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

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

Njira yamachitidwe

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

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

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

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

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

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

Mitundu ya kukonzekera kwa insulin

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

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

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

Makhalidwe a insulin kukonzekera kutengera kutalika kwa zochita

Onani	Mayina Mankhwala Osokoneza bongo	Kukhazikika kwa dongosolo pambuyo pa utsogoleri (mphindi)	Peak ntchito pambuyo jekeseni (maola)	Zochita (maola)
Ultrashort	Humalog, Apidra	5–20	0,5–2	3–4
Mwachidule	Actrapid NM, Humulin R, Insuman	30–40	2–4	6–8
Yapakatikati	Protafan NM, Insuman	60–90	4–10	12–16
Kutalika	Lantus, Levemir	60–120	−	16–30

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

Malangizo ogwiritsira ntchito

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

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

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

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

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

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

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

Mlingo Wothandizidwa ndi Insulin

Kulumikizana kwa shuga (mmol / L)	10	11	12	13	14	15	16
Mlingo (U)	1	2	3	4	5	6	7

Magulu apadera a odwala

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

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

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

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

Zotsatira zoyipa

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

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

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

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

Insulin yachilengedwe komanso yapangidwe

Insulini amatanthauza ma mahomoni omwe amakhala ndi mayendedwe osiyanasiyana ophunzitsira. Poyamba, m'masamba achisangalalo, monga m'maselo a beta, mumakhala ma amino acid okwanira 110, omwe amatchedwa preproinsulin. Puloteni yamkati imalekanitsidwa ndi iyo, ma proinsulin amawonekera. Mapuloteni awa amawaika m'miyala, pomwe amagawidwa mu C-peptide ndi insulin.

Njira yapafupi kwambiri ya amino acid ya insulin. M'malo mwa threonine mmenemo, unyolo B umakhala ndi alanine. Kusiyanitsa kwakukulu pakati pa bovine insulin ndi insulin yaumunthu ndi zotsalira za 3 amino acid. Ma antibodies amapangidwa pama insulin a nyama mthupi, omwe angayambitse kukana kwa mankhwala omwe amaperekedwa.

Kuphatikizika kwamakonzedwe amakono a insulin mu ma labotale kumachitika pogwiritsa ntchito ma genetic engineering. Biosynthetic insulin ndi yofanana mumapangidwe amino acid amunthu, amapangidwa pogwiritsa ntchito ukadaulo wa DNA. Pali njira ziwiri zazikulu:

Kaphatikizidwe kabakiteriya wosinthika ma genetic.
Kuchokera ma proinsulin opangidwa ndi bacterium yosinthidwa ma genetic.

Phenol ndi cholembera choteteza ku kuipitsidwa kwakanthawi kochepa ka insulini; insulin yayitali imakhala ndi paraben.

Cholinga cha insulin
Kupanga kwa mahomoni m'thupi kumapitilira ndipo kumatchedwa secaltion basal kapena maziko. Udindo wake ndikuwonetsetsa kuti shuga azikhala momasuka kunja kwa chakudya, komanso kuyamwa kwa glucose obwera kuchokera ku chiwindi.

Mukatha kudya, zakudya zamafuta zimalowa m'magazi kuchokera m'matumbo monga glucose. Kuti mumvetsetse pamafunika insulin yowonjezera. Kutulutsa kwa insulin m'magazi kumatchedwa secretion ya chakudya (postprandial), chifukwa, pambuyo maola 1.5-2, glycemia imabweranso muyeso wake woyamba, ndikulandila glucose kulowa m'maselo.

Mtundu 1 wa shuga, insulini silingapangidwe chifukwa cha kuwonongeka kwa autoimmune m'maselo a beta. Kuwonetsedwa kwa matenda ashuga kumachitika panthawi yomwe pafupifupi chiwonongeko chotheratu cha minofu ya islet. Mtundu woyamba wa matenda ashuga, insulin imabadwa kuyambira masiku oyamba a matendawa komanso moyo.

Mtundu wachiwiri wa matenda ashuga umatha kulipiriridwa ndi mapilitsi, ndikapita nthawi yayitali matendawa, kapamba amataya mphamvu kuti apange mahomoni akeawo. Zikatero, odwala amalowetsedwa ndi insulin limodzi ndi mapiritsi kapena ngati mankhwala.

Insulin imapangidwanso kuti ivulaze, kuchita opaleshoni, kutenga pakati, matenda, ndi zina zomwe shuga sangathe kuchepetsedwa pogwiritsa ntchito mapiritsi. Zolinga zomwe zimakwaniritsidwa ndikuyambitsa insulin:

Sinthanso magazi a shuga, komanso kupewa kuti achulukane kwambiri mukatha kudya chakudya.
Chepetsa shuga mkodzo wochepera.
Muzipewa kupuma kwambiri kwa hypoglycemia ndi matenda a shuga.
Muzikhala ndi thupi lokwanira.
Sinthani mafuta kagayidwe.
Sinthani moyo wabwino kwa anthu odwala matenda ashuga.
Pofuna kupewa misempha komanso mitsempha ya matenda ashuga.

Zizindikiro zoterezi zimadziwika ndi njira yabwino yophunzirira matenda a shuga. Ndi chiphuphu chokwanira, kuchotsedwa kwa zizindikiro zazikuluzikulu za matendawa, hypo- ndi hyperglycemic coma, ndi ketoacidosis amadziwika.

Nthawi zambiri, insulini yochokera ku kapamba imadutsa mu chotupa cha chotupa mu chiwindi, pomwe imawonongeka hafu, ndipo ndalama zotsalazo zimagawidwa mthupi lonse. Zomwe zimayambitsa insulin pansi pa khungu zimawonetsedwa chifukwa zimalowa m'magazi mochedwa, komanso m'chiwindi ngakhale pambuyo pake. Chifukwa chake, shuga wamagazi amakwezedwa kwakanthawi.

Motere, mitundu yosiyanasiyana ya insulini imagwiritsidwa ntchito: insulin yofulumira, kapena insulin yochepa, yomwe muyenera kubayidwa musanadye, komanso kukonzekera insulin yayitali (insulin yayitali), yogwiritsidwa ntchito kamodzi kapena kawiri pakukhazikika kwa glycemia pakati pa chakudya.

Insulin yochepa: kuwunikira ndi mayina a mankhwala abwino kwambiri

Insulin yaumunthu imanena za mahomoni omwe amapanga kapamba. Amagwiritsidwa ntchito pochiza matenda ashuga. Kuti muthane ndi chizolowezi cha kapamba, wodwalayo amapaka jakisoni:

zotsatira zazifupi
zopitilira
nthawi yayitali yochita.

Mtundu wa mankhwalawa umatsimikizika potengera thanzi la wodwala komanso mtundu wa matenda.

Mitundu ya insulin

Insulin idapangidwa koyamba kuchokera ku zikondamoyo za agalu. Patatha chaka chimodzi, mahomoniwa adagwiritsidwa ntchito kale. Zaka zina 40 zidapita, ndipo zidatheka kupanga insulin mosiyanasiyana.

Pakapita kanthawi, zinthu zodziyeretsa kwambiri zimapangidwa. Pambuyo pazaka zowerengeka, akatswiri adayamba kupanga kapangidwe ka insulin ya anthu. Kuyambira 1983, insulini idayamba kupangidwa pamakampani ambiri.

Zaka 15 zapitazo, matenda ashuga ankawagwiritsa ntchito zopangidwa ndi nyama. Masiku ano, ndi oletsedwa. M'mafakitala, mutha kupeza zokonzekera zaumisiri, kupanga ndalama izi kutengera kutengera kwa chinthu cha gene mu cell ya microorganism.

Pachifukwa ichi, yisiti kapena mtundu wa mabakiteriya osagwiritsa ntchito tizilombo ta Escherichia coli amagwiritsidwa ntchito. Zotsatira zake, tizilombo tating'onoting'ono timayamba kupanga insulin kwa anthu.

Kusiyana pakati pa zida zonse zamankhwala zomwe zilipo lero ndi:

munthawi yowonekera, osachita kanthu kwakanthawi kochepa, ma insulin osakhalitsa pang'ono komanso insulin yochepa.
mogwirizana ndi amino acid.

Palinso mankhwala ena omwe amaphatikizidwa kuti "zosakaniza", amakhala ndi insulin yokhala ndi nthawi yayitali komanso yochepa. Mitundu yonse 5 ya insulin imagwiritsidwa ntchito pazolinga zawo.

Pharmacokinetic katundu wa insulin

Mu shuga mellitus, mankhwala a insulin amatha kukhala osiyana. Nthawi yapamwamba kwambiri ya kuchuluka kwa plasma insulin komanso zotsatira zazikulu zochepetsera shuga zimatha kusiyana ndi 50%. Kukula kwinanso kwa kusinthaku kumadalira kuchuluka kosiyanasiyana kwa mankhwalawa kuchokera ku minofu yolowerera. Komabe, nthawi ya insulin yayitali komanso yochepa ndiyosiyana.

Kutengera ndi insulin, ndikofunikira kubaya mahomoni nthawi zonse m'matumbo a subcutaneous.

