Insulin yayitali: mayina ndi mitundu ya mankhwala

Tikukulimbikitsani kuti mudziwe bwino za nkhaniyi pamutuwu: "insulin yayitali ya dzina la mankhwalawa" ndi ndemanga zochokera kwa akatswiri. Ngati mukufuna kufunsa funso kapena kulemba ndemanga, mutha kuchita izi pansipa, nkhaniyo itatha. Katswiri wathu wamtundu wa endoprinologist adzakuyankhirani.

Amachita insulin kwa nthawi yayitali: mayina, mtengo, analogi mankhwala

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

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

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

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

Mulimonsemo, mankhwalawa amtundu wa 1 amaphatikizidwa ndi jakisoni afupiafupi kapena owonjezera-a insulin. Jekeseni wambiri wa insulin amachitidwa m'mawa pamimba yopanda kamodzi, patsiku, zosakwana awiri.Mankhwala amayamba kuchita pambuyo pa ola limodzi mpaka atatu, amagwira ntchito kuyambira maola 12 mpaka 24.

Milandu pakakhala kofunikira kuti mupereke insulin yayitali:

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

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

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

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

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

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

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

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

Zowunikira mitundu yapamwamba kwambiri ya insulin yokhala ndi tebulo

Ma insulin omwe akhala akuchita kwakanthawi amatha kukhala ndi shuga m'magazi tsiku lonse lililonse odwala matenda ashuga. Pankhaniyi, kuchepa kwa kuchuluka kwa shuga mu plasma kumachitika chifukwa cha kuyamwa kwake ndi minofu ya thupi, makamaka chiwindi ndi minofu. Mawu akuti "yaitali" a insulin amawonetsa kuti kutalika kwa zotsatira za jakisoni wotere, poyerekeza ndi mitundu ina ya mankhwala ochepetsa shuga, ndi yayitali.

Insulin yochita ntchito kwa nthawi yayitali imamasulidwa mwanjira yothetsera kapena kuyimitsidwa kwamkati ndi mtsempha wamitsempha. Mwa munthu wathanzi, timadzi timeneti timapangidwa mosalekeza ndi kapamba. Kutalika kwa mahomoni kunapangidwa kuti kuyerekezera zomwezo mwa anthu omwe ali ndi matenda ashuga. Koma jakisoni wowonjezera amakhala woponderezedwa mwa odwala omwe ali ndi matenda ashuga kapena oyipa.

Pakalipano, zinthu zazitali komanso zazitali ndizofunikira:

Amayendetsedwa pambuyo pa mphindi 60, mphamvu kwambiri imatheka pambuyo pa maola 2-8. Amalamulira kuchuluka kwa glucose m'magazi 18-20 maola.

Kuyimitsidwa kwawonjezera mtundu wa sc. Amagulitsidwa m'mabotolo a 4-10 ml kapena makatiriji a 1.5-3.0 ml kwa ma cholembera a syringe.

Imayamba kugwira ntchito pasanathe maola 1-1.5. Kuchita bwino kwambiri kumawonekera pambuyo pa 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.Matha maola 11 mpaka 24, mphamvu kwambiri imachitika munthawi ya maola 4-12.

Insulin yowonjezera kuti ikwaniritse sc. Wopezeka m'mabotolo atatu a 3 ml, m'mabotolo 5 ml ndi makilogalamu 3 ml a ma syringe pensulo.

Insulin yayitali imayambitsidwa mkati mwa maola 1.5. Kuchuluka kwa zochitika kumachitika pakati pa maola 3-10. Nthawi yayitali yochita ndi tsiku.

Njira / ntchito. Amazindikira m'mathumba ogwiritsira ntchito ma syringe a 3 ml, m'mabotolo a 10 ml.

Amayamba kuchita mphindi 60 pambuyo pa jekeseni, amawongolera kuchuluka kwa shuga m'magazi osachepera tsiku.

Ma cartridges ndiofala komanso kwa 3 ml syringe zolembera, mu 10 ml mbale za sc management.

Chiwopsezo cha ntchito chimachitika pambuyo pa maola 3-4. Kutalika kwa mphamvu ya wothandizira nthawi yayitali ndi maola 24.

Insulin yotalikilapo imadziwika m'mapensulo a 3 ml.

Dzina la hypoglycemic mankhwala ndi momwe mungagwiritsire ntchito insulin yowonjezereka ikhoza kuvomerezedwa ndi adokotala.

