Matenda a shuga ndi insulin. Chithandizo cha insulin

Ngati mukufuna (kapena simukufuna, koma moyo umakupangitsani) kuyamba kuchiza matenda anu a shuga ndi insulin, muyenera kuphunzira zambiri za izi kuti mumve zomwe mukufuna. Jakisoni wa insulin ndi chida chabwino kwambiri, chapadera pothana ndi matenda amtundu wa 1 komanso mtundu wa 2, koma pokhapokha mukamagwiritsa ntchito mankhwalawa molemekeza. Ngati ndinu wodwala komanso wodziletsa, ndiye kuti insulini ingakuthandizeni kukhala ndi shuga wabwinobwino, pewani zovuta komanso musakhale woipa kuposa anzanu popanda matenda ashuga.

Kwa odwala onse omwe ali ndi matenda ashuga a 1, komanso odwala ena omwe ali ndi matenda a shuga a 2, jakisoni wa insulin ndiwofunikira kwambiri kuti shuga azikhala bwino komanso kupewa zovuta. Ambiri mwa odwala matenda ashuga, pomwe dokotala awauza kuti ndi nthawi yoti alandire mankhwala a insulin, pakanani ndi mphamvu zawo zonse. Madokotala, monga lamulo, saumirira kwambiri, chifukwa ali kale ndi zovuta zokwanira. Zotsatira zake, zovuta za shuga zomwe zimayambitsa kulumala ndi / kapena kufa koyambirira kwakhala mliri.

Momwe mungachiritsire jakisoni wa matenda a shuga

Ndikofunikira kuchitira jakisoni wa insulin mu shuga osati temberero, koma monga mphatso yakumwamba. Makamaka mutatha kudziwa njira ya jakisoni wopanda insulin. Choyamba, jakisoni amapulumutsa pamavuto, amakulitsa moyo wa wodwala yemwe ali ndi matenda ashuga ndikuwongolera. Kachiwiri, jakisoni wa insulin amachepetsa katundu pa kapamba ndipo zimapangitsa kuti maselo ake a beta abwezeretsenso. Izi zimagwira ntchito kwa odwala omwe ali ndi matenda a shuga a 2, omwe amatsatira pulogalamu yamankhwala ndikutsatira njira. Ndikothekanso kubwezeretsa maselo a beta kwa odwala omwe ali ndi matenda a shuga 1, ngati mwapezeka posachedwapa ndipo nthawi yomweyo mumayamba kuthandizidwa ndi insulin. Werengani zambiri muzolemba "Pulogalamu yothandizira matenda a matenda ashuga a 2" ndi "Honeymoon a matenda a shuga 1: momwe angakulitsire kwa zaka zambiri".

Mudzaona kuti malingaliro athu ambiri polamulira shuga m'magazi ndi jakisoni wa insulin ndi osiyana ndi zomwe zimavomerezedwa nthawi zonse. Nkhani yabwino ndiyakuti simuyenera kutenga chilichonse pachikhulupiriro. Ngati muli ndi mita ya glucose yolondola (onetsetsani izi), iwonetsa mwachangu kuti ndi maupangiri ake ati omwe amathandiza kuchiza matenda a shuga komanso omwe alibe.

Pali mitundu yanji ya insulini?

Pali mitundu yambiri ndi mayina a insulin a shuga m'msika wazamankhwala masiku ano, ndipo m'kupita kwanthawi padzakhala zochulukirapo. Insulin imagawidwa malinga ndi njira yayikulu - imakhala yotalika motani magazi pambuyo pakubayidwa. Mitundu ya insulin iyi ilipo:

• ultrashort - Chitani zinthu mwachangu kwambiri;
• wamfupi - wodekha komanso wosalala kuposa waufupi;
• nthawi yayitali yochitapo kanthu (“sing'anga”);
• kuleza mtima (kutalikitsa).

