulu kutengera nthawi yomwe isanayambike zotsatira zake komanso nthawi yake.

Insulin yofupikitsa ndi m'modzi mwa "omwe" amatenga nawo gawo pazamankhwala. Ndizotchuka kwambiri pakugwiritsa ntchito, chifukwa zimakuthandizani kuti muchepetse shuga wamagazi mofulumira. Mankhwala amakono amakhala ndi mphamvu yochizira yothandiza kwambiri. Chotsatira, ndi insulin yayifupi kwambiri ndi mawonekedwe ake.

Kusiyana kwa mankhwala

Kumayambiriro kwa chochitikacho, kuyambika kwa "nsonga" komanso nthawi yayitali, zotsatira zamitundu izi ndizosiyanitsidwa:

• Insulin yofulumira imatchulidwanso insulin. Amatha kuyimitsa nsonga ndipo amakhala ndi 10 mpaka theka la ola jekeseni. Gululi limaphatikizapo mankhwala a ultrashort komanso achidule.
• Insulin zazitali - dzina lachiwiri ndi "basal". Izi zimaphatikizapo mankhwala osokoneza bongo a nthawi yayitali komanso mankhwala osokoneza bongo omwe amakhala nthawi yayitali. Cholinga cha kuyambitsa kwawo ndi kukhazikika pa insulin tsiku lonse. Zotsatira zake zimatha kuchoka pa 1 mpaka 4 maola.

Kudya ndikupereka insulin yochepa ndizinthu zomwe zimagwirizanitsidwa pochiza matenda a shuga

Kuphatikiza pa kuchuluka kwake, pali kusiyana kwina pakati pa magulu azamankhwala. Mwachitsanzo, insulin yochepa imalowetsedwa m'dera la khoma lamkati lakumbuyo kuti njira zolerera zimachitika mofulumira. Ma insulin okhala ndi nthawi yayitali amawongolera bwino kwambiri ntchafu.

Njira za ultrashort ndi zochitika zazifupi zimamangirizidwa nthawi zonse pakulandila chakudya m'thupi. Amaperekedwa musanadye chakudya kuti muchepetse kuchuluka kwa glucose mukangodya zakudya zomwe zimakhala ndi chakudya chamagulu. Mankhwala omwe akhala akuchita kwa nthawi yayitali amagwiritsidwa ntchito mosamalitsa malinga ndi dongosolo m'mawa ndi madzulo. Samalumikizana ndi zakudya.

Zofunika! Ndikosatheka kuphwanya malamulo omwe ali pamwambapa, chifukwa izi zimatha kubweretsa zovuta za matendawa. Regimen yothandizira insulin imasankhidwa ndi katswiri wochiritsira aliyense payekha.

Insulin yochepa

Mankhwala aliwonse amakhala ndi machitidwe ena a kapangidwe kake ndi zomwe zimakhudza thupi la munthu, zomwe zimayenera kuganiziridwa mwatsatanetsatane.

Malangizo ogwiritsira ntchito mankhwalawa akuwonetsa kuti chida ichi ndi analogue ya insulin ya anthu. Kapangidwe kake kamafanana ndi zotsalira za ma amino acid ena mu molekyulu. Mwa insulin yonse yomwe imagwiritsa ntchito mwachidule, iyi ndiyomwe imayamba mwachangu komanso kumapeto.Kutsika kwa shuga m'magazi kumachitika pakatha mphindi 15 jakisoni atatha, mpaka maola atatu.

Zisonyezo zakusankhidwa kwa Humalog:

• mtundu wodwala wa shuga
• kusalolera kwa mankhwala ena okhala ndi mahomoni,
• hyperglycemia yomwe imachitika mutatha kudya, yomwe sikukonzedwa mwanjira zina,
• mtundu wosadalira insulini womwe ungakane mankhwala ochepetsa shuga piritsi,
• mawonekedwe osadalira a insulin omwe amaphatikizidwa ndi opaleshoni kapena matenda ophatikizika omwe amalimbikitsa mawonetsedwe a "matenda okoma".

Mlingo wa insulin yochepa umasankhidwa payekha. Humalog mu Mbale imatha kuperekedwera osati kokha, komanso minyewa, kulowa mu mtsempha. M'makalata - kokha modekha. Mankhwalawa amaperekedwa chakudya chisanafike, mpaka 6 pa tsiku, kuphatikiza ndi insulin yayitali.

Humalog - mankhwala "afupikitsidwe", omwe amapezeka m'makalata ndi mbale

Zotsatira zoyipa za ntchito zimatha kuchepa pang'ono m'magazi a magazi, mawonekedwe a precoma, chikomokere, mawonekedwe a mawonekedwe, matupi awo sagwirizana, lipodystrophy (kuchepa kwa gawo lamafuta am'munsi patsamba lothandizira pafupipafupi).

Zofunika! Humalogue imasungidwa mufiriji, koma siyilola kuzizira, chifukwa mwanjira iyi malonda amasiya kugwira ntchito.

Dzina la mankhwalawa (NM) likuwonetsa kuti chinthu chomwe chimagwira ndi insulin. Actrapid NM amachepetsa shuga pambuyo theka la ola, nthawi - mpaka maola 8. Mankhwala amapatsidwa mtundu wa "matenda okoma" omwe amadalira insulin, komanso matenda amtundu wa 2 molumikizana ndi mikhalidwe iyi:

• kutayika kwa mapiritsi a hypoglycemic,
• kupezeka kwa matenda omwe amayambitsidwa ndi matenda omwe amayambitsa matenda.
• othandizira opaleshoni
• nthawi yobala mwana.

Actrapid NM akuwonetsedwa chifukwa cha machitidwe a hyperglycemic (ketoacidosis, hyperosmolar coma), hypersensitivity kwa zinthu zanyama, motsutsana ndi kufalikira kwa maselo a islets a Langerhans-Sobolev.

Kukhazikitsidwa kwa insulin yayifupi kumatheka kuyambira katatu mpaka katatu patsiku. Wodwala akapatsidwa mankhwalawo kuchokera ku insulin yaumunthu wina, mulingo wakewo sasinthidwa. Pankhani yosamutsidwa kuchokera ku mankhwala ochokera kuzinyama, mlingo uyenera kuchepetsedwa ndi 10%.

Actrapid NM - mankhwala omwe amakhala nawo mwachangu, koma amakhala nawo kwakanthawi

Zofunika! Actrapid NM sinafotokozeredwe shuga wochepa wamagazi komanso pamaso pa cell yotulutsa pancreatic chotupa (insulinoma).

Insuman Rapid

Kuphatikizikako kumaphatikizapo mahomoni omwe ali pafupi kwambiri ndi insulin yaumunthu. Vuto la Escherichia coli limatengera kapangidwe kake. Kuchita pang'ono kwa insulini kumachitika mkati mwa theka la ola ndipo kumatenga mpaka maola 7. Insuman Rapid imapezeka m'mbale ndi ma cartridge a syringe pens.

Zisonyezero zoika mankhwalawa ndi ofanana ndi Actrapid NM. Amabayidwa pang'onopang'ono mphindi 20 chakudya chisanalowe mthupi, nthawi iliyonse osintha jekeseni. Insuman Rapid ikhoza kuphatikizidwa ndi ma insulin omwe amakhala nthawi yayitali, omwe amakhala ndi ma protamine monga chinthu chodzipangira.

Homorap 40

Wina woyimira insulin yochepa, momwe imadziwonekera yokha mkati mwa theka la ora ndipo amatha kufikira maola 8. Kutalika kwa zochita zimatengera zinthu izi:

• Mlingo wa mankhwala
• njira yoyendetsera
• tsamba la jakisoni
• machitidwe a thupi la wodwala.

Chipangizocho chimayimitsa chiwonetsero chazomwe chikuchitika mwadzidzidzi (chikomokere matenda a shuga, precoma), chimayikidwa panthawi ya opaleshoni. Homorap 40 imawonetsedwa kwa odwala muubwana ndi unyamata, panthawi yomwe akubala mwana.

Jekeseni wa mankhwalawa amachitika mpaka katatu patsiku, kusankha payekha. Itha kuperekedwa pogwiritsa ntchito mapampu a insulin kapena syringe yomweyo ndi insulin yotalikilapo.

Zofunika! Ndi jakisoni "wophatikizika", insulin yayifupi imayamba kukokedwa mu syringe, kenako wothandizira kwa nthawi yayitali.

Pankhani ya glucocorticosteroids, beta-blockers, antidepressants komanso kuphatikiza kwapakati pakamwa, kusintha kwa mankhwala kwa mahomoni kumafunika.

Pachimake ndizobwerezanso insulin ya anthu. Amapezeka m'makalata ndi mabotolo. Amakhala ndi subcutaneous (phewa, ntchafu, khomo lamkati lam'mimba), makonzedwe amkati ndi mtsempha. Malowo a jakisoni amayenera kusintha nthawi zonse kuti malo omwewo asadzabwerezenso kangapo m'masiku 30.

Humulin Nthawi zonse - imodzi mwamankhwala omwe angafotokozeredwe kuchokera kubadwa

• kutsitsa shuga
• mawonetseredwe am'deralo (redness, kutupa ndi kuyabwa pamalowo jekeseni),
• zofunikira zonse
• lipodystrophy.

Humulin Nthawi zonse imatha kutengedwa kuyambira pakubadwa. Poterepa, kuchuluka kwa mankhwalawa amawerengedwa potengera kulemera kwa thupi la wodwalayo.

Berlinsulin HU-40

Amapezeka m'mitundu ingapo. Gome la ma insulin ndi mawonekedwe ake amakambidwa pansipa.

Kuwongolera kwa Mlingo wa insulini ndi mankhwala omwe afotokozedwera ndikofunikira pa matenda a genesis opatsirana, chithandizo cha opaleshoni, panthawi ya bere, ndi matenda a chithokomiro, aimpso komanso adrenal, komanso "matenda okoma" okalamba.

Zofunika! Mtundu uliwonse wa Berlsulin suyenera kusakanikirana ndi mankhwala ena okhala ndi insulin. Mitundu iyi imatha kusakanikirana wina ndi mnzake.

