Lantus ndi Levemir - insulin yokwanira

Lantus ndi Levemir ndi mitundu yamakono ya insulin yowonjezera, imabayidwa maola 12-24 aliwonse a mtundu woyamba wa 2 ndi matenda ashuga. Insulin yapakatikati yotchedwa protafan kapena NPH imagwiritsidwabe ntchito. Jakisoni wa insuliniyu amatha pafupifupi maola 8. Mukawerenga nkhaniyi, muphunzira momwe mitundu yonse ya insulini imasiyanirana, yomwe ndi yabwinoko, chifukwa chake muyenera kubayiramo.

Timaperekanso njira yatsatanetsatane komanso yothandiza yotsimikizira kuti shuga yanu yamagazi ndiyabwinobwino pamimba yopanda kanthu m'mawa.

Odwala omwe ali ndi matenda ashuga ayenera kuyamwa insulini usiku komanso / kapena m'mawa kwambiri ngakhale wodwala atalandira jakisoni wa insulin asanadye. Ena odwala matenda ashuga amangofunika chithandizo chokwanira ndi insulin. Ena safuna insulini yowonjezera, koma amapaka jakisoni pofupikitsa kapena pofupikitsa kwambiri kuti athetse magazi m'magawo atatha kudya. Enanso amafunika onse kuti akhale ndi shuga wabwinoko, kapena matendawa amabwera.

Kusankha mitundu ya insulini, mulingo komanso ndandanda ya jakisoni kwa munthu wodwala matendawa amatchedwa "kujambula dongosolo la insulin." Izi zimapangidwa malinga ndi zotsatira za kuwongolera kwathunthu shuga kwa masabata 1-3. Choyamba, muyenera kudziwa momwe shuga ya wodwala imakhalira nthawi zosiyanasiyana patsiku pokana zakudya zamagulu ochepa. Pambuyo pake, zimadziwika kuti ndi mtundu wanji wa mankhwala a insulin omwe amafunikira. Werengani zambiri mu nkhani yamuti: "Ndi insulin yamtundu wanji ya kubayitsa, munthawi yanji komanso mukuteteza? Njira za matenda a shuga 1 ndi matenda ashuga a 2. ”

Insulin yowonjezera singakhale yofunikira, koma jakisoni wofulumira wa insulin amafunikira musanadye. Kapena mosinthanitsa - mumafunikira insulin yayitali usiku, ndipo masana mutadya shuga ndizabwinobwino. Kapenanso wodwala matenda a shuga apeza vuto lina. Kutsiliza: ngati endocrinologist ikupereka mankhwala omwewo ndi mankhwala a insulin kwa odwala ake onse ndipo sayang'ana zotsatira za kuchuluka kwa shuga, ndibwino kukaonana ndi dokotala wina.

Kodi ndichifukwa chiyani ndimafunikira insulin yayitali?

Insulin Lantus wa nthawi yayitali, Levemir kapena Protafan ndi ofunikira kuti shuga azisala kudya. Pulogalamu yaying'ono ya insulin imayenda m'magazi a anthu nthawi zonse. Izi zimatchedwa insulin (maziko) a insulin. Zikondazo zimapatsa insulini ya basal mosalekeza, maola 24 patsiku. Komanso, poyankha chakudya, amapitilirabe kwambiri kwambiri ma cell a insulin m'magazi. Izi zimatchedwa mlingo wa bolus kapena bolus.

Mabolamu amawonjezera insulin ndende kwakanthawi kochepa. Izi zimapangitsa kuti kuzimitsa msanga shuga wowonjezereka yemwe amapezeka chifukwa chazakudya zomwe zidadyedwa. Odwala omwe ali ndi matenda amtundu 1, kapamba samatulutsa insal kapena insulin. Jekeseni wambiri wa insulin amapereka insulin, insal insulin. Ndikofunikira kuti thupi "lisadzigaye" mapuloteni ake komanso sizichitika matenda ashuga a ketoacidosis.

Cholinga china chakuchizira matenda a shuga ndi insulin yayitali ndikuletsa kuphedwa kwa maselo ena a pancreatic beta. Jekeseni wa Lantus, Levemir kapena Protafan amachepetsa katundu pa kapamba. Chifukwa cha izi, maselo ochepa kwambiri a beta amafa, ambiri a iwo amakhalabe ndi moyo. Jekeseni wa insulin yowonjezera usiku ndi / kapena m'mawa imawonjezera mwayi kuti matenda a shuga a 2 sangathe kudwala matenda ashuga amtundu woyamba. Ngakhale kwa odwala omwe ali ndi matenda a shuga 1, ngati nkotheka kusunga gawo la maselo a beta amoyo, matendawa amayenda bwino. Shuga samadumphadumpha, amakhala ngati ali bwinobwino.

Insulin yomwe imatenga nthawi yayitali imagwiritsidwa ntchito pazifukwa zosiyana kwambiri kuposa kudya mwachangu insulin musanadye. Sicholinga chofafaniza shuga wa magazi mukatha kudya. Komanso, siyenera kugwiritsidwa ntchito kuti ibweretsereni shuga msanga ngati ingadzere mwa inu. Chifukwa insulini yokhala nthawi yayitali sichichedwa kuchita izi. Kuti mumvetsetse zakudya zomwe mumadya, gwiritsani ntchito insulin yochepa kapena yochepa kwambiri. Zomwezo zimapita kuti shuga ibwereke mwachangu.

Ngati mukuyesera kupanga mitundu yambiri ya insulini yokhala ndi insulin yowonjezera, zotsatira za chithandizo cha matenda ashuga zidzakhala zopanda pake kwambiri. Wodwalayo amakhala ndi shuga wambiri m'magazi, zomwe zimayambitsa kutopa kwambiri komanso kukhumudwa. Pakangotha ​​zaka zochepa, mavuto adzaoneke omwe amapangitsa munthu kukhala wolumala.

Chifukwa chake, muyenera kudziwa bwino insulini yoyamba ya nthawi yayitali, kenaka jakisoni wa insulin yofulumira musanadye. Phunzirani kuwerengetsa moyenera mulingo woyenera. Chitani bwino matenda anu a shuga ndi insulin. Werengani werengani "Ultrashort insulin Humalog, NovoRapid ndi Apidra. Insulin Yachidule ya Anthu ”ndi“ Kuwerengeredwa kwa Mankhwala a Insulin Asanadye. Momwe mungachepetse shuga kuti akhale wabwinobwino ngati wadumpha. " Pogwiritsa ntchito glucometer, yang'anani momwe shuga yanu imakhalira masana. Mtundu wachiwiri wa matenda ashuga, mwina simungafunikire insulini yowonjezera, koma muyenera jakisoni wa insulin yofulumira musanadye. Kapena mosinthanitsa - mumafunikira insulin yowonjezera usiku, koma masana mutatha kudya komanso osabayidwa jakisoni wa insulin.

Kodi pali kusiyana kwanji pakati pa molekyulu ya Lantus ndi insulin ya anthu

Insulin Lantus (Glargin) amapangidwa pogwiritsa ntchito njira zopangira ma genetic. Amapezeka ndi kubwerezabwereza kwa Escherichia coli Escherichia coli bacteria bacteria (K12 tizilombo). Mu molekyulu ya insulin, Glargin anasintha katsitsumzukwa ndi glycine pamalo 21 a A mnyamatayo, ndipo mamolekyulu awiri a arginine omwe ali pamalo 30 a B unyolo anawonjezedwa. Kuphatikizidwa kwama molekyulu awiri a arginine ku C-terminus ya B-chain adasintha mawonekedwe a isoelectric kuchokera pH 5.4 mpaka 6.7.

