Kuwerengera mlingo wa insulin musanadye

Ndikulimbikitsidwa kuti muwerenge kaye nkhani yoyamba ya "Ultrashort Insulin Humalog, NovoRapid ndi Apidra. Insulin yochepa yaumunthu. " Kuchokera pamenepo muphunzira mtundu wa insulin ndi mitundu yochepa ya insulin, momwe amasiyana pakati pawo komanso pazomwe akufuna.

Ndi chithandizo chathu, mudzazindikira momwe mungawerengere kuchuluka kwa insulin kutengera zakudya za wodwala wodwala matenda ashuga ndi glucometer. Onetsetsani kuti palibe chinsinsi. Mawerengero a masamu ali pamlingo wa masamu. Ngati mulibe anzanu onse ndi manambala, muyenera kungopaka jekeseni yokhayo yomwe dokotala angakupatseni. Koma njira yophweka ngati imeneyi siyiletsa kuyambika kwa matenda ashuga.

Motsatira zochita:

1. Gulani muyeso wakukhitchini ndikuphunzira momwe mungagwiritsire ntchito. Dziwani kuchuluka kwa magalamu a chakudya, mapuloteni, ndi mafuta omwe mumadya nthawi iliyonse mukamadya kadzutsa, masana komanso chakudya chamadzulo.
2. Muyezo shuga 10-12 pa tsiku kwa masiku 3-7. Lembani magazi anu m'magazi a glucose ndi zochitika zina. Mwanjira imeneyi, onani kuti ndi zakudya ziti zomwe mungafune jakisoni wothamanga, ndipo musanazifune.
3. Phunzirani malamulo osungira insulini komanso zoyenera kuchita ngati insulin itasiya kugwira ntchito mwadzidzidzi.
4. Werengani njira yopweteketsa ya insulin yopanda ululu. Phunzirani kumwa jakisoni wa insulin mopanda kupweteka!
5. Phunzirani kupaka insulin usiku ndipo ngati kuli kotheka, m'mawa. Sankhani mlingo woyenera kuti shuga yanu yosala kudya ikhale yabwinobwino. Onani nkhani ya Lantus, Levemir ndi Protafan. Izi zikuyenera kuchitika musanayambe kuthana ndi insulin.
6. Phunzirani zamomwe mungapangire insulin. Ngati mutsatira zakudya zamafuta ochepa, ndiye kuti muyenera kuchita izi.
7. Muyenera kuwerengera poyambira nthawi yayitali kapena ya insulin. Momwe mungachite izi zikufotokozedwa pansipa. Kuyambira Mlingo wambiri udzakhala wotsika kuposa momwe muyenera kutsimikizira motsutsana ndi hypoglycemia.
8. Phunzirani nkhani "Hypoglycemia: Kupewa, Zizindikiro ndi Chithandizo". Gulani mapiritsi a glucose ku pharmacheni kuti muimitse hypoglycemia. Asungeni nthawi zonse.
9. Jekesani kuyamba Mlingo wa insulin. Pitilizani kuyeza shuga pafupipafupi ndikukhala ndi diary.
10. Kwezani kapena chepetsani inshuwaransi yanu musanadye, malinga ndi shuga lanu. Onetsetsani kuti shuga ndi 4.6 ± 0,6 mmol / L musanadye komanso pambuyo chakudya, khola. Nthawi iliyonse, kuphatikiza usiku, sayenera kukhala wotsika kuposa 3.5-3.8 mmol / l.
11. Zodabwitsa kuti Mlingo wambiri wa insulin ndi wofunikira bwanji musanadye chakudya mukamatsatira zakudya zotsika zamatumbo :).
12. Dziwani kuti ndi mphindi zingati musanadye zofunika kuti mupeze insulin. Kuti muchite izi, chitani zomwe tayeseza m'nkhaniyi.
13. Dziwani ndendende momwe 1 unit yochepa ndi ultrashort insulin imatsitsira shuga. Kuti muchite izi, chitani zomwe tayeseza m'nkhaniyi.
14. Phunzirani momwe mungathetsere shuga wambiri ndi jakisoni wa insulin kuti muchepetse, koma popanda hypoglycemia. Tsatirani njirayi pakafunika kutero.
15. Phunzirani momwe mungayambitsire shuga m'mawa. Tsatirani malangizowo. Onetsetsani kuti shuga yanu m'mawa simtunda kuposa 5.2 mmol / L, popanda hypoglycemia usiku.
16. Kutengera ndi muyeso wa shuga, yang'anani insulin sensitivity factor yanu ndi kuchuluka kwa chakudya padera pa kadzutsa, chakudya chamadzulo komanso chakudya chamadzulo.
17. Unikani zinthu ziwiri zomwe zimakhudza shuga wamagazi, kuwonjezera pa zakudya, jakisoni wa insulin, komanso mankhwala a shuga. Phunzirani kusintha mankhwalawa a insulin pazinthu izi.

Ambiri a endocrinologists amakhulupirira kuti kusintha shuga kwa odwala omwe ali ndi mtundu woyamba wa 2 ndi mtundu wa shuga ndi kovuta kwambiri, kosathandiza, kapenanso koopsa. Ngati wodwala matenda ashuga amatha kuwerengetsa Mlingo wa insulin kutengera zakudya ndi shuga, ndiye kuti dokotalayo amamulemekeza ndi kupereka thandizo loyenerera kwambiri. Odwala otere samakhala ndi zovuta za matenda ashuga, mosiyana ndi kuchuluka kwa odwala omwe aulesi amathandizidwa.

Kuwongolera odwala matenda ashuga okhala ndi insulin yochepa kapena yochepa kwambiri kumathandizira kuchepetsa shuga kuti ikhale yabwinobwino. Izi zimalepheretsa kufa kwa maselo a beta omwe akadalipobe m'mimba yanu. Maselo a beta ochulukirapo amasungidwa m'thupi, mtundu wovuta wa 1 kapena mtundu wa 2 ndi. Ngati muli ndi mwayi komanso maselo anu a beta akugwirabe ntchito, asamalire. Kuti muchite izi, tsatirani zakudya zamafuta ochepa komanso jekeseni wa insulin kuti muchepetse katundu paz kapamba.

Mawu okhudzana ndi mankhwala a insulin ndi matanthauzidwe awo

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

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

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

Chakudya chokhala ndi chakudya ndi insulin yofulumira, yomwe imafunika kuyamwa. Sizitengera momwe zinthu ziliri pamene wodwala matenda ashuga adakweza shuga kale asanadye.

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

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

Insulin yofulumira imatha kukhala yafupi yaumunthu (Actrapid NM, Humulin Regular, Insuman Rapid GT, Biosulin R ndi ena), komanso ma lipashort analogues aposachedwa kwambiri (Humalog, Apidra, NovoRapid). Kodi ndi chiyani ndipo akusiyana bwanji, werengani apa. Ngati mutsatira zakudya zamagulu ochepa musanadye, ndibwino kupaka insulin yochepa ya anthu. Mitundu ya insulashash ya insulin ndiyabwino kugwiritsa ntchito mukafuna kubweretsa shuga yayikulu mwachizolowezi.

