Kugwiritsa ntchito mankhwala amakono a insulin

* Zowonjezera mu 2017 malinga ndi RSCI

Bukuli limaphatikizidwa mu Mndandanda wamabuku omwe asayansi anzawo amawunikiranso a High Higest Attestation Commission.

Werengani mu magazini yatsopano

Type 2 matenda a shuga a mellitus (DM) ndi matenda opita patsogolo omwe amafunikira kulimbitsa kosalekeza kwa shuga kuti azisamalira chiwongolero cha glycemic kuti muchepetse chiwopsezo cha kukula ndi kupitilira kwa zovuta za mochedwa. Pazaka 15 zapitazi, magulu angapo atsopano a mankhwala ochepetsa shuga adapangidwa ndikuyamba kuyesedwa kuchipatala, kuphatikizapo mankhwala a insulin analogues ya nthawi yayitali komanso yapamwamba kwambiri. Nkhani zosankha regimen ndi insulin kukonzekera poyambitsa ndikuwonjezera chithandizo kwa odwala omwe ali ndi matenda a shuga a 2 ndizosokoneza. Ndemanga iyi ikufotokoza malingaliro a American Diabetes Association ndi European Association for the Study of Diabetes Mellitus pakuyambitsidwa ndi kulimbikitsa kwa insulin mankhwala kwa odwala omwe ali ndi matenda a 2 matenda a shuga, kuphatikizapo kugwiritsa ntchito mitundu ya ultrashort insulin.
Mankhwala ndi ma regimens othandizira odwala matenda ashuga a mtundu wa 2 sayenera kungothandizanso kuwongolera glycemic, komanso kuwonjezera kukhutira kwa wodwala ndi mankhwalawa ndikuwongolera moyo wawo. Mankhwala a pharmacokinetic ndi pharmacodynamic amakono a insulin analogs amachititsa kuti azitha kutsanzira kutulutsa kwachilengedwe kwa mahomoni pachiwopsezo chochepa chokhala ndi mayiko a hypoglycemic, kuti akwaniritse ndikusunga magawo a glycemic.

Mawu osakira: insulin glulisin, "basal +" regimen, basal-bolus insulin, mtundu 2 matenda a shuga.

Mwachitsanzo: I.V. Glinkina Kugwiritsa ntchito njira zamakono zopangira insulin mu matenda a matenda a shuga 2 mellitus // Khansa ya m'mawere. Kubwereza Kwachipatala. 2019.Palibe 1 (I). S. 26-30

Kugwiritsa ntchito njira zamakono kwambiri za insulin yocheperako pochizira matenda a shuga 2

I.V. Glinkina

University of Sechenov, Moscow

Type 2 matenda a shuga a mellitus (DM2) ndi matenda opita patsogolo omwe amafunikira kulimbikitsidwa kosalekeza kwa shuga kuti azisamalira chiwopsezo cha glycemic kuti muchepetse chiwopsezo cha kukula ndi kupitilira kwa zovuta zaposachedwa. Pazaka 15 zapitazi, magulu angapo atsopano a mankhwala ochepetsa shuga adapangidwa ndikuyamba kuyesedwa kuchipatala, kuphatikizapo onse omwe amakhala okalamba komanso osachedwa kuchita insulin analog. Kusankha kwa insulini regimen ndi mankhwala oyambira ndikuwonjezera mphamvu kwa odwala omwe ali ndi matenda a shuga 2 ndizovuta. Malangizo a American Diabetes Association ndi European Association for the Study of Diabetes pakuyambitsa komanso kutumiza insulin mankhwala kwa odwala omwe ali ndi matenda a shuga 2, kuphatikiza kugwiritsa ntchito mankhwala osokoneza bongo a insulin, omwe takambirana mu ndemanga iyi.
Mankhwala ndi ma regimens othandizira omwe amagwiritsidwa ntchito mu DM2 sayenera kungoyendetsa glycemic control, komanso kuwonjezera kukhutitsidwa kwa wodwala ndi mankhwalawa ndikuwongolera moyo wabwino. Pharmacokinetic ndi pharmacodynamic katundu amakono a insulin analog amalola kutsata kuteteza kwachilengedwe kwa mahomoni mpaka pazotheka momwe angathere ndi chiopsezo chochepa cha matenda a hypoglycemic, ndikukwaniritsa ndikusunga magawo a glycaemia.

Mawu osakira: insulin, glulisine, "basal +" mode, basal-bolus insulin, mtundu 2 matenda a shuga.
Mwachitsanzo: Glinkina I.V. Kugwiritsa ntchito njira zamakono kwambiri za insulin yocheperako pochizira matenda a shuga 2. RMJ. Kubwereza Kwachipatala. 2019.1 (I): 26-30.

Ndemanga iyi ikufotokoza malingaliro a American Diabetes Association ndi European Association for the Study of Diabetes mellitus pakuyambitsidwa ndi kulimbikitsa kwa insulin mankhwala kwa odwala omwe ali ndi matenda a shuga 2, kuphatikiza kugwiritsa ntchito mapangidwe a insulin.

Kukhazikitsa jakisoni

Malinga ndi malingaliro omwe adasinthidwa a ADA / EASD, nthawi zambiri, jakisoni wothandiziridwa amalimbikitsidwa ngati kuphatikiza kawiri kapena katatu kwa BSC sikugwira ntchito, pomwe aHPP-1 akulimbikitsidwa ngati mzere woyamba, ngati sanalembedwe kale. Wodwala akamaonetsa zizindikiro za kuchepa kwa metabolic kapena HbA1c> 10% (kapena kuposa 2% pamwamba pa chandamale), tikulimbikitsidwa kuti muganizire za kuyamba ndi insulin. Komabe, polingalira kuchuluka kotsika kwa kupezeka kwa aHPP-1 ku Russian Federation, chifukwa cha mtengo wawo wokwera, kulimbikitsidwa kwa njira yochepetsera shuga pamlingo wokulirapo wa odwala kunachitika ndipo akuyenera kuchitika poyambitsa chithandizo cha insulin. Mukamaganiza za kuperekera insulini, tikulimbikitsidwa kuti basal insulin, yolimba yoletsa mphamvu ya chiwindi mu chiwindi, iwonjezeke ku CSP yothandizira, yomwe imachepetsa kwambiri kusala kwa glycemia, ndipo izi zikuthandizira kuchepetsa glycemia masana.

Pakalipano, pafupifupi basal insulin yonse yokonzekera ikupezeka ku Russian Federation: kalasi ya ndewu ya Hagedorn yosafunikira (NPH-insulin), komanso njira yayitali yochitira ndi insulini - insulini, insulin glargine pamagawo awiri (100 PIECES / ml kapena 300 PIECES / ml) ndi insulin degludec (100 PIECES / ml). Mankhwalawa amasiyana pakapita nthawi, zomwe zimapangitsa kuti pakhale kusiyana kwama pafupipafupi pakukonzekera (1 r. / Day kapena 2 r. / Day). Mankhwala osokoneza bongo a insulin analogue amakhala ndi chiopsezo chochepa cha hypoglycemia poyerekeza ndi ya NPH-insulin, yomwe imakhala yabwino kwa odwala omwe ali ndi chiwopsezo cha mtima kapena CVD. Hypo pafupipafupi
glycemia pa insulin glargine mankhwala 300 IU / ml yotsika kuposa insulin glargine mankhwala 100 IU / ml. Kuphatikiza apo, kugwiritsa ntchito insulin glargine yozama (300 IU / ml) kungachepetse kuchuluka kwa insulini yoyendetsedwa, yomwe imakhala yabwino kwa odwala omwe ali ndi mafuta akuchulukirapo omwe amalandila 6,8. Chimodzi mwazinthu zikuluzikulu zakukwaniritsa zomwe mukufuna mu glycemic control mutayamba basal insulin chithandizo ndicho kugawa kwake kwakanthawi. Izi zimatheka pokhapokha pophunzitsa wodwalayo kudzipatula, zomwe zingatheke pogwiritsa ntchito algorithm yosavuta komanso yomveka.

