Matenda a shuga a insulin

Kwa zaka zambiri osalimbana ndi ma DIABETES?

Mutu wa Bungwe: “Mudzadabwitsidwa kuti kumakhala kovuta motani kuchiritsa matenda a shuga tsiku lililonse.

Kuwerengeredwa kwa mlingo wa insulin ndikofunikira kuti wodwala yemwe ali ndi matenda osokoneza bongo akhalebe wathanzi kugwira ntchito kwa thupi ndikuthandizira kuti ayambirenso matendawa. Mlingo wa insulin umayimiriridwa ndi maulungo a zochita - ED. Mankhwala amagulitsidwa m'mabotolo apadera. Botolo imodzi ya 5 ml ili ndi magawo 200 a insulin. Pogwiritsa ntchito kuwerengera kosavuta, mutha kudziwa kuti 1 ml ya chinthucho ili ndi magawo 40 a mankhwalawa. Pakukhazikitsa mlingo wa insulin, syringe yapadera imagwiritsidwa ntchito, pomwe zilembo za UNIT zimayikidwa.

Momwe mungadziwire kuchuluka kwa mkate

"Chikhomo" chachikulu cha zakudya za odwala omwe ali ndi matenda ashuga ndi chakudya chamafuta. Pofuna kudziwa zomwe zili mu malonda enaake, mkate wa XE umagwiritsidwa ntchito, womwe umawagwiritsa ntchito ngati mawerengero. Amakhulupirira kuti imakhala ndi 12 g yamafuta oyera komanso kuti imatha kuwonjezera shuga m'magazi ndi 1.7-2.7 mmol / L. Kuti muwone kuchuluka kwa chakudya chamafuta omwe mumalizidwa, muyenera kugawa kuchuluka kwa chakudya chosonyezedwa pazomwe zimapangidwa ndi 12. Mwachitsanzo, fakitolo yomwe ikukhazikitsa mkate imawonetsa kuti 100 g ya zinthu zili ndi 90 g yamafuta, ndikugawa manambala ndi 12 zimapezeka kuti 100 g mkate uli ndi 7.5 XE.

Momwe mungadziwire chidziwitso cha glycemic

GN - glycemic katundu ndi chizindikiro chomwe chimawonetsa kuchuluka ndi kuchuluka kwa chakudya chamagulu muzakudya. Kuti muwerengere, muyenera kudziwa index ya glycemic - GI peresenti. Chizindikirochi chikuwonetsa kuchuluka kwa mayamwidwe amthupi mu thupi. Zimakupatsani mwayi wambiri kudziwa momwe kuchuluka kwa shuga m'magazi kukwera pambuyo pokumba kwa chinthu poyerekeza ndi muyezo. Mwachitsanzo, GI ya 80 imatanthawuza kuti wodwala akatha kudya 50 g ya chinthu china, kuchuluka kwa shuga kwa magazi kumakhala 80% ya mtengo womwe umawonedwa m'magazi mutatha kudya 50 g ya shuga.

Kuyambitsa ndi kuwerengera kwa kuchuluka kwa insulin

Mukamawerengera insulin, mulingo woyenera kufotokozera za matenda ashuga uyenera kuganiziridwanso. Mukuyeneranso kukumbukira kuti zosaposa 1 unit ya mankhwala pa kilogalamu imodzi ya kulemera kwa thupi zitha kuperekedwa tsiku lililonse kwa odwala omwe ali ndi matenda osokoneza bongo a shuga, mwinanso kutha kwa bongo kungachitike.

Mlingo wa odwala omwe ali ndi matenda osiyanasiyana:

1. Yemwe 1 digiri yamatenda yapezeka posachedwa - mayunitsi 0,5 / kg.
2. Ndani ali ndi 1 degree ya matenda ashuga, ndipo nthawi yolipira ndi chaka chimodzi kapena kuposerapo - mayunitsi 0,6 / kg.
3. Ndani ali ndi 1 digiri ya zovuta za shuga komanso mkhalidwe wopweteketsa kosakhazikika - 0,7 U / kg.
4. Ndani wawononga shuga - mayunitsi 0,8 / kg.
5. Ndani ali ndi matenda a shuga mellitus ovuta ndi ketoacidosis - 0,9 U / kg.
6. Amayi oyembekezera mu 3 trimester amapatsidwa mayunitsi 1.0 / kg.

Chifukwa cha kuyambitsa kwa insulin yayitali, zotsatira za kuyerekeza kwamachitidwe achilengedwe amakwaniritsidwa. Mankhwalawa nthawi zambiri amaperekedwa musanadye chakudya cham'mawa komanso musanadye. Zakudya zina, mankhwalawa nthawi zambiri samaperekedwa. Mlingo wogwira ntchito waifupi komanso wa ultrashort patsiku uzikhala ndi magawo 14 mpaka 28. Chizindikirochi chimatha kusiyanasiyana malinga ndi momwe zinthu ziliri komanso kuchuluka kwa shuga m'magazi. Izi zimafuna kudziyang'anira pawokha, kochitika ndi glucometer.

Mukafuna kudziwa kuchuluka kwa insulin, ndikofunikira kudalira deta pa:

• mkodzo ndi shuga m'magazi
• nthawi ya tsiku
• kuchuluka kwa mafuta omwe mukufuna kudya pambuyo pa jekeseni,
• zolimbitsa thupi musanadye komanso pambuyo chakudya.

Zinthu zomwe zili pamwambazi ndizachidziwitso pakuwerengera, koma osati zokhazo.

Mukamawerengera insulin, muyenera kugwiritsa ntchito njira zotsatirazi: muyeso wa tsiku ndi tsiku pazinthu zolimbitsa thupi, kenako ndikugawidwa ndi 2. Mwachitsanzo, mlingo wa tsiku ndi tsiku ndi magawo 0,7. Kuchulukitsa ndi kulemera kwa makilogalamu 70, timapeza 49. Kugawa ndi 2, timapeza 24 (kuzungulira phindu). Ndiye kuti, mukadzadya kadzutsa muyenera kulowa mayunitsi 14, ndipo pakudya chakudya magawo 10.

Muwerenge ICD: 49-24 = 25. Kuchokera pamenepa timalandira kuti tisanadye kadzutsa muyenera kulowa mayunitsi a 9-11, musanadye chakudya cham'mawa mpaka 6 kapena 6 musanadye chakudya. Chotsatira, muyenera kusintha kuchuluka kwa mankhwalawa malinga ndi glycemia. Chenjezo: kuwerengera uku ndi pafupifupi ndipo kumafunikira kukonzedwa. Kuti muchepetse kuwonetsa zambiri, ndikofunikira kuganizira kuchuluka kwa shuga.

Ngati mumayang'anira kuchuluka kwa shuga m'magazi, ndikuwerengera moyenera mulingo wa insulin ndikutsatira malangizo onse a dokotala, mutha kukhala ndi moyo wautali komanso wachangu.

Insulin kwambiri

• Mlingo umodzi woyenera
• Mitundu iwiri ya bongo
• 3 Zoyambitsa matenda
• 4 Zizindikiro zazikulu
• Zotsatira za mankhwala osokoneza bongo ambiri a insulin
  • 5.1 Hypoglycemia
  • 5.2 Hypoglycemic chikomokere
• Zoyenera kuchita vuto la bongo?
• 7 woopsa mlingo
• Kupewa Kwambiri

Type 1 shuga mellitus amadalira insulini ndipo amafuna jakisoni wokhazikika wa insulin. Pazifukwa zina, kuchuluka kwa insulini kumachitika - chinthu chowopsa chomwe chimayambitsa zovuta zingapo. Kusankha mtundu wa mahomoni ndi mlingo wake uyenera kuchitidwa ndi adokotala. Kusintha kosavomerezeka pamalingo kapena pafupipafupi jakisoni kumatha kupha.

Mlingo woyenera

Osangokhala amtundu wa ashuga wokha komanso othamanga amapita jakisoni wa insulin monga gawo lokonzekera anabolic.

Mlingo wa insulin umayezedwa m'magawo ndipo amatanthauza "ED" kapena "INE". Muyezo wamakono, womwe umati 1ED = 1/24 mg ya mahomoni mu mawonekedwe a makhristali, adalandiridwa mmbuyo mu 1958. Mutha kuperekera insulin kwa munthu wathanzi labwino kuposa kuchuluka kwa mayunitsi a 2-4. Ochita masewera kumayambiriro kwa maphunziro amalimbikitsidwa kuti ayambe ndi mayunitsi awiri ndikukula pang'ono pang'onopang'ono, osapitirira 20 mayunitsi. Kwa odwala matenda ashuga, monga gawo la kubwezeretsa matendawa, pafupifupi 20-50 amayambitsidwa masana. Chizindikiro chokha chimasankhidwa ndi adokotala, ndipo zimatengera magawo otsatirawa:

• mtundu wa mankhwala
• zaka ndi kulemera kwa wodwalayo
• gawo la matenda
• thanzi laumunthu
• trimester pa mimba,
• kudalira kugwiritsa ntchito mankhwala pa nthawi ya tsiku ndi kudya.

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Mitundu ya bongo

Pa bongo wambiri wa mahomoni, kukomoka kumatha kudwala.

Mwa munthu wathanzi, kuchuluka kwa insulini kumachitika mofulumira kuposa odwala matenda ashuga, ngakhale mutagwiritsa ntchito timadzi tambiri timene timapanga. Mitundu ya mankhwala osokoneza bongo amasiyana kutengera kuchuluka kwa mahomoni ndi kutalika kwa chithandizo chosayenera. Mitundu yotsatirayi ikhoza kusiyanitsidwa:

• Matenda osokoneza bongo a bongo. Amayamba ngati makulidwe osayenera a mahomoni amakhala nthawi yayitali. Imawoneka ngati zizindikiro za hypoglycemia mu 35% ya milandu.
• Ricochet hyperglycemia. Kukula kwa matenda am'mimba kumawonedwa ngati chinthu chodabwitsa. Pambuyo pa hypoglycemia yomwe imachitika usiku, wodwalayo amakhala ndi hyperglycemia m'mawa.
• Pachimake bongo. Hypoglycemia wodziwika ndi zizindikiritso. Kukula kwa matenda am'mimba kumachitika ngati muika nthawi yayikulu ya mankhwala. Kuwonongeka kwakukulu kwa ubongo, chikomokere, ndi kufa ndizotheka.

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Zoyambitsa matenda

Zotsatira zotsatirazi za kuchuluka kwa mahomoni zimadziwika:

• makonzedwe olakwika a mahomoni kwa munthu wopanda matenda a shuga,
• kuphwanya kuwerengera mlingo,
• kusinthana ndi mankhwala ena kapena kugwiritsa ntchito mtundu wina wa syringe,
• pamitsempha, osati modzitchinjiriza,
• zolimbitsa thupi popanda kudya zakudya zamafuta,
• zolakwa za wodwalayo pakugawana mahomoni amtundu waifupi komanso wautali,
• kukana chakudya pambuyo jakisoni,
• mowa.

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Zizindikiro zazikulu

Kuchuluka kwina kwa insulin kumapangitsa kuti muwoneke. Woopsa akamwalira, munthu akhoza kufa.

Kuletsa kuukira kwa hypoglycemia, ndikokwanira kudya chokoleti pang'ono.

Ngati munthu wodwala matenda ashuga akuwoneka kuti wakhumudwitsidwa ndipo sagwirizana ndi ena, akhoza kukhala kuti ali ndi vuto lalikulu. Vutoli limatha kuyambitsa kukomoka komanso kutseka kwambiri. Chifukwa chake, ndikofunikira kuzindikira kuwonjezeka kwa mahomoni m'thupi pasadakhale. Chizindikiro chachikulu cha kuchuluka kwa plasma insulin ndi kusamva bwino kwa njala. Pakadali pano, muyenera kudya china lokoma, mwachitsanzo, chidutswa cha chokoleti kapena supuni ya shuga woyenga. Ngati izi sizinachitike, zizindikiro zotsatirazi zimachitika:

• kufooka m'thupi
• manja akunjenjemera
• dzanzi lilime
• kuwonongeka kwamawonekedwe
• kutuluka thukuta kwambiri
• tachycardia
• kuponderezedwa kapena kusokonezeka kwa psyche,
• kulephera kudziwa.