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

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

Chakudya chopatsa thanzi - magalamu angati a chakudya omwe amapezeka amakwirira gawo limodzi la insulin. Ngati mutsatira zakudya zamafuta ochepa kuti muchepetse matenda a shuga, "kuchuluka kwa mapuloteni" ndikofunikira kwa inu, ngakhale lingaliro ili siligwiritsidwa ntchito mwalamulo.

Zokhudza insulin sensitivity factor ndi carbohydrate chiŵerengero chake ndizosiyana ndi aliyense wodwala matenda ashuga. Makhalidwe omwe amapezeka muzowongolera sagwirizana ndi enieni. Amangopangidwira kuwerengera Mlingo wa insulin, mwachidziwikire sicholondola. Zokhudza insulin sensitivity factor ndi chakudya chopatsa mphamvu zimakhazikitsidwa poyesa zakudya zopatsa thanzi komanso zama insulin. Amasiyana mitundu yambiri ya insulini komanso nthawi zosiyanasiyana masana.

Kodi mumafunikira jakisoni wa insulin musanadye

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

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

Werengani komanso kangati patsiku muyenera kuyeza shuga.

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

Tikukulimbikitsani kuti m'mawa insulin imakhala yofooka kuposa nthawi ina iliyonse masana, chifukwa cha kutuluka kwa m'mawa. Izi zimagwira ntchito kwa insulin yawo yomwe imapangidwa ndi kapamba, komanso yomwe wodwala matenda ashuga amalandira ndi jakisoni. Pachifukwa ichi, ngati mukufuna jakisoni wa insulin mwachangu musanadye nkomwe, ndizotheka kuti adzafunike musanadye chakudya cham'mawa. Pazifukwa zomwezo, pachakudya chochepa chamafuta, chakudya chamagulu cham'mawa chimakhala chambiri kuwirikiza kawiri kuposa chakudya chamasana Wonaninso "Kodi mbandakucha chiyani chodabwitsa ndi momwe mungachigwiritsire ntchito"

Momwe mungawerengere Mlingo wa insulin musanadye

Ngakhale adokotala kapena odwala matenda ashuga sangathe kudziwa kuchuluka kwa insulin musanadye chakudya kuyambira pachiyambire. Kuti tichepetse chiopsezo cha hypoglycemia, timaganizira mopepuka milingo yoyambira, kenako ndikuwonjezera pang'onopang'ono. Poterepa, nthawi zambiri timayezera shuga wamagazi ndi glucometer. M'masiku ochepa mutha kudziwa mlingo woyenera wa mankhwala. Cholinga ndikupanga shuga kukhala abwinobwino, monga mwa anthu athanzi. Ndi 4.6 ± 0,6 mmol / L musanadye komanso mutadya. Komanso, nthawi iliyonse, iyenera kukhala osachepera 3.5-3.8 mmol / L.

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

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

Momwe mungasankhire mulingo woyenera wa jakisoni wa insulin musanadye:

1. Kuchokera pazomwe mungatchulidwe (onani pansipa), werengani mlingo woyambira wa insulin mwachangu musanadye.
2. Lowetsani insulin, ndiye kudikirani mphindi 20-45, kuyeza shuga musanadye, idyani.
3. Mukatha kudya, pimani shuga ndi glucometer pambuyo 2, 3, 4, ndi 5 maola.
4. Ngati shuga agwera pansi pa 3.5-3.8 mmol / L, idyani mapiritsi ochepa a shuga kuti muchepetse hypoglycemia.
5. M'masiku otsatirawa, onjezani kuchuluka kwa insulin musanadye (pang'onopang'ono! Mosamala!) Kapena kutsikira. Zimatengera kuchuluka kwa shuga m'mene mudatha kudya nthawi yayitali.
6. Malinga ngati shuga sakhazikika bwino, bwerezaninso mayendedwe kuyambira pa mfundo yachiwiri. Nthawi yomweyo, musamwe jakisoni wa mankhwala a "insulin", koma osinthidwa molingana ndi momwe dzulo limanenera shuga atatha kudya. Chifukwa chake, pang'onopang'ono muzindikire mlingo woyenera.

Cholinga ndikupanga shuga isanayambe komanso itadya 4.6 ± 0,6 mmol / L khola. Izi ndizotheka ngakhale ndi matenda oopsa a 1 shuga, ngati mumatsatira zakudya zamafuta ochepa ndikujambulira zochepa, muyezo wa insulin. Kuphatikiza apo, izi zimatheka mosavuta ndi matenda amtundu wa 2 shuga kapena mtundu wofatsa 1 shuga.

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

Choyambirira cham'mawa chimasokoneza kuwerengera kwa mankhwala a insulin musanadye. Chifukwa cha zomwe amachita, jakisoni wa insulin musanadye chakudya cham'mawa chimakhala chochepa kwambiri kuposa jakisoni wofanana wa insulin musanadye chakudya chamadzulo kapena chamadzulo. Kupatuka kwenikweni kwa wodwala aliyense wa shuga kuyenera kutsimikiziridwa payekhapayekha poyesa, kenako mlingo uyenera kuwonjezeka moyenerera musanadye chakudya cham'mawa. Werengani zambiri za zodabwitsa zam'mawa zam'mawa komanso momwe mungazilamulire.

Tsopano tiyeni tiwone zitsanzo za momwe Mlingo wa mankhwala ochepetsa insulin amawerengedwa musanadye. Kuphatikiza apo mu zitsanzo zonse, zimaganiziridwa kuti wodwala matenda ashuga amadzidula, m'malo mwa ultrashort, insulin asanadye. Mitundu ya insulashash ya insulin ndiyamphamvu kwambiri kuposa insulin yochepa yaumunthu. Mlingo wa Humalog uyenera kukhala pafupifupi 0,4 Mlingo wa insulin yayifupi, ndipo Mlingo wa NovoRapid kapena Actrapid uzikhala pafupifupi ⅔ (0.66) wa insulin yochepa. Coefficients 0.4 ndi 0.66 amafunika kutchulidwa payekhapayekha.

Mtundu 1 wa matenda ashuga kapena matenda apamwamba a 2 shuga

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

Tiyeni tikambirane za mtundu wa shuga wachiwiri womwe umamasulira mtundu wa shuga wovuta kwambiri chifukwa chamankhwala osayenera. Odwala ambiri omwe ali ndi matenda amtundu wa 2 amadzivulaza kwambiri kuposa zabwino kuchokera kuchipatala. Chakudya chamafuta ochepa sichikhala chithandizo chachikulu cha matenda ashuga a mtundu 2, chifukwa ogwira ntchito kuchipatala akukana kusintha. Mu 1970s, adakananso kukhazikitsidwa kwa ma glucometer ... Pakapita nthawi, malingaliro wamba adzakhalapo, koma masiku ano zinthu zomwe zili ndi matenda amtundu wa 2 ndizachisoni.

