Ogwira ntchito kwakutali

Pochiza matenda a shuga, mitundu yosiyanasiyana ya insulin imagwiritsidwa ntchito. Pali mitundu yambiri ya mankhwala omwe amasiyana mu mawonekedwe awo a insulin, chifukwa chake mankhwalawa samasinthasintha nthawi zonse.

Mtundu uliwonse wa insulin uli ndi nthawi yake komanso zochita zake. Dokotala amawona insulin yomwe amakonda ndi mitundu yonseyo, kutengera kuwopsa kwa matenda ashuga ndi matenda ena okhudzana ndi izi.

Njira ya jekeseni wa insulin isanayambike, ndikofunikira kudziwa mitundu ya insulini komanso momwe amakhudzira thupi la wodwalayo.

Mankhwala a insulin

Zikondazo zimabisala pafupipafupi 35-50 magawo a insulin usana ndi usiku, izi ndi magawo 0.6-1.2 pa kilogalamu imodzi yakulemera kwa thupi. 1 unit ya insulin yofanana ndi ma microgs a 36 (mcg) kapena 0,036 mg.

Secaltion ya basal insulin imapereka glycemia ndi kagayidwe pakati pa chakudya komanso kugona. Mpaka 50% yopanga insulin tsiku lililonse imawerengeredwa ndi basal insulin.

Zakudya zotulutsira insulin ndikutuluka kwa shuga m'magazi mutatha kudya, zomwe zimapangitsa kuti magazi asamagwidwe "atatha kudya" komanso kulowetsedwa kwa chakudya. Kuchuluka kwa insulin yazakudya pafupifupi ndendende ndi kuchuluka kwa chakudya chamafuta.

Kupanga kwa insulin kumasiyana malinga ndi nthawi ya tsiku. Kufunika kwa mahomoni awa ndikokwera m'mawa, kuyambira pafupifupi ma 4 koloko m'mawa, kenako kumayamba kuchepa.

Nthawi ya kadzutsa, magawo a 1.5-2,5 a insulin amapangidwira 12 g wa chakudya.

Zipinda za 1.0-1.2 ndi 1.1-1.3 zimasungidwa kuti zizikhala ndi zakudya zochuluka tsiku ndi tsiku.

Gulu la insulin

Poyamba, insulin yazomwe nyama idagwiritsidwa ntchito. Pakupita kwa zaka, asayansi adatha kupeza mahomoni awa mwachembere kwambiri. Mu 1983, insulin yochita kupanga idagwiritsidwa ntchito kwambiri pa zamankhwala, ndipo insulin ya nyama idaletsedwa.

Njira yopangira chida ichi ndi kuyika zida za jini mu maselo a tizilombo toyambitsa matenda a Escherichia coli kapena yisiti. Pambuyo podziwonetsera, mabakiteriya nawonso amatulutsa timadzi timeneti.

Ma insulini amakono amasiyanasiyana pokhudzana ndi kuwonetsedwa komanso kutsatana kwa ma amino acid. Malinga ndi kuchuluka kwa kuyeretsedwa, awa ndi:

• zachikhalidwe
• monopic,
• monocomponent.

Pali mitundu iwiri ya chakudya kapena yaifupi ya insulin:

1. Insulin yochepa: Biogulin R, Actrapid NM, Monodar, Humodar R, Actrapid MS, Monosuinsulin MK,
2. Ultrashort insulin: Insulin Glulizin (Apidra), Insulin Lizpro (Humalog).

Mankhwala omwe akhala akuchita kwa nthawi yayitali kapena mankhwala oyambira amakhala osokoneza bongo pakatikati. Mwa zina wamba:

• insulin isophane
• insulin zinc ndi ena.

Pali mankhwala omwe amaphatikiza ma insulin othamanga komanso mankhwala ogwiritsira ntchito nthawi yayitali - ma insulin osakanikirana. Amagwiritsidwa ntchito ngati mankhwala a insulin a 2 shuga.

Ma insulin osakanikirana amaphatikizidwanso pochiza matenda amtundu wa 1 shuga.

Ultrashort insulin

Nthawi zina, insulin ya insulin ndi mtundu wa uinjiniya womwe umayamba kugwira ntchito ukangolowetsedwa m'thupi la munthu, izi ndizofunikira chifukwa cha encephalopathy. Zochitikazo zimawonjezeka, nthawi zambiri pakatha ola limodzi ndi theka ndipo zimatha mpaka maola anayi.

Ultrashort insulin imayendetsedwa pokhapokha chakudya kapena isanachitike. Mtunduwu ukuphatikiza:

1. Insulin apidra,
2. Watsopano Watsopano
3. Insulin Humalog.

Zotsatira za insulin yamtunduwu zimadziwika kwa ambiri odwala matenda ashuga. Zotsatira zoyipa pambuyo pa utsogoleri zitha kuwonetsedwa nthawi yomweyo kapena sizikuwoneka konse. Zikachitika, ndikofunikira kufunsa dokotala nthawi yomweyo.

