Kuyimitsidwa kwa Zink Insulin Jekeseni wa matenda a shuga

Kuyimitsidwa kwa crystalline zinc insulin ya jekeseni (insulin "K" ultralente) - insulin wakonzekera kukonzekera zochizira matenda osokoneza bongo.

Kuyimitsidwa kwa crystalline zinc insulin kumatanthauza mankhwala omwe amapangitsa kuti shuga achepetse kwambiri, omwe amapezeka maola 6 - 6 atakhazikitsa, zotsatira zake zimakhala maola 16-16 pambuyo pa kupangika ndipo zimatha mpaka maola 30-36.

Malamulo ogwiritsira ntchito

Mlingo wa kuyimitsidwa ndi kuchuluka kwa jakisoni wa mankhwalawa patsiku limakhazikitsidwa payekhapayekha kwa wodwala aliyense, poganizira kuchuluka kwa shuga womwe umatuluka mkodzo nthawi zosiyanasiyana masana, kuchuluka kwa shuga, komanso nthawi yayitali ya hypoglycemic.

Kukonzekera konse kwamphamvu kwa insulin kumangoperekedwa kokha.

Zinc Insulin Kuyimitsidwa Lamulo

Kuyimitsidwa kwa crystalline zinc insulin ya jekeseni (Suspensio Zinc-insulini crystallisati pro injionubus) ndi kuyimitsidwa kotsika kwa crystalline insulini mu acetate buffer ndi pH ya 7.1-7.5. 1 ml ya kuyimitsidwa kuli ndi 40 IU ya insulin.

Kuyimitsidwa kumamasulidwa mu 5 ml ndi 10 ml wosabala osindikizira.

Malangizo ogwiritsira ntchito mankhwalawa

Kugwiritsa ntchito mankhwala kuyimitsidwa kwa nthaka insulin jekeseni tikulimbikitsidwa mankhwalawa mtundu 1 matenda a shuga, kuphatikiza ana ndi akazi udindo. Kuphatikiza apo, chida ichi chitha kugwiritsidwa ntchito pazachipatala cha mtundu wa 2 matenda a shuga, makamaka ndi kulephera kwa mapiritsi ochepetsa shuga, makamaka, omwe amachokera ku sulfonylurea.

Zulin insulin imagwiritsidwa ntchito kwambiri pothana ndi zovuta za matenda ashuga, monga kuwonongeka kwa mtima ndi mtsempha wamagazi, phazi la matenda ashuga komanso kuwonongeka kwa mawonekedwe. Kuphatikiza apo, ndizofunikira kwambiri pakuchita opaleshoni yayikulu ya shuga ndikuchira, komanso kuvulala kwambiri kapena zokumana nazo zamphamvu.

Kuyimitsidwa kwa zinc insulin kumapangidwira majakisoni amkati, koma nthawi zina amatha kuthandizira intramuscularly. Mothandizidwa ndi intravenous a mankhwalawa amaletsedwa mwamphamvu, chifukwa angayambitse matenda a hypoglycemia.

Mlingo wa mankhwala a insulin Zinc amawerengedwa aliyense payekha kwa wodwala aliyense. Monga ma insulin ena omwe akhala akuchita kwakanthawi, amayenera kuperekedwa kamodzi kapena kawiri patsiku, kutengera zosowa za wodwalayo.

Mukamagwiritsa ntchito kuyimitsidwa kwa insulin zinc panthawi yomwe muli ndi pakati, ndikofunikira kwambiri kukumbukira kuti m'miyezi itatu yoyambirira mutanyamula mwana mkazi akhoza kuchepetsa kufunika kwa insulin, ndipo m'miyezi isanu ndi umodzi yotsatira, iwonjezeke. Izi ziyenera kukumbukiridwa powerengera kuchuluka kwa mankhwalawo.

Pambuyo pa kubadwa kwa mwana mu shuga mellitus komanso poyamwitsa, ndikofunikira kuyang'anitsitsa kuchuluka kwa shuga mumagazi ndipo, ngati pakufunika kusintha, mupeze insulin.

Kusanthula kosamala kwa shuga komweku kumayenera kupitilizidwa mpaka mkhalidwewo utakhazikika.

Masiku ano, kuyimitsidwa kwa insulin ndizosowa kwambiri m'mafakitaya m'mizinda ya Russia. Izi zimachitika makamaka chifukwa cha kutuluka kwa mitundu yambiri yamakono ya insulin, yomwe idachotsa mankhwalawa m'mashelufu azamankhwala.

Chifukwa chake, ndizovuta kutchula mtengo weniweni wa insulin. M'mafakitala, mankhwalawa amagulitsidwa pansi pa mayina amalonda Insulin Semilent, Brinsulmidi MK, Iletin, Insulin Lente "HO-S", Insulin Lente SPP, Insulin Lt VO-S, Insulin-Long SMK, Insulong SPP ndi Monotard.

Ndemanga za mankhwalawa nthawi zambiri zimakhala zabwino. Odwala ambiri omwe ali ndi matenda ashuga akhala akuchigwiritsa ntchito bwino kwazaka zambiri. Ngakhale m'zaka zaposachedwa akuchitanso zina ndi anzawo amakono.

Monga fanizo la zinc insulin, mutha kutcha kukonzekera konse kwa insulin. Izi zikuphatikiza Lantus, Insulin Ultralente, Insulin Ultralong, Insulin Ultratard, Levemir, Levulin ndi Insulin Humulin NPH.

Mankhwalawa ndi mankhwala osokoneza bongo am'badwo waposachedwa. Insulin yomwe ikuphatikizidwa ndi mawonekedwe awo ndi analogue ya insulin yaumunthu, yomwe imapezeka ndi mainjiniering. Chifukwa chake, sichimayambitsa ziwopsezo ndipo zimalekeredwa bwino ndi wodwalayo.

Makhalidwe ofunikira kwambiri a insulin akufotokozedwa mu kanema m'nkhaniyi.

Insulin (insulinum)

Ndi mahomoni opangidwa ndi ma cell a ma pancreatic a Langerhans.

Kulemera kwa insulini kumakhala pafupifupi 12,000. Pazothetsera, pomwe pH ya sing'anga imasintha, molekyulu ya insulini imadzipatula kukhala ma monomer 2 omwe ali ndi zochitika zamahomoni. Kulemera kwa ma monomer kuli pafupifupi 6000.

Molekyu ya monomer imakhala ndi ma polypeptide awiri, amodzi mwa iwo ali ndi amino acid zotsalira (unyolo A), wachiwiri uli ndi zotsalira 30 amino acid zotsalira (unyolo B). Maunyolo amalumikizidwa ndi milatho iwiri yopanda tanthauzo.