Molekyulu ya Lantus - imasungunuka mosavuta ndi pH yokhala ndi acid. Nthawi yomweyo, imakhala yocheperako kuposa insulin yaumunthu, sungunuka pa pH ya thupi pH ya minofu yapansipansi. Kusintha katsabola wa A21 ndi glycine ndi kosagwirizana bwino. Amapangidwira kuti apatse analogue yaku insulin ya anthu ndikukhazikika. Glulin insulin imapangidwa pa acid acid pH ya 4.0, chifukwa chake amaletsedwa kusakanikirana ndi insulin yopangidwa mosavomerezeka pH, komanso kuyipaka ndi mchere kapena madzi osungunuka.

Insulin Lantus (Glargin) ili ndi mphamvu yowonjezera chifukwa imakhala ndi mtengo wapadera wotsika wa pH. Kusintha kwa pH kunapangitsa kuti mtundu wamtunduwu wa insulin usungunuke pang'ono pa pH ya thupi ya masamu a subcutaneous. Lantus (Glargin) ndi yankho lomveka bwino. Pambuyo subcutaneous makonzedwe a insulin, iwo amapanga micorecipients mu ndale zosakhalitsa pH wa subcutaneous danga. Insulin Lantus sayenera kuchepetsedwa ndi saline kapena madzi a jekeseni, chifukwa cha izi, pH yake imayandikira mwachizolowezi, ndipo njira yothandizira nthawi yayitali ya insulin idzasokonekera. Ubwino wa Levemir ndikuti ukuwoneka kuti ukuchepetsedwa momwe ungathere, ngakhale izi sizovomerezeka, werengani zambiri pansipa.

Zambiri za insulin ya nthawi yayitali Levemir (Detemir)

Insulin Levemir (Detemir) ndi analogue wina wokhala ndi insulin yayitali, wopikisana naye ku Lantus, yemwe adapangidwa ndi Novo Nordisk. Poyerekeza ndi insulin yaumunthu, amino acid yomwe ili mu molekyulu ya Levemir idachotsedwa pa malo 30 a B. M'malo mwake, zotsalira za asidi acid, myristic acid, womwe uli ndi maatomu 14 a kaboni, umalumikizidwa ndi amino acid lysine yomwe ili pamalo 29 a B. Chifukwa cha izi, 98-99% ya insulin Levemir m'magazi pambuyo poti jakisoni amamangidwa ku albumin.

Levemir imatengeka pang'onopang'ono kuchokera pamalowo jakisoni ndipo imakhala nthawi yayitali. Kuchedwa kwake kumatheka chifukwa chakuti insulin imalowera m'magazi pang'onopang'ono, komanso chifukwa ma molekyulu a insulin analogue amalowa m'maselo a pang'onopang'ono. Popeza mtundu wa insulin ulibe tanthauzo lalikulu, chiwopsezo cha hypoglycemia chimachepetsedwa ndi 69%, ndipo usiku hypoglycemia - ndi 46%. Izi zidawonetsedwa ndi kafukufuku wazaka 2 mwa odwala omwe ali ndi matenda ashuga a 1.

Ndi insulin yotalikilapo kuposa iti - Lantus kapena Levemir?

Lantus ndi Levemir achita zinthu monga insulin analogues, zomwe apeza posachedwapa pochiza matenda ashuga omwe ali ndi insulin. Ndiwofunikira chifukwa ali ndi mawonekedwe okhazikika osachita ntchito - chiwonetsero cha kuphatikizika kwa mitundu iyi ya insulin m'madzi am'magazi ndi mawonekedwe a "mafunde ndege". Imatengera yachilengedwe.

Lantus ndi Detemir ndi mitundu yokhazikika komanso yolosera za insulin. Amagwira pafupifupi odwala osiyanasiyana, komanso masiku osiyanasiyana mwa wodwala yemweyo. Tsopano munthu wodwala matenda ashuga sayenera kusakaniza chilichonse asadzipatse jakisoni wa insulin yayitali, koma izi zisanachitike panali kukangana kwambiri ndi insulin protafan.

Pa phukusi la Lantus kwalembedwa kuti insulini yonse iyenera kugwiritsidwa ntchito mkati mwa masabata 4 kapena masiku 30 pambuyo poti pulogalamuyo itasindikizidwa. Levemir ali ndi alumali wokhala ndi nthawi yayitali nthawi 1.5, mpaka masabata asanu ndi limodzi, komanso osagwirizana mpaka milungu 8. Ngati muli ndi chakudya chochepa kwambiri cha matenda a shuga a mtundu woyamba kapena a 2, mwina mudzafunika ma insulin okwanira tsiku lililonse. Chifukwa chake, Levemir ikhale yabwino kwambiri.

Palinso malingaliro (osatsimikiziridwa!) Kuti Lantus amawonjezera chiopsezo cha khansa kuposa mitundu ina ya insulin. Cholinga chake ndikuti Lantus ali ndi mgwirizano wambiri wa kukula kwama hormone omwe amapezeka pamaselo a khansa. Zambiri zokhudzana ndi kutenga kwa Lantus khansa sizinatsimikizidwe, zotsatira zakusaka ndizotsutsana. Koma mulimonse momwe zingakhalire, Levemir ndiotsika mtengo ndipo sizowopsa. Ubwino wake ndiwakuti Lantus sayenera kuchepetsedwa konse, ndipo Levemir - ngati kuli kotheka, azingokhala mwamwayi. Komanso, mutayamba kugwiritsa ntchito, Levemir amasungidwa nthawi yayitali kuposa Lantus.

Odwala ambiri omwe ali ndi matenda ashuga komanso endocrinologists amakhulupirira kuti ngati milingo yayikulu imayendetsedwa, ndiye kuti jakisoni imodzi ya Lantus patsiku ndi yokwanira. Mulimonsemo, levemir iyenera kubayidwa kawiri patsiku, chifukwa chake, ndi Mlingo waukulu wa insulin, ndizosavuta kuthandizidwa ndi Lantus. Koma ngati mukukhazikitsa pulogalamu yothana ndi matenda a shuga 1 kapena pulogalamu yachiwiri ya matenda ashuga, maulalo omwe amaperekedwa pansipa, ndiye kuti simungafunikire kuchuluka kwa insulin yayikulu. Sitigwiritsa ntchito Mlingo wakulu kwambiri kotero kuti amagwirabe ntchito tsiku lonse, kupatula kwa odwala matenda a shuga a mtundu wachiwiri omwe ali ndi kunenepa kwambiri. Chifukwa njira yokhayo ya akatundu yaying'ono yomwe imakulolani kuti muzitha kuyendetsa bwino magazi a shuga amtundu 1 komanso matenda a shuga a 2.

Timakhala ndi shuga wamagazi a 4,6 ± 0,6 mmol / L, ngati anthu athanzi, maola 24 patsiku, kusinthasintha pang'ono tisanadye komanso tudya. Kuti mukwaniritse cholinga chofuna kukwaniritsa izi, muyenera kupaka jakisoni wa insulin yaying'ono kawiri pa tsiku. Ngati matenda a shuga amathandizidwa ndi Mlingo wochepa wa insulin yayitali, ndiye kuti nthawi ya Lantus ndi Levemir ingafanane. Nthawi yomweyo, zabwino za Levemir, zomwe tafotokozazi, ziwonekera.