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Hypoglycemia

Mankhwala osokoneza bongo a insulin ndi njira yoopsa. Zotsatira zake, mosasamala za kuuma kwawo, zimakhudza mkhalidwe wamunthu wonse. Hypoglycemia imatha kukhala nthawi yayitali ndipo siziwopseza moyo. Ngati matenda amapezeka pafupipafupi, wodwalayo amakumana ndi mavuto amisala. Mu ana, chifukwa cha hypoglycemia, kukula kwa luntha kumalepheretsa kapena kuyimitsidwa. Ngati izi sizilamulidwa, chikomokere chingachitike.

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Hypoglycemic chikomokere

Vutoli, lomwe limachitika chifukwa cha kuchuluka kwa insulin kapena kukana kudya jakisoni, kumatha kukomoka kapena kufa. Zizindikiro za pathology zitha kugawidwa m'magawo anayi:

Kutha kuzindikira popanda thandizo kungayambitse imfa.

1. Mpweya wa okosijeni wam'mimba. Zizindikiro ndi zizindikiro za hypoglycemia, zomwe zasonyezedwa kale.
2. Kuphwanya gawo la ubongo, ndiye kutuluka thukuta, munthu amayamba kuchita zosayenera.
3. Kugwira ntchito kwapakati. Kuphatikizidwa ndi ana opukusidwa, kukokana. Mwambiri, kuukira kuli kofanana ndi chiwonetsero cha khunyu.
4. Kutaya chikumbumtima. Nthawi yovuta, popanda thandizo lofunikira, ndiyotheka edema ya ubongo ndi kufa.

Munthu aliyense pambuyo pakukomoka kwa vutoli amakhala ndi zotsatirapo zake. Izi zimasiya chizindikiro chake pa thanzi la wodwala. Ngati munthu achotsedwa msanga pamkhalidwewu, kudalira kwake ma jakisoni a insulin kumakulirakulira. Ngati izi zisanachitike, mawonetseredwe a kuchepa kwa mahomoni adawonekera patatha maola awiri ndi atatu, atangopulumuka kumene yemwe wodwala matenda ashuga amamuchepetsa 1 ora litachedwa jekeseni.

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Zoyenera kuchita vuto la bongo?

Pankhani ya kuchuluka kwa insulin, ndikofunikira kuthandiza omwe akukhudzidwa. Koma musanayambe kuchitapo kanthu, muyenera kuonetsetsa kuti Zizindikiro zomwe zimawonekerazi ndi chizindikiro cha hypoglycemia. Kuti tichite izi, tikulimbikitsidwa kukhazikitsa chizindikiro cha shuga m'magazi a odwala matenda ashuga pogwiritsa ntchito glucometer. Chipangizocho chimakulolani kuti mupeze zotsatira mkati mwa masekondi 5. Ngati zotsatira zake ndi 5.7 mmol / l, shuga ndi zabwinobwino. Kutsitsa mtengo wake, kumakhala kwakukulu kwambiri.

Kuti muchepetse mkhalidwe wa munthu, mutha kum'patsa tiyi wokoma.

Chithandizo choyamba cha hypoglycemia chimatsata malamulo otsatirawa:

• Dyetsani mwamunayo mokoma. Maswiti, bun, shuga kapena tiyi wokoma angachite.
• Pangani jakisoni wambiri wa shuga. Kuchuluka kwa ndalama kumatengera momwe wodwalayo alili.

Popereka chithandizo choyambirira ndi kuchuluka kwa insulin m'magazi, shuga wambiri sangaloledwe. Ndi matenda ashuga, izi zimabweretsa kuperewera kwa madzi m'thupi.

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Mlingo wa Lethal

Pakakhala chisamaliro chamankhwala, insulin yowonjezera imakwiyitsa zotsatira zakupha.Mlingo wowopsa wa insulin kwa odwala matenda ashuga amatsimikiziridwa ndi mawonekedwe a thupi, kulemera kwa thupi la munthu, kudya ndi zakumwa zoledzeretsa. Kwa anthu ena, 100 IU ndiye kuchuluka kwa insulini. Nthawi zina, imfa imachitika ndikuyambitsa kwa 300-500 IU ya mankhwalawa. Koma kuchuluka kwakukulu kwa insulin sikuti kumabweretsa imfa. Milandu imadziwika pamene odwala adalandira atalandira insulin kuchuluka kwa 3000 IU.

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Kupewa bongo

Njira yayikulu yopewa kupewera kwa insulin yambiri ndikugwiritsa ntchito kukonzekera kwa mahomoni mosamalitsa malinga ndi zomwe dokotala wakupatsani. Dokotala wa endocrinologist amapereka mankhwala a insulin. Zingwe ziyenera kuchitika nthawi yomweyo. Simungasinthe mwanjira yokhayo ya jakisoni ndi Mlingo, kapena kuletsa jakisoni kwathunthu. Kuti mahomoni azitha kuyamwa mwachangu, timalimbikitsidwa kupereka jakisoni pamimba. Mankhwala a insulin amatanthauza kukana kwathunthu zakumwa zoledzeretsa.

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

Zomwe bongo wambiri zimabweretsa

Kuchulukitsa mlingo wofotokozedwa ndi adokotala mosakayikira kumabweretsa kukula kwa hypoglycemic syndrome. Vutoli limadziwika ndi shuga wochepa wamagazi, omwe amatha kupha. Pankhani ya mlingo wovuta, thandizo loyamba limafunika, lomwe lingapulumutse moyo wa odwala matenda ashuga. Komabe, munthawi imeneyi ndikofunikira kwambiri kuti muzitha kusiyanitsa pakati pa hypoglycemic ndi hyperglycemic syndrome, chifukwa nthawi zina pambuyo pa utsogoleri wa insulin, kuwonongeka kwa mkhalidwe wa wodwala kumatha chifukwa cha kudumpha kwa shuga.

Kwa matenda a hyperglycemic, zizindikiro zotsatirazi ndizodziwika bwino:

• ludzu kwambiri
• kukodza pafupipafupi
• kutopa
• masomphenya osalala
• Kuuma ndi kuyabwa kwa pakhungu,
• kamwa yowuma
• arrhasmia,
• chikumbumtima
• chikomokere.

Mwanjira imeneyi, ndikuphwanya magwiridwe antchito aubongo, omwe ali oopsa makamaka kwa okalamba. Amatha kudwala ziwalo, paresis, kuchepetsedwa kwambiri kwa malingaliro. Mtima ndi mtima zimadwalanso - kuthamanga kwa magazi kumachepa, komwe nthawi zambiri kumayambitsa kuphwanya magazi m'mitsempha, zotupa zam'mimba, komanso zilonda zam'mimba zimatha kuonekera posachedwa. Pankhaniyi, wodwala ayenera kuthandizidwa kubayitsa mahomoni isanafike ambulansi.

Ngati bongo wambiri wayambitsa vuto la hypoglycemic, zizindikiro zotsatirazi zimawonedwa:

• kuchuluka kwamkwiyo, mantha,
• thukuta
• kamvekedwe ka minofu
• ana opukusidwa
• nseru komanso kusanza
• chizungulire, kupweteka mutu,
• machitidwe osayenera
• pre-syncope.

Ngati sanachitepo kanthu mwachangu, wodwalayo amatha kudwala matenda am'mimba, omwe amachititsa kuwonongeka kwamitsempha yamkati. Mavuto a pafupipafupi a hypoglycemic mwa akulu amachititsa kusintha kwakukulu kwa umunthu, ndipo mwa ana amachititsa kuchepa kwa luntha. Komanso, imfa siyimachotsedwa.

Thandizo loyamba

Ngati zizindikiro za kukomoka kwa hypoglycemic zilipo, zochita zotsatirazi ziyenera kuchitidwa kuti khazikitse mkhalidwe wa wodwalayo:

1. Anthu odwala matenda ashuga ayenera kupatsidwa chakumwa kapena china chokoma - tiyi wokhala ndi shuga, maswiti kapena uchi.
2. Onetsetsani malo okhazikika kapena abodza.
3. Pofuna kutaya chikumbumtima, wodwalayo ayenera kuyikidwa pambali pake ndikuyika kachidutswa ka shuga m'tsitsi mwake.
4. Onetsetsani kuti mukuyimbira gulu la ambulansi.

Pofuna kutaya chikumbumtima, 40% glucose (50 ml) amatumikiridwa kwa wodwalayo kudzera m'mitsempha. Ngati sikutheka kupaka mankhwalawa m'mitsempha, amathandizidwa mosavuta - 500 ml ya 6% shuga kapena 150 ml ya glucose 10% mu enema.

Pofuna kupewa kuchuluka kwa insulin yambiri m'matenda a shuga, ndikofunika kutsatira njira zodzitetezera: osaba jekeseni usiku, bola ngati wodwala sakhala usiku akuyang'aniridwa ndi achipatala. Kupatula apo, vuto lalikulu la hypoglycemic limatha kuchitika usiku, pamene munthu alibe thandizo. Anthu omwe ali ndi matenda ashuga nthawi zonse ayenera kukhala ndi zakudya zamagetsi zomwe zimapezeka nawo.

Momwe mungawerengere mlingo

Mlingo wa mahomoni kwa odwala matenda a shuga umayikidwa ndi adokotala okha. Chofunikira kwambiri pakuwona kuchuluka kwa chinthu chimatengedwa ngati kulemera kwa munthu. Komabe, ena akukhulupirirabe kuti chomwe chimapangitsa ndicho kuchuluka kwa shuga m'magazi. Izi sizolondola, zidatsimikiziridwa kalekale ndi sayansi. Endocrinologists amatsutsa kuti muyenera kulowa ma insulin ambiri momwe munthu amalemera.

Mlingo wowopsa kwa aliyense. Ndikulimbikitsidwa kugwiritsa ntchito chotulutsa chapadera, chomwe chimamangidwa pakhungu lam'mimba pogwiritsa ntchito chubu, ndipo kuchuluka kofunikira kwa mahomoniwa kumaperekedwa nthawi zonse m'magazi a wodwala.

Zoyambitsa bongo

Insulin imagwiritsidwa ntchito makamaka ndi odwala matenda ashuga, koma zotulukapo zake zambiri zimagwiritsidwa ntchito nthawi zina. Mwachitsanzo, mphamvu ya insulin ya insulin yapeza ntchito pakulimbitsa thupi.

Mlingo wa insulin amasankhidwa payekha, moyang'aniridwa ndi dokotala. Pankhaniyi, ndikofunikira kuyeza glucose m'magazi, kudziwa njira zodziletsa pakuthana ndi matendawa.

Kwa munthu wathanzi, mankhwalawa "osavulaza" amachokera ku 2 mpaka 4 IU. Omanga a thupi amabweretsa kuchuluka kwa 20 IU patsiku. Mankhwalawa matenda a shuga, kuchuluka kwa mankhwalawa omwe amaperekedwa patsiku kumasiyana magawo 20-50.

Mankhwala osokoneza bongo amatha kuchitika pazifukwa zingapo:

• Zolakwika za dotolo - jakisoni wa insulin kwa munthu wathanzi,
• Mlingo wolakwika
• kugwiritsa ntchito mankhwala atsopano kapena kusinthira mtundu wina wa syringe,
• zolakwika pa nthawi ya jakisoni - kuyambitsa sikuwoneka modekha, koma modekha.
• zolimbitsa thupi osamwa chakudya,
• zolakwa za wodwala pamene mukugwiritsa ntchito insulin yofulumira komanso mwachangu,
• kusowa chakudya pambuyo jakisoni.

