Mankhwala okhalitsa monga mankhwala a nthawi yayitali komanso mankhwala a nthawi yayitali.

1. Ma Insulin Yapakatikati (yambani kutalika kwa maola 1.5-2, kuchuluka pambuyo pa maola 3-12, kutalika kwa maola 8-12):

- main genetic engineering insulin-isophan (Biosulin N, Gansulin N, Gensulin N, Insuman Bazal GT, Insuran NPH, Protafan NM, Rinsulin NPH, Humulin NPH),

- Sememi-yopanga insulin-isophan (Biogulin N, Humodar B),

- monocomponent nkhumba insulin-isophan

(Monodar B, Protafan MS),

- insulin-zinc kuyimitsidwa pawiri (Monotard MS).

2. Kuchita insulini kwautali (kuyamba kwa pambuyo pa maola 4-8, kuchuluka pambuyo pa maola 8-18, kutalika kwa maola 20-30):

- insulin glargine (Lantus),

- insulin detemir (Levemir Penfill, Levemir Flex-chole).

Tsamba la jakisoni wa insulin

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

Kutanthauzira nthawi

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

Kudya Pambuyo Pakulowetsani Insulin

Insulin yotalikilapo sikuti imagwirizanitsidwa ndi chakudya; imatsata basal m'malo mopanda zakudya za insulin, motero, sikofunikira kudya pambuyo pakudya kwa insulin yayitali.

Insulin ya nthawi yayitali.

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

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

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

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

- Poyimitsidwa-insulin-zinc - Monotard MS.

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

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

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

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

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

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

Kuchita insulini kwautali yodziwika ndi kudziwikiratu kwakukulu kwakuchitika kwakanthawi kochepa poyerekeza ndi ma insulin aumunthu wamba. Amamwekedwa pang'onopang'ono kuchokera ku depot ya jakisoni ndipo amakhala ndi mphamvu yayitali, samakhala ndi chiwonetsero chokwanira (chomwe chimachepetsa mwayi wa hypoglycemia usiku ndi pakati pa chakudya) ndipo chimagwira ntchito mpaka maola 24, chitha kuperekedwa kamodzi kapena kawiri pa tsiku. Mankhwala a insulin okhazikika amathandizirana ndi kuwonjezeka kwa thupi, ndipo odwala omwe ali ndi matenda a shuga 2 amakhala onenepa kwambiri, kuwonjezeka kwa thupi panthawi ya mankhwala a insulin kumawonedwa ngati kosafunikira. Kafukufuku wokhala ndi ma insulin omwe amakhala nthawi yayitali amawonetsa kulemera kwamphamvu kwamthupi poyerekeza ndi ma insulin ena oyambira.

Kukonzekera kwapafupifupi insulin

Insulin ndi imodzi mwamahomoni ofunika kwambiri m'thupi la munthu.Insulin imapangidwa mu kapamba ndipo imapangidwa mokwanira pamomwe ma metabolic amapangira minofu ya thupi. Cholinga chachikulu cha gawo lothandiza ili ndikuchepetsa shuga mu thupi.

Pogwiritsa ntchito insulin yovuta, munthu amayamba kudwala matenda otchedwa shuga mellitus. Chifukwa cha kukula kwa matendawa, pali kuphwanya njira za kagayidwe kazakudya.

Anthu omwe ali ndi matenda a shuga akukumana ndi mfundo yoti mulingo wa insulin mthupi uyenera kusamalidwa.

Kuchuluka kwa insulini yomwe imalowetsedwa m'thupi kumadalira kusiyana kwa insulin yomwe thupi limapanga ndi kuchuluka kwa insulin yomwe thupi limafunikira pakuchita bwino.

Kukonzekera kwa insulin komweko kumagawidwa m'mitundu ingapo, kutengera kuthamanga kwake komanso nthawi yomwe mankhwalawo ali mthupi. Mtundu umodzi ndiwo insulin.

Insulin yayitali imakhala ndi mphamvu yayitali chifukwa cha nyumbayi, mankhwalawa amatchedwa insulin. Homoni yamtunduwu imakhala ngati gawo lalikulu la mahomoni omwe amapanga maziko a insulini m'thupi la wodwalayo.

Mankhwala osokoneza bongo amatha kudziunjikira insulin m'thupi tsiku lonse. Masana, ndikokwanira kuchita jekeseni wa 1-2 kuti utulutse mahomoni m'magazi.

Pang'onopang'ono, kugwiritsa ntchito insulin yokhala nthawi yayitali kumapangitsa kuti mahomoni azikhala mthupi.

Zotsatira zake zimatheka patsiku lachiwiri kapena lachitatu, ziyenera kudziwika kuti kuchuluka kwake kumatheka pambuyo masiku awiri, ndipo mankhwalawa amayamba kugwira ntchito maola ochepa.

Zokonzekera za insulin nthawi yayitali ndi izi:

• Insulin Monodar Long,
• Insulin Ultralong,
• Insulin Lantus.

Mwa mankhwala omwe akhala akuchita kwa nthawi yayitali, zomwe zimadziwika kuti zimapanga insulin. Mtundu wa insulini iyi, ukalowetsedwa m'thupi, ulibe chiopsezo chochita. Zotsatira za mankhwalawa pakhungu zimakhala zosalala komanso zofatsa. Mankhwala odziwika kwambiri a gululi ndi Levemir ndi Lantus.

Mitundu yonse ya insulini imayang'aniridwa mosiyanasiyana ndipo nthawi iliyonse malo a mankhwala a insulin asinthidwe. Kukonzekera kwa insulin sikuyenera kusakanikirana ndi kuchepetsedwa.

Musanasankhe ma insulin omwe amakhala nthawi yayitali, muyenera kuphunzira zomwe zimachitika ndi insulin yamtunduwu. Kuphatikiza apo, muyenera kuphunzira zomwe zafotokozedwazi mu malangizo omwe mungagwiritse ntchito ndikuwonana ndi endocrinologist.

Dokotala sayenera kuwerengera kuchuluka kwa mankhwalawo, komanso kukhazikitsa ndondomeko ya jakisoni.

Mpaka pano, mitundu iwiri ya insulin yowonjezera imagwiritsidwa ntchito pochiza matendawa:

• Mumakhala ndi nthawi yokwanira mpaka maola 16,
• Ma Ultra-insulin omwe amakhala kuposa maola 16.

Gulu loyamba la insulin limaphatikizapo:

1. Gensulin N.
2. Biosulin N.
3. Isuman NM.
4. Insuman Bazal.
5. Protafan NM.
6. Humulin NPH.

Gulu la insulin lalitali kwambiri

Ma insulini a Ultralong alibe kanthu. Mukamawerengera jakisoni wa jakisoni ndi mankhwala omwe ali ndi mphamvu yayitali, izi ziyenera kukumbukiridwa. Malamulo osankhidwa otsalawo ndiofala mitundu yonse ya insulin.

Mukamawerengera jekeseni imodzi ya insulin kulowa mthupi, chizindikirocho chikuyenera kukhala chakuti kuchuluka kwa glucose nthawi yonse yomwe pakati pa jakisoni kumakhalabe pamlingo wofanana. Kusintha kwovomerezeka sikuyenera panthawi imeneyi sikuyenera kupitirira 1-1.5 mmol / L.

Popanga chisankho chabwino cha insulin, kuchuluka kwa shuga m'magazi ndikokhazikika.

Sizoletsedwa kugwiritsa ntchito mankhwala okhala ndi insulin, moyo wa alumali womwe umatha.

Kugwiritsira ntchito insulin yomwe yatha mu mankhwalawa kumatha kuyambitsa thukuta, kufooka, kunjenjemera, kugwidwa, ndipo nthawi zina ngakhale kumachitika mthupi la wodwalayo.

Kukonzekera kwa insulin kwamakono kungatengedwe osati ndi jakisoni, komanso ndi pakamwa pakumwa mankhwala pakudya.

Kukonzekera kwa pakamwa kwa mankhwalawa ndikutukuka kosangalatsa, komwe kamapangidwa kuti kathandizire moyo wa munthu wodwala matenda ashuga.

Insulin yomwe imatenga nthawi yayitali imapangidwa ndi msika wogulitsa mankhwala mumitundu iwiri momwe kuyimitsidwa kapena yankho la jakisoni.

Insulin imatsitsa kuchuluka kwa shuga m'thupi mwa kupititsa mphamvu yake m'maselo a minofu ndi chiwindi, kumakhudza kuchuluka kwa kaphatikizidwe kazakudya zamapuloteni, kuifulumizitsa, kumachepetsa kupanga kwa glucose ndi hepatocytes.

Ndi kuwerengera kolondola kwa kuchuluka kwa insulin yomwe imakhala ndi nthawi yayitali, kuyambitsa kwake kumachitika maola 4 pambuyo pakukhazikitsa. Kufika pachimake kwa mankhwalawa kumachitika pambuyo pa maola 8 - 20 mankhwala atalowa m'thupi.

Nthawi yotsogola kwambiri imadalira mawonekedwe a thupi la wodwalayo komanso kuchuluka kwa jakisoni. Kuchita kwa insulin kumatha m'thupi patatha maola 28 kuchokera kumayikidwe ake.

Pankhani yopatuka panjira izi, izi zitha kuwonetsa kukhalapo kwa mthupi la wodwalayo. Ndipo apa ndikofunikira kuti mukhale ndi lingaliro la zomwe zingavulaze insulin mu shuga.

Kuperekera kwa mankhwalawa kwa mankhwalawa kumapangitsa kuti timadzi timene timakhala m'minyewa yambiri kwakanthawi, zomwe zimapangitsa kuti kuchepetsedwa kwake kulowa m'magazi.

Chizindikiro chogwiritsa ntchito insulin yayitali ndi:

1. Wodwala ali ndi matenda ashuga amtundu woyamba.
2. Wodwala ali ndi matenda ashuga a 2.
3. Kusadwalika kwa wodwala ku mankhwala amkamwa opangidwa kuti achepetse shuga.
4. Gwiritsani ntchito ngati gawo la zovuta mankhwala.
5. Kuchita ma opaleshoni.
6. Kupezeka kwa matenda a shuga kwa amayi apakati.

Kuchuluka kwa mahomoni omwe amagwiritsidwa ntchito amatsimikiziridwa ndi endocrinologist payekhapayekha ndikuganizira mbali zonse za thupi la wodwalayo. Mlingowu ungathe kuwerengetsa ndi endocrinologist pokhapokha mutalandira zotsatira za kufufuza kozama kwa wodwala ndikupeza mayeso a labotale.

Kugunditsa vala ndi insulini ndizoletsedwa pamaso pa jakisoni. Musanayambitse mankhwalawa, ndikofunikira kuti mupukutire botolo ndi dzanja la insulin m'manja, izi zimapangitsa kuti pakhale kupangika kophatikizanso ndipo nthawi yomweyo imakupatsani mwayi wothira mankhwalawa jakisoni.

Pankhani yosamutsa wodwala kuchokera ku mtundu wina wamankhwala kupita ku wina, ndikofunikira kusintha mtundu wa insulin wolandiridwa.

Chimodzi mwazinthu zomwe zimakonda kukonzekera insulin ndi Digludek. Mankhwalawa ali ndi chochitika china chowonjezera. Ndi analogue ya insulin yamunthu. Wopanga mankhwalawa ndi kampani yaku Danish Novo Nordisk.

Kuchita kwa mankhwalawa kumapangidwira pakukweza kugwiritsidwa ntchito kwa glucose kuchokera m'madzi am'magazi ndi maselo am'mafuta ndi minyewa yam'mimba.

