Insulin analogues: cholowa m'malo anu mankhwalawo

Ma analogi a insulin ndi mawonekedwe osinthika am'molekyu a insulin, omwe amalumikizana ndi insulin receptors, koma kutalika kwa zochita zawo ndi kosiyana ndi mahomoni achilengedwe.

Kukonzekera kwa Ultrashort - insulin lispro ("Little"), insulin (NovoRanid) insulin glulisin ("Apidra"). Muzochita zawo, ali ndi mwayi wotsatirawu: kuyambira mwachangu kumathandizira kuti insulin iperekedwe musanadye. Kubayilitsa amatha kutero mukatha kudya, kusankha mlingo malinga ndi kuchuluka kwa chakudya. Kutalika kwa nthawi ya ultrashort insulin pafupifupi kumafanana ndi nthawi yomwe shuga ya m'magazi imakwera mutatha kudya, kuti mupewe kusowa pakati pa chakudya.

Lyspro insulin ("Humalog") ndi yosiyana mwanjira ndi mamolekyulu a insulin achilengedwe. Mu insulin yaumunthu, amino acid proline ili pamalo a 28 a B-chain, ndi lysine pamalo a 29th. Mu kapangidwe ka lyspro insulin analog, ma amino acid awa "amakonzedwanso", i.e. m'malo a 28, lysine imadziwika, m'malo 29 - proline. Kuchokera pamenepo kumabwera dzina la analogue - insulin lispro. "Kukonzanso" kwa molekyulu ya insulin kwapangitsa kuti kusintha kwa zinthu zachilengedwe, ndi kayendetsedwe kake, kuyambiranso kufupikitsidwa poyerekeza ndi insulin yachilengedwe. Mphamvu ya hypoglycemic ya lyspro insulin imayamba mphindi 15 pambuyo pa kupangika, nthawi yake imakhala yochepa kwambiri kuposa ya insulin yochepa.

Zaka zingapo atayamba kugwiritsa ntchito insulin lispro, analog yatsopano ya insulin idapangidwa. Mu malo a 28 a insulin B, phula la amino acid limasinthidwa ndi acid yomwe imagwiritsidwa ntchito molakwika, yomwe idakhala maziko a dzina lake - insulin ("PovoRapid"). Kukhalapo kwa asipicic amino acid wogwiritsidwa ntchito molakwika kumalepheretsa kupangika kwa hexamers yokhazikika ndikuthandizira kuyamwa mwachangu kwa mamolekyulu a insulin kuchokera pamalo a jekeseni momwe amawonongera.

Insulin glulisin ("Apidra") amadziwika kuti m'malo a 3 ndi 29 a B-unyolo amino acid amakonzedwanso.

Kukonzekera kwa insulin yayikulu kwambiri: Novorapid, Humalog ndi Apidra amalola kubwezera komanso kuchuluka kwa kagayidwe kazakudya kwa odwala omwe ali ndi matenda osokoneza bongo kwa omwe ali ndi chikhalidwe cha munthu wathanzi, kuchepetsa kwambiri postprandial (atatha kudya) hyperglycemia. Ndikofunikira kukhazikitsa mankhwala musanadye chilichonse.

Mankhwala okhalitsa. Chithandizo cha insulin (Levemir) ndi analogue yosungunuka ya insulin-sing'anga yokhala ndi pH yopanda mbali. Detemir ndi acetylated yotengeka ya insulin yaumunthu ndipo imachulukira kwachilengedwe. Kapangidwe kake ka nthawi yayitali ka insulin detemir imatsimikiziridwa ndikupanga mapangidwe a insulin hexamers omwe ali ndi albumin.

Insulin glargine ("Lantus") ndi analogue yosungunuka ya insulin ya anthu omwe akhala akuchita kwakanthawi, ndimayendedwe amtundu wa insulin wokhala ndi nthawi yayitali kuposa Riisulin NPH. Kapangidwe ka molekyulu ya insulin glargine imasiyana ndi insulin ya anthu chifukwa, pa A21, glycine imasinthidwa ndi katsitsumzukwa ndipo zotsalira ziwiri za arginine zimapangidwira kumapeto kwa NH2-terminal ya B. Kusintha uku kapangidwe ka molekyulu ya insulin imasinthira ku chiwonetsero cha acidic pH yochulukirapo - kuyambira 5.4 (insulin yaumunthu yachilengedwe) mpaka 6.7, kotero insulin glargine siyisungunuka pang'ono paliponse pa mtengo wa pi I ndipo imatenga pang'onopang'ono, zomwe zikutanthauza kuti imagwira.

Mankhwala okhathamiritsa kwa nthawi yayitali. Zokomera iwo Insulin degludec ("Tciousba® Penfill ®") ndi insulin yatsopano, yokhala ndi nthawi yayitali. Pambuyo pa kayendetsedwe ka subcutaneous, degludec imapanga malo ochepa omwe amasungunuka, omwe amalowetsedwa m'magazi, ndikupereka mphamvu yotsitsa shuga yokhazikika kuposa maola 42.

Kukonzekera kwa insulin analogues ophatikizika (magawo awiri) yodziwika chifukwa chakuti hypoglycemic effect imayamba mphindi 30 pambuyo pa kayendetsedwe ka subcutaneous, imafika pazowonjezereka pambuyo pa maola 2-8 ndipo imatha mpaka maola 18-20. Amaphatikiza insulin aspartate ndi insulin, proteni yayitali (protofan). Woimira - insulin aspart biphasic (NovoMix 30 "),

Kukonzekera kwa Biphasic insulin degludec ndi insulin ("Rysodeg® Penfill ®") mu 100 PIECES ili ndi 70% ya insulini wa nthawi yayitali komanso 30% yochita zinthu zolimbitsa thupi mwachangu. Odwala ambiri omwe amagwiritsa ntchito insulin ya basal amakakamizika kutenga jakisoni yowonjezera panthawi ya chakudya. Popeza mankhwalawa ali ndi mitundu iwiri ya insulini - kuchitapo kanthu mwachangu komanso mwachangu, kumathandizira odwala kuti azilamulira shuga pakudya komanso kupewa hypoglycemia.

Zipangizo zamakono zopangira insulin (zolembera za syringe, jakisoni wosafunikira, zothetsera insulin zotulutsa) zimathandizira kwambiri pakuyambitsa insulin.

World Diabetes Federation (IDF) adapempha makampani otsogolera omwe amapanga - opanga insulin ndi mabungwe azadziko lonse ashuga ndi mabungwe omwe ali ndi lingaliro kuti asinthe kugwiritsa ntchito mtundu umodzi wa kukonzekera kwa insulin ndi kuchuluka kwa 100 IU / ml m'zaka zikubwerazi. Izi zimathandizidwa ndi WHO.