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

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

Mwinanso, mukudziba nokha kuchuluka kwa insulin, yomwe adalembera kuchipatala. Muyenera kusinthira ku kuwerengera kosinthika kwa mankhwalawa malinga ndi momwe mumadyera komanso zizindikiro za shuga. Mfundo zotsatirazi momwe mungachitire izi. Onetsetsani kuti ndizosavuta kuposa momwe zikumvera. Mawerengero a arithmetic ali pasukulu yoyamba. Kusintha kuchokera pakudya chamagulu olimbitsa thupi kukhala zakudya zamagulu ochepa, muyenera kuchepetsa kuchuluka kwa insulin nthawi 2-7, apo ayi padzakhala hypoglycemia. Odwala omwe ali ndi mtundu wocheperako wa shuga amakhala ndi mwayi "wolumpha" kuchokera ma jakisoni. Koma odwala omwe ali ndi matenda ashuga akulu amtundu wa 1 kapena matenda apamwamba a 2 sayenera kudalira izi.

Zomwe muyenera kuchita:

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

Chovuta ndikuti muyenera kusankha nthawi imodzi kuchuluka kwa insulin yayitali komanso yachangu. Pakabuka mavuto ndi shuga m'magazi, zimavuta kudziwa zomwe zidawachititsa. Mlingo wolakwika wa insulin yowonjezera? Muli ndi vuto lolakwika la insulin musanadye? Kapena kodi Mlingo woyenera wa insulin, koma kudya kwambiri / zochepa poyerekeza?

Tinene kuti lero muli ndi shuga wambiri kapena kudumpha. Pankhaniyi, mawa mukusintha chimodzi mwazinthu zazikulu zomwe zatchulidwa pamwambapa. Nthawi yomweyo, sungani zinthu ziwiri zomwezo monga dzulo. Onani momwe shuga yasinthira ndikufotokozera. Mutha kukhazikitsa boma lokhazikika pochita zoyeserera zambiri za mankhwala a insulin komanso zakudya. Nthawi zambiri zimatenga masiku 3-14. Pambuyo pa izi, muyenera kuthana ndi zinthu zachiwiri - zolimbitsa thupi, matenda, nkhawa, kusintha kwa nyengo, etc. Werengani zambiri mwatsatanetsatane "Zomwe zimakhudza shuga wamagazi: zinthu zachiwiri".

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

Zambiri zokhudzana ndi kuwerengera poyambira mlingo wake (manambala sakulondola!):

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

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

Wodwala wodwala matenda ashuga wolemera makilogalamu 63,5:

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

Kodi mumadziwa bwanji kuti 1 unit ya insulin yochepa imatsitsa shuga mwa munthu yemwe ali ndi kulemera kwakumunthu kosiyana? Ndikofunikira kupanga gawo ndikuwerengera.

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

Tikudziwanso pafupifupi:

• 1 unit yaifupi insulin imakhudza pafupifupi 8 magalamu a chakudya.
• 1 unit ya insulin Apidra ndi NovoRapid imakhudza pafupifupi 12 magalamu a chakudya.
• 1 unit ya insulin Humalog imakwirira 20 magalamu a chakudya.
• 1 unit ya insulin yochepa imakhala pafupifupi magalamu 57 a mapuloteni amadyedwa kapena pafupifupi 260 magalamu a nyama, nsomba, nkhuku, tchizi, mazira.
• 1 UNIT ya insulin Apidra ndi NovoRapid imakhudza pafupifupi 85 magalamu a mapuloteni amadyedwa kapena pafupifupi 390 magalamu a nyama, nsomba, nkhuku, tchizi, mazira.
• 1 UNIT ya insulin Humalog imakwirira pafupifupi 143 magalamu a mapuloteni amadyedwa kapena pafupifupi magalamu 640 a nyama, nsomba, nkhuku, tchizi, mazira.

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

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

Kuwerengeredwa kwa insulin Mlingo wa matenda a shuga 1: mwachitsanzo

Tiona mwachidule njira yokonzekera menyu komanso kuwerengetsa kuchuluka kwa insulini. Tiyerekeze kuti wodwala yemwe ali ndi matenda ashuga oopsa amalemera 64 makilogalamu asanadye Actrapid NM - insulin yochepa yaumunthu. Wodwalayo azidya zakudya zotsatsa komanso zomanga thupi tsiku lililonse:

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

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

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

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

Chakudya Chakudya Cham'mawa:

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

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

Chakudya chamasana:

• 12 magalamu a chakudya / 8 magalamu a chakudya = 1.5 ZINSINSI za insulin;
• 128 magalamu a mapuloteni / magalamu 57 a mapuloteni = 2,25 magawo a insulin.

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

Chakudya chamadzulo:

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

TIWONSE LA 1.5 PESCES + 3 PIECES = 4.5 ZITHUNZI za insulin.

Ngati kapamba wanu akupitiliza kupanga insulin yake, ndiye kuti milingo yoperekedwa pamwambapa iyenera kutsitsidwa. Kaya ma cell a pancreatic beta apulumuka atha kutsimikiziridwa pakuyesa magazi a C-peptide.

Ndichite chiyani ngati wodwala akufuna kubaya jekeseni posachedwa, koma insulin yochepa kwambiri ya asidi, NovoRapid kapena Humalog asanadye? Tikukumbukira kuti kuchuluka kwa Apidra ndi NovoRapida ndiye gawo la insulin yayifupi, yomwe tidawerengera. Humalog ndiye wamphamvu kwambiri. Mlingo wake uyenera kukhala Mlingo wochepa wa insulin.

Ngati ndi kotheka, timasintha mafuta oyambira kuchokera ku insulin yochepa kupita kwa yochepa kwambiri:

Chonde dziwani: wodwalayo ali ndi chidwi cholimba (munthu wathu! :)). Chakudya chamasana, amadya mapuloteni a 128 - pafupifupi magalamu 550 a zakudya zama protein. Monga lamulo, odwala matenda ashuga amtundu woyamba amadya zochepa. Tinene kuti mukukonzekera kudya magalamu 200 a zakudya zama protein zomwe zimakhala ndi magalamu 45 a mapuloteni abwino. Komanso saladi wa masamba obiriwira, momwe 12 g mafuta. Potere, mudzafunika kupaka phukusi la chakudya la mayunitsi 2.25 a insulin yochepa, magawo 1.5 a apidra kapena NovoRapida kapena 1 unit ya Humalog musanadye. Chakudya cham'mawa komanso chamadzulo, Mlingo umakhala wotsika kwambiri. Kutsiliza: Onetsetsani kuti mwaphunzira momwe mungapangire insulin.

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

Tidasamala mwadala kuyambitsa mabawu a chakudya mu mankhwala a insulin. Chifukwa chake, ndizokayikitsa kuti shuga yanu mukatha kudya imatsika pamlingo wa hypoglycemia. Komabe, izi siziphatikizidwa. Makamaka ngati mwayamba kudwala matenda a diabetesic gastroparesis, i.e., kuchepetsedwa kwa m'mimba mutatha kudya chifukwa cha neuropathy. Kumbali inayo, ngati mukunenepa kwambiri komanso chifukwa cha kukana kwa insulini, ndiye kuti Mlingo wa insulin yofulumira musanadye chakudya amafunika kwambiri.

