Mankhwala a insulin a shuga kwa ana: mawonekedwe ndi mawonekedwe a kayendetsedwe ka timadzi

Kutumiza ntchito yanu yabwino pamaziko azidziwitso ndikosavuta. Gwiritsani ntchito mawonekedwe pansipa

Ophunzira, ophunzira omaliza, asayansi achichepere omwe amagwiritsa ntchito chidziwitso m'maphunziro awo ndi ntchito adzayamika kwambiri.

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Anthu mamiliyoni ambiri padziko lapansi ali ndi matenda oopsa - matenda ashuga. Mwa odwala omwe ali ndi mtundu woyamba, odwala ambiri ndi ana ndi achinyamata. Chithandizo chachikulu cha matenda a shuga ndikuwongolera insulin - mahomoni a kapamba. Koma mwamwambo mtundu wamatenda okhudzana ndi msinkhu - mtundu 2 matenda a shuga tsopano ali ocheperako.

Kwa nthawi yoyamba, kukonzekera kwa insulin kunapezeka mu labotale ya Profesa MacLeod ku Toronto mu 1921. Pa Januware 14, 1922 ku Toronto, pambuyo poyesera koyambirira kochitidwa pa agalu opanikizika, kuyesedwa kunachitika kuti athandize odwala omwe ali ndi matenda a shuga mothandizidwa ndi "kukonzekera insulin".

Ku Russia, kukonzekera insulin kunagwiritsidwa ntchito ngati matenda ashuga mu 1926.

Zoyipa zamakonzedwe oyamba a insulin anali yochepa kanthawi kochepa komanso pafupipafupi pamafungo omwe thupi lawo limakumana nawo chifukwa chosakwanira kudziyeretsa. Crystallization idapangitsa kuonjezera kuyera kwa insulin yosungunuka ndikupangitsa kuti ikhale yoyenera kusintha kosiyanasiyana. Posakhalitsa, mankhwala omwe amakhala ndi nthawi yayitali atapangidwa adapangidwa - protamine-zinc-insulin, ndipo pambuyo pake NPH insulin (yosagwirizana ndi ndende ya Hagedorn), kapena isofan-insulin. Popeza mphamvu za antigenic za protamine, matepi a insulin adapangidwanso omwe ali ndi zinc muzosiyanasiyana, zomwe zimayang'anira nthawi ya insulin.

Cholinga chophunzirira: wodwala wodwala matenda a shuga,

Phunziro lakafukufuku: insulin,

Cholinga ndikuphunzira zomwe zimapezeka mu insulin,

Hypothesis - titaphunzira mabuku ofunikira, titha kuganiza kuti chithandizo cha insulini ndichinyengo chofunikira chomwe chimapulumutsa miyoyo ya odwala matenda a shuga,

1. Kuphunzira mabuku apadera azachipatala okhudzana ndi matenda a shuga ndi insulin.

2. Ganizirani mitundu ya insulini, malamulo osungira,

3. Perekani lingaliro la mankhwala a insulin ndipo muganizire za insulin.

4. Kuti muwerenge zovuta zomwe zimachitika mutabayidwa jakisoni.

5. Kudziwa udindo wa namwino pantchito yophunzitsa odwala omwe ali ndi matenda ashuga.

MUTU 1. KUGANIZIRA KWA ZINSINSI

1.1 Mitundu ya Insulin

Mankhwala a insulin ndi gawo lovuta lomwe limakwaniritsa kuphwanya thupi m'thupi la metabolism, njira zoterezi ndikubweretsa kukonzekera kwa insulin, nthawi zambiri mwa jakisoni.

1. Insulini mu ng'ombe - zochokera ku zikondamoyo. Insulin iyi ndi yosiyana kwambiri ndi anthu. Thupi lawo siligwirizana nthawi zambiri limachitika.

2. Nkhumba ya nkhumba - yochokera ku kapamba wa nkhumba. Amasiyana ndi munthu mu amino acid imodzi. Swine insulin nthawi zambiri amayambitsa chifuwa.

3. Anthu - kapena m'malo, fanizo la insulin ya anthu komanso ma insulin. Ma insuliniwa amapezeka m'njira ziwiri: mwa njira yoyamba, insulin yaumunthu imapangidwa ndi E. coli, ndipo njira yachiwiri, insulin yaumunthu imapezeka kuchokera ku insulin ya insulin ndikusintha amino acid.

Kutengera ndi chiyambi, nthawi ndi nsapato zake, mitundu inayi yayikulu ya insulin imasiyanitsidwa ndi nthawi yochitapo kanthu:

1. Kuchita mwachangu

Kuchita mwachangu insulini (insulini yosavuta) kumawoneka ngati madzi osalala, osalala. Insulin yamtunduwu imayamba kuchita pang'onopang'ono, kotero kuti jekeseni itatha kutenga mphindi 20 mpaka 40 musanadye. Ndi nthawi imeneyi yomwe ndiyofunikira kotero kuti nsonga za insulin ndi kuwonjezeka kwa shuga m'magazi. Kumbukirani kuti gawo lina la chakudya limafuna kuchuluka kwa insulin. Chifukwa chake, hypoglycemia (shuga m'magazi ochepa) imatha kuyambitsa chakudya chosakwanira, ndipo kuchuluka kwake, M'malo mwake, kumabweretsa hyperglycemia (shuga wowonjezera).

Popeza nthawi yochita insulin kuchokera pagulu losavuta ndi yotalikirapo kuposa kuchuluka kwa shuga m'magazi komwe kumachitika mutatha kudya, mankhwalawa amayenera kumwedwa patatha maola 2-4 jekeseni. Pakadali pano, nsonga ya insulini imachitika, ndipo chakudya chowonjezera chimalepheretsa hypoglycemia.

Ma insulini osavuta amaphatikizapo mankhwala:

2. Zochita za Ultrashort,

Pali gulu lina la ma insulin omwe amapanga mwansanga nthawi yomweyo kuwonjezeka kwa shuga m'magazi ndipo amalowetsedwa chakudya chikamamwa. Popeza ali ndi chizolowezi chomayambira mwachangu, ayenera kupatsidwa chakudya musanadye. Ngati sikungatheke kuwerengera kuchuluka kwa insulini pasadakhale poyerekeza kuchuluka kwa chakudya, jakisoni itha kupangidwa mutangodya. Popeza nthawi yayitali ya ultrashort ikulowerera ikugwirizana ndi nthawi yowonjezera ya shuga m'magazi omwe amayamba chifukwa cha zakudya, zokhwasula-khwasula zimatha kusiyidwa ndi zakudya. Gululi limaphatikizapo insulin:

3. Zochita zapakati,

Ma insulidi apakatikati (nthawi yayitali) amapangidwa kuti azikhala ndi shuga m'thupi mkati mwa tsiku pakati pa chakudya ndi nthawi yopuma usiku. Kukhazikika kwa zochita zawo ndi maora 1-3 pambuyo pa kubayidwa. Nthawi yonse yochitayo ikuchokera kwa maola 10 mpaka 14, motero, kwa kuchuluka kwa insulin masana, muyenera kuchita jakisoni 2 - nthawi zambiri m'mawa, m'mawa asanadye chakudya chamadzulo, komanso madzulo, musanadye chakudya chamadzulo, komanso nthawi yachakudya cham'mawa - musanayambe kugona. Kutalika kwa gawo la gulu la insulin ndilofanana ndi mlingo wawo. Peak zochita zimachitika pambuyo pafupifupi maola 6-8. Gululi limayimiridwa ndi mankhwala:

Mulinso zinthu zapadera zomwe zimalepheretsa kuyamwa kwa insulin, nthawi zambiri - njira ya zinc. Chifukwa chake, ma insulin awa amawoneka ngati madzi osungunuka, ndipo asanalowe, jakisoni, kuyimitsidwa kuyenera kusakanikirana bwino kuti insulin ikhale yunifolomu.

4. Kuchita zinthu motalika.

Ma insulin omwe amakhala nthawi yayitali (osakhalitsa) sakhala ndi matchulidwe ambiri ndipo ndi fanizo la insulin lotulutsidwa ndi kapamba wabwino, komwe kumatsimikizira kutalika kwa vutoli. Chiyambire cha kuchitidwa kwa insulin kotero mumakhala mu maola 1-2 kuyambira nthawi yoyang'anira. Amagwiritsidwa ntchito, monga lamulo, kamodzi kapena kawiri pa tsiku, kutengera malangizo a dokotala. Ma insulini awa amawoneka ngati madzi oyera.

Gululi limaphatikizapo:

Lantus amadziwika ndi kutalika kwa maola 24, motero ndikwanira 1 jakisoni wa mankhwalawa patsiku. Levemir amachita kwa maola 17-20, ndipo tsiku lililonse mlingo wake umagawidwa pawiri. Pazamankhwala ndi pharmacology, gulu la ma insulin ophatikizika limasiyanitsidwanso. Izi zikuphatikiza:

1.2 Malamulo osungira insulin

matenda a shuga a insulin

Ndi kusungidwa koyenera, insulin ikukonzekera kwathunthu kusunga katundu wawo mpaka kumapeto kwa tsiku lotha kutulutsidwa. Botolo losatsimikizika limasungidwa pamalo amdima pamtunda wa + 2-8 C, makamaka pakhomo la firiji, koma mulibe mufiriji. Osagwiritsa ntchito insulin yozizira! Ngakhale popanda firiji, insulini imatha kusungabe katundu wake, chifukwa kutentha kwa chipinda (+18 - 20 C) sikutaya ntchito.Ndipo tsiku lotha litatha, koma, komanso m'botolo lotseguka, kusungirako kwa insulin kumaloledwa mpaka mwezi umodzi. Kumbali ina, paulendo wautali chilimwe kupita kumadera otentha, ndibwino kusungira insulin mu thermos yotsegula lalikulu. Komanso, mankhwalawa amayenera kupangidwanso katatu patsiku ndi madzi ozizira. Mutha kukulunga botolo la mankhwala ndi nsalu yonyowa pokonza yomwe imanyowetsedwa ndimadzi nthawi ndi nthawi. Osasiya insulin pafupi ndi ma radiators kapena stoo. Ndipo koposa pamenepo, insulini siyenera kusungidwa padzuwa mwachindunji, chifukwa ntchito yake imachepera maulendo makumi angapo.

Insulin imawonedwa ngati yowonongeka ngati:

1. Yakhala ikuwumitsidwa kapena kuzizira,

2.Changa mtundu wake (motsogozedwa ndi kuwala kwa dzuwa, insulin imakhala ndi utoto wamtundu)

3. Njira yothetsayi idakhala yopanda mitambo kapena ngati mpweya udawonekeramo, ngati mapale adatulukira mu insulin yochepa,

4. Ngati, pamene ikuyambitsa, kuyimitsidwa kwa insulin sikupanga chisakanizo chopanda pake ndi zotupa (zotupa) kukhalabe m'm seo.

1.3 Njira zoyendetsera insulin

I. Malamulo a kawiri ka insulin (zosakanikirana za insulin). Zothandiza kwa ophunzira komanso odwala omwe akugwira ntchito. M'mawa ndi madzulo (musanadye chakudya cham'mawa komanso chamadzulo), ma insulin omwe amagwira ntchito mwachidule amathandizidwa kuphatikiza ndi ma insulin apakati kapena achitali. Pankhaniyi, 2/3 ya okwanira tsiku lililonse mankhwala amaperekedwa m'mawa ndipo 1/3 madzulo, 1/3 ya mlingo uliwonse wowerengeka amakhala ndi insulin yochepa, ndipo 2/3 imakulitsidwa, mlingo wa tsiku ndi tsiku umawerengeredwa pamaziko a 0.7 PIECES, ndi matenda oyamba omwe adapezeka - 0.5 PIECES) pa 1 kg ya theoretical weight.

II. Ndi jakisoni wa insulin patsiku.

Jekeseni wachiwiri wa insulin ya nthawi yayitali yochita kuchokera chakudya chamadzulo imasamutsidwa usiku (maola 21 kapena 22), komanso kuthamanga kwa glycemia (6 - 8 m'mawa).

III. Kwambiri zofunika - mankhwala a bolus amadziwika kuti ndiabwino kwambiri. Pankhaniyi, insulin yomwe imatenga nthawi yayitali imaperekedwa musanadye kadzutsa muyezo wofanana ndi 1/3 wa mlingo wa tsiku ndi tsiku, 2/3 ya mlingo wa tsiku ndi tsiku imayendetsedwa m'njira ya insulin yochepa (imagawiridwa asanadye kadzutsa, nkhomaliro ndi chakudya chamadzulo motalikirana ndi 3: 2: 1).

MUTU 2. NJIRA YAKUKHANIRA KWA KUTSOGOLA

2.1 Algorithm pakukhazikitsa insulin pogwiritsa ntchito syringe ndi cholembera

Jekeseni wa insulini (pancreatic mahormone) ndi mankhwala omwe dokotala amatengera ndi matenda a shuga. Mlingo wa insulin amayeza m'zigawo zingapo (UNITS). Pa phukusi liziwonetsa kuchuluka kwa mayunitsi omwe ali mu 1 cm3 ya mankhwalawa. Kukonzekera kwa insulin kumasiyana mu ndende - 40 PISCES mu 1 ml ndi 100 PIECES mu 1 ml.

Pamaso pa kasamalidwe, ndikofunikira kuti muwerenge mosamala zilembo zamkati ndi kulembapo kwa syringe yapadera ya insulin, chifukwa zolakwika za mlingo zingayambitse zovuta zazikulu.

- chilichonse chomwe mukufuna jekeseni,

- syringe ya insulini ndi singano,

- botolo lokhala ndi insulin.

1. Chitani manja, valani magolovesi osalala.

2. Unikaninso mosamala cholembera patsamba la botolo ndi cholembera. Dziwani kuchuluka kwa UNITS ya insulin ya ndende inayake yomwe ili mgawo limodzi la syringe.

3. Konzani chovala chamtundu wa insulin - chizikulunga mosamala m'manja mwanu kuti muchotse mankhwalawo, gwiritsani ntchito kapu ndi choletsa mphira.

4. Jambulani mpweya mu syringe, kuchuluka kwake komwe kungakhale kofanana ndi kuchuluka kwa insulin.

5. Chotsani kapu pachifuwa ndikuchiyika mu vial kudzera pa cork (vial ili patebulo).

6. Kanikizani syringe plunger ndikulowetsa mpweya mu vial, izi zimapangitsa insulini kulowa mosavuta mu syringe.

7. Kwezani botolo mozama ndikulowetsa insulini m'magawo a 2-4 kuposa momwe munaperekera.

8. Kupitiliza kugwirizira syringe ndi botolo molunjika, kukanikiza pang'ono piston, kuchotsa mpweya, kusiya mlingo wokhawo womwe dokotala wakupatsani mu syringe.

9. Chitani jakisoni kawiri ndi mpira wa thonje ndi antiseptic. Pukuta tsamba la jekeseni ndi mpira wowuma.

10. Lowetsani wodwalayo mosapeneka insulin (waukulu Mlingo - intramuscularly), mutayang'ana ngati singano yalowa m'mitsempha yamagazi. Pogwiritsa ntchito chala chanu chamanja komanso nkhonya zanu, pindani khungu.

Ikani singano pamunsi pa khungu pang'onopang'ono mpaka pakhungu kapena madigiri 45. Popanda kumasula ma crease (!), Press sinringe plunger njira yonse. Yembekezani masekondi 10-15, ndiye kuchotsa singano.

11. Gwiritsani ntchito zinthu.

Algorithm pakukhazikitsa insulin pogwiritsa ntchito cholembera:

1. Konzani cholembera.

2. Ngati mukufunikira kulowa mu NPH-insulin, iyenera kusakanikirana bwino (gwiranani ndi dzanja lanu ndi cholembera koloko mpaka mopondera kufikira yankho litasakanikirana ngati mitambo).

3. Musanayambe kumwa, tikulimbikitsidwa kuti mumasule insulin ziwiri mlengalenga ndi jekeseni iliyonse.

4. Pogwiritsa ntchito kuyimba, ikani mlingo wofunikira mu zenera.

5. Pakani malowo pakhungu lomwe mungabayire insulin. Pukutani ndi mowa malo a jakisoni sofunikira. Gwiritsani ntchito chala chanu chamanja ndi dzanja lanu.

6. Ikani singano pamunsi pa khungu pang'onopang'ono mpaka pakhungu kapena madigiri 45. Popanda kumasula ma crease (!), Press sinringe plunger njira yonse.

7. Chotsani singano masekondi angapo mutapatsidwa insulini (mpaka 10 ingathe kuwerengedwa).

2.2 Mavuto pambuyo jakisoni wa insulin

1. Kukana kwa insulin - mkhalidwe womwe umadziwika ndi kuwonjezeka kwa mlingo wa insulin chifukwa chakuchepa kwa mphamvu yake yochepetsera shuga poyankha zofunikira za thupi.

Malinga ndikuvuta, kukana insulini kumagawidwa:

- kuwala (insulin ya 80-120 U / tsiku),

- pafupifupi (mlingo wa insulin mpaka 200 PESCES / tsiku),

- kwambiri (insulin mlingo woposa 200 mayunitsi / tsiku).