Chifukwa chiyani ndikosayenera kugwiritsa ntchito NPH-insulin (protafan)

Mpaka kumapeto kwa zaka zam'ma 1990, mitundu yochepa ya insulin inali yoyera ngati madzi, ndipo ena onse anali mitambo, opaque. Insulin imakhala mitambo chifukwa chowonjezera pazinthu zomwe zimapanga zinthu zapadera zomwe zimasungunuka pang'onopang'ono pakhungu la munthu. Mpaka pano, ndi mtundu umodzi wokha wa insulini womwe wakhala wopanda mitambo - nthawi yayitali yochitapo kanthu, yomwe imatchedwa NPH-insulin, imaphatikizanso. NPH imayimira "Hagedorn's Neutral Protamine," puloteni wazomwe nyama.

Tsoka ilo, NPH-insulin imatha kulimbikitsa chitetezo cha mthupi kutulutsa ma antibodies kuti apange insulin. Ma antibodies awa samawononga, koma kumangika kwakanthawi gawo la insulini ndikupangitsa kuti ikhale yogwira ntchito. Kenako insulin yomangidwa mwadzidzidzi imayamba kugwira ntchito ngati singakufunenso. Izi ndizofooka kwambiri. Kwa odwala matenda ashuga wamba, kupatuka kwa shuga kwa ± 2-3 mmol / L sikukhudzidwa kwenikweni, ndipo sazindikira. Timayesetsa kukhala ndi shuga yabwinobwino, i.e., 4,6 ± 0,6 mmol / l tisanadye komanso titadya. Kuti tichite izi, timachita pulogalamu yothandizira odwala matenda ashuga kapena mtundu wachiwiri wa matenda a shuga. Zomwe tikukumana nazo, kusakhazikika kwa insulin kosadziwika kumawonekera ndikuwononga chithunzicho.

Pali vuto linanso ndi protamine Hagedorn yosaloledwa. Angiography ndikuwunika kwa mitsempha yamagazi yomwe imadyetsa mtima kuti mudziwe kuchuluka komwe amakhudzidwa ndi atherosclerosis. Iyi ndi njira yodziwika bwino yazachipatala. Asanayendetse, wodwalayo amapatsidwa jakisoni wa heparin. Ichi ndi mankhwala osokoneza bongo omwe amalepheretsa mapulateleti kuti asamatikane komanso kutsekereza mitsempha yamagazi ndimisempha yamagazi. Ndondomekoyo ikamaliza, jakisoni wina amapangidwa - NPH imayendetsedwa kuti "imitsani" heparin.Pochepa peresenti ya anthu omwe amathandizidwa ndi protafan insulin, thupi limakumana ndi zovuta pamenepa, zomwe zimatha kupha.

Mapeto ake ndikuti ngati nkotheka kugwiritsa ntchito zina m'malo mwa NPH-insulin, ndibwino kuchita izi. Monga lamulo, odwala matenda ashuga amasamutsidwa kuchokera ku NPH-insulin kupita ku insulin analogenes Levemir kapena Lantus. Kuphatikiza apo, amawonetsanso zotsatira zabwino za kayendedwe ka magazi.

Niche yokhayo kumene kugwiritsa ntchito NPH-insulin kumakhalabe koyenera lero kuli ku USA (!) Ana ang'onoang'ono omwe ali ndi matenda a shuga 1. Amafunikira mlingo wochepa kwambiri wa insulin. Mlingo wake ndiwocheperako kotero kuti insulin imayenera kuchepetsedwa. Ku United States, izi zimachitika pogwiritsa ntchito njira zowonjezera insulini zotayira zomwe opanga kwaulere. Komabe, kwa insulin analogues ya nthawi yayitali, njira zotere sizipezeka. Chifukwa chake, Dr. Bernstein amakakamizidwa kuti apange jakisoni wa NPH-insulin, yomwe ikhoza kuchepetsedwa katatu patsiku, kwa odwala ake achinyamata.

M'mayiko olankhula Chirasha, njira zothetsera insulin dilution sizipezeka masana ndi moto, ndalama zilizonse, kwaulere. Chifukwa chake, anthu amachepetsa insulin pogula saline kapena madzi a jakisoni m'masitolo. Ndipo zikuwoneka kuti njirayi imagwiranso ntchito kwambiri, kuweruza poyerekeza ndemanga pamabungwe ashuga. Mwanjira imeneyi, Levemir (koma osati Lantus!) Wowonjezera insulin. Ngati mumagwiritsa ntchito NPH-insulin kwa mwana, ndiye kuti muyenera kuchepetsa ndi mchere womwewo monga Levemir. Tiyenera kudziwa kuti Levemir amachita bwino ndipo sofunikira kumangoyambitsa. Werengani zambiri mu nkhani ya "Momwe mungapangire insulin kuti mupeze jekeseni wotsika"

Momwe amapangira shuga m'mawa wopanda kanthu anali abwinobwino

Tiyerekeze kuti mukumwa matenda a shuga a 2 usiku mutamwa mlingo wovomerezeka wamapiritsi ogwira ntchito. Ngakhale izi, shuga m'magazi anu m'mimba yopanda kanthu imakhala yokhazikika, ndipo nthawi zambiri imachuluka usiku. Izi zikutanthauza kuti mumafunikira jakisoni wa insulini yowonjezera usiku wonse. Komabe, musanapereke jakisoni, muyenera kuonetsetsa kuti wodwalayo adya chakudya chamadzulo maola asanu asanagone. Ngati shuga m'magazi amadzuka usiku chifukwa choti wodwala matenda ashuga amadya chakudya chamadzulo, ndiye kuti insulini yowonjezera usiku singathandize. Onetsetsani kuti mukukhala ndi chizolowezi chodyera chakudya cham'mawa kwambiri. Ikani chikumbutso pafoni yanu nthawi ya 5.30 p.m. kuti nthawi yakudya, ndipo mudzadye nthawi ya 6 k.m.-6.30 p.m. Mukatha kudya chakudya cham'mawa tsiku lotsatira, mudzakhala osangalala kudya zakudya zamaproteni chakudya cham'mawa.

Mitundu yowonjezera ya insulin ndi Lantus ndi Levemir. Pamwambapa m'nkhaniyi takambirana mwatsatanetsatane momwe amasiyana wina ndi mnzake komanso ndi bwino kugwiritsa ntchito. Tiyeni tiwone momwe jakisoni wa insulin yowonjezereka imagwira ntchito usiku. Muyenera kudziwa kuti chiwindi chimagwira makamaka posokoneza insulin m'mawa, mutatsala pang'ono kudzuka. Izi zimatchedwa mbandakucha chodabwitsa. Ndiye amene amayambitsa shuga m'magazi pamimba yopanda kanthu. Palibe amene akudziwa zifukwa zake. Komabe, imatha kulamulidwa bwino ngati mukufuna kukwaniritsa shuga m'mawa pamimba yopanda kanthu. Werengani zambiri mwatsatanetsatane "The Phenomenon of Morning Dawn and How to control it."