Zotsatira zoyipa za ntchito za insulin zimaphatikizapo thupi lawo siligwirizana pa malo a jakisoni wa insulin (antihistamines ndi mankhwala). Lipodystrophy yotheka ku malo a jakisoni. Pali chitukuko cha kukana kwachiwiri kwa insulin chifukwa cha kupangika kwa ma antibodies kwa iwo, kutsutsana kwa mahomoni (kupanga kowonjezera kwa glugagon, STH, mahomoni a chithokomiro, etc.), kutayika kwa chidwi cha receptor ku mahomoni, ndi zifukwa zina zosadziwika. Nthawi zambiri izi zimachitika mukamagwiritsa ntchito mankhwala a insulin, kotero muzochitika zoterezi zimalimbikitsidwa kusintha kwa insulin ya anthu. Kuwonjezeka kwa insulin kungatheke pokhapokha ngati mukugwirizana ndi endocrinologist.

Hypoglycemia imatha kuchitika chifukwa cha kuchuluka kwa insulin. Amayimitsidwa mwachangu ndi shuga kapena maswiti. Ngati hypoglycemia siinayimitsidwe pa nthawi, ndiye kuti kupweteka kwa hypoglycemic kumayamba. Zizindikiro za hypoglycemic chikomokoma: thukuta lozizira, kunjenjemera kwa malekezero, kufooka, njala, ana ambiri. Kusintha kumayamba, chikumbumtima sichitha. Pankhaniyi, ndikofunikira kuperekera kudzera m'mitsempha kwa mphindi 2-3 20-50 ml ya shuga 40% kapena mu mnofu 1 mg wa glucagon, mwina 0,5 ml ya yankho la adrenaline 0,1%. Pambuyo pozindikira, njira yothetsera shuga iyenera kutengedwa pakamwa. Kulephera kutero kungayambitse imfa.

Kuchepa kwa mahomoni kumatha kudzetsa matenda ashuga.

Zochita

Ma-insulin anthawi yocheperako-yochepa amayamba kulowa m'magazi mkati mwa mphindi 10 mpaka 20 kuyambira pa nthawi ya makonzedwe. Zochita zazikulu zimachitika ola limodzi pambuyo pa kukhazikitsa ndipo sizimatha maola atatu. Kutalika konse kwa kuchitapo kanthu kuyambira 3 mpaka 5 maola.

Ngakhale fanizo la insulin yocheperako-yayifupi yokhala ndi insulini yocheperako yazomwe zimagwira ntchito yomweyo ya "insulin" ya insulin, machitidwe awo a pharmacodynamic amasiyana kwambiri. Kusiyana kumeneku kunawonetsedwa bwino ndi zotsatira za kafukufuku wamankhwala woyerekeza wa ultra-yochepa-insulin analogue NovoRapid ® ndi imodzi mwakonzedwe ka insulin kochepa.

Zinapezeka kuti:

Mankhwala a NovoRapid ® ali apamwamba kuwirikiza kawiri kuposa a insulin,
nsonga za NovoRapid ® zimachitika mphindi 52 kuchokera ku makonzedwe, pomwe nsonga za insulin yochepa zimangofika pa mphindi ya 109,
kuchuluka kwa mayamwidwe a NovoRapid ® sikudalira kwenikweni kupezeka kwa malo a jakisoni,
kupezeka kwa nsonga ndi nthawi ya mankhwalawa NovoRapid ® sikudalira mtundu wake,
Kutalika kwa nthawi ya zochita za NovoRapid® kumachepetsa chiwopsezo cha kugona usiku kwambiri ndi 70% poyerekeza ndi insulin.

Zinthu zotere za pharmacodynamic za mayamwidwe ndi zochita za mankhwala osokoneza bongo a ultrashort zimapereka mwayi wokwanira wogwirizanitsa zochita za insulin ndi mayamwidwe ndikugwiritsa ntchito shuga pambuyo podya.

Mu chithunzi 3, zitha kuwoneka kuti mawonekedwe a ultrashort insulini ali pafupi kwambiri ndi mbiri ya insulin yoteteza munthu wathanzi.

Malangizo ogwiritsira ntchito ma insulin anthawi yayitali-kuyamwa mwachangu kumapangitsa kuti mankhwalawa aperekeke mwachangu musanadye, nthawi yakudya kapena itangotha.

Kutalika kwakanthawi kwa maulendo a insulin osakhalitsa sikumakhala ndi zokhwasula-khwasula. Izi ndizothandiza kwa achinyamata omwe akufuna kusintha moyo wawo ndi kudya kwaulere. Mu ana aang'ono omwe ali ndi chidwi chosakonzekera, mwayi waukulu ndikuyambitsa insulini yokhala ndi insulin yochepa pakatha mphindi 1 mutatha kudya:

Izi zimathandiza kusintha mlingo wa insulin kuti ukhale kuchuluka kwa chakudya chomwe mwana amadya.
Izi ndizofunikira ngati mwana adya pang'onopang'ono ndikudya zakudya zomwe zili ndi chakudya chamagulu omanga a glycemic, omwe glucose amalowetsedwa pang'onopang'ono pofuna kupewa kuchepa kwa glucose pa ola loyamba mutatha kudya.
Izi ndizofunikira ngati mwana adya chakudya, kuwonjezera pa chakudya chamafuta, okhala ndi protein yambiri ndi mafuta, pofuna kupewa kuchuluka kwa shuga patatha maola atatu atatha kudya.

Kodi pali kusiyana kotani pakati pa mankhwala?

Chimodzi mwazinthu zazikulu pakusankha mitundu ya insulin ndi chinthu monga kuthamanga kwa zotsatira zakepi. Mwachitsanzo, pali ena omwe amachita mwachangu kwambiri ndipo jakisoni amayenera kuchitidwa mphindi makumi atatu kapena makumi anayi asanadye. Koma pali iwo omwe, m'malo mwake, ali ndi mphamvu yayitali kwambiri, nthawi imeneyi imatha kufikira maola khumi ndi awiri. Potsirizira pake, njira iyi ingapangitse kukula kwa hypoglycemia mu shuga mellitus.

Pafupifupi mitundu yonse yamakono ya insulini imagwira ntchito mwachangu. Wotchuka kwambiri ndi insulin yakwathupi, imagwira mphindi imodzi kapena yachisanu pambuyo pa jakisoni.