Pakadali pano, kuphatikiza kwa molekyu ya insulin kwachitika.

Insulin imatha kuyendetsa kagayidwe kazachilengedwe, imathandizira kuyamwa kwa glucose ndi minofu ndipo imapangitsa kutembenuka kwake kukhala glycogen. Zimathandizanso kulowerera kwa glucose m'maselo.

Insulin ndi wothandizila wodwala matenda ashuga. Timalowetsedwa m'thupi, timachepetsa shuga m'magazi, timachepetsa kuphipha kwake mu mkodzo, timachotsa zotsatira za matenda a shuga.

Chithandizo cha matenda ashuga chimaphatikizapo kugwiritsa ntchito insulin pazakudya zoyenera.

Ntchito ya insulini imatsimikizika pakubadwa (mwa kukhoza kuchepetsa shuga m'magazi mu akalulu athanzi). Pa gawo limodzi lochita (UNIT) kapena gulu lapadziko lonse lapansi (1 IE), ntchito ya 0404082 mg wa crystalline insulin (muyezo) imatengedwa.

Kuphatikiza pa zotsatira za hypoglycemic, insulin imayambitsa zovuta zina zingapo: kuwonjezeka kwa masitolo a minofu ya glycogen, kuchuluka kwa mafuta, kusinthitsa kaphatikizidwe ka peptide, kuchepa kwa mapuloteni, ndi zina zambiri.

Insulin yogwiritsira ntchito zachipatala imapezeka kuchokera ku zikondamoyo za zolengedwa zazikazi (ng'ombe, nkhumba, ndi zina).

Pakadali pano, limodzi ndi insulin yachilendo (insulin ya jekeseni), pali mitundu ingapo ya mankhwala omwe amachitika nthawi yayitali.

Kuphatikiza kwa zinc, protamine (protein) ndi buffer yama mankhwalawa kumasintha kuchuluka kwa kuyamba kwa kutsika kwa shuga, nthawi yayitali kwambiri ("nsonga") ndi nthawi yonse yochitapo kanthu.

Mankhwala omwe akhala akuchita kwa nthawi yayitali amakhala ndi pH yayitali kuposa insulin ya jakisoni, yomwe imapangitsa kuti majakisidwe awo asakhale opweteka.

Mankhwala omwe akhala akuchita kwa nthawi yayitali amatha kuperekedwa kwa odwala nthawi zambiri kuposa insulin ya jakisoni, yomwe imathandizira kwambiri odwala omwe ali ndi matenda a shuga.

Chochita chothamanga kwambiri komanso chocheperako (pafupifupi maola 6) chimaperekedwa ndi insulin chifukwa cha jakisoni, chinthu chotalikirapo (maola 10-12) chimaperekedwa ndi kuyimitsidwa kwa zinc-insulin, kutsatiridwa ndi protamine-zinc-insulin ya jakisoni (mpaka maola 20), ndi kuyimitsidwa kwa insulin protamine (maola 18-30), kuyimitsidwa kwa zinc-insulin (mpaka maola 24), kuyimitsidwa kwa protamine-zinc-insulin (maola 24-36) ndi kuyimitsidwa kwa cry-insulin crystalline (mpaka maola 30 mpaka 36).

Kusankha kwa mankhwala omwe amagwiritsidwa ntchito kumadalira kuopsa kwa matendawa, momwe alili, momwe wodwalayo alili ndi zina za vutolo, komanso mphamvu ya mankhwalawa (kuthamanga kwachangu ndi nthawi ya hypoglycemic athari, pH, etc.).

Nthawi zambiri, mankhwalawa omwe amakhala ndi nthawi yayitali amalembedwa kwa odwala omwe ali ndi mitundu yayitali komanso yovuta ya matendawa, m'malo omwe odwala adalandira kale jakisoni wa 2-3 kapena kuposerapo insulin (yachilendo) patsiku.

M'mikhalidwe yodwala komanso matenda ashuga, komanso mitundu yayikulu yamatenda a shuga omwe amakhala ndi matenda a ketosis pafupipafupi komanso matenda opatsirana, mankhwala ophatikizika amatsutsana, mu milandu iyi, insulin yokhazikika imagwiritsidwa ntchito.

Insulin ya jakisoni (Insulinum pro injionibus).

Mankhwalawa amapezeka pakutha kwa crystalline insulin (ndi zochita zake zosachepera 22 PIECES mu 1 mg) m'madzi okhala ndi hydrochloric acid.

1.6-1.8% glycerol imawonjezeredwa ku yankho ndi phenol (0.25-0.3%) monga chosungira, pH yankho ndi 3.0-3.5. Madzi opanda mawonekedwe owala. Mankhwalawa amamasulidwa ndikuchita 40 kapena 80 PIERES mu 1 ml.

Ntchito makamaka pochiza matenda ashuga.

Mlingo umayikidwa payekha malinga ndi momwe wodwalayo alili, shuga mumkodzo (pamlingo wa 1 ED pa 5 g ya shuga yemwe amkodwamo mkodzo). Nthawi zambiri, Mlingo (wa akulu) umayambira magawo 10 mpaka 20 patsiku. Nthawi yomweyo, chakudya choyenera chimasankhidwa.

Kugwiritsa ntchito insulin ndi kusankha kwa milingo kumachitika motsogozedwa ndi shuga mumkodzo ndi magazi ndikuwunika momwe wodwalayo alili.

Mu chikomine cha matenda ashuga, mlingo wa insulini umachulukitsidwa mpaka 100 IU kapena kupitilira tsiku limodzi (wodwalayo amapatsidwa shuga wambiri).

Insulin ya jakisoni imakhala yofulumira komanso yochepa yochepetsera shuga. Zotsatira zake zimachitika pakadutsa mphindi 15-30 jakisoni, "kupendekera" kwa chochitikacho - pambuyo pa maola 2-4, kutalika konse kwa kuchitapo mpaka maola 6.

Mankhwalawa amapaka jekeseni katatu patsiku, mankhwalawa amaperekedwa pakhungu kapena intramuscularly kwa mphindi 15-20 musanadye. Mankhwalawa akaperekedwa katatu, pakaperekedwa jakisoni womaliza (asanadye chakudya chamadzulo), pamakhala mlingo wambiri wa insulin kuti mupewe usiku hypoglycemia.

Mothandizidwa ndi insulin, insulin imaperekedwa (mpaka 50) pokhapokha ngati munthu akudwala matenda ashuga, ngati jakisoni wokhoza kugwira ntchito sangakwanitse.

Mukasintha kuchokera ku chithandizo cha insulin kuti mupeze jakisoni wamankhwala osakhalitsa, ndikofunikira kuyang'anitsitsa momwe wodwalayo amagwirira ntchito, makamaka masiku oyambira 7-16, pamene mlingo wa mankhwala omwe wapatsidwawo unafotokozedwa.