Mu 1978, asayansi anali oyamba kugwiritsa ntchito njira zopangira majini kuti “akakamize” Escherichia coli Escherichia coli kupanga insulin ya munthu. Mu 1982, kampani yaku America ya Genentech idayamba kugulitsa zinthu zambiri. Izi zisanachitike, inshuwaransi ya bovine ndi nkhumba imagwiritsidwa ntchito. Amasiyana ndi anthu, chifukwa chake nthawi zambiri amayambitsa zotsutsana. Mpaka pano, insulin ya nyama sigwiritsidwanso ntchito. Matenda a shuga amathandizidwa kwambiri ndi jakisoni wa insulin yaumunthu.

Chizindikiro cha kukonzekera kwa insulin

Kuyambira 2000s, mitundu yatsopano yowonjezera ya insulin (Lantus ndi Glargin) idayamba kusanduliza nthawi yayitali NPH-insulin (protafan). Mitundu yatsopano yowonjezera ya insulini sikuti imangokhala insulin ya anthu, koma mawonekedwe ake, omwe amasinthidwa, kuwongoleredwa, poyerekeza ndi insulin yeniyeni ya anthu. Lantus ndi Glargin amakhala motalika komanso bwino, ndipo sakonda kuyambitsa chifuwa.

Yaitali-insulin analogues - amakhala nthawi yayitali, alibe nsapato, amakhala ndi insulini m'magazi

Zotheka kuti kusintha NPH-insulin ndi Lantus kapena Levemir monga insulini yanu yowonjezera (basal) kudzakulitsa zotsatira zanu zamankhwala othandizira odwala matenda ashuga. Kambiranani izi ndi dokotala. Kuti mumve zambiri, werengani nkhani yakuti “Insulin Lantus ndi Glargin. Medi-NPH-Insulin Protafan. "

Chakumapeto kwa ma 1990, ma ultrashort analogi a insulin Humalog, NovoRapid ndi Apidra adawonekera. Anapikisana ndi insulin yaifupi yaumunthu. Ma enulin obwera posachedwa-pang'ono amayamba kutsika magazi mkati mwa mphindi 5 pambuyo pa jakisoni. Amachita zinthu mwamphamvu, koma osakhalitsa, osaposa maola atatu. Tiyeni tiyerekeze zolemba za analogue yaifupi-yochepa komanso "yapafupifupi" insulin yafupi ya anthu pachithunzichi.

Ma analulin a insulin omwe amafupika pang'ono amakhala amphamvu kwambiri komanso mwachangu. Insulin "yaifupi" yaumunthu imayamba kutsitsa shuga m'magazi pambuyo pake ndikupita nthawi yayitali

Werengani nkhani iyi "Ultrashort insulin Humalog, NovoRapid ndi Apidra. Insulin yochepa yaumunthu. "

Yang'anani! Ngati mutsatira zakudya zamagulu ochepa m'matenda a shuga a 1 kapena 2, ndiye kuti insulini yocheperako yamunthu ndiyabwino kuposa ma insulin anthawi yayitali.

Kodi ndizotheka kukana jakisoni wa insulin atayambitsa?

Odwala ambiri omwe ali ndi matenda a shuga amawopa kuyamba kulandira chithandizo cha jakisoni wa insulin, chifukwa ngati mutayamba, ndiye kuti simungathe kudumphira insulin. Titha kuyankhidwa kuti ndibwino kubaya insulin ndikumakhala bwino kuposa kutsogolera kukhalapo kwa munthu wolumala chifukwa cha zovuta za matenda ashuga. Kupatula apo, ngati muyamba kulandira chithandizo cha jakisoni wa insulin munthawi yake, ndiye kuti muli ndi matenda a shuga a 2, mwayi umawonjezera kuti zitheka kuwasiya pakapita nthawi popanda kuvulaza thanzi.

Pali mitundu yambiri yam'maselo mu kapamba. Maselo a Beta ndi omwe amapanga insulin. Amafa kwambiri ngati akufunika kugwira ntchito mokwanira. Amaphedwa ndi kawopsedwe wa glucose, i.e., shuga wokwanira wodwala. Amaganiziridwa kuti kumayambiriro kwa matenda a shuga a mtundu 1 kapena 2, ma cell ena a beta amwalira kale, ena afooka ndipo atsala pang'ono kufa, ndipo ochepa okha ndi omwe akugwiranso ntchito nthawi zonse.