Mwambiri, ndikofunikira kuwunikira zotsatirazi zabwino za fanizo zamakono:

Mayankho osavomerezeka.
Mankhwalawa amapezeka pogwiritsa ntchito ukadaulo wamakono wama DNA.
Mafuta amakono a insulin ali ndi mankhwala atsopano.

Chifukwa cha zonse zomwe zili pamwambapa, zinali zotheka kukwanitsa bwino bwino pakati pa chiwopsezo chokhala ndi spikes mwadzidzidzi m'magawo a shuga ndikupeza zizindikiro za glycemic.

Mwa mankhwala odziwika amakono atha kudziwika:

Analog ya ultrashort insulin, yomwe ndi Apidra, Humalog, Novorapid.
Yaitali - Levemir, Lantus.

Wodwala akakhala ndi vuto lililonse pambuyo pa jakisoni, adokotala akuwonetsa kulowetsanso insulin.

Koma muyenera kuchita izi pokhapokha poyang'aniridwa ndi katswiri ndikuwonetsetsa momwe wodwalayo akusamalirani.

Zambiri za Humalog (lispro ndi kusakaniza 25)

Ichi ndi chimodzi mwazida zotchuka kwambiri - ma analogu a munthu. Kuzindikira kwake kumachitika chifukwa chakuti imatengedwa mwachangu m'magazi a munthu.

Ndizofunikanso kudziwa kuti ngati mutaba jakisoni mwanjira inayake komanso muyezo womwewo, ndiye kuti maola 4 mutatha jakisoni, ndende ya mahomoni amabwereranso ku gawo lake loyambirira. Poyerekeza ndi insulin wamba, nthawi imeneyi imakhala yochepa kwambiri chifukwa nthawi imeneyi imatha pafupifupi maola 6.

China chomwe chalowa m'malo mwa insulin ya anthu ndichakuti chimanenedweratu momwe mungathere, kotero nthawi yosinthira imadutsa popanda zovuta komanso mosavuta. Kutalika kwa mankhwalawa sikukutengera mlingo. M'malo mwake, ngakhale mutachulukitsa mlingo wa mankhwalawa, nthawi yamachitidwe ake imakhala yomweyo. Ndipo izi zimapereka chitsimikizo kuti wodwalayo sanachedwe glycemia.

Makhalidwe onse omwe ali pamwambapa amawapangitsa kukhala ofanana momwe angathere ndi insulin yaumunthu wamba.

Ponena za kusakaniza kwa Humalog 25, ziyenera kudziwika pano kuti izi ndi zosakanikirana za zinthu monga:

Unyinji wonenepa wa horosro (75%).
Insulin Humalog (25%).

Chifukwa cha gawo loyamba, mankhwalawa amakhala ndi nthawi yambiri yolumikizidwa ndi thupi. Mwa mitundu yonse ya insulin yomwe ilipo ya mahomoni amunthu, imapereka mwayi wambiri kubwereza momwe basal imapangidwira payokha.

Ma mahoni ophatikizika nthawi zambiri amaperekedwa kwa anthu omwe ali ndi vutoli. Mndandandandawu umaphatikizapo odwala omwe ndi okalamba kapena omwe ali ndi vuto la kukumbukira.

Izi ndichifukwa choti timadzi timeneti titha kuthandizira nthawi yomweyo tisanadye, kapena pambuyo pake.

Zoyenera kusankha - Apidra, Levemir kapena Lantus?

Ngati tizingolankhula za mahomoni oyamba, ndiye momwe zimakhalira mwachilengedwe zimafanana kwambiri ndi Humalog yomwe tafotokozazi. Koma ponena za mitogenic komanso metabolic zochita, ndizofanana ndi insulin yaumunthu. Chifukwa chake, itha kugwiritsidwa ntchito kwanthawi yayitali. Ndikofunika kudziwa kuti imayamba kuchita jakisoni mutayamba kubayidwa.

Monga momwe zimachitikira ndi Humalog, analog iyi ya insulin yamunthu nthawi zambiri imasankhidwa ndi anthu okalamba. Kupatula apo, imatha kumwedwa nthawi isanayambe kapena itatha.

Ponena za Levemir, imakhala ndi nthawi yayitali. Iyenera kugwiritsidwa ntchito kawiri pa tsiku ndipo kenako idzakhala yoyenera kusamala nthawi zonse tsiku lonse.

Koma Lantus, mmalo mwake, amachita mwachangu kwambiri. Komanso, imasungunuka bwino m'malo okhala acidic pang'ono, imasungunuka m'malo osalowerera ndale kwambiri. Mwambiri, kufalitsidwa kwake kumatenga pafupifupi maola makumi awiri ndi anayi. Chifukwa chake, wodwalayo ali ndi mwayi wophatikizira kamodzi patsiku. Ndikofunikira kudziwa kuti imatha kudindidwa m'chigawo chilichonse cha thupi: m'mimba, mkono kapena mwendo. Nthawi yayitali ya kuchitapo kwa mahormoni ndi maora makumi awiri ndi anayi, ndipo okwera amakhala makumi awiri ndi zisanu ndi zinayi.

Lantus ali ndi izi:

Tiziwalo zonse zam'mthupi zomwe zimatengera insulin zimayamba kudya shuga bwino.
Amachepetsa shuga wamagazi.
Imachepetsa njira yogawa mafuta, mapuloteni, kotero chiwopsezo chowonjezera kuchuluka kwa acetone m'magazi ndi mkodzo umachepetsedwa.
Imalimbikitsa kagayidwe kake ka minofu yonse mthupi.

Kafukufuku onse akutsimikizira kuti kugwiritsa ntchito mosalekeza malo a insulin yaumunthu kumapangitsa kuti kuthekera kwathunthu kutsanzira kapangidwe kazinthu zachilengedwe izi kamanoni m'thupi.

Kodi mungasankhe bwanji?

Pomwe funso lidayamba la zomwe zingalowe m'malo mwa insulin mthupi, chinthu choyamba kuchita ndikuwunika wodwalayo ndikuzindikira zonse zomwe zikuchitika pa matenda a shuga mellitus wodwala wina. Palibe choletsa kusintha wogwirizira yemwe wasankhidwa kale kapena kusinthira jakisoni mutamwa nokha mapiritsi, osayendera dokotala.

Pambuyo pofunsidwa mozama, dokotalayo amatha kupereka chilolezo chake kuti asinthe mankhwalawo kapena kuwapatsa mankhwala kwa nthawi yoyamba.