Njirayi imayambitsidwa ndi kuwonjezeredwa kwa mahomoni ku ma cell receptors. Mphamvu yachiwiri ya mankhwalawa ndikuletsa kupanga shuga m'magazi a chiwindi, zomwe zimachepetsa kuchuluka kwa shuga m'thupi la wodwalayo.

Kutalika kwa mankhwalawa ndi maola opitilira 42. Pazitali kuchuluka kwa insulin mu thupi zimatheka 24-36 mawola ntchito mankhwala.

Mankhwala a Insulin-glargine amapangidwa ndi kampani yaku France ya Sanori-Aventis.Kuphatikizidwa kwa mankhwalawa kumaphatikizapo insulin-glargine, m-cresol, zinc chloride, glycerol, sodium hydroxide, madzi a jekeseni amagwiritsidwa ntchito ngati mankhwala othandiza popanga mankhwalawa.

Mtundu wa mankhwalawa ndi analogue ya insulin ya anthu.

Ndi mankhwala oyambitsidwa kamodzi patsiku, kukhazikika kwa pawiri mthupi la wodwalayo kumawonedwa kwa masiku awiri mpaka anayi pambuyo pa kayendetsedwe ka makonzedwe.

Kukhala ndi nthawi yayitali yogwiritsira ntchito mankhwalawa, kumakuthandizani kuti muzigwiritsa ntchito masana kamodzi. Pambuyo pa jakisoni, mankhwalawa amayamba ola limodzi jekeseni.

Mankhwalawa amaloledwa kugwiritsidwa ntchito ndi jekeseni wa subcutaneous. Mankhwalawa amawayikidwa m'mafuta amkati mwa phewa kapena ntchafu.

Contraindication kuti mugwiritse ntchito ndi kupezeka kwa hypersensitivity kwa insulin-glargine kapena chilichonse mwa zigawo zamankhwala. Kuphatikiza apo, mankhwalawa sangathe kugwiritsidwa ntchito kwa ana ochepera zaka 6.

Mankhwala a Humulin L ndi chida chachipatala, kampani yaku America Eli-Lilly. Wothandizirayo ndikuyimira kwamtundu wa crystalline insulin yamunthu. Mankhwala ali ndi ntchito yayitali.

Mu kanema mu nkhaniyi, adokotala apitiliza kuwulula mutu wa insulin yowonjezera.

Sonyezani shuga yanu kapena sankhani jenda kuti muyimikize.

Insulin ndi mankhwala othandizira kupewa matenda ashuga, jekeseni amene amachepetsa kuchuluka kwa shuga m'magazi, ndikuwonjezera mayamwidwe ndi minyewa (chiwindi ndi minofu). Insulin yayitali imatchedwa choncho chifukwa nthawi yake imakhala yambiri kuposa mitundu ina ya mankhwalawo, ndipo izi zimafuna kutsika kochepa.

Zitsanzo za mayina a mankhwala:

• Lantus
• Insulin Ultralente,
• Insulin Ultralong,
• Insulin Ultratard,
• Levemir,
• Levulin,
• Humulin.

Amapezeka mu mawonekedwe a kuyimitsidwa kapena mayankho a jakisoni.

Kuchita insulin kwa nthawi yayitali kumachepetsa kuchuluka kwa shuga m'magazi, kumalimbitsa mayamwidwe ndi minofu ndi chiwindi, kuthamangitsa kaphatikizidwe kazinthu zopanga mapuloteni, ndikuchepetsa kuchuluka kwa shuga ndi hepatocytes (ma cell a chiwindi).

Ngati kuchuluka kwa insulin yowonjezera kumawerengeredwa molondola, kuyambitsa kwake kumayamba maola 4 pambuyo pa kubayidwa.

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

• "Insulin yayitali"
• "Basic insulin",
• "Basal"
• Insulin yowonjezera
• "Insulin yayitali."

Malangizo ogwiritsira ntchito

Matenda a diabetes 1 a mtundu (kawirikawiri mtundu wa 2) amadziwa bwino mankhwala a insulin omwe sangakhale nawo popanda. Pali zosankha zingapo za mahomoni awa: kachitidwe kochepa, nthawi yayitali, nthawi yayitali kapena kuphatikiza pamodzi.

Insulin yokhala nthawi yayitali imagwiritsidwa ntchito pakafunika nthawi yayitali pakati pa jakisoni.

Kufotokozera kwamagulu

Kutanthauza kwa insulin ndiko kugwiritsira ntchito njira zama metabolic komanso kudyetsa maselo ndi shuga. Ngati timadzi ta m'matimuwa mulibe m'thupi kapena silipangidwa m'chiwerengero chofunikira, munthu amakhala pachiwopsezo chachikulu, ngakhale kufa.

Kuletsedwa kokhako kusankha gulu lokonzekera insulin nokha. Posintha mankhwala kapena mlingo, wodwalayo ayenera kuyang'aniridwa ndikuwongolera kuchuluka kwa shuga m'magazi a magazi. Chifukwa chake, kuti mudye nthawi yayitali, muyenera kupita kwa dokotala.

Ma insulin omwe amakhala nthawi yayitali, omwe mayina awo adzapatsidwa ndi dokotala, nthawi zambiri amagwiritsidwa ntchito limodzi ndi mankhwalawa monga achidule kapena apakati. Pafupipafupi, amagwiritsidwa ntchito pochiza matenda a shuga a 2.

Mankhwalawa amayamba kukhudza thupi pambuyo pa maola 4-8, ndipo kuchuluka kwa insulini kudzapezekanso pambuyo pa maola 8-18. Chifukwa chake, kuchuluka kwathunthu kwa glucose - 20-30 hours.

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

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

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

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

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

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

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

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

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

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

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

Kusankha mlingo masana, munthu ayenera kumakhala ndi njala tsiku lonse komanso kumwa magawo omwewa, koma ola lililonse. Kuperewera kwa zakudya m'thupi kungathandize kupanga chithunzi chokwanira komanso cholondola m'thupi la wodwalayo.

Kukonzekera kwa insulin kochepa komanso kwanthawi yayitali kumagwiritsidwa ntchito mwa odwala omwe ali ndi matenda a shuga 1. Izi zimachitika kuti tisunge gawo limodzi la maselo a beta, komanso kupewa kutulutsa ketoacidosis. Odwala omwe ali ndi mtundu wachiwiri wa matenda osokoneza bongo nthawi zina amayenera kupereka mankhwalawa.

Kwa odwala omwe ali ndi mtundu woyamba wa 2 ndi matenda a shuga, kukhala ndi insulin yofunikira kwa nthawi yayitali ndi mankhwala ofunikira. Ndipo zonena izi zilibe maziko. Kuletsa kubayidwa ngakhale jekeseni m'modzi kungachititse kuti wodwalayo afe ngati thandizo silifika nthawi.

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

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

Atafika poti ndende yayitali kwambiri imangoyenda pang'onopang'ono, insulini yokhala nthawi yayitali imayamba kuchepa pang'onopang'ono popanda kuchitapo kanthu ndikudumpha m'magazi a wodwalayo. Ndipo apa chinthu chofunikira kwambiri ndikusaphonya mphindi yomwe jakisoni itayamba kukhala ziro ndikulowa muyezo wotsatira wa mankhwalawa. Insulin yayitali imakhala ndi zabwino komanso zovuta zake ngati mankhwala ena onse.

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

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

Ndi kuwerengera kolondola kwa kuchuluka kwa insulin yomwe imakhala ndi nthawi yayitali, kuyambitsa kwake kumachitika maola 4 pambuyo pakukhazikitsa. Kufika pachimake kwa mankhwalawa kumachitika pambuyo pa maola 8 - 20 mankhwala atalowa m'thupi.

Nthawi yotsogola kwambiri imadalira mawonekedwe a thupi la wodwalayo komanso kuchuluka kwa jakisoni. Kuchita kwa insulin kumatha m'thupi patatha maola 28 kuchokera kumayikidwe ake.

Pankhani yopatuka panjira izi, izi zitha kuwonetsa kukhalapo kwa mthupi la wodwalayo. Ndipo apa ndikofunikira kuti mukhale ndi lingaliro la zomwe zingavulaze insulin mu shuga.

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

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

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

Kuwongolera kumayikidwa pakusintha kuchokera ku insulin yakuchokera kwa nyama kukhala munthu. Mlingo ukusankhanso. Komanso, kusintha kwa mtundu wina wa insulini kupita ku wina kuyenera kutsatiridwa ndi kuyang'aniridwa ndi achipatala komanso kupenda kwambiri ndende yamagazi.

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

1. Hypoglycemia.
2. Kuzindikira magawo a mankhwalawa.
3. Ana osakwana zaka 6.
4. Mimba

Pambuyo pofunsana ndi katswiri, zotsutsana izi sizingakhale zovuta kuchitapo kanthu, chifukwa zabwino zake zimakhala zapamwamba kwambiri kuposa kuwopsa kwa zovuta zomwe zingachitike. Pangofunikira kuwerengera molondola mlingo wa insulin yomwe umayendetsedwa.

Jekeseni wothandizirana kwa nthawi yayitali amalola odwala matenda ashuga kuti athe kuchotsa mankhwalawa kangapo patsiku, chifukwa amalamulira shuga m'magazi tsiku lonse.

1. Potengera ma genetic, mahomoniwa amapangidwa ndi mabakiteriya.
2. Zopanga zokha, pogwiritsa ntchito kusintha kwa ma enzymes a nkhumba.

Mitundu ya Mankhwala Ochotsa Insulin

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

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

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

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

Mankhwala amakhudza thupi la wodwalayo:

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

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

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

Zowonetsedwa makamaka pakukhazikitsa mlingo wolakwika. Zazikulu.

Odwala omwe ali ndi vuto la insulini lawo lomwe amafunikira jakisoni wa moyo wonse wa mankhwala omwe ali ndi timadzi timeneti. Insulin yofupikitsa imagwiritsidwa ntchito ngati gawo limodzi la zovuta kuchizira matenda a shuga.

Ndikofunikira kudziwa!
Nkhani yatsopano yomwe ikulangizidwa ndi ma endocrinologists pakupitiliza kuyang'anira matenda ashuga!
Mumangofunika tsiku lililonse ...

Komanso, insulin yayifupi ingagwiritsidwe ntchito kuyimitsa shuga kwa wodwala panthawi yamagetsi owonjezereka: omwe ali ndi matenda oopsa komanso kuvulala. Ikagwiritsidwa ntchito, ingakhale mankhwala okhawo omwe amapereka.

Mlingo watsiku ndi tsiku wa insulin yochepa kwa akulu ndi magawo 8-24, kwa ana - osaposa magawo 8. Chifukwa cha kutulutsidwa kwa mahomoni amakula m'magazi, mlingo wa achinyamata ukuwonjezeka. Wodwala amatha kuwerengera payekha payekha.

1% ya timadzi timene timakhala ndi mlingo wofunika wothandizirana ndi mkate, ndi mlingo wochepetsera kuchuluka kwa shuga m'magazi. Zonsezi ndizofanana ndi zero. Kwa odwala matenda ashuga omwe ali ndi kulemera kwambiri, kuchuluka kwake kumachepetsedwa ndi 0,1, ndi kulemera kosakwanira kumawonjezereka ndi 0.1.

Mlingo umatha kusinthidwa. Kuchulukitsa kwake kumafunikira pakukaniza kwa mahomoni, kuphatikiza ndi corticosteroids, kulera, antidepressants ndi okodzetsa ena.

Mankhwalawa amaperekedwa pogwiritsa ntchito insulin kapena pampu yapadera. Chida choterocho chimalola njirayi kuti ichitike molondola kwambiri, zomwe sizingachitike ndi syringe wamba. Mutha kulowa yankho lomveka bwino popanda kunyengerera.

