Zonse zokhudzana ndi matenda amutu

M'mbuyomu, pamene sindinadziwe chilichonse chisonyezo ichi, tinali ndi shuga wambiri tikudya, ndipo atayamba kugwira insulin, anali atatsika kale. Ndimaganiza kuti insulini yochepa sinali yokwanira ndipo zonse zimawonjezera, ndikuwonjezera.

Koma kenako ndinayamba kulingalira. Shuga amabwerera pamlingo wake woyambirira komanso wotsikirapo, zomwe zikutanthauza kuti pali insulini yokwanira, chakudya chokha chimapeza insulini, ndipo glucose yemwe adalowetsedwa mwachangu sanatengeredwe ndi insulin.

Koma kenako, insulin ikayamba kugwira ntchito, imatenga shuga wophatikizana onse m'magazi, ndipo ngati mutabaya insulin yambiri, ndiye kuti mkhalidwe wa hypoglycemia - shuga wotsika wamagazi - ungayambike.

Pali lingaliro limodzi lokha - pankhaniyi, insulin iyenera kuchitidwa kale, mphindi zochepa asanadye

Nthawi yoti mutengepo imatengera mtundu wa insulin. Ma insulin osavuta aanthu amayamba kugwira ntchito mochedwa kuposa ma ultrashort insulin analogues. Malangizo a insulin yosavuta akuti amayamba kuchita mphindi 30 pambuyo pa kubayidwa. Uwu ndi mtengo wapakati, kwa munthu aliyense izi zimachitika mosiyanasiyana, koma chizindikirochi chitha kutengedwa ngati chitsogozo.

Malangizo a ultrashort insulin akuti amayamba kugwira ntchito mphindi 15 atabayidwa. Kuchokera pamanambala amenewa omwe timafunika kupitilirapo. Tsopano popeza tikudziwa momwe insulin iyenera kugwira ntchito, titha kusankha mawonekedwe abwino.

Ngakhale mulingo wosankhidwa bwino wa mahomoni amayenera kusintha:

1. Ultra-yochepa-insulin voliyumu malamulo. Kukonzekera kosakwanira kwa mankhwalawa kumatha kuyambitsa mawonekedwe a postprandial hyperglycemia. Kuti muchotse izi, muyenera kuwonjezera kuchuluka kwa mahomoni.
2. Kusintha koyambirira kwa mankhwala a nthawi yayitali kumadalira kuchuluka kwa shuga m'mawa ndi madzulo.
3. Somoji syndrome ikawoneka, ndikofunikira kuti muchepetse muyeso wa insulin yayitali usiku ndi magawo awiri.
4. Ngati urinalysis iwonetsa kukhalapo kwa matupi a ketone mmenemo, muyenera kupanga jakisoni wina wa mahomoni amtundu wa ultrashort.

Konzani mtundu wa mankhwalawa woperekedwa ndikufunika malinga ndi kuchuluka kwa zolimbitsa thupi.

Ndikofunika kukumbukira kuti pophunzira masewera olimbitsa thupi, thupi limawotcha shuga. Chifukwa chake, mkati mwa makalasi, mlingo woyambirira wa insulin uyenera kusinthidwa, apo ayi, osavomerezeka a bongo akhoza kukhala.

Kuti mukhale ndi vuto linalake kuchokera pakugwiritsa ntchito insulin, liyenera kusankhidwa ndi dokotala payekha pazomwe munthu akudziwa zokhudza thanzi la wodwalayo. Dokotala amayenera kuuza wodwalayo za matendawa momveka bwino, malamulo operekera mankhwalawa, kukhala ndi moyo wathanzi komanso zovuta zomwe zingachitike.

Ngati, pambuyo pa jakisoni wa mahomoni a kapamba a kapangidwe kake, mulingo wa shuga amakhalabe wokwera, ndiye kuti ndibwino kufunsa dokotala. Amamvetsera mosamala ndikupereka malangizo othandiza kuti achitenso kanthu.

Kodi ndi maumboni ati omwe akuyenera kuganiziridwa pakuwerengera kuchuluka kwa insulin?

Ngakhale mulingo wosankhidwa bwino wa mankhwala amafunika kusintha zina malinga ndi mphamvu ya zinthu zosiyanasiyana.

Mfundo zazikuluzikulu zomwe muyenera kulabadira, kuti insulini ibweretse zotsatira zoyenera:

1. Ultra-yochepa kukhudzana insulin mlingo. Izi zimachitika kuti kuyambitsidwa kwa mankhwala osakwanira (ndiye kuti, pakudya chakudya chamafuta ochepa) kungayambitse kukula kwa postprandial hyperglycemia. Kuti muthane ndi vutoli, tikulimbikitsidwa kuti muwonjezere mlingo wa mankhwalawo.
2. Kusintha kwa mankhwalawa kwa nthawi yayitali kumadalira kuchuluka kwa glucose musanadye chakudya komanso zisonyezo zam'mawa.
3. Ndi chitukuko cha matenda a Somogy, njira yoyenera ndiyo kuchepetsa mlingo wa mankhwala omwe amapezeka nthawi yayitali usiku pafupifupi magawo awiri.
4. Ngati mayesowo a mkodzo akuwonetsa kukhalapo kwa matupi a ketone mmenemo, kukonza kuyenera kupangidwa ponena za kuchuluka kwa acetone, ndiye kuti, jakisoni wowonjezera wa insulin wa insulin ayenera kuperekedwa.

Kusintha kwa mlingo kuyenera kusinthidwa malinga ndi kuchuluka kwa zolimbitsa thupi. Kanemayo munkhaniyi akukamba za insulini.

Chifukwa chiyani shuga samachepetsedwa pambuyo jakisoni wa insulin

Tiyerekeze kuti mukubwera chakudya chamadzulo ndi shuga ya 7.6 mmol / L. Ngati mupanga mtundu wa insulin mwachizolowezi ndikusunga kuchuluka kwa mphindi zanthawi ino, ndiye kuti mwina mutatha maola awiri mutatha kudya, shuga sangakusangalatseni.

Chifukwa chiyani? Chifukwa simunatenge kulungamitsidwa ndikuchepetsa ndipo simunathe kuyimilira nthawi yowonjezera yomwe gawo loyambirira lingagwere pazomwe mukufuna. Palinso vuto lina lomwe mulingo wochepera kuposa shuga wanu, koma si hypoglycemia.

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Mwachitsanzo, 3.9 mmol / L mwa anthu odwala matenda ashuga samayambitsa matenda a hypoglycemia, koma ngati mungayime nthawi musanadye ndi shuga, ndiye kuti mwina pali "hypo". Pankhaniyi, pali njira ziwiri: mungadye kena kena pang'ono musanadye kuti mulimbikitse shuga kapena kuti mulowe ndi insulin mukatha kudya kwathunthu.

Zizindikiro ziti za shuga wambiri?

Choyamba muyenera kuonetsetsa kuti muli ndi shuga wambiri. Zizindikiro zapamwamba za hyperglycemia ndi izi:

• Kumva ludzu kwambiri.
• Nthawi zambiri mumayamba kupita kuchimbudzi kukakodza.
• Pakamwa panga pakumva zowuma.
• Lethargy ndi kutopa kumakula (chizindikiro ichi chokha sichingadalire, chifukwa chitha kuchitika ndi hypoglycemia).
• Mumakhala wosakwiya, simusangalala.

Yang'anani shuga yanu yamagazi

Ngati muli ndi matenda ashuga ndipo mukumwa mankhwala omwe amachepetsa shuga ndipo amatha kuyambitsa hypoglycemia, ndikofunika kuti muyeza shuga mumagazi anu ndi glucometer musanayambe kutsitsa ndikuwabwezeretsa ngati abwinobwino. Izi zikuyenera kuchitika pofuna kupewa zina za shuga wochepa kuti asatengedwe chifukwa cha hyperglycemia. Izi ndizofunikira kwambiri ngati mukuthandizidwa ndi insulin.

Onetsetsani kuti mumayeza shuga kuti zitsimikizidwe kuti zimakwezedwa.

Kodi ndiyenera kupita liti kuchipatala?

Ndikofunika kudziwa kuti kuchuluka kwambiri kwa glucose m'magazi kungakhale koopsa ku thanzi, chifukwa chake simuyenera kubweretsa nokha, koma muyenera kuyitanitsa ambulansi. Ngati pakamwa panu mumanunkhira ngati acetone kapena zipatso, ndiye kuti mwayamba kudwala matenda ashuga ndipo mutha kuchiritsa moyang'aniridwa ndi dokotala. Ndikupezeka ndi shuga wambiri (oposa 20 mmol / lita), vuto lovuta kwambiri komanso loopsa la matenda ashuga limayamba - chikomokere cha matenda oopsa. Β Panthawi izi, simukuyenera kugwetsa shuga nokha, koma muyenera kuyimbira foni dokotala.

Jakisoni wa insulini athandizira kutsitsa shuga wamagazi ambiri (koma izi sizoyambira)

Ngati akukupatsani insulin, njira imodzi yochepetsera shuga yanu ndiyo kubaya insulini.

Jakisoni wa Insulin - Njira Yofunika Kwambiri Yothira Magazi A shuga

Komabe, samalani, chifukwa insulin imatha kuyamba kugwira ntchito pambuyo pa maola 4 kapena kupitirira apo, ndipo panthawiyi mkhalidwe wa wodwalayo ungakulire kwambiri.

Ngati mungaganize zokhala ndi shuga wambiri ndi insulini, gwiritsani ntchito insulin yochepa kapena yochepa kwambiri. Mitundu ya insulin iyi imayamba kuchita zinthu mwachangu kwambiri. Koma samalani, monga Kugwiritsa ntchito bongo mopitirira muyeso kumatha kuyambitsa hypoglycemia, ndipo kumatha kukhala koopsa, makamaka musanakagone.

Kuchepetsa shuga m'magazi kuyenera kukhala pang'onopang'ono.Pangani jakisoni ang'onoang'ono a insulin m'magawo atatu, kuyeza shuga m'magazi aliwonse theka la ola ndikuyika mulingo wochepa wa insulin mpaka shuga ibwerere mwakale.

Ndi ketoacidosis, mudzafunika kuthandizidwa

Ngati simunadziwe shuga woletsa, sikuletsedwa kudzipatula popanda magazi. Kumbukirani kuti insulin si chidole ndipo chingaike moyo pachiswe!

Kuchita masewera olimbitsa thupi Sizothandiza Nthawi Zonse Kuchepetsa shuga

Kuchita masewera olimbitsa thupi kumatha kuthandizira kuchepetsa shuga m'magazi anu, koma pokhapokha magazi anu akachulukitsidwa pang'ono ndipo mulibe hyperglycemia kapena ketoacidosis. Chowonadi ndi chakuti ngati muli ndi shuga wambiri musanayambe kuchita masewera olimbitsa thupi, zimawonjezereka kwambiri kuchokera pakuchita masewera olimbitsa thupi. Chifukwa chake, njirayi siili yofunikira poteteza matenda a glucose.

Mu kanema uyu, Elena Malysheva amafotokoza njira zochepetsera shuga.

Momwe mungabweretsere msanga shuga wambiri ndi wowerengeka azitsamba?

Kumbukirani kuti wowerengeka azitsamba amachepetsa shuga pang'onopang'ono, ndimangogwiritsa ntchito ngati othandizira komanso othandizira. Zithandizo zina zachikhalidwe simudzatha kubweretsanso shuga munthawi yochepa.

Mwachitsanzo, amalemba kuti bay tsamba limatsitsa shuga. Mwina zili choncho, koma mankhwalawa sachepetsa msanga magazi anu, makamaka ngati muli nawo pamwamba pa 10 mmol / lita.

Zithandizo za anthu ozizwitsa zimakhulupirira, monga lamulo, kwa iwo omwe adayamba kudwala matenda ashuga ndipo sakudziwa zenizeni. Ngati mukutsutsana ndi mankhwalawa ndi mapiritsi a insulini kapena kutsitsa shuga, ndiye kuti yesetsani kumwa wowerengeka, kenako kuyeza shuga. Ngati izi sizikuthandizani, itanani madokotala.

Imwani madzi ambiri

Ngati shuga wanu wamagazi ndiwokwera kwambiri, thupi lanu limayesetsa kuchotsa shuga owonjezera m'magazi kudzera mkodzo. Zotsatira zake, mufunika madzi ambiri kuti mudzinyonthoze ndikuyamba kudziyeretsa nokha. Imwani madzi abwino bwino, imwani ambiri, koma osapitilira, chifukwa Mutha kumwa zakumwa zam'madzi ngati mumamwa malita angapo a madzi kwakanthawi kochepa.

Madzi ndikofunikira, koma dziwani kuti simungathe kutsitsa shuga wambiri ndi madzi nokha. Madzi ndi gawo lofunikira polimbana ndi shuga ambiri mthupi.

Njira Zotsogola ndi Zachipatala za Insulin Kukwanira

Chifukwa chake, ngati mukuyang'anizana ndi zomwe tafotokozazi, ndipo simukudziwa chifukwa chake shuga samachepa, ngakhale mumalandira chithandizo ndi insulin, tikupangira kuti muwone zotsatirazi:

Kodi munayang'ana kuti tsiku lanu la insulin latha liti?

Wodwala yemwe analibe vuto la insulin amagwiritsa ntchito mwangozi insulin, zaka 1.5 zapitazo chifukwa Panalibe njira yofotokozera kuchuluka kwa shuga tsiku lililonse mpaka m'mawa mpaka kukonzedwa.

Kodi mumasungitsa insulini mufiriji? Kodi adamasuka? Kodi insulin ija inauma m'thumba, kodi inathanso kutentha? Kodi amatetezedwa ku kuwala?

Insulin yamoyo wabwinobwino imatha kuwonongeka ngati itasungidwa mosayenera. Wonongerani insulin: kuzizira, kutentha kwambiri, dzuwa mwachindunji.

Kodi mumasunga kutentha kwa insulin?

Inde, ikhoza kusungidwa m'chipinda kutentha (20-22C). Sikufunika kuisunga mufiriji: kuyambitsa kuzizira, kumakhala kofooka.

Kodi mumasakaniza ma insulini osiyanasiyana mu syringe imodzi?

Mankhwala ena a insulin ya nthawi yayitali (protafan, chymulin N) amatha kusindikizidwa musanalowetsa jakisoni imodzi ndi insulini yochepa (ngakhale izi zimafunikira kusungidwa kwa malamulo apadera ndikuwonjezera chiopsezo cha zolakwika pakusankha kwa mankhwala). Ma insulin ena owonjezera (monotard, tepi) akaphatikizidwa ndi insulin yochepa kumayambitsa kufooka kwa zochita za osakaniza.

Kodi mpweya walowa mu syringe?

Ngati simukuwona kuti mu mpweya mu syringe, mutha kubayira insulini yocheperako kuposa momwe mumayembekezera.

Kwa milungu ingapo, insulini imalowetsedwa mu gawo limodzi (mwachitsanzo, kumanzere kumanzere), masabata angapo otsatira - ena (mwachitsanzo, ntchafu lamanja ndi lamanzere) - zina.

Kodi simulowa mu zisindikizo kapena "wen" mutatha jakisoni yakale?

Mukalowetsa malowa, insulin imakhala yofooka kuposa masiku onse (mukalowetsa pakhungu labwinobwino).

Kodi mumapukuta khungu ndi mowa musanalowe jakisoni?

Mowa umawononga insulin. Kuphatikiza apo, chithandizo chotere cha khungu sichofunikira, chifukwa chiopsezo cha matenda omwe amapezeka jekeseni pogwiritsa ntchito insulin yamakono ndi syringes ndi zero.

Kodi mumapinda khungu musanabaye jekeseni?

Ngati izi sizichitika, insulin imatha kubayidwa mu minofu. Izi ndizoyipa chifukwa simukutsimikiza za insulin. Idzakhala yamphamvu kapena yopanda mphamvu. Khola la khungu silingathe kumasulidwa kufikira mutalowetsa insulini yonse.

Kodi mumadikirira masekondi 5-7 musanachotsere singano mutatha jakisoni? Kodi madontho a insulini amatuluka kuchokera m'malo a jakisoni?

Ngati izi sizichitika, insulin idzayambiranso kudzera m'malo a jakisoni. Poterepa, gawo losadziwika la insulin (2, 3, 5 kapena kuposa) silalowa mthupi. Pali njira zapadera zopewa kutayikira.

Patsala mphindi zingati kuti mudyetse? Kodi mumatsatira nthawi zonse?

Ngati mugwiritsa ntchito cholembera:

Kodi mumasakaniza insulin yochulukirapo motani?

Kugwetsa chogwirizira pakati pa manja sikothandiza! Ndikofunikira kutembenuza nthawi 5-7 ndi singano kumtunda ndi pansi.

Kodi insulin ikudontha kuchokera ku singano mutabayidwa?

Ngati mpweya ulowa m'matumba, nthawi ya jakisoni wa insulin imatha kutalika (chifukwa cha kupindika kwa mpweya). Mutha kuchotsa singano musanatuluke insulini yonse.

Kodi mukutenga insulini yoyenera? Kodi mukuyenera kumaliza mlingo womwe mwalandira?

Ndi vuto losaona, zolakwika zitha kuchitika ndikuyika nambala yamagulu amafunikira. M'mipeni ina ya syringe, ngati batani la piston silikakamizidwa kwathunthu, insulin imangoyendetsedwa pang'ono. Mukudziwa. Monga momwe zikusonyezera, nthawi zambiri "kuvuta kwa shuga" ndikunama.

Zifukwa zamankhwala zosagwiritsa ntchito insulin

• Kunenepa kwambiri
• Mafuta a cholesterol ndi okwera kwambiri kapena otsika kuposa momwe amafunikira
• Matenda osiyanasiyana amtima,
• Ovary Polycystic,
• Matenda a chiwindi.

• Kunenepa kwambiri

Zoyenera kuchita ngati insulini singathandize kuchepetsa shuga

Nthawi zambiri, anthu amakumana ndi mfundo yoti, ngakhale akugwiritsa ntchito insulin, shuga wamagazi sachepa. Ngati chomwe chimayambitsa ndondomekoyi sichikuletsa insulini kapena zovuta zina, ndiye kuti vuto ndi kugwiritsa ntchito molakwika gawo la mahomoni. Pankhaniyi, ndikofunikira kulingalira zolakwitsa zazikulu zomwe zimapangidwa pakugwiritsa ntchito insulin.

Moyo wa alumali ndi malo osungira

Choyamba, tisaiwale kuti insulin, monga mankhwala ena aliwonse ali ndi tsiku lotha ntchito. Phukusi kuchokera ku gawo la mahomoni, tsiku lenileni la kumaliza kwake ndi zizindikiro zofananira, zomwe zili zovomerezeka kale kuyambira pakutsegulira, zimasonyezedweratu. Ayenera kukumbukiridwa kapena kuonana ndi endocrinologist. Kupanda kutero, sikuti njira yongobwerera yokha siyotheka, komanso kupezeka kwa zovuta zina.

Kuphatikiza apo, mawonekedwe ake ngakhale atakhala ndi alumali ambiri akhoza kuwonongeka ngati malamulo osungira samatsatiridwa. Ponena za izi, akatswiri amalabadira kuzizira, kutentha kwambiri ndi kuwunika mwachindunji - zonsezi zimalimbikitsidwa kwambiri kuti musamale. Ndikofunika kulabadira kuti mawonekedwe ake ayenera kusungidwa pokhapokha kutentha. Tikulankhula za chizindikiro cha kutentha kuyambira madigiri 20 mpaka 22.

Kusungidwa kwa insulini mufiriji ndikosafunanso, chifukwa chinthu choterocho, ngati chikuyambitsidwa, chimachedwa. Nthawi zina ichi ndi chifukwa chake insulin siyitsitsa magazi.

Kuphatikiza mawonekedwe ndi zina

Mankhwala ena, monga omwe amadziwika chifukwa cha kuchuluka kwa insulin (mwachitsanzo, Protafan kapena Himulin N), ndizovomerezeka kuyimira mu syringe imodzi yokhala ndi gawo lalifupi musanalowe. Nthawi yomweyo, ndikulimbikitsidwa kuti musaiwale kuti izi zikufunika kutsatira malamulo ena ndipo zimawonjezera mwayi wolakwitsa mukamasankha mulingo.

Ichi ndichifukwa chake kufunsira kwa katswiri kukhala chinthu chofunikira.

Mitundu ina ya insulin yomwe imadziwika ndi zochita zazitali (mwachitsanzo, Monotard, Lente) itha kutaya katundu wawo. Mwambiri nthawi zambiri mukasakanikirana ndi insulin yochepa, izi zimayambitsa kufooka kwakukulu kwa zomwe zimasakanizidwa. Ichi ndichifukwa chake amakhumudwitsidwa mwamphamvu kusankha pawokha pakuphatikizidwa kwazinthu zina. Ndikufuna kuyang'ana zina:

1. ngati pali mpweya mu syringe, gawo laling'ono kwambiri la mahomoni lidzayambitsidwa kuposa zomwe zinali zofunikira poyamba. Pankhaniyi, ndikofunikira kulabadira kupezeka kwake kapena kusakhalapo,
2. mulingo woyenera kwambiri ndi mphamvu ya insulin ikabayidwa pamimba,
3. pang'ono, koma, komabe, chimakulirakulira komanso pang'ono pang'onopang'ono ndikamayikidwa mu ntchafu ndi zomata za chikopa pamwamba pa matako. Zofunikira kwambiri ndizomwe zimayambitsa dera.

Ndikofunikanso kuganizira kuti kutha kwa chiwonetsero cha insulin kumayendetsedwa ndi momwe magawo a kayendetsedwe ake amaphatikizidwira. Pachifukwa ichi, akatswiri amawunika ma algorithms awiri, oyamba omwe ali kuti gawo lililonse limagwiritsidwa ntchito tsiku lililonse malinga ndi mapulani omwe anakonzekera. Malinga ndi izi, jakisoni aliyense amakhala ndi gawo lake losiyana. Poterepa, gawo la mahomoni amtundu waufupi limalimbikitsidwa kuti liyambike pansi pakhungu pamimba. Mwanjira imeneyi, kuyamba kwa zovuta kwa wothandizirayo kumaperekedwa.

Polankhula za algorithm yachiwiri, ziyenera kudziwika kuti imakhala m'lingaliro lakuti mkati mwa milungu ingapo kupangidwako kuyenera kuyambitsidwa mu gawo limodzi. Tiyerekeze kuti ikhoza kukhala m'mbali kumanja kapena kumanzere, ndipo milungu yotsatirayi - mu algorithm osiyana (mwachitsanzo, m'dera la dzanja lamanja kapena lamanzere). Umu ndi momwe zingathekere kulankhula za kukwaniritsa kuchuluka kwakukulu ndi zotsatira za insulin. Komabe, awa ali kutali ndi malamulo onse omwe amapereka chitetezo ku mfundo yakuti gawo la mahomoni siligwira ntchito.

Monga mukudziwa, mapangidwe a wen amatha kutchedwa kuti pafupipafupi. Kuphatikiza apo, sizimawoneka nthawi zonse ndi maliseche, chifukwa chake odwala matenda ashuga sangadziwe za iwo ndikulowetsa insulin pamenepo, poganiza kuti izi ndizophweka pakhungu. Zachidziwikire, ndikukula kwazinthuzi, chinthucho chimapanga pang'onopang'ono kapena kusiya kuchepetsa shuga kwathunthu.

Akatswiri amaunika chidwi chakuti zolakwika nthawi zambiri zimapangidwa popereka insulin m'malo ena.

Pankhaniyi, ndikufuna kuwonetsa zina zomwe sizinawonetsedwepo kale. Chowonadi ndi chakuti ndikofunikira kugwiritsa ntchito mtunda wonse, kupangitsa kuti ikhale yotheka momwe mungathere. Mwachitsanzo, kumbali, ya mbali yapamwamba kwambiri ya thunthu kapena pansi mpaka kumapeto.

Pamalo pakati pa nthiti ndi navel, kugwiritsa ntchito gawo la mahomoni sikudzakhala kolondola chimodzimodzi.Izi sizingachitike mu insulin yokwanira, komanso chifukwa chakuti munthawi imeneyi, zisindikizo sizingapangike pakhungu, ndipo kuchuluka kwa ululu wa jakisoni kumachepetsedwa kwambiri.

Vuto linanso lalikulu ndi kumwa mowa nthawi yomweyo jakisoni isanachitike. Chowonadi ndi chakuti chikuwononga insulini. Kuphatikiza apo, chithandizo chotere pakhungu sichofunikira, chifukwa mwayi wokhala ndi kachilomboka m'malo opezeka jekeseni ndikuyambitsa insulin ndi syringes ndizochepa komanso pafupifupi zero.

Ndikulimbikitsidwa kwambiri kuti mupange khola la khungu, chifukwa, apo ayi, gawo la mahomoni limayambitsidwa m'chigawo cha minofu. Izi zimakhala ndi zotsatirapo zoyipa kwambiri, chifukwa sipadzakhala chidaliro mu mphamvu ya kapangidwe kake. Mwambiri, nthawi zambiri zimayamba kuchita zinthu mwamphamvu kapena zochepa, popanda kubweretsa zomwe mukufuna. Amakhala otaya mtima kumasula khola la khungu kufikira atayambitsidwa ndi insulin yonse.

Ndipo, pomaliza, malingaliro omaliza omwe amapangitsa kuti athandizidwe pamavuto ochepetsa shuga ndi omwe amayembekezeka masekondi asanu mpaka asanu ndi awiri kenako ndikuchotsa singano. Ngati simuchita izi, ndiye kuti gawo la mahomoni limasulidwanso kudzera m'jekeseni. Munthawi imeneyi, gawo losasinthika la kapangidwe kameneka (lingakhale magawo awiri kapena atatu kapena kupitirirapo) silalowa mkati mwa thupi la munthu.

Tiyenera kukumbukira kuti pali njira zambiri zapadera zomwe zimapangitsa kuti zitheke kuthekera kwa kutaya ndi kuchepetsa izi mtsogolo.

Choyenereradi kudziwa ndi momwe zolembera za syringe zikuyenera kugwiritsidwa ntchito.

Mawu ochepa za syringe pensulo

Kugwiritsa ntchito zolembera za syringe sikumayambitsa mafunso ambiri kwa odwala matenda ashuga okhudzana ndi kuchuluka kwa ntchito, ngakhale ali ndi automatism komanso kuphweka kwakukulu pakugwiritsira ntchito. Koposa zonse, ndikofunikira kuti mutsatire malamulo osakanikirana a insulin. Kuti tichite izi, ndikofunikira kutembenuza mozungulira ndi singano kasanu mpaka kasanu ndi kawiri.

Pogwiritsa ntchito cholembera, kulowetsedwa kwa mpweya kuyeneranso kupewedwa ngati kungatheke. Chowonadi ndi chakuti izi zimathandizira kukulitsa nthawi ya jakisoni wa insulin chifukwa cha kuwundana kwambiri kwa mpweya. Zotsatira za izi ndikuti singano imatha kuchotsedwa gawo lonse lazinthu zamahomoni zisanatuluke.

Kwa zovuta ndi ntchito ya masomphenya, zolakwika zitha kuchitika ndi chizindikiritso cha manambala omwe amafunikira. M'mitundu ina ya ma syringe, ngati chinsinsi cha piston sichidapangidwe kwathunthu, gawo la mahomoni limangoyambitsidwa. Ngati mukukayikira mukugwiritsa ntchito chipangizocho, ndikulimbikitsidwa kuti mupeze thandizo kwa katswiri.

Monga momwe amasonyezera, nthawi zambiri, zovuta za shuga m'magazi komanso kuwonongeka kwa insulin ndikunama. Izi zimachitika makamaka chifukwa chosagwirizana ndi miyezo yogwiritsira ntchito zinthuzi, kunyalanyaza zoyambitsa za akatswiri. Ichi ndichifukwa chake aliyense wodwala matenda ashuga ayenera kuyesedwa mwachidule isanayambike maphunziro, zomwe zingathandize kupewa mafunso omwe amachititsa kuti insulin isachepetse shuga.

Somoji syndrome kapena insulin yambiri

Somoji syndrome ndi mkhalidwe wa insulin yambiri. Dzina lina la matendawa ndi posthypoglycemic hyperglycemia kapena ricocheted hyperglycemia. Kutengera ndi mayina aposachedwa, titha kumvetsetsa kuti Somoji syndrome imayamba chifukwa cha hypoglycemia, yodziwikiratu komanso yobisika.

Kuti mumveke bwino bwino, ndipereka chitsanzo.Mwachitsanzo, munthu ali ndi shuga wa 11.6 mmol / L, podziwa izi, adadzipangira mlingo wa insulin kuti ayitsitse, koma patapita kanthawi adayamba kumva kufooka kwa hypoglycemia m'njira yofooka. Komabe, sanathe kuletsa izi mwachangu pazifukwa zina. Pakupita nthawi, adayamba kumva bwino, koma pamayezero otsatirawa adapeza kuchuluka kwa glucose a 15.7 mmol / L. Pambuyo pake adaganiziranso zopanga insulin, koma pang'ono.

Popita nthawi, Mlingo wanthawi zonse wa insulin sanachepetse shuga, koma hyperglycemia idalimbikira. Posazindikira zomwe anali kuchita, mwamunayo adayesa pachabe kuti athetse shuga mwa kuwonjezera kuchuluka kwa shuga mokulira. Zotsatira zake, adangokulirakulira, kumva kuti wathedwa mphamvu, kupweteka kwakumutu pafupipafupi kunayamba kumuzunza, adanenepa kwambiri, ndipo anali ndi njala nthawi zonse, sikuti shuga adangotukuka, koma adayamba kuchita zachilendo: idafika kwakukulu masaizi, kenako pazifukwa zosasinthika adagwa.