Musaiwale kuti pogwiritsira ntchito chida china, ndikofunikira kumuwunika wodwalayo pafupipafupi. Izi zikuyenera kuchitika pofuna kudziwa ngati kusintha kwamphamvu kwa thupi la wodwalayo kumachitika ndikumalandira jakisoni, ngati pali matenda ena ophatikizika, komanso ngati pali vuto la hypoglycemia. Kuti atsatire zonsezi, wodwalayo ayenera kupita pafupipafupi kwa endocrinologist wake ndikudziwitsa momwe thanzi lake lilili.

Koma kupatula malangizo onse omwe ali pamwambawa, muyenera kuvomerezabe zakudya zoyenera nthawi zonse. Komanso khalani ndi moyo wathanzi. Kuyenda mokhazikika mumweya watsopano kumapangitsa matendawo kukhala athanzi, komanso kumapangitsanso kupanga kwa insulin kwa thupi la wodwalayo palokha.

Posachedwa, pali maupangiri ambiri posankha zakudya zoyenera komanso zakudya zapadera zomwe zimathandizira kubwezeretsa kapamba ndi kukonza kupanga kwa mahomoni omwe tatchulawa. Koma, zoona, musanayambe kugwiritsa ntchito malangizowo, muyenera kufunsa dokotala. Kanemayo munkhaniyi amafotokoza za insulin.

Malangizo ogwiritsira ntchito mankhwala a insulin anthawi yayitali

Pokhudzana ndi mphamvu yodalira mlingo, jakisoni wa mankhwala Levemir® amachitika kamodzi kapena kawiri pa tsiku.

Kugwiritsa ntchito mankhwalawa kawiri mwa ana ndi achinyamata ndikofunikira kwambiri: mwa ana aang'ono - chifukwa cha kukonda kwambiri hypoglycemia tsiku lonse, komanso kusowa kwambiri kwa insulin, komanso kwa ana okulirapo - chifukwa cha zosowa zingapo za insulin nthawi yakusana ndi usiku maola. Malinga ndi mabuku akunja, 70% ya ana ndi achinyamata omwe amalandila Levemir ® ali kawiri konse kwa mankhwalawo.

Ngati mutha kuwongolera kuchuluka kwa shuga m'magazi, mothandizidwa ndi Levemir ®, malinga ndi malingaliro a adokotala, ana ndi achinyamata amatha kupereka insulin yamadzulo mwina pakudya chamadzulo, kapena asanagone, kapena maola 12 atatha kumwa kwa m'mawa. Pankhaniyi, ndikofunikira kuti mlingo wa m'mawa wa analogue woyambira uyenera kuperekedwa nthawi yomweyo ndi mlingo wa mmawa wa insulin.

Lantus® imayendetsedwa kamodzi patsiku, nthawi yomweyo, madzulo, asanagone.

Ngati ndi jekeseni limodzi la mankhwalawa mwana usiku, matendawo apezeka m'magazi ochepa, ndipo kuchepetsa shuga kumawonjezera kuchuluka kwa shuga m'mawa, mutha kuyesa kusinthanitsa ndi jakisoni wa insulin m'mawa kwambiri kapena m'mawa.

Mukasinthika ndimankhwala okhala ndi insulin analogi yokhazikika mu regimen imodzi, chisamaliro chiyenera kutengedwa ndipo masiku oyamba kupereka mankhwalawa muyezo womwe umachepetsedwa ndi 10%, chifukwa cha chiwopsezo cha hypoglycemia tsiku lonse.

Kugawa koyamba kwa tsiku ndi tsiku kwa mankhwala a insulin anthawi yayitali ataperekedwa kawiri kuli pafupifupi: 50% m'mawa ndi 50% madzulo. M'tsogolomu, tsiku ndi usiku kufunika kwa insulin kumatheka chifukwa cha kuchuluka kwa matenda a glycemia.

Chizindikiro cha insulin analogue omwe akhala akuchita kwa nthawi yayitali, mosiyana ndi ma insulin owonjezereka, ndiko kusowa kwa nsonga zotchulidwa, zomwe zimachepetsa chiopsezo cha hypoglycemia. Mankhwalawa amagwira ntchito mokwanira nthawi yonse ya zochita zawo, zomwe zimapereka kuchepa kwa shuga.

Pomaliza, ziyenera kutsimikiziridwa kuti ngakhale kuti insulin analogues imakhala ndi maubwino angapo pamankhwala amtundu wa anthu, kusintha kosavuta kwa mankhwala osokoneza bongo kwa mwana yemwe ali ndi shuga osapatsidwa inshuwaransi popanda kuwongolera shuga la magazi ndikumvetsetsa zifukwa zomwe zimapangitsa kuti insulin isagwire bwino ntchito. Ndikotheka kukwaniritsa chindapusa chokwanira cha matenda osokoneza bongo pazotsatira zonse zachikhalidwe ndi analog insulin. Kuchita bwino kwa mankhwala a insulin kumakhazikika podziletsa pakudziletsa pa matenda komanso kuunika kwamankhwala podziletsa!

Malangizo ogwiritsira ntchito mankhwala a Siofor ndi zotsatira zake zoyipa

Pochizira mafupa, owerenga athu adagwiritsa ntchito DiabeNot bwino. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Mankhwala osokoneza bongo a Siofor mu malangizo ogwiritsira ntchito amapereka malangizo atsatanetsatane kuti agwiritsidwe ntchito. Ichi ndi chimodzi mwamankhwala othandizira osati kokha pochizira matenda a shuga 2, komanso kupewa matenda oyambawa. Odwala omwe amamwa, kuchuluka kwa magazi kumayenda bwino, chiopsezo chokhala ndi mtima matenda amachepetsa, ndipo kulemera kwa thupi kumachepa.

Zochita zamankhwala

Siofor ndi mankhwala apamwamba kwambiri othana ndi matenda a shuga omwe ali ndi metformin yogwira ntchito. Amapezeka mu mawonekedwe a piritsi ndi kipimo: Siofor 500 mg, 850 ndi 1000 mg.

Kugwiritsa ntchito chida ichi kumakupatsani mwayi wochepetsera shuga, osati kokha mutatha kudya. Chizindikiro chonse chikucheperanso. Izi zimatheka chifukwa cha metformin pa kapamba. Imalepheretsa kupanga kwambiri insulin, yomwe imapewa hypoglycemia. Chifukwa cha kutenga Siofor ku matenda ashuga, odwala amatha kupewa hyperinsulinemia, yomwe ndi njira ya m'magazi momwe mulinso kuchuluka kwa insulin m'magazi. Mu shuga, zimabweretsa kuwonjezeka kwa kulemera kwa thupi komanso kukulitsa matenda a mtima.

