Kuwerengera kwa kuchuluka kwa insulin ndi gawo lofunikira kwambiri pakuwongolera insulin yokwanira ya matenda a shuga a mitundu yoyamba ndi yachiwiri.
Zowonetsa zazikulu za njira za pathological zili mu mtundu 1 wa matenda a shuga - kusakhalapo kwathuthu kwazinthu za insulin, zomwe zimayang'anira kuchuluka kwa shuga m'magazi ndipo zimapangidwa ndi kapamba, komanso mu mtundu 2 wa shuga - kukula kwa maselo ndi minyewa kupita ku mphamvu yotulutsa shuga.
Ichi ndichifukwa chake ndikofunikira kwambiri kuwerengera molondola mlingo wa insulin womwe umayambitsidwa mu milandu yoyamba ndi yachiwiri.
Funso la momwe mungasankhire yoyenera, kuwerengetsa mlingo wa insulini, ndipo zomwe zikufunika pa izi, zimakondweretsa pafupifupi munthu aliyense amene ali ndi matenda ashuga?
Ndi mitundu yanji yamakono yamankhwala yomwe ilipo?
Kukhazikitsa matekinoloje amakono a bioengineering amalola kuti pakhale insulin yambiri pokonzekera.
Kuti mupeze mankhwala okhala ndi insulin, njira zopangira zapadera zapangidwa.
Ubwino ndi chiyero cha insulin yopangidwa mwaluso zimatengera ukadaulo womwe umagwiritsidwa ntchito pakupanga kwake.
Ma pharmacology amakono amatha kupeza insulin ya mankhwala osokoneza bongo pogwiritsa ntchito njira ziwiri zazikulu.
- mankhwala opangira, omwe amapezeka chifukwa cha matekinoloje amakono;
- mankhwala omwe amapezeka munjira yopangira mahomoni ndi zikondamoyo za nyama (muzochita zamakono zamankhwala sizigwiritsidwa ntchito kambiri ndipo ndizofanana zaka zaka zapitazo).
Mankhwala opangira mankhwala amagawidwa m'magulu angapo akuluakulu, omwe ndi ofunikira pakugwiritsa ntchito imodzi mwazithandizo zamankhwala.
- Insulin yocheperako komanso yochepa, yomwe imawonetsa ntchito yake mkati mwa mphindi 20 pambuyo pa kubayidwa. Mankhwalawa ndi monga Actrapid, Humulin-regator komanso Insuman-yachilendo. Mankhwala amasungunuka ndipo amalowetsedwa m'thupi kudzera mu jakisoni wansanja. Jakisoni wamkati kapena wamkati nthawi zina amagwiritsidwa ntchito. Pazipita ntchito ya mankhwala kutumikiridwa zimawonedwa patatha maola awiri itatha. Ikani mankhwalawa amtundu wa insulin kuti muchepetse ma shuga a magazi m'magazi am'magazi chifukwa chophwanya zakudya zoyenera kapena chifukwa chodandaula kwambiri.
- Malangizo a nthawi yayitali. Mankhwalawa amakhudza thupi kuyambira maola 15 mpaka 24, motero ndikokwanira kuti odwala matenda ashuga apange jakisoni awiri patsiku.
- Mankhwala okhalitsa. Chikhalidwe chawo chachikulu ndikuti zotsatira pambuyo pa jakisoni zimadziwonekera kwa nthawi yayitali - kuchokera maola 20 mpaka 36. Zochita za insulin pamthupi la wodwalayo zimayamba kuwonekera patatha maola angapo jekeseni. Nthawi zambiri, madokotala amapereka mankhwala amtunduwu kwa odwala omwe akumva kuchepa kwa chidwi cha mahomoni.
Dokotala wokhayo amene angapereke mankhwala kwa wodwala, motero nkovuta kudziwa kuti insulin ndiyabwino bwanji. Kutengera ndi zovuta za matendawa, kufunikira kwa timadzi tambiri ndi zinthu zina zingapo, mankhwala oyenera a wodwalayo amasankhidwa.