Kuti muzindikire momwe wodwalayo amvera mankhwala atsopano, tikulimbikitsidwa kuti tichite maphunziro ochulukirapo a shuga (atatha masiku awiri) mumkodzo womwe umatengedwa magawo masana, komanso kuwerenga shuga ya m'mawa (m'mawa pamimba yopanda kanthu).

Kutengera ndi deta yomwe yapezeka, maola opereka mankhwala kwa nthawi yayitali amatchulidwa poganizira nthawi yoyambira kutsika kwambiri kwa shuga, komanso nthawi yowonjezera (ngati pakufunika) ka insulin yokhazikika komanso kugawa chakudya mu chakudya chatsiku ndi tsiku.

Popitilira chithandizo, shuga omwe amakhala mkodzo amayesedwa nthawi imodzi pa sabata, ndipo kuchuluka kwa shuga mumagazi nthawi 1-2 pa mwezi.

Mlingo wochepa wa insulin (mayunitsi 4-8 1-2 kawiri pa tsiku) amagwiritsidwa ntchito kuperewera kwa zakudya m'thupi, kuchepa kwa zakudya, furunculosis, chithokomiro, kusanza kwambiri kwa amayi apakati, matenda am'mimba (atony, gastroptosis), hepatitis, mitundu yoyambira ya chiwindi cirrhosis (glucose ndi mankhwala nthawi imodzi) )

Muzochita zamisala, insulin imagwiritsidwa ntchito kupangitsa matenda a hypoglycemic pochiza matenda amtundu wina wa schizophrenia. Insulin coma (mantha) amayamba chifukwa cha jakisoni wa tsiku ndi tsiku kapena jakisoni wa jakisoni wa jakisoni, kuyambira 4 IU, ndi kuwonjezera kwa 4 IU tsiku lililonse mpaka kuwoneka kwa stupor kapena chikomokere.

Pakakhala sopor, kuchuluka kwa insulin sikumakulitsidwa mkati mwa masiku awiri, patsiku la 3 mlingo umakulitsidwa ndi magawo anayi ndipo chithandizo chimapitilizidwa kukulira Mlingo mpaka kukomoka. Kutalika kwa nthawi yayitali ndi mphindi 5 mpaka 10, kenako aliyense ayenera kusiya. M'tsogolomu, nthawi yokhala chikomokere imakulitsidwa mpaka mphindi 30 mpaka 40.

Munthawi yamankhwala, amayimbira foni nthawi 25-30.

Kuyimitsa kukomoka kwa kulowetsedwa kwa 20 ml ya 40% ya shuga. Atasiya chikomokere, wodwalayo amalandira tiyi yemwe ali ndi 150-200 g shuga ndi kadzutsa. Ngati magazi a shuga a mtsempha wa magazi atha kuchepa, 400 ml ya tiyi wokhala ndi 200 g shuga imalowetsedwa m'mimba kudzera pa chubu.

Kugwiritsa ntchito insulin nthawi zonse kuyenera kuchitika mosamala. Pogwiritsa ntchito mankhwala osokoneza bongo mopitirira muyeso komanso kugwiritsidwa ntchito mosafunikira kwa chakudya, kuwopsa kwa hypoglycemic kumatha kuchitika ndikutaya chikumbumtima, kukhumudwa komanso kuchepa kwa ntchito zamtima.

Zizindikiro za hypoglycemia zikaonekera, wodwalayo ayenera kupatsidwa mikate yoyera 100 kapena ma cookie, komanso ndi matchulidwe ena ambiri, supuni zitatu zitatu kapena shuga wowonjezera.

Pothana ndi vuto la hypoglycemic, njira ya shuga 40% imalowetsedwa m'mitsempha ndipo shuga yambiri imaperekedwa (onani pamwambapa).

Zotsatira za kugwiritsa ntchito insulin ndi matenda omwe amapezeka ndi hypoglycemia, hepatitis yacute, cirrhosis, hemolytic jaundice, kapamba, nephritis, amyloidosis a impso, urolithiasis, m'mimba komanso zilonda zam'mimba.

Kusamalidwa kwakukulu kumafunika kwa odwala omwe ali ndi matenda osokoneza bongo pamaso pa kuperewera kwa mphamvu ya coronary ndi ngozi ya cerebrovascular.

Jakisoni wa insulin amatha kupweteka chifukwa cha pH yotsika yankho.

Njira yotulutsira insulin: M'mabotolo amgalasi osalowerera, osindikizidwa ndi zotsekera zotsekemera ndi zitsulo zotayirira, 5-10 ml ndi ntchito ya 40 ndi 80 PIECES mu 1 ml.

Insulin imatengedwa kuchokera pamtondo ndikuboola ndi singano syringe kapu, yomwe kale inali yopaka zakumwa zoledzeretsa kapena ayodini.

Kusunga: Mndandanda B. Pa kutentha kwa 1 mpaka 10 °, kuzizira sikuloledwa.

Insulin yomwe imapezeka kuchokera ku zikondamoyo za whale (whale insulin) imasiyana pang'ono mu kuphatikizika kwa amino acid kuchokera ku insulin wamba, koma imayandikira pafupi nayo pokhudzana ndi kuchepa kwa shuga.

Poyerekeza ndi insulin yodziwika bwino, insulin ya cetacean imachitika pang'onopang'ono, ikayambitsidwa pansi pakhungu, kuyambika kwa nthawi kumawonedwa pambuyo pa mphindi 30-60, nthawi yayitali pambuyo pa maola 3-6, kutalika kwa nthawi ndi maola 6-10.

Amagwiritsidwa ntchito pa matenda ashuga (mitundu yochepa komanso yoopsa).

Chifukwa chakuti mankhwalawa amasiyana mu kapangidwe ka mankhwala kuchokera ku insulin yomwe imapezeka kuchokera ku zikondamoyo za ng'ombe ndi nkhumba, nthawi zina imagwira ntchito pokhudzana ndi insulin wamba, imagwiritsidwanso ntchito ngati zovuta zina zimawonedwa kuchokera ku insulini wamba (komabe, nthawi zina insulin whale imayambitsanso ziwengo zina.

Lowani pansi pakhungu kapena intramuscularly katatu patsiku. Mlingo, kusamala, zovuta zina, contraindication ndizofanana ndi insulin ya jakisoni.
Whale insulin siyikulimbikitsidwa kuti pakhale matenda ashuga, chifukwa imagwira pang'onopang'ono kuposa insulin yokhazikika.