Chifukwa chake, patsiku loyamba la jakisoni wa insulin yochepa kapena ya ultrashort, timayeza shuga wathu musanadye, kenanso pambuyo pa maola 2, 3, 4 ndi 5 mutatha kudya. Tili ndi chidwi ndi kuchuluka kwa shuga yomwe idakula mutatha kudya. Kuchulukaku kungakhale kwabwino kapena kosalimbikitsa. Ngati alibe, ndiye kuti mlingo wa insulin musanadye nthawi ina yomwe muyenera kuchepetsa.

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

Tiyerekeze kuti wodwala wathu ali ndi zotsatirazi:

• Maola 4-5 mutadya kadzutsa - shuga adakula ndi 3.9 mmol / l;
• Ma 4-5 mawola atatha kudya masana - idatsika ndi 1.1 mmol / l;
• Maola 4-5 mutatha kudya - kuchuluka ndi 1.4 mmol / L.

Mlingo wa insulin musanadye chakudya amati ndiwoyenera, pambuyo pa maola 5 chakudya chatha, shuga amapatuka pazomwe anali asanadye osaposa 0,6 mmol / L mbali zonse ziwiri. Zachidziwikire, tinaphonya mitundu yoyambira, koma izi zinali zoyembekezeredwa. Zotsatira zam'mawa zam'mawa, zomwe zimachepetsa mphamvu ya jakisoni wofulumira wa insulin musanadye chakudya cham'mawa, zimawonetsedwa bwino poyerekeza ndi jakisoni musanadye chakudya chamadzulo.

Kodi muyenera kusintha zochuluka motani pa insulin? Kuti tidziwe, tiyeni tiwerenge ma bolawo okonza. Wodwala yemwe ali ndi matenda oopsa a shuga, omwe kapamba wake samatulutsa insulin konse, 1 unit ya insulin yochepa imachepetsa shuga la magazi ndi pafupifupi 2.2 mmol / l, ngati munthu akulemera 64 kg.

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

Wodwala matenda ashuga kwambiri omwe atchulidwa munkhaniyi amafufuza 64 kg. Kuti tiyambe, timaganiza kuti gawo limodzi la insulin yochepa limachepetsa shuga ya magazi ake ndi pafupifupi 2.2 mmol / L. Monga tikudziwa, mutadya chakudya cham'mawa komanso chamadzulo, shuga ake adalumphira, ndipo pambuyo chakudya chamadzulo chinatsika. Chifukwa chake, muyenera kuwonjezera kuchuluka kwa insulin musanadye chakudya cham'mawa komanso chakudya chamadzulo, komanso kutsikira pang'ono musanadye chakudya chamadzulo. Kuti tichite izi, timagawa kusintha kwa shuga ndi 2.2 mmol / L ndikuzungulira zotsatira zake kukhala 0,25 IU ya insulin mmwamba kapena pansi

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

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

Monga mukuwonera, kuwerengera sikovuta. Mothandizidwa ndi chowerengera, munthu aliyense wamkulu amatha kuzisamalira. Chovuta ndikuti phindu lazakudya zam'mawa, chakudya chamadzulo ndi chakudya chamadzulo zizikhala chimodzimodzi tsiku lililonse. Zakudya ndi mbale zimatha kusinthidwa, koma kuchuluka kwa chakudya komanso mapuloteni ayenera kukhala chimodzimodzi tsiku lililonse. Kutsatira lamuloli, miyeso ya kukhitchini imathandiza.

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

Chitsanzo china cha moyo

Wodwala matenda a shuga 1, zaka 26, kutalika 168 cm, kulemera kwa 64 kg. Amawona zakudya zamafuta ochepa, amavulaza Biosulin R. asanadye.
Nthawi ya 7 a.m. shuga yotsika inali 11.0 mmol / L. Chakudya cham'mawa: nyemba zobiriwira 112 magalamu, dzira 1 pc. Zakudya zomanga thupi ndi magalamu 4.9 okha. Asanadye chakudya cham'mawa, adalowetsa insulin Biosulin R pa mlingo wa 6. Pambuyo pake, pa maola 9 mphindi 35 shuga anali 5.6 mmol / L, ndipo pofika maola 12 adakwera mpaka 10,0 mmol / L. Ndinafunika kubayitsa mayunitsi ena 5 a insulin yomweyo. Funso - mudalakwitsa chiyani?

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

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

Podziwa phindu la chakudya cham'mawa, timawerengera poyambira kuchuluka kwa insulin isanachitike chakudya. Uwu ndi chiwerengero: kukonza mabasi + chakudya. Timalingalira kuti ndi thupi lolemera makilogalamu 64, 1 U ya insulin yochepa imachepetsa shuga la magazi ndi pafupifupi 2.2 mmol / L. Shuga wamba ndi 5.2 mmol / L. Malo owongolera amapezeka (11.0 - 5.2) / 2.2 = 2.6 mayunitsi. Gawo lotsatira ndikulingalira chakudya. Kuchokera pagululi timaphunzira kuti gawo limodzi la insulin yochepa limakhudza pafupifupi magalamu 8 a zakudya kapena pafupifupi magalamu 57 a mapuloteni azakudya. Puloteni, timafunikira (15 g / 57 g) = 0.26 PIECES. Kwa chakudya chamafuta, mumafunikira (5 g / 8 g) = 0,625 PIECES.

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

Ndipo wodwalayo adabayira ziwalo 6 tsiku lomwelo. Chifukwa chiyani shuga adachulukirachulukira, ngakhale kuti insulin idalowetsedwa kuposa zofunika? Chifukwa wodwala ndi mwana. Mlingo wowonjezera wa insulin unamupangitsa kuti amasulidwe kwambiri mahomoni opsinjika, makamaka, adrenaline. Zotsatira zake, shuga amalumpha. Ndikukonzekera kuti ngati mutaba jakisoni wocheperako, ndiye kuti shugayo siziwonjezereka, koma m'malo mwake amachepetsa. Umu ndi momwe amadabwitsa.

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

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

Mwachidule. Mu mtundu woyamba wa matenda ashuga 1 komanso mtundu wotsogola wa 2, taphunzira momwe tingawerengere chakudya komanso kukonza pobayira jakisoni wa insulin musanadye. Mwaphunzira kuti muyenera kuwerengera muyeso wa insulini malinga ndi ma coefficients, kenako ndikusintha malinga ndi zomwe zikuwonetsa shuga mutadya. Ngati shuga, pambuyo pa maola 4-5 mutatha kudya, wakula kuposa 0,6 mmol / L, mlingo wa insulin uyenera kuchuluka asanadye. Ngati itachepa mwadzidzidzi - mankhwala a insulin amafunikanso kuchepetsedwa. Mchere ukakhala wabwinobwino, umasinthanso osapitilira ± 0,6 mmol / l musanadye - chakudya cha insulin chimasankhidwa molondola.