Kukana kwa insulini kumatha kukhala kofanana komanso kotheratu.

Kukaniza kwa insulin kumamveka kuti kumatanthawuza kuwonjezeka kwa insulini chifukwa chosakwanira kupeza mankhwala a insulin komanso zakudya. Mlingo wa insulini pamilandu iyi, monga lamulo, sapitilira 100 PIECES / tsiku.

Mtheradi kukana insulini kungakhale chifukwa cha izi:

- kusowa kapena kuchepa kwa chidwi cha zolandilira zama cell a insulin -

- kupanga-maselo a islet mutant (osagwira).

- mawonekedwe a antibodies kuma insulin receptors,

- kuwonongeka kwa chiwindi matenda angapo,

chiwonongeko cha insulin ndi michere ya proteinolytic pakupanga njira iliyonse yopatsirana komanso yotupa,

- kuchuluka kwa mahomoni otsutsana - corticotropin, mahomoni okula, glucogon, etc.,

- kupezeka kwa kunenepa kwambiri kwa thupi (makamaka ndi mtundu wa kunenepa kwambiri (wam'mimba),

- kugwiritsa ntchito insulin yoyenera yoyeretsa,

- kukhalapo kwa thupi lawo siligwirizana.

Pofuna kupewa kukula kwa insulin, ndikofunikira kupatula zakudya zomwe zitha kugwiritsidwa ntchito m'zakudya, kutsatira mosamalitsa kwa odwala pakudya ndi magalimoto, kutsukidwa kwathunthu kwa maziko a matenda.

Zochizira kukana insulini, ndikofunikira kusamutsa wodwala kupita ku regimen yolimbikitsidwa ndi insulin mankhwala omwe ali ndi monocomponent kapena mankhwala osokoneza bongo a anthu. Pachifukwa ichi, mutha kugwiritsa ntchito ma insulin microdosers kapena zida "Biostator" ("Artificial pancreas"). Kuphatikiza apo, gawo la mlingo wa tsiku ndi tsiku limatha kutumikiridwa kudzera m'mitsempha, yomwe imakulolani kuti mumange mwachangu ndikuchepetsa kuchuluka kwa anti-insulin antibodies. Naturalization ya chiwindi ntchito kumathandizanso kuchepa insulin kukana.

Hemosorption, peritoneal dialysis, kukhazikitsidwa kwa Mlingo wocheperako wa glucocorticoids limodzi ndi insulin, kuyikidwa kwa ma immunomodulators angagwiritsidwe ntchito kuti athetse insulin.

2. A ziwengo insulin nthawi zambiri chifukwa cha kupezeka kwa mapuloteni zosayenera ndi kutchulidwa antigenic ntchito pokonzekera insulin. Ndi kuyambitsa monocomponent ndi insulin kukonzekera kwa anthu kuchita, pafupipafupi zovuta zomwe zimachitika mwa odwala omwe amawalandira zachepetsedwa kwambiri.

Pali zochitika zina zakomweko (kwanuko) komanso zowonjezera (zosasinthika) zimasiyana ndi insulin.

Zokhudzana ndi khungu lakudziko pakuwongolera insulin, izi ndizodziwika:

1.Mtundu wokhudzana ndi zomwe zimachitika pokhapokha pakukhazikitsa insulini ndikuwonetseredwa ndi erythema, kuwotcha, kutupa ndi kukhazikika pang'onopang'ono kwa khungu pamalo a jekeseni. Izi zimakulirakulira maola opitawa a 6 ndi kupitirira kwa masiku angapo. Uwu ndi mtundu wofala kwambiri wamomwe thupi limasokoneza poyipa wa insulin.

2. Nthawi zina, ndi insulin yophatikizira insulin, kukulira kwa zomwe zimadziwika kuti anaphylaxis (zochitika za Arthus) ndizotheka, pamene edema ndi hyperemia yayikulu ya khungu limawonekera pakubaya jakisoni pambuyo pa maola 1-8. Popita maola angapo otsatira, kutupa kumawonjezeka, kutupa kumakhala kofinya, khungu pakadali limakhala ndi mtundu wakuda. Kufufuza zakale za zinthu zakale za biopsy kumavumbula kutupa kwamatumbo-hemorrhagic. Ndi mlingo wochepa wa insulin yoyendetsedwa, kusintha kosinthika kumayamba mu maora ochepa, ndipo ndi mlingo waukulu, patatha tsiku limodzi kapena kupitilira, kutsimikizika kumayang'ana necrosis, ndikutsatiridwa. Mtundu uwu wa insulin hypersensitivity ndi wosowa kwambiri.

3. Zochita zam'deralo za mtundu wozengereza zimawonetsedwa maola 6-12 pambuyo pobayira jakisoni ndi erythema, kutupa, kuwotcha ndi kukulitsa khungu pamalo a jekeseni, mpaka kufika patatha maola 24 mpaka 248. Maselo oyambitsidwa ndi ma lymphocyte, ma monocytes ndi macrophages.

Zotsatira zamtundu wamtundu waposachedwa ndi zochitika za Arthus zimayang'aniridwa ndi kusungunuka kwa chitetezo, mwachitsanzo, kuzungulira kwa ma antibodies amakalasi a JgE ndi JgG. Wosachepera mtundu wa hypersensitivity amadziwika ndi gawo lalikulu la enieni omwe amapezeka. Njira zamtunduwu sizimagwirizanitsidwa ndi ma antibodies omwe amayenda m'magazi, koma amalumikizidwa ndi kuyambitsa kwa chitetezo chokwanira cha ma cell.

Zambiri zimatha kufotokozedwa ndi urticaria, Quincke's angioedema, bronchospasm, m'matumbo kukhumudwa, polyarthralgia, thrombocytopenic purpura, eosinophilia, kutupa kwa zamitsempha, komanso m'malo ovuta kwambiri, anaphylactic.

Mu pathogenesis ya chitukuko cha zokhudza zonse ziwengo kuti insulin, udindo wotsogolera ndi otchedwa reagents - kalasi E immunoglobulin antibodies to insulin.

Chithandizo cha matupi awo sagwirizana ndi insulin:

- kusankha chimodzi mwa zigawo za porcine kapena insulin ya anthu,

- Kukhazikitsidwa kwa mankhwala osokoneza bongo (fencarol, diphenhydramine, pipolfen, suprastin, tavegil, clarithin, etc.),

- kukhazikitsidwa kwa hydrocortisone ndi microdoses ya insulin (ochepera 1 mg ya hydrocortisone),

- kukhazikitsidwa kwa prednisone mu milandu yayikulu,

- ngati mavuto am'deralo sakhala kwa nthawi yayitali, ndiye kuti mtima wodziwika umachitika, womwe umakhala ndi jakisoni wotsatira wa insulin, sungunuka mu 1,5 ml ya isotonic sodium chloride solution pakuwonjezera ndende. 0.02 PIECES, 0.04 PIECES, 0 PIERES, 0 PA PESCES, 0 0 PIERES, 1 PIECES) pakadutsa mphindi 30. Ngati zochitika zakumaloko kapena zowonjezera zimachitika chifukwa cha mankhwala omwe amapatsidwa ndi insulin, kuchuluka kwa mahomoni kumatha.

3. Lipodystrophy ndikuphwanya kwachangu kwa lipogenesis ndi lipolysis komwe kumachitika minofu yaying'ono pamalo a jekeseni wa insulin. Lipoatrophy imawonedwa pafupipafupi, ndiye kuti, kuchepa kwamphamvu kwa minyewa yotupa kapena ma fossa, m'mimba mwake momwe nthawi zina imatha kupitilira masentimita 10. Kapangidwe ka minofu yambiri ya mafuta obwera, amakumbukira lipomatosis, sikofala kwenikweni.

Kufunika kofunikira mu pathogenesis ya lipodystrophy imaperekedwa kwa kuvulala kwakanthawi kwa minyewa ndi nthambi za zotumphukira zamitsempha ndi makina, matenthedwe ndi mafiziki. Udindo wina wa pathogenesis wa lipodystrophy umayikidwa pakukula kwa mayankho am'deralo a insulin, ndikuzindikira kuti lipoatrophy imatha kuyang'aniridwa kutali ndi malo a insulin, ndiye kuti njira za autoimmune.

Popewa kukula kwa lipodystrophy, malamulo otsatirawa ayenera kutsatiridwa:

- malo enanso a jekeseni wa insulin pafupipafupi ndi kulowa mkati mwake monga momwe

- jekeseni wotsatira umachitika momwe ungathere kuchokera pa woyamba,

- musanalowetse insulin, makina amayenera kukhala m'manja mwanu kwa mphindi 5 mpaka 10 kuti kutentha kutentha kwa thupi (musayenere kuperekera insulini mutachotsedwa mufiriji!),

- mutatha kuchiritsa khungu ndi mowa, ndikofunikira kudikirira kwakanthawi, kotero kuti chimasuluka kwathunthu kuti chisafike pakhungu.

- kugwiritsa ntchito insulin, gwiritsani ntchito singano zakuthwa zokha,

- pambuyo pa jekeseni, ndikofunikira kupukusa jakisoni wa insulin pang'ono, ndipo ngati ndi kotheka, ikani kutentha.

Chithandizo cha lipodystrophy chimakhala, choyamba, pophunzitsa wodwalayo njira zamankhwala othandizira insulin, ndiye poika mankhwalawa. V.V. Talantov adapereka lingaliro la mankhwalawa kuti atuluke m'mbali ya lipodystrophy, ndiye kuti, kuyambitsa malire a minofu yathanzi ndi lipodystrophy osakaniza-inshuvoine osakaniza: 0,5% yankho la novocaine pamlingo wofanana ndi mankhwalawa a insulin osakanikirana kamodzi ndi kamodzi pa 2-3 cha tsikulo. Zotsatira zake, monga lamulo, zimachitika pakadutsa masabata 2-3 mpaka miyezi 3-4 kuyambira chiyambi cha chithandizo.

MUTU 3. CHITSANZO CHA MEDICAL SKSTRA POPHUNZITSIRA Odwala OKHAZIKITSA MALAMULO A ZOPHUNZITSA

Udindo wa namwino pophunzitsa odwala ndi wofunikira. Posachedwa, sukulu za odwala matenda ashuga zakhala zikugwiritsidwa ntchito kwambiri. Cholinga chachikulu cha sukulu ndikuphunzitsa odwala omwe ali ndi matenda osokoneza bongo mwa njira yodziletsa, kusintha mankhwalawo kuti azikhala mokhazikika, komanso kupewa zovuta za matenda.

Mkalasi, dokotalayo amapereka chidziwitso cha ophunzirirawo, ndipo namwino amapatsa wodwalayo chilankhulo chofikirika ndikuwathandiza kutanthauzira zidziwitso kukhala maluso othandiza. Komanso namwino pamlingo wake amasankha njira ndi njira zamankhwala ndikuthandizira odwala kukulitsa mapulani awo ndi zolinga zawo.

Zolinga za pulogalamu yophunzitsa odwala matenda ashuga ndi izi:

1. Fotokozani zomwe zimayambitsa matendawo ndi zovuta zake.

2. Kukhazikitsa mfundo za mankhwalawa, kuyambira ndi malamulo osavuta osavuta komanso kukulitsa pang'onopang'ono malangizo othandizira ndikuwonetsetsa, kukonzekeretsa odwala kuti azitha kuyang'anira matendawa.

3. Apatseni odwala malangizo atsatanetsatane azakudya zoyenera komanso kusintha kwa moyo wanu.

4. Patsani odwala zolemba zawo.

Nthawi zambiri, makalasi amachitika mokhazikika pamisonkhano yophunzitsira, pomwe namwino ndi odwala amalankhulana mwachangu, kukambirana zovuta za aliyense.

Ndondomeko yakusukulu ya matenda ashuga:

Phunziro 1. Kodi shuga ndi chiyani? Kudziletsa kwa glycemia.

Phunziro 2. Zakudya zopatsa thanzi za mtundu 1 ndi matenda ashuga 2. (Zakumapeto 1).

Phunziro 3. Mavuto apakatikati ndi matenda a shuga.

Phunziro 4. Chithandizo cha insulin.

Phunziro 5. Kudziyang'anira pawokha matenda ashuga.

Sukulu ya matenda a shuga ndiyofunika kwa odwala komanso abale awo apamtima, chifukwa apa ndi pomwe munthu amaphunzira kudziletsa: kuwonjezera pa kudziyimira pawokha kudziwa kuchuluka kwa shuga pakupezeka kwa magazi kunyumba, komanso luso losintha kuchuluka kwa shuga potengera zizindikiritso zamankhwala zomwe zapezeka. Masiku ano, sukulu ya odwala omwe ali ndi matenda ashuga ndi imodzi mwazomwe zimathandiza kwambiri pochiritsa komanso kupewa kufooka kwa boma.

Pambuyo pophunzira mabuku azachipatala, zitha kunenedwa kuti shuga ndi matenda oopsa, chizindikiro chachikulu chomwe ndi kuwonjezeka kwa shuga m'magazi. Sizotheka kuchiritsa iye panobe. Koma pali mwayi wotalikitsa ndikuthandizira moyo wa wodwala mothandizidwa ndi insulin.

Mankhwala a insulin ndi gawo lofunika kwambiri pothandizira odwala matenda ashuga, amathandiza kukonza thanzi komanso kupulumutsa wodwala yemwe ali ndi matenda ashuga. Odwala ambiri amakonda cholembera cha insulin yotalika pang'onopang'ono, chifukwa ndi yosavuta, yothandiza komanso yopweteka.

Njira zogwira mtima pakuwongolera komanso kuchiza matenda a shuga zapangidwa, njira imodzi mwanjira iyi ndi bungwe la ntchito ya Sukulu ya Matenda a shuga.

Maphunziro a anthu omwe ali ndi matenda ashuga, njira za kudziletsa, "kasamalidwe" ka matenda awo ndikofunikira komanso kofunikira kuti apititse patsogolo chisamaliro cha odwala omwe ali ndi matenda ashuga kuti apewe zovuta komanso kulumala kowonjezereka.

1. Ametov A.S., Demidova T.Yu. Maphunziro a odwala omwe alibe insulin amadalira shuga. - M., 2010 .-- 241 p.

2. Osipova N. .. Tarasova I. Maphunziro a odwala / Anamwino, 2003, Na. 3.

3. Ndondomeko ya Unduna wa Zaumoyo ku Russia Federation ya pa 05.06.1997, No. 137 "Pa mapulogalamu ogwirizana komanso zothandizira zowoneka bwino m'masukulu ophunzitsira odwala omwe ali ndi matenda ashuga." Makonda Pofikira: http://www.lawmix.ru/med/15583.

4. Yeshenko V.A., Goldberg E.D., Bovt V.D. Matenda a shuga. Tomsk, 1993. Kuyambira 85-91. Matenda a shuga - Endocrinology - Encyclopedia.

5. Knyazev Yu.A., Nikberg II. Matenda a shuga. - M: Mankhwala, 2009.

6. Watkins P. J. Matenda a shuga. - M: Binom, 2006.

Mfundo zachithandizo zochizira.

Zakudya ziyenera kukhala zathanzi:

Kuchuluka kwa mphamvu mu chakudya kuyenera kukhala kofanana ndi mphamvu zomwe wodwala amafunikira. Kuchuluka kwa mapuloteni, mafuta, chakudya, kuyenera kukhala koyenera. Kudya masana - nthawi 5-6.

Kwa odwala onenepa kwambiri omwe ali ndi matenda ashuga, kuti muwonjezere kumverera kwadzaza, muyenera kuphatikiza masamba monga mwatsopano ndi sauerkraut, letesi, sipinachi, nandolo zobiriwira, nkhaka, phwetekere muzakudya. Kusintha ntchito ya chiwindi, yomwe imadwala kwambiri matenda ashuga, ndikofunikira kuyambitsa zinthu zokhala ndi lipotropic (kanyumba tchizi, soya, oatmeal, ndi zina) muzakudya, komanso kuchepetsa nyama, msuzi wa nsomba ndi zakudya yokazinga muzakudya.

Pali zosankha zingapo zodyetsa odwala omwe ali ndi matenda ashuga, koma pafupifupi kunyumba mungagwiritse ntchito kamodzi (zakudya 9), zomwe zimatha kusinthidwa mosavuta pochiza wodwala aliyense, kupatula kuwonjezera kuwonjezera mbale kapena zopangira zina.

Chakudyacho chimaloledwa kuphatikiza:

-Chakudya chophika mkate ndi chophika mkate - makamaka buledi wa bulauni (200-350 magalamu patsiku, malinga ndi zomwe dokotala wanena.

-Misuzi pa msuzi wamasamba, nyama yofooka ndi msuzi wa nsomba ndi masamba ochepa (nthawi 1-2 pa sabata).

- Zakudya zochokera ku nyama ndi nkhuku (ng'ombe, nyama yamwana wamkaka, nkhumba yodula, nkhuku, nyama yophika kapena ya wolimba).

- Zakudya zochokera ku nsomba, makamaka zopanda mafuta (pike nsomba, cod, pike, safodi ya cod, carp, ndi zina zina zotengera).