Kuphatikiza apo, katswiri wazachipatala azitha kukuwuzani zonse zokhuza matenda a shuga, Mlingo wa insulini, zovuta, chithandizo ndi mkate.
Momwe mungawerengere kuchuluka kwa jakisoni wochepa pang'ono?
Asanapange mlingo wa insulin, aliyense wodwala matenda ashuga ayenera kuthana ndi lingaliro la chakudya monga matenda a shuga.
Kugwiritsa ntchito kwawo masiku ano kumathandizira kwambiri kuwerengera kwa insulin. Gulu limodzi la mkate (pa 1 heh) limafanana ndi magalamu khumi a zopatsa mphamvu. Pofuna kuti isasokonezeke, ma Mlingo angapo a jakisoni wa insulin angafunike.
Ndikofunikira kusankha mlingo woganizira nthawi, chakudya chomwe mumadya, popeza kuchuluka kwa zochita za thupi panthawi zosiyanasiyana patsiku zimasiyanasiyana. Kuphatikiza apo, kubisika kwa zida zapachilumba za kapamba kumachitika mosiyanasiyana, awa ndi omwe amatchedwa kusintha kozungulira.
Tiyenera kukumbukira kuti m'mawa, mkate umodzi umafunikira magawo awiri a mahomoni, nthawi ya nkhomaliro - imodzi, ndipo madzulo - imodzi ndi theka.
Kuti mupeze molondola kuchuluka kwa insulin magawo a mawonekedwe amfupi, ndikofunikira kutsatira algorithm yodziwika bwino (pali tebulo lapadera la matenda a shuga a 2).
Chithandizo cha insulin chimapereka malamulo ndi mfundo zotsatirazi pazantchito za insulin:
- Kuchuluka kwa zopatsa mphamvu patsiku (kuchuluka kwatsiku ndi tsiku). Ili ndiye chikhalidwe chachikulu chomwe muyenera kulabadira kuti musankhe insulin yoyenera. Chiwerengero cha kilocalories patsiku chimatsimikizika potengera zolimbitsa thupi za odwala matenda ashuga.
- Masana, kuchuluka kwa zinthu zonse zamafuta amoto zomwe siziyenera kupitirira 60% yonse.
- Pogwiritsa ntchito gramu imodzi ya chakudya, thupi limatulutsa ma kilocalories anayi.
- Mlingo wa insulin umapangidwa poganizira kulemera kwa odwala matenda ashuga. Kuti muchite izi, pali matebulo apadera (komanso kuwerengera kwa insulin pa intaneti) komwe kumawonetsa kuchuluka kwa magawo a insulin omwe amayenera kuperekedwa ngati jekeseni pa kilogalamu ya kulemera kwa odwala.
- Choyamba, muyenera kusankha kuchuluka kwa mahomoni osakhalitsa, kenako owonjezera.
Chofunikira ndikuti endocrinology sigwiritsa ntchito kuwerengera (kwa mtundu 1 ndi matenda ashuga 2) pakumwa zakudya zomwe zili ndi mapuloteni kapena mafuta.
Kutengera mtundu wa njira ya pathological, mlingo wotsatira wa insulini umafunikira pa kilogalamu ya munthu wodwala matenda ashuga:
- matenda kuwonekera - 0.5ꓼ
- nthawi yanthawi yotchedwa "malingaliro abata" - 0.4ꓼ
- Kukula kwa nthawi yayitali -
- njira yowerengeka yamatendawa - 1.0 (pazipita - 1.5) ꓼ
- nthawi yokonzekera - 0,6-0.8ꓼ
- kutha msinkhu mwa ana achichepere - 1.5-2.0.
Chifukwa chake, insulin yochepa siyenera kutengedwa.
Pa mankhwala, magazi amayenera kuperekedwa kuti athe kudziwa kuchuluka kwa shuga ndipo ngati kuli kotheka, asinthe kuchuluka kwa insulin pa 1 kg yolemera.
