Insulin yokhala ndi nthawi yayitali komanso zizindikiro zazikulu zogwiritsira ntchito

Pofuna kusungitsa glucose pamlingo wolimbana ndi matenda ashuga komanso kuonetsetsa kuti magazi ake ali pachibelekeropo pamimba yopanda kanthu masana, insulin yowonjezera imagwiritsidwa ntchito. Cholinga chake ndikubweretsa timadzi tambiri m'magazi kuti tisayandikire. Insulin yayitali nthawi zambiri imaphatikizidwa ndi yochepa, yomwe imalowetsedwa musanadye chilichonse.

Ndikofunikira kudziwa! Nkhani yatsopano yomwe ikulangizidwa ndi ma endocrinologists a Kupitiliza kwa Matenda Atsopano! Ndi zofunika tsiku lililonse.

Mlingo ndiwofanana payekha, mutha kuwatenga mwanjira zoyesera. Popewa hypoglycemia, kuchuluka koyamba kwa mahomoniwo kumapangidwa kwambiri, kenako kumachepetsedwa pang'onopang'ono mpaka magazi a m'magazi amayamba.

Mlingo wosankhidwa bwino wa insulin yayitali umachepetsa zovuta za matenda ashuga ndipo umalola wodwala kukhalabe wokangalika kwa zaka zambiri.

Mayina Mankhwala Osokoneza bongo

Kusakhalapo kwa zochitika mu insulin yochitika kwa nthawi yayitali kumachitika chifukwa cha kupezeka kwa timadzi tating'onoting'ono timadzi timene timalowa m'magazi, momwe timalowa m'magazi mokwanira. Mlingaliro wa Glargine wa Ph ndiwac acid ndipo izi zimapatula kuyanjana kwake ndi kukonzekera kosatha kwa Ph Ph, i.e. yochepa komanso ya ultrashort insulin.

Mayina odziwika kwambiri a insulin omwe amakhala nthawi yayitali amaperekedwa pagome pofotokozeredwa bwino:

Pochiza matenda a shuga kunyumba, akatswiri akulangizani DiaLife . Ichi ndi chida chapadera:

• Amasinthasintha shuga
• Amayang'anira ntchito ya pancreatic
• Chotsani puffness, limayendetsa madzi kagayidwe
• Imasintha khungu
• Zoyenera akulu ndi ana.
• Alibe zotsutsana

Timapereka kuchotsera kwa owerenga tsamba lathu!

Gulani pa tsamba lovomerezeka

Matenda a shuga ndi kupsinjika kudzakhala chinthu chakale

Matenda a shuga ndi omwe amayambitsa pafupifupi 80% yonse yamikwingwirima ndi kuduladula. Anthu 7 mwa anthu 10 amafa chifukwa cha mitsempha ya mtima kapena ubongo. Pafupifupi nthawi zonse, chifukwa chomaliza chomaliza ndi chimodzimodzi - shuga wamwazi.

Shuga akhoza ndipo amayenera kugwetsedwa, apo ayi. Koma izi sizichiritsa matendawa, koma zimangothandiza kulimbana ndi kufufuza, osati zomwe zimayambitsa matendawa.

Mankhwala okhawo omwe amalimbikitsidwa mwalamulo kwa odwala matenda ashuga komanso ogwiritsidwa ntchito ndi ma endocrinologists pantchito yawo ndi Dzhi Dao Diabetes Adhesive.

Kugwiritsa ntchito bwino kwa mankhwalawa, kuwerengera malinga ndi njira yokhazikika (kuchuluka kwa odwala omwe achiwonjezere kuchuluka kwa odwala omwe ali pagulu la anthu 100 omwe adachitiridwa chithandizo):

• Matenda a shuga - 95%
• Kuthetsa kwa mitsempha thrombosis - 70%
• Kuthetsa kwa kugunda kwamtima kwamphamvu - 90%
• Kuthana ndi kuthamanga kwa magazi - 92%
• Kuwonjezeka kwa mphamvu masana, kukonza kugona usiku - 97%

Opanga Ji Dao si bungwe lazamalonda ndipo amalipiridwa ndi boma. Chifukwa chake, tsopano wokhala aliyense ali ndi mwayi wopeza mankhwalawo kuchotsera 50%.

Kusankhidwa kwa Insulin Yowonjezera

Kutulutsa kwa insulin m'magazi sikuyima mozungulira wotchi, ngakhale kukhalapo kapena kusowa kwa chakudya. Usiku ndi masana, pomwe chakudya chimodzi chakhala chikugwiritsidwa kale ndipo chinacho sichinafike, mawonekedwe am'mbuyomu amakhala osungika. Ndikofunikira kuti shuga amasweke, omwe amalowa m'magazi kuchokera m'masitolo a glycogen. Kuti muwonetsetse maziko, ngakhale khola, kukhazikitsa insulin yayitali ndikofunikira. Kutengera zomwe tafotokozazi, zikuwonekeratu kuti mankhwala abwino ayenera khalani ndi yayitali, yofananira , simunatchulidwe nsonga zapamwamba ndi zopondera.

Pazifukwa izi:

Kusankha kwa insulin yayitali ndi udindo wa dokotala. Imatengera kulanga kwa wodwala, kupezeka kwa chinsinsi cha mahomoni ake, chizolowezi cha hypoglycemia, zovuta zamavuto, kuchuluka kwa kusala kwa hyperglycemia.

Momwe mungasankhire insulin yayitali:

1. Nthawi zambiri, zokonda zimaperekedwa kwa ma insulin analogues, omwe ndi othandiza kwambiri komanso amaphunziridwa.
2. Ma Protamine othandizira amagwiritsidwa ntchito nthawi zambiri ngati njira ina ilibe. Ma insulin a NPH amatha kupereka chindapusa chokwanira cha matenda a shuga 2 mtundu woyamba wa mankhwala a insulin, pomwe kufunika kwa mahomoni kumakhalabe kotsika.
3. Tresiba ikhoza kugwiritsidwa ntchito bwino ndi mtundu wa 1 a matenda ashuga, omwe samakonda kutsika magazi ndikuyamba kumva zizindikiro za hypoglycemia koyambirira. Ndi matenda a shuga a 2, Tresib ndiye mtsogoleri wosagonjetseka pamsika wa insulin, chifukwa amaphatikiza bwino ndi othandizira pakamwa, amakhala ndi zotulukapo, ndipo amachepetsa pafupipafupi hypertlycemia yausiku.

Kuchuluka kwa insulin kwa nthawi yayitali kumagawidwa m'mawa ndi usiku makonzedwe, mlingo wawo nthawi zambiri umasiyana. Kufunika kwa mankhwalawa kumatengera kuopsa kwa matenda ashuga. Njira zingapo zapangidwa pakuwerengera kwake. Zonsezi zimafuna magawo angapo a shuga m'magazi. Kusankha kwa dose kumatenga nthawi,popeza poyambira kuchuluka kwa insulin yayitali kusinthidwa poganizira zovuta za mayamwidwe ndi kuphwanya kwa mahomoni m'thupi la wodwala wina. Kukhazikitsidwa kwa mlingo woyambira "ndi diso" kumabweretsa chiwopsezo chachikulu cha matenda ashuga, ndikukulitsa zovuta za matendawa.

Kukula kwa mlingo wosankhidwa bwino ndikubwino kwa kudya kwa glycemia, kuchepa kwam'mapapo komanso kusapezeka kwa hypoglycemia. Masana, kusinthasintha kwa shuga musanadye kumayenera kukhala ochepera 1.5 mmol / l -.

Kuwerengedwa kwa nthawi yamadzulo

Woyamba kusankha kuchuluka kwa insulin yochulukirapo, iyenera kupereka mulingo wa shuga usiku komanso m'mawa mutadzuka. Mu shuga mellitus, "zodzuka zam'mawa" nthawi zambiri zimawonedwa. Uku ndikuwonjezereka kwa glycemia m'mawa kwambiri, chifukwa cha kuwonjezeka kwa katulutsidwe ka mahomoni omwe amachepetsa mphamvu ya insulin. Mwa anthu athanzi, kutulutsidwa kwa insulin kumawonjezeka panthawiyi, motero shuga amakhazikika.

Mu shuga mellitus, kusinthasintha kumeneku kungathetsedwe kokha ndi kukonzekera kwa insulin. Kuphatikiza apo, kuchuluka kwa mankhwalawa kumachepetsa shuga m'magazi kuti akhale abwinobwino, koma kumapangitsa kutsika kwambiri kwa glycemia koyambira komanso pakati pausiku. Zotsatira zake, wodwala matenda ashuga amadwala malodza, mtima wake komanso thukuta lake limakulirakulira, mitsempha yake imadwala.

Kuti muthane ndi vuto la hyperglycemia m'mawa, osachulukitsa mlingo wa mankhwalawa, mutha kugwiritsa ntchito chakudya cham'mbuyomu, moyenera - maola 5 musanayambitse insulin yayitali. Munthawi imeneyi, shuga onse azakudya azikhala ndi nthawi yoti adutse m'magazi, zochita za timadzi tambiri tating'onoting'ono timatha, ndipo insulin yayitali ingasowe glycogen pachiwindi.

1. Kuti mudziwe kuchuluka kwa mankhwalawa jakisoni wamadzulo, manambala a glycemic kwa masiku angapo amafunikira. Muyenera kudya chakudya cham'mawa kwambiri, kuyeza shuga musanagone, kenako m'mawa mutangodzuka. Ngati m'matumbo glycemia anali wamkulu, miyeso imapitilira masiku ena anayi. Masiku omwe chakudya chidayandikira sachotsedwa pamndandanda.
2. Kuti muchepetse chiopsezo cha hypoglycemia, kusiyana kocheperako pakati pa miyeso iwiriyi kumasankhidwa masiku onse.
3. Chidziwitso cha insulin chimawerengedwa. Ichi ndiye kuchuluka kwa kuchepetsedwa kwa glycemia pambuyo poyang'anira gawo limodzi la mahomoni. Mwa munthu wolemera makilogalamu 63, gawo limodzi la insulin yowonjezera limatsitsa shuga ndi 4.4 mmol / L pafupifupi. Kufunika kwa mankhwalawa kukukula molingana ndi kulemera. PSI = 63 * 4.4 / kulemera kwenikweni. Mwachitsanzo, ndi kulemera kwa 85 kg, PSI = 63 * 4.4 / 85 = 3.3.
4. Mlingo woyambira amawerengedwa, ndi wofanana ndi kusiyana kocheperako pakati pa miyezo isanayambe kugona ndi m'mawa, yogawidwa ndi PSI. Ngati kusiyana ndi 5, lowetsani nthawi yogona musanadye magawo 5 / 3.3 = 1.5.
5. Kwa masiku angapo, shuga amayeza pambuyo podzuka, kutengera deta iyi, kuchuluka kwa insulini kumasinthidwa. Ndikwabwino kuti musinthe mankhwalawa pakadutsa masiku atatu, kusintha kulikonse kuyenera kupitirira gawo limodzi.

Ndi mtundu 2 wa shuga, shuga m'mawa amatha kukhala otsika kuposa nthawi yogona. Pankhaniyi, insulin yayitali sichikhala ndi jekeseni yamadzulo. Ngati glycemia atatha kudya chakudya chamadzulo, amapanga mankhwala othamanga a mahomoni othamanga. Insulin yayitali pazolinga izi sizingagwiritsidwe ntchito, imayendetsedwa chimodzimodzi.

Ngati kusintha kwa mlingo kumalephera

Hypoglycemia usiku ikhoza kubisika, ndiye kuti, wodwalayo m'maloto samva chilichonse ndipo sakudziwa za kukhalapo kwawo. Kuti mupeze kuchepa kobisika kwa shuga m'magazi, miyezo imachitika kangapo usiku: pa maola 12, 3 ndi 6. Ngati 3 koloko m'mawa glycemia ali pafupi ndi malire ochepa, tsiku lotsatira amayeza pa 1-00, 2-00, 3-00. Ngati chisonyezo chimodzi sichinachite bwino, zimawonetsa bongo

Anthu ena omwe ali ndi matenda ashuga omwe amafunikira insulin yaying'ono amakumana ndi zomwe zimachitika kuti timadzi tambiri timachepa m'mawa, ndipo sikokwanira kuthetsa vuto lodzuka m'mawa. Kuwonjezeka kwa mankhwalawa pamenepa kumabweretsa nocturnal hypoglycemia. Izi zimawonedwa mukamagwiritsa ntchito NPH-insulin yokha, komanso Lantus, Tujeo ndi Levemira.

Njira zothetsera vutoli: zowonjezera makonzedwe a 1-2 mayunitsi a insulin yayitali pa 2-00 kapena poplka ya 0.5-1 magawo a kukonzekera kwapafupi pa 4,00.

Ngati pali mwayi wazachuma, mutha kukambirana za kufunikira kwa insulini yayitali ndi dokotala. Zochita za Treshiba usiku wonse, ndiye kuti shuga m'magazi amakhala achilendo popanda jakisoni wowonjezera. Munthawi ya kusintha, kuwongolera pafupipafupi kwa glycemia kumafunikira kuti muchepetse kuchepa kwake masana.

Ambiri a endocrinologists amalimbikitsa kusinthira ku Treshiba kokha kuti awonetsetse. Anthu omwe ali ndi matenda ashuga, omwe othandizira amatsimikizira kuti amapereka chindapusa cha matendawa, akulangizidwa kuti apewe insulin yatsopano mpaka wopanga atapeza maphunziro okwanira ndipo zamuchitikira ndi mankhwalawo.

Doctor of Medical Science, Mutu wa Institute of Diabetesology - Tatyana Yakovleva

Ndakhala ndikuphunzira matenda a shuga kwa zaka zambiri. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinology Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsiratu matenda ashuga. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 98%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipira mtengo wapamwamba wa mankhwalawa. Ku Russia, odwala matenda ashuga mpaka pa Epulo 29 (kuphatikiza) nditha kuipeza - Kwa ma ruble 147 okha!

Mitundu ya Mankhwala Ochotsa Insulin

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.

Zomwe mungagwiritse ntchito insulin yayitali

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

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

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

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

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

Ganizirani momwe mungapewere zoyipa za insulin.

Mankhwala aliwonse a insulini, ngakhale atakhala nthawi yayitali bwanji;

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

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

Mankhwala otchuka

Ngakhale panali insulin yayitali, mayina omwe amaperekedwa patebulopo, otchuka kwambiri mpaka pano ndi Lantus ndi Levemir. Tiyeni tiwone chifukwa.

Mankhwala omwe odwala amagwiritsa ntchito nthawi zambiri kuposa ena. Sifunika kugwedezeka musanagwiritse jakisoni, kapangidwe kake ka kuyimitsidwa ndikowonekera komanso kopanda mpweya. Amapezeka mu cholembera, syringe, cartridge, ndi makatiriji makatoni asanu. Kukhalapo kwa chisankho choterocho kumapangitsa wodwala kusankha njira yomwe amavomerezeka kwa iye.

Pochiza matenda a shuga, mitundu ingapo ya insulini imagwiritsidwa ntchito, imodzi mwa izo ndi yayitali, kapena ya insulin yotalikilapo. Mankhwala ayenera kutha kumwa ndi kuwongolera.

Insulin ndi mankhwala othandizira kupewa matenda ashuga, jakisoni amene amachepetsa kuchuluka kwa shuga m'magazi, ndikuwonjezera mayamwidwe ndi minyewa (chiwindi ndi minofu). Insulin yayitali imatchedwa choncho chifukwa nthawi yake imakhala yambiri kuposa mitundu ina ya mankhwalawo, ndipo izi zimafuna kutsika kochepa.

Kusankhidwa kwa Mlingo wam'mawa

Insulin yayitali masana imafunikira kuti muchepetse shuga zakudya zikagayidwa kale. Zakudya zomanga thupi kuchokera ku chakudya zimalipitsidwa ndi mahomoni afupiafupi.Kuti mphamvu zake zisasokoneze kusankha kuchuluka kwa insulini yowonjezera, muyenera kufa ndi njala tsiku lina.