Wothandizirana mwachangu ndi insulin imaperekedwa kwa mphindi 30 mpaka 40 musanadye. Pambuyo pa jekeseni, musadumphe zakudya.Kupereka pambuyo pa mlingo uliwonse womwe waperekedwa uyenera kukhala womwewo. Patatha maola awiri mutadya mbale yayikulu, muyenera kukhala ndi kachakudya. Izi zingathandize kukhala ndi milingo yamagazi.

Kuti muchepetse kufalikira kwa insulin, malo osankhidwa amayenera kutenthetsedwa pang'ono povulala. Malowo a jakisoni sangathe kutentheka. Jakisoni amachitika mosazindikira m'mimba.

Ndi kuwonjezeka kwa ndende ya magazi, muyeso wowonjezera wa insulin umafunika mosasamala kanthu.

Kuchuluka kwa mahomoni kumatsimikiziridwa ndi dokotala aliyense payekha kwa wodwala aliyense. Kupitilira apo, wodwalayo amatha kuwerengetsa payekha payekha payekha kutengera zomwe amalimbikitsa. Mukasintha kuchokera ku insulin ya nyama ndikupanga munthu, ndikofunikira kusankha kachiwiri.

Posintha mtundu wina wa mankhwala ndi wina, kuyang'anira kwa dokotala ndikuwunika pafupipafupi kwa kuchuluka kwa shuga m'magazi ndikofunikira. Ngati mukusintha, mlingo womwe waperekedwa umapitilira mayunitsi 100, wodwalayo amatumizidwa kuchipatala.

Jakisoni amachitidwa mosazindikira, nthawi iliyonse kupita kumalo ena. Jakisoni wa insulin amatha kuchitika mu minofu ya triceps, m'chigawo chapafupi ndi navel, kumtunda kwakunja kwa minofu ya gluteal, kapena kumtunda kwa gawo la ntchafu.

Kukonzekera kwa insulin sikuyenera kusakanikirana kapena kuchepetsedwa. Syringe siyenera kugwedezeka musanabayidwe. Ndikofunikira kupotoza pakati pamafinya, kuti kapangidwe kake kamakhala kofanana kwambiri ndikuwotha pang'ono. Pambuyo pa jakisoni, singano imasiyidwa pansi pakhungu kwa masekondi angapo kuti iperekenso mankhwala mokwanira, ndikuchotsa.

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

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

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

Imayamba kugwira ntchito mkati mwa maola 1-1.5. Kuchita bwino kwambiri kumawonetsedwa pambuyo maola 4-12 ndipo kumatha maola 24.

Kuyimitsidwa kwa kukhazikitsidwa kwa s / c. Mmatumba atatu a 3 ml cartridge, ma 5 ma PC mu paketi.

Imayendetsedwa pambuyo maola 1-1.5. Yogwira ntchito, mphamvu yayikulu imapezeka nthawi ya maola 4-12.

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

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

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

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

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

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

Insulin yotalikilapo imadziwika m'mapensulo a 3 ml.

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

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

Monga lamulo, kupendekera kwakanthawi kochepa ka shuga kumagwiritsidwa ntchito m'malo mwa mankhwala osokoneza bongo nthawi yayitali. Chifukwa chakuti pofuna kukwaniritsa zoyambira, pafupifupi insulin imapangidwa kawiri pa tsiku, ndipo yayitali - kamodzi patsiku, kusintha kwa mankhwalawa sabata yoyamba kungayambitse kukhalanso kwa hypoglycemia ya m'mawa kapena usiku.

Vutoli litha kuwongoleredwa pochepetsa kuchuluka kwa mankhwala ochulukitsidwa ndi 30%, omwe amakwanira pang'ono chifukwa chosowa kwa nthawi yayitali kugwiritsa ntchito insulin yokhala ndi chakudya chochepa. Pambuyo pake, mlingo wa insulin yochulukitsidwa umasinthidwa.

Zomwe zimapangidwazo zimaperekedwa kamodzi kapena kawiri pa tsiku.Pambuyo polowa m'thupi kudzera mu jakisoni, mahomoni amayamba kuwonetsa ntchito zake pokhapokha maola ochepa. Nthawi yomweyo, mafotokozedwe azinthu zowonjezera pang'onopang'ono zomwe zimawonetsedwa patebulo ndizosiyana.

Koma ngati insulin yowonjezera ikufunika, lowetsani kuchuluka kwakukulu kwa 0,6 ma kilo imodzi ya kulemera kwa munthu, ndiye kuti mlingo womwe watchulidwa umagawidwa majakisoni awiri. Nthawi yomweyo, kupatula pakubwera zovuta, jakisoni amapangidwa mbali zosiyanasiyana za thupi.

Ganizirani momwe mungapewere zoyipa za insulin.

Mankhwala aliwonse a insulini, ngakhale atakhala nthawi yayitali bwanji;

• Hypoglycemia - mulingo wa glucose m'magazi umatsika pansi pa 3.0 mmol / L.
• Zosiyanasiyana komanso zamkati zimachitika - urticaria, kuyabwa ndi kapangidwe ka jekeseni.
• Kuphwanya mafuta kagayidwe - kodziwika ndi kudzikundikira kwamafuta, osati pansi pa khungu, komanso magazi.

Wolembera pang'onopang'ono insulin imapereka mwayi wabwino kwambiri wopewa zovuta za mtundu 1 ndi matenda ashuga 2. Kuphatikiza apo, insulin yayitali imapangitsa kuchiza matenda a shuga mosavuta. Pofuna kupatula chiwonetsero cha zotsatirazi, odwala matenda ashuga ayenera kutsata zakudya zomwe adokotala adanenanso ndikusintha malo a jekeseni nthawi zonse.

Njira zowerengera insulin yochepa

1. Mtundu umodzi wa matenda ashuga.
2. 2 mtundu wa matenda pomwe mankhwala ochepetsa shuga salinso othandizira.
3. shuga wambiri. Kwa gawo losavuta, jakisoni wa insulin yayitali nthawi zambiri amakhala yokwanira.
4. Opaleshoni ya kapamba, yomwe idayambitsa kusokonekera kwa mahomoni.
5. Chithandizo cha zovuta zamatenda a shuga: ndipo.
6. Nthawi yochulukirapo ya insulin: Matenda otentha kwambiri, vuto la mtima, kuwonongeka kwa ziwalo, kuvulala kwambiri.

Insulin imaloledwa panthawi yoyembekezera komanso poyamwitsa, chifukwa sichilowa m'magazi a mwana ndi mkaka wa m'mawere.

Atakwaniritsa ntchito zake, insulin yochepa imaphwanya ndikupanga ma amino acid: 60% ya timadzi timene timagwiritsidwa ntchito impso, 40% m'chiwindi, gawo laling'ono limalowa mkodzo osasinthika.

Insulin yochepa imatulutsidwa ngati njira yothetsera vutoli ndi kuzungulira kwa 100, osachepera 40 magawo pa millilita. Pakupangira jakisoni, mankhwalawa amaikidwa m'matumba agalasi ndi choyimitsa, kuti mugwiritse ntchito zolembera - mu makatoni.

• kuthamanga kwa hypoglycemic.
• makonzedwe yomweyo musanadye.
• kuthekera kwa kugwiritsa ntchito mukangodya. Izi ndizofunikira kwambiri pochiza matenda osokoneza bongo a ana, popeza sizikudziwika pasadakhale ngati mwana adzapambana gawo lonse.
• kuyambitsa matenda a glycemia munthawi yachilendo.
• kuthekera koonjezera kuchuluka kwa chakudya chambiri m'zakudya popanda kusiya matenda ashuga.
• kuchepa kwamphamvu kwa hypoglycemia.
• shuga wabwinoko mutatha kudya.

Odwala omwe ali ndi matenda osokoneza bongo, chizolowezi chomka usiku chimasinthidwa ndikupanga insulin. Ndikulimbikitsidwanso kwa ana aang'ono omwe akusintha chilimbikitso ndi achinyamata pakusintha kwantchito kwa mahormoni.

Ndakhala ndikuphunzira matenda a shuga kwa zaka zambiri.Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsa odwala matenda ashuga mellitus. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 98%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipira mtengo wapamwamba wa mankhwalawa. Ku Russia, odwala matenda ashuga mpaka Epulo 4 (wophatikizidwa)
nditha kuipeza - ma ruble 147 okha!

• Nkhani yathu yokhudza kuwerengera kwamawere
  —

Kuwerengera pamwambapa kumakupatsani mwayi wofanana ndi kukula kwa glycemia mukatha kudya. Ngati shuga musanadye bwino, mlingo wa insulin yochepa uyenera kuchuluka. Amakhulupirira kuti gawo limodzi lowonjezera la mahomoni limafunikira kuti muchepetse shuga ndi 2 mmol / L.

Kuti muwerenge molondola kwambiri muyezo wa mankhwalawa, mutha kugwiritsa ntchito fomula ya Forsham. Kutembenuza mmol / L kukhala mg%, amafunika kuchulukitsidwa ndi 18.

1. Sankhani tsamba la jakisoni. Mimba zomwe zimagwiritsidwa ntchito kwambiri, osati pafupi 3 cm kuchokera ku navel.
2. Tulutsani syringe yotayidwa bwino komanso yotayika kuti isungidwe.
3. Pierce chopukutira cha vial ndikujambulitsa kuchuluka kwa mankhwalawa kwa syringe.
4. Kukanikiza tsinde kumachotsa mpweya wonse ku syringe.
5. Sungani khungu pamalo oyambitsa kuti mukhale khungu ndi mafuta ochepa okha. Minofu siyenera kukhudzidwa.
6. Ikani singano mu crease ndikubaya insulini yonse.
7. Popanda kutulutsa singano kapena kuchotsera mafuta, dikirani masekondi angapo.
8. Chotsani singano pang'onopang'ono, kenako kumasula khungu.

Kutalika kwa malo omwe jakisoni wapitayo sikuyenera kukhala ochepera masentimita 2. Ngakhale khungu kapena singano sizichizidwa ndi zakumwa zoledzeretsa, chifukwa zimatha kufooketsa mphamvu ya insulin.

Onetsetsani kuti mwaphunzira!
Kodi mukuganiza kuti kuyamwa kwa mapiritsi ndi insulini kwa nthawi yonse yokhayo ndi njira yokhayo yosungira shuga m'manja? Sichowona! Mutha kutsimikizira izi nokha mwakuyamba kugwiritsa ntchito ...

Insulin Yaitali - Zida za Chithandizo cha Matenda A shuga

Insulin yowonjezereka yogwira mtima imafunikira pamene kusala kudya kwa shuga m'magazi kumafunikira kusintha. Ma insulin omwe amakhala nthawi yayitali kwambiri ndi Levemir ndi Lantus, omwe wodwalayo amayenera kuperekedwa kamodzi pa maola 12 kapena 24.

Imatsimikiza kufunika kwa chithandizo cha insulini ndikusankha mankhwala ena ndi dokotala, ndipo kupita patsogolo kwa mankhwalawa kumatengera matendawo.

Insulin yayitali imakhala ndi katundu wodabwitsa, imatha kutsanzira mahomoni achilengedwe omwe amapangidwa ndi maselo a kapamba. Nthawi yomweyo, amakhala ofatsa pamaselo oterowo, amathandizira kuchira, komwe mtsogolo limalola kukana insulin.

Jekeseni wa insulin wa nthawi yayitali ayenera kuperekedwa kwa odwala omwe ali ndi shuga wambiri masana, koma akuyenera kuwonetsetsa kuti wodwalayo amadya chakudya pasanathe maola 5 asanagone.

