Insulin yochepa: mayina a mankhwala, malangizo

Kukonzekera kwa insulini kumapezeka mu njira yothetsera mavutowa komanso momwe mungayimitsidwe mu mbale ndi machitidwe apadera a cartridge (makatiriji, makatiriji ndi makina opangidwa kuti azigwiritsidwa ntchito ndi cholembera).

Yankho la jakisoni limapangidwa m'mabotolo osalala a galasi wokhala ndi 5 ndi 10 ml, ndikuchita, monga lamulo, kuchokera ku 20 mpaka 100 PIERES mu 1 ml ya yankho.

Zomwe zimapangidwira kuti zitha kugwiritsidwa ntchito pachipatala ndi madzi osungunuka, oyera oyera a hygroscopic, omwe ali ndi sulufule ya 3.1%.

Solutions imawoneka ngati madzi oyera, opanda khungu kapena pang'ono pang'ono achikasu ndi acidity (pH) kuyambira 2.0 mpaka 3.5). Kuti akonze yankho, ufa wa makristalo amadzipaka m'madzi a jakisoni (Aqua pro injionibus), wopangidwa ndi hydrochloric acid (Acidum hydrochloricum) ndi kuwonjezera kwa glycerin (Glycerinum) ndi 0.25-00.3% yankho phenol (Phenolum) kapena tricresol (Tricresolum) wopalidwa.

Maimidwe oimitsidwa amasulidwe amaperekedwa ku malo ogulitsa mankhwala osakwanira 5 ndi 10 ml. Bokosi lirilonse limasindikizidwa ndi chosungira ndi mphira ndi chitsulo cha aluminium.

Mbiri yolamulira kwachilengedwe hypoglycemia yodziwika ndi mankhwala a magawo awiri a Novomix, komwe kuyimitsidwa magawo awiri, komwe kumakhala 30% kopitilira muyeso wa insulin ndi 70% ya protamine-crystallized insulin.

Mpaka pano, asayansi akwanitsa kuthetsa vuto la kapangidwe ka insulin kudzera m'mimba (popeza chinthucho ndi mapuloteni, imatha kuwonongedwa mothandizidwa ndi michere ya m'mimba) ndikupanganso yothandiza kwa odwala matenda ashuga mapiritsi.

Zotsatira za pharmacological

Kukonzekera kwa insulin kuli m'gulu la mankhwala omwe amakhudzachimbudzi ndi njira ya kagayidwe kachakudya mthupi.

Insulin yofunikira chakudya kagayidwe kazinthu mu thupi, zakunja ndi zachindunji antipyretic.

Ntchito zazikulu za insulin:

• Malangizo a kagayidwe kazakudya,
• kukondoweza kwa minofu yomwe imatenga shuga ndi njira zake zosinthira kukhala glycogen,
• kuyendetsa kulowa kwa glucose m'maselo a minofu,
• masitolo ogulitsa minofu,
• peptide synthesis kukondoweza,
• kutsitsa kwa mapuloteni,
• kukondoweza kwa glucosyl kuhamitsa, polyenzyme zovuta za pyruvate dehydrogenase, hexokinase enzyme,
• lipase zoletsaamene zochita zake zimayambitsa kuyambitsa mafuta acids of adipose minofu,
• lipoprotein lipase zoletsazomwe zimachepetsa "kusefukira" seramu yamagazi mutatha kudya zakudya zamafuta kwambiri.

Insulin imakhudza chakudya kagayidwe kachakudya. Izi ndichifukwa choti chinthucho chimalimbikitsa zoyendera. shuga kudzera ma cell membraneimawonjezera kugwiritsidwa ntchito kwake ndi minofu, komanso imathandizira glycogen biotransformation mu chiwindi.

Chifukwa glycogenolysis zoletsa (njira yomwe glycogen amaphulika mpaka glucose) ndi gluconeogenesis (maphunziro shuga kuchokera kumagulu osapatsa mafuta: kuchokera ma amino acid, mafuta acids etc.) insulin imachepetsa kupanga glucose wamkati.

Zotsatira za chinthu pa lipid kagayidwe kuwonetsedwa kupondaponda lipolysis (kusokonekera kwamafuta). Zotsatira zake, ndalama zimachepetsedwa mafuta acids aulere mu kayendedwe ka magazi ake.

Insulin imalepheretsa mapangidwe matupi a acetone (ketone) m'thupi, limadzutsa mafuta acid synthesis ndi maphunziro pambuyo pake esters. Amatenganso nawo gawo mapuloteni kagayidwe: imathandizira mayendedwe ma amino acid kudutsa cell nembanembakumapangitsa peptide kaphatikizidweamachepetsa kugwiritsa ntchito minofu mapuloteniImachepetsa kusintha amino acid kuti oxocarboxylic acid.

Pharmacodynamics ndi pharmacokinetics

Mphamvu yamachitidwe a insulin imalumikizidwa ndi mphamvu yake yolumikizana ndi cholandilira china, chomwe chimapangidwira plasma cell membrane, ndi mawonekedwe insulin receptor zovuta.

Molumikizana ndi insulin receptor imalowa mu khungu, momwe imakhudzira njira phosphution ya ma protein a ma cell, pakadali pano, palibe deta yolondola pazomwe zimachitika mu cell.

Insulin imagwira pafupifupi ziwalo zonse ndi thupi lathu, pomwe zolinga zake zimakhala chiwindi, minofu ndi adipose minofu.

Momwe kupopera kwa insulini kudzakhalire komanso momwe kuthira kwa kugwiritsira ntchito kwake kudzachitikire zimadalira malo a jakisoni (ndendende, pamlingo wopereka magazi kupita ku mafuta osakanikira pamalo opangira jakisoni), mlingo womwe umaperekedwa (oposa 12-16 UNITS yankho sayenera kuperekedwa m'malo amodzi) kuyimitsidwa), kuchuluka kwa yogwira pophika pokonzekera, monga insulin, kuchuluka kwa magazi am'deralo, ntchito ya minofu pamalo a jekeseni.

Zochitika za mankhwalawa zimatha kusinthasintha kwakukulu mwa anthu osiyanasiyana ndi munthu yemweyo.

Kulowa magaziinsulin imamangiriza ku α ndi β ma globulins. Mwambiri, chiŵerengero chomangirira chili mndandanda wa 5 mpaka 25%.

Maphunziro ma antibodies zimadzetsa kukula kwa insulin, komabe, mukamagwiritsa ntchito mankhwala amakono, oyeretsedwa bwino, izi sizimachitika kawirikawiri.

Hafu ya moyo wa magazi sichidutsa mphindi 10. Ambiri mwa omwe atengekedwa magazi insulin imawululidwachiwindi ndi impso enzymatic hydrolysisyomwe yakhazikika michere ya proteinolytic.

Kutupa kwa chinthu kumachitika mwachangu: pafupifupi 60% yaiwo amuchotsa impso, pafupifupi 40% - chiwindi (40%), ochepera 1.5% amachotsedwa mkodzo mwa maonekedwe oyera.

Zizindikiro zogwiritsidwa ntchito

Kugwiritsa ntchito insulin kumawonetsedwa makamaka pochizira insulin wodalira matenda a shuga (lembani matenda ashuga). Nthawi zina, ndikofunikira kupereka mankhwalawa kwa odwala omwe ali nawo shuga wosadalira insulin (mtundu II matenda ashuga).

Mankhwala ochepera omwe amagwiritsidwa ntchito shuga wotsika mwa mitundu ina schizophrenia, furunculosis, chithokomiro, matenda am'mimba, aakulu a chiwindimu magawo oyamba achitukuko matenda a chiwindi.

Kuphatikiza apo, nthawi zambiri amasankhidwa ngati Ma anabolic (zochizira kuwonda) kwa odwala omwe ali ndi vuto la kuperewera kwa zakudya m'thupi komanso kwa odwala omwe ali ndi vuto la zoperewera.

Chida ichi chitha kugwiritsidwanso ntchito ngati chimodzi mwazinthu zomwe zimagwiritsidwa ntchito pothana ndi "polarizing" pachimake koronare kusowa (chikhalidwe choyambitsidwa ndi kupindika kwapakati).

Kulimbitsa Thupi

Amakhulupirira kuti kugwiritsa ntchito insulin m'masewera ndikupeza kwenikweni. Nthawi yomweyo, kugwiritsa ntchito mankhwala osokoneza bongo kumapereka mphamvu yofunikira, makamaka, kuphatikiza ndi iliyonse anabolic kapena androgenic wothandizira.

Chimachitika ndi chiani ngati munthu wathanzi atavulaza insulin? Mothandizidwa ndi timadzi timatulutsa timadzuka minofu cell membrane kupezeka ndipo, chifukwa chake, kulowa kwa zinthuzi kuma cell kumathandizira ndikupangitsa. Zotsatira zake, ngakhale muyezo ochepera ma steroid amakhala ndi zotsatira zotchulidwa kwambiri kuposa momwe zimagwiritsidwira ntchito palokha.

Ndiye, momwe mungatengere insulin pomanga thupi? Choyamba, musamadye kwambiri (thupi limasunga kuchuluka kwazakudya zomwe zikulowa mu mawonekedwe mafuta) Kachiwiri, chepetsani mpaka pazokwanira. chakudya chambiri. Ndipo, chachitatu, musayang'ane kulemera, koma kuwunika pagalasi ndi tepi ya sentimita (muyenera kuyang'ana kuchuluka kwa mwendo wotsika, biceps, ntchafu). Maonekedwe a mafuta m'mimba ndi umboni wa mlingo wosankhidwa bwino.

Contraindication

Insulin sayenera kulembedwa matenda omwe amapezeka ndi hypoglycemia: at hemolytic jaundice, pachimake hepatitis, kapamba, matenda a chiwindi, yade, amyloid dystrophy, urolithiasis, mtima wowonongeka, zilonda zam'mimba, zimakhudza m'mimba ndi duodenum.

Mosamala, kukonzekera kwa insulin kumayikidwa:

• odwala matenda ashuga omwe kuperewera kwa coronary kapena kusokoneza magazi mu ubongo,
• odwala ndi matenda a chithokomiro,
• at Matenda a Addison (kuperewera kwa adrenocortical, komwe kumachitika pakachitika zovuta zoposa 90%) gren adrenal),
• at kulephera kwa aimpso.