Kuphatikiza apo, anthu omwe akudwala matenda ashuga sayenera kulowetsa m'malo mwake ndi analogue yomwe idatenga nthawi yayitali. Thupi lokhala ndi mahomoni ena liyenera kufotokozedwa moyenera monga lingaliro lazachipatala, ndipo chithandizo chamankhwala chiyenera kuchitidwa kokha moyang'aniridwa ndi dokotala.

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

1. Sulfonylurea.
2. Meglitinides.
3. Biguanides.
4. 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 kuti akwaniritse zotsatira zoyambira, kupezeka kwa insulini kumaperekedwa kawiri pa tsiku, ndipo yayitali - kamodzi patsiku, kusintha kwa mankhwalawa sabata yoyamba kumatha kupangitsa kukhalanso kwa hypoglycemia ya m'mawa kapena usiku. Mutha kuwongolera vutoli pochepetsa kuchuluka kwa mankhwala ochulukitsidwa ndi 30%, omwe amakwanira pang'ono chifukwa chosowa kwa nthawi yayitali pogwiritsa ntchito insulin yokhala ndiifupi. 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 insulini 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.

Posachedwa, mitundu iwiri yatsopano, yayitali-yochita, yovomerezedwa ndi FDA, yakhazikitsidwa kale pamsika wamankhwala othandizira odwala matenda a shuga akuluakulu:

• Degludek (wotchedwa Tresiba).
• Ryzodeg FlexTouch (Ryzodeg).

Tresiba ndi mankhwala atsopano omwe amavomerezedwa ndi FDA

Kugwiritsa insulin Degludec kwa nthawi yayitali kuti apangire utsogoleri wokhazikika. Kutalika kwa malamulo a shuga ndimagazi pafupifupi 40. Kugwiritsidwa ntchito pochiza odwala matenda ashuga njira yoyamba ndi yachiwiri yamatenda. Kuti atsimikizire chitetezo ndi kugwiritsa ntchito mankhwala omwe atulutsidwa kumene, kafukufuku wina anachitika pomwe odwala opitilira 2,000 anachitapo kanthu. Degludec wagwiritsidwa ntchito ngati cholankhulira pakamwa.

Mpaka pano, kugwiritsa ntchito mankhwala a Degludec ndikuloledwa ku EU, Canada ndi USA. Mumsika wam'nyumba, chitukuko chatsopano chidawonekera pansi pa dzina la Tresiba. Kuphatikizikako kumazindikira mbali ziwiri: 100 ndi 200 U / ml, mwa cholembera. Tsopano ndikotheka kusintha kuchuluka kwa shuga m'magazi mothandizidwa ndi wothandizila kwa nthawi yayitali mwa kugwiritsa ntchito yankho la insulin katatu kokha pa sabata.

Timalongosola kukonzekera kwa Ryzodeg. Wothandizira kutulutsidwa kwa Ryzodeg ndi kuphatikiza kwamahomoni, mayina awo omwe amadziwika bwino ndi odwala matenda ashuga, monga basal insulin Degludec ndi Aspart wachangu (70:30 ratio). Zinthu ziwiri zokhala ndi insulin m'njira inayake zimalumikizana ndi ma insulin receptors am'mbuyomu, chifukwa amazindikira zawo zamankhwala zimafanana ndi insulin.

Chitetezo ndikuyenda bwino kwa mankhwala omwe apangika kumenewo kwatsimikiziridwa ndikuyesa kwachipatala komwe odwala matenda ashuga 360 adatenga nawo mbali.

Ryzodeg adatengedwa limodzi ndi chakudya china chotsitsa shuga. Zotsatira zake, kutsika kwa shuga m'magazi kunakwaniritsidwa mpaka komwe m'mbuyomu kukanatheka kokha pogwiritsa ntchito insulin yokonzekera.

Mankhwala okhazikika a mahomoni Tresiba ndi Ryzodeg amatsutsana mwa anthu omwe ali ndi vuto lalikulu la matenda ashuga. Kuphatikiza apo, mankhwalawa, monga fanizo omwe takambirana pamwambapa, ayenera kuyikidwa ndi adokotala okha, chifukwa chake mavuto ena omwe amadza chifukwa cha hypoglycemia ndi mitundu mitundu ya ziwengo sizingapewe.