Kutulutsa mawonekedwe: m'mabotolo osindikizidwa ndi zotsekera mphira ndi zitsulo zotayikira, 5 ndi 10 ml ndi ntchito ya 40 PIECES mu 1 ml.

Kusunga: onani insulin ya jakisoni.

Matenda a shuga - kukonzekera insulin

Insulin-zinc-kuyimitsidwa "A" (ICS "A") - amorphous zinc-insulin. Mankhwalawa amayamba kugwira ntchito patatha maola 1-1.5 pambuyo pothandizidwa ndi subcutaneous ndipo amatha kwa maola 10-12 (zotsatira zazikulu zimawonedwa pa ola la 5-7th atatha jekeseni). Insulin-zinc-kuyimitsidwa "A" ndiwofanana ndi mankhwala achi Dutch "tepi zisanu ndi ziwiri".

Insulin-zinc-kuyimitsidwa "K" (ICS "K") - crystalline zinc-insulin. Ndi subcutaneous jakisoni, zotsatira zake zimayambira maola a 6-8 atatha kutsata. Imakwaniritsa zotsatira zazikulu pambuyo maola 12-18, ndipo imatha pambuyo pa maola 28-30. Analogue ya mankhwala aku Danish "Ultra-tepi."

Kuyimitsidwa kwa Insulin-zinc (ISC) ndi chisakanizo cha ICS "A" (30%) ndi ICS "K" (70%). Kukhazikika kwa mankhwalawa kumachitika pambuyo pa maola 1-1,5 ndipo kumatha maola 24. Pambuyo pokonzekera mankhwalawa, kuphatikiza kwachiwiri kwa zochita zake zimawonedwa - pambuyo pa maola 5-7 ndi maola 12-18, zomwe zimagwirizana ndi nthawi yomwe mankhwalawa amaphatikizidwira. Analogue ndi "tepi yatsopano".

B-insulin ndi yankho losabala, lopanda utoto wa insulin komanso prolongator yokonzedwa mosakanikira.Kukhazikika kwa hypoglycemic zotsatira kumachitika ola limodzi makonzedwe. Kutalika kwa kuchitapo kanthu ndi maola 10-16. Amapangidwa ku Germany.

Kukonzekera konseku kwa insulin kukonzekera kumapezeka m'mabotolo 5 ml okhala ndimitundu 40 m'mililita imodzi. Musanagwiritse ntchito, vial amayenera kugwedezeka pang'ono mpaka mawonekedwe aunifolomu awonekere. Tiyenera kukumbukira kuti mankhwalawa amatha kutumikiridwa kokha. Jakisoni wawo wamkati sakuvomerezeka. Simungathe kuzigwiritsanso ntchito ndi matenda a shuga.

Momwe mungapangire jakisoni wa insulin?

Odwala ambiri omwe ali ndi matenda ashuga amafunika jakisoni wa insulin tsiku lililonse (nthawi zina kangapo patsiku) kuti akhale ndi thanzi. Chifukwa chake, ndikofunikira kuti wodwala aliyense aphunzire kuperekera insulin payokha.

Zilonda nthawi zambiri zimaperekedwa pansi pa khungu kumalo a kunja ndi kumbuyo kwa phewa kapena pansi pa tsamba. Wodwalayo akavulala insulin palokha, ndikofunikira kwambiri kuchita izi kumanzere kumanzere kapena kumanja (kuchokera kunja), matako kapena pakati penipeni pamimba.

Ngati jakisoni, ndibwino kugwiritsa ntchito syringe yopangidwa ndi "insulin" kapena syringes yaying'ono (1-2 ml) yamagawo a 0,5 ml.

Musanayambe kuperekera insulin, ndikofunikira kudziwa pasadakhale kuchuluka kwa mankhwalawa omwe angayilowetsedwe mu syringe (mwanjira iyi, kuwongoleredwa ndi mlingo womwe dokotala wakupatsani.

Nachi zitsanzo: ngati magawo 40 a insulin ali ndi ъ ml ya mankhwalawa, ndipo wodwalayo ayenera kulowa magawo 20, ndiye kuti 0,5 ml ya insulini iyenera kukokedwa mu syringe, yomwe ikugwirizana ndi magawo 5 a gramu ya 1-gramu ndi 2,5 ya syringe ya 2-gramu.

Kuwerengera uku kumachitika pogwiritsa ntchito syringe yachilendo, koma ndibwino kugwiritsa ntchito syringe yapadera ya jakisoni wa insulin.

Mukabayidwa, ndikofunikira kuwona kusowa kwathunthu (kuti mupewe kufalitsa matenda).

Njira yakuyendetsera insulin ndi yosavuta ndipo sikutanthauza maphunziro apadera azachipatala. Komabe, jakisoni woyamba yemwe wodwalayo amapanga payekha ayenera kuchitika moyang'aniridwa ndi namwino komanso ndi chithandizo chake.

Asanapange jakisoni, wodwalayo amayenera kukhala ndi vuto lambiri ndi insulin, syringe yokhala ndi singano ziwiri, zotupa za anatomical, thonje lodziyamwa, ethyl kapena methyl mowa (chidutswa cha mowa), chosakanizira, kapena mbale zopangidwira makamaka kuwotcha syringe. Ndikofunikira kuti wodwala kuyambira pachiwopsezo azitenga jekeseni iliyonse mozama ndikuzolowera jakisoni. Zoyipa sizivomerezeka pano. Kuphwanya khunyu kumatha kuyambitsa zovuta zowopsa (zotupa, zina).

Pamaso pa jakisoni, syringe imasakanikirana, kenako, limodzi ndi singano ndi ma pulosha, zithupsa kwa mphindi 5 mpaka 10 m'madzi oyera. Syringe yosemedwayo imachotsedwa ndi ma tonneers ndikusakanika osakhudza nkhope ya pistoni ndi nsonga ya syringe. Singano imayikidwa pa syringe ndi ma tweezers, kuyenda kwa piston kumachotsa madzi otsalira mu syringe.

Madzi a insulini amatengedwa motere: pisitoni ya syringe imabweretsedwa ku chizindikiro chogwirizana ndi kuchuluka kwa insulin, pambuyo pake chigoba cha mphonje chakumenyedwa ndi singano yovalidwa pa syringe.

Pamene singano imayikidwa mu ampoule (isanamizidwe mu madzi), mpweya womwe uli mu syringe umamasulidwa (izi zimachitika ndikakanikizira piston). Kenako, ndikakulowetsa botolo, singano imamizidwa mu njira ya insulin. Pansi pa kuthamanga kwa mpweya, madzi amayamba kulowa mu syringe.

Mutayimba muyeso wokwanira wa mankhwalawo, singano ndi syringe zimachotsedwa pa ampoule. Panthawi imeneyi, mpweya umatha kulowa mu syringe.