Zotsatira zoyipa

Subcutaneous makonzedwe a insulin amakonzekera lipodystrophy (matenda omwe amadziwika atrophy kapena hypertrophy ya minofu ya adipose) pamalo opangira jekeseni.

Zovala zamakono zimatsukidwa kwathunthu, chifukwa chake thupi lawo siligwirizana potengera momwe amagwiritsidwira ntchito, amakula kawirikawiri, koma mwayi wazotsatira izi sizimakhudzidwa.

Pankhani ya chitukuko thupi lawo siligwirizana Nthawi yomweyo, wodwalayo amafunika mwachindunji hyposensitization ndi mankhwala.

Zomwe zimayambitsidwa ndi insulin

Malinga ndi malangizo ogwiritsira ntchito, insulin imaloledwa kutumizidwa pansi pa khungu, minofu kapena mtsempha. Izi zimatsimikizira kuti kukonzekera kwamitseko kumatha kukhala mankhwala osakhalitsa pokhapokha ngati wodwala akuwonetsa dziko labwino kapena adagwera wodwala matenda ashuga.

Kukhazikitsidwa kwa mtsempha wa mankhwala omwe amapezeka mwa kuyimitsidwa kumatsutsana. Pamaso jakisoni, mankhwalawa amayenera kutentha. Izi ndichifukwa choti insulin yozizira imamwidwa pang'onopang'ono.

Ndikofunikira kugwiritsa ntchito syringe ya pulasitiki jakisoni (osati galasi). Cholinga cha izi ndikuti mu galasi syringe yomwe imatchedwa "yakufa" imakhala yayikulupo kuposa ma syringes apulasitiki. Izi zimachepetsa kulondola kwa muyezo wa mankhwalawo ndipo zimapangitsa kuti insulin iwonongeke.

Chosavuta kugwiritsa ntchito ndi zolembera za insulin zomwe zimakhala ndi makatiriji apadera odzazidwa ndi yankho lomayikiramo. Amagwiritsidwa ntchito popanga njira zoyambira, zazifupi komanso zosakanikirana (zophatikizidwa). Mukamagwiritsa ntchito makina otere, musanagwiritse ntchito mankhwalawa, sikofunikira kulemba kapena kusakaniza nthawi iliyonse.

Singano zomwe zimagwiritsidwa ntchito masiku ano ma syringe ndi syringe zolembera za insulin ndizochepa thupi komanso zazifupi kotero kuti zimayambitsa kupweteka pang'ono panthawi ya jakisoni. Makulidwe a singano nthawi zambiri amachokera ku 0,3 mpaka 0,4 mm, kutalika sikokwanira 12 mm (nthawi zambiri kuyambira 8 mpaka 12 mm).

Koti kubaya mankhwala?

Funso "Kodi amawabayira insulini kuti?"

Kuyamwa mwachangu kwambirikuthamanga kwa magazi anati pambuyo subcutaneous jekeseni khomo lam'mimba lakunja, pang'onopang'ono zinthu zimalowa magazi kuyambira phewa ndi ntchafu yakunja, kuyamwa kocheperako kumawonedwa pambuyo pakupereka mankhwala mu mafuta osunthika pansi pa scapula kapena pabowo.

Chifukwa chake, muzochitika zamankhwala, jekeseni wa subcutaneous ndiye njira yoyenera yoperekera chithandizo.

Poona kuti mankhwalawo amamwetsedwa m'magazi mosiyanasiyana kuchokera ku mbali zosiyanasiyana za thupi, madotolo amalimbikitsa kubaya mankhwala osakhalitsa (kuyang'ana ngati yankho lomveka) pamimba, popewa navel, komanso mankhwala osakhalitsa (chigawo chodetsa nkhawa) m'deralo. m'chiuno kapena matako.

Lamulo lina lofunika ndilakuti madera omwe amayendetsedwa ndi mankhwala amasinthidwa, kutsatira ndondomeko yokhazikika malinga ndi nthawi ya tsiku (mwachitsanzo, m'mawa njira yochepa yokhomayo imalowetsedwa m'mimba, masana kulowa m'dera la ntchafu, ndi madzulo pansi pa khungu la matako.

Izi ndichifukwa choti kumasamba osiyanasiyana, kuwerengera kwa mankhwalawa kwa kuchuluka kwa XE kudzakhala kosiyana (monga nthawi zosiyanasiyana za tsiku).

Subcutaneous insulin jakisoni algorithm

Malamulo akuluakulu ogwiritsira ntchito insulin: musanapange jakisoni, ndikofunikira kuti muwone ngati mankhwalawo ndi othandizika, mtundu wake, nthawi yake komanso kuchuluka kwake, kusamba m'manja ndikuwonetsetsa kuti tsamba la jakisoni ndi loyera,

Njira yothandizira kuperekera insulin ndi iyi:

• Asanayambe makonzedwe, mankhwalawa amawonjezeredwa m'manja m'manja kutentha. Botolo sililoledwa kuti ligwedezeke, chifukwa ndiwofunda ndi mapangidwe a thovu.
• Chipewa cha botolo chimapukutidwa ndi mowa wa 70º.
• Amakoka syringe mumlengalenga kuti awerenge kuchuluka kwama insulin, kenako amawalowetsa mu vial, kusonkhanitsa mlingo wofunikira wa mankhwala + mpaka 10 ED zina.
• Mlingo wa yankho umayendetsedwa ndikugwira syringe pameso (ngati mutasintha ngodya, kulakwitsa kooneka kwa 1-5ED ndikotheka)
• Kugwedeza botolo, chotsani thovu.
• Musazichotsere khungu pakhungu jakisoni ndi mowa, popeza mowa umawononga insulini ndipo chifukwa chake, wodwalayo amatha kupanga lipodystrophy. Ngati izi zikufunika, ndikokwanira kungosambitsa khungu ndikalipukuta. Kukhazikitsidwa kwa mankhwalawa kudzera mu zovala ndikololedwa.
• Jakisoni amapangidwa m'malo otetezedwa ndi mankhwala: 2,5 cm kuchokera ku navel, 3 cm kuchokera phewa, ntchafu, kumtunda kwa butolo. Khola limapangidwa ndi chala chamanthu ndi chofiyira kuti lisalowe m'misempha (ikalowa minofu, mankhwalawo amalowetsedwa m'magazi mwachangu kuposa kuchokera pakatundu kakang'ono). Fanizo lotsatirali likuwonetsa momwe ungakhalire bwino khungu:

• Njira yothetsera vutoli iyenera kuperekedwa kwa theka la ola musanadye chakudya (insulin imalowetsedwa mkati mwa ola limodzi, kotero chakudya chizikhala pafupifupi mphindi 15-30 pambuyo pa jekeseni).

Momwe mungayikitsire syringe nthawi ya jakisoni

Singano imayilowetsa pakhungu pakhungu la 45º ngati jakisoni wachita khungu, pakhungu la 90º ngati jakisoni wachita popanda khungu.

Khola limapangidwa ngati mankhwalawo akuyenera kuti alowetsedwe paphewa kapena ntchafu, khola silimapangidwa ngati mankhwalawo akuyenera kubayidwa m'mimba kapena matako (popeza pali tinthu tosanjikana tating'ono).

Kodi insulini yabwino kwambiri ndi iti?

Palibe yankho limodzi ku funso ili. Kusankhidwa koyambirira kwa insulin (komanso kumwa ndi kuyamwa kwa mankhwalawa) kumachitika mu chipatala, malingana ndi kuopsa kwa matendawa komanso mikhalidwe ya matenda, mkhalidwe wa wodwalayo, kuthamanga kwa nthawi Hypoglycemic zotsatira ndi nthawi ya ntchito yake.

Kuwerengera Mlingo ndi insulin

Mlingo wa mankhwalawa amasankhidwa aliyense payekha.

Mankhwala osokoneza bongo achidule amapangidwira khungu kapena minofu (nthawi zina, kulowetsedwa kwamkati amaloledwa). Njira zoterezi zimachitika mwachangu, momwe zimagwiritsidwira ntchito ndizochepa.

Ma insulin omwe amangokhala pakanthawi kochepa amaperekedwa kwa mphindi 15-20 musanadye chakudya kamodzi kapena kangapo (kutengera mawonekedwe a matendawa) masana. Kuchepetsa shuga Amayamba pambuyo pa mphindi 15 mpaka 20 ndipo imafika pazokatha maola 2 (pomwe nthawi yonse yotalikira sichidutsa maola 6).

Mankhwala amtunduwu amagwiritsidwa ntchito kwambiri kuchipatala kuti akhazikitse mlingo wodwala, komanso wodwala matenda ashuga komanso precom(zofunikira zomwe zimafunikira kuti zinthu zisinthe mwachangu pantchito ya insulin mthupi).

Kuphatikiza apo, yankho lalifupi limagwiritsidwa ntchito ngati Ma anabolic. Pachifukwa ichi, nthawi zambiri amagwiritsidwa ntchito mu Mlingo wocheperako (kuyambira 4 mpaka 8 mayunitsi kamodzi kapena kawiri pa tsiku).

Mankhwala omwe akhala akuchita kwa nthawi yayitali (okhala nawo nthawi yayitali) ali ndi mitundu yambiri ya mulingo ndipo amadziwika ndi nthawi yayitali ya zotsatira (mwachitsanzo, insulin emit semylong, yayitali, ultralong).

Monga lamulo, zotsatira zake zimadziwika mkati mwa maola 10-36. Kugwiritsa ntchito mankhwala amtunduwu kumatha kuchepetsa kuchuluka kwa jakisoni tsiku lililonse.

Nthawi zambiri, ma insulin omwe amakhala nthawi yayitali amakhala akuimitsa. Amaperekedwa pansi pa khungu kapena minofu, kuwongolera kwamkati sikovomerezeka. Komanso ndizoletsedwa kugwiritsa ntchito mankhwala ochokera pagululi chikomokere ndi zokwanira.

Mukamasankha mankhwala, muyenera kuwonetsetsa kuti nthawi yomwe shuga kutsitsa kwenikweniambiri otchulidwa, ophatikizidwa mu nthawi ndi phwando lolemba.