Magulu otsatirawa a mankhwala amatha kupititsa patsogolo zotsatira za mankhwala, omwe amayenera kuganiziridwa posankha mtundu wa chithandizo:

• antidepressants
• beta-blockers,
• sulfonamides,
• kuphatikiza kulera kwamlomo,
• mankhwala othandizira testosterone
• ma antibayotiki (gulu la tetracycline),
• Zogulitsa zotchedwa Ethanol
• heparin
• okodzetsa
• Kukonzekera kwa lifiyamu
• mankhwala a chithokomiro a chithokomiro.

Mankhwala olimbitsa

Masiku ano, kugwiritsa ntchito ma insulin afupia kumagwiritsidwa ntchito kwambiri pantchito yomanga thupi, chifukwa momwe mankhwalawa ali ofanana ndi zomwe amapangira anabolic steroid. Chofunika kwambiri ndikuti ma hormone amasintha glucose kukhala minofu ya minofu, zomwe zimapangitsa kuchuluka kwake.

Kupanga minofu yochepa insulin - njira yomwe iyenera kuchitika pambuyo pa kufufuza kwathunthu ndi upangiri wa udokotala

Zimatsimikiziridwa kuti kugwiritsidwa ntchito koteroko kumayenera kuchitika "mwanzeru", chifukwa ntchito ya insulin imaphatikizapo kusamutsa ma monosaccharides osati minofu, komanso minyewa ya adipose. Zina zolimbitsa thupi sizitha kutsogola minofu, koma kunenepa kwambiri. Chifukwa chake, Mlingo wa mankhwala osokoneza bongo, komanso anthu odwala, amasankhidwa payekha. Ndikofunika kuti mupumule kwa miyezi inayi pambuyo pa miyezi iwiri ya jekeseni.

Muyenera kuyang'anira malamulo osungira insulin ndi mawonekedwe ake. Kwa mitundu yonse, ndizofanana:

• Mbale ndi ma cartridge ziyenera kusungidwa mufiriji (osati mufiriji!). Ndikofunika kuwayika pakhomo.
• Mankhwala ayenera kutsekedwa kokha.
• Mankhwala atatseguka, angagwiritsidwe ntchito mkati mwa masiku 30.
• Chogulitsacho chimayenera kunyamulidwa kuti chisalumikizane mwachindunji ndi dzuwa. Izi zimawononga mamolekyulu ndikuchepetsa mphamvu yake.

Musanagwiritse ntchito mankhwalawa, onetsetsani kusakhalapo kwa chinyezi, matope kapena mapesi panjira yothetsera vutolo, moyo wa alumali, malo osungirako.

Kutsatira upangiri wa akatswiri ndi chinsinsi cha moyo wapamwamba kwa odwala komanso kuthekera koletsa zovuta za matenda oyambitsidwa.

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

Njira yamachitidwe

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

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

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

Mitundu ya mankhwala

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

Kugwiritsa ntchito insulin yayitali pakulimbikitsidwa pazisonyezo izi:

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

Njira yogwiritsira ntchito

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

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

Kukonzekera kwa insulin yayitali sikuyenera kusakanikirana kapena kuchepetsedwa.

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

Kuwerengera Mlingo

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

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

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

Bongo

Kuchuluka kwa mankhwalawa kungayambitse hypoglycemia. Popanda thandizo lakuchipatala, zimabweretsa mavuto akulu. Kutembenuka, kusokonezeka kwamanjenje kumachitika, chikomokere cha hypoglycemic sichimachotsedwa, muzovuta zovuta zomwe zimatha kubweretsa imfa.

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

Contraindication

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

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

Zotsatira zoyipa

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

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

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

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

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 ma endocrinologists pantchito yawo ndi Dzhi 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.

Gulu la Horona

Insulin yosavuta idachotsedwa ku zikondamoyo za nyama pafupifupi theka la zaka zapitazo. Kuyambira pamenepo, yakhala ikugwiritsidwa ntchito pochiza matenda a shuga mpaka lero. Tsopano asayansi amatha kudzipangira okha mankhwala a insulin, popanda kutulutsa timadzi tating'onoting'ono tomwe timatulutsa timadzi tambiri. Awa ndi omwe amatchedwa othandiziranso zinthu. Munthawi imeneyi, mitundu yambiri ya mankhwala a mahomoniwa yapangidwa. Amakhala ndi nthawi yosiyanasiyana pochita, mawonekedwe ndi zina.

Ma insulin omwe amagwira ntchito mwachidule amagawidwa m'mitundu iwiri:

1. Kukonzekera mwachidule kwa insulin - Actrapid NM, Humodar R, Monodar, Biogulin R, Actrapid MS, Monosuinsulin MK, etc.
2. Ultrashort insulin - Humalog ndi Apidra.

Za insulin yayitali, zimaphatikizapo nthawi yapakatikati komanso insulin zazitali kwambiri. Awa ndi insulin-zinc, insulin-isophan ndi mankhwala ena.

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.

Kuwerengera molondola kwa mlingo wa insulin yayitali usiku

Kuti mukhale ndi moyo wabwinobwino, wodwalayo ayenera kuphunzira momwe angawerengere molondola kuchuluka kwa Lantus, Protafan kapena Levemir usiku, kotero kuti msanga wama glucose amasungidwa pa 4.6 ± 0.6 mmol / l.

Kuti muchite izi, mkati mwa sabata muyenera kuyeza kuchuluka kwa shuga usiku ndi m'mawa pamimba yopanda kanthu. Kenako muyenera kuwerengera mtengo wa shuga m'mamawa mtengo wake wa dzulo usiku ndikuwerengera kuchuluka, izi zikuwonetsa chisonyezo chochepa chofunikira.

Mwachitsanzo, ngati kuchuluka kwochepa kwa shuga ndi 4.0 mmol / l, ndiye kuti gawo limodzi la insulin yayitali ingachepetse chizindikirocho ndi 2.2 mmol / l mwa munthu wolemera makilogalamu 64. Ngati kulemera kwanu ndi makilogalamu 80, ndiye kuti timagwiritsa ntchito njira zotsatirazi: 2.2 mmol / L * 64 kg / 80 kg = 1.76 mmol / L. Mlingo wa insulin kwa munthu wolemera makilogalamu 80 uyenera kukhala magawo 1.13, chiwerengerochi chimakhala chozungulira kufika kotala ndipo timalandira 1.25E.

Tiyenera kudziwa kuti Lantus sangathe kuchepetsedwa, chifukwa chake imafunikira kubayidwa ndi 1ED kapena 1,5ED, koma Levemir imatha kuchepetsedwa ndikuvulaza ndi mtengo wofunikira. M'masiku otsatirawa, muyenera kuwunika momwe shuga angakhalire kudya ndikuwonjezera kapena kuchepetsa kuchuluka kwake. Amasankhidwa moyenera komanso molondola ngati, mkati mwa sabata, shuga osala kudya saposa 0.6 mmol / l, ngati mtengo wake umakhala wokwera, ndiye yesani kuwonjezera kuchuluka kwa mankhwala ndi mayunitsi a 0.25 masiku atatu aliwonse.

Kugwiritsa ntchito mankhwala osokoneza bongo chifukwa cha matenda ashuga

Insulin yogwira ntchito mwachidule imatengedwa theka la ola musanadye. Zikayambitsidwa, wodwalayo ayenera kudya, apo ayi kuchuluka kwa shuga m'magazi kumatsika kwambiri, komwe kungayambitse kusazindikira. Wodwala aliyense amasankha nthawi yoyendetsera yochepa insulin palokha, kutengera nthawi yazakudya.

Chifukwa chakuti insulin yayifupi imakhala ndi chiwonetsero chakanthawi kochepa, ndikofunikira kuiyendetsa kuti izi zitheke zimagwirizana ndi kuchuluka kwa shuga wamagazi mukatha kudya. Ngati mahomoni atayambitsidwa mosakwanira, padzakhala kuchuluka kwa shuga m'magazi), ngati kwambiri - hypoglycemia (motero, kusowa). Zinthu zonsezi ndi zoopsa kwa wodwala.

Madokotala amapereka jakisoni wa insulin yochepa kwa odwala matenda ashuga omwe amawonjezera kwambiri shuga m'magawo atatha kudya. Kugwiritsa ntchito mitundu yamtunduwu kuyenera kukhala ndi udindo, chifukwa kukonzekera insulin kwakanthawi kumakhala kotalikira kuposa kuchuluka kwa shuga m'magazi. Izi zikutanthauza kuti patatha maola angapo mutatha kudya china ndikuchotsa mawonekedwe a hypoglycemia.

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.

Mwachangu insulin, mitundu yake ndi kufunika kwake pochiza matenda ashuga

Gwero lofunikira lamphamvu kwa anthu ndi chakudya chopatsa mphamvu, chomwe chimakhudzidwa ndimayendedwe ambiri m'maselo a thupi. Ngakhale zabwino zonse, zochulukirapo zimakhala ndi zovuta za metabolic zamitundu mitundu.

Zotsatira zake ndi kusintha kosasintha mu ziwalo zamkati ndi ntchito zomwe iwo amachita. Mkhalidwe wamoyo ukuipiraipira kwambiri, ndipo kukhazikitsidwa kwa zochitika za tsiku ndi tsiku kumakhala ntchito yosatheka. Mavuto omwewo amawonekera chifukwa chogwiritsa ntchito molakwika kapamba, m'malo ovuta.

Maselo a beta sangathe kutulutsa timadzi tambiri timagulu tambiri timene timayang'anira kuchuluka kwa shuga, poganizira miyambo yomwe imagwirizana ndi thupi. Akatswiri amatcha njirayi insulin.

Mankhwala omwe amapezeka ndi mtundu wina wa matenda a shuga omwe amadalira insulin, dokotala yemwe akupezekapo akhoza kukupatsani mankhwala a insulin omwe angokhala nthawi yayitali komanso mayankho a insulin, mayina ndi opanga omwe adzaperekedwe mu nkhaniyi.

Insulin ndi yomwe imapangitsa kuchepetsa shuga m'magazi.

Nthawi yomweyo, nthawi yonse yotsala (zakudya zakunja), thupi limasunthira lokha kuzunzidwa kofunikira. Mu shuga, munthu payekha amakakamizidwa kuti azisungabe izi pogwiritsa ntchito mankhwala.

Ndikofunikira. Mlingo woyenera wa mitundu yosiyanasiyana ya insulini amasankhidwa malinga ndi lingaliro la adokotala potengera momwe wodwalayo alili, mbiri ya matendawa, mayeso a labotale, ndi moyo wawo.