Izi zikugwiranso ntchito kwa odwala omwe sangathe kuchepetsa kuchuluka kwa shuga m'magazi chifukwa cha zakudya komanso mankhwala omwe amachepetsa shuga, komanso azimayi omwe ali ndi matenda osokoneza bongo panthawi yomwe ali ndi pakati, odwala omwe ali ndi matenda omwe amapangidwa chifukwa cha pacreatectomy. Apa titha kunena kuti mapiritsi ochepetsa shuga a magazi samapereka mphamvu nthawi zonse.

Chithandizo cha insulin ndi chofunikira pa matenda monga:

hyperosmolar chikomokere,
matenda ashuga ketoacidosis,
pambuyo opaleshoni kwa odwala matenda a shuga,
pomwe chithandizo cha insulin chimathandizira kuti shuga akhale mu plasma,
Kuchotsa kwina kwa metabolic metabolologies.

Zotsatira zabwino zimatheka pogwiritsa ntchito njira zovuta zochizira:

Kufunika kwa insulin tsiku ndi tsiku

Munthu wokhala ndi thanzi labwino komanso wathanzi labwino amapanga magawo 18-40 patsiku, kapena mayunitsi 0,2-0,5 / kg wa insulin yayitali. Pafupifupi theka la bukuli ndi chimbudzi cha m'mimba, chotsalacho chimapukutidwa mutatha kudya.

Hormayo imapangidwa mawunitsi a 0.5-1 pa ola limodzi. Shuga atalowa m'magazi, kuchuluka kwa katulutsidwe ka timadzi timeneti kumakwera mpaka ku magawo 6 pa ola limodzi.

Anthu onenepa kwambiri komanso omwe ali ndi insulin kukana omwe amadwala matenda ashuga amatha kupanga ma insulini mwachangu kangapo podya. Pali kulumikizana kwa mahomoni omwe amapangidwa ndi portal system ya chiwindi, pomwe gawo limodzi limawonongeka ndipo silimafikira magazi.

Odwala amtundu wa matenda a shuga 1, kusowa kwa mahomoni tsiku ndi tsiku ndi kosiyana:

Kwenikweni, chizindikirochi chimasiyana kuchokera pa 0,6 mpaka 0,7 mayunitsi / kg.
Ndi kulemera kambiri, kufunikira kwa insulin kumawonjezeka.
Munthu akamafuna mayunitsi 0,5 okha patsiku, amakhala ndi maholide okwanira kapena thupi labwino.

Kufunika kwa insulin ya mahomoni ndi amitundu iwiri:

Pafupifupi theka la zosowa za tsiku ndi tsiku ndi za basal fomu. Hormone iyi imathandizira kupewa kufalikira kwa shuga mu chiwindi.

Mu mawonekedwe a posachedwa, zofunika tsiku lililonse zimaperekedwa ndi jakisoni musanadye. Timadzi timadzi timatenda timadzi timene timayamwa.

Kenako njira yothandizira mankhwalawo imagwiritsidwa ntchito kukhala yovuta kwambiri, pomwe insulini yokhala ndi nthawi yayitali kapena insulini yocheperako kapena yogwiritsira ntchito mwachangu insulin imagwiritsidwa ntchito limodzi.

Nthawi zambiri wodwalayo amathandizidwa molingana ndi mtundu wosakanikirana wa mankhwala, akaperekera jakisoni imodzi pakudya kadzutsa, ndipo wina amadya. Hormone mu nkhani iyi imakhala ndi insulin ya nthawi yayifupi komanso nthawi yayitali.

Mukalandira mlingo wamadzulo wa mahomoni NPH kapena insulin, tepiyo silipereka glycemia usiku, ndiye kuti jakisoni imagawidwa m'magawo awiri: asanadye chakudya chamadzulo, wodwalayo amapaka jekeseni wa insulin, ndipo asanagone amayikidwa ndi insulin NPH kapena tepi ya insulin.

Mtengo wa insulin umatsimikiziridwa payekhapayekha, kutengera mtundu wa shuga m'magazi. Chifukwa cha kuchuluka kwa ma glucometer, tsopano ndikosavuta kuyeza kuchuluka kwa hemoglobin m'magazi, ndipo kwakhala kovuta kudziwa kukula kwa mahomoni, kutengera zinthu izi:

matenda ophatikizika
madera ndi kuya kwakufa,
ntchito minofu m'dera jakisoni,
magazi
zakudya
zolimbitsa thupi
mtundu wa mankhwala
kuchuluka kwa mankhwalawa.

Insulin yofulumira: mayina, omwe mankhwala a insulin ndi mankhwala ali bwino?

Kukhazikitsidwa kwa insulin ngati njira yothanirana ndi matenda ashuga lero ndi njira yokhayo yothetsera matenda a hyperglycemia mu mtundu woyamba wa 1, komanso mu mtundu wachiwiri wa matenda a insulin.

Mankhwala a insulin amachitika m'njira yoti kukulitsa kubweretsereni kwa mahomoni m'thupi lathupi.

Chifukwa chake, mankhwala osokoneza bongo osiyanasiyana omwe amalumikizidwa ku minofu ya subcutaneous amagwiritsidwa ntchito. Ma insulin amatenga nthawi yayitali kutulutsa kwa mahomoni, komwe sikumakhudzana ndi kumeza kwa chakudya m'matumbo, ndipo ma insulin amafupikitsa komanso a ultrashort amathandiza kutsika glycemia atatha kudya.

Kodi insulin imagwira ntchito bwanji?

Kukonzekera kwa insulini, monga mahomoni achilengedwe, kumangiriza zolandilira pa membrane wa cell ndikulowa nawo. Mchipindamo, motsogozedwa ndi timadzi tating'onoting'ono tomwe timayambitsa ma biochemical reaction. Ma receptor oterewa amapezeka m'matupi onse, ndipo nthawi zambiri pamaselo olimbana. Kuti zimadalira insulin zimaphatikizira maselo a chiwindi, adipose ndi minofu minofu.

Insulin ndi mankhwala ake imayendetsa pafupifupi ma metabolic onse olumikizidwa, koma momwe zimakhalira ndi shuga ndimagazi.Hormoni imapereka kusuntha kwa glucose kudzera mu membrane wa cell ndikulimbikitsa kugwiritsa ntchito kwake njira yofunika kwambiri yopezera mphamvu - glycolysis. Glycogen imapangidwa kuchokera ku glucose m'chiwindi, ndipo mapangidwe a mamolekyulu atsopano amachepetsedwa.

Zotsatira za insulin zimawonekera chifukwa chakuti kuchuluka kwa glycemia kumatsika. Malangizo a insulin kaphatikizidwe ndi katulutsidwe amathandizidwa ndi shuga ndende - kuchuluka kwa glucose kumayambitsa, ndipo otsika amalepheretsa katulutsidwe. Kuphatikiza pa shuga, kaphatikizidwe kamakhudzidwa ndi zomwe zimakhala m'magazi (glucagon ndi somatostatin), calcium ndi amino acid.

Mphamvu ya kagayidwe ka insulin, komanso mankhwala osokoneza bongo omwe ali ndi zomwe zili mkati mwake, amawonetsedwa motere:

Imaletsa kuchepa kwamafuta.
Imalepheretsa mapangidwe a matupi a ketone.
Mafuta ocheperako amalowa m'magazi (amawonjezera chiopsezo cha atherosulinosis).
Mu thupi, kuwonongeka kwa mapuloteni kumalephereka ndipo kapangidwe kawo kamathandizira.

Mayamwidwe ndi kufalitsa insulin mthupi

Kukonzekera kwa insulin kumalowetsedwa m'thupi. Kuti muchite izi, gwiritsani ntchito ma syringe omwe amatchedwa insulin, syringe pens, pampu ya insulin. Mutha kubayira mankhwala pansi pa khungu, m'misempha ndi m'mitsempha. Pakulamulira kwa intravenous (pankhani ya chikomokere), ma insulin okhazikika pokhapokha (ICD) ndi omwe ali oyenera, ndipo njirayi imagwiritsidwa ntchito nthawi zambiri.

The pharmacokinetics ya insulin zimatengera jakisoni, Mlingo, ndende ya yogwira mankhwala. Komanso, magazi akuyenda pamalo a jakisoni, zochitika za minofu zimatha kukhudza kuchuluka kwa kulowa m'magazi. Kuthiridwa mwachangu kumaperekedwa ndi jakisoni kukhoma lamkati lakumbuyo; mankhwalawa omwe amayikidwa m'chigobere kapena pansi pa phewa amaponderezedwa kwambiri.

M'magazi, 04-20% ya insulin imamangidwa ndi ma globulins, mawonekedwe a ma antibodies kwa mankhwala amatha kuyambitsa zotsatira zoyanjana ndi mapuloteni, ndipo, chifukwa chake, insulin. Kutsutsa kwa mahomoni kumakhala kotheka ngati nkhumba kapena insulini yolembedwa.

Mbiri ya mankhwalawa singafanane ndi odwala osiyanasiyana, ngakhale mwa munthu m'modzi zimasinthasintha.

Chifukwa chake, pamene deta pazomwe zimachitika ndikuchotsa theka la moyo zimaperekedwa, ma pharmacokinetics amawerengedwa molingana ndi zowonetsa pafupifupi.