Kuzindikira insulin kumawonjezera mu nthawi yayitali ya mimba, motsutsana ndi maziko a matenda aimpso kulephera, ndi mafuta a chiwindi.

Kodi insulin yowonjezera imachitika liti m'thupi? Izi zitha kuchitika, ngati pali kuphwanya kwa kupanga kwa mahomoni ndi kapamba (mwachitsanzo, ndi zotupa).

Muyenera kusamala kwambiri pakugwiritsa ntchito insulin komanso mowa. Mwakutero, zakumwa zoledzeretsa sizikulimbikitsidwa kwa odwala omwe ali ndi matenda ashuga. Koma popeza zoletsa za madokotala sizimaletsa aliyense, madokotala amalangizidwa kuti azitsatira malamulo otsatirawa kuti muchepetse chiopsezo cha mavuto.

• musanamwe mowa, mankhwalawa a insulin ayenera kuchepetsedwa,
• musanamwe komanso mutamwa mowa, muyenera kudya zakudya zomwe zimakhala ndi mafuta ochulukirapo,
• amakonda zakumwa zoledzeretsa zochepa,
• mukamamwa mowa kwambiri tsiku lotsatira, ndikofunikira kusintha mlingo wa insulin, motsogozedwa ndi miyezo ya shuga.

Imfa ya mankhwala osokoneza bongo a insulin imachitika chifukwa chokhala ndi vuto la hypoglycemic. Mlingo wa mankhwala oopsa umatengera kulekerera kwa insulin m'thupi lililonse, kulemera kwa wodwalayo, ndi zina zotere - kumwa chakudya, mowa, ndi zina zambiri. Kwa ena, kuyambitsa kale IU ya 100 ya mankhwalawa kumakhala koopsa; kwa ena, ziwerengerozi zimachokera ku 300-500 IU. Milandu imadziwika pomwe anthu adapulumuka ngakhale jakisoni wa insulin wokwanira 3000 IU.

Zizindikiro za insulin yowonjezera

Kuonjezera insulin m'magazi kumapangitsa kutsika kwa shuga. Mutha kuyankhula za hypoglycemia ndi chizindikiro chotsika 3.3 mmol / L m'magazi a capillary. Kukula kwa zizindikiro kumadalira mtundu wamankhwala omwe amagwiritsidwa ntchito.Ndi kuyambitsa insulin yofulumira, zizindikirazo zimayamba kwakanthawi kochepa, ndi jakisoni wa insulin yoleza kwa nthawi yayitali.

Zizindikiro za insulin yowonjezera m'magazi ndi motere.

Pa gawo loyamba, kumakhala kumva njala, kufooka, mutu, kusokonezeka kwa mtima.

Imfa imachitika ndi kuchepa kwa ntchito zonse - kupuma, magazi, komanso kusowa kwa zinthu zina.

More bongo

Kugwiritsa ntchito kwambiri insulini popewa matenda a shuga kumayambitsa matenda osokoneza bongo, omwe amaphatikizidwa ndi kupanga mahomoni omwe amalepheretsa kuchepa kwa shuga m'magazi - adrenaline, corticosteroids, glucagon - ndipo amatchedwa "Somoji syndrome." Zizindikiro za odwala osokoneza bongo odwala matenda a shuga:

kwambiri matenda

Nthawi zambiri hypoglycemia imabisika. Zodziwika bwino "zam'mawa zam'mawa zodabwitsa". Hyperglycemia imayamba m'mawa, kuyambira 5 mpaka 7 m'mawa, zomwe zimafotokozedwa ndi kuchuluka kwa mahomoni obisika komanso kufooka kwa jakisoni wa insulin yamadzulo. Matenda a Somoji amasiyana ndi zomwe zimachitika m'mawa. Zotsatira zake, m'mawa wodwala amakhala ndi hyperglycemia woopsa chifukwa cha mankhwala osokoneza bongo a insulin yamadzulo.

Kuthandiza ndi bongo wa insulin

Zoyenera kuchita ndi bongo wa insulin? Thandizo loyamba kapena kudzithandiza ndekha ndi zizindikiro zoyambirira za boma la hypoglycemic zimakhala ndi zotsatirazi.

1. Idyani 50-100 magalamu a mikate yoyera.
2. Ngati zizindikirazo sizitha pambuyo pa mphindi 3-5, idyani maswiti angapo kapena supuni ziwiri za shuga.
3. Ngati pambuyo mphindi 5 zizindikiro zimapitilirabe, bwerezaninso kudya zakudya zamafuta.

Ndi kukula kwambiri hypoglycemia (kutaya chikumbumtima, kukomoka), yankho lalikulu la bongo la insulin ndi mtsempha wamagazi. Jakisoni wa 40% yankho mu kuchuluka kwa 30-50 ml amapangidwa, ngati pambuyo mphindi 10 wodwalayo sanayambenso kuzindikira, ndiye kuti kulowetsako kumachitika mobwerezabwereza.

Zotsatira za kuchuluka kwa insulin

Zotsatira za bongo wambiri zimadalira kuchuluka kwa momwe zimachitikira. Matenda ofooketsa okoma amachitika ndi onse odwala matenda ashuga. Malinga ndi kuchuluka kwa zamankhwala, pafupifupi gawo limodzi mwa magawo atatu a odwala amakhala ndi hypoglycemia. Choopsa chachikulu pano chikukula kwa matenda a Somoji ndipo, chifukwa chake, mankhwala osayenera a matenda a shuga, omwe samachepetsa njira ya matendawa ndipo pamapeto pake amayamba kukula kwa ketoacidosis.

Zotsatira zake pakakhala vuto la hypoglycemia wovomerezeka ziyenera kuchotsedwa pakukhazikitsa mankhwala oyenera, omwe amatha nthawi yayitali.

Woopsa milandu insulin poyizoni, angayambitse matenda a chapakati mantha dongosolo:

• matenda edema
• Zizindikiro zoyipa
• ntchito yamisala yodwala (dementia).

Komanso, zochitika pafupipafupi za hypoglycemic mwa anthu omwe ali ndi vuto la mtima wam'magazi zimatha kuyambitsa kuphwanya kwam'mbali, kupweteka kwam'mimba, komanso kupweteka kwam'mimba.

Pomaliza, ndikofunikira kudziwa kuti ngati chithandizo cha mankhwala a insulin chapanthawi yake, zotsatira zake mu njira ya imfa zimathetsedwa. Kupewa kwa zinthu ngati izi ndi lingaliro losamalitsa lomwe limayang'anira kuperekera insulin komanso kudziyang'anira pawokha. Kuukira kwakanthawi kwa hypoglycemia kumatha kuimitsidwa pakudya chakudya chomwe chili ndi chakudya chambiri - shuga, maswiti, chakumwa chokoma.

Maziko a insulin

Ndi regaleni ya basal-bolus for insulin management (zambiri zamomwe zilipo pamankhwala omwe amapezeka mu nkhaniyi), theka la okwana tsiku lililonse la mankhwalawa limagwera insulin, ndipo theka mwachidule. Gawo limodzi mwa magawo atatu a insulin yayitali imayendetsedwa m'mawa ndi masana, kupumula nthawi yamadzulo.

• Insulin yochepa-m'mawa (7), masana (10), madzulo (7),
• Insulin yapakatikati - m'mawa (10), madzulo (6),
• Kuchita insulin nthawi yayitali madzulo (16).

Jekeseni ayenera kutumikiridwa musanadye. Ngati kuchuluka kwa shuga m'magazi kumachulukitsa kale asanadye, ndiye kuti kuchuluka kwa insulin yocheperako kuyenera kuwonjezeka ndi kuchuluka kwa UNITS:

1. Ndi shuga 11 - 12 mmol / L pa 2,
2. Ndi shuga 13 - 15 mmol / l pa 4,
3. Ndi shuga 16 - 18 mmol / l pa 6,
4. Ndi glucose apamwamba kuposa 18 mmol / l ndi 12.

Wodwala matenda ashuga ayenera kulowetsa kapamba ndi manja ake ndi syringe, yomwe yakhazikika, malinga ndi kuchuluka kwa chakudya komanso kuchuluka kwa zochita zolimbitsa thupi, amatulutsa insulini yochulukirapo monga momwe amafunikira kuchepetsa shuga. Ndi matenda otupa, munthu ayenera kuyendetsa mankhwalawo, kuganizira mozama kuchuluka kwa insulin. Pafupifupi kuchuluka kwa mankhwalawa amawerengedwa mosamala - poyesa kuchuluka kwa glucose musanadye komanso pambuyo pake. Kuphatikiza apo, pali matebulo omwe akuwonetsa zofunikira zamagulu azakudya ndi mtundu wa insulin ofunikira mukamadya izi.

1. Kukula kwa mankhwalawa - jakisoni wa insulin amatumikiridwa 4 mpaka 5 patsiku,
2. Zilonda zimachitika tsiku lonse, zomwe sizingafanane ndi njira yamoyo (kuwerenga, ntchito, kuyenda mumayendedwe pagulu), muyenera kukhala ndi syringe - cholembera,
3. Pali kuthekera kwakukulu kwa kuwonjezereka kwa shuga kokhudzana ndi chakudya chokwanira kapena kuchuluka kwa insulin.

Mwazi wamagazi

Mulingo wathanzi wa munthu wathanzi (mkhalidwe A):

Mulingo wa shuga kwa odwala matenda ashuga (mkhalidwe B):

Odwala omwe ali ndi matenda a shuga a mellitus ayenera kutsatira zigawo za shuga za anthu athanzi, chifukwa kuchuluka kwa shuga kwa nthawi yayitali komwe kumayambitsa matenda ashuga kumayambitsa kukula kwa matenda osachiritsika (kuwonongeka kwa ziwiya za impso, miyendo, maso).

• Ndi matenda a shuga omwe amapezeka muubwana kapena zaka zazing'ono, osagwirizana ndi kuchuluka kwa shuga kwa munthu wathanzi, pali mwayi waukulu wokhala ndi matenda osatha mkati mwa zaka 20 mpaka 30.
• Anthu omwe ali ndi matenda ashuga atatha zaka 50 amatha kukhala ndi shuga yayikulu, popeza matenda osatha mwina alibe nthawi yoti atukuke, kapena amayenda ndi imfa yachilengedwe ya munthu. Akuluakulu odwala matenda ashuga ayenera kutsatira shuga wa 9 - 10 mmol / l. Mishuga ya shuga kwa nthawi yayitali yoposa 10 mmol / L imatsogolera pakupita kwadzidzidzi kwa matenda osachiritsika.

Madzulo mlingo wa insulin. Kubaya nthawi

• Kwa odwala omwe sagwiritsa ntchito poyambira - njira yothandizira pakubwera kwa insulin, osavomerezeka kupereka jakisoni kumapeto kwa 10 pm, chifukwa mankhwalawa atatha 11 - ola limodzi kumabweretsa chiwonetsero chachikulu cha ntchito ya insulin yayitali koloko m'mawa, pomwe odwala matenda ashuga adzagona ndipo sangathe kuwongolera mkhalidwe wake . Ndikwabwino ngati nsonga ya insulini ichitika asanafike 12 koloko (jekeseni iyenera kuchitidwa 9 koloko) ndipo wodwala matenda ashuga ali osagona.
• Kwa odwala omwe akuchita zozizira zamankhwala a bolus, nthawi yakudya yamadzulo sikugwira ntchito yayikulu, chifukwa mosasamala nthawi yakudya, mankhwalawa amaphatikizapo kusankhidwa kwa mlingo wa insulin womwe sungapangitse kuchepa kwa shuga usiku uliwonse ndikugwirizana ndi kuchuluka kwa shuga m'mawa pamimba yopanda kanthu.

