Zomwe insulin ili bwino: mfundo zosankha mankhwala abwino kwambiri
Insulin yochita ntchito kwa nthawi yayitali imamasulidwa mwanjira yothetsera kapena kuyimitsidwa kwamkati ndi mtsempha wamitsempha. Mwa munthu wathanzi, timadzi timeneti timapangidwa mosalekeza ndi kapamba. Kutalika kwa mahomoni kunapangidwa kuti kuyerekezera zomwezo mwa anthu omwe ali ndi matenda ashuga.
Amayendetsedwa pambuyo pa mphindi 60, mphamvu kwambiri imatheka pambuyo pa maola 2-8. Amalamulira kuchuluka kwa glucose m'magazi 18-20 maola.
Kuyimitsidwa kwawonjezera mtundu wa sc. Amagulitsidwa m'mabotolo a 4-10 ml kapena makatiriji a 1.5-3.0 ml kwa ma cholembera a syringe.
Imayamba kugwira ntchito mkati mwa maola 1-1.5. Kuchita bwino kwambiri kumawonetsedwa pambuyo maola 4-12 ndipo kumatha maola 24.
Kuyimitsidwa kwa kukhazikitsidwa kwa s / c. Mmatumba atatu a 3 ml cartridge, ma 5 ma PC mu paketi.
Imayendetsedwa pakatha maola 1-1.5.igwira maola 11 mpaka 24, mphamvu kwambiri imapezeka munthawi ya maola 4-12.
Insulin yowonjezera kuti ikwaniritse sc. Wopezeka m'mabotolo atatu a 3 ml, m'mabotolo 5 ml ndi makilogalamu 3 ml a ma syringe pensulo.
Insulin yayitali imayambitsidwa mkati mwa maola 1.5. Kuchuluka kwa zochitika kumachitika pakati pa maola 3-10. Nthawi yayitali yochita ndi tsiku.
Njira / ntchito. Amazindikira m'mathumba ogwiritsira ntchito ma syringe a 3 ml, m'mabotolo a 10 ml.
Amayamba kuchita mphindi 60 pambuyo pa jekeseni, amawongolera kuchuluka kwa shuga m'magazi osachepera tsiku.
Ma cartridges ndiofala komanso kwa 3 ml syringe zolembera, mu 10 ml mbale za sc management.
Chiwopsezo cha ntchito chimachitika pambuyo pa maola 3-4. Kutalika kwa mphamvu ya wothandizira nthawi yayitali ndi maola 24.
Insulin yotalikilapo imadziwika m'mapensulo a 3 ml.
Kuphatikiza apo, anthu omwe akudwala matenda ashuga sayenera kulowetsa m'malo mwake ndi analogue yomwe idatenga nthawi yayitali. Thupi lokhala ndi mahomoni ena liyenera kufotokozedwa moyenera monga lingaliro lazachipatala, ndipo chithandizo chamankhwala chiyenera kuchitidwa kokha moyang'aniridwa ndi dokotala.
Njira yatsopano yochizira matenda a shuga ndi insulin ndi pampu ya insulin.
Pampu ndi chipangizo (pampu yomwe, palokha, chosungira ndi insulini ndi cannula poperekera mankhwala), pomwe insulin imaperekedwa mosalekeza. Izi ndi zina bwino pakubayidwa jakisoni tsiku lililonse. Padziko lonse lapansi, anthu ochulukirachulukira akusintha motere.
Popeza mankhwalawa amaperekedwa mosalekeza, ma insulin okhazikika pokhapokha kapena oyambira pang'ono omwe amagwiritsidwa ntchito pamapampu.
Pampu ya insulin
Zipangizo zina zimakhala ndi masensa ochepetsa mphamvu ya shuga, zimangoganiza za kuchuluka kwa insulin, kupatsidwa zotsalira za insulin m'magazi ndikudya. Mankhwalawa amachotsedwa mosavuta, mosiyana ndi kuyambitsa kwa syringe.
Dziwani kuti anthu omwe amagwiritsa ntchito insulin pump amakhala ndi njira yokhazikika ya matenda ashuga, amakhala ndi zovuta zambiri komanso amakhala ndi moyo wabwino. Pampu imalondola kwambiri kubisalira kwa thupi ka insulin mwa munthu wathanzi.
Koma njirayi ilinso ndi zovuta zake. Wodwala matenda ashuga amadalira kwambiri ukadaulo, ndipo ngati pazifukwa zina chipangizocho chikutha (insulini yatha, batire yatha), wodwalayo amatha kudwala ketoacidosis.
Komanso, anthu omwe amagwiritsa ntchito pampu amayenera kupirira zovuta zina zomwe zimakhudzana ndi kuvala chida nthawi zonse, makamaka kwa anthu omwe akukhala ndi moyo wakhama.
Chofunikira ndichakuti mtengo wokwera kwambiri woperekera insulin.
Mankhwala samayima, mankhwala ochulukirachulukira atsopano, akumapangitsa moyo kukhala wosavuta kwa anthu omwe akudwala matenda ashuga. Tsopano, mwachitsanzo, mankhwala ozikidwa ndi insulin yolumikizidwa akuyesedwa.
Pamaso pa munthu aliyense wodwala matenda ashuga, posakhalitsa, funso lingabuke posankha njira yoyenera yogwiritsira ntchito insulin. Pharmacology yamakono imapereka jakisoni komanso mtundu wa piritsi wa timadzi timeneti.
Nthawi zina, osati kungopeza chithandizo chokwanira, komanso njira yotsatsira wodwala matenda ashuga itha kudalira kusankha koyenera.
Monga momwe zamankhwala zimasonyezera, kutumiza matenda ashuga ku jakisoni ndi ntchito yovuta. Izi zitha kufotokozedwa ndi kukhalapo kwa zikhulupiriro zambiri zabodza komanso malingaliro olakwika omwe amapezeka kuzungulira matendawa.
Ndizofunikira kudziwa kuti chodabwitsachi sichinadziwike pakati pa odwala okha, komanso pakati pa madokotala. Sikuti aliyense amadziwa kuti ndi insulin iti yabwino kwambiri.
Munthu aliyense yemwe amadziwa bwino matenda a shuga amadziwa kuti pali mitundu ingapo ya insulini, iliyonse yomwe ili ndi mbali zakezake komanso zovuta zakepi.
Kuti mudziwe nokha kuti insulini ndiyabwino, choyamba mutha kufotokoza zazikuluzikulu za mtundu uliwonse. Mwa munthu wathanzi, timadzi timeneti timapangidwa ndi kapamba, ndipo munthu wodwala amafunika kuwunika nthawi zonse, ndipo ngati kuli kotheka, jekeseni jakisoni wopanga.
Mankhwala amafunanso ndalama kwa odwala matenda ashuga. Pali mankhwala anzeru amakono aku Europe, koma samangokhala chete. Kuti.
Popeza kuchuluka kwa insulin kofunikira m'magazi, mankhwala omwe amapezeka kwa nthawi yayitali amapatsidwa kuti odwala matenda ashuga azigwira ntchito yoyambira. Ndalamazi zimayambitsidwa m'thupi la 1-2 kawiri pa tsiku, mutayang'ananso zakudya ndikunyamula tsiku lotsatira.
Ubwino wa mankhwalawa ndi mwayi wogwiritsidwa ntchito kamodzi patsiku, ndikuonetsetsa kuti thupi likusowa. Koma ngakhale kuyesa lingaliro sikuwoneka ngati kumatengera jakisoni wokhazikika, kupereka chisankho ku chithandizo chachitali popanda upangiri wa dokotala sichinthu chanzeru kwambiri.
Poyamba, mulingo womwewo umakupangirani machitidwe ena tsiku lotsatira, ndipo chachiwiri, jakisoni woteroyo samaganizira momwe shuga wakhalira mukatha kudya, chifukwa chake pamafunika mphamvu yowonjezera ya mahomoni ofulumira kuchitapo kanthu. Isanayambike insulin maola 4 pambuyo makonzedwe.
Mahomoni a mtundu wapakati, monga wakalewo, ndi oyambira, ndipo ali ndi zabwino ndi zovuta zonse zofanana ndi zoyambirira. Kusiyanako kukukhala pakubala kwa zomwe zimatanthawuza, zomwe zikutanthauza kuti ndizotheka kulinganiza momwe mungachitire tsiku lotsatira, koma kwa maola 12, koma kudalira kudya zakudya ndi kuvomerezedwa kwa mankhwala owonjezera a insulin, nthawi zambiri, amakhalabe.
Mankhwala ochita kupanga mwachidule ndi njira yabwinoko pankhani yokhazikitsira kuchuluka kwa shuga pambuyo pamafungo azakudya kuposa nthawi yayitali komanso yapakati, koma sangathe kupereka zosowa zoyambira za thupi.
Mankhwalawa amaperekedwa theka la ola chakudya chisanafike, pomwe zimadziwika kuti ndi chakudya chiti chomwe chimamwa, ndipo zakudya zomwe zimadyedwa zimalipiridwa kamodzi atalowa m'magazi.
Komabe, ndikofunikira kuganizira mtengo wokweza kwambiri patatha maola atatu jekeseni, pamafunika zowonjezera zakudya zowonjezera ndi nthawi yonse ya maola 6. Monga tanena kale, timadzi timeneti timapatsidwa hafu ya ola tisanayambe kudya, zomwe zikutanthauza kuti munthu amangokakamira kudya kuchuluka kwa chakudya.
Kupanda kutero, pamakhala chiopsezo cha hypoglycemia, ndipo simalo abwino kwambiri.Ndiye kuti, mtundu uwu wa mankhwalawo sungakhale woyenera kwa anthu omwe amakakamizidwa kuti azingoyendayenda kuzungulira mzindawo tsiku lonse logwirira ntchito komanso kwa ana omwe samakakamizidwa mosavuta kudya mbale yonse ngati atayesa supuni imodzi ndikukana chakudya chamasana.
Ndi chifukwa ichi kuti kusankha kwabwino kwambiri ndikopanda zamankhwala - mahashoni a ultrashort omwe amagwiritsa ntchito mfundo zazifupi komanso amalephera zina zake. Mwachitsanzo, kuyamwa mwachangu mthupi kumakupatsani mwayi woti mudye osati pokhapokha, komanso mukatha kudya kapena mukangomaliza kudya, potero kuwerengetsa mulingo woyenera kwa thupi.
Kuphatikiza apo, nthawi yovomerezeka ya maola atatu atatu sikukutanthauza kuti palibe chifukwa chofunikiranso chakudya cham'mawa / chakudya chamadzulo ndi chakudya chamadzulo kuti mulipirire shuga amene wagwa. Koma, ngati lalifupi, silingakwaniritse zosowa zofunika za insulin.
Monga mukuwonera, ndizosatheka kuyankha mosakayikira funso lomwe ndilo insulin yabwino kwambiri. Komabe, mutakambirana ndi dokotala, mutha kusankha njira yoyenera kwambiri kuti thupi lanu liphatikize mankhwala oyambira ndi ofupikira, ndikupangitsa kuti insulini ikhale yothandiza, komanso yabwino.
Ndinadwala matenda ashuga kwa zaka 31. Tsopano ali wathanzi. Koma, makapisozi awa sangafikire anthu wamba, safuna kugulitsa mankhwala, sizopindulitsa kwa iwo.
Kwa odwala matenda ashuga omwe amadalira insulin, ndikofunikira kugwiritsa ntchito mlingo woyenera wa insulin.
- nthawi yayitali, kugwira ntchito mpaka maola 17. Mankhwalawa akuphatikizapo Biosulin, Insuman, Gensulin, Protafan, Humulin.
- nthawi yayitali kwambiri, zotsatira zawo zimakhala mpaka maola 30. Awa ndi: Levemir, Tresiba, Lantus.
- Ndikofunikira kuyang'ana kuchuluka kwa mamolekyulu a shuga m'magazi kangapo patsiku. Zizindikiro zotsatirazi zimatengedwa ngati zabwinobwino: pamimba yopanda kanthu - 5-6 mmol / l ndipo patatha maola angapo mutatha kudya - 8 mmol / l. Kupatuka kwakukulu kuchokera kuzowonetsa komaliza ndizowonjezera 3 mmol / L.
- Hormon iyi iyenera kusankhidwa poganizira nthawi ya tsiku, kuchuluka kwa mankhwala ochulukitsa a carbohydrate omwe amwedwa, kuchuluka kwa kayendedwe ka wodwalayo asanadye komanso atatha kudya.
- Kuphatikiza apo, kuyenera kuyang'aniridwa kwa kulemera kwa wodwala, kupezeka kwa matenda ena owopsa kapena osachiritsika, nthawi ndi mawonekedwe ogwiritsira ntchito mankhwala ena. Chofunika kwambiri, zizindikirozi ndizomwe zimayikidwa nthawi yopuma ya jakisoni wa insulin yokonzekera nthawi yayitali. Chomwe chimapangitsa izi ndikuchepa kwa kudalira jakisoni panthawi yakudya, chifukwa mukamachigwiritsa ntchito, timadzi tambiri timene timayamwa mu seramu yamagazi a wodwala timapangidwa.