Kugwiritsa ntchito kwa Siofor kuchokera ku matenda a shuga kungakulitse kuthekera kwa maselo am'mimba kutulutsa shuga m'magazi ndikuwonjezera kuzindikira kwawo kwa insulin.
Mothandizidwa ndi mankhwalawa a gululi m'matumbo am'mimba, kuchuluka kwa mafuta omwe amalowa mthupi ndi chakudya kumachepa, makutidwe a oxidation aulere amathandizira, kuphwanya kwa glucose kumayambitsidwa, njala imathandizidwa, zomwe zimabweretsa kuwonda.

Anthu odwala matenda ashuga omwe amamwa mankhwalawa ndikutsatira zakudya zapadera nthawi zina amachepetsa thupi. Komabe, ichi sichizindikiro kuti Siofor ndi njira yochepetsera thupi. Odwala ambiri amatenga mankhwalawa ndi mawonekedwe ake kwa nthawi yayitali, koma kuchepa kwambiri kumawonedwa nthawi zina.

Malangizidwe aboma samanena kalikonse kuti mankhwalawo amalimbikitsa kuchepetsa thupi. Gwiritsani ntchito mankhwala oopsa ngati omwewo kuti musadzipweteke nokha. Musanatenge, muyenera kufunsa katswiri kuti mudziwe ngati angagwiritsidwe ntchito poonda. Mwina adotolo, potengera zomwe agwiritsa ntchito mankhwalawa komanso zotsatira za mayeso a wodwalayo, angakulimbikitse kutenga kuchuluka kwa Siofor 500. Komabe, ziyenera kukumbukiridwa kuti kuchepetsa thupi popanda kuchita chilichonse kulephera.

Mutatha kutenga Siofor, kuwunika kwa wodwala komanso zomwe akatswiri awonetsa: owonda akhoza kuchepa thupi. Koma pokhapokha mutatsatira zakudya zochepa zopatsa mphamvu ndikuchepetsa kuchuluka kwa chakudya chamagetsi.

Ntchito ndi mlingo

Malangizo a boma amapereka malangizo omveka bwino a momwe angatenge Siofor ndi fanizo lake. Kugwiritsa ntchito Mlingo wa 500, 1000 ndi Siofor 850 kumawonetsedwa kwa odwala akuluakulu omwe ali ndi matenda amtundu wa 2, omwe ali onenepa kwambiri komanso osagwiritsa ntchito bwino mankhwala omwe adalandira kale.

Posachedwa, akatswiri ayamba kupereka mankhwala a 500 mg kapena Siofor 850 pochiza matenda a prediabetes. Ichi ndi chikhalidwe chodziwika ndi kuchepa kwa kuchuluka kwa insulini yomwe imapangidwa ndi kapamba. Anthu omwe ali ndi vutoli ali pachiwopsezo chotenga matenda a shuga. Munthawi yomweyo ndi mankhwala, wodwalayo adamulamula kuti azitsatira mosamalitsa.

Kuphatikiza apo, mankhwalawo ndi gawo la mankhwala omwe amakhazikitsidwa ndi ovary ya polycystic. Izi ndichifukwa choti odwala omwe ali ndi matenda amtunduwu nthawi zambiri amavutika ndi vuto la carbohydrate.

Komabe, zoyipa za Siofor 500, 850 kapena 1000 mg zimakakamiza akatswiri kuyandikira nthawi yoikika mosamala kwambiri.

Mu matenda a shuga, mankhwalawa amatha kutumikiridwa mu mitundu itatu yokha: 500, 850 ndi Siofor 1000. Mtundu wanji wa kumwa mwa mtundu wina womwe umapezeka ndi dokotala yekha, malinga ndi momwe alili. Nthawi zambiri, mankhwala amayamba ndi mlingo wotsikitsitsa - 500 mg. Ngati wodwala ali ndi matenda a prediabetes, ndiye kuti mankhwalawa, monga lamulo, sawonjezereka. Kuphatikiza apo, Siofor 500 imaperekedwa kwa odwala omwe ayenera kuchepetsa thupi.

Ngati wodwalayo alibe zotsatira zoyipa masiku 7 atayamba kumwa mankhwalawa, mulingo umachulukitsa ndipo amalembera Siofor 850. Mapiritsi amatengedwa kokha moyang'aniridwa ndi dokotala, ndipo ngati palibe kupatuka, ndiye kuti masiku 7 aliwonse mankhwalawa amawonjezeka ndi 500 mg ya metformin mpaka othandiza kwambiri mfundo.

Kuchulukitsa mlingo wa mankhwalawa kumatha kuyambitsa mavuto. Poterepa, akuyenera kuchepetsa mlingo mpaka kuwonetsa koyambirira. Matenda a wodwalayo akayamba kukhala abwinobwino, muyeneranso kuyesetsa kukulitsa mlingo kukhala wogwira mtima kwambiri.

Piritsi imayenera kutengedwa yonse, osati kutafuna ndikusambitsidwa ndi madzi ambiri.
Ndikwabwino kuti muzidya nthawi yomweyo mukatha kudya kapena musanadye mwachindunji.
Ngati Siofor 500 yakhazikitsidwa, ndiye kuti imatengedwa kamodzi bwino madzulo kuti muchepetse chiopsezo cha mavuto.
Ngati Siofor 1000 mg yakhazikitsidwa, ndiye kuti piritsi liyenera kugawidwa pawiri.

Mlingo wapamwamba kwambiri womwe dokotala amatha kupereka ndi Siofor 1000 mg. Kwa chithandizo chokwanira komanso kuchepa thupi, ndikokwanira kumwa kawiri pa tsiku. Mankhwala, wodwalayo amathandizidwa kuti nthawi ndi nthawi ayesedwe magazi ndi ziwonetsero zosiyanasiyana kuti adziwe ntchito ya impso ndi chiwindi.

Contraindication ndi zoyipa

Anthu ambiri amaganiza kugwiritsa ntchito Siofor ndi fanizo lake kuti achepetse thupi. Samayimitsidwa ndikuti atatenga Siofor, zotsatira zoyipa ndizotheka. Musanayambe chithandizo, muyenera kuwerenga mosamala malangizo ndikulankhula ndi dokotala.

Munthu amene amamwa mankhwalawa kapena mawonekedwe ake ayenera kusiya kumwa zakumwa zoledzeretsa. Siofor ndi mowa sizigwirizana. Kuphatikizika kwawo kumatha kubweretsa zotsatira zoyipa kwambiri - chiwonongeko chosasinthika cha chiwindi.