Komabe, si odwala onse omwe ali ndi matenda amtundu wa 2 omwe ali ndi chiwonjezeko cha kuchepetsa shuga pakuwonjezera insal insulin kuti akwaniritse chandamale cha HbA1c. Makamaka, odwala omwe ali ndi kiwango chachikulu cha HbA1c, onenepa kwambiri kapena onenepa kwambiri, ali ndi nthawi yayitali matenda ndipo akhala akuphatikiza mankhwalawa kwa ma SSP angapo kwa nthawi yayitali, amafunikira kulimbikitsidwa kwambiri ndi chithandizo cha hypoglycemic nthawi yoyamba.

Ultrashort insulin Humalog, NovoRapid ndi Apidra. Insulin yochepa yaumunthu

Insulin yochepa yaumunthu imayamba kuchita mphindi 30-45 jakisoni, komanso mitundu yaposachedwa ya ultrashort ya insulin Humalog, NovoRapid ndi Apidra - ngakhale mwachangu, pambuyo pa mphindi 10-15.

Humalog, NovoRapid ndi Apidra sizomwe zili insulin yaumunthu, koma ma analogues, omwe amasinthidwa, amawongolera poyerekeza ndi insulin ya anthu enieni.

Chifukwa cha kachitidwe kawo kosinthika, amayamba kutsitsa shuga m'magazi mofulumira atalowa m'thupi.

Ma Ultrashort insulin analogue adapangidwa kuti azitha kupanikiza msana shuga wamagazi omwe amachitika pamene wodwala matenda ashuga akufuna kudya chakudya champhamvu kwambiri. Tsoka ilo, malingaliro awa sagwira ntchito, chifukwa shuga amadumpha kuchokera ku zinthu zoletsedwa ngati misala.

Ndi kulowa msika wa Humalog, NovoRapid ndi Apidra, timapitilizabe kutsatira zakudya zamafuta ochepa.

Timagwiritsa ntchito mankhwala a insulin oti insulin ingachepetse shuga kuti ikhale yokhazikika ngati ilumpha mwadzidzidzi, komanso mwa apo ndi apo pamikhalidwe yapadera musanadye, ndikakhala osavomerezeka kudikirira mphindi 40-45 musanadye.

Jekeseni wa insulin yochepa kapena ya ultrashort musanadye chakudya chofunikira kwa odwala omwe ali ndi matenda amtundu wa 2 kapena shuga, omwe ali ndi shuga yayikulu magazi atatha kudya. Amaganiziridwa kuti mukutsatira kale zakudya zamagulu ochepa, ndipo mwayesanso mitundu iwiri ya mapiritsi a shuga, koma njira zonsezi zangothandizapo pang'ono. Dziwani zambiri za matenda ashuga amtundu 2 komanso matenda amtundu 1 shuga.

Monga lamulo, zimamveka bwino kwa odwala omwe ali ndi matenda a shuga a 2 kuti ayesere kuchitira mankhwala okhawo omwe ali ndi insulin, monga tafotokozera m'nkhaniyi kuti "Insulin Lantus ndi Glargin." Medi-NPH-Insulin Protafan. "

Mwina kapamba wanu wa insulin yemwe amakhala nthawi yayitali amapuma bwino ndipo amakwaniritsidwa kotero kuti amatha kuzimitsa shuga m'magazi mutatha kudya, popanda jakisoni wowonjezera wa insulin musanadye.

Mulimonsemo, lingaliro lomaliza lomwe insulin imayendetsa, nthawi yayitali komanso pati, ndipo imayikidwa pokhapokha potsatira kuwunika kwathunthu kwa shuga osachepera masiku 7. Njira yothandizira ya insulini imangokhala payekha.

Kuti apange, adotolo ndi wodwala payekha ayenera kuyesera zochulukirapo kuposa kuti onse omwe ali ndi matenda ashuga alembe malangizo omwewa a jekeseni awiri a insulin patsiku. Tikukulimbikitsani kuti muwerenge nkhaniyi: “Ndi mtundu wanji wa insulini kuti mupeze jakisoni, munthawi yanji komanso mukutulutsa chiyani.

Njira za matenda a shuga 1 ndi matenda ashuga a 2. ”

Momwe mungathanirane ndi matenda ashuga omwe ali ndi insulin yochepa kapena yochepa kwambiri

Ultrashort insulini imayamba kugwira ntchito thupi isanakhale ndi nthawi yolowa mapuloteni ndikusintha ena mwa iwo kukhala glucose. Chifukwa chake, ngati mumatsatira zakudya zamafuta ochepa, insulin yochepa ndiyabwino kuposa Humalog, NovoRapid kapena Apidra musanadye.

Insulin yochepa iyenera kuperekedwa kwa mphindi 45 musanadye. Ino ndi nthawi yoyenera, ndipo wodwala aliyense yemwe ali ndi matenda ashuga amafunika kumafotokozera yekha payekha. Momwe mungachite, werengani apa. Kuchita mwachangu kwamtundu wa insulin kumatenga pafupifupi maola asanu.

Ino ndi nthawi yeniyeni yomwe anthu nthawi zambiri amafunika kugaya chakudya chomwe amadya.

Timagwiritsa ntchito mankhwala a "cellash" a "cell" mwadzidzidzi kuti achepetse shuga kuti akhale bwino ngati angulumuke mwadzidzidzi. Mavuto a shuga amakula pomwe shuga m'magazi amakwezedwa.

Chifukwa chake, timayesetsa kutsitsa kuti zikhale zabwinobwino mwachangu, ndipo kwa insulini yocheperako ndiyabwino kuposa yochepa. Ngati muli ndi matenda amtundu wachiwiri wa shuga, ndiye kuti, shuga wokwera msanga amakhala yekha, ndiye kuti simukufunika kuti mupeze insulin yowonjezera kuti muchepetse.

Kungoyang'anira shuga kwathunthu kwa masiku angapo otsatizana kumathandizira kumvetsetsa momwe shuga ya magazi imakhalira mwa wodwala yemwe ali ndi matenda ashuga.

Mitundu ya insulin yochepa kwambiri - imachita zinthu mwachangu kuposa aliyense

Mitundu ya insulashort ya insulin ndi Humalog (Lizpro), NovoRapid (Aspart) ndi Apidra (Glulizin). Amapangidwa ndi makampani atatu osiyanasiyana azachipatala omwe amapikisana nawo.

Insulin yochepa yofananira ndi yaumunthu, ndipo ma ultrashort ndi ma analogi, i.e. amasinthidwa, kusinthidwa, poyerekeza ndi insulin yeniyeni ya anthu.

Kusintha kuli potengera kuti amayamba kutsitsa shuga wamagazi ngakhale othamanga kuposa amfupi - mphindi 5 mpaka jakisoni.

Ma Ultrashort insulin analogi adapangidwa kuti achepetse kuchepa kwa shuga m'magazi pamene munthu wodwala matenda ashuga akufuna kudya chakudya champhamvu kwambiri. Tsoka ilo, malingaliro awa sagwira ntchito.

Zakudya zopatsa mphamvu, zomwe zimamwe nthawi yomweyo, zimakulitsa shuga m'magazi mwachangu kwambiri kuposa momwe insulin yaposachedwa kwambiri imatsikira. Ndi kukhazikitsidwa kwa mitundu yatsopanoyi ya insulin pamsika, palibe amene adaletsa kufunika kotsatira zakudya zamafuta ochepa ndikutsatira njira zopepuka.

Inde, muyenera kutsatira regimen pokhapokha ngati mukufuna kuwongolera matenda ashuga komanso kupewa zovuta zake.