Zosiyanasiyana za insulin

Ma insulin, omwe amaphatikizapo nkhumba, bovine, bovine, insulin, sanagwiritsidwe ntchito kwenikweni kupeza mankhwala opangira - analogues a insulin ya anthu. Mwanjira zambiri, yomwe imakhala yodziwika bwino kwambiri, insulin yabwino kwambiri imapangidwa kuchokera ku chibadwa.

Kutalika kwa nthawi ya kukonzekera kwa insulin kumagawidwa mu ultrashort ndi insulin yochepa. Amaberekanso zakudya zomwe zimapangitsa kuti thupi lizikhala ndi chakudya. Mankhwala a nthawi yayitali, komanso ma insulin amatengera momwe chinsinsi chake chimakhalira. Insulin yocheperako imatha kuphatikizidwa ndi insulin yayitali pakaphatikizidwe.

Momwe bwino kwambiri insulin - yayifupi, yapakati kapena yayitali, imatsimikiziridwa ndi mtundu wa insulin yodzikonzera, zomwe zimatengera zaka za wodwalayo, kuchuluka kwa hyperglycemia komanso kupezeka kwa matenda okhudzana ndi matenda a shuga.

Gulu la ma ultrashort insulins limadziwika ndi kuyambika mwachangu - pambuyo pa mphindi 10-20, shuga amachepetsa kwambiri pambuyo pa maola 1-2.5, kutalika konse kwa zotsatira za hypoglycemic ndi maola 3-5. Mayina a mankhwala: Humalog, NovoRapid ndi Apidra.

Insulin yochepa imachitika pambuyo pa mphindi 30-60, zotsatira zake zimatha maola 6-8, ndipo pazofunikira zimawonedwa kwa maola awiri atatha kutsata. M'pofunika kubaya insulini yocheperako mphindi 20-30 musanadye chakudya, chifukwa izi zimapereka kuchuluka kwa mahomoni m'magazi panthawi yomwe shugayo imakhala yofunikira kwambiri.

Insulin yochepa imapezeka pansi pa dzina lotsatira:

Actrapid NM, Rinsulin R, Humulin Regular (genetic engineering insulin pokonzekera)
Khumudar R, Biogulin R (semi-syntulin insulin).
Actrapid MS, Monosuinsulin MK (wowerengeka wa nkhumba).

Zomwe insulin ndi bwino kusankha pamndandandawu imatsimikiziridwa ndi dokotala yemwe amalingalira za chizolowezi chokhala ndi chifuwa, kuikidwa kwa mankhwala ena. Mukamagwiritsa ntchito ma insulini a mitundu yosiyanasiyana palimodzi, zimakhala bwino ngati mungasankhe wopanga mmodzi. Mtengo wa mitundu ingapo ya insulini umatsimikiziridwa ndi wopanga.

Kuchita insulin mwachangu kumasonyezedwera kukonzekera tsiku lililonse musanadye kwambiri, komanso chithandizo cha matenda a shuga pamankhwala ochita opaleshoni. Mlingo wocheperako, mankhwalawa amagwiritsidwa ntchito ndi othamanga kuti apange minofu, komanso kutopa kambiri, thyrotoxicosis, cirrhosis.

Mankhwala othandizira nthawi yayitali komanso nthawi yayitali amagwiritsidwa ntchito kuti asungidwe pafupipafupi kapena a insulin.

Malangizo ogwiritsira ntchito amakhala ndi malangizo pakumwedwa kwa mankhwalawa, nthawi zambiri amafunika kuwazidwa kamodzi kapena kawiri patsiku, kutengera mlingo wa glycemia.

Kuwerengetsa kwa insulin

Chisankho choyenera chimalola odwala omwe ali ndi matenda osokoneza bongo kuti asasiye zakudya zomwe amakonda, kupatula zinthu zomwe zimakhala ndi shuga ndi ufa woyera. Kukoma kokoma kumatha kupezeka pogwiritsa ntchito shuga.

Pofuna kumvetsetsa momwe mungawerengere mlingo, womwe insulin ndiyabwino, momwe mungapangire insulin, mlingo wake umachokera mukuganizira zomwe zili zamagulu a mkate (XE). Chigawo chimodzi chimatengedwa wofanana ndi 10 g wamafuta. Ma mkate a Mkate, owerengedwa molingana ndi matebulo amtundu wina wa mankhwala, mupeze zomwe insulin imayenera kutumikiridwa musanadye.

Pafupifupi 1 IU ya insulin imayendetsedwa pa XE. Mlingo ukuwonjezeka ndi kukana kwa munthu payekha mankhwalawo, komanso ndi munthawi yomweyo makonzedwe a mankhwala a steroid, njira zakulera, Heparin, antidepressants komanso okodzetsa ena.

Zotsatira za hypoglycemic za insulin zimapangidwira ndi mankhwala ochepetsa shuga m'mapiritsi, masilicylates, anabolic steroids, androgens, furazolidone, sulfonamides, theophylline, mankhwala okhala ndi lithiamu, calcium.

Ethanol amalepheretsa kupanga shuga m'magazi. Mwanjira iyi, kumwa zakumwa zoledzeretsa kumbuyo kwa insulin mankhwala kumabweretsa gawo lalikulu la hypoglycemic. Ndizowopsa kumwa mowa pamimba yopanda kanthu.

Malangizo othandiza kudziwa kuchuluka kwa insulin:

Kuwerengera kumachitika pa kilogalamu imodzi ya kulemera. Ndi misa yochulukirapo, chokwaniracho chimachepetsedwa ndi 0,1, ndikusowa - ndikuwonjezeka kwa 0,1.
Kwa odwala omwe ali ndi vuto la matenda a shuga 1, masamu 0,4-0,5 pa 1 kg.
Mtundu wa 1 wa shuga, ndi kulipidwa kosasunthika kapena kuwonongeka, mankhwalawa amawonjezeka mpaka 0.7-0.8 U / kg.

Mlingo wa insulin nthawi zambiri umachulukitsidwa kwa achinyamata chifukwa chobisika kwambiri chotulutsa timadzi tambiri ndi mahomoni ogonana kulowa m'magazi. Pakati pa mimba mu semes yachitatu, chifukwa cha mphamvu ya mahomoni a placental komanso chitukuko cha kukana insulin, mlingo wa mankhwalawa umasinthidwira m'mwamba.

Kwa odwala omwe amadziwitsidwa kuti apange insulini, chinthu choyambirira ndi kusintha kwa mankhwalawa, poganizira kuyang'anira shuga. Ngati mulingo wa glycemia mukatha kudya umaposa zomwe zimachitika, ndiye kuti tsiku lotsatira mlingo wa insulin ukadzuka ndi gawo limodzi.

Amavomerezeka kamodzi pa sabata kuti ajambule zithunzi zosintha zamwazi m'magazi, kuyeza asanadye komanso pambuyo chakudya chachikulu, komanso asanagone. Zambiri pa glycemia ya tsiku ndi tsiku, kuchuluka kwa magawo a mkate, kuchuluka kwa insulin yomwe ingaberekedwe kungathandize kusintha machitidwe a insulin kuti akhale ndi thanzi la wodwalayo.

Insulin yochepa komanso ya ultrashort ikufotokozedwa mu kanema munkhaniyi.

Kuchita insulin mwachangu

Thupi lamtunduwu limatchedwa dzina chifukwa limayamba kugwira ntchito pasanathe mphindi khumi ndi zisanu litayambitsidwa, koma nthawi yomweyo limatulutsidwa mofulumira kwambiri mthupi, kusiya ntchito pambuyo maola anayi.

Ma insulini oterowo ndi opindulitsa chifukwa safunikira kudikirira ola limodzi asanadye, imamwetsedwa mwachangu ndipo imatha kudyedwa pasanathe mphindi zisanu mpaka khumi pambuyo pa jakisoni, palinso mwayi woperekera mankhwalawo musanachitike, mutatha kudya.

Ultrashort insulin imadziwika kuti ndi yamphamvu kwambiri pakati pa mankhwala onse omwe amapangidwa ndi timadzi timeneti, mphamvu yake m'thupi imakhala yolimba kwambiri kuposa ya mankhwala osakhalitsa komanso osakhalitsa. Nthawi zambiri chimagwiritsidwa ntchito pamaso pa spikes lakuthwa m'magazi amwazi, chifukwa izi zimatha kubweretsa zovuta zambiri komanso kupsa mtima.

Mankhwala oterewa ndi ofunikira panthawi yadzidzidzi, mwachitsanzo, ngati sizingatheke kuwerengera nthawi yakudya, kuyamwa mwachangu kwambiri kwa chinthu kumakupatsani nkhawa kuti musadere nkhawa za kuperewera kwa vuto la hyperglycemic.

Koma ndikofunikira kuwerengera kuchuluka kwa mankhwalawo, chifukwa gawo limodzi la mankhwala lomwe limapangidwa pa ultrashort limatha kuchepetsa kuchuluka kwa shuga kawiri ndi theka, ndipo mankhwala osokoneza bongo ochulukirapo amatha kuwonjezera mwayi wokhala chikomokere china - hypoglycemic.

Kuchuluka kwa mankhwala a jakisoni sayenera kupitirira 0,04 Mlingo wa insulin yochepa.