Mukamamwa Siofor, zotsutsana zomwe zimayambitsa zimakhudzana ndi iwo omwe ali ndi vuto la kusowa madzi m'thupi, akuwonetsa chiwindi ndi impso, komanso mavuto ndi mtima. Muyenera kusiya kumwa mankhwalawa matenda opatsirana, pakukweza kutentha kwa thupi, musanachite opareshoni kapena mutavulala. Iyenera kusiyidwa ndi azimayi panthawi yoyembekezera komanso pakubala. Kuphatikiza apo, mankhwalawa amatsutsana ndi matenda a shuga 1.

Mankhwalawa sanatchulidwe ana. Anthu opitilira zaka 60 sachita zambiri. Osagwiritsa ntchito kwa iwo omwe akuchita masewera olimbitsa thupi kapena omwe akuchita masewera olimbitsa thupi. Ngati izi sizikwaniritsidwa, ndiye kuti chiopsezo chokhala ndi zovuta zomwe zimatchulidwa chikuwonjezeka.

Mukamatenga Siofor ndi mawonekedwe ake ndi mulingo wothandizila 500 mg, 850 ndi Siofor 1000, sizikulimbikitsidwa kuti mugwire ntchito yomwe imafunika chidwi ndi kuyendetsa galimoto. Kupanda kutero, chiwopsezo cha kukhala ndi hypoglycemia chikuwonjezeka.

Zowona kuti zovuta zomwe zimachitika pakumwa mankhwalawa zimachitika nthawi zambiri kuposa momwe mumagwiritsira ntchito mankhwala ena a shuga zimawonetsedwa ndi kuwunika kambiri kwa odwala ndi kuwonera kwa akatswiri. Mawonetsero olakwika amachitika mukamamwa Siofor 850 komanso mukamagwiritsa ntchito mlingo wa 500 mg. Wodwala amatha kudandaula za mseru komanso kupweteka kwam'mimba, kutsegula m'mimba, kusanza, kapena kugona. Kuphatikiza apo, mankhwalawa amatha kuyambitsa kuchepa kwa magazi komanso matupi awo.

Kugwiritsa ntchito mankhwala kwa nthawi yayitali kumayambitsa lactic acidosis. Ili ndiye vuto lowopsa lomwe limapangitsa kupweteka m'misempha ndi m'mimba. Wodwalayo akumva kugona, akuvutika ndi kupuma movutikira, kutentha kwake kwa thupi ndi kutsika kwa magazi, mtima wake umachepa. Zizindikirozi zikawoneka, wodwala amafunika kuthandizidwa mwachangu.

Biphasic Insulin Aspart

Insulin aspart ndi insulin yotsika mtengo yochepa yomwe imapezeka pogwiritsa ntchito njira zamtundu wa biotechnology komanso genetic engineering. Amapangidwa ndi mitundu yosinthika ya Saccharomyces cerevisiae yisiti, yomwe imalimidwa pazolinga izi pamakampani ogulitsa mankhwala. Mankhwalawa amachepetsa shuga la magazi kwa odwala omwe ali ndi matenda amtundu woyamba, pomwe samayambitsa matupi awo komanso sikuletsa chitetezo cha m'thupi.

Mfundo yogwira ntchito

Mankhwalawa amamangirira ku insulin receptors mu adipose minofu ndi minofu minofu. Mlingo wa glucose m'magazi umachepetsedwa chifukwa minofu imatha kuyamwa kwambiri glucose, Komanso, imalowanso m'maselo, pomwe kuchuluka kwa mapangidwe ake mu chiwindi, mosiyana, kumachepa. Ntchito yogawa mafuta m'thupi imakulirakulira komanso imathandizira kapangidwe ka mapuloteni.

Kuchita kwa mankhwalawa kumayamba pambuyo pa mphindi 10-20, ndipo kuchuluka kwake kwakukulu m'magazi kumadziwika pambuyo pa maola 1-3 (izi ndi maulendo awiri mwachangu poyerekeza ndi mahomoni amunthu wamba). Insulin yokhayo yotere imakhala yogulitsidwa pansi pa dzina la malonda NovoRapid (pambali pake, palinso gawo la insulin aspart, lomwe limasiyana mu kapangidwe kake).

Ubwino ndi zoyipa

Insulin aspart (biphasic ndi single-gawo) imasiyana pang'ono ndi insulin wamba ya anthu. Mwanjira inayake, amino acid proline imasinthidwa ndi aspartic acid (yomwe imadziwikanso kuti aspartate). Izi zimangotukula mphamvu za mahomoni ndipo sizikugwirizana mwanjira iliyonse kulekerera kwake bwino, ntchito komanso kutsika pang'ono. Chifukwa cha kusinthaku, mankhwalawa amayamba kugwira ntchito mwachangu kwambiri kuposa mawonekedwe ake.

Mwa zovuta za mankhwala omwe ali ndi mtunduwu wa insulin, ndizotheka kudziwa, ngakhale sizimachitika kawirikawiri, komabe zovuta zina zoyipa.

Amatha kudziwonetsa okha:

kutupa ndi zilonda pamalowo jekeseni,
lipodystrophy,
zotupa pakhungu
khungu lowuma,
sayanjana.

Zokhudza insulin yamakono

Pali zolephera zina pakugwiritsira ntchito insulin ya anthu, mwachitsanzo, kuyang'ana pang'onopang'ono (wodwala matenda ashuga ayenera kupereka jakisoni kwa mphindi 30 mpaka 40 asanadye) komanso nthawi yayitali kwambiri yogwira (mpaka maola 12), yomwe imakhala chinthu chofunikira kwambiri pakuchedwa hypoglycemia.

Kumapeto kwa zaka zana zapitazi, kufunikira kwakakulitsa mapangidwe a insulin omwe sangakhale opanda zolakwa izi. Ma insulin omwe amagwira ntchito mwachidule adayamba kupangidwa ndi theka lalifupi kwambiri la moyo.

Izi zinawabweretsa pafupi ndi mphamvu za insulin yakunja, yomwe imatha kulumikizidwa pambuyo pa mphindi 4-5 mutalowa m'magazi.

Mitundu ya insulin yopanda chopanda kanthu imatha kukhala yofanana komanso yodziwikika bwino kuchokera ku mafuta osakanikirana ndipo osaputa hypoglycemia yausiku.

Zaka zaposachedwa, pakhala kusintha kwakukulu mu pharmacology, chifukwa akuti:

Kusintha kwa mayankho acidic kukhala ndale,
kupeza insulin yaumunthu pogwiritsa ntchito tekinoloje ya DNA,
kupanga kwa insulin mmalo wapamwamba kwambiri ndi mawonekedwe atsopano a pharmacological.

Ma insulin analogi amasintha nthawi ya zochita za munthu mahomoni kuti apereke njira yodziwika yolumikizira matupi a anthu odwala matenda ashuga.