Kuwerengetsa kwa tsiku ndi tsiku mlingo wa algorithm:

1. Sankhani tsiku laulere kwathunthu. Idyani chakudya cham'mawa. Pangani kuchuluka kwa shuga mutadzuka, pambuyo pa ola limodzi, kenako katatu pakatha maola anayi aliwonse. Nthawi yonseyi yomwe simutha kudya, madzi okha ndi omwe amaloledwa. Pambuyo muyeso wotsiriza mutha kudya.
2. Sankhani shuga wochepa kwambiri patsiku.
3. Werengani kuwerengera kwakutali pakati pa mulingo uno ndi chandamale, chomwe 5 mmol / l amatengedwa.
4. Muwerenge insulin tsiku ndi tsiku: gawani kusiyana ndi PSI.
5. Pakatha sabata, bwerezani miyezo pamimba yopanda kanthu, ngati kuli kotheka, sinthani mlingo wake potengera deta

Ngati kusala kudya kwanthawi yayitali kuli koletsedwa kwa odwala matenda ashuga, muyezo ungachitike m'magawo angapo: woyamba kulumphira chakudya cham'mawa, tsiku lotsatira - nkhomaliro, tsiku lotsatira - chakudya chamadzulo. Kuchokera pakudya mpaka kuyeza shuga ayenera kutenga maola 5 ngati wodwalayo wavulala jakisoni wofupikiratu wa insulin asanadye, ndi pafupifupi maola 7 ngati insulin ya anthu yagwiritsidwa ntchito.

Ndalama zatsopano zimapitilira

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.

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

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

Wochedwa insulin

Chifukwa chake lero tikulankhula zakumbuyo ndi zoyambira za basal, ndipo m'nkhani yotsatira ndikulankhula za momwe mungasankhire mlingo wa chakudya, ndiye kuti, kubisa kufunika kwa kutetezedwa.

Pofuna kutsata secretion ya basal, insulin ya nthawi yayitali imagwiritsidwa ntchito. Pokhazikika pakati pa anthu odwala matenda a shuga, munthu akhoza kupeza mawu oti "insulin", "insulin yayitali", "insulin yayitali", "basal", zina.

Pakadali pano mitundu iwiri ya ma insulin omwe amagwira ntchito nthawi yayitali amagwiritsidwa ntchito: nthawi yayitali, yomwe imakhala mpaka maola 16, komanso yopanda nthawi yayitali, yomwe imagwira ntchito maola opitilira 16. Munkhaniyi ndidalemba kale za izi.

Zoyambirira zikuphatikiza:

• Humulin NPH
• Protafan HM
• Insuman Bazal
• Biosulin N
• Gensulin N

Lachiwiri limaphatikizapo:

Lantus ndi Levemir amasiyana ndi ena osati pakungokhala kosiyana, komanso poti amawonekera kwathunthu, pomwe ma insulini a gulu loyambalo ali ndi utoto wonyezimira, ndipo asanagwiritse ntchito amafunika kuti adulidwe pakati pa kanjedza kuti vutolo lithe mwamphamvu mitambo. Kusiyanaku kukugona m'njira zosiyanasiyana zopanga insulini, yomwe ndimalankhula nthawi ina m'nkhani yomwe adangopangira mankhwala osokoneza bongo.

Pitilizani? Ma insulini okhala ndi nthawi yayitali kwambiri, i.e., machitidwe awo amatha kutsata, osatchulika kuti ndi achifwamba omwe amangokhala osakwanitsa, komabe osakwanitsa. Pomwe ma insulin ochokera ku gulu lachiwiri amawonedwa ngati opanda ntchito. Ndi gawo ili lomwe limafunikira kuganizira posankha mtundu wa basal insulin. Koma malamulo onse amakhalabe chimodzimodzi kwa insulini zonse.

Chifukwa chake, mlingo wa insulin wa nthawi yayitali uyenera kusankhidwa kuti shuga ya magazi ikhale pakati pa chakudya. Kusinthasintha kosiyanasiyana kwa 1-1.5 mmol / L ndikuloledwa. Ndiye kuti, ndi mlingo wosankhidwa bwino, shuga wa magazi sayenera kuchuluka kapena kuchepa m'malo mwake. Zizindikiro zosalekeza ziyenera kukhala tsiku lonse.

Ndikufunanso kuwonjezera kuti insulini yokhala ndi nthawi yayitali imagwiridwa m'tchafu kapena pamphumi, koma osati m'mimba kapena mkono, chifukwa mumafunikira kuyamwa pang'onopang'ono komanso kosalala, komwe kungapezeke pokhapokha pobayira. Insulin yomwe imagwira ntchito mwachidule imalowetsedwa m'mimba kapena mkono kuti ikwaniritse bwino, yomwe iyenera kukhala pachimake pakulowetsedwa kwa chakudya.

Yaitali usiku usiku insulin

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

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

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

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

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

Yaitali tsiku ndi tsiku insulin mlingo

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

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

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

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

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

Ndi chisangalalo ndi chisamaliro, endocrinologist Dilara Lebedeva

Pharmacology yamakono imapatsa odwala omwe ali ndi matenda ashuga kusankha kwakukulu kwa kukonzekera kwa insulin. Ndipo lero tikulankhula zamitundu iti ya insulini.

Insulin yochepa

Kukonzekera mwachidule za insulin nthawi zambiri kumathandizidwa kwa odwala omwe ali ndi vuto la shuga.

Mankhwala atatha kulowa mthupi la munthu, amayamba kugwira ntchito patatha mphindi makumi atatu. Izi zimamupangitsa kukhala m'gulu la mankhwala othandiza kwambiri pochiza matenda ashuga. Nthawi zambiri, mtundu wa insulini umapangidwa nthawi imodzi ndi ma insulin omwe amakhala nthawi yayitali.

Kuti mupange chisankho, zinthu zotsatirazi ziyenera kukumbukiridwa:

• zambiri za wodwala
• malo oyang'anira
• Mlingo.

Zodziwika kwambiri ndizokonzekera insulin zomwe zimayamba kugwira ntchito mkati mwa mphindi 15 zoyambirira pambuyo pa kukhazikitsa. Izi zikutanthauza "Apidra", "Humagol" ndi "Novorapid".

Kulandila, Mlingo, kusungirako "kafupi" insulin

Imwani mankhwalawo musanadye. Pankhaniyi, ndi chakudya chomwe chimathandizira kuyamwa kwa insulin, zotsatira zake zimachitika nthawi yomweyo.

"Zofulumira" ma insulini amatha kutengedwa pakamwa, mutatha kuwayika madzi amadzimadzi.

Ngati subcutaneous makonzedwe a mankhwala amachitidwa, ndiye kuti jakisoni uyenera kuchitidwa pafupifupi mphindi 30 chakudya chisanachitike.

Mlingo wa munthu aliyense wodwala matendawa amasankhidwa payekha. Kwa akulu, mlingo umakhala magawo 8-24 patsiku, ndipo kwa ana - osaposa magawo 8.

Sungani mankhwala pamtunda wa + 2- + 8 madigiri. Chifukwa cha izi, alumali pakhomo la firiji ndiyabwino.

Insulin Yapakatikati

Anthu odwala matenda ashuga ayenera kumwa mankhwala omwe amawathandiza Koma mtundu uliwonse wa matenda ashuga umafunikira mtundu wina wa insulin. Chifukwa chake mankhwala omwe ali ndi nthawi yayitali amagwiritsidwa ntchito pamene glucose akufunika kuwonongeka pang'onopang'ono. Itha kugwiritsidwanso ntchito ngati pakadali pano palibe mwayi wogwiritsa ntchito insulin "yayifupi".

Zomwe zimapanga insulin "yapakatikati"

Kukonzekera kumakhala ndi zinthu zingapo:

• amayamba kugwira ntchito pasanathe mphindi 10 pambuyo pa utsogoleri,
• chida chimafunikira nthawi yayitali kuti chikwanire chokwanira.

• pakati pamatumba a anthu - ndalama Protafan, Humulin, Monotard ndi Homolong,
• Pakati pazithandizo zanyama - mankhwala "Berlsulin", "Monotard HM" ndi "Iletin II".

Insulin yayitali

Ndi mankhwala omwe amapezeka munthawi yake omwe amalola anthu odwala matenda ashuga kusangalala ndi moyo osakumana ndi zovuta chifukwa cha kukonzekera. Kodi pali kusiyana kotani pakukonzekera kwamtundu wa insulin ndi mitundu ina ya insulin yomwe timatenga nthawi yayitali? Tikambirana izi.

Kusiyanitsa kwakukulu pakati pa insulin pankhaniyi ndikuti mphamvu za mankhwalawa nthawi zina zimatha maola opitilira 24.

Kuphatikiza apo, mitundu yonse ya insulin yowonjezera-yomwe imakhala ndi mankhwala othandizira omwe amaonetsetsa kuti mankhwalawa agwira ntchito kwa nthawi yayitali. Amachedwetsanso kuyamwa kwa shuga. The achire zotsatira zimachitika pambuyo pafupifupi maola 4-6, ndipo nthawi yochita imatha kukhala maola 36.

Kuchita zinthu zazitali kwautali: mitundu yanji yomwe ilipo

Mankhwala omwe amadziwika kwambiri ndi Determit ndi Glargin. Kusiyanitsa kwawo kwakukulu ndi kuchepa kwamodzimodzi kwa shuga m'magazi.

Ma insulin omwe amakhala ndi nthawi yayitali ndi Ultratard, Ultralente-yletin-1, Khumininsulin, Ultralong, etc.

Mankhwala amathandizidwa ndi adokotala, omwe amathandizanso kupewa mavuto osiyanasiyana mwanjira zoyipa.

Gwiritsani ntchito ndikusunga mankhwalawa

Insulin yamtunduwu imatha kuperekedwa ndi jakisoni. Akangolowa mthupi mwanjira imeneyi, amayamba kugwira ntchito. Jakisoni amaikidwa patsogolo, ntchafu kapena ntchafu.

Musanagwiritse ntchito, vial amayenera kugwedezeka kuti chisakanizo mkati mwake chikhale chofanana. Pambuyo pake, yakonzeka kugwiritsa ntchito.

Sungani mankhwalawo m'malo omwewo monga ma insulin osakhalitsa. Mphamvu yotentha yamtunduwu imalepheretsa mapangidwe ake ndi kutsekemera kwa kusakaniza, komanso makutidwe ndi okosijeni a mankhwalawo.

Amabaya insulin kamodzi, nthawi zina kawiri patsiku.

Chiyambi cha insulin

Kusiyana kwa insulini - osati munthawi ya kuchitapo kanthu, komanso koyambira. Zopangira nyama ndi ma insulini omwe amafanana ndi anthu amakhala okhaokha.

Nkhumba imagwiritsidwa ntchito kuti ipeze mankhwala kuchokera ku gulu loyamba, ndipo mapangidwe a insulin omwe amapezeka ku ziwalo za nkhumba ndi abwino kwambiri kwa anthu. Kusiyana kwa nkhaniyi ndikosafunikira kokwanira - amino acid imodzi.

Koma mankhwala abwino kwambiri ndizachidziwikire, ma insulin a anthu, omwe amagwiritsidwa ntchito nthawi zambiri. mwina m'njira ziwiri:

1. Njira yoyamba ndikusintha amino acid imodzi yosayenera. Pankhaniyi, insulin yopanga mapangidwe imapezeka.
2. Njira yachiwiri yopangira mankhwalawa imakhudza Escherichia coli, wokhoza kupanga mapuloteni. Izi zikhala kale zothandiza pa zinthu ziwiri.

Kukonzekera kofanana ndi insulin yaumunthu kuli ndi zabwino zingapo:

• kupeza zofunika achire zotsatira kumafuna kukhazikitsa ang'onoang'ono Mlingo,
• Kukula kwa lipodystrophy ndikosowa,
• thupi lawo siligwirizana.

Kuchuluka kwa kuyeretsa

Kutengera kuchuluka kwa kuyeretsedwa, kukonzekera kumagawidwa:

• zachikhalidwe
• monopic,
• monocomponent.

Ma insulini achikhalidwe ndi amodzi mwa zoyambirira zoyambirira za insulin. Munali zinthu zambiri zodetsa, zomwe zinapangitsa kuti pakhale zovuta zosiyanasiyana. Pakadali pano, kumasulidwa kwa mankhwalawa kumachepetsedwa kwambiri.

Zopangidwa ndi insulin za Monopik zimakhala ndi zodetsa zochepa kwambiri (pamalire oyenera). Koma ma monocompitute insulins ali pafupifupi abwino kwambiri, chifukwa kuchuluka kwa zosafunika zosafunikira kumakhala kochepa kuposa malire.

Kusiyana kwakukulu pakati pa insulin "yayifupi" ndi "yayitali"

Monga mukuwonera, mitundu ya insulin (tebulo ikuwonetsa bwino izi) imasiyana pazizindikiro zoyambira. Ndipo izi ziyenera kuganiziridwa.

Tidasanthula mitundu yonse ya insulin ndi momwe amaonera thupi la munthu. Tikukhulupirira kuti mupeza chidziwitsochi kukhala chothandiza. Khalani athanzi!

Mu sayansi ya pharmacological, kukonzekera kwapadera kwa steroid kumatchedwa ma insulin, zomwe zimapangitsa kuyang'anira kuchuluka kwa mamolekyulu a shuga m'magazi a wodwala. Masiku ano pantchito yopanga zamankhwala ambiri amapanga ma insulin ambiri. Ambiri omwe ali ndi insulin yayifupi komanso yayitali. Kusiyana kwawo kwakukulu kumaphatikizapo: Mitundu ya zinthu zomwe zimapangidwira zomwe zimapangidwira, njira zopangira zinthu ndi nthawi yayitali. Masiku ano, insulin yochepa ndiyotchuka kwambiri.

Kutalika kwa mawonekedwe ake kuli mpaka maola 8. Chida ichi chili ndi cholinga chake - kuyimitsa mwachangu nsonga za chakudya, komanso kuphatikiza mankhwalawa a shuga.

Insulin yayitali imagwiritsidwa ntchito kuyerekezera kupangika kwamahomoni m'thupi la munthu kwa maola 24. Kutengera mitundu ya mankhwalawa, imakhala ndi nthawi yochita kuyambira maola 12 mpaka 30. Monga mitundu ya timadzi tambiri totalikirapo, mankhwala a nthawi yayitali komanso yayitali amatulutsidwa. Imachepetsa kuchuluka kwa ma molekyulu a glucose omwe ali m'magazi, imapangitsa mphamvu ya minofu ndi chiwindi kuyamwa, imathandizira kapangidwe ka mapuloteni, imachepetsa nthawi yofunikira yopanga mamolekyulu a shuga ndi maselo a chiwindi.

Anthu omwe adakumana ndi matenda oyamba a shuga amakhala ndi chidwi mwanjira ndi mafunso ngati awa: momwe mungasankhire insulin yoyenera komanso ndi insulin iti yomwe ndiyabwino kuyendetsa? Izi ndizofunikira kwambiri, chifukwa moyo wamtsogolo wodwalayo komanso thanzi lawo zimadalira kusankha molondola kwa mahomoni ndi kuwerengera kwake.

Zomwe madotolo amati pa matenda ashuga

Doctor of Medical Science, Pulofesa Aronova S. M.

Kwa zaka zambiri ndakhala ndikuphunzira za zovuta za DIABETES. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinology Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsiratu matenda ashuga. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 100%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipilira mtengo wonse wa mankhwalawo. Ku Russia ndi mayiko a CIS odwala matenda ashuga kale atha kupeza mankhwala ZAULERE .

Kusankhidwa kwa kukonzekera bwino kwambiri kwa insulin

Kwa odwala matenda ashuga omwe amadalira insulin, ndikofunikira kugwiritsa ntchito mlingo woyenera wa insulin.

Dziwani kuti ndizotheka kusankha mulingo woyenera wa mahomoni woyenera wodwala wina kuchipatala.

Pali malamulo angapo ofunikira omwe madokotala amatha kusankha pa mankhwalawa.