Mitundu yayikulu ya insulin ya ultrashort ndiyophatikiza mayina awa:

Insulin Yaitali

Zofanana poyerekeza ndi insulin yochepa komanso zinthu zazitali zimaperekedwa patebulo lotsatirali:

Mwachidule kuchita insulin	Insulin yayitali
Kuyambitsidwa kwa chinthucho ndikofunikira m'mimba, popeza izi zimapangitsa kuti mayendedwe azithamanga.	Ponyowa pang'onopang'ono, jakisoni amachitidwa ntchafu.
Imaperekedwa kwakanthawi musanadye (kutengera mtundu wa insulin yochepa), nthawi zambiri mumphindi khumi ndi zisanu kapena theka la ola.	Ndikofunikira kupanga jakisoni pafupifupi nthawi yomweyo m'mawa ndi madzulo, jakisoni wam'mawa umachitika molumikizana ndi insulin yochepa.
Insulin yosavuta iyenera kuperekedwa musanadye, sizingatheke kukana kudya, chifukwa izi zimawopseza chikomokere.	Mankhwala amtunduwu samagwirizanitsidwa ndi zakudya, amatsanza kutulutsidwa kwa insulin musanadye, koma tsiku lonse.

Mankhwala omwe akhala akuchita kwa nthawi yayitali amaphatikiza insulin monga:

Malangizo a nthawi yayitali yomvekera mwachitsanzo, NPH ndi Tape,
Mankhwala omwe akhala akuchita kwa nthawi yayitali monga Detemir ndi Glargin.

Ngakhale cholinga chake chachikulu, chomwe ndi kuyerekezera kubisalira kwa insulin, nthawi zambiri mankhwala ogwiritsidwa ntchito kwa nthawi yayitali amakhala odziwidwa ndi liwiro lonse tsiku lonse wodwala yemweyo. Ichi ndichifukwa chake kuyang'anira kuchuluka kwa shuga ndikofunikira, komwe ngakhale pogwiritsa ntchito mankhwala othandizira insulin amatha kudumpha kwambiri.

Insulin yosakanikirana

Ubwino wawukulu wa mankhwalawa ndikuti mphamvu zawo zimachitika mofulumira, mkati mwa theka la ola jakisoni, ndipo zimatha kwa maola 14 mpaka khumi ndi asanu ndi limodzi.

Popeza mphamvu zakukula kwa thupi zimadalira kuchuluka kwa mahomoni omwe amaphatikizidwa ndi mankhwalawa, simungayambe nthawi yodziyimira popanda kufunsa dokotala yemwe amakakamizidwa kuwerengetsa kuchuluka kwa mankhwalawo ndikusankha mankhwalawo, poganizira mawonekedwe a thupi la wodwala, mtundu wa matenda ashuga, ndi zina zambiri.

Woyimira wamkulu wa mankhwala osakanizika ndi Novomix 30, omwe amatha kugwiritsidwa ntchito ndi amayi oyembekezera.

Malangizo a kumwa insulin

Kumayambiriro kwa mankhwala a insulin, adokotala amayenera kuwerengera kuchuluka kwa mankhwalawa tsiku lililonse la mankhwalawa, potengera zaka, kulemera, mtundu wa matenda ashuga komanso mawonekedwe amunthu wodwala.

Ndalama zomwe zimawerengedwa patsiku ziyenera kugawidwa m'magawo atatu kapena anayi, omwe apanga mlingo umodzi.

Kuwunikira pafupipafupi kuchuluka kwa shuga kumakupatsani mwayi wowerengera molondola kuchuluka kwa zosakaniza zofunika.

Masiku ano, ma cholembera a syringe ndi otchuka kwambiri, omwe ali ndi singano yopyapyala kwambiri ndipo amatha kunyamulidwa bwino m'thumba lanu, ndikupereka jakisoni nthawi iliyonse yomwe mukufuna. Pamaso jakisoni, muyenera kutikita bwino pakhungu lanu, osapanga jakisoni wotsatira pamalo amodzi, ndibwino kusinthana.

Mlingo wofala kwambiri:

M'mawa - mahomoni azowonekera mwachidule komanso kwa nthawi yayitali,
Masana ndichowonekera pang'ono
Madzulo ndikungotuluka pang'ono
Usiku ndi timadzi tambiri tomwe timachita kwa nthawi yayitali.

Kulimbitsa Thupi

Mankhwala okhala ndi mahomoni okhala ndi pancreatic ali ndi tanthauzo la anabolic, chifukwa chake amagwiritsidwa ntchito molimbika pakupanga thupi. Chifukwa cha insulin, kagayidwe kachakudya kamafalikira, mafuta osanjikiza amawotchedwa mwachangu, ndipo minofu yochulukitsa ikukula mwachangu. Mphamvu ya anticatabolic ya chinthucho imakupatsani mwayi wopulumutsa minofu yolimba kwambiri, osaloleza kuti ichepe.

Ngakhale zabwino zonse zogwiritsa ntchito insulin pomanga thupi, pali chiopsezo chokhala ndi vuto la hypoglycemic, lomwe, popanda thandizo loyenerera, limatha kupha.

Amakhulupirira kuti Mlingo pamtunda wa PISCES 100 umawonedwa kuti ndiwopanda vuto, ndipo ngakhale ena adakhalabe athanzi ngakhale pambuyo pa mayunitsi 3000, simuyenera kuyika thanzi lanu pachiwopsezo chifukwa cha minofu yokongola komanso yosemedwa.

Kudya sikuchitika nthawi yomweyo, munthu amakhala ndi nthawi yokwanira kudya shuga m'thupi, ndiye kuti zotsatira zake zakupha sizisowa, koma izi sizithetsa mwayi wake.

Njira yoyendetsera ntchitoyo ndiyophatikiza, siyingagwiritsidwe ntchito kwa miyezi yopitilira iwiri, chifukwa izi zikutanthauza kuti kuphwanya kwa kupanga wina wa ma homoni ndikotheka.

Jakisoni woyamba amayamba ndi magawo awiri, ndiye kuti pang'onopang'ono kuchuluka kwake kumawonjezeka ndi enanso awiri. Ngati izi zikuchitika, mungathe kubweretsa mlingoyo magawo 15.

Njira yofatsa kwambiri yamakonzedwe ndikumalipira zinthu zochepa tsiku lililonse. Palibe chifukwa chake muyenera kulowa mankhwalawo musanaphunzitse komanso musanagone.

Insulin ndi chinthu chomwe chimagwira gawo lofunikira kwambiri mthupi, chifukwa chake kuyang'anitsitsa kusintha kwa katulutsidwe kake kumathandizira kukhala ndi thanzi labwino komanso thanzi. Mitundu yosiyanasiyana yamahomoni imakulolani kuti musankhe wodwala aliyense, kumulola kukhala ndi moyo wonse komanso osawopa kuyambika kwa chikomokere.

Insulin-yochepa: mndandanda wa mankhwala, mayina ndi matebulo

Insulin yochita ntchito mwachidule ndi mankhwala omwe amakupatsani mwayi kuti muchepetse nsonga za shuga.

Amadziwika kuti munthu amene ali ndi matenda ashuga amakakamizidwa moyo wake wonse kuti akhalebe ndi shuga mthupi kudzera jakisoni wa insulin.

Ma insulin omwe amagwira ntchito mwachidule amatha kugwiritsidwa ntchito onse pothandizira odwala mwadzidzidzi, komanso pochiritsira tsiku lililonse.

Chinsinsi cha mahomoni

Ma insulin afupiafupi, akaphatikizidwa m'thupi, amafikira mphamvu zawo pazowonjezera mphamvu pambuyo pa maola 1.5-2. Ndipo amakhala m'magazi mpaka maola 6, kenako nkulekana. Insulin yochepa imasiyanitsidwa ndi kapangidwe kake - palibe chomwe chimapangidwa kupatula mahomoni pawokha, pomwe mu insulin wamba mumakhala zowonjezera zingapo.

Imayamba kugwira ntchito mphindi 30 italowa m'magazi. Chifukwa chake, ayenera kumwedwa theka la ola musanadye. Pali mankhwala ena omwe amachitika mwachangu, amayamba kugwira ntchito mkati mwa mphindi 15 atalowa m'magazi. Mankhwalawa amatchedwa ma Ultra-insulins.

Pali mndandanda wamankhwala omwe mayina awo samadziwika ndi zotsatira zake, komabe, pakufotokozera jakisoni wa insulin iyi, pali chidziwitso cha nthawi yake yomwe achite.

Pofuna kuwerengera mndandandandandawo, gome lotsatira liperekedwa:

"Humalog", "Novorapid", "Apidr" - mankhwalawa ndi a ultrashort, nthawi yawo ndi maola 3-4.Amayamba kugwira ntchito atatha mphindi 5-15 pambuyo pa utsogoleri, kufikira kufika patatha maola awiri.
"Actrapid NM", "Humulin R", "Insuman" - mankhwalawa ndi achidule, nthawi yawo ndi maola 6-8. Amayamba kugwira ntchito patatha mphindi 30 kuchokera pakulowetsa thupi, kufika pachimake patatha maola 3-4.
"Protafan NM", "Humulin NPH", "Bazal" - amatanthauza ma insulins apakati. Kutalika kwawo ndi maola 12-16. Amayamba kugwira ntchito maola 1-1.5 atatha kulowetsedwa m'thupi, kufikira kutalika kwake mu maola 6 mpaka 10.
"Lantus", "Levemir" - mankhwalawa ndi amodzi omwe amakhala akuchita insulini kale. Kutalika kwawo ndi maola 24-30. Yambani kugwira ntchito mukatha maola 1 - 2. Peak pachimake sikunafotokozeredwe.