Ndi mitundu iti ya insulin yomwe ingagwiritsidwe ntchito bwino kwambiri, dokotala amasankha chilichonse.

Zotsatira zake zimatengera momwe wodwalayo alili, nthawi yogwiritsira ntchito komanso zigawo zomwe zilipo.

Insulin yochepa

Insulin yochepa kapena yosavuta imayamba kugwira ntchito pambuyo pa mphindi 20-30. Chimakula kwa maola 2-3 mutatha kuperekera mankhwalawa, ndipo nthawi yonse ya kuchitapo ndi maola 5-6.

Insulin yomwe imagwira ntchito mwachidule imaperekedwa musanadye, muyenera kupumira pakati pakubayidwa ndi kudya kwa mphindi 10-15.

Ndikofunikira kuti nthawi yakudya ifanane ndi nthawi yokwanira pachimake. Zosinthidwa, kusinthidwa ma genetin, ma insulin afupiafupi okhala ndi zovuta zazing'ono ndi:

• Insulan Actrapid,
• Humulin Nthawi Zonse "ndi ena.

Atafunsidwa chifukwa chake insulin imodzi imagwiritsidwa ntchito, dokotala wopezekapo amayenera kuyankha.

Mlingo wa insulini umatsimikizika potengera zomwe munthu wodwala matenda ashuga amachita.

Insulin Yapakatikati

Mukamaphunzira mitundu ya insulini, zinthu zomwe zimakhala ndi nthawi yayitali ziyenera kuchitika. Izi ndi insulin, zomwe zimatenga maola 12-14.

Insulin yapakatikati sifunikira kuposa jakisoni 1-2 patsiku. Nthawi zambiri, jakisoni amachitidwa ndi nthawi ya maola 8-12, amathandizira pambuyo pa maola awiri ndi atatu. Mphamvu ya mankhwalawa imachitika chifukwa chokulirapo thupi lathu. Insulin yapakatikati sikuti ndi mtundu wothandizira zokha, komanso umapangidwira.

Kuchuluka kwake kumamveka pambuyo pa maola 6-8. Ma insulin omwe amagwira ntchito pakati

1. Protafan
2. Insulan Humulin NPH,
3. Humodar br ndi ena.

Ndani mwa iwo ati agwire bwino ntchito ndipo chifukwa, adokotala asankha, kutengera mbiri yachipatala. Zotsatira zoyipa ndizosowa komanso pambuyo pake.

About gawo lina

Insulin imatha kudziwika potengera magawidwe ena. Kugawikaku kumachitika ndi zomwe zidachokera ku chinthucho.

Katundu wotchedwa ng'ombe amapezeka kuchokera ku kapamba ka ng'ombe. Thupi limakhala losiyana kwambiri ndi mawonekedwe aumunthu, thupi limakumana ndi zovuta zonse. Mankhwalawa akuphatikizapo:

Nthawi zambiri amapezeka mu mawonekedwe a mapiritsi a insulin.

Gawo la nkhumba litha kukhala nthawi yayitali. Zinthu zamtunduwu zimasiyana ndi insulin yaumunthu m'magulu amodzi amino acid, omwe amathanso kuyambitsa mavuto.

Analogue ina ya chinthu ndi chibadwa komanso uinjiniya. Zigawozi zimatengedwa motere:

1. gawo laumunthu limapangidwa pogwiritsa ntchito Escherichia coli,
2. kutembenuka kwa nkhumba ndi amino acid.

Chifukwa chomwe izi kapena njira iyi ilili bwinoko imatha kupezeka pokhapokha njira zingapo.

Zinthu zomwe zili zofanana ndi insulin ya anthu ndizophatikiza:

Gulu lomaliza lili ndi fanizo zamakono za insulin, zomwe zimaphatikizapo mawonekedwe ake a uinjiniya, omwe amachokera ku chibadwa komanso chinthu chopanga munthu. Insulin yosakanikirana imawerengedwa ngati yoyenera kwambiri kwa matenda ashuga, popeza mawonekedwe owoneka ndi zotsatira zoyipa amachepetsa. Izi zimatheka chifukwa palibe mapuloteni.

Kugawikaku kumapereka mpata wopanga lingaliro la mtundu uti womwe ungagwire bwino ntchito iliyonse.

Hormone antagonist insulin

Wotsutsa aliyense wa gawo la insulin amapereka shuga ochulukirapo. Akhoza kukhala achitapo kanthu.

Ma anti-mahomoni ofanana ndi zinthu zotere, mwachitsanzo, Sinamlbumin, adapangidwa.

Glucagon iyenera kuzindikiridwa ngati wotsutsana ndi insulin. Izi zikuphatikiza:

1. adrenaline
2. cortisol
3. corticosteroid
4. somatotrapin,
5. mahomoni ogonana
6. mahomoni azitroedny.

Insulin yogwira inshuwaransi ili mgululi; ndi njira yatsopano kwambiri yothetsera matenda ashuga.