Mankhwalawa amathandizira kuti athe kukwaniritsa bwino pakati pa zoopsa zothira m'magazi amwazi ndikwaniritsa glycemia yomwe mukufuna.

Mitundu yamakono ya insulin malinga ndi nthawi yomwe ikuchitika nthawi zambiri imagawidwa m'magulu:

ultrashort (Humalog, Apidra, Novorapid Penfill),
yayitali (Lantus, Levemir Penfill).

Kuphatikiza apo, pali mankhwala osakanikirana omwe amaphatikizidwa, omwe ali osakanikirana ndi mahashoni a ultrashort komanso ma nthawi yayitali muyeso inayake: Penfill, Humalog mix 25.

Humalog (lispro)

Mu kapangidwe ka insulin iyi, malo a proline ndi lysine adasinthidwa. Kusiyana pakati pa mankhwalawa ndi insulin yaumunthu yamunthu ndi kuchepa kocheperako kwa mayanjano apakati. Poona izi, lispro imatha kumizidwa mwachangu kulowa m'magazi a munthu wodwala matenda ashuga.

Ngati muzibayira mankhwala omwe ali mgulu lomwelo komanso nthawi yomweyo, Humalog iperekanso msanga kwambiri 2 times mwachangu. Hormone iyi imachotsedwa mwachangu kwambiri ndipo patatha maola 4 kuyika kwake kumafika pachimake. Kukumana kwa insulin yaumunthu yosavuta kudzasungidwa mkati mwa maola 6.

Kuyerekeza Lyspro ndi insulin yaying'ono yokhala ndi kanthawi kochepa, titha kunena kuti zakale zingalepheretse shuga kukhala ndi chiwindi kwambiri.

Palinso mwayi wina wa mankhwala a Humalog - ndiwodziwikiratu ndipo ungathe kuyambitsa kusintha kwa mankhwalawa muzakudya zopatsa thanzi. Amadziwika ndi kusowa kwa kusintha kwakanthawi kofikira kuchokera pakuwonjezeka kwa kuchuluka kwa zinthu.

Kugwiritsa ntchito insulin yosavuta yaumunthu, kutalika kwa ntchito yake kumasiyanasiyana kutengera mlingo. Ndi chifukwa ichi kuti nthawi yayitali maola 6 mpaka 12 imayamba.

Ndi kuwonjezeka kwa mlingo wa insulin Humalog, kutalika kwa ntchito yake kumakhalabe kofanana pamlingo umodzi ndipo kudzakhala maola 5.

Pambuyo pake ndikuwonjezeka kwa mlingo wa lispro, chiopsezo cha kuchepa kwa hypoglycemia sichikula.

Aspart (Novorapid Penfill)

Mafuta a insulin amenewa angayerekezere bwino mayankho okwanira a insulin pakudya. Kutalika kwake kumapangitsa kuti pakhale zovuta pakati pa chakudya, zomwe zimapangitsa kuti pakhale gawo lathunthu pakulamulira shuga.

Ngati tifanizira zotsatira za mankhwalawa ndi ma insulin omwe ali ndi insulin wamba yodziwika bwino, kuwonjezereka kwa mkhalidwe wowongolera wa shuga yamagazi a postprandial kumadziwika.

Kuphatikiza mankhwala ndi Detemir ndi Aspart kumapereka mwayi:

pafupifupi 100% imasintha mawonekedwe a tsiku lililonse la insulin,
kusintha moyenera mulingo wa glycosylated hemoglobin,
Amachepetsa mwayi wokhala ndi vuto la hypoglycemic,
muchepetse matalikidwe ndi kuchuluka kwa magazi a anthu odwala matenda ashuga.

Ndizofunikira kudziwa kuti pochita mankhwala ndi basal-bolus insulin analogues, kuchuluka kwambiri kwa thupi kunatsika kwambiri kuposa nthawi yonse yowonera mwamphamvu.

Glulisin (Apidra)

Anulin ya insulin ya anthu ndi mankhwala owonetsa pang'onopang'ono. Malinga ndi pharmacokinetic yake, mawonekedwe a pharmacodynamic ndi bioavailability, Glulisin ndi wofanana ndi Humalog. Mu ntchito yake ya mitogenic ndi metabolic, timadzi tambiri timasiyana ndi insulin yosavuta ya munthu. Chifukwa cha izi, ndizotheka kugwiritsa ntchito nthawi yayitali, ndipo ndizotetezeka kwathunthu.

Monga lamulo, Apidra iyenera kugwiritsidwa ntchito kuphatikiza ndi:

insulin yayitali yaumunthu
basal insulin analogue.

Kuphatikiza apo, mankhwalawa amadziwika ndi kuyamba mwachangu pantchito komanso nthawi yofupikirapo kuposa mahomoni abwinobwino amunthu. Zimathandizira odwala omwe ali ndi matenda ashuga kuwonetsa kusinthasintha kwakukulu pakugwiritsa ntchito ndi chakudya kuposa timadzi ta munthu. Insulin imayamba kugwira ntchito yake atangoyambika, ndipo magazi a shuga amatsika patadutsa mphindi 10 mpaka Apidra atabayidwa jakisoni.

Popewa hypoglycemia mwa okalamba odwala, madokotala amalimbikitsa kuyambitsidwa kwa mankhwalawa mutangodya kapena nthawi yomweyo. Kutsika kwa mahomoni kumathandiza kupewa zomwe zimadziwika kuti "overlay", zomwe zimapangitsa kupewa hypoglycemia.

Glulisin imatha kukhala yothandiza kwa iwo onenepa kwambiri, chifukwa kugwiritsa ntchito sikumayambitsa kulemera kowonjezereka. Mankhwalawa amadziwika ndi kuyambika mofulumira kwa kuchuluka kwa ndende poyerekeza ndi mitundu ina ya mahomoni a nthawi zonse ndi a lispro.

Apidra ndi yabwino kwa madigiri osiyanasiyana onenepa kwambiri chifukwa chosinthasintha kwambiri. Mu kunenepa kwa mtundu wa visceral, kuchuluka kwa mayamwidwe kwa mankhwalawa kumatha kusintha, zimapangitsa kuti zikhale zovuta kwa prandial glycemic control.

Detemir (Levemir Penfill)

Levemir Penfill ndi analogue of insulin ya anthu. Ili ndi nthawi yogwira ntchito ndipo ilibe nsonga. Izi zimathandizira kuyang'anira basal glycemic masana, koma amagwiritsidwa ntchito kawiri.