Kodi kusanthula kwa hemoglobin kukuwonetsa chiyani? Kodi pali kusiyana kotani pakuyesa kwa shuga?

Mlingo wa glucose pamene mlingo ndi wochepa kwambiri kuti muchepetse shuga:

Mlingo wokwera kwambiri kuti muchepetse shuga:

Kuwonjezeka kwa shuga m'magazi pambuyo pa hypoglycemia ndi chifukwa chakuti thupi limamasula shuga m'magazi a chiwindi, ndikudzipulumutsa ku dontho lakuthwa la shuga. Malire omwe pomwe hypoglycemia imalowera ndi osiyana ndi odwala matenda ashuga, ena amakhala ndi 3 mm mm / l, ena ali ndi 6-7 mmol / l. Chilichonse ndi payekha.

Zimayambitsa High shuga

Mchere wambiri womwe umakhala wokwezeka kwambiri kuposa wabwinobwino umatha kuphatikizidwa ndi chimfine wamba, njira yotupa yomwe imachitika m'thupi, itatha kudya chakudya cholemera. Pali njira ziwiri zochepetsera:

1. Zowonjezera insulin
2. Zochita zolimbitsa thupi.

komwe CaxH ndi shuga asanadye,

Shuga - shuga pambuyo chakudya,

Mlingo_tsiku - tsiku lonse la insulin ya wodwala.

Mwachitsanzo, kuti muwerenge kuchuluka kwa insulin yokwanira tsiku lililonse la matenda a 32 PESCES, kuchuluka kwa shuga musanadye - 14 mmol / L ndi kufunika kochepetsera kuchuluka kwa shuga mutatha kudya mpaka 8 mmol / L (SahK), timapeza:

izi zikutanthauza kuti pa mlingo wa insulin, wowerengeka kuchuluka kwa chakudya, muyenera kuwonjezera ziwonetsero ziwiri. Ngati chisonyezo chonse cha zinthu zomwe zimayikidwa pa nkhomaliro ndi magawo anayi a mkate, ndiye kuti magawo 8 a insulin yochepa amagwirizana nawo. Koma ndi shuga wokwera kwambiri, musanadye kale, ali ndi 14 mmol / l, ndikofunikira kuwonjezera ma 2 PIECES a insulin ku 8 PIECES. Chifukwa chake, jakisoni wa magawo 10 amaperekedwa.

Ngati kwa munthu wathanzi lino ndi njira yanthawi zonse yomwe imayambira kumayambiriro kwa tsikulo, kwa odwala matenda ashuga, kuwonjezereka kwa shuga m'mawa kumawopseza ndi hyperglycemia. Chizindikiro cha kuchuluka kwa shuga m'mawa ndichinthu chosowa komanso chosasintha. Zonse zomwe zitha kuchitidwa kuti shuga azikhala ndi shuga ndikuyambitsa 5 - 6 koloko m'mawa muyeso wina wa insulin "yochepa" pazachuma 2 - 6.

Chimachitika ndi chiyani ndi mankhwala osokoneza bongo?

Insulin, yolowa m'thupi, imagwiritsa ntchito mitundu yonse ya kagayidwe: chakudya, mafuta ndi mapuloteni.

Pankhani ya bongo wambiri, mphamvu ya kagayidwe kazachilengedwe imakhala yofunika kwambiri. Mothandizidwa ndi timadzi timeneti, kugwiritsidwa ntchito kwa glucose ndi maselo kumalimbikitsidwa ndipo kaphatikizidwe ka glycogen (njira yosungira shuga m'thupi) limayatsidwa. Zotsatira zake, kuchuluka kwa shuga m'magazi kumatsika kwambiri, hypoglycemia imayamba, ndipo zotsatira zake zimatengera mlingo womwe umaperekedwa.

Mwa njira, jakisoni wokhazikika wa insulin mwa anthu athanzi ndi osayenera kwambiri. Nthawi zambiri izi zimabweretsa zotupa za pancreatic.

Zokhudza mafuta kagayidwe zimakhudzana ndi kuwonjezeka kwa kupangika kwa mafuta acids kuchokera ku shuga. Chifukwa chake, pakakhala mankhwala osokoneza bongo ambiri a insulin, mafuta osanjikiza ndi kulemera kwakukulu kumawonjezeka.

Insulin: ndi chiyani ndipo ndi mitundu yanji yomwe ilipo?

Aliyense wa ife adamvapo za matenda osasangalatsa monga matenda a shuga, komanso za insulin, yomwe imayambitsidwa kwa odwala monga chithandizo chamankhwala.

Chowonadi ndi chakuti mwa odwala matenda ashuga, insulin mwina singapangidwe konse, kapena sachita ntchito zake.

M'nkhani yathuyi, tikambirana funso loti insulini ndi chiyani komanso momwe imakhudzira thupi lathu. Ulendo wokondwerera kudziko lamankhwala mukuyembekeza.

Insulin ndi ...

Insulin ndi mahomoni opangidwa ndi kapamba. Maselo ake apadera a endocrine, otchedwa islets of Langerhans (beta cell), amatulutsa. Pali zisumbu pafupifupi miliyoni miliyoni pa zikondamoyo za munthu wamkulu, zomwe ntchito zake zimaphatikizapo kupanga insulin.

Kodi insulin ndi chiyani kuchokera kwa azachipatala? Ichi ndi timadzi tokhala ngati mapuloteni omwe amachita ntchito zofunika kwambiri mthupi. M'matumbo am'mimba, silingalowe kuchokera kunja, chifukwa idzakumbwa, ngati chinthu china chilichonse chama protein.

Pansi pake pang'ono (basal) insulin imapangidwa tsiku lililonse ndi kapamba. Mukatha kudya, thupi limapereka chiwindi chomwe thupi lathu limafunikira kuti lipukute mapuloteni obwera, mafuta ndi chakudya.

Tsopano tiyeni tikambirane funso la insulin yomwe imapangitsa thupi.

Ntchito ya insulin

Insulin imayang'anira ndikusunga kagayidwe kazachilengedwe. Ndiye kuti, timadzi tating'onoting'ono timatulutsa minyewa yambiri m'thupi lathunthu, makamaka chifukwa cha kuyambitsa kwake kwa ma enzymes ambiri.

Chimodzi mwazinthu zazikulu komanso zodziwika bwino za hormone iyi ndikukhazikitsa kuchuluka kwa shuga m'magazi. Thupi limafunikira mosalekeza, chifukwa limatanthauzira michere yomwe imafunikira pakukula ndi kukula kwa maselo.

Insulin imaphwanya chinthu chophweka, ndikuthandizira kuti iwayike m'magazi. Ngati kapamba samatulutsa mokwanira, glucose samadyetsa maselo, koma amadziunjikira m'magazi.

Izi ndizodzaza ndi kuwonjezeka kwa shuga wamagazi (hyperglycemia), omwe amakhala ndi zotsatira zoyipa.

Komanso, mothandizidwa ndi insulin, amino acid ndi potaziyamu amayendetsedwa.
Ndi anthu ochepa omwe amadziwa insulin momwe insulin ingapangidwire, ngakhale kuposa momwe zimakhalira ndi ma steroid (omaliza, komabe, amachita mosankha).

Mitundu ya insulin

Gawani mitundu ya insulin mwanjira ndi zochita zawo.

Kuchita zinthu mwachangu kumakhudza thupi. Insulin yamtunduwu imayamba kugwira ntchito yake atangoyendetsa, ndipo nsonga yake imafika 1-1.5. Kutalika kwa kuchitapo kanthu ndi maola 3-4. Lowetsani nthawi yomweyo musanadye kapena musanadye. Kukonzekera kofanana ndi Novo-Rapid, Insulin Apidra ndi Insulin Humalog.

Insulin yochepa imakhala ndi tanthauzo mkati mwa mphindi 20-30 mutatha kugwiritsa ntchito. Pambuyo maora awiri ndi awiri, kuchuluka kwa mankhwalawa m'magazi kumafika pazowonjezera. Pafupifupi maola pafupifupi 5-6. Jakisoni amaperekedwa mphindi 15-20 asanadye.

Nthawi yomweyo, pafupifupi maola awiri atatulutsa insulin, ndikofunikira kuchita "zokhwasula-khwasula". Nthawi ya chakudya iyenera kuyenderana ndi nthawi yayitali ya mankhwala.

Mankhwala ochepetsa chidwi - kukonzekera "Humulin Regulia", "Insulin Actrapid", "Monodar Humodar".

Kutalika kwapakatikati kumakhudza thupi kwakutali - kuyambira maola 12 mpaka 16.

Ndikofunikira kuchita jakisoni 2-3 patsiku, nthawi zambiri ndimakhala ndi maola 8-12, chifukwa samayamba kuchitapo kanthu nthawi yomweyo, koma maola awiri atatha. Kutheka kwawo kwakukulu kumatheka pambuyo pa maola 6-8.

Kutalika kwapakatikati - insulin - Protafan (insulin ya anthu), Humudar BR, Insulin Novomiks.

Ndipo pamapeto pake, insulin yayitali, kuchuluka kwake komwe kumachitika pambuyo patatha masiku 2-3, ngakhale kuti imayamba kugwira ntchito pambuyo pa maola 4-6. Ikani izo 1-2 pa tsiku.

Awa ndi mankhwalawa monga "Insulin Lantus", "Monodar Long", "Ultralente". Insulin yotchedwa "yopanda chopanda" "itha".

Ichi ndi chiyani Izi ndi insulin, yomwe ilibe tanthauzo, imagwira ntchito mofatsa komanso mosazindikira, imasinthira "mbadwa" zomwe zimapangidwa ndi kapamba.

Zosiyanasiyana za insulin

Insulin yamunthu – ndi analogue ya mahomoni omwe amapangidwa ndi kapamba wathu. Insulin yotereyi komanso "abale" omwe amagwiritsa ntchito ngati ma genetic "amatengedwa kuti ndiopambana kuposa mitundu ina ya insulin yomwe inayambira nyama.

Mahomoni a nkhumba ndi ofanana ndi omwe ali pamwambapa, kupatulapo amino acid pamagulu. Zimatha kuyambitsa mavuto osiyanasiyana.

Ng'ombe za insulin ndizochepa kwambiri zofanana ndi anthu. Nthawi zambiri zimayambitsa ziwengo, chifukwa zimakhala ndi mapuloteni achilendo m'thupi lathu. Mlingo wa insulin m'mwazi mwa munthu wathanzi umakhala ndi malire. Tiyeni tiwalingalire mwatsatanetsatane.

Kodi mulingo wa insulin uyenera kukhala wotani m'magazi?

Pafupifupi, mwa munthu wathanzi, kuchuluka kwa insulin m'magazi pamimba yopanda kanthu kumasiyana kuchokera pa 2 mpaka 28 mcED / mol.

Mwa ana, ndizotsika pang'ono - kuchokera ku mayunitsi atatu mpaka 20, ndipo mwa amayi apakati, m'malo mwake, apamwamba - mawonekedwewo amachokera pa 6 mpaka 27 mcED / mol.

Pankhani ya kupatuka kosafunikira kwa insulin kuchokera ku chizolowezi (mulingo wa insulin m'mwazi ukuwonjezereka kapena kuchepetsedwa), tikulimbikitsidwa kuyang'anira chakudya chanu komanso moyo wanu.

Kuchulukitsa kwa Madzi

Kuchulukitsa kwa insulini kumaphatikizapo kuwonongeka kwa pafupifupi zabwino zake zonse, zomwe zimakhudza thanzi la thanzi.

Zimawonjezera kuthamanga kwa magazi, zimapangitsa kunenepa kwambiri (chifukwa cha kuthamanga kwa shuga), zimakhala ndi zotsatira zamagazi komanso zimawonjezera chiopsezo cha matenda ashuga.