Kodi insulin lantus ndi chiyani

Posachedwa, mahomoni ambiri opanga anali ndi nthawi yayitali yogwira ntchito mthupi (pafupifupi maola 12-16), anali ndi chiwopsezo chodabwitsa kwambiri. Lingaliro loterolo limakakamiza odwala kusintha dongosolo la moyo wawo kuti agwirizane ndi machitidwe a mankhwalawo, kukonza chakudya, kuchita masewera olimbitsa thupi kwa maola angapo.

Tsopano mndandanda woyamba wawonekera ndi kutalika kwa tsiku limodzi (maola 24). Chochititsa chachikulu cha insulin ndi kusakhalapo kwa pachimake pa zochitika, i.e. kutsanzira kwathunthu kwa masamba secretion, yomwe imachitika ndi kapamba wabwino. Mwayi wofunikira kwambiri - muyenera kulowa kamodzi kokha patsiku! Chifukwa chake, kuchuluka kwa jakisoni wautali kumachepera!

Limagwirira zake ntchito yaitali insulin

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

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

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

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

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

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

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

1. Insulin Glargine Lantus.
2. Chithandizo cha insulin

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

Pansipa pali malangizo atsatanetsatane ogwiritsira ntchito insulin Lantus.

Insulin yayitali ndi mankhwala omwe amagwiritsidwa ntchito nthawi yayitali kuti akhale athanzi lambiri la thupi kwa nthawi yayitali. Amatsanzira kupanga insulin ya basal ndi kapamba ndikulepheretsa kukula kwa gluconeogeneis.

Kukhazikitsa kwa timadzi tambiri timene timayang'aniridwa patatha pafupifupi maola 4 mutayamba kubaya. Peak okhutira ndi ofatsa kapena osakhalapo, khola la mankhwala ambiri limawonedwa kwa maola 8 - 8. Pakatha pafupifupi maola 28 mutakhazikitsa (kutengera mtundu wa mankhwala), ntchito yake imachepetsedwa mpaka zero.

Insulin yayitali simapangidwira kukhazikika kwa ma spikes mu shuga omwe amapezeka mutatha kudya. Imatsimikizira kuchuluka kwa kuthupi kwa mahomoni obisika.

Gulu la insulin

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).

Ma insulin afupia ndi a ultrashort amagwiritsidwa ntchito musanadye chakudya chilichonse kuti apewe kulumikizana ndi glucose komanso kusintha momwe mulili. .

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

Malangizo ogwiritsira ntchito mankhwalawa

Lantus Solostar 1 ml imakhala ndi insulin glargine mu kuchuluka kwa 3.63 mg, womwe ndi wofanana ndi 100 IU ya insulin ya munthu.

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

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

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

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

Mankhwala amakhudza thupi la wodwalayo:

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

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

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

Zotsatira zoyipa za insulin zimawonetsedwa makamaka pakukhazikitsa mlingo woyenera. Mitu ikuluikulu ndi:

• Hypoglycemia.
• Neuroglycopenia
• Malangizo oletsa Adrenergic.

Thupi lawo siligwirizana mu mawonekedwe a kuyabwa, kuwotcha ndi urticaria pamalo a jakisoni amathanso kuchitika. Chizindikiro cha komweko chimatha mpaka masiku asanu ndi awiri ndipo chimadzichitira chokha.

Malangizo apadera: mankhwalawa sayenera kusakanikirana ndi mitundu ina ya insulin, chifukwa Lantus ili ndi chilengedwe pH. Jekeseni amayenera kuperekedwa nthawi yomweyo, osadya. Kanema yemwe ali munkhaniyi akukuuzani amene amasankhidwa kuti akhale ndi insulin.

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.

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, chifukwa, pambuyo poti jekeseni wathandizidwa ndi antiseptic, ndikofunikira kudikirira mpaka kumira kwathunthu, kenako ndikupitilira ndi mankhwalawa. Ndikofunikanso kupatuka kuchokera pa malo omwe kale anali jekeseni osachepera 2 cm.

Njira yogwiritsira ntchito

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

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

Kubetcha insulin nkoletsedwa. Ndikofunikira kupukutira m'manja musanabale. Izi zimathandizira kuti pakhale kupangika kophatikizika kwa mankhwalawa ndikuwotcha nthawi yomweyo mankhwalawo kuchokera kutentha kwa manja.