Ngati mutsatira zakudya zamafuta ochepa a 1 kapena 2 shuga, ndiye kuti insulin yayifupi ya anthu ndiyabwinobwino jakisoni musanadye kuposa anzanu apambuyo pake.

Chifukwa odwala omwe ali ndi matenda ashuga omwe amadya zakudya pang'ono, thupi limayamba kugaya mapuloteniwo, kenako ndikusintha ena kuti akhale glucose. Uku ndikuchita pang'onopang'ono, ndipo insulin ya ultrashort imayamba kuchita zinthu mwachangu kwambiri.

Mitundu yayifupi ya insulin - kulondola. Nthawi zambiri amafunika kuti akhazikitsidwe mphindi 40-45 musanadye chakudya chamafuta ochepa.

Komabe, kwa odwala matenda ashuga omwe amaletsa zakudya zamagulu m'zakudya zawo, ma enamel a ultrashort insulin amathanso kukhala othandiza.

Ngati muyeza shuga ndi glucometer ndikupeza kuti ilumpha, ndiye kuti insulini yochepa kwambiri imatsitsa mofulumira kuposa lalifupi. Izi zikutanthauza kuti zovuta za matenda ashuga zimakhala ndi nthawi yochepa kwambiri yopanga.

Mutha kubayanso insulin ya ultrashort, ngati mulibe nthawi yoti mudikire mphindi 45 musanayambe kudya. Izi ndizofunikira mu lesitilanti kapena paulendo.

Yang'anani! Maultrashort ma insulin ndi amphamvu kwambiri kuposa amfupi amodzi. Mwachindunji, 1 unit ya Humaloga imatsitsa shuga wamagazi pafupifupi 2,5 kuposa 1 unit ya insulin yochepa. NovoRapid ndi Apidra ndi olimba pafupifupi 1.5 nthawi kuposa insulin.

Uwu ndi muyeso wofanana, ndipo kwa wodwala aliyense wodwala matenda ashuga ayenera kudzipangira yekha poyesa ndi kulakwitsa. Momwemo, Mlingo wa ultrashort insulin analogs uzikhala wotsika kwambiri kuposa milingo yofanana ya insulin ya anthu.

Komanso, kuyesa kukuwonetsa kuti Humalog imayamba kuchita mwachangu mphindi 5 kuposa NovoRapid ndi Apidra.

Ubwino ndi kuipa kwa ultrashort insulin

Poyerekeza ndi mitundu yaifupi ya insulin yaumunthu, mitundu yatsopano ya ultrashort insulin imakhala ndi zabwino komanso zovuta. Amakhala ndi chiopsezo choyambirira, koma ndiye kuti magazi awo amatsika kuposa ngati mumabayidwa ndi insulin yochepa.

Popeza ma insulin a ultrashort ali ndi nsonga zakuthwa, ndizovuta kudziwa kuti ndi zakudya zingati zomwe muyenera kudya kuti shuga ya magazi ikhale yachilendo.

Kuchita bwino kwa insulin yochepa kumakhala bwino kwambiri pakulandidwa kwa chakudya ndi thupi, ngati mutsatira zakudya zamagulu ochepa owononga shuga.

Kumbali inayo, jakisoni wa insulin yocheperako ayenera kuchitika kwa mphindi 40-45 asanadye. Mukayamba kudya mwachangu, ndiye kuti insulin yayifupi sikhala ndi nthawi yochitapo kanthu, ndipo magazi a magazi amalumpha. Mitundu yatsopano ya insulin ya insulin imayamba kugwira ntchito mwachangu, mkati mwa mphindi 10-15 mutabayidwa.

Izi ndizothandiza kwambiri ngati simukudziwa nthawi yomwe muyenera kuyamba kudya. Mwachitsanzo, mukadzakhala malo odyera. Ngati mumadya zakudya zochepa zamafuta, tikulimbikitsani kuti muzigwiritsa ntchito insulin yochepa anthu musanadye nthawi yokhazikika.

Komanso khalani ndi insulin yochepa kwambiri pakakhala zochitika zapadera.

Zomwe tikuwonetsa zikuwonetsa kuti mitundu ya insulin yomwe imapangidwa ndi insulin imakhudzanso shuga ya magazi osakhazikika kuposa yochepa. Amachita zinthu mosalosera, ngakhale atamwa jakisoni wocheperako, monga momwe odwala matenda ashuga amatsata, akamatsata zakudya zamafuta ochepa, komanso makamaka ngati atabaya jekeseni wamkulu.

Onaninso kuti mitundu ya insulin ya insulin ndiyamphamvu kwambiri kuposa yayifupi. 1 unit ya Humaloga imatsitsa shuga wamagazi ndi pafupifupi 2,5 nthawi yolimba kuposa 1 unit ya insulin yochepa. NovoRapid ndi Apidra ndi olimba pafupifupi 1.5 nthawi kuposa insulin yochepa. Momwemo, mulingo wa Humalog uyenera kukhala pafupifupi 0,4 Mlingo wa insulin yayifupi, ndi mlingo wa NovoRapid kapena Apidra - pafupifupi mlingo wa ⅔.

Ichi ndi chidziwitso chofunikira kwambiri chomwe muyenera kufotokozera.

Cholinga chathu chachikulu ndikuchepetsa kapena kuletsa kwathunthu kudumpha m'magazi a magazi mutatha kudya. Kuti izi zitheke, muyenera kupereka jakisoni musanadye ndi nthawi yokwanira kuti insulini iyambe kuchita. Komabe, tikufuna kuti insulini iyambe kutsika shuga m'magazi mukamayamwa chakudya chikuyamwa.

Komabe, ngati mutabayira insulansi molawirira kwambiri, shuga wanu wamagazi amatsika mofulumira kuposa chakudya chomwe chimatha kukweza. Kuchita kumawonetsa kuti ndibwino kubaya insulini yochepa mphindi 40-45 musanayambe chakudya chamafuta ochepa. Kupatula ena ndi odwala omwe adwala matenda a diabetesic gastroparesis, i.e.

wosakwiya m'mimba atatha kudya.

Nthawi zambiri, koma amakumana ndi odwala omwe ali ndi matenda ashuga, momwe mitundu yochepa ya insulini pazifukwa zina imatengedwa m'magazi makamaka pang'onopang'ono. Ayenera kubayira insulin monga, maola 1.5 asanadye.

Zachidziwikire, izi sizabwino kwambiri. Afunika kugwiritsa ntchito ma analogi aposachedwa a ultrashort musanadye, othamanga kwambiri omwe ndi Humalog.

Tikutsimikizanso kuti anthu odwala matenda ashuga siamachitika mwadzidzidzi.

Kupitiliza nkhani yomwe mwawerengayi ndi tsamba "Momwe mungawerengere kuchuluka kwa insulin musanadye. Momwe mungachepetse shuga kuti ukhale wabwinobwino ndi jakisoni wa insulin yofulumira. "

Ziwerengero zamanyumba zikuchepa kwambiri chaka chilichonse! Russian Diabetes Association imati munthu m'modzi mwa anthu 10 m'dziko lathu ali ndi matenda a shuga. Koma chowonadi ndichakuti si matenda omwewo omwe amawopsa, koma zovuta zake ndi moyo womwe umawatsogolera. Kodi ndingathane bwanji ndi matendawa, akutero poyankhulana ... Phunzirani zambiri ... "

Mfundo yogwira ntchito

Ultrashort insulin ndiwothamanga kwambiri pakuchita kwawo.Atangoyendetsa, amachititsa kuti zikondazo zipange insulini, yomwe imamanga ndikuwongolera kuchuluka kwa shuga m'magazi. Nthawi yomweyo, iyenera kutumizidwa mutatha kudya. Ngati mutsatira malamulo onse ogwiritsira ntchito, simuyenera kugwiritsa ntchito mitundu ina ya insulini.