- Mfundo yofunika kwambiri posankha mlingo wabwino wa mankhwala ndikusunga diary yapadera. Patsamba loterolo, zizindikiritso zam'molekyu m'magazi a wodwalayo, kuchuluka kwa mafuta omwe amamwetsa pakudya, ndi kuchuluka kwa kukonzekera kwa insulin yochepa kumalowetsedwa. Kusanthula kumachitika nthawi zambiri pamimba yopanda kanthu. Nthawi zambiri kuchuluka kwa wothandizirayo ndi magawo omwe amwedwa ndi chakudya ndi chiŵerengero cha 2 mpaka 1. Ngati kuchuluka kwa mamolekyu amwazi m'magazi kupitirira zovomerezeka, makonzedwe owonjezerawa akukonzekera kochepa ndikofunikira.
- Yambirani njira ya kusankha mlingo wa insulin ndi jakisoni usiku. Ndi kuyambitsa kwa mahomoni mu kuchuluka kwa magawo 10, nthawi yomweyo asanakagone, malinga ndi kuti mankhwalawa ndi oyenera, shuga m'magazi sadzaposa 7 mmol / L. Pamene, jakisoni wa woyamba mlingo, wodwalayo atuluka thukuta kwambiri, kukulitsa chilimbikitso, m`pofunika kuchepetsa usiku ndi angapo mayunitsi. Mtengo woyenera pakati pa Mlingo wa insulin woperekedwa masana ndi usiku uyenera kukhala 2: 1.
Zambiri
Insulin imagwira ntchito yofunika kwambiri m'thupi. Tili othokoza kuti maselo ndi minyewa ya ziwalo zamkati zimalandira mphamvu, chifukwa chomwe zimatha kugwira bwino ntchito ndikugwira ntchito yawo.Zikondwererozi zimaphatikizidwanso pakupanga insulin.
Ndipo ndikukula kwa matenda aliwonse omwe amachititsa kuti maselo ake awonongeke, amayamba chifukwa chakuchepa kwa kapangidwe ka timadzi tambiri timeneti. Zotsatira zake, shuga yemwe amalowa mthupi mwachindunji ndi chakudya sakhala m'magazi ndipo amakhala m'magazi momwe amapangira michere. Ndipo chimayamba matenda a shuga.
Koma ndi zamitundu iwiri - yoyamba ndi yachiwiri. Ndipo ngati ndi matenda a shuga 1 pakakhala kuperewera kwina kapena kokwanira, ndiye kuti ndi matenda amtundu wa 2, vuto losiyanako pang'ono limachitika mthupi. Zikondazo zimapitilizabe kupanga insulini, koma maselo amthupi amasiya kuzimva, chifukwa amasiya kuyamwa mphamvu zonse. Potengera maziko awa, shuga samatha mpaka kumapeto komanso amakhazikika m'magazi.
Koma nthawi zina, ngakhale ndi matenda a shuga a mtundu wachiwiri, kutsatira zakudya sikumabweretsa zotsatira zabwino, chifukwa pancreas "imatopa" komanso amasiya kutulutsa timadzi tambiri tambiri. Pankhaniyi, kukonzekera kwa insulin kumagwiritsidwanso ntchito.
Amapezeka m'mitundu iwiri - mapiritsi ndi mayankho a intradermal management (jekeseni). Ndipo polankhula za zomwe zili bwino, insulini kapena mapiritsi, ziyenera kudziwidwa kuti majekeseni ali ndi chiwonetsero chachikulu kwambiri mthupi, chifukwa zomwe zimagwira zimathandizira kulowa mu kayendedwe kazinthu ndikuyamba kuchita.
Kugwiritsira ntchito kukonzekera kwa insulin kuyenera kuchitika pokhapokha atakambilana ndi katswiri
Koma izi sizitanthauza kuti insulini m'mapiritsi ilibe ntchito zochepa. Zimathandizanso kuchepetsa magazi a m'magazi komanso zimathandizira kukonza zomwe zimachitika wodwalayo. Komabe, chifukwa chochepa pang'onopang'ono, sioyenera kugwiritsidwa ntchito mwadzidzidzi, mwachitsanzo, poyambika kwa hyperglycemic coma.
Chifukwa chiyani tikufunika majakisoni?
Kuchita izi sikungakhudze magazi a glucose. Izi zitha kumveka chifukwa cha glycated hemoglobin, yomwe imawonetsa kuchuluka kwa shuga m'miyezi 3 yapitayo.
Pafupifupi onse odwala matenda ashuga ayenera kusamala ndi nthawi zonse chizindikiritso chake. Ngati ichulukitsa malire a zonse (motsutsana ndi chithandizo cha mapiritsi a nthawi yayitali), ndiye njira yoyenera yosinthira makulidwe a insulin.
Pafupifupi 40% ya odwala matenda ashuga a mtundu 2 amafunikira jakisoni wa insulin.
Achibale athu omwe akudwala matenda ashuga asinthana ndi jakisoni patatha chaka chimodzi matenda atayamba. Izi zimachitika pakuwonjezeka kwa shuga komanso kuchepa kwa hemoglobin ya glycated. Komanso kuchuluka kwa odwalawa kumawonjezera matendawa.
Madokotala amafotokozera njirayi mwakulephera kukwaniritsa miyezo yapadziko lonse lapansi, ngakhale kuli kwina kwamakono kwamakono. Chimodzi mwazifukwa zazikulu izi ndi kuwopa odwala matenda ashuga a jekeseni a moyo.
Ngati wodwala yemwe ali ndi matenda osokoneza bongo sakudziwa kuti insulin ndiyabwino, akukana kusintha jakisoni kapena kusiya, ndiye kuti amakhala ndi shuga wambiri. Mkhalidwe wotere ungayambitse kukula kwa zovuta pa thanzi ndi moyo wa munthu wodwala matenda ashuga.
Ma hormone osankhidwa bwino amathandizira kuti wodwalayo akhale ndi moyo wathunthu. Chifukwa cha zida zamakono zapamwamba zomwe zingagwiritsidwenso ntchito, zidatha kuchepetsa kusasangalala komanso kupweteka kuchokera ku jakisoni.
Jakisoni wa insulin amachitika pogwiritsa ntchito syringe ya insulin kapena cholembera. Zotsalazo ndizosavuta kugwiritsa ntchito mankhwalawo mosamala, motero zimakondedwa. Mutha kuperekanso jakisoni ndi cholembera popanda kuvula zovala zanu, zomwe ndi zosavuta, makamaka ngati ali kuntchito kapena ku sukulu yophunzitsa.
Cholembera cha insulin
Insulin imalowetsedwa m'matumbo a mafuta am'malo osiyanasiyana, nthawi zambiri imakhala patsogolo pa ntchafu, pamimba ndi phewa. Mankhwala omwe akhala akuchita kwa nthawi yayitali amakonda kubisala ntchafu kapena kunja kwa khola, kumangokhala pang'ono m'mimba kapena phewa.
Chofunikira ndikutsatira malamulo aseptic, ndikofunikira kusamba m'manja musanalowe jakisoni ndikugwiritsa ntchito syringes zokhazo. Kumbukirani kuti mowa umawononga insulini, motero, mutalandira chithandizo cha mankhwala a jakisoni ndi antiseptic, ndikofunikira kudikirira mpaka mutamwalira kwathunthu, ndikupitilira ndi mankhwalawa. Ndikofunikanso kupatuka kuchokera pa malo omwe kale anali jekeseni osachepera 2 cm.
Gulu la insulin
Insulin yochepa-yankho ndi yankho la crystalline zinc-insulin. Chowonjezera chawo ndichakuti amachita mthupi la munthu mwachangu kwambiri kuposa mitundu ina ya kukonzekera kwa insulin. Koma nthawi yomweyo, nthawi yawo yochita umatha mwachangu momwe zimayambira.
Mankhwalawa amalowetsedwa subcutaneous theka la ola musanadye njira ziwiri - intracutaneous kapena intramuscular. Kuchuluka kwa kugwiritsidwa ntchito kwawo kumatheka pambuyo pa maola 2-3 mutatha kutsata. Monga lamulo, mankhwala osokoneza bongo omwe amagwiritsidwa ntchito posachedwa amagwiritsidwa ntchito limodzi ndi mitundu ina ya insulin.
Mankhwalawa amasungunuka pang'ono pang'onopang'ono m'matumbo amkati ndipo amatengeka ndi kayendedwe kazinthu, chifukwa chomwe zimakhala ndi mphamvu kwambiri kuposa ma insulin omwe amangokhala osachita kanthu. Nthawi zambiri pochita zamankhwala, insulin NPH kapena tepi ya insulin imagwiritsidwa ntchito.
Limagwirira zake zochita insulin
Insulini yapakatikati ndiyachinyama ndi anthu. Ali ndi ma pharmacokinetics osiyanasiyana. Kusiyana pakati pawo ndikuti insulin yakuchokera kwa anthu imakhala ndi hydrophobicity yayikulu kwambiri ndipo imagwirizana bwino ndi protamine ndi zinc.
Pofuna kupewa zoyipa zomwe zimagwiritsidwa ntchito ndi insulin ya nthawi yayitali, iyenera kugwiritsidwa ntchito mosamalitsa malinga ndi chiwembu - 1 kapena 2 kawiri pa tsiku. Ndipo monga tanenera pamwambapa, mankhwalawa nthawi zambiri amaphatikizidwa ndi ma insulin achidule.
Gulu la mankhwala omwe ali ndi mankhwala ali ndi kuyamwa pang'ono pang'onopang'ono m'magazi, motero amachitapo kanthu kwa nthawi yayitali. Izi amachititsa kuti magazi azikhala ndi shuga tsiku lililonse.
Mwa chiyambi, insulin ndi:
- Nkhumba. Amachotsedwa m'matumbo a nyama izi, zofanana kwambiri ndi munthu.
- Kuchokera kwa ng'ombe. Nthawi zambiri pamakhala zovuta zina za insulin iyi, chifukwa zimasiyana kwambiri ndi ma cell aanthu.
- Wamunthu Amagwiritsa ntchito mabakiteriya.
- Umisiri wamtundu. Zimapezeka kuchokera ku nkhumba, pogwiritsa ntchito matekinoloje atsopano, chifukwa cha izi, insulin imakhala yofanana ndi anthu.
Pofika nthawi:
- zochita za ultrashort (Humalog, Novorapid, etc.),
- zochita zazifupi (Actrapid, Humulin Regular, Insuman Rapid ndi ena),
- nthawi yayitali yochita (Protafan, Insuman Bazal, etc.),
- wogwira ntchito kwa nthawi yayitali (Lantus, Levemir, Tresiba ndi ena).
Insulin yamunthuMa insulin afupia ndi a ultrashort amagwiritsidwa ntchito musanadye chakudya chilichonse kuti apewe kulumikizana ndi glucose komanso kusintha momwe mulili. .
Kulakwitsa kwa Matenda A shuga
Sikuti mankhwala a insulin nthawi zonse amalimbikitsidwa ngati mutapanda kusunga insulin yanu. Chifukwa china chingakhale izi:
- chibayo
- chimfine
- Matenda ena akuluakulu
- kulephera kugwiritsa ntchito mankhwala pamapiritsi (ndimomwe thupi limagwirira chakudya, mavuto a chiwindi ndi impso).
Kusunthira jakisoni kutha kuchitika ngati wodwala matenda ashuga akufuna kukhala moyo wabwino kapena, osatha kutsatira njira yokhazikika komanso yotsika ya carb yotsika.
Jekeseni sangathe mwanjira iliyonse yazaumoyo. Mavuto aliwonse omwe akanakhalapo pakubwera kwa jakisoni amathanso kungoona ngati mwangozi komanso mwangozi. Komabe, musataye nthawi yomwe pali insulin yambiri.
Chomwe chimapangitsa izi siziri insulini, koma kukhalapo nthawi yayitali ndimagazi osavomerezeka a shuga. Ayi, molingana ndi ziwerengero zamayiko osiyanasiyana, mukasinthana ndi jakisoni, nthawi yayitali yomwe munthu amakhala ndi moyo ndi kuchuluka kwake.
Ndi kuchepa kwa kuchuluka kwa hemoglobin wa glycated ndi 1 peresenti, mwayi wa zovuta zotsatirazi zimachepa:
- myocardial infarction (14 peresenti),
- kudula kapena kufa (43%),
- michere yamavuto (37 peresenti).
Zomwe mungagwiritse ntchito insulin yayitali
Mtundu wa insulini yotani ndi kuchuluka kwake, ndi dokotala yekhayo amene amasankha, potengera zomwe wodwalayo ali nazo, kuchuluka kwa kuchuluka kwa matenda komanso kupezeka kwa zovuta ndi matenda ena. Kuti mudziwe kuchuluka kwake kwa insulin, ndikofunikira kuyang'anitsitsa kuchuluka kwa shuga m'magazi pambuyo pa kayendetsedwe kake.
Malo abwino kwambiri a insulin ndi khola lam'madzi pamimba.
Ponena za mahomoni omwe amayenera kupangidwa ndi kapamba, kuchuluka kwake kuyenera kukhala pafupifupi ED patsiku. Zomwezo zimafunikira kwa odwala matenda ashuga. Ngati ali ndi vuto losakwanira pancreatic, ndiye kuti kuchuluka kwa insulin kumatha kufika pa ED patsiku.