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

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

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

Samalani

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

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

Kodi anthu odwala matenda ashuga amatani? Endocrinology Research Center ya ku Russia Academy of Medical Sayansi idachita bwino

Insulin yayitali: limagwirira ntchito, mitundu ya mankhwala, njira yogwiritsira ntchito

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

Insulin yayitali ndi mankhwala omwe amagwiritsidwa ntchito nthawi yayitali kuti akhale athanzi lambiri la thupi kwa nthawi yayitali. Amatsanzira kupanga insulin ya basal ndi kapamba ndikulepheretsa kukula kwa gluconeogeneis.

Kukhazikitsa kwa timadzi tambiri timene timayang'aniridwa patatha pafupifupi maola 4 mutayamba kubaya. Peak okhutira ndi ofatsa kapena osakhalapo, khola la mankhwala ambiri limawonedwa kwa maola 8 - 8. Pakatha pafupifupi maola 28 mutakhazikitsa (kutengera mtundu wa mankhwala), ntchito yake imachepetsedwa mpaka zero.

Insulin yayitali simapangidwira kukhazikika kwa ma spikes mu shuga omwe amapezeka mutatha kudya. Imatsimikizira kuchuluka kwa kuthupi kwa mahomoni obisika.

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

Kugwiritsa ntchito insulin yayitali pakulimbikitsidwa pazisonyezo izi:

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

Insulin yokhala ndi nthawi yayitali imapezeka mu mawonekedwe a kuyimitsidwa kapena mayankho a jakisoni. Mothandizidwa ndi subcutaneally, mankhwalawa amakhalabe mu minofu ya adipose kwakanthawi, pomwe pang'onopang'ono ndikuyamba kulowa m'magazi.

Kuchuluka kwa mahomoni kumatsimikiziridwa ndi dokotala aliyense payekha kwa wodwala aliyense. Kupitilira apo, wodwalayo amatha kuwerengetsa payekha payekha payekha kutengera zomwe amalimbikitsa. Mukasintha kuchokera ku insulin ya nyama ndikupanga munthu, ndikofunikira kusankha kachiwiri. Posintha mtundu wina wa mankhwala ndi wina, kuyang'anira kwa dokotala ndikuwunika pafupipafupi kwa kuchuluka kwa shuga m'magazi ndikofunikira. Ngati mukusintha, mlingo womwe waperekedwa umapitilira mayunitsi 100, wodwalayo amatumizidwa kuchipatala.

Jakisoni amachitidwa mosazindikira, nthawi iliyonse kupita kumalo ena. Jakisoni wa insulin amatha kuchitika mu minofu ya triceps, m'dera loyandikana ndi navel, kumtunda kwakunja kwa minofu ya gluteal kapena kumtunda kwa anterolateral gawo la ntchafu. Kukonzekera kwa insulin sikuyenera kusakanikirana kapena kuchepetsedwa. Syringe siyenera kugwedezeka musanabayidwe. Ndikofunikira kupotoza pakati pamafinya, kuti kapangidwe kake kamakhala kofanana kwambiri ndikuwotha pang'ono. Pambuyo pa jakisoni, singano imasiyidwa pansi pakhungu kwa masekondi angapo kuti iperekenso mankhwala mokwanira, ndikuchotsa.

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

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

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

Kuchuluka kwa mankhwalawa kungayambitse hypoglycemia. Popanda thandizo lakuchipatala, zimabweretsa mavuto akulu. Kutembenuka, kusokonezeka kwamanjenje kumachitika, chikomokere cha hypoglycemic sichimachotsedwa, m'malo ovuta vutoli limatha kupha.

Ndi hypoglycemia, ndikofunikira kutenga chakudya champhamvu kwambiri, chomwe chidzakulitsa kuchuluka kwa shuga m'magazi. M'tsogolomu, mudzafunika kuthandizidwa ndi dokotala, kukonza zakudya komanso kupatsa insulin.

Insulin yotalikilapo siloledwa kwa magulu onse odwala. Sitha kugwiritsidwa ntchito kwa hypoglycemia ndi hypersensitivity pazigawo zamankhwala. Imasungidwa mu amayi apakati komanso ana osakwana zaka 6.

Mankhwalawa angagwiritsidwe ntchito molingana ndi katswiri ngati phindu lomwe likuyembekezeredwa limaposa chiopsezo chovuta. Mlingo uyenera kuwerengedwa ndi dokotala nthawi zonse.