Kugwira kwathunthu kwa kapamba mwa munthu wathanzi kumalola thupi kuyendetsa kagayidwe kazakudya nthawi yokhazikika masana. Komanso kuthana ndi katundu wamafuta mukamadya kapena njira zopatsirana ndi zotupa m'matenda.

Chifukwa chake, kuti tisungitse shuga m'magazi, timadzi timene timakhala ndi katundu wofanana, koma kuthamanga kwina, timafunikira. Tsoka ilo, pakadali pano, sayansi sinapeze yankho lavutoli, koma chithandizo chovuta ndi mitundu iwiri ya mankhwala monga insulin yayitali komanso yayifupi yakhala chipulumutso kwa odwala matenda ashuga.

Tebulo 1. Mndandanda wa mitundu yosiyanasiyana ya insulin:

Kuphatikiza pazomwe zili pamwambazi, palinso zinthu zina za insulin, ndiye kuti, kuyimitsidwa, komwe kumakhala ndi mahomoni onse awiri. Kumbali imodzi, izi zimachepetsa kwambiri kuchuluka kwa jakisoni wofunidwa ndi wodwala matenda ashuga, omwe ndi kuphatikiza kwakukulu. Komabe, pankhaniyi, ndikovuta kukhala ndi kagayidwe kazachilengedwe.

Mukamagwiritsa ntchito mankhwalawa, ndikofunikira kukhazikitsa chakudya chamagulu ochepa, masewera olimbitsa thupi, moyo wambiri. Ichi ndichifukwa chosatheka kusankha kuchuluka kwa mtundu wa insulin pakadali pano wofunikira.

Nthawi zambiri, timadzi tambiri timene timayambira kumbuyo timatchulidwanso kuti maziko. Kudya kwake kumapereka thupi kwa insulin kwa nthawi yayitali.

Amatuluka mu minofu ya pang'onopang'ono, pang'onopang'ono, mphamvu yogwira imakuthandizani kuti mukhale ndi shuga mkati mwazonse tsiku. Monga lamulo, zosaposa jakisoni katatu patsiku ndizokwanira izi.

Malinga ndi kutalika kwa nthawi, agawidwa m'mitundu itatu:

1. Kutalika kwapakati. Hormoni imayamba kugwira ntchito pambuyo pa 1.5 mawola ambiri atakhazikitsa mankhwala, motero, jekeseni pasadakhale. Poterepa, mphamvu ya thunthu limapezeka osakwana maola 3-12. Nthawi yochitidwa kuchokera kwa wogwiritsa ntchito sing'anga yayambira maola 8 mpaka 12, choncho, wodwala matenda ashuga ayenera kugwiritsa ntchito katatu katatu kwa maola 24.
2. Kuwonetsedwa nthawi yayitali. Kugwiritsa ntchito njira yamtunduwu kwakukhalitsa kwa ma horoni kungakupatseni chiyambi cha timadzi tambiri tomwe timatha kukhalabe ndi shuga tsiku lonse. Kutalika kwa kuchitapo kwake (maola 16-18) ndikokwanira pamene mankhwalawa amathandizira m'mimba popanda kanthu komanso madzulo asanagone.Mtengo wapamwamba kwambiri wa mankhwalawa ndi wa maola 16 mpaka 20 kuchokera nthawi yomwe umalowa m'thupi.
3. Wopatsa nthawi yayitali. Oyenera makamaka kwa okalamba ndi anthu olumala omwe amapatsidwa nthawi yayitali ya zinthu (maola 24 mpaka 36), ndipo, kutsika kwa kayendetsedwe ka kayendetsedwe kake (1 p. Mu maola 24). Kuchitikaku kumayambira maola a 6-8, ndi chiwonetsero chazinthu zambiri mkati mwa maola 16 mpaka 20 mutalowa mu minofu ya adipose.

Chithandizo cha insulin chimaphatikizapo kutsata zachilengedwe zobisika za mahomoni pogwiritsa ntchito mankhwala. Tsoka ilo, ndizosatheka kukwaniritsa zowonetsa bwino pogwiritsa ntchito mtundu umodzi wokha wamtundu wokhala ndi ma hormone. Ichi ndichifukwa chake ma insulin osakhalitsa sakhala ofunikira kwenikweni.

Dzinalo la mtundu uwu wa mahomoni limadzilankhulira lokha.

Mosiyana ndi mankhwala omwe akhala akugwira ntchito kwa nthawi yayitali, omwe amafupikitsidwa amapangidwa kuti abwezere kuthamanga kwa glucose m'thupi chifukwa cha zinthu monga:

• kudya
• kuchita masewera olimbitsa thupi mopitirira malire
• kukhalapo kwa njira zopatsirana ndi zotupa,
• kupsinjika kwakukulu ndi zinthu.

Kugwiritsa ntchito zakudya zamagulu mu chakudya kumawonjezera chidwi chawo m'magazi ngakhale akumamwa insulini yayikulu.

Pofika nthawi yayitali, mahomoni ochita zinthu mwachangu amagawidwa m'magulu awiri:

1. Mwachidule. Kukonzekera kwanthaŵi yochepa ya insulin pambuyo pa makonzedwe kumayamba kugwira ntchito pasanathe mphindi 30-60. Kukhala ndi chiwopsezo chokwera kwambiri, nsonga ya kukhathamira kopambana imakwaniritsidwa patatha maola 2-4 mutatha kumwa. Malinga ndi kuyerekezera kwapakati, zotsatira za mankhwalawa sizimatha maola opitilira 6.
2. Ultrashort insulin. Analogue yosinthidwa iyi ya mahomoni amunthu ndiwosiyana ndi ena chifukwa amatha kuchita zinthu mwachangu kuposa insulin. Patha mphindi 10-15 pambuyo pa jekeseni, chinthu chogwira ntchito chimayamba kugwira ntchito yake pakhungu ndipo izi zimachitika patadutsa mawola atatu mutabadwa. Zotsatira zimatha kwa maola 3-5. Kuthamanga komwe njira yothetsera mankhwala a ultrashort imalumikizidwira m'thupi, kumakulolani kuti mumwe musanadye kapena mutangomaliza kumene.

Ndikofunikira. Kukhazikika kwa zochita za wodwala matenda ashuga kuyenera kuyenderana ndi nthawi ya chimbudzi cha chakudya ndi mayamwidwe a chakudya kuchokera pamenepo. Nthawi ya kukhazikitsidwa kwa mankhwalawa, poganizira mtundu wa insulin ndi katundu wa thupi ndi chakudya chamagulu, muyenera kuvomerezana.

Kusankhidwa kwa hormone yoyenera kugwiritsidwa ntchito kumangokhala payekha, monga momwe zimakhalira pa mayeso a labotale, kuchuluka kwa matenda a munthu wodwala matenda ashuga, mbiri yathunthu, moyo wawo. Chosafunikira kwenikweni ndi mtengo wa mankhwalawo, chifukwa cha momwe amagwiritsidwira ntchito. Monga lamulo, iwo umachulukana mosiyanasiyana molingana ndi zovuta za kupanga kwa mankhwala, dziko lopangira, kulongedza.

Kuchita insulin nthawi yayitali: imalembedwa liti ndipo imagwiritsidwa ntchito bwanji

Palibe machiritso athunthu padziko lapansi omwe ali ndi matenda ashuga. Koma kugwiritsa ntchito mankhwala kwa nthawi yayitali kumatha kuchepetsa kuchuluka kwa jakisoni ofunikira ndikuthandizira kwambiri moyo.

Kodi tanthauzo la insulin yayitali mthupi la munthu ndi chiyani? Mankhwala apakati komanso a nthawi yayitali amathandizidwa ndi odwala matenda ashuga kawiri pa tsiku (m'mawa ndi madzulo) ndipo ndizofunikira. Kuchita bwino kwa insulin yayitali kumachitika pambuyo pa maola 8-10, koma kuchepa kwa shuga kumadziwika pambuyo pa maola 3-4.

Momwe mungasankhire mlingo wa insulin yokwanira kwa munthu: mavitamini ang'onoang'ono (osapitirira 10) amagwira ntchito kwa maola pafupifupi 12, kuchuluka kwakukulu kwa mankhwalawa - mpaka tsiku. Ngati insulin yowonjezereka imafotokozedwa mu Mlingo wopitilira mayunitsi 0,6 pa 1 makilogalamu, ndiye kuti jakisoniyo imachitika m'magawo angapo m'malo osiyanasiyana (phewa, ntchafu, m'mimba).

Mfundo Zogwiritsa Ntchito Insulin Yifupi

Pali malamulo ena ogwiritsira ntchito insulin yochepa kwambiri (kapena yofulumira). Izi ndi izi:

• kudya kwamafuta kuyenera kuchitika chakudya chachikulu chisanachitike.
• Insulin ingagwire bwino ntchito mukamamwa pakamwa,
• kupatula kutulutsa kwa jekeseni malo ake asanayambike, chifukwa izi zimatha kuyambitsa kuchuluka kwa mahomoni,
• kuchuluka kwa mapiritsi a insulin kwa wodwala aliyense amawerengedwa payekhapayekha malinga ndi kuchuluka kwa 8-24 kwa akulu ndi mpaka 8 kwa ana patsiku.

Mlingo wa mahomoni pawokha ndiosavuta kuwerengetsa. Kuti muchite izi, muyenera kudziwa kuchuluka kwa glucose omwe amawonjezera pa nthawi yanjala, komanso kuchuluka kwa mikate yomwe ingapezeke mu chakudya chomwe muyenera kudya. Mwachitsanzo, ngati wodwala ali ndi glucose wa 11.4 mmol / L wokhala ndi m'mimba yopanda kanthu, ayenera kutenga magawo awiri a insulin kuti abwezeretse shuga ku nthawi yayitali, komanso magawo ena owonjezera pokonza shuga kuchokera ku chakudya.

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.

Zomwe zimachitika posankha insulin. Mankhwala otchuka kwambiri

Kuchokera pazomwe zili mu gawo lapitalo la nkhaniyi, zikuwonekeratu kuti insulin yochepa ndiyani, koma osati nthawi yokhayo ndi kuthamanga kwake ndikofunikira. Mankhwala onse ali ndi mawonekedwe awo, analogue ya human pancreatic hormone sichili choncho.