Chifukwa chakumayambiriro kwam'mawa, jekeseni wa insulin yayitali usiku ndikulimbikitsidwa osaposa maola 8.5 musanadzuke m'mawa. Mphamvu ya jakisoni wa insulin yotalika usiku imachepetsedwa maola 9 pambuyo pa jekeseni. Ngati mukutsatira zakudya zamagulu ochepa a shuga, ndiye kuti mitundu yonse ya insulin, kuphatikizapo insulini yowonjezera usiku, imafunikira yocheperako. Zikakhala zotere, nthawi zambiri zotsatira za jakisoni wamadzulo wa Levemir kapena Lantus amayima usiku usanathe. Ngakhale opanga amati kuchita kwa mitundu iyi ya insulin kumatenga nthawi yayitali.

Ngati jakisoni wanu wamadzulo wa insulin yotalikilapo akupitilizabe kugwila ntchito usiku wonse ndipo ngakhale m'mawa, ndiye kuti mwayamwa jakisoni wamkulu, ndipo pakati pausiku shuga amatsika pansi movomerezeka. Zingakhale bwino, kumakhala zoopsa, komanso zowopsa kwambiri. Muyenera kukhazikitsa koloko ya alamu kuti mudzuke pambuyo pa maola 4, pakati pausiku, ndikuyezera shuga lanu lamagazi ndi glucometer. Ngati imagwera pansipa ya 3.5 mmol / L, ndiye kuti mugawikane mlingo wa mankhwalawa wa insulin yambiri m'malo awiri. Limodzi mwa magawo amenewa silimabailidwa nthawi yomweyo, koma atatha maola 4.

Timalimbikitsanso kuti: ngati mlingo wa insulin wa nthawi yayitali ukachuluka usiku, ndiye kuti shuga yothamanga sichepa m'mawa wotsatira, koma onjezerani.

Kugawa mlingo wamadzulo wa insulin yowonjezera m'magawo awiri, imodzi yomwe imalowetsedwa pakati pausiku, ndikulondola kwambiri. Ndi regimen iyi, mlingo wonse wamadzulo wa insulin yowonjezera ungathe kuchepetsedwa ndi 10-15%. Ndi njira yabwino kwambiri yolamulirira zodzuka m'mawa ndikukhala ndi shuga yabwinobwino m'mawa pamimba yopanda kanthu. Kubayira usiku usiku kumabweretsa zovuta zochepa mukazolowera. Werengani momwe mungapangire insulin kuwombera mopweteka. Pakati pausiku, mutha kubaya jekeseni wa insulin wa nthawi yayitali osakonzekereratu ngati mutakonzekera zonsezo madzulo kenako kugona tulo.

Momwe mungawerengere poyambira kuchuluka kwa insulin usiku

Cholinga chathu chachikulu ndikusankha Mlingo wa Lantus, Levemir, kapena Protafan kuti shuga osala kudya asungidwe wamba 4.6 ± 0,6 mmol / L. Zimakhala zovuta kwambiri kupanga shuga m'mawa m'mimba yopanda kanthu, koma vutoli limathekanso mukayesa. Momwe mungathetse izi tafotokozazi.

Odwala onse odwala matenda amtundu 1 amafunika jakisoni wa insulin yowonjezera usiku ndi m'mawa, komanso jakisoni wa insulin yofulumira musanadye. Likukhalira jekeseni 5-6 patsiku. Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri, vutolo limakhala losavuta. Angafunike kubayidwa pafupipafupi. Makamaka ngati wodwalayo atsatira zakudya zamagulu ochepa ndipo samakhala ulesi kuchita masewera olimbitsa thupi mosangalala. Odwala amtundu wa shuga 1 amalangizidwanso kuti asinthane ndi zakudya zamafuta ochepa. Popanda izi, simudzatha kuwongolera bwino shuga, ziribe kanthu momwe mumawerengera mosamala mulingo wa insulin.

Choyamba, timayeza shuga ndi glucometer 10-12 pa tsiku kwa masiku 3-7 kuti timvetse momwe zimakhalira. Izi zikutipatsa chidziwitso nthawi yanji yomwe muyenera kubayira insulin. Ngati ntchito ya ma cell a beta a kapamba ikasungidwa pang'ono, ndiye kuti mwina ndizotheka kupaka jakisoni usiku kapena zakudya zina. Ngati wodwala yemwe ali ndi matenda a shuga a 2 amafunikira jakisoni wa insulin yayitali, ndiye kuti choyamba Lantus, Levemir kapena Protafan amayenera kubayidwa usiku. Kodi jakisoni wa insulin wa nthawi yayitali amafunikira m'mawa? Zimatengera zizindikiro za mita. Dziwani momwe shuga lanu limakhalira masana

Choyamba, timawerengera poyambira kuchuluka kwa insulini yowonjezera, kenako patsiku lotsatira timasinthiratu mpaka zotsatira zovomerezeka

Kusintha kwa masitepe:

1. Pakupita masiku 7, timayeza shuga ndi glucometer usiku, ndipo m'mawa wotsatira pamimba yopanda kanthu.
2. Zotsatira zalembedwa pagome.
3. Timawerengera tsiku lililonse: shuga m'mawa pachabe chopanda kanthu m'mimba dzulo usiku.
4. Timataya masiku omwe odwala matenda ashuga adadyapo kale kuposa maola 4-5 asanagone.
5. Tikupeza mtengo wocheperako wowonjezera kuwonekera panthawiyi.
6. Buku lofufuza liziwona momwe 1 UNIT ya insulin imatsitsira shuga. Izi zimatchedwa putative insulin sensitivity factor.
7. Gawani kuchuluka kochepa kwa shuga usiku uliwonse ndi kuchuluka kwa mphamvu ya insulin. Izi zimatipatsa mlingo woyambira.
8. Mankhwala madzulo kuwerengera kuchuluka kwa insulin. Tinakhazikitsa alamu kuti tidzuke pakati pausiku ndikuyang'ana shuga.
9. Ngati shuga usiku ali m'munsi mwa 3.5-3.8 mmol / L, mlingo wa insulin wamadzulo uyenera kutsitsidwa. Njira imathandizira - kusamutsa gawo lina kwa jekeseni yowonjezera nthawi ya 1-3 am.
10. M'masiku otsatirawo, timachulukitsa kapena kuchepetsa mlingo, timayesa jakisoni osiyanasiyana, mpaka shuga m'mawa ulipo pakati pa 4.6 ± 0,6 mmol / L, nthawi zonse popanda usiku hypoglycemia.

Zitsanzo za kuwerengera muyeso wa Lantus, Levemir kapena Protafan usiku

Tikuwona kuti deta ya Lachinayi imayenera kutayidwa, chifukwa wodwala amamaliza kudya mochedwa. M'masiku ena onse, shuga wocheperachepera usiku uliwonse anali Lachisanu. Zinakwana 4.0 mmol / L. Timatenga kuchuluka kocheperako, osati kuchuluka kapena pakati. Cholinga chake ndi chakuti mlingo woyambira wa insulini ukhale wochepera m'malo motalika. Izi zimathandizanso wodwala kuti asadutse ndi hypoglycemia yausiku. Gawo lotsatira ndikupeza kuchuluka kwa insulin yolingalira kuchokera pamtengo wa patebulo.

Tiyerekeze kuti wodwala yemwe ali ndi matenda ashuga a 1, kapamba uja asiya kutulutsa insulin yake yonse. Mwanjira imeneyi, 1 U ya insulin yowonjezera imatsitsa shuga wamagazi ndi pafupifupi 2.2 mmol / L mwa munthu wolemera makilogalamu 64. Mukamayesa kwambiri, mankhwalawo amachepetsa mphamvu ya insulini. Mwachitsanzo, kwa munthu wolemera makilogalamu 80, 200 kg / L * 64 kg / 80 kg = 1.76 mmol / L adzapezedwa. Timathetsa vuto lolemba gawo limodzi kuchokera ku koyamba maphunziro a masamu.