Chifukwa chake, syringe iyenera kuchitika kwakanthawi ndi singano, kenako nkutulutsa mpweya ndi madzi pang'ono (chifukwa chake nthawi zonse muyenera kutenganso insulin pang'ono mu syringe kuposa momwe muyenera kubayira).

Tsamba la jakisoni liyenera choyamba kupukutidwa ndi ubweya wa thonje ndi mowa. Kenako, khungu lokhala ndi minyewa yolumikizira imagwidwa ndi dzanja lamanzere, ndipo singano imayikidwa ndi dzanja lamanja.

Pambuyo pake, gwiritsani ndi singano ndi dzanja lamanzere pamaluko ndi syringe, ndikulowetsa piston kumapeto ndi dzanja lamanja; mutachotsa singano, tsamba la jakisoni limapangidwanso mosamala ndi mowa.

Nthawi ya jakisoni, chisamaliro chikuyenera kuthandizidwa ndikuonetsetsa kuti insulini sikutuluka pakulowa ndi singano ndi syringe (gwiritsani ntchito singano zokha zomwe zimagwirizana ndi kutsegula kwa syringe).

Monga mukuwonera, njira yonse ya jakisoni siyimayambitsa zovuta zilizonse. Wodwala amapeza luso lofunikira. Ndikofunikira kutsatira mosamalitsa malamulo onse oyenera ndi kusamala.

Insulin yasintha njira yochizira matenda ashuga. Koma chithandizo ndi chithandizo chake, monga tawonera kale, sichimakhala pazovuta zina: ndikofunikira kupaka insulin m'njira jakisoni 2-3, ndipo nthawi zina ngakhale 4 pa tsiku, nthawi zina hypoglycemia imayang'aniridwa (ngati simutsatira zakudya), nthawi zina pamakhala munthu tsankho, abscesses pambuyo jekeseni, etc.

Insulin ndi mankhwala okhala ndi mapuloteni. Chifukwa chake, kugwiritsidwa ntchito kwake nthawi zina kumayambitsa thupi kulimbana. Ichi ndichifukwa chake mu milandu iyi ndikulimbikitsidwa kuti musinthe mndandanda wa insulini womwe umayendetsedwa. Mu matenda angapo, insulin nthawi zambiri imaphatikizidwa.

Kuledzera kwa insulin sikumakula. Itha kuchotsedwa mosavuta, makamaka pakadali pano, ngati pali magulu osiyanasiyana a hypoglycemic omwe odwala amatenga pakamwa. Izi zimaphatikizapo mankhwala ochepetsa shuga a sulfonamide ndi biguanides.

Kufotokozera za zinthu insulin nthaka kuyimitsidwa (insulin kuyimitsidwa, pawiri): malangizo, ntchito, contraindication ndi kakhazikidwe.

• Zabwino, reagents ndi zapakati

1 ml ya yankho losavomerezeka lamadzimadzi lili ndi nthaka (munthawi ya chloride) 47 μg, sodium kolorayidi 7 mg, sodium acetate 1.4 mg, methyl parahydroxybenzoate 1 mg, komanso sodium hydroxide ndi hydrochloric acid (kusintha kwa pH), mu 10 ml mbale , pamatoni 1 a botolo.

Kuchepetsa kwa insulin kukonzekera komwe kamapangidwa ndi Novo Nordisk kuyenera kuchitidwa pang'onopang'ono mpaka muyeso wokhazikitsidwa ndi adokotala malinga ndi kuchuluka kwa mankhwala omwe ali nawo makamaka ana.

Pamalo amdima pakutentha kwa 2 8 C. M'firiji. Kusungidwa pamalo otetezedwa ndi kuwala kwa dzuwa kumavomerezedwa kutentha pang'ono kuposa 25 C kwa milungu 6.

Pewani kufikira ana.

Zaka 2 Wopangidwa ndi 10 IU / ml, kukonzekera kwa insulini kumakhala kosasunthika kwa masabata awiri ndikasungidwa mufiriji osati pafupi kwambiri ndi mufiriji pamtunda wa 2-8 C.

Nthawi zina, chiwonetsero cha thupi lawo siligwirizana pazigawo za mankhwala ndizotheka. Kupitilira muyeso womwe walimbikitsidwa, kulimbitsa thupi mwamphamvu, kudya mosasamala, matenda opatsirana omwe amachitika ndi matenda am'mimba komanso kusanza kungayambitse hypoglycemia.

Nthawi yomweyo, mphaka amakhala ndi vuto logwedeza, kutuluka thukuta kwambiri, kumangokhalira kumva njala, kugunda kwamtima ndi kugunda kwamphamvu, mantha, nkhawa, komanso kulephera kuyang'ana malo. Zizindikirozi zikaonekera, kuyezetsa magazi ndikofunikira kudziwa kuchuluka kwa shuga ndi kusintha mankhwalawo. Zikatero, dontho la glucose limagwiritsidwa ntchito.

Ngati chiweto sichilandira insulini yokwanira, ndipo jakisoni sanachitike munthawi yake, ndiye kuti hyperglycemia (diabetesic acidosis) ingachitike. Izi zikuwoneka ndikuwoneka ndi ludzu lalikulu, chikomokere, kugona komanso kuwuma.

Mphaka umapatsidwa jakisoni woyamba m'mawa asanadye. Komanso, kuchuluka kwa chakudya kuyenera kukhala 50% ya chakudya chokwanira cha tsiku lililonse. Kudya kwachiwiri kumachitika pambuyo pa maola 12 komanso pambuyo popereka mankhwala.

Kutengera ndi malangizo, palibe zoyipa zomwe zimadziwika. Ngakhale kugwiritsidwa ntchito kwa nthawi yayitali kwa caninsulin kumatha kuyambitsa lipodystrophy. Musapereke mankhwalawa kwa nyama yokhala ndi shuga wochepa wamagazi (hypoglycemia).

E10 Matendawa wodwala matenda a shuga a insulin E11

Insulin Yapakatikati. Monocomponent (yoyeretsedwa kwambiri) nkhumba yosakanizidwa ndi zinc-insulin. Amapezeka mu mawonekedwe a kusayimira kosagwirizana ndi jekeseni wokhala ndi 30% amorphous ndi 70% crystalline insulin.

Pharmacology

Zotsatira zam'magazi ndi hypoglycemic.