Chifukwa chake, jakisoni wa insulin amamasula katundu m'maselo a beta. Mutha kusinthanso shuga m'magazi anu ndi zakudya zamafuta ochepa. M'mikhalidwe yabwinoyi, maselo anu ambiri a beta adzapulumuka ndikupitiliza kupanga insulini. Mwayi wa izi ndi wokwanira ngati mutayambitsa mtundu wa chithandizo chachiwiri cha matenda ashuga kapena mtundu 1 wa chithandizo cha matenda ashuga panthawi, koyambirira.

Mtundu woyamba wa matenda ashuga, mankhwala atangoyamba kumene, nthawi ya "kukwatirana tulo" imachitika pamene kufunika kwa insulin kutsika pafupifupi zero. Werengani zomwe zili. Ikufotokozanso momwe angakulitsire kwa zaka zambiri, kapena ngakhale kwa moyo wonse. Ndi matenda amtundu wa 2 shuga, mwayi wopereka jakisoni wa insulin ndi 90%, ngati muphunzira masewera olimbitsa thupi mosangalala, ndipo muzichita pafupipafupi. Zachidziwikire, muyenera kutsatira mosamalitsa zakudya zamagulu ochepa.

Pomaliza Ngati pali umboni, ndiye kuti muyenera kuyamba kuchiza matenda a shuga ndi jakisoni wa insulin mwachangu, osazengereza nthawi. Izi zimawonjezera mwayi kuti pakapita kanthawi ndizotheka kukana jakisoni wa insulin. Zikumveka ngati zododometsa, koma zilipo. Dziwani bwino njira ya jakisoni wopanda insulin. Tsatirani pulogalamu ya matenda a shuga a 2 kapena mtundu wa matenda ashuga 1. Tsatirani malamulo, musapumule. Ngakhale mutakhala kuti simungakane jakisoni, mulimonse, mutha kuyang'anira ma insulin ochepa.

Kodi ndende ya insulin ndi chiyani?

Zochita zokhudzana ndi chilengedwe komanso Mlingo wa insulin zimayezedwa m'magawo (UNITS). Mlingo wocheperako, magawo awiri a insulin amayenera kutsika shuga m'magazi ndendende nthawi ziwiri kuposa mphamvu imodzi. Pa syringes za insulin, sikelo imakonzedwa m'magawo. Ma syringe ambiri amakhala ndi gawo la 1-2 PIECES motero musalole molondola kuti mulingo wa insulin utengedwe kuchokera ku vial. Ili ndi vuto lalikulu ngati mukufunikira jekeseni wa 0,5 UNITS wa insulin kapena kuchepera. Zotsatira za yankho lake zafotokozedwa mu nkhani ya "Insulin Syringes and Syringe Pens". Werengani komanso momwe mungatungire insulin.

Kuzunza kwa insulin ndi chidziwitso chambiri cha UNITS chomwe chili 1 ml yankho mu botolo kapena cartridge. Zomwe zimagwiritsidwa ntchito kwambiri ndi U-100, i.e 100 IU ya insulin mu 1 ml yamadzimadzi Komanso, insulin pamsasa wa U-40 imapezeka. Ngati muli ndi insulin yokhala ndi U-100, ndiye kuti gwiritsani ntchito ma syringe omwe amapangidwira insulin pa nthawiyo. Zalembedwa pamakoma a syringe iliyonse. Mwachitsanzo, syringe ya insulin U-100 yokhala ndi mphamvu ya 0,3 ml imasunga 30 IU ya insulin, ndipo syringe yokhala ndi 1 ml ya insulini imakwana 100 IU. Kuphatikiza apo, 1 ml syringes ndiwofala kwambiri m'mafakisi. Zimakhala zovuta kunena kuti ndi ndani amene amafunikira inshuwaransi ya 100 PESCES ya insulin nthawi yomweyo.