Kwa odwala omwe ali ndi matenda amtundu woyamba wa shuga, timangomutenga mwachindunji. Koma kwa odwala omwe ali ndi matenda a shuga a 2 kapena mtundu 1 wa shuga m'mitundu yocheperako, amatha kwambiri. Tiyerekeze kuti kapamba wanu akupangabe insulini. Kuti tithane ndi vuto la hypoglycemia, choyamba tilingalira "m'malire" kuti gawo limodzi la insulini yotalikilapo imatsitsa shuga ndi 4.4 mmol / l ndipo limalemera 64 kg. Muyenera kudziwa kufunika kwa kulemera kwanu. Pangani gawo, monga momwe tafotokozera pamwambapa. Kwa mwana yemwe akulemera 48 kg, 4.4 mmol / L * 64 kg / 48 kg = 5.9 mmol / L adzapezedwa. Kwa wodwala yemwe wadwala bwino matenda a shuga a 2 ndipo ali ndi kulemera kwa 80 makilogalamu, padzakhala 4.4 mmol / L * 64 kg / 80 kg = 3.52 mmol / L.

Tapeza kale kuti kwa odwala athu, kuchuluka kochepa kwa shuga m'magazi usiku uliwonse kunali 4,5 mmol / L. Kulemera kwake kwa thupi ndi 80 kg. Kwa iye, malinga ndi kuyesa "kosamala" kwa 1 U wa insulin yayitali, amachepetsa shuga la magazi ndi 3.52 mmol / L. Pankhaniyi, kwa iye, mlingo woyambira wa insulin yayitali usiku adzakhala magawo a 4.0 / 3.52 = 1.13. Pitani kumayendedwe apafupi kwambiri a 1/4 PIECES ndikupeza 1.25 PIECES. Kuti mupeze jekeseni yochepa chonchi, muyenera kuphunzira momwe mungapangire insulin. Lantus mwatsatanetsatane sangathe kuchepetsedwa. Chifukwa chake, iyenera kudulidwa 1 unit kapena nthawi yomweyo 1.5 mayunitsi. Ngati mugwiritsa ntchito Levemir m'malo mwa Lantus, ndiye kuti muthira kuti mupeze molondola 1.25 PIECES.

Chifukwa chake, adayika jekeseni woyambira wa insulin yayitali usiku. M'masiku otsatira, timakonza - kuchulukitsa kapena kuchepa mpaka shuga m'mawa pamimba yopanda kanthu ndikukhazikika pa 4.6 ± 0,6 mmol / l. Kuti mukwaniritse izi, muyenera kusiyanitsa mlingo wa Lantus, Levemir kapena Protafan wausiku ndi prick gawo pambuyo pake, pakati pausiku. Werengani malingaliro pamwambapa mu gawo "Momwe Mungapangire Kuti shuga Aziwonjezeka Mmawa"

Wodwala mtundu uliwonse 1 kapena mtundu wa 2 wodwala yemwe ali ndi zakudya zochepa za chakudya amafunika kuphunzira momwe angapangire insulin kuti mupeze jekeseni yotsika. Ndipo ngati simunasinthebe zakudya zamafuta ochepa, ndiye mukuchita chiyani apa? 🙂

Kukonza mlingo wa insulin yayitali usiku

Chifukwa chake, tidapeza momwe tingawerengere kuchuluka koyambira kwa insulin usiku. Ngati mwaphunzira masamu kusukulu, ndiye kuti mutha kuthana nawo. Koma chimenecho chinali chiyambi chabe. Chifukwa mlingo woyambira ungakhale wotsika kwambiri kapena wapamwamba kwambiri. Kusintha mlingo wa insulin yayitali usiku, mumalemba shuga anu m'magazi kwa masiku angapo, kenako m'mawa m'mimba yopanda kanthu. Ngati kuchuluka kwambiri kwa shuga patsiku lililonse sikunapamwamba kuposa 0.6 mmol / l - ndiye kuti mankhwalawo ndi olondola. Pankhaniyi, muyenera kuganizira masiku okhawo omwe mudadya pasanadutse maola opitilira 5 musanakagone. Kudya msanga ndi chizolowezi chofunikira kwa odwala matenda ashuga omwe amathandizidwa ndi insulin.

Ngati kuchuluka kwambiri kwa shuga patsiku ndi kupitirira 0,6 mmol / L - zikutanthauza kuti muyenera kuyesetsa kuwonjezera mlingo wa mankhwalawa oonjezera a insulin. Mungachite bwanji? Ndikofunika kuiwonjezera ndi magawo 0,25 masiku atatu aliwonse, ndipo tsiku lililonse kuwunika momwe izi zingakhudzire kuchuluka kwa shuga m'magazi. Pitilizani kuonjezera mlingo pang'onopang'ono mpaka m'mawa m'mawa osapitirira 0,6 mmol / L apamwamba kuposa shuga lanu lamadzulo. Werengani werengani momwe mungayang'anire zochitika za m'mawa.

Momwe mungasankhire mulingo woyenera wa insulin usiku:

1. Muyenera kuphunzira kudya m'mawa kwambiri, maola 4-5 musanagone.
2. Ngati mutadya chakudya chamadzulo, ndiye kuti tsiku lotere silili loyenera kusintha kwa insulin usiku.
3. Kamodzi pa sabata pamasiku osiyanasiyana, yang'anani shuga yanu pakati pausiku. Iyenera kukhala osachepera 3.5-3.8 mmol / L.
4. Onjezerani mlingo wamadzulo wa insulin yochulukirapo ngati masiku atatu mulifupi shuga m'mimba yopanda kanthu imaposa 0.6 mmol / L kuposa momwe idalili dzulo asanagone.
5. Malangizo am'mbuyo - lingoganizirani za masiku omwe mudadya kadzutsa!
6. Kwa odwala omwe ali ndi matenda amtundu wa 1 ndi mtundu wa 2 omwe amatsata zakudya zamafuta ochepa. Mlingo wa insulin wautali usiku wonse tikulimbikitsidwa kuti uwonjezeke ndi osaposa magawo 0,25 masiku atatu aliwonse. Cholinga ndikudzibweretsera nokha momwe mungathere kuchokera ku nocturnal hypoglycemia.
7. Zofunika! Ngati mudakulitsa kuchuluka kwa insulin yamadzulo - masiku awiri otsatira, onetsetsani kuti muli ndi shuga pakati pausiku.
8. Kodi mungatani ngati shuga usiku mwadzidzidzi sakhala yocheperako kapena yolakwika? Chifukwa chake, muyenera kuchepetsa kuchuluka kwa insulin, yomwe imabayidwa musanagone.
9. Ngati mukufunikira kuchepetsa mlingo wamadzulo wa insulin yowonjezereka, tikulimbikitsidwa kusamutsa gawo lina la jekeseni yowonjezera pa 1-3 am.

