Kukonzekera kwa insulin kumathandizira odwala omwe ali ndi matenda ashuga. Amagawika potenga nthawi yayifupi ndikuwonjezera. Kutalika kwa zochita za anthu osiyanasiyana ndi kwamunthu aliyense payekha. Chifukwa chake, kusankha kwa mankhwala a insulin nthawi zambiri kumachitika mu chipatala.
Kufikira izi, onetsetsani kuchuluka kwa glycemia masana. Kenako dotolo amakupatsani mankhwala a insulin malinga ndi kuchuluka kwa kagayidwe, zakudya, zolimbitsa thupi, kuphatikiza mitundu yosiyanasiyana ya mankhwala.
Kuchuluka kwa chakudya chamafuta ochulukitsa, kuchepa kwa magazi tsiku ndi tsiku, motero, kumachepetsa chiwopsezo cha matenda ashuga.
Malamulo oyambira a insulin
Nthawi zambiri, 23-59 IU ya insulin imapangidwa, iyi ndi pafupifupi 1 kg ya kulemera kwa thupi - 0.6 - 1.0 IU. Chinsinsi ichi chimagawidwa basal ndi chakudya (bolus). Katemera wa insulin yayikulu pafupifupi pafupifupi gawo limodzi pa ola limodzi. Amalimbikitsidwa ndi chakudya, kupanga ndi kutulutsidwa kwa insulin - 1 unit ya 10 kapena 12 g iliyonse ya chakudya chamagulu (1XE).
Kufunika kwa insulin kumakulirakulira m'mawa, ndipo chidwi chimawonjezeka madzulo. Izi ndizofunikira pokonza dongosolo la kayendetsedwe ka mankhwala, chifukwa cholinga cha mankhwala a insulin ndikuwunikira insulin kukonzekera kwawo kwachinsinsi.
Njirayi imatchedwa maziko-aubus a insulin. Amayambitsa insulin mankhwala komanso kugwiritsa ntchito mankhwala a insulin. Yambitsani katulutsidwe ka insulin mwazonse, kupatula mafuta a shuga (glucose), ma amino acid ndi mapuloteni.
Insulin yoyambitsidwa ili ndi mayamwidwe osiyana, zomwe zimatengera zinthu izi:
Chofunika kwambiri mwa izi ndi awa:
- Kutentha kwa kukonzekera kwa insulin, kusungunuka kwake.
- Kuchuluka kwa yankho.
- Madera a jakisoni (mwachangu kuchokera pakhungu lam'mimba, pang'onopang'ono kuchokera ntchafu kapena phewa).
- Zochita zolimbitsa thupi.
- Odwala Zamakhalidwe Osavuta
Cholinga cha mankhwala a insulin: Vozulim N, zikuonetsa
Insulin imayikidwa kuti ikhale ndi metabolism ya carbohydrate. Zolondola, izi zikutanthauza kukwaniritsa glucose wabwinobwino, kupewa kuchulukitsa kwambiri mutatha kudya, sayenera kukhala ndi shuga mumkodzo, palibe kuukira kwa hypoglycemia.
Zizindikiro zokwanira za kulondola kwa mankhwalawa ndikuchepetsa kapena kuchotsera zizindikiro zazikulu za matenda ashuga, kusowa kwa ketoacidosis, hyperglycemia, pafupipafupi matenda a hypoglycemia.
Kuchiza ndi insulin kumakupatsani mwayi wokhala ndi thupi lolimbitsa thupi komanso kudya zakudya zokhala ndi chakudya (kupatula zosavuta), khalani ndi chiŵerengero chokwanira cha lipoproteins, cholesterol.
Cholinga chachikulu cha mankhwala a insulin ndi moyo wabwinobwino, luso lotha kucheza ndi anthu. Kusamalira moyenera ndi moyenera insulini kumathandiza kupewa kapena kuchepetsa matenda amitsempha ndi mtima.
Zizindikiro zazikulu za mankhwala omwe ali ndi insulin ya matenda a shuga ndi awa:
- Mtundu woyamba wa matenda ashuga.
- Ketoacidosis (mitundu yosiyanasiyana).
- Coma: hyperosmolar, ketoacidotic, lactic acidosis.
- Matenda a zolimbitsa mwamphamvu komanso njira zopatsa mphamvu.
- Chifuwa chachikulu
- Kuchepetsa thupi mwadzidzidzi.
- Pancreatitis yobwezeretsanso, kapamba, pancreatic necrosis.
Insulin imagwiritsidwa ntchito mosasamala mtundu wa matenda ashuga pakakhala michereopathies yayikulu yokhala ndi vuto la ziwalo, kuphwanya magazi muubongo ndi myocardial infarction, kulowererapo kwa maopareshoni.
Mtundu wachiwiri wa matenda a shuga a mellitus, insulansi imasonyezedwanso chifukwa chokana mankhwala osokoneza bongo komanso matenda oopsa a hypertriglyceridemia.