Ichi ndi chitsanzo chabwino kwambiri cha kukula kwa matenda a Somoji, koma pali zochitika zina, zomwe zimapangitsa kuti zikhale zosiyana. Komabe, onsewa amaphatikizidwa ndi pathogenis imodzi ndi zotulukapo. Matenda a insulin kwambiri amakhala amtundu uliwonse wa matenda ashuga omwe jakisoni wa insulin amagwiritsidwa ntchito ngati chithandizo. Zilibe kanthu kuti mumangogwiritsa ntchito insulin basi. Pankhani ya mankhwala osokoneza bongo a basal insulin, hypoglycemia imatha kuchitika mwanjira yomweyo, makamaka usiku, pomwe wodwalayo "adzadabwa" ndi zovuta zam'mawa kwambiri, ndipo madzulo amenewo adzawonjezera kuchuluka kwa basal, ndikuganiza kuti sikokwanira.

Chifukwa chiyani shuga limatuluka pambuyo pa hypoglycemia

Chifukwa chake, mukumvetsetsa kuti matendawa amakula poyankha pafupipafupi hypoglycemia. Tsopano ndikufotokozera chifukwa chake pafupipafupi hypoglycemia ingayambitse vutoli. Kutsika kwa shuga m'magazi kumazindikiridwa ndi thupi ngati kupsinjika kwakukulu, ndi chizindikiro cha ngozi. Chifukwa chotsitsa glucose pansi pamlingo wina, njira yoteteza imayatsidwa. Njira iyi imakhala ndi kutulutsidwa kwamphamvu kwa ma hormone onse a contra-mahormoni: cortisol, adrenaline ndi norepinephrine, kukula kwa mahomoni ndi glucagon.

Kuwonjezeka kwa magazi a mahomoni opatsirana kumayambitsa kusweka kwa glycogen, malo ofunika kwambiri a glucose m'chiwindi kuti pakachitika ngozi mwadzidzidzi. Zotsatira zake, chiwindi chimatulutsa shuga m'magazi mosavuta, motero zimachulukitsa kangapo kuposa momwe zimakhalira. Zotsatira zake, timawerenga kwambiri za kuchuluka kwa shuga pamamitala (mmol / L kapena kuposa).

Nthawi zina kutsika kwa glucose kumachitika mwachangu komanso mwachangu kwambiri kotero kuti munthu alibe nthawi yoti athe kuzindikira zizindikiro za hypoglycemia, kapena amangochita zodandaula kwambiri. Hypoglycemia yotchedwa latent kapena propping. Popita nthawi, ngati zochitika za hypoglycemic zibwerezedwa pafupipafupi, nthawi zambiri munthu amalephera kuzimva. Koma hypoglycemia ikayamba kuchepa kapena kutha paliponse, kuthekera kwa kuganiza komweko kumatha.

Zotsatira zake za kutulutsidwa kwa mahomoni opikisana, kuphatikizidwa kwa mafuta kumachitika, kusweka kwawo ndikupanga matupi a ketone, omwe amabisidwa ndi mapapu ndi impso. Chifukwa chake mu mkodzo mumawoneka ma acetone, makamaka m'mawa. Chifukwa chake, ngakhale pamisempha yotsika kwambiri mumkodzo, acetone imawoneka, chifukwa sizobwera chifukwa cha hyperglycemia, koma chifukwa cha ntchito ya mahomoni olimbana ndi mahomoni.

Chifukwa cha kuchuluka kwa insulin, munthu amafunitsitsa kudya, ndipo amadya, pomwe thupi limakula mwachangu, ngakhale ndi ketoacidosis, kunenepa, m'malo mwake, kumayenera kumachoka. Pano pali kuwonjezereka kwapadera kwa kulemera kwa thupi motsutsana ndi maziko akumera ketoacidosis. Lembetsani ku zolemba zatsopano za blog kuti mudziwe zambiri za ketoacidosis.

Zizindikiro za Somoji Syndrome

Chifukwa chake, mwachidule.Kutengera ndi zizindikiro zotsatirazi, mankhwala osokoneza bongo a insulini amatha kukayikakayika kapena kuwapeza.

• Kusinthasintha kowopsa m'magazi a glucose masana kuyambira otsika kupita pamtunda, zomwe zimatchedwa diagonals.
• Hypoglycemia pafupipafupi: zonse zowonekera komanso zobisika.
• Kuchuluka kwa maonekedwe a ketone m'magazi ndi mkodzo.
• Kulemera kwambiri komanso kumangokhala ndi njala.
• Kuzindikira kwa maphunziro a shuga poyesa kuwonjezera Mlingo wa insulin, komanso, kusintha ndi kuchepa.
• Kuwongolera magwiridwe antchito a shuga panthawi ya chimfine, pamene kufunikira kwa insulin mwachilengedwe kumawonjezeka komanso kumwa kwa m'mbuyomu ndikokwanira.

Mufunsanso kuti: "Mungadziwe bwanji hypently hypemlycemia komanso kuti shuga yachuluka chifukwa cha ichi?" Ndiyesa kuyankha funsoli, chifukwa mawonetsedwewo akhoza kukhala osiyana kwambiri komanso onse amodzi.

Zizindikiro zosatsatirika za ana ndi akulu omwe:

• Kuchepa kwadzidzidzi ndi mutu womwe umasowa pambuyo podyera chakudya.
• Kusintha kwamwadzidzidzi, nthawi zambiri pamakhala kusasamala, nthawi zambiri - euphoria.
• Kuwoneka kwadzidzidzi kwa madontho, kuzimiririka patsogolo pa maso a ntchentche zomwe zimadutsa mwachangu.
• Kusokonezeka tulo. Kugona kopitilira muyeso, kumangolota usiku.
• Kumva kutopa m'mawa, kuvutika kudzuka.
• Kuchulukitsa kugona masana.

Mu ana, hypoglycemia yamakono imatha kukayikiridwa ngati mwana, amakonda kwambiri chinthu, mwadzidzidzi amasiya kusewera, kusangalala kapena, mosatopa, komanso kupsinjika. Mumsewu, mwana angadandaule chifukwa cha kufooka m'miyendo, kuti zimamuvuta kupita patsogolo, ndipo akufuna kukhala. Ndi hypoglycemia usiku, ana amalira m'maloto, kugona tulo, ndipo m'mawa amadzuka oopsa komanso osweka.

Kusalephera kudziletsa komanso kusatsimikizika kwa hypoglycemia kumatha kukhala kwa maola makumi asanu ndi awiri ndi umodzi kapena kuposerapo, ndi nthawi ino kuti mkuntho wa mahomoni mkati mwamthupi umachepa. Ichi ndichifukwa chake zimakhala zovuta kusintha ngakhale shuga ngati hypoglycemia imachitika tsiku lililonse. Madzi atangoyamba kukula, motero hypoglycemia yatsopano imabweretsa chisangalalo chatsopano. Kusatsimikizika kwathu nthawi zambiri kumakhala kwa tsiku limodzi, ndiye kuti zonse zimakhazikika. Nanga bwanji inu?

Chizindikiro china chomwe tikuthandizira kuwonjezeka kwa shuga m'magazi chifukwa cha hypoglycemia ndiko kusowa koyankha kwa mankhwala a insulini akale pomwe timabaya kuti tichepetse, ndiye kuti, palibe chidwi chokhudza insulini yomwe idalipo kale, ndikuchepetsa kwambiri shuga, muyenera kuwonjezera mlingo wa insulin. Ndimagwiritsa ntchito lamulo ndekha ndikukulangizani kuti mugwire ntchito.

Zoyenera kuchita ndi Somoji syndrome

Ndipo, munthu akawona shuga yapamwamba kwambiri, amayamba kuchita chiyani? Ndizowona, ambiri amayamba kuwonjezera kuchuluka kwa insulin, koma chinthu choyamba kuchita ndikutembenukira ku ubongo ndikuwona chifukwa chake zoterezi zimachitika pakati pa shuga. Zikatero, ndikulimbikitsa kubwereza kuyeserera komweko mwa zinthu zomwezo (chakudya, kugona, kuchita masewera olimbitsa thupi ndi mlingo wa insulin). Ngati nkhaniyo ibwereza kangapo, ndiye kuti muyenera kuyamba kuganiza zoyenera kuchita. Koma zambiri pambuyo pake.

Pali mfundo ina inanso. Anthu ena amakhala ndi shuga wambiri kwa nthawi yayitali, mwachitsanzo, kuchuluka kwa okolomol / l, atatha kudya dentol / l ina ikukwera. Ndipo munthu akafuna kudzisamalira ndikumaliza shuga, zovuta zimatha kubuka. Chowonadi ndi chakuti thupi panthawiyi limagwiritsidwa ntchito kuzizindikiritsa izi ndikuziwona kuti ndizobwinokha pazokha. Zachidziwikire, palibe chachilendo malinga ndi zovuta. Kutsitsa shuga kufikira anthu osiyanasiyana athanzi, mwachitsanzo, mpaka 5.0 mmol / l, kumamupangitsa kukhala ndi vuto la hypoglycemia, kenako matenda a rebound.

Pankhaniyi, simukuyenera kuyesetsa kuti muchepetse shuga mwachangu kuti musabwezere m'mbuyo, monga momwe anthu ashuga odziwa matenda ashuga amatchedwanso posthypoglycemic reaction. Ndi nthawi komanso kuchepa kwapang'onopang'ono kwa shuga m'magazi, kudziwa mphamvu zamagulu a glucose kudzabwezeretsanso.Potere, kuthamanga kumangowawa.

Tsoka ilo, nthawi zina kuchepetsedwa kwa insulin sikokwanira. Kuti thupi libwerere mwakale, pamafunika njira zosiyanasiyana. Ndikofunikira kuyang'ananso kuchuluka kwa chakudya chamafuta, kuchepetsa kuchuluka kwake, komanso kulumikizanso zochitika zolimbitsa thupi nthawi zonse.

Mukamawona shuga m'mawa pafupipafupi, musathamangire kuti muchepetse mankhwala a basal insulin nthawi yomweyo. Somoji syndrome imayenera kusiyanitsidwa ndi Morning Dawn syndrome kapena kuchepa kwa banal kwa basal iyi.

Momwe Mungatsimikizire Kuti Ndi Odwala Kwambiri A Insulin

Kuti muchite izi, muyenera kulimbikira kugwira ntchito usiku ndikusankha miyezo ya shuga pafupipafupi. Inde, zingakhale bwino kugwiritsa ntchito chipangizocho kupitiliza kuyang'anira shuga, mwachitsanzo, Dekskoma. Koma ngati sichoncho, mutha kuthana ndi mita. Kuti muyambe, kuyeza shuga maola atatu aliwonse kuyambira 21:00. Mwanjira imeneyi mumatha kuzindikira kusinthasintha kwakukulu. Monga lamulo, hypoglycemia imatha kupezeka pakati pa 2:00 mpaka 3:00 usiku.

Ndi panthawiyi pomwe kufunika kwachilengedwe ka insulin kumachepa + pakadali pano kuchuluka kwambiri kwa insulin (Protafan, Humulin NPH) nthawi zambiri kumatha kugwa ngati kunapangidwa zisanu ndi zitatu kapena zisanu ndi zinayi madzulo. Koma ngati mlingo wa insulin ndi waukulu kwambiri, ndiye kuti hypoglycemia imatha kuchitika nthawi ina iliyonse usiku, kotero ndikulimbikitsa kuyang'anira usiku wonse, osangokhala 2:00 kapena 3:00 usiku.

Ndi Morning Dawn Syndrome, msinkhu wa shuga umakhala wokhazikika usiku wonse, ndipo umadzuka m'mawa. Ndikusowa kwa insulin ya basal usiku, mulingo wa shuga umakwera pang'onopang'ono kuyambira nthawi yomwe mumagona. Ndi Somoji syndrome, kuchuluka kwa shuga kumayambiriro kwa usiku ndikokhazikika, pofika pakati kumayamba kutsika, kumafika pamlingo winawake, chifukwa chomwe njira ya antihypoglycemic imayamba, kenako timawona kuchuluka kwa shuga m'mawa.

Chifukwa chake, kuti ayambe kutuluka pagulu loyipalo, munthu ayenera kuyamba kuyang'ana pang'onopang'ono kupanga kupanga kwa insulin panthawi zosiyanasiyana za tsiku. Muyenera kuyamba ndi usiku insulin, kenako onani momwe basal imagwirira ntchito masana, kenako pang'onopang'ono kuwunika zotsatira za insulin yochepa.

Ntchitoyi ikhoza kutenga nthawi yambiri, mwina ngakhale miyezi ingapo. Ndikupangira kuti musinthe mlingo wa inulin inayake, onetsetsani kuti mwofunikira. Nthawi zambiri ndimasunga masiku atatu ndisanasankhe kusintha mtundu wa insulin. Izi sizikugwira ntchito kokha ku Somoji syndrome, komanso ku chizolowezi chofanana ndi kusankha maselo a insulin. Mwa njira, ndayiwala kunena kuti: onetsetsani kuti mukuwerenga chakudya moyenera. Nthawi zina sizigwira ntchito chifukwa kukana kwa banal kugwiritsa ntchito zolemera. Pankhaniyi, mosalephera nthawi iliyonse mafuta ochulukirapo akapezeka.

Mawu okhudzana ndi mankhwala a insulin ndi matanthauzidwe awo

Fotokozani mawu omwe tikufuna kufotokozera mankhwalawa a matenda a shuga ndi insulin.

Maziko - insulin yowonjezera, yomwe imatenga nthawi yayitali mutatha jakisoni (maola 8-24). Uyu ndi Lantus, Levemir kapena Protafan. Amapanga maziko a insulin m'magazi. Jakisoni oyambilira amapangidwira kuti shuga asakhale bwino pamimba yopanda kanthu. Osayenera kuzimitsa shuga wapamwamba kapena kugaya chakudya.

Chimbudzi ndi jakisoni wa insulini yofulumira (yaifupi kapena ya ultrashort) musanadye chakudya kuti mupeze chakudya chomwe chakudya ndikuletsa kuti shuga asatuluke mukatha kudya. Komanso, bolus ndi jakisoni wa insulin yofulumira panthawi yomwe shuga yachuluka ndipo ikufunika kuti ibwezeretsedwe.

Chakudya chogwiritsa ntchito ndi mtundu wa insulin yofulumira yomwe imafunika kuyamwa chakudya. Sizitengera momwe zinthu ziliri pamene wodwala wa shuga adakweza kale shuga asanadye.

Corusction bolus - mlingo wa insulin yofulumira, yomwe imafunikira kuti muchepetse shuga wokwanira kukhala yokhazikika.

Mlingo wa insulin yochepa kapena ya ultrashort musanadye ndiye kuchuluka kwa chakudya ndi kukonza mabulusuli.Ngati shuga musanadye zabwinobwino, ndiye kuti cholowacho ndi zero. Ngati shuga adalumphira mwadzidzidzi, ndiye kuti muyenera kupaka jekeseni wowonjezera, osadikirira chakudya chotsatira. Mutha kubayanso jekeseni kakang'ono ka insulin prophylactically, mwachitsanzo, musanalankhule pagulu lopanikizika, lomwe lidzakweza shuga.

Insulin yofulumira imatha kukhala yaifupi ya anthu (Actrapid NM, Humulin Regular, Insuman Rapid GT, Biosulin R ndi ena), komanso ma analogues apamwamba aposachedwa kwambiri (Humalog, Apidra, NovoRapid). Kodi ndi chiyani ndipo akusiyana bwanji, werengani. Mukawonedwa musanadye, ndibwino kupaka insulin yochepa ya anthu. Mitundu ya insulashash ya insulin ndiyabwino kugwiritsa ntchito mukamafuna kuti shuga ibweretsedwe mwachangu.

Basis-bolus insulin mankhwala - mankhwala a shuga ndi jakisoni wa insulin yowonjezera usiku ndi m'mawa, komanso jekeseni wa insulin yofulumira musanadye. Iyi ndiye njira yovuta kwambiri, koma imapereka chiwongolero cha shuga komanso kupewa zinthu zovuta za shuga. Basis-bolus insulin therapy imaphatikizapo jekeseni 5-6 patsiku. Ndikofunikira kwa odwala onse omwe ali ndi matenda amtundu woyamba 1 shuga. Komabe, ngati wodwala ali ndi matenda a shuga a 2 kapena mtundu 1 wa shuga wofatsa (LADA, MODI), ndiye kuti mwina atha kupangira jakisoni ochepa a insulin.

Insulin sensitivity factor - kuchuluka kwa 1 UNIT ya insulin kumachepetsa shuga.

Chakudya chopatsa thanzi - magalamu angati a chakudya omwe amapezeka amakwirira gawo limodzi la insulin. Ngati mumvera, ndiye kuti "kuchuluka kwa mapuloteni" ndikofunikanso kwa inu, ngakhale lingaliro ili siligwiritsidwa ntchito mwalamulo.

Zokhudza insulin sensitivity factor ndi carbohydrate chiopsezo ndizopadera mwa aliyense wodwala matenda a shuga. Makhalidwe omwe amapezeka muzowongolera sagwirizana ndi enieni. Amapangidwa kuti awerenge kuchuluka kwa insulin, mwachidziwikire sicholondola. Zokhudza insulin sensitivity factor ndi chakudya chopatsa mphamvu zimakhazikitsidwa poyesa zakudya zopatsa thanzi komanso zama insulin. Amasiyana mitundu yambiri ya insulini komanso nthawi zosiyanasiyana masana.

Kodi mumafunikira jakisoni wa insulin musanadye

Momwe mungadziwire ngati mukufuna jakisoni wa insulin yachangu musanadye? Izi zitha kukhazikitsidwa pokhapokha podziyang'anitsitsa shuga wa magazi osachepera masiku atatu. Ndikwabwino kusawononga masiku atatu, koma sabata yonse kuti muwone ndikukonzekera. Ngati muli ndi matenda ashuga akulu amtundu woyamba, ndiye kuti muyenera jakisoni wa insulin yowonjezera usiku ndi m'mawa, komanso ma bolashi musanadye nawo. Koma ngati wodwala ali ndi matenda a shuga a 2 kapena mtundu 1 wa shuga wofatsa (LADA, MODI), ndiye kuti mwina jakisoni wocheperako amafunikira.

Muyenera kuyeretsa shuga nthawi iliyonse musanadye, komanso maola 2-3 mutatha kudya.

Mwachitsanzo, malinga ndi zotsatira za kuwona, zitha kutheka kuti muli ndi shuga wabwinobwino nthawi zonse masana, kupatula nthawi yakudya. Chifukwa chake, mumafunika jakisoni wa insulin yochepa musanadye chakudya chamadzulo. M'malo mwa chakudya cham'mawa, chakudya cham'mawa kapena chamasana chitha kukhala chakudya chovuta. Wodwala aliyense yemwe ali ndi matenda ashuga ali ndi vuto lakelo. Chifukwa chake, kupereka mitundu yonse ya mankhwala a insulin kwa aliyense ndi udindo wa dokotala mosasamala. Koma ngati wodwalayo ndi waulesi kwambiri kuti athe kuyendetsa shuga ndikulemba zotsatira zake, ndiye kuti palibe chomwe chimatsala.

Inde, sizokayikitsa kuti chiyembekezo chodzabayira insulin nthawi zambiri masana chimakupatsani chisangalalo chachikulu. Koma ngati mutsatira zakudya zamafuta ochepa, zitha kuzindikira kuti mumafunikira jakisoni wa insulin musanadye ena, koma osati pamaso pa ena. Mwachitsanzo, mwa odwala ena omwe ali ndi matenda ashuga a 2, ndikotheka kukhalabe ndi shuga yabwinobwino mwa kubaya insulin yochepa musanadye chakudya cham'mawa komanso chakudya chamadzulo, komanso asanadye chakudya chamadzulo amangofunika kumwa.

Momwe mungawerengere Mlingo wa insulin musanadye

Ngakhale adokotala kapena odwala matenda ashuga sangadziwe mtundu woyenera wa mankhwala a insulin musanadye kuyambira koyamba.Kuti muchepetse chiopsezo cha hypoglycemia, timaganizira pang'onopang'ono matendawo poyamba, kenako ndikuwonjezera pang'onopang'ono. Poterepa, nthawi zambiri timayezera shuga wamagazi ndi glucometer. M'masiku ochepa mutha kudziwa mlingo woyenera wa mankhwala. Cholinga ndikupanga shuga kukhala abwinobwino, monga mwa anthu athanzi. Ndi 4.6 ± 0,6 mmol / L musanadye komanso mutatha kudya. Komanso, nthawi iliyonse, iyenera kukhala osachepera 3.5-3.8 mmol / L.

Mlingo wa insulin yachangu musanadye zimatengera chakudya chomwe mumadya komanso kuchuluka. Lembani kuchuluka kwa zakudya komanso zomwe mumadya, ku gramu yapafupi. Izi zimathandiza mamba khitchini. Ngati mutsatira zakudya zamafuta ochepa kuti muchepetse matenda a shuga, ndikofunika kugwiritsa ntchito insulin yayifupi ya anthu musanadye. Awa ndi Actrapid NM, Humulin Regular, Insuman Rapid GT, Biosulin R ndi ena. Ndikulangizidwanso kukhala ndi Humalog ndikumudula mukafunikira kuthamangitsa shuga. Apidra ndi NovoRapid ndi osachedwa kuposa Humalog. Komabe, insulin yochepa kwambiri siikhala yothandiza kwambiri kuti pakhale zakudya zamafuta ochepa, chifukwa amachitika mofulumira kwambiri.

Kumbukirani kuti kuchuluka kwa insulin musanadye chakudya ndi kuchuluka kwa chakudya komanso malo okuwongolera. Chakudya Chakudya - kuchuluka kwa insulin yomwe ingafunike kuphimba chakudya chomwe mukufuna kudya. Ngati munthu wodwala matenda ashuga atadya zakudya zoyenera, ndiye kuti mafuta ochepa okha ndiwo amawaganizira. Ngati mumadya zakudya zamafuta ochepa, ndiye kuti zopatsa mphamvu, komanso mapuloteni, zimawerengedwa. Chowongolera ndi kuchuluka kwa insulini yomwe imafunikira kuti muchepetse shuga la wodwala kukhala yokhazikika ngati itakwezedwa panthawi ya jakisoni.

Momwe mungasankhire mulingo woyenera wa jakisoni wa insulin musanadye:

1. Kuchokera pazomwe mungatchulidwe (onani pansipa), werengani mlingo woyambira wa insulin mwachangu musanadye.
2. Lowetsani insulin, ndiye kudikirani mphindi 20-45, kuyeza shuga musanadye, idyani.
3. Mukatha kudya, pimani shuga ndi glucometer pambuyo 2, 3, 4, ndi 5 maola.
4. Ngati shuga agwera pansi pa 3.5-3.8 mmol / L, idyani mapiritsi ochepa a shuga kuti muchepetse hypoglycemia.
5. Pamasiku otsatira, onjezani kuchuluka kwa insulin musanadye (pang'onopang'ono! Mosamala!) Kapena kutsikira. Zimatengera kuchuluka kwa shuga nditatha kudya.
6. Mpaka shuga atakhala okhazikika, bwerezani zomwe zikuyambira pa mfundo yachiwiri. Nthawi yomweyo, musanengeni jakisoni wa "insulin", koma osinthidwa molingana ndi shuga dzulo mutadya. Chifukwa chake, pang'onopang'ono muzindikire mlingo woyenera.

Cholinga ndikupanga shuga isanayambe komanso itadya 4.6 ± 0,6 mmol / L khola. Izi ndizotheka ngakhale ndi matenda oopsa a mtundu woyamba 1, ngati mungatsatire ndi jekeseni, muwerengere Mlingo wa insulin. Kuphatikiza apo, izi ndizosavuta kukwaniritsa ndi matenda a shuga a 2 kapena mtundu wofatsa 1 shuga.

Kwa matenda amtundu wa 1 komanso a 2 a shuga, njira zosiyanasiyana zimagwiritsidwa ntchito kuwerengera muyeso wa insulin musanadye. Njirazi zikufotokozedwa mwatsatanetsatane pansipa. Kusintha kwa Mlingo wa insulin kumachitika palokha kwa wodwala aliyense. Sungani mapiritsi a shuga pokhapokha ngati mukufuna kusiya hypoglycemia. Phunzirani pasadakhale. Muyenera kuchita izi.

Kodi malire a insulin yofulumira musanadye?

1. Muyenera kudya katatu katatu patsiku - kadzutsa, chakudya chamasana komanso chakudya chamadzulo, ndimatha maola 4-5, osatinso. Ngati mukufuna, mutha kulumpha zakudya masiku ena. Nthawi yomweyo, mumasowa kuwombera kwa chakudya.
2. Simungathe kuseka! Chithandizo chamankhwala chimanena zomwe zingatheke komanso zomwe sizingachitike. Mamita anu adzatsimikizira kuti akunena zoona.
3. Yesani kudya kuchuluka kwamapuloteni ndi chakudya chamagulu tsiku lililonse chakudya cham'mawa, nkhomaliro komanso chakudya chamadzulo. Zakudya ndi mbale zimasiyana, koma phindu lawo lazakudya liyenera kukhala lomwelo. Izi ndizofunikira kwambiri m'masiku oyambirirawo, pomwe simun "adalowe mu regimen", koma sankhani mitundu yanu.

Tsopano tiyeni tiwone zitsanzo za momwe Mlingo wa mankhwala ochepetsa insulin amawerengedwa musanadye.Kuphatikiza apo mu zitsanzo zonse, zimaganiziridwa kuti wodwala matenda ashuga amadzidula, m'malo mwa ultrashort, insulin asanadye. Mitundu ya insulashash ya insulin ndiyamphamvu kwambiri kuposa insulin yochepa ya munthu. Mlingo wa Humalog uyenera kukhala wofanana ndi pafupifupi 0,4 Mlingo wa insulin yochepa, ndipo mlingo wa NovoRapid kapena Actrapid uyenera kukhala pafupifupi ⅔ (0.66) Mlingo wa insulin yochepa. Ma coefficients 0,4 ndi 0,66 amafunika kutchulidwa payekhapayekha.

Mtundu 1 wa matenda ashuga kapena matenda apamwamba a 2 shuga

Mtundu woyamba wa matenda ashuga 1, muyenera kubayira insulin mwachangu musanadye chakudya chilichonse, komanso insulin yokwanira usiku ndi m'mawa. Amakhala jekeseni 5-6 patsiku, nthawi zina ochulukirapo. Ndi matenda apamwamba a shuga a 2, chinthu chomwecho. Chifukwa kwenikweni imalowa mu matenda a shuga a 1 omwe amadalira insulin. Musanawerenge kuchuluka kwa insulin yofulumira musanadye, muyenera kukonza chithandizo ndi insulin yayitali. Zindikirani usiku ndi m'mawa.

Tiyeni tikambirane momwe mtundu 2 wa shuga umasinthira kukhala matenda a shuga amtundu woyamba chifukwa chamankhwala osayenera. Odwala ambiri omwe ali ndi matenda amtundu wa 2 amalandiranso zowawa zambiri kuposa zabwino zomwe amathandizidwa nazo. sanakhale chithandizo chachikulu cha matenda amtundu wa 2, chifukwa ogwira ntchito kuchipatala akukana kusintha. Mu 1970s, adakananso kukhazikitsidwa kwa ma glucometer ... Pakapita nthawi, malingaliro wamba adzakhalapo, koma masiku ano zinthu zomwe zili ndi matenda amtundu wa 2 ndizachisoni.

Odwala amadya chakudya choyenera komanso chokwanira. Amatenganso mapiritsi owopsa omwe amamwa kapamba wawo. Zotsatira zake, maselo a pancreatic beta amafa. Chifukwa chake, thupi limasiya kutulutsa yake insulin. Matenda a shuga a Mtundu Wachiwiri amamasulira mtundu woyamba wa matenda ashuga. Izi zimawonedwa pambuyo poti matendawa atenga zaka 10-15, ndipo nthawi yonseyi akuchiritsidwa molakwika. Chizindikiro chachikulu ndikuti wodwalayo mwachangu komanso mosadalirika amachepetsa thupi. Mapiritsi nthawi zambiri amachepetsa shuga. Njira yowerengera kuchuluka kwa ma insulin omwe afotokozedwa apa ndi oyenera milandu ngati imeneyi.

Chifukwa chiyani tikuwona odwala ochepa omwe mtundu wa 2 shuga umasandulika kukhala mtundu woyamba wa shuga? Chifukwa ambiri a iwo amafa ndi vuto la mtima / sitiroko kapamba akalephera.

Chifukwa chake, wodwala wodwala matenda ashuga a mtundu woyamba kapena mtundu wachiwiri wa 2 adasankha kuti asinthane ndi njira yatsopano yodalirika. Amayamba kudya chakudya chamafuta ochepa. Komabe, ali ndi vuto lolimba. Chakudya chopanda jakisoni wa insulin, ngakhale chimachepetsa shuga, sikokwanira. Ndikofunikira kubaya insulini kuti zovuta za matenda ashuga zisamachitike. Phatikizani jakisoni wa insulin yowonjezera usiku ndi m'mawa ndi jakisoni wa insulin yofulumira musanadye.

Mwinanso, mukudziyambitsa nokha mlingo wa insulin, womwe udanenedwa kuchipatala. Muyenera kusinthira ku kuwerengera kosinthika kwa mankhwalawa malinga ndi momwe mumadyera komanso zizindikiro za shuga. Mfundo zotsatirazi momwe mungachitire izi. Onetsetsani kuti ndizosavuta kuposa momwe zimamveka. Mawerengero a arithmetic ali pasukulu yoyambira. Kusuntha kuchokera ku chakudya chopatsa thanzi ndikuyenera kukhala ndi zakudya zochepa zamankhwala ochepa, muyenera nthawi yomweyo kuchepetsa kuchuluka kwa insulin ndi nthawi 2-7, apo ayi padzakhala hypoglycemia. Odwala omwe ali ndi mtundu wocheperako wa shuga amakhala ndi mwayi "wolumpha" kuchokera pama jakisoni kwathunthu. Koma odwala omwe ali ndi matenda ashuga akulu amtundu wa 1 kapena matenda apamwamba a 2 sayenera kudalira izi.