Insulin yocheperako pang'ono imakonda kugwiritsidwa ntchito kuti matenda a shuga achulukane. Ndi chithandizo chake, thanzi lake limabwezeretsedwa m'mphindi zochepa chabe.

Insulin yochepa - ndi chiyani?

Insulin yochita ntchito mwachidule ndi njira yochepetsera shuga yomwe imayendetsa kagayidwe kake m'thupi.

Kuphatikizika kwa mankhwalawa kumaphatikizapo yankho loyera la mahomoni, lomwe mulibe zina zowonjezera zomwe zimathandizira thupi.

Gulu la ochita zinthu mwachidule limachita zinthu mwachangu kuposa ena, koma nthawi yonse yomwe ntchito zawo ndi zazifupi.

Mankhwala osokoneza bongo amapezeka mu Mbale zagalasi losindikizidwa, losindikizidwa ndi zoletsa ndi ma aluminium processing.

Zotsatira za insulin yochepa m'thupi limodzi ndi:

kuponderezana kapena kukondoweza kwa ma enzyme ena,
kutsegula kwa kapangidwe ka glycogen ndi hexokinase,
kuponderezedwa kwa lipase yothandizira mafuta acids.

Mlingo wa secretion ndi biosynthesis zimadalira kuchuluka kwa shuga m'magazi. Ndi kuwonjezeka kwa msinkhu wake, njira zopangira insulin mu kapamba zimachulukirachulukira, komanso, ndikuchepa kwa ndende, katulutsidwe kamachepa.

Mayina Mankhwala Osokoneza bongo

Ultrashort insulin ikufalikira tsiku lililonse. Mwa zofanizira, ndizatsopano kwambiri, kufufuza kumachitika nthawi zonse kwa ife. Nthawi zambiri, akatswiri amapereka mankhwala a Humulin, Insuman Rapid, Homor, Actrapid.

Muzochita zawo, ndizofanana ndi mahomoni achilengedwe. Kusiyana kwawo kokhako ndikuti angagwiritsidwe ntchito koyamba komanso mtundu wachiwiri wa matenda ashuga. Amathanso kutengedwa panthawi yomwe ali ndi pakati, kwa odwala atachitidwa opaleshoni komanso ndi ketoocytosis.

Wotchuka kwambiri pakati pa ma insulin onse oyambira-pang'ono ndi Humalog. Sichimayambitsa zotsatira zoyipa, zimadzikhazikitsa ngati chida chothandiza kwambiri.

Pafupipafupi, odwala amatchulidwa Novorapid ndi Apidra. Iwo ndi yankho la liproinsulin kapena glulisin insulin. Onsewa ndi ofanana pochita ndi organic. Atangoyendetsa makina, amatsitsa shuga m'magazi, kusintha moyo wa munthu.

Gulu Lachidule la Insulin

Malinga ndi nthawi ya insulin yocheperako ndi:

Pofupikitsa (sungunuka, oyang'anira) insulin - chitani pambuyo pakatha theka la ola, choncho tikulimbikitsidwa kuti muzigwiritsa ntchito mphindi 40-50 musanadye. Tizilombo tambiri tomwe timagwira mu mtsempha wamagazi timafika patatha maola awiri, ndipo titatha maola 6 okha mankhwalawa amatsalira m'thupi. Zovala zazifupi zimaphatikizira mafuta osungunuka amtundu wa anthu, mafuta osungunuka a semisynthetic ndi nkhumba zosungunulira zina zosungunulira.
Ultrashort (waumunthu, wa analog) wosungira - ayambe kusokoneza thupi pambuyo pakatha mphindi 15. Zochita zapamwamba zimapezekanso patatha maola angapo. Kuchotsa kwathunthu kwa thupi kumachitika pambuyo pa maola anayi. Chifukwa chakuti ultrashort insulin imakhudzanso zolimbitsa thupi, kukonzekera komwe kumakhalapo kumatha kugwiritsidwa ntchito mphindi 5-10 musanadye kapena mukangodya. Mankhwala amtunduwu amatha kuphatikizira insulin ndi insulin yopanga anthu.

Dziwani kuti insulin yapamwamba kwambiri imafanana ndi kusintha kwachilengedwe kwa thupi la munthu ndikukula kwa shuga wamagazi atatha kudya. Chifukwa chake amayenera kumwedwa nthawi yochepa asanadye kapena akangomaliza kudya.

Bweretsani ku nkhani

Ubwino ndi zoyipa

Ngati tiyerekeza insulin yocheperapo pang'ono ndi mitundu ina ya mankhwalawa, ili ndi zabwino zambiri. Imagwira, koma imatulutsidwa msanga m'thupi.

Insulin yomwe imagwira ntchito mwachidule imayendetsedwa pang'onopang'ono, pomwe imakhalapobe mthupi. Ndi mtundu wochepa kwambiri wa mankhwalawa, ndikosavuta kudziwa kuchuluka kwa zakudya zomwe muyenera kudya.

Komanso, ndi insulin yochepa kwambiri, simukuyenera kudziwa nthawi yomwe mukufuna kudya. Ndikokwanira kulowa mankhwalawo mwachindunji kapena osachepera mphindi 10 musanadutse. Izi ndizothandiza kwambiri kwa anthu omwe sangakhale ndi dongosolo lokhazikika. Imagwiritsidwanso ntchito pazinthu zadzidzidzi pakafunika kuchepetsa kukhumudwa kwa odwala matenda ashuga.

Momwe mungawerengere mlingo?

Mlingo wofanana wa kuchuluka kwa insulin ya ultrashort zimatengera mawonekedwe amthupi ndi njira ya matendawa.

Choyamba, katswiri amayenera kuwunika mkhalidwe wa kapamba: momwe aliri wathanzi, kuchuluka kwa insulin yomwe imapangidwa.

Katswiri amafunika kudziwa kuti ndi mahomoni angati pa 1 makilogalamu angapo omwe amapangidwa patsiku. Chiwerengerocho chimagawika pawiri, kenako mlingo umatsimikiza. Mwachitsanzo: munthu amene ali ndi matenda ashuga amalemera 70 kg. Chifukwa chake, akuyenera kugwiritsa ntchito 35 U ya insulini yocheperako-pang'onopang'ono kuti thupi lake lizigwira ntchito moyenera.

Ngati kapamba akakhala kuti akhoza kugwira ntchito payokha, ndiye kuti insulin yotsalira pang'ono imasakanizidwa ndi nthawi yayitali kuchuluka kwa 50 mpaka 50 kapena 40 - 60 - katswiriyo ndi amene amafufuza kuchuluka kwake. Kumbukirani kuti mudzafunika kuchita mayeso pafupipafupi kuti musinthe mankhwalawo nthawi zonse.

Kumbukirani kuti tsiku lonse, kufunika kwa insulin kumasintha. Mwachitsanzo, m'mawa amakhala kuti amadya kawiri kuposa mkate. Madzulo, chokwanira ichi chimatsikira mpaka 1.5, ndipo madzulo - mpaka 1.25.

Musaiwale kusinthasintha njira zamankhwala ngati mukuchita masewera olimbitsa thupi kapena ngati mukuchita masewera olimbitsa thupi. Ngati muli ndi katundu wocheperako, ndiye kuti palibe chifukwa chosinthira mlingo. Ngati shuga ali pamlingo wabwinobwino, ndiye kuti magawo atatu a buledi amawonjezeredwa pa mlingo womwe waperekedwa.

Njira yolandirira

Ngakhale kutetezeka kwake konse, mukamagwiritsa ntchito insulin ya ultrashort, mumafunikabe kutsatira malamulo ndi zina zingapo zofunika.