Ngati mwakulitsa insulin, muyenera kulabadira zakudya zanu, kuyesera kudya zakudya zambiri momwe mungathere ndi mafuta ochepa mkaka wamafuta, masamba, zipatso zosapatsa mkaka, mkate wamchere.

Madzi ochepa a insulin

Pali nthawi zina pamene insulin imatsitsidwa m'magazi. Ndi chiyani komanso momwe mungachitire? Kuchuluka kwa shuga m'magazi kumapangitsa kuti ubongo ugwire ntchito.

Pankhaniyi, tikulimbikitsidwa kuyang'anira zinthu zomwe zimayambitsa kapamba - iyi kefir, mabulosi abwino, nyama yophika, maapulo, kabichi ndi masamba a parsley (msuzi umagwira makamaka mukakhala pamimba yopanda kanthu).

Chifukwa cha zakudya zoyenera, mutha kusintha matenda a insulin ndi kupewa zovuta, makamaka matenda a shuga.

Insulin ndi matenda a shuga

Pali mitundu iwiri ya matenda ashuga - 1 ndi 2. Yoyamba ikutanthauza matenda obadwa nawo ndipo amadziwika ndi kuwonongeka pang'onopang'ono kwa maselo a pancreatic beta.

Ngati akhala pansi osachepera 20%, thupi limaleka kulimbana, ndikuyamba kulandira chithandizo chofunikira. Koma malo omwe ali opitilira 20%, mwina simungathe kuzindikira kusintha kulikonse paumoyo wanu.

Nthawi zambiri, insulin yochepa komanso ya ultrashort imagwiritsidwa ntchito pochiza, komanso kumbuyo (kukulitsidwa).

Mtundu wachiwiri wa shuga umapezeka.

Maselo a Beta omwe ali ndi vuto lodziwitsa za matendawa “amakhala ndi chikumbumtima chokwanira”, komabe, insulin imalephera - singathenso kugwira ntchito zake, chifukwa chomwe shuga imadziwikanso m'magazi ndipo imatha kuyambitsa zovuta zambiri, mpaka kutseka kwa hypoclycemic. Kwa mankhwalawa, mankhwalawa amagwiritsidwa ntchito omwe amathandizira kubwezeretsa ntchito ya mahomoni otayika.

Jakisoni wa insulin ndiwofunika kwambiri kwa odwala omwe ali ndi matenda a shuga a mtundu woyamba, koma odwala matenda ashuga a 2 nthawi zambiri amawononga mankhwala kwa nthawi yayitali (zaka komanso zaka makumi ambiri).Zowona, kuti pakupita nthawi, muyenera "kukhala pansi" pa insulin.

Chithandizo cha insulin chimathandizira kuchotsa zovuta zomwe zimakhalapo ndikunyalanyaza kufunika kwa thupi kuchokera kunja, komanso zimathandizira kuchepetsa katundu pa kapamba ndipo zimathandizanso kubwezeretsa pang'ono kwa maselo ake a beta.

Amakhulupirira kuti kuyambitsa mankhwala a insulin, sizothekanso kubwerera ku mankhwala osokoneza bongo (mapiritsi). Komabe, muyenera kuvomereza, ndibwino kuyambitsa insulin kale ngati kuli koyenera, m'malo mokana - pankhaniyi, zovuta zazikulu sizingapewe.

Madokotala ati pali mwayi mtsogolomo wosiya jakisoni wa matenda a shuga 2 ngati chithandizo cha insulin chinayamba pa nthawi. Chifukwa chake, yang'anirani thanzi lanu mosamala, musaiwale kutsatira zakudya - ndizofunikira kwambiri kuti mukhale ndi thanzi.

Kumbukirani kuti shuga si sentensi, koma njira ya moyo.

Kafukufuku watsopano

Asayansi akupitiliza kufunafuna njira yosinthira moyo wa anthu omwe ali ndi matenda ashuga. Mu 2015, United States idayambitsa chitukuko chatsopano - chipangizo cha insulin inhalation chomwe chidzalowe m'malo mwa syringes, ndikupangitsa moyo kukhala wosavuta kwa odwala matenda ashuga. Chipangizochi chimapezeka kale ku malo ogulitsa mankhwala ku America mwa mankhwala.

M'chaka chomwechi (komanso ku USA) wotchedwa "smart insulin" adayambitsidwa, womwe umalowetsedwa m'thupi kamodzi patsiku, umayendetsa ntchito pawokha ngati pakufunika.

Ngakhale kuti mpaka pano adayesedwa pa nyama zokha ndipo sanayesedwebe pa anthu, zikuwonekeratu kuti asayansi adapeza zofunikira kwambiri kumayambiriro kwa chaka cha 2015.

Tili ndi chiyembekezo kuti mtsogolomo asangalala ndi anthu odwala matenda ashuga ndi zomwe apeza.

Madzi a insulin

Insulin ndi mahomoni a pancreatic omwe amawongolera kagayidwe kazinthu, amakhala ndi shuga m'magazi pamlingo woyenera kwambiri ndipo amatenga nawo mbali mu metabolism yamafuta. Kuperewera kwa insulin kumabweretsa kuwonjezeka kwa shuga m'magazi ndi kuperewera kwa mphamvu kwa maselo, komwe kumakhudza njira zamkati ndikuyambitsa ma endologies ambiri a endocrine.

Kuwunikira kwa insulin m'mwazi kumakupatsani mwayi wodziwa zovuta za metabolic (metabolic syndrome), kuchuluka kwa kuzindikira kwa insulin (insulin kukana) ndikuzindikira matenda oopsa monga matenda a shuga mellitus ndi insulinoma (hormone-secreting chotupa cha maselo a pancreatic beta).

Insulin ndi puloteni inayake yomwe imasungidwa m'maselo a pancreatic beta kuchokera ku proinsulin. Kenako imatulutsidwa m'magazi, pomwe imagwira ntchito yake yayikulu - kukhazikitsidwa kwa kagayidwe kazakudya komanso kukonza magawo a glucose ofunika mu seramu yamagazi.

Wopanda vuto lokwanira la mahomoni, wodwalayo amakhala ndi matenda a shuga, omwe amadziwika ndi kuchepa kwapadera kwa glycogen (chakudya chopatsa mphamvu) m'mitsempha ndi chiwindi. Komanso, motsutsana ndi maziko a matendawa, kuchuluka kwa okosijeni wa glucose amachepetsa, lipid ndi mapuloteni amachepetsa, kugwiritsidwa ntchito kwa nitrogen moipa, komanso kuchuluka kwa cholesterol yoyipa m'magazi imakwera.

Pali mitundu iwiri ya matenda ashuga.

• Mtundu woyamba, insulin siipangidwa konse. Potere, chithandizo chamankhwala cha mahomoni nchofunikira, ndipo odwala amapatsidwa gulu la odwala omwe amadalira insulin.
• Mtundu wachiwiri, kapamba amatulutsa mahomoni, komabe, sangathe kuyang'anira kuchuluka kwa shuga. Palinso mkhalidwe wapakatikati (gawo loyambirira) momwe zizindikiro zodziwika bwino za matenda ashuga sizikupezeka, koma mavuto opanga insulin alipo kale.

Zofunika! Matenda a shuga ndi matenda oopsa omwe amachepetsa kwambiri moyo, amabweretsa zovuta zambiri ndipo amatha kupangitsa kuti akhale ndi vuto la matenda ashuga (omwe nthawi zambiri amafa).Chifukwa chake, kupezeka kwa matenda a shuga panthawi yake ndikusanthula kuchuluka kwa insulin m'magazi ndikofunikira kwambiri kuchipatala.

Zizindikiro zakusanthula

• Kuzindikira ndi kuwongolera njira ya matenda osokoneza bongo a mtundu woyamba ndi wachiwiri,
• Kuyesa kwa odwala omwe ali ndi tsogolo la matenda ashuga,
• Dziwani matenda amisala mwa amayi apakati,
• Kutsimikiza kwa chitetezo chathupi mthupi kupita ku insulin,
• Kukhazikitsa zomwe zimayambitsa hypoglycemia (kutsitsa glucose),
• Insulin Wokayikira
• Kupangira kukonzekera kwa insulin ndi kusankha kwa mankhwalawa,
• Kupenda kwathunthu kwa odwala omwe ali ndi vuto la metabolic,
• Kunenepa kwambiri
• Kuyesedwa kwa odwala omwe ali ndi polycystic ovary syndrome (kusowa kwamchiberekero ndi kusamba kwa msambo),
• Dziwani matenda amtundu wa endocrine,
• Kuwunikira odwala atasinthidwa kwa maselo a islet (maselo a beta a islets of Langerhans).

Zizindikiro pamaso pomwe maphunziro a insulin

• Kukwiya, kukhumudwa, kutopa kwambiri,
• Kuwonongeka kwamtima
• Kusintha kwakukutu kwakanthawi thupi polimbitsa thupi zakudya komanso zizolowezi zolimbitsa thupi,
• Kumva ludzu ndi njala pafupipafupi,
• Khungu lowuma komanso zimagwira pakamwa (pakamwa pouma),
• Thukuta kwambiri, kufooka,
• Mbiri ya tachycardia ndi matenda amtima,
• Kuzindikira koperewera, kuwona kawiri, chizungulire,
• Kuchiritsidwa kwakanthawi kwa mabala apakhungu, ndi zina.

Kuunika kwathunthu ndi cholinga cha phunziroli zimachitika ndi endocrinologist, dokotala wa opaleshoni, othandizira kapena dokotala wa mabanja. Pankhani ya matenda a shuga a gestational, dokotala wazachipatala ayenera kufunsidwa. Mukazindikira insulinomas kapena mitundu ina ya kapamba, a oncologist amatsutsa mayeso ake.

Kuchiritsa

Mayeso wamba: μU / ml kapena uchi / l.

Chipinda china: pmol / lita (mkED * 0.138 mked / ml).

Nthawi zambiri, kuchuluka kwa insulin m'magazi

Zinthu zothandiza pa zotsatirapo zake

Zotsatira za kafukufukuyu zimakhudzidwa ndi kugwiritsa ntchito mankhwala:

• levodopa,
• mahomoni (kuphatikiza kulera kwamlomo),
• corticosteroids
• insulin
• Albuterol
• chlorpropamide
• glucagon,
• shuga
• sucrose
• fructose
• niacin
• kapamba,
• quinidine
• spironolctone,
• prednisolone
• tolbutamide etc.

Mkulu insulin

• Type 2 shuga mellitus (wodwala samatengera kukonzekera kwa insulin),
• Pancreatic hormone yotulutsa zotupa, monga insulinoma,
• Acromegaly (kukomoka kwa tchire lakutsogolo),
• Matenda a chiwindi
• Myotonic dystrophy (kuwonongeka kwa majini m'misempha),
• Cushing's Syndrome (hypersecretion yama adrenal mahomoni),
• Kuvuta tsankho kwa shuga (glucose, fructose, lactose, etc.),
• Magawo onse a kunenepa kwambiri.

Yang'anani!
Mutithandiza kwambiri ngati mungayankhe mafunso atatu. Osapitirira mphindi imodzi.

Kukonzekera kwa kusanthula

Kuti mudziwe insulin, ndikofunikira kupatsira magazi a venous pamimba yopanda kanthu. Nthawi yosala kudya ili pafupifupi maola 8-10, patsiku losintha mutha kumwa madzi wamba osakhala amchere ndi mpweya.

Kwa masiku angapo, muyenera kukana kumwa zakumwa zoledzeretsa ndi zamphamvu, kupewa nkhawa zilizonse zamaganizidwe ndi thupi. Ndiosafunanso kusuta patsiku lopereka magazi.

Kwa tsiku, tikulimbikitsidwa kupatula mbale zamafuta ndi zonunkhira, zonunkhira kuchokera kuzakudya.