Maina onse omwe adawonetsedwa adatsimikizidwa, adayesedwa. Mankhwala osadziwika komanso osavomerezeka sayenera kugwiritsidwa ntchito.

Kodi chimagwiritsidwa ntchito ndi chiyani?

Zikuwonekeratu kuti insulin ndi mankhwala omwe amalola kuti anthu omwe ali ndi matenda ashuga azitha kukhalapo. Koma kodi ndi zolinga ziti zomwe zimakwaniritsidwa, ndikuwonetsa kwake? Cholinga chachikulu ndikupanga shuga m'magazi, makamaka mukamadya chakudya.

Cholinga china ndikuchotsa chiopsezo cha kuperewera kwa hypoglycemia ndi matenda ashuga. Munthu amene akumwa insulin amalepheretsa kukula kwa thupi, amenenso ndi ntchito yovuta kwa mankhwalawo.

Insulin m'magazi, imalepheretsa kukula kwa matenda amitsempha, kuwonongeka kwa makoma awo ndipo, chifukwa chake, mawonekedwe a gangrene. Mapeto ake, kumwa insulin munthu kumawongolera bwino moyo wawo.

Zofunikira zokhazokha ndikutsatira malamulo omwera mankhwalawa.

Zomwe zimapangidwa

Insulin ndi mahomoni ovuta kwambiri opangidwa ndi kuchuluka kwa ma amino acid. Mapangidwe ake amapezeka m'magawo angapo. Pa gawo loyamba, amino acid amapanga prroinsulin. Pambuyo polekanitsa mapuloteni a chizindikiro kwa iwo, proinsulin imapangidwa. Puloteni iyi imasandulika kukhala granules, mkati mwake momwe chinthucho chimasiyanitsidwa ndi C-peptide ndi insulin.

Izi zimachitika mobwerezabwereza nyama. Mwakutanthauza mu nkhumba ndi ng'ombe. Kusiyana kokhako kuchokera ku homon kwa anthu ndikuti si threonine koma alanine amagwiritsidwa ntchito mu amino acid. Choipa cha insulin ya nyama ndichakuti ma antibodies amatha kupanga mu thupi la munthu.

Pankhaniyi, munthu amasinthana ndi wina. Zimapangidwa ndi tekinoloje ya DNA. Poterepa, njira ya kaphatikizidwe ka mabakiteriya osinthidwa ma genital imagwiritsidwa ntchito. Insulin yochepa yokhala ndi phenol ndi insulini wamba yokhala ndi paraben imasungidwa kuti iteteze antimicrobial.

Malamulo ogwiritsira ntchito

Insulin yocheperako imatha kupangidwa kuchokera ku zinthu zachilengedwe, nthawi zambiri nkhumba, kapena kapangidwe kake. Ndi iti yomwe ili yoyenera kwa wodwala aliyense payekha, adokotala amasankha. Izi zikuwonetsedwa chifukwa chakuti kuchuluka kwa metabolic ndi kosiyana kwa aliyense, komanso kulemera, zaka, ndi zinthu zina zambiri.

Ngakhale kuchuluka kwa zakudya zomwe zadyedwa. Mlingo wothandizidwa ndi insulin yochepa umadalira. Lamulo lina lofunikira ndikugwiritsa ntchito ma insulin ena apadera. Ndi chithandizo chawo pokhapokha ngati mutha kudziwa bwino kuchuluka kwa mankhwalawo.

Lamulo lachitatu - nthawi yakumwa mankhwalawo iyenera kukhala yomweyo. Thupi liyenera kuzolowera dongosolo lazomwe limayang'anira, ndiye kuti kulimba kwake kumachulukanso.

Lamulo lachinayi ndikuti jakisoni watsopano aliyense wa insulin apangidwe m'malo ena. N`zosatheka kumenya nthawi yomweyo tsiku lililonse, abscess ikhoza kuyamba.

Nthawi yomweyo, simungathe kupaka malo a jakisoni, chifukwa mankhwalawa amayenera kumizidwa bwino m'magazi.

Ndipo lamulo lomaliza - ngakhale liyenera kukhala ndi insulin yofulumira, singatengedwe mosalekeza, komanso, m'malo mwake, tengani ndi mankhwala omwe akhala akuchita kwa nthawi yayitali.

Izi ndichifukwa choti insulin imathamanga mwachangu, ndipo ndizosatheka kuwerengetsa moyenera kuchuluka kwa makonzedwe am'tsogolo.

Ngati akuchitiridwa zachipongwe ndikugwiritsidwa ntchito pafupipafupi, posachedwa, zotsatira zoyipa zimatha - mwachitsanzo, matenda a shuga.

Bongo

Ngati insulin yayifupi siyigwiritsidwa ntchito moyenera, zizindikiro za bongo zitha kuwoneka. Zonsezi zimayambitsidwa ndi kuchepa kwakukulu kwa shuga m'magazi, zomwe zikutanthauza kusokonekera kwa metabolism. Zoterezi zimakhudza thupi zimakhala ndizowonekera:

Chizungulire mpaka kutaya kwathunthu kwa kuyang'ana m'malo ndi mdima m'maso poyesa kusintha mawonekedwe amthupi.
Mwa munthu wokhala ndi mankhwala osokoneza bongo ambiri, mumakhala ndi vuto losamva bwino lanjala.
Nthawi zambiri pamakhala mutu wovuta.
Kugunda kwa mtima kumachulukirachulukira, mpaka ku tachycardia ndi atric ventricular fibrillation.
Kutukwana kumachuluka.
Psyche ya munthu motsogozedwa ndi insulin imasintha, imakwirira nkhawa, imasandulika mantha. Zimathanso kukhala zopanda pake komanso zoyipa.

Pofuna kuthandiza munthu yemwe ali ndi vuto losokoneza bongo, pali zinthu zingapo zofunika kuchita:

Choyamba, ndikofunikira kuyimba ambulansi kapena kupulumutsa munthu yemwe ali ndi mankhwala osokoneza bongo ku chipatala chapafupi.
Kachiwiri, wozunzidwayo ayenera kupatsidwa chakudya kuti akhale ndi mapuloteni ndi chakudya.
Chachitatu, simungalole munthu kugwa. Zoonadi, chimodzi mwazinthu zomwe zimapangitsa insulin kugona tulo tofa nato. Mukalola munthu yemwe ali ndi bongo kuti agone kapena asaonetsetse, akhoza kuyamba kudwala matenda ashuga. Tiyenera kumvetsetsa kuti nthawi zonse vuto lawo limatha kuchotsa wodwalayo.

Kugwiritsa ntchito insulin yochepa pamasewera

Insulin yofupikayi yapeza kuti imagwiritsidwa ntchito osati pakulimbana ndi matenda a shuga, komanso masewera. Mwakutero, pomanga thupi. Masewera awa amakhala pakupanga minofu yambiri, ndipo insulin ndiwofunikira kwambiri pankhaniyi. Imagwira mamolekyulu a glucose ndikuwapereka ku minofu iliyonse yam'mimba, potero imakulitsa kukula kwake.

Mkhalidwe wofunikira pomanga minofu yamatumbo ndi insulin ndi katundu wokhazikika pamisempha. Ndiye kuti, wothamanga ayenera kupereka zabwino zonse pophunzitsidwa pa 100%, apo ayi thupi silikhala ndi zofunikira pakumanga minofu.

Komanso, wothamanga ayenera kudya moyenera komanso moyenera. Simungathe popanda thandizo la akatswiri azakudya.

Kuti awerenge zakudya, katswiriyo amaganizira za kuchuluka kwa othamanga, nthawi yomwe amaphunzitsidwa, komanso zotsatira za kuyesedwa kwa magazi ndi mkodzo wa shuga ndi mahomoni angapo.

Ochita zinthu mwachidule: mayina a mankhwala abwino kwambiri

Mankhwala a insulin amachitika m'njira yoti kukulitsa kubweretsereni kwa mahomoni m'thupi lathupi.

Kanema (dinani kusewera).

Kaphatikizidwe kabakiteriya wosinthika ma genetic.
Kuchokera ma proinsulin opangidwa ndi bacterium yosinthidwa ma genetic.

Phenol ndi cholembera choteteza ku kuipitsidwa kwakanthawi kochepa ka insulini; insulin yayitali imakhala ndi paraben.

Sinthanso magazi a shuga, komanso kupewa kuti achulukane kwambiri mukatha kudya chakudya.
Chepetsa shuga mkodzo wochepera.
Muzipewa kupuma kwambiri kwa hypoglycemia ndi matenda a shuga.
Muzikhala ndi thupi lokwanira.
Sinthani mafuta kagayidwe.
Sinthani moyo wabwino kwa anthu odwala matenda ashuga.
Pofuna kupewa misempha komanso mitsempha ya matenda ashuga.

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:

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.

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

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

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

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

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

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

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

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

Katizidwe katemera wa insulin

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

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

Gulu la insulin limafotokozedwa pagome:

Insulin 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 moyenera ndipo mahomoni satetezeka mokwanira, matenda a shuga amakula.