Musaiwale za malingaliro otsatirawa:

Mankhwala amaperekedwa nthawi yomweyo musanadye,
Pobayira, gwiritsani ntchito syringe yapadera,
Ndikofunika kuperekera mankhwalawa m'mimba kapena matako,
Pamaso jakisoni, phatikizani jekeseni mosamala,
Pitani ku dokotala wanu pafupipafupi kuti ayang'anire kusintha konse.

Dziwani kuti kugwiritsa ntchito insulin yocheperako-pang'onopang'ono kuyenera kukhala kwachizolowezi: imachitika muyezo womwewo, pafupifupi nthawi yomweyo. Malo oyang'anira mankhwalawa amasinthidwa bwino nthawi zonse kuti aletse mabala owawa.

Musaiwale kuti mankhwalawa amafunikira kusungidwa kwapadera. Muyenera kusunga ma ampouleswo pamalo ozizira pomwe dzuwa silifikako. Nthawi yomweyo, ma ampoules otseguka satha kusungidwa - apo ayi asintha malo ake.

Ngati mumadya moyenera komanso mokwanira, simuyenera kugwiritsa ntchito insulini yochepa kwambiri. Amagwiritsidwa ntchito pokhapokha ngati pakufunika kuchepetsa kuchuluka kwa shuga m'magazi posachedwa pofuna kupewa kukula kwa zovuta zazikulu.

Ngati mumanyalanyaza mfundo yoti kuchuluka kwanu kwa glucose ndikutalika kwa nthawi yayitali, kumayambitsa kusokonezeka kwakukulu mu mtima. Kumwa insulin yayifupi kwambiri kumathandizira kuti imveke pakapita mphindi. Pankhaniyi, simungamve chilichonse, mutha kubwerera kubizinesi yanu nthawi yomweyo.

Insulin yochepa pochiza matenda a shuga

Matenda a shuga amathandizira kupewa kukula kwa zovuta, kutalikitsa moyo wa anthu odwala matenda ashuga ndikuwongolera. Komanso, jakisoni wa mankhwalawa amachepetsa katundu pa kapamba, zomwe zimapangitsa kubwezeretsa pang'ono kwa maselo a beta.

Zoterezi zimatheka ndi mtundu wachiwiri wa matenda ashuga ndikukhazikitsa pulogalamu yoyenera ndikutsatira dongosolo lomwe dokotala walimbikitsa. Kubwezeretsa maselo a Beta ndikothekanso ndi matenda amtundu wa 1 pokhapokha mutapezeka kuti ali ndi vuto komanso njira zamankhwala zimatengedwa mwachangu.

Kodi odwala matenda ashuga azikhala ndi chiyani? Onani mndandanda wathu wazabwino sabata iliyonse pano!

Jakisoni wa insulin amayikidwa pa Mlingo wa 2-3 patsiku theka la ola musanadye. Mlingo wamba wa mankhwalawa umachokera kwa 10 mpaka 40 magawo patsiku.

Ndi chifuwa cha matenda ashuga, kuchuluka kwakukulu kwa mankhwalawa kumafunikira: makonzedwe a subcutaneous - kuchokera ku 100 PIECES komanso apamwamba, komanso kwa intravenous management - mpaka 50 PIECES patsiku.

Pochiza matenda amishuga a shuga, kuchuluka kwa insulini kumawerengeredwa molingana ndi kuopsa kwa matenda oyambitsidwa.

Nthawi zina, kuchuluka kwa ma horoni sikofunikira; mulingo wocheperako umalimbikitsidwa, koma nthawi zambiri.

Zotsatira zoyipa zazikulu pambuyo pa kupangidwira kwa othandizira m'madzi zimachitika pamene mulingo wotsatira mulibe kutsatiridwa. Izi zimaphatikizidwa ndi kuwonjezeka kwakukulu kwa insulin mumtsinje wamagazi.

Milandu yayikulu ikukwera kwamadzi mu mtsempha wamagazi (ngati palibe chakudya chamthupi), kukomoka kumatha kuchitika, komwe kumachitika chifukwa cha chikumbumtima komanso chikomokere.

Mankhwala onse omwe amakhala ndi ma insulin amtundu wa anthu kapena mawonekedwe awo ali ndi zofanana. Chifukwa chake, ngati kuli kotheka, zitha kusinthidwa, ndikuwona mlingo womwewo, ndi kufunsa kwa adokotala ndikofunikira. Chifukwa chake, kusankha kochepa kwa maina a insulin pang'ono komanso othamanga

Wotchuka kwambiri komanso mankhwala kuchita mwachidule ndi:

Yaifupi ndi ya insulin

Pafupifupi ndi ultrashort insulin 5 (100%) anavota 1

Matenda a shuga si matenda osangalatsa.

Ndipo kodi pali matenda ena osangalatsa konse? Izi oxymoron umaperekedwa apa pazifukwa - pambuyo pa zonse, mankhwalawa a shuga amatha kukhala osiyanasiyana, kuphatikizapo osapweteka. Zimatengera matenda enieni, mtundu wake komanso mawonekedwe ake.

M'nkhaniyi, tikufuna kuganizira njira imodzi yodziwika bwino yoletsera komanso kuchiza matenda ashuga - yochepa-insulin.

Kodi insulin ndi chiyani, mumafunsa? Ichi ndi mankhwala othandizira odwala matenda a shuga omwe amathandizira kuti muchepetse magazi, komanso amalimbikitsanso kuyamwa kwa glucose komanso kumakulitsa glycogeneis.

Tili ndi chidwi ndi insulin yochepa. Kupatula apo, ndi mtundu uwu wamankhwala omwe amakupatsani mwayi kuti mupewe msanga komanso munthawi yake kupewa kuchuluka kwa shuga m'magazi, zomwe zikutanthauza kuti muimitse zopweteka pakapita nthawi.

Zochita zazifupi ndi za insulin

Mwachizolowezi, insulin yofulumira ndi mtundu wa insulin, kapena mtundu wa insulini yandale. Zimapangidwa kudzera pakusintha kwa insulin, kenako kutsekeka.

Pambuyo pa insulin yamtunduwu akaperekedwa kwa wodwala pansi pa khungu, zochita zake zimayamba pakati pa theka la ola, zomwe zimapangitsa kukhala mankhwala othandizira odwala kwambiri. Nthawi zambiri, insulin yotereyi imaphatikizidwa ndi insulin yokhala ndi nthawi yayitali.

Wongokhala mwachidule kapena kopitilira muyeso-wokhala ndi insulin, uti asankhe?

Kuti muyankhe funsoli, muyenera kuyamba kuchokera pazinthu zingapo - mkhalidwe wodwala, tsamba la jakisoni, komanso mlingo.

Pakati pa ma insulin apamwamba kwambiri, Humalog, Apidra ndi Novorapid ndizodziwika kwambiri. Awa ndi mankhwala osokoneza bongo a insulin omwe amayamba kuchita Mphindi 15.

Ngati timakambirana insulini zamunthu kuchitapo kanthu mwachangu, ndikofunikira kuwonetsa Actrarapid, Insuman Rapid ndi Homorap.

Mitundu ya nyama ya insulin yoyimiriridwa ndi mankhwala monga Insulrap SPP, Pensulin SR, Iletin II Wokhazikika komanso ena ambiri. Nthawi zambiri, amakhala oyenera kwa odwala omwe ali ndi vuto la insulin lodziimira pawokha, mwanjira ina, mtundu II shuga mellitus.

Ma insulini okhala ngati nyama yokhala ngati yochepa amadziwika ndi kusayenerana ndi thupi la munthu, chifukwa cha kupezeka kwa mapuloteni ena osiyana kwambiri ndi iwo. Kuphatikiza apo, insulin yamtunduwu sioyenera odwala onse, chifukwa cha mawonekedwe a thupi, mwachitsanzo, kulephera kuyamwa lipids ya nyama.