Mndandanda wazinthu zamankhwala omwe muyenera kulabadira:

• gwero la chiphaso
• digiri ya kuyeretsa
• kusamalira
• pH ya mankhwalawa
• wopanga ndi kusakaniza katundu.

Chifukwa chake, mwachitsanzo, analogue ya komwe nyama zimapangidwa ndikuchiritsa kapamba wa nkhumba ndikuyeretsa. Mankhwala opangidwa ndi theka, nyama zomwezi zimatengedwa ngati maziko ndipo pogwiritsa ntchito njira ya kusintha kwa enzymatic, insulin imapezeka pafupi ndi zachilengedwe. Tekinoloje izi nthawi zambiri zimagwiritsidwa ntchito ngati timadzi tambiri.

Kupanga mainjiniya kwapangitsa kuti zibwererenso maselo enieni a insulin yaumunthu omwe amapangidwa kuchokera ku Escherichia coli ndi kusintha kwasinthidwe. Ma mahormoni a Ultrashort nthawi zambiri amatchedwa okonzekera chibadwa cha insulin.

Zovuta kwambiri kupanga zothetsera zimayeretsedwa kwambiri (chopanga-mono). Zopanda zodetsa zambiri, ndizochulukirapo ndipo zimachepetsa zolakwika pakugwiritsa ntchito. Chiwopsezo cha mawonekedwe awomwe amagwiritsidwa ntchito pogwiritsa ntchito analogue ya hormone imachepetsedwa.

Kukonzekera kwa njira zosiyanasiyana zopangira, mitengo yowonekera, mafakitale, mitundu, ikhoza kuyimiridwa ndi kutsata kosiyanasiyana. Chifukwa chake, gawo lomwelo la insulin ingagwiritsidwe ntchito syringe.

Kugwiritsa ntchito mankhwala osokoneza bongo acidity ndikofunikira, izi zimapewe zomverera zosasangalatsa pamalo opangira jekeseni. Komabe, mtengo wa ndalama zotere umakhala wokwera kwambiri kuposa acidic.

Popeza kunja, sayansi ili patsogolo kwambiri pa sayansi yam'nyumba, ndizovomerezeka kuti makhwala ochokera kumayiko otukuka ndiwabwino komanso othandiza. Katundu wofunikira kuchokera kwa opanga odziwika ndiwotsika mtengo kwambiri.

Ndikofunikira.Chofunika kwambiri pakulimbitsa mankhwala a insulin si dziko lomwe limapangidwira, momwe mankhwalawo amagwiritsidwira ntchito ndi kugwiritsidwa ntchito kwawo pogwiritsa ntchito mahomoni atali ndi aafupi.

Mitundu ya Insulin Yafupifupi

M'masitolo ogulitsa mankhwala, mutha kugula ma insulin apafupi. Awa ndi Humulin, Actrapid, Insuman Rapid, Homor ndi mankhwala omwe atchulidwa pamwambapa. Onsewa ali ndi mawonekedwe awo omwe ayenera kulingaliridwa posankha mankhwala. Chifukwa cha kukonzekera kwa nkhumba, nthawi zambiri kumayambitsa mavuto chifukwa chokana izi.

Pofuna kuchepetsa zovuta, ndikofunikira kukhazikitsa mlingo woyenera wa mankhwalawa, musaphonye nthawi yoyendetsera, sankhani malo atsopano a jakisoni ndikusunga mahomoni enieniwo molondola.

Kodi chimapereka chithandizo chotere ndi chiani?

Insulin yomwe imatenga nthawi yayitali imafunikira kuti glucose isinthe. Katswiri wokhazikika, pamaziko a kudziletsa kwa wodwalayo, ndi omwe angadziwe ngati wodwalayo amafunikira majakisoni akukonzekera pang'ono asanadye nawo komanso nthawi yayitali komanso yayitali.

Ndikofunikira. Insulin yomwe imatenga nthawi yayitali ndichosinthira kwathunthu kwa masamba oyambira omwe amaperekedwa ndi kapamba. Imachepetsa kufa kwa maselo a beta.

Momwe mungayendetsere insulin yayifupi ngati shuga ndi yokwera

Pali zifukwa zosiyanasiyana zowonjezera kuchuluka kwa shuga m'magazi. Mulimonsemo, ngati wodwala wodwala matenda a shuga achulukitsa 10mmol / l, insulin yochepa ndiyofunikira. Ndiwosavuta kuwerengera kuchuluka kwa mankhwalawa pamlingo wa shuga pafupifupi 10 mmol / L; 1 unit imayendetsedwa, pazigawo za 11 mmol / L - 2, etc.

Koma kusankha mwachangu ndi kugwiritsa ntchito mahomoni mosasamala sikofunika. Ndikofunikira kumvetsetsa chifukwa chake shuga m'magazi adakwera, kenako mankhwalawa amayenera kuperekedwa pang'onopang'ono komanso muyezo womwewo. Kupanda kutero, ngati ilipo yambiri m'magazi, imachepetsa kwambiri kuchuluka kwa shuga, kenako imadzukanso kwambiri. Kudumpha kotereku sikungathandize.

Kuchuluka kwa mayunitsi omwe angalowe nawo ndi 7, ngakhale mulingo wa glucose uli pamwamba 16 mmol / L. Pambuyo maola anayi, kusanthula kumabwerezedwanso ndipo, ngati kuli kofunikira, mahomoni ena otsalawo amawathandizanso. Pakalibe chithandizo chochiritsa (ngati kwa nthawi yayitali, ngakhale mutayamwa mankhwalawa, zizindikiro za shuga zidakalipo), muyenera kupita kuchipatala, komwe akamakawunika matupi a ketone. Mukhozanso kuwunikira mosamala pogwiritsa ntchito mizera yoyesera Uriket ndi Uriglyuk.

Insulin yochepa komanso acetone mu mkodzo

Ngati thupi lilandira mafuta ochulukirapo, amayenera kulipeza kuchokera ku mafuta. Pakusintha kwazinthu ziwirizi, acetone imapangidwa, yomwe imapezeka mkodzo. Zilibe kanthu kuti ndi gawo liti la mafuta omwe amawonekera m'magazi. Nthawi zambiri amatsitsidwa.

Mlandu womwe acetone wapezeka mkodzo ndikuwukweza shuga, magazi amayamba chifukwa cha kusowa kwa insulin. Amathandizidwanso pamlingo wa 20% ya tsiku lililonse la mtundu waifupi wa mahomoni. Patatha maola atatu, kuwunikiranso kumachitika mobwerezabwereza, ndipo ngati chilichonse chikadalipo, chitaninso izi.

Monga mukudziwa, ma acetone amakhudza molekyu mamolekyulu a timadzi timeneti. Amawawononga ndikuletsa kuti asagwire ntchito. Ndipo ngati shuga agwera panthawi ya jakisoni suwonera, amaperekedwa mpaka zizindikirazo zimasintha. Ndikofunikanso kudikirira mpaka acetone ichoke m'thupi. Koma nthawi yomweyo amapitiliza kuwunika momwe shuga amawonekera kuti ndi abwinobwino.

Momwe mungawerengere kuchuluka kwake pakuchita masewera olimbitsa thupi

Kuchita masewera olimbitsa thupi kumawonjezera kuchuluka kwa shuga m'magazi. Minofu imafunikira mphamvu yochulukirapo, motero chiwindi chimatulutsa mamolekyulu am'magazi ndikuwabweza m'magazi. Chifukwa chake, ngati kusanthula kukuwonetsa kukhalapo kwa shuga pakuwonjezeredwa kwa 16 mmol / l ndi pamwamba, katundu aliyense ndi woletsedwa mpaka chizindikirocho chibwezeretsedwe. Pambuyo pokhapokha mutatha kuchita zinazake.

Ngati kuchuluka kwa shuga ndi kochepera 10 mmol / L, kuchita masewera olimbitsa thupi kungathandizenso kuchepetsa kuchuluka kwake.Apa mukuyeneranso kuyang'anira kuti musapange hypoglycemia. Ngati zolimbitsa thupi ndizochepa, simungathe kusintha mlingo. Kuti muchite izi, ndikokwanira kumangitsa thupi ndi mafuta ochulukirapo mphindi 30 zilizonse.

Pankhani yochita masewera olimbitsa thupi kwa nthawi yayitali, mulingo wa mahomoni umachepetsedwa ndi 10-50% malinga ndi nthawi yochita zolimbitsa thupi komanso kuopsa kwa katundu. Nthawi zina amasinthanso kuchuluka kwa insulin yayitali.

Mankhwala Otchuka a insulin

Gulu lachiwiri la mahomoni omwe amaperekedwa kwa odwala matenda ashuga ndi ambiri omwe amakhala ndi insulini. Kuyambitsa kwawo ndikofunikira kwambiri. Kupatula apo, thupi mwachilengedwe limazindikira kuti mankhwalawa, omwe ali ofanana ndi zochitika zachilengedwe. Mahomoni m'thupi lathanzi samapangidwa nthawi yomweyo - mulingo wake m'magazi umasungidwa pamlingo woyenera. Kuchita insulin kwa nthawi yayitali kumakuthandizani kuti muwonjezere mwayi wolowa m'malo mwa mankhwalawa. Anthu odwala matenda ashuga amatchulanso cholinga "mawu oyang'anira maziko."

Usiku ndi m'mawa machitidwe

Anthu omwe amawapeza ndi pafupifupi m'mawa amakhala ndi shuga. Izi zikutanthauza kuti usiku thupi limasowa insulin yayitali. Koma asanakakamize kuti asungidwe mahomoni owonjezera, dokotala amayenera kufufuza kuti adye liti munthu womaliza kudya. Ngati chakudya chikuchitika maola asanu kapena ochepera asanagone, ndiye kuti kugwiritsa ntchito mankhwala osokoneza bongo kwa nthawi yayitali sikungathandize kukhazikitsa shuga.

Yofotokozedwa bwino ndi akatswiri komanso chodabwitsa cha "m'bandakucha." Atatsala pang'ono kudzuka, chiwindi chimatulutsa mahomoni mofulumira, zomwe zimayambitsa hyperglycemia. Ndipo ngakhale mutasintha mlingo, izi zimathandizanso.

Zokhudza thupi la izi zimatsimikizira njira ya jakisoni: jakisoni amapangidwa maola asanu ndi atatu kapena ochepera nthawi yofananira yodzuka. Pambuyo maola 9-10, insulin yotalikilapo imakhala yofooka.