Zomwe muyenera kuchita:

1. Sankhani mlingo woyenera wa insulin usiku ndi m'mawa. Werengani zambiri. Pali njira yowerengera.
2. Dziwani kuchuluka kwa magalamu a chakudya komanso mapuloteni omwe amaphatikizidwa ndi 1 UNIT ya insulin yomwe mumabaya musanadye. Timawerengera poyambira malingana ndi kuchuluka kwa manambala (onani pansipa), kenako timalongosola "zoona" mpaka shuga atakhala wokhazikika komanso wabwinobwino.
3. Dziwani kuti shuga yanu ndimachepera motani 1 UNIT ya insulin yofulumira yomwe mumabayidwa. Izi zimachitika pochita zoyeserazi, zomwe zikufotokozedwa pansipa.
4. Dziwani kuti ndi mphindi zingati musanadye zakudya zomwe mwayilowetsa mwachangu ndi insulin. Standard: insulin yochepa mumphindi 45, Apidra ndi NovoRapid mu mphindi 25, Humalog m'mphindi 15. Koma ndikwabwino kudziwa payekhapayekha, kudzera poyeserera kopepuka, komwe kumafotokozedwanso pansipa.

Chovuta ndikuti muyenera kusankha nthawi imodzi kuchuluka kwa insulin yayitali komanso yachangu. Mavuto akabwera ndi shuga wamagazi, nkovuta kudziwa chomwe chinayambitsa. Mlingo wolakwika wa insulin yowonjezera? Muli ndi vuto lolakwika la insulin musanadye? Kapena kodi Mlingo woyenera wa insulin, koma amadya kwambiri / zochepa poyerekeza?

Zinthu zazikulu zomwe zimakhudza shuga:

• Chakudya chopatsa thanzi
• Mlingo Wowonjezera wa Insulin
• Sungani jakisoni wa insulin musanadye

Moyenerera, mumagwiritsa ntchito insulin yochepa musanadye komanso ngakhale owonjezera ultrashort mukafunikira kuthimitsa shuga yayikulu. Ngati ndi choncho, ndiye kuti mtundu uliwonse wa insulin, muyenera kudziwa payokha momwe 1 unit imatsitsira shuga. Zowonadi, ochepa odwala matenda ashuga adzafuna "kusewera" ndi mitundu itatu ya insulini - imodzi yowonjezera ndi iwiri mwachangu. Ngati mukuwonetsetsa kuti Humalog, Apidra kapena NovoRapid sagwira ntchito bwino musanadye, chifukwa chodumpha mu shuga, kenako sinthani insulin ya anthu.

Zambiri zokhudzana ndi kuchuluka kwa mankhwalawa (manambala sakulondola!):

• Insulin yochepa - Actrapid NM, Humulin Regular, Insuman Rapid GT, Biosulin R ndi ena.
• Mitundu yonse ya insulin yayifupi ndiyofanana mphamvu ndipo imayamba kuchita zinthu mwachangu.
• Ultrashort insulin - Humalog, NovoRapid, Apidra.
• NovoRapid ndi Apidra ndi amphamvu kwambiri nthawi 1.5 kuposa insulin iliyonse. Mlingo wa NovoRapid ndi Apidra uyenera kukhala ⅔ (0.66) wa mlingo wofanana wa insulin yochepa.
• Humalog ndi yamphamvu kwambiri ma 2,5 kuposa insulin iliyonse yayifupi. Mlingo wa Humalog uyenera kukhala 0,4 Mlingo wofanana wa insulin yochepa.

Odwala omwe ali ndi matenda oopsa a m'mimba, kapamba amene samapanga insulin, galamu imodzi ya chakudya imawonjezera shuga m'magazi pafupifupi 0.28 mmol / l wokhala ndi kulemera kwa kilogalamu 63,5.

Wodwala wodwala matenda ashuga wolemera makilogalamu 63,5:

• 1 unit ya insulin yochepa imachepetsa shuga la magazi ndi pafupifupi 2.2 mmol / L.
• 1 unit ya insulin Apidra kapena NovoRapid idzachepetsa magazi ndi pafupifupi 3.3 mmol / L.
• 1 unit ya insulin Humalog imachepetsa shuga la magazi ndi pafupifupi 5.5 mmol / L.

Momwe mungadziwire momwe 1 U ya insulin yochepa imachepetsera shuga mwa munthu yemwe ali ndi kulemera kwina kwa thupi? Ndikofunikira kupanga gawo ndikuwerengera.

Mwachitsanzo, kwa wodwala yemwe ali ndi shuga yayikulu wokhala ndi thupi lolemera 70 makilogalamu, 2.01 mmol / L adzapezedwa. Kwa wachinyamata wolemera makilogalamu 48, zotsatira zake zimakhala 2.2 mmol / L * 64 kg / 48 kg = 2.93 mmol / L. Munthu akamalemera kwambiri, mphamvu ya insulin imachepa. Yang'anani! Izi si ziwerengero zenizeni, koma zikuwonetsa, pokhapokha pakuwerengera Mlingo wa insulin. Dziyeretseni nokha mwa kuyesa. Amasiyana ngakhale pa nthawi zosiyanasiyana za tsiku. Asanadye chakudya cham'mawa, insulin ndi yofooka kwambiri, motero mlingo wake umayenera kuchuluka.

Tikudziwanso pafupifupi:

• 1 unit yaifupi insulin imakhudza pafupifupi 8 magalamu a chakudya.
• 1 unit ya insulin Apidra ndi NovoRapid imakhudza pafupifupi 12 magalamu a chakudya.
• 1 UNIT ya insulin Humalog imakwirira 20 magalamu a chakudya.
• 1 unit ya insulin yochepa imakhala pafupifupi magalamu 57 a mapuloteni amadyedwa kapena pafupifupi 260 magalamu a nyama, nsomba, nkhuku, tchizi, mazira.
• 1 UNIT ya insulin Apidra ndi NovoRapid imakhudza pafupifupi 87 magalamu a mapuloteni amadyedwa kapena pafupifupi 390 magalamu a nyama, nsomba, nkhuku, tchizi, mazira.
• 1 UNIT ya insulin Humalog imakwirira pafupifupi 143 magalamu a mapuloteni amadyedwa kapena pafupifupi magalamu 640 a nyama, nsomba, nkhuku, tchizi, mazira.

Zidziwitso zonse pamwambapa ndizodziwonetsa. Amangopangidwira kuwerengera poyambira, mwachidziwikire sicholondola. Fotokozerani chithunzi chilichonse mwa kuyeserera. Ziwerengero zenizeni za wodwala aliyense wa shuga ndi zosiyana. Sinthani mlingo wa insulin payokha, kuyesa ndi cholakwika.

Makhalidwe omwe tawonetsedwa pamwambapa amatanthauza odwala omwe ali ndi matenda amtundu woyamba 1 omwe kapamba samatulutsa insulin konse komanso omwe alibe vuto la insulin. Ngati ndinu wonenepa kwambiri, ndinu wachinyamata mu nthawi ya kukula msanga kapena mayi woyembekezera, ndiye kuti kufunika kwa insulini kumakulirakulira. Komabe, ngati maselo a beta a kapamba anu amapangitsanso insulini, ndiye kuti mulingo woyenera wa insulini mu jakisoni ungakhale wotsika kwambiri.

Kuwerengeredwa kwa insulin Mlingo wa matenda a shuga 1: mwachitsanzo

Tiona mwachidule nkhani yakukonzekera menyu komanso kuwerengera kuchuluka kwa insulini. Tiyerekeze kuti wodwala yemwe ali ndi matenda ashuga oopsa amalemera 64 kg musanadye Actrapid NM - insulin yochepa yaumunthu. Wodwalayo azidya zakudya zotsatsa komanso zomanga thupi tsiku lililonse:

• Chakudya cham'mawa - 6 magalamu a chakudya ndi magalamu 86 a protein,
• Chakudya chamasana - magalamu 12 a chakudya ndi magalamu a 128 a protein,
• Chakudya chamadzulo - 12 magalamu a chakudya ndi 171 magalamu a mapuloteni.

Sitimaganizira zamafuta akudya, chifukwa sizimakhudza shuga. Idyani mafuta omwe amapezeka muzakudya zamapuloteni modekha. Kumbukirani kuti nyama, nsomba, nkhuku, mazira ndi tchizi zolimba zimakhala ndi 20-25% ya mapuloteni oyera. Kuti mupeze kulemera kwa zinthu zamapuloteni zomwe ngwazi yathu imadya, muyenera kuchulukitsa kuchuluka kwa mapuloteni ndi 4 kapena 5, avareji ya 4.5. Muyenera kuti mukhale ndi njala pazakudya za carb zotsika :).

Mukamawerengera kuchuluka kwa insulini yofulumira musanadye, tikufuna kuteteza odwala matenda ashuga ku hypoglycemia. Chifukwa chake, tsopano tikunyalanyaza zovuta zam'mawa, komanso kukana kwa insulini (kuchepa kwamphamvu kwa maselo kupita ku insulin), zomwe zimatheka ngati wodwalayo watupa kwambiri. Izi ndi zinthu ziwiri zomwe zingatipangitse kuti tiwonjezere Mlingo wa insulin musanadye. Koma poyambilira sitimawaganizira.

Kuti mupeze poyambira chakudya, timagwiritsa ntchito zomwe zalembedwa pamwambapa. 1 unit ya insulin yochepa pafupifupi yokwanira magalamu 8 a chakudya. Komanso, gawo limodzi la insulin yochepa limakhala pafupifupi magalamu 57 a mapuloteni azakudya.

Chakudya Chakudya Cham'mawa:

• 6 magalamu a chakudya / 8 magalamu a chakudya = ¾ UNITS ya insulin,
• 86 magalamu a mapuloteni / magalamu 57 a mapuloteni = 1.5 ZINSINSI za insulin.

TOTAL ¾ PIECES + 1.5 PIECES = 2.25 PIECES of insulin.

Chakudya chamasana:

• 128 magalamu a protein / 57 magalamu a protein = 2.25 magawo a insulin.

ZONSE ZONSE 1.5 PIECES + 2.25 PIECES = 3.75 PIECES of insulin.

Chakudya chakudya chamadzulo:

• 12 magalamu a chakudya / 8 magalamu a chakudya = 1.5 ZINSINSI za insulin,
• 171 magalamu a protein / 57 magalamu a mapuloteni = 3 magawo a insulin.

ZONSE ZONSE 1.5 ZIWANDA + 3 ZOCHITIKA = 4.5 ZINSINSI za insulin.

Zoyenera kuchita ngati wodwalayo ati adzapange jekeseni posachedwa, koma insulin yochepa-yayifupi, NovoRapid kapena Humalog musanadye? Tikukumbukira kuti kuchuluka kwa Apidra ndi NovoRapida ndiye gawo la insulin yayifupi, yomwe tidawerengera. Humalog ndiye wamphamvu kwambiri. Mlingo wake uyenera kukhala Mlingo wochepa wa insulin.

Ngati ndi kotheka, sinthani poyambira chakudya kuchokera pa insulin yayifupi kupita kwa yochepa kwambiri:

Chonde dziwani: wodwala ali ndi chidwi champhamvu (munthu wathu! :)). Chakudya chamasana, amadya mapuloteni a 128 - pafupifupi magalamu 550 a mapuloteni. Monga lamulo, odwala matenda ashuga amtundu woyamba amadya zochepa. Tinene kuti chakudya chamasana mukukonzekera kudya magalamu 200 a mapuloteni omwe ali ndi magalamu 45 a mapuloteni abwino. Komanso saladi wa masamba obiriwira, momwe 12 g mafuta. Pankhaniyi, muyenera kupaka jakisoni wa 2.25 IU wa insulin yifupi, 1.5 IU ya Apidra kapena NovoRapida kapena 1 IU ya Humalog musanadye. Chakudya cham'mawa komanso chamadzulo, Mlingo umakhala wotsika kwambiri. Kutsiliza: onetsetsani kuti muphunzira.

Zowonadi zowonjezera za insulin pazakudya zina zimakhala zochepa kwambiri, ndipo zina - zokulirapo. Kuti mudziwe momwe insulini imagwirira ntchito, muyenera kuyeza shuga wa magazi 4 ndi maola 5 mutatha kudya. Ngati mungayezedwe kale, zotsatira zake sizikhala zolondola, chifukwa insulin ikupitirirabe, ndipo chakudyacho chikugayidwabe.

Tidapanda dala poyambitsa mabawuti a chakudya mu insulin. Chifukwa chake, ndizokayikitsa kuti shuga yanu mukatha kudya ingagwere pamlingo wa hypoglycemia. Komabe, izi siziphatikizidwa. Makamaka ngati mwakula, i.e., kuchedwa kutulutsa m'mimba mutatha kudya chifukwa cha neuropathy.Kumbali inayo, ngati mukunenepa kwambiri ndipo chifukwa cha izi, ndiye kuti Mlingo wa insulin yofulumira musanadye zakudya zambiri.

Chifukwa chake, tsiku loyamba la jakisoni waifupi kapena wa insulin, timayeza shuga tisanadye, kenanso pambuyo pa chakudya cha 2, 3, 4 ndi 5 mutatha kudya chilichonse. Tili ndi chidwi ndi kuchuluka kwa shuga yomwe idakula mutatha kudya. Kuchulukaku kungakhale kwabwino kapena kosalimbikitsa. Ngati zili ndi vuto, ndiye kuti nthawi ina mukamadzachepetsa mulingo wa insulin musanadye.

Ngati shuga ndi maola 2-3 mutatha kudya pokhapokha musanadye, musasinthe mlingo wa insulin. Chifukwa munthawi imeneyi, thupi silinakwanitse kugaya komanso kuyamwa zakudya zamafuta ochepa. Zotsatira zomaliza ndi maola 4-5 mutatha kudya. Fotokozani. Chepetsani mankhwalawa pokhapokha, mutatha kudya pambuyo pa maola atatu ndi atatu, shuga "amasowe" pansipa 3.5-3.8 mmol / L.

Tiyerekeze kuti wodwala wathu ali ndi zotsatirazi:

• Maola 4-5 mutadya kadzutsa - shuga adakula ndi 3.9 mmol / l,
• Maola 4-5 pambuyo pa nkhomaliro - idatsika ndi 1.1 mmol / l,
• Maola 4-5 mutatha kudya - kuchuluka ndi 1.4 mmol / L.

Mlingo wa insulin musanadye chakudya, amamuona kuti ndi wolondola, pambuyo pa maola 5 chakudya chatha, shuga atapatuka pazakudya asanadutse 0,6 mmol / l mbali iliyonse. Zachidziwikire, tinaphonya mitundu yoyambira, koma izi zinali zoyembekezeredwa. Zotsatira zimawonetsedwa bwino, zomwe zimachepetsa mphamvu ya jakisoni wa insulin yachangu musanadye kadzutsa, poyerekeza ndi jakisoni musanadye nkhomaliro komanso chakudya chamadzulo.

Kodi muyenera kusintha zochuluka motani pa insulin? Kuti tidziwe, tiyeni tiwerenge ma bolawo okonza. Wodwala yemwe ali ndi matenda oopsa a shuga, kapamba yemwe samatulutsa insulini konse, gawo limodzi la insulin yochepa limachepetsa shuga la magazi ndi pafupifupi 2.2 mmol / l, ngati munthu akulemera 64 kg.

Kuchuluka kwa thupi, kumachepetsa mphamvu ya insulin. Kuchepetsa thupi, mphamvu 1 ya insulin imatsitsa shuga.

Kuti mupeze phindu la kulemera kwanu, muyenera kupanga gawo. Mwachitsanzo, kwa munthu wolemera makilogalamu 80, mumapeza 2.2 mmol / L * 64 kg / 80 kg = 1.76 mmol / L. Kwa mwana wolemera 32 kg, 2.2 mmol / L * 64 kg / 32 kg = 4.4 mmol / L amapezeka.

Wodwala matenda ashuga kwambiri omwe amatchulidwa mu nkhani iyi amakhala ndi 64 kg. Poyambira, timaganiza kuti 1 unit ya insulin yochepa imachepetsa shuga ya magazi ake ndi pafupifupi 2.2 mmol / L. Monga tikudziwa, mutadya nkhomaliro komanso chakudya chamadzulo, shuga ake adalumphira, ndipo pambuyo pa chakudya chamadzulo chinatsika. Chifukwa chake, muyenera kuwonjezera kuchuluka kwa insulin musanadye chakudya cham'mawa komanso chakudya chamadzulo, komanso kutsikira pang'ono musanadye chakudya chamadzulo. Kuti tichite izi, timagawa kusintha kwa shuga ndi 2.2 mmol / L ndikuzungulira zotsatira zake kukhala 0,25 IU ya insulin mmwamba kapena pansi

Tsopano tikusintha mtundu wa insulin yochepa musanadye chakudya potengera zotsatira za tsiku loyamba la zoyesazo. Nthawi yomweyo, timayesetsa kusunga kuchuluka kwa mapuloteni komanso zakudya zamafuta omwe amadya m'mawa, chakudya chamadzulo komanso chamadzulo chimodzimodzi.

Tsiku lotsatira, bwerezani zomwezo, kenako ina, monga pakufunika. Tsiku lililonse, kupatuka m'magazi a anthu mukatha kudya kumakhala kocheperako. Mapeto ake, mupeza mlingo woyenera wa insulin yochepa musanadye.

Monga mukuwonera, kuwerengera sikovuta. Mothandizidwa ndi chowerengera, munthu aliyense wamkulu amatha kuzisamalira. Chovuta ndichakuti kuchuluka kwa zakudya zopezeka m'mawa, chakudya chamadzulo ndi chakudya chamadzulo kumayenera kukhala chimodzimodzi tsiku lililonse. Zakudya ndi mbale zimatha kusinthidwa, koma kuchuluka kwa chakudya komanso mapuloteni ayenera kukhala chimodzimodzi tsiku lililonse. Milozo ya kukhitchini imathandizira kutsatira lamuloli.

Ngati mutatha kudya nthawi zambiri mumangokhala kuti simukukhuta, mutha kuwonjezera kuchuluka kwa mapuloteni. Mapuloteni ena omwewo akuyenera kudyedwa m'masiku otsatirawa. Poterepa, simungathe kuwonjezera kuchuluka kwa chakudya chambiri! Musadye zopitilira 6 za chakudya cham'mawa, magalamu 12 a nkhomaliro komanso chakudya chofanana.Mutha kudya zakudya zamafuta ochepa, bola ngati mungadye zochulukirapo. Pambuyo pakusintha kuchuluka kwa mapuloteni munthawi yachakudya china, muyenera kuyang'ana momwe shuga amasinthira mukatha kudya ndikusankhanso insulin yabwino kwambiri.

Chitsanzo china cha moyo

Wodwala matenda a shuga 1, zaka 26, kutalika 168 cm, kulemera kwa 64 kg. Zimayenderana, zimapatsa biosulin R. asanadye.
Nthawi ya 7 a.m. shuga yotsika inali 11.0 mmol / L. Chakudya cham'mawa: nyemba zobiriwira 112 magalamu, dzira 1 pc. Zakudya zomanga thupi ndi magalamu 4.9 okha. Asanadye chakudya cham'mawa, adalowetsa insulin Biosulin R pa mlingo wa 6. Pambuyo pake, pa maola 9 mphindi 35 shuga anali 5.6 mmol / L, ndipo pofika maola 12 adakwera 10,5 mmol / L. Ndinafunika kubayitsa mayunitsi ena 5 a insulin yomweyo. Funso - mudalakwitsa chiyani?

Biosulin P ndi insulin yochepa ya anthu. Ngati mutsatira zakudya zamafuta ochepa pobayira jakisoni musanadye, ndibwino kuposa mitundu yayifupi ya insulin.

Wodwala amakhala ndi shuga ya 11.0. Akukonzekera kuluma nyemba 112 za nyemba ndi 1 pc ya mazira akudya cham'mawa. Tikuwona magome a zakudya zopatsa thanzi. 100 magalamu a nyemba zobiriwira zimakhala ndi magalamu 2.0 a protein ndi 3.6 magalamu a chakudya. M'magalamu a 112, izi zimapereka magawo a 2.24 a mapuloteni ndi 4 magalamu a chakudya. Dzira la nkhuku limakhala ndi pafupifupi magalamu 12,7 a mapuloteni ndi magalamu 0,7 a chakudya. Pamodzi, chakudya chathu cham'mawa chimakhala ndi mapuloteni 2.24 + 12.7 = 15 magalamu ndi chakudya 4 + 0.7 = 5 magalamu.

Podziwa phindu la chakudya cham'mawa, timawerengera poyambira kuchuluka kwa insulini yochepa musanadye. Uwu ndi chiwerengero: kukonza mabasi + chakudya. Timalingalira kuti ndi thupi lolemera makilogalamu 64, 1 U ya insulin yochepa imachepetsa shuga la magazi ndi pafupifupi 2.2 mmol / L. Shuga wamba ndi 5.2 mmol / L. Corusction bolus imapezeka (11.0 - 5.2) / 2.2 = 2.6 mayunitsi. Gawo lotsatira ndikulingalira chakudya. Kuchokera pagululi timaphunzira kuti gawo limodzi la insulin yochepa limakhudza pafupifupi magalamu 8 a zakudya kapena pafupifupi magalamu 57 a mapuloteni azakudya. Puloteni, timafunikira (15 g / 57 g) = 0,26 PIECES. Kwa chakudya chamafuta, mumafunikira (5 g / 8 g) = 0,625 PIECES.

Mlingo wa insulin wokwanira: 2.6 IU yokonza bolus + 0,26 IU pa mapuloteni + 0,625 IU wa chakudya chamafuta = 3,5 IU.

Ndipo wodwalayo adabayira ziwalo 6 tsiku lomwelo. Chifukwa chiyani shuga adakwera ngakhale insulin yambiri idalowetsedwa kuposa momwe ikufunikira? Chifukwa wodwala ndi mwana. Mlingo wowonjezera wa insulin unamupangitsa kuti amasulidwe kwambiri mahomoni opsinjika, makamaka, adrenaline. Zotsatira zake, shuga amalumpha. Ndikukonzekera kuti ngati mutabaya insulini yocheperako, ndiye kuti shugayo sawonjezereka, koma m'malo mwake amachepetsa. Umu ndi momwe amadabwitsa.

Mulingo wochepa kapena wosalondola wa insulin yofotokozedwa pamwambapa ndi ziwalo za 3.5. Tingoyerekeza kuti mutha kubayitsa mayunitsi atatu kapena anayi, kusiyana kwake sikudzakhala kwakukulu kwambiri. Koma tikufuna kuthetsa shuga. Ngati mungathe kuchita izi, ndiye kuti simusowa kuti mugwire pakubwezeretsa kwakukulu. Ndipo chakudya chonse ndi pafupifupi 1 UNIT ± 0,25 UNITS.

Tinene kuti padzakhala kukonza kwa 1 PIECE ± 0,25 PISCES ndi chakudya chofanana cha 1 PIECES 25 0.25 PIECES. Magawo awiri a 2 units 0,5. Pakati Mlingo wa insulin 3 ndi 4, kusiyana sikokulira. Koma pakati pa Mlingo wa 1.5 PIERES ndi 2 PIERES, kusiyana kwa msambo wa chikopa cha magazi kumakhala kofunika. Kutsiliza: muyenera kuphunzira. Palibe njira popanda icho.

Mwachidule. Mu mtundu woyamba wa matenda ashuga 1 ndi matenda apamwamba a 2, taphunzira momwe tingawerengere chakudya komanso kukonza pobayira jakisoni wa insulin musanadye. Mwaphunzira kuti choyamba muyenera kuwerengera muyeso wa insulini malinga ndi ma coefficients, kenako ndikusintha malinga ndi zomwe zikuwonetsa shuga mutatha kudya. Ngati shuga mu maola 4-5 chakudya chikakula ndi oposa 0,6 mmol / L - Mlingo wa insulin musanadye chakudya uyenera kuchuluka. Ngati itachepa mwadzidzidzi - Mlingo wa insulin umafunikiranso kutsitsidwa. Mchere ukakhala wabwinobwino, umasinthanso osapitirira ± 0,6 mmol / l asanadye komanso chakudya - Mlingo wa insulin unasankhidwa molondola.

Type 2 shuga kapena mtundu wofatsa 1 shuga LADA

Tiyerekeze kuti muli ndi matenda amtundu wa 2, osati vuto lotsogola kwambiri. Mumatsata zakudya zama carbohydrate otsika, kutenga, kutenga jakisoni wa insulin yowonjezera usiku ndi m'mawa. Mlingo wa insulin Lantus, Levemir kapena Protafan amasankhidwa kale molondola. Chifukwa cha izi, shuga m'magazi anu amakhalanso abwinobwino ngati mutadumphira chakudya.Koma mukatha kudya, amalumpha, ngakhale mutamwa mapiritsi ambiri ovomerezeka. Izi zikutanthauza kuti jakisoni waifupi wa insulin amafunikira chakudya musanadye. Ngati ndinu aulesi kwambiri kuzichita, ndiye kuti zovuta za matenda ashuga zimayamba.

Kwa matenda a shuga a 2 kapena mtundu wofatsa 1 shuga, LADA, muyenera choyamba kubayitsa Lantus kapena Levemir usiku ndi m'mawa. Werengani zambiri. Mwina jakisoni wautali wa insulin ungakhale wokwanira kukhala ndi shuga wabwino. Ndipo pokhapokha shuga atatha kudya, onjezerani insulin mwachangu musanadye.

Pancreas ikupitiliza kupanga insulini ina, ndipo izi ndi zomwe mkhalidwe wanu umasiyana ndi odwala omwe ali ndi matenda amtundu woyamba 1 shuga. Sitikudziwa kuti muli ndi insulini ingati kuti muchepetse shuga yayikulu mutatha kudya, koma muyenera kuwonjezera zochuluka motani ndi jakisoni. Komanso, sitikudziwa bwino momwe insulin imasamalirira maselo (kukana insulini) chifukwa cha kunenepa kwambiri kumakulitsa kufunikira kwa insulin. Zikakhala zotere, sizophweka kungoganiza ndi kumwa kwa insulin yochepa musanadye. Momwe mungawerengere molondola kuti pasapezeke hypoglycemia? Lotsatirali ndi yankho lafunso ili.

Musanalowetse jakisoni, muyenera kupaka insulin kokha kwa odwala omwe ali ndi matenda amtundu wa 2 omwe ndi aulesi kuchita masewera olimbitsa thupi

Ndikumveka kuti mukupitiliza kutsatira. Muyeneranso kudya zakudya zofanana zamankhwala ndi mapuloteni tsiku lililonse chakudya cham'mawa, nkhomaliro komanso chakudya chamadzulo. Muzisunga shuga musanadye komanso pambuyo masiku atatu, kenako werengani kuti mupeze Mlingo wa insulin musanadye.

Sonkhanani zambiri za kuchuluka kwa shuga m'magazi mukatha kudya kadzutsa, nkhomaliro, ndi chakudya chamadzulo, ngati simupaka insulin musanadye, koma ingomwa mapiritsi anu a shuga.

Ndi matenda amtundu wa 1 shuga, LADA palibe mapiritsi othandizira, kuphatikiza ndi Siofor. Osawatenga!

Ndikofunikira kuyeza shuga musanadye, kenako pambuyo pa chakudya 2, 3, 4 ndi 5 mukatha kudya. Chitani izi kwa masiku 3-7 motsatana. Lembani zotsatira za miyeso, sungani cholemba. Masiku ano muyenera kudya katatu patsiku, osadya. Zakudya zamafuta ochepa zimakhala ndi maola 4-5. Mudzakhala odzaza nthawi zonse osaneneka.

Nthawi yowonera ikukonzekera ndi masiku 3-7. Tsiku lililonse mumakhala ndi chidwi ndi kuchuluka kwakukulu kwa shuga mutatha kadzutsa, nkhomaliro komanso chakudya chamadzulo. Mwambiri, zidzakhala maola atatu mutatha kudya. Koma wodwala aliyense yemwe ali ndi matenda ashuga ndi osiyana. Izi zitha pambuyo maola 2, komanso maola 4 kapena 5. Muyenera kuyeza shuga ndikuwona momwe amakhalira.

Tsiku lililonse, lembani kuchuluka kwa shuga ochulukirapo mutatha kadzutsa, nkhomaliro, ndi chakudya chamadzulo. Mwachitsanzo, Lachitatu asanadye, shuga anali 6.2 mmol / L. Atatha kudya, adakhala:

Mtengo wokwanira ndi 7.8 mmol / L. Kukula kwake ndi 1.6 mmol / L. Timafunikira, zilembeni. Chitani chimodzimodzi pa kadzutsa ndi chakudya chamadzulo. Tsiku lililonse mumayenera kuyeza shuga ndi glucometer nthawi 15. Izi sizingapeweke. Koma tikuyembekeza kuti musanadye zakudya zina, simudzafunika jakisoni wa insulin yofulumira. Malinga ndi zotsatira za nthawi yowonera, mudzakhala ndi tebulo ili:

Pakati pazabwino zonse zatsiku ndi tsiku, yang'anani zinthu zochepa. Amawerengera kuchuluka kwa insulin musanadye chilichonse. Timatenga manambala ocheperako kuti mulingo woyambira ukhale wotsika motero timalimbana ndi hypoglycemia.

Wodwala matenda a shuga a Type 2, omwe zotsatira zake zikuwonetsedwa patebulo, amafunika jakisoni wa insulin yokhayo asanadye chakudya cham'mawa komanso chakudya chamadzulo, koma osati chakudya chamadzulo. Chifukwa chakudya chamadzulo, shuga ake samakula. Izi zimachitika chifukwa cha chakudya chamafuta ochepa, kudya pang'ono komanso kuchita zolimbitsa thupi mkati mwa tsiku. Ndikukumbutseni kuti ngati muphunzira, zimapatsa mwayi kukana jakisoni wa insulin musanadye.