- Zakudya ndi mbale zam'mbali zamasamba (masamba amadyera, kabichi (zoyera, kolifulawa), saladi, rutabaga, radish, nkhaka, zukini, mbatata, beets, kaloti) mu mawonekedwe owiritsa, yaiwisi komanso yophika.

- Zakudya ndi mbale zam'mbali za tirigu, nyemba, pasitala (nthawi zochepa, nthawi zina, uku mukuchepetsa kuchuluka kwa buledi).

- Zakudya zochokera mazira (zosaposa zidutswa ziwiri patsiku mu mawonekedwe a omelet kapena owiritsa, komanso kuwonjezera zina mbale).

- Wotsekemera ndi wowawasa komanso wowawasa wazipatso ndi zipatso (maapulo a Antonov, mandimu, malalanje, ofiira ofiira, cranberries ndi ena) mpaka 200 magalamu patsiku mu mawonekedwe osaphika, mwanjira yopanda zipatso pa xylitol kapena sorbite. Mwachilolezo cha dokotala, zakudya zotsekemera komanso zopangidwa ndi matenda ashuga zitha kugwiritsidwa ntchito.

-Milk - ndi chilolezo cha dokotala, kefir, yogati (magalasi 1-2 okha patsiku), tchizi tchizi (50-200 magalamu patsiku) mwa mtundu kapena mawonekedwe a tchizi tchizi, cheesecakes ndi puddings.

- Wofatsa amasenda msuzi wamasamba ndi viniga, phwetekere puree, mizu, ndi mkaka.

-Kukhala ndi mkaka, khofi ndi wofooka, madzi a phwetekere, zipatso ndi mabulosi (amadzaza madzi ndi supu mpaka magalasi 5 patsiku).

- Batala, mafuta a masamba (40 magalamu okha patsiku mu mawonekedwe aulere komanso kuphika).

- Zakudya za wodwala yemwe ali ndi matenda ashuga ayenera kukhala ndi mavitamini ambiri, chifukwa chake, ndikofunika kuyambitsa yisiti yophika ndi yisiti yophika mkate ndi zakudya za rosehip.

-Kungokhala, chokoleti, confectionery, muffin, kupanikizana, uchi, ayisikilimu ndi maswiti ena,

- zokometsera, zokometsera, zamchere ndi zosuta zazakudya ndi mbale, mutton ndi nkhumba mafuta,

mphesa, nthochi, zoumba,

Shuga amaloledwa m'miyeso yaying'ono pokhapokha ngati dokotala walola.

Yolembedwa pa Allbest.ru

Zolemba zofananira

Zokhudza chithandizo cha matenda amtundu wa I.Kugwiritsa ntchito mankhwala azakudya, zolimbitsa thupi, insulin. Njira zoyenera kulipira anthu odwala matenda ashuga. Malangizo pa boma la zolimbitsa thupi. Matenda osokoneza bongo a insulin (Somogy syndrome).

Zowonetsera 2.4 M, zowonjezera 09/23/2016

Abstract 308.1 K, owonjezera Disembala 18, 2012

Mfundo zoyenera kuchitira odwala matenda ashuga. Mayendedwe a akatswiri pantchito ya namwino wa dipatimenti ya endocrinology. Zizindikiro za hypoglycemia ndi matenda ashuga a ketoacidosis. Malangizo oyendetsera insulin. Zolemba za odwala matenda ashuga, kuikidwa kwa glucometer.

chiwonetsero cha 1,7 M, chowonjezera 03/18/2017

Zomwe zimayambira chiyambi cha rebound hyperglycemia. Chithunzi chachipatala cha kuphatikizika kwa insulin. Mawonetseredwe akulu ndi zizindikiritso za insulin overdose syndrome. Zodabwitsa za matenda a shuga mellitus mu matenda opumira kwambiri. Kuzindikira ndi chithandizo.

chiwonetsero cha 617.9 K, kuwonjezera pa 05/10/2016

Kufufuza kwa etiology ndi pathogenesis ya matenda osokoneza bongo - matenda omwe amayamba chifukwa cha kusowa kwathunthu kapena wachibale. Zakudya zamankhwala, mayeso a labotale, zoopsa, zakukula. Dispensary kuwunika kwa odwala matenda ashuga.

Abstract 65.1 K, owonjezera 02/06/2013

Etiology ya matenda a shuga, kupezeka kwake koyambirira. Mayeso a kulolera a glucose. Kufalikira kwa matenda ashuga ku Russia. Mafunso: "Kuyesa kwa ngozi". Memo wa akatswiri othandiza pangozi "

pepala lalitali 1.7 M, lowonjezera 05/16/2017

Kapangidwe ka molekyulu ya insulin. Udindo ndi kufunikira kwa kapamba m'mimba. Limagwirira ntchito ya timadzi timeneti kudzera mu mapuloteni olandirira. Kugwiritsa ntchito mankhwala ambiri a insulin pofuna kuchiza odwala matenda a shuga. Matenda omwe amayamba chifukwa cha insulin.

Abstract 175.0 K, kuwonjezera pa 04/12/2015

Ultrashort, yochepa komanso yotalika (yotalika) amachita. Pulogalamu yodziwika bwino yowonjezera insulin. Mbiri yakuchitikira kwa ma insulin afupiafupi. Kuzungulira kwa shuga m'magazi. Sinthani kapangidwe ka mankhwala a insulin.

Zowonetsa 71,0 K, zidawonjezeredwa 11/7/2013

Makhalidwe a shuga ngati vuto lapadziko lonse lapansi. Kuwerengera magawidwe ndi magawo a kukula kwa matendawo. Zolemba za njira ya unamwino mu shuga. Tekinoloje Yosamalira Odwala. Chithandizo choyamba cha chikhalidwe cha hypoglycemic.

mapepala a 509.8 K, owonjezera 08/17/2015

Unamwino ngati maziko a chisamaliro chothandiza paumoyo. Makhalidwe a shuga. Gulu la ntchito pachipatala ndi kusamalira ana omwe ali ndi matenda ashuga m'madipatimenti apadera. Magulu a ntchito yaamwino.

pepala 470.2 K, kuwonjezera 07/10/2015

Kodi ndi mitundu iti ya mankhwala a insulini yomwe imapangidwira?

Basis-bolus insulin mankhwala ndi amodzi mwa mitundu ya makonzedwe a mahomoni. Pazinthu zilizonse zathanzi, inshuwaransi yodziwika imapezeka pamimba yopanda kanthu, yomwe imawerengedwa kuti ndiyo chinthu chofunikira kwambiri cha timadzi timeneti.

Pa milingo yokhazikika ya mahomoni awa, pakudya chakudya, mapuloteni omwe amabwera nawo sasintha kukhala shuga. Mankhwala akhungu akawonedwa, milingo ya insulin imakhala yachilendo, ndiko kuti, kupatuka kuzololedwa kumachitika.

Zotsatira zake, izi zimatsogolera mkhalidwe wamatenda m'thupi la munthu, chifukwa chomwe glucose imayamba kukhazikika kwambiri. Zikondazo zimatulutsa insulin pakati pa chakudya.

Poterepa, gawo limodzi la mahomoni limatsimikizira kuti insulin ili mokwanira m'thupi, ndipo gawo lachiwiri, silimalola kudumpha mu shuga mthupi.

Basis-bolus insulin therapy imatanthawuza kuti kudziunjikira kwakumbuyo kwa insulin m'thupi kumapangidwa pomwe mahomoni amakhala nthawi yayitali kapena sakhalapo pang'ono m'mawa kapena asanagone.Chifukwa chake, kudzera pakubweretsa mankhwala, ndizotheka kutsanzira kugwira ntchito kwathunthu kwa kapamba.

Zomwe zimachitika pachikhalidwe kapena chakale cha insulin.

• Mitundu yonse ya mahomoni imaphatikizidwa jakisoni imodzi. Ubwino wake ndikuti kuchuluka kwa jakisoni kumatha kuchepetsedwa kukhala ochepa.
• Choyipa cha njirayi ndikuti sizingatheke kutsanzira ntchito zodzala zamkati. Zotsatira zake, sikungatheke kulipira kwathunthu kudwala kwa carbohydrate metabolism.

Malangizo a chikhalidwe a insulini amaperekedwa monga:

Mtundu wachitatu wa insulin yoyang'anira ndi kudzera pampu. Pampu ya insulin ndi chida chamagetsi chomwe chimapereka kuyendetsa kwakanthawi kwa timadzi tosiyanasiyana mosapumira.

Mitundu ya makina a insulin pump ndi awa:

1. Kuthamanga kwa Bolus. Potere, wodwala matenda ashuga amatha kuyang'anira payokha kuchuluka komanso kuchuluka kwa malowedwe amthupi.
2. Kupitiliza kwa mahomoni mosalekeza m'magawo ang'onoang'ono.

Monga lamulo, regimen yoyambirira imalimbikitsidwa musanadye kapena panthawi yomwe kulumikizana kwakuthwa m'thupi la wodwala sikumatha. Kenako, njira yachiwiri imakupatsani mwayi wofanizira magwiridwe antchito amkati, omwe amalola kugwiritsa ntchito timadzi tambiri.

Therapy yolimbitsa insulin imayikidwa popanda kusokonezeka m'maganizo mwa wodwala, imalimbikitsidwa kamodzi pa maola 24 aliwonse. Miyezo yayikulu yomwe ikuperekedwa kwa mtundu wamtunduwu wa mahomoni:

• Horm yomwe yatchulidwa imayenera kutsanzira kwathunthu mahomoni enieni omwe amapangidwa ndi thupi la munthu.
• Hormoni imayenera kumanizidwa mu mlingo wofunikira kuti mupange shuga.

Mosasamala mtundu wa makonzedwe a mahomoni, wodwalayo ayenera kukhala ndi shuga mpaka magawo 11 akatha kudya, matenda a shuga amatsika osaposa kamodzi pa sabata, ndipo zomwe zili ndi shuga pamimba yopanda 7.

Mtundu woyamba wa shuga

Mu mtundu woyamba wamatenda, mahomoni m'thupi la munthu amapangidwa mwapangidwe kakang'ono, motero sikungatheke kuti pakhale shuga. Kapena insulini siipangidwa konse ndi kapamba.

Odwala ena amafunsa funso, kodi ndizotheka kuchita popanda kuyambitsa mahomoni? Tsoka ilo, yankho lidzakhala lakuti ayi. Poterepa, kuyambitsidwa kwa timadzi m'thupi la munthu ndi gawo lokhalo lomwe limapulumutsa moyo.

Insulin mankhwala a mtundu 1 matenda a shuga amakhala ndi chiwembu china: basal hormone imaperekedwa kangapo patsiku musanadye. Ndi mtundu woyamba wa matenda, chithandizo choterocho chimachotsa ntchito yonse yokhudza zikondamoyo za munthu.

Mlingo amawerengedwa ndi dokotala payekhapayekha, pomwe pali zinthu zambiri zomwe zimawerengedwa. Mahomoni oyambira nthawi zambiri amapanga pafupifupi 40% ya mankhwala onse omwe amaperekedwa.

Kenako, kukhazikitsa mankhwala pogwiritsa ntchito njira yotsekera kumatanthauza kuwerengera kwamunthu payekha. Kuti awone momwe mankhwalawa amathandizira, wodwalayo ayenera kuyeza shuga m'thupi lake nthawi zonse.

Mtundu woyamba wa insulin mankhwala regimen ungasiyane kwambiri. Chitsanzo ndi chimodzi mwazomwe zalimbikitsa kwambiri:

1. Asanadye chakudya cham'mawa, thupi la wodwalayo liyenera kulandira mahomoni ofupikitsa komanso okhalitsa.
2. Asanadye nkhomaliro, timadzi tomwe timayendetsa pang'ono timayendetsedwa.
3. Asanadye chakudya chamadzulo, mahoni omwe amagwira ntchito mwachidule amathandizidwa.
4. Nthawi yomweyo asanagone, timadzi tomwe timakhala nthawi yayitali timatulutsa.

Dziwani kuti chiwembuchi ndichachikhalidwe, ndipo chimalimbikitsidwa nthawi zambiri.

Koma kuti muthandizire bwino, muyenera kuyang'anira shuga yanu mthupi lanu kuti musadutse kapena kuchepetsa mlingo wake.

Type 2 shuga

Monga lamulo, mu mtundu wachiwiri wa matenda, odwala matenda ashuga sayenera kupereka mahomoni. Komabe, zithunzi zamankhwala zoterezi zimasiyanitsidwa pomwe, pamlingo wina wamatendawa, mankhwala ochepetsa shuga sathandizira kukonza shuga, chifukwa chake makonzedwe a mahomoni ayenera kugwiritsidwa ntchito.

Mahomoni amtundu wachiwiri wa matenda amatha kutumiza kwakanthawi. Mwachitsanzo, musanachite opareshoni, kapena ngati wodwala ali ndi matenda opatsirana.

Njira yachiwiri, kuphatikiza insulin mosalekeza kungalimbikitsidwe ngati mapiritsi ochepetsa magazi sagwirizana ndi ntchitoyo.

Chithandizo cha insulin chokhazikika chitha kutumikiridwa ngati odwala matenda ashuga sayenera kudya, ndiye kuti, samatsata zakudya zomwe adokotala adamwa, samamwa mankhwala kuti athe kuthana ndi shuga m'thupi.

Zowonetsa monga chithandizo cha matenda amtundu wa 2 ali m'mikhalidwe:

• Kupezeka kwa acetone mu mkodzo (matupi a ketone mumkodzo).
• Zizindikiro zakuchepa kwa timadzi m'thupi.
• Pamaso pa opareshoni.
• Kukhalapo kwa matenda opatsirana.
• Kuchulukitsa kwa matenda osachiritsika.
• Pa nthawi yoyembekezera, yoyamwitsa.
• Precomatose state, chikomokere.
• Kuchepa kwa thupi la munthu.

Mosalephera, zizindikiro zamankhwala zimathandizidwanso. Ngati wodwala akumwa mankhwala ochepetsa shuga, koma shuga pamimba yopanda kanthu akadali wopitilira magawo 8, ndiye kuti insulini ikulimbikitsidwa.

Lembani insulin kwa odwala komanso ndi zotsatirazi: kuchuluka kwa hemoglobin wa glycated kuli pamwamba pa 7%, kuchuluka kwa C-peptide kumakhala kochepa kuposa magawo a 0.2.

Mankhwala a insulin mwa ana ndi amayi apakati

Mankhwala a insulin mwa ana amasankhidwa payekha. Mwambiri, dokotala angalimbikitse kuyika mahandiredi awiri kapena katatu patsiku. Kuti muchepetse kuchuluka kwa jakisoni wa mankhwalawa, insulin yochepa komanso yapakati imatha kuphatikizidwa.

Dziwani kuti chidwi cha mwana pa insulin ndi chambiri kwambiri poyerekeza ndi munthu wamkulu. Ichi ndichifukwa chake ndikofunikira kusintha mosiyanasiyana mlingo wa mahomoni opanga mu magawo.

Chovomerezeka kusintha mlingo wokha mkati mwa magawo awiri, pomwe pazofunikira kwambiri ndi magawo anayi.

Malamulo othandizira insulin amatanthauza kuwunikira mosalekeza, ngakhale kuti sizingatheke kusintha nthawi imodzimodzi mumayendedwe a mahomoni ndi mamawa.

Zomwe zimayambitsidwa ndi insulin kwa amayi apakati:

1. Ma metabolic omwe amachitika mwa mayi wapakati amadziwika ndi kusakhazikika kwapadera. Ichi ndichifukwa chake nthawi zambiri ndikofunikira kusintha kuchuluka kwa mahomoni omwe amaperekedwa.
2. Monga lamulo, timadzi timene timayendetsedwa m'mawa nthawi yomweyo tisanadye, kenako asanadye.
3. Amatha kugwiritsa ntchito insulin yayifupi komanso yapakati ndipo atha kuphatikizidwa.

Mlingo wa timadzi timene timasankhidwa payekhapayekha, ndipo zimatengera msinkhu wa wodwalayo, machitidwe ake aumunthu, zisonyezo zomwe zimapezeka mu labotor, matenda ophatikizana ndi zovuta.

Pambuyo poyambitsa mahomoni, wodwalayo amatha kukhala ndi mavuto. Chimodzi mwa izo ndi kuchepa kwa shuga m'magazi, omwe amapezeka motsutsana ndi mawonekedwe a mawonekedwe: njala, kugunda kwamtima kawirikawiri, thukuta lomwe linakulirakulira.

Nthawi zina odwala amakhala ndi lipodystrophy, yomwe imadziwika ndi kutha kwa tinthu tina tosanjikizana. Ndipo izi zimachitika ngati wodwala amayambitsa mahomoni nthawi zonse pamalo amodzi.

Pomaliza, ziyenera kunenedwa kuti kuyambitsidwa kwa mahomoni mu mtundu woyamba wa matenda ndikofunikira kwambiri.Nawonso matenda a shuga a mtundu wachiwiri, kuperekera mankhwala osokoneza bongo sikungachotsedwe ngati mumadya moyenera ndikutsatira uphungu wonse wa dokotala.

Kodi mukuganiza bwanji pamenepa? Kodi mankhwala a insulin adalembedwa liti ndipo adokotala adalimbikitsa chiyani?