Mankhwala omwe akhala akuchita kwa nthawi yayitali sangakhale ndi shuga m'mawa. Izi zikachitika, ndiye kuti adokotala adalemba kuchuluka kwa mahomoni. Kuchuluka kwa mankhwalawa kumakhala ndi hypoglycemia. M'maloto, panjira, imadziwonetsa yokha mwa nkhawa komanso zoopsa usiku.

Kuti mupewe izi, mutha kuchita cheke ichi: maola anayi mutatha jakisoni, muyenera kudzuka ndikuyeza mulingo wama gluu. Ngati chizindikirocho chili chochepera 3.5 mmol / L, ndiye ndikofunika kuti mupeze insulini yowonjezera m'magawo awiri - nthawi yomweyo musanayambe kugona ndipo mutatha maola 4 ena.

Kugwiritsa ntchito regimen iyi kumakupatsani mwayi wochepetsera mlingo mpaka 10-15%, kuwongolera zochitika za "m'mawa kutacha" ndikudzuka ndi shuga wamagazi oyenera.

Mankhwala omwe akhala akuchita kwa nthawi yayitali

Mwa mahomoni omwe atenga nthawi yayitali, mayina otsatirawa nthawi zambiri amapezeka (malinga ndi radar):

Zitsanzo ziwiri zomaliza zimadziwika kuti zimakhudza kwambiri shuga. Insulin yotalika chotere imalowetsedwa kamodzi patsiku ndipo siziwonjezera kukula kwa hypoglycemia usiku. Imawerengedwa kuti ikulonjeza pa gawo la mankhwala a insulin.

Zotsatira zazitali za Lantus insulin (mawonekedwe a glargine) zimatha kufotokozedwa pang'onopang'ono ndi mayendedwe ochepetsa. Zowona, kuti musunge izi, nthawi iliyonse muyenera kusankha tsamba latsopano.

Mlingo wa Lantus insulin ndi mankhwala okhazikika a shuga m'thupi (mpaka tsiku). Chogulitsacho chimapezeka m'mak cartridge ndi syringe pens yokhala ndi 3 ml ndi mabotolo okhala ndi 10 ml ya mankhwalawa. Kutalika kwa kuchitapo kanthu kuchokera pa maola 24 mpaka 29. Zowona, chisonkhezero tsiku lonse zimadalira thupi.

Mtundu woyamba wa matenda ashuga, Lantus-insulin yomwe imakhala yayitali amalembedwa kuti ndiye wamkulu; ndipo yachiwiri, imatha kuphatikizidwa ndi mitundu ingapo ya mankhwala ochepetsa shuga.

Mukasintha kuchokera kwa zitsanzo zazifupi ndi zapakatikati kukhala ndi insulin yayitali m'masiku oyamba, mlingo ndi ndandanda ya jakisoni imasinthidwa.Mwa njira, m'zaka zaposachedwa, pakhala pali chizolowezi china chomwe odwala akuyesera kuti asamutse mankhwala opitilira muyeso kuti achepetse jakisoni ndikuti akhale ndi moyo wabwino.

Ultra kutalika kwenikweni

Ma insulini omwe akhala akuchita kwa nthawi yayitali omwe atchulidwa pamwambapa ndi othandiza kwambiri. Kuwonekera kwathunthu kumawasiyanitsa: safunikira kugwedezeka, kulungidwa m'manja kuti atsimikizire kuti magawidwe ofanana amatayidwa. Pamodzi ndi Lantus, Levemir ndi mankhwala okhazikika kwambiri, mawonekedwe ake ndi ofanana kwa odwala matenda ashuga omwe ali ndi mitundu yonse iwiri yamatenda.

Ndikofunika kudziwa kuti mitundu yayitali ikadalipo pang'ono pantchito yawo. Nawonso, mankhwalawa alibe. Ndipo chododometsa chiyenera kukumbukiridwanso pakukonzanso kwa mlingo.

Mankhwala oyambira amawerengeredwa potengera momwe angakhalire shuga wosakhazikika, wamagazi. Kusintha kwovomerezeka sikoposa 1.5 mmol / l. Komabe, izi siziyenera kuchitika patangotha ​​tsiku limodzi jekeseni. Monga lamulo, mankhwala owonjezereka amakankhidwa m'tchafu kapena matako. Apa, mafutawo amachepetsa kuyamwa kwa timadzi m'magazi.

Nthawi zambiri, odwala matenda ashuga osadziwa amayesa kuloweza lalifupi ndi insulin yayitali, yomwe singachitike. Kupatula apo, mitundu iliyonse ya mahomoni ndiyofunikira kuchita ntchito yofotokozedwa mosamalitsa. Chifukwa chake, ntchito ya wodwalayo ndikuonetsetsa mosamalitsa chithandizo chamankhwala cha insulin.

Pokhapokha ngati agwiritsidwa ntchito moyenera, amakhala ndi insulin nthawi yayitali.

Wokhala insulin yayitali komanso dzina lake

Matenda a shuga amadziwika ndi kulephera kwa thupi kugwetsa glucose, chifukwa chomwe chimakhazikika m'magazi, zimayambitsa kusokonezeka kwakukulu pakugwira ntchito kwa minofu ndi ziwalo zamkati. Izi zikachitika chifukwa chosakwanira kupanga insulin ndi kapamba.

Ndipo kuti apange mahomoni awa m'thupi, madokotala amapereka insulin yayitali kwa odwala awo. Kodi ndi chiyani ndipo mankhwalawa amagwira ntchito bwanji? Izi ndi zina zambiri tidzazikambirana tsopano.

Chifukwa chiyani ma jakisoni a insulin amafunikira?

Insulin yolimbitsidwa imapereka kusala kudya kwa glucose mwachangu. Mankhwalawa amatchulidwa ndi dokotala pokhapokha ngati wodwala ayesa kuyeza magazi ake mkati mwa sabata amawona kuphwanya kwakukulu kwa chizindikiro ichi m'mawa.

Potere, ma insulin afupiafupi, apakati kapena ataliatali amatha kukhazikitsidwa. Zothandiza kwambiri pamenepa, mwachidziwikire, ndimankhwala ogwirira ntchito kwa nthawi yayitali. Mankhwalawa amagwiritsidwa ntchito pochiza matenda amtundu wa 2. Amaperekedwa ndi mtsempha wa magazi kawiri pa 1-2 patsiku.

Dziwani kuti insulin yotalikirapo imatha kutumizidwa ngakhale odwala matenda ashuga omwe adadzipatsa kale majekeseni osakhalitsa. Chithandizo choterechi chimakupatsani mwayi othandizira komanso kupewa mavuto ambiri.

Zofunika! Kukhazikitsidwa kwa insulin yochita ntchito kwa nthawi yayitali kumachitika pakakhala kukanika kokwanira (imaleka kutulutsa timadzi tating'onoting'ono) ndipo kufa mwachangu kwa maselo a beta kumawonedwa.

Insulin yayitali imayamba kugwira ntchito pambuyo pa maola 3-4 Pankhaniyi, pali kuchepa kwa shuga m'magazi ndikusintha kwakukulu pamachitidwe a wodwala. Kuchuluka kwa kugwiritsidwa ntchito kwake kumawonedwa pambuyo pa maola 8-10. Zotsatira zake zimatha kukhala maola 12 mpaka 24 ndipo zimatengera mlingo wa insulin.

Zocheperako zimakupatsani mwayi kuti mupeze insulini mu kuchuluka kwa magawo 8010. Amachitapo kanthu kwa maola 14-16. Insulin m'magawo 20. ndi kuthekera kosunga shuga m'magazi pafupifupi tsiku limodzi. Dziwani kuti ngati mankhwalawa ndi mankhwala ochepetsa mayunitsi oposa 0.6. pa kilogalamu imodzi ya kulemera, ndiye kuti jakisoni 2-3 amaikidwa nthawi yomweyo m'malo osiyanasiyana a thupi - ntchafu, mkono, m'mimba, ndi zina zambiri.

Ndikofunikira kugwiritsa ntchito insulin yowonjezera molondola. Siligwiritsidwa ntchito kukhazikitsa glucose wamagazi mukatha kudya, chifukwa sichichita mwachangu, mwachitsanzo, insulin. Komanso, jakisoni wa insulin ayenera kukonzekera.

Ngati mungadumphe nthawi ya jakisoni kapena kukulitsa / kufupikitsa kusiyana pamaso pawo, izi zitha kubweretsa kuwonongeka muzochitika za wodwalayo, popeza kuchuluka kwa glucose "kumadumpha" nthawi zonse, zomwe zimapangitsa kuti pakhale zovuta.

Kuchita insulini kwa nthawi yayitali

Jekeseni wothandizirana kwa nthawi yayitali amalola odwala matenda ashuga kuti athetse kufunika kwa kumwa mankhwalawa kangapo patsiku, chifukwa amalamulira shuga m'magazi tsiku lonse. Kuchita izi kumachitika chifukwa chakuti mitundu yonse ya insulini yokhala nthawi yayitali imakhala ndi mankhwala othandizira kuti akhale ogwira ntchito.

Kuphatikiza apo, mankhwalawa ali ndi ntchito inanso - amachepetsa njira yolembera shuga m'thupi, potero amapereka kusintha kwa zomwe wodwalayo ali nazo. Zotsatira zoyambirira pambuyo pa jekeseni zimawonedwa kale pambuyo pa maola 4-6, pomwe zimatha kupitiliza kwa maola 24-36, malingana ndi kuopsa kwa njira ya matenda ashuga.

Mayina a mankhwala omwe amakhala ndi insulin nthawi yayitali:

Mankhwalawa ayenera kuyikidwa ndi adokotala okha, chifukwa ndi ofunikira kwambiri, omwe angapewe kuwonongeka pambuyo pobayira. Mankhwalawa amaperekedwa mosavuta m'matako, matako ndi mikono yakutsogolo.

Ndikofunika kusunga mankhwalawa pamtunda wa minus 2 degree (ndikotheka mufiriji). Izi zimapangitsa kuti makutidwe ndi okosijeni a mankhwalawo komanso mawonekedwe a granular osakaniza. Musanagwiritse ntchito, botolo liyenera kugwedezeka kuti zomwe zili mkati mwake zithe.

