Chithandizo cha insulin ndi mankhwala othandizira odwala matenda amtundu 1 omwe amalephera kupezeka mu chakudya. Koma nthawi zina chithandizo chofananacho chimagwiritsidwa ntchito ku mtundu wachiwiri wa matenda, omwe maselo amthupi samawona insulin (mahomoni omwe amathandiza kusintha glucose kukhala mphamvu).
Izi ndizofunikira ngati matendawa akula komanso kuwonongeka.
Komanso, makonzedwe a insulini akuwonetsedwa nthawi zina zingapo:
- matenda a shuga;
- contraindication kugwiritsa ntchito mankhwala ochepetsa shuga;
- kusowa kwa zotsatira zabwino mutatha kutenga antiglycemic wothandizira;
- kwambiri matenda ashuga.
Insulin ndi puloteni yomwe imalowetsedwa nthawi zonse mthupi. Mwa chiyambi, ikhoza kukhala nyama komanso anthu. Kuphatikiza apo, pali mitundu yosiyanasiyana ya mahomoni (heterologous, homologous, pamodzi) ndi nthawi zosiyanasiyana.
Kuchiza matenda a shuga kudzera mu mankhwala a mahomoni kumafuna malamulo ena ndi kuwerengera koyenera. Kupanda kutero, mavuto osiyanasiyana a insulin amayamba, omwe aliyense wodwala matenda ashuga ayenera kudziwa.
Hypoglycemia
Pakakhala mankhwala osokoneza bongo, kuperewera kwa chakudya chamafuta kapena pakadutsa jakisoni, kuchuluka kwa shuga m'magazi kumatha kutsika kwambiri. Zotsatira zake, dziko la hypoglycemic limakula.
Ngati wothandizila wokhazikika azigwiritsidwa ntchito, ndiye kuti kuphatikiza kwofananako kumachitika pamene kuchuluka kwa zinthu kumakhala kwakukulu. Komanso, kuchepa kwa shuga kwamasamba kumadziwika pambuyo kuchita zolimbitsa thupi mwamphamvu kapena kugwedezeka kwamphamvu.
Ndizofunikira kudziwa kuti malo omwe akutsogolera pakupanga hypoglycemia sindiwo kuchuluka kwa glucose, koma kuchepa kwake. Chifukwa chake, Zizindikiro zoyambirira za kuchepa zimatha kuchitika 5.5 mmol / L motsutsana ndi kutsika msanga kwamisempha. Ndi kuchepa kwapang'onopang'ono kwa glycemia, wodwalayo amatha kumva bwino, pomwe kuwerengera kwa glucose ndi 2.78 mmol / L kapena kutsikira.
Matenda a hypoglycemic amaphatikizidwa ndi zizindikiro zingapo:
- njala yayikulu;
- kukoka kwamtima;
- thukuta kwambiri;
- kugwedezeka kwamiyendo.
Ndi kupita patsogolo kwa zovuta, kukhudzika kumawonekera, wodwalayo amakhala wosakwanira ndipo amatha kulephera.
Ngati kuchuluka kwa shuga sikunachepetse kwambiri, ndiye kuti izi zimachotsedwa m'njira yosavuta, yomwe imakhala mu chakudya chamafuta (100 g ya muffin, zidutswa 3-4 za shuga, tiyi wokoma). Ngati palibe kusintha pakapita nthawi, wodwalayo ayenera kudya zakudya zofanana.
Ndi kukula kwa hypoglycemic chikomokere, iv yoyika 60 ml ya shuga njira (40%) akuwonetsedwa. Nthawi zambiri, izi zitachitika, wodwalayo amakhala okhazikika. Ngati izi sizingachitike, ndiye pambuyo pa mphindi 10. Amabayidwanso ndi glucose kapena glucagon (1 ml subcutaneally).
Hypoglycemia ndimavuto owopsa a matenda ashuga, chifukwa amatha kupha. Pangozi ndi okalamba omwe ali ndi kuwonongeka kwa mtima, ubongo ndi mitsempha yamagazi.
Kuchepetsa shuga kosalekeza kungapangitse kuti muwoneke matenda osintha bongo.
Komanso, nzeru za wodwalayo, kukumbukira kwake kumakulirakulira komanso njira ya retinopathy imayamba kukula.
Kukana insulini
Nthawi zambiri ndi matenda ashuga, mphamvu zama cell kupita ku insulin zimachepa. Kutiilipira chakudya cha carbohydrate metabolism, 100-200 PIECES of hormone is hlokahala.
Komabe, izi zimachitika osati chifukwa chakuchepa chabe kwa zomwe zili kapena kutsutsana kwa mapuloteni, komanso pamene ma antibodies a receptor kapena mahomoni amawoneka. Komanso, kukana insulini kumayamba motsutsana ndi kumbuyo kwa kuwonongeka kwa mapuloteni ndi ma enzymes ena kapena mphamvu yake.