Malangizo abwino kwambiri omwera mankhwalawa amadziwika kuti amaphatikiza insulin yochepa komanso yapakati. Mwachilengedwe, njira yogwiritsira ntchito mankhwalawa imadaliranso izi. Nthawi zambiri pamachitidwe otere, njira zotsatirazi zimagwiritsidwa ntchito:
- kugwiritsa ntchito nthawi imodzimodziyo insulini yochepa komanso yaying'ono pamimba yopanda kanthu m'mawa asanadye chakudya cham'mawa, ndipo madzulo kumangokhala mankhwala osakhalitsa (musanadye chakudya chamadzulo) amawayika ndikatha maola ochepa - ochita masewera olimbitsa thupi,
- Mankhwala okhala ndi kanthu kwakanthawi amagwiritsidwa ntchito tsiku lonse (mpaka kanayi pa tsiku), ndipo asanagone, jakisoni wa mankhwala a nthawi yayitali kapena yayifupi amatumizidwa,
- pa 5-6 a.m. insulin ya sing'anga kapena nthawi yayitali imayendetsedwa, ndipo musanadye chakudya cham'mawa komanso chakudya chilichonse chotsatira - chochepa.
Ngati dotolo adapereka mankhwala amodzi kwa wodwala, ndiye kuti ayenera kugwiritsidwa ntchito mosamalitsa. Chifukwa, mwachitsanzo, insulin yochepa imayikidwa katatu patsiku masana (omaliza asanagone), pakati - kawiri pa tsiku.
Insulin yokhala ndi nthawi yayitali, kutengera mtundu wa shuga, imatha kuphatikizidwa ndi wothandizira, yemwe amachitika kuti akwaniritse ntchito yake yoyambira, kapena angagwiritsidwe ntchito ngati mankhwala amodzi. Mwachitsanzo, mu mtundu woyamba wa matenda ashuga, insulin yokhala ndi nthawi yayitali nthawi zambiri imaphatikizidwa ndi mankhwala afupipafupi kapena a ultrashort.
- Sulfonylurea.
- Meglitinides.
- Biguanides.
- Thimang.
Insulin yokhala ndi nthawi yayitali imatha kutengedwa ngati chipangizo chimodzi, monga mankhwala ena onse
Monga lamulo, kupendekera kwakanthawi kochepa ka shuga kumagwiritsidwa ntchito m'malo mwa mankhwala osokoneza bongo nthawi yayitali. Chifukwa chakuti pofuna kukwaniritsa zoyambira, pafupifupi insulin imapangidwa kawiri pa tsiku, ndipo yayitali - kamodzi patsiku, kusintha kwa mankhwalawa sabata yoyamba kungayambitse kukhalanso kwa hypoglycemia ya m'mawa kapena usiku.
Vutoli litha kuwongoleredwa pochepetsa kuchuluka kwa mankhwala ochulukitsidwa ndi 30%, omwe amakwanira pang'ono chifukwa chosowa kwa nthawi yayitali kugwiritsa ntchito insulin yokhala ndi chakudya chochepa. Pambuyo pake, mlingo wa insulin yochulukitsidwa umasinthidwa.
Zomwe zimapangidwazo zimaperekedwa kamodzi kapena kawiri pa tsiku. Pambuyo polowa m'thupi kudzera mu jakisoni, mahomoni amayamba kuwonetsa ntchito zake pokhapokha maola ochepa. Nthawi yomweyo, mafotokozedwe azinthu zowonjezera pang'onopang'ono zomwe zimawonetsedwa patebulo ndizosiyana.
Koma ngati insulin yowonjezera ikufunika, lowetsani kuchuluka kwakukulu kwa 0,6 ma kilo imodzi ya kulemera kwa munthu, ndiye kuti mlingo womwe watchulidwa umagawidwa majakisoni awiri. Nthawi yomweyo, kupatula pakubwera zovuta, jakisoni amapangidwa mbali zosiyanasiyana za thupi.
Ganizirani momwe mungapewere zoyipa za insulin.
Mankhwala aliwonse a insulini, ngakhale atakhala nthawi yayitali bwanji;
- Hypoglycemia - mulingo wa glucose m'magazi umatsika pansi pa 3.0 mmol / L.
- Zosiyanasiyana komanso zamkati zimachitika - urticaria, kuyabwa ndi kapangidwe ka jekeseni.
- Kuphwanya mafuta kagayidwe - kodziwika ndi kudzikundikira kwamafuta, osati pansi pa khungu, komanso magazi.
Wolembera pang'onopang'ono insulin imapereka mwayi wabwino kwambiri wopewa zovuta za mtundu 1 ndi matenda ashuga 2. Kuphatikiza apo, insulin yayitali imapangitsa kuchiza matenda a shuga mosavuta. Pofuna kupatula chiwonetsero cha zotsatirazi, odwala matenda ashuga ayenera kutsata zakudya zomwe adokotala adanenanso ndikusintha malo a jekeseni nthawi zonse.
Kutalika kapena kufupikitsa?
Kuti mupeze kubisala kwapansi, ndichizolowezi kugwiritsa ntchito insulin. Mpaka pano, pharmacology imatha kupereka mitundu iwiri ya mankhwalawa. Itha kukhala insulin ya nthawi yayitali (yomwe imagwira ntchito mpaka maola 16) ndi kuwonetsa nthawi yayitali (nthawi yake imakhala yoposa maola 16).
Mahomoni a gulu loyamba amaphatikizapo:
- Gensulin N,
- Humulin NPH,
- Insuman Bazal,
- Protafan HM,
- Biosulin N.
Kukonzekera kwa gulu lachiwiri:
Levemir ndi Lantus amasiyana kwambiri ndi mankhwala ena onse chifukwa amakhala ndi nthawi yosiyanitsidwa ndi thupi la odwala matenda ashuga ndipo amawonekeratu. Insulin ya gulu loyamba ndi yoyera matope. Asanagwiritse ntchito, zomwe zimagwiritsidwa ntchito ndi iwo ziyenera kugulitsidwa mosamala pakati pa kanjedza kuti mupeze yankho lofanana ndi mitambo. Kusiyanaku kumachitika chifukwa cha njira zosiyanasiyana zopangira mankhwala.
Ma insulini ochokera pagulu loyamba (nthawi yayitali) ndiwopamwamba. Mwanjira ina, nsanja ya chisautso imatha kuyambika pakuchita kwawo.
Mankhwala ochokera ku gulu lachiwiri samadziwika ndi izi. Ndizinthu izi zomwe ziyenera kukumbukiridwa posankha mulingo woyenera wa insulin. Komabe, malamulo apadera a mahomoni onse ndi ofanana.
Kuchuluka kwa nthawi yayitali insulini iyenera kusankhidwa kuti ipangitse kuchuluka kwa shuga m'magazi pakati pa zakudya zovomerezeka. Mankhwala amaphatikizapo kusinthasintha kakang'ono pamtunda kuchokera pa 1 mpaka 1.5 mmol / L.
Ngati mlingo wa insulini udasankhidwa bwino, ndiye kuti shuga ya magazi sayenera kugwa kapena kuchuluka. Chizindikiro ichi chiyenera kuchitika kwa maola 24.
Insulin yotalikilapo iyenera kubayidwa pang'onopang'ono mpaka ntchafu kapena matako. Chifukwa chakufunika koyamwa mosavuta komanso pang'onopang'ono, jakisoni m'manja ndi m'mimba ndizoletsedwa!
Zilonda m'malo awa zimapatsa zotsatirazi. Insulin yochepa-yoika, yomwe imagwiritsidwa ntchito pamimba kapena mkono, imapereka chiwongola dzanja chokwanira panthawi yomwe imayamwa chakudya.
Momwe mungaswe usiku?
Madokotala amalimbikitsa kuti odwala matenda ashuga ayambe jekeseni wa insulin nthawi yayitali. Komanso, onetsetsani kuti mukudziwa komwe mungabayire insulin. Ngati wodwalayo sakudziwa momwe angachitire izi, ayenera kumwedwa mosiyanasiyana maola atatu aliwonse:
Ngati nthawi iliyonse wodwala yemwe ali ndi matenda ashuga akadumphadumpha zizindikiritso za shuga (utachepa kapena kuwonjezeka), ndiye, pamenepa, mlingo womwe ukugwiritsidwa ntchito uyenera kusintha.
Muzochitika zoterezi, ziyenera kukumbukiridwa kuti kuwonjezeka kwa glucose sikuti nthawi zonse kumachitika chifukwa cha kuchepa kwa insulin. Nthawi zina izi zimatha kukhala umboni wa latent hypoglycemia, yomwe yamveka ndi kuwonjezeka kwa glucose.
Kuti mumvetsetse chifukwa cha kuchuluka kwa shuga usiku, muyenera kuganizira bwino nthawi yonseyo. Poterepa, pakufunika kuwunika kuchuluka kwa glucose kuyambira 00.00 mpaka 03.00.
Ngati pakhala kuchepa mkati mwake munthawiyi, ndiye kuti pali wolemekezeka wotchedwa "proxy" wokhazikika. Ngati ndi choncho, ndiye kuti mlingo wa insulin wa nocturnal uyenera kuchepetsedwa.
Aliyense endocrinologist anganene kuti chakudya chimakhudza kwambiri kuwunika kwa insulin yoyamba mthupi la odwala matenda ashuga. Kuyerekeza kolondola kwambiri kwa kuchuluka kwa insulin ya basal kumatheka pokhapokha ngati palibe shuga m'magazi omwe amabwera ndi chakudya, komanso insulini yokhala ndi nthawi yayitali.
Pachifukwa ichi, musanayanize insulini yanu usiku, ndikofunikira kudumpha chakudya chanu chamadzulo kapena kudya chakudya chamadzulo kwambiri kuposa masiku onse.
Ndikwabwino kusagwiritsira ntchito insulin yayifupi kuti mupewe chithunzi chowoneka ngati cha thupi.
Kuti mudziyang'anire, ndikofunika kusiya kumwa mapuloteni ndi mafuta nthawi yamadzulo komanso musanayang'ane shuga. Ndikwabwino kupatsa chidwi ndi zinthu zamafuta.
Izi ndichifukwa choti mapuloteni ndi mafuta zimatengedwa ndi thupi pang'onopang'ono ndipo zimatha kuwonjezera kwambiri misempha ya shuga usiku. Mkhalidwewo, umakhala cholepheretsa kupeza zotsatira zoyenera za insulin ya usiku.
Masana maselo
Poyesa insulin ya masana masana, imodzi mwa chakudya siyiyenera kuyikidwa kunja. Mwabwino, mutha kukhala ndi njala tsiku lonse, kwinaku mukuyesa kuchuluka kwa glucose ola limodzi. Izi zimapereka mwayi wowona bwino nthawi yakuchepetsa kapena kuwonjezera shuga.
Kwa ana aang'ono, njira yodziwitsira matenda sioyenera.
Pankhani ya ana, insulin yoyambira iyenera kuwunikiridwa nthawi yodziwika. Mwachitsanzo, mutha kudumphira chakudya cham'mawa ndikuwayeza kuchuluka kwa magazi ola lililonse:
- kuyambira mwana akamadzuka,
- popeza jakisoni wa insulin yofunika.
Amapitilizabe miyeso musanadye chakudya chamadzulo, ndipo atatha masiku angapo muyenera kulumphira nkhomaliro, kenako ndi chakudya chamadzulo.
Pafupifupi insulin yonse yowonjezereka iyenera kubayidwa kawiri pa tsiku. Chosiyana ndi mankhwala a Lantus, omwe amalowetsedwa kamodzi patsiku.
Ndikofunika kukumbukira kuti ma insulin onse omwe ali pamwambapa, kupatula Lantus ndi Levemir, ali ndi mtundu wa pobisalira. Monga lamulo, nsonga za mankhwalawa zimachitika mkati mwa maola 6-8 kuchokera nthawi yomwe chiwonetserochi chikuwonekera.
Panthawi zapamwamba, kutsika kwa shuga m'magazi kumatha kuchitika. Izi ziyenera kukonzedwa ndi ufa waung'ono wa mikate.
Madokotala amalimbikitsa kubwereza cheke cha basal insulin pakusintha kulikonse. Ndikokwanira masiku atatu kuti mumvetsetse mphamvu imodzi. Kutengera ndi zotsatira zake, dokotala adzalembera zoyenera kuchita.
Kuti mupeze insulini yatsiku ndi tsiku ndikumvetsetsa kuti insulin ndiyabwino, dikirani maola 4 kuchokera pachakudya chanu chapita. Nthawi yoyenera imatha kutchedwa maola 5.
Odwala omwe ali ndi matenda ashuga omwe amagwiritsa ntchito insulin yayifupi ayenera kupirira nthawi yoposa maola 6-8:
Izi ndizofunikira chifukwa cha zinthu zina zomwe zimapangitsa kuti inshuwaransi ipangidwe thupi la wodwala. Ma Ultrashort insulins (Novorapid, Apidra ndi Humalog) samvera lamuloli.