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

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.

Kuthamanga kwa insulin nthawi zambiri kumawalembera odwala omwe amawonjezera kwambiri shuga pambuyo 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 mankhwalawa sikunayambike kokwanira, hyperglycemia imachitika,
kukulira mlingo kumayambitsa hypoglycemia.

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

Odwala omwe ali ndi matenda amtundu wa 1 ndi mtundu wa 2 omwe ali ndi zakudya zamafuta ochepa amalangizidwa kuti azigwiritsa ntchito insulin mwachangu. Ndi kuchepa kwa chakudya m'thupi, gawo la mapuloteni pambuyo pa cleavage limasinthidwa kukhala glucose. Iyi ndi nthawi yayitali ndipo machitidwe a ultrashort insulin amayamba msanga.

Komabe, aliyense wodwala matenda ashuga amalangizidwa kuti apereke mlingo wa mahomoni a ultrafast pakafunika mwadzidzidzi. Ngati atatha kudya shuga atakhala wovuta, mahomoni oterowo amathandizanso.

Momwe mungawerengere insulin yofulumira komanso nthawi yayitali

Chifukwa chakuti wodwala aliyense ali ndi vuto lakumwa mankhwala osokoneza bongo, kuchuluka kwa mankhwala ndi nthawi yodikirira asanadye ziyenera kuwerengedwa payekhapayekha kwa wodwala aliyense.

Momwe mungasungire shuga kukhala wabwinobwino mu 2019

Mlingo woyamba uyenera kudulidwedwa mphindi 45 asanadye. Kenako kugwiritsa ntchito glucometer mphindi 5 zilizonse kujambula kusintha kwa shuga. Mafuta akayamba kuchepa ndi 0,3 mmol / L, mutha kudya.

Kuwerenga molondola kutalika kwa mankhwalawo ndiye njira yothandiza kwambiri yothandizira matenda ashuga.

Makalata ochokera kwa Owerenga

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

Mwangozi ndidapeza nkhani pa intaneti yomwe idapulumutsa moyo wanga. Zinali zovuta kuti ndione chizunzo, ndipo fungo loipa m'chipindacho linali kundiyambitsa misala.

Kupyola nthawi ya chithandizo, agogo aja adasinthanso momwe akumvera. Ananenanso kuti miyendo yake sikupweteka komanso zilonda zake sizinayende; sabata yamawa tidzapita ku ofesi ya dotolo. Falitsa ulalo wa nkhaniyo

Kuchita kwa insulin ya ultrashort kumachitika nthawi yomweyo. Uku ndiye kusiyana kwake kwakukulu: wodwalayo sayenera kudikirira kuti nthawi yake iperekedwe kuti mankhwalawo akhale ndi mphamvu. Amalembera odwala omwe samathandizira insulin yofulumira.

Horona yofunikira kwambiri imapangidwa kuti izitha kuthandiza odwala matenda ashuga kuti azitha kudya zakudya zamafuta nthawi ndi nthawi, makamaka maswiti. Komabe, kwenikweni, izi siziri choncho.

Zakudya zam'mimba zilizonse zosavuta zimachulukitsa shuga posachedwa kuposa momwe insulin yothamanga imagwirira ntchito.

Ichi ndichifukwa chake zakudya zama carb zotsika mtengo ndizomwe zimayang'anira chisamaliro cha shuga. Kutsatira zakudya zomwe wodwalayo adwala, wodwalayo amatha kuchepetsa mwayi wovuta kwambiri.

Ultrafast insulin ndi mahomoni amunthu omwe ali ndi mawonekedwe osinthika. Itha kugwiritsidwa ntchito pa matenda a shuga 1 ndi mtundu 2, komanso amayi apakati.

Monga mankhwala aliwonse, insulin yochepa imakhala ndi mphamvu ndi zofooka zake.

mtundu uwu wa insulin umatsitsa magazi kukhala wabwinobwino popanda kupangitsa hypoglycemia,
Khola shuga
ndizosavuta kuwerengetsa kukula ndi kapangidwe ka gawo lomwe lingadyedwe, ikatha nthawi yoikika jekeseni,
Kugwiritsa ntchito mitundu yamtunduwu kumalimbikitsa kuyamwa kwabwino pakudya, ndikutsimikizira kuti wodwalayo amatsatira zakudya zomwe adalandira.

Timapereka kuchotsera kwa owerenga tsamba lathu!

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"

Humalog 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 amagwira ntchito omwe 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.

Kukonzekera mwachangu kwa insulin kumapangidwira kwa odwala matenda ashuga ngati mankhwala. Kuti tikwaniritse chithandizo chokwanira, kutsatira kwambiri dosing, kutsatira zakudya ndizofunikira. Kusintha kuchuluka kwa mahomoni omwe amaperekedwa, kusintha imodzi ndi inzake kumatheka pokhapokha povomerezana ndi adokotala.

Matenda a shuga nthawi zonse amayambitsa zovuta zakupha. Mwazi wamagazi ochulukirapo ndi woopsa kwambiri.

A Alexander Myasnikov mu Disembala 2018 adapereka chidziwitso chokhudza chithandizo cha matenda ashuga. Werengani kwathunthu

Mu pharmacology, ma insulin ndi mahomoni apadera omwe amakupatsani mwayi wowongolera kuchuluka kwa shuga m'magazi. Makampani amakono azamankhwala, mankhwalawa amapangidwa m'njira zazikulu. Amasiyana mumtundu wa zowonjezera, njira zakukonzekera komanso nthawi yayitali. Kutchuka kwambiri ndi insulin yochepa.Mankhwalawa amapangidwira kuti matendawa akhazikike msanga, komanso angagwiritsidwe ntchito pochiza matenda ashuga.

Ma insulin omwe amagwira ntchito mwachidule amakhala osungunuka ndipo amatha kusintha mwachangu momwe kagayidwe kachakudya mthupi la munthu kamalumikizana ndi mayamwidwe a shuga. Mosiyana ndi ma insulin omwe amakhala nthawi yayitali, kukonzekera kwakanthawi kwamahomoni kumakhala ndi njira yofananira yokhala ndi mahomoni omwe mulibe zowonjezera zina. Chowoneka mosiyanitsa ndi mankhwalawa ndikuti amayamba kugwira ntchito mwachangu ndipo m'nthawi yochepa amatha kutsitsa shuga m'magazi kuti akhale abwinobwino. Zochita zake zapamwamba za mankhwalawa zimawonedwa pafupifupi maola awiri pambuyo pokhazikitsa, ndiye kuti pakukula kwakeko mwachangu. Pambuyo maola asanu ndi limodzi m'magazi pamakhala zinthu zochepa zomwe zimayendetsedwa ndi mahomoni. Mankhwalawa amawagawa m'magulu otsatirawa kutengera nthawi yomwe akuchita:

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

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

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

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

Zonsezi, ndi njira ina zomwe zimafanana kwathunthu ndi mahomoni amunthu wachilengedwe, chifukwa chake zimakhala ndi kuchepetsa shuga. Mosiyana ndi mankhwala omwe akhala akugwiritsidwa ntchito kwa nthawi yayitali, alibe zinthu zina zilizonse zowonjezera, chifukwa chake sizimayambitsa zovuta zilizonse. Kukhalabe ndi shuga yabwinobwino mwa odwala omwe ali ndi matenda a shuga, ma insulin osakhalitsa, omwe amaperekedwa pafupifupi theka la ola musanadye, nthawi zambiri amagwiritsidwa ntchito. Ndikofunikira kumvetsetsa kuti wodwala aliyense ali ndi mawonekedwe ake a thupi, chifukwa chake, kuwerengera kwa kuchuluka kwa mankhwala kumachitika nthawi zonse ndi dokotala. Kuphatikiza apo, ndikofunikira kuti kuchuluka kwa zakudya zomwe zimatengedwa ndizofanana ndi mlingo wa insulin. Malamulo oyambira kuperekera mankhwala a mahomoni musanadye motere:

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

Ultrashort insulin ndi analogue yosinthika ya insulin ya anthu, izi zikufotokozera kuthamanga kwazotsatira zake. Mankhwalawa adapangidwa ndi cholinga chothandizidwa mwadzidzidzi kwa munthu yemwe wakumanapo ndi shuga m'magazi pazifukwa zosiyanasiyana. Ichi ndichifukwa chake sagwiritsidwa ntchito kawirikawiri pachipatala chovuta kwambiri cha matenda ashuga. Jakisoni wa insulin ya ultrashort imalimbikitsidwanso panthawi yomwe munthu alibe mwayi woti adikire kwakanthawi asanadye. Koma pazikhalidwe zokhala ndi zakudya zoyenera, mankhwalawa samalimbikitsidwa kuti atengedwe, chifukwa chakuti imatsika kwambiri chifukwa chochokera pamtengo wambiri, kotero ndizovuta kwambiri kuwerengera mlingo woyenera.