Amayang'anira kagayidwe kazakudya zam'mimba, lipids ndi mapuloteni. Amalumikizana ndi ma membrane ena a cytoplasmic cell ndipo amapanga insulini yolandirira. Pogwiritsa ntchito cAMP (m'maselo amafuta ndi ma cell a chiwindi) kapena kulowa mwachindunji mu cell (minofu), zovuta zimayambitsa zochitika zina, kuphatikizapo

amathandizira kaphatikizidwe kachulukidwe ka glycolysis michere ya hexokinase, phosphofructokinase, pyruvate kinase ndi ena angapo, kuphatikiza glycogen synthetase mu ziwalo zolumikizira (chiwindi, minofu yamatumbo). Kuchulukitsa kukula kwa masanjidwe am'magazi a glucose komanso kuchuluka kwa magwiritsidwe ake ndi minofu.

Kutsika kwa shuga m'magazi kumayendetsedwa ndi kuwonjezeka kwa lipogenesis, glycogenogeneis, kaphatikizidwe ka mapuloteni komanso kuchepa kwa kupanga kwa chiwindi. Imakhala ndi vuto losagwirizana ndi madzi komanso michere metabolism.

Mafuta ndi kuyambika kwa matendawo kumadalira njira (s / c / mu / m) ndi malo (pamimba, ntchafu, matako) oyang'anira, kuchuluka kwa jakisoni, kuchuluka kwa insulini mu mankhwalawa, ndi zina zotere. mkaka. T1 / 2 ndi mphindi 5-6. Amawonongedwa ndi insulinase m'chiwindi komanso impso. Amachotsa impso (30 80%).

Mtundu woyamba wa matenda a shuga 1, kuphatikizapo mwa ana ndi amayi apakati (ndi kusakhazikika kwa mankhwala othandizira pakudya), lembani matenda ashuga a 2 (mothandizidwa ndi matenda a hypoglycemic othandizira amachokera ku sulfonylureas), omwe ali ndi matenda okhudzana, othandizira kwambiri, m'malo opatsirana, ovulala komanso opsinjika.

Contraindication

Hypersensitivity, hypoglycemia, insuloma.

Pa nthawi ya pakati, ndikofunikira kuti muzizindikira kuchepa (I trimester) kapena kuwonjezeka (II ndi III trimesters) pazofunikira za insulin. Panthawi yoyamwitsa, kuyang'anira mosalekeza kwa miyezi ingapo kumalimbikitsidwa (mpaka kufunika kwa insulini ndikukhazikika).

Hypoglycemia (wokhala ndi waukulu milomo, kudumphadumpha kapena kuchedwetsa chakudya, kuchita masewera olimbitsa thupi, motsutsana ndi kumbuyo kwa matenda kapena matenda, makamaka kusanza ndi kutsekula m'mimba): kusowa thukuta, thukuta, kusowa tulo, kunjenjemera ndi zizindikiro zina, mpaka mpaka kukomoka.

hyperglycemia ndi matenda ashuga acidosis (pa Mlingo wochepera, jakisoni wambiri, zakudya zosakwanira, motsutsana ndi matendawa ndi matenda otentha thupi), limodzi ndi kugona, ludzu, kusowa kudya, kuthina kwamaso ndi zizindikiro zina, mpaka kukomoka.

matupi awo onse. anaphylactoid zimachitika (zosowa), zotupa, angioedema, laryngeal edema, anaphylactic mantha, hyperemia ndi kuyabwa pamalowo jekeseni (m'masabata oyamba azachipatala), lipodystrophy (yolamulira nthawi yayitali pamalo omwewo).

Kuchita

kulera kwapakamwa kwa mahomoni, mankhwala opatsirana a steroidal, mahomoni a chithokomiro, heparin, kukonzekera kwa lithiamu, nikotini (kusuta), thiazide ndi loop diuretics. Ethanol ndi mankhwala opha majeremusi amachepetsa zochita (zamankhwala am'magazi), sizigwirizana (sizingasakanikirane) ndi ma insulin okhala ndi phosphate, ndi kuyimitsidwa kwina kwa zinc-insulin.

Bongo

Zizindikiro: zizindikiro za hypoglycemia, thukuta lozizira, kufooka, khungu, kugona, kugwedezeka, miyendo, milomo, lilime, mutu, m'malo opweteka kwambiri.

Chithandizo: cha hypoglycemia yofatsa komanso yolimbitsa thupi, kuchuluka kwa shuga (mapiritsi a shuga, zipatso zamasamba, uchi, shuga ndi zakudya zina zokhala ndi shuga), wokhala ndi vuto lalikulu la hypoglycemia, makamaka chifukwa cha kusazindikira komanso kupuma kwa 50 ml ya magawo 50 a iv. kulowetsedwa kwa 5 10% yamadzi glucose solution, kapena 1 2 mg ya glucagon (i / m, s / c, iv), nthawi zina, diazoxide iv 300 mg kwa mphindi 30 maola 4 aliwonse,

Hypoglycemia (wokhala ndi waukulu milomo, kudumphadumpha kapena kuchedwetsa chakudya, kuchita masewera olimbitsa thupi, motsutsana ndi kumbuyo kwa matenda kapena matenda, makamaka kusanza ndi kutsekula m'mimba): kusowa thukuta, thukuta, kusowa tulo, kunjenjemera ndi zizindikiro zina, mpaka mpaka kukomoka.

hyperglycemia ndi matenda ashuga acidosis (pa Mlingo wochepera, jakisoni wambiri, zakudya zosakwanira, motsutsana ndi matendawa ndi matenda otentha thupi), limodzi ndi kugona, ludzu, kusowa kudya, kuthina kwamaso ndi zizindikiro zina, mpaka kukomoka.

matupi awo onse. anaphylactoid zimachitika (zosowa) - zotupa, angioedema, laryngeal edema, anaphylactic mantha, jekeseni - hyperemia ndi kuyabwa (m'masabata oyamba azachipatala), lipodystrophy (yolamulira nthawi yayitali pamalo omwewo).

kulera kwapakamwa kwa mahomoni, mankhwala opatsirana a steroidal, mahomoni a chithokomiro, heparin, kukonzekera kwa lithiamu, nikotini (kusuta), thiazide ndi loop diuretics. Ethanol ndi mankhwala opha majeremusi amachepetsa zochita (zamankhwala am'magazi), sizigwirizana (sizingasakanikirane) ndi ma insulin okhala ndi phosphate, ndi kuyimitsidwa kwina kwa zinc-insulin.

Gulu la mankhwala

Kukonzekera kwa gulu la insulin-zinc-kuyimitsidwa kuli ndi nthawi yayitali. Mankhwala a insulin-zinc-insulin A (amorphous zinc-insulin) amawonetsa kutsitsa kwambiri shuga pambuyo ma 1 11/2 jekeseni, yemwe amakhala pafupifupi maola 7, kenako pang'onopang'ono amayamba kutsika. Kutalika konsekonse kwa kuchepetsa shuga kwa mankhwalawa ndi maola 10 12.