Watsopano omwe akhala akuchita insulin amasiyanitsidwa ndi kutalika kwa zotsatira ndi kapangidwe kake. Agawidwa m'magulu awiri:

• zofanana ndi mahomoni amunthu,
• zoyambira nyama.

Zoyambazo zimachotsedwa m'matumbo a ng'ombe ndipo zimalekeredwa ndi 90% ya odwala matenda ashuga. Ndipo zimasiyana ndi insulin ya chilengedwe chanyama pokhapokha mwa ma amino acid. Mankhwalawa ndi okwera mtengo kwambiri, koma kukhala ndi zabwino zambiri :

• kuti mupeze kuchuluka kwa achire kwambiri, kukhazikitsa milingo yaying'ono ndikofunikira,
• lipodystrophy pambuyo makonzedwe awo amawonedwa pafupipafupi,
• Mankhwalawa samayambitsa zotsatira zoyipa ndipo angagwiritsidwe ntchito mosavuta kuwongolera shuga m'magazi a omwe ali ndi matendawa.

Nthawi zambiri, anthu osazindikira odwala matenda ashuga osagwiritsa ntchito mankhwala okhawo omwe amakhala ndi nthawi yayitali amatha kugwiritsa ntchito mankhwala osakhalitsa. Koma ndizosatheka kuchita izi. Kupatula apo, iliyonse mwa mankhwalawa imagwira ntchito yake. Chifukwa chake, kuti muthe kusintha shuga m'magazi ndikuyenda bwino, palibe chifukwa chomwe mungasinthire mosamalitsa chithandizo. Dokotala yekha ndiye ayenera kuchita izi.

Kubwereza mwachidule

Mankhwala osokoneza bongo, omwe mayina awo adzafotokozeredwe pansipa, sayenera kugwiritsidwa ntchito popanda kulandira dokotala! Kugwiritsa ntchito molakwika kumabweretsa zotsatirapo zoyipa kwambiri.

Mankhwala chikuyendetsedwera, osapitirira 1 nthawi patsiku. Ndikulimbikitsidwa kupereka jakisoni pogona nthawi yomweyo. Kugwiritsa ntchito Basaglar nthawi zambiri kumakhala limodzi ndi mawonekedwe a mavuto mwa zomwe ambiri ndi:

• chifuwa
• kutupa kwa m'munsi m'munsi ndi kumaso.

Ichi ndi chimodzi mwa mankhwala abwino kwambiri, omwe ndi analogue a insulin ya anthu. 90% ya odwala amaloledwa bwino. Mwa odwala matenda ashuga okha, kugwiritsidwa ntchito kwake kumatsutsa zomwe zimapangitsa kuti asayanjane ndi lipodystrophy (ndikugwiritsa ntchito nthawi yayitali).

Tresiba ndi insulin yokhala ndi nthawi yayitali yomwe imatha kuyendetsa shuga m'magazi mpaka maola 42. Mankhwalawa amaperekedwa kamodzi pa tsiku nthawi imodzi. Mlingo wake umawerengedwa aliyense payekha.

Kutalika kwa mankhwalawa kwa mankhwalawa kumachitika chifukwa chakuti omwe amapanga amathandizira pakuwonjezera insulin ndi maselo amthupi komanso kuchepa kwa chiwonetsero cha zinthuzi ndi chiwindi, zomwe zimapangitsa kutsika kwakukulu kwa shuga m'magazi.

Koma chida ichi chili ndi zovuta zake. Akuluakulu okha ndi omwe amatha kugwiritsa ntchito, ndiye kuti, imaphatikizidwa kwa ana. Kuphatikiza apo, kugwiritsidwa ntchito kwake ngati chithandizo cha matenda ashuga sikungatheke mwa azimayi pakubereka kwawo, chifukwa izi zimatha kusokoneza thanzi la mwana wosabadwa.

Ndi analogue of insulin ya anthu. Imayendetsedwa mosavuta, nthawi 1 patsiku nthawi yomweyo. Imayamba kugwira ntchito 1 ola limodzi pambuyo pa utsogoleri ndipo imagwira ntchito kwa maola 24. Ali ndi analogue - Glargin.

Chodabwitsa cha Lantus ndikuti chitha kugwiritsidwa ntchito pazaka zopitilira 6. Mwambiri, kulekerera bwino. Okha odwala matenda ashuga okha ndi omwe amapangitsa kuti thupi liziganiza, kutupira, komanso kufooka kwa milomo.

Pofuna kupewa kukula kwa lipodystrophy ndikugwiritsa ntchito mankhwalawa kwa nthawi yayitali, tikulimbikitsidwa kusintha tsamba la jekeseni. Mutha kuzichita m'mapewa, ntchafu, m'mimba, matako, ndi zina zambiri.

Ndi sungunuka basal analogue wa insulin yamunthu. Zovomerezeka kwa maola 24, zomwe zimachitika chifukwa cha kudziyimira pawokha kwa mamolekyulu a insulir m'deralo la jakisoni ndikumangidwa kwa mamolekyulu a mankhwala kuti a albumin ndi unyolo wamafuta acid.

Mankhwalawa amaperekedwa pang'onopang'ono katatu patsiku, kutengera zosowa za wodwala. Zitha kupangitsanso kupezeka kwa lipodystrophy, chifukwa chake malo a jekeseni amayenera kusinthidwa nthawi zonse, ngakhale jakisoni atayikidwa m'dera lomwelo.

Kumbukirani kuti ma insulin omwe akhala akuchita kwa nthawi yayitali ndi mankhwala amphamvu omwe muyenera kugwiritsa ntchito mosamalitsa malinga ndi dongosolo, osaphonya nthawi ya jakisoni. Kugwiritsa ntchito mankhwalawa kumapangidwira ndi dokotala, komanso mlingo wawo.

Tsiku labwino kwa onse! Monga ndidalemba kale m'nkhani yanga yaposachedwa "Helo insulin - choyambirira chokhudza mafuta a metabolism", insulin yaumunthu imapangidwa nthawi yonseyo. Kubisirana kwa insulin kumatha kugawidwa pansi ndikuyambitsa.

Mwa munthu yemwe ali ndi vuto la insulin lokwanira, cholinga cha mankhwalawa ndikuwonetsetsa kuti chinsinsi chizigwira bwino ntchito monga momwe mungathere, zonse zoyambira komanso zolimbikitsidwa. Munkhaniyi ndikukuwuzani kusankha momwe mungasankhire insulin yoyenera. Pakati pathu odwala matenda ashuga, mawu akuti "sungani maziko" amagwiritsidwa ntchito, ndipo chifukwa cha ichi payenera kukhala ndi mlingo wokwanira wa insulin.

Yaitali usiku usiku insulin

Ndikulimbikitsidwa kuti muyambe kusankha mtundu wa insulin yayitali usiku. Ngati simunachite izi, onani momwe glucose wamagazi amakhalira usiku. Tengani miyeso kuyamba maola atatu aliwonse - 21:00, 00:00, 03:00, 06:00. Ngati panthawi inayake mumakhala ndi kusinthasintha kwakukulu kwa zomwe zimapangitsa kuti magazi aziwoneka kuti akuchepa kapena, mosiyana, kukulira, ndiye kuti izi zikutanthauza kuti mlingo wa insulin sunasankhidwe bwino.

Pankhaniyi, muyenera kuwona gawo ili mwatsatanetsatane. Mwachitsanzo, mumapita usiku ndi shuga 6 mmol / L, nthawi ya 00:00 - 6.5 mmol / L, ndipo 3:00 imadzuka mwadzidzidzi kufika pa 8.5 mmol / L, ndipo m'mawa mumabwera ndi shuga wambiri. Zinthu zili motere kuti insulin ya usiku inali yosakwanira ndipo ikuyenera kuwonjezeka pang'onopang'ono. Koma pali mfundo imodzi. Ngati pali kuwonjezeka koteroko komanso kukwera kwambiri usiku, ndiye kuti sizitanthauza kusowa kwa insulin nthawi zonse.Nthawi zina, imatha kukhala hypoglycemia yotsika, yomwe idapereka koyamba - kuwonjezeka kwa shuga m'magazi.

Kuti mumvetsetse kuti chifukwa chiyani shuga amatuluka usiku, muyenera kuyang'ana nthawi imeneyi ola lililonse. Pazomwe tafotokozazi, muyenera kuyang'ana shuga nthawi ya 00:00, 01:00, 02:00 ndi 03:00 a.m. Ngati kuchepa kwa glucose pakadali pano, ndiye kuti mwina panali "kubisa" kobisika Ngati ndi choncho, ndiye kuti mlingo wa insulin yoyambira uyenera kuchepetsedwa.

Kuphatikiza apo, mudzavomera ndi ine kuti chakudya chomwe mumadya chimakhudza kuwunika kwa insulin yoyamba. Chifukwa chake, kuti tiwunikire moyenera ntchito ya basulin insulin, sipayenera kukhala insulin yocheperako komanso glucose yomwe imabwera ndi chakudya m'magazi. Chifukwa chake, musanayang'anize insulin yausiku, ndikofunikira kuti tidumphire chakudya chamadzulo kapena kudya chakudya chamadzulo m'mbuyomu kuti chakudyacho ndi insulin yochepa yopangidwira isafotokozere bwino.

Chifukwa chake, tikulimbikitsidwa kuti tidye chakudya chamadzulo chokhacho, kupatula mapuloteni ndi mafuta. Popeza zinthuzi zimaphatikizidwa pang'onopang'ono ndipo pamlingo wina wake zimatha kukulitsa shuga, zomwe zingathenso kusokoneza kuyesa koyenera kwa magwiridwe antchito a insulin usiku.

Yaitali tsiku ndi tsiku insulin mlingo

Momwe mungayang'anire "basal" masana? Ndiwosavuta. Ndikofunikira kupatula chakudya. Zoyenera, muyenera kukhala ndi njala masana ndikumwa shuga m'magazi ola lililonse. Izi zikuwonetsani komwe kuchuluka kuli ndi komwe kuchepa kuli. Koma nthawi zambiri izi sizingatheke, makamaka mwa ana aang'ono. Poterepa, onani momwe insulin yoyamba imagwirira ntchito nthawi. Mwachitsanzo, idumphani chakudya cham'mawa choyamba ndikuyesa ola lililonse kuyambira nthawi yomwe mwadzuka kapena jakisoni wa insulin ya tsiku ndi tsiku (ngati muli ndi imodzi), mpaka chakudya chamasana, mutatha kudya chakudya chamasana, kenako ndikudya chakudya chamadzulo.