• Ndikofunikira kuyang'ana kuchuluka kwa mamolekyulu a shuga m'magazi kangapo patsiku. Zizindikiro zotsatirazi zimatengedwa ngati zabwinobwino: pamimba yopanda kanthu - 5-6 mmol / l ndipo patatha maola angapo mutatha kudya - 8 mmol / l. Kupatuka kwakukulu kuchokera kuzowonetsa komaliza ndizowonjezera 3 mmol / L.
• Hormon iyi iyenera kusankhidwa poganizira nthawi ya tsiku, kuchuluka kwa mankhwala ochulukitsa a carbohydrate omwe amwedwa, kuchuluka kwa kayendedwe ka wodwalayo asanadye komanso atatha kudya.
• Kuphatikiza apo, kuyenera kuyang'aniridwa kwa kulemera kwa wodwala, kupezeka kwa matenda ena owopsa kapena osachiritsika, nthawi ndi mawonekedwe ogwiritsira ntchito mankhwala ena. Chofunika kwambiri, zizindikirozi ndizomwe zimayikidwa nthawi yopuma ya jakisoni wa insulin yokonzekera nthawi yayitali. Chomwe chimapangitsa izi ndikuchepa kwa kudalira jakisoni panthawi yakudya, chifukwa mukamachigwiritsa ntchito, timadzi tambiri timene timayamwa mu seramu yamagazi a wodwala timapangidwa.
• Mfundo yofunika kwambiri posankha mlingo wabwino wa mankhwala ndikusunga diary yapadera. Patsamba loterolo, zizindikiritso zam'molekyu m'magazi a wodwalayo, kuchuluka kwa mafuta omwe amamwetsa pakudya, ndi kuchuluka kwa kukonzekera kwa insulin yochepa kumalowetsedwa. Kusanthula kumachitika nthawi zambiri pamimba yopanda kanthu. Nthawi zambiri kuchuluka kwa wothandizirayo ndi magawo omwe amwedwa ndi chakudya ndi chiŵerengero cha 2 mpaka 1. Ngati kuchuluka kwa mamolekyu amwazi m'magazi kupitirira zovomerezeka, makonzedwe owonjezerawa akukonzekera kochepa ndikofunikira.
• Yambirani njira ya kusankha mlingo wa insulin ndi jakisoni usiku. Ndi kuyambitsa kwa mahomoni mu kuchuluka kwa magawo 10, nthawi yomweyo asanakagone, malinga ndi kuti mankhwalawa ndi oyenera, shuga m'magazi sadzaposa 7 mmol / L. Pamene, jakisoni wa woyamba mlingo, wodwalayo atuluka thukuta kwambiri, kukulitsa chilimbikitso, m`pofunika kuchepetsa usiku ndi angapo mayunitsi. Mtengo woyenera pakati pa Mlingo wa insulin woperekedwa masana ndi usiku uyenera kukhala 2: 1.

Pomwe mlingo wa mankhwalawa ukwaniritsa zofunikira za thupi, zomwe mamolekyu am'magazi a seramu m'magazi sayenera kusintha kapena kutsika. Kuchuluka kwa glucose sayenera kusinthika masana.

Samalani

Malinga ndi WHO, chaka chilichonse padziko lapansi anthu 2 miliyoni amafa chifukwa cha matenda ashuga komanso zovuta zake. Pokhapokha pakhale thandizo loyenerera la thupi, matenda ashuga amabweretsa mavuto osiyanasiyana, pang'onopang'ono kuwononga thupi la munthu.

Mavuto omwe amakonda kwambiri ndi awa: matenda a shuga a shuga, nephropathy, retinopathy, trophic zilonda zam'mimba, hypoglycemia, ketoacidosis. Matenda a shuga amathanso kuyambitsa kukula kwa zotupa za khansa. Pafupifupi nthawi zonse, wodwala matenda ashuga amwalira, akulimbana ndi matenda opweteka, kapena amasintha kukhala munthu weniweni wolumala.

Kodi anthu odwala matenda ashuga amatani? Endocrinological Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga chida chomwe chimachiritsa kwathunthu matenda a shuga.

Pulogalamu ya Federal "Health Health Nation" ikuchitika, mkati mwanjira yomwe mankhwalawa amaperekedwa kwa aliyense wokhala ku Russian Federation ndi CIS ZAULERE . Kuti mumve zambiri, onani tsamba lovomerezeka la MINZDRAVA.

Kuti mudziwe insulin yabwino kwambiri kwa wodwala winawake, ndikofunikira kusankha mankhwala oyambira. Pofuna kutsimikizira kupanga basal, nthawi zambiri amagwiritsa ntchito kukonzekera kwa insulin yayitali. Tsopano makampani opanga mankhwala amapanga mitundu iwiri ya insulin:

• nthawi yayitali, kugwira ntchito mpaka maola 17. Mankhwalawa akuphatikizapo Biosulin, Insuman, Gensulin, Protafan, Humulin.
• nthawi yayitali kwambiri, zotsatira zawo zimakhala mpaka maola 30. Awa ndi: Levemir, Tresiba, Lantus.

Ndalama za insulini Lantus ndi Levemir ali ndi kusiyana kwakukulu kwa insulini zina. Kusiyana kwake ndikuti mankhwalawa ndiwowonekera bwino ndipo ali ndi nthawi yayitali yogwira wodwala yemwe ali ndi matenda ashuga. Mtundu woyamba wa insulin uli ndi tint yoyera komanso mtundu wina wamafinya, chifukwa chake mankhwalawo ayenera kugwedezeka asanagwiritse ntchito.

Pogwiritsa ntchito mahomoni a nthawi yayitali, nthawi zapamwamba zimatha kuwonedwa mu kupsinjika kwawo. Malangizo a mtundu wachiwiri alibe chochitika ichi.

Mlingo wa kukonzekera kwa insulin yayitali kuyenera kusankhidwa kuti mankhwalawa athetse shuga.

Chifukwa chofunikira kuti muchepetse kuyamwa pang'onopang'ono, insulin yayitali imathandizidwa pansi pa khungu la ntchafu kapena matako. Mwachidule - pamimba kapena mikono.

Owerenga athu amalemba

Mutu: Matenda a shuga apambana

Ku: my-diabet.ru Administration

Ndili ndi zaka 47, anandipeza ndi matenda a shuga a 2. M'masabata angapo ndinapeza pafupifupi 15 kg. Kutopa nthawi zonse, kugona, kumva kufooka, kuwona kunayamba kukhala pansi. Nditakwanitsa zaka 66, ndinali ndikumenya insulin yanga, zonse zinali zoipa kwambiri.

Nayi nkhani yanga

Matendawa adapitilirabe, kukomoka kwakanthawi kunayamba, ambulansi imandibwezera kuchokera kudziko lina. Nthawi zonse ndimaganiza kuti nthawi ino ikhala yomaliza.

Chilichonse chinasintha mwana wanga wamkazi atandilola kuti ndiwerenge nkhani imodzi pa intaneti. Simungayerekeze m'mene ndimamuyamikirira. Nkhaniyi inandithandiza kuthana ndi matenda ashuga, omwe amati ndi osachiritsika. Zaka 2 zapitazi ndidayamba kusuntha kwambiri, nthawi yamasika ndi chilimwe ndimapita kumayiko tsiku lililonse, timakhala ndi moyo wachangu ndi amuna anga, timayenda maulendo ataliatali. Aliyense amadabwitsidwa ndimomwe ndimakwanitsira chilichonse, komwe ndimatha mphamvu zambiri, sakhulupirira kuti ndili ndi zaka 66 zakubadwa.

Ndani akufuna kukhala ndi moyo wautali, wamphamvu komanso kuiwalako za matenda oyipawa kwamuyaya, tengani mphindi 5 ndikuwerenga nkhaniyi.

Pitani pa nkhaniyi >>>

Jakisoni woyamba wa insulin yayitali amachitika usiku ndi miyeso ya shuga yotengedwa maola atatu aliwonse. Pofuna kusintha kwakukulu kuzowonetsa glucose, kusintha kwa mankhwalawa kumapangidwa. Kuti mudziwe zomwe zimayambitsa kuchuluka kwa shuga usiku, ndikofunikira kuti muphunzire nthawi yayitali pakati pa 00.00 ndi 03.00. Ndi kuchepa kwa magwiridwe, mlingo wa insulin usiku uyenera kuchepetsedwa.

Molondola kwambiri, kuchuluka kwa insulin kofunikira kungadziwike pokhapokha ngati pali shuga komanso chifuwa chachikulu cha insulin m'magazi. Chifukwa chake, popenda insulin ya usiku, muyenera kukana chakudya chamadzulo.

Kuti mupeze chithunzi chothandiza kwambiri, simuyenera kugwiritsa ntchito insulin yochepa, simuyenera kudya mapuloteni kapena zakudya zamafuta

Kuti muzindikire mafuta oyambira masana masana, muyenera kuchotsa chakudya chimodzi kapena kudya tsiku lonse. Miyeso imapangidwa ola lililonse.

Musaiwale kuti mitundu yonse ya insulini, kuphatikiza Lantus ndi Levemir, ili ndi katulutsidwe kabwino. Mphindi yayitali kwambiri ya mankhwalawa imachitika pambuyo pa maola 6-8 kuchokera nthawi yoyendetsa. M'mawola awa, kutsika kwa shuga kumachitika, komwe kumakonzedwa ndikudya magawo a mkate.

Malingaliro oterowo ayenera kuchitidwa nthawi iliyonse akasinthidwa. Kuti mumvetsetse momwe shuga imakhalira mukupatsa mphamvu, kungoyesa masiku atatu ndikokwanira. Ndipo pokhapokha pazotsatira zomwe zapezeka, dokotala amatha kupereka mankhwala momveka bwino.

Kuti muwone mahomoni ofunikira masana ndi kuzindikira mankhwala abwino, muyenera kudikirira maola asanu kuchokera nthawi yomwe mumamwa chakudya chotsatira. Anthu odwala matenda ashuga omwe amagwiritsa ntchito insulin yochepa amayenera kupirira nthawi kuchokera maola 6. Gulu lama insulin lalifupi limayimiriridwa ndi Gensulin, Humulin, Actrapid. Ma insulin a Ultrashort akuphatikizapo: Novorapid, Apidra, Humalog. Ma mahormoni a Ultrashort amachita komanso amafupikitsa, koma amathetsa zophophonya zambiri. Nthawi yomweyo, chida ichi sichingathe kukhutiritsa kufunikira kwa insulin.

Sizotheka kupereka yankho lenileni ku funso loti insulin ndiyabwino kwambiri. Koma pazotsatira za dokotala, mutha kusankha mlingo woyenera wa basal ndi insulin yochepa.

Fotokozani

Ngati muwerenga izi, mutha kuzindikira kuti inu kapena okondedwa anu mukudwala matenda ashuga.

Tinachita kafukufuku, tinaphunzira zambiri zamagulu ndipo makamaka ndinayang'ana njira ndi mankhwala ambiri a shuga. Chigamulochi ndi motere:

Ngati mankhwalawa onse akaperekedwa, zinali zotsatira zosakhalitsa, atangomaliza kudya, matendawa amakula kwambiri.

Mankhwala okhawo omwe adapereka chofunikira ndi kusiyana.

Pakadali pano, awa ndiye mankhwala okhawo omwe amachiritsiratu matenda ashuga. Makamaka machitidwe amphamvu a Kusiyanitsa adawonetsa koyambirira kwa matenda ashuga.

Tidafunsa Unduna wa Zaumoyo:

Ndipo kwa owerenga tsamba lathu lino mwayi
khalani ndi kusiyana ZAULERE!

Yang'anani! Milandu yogulitsa mankhwalawa yabodza Kusiyanako kwakhala komweko.
Mukayika lamulo pogwiritsa ntchito maulalo pamwambapa, mumatsimikiziridwa kuti mudzalandira malonda kuchokera kwa wopanga wamkulu. Kuphatikiza apo, mukamayitanitsa pa tsamba lovomerezeka, mumalandira chitsimikizo cha kubweza (kuphatikizapo ndalama zoyendera) ngati mankhwalawo alibe.

Matenda a shuga a Type 1 samachiritsidwa. Kuti khazikitse mkhalidwe, wodwala ayenera tsiku ndi tsiku. Pali mitundu ingapo ya mankhwala a timadzi iyi, koma choyambirira pakati pawo ndi insulin.

Popanda insulini, thupi limatha kugwira ntchito moyenera. Hormone iyi imayang'anira protein, mafuta ndi carbohydrate metabolism. Palibe, kapena ndende zochepa, njira za metabolic m'thupi zimachepa. Izi zimabweretsa zovuta zowopsa zomwe zimatha kupha.

Odwala onse omwe ali ndi matenda ashuga amafunikira insulin, makamaka mankhwala omwe amakhala kwa nthawi yayitali. Matendawa amakula chifukwa chosapezeka m'thupi la wodwalayo omwe amapanga mahomoni ake, insulin, yomwe imayang'anira njira zama metabolic komanso glucose. Chifukwa chake, mankhwala amakono omwe amagwira ntchito kwa nthawi yayitali amalola kuti thupi la wodwalayo lizigwira ntchito.

Matenda a shuga ndi owopsa chifukwa cha zovuta zake. Insulin yomwe imaperekedwa kwa wodwala, mwachitsanzo, kuchitapo kanthu kwa nthawi yayitali, kumapewa kuyambitsa zovuta izi, zomwe nthawi zambiri zimayambitsa kufa.

Mukamasankha insulin yaing'onoting'ono kapena yayitali, mayina omwe nthawi zina amasokonezedwa, ndikofunikira kuti musamadziyike. Ngati mukufunikira kusintha mankhwalawa kapena kusintha mlingo wa tsiku ndi tsiku, funsani dokotala.

Mitundu ya jakisoni

Wodwala matenda ashuga amakakamizidwa kumwa jakisoni tsiku lililonse, ndipo kangapo patsiku. Kuyambitsa insulin tsiku lililonse kumathandizira kukhazikika kwa mkhalidwe. Popanda mahomoni awa, sizingatheke kutulutsa shuga m'magazi. Popanda jakisoni, wodwalayo amamwalira.

Chithandizo chamakono cha shuga chimapereka mitundu ingapo ya jakisoni.Amasiyana pakutalika komanso kuthamanga.

Pali mankhwala osakhalitsa, a ultrashort, ophatikizika komanso opanga nthawi yayitali.

Mwachidule ndipo amayamba kugwira ntchito pafupifupi mukangoyendetsa. Kuchulukitsa kwakukulu kumatheka mkati mwa ola limodzi kapena awiri, kenako zotsatira za jakisoni zimatha pang'onopang'ono. Mwambiri, mankhwalawa amagwira ntchito pafupifupi maola 4-8. Monga lamulo, majekeseni oterewa amakulimbikitsidwa kuti aperekedwe mukangodya, pambuyo pake kuchuluka kwa shuga m'magazi a wodwalayo kumayamba kuchuluka.

Insulin yotalikilapo imakhala maziko a chithandizo. Imagwira kwa maola 10-28, kutengera mtundu wa mankhwalawa. Kutalika kwa nthawi ya mankhwalawa kumasiyanasiyana mwa wodwala aliyense, kutengera mtundu wa matendawa.

Zolemba za mankhwala okhala nthawi yayitali

Insulin yotalikilapo ndiyofunikira kuti athe kutsanzira molondola momwe amapangira mahomoni ake mu wodwala. Pali mitundu iwiri ya mankhwalawa - Mankhwala okhala ndi nthawi yayitali (amagwira ntchito kwa maola pafupifupi 15) komanso mankhwala opangira nthawi yayitali (mpaka maola 30).

Mankhwala a nthawi yapakatikati ali ndi mawonekedwe othandizira. Insulin imakhala ndi utoto woyera. Musanayambitse mahomoni, muyenera kukwaniritsa utoto.

Pambuyo popereka mankhwalawa, kuwonjezeka kwapang'onopang'ono kwa kuchuluka kwa mahomoni kumawonedwa. Panthawi inayake, pachimake pa mchitidwe wa mankhwalawa amadza, pambuyo pake ndende imayamba kuchepa ndikutha. Ndiye kuti jakisoni watsopano ayenera kupangidwa.

Mlingo wake umasankhidwa kuti mankhwalawa azitha kuyendetsa bwino shuga wa magazi, kupewa kudumphira pakati pa jakisoni. Mukamasankha kuchuluka kwa insulin kwa wodwala, dokotala amaganizira nthawi yochuluka yomwe mankhwalawa amapezeka.

Mbali inanso ndi tsamba la jakisoni. Mosiyana ndi mankhwala osokoneza bongo omwe amachedwa m'mimba kapena mkono, insulin yayitali imayikidwa m'tchafu - izi zimakuthandizani kuti mukwaniritse kusintha kwa mankhwala mthupi lanu.

Ndiwowonjezereka kosalala kosakanikirana ndi mankhwalawa komwe kumatsimikiza kugwira ntchito kwake ngati jekeseni wa maziko.

Kodi kubayira kangati?

Pali mankhwala angapo a insulin. Ambiri aiwo amadziwika ndi kusasinthasintha kwamtambo komanso kupezeka kwa zochitika zapamwamba, zomwe zimachitika pafupifupi maola 7 mutatha kutsata. Mankhwalawa amatumizidwa kawiri pa tsiku.