Ngati izi ndizofunikira, zimaloledwa kuphatikiza mankhwala omwe akhala akuchita nthawi yayitali munthawi yomweyo.

Nthawi zina, odwala sayenera kungokonza nthawi yayitali pokhapokha pakufunika shuga, komanso munthawi yomweyo. Kuti muchite izi, amapatsidwa mankhwala oyambitsa afupikitsa komanso kwa nthawi yayitali.

Monga lamulo, jekeseni wa kuyimitsidwa kwa nthawi yayitali amachitidwa m'mawa, chakudya choyamba chisanachitike, koma makonzedwe panthawi ina masana amaloledwa.

Jekeseni amalimbikitsa odwala kuti aziphatikiza ndi zakudya zapadera za odwala matenda ashuga. Kufunika kwa chakudya muzonsezo kuyenera kutsimikiziridwa ndi kulemera kwamthupi la wodwalayo panthawi yamankhwala komanso kuchuluka kwa zochita zake zolimbitsa thupi.

Pokhala wopanda zakudya komanso kuwonjezera masewera olimbitsa thupi, wodwalayo amawonetsedwa kudya pafupifupi kilogalamu 3,000 patsiku, kudya kwambiri komanso kusachita masewera olimbitsa thupi kuchuluka kwa zopatsa mphamvu sikuyenera kupitilira 2000 (moyenera - pafupifupi 1700).

Momwe mungayikitsire mankhwala mu syringe ya insulin?

Ngati mukufuna kulowa insulin yamtundu umodzi, pisitoni ya syringe imakokedwa ndikuyika chizindikiro chogwirizana ndi chiwerengero chofunikira, pambuyo pake kuyimitsa kwa vial ndi mankhwalawo kumenyedwa ndipo, atakanikiza piston, amalola mpweya kulowa.

Kenako, tembenuzani botolo ndi syringe mozungulirapo, ndikuwagwira dzanja limodzi kumaso, ndikukoka piston mpaka kuyika chizindikiro pamwamba pa gawo lomwe mukufuna.

Kubowoleza nkhumba ndi mankhwala kumachitika bwino kwambiri pakatikati, ndikugwiritsa ntchito singano yakuda pama syringe wamba. Kubayira mpweya ndikutola mankhwalawo, syringe ya insulini imagwiritsidwa ntchito kale - singano yake imayikidwa m'malo opumira.

Ngati thovu lakumlengalenga likuwoneka mu syringe yovulazidwa, muyenera kudina zala zanu pang'ono pa syringe ndikusunthira piston mosamala chizindikiro chomwe mukufuna.

Kuwerengetsa kwa insulin

Kuwerengera ndi kukhazikitsa mlingo wa mankhwalawa kumachitika, kuyambira kuti mankhwalawa apamwamba kwambiri tsiku lililonse sayenera kupitirira 1 kilogalamu imodzi ya kilogalamu ya thupi la wodwalayo.

Malangizo a momwe mungawerengere mankhwalawo moyenera mankhwalawa amaperekedwa malinga ndi mawonekedwe a matendawa.

Mu shuga ine digiri, mlingo ndi:

• 0.5 PIECES / kg - kwa odwala omwe matendawa adapezeka posachedwa,
• 0.6 PIECES / kg - ngati chipukutirocho chimatha chaka chimodzi kapena kupitilira,
• 0,7 PIECES / kg - pakafunika kubwezeredwa kosakhazikika,
• 0,8 PIECES / kg - kuti kubweza,
• 0,9 PIECES / kg - ngati matendawa ndi ovuta ketoacidosis,
• Ma mayunitsi 1.0 / kg kwa azimayi m'miyezi itatu yapitayi ya kutenga pakati.

Momwe mungawerengere mlingo wa insulin osalakwitsa? Kuti mupewe zolakwika, mutha kuyang'ana pa chitsanzo pansipa.

Kuwerengera kwa mankhwala omwe akhala akuchita kwa nthawi yayitali pamankhwala a 0,6 PIECES / kg ndi kulemera kwa wodwala 75 kg: 0.6 * 75 = 45. Ndikofunikira kutenga 50% ya mtengo womwe unayambika ndikuzungulira (mpaka 20). Chifukwa chake, musanadye chakudya cham'mawa, muyenera kulowa magawo 12, ndipo otsala 8 - madzulo asanakwane.

Kuwerengera koyenera kwa mankhwala omwe amangokhala pakanthawi kochepa kwa 0,6 PIECES / kg ndipo wodwala kulemera kwa 75 kg amapangidwa molingana ndi formula: 0.6 * 75 = 45, 45-20 = 25. Chifukwa chake, magawo 9 mpaka 11 ayenera kulowa asanadye m'mawa , kuyambira magawo 6 mpaka 8 - chakudya chamadzulo, chakudya chotsalira - kuyambira magawo 4 mpaka 6 - chakudya chamadzulo chisanachitike.

Bongo

Kuchulukitsa kwa mankhwala omwe adokotala adamupatsa kumapangitsa kuti ayambe kukula hypoglycemic syndromezomwe zimatsagana shuga wamagazi ochepa ndipo imatha kupha wodwala.

Pogwiritsa ntchito mlingo woopsa, wodwalayo ayenera kupereka chithandizo choyamba.

Zizindikiro hyperglycemic Zinthu zake ndi:

• kumverera kwa ludzu,
• kuchuluka kukodza,
• kutopa,
• kuchuluka kuuma kwa mucosa mkamwa ndi khungu,
• Khungu,
• masomphenya osalala,
• chikumbumtima,
• arrhythmia,
• choyambirira,
• chikomokere.

Zotsatira za bongo wa insulin kwambiri kusokonezeka kwa ubongo(zomwe ndizowopsa kwa okalamba). Wodwala akhoza kuyamba ziwalo kapena paresis, idachepetsa kwambiri malingaliro aumunthu.

Tiyeneranso kukumbukira kuti mitundu yayikulu ya Mlingo wowopsa. Poyerekeza zakumbuyo kwawo ochepa elasticity amachepetsa ndi magazi amadzimadzi amayamba kuwonda.

Mu magawo oyamba hypoglycemia tiyi wokoma, kugwiritsa ntchito uchi kapena msuzi wa zipatso kumathandizira kukula kwamisempha.

Atchikomokere jekeseni yomweyo ya 10-20 ml ya zolimba yankho mu mtsempha shuga (20-40%). Ngati palibe mwayi wolowa mu mtsempha, amaloledwa kuchita:

• mu mnofu jekeseni 1-2 mg glucagon (glucagon ndi wokonda kuteteza thupi)
• subcutaneous jakisoni wa 0,5 ml epinephrine hydrochloride 0,1% yankho
• enema pogwiritsa ntchito 150 ml ya 10% yankho shuga.

Kuchita

Kuchepetsa shuga kukulitsidwa ndi kugwiritsa ntchito insulin limodzi ndi:

• α-adrenergic blockers,
• acetylsalicylic acid,
• onjezerani,
• fluoxetine,
• Mao zoletsa,
• cyclophosphamide,
• methyldopa,
• manzeru,
• ifosfamide.

Kuchepetsa mphamvu ya shuga kumachepetsedwa pogwiritsa ntchito mankhwalawa limodzi:

• chlorprothixene,
• kulera kwamlomo,
• GKS,
• diazoxide,
• heparin,
• lithiamu carbonate,
• saluretics,
• nicotinic acid ndi zotumphukira zake,
• mahomoni a chithokomiro,
• diphenin,
• amphanomachul,
• tridclic antidepressants.

Momwe mungasungire insulin?

Mankhwalawa amasungidwa m'malo amdima, ozizira. Kutentha kwenikweni kosungirako kumawonedwa ngati kutentha kuchokera +2 mpaka +8 digiri Celsius (bwino mufiriji, kutali ndi mufiriji).

Mankhwala ozizira a gululi, komanso kutentha kwambiri, sikuvomerezeka.

Kutentha kwapamwamba kuposa digiri 30 mpaka 35 Celsius kumavulaza mankhwalawo.

Kwa anthu omwe akutsogolera moyo wokangalika, yankho labwino ndi chikwama cha thermo cha insulin.

Kodi ndi liti pamene mankhwala amawonongeka?

Poyang'anitsitsa chosungira chimodzi, mankhwalawo ayenera kutayidwa. Komanso yankho lomwe pazifukwa zingapo zasintha mtundu wake, ndipo yankho lomwe m'magulu, zopumira, ndi ulusi sizinagwiritsidwe ntchito.

Kuyimitsidwa kumaganiziridwa kuti ndi koyipa ngati, ndikusuntha, sikupanga kuyera koyera kapena kuyera.

Ndikofunika kukumbukira kuti ma insulins okha a ultrashort, ofulumira komanso othamanga ayenera kukhalabe owonekera, komanso, komanso insulin glargine kuchitapo kanthu kwanthawi yayitali.

Malangizo apadera

Kodi insulin ndi chiyani?

Wikipedia ikuwonetsa kuti insulini ya mahomoni ndi chinthu chomwe chimakhudza mbali zambiri za mapangidwe a metabolic pafupifupi minofu yonse.

Insulin yogwira insulin imapangitsa kuti michere ya plasma ikhale yambiri kwa glucose, yomwe imapereka mofulumira komanso kosavuta kusintha kwa magazi kuchoka m'malo ena kupita kwina.

Kuperewera kwa insulin kaphatikizidwe kumayambitsa kusokonezeka kwa metabolic, zomwe zimapangitsa kuti pakhale shuga.

Insulin yogwira ntchito - ndi chiyani? Ndi chiwalo chiti chomwe chimatulutsa insulini?

Pamafunso oti "Ndi gland yomwe imatulutsa insulini?" Kapena "kodi insulini imapangidwa kuti?" Wikipedia imayankha kuti timadzi tating'onoting'ono timene timapangidwa ndi maselo is maselo a Langerhans (omwe amapezeka makamaka mchira wakekapamba(Pancreas) zochuluka za maselo a endocrine).

Homoni wopangidwa ndi thupi amatchedwa insulin kapena immunoreactive insulin (yofupikitsidwa ngati IRI).

Gwero loyambirira lopangira insulin, yomwe imapereka mwayi wokhala ndi moyo wabwinobwino kwa anthu omwe thupi lawo silitulutsa timadzi tokha palokha momwe timafunira, kapamba nkhumba ndi ng'ombe.