Kuphatikiza apo, kusowa kwa chidwi kumawonekera pakuwonekera kwa secretion ya mahomoni a contrainsulin. Izi zimachitika motsutsana ndi maziko a hypercortinism, kuphatikiza zakumwa zoziziritsa kukhosi, acromegaly ndi pheochromocytoma.
Maziko a chithandizo ndikuzindikira mtundu wa momwe aliri. Kuti izi zitheke, chotsani chizindikiro cha matenda opatsirana (cholecystitis, sinusitis), matenda a endocrine glands. Komanso, mtundu wa insulin umalowedwa m'malo kapena mankhwala a insulin amathandizidwa ndi kugwiritsa ntchito mapiritsi ochepetsa shuga.
Nthawi zina, glucocorticoids amasonyezedwa. Kuti muchite izi, onjezani mlingo wa mahomoni tsiku ndi tsiku ndikukupatseni chithandizo cha masiku khumi ndi prednisone (1 mg / kg).
Kupitilira apo, potengera momwe wodwalayo alili, mlingo wa mankhwalawo umachepetsedwa. Koma nthawi zina kugwiritsa ntchito ndalama mwachidule (mpaka 15 mg pa tsiku) ndikofunikira.
Komanso, chifukwa cha kukana insulini, insulin yokwanira ingagwiritsidwe ntchito. Ubwino wake ndikuti sizigwira ntchito ndi ma antibodies, ilinso ndi ntchito yachilengedwe ndipo sikuti imayambitsa zotsatira zoyipa. Koma posinthana ndi mankhwalawa, odwala ayenera kudziwa kuti mlingo wa woyeserera, poyerekeza ndi mawonekedwe osavuta, umachepetsedwa kukhala ¼ wa kuchuluka kwa mankhwalawa.
Ziwengo
Insulin ikaperekedwa, zovuta zake zimakhala zosiyanasiyana. Chifukwa chake, mwa odwala ena pali ziwopsezo, zomwe zimadziwoneka m'mitundu iwiri:
- Pafupi. Maonekedwe a erythematous, chodzidzimutsa, kuyatsidwa papule kapena kuumitsa malo a jekeseni.
- Generalized, momwe urticaria amapezeka (khosi, nkhope), nseru, kuyabwa pakhungu, kukokoloka pa mucous nembanemba mkamwa, maso, mphuno, nseru, kupweteka m'mimba, kusanza, kuzizira. Nthawi zina mantha a anaphylactic amayamba.
Pofuna kupewa kupitirira kwa chifuwa, kubwezeretsa insulin nthawi zambiri kumachitika. Kuti izi zitheke, mahomoni a nyama amasinthidwa ndi mahomoni amunthu kapena wopanga mankhwalawo amasinthidwa.
Ndikofunikira kudziwa kuti ziwonetserozo sizimangokhala kokha pa mahomoni pawokha, koma pazomwe zimagwiritsidwa ntchito poyimitsa. Potere, makampani opanga mankhwala amatha kugwiritsa ntchito mankhwala osiyanasiyana.
Ngati sikutheka kusintha mankhwalawa, ndiye kuti insulin imaphatikizidwa ndikukhazikitsa milingo yaying'ono (mpaka 1 mg) ya hydrocortisone. Zotsatira zoyipa sizigwirizana, mankhwalawa amagwiritsidwa ntchito:
- Calcium calcium;
- Hydrocortisone;
- Diphenhydramine;
- Suprastin ndi ena.
Ndizofunikira kudziwa kuti chiwonetsero cha mankhwala amderalo nthawi zambiri chimawonekera ngati jakisoni wachitika molakwika.
Mwachitsanzo, pankhani yosankha yolakwika ya malo a jakisoni, kuwonongeka kwa khungu (khungu lonyansa, singano), ndikuyambitsa njira yozizira kwambiri.
Pastipsulip Lipodystrophy
Pali mitundu iwiri ya lipodystrophy - atrophic ndi hypertrophic. Mtundu wa atrophic wa pathology umayamba motsutsana ndi maziko amtundu wautali wamtundu wa hypertrophic.
Momwe mawonekedwe a post-jakisoni otere amachitikira sakhazikitsidwe Komabe, madotolo ambiri amawonetsa kuti amawonekera chifukwa cha zowawa zaposachedwa zam'mitsempha yamatenda yomwe ili ndi zovuta zina zakumaloko. Zolakwika zimathanso kuchitika chifukwa chogwiritsa ntchito insulin mosakwanira.
Koma mutatha kugwiritsa ntchito mankhwalawa othandizira, kuchuluka kwa lipodystrophy kumachepetsedwa kwambiri. Chofunikira china ndikuwongolera kolakwika kwa mahomoni, mwachitsanzo, hypothermia ya malo operekera jakisoni, kugwiritsa ntchito mankhwala ozizira, ndi zina zotero.