Mankhwala ena (Tresiba, Lantus) amaperekedwa nthawi imodzi patsiku. Mankhwalawa amadziwika ndi nthawi yayitali yogwira ntchito komanso kuyamwa pang'onopang'ono, popanda kuchuluka kwa ntchito - ndiye kuti, mahomoni omwe amayambitsidwa amachita bwino nthawi yonse yochitayi. Chowonjezera china mwa mankhwalawa ndikuti alibe mtambo ndipo amatha kusiyanitsidwa ndi mtundu wowonekera.

Dokotala pakuthandizanakukuthandizani kusankha mankhwala abwino kwambiri kwa wodwala wina. Katswiriyu amasankha insulin yoyambira kapena yotalikilapo ndipo atchule mayina a mankhwala abwino. Sizikulimbikitsidwa kuti muzisankha nokha insulin yayitali.

Momwe mungasankhire mlingo?

Matenda a shuga sagona usiku. Chifukwa chake, wodwala aliyense amadziwa kufunika koti asankhe mlingo woyenera wa mankhwalawa kuti apewe shuga pamene akupumula usiku.

Kusankha mankhwalawa molondola, muyenera kuyeza shuga m'magazi awiri tsiku lililonse.

Musanayambe kugwiritsa ntchito insulin, nthawi yayitali, ndikulimbikitsidwa kukana chakudya chamadzulo. Usiku, kuchuluka kwa shuga kumayesedwa, ndipo, potengera izi, pamtundu wofunikira wa jakisoni umatsimikizika pambuyo pokambirana ndi dokotala.

Kudziwa tsiku ndi tsiku mankhwala omwe akhala akuchita kwa nthawi yayitali kumafunikiranso njira yapadera. Njira yabwino ndikukana chakudya tsiku lonse ndi milingo ya shuga.Zotsatira zake, pofika madzulo, wodwalayo amadziwa momwe shuga ya m'magazi imakhalira jekeseni chifukwa chokhala nthawi yayitali.

Zotheka zotheka ku jakisoni

Insulin iliyonse, mosasamala kanthu za kutalika kwa nthawi, imatha kuyambitsa zovuta zingapo. Nthawi zambiri, chomwe chimayambitsa zovuta ndi kuperewera kwa zakudya m'thupi, kumwa mankhwala osankhidwa mosayenera, kuphwanya njira yoyendetsera mankhwala. Muzochitika izi, kukula kwa zotsatirazi ndizotheka:

• mawonekedwe a thupi lawo siligwirizana.
• kusapeza bwino pamalowo jekeseni,
• kukula kwa hypoglycemia.

Monga mukudziwa, hypoglycemia imatha kubweretsa zovuta zazikulu, mpaka kukomoka kwa matenda ashuga. Pewani izi mwakutsatira mosamalitsa malangizo onse omwe dokotala amakupatsirani.

Mawerengero Achitsanzo

Wodwala wodwala matenda a shuga a mtundu wa 2 wolemera makilogalamu 96 sikokwanira othandizira, motero amamuika mankhwala a insulin. Kuwerengera tsiku ndi tsiku insulin yayitali, timayeza:

Mtengo wocheperako ndi 7.2. Kusiyana kwake ndi gawo la chandamale: 7.2-5 = 2.2. PSI = 63 * 4.4 / 96 = 2.9. Mlingo wofunikira tsiku lililonse = 2.2 / 2.9 = 0,8 mayunitsi, kapena 1 unit. zokhala ndi zozungulira.

Kodi mungapewe bwanji zovuta?

Matenda a shuga ndi matenda oopsa ndipo ndizovuta kupirira. Komabe, wodwala yekha ndiye amene angatsimikizire kukhala ndi moyo wabwino. Kuti tichite izi, ndikofunikira kugwiritsa ntchito njira zonse zomwe zingathandize kupewa zovuta komanso thanzi labwino.

Maziko othandizira matenda amtundu wa shuga ndi jakisoni, koma kudzipereka nokha ndiwowopsa. Chifukwa chake, pakakhala mafunso aliwonse okhudzana ndi mankhwala omwe amaperekedwa, wodwalayo ayenera kufunsa dokotala wokha.

Kuti mumve wathanzi, muyenera kudya moyenera. Insulin imathandizira kuyendetsa magazi m'magazi, koma wodwalayo ayenera kuyesetsa kuti asawakhumudwitse. Kuti izi zitheke, madokotala amatipatsa zakudya zapadera zomwe zithandiza kukhazikika mtima kwa wodwala.

Mankhwala aliwonse omwe amagwiritsidwa ntchito ngati mankhwala ayenera kugwiritsidwa ntchito molingana ndi malangizo a dokotala.

Zochita za insulin yayitali

Zitsanzo za mayina a mankhwala:

• Lantus
• Insulin Ultralente,
• Insulin Ultralong,
• Insulin Ultratard,
• Levemir,
• Levulin,
• Humulin.

Amapezeka mu mawonekedwe a kuyimitsidwa kapena mayankho a jakisoni.

Kuchita insulin kwa nthawi yayitali kumachepetsa kuchuluka kwa shuga m'magazi, kumalimbitsa mayamwidwe ndi minofu ndi chiwindi, kuthamangitsa kaphatikizidwe kazinthu zopanga mapuloteni, ndikuchepetsa kuchuluka kwa shuga ndi hepatocytes (ma cell a chiwindi).

Ngati kuchuluka kwa insulin yowonjezera kumawerengeredwa molondola, kuyambitsa kwake kumayamba maola 4 pambuyo pa kubayidwa. Chiwongola dzanja chokwanira chiyenera kuyembekezeredwa pambuyo pa maola 8-20 (kutengera mawonekedwe a munthu ndi kuchuluka kwa insulini). Zochita za insulin m'thupi zimachepetsedwa mpaka zero pambuyo pa maola 28 utatha. Zosiyana ndi zomwe zili munthawi imeneyi zikuwonetsa mawonekedwe akunja ndi amkati a thupi la munthu.

Kukhazikika kwa mankhwalawa kumapangitsa kuti insulini ikhale kwakanthawi kwakanthawi, ndipo izi zimathandizira kuti magaziwo ayambe pang'onopang'ono komanso pang'ono pang'ono.

Zisonyezero zogwiritsa ntchito insulin yayitali

1. Kukhalapo kwa matenda a shuga 1.
2. Kukhalapo kwa matenda ashuga amtundu wa 2.
3. Kuperewera kwa mankhwala pakamwa kuti muchepetse magazi a m'magazi.
4. Gwiritsani ntchito ngati mankhwala othandizira.
5. Ntchito.
6. Matenda a shuga kwa amayi apakati.

Njira yogwiritsira ntchito

Kuchuluka kwa mahomoni omwe amaperekedwa amatsimikiziridwa ndi dokotala aliyense payekha kwa wodwala aliyense. Mutha kuwerengera nokha mlingowo pokhapokha mukaonana ndi katswiri ndikupanga mayeso a labotale.

Kubetcha insulin nkoletsedwa. Ndikofunikira kupukutira m'manja musanabale. Izi zimathandizira kuti pakhale kupangika kophatikizika kwa mankhwalawa komanso kutentha munthawi yomweyo.

Pambuyo pa jekeseni, musachotsere singano nthawi yomweyo. Ndikofunikira kusiya masekondi angapo pansi pa khungu kuti mupeze mlingo wokwanira.

Kuwongolera kumayikidwa pakusintha kuchokera ku insulin yakuchokera kwa nyama kukhala munthu. Mlingo ukusankhanso. Komanso, kusintha kwa mtundu wina wa insulini kupita ku wina kuyenera kutsatiridwa ndi kuyang'aniridwa ndi achipatala komanso kuunika kwa magazi pafupipafupi. Ngati kusinthaku kwapangitsa kuti mankhwalawo opatsirana apitirire mayunitsi zana, wodwala amayenera kutumizidwa kuchipatala.

Kukonzekera konse kwa insulin kumayendetsedwa mosadukiza, ndipo jekeseni iliyonse yotsatira iyenera kupangidwa m'malo osiyana. Kukonzekera kwa insulin sikungasakanikiridwe ndi kuchepetsedwa.

Werengani kuchuluka kwa insulin

Kuti magazi a glucose akhalebe osakhazikika tsiku lonse, ndikofunikira kuyambitsa mtundu wa insulin, kapena mlingo woyambira. Msuzi ndimtundu wa insulin wa nthawi yayitali kapena wapakatikati, womwe umapangidwa kuti ukhale ndi shuga wamagazi osadya kapena pamimba yopanda kanthu, monga mwa munthu wathanzi, secretion basal.

Ndi magwiridwe antchito a maselo a pancreatic mwa anthu, 24-26 IU ya insulin imapangidwa tsiku lililonse. Izi zikuchokera pafupi 1 unit pa ola limodzi. Izi zikutanthauza kuti chiwerengero chonse cha insulini ndicho maziko kapena insulin yowonjezera yomwe muyenera kulowa.

Ngati opaleshoni, njala, kupsinjika kwamalingaliro ndi kutulutsa kwakukonzekera, ndiye kuti kuchuluka kwa insulin kofunikira kumafunikiranso.

Kuyesa kwa Insulin

Ndikotheka kumvetsetsa palokha ngati mulingo woyambira umasankhidwa molondola. Uwu ndiudindo wa munthu aliyense wodwala matenda ashuga, chifukwa ngakhale mlingo wa insulin wofotokozedwa ndi dokotala atha kukhala wosayenera kwa vuto lanu. Chifukwa chake, monga akunenera, khulupilirani, koma yang'anani, makamaka ngati zikugwirizana mwachindunji ndi thanzi lanu.

Poyesa, muyenera kusankha tsiku linalake, ndibwino kuti lidzakhale tsiku lopuma, chifukwa muyenera kuyang'anira glucose mosamala. Ndiye, mungayang'anire bwanji ngati mulingo woyenera wa insulin wowonjezereka wakupangira.

1. Osamadya kwa maola asanu.
2. Ola lililonse muyenera kuyeza shuga ndi glucometer.
3. Nthawi yonseyi, hypoglycemia kapena kudumpha kwa glucose wa 1.5 mmol / l sikuyenera kuzindikirika.
4. Kutsika kwa shuga kapena kuchuluka kumawonetsa kufunika kosintha maziko a insulin.

Kuyesedwa koteroko kuyenera kuchitidwa mobwerezabwereza. Mwachitsanzo, mudayang'ana kuchuluka kwanu kwa insulin m'mawa, koma momwe zinthu zilili ndi kusintha kwa glucose masanawa kapena madzulo. Chifukwa chake, sankhani tsiku lina kuti mupeze insulin yamadzulo komanso usiku.

Chokhacho muyenera kukumbukira: kuti insulin yochepa yomwe idalowetsedwa m'madzulo sizikuwakhudza magazi, kuyesaku kuyenera kuchitika patatha maola 6 kuchokera pakukhazikitsidwa kwake (ngakhale patakhala usiku).

Malangizo oyendetsa

Palinso malo owongolera okonzekera insulin yayitali kapena yapakati. Ngati zidzachitike kuti mukayang'ana shuga mu "mfundo" izi ziwonjezereka kapena kuchepetsedwa, ndiye kuti kuyesa koyambira komwe tafotokozazi kuyenera kuchitika.

Ku Lantus, nthawi iliyonse masana, shuga sayenera kupitirira mtengo wa 6.5 mmol / L pamimba yopanda kanthu.

Protafan NM, Humalin NPH, Insumal Bazal, Levemir. Kwa mankhwalawa, malo owongolera ayenera kukhala musanadye chakudya chamadzulo ngati mlingo umaperekedwa m'mawa. Zikatero, ngati mankhwalawa amaperekedwa madzulo, ndiye kuti amayenera kuwongolera m'mawa pamimba yopanda kanthu. M'zochitika zonse zoyambirira ndi zachiwiri, phindu la shuga pamimba yopanda kanthu sayenera kupitirira 6.5 mmol / L.

Ngati mukuwona kuti kuchepa kapena kuwonjezeka kwa shuga pamimba yopanda kanthu, ndiye kuti simuyenera kusintha mlingo wa insulin nokha! Kuyesa koyambira kuyenera kuchitidwa. Ndipo pokhapokha musinthe mlingo kapena funsani kwa dotolo. Kudumphira koteroko kumatha kuchitika chifukwa cha matenda a m'mawa kapena chifukwa cholakwika cha insulin yamadzulo.

Bongo

Ngakhale kuwonjezeka pang'ono kwa insulin ndende komwe sikukwaniritsa zofunikira za thupi kumatha kudzetsa hypoglycemia, yomwe pakufunika kosagwirizana ndi chithandizo chamankhwala kungayambitse wodwala kapena zovuta zazikulu.

Ndi hypoglycemia, wodwalayo ayenera kudya zakudya zamafuta kwambiri, zomwe nthawi yochepa zimachulukitsa shuga m'magazi.

Zingayambitse kukomoka, kusokonezeka kwamanjenje, komanso ngakhale kupweteka. M'tsogolomu, ndikofunikira kuwongolera dokotala ndikuwongolera zakudya komanso kupatsa jekeseni wa insulin yayitali.

Mankhwala Lantus ndi analogue a insulin ya anthu. Amapezeka mu labotale kuchokera ku zida za majini a bakiteriya, E. coli. Amasiyana ndi anthu pokhapokha ngati mamolekyulu awiri a arginine ndi kukhalapo kwa katsitsumzukwa m'malo mwa glycine.

Lantus, monga insulin ina iliyonse, amaletsedwa kusakanikirana ndi mitundu ina ya insulin ndipo, makamaka, ndi mankhwala ochepetsa shuga. Kusakaniza kudzayambitsa insulin yoyipa mosayenera. Choyipa choopsa kwambiri chosakanikirana ndicho kukhala kwamvula.

Popeza insulin Lantus imakhala ndi ma antibodies aumunthu, mayamwidwe ake ndikukhazikika kwa thupi ndizabwino kwambiri kuposa zomwe zimafananizira. Komabe, sabata yoyamba ndikofunika kulipira chidwi chochuluka machitidwe a thupi ndi insulin yamtunduwu, makamaka atatha kusintha kuchokera ku mtundu wina.

Lantus amagwiritsidwa ntchito ndi jekeseni wa subcutaneous. Kuwongolera kwamitsempha sikovomerezeka, chifukwa pamakhala chiwopsezo cha hypoglycemia.

Popeza insulin ili ndi zotsutsana zina pakugwiritsira ntchito (kulera, kulephera kwa impso), sizinali zotheka kudziwa zoyipa zoyipa ndi zoletsa izi, chifukwa palibe maphunziro omwe adachitika.

Kwa amayi omwe ali ndi pakati komanso oyamwitsa, kugwiritsa ntchito insulin yayitali ndizotheka, koma kuyang'aniridwa ndi katswiri ndikugwiritsa ntchito njira zothandizirana: mapiritsi ochepetsa shuga, zakudya.

Contraindication

1. Hypoglycemia.
2. Kuzindikira magawo a mankhwalawa.
3. Ana osakwana zaka 6.
4. Mimba

Pambuyo pofunsana ndi katswiri, zotsutsana izi sizingakhale zovuta kuchitapo kanthu, chifukwa zabwino zake zimakhala zapamwamba kwambiri kuposa kuwopsa kwa zovuta zomwe zingachitike. Pangofunikira kuwerengera molondola mlingo wa insulin yomwe umayendetsedwa.

Malangizo apadera ndi kusamala

Insulin yotalikilapo sicholinga chake pochiza ketoacidosis. Matupi a Ketone amachotsedwa m'thupi pokhapokha kudzera pakukonzekera kwa insulin yayifupi.

Kwa mtundu woyamba wa shuga, kuphatikiza insulin kwa nthawi yayitali. Yotalika nthawi yayitali imakhala ngati maziko, ndiye kuti imasunga insulini yambiri m'magazi momwe kapamba amayenera kutulutsa munthawi yoyenera.

Masamba osiyanasiyana obayidwa alibe kusiyana muzotsatira zomaliza, ndiye kuti, kuphatikiza kwa mankhwala omwe ali m'magazi kudzakhala chimodzimodzi mulimonse. Ndikofunikira kuti musinthe malo potsatira jakisoni wotsatira.

Mukamasintha kuchokera ku insulin yayitali mpaka yayitali, muyenera kumayang'aniridwa ndi dokotala ndi glucometer, popeza mlingo wa insulin womwe umayendetsedwa umasinthidwa ndikuwonjezera njira zina zofunikira kuti muchepetse shuga ya magazi (mapiritsi, insulin yochepa).

Popewa hypoglycemia usiku ndikadzuka, amalangizidwa kuti achepetse kuchuluka kwa insulin ndikukulitsa insulin yochepa ndi chakudya. Dokotala yekha ndi amene ayenera kuwerengetsa mlingo wake.