Mphindi 30 musanayambe phunziroli, muyenera kukhala pansi ndikukhala omasuka kwathunthu. Kupsinjika kulikonse kwakuthupi kapena kwamaganizidwe pakadali pano ndizoletsedwa, chifukwa kupsinjika kumatha kuyambitsa kutulutsa kwa insulin, komwe kumapangitsa zotsatira zoyeserera.

Chidziwitso: pofuna kupewa zotsatira zolakwika, kuwunikira kumayikidwa asanayambe maphunziro othandizira pozindikira komanso njira zowunika (ultrasound, x-ray, kufufuza kwa rectal, CT, MRI, physiotherapy, etc.) kapena masabata 1-2 atatha.

Muyenera kuti mwapatsidwanso ntchito:

Hormone insulin - zambiri

Mu matenda a shuga, insulini sikhala yopangidwa mokwanira (mtundu 1 wa shuga), kapena maselo ndi minyewa sizimayankha moyenera (mtundu wachiwiri wa matenda ashuga). Insulin ndi yofunika kwambiri kwa metabolism ya carbohydrate.

Insulin ndi galimoto yomwe imapulumutsa shuga ku magazi kupita ku maselo. Shuga wowukitsidwa ndi chifukwa chachindunji cha kuchepa kwa insulin. Ngati mahomoni awa ndi osakwanira (kapena maselo sawayankha), njira zonse za metabolic zimasokonekera. Kuperewera kwa insulin kumakhudza mkhalidwe wamitsempha yamagazi, minofu, ndi dongosolo lamanjenje.

Magazi okwera m'magazi ndiopseza ziwalo zonse zamunthu.

Mankhwala a insulin

Mankhwala a insulin nthawi zonse amafunikira mtundu 1 wa matenda ashuga. Mtundu wachiwiri wa matenda a shuga, jakisoni wa insulin amatchulidwa malinga ndi kutha kwa chizindikirocho komanso kuchuluka kwa chiphuphu.

Mankhwala a insulin - kukhazikitsidwa kwa insulin yowonjezera mthupi ndi kuchepa kwa chilengedwe kwa timadzi timeneti. Komabe, ziyenera kumvetsedwa kuti ngakhale mankhwala abwino kwambiri sangathe kusintha insulin yonse ya thupi.

Ndi chithandizo cha insulin, mankhwalawa amalowetsedwa m'matumbo a subcutaneous, pambuyo pake amalowa m'magazi. Zimatenga mphindi 15 mpaka 25. Nthawi yonseyi, kuchuluka kwa shuga m'magazi kumakhalabe kokwezeka, komwe kumakhudza mitsempha, minyewa yamitsempha, komanso ziwalo zamkati. Ichi ndichifukwa chake ngakhale bwino kwambiri mankhwala a insulini sangathandize kupewetsa zovuta za matenda ashuga.

Pali njira zingapo zamankhwala a insulin, omwe amalembedwa ndi adokotala potengera momwe wodwalayo alili. Mankhwala ofulumira, apakati komanso a nthawi yayitali apangidwa: amagwiritsidwa ntchito pazosankha zingapo zamankhwala.

Cholinga chachikulu cha mankhwala a insulini ndikubwezerera zomwe zimachitika chifukwa chophwanya kagayidwe kazakudya, kuchepetsa shuga

Wapakati tsiku lililonse insulin (SSD) ayenera kukhala oyandikira kwambiri momwe angakwanitse kuchuluka kwa mahomoni achilengedwe. Nthawi zambiri, insulin yocheperako komanso mankhwala omwe amakhala ndi mphamvu yayitali amakhala akuphatikizidwa mu njira yochizira. Zingwe zimaperekedwa musanadye kadzutsa, nkhomaliro, chakudya chamadzulo ndi usiku.

Mankhwala amaperekedwa pogwiritsa ntchito cholembera, syringe yotulutsa kapena pampu ya insulin. Njira yotsiriza imawonetsedwa kuti ndiyabwino kwambiri: kuchuluka kwa nthawi ya mankhwalawa ndikuwerengera okha. Komabe, mapampu a insulin ali ndi zovuta zawo.

Kuti mumve zambiri za mitundu ya mankhwala a insulin, mulingo, kukonzekera insulin, werengani zolemba zomwe zili mgawali.

Kodi insulin imagwira ntchito bwanji: ndi chiyani ndipo imagwira ntchito bwanji

Madzi a protein a insulini ndiye chinthu chofunikira kwambiri mu kagayidwe kazinthu zonse zathupi la munthu, amagwira ntchito yofunika kwambiri monga kuchepetsa kuchuluka kwa shuga m'magazi.

Komabe, magwiridwe antchito a insulin ndi ophatikizidwa kwambiri, chifukwa amakhudza mitundu yonse ya njira za metabolic mthupi laumunthu ndipo sikuti amangoletsa kayendedwe kabwino ka chakudya.

Kuphwanya kapangidwe ka insulin ndi zotsatira zake pa minofu ndizofunikira kwambiri pakukula kwa vuto la pathological - shuga mellitus.

Kapangidwe ka insulin

Biosynthesis ya mapuloteni awa ndimapangidwe ovuta, omwe ali ndi magawo angapo achilengedwe ovuta.

Choyamba, mawonekedwe osagwira ntchito a molekyulu a insulin, omwe amatchedwa proinsulin, amapangidwa m'thupi.

Prohormone iyi, yomwe imayambitsa insulini, ndi chofunikira pakuwonetsa pancreatic ntchito. Kuphatikiza apo, pakupanga, pambuyo pa kusintha kwamitundu, proinsulin imayamba kugwira ntchito.

Kupanga kwa insulin mwa munthu wathanzi kumachitika tsiku lonse ndi usiku, komabe, kupanga kwofunikira kwambiri kwa timadzi timeneti ta peptide kumawonedwa mukangomaliza chakudya cham'mawa.

Insulin, monga yogwira pophika yomwe imapangidwa ndi kapamba, imakulitsa katulutsidwe kake chifukwa cha njirazi:

• Anakweza magazi seramu shuga pa gawo la matenda ashuga. Pambuyo pake, kutsika kwa insulin kudzakhala mwachindunji ndikukula kwa shuga.
• Mkulu mafuta a asidi aulere. Poyerekeza zakumbuyo kokulirapo kwamafuta amthupi (kunenepa kwambiri), pamakhala kuchuluka kwakukulu kwamafuta amwazi m'magazi. Njira izi zimawononga thanzi la munthu, zimayambitsa kubisalira kwambiri kwa timadzi timene timachepetsa shuga, timawonongera ma cell a minofu, komanso timathandizira pakupanga ma pathologies owopsa.
• Zotsatira za amino acid, makamaka arginine ndi leucine. Ma organic awa amathandizira kupanga insulin kuchokera ku kapamba. Ma amino acid ochulukirapo m'thupi, amapanga insulin kwambiri.
• Kuchuluka kwa calcium ndi potaziyamu. Kuchuluka kwa zinthu izi kumawonjezera kubisika kwa mapuloteni-peptide, omwe amatulutsidwa chifukwa cha kusintha kwakuthwa mikhalidwe yazachilengedwe.
• Kuwonetsedwa kwa mahomoni opangidwa ndi maselo am'mimba ochita kupukusa ndi kapamba. Mahomoni oterewa amaphatikizapo: gastrin, cholecystokinin, secretin ndi ena. Zinthu zoterezi zimapangitsa kuti insulini itulutsidwe pang'ono ndipo amapangidwa ndi maselo am'mimba atatha kudya.
• Matupi a Ketone ndi mankhwala omwe amapangidwa ndi chiwindi ndipo ndi zinthu zapakatikati zamachitidwe a metabolic: chakudya, mapuloteni ndi mafuta. Zizindikiro zowonjezera za zinthuzi m'thupi, zimawonetsa kusokonezeka kwa kagayidwe kazakudya ndipo, monga chotulukapo, chitetezo chokwanira cha insulin.

Mahomoni opsinjika, monga adrenaline, norepinephrine, ndi cortisol, amayambitsa kutulutsa kwakukulu kwa insulin m'magazi. Izi zimagwira mkati mwa katulutsidwe kamkati zimapangidwa nthawi yochulukirapo, kuti muthe kugwedeza thupi.

Njira zopsinjika zimachitika motsutsana ndi maziko a kulumpha lakuthwa m'magazi amwazi, omwe ali machitidwe achindunji kuti thupi lipulumuke pangozi. Pali lingaliro - kupsinjika kwa hyperglycemia, mphamvu ya mahomoni, yomwe imadziwika ndi kuwonjezeka kwa kuchuluka kwa shuga m'magazi panthawi yamavuto amanjenje.

Kupewa matenda a shuga: Malangizo Othandizira kupewa Matenda A shuga

Carbohydrate kagayidwe

Mphamvu ya insulin, pamenepa, ndikuwonjezera mphamvu ya ma cell a glucose.

Komanso mahomoni a peptide-protein amalimbikitsa mapangidwe ndi kulimbitsa kaphatikizidwe kameneka wofunika - glucokinase, potero amafulumizitsa njira ya kufalikira kwa glucose m'maselo (glycolysis).

Kuphatikiza apo, insulini imachulukitsa ntchito ya mapuloteni ofunikira a glycolysis, komanso imawonjezera chiwerengero chawo. Kuchepetsa shuga kumapangitsa kuti gluconeogenesis apangidwe, omwe amadziwika ndi kupanga mamolekyulu a shuga m'magazi ndi impso kuchokera pazinthu zopanda mafuta.

Kusinthana Kwama protein

Kuphatikiza kwakukulu kwa insulin mu kagayidwe kazakudya ndizopangitsa kuti ntchito ya amino acid ikhale m'matumbo a chiwindi ndi chiwindi. Mothandizidwa ndi mahomoni a peptide, kapangidwe ka mapuloteni m'matumbo am'mimba ndi ziwalo zamkati zimakulitsidwa, komanso, zimalepheretsa kuwonongeka kwa mapuloteni m'thupi. Insulin imathandizira kukula kwa zigawo za intracellular, imalimbikitsa kubereka ndi kugawa maselo.

Mafuta kagayidwe

Insulin imachepetsa kuchepa kwa mafuta (lipolysis) mu minofu ya adipose ndi chiwindi.

Komanso, ma protein a protein amatha kuyambitsa kuphatikizika kwamafuta osagwiritsidwa ntchito m'thupi (triacylglycerols) mu minofu ya adipose ya thupi la munthu.

Insulin imatha kupititsa patsogolo kaphatikizidwe kazinthu zamafuta acid, ndikulepheretsa kaphatikizidwe ka matupi a ketone mu minyewa ya chiwindi. Kuchulukitsa kwa matupi a ketone kumawonetsa kusagwira bwino ntchito ndi kusintha kwa matenda a chiwindi.

Magazi a shuga

Limagwirira ntchito popereka magazi a shuga mwa anthu athanzi amatha kuchitika pogwiritsa ntchito zakudya zina. Pomwe anthu omwe ali ndi matenda ashuga amatha kumwa mankhwala ena kuti athandizire kuwongolera shuga.

Kuwongolera kwa kagayidwe kazachilengedwe kumachitika pamagulu osiyanasiyana a mabungwe a zinthu zachilengedwe: ma cell, minofu, chamoyo ndi chamoyo. Kuwongolera kwa shuga kumachitika pamaziko a zinthu zingapo, momwe pakati paumoyo wodwala, kupezeka kwa ma pathologies ena, kakhalidwe ndi moyo wake ndizofunikira kwambiri.

Hyperglycemia ndi hypoglycemia

Hyperglycemia ndi hypoglycemia ndi njira ziwiri zomwe zimapangika motsutsana ndi maziko a shuga m'magazi. Izi pathologies zimatha kukhala ndi zotsatirapo zowawa kwambiri kwa wodwala, chifukwa chake ndikofunikira kwambiri kuti muzitha kuzindikira zomwe zikuwonetsa pakadali pano ndikupanga chithandizo chamankhwala mwachangu!

