Mankhwala a insulin

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Pali mitundu ingapo ya insulin ya odwala matenda ashuga. Chiwembu chilichonse chimadziwika ndi luso lake komanso kuchuluka kwa insulin. Pokhudzana ndi zodabwitsa za thupi, zochitika zolimbitsa thupi zosiyanasiyana, chakudya chotengedwa ndi anthu odwala matenda ashuga, munthu amawerengera mlingo umodzi wa mankhwalawo, kuwerengera malinga ndi chiwembu kapena njira ina.

Mwachidziwitso, ndizovuta kwambiri kuwerengera kuchuluka kwa insulini - mlingo womwewo woperekedwa ndi odwala osiyanasiyana ungayambitse kuyambanso kwamtundu wina, chifukwa cha kuchuluka kwa mankhwalawa, nthawi yayitali komanso nthawi yayitali. Kuwerengera kuchuluka kwa insulini kumachitika mchipatala, odwala matenda ashuga payekha amawerengera kuchuluka kwake, ndikusintha ndikulimbitsa thupi, amatenga chakudya ndi shuga m'magazi.

Malonda a insulin

Mwa mitundu yomwe ilipo ya mankhwala a insulin, mitundu 5 ikuluikulu ndi iyi:

  1. Jakisoni imodzi yokha ya insulin kapena yochita pakati;
  2. Kubayidwa kawiri kwa insulin yapakatikati;
  3. Kubayiranso kawiri kwa insulin yapakati komanso yochepa;
  4. Katatu kubayidwa wa insulin yayitali;
  5. Maziko ndi njira ya bolus.

Njira yachilengedwe yopanga insulin tsiku ndi tsiku imatha kuyimilidwa ngati mzere uli ndi ma vertices panthawi yakuthengo ya insulin yomwe imachitika ola limodzi mutatha kudya (Chithunzi 1). Mwachitsanzo, ngati munthu adya chakudya nthawi ya 7 koloko, 12 p.m., 6 p.m. ndi 10 p.m., ndiye kuti insulin ikayamba 8 koloko m'mawa, 1 p.m. 7 p.m ndi 11 p.m.

Pokhotakhota pobisalira mwachilengedwe pamakhala magawo olunjika, kulumikiza komwe timapeza maziko - mzere. Zigawo zachindunji zikugwirizana ndi nthawi zomwe munthu yemwe alibe matenda ashuga samadya ndipo insulin imachotsedwapo pang'ono. Panthawi ya kutulutsidwa kwa insulin mutatha kudya, mzere wachindunji wa katulutsidwe wachilengedwe umagawidwa ndi nsonga za mapiri ndi kukwera kwakuthwa komanso kutsika pang'ono.

Mzere wokhala ndi nsonga zinayi ndi njira "yabwino", yofanana ndi kutulutsidwa kwa insulin ndi zakudya 4 patsiku panthawi yodziwika bwino.
M'malo mwake, munthu wathanzi amatha kusuntha nthawi yakudya, kulumpha chakudya chamasana kapena chakudya chamadzulo, kuphatikiza nkhomaliro ndi nkhomaliro kapena kudya zochepa, pamenepa ma peyala a insulin owonjezera amawonekera pamapindikira.

Jekeseni imodzi yokha ya insulin yochita kapena yapakatikati

Jakisoni imodzi imatheka chifukwa cha kuyamwa kwa insulin tsiku lililonse m'mawa musanadye chakudya cham'mawa.

Zochita za chiwembuchi ndizopondera zomwe zimayambira nthawi ya makonzedwe a mankhwalawa, kufikira pofika nthawi ya nkhomaliro ndikutsika chakudya chamadzulo (graph 2)

Chiwembuchi ndi chimodzi chophweka, chili ndi zovuta zambiri:

  • Mphepete yowombera kamodzi sangafanane ndi kupindika kwachilengedwe kwa insulin.
  • Kugwiritsa ntchito njirayi kumaphatikizapo kudya kangapo patsiku - chakudya cham'mawa chopepuka chimasinthidwa ndi chakudya chambiri, chakudya chambiri komanso chakudya chochepa.
  • Kuchuluka kwake ndi kapangidwe kake ka chakudya kuyenera kulumikizidwa ndi mphamvu ya zochita za insulin pakadali pano komanso kuchuluka kwa zolimbitsa thupi.
Zoyipa zamakimuyi zimaphatikizapo chiopsezo chachikulu cha hypoglycemia, usana ndi usiku. Kupezeka kwa nocturnal hypoglycemia, limodzi ndi kuchuluka kwa insulin yam'mawa, kumawonjezera chiopsezo cha hypoglycemia pa nthawi yokwanira

Kukhazikitsidwa kwa mlingo waukulu wa insulini kumasokoneza kagayidwe ka mafuta m'thupi, komwe kungayambitse matenda ophatikizika.

Izi sizikulimbikitsidwa kwa anthu odwala matenda ashuga amtundu 1, mitundu yachiwiri ya anthu odwala matenda ashuga, mankhwalawa amagwiritsidwa ntchito molumikizana ndi mankhwala ochepetsa shuga omwe adayambitsidwa nthawi yamadzulo.