Tiyerekeze, malinga ndi zotsatira zakuwonera shuga mkati mwa sabata, zidakwaniritsidwa:

• Kupeza kochepa shuga mukatha kudya kadzutsa: 5.9 mmol / l,
• Kupeza shuga kochepa mutatha kudya: 0,95 mmol / L,
• Kupeza shuga kochepa mutatha kudya: 4.7 mmol / L.

Poyamba, timaganiza mosamala kuti 1 U ya insulin yayifupi amachepetsa shuga m'magazi a 2 odwala omwe amadwala kwambiri kuposa 5.0 mmol / L. Izi ndizochulukirapo, koma timayang'ana mwachangu mlingo woyambirira wa insulin kuti muteteze wodwala ku hypoglycemia. Kuti mupeze mlingo woyambira wa insulin musanadye, gawani kuchuluka kochepa kwa kuchuluka kwa shuga ndi chiwerengerochi. Timalizitsa zotsatila kufika pa 0.25 PIECES mmwamba kapena pansi.

Tikugogomezera kuti tikulankhula za insulin yaifupi yaumunthu - Actrapid NM, Humulin Regular, Insuman Rapid GT, Biosulin R ndi ena. Ngati wodwala yemwe ali ndi matenda ashuga adzadula Apidra kapena NovoRapid musanadye, ndiye kuti mlingo wowerengeka uyenera kuchulukitsidwa ndi 0.66, ndipo ngati Humalog - ichuluke ndi 0,4.

Timayamba kubayidwa poyambira Mlingo waifupi wa insulin 40-45 mphindi musanadye, ultrashort - mphindi 15-25. Kuti mupange jakisoni molondola wa 0.25 ED, muyenera kuphunzira. Pamabwalo ochezera achilankhulo cha Russia komanso akunja, odwala matenda ashuga amatsimikizira kuti insulin yochepa komanso yochepa kwambiri imakhala bwino. Timapitilizabe kuyeza shuga 2, 3, 4, ndi maola 5 mutatha kudya kuti tidziwe momwe insulin mankhwala imagwirira ntchito.

Ngati mwadya kamodzi pambuyo pa maola 4-5 (osati pambuyo pa maola awiri!) Shuga amakweza kuposa 0,6 mmol / l - mlingo wa insulin musanadye tsiku lotsatira ungayesedwe kuti uwonjezeke. Mayunitsi 0,25, mayunitsi 0,5 kapena ngakhale 1 unit. Odwala omwe ali ndi matenda a shuga a 2 omwe ali ndi kunenepa kwambiri (oposa 40 makilogalamu owonjezera) angafunikire kuwonjezera kuchuluka kwa insulin musanadye mu zowonjezera za 2 mayunitsi. Koma kwa wina aliyense, izi ndizodzaza ndi hypoglycemia yayikulu. Ngati mwadzidzidzi shuga yanu itatha kudya idaposa 0,6 mmol / L yotsika kuposa momwe idalili chakudya, zikutanthauza kuti muyenera kutsitsa insulini musanadye.

Njira yomwe ili pamwambapa yosinthira Mlingo wa insulin musanadye iyenera kubwerezedwa mpaka shuga atakhalabe wofanana ndendende ndi chakudya musanadye maola 4-5 Tsiku lililonse mudzatchulanso kuchuluka kwa insulin. Chifukwa cha izi, shuga mutatha kudya lidzakhala pafupi kwambiri. Sichisinthasintha kuposa 0,6 mmol / l m'mwamba kapena pansi. Ndikupangira kuti mutsatire kuwongolera matenda ashuga.

Yesani kudya kuchuluka kwamapuloteni ndi chakudya chamagulu tsiku lililonse chakudya cham'mawa, nkhomaliro komanso chakudya chamadzulo. Ngati pachakudya chilichonse mukufuna kusintha kuchuluka kwa mapuloteni omwe mumadya, ndiye kuti njira yowerengera ndikusintha kuchuluka kwa insulin chakudya ichi chisanachitike. Kumbukirani kuti kuchuluka kwa chakudya chamafuta sikungasinthidwe, kuyenera kukhala kotsika, chifukwa zakudya zimatchedwa low-carbohydrate.

Momwe mungadziwire kuchuluka kwa mphindi musanadye jakisoni wa insulin

Momwe mungadziwire ndendende kuti musanadye mphindi zochepa bwanji musanadye jakisoni wambiri? Izi zitha kuchitika poyeserera, yomwe ikufotokozedwa pansipa. Kuyesera kumapereka zotsatira zodalirika pokhapokha ngati wodwala matenda ashuga ayamba kuchita ngati ali ndi shuga pafupi ndi zabwinobwino. Izi zikutanthauza kuti shuga ya magazi idakhalabe pansi pa 7.6 mmol / L kwa maola osachepera atatu.

Ikani insulini yofulumira (yaifupi) mphindi 45 musanakonzekere kukhala pansi kuti mudye. Muyeza shuga ndi glucometer 25, 30, 35, 40, 45 mphindi pambuyo pa jekeseni. Atangogwa ndi 0,3 mmol / l - ndi nthawi yoti ayambe kudya. Ngati izi zinachitika pambuyo pa mphindi 25 - ndiye kuti simungathe kuziyeza, koma mwachangu yambani kudya kuti pasakhale hypoglycemia. Ngati pambuyo pa mphindi 45 shuga wanu amakhalabe yemweyo - sinthanitsani kuyamba kwa chakudyacho. Pitilizani kuyeza shuga wanu mphindi zisanu zilizonse mpaka muone kuti layamba kugwa.

Ngati mutha jakisoni wa Ultrahumid insulin Humalog, NovoRapid kapena Apidra musanadye, ndiye kuti muyenera kuyamba kuyeza shuga pambuyo pa mphindi 10, osati pambuyo pa mphindi 25.

Iyi ndi njira yosavuta komanso yolondola yodziwira kuti mwatsala mphindi zochepa bwanji musanadye jakisoni. Kuyesaku kuyenera kubwerezedwanso ngati mlingo wanu wa insulin yothira musanadye ndi 50% kapena kuposa. Chifukwa chokulirapo kwa insulin, imayamba kuchitapo kanthu. Apanso, zotsatira zake sizingakhale zosadalirika ngati shuga yanu yoyambira idakhala yoposa 7.6 mmol / L. Ikani kuyesereraku mpaka mutayandikira shuga yanu mwachizolowezi. Izi zisanachitike, ingoganizirani kuti muyenera kubaya insulin yayifupi mphindi 45 musanadye.

Tingoyerekeza kuti kuyesa kukuwonetsa kuti muyenera kubaya insulin mphindi 40 musanadye. Chimachitika ndi chiani ngati mutayamba kudya posachedwa? Mukayamba kudya mphindi 5 m'mbuyomu kapena pambuyo pake, sipadzakhala kusiyana kwakukulu. Mukayamba kudya mphindi 10 m'mbuyomu kuposa momwe mungafunikire, ndiye kuti panthawi ya chakudyacho shuga wanu adzauka, koma pambuyo pake, ambiri amatsika. Izi sizowopanso ngati mumalakwitsa kawirikawiri. Koma ngati shuga amadzuka pafupipafupi nthawi ya chakudya komanso pambuyo pake, ndiye kuti pamakhala mwayi woti mudziwe zovuta za matenda ashuga.

Ngati mutayamba kudya mphindi 15 kapena 20 m'mbuyomu kuposa momwe zingafunikire, ndiye kuti shuga ya magazi imatha kukwera kwambiri, mwachitsanzo, mpaka 10,0 mmol / L. Mothandizidwa ndi izi, thupi lanu limakana kugonjera insulin yomwe mwachangu. Izi zikutanthauza kuti mankhwalawa sakhala okwanira kutsika shuga. Popanda owonjezera a insulin, shuga amakhalanso okwera kwa nthawi yayitali. Izi ndi zowopsa pokhudzana ndi kukula kwa zovuta za matenda ashuga.

Kodi chidzachitike ndi chiani ngati mutayamba jakisoni wa insulin mwachangu mutayamba kudya mphindi 10-15 pambuyo pofunikira? Panthawi imeneyi, mumapempha zovuta. Kupatula apo, sitimadya zakudya zamafuta pang'ono ayi. Thupi limafunikira choyamba kupukusa mapuloteni, kenako ndikusintha ena kuti akhale glucose. Uku ndikuyenda pang'ono. Ngakhale kuchedwa kwakanthawi kwa mphindi 10 kungayambitse kutsika kwa shuga kwambiri, ndipo kusangalatsidwa ndi chakudya chamafuta ochepa sikungathandize kuti zibwerere mwakale. Kuopsa kwa hypoglycemia ndikofunikira.

Nthawi zambiri amalimbikitsa kuti pakhale insulin yaifupi ya munthu asanadye chakudya, ndi ultrashort - mphindi 15-25. Komabe, ndikulimbikitsidwa kuti musakhale aulesi, koma kuti mupeze nthawi yoyenera ya jakisoni. Tafotokoza pamwambapa momwe mungachitire izi komanso zomwe mungapeze. Makamaka ngati mutsatira zakudya zamafuta ochepa. Tikubwereza axiom: osasunga mapepala oyeserera a mita kuti musapite kukaphwanya chithandizo cha matenda ashuga.

Kodi ndikufunika kudya nthawi zonse nthawi imodzi?

Asanayambitse mitundu ya insulin yochepa komanso ya ultrashort, odwala matenda ashuga amayenera kudya nthawi yomweyo. Zinali zovuta kwambiri, ndipo zotsatirapo zake zinali zoipa. Tsopano timalipira kukwera kwa shuga mutatha kudya ndi insulin yochepa kapena yochepa kwambiri. Izi zimapangitsa kuti muzitha kudya mukafuna. Ndikofunikira kupanga jakisoni wa insulin panthawi musanakhale pansi kuti mudye.

Ngati mungabaye insulin musanadye, ndiye kuti musadye mopitilira kamodzi pa maola 4-5.

Zoyenera kuchita ngati mwaiwala kubaya insulin musanadye

Zitha kuchitika kuti muyiwala kupereka chiwombankhanga cha insulin yochepa ndikuganiza za izi ndikangomaliza kudya kapena mwayamba kale kudya. Pankhani yadzidzidzi yotere, ndikofunikira kuti mukhale ndi insulini yochepa kwambiri, komanso Humalog, yomwe ndiyo yachangu kwambiri. Ngati mwayamba kale kudya kapena chakudya chisanayambike, palibe mphindi 15 zomwe zatsala - perekani jakisoni wa Humaloga. Kumbukirani kuti imakhala yolimba kwambiri kuposa ma insulin aafupi. Chifukwa chake, Mlingo wa Humalog uyenera kukhala 0,4 wa mlingo wanu wanthawi zonse wa insulin. Choyimira 0.4 chikuyenera kufotokozedwa payekhapayekha.

Kuthamanga kwambiri kwa insulin kumapangitsa shuga

Pali mitundu inayi ya mahomoni a protein omwe amaperekedwa kwa odwala omwe ali ndi matenda ashuga. Mtundu uliwonse wa mankhwalawa uli ndi nthawi yake yogwira komanso kuthamanga kwa kuchepetsa kwa dextrose ya plasma.

• Zochita za Ultrashort. Mankhwala a gululi akuphatikizapo Apidra, Humalog ndi Novorapid. Shuga amachepetsedwa mphindi 10 atalandira mlingo woyenera wa timadzi. Kuzindikira kwakukulu m'magazi kumachitika pakatha mphindi 30 - maola awiri. Kutalika kwa kuchitapo kanthu - mpaka maola 5.
• Zochita zazifupi. Mankhwala abwino kwambiri: Rapid, Insuman, Actripid NM, Humorap 40, Berlsulin. Mankhwala amathandizira kuchepetsa shuga. Hafu ya ola pambuyo pa jekeseni, mpumulo umabwera. Kuchuluka kwa ndende kumachitika pambuyo maola 2 - 4. Kutalika kwa ntchito mpaka maola 8.
• Zochita zapakatikati. Insuman Bazal GT, Insuran, Gensulin, Protafan NM Penfill, Humulin ali m'gulu la mankhwalawa. Mankhwalawa amayamba kugwira ntchito patatha maola 1-2 mpaka jakisoni wa jakisoni. Kuchuluka kwakukulu kumatha kuchitika pambuyo pa maola 6-10. Kutalika kwa ntchito ya mankhwala kumadalira mlingo womwe umasankhidwa. Kutalika kwake ndi maola 12-14.
• Kuchita kwakutali. Mankhwala omwe ali ndi zochitika zoterezi akuphatikiza Lantus SoloStar, Levemir Penfill kapena FlexPen. Zizindikiro zoyambirira za kuyamwa zimawonedwa ola limodzi pambuyo pa jekeseni. Kuzindikira kwakukulu kwa plasma kumachitika pambuyo pa maola 5-16. Ndalamazi zimasiyanitsidwa ndi kutalika kwakutali kwakuthupi. Kutalika - mpaka tsiku.

Mankhwala ochepetsa mphamvu posakhalitsa amatha kuchepetsa dextrose m'magazi. Kupititsa patsogolo kumawonedwa pakatha mphindi 10, ndipo theka la ola munthu amamva mwachizolowezi.

Komabe, mankhwala a ultrashort sakonda kutumikiridwa chifukwa amafunika kugwiritsa ntchito Mlingo wambiri. Ndikulimbikitsidwa kuti nthawi zonse muzikhala okonzekera. Itha kuphatikizidwa ndi mitundu ina ya insulin malinga ndi nthawi yayitali. Ndizoyenera ngati mwayiwala kupereka jakisoni, kupsinjika, kapena chifukwa china, shuga yawuka. Mankhwala obwezeretsa posachedwa amachepetsa zizindikiro zonse, pambuyo pake ndizotheka kubwerera mumachitidwe abwinobwino.

Jakisoni wa insulin kuti adye m'malo odyera komanso ndege

M'malesitilanti, m'mahotela ndi ndege, chakudya chimaperekedwa malinga ndi dongosolo lawo, osati lanu. Ndipo nthawi zambiri izi zimachitika mochedwa kuposa zomwe olonjezedwa ndi antchito kukonza kapena timabuku totsatsa. Iwo omwe alibe matenda ashuga amakwiya akafuna kukhala ndi njala ndikudikirira kuti palibe amene amadziwa nthawi. Koma ngati mwalandira kale jakisoni wa insulin mwachangu, ndiye kuti chiyembekezochi sichingokhumudwitsa, komanso chitha kukhala chowopsa, chifukwa pali chiopsezo cha hypoglycemia (shuga yochepa).

Zikatero, n`zotheka jekeseni osati yochepa insulin, koma ultrashort. Lowetsani mukadzaona kuti woperekera zakudya akukonzekera njira yoyamba kapena appetizer. Ngati mukuyembekeza kuchedwa kutumikiradi maphunziro enieniwo, gawani muyeso wa ultrashort insulin m'magawo awiri. Yendetsani theka loyamba nthawi yomweyo, ndipo yachiwiri - mukawona kuti woperekera zakudya wanyamula mayeso. Shuga amatha kutuluka pang'ono, koma mumakhala otsimikizika kuti mupewe hypoglycemia, ngakhale chakudya chitaperekedwa mosachedwa. Ngati mumayitanitsa zakudya zamafuta ochepa ndikuzidya pang'onopang'ono, mutha kupewa kuchuluka kwa shuga kwakanthawi.

Osayitanitsa kapena kudya zakudya za "matenda ashuga" omwe akukwera! Ndi chakudya nthawi zonse chomwe chimadzaza ndi chakudya chamafuta, mwinanso chowopsa kwa ife kuposa chakudya cham'masiku onse. Ngati ndege ikupereka chisankho, ndiye kuti mukulamula zakudya zam'nyanja. Ngati palibe chakudya mundege, ndibwino, chifukwa pali ziyeso zochepa zopatuka kuchoka pachakudya. Ngati okhawo omwe akuyendetsa ndege amathawa madzi othamanga, timadzipatsa chakudya chokwanira kuchokera kuzomwe zatilowetsa ku matenda ashuga.

Chenjezo Ngati mwakulitsa, i.e.wosakwiya m'mimba mutatha kudya, ndiye musagwiritse ntchito insulin ya ultrashort, koma yochepa pokhapokha. Ngati zakudya zikupezeka m'mimba mwanu, ndiye kuti insulini yochepa kwambiri imakhalapo mofulumira kuposa momwe iyenera kukhalira. Tikukumbukiranso kuti mitundu ya insulin ya insulin ndiyamphamvu kwambiri kuposa yochepa, chifukwa chake mlingo wawo uyenera kukhala wocheperako 1.5-2,5 nthawi.

Ngati shuga sagwa pambuyo pa jekeseni

Ndizachilendo kuti odwala matenda ashuga asakhale ndi kuchepa kwa shuga pambuyo pa insulin, ndikofunikira kumvetsetsa chifukwa chake izi zimachitika. Pali zifukwa 5 za vutoli.

Zifukwa zakuchepera pafupipafupi:

• kusungidwa kosayenera
• kukana
• Mlingo wolakwika
• tsamba lolakwika la jakisoni
• Somoji syndrome.

Munthu wodwala matenda ashuga nthawi zonse amayenera kukhala pafupi ndi glucometer pafupi. Ndikofunikira kuyeza kuchuluka kwa shuga musanadye chakudya chotsatira, pambuyo pake kapena patatha kanthawi kotsiriza pambuyo poti mwalandira (kutengera mtundu wa insulin).

Kusungidwa kosayenera kwa mankhwala

Insulin ndi mahomoni a protein. Kuti mankhwalawa agwire ntchito bwino, ndikofunikira kuwasunga molondola.

Zolakwitsa zomwe odwala amachita:

• amaika mankhwala pafupi ndi mufiriji,
• osayang'anira moyo wa alumali
• Amasunga mankhwalawo pawindo, pomwe dzuwa limawala, ndipo mankhwalawa amawonekera kutentha kwambiri.

Hormolo idaleka kugwira ntchito pomwe sipanathe kuchepa kwa glucose pambuyo pa jekeseni komanso ngati panali ma flakes m'botolo kapena cartridge.

Homoniyo amagulidwa pasadakhale ndi malire a miyezi ingapo, popeza wodwalayo amagwiritsa ntchito mankhwalawo mosalekeza. Komabe, ndikofunikira kuzisunga molondola.

Sungani miyezi 31 mpaka 34otseka, mwezi wotseguka. Kutentha - + 2- + 8 madigiri.

Ngati mukuyenera kuyenda mtunda wautali, sungani mankhwalawo m'matumba ndi othandizira ozizira mkati kapena m'mafuta otentha.

Kukaniza

Ngakhale ndi mulingo woyenera wa mankhwalawa, simungapeze zotsatira zabwino pambuyo pa jakisoni. Mfundo yake ndi kukana mankhwala.

• kuthamanga kwa magazi
• kukula kwa endocrine matenda ali woyembekezera,
• kuphwanya lipid kagayidwe,
• zakudya zopanda thanzi
• chibadwa
• polycystic ovary mwa akazi,
• kumangokhala
• kusokonezeka kwa mahomoni
• kuphwanya insulin-yolimbikitsa kugwiritsidwa ntchito kwa minofu minofu.

Kukaniza ndikutaya kwa maselo a kuthekera kwawo kuyankha kwa mahomoni. Vutoli limadziwonekera ndi kuwonjezeka kwa kuthamanga kwa magazi komanso kuthamanga kwa magazi, kunenepa kwambiri, komanso mawonekedwe a mapuloteni mumkodzo.

Kukaniza kungathe kulamulidwa. Yendani kwambiri, yesani kudya moyenera, khalani ndi mayeso munthawi ndikuyendera katswiri wazamankhwala, kusiya zizolowezi zoyipa.

Kubwezeretsa kuthekera kwa maselo kuyankha ku insulin, madokotala amatiuza mavitamini, zakudya zopatsa thanzi, komanso zinthu zina.

Sinthani shuga yambiri ndi insulin

Ngakhale mutayesetsa bwanji kuthana ndi matendawa, kuchita kapena, nthawi zina, shuga umadumpha. Pali zifukwa zosiyanasiyana:

• matenda opatsirana
• kupsinjika kwam'maganizo
• kuwerengetsa kolakwika kwa zakudya zamagulu azakudya ndi mapuloteni,
• zolakwika insulin.

Ngati matenda a shuga a mtundu wa 2 wa beta ya kapamba anu akupitilizabe kupanga insulini, ndiye kuti shuga yayikulu imatha kutsika mwanjira yochepa pakapita maola ochepa. Komabe, ngati muli ndi matenda osokoneza bongo a mtundu woyamba 1 ndikupanga insulini m'thupi mwatsika mpaka zero, ndiye kuti kuwombera kwapafupifupi ndi insulini yochepa kapena kochepa kukufunika kuti muchepetse kudumpha kwa shuga. Muyenera kugwetsanso shuga owonjezera ndi jakisoni wa insulin ngati muli ndi matenda a shuga a 2 komanso kukana kwambiri kwa insulin, i.e, chidwi cha maselo pakuchitika kwa insulin kuchepa.

Mlingo wa insulin yofulumira yomwe imafunikira kuti shuga yapamwamba ithekere. Sichokhudzana ndi zakudya.Chakudya chokhala ndi chakudya ndi mlingo wa insulin musanadye, womwe umafunika kuti shuga asatuluke chakudya chikamamwa. Ngati shuga adumpha ndipo muyenera kuyambitsa bolus ya kukonzanso, ndiye chifukwa chake ndikofunikira kugwiritsa ntchito imodzi mwazosankha zazifupi kwambiri za insulin, chifukwa zimachitika mwachangu kuposa zazifupi.

Nthawi yomweyo, ngati mukuyang'ana, ndiye ndikofunika kugwiritsa ntchito insulin yayifupi m'malo mwa ultrashort ngati bolus ya chakudya. Ochepa odwala matenda ashuga ochepa amakhala okonzeka kugwiritsa ntchito insulin yochepa asanadye tsiku lililonse, kwinaku akusunga insulini yocheperako pang'ono pokonzekera zochitika zapadera. Ngati mukuchitabe izi, kumbukirani kuti mitundu ya insulin ndi yamphamvu kwambiri kuposa yochepa. Humalog ili ndi nthawi pafupifupi 2.5, pomwe NovoRapid ndi Apidra amakhala olimba nthawi 1.5-2.

Kuti mukhale okonzeka kugwiritsa ntchito insulini yachangu ngati chowongolera shuga ikadumphira, muyenera kudziwa momwe 1 PULANI ya insulinyi imatsitsira shuga. Kuti tichite izi, tikulimbikitsidwa kuti tichite zoyeserera pasadakhale, zomwe zikufotokozedwa pansipa.

Mlingo wolakwika

Kuchita bwino kwa mankhwalawa kumakhudzidwa ndikusagwirizana ndi magawo apakati pa jakisoni, kusakaniza mu syringe imodzi yamitundu ingapo ya opanga osiyanasiyana, ndi mlingo wolakwika.

Zotsirizira zimawonedwa pafupipafupi. Ichi ndichifukwa chake ndikofunikira kukaonana ndi dokotala mwezi uliwonse.

Mlingo wa mahomoni umasinthidwa molingana ndi zotsatira za kusanthula ndi zinthu zina. Zotsalazo zimaphatikizanso matupi a ketone mumkodzo, zizindikiro za shuga pambuyo chakudya cham'mawa ndi chamadzulo.

Momwe mungadziwire ndendende gawo limodzi la 1 la insulin limatsitsa shuga

Kuti mudziwe ndendende kuchuluka kwa insulin ya 0.5 U kapena 1 U ya insulin yocheperako kapena kopitilira muyeso kumachepetsa shuga, muyenera kuyesa. Tsoka ilo, kuyesa uku kumafuna kudumpha chakudya chamasana tsiku lina. Koma sizifunikira kuchitika pafupipafupi, ndizokwanira kamodzi, kenako mutha kubwereza zaka zingapo zingapo. Chofunika cha kuyeseraku chikufotokozedwa mwatsatanetsatane pansipa, komanso zomwe angapeze.

Yembekezani mpaka tsiku lanu asanafike shuga kuti alumphe osachepera 1.1 mmol / L pamwamba pa chandamale. Chifukwa cha kuyesera uku, shuga wowonjezera m'mawa wopanda kanthu suyenera, chifukwa zotsatira zidzasokonekera. Shuga sayenera kukwezedwa osapitilira maola 5 mutatha kadzutsa. Izi ndizofunikira kuti mlingo wa insulin yachangu musanadye chakudya cham'mawa. Komanso, onetsetsani kuti mwatenga jakisoni wanu wachilendo wa insulin m'mawa uno.

Kuyesera ndikuti mumadumphira chakudya chamasana ndikuwombera mwachangu insulin musanadye, yomwe imakhala chakudya. M'malo mwake, mumabayira insulin yofulumira, bolus yokonzanso, ndikuwona momwe imatsitsira shuga lanu. Ndikofunikira kupaka jekeseni ya insulin yotsika kapena yolondola kwambiri kuti isachepetse shuga - yayitali kwambiri kuti muchepetse hypoglycemia. Gome lili pansipa likuthandizani ndi izi.

Kodi gawo limodzi la insulin yothamanga lingachepetse shuga m'magazi, kutengera mlingo wa tsiku lililonse wa insulin

Zolemba pagome:

• Malonda onse omwe apatsidwa ali pafupifupi, amangogwiritsa ntchito jakisoni woyamba "woyesera" wa insulin yofulumira. Dziwani manambala omwe mungagwiritse ntchito tsiku ndi tsiku ndi inu nokha, poyesera.
• Chachikulu sikuti kubaya insulini yothamanga kwambiri nthawi yoyamba, kupewa hypoglycemia.
• Humalog ndi insulin yamphamvu kwambiri. Zowonadi zake ziyenera kukonzedwa m'njira yosungunuka. Mulimonsemo, phunzirani.

Akuti mumatsatira zakudya zamafuta ochepa ndikubaya Mlingo wokwanira wa insulin. Ndikutanthauza - mumagwiritsa ntchito insulin yayitali pokhapokha kuti mukhale ndi shuga wamba. Apanso, tikulimbikitsa odwala omwe ali ndi matenda ashuga kuti asayese kugwiritsa ntchito insulin yayitali kutengera zotsatira za insulin yomwe imapangitsa kuti shuga asatulutse. Werengani nkhaniyo ”. Tsatirani malangizo omwe afotokozedwamo.

Tiyeni titenge chitsanzo chothandiza. Tingoyerekeza kuti mutha kupaka majekisoni okwanira 9 a insulin yowonjezera tsiku lililonse, ndikugwiritsa ntchito NovoRapid ngati insulin yofulumira. Mu tebulo tili ndi deta ya Mlingo wa insulin yokwanira 8 ndi ma unit 10, koma 9 mayunitsi. Mwanjira iyi, timapeza pafupifupi ndikugwiritsa ntchito ngati poyambira. Chiwerengero (4.4 mmol / L + 3.6 mmol / L) / 2 = 4.0 mmol / L. Shuga wanu musanadye chakudya chidakhala 9,7 mmol / L, ndipo mulingo wake anali 5.0 mmol / L. Ndikusintha kuti shuga imaposa zomwe zimachitika ndi 4.7 mmol / L. Ndi magawo angati a NovoRapid omwe amafunikira kubayidwa kuti muchepetse shuga kuti ukhale wabwinobwino? Kuti mudziwe, werengani 4.7 mmol / L / 4.0 mmol / L = 1.25 IU ya insulin.

Chifukwa chake, timabayidwa mayunitsi 1.25 a NovoRapida, kudumphira chakudya chamasana ndipo, motero, timabaya chakudya musanadye chakudya chamadzulo. Timayetsa shuga m'magazi pambuyo pa 2, 3, 4, 5, ndi maola 6 pambuyo pobayira jakisoni wowongolera. Tili ndi chidwi ndi muyezo womwe ungawonetse zotsatira zochepa. Imapereka chidziwitso chofunikira:

• Ndi ma mmol / l angati omwe NovoRapid amatsitsa magazi anu,
• jakisoni amatenga nthawi yayitali bwanji.

Kwa odwala ambiri, jakisoni wa insulin mwachangu amasiya mkati mwa maola 6 otsatira. Ngati muli ndi shuga wotsika kwambiri pambuyo maola 4 kapena 5, zikutanthauza kuti payekha insulini iyi imakugwirani ntchito panokha.

Tiyerekeze, malinga ndi momwe anakuwonera, zinapezeka kuti shuga m'magazi anu pambuyo pa jekeseni la NovoRapida la 1.25 IU idagwa kuchokera ku 9.7 mmol / L mpaka 4.5 mmol / L, ndipo patatha maola 6 sichinatsikenso. Chifukwa chake, tidaphunzira kuti magawo 1.25 a NovoRapid adatsitsa shuga yanu ndi 5.2 mmol / L. Chifukwa chake, gawo limodzi la insulin iyi limatsitsa shuga wanu ndi (5.2 mmol / l / 1.25) = 4.16 mmol / l. Ichi ndi chinthu chamtengo wapatali chotchedwa insulin sensitivity factor. Gwiritsani ntchito mukafuna kuwerengera kuti mupeze shuga yayikulu.

Zomwe insulin sensitivityity imasiyana m'mawa, masana ndi madzulo. Chitani ziyeso zingapo nthawi zosiyanasiyana patsiku.

Momwe mungazimitsire shuga yayikulu ndi jakisoni wa insulin

Chifukwa chake, mudayesa ndikuwona momwe 1 unit yochepa kapena ya ultrashort insulin imatsitsira shuga lanu. Tsopano mutha kugwiritsa ntchito insuliniyi ngati njira yolankhulira, ndiye kuti, kuzimitsa shuga kuti azikhala bwino ngati alumpha. Maola ochepa pambuyo poti jekeseni wa enieni a insulin, shuga wanu akhoza kubwerera mwakale.