Pali nthawi zina pamene wodwala matenda ashuga ali ndi insulin U-40, ndipo syringe yekha U-100. Kuti mupeze insulini yoyenera ya UNITS ndi jakisoni, mwanjira imeneyi muyenera kukoka yankho la 2,5 nthawi syringe. Mwachidziwikire, pali mwayi waukulu kwambiri wolakwitsa ndikupanga jakisoni wolakwika wa insulin. Padzakhala shuga wowonjezera wamagazi kapena hypoglycemia yowonjezereka. Chifukwa chake, zinthu ngati izi ndizopewedwa bwino. Ngati muli ndi insulin ya U-40, ndiye yesani kupeza syringes ya U-40 yake.

Kodi mitundu yosiyanasiyana ya insulini ili ndi mphamvu imodzimodzi?

Mitundu yosiyanasiyana ya insulini imasiyana pakati pawo pa liwiro lokhala ndi nthawi yayitali, komanso mu mphamvu - palibe. Izi zikutanthauza kuti gawo limodzi la insulin yokwanira imachepetsa shuga m'magazi odwala matenda ashuga. Kupatula pa lamuloli ndi mitundu ya insulin. Humalog ili ndi nthawi pafupifupi 2,5 yolimba kuposa mitundu yochepa ya insulin, pomwe NovoRapid ndi Apidra ndi 1.5 nthawi zamphamvu. Chifukwa chake, Mlingo wa ultrashort analogu ukhale wotsika kwambiri kuposa milingo yofanana ya insulin. Ichi ndi chidziwitso chofunikira kwambiri kwa odwala omwe ali ndi matenda ashuga, koma pazifukwa zina sayang'ana pa iwo.

Malamulo Osungira Insulin

Ngati mungasungitse vial wosindikizidwa kapena katoni ndi insulin mufiriji pamtunda wa + 2-8 ° C, ndiye kuti isunga zonse zomwe zikuchitika mpaka tsiku lomaliza lisindikizidwe pa phukusi. Mphamvu ya insulini imatha kuwonongeka ngati ikusungidwa kutentha kwa chipinda kwanthawi yayitali 30-60 masiku.

Mlingo woyamba wa phukusi latsopano la Lantus utabayidwa, uyenera kugwiritsidwa ntchito masiku onse 30, chifukwa ndiye kuti insulin itaya gawo lake lalikulu. Levemir ikhoza kusungidwa pafupifupi nthawi ziwiri mukangogwiritsa ntchito koyamba. Kutalika kwakanthawi ndi kwapakatikati, komanso Humalog ndi NovoRapid, kumatha kusungidwa m'chipinda chochepera chaka chimodzi. Apidra insulin (glulisin) imasungidwa bwino mufiriji.

Ngati insulin yasiya kuchita zina, izi zimapangitsa kuti shuga wodwala yemwe alibe shuga asamve. Pankhaniyi, insulin yowonekera imatha kukhala mitambo, koma imakhalabe yowonekera. Ngati insulini yakhala ya mtambo pang'ono, zikutanthauza kuti yasokonekera, ndipo simungathe kuigwiritsa ntchito. NPH-insulin (protafan) munthawi yabwinobwino siowonekera, chifukwa chake zimakhala zovuta kwambiri kuthana nayo. Yang'anirani mosamala ngati wasintha mawonekedwe ake. Mulimonsemo, ngati insulin ikuwoneka yabwinobwino, ndiye kuti izi sizitanthauza kuti sizinade.

Zomwe muyenera kuyang'ana ngati shuga ali magazi okwanira masiku angapo motsatana:

• Kodi mwaphwanya zakudya? Kodi zakudya zobisika zomwe zalowa m'zakudya zanu? Kodi mudadya kwambiri?
• Mwina muli ndi matenda mthupi lanu omwe amabisika? Werengani "shuga m'magazi chifukwa cha matenda opatsirana."
• Kodi insulin yanu yawonongeka? Izi zimachitika makamaka ngati mugwiritsa ntchito ma syringes nthawi zopitilira kamodzi. Simudzazindikira izi chifukwa cha insulin. Chifukwa chake, ingoyesani kuyambitsa jakisoni "watsopano". Werengani za kugwiritsanso ntchito ma syringes a insulin.