Zaka zopitilira 30 zapitazo kuchitira odwala matenda ashuga ndinayamba kugwiritsa ntchito insulin yaumunthu. Kuti mumve, gwiritsani ntchito imodzi mwanjira ziwiri:

• Kusintha kwa njira ya insulin, yomwe imakhudzanso kusintha kwa ma amino acid omwe amapezeka alanine pa threonine,
• njira zopangira ma genetic, zomwe zimaphatikizapo kusintha gawo lina la DNA.

Gulu la insulin kukonzekera

Mankhwala omwe amagwiritsidwa ntchito pano nthawi zambiri amagawidwa malinga ndi zizindikiro zingapo:

• potengera nthawi,
• kuchokera kochokera,
• kutengera pH ya yankho (itha kukhala yopanda mbali kapena acidic)
• kupezeka kwa mankhwala pokonzekera (phenol, methyl paraben, cresol, phenol-cresol),
• kutengera kuchuluka kwa insulin (40, 80, 100, 200, 500 mayunitsi) ml.

Kugawa malinga ndi nthawi yochitapo kanthu:

• kukonzekera kwa ultrashort
• mankhwala osokoneza bongo
• mankhwala ogwirira ntchito kwa nthawi yayitali (kuphatikiza nthawi yayitali (yapakatikati) komanso kuchitapo kanthu kwa nthawi yayitali),
• mankhwala oledzera
• mankhwala ophatikiza pamodzi (mankhwala a biphasic).

Ultrashort zochita yodziwika ndi lizpro, Aspartkomanso glulisin.

Insulin yofulumira.

• sungunuka wa chibadwa cha anthu,
• sungunuka kwamunthu wopanga,
• sungunuka wa nkhumba yosungunuka.

Insulin yapakatikati ndi insulin isophane (zomangira zamtundu wa anthu), insulin isophane (zopangidwa ndi anthu) insulin kuyimitsidwa kwa pawiri.

Mitundu yanji ya insulin yomwe imatenga nthawi yayitali? Gawoli limaphatikizapo glargine komanso kunyansidwa.

Kukonzekera kwa Biphasic - biphasic human semi-synthetic, biphasic genetic engineering, biphasic aspart.

Malinga ndi gawoli, kutengera mtundu wa kuyeretsedwa, kukonzekera komwe kumapangidwa kuchokera ku minofu yazinyama kumagawidwa:

Mitundu ya insulin kutengera zomwe zidachokera:

• nkhumba (chofotokozedwa ndi kalata C, monopic - SMP, monocomponent - QMS),
• ng'ombe (ng'ombe, yomwe ikuwonetsedwa ndi kalata G, monopic - GMF, monocomponent - GMK),
• wamunthu (wotchulidwa ndi kalata H).

Mlingo wa insulin - yachilendo komanso kupatuka kwa iwo

Chizindikiro chomwe chikuwonetsa kuchuluka kwa mahomoni mkati magazi munthu wathanzi, ali pamtunda wa 3 mpaka 20 μU / ml.

Kuchepetsa kwake ndizofunikira kwambiri kuti mutukulematenda ashuga. Poterepa, zomwe zimayambitsa mavuto akulu zimatha kukhala kuchuluka kwa homon m'magazi.

Kuchuluka kwa insulin m'mwazi - zikutanthauza chiyani?

Insulin imalepheretsa izi kaphatikizidwe ka shuga kuchokera kuma protein ndi lipids. Chifukwa chake, pakuwonjezeka kwa kuchuluka kwa mahomoni opitilira 20 μU / ml (hyperinsulinism), munthuyo, komanso kuperewera kwa insulin, amayamba kuwonekera hypoglycemia - kusokonekera kumawonjezera, kukumbukira kumakulirakulira ndikuyang'anitsitsa kumachepa, kutopa kokwanira kumawonjezeka (pakapita nthawi, kumakhala kosatha), kumawonjezeka kuthamanga kwa magazi ndi zina ..

Zomwe Zimapangitsa Insulin Kukulira

Ngati insulin imakwezedwa mkati magazi, chifukwa chitha kukhala chakuti munthu wadya chakudya chamafuta ambiri (i.e. glucose).

Popeza zopangidwa ndi mafuta ochulukirapo zimapangitsa kuchuluka kwa mahomoni, simuyenera kudya musanapereke magazi kuti mupeze mayeso a insulin magazi chita pamimba yopanda kanthu).

Kugwira ntchito kumatha kupangitsanso kuchuluka kwa mahomoni. ma pancreatic β-cell (Pankhaniyi, amalankhula za pulayimale, pancreatic, hyperinsulinism), komanso kubisala kwazinsinsi za mahomoni ena (mwachitsanzo katekisimaamu kapena corticotropin), kuwonongeka kwamanjenjeHypersensitivity insulin zolandilira (muzochitika zonsezi, matendawa ndi "a sekondale, kapena a extrapancreatic, hyperinsulinism").

Choyambitsa kukhumudwa ПЖЖpomwe adayamba chifukwa cha insulin yayikulu, atha:

• zotupa pa ПЖЖzomwe zimapangitsa kuti timadzi timene timapanga,
• kuchepa kwa ndende komwe kumapangidwa m'thupi glucagon,
• hyperplasia of islets of Langerhans.

Komanso, insulin yowonjezereka imakonda kuzindikiridwa ndi kulemera kwambiri. Kuwonjezeka kwa ndende ya mahomoni kumawonetsa kuti ПЖЖimagwira ntchito ndi katundu wina.

Momwe mungachepetse magazi a insulin

Musanachiritse kuchuluka kwa insulin, ndikofunikira kukhazikitsa chomwe chinayipitsa. Monga lamulo, atathetsedwa, mkhalidwe wa wodwalayo umabwerera mwakale.

Kupewa kuukira hypoglycemiaidyani china chokoma kapena jekeseni yankho shuga. Muzovuta kwambiri, makonzedwe angafunike. glucagon kapena adrenaline.

Momwe mungachepetse kuchuluka kwa mahomoni kunyumba? Kuti musinthe matenda a insulin, muyenera kusintha zakudya zanu. Zakudyazo ziyenera kukhala zopanda phokoso (ndizokwanira kudya pang'ono m'malo osachepera kasanu patsiku), ndipo kuchuluka kwa chakudya cha tsiku ndi tsiku sikuyenera kupitirira 150 g.

Nthawi yomweyo, oatmeal, phala la buckwheat, kefir wopanda mafuta ndi mkaka, tchizi chosawoneka bwino, tchizi, mazira, masamba, nsomba, zipatso za munthu payekha ziyenera kukhala patsogolo pazakudya.

Matendawa amatithandizanso kudziwa zolimbitsa thupi komanso kuchepa thupi.

Kodi shuga amamuberekera shuga uti?

Kuwunikira kuti mupeze kuchuluka kwa mahomoni amomwe amasiyanitsa matendawo kumachitika kwa anthu omwe sanalandire insulin kukonzekera kale. Izi ndichifukwa choti thupi limayankha poyambitsidwa mahomoni achilendo popanga ma antibodies.

Kuchuluka kwa shuga ndi chimodzi mwazizindikiro.kagayidwe kachakudya matenda. Mkhalidwe umatengedwa kuti prediabetes.

Ngati insulin yakwezedwa ndipo shuga ndi yabwinobwino, lankhulani zosagwira insulin mawonekedwe a shuga tsankho ndi matenda ashuga. Izi zitha kuwonetsa zingapo insulin kugonjetsedwa ndi zinthu.

Mitundu yambiri yokhala ndi shuga yochepa nthawi zambiri imakhala chizindikiro pathological hyperinsulinemia. Nthawi zina, kuzungulira kwakukulu kozungulira magazi mahomoni ogwirizana ndi matenda oopsa,mtima ndi mtima matenda.

Mulingo wotsika kwambiri wokhala ndi shuga wabwinobwino umafunikanso endocrinologist kuti adziwe chomwe chimayambitsa vutoli ndikupanga mayeso ofunikira (kuyimira kwa HLI, kuyesa ma antibodies kuti apange insulin, kudziwa mulingo wa antibodies mpaka GAD, kuyezetsa hemoglobin ya glycated).

Lingaliro la kufunika kwa jakisoni limapangidwa, kuyambira osati kuzisonyeza za kuchuluka kwa shuga, koma poganizira zifukwa zomwe zidawonjezera kuchuluka kotere.

Monga lamulo, kukhazikitsidwa kwa mankhwalawa kumakhala kosapeweka ngati kuchuluka kwa shuga m'magazi kumangosungidwa kwanthawi yayitali mkati mwa 12 mmol / l, ndipo mapiritsi ndi chakudya chamagulu sichimatsogolera kuchepa kwawo.

Kukongoletsa kwa kuyezetsa kwa magazi kwa insulini kumakupatsani mwayi wodziwa dokotala womwe mumafuna.

Chikhalidwe mwa akazi ndi abambo ndi chimodzimodzi. Zizindikiro za 3.3-7.8 mmol / l zimawonetsa noormoglycemia. Mulingo wa shuga wamagazi pamimba yopanda kanthu kuchokera pa 3.3 mpaka 5.5 mmol / l. Pambuyo pachakudya, chithunzi chomwe chimaposa 7.8 mmol / L chimawoneka chabwinobwino.

Mulingo wa insulin pambuyo potulutsa shuga ndi wokwera mpaka 7.7 mmol / l. Ngati chizindikirocho chili m'gulu la 7.8-11.1 mmol / l, amalankhula za kuphwanya kulekerera kwa glucose.

Chichewa (insulin lispro), insulin Levemire, Humulin NPH, Humulin R,Humulin Minsulin Apidrainsulin Kusintha kwa Humalog 50insulinMatepi (NM ndi NGN), NovoRapid Flexpeninsulin Protafan NM Penfillinsulin Aktrapidinsulin Wofulumira (Insuman Rapid GT), insulini Basal-nKuphatikizanso insulin yaumunthu, ndi zina zambiri ..

Insulin yokhala ndi pakati

Kuletsa kwamankhwala matenda ashuga Ndi ntchito ya insulin pa mimba ndi mkaka wa m`mawere ayi.