Mlingo wa insulin yayitali umasinthidwa:

• kusintha zakudya
• ndimphamvu zolimbitsa thupi,
• matenda opatsirana
• machitidwe
• kubala mwana
• matenda a endocrine
• matenda a impso (makamaka kulephera),
• shuga mu okalamba (65 kapena kuposa),
• kuchepa thupi kwambiri kapena kunenepa kwambiri,
• kumwa mowa
• zifukwa zina zomwe zimakhudza kuchuluka kwa shuga m'magazi.

Ndikofunikanso kusamala ndi omwe ali ndi glycosylated hemoglobin pansipa.Mwa anthu oterowo, hypoglycemia imakhala yotheka usana ndi usiku popanda chifukwa.

Momwe mungasungire

Muyenera kupeza malo pomwe kutentha kuchokera pa + 2 ° C mpaka + 8 ° C. Nthawi zambiri pamakhala mashelufu a firiji. Ndikofunika kupewa kuzizira kwa insulini, zomwe zikutanthauza kuti simuyenera kusunga majakisoni ndi chidebe mufiriji.

Pewani kufikira ana.

Akatsegulidwa ndikuyamba kugwiritsa ntchito, kutentha kosungirako sikuyenera kupitirira +25 degrees. Tiyenera kukumbukira kuti moyo wa alumali wa insulin mutatseguka ndi masabata anayi.

Patsiku lotha ntchito, kugwiritsa ntchito mankhwalawo koletsedwa.

Mutha kugula insulini yokhayo pokhapokha ngati mukupezeka ndi mankhwala a dokotala.

Insulin ndi timadzi tomwe timatulutsa ma cell a pancreatic. Ntchito yake yayikuru ndi kuphatikiza kagayidwe kazakudya ndi "kupumula" shuga.

Makina ogwirira ntchito ndi awa: munthu amayamba kudya, pambuyo poti wapanga insulin pafupifupi mphindi 5, amapima shuga, amawonjezereka atatha kudya.

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

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

Makalata ochokera kwa Owerenga

Mutu: Magazi a agogo aakazi abwerera mwakale!

Kupita ku: Webusayiti yoyang'anira

Christina
Moscow

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

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

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

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

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

Hypo- ndi hyperglycemia imakhala yoopsa kwambiri kwa wodwala matenda ashuga, chifukwa amatha kudzetsa mavuto akulu.

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

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

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

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

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

Gome: "Ochita zinthu mwachangu"

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

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

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

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

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

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

Zotsatira zoyambirira za kukonzekera kwa insulin mwachangu ndi hypoglycemia. Mawonekedwe ake ofatsa safuna kusintha kwa mankhwalawa ndi chithandizo cha mankhwala. Ngati shuga wochepa wapita pang'ono kapena kovuta, chithandizo chamankhwala chofunikira ndiyofunika. 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 mankhwalawa amwa 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.

Mu sayansi ya pharmacological, kukonzekera kwapadera kwa steroid kumatchedwa ma insulin, zomwe zimapangitsa kuyang'anira kuchuluka kwa mamolekyulu a shuga m'magazi a wodwala. Masiku ano pantchito yopanga zamankhwala ambiri amapanga ma insulin ambiri. Ambiri omwe ali ndi insulin yayifupi komanso yayitali. Kusiyana kwawo kwakukulu kumaphatikizapo: Mitundu ya zinthu zomwe zimapangidwira zomwe zimapangidwira, njira zopangira zinthu ndi nthawi yayitali. Masiku ano, insulin yochepa ndiyotchuka kwambiri.

Kutalika kwa mawonekedwe ake kuli mpaka maola 8. Chida ichi chili ndi cholinga chake - kuyimitsa mwachangu nsonga za chakudya, komanso kuphatikiza mankhwalawa a shuga.

Insulin yayitali imagwiritsidwa ntchito kuyerekezera kupangika kwamahomoni m'thupi la munthu kwa maola 24. Kutengera mitundu ya mankhwalawa, imakhala ndi nthawi yochita kuyambira maola 12 mpaka 30. Monga mitundu ya timadzi tambiri totalikirapo, mankhwala a nthawi yayitali komanso yayitali amatulutsidwa. Imachepetsa kuchuluka kwa ma molekyulu a glucose omwe ali m'magazi, kukonza mphamvu ya minofu ndi chiwindi kuti ikwaniritse, imathandizira njira yopangira mapuloteni, kumachepetsa nthawi,zofunikira pakupanga mamolekyulu a shuga ndi maselo a chiwindi.

Anthu omwe adakumana ndi matenda oyamba a shuga amakhala ndi chidwi mwanjira ndi mafunso ngati awa: momwe mungasankhire insulin yoyenera komanso ndi insulin iti yomwe ndiyabwino kuyendetsa? Izi ndizofunikira kwambiri, chifukwa moyo wamtsogolo wodwalayo komanso thanzi lawo zimadalira kusankha molondola kwa mahomoni ndi kuwerengera kwake.

Kwa odwala matenda ashuga omwe amadalira insulin, ndikofunikira kugwiritsa ntchito mlingo woyenera wa insulin.

Dziwani kuti ndizotheka kusankha mulingo woyenera wa mahomoni woyenera wodwala wina kuchipatala.

Pali malamulo angapo ofunikira omwe madokotala amatha kusankha pa mankhwalawa.

1. Ndikofunikira kuyang'ana kuchuluka kwa mamolekyulu a shuga m'magazi kangapo patsiku. Zizindikiro zotsatirazi zimatengedwa ngati zabwinobwino: pamimba yopanda kanthu - 5-6 mmol / l ndipo patatha maola angapo mutatha kudya - 8 mmol / l. Kupatuka kwakukulu kuchokera kuzowonetsa komaliza ndizowonjezera 3 mmol / L.
2. Hormon iyi iyenera kusankhidwa poganizira nthawi ya tsiku, kuchuluka kwa mankhwala ochulukitsa a carbohydrate omwe amwedwa, kuchuluka kwa kayendedwe ka wodwalayo asanadye komanso atatha kudya.
3. Kuphatikiza apo, kuyenera kuyang'aniridwa kwa kulemera kwa wodwala, kupezeka kwa matenda ena owopsa kapena osachiritsika, nthawi ndi mawonekedwe ogwiritsira ntchito mankhwala ena. Chofunika kwambiri, zizindikirozi ndizomwe zimayikidwa nthawi yopuma ya jakisoni wa insulin yokonzekera nthawi yayitali. Chomwe chimapangitsa izi ndikuchepa kwa kudalira jakisoni panthawi yakudya, chifukwa mukamachigwiritsa ntchito, timadzi tambiri timene timayamwa mu seramu yamagazi a wodwala timapangidwa.
4. Mfundo yofunika kwambiri posankha mlingo wabwino wa mankhwala ndikusunga diary yapadera. Patsamba loterolo, zizindikiritso zam'molekyu m'magazi a wodwalayo, kuchuluka kwa mafuta omwe amamwetsa pakudya, ndi kuchuluka kwa kukonzekera kwa insulin yochepa kumalowetsedwa. Kusanthula kumachitika nthawi zambiri pamimba yopanda kanthu. Nthawi zambiri kuchuluka kwa wothandizirayo ndi magawo omwe amwedwa ndi chakudya ndi chiŵerengero cha 2 mpaka 1. Ngati kuchuluka kwa mamolekyu amwazi m'magazi kupitirira zovomerezeka, makonzedwe owonjezerawa akukonzekera kochepa ndikofunikira.
5. Yambirani njira ya kusankha mlingo wa insulin ndi jakisoni usiku. Ndi kuyambitsa kwa mahomoni mu kuchuluka kwa magawo 10, nthawi yomweyo asanakagone, malinga ndi kuti mankhwalawa ndi oyenera, shuga m'magazi sadzaposa 7 mmol / L. Pamene, jakisoni wa woyamba mlingo, wodwalayo atuluka thukuta kwambiri, kukulitsa chilimbikitso, m`pofunika kuchepetsa usiku ndi angapo mayunitsi. Mtengo woyenera pakati pa Mlingo wa insulin woperekedwa masana ndi usiku uyenera kukhala 2: 1.

Pomwe mlingo wa mankhwalawa ukwaniritsa zofunikira za thupi, zomwe mamolekyu am'magazi a seramu m'magazi sayenera kusintha kapena kutsika. Kuchuluka kwa glucose sayenera kusinthika masana.

Ndi insulin iti yomwe imagwiritsidwa ntchito bwino

Kuti mudziwe insulin yabwino kwambiri kwa wodwala winawake, ndikofunikira kusankha mankhwala oyambira. Pofuna kutsimikizira kupanga basal, nthawi zambiri amagwiritsa ntchito kukonzekera kwa insulin yayitali. Tsopano makampani opanga mankhwala amapanga mitundu iwiri ya insulin:

• nthawi yayitali, kugwira ntchito mpaka maola 17. Mankhwalawa akuphatikizapo Biosulin, Insuman, Gensulin, Protafan, Humulin.
• nthawi yayitali kwambiri, zotsatira zawo zimakhala mpaka maola 30. Awa ndi: Levemir, Tresiba, Lantus.

Ndalama za insulini Lantus ndi Levemir ali ndi kusiyana kwakukulu kwa insulini zina. Kusiyana kwake ndikuti mankhwalawa ndiwowonekera bwino ndipo ali ndi nthawi yayitali yogwira wodwala yemwe ali ndi matenda ashuga.Mtundu woyamba wa insulin uli ndi tint yoyera komanso mtundu wina wamafinya, chifukwa chake mankhwalawo ayenera kugwedezeka asanagwiritse ntchito.

Pogwiritsa ntchito mahomoni a nthawi yayitali, nthawi zapamwamba zimatha kuwonedwa mu kupsinjika kwawo. Malangizo a mtundu wachiwiri alibe chochitika ichi.

Mlingo wa kukonzekera kwa insulin yayitali kuyenera kusankhidwa kuti mankhwalawa athetse shuga.

Chifukwa chofunikira kuti muchepetse kuyamwa pang'onopang'ono, insulin yayitali imathandizidwa pansi pa khungu la ntchafu kapena matako. Mwachidule - pamimba kapena mikono.

Jakisoni woyamba wa insulin yayitali amachitika usiku ndi miyeso ya shuga yotengedwa maola atatu aliwonse. Pofuna kusintha kwakukulu kuzowonetsa glucose, kusintha kwa mankhwalawa kumapangidwa. Kuti mudziwe zomwe zimayambitsa kuchuluka kwa shuga usiku, ndikofunikira kuti muphunzire nthawi yayitali pakati pa 00.00 ndi 03.00. Ndi kuchepa kwa magwiridwe, mlingo wa insulin usiku uyenera kuchepetsedwa.

Molondola kwambiri, kuchuluka kwa insulin kofunikira kungadziwike pokhapokha ngati pali shuga komanso chifuwa chachikulu cha insulin m'magazi. Chifukwa chake, popenda insulin ya usiku, muyenera kukana chakudya chamadzulo.

Kuti mupeze chithunzi chothandiza kwambiri, simuyenera kugwiritsa ntchito insulin yochepa, simuyenera kudya mapuloteni kapena zakudya zamafuta

Kuti muzindikire mafuta oyambira masana masana, muyenera kuchotsa chakudya chimodzi kapena kudya tsiku lonse. Miyeso imapangidwa ola lililonse.

Pafupifupi insulin zonse zazitali zimaperekedwa kamodzi pa maola 12 aliwonse. Lantus yekha samataya mphamvu zake tsiku lonse.

Musaiwale kuti mitundu yonse ya insulini, kuphatikiza Lantus ndi Levemir, ili ndi katulutsidwe kabwino. Mphindi yayitali kwambiri ya mankhwalawa imachitika pambuyo pa maola 6-8 kuchokera nthawi yoyendetsa. M'mawola awa, kutsika kwa shuga kumachitika, komwe kumakonzedwa ndikudya magawo a mkate.

Malingaliro oterowo ayenera kuchitidwa nthawi iliyonse akasinthidwa. Kuti mumvetsetse momwe shuga imakhalira mukupatsa mphamvu, kungoyesa masiku atatu ndikokwanira. Ndipo pokhapokha pazotsatira zomwe zapezeka, dokotala amatha kupereka mankhwala momveka bwino.

Kuti muwone mahomoni ofunikira masana ndi kuzindikira mankhwala abwino, muyenera kudikirira maola asanu kuchokera nthawi yomwe mumamwa chakudya chotsatira. Anthu odwala matenda ashuga omwe amagwiritsa ntchito insulin yochepa amayenera kupirira nthawi kuchokera maola 6. Gulu lama insulin lalifupi limayimiriridwa ndi Gensulin, Humulin, Actrapid. Ma insulin a Ultrashort akuphatikizapo: Novorapid, Apidra, Humalog. Ma mahormoni a Ultrashort amachita komanso amafupikitsa, koma amathetsa zophophonya zambiri. Nthawi yomweyo, chida ichi sichingathe kukhutiritsa kufunikira kwa insulin.

Sizotheka kupereka yankho lenileni ku funso loti insulin ndiyabwino kwambiri. Koma pazotsatira za dokotala, mutha kusankha mlingo woyenera wa basal ndi insulin yochepa.

Wochedwa insulin

Chithandizo cha insulin chowonjezera chiyenera kuloza kutulutsidwa kwa thupi kwa insulin, mokwanira komanso mukatha kudya. Mwa anthu odwala matenda ashuga amtundu woyamba, njira yokhayo yobwezeretsanso insulin katulutsidwe ndikugwiritsa ntchito insulin.

Insulin yoyamba ili pafupifupi 40-60% ya zofunika tsiku ndi tsiku za thupi. Panthawi yabwino, mlingo wa basal insulin uyenera kuvala zosowa pakati pa chakudya, ndipo oyang'anira osakhalitsa insulin azikonza postprandial glycemia.

Ndi matendawa, matenda a shuga amafunikira chithandizo cha insulin. Insulin yochepa ndi insulin yayitali imagwiritsidwa ntchito pochiza matendawa. Moyo wamunthu wodwala matenda ashuga kwambiri umatengera kutsatira malangizo onse azachipatala.

Insulin yowonjezereka yogwira mtima imafunikira pamene kusala kudya kwa shuga m'magazi kumafunikira kusintha.Lantus amadziwikanso ngati insulin yodziwika kwambiri kwa nthawi yayitali mpaka pano, yomwe wodwalayo amayenera kuperekedwa kamodzi pa maola 12 kapena 24.

Imatsimikiza kufunika kwa chithandizo cha insulini ndikusankha mankhwala ena ndi dokotala, ndipo kupita patsogolo kwa mankhwalawa kumatengera matendawo.

Insulin yayitali imakhala ndi katundu wodabwitsa, imatha kutsanzira mahomoni achilengedwe omwe amapangidwa ndi maselo a kapamba. Nthawi yomweyo, amakhala ofatsa pamaselo oterowo, amathandizira kuchira, komwe mtsogolo limalola kukana insulin.

Jekeseni wa insulin wa nthawi yayitali ayenera kuperekedwa kwa odwala omwe ali ndi shuga wambiri masana, koma akuyenera kuwonetsetsa kuti wodwalayo amadya chakudya pasanathe maola 5 asanagone. Komanso, insulin yayitali imapangidwira chizindikiro cha "m'mawa kutacha", maselo a chiwindi akayamba usiku wodwalayo asanadzuke, asokoneze insulin.

Ngati insulin yayifupi ikufunika kubayidwa masana kuti muchepetse kuchuluka kwa glucose omwe amabwera ndi chakudya, ndiye kuti insulin yayitali imatsimikizira maziko a insulini, imathandizira kupewa, imathandizanso kubwezeretsa maselo a pancreatic beta. Jekeseni wa insulin wa nthawi yayitali amayenera kuthandizidwa kale chifukwa amathandizira wodwalayo kuonetsetsa kuti matenda amtundu wa 2 sangadutse matenda oyamba.

Kuwerengera molondola kwa mlingo wa insulin yayitali usiku

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

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

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

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

Kuchita insulin nthawi yayitali: imalembedwa liti ndipo imagwiritsidwa ntchito bwanji

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

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

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

Kodi chimapereka chithandizo chotere ndi chiani?