Kusiyana pakati pa mitundu ya mankhwala a insulin

Kusankha kwa insulin mankhwala a matenda amtundu wa 1 amachitika ndi endocrinologist malinga ndi mawonekedwe a thupi la wodwalayo.

Ngati wodwala alibe vuto la kunenepa kwambiri, ndipo alibe nkhawa kwambiri m'moyo, ndiye kuti insulini imalembedwa mu ziwerengero za 0.5-1 kamodzi patsiku malinga ndi kilogalamu imodzi ya kulemera kwa thupi la wodwalayo.

Mpaka pano, endocrinologists apanga mitundu yotsatirayi ya mankhwala a insulin:

• kukulitsa
• zachikhalidwe
• zochita pampu
• maziko a botus.

Zolemba pa ntchito zolimbitsa insulin

Therapy yolimbitsa insulin imatha kutchedwa maziko a inshuwaransi ya insulin, malinga ndi zina mwa kugwiritsa ntchito njirayi.

Chizindikiro cha insulin yowonjezereka ndikuti chimagwira ngati chida chobisika cha insulin m'thupi la wodwalayo.

Njirayi imagwiritsidwa ntchito pakafunika insulin mankhwala a mtundu 1 wa shuga. Ndi mankhwalawa matenda amtunduwu omwe chithandizo chotere chimapereka mayendedwe abwino kwambiri azachipatala, ndipo izi zimatsimikiziridwa.

Kuti mukwaniritse ntchito imeneyi, mndandanda wina wa mikhalidwe umafunika. Izi ndi izi:

1. Insulin iyenera kulowetsedwa m'thupi la wodwalayo m'njira zokwanira kugwiritsira ntchito shuga.
2. Ma insulini omwe amalowetsedwa m'thupi ayenera kukhala ofanana kwathunthu ndi ma insulin omwe amapangidwa ndi kapamba wa wodwala yemwe ali ndi matenda osokoneza bongo.

Zomwe zidafotokozedwazi zimayambitsa zovuta za insulin mankhwala zomwe zimagawanitsa mankhwala omwe amagwiritsidwa ntchito posachedwa ndi insulin.

Ma insulin omwe amakhala nthawi yayitali amagwiritsidwa ntchito kuperekera insulin m'mawa ndi madzulo. Mankhwala amtunduwu amalinganiza kwathunthu zinthu zomwe zimapangidwa ndi maholide.

Kugwiritsa ntchito ma insulin okhala ndi kanthawi kochepa kumakhala koyenera pambuyo poti mudya chakudya chamafuta ambiri. Mlingo womwe umagwiritsidwa ntchito kuti ubweretsere mankhwalawa m'thupi umatengera kuchuluka kwa mkate womwe umapezeka mu chakudya ndipo umatsimikiziridwa mosamalitsa payekhapayekha kwa wodwala aliyense.

Kugwiritsa ntchito mankhwala a insulin olimbitsa a 1 mtundu wa shuga kumafananizira kuchuluka kwa glycemia musanadye.

Zomwe zimagwiritsidwa ntchito pa mankhwala a insulin

Chithandizo cha insulin chachikhalidwe ndi njira yophatikizira yomwe imaphatikizapo kuphatikiza insulin yochepa komanso yayitali.

Ubwino waukulu wogwiritsa ntchito mankhwalawa ndikuchepetsa kuchuluka kwa jakisoni pang'ono. Nthawi zambiri, kuchuluka kwa jakisoni panthawi ya mankhwalawa malinga ndi njirayi imachokera pa 1 mpaka 3 patsiku.

Choipa chogwiritsa ntchito njirayi ndikulephera kwofanizira zochitika za kapamba. Izi zimabweretsa chifukwa chakuti pogwiritsa ntchito njirayi ndizosatheka kulipira kwathunthu kuphwanya kwa kagayidwe kazakudya kamunthu.

Mukugwiritsa ntchito njira iyi, wodwalayo amalandira jakisoni 1-2 patsiku. Ma insulin afupiafupi ndi aatali amayendetsedwa nthawi yomweyo kulowa m'thupi. Ma insulini omwe amakhala ndi nthawi yayitali kuti awonetsedwe pafupifupi pafupifupi 2/3 ya kuchuluka kwa mankhwalawa, gawo limodzi mwa magawo atatu a mankhwalawa amakhala osapumira.

Chithandizo cha matenda a shuga 1 amtundu wachiberekero wamtundu wa mankhwala a insulin sichifuna kuti munthu azitsatira glycemia musanadye.

Zomwe zimagwiritsidwa ntchito popopa insulin

Pampu ya insulin ndi chipangizo chamagetsi chomwe chimapangidwa kuti chizigwira ntchito mozungulira nthawi yomweyo.

Mukamagwiritsa ntchito mtundu uwu wa mankhwalawa, mankhwalawa amaperekedwa mu Mlingo wa mini.

Njira yamagetsi ya insulin yamagetsi imatha kuchitika m'njira zosiyanasiyana. Njira zazikulu zogwiritsira ntchito pampu ndi izi:

1. Kupitiliza kuperekera mankhwala m'thupi mwa ma microdoses okhala ndi oyambira.
2. Kukhazikitsidwa kwa mankhwalawa m'thupi mothandizidwa ndi kubayidwa pafupipafupi kwa jakisoni wa mankhwala.

Pankhani ya njira yoyambirira yoyendetsera insulin, kuyeserera kwathunthu kwa chinsinsi cha mahomoni mu kapamba kumachitika. Njira zoterezi zimapangitsa kuti mankhwalawa asagwiritsidwe ntchito kwa nthawi yayitali.

Kugwiritsa ntchito njira yachiwiri yobweretsera insulini m'thupi kumakhala koyenera musanadye kapena nthawi zina pakakhala kuchuluka kwa index ya glycemic.

Chiwembu cha insulin chogwiritsa ntchito pampu chimalola kuphatikiza kwa liwiro kuti athe kutsata njira ya insulin yobisalira m'thupi la munthu, yomwe imakhala ndi kapamba wabwino. Mukamagwiritsa ntchito pampu, catheter iyenera kusinthidwa masiku atatu aliwonse.

Kugwiritsa ntchito pampu yamagetsi kumakupatsani mwayi wothana ndi mavuto poyesa njira yobisika yolembera insulin mthupi la munthu.

Kuchita insulin mankhwala muubwana

Mankhwala a insulin mu ana amafunika kuchita payekha ndipo amafunikira zinthu zambiri ndi zochitika za thupi la mwanayo posankha njira.

Mukamasankha mtundu wa insulin yothandizira mtundu wa 1 matenda ashuga mwa ana, makonda amaperekedwa kwa 2- ndi 3-fold ya mankhwala okhala ndi insulin mthupi la mwana.

Chowonjezera cha mankhwala a insulin mwa ana ndi kuphatikiza kwa insulin ndi nthawi ina yochita kuti muchepetse kuchuluka kwa jakisoni patsiku.

Kwa ana omwe ali ndi zaka zopitilira 12, tikulimbikitsidwa kugwiritsa ntchito njira yolimbikitsira yochizira.

Mbali ya thupi la mwana imamvetseka kwambiri ndi insulin poyerekeza ndi thupi la munthu wamkulu. Izi zimafunikira endocrinologist kusintha pang'onopang'ono mlingo wa insulin yomwe mwana akutenga. Mwana akapezeka ndi mtundu woyamba wa matenda a shuga, ndiye kuti kusinthaku kuyenera kugundika pakati pamagawo awiri ndi jakisoni imodzi, ndipo malire okwanira osinthika amodzi sayenera kupitirira magawo anayi.

Kuti muwone bwino kusinthaku, ndikofunikira kuyang'anira kusintha kwa thupi kwa masiku angapo.

Popanga kusintha, ma endocrinologists samalimbikitsa nthawi yomweyo kusintha kwamankhwala omwe amachitika ndi m'mawa ndi madzulo makonzedwe a insulin mthupi la ana.

Chithandizo cha insulin ndi zotsatira za chithandizo chotere

Mukapita ku dokotala-endocrinologist, odwala ambiri amakhala ndi nkhawa kuti mankhwala omwe amapezeka ndi insulin amachitika bwanji ndipo zotsatira zake zingakhale bwanji pogwiritsa ntchito mankhwala omwe ali ndi insulin.

Mulingo uliwonse, njira yeniyeni yovomerezeka imapangidwa ndi endocrinologist. Pakadali pano, amapangira cholembera chapadera kuti odwala azithandizira. Potsirizira izi, mutha kugwiritsa ntchito ma insulin omwe ali ndi singano yochepa kwambiri ya insulin.

Kuchiza wodwala yemwe ali ndi matenda a shuga insulin kumachitika molingana ndi chiwembu chotsatira:

• Musanayambe kuchita insulin, kulowetsa insulin mthupi, kugwiritsa ntchito jakisoniyo.
• Kudya sikuyenera kuchitika pasanathe mphindi 30 kuchokera pakumwa mankhwala.
• Mlingo woyenera kwambiri wa kasodzi m'modzi sayenera kupitirira 30 magawo.

Kugwiritsa ntchito zolembera za syringe kumakondedwa komanso ndikutetezeka. Kugwiritsa ntchito zolembera panthawi yamankhwala kumawerengedwa bwino kwambiri pazifukwa izi:

1. Kupezeka kwa singano ndi kupindika kwapadera mu cholembera kumachepetsa ululu panthawi ya jekeseni.
2. Kupanga kosavuta kwa cholembera kumakulolani kuti mugwiritse ntchito chipangacho nthawi iliyonse komanso kulikonse, ngati kuli kotheka, kubaya insulini.
3. Mitundu ina yamapensulo amakono omwe ali ndi ma insulin. Izi zimapangitsa kuphatikiza kwa mankhwalawa komanso kugwiritsa ntchito mitundu yambiri ya zochizira pamankhwala othandizira.

Malangizo a matenda a shuga omwe ali ndi jakisoni wa insulin akuphatikiza zotsatirazi:

• Asanadye chakudya cham'mawa, wodwala matenda ashuga amayenera kupereka insulin yochepa kapena yayitali.
• Kukhazikitsidwa kwa insulin musanadye chakudya chamadzulo kuyenera kuphatikizapo mlingo wokhala ndi kukonzekera kwakanthawi.
• Jekeseni asanadye chakudya chamadzulo, ayenera kukhala ndi insulin.
• Mlingo wa mankhwala omwe kutumikiridwa musanakagone uyenera kuphatikiza mankhwala osatulutsa.

Zilonda m'thupi zitha kuchitika m'malo angapo a thupi. Kuchuluka kwa mayeso m'dera lililonse.

Kuthiridwa mwachangu kwambiri kumachitika pamene mankhwalawa amatumizidwa pansi pakhungu pamimba.

Njira zakuchitikira ndi zotsatira za insulin

Mankhwala a insulin amachitika kuti athetse vuto la glucose ndikusintha ntchito yopanga maselo a beta okhala ndi hyperglycemia wapakati. Poyamba, kukomoka kwa maselo a beta omwe amapezeka m'matumbo ndikupanga insulin kumatha kusintha. Kupanga kwamkati kwa insulin kumabwezeretsedwa ndi kuchepa kwa shuga m'miyezo yabwinobwino.

Kukhazikitsidwa koyambirira kwa insulini kuyesa odwala matenda ashuga a 2 ndi njira imodzi yothandizira odwala pakanthawi kovutira pakudya ndikuchita masewera olimbitsa thupi, podutsa gawo lokonzekera piritsi.

Njirayi ndiyabwino kwa odwala matenda ashuga omwe amakonda insulin, mmalo mwakugwiritsa ntchito mankhwala ochepetsa shuga. Komanso mwa odwala omwe amachepetsa thupi komanso omwe akuwonetsetsa kuti ali ndi matenda a autoimmune a shuga akulu.

Kuchepetsa bwino kwa shuga mu chiwindi mu mtundu 2 wa shuga kumafuna kuponderezedwa kwa njira ziwiri: glycogenolysis ndi gluconeogeneis. Kukhazikitsa insulin kumachepetsa hepatic glycogenolysis ndi gluconeogeneis, komanso kuonjezera mphamvu ya zotumphukira zimakhala kuti insulin. Zotsatira zake, zimatha "kukonza bwino" zida zonse za matenda a shuga a mtundu wachiwiri.

Zotsatira zabwino za insulin mankhwala a shuga

Pali mbali zabwino za kumwa insulin, monga:

• kusala ndi pambuyo chakudya
• kuchuluka kwa mapangidwe a insulin chifukwa cha kukhudzidwa ndi shuga kapena kudya,
• shuga wocheperako,
• kupanga shuga wa chiwindi
• kuyimitsidwa kwa secretion wa glucagon mutatha kudya,
• kusintha kwa mbiri ya lipoproteins ndi lipids,
• kukakamiza kwa lipolysis mutatha kudya,
• kusintha kwa anaerobic ndi aerobic glycolysis,
• kuchepa kwa glycation wa lipoproteins ndi mapuloteni.

Kuthandizira odwala matenda ashuga makamaka kumakwaniritsa ndikukhalitsa komwe kumayambira glycosylated hemoglobin, kusala shuga m'magazi ndikatha kudya. Zotsatira zake zidzakhala kuchepetsera kuthekera kwa kakulidwe ndi kupitilira kwa zovuta.

Kukhazikitsidwa kwa insulini kuchokera kunja kumakhala ndi phindu pa chakudya, mapuloteni ndi metabolism yamafuta. Hormone iyi imayambitsa kutsimikizika ndikuletsa kupasuka kwa shuga, mafuta ndi amino acid.Imachepetsa kuchuluka kwa shuga mwakuwonjezera mayendedwe ake kupita pakati pa cell kudzera pa khoma la cell la adipocytes ndi myocyte, komanso kuletsa kwa kupanga chiwindi cha glucose (glycogenolysis ndi gluconeogenesis).

Kuphatikiza apo, insulin imayambitsa lipogenesis ndipo imalepheretsa kugwiritsa ntchito mafuta aulere acids mu metabolism ya mphamvu. Imalepheretsa minofu ya proteinol komanso imathandizira kupanga mapuloteni.

Mitundu ya Insulin Therapy

Kusankha kwa insulin mankhwala a matenda amtundu wa 1 amachitika ndi endocrinologist malinga ndi mawonekedwe a thupi la wodwalayo.

Ngati wodwala alibe vuto la kunenepa kwambiri, ndipo alibe nkhawa kwambiri m'moyo, ndiye kuti insulini imalembedwa mu ziwerengero za 0.5-1 kamodzi patsiku malinga ndi kilogalamu imodzi ya kulemera kwa thupi la wodwalayo.

Mpaka pano, endocrinologists apanga mitundu yotsatirayi ya mankhwala a insulin:

• kukulitsa
• zachikhalidwe
• zochita pampu
• maziko a botus.

Ngati wodwala alibe zovuta za kunenepa kwambiri ndipo samakhala ndi nkhawa kwambiri, insulin imayikidwa mu ½ - 1 unit 1 nthawi patsiku malinga ndi 1 kg ya thupi. Nthawi yomweyo, insulin yokwanira imakhala ngati chida chobisika cha mahomoni.

Malamulo a insulin chithandizo amafunika kukwaniritsidwa kwa zinthu izi:

• mankhwalawa amayenera kulowa m'thupi la wodwalayo wokwanira kugwiritsa ntchito shuga,
• insulin yakunja iyenera kukhala kutsanzira kwathunthu kwa secretion ya basal, ndiye kuti kapamba amatulutsa (kuphatikiza mfundo yayikulu kwambiri ya chakudya pambuyo podyera).

Zofunikira zomwe zatchulidwa pamwambapa zimafotokozera mtundu wa insulin mankhwala, momwe mlingo wa tsiku ndi tsiku umagawidwira kukhala wautali kapena wosakhalitsa.

Ma insulin aatali nthawi zambiri amathandizidwa m'mawa ndi madzulo ndipo amayeserera mwamphamvu zochita zogwiritsira ntchito kapamba.

Kumwa insulini yochepa ndikofunikira mukatha kudya zakudya zopatsa mphamvu. Mlingo wa insulin yamtunduwu umatsimikiziridwa payekhapayekha ndipo umatsimikiziridwa ndi kuchuluka kwa ma XE (magawo a mkate) pachakudya chopatsidwa.

Anakulitsa Insulin Therapy

Ngati wodwala sananenepa kwambiri komanso kukhumudwa kwakanema sikuwonetsedwa, mankhwalawa amadziwitsidwa mu ½ - 1 unit pa 1 makilogalamu a thupi 1 nthawi patsiku. Nthawi yomweyo, insulin yokhazikika idapangidwa kuti ikhale yotsanzira kutulutsa kwachilengedwe kwa mahomoni.

Ntchitoyi imafuna zotsatirazi:

1. Insulini iyenera kuperekedwa kwa wodwala muyezo wokwanira wogwiritsa ntchito shuga.
2. Insulin yomwe imayendetsedwa kuchokera kunja iyenera kukhala yoyeserera kwathunthu ya zotsekemera zomwe zimaperekedwa ndi kapamba (kuphatikizapo nsonga ya kupatukana kwake itatha kudya).