Anthu ambiri adazindikira matenda ashuga, fufuzani mayankho azidziwitso za mankhwala ena, kufunsa kuti muwunikenso za insulin Lantus kapena, mwachitsanzo, kuwunikira insulin Levemire.

Komabe, ndikofunikira kwambiri kukumbukira kuti kusankha mtundu wa mankhwalawa ndi mlingo woyenera kumachitika kokha ndi adokotala. Chithandizo chokwanira ndichofunikira kwambiri kuti wodwalayo athe kukhala ndi moyo wabwinobwino, wokhazikika, kotero kudzichitira nokha mankhwala sikovomerezeka.

Odwala ena amakhulupirira kuti insulini siyithandiza, ndipo kayendetsedwe kake kamaphatikizidwa ndi zovuta zina. Mankhwalawa ali ndi tanthauzo lokhudza thupi ndi shuga wamagazi ochepa.

Kuzitenga koyambirira kwa matendawo, osati monga chomaliza, kumathandiza kupewa kapena kuchedwetsa zovuta zomwe zingayambike.

Kupatula anthu omwe ali ndi matenda ashuga, ndemanga zokhudzana ndi mankhwalawa zimatsalira ndi mafani amasewera olemera. Poyang'ana pa iwo, titha kunena kuti pakupanga thupi, chipangizocho chidziyambitsa chokha ngati chosapambana anabolic.

Mtengo wa insulin

Mtengo muma pharmacies umasiyanasiyana kutengera wopanga ndi mawonekedwe a mankhwala ena ake. Mwachitsanzo, mwachitsanzo, mtengo wa insulin Khalid ku Ukraine - kuchokera 166 mpaka 435 UAH, ndiNovoRapid FlexPen Mutha kugula pafupifupi 850 UAH (molondola kudziwa momwe angapangire insulini polumikizana ndi mankhwala enaake).

Mtengo wa insulin Lantus m'mizinda yayikulu ya Ukraine (mwachitsanzo, ku Kiev kapena Donetsk) - pafupifupi 1050 UAH, mugule insulin NovoRapid zotheka za 780-900 UAH, mtengo Protafana NM - kuyambira 177 UAH, Chichewa - kuyambira 760 mpaka 1135 UAH, botolo lomwe lili ndi mankhwalawa Insuman Bazal zingagule pafupifupi UAH 72, mtengo wa insulin Levemip - kuchokera 1280 UAH.

Mtengo wapakati wa cholembera ndi syringe ndi 800-850 UAH. Gulani cholembera cha insulinNovoPen 4 ikhoza kukhala pafupifupi 700 UAH, koma mtengo wa cholembera NovoPen Echo - pafupifupi 1000 UAH.

Mapiritsi a insulin (mankhwala Novonorm) mtengo kuchokera ku 150 mpaka 200 UAH.

Mutha kugula mankhwala mumafakitala wamba, malo ogulitsa pa intaneti, komanso m'malo ochezera ndi odwala matenda ashuga, momwe otsatsa a "kugula / kugulitsa" amapezeka nthawi zambiri. Kudzera mu zinthu zomwezi, insulin ingagulitsenso.

Kugula insulin ku Moscow ndi St. Petersburg? Mankhwalawa amagulitsidwa pafupifupi m'mafakitale onse, chidziwitso pa iwo chimasinthidwa nthawi zonse pa intaneti.

Mitundu ya 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 m'maselo a non-pathogenic of E. 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.

Kukonzekera kwa insulin kumagawika m'magulu kutengera nthawi yomwe thupi likudwala. Pali mitundu isanu ya mankhwala - insulin yotsalira-yochepa, yochepa, yapakatikati, yopitilira (yowonjezereka) komanso yosakanikirana.

Nthawi yomwe amagwira ntchito mthupi amasiyanasiyana ndipo amayambira ola limodzi mpaka maola 24. Mankhwala a ultrashort amayamba kuchita pakapita mphindi zochepa ndipo zotsatira zake zimakhala kuchokera 1 mpaka 3 maola, kukulitsa insulin pambuyo pa ola limodzi ndikupitilizabe kuchepetsa shuga kwa maola 24.

Kukonzekera kwa insulin kumasiyana mosiyanasiyana momwe amagwiritsidwira ntchito. Ngati insulin yotalika imathandizira wodwala kukhalabe ndi shuga masana, ndiye kuti insulin yocheperako imatchulidwanso kuti insulin - imagwira thupi pakudya ndipo imalepheretsa kusintha kwa mafuta omwe amapezeka panthawi ya chakudya.

Ultrashort insulini imapangidwira kuti ituluke mwadzidzidzi mu glucose, ngati ikufunika kuchepetsedwa mwachangu.

Mankhwalawa amapangidwa ndi kampani yopanga zamankhwala monga Novo Nordisk, omwe mabizinesi ake amapezeka ku Denmark ndi India. Mtundu wotchuka kwambiri wa Actrapid ndiwopangidwa wokhala ndi cholozera cha World Cup.

Chidule ichi chimayimira "kubadwa kwa chibadwa cha anthu" komanso "kuphatikiza pamodzi." Nthawi yomweyo, kampani yaku Danish imatulutsa mitundu ya Actrapid MS: mosiyana ndi yoyamba, insulini iyi ndi nkhumba (index ya MS imatanthawuza kuchuluka koyera kwa chiyero cha mankhwalawa komanso zotsika pazosayera mkati mwake).

Nthawi zina Actrapid MR imapezekanso, yomwe imasiyana ndi mtundu wa MS pakuyera pang'ono kwa chinthucho

Kuphatikiza pa chiyambi, mankhwala a insulin amawerengedwa ndi kuthamanga kwa nthawi yawo yoyambira komanso nthawi yayitali. Zomwe zikutanthauza kupereka chisankho mu vuto linalake, zimatengera momwe wodwalayo alili. Mitundu ya insulin iyi ilipo:

• kukonzekera kwa ultrashort (Humalog, NovoRapid, Apidra),
• insulin yochepa (Actrapid, Humudar R),
• mankhwala a nthawi yayitali (Insuman Bazan GT, Humudar B, Protafan MS),
• mankhwala owonjezera
• mankhwala oledzera.

Mankhwala a insulin amaperekedwa makamaka mosagwirizana komanso kudzera m'mitsempha. Jekeseni wovomerezeka ndi zotheka kudzera ndimankhwala osakhalitsa ndipo muzovuta kwambiri odwala matenda a shuga komanso chikomokere. Musanalowe mankhwalawa, muyenera kutentha ndi manja anu: yankho lozizira limayamwa pang'onopang'ono ndipo ndi jakisoni yopweteka.

Kuthamanga kwa insulin kumadalira mlingo wa malo, malo oyendetsera, gawo la nthendayi. Mankhwalawa amalowa m'magazi pambuyo poti jekeseni wamkati wam'mimba, pang'onopang'ono kuchokera kutsogolo kwa ntchafu ndi dera lamapewa, komanso kutalika kwambiri kuchokera pakabowo ndi pachiwopsezo.

Musanayambe jakisoni m'malo amodzi, muyenera kufunsa dokotala yemwe adzakuwonetseni tsambalo. Kuonana ndi dokotala ndikofunikanso ngati pakufunika kusintha tsamba la jakisoni.

Insulin ndi yachilengedwe komanso yopanga. Insulin yachilengedwe imapangidwa ndi maselo mu kapamba aanthu kapena nyama. Insulin yokumba imapangidwa m'malo a labotale ndi njira yolumikizira ya chinthu chachikulu ndi zowonjezera zina. Mtundu wachiwiri umapangidwira zochizira odwala omwe ali ndi matenda ashuga nthawi zambiri.

Chenjezo makamaka pofunsa mankhwala liyenera kukhala lothandiza odwala okalamba ndi ana oyambira ana kuti muchepetse zovuta zomwe zingachitike. Chifukwa chake, kudziwa mitundu ya insulini ndikofunikira kwambiri popanga dongosolo la mankhwala.

Monga chithandizo, jakisoni wa insulin tsiku lililonse amagwiritsidwa ntchito. Kuti musankhe mankhwala oyenera, muyenera kudziwa mtundu wa insulin womwe ulipo. Njirayi imapewa zotsatira zosafunikira.

Zosiyanasiyana za insulin zimagawidwa ndi magawo otsatirawa:

1. Kuthamanga kwa zochita pambuyo pa kupatsidwa mankhwala
2. Kutalika kwa mankhwalawa
3. Zomwe mankhwalawo amapangidwa
4. Kutulutsa mawonekedwe.

Mfundo yofunika! Piritsi mawonekedwe a mankhwalawa ndi mankhwala omwe angagwiritsidwe ntchito pochiza matenda a shuga. Pogwiritsa ntchito pafupipafupi, edema imachepetsedwa kwambiri, ndipo chiopsezo chokhala ndi gangrene chimachepetsedwa.

Kuphatikiza pa mitundu yayikulu, insulin imagawikidwanso mu monovoid ndikuphatikiza pamodzi. Poyamba, mankhwalawa amakhala ndi mtundu umodzi wokha wa insulin - mwachitsanzo, nkhumba kapena bovine. Kachiwiri, kuphatikiza mitundu ingapo ya insulini kumagwiritsidwa ntchito. Mitundu yonseyi imagwiritsidwa ntchito mosamala pochiza matenda ashuga.

Njira yowonetsera mtundu uliwonse wamtundu wa munthu ndiyosiyana kwambiri ndipo iyenera kuthandizidwa ndi dokotala popereka mankhwala.

Mtundu waufupi wapamwamba

Mtundu wothamanga kwambiri wa insulin. Amayamba kuchita nthawi yomweyo atalowa m'magazi. Nthawi yomweyo, zochita zake zimadutsanso mwachangu - kwenikweni m'maola atatu kapena anayi. Pafupifupi ola limodzi jakisoni, jakisoni wokulirapo wazinthu zimapezeka m'magazi.

Kukhazikitsidwa kwa mankhwalawa kumachitika musanadye chakudya, kapena pambuyo pake. Nthawi ya tsiku ilibe kanthu. Ngati simutsatira mosamalitsa chiwembucho, ndiye kuti kuchepa kwambiri kwa shuga m'magazi kumatha kuchitika.