Malangizo

Mwa mankhwala onse omwe amapezeka, muyenera kusankha omwe amayambitsa zotsatira zoyipa ndi zoyipa. Ndalama zotere ndizoyenera kuchuluka kwa anthu odwala matenda ashuga.

Ma insulini azinyama samakonda kwambiri chifukwa ali ndi mapuloteni akunja. Ndikofunikira kuti nthawi zonse muwerenge mosamala zilembo zomwe zalembedwa. MS ndi gawo limodzi, loyeretsa kwambiri insulin. NM ndi analogue ya insulin yamunthu.

Manambala "100" kapena "50" akuwonetsa kuchuluka kwa insulin yomwe ili 1 ml. Ngati opitilira zana - iyi ndi insulin yambiri. Kuti mugwiritse ntchito, muyenera kukhala ndi cholembera chomwe jakisoni wa insulin imachitikira.

Njira yakale yovulirira insulini imakhala ndi zovuta zingapo, kuyambira pakufunika kuyamba kwa mankhwala a insulin, kumatha ndi mapangidwe a mantha a majekeseni. Asayansi akupanga njira zomwe mungabayire jakisoni kapena nthawi yayitali.

Orulin insulin ndikutukuka kolimbikitsa, mtengo wake ndiwokwera kwambiri. Njira yake ndiyabwino chifukwa palibe chifukwa chobayira jakisoni kamodzi patsiku kapena kuposerapo.

Insulin ya mkamwa, yomwe munthu amalandila ndi chakudya, imayambitsa shuga kulowa m'magazi. Pamene ndende ya shuga ikachuluka, kapamba amayamba kugwira ntchito ndikupanga insulini. Pamodzi ndi zogaya, insulin imafika m'chiwindi. Chiwalochi chimagwira ngati gawo lomwe limagawira insulin mokwanira mu ziwalo zina.

Poganizira mitundu ya insulin ndi zotsatira zake, titha kutchula chakudya, makamaka masamba ndi zipatso. Chowonadi ndi chakuti zinthu izi zimapangitsa mtundu wa insulin kulowa mthupi la munthu.

Thandizani shuga wochepa:

Kuchuluka kwa insulin:

Insulin yomwe idatha ntchito sikuyenera kugwiritsidwa ntchito. Onani malamulo osungira a mankhwalawo. Insulin yochulukirapo ikhoza kusokoneza kuyenda koyenera ndipo imayambitsanso:

Insulin iyenera kusungidwa pa kutentha kwa madigiri 2-8 pamalo amdima, koma osazizira. Pamatenthedwe, thunthu limasungabe mawonekedwe ake a aseptic komanso achilengedwe.

Kutentha kwambiri kumachepetsa kuphatikiza kwa mankhwalawa. Ngati insulin ili ndi mitambo, ndiye kuti siyenera kugwiritsidwa ntchito. Izi, monga lamulo, zimawonedwa pansi pa kutentha kwakukulu pamodzi ndikugwedezeka.

Ngati mankhwalawo adakundidwa kamodzi, ndiye kuti sangagwiritsenso ntchito. Zopezeka zilizonse komanso zomata pazoyimitsidwa zimawonetsa kuti ndikosayenera kuzigwiritsa ntchito.

Mosasamala kanthu kuti chinthucho chili m'gulu la zosavuta kapena kuphatikiza insulini, mankhwalawa amayenera kusungidwa kwa milungu isanu ndi umodzi, kufikira atatupa. Izi zikachitika, chinthucho sichingagwiritsenso ntchito.

Insulin imayikidwa ndi katswiri kapena endocrinologist. Ngati pali kulemala, ndiye kuti pali zabwino zina.

Zambiri zamitundu ya insulini zitha kupezeka ndikuwona kanema munkhaniyi.

Kodi kuchita insulin nthawi yayitali bwanji?

Kwa odwala omwe ali ndi mtundu woyamba wa 2 ndi matenda a shuga, kukhala ndi insulin yofunikira kwa nthawi yayitali ndi mankhwala ofunikira. Ndipo zonena izi zilibe maziko. Kuletsa kubayidwa ngakhale jekeseni m'modzi kungachititse kuti wodwalayo afe ngati thandizo silifika nthawi. Chilichonse ndi chachikulu kwambiri pachifukwa chimodzi - jakisoni wa insulin amalipira mahomoni m'thupi, omwe, chifukwa cha matenda, amaleka kutulutsa kapamba pazofunikira.

Ngati thupi lili m'mayambiriro a matendawa, wodwalayo nthawi zambiri amafunikira chithandizo chamankhwala chokhala ndi insulin yochepa kapena yapamwamba. Pankhaniyi, jakisoni amaperekedwa pambuyo podyera.

Matenda a shuga kapena shuga ndi kuwonongeka kwa thupi komwe kumayenderana ndi kuperewera kwa dongosolo la endocrine. Mtundu woyamba ...

Ngati matendawa afika pa gawo lotsatira la chitukuko, mitundu ya insulin yomwe imatenga nthawi yayitali imapatsidwa kwa wodwala, dongosolo lomwe limamangidwa nthawi yake ndipo limafunikira njira yolimba kwambiri.