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

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

Kuyerekeza malamulo a kuwerengera Mlingo wam'mawa ndi wamadzulo

Ndi matenda 2 a shuga, sikofunikira kuti mukhale ndi insulin yayifupi komanso yayitali. Zitha kuzindikirika kuti kapamba payekha imapilira kupereka maziko oyambira, ndipo mahomoni owonjezera safunika. Ngati wodwala amatsatira zakudya zamafuta ochepa, mwina sipangakhale chifukwa chochepa cha insulin musanadye. Ngati wodwala matenda ashuga amafuna insulin yayitali kwa onse usana ndi usiku, mlingo wa tsiku ndi tsiku umakhala wotsikirapo.

Pakadutsa matenda a shuga 1, mtundu ndi kuchuluka kwa mankhwalawo amafunikira nthawi zambiri amasankhidwa kuchipatala. Malamulo kuwerengera omwe ali pamwambapa angagwiritsidwe ntchito kusintha mlingo ngati woyamba anali kusiya kupereka chipepeso chabwino.

Zoyipa za NPH-Insulin

Poyerekeza ndi Levemir ndi Lantus, ma NPH-insulins ali ndi zovuta zingapo zazikulu:

• sonyezani kuchuluka kwakukulu kwa ntchito pambuyo pa maola 6, chifukwa chake musayerekeze kubisala kwakumbuyo, komwe kumakhala kokhazikika,
• Kuwonongeka kosasinthika, kotero zotsatira zake zingakhale zosiyanasiyana masiku osiyana,
• Nthawi zambiri zomwe zingayambitse matenda ashuga. Chiwopsezo cha kusinthika kwa anaphylactic chimachulukitsidwa ndi maantibayotiki, ma radiopaque, NSAIDs,
• Iwo ndi oyimitsa, osati yankho, chifukwa chake zimatengera kusakanikirana kwathunthu kwa insulin ndikutsatira malamulo ake.

Ma inshuwiti amakono samakhala opanda zofooka izi, chifukwa chake kugwiritsa ntchito mankhwalawa matenda a shuga ndikofunikira.

Onetsetsani kuti mwaphunzira! Kodi mukuganiza kuti kuyamwa kwa mapiritsi ndi insulini kwa nthawi yonse yokhayo ndi njira yokhayo yothanirana ndi shuga? Sichowona! Mutha kutsimikizira izi nokha ndikuyamba kuzigwiritsa ntchito.

Insulin ya odwala matenda ashuga a mtundu woyamba, ndipo kawirikawiri, ndi mankhwala ofunikira. Imalowa m'malo mwa insulin ya mahomoni, yomwe kapamba amayenera kutulutsa zochuluka.

Nthawi zambiri, odwala amapatsidwa insulin yochepa komanso ya ultrashort, jekeseni omwe amaperekedwa pambuyo chakudya. Koma zimachitikanso kuti insulin yogwira ntchito yayitali ndiyofunika, yomwe ili ndi zofunika zina panthawi ya jakisoni.

Pansipa tikambirana mayina amalonda a insulin omwe amakhala ndi nthawi yayitali, momwe amapangira mankhwala ndi milandu pamene jakisoni wawo akufunika, komanso ndemanga ya odwala matenda ashuga pakugwiritsa ntchito insulin yayitali.

Wochedwa insulin

Anthu odwala matenda ashuga a mtundu woyamba amapatsidwa insulini wa insalin, ndipo wachiwiri monga mono-tiba. Lingaliro la basal insulin limatanthawuza insulin, yomwe imayenera kupangidwa m'thupi masana, mosasamala zakudya. Koma ndi matenda amtundu wa 1 shuga, si odwala onse omwe ali ndi kapamba omwe amatha kutulutsa timadzi tating'onoting'ono tomwe timatulutsa mitundu yochepa.

Mulimonsemo, chithandizo chamankhwala cha 1 chimaphatikizidwa ndi jakisoni wamfupi kapena wowonjezera-wa insulin. Jekeseni wambiri wa insulin amachitidwa m'mimba pamimba yopanda kamodzi, patsiku, zosakwana ziwiri.yogwira maola 12 mpaka 24.

Milandu pakakhala kofunikira kuti mupereke insulin yayitali:

• kuponderezana kwa m'bandakucha
• kukhazikika kwa shuga m'magazi pamimba yopanda kanthu,
• Chithandizo cha mtundu wachiwiri wa matenda ashuga, kupewa kuti asatenge mtundu woyamba,
• mu mtundu woyamba wa shuga, kupewa ketoacidosis ndi kusungidwa pang'ono kwa maselo a beta.

Ma insulin owonjezerapo omwe anali osankhidwa kale anali ndi chisankho; odwala adalembedwa NPH-insulin yotchedwa Protofan. Ili ndi mtundu wamtambo, ndipo jakisoni asanalowe m'botolo linagwedezeka. Pakadali pano, gulu la endocrinologists lazindikira motsimikiza kuti Protofan ili ndi vuto loyipa la chitetezo cha mthupi, ndikulimbikitsa kuti lipange ma antibodies a insulin.

Zonsezi zimabweretsa momwe ma insulin antibodies amalowera, zomwe zimapangitsa kuti ikhale yogwira ntchito. Komanso, insulin yomangidwa imatha kukhala yotakataka ngati izi sizifunikanso. Izi zimapangitsa kukhala ndi mawonekedwe otchulidwa pang'ono ndipo kumakhala kulumpha pang'ono mu shuga, mkati mwa 2-3 mmol / l.

Izi sizimamvedwa makamaka ndi wodwala, koma, zambiri, chithunzi cha chipatala chimakhala chosatsutsa. Posachedwa, mankhwala ena apangidwa omwe samakhudza thupi la wodwalayo. Analogi

Amakhala ndi mtundu wowoneka bwino, safuna kugwedezeka pamaso pa jekeseni. Anulin yokhala ndi insulin ingagulidwe mosavuta pa pharmacy iliyonse.

Mtengo wapakati wa Lantus ku Russian Federation umachokera ku 3335 - 3650 rubles, ndi Protofan - 890-970 rubles. Ndemanga ya odwala matenda ashuga akuwonetsa kuti Lantus ali ndi vuto lofanana ndi shuga m'magazi tsiku lonse.

Asanapereke insulin yayitali, endocrinologist imafunikira kuti wodwalayo azilemba ndi magazi a shuga, omwe amapangidwa sabata limodzi mpaka atatu tsiku lililonse. Izi zikuwonetsa chithunzi chathunthu cha kulumpha m'magazi a magazi ndi kufunikira kwake, kapena kuthetsedwa kwa kusankha kwa insulin.

Ngati dokotala atakufotokozerani mankhwalawa osaganizira za chithunzi cha kuchuluka kwa shuga, ndiye kuti ndi bwino kulumikizana ndi endocrinologist wina.

Limagwirira zake ntchito yaitali insulin

Mankhwala omwe akhala akuchita kwa nthawi yayitali amaphatikiza kukonzekera kwa insulin kotalika komanso yayitali. Kuphatikiza apo, oyamba amayamba kugwira ntchito mthupi mkati mwa ola limodzi - maola awiri, mpaka kufika maola 4 - 11, nthawi yonse ya maola 9 - 12.

Mankhwala a nthawi yapakatikati amawayamwa pang'onopang'ono, ndikuwonetsa kutalika kwa nthawi yayitali. Izi zimatheka chifukwa cha prolongator yapadera - protamine kapena zinc. NPH-insulin imaphatikizanso mu protamine ya kapangidwe kake kamapezeka mkaka wa nsomba mu gawo la stoichiometric.

Pamsika wamankhwala kwa odwala matenda ashuga, kukonzekera kwa insulin kwa nthawi yayitali kumanenedwa:

• Mtundu wopanga insulin, mayina amalonda Protafan XM, Humulin NPH, Biosulin, Gansulin.
• Insulin yopanga yaumunthu - Humador, Biogulin.
• Chomera cha nkhumba mono insulin - Protafan MS,
• Insulin mu kuyimitsidwa pawiri - Monotard MS.

Mankhwala omwe akhala akuchita kwa nthawi yayitali amayamba kugwira ntchito yake mkati mwa maola 1.5 pambuyo pa jekeseni, nthawi yonse ndi maola 20 - 28. Komanso, mankhwalawa amagawa insulin m'thupi la wodwalayo momwemonso, zomwe zimakongoletsa chithunzi cha kuchipatala ndipo sizipangitsa kusintha pafupipafupi kuchuluka kwa jakisoni wa insulin yochepa komanso yapamwamba.

Mankhwala omwe akhala akuchita kwa nthawi yayitali amaphatikizapo insulin glargine, yomwe imafanana ndi insulin ya anthu. Ilibe zochita zolemekezeka, chifukwa imatulutsidwa m'magazi mosalekeza. Glargin ali ndi acid pH yoyenera. Izi sizimaphatikiza makina ake ophatikizidwa ndi ma insulin amafupifupi ndi a ultrashort, popeza mankhwalawa alibe pH yopanda malire.

Mankhwalawa a insulin nthawi zambiri amapezeka poyimitsa ndipo amaperekedwa ngati amkakamiza kapena kudzera m'mitsempha. Mayina Ogulitsa:

1. Insulin Glargine Lantus.
2. Chithandizo cha insulin

Pali zotsutsana chotere cha jakisoni wa insulin glargine ndi khungu - matenda a shuga, chikomokere.

Pansipa pali malangizo atsatanetsatane ogwiritsira ntchito insulin Lantus.

Malangizo ogwiritsira ntchito mankhwalawa

Lantus Solostar 1 ml ili ndi 3.63 mg insulin glargine, yomwe ndi wofanana ndi 100 IU ya insulin ya munthu.

Zina zomwe zimaphatikizidwapo: glycerol, nthaka ya chloride, sodium hydroxide, madzi a jakisoni.

M'mawonekedwe, ndimadzimadzi owoneka bwino, osapaka khungu la kulowetsa pang'onopang'ono mu minofu ya adipose ya wodwalayo. Mankhwala ali ndi mitundu ingapo yomasulidwa:

• Dongosolo la OpticClick, lomwe limaphatikizapo ma cartridge atatu 3 ml. Makatoni asanu phukusi limodzi.
• 3 ml OptiSet Syringe Mapensulo Insulin ikatha, mumangofunika kugula cartridge yatsopano ndikuyiika mu cholembera. Phukusi limodzi la makatoni, ma cholembera asanu.
• Lantus Solotar, ma cartridge atatu a 3 ml. Amayikidwa modabwitsa mu cholembera kuti agwiritse ntchito kamodzi, makatiriji sanasinthidwe. Phukusi limodzi la makatoni, ma cholembera asanu, popanda singano zamajekeseni.

Lantus ndi mankhwala a gulu la pharmacotherapeutic a mankhwala antidiabetes. The yogwira mankhwala a Lantus - insulin glargine ndi analogue anthu insulin basal kanthu. Sungunuka kwathunthu m'magazi. amabwera mwachangu.

Mankhwala amakhudza thupi la wodwalayo:

1. Amachepetsa magazi.
2. Zimawonjezera kukhathamira kwa glucose ndikugwiritsa ntchito mwa minofu yam'magazi ndi minofu ya adipose.
3. Imathandizira biotransfform ya glucose kukhala glycogen m'chiwindi.
4. Mu minofu ya minofu, imawonjezera kupanga mapuloteni.
5. Kuchulukitsa kwa lipid.

Ndi bwino jekeseni kamodzi patsiku, ndi endocrinologist wokhayo amene amapereka mlingo wa mankhwalawo, poganizira kuopsa kwa matendawa. Kwa odwala omwe ali ndi shuga omwewo, Mlingo amathanso kukhala osiyana, chifukwa cha zotsatira zosiyanasiyana pa thupi la wodwalayo komanso zolimbitsa thupi.

Lantus amangopatsidwa matenda a shuga a mtundu woyamba ndi wachiwiri, kwa akulu ndi ana opitilira zaka zisanu ndi chimodzi. Kugwiritsa ntchito mankhwalawa sikunayesedwe kwa ana ochepera zaka zisanu ndi chimodzi.

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

Mitundu ya mankhwala

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

Kugwiritsa ntchito insulin yayitali pakulimbikitsidwa pazisonyezo izi:

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

Kuwerengera Mlingo

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

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

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

Zotsatira zoyipa

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

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

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

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

Matenda a shuga amadziwika ndi kulephera kwa thupi kugwetsa glucose, chifukwa chomwe chimakhazikika m'magazi, zimayambitsa kusokonezeka kwakukulu pakugwira ntchito kwa minofu ndi ziwalo zamkati. Mtundu wa 1 wa matenda ashuga, izi zimachitika chifukwa chopanga insulin. Ndipo kuti apange mahomoni awa m'thupi, madokotala amapereka insulin yayitali kwa odwala awo. Kodi ndi chiyani ndipo mankhwalawa amagwira ntchito bwanji? Izi ndi zina zambiri tidzazikambirana tsopano.

Chifukwa chiyani ma jakisoni a insulin amafunikira?

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

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

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

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

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

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

Ndikofunikira kugwiritsa ntchito insulin yowonjezera molondola. Siligwiritsidwa ntchito kukhazikitsa glucose wamagazi mukatha kudya, chifukwa sichichita mwachangu, mwachitsanzo, insulin. Komanso, jakisoni wa insulin ayenera kukonzekera.Ngati mungadumphe nthawi ya jakisoni kapena kukulitsa / kufupikitsa kusiyana pamaso pawo, izi zitha kubweretsa kuwonongeka muzochitika za wodwalayo, popeza kuchuluka kwa glucose "kumadumpha" nthawi zonse, zomwe zimapangitsa kuti pakhale zovuta.

Kubwereza mwachidule

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

Mankhwala chikuyendetsedwera, osapitirira 1 nthawi patsiku. Ndikulimbikitsidwa kupereka jakisoni pogona nthawi yomweyo. Kugwiritsa ntchito Basaglar nthawi zambiri kumayendera limodzi ndi kuwoneka kwa zovuta, zomwe zina mwa izi ndizambiri:

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

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

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

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

Koma chida ichi chili ndi zovuta zake. Akuluakulu okha ndi omwe amatha kugwiritsa ntchito, ndiye kuti, imaphatikizidwa kwa ana. Kuphatikiza apo, kugwiritsa ntchito mankhwalawa chifukwa cha matenda ashuga sikungatheke mwa amayi panthawi yoyembekezera komanso pakubala, chifukwa izi zimatha kusokoneza thanzi la mwana wosabadwa.

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

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

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

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

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

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

Mu thupi lathanzi, insulini imasungidwa mosalekeza (chofunikira chachikulu) ndipo imayamba kupangidwa pakafunika kutsika shuga m'magazi (mwachitsanzo, mutatha kudya). Ngati kusowa kwa insulin kupezeka m'thupi la munthu, amafunika kupaka insulin ndi jakisoni, ndiko kuti, insulin.

Udindo wa insulin wa nthawi yayitali (wokhala nthawi yayitali), womwe umapezeka mwa zolembera, umawonetsera kubisalira kwapadera (kosalekeza) kwapancreatic.

Cholinga chachikulu cha mankhwalawa ndikukhalabe ndi chidwi chofunikira cha mankhwalawa m'magazi kwanthawi yayitali. Chifukwa chake, amatchedwa basal insulin.

Hormoni iyi imagawidwa m'magulu awiri: mankhwala osokoneza bongo (NPH) omwe amakhala ndi nthawi yayitali komanso analogue.

Next Generation Insulin Yaitali

Kwa anthu odwala matenda ashuga, inshuwaransi ya anthu ya NPH komanso zochitika zake zazitali zomwe zilipo. Gome ili pansipa likuwonetsa kusiyana kwakukulu pakati pa mankhwalawa.

Mu Seputembara 2015, insulin yatsopano ya Abasaglar idayambitsidwa, yomwe imafanana ndi Lantus yubiquitous.

Wochedwa insulin

Food and Drug Administration (FDA, US FDA) - Bungwe la boma lomwe lachita pansi pa dipatimenti ya zaumoyo ku U.S. mu 2016 linavomerezanso mtundu wina wa insulin. Izi zimapezeka pamsika wapanyumba ndipo zimatsimikizira kuyenera kwake pochiza matenda ashuga.

NPH insulini (NPH Neutral Protamine Hagedorn)

Uwu ndi mtundu wa ma insulin opangira momwe amapangira mapangidwe a insulin yaumunthu, koma olemeretsedwa ndi protamine (protein protein) kuti achepetse. NPH ndi mitambo. Chifukwa chake, isanayambe makonzedwe, iyenera kuzunguliridwa bwino kusakaniza bwino.

NPH ndi mtundu wotsika mtengo kwambiri wa insulin. Tsoka ilo, imakhala ndi chiopsezo chachikulu cha hypoglycemia ndi kulemera kwakukulu, popeza imakhala ndi chiwonetsero chokwanira pantchito (ngakhale zimachitika pang'onopang'ono osati mwachangu ngati insulin pamabowo).