Ma insulin amfupi ndi a ultrashort amagwiritsidwa ntchito kwambiri masiku ano pomanga thupi. Mankhwala osokoneza bongo amawonedwa ngati othandizira kwambiri a anabolic.Chomwe chimagwiritsidwa ntchito pomanga thupi ndichakuti insulini ndi mahomoni oyendera omwe amatha kugwira glucose ndikupereka kwa minofu yomwe imayankha izi zikukula mwachangu. Ndikofunikira kuti othamanga azitha kugwiritsa ntchito mankhwala a mahomoni pang'onopang'ono, potero amazolowera thupi ku mahomoni. Popeza kukonzekera kwa insulini ndi mankhwala olimbitsa thupi mwamphamvu kwambiri, ndizoletsedwa kuwatengera ngati achinyamata othamanga.

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

mu minofu ya minofu
mu mafuta m'thupi.

Pankhaniyi, ngati mankhwala a mahomoni atengedwa molakwika, ndiye kuti simungathe kupanga minofu yokongola, koma kuyipa koyipa. Tiyenera kukumbukira kuti mukamalandira mankhwalawa, kuphunzitsa kuyenera kukhala kothandiza. Pokhapokha pokhapokha, timadzi ta mayendedwe timatulutsa shuga ku minofu yotukuka. Kwa wosewera aliyense yemwe akuchita masewera olimbitsa thupi, mlingo umaperekedwa payekhapayekha. Amakhazikika pambuyo poyesa kuchuluka kwa shuga m'magazi ndi mkodzo.

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

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

Tikulimbikitsidwa kuti ma horoni wothandizirana alowetse m'mimba m'mimba atangophunzitsidwa mphamvu. Muyenera kuyamba ndi Mlingo wocheperako ndipo nthawi yomweyo muyenera kuwunika momwe thupi limayambira. Pafupifupi kotala la ola pambuyo pa jakisoni, chinthu chokoma chiyenera kudyedwa. Chiŵerengero cha mafuta ogwiritsika ntchito kwa gawo lomwe mankhwalawo amaperekedwa ayenera kukhala 10: 1. Pambuyo pake, pambuyo pa ola limodzi muyenera kudya bwino, ndipo chakudyacho chizikhala ndi zakudya zomwe zili ndi mapuloteni ambiri.

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

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

Pambuyo pakuwoneka chimodzi mwazizindikirozi, muyenera kumwa mwachangu kuchuluka kwa chakumwa chokoma, ndipo mutatha theka la ola limodzi mumatha kudya gawo la chakudya chomanga thupi. Komanso chizindikiro cham'mbali cha hypoglycemia ndikochitika kwa chikhumbo chogona. Palibe zovuta kuchita izi, popeza ndizotheka kukulitsa vutoli. Tiyenera kukumbukira kuti ndi mankhwala osokoneza bongo ambiri aifupi komanso a ultrashort, chikomokere chimatha kuchitika mwachangu kwambiri. Pofuna kutaya mtima ndi wothamanga, ndikofunikira kufunsa thandizo kuchipatala.

Ubwino wawukulu pokonzekera insulin mukamagwiritsa ntchito polimbitsa thupi ndikuti sangathe kuyesedwa pamayeso oyeserera. Insulin yochepa komanso ya ultrashort ndi mankhwala otetezeka omwe sangawononge molakwika kugwira ntchito kwamkati mwa ziwalo zamkati. Chofunikanso ndichakuti mankhwala amatha kugula popanda mankhwala komanso mtengo wake, poyerekeza ndi anabolics ena, ndi wotsika mtengo. Chofunika kwambiri pakukonzekera insulini, koma chofunikira kwambiri nthawi yomweyo, ndikofunikira kuwatenga motsatira ndondomeko yomwe dokotala wakhazikitsa.

Russell Jesse Mtundu Wachiwiri wa Matenda a shuga, Bukhu Lamavuto -, 2012. - 962 c.
Kamysheva, E. Insulin kukana matenda ashuga. / E. Kamysheva. - Moscow: Mir, 1977 .-- 750 p.
Danilova L.A. Kuyesa kwa magazi ndi mkodzo. St. Petersburg, Dean Publishing House, 1999, 127 pp., Kufalitsidwa makope 10,000.

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 webusayiti, kukambirana ndi akatswiri ndizofunikira nthawi zonse.

Gulu la insulin

Mwa chiyambi, insulin ndi:

Nkhumba. Amachotsedwa m'matumbo a nyama izi, zofanana kwambiri ndi munthu.
Kuchokera kwa ng'ombe. Nthawi zambiri pamakhala zovuta zina za insulin iyi, chifukwa zimasiyana kwambiri ndi ma cell aanthu.
Wamunthu Amagwiritsa ntchito mabakiteriya.
Umisiri wamtundu. Zimapezeka kuchokera ku nkhumba, pogwiritsa ntchito matekinoloje atsopano, chifukwa cha izi, insulin imakhala yofanana ndi anthu.

Pofika nthawi:

zochita za ultrashort (Humalog, Novorapid, etc.),
zochita zazifupi (Actrapid, Humulin Regular, Insuman Rapid ndi ena),
nthawi yayitali yochita (Protafan, Insuman Bazal, etc.),
wogwira ntchito kwa nthawi yayitali (Lantus, Levemir, Tresiba ndi ena).

Insulin yamunthu

Ma insulin afupia ndi a ultrashort amagwiritsidwa ntchito musanadye chilichonse kuti apewe kulumikizana ndi glucose komanso kusintha momwe mulili. .

Ultra yochepa komanso yochepa kuchita insulin

Kumbukirani kuti kufulumira kwa mankhwalawa kumayamba, kufupikitsa nthawi yake yochitapo kanthu. Ma insulin osakhalitsa pang'ono amayamba kugwira ntchito pambuyo pakudya kwa mphindi 10, chifukwa chake ayenera kugwiritsidwa ntchito musanadye kapena akangomaliza kudya. Amakhala ndi mphamvu kwambiri, pafupifupi nthawi ziwiri mwamphamvu kuposa mankhwala osokoneza bongo. Kutsitsa kwa shuga kumatenga pafupifupi maola atatu.

Mankhwalawa sagwiritsidwa ntchito kawirikawiri pachipatala chovuta kwambiri cha matenda ashuga, chifukwa momwe amawagwirira ntchito osalamulirika ndipo zotsatira zake zimakhala zosadalirika. Koma ndizofunikira ngati wodwala matenda ashuga adadya, ndikuyiwala kulowa insulin yochepa. Mothandizidwa ndi izi, jakisoni wa mankhwala a ultrashort amathetsa vutoli ndikuwonjezera msanga shuga.

Insulin yogwira ntchito yayifupi imayamba kugwira ntchito pambuyo pa mphindi 30, imaperekedwa kwa mphindi 15-20 musanadye. Kutalika kwa ndalamazi ndi pafupifupi maola 6.

Ndondomeko ya insulin

Mlingo wa mankhwala ochitika msanga amawerengedwa ndi dokotala, ndipo amakuphunzitsani za wodwalayo ndi njira ya matendawa. Komanso, mankhwalawa omwe angagwiritsidwe ntchito amatha kusinthidwa ndi wodwala malinga ndi kuchuluka kwa mkate womwe wagwiritsidwa ntchito. 1 unit yaifupi yogwira insulin imayambitsidwa pa 1 mkate. Kuchuluka kovomerezeka kamodzi kogwiritsidwa ntchito kamodzi ndi gawo limodzi pa kilogalamu imodzi ya kulemera kwa thupi; zovuta zazikulu zimatheka ngati mankhwalawa adapitilira.

Kukonzekera kwapafupipafupi ndi ultrashort kumayendetsedwa mosadukiza, kutanthauza kuti, m'matumbo amafuta ochulukirapo, izi zimapangitsa kuti magazi ayambe kuyenda pang'onopang'ono komanso mofananirana.

Kuti muwerenge molondola kuchuluka kwa insulin yochepa, ndikofunikira kuti odwala matenda ashuga asungireko diary komwe chakudya chimawonjezera (kadzutsa, nkhomaliro, etc.) akusonyeza, shuga atatha kudya, mankhwala omwe adathandizidwa ndi jekeseni ya shuga pambuyo pobayira. Izi zithandiza wodwalayo kuzindikira momwe mankhwalawo amakhudzira glucose makamaka mwa iye.

Ma insulin afupia ndi a ultrashort amagwiritsidwa ntchito pothandizidwa mwadzidzidzi pokonzekera ketoacidosis.Pankhaniyi, mankhwalawa amaperekedwa kudzera m'mitsempha, ndipo zimachitika nthawi yomweyo. Zotsatira zake mwachangu zimapangitsa mankhwalawa kukhala othandizira othandizira madokotala azadzidzidzi komanso malo othandizira odwala kwambiri.