Ndikofunikira kudziwa kuti mayina onse a insulin owonjezera amalembedwa ndi dokotala komanso pokhapokha ngati palibwe palokha pakapangidwe kodziyimira payekha wa mahomoni ndi ma pancreas aumunthu, ndi kufa mwachangu kwa maselo a beta.

Matenda a 2 a shuga amatchedwanso shuga osadalira insulini. Ichi ndi matenda oopsa omwe amadziwika ndi ...

Popereka mankhwala, dokotalayo ayenera kuphunzira zolemba za wodwalayo, kuwonetsa kuchuluka kwa shuga m'magazi atatu apitawa, makamaka mwezi umodzi kapena iwiri.

Ngati insulin yayitali imagwiritsidwa ntchito

Kwa moyo wabwinobwino, insulin yayitali imapangidwa kuti ikhale yoyambira, kwa odwala omwe ali ndi vuto la matenda ashuga a mtundu woyamba 1, omwe amadziwika kuti ali ndi matenda amtundu wa 2, insulin yowonjezereka imayikidwa ngati monotherapy.

Basal insulin ndi insulin yomwe imapangidwa m'thupi nthawi zonse 24 tsiku lililonse, mosasamala nthawi ndi kuchuluka kwa kudya. Komabe, mwa odwala omwe ali ndi matenda amtundu wa II, kapamba sangathe kutulutsa timadzi tating'onoting'ono. Jekeseni wambiri wa insulin amapatsidwa 1 m'mawa, asanadye, nthawi zina ziwiri. Mankhwalawa amayamba kugwira ntchito kwathunthu pambuyo pa maola atatu ndipo amakhalapobe mpaka maola 24.

Pochizira matenda amtundu wa 1 shuga, insulin ya basal imathandizika ndi jakisoni afupifupi kapena a ultrashort.

Insulin yokhala nthawi yayitali, omwe mayina awo omwe amaperekedwa pansipa, ndiofunikira pankhani zotsatirazi:

Kuzindikira kwa shuga - ingomwani tsiku lililonse.

• kukhazikika kwa shuga m'magazi musanadye,
• kusungidwa kwofunikira kwa mahomoni usiku,
• sinthani zovuta zotere ngati "m'mawa kutacha",
• kupewa ketoocytosis ndi kusunga maselo a beta mu mtundu 1 wa shuga,
• kukhazikika kwa mkhalidwe wamthupi ndi kusungika kwake pakupititsa patsogolo matendawa mtundu wa 2 shuga.

Kukula kwa kuchuluka kwa insulin yayitali kumatsimikiziridwa ndi adokotala okha, atafufuza mwatsatanetsatane wodwala komanso jakisoni wazinthu zingapo. Pofuna kupewa hypoglycemia mu Mlingo woyambirira, kuchuluka kwa mahomoni kumakhala kwakukulu. Kenako, ndendeyo imayamba kuchepa m'magazi a shuga m'magazi.

Insulin yayitali ndikofunikira kugwiritsa ntchito moyenera. Sizothandiza, monga thandizo ladzidzidzi, kukhazikika shuga m'magazi mutatha kudya, monga insulin yochepa kapena yochepa kwambiri. Zochita zake sizothamanga kwambiri. Jekeseni wa insulin wa nthawi yayitali amafunikira kutsatira kwambiri njira ndi ndandanda. Kupatuka kuyambira nthawi yoikidwiratu kumatha kudzetsa zovuta kwa thanzi la wodwalayo, chifukwa chizindikiro cha shuga chamagazi sichikhazikika.

Ubwino ndi zoyipa

Pogwiritsa ntchito ma insulins omwe akhala akuchita kwa nthawi yayitali, wodwalayo amapatsa thupi lake chilinganizo cholondola kwambiri cha mahomoni amunthu. Mokhazikika, insulin yomwe yakhala ikugwira ntchito kwa nthawi yayitali, mayina omwe tikambirana pansipa, amagawika m'magulu awiri: nthawi yayitali ndi maola 15 ndipo nthawi yayitali ikufika mpaka maola 30.

Pofika pakufunika kwakanthawi kochepa pang'onopang'ono, insulini yokhala nthawi yayitali imayamba kuchepa pang'onopang'ono popanda kuyambitsa zovuta komanso kudumphira m'magazi a wodwalayo. Ndipo apa chinthu chofunikira kwambiri ndikusaphonya mphindi yomwe jakisoni itayamba kukhala ziro ndikulowa muyezo wotsatira wa mankhwalawa. Insulin yayitali imakhala ndi zabwino komanso zovuta zake ngati mankhwala ena onse.

• mawu oyambira osavuta
• Njira zamankhwala ndizosavuta komanso zomveka kwa wodwalayo komanso abale ake,
• chizindikiro chotsika cha kuphatikiza kwa luso ndi chidziwitso chofunikira chamankhwala,
• kusowa kwa kuyang'anira kuchuluka kwa shuga m'magazi,
• kudziyimira pawokha pazotsatira zamatendawa ndikuchiritsika kosatha ndikotheka.