Momwe mungapangire shuga m'mawa pamimba yopanda kanthu

Ngati shuga m'mimba yopanda kanthu nthawi zambiri imakwezedwa, ndiye kuti zingakhale zovuta kwambiri kuti zitsike pang'ono. Vutoli limatchedwa chodabwitsa cha m'bandakucha. Mwa odwala ena omwe ali ndi matenda a shuga, amachepetsa kwambiri kumva kwa insulin, mwa ena kumakhala kochepa. Mutha kuwona kuti m'mawa, insulin yothamanga imachepetsa shuga m'magazi kuposa momwe zimakhalira masana kapena madzulo. Chifukwa chake, mlingo wake wa bolus yokonzanso m'mawa umayenera kuwonjezeka ndi 20%, 33% kapena kuposa pamenepo. Kambiranani izi ndi dokotala. % Yeniyeni imatha kutsimikiziridwa ndi kuyesa ndi zolakwika. Kupuma tsiku lonse, insulini iyenera kugwira ntchito mwachizolowezi.

Ngati mumakhala ndi vuto la shuga m'mawa m'mimba yopanda kanthu, phunzirani "". Tsatirani malangizo omwe afotokozedwa pamenepo.

Zoyenera kuchita ngati shuga atakwera pamwamba pa 11 mmol / l

Ngati shuga atakwera pamtunda wa 11 mmol / l, ndiye kuti wodwala yemwe ali ndi matenda ashuga, mphamvu ya maselo pakuchitanso insulin ikhoza kuchepera. Zotsatira zake, jakisoni adzakulirakulira kuposa masiku onse. Izi zimanenedweratu makamaka ngati shuga atakwera mpaka 13 mmol / L ndikukwera. Mwa anthu omwe amachita mosamala kapena, shuga wambiri ndiye osowa kwambiri.

Ngati mukuvutikabe ndi zovuta zoterezi, ikani kaye insulini yachangu ngati cholowera, monga mumakonda.Muwerenge mlingo wake malinga ndi njira yomwe tafotokozayi. Amaganiziridwa kuti mwapeza kale momwe gawo limodzi la insulini limatsitsira shuga. Yembekezani maola 5, kenako kuyeza shuga ndi glucometer ndikubwereza njirayi. Kuyambira koyamba, shuga sangayerekezere kukhala wabwinobwino, koma kuyambira nthawi yachiwiri, mwina, inde. Onani chifukwa chomwe shuga yanu idalumphira kwambiri, ndikuthana nawo. Ngati muchiza matenda anu a shuga malinga ndi malingaliro omwe adatsamba lathu, ndiye kuti izi siziyenera kuchitika konse. Mulingo uliwonse wotere uyenera kufufuzidwa bwino.

Matenda opatsirana ndikuwongolera matenda a shuga

Pambuyo powerenga nkhaniyi, mudaphunzira kuwerengera Mlingo wamfupi ndi wa insulin ya jakisoni musanadye, komanso momwe mungapangitsire shuga ngati limatuluka. Lembali limapereka zitsanzo zatsatanetsatane zowerengera mwachangu insulin. Malamulo a odwala omwe ali ndi matenda ashuga amtundu 1 komanso mitundu yachiwiri ya shuga ndi osiyana, motero zitsanzo ndizosiyana. Tinayesetsa kuti zitsanzo zikhale zomveka bwino momwe zingathere. Ngati china chake sichimamveka bwino - funsani mafunso mu ndemanga, ndipo woyang'anira tsamba awayankha mwachangu.

1. - Njira yayikulu yochizira (control) yamtundu 1 ndi matenda ashuga 2.
2. Ngati mutsatira zakudya zamafuta ochepa, mapiritsi a insulin amafunikira otsika. Pambuyo posintha kuchokera ku chakudya chamagulu "choyenera" kapena kocheperako, amachepetsa nthawi 2-7.
3. Mtundu wachiwiri wa matenda ashuga, amayamba ndi jakisoni wa insulin Lantus kapena Levemir wowonjezera usiku ndi m'mawa. Majekiseni a insulini yachangu musanadye amawonjezera pambuyo pake ngati pakufunika.
4. Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri, makamaka amathamangira, amathira shuga m'malo mwa jakisoni wa insulin. Maphunziro akuthupi samathandiza kokha mwa 5% ya milandu yapamwamba kwambiri. Pazotsalira 95%, zimakupatsani mwayi wokana jakisoni wa insulin musanadye.
5. Ngati mumatsatira zakudya zamafuta ochepa, ndiye musanadye, ndibwino kupaka insulin yochepa ya anthu - Actrapid NM, Humulin Regular, Insuman Rapid GT, Biosulin R.
6. Mitundu ya Ultrashort ya insulin - Humalog, Apidra, NovoRapid - ndiyabwino kwambiri kudya chifukwa amachitapo kanthu mwachangu ndikupangitsa kudumpha mu shuga.
7. Ndibwino kuti mupeze insulini yowonjezera usiku ndi m'mawa, insulin yochepa musanadye, ndikukhalabe ndi Humalog yochepa kwambiri pamilandu yomwe muyenera kuthana ndi shuga msanga.
8. Chidziwitso cha insulini ndichoti 1 UNIT ya insulin imatsitsa shuga lanu lamagazi.
9. Chakudya chopatsa mphamvu - kuchuluka kwa zakudya zomwe zimaphimba gawo limodzi la insulin.
10. Zomwe zimapangitsa insulin sensitivity factor komanso ma carbohydrate coefficients omwe mungapeze m'mabuku komanso pa intaneti sizolondola. Wodwala aliyense wa shuga ali ndi wake. Ikani ngati mwayesa. M'mawa, pachakudya chamadzulo komanso madzulo ndizosiyana.
11. Osayesa kuloweza jakisoni wa insulin yofulumira musanadye ndi jakisoni wamkulu wa insulin yayitali!
12. Osasokoneza kuchuluka kwa insulin yochepa komanso ya ultrashort. Mitundu ya insulashort ya insulini imakhala yolimba nthawi 1.5-2,5 kuposa yayifupi, kotero kuti ma dosages awo ayenera kukhala ochepa.
13. Phunzirani. Onani momwe insulin yochepa ndi ya ultrashort ikuchitira.
14. Phunzirani ndi kuwatsatira.

Chifukwa chake, mudaganizira momwe mungawerengere kuchuluka kwa insulin yochepa komanso ya ultrashort ya jakisoni munjira zosiyanasiyana. Chifukwa cha izi, muli ndi mwayi wokhala ndi shuga wabwino kwambiri, monga momwe mumakhalira anthu athanzi. Komabe, chidziwitso cha chithandizo cha matenda ashuga cha jakisoni wa insulin sichimathetsa kufunika kotsatira. Ngati zakudya za anthu odwala matenda ashuga zimadzaza ndi chakudya, ndiye kuti palibe kuwerengera kwa mankhwala a insulini omwe angamupulumutse ku kuchuluka kwa shuga, kukula kwa zovuta komanso zam'mimba.

Palinso zinthu zina zachiwiri zomwe zimakhudza shuga kwa odwala matenda ashuga. Awa ndimatenda opatsirana, zochitika zovutitsa, nyengo, kusintha kwa nyengo, kumwa mankhwala, makamaka mankhwala a mahomoni. Mwa akazi, komanso magawo a kusamba, msambo, kusamba.Mukudziwa kale momwe mungasinthire kuchuluka kwa insulin malinga ndi zakudya komanso shuga. Gawo lotsatira ndikuphunzira momwe mungapangire zosintha poganizira zinthu zachiwiri. Werengani tsatanetsatane wa m'nkhaniyo. Ndikofunikira kuwonjezera pazomwe mudadutsamo.

Insulin ndi gawo lofunikira kwambiri kwaanthu chifukwa cha kapamba. Magazi a shuga a m'magazi amasokonezeka, chifukwa mankhwalawo ali ndi mphamvu zambiri pa zochita za metabolic mthupi la munthu.

Mlingo wosakwanira wa mahomoni amasokoneza kagayidwe, matenda a shuga amakula pang'onopang'ono, ndipo chiopsezo cha matenda a impso chikuwonjezeka. Gawoli ndilofunikira kuti kagayidwe ka mapuloteni apangidwe ndikupanga mitundu yatsopano ya mapuloteni.

Insulin yotsika imawonetsa kupezeka kwa mtundu I shuga mellitus ndi ma pathologies ena.

Ganizirani momwe mungakulitsire insulin m'magazi.

Zinthu zophwanya lamulo

Kuchepetsa insulini m'magazi - zimatanthawuza, momwe mungapangire zowunikira? Ndiwo mahomoni okhawo omwe amachepetsa kuchuluka kwa shuga m'magazi. Kuperewera kwa insulin ndi chinthu chofunikira kwambiri chotsogolera pakupanga shuga. Ndi zizindikiro zotere, Zizindikiro za hyperglycemia zimawonekera - msinkhu wa shuga umakwera.

Glucose monosaccharide satha kusunthira ku ma cell omwewo; amadziunjikira m'mitsempha yamagazi. Maselo akuvutika ndi kusowa kwa shuga, kufunafuna magwero ena a mphamvu. Ketosis imayamba. Chifukwa cha kufa kwa chakudya m'maselo m'maselo, mafuta amawonongeka ndipo matupi a ketone amapangidwa. Pang'onopang'ono, zinthu zowola zimachulukana, zimapangitsa kufa chifukwa cha kuledzera.

Matenda a shuga a Type I amapezeka nthawi zambiri. Odwala omwe ali ndi vuto lofananalo amayenera kuwunika glucose moyo wawo wonse ndikupanga jekeseni wa insulin nthawi zonse kuti achepetse shuga.

Mitengo ya insulin ingakhale yovomerezeka, i.e. pali kuchepa kwapafupipafupi, koma mahomoni a protein samachita ntchito zake mokwanira chifukwa chophwanya malamulo. Kenako, kukana insulini ndi mtundu II matenda a shuga akupezeka.

Mtundu wolephera

Ngati mulingo wa insulin m'magazi ndi wotsika, mitundu yotsatana ya kuperewera kwa zinthu imasiyanitsidwa:

Kuchepetsa insulin ndi shuga wabwinobwino m'magazi kumatha kubweretsanso zovuta zama metabolic. Shuga wambiri amawonekera mukuyesedwa kwa mkodzo. Glycosuria nthawi zambiri amakhala limodzi ndi polyuria. Ketosis imayamba.

Ngati simukuyamba chithandizo, ndiye kuti ketoacidosis imatsata - iyi ndi njira yamatenda. Kuchuluka kwa matupi a ketone kukwera, ndipo munthu akhoza kufa. Uku ndikuvutikira kwambiri kwa matenda ashuga.

Mtundu wina wa mahomoni osagwira bwino ntchito ndi kuchuluka kwamapuloteni. Kuchepetsa mphamvu kumachepetsa kuchuluka kwa glucose omwe amayendetsedwa m'maselo, kuthandiza kuchepetsa shuga. Ndi zochulukirapo, tiziwalo ta sebaceous timayamba kugwira ntchito kwambiri.

Kutsitsa gawo la mahomoni kumayambitsa zinthu zambiri. Kuti mudziwe zifukwa zenizeni, amapita kwa dokotala, kukayezetsa, ndi kukayezetsa.

Kuzindikira kumabweretsa:

Uno ndi m'badwo wowopsa kwambiri pa zolephera. Pofika zaka zisanu, kapamba amapangidwa ndikugwira ntchito. Low insulin mwa mwana ndi owopsa chifukwa cha kupezeka kwa matenda opatsirana (ma mumps, chikuku, rubella), kusachedwa kwakula.

Mutha kudziyimilira payekha mwa mwana: mwana ali ndi ludzu, amamwa madzi mwachangu kapena mkaka, saledzera, ma diapine amkodzo amayenda chifukwa cha shuga. Mwana wamkulu amakhalanso ndi vuto losowa madzi.

Pofuna kupewa zovuta komanso chiwopsezo cha matenda ashuga, muyenera kupatsidwa katemera wamba, samalani ana anu. Ndikulimbikitsidwa kuti mwana athe kudya zakudya zopatsa mphamvu 10g / kg.

Phunzirani momwe mungawonjezere insulin.

Njira zokhazikitsira zizindikiro

Therapy akusowa insulin lakonzedwa kuti azikhalanso okhathamira zili, kuchepetsa matenda a shuga. Chithandizo chilichonse chimaperekedwa ndi dokotala. Ndi katswiri yemwe angapereke malingaliro oyenera, sankhani chithandizocho, ndikukuwuzani momwe mungakulitsire insulin mthupi.

Njira zazikulu zobwezeretsera kuchuluka kwa mahomoni ndi insulin mankhwala ndi kudya moyenera.

Mankhwala Ochiritsa Odwala

Ndi insulin yotsika komanso shuga wambiri, jakisoni wa mahomoni amafunikira. Thupi silingatulutse mahomoni omwe amafunikira mtundu woyamba wa shuga.

Madokotala amalembanso izi pazakudya zotsatirazi:

Pofuna kuthana ndi vuto la kuperewera kwa mahomoni, kudya zakudya zamagetsi kumaphatikizidwa ndi physiotherapy, zakudya, komanso masewera.

Chifukwa chiyani zakudya? Zogulitsa zotere zimathandiza kugaya shuga, kusintha magazi, kusintha kagayidwe kazinthu.

Dziwani zakudya zomwe zakhudza.

Kusintha kwa zakudya

Ngati insulini idatsitsidwa, zovuta za mankhwala zimayikidwa. Zakudya zochiritsa ndizofunikira kwa odwala matenda ashuga. Zakudyazo ziyenera kukhala zamagulu ochepa, ochepa-carb, otsika kwambiri, zomwe zimakhala ndi zakudya zomwe zimatsitsa insulin.

Zakudya zomwe zimakhala ndi index yayikulu ya glycemic komanso zakudya zama calorie ambiri siziyikidwa pambali: mbatata, mpunga, caramel, semolina, uchi.

Zakudya zochizira odwala zimaphatikizanso mbale zomwe zimapangitsa kapamba. Ndi zakudya ziti zomwe zimawonjezera insulin? Awa ndi maapulo, nyama yodya, mkaka wowawasa, kabichi, nsomba, ng'ombe, mkaka.

Ndi zakudya zina ziti zomwe zimatsitsa insulin? Oatmeal, mtedza (osadya zoposa 50 g patsiku), sinamoni (ungathe kuwonjezedwa ndi chimanga, yogurts, zakumwa za zipatso), avocado, mapira (phala ili lilibe shuga, koma fiber yambiri), broccoli, adyo.

Ndi chakudya choyenera, zotsatira zoyambirira zidzaonekera kale sabata yoyamba ya zakudya zapadera. Muyenera kudya magawo ang'onoang'ono, ndikugawana chakudyacho m'magawo asanu. Zakudya zochepa zama calorie zimangovulaza thanzi.

Zochita zolimbitsa thupi

Momwe mungakwezere insulin yamagazi ndi masewera? Odwala amayenera kuyenda kwambiri, zolimbitsa thupi zolimbitsa thupi zimapangitsa kuti shuga azitha kulowa mu minofu ya minofu, kuchepetsa shuga. Kuchita masewera olimbitsa thupi pafupipafupi kumapangitsa kuti odwala matenda ashuga azikhala bwino.

Momwe mungakulitsire azitsamba a magazi a insulin? Zoyenera kugwira ntchito iyi.

Nthawi zina odwala matenda ashuga amakumana ndi zodabwitsazi pomwe insulin singachepetse shuga. Zifukwa zake ndizosiyana - mlingo wolakwika, kusungidwa kwa mankhwala, bongo wambiri (mphamvu ya Somoji). Ndikofunikira kumvetsetsa mwatsatanetsatane chifukwa chomwe mahomoni samathandizira, chifukwa ndi kutukuka kwenikweni kwa insulin ndikotheka.

Chifukwa chiyani mahomoni samachepetsa shuga?

Mlingo wa insulin wowerengeka molondola si chitsimikizo kuti mankhwalawo adzagwira ntchito.

Zotsatira za mahomoni oyambitsidwa zimatha kutengera zinthu zambiri:

• Kulephera kutsatira zomwe zimachitika pakatipa.
• Kuphatikiza insulin kuchokera kwa opanga osiyanasiyana mu syringe yomweyo.
• Kukhazikitsidwa kwa mankhwala omwe atha.
• Kugwiritsa ntchito mankhwala osungidwa osatsatira malamulo kapena pambuyo pozizira.
• Jakisoni siwosinjirira, koma mwamitsempha.
• Mukamapukuta tsamba la jakisoni ndi mowa. Mphamvu ya mankhwalawa imayendetsedwa mukamacheza ndi mowa.

Kodi kukana kwa mankhwala kumawonetsedwa bwanji?

Ngati malamulo onse atsatiridwa, ndipo insulini singachepetse shuga, magazi a metabolic kapena kukana kwa mankhwala akhoza kuyamba. Zizindikiro zakukaniza:

Mapuloteni mumkodzo akuwonetsa kuti impso sizitha kuthana ndi nkhawa zambiri.

• matenda a impso amakula, monga umboni wa mapuloteni posanthula mkodzo,
• kusala kwambiri magazi,
• kunenepa
• fragility ya mtima makoma, thrombosis ndi atherosulinosis,
• kusakhazikika kwa "zoyipa" komanso "zabwino" cholesterol.

Ndi kukana, insulini imagwira ntchito chifukwa cha kulephera kwa maselo kuyamwa mokwanira mankhwala omwe amaperekedwa.Mchere wambiri umakhazikika, ndipo kapamba amatulutsa kuchuluka kwamahomoni. Zotsatira zake, shuga ndi insulin yambiri yomwe imadziwika ndi matenda a shuga a 2. Zina zomwe zimayambitsa izi:

• ovary polycystic,
• kuchuluka kwa cholesterol "choyipa",
• matenda amitsempha yamagazi ndi mtima,
• matenda oopsa
• kunenepa.

Limagwirira a Syomogy syndrome

Somoji syndrome imawoneka ndi mankhwala osokoneza bongo osaneneka. Zizindikiro zake:

• matupi a ketone amawonekera mkodzo,
• ndi kuwonjezeka kwa tsiku ndi tsiku mlingo wa mankhwalawa, mkhalidwe umakhala bwino,
• glucose amachepetsa ndi fuluwenza chifukwa cha kuchuluka kwa mahomoni panthawi ya matenda,
• kusintha kwadzidzidzi kwa glucose tsiku limodzi,
• wodwala amakhala ndi njala nthawi zonse, thupi limachuluka,
• pafupipafupi hypoglycemia.

Ngati insulini singathandize, wodwalayo amayamba kuchuluka. Musanachite izi, ndikofunikira kumvetsetsa mgwirizano womwe ulipo pakati pa kupumula komanso kukhala maso, kulimba kwa katunduyo, ndikuwunika zakudya. Ngati shuga satsika, imangowonjezereka ngakhale pamimba yopanda kanthu, palibe chifukwa chothamangira kuti musinthe mlingo. Mwina izi ndi zomwe zimachitika mthupi, ndipo kuchepa kwa mankhwala omwe amathandizidwawo kumayambitsa matenda a Somoji.

Kuyeza kwa shuga usiku uliwonse pafupipafupi kungathandize kudziwa kuchuluka kwa mahomoni.

Kuti mupeze bongo wambiri, ndikofunikira kutenga miyeso ya usiku uliwonse pafupipafupi, mwachitsanzo, 3 koloko. Patatha maola awiri pakati pausiku, hypoglycemia imachitika. Kufunika kwa mahomoni kumatsikira pang'ono. Mankhwalawa atagwiritsidwa ntchito pakadutsa maola atatu pakati pausiku, kuchuluka kwa mankhwalawa kumawonedwa.

Ngati wodwala ali ndi matenda a Somoji, glucose amakhala wolimba kumayambiriro kwausiku, pang'onopang'ono amatsika ndi ola lachitatu lausiku, ndipo amakula mwachangu m'mawa.

Shuga mellitus ndi matenda omwe amadziwika ndi kuchepa kwa katulutsidwe (kapena kusakhalapo kwathunthu) kwa pancreatic insulin. Kuti athandize kufooka kwa timadzi timeneti m'thupi, madokotala amatipatsa jakisoni wa insulin. Koma mwa odwala ena, kugwiritsa ntchito kwawo sikumapereka zotsatirapo. Nanga bwanji ngati insulini siyithandiza? Ndipo ndi chiyani chomwe chingasokoneze kugwira ntchito kwake?

Moyo wa alumali ndi malo osungira

Pali zifukwa zambiri zosonyeza kuti insulini sithandiza odwala matenda ashuga kusintha shuga. Ndipo choyambirira, ziyenera kudziwika kuti, monga mankhwala ena aliwonse, insulin ili ndi tsiku lotha ntchito, pambuyo pake kugwiritsidwa ntchito sikungopereka zotsatira zabwino, komanso kungavulaze kwambiri thanzi.

Nthawi yomweyo, ziyenera kunenedwa kuti nthawi ya insulin iyenera kuwerengedwa mutatsegula mankhwalawa. Mwatsatanetsatane za moyo wamatumba

Komanso, ngakhale masiku atha kukhala abwinobwino, mankhwalawo amatha kutha msanga ngati wodwala satsatira malamulo oti asungidwe. Zinthu zokhala ndi insulini ziyenera kutetezedwa kuti zisazizidwe, kuzizira kwambiri komanso kuyatsidwa ndi dzuwa. Ayenera kusungidwa m'chipinda chofunda (madigiri 20 mpaka 22) ndi malo amdima.

Kusunga ndalama zotere m'mashelufu apansi a firiji, monga momwe odwala ambiri amakhalira, ndizosafunanso. Popeza insulini imagwira ntchito pang'onopang'ono panthawi yozizira, chifukwa chake pambuyo pa kupangika, shuga m'magazi sabwerera mwachizolowezi kwa nthawi yayitali.

Zolemba ntchito

Nthawi zambiri, anthu odwala matenda ashuga amawayikidwa jakisoni limodzi ndi insulin. Monga lamulo, mankhwalawa amasonkhanitsidwa mu syringe imodzi ndikuperekedwa nthawi imodzi. Komabe, pankhaniyi ndikofunikira kutsatira malingaliro onse a dokotala. Nthawi zambiri, chithandizo cha odwala omwe amadzipangira mlingo wochepa wa nthawi yayitali ndi insulin ndi chimodzi mwa zifukwa zomwe jakisoni samathandizira kuti shuga asungidwe.

Mankhwala omwe akhala akuchita kwa nthawi yayitali amatha kutaya katundu wawo ngati atasakanizidwa ndimankhwala osakhalitsa. Mothandizidwa ndi owongolera, mphamvu zawo zimaponderezedwa, ndipo jakisoni sapereka zotsatira. Pachifukwa ichi, madokotala salimbikitsa kuti apange chisankho pazokha zomwe zingaphatikizidwe ndi insulin ndi zotsatira zosiyanasiyana.

Kuphatikiza apo, ngati insulin siyithandiza, ndikofunikanso kuwunika momwe kayendetsedwe kake kamayendera. Anthu ambiri amalakwitsa pakubaya, chifukwa chomwe amalephera kuchiritsa matenda awo.

Mimba ndiye malo abwino kwambiri a jekeseni.

Chifukwa, mwachitsanzo, anthu ambiri samvera chidwi ndi kukhalapo kwa mpweya mu syringe. Ndipo izi ndizofunikira kwambiri. Kukhalapo kwake kumayambitsa kuchepa kwa kuchuluka kwa mahomoni omwe adayambitsidwa ndipo, mwachilengedwe, motsutsana ndi maziko a izi, njira yotsitsa shuga m'magazi imalepheretseka.

Gawo lofunikanso pakupanga jakisoni ndikusankha kwa malo a jekeseni. Zimakhala zoyipa kwambiri ngati kumayambiriro kumachitika m'chiuno kapena m'mbali mwa khungu pamwamba pa matako. Zingwe ziyenera kupangidwa mwachindunji kumapewa kapena pamimba. Magawo awa ndi oyenera kwambiri kutsata insulin.

Komabe, jakisoni m'gawo lomwelo amaletsedwa. Ndikofunikira kuti muzitha kuphatikiza magawo a mankhwalawo moyenera, popeza kutha kwake kumadaliranso pamenepa. Akatswiri amatanthauzira ma aligoramu angapo pakuyambitsa insulin. Loyamba - kwa mankhwala aliwonse ali ndi gawo lake. Chifukwa, mwachitsanzo, ngati wodwala agwiritsa ntchito insulin yochepa, ndiye kuti iyenera kuperekedwa pakhungu pamimba, popeza pano ndiwothandiza kwambiri. Ngati insulin yogwira ntchito yayitali imagwiritsidwa ntchito, iyenera kuyikidwa m'dera la phewa, etc. Zonsezi zimakonzedweratu ndi adotolo.

Algorithm yachiwiri ndikupaka mankhwalawo pamalo omwewo kwa sabata, pambuyo pake dera la jakisoni likusintha. Ndiye kuti, poyamba munthu amatha kupereka jakisoni padera la phewa lamanja, ndipo patatha sabata ayenera kusintha jakisoni, mwachitsanzo, kumadera a ntchafu lakumanzere. Kusintha kwa jakisoni wa insulin kuyenera kuchitika masiku 7 aliwonse.

Malinga ndi akatswiri, ndi ndendende malamulo amenewa omwe amathandizira kuti adzigwira bwino. Komabe, izi sizinthu zofunikira zonse zofunika kuziganizira mukamagwiritsa ntchito mankhwala okhala ndi insulin.

Ngati jakisoni wa insulin sapereka zotsatira zabwino, muyenera kuuzako dokotala

Mwa anthu odwala matenda ashuga, nthawi zambiri amakhala ndi mitundu ya minofu yolumikizidwa m'mimba, yosawoneka ndi zida. Nthawi yomweyo, odwala samakayikira kupezeka kwawo, kumawazindikira ngati minofu ya adipose, pomwe amaba jakisoni. Mwachilengedwe, munthawi imeneyi, zotsatira za mankhwalawa zimacheperachepera, ndipo nthawi zina palibe zotsatira zake zimawonedwa kuchokera ku kugwiritsidwa ntchito kwake.

Ndipo monga tafotokozera pamwambapa, zambiri zimatengera gawo la mankhwalawa. Koma sizinawonetsedwepo kale kuti mukabayidwa ndikofunika kugwiritsa ntchito kwathunthu dera lonse. Mwachitsanzo, ngati mankhwalawo alowetsedwera pambuyo pake, ndiye kuti gawo liyenera kukulitsidwa mpaka kumapeto a inguinal.

Malo pakati pa nthiti ndi navel amaonedwa ngati malo abwino kwambiri oyendetsera insulin. Kuyika m'malo opaka jakisoni sikuti kumangowonjezera mphamvu ya mankhwalawo, komanso sikuti kumayambitsa mapangidwe azisindikizo zopweteka zomwe zimachitika, mwachitsanzo, pamene insulin imalowetsedwa m'chigawo cha gluteal.

Zochitika zomwe zimachitika mankhwala asanakhazikitsidwe zimathandizanso kuti likhale labwino. Anthu ambiri amathandizira jakisoni wa m'deralo ndi mowa, womwe umaletsedwa mwamphamvu, chifukwa mowa umawononga insulin, ndipo kutha kwake kumachepetsedwa kwambiri.

Kuthamanga ndi kutalika kwa insulin

Poona izi, ambiri odwala matenda ashuga ali ndi funso lambiri momwe angapangire khungu. Ndipo palibe chomwe chikufunika. Kuopsa kwa kachilombo pobweretsa insulin yamakono ndi ma syringe omwe amagulitsidwa ndizochepa, chifukwa chake, chithandizo chowonjezera pakhungu jakisanachitike. Pankhaniyi, zitha kuvulaza.

Ndipo musanalowe mankhwalawa, muyenera kupanga khola la khungu, kulikhomekera ndi zala zanu ndikukokera kutsogolo pang'ono. Kupanda kutero, mankhwalawa amatha kuyambitsa minofu, yomwe imakhudza zotsatira zake. Potere, silikulimbikitsidwa kuti limasulidwe khungu mpaka mankhwala ataperekedwa kwathunthu.

Ndipo chofunikira kwambiri, mankhwalawa atalowetsedwa pakhungu, simuyenera kuchotsa singano nthawi yomweyo. Muyenera kudikirira masekondi 5 mpaka 10 kuti magawo omwe agwira awononge magazi. Mukachotsa singano mutapangidwa kale, ndiye kuti mwatuluka khungu lomwe limatuluka pakhungu. Mwachiwonekere, pambuyo pake thupi sililandira kuchuluka kwa insulin, ndipo kuchuluka kwa shuga kwa magazi kumakhalabe chimodzimodzi.

Tsamba losavomerezeka

Musamwe mankhwalawo intramuscularly. Kubayira koteroko kumakhala kuwononga mankhwala, chifukwa kuchuluka kwa glucose kumakhalabe chimodzimodzi.

Momwe mungapangire mankhwalawo komanso momwe mungagwiritsire ntchito:

• Malo abwino amatengedwa ngati m'mimba. Choyamba, ndikosavuta kuti wodwalayo apange khungu. Kachiwiri, wodwala matenda ashuga amawona momwe amaponyera singano (pali mitundu itatu ya singano ya insulin ndipo amayikidwa pansi pakhungu m'njira zosiyanasiyana).
• Kuboola kumaloledwa kutsogolo kwa ntchafu, gawo lakunja lamanja ndi m'deralo pamapewa.
• Mankhwala ozizira sangathe kutumikiridwa. Wofunda m'manja. Osakola ndi mowa mutayambitsa insulin. Chifukwa chiyani? Imawononga mahomoni. Mukhoza kugwiritsa ntchito mowa kuti mupeze mankhwala osagwiritsa ntchito jakisoni, koma dikirani mpaka atupuke.

Dera loyendetsera mankhwala limasinthidwa nthawi iliyonse. Pakati pa jakisoni malo amodzi akuyenera kudutsa osachepera masiku 15.