Hyperglycemia ndi mkhalidwe womwe umadziwika ndi kuchuluka kwa shuga wa plasma.

Mwa anthu omwe ali ndi matenda a shuga, zinthu zotsatirazi zimatha kuyambitsa kukula kwa hyperglycemia: kudya kwambiri, kudya zakudya zovulaza, kuphwanya malamulo a kudya, kusachita masewera olimbitsa thupi pang'ono, kugwiritsa ntchito mankhwala osokoneza bongo omwe ali ndi shuga, kuvutikira kapena kubaya jakisoni wa insulin panthawi yake.

Timalimbikitsanso kuti muzidziwitsa nokha: mitundu ndi kusankha kwa insulin.

Zizindikiro za izi:

• Kumva ludzu kwamphamvu.
• Kukoka pafupipafupi.
• Mutu ndi kuwonongeka kwa ndende.
• Kudziona kuti wagwira ntchito yambiri.
• Maonekedwe a "nyenyezi" patsogolo pa maso.

Pochiza matenda a hyperglycemia, cholinga chimayang'aniridwa mosamala ndi zizindikiro za shuga, pogwiritsa ntchito zida zapadera, komanso kutsatira mosamalitsa chithandizo chamadokotala. Komanso, dotolo amatipatsa mankhwala omwe amachepetsa shuga m'magazi.

Mtundu woyamba wa shuga

Matenda a shuga a Type 1 ndi autoimmune endocrine pathology yolumikizidwa ndi kusowa kwathunthu kwa insulin mthupi. Zodzipanga zokha za mapuloteni-peptide pafupifupi zimakhala zitasiya.

Chofunikira pakukula kwa matendawa ndichisokonezo cha chitetezo chamthupi cha munthu. Nthawi zambiri, mtundu uwu wa matenda ashuga umayamba chifukwa chakhumudwa kwambiri kapena chifukwa cha chibadwa chamunthu.

Odwala amamva kuphatikizidwa kwazovuta za matendawa: kuchepa kwambiri kwa thupi, kuwonongeka msanga mu thanzi, kusabala, khungu lowuma, mabala osachiritsika. Kuphatikiza apo, madzi am'mimba amachitika chifukwa cha kukodza pafupipafupi, komwe kumapangitsa kuti munthu azikhala ndi ludzu pafupipafupi.

Anthu omwe ali ndi matendawa amafunikira chithandizo cha insulin tsiku lililonse. Ndikofunika kumvetsetsa kuti matenda amtundu wa 1 sangathe kuchiritsidwa, chifukwa palibe mankhwala amodzimodzi omwe angatsitsimutse maselo omwe amwalira panthawi yayikuluyi.

Kuyang'anira shuga ndi magazi kwambiri ndi njira zokhazo zochizira matendawa.

Chifukwa cha kuchepa kwenikweni kwa mankhwala a insulin m'thupi la wodwalayo, adokotala amatiuza za insulin ya anthu mwachindunji, monga Novorapid.

Insulin iyi ya ultrashort imakhudzanso pambuyo pa mphindi 10, pambuyo pa makonzedwe, pomwe insulini yochepa yaumunthu imayambika osapitilira theka la ola.Kuwonetsedwa kwamitundu yamtundu wa insulin kumatenga pafupifupi maola asanu.

Type 2 shuga

Izi matenda amayamba chifukwa cha kuchuluka kwambiri kwazomera za seramu. Kusokonezeka kwa chiwopsezo cha minyewa ndi maselo amthupi kupita ku insulin ndi chikhalidwe cha matenda amtunduwu. Mtundu wa matenda amtunduwu umapezeka kwambiri pakati pa odwala. Omwe amayambitsa matendawa ndi:

• Kunenepa kwambiri
• Zakudya zoperewera.
• Hypodynamia ndi moyo wongokhala.
• Kupezeka kwa abale apamtima omwe ali ndi matenda ofanana.
• Zovuta kwambiri.

Chimachitika ndi chiani mthupi la munthu yemwe ali ndi matenda ashuga a 2?

Pambuyo pachakudya chokhazikika, pamakhala kuchuluka kowonjezereka kwa shuga, pomwe kapamba sangathe kumasula insulin, yomwe imadziwika ndi kuchuluka kwa shuga.

Chifukwa cha njirayi, chidwi cham'manja chomwe chimapangitsa kuti timadzi totsika timene timakhala ndi shuga sichitha.

Vutoli limatchedwa insulin kukana, kukana kwa membrane wa cell kukakamizidwa ndi insulin.

Zizindikiro

Kuti muzindikire matendawa, maphunziro otsatirawa amachitika:

1. Laboratory magazi mayeso.
2. Kudziwitsa glycosylated hemoglobin level. Zizindikiro zake zimaposa kwambiri anthu omwe ali ndi matenda ashuga.
3. Mayeso a kulolera a glucose.
4. Urinalysis ya shuga ndi ketone mankhwala.

Kulephera kuchitapo kanthu pozindikira komanso kusapezeka kwa njira yoyenera yodwala matenda a shuga 2 kungamuthandize wodwalayo kukumana ndi zovuta zambiri, zomwe nthawi zambiri zimayamba ndi chitukuko cham'tsogolo.

Mavuto omwe amatchuka kwambiri ndi monga kupezeka kwa kukanika kwa impso, kuthamanga kwa magazi (matenda oopsa), kuwonongeka kwa maonekedwe ndi ma catalo, kuwonongeka kwa ziwalo zam'munsi komanso mapangidwe a zilonda zam'mimba.

: Chifukwa chiyani insulin ikufunika ndipo imagwira ntchito bwanji?

Ndikofunika kumvetsetsa kukula kwa matenda amtunduwu wa endocrine ndikuyesetsa kuti muchepetse kukula kwa matendawa, kudzera pakuzindikira koyambirira, njira yabwino yothandizira ndi malangizo okhwima a zakudya. Kupanda kutero, njira za shuga zomwe zimayambitsa matenda am'mimba zimatha kubweretsa zovuta zomwe sizingasinthe chifukwa cha thanzi la munthu.

Zosiyanasiyana za insulin

Pofulumira kuwonekera, ma insulins amagawidwa m'magulu angapo:

• Ultra yochepa-insulin
• Mankhwala osokoneza bongo mwachidule
• Insulin yochita pakati
• Mankhwala okhalitsa
• Kuphatikiza kapena kusakaniza ndi insulin.

Pali magulu osavuta, omwe mankhwalawa amagawidwa pocheperapo pang'ono ndikukonzekera insulin.

Insulin yochepa

Mankhwala amtunduwu amayamba kugwira ntchito mwachangu, nthawi zambiri mu theka loyamba la ola, nthawi zina kuyatsidwa kumachedwa kwa maola angapo. Koma zinthu zotere sizimatenga nthawi yayitali: maola sikisi mpaka asanu ndi atatu okha.

Pali njira zambiri zochitira insulin yayifupi, ndipo zimatengera iwo pamene insulansi yothamanga ikuyamba kuchita:

• Mothandizidwa ndi mtsempha wa magazi, chinthucho chimayamba kugwira ntchito mphindi imodzi,
• Njira ya intranasal imathanso kwambiri - mahomoni amayamba kugwira ntchito mphindi khumi,
• Introperitoneal management (i.e. peritoneum) imalola chinthu chogwira ntchito kuti chidziwike pakatha mphindi khumi ndi zisanu,
• Ndi makonzedwe a mu mnofu, mahomoni amayamba kutsitsa shuga pambuyo pa ola limodzi,
• Njira yodutsa yoyendetsedwera imacheperachepera - pankhani iyi, mahomoni amangogwira ola limodzi ndi theka.

Kubayirirani kuchitike osachepera mphindi makumi anayi musanadye chakudya kuti thupi likhe kugwetsa shuga. Choipa cha insulin yochepa ndikufunika kupanga jakisoni watsopano maola asanu ndi limodzi mpaka asanu ndi atatu.

Oimira amtunduwu akuphatikiza sungunuka:

• Majini opanga ma genetic amtundu wa anthu amachokera ku chotupa, momwe amino acid imasinthidwa mwachitsanzo, Bioinsulin R, Insuran R, Rinsulin R ndi zina zambiri,
• Semi-yopanga insulin yamunthu yomwe idagwiritsidwa ntchito ndi E. coli, mwachitsanzo, Humodar P,
• Chowerengeka cha nkhumba, chomwe chimasiyana ndi munthu mu amino asidi amodzi, mwachitsanzo, Monodar.

Kuchita insulin mwachangu

Thupi lamtunduwu limatchedwa dzina chifukwa limayamba kugwira ntchito pasanathe mphindi khumi ndi zisanu litayambitsidwa, koma nthawi yomweyo limatulutsidwa mofulumira kwambiri mthupi, kusiya ntchito pambuyo maola anayi.

Ma insulini oterowo ndi opindulitsa chifukwa safunikira kudikirira ola limodzi asanadye, imamwetsedwa mwachangu ndipo imatha kudyedwa pasanathe mphindi zisanu mpaka khumi pambuyo pa jakisoni, palinso mwayi woperekera mankhwalawo musanachitike, mutatha kudya.

Ultrashort insulin imadziwika kuti ndi yamphamvu kwambiri pakati pa mankhwala onse omwe amapangidwa ndi timadzi timeneti, mphamvu yake m'thupi imakhala yolimba kwambiri kuposa ya mankhwala osakhalitsa komanso osakhalitsa. Nthawi zambiri chimagwiritsidwa ntchito pamaso pa spikes lakuthwa m'magazi amwazi, chifukwa izi zimatha kubweretsa zovuta zambiri komanso kupsa mtima.

Mankhwala oterewa ndi ofunikira panthawi yadzidzidzi, mwachitsanzo, ngati sizingatheke kuwerengera nthawi yakudya, kuyamwa mwachangu kwambiri kwa chinthu kumakupatsani nkhawa kuti musadere nkhawa za kuperewera kwa vuto la hyperglycemic.

Koma ndikofunikira kuwerengera kuchuluka kwa mankhwalawo, chifukwa gawo limodzi la mankhwala lomwe limapangidwa pa ultrashort limatha kuchepetsa kuchuluka kwa shuga kawiri ndi theka, ndipo mankhwala osokoneza bongo ochulukirapo amatha kuwonjezera mwayi wokhala chikomokere china - hypoglycemic.

Kuchuluka kwa mankhwala a jakisoni sayenera kupitirira 0,04 Mlingo wa insulin yochepa.

Mitundu yayikulu ya insulin ya ultrashort ndiyophatikiza mayina awa:

Insulin Yaitali

Zofanana poyerekeza ndi insulin yochepa komanso zinthu zazitali zimaperekedwa patebulo lotsatirali:

Mankhwala omwe akhala akuchita kwa nthawi yayitali amaphatikiza insulin monga:

• Malangizo a nthawi yayitali yomvekera mwachitsanzo, NPH ndi Tape,
• Mankhwala omwe akhala akuchita kwa nthawi yayitali monga Detemir ndi Glargin.

Ngakhale cholinga chake chachikulu, chomwe ndi kuyerekezera kubisalira kwa insulin, nthawi zambiri mankhwala ogwiritsidwa ntchito kwa nthawi yayitali amakhala odziwidwa ndi liwiro lonse tsiku lonse wodwala yemweyo. Ichi ndichifukwa chake kuyang'anira kuchuluka kwa shuga ndikofunikira, komwe ngakhale pogwiritsa ntchito mankhwala omwe amapezeka ndi insulin amatha kudumphira kwambiri.

Insulin yosakanikirana

Zosakanikirana zosakanikirana zimakhala ndi zinthu zazifupi ndi zazitali zochita mosiyanasiyana, kutengera momwe thupi liyenera kuchitira.