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

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

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

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

Insulin yayitali imayenera kuwongoleredwa ngati musintha zakudya ndi masewera olimbitsa thupi, komanso ndi matenda opatsirana, opaleshoni, mimba, matenda a impso, ndi endocrine. Mlingo umasinthidwa ndikusintha kwamankhwala, zakumwa zoledzeretsa komanso mothandizidwa ndi zinthu zina zomwe zimasintha kuchuluka kwa shuga m'magazi. Ndi kuchepetsedwa kwambiri kwa hemoglobin ya glycosylated, ziyenera kukumbukiridwa kuti hypoglycemia mwadzidzidzi imatha kuchitika usana ndi usiku.

Insulin yayitali yochita kupaka makatoni iyenera kusungidwa pabalaza la chitseko cha firiji, pomwe kutentha ndi +2. +8 ° С. Zikatero, sizimawuma.

Mutatsegula phukusi, kutentha kwa chosungiracho sikuyenera kupitirira +25 ° C, koma sikuyenera kuchotsedwa mufiriji. Sungani bokosilo kwa ana. Moyo wa alumali wa insulin yosindikizidwa ndi zaka 3, zotsegulidwa - pafupifupi mwezi.

Matenda a shuga ndi matenda omwe thupi limalephera kuthana ndi glucose omwe akubwera, chifukwa chomwe chimakhalabe m'magazi, zomwe zimapangitsa kuti pakhale zochitika zamatenda komanso ziwalo.

Ndi anthu okhawo omwe amapezeka ndi matenda a shuga omwe amadziwa zomwe mawu oti "osasunthika" amatanthauza.

Ndi insulin yokhayo yokhayo yomwe ingawathandize pa ntchitoyi. Kuperewera kwa mahomoni m'thupi la anthu odwala matenda ashuga kumatha kuthandizidwa pokhapokha pomupatsa mankhwala osokoneza bongo. Cholinga chachikulu cha mankhwalawa ndi kubwerezanso zachilengedwe mosamala momwe zingathere. Ndipo zimathandizira mu insulin yotalikilapo kanthu.

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

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

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

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

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

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

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

Makalata ochokera kwa Owerenga

Agogo anga akhala akudwala matenda a shuga kwa nthawi yayitali (mtundu 2), koma posachedwa zovuta zapezeka m'miyendo ndi ziwalo zamkati.

Mwangozi ndidapeza nkhani pa intaneti yomwe idapulumutsa moyo wanga. Zinali zovuta kuti ndione chizunzo, ndipo fungo loipa m'chipindacho linali kundiyambitsa misala.

Kupyolela pa zamankhwala, agogo aja adasinthanso momwe akumvera. Ananenanso kuti miyendo yake sikupweteka komanso zilonda zake sizinayende; sabata yamawa tidzapita ku ofesi ya dotolo. Falitsa ulalo wa nkhaniyo

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

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

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

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

Momwe mungasungire shuga kukhala wabwinobwino mu 2019

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

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

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

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

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

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

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

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

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

Timapereka kuchotsera kwa owerenga tsamba lathu!

Insulin wa nthawi yayitali: mayina a mankhwala

Tsamba la jakisoni wa insulin

Kukhazikitsidwa kwa insulin yayitali kumachitika mu ntchafu (kuyamwa pang'onopang'ono).

Kutanthauzira nthawi

Imaperekedwa pafupifupi nthawi yomweyo, m'mawa ndi madzulo, ndipo mlingo wa m'mawa nthawi zambiri umayendetsedwa nthawi yomweyo ndi insulin yochepa.

Kudya Pambuyo Pakulowetsani Insulin

Insulin yotalikilapo sikuti imakhudzana ndi chakudya, imatengera momwe zimakhalira m'malo mopatsa zakudya za insulin, motero, sikofunikira kudya pambuyo pakudya kwa insulin yayitali.

Insulin ya nthawi yayitali.

Imayamba kugwira ntchito ndi makina ozungulira pambuyo pa maola 1-2, nsonga ya zochitika imachitika pambuyo pa maola 6-8, nthawi yochita ndi maola 10-12. Mlingo wamba ndi 24 mayunitsi / tsiku mu 2 waukulu.

- Insulin-isophan (umisiri wa chibadwa cha anthu) - Biosulin N, Gansulin N, Gensulin N, Insuman Bazal GT, Insuran NPH, Protafan NM, Rinsulin NPH, Humulin NPH.

- Insulin-isophane (yaumunthu yopanga) - Biogulin N, Humodar B

- Insulin-isophan (woweta nkhumba) - Monodar B, Protafan MS.

- Poyimitsidwa-insulin-zinc - Monotard MS.