Komanso, mankhwala osokoneza bongo osakhalitsa komanso achidule amaperekedwa m'mimba. Pa ntchafu, amapaka jakisoni ndimankhwala apakatikati ndi nthawi yayitali.

Zina zoyambitsa insulin kulephera

Kuphatikiza pazolakwika za anthu odwala matenda ashuga ndi kuyambitsa insulin, pali zinthu zina zomwe zingayambitse kuchepa kwa ntchito ya mankhwala omwe amagwiritsidwa ntchito. Izi zikuphatikiza:

• kukula kwa matenda a Samoji.

Kuti mumvetsetse chifukwa chake kuchepa kwa mphamvu ya insulini, ndikofunikira kulingalira izi mwatsatanetsatane.

Samoji Syndrome

Matenda a Samoji amapanga mtundu wa insulin. Amakhala mu mawonekedwe a kuyankha kwa thupi kuukira mwadongosolo kuwonjezeka shuga. Matenda a Samoji amawoneka ndi zotsatirazi:

• Masana pali kusinthasintha kwakukuru kwamlingo wamagazi m'magazi, kenako ndikulowera kumalire ena, kumapeto.
• pafupipafupi kuukira kwa hypoglycemia, komwe kumatha kuwonekera pompopompo posachedwa
• kuwoneka mumkodzo wa matupi a ketone (wapezeka ndi kutumiza kwa OAM),
• njala yosalekeza
• kunenepa
• Mlingo wa insulin ulikulidwe, matenda akuwonjezeka,
• ndi chimfine, kuchuluka kwa shuga m'magazi sikusinthika (izi zimachitika chifukwa chakuti kachilombokaakalowa m'thupi, pamafunika mphamvu zambiri kuti athetse).

Somoji syndrome imatha kupangitsa kuti mupeze insulin yambiri

Odwala ambiri, akangoona kuchuluka kwa shuga m'magazi, amayamba kuwonjezera kuchuluka kwa insulin yomwe imagwiritsidwa ntchito, osakambirana ndi adokotala. Koma kuchita izi ndizoletsedwa. M'malo mochulukitsa kuchuluka kwa insulini yoyendetsedwa, muyenera kulabadira zina, monga mtundu wa chakudya chomwe mumadya, masewera olimbitsa thupi (wokhala ndi moyo wangwiro, ndalama zamagetsi ndizochepa, zomwe zimapangitsa kuchuluka kwa shuga) komanso kupezeka kwa kuchuluka kwambiri kugona ndikupumula.

Anthu omwe ali ndi matenda ashuga komanso kuwonjezeka kwa shuga m'magazi kwa nthawi yayitali sayenera kugwiritsa ntchito jakisoni wa insulin. Chowonadi ndichakuti kwa munthu aliyense wodwala matenda ashuga pamakhala miyezo yama glucose amomwe amamva bwino.Kugwiritsa ntchito insulin pankhaniyi kungayambitse kukula kwa matenda a Somogy komanso kufunikira kwa chithandizo chowonjezera.

Ngati mukukayikira kuti chitukuko cha matenda a Somoji chikufunika, muyenera kuyesedwa mokwanira kuchipatala

Kuti atsimikizire kupezeka kwa mankhwala osokoneza bongo ambiri a insulin m'thupi, wodwalayo amafunika kufufuza njira zingapo. Chofunikira kwambiri mu bizinesi iyi ndi muyezo wamagulu a shuga wamagazi. Osatinso masana, komanso usiku. Kusanthula kumachitika nthawi zonse. Kuyesa koyambirira kwa magazi kuyenera kuchitika pafupifupi 9 koloko madzulo, miyeso yonse yotsatira iyenera kuchitika maola atatu aliwonse.

Ndi chitukuko cha matenda a Somogy, kuchepa kwambiri kwa shuga m'magazi kumawonedwa pafupifupi 2 koloko m'mawa. Ndipo ziyenera kudziwika kuti ndi usiku womwe thupi limadya mphamvu zochepa, chifukwa chake, insulin yomwe imayambitsidwa nthawi ya 8-9 pm izichita bwino kwambiri komanso motalika. Kuwonjezeka kwa shuga m'magazi a Somoji syndrome nthawi zambiri kumawonedwa m'maola 6.7 m'mawa.

Ndi njira yoyenera, Somoji syndrome imachiritsidwa mosavuta. Chachikulu ndikutsatira mosamalitsa malingaliro onse a adokotala ndipo musapitirire muyeso wa mankhwala omwe ali ndi insulin.

Malangizo pakuwerengera kuchuluka kwa insulin

Kuchita kwa insulin mwachindunji kumatengera mlingo womwe umagwiritsidwa ntchito. Ngati mungalowe mu kuchuluka kosakwanira, kuchuluka kwa shuga kwa magazi kumakhalabe kosasinthika. Ngati mukulitsa kuchuluka, ndiye kuti izi zingapangitse kukula kwa hypoglycemia.

Chifukwa chake, ndikofunikira kwambiri pakupanga shuga kuti awerenge molondola kuchuluka kwa insulin. Pankhaniyi, mfundo zotsatirazi ziyenera kukumbukiridwa:

• Ultra-yochepa-kuchita insulin mlingo kusintha. Nthawi zambiri, anthu omwe samayang'anira zakudya zawo amakumana ndi vuto la postprandial hyperglycemia. Zimachitika ngati wodwalayo asanadye chakudya asanayambitse kuchuluka kwa insulin ndipo nthawi yomweyo amadya mkate wambiri kuposa momwe angafunikire. Zikatero, makonzedwe a insulin mwachangu amakhala okwanira.
• Kusintha kwa insulin yayitali kwa nthawi yayitali kumadalira shuga m'magazi ndi m'mawa.
• Ngati wodwala ali ndi matenda a Somoji, mlingo wa mankhwala otulutsidwa m'mawa uyenera kukhala wamitundu iwiri kuposa madzulo.
• Ngati pali matupi a ketone mu mkodzo, kuchuluka kwa insulin yochepa-mwachidule kumayikidwa.

Nthawi yomweyo, monga tanena kale, zakudya za wodwalayo komanso zolimbitsa thupi tsiku lonse zimaganiziridwa. Chifukwa chakufunika kuzindikira zonsezi, ndi dokotala yekha yemwe angakhazikitse mlingo woyenera wa insulin, womwe ungagwire ntchito pochiza matenda a shuga.

Nthawi zambiri, anthu amakumana ndi mfundo yoti, ngakhale akugwiritsa ntchito insulin, shuga wamagazi sachepa. Ngati chomwe chimayambitsa ndondomekoyi sichikuletsa insulini kapena zovuta zina, ndiye kuti vuto ndi kugwiritsa ntchito molakwika gawo la mahomoni. Pankhaniyi, ndikofunikira kulingalira zolakwitsa zazikulu zomwe zimapangidwa pakugwiritsa ntchito insulin.

Zoyambitsa bongo

Chithandizo cha insulin chingabwezeretse kagayidwe kazakudya mu shuga ndikupatsa anthu omwe ali ndi matendawa kuti azikhala popanda zoletsa zazikulu.

Komanso, insulin imagwiritsidwa ntchito mwachangu ndi omanga thupi chifukwa cha anabolic.

Koma kumwa mankhwala molakwika kwambiri kungayambitse vuto lakumoyo.

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.

Ndikofunikira kudziwa chifukwa chake insulin yamagazi imakwezedwa. Zifukwazi zimakhala zosiyanasiyana. Mwachitsanzo:

• njala yayitali
• kulimbitsa thupi kwambiri,
• mimba
• kumwa mankhwala ena
• Pali zakudya zambiri zokhala ndi shuga
• kusagwira bwino ntchito kwa chiwindi.

Komabe, nthawi zina chimayambitsa vuto la kuperewera kwa zakudya m'thupi kwa nthawi yayitali ndikupangitsa kuti mantha azitha. Kenako mufunika kupuma kwakanthawi komanso kukhala ndi zakudya zabwino kuti mulingo wa mahomoni ubwerere mwakale.

Komanso anomatic yotere imayambitsidwa ndi neoplasm mu kapamba, wotchedwa insulinoma. Mu khansa, misempha ya insulin imakwezedwa nthawi zonse. Ndipo insulin imakhala ndi zizindikiritso zina zowonjezereka, zowawa kwambiri.

1. Kufooka minofu.
2. Kudzanjenjemera.
3. Zowonongeka.
4. Kusokonekera kwa mawu.
5. Mutu waukulu.
6. Zingwe.
7. Njala komanso thukuta lozizira.

Madzi a insulin ndi amodzi mwa ofunika kwambiri m'thupi la munthu. Popanda iyo, magwiridwe antchito a machitidwe ambiri ndiosatheka. Choyamba, zimathandizira kudziwa kuchuluka kwa shuga m'magazi a munthu ndipo, ngati pakufunika, musinthe.

Koma nthawi zina ngakhale ndi shuga wabwinobwino, insulin imakulitsidwa kwambiri. Zomwe zimachitika izi, monga zikuwonetseredwa ndi kuchuluka kwa shuga kapena insulini m'magazi, kuposa momwe amawopsezera, ndizotsika.

Insulin ndi tanthauzo lake

Monga ananenera, palibe njira iliyonse m'thupi la munthu yomwe imayamba popanda insulini. Amathandizira nawo pakuwonongeka kwa mapuloteni ndi mafuta. Koma, zoona, ntchito yayikulu ndikuwongolera kuchuluka kwa shuga m'magazi. Ngati shuga asweka, mphamvu ya metabolism sidzachitika mthupi moyenera.

Insulin yathanzi, yathanzi yogwira ntchito imakhala yambiri:

• Ana, kuyambira 3.0 mpaka 20 μU / ml,
• Akuluakulu, kuyambira 3.0 mpaka 25 μU / ml.

Mwa anthu achikulire omwe zaka zawo zadutsa zaka 60-65, insulin ikhoza kukhala ndi kuchuluka kwa 35 mcU / ml. Zonsezi ndizizindikiro wamba. Ngati manambala apamwamba adapitilira, muyenera kukaonana ndi dokotala posachedwa - adzakhazikitsa zifukwa ndikufotokozera chifukwa chake insulini imakwezedwa modabwitsa.

Chidandaulo chachikulu chiyenera kukhala mkhalidwe momwe mahomoni amakwezedwa, ndipo shuga amakhalanso abwinobwino. Pofuna kuyang'anira kuchuluka kwa insulin ndi glucose kunyumba, glucometer iyenera kukhala pafupi.

Ndikofunikira kutenga miyezo ya shuga kangapo patsiku - makamaka osachepera 5, kuti mumvetse bwino.

Koma ngati izi sizingatheke, ndiye kuti shuga amayenera kuwunika kawiri patsiku: m'mawa mutadzuka, ndipo madzulo, asanagone.

Chifukwa insulin ndi yokwera - zifukwa

Ngati insulini imakwezedwa, izi nthawi zonse zimawonetsa kuvulaza kwakukulu m'thupi, china chake sichili bwino ndi thanzi. Choyamba, titha kufotokoza za chitukuko cha mtundu wachiwiri wa matenda ashuga - ndi mtundu uwu wa matendawa omwe amawonetsa ali amtunduwu.

Nthawi zambiri, milingo yokwezeka kwambiri imawonetsa matenda omwe amatchedwa Cushing's. Ndi acromegaly, mahomoni ambiri okula m'magazi amawerengedwa limodzi. Shuga, komabe, amakhalabe wabwinobwino.

Insulin yokwera ndi chimodzi mwazizindikiro za zovuta zazikulu za chiwindi. Nthawi zambiri, chizindikiro chofananacho chikuwonetsa kupezeka kwa insulinomas - chotupa chomwe chimatulutsa timadzi timeneti.

Dystrophic myotonia, matenda oopsa a neuromuscular, ndi chifukwa china chowonjezera cha kuchuluka kwa insulin. Mutha kukayikiranso gawo loyambirira la kunenepa kwambiri komanso kuchepa kwa chidwi cha maselo am'mimba kupita ku mahomoni ndi ma carbohydrate omwe amachokera pamenepo.

Zomwe zimapangitsa kuti insulin iwonjezeke mwadzidzidzi, kupenda wodwalayo ndikofunikira.

Chofunikira: nthawi zambiri mahomoni a pancreatic amawonjezereka mwa azimayi panthawi yopaka. Amakhulupilira kuti popeza thupi limalowa mthupi latsopano, kusintha kotereku ndikwabwinobwino. Koma, komabe, ndikulimbikitsidwa kuwunikira thanzi lanu, zakudya komanso kunenepa.

Gulu la matenda ngati shuga

Mankhwalawa matenda a shuga, wodwala ayenera kuonana ndi endocrinologist - momwe angapangire insulin. Zingwe zitha kuchitidwa:

• kudzera m'mitseko - kokha kuchipatala (kuchipatala chachikulu),
• intramuscularly - Umu ndi momwe mankhwalawa amaperekedwa kwa ana (ngati sizingatheke kupatsirana mankhwalawo mu minofu yamkati),
• subcutaneally - madera okhala ndi zigawo zokwanira za adipose minofu (pamimba, kunja kwa phewa, ntchafu yakunja, dera la gluteal).

Jakisoni wa insulini amatha kuchitidwa pogwiritsa ntchito cholembera kapena syringe yotayika yokhala ndi gawo lapadera, lomwe limapangidwira mulingo woyenera wa mankhwalawo.

Kuchuluka kwa yankho kumawerengedwa osati kuwerengeka, monga zochulukirapo, koma m'magawo a mkate (XE), kotero muyeso wa insulini uli ndi ma gridi awiri.

Cholembera cha payekha ndi chida chothandiza kupangira insulin - chitha kugwiritsidwa ntchito popanda mavuto pafupifupi kulikonse (kuntchito, patchuthi, paulendo).

Zomwe zimatchuka pakukula kwa njira yokhayo yoperekera insulin mu shuga imatha kuganiziridwa ngati mawonekedwe a chipangizocho, chidutswa chake chonse ndi singano, kuthekera kosankha molondola kuchuluka kwa mankhwalawo.

Kugwiritsa ntchito ma syringes ochiritsira 1 ml ndikofunikira ngati kuphatikiza mitundu ingapo ya insulin pochiritsira (mankhwala osiyanasiyana opatsirana), yomwe nthawi zambiri imalimbikitsidwa kwa ana ndi achinyamata, komanso kwa odwala omwe ali ndi vuto lomwe lakhazikitsidwa kumene, ngati kuli kotheka, sinthani mlingo wa mahomoni.

Mitundu ya matenda ashuga ikhoza kukhala yosiyana. Muzochita zamankhwala, mawu akuti "shuga mellitus" amatanthauza matenda ambiri omwe ali ndi zofanana. Koma ziribe kanthu mtundu wamatenda omwe mwiniwakeyo amakhala nawo, amakhala ndi shuga wambiri m'magazi.

Pali zifukwa zambiri zomwe zimapangitsa kuti thupi lisamayendetsedwe ndi shuga kuchoka m'magazi kupita ku maselo, ndipo zotsatira zake zimakhala zofanana: magazi "okoma" kwambiri sangapatse maselo chakudya choyenera.

Izi zitha kufotokozedwa ngati "njala pakati pazambiri." Koma awa si mavuto onse omwe amayembekezera odwala matenda ashuga.

Shuga omwe sakalowa m'maselo amathandiza kuchotsa madzi kwa iwo.

Mwazi, wokhala ndi madzi ambiri, amuchotsa kudzera mu impso, chifukwa, thupi la wodwalayo limasowa madzi m'madzi. Izi zikuwonetsedwa ndi "zikuluzikulu" zamatendawa: mkamwa youma, ludzu, kumwa kwambiri, chifukwa chake, kukodza pafupipafupi.

Gulu la anthu odwala matenda ashuga limafalikira, pali mitundu yambiri yamatenda, ndipo ena a iwo ali ndi mitundu yosiyanasiyana.

Mitundu yodziwika bwino ya matenda ashuga: odalira insulini komanso osadalira insulin, shuga komanso osapatsa shuga, postoperative, kapamba komanso osapindika, etc.

Insulin yodalira insulin komanso yosadalira insulin

Type 1abetes mellitus ndimatenda omwe amadalira insulin, zomwe zimapangitsa kuwonongeka kwa autoimmune kapena ma virus ku chiwalo chomwe chimapanga inshuwaransi ya pancreatic. Mlingo wa insulin m'magazi a odwala ndiwosazindikira kapena kulibe.

Matenda a shuga omwe amadalira insulin nthawi zambiri amakhudza anthu achinyamata ndipo amawonetsedwa ndi zizindikiritso monga kumwa kwambiri, kukodza pafupipafupi, kuchepa thupi, kumva kunjenjemera kwamatenda komanso asetone mumkodzo.

Kuchiza matenda amtunduwu ndikotheka pokhazikitsa mtundu woyenera wa insulin. Mankhwala ena alibe mphamvu pano.

Zizindikiro za mankhwala a insulin

Kwa munthu wathanzi, mlingo wabwino wa thupilo ndi 2-4 IU mu maola 24. Ngati tikulankhula za omanga thupi, ndiye 20 IU iyi. Kwa anthu odwala matenda a shuga, chizolowezi chake ndi 20-25 IU patsiku. Ngati dokotalayo ayamba kuledzera pamankhwala ake, ndiye kuti kuchuluka kwa mahomoniwo kumawonjezera bongo.

Zomwe zimayambitsa hypoglycemia ndi izi:

• kusankha kolakwika kwa mankhwala,
• kusintha mtundu wa syringes ndi mankhwala,
• masewera osapatsa mafuta
• kudya moyenera komanso nthawi yomweyo insulin,
• kuphwanya zakudya pambuyo jekeseni (kunalibe chakudya atangochita),

Munthu aliyense amene amadalira insulin, kamodzi kamodzi m'moyo wake, anali kumva zosasangalatsa zomwe zimayambitsidwa ndi mankhwala osokoneza bongo ambiri. Zizindikiro zazikulu za bongo za insulin:

1. kufooka kwa minofu
2. ludzu
3. thukuta lozizira
4. miyendo yanjenjemera
5. chisokonezo,
6. kuchuluka kwa thambo ndi lilime.

Zizindikiro zonsezi ndi chizindikiro cha hypoglycemic syndrome, chomwe chimakwiya chifukwa cha kuchepa msanga kwa magazi m'thupi. Yankho lofananalo ku funso la zomwe zimachitika ngati mutabaya insulin mwa munthu wathanzi.

Matendawa amayenera kuyimitsidwa msanga, apo ayi wodwalayo amagwa, ndipo zimakhala zovuta kwambiri kuti atuluke.

Komabe, munthu aliyense wodalira insulin, kamodzi kamodzi m'moyo wake, samakumana ndi zosasangalatsa zomwe zimayambitsidwa ndi mankhwala osokoneza bongo ambiri. Zizindikiro za bongo zikuphatikiza:

• kufooka kwa minofu
• kugwedezeka miyendo,
• lilime ndi thambo,
• thukuta lozizira
• ludzu
• kusokonezeka kwa chikumbumtima.

Zizindikiro zonsezi ndizizindikiro za hypoglycemic syndrome, zolimbikitsidwa ndi kuchepa kwambiri kwa shuga m'magazi. Iyenera kuyimitsidwa posachedwa. Kupanda kutero, wodwalayo akhoza kugwa, nthawi zina zimakhala zovuta kutuluka, ndipo insulin yambiri ndi yomwe imayambitsa zonsezi.

Ngati pali insulin yochulukirapo, izi zimabweretsa kutsika kwa msanga kwa shuga.

Hypoglycemia imayamba ngati shuga itatsika pansi 3.3 mmol / L.

Kuchulukitsa kwa zizindikiro kumayenderana kwambiri ndi mtundu wa insulin (yayitali, yochepa kapena ya ultrashort) ndi mlingo.

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.

Njira zamankhwala othandizira insulin :: mankhwala a odwala omwe ali ndi matenda osokoneza bongo a insell :: insulin

Malinga ndi kuyezetsa magazi kwa shuga, adotolo adzalembera chithandizo chofunikira. Mu shuga, chomwe chimapangitsa kuti pakhale osakwanira pancreatic secretion (ya mtundu woyamba), ndikofunikira jakisoni insulin kawiri pa tsiku. Dokotala amafotokozanso za kusowa kwa zakudya zoyenera kudya, zomwe ziyenera kuyang'aniridwa nthawi zonse.

Eya, matenda ashuga amtundu wachiwiri ndi zotsatira za kupsinjika ndi njira yolakwika, yosagwira ntchito, nthawi zambiri imapangitsa kuti insulini iwonjezeke. Mtunduwu umatchedwa kuti shuga yemwe amadalira insulin, umathandizidwa ndimankhwala ena.

Ndikofunika kupeza masewera aliwonse omwe mumakonda ndikukonzekera zolimbitsa thupi minofu. Komabe, mulingo wa insulini umafunikanso kufufuzidwa pafupipafupi ndi kukaonana ndi dokotala-endocrinologist.

Mwa munthu wathanzi, insulin secretion imachitika nthawi zonse ndipo imakhala pafupifupi 1 IU ya insulini pa ola limodzi, iyi ndiye yotchedwa basal kapena secretion yam'mbuyo. Pakudya, kuchulukitsa msanga kwa insulin kumachitika kangapo.

Kukondoweza insulin katulutsidwe pafupifupi mayunitsi 1-2 pa 10 g wa chakudya.Nthawi yomweyo, kuwongolera kosalekeza kumasungidwa pakati pazowonjezera insulin ndi kufunika kwake malinga ndi mfundo ya mayankho.

Wodwala wodwala matenda a shuga 1 amafunika insulin yomwe ingafanane ndi insulini m'malo mwake. Ndikofunikira kugwiritsa ntchito mitundu yosiyanasiyana ya kukonzekera kwa insulin panthawi zosiyanasiyana.

Ndikosatheka kukwaniritsa zotsatira zogwira mtima ndi jakisoni imodzi ya insulin mwa odwala matenda a shuga 1. Chiwerengero cha jakisoni amatha kuyambira 2 mpaka 5-6 pa tsiku.

Jakisoni wambiri, njira ya insulin yotsatizana imayandikira kwachilengedwe. Odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga omwe ali ndi cell ya beta-yosungirako, kusungirako kamodzi, kawiri kokha kumapangitsa insulini.

Pali njira zingapo zoperekera insulin patsiku:

• jekeseni imodzi
• jakisoni awiri
• regimen yambiri
• insulin dispenser kapena pampu.

Ndondomeko ya insulin mankhwala ayenera kukhala payekha, kutengera zolinga za glycemic control mwa wodwala aliyense. Wodwala mothandizidwa ndi dokotala ayenera kusungabe nthawi zonse pakati pa insulini yomwe imayendetsedwa ndi kufunika kwake, komwe kumatsimikiziridwa ndi zakudya komanso zolimbitsa thupi.

Kupita patsogolo kwa matenda ashuga matenda azakudya m'zaka 10 zapitazi kwapangitsa kuti kuunikenso mfundo zomwe zilipo kale za mankhwala a insulin. Pakadali pano, mitundu iwiri yayikulu ya mankhwala a insulin imagwiritsidwa ntchito: yachikhalidwe (mwachizolowezi) ndikuwonjezera (kwambiri).

Malinga ndi mfundo zachikhalidwe zamatenda a insulin, anthu ambiri omwe amakhala ndi insulin amathandizidwa limodzi ndi insulin. Majakisoni nthawi zambiri amapangidwa kawiri patsiku ndipo chakudyacho "chimakonzedwa" mwa insulin, momwe wodwalayo angadye pang'ono, kangapo ka 5-6 patsiku panthawi inayake.

Kukhazikika kamodzi kwa insulini kumakhala koyenera kokha ngati pali shuga wokhazikika yemwe ali ndi vuto laling'ono la insulin (ochepera 30-40 magawo / tsiku) makamaka mwa anthu omwe ali ndi matenda a shuga a 2.

Jekeseni imodzi ya insulin nthawi zina imagwiritsidwa ntchito mwa odwala omwe ali ndi matenda a shuga 1 nthawi yachikhululukiro.

Pakaperekedwa kawiri, kawirikawiri 2/3 ya tsiku ndi tsiku imaperekedwa musanadye chakudya cham'mawa, chachitatu - musanadye chakudya, 1/3 ya mlingo uliwonse wa jekeseni ndi insulin, komanso 2/3 ya nthawi yayitali. Mlingo wa insulin, womwe umapereka nthawi ya masana, uyenera kukhala wokulirapo kuposa nthawi yamadzulo.

Komabe, magawoli nthawi zonse amakhala amodzi payekha, ndipo malingaliro ali pabwino. Kuphatikiza kwa insulin yosavuta komanso yayitali imagwiritsidwanso ntchito (ultralente, ultratard).

Kuphatikiza kosiyanasiyana ndikotheka, makamaka pogwiritsa ntchito zosakaniza zopangidwa kale. Sitikulimbikitsidwa kugwiritsa ntchito mitundu itatu ya mankhwala osiyanasiyana munthawi imodzi (jekeseni, yapakatikati ndi nthawi yayitali) pobayira limodzi.

M'maphatikizidwe otere, nsonga za mitundu yosiyanasiyana ya insulini imatha kudutsa ndikupangitsa kuti hypoglycemia ikhale ndi nthawi yayitali, kenako ndikutsatira kwa hyperglycemia usiku kapena m'mawa. Bwino gwiritsani ntchito jakisoni wowonjezera wa insulin.

Mlingo wa insulin uyenera kukhazikitsidwa kwa wodwala aliyense payekhapayekha. Kufunikira kwachilengedwe kwa munthu wathanzi la insulin (30-70 U / tsiku) kumatha kukhala chitsogozo chotsimikizika cha mlingo wa tsiku ndi tsiku.

Mlingo wambiri, womwe umapangidwa makamaka ndi kubisika kwa insulini komanso kudziwa kutulutsa insulin, umachokera ku 0.3 mpaka 0.8 U / kg thupi tsiku lililonse mwa odwala. Odwala omwe ali ndi matenda a nthawi yayitali omwe amakhala ndi matenda a shuga a insulin, omwe amadziwika ndi zochepa kapena alibe chinsinsi, kufunika kwa insulini ndi 0.7-0.8 U / kg kulemera kwa thupi.

Odwala omwe ali ndi matenda a shuga omwe amangopezeka kumene pogwiritsa ntchito mankhwala amakono a insulin, mlingo wake wa tsiku ndi tsiku umakhala pafupifupi 0,5 IU / kg ya kulemera kwa thupi.Pambuyo kumayambiriro kwa kubwezeretsa matenda, imatha kutsikira ku 0.3-0.4 U / kg kapena kuchepera.

Mlingo wa tsiku ndi tsiku wa 1 U / kg kapena zingapo umawonetsa, ambiri, kukana kwambiri kapena insulin. Komabe izi

Kuwonongeka kwa nthawi yayitali chifukwa cha matendawa, kutenga pakati, matenda oyanjana kumachepetsa kwambiri kumva kwa insulin, komwe kumapangitsa kuchuluka kwa mankhwalawa. Kugwiritsa ntchito mitundu yamakono ya insulin yotsukidwa kwambiri, komanso mwayi watsopano wokwaniritsira ndi kubwezera kwakanthawi matendawa, pakuwonjezereka kwa odwala kumapangitsa kutsika kwakukulu kwa mlingo wa insulin wa tsiku ndi tsiku.

Mu 70-80s, odwala omwe ali ndi insulin ya tsiku ndi tsiku a 70-80-90 mayunitsi anali olamulira m'malo kusiyapo. Kusintha kwa ma insulin apamwamba kwambiri kwapangitsa kuchepa kwa mlingo wake watsiku ndi tsiku.

Pakadali pano, wodwala yemwe ali ndi mlingo wa insulini wopitilira 1 U / kg kulemera kwa thupi ayenera kudziwa zomwe zimayambitsa kukana kwa insulini komanso kuphatikizidwa kwa matenda osokoneza bongo omwe angathe.

Popereka mankhwala a insulin, muyenera kutsatira malamulo ofunika omwe wodwalayo ayenera kuphunzitsidwa kuchipatala. Zotsatira za tsiku lililonse za insulin ziyenera kukhala zazing'ono momwe mungathere, komanso zokulirapo.

Mlingo wa insulin mu jakisoni imodzi sayenera kupitirira 40 mayunitsi. Kumbukirani kuti milingo yaying'ono ya insulin imakhala ndi nthawi yochepa kwambiri kuposa waukulu.

Mu mkulu-ndende insulin (U-100), kuchuluka kwa mayamwidwe, chifukwa, nthawi ya zochita za mankhwala amachepetsa pang'ono. Kuchuluka kwa zomwe zimapangidwira insulin kukonzekera kuyenera kuyenderana ndi kudya.

Pambuyo pakatha maola 2-3 (nsonga ya insulin yosavuta), wodwalayo amayeneranso kuluma. Pogwiritsa ntchito mankhwala a nthawi yayitali, wodwalayo ayenera kudya maola 4 aliwonse, komaliza maola awiri asanagone.

Kumbukirani kuti kukonzekera kwa insulin kwa anthu kumakhala ndi nthawi yochepa poyerekeza ndi nkhumba. Kuyamba mwachangu kwa zinthu zoterezi kumathandiza kuti jakisoni wodziwika bwino ndi mphindi 15 musanadye kapena ngakhale musanadye.

Ngati kawiri makonzedwe a insulini (jekeseni wachiwiri musanadye chakudya chamadzulo) amakhalabe akuthamanga kwambiri glycemia, muyenera kuyesa kubwezeretsa jakisoni wamadzulo wa insulin yayitali nthawi ina pambuyo pake (22.00-23.00). Pankhaniyi, musanadye chakudya chamadzulo, ndikofunikira kubaya insulini yophweka.