• chiopsezo chokhazikika cha hypoglycemia,
• hyperinsulinemia yokhazikika, yomwe imawonjezera mwayi wokhala ndi matenda oopsa,
• kudya mwamphamvu ndi jakisoni,
• kunenepa

Mayina Mankhwala Osokoneza bongo

Kusakhalapo kwa zochitika mu insulin yochitika kwa nthawi yayitali kumachitika chifukwa cha kupezeka kwa timadzi tating'onoting'ono timene timalowa m'magazi. Kuyesa kwa Phargine ndi acidic ndipo izi zimapatula kuyanjana kwake ndi kukonzekera kosatha kwa Ph Ph, i.e. yochepa komanso ya ultrashort insulin.

Mayina odziwika kwambiri a insulin omwe akhala akuchita nthawi yayitali amaperekedwa pagome pofotokoza mwatsatanetsatane:

Timapereka kuchotsera kwa owerenga tsamba lathu!

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.

Mankhwalawa amakhazikika m'magazi a shuga a maola 24. Amapezeka mu cholembera cha ma syringe ambiri omwe angathe kutayika komanso makatiriji asanu oikika oyenda.

Ndikofunikira kuti odwala adziwe kuti ma insulini onse omwe akhala akuchita kwakanthawi sangakhale oundana. Moyo wa alumali ndi miyezi 30 ndipo mankhwalawa amaperekedwa pokhapokha ngati mwalandira mankhwala.

Mtengo wake umatengera dzina la insulin yemwe amakhala nthawi yayitali. Izi ziyeneranso kuganiziridwa polumikizana ndi dokotala komanso kulandira chithandizo chamankhwala. Koma, nthawi zambiri, ndipo izi ndizomveka, odwala amawongoleredwa osati ndi mitengo, koma mwa kulekerera kwapadera kwa mankhwala.

Matenda a shuga nthawi zonse amayambitsa zovuta zakupha. Shuga wambiri ndi owopsa kwambiri.

Aronova S.M. adafotokoza za chithandizo cha matenda ashuga. Werengani kwathunthu

Mawonekedwe

Pakati pazovuta zomwe anthu akuchita mwachangu, zokonzekera Homorap ndi Insumad Rapid ndizofunikira kuziwunikira. Palibe kusiyana pakati pawo. Kusiyana komwe kuli mu kuchuluka kwatsalira a amino acid omwe amapezeka pakapangidwe kake.

Insulin "yachangu" yazachinyama imaphatikizanso mankhwala "Insulrap SPP", "Iletin II Regular" ndi ena. Amakonda kupatsidwa matenda a shuga a mtundu II. Njira zochokera pagululi zili ndi mapuloteni okhala ndi mawonekedwe ena, chifukwa chake sioyenera kwa odwala onse. Mwachitsanzo, ma insulini opangidwa "nyama mwachangu" sangaperekedwe kwa anthu omwe matupi awo sangathe kukonza lipids.

Kulandila, Mlingo, kusungidwa kwa "kufupikitsa" 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 amakakamizidwa kumwa mankhwala omwe amathandizira kuti shuga azikhala bwino. Koma mtundu uliwonse wa matenda ashuga umasowa mtundu wina wa insulini. 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".

Insulin yayitali

Ndi mankhwala okhazikitsidwa panthawi yake omwe amalola odwala matenda ashuga kusangalala ndi moyo osakumana ndi zovuta zomwe zimayambitsidwa ndi shuga wambiri. Kodi pali kusiyana kotani pakati pa mtundu wa insulin yokonzekera kuchokera kwa ena ndi mitundu yanji ya insulin yomwe ilipo - tiyeni tikambirane izi.

Kusiyanitsa kwakukulu pakati pa insulin pankhaniyi ndikuti mphamvu ya mankhwalawa nthawi zina imatha 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 kwa 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 nthawi yayitali ndi Ultratard, Ultralente-yletin-1, Huminsulin, 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 insulin - osati munthawi ya kuchitapo kanthu, komanso koyambira. Kukonzekera kwanyama ndi ma insulini omwe amafanana ndi anthu amakhala okhaokha.

Kupeza mankhwala kuchokera ku gulu loyamba, kapamba wa nkhumba, komanso ng'ombe, umagwiritsidwa ntchito. Kapangidwe kazachilengedwe ka insulin yotengedwa kuchokera ku ziwalo za nkhumba ndizoyenera kwambiri kwa anthu. Kusiyana kwa nkhaniyi ndikosafunikira kwathunthu - amino acid imodzi.

Koma mankhwala abwino kwambiri ndizachidziwikire, ma insulin a anthu, omwe amagwiritsidwa ntchito nthawi zambiri. Pali njira ziwiri zopangira malonda:

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!