Mitundu ya insulin ndi momwe zimakhalira mwachindunji zimadalira komwe zidachokera. Monga tafotokozera pamwambapa, pali mitundu iwiri yayikulu - iyi ndi insulin yachilengedwe ndipo yapangidwa mu labotale.

Insulin yachilengedwe yomwe imapangidwa ndi kapamba wama ng ombe imakhala yosiyana ndi zomwe anthu aminoxylots atatu osayenera omwe amatha kuyambitsa ziwengo. Ndondomeko ya insulin ikupezeka pafupi ndi anthu, popeza pali asidi amodzi m'modzi momwe amapangidwira.

Whale insulin imagwiritsidwa ntchito pochiza nthawi zina, chifukwa kusiyana kwake ndi ma cell a insulin ya munthu ndikofunikira kwambiri kuposa ng'ombe.

Mankhwala osakanizidwa agawidwa m'mitundu iwiri:

1. Kusinthidwa kwa chibadwa - analogue ya insulin yaumunthu imachotsedwa ku kaphatikizidwe ka Escherichia coli wokhala ndi porcine osiyana amino acid.
2. Umisiri - umakhazikitsidwa ndi insulin ya parailamu ndikusintha kwa minoatching amino acid mu unyolo.
   Chithandizo chilichonse chimasankhidwa mosiyanasiyana payekha, kutengera kusanthula ndi momwe wodwalayo alili.

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

Masana, mahomoni amalowa m'magazi othamanga mosiyanasiyana. Secretion yake yoyambira imakupatsani mwayi wokhala ndi shuga wokhazikika mosasamala zakudya.

Kutulutsa kwa insulin komwe kumachitika pakudya. Poterepa, kuchuluka kwa glucose omwe amalowa mthupi ndi zakudya zomwe zimakhala ndi zakudya zamafuta amachepetsa.

Ndi shuga, njira izi zimasokonekera, zomwe zimabweretsa zotsatirapo zoyipa. Chifukwa chake, chimodzi mwazinthu zothandizira kuchiritsa matendawa ndikobwezeretsa mtundu woyenera wa kutulutsidwa kwa ma cell m'mwazi.

Ma insulin omwe amagwira ntchito mwachidule amagwiritsidwa ntchito poyeserera katulutsidwe wamahomoni omwe amakhudzidwa ndi zakudya. Gawo lakumbuyo limathandizidwa ndi mankhwala omwe ali ndi zochita zazitali.

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

Mtundu	Mutu
Zida zopangira ma genetic	Pafupipafupi - insulin ya anthu sungunuka (Actrapid NM, Humulin Regular, Insuman Rapid GT ndi ena)
	Nthawi yayitali yochita zinthu ndi insulin-isophan (Humulin NPH, Protafan, Insuman Bazal GT ndi ena)
	Mafomu a magawo awiri - Humulin M3, Insuman Comb 25 GT, Biosulin 30/70
Mafuta a Insulin a Anthu	Ultrashort - lispro (Humalog), glulisin (Apidra), aspart (NovoRapid)
	Kuchitapo kanthu kwanthawi yayitali - glargine (Lantus), detemir (Levemir), degludec (Treshiba)
	Mafomu a magawo awiri - Ryzodeg, Humalog Mix 25, Humalog Mix 50, Novomiks 30, Novomiks 50, Novomiks 70

Kukonzekera kwa insulin kumasiyana kutengera nthawi yomwe mayamwidwe am'mimba ndi zochita zake. Ma insulin aatali amatha kusintha kuchuluka kwa shuga m'magazi mkati mwa masiku 1-1.5, mwa kuyerekezera ndi mahomoni oyambira omwe sagwirizana ndi kudya.

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

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

Makhalidwe a insulin kukonzekera kutengera kutalika kwa zochita

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

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

Chifukwa cha ntchito yolumikizana ya asayansi, madotolo, akatswiri a majini, akatswiri a sayansi ya zamankhwala, akatswiri a sayansi ya zamankhwala, ndiukadaulo, lero tili ndi mitundu yosiyanasiyana yokonzekera insulin. Zosowa za munthu aliyense ndi zayekha. Insulin imasinthika ndikuphatikiza njira yothandizira odwala omwe ali ndi matenda ashuga.

Pali mitundu isanu ya insulini kuyambira ultrashort mpaka nthawi yayitali ndipo amawerengedwa molingana ndi nthawi yomwe akhala akugwira ntchito mthupi. Ma insulini ena ndi opepuka komanso owonekera, pomwe ena amakhala opepuka.

Mwachangu (ultrashort) insulin

Ma insulini othamanga amakhala ndi mawonekedwe owoneka bwino. Kuchita mwachangu kwambiri.

Yambani kugwira ntchito kuyambira mphindi 1 mpaka 20 pambuyo pa kutsata. Zotsatira zake zabwino zimatheka pambuyo pafupifupi ola limodzi ndipo zimatha kwa maola atatu mpaka asanu.

Mukamagwiritsa ntchito ma insulin, ndikofunikira kudya mukangolowa jakisoni. Chotsani hyperglycemia mutatha kudya, ndiye kuti, kuphimba kufunika kwa insulin kuti muchepetse shuga mwachangu.

Mwa ma polashort ma insulins omwe alipo:

• Apidra (insulin glulisin)
• NovoRapid (insulin aspart)
• Humalog (insulin lyspro)

Onsewa ndi oyenera kugwirira ntchito mosavomerezeka, komabe, ma spart ndi lispro insulins amatha kutumikiridwa kudzera m'mitsempha. Chotsani hyperglycemia mutatha kudya, ndiye kuti, kuphimba kufunika kwa insulin kuti muchepetse shuga mwachangu.

Insulin yochepa: mayina a mankhwala

Insulin yochepa imawoneka bwino. Amayamba kutsika shuga m'magazi mkati mwa theka la ola. Muyenera kupaka insulin theka la ola musanadye. Ntchito yayitali imatheka pambuyo pa maola 2-4, ndipo imakhala kwa maola 6-8.

• Insuman • Actrapid • Humulin

Mankhwalawa onse ndi a kayendetsedwe ka subcutaneous. Koma popeza momwe amagwiritsidwira ntchito ndiwofala kwambiri m'zochita zamankhwala, nthawi zambiri amakumana ndi makina amkati. Chochitikacho chimadza mochedwa pang'ono kuposa mayina othamanga, zomwe zimatanthawuza kuti mlingowo ndi wokulirapo. Cholinga chachikulu ndikukonzanso kwa postprandial hyperglycemia.

Pakati (Pakati Pakatikati) Insulin

Ma insulini apakatikati amakhala ndi mawonekedwe osalala. Ndizoyimitsidwa (zosakaniza) zamakristali a insulin yokhazikika ya anthu omwe ali ndi protamine ndi zinc, akuchedwa kuyamwa.Kuchita bwino kumawonekera patatha pafupifupi ola limodzi jakisoni, zotsatira zabwino kwambiri zimachitika pambuyo pa maola 4-12 ndipo zimatha maola 16 mpaka 24.

Mitundu ya mankhwalawa imagwiritsidwa ntchito pokhapokha ngati subcutaneous management. Pamaso jakisoni, werengani malangizo a mankhwalawa kuti mudziwe momwe mungagwiritsire ntchito insulin. Nthawi zambiri mawonekedwe awa amagwedezedwa pang'ono kapena kuzunguliridwa musanagwiritse ntchito.

Kuchita insulin nthawi yayitali

Insulin yomwe imatenga nthawi yayitali imaperekedwa kamodzi kapena kawiri pa tsiku. Zochita zake zimatha mpaka maola 24.

Ngati muli ndi matenda a shuga amtundu woyamba, ndiye kuti insulini yokhala nthawi yayitali iyenera kupatsidwa mankhwala a jakisoni ofulumira kapena osakhalitsa. Ngati muli ndi matenda a shuga a mtundu wachiwiri omwe amafunikira chithandizo cha insulin, zingakhale zofunikira kuti muwonjezere mwachidule kapena mwachangu, kapena mapiritsi osakanikirana ndi insulin.

Dokotala wanu adzakulangizani pazophatikizira zabwino kwambiri.

Insulin yotalika pompano:

• Lantus (insulin glargine)
• Levemir (insulin detemir)

Lantus sayenera kusakanikirana ndi insulin ina mu syringe. Lantus ikupezeka kuti mugwiritse ntchito ngati cholembera chotchedwa SoloSTAR, komanso katoni katapira 3 ml kuti mugwiritse ntchito pampu ya insulSTAR insulin. Levemir imapezeka kuti igwiritsidwe ntchito mu cholembera chotchedwa FlexPen, komanso katoni katemera ka 3 ml kuti mugwiritse ntchito pampu ya insulin.

Insulin yosakanikirana

Ma insulin osakanikirana amakhala ndi mawonekedwe osalala. Mtundu wosakanikirana wa insulin yofulumira kapena yocheperako, ndiye mitundu iwiri ya insulini imodzi jekeseni Ngati insulini ndi 30/70, zomwe zikutanthauza kuti imakhala ndi 30% yogwira ntchito mwachangu komanso 70% yapakatikati insulin, ndipo 50/50 imakhala ndi 50% ya insulin aliyense wa iwo.

Mwa mitundu ya insulin yosakanikirana imatha kusiyanitsidwa:

• Insuman Combi 25 (25/75)
• Mikstard 30 (30/70)
• X Umulin M3 (30/70)
• NovoMix 30 (30% insulin aspart, 70% protamine kuyimitsidwa kwa insulin aspart)
• Humalog Mix 25 (25% insulin lispro, 75% protamine kuyimitsidwa kwa insulin lispro)
• Humalog Mix 50 (50% insulin lispro, 50% protamine kuyimitsidwa kwa insulin lispro)

Mlingo wa kuyeretsa kwamankhwala

Kutchulidwa kwa kukonzekera kwa insulin kumadaliranso kuchuluka kwa kuyeretsedwa kwawo ndi kufunika kwa njirayi:

1. Maonekedwe achikhalidwe amapezeka ndi liquefaction ndi asidi ethanol, kusefera, kusefukira kunja ndi mitundu yambiri. Njira yodziyeretsa siziwoneka kuti ndiyabwino chifukwa cha zodetsa zomwe sizingagwiritsidwe ntchito.
2. Peak monopic amapezeka pambuyo pa chikhalidwe chamtundu wa kuyeretsa, kenako kusefa kudzera mu gel yapadera. Zovuta pakukonzanso zimakhalabe, koma zochepa.
3. Mitundu ya monocomponent imawerengedwa kuti ndi yabwino kwambiri pochizira matendawa, chifukwa ma cell sieving ndi ion-exchange chromatography amagwiritsidwa ntchito pakuyeretsa kwake.