- NPH Neutral Protamine Hagedorn (NUL insulins, mwachitsanzo, Humulin N ®, Protofan XM ®)

- Zinc (zinc-insulins, mwachitsanzo Ultratard HM ®, Humulin Ultalente ®)

- Surfen (surfen-insulin, i.e. Depo-Insulin ®)

Imayamba kugwira ntchito pambuyo pa maola 4-8, kuchuluka kwake kwa zochitika kumachitika pambuyo pa maola 8-18, nthawi yayitali ndi maola 20-30.

- Insulin glargine (Lantus) - mlingo wamba wa magawo 12 / tsiku. Insulin glargine ilibe chiopsezo chonenedwa, chifukwa imatulutsidwa m'magazi pamlingo wokhazikika, chifukwa chake imaperekedwa kamodzi. Imayamba kugwira ntchito maola 1-1.5. Sipereka konse hypoglycemia.

- Pulogalamu ya insulin (Levemir Penfill, Levemir Flexpen) - mlingo wamba wa 20 PIECES / tsiku. Popeza ili ndi nsonga yaying'ono, ndibwino kugawa mlingo wa tsiku ndi tsiku mu 2 waukulu.

Kuchita insulini kwa nthawi yayitali yodziwika ndi kudziwikiratu kwakukulu kwakuchitika kwakanthawi kochepa poyerekeza ndi ma insulin aumunthu wamba. Amamwekemera pang'onopang'ono kuchokera pakabowo ka jakisoni ndipo amakhala ndi mphamvu yayitali, samakhala ndi chiwonetsero chokwanira (chomwe chimachepetsa mwayi wa hypoglycemia usiku ndi pakati pa chakudya) ndipo chimagwira kwa maola 24, chitha kuperekedwa kamodzi kapena kawiri pa tsiku. Chithandizo cha insulin chokhazikika chimaphatikizidwa ndi kuwonjezeka kwa kulemera kwa thupi, ndipo odwala omwe ali ndi mtundu wa 2 matenda a shuga amakhala onenepa kwambiri, kuwonjezeka kwa thupi kumbuyo kwa insulin. Kafukufuku wokhala ndi ma insulin omwe amakhala nthawi yayitali amawonetsa kulemera kwamphamvu kwa thupi poyerekeza ndi ma insulin ena oyambira.

Insulin yokhala ndi nthawi yayitali komanso zizindikiro zazikulu zogwiritsira ntchito

Matenda a diabetes 1 a mtundu (kawirikawiri mtundu wa 2) amadziwa bwino mankhwala a insulin omwe sangakhale nawo popanda. Pali zosankha zingapo za mahomoni awa: kachitidwe kochepa, nthawi yayitali, nthawi yayitali kapena kuphatikiza pamodzi. Ndi mankhwala otere, ndizotheka kubwezeretsanso, kuchepetsa kapena kukulitsa kuchuluka kwa mahomoni mu kapamba.

Kutanthauza kwa insulin ndiko kugwiritsira ntchito njira zama metabolic komanso kudyetsa maselo ndi shuga. Ngati mahomoniwa sapezeka m'thupi kapena sanapangidwe kuchuluka, munthu amakhala pachiwopsezo chachikulu, ngakhale kufa.

Kuletsedwa kokhako kusankha gulu lokonzekera insulin nokha. Posintha mankhwala kapena mlingo, wodwalayo ayenera kuyang'aniridwa ndikuwongolera kuchuluka kwa shuga m'magazi a magazi. Chifukwa chake, pochita zinthu zofunika kwambiri zotere, muyenera kupita kwa dokotala.

Ma insulin omwe amakhala nthawi yayitali, omwe mayina awo adzapatsidwa ndi dokotala, nthawi zambiri amagwiritsidwa ntchito limodzi ndi mankhwalawa monga achidule kapena apakati. Pafupipafupi, amagwiritsidwa ntchito pochiza matenda a shuga a 2. Mankhwala oterowo amasunga shuga nthawi zonse chimodzimodzi, osaloleza kutalika kapena pansi.

Mankhwalawa amayamba kukhudza thupi pambuyo pa maola 4-8, ndipo kuchuluka kwa insulini kudzapezekanso pambuyo pa maola 8-18. Chifukwa chake, kuchuluka kwathunthu kwa glucose - 20-30 hours. Nthawi zambiri, munthu amafunika njira imodzi yoperekera jakisoni wa mankhwalawa, nthawi zambiri zimachitika kawiri.