Type 2 shuga kapena mtundu wofatsa 1 shuga LADA

Tiyerekeze kuti muli ndi matenda amtundu wa 2, vuto lomwe silinyalanyazidwa. Mumatsata zakudya zamafuta ochepa, mumatenga mapiritsi a Siofor kapena Glucofage Long, ndipo mumatenga jakisoni wowonjezera usiku ndi m'mawa. Mlingo wa insulin Lantus, Levemir kapena Protafan amasankhidwa kale molondola. Chifukwa cha izi, shuga wanu wamagazi amakhalabe wabwinobwino ngati mutadumphira chakudya. Koma akatha kudya, amalumpha, ngakhale mutamwa mapiritsi ambiri ovomerezeka. Izi zikutanthauza kuti jakisoni waifupi wa insulin amafunikira chakudya musanadye. Ngati ndinu aulesi kwambiri kuzichita, ndiye kuti zovuta za matenda ashuga zimayamba.

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

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

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

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

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

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

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

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

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

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

Wodwala matenda a shuga a Type 2, omwe zotsatira zake zikuwonetsedwa patebulo, amafunika jakisoni wa insulin yokhayo musanadye chakudya cham'mawa komanso chakudya chamadzulo, koma osati chakudya chamadzulo. Chifukwa chakudya chamadzulo shuga ake samakula. Izi zimachitika chifukwa cha chakudya chamafuta ochepa, kudya mapiritsi a Siofor, komanso kuchita zolimbitsa thupi mkati mwa tsiku. Ndikukumbutseni kuti ngati muphunzira kusangalala ndi maphunziro akuthupi, zimapereka mwayi wokana jakisoni wa insulin musanadye.

Tiyerekeze, malinga ndi zotsatira za kupenyerera kwa shuga mkati mwa sabata zachitika motere:

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

Choyamba, timaganiza mosamala kuti 1 U ya insulin yochepa imatsitsa shuga m'magazi a 2 odwala omwe amadwala kwambiri kuposa 5.0 mmol / L. Izi ndizochulukirapo, koma timayang'ana mwapang'onopang'ono mlingo woyambira wa insulin kuti muteteze wodwala ku hypoglycemia. Kuti mupeze mulingo woyambira wa insulin musanadye, timagawaniza kuchuluka kwa shuga ndi chiwerengerochi. Timalizitsa zotsatila kufika pa 0.25 PIECES mmwamba kapena pansi.

Tikutsindika kuti tikulankhula za insulin yaifupi yaumunthu - Actrapid NM, Humulin Regular, Insuman Rapid GT, Biosulin R ndi ena. Ngati wodwala yemwe ali ndi matenda ashuga adzadula Apidra kapena NovoRapid asanadye, ndiye kuti kuchuluka kwa mankhwalawa kuyenera kuchulukitsidwa ndi 0.66, ndipo ngati Humalog - ichulukane ndi 0.4.

Timayamba kubayidwa poyambira Mlingo waifupi wa insulin 40-45 mphindi musanadye, ultrashort - mphindi 15-25. Kuti mupange jakisoni molondola wa 0,25 ED, muyenera kuphunzira momwe mungapangire insulin. Pamabwalo achilankhulo achi Russia komanso akunja, odwala matenda ashuga amatsimikizira kuti insulin yochepa komanso yochepa kwambiri imakhala yokhazikika. Timapitilizabe kuyeza shuga 2, 3, 4, ndi maola 5 mutatha kudya kuti tidziwe momwe mankhwala a insulin amagwirira ntchito.

Ngati munadya kamodzi pambuyo pa maola 4-5 (osati pambuyo pa maola 2-3!) Shuga amakweza ndi oposa 0.6 mmol / l - mlingo wa insulin musanadye tsiku lotsatira angayesedwe kuti uwonjezeke. Mayunitsi 0,25, mayunitsi 0,5 kapena ngakhale 1 unit. Odwala omwe ali ndi matenda amtundu wa 2 omwe ali ndi kunenepa kwambiri (oposa 40 makilogalamu olemera kwambiri) angafunikire kuwonjezera kuchuluka kwa insulin musanadye zakudya zowonjezera zamitundu iwiri. Koma kwa aliyense, izi ndizodzaza ndi hypoglycemia yayikulu. Ngati mwadzidzidzi shuga yanu itatha kudya yoposa 0,6 mmol / L yotsika kuposa momwe idalili chakudya, zikutanthauza kuti muyenera kutsitsa insulini musanadye.

Njira yomwe ili pamwambapa yosinthira Mlingo wa insulin musanadye iyenera kubwerezedwa mpaka shuga m'masiku 4-5 mutatha kudya mosakhalitsa amakhalanso chimodzimodzi monga chakudya chisanachitike. Tsiku lililonse mudzatchulanso kuchuluka kwa insulin. Chifukwa cha izi, shuga mutatha kudya lidzakhala pafupi kwambiri. Siyenera kukhala oscillate woposa 0.6 mmol / l m'mwamba kapena pansi. Akuti mumatsatira zakudya zamafuta ochepa kuti muchepetse matenda ashuga.

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

Momwe mungadziwire kuchuluka kwa mphindi musanadye jakisoni wa insulin

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

Tengani jakisoni wa insulin (yachidule) ya mphindi 45 musanakonzekere kukhala pansi kuti mudye. Muyeza shuga ndi glucometer 25, 30, 35, 40, 45 Mphindi pambuyo jekeseni. Atangogwa ndi 0,3 mmol / L - ndi nthawi yoti ayambe kudya. Ngati izi zinachitika pambuyo pa mphindi 25 - ndiye kuti simungathe kuziyeza, koma mwachangu yambani kudya kuti pasakhale hypoglycemia. Ngati pambuyo pa mphindi 45 shuga wanu amakhalabe yemweyo - sinkhaninso chakudya. Pitilizani kuyeza shuga lanu mphindi zisanu zilizonse mpaka muone kuti layamba kugwa.

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

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

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

Chimachitika ndi chiani ngati, mutayamba jekeseni mwachangu, mumayamba kudya mphindi 10-15 pambuyo pofunikira? Panthawi imeneyi, mumapempha zovuta. Kupatula apo, sitimadya zakudya zamafuta pang'ono ayi. Thupi limafunikira choyamba kupukusa mapuloteni, kenako ndikusintha ena kuti akhale glucose. Uku ndikuyenda pang'ono. Ngakhale kuchedwa kwakanthawi kwa mphindi 10 kungapangitse kuti shuga asakhale otsika kwambiri, komanso kusangalatsidwa ndi chakudya chamafuta ochepa sikungathandize kuti zibwerere mwakale. Kuopsa kwa hypoglycemia ndikofunikira.

Nthawi zambiri amalimbikitsa kuti pakhale insulin yaifupi ya munthu asanadye chakudya, komanso ndi ultrashort - mphindi 15-25. Komabe, Dr. Bernstein amalimbikitsa kuti musakhale aulesi, koma kuti mudziwe nthawi yanu yoyenera ya jakisoni. Talongosola pamwambapa momwe mungachitire izi komanso zomwe mungapeze. Makamaka ngati mutsatira zakudya zamafuta ochepa. Tikubwereza axiom: musasunge mapepala oyesera mita kuti musapite kukaphwanya chithandizo cha matenda ashuga.

Kodi ndikufunika kudya nthawi zonse nthawi imodzi?