Njira yogwiritsira ntchito insulin yochepa

Chifukwa chake, ziribe kanthu mtundu wa insulin yomwe wodwala angasankhe, zotsatira zake sizosiyana - kuwamwa musanadye, wodwalayo amathandizira kuyamwa kwawo mwachangu, zomwe zikutanthauza kuti vutoli limachitika nthawi yomweyo.
Nthawi zambiri, ma insulin othamanga amatengedwa pakamwa ngati mawonekedwe amadzimadzi. Izi sizothandiza, komanso zopindulitsa thupi, chifukwa siziyenera kusungunula zinthu zowonjezera.
Mutha kuperekanso jakisoni, koma theka la ola musanadye. Chitani mosamala ndipo musalowe mumtsempha wamagazi. Pambuyo jekeseni, ndikofunika kuti musenzetse mankhwalawo. Yesani kumenya nthawi iliyonse pamalo osiyana.
Mlingo wa munthu aliyense wodwala matenda ashuga akhale payekha. Nthawi zambiri kwa akuluakulu zimakhala kuyambira magawo 8 mpaka 24 patsiku. Ana - mpaka magawo 8 patsiku.
Musamale kuti musamadandaule kwambiri. Pankhaniyi, hypoglycemia ikhoza kuchitika. Mudzamva kuwawa, mantha, komanso kunjenjemera.
Sungani mwachangu insulini mufiriji pamtunda wa 2 mpaka 8 madigiri.

Tchulani Insulin Yogwira Ntchito Pafupifupi

Kwa pafupifupi zaka zana limodzi, kupanga mankhwala a mahomoni kwa odwala matenda ashuga kwakhala kofunika kwambiri pamakampani opanga mankhwala. Zaka kotala zana zapitazo pali mitundu yoposa makumi asanu ya othandizira a hypoglycemic.

Insulin ndi nthawi yawo

Mpaka pano, ma insulin angapo amadziwika. Kwa odwala matenda ashuga, magawo ofunikira a mankhwala omwe amaphatikizidwa ndi mtundu wake, gulu, njira yodzaza, yopangidwa ndi kampani.

Nthawi yotalikira yochita ndi hypoglycemic wothandizira pa thupi limawonekera malinga ndi njira zingapo:

insulin ikayamba kupasuka pambuyo pa jekeseni,
kuchuluka kwake kwakukulu
kuvomerezeka kwathunthu kuyambira koyambira mpaka kumapeto.

Ultrashort insulin ndi imodzi mwazigawo za mankhwalawa, kupatula zapakati, zosakanikirana, zazitali. Ngati tiyang'ana pagawo lazoyeserera za mahomoni am'magazi, ndiye kuti limakwera kwambiri komanso limapanikizika mwamphamvu nthawi yomweyo.

Mizere yazithunzi za wobisika, ndipo yayitali, njira zimasalala komanso kupitilira nthawi yayitali

Kuchita, kutalika kwa insulin yamtundu uliwonse, kupatula malo a jakisoni, zimatengera zinthu zambiri:

madera a hypoglycemic wothandizira (pansi pa khungu, m'mitsempha yamagazi, minofu),
kutentha kwa thupi ndi chilengedwe (kuthamanga kumathandizira njira, kuthamanga kwambiri),
tsitsani khungu pakhungu jakisoni (kumenyedwa, kulumala kumawonjezera kuchuluka kwa mayamwidwe),
kusanthula, mwina malo osungiramo mankhwalawo m'misempha yolowera,
zochita ndi munthu kutumikiridwa mankhwala.

Popeza atawerengera zenizeni zofunika kulipira chakudya chamagulu omwe adya, wodwalayo sangaganizire za kusamba koyambirira kapena kuwonekera kwa dzuwa ndikumva zizindikiro za kuchepa kwa shuga m'magazi. Hypoglycemia imawonetsedwa ndi chizungulire, kusokonezeka kwa chikumbumtima, kumverera kofooka kwambiri m'thupi lonse.

Kupereka kwa insulin ya insulin yam'mimba kumawonekera patatha masiku angapo jakisoni.Popewa kudwala kwa hypoglycemia yosayembekezereka, yomwe ingayambitse kusamba, odwala matenda ashuga ayenera kukhala ndi "zakudya" zopezeka mwachangu zokhala ndi shuga, zotsekemera zophika bwino zopangidwa ndi ufa woyamba.

Mphamvu ya jakisoni wa pancreatic timadzi zimatengera pomwe amachitidwira. Kuyambira pamimba, mpaka 90% imalowa. Poyerekeza, ndi mikono kapena miyendo - 20% yocheperako.

Kuchokera pamankhwala omwe amaperekedwa m'mimba, mankhwalawa amayamba kufalikira mofulumira kuposa omwe amachokera paphewa kapena ntchafu

Zizindikiro zosakhalitsa za insulin ya ultrashort, kutengera mlingo

Ma insulini omwe ali ndi mawonekedwe ofanana, koma mafakitale osiyanasiyana amatha kugwiritsidwa ntchito mosiyanasiyana. Novorapid imapangidwa ndi kampani yolumikizana ya Danish-Indian Novo Nordiks. Opanga ma Humalog ndi USA ndi India. Onsewa ndi amtundu wa insulin.

Wotsirizirayi ali ndi njira ziwiri zokulitsira: mu botolo ndi mpango. Sanofi-Aventis, mahomoni opangidwa ndi Apidra ku Germany, amawaika m'matumba a syringe.

Zipangizo zamapangidwe apadera zomwe zimawoneka ngati cholembera cha inki zili ndi mwayi wosaneneka pamiyambo ndi syringe:

ndizofunikira kwa anthu omwe ali ndi vuto loona, popeza milingo imayikidwa pakumveka bwino,
ndi chithandizo chawo, mankhwalawa amatha kuperekedwa m'malo ali onse, kudzera zovala,
singano ndiyofera kuposa insulin.

Mankhwala omwe adalowetsedwa ku Russian Federation amalembedwa ku Russia. Madeti opanga ndi tsiku lotha ntchito (abwinobwino - mpaka zaka 2) ali pamavuto ndi ma CD ndi chida cha galasi. Ziyembekezero zaku mafakitale opanga zimatsimikizira mawonekedwe osakhalitsa. Malangizo adatsekedwa m'mapaketi, amawonetsa manambala azolemba omwe wodwala matenda ashuga amayenera kutsatiridwa.

Kutalika kwa nsombazi kumatenga maola angapo. Zimachitika pakakakumba chakudya cham'mimba kwambiri, kuwonongeka kwa zovuta zam'mimba komanso kulowa kwa glucose m'magazi. Kuwonjezeka kwa glycemia kumalipiridwa mokwanira ndi insulin yoyendetsedwa pa mlingo woyenera.

Pafupipafupi amatsimikiza, omwe amakhala kuti kuchuluka kwa mankhwalawa kumathandizanso kutalika kwa nthawi ya zochita za hypoglycemic mankhwala, pamndandanda wazithunzi zomwe zikuwonetsedwa mu malangizo. Zowonadi zake, mahomoni othamanga amagwira ntchito mpaka maola 4 pa mlingo wochepera 12 mayunitsi.

Mlingo waukulu umachulukitsa kutalika kwa maola angapo. Kupitilira magawo 20 a insulin ya ultrashort nthawi imodzi osavomerezeka. Pali chiopsezo chachikulu cha hypoglycemia. Insulin yochulukirapo singatengeke ndi thupi, imakhala yopanda ntchito komanso yowopsa.

Kukonzekera kwa "nthawi yayitali" ndi "pakati" kumawoneka kosamveka chifukwa cha omwe amawonjezera. Mtundu wa insulin wa ultrashort ndi wosiyana. Imakhala yoyera komanso yowonekera, popanda mitambo, matanga ndi mawanga. Chizindikiro chakunja chimasiyanitsa ma insashins a prolort kuchokera kwa nthawi yayitali.