Ngati insulin yayifupi imafunikira jekeseni masana kuti muchepetse shuga omwe amaperekedwa ndi chakudya, ndiye kuti insulin yayitali imatsimikizira maziko a insulini, imathandizira kupewa ketoacidosis, komanso imathandizanso kubwezeretsa maselo a pancreatic beta.

Kuti mukhale ndi moyo wabwinobwino, wodwalayo ayenera kuphunzira momwe angawerengere molondola kuchuluka kwa Lantus, Protafan kapena Levemir usiku, kotero kuti msanga wama glucose amasungidwa pa 4.6 ± 0.6 mmol / l.

Kuti muchite izi, mkati mwa sabata muyenera kuyeza kuchuluka kwa shuga usiku ndi m'mawa pamimba yopanda kanthu. Kenako muyenera kuwerengera mtengo wa shuga m'mamawa mtengo wake wa dzulo usiku ndikuwerengera kuchuluka, izi zikuwonetsa chisonyezo chochepa chofunikira.

Tiyenera kudziwa kuti Lantus sangathe kuchepetsedwa, chifukwa chake imafunikira kubayidwa ndi 1ED kapena 1,5ED, koma Levemir imatha kuchepetsedwa ndikuvulaza ndi mtengo wofunikira.M'masiku otsatirawa, muyenera kuwunika momwe shuga angakhalire kudya ndikuwonjezera kapena kuchepetsa kuchuluka kwake.

Amasankhidwa moyenera komanso molondola ngati, mkati mwa sabata, shuga osala kudya saposa 0.6 mmol / l, ngati mtengo wake umakhala wokwera, ndiye yesani kuwonjezera kuchuluka kwa mankhwala ndi mayunitsi a 0.25 masiku atatu aliwonse.

Matenda a shuga ndi omwe amayambitsa pafupifupi 80% yonse yamikwingwirima ndi kuduladula. Anthu 7 mwa anthu 10 amafa chifukwa cha mitsempha ya mtima kapena ubongo. Pafupifupi nthawi zonse, chifukwa chomaliza chomaliza ndi chimodzimodzi - shuga wamwazi.

Shuga akhoza ndipo amayenera kugwetsedwa, apo ayi. Koma izi sizichiritsa matendawa, koma zimangothandiza kulimbana ndi kufufuza, osati zomwe zimayambitsa matendawa.

Kugwiritsa ntchito bwino kwa mankhwalawa, kuwerengera malinga ndi njira yokhazikika (kuchuluka kwa odwala omwe achiwonjezere kuchuluka kwa odwala omwe ali pagulu la anthu 100 omwe adachitiridwa chithandizo):

• Matenda a shuga - 95%
  
• Kuthetsa kwa mitsempha thrombosis - 70%
  
• Kuthetsa kwa kugunda kwamtima kwamphamvu - 90%
  
• Kutumiza kuthamanga kwa magazi - 92%
  
• Vigor masana, kugona bwino usiku - 97%
  

Opanga ma Ji dao
si bungwe lazamalonda ndipo amalipidwa ndi chithandizo cha boma. Chifukwa chake, tsopano wokhala aliyense ali ndi mwayi wopeza mankhwalawo kuchotsera 50%.

Anthu odwala matenda ashuga amatenga insulin pang'ono, kuchokera pamenepo imalowetsedwa m'magazi. M'magawo oyambiranso, makonzedwe amkati amagwiritsidwa ntchito. Njirayi imakuthandizani kuti muchepetse zovuta zovuta za matenda ashuga ndikuyankha panthawi yake pakufunika kwakanthawi kwa kusintha kwa mahomoni panthawi yopuma.

Ziwerengero za anthu odwala matenda ashuga zikuwonjezeka chaka chilichonse! Russian Diabetes Association imati munthu m'modzi mwa anthu 10 m'dziko lathu ali ndi matenda a shuga. Koma chowonadi ndichakuti si matenda omwewo omwe amawopsa, koma zovuta zake ndi moyo womwe umawatsogolera.

Malangizo apadera ndi kusamala

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

Insulin yotalikilapo sicholinga chake pochiza ketoacidosis. Matupi a Ketone amachotsedwa m'thupi pokhapokha kudzera pakukonzekera kwa insulin yayifupi.

Kwa mtundu woyamba wa shuga, kuphatikiza insulin kwa nthawi yayitali. Yotalika nthawi yayitali imakhala ngati maziko, ndiye kuti imasunga insulini yambiri m'magazi momwe kapamba amayenera kutulutsa munthawi yoyenera.

Masamba osiyanasiyana obayidwa alibe kusiyana muzotsatira zomaliza, ndiye kuti, kuphatikiza kwa mankhwala omwe ali m'magazi kudzakhala chimodzimodzi mulimonse. Ndikofunikira kuti musinthe malo potsatira jakisoni wotsatira.

Mukamasintha kuchokera ku insulin yayitali mpaka yayitali, muyenera kumayang'aniridwa ndi dokotala ndi glucometer, popeza mlingo wa insulin womwe umayendetsedwa umasinthidwa ndikuwonjezera njira zina zofunikira kuti muchepetse shuga ya magazi (mapiritsi, insulin yochepa).

Popewa hypoglycemia usiku ndikadzuka, amalangizidwa kuti achepetse kuchuluka kwa insulin ndikukulitsa insulin yochepa ndi chakudya. Dokotala yekha ndi amene ayenera kuwerengetsa mlingo wake.

Mlingo wa insulin yayitali umasinthidwa:

• kusintha kwa zakudya
• ndimphamvu zolimbitsa thupi,
• matenda opatsirana
• machitidwe
• kubala mwana
• matenda a endocrine
• matenda a impso (makamaka kulephera),
• shuga mu okalamba (65 kapena kuposa),
• kuchepa thupi kwambiri kapena kunenepa kwambiri,
• kumwa mowa
• zifukwa zina zomwe zimakhudza kuchuluka kwa shuga m'magazi.

Ndikofunikanso kusamala ndi omwe ali ndi glycosylated hemoglobin pansipa. Mwa anthu oterowo, hypoglycemia imatheka usana ndi usiku popanda chifukwa.

Insulin yofupikitsa nthawi zambiri imagwiritsidwa ntchito ndi othamanga omwe akuchita nawo masewera olimbitsa thupi. Zotsatira zamankhwala ndizofanana ndi zotsatira za anabolic. Insulin yochepa imayendetsa kayendedwe ka glucose kumaselo onse amthupi, makamaka minofu yamatumbo.

Izi zimathandizira kuti chiwonjezeke komanso kusamalira kamvekedwe ka minofu. Pankhaniyi, mlingo umatsimikiziridwa ndi dokotala payekhapayekha. Njira yovomerezeka imatha miyezi iwiri. Pambuyo pakupuma kwa miyezi 4, mankhwalawa amatha kubwerezedwa.

Nthawi zina, ndikusowa kwa chakudya chamafuta m'thupi, thupi limayamba kugwiritsa ntchito matupi a adipose ngati mphamvu. Ikagawika, matupi a ketone otchedwa acetone amasulidwa.

Pankhani ya shuga wamagazi ambiri komanso kupezeka kwa ma ketones mu mkodzo, wodwalayo amafunikira zowonjezera insulin - 20% ya tsiku ndi tsiku. Ngati palibe kusintha komwe kumadziwika pambuyo pa maola atatu, mubwereze jakisoni.

Anthu odwala matenda ashuga okhala ndi kutentha okwanira kwamthupi (mpaka 37 ° C) amafunika kuchita glucometry ndi insulin. Pafupifupi, tsiku lililonse mlingo umakulitsidwa ndi 10%. Kutentha mpaka 39 ° C, mlingo wa tsiku ndi tsiku umachulukitsidwa ndi 20-25%.

Insulin yokhala ndi nthawi yayitali: mayina a mankhwala omwe akhala akuchita kwakanthaŵi. Mitundu ya insulin ndi zochita zawo

Tsiku labwino kwa onse! Monga ndidalemba kale m'nkhani yanga yaposachedwa "Helo insulin - choyambirira chokhudza mafuta a metabolism", insulin yaumunthu imapangidwa nthawi yonseyo. Kubisirana kwa insulin kumatha kugawidwa pansi ndikuyambitsa.

Mwa munthu yemwe ali ndi vuto la insulin lokwanira, cholinga cha mankhwalawa ndikuyerekeza momwe chinsinsi chimakhalira mosamala momwe mungathere, zonse zoyambira komanso zolimbikitsidwa. Munkhaniyi ndikukuwuzani kusankha momwe mungasankhire insulin yoyenera. Pakati pathu odwala matenda ashuga, mawu akuti "sungani maziko" amagwiritsidwa ntchito, ndipo chifukwa cha ichi payenera kukhala ndi mlingo wokwanira wa insulin.

Zotsatira zoyipa

Kapangidwe ka ma antibodies ku insulin kungapangitse kuti zochita zamtunduwu zizigwirizana. Izi zimayambitsa kukana kwa insulin. Nthawi zambiri, kukana kwa mahomoni kumawonedwa ndikuyamba kwa nkhumba kapena bovine insulin.

Mankhwala omwe amangokhala ndi kanthawi kochepa samayambitsa mavuto. Thupi lawo siligwirizana nthawi zambiri limachitika mu mawonekedwe a kuyabwa kwa khungu, redness. Nthawi zina kukwiya pamalowa jakisoni kumadziwika.

Pogwiritsa ntchito bongo mopitirira muyeso kapena kugwiritsa ntchito molakwika insulin, hypoglycemic syndrome ndiyotheka, yodziwika ndi kuchepa kwamphamvu kwa shuga m'magazi. Zizindikiro za hypoglycemia: chizungulire, kupweteka mutu, njala yayikulu, kuthamanga kwa mtima, kuchuluka thukuta, nkhawa komanso kusakwiya.

Kuti muthane ndi zizindikirazi, muyenera kumwa njira yothetsera shuga, pakatha mphindi 15 mpaka 20 - tengani gawo lomwe lili ndi mapuloteni ambiri komanso chakudya. Osagona: izi zimatha kuyambitsa kuyambika kwa hypoglycemic coma.

Kuchita insulin mwachangu mwachangu komanso moyenera kumatulutsa shuga. Chithandizo choterochi chimathandizira odwala matenda ashuga kuti azikhala mwamphamvu komanso kuti apewe zovuta.

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

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

Mtundu woyamba wa matenda ashuga, insulin yotalikilapo imaphatikizidwa ndi mankhwala osakhalitsa ndipo imakhala ngati chinthu chofunikira kwambiri pochizira. Kuti musunge kuchuluka kwa mankhwalawo chimodzimodzi, tsamba la jakisoni limasinthidwa nthawi iliyonse.

Kusintha kuchokera ku insulin yayitali mpaka yayitali kuyenera kuchitika moyang'aniridwa ndi dokotala ndikuyang'aniridwa pafupipafupi kuchuluka kwa shuga m'magazi. Ngati mlingo sukumana ndi zosowa, uyenera kusintha pogwiritsa ntchito mankhwala ena.

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

1. Hypoglycemia.
2. Coma ndi precomatose boma.
3. Redness ndi kuyabwa pamalowa jakisoni.
4. Ziwengo
5. Kuwonongeka kwa lipids ya thupi.

Chifukwa chiyani ma jakisoni a insulin amafunikira?

Insulin yolimbitsidwa imapereka kusala kudya kwa glucose mwachangu. Mankhwalawa amatchulidwa ndi dokotala pokhapokha ngati wodwala ayesa kuyeza magazi ake mkati mwa sabata amawona kuphwanya kwakukulu kwa chizindikiro ichi m'mawa.