Kupewa kwa nocturnal hypoglycemia

Werengani nkhani yayikulu, Hypoglycemia in Diabetes. Kupewa komanso kupumula kwa hypoglycemia. "

Hypoglycemia yausiku ndimavuto am'mawa ndimwambo wosasangalatsa komanso wowopsa ngati mukukhala nokha. Tiyeni tiwone momwe mungapewere ngati mukungoyamba kuchiza matenda anu a shuga ndi jakisoni wa insulin yowonjezera usiku. Khazikitsani alarm yanu kuti ikudzutsireni maola 6 mutawombera. Mukadzuka, pimani shuga m'magazi anu ndi glucometer. Ngati ili m'munsi mwa 3.5 mmol / l, idyani chakudya pang'ono kuti pasakhale hypoglycemia. Yang'anirani shuga yanu usiku m'masiku oyamba a inshuwaransi ya shuga, komanso nthawi iliyonse mukamayesetsa kuwonjezera kuchuluka kwa insulin usiku umodzi. Ngakhale amodzi mwa milandu yotereyi akutanthauza kuti mlingo uyenera kuchepetsedwa.

Ambiri odwala matenda ashuga ochulukirapo a carbohydrate amafuna kuchuluka kwa insulin usiku umodzi wochepera wazigawo zisanu ndi zitatu. Kupatula pa lamuloli ndi odwala a mtundu 1 kapena 2 a shuga, onenepa kwambiri, odwala matenda a shuga, komanso omwe tsopano ali ndi matenda opatsirana. Ngati mukulowetsa insulin usiku umodzi pakapita 7 mayunitsi kapena kupitilira, ndiye kuti malo ake amasintha, poyerekeza ndi waukulu. Zimakhala nthawi yayitali. Hypoglycemia imatha kuchitika musanadye tsiku lotsatira. Kuti mupewe mavutowa, werengani "Momwe mungapangire jakisoni waukulu wa insulin" ndikutsatira malangizowo.

Ngati mukufuna kumwa kwamadzulo kwa Lantus, Levemir kapena Protafan, ndiko kuti, kupitilira mayunitsi 8, ndiye kuti tikuligawa pakati pausiku. Madzulo, odwala matenda ashuga amakonza zofunikira zonse, ndikayika alamu pakati pausiku, ndipo akaitana ali osakomoka, amadzipweteka ndipo nthawi yomweyo amagonanso. Chifukwa cha izi, zotsatira za chithandizo cha matenda a shuga zimayenda bwino kwambiri. Ndikofunika kuti pasakhale vuto kuti tipewe hypoglycemia komanso kuti tipeze shuga m'mawa m'mawa. Komanso, zovuta zoterezi sizingakhale zochepa mutadziwa bwino jakisoni wa insulin wopanda ululu.

Kodi mukufuna majakisoni a insulin yowonjezera m'mawa?

Chifukwa chake, tidaganiziratu momwe tikhazikitsire Latnus, Levemir kapena Protafan usiku. Choyamba, timazindikira ngati tingachite izi konse. Ngati zina zikufunika, ndiye kuti tikuwerengera ndikuyamba kumwa. Ndipo timakonza mpaka shuga m'mawa pamimba yopanda kanthu ndikubwinobwino 4.6 ± 0,6 mmol / l. Pakati pausiku, sikuyenera kugwera pansi pa 3.5-3.8 mmol / L. Chowunikira chomwe mwaphunzira pa tsamba lathu la webusayiti ndikuti mutenge chiwopsezo chowonjezera cha insulin pakati pausiku kuti muziwongolera zochitika zam'mawa. Gawo lamankhwala lamadzulo limasamutsira iwo.

Tsopano tiyeni tiganizire za m'mawa mulingo wa insulin. Koma apa pakubwera zovuta. Kuti muthane ndi zovuta ndi jakisoni wowonjezera m'mawa, muyenera kufa ndi njala masana kuyambira chakudya chamadzulo. Timabaya Lantus Levemir kapena Protafan kuti tisunge shuga wamba. Usiku mumagona ndi kugona mwanjira yachilengedwe. Ndipo masanawa kuyang'anira shuga m'mimba yopanda kanthu, muyenera kukana kudya. Tsoka ilo, iyi ndiye njira yokhayo yowerengera mlingo wa mmawa wa insulin. Njira ili pansipa ikufotokozedwa mwatsatanetsatane.

Tiyerekeze kuti mumalumpha shuga masana kapena imakwezeka pang'ono. Funso lofunika kwambiri: kodi shuga wanu amakwera chifukwa cha chakudya kapena pamimba yopanda kanthu? Kumbukirani kuti insulini yowonjezera imafunika kuti shuga ikatha mwachangu, komanso mwachangu - kupewa kuwonjezeka kwa shuga wamagazi mukatha kudya. Timagwiritsanso ntchito insulin ya insulin kuti tichepetse shuga kukhala abwinobwino ngati angadumphe.

Kutha shuga m'magawo mutatha kudya ndi insulin yochepa kapena jekeseni wowonjezera m'mawa kuti mukhale ndi shuga wabwinobwino tsiku lonse m'mimba yopanda kanthu ndi kosiyana kwambiri. Chifukwa chake, ndikofunikira kudziwa momwe shuga yanu imakhalira masana, ndipo atatha kupereka mankhwala a insulini patsiku. Madokotala osaphunzira komanso odwala matenda ashuga amayesa kugwiritsa ntchito insulin yochepa masana pomwe nthawi yayitali imafunikira, mosinthana. Zotsatira zake zimakhala zomvetsa chisoni.

Ndikofunikira poyesa kudziwa momwe shuga yanu imakhalira masana. Kodi imachuluka ngati chakudya kapena pamimba yopanda kanthu? Tsoka ilo, muyenera kufa ndi njala kuti mumve izi. Koma kuyesera ndikofunikira. Ngati simukufunika jakisoni wa insulin yotalika usiku kuti mulipirire zomwe zachitika m'mawa, ndiye kuti sizingatheke kuti shuga lanu liziwonjezereka masana pamimba yopanda kanthu. Komabe mukuyenera kuwunika ndikuwonetsetsa. Komanso, muyenera kuchita zoyeserera ngati mutaba jakisoni wa insulin yowonjezera usiku.

Momwe mungasankhire mlingo wa Lantus, Levemir kapena Protafan m'mawa:

1. Patsiku loyesera, musadye chakudya cham'mawa kapena chamasana, koma konzekerani kudya chakudya chamadzulo maola 13 mutadzuka. Iyi ndi nthawi yokhayo yomwe mumaloledwa kudya mochedwa.
2. Ngati mukumwa Siofor kapena Glucofage Long, ndiye kuti mumwa mankhwalawa m'mawa.
3. Imwani madzi ambiri tsiku lonse, mutha kugwiritsa ntchito tiyi ya zitsamba popanda shuga. Osamwalira ndi njala. Kofi, cocoa, tiyi wakuda ndi wobiriwira - ndibwino kuti musamwe.
4. Ngati mukumwa mankhwala a shuga omwe angayambitse hypoglycemia, ndiye kuti lero musamawatenge ndipo nthawi zambiri mungowasiya. Werengani kuti ndi mapiritsi ati a shuga omwe ali oyipa komanso abwino.
5. Pimani magazi anu ndi glucometer mutangodzuka, kenako pambuyo pa ola limodzi, pambuyo pa maola 5, pambuyo pa maola 9, pambuyo pa maola 12 ndi maola 13 musanadye chakudya. Mwathunthu, mudzatenga miyezo 5 masana.
6. Ngati pakati pa maola 13 a kusala kudya kwatsiku ndi tsiku shuga adachulukanso kuposa 0,6 mmol / l ndipo sanagwe, ndiye kuti muyenera jakisoni wa insulin yowonjezera pamimba yopanda kanthu. Timawerengera kuchuluka kwa Lantus, Levemir kapena Protafan a jakisoni awa momwemonso ndi insulin yowonjezera usiku.