Malangizo a patatu insulini makonzedwe amatanthauza makonzedwe a 40-50% ya mlingo musanadye kadzutsa (1/3 yosavuta ndi 2/3 ya insulin ya nthawi yayitali), 10-15% ya mankhwalawa imayendetsedwa musanadye chakudya chamadzulo monga mawonekedwe a insulin yochepa, ndi 40% ya insulin yayitali musanagone.

Pitani jakisoni wa insulin

Popeza mankhwalawa a mtundu woyamba wa matenda a shuga amachitika kokha mwa njira ya inulin yomwe imachotsa mankhwalawa nthawi zonse, makonzedwe a mankhwala ndi mwayi wokhawo wokhala ndi shuga.

Kugwiritsa ntchito bwino insulin kukonzekera kungalepheretse kusinthasintha kwa shuga komanso kupewa zovuta za matenda ashuga:

1. Kukula kwa machitidwe a comatose omwe ali pachiwopsezo cha moyo: ketoacidosis, lactactacidosis, hypoglycemia.
2. Kuwonongeka kwa mtima khoma - yaying'ono- ndi macroangiopathy.
3. Matenda a shuga.
4. Mawonedwe akuchepera - retinopathy.
5. Zilonda zamanjenje - diabetesic neuropathy.

Njira yabwinoko yogwiritsira ntchito insulin ndiyo kubwereza mtundu wake wolimbitsa thupi kulowa m'magazi. Pachifukwa ichi, ma insulins a nthawi zosiyanasiyana amagwiritsidwa ntchito. Kuti apange magazi okwanira nthawi zonse, insulin yayitali imayendetsedwa kawiri pa tsiku - Protafan NM, Humulin NPH, Insuman Bazal.

Insulin yofupikitsa imagwiritsidwa ntchito m'malo mwa kutulutsidwa kwa insulin poyankha chakudya. Amayambitsidwa musanadye katatu pa tsiku - musanadye chakudya cham'mawa, chakudya chamasana komanso musanadye. Pambuyo jekeseni, muyenera kudya chakudya pakadutsa mphindi 20 mpaka 40. Poterepa, mlingo wa insulin uyenera kupangidwa kuti utenge kuchuluka kwamafuta ena.

Ngati munthu ali ndi mtundu woyamba wa shuga wambiri, amakhala ndi jakisoni wa insulin wa nthawi yayitali madzulo ndi m'mawa, ndikuchotsetsa chakudya chisanafike. Koma ndi matenda a shuga a mtundu wachiwiri kapena matenda ashuga 1 omwe amakhala osavuta, ndichizolowezi kupanga jakisoni ochepa.

Kuyeza shuga kumafunika nthawi iliyonse musanadye chakudya, ndipo mutha kuchita izi maola ochepa mukatha kudya. Kuwona kungawonetsetse kuti shuga ali bwino masana kupatula kupumira madzulo. Izi zikusonyeza kuti jakisoni wa insulin yochepa ndiyofunikira pakadali pano.

Kugawana njira yomweyo ya insulin kwa aliyense wodwala matenda ashuga ndi koopsa komanso kosavomerezeka. Ngati mutsatira zakudya zamafuta ochepa, zimatha kudziwa kuti munthu m'modzi amafunika kupatsidwa jakisoni asanadye, ndipo chinthu china ndikwanira.

Chifukwa chake, mwa anthu ena omwe ali ndi matenda ashuga a 2, zimakhala kuti pakhale shuga wabwinobwino. Ngati uwu ndi mtundu wa matendawa, ikani insulini yochepa musanadye chakudya cham'mawa komanso m'mawa. Asanadye nkhomaliro, mungotenga mapiritsi a Siofor.

M'mawa, insulin imakhala yofooka pang'ono kuposa nthawi ina iliyonse masana. Izi ndichifukwa cha m'mawa. Zomwezo zimaperekanso insulin yomwe, yomwe imatulutsa kapamba, komanso yomwe odwala matenda ashuga amalandira ndi jakisoni. Chifukwa chake, ngati mukufuna insulin yofulumira, monga lamulo, mumawaba jakisoni musanadye chakudya cham'mawa.

Aliyense wodwala matenda ashuga ayenera kudziwa momwe angapangire jakisoni molondola musanadye kapena pambuyo chakudya. Kuti mupewe hypoglycemia momwe mungathere, muyenera choyamba kuti muchepetse kuchuluka kwake, kenako ndikuwonjezera pang'onopang'ono. Poterepa, ndikofunikira kuyeza shuga kwakanthawi.

M'masiku ochepa mutha kudziwa kuchuluka kwanu. Cholinga ndikupanga shuga pamlingo wokhazikika, monga mwa munthu wathanzi. Pankhaniyi, 4.6 ± 0,6 mmol / L musanadye chakudya kapena chakudya mukamatha kudya ndiye kuti ndi chizolowezi.

Nthawi iliyonse, chizindikirocho sichiyenera kukhala ochepera 3.5-3.8 mmol / L. Mlingo wa insulin yofulumira komanso kuchuluka kwa nthawi yomwe amatenga zimatengera mtundu ndi chakudya. Ziyenera kulembedwa zomwe zakudya zimadyedwa m'magalamu. Kuti muchite izi, mutha kugula muyeso wamakhitchini. Ngati mutsatira zakudya zamafuta ochepa kuti muchepetse matenda a shuga, ndibwino kugwiritsa ntchito mwachidule insulin musanadye, mwachitsanzo:

1. Actrapid NM
2. Humulin Wokhazikika,
3. Insuman Rapid GT,
4. Biosulin R.

Mutha kubayanso Humalog, ngati mukufunikira kuti muchepetse shuga mofulumira. Insulin NovoRapid ndi Apidra ndizosachedwa kuposa Humalog. Pofuna kuti muzitha kuyamwa zakudya zamagulu ochepa zam'mimba, insulini yocheperako posakhalitsa siyabwino kwambiri, chifukwa nthawi yochita ndiyifupi komanso yachangu.

Kudya kumayenera kukhala katatu katatu patsiku, pakadutsa maola 4-5. Ngati ndi kotheka, ndiye kuti masiku ena mutha kulumpha limodzi lamadyedwe.

Zakudya ndi chakudya ziyenera kusintha, koma mtengo wa zopatsa thanzi suyenera kukhala wotsika kuposa zokhazikitsidwa.

Mlingo wa mayamwidwe, chifukwa chake nthawi yovutikira insulini, zimatengera kusankha malo a jakisoni. Mimba imadziwika kuti ndi malo achangu kwambiri a insulin.

Chifukwa chake, kuti tithandizire kuchepa kwa insulin m'mawa kale, timabayirira m'matumbo a insulin m'mimba. Koma malo ena onse (mapewa, matako ndi chiuno) ndi "kuchepera" pantchito ya insulin.

Mukutsimikiza kuti mumayang'anira insulini molondola?

Kodi munayang'ana kuti tsiku lanu la insulin latha liti? Insulin yomwe yatha ingathe kuchita zinthu zochepa kwambiri kuposa masiku onse. Ngati insulin ikayamba kusinthika, maonekedwe ake amasintha.Chongani - insulin yayifupi (komanso ma "analog" owonjezera) owoneka bwino ayenera kukhala owonekera, osayeserera, owonjezeredwa atasakanikirana - kwamitambo, popanda ma flakes.

Zotsatira ndi mawonekedwe othandizira

Pochiza matenda a shuga, pamakhala chiopsezo cha mankhwala osokoneza bongo ambiri. Munjira imeneyi, pofuna kupewa imfa, thandizo loyenerera lofunikira likufunika. Ndikofunikira kudziwa zoyenera kuchita nthawi yomweyo ndi mankhwala osokoneza bongo ambiri.

Kuti muwonjezere chakudya chamagulu ochulukirapo, muyenera kudya chofufumitsa cha mkate wa tirigu mpaka g 100. Mukapitiliza kuukira kwa mphindi 3-5 muyenera kuwonjezera shuga. Madokotala amalimbikitsa kumwa tiyi ndi supuni zochepa za shuga.

Ngati chochitikacho chitachitika, kuchuluka kwa insulini m'magazi sikumakhala kotakasuka, mukufunikirabe kudya ma protein munthawi yomweyo. Ngakhale kuti bongo wambiri ndi chinthu wamba, ngati inu kunyalanyaza zofunika kuchita, kuwonjezeka kwa Somoji syndrome kumachitika.

Kukula kwa matendawa kumasokoneza kwambiri mankhwalawa komanso kumadzetsa ketoacidosis yovuta kwambiri.

Pankhaniyi, mungafunike kusintha mankhwalawo ndikuyamba kumwa mankhwala amphamvu.

• matenda edema,
• Zizindikiro za meningitis,
• kutha msanga kwa matenda a dementia ndimavuto amisala.

Pakati pa anthu omwe ali ndi vuto la mtima, kuchuluka kwa insulini kungayambitse:

1. sitiroko
2. vuto la mtima
3. retinal hemorrhage.

Musanaganize chilichonse, muyenera kuonetsetsa kuti ndi mankhwala osokoneza bongo omwe amatsogolera pazomwe zili pamwambapa. Kuti muchite izi, muyenera kuyeza mulingo wa shuga wamagazi ndi glucometer - chipangizo chopangidwa mwapadera. Mamita masekondi 5 amapereka zotsatira za kusanthula. Zisonyezero za 5.7 mmol / L ndizomwe zili ponseponse, ndipo zotsikirako chizindikiro, kuvutika kwambiri komwe wodwala akukumana nako.

Ntchito yayikulu pakupereka chithandizo choyamba ndikuwonjezera kuchuluka kwa shuga m'magazi. Pali njira ziwiri zochitira izi:

1. Mupatseni munthuyu chakudya china chokoma, monga maswiti, bun, chokoleti chokoleti, tiyi wokoma.
2. Fotokozerani wodwalayo njira yatsopano ya shuga, kuchuluka kwake komwe kumatsimikizika mogwirizana ndi momwe wodwalayo alili.

Poyesa kuchuluka kwa shuga m'magazi, simungathe kupita patali kwambiri ndi mafuta. Shuga owonjezera mwa munthu wathanzi amatha kusungidwa mu glycogen, kenako ndikugwiritsira ntchito mphamvu. Kwa wodwala yemwe ali ndi matenda ashuga, madipoziti amenewo amadzaza ndi kuchepa kwa minofu komanso kufooka kwa thupi.

Ngati mankhwalawa ali ndi insulin yambiri, makamaka yanthawi yochepa, thandizo loyenerera liyenera kuperekedwa nthawi yomweyo. Ndiosavuta kwambiri: wodwalayo ayenera kumwa tiyi wokoma, kudya maswiti, supuni ya supuni kapena shuga. Ngati vuto lakelo silikuyenda bwino mkati mwa mphindi 3-5, chakudya chomwe chimakhala ndi zovuta zam'mimba zimayenera kubwerezedwa.

Zovuta zotheka

Zotsatira zoyipa kwambiri za kuchuluka kwa insulin ndi chikomokere mu ubongo, pomwe ubongo umatha kupezeka, womwe ungapweteketse ziwalo zaubongo komanso kuwonongeka kwa ubongo.

• Kusintha kwa chikhalidwe, kudzitsitsa kwa umunthu,
• kusokera mukulitsa kwa luntha kwa ana,
• kusokonezeka kwa ntchito zapamwamba za ubongo (izi ndi monga kukumbukira, kusamalira, kuganiza, ndi zina),
• chitukuko cha matenda ashuga encephalopathy okalamba.

Matenda a hypoglycemia popanda chitukuko cha chikomokere zimawonongeranso zochita za ubongo.

Hypoglycemic coma mu okalamba omwe ali ndi mbiri ya ischemia ndi matenda amtima amawonjezera chiopsezo cha kugwidwa ndi matenda a mtima, chifukwa chake ndikofunikira kuyesedwa pambuyo poyesa kuti mupeze kuphwanya.

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.

Moyo wopanda zizolowezi zoipa ndiye njira yabwino yopewera

M'malo mwake, matenda ngati a shuga sakhala osachiritsika. Nthawi zina, kusintha kwa wodwalayo kumawonedwa. Muzochitika kuti nthawi zonse amayang'aniridwa ndi madokotala.

Koma moyenera, ngakhale kuwunika shuga pafupipafupi, matendawa amapita patsogolo ndikubweretsa chotupa cha khansa kapena kunenepa kwambiri, kufupika mtima komanso kugunda kwa mtima.

Ndikofunika kuyenda koyenda pafupipafupi, kuteteza dongosolo lanu lamanjenje kuti musapanikizike kwambiri mothandizidwa ndi zochitika zolimbitsa thupi komanso kusangalala ndi moyo. Zakudya zopatsa thanzi, zopanda mafuta ochulukirapo, popanda kudya mwachangu zidzakulitsa moyo wanu ndikupulumutsani ku matenda ambiri. Osati kokha kuchokera kuphwanya kwamankhwala a insulin.

Chakudya cha odwala matenda ashuga

Maziko a shuga ndi zakudya. Zimatengera kuchuluka kwa insulin. Ngati insulini yamagazi ikwezedwa, zotsatirazi ziyenera kutsatiridwa.

1. Zinthu zothandiza mkaka, koma zopanda mafuta.
2. Mphete Zonse.
3. Nsomba zamafuta ochepa.
4. Mazira owiritsa, osaposa 3 ma PC. kwa masiku 7.
5. Nyama iyenera kutayidwa, makamaka mafuta a nkhumba ambiri.

M'pofunika kudya munthawi yovomerezeka. Kenako thupi pakapita nthawi limatulutsa michere yonse yofunikira yokumba m'mimba.

Ndikofunikanso kuti zigawozo ndizochepa, koma muyenera kudya kasanu kapena kasanu ndi kamodzi patsiku.

Tikudziwa kuti insulini imawonjezera shuga m'magazi, motero kwa iwo omwe ali ndi matenda a shuga omwe amadalira insulin, zakudya zake zimakhala zowumitsa. Pazakudya zotere, ma calories onse ayenera kuwerengeredwa mosamalitsa kuti insulini ikhale yokwanira kusintha molekyu iliyonse ya sucrose kukhala mphamvu.

Nthawi zina amakumana ndi kuti majakisoni a insulin (mahomoni a kapamba) samathandiza kubwezeretsa kuchuluka kwa shuga m'magazi.

Chifukwa chake, odwala matenda ashuga ambiri amakhala ndi nkhawa ngati shuga singachepetse jakisoni wa insulin.

Zifukwa ndi zoyenera kuchita ngati izi zitha kukhazikitsidwa ndi katswiri. Kuphatikiza apo, muyenera kulabadira kulemera kwa thupi, komanso kuwerenganso bwinobwino zakudya, m'malo mokomera chakudya, chomwe chingapewe kulumpha kwa glucose mu plasma.

Zomwe zimayambitsa izi zimatha kukhala kukana kwa mahomoni. Kupezeka kwa Somoji syndrome, zolakwika zosankhidwa molakwika pa - zonsezi zimatha kukhala chifukwa cha insulin.

Malamulo okhathamira bwino:

1. Onetsetsani kuti muli ndi thupi lolemera kwambiri, pewani kunjenjemera kosafunikira.
2. pakuchepetsa kudya zamafuta ndi mafuta.
3. chilengedwe. Amathanso kuwonjezera shuga mthupi.
4. Khalani ndi moyo wokangalika ndipo.

Nthawi zina, mankhwala a insulin samathandiza kuchepetsa shuga.

Zomwe zimapangitsa kuchepa kwa jakisoni sikungokhala mu kulondola kwa Mlingo wosankhidwa, komanso kutengera njira yoyendetsera zinthu.

Zinthu zazikuluzikulu ndi zoyambitsa zomwe zingayambitse kuchepa kwa mphamvu ya mahomoni a kapamba omwe amachokera:

1. Kulephera kutsatira malamulo osungira mankhwalawa. Makamaka ngati insulin inali m'malo otentha kwambiri kapena kutentha kwambiri.
2. Kugwiritsa ntchito mankhwala omwe atha.
3. Kuphatikiza mitundu iwiri yosiyanasiyana ya mankhwala mu syringe imodzi. Izi zimatha kudzetsa kusayenerera koyenera kuchokera ku mahomoni oyambitsidwa.
4. Kuwonongeka kwa khungu ndi ethyl mowa pamaso mwachindunji mankhwala. Njira yothirira mowa imapangitsa insulini.
5. Ngati mukulowetsa jakisoni pakhungu, koma kulowa mu minofu, ndiye kuti momwe thupi limaperekera mankhwalawa lingakhale losadalilika. Pambuyo pake, munthu amatha kusinthasintha m'magawo a shuga: amatha kuchepa komanso kuchuluka.
6. Ngati nthawi ya makonzedwe a mahomoni oyambira sanawonedwe, makamaka musanadye chakudya, mphamvu ya mankhwala imatha kugwa.

Pali zinthu zambiri komanso malamulo omwe angathandize kupangira jakisoni wa insulin. Madokotala amalimbikitsa kugwirira ntchito jakisoni pambuyo pakukonzekera kwa masekondi khumi kuti mankhwalawo asatuluke. Komanso, nthawi ya jakisoni iyenera kuyang'aniridwa mosamalitsa.

Mukuchita izi, ndikofunikira kuwonetsetsa kuti palibe mpweya womwe umalowa mu syringe.

Kuphwanya kosungika kwa mankhwalawa

Opanga nthawi zonse amauza ogula zawo za njira zosungira insulin ndi moyo wa alumali. Ngati muwanyalanyaza, ndiye kuti mutha kukumana ndi mavuto akulu.

Mahomoni opanga pancreas nthawi zonse amagulidwa ndi malire a miyezi ingapo.

Izi ndichifukwa chakufunika kosagwiritsa ntchito mankhwalawa malinga ndi dongosolo lomwe likhazikitsidwa ndi katswiri.

Kenako, mtundu wa mankhwalawo ukayamba kuzimiririka mchidebe kapena syringe, utha kusintha m'malo mwachangu. Zifukwa izi zitha kukhala izi:

1. Kutha kwa mankhwalawa. Zawonetsedwa pabokosi.
2. Kusintha kowoneka mu kusasinthika kwa mankhwalawa mu botolo. Insulin yotereyi sifunikira kugwiritsidwa ntchito, ngakhale moyo wa alumali sunathebe.
3. Kutsitsa zomwe zili mu bokosi. Izi zikuwonetsa kuti mankhwala omwe awonongedwa ayenera kutayidwa.

Malo oyenera kusunga mankhwalawo ndi kutentha kwa madigiri awiri mpaka asanu ndi awiri. Sungani insulini pokhapokha pouma komanso mumdima. Monga mukudziwa, alumali aliyense pakhomo la firiji amakwaniritsa zofunikira izi.

Komanso kuwala kwa dzuwa ndizowopsa kwa mankhwalawo. Mothandizidwa ndi insulin, thupi limayamba kuwola msanga. Pazifukwa izi, ziyenera kutayidwa.

Mukamagwiritsa ntchito ma horoni opera ntchito kapena kuwonongeka - shuga adzakhalabe chimodzimodzi.

Ngati insulin singachepetse shuga, sizithandiza - kukana kwake

Wodwala aliyense yemwe ali ndi matenda ashuga kamodzi amayenera kupezapo mankhwala a insulin. Nthawi zina mutha kukumana ndi terminology yina - metabolic syndrome, yomwe, imatanthawuza chinthu chomwecho: insulini siyimachepetsa shuga, ngakhale njira yoyenera yosankhidwa ndi kutsatira malangizo onse a dokotala.

Kukana kwa insulini kumayamba chifukwa cha zovuta zingapo zaumoyo, zomwe zimapangitsa kuti munthu azidwala matenda ashuga. Nthawi zambiri, zovuta ngati izi zimadzetsa munthu matenda a shuga kapena, mulimonse, zimamuika pachiwopsezo. Matendawa ndi monga:

Mankhwala amafunanso ndalama kwa odwala matenda ashuga. Pali mankhwala anzeru amakono aku Europe, koma samangokhala chete. Kuti.

Kuti mumvetsetse chifukwa chake insulini siyichepetsa shuga, muyenera kumvetsetsa pang'ono momwe limagwirira ntchito zomwe zimachitika chifukwa cha kuyamwa kwa timadzi timeneti. Monga lamulo, kutulutsidwa kwa insulin kofunikira kumafunikira pamene misempha ya magazi ikukwera kwambiri. Katunduyu amakupatsani mwayi kuti muchepetse shuga m'magazi ndikusintha kukhala mphamvu, popanda zomwe zimachitika mthupi kugwira ntchito sizingatheke. Ngati munthu akukana, madipatimenti oyang'anira a thupi samawona mankhwalawo ndipo alibe mphamvu yake mwachindunji: mwanjira ina, sizithandiza kuchotsa shuga m'magazi ndikusintha shuga kukhala mphamvu. Popeza insulini yosakhudzidwa imadziunjikira m'magazi, wodwala wokhala ndi kukana amapeza mavuto awiri nthawi imodzi: shuga yayikulu ya magazi ndi hyperinsulinization ya thupi.

Ngati insulini siyithandiza, ndipo, ngakhale kusinthidwa kwakanthawi kwamankhwala, sikuchepetsa shuga, dokotala angakayikire kukana. Pofuna kutsimikizira kuti wapezeka kuti ali ndi vutoli, zizindikiro ndi mikhalidwe yotsatirayi ilinso:

• Kusala kudya magazi
• Kupanikizika kowonjezereka (ngakhale pakadali pano sikunakhazikitsidwe bwino chifukwa chake mahomoni samatsitsa glucose ndendende ndi matenda oopsa),
• Kunenepa kwambiri, makamaka mafuta oyika m'chiuno,
• Mapuloteni mumkodzo. Sikuti nthawi zonse kumakhala umboni wotsutsa, koma nthawi zambiri, ngati pali mavuto a impso, insulin yotsika sikuchepetsa kuchuluka kwa glucose pazomwe mukufuna.

Ndinadwala matenda ashuga kwa zaka 31. Tsopano ali wathanzi. Koma, makapisozi awa ndi osatheka ndi anthu wamba, safuna kugulitsa mankhwala, sizopindulitsa kwa iwo.

Njira yayikulu yotsatirira shuga wamagazi anu ndi kuyesa kwa A1c. Monga mukudziwa, cholinga cha American Diabetes Association ndikupereka zosakwana 7% A1c, ndipo zipatala zambiri tsopano zimakonda kutsika mitengo kwambiri: 6.5 kapena 6%. Ngati mukulephera kuchepetsa shuga, nayi malangizo.

Bwerera kumayambiriro komwe (inde, kachiwiri). Ngati mukunenepa kwambiri, kuchepa thupi ndiye chizindikiro chokwanira cha kuchepa kwamphamvu kwa hemoglobin A1c. Kaya ndinu onenepa kwambiri kapena ayi, mfundo zomwezo ndizothandizanso pakuyang'anira shuga. Ngati chakudyacho chimangokhala zamasamba, ndiye kuti, simumadya mafuta a nyama. Ndipo ngati munasiya mafuta azamasamba, ndiye kuti simukulemera konse. Ndi masinthidwe opatsa thanzi awa, mumawotcha mafuta mkati mwa minofu yanu. Monga momwe mudawonera m'mutu 2, ndizomwe zimapangitsa kuti insulin ikane.

Phatikizaponso zakudya zopatsa thanzi. Anthu ambiri mopanda malire amapewa zakudya zokhazikika. Amanenanso kuti nyemba, mphodza, pasitala, mbatata kapena malema zimawonjezera shuga. Zachidziwikire, mukamayeza shuga mutatha kudya, mawerengedwa amakula. Komabe, ichi sindiye chifukwa chosiya zakudya zamafuta ndi kubwerera ku zakudya zamafuta kapena zama protein. Chifukwa chake.

Mafuta a nsomba ndi mbalame amalepheretsa kuyesa kuchepa. Zimasokonezeranso insulin kukana. Nayi zochitika.

Munthu amamva kuti "zakudya zopatsa mphamvu sizabwino," kapena amawona kuti shuga wamagazi amawonjezeka atangodya mpunga kapena masamba omwe ali ndi wowuma. Akuganiza zosiya zakudya zamagulu m'malo mwa nkhuku ndi nsomba. Chilichonse chimayenda bwino poyamba. Glucose ndi wokhazikika ndipo samachulukitsa kwambiri pambuyo pa chakudya chomwe chimakhala ndi shuga ochepa. "Eya!" Akutero. "Ndazindikira kuti kudya koteroko kumachepetsa shuga!" M'masiku angapo otsatira, wodwalayo adazindikira kuti kuwerenga kwake kwa glucose kudayamba kusintha. Amachulukana pang'onopang'ono, ndipo pakatha sabata kapena awiri kuchuluka kumakhala kwakukulu. "Ndi chiyani?" Tipereka yankho. Pali magawo atatu okha a zopatsa mphamvu: chakudya, mafuta, ndi mapuloteni.Kukana chakudya chamafuta, munthu amadya mafuta, omwe amakonda kuwonjezera kukana kwa insulin, komanso mapuloteni, omwe ali ndi zotsatira zoyipa zambiri. Kumwa mafuta mwachangu sikunawonjezere shuga m'magazi, koma zakudya zamafuta zimakonda kuwonjezera kuchuluka kwamafuta m'maselo a thupi. Zotsatira zake, kukana insulini kumayamba kuchepa. Izi zikutanthauza kuti zakudya zilizonse zomwe adadya pambuyo pake zimapangitsa kuti shuga wamagazi azikula kuposa kale. Chifukwa chake, insulin ikukula tsiku lililonse.

Zakudya zamafuta ziyenera kupewedwa ndipo zakudya zopatsa thanzi zopatsa thanzi ziyenera kudyedwa, kuzisankha zozikidwa pamlo wamagulu a shuga. Mwachitsanzo, nyemba (nyemba, nandolo, ndi mphodza), masamba, zipatso, ndi tirigu wathunthu. Zakudya nthawi zonse zimapangitsa kuchuluka kwa shuga m'magazi, koma posachedwa mudzaona kuti insulivityity ikubwerera pang'onopang'ono.

Pitani kwa dokotala. Chovuta chofala kwambiri cha kuchuluka kwa shuga ndi matenda. Kuzizira, matenda amkodzo, zotupa za pakhungu. Zonsezi zimakonda kukweza glucose wamagazi. Nthawi zina ngakhale kudula pang'ono kapena chifuwa kumayambitsa kulumpha mwamphamvu mmenemo. Pa chithandizo (ngati izi zachitika ndi zonse zofunika), kuchuluka kwa glucose amabwezeretseka. Munthawi imeneyi, adokotala angasankhe mankhwala apadera a shuga.

Penyani misempha yanu. Unasi uliwonse umakweza shuga. Kuyankha kwakuthupi kupsinjika komwe kumakukonzekerani kuti mumenye kapena kuthawa zoopsa kumatha kuchitika ndi mtundu wina uliwonse wowopseza, weniweni kapena woganiza. Kuchulukitsa kuchuluka kwa shuga m'magazi kunali kopindulitsa kwambiri panthawi yomwe titha kukumana ndi olusa komanso mafuko omenyera nkhondo. Magazi owonjezera a shuga adadyetsa magulu akulu a minofu, kuthandiza kuthamanga kapena kumenya. Masiku ano tikuopa zovuta kuntchito, zovuta zachuma komanso mavuto mu maubale. Komabe, momwe zochita zathupi sizinasinthe, kuyankha kukugwirabe ntchito, kuchititsa kukwera kwa shuga m'magazi. Ngati kupsinjika sikukhala motalika - mutha kuzindikira kuti kuchuluka kwa shuga kubwereranso mwachangu mokwanira. Ngati ndi yayitali, chitani masega a yoga, kusinkhasinkha. Vutoli likhoza kukhala lakuya kwambiri, pazinthu zoterezi ndizotheka kukhala ndi nkhawa, kumverera kwa nkhawa yayitali - ndiye musayese kukhala ngwazi.

Masewera olimbitsa thupi. Ngati simukugwiritsidwa ntchito kuti mukhale moyo wokonzekera - ndi nthawi yoti muyambe. Kuchita masewera olimbitsa thupi kumathandizira kuchepetsa shuga.

Nthawi zambiri, kutsatira malangizowa kungakuthandizeni kuti muchepetse shuga. Ngati magazi a shuga akukhalabe okwera, ngakhale mutayesetsa kwambiri, dokotala amafunsira mankhwala ena.

Shuga mellitus ndi matenda omwe amadziwika ndi kuchepa kwa katulutsidwe (kapena kusakhalapo kwathunthu) kwa pancreatic insulin. Kuti athandize kufooka kwa timadzi timeneti m'thupi, madokotala amatipatsa jakisoni wa insulin. Koma mwa odwala ena, kugwiritsa ntchito kwawo sikumapereka zotsatirapo. Nanga bwanji ngati insulini siyithandiza? Ndipo ndi chiyani chomwe chingasokoneze kugwira ntchito kwake?

Kuwerengera koyenera kwa Mlingo wa insulin

Mlingo wa mankhwalawa umasinthidwa malinga ndi kukhalapo kwa matupi a ketone mu mkodzo, kuwerenga kwa plasma glucose musanayambe komanso mukatha kudya m'mawa / madzulo. Ndi Somoji syndrome, mlingo umachepetsedwa ndi magawo awiri.

Kuwerengera kwa insulin kumachitika ndi wodziwa ntchito za endocrinologist komanso wazakudya, poganizira kadyedwe ka wodwalayo.

• Kugwiritsa ntchito mankhwala a nthawi yayitali kapena yapakatikati, yang'anani kuchuluka kwa shuga musanadye komanso m'mawa.
• Ngati matupi a ketone ali mumkodzo, jekeseni owonjezera wa mahomoni a ultrashort.
• Sinthani mlingo wake mukamachita masewera olimbitsa thupi. Kugwira ntchito yolimbitsa thupi, shuga ya minofu imawotchedwa. Chifukwa chake, muyenera kusintha mlingo kuti mupewe kumwa mopitirira muyeso.