Potere, ma insulin afupiafupi, apakati kapena ataliatali amatha kukhazikitsidwa. Zothandiza kwambiri pamenepa, mwachidziwikire, ndimankhwala ogwirira ntchito kwa nthawi yayitali. Mankhwalawa amagwiritsidwa ntchito pochiza matenda amtundu wa 2. Anayambitsidwa kudzera m`nsinga 1-2 pa tsiku.

Dziwani kuti insulin yotalikirapo imatha kutumizidwa ngakhale odwala matenda ashuga omwe adadzipatsa kale majekeseni osakhalitsa. Chithandizo choterechi chimakupatsani mwayi othandizira komanso kupewa mavuto ambiri.

Zofunika!
Kukhazikitsidwa kwa insulin yochita ntchito kwa nthawi yayitali kumachitika pakakhala kukanika kokwanira (imaleka kutulutsa timadzi tating'onoting'ono) ndipo kufa mwachangu kwa maselo a beta kumawonedwa.

Insulin yayitali imayamba kugwira ntchito pambuyo pa maola 3-4 Poterepa, pali kuchepa kwa shuga m'magazi ndikusintha kwakukulu pamachitidwe a wodwala. Kuchuluka kwa kugwiritsidwa ntchito kwake kumawonedwa pambuyo pa maola 8-10. Zotsatira zake zimatha kukhala maola 12 mpaka 24 ndipo zimatengera mlingo wa insulin.

Zocheperako zimakupatsani mwayi kuti mupeze insulini mu kuchuluka kwa mayiti a 8010. Amachitapo kanthu kwa maola 14-16. Insulin mu kuchuluka kwa magawo makumi awiri. ndi kuthekera kosunga shuga m'magazi pafupifupi tsiku limodzi.

Ndikofunikira kugwiritsa ntchito insulin yowonjezera molondola. Siligwiritsidwa ntchito kukhazikitsa glucose wamagazi mukatha kudya, chifukwa sichichita mwachangu, mwachitsanzo, insulin. Komanso, jakisoni wa insulin ayenera kukonzekera.

Ngati mungadumphe nthawi ya jakisoni kapena kukulitsa / kufupikitsa kusiyana pamaso pawo, izi zitha kubweretsa kuwonongeka muzochitika za wodwalayo, chifukwa kuchuluka kwa glucose "kumadumpha" nthawi zonse, zomwe zimapangitsa kuti pakhale zovuta.

Gulu la mankhwala okhala ndi insulin

Wochedwa insulin

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

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

Milandu pakakhala kofunikira kuti mupereke insulin yayitali:

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

Ma insulin owonjezerapo omwe anali osankhidwa kale anali ochepa kusankha; Ili ndi mtundu wamtambo, ndipo jekeseni isanayambe kugwedezeka.Pakadali pano, gulu la endocrinologists lazindikira motsimikiza kuti Protofan ili ndi vuto lakumateteza kumatenda, ndikulimbikitsa kuti lipange ma antibodies a insulin.

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

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

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

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

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

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

Yaitali usiku usiku insulin

Ndikulimbikitsidwa kuti muyambe kusankha mtundu wa insulin yayitali usiku. Ngati simunachite izi, onani momwe glucose wamagazi amakhalira usiku. Tengani miyeso kuyamba maola atatu aliwonse - 21:00, 00:00, 03:00, 06:00. Ngati panthawi inayake mumakhala ndi kusinthasintha kwakukulu kwa zomwe zimapangitsa kuti magazi aziwoneka kuti akuchepa kapena, mosiyana, kukulira, ndiye kuti izi zikutanthauza kuti mlingo wa insulin sunasankhidwe bwino.

Pankhaniyi, muyenera kuwona gawo ili mwatsatanetsatane. Mwachitsanzo, mumapita usiku ndi shuga 6 mmol / L, nthawi ya 00:00 - 6.5 mmol / L, ndipo 3:00 imadzuka mwadzidzidzi kufika pa 8.5 mmol / L, ndipo m'mawa mumabwera ndi shuga wambiri. Zinthu zili motere kuti insulini ya usiku sinali yokwanira ndipo ikufunika kuwonjezeka pang'onopang'ono. Koma pali mfundo imodzi. Ngati pali kuwonjezeka koteroko komanso kukwera kwambiri usiku, ndiye kuti sizitanthauza kusowa kwa insulin nthawi zonse. Nthawi zina, imatha kukhala hypoglycemia yotsika, yomwe idapereka koyamba - kuwonjezeka kwa shuga m'magazi.

Kuti mumvetsetse kuti chifukwa chiyani shuga amatuluka usiku, muyenera kuyang'ana nthawi imeneyi ola lililonse. Pazomwe tafotokozazi, muyenera kuyang'ana shuga nthawi ya 00:00, 01:00, 02:00 ndi 03:00 a.m. Ngati kuchepa kwa glucose pakadali pano, ndiye kuti mwina panali "kubisa" kobisika Ngati ndi choncho, ndiye kuti mlingo wa insulin yoyambira uyenera kuchepetsedwa.

Kuphatikiza apo, mudzavomera ndi ine kuti chakudya chomwe mumadya chimakhudza kuwunika kwa insulin yoyamba. Chifukwa chake, kuti tiwunikire moyenera ntchito ya basulin insulin, sipayenera kukhala insulin yocheperako komanso glucose yomwe idabwera ndi chakudya m'magazi. Chifukwa chake, musanayang'anize insulin yausiku, ndikofunikira kuti tidumphire chakudya chamadzulo kapena kudya chakudya chamadzulo m'mbuyomu kuti chakudyacho ndi insulin yochepa yopangidwira isafotokozere bwino.

Chifukwa chake, tikulimbikitsidwa kuti tidye chakudya chamadzulo chokhacho, kupatula mapuloteni ndi mafuta. Popeza zinthuzi zimaphatikizidwa pang'onopang'ono ndipo pamlingo wina wake zitha kukulitsa shuga, zomwe zingasokonezenso kuyesa koyenera kwa kugwira ntchito kwa insulin usiku.

Yaitali tsiku ndi tsiku insulin mlingo

Momwe mungayang'anire "basal" masana? Ndiwosavuta. Ndikofunikira kupatula chakudya. Zoyenera, muyenera kukhala ndi njala masana ndikumwa shuga m'magazi ola lililonse.Izi zikuwonetsani komwe kuchuluka kuli ndi komwe kuchepa kuli. Koma nthawi zambiri izi sizingatheke, makamaka kwa ana aang'ono. Poterepa, onani momwe insulin yoyamba imagwirira ntchito nthawi. Mwachitsanzo, idumphani chakudya cham'mawa choyamba ndikuyesa ola lililonse kuyambira nthawi yomwe mwadzuka kapena jakisoni wa insulin ya tsiku ndi tsiku (ngati muli ndi imodzi), mpaka chakudya chamasana, mutatha kudya chakudya chamasana, kenako ndikudya chakudya chamadzulo.

Ndikufuna kunena kuti pafupifupi ma insulin onse owonjezera amayenera kubayidwa katatu patsiku, kupatula Lantus, yomwe imachitika kamodzi. Musaiwale kuti onse omwe ali pamwambapa, kupatula Lantus ndi Levemir, ali ndi chiwonetsero chapadera kwambiri. Monga lamulo, nsonga imapezeka pa maola 6-8 a mankhwala ogwiritsidwa ntchito. Chifukwa chake, panthawi ngati izi, pakhoza kukhala kuchepa kwa glucose, womwe umayenera kuthandizidwa ndi XE yaying'ono.

Ndikufunanso kunena kuti mukasintha mtundu wa insal insulin, muyenera kubwereza izi zonse kangapo. Ndikuganiza kuti masiku atatu ndiokwanira kuti zitsimikizire kuti zotsatira zake zachitika mbali iliyonse. Ndipo kutengera zotsatira zake, chitani zotsatirazi.

Mukamayesa insulin ya tsiku ndi tsiku kuchokera ku chakudya cham'mbuyomu, pafupifupi maola 4 ayenera kudutsa, makamaka maola 5. Kwa iwo omwe amagwiritsa ntchito ma insulin afupiafupi (Actrapid, Humulin R, Gensulin R, etc.), osati ultrashort (Novorapid, Apidra, Humalog), nthawiyo iyenera kukhala yayitali - maola 6-8, chifukwa izi zimachitika chifukwa cha zovuta zina zomwe zikuchitika. za insulin izi, zomwe ndikambirana m'nkhani yotsatira.

Ndikukhulupirira kuti ndinafotokozera momveka bwino komanso mosavuta momwe mungapangire Mlingo wa insulin yayitali. Ngati muli ndi mafunso, omasuka kufunsa. Mukasankha bwino kuchuluka kwa insulin yomwe imatenga nthawi yayitali, mutha kusankha mtundu wa insulin yochepa. Ndipo kusangalalako kumayamba, koma koposa pamenepo m'nkhani yotsatira. Pakadali pano - bye!

Ndi chisangalalo ndi chisamaliro, endocrinologist Dilara Lebedeva

Matenda a shuga a Type 1 samachiritsidwa. Kuti khazikitse mkhalidwe, wodwala ayenera tsiku ndi tsiku. Pali mitundu ingapo ya mankhwala a timadzi iyi, koma choyambirira pakati pawo ndi insulin.

Popanda insulini, thupi limatha kugwira ntchito moyenera. Hormone iyi imayang'anira protein, mafuta ndi carbohydrate metabolism. Palibe, kapena ndende zochepa, njira za metabolic m'thupi zimachepa. Izi zimabweretsa zovuta zowopsa zomwe zimatha kupha.

Odwala onse omwe ali ndi matenda ashuga amafunikira insulin, makamaka mankhwala omwe amakhala kwa nthawi yayitali. Matendawa amakula chifukwa chosapezeka m'thupi la wodwalayo omwe amapanga mahomoni ake, insulin, yomwe imayang'anira njira zama metabolic komanso glucose. Chifukwa chake, mankhwala amakono omwe amagwira ntchito kwa nthawi yayitali amalola kuti thupi la wodwalayo lizigwira ntchito.

Matenda a shuga ndi owopsa chifukwa cha zovuta zake. Insulin yomwe imaperekedwa kwa wodwala, mwachitsanzo, kuchitapo kanthu kwa nthawi yayitali, kumapewa kuyambitsa zovuta izi, zomwe nthawi zambiri zimayambitsa kufa.

Mukamasankha insulin yaing'onoting'ono kapena yayitali, mayina omwe nthawi zina amasokonezedwa, ndikofunikira kuti musamadziyike. Ngati mukufunikira kusintha mankhwalawa kapena kusintha mlingo wa tsiku ndi tsiku, funsani dokotala.

Zomwe mungagwiritse ntchito insulin yayitali

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

1. Sulfonylurea.
2. Meglitinides.
3. Biguanides.
4. Pangamanga.

Insulin yokhala ndi nthawi yayitali imatha kutengedwa ngati chipangizo chimodzi, monga mankhwala ena onse

Monga lamulo, kupendekera kwakanthawi kochepa ka shuga kumagwiritsidwa ntchito m'malo mwa mankhwala osokoneza bongo nthawi yayitali. Chifukwa chakuti pofuna kukwaniritsa zoyambira, pafupifupi insulin imapangidwa kawiri pa tsiku, ndipo yayitali - kamodzi patsiku, kusintha kwa mankhwalawa sabata yoyamba kungayambitse kukhalanso kwa hypoglycemia ya m'mawa kapena usiku. Vutoli litha kuwongoleredwa pochepetsa kuchuluka kwa mankhwala ochulukitsidwa ndi 30%, omwe amakwanira pang'ono chifukwa chosowa kwa nthawi yayitali kugwiritsa ntchito insulin yokhala ndi chakudya chochepa. Pambuyo pake, mlingo wa insulin yochulukitsidwa umasinthidwa.