Kusintha kwa Humalog ndi Humalog 50: kusiyana
Ena odwala matenda ashuga molakwika amalingalira kuti mankhwalawo ndi othandizira kwathunthu. Izi siziri choncho. Prost proteni Hagedorn (NPH), yomwe imachepetsa kuchitira insulin, imayambitsidwa mu Kusakanikirana kwa Humalog 50.
Zowonjezera zowonjezera, nthawi yayitali ntchito. Kutchuka kwake pakati pa odwala matenda ashuga ndi chifukwa chakuti imathandizira njira yothandizira mankhwala a insulin.
Humalog Sakanizani ma cartridge 50 100 IU / ml, 3 ml mu syringe ya Quick Pen
Chiwerengero cha tsiku ndi tsiku cha jakisoni chimachepetsedwa, koma izi sizothandiza kwa odwala onse. Ndi jakisoni, ndizovuta kusunga magazi abwino amawongolera. Kuphatikiza apo, ndale ya protamine Hagedorn nthawi zambiri imayambitsa zovuta zomwe zimayambitsa matenda ashuga.
Nthawi zambiri, insulin yomwe imatenga nthawi yayitali imaperekedwa kwa odwala okalamba, omwe, chifukwa cha ukalamba, amayiwala kupanga jakisoni panthawi.
| Insulin yayitali | Insulin yochepa | |
| Malo oyambira | Jakisoni amaikidwa ntchafu, chifukwa pamenepa mankhwalawa amamwa pang'onopang'ono | Jakisoni amaikidwa pakhungu la pamimba, chifukwa pamenepa insulin imayamba kugwira ntchito pafupifupi nthawi yomweyo |
| Kutanthauzira nthawi | Imayambitsidwa nthawi yomweyo (m'mawa ndi madzulo). Munthawi yomweyo ndi mlingo wam'mawa, jakisoni wa insulin "yofupika" imaperekedwa | Kumwa mankhwalawa kwa mphindi 20 mpaka 30 musanadye |
| Chakudya chomangirira | Insulin "yayitali" simalumikizidwa ndi chakudya | Pambuyo pakukhazikitsa insulin yochepa, chakudya chimayenera kuchitika mosalephera. Ngati izi sizichitika, ndiye kuti pali mwayi wakukula kwa hypoglycemia |
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!
Mitundu ya insulin ndi zochita zawo
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.
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.
| 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 |
Ma insulin, omwe amaphatikizapo nkhumba, bovine, bovine, insulin, sanagwiritsidwe ntchito kwenikweni kupeza mankhwala opangira - analogues a insulin ya anthu. Malinga ndi magawo ambiri, omwe ambiri ndi allergenicity, insulini yabwino kwambiri imapangidwa kuchokera ku majini.
Kutalika kwa nthawi ya kukonzekera kwa insulin kumagawidwa mu ultrashort ndi insulin yochepa. Amaberekanso zakudya zomwe zimapangitsa kuti thupi lizikhala ndi chakudya chambiri. Mankhwala a nthawi yayitali, komanso ma insulin amatengera momwe chinsinsi chake chimakhalira. Insulin yocheperako imatha kuphatikizidwa ndi insulin yayitali pakukonzekera.
Ndibwino kuti mupeze insulin - yayifupi, yapakatikati kapena yayitali, imatsimikiziridwa ndi mtundu wa insulin yothandizira, zomwe zimatengera zaka za wodwalayo, kuchuluka kwa hyperglycemia komanso kupezeka kwa matenda okhudzana ndi matenda a shuga.
Gulu la ma ultrashort insulins limadziwika ndi kuyambika mwachangu - pambuyo pa mphindi 10-20, shuga amachepetsa kwambiri pambuyo pa maola 1-2.5, kutalika konse kwa zotsatira za hypoglycemic ndi maola 3-5. Mayina a mankhwala: Humalog, NovoRapid ndi Apidra.
Insulin yochepa imachitika pambuyo pa mphindi 30-60, zotsatira zake zimatha maola 6-8, ndipo pazofunikira zimawonedwa kwa maola awiri atatha kutsata.Ndikofunikira kubaya insulini yocheperako mphindi 20-30 musanadye chakudya, chifukwa izi zimapereka kuchuluka kwa mahomoni m'magazi nthawi yomwe shuga imakhala ndi mtengo wokwera kwambiri.
Insulin yochepa imapezeka pansi pa dzina lotsatira:
- Actrapid NM, Rinsulin R, Humulin Regular (genetic engineering insulin pokonzekera)
- Khumudar R, Biogulin R (semi-syntulin insulin).
- Actrapid MS, Monosuinsulin MK (wowerengeka wa nkhumba).
Zomwe insulin ndiyabwino kusankha pamndandandawu imatsimikiziridwa ndi dokotala yemwe amaganizira za chizolowezi chokhala ndi chifuwa, kuikidwa kwa mankhwala ena. Mukamagwiritsa ntchito ma insulini a mitundu yosiyanasiyana palimodzi, zimakhala bwino ngati mungasankhe wopanga mmodzi. Mtengo wa mitundu ingapo ya insulin imatsimikiziridwa ndi wopanga.
Kuchita insulin mwachangu kumasonyezedwera kukonzekera tsiku lililonse musanadye kwambiri, komanso chithandizo cha matenda a shuga pamankhwala ochita opaleshoni. Mlingo wocheperako, mankhwalawa amagwiritsidwa ntchito ndi othamanga kuti apange minofu, komanso kutopa kambiri, thyrotoxicosis, cirrhosis.
Mankhwala othandizira nthawi yayitali komanso nthawi yayitali amagwiritsidwa ntchito kuti asungidwe pafupipafupi kapena a insulin.
Kugwira kwathunthu kwa kapamba mwa munthu wathanzi kumalola thupi kuyendetsa kagayidwe kazakudya nthawi yokhazikika masana. Komanso kuthana ndi katundu wamafuta mukamadya kapena njira zopatsirana ndi zotupa m'matenda.
Chifukwa chake, kuti tisungitse shuga m'magazi, timadzi timene timakhala ndi katundu wofanana, koma kuthamanga kwina, timafunikira. Tsoka ilo, pakadali pano, sayansi sinapeze yankho lavutoli, koma chithandizo chovuta ndi mitundu iwiri ya mankhwala monga insulin yayitali komanso yayifupi yakhala chipulumutso kwa odwala matenda ashuga.
| Feature | Kuchita motalika | Zochita zazifupi |
| Nthawi yolandila | Pamimba yopanda kanthu | Asanadye |
| Kuyamba kuchitapo kanthu | Pambuyo maola 1.5-8 | Pambuyo 10-60 Mphindi |
| Peak | Pambuyo maola 3-18 | Pambuyo pa maola 1-4 |
| Kutalika kwachitidwe | Maola 8-30 | 3-8 h |
Kuphatikiza pazomwe zili pamwambazi, palinso zinthu zina za insulin, ndiye kuti, kuyimitsidwa, komwe kumakhala ndi mahomoni onse awiri. Kumbali imodzi, izi zimachepetsa kwambiri kuchuluka kwa jakisoni wofunidwa ndi wodwala matenda ashuga, omwe ndi kuphatikiza kwakukulu. Komabe, pankhaniyi, ndikovuta kukhala ndi kagayidwe kazachilengedwe.
Mukamagwiritsa ntchito mankhwalawa, ndikofunikira kukhazikitsa chakudya chamagulu ochepa, masewera olimbitsa thupi, moyo wambiri. Ichi ndichifukwa chosatheka kusankha kuchuluka kwa mtundu wa insulin pakadali pano wofunikira.
Insulin yoyamba idapezeka kuchokera ku nyama, kuyambira pamenepo yakhala ikusinthidwa koposa kamodzi. Tsopano mankhwala osokoneza bongo a nyama sagwiritsidwanso ntchito, adasinthidwa ndi ma genetic engineering hormone komanso ma insulin analogues atsopano. Mitundu yonse ya insulini yomwe tili nayo ingagawike m'magulu molingana ndi kapangidwe ka molekyulu, nthawi yayitali, kapangidwe kake.
Njira yothetsera jakisoni itha kukhala ndi mahomoni amitundu yosiyanasiyana:
- Wamunthu Adalandira dzina ili chifukwa amabwereza kwathunthu kapangidwe ka insulin m'matumbo athu. Ngakhale ma molekyuli adachitika mokwanira, kutalika kwa insulin yamtunduwu ndi kosiyana ndi kwamoyo. Hormone yochokera ku kapamba imalowa m'magazi nthawi yomweyo, pomwe mahomoni opanga amatenga nthawi kuti ayamwe kuchokera mu minofu yaying'ono.
- Analogs a insulin. Thupi lomwe limagwiritsidwa ntchito lili ndi mawonekedwe ofanana ndi insulin yaumunthu, ntchito yofanana ndi yochepetsera shuga. Nthawi yomweyo, zotsalira za amino acid zochepa zomwe zimakhala mu molekyulu zimasinthidwa ndi wina. Kusintha kumeneku kumakupatsani mwayi kufulumizitsa kapena kuchepetsa liwiro la mahomoni kuti mubwereze mwatsatanetsatane kapangidwe ka thupi.
Mitundu yonse iwiri ya insulini imapangidwa ndi mainjiniine. Timadzi timadzi timene timalandira ndi kukakamiza kuti tisakanikize tizilombo ta Escherichia coli kapena yisiti, pambuyo pake mankhwalawo amatsukidwa kambiri.
| Onani | Feature | Kusankhidwa | Kapangidwe ka insulin |
| Ultrashort | Yambani ndikumaliza ntchito mofulumira kuposa mankhwala ena. | Lowani musanadye chakudya chilichonse, muyezo wake umawerengera zakudya zomwe zimapezeka mu chakudya. | analog |
| Mwachidule | Kutsitsa kwa shuga kumayamba mu theka la ola, nthawi yayikulu yogwira ntchito ili pafupifupi maola 5. | munthu | |
| Zochita zapakatikati | Kapangidwe ka nthawi yayitali (mpaka maola 16) kukonza shuga pamagulu abwinobwino. Kulephera kumasula magazi mwachangu kuchokera kwa shuga mutatha kudya. | Amaba jakisoni 1-2 patsiku, ayenera kudya shuga usiku ndi masana pakati pa chakudya. | munthu |
| Kutalika | Amasankhidwa ndi zolinga zofanana ndi zapakati. Ndiwo njira yawo yosinthira, amagwira ntchito nthawi yayitali komanso wogawana. | analog |
Kutengera ndi kapangidwe kake, mankhwalawo amagawidwa kukhala amodzi ndi amodzi. Zoyambazo zimakhala ndi mtundu umodzi wokha wa insulini, izi zimaphatikiza nthawi yayifupi komanso yapakatikati kapena ma ultrashort ndi mahomoni amatali mosiyanasiyana.
Insulin yosavuta idachotsedwa ku zikondamoyo za nyama pafupifupi theka la zaka zapitazo. Kuyambira pamenepo, yakhala ikugwiritsidwa ntchito pochiza matenda a shuga mpaka lero. Tsopano asayansi amatha kudzipangira okha mankhwala a insulin, popanda kutulutsa timadzi tating'onoting'ono tomwe timatulutsa. Awa ndi omwe amatchedwa othandiziranso zinthu. Munthawi imeneyi, mitundu yambiri ya mankhwala a mahomoniwa yapangidwa. Amakhala ndi nthawi yosiyanasiyana pochita, mawonekedwe ndi zina.
Ma insulin omwe amagwira ntchito mwachidule amagawidwa m'mitundu iwiri:
- Kukonzekera mwachidule kwa insulin - Actrapid NM, Humodar R, Monodar, Biogulin R, Actrapid MS, Monosuinsulin MK, etc.
- Ultrashort insulin - Humalog ndi Apidra.
Ponena za insulin zazitali, zimaphatikizapo nthawi yayitali komanso insulin zazitali kwambiri. Awa ndi insulin-zinc, insulin-isophan ndi mankhwala ena.
Tsambali likufotokoza mitundu yosiyanasiyana ya insulini komanso kusiyana pakati pawo. Werengani zomwe mankhwala omwe akupezeka pakuyambira, nthawi yayitali, yochepa komanso ya ultrashort. Matebulo abwino amawonetsa zizindikilo zawo, mayina apadziko lonse komanso zambiri zowonjezera.
Mitundu ya insulin yapakatikati ndi yayitali - Protafan, Levemir, Lantus, Tujeo, komanso mankhwala atsopano a Tresiba akuyerekeza. Zimafotokozedwera momwe mungaziphatikize ndi jekeseni othamanga musanadye - insulin yochepa kapena imodzi mwazosankha zazifupi Humalog, NovoRapid, Apidra.
Mitundu ya insulin ndi momwe zimachitikira: nkhani yatsatanetsatane
Mudzalandira zotsatira zabwino kuchokera ku majekeseni ngati mugwiritsa ntchito limodzi ndi zakudya zama carb otsika komanso malingaliro ena a Dr. Bernstein. Kuti mumve zambiri, onani njira 2 yothetsera matenda ashuga kapena mtundu wa pulogalamu yothetsera matenda a shuga. Kusunga kuchuluka kwa glucose 3.9-5,5 mmol / L khola maola 24 patsiku, monga mwa anthu athanzi, ndizowona. Zambiri patsamba lino ndi zaulere.