Ndikufuna kunena kuti pafupifupi ma insulin onse owonjezera amayenera kubayidwa katatu patsiku, kupatula Lantus, yomwe imachitika kamodzi. Musaiwale kuti onse omwe ali pamwambapa, kupatula Lantus ndi Levemir, ali ndi chidziwitso chapadera kwambiri. Monga lamulo, nsonga imapezeka pa maola 6-8 a mankhwala ogwiritsidwa ntchito. Chifukwa chake, panthawi ngati izi, pakhoza kukhala kuchepa kwa glucose, womwe umayenera kuthandizidwa ndi XE yaying'ono.

Ndikufunanso kunena kuti mukasintha mlingo wa insal insulin, muyenera kubwereza izi zonse kangapo. Ndikuganiza kuti masiku atatu ndiokwanira kuti zitsimikizire kuti zotsatira zake zachitika mbali iliyonse. Ndipo kutengera zotsatira zake, chitani zotsatirazi.

Mukamayesa insulin ya tsiku ndi tsiku kuchokera ku chakudya cham'mbuyomu, pafupifupi maola 4 ayenera kudutsa, makamaka maola 5. Kwa iwo omwe amagwiritsa ntchito ma insulin afupiafupi (Actrapid, Humulin R, Gensulin R, etc.), osati ultrashort (Novorapid, Apidra, Humalog), nthawiyo iyenera kukhala yayitali - maola 6-8, chifukwa izi zimachitika chifukwa cha zovuta zina zomwe zikuchitika. za insulin izi, zomwe ndikambirana m'nkhani yotsatira.

Ndikukhulupirira kuti ndinafotokozera momveka bwino komanso mosavuta momwe mungapangire Mlingo wa insulin yayitali. Ngati muli ndi mafunso, omasuka kufunsa. Mukasankha bwino kuchuluka kwa insulin yomwe imatenga nthawi yayitali, mutha kusankha mtundu wa insulin yochepa. Ndipo kusangalala kumayambira, koma zambiri m'nkhani yotsatira. Pakadali pano - bye!

Ndi chisangalalo ndi chisamaliro, endocrinologist Dilara Lebedeva

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

Kusankha kwa Mlingo wa insulin usiku

Ngati akuwonetsedwa kugwiritsa ntchito insulin yayitali, muyenera kusankha kaye mankhwalawa usiku. Kuti muchite izi, ndikofunikira kudziwa momwe glucose m'magazi amakhalira nthawi ino. Njirayi ndiyosavuta, koma yopindulitsa, chifukwa maola atatu aliwonse, kuyambira 21:00, muyenera kudzuka ndikukhala ndi miyezo ya shuga mpaka 6 m'mawa.

Kwa nthawi yonseyi, kuchuluka kwa shuga m'magazi ndikukhazikitsa kwa mtundu wa mahomoni ambiri kuyenera kukhala komwe. Ngati kusinthasintha kulikonse kwawonedwa, ndikofunikira kusintha mlingo kuti uwonjezere kapena kuchepa.

Yang'anirani gawo lomwe nthawi yomwe kupatukirako kunachitika. Mwachitsanzo, wodwala akagona, shuga ake amakhala 6 mmol / L, pakati pausiku - 6.5 mmol / L, koma pofika 03:00 amadzuka kale mpaka 8.5 mmol / L. Izi zikutanthauza chinthu chimodzi chokha - chochepa kwambiri chomwe chidalowetsedwa usiku, ndipo wodwalayo adzuka kale ndi mitengo yambiri. Chifukwa chake, kumwa kwake kuyenera kusinthidwa chokwera. Koma pali zina.

Nthawi zina, kuchuluka kwa mafuta ochulukirapo mwina sikungawonetse kuchepa kwa mahomoni omwe amawongolera msinkhu wawo. Zimachitika kuti kudumpha kotereku kumalumikizidwa ndi hypoglycemia, kotero usiku thupi limayeserera kuti lithe kusintha zomwe zimachitika ndikuwonjezera kuchuluka kwa glucose kulipirira kuchepa kwake nthawi ina.

Pankhaniyi, maupangiri angapo amadzitsimikizira:

• Ngati mukukayikira zifukwa zowonjezera kuchuluka kwa shuga usiku, ndikofunikira kuti tionenso nthawi yayitali (munthawi yathu, 24: 00-3: 00), koma ndi kusanthula pafupipafupi kwa ola limodzi. Ngati munthawi imeneyi pamakhala nthawi zina pomwe kutsekemera kwa glucose kumatsika mulingo wokhazikika, ndizotheka kunena kuti thupi liyesanso kubwereranso. Ndiye kuchuluka kwa mahomoni kuyenera kuchepetsedwa.
• Ndikofunikira kuganizira chakudya chomwe chimadyedwa patsiku, chifukwa chimakhudzanso chithandizo cha mankhwalawa ndimitundu yayitali ya mahomoni.
• Kuti muwone bwino momwe magazi amapangira insulin usiku, kupezeka kwa insulin yotsalira ndi shuga wotsalira pazakudya sikumayikidwa mkatimo. Kuti izi zitheke, ndibwino kulumphira chakudya chamadzulo kapena kuwononga nthawi yayitali kuposa masiku onse.
• Ndikulimbikitsidwa kupanga mndandanda wazakudya zam'madzulo m'njira yoti zimangophatikizapo zinthu zokhala ndi zomanga thupi, popeza kupezeka kwa mafuta ndi mapuloteni ochulukirapo kungakhudze zotsatira za phunziroli. Monga mukudziwa, kagayidwe ka mafuta ndi mapuloteni ndizochedwa kuchepa kuposa chakudya, motero kupezeka kwawo m'magazi kumatha kuwonjezera kuchuluka kwa shuga ndikupanga kuwunika kwa mitundu yowonjezereka ya insulin yabodza.

Mankhwala otchuka kwambiri achidule achidule

Popeza kuti chamoyo chilichonse chimachita chilichonse payekha ndipo chitha kupezeka ndi mankhwala amtundu wina kapena wina akhoza kusiyanasiyana. Pogwiritsa ntchito regimen ya insulin, momwe mankhwalawa amathandizidwa katatu patsiku musanadye, odwala matenda ashuga nthawi zambiri amagwiritsa ntchito mayina amafupikidwe a insulin, omwe amaperekedwa pagome.

Tebulo No. 2. Mndandanda wa othandizira odwala matenda a shuga nthawi zambiri amauza akatswiri.

Kusankha tsiku lililonse insulin

Mlingo wa tsiku ndi tsiku wa basulin (wautali) wa insulin umatsimikiziridwa chimodzimodzi monga usiku. Chifukwa cha izi, amakhala ndi njala tsiku lonse ndipo amasanthula ola lililonse. Chifukwa cha njirayi, mutha kudziwa kuti nthawi yayitali bwanji pakukula kwa glucose, komwe - kutsika.

Koma pali odwala (mwachitsanzo, ana aang'ono) omwe sangatengedwe nawo kafukufuku wophunzitsika. Kenako samva njala, ndipo magazi amatengedwa kwa iwo pokhapokha. Mwachitsanzo, tsiku lina mutha kudumphira chakudya cham'mawa ndikumatenga miyezo yam'mawa, inayo - nkhomaliro, ndipo lachitatu - chakudya chamadzulo.

Ma insulin okhazikika nthawi zambiri amaperekedwa kawiri pa tsiku, ndipo mankhwala amakono a Lantus - kamodzi.

Monga tanena kale, ambiri mwa mankhwalawa ndi apamwamba. Izi zikutanthauza kuti pakatha maola 6-8 jekeseni m'magazi padzakhala kuchuluka kwa timadzi timene timakhala, kotero muyenera kudya kena kake mu gawo la chakudya kuti hypoglycemia isamere.

Tiyenera kukumbukira kuti, pazifukwa zina, kuchuluka kwa insulin ya insulin kuyenera kusinthidwa, maphunzirowo abwerezedwa kuti awonetsetse kuti kuwerengera konse kumachitika ndikuwonetsetsa kuti ndi mlingo womwe thupi limafunikira. Malingana ndi kuchuluka kwa mitundu yayitali ya mahomoni yomwe yasankhidwa, kuchuluka kwa mitundu yochepa kumatsimikiziridwa.

Chifukwa chake, mitundu iwiri ya insulin yapangidwa - yayitali komanso yochepa. Choyambirira chimafunikira kuti magazi azisungunuka nthawi zonse m'magazi. Lachiwiri ndi loti thupi lizitha kuthana ndi vuto la shuga pambuyo podya. M'njira zonsezi, ndikofunikira kusankha mlingo woyenera, pochita izi modziyesa. Izi ndizofunika kwambiri, chifukwa kusungabe kuchuluka kwa glucose panthawi yokhazikika ndiye chitsimikizo kuti matenda a shuga sangakule ndikukula.

Zowunikira mitundu yapamwamba kwambiri ya insulin yokhala ndi tebulo

Ma insulin omwe akhala akuchita kwakanthawi amatha kukhala ndi shuga m'magazi tsiku lonse lililonse odwala matenda ashuga. Pankhaniyi, kuchepa kwa kuchuluka kwa shuga mu plasma kumachitika chifukwa cha kuyamwa kwake ndi minofu ya thupi, makamaka chiwindi ndi minofu. Mawu akuti "yaitali" a insulin amawonetsa kuti kutalika kwa zotsatira za jakisoni wotere, poyerekeza ndi mitundu ina ya mankhwala ochepetsa shuga, ndi yayitali.

Insulin yochita ntchito kwa nthawi yayitali imamasulidwa mwanjira yothetsera kapena kuyimitsidwa kwamkati ndi mtsempha wamitsempha. Mwa munthu wathanzi, timadzi timeneti timapangidwa mosalekeza ndi kapamba. Kutalika kwa mahomoni kunapangidwa kuti kuyerekezera zomwezo mwa anthu omwe ali ndi matenda ashuga. Koma jakisoni wowonjezera amakhala woponderezedwa mwa odwala omwe ali ndi matenda ashuga kapena oyipa.