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 zotsekemera za 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.

Kukonzekera kwapafupifupi insulin

Ndikotheka kubaya Actrapid mwina mwanjira ina, kapena kudzera m'mitsempha kapena m'mitsempha, ngakhale ndi njira yoyamba yomwe ili yofala kwambiri. Ntchafu ndi malo abwino kwambiri a jekeseni, chifukwa pamenepa mankhwalawa amalowa m'magazi m'njira yoyeserera komanso yopita patsogolo, ngakhale ngati kuli koyenera, jakisoni ikhoza kuikidwa m'matumbo, minofu ya brachial kapena pamimba.

Kumbukirani kuti singano iyenera kuyikiridwa mu khola la khungu lotetezedwa kuti isavulaze kulowa mkatikati, ndipo jekeseniyo iyenera kusinthidwa nthawi iliyonse chifukwa cha lipodystrophy.

Nawonso njira zamkati komanso zotheka kupangira Actrapid ndizovomerezeka pokhapokha kuyang'aniridwa ndi dokotala yemwe amalipira chifukwa chakugwirira ntchito mwachangu ndi mankhwala ofanana a sing'anga kapena a nthawi yayitali.

Ponena za kuchuluka kwa mankhwalawo, chinthu chofunikira kwambiri kuti muzindikire, momwemonso, ndi mkhalidwe wa munthu wodwala matenda ashuga komanso kuchuluka kwa shuga m'magazi ake. Pafupifupi, tsiku lililonse pamakhala theka kapena IU imodzi (yapadziko lonse lapansi) pa kilogalamu yodwala.

M'malo mwake, odwala matenda ashuga nthawi zambiri amalembedwa kumwa katatu patsiku - motero, zakudya zazikulu zitatu monga kadzutsa, chakudya chamadzulo ndi chakudya chamadzulo. Ngakhale, ngati kuli kofunikira, pafupipafupi kuvomerezedwa kumatha kukwezedwa mpaka kasanu mpaka kasanu ndi kamodzi patsiku.

Kutengera ndi enieni ake, zotsatira za hypoglycemic za Actrapid zimatha kuwonjezeka kapena, mosiyana, zimafooka. Izi ndi zofunika kukumbukira kuti osachulukitsa ndi kuchepa kwa magazi kapena kuti muchepetse kuyesayesa kwanu. Chifukwa chake, zotsatira za hypoglycemic zidzakhala zapamwamba zikaphatikizidwa ndi:

• sulfonamides
• kaboni anhydrase zoletsa,
• ma steroid
• bromocreptin,
• clifibrate
• pyridoxine
• chitin
• fenfluramine
• androgens
• machez
• ketonazole
• quinine
• Mowa.

Mankhwala okhala ndi nthawi yochepa ayenera kupatsidwa mankhwala makumi atatu, makamaka mphindi makumi anayi ndi zisanu asanadye. Pamene chiwopsezo cha zochita za mankhwalawa chikuyandikira, muyenera kusowa. Mankhwalawa amakhudza thupi pakatha mphindi makumi atatu mpaka makumi atatu ndipo amatha kufikira pakatha maola awiri kapena atatu atabayidwa. Kuchita kwa insulin kumatenga maola asanu mpaka asanu ndi limodzi.

Mankhwala osokoneza bongo amagwiritsidwa ntchito pakukhazikitsa mlingo wa insulin, komanso ngati mukufunikira mwachangu ndipo palibe mankhwala omwe ali ndi yochepa kwambiri. Gawo lina logwiritsira ntchito ndi monga othandizira ma anabolic omwe amalimbikitsa mapangidwe ndi kukonzanso magawo a maselo, minofu, minyewa (yoyendetsedwa mu waukulu).

Chimodzi mwazinthu zovuta zomwe zimapangitsa kuti ma insulin azigwiritsa ntchito mwachidule ndikuti kugwiritsa ntchito kwawo kumafuna jakisoni pafupipafupi. Chifukwa chake, asayansi apanga mankhwala a nthawi yayitali, omwe amawaganizira kuti ndi njira yabwino kwambiri yodwala matenda ashuga: nthawi yawo imayamba kuchokera maola 16 tsiku lililonse (kutengera matenda, machitidwe a thupi, njira yoyendetsera).

Pachifukwa ichi, thupi silifunanso jekeseni awiri kapena atatu patsiku.

Kutalika kwa nthawi ya mankhwalawa kumachitika chifukwa cha zinki kapena protamine (isofan, basal, protafan) pokonzekera, chifukwa sizimasungunuka komanso ma insulin amafupikitsidwe, zimatengedwa pang'ono ndi pang'ono m'magazi kuchokera kuzinthu zowoneka bwino, zomwe zimapangitsa kuti pakhale nthawi yayitali.

Pazifukwa zomwezo, mankhwala osokoneza bongo omwe sanapangidwe kuti asapangidwe ndi glucose surts: amayamba kuchita pakatha ola limodzi kapena awiri atabaya.

Kuchuluka kwa mankhwala omwe ali ndi nthawi yayitali kumatenga nthawi yayitali kuposa ya mankhwala omwe amakhala ndi kanthawi kochepa - zimayamba maola anayi pambuyo poti jakisoni wadzibaya ndipo amachepa patatha maola khumi ndi awiri.

Insulin idapangidwa kuti itsitse shuga. Komabe, pali mitundu ya insulin yomwe imakhala ndi zotsutsana, ndikofunikira kuganiziranso posankha chithandizo.

Makampani opanga mankhwala masiku ano amatulutsa mankhwala ambiri a insulin, motero gulu lawo la mankhwala ndi zina ndiwambiri. Adokotala okhawo omwe angapite ndi omwe angasankhe mankhwala oyenera.

Kukonzekera ndi kuyimitsidwa kwamitundu yayifupi ndi kwapakatikati kuchitira insulin. Ndalama zotere zimayambitsidwa m'thupi kuwirikiza kawiri kuposa momwe mtundu uliwonse wa mankhwala umafunira.

Mitundu ndi mafotokozedwe a insulin ya biphasic amaperekedwa pagome.

Dzina lamankhwala	Mtundu	Kutulutsa Fomu	Mawonekedwe
Humodar K25	Zopanga	Botolo, katoni	Amabayidwa mosamalitsa pakhungu, angagwiritsidwe ntchito kwa odwala omwe ali ndi matenda osokoneza bongo a digiri yachiwiri.
Biogulin 70/30	Zopanga	Katiriji	Imaperekedwa pansi pakhungu kamodzi kapena kawiri pa tsiku kwa mphindi 30 asanadye.
Humulin M3	Umisiri wamtundu	Botolo, katoni	Mothandizirana mwamphamvu komanso modekha.
Insuman Comb 25GT	Umisiri wamtundu	Botolo, katoni	Imapezeka kamodzi patsiku ndipo imayamba kugwira ntchito ola limodzi pambuyo pa jekeseni. Subcutaneous jakisoni wokha.
NovoMix 30 Penfill	Insulin	Katiriji	Imayamba kuchita zinthu mwachangu, pomwe jekeseni imodzi modukiza tsiku ndi yokwanira.

Insulin ya mitundu yodziwika, kuphatikizapo patebulopo, imangosungidwa mu zida zafiriji zokha. Mankhwala otseguka amagwira ntchito kwa mwezi umodzi, pambuyo pake mphamvu zake zochiritsa zimatayika.

Ndikofunikira kungoyendetsa insulin pokonzekera ndi gel kapena kapu yozizirirapo, ngati sizotheka kutengera mufiriji. Ndikofunika kwambiri kuti mankhwalawo asakumane ndi ozizira, apo ayi mankhwala ake nawonso atayika.

Mankhwala ochita kupanga mwachangu amapangidwa m'mabotolo, makatiriji ndi zolembera zopangidwa kale. Njira yothetsera vutoli imaperekedwa pogwiritsa ntchito ma insulin, ma syringe ndi mapampu apadera.

Insulin yochepa imapezeka m'njira ziwiri:

1. Potengera ma genetic, mahomoniwa amapangidwa ndi mabakiteriya.
2. Zopanga zokha, pogwiritsa ntchito kusintha kwa ma enzymes a nkhumba.

Mitundu yonse iwiri ya mankhwalawa imatchedwa yaumunthu, chifukwa ndi kapangidwe kake ka amino acid amabwereza kwathunthu mahomoni omwe amapangidwa mu kapamba athu.

Gululi	Mayina Mankhwala Osokoneza bongo	Nthawi yochita mogwirizana ndi malangizo
		Yambani, min	Maola	Kutalika, maola
ukadaulo wamtundu	Actrapid NM	30	1,5-3,5	7-8
	Gensulin r	30	1-3	mpaka 8
	Rinsulin P	30	1-3	8
	Humulin Wokhazikika	30	1-3	5-7
	Insuman Rapid GT	30	1-4	7-9
opanga	Biogulin P	20-30	1-3	5-8
	Humodar R	30	1-2	5-7

Insulin yochepa imatulutsidwa ngati njira yothetsera vutoli ndi kuzungulira kwa 100, osachepera 40 magawo pa millilita. Pakupangira jakisoni, mankhwalawa amaikidwa m'matumba agalasi ndi choyimitsa, kuti mugwiritse ntchito zolembera - mu makatoni.

Chofunikira: Momwe mungasungire insulin yochepa kunyumba, pamsewu komanso kutentha kwake, tafotokozera mwatsatanetsatane apa.

Ngati timalankhula za mawonekedwe a mankhwalawa, muyenera kuyamba ndi insulin yochepa. Ichi ndi mankhwala a mahomoni enieni, omwe amatha kupangidwa m'njira ziwiri:

• mankhwala awo a insulin (nthawi zambiri nkhumba zimagwiritsidwa ntchitozi),
• pamene matekinoloje amtundu wa majini amagwiritsidwa ntchito, mothandizidwa ndi njira ya biosynthesis imayamba.