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.
Zizindikiro Zambiri
Kugwiritsa ntchito insulini "Apidra" posakhalitsa kumatha kukupweteketsani ngati simumatsatira mlingo womwe wapatsidwa. Kuyipa wamba ndikukhazikitsa dziko la hypoglycemic.Poterepa, muyenera kugwiritsa ntchito zakudya zomwe zili ndi shuga kuti mukhale ndi thanzi labwino. Poyerekeza ndi maziko oopsa a hypoglycemia, wodwalayo amatha kukomoka, ndipo kuti amuchotsere vutoli, makina a Dextoses kapena Glucagon amafunikira.
MISONKHANO
- Kuthamanga kwa muyeso wa glucose (katatu).
Glucose wabwinobwino amasala glucose mpaka 6,1 mmol / L.
Ngati kuchokera 6.1 mpaka 7.0 mmol / L - kuphwanya glycemia.
Zoposa 7 mmol / l - shuga.
Mayeso a kulolera a glucose. Zimachitika kokha ndi zotsatira zoyipa, ndiye kuti, ngati glucose amachokera ku 6.1 mpaka 7.0 mmol / L.
Maola 14 asanayambe phunziroli, njala imalembedwa, ndiye kuti magazi amatengedwa - gawo loyambirira la shuga limakhazikitsidwa, ndiye kuti 75g ya shuga imasungunuka mu 250 ml ya madzi imapatsidwa kuti amwe. Pambuyo maora 2, amatenga magazi ndikuwonera:
- ngati ochepera 7.8, ndiye kuti kulolerana kwachilengedwe kwa glucose.
- ngati kuyambira 7.8-11.1, ndiye kuti kulekerera kwa glucose.
- ngati oposa 11.1 ndiye SD.
■ Cholinga chachikulu chothandizira odwala omwe ali ndi matenda a shuga 1 ndikuwongolera glycemia.
Kusungabe kuchuluka kwa hemoglobin wa glycosylated.
Kusintha kwachulukidwe ka zinthu zonse: kuwongolera kukula, kulemera kwa thupi, kutha msinkhu, kuyang'anira kuthamanga kwa magazi (mpaka 130/80 mm Hg), lipids yamagazi (LDL cholesterol mpaka 3 mmol / L, HDL cholesterol yoposa 1.2 mmol / L , triglycerides mpaka 1.7 mmol / l), chiwongolero cha ntchito ya chithokomiro.
Mfundo za zakudya za matenda am'mbuyomu matenda a shuga zimaphatikizaponso kuyang'anira kudya zakudya zopatsa mphamvu komanso kuwerengera chakudya chomwe mumadya.
■ Mapuloteni amapanga 15%, mafuta 25-30%, chakudya - mpaka 55% ya zopatsa mphamvu tsiku ndi tsiku. Kuchuluka kwa mafuta ndi kuchuluka kwa mafuta ochulukirapo a polyunsaturated kuyenera kukhala osachepera 10% ya okwanira kalori. Mwakuchita izi, kufunafuna mkaka wamafuta, mafuta olimba a masamba ndi zopangidwa ndi nyama zamafuta ziyenera kukhala zochepa, ndipo kudya mafuta osapanga mafuta ndi nsomba kumayenera kuwonjezeka.
■ Ndikofunikira kuchepetsa kuchuluka kwa chakudya chamafuta ochepa (osaposa 1/3 kupatula sucrose ndi glucose). Zakudya zomanga thupi zovuta zopakidwa ndi michere yambiri ndizakudya zina zomwe zimakondedwa. Ndikulimbikitsidwa kuti muzidya zakudya zokhala ndi michere yazomera (mkate kuchokera ku ufa wa wholemeal, masamba, nandolo, zipatso).
Pewani kugwiritsa ntchito sucrose. Zochepa (pafupifupi 10 g) muzakudya zonse zopatsa mphamvu zomwe zimaloledwa. Zipatso ndi zipatso zimatha kudyedwa pang'ono.
■ Mchere uyenera kukhala wopanda chakudya.
■ Mowa (vinyo wowuma) ndiolandiridwa pang'ono. Ndikofunikira kukana kugwiritsa ntchito zakumwa zotsekemera.
Pofuna kuthandiza odwala, lingaliro la "mkate mkate" lazidziwitsidwa. “Mkate” umodzi umafanana ndi 10-12 g wa chakudya chambiri, chifukwa cha kukondoweza, magawo 1-2 a insulin amafunikira. Chilichonse chomwe chili ndi ma carbohydrate chimatha kufotokozedwa mu "mkate". Kufunikira kwa "zigawo za mkate" patsiku: kwa anthu omwe ali ndi vuto lolemera lamthupi, omwe amagwira ntchito yayikulu, - 25-30,
■ Wodwalayo asunge diary yowerengera kuchuluka kwa "mkate" ndikuwonetsa glycemia ndi mlingo wa insulin.
Kuchita masewera olimbitsa thupi kumathandizira kuchuluka kwa insulin. Pankhaniyi, ndikofunikira kusintha mlingo wa insulin womwe umayikidwa poganizira zomwe anakonza. Chofunikira ndi njira yomwe munthu angagwiritsire ntchito katundu wake.
Kuopsa kwa hypoglycemia kumawonjezeka panthawi yochita masewera olimbitsa thupi komanso mkati mwa maola 12 mpaka 40 pambuyo pochita masewera olimbitsa thupi kwa nthawi yayitali komanso / kapena.
Kuti muthane ndi zolimbitsa zolimbitsa thupi zosaposa ola limodzi, kudya zakudya zowonjezera zamafuta kumakhala kofunikira musanayambe kuchita masewera olimbitsa thupi (15 g ya chakudya chosagwiritsidwa ntchito bwino kwa mphindi 40 zilizonse zolimbitsa thupi).
For Kuchita masewera olimbitsa thupi kopitilira ola limodzi ndikuchita masewera olimbitsa thupi, kuchepetsa 20% 50% ya insulin, yomwe imagwira ntchito panthawi yotsatizana ndi maola 6 mpaka 12, ndikofunikira.
Kugawira shuga m'magazi kuyenera kutsimikizika musanayambe kuchita masewera olimbitsa thupi komanso pambuyo poti muchite masewera olimbitsa thupi.
Kusagwiritsa ntchito mankhwala osokoneza bongo kumaphatikizapo kusiya kusuta. Zikuwonetsedwa kuti chiopsezo chokhala ndi albinuria mwa omwe amasuta ndikuwonjezeka kawiri.
Momwe mungathanirane ndi matenda ashuga omwe ali ndi insulin yochepa kapena yochepa kwambiri
Ultrashort insulini imayamba kugwira ntchito thupi isanakhale ndi nthawi yolowa mapuloteni ndikusintha ena mwa iwo kukhala glucose. Chifukwa chake, ngati mumatsatira zakudya zamafuta ochepa, insulin yochepa ndiyabwino kuposa Humalog, NovoRapid kapena Apidra musanadye. Insulin yochepa iyenera kuperekedwa kwa mphindi 45 musanadye. Ino ndi nthawi yoyenera, ndipo wodwala aliyense yemwe ali ndi matenda ashuga amafunika kumafotokozera yekha payekha.
Timagwiritsa ntchito mankhwala a "cellash" a "cell" mwadzidzidzi kuti achepetse shuga kuti akhale bwino ngati angulumuke mwadzidzidzi. Mavuto a shuga amakula pomwe shuga m'magazi amakwezedwa. Chifukwa chake, timayesetsa kutsitsa kuti zikhale zabwinobwino mwachangu, ndipo kwa insulini yocheperako ndiyabwino kuposa yochepa. Ngati muli ndi matenda amtundu wa shuga wachiwiri, i.e.
Mfundo za Insulin Therapy
■ Kuwonekera kwa mtundu woyamba wa matenda ashuga (kusankha ndi kusankhira mankhwala a insulin, kuphunzitsa wodwalayo malamulo a kudziletsa kwa glycemia, zakudya, ntchito, ndi zina). Kuwonongeka kwa matenda a shuga amtundu woyamba amafuna chithandizo chamankhwala chapadera - nthawi zambiri m'malo ogona kwambiri. Pambuyo pochotsa wodwala ku matenda a matenda ashuga ketoacidosis, chithandizo chokwanira ndichofunikira, chokhala ndikusankhidwa kwa njira yoyenera ya insulin komanso pulogalamu yophunzitsira "Sukulu ya mtundu 1 shuga mellitus" (maphunziro sayenera kuchitika pasanathe miyezi isanu ndi umodzi kuchokera pamene matendawa adayamba).
Matenda a diabetesic ketoacidosis (ketonuria, hyperglycemia).
■ Precoma kapena chikomokere (ketoacidotic, hypoglycemic).
Kusunthika kwa zovuta zamafupa.
■ Zinthu zofunikira: matenda, kuledzera, kufunika kwa kuchitapo kanthu kwa opaleshoni, gastroenteritis, kuchepa magazi. Kufunika kokhalira kuchipatala kumawonetsedwa ndi kukula kwachilengedwe kwa metabolic acidosis, hyperglycemia ndi kuyamwa kwa insulin.
Chithandizo cha matenda a shuga 1 amachokera ku insulin. Cholinga cha mankhwala a insulin ndikuthandizira mokwanira machitidwe ofunikira. Mankhwala a insulin amawerengedwa potengera mphamvu yomwe munthu angadye nayo, kuchuluka kwa chakudya chambiri chakudya chilichonse, nthawi yayitali ya matenda ashuga 1 ndi zovuta zake.
■ Kufunikira kwa insulin kwa munthu wamkulu wodwala matenda a shuga 1 ndipo woposa chaka chimodzi ndi magawo a 0.6-0.8 a insulin pa kilogalamu ya thupi. Mu achinyamata mutha msinkhu, kufunikira kumeneku ndikofunika kwambiri ndipo kumawerengeka 1.0-1.5 U / kg. Kufunika kwa insulin kumakulirakulira ndi kupsinjika, matenda, opareshoni. Ndi kukula kwa aimpso kulephera, zolimbitsa thupi, kufunika kwa insulin kumachepa.
■ Mfundo ya insulin yothandizira mtundu woyamba wa matenda ashuga ndikutsatira secretion ya insulin ndikuwonjezeranso insulin yochepa (kapena analogues ya ultrashort) musanadye. Ma insulin amfupi kapena a ultrashort amatha kutumizidwa popanda kudya kuti muchepetse glycemia wokwera. Mtundu woyamba wa matenda ashuga, wodwalayo ayenera kusintha kuchuluka kwa insulini yoyendetsedwa molingana ndi mfundo za glycemia zomwe zimapezeka pakudziyang'anira tsiku ndi tsiku. Ndikofunikira kwambiri kuti muchepetse kusintha kwa zotsatira za hypoglycemic, ndipo zikachitika, mpumulo wa panthawi yake.
Kusiyanitsa kwakukulu pakati pa mankhwala amakono a insulin ndi kuchuluka kwa mapangidwe a insulin, makamaka kusintha matendawa atatha kudya. Odwala amadziwa kufunika kwa insulini pachakudya chilichonse pachakudya, ndipo izi zimapangitsa kuti azisintha kuchuluka kwa insulini yoyendetsedwa molingana ndi kuchuluka kwa mkate. Kuti muthe kugwiritsa ntchito "mkate" umodzi, magawo atatu a insulin amafunikira (kutengera nthawi ya tsiku ndi chidwi chake).
■ Insulin imayendetsedwa mobwerezabwereza, mankhwala osakhalitsa pamimba, nthawi yayitali yogwira minofu ya m'chiuno kapena matako.
Kugawana kwakanthawi kofunikira kwa insulin: 50-60% imagwera pama insulin a nthawi yayitali (kapena yayitali), ena onse - pa insulin yochepa.
Mankhwala Otchuka a insulin
Mankhwala omwe sanagwiritsidwe ntchito ayenera kukhala mufiriji. Chida chogwiritsira ntchito tsiku ndi tsiku chimasungidwa kutentha kwanyumba kwa mwezi umodzi. Asanayambike insulin, dzina lake, patency ya singano imayang'aniridwa, kuwonekera kwa yankho ndi tsiku lotha ntchito kumawunikiridwa.
Mitundu ya prandial imalowetsedwa m'matumbo a subcutaneous pamimba. Mderali, yankho limakhala lotanganidwa ndikuyamba kuchitapo kanthu mwachangu. Tsamba la jakisoni mkati mwa malowa limasinthidwa tsiku lililonse.
Mukamagwiritsa ntchito syringe, ndikofunikira kutsimikizira kuchuluka kwa mankhwalawa omwe amasonyezedwera komanso vial. Monga lamulo, ndi 100 IU / ml. Pakukhazikitsa mankhwalawa, khola limapangidwa, jekeseni limapangidwa pakona pa madigiri 45.
Pali mitundu ingapo ya zolembera za syringe:
- Yodzaza (okonzeka kudya) - Apidra SoloStar, Humalog QuickPen, Novorapid Flexpen. Njira yothetsera njirayi ikatha, chogwirira chimayenera kutayidwa.