Mankhwala insulin-zinc-insulin K (crystalline zinc-insulin) amakhala ndi nthawi yayitali kwambiri mpaka atakwanitsa maola 30 jekeseni litayamba, patapita maola 12 mpaka 18, apezeka. Kuyimitsidwa kwa mankhwala a insulin-zinc (osakanikirana amorphous ndi crystalline) kumakhala ndi nthawi yayitali mpaka maola 24 ndi mphamvu yayitali pambuyo pa maola 8 mpaka 12.

Posamutsa wodwala jakisoni wa insulini-zinc-kuyimitsidwa kukonzekera, kuchuluka kwazigawo zonse za insulin zomwe zimadulitsika kale kwa odwalayo kawiri kapena zingapo jakisoni masana imabayidwa musanadye chakudya cham'mawa.

Mukakusamutsira jakisoni wa protamine-zinc-insulin kapena mitundu ina ya insulin-zinc-insulin (K kapena kusakaniza) tsiku loyamba musanadye chakudya cham'mawa, insulin yosavuta imalowetsedwa pafupifupi kuchuluka kwa gawo limodzi mwa magawo atatu a kuchuluka kwa insulin yomwe idalandiridwa tsiku latha, kenako ndi jakisoni wolembedwa dotolo wa chimodzi mwazomwe zatchulidwazi akuchita insulini yolingana ndi gawo limodzi mwa magawo awiri atatu aliwonse a insulin.

Mtsogolomo, kuyambira tsiku lotsatira, monga momwe dokotala angakulangizirani, mutha kusintha jakisoni imodzi yokha ya insulin yokwanira tsiku lililonse musanadye chakudya cham'mawa kapena kupitiriza kumwa jakisoni wa insulin wophatikizana ndi jakisoni wosavuta wa insulin, monga tafotokozera pamwambapa.

Posamutsa wodwala jakisoni wa protamine-zinc-insulin kapena kuyimitsidwa kwa insulini-zinc wa ICC ndi ICSC, zakudya zake ziyenera kumangidwanso kuti chiwerengero chachikulu cha zakudya zomwe zili ndi mafuta ambiri m'mawa ndi madzulo.

Izi ndi zofunika kukwaniritsa yunifolomu yochepetsera shuga masana ndi jakisoni wa tsiku ndi tsiku komanso kupewa kuyambika kwa usiku hypoglycemia. Kwa izi, odwala amalangizidwanso kuti azisiyako gawo laling'ono lazakudya zomwe azidya asanalowe (mwachitsanzo, kapu yamkaka kapena kefir ndi 50 magalamu a buledi).

Kuti musankhe kukonzekera kwa insulin mokwanira komanso kusintha kwake kwa dokotalayo kuti muwone wodwalayo, ndikofunikira kukhala ndi chidziwitso cha kuchuluka kwa shuga omwe amapatsidwa kwa odwala nthawi zosiyanasiyana masana. Pachifukwa ichi, wodwalayo ayenera kutenga mkodzo patsiku kuti awunikidwe m'njira zosiyanasiyana.

Ngati zidzachitike kuti wodwalayo, kutsatira zakudya zolimbitsa thupi, amathira shuga mkodzo koposa zonse mu theka loyambirira la tsiku (pambuyo pa chakudya cham'mawa komanso pambuyo pa nkhomaliro), pamenepa, kuyimitsidwa kwa insulin-zinc nthawi zambiri kumayikidwa.

Ndi kuchuluka kwa shuga kwamkodzo mu mkodzo, osati masana, komanso madzulo, dokotala amafotokozera wodwala kuyimitsidwa kwa insulin-zinc. Pakakhala kuchuluka kwa shuga ndi mkodzo usiku ndi m'mawa musanadye chakudya cham'mawa, ndiye kuti mankhwalawa ndi mankhwala a insulin-zinc-kuyimitsidwa K. M'milandu iwiri yotsiriza, kuyang'anira protamine-zinc-insulin kungakhale koyenera.

Matenda a shuga, N.R. Pyasetskiy

Malangizo apadera

Munthawi ya chithandizo ndi Caninsulin, mphaka uyenera kukhala pachakudya chokhwima. Mankhwala sayenera kutumizidwa ngati nyama ili yolemera kwambiri. Insulin singagwiritsidwe ntchito munthawi yomweyo ndi ma tetracycline antibayotiki, corticosteroids, sulfonamides ndi progestogens.

Ngati zakudya komanso chikhalidwe chake zimasintha, ndiye kuti kuchuluka kwa Caninsulin kumasintha. Mlingowo umasinthidwanso ngati matenda a impso ndi chiwindi amachitika, atachitidwa opaleshoni, panthawi yapakati komanso matenda opatsirana.

Ndemanga za mankhwala

Katherine. Mphaka wathu ali ndi zaka zopitilira 10, ndipo posachedwapa wapezeka ndi matenda a shuga. Dokotala adalangiza jakisoni wa Caninsulin, kawiri pa tsiku. Sindinganene kuti vutoli likuwonekera kwambiri, koma mphaka akumva bwino, kuchuluka kwa glucose kumayamba kuchepa.

Anna Ndimakondwera ndi mankhwalawa. Takhala tikugwiritsa ntchito caninsulin kwa nthawi yayitali, chifukwa mphaka wakhala akudwala matenda a shuga a pafupifupi insulin pafupifupi zaka 5. Sanawone zotsatira zoyipa, koma mankhwalawo sanawonjezeke. Ndikofunikira kwambiri kutsatira zakudya mosasamala kuti nyama izikhala yodetsa nkhawa.

Olga Pa intaneti, pamakhala ndemanga zotsutsana pa mankhwalawa. Apa, zambiri zimatengera momwe thupi limagwirira ntchito pazochitika za Caninsulin. Mphaka wathu amalekerera bwino, pokhapokha jakisoni atatha kukula kwakanthawi kwakanthawi.

Insulin yochepa komanso yayitali - kuphatikiza pamodzi

Pochizira amakono a shuga, onse omwe amakhala akuchita insulin komanso insulin yocheperako amagwiritsidwa ntchito. Zingakhale bwino kwambiri kwa odwala ambiri omwe amagwiritsa ntchito mankhwala osakanikirana kuti asakanikize kwakanthawi ndikuwonjezera insulini imodzi mu syringe imodzi, mwakutero amapanga khungu limodzi pakhungu m'malo awiri.

Kugawana

Kugwiritsa ntchito nthawi yayitali insulin ndi insulin sikuvuta nthawi zonse kusakaniza. T.N. mankhwala (galenic) omwe amagwirizana ndi insulin kukonzekera kwambiri kumakupatsani mwayi wophatikiza insulin ndi insulin.