Tsoka ilo, kuti musinthe mlingo wa m'mawa wa insulin yayitali, muyenera kusala chimodzimodzi tsiku losakwanira ndikuwona momwe shuga ya magazi imakhalira tsiku lino. Kupulumuka masiku anjala kawiri mu sabata limodzi ndikosasangalatsa. Chifukwa chake, dikirani mpaka sabata lotsatira musanayesenso momwemo kuti musinthe insulin yanu yayitali. Tikugogomezera kuti njira zovutazi ndizofunikira kwa odwala okha omwe amatsatira zakudya zamafuta ochepa ndikuyesetsa kukhala ndi shuga yokhazikika 4.6 ± 0,6 mmol / L. Ngati kupatuka kwa ± 2-4 mmol / l sikokuvutitsani, ndiye kuti simungathe kuvutitsa.

Mtundu wachiwiri wa matenda ashuga, ndikofunikira kuti mumafunikira jakisoni wa insulin musanadye, koma simukufuna jakisoni wowonjezera m'mawa. Komabe, izi sizinganenedwe popanda kuyesera, chifukwa chake musakhale aulesi kuzichita.

Tiyerekeze kuti mwayamba kuchiza matenda amtundu wa 2 shuga ndi jakisoni wowonjezera usiku, ndipo mwina m'mawa. Pakapita kanthawi, mudzatha kupeza mlingo woyenera wa insulini kuti musunge shuga yathamanga yamagazi 24 tsiku lililonse. Zotsatira zake, kapamba amatha kukhala owuma kwambiri ngakhale popanda jakisoni wa insulin mwachangu amatha kuthetsa kuchuluka kwa shuga atatha kudya. Izi zimachitika kawirikawiri ndi mtundu wofatsa wa 2 shuga. Koma ngati mutadya shuga wamagazi anu akupitiliziranso kupitirira 0,6 mmol / L kuposa momwe anthu wamba amakhalira athanzi, zikutanthauza kuti mumafunikanso jakisoni wa insulin yochepa musanadye. Kuti mumve zambiri, onani "Kuwerengera mlingo wa insulin yachangu musanadye."

Insulin yowonjezereka ndi Levemir: mayankho a mafunso

Glycated hemoglobin inatsika mpaka 6,5% - zabwino, komabe pali ntchito yofunika kuchita :). Lantus amatha kumenyedwa kawiri patsiku. Kuphatikiza apo, tikupangira kuti aliyense achite izi kuti apititse patsogolo shuga. Pali zifukwa zina zosankhira Levemir m'malo mwa Lantus, koma ndizochepa. Ngati Lantus amaperekedwa kwaulere, koma Levemir - ayi, ndiye kuti muzipaka jekeseni modekha kawiri pa tsiku insulin yomwe boma limakupatsirani.

Ponena za kusagwirizana kwa Lantus ndi NovoRapid ndi mitundu ina ya insulin kuchokera kwa opanga osiyanasiyana. Awa ndimabodza opusa, osatsimikiziridwa ndi chilichonse. Sangalalani ndi moyo mukalandira insulin yabwino yoyendetsedwa kunja kwaulere. Ngati muyenera kusinthana ndi zoweta, ndiye kuti mukukumbukirabe nthawi izi ndi mphuno. About "zidandivuta kuti ndilipire shuga." Sinthani ku chakudya chamafuta ochepa ndikutsatira njira zina zonse zomwe zatchulidwa mu pulogalamu yathu ya matenda ashuga a Type 1. Ndikupangira kwambiri jekeseni Lantus kawiri patsiku, m'mawa ndi madzulo, ndipo osati kamodzi, monga aliyense amakonda kutero.

Ndikadakhala m'malo mwako, m'malo mwake, ndikulimbikitsa Lantus, mopitilira apo, kawiri patsiku, osati usiku wokha. Pankhaniyi, mutha kuyesa kuchita popanda jakisoni wa Apidra. Sinthani ku chakudya chamafuta ochepa ndikutsatira zochitika zina zonse monga zikufotokozedwera mu pulogalamu yachiwiri ya matenda a shuga. Chitani shuga yonse ya magazi podziyang'anira kamodzi pa sabata. Ngati mumatsatira zakudya mosamala, imwani mankhwalawa mtundu wachiwiri wa matenda ashuga, komanso makamaka kuchita masewera olimbitsa thupi mosangalala, ndiye kuti mwina mwapeza 95% jakisoni wa jakisoni wa insulin. Ngati popanda shuga shuga wanu ukhalabe wapamwamba, ndiye kuti pobayani kaye Lantus. Jekeseni wa insulin yofulumira musanadye mtundu wachiwiri wa matenda ashuga wofunikira 2 pokhapokha ngati wodwalayo ali waulesi kwambiri kuti azitsatira zakudya zamagulu pang'ono ndipo nthawi zambiri amatsata njira.

Werengani nkhani "Njira ya Insulin In injion". Yesani pang'ono - ndipo phunzirani momwe mungapangire jakisoniyo mopweteka. Izi zidzabweretsa mpumulo ku banja lanu lonse.

Inde, zilipo. Komanso, muyenera kugula Lantus kapena Levemir ndalama zanu, mmalo mwakugwiritsa ntchito "average" yaulere. Chifukwa - adakambirana mwatsatanetsatane.

Neuropathy, phokoso la matenda ashuga komanso zovuta zina zimatengera momwe mumakwanitsira kuti shuga yanu ikhale pafupi ndi nthawi yofananira. Ndi mtundu wanji wa insulin yomwe mumagwiritsa ntchito ilibe vuto lililonse ngati ikuthandizira kulipira matenda a shuga. Ngati mungasinthe kuchoka pa protafan kupita ku Levemir kapena Lantus monga insulin yowonjezera, ndiye kuti kutenga matenda a shuga kumakhala kosavuta. Anthu odwala matenda ashuga adachotsa ululu ndi zizindikiro zina za neuropathy - izi zimachitika chifukwa chakuti asintha magazi. Ndipo mitundu yapadera ya insulin ilibe chochita nayo. Ngati mukusamala ndi neuropathy, ndiye werengani nkhaniyi pa alpha lipoic acid.

Poyesa jakisoni wa insulin yowonjezera, mutha kusintha shuga yanu m'mawa popanda kanthu. Ngati mumadya zakudya zabwino ", zodzaza ndi zomanga thupi, ndiye kuti muyenera kugwiritsa ntchito milingo yayikulu ya Levemir. Poterepa, yesani kumwa mankhwalawa madzulo 22.00-00.00. Kenako nsonga ya machitidwe ake idzachitika 5.00-8.00 m'mawa, pomwe chodabwitsa cha m'bandakucha chikuwoneka momwe mungathere. Ngati mutasintha zakudya zamafuta ochepa ndipo zakudya zanu za Levemir ndizochepa, tikulimbikitsidwa kusinthana ndi jakisoni 3 kapena 4 patsiku kuchokera pakukonzekera kwa nthawi ya 2. Poyamba, izi ndizovuta, koma mumazolowera, ndipo shuga m'mawa umayamba kukusangalatsani.