Zomwe zimapangidwazo zimaperekedwa kamodzi kapena kawiri pa tsiku. Pambuyo polowa m'thupi kudzera mu jakisoni, mahomoni amayamba kuwonetsa ntchito zake pokhapokha maola ochepa. Nthawi yomweyo, mafotokozedwe azinthu zowonjezera pang'onopang'ono zomwe zimawonetsedwa patebulo ndizosiyana. Koma ngati insulin yowonjezera ikufunika, lowetsani kuchuluka kwakukulu kwa 0,6 ma kilo imodzi ya kulemera kwa munthu, ndiye kuti mlingo womwe watchulidwa umagawidwa majakisoni awiri. Nthawi yomweyo, kupatula pakubwera zovuta, jakisoni amapangidwa mbali zosiyanasiyana za thupi.

Ganizirani momwe mungapewere zoyipa za insulin.

Mankhwala aliwonse a insulini, ngakhale atakhala nthawi yayitali bwanji;

• Hypoglycemia - mulingo wa glucose m'magazi umatsika pansi pa 3.0 mmol / L.
• Zosiyanasiyana komanso zamkati zimachitika - urticaria, kuyabwa ndi kapangidwe ka jekeseni.
• Kuphwanya mafuta kagayidwe - kodziwika ndi kudzikundikira kwamafuta, osati pansi pa khungu, komanso magazi.

Wolembera pang'onopang'ono insulin imapereka mwayi wabwino kwambiri wopewa zovuta za mtundu 1 ndi matenda ashuga 2. Kuphatikiza apo, insulin yayitali imapangitsa kuchiza matenda a shuga mosavuta. Pofuna kupatula chiwonetsero cha zotsatirazi, odwala matenda ashuga ayenera kutsata zakudya zomwe adokotala adanenanso ndikusintha malo a jekeseni nthawi zonse.

Ndalama zatsopano zimapitilira

Posachedwa, mitundu iwiri yatsopano, yayitali, yovomerezedwa ndi FDA, yakhazikitsidwa kwakanthawi yayambitsidwa pamsika wamankhwala ochizira odwala matenda a shuga ngati akulu:

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

Tresiba ndi mankhwala atsopano omwe amavomerezedwa ndi FDA

Kugwiritsa insulin Degludec kwa nthawi yayitali kuti apangire utsogoleri wokhazikika. Kutalika kwa magazi a shuga ndi pafupi maola 40. Kugwiritsidwa ntchito pochiza odwala matenda ashuga njira yoyamba ndi yachiwiri yamatenda. Kuti atsimikizire chitetezo ndi kugwiritsa ntchito mankhwala omwe atulutsidwa kumene, kafukufuku wina anachitika pomwe odwala oposa 2000 adachitapo kanthu. Degludec wagwiritsidwa ntchito ngati cholankhulira pakamwa.

Mpaka pano, kugwiritsa ntchito mankhwala a Degludec ndikuloledwa ku EU, Canada ndi USA. Msika wam'nyumba, chitukuko chatsopano chidawonekera pansi pa dzina la Tresiba. Kuphatikizikako kumazindikira mbali ziwiri: 100 ndi 200 U / ml, mwa cholembera. Tsopano, ndikotheka kusinthitsa kuchuluka kwa shuga m'magazi mothandizidwa ndi othandizira-kutulutsa kwambiri pogwiritsa ntchito njira ya insulin katatu kokha pa sabata.

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

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

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

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

Mitundu ya jakisoni

Wodwala matenda a shuga amakakamizika kumwa jakisoni tsiku lililonse, ndipo kangapo patsiku. Kuyambitsa insulin tsiku lililonse kumathandizira kukhazikika kwa mkhalidwe. Popanda mahomoni awa, sizingatheke kutulutsa shuga m'magazi. Popanda jakisoni, wodwalayo amamwalira.

Chithandizo chamakono cha shuga chimapereka mitundu ingapo ya jakisoni. Amasiyana pakutalika komanso kuthamanga.

Pali mankhwala osakhalitsa, a ultrashort, ophatikizika komanso opanga nthawi yayitali.

Mwachidule ndipo amayamba kugwira ntchito pafupifupi mukangoyendetsa. Kuchulukitsa kwakukulu kumatheka mkati mwa ola limodzi kapena awiri, kenako zotsatira za jakisoni zimatha pang'onopang'ono. Mwambiri, mankhwalawa amagwira ntchito pafupifupi maola 4-8. Monga lamulo, majekeseni oterewa amakulimbikitsidwa kuti aperekedwe mukangodya, pambuyo pake kuchuluka kwa shuga m'magazi a wodwalayo kumayamba kuchuluka.

Insulin yotalikilapo imakhala maziko a chithandizo. Imagwira kwa maola 10-28, kutengera mtundu wa mankhwalawa. Kutalika kwa nthawi ya mankhwalawa kumasiyanasiyana mwa wodwala aliyense, kutengera mtundu wa matendawa.

Zina za mankhwala omwe akhala akuchita kwa nthawi yayitali

Insulin yotalikilapo ndiyofunikira kuti athe kutsanzira molondola momwe amapangira mahomoni ake mu wodwala. Pali mitundu iwiri ya mankhwalawa - Mankhwala okhala ndi nthawi yayitali (amagwira ntchito kwa maola pafupifupi 15) komanso mankhwala opangira nthawi yayitali (mpaka maola 30).

Mankhwala a nthawi yapakatikati ali ndi mawonekedwe othandizira. Insulin imakhala ndi utoto woyera. Musanayambitse mahomoni, muyenera kukwaniritsa utoto.

Pambuyo pakuyambitsidwa kwa mankhwalawa, kuwonjezeka kwapang'onopang'ono kwa kuchuluka kwa mahomoni kumawonedwa. Panthawi inayake, pachimake pa mchitidwe wa mankhwalawa amadza, pambuyo pake ndende imayamba kuchepa ndikutha. Ndiye kuti jakisoni watsopano ayenera kupangidwa.

Mlingo wake umasankhidwa kuti mankhwalawa azitha kuyendetsa bwino shuga wa magazi, kupewa kudumphira pakati pa jakisoni. Mukamasankha kuchuluka kwa insulin kwa wodwala, dokotala amaganizira nthawi yochuluka yomwe mankhwalawa amapezeka.

Mbali inanso ndi tsamba la jakisoni. Mosiyana ndi mankhwalawa amagwira ntchito mwachidule, omwe amalowetsedwa pamimba kapena mkono, insulin yayitali imayikidwa m'chafu - izi zimakuthandizani kuti mukwaniritse kusintha kwa mankhwala mthupi lanu.

Ndiwowonjezereka kosalala kosakanikirana ndi mankhwalawa komwe kumatsimikiza kugwira ntchito kwake ngati jekeseni wa m'munsi.

Kodi kubayidwa kangati?

Pali mankhwala angapo a insulin. Ambiri aiwo amadziwika ndi kusasinthasintha kwamtambo komanso kupezeka kwa zochitika zapamwamba, zomwe zimachitika pafupifupi maola 7 mutatha kutsata. Mankhwalawa amatumizidwa kawiri pa tsiku.

Mankhwala ena (Tresiba, Lantus) amaperekedwa nthawi imodzi patsiku. Mankhwalawa amadziwika ndi nthawi yayitali yogwira ntchito komanso kuyamwa pang'onopang'ono, popanda kuchuluka kwa ntchito - ndiye kuti, mahomoni omwe amayambitsidwa amachita bwino nthawi yonse yochitayi. Chowonjezera china mwa mankhwalawa ndikuti alibe mtambo ndipo amatha kusiyanitsidwa ndi mtundu wowoneka bwino.

Dokotala pakuthandizanakukuthandizani kusankha mankhwala abwino kwambiri kwa wodwala wina. Katswiriyu amasankha insulini yoyambira kapena yotalikilapo ndipo atchule mayina a mankhwala abwino. Sizikulimbikitsidwa kuti muzisankha nokha insulin yayitali.

Momwe mungasankhire mlingo?

Matenda a shuga sagona usiku. Chifukwa chake, wodwala aliyense amadziwa kufunika koti asankhe mlingo woyenera wa mankhwalawa kuti apewe shuga pamene akupumula usiku.

Kusankha mankhwalawa molondola, muyenera kuyeza shuga m'magazi awiri tsiku lililonse.

Musanayambe kugwiritsa ntchito insulin, nthawi yayitali, ndikulimbikitsidwa kukana chakudya chamadzulo. Usiku, kuchuluka kwa shuga kumayesedwa, ndipo, potengera izi, pamtundu wofunikira wa jakisoni umatsimikizika pambuyo pokambirana ndi dokotala.

Kudziwa tsiku ndi tsiku mankhwala omwe akhala akuchita kwa nthawi yayitali kumafunikiranso njira yapadera. Njira yabwino ndikukana chakudya tsiku lonse ndi milingo ya shuga. Zotsatira zake, pofika madzulo, wodwalayo amadziwa momwe shuga ya m'magazi imakhalira jekeseni chifukwa chokhala nthawi yayitali.

Zotheka zotheka ku jakisoni

Insulin iliyonse, mosasamala kanthu za kutalika kwa nthawi, imatha kuyambitsa zovuta zingapo. Nthawi zambiri, chomwe chimayambitsa zovuta ndi kuperewera kwa zakudya m'thupi, kumwa mankhwala osankhidwa mosayenera, kuphwanya njira yoyendetsera mankhwala. Zikatero, zotsatirazi zimayamba:

• mawonekedwe a thupi lawo siligwirizana.
• kusapeza bwino pamalowo jekeseni,
• kukula kwa hypoglycemia.

Monga mukudziwa, hypoglycemia imatha kubweretsa zovuta zazikulu, mpaka kukomoka kwa matenda ashuga. Pewani izi mwakutsatira mosamalitsa malangizo onse omwe dokotala amakupatsirani.

Kodi mungapewe bwanji zovuta?

Matenda a shuga ndi matenda oopsa ndipo ndizovuta kupirira. Komabe, wodwala yekha ndiye amene angatsimikizire kukhala ndi moyo wabwino. Kuti tichite izi, ndikofunikira kugwiritsa ntchito njira zonse zomwe zingathandize kupewa zovuta komanso thanzi labwino.

Maziko othandizira matenda amtundu wa shuga ndi jakisoni, koma kudzipereka nokha ndiwowopsa. Chifukwa chake, pakakhala mafunso aliwonse okhudzana ndi mankhwala omwe amaperekedwa, wodwalayo ayenera kufunsa dokotala wokha.

Kuti mumve wathanzi, muyenera kudya moyenera. Insulin imathandizira kuyendetsa magazi m'magazi, koma wodwalayo ayenera kuyesetsa kuti asawakhumudwitse. Kuti izi zitheke, madokotala amatipatsa zakudya zapadera zomwe zithandiza kukhazikika mtima kwa wodwala.

Mankhwala aliwonse omwe amagwiritsidwa ntchito ngati mankhwala ayenera kugwiritsidwa ntchito molingana ndi malangizo a dokotala.

Matenda a shuga amadziwika ndi kulephera kwa thupi kugwetsa glucose, chifukwa chomwe chimakhazikika m'magazi, zimayambitsa kusokonezeka kwakukulu pakugwira ntchito kwa minofu ndi ziwalo zamkati. Mtundu wa 1 wa matenda ashuga, izi zimachitika chifukwa chopanga insulin. Ndipo kuti apange timadzi tating'ono totere m'thupi, madokotala amapereka insulin yayitali kwa odwala awo. Kodi ndi chiyani ndipo mankhwalawa amagwira ntchito bwanji? Izi ndi zina zambiri tidzazikambirana tsopano.