Nthawi zina, motsutsana ndi maziko a lipodystrophy, insulin kukana kosiyanasiyana kumachitika.
Ngati matenda ashuga amakonzedweratu kuoneka ngati lipodystrophy, ndikofunikira kwambiri kutsatira malamulo a insulin mankhwala, kusintha malo a jakisoni tsiku lililonse. Komanso, pofuna kupewa kupezeka kwa lipodystrophy, timadzi timadzi timene timaphatikizidwa ndi voliyumu yofanana ya Novocaine (0.5%).
Kuphatikiza apo, zidapezeka kuti lipoatrophy imazimiririka pambuyo pokumana ndi insulin ya munthu.
Zotsatira zina za insulin
Nthawi zambiri odwala matenda a shuga omwe amadalira insulin, chophimba chimawonekera pamaso. Izi zimapangitsa kuti munthu asamasangalale kwambiri, motero sangathe kulemba ndi kuwerenga nthawi zonse.
Odwala ambiri amalakwitsa chizindikiro ichi cha matenda ashuga retinopathy. Koma chophimba pamaso pa maso ndi chifukwa cha kusintha kwa kusintha kwa mandala.
Zotsatira zake zimadutsa palokha pakatha masiku 14-30 kuyambira poyambira chithandizo. Chifukwa chake, palibe chifukwa chododometsera chithandizo.
Zovuta zina zamatenda a insulin ndizotupa za m'munsi. Koma mawonetseredwe oterowo, monga mavuto amawonedwe, amapita okha.
Kutupa kwa miyendo kumachitika chifukwa cha madzi ndi mchere womwe umasungidwa, womwe umayamba jekeseni wa insulin. Komabe, pakapita nthawi, thupi limasinthana ndi mankhwalawa, motero limasiya kudzikundikira madzi.
Pazifukwa zofananazo, poyambira chithandizo, odwala nthawi zina amatha kuwonjezera magazi.
Komanso, motsutsana ndi maziko a mankhwala a insulin, odwala matenda ashuga ena amalemera. Pafupifupi, odwala amachira ndi ma kilogalamu 3-5. Kupatula apo, chithandizo cha mahomoni chimayambitsa lipogenesis (njira yopanga mafuta) ndikuwonjezera chilimbikitso. Pankhaniyi, wodwalayo ayenera kusintha zakudya, makamaka, zopatsa mphamvu zake komanso zakudya zake pafupipafupi.
Kuphatikiza apo, kuyendetsa insulin mosalekeza kumapangitsa kuti magazi azikhala m'magazi. Vutoli limatha kuthana ndi zakudya zapadera.
Pachifukwa ichi, menyu tsiku ndi tsiku a odwala matenda ashuga ayenera kukhala odzaza ndi zipatso za zipatso, zipatso (currants, sitiroberi), zitsamba (parsley) ndi masamba (kabichi, radish, anyezi).
Kupewa mavuto
Kuti muchepetse chiopsezo cha zovuta za insulin, aliyense wodwala matenda ashuga ayenera kudziwa njira za kudziletsa. Izi zikuphatikiza malamulo otsatirawa:
- Kuyang'anira kuchuluka kwa shuga m'magazi, makamaka mukatha kudya.
- Kuyerekeza zizindikiro ndi atypical zinthu (zakuthupi, kupsinjika, matenda mwadzidzidzi, etc.).
- munthawi yake kusintha kwa insulin, mankhwala antidiabetes ndi zakudya.
Poyesa glucose, mizere yoyesera kapena glucometer imagwiritsidwa ntchito. Kuwona mulingo mothandizidwa ndi mizere yoyesera kumachitika motere: pepala limamizidwa mumkodzo, kenako amayang'ana gawo loyeserera, mtundu wake womwe umasintha malinga ndi kuchuluka kwa shuga.
Zotsatira zolondola kwambiri zitha kupezeka pogwiritsa ntchito zingwe zomwe zili ndi munda wapawiri. Komabe, kuyezetsa magazi ndi njira yothandiza kwambiri yodziwira kuchuluka kwa shuga.
Chifukwa chake, odwala matenda ashuga ambiri amagwiritsa ntchito glucometer. Chipangizochi chikugwiritsidwa ntchito motere: dontho la magazi limayikidwa pachoyimira. Kenako, masekondi angapo, zotsatira zake zimawonekera pazowonetsera digito. Koma kumbukirani kuti glycemia pazida zosiyanasiyana zitha kukhala zosiyana.
Komanso, kuti mankhwala a insulin asamathandizire kukulitsa zovuta, wodwala matenda ashuga amayenera kuyang'anira thupi lake lonse. Mutha kudziwa ngati pali kulemera kowonjezera ndikudziwa Kealog index kapena kulemera kwa thupi.
Zotsatira zoyipa za mankhwala a insulin zakambidwa mu kanema munkhaniyi.