Odwala omwe ali ndi matenda amtundu woyamba 1 amapatsidwa kawiri kawiri la NPH insulin patsiku. Ndipo odwala omwe ali ndi matenda a shuga a 2 amatha jekeseni kamodzi patsiku. Zonse zimatengera kuchuluka kwa shuga m'magazi ndi malingaliro a dokotala.

Ogwira ntchito nthawi yayitali insulin

Insulin, zomwe zimapangidwa ndi mankhwala omwe amasinthika kotero kuti amachedwetsa kuyamwa ndi mphamvu ya mankhwalawo, amadziwika kuti ndi insulin yopanga anthu.

Lantus, Abasaglar, Tujeo ndi Tresiba ali ndi zochitika zodziwika bwino - nthawi yayitali yogwirira ntchito komanso chiwonetsero chochepa kwambiri cha ntchito kuposa NPH. Mwanjira iyi, kudya kwawo kumachepetsa chiopsezo cha hypoglycemia ndi kulemera. Komabe, mtengo wa analogues ndiwokwera.

Abasaglar, Lantus, ndi Tresiba insulin amatengedwa kamodzi patsiku. Odwala ena amagwiritsanso ntchito Levemir kamodzi patsiku. Izi sizikugwira ntchito kwa odwala matenda ashuga 1 omwe mankhwalawa ndi ochepera maola 24.

Tresiba ndiye mtundu watsopano kwambiri ndipo tsopano ndi wotchipa kwambiri wa insulin pamsika. Komabe, ili ndi mwayi wofunikira - chiopsezo cha hypoglycemia, makamaka usiku, ndizotsika kwambiri.

Insulin imatenga nthawi yayitali bwanji

Udindo wa insulin yayitali ndikuwimira chinsinsi chachikulu cha insulini kudzera m'mapapo. Chifukwa chake, muyezo wofanana wa timadzi tomwe timagazi timatsimikizika pantchito yake yonse. Izi zimathandizira kuti maselo a thupi lathu agwiritse ntchito shuga wosungunuka m'magazi kwa maola 24.

Momwe mungabayitsire insulin

Ma insulini onse omwe akhala akuchita kwa nthawi yayitali amalowetsedwa pansi pa khungu m'malo omwe mumakhala mafuta. Gawo lotsatira la ntchafu ndilabwino kwambiri pazolinga izi. Malowa amalola kuti kulowetsedwa pang'onopang'ono, kwa yunifolomu. Kutengera ndi nthawi ya endocrinologist, muyenera kuchita jakisoni imodzi kapena iwiri patsiku.

Usiku ndi m'mawa machitidwe

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

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

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

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

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

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

Mankhwala omwe akhala akuchita kwa nthawi yayitali

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

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

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

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

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

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

Ultra kutalika kwenikweni

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

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

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

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

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

Kukonzekera mwachidule za insulin

Ma insulin omwe amagwira ntchito mwachidule amakhala osungunuka ndipo amatha kusintha mwachangu momwe kagayidwe kachakudya mthupi la munthu kamalumikizana ndi mayamwidwe a glucose. 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.

Zinthu zazifupi ndi insulin

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. 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.

Kulimbitsa Thupi

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 pakupanga thupi ndikuti insulin 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 pomwa mankhwalawo. Mwasankha, sinthani nyengo ya miyezi iwiri ya kumwa mankhwalawo ndikupumula kwa miyezi inayi kuchokera pamenepo.

Malamulo a kumwa mankhwala osokoneza bongo

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

Tikulimbikitsidwa kuti ma horoni wothandizirana alowetse m'mimba m'mimba patangophunzitsidwa 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 kugwiritsa ntchito 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 bongo wa insulin yochepa komanso ya ultrashort, chikomokere chimatha kuchitika mwachangu kwambiri. Pofuna kutaya mtima ndi wothamanga, ndikofunikira kufunsa thandizo kuchipatala.

Ubwino wawukulu pokonzekera insulin mukamagwiritsa ntchito mapangidwe ake ndi kuti sangathe kuyesedwa pakuyesa.Insulin yochepa komanso ya ultrashort ndi mankhwala otetezeka omwe sangawononge molakwika kugwira ntchito kwa 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.

Munthu aliyense wodwala matenda ashuga ayenera kudziwa mitundu ya insulini, komanso momwe amagwiritsidwira ntchito ndi zomwe zimapangitsa thupi. Nthawi zina, thunthu amapangidwa ndi kapamba, amathandiza kugwetsa glucose ndikuwongolera kuyika kwake m'magazi. Matenda a shuga akapezeka, timadzi timalo timasiya kutulutsidwa kwathunthu, kapena maselo athupi lathu amakhala osagwirizana ndi insulini ndikusiya kuwona mahomoni ngati chinthu chofunikira pakumeta. Kuti apange kufooka kwa timadzi ta mu timuyo, dotolo amakupatsirani mankhwala kutengera.

Pofulumira kuwonekera, ma insulins amagawidwa m'magulu angapo:

• Ultra yochepa-insulin
• Mankhwala osokoneza bongo mwachidule
• Insulin yochita pakati
• Mankhwala okhalitsa
• Kuphatikiza kapena kusakaniza ndi insulin.

Pali magulu osavuta, omwe mankhwalawa amagawidwa pocheperapo pang'ono ndikukonzekera insulin.

Insulin yochepa

Mankhwala amtunduwu amayamba kugwira ntchito mwachangu, nthawi zambiri mu theka loyamba la ola, nthawi zina kuyatsidwa kumachedwa kwa maola angapo. Koma zinthu zotere sizimatenga nthawi yayitali: maola sikisi mpaka asanu ndi atatu okha.

Pali njira zambiri zochitira insulin yayifupi, ndipo zimatengera iwo pamene insulansi yothamanga ikuyamba kuchita:

• Mothandizidwa ndi mtsempha wa magazi, chinthucho chimayamba kugwira ntchito mphindi imodzi,
• Njira ya intranasal imathanso kwambiri - mahomoni amayamba kugwira ntchito mphindi khumi,
• Introperitoneal management (i.e. peritoneum) imalola chinthu chogwira ntchito kuti chidziwike pakatha mphindi khumi ndi zisanu,
• Ndi makonzedwe a mu mnofu, mahomoni amayamba kutsitsa shuga pambuyo pa ola limodzi,
• Njira yodutsa yoyendetsera imayamba kuchepera - pankhani iyi, mahomoni amangogwira ola limodzi ndi theka.

Kubayirirani kuchitike osachepera mphindi makumi anayi musanadye chakudya kuti thupi likhe kugwetsa shuga. Choipa cha insulin yochepa ndikufunika kupanga jakisoni watsopano maola asanu ndi limodzi mpaka asanu ndi atatu.

Oimira amtunduwu akuphatikiza sungunuka:

• Majini opanga ma genetic amtundu wa anthu amachokera ku chotupa, momwe amino acid imasinthidwa mwachitsanzo, Bioinsulin R, Insuran R, Rinsulin R ndi zina zambiri,
• Semi-yopanga insulin yamunthu yomwe idagwiritsidwa ntchito ndi E. coli, mwachitsanzo, Humodar P,
• Chowerengeka cha nkhumba, chomwe chimasiyana ndi munthu mu amino asidi amodzi, mwachitsanzo, Monodar.

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:

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.

Zosakanikirana zosakanikirana zimakhala ndi zinthu zazifupi ndi zazitali zochita mosiyanasiyana, kutengera momwe thupi liyenera kuchitira.

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.

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.

1. Matenda a shuga: retinopathy, nephropathy / Ivan Ivanovich Dedov, Marina Vladimirovna Shestakova, Tamara Miroslavovna Milenkaya. - M: Mankhwala, 2001 .-- 176 p.
2. Glycosylated hemoglobin ndi mafuta aulere acids pamavuto a matenda ashuga ndi metabolic syndrome: Mwayi watsopano wazidziwitso, mankhwala ndi kuwunika kwawopsa. - Moscow: b. ndi., 2014 .-- 100 s. : mpunga, tebulo - Bibliog. kumapeto kwa mitu.
3. Chithandizo champhamvu komanso chadzidzidzi mu endocrinology: manja. kwa madokotala / V. L. Bogdanovich. - N. Novgorod: boma la Novgorod. honey.acad., 2000 .-- 324 p.
4. Kuwongolera kwa matenda a shuga a mtundu wachi II pamankhwala othamangitsidwa kunja: kuchita. mitsinje kwa akatswiri wamba (madokotala a mabanja) / I. S. Petrukhin. - Tver: b. ndi., 2003. - 20 s.
5. Matenda a shuga ndi matenda oopsa oopsa: buku la madokotala / Russian Acad. wokondedwa Sayansi / Ivan Ivanovich Dedov, Marina Vladimirovna Shestakova. - M: Medical News Agency, 2006. - 343 p. - Bibliog. kumapeto kwa machaputala lamulo

Anamaliza maphunziro awo ku Kirov State Medical Academy mu 2006. Mu 2007, adagwira ntchito mu chipatala cha Tikhvin Central District mothandizidwa ndi dipatimenti yochiritsa. Kuyambira 2007 mpaka 2008 - wogwira ntchito pachipatala cha kampani yopanga migodi ku Republic of Guinea (West Africa). Kuyambira 2009 mpaka pano, akhala akugwira ntchito yopanga zidziwitso zamankhwala. Timagwira ntchito ndi makina ambiri otchuka, monga Sterilno.net, Med.ru, tsamba

Makampani opanga mankhwala amapanga mitundu yambiri ya mankhwala a mahomoni kuti athandizire shuga. Chimodzi mwa izo ndi insulin yochepa. Imatha kusintha matenda a shuga mwa odwala omwe ali ndi matenda osokoneza bongo nthawi yochepa, zomwe zimapangitsa kukhala chida chofunikira kwambiri.

Lingaliro la insulin yochepa

Insulin ikangoyambitsidwa, imasungunuka ndipo imasinthasintha mwachangu njira za metabolic zomwe zimagwirizanitsidwa ndi kuyamwa kwa shuga.

Mosiyana ndi mankhwala omwe akhala akuchita kwa nthawi yayitali, amakhala ndi yankho loyera la mahomoni popanda zowonjezera zina. Kuchokera ku dzinalo ndizodziwikiratu kuti akatha kuyambitsa, amayamba kugwira ntchito mwachangu, ndiye kuti, kwakanthawi kochepa amatsitsa shuga.Koma panthawi imodzimodziyo, amasiya kuchitapo kanthu mwachangu kuposa mankhwala omwe amakhala ndi nthawi yayitali pochita, monga momwe tikuwonera pachitsanzo chotsatira:

Kodi insulin yamtunduwu imalembedwa liti?

Zovala zazifupi zimagwiritsidwa ntchito zokhazokha kapena kuphatikiza ndi mahomoni okhala ndi nthawi yayitali. Amaloledwa kulowa mpaka 6 pa tsiku. Nthawi zambiri, amawalemba ngati:

• kuyambiranso,
• chosafunikira thupi insulin,
• othandizira opaleshoni
• zophulika
• matenda a shuga - ketoacidosis.

Kodi insulin yayifupi imagwira ntchito mpaka liti?

Ndi subcutaneous makonzedwe, mphamvu yayitali kwambiri ya mankhwalawa imawonedwa, yomwe imachitika pakadutsa mphindi 30 mpaka 40, nthawi yomwe chimbudzi cha chakudya chodyedwa chimachitika.

Mutatha kumwa mankhwalawa, nsonga ya insulin imatheka pambuyo pa maola awiri ndi atatu. Kutalika kumatengera mlingo womwe umaperekedwa:

• ngati ma 4 UNITS - 6 UNITS, nthawi yodziwika bwino ndi pafupifupi maola 5,
• ngati 16 mayunitsi kapena kupitilira apo, itha kufika maola 6-8.

Pambuyo pakutha kwa chochitikacho, mankhwalawa amachotsedwa m'thupi ndi mahomoni olimbana ndi mahomoni.

Ultra Yokhala-Mwachidule Insulin

Izi ndi zomwe zapangidwa posachedwapa mu pharmacology. Amasiyana ndi mitundu ina yonse monga momwe zimakhalira nthawi yomweyo, ndikupanga shuga m'magazi. Mankhwala odziwika bwino ndi awa:

Mankhwalawa ndi fanizo la munthu la munthu. Ndiwothandiza panthawi yomwe muyenera kudya, koma kuchuluka kwake sikudziwika, pakakhala zovuta kudziwa kuchuluka kwa insulin yokumba. Mutha kudya kaye, kenako kuwerengera ndi kumwa mankhwalawo. Popeza zochita za insulin ndizothamanga, chakudya sichikhala ndi nthawi yokwanira.

Insulin iyi ya ultrashort idapangidwa kuti izigwiritsidwa ntchito pamene anthu omwe ali ndi matenda ashuga amaswa zakudya zawo ndikudya maswiti ambiri kuposa omwe adalimbikitsa. Nthawi zambiri muzochitika zotere mumakhala kuchuluka kwambiri kwa shuga, komwe kumatha kubweretsanso thanzi. Kenako mankhwalawa atha kuthandiza. Nthawi zina, pomwe wodwala sangathe kudikirira kwa mphindi 40, ndikulakwira chakudyacho kale, inshuwaransi yamtunduwu ikhoza kuphatikizidwanso.

Insulin yotereyi sikuti imaperekedwa kwa odwala omwe amatsatira malamulo onse azakudya. Nthawi zambiri, ngati ambulansi yokha yolumphira shuga.

Sipakhudzidwa mu amayi apakati omwe ali ndi matenda a shuga. Amaloledwa kugwiritsidwa ntchito, ngakhale pali toxosis ya mimba.

Phindu la ultrashort insulini ndikuti:

• muchepetse kuchuluka kwa shuga m'magazi usiku, makamaka kumayambiriro kwa kutenga pakati,
• thandizirani kusintha matendawa msanga mwa mayi woyembekezera panthawi ya cesarean,
• kuchepetsa chiopsezo cha zovuta mukatha kudya.

Mankhwalawa ndi othandiza kwambiri mwakuti amatha kusinthitsa shuga pakanthawi kochepa, pomwe mlingowo umathandizidwa pang'ono, zomwe zimathandiza kupewa zovuta zingapo.

Kubayira pafupipafupi

Ngati cholinga chanu ndikusunga ma jakisoni a insulin otsika mtengo, gwiritsani ntchito Abasaglar, Lantus, Toujeo kapena Tresiba analogues. Jakisoni m'modzi (m'mawa kapena madzulo, koma nthawi zonse nthawi yomweyo) amatha kupereka insulin yofananira ndi wotchi.

Mungafunike jekeseni awiri patsiku kuti mukhale ndi mahomoni azambiri zamagazi posankha NPH. Izi, zimakupatsirani kusintha kwa mankhwalawa kutengera nthawi yatsiku ndi zochitika - zapamwamba masana komanso zochepa pogona.

Chiwopsezo cha hypoglycemia pakugwiritsa ntchito insulin

Zatsimikiziridwa kuti ma insulin anthawi yayitali amakhala osayambitsa matenda a hypoglycemia (makamaka hypoglycemia usiku) poyerekeza ndi NPH. Mukamagwiritsa ntchito, zofunika za glycated hemoglobin HbA1c ndizotheka.

Palinso umboni wosonyeza kuti kugwiritsa ntchito mankhwala okhala ndi insulin analoques nthawi yayitali poyerekeza ndi isoflan NPH kumayambitsa kuchepa kwa thupi (ndipo, chifukwa chake, kutsika kwa kukana kwa mankhwalawa komanso kufunika kwathunthu kwa mankhwalawo.

Kutenga nthawi yayitali insulin ya matenda a shuga a mtundu I

Ngati mukudwala matenda ashuga amtundu 1, kapamba wanu sangathe kupanga insulini yokwanira. Chifukwa chake, mutatha kudya chilichonse, muyenera kugwiritsa ntchito mankhwala omwe amathandizira kubisalira kwa insulin ndi maselo a beta. Ngati mwaphonya jakisoni, pamakhala chiopsezo chokhala ndi matenda ashuga a ketoacidosis.

Mukamasankha pakati pa Abasaglar, Lantus, Levemir ndi Tresiba, muyenera kudziwa zina mwazinthu za insulin.