Kuwerengera koyenera kwa kuchuluka kwa mankhwalawa kumachokera ku zakudya.Wodwala matenda ashuga ayenera kudya zakudya sabata yonse ndikutsatira pafupipafupi. Ngati mukufuna kuyesa china chatsopano, kudya nkhomaliro kapena nkhomaliro ku malo odyera, mudzasinthanso mlingo.

Ndikotheka kuchita nokha mwakuyesera ndi kulakwitsa, poyang'ana momwe mukumvera, kuchuluka kwa mahomoni omwe adagwiritsidwa ntchito kale.

Popewa kuyambitsa mulingo woyenera wa mankhwalawa, ndikofunikira kugwiritsa ntchito cholembera pomwe pali zilembo zomveka bwino zomwe sizingakuthandizeni kulowa nawo mankhwalawa kuposa momwe akufunira.

Musanayambitse mlingo watsopano, ndikofunikira kumvetsetsa chifukwa chake shuga siyigwa pambuyo pobayira jakisoni. Izi zikuthandizani kupewa bongo ndi zovuta zina.

Chisankho cholakwika

Ngati mulingo wa insulin sunasankhidwe molondola, ndiye kuti shuga yayikulu imakhalabe yolingana.

Asanasankhe kuchuluka kwa mahomoni, aliyense wodwala matenda ashuga ayenera kudziwa zomwe mkate amapezeka. Kugwiritsa ntchito kwake kumathandizira kuwerengera kwa mankhwalawa. Monga mukudziwa, 1 XE = 10 g yamafuta. Mlingo wosiyanasiyana wa mahomoni angafunikire kuti athetse kuchuluka kumeneku.

Kuchuluka kwa mankhwalawa kuyenera kusankhidwa poganizira nthawi ndi chakudya chomwe mumadya, popeza kuchuluka kwa zochita za thupi panthawi zosiyanasiyana masana ndi usiku ndizosiyana kwambiri. Komanso, chinsinsi cha pancreatic chimachitika m'njira zosiyanasiyana.

Musaiwale kuti m'mawa pa 1 XE magawo awiri a insulin amafunikira. Pa nkhomaliro - chimodzi, ndipo madzulo - gawo limodzi ndi theka la mankhwala.

Kuti muwerengere molondola mlingo wa mahomoni osankha pang'ono, muyenera kutsatira izi:

1. Mukamawerengera kuchuluka kwa insulini, muyenera kuganizira zama calories omwe amagwiritsidwa ntchito patsiku.
2. Tsiku lonse, kuchuluka kwa chakudya chamafuta sikuyenera kupitirira 60% ya zakudya zonse.
3. Mukamadya 1 g yamafuta, thupi limatulutsa 4 kcal.
4. Kuchuluka kwa mankhwalawa kumasankhidwa potengera kulemera.
5. Choyamba, muyenera kusankha mtundu wa insulin yochepa, kenako pokhapokha - yayitali.

Gulu la insulin

Bovine, nkhumba, ndi insulin yaumwini imabisidwa, kutengera magawo awo. Mitundu iwiri yoyambirira sigwiritsidwa ntchito masiku ano. Chachitatu, makamaka chopezeka pogwiritsa ntchito matekinoloje amtundu, ndikusankha koyamba kwa insulin.

Malinga ndi kutalika kwa kuchitapo, pali:

• IUD - owonjezera omwe amagwira ntchito mwachidule,
• ICD - ma insulin osakhalitsa,
• ISD - mankhwala a nthawi yayitali pochita,
• IDD - kuchitapo kanthu
• ma insulin ophatikizika (amakhala ndi insulini yamaudindo osiyanasiyana).

Mfundo zoyenera kuchita ndi insulin ndi zotsatira zake

Insulin ndi mahomoni a polypeptide. Nthawi zambiri, mu β-maselo a kapamba amene amayambira amapangika - ma proinsulin, omwe C-peptide imayikidwa ndikupanga insulin. Ndi kuwonjezeka kwa shuga wamagazi, kukwiya kwa mitsempha ya vagus, komanso mothandizidwa ndi zinthu zina zingapo, njira zomwe zimatulutsira insulini zimayambitsidwa.

Mwa kumangiriza ku cholandirira pa membrane wa selo lomwe likutsikira, timadzi timene timayamba kugwira ntchito, ndikuwonetsa mphamvu zake:

• kutsika kwa shuga m'magazi (kumapangitsa kuti mayamwidwe azikhala ndi minofu, kumalepheretsa mapangidwe ake mkati mwa thupi kuzinthu zina),
• amachititsa kaphatikizidwe ka glycogen,
• amalepheretsa mapangidwe a matupi a ketone,
• amalepheretsa mapangidwe a shuga kuchokera ku mankhwala osagwiritsa ntchito chakudya,
• activates mapangidwe otsika kwambiri osalimba lipoproteins ndi triglycerides,
• imayambitsa kapangidwe ka mapuloteni osiyanasiyana,
• imathandizira kupanga glycogen, yomwe imagwiritsa ntchito mphamvu zamphamvu zathupi,
• amalepheretsa kuwonongeka kwa mafuta, imayambitsa kupanga kwa mafuta acids kuchokera ku chakudya.

Momwe insulin yakunja imachitikira mthupi

Njira yayikulu yoyendetsera insulin ndi yodutsa, koma pachitika mwadzidzidzi, kuti mankhwalawa akwaniritsidwe mwachangu, mankhwalawa amatha kulowa mu minofu kapena mtsempha.

Kuchuluka kwa mayamwidwe m'thupi la malo ophatikizira subcutaneous kumadalira malo a jakisoni, mtundu ndi mlingo wa mankhwalawo, kuchuluka kwa kayendedwe ka magazi ndi ntchito ya minofu m'dera la jakisoni, komanso potsatira njira ya jakisoni.

• Ma insulin okhala ndi nthawi yayitali amakhala otengedwa mwachangu komanso mkati mwa mphindi 10-20 pambuyo pa kubayidwa kwa jakisoni. Amagwira kwambiri pambuyo pa mphindi 30-180 (kutengera mankhwala). Zovomerezeka kwa maola 3-5.
• Zotsatira za insulin zazifupi zimachitika mphindi 30-45 pambuyo poyang'anira. Kuchuluka kwa zochitika ndikuchokera ku 1 mpaka maola 4, kutalika kwake ndi maola 5-8.
• Kutalika kwa insulin kumatenga pang'onopang'ono kuchokera m'malo a jakisoni ndikupereka kuchepa kwa shuga m'magawo awiri pambuyo pa jekeseni wa subcutaneous. Kuchuluka kwa zomwe zalembedwa mkati mwa maola 4-12, kuchuluka kwa mankhwalawa ndi masiku 0.5-1.
• Insulin yokhala ndi nthawi yayitali imayamba kugwira ntchito pambuyo pa maola a 1-6 pambuyo pothandizidwa ndi subcutaneous, imachepetsa shuga chimodzimodzi - kuchuluka kwa mankhwalawa ambiri sikufotokozeredwa, kumatenga maola 24, zomwe zimapangitsa kuti pakhale jekeseni wa mankhwala kamodzi kokha patsiku.

"Khalidwe" la insulin m'thupi pambuyo makonzedwe limakhudzidwanso ndi:

• Mlingo wa mankhwalawa (akachulukirapo, mankhwalawa amayamba kucheperachepera ndipo amatenga nthawi yayitali),
• gawo la thupi lomwe jekeseni adapangira (m'mimba, mayamwidwe ndiwambiri, m'mapewa pang'ono, m'matumbo a ntchafu ngakhale pang'ono),
• njira ya makonzedwe (ndi jekeseni wotsekemera, mankhwalawa amamwetsedwera pang'onopang'ono kuposa momwe amapaka jekeseni minofu, koma amakhala motalikirapo),
• kutentha kwa minofu m'dera loyang'anira (ngati liwonjezereka, kuchuluka kwa mayamwidwe kumawonjezeka),
• lipomas kapena lipodystrophy ya zimakhala (pazomwe zili, werengani pansipa),
• ntchito ya kutikita minofu kapena minofu (njira zoyamwa zimathandizira).

M'mayiko ena, akatswiri amafufuza za insulin pokonzekera njira zowadwalitsira wodwala. Chifukwa chake, ku US mumakhala insulini yothandizira pakhungu. Imayamba kuchita pambuyo pa mphindi 30 (zomwe zikufanana ndi IUD), nsonga ya zochitika imadziwika pambuyo pafupifupi maola awiri, nthawi yake imakhala mpaka maola 8 (omwe ali ofanana ndi ICD).

Zizindikiro zogwiritsidwa ntchito

Mankhwala a insulin angafunike kwa wodwalayo pazinthu zotsatirazi:

• adawonetsa mtundu wa shuga wotchedwa I,
• wapezeka zovuta zilizonse,
• ali ndi vuto la matenda ashuga, hyperosmolar kapena lactic acidosis,
• matenda oopsa a purulent amachitika
• ndi matenda osakhazikika a pachimake, akudwala kwambiri,
• pamaso pamavuto a shuga, makamaka zotupa zam'mimba zomwe zimalepheretsa thupi kugwira ntchito,
• ngati wodwala amamwa mankhwala a hypoglycemic pakamwa, koma mlingo wawo wokwanira, ngakhale kuphatikiza zakudya, samakhala ndi zotsatira zoyenera (kusala shuga m'magazi oposa 8 mmol / l, glycosylated hemoglobin woposa 7.5%),
• pa ngozi ya pachimake yamatsenga (),
• at
• pa kuchitapo kanthu pochita opaleshoni, makamaka, kapamba (kuchotsedwa kwa kapamba),
• ndi kuchepa kwambiri kwamphamvu kwa thupi la wodwalayo.

Mankhwala a insulin

Pali njira ziwiri zopangira insulin mu matenda a shuga:

1. Zachikhalidwe. Chomwe chimagona pakukhazikitsa tsiku lililonse mankhwala a insulini (ofanana) pafupifupi nthawi zambiri (kawirikawiri 1-2). Zosakanikirana zakonzedwa zazifupi ndi zapakatikati zimagwiritsidwa ntchito, ndi 2/3 ya mlingo wa tsiku ndi tsiku womwe umaperekedwa m'mawa, ndipo wotsalira asanadye chakudya chamadzulo. Izi siziwathandiza anthu akhama, popeza milingo ya mankhwalawa ndi yokhazikika ndipo wodwala alibe mwayi wowasintha.Amawonetsedwa kwa okalamba, ogona komanso odwala olumala.
2. Zoyambira kwenikweni (zolimba). Chimafanana ndi kutulutsa kwathupi kwa insulin. Zofunikira zake zimaperekedwa ndi jakisoni wam'mawa ndi madzulo a insulin, ndipo wodwalayo amaperekanso insulin yochepa asanadye. Amawerengera yekha mlingo wake womaliza, molingana ndi kuchuluka kwa shuga wamagazi ndi kuchuluka kwa chakudya chamagulu omwe azigwiritsa ntchito. Ndilo chiwembu chomwe chimalepheretsa kukula kwa zovuta za matenda ashuga ndikukulolani kuti muzitha kuthana ndi matendawa. Inde, pamafunikira maphunziro a wodwala asanachitike.

Kufunika kwa insulin tsiku ndi tsiku kumatsimikiziridwa payekha kwa wodwala kutengera gawo la matendawo ndi zina zina.

Insulin imalowetsedwa pogwiritsa ntchito zapadera - insulin - syringes kapena syringe pens. Kuti mankhwalawa akhale othandiza, wodwalayo ayenera kukhala ndi njira yodzibayira, komanso ayenera kumvetsetsa malamulo otsatirawa:

• insulini yocheperako pang'ono iyenera kuperekedwa nthawi yomweyo isanadye (ngati mphindi iyi yasowa, osachedwa kupereka jakisoni ndi chakudya),
• insulin yochepa imaperekedwa kwa theka la ola kapena ola limodzi asanadye,
• Jakisoni wa ICD amachitika mwakuya kwamatumbo am'mimba, ndipo ISD imalowetsa ntchafu kapena matako, minofu imalowetsedwa kwambiri ndi zala, singano imayikidwa pakona pa madigiri 45 kapena 90,
• Kutentha kwa yankho musanakonzere kuyenera kukhala mkati mwa kutentha kwa chipinda,
• musanagwiritse mankhwala mu syringe, muyenera kugwedeza bwino,
• popewa kukula kwa lipodystrophy, jakisoni imachitika tsiku lililonse m'malo atsopano, koma mkati mwake.

Ngati, motsutsana ndi maziko a mankhwalawa a insulin, sizingatheke kulipirira matendawa, mapampu omwe amatchedwa insulin amagwiritsidwa ntchito, omwe amawonetsetsa kuti insulini ikupitirirabe.

Contraindication kuti insulin mankhwala

Contraindication kwa jakisoni wa insulin ndi osakwatiwa. Uwu ndi shuga wochepetsedwa wamagazi - hypoglycemia, komanso zosakanikirana ndi kukonzekera kwina kwa insulin kapena chilichonse cha zigawo zake.

Insulin yomwe ili mkati mwake imakhala yovuta kwambiri. Kugwiritsa ntchito kwawo sikuloledwa kwa odwala omwe ali ndi mbiri ya ana, komanso matenda ena am'mapapo - emphysema. Kuphatikiza apo, mankhwalawa amaphatikizidwa kwa odwala omwe amasuta m'miyezi isanu ndi umodzi yapitayo.

Zotsatira zoyipa za insulin

Zotsatira zoyipa kwambiri za insulin mankhwala ndi hypoglycemia. Zimachitika ngati wodwala:

• amayambitsa kuchuluka kwa mankhwalawa.
• molakwika kuvulaza insulini (mu minofu, osati mwanjira ina),
• amathamangira chakudya chotsatira kapena kuwononga,
• otsika mafuta
• kuchita masewera olimbitsa thupi osakonzekera,
• amamwa mowa wambiri.

Komanso, wodwalayo amatha kudwala matenda ena, makamaka:

• kunenepa kwambiri (ndi zakudya zosayenera pamaziko a mankhwala a insulin),
• thupi lawo siligwirizana (nthawi zambiri amalembedwa poyambira kukhazikitsa insulin m'thupi - pankhani iyi, ndikofunikira kusamutsa wodwala kupita ku insulin yaumunthu, ngati ziwopsezo zimamuyambitsa, mankhwala sangathe, izi zimathetsedwa pogwiritsa ntchito antihistamines kapena glucocorticosteroids),
• kutupa kwa miyendo yomwe imawoneka yokha kapena kutha yokha (ingachitike m'milungu yoyamba ya mankhwala a insulin chifukwa cha kuchepa kwa thupi lama sodium ion),
• kuwonongeka kwa mawonekedwe (khazikikani mwa odwala ambiri atangoyamba mankhwala a insulin, chifukwa chake ndikusintha kwa kusintha kwa mandala, kupenya kwamtunduwu kumachitika popanda chithandizo mkati mwa masabata 2-3),
• lipodystrophy (atrophy kapena hypertrophy ya subcutaneous mafuta, choyambirira chosinthira cha pathology sichikupezeka konse lero, chachiwiri chimayamba chifukwa cha jakisoni wa insulin tsiku lililonse pamalo omwewo, izi sizongolimbana ndi zodzikongoletsera, zimakhudzanso kuchuluka kwa mankhwalawa (amachepetsa kuchepa kwa mankhwala) ),
• abscesses (sizipezeka kawirikawiri pamene michere ya pyogenic ilowa pansi pakhungu, khungu lomwe limapezeka m'thupi la mankhwalawo liyenera kukhala loyera, koma chithandizo ndi mankhwala opha majeremusi sichifunika.

Ma insulin okhala ndi inshuwaransi amatha kuyambitsa michere ya minyewa ya m'mapapo ndikuwonjezera kuthinikizidwa m'matumbo awo, kuchepetsa kuchuluka kwamapapu, komanso kuyankha kwa chitetezo chathupi kwa insulin (mapangidwe a antibodies kwa iwo).

Kuchita kwa insulin ndi mankhwala ena

Zotsatira za mankhwalawa zidzafotokozedwanso limodzi ndi kagwiritsidwe kake kamodzi ndi gulu la hypoglycemic, antihypertensive mankhwala a gulu la beta-blockers, Mowa.

Kuchepetsa mphamvu ya insulini, kuonjezera mwayi wa kuchuluka kwa ma protein a hyperglycemia glucocorticosteroid.

Ma insulin omwe amapanga nthawi yayifupi ndi awa:

• glulisin (Apidra),
• Aspart (mayina amalonda - NovoRapid Penfill kapena Flexpen),
• lispro (Humalog).

Ma insulin achidule:

• soluble human genetic engineering (Biosulin, Gensulin, Insuman, Actrapid NM, Insuran, Humodar),
• sungunuka wa semisynthetic wa anthu (Brinsulrapi, Humodar P 100, Berlsulin N wabwinobwino U-40 ndi ena).

Insuluta Yapakatikati

• isofan (Berlsulin N Basal U-40, Isofan-Insulin World Cup, Humodar B 100),
• kuyimitsidwa kwa zinc-insulin (Monotard MS, Insulong SPP, Insulin Tape "XO-S").

Malo olakwika a jakisoni

Ngati mankhwalawa sanaperekedwe osati mosinjirira, koma mwamitsempha, ndiye kuti shuga wokwezekayo samakhazikika.

Mpweya mu syringe umachepetsa kuchuluka kwa mankhwala omwe amaperekedwa. Malo ofunikira kwambiri a jakisoni amawonedwa ngati pamimba. Pakupakidwa jekeseni kapena ntchafu, mphamvu ya mankhwalawo imachepetsedwa.

Zoyenera kuchita ngati shuga m'magazi satsika pambuyo pa insulin

Ngakhale mulingo wosankhidwa bwino wa mahomoni amayenera kusintha:

1. Ultra-yochepa-insulin voliyumu malamulo. Kukonzekera kosakwanira kwa mankhwalawa kumatha kuyambitsa mawonekedwe a postprandial hyperglycemia. Kuti muchotse izi, muyenera kuwonjezera kuchuluka kwa mahomoni.
2. Kusintha koyambirira kwa mankhwala a nthawi yayitali kumadalira kuchuluka kwa shuga m'mawa ndi madzulo.
3. Somoji syndrome ikawoneka, ndikofunikira kuti muchepetse muyeso wa insulin yayitali usiku ndi magawo awiri.
4. Ngati urinalysis iwonetsa kukhalapo kwa matupi a ketone mmenemo, muyenera kupanga jakisoni wina wa mahomoni amtundu wa ultrashort.

Konzani mtundu wa mankhwalawa woperekedwa ndikufunika malinga ndi kuchuluka kwa zolimbitsa thupi.

Ndikofunika kukumbukira kuti pophunzira masewera olimbitsa thupi, thupi limawotcha shuga. Chifukwa chake, mkati mwa makalasi, mlingo woyambirira wa insulin uyenera kusinthidwa, apo ayi, osavomerezeka a bongo akhoza kukhala.

Kuti mukhale ndi vuto linalake kuchokera pakugwiritsa ntchito insulin, liyenera kusankhidwa ndi dokotala payekha pazomwe munthu akudziwa zokhudza thanzi la wodwalayo. Dokotala amayenera kuuza wodwalayo za matendawa momveka bwino, malamulo operekera mankhwalawa, kukhala ndi moyo wathanzi komanso zovuta zomwe zingachitike.

Ngati, pambuyo pa jakisoni wa mahomoni a kapamba a kapangidwe kake, mulingo wa shuga amakhalabe wokwera, ndiye kuti ndibwino kufunsa dokotala. Amamvetsera mosamala ndikupereka malangizo othandiza kuti achitenso kanthu.

Somoji syndrome ndi mkhalidwe wa insulin yambiri. Dzina lina la matendawa ndi posthypoglycemic hyperglycemia kapena ricocheted hyperglycemia. Kutengera ndi mayina aposachedwa, titha kumvetsetsa kuti Somoji syndrome imayamba chifukwa cha hypoglycemia, yodziwikiratu komanso yobisika.

Kuti mumveke bwino bwino, ndipereka chitsanzo. Mwachitsanzo, munthu ali ndi shuga wa 11.6 mmol / L, podziwa izi, adadzipangira mlingo wa insulin kuti ayitsitse, koma patapita kanthawi adayamba kumva kufooka kwa hypoglycemia m'njira yofooka.Komabe, sanathe kuletsa izi mwachangu pazifukwa zina. Pakupita nthawi, adayamba kumva bwino, koma pamayezero otsatirawa adapeza kuchuluka kwa glucose a 15.7 mmol / L. Pambuyo pake adaganiziranso zopanga insulin, koma pang'ono.

Popita nthawi, Mlingo wanthawi zonse wa insulin sanachepetse shuga, koma hyperglycemia idalimbikira. Posazindikira zomwe anali kuchita, mwamunayo adayesa pachabe kuti athetse shuga mwa kuwonjezera kuchuluka kwa shuga mokulira. Zotsatira zake, adangokulirakulira, kumva kuti wathedwa mphamvu, kupweteka kwakumutu pafupipafupi kunayamba kumuzunza, adanenepa kwambiri, ndipo anali ndi njala nthawi zonse, sikuti shuga adangotukuka, koma adayamba kuchita zachilendo: idafika kwakukulu masaizi, kenako pazifukwa zosasinthika adagwa.

Ichi ndi chitsanzo chabwino kwambiri cha kukula kwa matenda a Somoji, koma pali zochitika zina, zomwe zimapangitsa kuti zikhale zosiyana. Komabe, onsewa amaphatikizidwa ndi pathogenis imodzi ndi zotulukapo. Matenda a insulin kwambiri amakhala amtundu uliwonse wa matenda ashuga omwe jakisoni wa insulin amagwiritsidwa ntchito ngati chithandizo. Zilibe kanthu kuti mumangogwiritsa ntchito insulin basi. Pakakhala mankhwala osokoneza bongo a basal insulin, amatha kuchitika mwanjira yomweyo, ndipo wodwalayo "adzadabwa" ndi zovuta zam'mawa kwambiri, ndipo madzulo amenewo adzakulitsa mlingo wa basal, poganiza kuti sikokwanira.

Ndi chifukwa chiyani kusachita insulin?

Nthawi zina, mankhwala a insulin samalola kuchepetsa ndi kutsitsa kuchuluka kwa shuga.

Chifukwa chiyani insulin siyitsitsa shuga? Zotsatira zake zimatsimikizira kuti zifukwa sizingokhala mu kulondola kwa Mlingo wosankhidwa, komanso kutengera njira ya jekeseni yokha.

Zomwe zimayambitsa ndi zomwe zimayambitsa osagwiritsa ntchito mankhwalawa:

1. Kulephera kutsatira malamulo osungira a mankhwala, omwe amatha kupezeka ozizira kwambiri kapena kutentha kwambiri, padzuwa. Kutentha kwakukulu kwa insulin kumachokera madigiri 20 mpaka 22.
2. Kugwiritsa ntchito mankhwala omwe atha.
3. Kuphatikiza mitundu iwiri ya insulini mu syringe imodzi kungapangitse kuti mankhwala osokoneza bongo asaperekedwe.
4. Pukutani khungu musanabale ndi ethanol. Tiyenera kudziwa kuti mowa umathandizira kuti muchepetse mavuto a insulin.
5. Ngati insulini idalowetsedwa mu minofu (osatinso khola), momwe thupi limaperekera mankhwala lingasakanikirane. Pankhaniyi, pakhoza kukhala kuchepa kapena kuwonjezeka kwa shuga chifukwa cha jakisoni.
6. Ngati nthawi ya insulin makonzedwe satiwone, makamaka asanadye, mphamvu ya mankhwalawa itha kuchepa.

Tiyenera kudziwa kuti pali miyambo yambiri komanso malamulo omwe angathandize kukhazikitsa bwino. Madotolo amalimbikitsanso kuti muzisamala ndi mfundo zotsatirazi ngati jakisoniyo sangatulutse shuga wambiri:

• Jekeseni iyenera kuchitika pambuyo popereka mankhwalawo kwa masekondi asanu mpaka asanu ndi awiri kuti magazi asatayike.
• Onani mosamala nthawi yomwe mankhwalawo amamwa komanso chakudya chachikulu.

Chisamaliro chikuyenera kuthandizidwa ndikuonetsetsa kuti palibe mpweya womwe umalowa mu syringe.

Mawonekedwe a kukana mankhwala

Nthawi zina ngakhale ndi njira yoyenera yoyendetsera ndikutsatira Mlingo wonse womwe dokotala wakupatsani, insulini siyithandiza ndipo siyotsitsa shuga.

Izi zitha kukhala chiwonetsero chokana chida chachipatala. Mu terminology yamankhwala, dzina la "metabolic syndrome" limagwiritsidwabe ntchito.

Zifukwa zazikuluzikuluzi zimatha kukhala izi:

• kunenepa kwambiri komanso kunenepa kwambiri
• kukula kwa matenda ashuga amitundu iwiri,
• kuthamanga kwa magazi kapena cholesterol,
• zosiyanasiyana za mtima dongosolo,
• kukula kwa polycystic ovary.

Pamaso pa shuga sikuchepetsa chifukwa maselo amthupi sangathe kuchitapo kanthu mothandizidwa ndi mankhwala. Zotsatira zake, thupi limapeza shuga wambiri, pomwe kapamba amawona ngati akusowa insulini. Chifukwa chake, thupi limapanga insulini yambiri kuposa momwe limafunikira.

Zotsatira za kukana kulowa m'thupi zimawonedwa:

• shuga wamagazi ambiri
• kuchuluka kwa insulin.

Zizindikiro zazikulu zomwe zikuwonetsa kukula kwa njirayi zikuwonetsedwa motere:

• pali kuchuluka kwa shuga m'magazi pamimba yopanda kanthu,
• kuthamanga kwa magazi kumakhala kosakhazikika,
• pali kuchepa kwa cholesterol "yabwino" yokhala ndi chiwopsezo chakuthwa kwambiri mpaka kufika pamlingo woipa "woipa",
• mavuto ndi matenda a ziwalo zamtima zimatha kukhazikika, nthawi zambiri pamakhala kuchepa kwamankhwala am'mimba, komwe kumayambitsa matenda a atherosclerosis ndi mapangidwe a magazi,
• kunenepa
• pali zovuta ndi impso, monga zimatsimikiziridwa ndi kupezeka kwa mapuloteni mkodzo.

Ngati insulini satulutsa bwino, ndipo shuga wamagazi sayamba kutsika, ndikofunikira kuti mupititse mayeso owonjezera ndikuyesa mayeso owunikira.

Mwina wodwalayo amakhala ndi insulin.

Kodi tanthauzo la chitukuko cha matenda a Syomozhdi ndi ati?

Chizindikiro chimodzi cha mankhwala osokoneza bongo osokoneza bongo ndikuwonekera kwa matenda a Somogy. Vutoli limayamba chifukwa cha kufupika kwa shuga m'magazi.

Zizindikiro zazikuluzikulu zodwala zomwe zimapangitsa wodwala kukhala ndi insulin mopitirira muyeso ndi motere:

• masana pali kulumpha kowopsa m'magulu a shuga, omwe amatha kufikira kwambiri, kenako kutsikira pansi pazisonyezo wamba,
• kukulitsa kwa pafupipafupi hypoglycemia, munthawi imodzimodzi, kuukira kwadzidzidzi komanso koonekeratu kungawoneke,
• urinalysis ikuwonetsa mawonekedwe a matupi a ketone,
• wodwalayo amakhala akumagona ndi njala, ndipo thupi limakulirakulira,
• Matendawa akuwonjezeka ngati mukulitsa kuchuluka kwa insulin, ndipo mukulira ngati muleka kuwonjezera mlingo wake.
• nthawi ya chimfine, pali kusintha kwamasamba amwazi, izi zimafotokozedwa ndikuti nthawi yamatendawa thupi limafunikira kuchuluka kwa insulini.

Monga lamulo, wodwala aliyense yemwe ali ndi shuga wambiri m'magazi amayamba kuchuluka kwa insulini yoyendetsedwa. Potere, musanachite izi, ndikulimbikitsidwa kupenda zomwe zikuchitika ndikuwonetsetsa kuchuluka ndi chakudya chomwe chimatengedwa, kupezeka kwa kupumula koyenera komanso kugona, kuchita zolimbitsa thupi mokwanira.

Kwa anthu omwe misempha ya glucose imakhala pamilingo yokwera kwa nthawi yayitali, ndipo mutatha kudya pang'ono, palibe chifukwa chosungira vutoli ndi insulin. Kupatula apo, pali zochitika pamene mitengo yayikulu imadziwika ndi thupi laumunthu monga momwe limakhalira, ndikuchepetsa kwawo, kumatha kuyambitsa chitukuko cha matenda a Somoji.

Kuti muwonetsetse kuti ndi mankhwala osokoneza bongo a insulin omwe amapezeka m'thupi, ndikofunikira kuchita zingapo zokhudzana ndi kuzindikira. Wodwala amayenera kukhala ndi miyezo ya shuga usiku panthawi inayake. Kuyambika kwa njirayi kumalimbikitsidwa kuti ichitike pafupifupi 9 koloko madzulo, kenako ndikubwereza kwa maola atatu aliwonse.

Monga momwe machitidwe amasonyezera, hypoglycemia imachitika pafupifupi ola lachiwiri kapena lachitatu lausiku. Tiyeneranso kudziwa kuti ndi nthawi imeneyi yomwe thupi limafunikira insulini pang'ono, ndipo nthawi yomweyo mphamvu zambiri zimachokera ku makonzedwe a mankhwala a nthawi yayitali (ngati jakisoni amapangidwa nthawi ya 8 kapena 9 madzulo).

Matenda a Somoji amadziwika ndi kukhazikika kwa shuga kumayambiriro kwa usiku ndikuchepa kwake pang'onopang'ono kwa maola awiri kapena atatu ndi kulumpha lakuthwa pafupi ndi m'mawa. Kuti mudziwe mlingo woyenera, muyenera kufunsa dokotala ndikutsatira malangizo ake onse.

Pokhapokha ngati izi, vuto loti shuga wa magazi sanachepetse limatha.