Kusiyananso kwakukulu pakati pa mitundu yosiyanasiyana ya insulini ndikuti "yifupi" imachitika mozungulira, mwamkati komanso mwa intramuscularly, ndi "yayitali" - pokhapokha pokhapokha.

Kuphatikiza apo, odwala matenda ashuga ayenera kudziwa kuti izi sizingachitike:

gwiritsani ntchito mankhwala omwe atha ntchito (kuposa miyezi 2-3),
pezani pamisika yotsimikizika,
kuti amasule.

Chisamaliro chiyenera kuchitidwa kuti chitha kupangira wopanga watsopano, wosadziwika. Ndikulimbikitsidwa kusunga mankhwalawo mufiriji pa kutentha kuphatikiza kwa madigiri 2-8. Insulin yogwiritsidwa ntchito pakadali pano siyenera kusungidwa pamalo ozizira, kutentha kwa chipinda ndi koyenera kuti isungidwe.

Milandu yapadera yogwiritsa ntchito mahomoni a ultrashort

M'bandakucha, anthu ena omwe ali ndi chimbudzi chatsiku ndi tsiku amakhala ndi mahomoni ambiri. Mayina awo ndi adrenaline, glucagon, cortisol.

Amatsutsana ndi chinthu chotchedwa insulin. Kubisirana kwa mahomoni kumatanthauza kuti thupi likukonzekera kulowa gawo lake la moyo watsiku ndi tsiku.

Pankhaniyi, pali shuga wambiri kwambiri pakakhala kuti palibe nocturnal hypoglycemia, kuphwanya kwambiri zakudya.

Chifukwa cha zikhalidwe za munthu payekha, kubisala kwa mahomoni kumatha kuchitika mwachangu komanso mwachangu. Mu odwala matenda ashuga, m'mawa hyperglycemia imakhazikitsidwa. Matenda ofananawo amapezeka nthawi zambiri, ndipo mwa odwala onse amtundu wa 1 ndi 2. Pafupifupi nkovuta kuzithetsa. Njira yokhayo yotulukamo ndi jakisoni wa ma unit 6 omwe ali ndi insulin ya insulin, yochitidwa m'mawa kwambiri.

Kugwiritsa ntchito mankhwala a ultrashort sikukukhudzani kusunga kwaukakamira kwa zinthu zotsika pa carb zakudya

Mankhwala a Ultrafast nthawi zambiri amapangidwira chakudya. Chifukwa chakuthamanga kwamphezi, jekeseni amatha kuchitidwa nthawi ya chakudya komanso pambuyo pake.

Kutalika kwa nthawi ya insulin kumakakamiza wodwala kuti apange jakisoni tsiku lonse, ndikutsata katemera wachilengedwe pancreas pamtundu wa chakudya cha carbohydrate. Kufikira nthawi 5-6, molingana ndi kuchuluka kwa zakudya.

Kuti muchepetse kusokonezeka kwakukulu kwa kagayidwe kachakudya koyipa kapena chikomokere, kuvulala, matenda m'thupi, kukonzekera kwa ultrashort kumagwiritsidwa ntchito popanda kuphatikizana ndi nthawi yayitali. Pogwiritsa ntchito glucometer (chipangizo choyezera shuga m'magazi), glycemia imayang'aniridwa ndipo kuwonongeka kwa shuga kumabwezeretseka.

Kodi mlingo wa insulini wa ultrafast amawerengedwa bwanji?

Mlingo umatengera luso la kapamba kuti apange insulin yake. Onani kuthekera kwake ndikosavuta.

Amakhulupirira kuti gawo lathanzi lamtundu wa endocrine limapanga mahomoni ambiri patsiku, kotero kuti gawo limodzi la kulemera lili ndi mayunitsi 0,5.

Ngati wodwala matenda ashuga akulemera, mwachitsanzo, makilogalamu 70 ndipo akufunika 35 U kapena kupitiliza kulipira, izi zikuwonetsa kuchotsedwa kwathunthu kwa ntchito ya pancreatic cell.

Pankhaniyi, insulin ya ultrashort imafunikira, limodzi ndi nthawi yayitali, mosiyanasiyana: 50 mpaka 50 kapena 40 mpaka 60. Endocrinologist imapereka njira yabwino kwambiri. Kotero ndi kuthekera pang'ono kotayika kwa kapamba kuti athe kulimbana ndi ntchito yake, kuwerengera koyenera ndikofunikira.

Masana, kufunika kwa "ultrafast" ndikusinthanso. M'mawa chakudya cham'mawa, ndikofunikira 2 mozungulira kuposa magawo a mkate (XE), masana - 1.5, madzulo - kuchuluka komweko.

Ndikofunikira kuganizira ntchito zolimbitsa thupi zomwe zachitika, masewera olimbitsa thupi. Ndi katundu wochepa, mlingo wa insulin nthawi zambiri sasintha.

Mukamamanga thupi, mwachitsanzo, tikulimbikitsidwa kuti pakadutsa masiku abwinobwino glycemia (6-8 mmol / l) muzidya 4 HE.

Mosiyana ndi izi, insulin edema ndizovuta zachilengedwe za endocrine. Pofuna kuti usaiwale komwe jakisoni udapangidwira, chiwembuchi chithandiza. Pamimba pake, m'mimba (miyendo, mikono) amagawidwa m'magulu kutengera masiku a sabata. Pakatha masiku angapo, khungu lomwe limakhala m'malo osungika limabwezeretseka bwino.

Ultrashort insulin: mikhalidwe, mankhwala, zabwino ndi mavuto

Munthu amafunikira insulin kuti ikhale yachilengedwe m'thupi lake. Hormoni iyi imapangidwa mu kapamba, ndipo imapangidwira kuti shuga m'magazi akhale bwino. Ngati kuchuluka kwa mahomoniwa kumasokonekera, munthu amayamba ndi matenda monga matenda a shuga.

Ngati tizingolankhula za insulin ya ultrashort, ndiye kuti imatchulidwa ngati ma module ofanana a mahomoni omwe amapangidwa m'thupi la munthu palokha.

Ndikofunikira kunena kuti insulin yamtunduwu imakhudza mwachangu kwambiri kuposa anthu.

Mwachitsanzo, poyerekeza kuthamanga kwa zochita zawo zimatsata kuti mahomoni amunthu amachitika pambuyo pa mphindi 30 mpaka 40 atakhazikitsa, ndipo ma ultrashort azichita zosakwana mphindi 15.

Kodi insulin ya insulin ndi chiyani?

Insulin yamtunduwu imatchedwa kuti inshuwaransi yaposachedwa kwambiri pankhani ya pharmacology. Amasiyana ndi ena onse m'mawu kuti amayamba kuchita zinthu zosakwana 15 atabayidwa. Insulin yamtunduwu imaphatikizapo:

Mankhwalawa amasinthidwa bwino ka insulin, popeza amayamba kutengera mwachangu kwambiri kuposa mitundu ina yonse.

Poyamba, insulin ya ultrashort inali yongopangira okhawo omwe ali ndi matenda ashuga omwe samatha kudziletsa ndikudya zakudya zopepuka za chakudya, ndipo izi zimayambitsa mwachangu kudumphadumpha kwa shuga.

Koma chifukwa chakuti palibe ambiri odzipha monga akuti, mankhwala opitawa afika pamsika.

Ndipo amachita ntchito yabwino kwambiri yochepetsera kutsika kwa shuga pomwe ikulumpha msanga kapena pamalo pomwe wodwalayo alibe nthawi yodikira mpaka mphindi 40 asanadye.

Momwe mungathandizidwire ndi insulin ya insulin?

Pochita ndi mankhwalawa, ndikofunikira kumvetsetsa kuti zochita zake zimachitika mwachangu kwambiri kuposa momwe mapuloteni amaphatikizidwa kuti asinthe shuga pambuyo pake. Chifukwa chake, kutsatira zakudya zamafuta ochepa, ndibwino kugwiritsa ntchito insulin yayifupi, yomwe imaperekedwa kwa mphindi 40 chakudya chisanachitike, kuti chakudyacho chizitha kumamwa.