Pakalipano, zinthu zazitali komanso zazitali ndizofunikira:

Amayendetsedwa pambuyo pa mphindi 60, mphamvu kwambiri imatheka pambuyo pa maola 2-8. Amalamulira kuchuluka kwa glucose m'magazi 18-20 maola.

Kuyimitsidwa kwawonjezera mtundu wa sc. Amagulitsidwa m'mabotolo a 4-10 ml kapena makatiriji a 1.5-3.0 ml kwa ma cholembera a syringe.

Imayamba kugwira ntchito mkati mwa maola 1-1.5. Kuchita bwino kwambiri kumawonetsedwa pambuyo maola 4-12 ndipo kumatha maola 24.

Kuyimitsidwa kwa kukhazikitsidwa kwa s / c. Mmatumba atatu a 3 ml cartridge, ma 5 ma PC mu paketi.

Imayendetsedwa pakatha maola 1-1.5.igwira maola 11 mpaka 24, mphamvu kwambiri imapezeka munthawi ya maola 4-12.

Insulin yowonjezera kuti ikwaniritse sc. Wopezeka m'mabotolo atatu a 3 ml, m'mabotolo 5 ml ndi makilogalamu 3 ml a ma syringe pensulo.

Insulin yayitali imayambitsidwa mkati mwa maola 1.5. Kuchuluka kwa zochitika kumachitika pakati pa maola 3-10. Nthawi yayitali yochita ndi tsiku.

Njira / ntchito. Amazindikira m'mathumba ogwiritsira ntchito ma syringe a 3 ml, m'mabotolo a 10 ml.

Amayamba kuchita mphindi 60 pambuyo pa jekeseni, amawongolera kuchuluka kwa shuga m'magazi osachepera tsiku.

Ma cartridges ndiofala komanso kwa 3 ml syringe zolembera, mu 10 ml mbale za sc management.

Chiwopsezo cha ntchito chimachitika pambuyo pa maola 3-4. Kutalika kwa mphamvu ya wothandizira nthawi yayitali ndi maola 24.

Insulin yotalikilapo imadziwika m'mapensulo a 3 ml.

Dzina la hypoglycemic mankhwala ndi momwe mungagwiritsire ntchito insulin yowonjezereka ikhoza kuvomerezedwa ndi adokotala.

Kuphatikiza apo, anthu omwe akudwala matenda ashuga sayenera kulowetsa m'malo mwake ndi analogue yomwe idatenga nthawi yayitali. Thupi lokhala ndi mahomoni ena liyenera kufotokozedwa moyenera monga lingaliro lazachipatala, ndipo chithandizo chamankhwala chiyenera kuchitidwa kokha moyang'aniridwa ndi dokotala.

Insulin yokhala ndi nthawi yayitali, kutengera mtundu wa shuga, imatha kuphatikizidwa ndi wothandizira, yemwe amachitika kuti akwaniritse ntchito yake yoyambira, kapena angagwiritsidwe ntchito ngati mankhwala amodzi. Mwachitsanzo, mu mtundu woyamba wa matenda ashuga, insulin yokhala ndi nthawi yayitali nthawi zambiri imaphatikizidwa ndi mankhwala afupipafupi kapena a ultrashort. Mwanjira yachiwiri ya matenda ashuga, mankhwalawa amagwiritsidwa ntchito mosiyana. Pa mndandanda wa mankhwala amkamwa a hypoglycemic, omwe mankhwala a mahomoni amaphatikizidwa nthawi zambiri, ndi:

1. Sulfonylurea.
2. Meglitinides.
3. Biguanides.
4. Pangamanga.

Insulin yokhala ndi nthawi yayitali imatha kutengedwa ngati chipangizo chimodzi, monga mankhwala ena onse

Monga lamulo, kupendekera kwakanthawi kochepa ka shuga kumagwiritsidwa ntchito m'malo mwa mankhwala osokoneza bongo nthawi yayitali. Chifukwa chakuti pofuna kukwaniritsa zoyambira, pafupifupi insulin imapangidwa kawiri pa tsiku, ndipo yayitali - kamodzi patsiku, kusintha kwa mankhwalawa sabata yoyamba kungayambitse kukhalanso kwa hypoglycemia ya m'mawa kapena usiku. Vutoli litha kuwongoleredwa pochepetsa kuchuluka kwa mankhwala ochulukitsidwa ndi 30%, omwe amakwanira pang'ono chifukwa chosowa kwa nthawi yayitali kugwiritsa ntchito insulin yokhala ndi chakudya chochepa. Pambuyo pake, mlingo wa insulin yochulukitsidwa umasinthidwa.

Zomwe zimapangidwazo zimaperekedwa kamodzi kapena kawiri pa tsiku. Pambuyo polowa m'thupi kudzera mu jakisoni, mahomoni amayamba kuwonetsa ntchito zake pokhapokha maola ochepa. Nthawi yomweyo, mafotokozedwe azinthu zowonjezera pang'onopang'ono zomwe zimawonetsedwa patebulo ndizosiyana. Koma ngati insulin yowonjezera ikufunika, lowetsani kuchuluka kwakukulu kwa 0,6 ma kilo imodzi ya kulemera kwa munthu, ndiye kuti mlingo womwe watchulidwa umagawidwa majakisoni awiri. Nthawi yomweyo, kupatula pakubwera zovuta, jakisoni amapangidwa mbali zosiyanasiyana za thupi.

Ganizirani momwe mungapewere zoyipa za insulin.

Mankhwala aliwonse a insulini, ngakhale atakhala nthawi yayitali bwanji;

• Hypoglycemia - mulingo wa glucose m'magazi umatsika pansi pa 3.0 mmol / L.
• Zosiyanasiyana komanso zamkati zimachitika - urticaria, kuyabwa ndi kapangidwe ka jekeseni.
• Kuphwanya mafuta kagayidwe - kodziwika ndi kudzikundikira kwamafuta, osati pansi pa khungu, komanso magazi.

Wolembera pang'onopang'ono insulin imapereka mwayi wabwino kwambiri wopewa zovuta za mtundu 1 ndi matenda ashuga 2. Kuphatikiza apo, insulin yayitali imapangitsa kuchiza matenda a shuga mosavuta. Pofuna kupatula mawonetsedwe azotsatira izi, odwala matenda ashuga ayenera kutsatira zakudya zomwe adokotala amafunikira tsiku lililonse ndikusintha malo a jekeseni pafupipafupi.

Posachedwa, mitundu iwiri yatsopano, yayitali, yovomerezedwa ndi FDA, yakhazikitsidwa kwakanthawi yayambitsidwa pamsika wamankhwala ochizira odwala matenda a shuga ngati akulu:

• Degludek (wotchedwa Tresiba).
• Ryzodeg FlexTouch (Ryzodeg).

Tresiba ndi mankhwala atsopano omwe amavomerezedwa ndi FDA

Kugwiritsa insulin Degludec kwa nthawi yayitali kuti apangire utsogoleri wokhazikika. Kutalika kwa malamulo a shuga ndimagazi pafupifupi 40. Kugwiritsidwa ntchito pochiza odwala matenda ashuga njira yoyamba ndi yachiwiri yamatenda. Kuti atsimikizire chitetezo ndi kugwiritsa ntchito mankhwala omwe atulutsidwa kumene, kafukufuku wina anachitika pomwe odwala opitilira 2,000 anachitapo kanthu. Degludec wagwiritsidwa ntchito ngati cholankhulira pakamwa.

Mpaka pano, kugwiritsa ntchito mankhwala a Degludec ndikuloledwa ku EU, Canada ndi USA. Mumsika wam'nyumba, chitukuko chatsopano chidawonekera pansi pa dzina la Tresiba. Kuphatikizikako kumazindikira mbali ziwiri: 100 ndi 200 U / ml, mwa cholembera. Tsopano, ndikotheka kusinthitsa kuchuluka kwa shuga m'magazi mothandizidwa ndi othandizira-kutulutsa kwambiri pogwiritsa ntchito njira ya insulin katatu kokha pa sabata.

Timalongosola kukonzekera kwa Ryzodeg. Wothandizira kutulutsidwa kwa Ryzodeg ndi kuphatikiza kwamahomoni, mayina awo omwe amadziwika bwino ndi odwala matenda ashuga, monga basal insulin Degludec ndi Aspart wachangu (70:30 ratio). Zinthu ziwiri zokhala ndi insulin m'njira inayake zimalumikizana ndi ma insulin receptors, chifukwa zimazindikira mphamvu zawo zamankhwala ofanana ndi insulin.

Chitetezo ndikuyenda bwino kwa mankhwala omwe apangika kumenewo kwatsimikiziridwa ndikuyesa kwachipatala komwe odwala matenda ashuga 360 adatenga nawo mbali.

Ryzodeg adatengedwa limodzi ndi chakudya china chotsitsa shuga. Zotsatira zake, kutsika kwa shuga m'magazi kunakwaniritsidwa mpaka komwe m'mbuyomu kukanatheka kokha pogwiritsa ntchito insulin yokonzekera.

Mankhwala okhazikika a mahomoni Tresiba ndi Ryzodeg amatsutsana mwa anthu omwe ali ndi vuto lalikulu la matenda ashuga. Kuphatikiza apo, mankhwalawa, monga fanizo omwe takambirana pamwambapa, ayenera kuyikidwa ndi adokotala okha, chifukwa chake mavuto ena omwe amadza chifukwa cha hypoglycemia ndi mitundu mitundu ya ziwengo sizingapewe.

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

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

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

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

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

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

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

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

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

Yesaninso kutsatira malangizo awa:

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

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

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

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

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

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

Magulu otsatirawa a insulin ndi omwe amadziwika:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Mutha kuzindikira kukula kwazomwe zikuwonetsedwa:

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

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

Kumbukirani kuti kugwiritsa ntchito insulin posakhalitsa pamafunika kutsatira malamulo ena.

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

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

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

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

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

1. 
   Neymark M.I., Kalinin A.P. Perioperative nyengo in endocrine surge, Medicine - M., 2016. - 336 p.
2. 
   Kalits, I. Odwala odwala matenda a shuga / I. Kalits, J. Kelk. - M.: Valgus, 1983 .-- 120 p.
3. 
   Matenda A shuga a Cheryl Foster (otanthauziridwa kuchokera ku Chingerezi). Moscow, Panorama Publishing House, 1999.
4. Shevchenko V.P. Clinical Dietetics, GEOTAR-Media - M., 2014 .-- 256 p.

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