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

Mutha kulumpha zakudya ngati mwaphonya jakisoni woyenera wa insulin musanadye. Ngati mwasankha moyenera kuchuluka kwa insulini yowonjezera, yomwe mumabaya usiku ndi / kapena m'mawa, ndiye kuti mutadumphira chakudya, shuga yanu yamagazi iyenera kukhala yabwinobwino - osagwa kwambiri komanso osadzuka. Momwe mungadziwire kuchuluka kwa mitundu yambiri ya insulin, werengani nkhaniyo "Insulin Lantus ndi Glargin." Medi-NPH-Insulin Protafan. "

Zoyenera kuchita ngati mwaiwala kubaya insulin musanadye

Zitha kuchitika kuti muyiwala kupereka kuwombera kwa insulin yochepa ndikuganiza za nthawiyo pamene chakudyacho chatsala pang'ono kutumizidwa kapena mwayamba kale kudya. Pankhani yadzidzidzi yotere, ndikofunikira kuti mukhale ndi insulin yochepa kwambiri, ndipo ndi Humalog, yomwe ndiyo yachangu kwambiri. Ngati mwayamba kale kudya kapena chakudya chisanayambenso mphindi 15 - perekani jakisoni wa Humaloga. Kumbukirani kuti imakhala yolimba nthawi ziwiri kuposa insulin yochepa. Chifukwa chake, Mlingo wa Humalog uyenera kukhala 0,4 wa mlingo wanu wanthawi zonse wa insulin. Choyimira 0.4 chikuyenera kufotokozedwa payekhapayekha.

Jakisoni wa insulin kuti adye m'malo odyera komanso ndege

M'malesitilanti, m'mahotela ndi ndege, chakudya chimaperekedwa malinga ndi dongosolo lawo, osati lanu. Ndipo nthawi zambiri izi zimachitika mochedwa kuposa zomwe olonjezedwa ndi ogwira kukonza kapena timabuku totsatsa. Iwo omwe alibe matenda ashuga amakwiya akafuna kukhala ndi njala ndikudikirira nthawi yosadziwika. Koma ngati mwalowa kale insulini yothamanga, ndiye kuti chiyembekezochi sichingokhumudwitsa, koma chitha kukhala chowopsa, chifukwa pali chiopsezo cha hypoglycemia (shuga ochepa).

Zikatero, n`zotheka jekeseni osati yochepa insulin, koma ultrashort. Lowetsani mukadzaona kuti woperekera zakudya akukonzekera kutumikiranso pulogalamu yoyamba kapena pulogalamu ya masewera. Ngati mukuyembekeza kuchedwa kutumikiradi maphunziro, gawani muyeso wa ultrashort insulin m'magawo awiri. Gwiritsani theka loyambirira nthawi yomweyo, ndipo chachiwiri - mukadzaona kuti woperekera zakudya wanyamula mayeso. Shuga amatha kutuluka pang'ono, koma mumakhala otsimikizika kuti mupewe hypoglycemia, ngakhale chakudya chitaperekedwa mosachedwa. Ngati munalamulira zakudya zamafuta ochepa ndikuzidya pang'onopang'ono, mutha kupewa kuchuluka kwa shuga kwakanthawi.

Pa ndege simungafune kusankhidwa mbale, pokhapokha mutayenda mu bizinesi yanu. Nthawi zambiri, onse okwera ndege amapatsidwa chakudya chomwechi - osati chokoma, chodzaza ndi chakudya ndipo sichabwino kwa odwala matenda ashuga. Chifukwa chake, wodwala matenda ashuga amatenga zakudya zamagetsi otsika. Ikhoza kukhala nyama kapena nsomba magawo, tchizi, mitundu yovomerezeka ya mtedza. Tengani zambiri kuti mukhale ndi zokwanira kugawana ndi oyandikana nawo omwe amakhala pafupi ndi nyumba yanu. Ngati muli ndi mwayi, ndiye kuti saladi wa masamba omwe adzatumikiridwe amasintha kukhala masamba obiriwira oyenera kudya zakudya zamagulu ochepa.

Osayitanitsa kapena kudya zakudya za "matenda ashuga" okwera ndege! Ndi chakudya nthawi zonse chomwe chimadzaza ndi chakudya chamafuta, mwinanso chowopsa kwa ife kuposa chakudya cha ndege nthawi zonse. Ngati ndege ikupereka chisankho, ndiye kuti mukulamula zakudya zam'madzi. Ngati palibe chakudya mundege, ndibwino, chifukwa pali ziyeso zochepa zopatuka kuchoka pachakudya. Ngati okhawo omwe akuyendetsa ndege amathanso kuthirira madzi, ndipo tidzadzipatsa chakudya chokwanira kuchokera kuzomwe zatilowetsa ku matenda ashuga.

Chenjezo Ngati mwadwala matenda a shuga a gastroparesis, i.e., kuchepetsedwa kutulutsa m'mimba mutatha kudya, musagwiritse ntchito insulin ya ultrashort, koma nthawi yochepa chabe. Ngati zakudya zikupezeka m'mimba mwanu, ndiye kuti insulini yochepa kwambiri imakhalapo mofulumira kuposa momwe iyenera kukhalira. Tikukumbukiranso kuti mitundu ya insulin ya insulin ndiyamphamvu kwambiri kuposa yochepa, chifukwa chake, mankhwalawa amayenera kukhala ocheperako 1.5-2,5.

Sinthani shuga yambiri ndi insulin

Ngakhale mutayesetsa bwanji kuthana ndi matendawa poyendetsa pulogalamu yothana ndi matenda a shuga 2 kapena mtundu 1 wa mankhwala a shuga, nthawi zina shuga amatsalirabe. Pali zifukwa zosiyanasiyana:

• matenda opatsirana;
• kupsinjika kwa mtima;
• kuwerengetsa kolakwika kwa zakudya zamagulu ndi mapuloteni;
• zolakwika insulin.

Werengani nkhani yatsatanetsatane, "Zomwe Zimakhudza Mashuga a Magazi."

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

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

Nthawi yomweyo, ngati mutsatira zakudya zamafuta ochepa kuti muchepetse matenda a shuga, ndikofunika kugwiritsa ntchito insulin yayifupi osati yotsika pang'ono ngati phokoso lazakudya. Ochepa odwala matenda ashuga ochepa amakhala okonzeka kugwiritsa ntchito insulin yochepa asanadye tsiku lililonse, kwinaku akusungitsa insulin yochepa kwambiri pokonzekera zochitika zapadera. Ngati mukuchitabe izi, kumbukirani kuti mitundu ya insulin ndi yamphamvu kwambiri kuposa yochepa. Humalog ili ndi nthawi pafupifupi 2.5, pomwe NovoRapid ndi Apidra amakhala olimba nthawi 1.5-2.

Kuti mukhale okonzeka kugwiritsa ntchito insulin yofulumira ngati chowongolera shuga ikadumphira, muyenera kudziwa momwe 1 unit ya insuliniyi imatsitsira shuga wanu. Kuti tichite izi, tikulimbikitsidwa kuti tichite zoyeserera pasadakhale, zomwe zikufotokozedwa pansipa.