Kusiyana kwa insulin koyambira

Malinga ndi mfundo iyi, mitundu yotsatirira ya insulini imasiyanitsidwa:

• ng'ombe insulin - kuchotsedwa kwa kapamba a nyama. Insulin iyi ndi yosiyana kwambiri ndi anthu. Thupi lawo siligwirizana nthawi zambiri limachitika.
• nkhumba - yochokera ku kapamba wa nkhumba. Amasiyana ndi munthu mu amino acid imodzi. Swine insulin nthawi zambiri amayambitsa ziwengo.
• anthu - kapena m'malo, fanizo la insulin yaumunthu komanso ma genulin okhala ndi insulin. Ma insuliniwa amapezeka m'njira ziwiri: mwa njira yoyamba, insulin yaumunthu imapangidwa ndi E. coli, ndipo njira yachiwiri, insulin yaumunthu imapezeka kuchokera ku insulin ya insulin ndikusintha amino acid.

Ma insulins amphaka amaphatikizapo: Insulrap GLP, Ultralente, Ultlente MS.

Zowetcha nkhumba zimaphatikizapo: Monodar K (15.30.50), Monodar ultralong, Monodar Long, Monosuinsulin, Insulrap SPP, etc.

Ma insulin a anthu amaphatikizapo: Actrapid, Novorapid, Lantus, Humulin, Humalog, Novomiks, Protafan ndi ena ambiri.

Ma analogues abwino kwambiri ndi insulin yaumunthu komanso ma genulin omwe adapangidwira, ali ndi kuyeretsa kwabwino, samakhala ndi zotsatira zoyipa monga insulin yoyambira nyama, samayambitsa zotsatira zoyipa pafupipafupi monga ma insulin a nyama, popeza alibe mapuloteni achilendo, mosiyana ndi insulin yanyama .

Kusiyana kwa insulin nthawi yayitali

Malinga ndi mfundo ndi nthawi yochitapo kanthu, ma insulins a ultrashort amasiyanitsidwa, afupikitsa, nthawi yayitali, achitapo kanthu.

Ma Ultrashort ma insulin amayamba kugwira ntchito atangomaliza kukonzekera, kufika pachimake pambuyo pa 1-1.5, ndipo maola atatu omaliza.
Izi inshuwaransi zitha kutumikiridwa nthawi isanayambe komanso itatha. Ndi kukhazikitsidwa kwa insulin ya phashort musanadye, sikofunikira kuti muchepetse pakati pa jakisoni ndi chakudya.

Maultrashort ma insulin safuna zokhwasula-khwasula pazowonjezerapo kanthu, zomwe ndizosavuta kuposa zazifupi.

Ma insulin a Ultrashort akuphatikizapo Apidra, Novo-Rapid, Humalog.

Ma insulin afupiafupi amayamba zochita zawo atatha mphindi 20-30, nsonga ya zochitika imachitika patatha maola awiri ndi atatu, nthawi yayitali imakhala pafupifupi maola 5-6.
Ma insulin amafupikitsa musanadye, nthawi zambiri ndikofunikira kuti muchepetse pakati pakati pa jakisoni ndi kuyamba kwa chakudya mu mphindi 10-15.

Mukamagwiritsa ntchito insulin yochepa, ndikofunikira kuti mukhale ndi chakudya chamkati patatha maola atatu jakisoni, nthawi yokhazikika iyenera kugwirizana ndi nthawi yayitali ya insulini.

Ma insulin amafupikitsawa ndi monga Actrapid, Himulin Regular, Monodar (K50, K30, K15), Insuman Rapid, Humodar, etc.

• Ma Insulin Yapakatikati

Gululi limaphatikiza ma insulin, omwe amakhala ndi nthawi yayitali, pafupifupi maola 12-16.

Nthawi zambiri, matenda amtundu 1, ma insulini amagwiritsidwa ntchito ngati basal kapena maziko. Zimatenga jakisoni awiri (nthawi zina atatu) patsiku, nthawi zambiri m'mawa ndi madzulo ndimatenga maola 12.

Ma insulini awa amayamba kugwira ntchito atatha maola 1-3, amafika pachimake patatha maola 4-8 (pafupifupi) ndipo amakhala pafupifupi maola 12-16.

Ma inshuwaransi apakatikati amakhala ndi ma insulin monga Protafan, Humulin NPH, Humodar br, Insuman Bazal, Novomiks.

• Ogwira ntchito kwakutali

Izi insulini amachita ngati maziko kapena insal insulin. Wina (nthawi zina ziwiri) jakisoni patsiku amafunikira.
Ma insulin omwe amakhala nthawi yayitali amagwiritsidwa ntchito ngati mtundu wa 2 shuga wa insulin.

Mlingo wawo ndiwachilengedwe, kutanthauza kuti, ngati gawo la makonzedwe litasinthidwa, zotsatira zake zimawonekera kwathunthu masiku atatu.

Insulin yayitali imayamba kugwira ntchito maola 4-6 pambuyo pa utsogoleri, ntchito yayitali kwambiri mu maola 10 mpaka 14, zotsatira zawo zimatha maola 20-24.
Mwa ma insulin omwe amakhala ndi "insulin" osatulutsa, ndiye kuti samapereka chidindo, motero, amachita zinthu modekha komanso mokulira kutsanzira zomwe amaletsa insulin mwa munthu wathanzi.