Zomwe zalembedwazi zimatsimikiza dongosolo la insulin yolimbikitsidwa pamene mlingo wa insulin tsiku lililonse umagawika ma insulin okhala ndi kufupikitsa kapena kwanthawi yayitali. Zotsirizira zimayambitsidwa nthawi zambiri m'mawa ndi madzulo, zimayerekeza kwathunthu ndi kapamba.

Kuchita insulin mwachidule kumakhala koyenera mukatha kudya ndi chakudya. Mlingo wa ma insulin awa umatsimikiziridwa payekhapayekha ndipo zimatengera kuchuluka kwa mkate pazakudya izi.

Chithandizo cha mankhwala a insulin

Njira yophatikiza, yomwe imaphatikizapo kuphatikiza insulin yonse jakisoni imodzi, imatchedwa kuti mankhwala a insulin.

Ubwino waukulu wa njirayi ndikuchepetsa kuchuluka kwa jakisoni kufikira ochepa (kuyambira 1 mpaka 3 masana).

Zoyipa zamankhwala ndizoperewera kwa kuthekera kochita masewera olimbitsa thupi chifukwa cha kapamba, zomwe zimapangitsa kuti pakhale kusowa kwachidziwitso chokwanira cha kagayidwe kazakudya ka odwala.

Nthawi yomweyo, chikhalidwe cha insulin mankhwala chimakhala motere: wodwalayo amalandira jakisoni wa 1-2 patsiku, pomwe ma insulin omwe amakhala ndi nthawi yayitali komanso nthawi yayitali amakhala akupatsidwa nthawi yomweyo. ISD (ya insulini insulini ya inshuwaransi) yaaka 2/3 ya kuchuluka kwathunthu kwa SSD, 1/3 yotsalayo imagwera pa ICD.

Chithandizo cha insulin

Pampu ya insulin ndi mtundu wa chinthu chamagetsi chomwe chimapereka ma jakisoni ozungulira-ndi-kutalika kwa insulin yokhala ndi nthawi yayifupi kapena yopitilira muyeso yocheperako pakapangidwe kakang'ono ka mini.

Pampu ya insulin ingagwire ntchito mitundu yosiyanasiyana ya mankhwala:

• Kupitiliza kwakachulukidwe ka ma pancreatic mahomoni, otchedwa kuchuluka kwa basal.
• Kuthamanga kwa Bolus, pomwe pafupipafupi makonzedwe a mankhwala ndi mlingo wake amakonzedwa ndi wodwalayo.

Mukamagwiritsa ntchito mawonekedwe oyamba, inshuwaransi yam'mbuyo imapangidwa, yomwe imalola kusintha kwa insulin "yayitali". Kugwiritsira ntchito kwa regimen yachiwiri kumakhala koyenera nthawi yomweyo chakudya cha wodwala chisanachitike kapena panthawi yomwe chiwonetsero cha glycemic chikuwonjezeka.

Chithandizo cha insulin pamene mukulumikiza mulingo wa bolus kumakupatsani mwayi wina kuti muchotse insulin ndi Ultra yochepa kapena yochepa yochepa.

Kuphatikiza kwa ma liwiro awa momwe mungathere kumathandizira kubisirana kwa insulin m'thupi la mwini wa kapamba wamoyo. Wodwala ayenera m'malo mwa catheter pambuyo masiku atatu.

Mankhwala a insulin

Mankhwala a insulin mu ana amafunika kuchita payekha ndipo amafunikira zinthu zambiri ndi zochitika za thupi la mwanayo posankha njira.

Mukamasankha mtundu wa insulin yothandizira mtundu wa 1 matenda ashuga mwa ana, makonda amaperekedwa kwa 2- ndi 3-fold ya mankhwala okhala ndi insulin mthupi la mwana.

Chowonjezera cha mankhwala a insulin mwa ana ndi kuphatikiza kwa insulin ndi nthawi ina yochita kuti muchepetse kuchuluka kwa jakisoni patsiku.

Kwa ana omwe ali ndi zaka zopitilira 12, tikulimbikitsidwa kugwiritsa ntchito njira yolimbikitsira yochizira.

Mbali ya thupi la mwana imamvetseka kwambiri ndi insulin poyerekeza ndi thupi la munthu wamkulu. Izi zimafunikira endocrinologist kusintha pang'onopang'ono mlingo wa insulin yomwe mwana akutenga.

Mwana akapezeka ndi mtundu woyamba wa matenda a shuga, ndiye kuti kusinthaku kuyenera kugundika pakati pamagawo awiri ndi jakisoni imodzi, ndipo malire okwanira osinthika amodzi sayenera kupitirira magawo anayi.

Kuti muwone bwino kusinthaku, ndikofunikira kuyang'anira kusintha kwa thupi kwa masiku angapo.

Popanga kusintha, ma endocrinologists samalimbikitsa nthawi yomweyo kusintha kwamankhwala omwe amachitika ndi m'mawa ndi madzulo makonzedwe a insulin mthupi la ana.

Mukamasankha maphunziro a insulin muubwana, makonda amapatsidwa kuwirikiza kawiri kapena katatu kuyambitsa zinthu zomwe zili ndi insulin. Mbali ya maphunzirowa mu mwana imayenera kuganiziridwa ngati kuphatikiza ma insulin ndi nthawi ina yochita kuti muchepetse pafupipafupi jakisoni masana. Kwa ana omwe ali ndi zaka zopitilira 12, ndikulimbikitsidwa kugwiritsa ntchito kwambiri mankhwala.

Mankhwala a insulin mwa ana ayenera kutengera lingaliro la zinthu monga kuchuluka kwamphamvu kwa insulin (poyerekeza, mwachitsanzo, ndi thupi la munthu wamkulu). Izi zimafuna katswiri kuti akonze pang'onopang'ono kuchuluka kwa chinthu chomwe mwana amagwiritsa ntchito.

Chifukwa chake, kusinthaku kuyenera kukhala pakati pa mayunitsi awiri kapena awiri pa jekeseni, pomwe malire owongolera nthawi imodzi sayenera kupitirira magawo anayi.

Kuti mumve molondola pamlingo wa kusinthaku, kuwunika kosinthika kwakusintha kwazosintha kwa masiku angapo kumafunikira.

Pokonzekera insulin mankhwala a matenda a shuga 1 a ana, ma endocrinologists samalimbikitsa kuti pakhale kusintha kwamankhwala mosiyanasiyana.

Thupi la mwana limatengeka kwambiri ndi mahomoni kuposa munthu wamkulu, chifukwa chake matenda ashuga ali mwana amafunikira chisamaliro chapadera. Njira yodziwika bwino yothetsera insulin mwa ana ndi katatu patsiku.

Kuti muchepetse kuchuluka kwa jakisoni, mankhwala omwe amangokhala pang'ono amaphatikizidwa ndi pafupifupi. Zomwe amathandizira pakadali pano ali ndi kuyang'anira nthawi zonse za momwe khanda limasinthira ndi kusintha kwa mankhwalawa mkati mwa 2 UNITS (pazipita - 4 UNITS).

Ndikofunika kuti musasinthe kuchuluka kwa insulin yam'mawa ndi yamadzulo nthawi yomweyo. Kwambiri mankhwala angathe kuchitika kuyambira azaka 12 zokha.

Chithandizo cha insulin pa nthawi ya pakati

Chithandizo cha matenda osokoneza bongo pa nthawi ya bere cholinga chake ndi kusungitsa ndende ya magazi, yomwe iyenera kukhala:

• M'mawa pamimba yopanda kanthu - 3.3-5.6 mmol / l.
• Mutatha kudya, 5.6-7.2 mmol / L.

Kutsimikiza kwa shuga m'magazi kwa miyezi 1-2 kumakupatsani mwayi wowunika momwe mankhwalawo amathandizira. Kagayidwe kachakudya mthupi la mayi wapakati ndi chododometsa kwambiri. Izi zimafunikira kukonzanso pafupipafupi kwa regimen (regimen) ya insulin.

Kwa amayi apakati omwe ali ndi matenda a shuga 1, chithandizo cha insulin chimayikidwa motere: pofuna kupewa m'mawa ndi pambuyo pa hyperglycemia, wodwalayo amafunika jekeseni osachepera awiri patsiku.

Insulin yochepa kapena yapakati imayendetsedwa isanayambike chakudya cham'mawa chisanafike komanso chakudya chisanafike. Mlingo wophatikiza ungagwiritsidwenso ntchito. Mlingo wa tsiku ndi tsiku uyenera kugawidwa moyenera: 2/3 ya voliyumu yonse imakonzekera m'mawa, ndipo gawo 1/3 - asanadye chakudya chamadzulo.

Popewa usiku ndi m'mawa hyperglycemia, mlingo "musanadye" umasinthidwa kukhala jakisoni wopangidwa asanagone.

Kuthandizira matenda mukakhala ndi pakati kumapangitsa kuti shuga azikhala ndi shuga. M'mawa pamimba yopanda kanthu, iyenera kuchokera pa 3,3 mpaka 5.6 mmol, mutatha kudya - kuyambira 5.6 mpaka 7.2. Kuti mankhwala a insulin panthawi yapakati akhale olondola, muyenera:

• kudziwa kuchuluka kwa shuga m'magazi kwa mwezi umodzi kapena iwiri. Izi zipangitsa kuti kuunikira kuthandizike,
• kagayidwe mu mkazi woyembekezera akutiwopseza kwambiri. Mfundo yomwe ikuperekedwa ikuwonetsa kusintha kwazomwe zimachitika panjira ya insulin,
• Kwa amayi apakati omwe ali ndi matenda a shuga 1, chithandizo chimayikidwa malinga ndi dongosolo linalake. Chifukwa chake, pofuna kupatula glycemia yam'mawa, komanso mutatha kudya chakudya, wodwalayo akulimbikitsidwa kuchita jekeseni awiri osakwana maola 24.

Pofuna kuthetsa zovuta za insulin, mitundu yochepa kapena yapakatikati ya insulin imayambitsidwa koyamba chakudya cham'mawa, komanso chakudya chisanachitike. Mlingo wophatikiza ndiolandiridwa.

Ndikofunikira kugawa mlingo wonse patsiku: pafupifupi 60% ya buku lonse limagwiritsidwa ntchito m'mawa, pafupifupi 30% - asanadye chakudya chamadzulo. Pofuna kupewa usiku ndi m'mawa hyperglycemia, kuchuluka kwa "musanadye chakudya" kumasinthidwa kukhala jakisoni wopangidwa musanagone.

Kodi insulin imathandizidwa bwanji?

Mukapita ku dokotala-endocrinologist, odwala ambiri amakhala ndi nkhawa kuti mankhwala omwe amapezeka ndi insulin amachitika bwanji ndipo zotsatira zake zingakhale bwanji pogwiritsa ntchito mankhwala omwe ali ndi insulin.

Mulingo uliwonse, njira yeniyeni yovomerezeka imapangidwa ndi endocrinologist. Pakadali pano, amapangira cholembera chapadera kuti odwala azithandizira. Potsirizira izi, mutha kugwiritsa ntchito ma insulin omwe ali ndi singano yochepa kwambiri ya insulin.

Kuchiza wodwala yemwe ali ndi matenda a shuga insulin kumachitika molingana ndi chiwembu chotsatira:

• Musanayambe kuchita insulin, kulowetsa insulin mthupi, kugwiritsa ntchito jakisoniyo.
• Kudya sikuyenera kuchitika pasanathe mphindi 30 kuchokera pakumwa mankhwala.
• Mlingo woyenera kwambiri wa kasodzi m'modzi sayenera kupitirira 30 magawo.

Kugwiritsa ntchito zolembera za syringe kumakondedwa komanso ndikutetezeka. Kugwiritsa ntchito zolembera panthawi yamankhwala kumawerengedwa bwino kwambiri pazifukwa izi:

1. Kupezeka kwa singano ndi kupindika kwapadera mu cholembera kumachepetsa ululu panthawi ya jekeseni.
2. Kupanga kosavuta kwa cholembera kumakulolani kuti mugwiritse ntchito chipangacho nthawi iliyonse komanso kulikonse, ngati kuli kotheka, kubaya insulini.
3. Mitundu ina yamapensulo amakono omwe ali ndi ma insulin. Izi zimapangitsa kuphatikiza kwa mankhwalawa komanso kugwiritsa ntchito mitundu yambiri ya zochizira pamankhwala othandizira.

Malangizo a matenda a shuga omwe ali ndi jakisoni wa insulin akuphatikiza zotsatirazi:

• Asanadye chakudya cham'mawa, wodwala matenda ashuga amayenera kupereka insulin yochepa kapena yayitali.
• Kukhazikitsidwa kwa insulin musanadye chakudya chamadzulo kuyenera kuphatikizapo mlingo wokhala ndi kukonzekera kwakanthawi.
• Jekeseni asanadye chakudya chamadzulo, ayenera kukhala ndi insulin.
• Mlingo wa mankhwala omwe kutumikiridwa musanakagone uyenera kuphatikiza mankhwala osatulutsa.

Zilonda m'thupi zitha kuchitika m'malo angapo a thupi. Kuchuluka kwa mayeso m'dera lililonse.

Kuthiridwa mwachangu kwambiri kumachitika pamene mankhwalawa amatumizidwa pansi pakhungu pamimba.

Type 2 matenda a shuga a mellitus A matenda m'malingaliro onse Makulidwe apang'onopang'ono a insulin ndi nkhani yanthawi yochepa chabe.

Pakadali pano, imatengedwa kuti ndi yachikhalidwe kupatsa mankhwala awiri ochepetsa shuga. Pambuyo pazaka 10-15 kumwa mapiritsi, amapita kumapeto - insulin.

Kuchedwa kwa njirayi yamankhwala kumafotokozedwanso ndikuti jakisoni ndi ofunikira, hypoglycemia imayamba, ndipo wodwalayo amatha kulemera kwambiri. Komabe, odwala ambiri amakhulupirira kuti zotsatira zake ndizosakhazikika, zolimba pang'ono.

Zomwe sizikuyenda bwino zimachepetsa mankhwalawo ngati chithandizo chosankhidwa mosayenera chimayambitsa zochitika pafupipafupi za hypoglycemic. Dziwani kuti kuperekedwa kwa nthawi yochepa ya mankhwala a insulin koyambirira kwamatenda kumatha kubweretsa kuchotsedwa kwa nthawi yayitali komanso kufanana kwa glycemia popanda chifukwa chogwiritsira ntchito mankhwala ochepetsa shuga.

Komabe, ambiri omwe amatsatira endocrinologists savomereza njirayi ndipo amalimbikitsa chithandizo chamankhwala. Zachidziwikire, pali nthawi zina pomwe kuyamba kwa insulin kuyenera kwambiri.

Mwachitsanzo, ndi kugwiritsa ntchito mankhwala osachepetsa shuga m'migawo yoyambirira, insulin imayikidwa. Kuchokera ku mankhwalawa, moyo wabwino komanso kukhutira kwa wodwala ndi chithandizo kumachulukitsidwa kangapo.

Zoopsa za insulin

Kafukufuku wambiri awonetsa kuti hyperinsulinemia ndiyomwe imayambitsa kukula kwa atherosulinosis. Kuphatikiza apo, kugwiritsidwa ntchito koyambirira kwa insulin ngati mankhwala kumatha kubweretsa kupangika kwa matenda a mtima (CHD). Koma mpaka pano, palibe zambiri zolondola komanso zodalirika pankhani yolumikizayi.

Musanayambe mankhwala a insulin, ndikofunikira kudziwa ndikuganizira zinthu zingapo zomwe zingakhudze njirayi. Kuchokera kwa iwo tikuwonetsa kuti:

• kulemera kwa thupi
• zonena za moyo
• Kukhalapo, kuopsa kwa kusintha kwamphamvu kwambiri,
• Kulephera kwa chithandizo cham'mbuyomu.

Kuti muwonetsetse kuti chithandizo cha insulin ndi chofunikira, ndikofunikira kudziwa kuchuluka kwa maselo a pancreatic beta pozindikira kuchuluka kwa C-peptide yopanga.

Muyenera kuyamba mankhwalawa a insulin a 2 matenda a shuga:

• ali ndi hyperglycemia yayikulu komanso yayikulu mankhwala ochepetsa shuga,
• kuwonda mwadzidzidzi
• otsika C-peptide.

Monga chithandizo chakanthawi, insulin imayikidwa ngati pakufunika kuchepetsa matenda a glucose omwe ali ndi kuchuluka kwa magazi. Kafukufuku wasonyeza kuti mankhwala a insulin amachepetsa kwambiri mwayi wokhala ndi zovuta za microvascular.

lechenie-simptomy.ru

Chithandizo cha odwala matenda ashuga a mtundu 2 chimafunika chiwembu. Chofunika cha mankhwalawa ndikuti, Mlingo wocheperako wa insalini amawonjezedwa pang'onopang'ono ku mankhwala ochepetsa shuga a wodwala.

Kwa nthawi yoyamba yomwe amakumana ndi kukonzekera koyambira, komwe kumapangidwira m'njira yopanda insulin (mwachitsanzo, insulin glargine), odwala ayenera kuyima pa 10 IU patsiku. Makamaka, jakisoni amaperekedwa nthawi yomweyo.