- Kuchitikanso, ndi cholembera insulin cartridge - OptiPen Pro, OptiKlik, HumaPen Ergo 2, HumaPen Luxura, Biomatic pen.
Musanagwiritse ntchito, kuyezetsa kumayesedwa ndi momwe umafunikira kwa singano. Kuti muchite izi, pezani magawo atatu a mankhwalawa ndikusindikiza piston. Ngati dontho la yankho litawoneka pamutu pake, mutha kubaya insulini. Ngati zotsatirapo zake zili zopanda pake, kubwereza kumabwerezedwa kawiri, kenako singano imasinthidwa kukhala yatsopano. Ndi mafuta osanjika bwino ophatikizika, makonzedwe a wothandizira amachitika mbali yoyenera.
Pampu za insulin ndi zida zomwe zimathandizira mabisidwe oyambira komanso olimbikitsidwa a secretion ya mahomoni. Amakhazikitsa cartridgeges omwe ali ndi ma ultrashort analogues. Kukhazikika kwakanthawi kochepa kwa yankho mu subcutaneous minofu kumatsitsa mwazonse momwe timadzi timene timayendetsa masana masana ndi usiku, ndipo kuwonjezereka kwa gawo loyambirira kumachepetsa shuga omwe amalandiridwa kuchokera ku chakudya.
Kuchokera pazomwe zili mu gawo lapitalo la nkhaniyi, zikuwonekeratu kuti insulin yochepa ndiyotani, koma osati nthawi yokhayo ndi kuthamanga kwake ndikofunikira. Mankhwala onse ali ndi mawonekedwe awo, analogue ya human pancreatic hormone sichili choncho.
Mndandanda wazinthu za mankhwalawa zomwe muyenera kutsatira:
- gwero la chiphaso
- digiri ya kuyeretsa
- kusamalira
- pH ya mankhwalawa
- wopanga ndi kusakaniza katundu.
Chifukwa chake, mwachitsanzo, analogue ya komwe nyama zimapangidwa ndikuchiritsa kapamba wa nkhumba ndikuyeretsa. Mankhwala opangidwa ndi theka, nyama zomwezi zimatengedwa ngati maziko ndipo pogwiritsa ntchito njira ya kusintha kwa enzymatic, insulin imapezeka pafupi ndi zachilengedwe. Tekinoloje izi nthawi zambiri zimagwiritsidwa ntchito ngati timadzi tambiri.
Kupanga mainjiniya kwapangitsa kuti zibwererenso maselo enieni a insulin yaumunthu yomwe amapangidwa kuchokera ku Escherichia coli ndi kusintha kwasinthidwe. Ma mahomoni a Ultrashort, monga lamulo, amatchedwa mankhwala opangidwa ndi chibadwa cha insulin ya anthu.
Zovuta kwambiri kupanga zothetsera zimayeretsedwa kwambiri (chopanga-mono). Zopanda zodetsa zambiri, ndizochulukirapo ndipo zimachepetsa zolakwika chifukwa zimagwiritsidwa ntchito. Chiwopsezo cha mawonekedwe awomwe amagwiritsidwa ntchito pogwiritsa ntchito analogue ya hormone imachepetsedwa.
Kukonzekera kwa njira zosiyanasiyana zopangira, mitengo yowonekera, mafakitale, mitundu, ikhoza kuyimiridwa ndi kutsata kosiyanasiyana. Chifukwa chake, gawo lomwelo la insulin ingagwiritsidwe ntchito syringe.
Kugwiritsa ntchito mankhwala osokoneza bongo acidity ndikofunikira, izi zimapewe zomverera zosasangalatsa pamalo opangira jekeseni. Komabe, mtengo wa ndalama zotere umakhala wokwera kwambiri kuposa acidic.
Popeza kunja, sayansi ili patsogolo kwambiri pa sayansi yam'nyumba, ndizovomerezeka kuti makhwala ochokera kumayiko otukuka ndiwabwino komanso othandiza. Katundu wofunikira kuchokera kwa opanga odziwika ndiwotsika mtengo kwambiri.
Matenda a shuga a Mtundu Wachiwiri amadziwika chifukwa cha kuchepa kwa kapamba komanso kuchepa kwa ntchito ya maselo a beta, omwe ali ndi udindo wopanga insulin.
Kuchita izi sikungakhudze magazi a glucose. Izi zitha kumveka chifukwa cha glycated hemoglobin, yomwe imawonetsa kuchuluka kwa shuga m'miyezi 3 yapitayo.
Pafupifupi onse odwala matenda ashuga ayenera kusamala ndi nthawi zonse chizindikiritso chake. Ngati ichulukitsa malire a zonse (motsutsana ndi chithandizo cha mapiritsi a nthawi yayitali), ndiye njira yoyenera yosinthira makulidwe a insulin.
Achibale athu omwe ali ndi matenda a shuga, pitani jakisoni zaka 12 mpaka 15 atatha matendawa. Izi zimachitika pakuwonjezeka kwa shuga komanso kuchepa kwa hemoglobin ya glycated. Komanso kuchuluka kwa odwalawa kumawonjezera matendawa.
Madokotala amafotokozera njirayi mwakulephera kukwaniritsa miyezo yapadziko lonse lapansi, ngakhale kuli kwina kwamakono kwamakono. Chimodzi mwazifukwa zazikulu izi ndi kuwopa odwala matenda ashuga a jekeseni a moyo.
Ngati wodwala yemwe ali ndi matenda osokoneza bongo sakudziwa kuti insulin ndiyabwino, akukana kusintha jakisoni kapena kusiya, ndiye kuti amakhala ndi shuga wambiri. Mkhalidwe wotere ungayambitse kukula kwa zovuta pa thanzi ndi moyo wa munthu wodwala matenda ashuga.
Ma hormone osankhidwa bwino amathandizira kuti wodwalayo akhale ndi moyo wathunthu. Chifukwa cha zida zamakono zapamwamba zomwe zingagwiritsidwenso ntchito, zidatha kuchepetsa kusasangalala komanso kupweteka kuchokera ku jakisoni.
Gulu lachiwiri la mahomoni omwe amaperekedwa kwa odwala matenda ashuga ndi ambiri omwe amakhala ndi insulini. Kuyambitsa kwawo ndikofunikira kwambiri. Kupatula apo, thupi mwachilengedwe limazindikira kuti mankhwalawa, omwe ali ofanana ndi zochitika zachilengedwe. Mahomoni m'thupi lathanzi samapangidwa nthawi yomweyo - mulingo wake m'magazi umasungidwa pamlingo woyenera. Kuchita insulin kwa nthawi yayitali kumakuthandizani kuti muwonjezere mwayi wolowa m'malo mwa mankhwalawa. Anthu odwala matenda ashuga amatchulanso cholinga "mawu oyang'anira maziko."
Insulin yochepa imapezeka m'njira ziwiri:
- Potengera ma genetic, mahomoniwa amapangidwa ndi mabakiteriya.
- 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.
Ndikotheka kuphatikiza insulin "Epidera", koma mosamala komanso kukambirana ndi adokotala. Mankhwala ena amakhudza kagayidwe kazakudwala, ndichifukwa chake kusintha kwa Apidra kumafunikira. Kuphatikiza kwa insulin ndi mankhwala otchulidwa patebulo kumatha kuwonjezera kapena kuchepetsa mwayi wokhala ndi hypoglycemia.
| Zotsatira za Insulin | Mankhwala |
| Kuchulukitsa | Propoxifene |
| Pentoxifylline | |
| Monoamine Oxidase Inhibitors | |
| "Fluoxetine" | |
| Hypoglycemic mankhwala amkamwa | |
| ACE zoletsa | |
| "Disopyramides" | |
| Fenofibrate ndi mankhwala ena okhala ndi ma fiber | |
| ACE zoletsa | |
| Kuchepa | Corticosteroids |
| Danazol | |
| Diazoxide | |
| Zodzikongoletsera | |
| Isoniazid | |
| Ma estrogens ndi progestogen omwe amapanga njira zakulera za mahomoni | |
| Somatropin | |
| Mahomoni a chithokomiro |
Ma insulin omwe amagwira ntchito mwachidule amakhala osungunuka ndipo amatha kusintha mwachangu momwe kagayidwe kachakudya mthupi la munthu kamalumikizana ndi mayamwidwe a glucose. Mosiyana ndi ma insulin omwe amakhala nthawi yayitali, kukonzekera kwakanthawi kwamahomoni kumakhala ndi njira yofananira yokhala ndi mahomoni omwe mulibe zowonjezera zina. Chowoneka mosiyanitsa ndi mankhwalawa ndikuti amayamba kugwira ntchito mwachangu ndipo m'nthawi yochepa amatha kutsitsa shuga m'magazi kuti akhale abwinobwino.
- Ochita zinthu mwachidule amaika ntchito mphindi 30 pambuyo pa kutsata. Amalimbikitsidwa kuti asatengedwe pasanathe theka la ola musanadye.
- Ultrashort amaika inshuwaransi yomwe imayamba kugwira ntchito patatha ola limodzi. Mankhwalawa amalimbikitsidwa kumwa pafupifupi mphindi 5 mpaka 10 asanadye kapena atangodya.
Pa tebulo pansipa, kufanizira, kufunika kwa kuthamanga ndi kutalika kwa zochita zamitundu mitundu yamahisitala amakhudzidwa. Mayina a mankhwalawa amaperekedwa mosasamala, popeza pali mitundu yayikulu ya mitundu yawo.
| Mtundu wa insulin | Chitsanzo cha mankhwala osokoneza bongo | Kuyambika mukamayambitsa | Nthawi yantchito yayitali | Kutalika kwa nthawi |
| Ultra lalifupi | Humalog, Novorapid, Apidra | 5-15 mphindi | Kuyambira theka la ola mpaka maola awiri | 3 mpaka 4 maola |
| Mwachidule | Actrapid NM, Humulin R, Insuman, Rapid | Mphindi 30 | 4 mpaka 2 maola | 6 - maola 8 |
| Kutalika kwapakati | Protafan NM, Humulin NPH, Insuman, Bazal | 1-1,5 maola | 4 mpaka 10 maola | Maola 12-16 |
| Kuchita motalika | Lantus | Ola limodzi | Zosafotokozedwa | Maola 24 - 30 |
| Levemire | Maola awiri | 16 - 20 maola |
Apidra Solostar: malangizo ogwiritsira ntchito
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.
| 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).
Kuti mudziwe insulin yabwino kwambiri kwa wodwala winawake, ndikofunikira kusankha mankhwala oyambira. Pofuna kutsimikizira kupanga basal, nthawi zambiri amagwiritsa ntchito kukonzekera kwa insulin yayitali. Tsopano makampani opanga mankhwala amapanga mitundu iwiri ya insulin:
- nthawi yayitali, kugwira ntchito mpaka maola 17. Mankhwalawa akuphatikizapo Biosulin, Insuman, Gensulin, Protafan, Humulin.
- nthawi yayitali kwambiri, zotsatira zawo zimakhala mpaka maola 30. Awa ndi: Levemir, Tresiba, Lantus.
Ndalama za insulini Lantus ndi Levemir ali ndi kusiyana kwakukulu kwa insulini zina. Kusiyana kwake ndikuti mankhwalawa ndiwowonekera bwino ndipo ali ndi nthawi yayitali yogwira wodwala yemwe ali ndi matenda ashuga. Mtundu woyamba wa insulin uli ndi tint yoyera komanso mtundu wina wamafinya, chifukwa chake mankhwalawo ayenera kugwedezeka asanagwiritse ntchito.
Pogwiritsa ntchito mahomoni a nthawi yayitali, nthawi zapamwamba zimatha kuwonedwa mu kupsinjika kwawo. Malangizo a mtundu wachiwiri alibe chochitika ichi.
Mlingo wa kukonzekera kwa insulin yayitali kuyenera kusankhidwa kuti mankhwalawa athetse shuga.
Chifukwa chofunikira kuti muchepetse kuyamwa pang'onopang'ono, insulin yayitali imathandizidwa pansi pa khungu la ntchafu kapena matako. Mwachidule - pamimba kapena mikono.
Jakisoni woyamba wa insulin yayitali amachitika usiku ndi miyeso ya shuga yotengedwa maola atatu aliwonse. Pofuna kusintha kwakukulu kuzowonetsa glucose, kusintha kwa mankhwalawa kumapangidwa. Kuti mudziwe zomwe zimayambitsa kuchuluka kwa shuga usiku, ndikofunikira kuti muphunzire nthawi yayitali pakati pa 00.00 ndi 03.00. Ndi kuchepa kwa magwiridwe, mlingo wa insulin usiku uyenera kuchepetsedwa.
Molondola kwambiri, kuchuluka kwa insulin kofunikira kungadziwike pokhapokha ngati pali shuga komanso chifuwa chachikulu cha insulin m'magazi. Chifukwa chake, popenda insulin ya usiku, muyenera kukana chakudya chamadzulo.