Pali mitundu ingapo yamitundu iyi ya mahomoni amunthu. Chifukwa chake, amasiyanitsa mtundu wa ultrashort ndi mtundu waufupi, wopitilira komanso wophatikizidwa.

Mitundu yoyamba imakhudza thupi patadutsa mphindi 15 kuchokera kukhazikitsidwa kwake, ndipo kuchuluka kwa insulin kumatha kuwonekera patatha maola 1-2 mutabayidwa. Koma kutalika kwa chinthu m'thupi ndi chochepa kwambiri.

Ngati tilingalira ma insulin omwe akhala akuchita kwa nthawi yayitali, mayina awo akhoza kuyikidwa padera.

Insulin yayitali imagwiritsidwa ntchito kutsimikizira molondola zomwe zimachitika mu mahomoni amunthu. Zitha kugawidwa m'magulu awiri: nthawi yayitali (mpaka maola 15) komanso nthawi yayitali, yomwe imafika mpaka maola 30.

Opanga adapanga mtundu woyamba wa mankhwalawo ngati mawonekedwe amadzimadzi amtambo. Asanapereke jakisoni, wodwalayo ayenera kugwedeza chidebecho kuti akwaniritse utoto. Pambuyo pokhapokha pokhapokha amatha kulowa mu subcutaneally.

Insulin yokhala ndi nthawi yayitali imapangidwa kuti iwonjezere pang'ono ndende yake ndikuisunga pamlingo womwewo. Panthawi inayake, nthawi ya kuphatikiza kwakukulu kwa malonda imabwera, pambuyo pake mulingo wake umachepa.

Ndikofunikira kuti musaphonye pamene gawo likhala lopanda pake, pambuyo pake mlingo wotsatira wa mankhwalawo uyenera kuperekedwa. Palibe kusintha kwakuthwa kwa chizindikirocho kuyenera kuloledwa, chifukwa chake adokotala aziganizira zazomwezo m'moyo wa wodwalayo, pambuyo pake adzasankha mankhwala oyenera ndi mlingo wake.

Kuyendetsa bwino thupi kosadumpha mwadzidzidzi kumapangitsa kuti inshuwaransi ikhale yogwira mtima kwakanthawi. Gululi la mankhwalawa lili ndi gawo lina: liyenera kutumikiridwa kokha mu ntchafu, osati pamimba kapena manja, monga zosankha zina. Izi ndichifukwa cha nthawi yonyamula zinthu, chifukwa m'malo ano zimachitika pang'onopang'ono.

Nthawi ndi kuchuluka kwa kayendetsedwe kazinthu zimatengera mtundu wa wothandizira. Ngati madzi ali ndi mawonekedwe osasinthika amtunduwu, mankhwalawa ali ndi ntchito yapamwamba, ndiye kuti nthawi yayitali ya ndende imachitika mkati mwa maola 7. Ndalamazi zimaperekedwa kawiri pa tsiku.

Ngati mankhwalawa alibe kuchuluka kwakukulu, ndipo zotsatira zake zimasiyana pakapita nthawi, ziyenera kuperekedwa nthawi imodzi patsiku. Chida chake ndi chosalala, cholimba komanso chosasinthasintha. Madziwo amapangidwa monga madzi oyera popanda kukhalapo kwamtambo pansi. Insulin yotenga nthawi yayitali ndi Lantus ndi Tresiba.

Kusankhidwa kwa Mlingo ndikofunikira kwambiri kwa odwala matenda ashuga, chifukwa ngakhale usiku, munthu amatha kudwala. Muyenera kuganizira izi ndikupanga jakisoni wofunikira pa nthawi. Kuti mupange chisankhochi molondola, makamaka usiku, miyezo ya glucose iyenera kutengedwa usiku. Izi zimachitika bwino pakadutsa maola awiri aliwonse.

Kuti akonzekere insulin kukonzekera, wodwalayo ayenera kudya popanda chakudya chamadzulo. Usiku wotsatira, munthu ayenera kutenga miyezo yoyenera. Wodwalayo amagaira zomwe adapeza kwa asing'anga, yemwe, atazipenda, amasankha gulu lolondola la insulin, dzina la mankhwalawo, ndikuwonetsa kuchuluka kwake.