Sungani insulin ya nthawi yayitali mufiriji, paphewa pakhomo, kutentha kwa + 2-8 ° C. Osamauma konse insulini! Ngakhale itapendekera, inali itasokonekera kale. Vutamini kapena inshuwaransi yomwe mukugwiritsa ntchito pano ikhoza kusungidwa kutentha. Izi zikugwira ntchito pa mitundu yonse ya insulin, kupatula Lantus, Levemir ndi Apidra, omwe amasungidwa bwino mufiriji nthawi zonse.

Musasungire insulin m'galimoto yokhoma, yomwe imatha kusefukira ngakhale nthawi yozizira, kapena bokosi lamagalasi. Osaziyalutsa kuti ziwongolere dzuwa. Ngati kutentha kwa chipinda kufikira + 29 ° C ndi kupitilira, ndiye kusunthira insulini yanu yonse mufiriji. Ngati insulini yadziwika ndi kutentha kwa + 37 ° C kapena kupitirira tsiku limodzi kapena kutalika, ndiye kuti iyenera kutayidwa. Makamaka, ngati yatenthedwa m'galimoto yokhoma. Pazifukwa zomwezo, ndikosayenera kunyamula botolo kapena cholembera pafupi ndi thupi, mwachitsanzo, mthumba la malaya.

Tikukuchenjezaninso: ndibwino osagwiritsanso ntchito ma syringe kuti musawononge insulini.

Nthawi ya insulin

Muyenera kudziwa nthawi yayitali jekeseni, insulin ikayamba kuchita, komanso ngati zochita zake zimatha. Izi zimasindikizidwa pamalangizo. Koma ngati mungatsatire zakudya zamafuta ochepa ndikubaya ma insulin pang'ono, mwina sizowona. Chifukwa chidziwitso chomwe wopanga amapanga chimachokera pa insulin Mlingo woposa omwe amafunidwa ndi odwala matenda ashuga pazakudya zochepa zama carbohydrate.

Kuti muwone kuti patenga nthawi yayitali bwanji jakisoni, insulini ikayamba kugwira ntchito poyambira chithandizo cha matenda a shuga, werengani tebulo la "Makhalidwe a insulin kukonzekera", omwe aperekedwa pamwambapa. Zimakhazikitsidwa ndi data kuchokera ku machitidwe ochulukirapo a Dr. Bernstein. Zomwe zili patebulopo, muyenera kudzifotokozera nokha payekha pogwiritsa ntchito miyezo ya shuga wamagazi ndi glucometer.

Mlingo waukulu wa insulin umayamba kugwira ntchito mwachangu kuposa zazing'ono, ndipo zotsatira zake zimakhala motalika. Komanso nthawi ya insulin ndi yosiyana mwa anthu osiyanasiyana. Kuchita jakisoni kumathandizira kwambiri ngati mutachita masewera olimbitsa thupi mothandizidwa ndi insulin. Mchitidwewu uyenera kuganiziridwanso ngati simukufuna kuthamangitsa insulin. Mwachitsanzo, musamwe jakisoni wambiri m'manja mwake musanapite kumalo olimbitsa thupi, komwe mungakweze bala ndi dzanja ili. Kuchokera pamimba, insulin nthawi zambiri imatengedwa mwachangu, komanso masewera olimbitsa thupi, ngakhale mwachangu.

Kuwunika zotsatira za chithandizo cha matenda a shuga a insulin

Ngati muli ndi matenda ashuga osafunikira kotero kuti muyenera kupanga jakisoni wa insulin musanadye, ndikofunika kuti mupitilize kudzipenda nokha magazi. Ngati mukufuna jakisoni wokwanira wa insulini yowonjezera usiku ndi / kapena m'mawa, popanda jakisoni mwachangu musanadye, kuti mupeze chipukutiro cha matenda a shuga, ndiye muyenera kungoyesa shuga m'mawa pamimba yopanda kanthu komanso madzulo musanagone. Komabe, gwiritsani ntchito magazi tsiku lonse 1 pa sabata, makamaka masiku awiri sabata iliyonse. Ngati zikuwoneka kuti shuga yanu imakhala osachepera 0,6 mmol / L pamwambapa kapena pansi pazofunikira, ndiye muyenera kufunsa dokotala ndikusintha china chake.