Ubwino wawukulu wa mankhwalawa ndikuti mphamvu zawo zimachitika mofulumira, mkati mwa theka la ola jakisoni, ndipo zimatha kwa maola 14 mpaka khumi ndi asanu ndi limodzi.

Popeza mphamvu zakukula kwa thupi zimadalira kuchuluka kwa mahomoni omwe amaphatikizidwa ndi mankhwalawa, simungayambe nthawi yodziyimira popanda kufunsa dokotala yemwe amakakamizidwa kuwerengetsa kuchuluka kwa mankhwalawo ndikusankha mankhwalawo, poganizira mawonekedwe a thupi la wodwala, mtundu wa matenda a shuga, ndi zina zambiri.

Woyimira wamkulu wa mankhwala osakanizika ndi Novomix 30, omwe amatha kugwiritsidwa ntchito ndi amayi oyembekezera.

Malangizo a kumwa insulin

Kumayambiriro kwa mankhwala a insulin, adokotala amayenera kuwerengera kuchuluka kwa mankhwalawa tsiku lililonse la mankhwalawa, potengera zaka, kulemera, mtundu wa matenda ashuga komanso machitidwe amunthu wodwala.

Manambala omwe amawerengedwa tsiku lililonse ayenera kugawidwa m'magawo atatu kapena anayi, omwe akhale gawo limodzi.

Kuwunikira pafupipafupi kuchuluka kwa shuga kumakupatsani mwayi wowerengera molondola kuchuluka kwa zosakaniza zofunika.

Masiku ano, ma cholembera a syringe ndi otchuka kwambiri, omwe ali ndi singano yopyapyala kwambiri ndipo amatha kunyamulidwa bwino m'thumba lanu, ndikupanga jakisoni nthawi iliyonse yomwe mukufuna. Pamaso jakisoni, muyenera kutikita bwino pakhungu lanu, osapanga jakisoni wotsatira pamalo amodzi, ndibwino kusinthana.

Mlingo wofala kwambiri:

• M'mawa - mahomoni azowonekera mwachidule komanso kwa nthawi yayitali,
• Masana ndichowonekera pang'ono
• Madzulo ndikungotuluka pang'ono
• Usiku ndi timadzi tambiri tomwe timachita kwa nthawi yayitali.

Zotsatira zoyipa

Ngati atatengedwa molakwika, zotsatirazi zingachitike:

• Kuyabwa ndi redness pamalo a jakisoni, matupi awo sagwirizana,
• Zizindikiro za hypoglycemia: njala yayikulu, palpitations, kunjenjemera, kufooka. Vutoli limatha kuchitika ngati munthu wachulukitsa kuchuluka kwa mankhwalawo kapena sanadye jakisoni.
• Lipodystrophy, kapena kuphwanya kukhulupirika kwa minofu yolowera pamalo opangira jakisoni. Cholinga chake ndikuphwanya njira ya jakisoni: kuyika singano pamalo amodzi, ozizira kwambiri yankho, singano yovuta, ndi zina zotero.

Kulimbitsa Thupi

Mankhwala okhala ndi mahomoni okhala ndi pancreatic ali ndi tanthauzo lotchedwa anabolic, chifukwa chake amagwiritsidwa ntchito molimbika pakupanga thupi. Chifukwa cha insulini, kagayidwe kamayenda bwino, mafutawo amawotchedwa mwachangu, ndipo minofu yochulukitsa ikukula mwachangu. Mphamvu ya anticatabolic ya chinthucho imakupatsani mwayi wopulumutsa minofu yolimba kwambiri, osalola kuti inyeke.

Ngakhale zabwino zonse zogwiritsa ntchito insulin pomanga thupi, pali chiopsezo chokhala ndi vuto la hypoglycemic, lomwe, popanda thandizo loyenerera, lingayambitse imfa.

Amakhulupirira kuti Mlingo pamtunda wa PISCES 100 umawonedwa kuti ndiwopanda vuto, ndipo ngakhale ena adakhalabe athanzi ngakhale pambuyo pa mayunitsi 3000, simuyenera kuyika thanzi lanu pachiwopsezo chifukwa cha minofu yokongola komanso yosemedwa.

Kudya sikuchitika nthawi yomweyo, munthu amakhala ndi nthawi yokwanira kudya shuga m'thupi, ndiye kuti zotsatira zake zakupha sizisowa, koma izi sizithetsa mwayi wake.

Njira yoyendetsera ntchitoyo ndiyophatikiza, siyingagwiritsidwe ntchito kwa miyezi yopitilira iwiri, chifukwa izi zikutanthauza kuti kuphwanya kwa kupanga wina wa ma homoni ndikotheka.

Jakisoni woyamba amayamba ndi magawo awiri, ndiye kuti pang'onopang'ono kuchuluka kwake kumawonjezeka ndi enanso awiri. Ngati izi zikuchitika, mungathe kubweretsa mlingoyo magawo 15.

Njira yofatsa kwambiri yamakonzedwe ndikumalipira zinthu zochepa tsiku lililonse. Palibe chifukwa chake muyenera kulowa mankhwalawo musanaphunzitse komanso musanagone.

Insulin ndi chinthu chomwe chimagwira gawo lofunikira kwambiri mthupi, chifukwa chake kuyang'anitsitsa kusintha kwa katulutsidwe kake kumathandizira kukhala ndi thanzi labwino komanso thanzi. Mitundu yosiyanasiyana yam mahomoni imakupatsani mwayi woti musankhe wodwala aliyense, kumulola kukhala ndi moyo wonse komanso osawopa kuyambika kwa chikomokere.

Zizindikiro za matenda a shuga a insulin

Zizindikiro za hypoglycemia zimachitika pang'onopang'ono.Zizindikiro zoyambirira zimawonekera pamene misempha ya glucose ili pansi 3.3 mmol / L. Pakukayikira kochepa kwa shuga wochepetsedwa kapena kupezeka kwa chizindikiro chimodzi, ndikofunikira kugwiritsa ntchito glucometer.

Pachiyambi pamabwera kumverera kowawa kwanjala, kugwedeza manja, kukwiya, kupusa, thukuta, palpitations, pallor. Pakadali pano, wodwalayo amatha kudzithandiza yekha pakudya nthawi yomweyo zakudya zopatsa mphamvu zamafuta ambiri. Zakudya zoterezi zimaphatikizapo maswiti, shuga, msuzi wokoma, uchi, muffin komanso mapiritsi a shuga. Aliyense wodwala matenda ashuga ayenera kukhala ndi mtundu wina waotseka ndi iye.

Madzi a glucose mita

Ngati palibe chochitapo, kuwonongeka kwina kumachitika. Pali kufooka, mutu, chisokonezo. Pambuyo pake, kusokonezeka kwa mgwirizano, masomphenya ndi malankhulidwe kumachitika, kukhudzika kumatha kuyamba. Pakadali pano, wodwalayo sangathe kuthana ndi vutoli payekha, thandizo ladzidzidzi la othandizira likufunika. Amachita kulowetsedwa kwamphamvu kwa 40% shuga, m'magawo pafupifupi 40 ml, komanso jekeseni wa glucagon wa m'magazi, omwe amachititsa kuti shuga azikhala magazi.

Ngati thandizo siliperekedwa pakadali pano, chikomokere chimachitika, chomwe nthawi zambiri chimatha.

Mlingo wowopsa kwa munthu wathanzi komanso wodwala yemwe ali ndi matenda ashuga amachokera ku 100-500 IU patsiku ndipo zimatengera umunthu wake. Koma izi zimagwira ndendende jakisoni, ngati mumamwa mlingo womwewo, palibe chomwe chidzachitike, chifukwa insulini idawonongedwa kwathunthu ndi madzi a m'mimba. Ndi chifukwa ichi kuti palibe mitundu yamapiritsi ya mahomoni yochizira matenda a shuga.

Ngati mulingo wamphamvu kwambiri, kusintha kuchokera pagawo lina kupita kwina kumachitika mwachangu kwambiri, ndipo thandizo silikhala ndi nthawi yoti lifike pa nthawi. Chifukwa chake, muyenera kuyang'anira kayendetsedwe ka insulin ndikutsatira malangizo onse a dokotala. M'masiku owopsa, mwachitsanzo, mankhwala akasinthidwa, shuga amayenera kuyang'aniridwa nthawi zambiri ndi glucometer. Tiyenera kukumbukira kuti bongo la insulin ingathe kufa.

Matenda oopsa a hypoglycemia, wodwala akamamwa mlingo waukulu wa mankhwala kuposa momwe amayenera kuchitira, zizindikiro zotsatirazi zingachitike:

• kulakalaka
• Kulemera msanga, ngakhale ndi chakudya,
• pafupipafupi matenda a hypoglycemia,
• shuga yayikulu kwambiri
• Somoji syndrome ikhoza kuchitika.

Zotsatira za hypoglycemia

Pafupifupi odwala onse omwe ali ndi matenda ashuga amakumana ndi mikhalidwe ya hypoglycemic. Zotsatira za mankhwala osokoneza bongo a insulin ambiri amatha kukhalabe pambuyo pa matenda oopsa a hypoglycemia, kapena chifukwa chokhala ndi kuchuluka kwa mahomoni ambiri.

Poyamba, zosinthazi zimakhudzana kwambiri ndi dongosolo lamanjenje, chifukwa cha mphamvu yanjala, ubongo umataya zina mwazomwe zimagwira, wodwalayo amatha kukhalabe ndi mavuto amisala ndikuyamba kukhala ndi vuto la maganizo.

Ndi kukhazikitsidwa kosalekeza kwa Mlingo waukulu wa mahomoni, monga tafotokozera pamwambapa, matenda a Somoji, omwe amatchedwa kuti insulin overdose syndrome, amatha kuchitika.

Somoji syndrome

Matendawa amadziwika chifukwa chakuti thupi poyankha pafupipafupi hypoglycemia limalimbikitsa kupanga mahomoni olimbana ndi mahomoni (glucagon, adrenaline, glucocorticosteroids). Ndipo pali paradoxical zotsatira, mlingo wa insulin ndi waukulu, ndipo kuchuluka kwa glucose kumakhalabe kokulirapo. Zotsatira zake, wodwalayo amakumana ndi kudumpha kosatha kwa shuga, kenako hypoglycemia, kenako hyperglycemia. Izi zimadzetsa vuto la matendawa.

Zizindikiro za Somoji syndrome:

• kufooka, kugona,
• mutu
• osagona, osagona,
• njala yosalekeza
• kuchuluka phindu
• matupi a ketone amawonekera mkodzo,
• wodwalayo amalembetsa ndi glucometer mwina otsika kapena yayikulu zizindikiro,
• matendawa amatha bwino pambuyo pakuchepa kwa mphamvu ya mahomoni.

Kuvuta kwa matendawa ndikuti pali zizindikiro za kuchuluka kwa insulin komanso kuchepa.Kuzindikira kumakhala kovuta kwambiri kuti apange, chifukwa chake ma endocrinologists amakhulupirira molakwika kuti chithandizo sichokwanira ndipo ngakhale amachulukitsa mlingo wa mankhwalawo.

Kuti mudziwe bwino, muyenera kuyeza kuchuluka kwa shuga m'mawa kwambiri, pakangotha ​​maola 2 mpaka 4. Ndi matenda a Somogy, padzakhala hypoglycemia yayikulu, ndi mtundu wabwinobwino wa mahomoni, amatha kukhala abwinobwino kapena okwera.

Chithandizo chimakhala poika mankhwala okwanira, momwe mkhalidwe wodwalayo amabwerera mwakale.

Mavuto aliwonse a shuga amakhala osavuta kupewa kuposa kuchiza - wodwala aliyense ayenera kukumbukira izi, ayenera kuyang'anitsitsa zakudya zawo ndi chithandizo chake, kutsatira malangizo onse a dokotala ndipo musamadziderere.