Kuchita insulini kwautali

Jekeseni wothandizirana kwa nthawi yayitali amalola odwala matenda ashuga kuti athe kuchotsa mankhwalawa kangapo patsiku, chifukwa amalamulira shuga m'magazi tsiku lonse. Kuchita izi ndi chifukwa chakuti zonse zomwe zakhala zikuchitika nthawi yayitali zimaphatikizira othandizira ena amagetsi.

Kuphatikiza apo, mankhwalawa ali ndi ntchito inanso - amachepetsa njira yolembera shuga m'thupi, potero amapereka kusintha kwa zomwe wodwalayo ali nazo. Zotsatira zoyambirira pambuyo pa jekeseni zimawonedwa kale pambuyo pa maola 4-6, pomwe zimatha kupitiliza kwa maola 24-36, malingana ndi kuopsa kwa njira ya matenda ashuga.

Mayina a mankhwala omwe amakhala ndi insulin nthawi yayitali:

Mankhwalawa amayenera kuperekedwa ndi adokotala okha, chifukwa ndikofunikira kwambiri kuwerengera mulingo woyenera wa mankhwalawa, omwe angapewe kuwonongeka pambuyo pobayira. Mankhwalawa amaperekedwa mosavuta m'matako, matako ndi mikono yakutsogolo.

Ndikofunika kusunga mankhwalawa pamtunda wa minus 2 degree (ndikotheka mufiriji). Izi zimapangitsa kuti makutidwe ndi okosijeni a mankhwalawo komanso mawonekedwe a granular osakanikirana nawo. Musanagwiritse ntchito, botolo liyenera kugwedezeka kuti zomwe zili mkati mwake zithe.

Kusungika kosayenera kwa mankhwalawa kumachepetsa kugwira ntchito kwake komanso alumali

Watsopano omwe akhala akuchita insulin amasiyanitsidwa ndi kutalika kwa zotsatira ndi kapangidwe kake. Agawidwa m'magulu awiri:

• zofanana ndi mahomoni amunthu,
• zoyambira nyama.

Zoyambazo zimapezeka kuchokera kapamba wama ng'ombe ndipo zimalekeredwa bwino ndi 90% ya odwala matenda ashuga. Ndipo zimasiyana ndi insulin ya chilengedwe chanyama pokhapokha mwa ma amino acid. Mankhwalawa ndi okwera mtengo kwambiri, koma ali ndi zabwino zambiri:

• kuti mupeze kuchuluka kwa achire kwambiri, kukhazikitsa milingo yaying'ono ndikofunikira,
• lipodystrophy pambuyo makonzedwe awo amawonedwa pafupipafupi,
• Mankhwalawa samayambitsa zotsatira zoyipa ndipo angagwiritsidwe ntchito mosavuta kuwongolera shuga m'magazi a omwe ali ndi matendawa.

Nthawi zambiri, anthu osazindikira odwala matenda ashuga osavomerezeka amangoima m'malo mwa mankhwala omwe amangotenga nthawi yayitali. Koma ndizosatheka kuchita izi. Kupatula apo, iliyonse mwa mankhwalawa imagwira ntchito yake. Chifukwa chake, kuti muthe kusintha shuga m'magazi ndikuyenda bwino, palibe chifukwa chomwe mungasinthire mosamalitsa chithandizo. Dokotala yekha ndiye ayenera kuchita izi.

Kubwereza mwachidule

Mankhwala osokoneza bongo, omwe mayina awo adzafotokozeredwe pansipa, sayenera kugwiritsidwa ntchito popanda kulandira dokotala! Kugwiritsa ntchito molakwika kumabweretsa zotsatirapo zoyipa kwambiri.

Mankhwala chikuyendetsedwera, osapitirira 1 nthawi patsiku. Ndikulimbikitsidwa kupereka jakisoni pogona nthawi yomweyo. Kugwiritsa ntchito Basaglar nthawi zambiri kumayendera limodzi ndi kuwoneka kwa zovuta, zomwe zina mwa izi ndizambiri:

• chifuwa
• kutupa kwa m'munsi m'munsi ndi kumaso.

Ichi ndi chimodzi mwa mankhwala abwino kwambiri, omwe ndi analogue a insulin ya anthu. 90% ya odwala amaloledwa bwino. Mwa odwala matenda ashuga okha, kugwiritsidwa ntchito kwake kumawonetsa kuyipa kwa matupi awo sagwirizana ndi lipodystrophy (ogwiritsira ntchito nthawi yayitali).

Tresiba ndi insulin yokhala ndi nthawi yayitali yomwe imatha kuyendetsa shuga m'magazi mpaka maola 42. Mankhwalawa amaperekedwa kamodzi pa tsiku nthawi imodzi. Mlingo wake umawerengedwa aliyense payekha.

Kutalika kwa mankhwalawa kwa mankhwalawa kumachitika chifukwa chakuti omwe amapanga amathandizira pakuwonjezera insulin ndi maselo amthupi komanso kuchepa kwa chiwonetsero cha zinthuzi ndi chiwindi, zomwe zimapangitsa kutsika kwakukulu kwa shuga m'magazi.

Koma chida ichi chili ndi zovuta zake. Akuluakulu okha ndi omwe amatha kugwiritsa ntchito, ndiye kuti, imaphatikizidwa kwa ana. Kuphatikiza apo, kugwiritsa ntchito mankhwalawa matenda a shuga sikungatheke mwa amayi panthawi yoyembekezera komanso pakubala, chifukwa izi zimatha kusokoneza thanzi la mwana wosabadwa.

Ndi analogue of insulin ya anthu. Imayendetsedwa mosavuta, nthawi 1 patsiku nthawi yomweyo. Imayamba kugwira ntchito 1 ola limodzi pambuyo pa utsogoleri ndipo imagwirabe ntchito kwa maola 24. Ali ndi analogue - Glargin.

Chodabwitsa cha Lantus ndikuti chitha kugwiritsidwa ntchito mu achinyamata ndi ana opitilira zaka 6. Mwambiri, kulekerera bwino. Okha odwala matenda ashuga okha ndi omwe amapangitsa kuti thupi lawo liziganiza, kutupira, komanso kufooka kwa milomo.

Pofuna kupewa kukula kwa lipodystrophy ndikugwiritsa ntchito mankhwalawa kwa nthawi yayitali, tikulimbikitsidwa kusintha tsamba la jekeseni. Mutha kuzichita m'mapewa, ntchafu, m'mimba, matako, ndi zina zambiri.

Ndi sungunuka basal analogue wa insulin yamunthu. Zovomerezeka kwa maola 24, zomwe zimachitika chifukwa cha kudziyimira pawokha kwa mamolekyulu a insulir m'dera la jakisoni ndikumangidwa kwa mamolekyulu a mankhwala kuti a albumin ndi unyolo wamafuta acid.

Mankhwalawa amaperekedwa pang'onopang'ono katatu patsiku, kutengera zosowa za wodwala. Zitha kupangitsanso kupezeka kwa lipodystrophy, chifukwa chake malo a jekeseni amayenera kusinthidwa nthawi zonse, ngakhale jakisoni atayikidwa m'dera lomwelo.

Kumbukirani kuti ma insulin omwe akhala akuchita kwa nthawi yayitali ndi mankhwala amphamvu omwe muyenera kugwiritsa ntchito mosamalitsa malinga ndi dongosolo, osaphonya nthawi ya jakisoni. Kugwiritsa ntchito mankhwalawa kumapangidwira ndi dokotala, komanso mlingo wawo.

Zaka zana limodzi zapitazo, matenda a shuga amawonedwa ngati matenda akupha. Madokotala amadziwa momwe matendawa amawonekera, komanso amatchedwa zosayambitsa - mwachitsanzo, kapena. Ndipo m'zaka khumi zokha zapitazi, asayansi adazindikira ndikuwerengera. Ichi chinali chipulumutso chenicheni kwa odwala matenda ashuga.

Magulu amakonzekera insulin

Njira yayikulu yothandizira matenda a shuga a mtundu woyamba ndikuwonetsa madontho ena a insulin yophatikizidwa m'magazi a wodwala. Malinga ndikuwonetsa payekhapayekha, timadzi timeneti timagwiritsidwanso ntchito pa mtundu II wa shuga.

Udindo waukulu wa insulin m'thupi ndi kutenga gawo la kagayidwe kazakudya ndikupanga kuchuluka kwabwino kwa shuga m'magazi.

Chemarology yamakono imagawa kukonzekera kwa insulin m'magulu potengera kuchuluka kwa hypoglycemic (kutsitsa shuga m'magazi) zotsatira:

Kukhalitsa: Zabwino ndi Zabwino

Mpaka posachedwa, kukonzekera kwa insulin kogawika kunagawika m'magulu awiri: apakati komanso okhalitsa. Zaka zaposachedwa, zadziwika pachitukuko cha insulin yayitali nthawi yayitali.

Kusiyanitsa kofunikira pakati pa mankhwala a magulu onse atatu ndi nthawi ya hypoglycemic zotsatira:

• kuchuluka kwa nthawi yayitali ndi 8-12, mwa odwala - mpaka maola 20,
• kuchitapo kanthu kwanthawi yayitali - 20-30 (nthawi zina 36) maola,
• zowonjezera zazitali - zoposa maola 42.

Ma insulini amasungidwe amasungidwe nthawi zambiri amapezeka mu mawonekedwe a kuyimitsidwa ndipo amapangidwira ma subcutaneous kapena intramuscular management.

Nthawi zambiri, mwa munthu yemwe alibe matenda a shuga, insulin imapangidwa mosalekeza. Kukonzekera kwa insulin kwa nthawi yayitali kwapangidwa kuti kuyerekezera zomwezo mwa odwala omwe ali ndi matenda a shuga. Ntchito yawo yayitali mthupi ndiyofunikira kwambiri ndi chithandizo chowongolera. Kuchepetsa kuchuluka kwa jakisoni ndi kuphatikiza kwinanso kwa mankhwalawa.

Koma pali kuchepa: ma insulin osakhalitsa sangathe kugwiritsidwa ntchito poyipa matenda ashuga kapena malo oyipa a wodwalayo.

Isofan insulin

Izi zimagwira ntchito mankhwala osokoneza bongo. nthawi yayitali machitidwe. Woimira akhoza kuonedwa ngati French Insuman Bazal GT. Imapezeka mu mawonekedwe a kuyimitsidwa ndi insulin yokhala ndi 40 kapena 100 mayunitsi. Kuchuluka kwa botolo limodzi ndi 10 kapena 5 ml, motsatana.

Chachilendo cha mankhwalawa ndi kulekerera bwino kwake kwa odwala omwe amadziwika kuti amatsutsana ndi insulini zina. Kuphatikiza apo, mankhwalawa amatha kugwiritsidwa ntchito pakuyembekezera amayi ndi kuyamwa Isofan insulin imayendetsedwa kamodzi tsiku lililonse.

Mtengo woyeserera wa phukusi la mabotolo asanu a 5 ml - kuchokera ku ma ruble 1300.

Insulin glargine

Mankhwala kuchitapo kanthu kwa nthawi yayitali ndi yapadera m'njira yake. Chowonadi ndi chakuti insulin yambiri imakhala ndi chotchedwa peak. Ino ndi nthawi yomwe kukhazikika kwa mahomoni m'magazi kumafika pazokwanira.Kugwiritsa ntchito insulin glargine kumachotsa mphindi yapamwamba kwambiri: mankhwalawa amachita mosiyanasiyana komanso mosalekeza. Mankhwalawa amapangidwira tsiku limodzi.