Kuti mupeze chithunzi chothandiza kwambiri, simuyenera kugwiritsa ntchito insulin yochepa, simuyenera kudya mapuloteni kapena zakudya zamafuta
Kuti muzindikire mafuta oyambira masana masana, muyenera kuchotsa chakudya chimodzi kapena kudya tsiku lonse. Miyeso imapangidwa ola lililonse.
Musaiwale kuti mitundu yonse ya insulini, kuphatikiza Lantus ndi Levemir, ili ndi katulutsidwe kabwino. Mphindi yayitali kwambiri ya mankhwalawa imachitika pambuyo pa maola 6-8 kuchokera nthawi yoyendetsa. M'mawola awa, kutsika kwa shuga kumachitika, komwe kumakonzedwa ndikudya magawo a mkate.
Malingaliro oterowo ayenera kuchitidwa nthawi iliyonse akasinthidwa. Kuti mumvetsetse momwe shuga imakhalira mukupatsa mphamvu, kungoyesa masiku atatu ndikokwanira. Ndipo pokhapokha pazotsatira zomwe zapezeka, dokotala amatha kupereka mankhwala momveka bwino.
Kuti muwone mahomoni ofunikira masana ndi kuzindikira mankhwala abwino, muyenera kudikirira maola asanu kuchokera nthawi yomwe mumamwa chakudya chotsatira. Anthu odwala matenda ashuga omwe amagwiritsa ntchito insulin yochepa amayenera kupirira nthawi kuchokera maola 6. Gulu lama insulin lalifupi limayimiriridwa ndi Gensulin, Humulin, Actrapid. Ma insulin a Ultrashort akuphatikizapo: Novorapid, Apidra, Humalog.
Sizotheka kupereka yankho lenileni ku funso loti insulin ndiyabwino kwambiri. Koma pazotsatira za dokotala, mutha kusankha mlingo woyenera wa basal ndi insulin yochepa.
| Kupanga | |
| Mankhwala | Malingana ndi mfundo komanso mphamvu yogwira, glulisin imafanana ndi insulin yaumunthu, imaposa liwiro ndi nthawi yogwira ntchito. Apidra amachepetsa kuchuluka kwa shuga m'mitsempha yamagazi ndikulimbikitsa mayamwidwe ake ndi minofu ndi minyewa ya adipose, komanso amalepheretsa kuphatikizika kwa shuga ndi chiwindi. |
| Zizindikiro | Ntchito shuga kuti muchepetse shuga pambuyo chakudya. Mothandizidwa ndi mankhwalawa, hyperglycemia imatha kuwongoleredwa mwachangu, kuphatikiza ndi zovuta za matenda ashuga. Itha kugwiritsidwa ntchito mwa odwala onse kuyambira azaka 6, ngakhale atakhala kuti ndi amuna kapena akazi komanso kulemera. Malinga ndi malangizo, insulin Apidra imaloledwa kwa okalamba omwe ali ndi hepatic komanso aimpso komanso osakwanira. |
| Contraindication | |
| Malangizo apadera |
|
| Mlingo | Mlingo wofunikawo umatsimikizika poyerekeza kuchuluka kwa chakudya chamagulu ndi chakudya komanso zinthu zina zomwe zimasinthidwa ndi zigawo za insulin. |
| Zosafunika | |
| Mimba ndi GV | |
| Kuyanjana kwa mankhwala | |
| Kutulutsa Mafomu | |
| Mtengo | Ma phukusi omwe ali ndi zolembera za syringe ya Apidra SoloStar amatenga ma ruble 2100, omwe amafananizidwa ndi analogues apafupi kwambiri - NovoRapid ndi Humalog. |
| Kusunga | Alumali moyo wa Apidra ndi zaka 2, bola nthawi yonseyi adasungidwa mufiriji. Kuti muchepetse chiopsezo cha lipodystrophy ndi ululu mu jakisoni, insulin imayatsidwa kutentha kwa chipinda musanagwiritse ntchito. Popanda kupeza dzuwa, kutentha mpaka 25 ° C, mankhwalawa amapezeka m'khola la syringe. |
| Zotsatira za pharmacological | Monga mitundu ina ya insulin, Humalog amachepetsa shuga m'magazi ndikulimbikitsa maselo am'mimba ndi chiwindi kuti agwire shuga. Zimawonjezeranso kuphatikiza mapuloteni ndipo zimalepheretsa kuwonongeka kwa minofu ya adipose. Mankhwalawa amachepetsa mphamvu ya shuga pambuyo pakudya mwachangu kuposa insulin yochepa. |
| Zizindikiro zogwiritsidwa ntchito | Lembani 1 ndi matenda a shuga a 2, momwe sizingatheke popanda kuchitira insulin. Ana amatha kutumikiridwa kuyambira azaka za 2-6. Kuti shuga yanu ikhale yolimba, onani nkhani "Chithandizo cha Matenda Aakulu a Matendawa mwa Akuluakulu ndi Ana" kapena "Insulin ya Type 2 Diabetes". Zindikiranso apa pamitundu iti ya insulin yamagazi yomwe imayamba kupatsidwa. |
| Contraindication | Hypersensitivity kwa yogwira mankhwala kapena othandizira zigawo zikuluzikulu za jakisoni. Kulephera kusankha kuchuluka kwa mankhwala amphamvu komanso othamanga a Humalog kuti mupewe zochitika zam'magazi ochepa a shuga (hypoglycemia). |
| Malangizo apadera | Kusintha kuchokera ku insulin ina kupita ku Humalog kuyenera kuchitika moyang'aniridwa ndi achipatala kuti apewe hypoglycemia yayikulu. Werengani momwe mungaphatikizire jakisoni wa insulin ndi mowa. Dziwani panonso za zinthu zomwe zimapangitsa chidwi cha thupi kuti chikhudze izi. Mvetsetsani momwe zochita zolimbitsa thupi, nyengo, kuzizira, nkhawa zimakhudzira. Kuyambira pobayira insulin ya ultrashort musanadye, pitilizani kupewa zakudya zoletsedwa. |
| Mlingo | Mlingo woyenera wa mankhwala a Humalog amasankhidwa mosiyanasiyana payekhapayekha kwa wodwala aliyense. Werengani nkhani yokhudza kuwerengera Mlingo wa insulin. Komanso werengani za "insulin management: momwe ndi momwe mungabayitsire". Kumbukirani kuti Humalog ndi wamphamvu kwambiri. Pangakhale kofunikira kuti muchepetse ndi saline yachilengedwe osati mwa ana, komanso odwala matenda ashuga akuluakulu. |
| Zotsatira zoyipa | Zotsatira zoyipa kwambiri ndizovuta za m'magazi (hypoglycemia). Mivuto yayikulu ikhoza kuyambitsa kukomoka komanso kufa. Komanso, kwa mankhwalawa Humalog ndi mawonekedwe ake, chiwopsezo ndichambiri. Ndi njira yolakwika yoyendetsera insulin, pakhoza kukhala lipohypertrophy pamalo opangira jakisoni. Thupi lawo siligwirizana nthawi zambiri silimachitika: redness, kuyabwa, kutupa, kutentha, kupumira, palpitations, thukuta. |
Analogs mwa chisonyezo ndi njira yogwiritsira ntchito
Insulin imalembedwa kuti imasinthasintha kuchuluka kwa shuga m'magawo osiyanasiyana a shuga. Zowonetsa kugwiritsa ntchito mahomoni ndi mitundu yotsatirayi yamatenda:
- Mtundu woyamba wa shuga wokhudzana ndi kuwonongeka kwa autoimmune ku maselo a endocrine komanso kukula kwa kuperewera kwathunthu kwa mahomoni,
- Mtundu Wachiwiri, womwe umadziwika ndi kusowa kwa insulini chifukwa cha chilema pakuphatikizika kwake kapena kuchepa kwa chidwi cha zotumphukira pazomwe zimachitika,
- matenda amishuga azimayi apakati
- kapamba mawonekedwe a matendawa, omwe amayamba chifukwa cha pancreatitis yovuta kapena yopweteka,
- Mitundu yopanda chitetezo cha matenda - matenda am'magazi a Wolfram, Rogers, MODY 5, matenda a neonatal shuga ndi ena.
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:
- Mtundu umodzi wa matenda ashuga.
- 2 mtundu wa matenda pomwe mankhwala ochepetsa shuga salinso othandizira.
- Matenda a shuga okhathamira okhala ndi glucose ambiri. Kwa gawo losavuta, jakisoni wa insulin yayitali nthawi zambiri amakhala yokwanira.
- Opaleshoni ya kapamba, yomwe idayambitsa kusokonekera kwa mahomoni.
- Chithandizo cha pachimake zovuta za matenda ashuga: ketoacidotic ndi hyperosmolar coma.
- Nthawi yochulukirapo ya insulin: Matenda otentha kwambiri, vuto la mtima, kuwonongeka kwa ziwalo, kuvulala kwambiri.
Insulin glulisin tikulimbikitsidwa mosamala odwala omwe ali ndi vuto la chiwindi. Izi ndichifukwa choti ndi ntchito yolakwika ya chiwindi, kufunika kwa insulini kumachepetsedwa chifukwa cha kufupika kwa glucogeneis. Ndi zoletsedwa kugwiritsa ntchito "Apidra" ndi vuto la kukopeka kapena kale shuga wochepa m'magazi. Ngati wodwala sagwirizana ndi zomwe zikuthandizira kapena zothandiza pazothetsera vutoli, ndibwino kusiya kugwiritsa ntchito mankhwalawo. Pankhaniyi, mutha kupitiliza mankhwala pogwiritsa ntchito Novorapid ndi ma analogu ena.
Ngati Mlingo womwe dokotala watchulidwa sukwaniritsidwa, Apidra ikhoza kuyambitsa vuto la hypoglycemia ndi zovuta zina, kuphatikizapo:
- kutopa,
- kumangokhala wotopa ndi kufooka,
- kulephera kuyang'ana pa ntchito, zochitika,
- zovuta zamawonedwe
- kufunitsitsa kosagona,
- mutu
- kulumikizana.
Mankhwalawa sayenera kuperekedwa ngati pali kapena akukayikira hypoglycemia. Kuphatikiza apo, ziyenera kukumbukiridwa kuti nthawi zina, ngakhale kawirikawiri, odwala ena amatha kukumana ndi insulini kapena ziwalo zina za Novorapid insulin (metacresol, phenol, glycerol, sodium hydrogen phosphate dihydrate, zinc chloride, etc.). Muyeneranso kuganizira kuthekera kwa tsankho kwa insulin.
Mankhwala okhala ndi insulin Apidra Solostar sagwiritsidwa ntchito kuwonetsa hypoglycemia ndikuwonjezereka kwa magawo a mankhwala.
Mukamagwiritsa ntchito mankhwala ena a insulin ochokera kwa wopanga wina, muyenera kuwongolera chithandizo chamankhwala omwe amachokera kwa dokotala yemwe akupezekapo, chifukwa kufunika koti mugwiritse ntchito mankhwalawa sikungatheke. Mungafunike kusintha chiwembu cha hypoglycemic mankhwalawa pakamwa.
Kutsiliza kwa mankhwala othandizira kapena kugwiritsa ntchito mankhwala osokoneza bongo okwanira, makamaka mwa anthu omwe ali ndi matenda ashuga, kumatha kuyambitsa matenda a shuga komanso matenda a hypoglycemia.
Nthawi yopezeka ya hypoglycemia ikukhudzana mwachindunji ndi kuchuluka kwa chitukuko cha hypoglycemic kuchokera ku mankhwala omwe amagwiritsidwa ntchito, amatha kusintha ndi kusintha kwa chithandizo cha antidiabetesic.
Zina zomwe zimatha kuchepetsa zovuta za hypoglycemia, zimaphatikizapo:
- Njira yayitali ya matenda a shuga
- Kwambiri insulin mankhwala
- Kukula kwa matenda a shuga
- Kugwiritsa ntchito mankhwala angapo (mwachitsanzo, β-blockers).
Kusintha kwa mlingo wa insulin Apidra Solostar kumachitika ndi kuwonjezeka kwa zochitika zolimbitsa thupi kapena kusintha kwa zakudya za tsiku ndi tsiku.
Pankhani ya kuchuluka zolimbitsa thupi mutatha kudya, mwayi wokhala ndi hypoglycemia ukuwonjezeka. Kuchita insulin mwachangu kungayambitse hypoglycemia.
Zizindikiro zosafupika za hypo- ndi hypoglycemic zimayambitsa kupezeka kwa matenda a shuga, chikomokere, kapena kutsogolo kwa imfa.
Ndi kusintha kwa mkhalidwe wamalingaliro, kukula kwa matenda ena, pangafunikire kusintha mlingo wa mankhwala okhala ndi insulin.
Mukamagwira ntchito mosamala, magalimoto oyendetsa, chiopsezo chokhala ndi hypo- ndi hyperglycemia chikuwonjezeka, choncho muyenera kusamalidwa mwapadera.
Mtundu wabwino kwambiri wa insulin
Mankhwala a gululi atha kugawidwa m'magulu awiri: yokumba komanso yachilengedwe. Yoyamba imapangidwa mu labotore kuphatikiza chinthu chachikulu chogwira ntchito ndi zina zowonjezera zomwe zimathandizira kuchepa kwamphamvu kwa glucose wamagazi.