Ngati matenda a shuga akupitiliza kuyenda ndikuphatikizidwa kwa mankhwala ochepetsa shuga (mawonekedwe a piritsi) ndi jakisoni wa basal samabweretsa zotsatira zomwe akufuna, muzochitika izi adokotala asankha kusamutsa kwathunthu wodwalayo ku regimen yothandizira.

Nthawi yomweyo, kugwiritsa ntchito mankhwala osiyanasiyana kumalimbikitsidwa, koma aliyense wa iwo ayenera kuvomerezedwa ndi adokotala.

Ana ndi gulu lapadera la odwala, chifukwa chake chithandizo cha insulini chokhudza matenda a shuga a ana nthawi zonse chimafunikira munthu payekha. Nthawi zambiri, pochizira ana, amagwiritsa ntchito maulamu atatu a insulin. Kuchepetsa kuchuluka kwa jakisoni kwa odwala ang'onoang'ono, kuphatikiza kwa mankhwala omwe amakhala ndi nthawi yochepa komanso yapakatikati kumachitika.

Chithandizo cha insulin chimachitika mogwirizana ndi dongosolo lotsatirali:

1. Musanapange jekeseni wapansipansi, tsamba lamalowo limapindika.
2. Kudya pambuyo jakisoni sikuyenera kupitilira theka la ola.
3. Mlingo waukulu kwambiri sungadutse mayunitsi 30.

Munthawi zonsezi, dongosolo lenileni la insulin liyenera kukhala dokotala. Posachedwa, zolembera za insulini zakhala zikugwiritsidwa ntchito pochiza, ma insulin omwe amakhala ndi singano yochepa thupi angagwiritsidwe ntchito.

Kugwiritsa ntchito zolembera za syringe kumakhala koyenera pazifukwa zingapo:

• Chifukwa cha singano yapadera, kupweteka kwa jakisoni kumachepetsedwa.
• Kusavuta kwa chipangizocho kumakulolani kuti mupange jakisoni kulikonse komanso nthawi iliyonse.
• Mapensulo ena amtundu wa syringe ali ndi mbale za insulin, zomwe zimapereka mwayi wophatikiza mankhwalawa ndikugwiritsa ntchito njira zosiyanasiyana.

Zomwe zimapangidwira mu insulin regimen yamtundu wa 1 komanso mtundu wa 2 wa shuga ndi motere:

1. Asanadye chakudya cham'mawa, wodwalayo ayenera kupereka mankhwala osakhalitsa kapena a nthawi yayitali.
2. Jakisoni wa insulin musanadye masana ayenera kukhala ndi mahomoni osakhalitsa.
3. Jakisoni yemwe asanachitike chakudya chamadzulo amaphatikizapo insulin yochepa.
4. Asanagone, wodwalayo ayenera kukonzekera kwa nthawi yayitali.

Pali madera angapo oyendetsera thupi la munthu. Kuchuluka kwa mankhwalawa kwa mankhwala m'gawo lililonse ndi kosiyana. Mimba imayamba kugwira chisonyezo ichi.

Ndi malo osankhidwa molakwika, makonzedwe a insulin sangapereke zotsatira zabwino.

Mankhwala a insulin, momwe mankhwala apadera amagwiritsidwa ntchito, amakhudza thupi motere:

• kapamba amalimbikitsidwa ndi insulin katulutsidwe,
• kudya glycemia ndikatha kudya,
• kusintha kwa mapuloteni a chiwindi kukhala glucose kumachepa,
• kupanga mahomoni omwe amawonjezera glycemia atatha kudya amachepetsa.

Chithandizo cha pampu

Therapy yolimbitsa insulin imatha kutchedwa maziko a inshuwaransi ya insulin, malinga ndi zina mwa kugwiritsa ntchito njirayi.

Chizindikiro cha insulin yowonjezereka ndikuti chimagwira ngati chida chobisika cha insulin m'thupi la wodwalayo.

Njirayi imagwiritsidwa ntchito pakafunika insulin mankhwala a mtundu 1 wa shuga. Ndi mankhwalawa matenda amtunduwu omwe chithandizo chotere chimapereka mayendedwe abwino kwambiri azachipatala, ndipo izi zimatsimikiziridwa.

Kuti mukwaniritse ntchito imeneyi, mndandanda wina wa mikhalidwe umafunika. Izi ndi izi:

1. Insulin iyenera kulowetsedwa m'thupi la wodwalayo m'njira zokwanira kugwiritsira ntchito shuga.
2. Ma insulini omwe amalowetsedwa m'thupi ayenera kukhala ofanana kwathunthu ndi ma insulin omwe amapangidwa ndi kapamba wa wodwala yemwe ali ndi matenda osokoneza bongo.

Zomwe zidafotokozedwazi zimayambitsa zovuta za insulin mankhwala zomwe zimagawanitsa mankhwala omwe amagwiritsidwa ntchito posachedwa ndi insulin.

Ma insulin omwe amakhala nthawi yayitali amagwiritsidwa ntchito kuperekera insulin m'mawa ndi madzulo. Mankhwala amtunduwu amalinganiza kwathunthu zinthu zomwe zimapangidwa ndi maholide.

Kugwiritsa ntchito ma insulin okhala ndi kanthawi kochepa kumakhala koyenera pambuyo poti mudya chakudya chamafuta ambiri. Mlingo womwe umagwiritsidwa ntchito kuti ubweretsere mankhwalawa m'thupi umatengera kuchuluka kwa mkate womwe umapezeka mu chakudya ndipo umatsimikiziridwa mosamalitsa payekhapayekha kwa wodwala aliyense.

Kugwiritsa ntchito mankhwala a insulin olimbitsa a 1 mtundu wa shuga kumafananizira kuchuluka kwa glycemia musanadye.

Chithandizo cha insulin chachikhalidwe ndi njira yophatikizira yomwe imaphatikizapo kuphatikiza insulin yochepa komanso yayitali.

Ubwino waukulu wogwiritsa ntchito mankhwalawa ndikuchepetsa kuchuluka kwa jakisoni pang'ono. Nthawi zambiri, kuchuluka kwa jakisoni panthawi ya mankhwalawa malinga ndi njirayi imachokera pa 1 mpaka 3 patsiku.

Choipa chogwiritsa ntchito njirayi ndikulephera kwofanizira zochitika za kapamba. Izi zimabweretsa chifukwa chakuti pogwiritsa ntchito njirayi ndizosatheka kulipira kwathunthu kuphwanya kwa kagayidwe kazakudya kamunthu.

Mukugwiritsa ntchito njira iyi, wodwalayo amalandira jakisoni 1-2 patsiku. Ma insulin afupiafupi ndi aatali amayendetsedwa nthawi yomweyo kulowa m'thupi. Ma insulini omwe amakhala ndi nthawi yayitali kuti awonetsedwe pafupifupi pafupifupi 2/3 ya kuchuluka kwa mankhwalawa, gawo limodzi mwa magawo atatu a mankhwalawa amakhala osapumira.

Chithandizo cha matenda a shuga 1 amtundu wachiberekero wamtundu wa mankhwala a insulin sichifuna kuti munthu azitsatira glycemia musanadye.

Pampu ya insulin ndi chipangizo chamagetsi chomwe chimapangidwa kuti chizigwira ntchito mozungulira nthawi yomweyo.

Mukamagwiritsa ntchito mtundu uwu wa mankhwalawa, mankhwalawa amaperekedwa mu Mlingo wa mini.

Njira yamagetsi ya insulin yamagetsi imatha kuchitika m'njira zosiyanasiyana. Njira zazikulu zogwiritsira ntchito pampu ndi izi:

1. Kupitiliza kuperekera mankhwala m'thupi mwa ma microdoses okhala ndi oyambira.
2. Kukhazikitsidwa kwa mankhwalawa m'thupi mothandizidwa ndi kubayidwa pafupipafupi kwa jakisoni wa mankhwala.

Pankhani ya njira yoyambirira yoyendetsera insulin, kuyeserera kwathunthu kwa chinsinsi cha mahomoni mu kapamba kumachitika. Njira zoterezi zimapangitsa kuti mankhwalawa asagwiritsidwe ntchito kwa nthawi yayitali.

Kugwiritsa ntchito njira yachiwiri yobweretsera insulini m'thupi kumakhala koyenera musanadye kapena nthawi zina pakakhala kuchuluka kwa index ya glycemic.

Chiwembu cha insulin chogwiritsa ntchito pampu chimalola kuphatikiza kwa liwiro kuti athe kutsata njira ya insulin yobisalira m'thupi la munthu, yomwe imakhala ndi kapamba wabwino. Mukamagwiritsa ntchito pampu, catheter iyenera kusinthidwa masiku atatu aliwonse.

Kugwiritsa ntchito pampu yamagetsi kumakupatsani mwayi wothana ndi mavuto poyesa njira yobisika yolembera insulin mthupi la munthu.

Nthawi zambiri, anthu odwala matenda ashuga a 2 safunikira mankhwala a insulin, chifukwa kuchuluka kwa shuga kumatha kuwongoleredwa mothandizidwa ndi mankhwala ochepetsa shuga kapena zakudya. Thupi limatha kudzipangira payekha payokha, koma kuchuluka kwake sikokwanira pantchito yathunthu.

Jakisoni wa insulin angafunikire ngati zikondazo zimatha kuthana palokha ndi ntchito yopanga mahomoni ndipo munthuyo akhale ndi zotsatirazi:

• kusowa kwamadzi
• mtima mavuto, kuwonda.

Komanso, zingakhale zofunika kupangitsa kuti mankhwalawa ayambike, ketoacidosis, opaleshoni kapena matenda opatsirana.

Mu odwala matenda ashuga a mtundu wachiwiri, kudalira insulini sikutheka, ngati pali kusintha, ndiye kuti mutha kuyimitsa makonzedwe a mankhwalawa.

Malinga ndi algorithm yamakono, ndibwino kuyambitsa mankhwala a insulin ndi basal kapena biphasic insulin. Njirayi itha kuchitika kwakanthawi kapena kosatha (ngati mankhwala ochepetsa shuga alibe zomwe mukufuna).

Kuchuluka kwa jakisoni wa insulin kwa mtundu wachiwiri wa matenda ashuga kumatengera kuchuluka kwa shuga mthupi komanso chakudya. Nthawi zambiri, odwala oterewa amapatsidwa mankhwala a bolus, omwe amatanthauza kumayambitsa insulin yochepa tsiku lonse.

Ana, komanso achikulire, amakhala ndi matenda ashuga. Mlingo wa insulin wa mwana amawerengedwa m'magawo. Kwa masiku angapo, mwana amawonedwa kuti adziwe kuchuluka kwa shuga ndikulumpha ndi kupereka mankhwala ake.

Kwa ana, insulin yovomerezeka imabayidwa, yomwe imachepetsa chiopsezo cha bongo.

Ndikofunikira kuwongolera ndi kuyambitsa insulini kuyambira ali aang'ono kwambiri momwe mungathere, chifukwa thupi silikukhazikika mokwanira komanso mozunzika kwambiri silingathe kuthana ndi zovuta.

Pampu ya insulin ndi chipangizo chamagetsi chomwe chili chaching'ono kukula, chimagwira mthumba kapena kumangirira lamba. Ntchito yayikulu ya chipangizochi ndikuwunikira ntchito ya kapamba, mwa kuyendetsa mosalekeza mahomoni - insulin, pansi pa khungu.

Chifukwa cha chipangizochi, insulin imayendetsedwa kuzungulira wotchi, muyezo woyenera komanso panthawi yoyenera.

Ubwino waukulu wa inshuwaransi yamapulogalamu:

• Mlingo wa makonzedwe umakhazikitsidwa malinga ndi zomwe munthu akuzindikira komanso kuzindikira. Pali mwayi wowongolera, kutengera zosowa.
• Makina owerengera omwe amapangidwa amapangitsa kuti azitha kuwerengera mankhwalawo ndikuwongolera mankhwalawo chizindikiro choyambirira cha hyperglycemia.
• Kulumikizana popanda zingwe sikubweretsa kusasangalala kwakukulu, m'malo mwake, zimangothandiza munthu kuti azikhala otetezeka nthawi zonse.

Zowonetsa kugwiritsa ntchito pampu ya insulin zingakhale motere:

• Ngati angafune.
• Pamavuto akukumana ndimatenda abwino a shuga.
• Ndi mawonetseredwe pafupipafupi a hyperglycemia.
• Mukakonzekera kukhala ndi pakati.
• Ndi matenda a shuga kwa ana.

Chofunikira pakugwiritsa ntchito pampu ndikuti iyenera kusinthidwa masiku onse atatu. Dongosolo la kulowetsedwa ndi cannula pulasitiki limayikidwa pansi pa khungu. Malo oyikapo mankhwalawa amasankhidwa komanso malo a jekeseni: m'mimba, matako, m'chiuno, mapewa.

Pogwiritsa ntchito pampu, anulin ya insulini yokhala ndi zochita za ultrashort komanso yaying'ono imalowetsedwa m'thupi.

Mukamasankha pampu ya insulin, muyenera kuganizira kuchuluka kwa thankiyo, yomwe ikhale yokwanira masiku atatu ogwiritsa ntchito. Muyenera kusankhanso chida chomwe chimawerengera bwino, kuwala kokwanira komanso kusiyanitsa.

Pali contraindication ogwiritsa ntchito pampu, omwe ali motere:

• Ngati wodwala matenda ashuga amawongolera okha shuga, amatsatira kwambiri zakudya ndi zopatsa mphamvu.
• Pakakhala zovuta m'maganizo, chifukwa chomwe munthu sangathe kuyigwiritsa ntchito.
• Kuwona bwino kungachititse zinthu zambiri, chifukwa munthu sangathe kuwona zomwe zalembedwa pazenera.

Pazonse, chithandizo cha insulin cha pampu chimakhala ndi mphindi zingapo ndi ma pluses. Ndikwabwino kuzigwiritsa ntchito ngati kugwiritsa ntchito syringe komanso zakudya zama carb ochepa sikupereka zotsatira zoyenera.

Odwala omwe ali ndi vuto la m'maganizo amathanso kuikidwa pa insulin. Pankhaniyi, mankhwalawa amatumizidwa musanadye.

Vuto lalikulu mwa odwala chotere ndikuti iwo omwe ali ndi hypoglycemia amasiya kumva ludzu, kufooka, njala ndi zizindikiro zina. Munthuyo amamasilira ena. Nthawi yofananira yazizindikiro zotere ndi maola atatu, pambuyo pake insulin ikuchita, ndipo munthuyo amayamba kumva bwino.

Malinga ndi akatswiri a matenda ashuga ku Europe, mankhwala a insulin sayenera kuyamba molawirira kwambiri komanso osachedwa. Osati chilonda, chifukwa kusakwanira kwachinsinsi kungakhale kwachiwiri kwa insulinitensity, komanso chifukwa cha chiopsezo cha hypoglycemia. Sanachedwe, chifukwa ndikofunikira kukwaniritsa kuyenera koyenera ka glycemic.

Aliyense endocrinologist kuyambira nthawi yomwe amadziwika kuti ali ndi matenda a shuga a 2 ayenera kudziwitsa odwala ake kuti chithandizo cha insulin masiku ano ndi njira imodzi yothandiza kwambiri. Komanso, nthawi zina, mankhwala a insulini akhoza kukhala njira yokhayo, yokwanira yokwaniritsira Normoglycemia, ndiko kuti, kubwezeretsa matenda.

Samazolowera insulin. Musaganize kuti posintha ma jakisoni a insulin, mtsogolomo mudzalandira "odalira insulin". Chinthu china, nthawi zina zovuta kapena zovuta za insulin mankhwala zimatha kuonedwa, makamaka kumayambiriro.

Yemwe akutsogolera pakusankha kuperekedwa kwa mankhwala a insulin ayenera kusewera pazidziwitso za beta-cell ya gland. Pang'onopang'ono, mtundu wachiwiri wa matenda a shuga ukamapitirira, vuto la beta-cell limayamba, ndikufunika posintha nthawi yomweyo ku chithandizo cha mahomoni. Nthawi zambiri, pokhapokha mothandizidwa ndi insulin mankhwala amatha kukwaniritsa ndi kusunga kuchuluka kwa glycemia.

Kuphatikiza apo, insulin yothandizira mtundu wa matenda a shuga a 2 ingafunike kwakanthawi kwakanthawi kochepa kwakadwala. Izi ndi zochitika pamene insulin yothandizira mtundu wachiwiri wa shuga ikufunika.

1. Mimba
2. Zovuta za macrovascular, monga myocardial infarction ndi stroke,
3. Kuperewera kwa insulin, komwe kumawoneka ngati kuchepa thupi pang'onopang'ono ndi chidwi, kulimba kwa ketoacidosis,
4. Opaleshoni
5. Matenda osiyanasiyana opatsirana ndipo koposa zonse, purulent-septic m'chilengedwe,
6. Zizindikiro zoyipa za njira zosiyanasiyana zofufuzira matenda:

• kukonza kwa otsika C-peptide ndi / kapena insulini pakusala magazi.
• mobwerezabwereza mtima hyperglycemia milandu wodwalayo akamamwa mankhwala a hypoglycemic, akuwonetsetsa kuti azichita zolimbitsa thupi.
• glycosylated hemoglobin woposa 9,0%.