Momwe mungadziwe momwe ndendende 1 ya insulini imatsitsira shuga

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

Yembekezani mpaka tsiku lanu asanafike kuti shuga yanu idumphe pafupifupi 1.1 mmol / L pamwamba pa chandamale. Pachiyeso ichi, shuga ochulukirapo m'mimba yopanda kanthu suyenera, chifukwa zotsatira zake zitha kusintha zomwe zimachitika m'mawa. Shuga sayenera kukwezedwa osapitilira maola 5 mutatha kadzutsa. Izi ndizofunikira kuti mlingo wa insulin yachangu musanadye chakudya cham'mawa. Komanso onetsetsani kuti mwatenga jakisoni wanu wanthawi zonse wa insulin m'mawa uno.

Kuyesera ndikuti mumadumphira chakudya chamasana ndikuwombera mwachangu insulin musanadye, komwe kumakhala chakudya. M'malo mwake, mumabayira insulin yofulumira, bolus yokonzanso, ndikuwona momwe imachepetsa shuga yanu. Ndikofunika kupaka jekeseni wa insulin yotsika kapena yolondola kwambiri kuti asatseke shuga - osati yayitali kwambiri kuti muchepetse hypoglycemia. Gome lili pansipa likuthandizani ndi izi.

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

Zolemba pagome:

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

Akuti muzitsatira zakudya zamafuta ochepa komanso kupaka jekeseni wowonjezera wa insulin. Ndikutanthauza - mumagwiritsa ntchito insulin yayitali pokhapokha kuti mukhale ndi shuga wamba. Apanso, tikulimbikitsa odwala omwe ali ndi matenda ashuga kuti asayese kugwiritsa ntchito insulin yayitali kutengera zotsatira za insulin yomwe imapangitsa kuti shuga asatulutse. Werengani nkhani yakuti “Insulin Lantus ndi Glargin yowonjezera. Medi-NPH-Insulin Protafan. " Tsatirani malangizo omwe afotokozedwamo.

Tiyeni titenge chitsanzo chothandiza. Tingoyerekeza kuti mutha kupaka majekisoni okwana 9 a insulin yowonjezera tsiku lililonse, ndikugwiritsa ntchito NovoRapid ngati insulin yofulumira. Mu tebulo tili ndi chidziwitso cha Mlingo wa insulin yowonjezera ya magawo 8 ndi magawo 10, koma magawo 9 ayi. Poterepa, tapeza pafupifupi ndikugwiritsa ntchito ngati poyambira. Chiwerengero (4.4 mmol / L + 3.6 mmol / L) / 2 = 4.0 mmol / L. Shuga wanu musanadye chakudya chidayamba kukhala 9,7 mmol / L, ndipo mulingo wake anali 5.0 mmol / L. Ndikusintha kuti shuga imaposa zomwe zimachitika ndi 4.7 mmol / L. Ndi magawo angati a NovoRapid omwe amayenera kupatsidwa jekeseni kuti achepetse shuga kukhala abwinobwino? Kuti mudziwe, werengani 4.7 mmol / L / 4.0 mmol / L = 1.25 IU ya insulin.

Chifukwa chake, timabayidwa mayunitsi 1.25 a NovoRapida, kudumphira chakudya chamasana ndipo, motero, timabayidwa pakudya musanadye nkhomaliro. Timayetsa shuga m'magazi 2, 3, 4, 5 ndi 6 patatha jakisoni wa bolus yokonza. Tili ndi chidwi ndi muyezo womwe ungawonetse zotsatira zochepa. Imakhala ndi chidziwitso chofunikira:

• kuchuluka kwa mmol / l komwe NovoRapid amachepetsa shuga m'magazi anu;
• jakisoni amatenga nthawi yayitali bwanji?

Kwa odwala ambiri, jakisoni wa insulin mwachangu amasiya pakati pa maola 6 otsatira. Ngati muli ndi shuga wotsika kwambiri pambuyo maola 4 kapena 5, zikutanthauza kuti payekhapayekha insulini iyi imakuchitirani mwa njira yake.

Tiyerekeze, malinga ndi momwe anakuwonera, zinapezeka kuti shuga m'magazi anu pambuyo pa jekeseni la NovoRapida la 1.25 IU lagwa kuchokera 9.7 mmol / L mpaka 4.5 mmol / L, ndipo patatha maola 6 silinatsikenso. Chifukwa chake, tidaphunzira kuti 1.25 IU NovoRapida idatsitsa shuga wanu ndi 5.2 mmol / L. Chifukwa chake, gawo limodzi la insulini limatsitsa shuga wanu (5.2 mmol / l / 1.25) = 4.16 mmol / l. Ichi ndi chinthu chamtengo wapatali chomwe chimatchedwa insulin sensitivity factor. Gwiritsani ntchito mukafunikira kuwerengera kuti mupeze shuga kuti muchepetse shuga yayikulu.

Ngati mukuyesera shuga panthawi ina imagwera pansi pa 3.5-3.8 mmol / L, idyani mapiritsi ochepa a glucose kuti pasakhale hypoglycemia. Werengani zambiri za momwe mungayimitsire hypoglycemia. Kuyesera kwalephera lero. Amunso tsiku lina, jekeseni mlingo wapansi wa insulin.

Momwe mungazimitsire shuga yayikulu ndi jakisoni wa insulin

Chifukwa chake, mudayesa ndikuwona momwe 1 unit yochepa kapena ya ultrashort insulin imatsitsira shuga lanu. Tsopano mutha kugwiritsa ntchito insuliniyi ngati njira yolankhulira, ndiye kuti, kuzimitsa shuga kuti azikhala bwino ngati alumpha. Pakupita maola ochepa mutatha jakisoni wa enieni a insulin mwachangu, shuga yanu imatha kubwerera mwakale.

Ngati mutsatira zakudya zamafuta ochepa, komanso mowerengera molondola kuchuluka kwa insulini komanso insulin yachangu musanadye, ndiye kuti shuga sayenera kupitirira 3-4 mmol / l pamwamba pazomwe mukufuna. Izi zimatha kuchitika mwadzidzidzi.

Ngati mitundu iwiri ya insulin yothamanga imachita nthawi imodzi, ndiye kuti shuga ingachepetse kwambiri ndikuwopsa kwa hypoglycemia. Yembekezani maola osachepera 4-5 kuchokera nthawi yomwe jakisoni wotsatira wasowa kwambiri, ndipo kenaka lembani zotupa. M'malo mwake, zochita za insulin zamtunduwu zimatha maola 6-8, koma m'maola otsiriza izi ndi "zotsalira" zochepa. Chifukwa chake, ndikokwanira kudikirira maola 4-5.

Zingakhale zovuta kwambiri kudikirira maola 6 pakati pa jakisoni onse aifupi kapena a insulin. Ngati mumadya katatu katatu patsiku, muyenera kukhala maso kwa maola 18, ndipo kugona sikungopitilira maola 6. Zochita zikuwonetsa kuti maulendo 4-5 okwanira. Pambuyo pa izi, mutha kubaya jekeseni wotsatira wa insulin yofulumira, chifukwa yapita kale ili ndi vuto laling'ono.

Zoyenera kuchita ngati insulin sikuchepetsa shuga

Nthawi zina zimachitika kuti jakisoni waifupi kapena wa ultrashort insulin samachepetsa shuga la magazi, mwachizolowezi, koma amachita kwambiri kapena ayi. Tiyeni tiwone zifukwa zingapo zomwe zingayambitse izi.