Limodzi mwa mayina amalonda ndi Lantus. Yopangidwa ku France ngati kuyimitsidwa kwa jakisoni wotsekemera. Mtengo wa mankhwalawa ndi pafupifupi ma ruble 3,500 a ma syringes asanu a 3 ml aliyense.

Insulin degludec

Awa ndi dzina lapadziko lonse lamankhwala. kupatula nthawi . Malinga ndi kuyerekezera kwa akatswiri, tsopano lilibe mndandanda wonse padziko lonse lapansi. Mbiri yamalonda - "Tresiba Penfill", dziko lomwe adachokera - Denmark. Kutulutsidwa mawonekedwe - makatiriji okhala ndi mphamvu ya 3 ml (mayunitsi zana a insulin / ml), mu bokosi - makatoni asanu. Mtengo woyerekeza wa mankhwalawo ndi pafupifupi ma ruble 7500.

Mankhwalawa amaperekedwa kamodzi pa maola 24 aliwonse nthawi iliyonse (kupitilizanso kuti azitsatira). Insulin degludec imapangidwira zochizira matenda ashuga odwala akulu, kuphatikizapo omwe ali ndi zaka zopitilira 65. Tsopano sichigwiritsidwa ntchito pochiza matenda a shuga ku unamwino, amayi apakati, komanso mwa ana ndi achinyamata.

Mu thupi lathanzi, insulini imasungidwa mosalekeza (chimbudzi chachikulu) ndipo imayamba kupangidwa pakafunika kutsitsa shuga m'magazi (mwachitsanzo, mutatha kudya). Ngati mukusowa insulini m'thupi la munthu, amafunika kupaka insulin ndi jakisoni, ndiye kuti insulini.

Udindo wa insulin wa nthawi yayitali (wokhala nthawi yayitali), womwe umapezeka mwa zolembera, umawonetsera kubisalira kwapadera (kosalekeza) kwapancreatic.

Cholinga chachikulu cha mankhwalawa ndikukhalabe ndi chidwi chofunikira cha mankhwalawa m'magazi kwanthawi yayitali. Chifukwa chake, amatchedwa basal insulin.

Hormoni iyi imagawidwa m'magulu awiri: mankhwala osokoneza bongo (NPH) omwe amakhala ndi nthawi yayitali komanso analogue.

Next Generation Insulin Yaitali

Kwa odwala matenda ashuga, inshuwaransi ya NPH yaumunthu komanso mawonekedwe ake otenga nthawi yayitali amapezeka. Gome ili pansipa likuwonetsa kusiyana kwakukulu pakati pa mankhwalawa.

Mu Seputembara 2015, insulin yatsopano ya Abasaglar idayambitsidwa, yomwe ili yofanana ndi Lantus yubiquitous.

Wochedwa insulin

Food and Drug Administration (FDA, US FDA) - Bungwe la boma lomwe lachita pansi pa dipatimenti ya zaumoyo ku U.S. mu 2016 linavomerezanso mtundu wina wa insulin. Izi zimapezeka pamsika wapanyumba ndipo zimatsimikizira kuyenera kwake pochiza matenda ashuga.

NPH insulini (NPH Neutral Protamine Hagedorn)

Uwu ndi mtundu wa ma insulin opangira momwe amapangira mapangidwe a insulin yaumunthu, koma olemeretsedwa ndi protamine (protein protein) kuti achepetse mphamvu yake. NPH ndi mitambo. Chifukwa chake, isanayambe makonzedwe, iyenera kuzunguliridwa bwino kusakaniza bwino.

NPH ndi mtundu wotsika mtengo kwambiri wa insulin. Tsoka ilo, imakhala ndi chiopsezo chachikulu cha hypoglycemia ndi kulemera kwakukulu, popeza imakhala ndi chiwonetsero chokwanira pantchito (ngakhale zimachitika pang'onopang'ono osati mwachangu ngati insulin pamabowo).

Odwala omwe ali ndi matenda amtundu woyamba 1 amapatsidwa kawiri kawiri la NPH insulin patsiku. Ndipo odwala omwe ali ndi matenda a shuga a 2 amatha jekeseni kamodzi patsiku.Zonse zimatengera kuchuluka kwa shuga m'magazi ndi malingaliro a dokotala.

Ma Anulin a Nthawi Yaitali a Insulin

Insulin, zomwe zimapangidwa ndi mankhwala omwe amasinthika kotero kuti amachedwetsa kuyamwa ndi mphamvu ya mankhwalawo, amadziwika kuti ndi insulin yopanga anthu.

Lantus, Abasaglar, Tujeo ndi Tresiba ali ndi zochitika zodziwika bwino - nthawi yayitali yogwirira ntchito komanso chiwonetsero chochepa kwambiri cha ntchito kuposa NPH. Mwanjira iyi, kudya kwawo kumachepetsa chiopsezo cha hypoglycemia ndi kulemera. Komabe, mtengo wa analogues ndiwokwera.

Abasaglar, Lantus, ndi Tresiba insulin amatengedwa kamodzi patsiku. Odwala ena amagwiritsanso ntchito Levemir kamodzi patsiku. Izi sizikugwira ntchito kwa odwala matenda ashuga 1 omwe mankhwalawa ndi ochepera maola 24.

Tresiba ndiye mtundu watsopano kwambiri ndipo tsopano ndi wotchipa kwambiri wa insulin pamsika. Komabe, ili ndi mwayi wofunikira - chiopsezo cha hypoglycemia, makamaka usiku, ndizotsika kwambiri.

Insulin imatenga nthawi yayitali bwanji

Udindo wa insulin yayitali ndikuwimira chinsinsi chachikulu cha insulini kudzera mu kapamba. Chifukwa chake, muyezo wofanana wa timadzi tomwe timagazi timatsimikizika pantchito yake yonse. Izi zimathandizira kuti maselo a thupi lathu agwiritse ntchito shuga wosungunuka m'magazi kwa maola 24.

Momwe mungabayitsire insulin

Ma insulini onse omwe akhala akuchita kwa nthawi yayitali amalowetsedwa pansi pa khungu m'malo omwe mumakhala mafuta. Gawo lotsatira la ntchafu ndilabwino kwambiri pazolinga izi. Malowa amalola kuti kulowetsedwa pang'onopang'ono, moyenera. Kutengera ndi nthawi ya endocrinologist, muyenera kuchita jakisoni imodzi kapena iwiri patsiku.

Kubayira pafupipafupi

Ngati cholinga chanu ndikusunga ma jakisoni a insulin otsika kwambiri, ndiye kuti gwiritsani ntchito Abasaglar, Lantus, Toujeo kapena Tresiba analogues. Jakisoni m'modzi (m'mawa kapena madzulo, koma nthawi zonse nthawi yomweyo) amatha kupereka insulin yofananira ndi wotchi.

Mungafunike jekeseni awiri patsiku kuti mukhale ndi mahomoni azambiri zamagazi posankha NPH. Izi, zimakupatsirani kusintha kwa mankhwalawa kutengera nthawi yatsiku ndi zochitika - zapamwamba masana komanso zochepa pogona.

Chiwopsezo cha hypoglycemia pakugwiritsa ntchito insulin

Zatsimikiziridwa kuti anthu omwe amakhala ndi insulin analogues osakhala nthawi yayitali amachititsa kuti hypoglycemia (makamaka hypoglycemia usiku) poyerekeza ndi NPH. Mukamagwiritsa ntchito, zofunika za glycated hemoglobin HbA1c ndizotheka.

Palinso umboni wosonyeza kuti kugwiritsa ntchito mankhwala okhala ndi insulin analoques nthawi yayitali poyerekeza ndi isoflan NPH kumayambitsa kuchepa kwa thupi (ndipo, chifukwa chake, kuchepa kwa kukana kwa mankhwalawa komanso kufunika kwakukulu kwa mankhwalawo).

Mtundu wochita kwa nthawi yayitali I shuga

Ngati mukudwala matenda ashuga amtundu 1, kapamba wanu sangathe kupanga insulini yokwanira. Chifukwa chake, mutatha kudya chilichonse, muyenera kugwiritsa ntchito mankhwala omwe amathandizira kubisalira kwa insulin ndi maselo a beta. Ngati mwaphonya jakisoni, pamakhala chiopsezo chokhala ndi matenda ashuga a ketoacidosis.

Mukamasankha pakati pa Abasaglar, Lantus, Levemir ndi Tresiba, muyenera kudziwa zina mwazinthu za insulin.

• Lantus ndi Abasaglar ali ndi mbiri yosyasyalika pang'ono kuposa Levemir, ndipo kwa odwala ambiri, amagwira maola 24.
• Levemir angafunikire kutengedwa kawiri tsiku lililonse.
• Pogwiritsa ntchito Levemir, Mlingo umatha kuwerengeka malinga ndi nthawi ya tsiku, motero kuchepetsa chiopsezo cha nocturnal hypoglycemia ndikuwongolera nthawi yolamulira masana.
• Toujeo, Tresibia mankhwalawa amachepetsa zizindikiro zomwe zili pamwambazi poyerekeza ndi Lantus.
• Muyenera kuganiziranso za zovuta za mankhwala monga zotupa. Izi zimachitika kawirikawiri, koma zimatha kuchitika.
• Ngati mukufunikira kusintha kuchokera ku mankhwala a insulin omwe akhala akuchita nthawi yayitali kupita ku NPH, kumbukirani kuti mlingo mukatha kudya ungafunikire kuchepetsedwa.

Kutenga nthawi yayitali insulin ya matenda a shuga a mtundu II

Kuchiza matenda a shuga a mtundu II kumayambira pobweretsa zakudya zoyenera komanso mankhwala amkamwa (Metformin, Siofor, Diabeteson, etc. ..). Komabe, pali zochitika zina pomwe madokotala amakakamizidwa kugwiritsa ntchito insulin.

Zofala kwambiri zalembedwa pansipa:

• Kusakwanira kwa mankhwala amkamwa, kulephera kukwaniritsa bwinobwino glycemia ndi glycated hemoglobin
• Contraindication pakamwa
• Kuzindikira matenda ashuga omwe ali ndi ziwonetsero zambiri za glycemic, kuchuluka kwa matenda
• Myocardial infarction, coronary angiography, sitiroko, matenda owopsa, opaleshoni
• Mimba

Mbiri yayitali ya insulin

Mlingo woyambirira nthawi zambiri amakhala mayunitsi 0,2 kg / thupi. Calculator iyi ndi yothandiza kwa anthu popanda kukana insulini, yokhala ndi chiwindi chokhazikika komanso impso. Mlingo wa insulin umayikidwa ndi dokotala wokha (!)

Kuphatikiza pa kutalika kwa nthawi yochitikira (yayitali kwambiri ndi degludec, yocheperako kwambiri ndi ma genetic engineer a insulin-isophan), mankhwalawa amakhalanso osiyana mawonekedwe. Pankhani ya insulin NPH, pachimake chiwonetserochi chimagawidwa nthawi yayitali ndipo chimachitika pakati pa maola 4 ndi 14 jakisoni. Analogue yogwira ntchito ya insulir yaigwira kwa nthawi yayitali imafika pachimake pakati pa maola 6 ndi 8 jakisoni, koma imakhala yochepa kwambiri.

Insulin glargine chifukwa chake imatchedwa basal insulin. Kuphatikiza kwake m'magazi kumakhala kochepa kwambiri, kotero chiopsezo cha hypoglycemia ndichotsika kwambiri.

Matenda a Alzheimer's: zoyambitsa ndi chithandizo. Zomwe muyenera kudziwa