Zinthu 1, 2, 4, ndi 5 zimafuna kusintha kosakhalitsa kwa insulin. Pambuyo pokhazikika kapena kubereka, insulin imathetsedwa.

Pankhani ya hemoglobin ya glycosylated, kayendedwe kake kamayenera kubwerezedwa pambuyo pa miyezi 6. Ngati munthawi imeneyi kuchuluka kwake kumatsika ndi 1.5%, mutha kubwezeretsa wodwala kuti atenge mapiritsi ochepetsa shuga, ndikukana insulin.

Ngati kuchepa kwa chizindikirocho sikuwonetsedwa, chithandizo cha insulin chiyenera kupitilizidwa.

Alexey ROMANOVSKY, Pulofesa Wothandizira, Dipatimenti ya Endocrinology BelMAPO, Woyankha wa Sayansi ya Zamankhwala

Kodi nchifukwa ninji munthu amafunikira insulin?

Ndi kuchepa kwamphamvu kwa kubisala kwa cell ya beta komanso kusagwira bwino ntchito kwa mankhwala ochepetsa shuga, insulin imalimbikitsidwa m'njira zophatikizira kapena kuphatikiza mankhwala ochepetsa shuga.

Zizindikiro zokwanira zama insulin

• Zizindikiro zakuchepa kwa insulini (mwachitsanzo, kuchepa thupi, zizindikiro za kuwonongeka kwa matenda amtundu wa 2),
• kukhalapo kwa ketoacidosis ndi (kapena) ketosis,
• zovuta zilizonse za matenda a shuga a 2,
• kuchuluka kwa matenda osachiritsika, matenda opatsirana opweteka kwambiri (stroko, gangrene, vuto la mtima), kufunikira kwa maopareshoni, matenda oopsa,
• omwe adapezeka kumene amtundu wachiwiri wa shuga, womwe umayendetsedwa ndi shuga wambiri masana komanso pamimba yopanda kanthu, osaganizira kulemera kwa thupi, zaka, kuchuluka kwa matendawa,
• omwe adapezeka kumene amtundu wachiwiri wa matenda ashuga pamaso pa ziwengo ndi zina zotsutsana ndi kugwiritsa ntchito mankhwala kuchokera kwa shuga m'mapiritsi. Matenda a hemorrhagic, matenda a impso ndi chiwindi.
• mimba ndi mkaka wa m`mawere
• kuwonongeka kwambiri kwa impso ndi chiwindi.
• kusowa kwa shuga wowongolera pa mankhwalawa pogwiritsa ntchito mankhwala osachepera shuga ochulukirapo omwenso amathandiza kuti asakanikirane ndi kuphatikiza Mlingo wovomerezeka, komanso kuyesetsa wokwanira
• precoma, chikomokere.

Mankhwala a insulin amadziwika kuti ali ndi odwala omwe ali ndi matenda a shuga a 2 omwe ali ndi magawo a Laborator otsatirawa:

• kusala shuga m'magazi pamwamba pa 15 mmol / L mwa odwala omwe akukayikira
• kuchuluka kwa plasma ya C-peptide pansipa 0,2 nmol / l pambuyo poyesedwa mwamphamvu ndi 1.0 mg ya glucagon,
• ngakhale mutagwiritsa ntchito mankhwala osachepera tsiku lililonse okonzekera shuga, kuthamanga kwa shuga m'magazi kumakhala kwakukulu kuposa 8.0 mmol / l, mutatha kudya kwambiri kuposa 10.0 mmol / l,
• mulingo wa glycosylated hemoglobin nthawi zonse umapitirira 7%.

Ubwino wambiri wa insulin pochiza matenda amtundu wa 2 ndi momwe zimachitikira mbali zonse za matenda amtunduwu. Choyambirira, izi zimathandizira kulipirira kuchepa kwa mphamvu ya insulin ya insulin, yomwe imawonedwa ndi kuchepa kwapang'onopang'ono kwa magwiridwe antchito a beta.

Choyamba, ndikofunikira kukambirana cholinga chopereka mankhwala a insulin kwa odwala omwe ali ndi matenda a shuga a 2. Zitha kupangidwa motere:

1. kupewa ketoacidosis ndi matenda ashuga,
2. kuthetsa kwa zizindikiro za hyperglycemia / glucosuria (polyuria, ludzu, kuchepa thupi, ndi zina zambiri).
3. kutsitsa pafupipafupi komanso kuopsa kwa njira zopatsirana,
4. kupewa michere ndi macrovascular yamavuto omwe ali ndi chiopsezo chachikulu cha kukula kwawo ndi / kapena kuyimitsidwa kwa kupitilira kwa zovuta zomwe zilipo.

Zina mwazomwe zalembedwaku ndi zachangu, zikuwonekeratu (kukwaniritsa zolinga zitatu zoyambayo kumapangitsa kuti wodwalayo akhale bwino) ndipo zimatheka mosavuta. Kupewa matenda obwera chifukwa cha matenda ashuga ndi cholinga chomwe sichikudziwika, ndipo kukwaniritsidwa kwake kuli ndi zovuta zambiri.

Therapy Insulin Yakanthawi

Zinthu zotsatirazi zomwe zimafunikira insulin posakhalitsa sizikukambidwa pang'ono: mimba, chithandizo chachikulu cha opaleshoni, matenda oopsa osachiritsika komanso otupa, zochitika zingapo za pachimake (myocardial infarction, ngozi ya pachimake ya kuvulala, kuvulala kwambiri, etc.

d.).Kwa amayi apakati omwe ali ndi matenda a shuga a 2, komanso matenda a shuga 1, kusungabe glycemia koyenera ndikofunikira pakubadwa kwa mwana ndi amayi, komanso kugwiritsa ntchito mankhwala amkamwa hypoglycemic ndizotsutsana.

Zikuwoneka kuti ndibwino kwa odwala omwe ali ndi matenda oopsa kapena akufunika kuchitira opaleshoni yayikulu kuti apereke insulin mu regimen yothandizidwa kwambiri ndikusunga milingo ya glycemic pafupi kwambiri.

Ngakhale akuchita, nkhawa zambiri za kukula kwa hypoglycemia nthawi zambiri zimapangitsa kuti pakakhala kusintha kwa insulin, kuchuluka kwa kayendedwe ka glycemic kumakhalabe kosakhutiritsa.

Mavuto a insulin

Kugwiritsa ntchito mankhwala othandizira, monga chithandizo china chilichonse, sikungokhala ndi zotsutsana zokha, komanso zovuta. Chimodzi mwazomwe zikuwonetsa zovuta zomwe zimachitika chifukwa cha insulin mankhwala ndimomwe thupi lawo siligwirizana.

Kupezeka kofala kwambiri kwa chifuwa kumagwirizanitsidwa ndiukadaulo wa jakisoni mukamagwiritsa ntchito mankhwala okhala ndi insulin. Zomwe zimayambitsa matenda osokoneza bongo zitha kukhala kugwiritsidwa ntchito kwa singano yovutitsa kapena yolimba mukapaka jakisoni, osapangidwa kuti apangire insulin, komanso, chifukwa cha ziwengo zitha kukhala malo olakwika a jakisoni ndi zina.

Vuto linanso la mankhwala a insulin ndi kuchepa kwa shuga m'magazi a wodwala komanso kukula kwa hypoglycemia m'thupi. Mkhalidwe wa hypoglycemia ndi wopatsa thupi.

Kupezeka kwa hypoglycemia kumatha chifukwa cha kuphwanya kusankha kwa mankhwala a insulin kapena kusala kudya kwanthawi yayitali. Nthawi zambiri glycemia imachitika munthu akamakhala ndi nkhawa yambiri.

Vuto linanso lomwe limapangitsa kuti mankhwala a insulin apangidwe ndi lipodystrophy, chizindikiro chachikulu chomwe ndi kuchepa kwa mafuta osunthika m'malo a jakisoni. Popewa kutukuka kwa vutoli, dera la jakisoni liyenera kusinthidwa.

Mu kanema munkhaniyi, njira yothandizira insulin pogwiritsa ntchito cholembera imawonetsedwa bwino.

Mtundu woyamba wa matenda a shuga a mellitus insulin: mawonekedwe ndi mitundu ya mankhwala

Mankhwala a insulini a shuga amaperekedwa ndi endocrinologist. Insulin yomwe imagwiritsidwa ntchito pochiritsa imapangitsa kwambiri shuga m'thupi la wodwala.

Kukhazikitsidwa kwa regulen ya mankhwala a insulin sikuyenera kukhala yokhazikika, njira yodalirika iyenera kutengedwa kwa wodwala aliyense, ndipo chitukuko cha regulin yoyendetsedwa payekha chimachitika molingana ndi deta yomwe yapezeka chifukwa cha kuwunika kwathunthu shuga mkati mwa sabata.

Ngati madokotala opezekapo, akupanga njira zamankhwala othandizira, samaganizira za thupi la wodwalayo komanso kuchuluka kwa zomwe wapeza chifukwa chakuwunika kuchuluka kwa shuga m'magazi, muyenera kuthandizidwa ndi katswiri wina.

Malangizo a insulin mankhwala atapangidwa molakwika amatha kukulitsa vuto la wodwalayo mpaka kuyamba kwa chizindikiro cha kulephera kwa impso komanso kusokonezeka kwa magazi m'miyendo.

Ngati dongosolo la mankhwala a insulini limapangidwa popanda kuganizira za thupi la wodwalayo, pamapeto pake izi zitha kubweretsa zotsatirapo zowonongeka chifukwa chakuwonongeka kwa ziwopsezo zomwe zimachitika chifukwa cha kukula kwa machitidwe aubwino m'matupi.

Kusankha kwa insulin mankhwala a matenda amtundu wa 1 amachitika ndi endocrinologist malinga ndi mawonekedwe a thupi la wodwalayo.

Ngati wodwala alibe vuto la kunenepa kwambiri, ndipo alibe nkhawa kwambiri m'moyo, ndiye kuti insulini imalembedwa mu ziwerengero za 0.5-1 kamodzi patsiku malinga ndi kilogalamu imodzi ya kulemera kwa thupi la wodwalayo.

Mpaka pano, endocrinologists apanga mitundu yotsatirayi ya mankhwala a insulin:

• kukulitsa
• zachikhalidwe
• zochita pampu
• maziko a botus.

New-isanayambike mtundu 2 shuga

Odwala ena kumene anapezeka ndi matenda a mtundu 2 shuga kwenikweni ndi otchedwa pang'onopang'ono mwapang'onopang'ono zosinthika a mtundu 1 shuga kapena autoimmune shuga la akulu (LADA).

Malinga ndi ena, kolichesivo odwala amenewa ndi 10-12% odwala ndi kumene anapezeka "mtundu 2 shuga". Zimapezeka zolembera onse immunological a mtundu 1 shuga.

Koma monga mchitidwe ochiritsira, tanthauzo la umoyo wa zolembera izi palibe, chithandizo cha odwala otere nthawi zambiri imachitikira pa ma aligorivimu womulera mtundu 2 shuga. Pali lingaliro losagwirizana kuti anthu azaka zapakati pa 40 ndi / kapena onenepa kwambiri ndi omwe akuyembekezeredwa kwambiri kulandira chithandizo cha insulin kuyambira pomwe azindikira matenda a shuga.

Komabe, yolondola kwambiri akadali motsogozedwa ndi matenda, osati zaziwerengero kapena anthropometric muyezo. Wodwala yemwe ali ndi vuto losowa kwambiri mu insulin katulutsidwe ayenera kulandira chithandizo cha insulin kuyambira kumayambiriro kwa matendawa, mosaganizira zaka, kulemera kwa thupi, kapena kutalika kwa matendawo.

Zizindikiro ndi insulinodefitsita ketosis zizindikiro za hyperglycemia kwambiri ndi imfa kwambiri kulemera. Muyeso masika ayenera kugwiritsidwa ntchito mosasamala kulemera mtheradi wa thupi, ie, ngakhale wodwala onenepa kwambiri yemwe akuchepetsa thupi kuchepa msanga komanso akumakhala ndi zizindikiro zina za kuchepa kwa insulini amayeneranso kulandira insulin, osachepera gawo loyambirira la chithandizo.

Mulimonsemo, wodwala yemwe wapangidwapo mankhwala a insulin amafunikira kuwunika mosamala, onse kuti akwaniritse ndikubwezeretsanso kagayidwe kazakudya, ndikuwonetsetsa njira zina zochizira.

Mankhwala a insulin amafotokozedwanso kwa odwala omwe ali ndi vuto la matenda ashuga a 2, omwe, kuwonjezera pa zakudya, amafunika mankhwala a hypoglycemic, koma ali ndi zotsutsana popereka mankhwala amkamwa a hypoglycemic (chiwindi chachikulu, impso, kukanika, zina ndi zina.

Odwala ndi osauka ulamuliro glycemic pa zakudya mankhwala

Kwa gulu la odwala insulin ndi m'kamwa hypoglycemic preparty mukhoza kutengedwa ngati njira zochizira ndi kupikisana. Choncho chinthu choyamba ndiponso chofunika kwambiri posankha pakati pawo - kusiyana angathe kukhala zotsatira efficacy pa glycemia.

The chachiwiri zofunika kuganizira - kodi amasiyana chitetezo. Zinthu ngati chomasuka ntchito, mayiko, kuvomereza wodwalayo, malinga ndi kufunika kotsatira woyamba awiri.

Zambiri pazakuyerekeza kothandizika kwa mankhwala a insulin ndi pakamwa zimaperekedwa mu kuchuluka kwakukulu kwa kafukufuku woyembekezeredwa, wosakhalitsa, wakhungu lachiwiri kapena wopanga gawo. Mmodzi wa kafukufuku waukulu posachedwapa anali kuphunzira British oyembekezera pa ulamuliro wa shuga ndi chitukuko cha mavuto (UKPDS).

Zinatha pafupifupi zaka 20, nawo odwala oposa 5000 ndi mtundu 2 shuga. Odwala adagawika m'magulu omwe adalandira mitundu yosiyanasiyana ya mankhwalawa kuyambira pomwe apezeka ndi matenda a shuga: chakudya chokha, mankhwala amkamwa a hypoglycemic, insulin.

Mwachangu ofanana ndi m'kamwa insulin preparty mwasonyezedwa kwa nthawi yaitali odwala awa.

Odwala ndi osauka ulamuliro glycemic pa mankhwala m'kamwa antidiabetic.

Pafupifupi 10% ya odwala omwe ali ndi matenda a shuga 2 amayamba kugonjetsedwa ndimankhwala a hypoglycemic (makamaka sulfonylureas) ndi 5-10% ya odwala sazindikira mankhwalawa chaka chilichonse.

Insulin iyenera kufotokozedwa mwachangu komanso mwachangu, ngati wodwalayo akuonetsa kuti ali ndi vuto la insulin. Tsoka ilo, pochita, pamene insulin imalembedwa kwa odwala pambuyo poti sanachite bwino ndi mankhwala amkamwa, glycemia sikuti nthawi zonse imasintha.

Zomwe zimapangitsa kuti insulin isagwire bwino ntchito kwa odwala nthawi zambiri imakhala yofanana ndi yomwe ili pamwambapa ndi odwala omwe amadziwika kuti ali ndi matenda a shuga 2: kugwiritsa ntchito insulin yokwanira, makamaka kwa odwala omwe ali ndi kunenepa kwambiri, kapena ma insulin.

Komanso, nthawi zambiri nthawi yomweyo palibe kudziletsa wa glycemia. Odwala onenepa omwe kugwiritsa ntchito mankhwala a hypoglycemic sanathe, omwe amakhalabe ovomerezeka atasamukira ku insulin, mwina ndi omwe ali ovuta kwambiri ("opanda chiyembekezo" a madokotala ambiri).

Kuchepetsa ndi kukonza zina thupi ntchito otsika kalori zakudya ndi zinthu zolimbitsa thupi odwala awa - njira mtima kwambiri kukwaniritsa malipilo, koma kumafuna khama kuchokera wodwala ndi dokotala.

Ngati kuwonjezeka kwa thupi panthawi ya insulin wodwala, zinthu zitatu zonsezi zosagwirizana zimapitilirabe ngakhale kupita patsogolo: hyperglycemia, kunenepa kwambiri, komanso kukana insulini ndi hyperinsulinemia yapamwamba.

Добиваться снижения массы тела в таких случаях становится важнейшей терапевтической целью, и затраты времени и усилий в этом направлении, безусловно, оправданы. odwala Tiyenera kuphunzitsa mapulogalamu apadera, komanso thandizo maganizo.

Ngati insulin ndi kutumikiridwa mu chipatala, mawu ayenera inakonzedwa malangizo kupita kwa dokotala ndi zotsatira za mlingo kudzimvera kuyan'anila shuga magazi kuti azolowere pokhazikitsa ndi outpatient. Chosowa kudziletsa kwambiri amachepetsa mphamvu ya mankhwala.

В руководстве Европейской группы в области стратегии лечения сахарного диабета критерии для назначения инсулина достаточно строгие. M'malo mwake, chizindikiritso cha kusamutsa ku mankhwala a insulini ndizosatheka kukwaniritsa pafupifupi zonse za proteinoglycemia pamimba yopanda kanthu ndikatha kudya, komanso kuchuluka kwa hemoglobin HbA1c yoposa 6.5% mukalandira chithandizo chambiri.