Kodi chimagwiritsidwa ntchito ndi chiyani?

Insulin Actrapid yomwe imagwira ntchito mwachidule imagwiritsidwa ntchito pamatenda osiyanasiyana: mwachitsanzo, izi zimaphatikizapo hyperosmolar kapena ketoacidotic coma, komanso matenda ashuga a ketoacidosis. Kuphatikiza apo, chizindikiritso chogwiritsidwa ntchito chikhoza kukhala kuleza mtima kwa insulin yachilengedwe (nyama), insulin kukana kapena lipoatrophy.

Ndipo, matenda akuluakulu omwe amafunikira Actrapid insulin ndi awa:

• mtundu 1 shuga
• mtundu 2 shuga
• Mimba ndi kuphwanya kwa chakudya kagayidwe kachakudya kapena yogwira mankhwala achire.

Ndikofunikira kuwonjezera kuti ndi mtundu wachiwiri wa matenda ashuga, zifukwa zosinthira kugwiritsa ntchito mankhwalawa zimatha kukhala zosiyana. Choyamba, ndikofunikira kukana kwathunthu kapena pang'ono kwa mankhwala a hypoglycemic omwe amagwiritsidwa ntchito pakamwa, chachiwiri, ndi mitundu yosiyanasiyana ya opareshoni, ndipo, pamapeto pake, matenda aliwonse omwe angayambike ndi matenda a shuga.

Pali ma fanizo a Actrapid, ofanana ndi iwo momwe amawagwirira ntchito, ndipo akuphatikiza Maxirapid, Iletin Regular, Betasint ndi mankhwala ena. Komabe, ndikofunikira kukumbukira kuti ndi dokotala wokhayo amene angadziwe kufunika kowgwiritsa ntchito.

Choyamba, wodwala matenda ashuga amakakamizidwa kuyang'anira pawokha kuchuluka kwa shuga m'magazi ake nthawi yonse yogwiritsira ntchito Actrapid, makamaka ngati mankhwalawa adaphatikizidwa pakuphatikizidwa kwa mayankho a kulowetsedwa kwamitsempha.

Iyenera kuwonjezeredwa kuti mulingo wolakwika wa mankhwalawo, komanso kusokonezedwa popanda kugwiritsa ntchito, kungayambitse hyperglycemia (kapena matenda ashuga a ketoacidosis). Ndi zochitika zoterezi, wodwala matenda ashuga amatha chifukwa cha ludzu lalikulu, kukodza pafupipafupi, nseru, kufupika kwa khungu ndi kusadya.

Kuphatikiza apo, fungo lomveka bwino la acetone lidzapezekanso mu mpweya wotulutsidwa ndi ilo, lomwe maonekedwe ake amathanso kukhala mkodzo wa wodwala.

Monga tafotokozera pamwambapa, chizindikiro china chogwiritsira ntchito Actrapid chikhoza kukhala pakati: m'miyezi yoyamba, kufunika kwa insulini kumachepetsedwa, koma pamene mimba ikula, imachuluka, makamaka panthawi yobereka.

Mwana akangobadwa kumene, zofuna za amayi ake zowonjezera insulin zidzachepa kwambiri, koma kenako thupi liyenera kupatsidwanso mankhwala omwewo monga momwe adakhalira ndi pakati. Nthawi yonse yodyetsa mwana imafunika chisamaliro chapadera, komabe, zonse zimatengera momwe mayi aliyense alili, ndipo kufunika kwa jakisoni wa Actrapid kumatsimikiziridwa ndi dokotala wopita.

Insulin imagawitsidwa ku pharmacies kokha mwa mankhwala. Musanagwiritse ntchito mankhwalawa, muyenera kudziwa momwe amagwiritsidwira ntchito mankhwalawa.

Mankhwala amapangidwa mwanjira yothanirana ndi mavutidwe omwe amaphatikizidwa ndi minofu yaying'ono. Pamaso jakisoni wa prandial insulin, ndende ya glucose imayesedwa pogwiritsa ntchito glucometer.

Ngati shuga ali pafupi ndi chizolowezi chomwe wodwala amakhala nacho, ndiye kuti mafupiafupi amagwiritsidwa ntchito mphindi 20-30 musanadye, ndipo owonjezera amafupikitsidwa musanadye. Ngati chizindikirocho chimaposa zofunika zovomerezeka, nthawi pakati pa jakisoni ndi chakudya imachulukitsidwa.

Mlingo wa mankhwala amayeza mu mayunitsi (UNITS). Sichikukonzedwa ndipo imawerengeredwa padera asanadye kadzutsa, nkhomaliro komanso chakudya chamadzulo. Mukafuna kudziwa kuchuluka kwa mankhwalawa, kuchuluka kwa shuga musanadye komanso kuchuluka kwa zakudya zomwe wodwala akufuna kudya zimaganiziridwa.

Kuti musavutike, gwiritsani ntchito lingaliro la gawo la mkate (XE). 1 XU ili ndi magalamu 12-15 a chakudya. Makhalidwe azinthu zambiri amaperekedwa pagome lapadera.

Amakhulupirira kuti 1 unit ya insulin imachepetsa shuga ndi 2.2 mmol / L. Palinso kufunikira kwakukonzekera 1 XE tsiku lonse. Kutengera ndi izi, ndizosavuta kuwerengera kuchuluka kwa mankhwalawa pachakudya chilichonse.

Kudya	Kufunika kwa insulin (1 XE), m'mayunitsi
Chakudya cham'mawa	1,5–2
Chakudya chamadzulo	0,8–1,2
Chakudya chamadzulo	1,0–1,5

Tiyerekeze kuti munthu wodwala matenda ashuga ali ndi 8.8 mmol / L yosala kudya magazi m'mawa pamimba yopanda kanthu (ali ndi cholinga chimodzi cha 6.5 mmol / L), ndipo akufuna kudya 4 XE pakudya m'mawa. Kusiyana pakati pazowoneka bwino ndi chizindikiro chenicheni ndi 2.3 mmol / L (8.8 - 6.5).

Kuti muchepetse shuga kukhala wabwinobwino popanda kuganizira chakudya, 1 UNIT ya insulin imafunikira, ndipo 4 HE ikamagwiritsidwa ntchito, mankhwala ena 6 a PIERES (1.5 PIECES * 4 XE). Chifukwa chake, asanadye, wodwala ayenera kulowa magawo 7 a prandial mankhwala (1 unit 6 unit).

Kwa odwala omwe amalandira insulin, chakudya chamafuta ochepa sichofunikira. Kupatula kunenepa kwambiri kapena kunenepa kwambiri. Amalimbikitsidwa kudya 11-17 XE patsiku. Ndi kulimbitsa thupi kwambiri, kuchuluka kwa chakudya chamthupi kumatha kuchuluka mpaka 20-25 XE.

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

Mlingo watsiku ndi tsiku wa insulin yochepa kwa akulu ndi magawo 8-24, kwa ana - osaposa magawo 8. Chifukwa cha kutulutsidwa kwa mahomoni amakula m'magazi, mlingo wa achinyamata ukuwonjezeka.

Wodwala amatha kuwerengera payekha payekha. 1% ya timadzi timene timakhala ndi mlingo wofunika wothandizirana ndi mkate, ndi mlingo wochepetsera kuchuluka kwa shuga m'magazi.

Zonsezi ndizofanana ndi zero. Kwa odwala matenda ashuga omwe ali ndi kulemera kwambiri, kuchuluka kwake kumachepetsedwa ndi 0,1, ndi kulemera kosakwanira kumawonjezereka ndi 0.1.

Mlingo wa 0.4-00,5 U / kg amawerengedwa kwa odwala omwe ali ndi matenda a shuga 1. Kutengera mtundu wa mankhwalawa, jakisoni 1 mpaka 6 patsiku amatha kutumikiridwa.

Mlingo wa tsiku lililonse wa insulin yochepa: kwa akulu - mayunitsi 8-24, kwa ana - osapitirira 8 mayunitsi.

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

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

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

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

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

Mlingo Wothandizidwa ndi Insulin

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

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

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

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

Zofunikira zokhazokha ndikutsatira malamulo omwera mankhwalawa.

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

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

Lamulo lachitatu - nthawi yakumwa mankhwalawo iyenera kukhala yomweyo. Thupi liyenera kuzolowera dongosolo lazomwe limayang'anira, ndiye kuti kulimba kwake kumachulukanso. Lamulo lachinayi ndikuti jakisoni watsopano aliyense wa insulin apangidwe m'malo ena. N`zosatheka kumenya nthawi yomweyo tsiku lililonse, abscess ikhoza kuyamba. Nthawi yomweyo, simungathe kupaka malo a jakisoni, chifukwa mankhwalawa amayenera kumizidwa bwino m'magazi.

Zisonyezo 1

Mwachizolowezi, insulin yocheperako imaphatikizidwa ndi mankhwala apakatikati ndi ogwiritsira ntchito nthawi yayitali: yochepa imaperekedwa musanadye, komanso yayitali - m'mawa komanso asanagone. Chiwerengero cha jakisoni wa mahomoni sichikhala ndi malire ndipo zimangotengera zosowa za wodwalayo.

Kuti muchepetse kuwonongeka kwa khungu, muyezo ndi jakisoni 3 musanadye chakudya chilichonse komanso kuphatikiza jakisoni 3 kukonza hyperglycemia. Ngati shuga amadzuka chakudya chisanafike, makonzedwe opangira mankhwala amaphatikizidwa ndi jekeseni yomwe anakonza.

Mukafuna insulin yayifupi:

1. Mtundu umodzi wa matenda ashuga.
2. 2 mtundu wa matenda pomwe mankhwala ochepetsa shuga salinso othandizira.
3. Matenda a shuga okhathamira okhala ndi glucose ambiri. Kwa gawo losavuta, jakisoni wa insulin yayitali nthawi zambiri amakhala yokwanira.
4. Opaleshoni ya kapamba, yomwe idayambitsa kusokonekera kwa mahomoni.
5. Chithandizo cha pachimake zovuta za matenda ashuga: ketoacidotic ndi hyperosmolar coma.
6. Nthawi yochulukirapo ya insulin: Matenda otentha kwambiri, vuto la mtima, kuwonongeka kwa ziwalo, kuvulala kwambiri.