Momwe mungawerengere kuchuluka kwa jakisoni wa nthawi yayitali?
Kodi insulin ingatalikirane mpaka liti? Homoni yowonjezerayi imagwiritsidwa ntchito kukonzanso hyperglycemia m'mawa pamimba yopanda kanthu. Chithandizo chikugwiritsidwa ntchito onse pakukonzekera matenda a shuga a mitundu yoyamba ndi yachiwiri (kuwonjezera kukula kwa maselo kupita ku insulin). Izi sizitenga nawo mbali monga kuperewera kwa timadzi tambiri totulutsa thupi tisanadye. Masiku ano, pali magulu atatu a anthu odwala matenda ashuga - omwe amagwiritsa ntchito mahomoni amtali wa nthawi yayitali, odwala omwe amafunikira insulini yochepa komanso ya ultrashort kuti athetse kusanja kwa shuga, komanso odwala omwe sangathe popanda mitundu yonse ya mahomoni.
Tiyenera kudziwa kuti ngati mlingo wa insulin yowonjezera amawerengedwa molakwika, padzakhala kusayenerera mu mawerengeredwe a mahomoni amtundu waifupi komanso wa ultrashort.
Chimodzi mwazinthu zazikulu zomwe zimayenera kukumbukiridwa ndi odwala omwe ali ndi matenda osokoneza bongo ndi momwe amawerengera kuchuluka kwa insulini kuti kuchuluka kwake kumapangitsa kuti shuga azikhala mulibe malire.
Mlingo wa insulin wa nthawi yayitali wa shuga uyenera kuwerengedwa malinga ndi zotsatirazi:
- Patsiku losankhidwa, muyenera kudumphira chakudya choyamba - chakudya cham'mawa, ndikuyamba kumwa miyezo ya shuga ya magazi mpaka nthawi ya nkhomaliro kwa ola lililonse.
- Pa tsiku lachiwiri, muyenera kukhala ndi chakudya cham'mawa, kenako kudikirira maola atatu ndikuyamba kuyeza milingo ya shuga kwa ola lililonse musanadye chakudya chamadzulo. Mfundo yofunika kuiganizira ndi kulumpha nkhomaliro.
- Pa tsiku lachitatu, odwala matenda ashuga amatha kudya chakudya cham'mawa komanso nkhomaliro, koma amadumphira chakudya chamadzulo. Kuzungulira kwa glucose m'magazi kumayesedwa masana.
Zowoneka bwino, zofunikira zam'mawa ziyenera kukhala zopitilira malire, ndipo kukula kwawo kumawonjezeka masana mpaka madzulo. Pakhoza kukhalapo zochitika pamene shuga ali kwambiri m'mawa (sadzagwa) kuposa madzulo. Kenako ndikofunikira kusintha kuchuluka kwa insulini yomwe imayendetsedwa.
Mpaka pano, mfundo ya Forsy yowerengera imagwiritsidwa ntchito nthawi zonse (momwe mungawerengere bwino insulin mu mtundu 1 ndi mtundu 2 wa shuga, njira yowerengera insulin).
Kuphatikiza apo, dongosolo lotsatirali lingathe kukumbukiridwa:
- kudya kwa mahomoni tsiku ndi tsiku kumasankhidwa mosasamala nthawi yomwe akukhudzidwa - chifukwa ndikofunikira kugwiritsa ntchito gome ndi kuchulukitsa kulemera kwa wodwalayo chifukwa cha chinthuꓼ
- Chotsani kuchuluka kwa insulin yochepa pang'onopang'ono pazomwe mwapeza, zomwe zimapangitsa kuti gawo limodzi la mahomoni ofotokozera likhalebe.
Zambiri mwatsatanetsatane mwanjira yodziwira kuchuluka kwa insulin zitha kuperekedwa ndi adokotala, poganizira mawonekedwe a thupi la wodwalayo.
Kodi mitundu yosiyanasiyana ya kusankha ndi iti?