• Lantus ndi Abasaglar ali ndi mbiri yosyasyalika pang'ono kuposa Levemir, ndipo kwa odwala ambiri, amagwira maola 24.
• Levemir angafunikire kutengedwa kawiri tsiku lililonse.
• Pogwiritsa ntchito Levemir, Mlingo umatha kuwerengeka malinga ndi nthawi ya tsiku, motero kuchepetsa chiopsezo cha nocturnal hypoglycemia ndikuwongolera nthawi yolamulira masana.
• Toujeo, Tresibia mankhwalawa amachepetsa zizindikiro zomwe zili pamwambazi poyerekeza ndi Lantus.
• Muyenera kuganiziranso za zovuta za mankhwala monga zotupa. Izi zimachitika kawirikawiri, koma zimatha kuchitika.
• Ngati mukufunikira kusintha kuchokera ku mankhwala a insulin ofanana ndi NPH, dziwani kuti mlingo wa mankhwalawa mukatha kudya ungafunikire kuchepetsedwa.

Kutenga nthawi yayitali insulin ya matenda a shuga a mtundu II

Kuchiza matenda a shuga a mtundu II kumayambira pobweretsa zakudya zoyenera komanso mankhwala amkamwa (Metformin, Siofor, Diabeteson, etc. ..). Komabe, pali zochitika zina pomwe madokotala amakakamizidwa kugwiritsa ntchito insulin.

Zofala kwambiri zalembedwa pansipa:

• Kusakwanira kwa mankhwala amkamwa, kulephera kukwaniritsa bwinobwino glycemia ndi glycated hemoglobin
• Contraindication pakamwa
• Kuzindikira matenda ashuga omwe ali ndi ziwonetsero zambiri za glycemic, kuchuluka kwa matenda
• Myocardial infarction, coronary angiography, sitiroko, matenda owopsa, opaleshoni
• Mimba

Mulingo woyenera wa osakwatira

Mlingo uliwonse wa insulin umasinthidwa ndi adotolo, koma sayenera kukhala apamwamba kuposa ma PIECES, omwe amawerengedwa pa kilogalamu imodzi ya kuchuluka kwake. Uwu ndiye mlingo waukulu.

Mankhwala osokoneza bongo amatha kubweretsa zovuta.

Nthawi zambiri, dokotala amatsatira malamulo otsatirawa:

• Ngati matenda a shuga a mtundu woyamba wangopezedwa kumene, muyezo wosaposa 0,5 / kg mankhwala.
• Ndikulipirira kwabwino chaka, mankhwalawa ndi 0.6 U / kg.
• Ngati kusakhazikika kumawonedwa mu mtundu 1 wa shuga, shuga amasinthasintha, ndiye kuti 0,7 U / kg amatengedwa.
• Ndi matenda a shuga ophatikizika, mlingo ndi 0.8 IU / kg.
• Ndi ketacidosis, 0,9 U / kg amatengedwa.
• Ngati pakati mu trimester yomaliza ndi mayunitsi 1.0 / kg.

Momwe mungabayitsire insulin yochepa? (kanema)

Mitundu yonse ya insulin nthawi zambiri imayendetsedwa chimodzimodzi asanadye. Ndikulimbikitsidwa kuti musankhe madera amthupi la munthu pomwe mitsempha yayikulu ya magazi siyidutsa, pali ma amana amafuta ochepa.

Ndi makonzedwe a venous, zochita za insulin zidzakhala nthawi yomweyo, zosavomerezeka pamankhwala amasiku onse. Chifukwa chake, kuyamwa kwa mankhwalawa kumalimbikitsidwa, zomwe zimapangitsa kuti mayendedwe a insulin ayambe kulowa m'magazi.

Mutha kusankha pamimba, koma osangolimbitsa mkati mwa masentimita 6 kuchokera ku navel. Pamaso jakisoni, muyenera kutsuka malowa ndikusamba m'manja ndi sopo ndikuuma. Konzani chilichonse chomwe chikufunika munjira yake: syringe yotayidwa, botolo lomwe lili ndi mankhwala komanso pedi. Onetsetsani kuti mwamaliza bwanji!

1. Chotsani kapu ku syringe, ndikusiya kapu ya mphira.
2. Chitani ndi singano ndi mowa ndikuyika mosamala mu botolo ndi mankhwala.
3. Sonkhanitsani kuchuluka kwa insulin.
4. Tulutsani singano ndikutulutsa mpweya, kutsogoza wopondayo mpaka dontho la insulin lithe.
5. Ndi chala chachikulu ndi chofiyira, tengani kachikopa kakang'ono. Ngati subcutaneous mafuta wosanjikiza ndi wandiweyani, ndiye kuti timayambitsa singano pamakona madigiri 90, ndi yopyapyala - singano ndiyofunika kupendekeka pang'ono pakona madigiri 45. Kupanda kutero, jekeseni sangakhale wosinjirira, koma wamitsempha. Ngati wodwalayo alibe kulemera kwambiri, ndibwino kugwiritsa ntchito singano yopyapyala komanso yaying'ono.
6. Pang'onopang'ono komanso bwino insulin. Kuthamanga kuyenera kumayendera yunifolomu pakukonzekera.
7. Syringe ikapanda kanthu, chotsani singano yomweyo pansi pa khungu ndikumasula khola.
8. Ikani kapu yoteteza pa singano ya syringe ndikuitaya.

Simungakhale malo amodzi nthawi zonse, ndipo mtunda kuchokera pa jakisoni wina kupita kwina uzikhala wa masentimita awiri. Majekeseni enanso: koyambirira m'ntchafu imodzi, kenako kwina, kenako kumatako. Kupanda kutero, kuphatikizika kwamafuta kumatha kuchitika.

Kuchuluka kwa mahomoni kumadalira kusankha malo. Mofulumira kuposa zonse, insulin imatengedwa kuchokera kukhoma lakutsogolo kwa m'mimba, kenako mapewa ndi matako, ndipo pambuyo pake kuchokera kutsogolo kwa ntchafu.

Ndikofunika kubayira m'mimba, kuti chochitikacho chichitike mwachangu akangodya.

Kuti mudziwe zambiri zamomwe mungagwiritsire ntchito kupatsa insulin, onani nkhani iyi kapena kanema wotsatira:

Pomaliza, ndikofunikira kudziwa kuti simungathe kusankha nokha mankhwala osankha mwachidule, kusintha mlingo wake popanda mankhwala a dokotala. Ndikofunikira kukhazikitsa, pamodzi ndi endocrinologist, dongosolo la kayendetsedwe kake malinga ndi regimen ndi kuchuluka kwa chakudya chomwe chimatengedwa. Ndikofunika kuti musinthe nthawi zonse jakisoni, sungani bwino mankhwalawo, onani masiku omwe atha. Ndipo pakusintha pang'ono komanso zovuta, funsani dokotala.

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

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

Kusiyana kwa mankhwala

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

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

Kudya ndikupereka insulin yochepa ndizinthu zomwe zimagwirizanitsidwa pochiza matenda a shuga

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

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

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

Insuman Rapid

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

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

Homorap 40

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

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

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

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

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

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

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

Humulin Nthawi zonse - imodzi mwamankhwala omwe angafotokozeredwe kuchokera kubadwa

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

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

Berlinsulin HU-40

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

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

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

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

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

Mbiri yayitali ya insulin

Mlingo woyambirira nthawi zambiri amakhala mayunitsi 0,2 kg / thupi. Calculator iyi ndi yothandiza kwa anthu popanda kukana insulini, yokhala ndi chiwindi chokhazikika komanso impso. Mlingo wa insulin umayikidwa ndi dokotala wokha (!)

Kuphatikiza pa kutalika kwa nthawi yochitikira (yayitali kwambiri ndi degludec, yocheperako kwambiri ndi ma genetic engineer a insulin-isophan), mankhwalawa amakhalanso osiyana mawonekedwe. Pankhani ya insulin NPH, pachimake chiwonetserochi chimagawidwa nthawi yayitali ndipo chimachitika pakati pa maola 4 ndi 14 jakisoni. Analogue yogwira ntchito ya insulir yaigwira kwa nthawi yayitali imafika pachimake pakati pa maola 6 ndi 8 jakisoni, koma imakhala yochepa kwambiri.

Insulin glargine chifukwa chake imatchedwa basal insulin. Kuphatikiza kwake m'magazi kumakhala kochepa kwambiri, kotero chiopsezo cha hypoglycemia ndichotsika.

Matenda a Alzheimer's: zoyambitsa ndi chithandizo. Zomwe muyenera kudziwa

Insulin yayitali

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

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

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

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

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

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

Levemir ndi Lantus amasiyana ndi ma insulini ena osati munthawi yawo yosiyana, komanso paziwonekero zakunja, pomwe gulu loyambirira la mankhwalawo limakhala ndi mtundu wa mitambo yoyera, ndipo asanakayimidwe amafunikira kuti agulidwe.

Kusiyana kumeneku kumachitika chifukwa cha njira zingapo zopangira insulin, koma zina pambuyo pake. Mankhwala a nthawi yayitali yochitapo kanthu amaonedwa kuti ndi achichepere, ndiye kuti, momwe amagwirira ntchito, njira yosatchulika ikuwoneka, monga kwa insulin yochepa, komabe pali nsonga.

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

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

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

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

Insulin yayitali - mlingo usiku

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

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

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

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

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

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

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

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

Mankhwala olimbitsa

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

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

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

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

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

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

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

Magulu amakonzekera insulin

Njira yayikulu yothandizira matenda a shuga a mtundu woyamba ndikuwonetsa madontho ena a insulin yophatikizidwa m'magazi a wodwala. Malinga ndikuwonetsa payekhapayekha, timadzi timeneti timagwiritsidwanso ntchito pa matenda a shuga a II.

Udindo waukulu wa insulin mthupi ndi kutenga gawo la kagayidwe kazakudya ndikupanga shuga ochuluka m'magazi.

Chemarology yamakono imagawa kukonzekera kwa insulini m'magulu potengera kuchuluka kwa hypoglycemic (kutsitsa shuga m'magazi)

Kukhalitsa: Zabwino ndi Zabwino

Mpaka posachedwa, kukonzekera kwa insulin kogawika kunagawika m'magulu awiri: apakati komanso okhalitsa. Zaka zaposachedwa, zadziwika pachitukuko cha insulin yayitali nthawi yayitali.

Kusiyanitsa kofunikira pakati pa mankhwala a magulu onse atatu ndi nthawi ya hypoglycemic zotsatira:

• kuchuluka kwa nthawi yayitali ndi 8-12, mwa odwala - mpaka maola 20,
• kuchitapo kanthu kwanthawi yayitali - 20-30 (nthawi zina 36) maola,
• zowonjezera zazitali - zoposa maola 42.

Ma insulini amasungidwe amasungidwe nthawi zambiri amapezeka mu mawonekedwe a kuyimitsidwa ndipo amapangidwira ma subcutaneous kapena intramuscular management.

Nthawi zambiri, mwa munthu yemwe alibe matenda a shuga, insulin imapangidwa mosalekeza. Kukonzekera kwa insulini kosasunthika kwakonzedwanso kuti kutsanzire chimodzimodzi kwa odwala omwe ali ndi matenda a shuga. Ntchito yawo yayitali mthupi ndiyofunikira kwambiri ndi chithandizo chowongolera. Kuchepetsa kuchuluka kwa jakisoni ndi kuphatikiza kwinanso kwa mankhwalawa.

Koma pali kuchepa: ma insulin osakhalitsa sangathe kugwiritsidwa ntchito poyambitsa matenda ashuga kapena malo oyipa a wodwalayo.

Isofan insulin

Izi zimagwira ntchito mankhwala osokoneza bongo. nthawi yayitali machitidwe. Woimira akhoza kuonedwa ngati French Insuman Bazal GT. Imapezeka mu mawonekedwe a kuyimitsidwa ndi insulin yokhala ndi 40 kapena 100 mayunitsi. Kuchuluka kwa botolo limodzi ndi 10 kapena 5 ml, motsatana.

Chachilendo cha mankhwalawa ndi kulekerera bwino kwake kwa odwala omwe amadziwika kuti amatsutsana ndi insulini zina. Kuphatikiza apo, mankhwalawa amatha kugwiritsidwa ntchito pakuyembekezera amayi ndi kuyamwa Isofan insulin imayendetsedwa kamodzi tsiku lililonse.

Mtengo woyerekeza wa phukusi la mabotolo asanu a 5 ml - kuchokera ku ma ruble 1300.

Insulin glargine

Mankhwala kuchitapo kanthu kwa nthawi yayitali ndi yapadera m'njira yake. Chowonadi ndi chakuti insulin yambiri imakhala ndi chotchedwa peak. Ino ndi nthawi yomwe kukhazikika kwa mahomoni m'magazi kumafika pazokwanira. Kugwiritsa ntchito insulin glargine kumachotsa mphindi yapamwamba kwambiri: mankhwalawa amachita mosiyanasiyana komanso mosalekeza. Mankhwalawa amapangidwira tsiku limodzi.

Limodzi mwa mayina amalonda ndi Lantus. Yopangidwa ku France ngati kuyimitsidwa kwa jakisoni wotsekemera. Mtengo wa mankhwalawa ndi pafupifupi ma ruble 3,500 a ma syringes asanu a 3 ml aliyense.

Insulin degludec

Awa ndi dzina lapadziko lonse lamankhwala. kupatula nthawi . Malinga ndi kuyerekezera kwa akatswiri, tsopano lilibe mndandanda wonse padziko lonse lapansi. Mbiri yamalonda - "Tresiba Penfill", dziko lomwe adachokera - Denmark. Kutulutsidwa mawonekedwe - makatiriji okhala ndi mphamvu ya 3 ml (mayunitsi zana a insulin / ml), mu bokosi - makatoni asanu. Mtengo woyerekeza wa mankhwalawo ndi pafupifupi ma ruble 7500.

Mankhwalawa amaperekedwa kamodzi pa maola 24 aliwonse nthawi iliyonse (kupitilizanso kuti azitsatira). Insulin degludec imapangidwira zochizira matenda ashuga odwala akulu, kuphatikizapo omwe ali ndi zaka zopitilira 65. Tsopano sichigwiritsidwa ntchito pochiza matenda a shuga ku unamwino, amayi apakati, komanso mwa ana ndi achinyamata.

Mu sayansi ya pharmacological, kukonzekera kwapadera kwa steroid kumatchedwa ma insulin, zomwe zimapangitsa kuyang'anira kuchuluka kwa mamolekyulu a shuga m'magazi a wodwala. Masiku ano pantchito yopanga zamankhwala ambiri amapanga ma insulin ambiri. Ambiri omwe ali ndi insulin yayifupi komanso yayitali. Kusiyana kwawo kwakukulu kumaphatikizapo: Mitundu ya zinthu zomwe zimapangidwira zomwe zimapangidwira, njira zopangira zinthu ndi nthawi yayitali. Masiku ano, insulin yochepa ndiyotchuka kwambiri.

Kutalika kwa mawonekedwe ake kuli mpaka maola 8. Chida ichi chili ndi cholinga chake - kuyimitsa mwachangu nsonga za chakudya, komanso kuphatikiza mankhwalawa a shuga.

Insulin yayitali imagwiritsidwa ntchito kuyerekezera kupangika kwamahomoni m'thupi la munthu kwa maola 24. Kutengera mitundu ya mankhwalawa, imakhala ndi nthawi yochita kuyambira maola 12 mpaka 30. Monga mitundu ya timadzi tambiri totalikirapo, mankhwala a nthawi yayitali komanso yayitali amatulutsidwa. Imachepetsa kuchuluka kwa ma molekyulu a glucose omwe ali m'magazi, imapangitsa mphamvu ya minofu ndi chiwindi kuyamwa, imathandizira kapangidwe ka mapuloteni, imachepetsa nthawi yofunikira yopanga mamolekyulu a shuga ndi maselo a chiwindi.

Anthu omwe adakumana ndi matenda oyamba a shuga amakhala ndi chidwi mwanjira ndi mafunso ngati awa: momwe mungasankhire insulin yoyenera komanso ndi insulin iti yomwe ndiyabwino kuyendetsa? Izi ndizofunikira kwambiri, chifukwa moyo wamtsogolo wodwalayo komanso thanzi lawo zimadalira kusankha molondola kwa mahomoni ndi kuwerengera kwake.

Zomwe madotolo amati pa matenda ashuga

Doctor of Medical Science, Pulofesa Aronova S. M.

Kwa zaka zambiri ndakhala ndikuphunzira za zovuta za DIABETES. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinology Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsiratu matenda ashuga. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 100%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipilira mtengo wonse wa mankhwalawo. Ku Russia ndi mayiko a CIS odwala matenda ashuga kale atha kupeza mankhwala ZAULERE .