Madokotala anu ali ndi nkhawa ndipo alibe chochita. Ngati m'zaka zinayi simunakhalepo ndi insulin, ndiye kuti sizingatheke kuti ziziwoneka modzidzimutsa. Ndimatengera izi. Zakudya zamafuta ochepa a shuga sizimangoyambitsa shuga m'magazi, komanso zimachepetsa mwayi wazomwe zimayambitsa matenda onse osokoneza bongo. Chifukwa pafupifupi zinthu zonse zomwe zingayambitse ziwengo, timapatula chakudyacho, kupatula mazira a nkhuku.

Ayi, ayi. Panali mphekesera zoti Lantus amasokoneza khansa, koma sizinatsimikizidwe. Omasuka kusintha kuchokera ku protafan kupita ku Levemir kapena Lantus - insulin analogues. Pali zifukwa zazing'ono zomwe zimakhala bwino kusankha Levemir kuposa Lantus. Koma ngati Lantus amaperekedwa kwaulere, koma Levemir - ayi, ndiye kuti mupeze insulin yaulere yapamwamba kwambiri. Zindikirani Timalimbikitsa jakisoni Lantus kawiri kapena katatu patsiku, osati kamodzi.

Simukuwonetsa zaka zanu, kutalika, kulemera, mtundu wa matenda ashuga komanso kutalika kwachabe. Palibe mayankho omveka bwino a funso lanu. Mutha kugawa magawo 15 pakati. Kapena muchepetse muyeso wonse mwa ma PIECES a 1-2 ndikugawa pakati. Kapenanso mutha kubaya kwambiri madzulo kuposa m'mawa kuti muchepetse zovuta za m'mawa. Zonsezi ndiz payekha. Chitani kudziletsa kwathunthu kwa shuga wamagazi ndikuwongoleredwa ndi zotsatira zake. Mulimonsemo, kusinthana ndi jakisoni imodzi ya Lantus patsiku mpaka masiku olondola.

Palibe yankho lomveka bwino la funso lanu. Chitani kudziletsa kwathunthu kwa shuga wamagazi ndikuwongoleredwa ndi zotsatira zake. Iyi ndiyo njira yokhayo yosankha zolondola zokulirapo komanso zolimbitsa insulin. Ndikukulimbikitsani kuyankhulana ndi makolo a mwana wazaka 6 wazaka 6. Anatha kudumphira insulin kwathunthu atasinthira kuzakudya zoyenera.

Insulin yotalikilapo, yomwe imaphatikizapo Levemir, sikuti cholinga chake kuti muchepetse magazi mwachangu. Cholinga cha kugwiritsidwa ntchito kwake ndizosiyana kotheratu. Shuga mumkhalidwe wanu amakula motsogozedwa ndi zakudya zomwe zadyedwa posachedwa. Izi zikutanthauza kuti mlingo wa insulin yofulumira musanadye sichinasankhidwe molondola. Ndipo, mwina, chifukwa chachikulu ndikudya zakudya zosayenera. Werengani pulogalamu yathu ya Matenda A shuga A Type 1 kapena Type 2 Shuga. Kenako phunzirani mosamala zolemba zonse pamutu wa "Insulin".

Insulin yayitali kwa mtundu 1 komanso matenda amitundu iwiri: zomwe zapezedwa

M'nkhaniyi, mwaphunzira mwatsatanetsatane zomwe Lantus ndi Levemir, insulin-yaitali, komanso a NPH-insulin protafan ali. Tazindikira chifukwa chake kuli koyenera kugwiritsa ntchito jakisoni wa insulin yowonjezera usiku ndi m'mawa, ndipo ndi chifukwa chiyani sizili zolondola. Chinthu chachikulu chomwe chikufunika kuphunziridwa: insulini yowonjezereka-yogwirira ntchito imachirikiza shuga wamba wamagazi. Sicholinga chodzimitsa kulumpha mu shuga mutatha kudya.

Osayesa kugwiritsa ntchito insulin yochulukirapo kumene yochepa kapena yapamwamba kwambiri pakufunika. Werengani nkhani zakuti “Ultrashort Insulin Humalog, NovoRapid ndi Apidra. Insulin Yachidule ya anthu ”komanso“ jakisoni wa insulin yofulumira musanadye. Momwe mungachepetse shuga kuti akhale wabwinobwino ngati wadumpha. "Muyenera kuchiritsa matenda anu a shuga ndi insulin ngati mukufuna kupewa zovuta zake.

Tidasanthula momwe tingawerengere kuchuluka koyenera kwa insulin usiku ndi m'mawa. Malangizo athu ndiosiyana ndi zomwe zalembedwa m'mabuku odziwika komanso zomwe zimaphunzitsidwa ku "sukulu ya shuga". Mothandizidwa ndi kudziyang'anira pawokha shuga, onetsetsani kuti njira zathu ndizothandiza, ndizopatula nthawi. Kuti muwerenge ndikusintha kuchuluka kwa insulin yowonjezera m'mawa, muyenera kudumphira chakudya cham'mawa komanso nkhomaliro. Izi ndizosasangalatsa, koma tsoka, njira yabwinoko kulibe. Kuwerengera ndikusintha kuchuluka kwa insulini yowonjezera usiku ndikosavuta, chifukwa usiku, mukamagona, simukudya mulimonse.

Malingaliro achidule:

1. Wowonjezera insulin Lantus, Levemir ndi protafan amafunikira kuti shuga wabwinobwino asakhale pamimba yopanda kanthu kwa tsiku limodzi.
2. Ultrashort ndi insulin yochepa - kuthetsa shuga yowonjezereka yomwe imachitika mukatha kudya.
3. Musayese kugwiritsa ntchito mankhwala osokoneza bongo okwanira m'malo obayira jakisoni mwachangu musanadye!
4. Ndi insulin iti yomwe ili bwino - Lantus kapena Levemir? Yankho: Levemir ali ndi mwayi wocheperako. Koma ngati mutenga Lantus kwaulere, ndiye kuti mumulore.
5. Kwa matenda a shuga a 2, jekeseni woyamba amawonjezera usiku ndi / kapena m'mawa, kenako ndikulimbitsa insulin musanadye.
6. Ndikofunika kuti musinthe kuchoka pa protafan kupita ku Lantus kapena Levemir, ngakhale mutagula insulini yatsopano chifukwa cha ndalama zanu.
7. Pambuyo pakusintha ku chakudya chochepa chamafuta a shuga 1, 2, mitundu ya insulin yonse imachepetsedwa nthawi 2-7.
8. Nkhaniyi imapereka malangizo a pang'onopang'ono a momwe angawerengere kuchuluka kwa insulini yowonjezera usiku ndi m'mawa. Afufuzeni!
9. Ndikulimbikitsidwa kutenga jekeseni wowonjezera wa Lantus, Levemir kapena Protafan pa 1-3 a.m. kuti athe kuwongolera bwino zomwe zimachitika m'mawa.
10. Anthu odwala matenda ashuga, omwe amadya chakudya chamadzulo maola 4-5 asanagone komanso kuwonjezera jekeseni wowonjezera nthawi ya 1 m'mawa, amakhala ndi shuga wabwinoko m'mawa wopanda kanthu.

Ndikukhulupirira kuti nkhaniyi yakhala ikuthandizani. Ngati ndi kotheka, ndikofunikira kusintha m'malo mwa NPH-insulin (protafan) m'malo mwa Lantus kapena Levemir kuti muthe kusintha zotsatira za chithandizo cha matenda ashuga. Mu ndemanga, mutha kufunsa mafunso pochiza matenda a shuga ndi mitundu yambiri ya insulini. Oyang'anira tsambalo sachedwa kuyankha.