Gome - Makhalidwe ndi mayina a kukonzekera kwapafupifupi ndi a insulin

Dzina lamankhwala	Mtundu wa mankhwala mwachangu	Mtundu wa mankhwala malinga	Zotsatira zoyambira	Kutalika kwa nthawi	Zochita zapamwamba
Apidra	Ultra lalifupi	Umisiri wamtundu	0-10 mphindi	Maola atatu	Mu ola limodzi
NovoRapid	Ultra lalifupi	Umisiri wamtundu	10-20 mphindi	Maola 3-5	Maola 1-3 pambuyo pake
Chichewa	Ultra lalifupi	Umisiri wamtundu	10-20 mphindi	Maola 3-4	Pambuyo maola 0,5-1,5
Khalid	Mwachidule	Umisiri wamtundu	Mphindi 30	Maola 7-8	Pambuyo maola 1.5-3,5
Gansulin r	Mwachidule	Umisiri wamtundu	Mphindi 30	Maola 8	Pambuyo maora 1-3
Humulin Wokhazikika	Mwachidule	Umisiri wamtundu	Mphindi 30	Maola 5-7	Pambuyo maora 1-3
Wofulumira GT	Mwachidule	Umisiri wamtundu	Mphindi 30	Maola 7-9	Pambuyo maola 4 - 4

Tiyenera kukumbukira kuti kuchuluka kwa mayamwidwe ndi kuyambika kwa mankhwala kumatengera zinthu zambiri:

Mlingo wa mankhwala. Mukachulukitsa kuchuluka kwake, zotsatira zake zimayamba msanga.
Tsamba la jakisoni. Kuthamanga kwambiri kumayamba ndikulowetsedwa pamimba.
Makulidwe a subcutaneous mafuta wosanjikiza. Ndikamakulirakulira, kumachepetsa mayamwa.

Insulin Yapakatikati ndi Yaitali

Mankhwalawa amathandizidwa ngati chithandizo choyenera cha matenda ashuga. Amathandizidwa tsiku lililonse nthawi yomweyo m'mawa komanso / kapena madzulo, osasamala chakudya.

Mankhwala a pafupifupi nthawi ya zochita zotchulidwa 2 pa tsiku. Zotsatira pambuyo jakisoni zimachitika mkati 1-1,5 maola, ndipo zotsatira zake zimakhala mpaka 20 maola.

Insulin yokhala nthawi yayitali, kapena kupitilira apo, imatha kutumikiridwa kamodzi patsiku, pali mankhwala omwe angagwiritsidwe ntchito ngakhale kamodzi masiku awiri. Zotsatira zimachitika pambuyo pa maola atatu pambuyo pa utsogoleri ndipo zimatha pafupifupi maola 24. Ubwino wa mankhwalawa ndikuti alibe chiwonetsero chazithunzithunzi, koma amapanga yunifolomu mosalekeza m'magazi.

Ngati jakisoni wa insulini amatchulidwa 2 pa tsiku, ndiye kuti 2/3 ya mankhwalawa imaperekedwa musanadye kadzutsa, ndipo 1/3 musanadye chakudya chamadzulo.

Gome - Zofanana ndi mankhwala ena apakati komanso nthawi yayitali yochitapo kanthu

Dzina lamankhwala	Mtundu wa mankhwala mwachangu	Zotsatira zoyambira	Kutalika kwa nthawi	Zochita zapamwamba
Humulin NPH	Yapakatikati	Ola limodzi	18-18 maola	2-8 maola pambuyo pake
Insuman Bazal	Yapakatikati	Ola limodzi	11-16 maola	Patatha maola 3-4
Protofan NM	Yapakatikati	1,5 ola	Kufikira maola 24	Pambuyo maola 4-12
Lantus	Chokhalitsa	Ola limodzi	Maola 24-29	—
Levemir	Chokhalitsa	Maola 3-4	Maola 24	—
Humulin	Chokhalitsa	Maola 3-4	Maola 24-30	—

Pali mitundu iwiri ya insulin.

Chachikhalidwe kapena Kuphatikiza. Zimadziwika chifukwa chakuti pali mankhwala amodzi okha omwe ali ndi mankhwala onse omwe amakhala ndi insulin. Ubwino wake ndi jakisoni ochepa, koma chithandizo chotere sichothandiza pochiritsa matenda ashuga. Ndi iye, kubwezeredwa kumakhala koyipa kwambiri ndipo zovuta zimachitika mwachangu.

Chithandizo chachikhalidwe chimaperekedwa kwa odwala okalamba komanso anthu omwe sangathe kuwongolera chithandizo ndikuwerengera kuchuluka kwa mankhwalawa. Izi zimaphatikizapo, mwachitsanzo, anthu omwe ali ndi vuto la m'maganizo kapena omwe sangathe kudzipereka.

Therapy Bolus. Ndi mtundu uwu wa mankhwalawa, mankhwala oyambira, opanga nthawi yayitali kapena wapakati, komanso osagwirizana ndi mankhwala omwe amapezeka jekeseni osiyanasiyana amalembedwa. Basis-bolus therapy imawonedwa ngati njira yabwino kwambiri yoperekera chithandizo, imawonetsa bwino katulutsidwe kamatenda a insulin ndipo, ngati zingatheke, imaperekedwa kwa odwala onse omwe ali ndi matenda osokoneza bongo.

Njira ya Insulin In injion

Jakisoni wa insulin amachitika pogwiritsa ntchito syringe ya insulin kapena cholembera. Zotsalazo ndizosavuta kugwiritsa ntchito mankhwalawo mosamala, motero zimakondedwa. Mutha kuperekanso jakisoni ndi cholembera popanda kuvula zovala zanu, zomwe ndi zosavuta, makamaka ngati ali kuntchito kapena ku sukulu yophunzitsa.

Cholembera cha insulin

Insulin imalowetsedwa m'matumbo a mafuta am'malo osiyanasiyana, nthawi zambiri imakhala patsogolo pa ntchafu, pamimba ndi phewa. Mankhwala omwe akhala akuchita kwa nthawi yayitali amakonda kubisala ntchafu kapena kunja kwa khola, kumangokhala pang'ono m'mimba kapena phewa.

Chofunikira ndikutsatira malamulo aseptic, ndikofunikira kusamba m'manja musanalowe jakisoni ndikugwiritsa ntchito syringes zokhazo. Kumbukirani kuti mowa umawononga insulini, chifukwa, pambuyo poti jekeseni wathandizidwa ndi antiseptic, ndikofunikira kudikirira mpaka kumira kwathunthu, kenako ndikupitilira ndi mankhwalawa. Ndikofunikanso kupatuka kuchokera pa malo omwe kale anali jekeseni osachepera 2 cm.

Mafuta a insulin

Njira yatsopano yochizira matenda a shuga ndi insulin ndi pampu ya insulin.

Pampu ndi chipangizo (pampu yomwe, palokha, chosungira ndi insulini ndi cannula poperekera mankhwala), pomwe insulin imaperekedwa mosalekeza. Izi ndi zina bwino pakubayidwa jakisoni tsiku lililonse. Padziko lonse lapansi, anthu ochulukirachulukira akusintha motere.

Popeza mankhwalawa amaperekedwa mosalekeza, ma insulin okhazikika pokhapokha kapena oyambira pang'ono omwe amagwiritsidwa ntchito pamapampu.

Pampu ya insulin

Zipangizo zina zimakhala ndi masensa ochepetsa mphamvu ya shuga, zimangoganiza za kuchuluka kwa insulin, kupatsidwa zotsalira za insulin m'magazi ndikudya. Mankhwalawa amachotsedwa mosavuta, mosiyana ndi kuyambitsa kwa syringe.

Koma njirayi ilinso ndi zovuta zake. Munthu wodwala matenda ashuga amadalira kwambiri ukadaulo, ndipo ngati pazifukwa zina chipangizocho chikutha (insulini yatha, batire yatha), wodwala amatha kudwala ketoacidosis.

Komanso, anthu omwe amagwiritsa ntchito pampu amayenera kupirira zovuta zina zomwe zimakhudzana ndi kuvala chida nthawi zonse, makamaka kwa anthu omwe akukhala ndi moyo wakhama.

Chofunikira ndichakuti mtengo wokwera kwambiri woperekera insulin.

Mankhwala samayima, mankhwala ochulukirachulukira atsopano, akumapangitsa moyo kukhala wosavuta kwa anthu omwe akudwala matenda ashuga. Tsopano, mwachitsanzo, mankhwala ozikidwa ndi kupuma kwa insulin akuyesedwa. Koma muyenera kukumbukira kuti ndi akatswiri okhawo omwe amatha kutumiza, kusintha mankhwala, njira kapena pafupipafupi kasamalidwe. Kudzipatsa nokha mankhwala a shuga kumakhala ndi zotsatirapo zoyipa kwambiri.

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.

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.

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.

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).

Actrapid NM

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%.

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.

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

Humulin Wokhazikika

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.

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.

Mayina a insulin	Kupanga	Chiwerengero cha magawo pokonzekera	Kuchuluka kwa yogwira 1 ml	Kutalika kwa nthawi
H wabwinobwino U-40	Insulin	Mmodzi	40 magawo	Kufikira maola 8 (kuyambira mphindi 15)
H basal U-40	Insulin ndi protamine	Mmodzi	40 magawo	Kufikira maola 20 (kuyambira mphindi 40)
H 10/90 U-40	Insulin ndi protamine	Awiri	4 mayunitsi	Kufikira maola 18 (yambani pambuyo pa mphindi 45)
H 20/80 U-40	Insulin ndi protamine	Awiri	Magawo 8	Kufikira maola 16 (yambani mu mphindi 40)
H 30/70 U-40	Insulin ndi protamine	Awiri	Magawo 12	Kufikira maola 15 (yambani mu mphindi 40)
H 40/60 U-40	Insulin ndi protamine	Awiri	16 magawo	D maola 15 (yambani pambuyo pa mphindi 45)

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.

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.

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.

Upangiri wa Katswiri ndi Nuances Ogwiritsira Ntchito

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.