Momwe mungalowe Vulim N?
Mankhwalawa ndi insulin yaumunthu, isofan, wopezedwa ndi ma genetic engineering. Fomu ya mlingo ndi kuyimitsidwa koyendetsedwa ndi khungu. Mililita imodzi imakhala ndi mapiritsi a 100 a insulin. Amapezeka m'mililita 10 ndi makatiriji okhala ndi voliyumu ya 3 ml.
Kuti mulowe Vozulim N, muyenera kudziwa momwe mungabayire insulin molondola. Asanayambitsidwe, muyenera kutenga botolo kuchokera mufiriji m'mphindi 30. Onani tsiku lotulutsa ndi tsiku lotha ntchito. Mankhwala atha kapena atsegulidwa masiku opitilira 28 sangathe kutumizidwa.
Jakisoni amayenera kuchitidwa pokhapokha ngati manja osambitsidwa ndi owuma pakhungu loyera (mowa sayenera kuzichotsa). Botolo la insulini Vozulim N lifunika kukukulira m'manja kuti mtundu wa kuyimitsidwa ukhale woyera, wopanda mitambo.
Ngati jakisoni wachitika ndi syringe, malamulo awa akuyenera kuonedwa:
- Osakhudza singano ndi chilichonse.
- Onani mosamala mlingo wa insulin.
- Malowo a jakisoni sayenera kukhala pafupi ndi timadontho (pafupi ndi 2,5 cm) kapena navel, simungathe kumangika m'malo ovulala kapena kutupa.
- Pambuyo pa jakisoni, syringe imayenera kukhala pansi pakhungu kwa masekondi ena asanu.
- Singano ndi syringe zimayenera kutayidwa mosamala pambuyo pobayira jakisoni.
Ndi kuyambitsa kwa mankhwala ndi syringe cholembera, muyenera kukhazikitsa dispenser pamlingo womwe mukufuna ndikudina batani loyambira. Pambuyo pake, gwiritsani cholembera kwa masekondi khumi osachotsa pakhungu. Singano yomwe imagwiritsidwa ntchito iyenera kutayidwa nthawi yomweyo.
Tsamba la jakisoni liyenera kusinthidwa, kudzipangira nokha. Kuti muchepetse kuwawa, muyenera kukhala ndi singano yopyapyala komanso yochepa.
Kodi Vulim N amachita bwanji pambuyo pa utsogoleri?
Vozulim N ndi nthawi yayitali yopanga insulin. Kuti ayambe kutsitsa shuga wamagazi, ayenera kulumikizana ndi cholandirira china kumtundu wakunja kwa khungu. Vozulim N imapanga insulin + receptor zovuta zomwe zimapangitsa chidwi cha biochemical intracellular reaction.
Kutsika kwa glycemia kumalumikizidwa ndi kuchuluka kwa shuga ndi maselo ndikuphatikizidwa kwake mu kagayidwe kazinthu ka glycolysis kwa mphamvu. Insulin imakhalanso ndi mwayi wokuthandizira kupangika kwa mafuta ndi glycogen. M'maselo a chiwindi, kupangidwa kwa mamolekyulu atsopano a shuga ndi kuwonongeka kwa masitolo a glycogen ndizoletsa.
Nthawi yochita insulin Vozulima N imachitika chifukwa cha kuchuluka kwa mayamwidwe. Zimatengera zinthu zingapo: mlingo, njira, malo oyendetsera. Pankhaniyi, mawonekedwe a insulin amachititsa kusinthasintha kwa odwala osiyanasiyana komanso mwa munthu yemweyo.
Mphamvu ya mankhwalawa imayamba ola limodzi pambuyo pa kukhazikitsa, kuchuluka kwake (pakati) ndizofunikira pakati pa maola 2 ndi 7, nthawi ya Vozulima N ndi maola 18-20. Imawonongeka ndi insulinase m'chiwindi. Imafufutidwa kudzera mu impso.
Zomwe mungagwiritse ntchito Vozulima N:
- Itha kuperekedwa kwa amayi apakati komanso nthawi yoyamwitsa.
- Jakisoni amachitidwa pansi pa khungu, yankho lake liyenera kukhala kutentha.
- Kukhazikitsidwa munthawi yomweyo ndi insulin yochepa - Vozulim R.
- Gwiritsani ntchito katoni katemera wa syringe kokha.
- Chifukwa cha kuthekera koperewera, kugwiritsa ntchito mapampu a insulini sikulimbikitsidwa.
Ngati insulin idalembedwa koyamba kapena kusintha kwake kwachitika, ndikumapanikizika kwakukulu kwakuthupi kapena kwamaganizidwe, ndiye kuti kuthekera kochepetsedwa koyendetsa galimoto ndikotheka. Kuwongolera kwa ukadaulo kukukhala ntchito yowopsa.