Insulin ndi mitambo - iponyekeni

Choyamba, yang'anani vial kapena cartridge yokhala ndi insulin pamtundu kuti muwonetsetse kuti mulibe mitambo. Mutha kuyerekezera ndi insulin yatsopano yopanda mtundu womwewo kuti mutsimikizire. Insulin iliyonse, kupatula pafupifupi NPH-insulin (protafan), imayenera kukhala yowala bwino komanso yowonekera, ngati madzi. Ngati ali ndi mitambo pang'ono, izi zikutanthauza kuti walephera pang'ono kuchepetsa shuga. Osagwiritsa ntchito insulin yotere, ichotseni ndikuisintha mwatsopano.

Momwemonso, insulin siyenera kugwiritsidwa ntchito ngati idasungika mwangozi, kuwundana ndi kutentha kwambiri kapena kugona kunja kwa firiji kwa miyezi yopitilira 3. Makamaka kutentha kwaposachedwa 37 digiri Celsius kumakhudza Levemir ndi Lantus. Mitundu ya insulin yocheperako kapena ya ultrashort imalimbana nayo kwambiri, koma imafunikanso kusungidwa mosamala. Werengani zambiri zamalamulo osungira insulin.

Momwe mungapangire shuga m'mawa pamimba yopanda kanthu

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

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

Zoyenera kuchita ngati shuga atakwera pamwamba pa 11 mmol / l

Ngati shuga atakwera pamtunda wa 11 mmol / l, ndiye kuti wodwala yemwe ali ndi matenda ashuga, mphamvu ya maselo pakuchitanso insulin ikhoza kuchepera. Zotsatira zake, jakisoni adzakulirakulira kuposa masiku onse. Izi zimanenedweratu makamaka ngati shuga atakwera mpaka 13 mmol / L ndikukwera. Mwa anthu omwe amatsatira mosamalitsa mtundu wa 1 wa chithandizo cha matenda a shuga kapena pulogalamu yachiwiri ya matenda ashuga, shuga wambiri ndiye osowa kwambiri.

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

Matenda opatsirana ndikuwongolera matenda a shuga

Matenda opatsirana kapena obwera chifukwa chachikulu chotengera kuti jakisoni wa insulin ndi woipa kuposa masiku onse. Unikani gawo la “Matenda Opatsirana” lomwe lili mu nkhani ya “Zomwe Zimakhudza Magazi a Magazi”. Werengani komanso momwe mungathandizire kuzizira, kutentha thupi, kusanza komanso kutsegula m'mimba m'mimba.

Mapeto

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

Malingaliro achidule:

1. Chakudya chamafuta ochepa ndi njira yayikulu yochizira (control) Type 1 ndi mtundu 2 wa matenda ashuga.
2. Ngati mutsatira zakudya zamafuta ochepa, mapiritsi a insulin amafunikira otsika. Pambuyo posintha kudya "zopatsa thanzi" kapena zama calorie ochepa, amachepera 2-7.
3. Mtundu wachiwiri wa matenda ashuga, amayamba ndi jakisoni wa insulin Lantus kapena Levemir wowonjezera usiku ndi m'mawa. Jekeseni mwachangu insulin musanadye chakudya pambuyo pake.
4. Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri, maphunziro olimbitsa thupi mosangalatsa, makamaka kuthamanga, amalimbitsa shuga m'malo mwa jakisoni wa insulin. Maphunziro akuthupi samangothandiza mu 5% yokha yamilandu yapamwamba kwambiri. Pazotsalira 95%, zimakupatsani mwayi wokana jakisoni wa insulin musanadye.
5. Ngati mumatsatira zakudya zamafuta ochepa, ndiye kuti musanadye ndibwino kubaya insulin yayifupi ya anthu - Actrapid NM, Humulin Regular, Insuman Rapid GT, Biosulin R.
6. Mitundu ya Ultrashort ya insulin - Humalog, Apidra, NovoRapid - ndiyabwino kwambiri kudya chifukwa amachitapo kanthu mwachangu ndikupangitsa kudumpha mu shuga.
7. Ndibwino kuti mupeze insulini yowonjezera usiku ndi m'mawa, insulin yochepa musanadye, ndikukhalabe ndi Humalog yochepa kwambiri pamilandu yomwe mufunika kuthana ndi shuga msanga.
8. Insulin sensitivity factor - kuchuluka kwa 1 UNIT ya insulini kumatsitsa shuga lanu lamagazi.
9. Chakudya chopatsa mphamvu - kuchuluka kwa zakudya zomwe zimaphimba gawo limodzi la insulin.
10. Zomwe zimapangitsa insulin sensitivity factor komanso ma carbohydrate coefficients omwe mungapeze m'mabuku komanso pa intaneti sizolondola. Wodwala aliyense wa shuga ali ndi wake. Ikani ngati mwayesa. M'mawa, pachakudya chamadzulo komanso madzulo ndizosiyana.
11. Osayesa kuloweza jakisoni wa insulin yofulumira musanadye ndi jakisoni wa Mlingo waukulu wa insulin yayitali!
12. Osasokoneza kuchuluka kwa insulin yochepa komanso ya ultrashort. Mitundu ya insulashort ya insulini imakhala yolimba nthawi 1.5-2,5 kuposa yayifupi, kotero kuti ma dosages awo ayenera kukhala ochepa.
13. Phunzirani kuchepetsa insulin. Onani momwe insulin yochepa komanso yopanda phokoso imakuchitirani.
14. Phunzirani malamulo osungira insulini ndikutsatira.

Chifukwa chake, mudaganizira momwe mungawerengere kuchuluka kwa insulin yochepa komanso ya ultrashort ya jakisoni munjira zosiyanasiyana. Chifukwa cha izi, muli ndi mwayi wokhala ndi shuga wabwino kwambiri, monga momwe mumakhalira anthu athanzi. Komabe, kudziwa zamankhwala a shuga a jakisoni wa insulin sikuchotsa kufunikira kwa zakudya zamagulu ochepa. Ngati zakudya za anthu odwala matenda ashuga zimadzaza ndi chakudya, ndiye kuti palibe kuwerengera kwa mankhwala a insulini omwe angamupulumutse ku kuchuluka kwa shuga, kukula kwa zovuta komanso zotupa za mtima.

Palinso zinthu zina zachiwiri zomwe zimakhudza shuga kwa odwala matenda ashuga. Awa ndimatenda opatsirana, zochitika zovutitsa, nyengo, kusintha kwa nyengo, kumwa mankhwala, makamaka mankhwala a mahomoni. Mwa akazi, palinso magawo a kusintha kwa msambo, kutenga pakati, kusamba. Mukudziwa kale momwe mungasinthire kuchuluka kwa insulin malinga ndi zakudya ndi zizindikiro za shuga. Gawo lotsatira ndikuphunzira momwe mungapangire zosintha poganizira zinthu zachiwiri. Onani nkhani yakuti “Zomwe Zimakhudza Magazi a Magazi” kuti mumve zambiri. Ndikofunikira kuwonjezera pazomwe mudadutsamo.