Kubayidwa kawiri kwa insulin yapakatikati

Chithandizo cha insulin ichi chimachitika chifukwa chobweretsa mankhwala m'mawa musanadye chakudya cham'mawa komanso madzulo asanadye. Mlingo wa tsiku ndi tsiku wa insulin umagawidwa m'mawa ndi madzulo pazotsatira za 2: 1, motero (graph 3).

  • Ubwino wa chiwembuchi ndikuti chiopsezo cha hypoglycemia chichepe, ndikulekanitsidwa kwa insulini mumadontho awiri kumapangitsa kuti mlingo wocheperako uzungulira thupi la munthu.
  • Zoyipa zamakimuyi zimaphatikizira kukonda kwambiri regimen ndi zakudya - wodwala matenda ashuga ayenera kudya zosakwana 6 pa tsiku. Kuphatikiza apo, kupindika kwa insulini, monga momwe zimakhalira pachiwonetsero choyamba, sikutalikirana kwambiri ndi kutengera kwa insulin katulutsidwe.

Kubayiranso kawiri kwa kwapakatikati ndikuyambitsa insulin pang'ono

Imodzi mwa njira zoyenera kwambiri imawonetsedwa kuti ndi jakisoni wapawiri wa insulin komanso wapakati.
Izi zimadziwika ndi kuyambitsa kwa mankhwala m'mawa ndi madzulo, koma mosiyana ndi zomwe zidapangidwira kale, zimatha kusintha mtundu wa insulin tsiku lililonse malinga ndi masewera olimbitsa thupi omwe akubwera kapena kudya.

Mwa odwala matenda ashuga, chifukwa cha kuchulukitsa kwa kuchuluka kwa insulin, zimatha kukhala zosiyanitsa menyu pogwiritsa ntchito mankhwala omwe ali ndi shuga wambiri kapena kuwonjezera chakudya chomwe chimatengedwa (tchati 4).

  • Ngati masana mukukonzekera masewera othamanga (kuyenda, kuyeretsa, kukonza), m'mawa muyezo wa insulin yochepa umawonjezereka ndi magawo awiri, ndipo mlingo wapakatikati umachepa ndi magawo 4 - 6, chifukwa zochitika zolimbitsa thupi zimathandizira kuchepetsa shuga;
  • Ngati chochitika chofunikira ndi chakudya chamadzulo chikonzedwa madzulo, mlingo wa insulin yochepa uyenera kuwonjezeka ndi magawo anayi, yemwe ali pakati - achokere chimodzimodzi.
Chifukwa cha magawano a tsiku ndi tsiku a mankhwalawa, kupindika pawiri jakisoni wapakati komanso wosakhalitsa kwa insulin kumayandikira kwambiri kupendekera kwachilengedwe, komwe kumapangitsa kuti ikhale yoyenera komanso yoyenera kwambiri yothandizira matenda a shuga 1. Kuchuluka kwa insulin yomwe imabayidwa imazungulira ndimagazi, zomwe zimachepetsa chiopsezo cha hypoglycemia.

Ngakhale zabwino, chiwembu sichikhala ndi zovuta, zomwe zimagwirizanitsidwa ndi kudya zolimba. Ngati chithandizo cha insulin chowirikiza chimakulolani kuti musiyanitse mitundu ya chakudya, ndiye kuti kupatuka pa dongosolo la zakudya ndizoletsedwa. Kupatuka pa dongosolo la theka la ola kumawopseza kupezeka kwa hypoglycemia.

Katatu kubayidwa wa insulin yayitali komanso yayitali

Kubayira katatu kwa insulin m'mawa ndi masana kumagwirizana ndi njira yoyamba yothandizira anthu awiri, koma imasinthasintha madzulo, zomwe zimapangitsa kukhala koyenera. Malamulowa amakhudza kuphatikiza mankhwala osakanikirana aafupi komanso osakhalitsa m'mawa asanadye kadzutsa, Mlingo wa insulin yochepa musanadye nkhomaliro komanso kumwa kwa insulin yayitali musanadye chakudya chamadzulo (Chithunzi 5).
Chiwembuchi chimasinthasintha, chifukwa chimalola kusintha kwa chakudya chamadzulo komanso kuchepa kwa insulin yayitali. Kupindika kwapakati patatu kumayandikira kwambiri kumapeto kwa insulin katulutsidwe madzulo.

Maziko - Bolus Scheme

Maziko - njira yotsimikizika ya insulin kapena yolimbikitsa kwambiri, popeza ndiyomwe imayandikira kwambiri kupindika kwa insulin katulutsidwe.

Ndi malamulo oyambira a insulin, hafu ya mlingo wonse umagwera insulin, ndipo theka la "lalifupi". Gawo limodzi mwa magawo atatu a insulin yayitali imayendetsedwa m'mawa ndi masana, kupumula nthawi yamadzulo. Mlingo wa insulin "yayifupi" zimatengera kuchuluka ndi chakudya chomwe chatengedwa.

Mlingo wochepa wa insulin samayambitsa chiopsezo cha hypoglycemia, kupereka mlingo wofunikira wa mankhwala m'magazi.

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