Chifukwa chake, salimbikitsa ntchito yomwe imafuna chidwi chochulukirapo, kuthamanga kwa malingaliro ndi magalimoto pamagalimoto.
Zotsatira zoyipa ndi zovuta
Kukhazikika kwa insulin nthawi zambiri kumabweretsa kutsika kwa shuga m'magazi. Malingaliro a odwala omwe ali ndi matenda a shuga sikuti nthawi zonse amawonetsa chithunzi chenicheni cha matenda. Mu diabetesic neuropathy, kuchepa kwakukulu kwa shuga m'magazi sikungazindikiridwe, ndipo shuga yovunda, ngakhale kuchepa pang'ono kwa glycemia kumadzetsa kusasangalala.
Zizindikiro za kuukira kwa hypoglycemic zimalumikizidwa ndi kuyambitsa kwachilengedwe kosasiyanitsa komanso kuperewera kwa michere ku ubongo. Thukuta, njala, manja akunjenjemera, nkhawa zamkati, dzanzi la milomo ndi lilime, kufooka kumawonekera.
Kuwonetsedwa kwa hypoglycemia kumachitika chifukwa ubongo ulibe malo ake ogulitsa glucose, ndipo zakudya zikachepetsa, zimakhudzana ndi hypoxia ndi chizungulire, kufooka, komanso kufunikira chakudya. Kenako kutulutsa kwa mitsempha kumafalikira ku pituitary gland, mahomoni amasulidwa. Kutulutsa kwakasinthasintha kwakapangidwa kuti kubwezeretsa glycemia.
Kuchepetsa hypoglycemia m'magawo oyamba komanso pang'ono, ndikokwanira kutenga shuga, uchi, maswiti, mapiritsi a shuga. Odwala kwambiri komanso kuti ali ndi vuto losokonezeka, odwala amayenera kupita kuchipatala komwe glucose amawathandizira kudzera m'mitsempha ndipo glucagon amaperekedwa.
Pafupipafupi hypoglycemia mu matenda osokoneza bongo amatsogolera kukukula kwa insulin overdose syndrome (Somoji syndrome). Zizindikiro zake zamankhwala ndi izi:
- Kufunika kwakukulu kwa insulin (kukana insulin yabodza).
- Zochita zowonjezera za matenda ashuga (pseudolability).
- Kulemera kosasunthika kapena kulemera kwakukulu ndi glycosuria yayikulu.
- Kupititsa patsogolo kagayidwe kazakudya chifukwa cha matenda ophatikizika kapena kuchepa kwapadera.
- Kuzindikira kwa moyo wabwino ndi kuchuluka kowonjezereka.
- Kumva njala mosalekeza.
- Kusintha kwakukulu mu shuga wamagazi ndi mkodzo.
Kukana insulini kumatha kukula, ngakhale mlingo wa 80 mayunitsi sabweretsa kufunika, ndipo ma antibodies a insulin amapezeka m'magazi. Kukana kwa insulini ndikanthawi yochepa (ndi kuwonongeka, kufalikira kwa matenda, kuchuluka kwa matenda opatsirana kapena endocrine) komanso kupitilira.
Zomwe zimachitika mwanjira iliyonse zokhudza insulin zimawonekera mu mawonekedwe a Quincke's edema kapena generalized urticaria, ndizosowa. Zomwe zimachitika mderalo zimadziwika ndi mawonekedwe a hyperemia, kutupa m'malo a jakisoni wa insulin kapena kuyabwa kwa khungu. Nthawi zambiri, mawonetseredwe am'deralo safuna chithandizo ndipo amatha popanda zotsatira.
Lipodystrophy pamalo a jakisoni wa inulin, komanso njira ya atrophic pamatumbo ochepera, pamene insulin yaumunthu ikuphatikizidwa, zimachitika ndikulakwira insulin, komanso kuwonongeka kwa odwala omwe akhudzidwa ndi kukonzekera kwa insulin. Popewa, muyenera kusintha tsamba la jakisoni.
Kumayambiriro kwa mankhwala a insulin kapena kuwonjezeka kwa mankhwala omwe apatsidwa, insulin edema imayamba, yomwe imazimiririka osagwiritsa ntchito diuretics mwezi umodzi. Izi zimagwirizanitsidwa ndikukula kwa kayendedwe ka immunological ndi kusunga kwa sodium mu thupi.
Edema yotere imatha kutha kuwonongeka kwakanthawi koyamba kugwiritsa ntchito kukonzekera kwa insulin. Magalasiwo amasintha makulidwe ndipo odwala amapeza masinthidwe osakhalitsa a kanthawi komanso amavutika kuwerenga. Izi zitha kupitilira masabata angapo ndipo sizifunikira chithandizo kapena kusankha magalasi kuti mukonze.
Kanemayo munkhaniyi akuwonetsa njira yoyendetsera insulin.