Ma insulin omwe akhala akuchita kwakutali akuphatikizapo Lantus, Monodar Long ndi Monodar Ultralong, Ultlente, Ultralong, Humulin L, etc.
Ma insulin opanda kanthu akuphatikizira Levemir, Lantus.

Mtundu wa insulin

Feature

Kuyamba kuchitapo kanthu

Zochita zapamwamba

Kutalika kwa chochita

Mitundu yamahomoni ndi kusiyana kwawo

Matenda a shuga amakakamiza kugwiritsa ntchito mitundu yosiyanasiyana ya insulin. Hormoni iliyonse yobala imakhala ndi umunthu wake. Chifukwa cha izi, ndikotheka kusankha mankhwala pazomwe munthu wina wapanga, koma zinthu ngati izi sizisinthana.

Mankhwala aliwonse amasiyana ndi ma analogues munthawi yomwe akukhudza thupi ndi nsonga za ntchito. Katswiri wodziwa bwino (dokotala) ndi amene amasankha njira yabwino kwambiri yokwaniritsira wodwala, potengera kuwopsa kwa matendawa.

Mitundu yayikulu yamahomoni:

1. Insulin, yomwe idapezeka kuchokera ku kapamba amkaka wamkaka (ng'ombe, ng'ombe). Muli ma amino acid ena owonjezera atatu omwe mulibe mu munthu, motero mankhwalawa amatha kuyambitsa zovuta zina.
2. Mankhwala molingana ndi chithaso cha nkhumba. Kupanga kwawo kwa biochemical kumayandikirana kwambiri ndi mahomoni a anthu, kupatula kusiyanasiyana kwa amino acid amodzi kuchokera kumtambo wama protein.
3. Mtundu wachilendo kwambiri wa mahomoni ndi chinsomba, umakhala ndi kusiyana kwakukulu poyerekeza ndi insulin yaumunthu, chifukwa chake umagwiritsidwa ntchito pazovuta kwambiri.
4. Mtundu woyenera kwambiri wa ma hormone ndi wokhazikitsidwa ndi anthu. Chiwonetserochi chimapangidwa kuchokera ku zenizeni za Escherichia coli (maselo enieni a insulin) kapena kusintha kwa ma genetic mainjini a porcine (m'malo mwa "osayenera" amino acid).

Nthawi yowonetsera mtundu uliwonse wa mankhwalawa ndi payekha, kotero kusankha koyenera kwa mahomoni ophatikizidwa ndikofunikira kwambiri kwa wodwala aliyense.

Malinga ndi nthawi ya mankhwalawa, amagawika m'magulu:

Kuthamanga kwambiri (kopitilira muyeso). Mankhwalawa amayamba kugwira ntchito pambuyo pa mphindi 15-30 ndikufika pazovuta zake pakapita maola atatu, kumatha mpaka maola 6. Insulin imagwiritsidwa ntchito musanadye, kwinakwake m'mphindi 30, ndikuigwira ndi chakudya chochepa.

Gulu ili la mahomoni limaphatikizapo mankhwala a ultrashort komanso ma insulin osakhalitsa.

Ma mahomoni a Ultrashort amakhala ndi mphamvu mwachangu ndipo amachepetsa shuga nthawi yomweyo. Amadyedwa atatsala pang'ono kudya.

Mitundu yayikulu yamankhwala monga awa:

1. Chichewa. Amagwiritsidwa ntchito ngati: mtundu 1 wa matenda a shuga, kusalolera kwa mankhwala ofananawo, kukana insulini komanso mtundu wachiwiri (ngati mankhwala ena alibe mphamvu).
2. NovoRapid. Wopezeka mumtsuko wokhala ndi voliyumu ya 3 ml, yomwe imagwirizana ndi zomwe 300 mayonesi ali nazo. Itha kugwiritsidwa ntchito ndi amayi apakati.
3. Apidra. Amagwiritsidwa ntchito ngati mankhwala, onse akulu ndi ana azaka zopitilira 6, kugwiritsa ntchito njira yopangira pampu kapena njira ina yoyendetsera makina.

Ma insulin afupiafupi amayamba zochita zawo pakatha theka la ola ndipo amagwira mpaka maola 6. Amagwiritsidwa ntchito musanayambe chakudya m'mphindi 20. Zitha kugwiritsidwa ntchito ngati mankhwala osokoneza bongo.

Oyimira akuluakulu ndi:

1. Actrapid NM. Insulin yomwe idapezeka kudzera m'makampani opanga ma genetic engineering. Imalowetsedwa ndi jekeseni wamkati kapena kudzera mu mtsempha. Amaperekedwa mosamalitsa malinga ndi mankhwala omwe adokotala amapita.
2. Humodar R. Mankhwala ali pamapangidwe apakati.
3. Humulin Wokhazikika. Amagwiritsidwa ntchito m'magawo oyamba azindikira matendawa, amaloledwa kugwiritsidwa ntchito ndi amayi oyembekezera.
4. Monodar. Ntchito zamagulu a shuga mellitus 1 ndi 2 magawo.