Ma hormone achilengedwe a endocrine dongosolo amapangidwa mwa munthu kapena nyama. Mitundu yabwino kwambiri ya insulin imatha kufotokozedwa ndi kutalika kwa zochita zake:
- Ultrashort - mankhwalawa amayamba kugwira ntchito atangolowa m'magazi, ndipo nthawi yawo yothandizira ndi maola 3-4. Ubwino wa mankhwalawa ndikuti umatengedwa ndi thupi mwachangu, ndipo jakisoni imodzi yokhazikika imakhala yolimba kwambiri.
- Pafupifupi - mahomoni a gululi amayamba kugwira ntchito mphindi 15 mpaka 20 atakwanitsidwa ndi thupi, ndipo kuchuluka kwa mankhwalawa sikupitilira maola 6. Homoni yamtunduwu imakhala yosavuta kugwiritsa ntchito kwa odwala omwe ali ndi moyo wokangalika ndipo sangathe kulinganiza bwino dongosolo la tsikulo.
- Yapakatikati - yokhazikika, koma yochedwa kulowa m'magazi, yomwe imatenga nthawi yayitali. Kutalika kwa mankhwalawa kumatenga maola 12.
- Kutalika - mahomoni amtunduwu amapatsa wodwala kuchuluka kwa insulin kwa maola 24-36. Choyipa chachikulu cha mankhwalawa ndikuti chinthu chokhacho chimayamba kugwira ntchito patatha maola 1-2 pambuyo pa jekeseni.
Kodi insulin yabwino kwambiri ndi iti?
Makampani amakono azamalonda amapatsa mitundu yambiri ya insulin, omwe ali m'gulu la mankhwala omwe ali mgulu lawo.
Aliyense wa iwo ali ndi zabwino zake komanso zovuta zake malinga ndi momwe zimakhudzira odwala matenda ashuga. Mitundu yotsatirayi ya mankhwalawa imasiyanitsidwa yomwe imakhudza thupi la odwala matenda ashuga komanso imasunganso kuchuluka kwa glucose m'magazi:
- Humalog ndi mahashoni a ultrashort omwe ali ndi mankhwala ofanana ndi insulin yaumunthu, yodziwika ndi kuchuluka kwa magazi (mphindi 15), komanso nthawi yokhazikika pamatumbo kuyambira theka la ola mpaka maola 2 (chiwerengero cha mankhwala chimatsimikiziridwa ndi dokotala yekhayo),
- Actrapid - ali ndi nthawi yayitali yothandizirana, kuyambika kwa mankhwala ophatikizidwa patatha mphindi 30 pambuyo pa jekeseni wosanjikiza, ndipo mphamvu yake ya mankhwalawa imawonekera patangotha maola 1 mpaka jekeseni (kutalika kwa maola 6 mpaka 8 popanda chiopsezo cha hypoglycemia),
- Protafan - amatanthauza gulu la mankhwala omwe amakhala ndi nthawi yayitali yochita zinthu, wofanana ndi insulin yaumunthu, kulowa pansi pakhungu kumayamba kulowetsedwa m'magazi 1-1.5 pambuyo pa jakisoni (mphamvu yayitali ikuwonekera mu nthawi kuyambira maola 4 mpaka 12, ndipo kutalika konse kwa kuchitapo ndi 16 -Maola 24)
- Lantus ndi mankhwala a mahomoni omwe amakhala ndi nthawi yochedwa kuphulika kwa mamolekyulu a shuga, amayamba kugwira ntchito ola limodzi pambuyo pa kupangika, amamizidwa pang'onopang'ono, chifukwa chake sichiyambitsa kutentha msanga kwa glucose mutangotha jekeseni (nthawi yayitali kwambiri ya mankhwalawa imachokera maola 24 mpaka 30, koma imaperekedwa zosaposa nthawi 1 patsiku nthawi imodzi),
- Tresiba ndi mankhwala omwe amagwira ntchito kwa nthawi yayitali omwe amachititsa kuti azitha kuwongolera kuchuluka kwa shuga m'magazi kuyambira maola 24 mpaka 26, amavomerezedwa kuti azigwiritsidwa ntchito ndi achikulire ndi ana osaposa chaka chimodzi (chitetezo ndi kutsimikizika kwa insulin kwatsimikiziridwa ndi maphunziro azachipatala, ndipo mlingo umaperekedwa pokhapokha panjira yodutsa).
Kusankha imodzi mwamankhwala abwino komanso othandiza kwambiri ndi gawo lofunikira mu maphunziro onse azachipatala. Ndikofunikira kufunsa endocrinologist kuti muthandizire kusankha payekha mtundu wa insulin, mulingo komanso kuchuluka kwa jakisoni wa tsiku lililonse kwa wodwala aliyense payekhapayekha.
Matenda a shuga nthawi zonse amayambitsa zovuta zakupha. Mwazi wamagazi ochulukirapo ndi woopsa kwambiri.
Aronova S.M. adafotokoza za chithandizo cha matenda ashuga. Werengani kwathunthu
Zotsatira zoyipa
Mankhwala osankhidwa moyenera ndi mlingo wake pafupifupi sizipangitsa kukhalapo kwa mavuto. Komabe, pali zochitika zina pamene insulin yokha siyili yoyenera kwa munthu, ndipo pamenepa mavuto ena angabuke.
Kupezeka kwa zotsatira zoyipa mukamagwiritsa ntchito insulin nthawi zambiri kumayenderana ndi kupezeka kwa mankhwala osokoneza bongo, kosayenera pakukonzekera kapena kusungidwa kwa mankhwalawa
Nthawi zambiri, anthu amasintha okha pawokha, ndikuwonjezera kapena kuchepetsa kuchuluka kwa insulini, zomwe zimapangitsa kuti ziwonetsero zomwe sizingachitike. Kuchulukitsa kapena kutsika kwa mankhwalawa kumabweretsa kusinthasintha kwa shuga wamagazi mbali imodzi kapena imodzi, mwakutero kukulitsa kukula kwa hypoglycemic kapena hyperglycemic coma, yomwe imatha kubweretsa mwadzidzidzi.
Vuto lina lomwe odwala matenda ashuga nthawi zambiri amakumana nalo ndi zovuta zomwe zimachitika, zomwe zimachitika kawirikawiri chifukwa cha insulini yoyambira nyama. Zizindikiro zawo zoyambirira ndizowoneka ngati kuyabwa ndi kuwotcha pamalo a jekeseni, komanso khungu la khungu ndi kutupa kwawo.
Atrophy ya adipose minofu ndi vuto lofanananso kwa odwala matenda ashuga ndi kugwiritsa ntchito insulin nthawi yayitali. Izi zimachitika chifukwa chakuwongolera pafupipafupi kwa insulin pamalo amodzi. Izi sizimayambitsa mavuto ambiri kuumoyo, koma malo omwe jakisoni amayenera kusinthidwa, popeza mulingo wawo wolowetsa umakhala wolakwika.
Pogwiritsa ntchito insulin kwa nthawi yayitali, mankhwala osokoneza bongo amathanso kuchitika, omwe amawonetsedwa ndi kufooka kwa mutu, kupweteka mutu, kutsika kwa magazi, ndi zina zambiri. Pankhani ya mankhwala osokoneza bongo, ndikofunikira kufunsa dokotala nthawi yomweyo.
Mwachidule
Pansipa tikambirana mndandanda wa mankhwala omwe amapezeka ndi insulin omwe amagwiritsidwa ntchito nthawi zambiri pochiza matenda a shuga. Amaperekedwa pazidziwitso zokhazokha, simungathe kuzigwiritsa ntchito popanda chidziwitso cha dokotala mulimonse. Kuti ndalamazo zigwire bwino ntchito, ziyenera kusankhidwa mokhazikika!
Yabwino kwambiri yochezera pang'ono insulin. Muli insulin yaumunthu. Mosiyana ndi mankhwala ena onse, imayamba kuchita zinthu mwachangu kwambiri. Pambuyo pakugwiritsidwa ntchito, kuchepa kwa shuga m'magazi kumawonedwa pambuyo pa mphindi 15 ndipo kumakhalabe m'malo ena owonekera kwa maola ena atatu.
Humalog mu mawonekedwe a cholembera
Zizindikiro zazikulu pakugwiritsira ntchito mankhwalawa ndi izi:
- shuga wodalira matenda a shuga
- Matupi awo sagwirizana ndi insulin ina.
- hyperglycemia
- kukana kugwiritsa ntchito mankhwala ochepetsa shuga,
- shuga wodalira insulin asanafike opaleshoni.
Mlingo wa mankhwalawa amasankhidwa payekha. Kumayambiriro kwake kumatha kuchitika pang'onopang'ono komanso m'njira zamitsempha. Komabe, kupewa mavuto kunyumba, tikulimbikitsidwa kupatsana mankhwala pokhapokha musanadye.
Mankhwala osokoneza bongo amakono, kuphatikiza Humalog, ali ndi zotsatira zoyipa. Ndipo pankhaniyi, mwa odwala ndi momwe amagwiritsidwira, mankhwalawa nthawi zambiri amapezeka, kuchepa kwa masomphenya, matupi ndi milomo.
Kuti mankhwala azigwira ntchito pakapita nthawi, ayenera kusungidwa bwino. Ndipo izi ziyenera kuchitidwa mufiriji, koma siziyenera kuloledwa kuziziritsa, chifukwa pamenepa malonda amataya katundu wake wochiritsa.
Insuman Rapid
Mankhwala enanso okhudzana ndi ma insulin osankha mwachidule kutengera timadzi ta munthu. Mphamvu ya mankhwalawa imafika pachimake patatha mphindi 30 kuchokera pakukonzekera ndipo imapereka chithandizo chokwanira kwa thupi kwa maola 7.
Insuman Rapid ya subcutaneous makonzedwe
Chochita chimagwiritsidwa ntchito mphindi 20 musanadye chilichonse. Pankhaniyi, tsamba la jakisoni limasintha nthawi iliyonse. Simungapereke jakisoni m'malo awiri. Ndikofunikira kuti musinthe nthawi zonse. Mwachitsanzo, nthawi yoyamba imachitika m'chigawo chamapewa, chachiwiri m'mimba, chachitatu pamphaka, etc. Izi zimapewe kuwonongeka kwa minofu ya adipose, yomwe wothandizirayo amakwiya.
Biosulin N
Mankhwala osokoneza bongo omwe amalimbikitsa chinsinsi cha kapamba. Ili ndi mahomoni ofanana ndi anthu, omwe amalekeredwa mosavuta ndi odwala ambiri ndipo samasangalatsa kwambiri mawonekedwe.
Zingachitike kuti munthu atalowetsa mankhwalawa ndi mankhwala ofanana, ndiye kuti akhoza kudwala hypoglycemia. Zinthu monga kupsinjika kwambiri kapena kudya zakudya zodumphadwala kumatha kuyambitsa kuwonekera kwake atagwiritsidwa ntchito ndi Biosulin N. Chifukwa chake, ndikofunikira kwambiri poigwiritsa ntchito kuyeza miyezo ya shuga ya magazi nthawi zonse.
Gensulin N
Zimatanthauzanso ma insulin apakati omwe amawonjezera kupanga kwa ma pancreatic. Mankhwalawa amaperekedwa mosavuta. Kugwiranso ntchito kwake kumapezekanso ola limodzi pambuyo pa kukhazikitsa ndipo kumatenga maola.
Zosiyanasiyana zamankhwala Gensulin
Insulin yayitali, yomwe imagwiritsidwa ntchito kuwonjezera pancreatic insulin secretion. Zovomerezeka kwa maola. Mphamvu yake yokwanira imatheka patadutsa maola awiri pambuyo pa makonzedwe.
Mankhwala ena omwe akhala akuchita kwa nthawi yayitali omwe amagwiritsidwa ntchito mwachangu kuchepetsa shuga m'magazi a shuga. Kuchita kwake kumakwaniritsidwa patatha maola 5 mutatha kuyang'anira ndipo kumapitilira tsiku lonse.
Makhalidwe a mankhwalawa, omwe amafotokozedwa patsamba lovomerezeka la wopanga, akuwonetsa kuti mankhwalawa, mosiyana ndi kukonzekera kwina kwa insulin, amatha kugwiritsidwa ntchito ngakhale mwa ana opitirira zaka 2.
Pali zokonzekera zambiri za insulin. Ndipo kunena kuti ndi yabwino kwambiri ndizovuta kwambiri. Tiyenera kumvetsetsa kuti chamoyo chilichonse chimakhala ndi zake ndipo m'njira zake zimagwirizana ndi mankhwala ena ake. Chifukwa chake, kusankha kwa insulin kukonzekera kuyenera kuchitika payekha komanso kokha ndi dokotala.
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Chithandizo cha matenda a shuga ndi wowerengeka azitsamba a mabulosi
Mabulosi ndi njira yabwino kwambiri yothandiza anthu pochiza matenda a shuga Mabulosi, kapena mabulosi ndi njira yothetsera matenda yomwe yakhala ikugwiritsidwa ntchito kwa nthawi yayitali kuti muchepetse matenda komanso matenda oopsa monga matenda a shuga. ... -
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