Mothandizidwa ndi subcutaneally, Detemir amapanga zinthu zomwe zimalumikizana ndi serum albin mu madzi amkati. Pambuyo posamutsira kudzera khoma la capillary, insulin imamangirizanso ku albumin m'magazi.

Pokonzekera, ndi gawo laulere lokha lomwe likugwira ntchito mwachilengedwe. Chifukwa chake, kumangiriza albumin ndi kuvunda kwake pang'onopang'ono kumapereka ntchito yayitali komanso yopanda pake.

Levemir Penfill insulin imagwira wodwala yemwe ali ndi matenda ashuga bwino komanso amakwaniritsa zosowa zake zonse za insal insulin. Sipereka kugwedeza musanayambe makatani.

Glargin (Lantus)

Glargin insulin cholowa m'malo mwake imakhala yothamanga kwambiri. Mankhwala amatha kusungunuka bwino m'malo ena acidic, ndipo osalowerera ndale (m'mafuta onenepa) samasungunuka bwino.

Atangokhala subcutaneous makonzedwe, Glargin amalowa mu kusayanjana ndi mapangidwe a microprecipitation, komwe ndikofunikira kuti amasulidwe enanso a mankhwalawa komanso kugawa kwawo kukhala ma cell a insulin komanso ma dimers.

Chifukwa cha kuyenda kosadukiza komanso kwapang'onopang'ono kwa Lantus kulowa m'magazi a wodwala yemwe ali ndi matenda ashuga, kufalikira kwake mu njira kumachitika mkati mwa maola 24. Izi zimapangitsa kuti jakisoni wa mankhwala a insulin azitha kamodzi kokha patsiku.

Tikatulutsa zinc zochepa, inshuwaransi ya Lantus imalira m'misempha, yomwe imakulitsa nthawi yake. Mtheradi zonse za mankhwalawa zimatsimikizira mawonekedwe ake osalala komanso opanda chiyembekezo.

Glargin amayamba kugwira ntchito atatha mphindi 60 atabaya jekeseni wa subcutaneous. Mphamvu yake m'magazi a wodwala imatha kuthandizidwa pambuyo pa maola 2-4 kuyambira nthawi yoyamba kumwa mankhwala.

Mosasamala nthawi yeniyeni yovomerezeka ya jakisoni wa mankhwalawa (m'mawa kapena madzulo) ndi malo omwe jakisoni idzakhalire (m'mimba, mkono, mwendo), nthawi yowonekera kwa thupi idzakhala:

pafupifupi - maola 24
pazambiri - maola 29.

Kusintha kwa insulin Glargin kumatha kufanana ndi mahomoni achilengedwe pakuyenda kwawo kwambiri, chifukwa mankhwalawa:

Moyenerera amathandizira kudya shuga ndi zotumphukira zotengera insulin (makamaka mafuta ndi minofu),
amalepheretsa gluconeogeneis (amachepetsa shuga).

Kuphatikiza apo, mankhwalawa amachepetsa kwambiri gawo logawanika la adipose minofu (lipolysis), kuwonongeka kwa mapuloteni (proteinolysis), pomwe amalimbikitsa kupanga minofu.

Kafukufuku wazamankhwala a Glargin's pharmacokinetics awonetsa kuti kugawa kosagwiritsa ntchito bwino kwa mankhwalawa kumapangitsa kuti pafupifupi 100% ikhale ndi fanizo loyambira la insulin ya insulin mkati mwa maola 24. Nthawi yomweyo, mwayi wokhala ndi machitidwe a hypoglycemic ndi kulumpha lakuthwa m'magazi a shuga amachepetsa kwambiri.

Kusakaniza kwa Humalog 25

Mankhwala awa ndi osakaniza omwe amakhala ndi:

75% yovala kuyimitsidwa kwa horpro ya mahomoni,
25% insulin Humalog.

Izi ndi mitundu ina ya insulin imaphatikizidwanso mogwirizana ndi njira yawo yotulutsira. Kutalika kwa mankhwalawa kumaperekedwa chifukwa cha kufalikira kwa mahomoni lyspro, zomwe zimapangitsa kubwereza kupanga kwapansi kwa mahomoni.

25% yotsala ya inshuwaransi ya lispro ndi gawo lomwe limakhala ndi nthawi yayitali yodziwonetsa, yomwe imakhudza glycemia atatha kudya.

Ndizofunikira kudziwa kuti Humalog mu kapangidwe kazosakaniza zimakhudza thupi mwachangu kwambiri poyerekeza ndi mahomoni afupiafupi. Imapereka chiwongolero chomaliza cha glycemia ya postpradial chifukwa chake mbiri yake imakhala yolimba poyerekeza ndi insulin yochepa.

Ma insulin osakanikirana amalimbikitsidwa makamaka kwa anthu omwe ali ndi matenda a shuga a 2. Gululi limaphatikizapo odwala okalamba omwe, monga lamulo, amavutika ndi mavuto a kukumbukira. Ichi ndichifukwa chake kuyambitsidwa kwa mahomoni musanadye kapena atangomaliza kumene kumathandiza kwambiri kukonza moyo wa odwala.

Kafukufuku wokhudzana ndi thanzi la odwala matenda ashuga omwe ali pagulu la zaka 60 mpaka 80 pogwiritsa ntchito mankhwala osakanikirana a Humalog 25 adawonetsa kuti adakwanitsa kulipidwa bwino chifukwa cha kagayidwe kazakudya. Mwanjira yovomerezeka ya mahomoni isanayambe komanso itatha kudya, madokotala adakwanitsa kuonda pang'ono komanso kutsika kwambiri kwa hypoglycemia.

Kodi insulini yabwino ndi iti?

Ngati tingayerekeze ma pharmacokinetics a mankhwalawa omwe amawaganizira, ndiye kuti kupezeka kwawo ndi adotolo kuli koyenera ngati pali matenda a shuga, onse oyamba ndi achiwiri. Kusiyana kwakukulu pakati pa ma insulin awa ndi kusowa kwa kuwonjezeka kwa thupi panthawi yamankhwala komanso kuchepa kwa chiwerengero cha kusintha kwamasiku usiku m'magazi.

Kuphatikiza apo, ndikofunikira kuzindikira kufunika kwa jakisoni imodzi masana, yomwe ili yabwino kwambiri kwa odwala. Mwapamwamba kwambiri ndizothandiza kwa Glargin human insulin analogue kuphatikiza ndi metformin kwa odwala omwe ali ndi matenda a shuga a 2. Kafukufuku akuwonetsa kuchepa kwakukulu kwa ma spikes ausiku mu ndende ya shuga. Izi zimathandizira modabwitsa tsiku lililonse glycemia.