Mitundu yonse yamankhwala othandizira amakono amagwiritsidwa ntchito musanadye, popeza njira yogaya chakudya imathandizira kuti njira yonyamula mankhwalawa ichitike mofulumira. Ma Horona a ultrafast komanso kuchitapo kanthu mwachangu amaloledwa kumwedwa pakamwa, atawabweretsa kumtunda.

Pankhani ya subcutaneous makonzedwe a mankhwala, njirayi sayenera kuchitidwa osapitirira theka la ola chakudya chisanachitike. Mlingo wa mankhwala kwa wodwala aliyense amakhala amodzi payekha ndipo amatsimikiziridwa ndi adokotala okha. Mlingo wa akuluakulu ungakhale wa magawo 8 mpaka 23 patsiku, ndipo kwa ana - osaposa magawo 9.

Ma mahomoni opangidwa amasunga katundu wawo pakutentha kuchokera ku madigiri 2 mpaka 8, chifukwa chake amasungidwa mufiriji.

Mankhwala

Mankhwala amtunduwu amakhala ndi mphamvu yayitali.

Pali mitundu iwiri ya mankhwala:

• kutengera maselo amunthu (kapangidwe kawo), monga: Protafan, Homolong, etc.,
• pa nyama, mwachitsanzo: Berlsulin, Iletin 2 ndi ena.

Ma insulin apakatikati amakhala ndi mphamvu pakatha mphindi 15 atamwa, koma zotsatira za kukomoka kwathunthu zimatheka patapita nthawi yayitali.

Gulu ili la mankhwala lili ndi zinthu mosiyanasiyana, mwachitsanzo, zinc ndi isophan.

Zogulitsa zazitali

Mankhwala osokoneza bongo omwe amakhala m'gululi amagwira ntchito thupi la wodwalayo kwa tsiku limodzi kapena kupitilira apo. Mankhwala osiyanasiyana omwe akhala akuchita kwa nthawi yayitali amapangidwa mothandizidwa ndi mankhwala, omwe amathandizira kuwonetsera kotereku.

Ma insulini omwe amakhala ndi "nthawi yayitali" amathandizira kuchepa kwa shuga m'magazi ndipo amatha kukhala ndi mphamvu mpaka maola 30 motsatana.

Mitundu yotchuka kwambiri imaphatikizapo:

• otchuka kwambiri: Determid, Glargin (shuga wotsika pang'ono),
• zolemba zotsika mtengo: Ultralente-Iletin-1, Ultralgon, Ultratard.

Kuti muthane kwathunthu mawonekedwe a mavuto osafunikira, muyenera kulumikizana ndi katswiri yemwe angakuthandizeni kudziwa kuchuluka kwa mankhwalawa malinga ndi magawo ake.

Insulini "zazitali" zimayendetsedwa ndi jakisoni wokha.

Makina osungira amitundu yonse yamankhwala munjira iyi ndi ofanana. Ampoules ndi mankhwalawa amathanso kusungidwa mufiriji. Ndi kutentha kokha komwe kumakhala mankhwala omwe samakonda kupangika kwa granules kapena flakes.

Gulu la madigiri oyeretsa

Thupi lokhazikika la mahomoni limapangidwira zosowa zosiyanasiyana. Chogulitsa chomaliza chimapezeka pogwiritsa ntchito mitundu ingapo ya kuyeretsa.

Gome la madigiri angapo a kuyeretsa kwa mahomoni:

Nkhani yamavidiyo pa mitundu ndi magulu a mahomoni:

Kusiyana kwakukulu pakati pa insulin yayifupi ndi yayitali

Zida zapadera za insulin yochepa:

• Mankhwala amatengedwa theka la ola musanadye,
• pakuyamba mwachangu kuchitapo kanthu, adayilowetsedwa m'chigawo cham'mimba pamimba,
• jakisoni wa mankhwalawa amayenera kutsagana ndi chakudya china pofuna kupatula mwayi wokhala ndi matenda monga hypoglycemia.

Mawonekedwe apadera a mahomoni omwe atenga nthawi yayitali:

• mankhwala amtunduwu amaperekedwa nthawi inayake (nthawi zambiri nthawi yomweyo m'mawa kapena madzulo). Wobayira m'mawa uyenera kuchitidwa limodzi ndi jakisoni wa insulin yofulumira,
• chifukwa chosachedwa kuyamwa kwa mankhwalawo m'magazi, jekeseni amapangidwa m'tchafu mwendo,
• mtundu uwu wa mahomoni samatengera nthawi yakudya.

Kuchokera pazomwe zili pamwambapa zamtundu uliwonse wamankhwala, titha kunena kuti kusankha kwa insulin yoyenera, mlingo wake komanso momwe amalowera m'thupi kumatengera zinthu zambiri.

Kuti mudziwe njira yoyenera yamankhwala, muyenera kufunsa dokotala.