Pali mitundu ingapo ya mankhwala a insulin omwe amagwiritsidwa ntchito masiku ano.
Mtundu wophatikizika. Kugwiritsa ntchito, kuchuluka kwa insulin kudzaperekedwa munjira ya jakisoni waifupi komanso wopitilira (muyezo wa 30 mpaka 70). Zizindikiro zotere zimawerengeredwa ngati pali njira yosasinthika ya matenda am'mthupi yomwe imadumpha shuga. Ubwino waukulu wa mankhwalawa ndiosavuta posankha ma insulin tsiku lililonse ndikuwongolera glycemia katatu pa sabata. Zabwino kwa odwala okalamba ndi ana. Kuti mupewe kugwa mwadzidzidzi m'magazi a shuga, muyenera kutsatira zakudya zamagulu.
Mtundu wolimbikira ndizovuta kutsatira. Kuti muwerenge kuchuluka kwamagawo a insulini omwe amafunikira masana, kulemera kwa wodwalayo kumawaganiziridwa ndikugwiritsa ntchito tebulo lapadera. Hormone ya nthawi yayitali imakhala pafupifupi 40-50%, gawo lomwe (2/3) limayendetsedwa m'mawa, komanso madzulo otsatira. Insulin yogwira ntchito yayifupi iyenera kuperekedwa katatu patsiku muyezo - 40% m'mawa musanadye, ndi 30% m'mawa ndi chakudya chamadzulo.
Chithandizo cha insulin chachikhalidwe chimadziwikanso kuti regimen yodziwika bwino. Ngati, pazifukwa zina, wodwalayo sangathe kuyang'anira kuchuluka kwa glycemia, ndiye akatswiri azachipatala amalimbikitsa kugwiritsa ntchito mankhwalawa.
Titha kusiyanitsa zabwino zotsatirazi zamankhwala awa:
- Palibe ma algorithms ovuta komanso kuwerengera, momwe mungawerengere kuchuluka kwa insulin.
- Amachotsa kufunika kwa pafupipafupi miyeso ya shuga.
Kuchokera kwa wodwala, pankhaniyi, amangofunikira kuti azitsatira malangizo onse a adokotala.
Zoyenera kuchita ngati hyperglycemia ikudziwonekera?
Kuwonetsedwa kwa hyperglycemia kumafuna kukonza pazomwe zasankhidwa kale. Kuti tichite izi, ndikofunikira kupatula kuthekera kwa njira zolakwika za jakisoni.
Insulin yotulutsidwa yotsekemera iyenera kuvulazidwa pokhapokha paphewa kapena ntchafu, ndipo timadzi tating'onoting'ono timayikidwa m'mimba be the
Insulin yomwe imagwira ntchito mwachidule imagwiritsidwa ntchito mphindi khumi ndi zisanu mpaka makumi awiri asanayambe chakudya chachikulu
Mlingo wa tsiku ndi tsiku wa insulin yayitali (mpaka maola 12) umagawika pawiri ndipo umaperekedwa kawiri pa tsiku. Ngati mankhwalawa agwiritsidwa ntchito mopitilira nthawi yayitali, ndiye kuti jakisoni imodzi patsiku imafunikira.
Njira yothetsera jakisoni iyenera kukhazikitsidwa potsatira jakisoni wofulumira, koma jekeseni pang'onopang'ono wa mankhwala omwe ali pansi pakhungu (ndikofunikira kuti muwerengere mpaka khumi).
Ngati njira yophera imachitika moyenera, koma nthawi yomweyo pali vuto la glycemia, izi ziyenera kukambirana ndi katswiri wazachipatala. Dokotala wothandizirayo akupatseni mankhwala ena a insulin tsiku lililonse. Kuphatikiza apo, mfundo yofunika mu matenda a shuga a mtundu woyamba ndikuwerengera zochitika zolimbitsa thupi.
Momwe mungawerengere kuchuluka kwa insulin muuzeni katswiri mu kanemayu.