Malinga ndi mfundo Russian, ndi umboni waukulu insulin mankhwala odwala ndi mtundu 2 shuga ndi osamveka zakudya ndi yayikulu m'kamwa wothandizila hypoglycemic, Kusala Glycemia

Mankhwala a mtundu Ine shuga ana: mlingo wa insulin ndi insulin chiwembu

Сахарный диабет первого типа (СД-1), до недавнего времени именовавшийся инсулинозависимым процессом, а ранее имевший название ювенильного СД, считается патологией преимущественно молодых людей и детей, подростков.

Pa zaka zapitazi pakhala kuwonjezeka lakuthwa mu zochitika za T1D, lapadera - ana ndi unyamata.

Ili ndi vuto lalikulu pakubwera kwa thanzi ndipo makolo, ana omwe ali ndi matenda amtundu wa 1 amafuna chithandizo chanthawi zonse chifukwa cha insulin, yomwe singathe kupanga kapamba wawo.

Sd-1 uli gulu la pathologies autoimmune, chifukwa cha zotsatira zosiyanasiyana anawonongedwa ndi chitetezo eni maselo pancreatic kubala insulin zofuna za thupi.Ndi imfa yoposa 85% ya ma cell a beta a gland, mkhalidwe wa kufooka kwathunthu kwa insulin, zomwe zimayambitsa matenda a hyperglycemia (glucose yayikulu ya plasma) ndi zovuta zingapo za metabolic.

Kuchokera koyesera koyamba pakukhazikitsidwa kwa insulin m'thupi la munthu kuchokera kunja - mpaka lero, insulin mankhwala mu matenda a shuga 1 ndi lalikulu kukonzedwa njira kusintha kagayidwe kachakudya mu thupi la mwanayo.

Zochitika pakugwiritsa ntchito insulin kuchipatala zakhala ndi zaka zopitilira 80, munthawi imeneyi mankhwalawa asintha kwambiri, ubora wawo wapita patsogolo, ndipo njira zothandizira ake zayendera.

1. Liwiro (lalifupi wotenga insulin, yosavuta)

Zowonjezera zochizira insulin yomwe imagwira mwachangu zimadziwika nthawi yomweyo, pakadutsa mphindi 15-30 pambuyo pake. Peak ntchito - chimodzi ndi theka maola atatu pambuyo utsogoleli.

Zimene insulin mu mlingo unsembe yozungulira, akhoza anakhalabe maola sikisi. The insulin kwambiri chabe muli kudwala, yaitali Kutalika kwa kanthu.

Wotenga nthawi yochepa njira insulin - wopanda khungu komanso wowonekera, mosiyana ndi turbid insulin pakati komanso wokhalitsa. Majekeseni ndi insulins zoterozo musanadye.

Koma mitundu ina ya insulini sikutanthauza kuchuluka kwa jakisoni, popeza amatha kusunga kuchuluka kwa insulin m'magazi masana.

2. Mankhwala kukhala ndi nthawi avareji kanthu

Gulu lalikulu kwambiri mankhwala ndi insulin zambiri. Isanayambike ntchito mankhwala - pambuyo maola 1-3 pambuyo utsogoleli.

Chifukwa cha zovuta za dosing ndi zotsatira za glycemia mwa ana, sizigwiritsidwa ntchito.

Long wotenga insulins ayamba kuchita kudzera maola 4-6 pambuyo makonzedwe mankhwala. Khalanibe mphamvu, mungathe kwa 12 - 36 maola.

Zoona zake, mphamvu ya mankhwalawa imatha kale kwambiri, kotero, kuti katulutsidwe koyambirira ka insulin kabwerere mwakale, sikayenera kugwiritsidwa ntchito pambuyo pa maola 36, ​​koma pambuyo pa 24.

Ichi ndi maziko oyamba a iwiri wapakatikati wotenga insulin.

1. Animal insulins. Ma insulini opangidwa ndi nyama amasiyanitsidwa ndi ziphuphu za nyama - makamaka nkhumba, komanso ng'ombe. Porcine kapamba kwambiri poyerekeza. Ndi zofanana kwambiri ndi insulin anthu, ndi yosiyana kwa izo ndi asidi chimodzi chokha kwa amino.
2. Insulins, ofanana ndi munthu, amene chabe amatchedwa "anthu". Best mu dziko ankaona kuti insulin zofanana kwa anthu. Zochita zambiri ndi dokotala n'kukulemberani. Mtundu wa insulin angathe kukonzekera m'njira ziwiri. Semi-yopanga insulin yamunthu imapezeka ndikusintha insulin ndi kusungitsa amino acid imodzi. Yachiwiri njira zachokera chitukuko zamakono zosinthira chibadwa. Asayansi anatha "mphamvu" E. coli "E. Coli »ndi kaphatikizidwe analogue a insulin anthu. Mankhwalawa amatchedwa biosynthetic insulin anthu.

• Pofuna kukwaniritsa malipilo, chofunika Mlingo wocheperako mankhwala.
• Postinjection lipodystrophy zimachokeradi mofulumira ndi mwachangu.
• Pasanathe reactogenic ndi immunogens poyerekeza ndi nyama analogues.

Features mankhwala insulin ana ndi shuga

Matenda a shuga ndi matenda osachiritsika omwe, popanda chithandizo choyenera, amatha kukhala ovuta ndikupangitsa zovuta zingapo. Makamaka kufunika boma kuti ana kulamulira.

Mavutowa samangokhala pakusankhidwa kwa mankhwala a insulin, komanso kuti panthawi ya mankhwala a insulin mwana ayenera kudya pakapita nthawi. Kodi jekeseni ndi kudya nthawi yaitali bwanji, nkhani akukamba.

Makolo ambiri omwe akukumana ndi vuto la matenda osokoneza bongo amadzifunsa kuti: bwanji nthendayi idawonekera, kodi ichiritsidwa?

Shuga yoyamba amapezeka oyambirira, wamng'ono.

Amakhulupirira kuti chinthu chofunikira kwambiri cha matenda ashuga mwa ana ndi makolo ndi abale apamtima, amenenso ali ndi matenda otere. Kupatula apo, matendawa amakula mwa anthu okonzedweratu.

Kuwonongedwa kwa maselo beta mu tizilumba tina pancreatic poyamba sayambitsa kuphwanya zimam'patsa kagayidwe. Koma pa siteji kawirikawiri kupeza autoantibodies kuti insulin. Matenda a shuga a Autoimmune amakula chifukwa cha zovuta zapamimba.

Ma virus amatenganso gawo lofunikira pakukweza kwa shuga kwa ana. Iwo adzatulutsa mapuloteni ofanana ndi mapuloteni beta-maselo. Chifukwa cha zimenezi, kuyambira zimene thupi, imbaenda kuukira maselo yake. Komanso ma virus amatha kuwononga ma cell a islet.

Ndi zinthu a shuga a mtundu woyamba pazikhalanso:

• mavuto obwera chifukwa cha mankhwala
• kudya zakumwa zoziziritsa kukhosi,
• mavuto
• kuperewera kwa zakudya m'thupi.

Chifukwa chake, ngati mwana ali pachiwopsezo, ndikofunikira kumuwunikira mosamala kuti muchepetse kukula kwa matenda.

Pakati pa matenda onse okhalitsa, matenda ashuga mwa ana ndi achiwiri kwambiri. Matenda amayambitsa mavuto ambiri kuposa akulu.

Inde, ndizovuta m'malingaliro kwa mwana yemwe ali ndi vuto la metabolism ya glucose kuti azolowere gulu la anzawo. Zimakhala zovuta kwa iye kuti amvetse chifukwa chake ena amaloledwa kudya maswiti, koma satero, chifukwa jakisoni wowawa amafunikira tsiku lililonse.

Ana omwe apezeka ndi matenda a shuga 1 amafunika jakisoni wa insulin tsiku lililonse.

Palibe vuto kumwa mankhwala pakamwa. Popeza michere m'mimba MBAFUDZA insulin.

Kukonzekera kumabwera m'njira zambiri.

Ena msanga kuchepetsa shuga, koma Kusiya kukhudza pambuyo maola 3-4. Ena kuchepetsa shuga pang'onopang'ono ndipo pang'onopang'ono, pa maola 8-24.

Kuti mukhale ndi matenda abwinobwino ashuga, ndikofunikira kuti muphunzire zambiri zokhudzana ndi matendawa. Mutha kubayira pafupipafupi mankhwala omwewo a hypoglycemic, koma sizingathandize kulimbana ndi matendawa. Ndikofunika kumvetsetsa momwe mungawerengere mulingo woyenera wa mankhwalawa malinga ndi zakudya komanso shuga ya magazi.

injectable njira Lantus SoloSTAR

Mankhwala kupereka okonzeka zopangidwa chisakanizo cha mitundu yambiri ya insulin. Koma endocrinologists odziwa musati amalangiza ntchito zawo. Kawirikawiri wodwala akatulutsidwa ufulu insulin Protafan. Ndikofunika kusamutsa mwanayo kupita ku Lantus kapena Levemir, omwe amawerengedwa bwino. The bwino lero ndi insulin nthaka kuyimitsidwa ndi protamine. Mankhwalawa amathandizidwa mosavuta. Chochitikacho chimatha kwa maola 18-24.

Nthawi zambiri makolo amafunsa ngati kuli koyenera kupereka jakisoni wa insulin ngati mwana wadwala posachedwa, kapena ndi kotheka kuwongolera vutoli kudzera m'zakudya. Pa intaneti, nthawi zambiri pamakhala zotsatsa za machiritso ozizwitsa omwe amachotsa matenda ashuga kotheratu. Koma mwalamulo, mankhwalawa sapezeka. Madokotala amadziwa kuti palibe zakudya zosaphika zazakudya, mapemphero, bioenergy, mapiritsi omwe amatha kuchiza matenda oyamba.

Mphamvu ashuga zimadalira insulin. Kuti mupange regimen regimen, ndikofunika kuyankha mafunso angapo:

• Kodi ndi mankhwala amtundu wanji omwe amagwiritsidwa ntchito?
• Kodi mankhwalawa amaperekedwa kangati?
• Kodi jakisoni amaperekedwa nthawi yanji?

Ngati insulin yochepa imagwiritsidwa ntchito, imaperekedwa kwa theka la ola musanadye. The pazipita kuchepa madzi a shuga magazi kumachitika maola atatu. Chifukwa chake, pofika nthawi ino, mwana ayenera kudyetsedwa zakudya zamafuta ambiri. Apo ayi, kuyamba gipoglikemiya.ads-chigulu-1

Insulin sing'anga (yaitali) kanthu minimizes shuga maola 5-12. Apa zambiri zimatengera wopanga, mayankho a wodwalayo ku mankhwalawo komanso zinthu zina zingapo. Palinso insulin ya ultrafast. Amapatsidwa mphindi zisanu asanadye. Pambuyo mphindi 30-60, mankhwalawa amachepetsa shuga.

wosanganiza insulin kumeneko. Chidachi m'magawo osiyanasiyana chimakhala ndi insulini yapakati komanso yochepa. Mankhwala oterewa kawiri kawiri amayambitsa kuchepa kwa shuga. Ndi mankhwala a insulin, njira zosiyanasiyana zimagwiritsidwa ntchito. Poganizira njira yomwe yasankhidwa, zakudya zimasankhidwa. Mwachitsanzo, mankhwala chikuyendetsedwera kawiri patsiku: m'mawa jekeseni 2/3 mlingo tsiku madzulo - 1/3.

Njira yamagetsi yolingana ndi dera lofananalo ikuwonetsedwa pansipa:

• kadzutsa woyamba. Ndikofunika kupanga zochepa. Kupatula apo, mankhwalawa sanatchulidwe,
• chakudya cham'mawa chachiwiri. maola anayi pambuyo jekeseni ya. Muyenera kudyetsa mwana bwinobwino,
• nkhomaliro - pambuyo maola 6 pambuyo jekeseni. Chakudya chizikhala chopatsa thanzi, chamafuta ambiri,
• chakudya chamadzulo. Mukhoza kukhala kosavuta. Popeza kuchuluka kwa glucose kumawonjezeka pang'ono panthawiyi,
• kwa usiku. M`pofunika kudyetsa mwana mwamphamvu, kuganizira mlingo wa mankhwala kutumikiridwa madzulo.

Dongosolo lotere limathandiza kukhala ndi thanzi labwino, kupewa matenda a hypoglycemia. Koma ndi yoyenera pokhapokha ngati tsiku lililonse insulin ili yochepa.

Nthawi zina wothandizila hypoglycemic ndi kutumikiridwa kasanu: mungafike wotenga insulin - chakudya ndi pamaso yogona ndi waufupi wotenga - musanadye waukulu.

Zakudya ayenera gulu motere:

• kadzutsa woyamba
• chakudya cham'mawa chachiwiri
• nkhomaliro
• tiyi wamadzulo
• chakudya chamadzulo choyamba
• chakudya chachiwiri.

Zokhwasula ayenera kukhala pa nthawi ya pazipita zochita yochepa insulin.

Sitikulimbikitsidwa kugwiritsa ntchito malonda okhala ndi index yotsika kwambiri kapena yapamwamba kwambiri. Nkofunika kuzindikira kuti nsomba, nyama, mazira, tchizi, soseji ndi zina chakudya chofanana popanda chakudya sizimathandiza kupewa chitukuko cha hypoglycemia. Chakudya chilichonse chimayenera kuphatikiza 80 magalamu a chakudya.

Pali zinthu zina zokhudza insulin zomwe zimachitika mwa mwana. Chifukwa chake, kwa ana nthawi zambiri amasankha makina awiri kapena atatu a mapangidwe a insulin. Kuti muchepetse kuchuluka kwa jakisoni pang'ono, gwiritsani ntchito mankhwala osakanikirana ochepa komanso achidule. Kuzindikira kwa insulin mwa ana ndikwapamwamba pang'ono kuposa kwa akuluakulu.

Chifukwa chake, ndikofunikira kuti muchite kusintha kwa gawo la hypoglycemic.

Chololedwa kusintha mlingo pakati kuchokera 1 mpaka 2 mayunitsi. Kuti muwone kusintha, ndikofunikira kuwunika momwe mwanayo alili masiku angapo.

Mu tsiku limodzi, kusintha kwamadzulo ndi m'mawa mulingo osavomerezeka. Pamodzi ndi zakudya, madokotala nthawi zambiri amalemba mankhwala a pancreatin, lipocaine, mavitamini ambiri. Mu magawo oyamba, mankhwala a sulufa nthawi zambiri amapatsidwa mankhwala. Mwachitsanzo, cyclamide, bukarban, chlorpropamide. Ndalama zonsezi zimapatsa mphamvu ndikulimbitsa thupi la ana ofooka.

Jakisoni wa insulin ndi zakudya zofunika kwambiri kwa ophunzira. Makolo ayenera awadziwitse chodyera ndodo kuti akuvutika mwana matenda a shuga, ndi kofunika kupereka ena produkty.ads-chigulu-2

M'pofunika kuthetsa pasadakhale ndi oyang'anira pasukulu izi:

• Kodi mwana angapange kuti jakisoni wa insulin: mu ofesi ya namwino kapena mkalasi?
• Nanga bwanji ngati ofesi ya namwino yatsekedwa?
• Ndani angawonetsetse kuti mwana abweretsa mankhwala ati?

Ndikofunika kupangira mwana wanu dongosolo lochitira ngati zinthu sizingachitike pasukulu kapena panjira yopita.

Mwachitsanzo, bwanji ngati chikwama cham'mabuku chokhala ndi chakudya chatsekedwa mkalasi? Kapena chochita ngati chifungulo cha nyumbayo chatayika? Pa nthawi iliyonse, mwana ayenera kudziwa mmene kudya kusiya zizindikiro za hypoglycemia ndi momwe mungapewere pakuwonekera kwake.

Mitundu ya insulini, kutengera kuthamanga ndi nthawi yake:

Chifukwa chake, ana amapezeka ndi matenda ashuga amtundu woyamba. Matendawa ndiosatheka kuthana nawo.Mavuto akulu amatuluka popanda njira yabwino komanso zakudya zabwino. Chifukwa chake, muyenera kudziwa mawonekedwe a insulin yomwe mumagwiritsa ntchito, nthawi yomwe muyenera kudyetsa mwana pambuyo pa jekeseni, komanso chakudya chomwe mukufuna kupatsa.

• Imakhazikika pamisempha ya shuga kwa nthawi yayitali
• Zimabwezeretsa kupanga kwa insulin

1. 
   Aleksandrovsky, Y. A. Matenda a shuga. Zoyeserera komanso zokopa. Machaputala Osankhidwa / Ya.A. Alesandro. - M: SIP RIA, 2005 .-- 220 p.
2. 
   Tsyb, A.F. Radioiodine mankhwala a thyrotoxicosis / A.F. Tsyb, A.V. Dreval, P.I. Garbuzov. - M: GEOTAR-Media, 2009. - 160 p.
3. 
   Strelnikova, Natalia Chakudya chomwe chimachiritsa matenda ashuga / Natalya Strelnikova. - M.: Vedas, 2009 .-- 256 p.

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