Kukonzekera kwa insulin kochepa komanso kwanthawi yayitali kumagwiritsidwa ntchito mwa odwala omwe ali ndi matenda a shuga 1. Izi zimachitika kuti tisunge gawo limodzi la maselo a beta, komanso kupewa kutulutsa ketoacidosis. Odwala omwe ali ndi mtundu wachiwiri wa matenda osokoneza bongo nthawi zina amayenera kupereka mankhwalawa. Kufunika kwa machitidwe oterewa kufotokozedwa mophweka: simungathe kulola kusintha kwa matenda ashuga kuchokera ku mtundu wachiwiri mpaka 1.

Kuphatikiza apo, insulini yokhala ndi nthawi yayitali imalembedwa kupondaponda vuto la m'mawa komanso kukhazikitsa kuchuluka kwa shuga m'mawa (pamimba yopanda kanthu). Kuti akupatseni mankhwalawa, dokotala angakufunseni kuti mupeze zolemba zolimbitsa thupi za milungu itatu.

Insulin yokhala ndi nthawi yayitali imakhala ndi mayina osiyanasiyana, koma odwala ambiri amagwiritsa ntchito mankhwalawa. Mankhwala oterowo safunikira kugwedezeka musanayambe kutsata, amadzimadzi amakhala ndi mtundu wowonekera komanso wosasinthika. Opanga amapanga mankhwalawo m'mitundu ingapo: cholembera cha OpiSet (3 ml), makatoni a Solotar (3 ml) ndi dongosolo lomwe lili ndi OptiClick cartridgeges.

Munjira yomalizirayi, mumakhala ma cartridge 5, lililonse la 5 ml. Poyambirira, cholembera ndichida chofunikira, koma makatoni amayenera kusinthidwa nthawi iliyonse, kukhazikitsa syringe. M'dongosolo la Solotar, simungasinthe madzimadzi, chifukwa ndi chida chotayikira.

Malangizowo akuti amafunikira jakisoni imodzi, ndipo endocrinologist imatha kudziwa mlingo. Izi zimatengera kuopsa kwa matendawa komanso machitidwe ake amwana. Muwapatse ana azaka zopitilira 6 ndi akulu omwe ali ndi matenda a shuga 1 kapena mtundu 2.

Ili ndi dzina la insulin yayitali. Kuchepa kwake kuli mu kukula kwapadera kwa hypoglycemia, ngati wothandizirayo amagwiritsidwa ntchito pochiza odwala omwe ali ndi matenda a shuga 1. Phunziro lotere linachitidwa ku United States. Mankhwalawa, malinga ndi malangizo, amatha kuperekedwa osati kwa odwala akuluakulu, komanso kwa ana okulirapo kuposa 2 years.

Kutalika kwa thupi ndi maola 24, ndipo kuphatikiza kwakukulu kumawonedwa pambuyo maola 14. Jekeseni imaperekedwa mwa njira yankho la subcutaneous makonzedwe 300 IU katoni iliyonse. Zinthu zonsezi zimasindikizidwa mu cholembera cha syringe yambiri. Ndi zotheka. Phukusili lili ndi ma PC 5.

Ndi zoletsedwa kuti tiumitse katunduyo. Sitolo sikuyenera kupitirira 30 miyezi. Chipangizocho chimatha kupezeka m'mafamu aliwonse, koma amangomangotulutsa ndi mankhwala kuchokera kwa dokotala.

1. 
   Davidenkova, E.F. Genetics ya matenda a shuga a mellitus / E.F. Davidenkova, I.S. Lieberman. - M: Mankhwala, 1988 .-- 160 p.
2. 
   Bogdanovich V.L. Matenda a shuga. Library Yothandiza. Nizhny Novgorod, "Nyumba Yosindikiza ya NMMD", 1998, 191 p., Makope 3000.
3. 
   M.A., Darenskaya Mtundu woyamba wa matenda ashuga: / M.A. Darenskaya, L.I. Kolesnikova und T.P. Bardymova. - M: LAP Lambert Academic Publishing, 2015 .-- 124 c.

Ndiloleni ndidziwitse. Dzina langa ndi Elena. Ndakhala ndikugwira ntchito ya endocrinologist kwa zaka zoposa 10. Ndikukhulupirira kuti pakadali pano ndili katswiri pantchito yanga ndipo ndikufuna kuthandiza alendo onse omwe amapezeka patsamba lino kuti athetse zovuta koma osati ntchito. Zinthu zonse za tsambalo amazisonkhanitsa ndikuzikonza mosamala kuti athe kufotokoza zambiri zofunikira. Musanagwiritse ntchito zomwe zikufotokozedwa pa webusayiti, kukambirana ndi akatswiri ndizofunikira nthawi zonse.