Ndikofunika kutsindika kuti insulini yochepa kwambiri imakhala yoyenera nthawi zonse pazovuta zonse, monga momwe zimafunikira kuti muchepetse shuga m'magazi. Izi zitha kuchitika munthu wodwala matenda ashuga atadya chidutswa cha keke kapena chokoleti. Chifukwa chake, ndizotheka kupewa zovuta zoyipa.

Kodi zabwino komanso zoipa zake ndi ziti?

Poyerekeza insulin yochepa komanso ya ultrashort, titha kunena mosabisa kuti chomaliza chili ndi nsonga yogwira kwambiri, koma mulingo wakewo umatsika mofulumira. Ndi insulini yochepa, izi zimachedwa. Kuphatikiza apo, ndikofunikira kuganizira kuti chiwonetsero chakuthwa sichimakhala munthawi zonse zimapangitsa kuti mumvetsetse kuchuluka kwa chakudya chamagulu omwe amapezeka mu chakudya.

Komabe, ngati insulin yayifupi, jekeseni iyenera kuchitidwa mphindi 40 chakudya chisanayembekezeredwe kuti insulin iyi iyambe kugwira ntchito. Pankhaniyi, insulin yochepa kwambiri pazofunikira izi kuyambira mphindi 10 mpaka 15. Ndipo izikhala yabwino kwa iwo omwe alibe nthawi yakudya.

Chifukwa chake, monga mawu omaliza, titha kunena kuti insulin ya ultrashort ndiyofunikira panthawi yadzidzidzi komanso kwa iwo omwe sakudziwa nthawi yeniyeni ya chakudya. Koma si nthawi zonse mtundu wa insulini uwu womwe ungakhale wothandiza, chifukwa ndizovuta kuwerengera kuchuluka kwa chakudya chamagulu muzakudya.

Ultrashort insulin Humalog ndi mawonekedwe ake - ndizabwino kugwiritsa ntchito shuga?

Nzosadabwitsa kuti matenda ashuga amatchedwa matenda a zaka zana lino. Kuchuluka kwa odwala omwe ali ndi vutoli kukukulira chaka chilichonse.

Ngakhale zomwe zimayambitsa matendawa ndizosiyana, chibadwidwe ndichofunika kwambiri. Pafupifupi 15% ya odwala onse amadwala matenda a shuga 1. Mankhwala amafunika jakisoni wa insulin.

Nthawi zambiri, zizindikiro za matenda amtundu 1 zimawonekera paubwana kapena kuubwana. Matendawa amadziwika ndi kukula kwake mwachangu. Ngati zinthu sizikutsatiridwa munthawi yake, zovuta zimatha kubweretsa kusokonekera kwa machitidwe amodzi payekha, kapena thupi lonse.

Kugawa insulin kungachitike pogwiritsa ntchito Humalog, fanizo la mankhwalawa. Mukamatsatira malangizo onse a dokotala, wodwalayo amakhala wodekha. Mankhwala ndi analogue a insulin ya anthu.

Pamaapangidwe ake, pakufunika DNA yofunikira. Ili ndi mawonekedwe - imayamba kuchita zinthu mwachangu (pasanathe mphindi 15). Komabe, kutalika kwa zochita sikupitirira 2-5 mawola atalandira mankhwalawa.

Mankhwalawa amapangidwa ku France. Alinso ndi dzina lina lapadziko lonse - Insulin lispro.

Chofunikira chachikulu

Mankhwalawa ndi njira yopanda maonekedwe, yopaka makatoni (1.5, 3 ml) kapena mabotolo (10 ml). Imaperekedwa kudzera m'mitsempha. Chithandizo chogwira mankhwalawa ndi insulin lispro, kuchepetsedwa ndi zina zowonjezera.

Zowonjezera zina zikuphatikiza:

metacresol
glycerol
zinc oxide
sodium hydrogen phosphate,
10% hydrochloric acid solution,
10% sodium hydroxide solution,
madzi osungunuka.

Mankhwala akuphatikizidwa mu kayendedwe ka glucose, pochita zotsatira za anabolic.

Analogs ATC Level 3

Mankhwala opitilira atatu omwe ali ndi mawonekedwe osiyana, koma ofanana ndi mawonekedwe, njira yogwiritsira ntchito.

Mayina a ena ofanana ndi Humalog malinga ndi kuchuluka kwa code ya ATC 3:

Biosulin N,
Insuman Bazal,
Protafan
Humodar b100r,
Gensulin N,
Insugen-N (NPH),
Protafan NM.

Kusintha kwa Humalog ndi Humalog 50: kusiyana

Ndikofunikira kudziwa! Popita nthawi, mavuto okhala ndi shuga amatha kubweretsa matenda ambiri, monga mavuto amaso, khungu ndi tsitsi, zilonda zam'mimba, zilonda zam'mimba komanso ngakhale zotupa za khansa! Anthu amaphunzitsa zomwe zinawawa kuti azisintha shuga yawo kuti asangalale ...

Ena odwala matenda ashuga molakwika amalingalira kuti mankhwalawo ndi othandizira kwathunthu. Izi siziri choncho. Prostamine Hagedorn (NPH) yosalowerera ndale, yomwe imachepetsa kuchitira insulin, imayambitsidwa mu Kusakaniza kwa Humalog 50.

Zowonjezera zowonjezera, nthawi yayitali ntchito. Kutchuka kwake pakati pa odwala matenda ashuga ndi chifukwa chakuti imathandizira njira yothandizira mankhwala a insulin.

Humalog Sakanizani ma cartridge 50 100 IU / ml, 3 ml mu syringe ya Quick Pen

Chiwerengero cha tsiku ndi tsiku cha jakisoni chimachepetsedwa, koma izi sizothandiza kwa odwala onse. Ndi jakisoni, ndizovuta kusunga magazi abwino amawongolera. Kuphatikiza apo, ndale ya protamine Hagedorn nthawi zambiri imayambitsa zovuta zomwe zimayambitsa matenda ashuga.

Kusakaniza kwa humalog 50 sikulimbikitsidwa kwa ana, odwala azaka zapakati. Izi zimawathandiza kupewa zovuta za matenda ashuga.

Nthawi zambiri, insulin yomwe imatenga nthawi yayitali imaperekedwa kwa odwala okalamba, omwe, chifukwa cha ukalamba, amayiwala kupanga jakisoni panthawi.

Humalog, Novorapid kapena Apidra - ndibwino?

Poyerekeza ndi insulin yaumunthu, mankhwalawo pamwambapa amalandiridwa mochita kupanga.

Mitundu yawo yosinthika imapangitsa kuti achepetse shuga mwachangu.

Insulin yaumunthu imayamba kuchita theka la ola, mankhwala ake omwe amafananizidwa ndi zotsatira zake amafunika mphindi 5-15 zokha. Humalog, Novorapid, Apidra ndi mankhwala a ultrashort omwe amapangidwa kuti achepetse shuga.

Mwa mankhwala onse, wamphamvu kwambiri ndi Humalog.. Imachepetsa shuga m'magazi 2,5 kuposeranso insulin yayifupi ya munthu.

Novorapid, Apidra ndiwofooka pang'ono. Ngati mungayerekeze mankhwalawa ndi insulin ya munthu, zimapezeka kuti zimakhala zamphamvu nthawi 1.5 kuposa zotsalazo.

Kupereka mankhwala enaake ochizira matenda a shuga ndi udindo wapadera wa dokotala. Wodwala amakumana ndi ntchito zina zomwe zingamulole kuthana ndi matendawa: kutsatira kwambiri zakudya, malangizo a dokotala, kukhazikitsa njira zotheka zolimbitsa thupi.