• Mukasakaniza, ndikofunikira kukumbukira kuti insulin yochepa imagwira ntchito kwambiri ndipo ngati ingasakanizidwe mosayenera, zotsatira zake zitha kutayika. Zatsimikiziridwa kuti insulin yayifupi ikhoza kusakanizika mu syringe yomweyo ndi yankho la protamine-insulin. Mphamvu ya insulin yochepa sikuchepetsa, kotero insulin yosungunuka siyimangiriza protamine.
• Zilibe kanthu kuti ndi makampani ati omwe amapanga mankhwalawa. Chifukwa chake, ndikosavuta kusakaniza actrapid ndi humulin H kapena actrapid ndi protafan. Zosakaniza za insulin izi zimasungidwa nthawi zambiri.
• Komabe, kuyimitsidwa kwa crystalline insulin-zinc sikuyenera kusakanikirana ndi insulin yayifupi, monga kuphatikiza ndi ayoni a zinc ambiri, insulin yochepa imasinthidwa pang'ono mpaka kukhala insulin.

Sizachilendo kuti odwala azilowetsa jakisoni wofupikitsa, kenako, popanda kutenga singano kunja kwa khungu, amapaka jekeseni wa zinc. Sizitsimikiziridwa mwasayansi, komabe, titha kuganiza kuti poyambitsa izi, kusakanikirana kwapafupifupi ndi insulin mitundu ya khungu pansi pa khungu, ndipo izi sizingasinthe kuyamwa kwa gawo loyambirira.

Pofuna kupewa zoyipa, kuphatikiza kwapadera kwa insulin ndi insulin ya insulin ndikulimbikitsidwa mwamphamvu (mwa jekeseni padera m'malo osiyanasiyana a khungu, mtunda pakati pa malo oyang'anira ndi osachepera 1 cm).

Chizindikiro chakuyimitsidwa kwa protamine-zinc-insulin

Kuyimitsidwa kwa crystalline zinc insulin kumagwiritsidwa ntchito pa shuga mellitus wa mawonekedwe olimbitsa komanso oopsa.

Opanga a matenda a shuga a shuga amawapangitsanso insulin. Mankhwala oterewa ndi kuphatikiza kwa insulin yochepa komanso protamine insulin pa chiwopsezo chokhazikika (mixtard, actrafan, insuman comb, etc.).

Zosakaniza zothandiza kwambiri zomwe zimakhala ndi 30% yochepa insulin ndi 70% protamine insulin kapena 25% yochepa insulin ndi 75% protamine insulin. Kuwerengera kwa zigawo zikuluzikulu kumawonetsedwa mu malangizo ogwiritsira ntchito.

Mankhwalawa ndi oyenera kwa odwala omwe amatsatira zakudya zosasintha, zomwe zimatsogolera moyo wokangalika, etc. (ambiri okalamba okonda ndi matenda a shuga II).

Komabe, kuphatikiza insulin kumakhala kosavuta pakuthandizira kusintha kwa insulin. Ndi mankhwalawa, ndikofunikira ndipo nthawi zambiri zimatha kusintha kuchuluka kwa insulin yochepa, kutengera zomwe zili ndi chakudya mu chakudya, zolimbitsa thupi, ndi zina zambiri. Mlingo wa insulin wa nthawi yayitali (basal) umasiyana pang'ono.

Mlingo ndi makonzedwe

S / c kuya (kutsogolo, ntchafu ya kumtunda, matako, m'mimba) musanagwiritse ntchito, gwedezani botolo mpaka kuyimitsidwa koyipa, mutengere nthawi yomweyo ndikulowetsa muyezo woyenera, musamuwiritse ntchito jakisoni wa jekeseni.

Mlingo umayikidwa mosiyanasiyana payekhapayekha (potengera kuchuluka kwa shuga m'magazi ndi kulemera kwa thupi). Pakulowa kwa tsiku lililonse kopitilira 0,6 U / kg, ndikofunikira kupangira jekeseni wa 2 kapena kuposa m'malo osiyanasiyana a thupi.

Mukasintha kuchokera ku majakisoni a porcine yotsukidwa kwambiri kapena insulin ya anthu, mlingo umakhalabe wosasinthika, pakubwezeretsa bovine kapena insulin ina yosakanikirana (kuwunika kwa shuga m'magazi ndikofunikira), mankhwalawa nthawi zambiri amachepetsedwa ndi pafupifupi 10% (kupatula ngati sichikupita 0.6 U / kg). Odwala omwe amalandila 100 IU kapena kuposerapo patsiku, akachotsa insulin, ndikofunika kuchipatala.

Njira zopewera kupewa ngozi

Kusintha kwa Mlingo ndikofunikira posintha chikhalidwe ndi zakudya, kuchuluka kwa zochitika zolimbitsa thupi, matenda opatsirana, kutentha thupi, kutsekula m'mimba, gastroparesis ndi zina zomwe zimachedwetsa mayamwa kudya, njira zopangira opaleshoni, kuchepa kwa chithokomiro cha chithokomiro, nyemba za adrenal (matenda a Addison), gland planditary (hypopituitism), Kulephera kwaimpso, kupitirira kwa matenda a chiwindi, kutenga pakati, kuyamwitsa, mwa ana osadukiza komanso odwala omwe ali ndi zaka zopitilira 65 (chiopsezo chowonjezeka cha hypoglycemia).

Chepetsani mankhwalawa ngati mutha kwambiri kusuta, ngati muli ndi vuto la matenda ashuga 1, onjezani nthawi yolowa pakati pa mabungwe ndikuchepetsa mankhwalawa kumbuyo kwa othandizira omwe amachititsa hypoglycemia (kuchuluka - poika mankhwala a hyperglycemic).

Kusintha kwa mlingo kumatheka mu masabata oyambilira a 1-2 mutatha kulowetsa mtundu wina wa insulin ndi ina. Chenjerani pakufunika koyambirira, kusintha kwa insulin, kupsinjika kwa thupi kapena malingaliro mwa anthu omwe amayendetsa galimoto, kuwongolera njira zosiyanasiyana ndi zochitika zina zowopsa zomwe zimafuna chidwi chochulukirapo komanso kuthamanga kwa zochitika zama psychomotor.

Mankhwalawa, miyezi itatu iliyonse (kapena pafupipafupi wokhala ndi vuto losakhazikika), kuchuluka kwa glucose m'magazi kumatsimikiziridwa ndipo, ngati ndizoposa 11.1 mmol / l, mulingo wa ma ketones (acetone, keto acid) mumkodzo. Ndi hypoglycemia ndi ketoacidosis, pH ndi kuchuluka kwa ayoni a potaziyamu mu seramu yamagazi amalembedwa,