Onetsetsani kuti mumayeza shuga musanayambe kuchita masewera olimbitsa thupi, kumapeto, komanso ndi nthawi ya 1 kwa maola angapo mukamaliza kuchita masewera olimbitsa thupi. Mwa njira, werengani luso lathu lapadera la momwe mungasangalalire ndi maphunziro akuthupi a shuga. Ikufotokozanso njira zothanirana ndi hypoglycemia panthawi yamaphunziro akuthupi kwa odwala omwe amadalira matenda a shuga.

Ngati muli ndi matenda opatsirana, ndiye kuti masiku onse mukumenyedwa, onetsetsani kudziletsa kwa shuga wamagazi ndikuwonjezera msanga shuga yapamwamba ndi jakisoni wa insulin mwachangu. Odwala onse a shuga omwe amalandiridwa ndi jakisoni wa insulin ayenera kuyang'ana shuga asanayende, kenako ola lililonse pamene akuyendetsa. Mukamayendetsa makina owopsa - chinthu chomwecho. Ngati mukupita kukasambira, ndiye kuti mwatuluka mphindi 20 zilizonse kuti mupeze shuga.

Momwe nyengo imakhudzira insulin

Nthawi yozizira ikayamba kutentha, nthawi zambiri odwala matenda ashuga amapeza kuti kufunika kwa insulini kumatsika kwambiri. Izi zitha kutsimikizika chifukwa mita imawonetsa shuga wochepa kwambiri wa magazi. Mwa anthu otere, kufunika kwa insulini kumachepetsa nyengo yotentha ndikuwonjezeka nthawi yachisanu. Zomwe zimayambitsa izi sizikudziwika bwino. Amatinso kuti mothandizidwa ndi nyengo yofunda, mitsempha yamagazi yotumphukira imapuma bwino ndikutulutsa magazi, glucose ndi insulin kuzinthu zotumphukira bwino.

Mapeto ake ndikuti muyenera kuyang'ana bwino magazi anu akayamba kutentha kunja kuti hypoglycemia isachitike. Ngati shuga agwera kwambiri, musamasuke kuti muchepetse mulingo wa insulin. Mwa odwala matenda ashuga omwe amakhalanso ndi eusthematosus, zonse zitha kuchitika mwanjira ina. Nyengo yotentha, imafunikira insulin.

Wodwala yemwe ali ndi matenda ashuga atayamba kuthandizidwa jakisoni wa insulin, iyenso, ndi achibale ake, abwenzi ndi ogwira nawo ntchito ayenera kudziwa zizindikiro za hypoglycemia komanso momwe angamuthandizire pakavulaza kwambiri. Anthu onse omwe mukukhala nawo ndikugwira nawo ntchito, tiyeni tiwerenge tsamba lathu zokhudzana ndi hypoglycemia. Bukuli limafotokozedwa mwatsatanetsatane.

Chithandizo cha insulin kwa matenda ashuga: mawu omaliza

Nkhaniyi imapereka chidziwitso chofunikira chomwe odwala onse omwe ali ndi matenda amtundu wa 1 kapena mtundu wa 2 omwe amalandira jakisoni wa insulin ayenera kudziwa. Chachikulu ndikuti mwaphunzira mitundu ya insulini yomwe ilipo, zomwe ali nazo, komanso malamulo osungira insulin kuti isawonongeke. Ndikupangira kuti muwerenge mosamala zolemba zonse za "Insulin pochiza matenda amtundu wa 2 ndi mtundu wa shuga 2 ngati mukufuna kubwezera bwino matenda anu a shuga. Ndipo, inde, tsatirani mosamala zakudya zamafuta ochepa. Dziwani tanthauzo la njira yowonjezera kuwala. Gwiritsani ntchito mankhwalawa kuti musungitse shuga yokhazikika yokhazikika komanso kuti mulimbane ndi kuchuluka kwa insulin.